Professional Providers  - All CMS 1500 and Dental Claims,,,,,,,,,,,,,,,,,,,,,,,,,
Run Date:,9/23/2025,,,,,,,,,,,,,,,,,,,,,,,,
SFY ,2025,,,,,,,,,,,,,,,,,,,,,,,,
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Note 1: The dataset is based on Date of Payment,,,,,,,,,,,,,,,,,,,,,,,,,
Note 2: Any payment in the Paid amount column is made to the Billing Provider,,,,,,,,,,,,,,,,,,,,,,,,,
"Note 3: Due to Provider Taxonomy  Privacy concerns, paid amount of $10,000 or less has been changed to # ",,,,,,,,,,,,,,,,,,,,,,,,,
"Note 4: Due to Patient privacy concerns, beneficiary counts less than 11 have been changed to #.",,,,,,,,,,,,,,,,,,,,,,,,,
Note 5:  Amount paid includes recoupments and adjusted claims( Negative paid amounts possible),,,,,,,,,,,,,,,,,,,,,,,,,
"Note 6:  The Supplemental and Settlement payments are not included in this Provider report.  They will be listed on a separate report, because they are processed outside of the Medicaid  Claims System.",,,,,,,,,,,,,,,,,,,,,,,,,
Note 7:  The Reason for Unknown county code/ Name is because the Provider information has a blank under county code in NC tracks or claim come in with blank location code,,,,,,,,,,,,,,,,,,,,,,,,,
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Note 8: The below Dataset includes Professional claims( all those claims under CMS 1500),,,,,,,,,,,,,,,,,,,,,,,,,
Note 9: The recipient count is a distinct count of Members seen by provider by provider type at the rendering location along with the Billing provider information,,,,,,,,,,,,,,,,,,,,,,,,,
Note 10: A visit for this report is calculated as count of member visit by service date at that Rendering provider Location along with the Billing Provider that filed the claim,,,,,,,,,,,,,,,,,,,,,,,,,
Note 11:The number of Procedures performed is calculated by getting a count of Procedure Codes by the same provider level detail,,,,,,,,,,,,,,,,,,,,,,,,,
"Note 12: Some rendering Provider Taxonomy codes are not available on a claim, therefore the Rendering Provider Taxonomy code and its Provider type and Specialization descriptions are not populated on this worksheet.",,,,,,,,,,,,,,,,,,,,,,,,,
"Note 13: When Payer=Medicaid Direct the data source is what Medicaid paid, when Payer=Plan ID then data pertains to what each standard plan has paid as part of MCT,when Payer=LME-MCO then the data source is claims that are submitted by LME-MCO to Medicaid",,,,,,,,,,,,,,,,,,,,,,,,,
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PAYER,Billing NPI/Atypical,Billing Provider Name ,Billing Provider DBA Name,Billing  Address,Billing County Code,Billing County Name,Billing Provider Taxonomy Code,Billing Provider Type,Billing Provider Classification,Billing Provider Specialization,Rendering NPI/Atypical,Rendering Provider Name ,Rendering Address,Rendering County Code,Rendering County Name,Rendering Taxonomy Code,Rendering Provider Type,Rendering Provider Classification,Rendering Provider Specialization,  Number of Recipients  , Number of Visits , Number of Procedures , Amount Paid ,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003005729,"WALNOHA, WADE, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1003005729,"WALNOHA, WADE, EDWARD",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003005729,"WALNOHA, WADE, EDWARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1003005729,"WALNOHA, WADE, EDWARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003005729,"WALNOHA, WADE, EDWARD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003005729,"WALNOHA, WADE, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003005729,"WALNOHA, WADE, EDWARD",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003006149,"GAMBOA, STEPHEN, HODGES",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 65 , 78 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003006503,"JEGEDE, OLUGBEMIGA, EBENEZER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 26 , 29 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003006503,"JEGEDE, OLUGBEMIGA, EBENEZER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003006503,"JEGEDE, OLUGBEMIGA, EBENEZER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 52 , 53 ,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003006636,"HASAN, SABA, FARHEEN",844 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003006636,"HASAN, SABA, FARHEEN",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003007964,"KRAMER, OLGA, MARIA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003007964,"KRAMER, OLGA, MARIA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003007964,"KRAMER, OLGA, MARIA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003007964,"KRAMER, OLGA, MARIA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003009838,"SIMHA, SHRUTI, VIJAYA",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 54 , 125 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1003009952,"GELMANN, MARY, COLEEN",116 ARNOLD PALMER DR   ADVANCE NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1003009952,"GELMANN, MARY, COLEEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1003009952,"GELMANN, MARY, COLEEN",116 ARNOLD PALMER DR   ADVANCE NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922193622,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1003010463,"BURGART, JENNIFER, ELDER",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1003010463,"BURGART, JENNIFER, ELDER",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 108 , 291 ,$#,,
MEDICAID DIRECT,1003011446,BAXTER J SMITH JR OD PA,HEALTHDRIVE EYE CARE GROUP,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003011446,BAXTER J SMITH JR OD PA,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 312 , 313 , 313 ,$#,,
MEDICAID DIRECT,1154442630,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1003011578,"RICHARDSON, GAA, ODETTA",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1003011578,"RICHARDSON, GAA, ODETTA",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 55 , 88 , 104 ,$#,,
MEDICAID DIRECT,1003012378,COUNTY OF BEAUFORT,BEAUFORT COUNTY DSS,632 W 5TH ST   WASHINGTON NC,007,Beaufort,251B00000X,Agencies,Case Management,,1003012378,COUNTY OF BEAUFORT,632 W 5TH ST   WASHINGTON NC,007,Beaufort,251B00000X,Agencies,Case Management,, 78 , 696 , 696 ," $262,392.00 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003012451,"MITRA, RANJANA, NEELANJANA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003013756,"PHUNG, ANDY",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003013756,"PHUNG, ANDY",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003013756,"PHUNG, ANDY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003013756,"PHUNG, ANDY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 115 , 512 , 714 ," $12,797.36 ",,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003016163,"HARTSHORN, HEATHER, ANNE",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003016163,"HARTSHORN, HEATHER, ANNE",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 17 , 23 ,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1003016999,"HICKLING BECKMAN, PATRICIA, ANN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003021080,"RINEHAMMER, VALERIE, JEANNE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 22 , 24 ,$#,,
MEDICAID DIRECT,1588216253,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE CLAYTON,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1003021080,"RINEHAMMER, VALERIE, JEANNE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003021908,"ROBERTS, CHARLES, WAITSEL",~,142 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,1003021908,"ROBERTS, CHARLES, WAITSEL",142 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 168 , 309 ," 1,162 "," $40,114.55 ",,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003022468,"EGAN, JENNIFER, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 99 , 114 , 190 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003022591,"KEMPTON, LAURENCE, BYRON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 62 , 73 , 115 ," $28,478.45 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003022591,"KEMPTON, LAURENCE, BYRON",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 24 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003023201,"ECKSTEIN, CHRISTOPHER, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 36 , 42 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003023201,"ECKSTEIN, CHRISTOPHER, PAUL",40 DUKE MEDICINE CIR DUKE CLINIC 1L DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003023201,"ECKSTEIN, CHRISTOPHER, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003023201,"ECKSTEIN, CHRISTOPHER, PAUL",40 DUKE MEDICINE CIR DUKE CLINIC 1L DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003024365,"OMALLEY, RIKA, NAGAKUNI",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003027764,"BUCK, TONDRE, TREMAINE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003028051,"OLENGA, WELO, SYLVIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 66 , 75 , 75 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003028051,"OLENGA, WELO, SYLVIE",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003028051,"OLENGA, WELO, SYLVIE",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 11 , 13 , 33 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 24 , 38 , 69 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,,,Unknown,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#, 18 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 79 , 92 , 172 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003031691,"HALL, WILLIAM, BROOKS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 21 , 32 ,$#,,
MEDICAID DIRECT,1124135603,OUR CHILDRENS CLINIC,Our Childrens Clinic,4024A OLD TAR RD   WINTERVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1003034745,"BYRNE, JOSEPH, PATRICK",4024A OLD TAR RD   WINTERVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 54 , 145 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003037359,"COLE, IAN, OLUREMILEKUN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1003037359,"COLE, IAN, OLUREMILEKUN",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 45 , 55 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1003037359,"COLE, IAN, OLUREMILEKUN",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003038779,BAPTIST CHILDRENS HOME OF NC INC,THREE FORKS HOME,392 CAMP JOY RD   ZIONVILLE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003038779,BAPTIST CHILDRENS HOME OF NC INC,392 CAMP JOY RD   ZIONVILLE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 89 , 89 ,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003040429,"MAHAJAN, NIYATI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 32 , 101 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003040429,"MAHAJAN, NIYATI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 31 , 31 ,$#,,
MEDICAID DIRECT,1003041534,"CHURCH, THOMAS, GARY",MOUNTAINEER MEDICAL SERVICES,2990 HICKORY BLVD   HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1003041534,"CHURCH, THOMAS, GARY",2990 HICKORY BLVD   HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 ," 1,119 "," 2,255 "," $161,945.44 ",,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003042409,"TEPPARA, NIKHIL",1710 KERNERSVILLE MEDICAL PKWY STE 202 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 41 , 53 ,$#,,
MEDICAID DIRECT,1114250354,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SALEM SURGICAL ASSOCIATES,2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003042409,"TEPPARA, NIKHIL",1710 KERNERSVILLE MEDICAL PKWY STE 202 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1114250354,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SALEM SURGICAL ASSOCIATES,2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003042409,"TEPPARA, NIKHIL",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003042409,"TEPPARA, NIKHIL",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 68 , 89 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003043399,"YELVERTON, JOSHUA, CALVIN",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 79 , 100 , 125 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003043399,"YELVERTON, JOSHUA, CALVIN",1180 WYKE RD   SHELBY NC,023,Cleveland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 93 , 112 , 145 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003044231,"KNOX, CAROLINE, KELSEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 71 , 82 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1003044819,"NORBET, CHRISTOPHER, JOHN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003044819,"NORBET, CHRISTOPHER, JOHN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003044819,"NORBET, CHRISTOPHER, JOHN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003044819,"NORBET, CHRISTOPHER, JOHN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 152 , 164 , 182 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,1401 MATTHEWS TOWNSHIP PKWY STE 310 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003044819,"NORBET, CHRISTOPHER, JOHN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003044819,"NORBET, CHRISTOPHER, JOHN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 187 , 198 , 227 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003045022,"DONAHUE, ARTHUR, HARVEY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 26 ,$#,,
MEDICAID DIRECT,1215942933,STRATA PATHOLOGY SERVICES INC,STRATADX,1 CRANBERRY HL STE 303 LEXINGTON MA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1003045063,"BECKER, NILS",1 CRANBERRY HL STE 303 LEXINGTON MA,102,Out of State > 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003047457,"CANEPA ESCARO, FABRIZIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003048117,"AGHA, HAIDR",1200 FIRST COLONIAL RD STE 202 VIRGINIA BCH VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1003048679,"HERLIHY, MICHELLE, LYNNETTE",101 ROBESON ST STE 202 E FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003051418,"CROSSMAN, MOLLY, JEAN",145 APPLECROSS RD   PINEHURST NC,063,Moore,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 12 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003051418,"CROSSMAN, MOLLY, JEAN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1003051418,"CROSSMAN, MOLLY, JEAN",1140 CARTHAGE ST   SANFORD NC,053,Lee,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003053935,"DAYVAULT, PHILIP, MAXIMILIAN",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003054586,"BALLISTER, MICHELE, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1003055575,"ROGERS, ANITA, ELLEN",425B S CHESTNUT ST   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558975433,KERR AREA RURAL MEDICAL ALLIANCE PL,,425B S CHESTNUT ST   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1003055575,"ROGERS, ANITA, ELLEN",425B S CHESTNUT ST   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 215 , 325 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1003055575,"ROGERS, ANITA, ELLEN",425 S CHESTNUT ST   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1558975433,KERR AREA RURAL MEDICAL ALLIANCE PL,,425B S CHESTNUT ST   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1003055575,"ROGERS, ANITA, ELLEN",425 S CHESTNUT ST   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 50 , 60 ,$#,,
MEDICAID DIRECT,1003062696,"LITTLEJOHN, BRYAN, GLENN",~,,,Unknown,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1003062696,"LITTLEJOHN, BRYAN, GLENN",6015 FARRINGTON RD STE 101A CHAPEL HILL NC,019,Chatham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003066119,"JAMES PETERSON, BELINDA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003067034,"IRONS, ANDREW, THOMAS",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 36 , 38 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003067455,"FENG, YAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 112 , 291 , 294 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003067455,"FENG, YAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003068263,"STRUNA, JOYCE, ANGELA",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 162 , 664 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,111 CENTRAL ST   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1003068263,"STRUNA, JOYCE, ANGELA",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003068263,"STRUNA, JOYCE, ANGELA",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003068263,"STRUNA, JOYCE, ANGELA",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 27 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003068263,"STRUNA, JOYCE, ANGELA",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003069683,NEW DIMENSIONS INTERVENTIONS,New Dimensions Interventions Inc,2856 ANDERSON RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003069683,NEW DIMENSIONS INTERVENTIONS,2856 ANDERSON RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 756 , 756 ," $47,747.12 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003070327,"PASSIAS, PETER, GUST",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003070327,"PASSIAS, PETER, GUST",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003070327,"PASSIAS, PETER, GUST",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003070327,"PASSIAS, PETER, GUST",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003070350,"CHAWLA, HARSH",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003070350,"CHAWLA, HARSH",310 S MCCASKEY RD   WILLIAMSTON NC,058,Martin,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003070350,"CHAWLA, HARSH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 157 , 299 , 324 ," $11,278.24 ",,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003072000,"MILLS, KYLE, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 38 , 36 , 57 ,$#,,
MEDICAID DIRECT,1477519148,PATHOLOGISTS MEDICAL LABORATORY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1003072000,"MILLS, KYLE, CHARLES",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 65 , 71 , 94 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 13 , 15 , 27 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 15 , 19 , 34 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 83 , 89 , 89 ,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003073396,"ST CLAIR, SHANNON, MITCHELL",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003074154,"ROHILLA, RAJESH",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 185 , 185 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003074246,"PAPPALARDI, JILL, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003074246,"PAPPALARDI, JILL, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 68 , 68 ,$#,,
MEDICAID DIRECT,1740920362,QUADRANT PA VIRTUAL CARE PC,,5000 CENTRE GREEN WAY STE 500 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1003075805,"BURTON, TRACY, CHANG",5000 CENTRE GREEN WAY STE 500 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 39 , 39 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",115 HEART DR   GREENVILLE NC,074,Pitt,207RI0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical & Laboratory Immunology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 238 , 346 , 402 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003077140,"CATANZARO, JOHN, NICHOLAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1407483175,INFINITE MEDICAL PC,,310 PENSACOLA RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1003077322,"FENSTERSZAUB, SIMON",310 PENSACOLA RD   BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 95 , 176 , 211 ,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003077942,"PATEL, MICHELLE, DILIPKUMAR",2709 BLUE RIDGE RD   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 53 , 79 , 112 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003079450,"CRAVEN, SUSAN, LILL",444 SW CENTER ST   FAISON NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1285165266,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER ROCKINGHAM,125 BILTMORE DR STE 1 ROCKINGHAM NC,077,Richmond,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003079450,"CRAVEN, SUSAN, LILL",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003079450,"CRAVEN, SUSAN, LILL",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1811319171,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,5330B SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003079518,"MCFADDEN, SHEMEEKA",6311 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003079625,"KREMPECKI, JOHN, TIMOTHY",~,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,1003079625,"KREMPECKI, JOHN, TIMOTHY",95 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003079625,"KREMPECKI, JOHN, TIMOTHY",95 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,152W00000X,Eye and Vision Services Providers,Optometrist,, 185 , 239 , 342 ," $17,309.19 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003079625,"KREMPECKI, JOHN, TIMOTHY",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003079872,VALLEY PINES ADULT CARE LLC,VALLEY PINES ADULT CARE,2521 MURIEL DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003079872,VALLEY PINES ADULT CARE LLC,2521 MURIEL DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 163 , 163 ," $80,818.33 ",,
MEDICAID DIRECT,1003080599,SPEECH KIDZ INC,Speech 4 Kidz Inc,1174 TURLINGTON AVE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1003080599,SPEECH KIDZ INC,1174 TURLINGTON AVE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,#, 95 , 97 ,$#,,
MEDICAID DIRECT,1003080599,SPEECH KIDZ INC,Speech 4 Kidz Inc,5919 OLEANDER DR STE 119 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003080599,SPEECH KIDZ INC,5919 OLEANDER DR STE 119 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 18 , 65 , 81 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003083148,"CAMPBELL, DENNIS, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 29 , 24 , 40 ," $14,851.49 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003083148,"CAMPBELL, DENNIS, MICHAEL",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003083148,"CAMPBELL, DENNIS, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003083148,"CAMPBELL, DENNIS, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,,,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1003083304,"DUBAY, REBECCA, SAENZ",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 131 , 136 , 163 ," $11,056.59 ",,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003083478,"BLALOCK, DARRYL, EUGENE",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003083478,"BLALOCK, DARRYL, EUGENE",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003083478,"BLALOCK, DARRYL, EUGENE",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003083478,"BLALOCK, DARRYL, EUGENE",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902020308,NC DHHS CHILD AND FAMILY WELL-BEING,DURHAM CDSA,115 MARKET ST STE 201 DURHAM NC,032,Durham,252Y00000X,Agencies,Early Intervention Provider Agency,,1003084906,"HARDISTY, MEGAN, SEAN",115 MARKET ST STE 201 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1003084906,"HARDISTY, MEGAN, SEAN",115 MARKET ST STE 201 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 44 , 47 , 75 ,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003092065,"HALL, CHERYL, MORRISON",131 W EDINBOROUGH AVE   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003095001,"OWREY, SARAH, ELIZABETH HUDSON",3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003095001,"OWREY, SARAH, ELIZABETH HUDSON",10208 CERNY ST STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003095886,"SUNG, CHRISTIAN, ANTON",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003095886,"SUNG, CHRISTIAN, ANTON",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003095886,"SUNG, CHRISTIAN, ANTON",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477240711,RDMG ASSOCIATES PA,RDMG BEHAVIORAL HEALTH,7205 STONEHENGE DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003096934,"WISOTSKY, JOANNA, BETH",7205 STONEHENGE DR STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 16 , 29 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003102146,"STALLINGS, LEONARD, ALEXANDER",201 E GROVER ST   SHELBY NC,023,Cleveland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003102740,"BOYD, EMILY, G",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003102740,"BOYD, EMILY, G",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003104654,"FLYNN, KIERSTEN, BRIE",8838 US HIGHWAY 70 W STE 300 CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003106956,"ALMOND, RACHEL, IRVING",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 17 , 33 , 36 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003106956,"ALMOND, RACHEL, IRVING",5160 OCEAN HWY W   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003106956,"ALMOND, RACHEL, IRVING",5160 OCEAN HWY W   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1003108317,"DENWOOD, CAROLINE, LEA",29 NETTLEWOOD DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003108317,"DENWOOD, CAROLINE, LEA",~,68 HOSPITAL RD   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1003108317,"DENWOOD, CAROLINE, LEA",68 HOSPITAL RD   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1003108317,"DENWOOD, CAROLINE, LEA",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1003108317,"DENWOOD, CAROLINE, LEA",68 HOSPITAL RD   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003108317,"DENWOOD, CAROLINE, LEA",~,486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1003108317,"DENWOOD, CAROLINE, LEA",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1003108317,"DENWOOD, CAROLINE, LEA",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003108317,"DENWOOD, CAROLINE, LEA",~,137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1003108317,"DENWOOD, CAROLINE, LEA",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1003108317,"DENWOOD, CAROLINE, LEA",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 64 , 132 , 173 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003108317,"DENWOOD, CAROLINE, LEA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003109828,"ANACIUS, ELISABETH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003109869,"YOURSHAW, JEFFREY, PETER",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003109869,"YOURSHAW, JEFFREY, PETER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003111782,OPTION CARE ENTERPRISES INC,OPTION CARE,131 RACINE DR STE 100B WILMINGTON NC,065,New Hanover,251F00000X,Agencies,Home Infusion,,1003111782,OPTION CARE ENTERPRISES INC,131 RACINE DR STE 100B WILMINGTON NC,065,New Hanover,251F00000X,Agencies,Home Infusion,, 31 , 684 ," 1,966 "," $138,461.90 ",,
MEDICAID DIRECT,1003111782,OPTION CARE ENTERPRISES INC,OPTION CARE,131 RACINE DR STE 100B WILMINGTON NC,065,New Hanover,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1003111782,OPTION CARE ENTERPRISES INC,131 RACINE DR STE 100B WILMINGTON NC,065,New Hanover,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 32 , 246 , 705 ," $146,222.30 ",,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003114067,"THOMPSON, LUKE, KENAN",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 21 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003114067,"THOMPSON, LUKE, KENAN",142 AIRPORT RD UNIT KL ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 44 , 44 ,$#,,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003114067,"THOMPSON, LUKE, KENAN",545 CENTER ST   BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003114992,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST SHAPIRO EYE CARE,1311 N ELM ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003114992,WAKE FOREST HEALTH NETWORK LLC,1311 N ELM ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003116807,"FOUREMAN, MEGAN, FOREMAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003120247,"EMAMI-KELISHADI, NADER, CYRUS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 40 , 40 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003120247,"EMAMI-KELISHADI, NADER, CYRUS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003122557,DYNAMEDICS HEALTHCARE SERVICES INC,DYNAMEDICS HEALTHCARE SERVICES INC,1053 BULLARD CT   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1003122557,DYNAMEDICS HEALTHCARE SERVICES INC,1053 BULLARD CT   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 6,570 "," 6,597 "," $879,553.24 ",,
MEDICAID DIRECT,1003122557,DYNAMEDICS HEALTHCARE SERVICES INC,DYNAMEDICS HEALTHCARE SERVICES INC,1053 BULLARD CT   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1003122557,DYNAMEDICS HEALTHCARE SERVICES INC,1053 BULLARD CT   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#,,,$#,,
MEDICAID DIRECT,1003122557,DYNAMEDICS HEALTHCARE SERVICES INC,DYNAMEDICS HEALTHCARE SERVICES INC,1053 BULLARD CT   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1003122557,DYNAMEDICS HEALTHCARE SERVICES INC,1053 BULLARD CT   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#, 854 , 896 ," $539,111.00 ",,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 53 , 54 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 83 , 83 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003123530,"MARUPAKULA, VIDYASAGARGOUD",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1669797700,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER NEW RIVER,1200 HARGETT ST   JACKSONVILLE NC,067,Onslow,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003124645,"STITZEL, STEPHANIE, NICOLE",1200 HARGETT ST   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003124645,"STITZEL, STEPHANIE, NICOLE",1200 HARGETT ST   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255775938,COATS MEDICAL SERVICES LLC,CFV PRIMARY CARE FAMILY MEDICINE CONT CLINIC-COATS,25 N JOHNSON ST   COATS NC,043,Harnett,193400000X,Group,Single Specialty,,1003127218,"BRAY BROWN, REGINA, BRAXTON",25 N JOHNSON ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 57 , 80 ,$#,,
MEDICAID DIRECT,1255775938,COATS MEDICAL SERVICES LLC,CFV PRIMARY CARE FAMILY MEDICINE CONT CLINIC-COATS,25 N JOHNSON ST   COATS NC,043,Harnett,193200000X,Group,Multi-Specialty,,1003127218,"BRAY BROWN, REGINA, BRAXTON",25 N JOHNSON ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 38 , 47 ,$#,,
MEDICAID DIRECT,1770897142,LILLINGTON MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-LILLINGTON,7 E DUNCAN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1003127218,"BRAY BROWN, REGINA, BRAXTON",7 E DUNCAN ST   LILLINGTON NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326346602,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT PEDIATRICS,719 GREEN VALLEY RD STE 209 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003127507,"AGBUYA, PERRY, SCOTT",719 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 45 , 112 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003130055,"HARRELL, KRISTINA, JASMIN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003130055,"HARRELL, KRISTINA, JASMIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003131970,"MCCARTNEY, SHARON, LORRAINE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003131970,"MCCARTNEY, SHARON, LORRAINE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003131970,"MCCARTNEY, SHARON, LORRAINE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003133737,"FLOOD, MELISSA, RENEE",101 E W T HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003133737,"FLOOD, MELISSA, RENEE",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 74 , 74 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003133737,"FLOOD, MELISSA, RENEE",1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003136136,"GODFREY, ALEXANDRA, HELOISE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 45 , 68 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003136136,"GODFREY, ALEXANDRA, HELOISE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003136136,"GODFREY, ALEXANDRA, HELOISE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003136383,"JONES, JAMANDE, AMIN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 28 , 46 , 59 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003136383,"JONES, JAMANDE, AMIN",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003137407,"HENDERSON, KAMAL, HANEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003137407,"HENDERSON, KAMAL, HANEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003137423,"SEBRING, AMANDA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 26 , 54 , 71 ," $17,862.47 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003139049,"MANNING, ERIN, LIN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 23 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003139049,"MANNING, ERIN, LIN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1003139049,"MANNING, ERIN, LIN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003139049,"MANNING, ERIN, LIN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003139049,"MANNING, ERIN, LIN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003142761,CREATIVE CONCEPTS THERAPEUTIC SERVI,~,100 PEAR ST   ABERDEEN NC,063,Moore,251S00000X,Agencies,Community/Behavioral Health,,1003142761,CREATIVE CONCEPTS THERAPEUTIC SERVI,100 PEAR ST   ABERDEEN NC,063,Moore,251S00000X,Agencies,Community/Behavioral Health,, 61 ," 1,054 "," 1,054 "," $68,140.80 ",,
MEDICAID DIRECT,1003149600,THE OAKS OF ALAMANCE LLC,THE OAKS OF ALAMANCE LLC,1670 WESTBROOK AVE   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003149600,THE OAKS OF ALAMANCE LLC,1670 WESTBROOK AVE   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 28 ," 7,218 "," 7,218 "," $498,202.79 ",,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003151820,"SPANGLER, CHARLOTTE, ROWE",,,Unknown,,,,,#,,,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003151820,"SPANGLER, CHARLOTTE, ROWE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 34 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003158288,"GREENWALD, EMILY, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 58 , 67 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003158312,"WILSON, DANIELLE, RENEE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003158312,"WILSON, DANIELLE, RENEE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003158312,"WILSON, DANIELLE, RENEE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003158312,"WILSON, DANIELLE, RENEE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003158312,"WILSON, DANIELLE, RENEE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 16 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003158312,"WILSON, DANIELLE, RENEE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1003158452,"MOONEY, ANNA, FRANKLIN",24 FALCON CREST LN   CLYDE NC,044,Haywood,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 60 , 199 , 307 ," $18,307.03 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003158775,"STRINGFELLOW, JOSEPH, RAYMOND",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003158775,"STRINGFELLOW, JOSEPH, RAYMOND",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003158775,"STRINGFELLOW, JOSEPH, RAYMOND",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 13 , 23 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003158775,"STRINGFELLOW, JOSEPH, RAYMOND",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 49 , 81 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003158775,"STRINGFELLOW, JOSEPH, RAYMOND",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 20 , 21 ," $13,211.82 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003158809,"SCHROEDER, MICHELLE, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 38 , 66 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003158809,"SCHROEDER, MICHELLE, NICOLE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003159179,"RAY, CANDICE, MARLOW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 24 , 46 , 49 ,$#,,
MEDICAID DIRECT,1003160441,BURLINGTON AL HOLDINGS I LLC,ALAMANCE HOUSE,2766 GRAND OAKS BLVD   BURLINGTON NC,001,Alamance,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1003160441,BURLINGTON AL HOLDINGS I LLC,2766 GRAND OAKS BLVD   BURLINGTON NC,001,Alamance,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 17 , 38 , 44 ,$#,,
MEDICAID DIRECT,1003160441,BURLINGTON AL HOLDINGS I LLC,ALAMANCE HOUSE,2766 GRAND OAKS BLVD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003160441,BURLINGTON AL HOLDINGS I LLC,2766 GRAND OAKS BLVD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 60 ," 12,826 "," 12,826 "," $1,145,601.82 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003162595,"LAISURE, HEATHER, JOY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 35 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003162595,"LAISURE, HEATHER, JOY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003163213,"WILLIAMS, KEREN, HAPPUCH",140 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003167586,UPWARD PROCESS INC,UPWARD PROCESS HOME CARE AGENCY,568 ALLEGHANY RD   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003167586,UPWARD PROCESS INC,568 ALLEGHANY RD   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,107 "," 1,107 "," $112,818.69 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003170861,"GREENE, STEPHEN, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 29 , 56 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003170861,"GREENE, STEPHEN, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003170861,"GREENE, STEPHEN, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 12 , 46 , 62 ,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003171265,"UNDERHILL, BAILEY, HARDY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003171265,"UNDERHILL, BAILEY, HARDY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003171265,"UNDERHILL, BAILEY, HARDY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003171265,"UNDERHILL, BAILEY, HARDY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003171539,"EL HARAKI, AMR, SHERIF MOHAMED RIFAA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 77 , 130 , 207 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1003171539,"EL HARAKI, AMR, SHERIF MOHAMED RIFAA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003172040,"MEADOWS, CYNTHIA, GAIL",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003172040,"MEADOWS, CYNTHIA, GAIL",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003172321,"WINDOM, MCALLISTER, OPHELIA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003172321,"WINDOM, MCALLISTER, OPHELIA",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003172321,"WINDOM, MCALLISTER, OPHELIA",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 36 , 50 , 143 ," $11,115.83 ",,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003172990,"GARDNER, FAITH, LOCKETT",606 N ELM ST   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1598762940,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003172990,"GARDNER, FAITH, LOCKETT",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 14 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003173618,"FEIGAL, JACOB, PAUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003173618,"FEIGAL, JACOB, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 22 , 77 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003173618,"FEIGAL, JACOB, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1003174772,LABORATORY CORPORATION OF AMERICA H,,214 E ELM ST CHRISSMAN FAMILY PRACTICE GRAHAM NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,,1003174772,LABORATORY CORPORATION OF AMERICA H,214 E ELM ST CHRISSMAN FAMILY PRACTICE GRAHAM NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003176058,"STEEN, BARTLETT, DAVID",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003176058,"STEEN, BARTLETT, DAVID",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003176058,"STEEN, BARTLETT, DAVID",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003176058,"STEEN, BARTLETT, DAVID",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003176058,"STEEN, BARTLETT, DAVID",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003176967,"SIAS, CORRIE, ELISABETH",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003176967,"SIAS, CORRIE, ELISABETH",161 WALKER ST   COLUMBUS NC,075,Polk,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003179045,"MCCORMACK, MICHAEL, JOSEPH",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003179045,"MCCORMACK, MICHAEL, JOSEPH",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003179045,"MCCORMACK, MICHAEL, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 62 , 120 , 135 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003179151,"CAVANAUGH, SEAN, OLIVER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 41 , 57 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003179151,"CAVANAUGH, SEAN, OLIVER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 78 , 102 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003179151,"CAVANAUGH, SEAN, OLIVER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003179151,"CAVANAUGH, SEAN, OLIVER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003179151,"CAVANAUGH, SEAN, OLIVER",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1003179961,"KOTTKAMP, GREGORY, SCOTT",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 17 , 20 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1003179961,"KOTTKAMP, GREGORY, SCOTT",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 41 , 50 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003182015,"JOHNSON, SOREN, MORGAN",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 45 , 72 , 154 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003182411,"WORKMAN, EMILY, YOUNG",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1265711956,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MCALISTER PEDIATRI,447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003182411,"WORKMAN, EMILY, YOUNG",447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003184037,DOGWOOD VILLAS INC,~,74 LOTUS LN   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003184037,DOGWOOD VILLAS INC,74 LOTUS LN   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 14 ," 2,440 "," 2,460 "," $161,137.82 ",,
MEDICAID DIRECT,1881712842,NORTH CAROLINA STATE UNIVERSITY,,2815 CATES AVE   RALEIGH NC,092,Wake,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1003186883,"KUMAR, JOANNA, MORRIS",2815 CATES AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003190919,"MOODY, SHAWN, RYAN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 28 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003190919,"MOODY, SHAWN, RYAN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003194382,"AKTOLGA, SERDAL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003194382,"AKTOLGA, SERDAL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003194382,"AKTOLGA, SERDAL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 187 , 187 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1003196353,"KORRAPATI, VINEET",1809 BRENNER AVE STE 102 SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 38 , 40 , 56 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1003196353,"KORRAPATI, VINEET",611 MOCKSVILLE AVE ROWAN DIAGNOSTIC CLINIC SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 221 , 404 , 459 ," $15,124.37 ",,
MEDICAID DIRECT,1528625399,ROWAN ENDOSCOPY CENTER,,1809 BRENNER AVE   SALISBURY NC,080,Rowan,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1003196353,"KORRAPATI, VINEET",1809 BRENNER AVE STE 102 SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1003200809,"CLAIR, JOSEPH, MICHAEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1003200809,"CLAIR, JOSEPH, MICHAEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003202664,"AHMED, IMRAN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003202664,"AHMED, IMRAN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003202664,"AHMED, IMRAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 56 , 56 , 73 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003202664,"AHMED, IMRAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1003204025,"PATROCINIO MASSINGA, CHRISTINE, MCCREE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 80 , 86 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003205170,"MARTIN, BROCK, AARON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 169 , 176 , 261 ,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003205626,"WHITESIDE, DAVID, HOWARD",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003205964,CARY HEALTH HOLDINGS LLC,THE BLAIR MEMORY CARE CENTER OF CARY,809 W CHATHAM ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003205964,CARY HEALTH HOLDINGS LLC,809 W CHATHAM ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 95 , 95 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003206434,"OCCHIBOI, EMIL, PETER",10030 GILEAD RD STE 140 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003206434,"OCCHIBOI, EMIL, PETER",4741 RANDOLPH RD STE 100&200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003206434,"OCCHIBOI, EMIL, PETER",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 28 ,$#,,
MEDICAID DIRECT,1730343922,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,136 S PARK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1003207903,"WARD, KAYANA, SHAYLA",136 S PARK ST   ASHEBORO NC,076,Randolph,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 53 , 67 ," $10,463.48 ",,
MEDICAID DIRECT,1326078072,PROVIDENCE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS PROVIDENCE PEDIATR,14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003211095,"PARDEEP, FNU",14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003211095,"PARDEEP, FNU",14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 37 ,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003212234,"RAMSEY, MIRANDA, JOY",448 CRANBERRY ST   NEWLAND NC,006,Avery,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003212234,"RAMSEY, MIRANDA, JOY",935 STATE FARM RD   BOONE NC,095,Watauga,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003212234,"RAMSEY, MIRANDA, JOY",935 STATE FARM RD   BOONE NC,095,Watauga,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1003219429,"DUCKETT, TIFFANY, YOUNG",8841 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 16 , 14 , 36 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1003219429,"DUCKETT, TIFFANY, YOUNG",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1003219429,"DUCKETT, TIFFANY, YOUNG",2007 WALNUT ST   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003220518,"HAGLEY, JESSICA, LAUREN",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003220518,"HAGLEY, JESSICA, LAUREN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003220518,"HAGLEY, JESSICA, LAUREN",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003220518,"HAGLEY, JESSICA, LAUREN",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003221060,"LONGVALL, ZENA, COREN",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003222399,"DOIRON, REBEKAH, MCBRYDE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003222399,"DOIRON, REBEKAH, MCBRYDE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,465 W MAIN ST   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1003224502,"AHRENS, STEPHEN, FRANCIS",465 W MAIN ST   SPINDALE NC,081,Rutherford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 25 , 126 , 348 ,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,60 SHUFORD RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1003224502,"AHRENS, STEPHEN, FRANCIS",465 W MAIN ST   SPINDALE NC,081,Rutherford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 89 , 256 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1003226051,"MITKOV, MARIO, VENTZISLAVOV",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,3107 BRASSFIELD RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003226051,"MITKOV, MARIO, VENTZISLAVOV",3107 BRASSFIELD RD STE 300 GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1003226051,"MITKOV, MARIO, VENTZISLAVOV",3107 BRASSFIELD RD STE 300 GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 19 , 44 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,2874 WARD BLVD   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1003226051,"MITKOV, MARIO, VENTZISLAVOV",3107 BRASSFIELD RD STE 300 GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 92 , 122 , 181 ,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,1900 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 61 , 73 , 74 ,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1003227000,"VANI, ANISH, KAUSHIK",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003227810,"PATEL-NGUYEN, SONYA, VIPUL",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 101 , 101 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003227810,"PATEL-NGUYEN, SONYA, VIPUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003227810,"PATEL-NGUYEN, SONYA, VIPUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003227810,"PATEL-NGUYEN, SONYA, VIPUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003227810,"PATEL-NGUYEN, SONYA, VIPUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 32 , 32 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003227810,"PATEL-NGUYEN, SONYA, VIPUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1558638676,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PULMONARY & CRITICAL CARE SEACOAST,115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003227976,"MAHALINGASHETTY, ABHIJIT, PRAKASH",115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1558638676,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PULMONARY & CRITICAL CARE SEACOAST,115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003227976,"MAHALINGASHETTY, ABHIJIT, PRAKASH",3980 HIGHWAY 9 E STE 340 LITTLE RIVER SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003230483,"MAYNOR, HEATHER, MCPHAIL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 192 , 192 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1003230848,"COWAN, KIRSTIEMA, ANN-MARIE",1899 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 42 , 93 ,$#,,
MEDICAID DIRECT,1942301957,BLUE RIDGE HEALTHCARE MEDICAL GROUP,DREXEL MEDICAL PRACTICE,2659 US HIGHWAY 70 E   VALDESE NC,012,Burke,193400000X,Group,Single Specialty,,1003231705,"ELLIOTT, MICHELLE, SLUDER",2659 US HIGHWAY 70 E   VALDESE NC,012,Burke,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 91 , 249 , 315 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 70 , 70 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 81 , 81 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1003232992,"MEACHEM, KATRINA, ELLEN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003234204,"WILLIAMSON, RYAN, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 22 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003234857,"HADLEY, NICOLE, MICHELLE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 28 , 45 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003235128,"FOSTER, ERIN, MIELE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003235128,"FOSTER, ERIN, MIELE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003235292,"THOMAS, SCOTT, WARREN",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 37 , 57 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1003236787,"BONAKDAR, ROMIN",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003236787,"BONAKDAR, ROMIN",4917 OLD FARM RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 107 , 108 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003236787,"BONAKDAR, ROMIN",1507 W PETTIGREW ST   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 66 , 66 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003236787,"BONAKDAR, ROMIN",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 106 , 358 , 421 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003237702,"THOMAS, TONYA",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 17 , 23 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4600 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003237702,"THOMAS, TONYA",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 25 , 36 , 48 ,$#,,
MEDICAID DIRECT,1003242686,WALGREEN CO,WALGREENS 16133,454 S MAIN ST   SPARTA NC,003,Alleghany,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1003242686,WALGREEN CO,454 S MAIN ST   SPARTA NC,003,Alleghany,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003242959,WALGREEN CO,WALGREENS 16149,1050 S HORNER BLVD   SANFORD NC,053,Lee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1003242959,WALGREEN CO,1050 S HORNER BLVD   SANFORD NC,053,Lee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1003247230,"COOK, BENJAMIN, JOSEPH",5716 FAYETTEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003247230,"COOK, BENJAMIN, JOSEPH",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003247230,"COOK, BENJAMIN, JOSEPH",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1003247230,"COOK, BENJAMIN, JOSEPH",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336317692,KENNETH B LEWIS DDS PA,LEWIS FAMILY DENTISTRY,4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1003252917,"DINE, KENLY, LEWIS",4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 24 , 72 ,$#,,
MEDICAID DIRECT,1003252917,"DINE, KENLY, LEWIS",~,4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1003252917,"DINE, KENLY, LEWIS",4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 50 , 154 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003253238,"FELTUS, WHITNEY, YVONNE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003253238,"FELTUS, WHITNEY, YVONNE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 88 , 86 , 107 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1003253238,"FELTUS, WHITNEY, YVONNE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003253543,"STEPHENS, SARAH, ELIZABETH",5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003253543,"STEPHENS, SARAH, ELIZABETH",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 22 , 53 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003253857,"WILT, ERICA, RENE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003253923,"LINTON, ERIC, LEAMAN",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 61 , 61 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003253931,"TWUM-BARIMAH, PATRICK",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003254673,"EMBERGER, JENNIFER, BETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 28 , 28 , 46 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003254673,"EMBERGER, JENNIFER, BETH",2390 HEMBY LN   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003254673,"EMBERGER, JENNIFER, BETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 29 , 39 , 39 ,$#,,
MEDICAID DIRECT,1912547415,GASTON FAMILY HEALTH SERVICES INC,IREDELL PSYCHIATRY,766 HARTNESS RD   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003254806,"RAJU, SUJA",766 HARTNESS RD   STATESVILLE NC,049,Iredell,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 30 , 61 , 61 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003255225,"SCHUMAN, CHRISTANNA, RAE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003255225,"SCHUMAN, CHRISTANNA, RAE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003255225,"SCHUMAN, CHRISTANNA, RAE",6488 WEDDINGTON MONROE RD   MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003255225,"SCHUMAN, CHRISTANNA, RAE",2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003255357,"ZEYLIKMAN, YURIY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 31 , 83 , 83 ," $10,759.14 ",,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1003255357,"ZEYLIKMAN, YURIY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 96 , 170 , 170 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003257361,"MCKENZIE, RACHEL, GREY",1471 JAG BRANCH BLVD UNIT 103 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1003257361,"MCKENZIE, RACHEL, GREY",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 97 , 123 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003257361,"MCKENZIE, RACHEL, GREY",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 40 , 46 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003257361,"MCKENZIE, RACHEL, GREY",4901 AUBURN RD   SUMMERFIELD NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003257361,"MCKENZIE, RACHEL, GREY",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003258237,"DATLA, SATYA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003258716,"MARGOLIES, SKYE, MIMS OCHSNER",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6330 QUADRANGLE DR STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1003258716,"MARGOLIES, SKYE, MIMS OCHSNER",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003260597,"POWELL, DUSTIN, CLAY",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003260597,"POWELL, DUSTIN, CLAY",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003260597,"POWELL, DUSTIN, CLAY",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003260597,"POWELL, DUSTIN, CLAY",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 72 , 78 , 97 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003260597,"POWELL, DUSTIN, CLAY",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207UN0902X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Imaging & Therapy,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003260597,"POWELL, DUSTIN, CLAY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 38 , 44 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003260597,"POWELL, DUSTIN, CLAY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 59 , 68 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003260597,"POWELL, DUSTIN, CLAY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 37 , 51 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003260597,"POWELL, DUSTIN, CLAY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 25 , 35 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003260597,"POWELL, DUSTIN, CLAY",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003260597,"POWELL, DUSTIN, CLAY",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003261074,"NIVENS, DOROTHY, JAMES",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003261306,"LIANG, ZHONGFEI",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 107 , 177 , 442 ," $17,995.11 ",,
MEDICAID DIRECT,1093706111,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - SOUTHEAST RALEIGH DENTA,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003261306,"LIANG, ZHONGFEI",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1003261918,ASHE FAMILY CARE HOMES LLC,,523 MILT HOUCK RD   TODD NC,005,Ashe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003261918,ASHE FAMILY CARE HOMES LLC,523 MILT HOUCK RD   TODD NC,005,Ashe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,292 "," 2,292 "," $139,310.00 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003263955,"SCHWORER, STEPHEN, ANDREW",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RA0201X,Allopathic & Osteopathic Physicians,Internal Medicine,Allergy & Immunology,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003263955,"SCHWORER, STEPHEN, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RA0201X,Allopathic & Osteopathic Physicians,Internal Medicine,Allergy & Immunology,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1003265505,"SOWERS, CHRISTOPHER, BARRET",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1003267006,"HUSSAIN, ALI",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1003267006,"HUSSAIN, ALI",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003268848,"BEASLEY, SPENSER, ROBERT",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 32 , 59 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003269085,"BADAMI, SUNIL",105 HOSPITAL DR   TARBORO NC,033,Edgecombe,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003269085,"BADAMI, SUNIL",105 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003269085,"BADAMI, SUNIL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 134 , 283 , 283 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1003269556,"MCKNIGHT II, WESLEY, HD",113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1003269556,"MCKNIGHT II, WESLEY, HD",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003269606,"ROBINSON, LORI, LOVETT",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003269606,"ROBINSON, LORI, LOVETT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003269606,"ROBINSON, LORI, LOVETT",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 38 , 39 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003269606,"ROBINSON, LORI, LOVETT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003269606,"ROBINSON, LORI, LOVETT",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003269606,"ROBINSON, LORI, LOVETT",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003269606,"ROBINSON, LORI, LOVETT",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003270042,"MCKENZIE-SOLIS, JORDAN, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003270042,"MCKENZIE-SOLIS, JORDAN, DANIELLE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003271644,"DIMARTINO, GINA, ELIZABETH",1028 LEE ANN DR NE STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003271644,"DIMARTINO, GINA, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003271644,"DIMARTINO, GINA, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003271644,"DIMARTINO, GINA, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003271644,"DIMARTINO, GINA, ELIZABETH",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1003271644,"DIMARTINO, GINA, ELIZABETH",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003271834,"GIBSON, ALLISON, LAUREN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 43 , 53 ,$#,,
MEDICAID DIRECT,1205375953,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA WOUND CARE,117 DENNIS DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1003275611,"FOX, LINDSAY, MERRIMAN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1528154473,COASTAL INFECTIOUS DISEASE CONSULTA,COASTAL INFECTIOUS DISEASE CONSULTANTS,2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1003277948,"LUBLIN, CRYSTAL, ANNE",2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 87 , 93 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003278953,"BROGDON, STEPHANIE, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003278953,"BROGDON, STEPHANIE, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003279514,"CONRAD, RANDALL, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003279779,"CECIL, WILLIAM, TYLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1003285123,"EDWARDS, GALEN, MATTHEW",695 W FLEMING DR   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 23 , 24 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003285123,"EDWARDS, GALEN, MATTHEW",695 W FLEMING DR   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1003285123,"EDWARDS, GALEN, MATTHEW",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003285123,"EDWARDS, GALEN, MATTHEW",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1003285123,"EDWARDS, GALEN, MATTHEW",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 108 , 134 , 280 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003290263,"ANDERSON, SETH, RYAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003290693,"BROUWER, JESSE, ETHAN",11081 FOREST PINES DR STE 112 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003290859,"ORJUELA, JORGE, ANDRES",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003290859,"ORJUELA, JORGE, ANDRES",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003290859,"ORJUELA, JORGE, ANDRES",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003290859,"ORJUELA, JORGE, ANDRES",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003290859,"ORJUELA, JORGE, ANDRES",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003291311,"COLLINS, LINDSAY, CAROLINE",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,6237 CAROLINA COMMONS DR STE 110 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003291311,"COLLINS, LINDSAY, CAROLINE",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003294059,"CLINE, ADRIANA, IDA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 45 , 113 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003294059,"CLINE, ADRIANA, IDA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003295072,"MANY, JEFFREY, RICHARD",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003295072,"MANY, JEFFREY, RICHARD",269 GILLMAN RD STE 200B DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003295072,"MANY, JEFFREY, RICHARD",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 40 , 80 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,16525 HOLLY CREST LN STE 150   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003295072,"MANY, JEFFREY, RICHARD",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1003295171,"ANDREW, WILLIAM, COLE",,1330 TAYLOR AT MARION STS   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1003295171,"ANDREW, WILLIAM, COLE",1330 TAYLOR AT MARION STS   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003296054,"PARRISH, MARY, LAUREN CHEEK",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003296054,"PARRISH, MARY, LAUREN CHEEK",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003296054,"PARRISH, MARY, LAUREN CHEEK",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 106 , 276 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003296484,"WALLACE, JOHN, HUGH",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1003296484,"WALLACE, JOHN, HUGH",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 117 , 130 , 173 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1003296484,"WALLACE, JOHN, HUGH",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 98 , 108 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003296484,"WALLACE, JOHN, HUGH",2201 S STERLING ST   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 61 , 65 ,$#,,
MEDICAID DIRECT,1861534950,STEVEN R PATTY DDS PA,~,1851 WELLNESS BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1003296831,"RICCIUTI, JESSE, ERIC",10801 WOODLAND BEAVER RD STE 103 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 32 , 46 , 112 ,$#,,
MEDICAID DIRECT,1861534950,STEVEN R PATTY DDS PA,~,1851 WELLNESS BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1003296831,"RICCIUTI, JESSE, ERIC",1851 WELLNESS BLVD   MONROE NC,090,Union,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 55 , 84 , 354 ," $39,224.34 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003297342,"JONES, ANISHA, APPHIA",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 59 , 65 ,$#,,
MEDICAID DIRECT,1003299066,INNERBANKS MEDICAL TRANSPORT CO,,1135 CREEK DR   WILLIAMSTON NC,058,Martin,3416L0300X,Transportation Services,Ambulance,Land Transport,1003299066,INNERBANKS MEDICAL TRANSPORT CO,1135 CREEK DR   WILLIAMSTON NC,058,Martin,3416L0300X,Transportation Services,Ambulance,Land Transport, 88 , 452 , 888 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003299561,"VICK, CHRISHAUNDA, LAKEISH",4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003299561,"VICK, CHRISHAUNDA, LAKEISH",1500 GARNER RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003299561,"VICK, CHRISHAUNDA, LAKEISH",4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 104 , 189 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2807 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003299637,"ONDEK, RACHEL, LYNN",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1003299637,"ONDEK, RACHEL, LYNN",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003310590,"MCKIE, DALE-MARIE, NEKEISHA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 31 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 66 , 67 , 85 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003311788,"MCGAVIN, JASON, ARTHUR E",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003311903,"ADCOCK, LESLIE, KAY RUFFING",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 80 , 121 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003311903,"ADCOCK, LESLIE, KAY RUFFING",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003311903,"ADCOCK, LESLIE, KAY RUFFING",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 59 , 80 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003311903,"ADCOCK, LESLIE, KAY RUFFING",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 22 , 32 ,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1003311903,"ADCOCK, LESLIE, KAY RUFFING",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1003311903,"ADCOCK, LESLIE, KAY RUFFING",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1003313818,"GROSS, SARAH, HALEY",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 21 , 59 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003315383,"TURREGANO, CASSADY, TETSWORTH",1540 SUNDAY DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 45 , 54 ,$#,,
MEDICAID DIRECT,1003321365,VALLEYGATE DENTAL SURGERY CENTER OF,,2038 LITHO PL   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1003321365,VALLEYGATE DENTAL SURGERY CENTER OF,2038 LITHO PL   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 120 , 119 , 124 ," $346,719.97 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1003324500,"PATTERSON, LAUREN, ANN",5680 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1003324500,"PATTERSON, LAUREN, ANN",5680 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1003334111,"GLECKLER, BRADLEY, RICHARD",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1003334111,"GLECKLER, BRADLEY, RICHARD",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 35 , 35 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003334111,"GLECKLER, BRADLEY, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003335860,"SAWYER, HOLLY, KAIMANAKEA GYURE",336 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003335860,"SAWYER, HOLLY, KAIMANAKEA GYURE",336 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,10030 GREEN LEVEL CHURCH RD STE 808 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003336710,"MORETTO, REBECA, ALEJANDRA",10030 GREEN LEVEL CHURCH RD STE 808 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1003336710,"MORETTO, REBECA, ALEJANDRA",781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 15 , 19 , 21 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003340019,"DAHAL, BINITA",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1003340019,"DAHAL, BINITA",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003340019,"DAHAL, BINITA",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 190 , 191 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003340019,"DAHAL, BINITA",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003340019,"DAHAL, BINITA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003343757,"SNYDER, JENNIFER, ELIZABETH",2400 PRATT ST NORTH PAVILION SUITE 1100 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003344045,"LANE, STACY, JOELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,295 MIDLAND PKWY   SUMMERVILLE SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1003344169,"MCCARTHY, JORDAN, JAMES",800 N FANT ST   ANDERSON SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,101 REDFORD PLACE DR STE 100   ROLESVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1003344300,"TELIN, JORDAN, JOSEPH",7535 CARPENTER FIRE STATION RD STE 201A CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 18 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,101 REDFORD PLACE DR STE 100   ROLESVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1003344300,"TELIN, JORDAN, JOSEPH",1625 N MAIN ST STE 201 FUQUAY VARINA NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,1460 KELLY RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1003344300,"TELIN, JORDAN, JOSEPH",1460 KELLY RD   APEX NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 39 , 42 , 178 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,7860 BRIER CREEK PKWY STE 100A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003344300,"TELIN, JORDAN, JOSEPH",7860 BRIER CREEK PKWY   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 56 , 75 , 310 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,1625 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1003344300,"TELIN, JORDAN, JOSEPH",1625 N MAIN ST STE 201 FUQUAY VARINA NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 36 , 36 , 135 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,101 REDFORD PLACE DR STE 100   ROLESVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1003344300,"TELIN, JORDAN, JOSEPH",1936 HERITAGE BRANCH RD STE 200 WAKE FOREST NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 17 , 20 , 61 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,7535 CARPENTER FIRE STATION RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003344300,"TELIN, JORDAN, JOSEPH",7535 CARPENTER FIRE STATION RD STE 201A CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 81 , 111 , 430 ," $13,407.98 ",,
MEDICAID DIRECT,1003347014,DR JAMES R MASON OPTOMETRIST PLLC,,316 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1003347014,DR JAMES R MASON OPTOMETRIST PLLC,316 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,, 31 , 32 , 62 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003348558,"WHITE, DANIEL, RHYNE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 65 , 96 , 103 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1003348848,"ELSARRAG, SAMMY, ZAKI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003348848,"ELSARRAG, SAMMY, ZAKI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1003348848,"ELSARRAG, SAMMY, ZAKI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003348848,"ELSARRAG, SAMMY, ZAKI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 57 , 66 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003348848,"ELSARRAG, SAMMY, ZAKI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003348848,"ELSARRAG, SAMMY, ZAKI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003348848,"ELSARRAG, SAMMY, ZAKI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003349143,"HELMIG, KATHRYN, CHARLOTTE",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003349341,"FLETCHER, AMANDA, NICOLE",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 61 , 100 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003349341,"FLETCHER, AMANDA, NICOLE",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003349341,"FLETCHER, AMANDA, NICOLE",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",37 CRESTVIEW HTS # B SYLVA NC,050,Jackson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",37 CRESTVIEW HTS # B SYLVA NC,050,Jackson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,902 FLEMING ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 48 , 58 , 228 ," $20,905.62 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,149 PLANTATION RIDGE DR STE 170 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",37 CRESTVIEW HTS # B SYLVA NC,050,Jackson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,37 CRESTVIEW HTS # B SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",37 CRESTVIEW HTS # B SYLVA NC,050,Jackson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 20 , 20 , 61 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 52 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 15 , 15 , 30 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 172 , 255 , 933 ," $98,099.93 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 VANDERBILT PARK DR STE 210 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003349515,"WARREN, VICTOR, TAYLOR",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003349614,"WYBLE, JONATHAN, EDWARD",10B YORKSHIRE ST   ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 681 ," 1,247 "," 4,911 "," $214,463.77 ",,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003349614,"WYBLE, JONATHAN, EDWARD",247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 212 , 228 ," 1,159 "," $65,738.82 ",,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003349614,"WYBLE, JONATHAN, EDWARD",37 CRESTVIEW HTS   SYLVA NC,050,Jackson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 66 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003351651,"WADE, JASMINE, DAWN",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 25 , 25 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1003351651,"WADE, JASMINE, DAWN",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003351651,"WADE, JASMINE, DAWN",401 N MORGAN ST   SHELBY NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003351651,"WADE, JASMINE, DAWN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003351651,"WADE, JASMINE, DAWN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003351651,"WADE, JASMINE, DAWN",,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1003351651,"WADE, JASMINE, DAWN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1518312073,MCPC-17 LLC,FIRSTHEALTH PRIMARY CARE,293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003352907,"SMYTH, NANCY, MARIE",293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 18 , 29 ,$#,,
MEDICAID DIRECT,1518312073,MCPC-17 LLC,FIRSTHEALTH PRIMARY CARE,293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003352907,"SMYTH, NANCY, MARIE",293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 52 , 80 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003356122,"WILLIAMS, BROOKE, ASHLYNN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003356122,"WILLIAMS, BROOKE, ASHLYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 85 , 85 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003356122,"WILLIAMS, BROOKE, ASHLYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447314075,MORCOM MEDICAL CONSULTANTS PLLC,MORCOM MEDICAL CONSULTANTS PLLC,235 JENKINS RD   DOVER NC,052,Jones,193200000X,Group,Multi-Specialty,,1003356767,"CRISTE, SAMANTHA, JOANNE",235 JENKINS RD   DOVER NC,052,Jones,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 549 ," 4,848 "," 4,853 "," $84,898.10 ",,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,620 N CHURCH ST STE 113 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003359886,"SUNDARESH, RAGHAVANAND",620 N CHURCH ST STE 113 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 540 ," 1,186 "," 4,087 "," $243,037.82 ",,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,620 N CHURCH ST STE 113 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003359886,"SUNDARESH, RAGHAVANAND",230 E WT HARRIS BLVD STE A3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,4425 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003359886,"SUNDARESH, RAGHAVANAND",4425 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 279 , 591 ," 2,189 "," $134,323.45 ",,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,230 E WT HARRIS BLVD STE A3 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003359886,"SUNDARESH, RAGHAVANAND",230 E WT HARRIS BLVD STE A3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 742 ," 1,629 "," 5,649 "," $325,114.47 ",,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,230 E WT HARRIS BLVD STE A3 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003359886,"SUNDARESH, RAGHAVANAND",4425 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,2100 S TRYON ST UNIT 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003359886,"SUNDARESH, RAGHAVANAND",620 N CHURCH ST STE 113 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#, 13 , 35 ,$#,,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,4425 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003359886,"SUNDARESH, RAGHAVANAND",230 E WT HARRIS BLVD STE A3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003360405,"WERNER, LAURA, HUDSON",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003361106,"TOMLIN, PRISCILA, MACHADO",3004 TOWER BLVD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003361106,"TOMLIN, PRISCILA, MACHADO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1003361163,EDWARDS EYE CARE OD PLLC,,1488 MEMORIAL DR E   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1003361163,EDWARDS EYE CARE OD PLLC,1488 MEMORIAL DR E   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,, 975 , 979 ," 1,952 "," $26,538.58 ",,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003362161,"HEAGERTY, MARY, ELIZABETH",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 33 , 46 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003362161,"HEAGERTY, MARY, ELIZABETH",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 144 , 248 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003362765,"MARSHBURN, AMANDA, DIANE",8210 RICHLANDS HWY   RICHLANDS NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 151 , 254 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003362799,"RAMOS, CLOTILDE, JORGINA",2025 GLENN MITCHELL DR 4TH FL TOWER A VIRGINIA BEACH VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003365511,"SANDERS, TAWANA, DENISE",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003365511,"SANDERS, TAWANA, DENISE",14215 BALLANTYNE CORPORATE PL STE 240 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003365511,"SANDERS, TAWANA, DENISE",284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1689360307,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,5023 CAROLINA FOREST BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003365859,"THOMAS, NAKETA, AMENIA",5023 CAROLINA FOREST BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003367541,"RODRIGUEZ, MARIAH, LEIGH",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003369349,"WRIGHT, JUSTEN, DANIEL",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003369349,"WRIGHT, JUSTEN, DANIEL",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 71 , 80 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003369760,"MOONEY, SARA, CHRISTINE",304 10TH AVE NE   HICKORY NC,018,Catawba,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003372079,"MATTINGLY, KATHERINE, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003372079,"MATTINGLY, KATHERINE, MICHELLE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003372079,"MATTINGLY, KATHERINE, MICHELLE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003372079,"MATTINGLY, KATHERINE, MICHELLE",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003372079,"MATTINGLY, KATHERINE, MICHELLE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003372079,"MATTINGLY, KATHERINE, MICHELLE",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003372079,"MATTINGLY, KATHERINE, MICHELLE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1003374000,"MILLER, ONDREA, MARIE",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 76 , 124 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 24 , 76 , 76 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 75 , 708 , 710 ," $14,960.21 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1555 WILLIS AVE   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 19 , 126 , 127 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1555 WILLIS AVE   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 19 , 79 , 79 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,620 JOHNS RD   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",401 W 27TH ST   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",401 W 27TH ST   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 21 , 64 , 68 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 43 , 188 , 188 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1003374208,"BARTON, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1003374877,"SCHREIBER, BRIANNE, V",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003375288,PEDIATRIC THERAPY CONNECTION PLLC,,4144 MENDENHALL OAKS PKWY STE 103 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003375288,PEDIATRIC THERAPY CONNECTION PLLC,4144 MENDENHALL OAKS PKWY STE 103 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,, 25 , 287 , 298 ," $21,721.01 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1003376393,"RAY, NEHA",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003376393,"RAY, NEHA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 84 , 114 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003376393,"RAY, NEHA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003376393,"RAY, NEHA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003376393,"RAY, NEHA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 42 , 55 ,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003376534,"IVANOV, NICOLE, LUDMIL",9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 44 , 73 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003377144,"LEAL, KEVIN, WILLIAM",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 26 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003377144,"LEAL, KEVIN, WILLIAM",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1003377425,"MARTIN, CHRISTINE, IRIS",1001 CRESCENT GREEN DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1021 W WILLIAMS ST STE 105 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1003377425,"MARTIN, CHRISTINE, IRIS",1021 W WILLIAMS ST   APEX NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003377870,"ALBERT, CHRISTINA, MARIA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003377870,"ALBERT, CHRISTINA, MARIA",930 3RD ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 105 , 147 ," $11,753.80 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003377870,"ALBERT, CHRISTINA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003377920,"CROSS, KRISTEN, ELIZABETH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1003377920,"CROSS, KRISTEN, ELIZABETH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003377920,"CROSS, KRISTEN, ELIZABETH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003377920,"CROSS, KRISTEN, ELIZABETH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 52 , 52 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1003377920,"CROSS, KRISTEN, ELIZABETH",116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003378332,"PATEL, JAY, MUKESH",1420 E FRANKLIN ST   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003378761,"PETERS, KATHERINE, SUMARRIVA",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1104880723,WNC EYE SURGERY CENTER,,8B MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1003378761,"PETERS, KATHERINE, SUMARRIVA",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1881841518,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT SCOTLAND NECK,919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003379306,"ANTONY, TREESA",919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588115752,RDMG ASSOCIATES PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1003380098,"PARRELLA, EMILY, LAUREN VOYNOVICH",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003380510,"PHELPS, HANNAH, EVE",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003391251,"RAINEY, HANNAH, FORTWENGLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 36 , 37 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1003394909,"RAMEY, BEVERLY, JUNE",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003395948,"HASKINS, KAILA, RENEA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003395948,"HASKINS, KAILA, RENEA",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003395948,"HASKINS, KAILA, RENEA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003396383,"MASUDAL, ROCHELLE, GABRIELA",110 KILDAIRE PARK DR   CARY NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003400144,"RAMSEY, LAUREN, MICHELLE",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003400144,"RAMSEY, LAUREN, MICHELLE",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1003405267,"TILLES, FELICIA, MONICA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 496 , 687 ," $35,509.82 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1003406752,"DENTON, KYLE, SPENCER",315 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 46 ,$#,,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1003406752,"DENTON, KYLE, SPENCER",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1003406752,"DENTON, KYLE, SPENCER",KYLE DENTON DMD,3501 ASSOCIATE DR   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1003406752,"DENTON, KYLE, SPENCER",3501 ASSOCIATE DR   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 673 , 967 ," 5,324 "," $822,782.69 ",,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003406752,"DENTON, KYLE, SPENCER",3501 ASSOCIATE DR   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003406752,"DENTON, KYLE, SPENCER",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 57 ,$#,,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1003406752,"DENTON, KYLE, SPENCER",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003407537,"CULLEY, EMILY, BATCHELOR",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003407537,"CULLEY, EMILY, BATCHELOR",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 42 , 55 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003407701,"BUERY, AMY, SUZANNE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003407701,"BUERY, AMY, SUZANNE",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 119 , 260 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003407701,"BUERY, AMY, SUZANNE",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1801126479,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST UROLOGY,144 POOLE RD STE 102 LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1003407966,"MATHESON, BRANDY, WATTS",320 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1801126479,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST UROLOGY,320 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1003407966,"MATHESON, BRANDY, WATTS",320 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 102 , 201 , 273 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003408758,"HOFER, MICAELA, MARIE",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003408758,"HOFER, MICAELA, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003408758,"HOFER, MICAELA, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720643174,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR STRUCTURAL HEART,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003408758,"HOFER, MICAELA, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003410358,"WARNER, CHRISTINE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 25 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1003413329,"KIRK, DARREN, RICHARD",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003413329,"KIRK, DARREN, RICHARD",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003413329,"KIRK, DARREN, RICHARD",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 55 , 90 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2200 TREELIGHT WAY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1003413543,"CHILDRESS, ALLYSON, DUPAY",2200 TREELIGHT WAY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1003413543,"CHILDRESS, ALLYSON, DUPAY",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1003413543,"CHILDRESS, ALLYSON, DUPAY",388 VENTURE DR STE I SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1003413543,"CHILDRESS, ALLYSON, DUPAY",388 VENTURE DR STE I SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1003413543,"CHILDRESS, ALLYSON, DUPAY",388 VENTURE DR STE I SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003413543,"CHILDRESS, ALLYSON, DUPAY",388 VENTURE DR STE I SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003416496,HEALING HEARTS NC,~,108 MEMORY PLZ STE B WHITEVILLE NC,024,Columbus,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1003416496,HEALING HEARTS NC,108 MEMORY PLZ STE B WHITEVILLE NC,024,Columbus,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 79 , 942 ," 1,069 "," $76,958.20 ",,
MEDICAID DIRECT,1003416496,HEALING HEARTS NC,~,108 MEMORY PLZ STE B WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1003416496,HEALING HEARTS NC,108 MEMORY PLZ STE B WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 5,236 "," 5,237 "," $460,679.76 ",,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003421603,"BARKLEY, LOGAN, MICHAEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003421603,"BARKLEY, LOGAN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003421751,"TUTTLE, NICHOLAS, RYAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 36 , 38 ,$#,,
MEDICAID DIRECT,1003425109,FOUR OAKS HOME CARE SERVICES LLC,,301 W J J DR STE C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1003425109,FOUR OAKS HOME CARE SERVICES LLC,301 W J J DR STE C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 83 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003426107,"BOUNVILAY, CELENA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 43 , 144 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003426107,"BOUNVILAY, CELENA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003426107,"BOUNVILAY, CELENA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003426719,"DONATO, KATHRYN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1003426719,"DONATO, KATHRYN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003426719,"DONATO, KATHRYN, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 77 , 77 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 127 , 394 , 396 ," $11,471.75 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003428293,"FULKS, KASHARI, LASHEA",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 38 , 38 ,$#,,
MEDICAID DIRECT,1003428871,TAYLOR5 HOME CARE SERVICES LLC,,1907 HARDEE RD   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1003428871,TAYLOR5 HOME CARE SERVICES LLC,1907 HARDEE RD   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,#," 2,291 "," 2,361 "," $389,606.92 ",,
MEDICAID DIRECT,1043510696,HARNETT OBGYN LLC,CAPE FEAR VALLEY OB GYN-DUNN,805 TILGHMAN DR STE C DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1003431404,"LOVVORN, RHONDA, MANN",805 TILGHMAN DR STE C DUNN NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 81 , 108 , 187 ,$#,,
MEDICAID DIRECT,1043510696,HARNETT OBGYN LLC,CAPE FEAR VALLEY OB GYN-DUNN,805 TILGHMAN DR STE C DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1003431404,"LOVVORN, RHONDA, MANN",700 TILGHMAN DR STE 700 DUNN NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003432790,"MCDANIEL, JOSHUA, LEE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 36 , 55 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003432790,"MCDANIEL, JOSHUA, LEE",1730 KERNERSVILLE MEDICAL PKWY STE 203 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 81 , 105 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003435504,"POPHAL, CHARLES, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 41 , 45 ,$#,,
MEDICAID DIRECT,1003436510,HEALTHY HANDS HOME CARE AGENCY LLC,HEALTHY HANDS HOME CARE AGENCY LLC,951 S MCPHERSON CHURCH RD STE 103B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1003436510,HEALTHY HANDS HOME CARE AGENCY LLC,951 S MCPHERSON CHURCH RD STE 103B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,714 "," 1,714 "," $99,774.60 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003439639,"OGUNJOBI, OLUFUNSO, MERCY",320 BOULEVARD ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1003440520,"CHAANINE, KAREN, MESMER",4370 ARENDELL ST STE A MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003440520,"CHAANINE, KAREN, MESMER",4370 ARENDELL ST STE A MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 87 , 296 , 441 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1003440520,"CHAANINE, KAREN, MESMER",4370 ARENDELL ST STE A MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003440520,"CHAANINE, KAREN, MESMER",4370 ARENDELL ST STE A MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 28 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003443276,"BOETTCHER, LILLIAN, BALDRIDGE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003443292,"MCKINNEY, BENJAMIN, TYLER",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003443821,"HOFACKER, SAMUEL, AUGUSTUS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003443821,"HOFACKER, SAMUEL, AUGUSTUS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 66 , 67 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003443821,"HOFACKER, SAMUEL, AUGUSTUS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003444654,"TIMMER, TRENTON, PETER",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 25 , 25 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003444654,"TIMMER, TRENTON, PETER",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 154 , 167 ," $12,455.59 ",,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1003444860,"DAVIS FRANCOIS, KATHERINE, MARIE",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003444860,"DAVIS FRANCOIS, KATHERINE, MARIE",MEDICAL CENTER BLD   WINSTON SALEM NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1003452236,ART OF LIFE HOME CARE AND STAFFING,,619 E PRICE AVE STE 4 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1003452236,ART OF LIFE HOME CARE AND STAFFING,619 E PRICE AVE STE 4 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#, 282 , 282 ," $17,129.44 ",,
MEDICAID DIRECT,1003456922,CAROLINA THERAPY ASSOCIATES PLLC,,1325 SEATTLE SLEW LN   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003456922,CAROLINA THERAPY ASSOCIATES PLLC,1325 SEATTLE SLEW LN   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 53 , 53 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003460569,"FITZPATRICK, SHAUN",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 139 , 296 , 304 ," $14,487.73 ",,
MEDICAID DIRECT,1992703540,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003461583,"BEASLEY, CALLIE, BROWN",234 CROOKED CREEK PKWY STE 310 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003461583,"BEASLEY, CALLIE, BROWN",234 CROOKED CREEK PKWY STE 310 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003463969,"DAVIS, BROOKE, ALYSSA",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003463969,"DAVIS, BROOKE, ALYSSA",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003464157,"PELLEGRINI, EMILY, KATHERINE",6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1003464157,"PELLEGRINI, EMILY, KATHERINE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003464157,"PELLEGRINI, EMILY, KATHERINE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003469917,"PEARCE, AMANDA, CAROL",1705 TARBORO ST SW   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1003469917,"PEARCE, AMANDA, CAROL",1705 TARBORO ST SW   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1003469917,"PEARCE, AMANDA, CAROL",1705 TARBORO ST SW   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003471103,"GORDON, ANNE, MARIE LACKEY",709 N DEKALB ST   KINGSTOWN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 27 , 46 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003473307,"BOOTH, ANGELA, DEVINCENT",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568624344,PEDIATRIC DENTISTRY OF STEELE CREEK,STEELE CREEK PEDIATRIC DENTISTRY,13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003474040,"MENAKER, NOAH, HARVEY",13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 111 , 147 , 528 ," $17,682.74 ",,
MEDICAID DIRECT,1568624344,PEDIATRIC DENTISTRY OF STEELE CREEK,STEELE CREEK PEDIATRIC DENTISTRY,13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003474040,"MENAKER, NOAH, HARVEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 46 ,$#,,
MEDICAID DIRECT,1104845270,PEDIATRIC DENTISTRY OF MATTHEWS,~,1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003474040,"MENAKER, NOAH, HARVEY",1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 211 , 282 ," 1,096 "," $46,700.25 ",,
MEDICAID DIRECT,1699400978,HAMREN SCHELLER & ASSOCIATES PLLC,VIEWMONT FAMILY DENTISTRY,2782 2ND ST NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1003477159,"HAMREN, DUSTIN, JOHN",2782 2ND ST NE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 150 , 189 , 507 ," $54,760.36 ",,
MEDICAID DIRECT,1265264170,SCHELLER HAMREN AND ASSOC DDS PLLC,SOUTH MOUNTAIN FAMILY DENTISTRY,600 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,193200000X,Group,Multi-Specialty,,1003477159,"HAMREN, DUSTIN, JOHN",2782 2ND ST NE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7496 ROCKFISH RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003477233,"MCWHIRTER, PAMELA, MARTIN",245 E ROOSEVELT AVE   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003481078,"MORINI, ALEXIS, ANNE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 85 , 99 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003481078,"MORINI, ALEXIS, ANNE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1003482365,"CRON, MARY, CLAIRE",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003482365,"CRON, MARY, CLAIRE",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003482365,"CRON, MARY, CLAIRE",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1003485111,LIVING AT HOME CARE SERVICES INC,,1624 WHITE OAK CHURCH RD   APEX NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1003485111,LIVING AT HOME CARE SERVICES INC,1624 WHITE OAK CHURCH RD   APEX NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,150 "," 1,150 "," $90,848.28 ",,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003485699,"MORRIS, IEACHIA, TANISHA",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003485756,"BONZANO, NICHOLE, MARIANNE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 53 , 64 ,$#,,
MEDICAID DIRECT,1386485126,BENJAMIN CRAWFORD DMD PLLC,HUDSON FAMILY DENTISTRY,3094 HICKORY BLVD 3094 HICKORY BLVD HUDSON NC,014,Caldwell,193400000X,Group,Single Specialty,,1003488594,"CRAWFORD, BENJAMIN, SCOTT",155 HICKMAN AVE   HUDSON NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice," 1,373 "," 3,386 "," 9,749 "," $879,965.98 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003489428,"TREXLER, JUSTIN, ANDREW",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1003489428,"TREXLER, JUSTIN, ANDREW",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1003489428,"TREXLER, JUSTIN, ANDREW",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003494055,"MERCADER, DANIEL, LOUIS",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 38 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003494055,"MERCADER, DANIEL, LOUIS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 36 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003494709,"SLATTERY, NICHOLAS, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609978824,GRACE MEDICAL CLINIC PA,,2317 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003500091,"DIAKALELA, SYDNEY, THAMES",2317 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 44 , 119 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003500091,"DIAKALELA, SYDNEY, THAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1871977249,CENTRAL PEDIATRICS & INTERNAL MED,,3040 EASTWAY DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003500091,"DIAKALELA, SYDNEY, THAMES",2317 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952410110,"TOKUNBOH, JULIUS, KENNY",~,2317 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1003500091,"DIAKALELA, SYDNEY, THAMES",2317 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 26 , 66 ,$#,,
MEDICAID DIRECT,1003501032,ALLIANCE CARE & SUPPORT SERVICES,ALLIANCE CARE & SUPPORT SVCS,7633 KNIGHTDALE BLVD STE 103 KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1003501032,ALLIANCE CARE & SUPPORT SERVICES,7633 KNIGHTDALE BLVD STE 103 KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 1,066 "," 1,094 "," $95,085.84 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003505348,"TREADWELL, ALLYSSA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 58 , 58 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003506114,"WICKEY, KENNETH, JAMES",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 28 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003506114,"WICKEY, KENNETH, JAMES",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 33 , 60 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003506445,"HOLEVAS, LEA, MARIA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1003507617,"HAYBA, ERIN, ANGELINE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1003507617,"HAYBA, ERIN, ANGELINE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 83 , 83 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003508102,"TCHEDRE, SOLIM",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 40 , 68 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003514456,"LACKEY, SUMMER, ELIZABETH",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 40 , 149 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003514456,"LACKEY, SUMMER, ELIZABETH",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 25 , 45 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003514456,"LACKEY, SUMMER, ELIZABETH",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 24 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003514456,"LACKEY, SUMMER, ELIZABETH",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 88 , 180 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,118 KIRKMAN CT   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003514456,"LACKEY, SUMMER, ELIZABETH",118 KIRKMAN CT   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 28 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003514456,"LACKEY, SUMMER, ELIZABETH",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003514670,"GOLDUP, BRENDAN, SCOTT",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 83 , 170 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003514746,"WOLFF, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003514746,"WOLFF, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003516170,LEGACYS HOME CARE AGENCY LLC,LEGACY HOME CARE AGENCY,1700 E ASH ST STE 302 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1003516170,LEGACYS HOME CARE AGENCY LLC,1700 E ASH ST STE 302 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,460 "," 2,460 "," $164,102.47 ",,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1003517038,"BEAULIEU, NATALIE, FRANCES",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 50 , 51 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003527060,"HOTCHKISS, AMANDA, MADISON",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003530544,"BARNES, TYLER, JOHN",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003531153,"LONG, STEPHANIE, RENEE",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 43 , 49 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003533191,"ROBBINS, CORA",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003534355,"HOWARD, CHERIE, DE CASTRO",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 249 , 715 , 767 ," $16,651.99 ",,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003538356,"CLOUD, VALERIE, PACHECO",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003538356,"CLOUD, VALERIE, PACHECO",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,3 S TUNNEL RD # 187 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003539214,"BEATY, WILLIAM, RICHARD",3 S TUNNEL RD   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,3 S TUNNEL RD # 187 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003539214,"BEATY, WILLIAM, RICHARD",3 S TUNNEL RD   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003540634,"HEINZ, SARA, ELIZABETH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003541673,"LONGO, NICOLE, ELIZABETH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003541673,"LONGO, NICOLE, ELIZABETH",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 40 , 72 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003545609,"JOHNSON, VICTORIA, NICOLE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003547241,"JAKOBEK, HANNA, LYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003554411,"BARTLETT, HEATHER, LAUREN",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003554411,"BARTLETT, HEATHER, LAUREN",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003558362,"KILPATRICK, BREA, DEANN",4505 FAIR MEADOWS LN STE 102 RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1790115533,MOSES CONE AFFILIATED PHYSICIANS IN,CROSSROADS PSYCHIATRIC GROUP,445 DOLLEY MADISON RD STE 410 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003574765,"WHITE, BRIAN, ANTHONY",445 DOLLEY MADISON RD STE 410 GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003580598,"SLEDGE, RACHEL, ALEXANDRA",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 29 , 58 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003582099,"HUFFMAN, GAVIN, MARC",214 18TH ST SE   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003587098,SAFE HAVENS HOME HEALTH LLC,,3325 WASHBURN AVE STE 209 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1003587098,SAFE HAVENS HOME HEALTH LLC,3325 WASHBURN AVE STE 209 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 8,150 "," 8,234 "," $632,176.45 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003587510,"LINVILLE, TABITHA, LEANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003587510,"LINVILLE, TABITHA, LEANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1003588989,"ARNOLD-RECCA, CHRISTINE, ELIZABETH",4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 18 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1003588989,"ARNOLD-RECCA, CHRISTINE, ELIZABETH",2035 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 16 , 41 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1003588989,"ARNOLD-RECCA, CHRISTINE, ELIZABETH",6415 BROOKSTONE LN STE 101 FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 41 , 55 , 149 ,$#,,
MEDICAID DIRECT,1326313735,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,305 1ST ST E   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003592916,"MORALES, BRIANNA, IDALIS",305 1ST ST E   CONOVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 53 , 69 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003598368,"LATHROP, MARK, CLIFFORD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1003612193,"KOSTAL, LEXI, LEE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1003622051,"HARDISON, ALYSON, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1003622051,"HARDISON, ALYSON, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1003622051,"HARDISON, ALYSON, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003631904,"YOUNG, MAKEDA, TIYE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003631904,"YOUNG, MAKEDA, TIYE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1003635947,"KAHN, LAUREN, LEE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 18 , 111 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1003651266,"FINKLE, TRAVIS, AARON",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1003651266,"FINKLE, TRAVIS, AARON",20 MEDICAL CAMPUS DR NW STE 207 SUPPLY NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 121 , 126 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1003651266,"FINKLE, TRAVIS, AARON",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 88 , 132 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1003651266,"FINKLE, TRAVIS, AARON",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1003651266,"FINKLE, TRAVIS, AARON",5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1003651266,"FINKLE, TRAVIS, AARON",5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003654005,"JAWANDA, RUHI, KAUR",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003654310,"TALBOT, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003659251,"CRUZ, ALEX, EDGARDO",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 142 , 163 , 369 ," $17,416.77 ",,
MEDICAID DIRECT,1568464386,GREENE COUNTY HEALTH CARE INC,GREENE DENTAL SERVICES,6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003659251,"CRUZ, ALEX, EDGARDO",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003664533,"ARANA, NIEVA, PATRICIA",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 89 , 89 ," $26,360.02 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003665290,"USTANIK, MADELINE, BELLE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003665290,"USTANIK, MADELINE, BELLE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003665696,ILLUMINATE EYE CARE OD PLLC,,7 E 13TH AVE   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1003665696,ILLUMINATE EYE CARE OD PLLC,7 E 13TH AVE   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,, 108 , 111 , 214 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003670001,"KITCHKO, JANETTA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003670001,"KITCHKO, JANETTA",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 48 , 50 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003670001,"KITCHKO, JANETTA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1013489947,AGES & STAGES PEDIATRICS PLLC,,10340 PARK RD STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003671504,"WRIGHT, ALLISON",10340 PARK RD STE B CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 21 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003681545,"ACEVEDO, YUDITH, ELVIRA",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 85 , 154 , 208 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1003683400,"BEASLEY, HANNAH, GRACE",911 E ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 85 , 109 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1003683400,"BEASLEY, HANNAH, GRACE",911 E ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1003683400,"BEASLEY, HANNAH, GRACE",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1003683400,"BEASLEY, HANNAH, GRACE",631 CC CAMP RD   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1003683400,"BEASLEY, HANNAH, GRACE",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003688839,"PASSARO, VIKTORIIA, VIKTORIVNA",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003688839,"PASSARO, VIKTORIIA, VIKTORIVNA",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,556 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003688839,"PASSARO, VIKTORIIA, VIKTORIVNA",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 40 , 107 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003688839,"PASSARO, VIKTORIIA, VIKTORIVNA",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003688839,"PASSARO, VIKTORIIA, VIKTORIVNA",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1003692922,"DOWTY, ISABEL, ANN",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003692922,"DOWTY, ISABEL, ANN",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 23 , 59 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1003693037,"KOYIET, LEONARD, LEMAYIAN",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003695289,WILLIAMS INDEPENDENT HOME CARE LLC,,375 E 3RD ST STE 211 WENDELL NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1003695289,WILLIAMS INDEPENDENT HOME CARE LLC,375 E 3RD ST STE 211 WENDELL NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,192 "," 1,192 "," $74,201.45 ",,
MEDICAID DIRECT,1003863580,ASSOCIATED PATHOLOGISTS LLC,PATHGROUP,5301 VIRGINIA WAY   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1003800152,"WANG, JINGCHUAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1982839015,SOUTHPORT PULMONARY MEDICINE PLLC,SOUTHPORT PULMONARY MEDICINE PLLC,1517 N HOWE ST STE 12 SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1003801309,"SCHNEYER, BARTON, LEWIS",1517 N HOWE ST STE 12 SOUTHPORT NC,010,Brunswick,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 170 , 246 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003801606,"LEVY, FREDERIC, EVAN",1180 WYKE RD   SHELBY NC,023,Cleveland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003801606,"LEVY, FREDERIC, EVAN",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 87 , 196 , 277 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003801606,"LEVY, FREDERIC, EVAN",209 PARK ST STE 500 BELMONT NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,419 TWINS WAY   ADVANCE NC,030,Davie,193200000X,Group,Multi-Specialty,,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,419 TWINS WAY   ADVANCE NC,030,Davie,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,, 363 ," 1,441 "," 2,298 "," $27,861.35 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003803040,"CARON, PHILIP, DAVID",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 51 , 57 , 57 ," $15,984.94 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003804535,"VELARDO, BERNARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 49 , 50 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,4429 W HIGHWAY 27   VALE NC,055,Lincoln,193400000X,Group,Single Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851555734,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RIVERWOOD FAMILY MEDICI,3715 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",3715 UNION RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1003804972,"DESAMERO, JONATHAN, LABAYO",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003806043,"HARLAN, WILLIAM, ROBERT",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003806043,"HARLAN, WILLIAM, ROBERT",189 HOSPITAL DRIVE   SPRUCE PINE NC,061,Mitchell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003806043,"HARLAN, WILLIAM, ROBERT",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1003806043,"HARLAN, WILLIAM, ROBERT",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 58 , 79 , 100 ,$#,,
MEDICAID DIRECT,1003806266,"GODFREY, TERRY, ANTHONY",,129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1003806266,"GODFREY, TERRY, ANTHONY",129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,3600 MINNESOTA DR STE 800 EDINA MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1003806381,"GUISLER, PAUL, DAVID",4631 GRIFFIN CREEK RD   MEDFORD OR,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1003806381,"GUISLER, PAUL, DAVID",4631 GRIFFIN CREEK RD   MEDFORD OR,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1942278411,PATHOLOGISTS DIAGNOSTIC SERVICES PL,,,,Unknown,193400000X,Group,Single Specialty,,1003808288,"CERVIN, JAMES, ROBERT",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003809427,"MELTON SMITH, RENEE, BRONTAE",711 N DEKALB ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 38 , 57 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003809427,"MELTON SMITH, RENEE, BRONTAE",807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 106 , 142 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003809542,"DIMARTINO, THOMAS, CALVIN",201 VIRGINIA RD   EDENTON NC,021,Chowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003809633,"HASHMI, MASUD, SHAH",2905 CROUSE LN   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003809633,"HASHMI, MASUD, SHAH",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 36 , 44 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003809633,"HASHMI, MASUD, SHAH",1901 S HAWTHORNE RD STE 220 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003809633,"HASHMI, MASUD, SHAH",1710 KERNERSVILLE MEDICAL PKWY STE 220 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 80 , 90 ,$#,,
MEDICAID DIRECT,1356305841,CAROLINA ONCOLOGY SPECIALISTS PA,~,2406 CENTURY PL SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003810383,"CURRAN, COLIN, PATRICK",2406 CENTURY PL SE   HICKORY NC,018,Catawba,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1356305841,CAROLINA ONCOLOGY SPECIALISTS PA,~,2406 CENTURY PL SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003810383,"CURRAN, COLIN, PATRICK",2406 CENTURY PL SE   HICKORY NC,018,Catawba,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 107 , 300 , 607 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003810706,"KENNEDY JR, JOHN, PATRICK",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003810706,"KENNEDY JR, JOHN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003810706,"KENNEDY JR, JOHN, PATRICK",310 LONG SHOALS RD STE 203 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003810706,"KENNEDY JR, JOHN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003810706,"KENNEDY JR, JOHN, PATRICK",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 28 , 30 ,$#,,
MEDICAID DIRECT,1003813064,ACTIVE HEALTHCARE INC,ACTIVE HEALTHCARE INC,9104 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1003813064,ACTIVE HEALTHCARE INC,9104 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 585 ," 1,138 "," 1,817 "," $50,593.15 ",,
MEDICAID DIRECT,1003813064,ACTIVE HEALTHCARE INC,ACTIVE HEALTHCARE INC,9104 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1003813064,ACTIVE HEALTHCARE INC,9104 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003813650,"TOBORG, ROBERT, THEODORE",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 84 , 116 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003814732,"YAN, JIEMING",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003814914,"ASHER, ANTHONY, LAWRENCE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003814914,"ASHER, ANTHONY, LAWRENCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1457729634,APPALACHIAN REGIONAL MEDICAL ASSOCI,BOONE UROLOGY CENTER,870 STATE FARM RD STE 100 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1003815259,"HALL, STANLEY, CHRISTOPHER",870 STATE FARM ROAD SUITE 100 BOONE NC,095,Watauga,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 13 , 24 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003815937,"LANG, JOHN, MICHAEL",1 TOWN SQUARE BLVD STE 220 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 26 , 33 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003815937,"LANG, JOHN, MICHAEL",1 TOWN SQUARE BLVD STE 220 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 39 , 60 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003816158,"SEGAL, ALAN, BRUCE",4414 LAKE BOONE TRL STE 405 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073737995,WILSON RADIATION ONCOLOGY ASSOCIATE,~,1703 MEDICAL PARK DR W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1003817412,"METTS, MARGARET, CABELL",1703 MEDICAL PARK DR W   WILSON NC,098,Wilson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 14 , 103 , 142 ,$#,,
MEDICAID DIRECT,1003818964,"REEVES, KERRY, MALCOLM",ADVANCED EYE CARE,131 GLENSFORD DR STE 105 FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,1003818964,"REEVES, KERRY, MALCOLM",131 GLENSFORD DR STE 105 FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 84 , 89 , 92 ,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003819434,"POST, JAMES, RICHARD",3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1003819434,"POST, JAMES, RICHARD",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003819533,"AYCOCK, SUSAN, JANE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003819780,"VAUGHN, BRADLEY, KENT",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003819780,"VAUGHN, BRADLEY, KENT",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 18 , 28 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1003819780,"VAUGHN, BRADLEY, KENT",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003822206,"HAYES, DANIEL, HARVEY",2700 ROYAL COMMONS LN   MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003822206,"HAYES, DANIEL, HARVEY",10011 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003823634,"BRADSHAW, WILLIAM, ALAN",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003823634,"BRADSHAW, WILLIAM, ALAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003827247,INGLES MARKETS INC,INGLES PHARMACY 110,230 US 64 E   CASHIERS NC,050,Jackson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1003827247,INGLES MARKETS INC,230 US 64 E   CASHIERS NC,050,Jackson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 69 , 95 , 158 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 46 , 51 , 55 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 118 , 152 , 152 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003827296,"FEDOR, JOHN, MICHAEL",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003828716,"IULIANO, PHILIP, JAMES",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003828716,"IULIANO, PHILIP, JAMES",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003828716,"IULIANO, PHILIP, JAMES",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 89 , 129 , 219 ,$#,,
MEDICAID DIRECT,1003829342,ORTHO RX INC,~,400 MEADOWMONT VILLAGE CIR STE 425 CHAPEL HILL NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1003829342,ORTHO RX INC,400 MEADOWMONT VILLAGE CIR STE 425 CHAPEL HILL NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 312 , 348 , 372 ," $43,028.15 ",,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1003830795,"SCOTT, RHETT, HOWELL",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003830795,"SCOTT, RHETT, HOWELL",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003832221,"KLUTKE, CARL, GEORG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 23 , 39 , 63 ,$#,,
MEDICAID DIRECT,1003833252,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1392,5226 SIGMON RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1003833252,WAL-MART STORES EAST LP,5226 SIGMON RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003835315,"HUNT-HARRISON, TYEHIMBA, AFRIKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003835398,"MOHANTY, KATHY, GARLAND",6324 FAIRVIEW RD STE 350 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003835398,"MOHANTY, KATHY, GARLAND",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003835869,"THOMPSON, ALAN, ROBERT",ALAN ROBERT THOMPSON,905 VERDAE BLVD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1003835869,"THOMPSON, ALAN, ROBERT",905 VERDAE BLVD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1194298828,JOHN S WON MD PA,POMS,1112 E CONE BLVD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1003836321,"WON, JOHN, SUNGHOON",5427 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 630 , 756 ," 4,483 "," $484,822.85 ",,
MEDICAID DIRECT,1003836321,"WON, JOHN, SUNGHOON",~,5427 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1003836321,"WON, JOHN, SUNGHOON",5427 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery," 2,687 "," 3,593 "," 14,584 "," $1,775,896.92 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,559 RIVER HWY   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003838632,"SPEAKS, DEBORAH, ONEIL",559 RIVER HWY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 21 ,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003839986,"PRASAD, ANUJ",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1003840455,"LOFTON, CONNIE, SUE",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 40 , 40 ,$#,,
MEDICAID DIRECT,1720401151,NEURO CARE PLLC,,3050 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1003841271,"HOFMANN, MICHAEL, DAVID",3050 HENDERSON DR   JACKSONVILLE NC,067,Onslow,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 14 , 27 , 27 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1003841875,"MALIK, NOMAN, AHMED",871 TUFTHUNTER   MACON GA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 77 , 81 , 96 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1003841875,"MALIK, NOMAN, AHMED",871 TUFTHUNTER   MACON GA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003841925,"GEARY, RICHARD, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003842113,"KNIPPER, THOMAS, PATRICK",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1003842113,"KNIPPER, THOMAS, PATRICK",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003842113,"KNIPPER, THOMAS, PATRICK",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003842113,"KNIPPER, THOMAS, PATRICK",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003842980,"WEST, KEVIN, EUGENE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 82 , 82 , 83 ," $15,053.41 ",,
MEDICAID DIRECT,1003843442,DYNAMIC THERAPY INC,DYNAMIC THERAPY INC,2920 RIDGEPINE DR   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1003843442,DYNAMIC THERAPY INC,2920 RIDGEPINE DR   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,, 30 , 513 , 519 ," $39,712.40 ",,
MEDICAID DIRECT,1679600969,LENOIR CO HEALTH DEPT,LENOIR COUNTY HEALTH DEPARTMENT,201 N MCLEWEAN ST   KINSTON NC,054,Lenoir,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1003843608,"SHAPIRO, SOLOMON",201 N MCLEWEAN ST   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 50 , 72 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 66 , 69 , 95 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 172 , 199 , 256 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 19 , 25 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003844101,"HOUSTON, THADDEUS, DREXEL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326084898,COOK CHIROPRACTIC INC,COOK CHIROPRACTIC,1715 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1003844887,"TROUTMAN, RANDAL, G",1715 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,111N00000X,Chiropractic Providers,Chiropractor,, 18 , 71 , 74 ,$#,,
MEDICAID DIRECT,1285697086,THE PAIN RELIEF CENTERS PA,,,,Unknown,193400000X,Group,Single Specialty,,1003844903,"MITCHELL, PENNY, WILLIAMSON",1224 COMMERCE ST SW STE A CONOVER NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003844903,"MITCHELL, PENNY, WILLIAMSON",232 SHARON AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 65 , 81 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003844903,"MITCHELL, PENNY, WILLIAMSON",232 SHARON AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 348 , 391 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003845363,"CARNES, KENNETH, MICHAEL",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003845363,"CARNES, KENNETH, MICHAEL",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 53 , 71 , 97 ,$#,,
MEDICAID DIRECT,1598755910,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE FOOTHILLS,296 OAK ST   SPINDALE NC,081,Rutherford,193400000X,Group,Single Specialty,,1003847286,"BOWYER, TONI, HICKS",296 OAK ST   SPINDALE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 55 , 57 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003847310,"MAKHULI, MARK, JOSEPH",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 40 , 47 , 67 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003847310,"MAKHULI, MARK, JOSEPH",1023 EDGEHILL RD S   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 28 , 42 , 71 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1003847898,"TAFT, STEPHANIE, ANJA",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1003847898,"TAFT, STEPHANIE, ANJA",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003847898,"TAFT, STEPHANIE, ANJA",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003848029,"CARAHER, KRISTEN, WOLFINGER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003848540,"ABRAHAM, VICTOR, ELIAS",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 20 ,$#,,
MEDICAID DIRECT,1417150236,COASTAL UROLOGY PLLC,~,1099 MEDICAL CENTER DR STE 101 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1003848540,"ABRAHAM, VICTOR, ELIAS",1099 MEDICAL CENTER DR STE 101 WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 22 , 37 , 85 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003848540,"ABRAHAM, VICTOR, ELIAS",1099 MEDICAL CENTER DR STE 101 WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 19 , 21 , 49 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003849134,"POCHICK, MEREDITH, GIVENS",3129 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 16 , 41 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1003851395,"DEFEO, DAVID, NMN",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003851395,"DEFEO, DAVID, NMN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 22 , 40 , 42 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1003851395,"DEFEO, DAVID, NMN",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 167 , 200 , 437 ," $11,476.24 ",,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1003851395,"DEFEO, DAVID, NMN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 15 , 25 , 27 ,$#,,
MEDICAID DIRECT,1336817345,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CRITICAL CARE FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003851395,"DEFEO, DAVID, NMN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003851395,"DEFEO, DAVID, NMN",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1922013457,CALDWELL MEMORIAL HOSPITAL,MULBERRY PEDIATRICS,906 COLLEGE AVE SW STE C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1003851437,"KUNKLE, ANDRA, GODSOE",906 COLLEGE AVE SW STE C LENOIR NC,014,Caldwell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 61 , 115 , 252 ,$#,,
MEDICAID DIRECT,1518207216,ONSLOW AMBULATORY SERVICES INC,ONSLOW PULMONOLOGY ASSOCIATES,237 WHITE ST STE 1 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1003853417,"BRUTON, HENRY, DAVID",237 WHITE ST STE 1 JACKSONVILLE NC,067,Onslow,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 145 , 221 , 411 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003853821,"BAHNER, DON, ROBERT",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 94 , 100 , 155 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1003854308,"VINSON, SHARON, LEE",1919 S 16TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003854308,"VINSON, SHARON, LEE",1919 S 16TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1003854308,"VINSON, SHARON, LEE",1919 S 16TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003854860,"PICKETT, MARCIE, LYNNE",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003854860,"PICKETT, MARCIE, LYNNE",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003854860,"PICKETT, MARCIE, LYNNE",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003854860,"PICKETT, MARCIE, LYNNE",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003854860,"PICKETT, MARCIE, LYNNE",2015 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003855578,"DACH, BRIAN, WAYNE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003859943,"MORAN, MARCIA, LILIANA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003859943,"MORAN, MARCIA, LILIANA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 64 , 115 ,$#,,
MEDICAID DIRECT,1003860917,SURGERY CENTER OF PINEHURST LLC,SURGERY CENTER OF PINEHURST LLC,10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1003860917,SURGERY CENTER OF PINEHURST LLC,10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 77 , 86 , 120 ," $35,549.99 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003860990,"TILLES, STEVEN, JOSEPH",1814 WESTCHESTER DR STE 300 HIGH POINT NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 132 , 199 , 249 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003860990,"TILLES, STEVEN, JOSEPH",601 N ELM ST   HIGH POINT NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1003861709,"HOPE, PHYLLIS, RHIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 43 , 46 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1003861840,"HUCKABEE, JOANNA, NORDLANDER",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1003861840,"HUCKABEE, JOANNA, NORDLANDER",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1003861840,"HUCKABEE, JOANNA, NORDLANDER",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1003862152,"FRYER, MARGARET, ANNE MARSDEN",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003862574,"SITHER, WILLIAM, THOMPSON",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 29 , 40 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1003862574,"SITHER, WILLIAM, THOMPSON",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 52 , 62 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,,,Unknown,193200000X,Group,Multi-Specialty,,1003862574,"SITHER, WILLIAM, THOMPSON",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003862608,"MELONE, HEIDI, SUSAN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003863689,SILER CITY PHARMACY LLC,~,202 E RALEIGH ST STE A SILER CITY NC,019,Chatham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1003863689,SILER CITY PHARMACY LLC,202 E RALEIGH ST STE A SILER CITY NC,019,Chatham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1003863689,SILER CITY PHARMACY LLC,~,202 E RALEIGH ST STE A SILER CITY NC,019,Chatham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1003863689,SILER CITY PHARMACY LLC,202 E RALEIGH ST STE A SILER CITY NC,019,Chatham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003864521,"DAVIS, LANCE, LEE",50 HOSPITAL DR STE 1B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003864521,"DAVIS, LANCE, LEE",50 HOSPITAL DR STE 1B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 40 , 54 ,$#,,
MEDICAID DIRECT,1932661246,RALEIGH DURHAM MEDICAL GROUP PA,HEALTHPARK PEDIATRICS,8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003866211,"FLANNELLY, CHRISTINA, MARIE",8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 19 , 39 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003866427,"BOARDMAN, LYNN, AMY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 34 , 35 , 38 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003866427,"BOARDMAN, LYNN, AMY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003866591,"BARRICK, BRIAN, PATRICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 46 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003867011,"ERSKINE BAUER, LINDA, LEE",10207 CERNY ST   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003867011,"ERSKINE BAUER, LINDA, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003867011,"ERSKINE BAUER, LINDA, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1003867334,"FALANA, BABAJIDE, OLUKAYODE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992754311,MEADOWS LUTCACAGE SMITH VINTON FIDL,Meadows Schaberg Lutcacage DBA Drs Lutcavage & Fi,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1003867524,"FIDLER JR, JOHN, EDWIN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003867524,"FIDLER JR, JOHN, EDWIN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 49 , 51 , 139 ," $12,608.33 ",,
MEDICAID DIRECT,1992754311,MEADOWS LUTCACAGE SMITH VINTON FIDL,Meadows Schaberg Lutcacage DBA Drs Lutcavage & Fi,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1003867524,"FIDLER JR, JOHN, EDWIN",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 52 , 57 , 158 ," $18,184.88 ",,
MEDICAID DIRECT,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",~,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1003867524,"FIDLER JR, JOHN, EDWIN",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 41 ,$#,,
MEDICAID DIRECT,1992754311,MEADOWS LUTCACAGE SMITH VINTON FIDL,Meadows Schaberg Lutcacage DBA Drs Lutcavage & Fi,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1003867524,"FIDLER JR, JOHN, EDWIN",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223P0106X,Dental Providers,Dentist,Oral and Maxillofacial Pathology,#,#,#,$#,,
MEDICAID DIRECT,1043773427,"CANNON, DARRIEL, JOSEPH",,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1003867524,"FIDLER JR, JOHN, EDWIN",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1003867524,"FIDLER JR, JOHN, EDWIN",~,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1003867524,"FIDLER JR, JOHN, EDWIN",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 38 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003867789,"HASELDEN, LISA, SHERMAN",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003867839,"JACOB, SHIBIN, THOMAS",101 E WT HARRIS BLVD STE 5101 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 56 , 97 , 131 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003867839,"JACOB, SHIBIN, THOMAS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 22 , 22 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003867839,"JACOB, SHIBIN, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 21 , 32 ,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003868761,"PUTNAM JR, HARVEY, WILLIS",3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3112 CASEY ST UNIT A LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003868761,"PUTNAM JR, HARVEY, WILLIS",3112 CASEY ST UNIT A LORIS SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 39 , 53 ,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003868761,"PUTNAM JR, HARVEY, WILLIS",3112 CASEY ST UNIT A LORIS SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003868761,"PUTNAM JR, HARVEY, WILLIS",115 MCLEOD HEALTH BLVD BLDG 3 MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003868761,"PUTNAM JR, HARVEY, WILLIS",101 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1003868761,"PUTNAM JR, HARVEY, WILLIS",101 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003868985,"NOBLIN, SHANNON, NOELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003868985,"NOBLIN, SHANNON, NOELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003869371,"BRAZINSKI, MARK, STEVEN",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003869371,"BRAZINSKI, MARK, STEVEN",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 62 , 109 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003869413,"SHERRILL, GARY, BRADLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003869413,"SHERRILL, GARY, BRADLEY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003869413,"SHERRILL, GARY, BRADLEY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 108 , 108 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 97 , 120 , 128 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,312 WARREN AVE   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1304 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",1303 HEALTH DR   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,225 WHITE ST   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 295 , 390 , 408 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 29 , 29 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1304 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1003869819,"KRISHNARAJ, RAMESH, L",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003870072,BRAVEHEART MEDICAL TRANSPORT LLC,Braveheart Medical Transport LLC,114 JOHN ST   LAURINBURG NC,083,Scotland,3416L0300X,Transportation Services,Ambulance,Land Transport,1003870072,BRAVEHEART MEDICAL TRANSPORT LLC,114 JOHN ST   LAURINBURG NC,083,Scotland,3416L0300X,Transportation Services,Ambulance,Land Transport, 120 , 445 , 634 ," $97,570.12 ",,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003870171,"MANNING, KENNETH, RUSSELL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 159 , 313 , 313 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003870593,"POCIASK, STEPHEN, BRYAN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,,,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003874348,"CAULDER, RACHEL, BOWEN",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003874538,"PAGANO, RICHARD, RALPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 55 , 61 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003875170,"SAUVAGER, JOYCE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003875170,"SAUVAGER, JOYCE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700848645,ROCKINGHAM INTERNAL MEDICINE ASSOCI,ROCKINGHAM INTERNAL MEDICINE ASSOCIATES,507 HIGHLAND PARK DR   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1003876871,"HASANAJ, XAJE, ADEM",507 HIGHLAND PARK DR   EDEN NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 195 , 502 , 667 ," $18,173.69 ",,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1003876913,"RAMIREZ, NORMA, ZEPEDA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 13 ,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1003876913,"RAMIREZ, NORMA, ZEPEDA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 13 , 32 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1003877218,"WASHINGTON, TONI, ANNE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 36 , 47 ,$#,,
MEDICAID DIRECT,1447925987,LEGACY RECOVERY AND WELLNESS,,558 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1003877275,"WHEELER, LISA, KLAVENESS",840 FLEMING ST STE 1 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 30 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003877655,"UPDYKE, RALPH, DENTON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003877655,"UPDYKE, RALPH, DENTON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 38 , 41 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003877655,"UPDYKE, RALPH, DENTON",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003878919,"WARD, SIMON, VIVIAN",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003878919,"WARD, SIMON, VIVIAN",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003878919,"WARD, SIMON, VIVIAN",14215 BALLANTYNE CORPORATE PL STE 110 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003878919,"WARD, SIMON, VIVIAN",1918 RANDOLPH RD STE 740 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003878919,"WARD, SIMON, VIVIAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114960069,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH DERMATOLOGY ASSOCIATES,1450 MATTHEWS TOWNSHIP PKWY STE 355 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003880121,"DORENFELD, DAVID, JONATHAN",1450 MATTHEWS TOWNSHIP PKWY STE 170 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003880121,"DORENFELD, DAVID, JONATHAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114960069,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH DERMATOLOGY ASSOCIATES,,,Unknown,193200000X,Group,Multi-Specialty,,1003880121,"DORENFELD, DAVID, JONATHAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003880121,"DORENFELD, DAVID, JONATHAN",1401 MATTHEWS TOWNSHIP PKWY STE 220 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 28 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003880121,"DORENFELD, DAVID, JONATHAN",1450 MATTHEWS TOWNSHIP PKWY STE 355 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 44 , 61 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1003880873,"SHELTON, SUSAN, ELIZABETH",1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1003883877,PATHOLOGIST DIAGNOSTIC LABORATORY P,~,1800 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,291U00000X,Laboratories,Clinical Medical Laboratory,,1003883877,PATHOLOGIST DIAGNOSTIC LABORATORY P,1800 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1003884503,"LEAP, KEITH, EDWIN",3990 US HIGHWAY 64 EAST ALTERNATE   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003884693,"PICCINI, JONATHAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003884693,"PICCINI, JONATHAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 17 , 22 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1003884693,"PICCINI, JONATHAN, PAUL",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 26 , 31 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003884693,"PICCINI, JONATHAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003884883,"COLLINS, EMMA, MAUREEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,2704 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003884883,"COLLINS, EMMA, MAUREEN",2704 HENRY ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003884883,"COLLINS, EMMA, MAUREEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003887159,"HINSON, TONY, RAY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003887159,"HINSON, TONY, RAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003887159,"HINSON, TONY, RAY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1003887159,"HINSON, TONY, RAY",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003887449,"PANNETON, JEAN, MICHEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003887860,"GIPE, STACEY, BUTLER",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 85 , 161 , 202 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003889965,"ROACH, PAULA, BETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890070,"MARTIN, DAVID, FRANKLIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890302,"CHILES, CAROLINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 214 , 253 , 266 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890302,"CHILES, CAROLINE",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890302,"CHILES, CAROLINE",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging,#,,,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890302,"CHILES, CAROLINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890302,"CHILES, CAROLINE",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890302,"CHILES, CAROLINE",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003890492,"WINSLOW, JAMES, ELBERT",MEDICAL CEMTER BLVD   WINSTON SALEM NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 64 , 69 , 80 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003891094,"BRANN, OSCAR, SVEN",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003891532,"STOPYRA, JASON, PATRICK",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1003891532,"STOPYRA, JASON, PATRICK",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003892365,"HOLCZER, DOUGLAS, JOSEPH",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1003892365,"HOLCZER, DOUGLAS, JOSEPH",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1003892365,"HOLCZER, DOUGLAS, JOSEPH",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1003892522,"SEIFERT, BRENT, WILLIAMS",611 MOCKSVILLE AVE ROWAN DIAGNOSTIC CLINIC SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 157 , 539 , 854 ," $13,257.82 ",,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003892928,"GREENBERG, ODED",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1003892928,"GREENBERG, ODED",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1003892928,"GREENBERG, ODED",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003893629,"WATERS, GREGORY, STIEGLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 51 , 92 , 97 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 50 , 50 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",2833 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",2833 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3411 W MILLBROOK RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 39 , 155 , 155 ," $16,985.58 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 98 , 98 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",2700 LEIGHTON RIDGE DR   WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 12 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003894056,"CASEY, MICHAEL, JOSEPH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 37 , 60 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1003894742,"BURGOS-VIERA, NELSON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255683157,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS PEDIATRICS,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003894890,"VALLIANI, MAQSOOD, AHMED",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 45 , 107 ,$#,,
MEDICAID DIRECT,1003896879,"LIVENGOOD, MICHAEL, ADAM",MOUNT OLIVE PHYSICAL THERAPY,232 SMITH CHAPEL RD   MOUNT OLIVE NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1003896879,"LIVENGOOD, MICHAEL, ADAM",232 SMITH CHAPEL RD   MOUNT OLIVE NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1841328390,MOUNT OLIVE PHYSICAL THERAPY,,232 SMITH CHAPEL RD   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1003896879,"LIVENGOOD, MICHAEL, ADAM",232 SMITH CHAPEL RD   MOUNT OLIVE NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 39 , 54 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1003897042,"MITCHELL, PHILIP, KEITH",116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003897042,"MITCHELL, PHILIP, KEITH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003897042,"MITCHELL, PHILIP, KEITH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1003898107,"MCLEOD, JULIAN, EUGENE CHRISTOPHER",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003899014,"ERDIE-LALENA, CHRISTINE, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 35 , 79 ," $15,490.27 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003899014,"ERDIE-LALENA, CHRISTINE, ROSE",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1003899014,"ERDIE-LALENA, CHRISTINE, ROSE",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics," 1,215 "," 7,690 "," 8,358 "," $561,521.33 ",,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,1212 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003899766,"EDGE, MARK, THOMAS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003899766,"EDGE, MARK, THOMAS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 179 , 190 , 232 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003899766,"EDGE, MARK, THOMAS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085U0001X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Ultrasound,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003899766,"EDGE, MARK, THOMAS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 138 , 157 , 205 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003899766,"EDGE, MARK, THOMAS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346624590,KIDZCARE PEDIATRICS PC,,1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1003903493,"HILL, DAVID, LLOYD",1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1003903493,"HILL, DAVID, LLOYD",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003903493,"HILL, DAVID, LLOYD",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1003903493,"HILL, DAVID, LLOYD",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003904129,"LAWRENCE, RYA, ELISABETH",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 38 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003904129,"LAWRENCE, RYA, ELISABETH",1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003904129,"LAWRENCE, RYA, ELISABETH",8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003904129,"LAWRENCE, RYA, ELISABETH",5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 37 , 83 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1003904731,"PIVEN, JOSEPH",100 RENEE LYNN CT   CARRBORO NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,1900 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003906140,"HUNDLEY, WILLIAM, ROBERT",1900 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,598 RIVER HWY SPC 4-B MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1003906140,"HUNDLEY, WILLIAM, ROBERT",598 RIVER HWY SPC 4-B MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003906140,"HUNDLEY, WILLIAM, ROBERT",3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,8455 PIT STOP CT NW STE 125 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1003906140,"HUNDLEY, WILLIAM, ROBERT",3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003906579,"KUMAR, PRIYA, AJIT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1003906751,"PATEL, ALPESH",2210 HEMBY LN   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 47 , 52 , 67 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003906751,"PATEL, ALPESH",2210 HEMBY LN   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003906751,"PATEL, ALPESH",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 23 , 38 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1003906751,"PATEL, ALPESH",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 54 , 75 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003908344,"JOHNSTON, BARBARA",414 E MAIN ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003909169,"SENFT, JAMES, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003909169,"SENFT, JAMES, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003911942,FAMILY MEDICAL SUPPLY LLC,~,4600 MAIN ST STE 12 SHALLOTTE NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1003911942,FAMILY MEDICAL SUPPLY LLC,4600 MAIN ST STE 12 SHALLOTTE NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 265 ," 1,432 "," 2,238 "," $49,476.81 ",,
MEDICAID DIRECT,1003911942,FAMILY MEDICAL SUPPLY LLC,~,4600 MAIN ST STE 12 SHALLOTTE NC,010,Brunswick,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1003911942,FAMILY MEDICAL SUPPLY LLC,4600 MAIN ST STE 12 SHALLOTTE NC,010,Brunswick,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1003912395,"HODOS, MICHAEL, JON",833 WAKE FOREST BUSINESS PARK STE C WAKE FOREST NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 73 , 192 , 298 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1003912395,"HODOS, MICHAEL, JON",833 WAKE FOREST BUSINESS PARK STE C WAKE FOREST NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 19 , 20 , 27 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003913021,"EHRHART, TROY, JUSTIN",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 24 , 31 ,$#,,
MEDICAID DIRECT,1477692606,COUNTY OF ONSLOW,ONSLOW COUNTY HEALTH DEPARTMENT,612 COLLEGE ST   JACKSONVILLE NC,067,Onslow,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1003913021,"EHRHART, TROY, JUSTIN",612 COLLEGE ST   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 396 , 545 ," 1,251 "," $42,969.42 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1003913021,"EHRHART, TROY, JUSTIN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 18 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003915885,"MINCHEW, JOE, TOMMY",120 E CARVER ST   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003915885,"MINCHEW, JOE, TOMMY",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003915885,"MINCHEW, JOE, TOMMY",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003919788,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07512,4553 MAIN ST   SHALLOTTE NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1003919788,NORTH CAROLINA CVS PHARMACY LLC,4553 MAIN ST   SHALLOTTE NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1003919788,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07512,4553 MAIN ST   SHALLOTTE NC,010,Brunswick,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1003919788,NORTH CAROLINA CVS PHARMACY LLC,4553 MAIN ST   SHALLOTTE NC,010,Brunswick,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003923004,"REED, JENNIFER, MASDEN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1003923004,"REED, JENNIFER, MASDEN",6251 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1003923814,"RESTELLI, EVAN, RYAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 30 , 34 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1003923814,"RESTELLI, EVAN, RYAN",2604 DR MARTIN LUTHER KING JR BLVD STE B NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1003923814,"RESTELLI, EVAN, RYAN",2117 S GLENBURNIE RD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1003923814,"RESTELLI, EVAN, RYAN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 85 , 146 , 270 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003929803,"HAWBLITZEL YARNALL, KIMBERLY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 12 , 36 ,$#,,
MEDICAID DIRECT,1104845270,PEDIATRIC DENTISTRY OF MATTHEWS,~,1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003929860,"GOODMAN, SCOTT",1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 21 , 21 , 75 ,$#,,
MEDICAID DIRECT,1568624344,PEDIATRIC DENTISTRY OF STEELE CREEK,STEELE CREEK PEDIATRIC DENTISTRY,13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003929860,"GOODMAN, SCOTT",13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003929860,"GOODMAN, SCOTT",1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003932971,"WILSON DURHAM, ELIZABETH, OLUDAYO",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003932971,"WILSON DURHAM, ELIZABETH, OLUDAYO",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003934951,"CHAPMAN, DONALD, SHELTON",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003935750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003935750,GASTON FAMILY HEALTH SERVICES INC,119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003936295,"BAXLEY, JENNIFER, CARMACK",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 29 , 46 ,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1003936295,"BAXLEY, JENNIFER, CARMACK",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003936295,"BAXLEY, JENNIFER, CARMACK",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003936295,"BAXLEY, JENNIFER, CARMACK",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003936295,"BAXLEY, JENNIFER, CARMACK",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003937079,"KASTEN, KEVIN, RICHARD",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003937079,"KASTEN, KEVIN, RICHARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003937079,"KASTEN, KEVIN, RICHARD",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003937079,"KASTEN, KEVIN, RICHARD",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003937079,"KASTEN, KEVIN, RICHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 25 , 25 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003937079,"KASTEN, KEVIN, RICHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003939117,"DUNCAN, GRAHAM, SHAW",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 35 , 81 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1003939117,"DUNCAN, GRAHAM, SHAW",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003940313,ACTION HEALTH STAFFING,ACTION HEALTH STAFFING INC,609 COUNTRY CLUB DR STE A GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1003940313,ACTION HEALTH STAFFING,609 COUNTRY CLUB DR STE A GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 401 , 401 ," $24,287.00 ",,
MEDICAID DIRECT,1003940933,JAESAN PC,SPEECHWORKS THERAPY SERVICES,3116 MILTON RD STE F CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003940933,JAESAN PC,3116 MILTON RD STE F CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 82 ," 2,284 "," 2,318 "," $153,900.77 ",,
MEDICAID DIRECT,1003941097,BAPTIST CHILDRENS HOME OF NC INC,STEGALL HOME,7820 HIGHWAY 74 E   MARSHVILLE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003941097,BAPTIST CHILDRENS HOME OF NC INC,7820 HIGHWAY 74 E   MARSHVILLE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 324 , 324 ," $17,051.56 ",,
MEDICAID DIRECT,1083345664,LANE AND ASSOCIATES XLVII DDS PA,,515 S CASWELL ST   LA GRANGE NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1003941899,"DENTON, KENT, SWINDELL",515 S CASWELL ST   LA GRANGE NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice," 1,483 "," 2,671 "," 8,868 "," $437,985.73 ",,
MEDICAID DIRECT,1659642395,LANE AND ASSOCIATES XXV DDS PA,,1117 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1003941899,"DENTON, KENT, SWINDELL",515 S CASWELL ST   LA GRANGE NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1083756571,COUNTY OF CALDWELL,~,2345 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1003942483,"PICTON, JOHN, MARK",2345 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 110 , 236 , 386 ," $18,533.69 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003944398,"HILINSKI, BENJAMIN, JANEK PARRILL",75A LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003946393,"AKINOLA, MODUPEOLA, OLUWATOYIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 59 , 59 ," $11,737.46 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1003946724,"SPEIGHT, MARCY, SUE",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1003946724,"SPEIGHT, MARCY, SUE",400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003947516,"TENDLER, AMY, BETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003947516,"TENDLER, AMY, BETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003949223,YELTON & ASSOCIATES,~,160 HEALTH CARE DR   RUTHERFORDTON NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1003949223,YELTON & ASSOCIATES,160 HEALTH CARE DR   RUTHERFORDTON NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 13 ," 3,084 "," 3,084 "," $201,970.68 ",,
MEDICAID DIRECT,1619099256,FAMILY MEDICAL ASSOCS OF RALEIGH,,3500 BUSH ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1003949595,"FLICK, CONRAD, LLOYD",3500 BUSH ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 48 , 71 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1003949843,"MARKHAM, DEANNA, GAY",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 90 , 167 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1003949843,"MARKHAM, DEANNA, GAY",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 23 ,$#,,
MEDICAID DIRECT,1003950585,PACIFIC TOXICOLOGY LABORATORIES,PACIFIC TOXICOLOGY LABORATORIES,9348 DE SOTO AVE   CHATSWORTH CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1003950585,PACIFIC TOXICOLOGY LABORATORIES,9348 DE SOTO AVE   CHATSWORTH CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 20 , 40 , 40 ,$#,,
MEDICAID DIRECT,1003950916,"GOSU, UMA, KALANI",,7904 WILBY HOLLOW DR   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1003950916,"GOSU, UMA, KALANI",7904 WILBY HOLLOW DR   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 46 , 404 , 405 ," $30,625.62 ",,
MEDICAID DIRECT,1457913006,CAROMONT MEDICAL GROUP INC,CAROMONT FOOT AND ANKLE,2391 COURT DR STE 100 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1003954553,"CANE, LAURENCE, ZACHARY",2391 COURT DR STE 100 GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457913006,CAROMONT MEDICAL GROUP INC,CAROMONT FOOT AND ANKLE,2391 COURT DR STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003954553,"CANE, LAURENCE, ZACHARY",2391 COURT DR STE 100 GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 86 , 144 , 202 ,$#,,
MEDICAID DIRECT,1457913006,CAROMONT MEDICAL GROUP INC,CAROMONT FOOT AND ANKLE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003954553,"CANE, LAURENCE, ZACHARY",2525 COURT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 21 , 44 , 62 ,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1003955402,"LAMERS, CHRISTOPHER, MICHAEL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1003958620,"PERRY, EVERETT, LAVERN",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 86 , 88 , 115 ,$#,,
MEDICAID DIRECT,1700119534,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,,,Unknown,193400000X,Group,Single Specialty,,1003960121,"ASRANI, SANJAY, GIRDHARI",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2000 REGENCY PKWY   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003960121,"ASRANI, SANJAY, GIRDHARI",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 16 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003960121,"ASRANI, SANJAY, GIRDHARI",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003960667,"RANSOM, DONNA",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003960667,"RANSOM, DONNA",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447214242,TRIANGLE PEDIATRIC CENTER,TRIANGLE PEDIATRIC CENTER,105 RIDGE VIEW DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1003963166,"BANKS, KATHRYN, VICTORIA",105 RIDGE VIEW DR   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1861626723,EASTPOINT PROSTHEICS AND ORTHOTICS,EASTPOINT PROSTHETICS & ORTHOTICS INC,310 AIRPORT RD   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1003964867,"SUGG, MITCHEL, PAUL",310 AIRPORT RD   KINSTON NC,054,Lenoir,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#, 11 , 110 ,$#,,
MEDICAID DIRECT,1861626723,EASTPOINT PROSTHEICS AND ORTHOTICS,EASTPOINT PROSTHETICS & ORTHOTICS INC,310 AIRPORT RD   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1003964867,"SUGG, MITCHEL, PAUL",310 AIRPORT RD   KINSTON NC,054,Lenoir,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 20 , 21 , 64 ,$#,,
MEDICAID DIRECT,1528316239,EASTPOINT PROSTHEICS AND ORTHOTICS,~,11030 RAVEN RIDGE RD STE 109 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1003964867,"SUGG, MITCHEL, PAUL",310 AIRPORT RD   KINSTON NC,054,Lenoir,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1003966789,TRI CITY OPTOMETRIC PA,~,337 N MAIN ST   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1003966789,TRI CITY OPTOMETRIC PA,337 N MAIN ST   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,, 226 , 226 , 450 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003967910,"BECKER, DAVID, LOWELL",1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 26 , 42 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003967910,"BECKER, DAVID, LOWELL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 31 , 52 ,$#,,
MEDICAID DIRECT,1003968603,WILSON COUNTY SCHOOLS,WILSON COUNTY SCHOOLS,117 TARBORO ST NE   WILSON NC,098,Wilson,251300000X,Agencies,Local Education Agency (LEA),,1003968603,WILSON COUNTY SCHOOLS,117 TARBORO ST NE   WILSON NC,098,Wilson,251300000X,Agencies,Local Education Agency (LEA),, 411 ," 7,122 "," 7,381 "," $323,036.53 ",,
MEDICAID DIRECT,1659777282,STEPHEN KNOWLTON MD,~,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1003969874,"KNOWLTON, STEPHEN, DANA",601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 69 , 70 ,$#,,
MEDICAID DIRECT,1003969874,"KNOWLTON, STEPHEN, DANA",~,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1003969874,"KNOWLTON, STEPHEN, DANA",601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 24 , 25 ,$#,,
MEDICAID DIRECT,1083886345,SKIP TYSON DDS & STEPHANIE HEANEY D,SKIP TYSON DDS AND STEPHANIE HEANEY DDS PA,2606 IRON GATE DR STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1003970534,"TYSON IV, CHESTER, JULIAN",2606 IRON GATE DR STE 200 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 261 , 386 ," 1,286 "," $55,180.69 ",,
MEDICAID DIRECT,1003974973,HOME LIFE CARE INC,~,300 VIRGINIA RD STE F EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,,1003974973,HOME LIFE CARE INC,300 VIRGINIA RD STE F EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,, 110 ," 19,438 "," 19,488 "," $1,725,110.08 ",,
MEDICAID DIRECT,1861557068,CAROLINA KIDNEY AND VASCULAR PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1003975285,"DUNMIRE, ROBERT, BRADEN",2809 MCLAMB PL   GOLDSBORO NC,096,Wayne,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1003976564,"CRETA, MICHAEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 32 , 32 ," $12,064.00 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1003976564,"CRETA, MICHAEL",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 90 , 156 , 260 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1003976564,"CRETA, MICHAEL",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 96 , 178 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003979063,"KANTOR, JEFFREY, LAWRENCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003979063,"KANTOR, JEFFREY, LAWRENCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003979063,"KANTOR, JEFFREY, LAWRENCE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003979063,"KANTOR, JEFFREY, LAWRENCE",1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003979063,"KANTOR, JEFFREY, LAWRENCE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 16 , 18 , 20 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003979063,"KANTOR, JEFFREY, LAWRENCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003982695,"MORGAN, MICHAEL, RICHARD",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 47 , 86 , 113 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003982695,"MORGAN, MICHAEL, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 44 , 150 , 165 ,$#,,
MEDICAID DIRECT,1194873901,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INFECTIOUS DISEASE SPECIALISTS,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003982695,"MORGAN, MICHAEL, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003982695,"MORGAN, MICHAEL, RICHARD",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194873901,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INFECTIOUS DISEASE SPECIALISTS,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003982695,"MORGAN, MICHAEL, RICHARD",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,,,$#,,
MEDICAID DIRECT,1003984865,APPALACHIAN HOME CARE LLC,~,7883 NC HIGHWAY 105 S UNIT E BOONE NC,095,Watauga,253Z00000X,Agencies,In Home Supportive Care,,1003984865,APPALACHIAN HOME CARE LLC,7883 NC HIGHWAY 105 S UNIT E BOONE NC,095,Watauga,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,812 "," 1,874 "," $266,859.00 ",,
MEDICAID DIRECT,1003985474,HAPPY HOMECARE STAFFING INC,,201 MOUNT WILLING RD   EFLAND NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,1003985474,HAPPY HOMECARE STAFFING INC,201 MOUNT WILLING RD   EFLAND NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,#, 544 , 544 ," $37,977.12 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003990912,"LIN, SHU, SHIUH-SHIEU",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003990912,"LIN, SHU, SHIUH-SHIEU",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003990912,"LIN, SHU, SHIUH-SHIEU",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003990995,"ORTEL, THOMAS, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 44 , 46 , 64 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003991548,"JAMES, FELICE, ANAIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 33 ,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003991548,"JAMES, FELICE, ANAIS",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 97 , 101 ,$#,,
MEDICAID DIRECT,1073034625,CENTERWELL SENIOR PRIMARY CARE NC P,CENTERWELL SENIOR PRIMARY CARE NC PC,2910 E FRANKLIN BLVD # 1 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1003992058,"SHEPARD, SUSANNA, MARIE",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003992058,"SHEPARD, SUSANNA, MARIE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1003992058,"SHEPARD, SUSANNA, MARIE",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",3475 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1003992884,"RIBOH, MYRIAM, DANIELLE",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003992900,"ROSBRUGH, MELISSA, HARRISON",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003992900,"ROSBRUGH, MELISSA, HARRISON",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 42 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1003992900,"ROSBRUGH, MELISSA, HARRISON",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1003992900,"ROSBRUGH, MELISSA, HARRISON",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1003992900,"ROSBRUGH, MELISSA, HARRISON",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003993197,DIVINE HEALTHCARE INC,DIVINE HEALTHCAREINC,1001 NAVAHO DR STE 203B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1003993197,DIVINE HEALTHCARE INC,1001 NAVAHO DR STE 203B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,956 "," 5,125 "," $673,078.25 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1003994286,"STOUFFER III, GEORGE, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003994286,"STOUFFER III, GEORGE, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 50 , 72 , 115 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1003998287,"BOCANEGRA, NEPTALI, RUBEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1003999780,"ERLACHER, GRAHAM, HENRY",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1003999780,"ERLACHER, GRAHAM, HENRY",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 32 , 38 ,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013000173,"RAYALA, CHRISTOPHER, ZAGUIRRE",150 E DAVIE ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 76 , 83 ,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013000173,"RAYALA, CHRISTOPHER, ZAGUIRRE",101 MAYNARD CROSSING CT   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1013001924,"ZAHREBELSKI, GEORGE",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1013003037,"DAY JR, EUGENE, DAVIS",104 NEW COLLEGE ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 50 , 50 ," $13,773.72 ",,
MEDICAID DIRECT,1609058601,EUGENE DAVIS DAY MD PA,EUGENE DAVIS DAY MD PA,104 NEW COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1013003037,"DAY JR, EUGENE, DAVIS",104 NEW COLLEGE ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 111 , 287 , 371 ," $10,412.87 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013003094,"GULLEY, MARGARET, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1013004910,AUSTIN ADULT CARE,AUSTIN ADULT CARE,511 BUMGARNER INDUSTRIAL DR SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013004910,AUSTIN ADULT CARE,511 BUMGARNER INDUSTRIAL DR SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 23 ," 4,054 "," 4,054 "," $283,421.65 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013005701,"VAN BOURGONDIEN, MARY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1013008036,"KOONTZ, WAYNE, CARSON",129 WOODSON ST   SALISBURY NC,080,Rowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013008044,"COLEMAN, TANA, M",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013008218,"KATZ, MARK, JAY",MARK JAY KATZ,2018 NEW GARDEN RD STE A GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1013008218,"KATZ, MARK, JAY",2018 NEW GARDEN RD STE A GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1013008234,CLEMMONS VILLAGE I LLC,CLEMMONS VILLAGE I,6401 HOLDER RD   CLEMMONS NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013008234,CLEMMONS VILLAGE I LLC,6401 HOLDER RD   CLEMMONS NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 14 ," 3,512 "," 3,512 "," $351,410.18 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013008523,"BELGADO, MONICA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1013008523,"BELGADO, MONICA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1013008523,"BELGADO, MONICA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013008523,"BELGADO, MONICA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013008705,"KITCHEN, MICHAEL, STEVEN",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104202761,VANDERBILT UNIVERSITY MEDICAL CENTE,VANDERBILT MEDICAL GROUP,3601 THE VANDERBILT CLINIC   NASHVILLE TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1013009448,"FLEISCHER, ARTHUR, CARROLL",3601 THE VANDERBILT CLINIC   NASHVILLE TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013010701,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07055,109 DABNEY DR   HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1013010701,NORTH CAROLINA CVS PHARMACY LLC,109 DABNEY DR   HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1013010701,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07055,109 DABNEY DR   HENDERSON NC,091,Vance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1013010701,NORTH CAROLINA CVS PHARMACY LLC,109 DABNEY DR   HENDERSON NC,091,Vance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1013011782,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04202,1830 W DIXON BLVD   SHELBY NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1013011782,NORTH CAROLINA CVS PHARMACY LLC,1830 W DIXON BLVD   SHELBY NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1013011782,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04202,1830 W DIXON BLVD   SHELBY NC,023,Cleveland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1013011782,NORTH CAROLINA CVS PHARMACY LLC,1830 W DIXON BLVD   SHELBY NC,023,Cleveland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1013013556,"RAY, JEFFREY, ALLEN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1013013556,"RAY, JEFFREY, ALLEN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1013013556,"RAY, JEFFREY, ALLEN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 19 , 30 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1013013556,"RAY, JEFFREY, ALLEN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,3107 BRASSFIELD RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013013762,"PESCI, CORIN, ALYSIA",1587 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1210 CENTRAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1013013762,"PESCI, CORIN, ALYSIA",1210 CENTRAL DR   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1013013762,"PESCI, CORIN, ALYSIA",1210 CENTRAL DR   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013013762,"PESCI, CORIN, ALYSIA",1587 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,2874 WARD BLVD   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1013013762,"PESCI, CORIN, ALYSIA",1587 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013013762,"PESCI, CORIN, ALYSIA",1587 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 62 , 76 ,$#,,
MEDICAID DIRECT,1013014588,"ALFORD, CLARENCE, ARTHUR",~,3902 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1013014588,"ALFORD, CLARENCE, ARTHUR",3902 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 55 , 110 , 297 ," $14,295.79 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013017540,"D SILVA, MARISA, ROMILDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 25 , 40 ,$#,,
MEDICAID DIRECT,1366588212,PRIVATE DIAGNOSTIC CLINIC PLLC,GENERAL INTERNAL MEDICINE,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013017540,"D SILVA, MARISA, ROMILDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013017540,"D SILVA, MARISA, ROMILDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 11 , 20 , 20 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 31 , 32 , 35 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013017748,"PERVEZ, ADNAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013018159,"CROSBY, KENNETH, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 23 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013018159,"CROSBY, KENNETH, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1013018159,"CROSBY, KENNETH, LEE",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 34 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013018159,"CROSBY, KENNETH, LEE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013018761,"MATHAPATI, SHAKUNTALA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 261 , 261 ," $15,052.67 ",,
MEDICAID DIRECT,1013019470,"AVBUERE, EDWIN, AZIEGBE",ALPHA CLINICS PA,3231 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1013019470,"AVBUERE, EDWIN, AZIEGBE",3231 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 319 , 743 ," 2,871 "," $23,430.99 ",,
MEDICAID DIRECT,1326364837,ALPHA CLINICS PA,~,3231 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013019470,"AVBUERE, EDWIN, AZIEGBE",2325 RANDLEMAN RD   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 52 , 116 ,$#,,
MEDICAID DIRECT,1326364837,ALPHA CLINICS PA,~,3231 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013019470,"AVBUERE, EDWIN, AZIEGBE",3231 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 284 , 577 ," 1,508 "," $23,202.63 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013020775,"MOORE, RUCHI, PATEL",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013020775,"MOORE, RUCHI, PATEL",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528559671,BLADEN HEALTHCARE LLC,CFV BLADEN MEDICAL ASSOCIATES-WHITE LAKE,273 WHITE LAKE DR   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013020882,"BYRD, TEMPLE, BRITT",273 WHITE LAKE DR   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699206649,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE CLINTON,606 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1013020882,"BYRD, TEMPLE, BRITT",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 24 , 47 ,$#,,
MEDICAID DIRECT,1699206649,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE CLINTON,606 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1013020882,"BYRD, TEMPLE, BRITT",606 BEAMAN ST   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 148 , 243 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013024124,"ALFORD, KRISTEN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1033521836,BERTRAND A BONNICK DDS PLLC,WALNUT COVE DENTAL ASSOCIATES,1218 N MAIN ST   WALNUT COVE NC,085,Stokes,193400000X,Group,Single Specialty,,1013025352,"MABE, TIM",1218 N MAIN ST   WALNUT COVE NC,085,Stokes,1223G0001X,Dental Providers,Dentist,General Practice, 251 , 430 ," 1,309 "," $71,123.89 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013026152,"PRICE, ELLEN, BARBOUR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013026152,"PRICE, ELLEN, BARBOUR",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013026152,"PRICE, ELLEN, BARBOUR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801126479,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST UROLOGY,144 POOLE RD STE 102 LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1013031996,"MCCARTHY, ROC, ALAN",320 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 33 , 47 , 63 ,$#,,
MEDICAID DIRECT,1801126479,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST UROLOGY,144 POOLE RD STE 102 LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1013031996,"MCCARTHY, ROC, ALAN",144 POOLE RD STE 102 LELAND NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,, 51 , 73 , 97 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013034727,"PATEL, JAY",309 NEW ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 202 , 438 , 591 ," $16,993.27 ",,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013034727,"PATEL, JAY",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013037316,"ATKIN, SUSAN, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 27 , 32 ,$#,,
MEDICAID DIRECT,1114143542,NC DHHS CHILD AND FAMILY WELL-BEING,MORGANTON HICKORY CDSA,145 W PARKER RD STE A MORGANTON NC,012,Burke,252Y00000X,Agencies,Early Intervention Provider Agency,,1013040104,"BROWN, CANDACE, COOPER",145 W PARKER RD STE A MORGANTON NC,012,Burke,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 83 , 86 , 154 ," $20,202.68 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013040666,"WALLACE, SHANA, DALE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1366409492,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC NEUROLOGY AND SLEEP - RAND,1900 RANDOLPH RD STE 1010 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013040666,"WALLACE, SHANA, DALE",1900 RANDOLPH RD STE 1010 CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013040666,"WALLACE, SHANA, DALE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 14 , 26 , 33 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013040666,"WALLACE, SHANA, DALE",1900 RANDOLPH RD STE 1010 CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 79 , 126 , 142 ,$#,,
MEDICAID DIRECT,1245895697,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OUTPATIENT BEHAVIORAL HEALTH,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013043447,"POLITTE, LAURA, CATHERINE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013045525,"PATEL, NILESH, KANTILAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 119 , 127 , 169 ," $10,495.05 ",,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013048016,"PATEL, VINAY",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 52 , 72 , 91 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013048016,"PATEL, VINAY",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013048016,"PATEL, VINAY",9965 POPLAR TENT RD   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 35 , 42 , 48 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013048016,"PATEL, VINAY",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013048016,"PATEL, VINAY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477078954,WRIGHT AND ASSOCIATES VIII DDS PA,,108 PICCADILLY DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013049634,"BAUMANN, ANDREA, LOU",108 PICCADILLY DR   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 120 , 347 , 559 ," $90,737.75 ",,
MEDICAID DIRECT,1477078954,WRIGHT AND ASSOCIATES VIII DDS PA,,108 PICCADILLY DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013049634,"BAUMANN, ANDREA, LOU",5925 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 14 ,$#,,
MEDICAID DIRECT,1750737102,WRIGHT AND ASSOCIATES I DDS PA,NC ORAL SURGERY AND ORTHODONTICS,5925 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013049634,"BAUMANN, ANDREA, LOU",5925 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 67 , 230 , 268 ," $51,457.13 ",,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013051432,"SOLIMAN, MONA",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 42 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013054477,"KING, LINDSAY, YOUNT",200 TRENT DR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013054477,"KING, LINDSAY, YOUNT",200 TRENT DR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013054477,"KING, LINDSAY, YOUNT",200 TRENT DR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013054477,"KING, LINDSAY, YOUNT",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013054477,"KING, LINDSAY, YOUNT",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013054477,"KING, LINDSAY, YOUNT",200 TRENT DR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 34 , 59 , 75 ,$#,,
MEDICAID DIRECT,1013056035,ANGEL HOUSE FCH LLC,ANGEL HOUSE FAMILY CARE HOMES LLC,60 HORNOT CIR BLDG D1 ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013056035,ANGEL HOUSE FCH LLC,60 HORNOT CIR BLDG D1 ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,414 "," 1,414 "," $90,706.82 ",,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013056761,"KIM, EUGENE, HONG",35 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013056761,"KIM, EUGENE, HONG",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1013058130,"ASIKA, KIMKYA, CHINWE",107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1306986278,COMMUNITY FAMILY PRACTICE PHYSICIAN,COMMUNITY FAMILY PRACTICE PHYSICIANS PA,107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1013058130,"ASIKA, KIMKYA, CHINWE",107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 98 , 130 ,$#,,
MEDICAID DIRECT,1013058130,"ASIKA, KIMKYA, CHINWE",~,107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1013058130,"ASIKA, KIMKYA, CHINWE",107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013060763,"SWAIM, JULIE, ANNE",7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1013060763,"SWAIM, JULIE, ANNE",169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1013060763,"SWAIM, JULIE, ANNE",169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013060763,"SWAIM, JULIE, ANNE",169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013060763,"SWAIM, JULIE, ANNE",150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013065200,"MOORE, ERIC, STEPHEN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013065200,"MOORE, ERIC, STEPHEN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013065200,"MOORE, ERIC, STEPHEN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 146 , 162 , 181 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1013065200,"MOORE, ERIC, STEPHEN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013065200,"MOORE, ERIC, STEPHEN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 86 , 122 , 208 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013065200,"MOORE, ERIC, STEPHEN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 117 , 161 , 209 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013065200,"MOORE, ERIC, STEPHEN",540 NEW WAVERLY PL   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013065507,"CAGLE-RICHARDSON, NICOLE, ALEXANDRIA",201 E GROVER ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 37 , 38 ,$#,,
MEDICAID DIRECT,1033442751,MICHAEL BRIAN BUSH DMD PA,~,7864 US HWY 117 S STE A ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1013069491,"BUSH, MICHAEL, BRIAN",7864 US HWY 117 S STE A ROCKY POINT NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 167 , 236 , 661 ," $27,758.83 ",,
MEDICAID DIRECT,1013069855,JEANNE CULP MOORE,FOREVER YOUNG RETREAT,44913 BYRD RD   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013069855,JEANNE CULP MOORE,44913 BYRD RD   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,277 "," 1,277 "," $76,950.41 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1013070887,"FORD, ANNE, CUNANAN",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 15 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013070887,"FORD, ANNE, CUNANAN",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013070895,"PRASAD, VINOD, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1013070895,"PRASAD, VINOD, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,,,$#,,
MEDICAID DIRECT,1992881254,VALERIE C POLLOCK DDS PA,VALERIE C POLLOCK DDS PA,302 S BENNETT ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1013074020,"POLLOCK, VALERIE, COBLE",302 S BENNETT ST   BURGAW NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 272 , 447 ," 1,304 "," $87,165.66 ",,
MEDICAID DIRECT,1013077031,ST VINCENT HOME CARE SERVICES,ST VINCENT HOME CARE AGENCY,1302 E ASH ST   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1013077031,ST VINCENT HOME CARE SERVICES,1302 E ASH ST   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 57 ," 13,171 "," 13,171 "," $836,203.12 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013077072,"FLOOD, CURTIS, LEE",1718 E 4TH ST STE 201 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013077072,"FLOOD, CURTIS, LEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013077072,"FLOOD, CURTIS, LEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1669624540,MILLER CHIROPRACTIC OF ROCKY MOUNT,MILLER CHIROPRACTIC OF ROCKY MOUNT PC,2747 SUNSET AVE STE 107 ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1013078021,"MCDERMOTT MILLER, JULIA, RENEE",2747 SUNSET AVE STE 107 ROCKY MOUNT NC,064,Nash,111N00000X,Chiropractic Providers,Chiropractor,, 13 , 25 , 27 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013079938,"HOGGARD, SUSAN, TAYLOR",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 21 , 31 ,$#,,
MEDICAID DIRECT,1043264724,EASTERN CAROLINA CARDIOVASCULAR,EASTERN CAROLINA CARDIOVASCULAR PA,1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1013082163,"TAMAYO, SALLY, GENE",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 34 , 45 , 50 ,$#,,
MEDICAID DIRECT,1013082312,SANDHILLS CHILDRENS CENTER,SANDHILLS CHILDRENS CENTER,1280 CENTRAL DR   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1013082312,SANDHILLS CHILDRENS CENTER,1280 CENTRAL DR   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,, 25 , 798 ," 1,542 "," $77,542.20 ",,
MEDICAID DIRECT,1013082312,SANDHILLS CHILDRENS CENTER,SANDHILLS CHILDRENS CENTER,1280 CENTRAL DR   SOUTHERN PINES NC,063,Moore,251S00000X,Agencies,Community/Behavioral Health,,1013082312,SANDHILLS CHILDRENS CENTER,1280 CENTRAL DR   SOUTHERN PINES NC,063,Moore,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013084755,"LAWRENCE, LEO, PAUL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 34 , 40 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013084755,"LAWRENCE, LEO, PAUL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 36 , 37 ,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013086255,"CONDER, ELIZABETH, SARAH",1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1023256518,CAROLINA HEADACHE INSTITUTE PA,CAROLINA HEADACHE INSTITUTE PA,6114 FAYETTEVILLE RD STE 109 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013088350,"KAHN, KEVIN, ALEXANDER",6114 FAYETTEVILLE RD STE 109 DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 25 , 58 , 135 ,$#,,
MEDICAID DIRECT,1013089432,DANNY TUTTLE INC,~,1290 DENNY RD   KING NC,085,Stokes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013089432,DANNY TUTTLE INC,1290 DENNY RD   KING NC,085,Stokes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,236 "," 1,236 "," $95,174.13 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013091339,"THOMAS, KAREN, MARGARET",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013091339,"THOMAS, KAREN, MARGARET",1950 GLENN MITCHELL DR STE 200 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013093939,"BURNEY, HEATHER, MONIQUE",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 154 , 267 , 355 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013093939,"BURNEY, HEATHER, MONIQUE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 42 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013093939,"BURNEY, HEATHER, MONIQUE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1013094903,"CALDWELL, RONALD, RENORD",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 32 , 39 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013094903,"CALDWELL, RONALD, RENORD",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013095033,"KNAPP, EVE, APPLEBAUM",1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 38 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013095033,"KNAPP, EVE, APPLEBAUM",1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013096106,"REDDICK, STEPHANIE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 41 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013096981,"FESPERMAN, JOHN, EMMETT",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 ," 1,052 "," 1,135 "," $21,896.67 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013098946,"HORNE, ANUPAMA, BETKERUR",120 E CARVER ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013098946,"HORNE, ANUPAMA, BETKERUR",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 50 , 99 ,$#,,
MEDICAID DIRECT,1366598807,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,2100 ERWIN RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1013098946,"HORNE, ANUPAMA, BETKERUR",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013098946,"HORNE, ANUPAMA, BETKERUR",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 41 , 74 ,$#,,
MEDICAID DIRECT,1366598807,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,2100 ERWIN RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1013098946,"HORNE, ANUPAMA, BETKERUR",6104 FAYETTEVILLE RD STE 108 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013098946,"HORNE, ANUPAMA, BETKERUR",6104 FAYETTEVILLE RD STE 108 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 45 , 53 , 105 ,$#,,
MEDICAID DIRECT,1366598807,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1013098946,"HORNE, ANUPAMA, BETKERUR",6104 FAYETTEVILLE RD STE 108 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013099142,"BORDEAUX, CATHERINE, JONES",3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013099142,"BORDEAUX, CATHERINE, JONES",3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013099142,"BORDEAUX, CATHERINE, JONES",3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 24 , 27 ,$#,,
MEDICAID DIRECT,1083050389,ORANGE COUNTY,~,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1013099696,"CHERRY, DIANE, CRUMPLER",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 52 , 52 , 207 ,$#,,
MEDICAID DIRECT,1013104603,LUTHERAN HOME-ALBEMARLE INC,TRINITY PLACE,24724 S BUSINESS 52   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013104603,LUTHERAN HOME-ALBEMARLE INC,24724 S BUSINESS 52   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,417 "," 2,417 "," $151,797.26 ",,
MEDICAID DIRECT,1053561555,A DARREN SHOLAR DDS PA,SOUTHLAND DENTAL CARE,522 S NORWOOD ST   WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1013105782,"PARKER, TINA, JOELL KENNEDY",522 S NORWOOD ST   WALLACE NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice, 75 , 104 , 316 ," $12,435.11 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,147 PEACHTREE LN   ADVANCE NC,030,Davie,193200000X,Group,Multi-Specialty,,1013106038,"VANN, RYAN, CARPENTER",147 PEACHTREE LN   ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013106038,"VANN, RYAN, CARPENTER",147 PEACHTREE LN   ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 121 , 178 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,9 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013109594,"HALDEMAN-ENGLERT, CHAD, ROBERT",9 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013109594,"HALDEMAN-ENGLERT, CHAD, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.), 16 , 17 , 22 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1013110162,"JONES, MELISSA, THOMPKINS",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1013110162,"JONES, MELISSA, THOMPKINS",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1013110162,"JONES, MELISSA, THOMPKINS",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013110717,"GUZIK, AMY, KATHERINE",624 QUAKER LN   HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013110717,"GUZIK, AMY, KATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 22 , 34 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013111327,"PALWAI, AISHWARYA",201 E GROVER ST   SHELBY NC,023,Cleveland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1013111327,"PALWAI, AISHWARYA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1013113646,CLAY COUNTY,CLAY COUNTY DSS,119 COURTHOUSE DR   HAYESVILLE NC,022,Clay,251B00000X,Agencies,Case Management,,1013113646,CLAY COUNTY,119 COURTHOUSE DR   HAYESVILLE NC,022,Clay,251B00000X,Agencies,Case Management,, 43 , 347 , 347 ," $137,214.00 ",,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013114701,"MASSENBURG, O'LAF, SORENTO",1309 LEES CHAPEL RD LAKE JEANETTE URGENT CARE PLLC GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1013114701,"MASSENBURG, O'LAF, SORENTO",1309 LEES CHAPEL RD LAKE JEANETTE URGENT CARE PLLC GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 60 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1013114701,"MASSENBURG, O'LAF, SORENTO",1309 LEES CHAPEL RD LAKE JEANETTE URGENT CARE PLLC GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 49 , 142 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1013114701,"MASSENBURG, O'LAF, SORENTO",371 NC HIGHWAY 65   WENTWORTH NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1063500908,KNOX CLINIC PEDIATRICS PLLC,KNOX CLINIC,2304 DELANEY AVE KNOX CLINIC WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013116599,"EDRALIN, LENARD, JOSEPH",2304 DELANEY AVE   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 44 , 79 , 191 ,$#,,
MEDICAID DIRECT,1063500908,KNOX CLINIC PEDIATRICS PLLC,KNOX CLINIC,2304 DELANEY AVE KNOX CLINIC WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013116599,"EDRALIN, LENARD, JOSEPH",2304 DELANEY AVE   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 25 , 41 ,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013116961,"GASTON, VALERIE, ALAYNE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 47 , 56 , 68 ," $13,616.55 ",,
MEDICAID DIRECT,1992857841,COUNTY OF CATAWBA OFFICE OF ACCOUNT,CATAWBA COUNTY PUBLIC HEALTH,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1013116961,"GASTON, VALERIE, ALAYNE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 20 , 30 , 79 ,$#,,
MEDICAID DIRECT,1811024979,EASTERN PEDIATRICS PA,Eastern Pediatrics PA,1901 STONEHENGE DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013117126,"GOTH, KAREN, MARY",1901 STONEHENGE DR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 38 , 64 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013117126,"GOTH, KAREN, MARY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,50 MILLER ST STE G WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 35 , 43 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 33 ,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 42 , 50 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 32 , 37 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013118207,"HORVATH, JEFFREY, JOHN",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1013119148,"OFOSU, ERIC",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 111 , 114 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013120161,"SCANGA, LORI, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 11 ,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013120161,"SCANGA, LORI, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013120161,"SCANGA, LORI, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 51 , 51 , 85 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013120161,"SCANGA, LORI, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#, 15 ,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013122092,"JUSTICE, JOY, LIANNE",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 83 , 83 ,$#,,
MEDICAID DIRECT,1013124213,GORDIAN MEDICAL INC,RESTORIXHEALTH,17595 CARTWRIGHT RD   IRVINE CA,102,Out of State > 40 miles,332BN1400X,Suppliers,Durable Medical Equipment & Medical Supplies,Nursing Facility Supplies,1013124213,GORDIAN MEDICAL INC,17595 CARTWRIGHT RD   IRVINE CA,102,Out of State > 40 miles,332BN1400X,Suppliers,Durable Medical Equipment & Medical Supplies,Nursing Facility Supplies, 30 , 71 , 128 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013128792,"DEMBLA, VIKAS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306904917,COUNTY OF PITT OFFICE OF AUDITOR,PITT COUNTY HEALTH DEPT,201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1013131127,"POOLE, LISA, GRAY",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 147 , 219 , 726 ," $30,221.88 ",,
MEDICAID DIRECT,1013131689,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 08417,3581 DAVIS DR   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1013131689,NORTH CAROLINA CVS PHARMACY LLC,3581 DAVIS DR   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1013131689,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 08417,3581 DAVIS DR   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1013131689,NORTH CAROLINA CVS PHARMACY LLC,3581 DAVIS DR   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013131994,"JACKSON, FREEMAN, RANDOLPH",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 56 , 66 ,$#,,
MEDICAID DIRECT,1700202116,WILLIAM R PLASTER DDS PA,~,1455 E MARION ST STE F SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1013133156,"PLASTER, WILLIAM, ROGERS",1455 E MARION ST STE F SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 34 , 92 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013136308,"PARALA-METZ, ARMIDA, GALANG",711 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013136308,"PARALA-METZ, ARMIDA, GALANG",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 18 , 33 , 51 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013136308,"PARALA-METZ, ARMIDA, GALANG",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1407277536,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013136308,"PARALA-METZ, ARMIDA, GALANG",711 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699006858,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GENERAL SURGERY LINCOLN,441 MCALISTER RD STE 2100 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",441 MCALISTER RD STE 2100 LINCOLNTON NC,055,Lincoln,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",1550 FAULK ST STE 1100 MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",1550 FAULK ST STE 1100 MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 27 , 28 ,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013136415,"TRACEY, JACQUELINE, YVETTE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013137942,"EKATAN, ANDREW, OMOIT",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013138528,"MIKETA, JOHN, P",~,122 N MAIN ST   FUQUAY VARINA NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1013138528,"MIKETA, JOHN, P",122 N MAIN ST   FUQUAY VARINA NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073003752,GOODEN MOBILE POD NC PLLC,,311 MCFADYEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013138528,"MIKETA, JOHN, P",122 N MAIN ST   FUQUAY VARINA NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 50 , 36 , 38 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013139039,"NACEY, THERESA, ANN",2544 COURT DR STE F GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013139039,"NACEY, THERESA, ANN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013139039,"NACEY, THERESA, ANN",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013139039,"NACEY, THERESA, ANN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013139039,"NACEY, THERESA, ANN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013139039,"NACEY, THERESA, ANN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1013139096,"CLARKE, JEFFREY, ALAN",619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 143 , 381 , 551 ,$#,,
MEDICAID DIRECT,1013140938,INGLES MARKETS INC,INGLES PHARMACY 116,230 HWY 64 E   HAYESVILLE NC,022,Clay,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1013140938,INGLES MARKETS INC,230 HWY 64 E   HAYESVILLE NC,022,Clay,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013141936,"VOLSKY, PETER, GEORGE",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013141936,"VOLSKY, PETER, GEORGE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013145135,"WILLIAMS, FELICIA, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 85 , 211 ," $50,447.47 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013146463,"GUTHRIE, CLAYTON, WALTER",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1013148923,THERAPLAY LLC,~,135 CHATHAM ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1013148923,THERAPLAY LLC,135 CHATHAM ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1013148923,THERAPLAY LLC,~,135 CHATHAM ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1013148923,THERAPLAY LLC,135 CHATHAM ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,, 25 , 68 , 78 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013150358,"MEHRABYAN, ANAHIT, CHELUSKIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 73 , 116 , 147 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,194 FINLEY GOLF COURSE RD STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013150358,"MEHRABYAN, ANAHIT, CHELUSKIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013151653,"SUBNANI, KISHORE, RAJ",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013151653,"SUBNANI, KISHORE, RAJ",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1457804080,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES MYRTLE BEACH,107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013151653,"SUBNANI, KISHORE, RAJ",107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 36 , 53 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013151653,"SUBNANI, KISHORE, RAJ",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013152594,"TRACY, CHRISTOPHER, LEE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013152594,"TRACY, CHRISTOPHER, LEE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 17 , 18 , 52 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013152594,"TRACY, CHRISTOPHER, LEE",4204 MURDOCKSVILLE RD   WEST END NC,063,Moore,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 92 , 132 , 292 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013152594,"TRACY, CHRISTOPHER, LEE",205 PAGE RD   PINEHURST NC,063,Moore,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 62 , 83 , 270 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1013153014,"DESAI, HIMANSHU, DEEPAKKUMAR",534 CARATOKE HWY   MOYOCK NC,027,Currituck,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 27 , 52 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013153014,"DESAI, HIMANSHU, DEEPAKKUMAR",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 222A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013153014,"DESAI, HIMANSHU, DEEPAKKUMAR",300 MEDICAL PKWY STE 222A CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 33 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013153816,"CATRON, JULIE, MIKEL",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 48 , 93 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013153816,"CATRON, JULIE, MIKEL",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013155969,"MODOOR, LILLYKUTTY, ABRAHAM",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1013157171,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT WHITAKERS,105 SE RAILROAD ST   WHITAKERS NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013157171,RURAL HEALTH GROUP INC,105 SE RAILROAD ST   WHITAKERS NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 64 , 103 , 104 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013157254,"HARRIS, GAIL, MARGARET",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013157437,"JACKSON, PAMELA, CAROL",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013157437,"JACKSON, PAMELA, CAROL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013157437,"JACKSON, PAMELA, CAROL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013159177,"PROUD, CRYSTAL, MILLER",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013159177,"PROUD, CRYSTAL, MILLER",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#, 18 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013159680,"LOCKER, MATTHEW, JAMES",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013159680,"LOCKER, MATTHEW, JAMES",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 175 , 190 , 270 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013159680,"LOCKER, MATTHEW, JAMES",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013159680,"LOCKER, MATTHEW, JAMES",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1013159680,"LOCKER, MATTHEW, JAMES",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013159680,"LOCKER, MATTHEW, JAMES",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013160621,"COWEN, CHRISTOPHER, STEVEN",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 35 , 43 ,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1013161736,"DECARLO JR, PAUL, SAMUEL",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 27 , 60 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 76 , 92 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 26 , 28 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013162270,"SUNDARAM, VISHALAKSHI, KALYANA",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013164680,"HEGERICH, DAVID, JONATHAN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,10502 PARK RD STE 110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013164979,"LASTORIA, PAULA, JEANETTE",10502 PARK RD STE 110 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 25 , 28 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013164979,"LASTORIA, PAULA, JEANETTE",301 E WENDOVER AVE STE 412 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013164979,"LASTORIA, PAULA, JEANETTE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013164979,"LASTORIA, PAULA, JEANETTE",301 E WENDOVER AVE STE 412 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013165695,"AYAFOR, LOUISA, APONGSE",113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013169226,"DUNIPACE, DAVID, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1013169226,"DUNIPACE, DAVID, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013169226,"DUNIPACE, DAVID, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013171735,"BICE, THOMAS, JOSEPH",1969 WELLNESS BLVD   MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013171735,"BICE, THOMAS, JOSEPH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013171735,"BICE, THOMAS, JOSEPH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013171735,"BICE, THOMAS, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013172485,"AMERY, SAHAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013174275,"BARBAS, ANDREW, SERGHIOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013174275,"BARBAS, ANDREW, SERGHIOS",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013174275,"BARBAS, ANDREW, SERGHIOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013175207,"MULLANEY, MORGAN, EILEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 37 , 50 , 66 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013175322,"GETTYS, FRANKLIN, KEITH",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013175769,"REARDON, KELLI, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 18 , 39 , 46 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013175769,"REARDON, KELLI, ANNE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013176965,"HOPKINS, SHAWN, MICHAEL",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 96 , 138 , 267 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013177021,"RANCOUR, STEPHEN, THOMAS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013177021,"RANCOUR, STEPHEN, THOMAS",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013177021,"RANCOUR, STEPHEN, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013177021,"RANCOUR, STEPHEN, THOMAS",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013177021,"RANCOUR, STEPHEN, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 26 , 45 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013177021,"RANCOUR, STEPHEN, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 17 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013177021,"RANCOUR, STEPHEN, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 29 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013177039,"ARADO, KAY, MARIE",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1013177039,"ARADO, KAY, MARIE",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 25 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1013177138,"ADEBIMPE, THAMRAH, RHOXANA",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1013177138,"ADEBIMPE, THAMRAH, RHOXANA",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 33 , 33 ," $13,063.05 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013177138,"ADEBIMPE, THAMRAH, RHOXANA",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 137 , 257 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013177138,"ADEBIMPE, THAMRAH, RHOXANA",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013177138,"ADEBIMPE, THAMRAH, RHOXANA",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",545 E MARKET ST   SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",3031 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",916 S MAIN ST   FUQUAY VARINA NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",105 COTTEN LN   HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",3031 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",916 S MAIN ST   FUQUAY VARINA NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013177252,"OWENS, ELISABETH, ISENHOUR",105 COTTEN LN   HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013177344,"LEITZ, EVAN, MICHAEL",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 307 , 314 , 406 ," $13,426.27 ",,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013177344,"LEITZ, EVAN, MICHAEL",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 15 , 23 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1013177344,"LEITZ, EVAN, MICHAEL",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 385 , 439 , 559 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,270 HORIZON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013178243,"SALDANA, LARISSA, MARIE SONGALIA",270 HORIZON DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 40 , 93 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 68 , 92 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 55 , 69 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 55 , 74 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013179266,"WETZEL, RAUN, JOSEPH",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013180108,"SPECA, JOELLEN, CHRISTINE",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013180108,"SPECA, JOELLEN, CHRISTINE",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 39 , 39 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013180876,"WEAVER, KIBWE, AKIN",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013181775,"MARUYAMA, HIROMI",1425 PROMISE BEACON CIR STE 109 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 37 , 48 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013181775,"MARUYAMA, HIROMI",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 116 , 128 ," $11,247.13 ",,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1425 PROMISE BEACON CIR STE 109 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013181775,"MARUYAMA, HIROMI",1425 PROMISE BEACON CIR STE 109 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 28 , 29 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013181775,"MARUYAMA, HIROMI",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013181775,"MARUYAMA, HIROMI",1425 PROMISE BEACON CIR STE 109 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 34 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013183136,"REGAN, KARA, ANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 72 , 92 , 118 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013184571,"BHUTANI, MANISHA",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013184571,"BHUTANI, MANISHA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013184571,"BHUTANI, MANISHA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 35 , 35 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013184886,"KINMANN, ANGELA, LYNN",2601 LAKE DR   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013184886,"KINMANN, ANGELA, LYNN",2601 LAKE DR   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013192319,"LOCKE, ADAIR, QUATTLEBAUM",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013192319,"LOCKE, ADAIR, QUATTLEBAUM",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 27 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013192319,"LOCKE, ADAIR, QUATTLEBAUM",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013192319,"LOCKE, ADAIR, QUATTLEBAUM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 39 , 46 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013192319,"LOCKE, ADAIR, QUATTLEBAUM",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1013193697,"ZAWILINSKI, NICOLOTTE, L",~,2435 PLANTATION CENTER DR STE 120 MATTHEWS NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,1013193697,"ZAWILINSKI, NICOLOTTE, L",2435 PLANTATION CENTER DR STE 120 MATTHEWS NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 293 , 316 , 587 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013194471,"JUNAGADHWALLA, ZAHID, AZIZ",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013194471,"JUNAGADHWALLA, ZAHID, AZIZ",3073 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 213 , 263 , 293 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013196989,"KLAPPER, JACOB, ARTHUR",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013196989,"KLAPPER, JACOB, ARTHUR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013196989,"KLAPPER, JACOB, ARTHUR",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013196989,"KLAPPER, JACOB, ARTHUR",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013196989,"KLAPPER, JACOB, ARTHUR",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013200203,"KLINE, AARON, DAVID",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013200203,"KLINE, AARON, DAVID",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 371 , 367 , 467 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013200203,"KLINE, AARON, DAVID",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013200203,"KLINE, AARON, DAVID",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,204 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1013200203,"KLINE, AARON, DAVID",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013203470,"LICHSTEIN, PAUL, MICHAEL",4741 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013203470,"LICHSTEIN, PAUL, MICHAEL",810 MITCHELL AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 132 , 266 , 484 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013204148,"MERRITT, CARRIE, HALL",105 STADIUM OAKS DR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 43 , 58 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013206911,"SMITH, CECILY, ROBIN",815 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013208313,"BROOKS, WALKER, DAVID",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 234 , 235 ," $12,977.78 ",,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013208933,"MERRILL, MICHAEL, STEPHEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013208933,"MERRILL, MICHAEL, STEPHEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 124 , 137 , 195 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013208933,"MERRILL, MICHAEL, STEPHEN",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013208933,"MERRILL, MICHAEL, STEPHEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013208933,"MERRILL, MICHAEL, STEPHEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1013210459,"ADAMOLEKUN, OLUFUNSHO, DAVID",1600 MEDICAL DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013212158,"RICHARDSON, FELICIA, RENEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013216241,"SUBRAMANIAN, NEEL",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 61 , 69 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013216241,"SUBRAMANIAN, NEEL",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1013216282,"ABBOTT, STEPHEN, TYLER",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 208 , 216 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013217561,"HUANG, JIBIAO",600 GRESHAM DR STE 8630 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,301 RIVERVIEW AVE STE 830 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013217561,"HUANG, JIBIAO",301 RIVERVIEW AVE STE 202 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013218098,"HEYWARD, KITILA, SMITH",600 HOSPITAL DR   MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 48 , 52 , 55 ," $20,715.96 ",,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013218098,"HEYWARD, KITILA, SMITH",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 50 , 61 ,$#,,
MEDICAID DIRECT,1528314994,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OB GYN,2700 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,193400000X,Group,Single Specialty,,1013218098,"HEYWARD, KITILA, SMITH",2700 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 22 , 32 ,$#,,
MEDICAID DIRECT,1013221589,"VAGHELA, GOPALBHAI, KANJIBHAI",~,129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1013221589,"VAGHELA, GOPALBHAI, KANJIBHAI",129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013223049,"ROGERS, SAMANTHA, DEVINEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013226919,"VELAGAPUDI, MANASA",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013226919,"VELAGAPUDI, MANASA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013226919,"VELAGAPUDI, MANASA",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013226919,"VELAGAPUDI, MANASA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013226919,"VELAGAPUDI, MANASA",600 HOSPITAL DR   MONROE NC,090,Union,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013226919,"VELAGAPUDI, MANASA",600 HOSPITAL DR   MONROE NC,090,Union,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013230952,"JONES, CAROLYN, WEST",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1013231943,INFOCUS EYEWEAR,INFOCUS EYEWEAR,719 GREEN VALLEY RD STE 303B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013231943,INFOCUS EYEWEAR,719 GREEN VALLEY RD STE 303B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,," 1,900 "," 1,980 "," 3,901 "," $53,704.76 ",,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013232792,"OU, JAO, JIH",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 43 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013232792,"OU, JAO, JIH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013232792,"OU, JAO, JIH",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013232792,"OU, JAO, JIH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 187 , 199 , 244 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013232792,"OU, JAO, JIH",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013234251,"MARTINEZ-WILSON, HECTOR, FERNANDO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013234251,"MARTINEZ-WILSON, HECTOR, FERNANDO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013234251,"MARTINEZ-WILSON, HECTOR, FERNANDO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013234251,"MARTINEZ-WILSON, HECTOR, FERNANDO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 29 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 16 , 22 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 11 , 58 , 59 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013234335,"WESTREICH, KATHERINE, DAVIS",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 21 , 41 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013235464,"MENON, SUMA",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013235464,"MENON, SUMA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 84 , 84 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013235902,"THOMAS, JENNIFER",825 FAIRFAX AVE   NORFOLK VA,101,Out of State <= 40 miles,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,,,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013237916,"JUDD, MARY, JENNETTE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1013238138,"HENSLEY, KIMBERLY, FAYETTE JEAN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154721272,URGENT CARE DOWN EAST INC,,853 WASHINGTON SQUARE MALL   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1013239995,"DEL ROSARIO, JOSEPHINE, VIDA",1412 CAROLINA AVE   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013243583,HEAVEN SENT GROUP HOME INC,HEAVEN SENT GROUP HOME INC,3209 WINFIELD CT   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013243583,HEAVEN SENT GROUP HOME INC,3209 WINFIELD CT   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 696 , 711 ," $47,261.03 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013243872,"BAUSCH, MARTHA, CLARE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 22 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013244052,"SIPPO, DOROTHY, AMY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1013244326,BURGAW EYE CENTER OD PA,BURGAW EYE CENTER OD PA,106 E SATCHWELL ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1013244326,BURGAW EYE CENTER OD PA,106 E SATCHWELL ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,, 22 , 22 , 44 ,$#,,
MEDICAID DIRECT,1013244326,BURGAW EYE CENTER OD PA,BURGAW EYE CENTER OD PA,106 E SATCHWELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1013244326,BURGAW EYE CENTER OD PA,106 E SATCHWELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,, 18 , 18 , 36 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013247428,"SIEBERT, MARCIE, HESLOP",1915 RANDOLPH RD STE 2 CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 23 , 50 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013247493,"BHARDWAJ, SHILPA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 37 , 63 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013247493,"BHARDWAJ, SHILPA",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 27 , 44 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013248491,"STONE, JASMINE, SICILIA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396166088,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB - MT,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013248491,"STONE, JASMINE, SICILIA",275 BEATTY DR   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013248491,"STONE, JASMINE, SICILIA",2711 X RAY DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013248491,"STONE, JASMINE, SICILIA",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1013248509,"HEIM, ROBERT, EDWARD",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013248509,"HEIM, ROBERT, EDWARD",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4600 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013250430,"BUBLA, CINDY, ANN",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013250802,"JIA, SHAWN, YIXUAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 58 , 72 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013250802,"JIA, SHAWN, YIXUAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013250802,"JIA, SHAWN, YIXUAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013250802,"JIA, SHAWN, YIXUAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013250992,"SANCHEZ, CHRISTIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013250992,"SANCHEZ, CHRISTIAN",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013251271,"KIM, MICHELLE, EUN-KYUNG",247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 40 , 113 ,$#,,
MEDICAID DIRECT,1366611279,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013251271,"KIM, MICHELLE, EUN-KYUNG",247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,505 "," 1,706 "," 6,134 "," $282,117.03 ",,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013262047,"BECNEL, BRENT, JOHN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013262047,"BECNEL, BRENT, JOHN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262047,"BECNEL, BRENT, JOHN",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262047,"BECNEL, BRENT, JOHN",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262047,"BECNEL, BRENT, JOHN",114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262047,"BECNEL, BRENT, JOHN",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 46 , 90 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262047,"BECNEL, BRENT, JOHN",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1659673838,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT SENIOR CARE,1309 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013262245,"NGETICH, DINAH, CHEBOTIP",1309 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 126 , 167 ,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262393,"BAKER, JORDAN, RENEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262393,"BAKER, JORDAN, RENEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262393,"BAKER, JORDAN, RENEE",10620 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262393,"BAKER, JORDAN, RENEE",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 56 , 139 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013262393,"BAKER, JORDAN, RENEE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013262419,"FUDIM, MARAT",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 20 , 37 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013262419,"FUDIM, MARAT",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013262419,"FUDIM, MARAT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013262419,"FUDIM, MARAT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 28 , 56 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013262765,"KAUR, RAMANDEEP",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 49 , 89 , 89 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013265057,"HOWARD, ANTONIO, TOM",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013265057,"HOWARD, ANTONIO, TOM",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013265057,"HOWARD, ANTONIO, TOM",5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 67 , 93 , 155 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013265057,"HOWARD, ANTONIO, TOM",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 16 , 30 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013265057,"HOWARD, ANTONIO, TOM",5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013265495,"GILROY, ANDREA, FRANCES",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 38 , 40 , 72 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013269745,"DEEM, NANCY, ELIZABETH",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 26 , 41 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013269745,"DEEM, NANCY, ELIZABETH",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 67 , 87 , 129 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",1220 MAGNOLIA ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 14 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013270248,"ACHARYA, GAYATRI, AJAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013270487,"MITCHELL, LYDIA, DARLUD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 122 , 127 , 133 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013270511,"HIESTAND, KYLE, GATES",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013270511,"HIESTAND, KYLE, GATES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013270511,"HIESTAND, KYLE, GATES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013274778,"BRUNS, STEPHANIE, MICHAL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 38 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013275379,"BABCOCK, SHARON, N.",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 14 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013275379,"BABCOCK, SHARON, N.",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 45 , 71 , 123 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 153 , 160 , 214 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 15 , 17 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1013276021,"TANPITUKPONGSE, TEERATH, PETER",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013276914,J IVERSON RIDDLE DEVELOPMENT CENTER,FAMILY INFANT AND PRESCHOOL PROGRAM,300 ENOLA RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1013276914,J IVERSON RIDDLE DEVELOPMENT CENTER,300 ENOLA RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1013281476,"WIJESINGHE, EKMINI",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1013282854,TOUCHING LIVES,VIRGINIAS PLACE,1517 GOVERNORS RD   WINDSOR NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013282854,TOUCHING LIVES,1517 GOVERNORS RD   WINDSOR NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 65 , 65 ," $63,771.33 ",,
MEDICAID DIRECT,1013285162,"HARRIS, MEKA, BLACK",~,8301 UNIVERSITY EXEC PARK DR STE 170 CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1013285162,"HARRIS, MEKA, BLACK",8301 UNIVERSITY EXEC PARK DR STE 170 CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 89 ," 2,402 "," 2,402 "," $162,773.38 ",,
MEDICAID DIRECT,1013285485,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,2500 E ASH ST   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1013285485,CNC-ACCESS INC,2500 E ASH ST   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#, 570 , 570 ," $43,919.24 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013289040,"DRAPER, MEREDITH, LEACH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013289131,"POTTS, TIMOTHY, VIRGIL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689673279,PIEDMONT NEPHROLOGY AND HYPERTENSIO,~,1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013289271,"BADESCU, OANA, CRISTINA",1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 55 , 127 , 129 ,$#,,
MEDICAID DIRECT,1689673279,PIEDMONT NEPHROLOGY AND HYPERTENSIO,~,1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013289271,"BADESCU, OANA, CRISTINA",352 E PARKER RD STE B MORGANTON NC,012,Burke,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 69 , 70 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013291624,"KRAUSE, STACY, ANN",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013293034,"GARRISON, BRIANNA, LEE",4515 PREMIER DR STE 308 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013295195,"HENSON, BAKER, LIVINGSTON",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013295195,"HENSON, BAKER, LIVINGSTON",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 60 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013295195,"HENSON, BAKER, LIVINGSTON",420 N CENTER ST   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013295641,"PANNU, AMRITPAL, SINGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 54 , 176 , 177 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013295641,"PANNU, AMRITPAL, SINGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013295641,"PANNU, AMRITPAL, SINGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013295641,"PANNU, AMRITPAL, SINGH",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 38 , 38 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013295880,"LEWIS, KATHY, LONG",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013295880,"LEWIS, KATHY, LONG",5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 154 , 160 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1013295880,"LEWIS, KATHY, LONG",5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1013295880,"LEWIS, KATHY, LONG",5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780352252,J ARTHUR DOSHER MEMORIAL HOSPITAL,,4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1013295880,"LEWIS, KATHY, LONG",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 25 , 25 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013295880,"LEWIS, KATHY, LONG",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013295880,"LEWIS, KATHY, LONG",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013295948,"HARRIS, MICHAEL, DAVID",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013295948,"HARRIS, MICHAEL, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013295948,"HARRIS, MICHAEL, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 23 , 41 ,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1013297977,"RIDGEWAY POLLARD, MARGARET, VICTORIA",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1013298926,MATTHEWS SURGERY CENTER LLC,MATTHEWS SURGERY CENTER LLC,710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1013298926,MATTHEWS SURGERY CENTER LLC,710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1013299189,"BHATTI, GURVINDER, SINGH",DR BHATTI DDS PLLC,201 N CHERRY ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1013299189,"BHATTI, GURVINDER, SINGH",201 N CHERRY ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 130 , 149 , 481 ," $33,387.66 ",,
MEDICAID DIRECT,1194382945,MOBILE FNP JRJOHNSON PLLC,,236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013300383,"JOHNSON, JULIE, RANDOLPH",236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 501 , 662 ," $12,227.50 ",,
MEDICAID DIRECT,1013300383,"JOHNSON, JULIE, RANDOLPH",,110 N FRANKLIN ST   MADISON NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,1013300383,"JOHNSON, JULIE, RANDOLPH",236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1013300383,"JOHNSON, JULIE, RANDOLPH",,236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1013300383,"JOHNSON, JULIE, RANDOLPH",236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1194382945,MOBILE FNP JRJOHNSON PLLC,,236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013300383,"JOHNSON, JULIE, RANDOLPH",236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1013300383,"JOHNSON, JULIE, RANDOLPH",,236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,1013300383,"JOHNSON, JULIE, RANDOLPH",236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1013300383,"JOHNSON, JULIE, RANDOLPH",,110 N FRANKLIN ST   MADISON NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,1013300383,"JOHNSON, JULIE, RANDOLPH",110 N FRANKLIN ST   MADISON NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013303049,"SHI, CHEN",550 MOUNT HOLLY MEDICAL PKWY   BELMONT NC,036,Gaston,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 38 , 57 , 76 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013303049,"SHI, CHEN",811 COX RD   GASTONIA NC,036,Gaston,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 35 , 42 , 47 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013303049,"SHI, CHEN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1013303627,"HERTWIG, GREGORY, FREDERICK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013304963,"PARRISH, NICHOLAS, FREDRIC",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013304963,"PARRISH, NICHOLAS, FREDRIC",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013305465,LARETTA SHANTELL BOWERS,ANGELS AT HEART HOME CARE,1114 S MAIN ST   CHINA GROVE NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1013305465,LARETTA SHANTELL BOWERS,1114 S MAIN ST   CHINA GROVE NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 1,673 "," 1,703 "," $161,098.80 ",,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1013311653,"DALLAS, REBECCA, KENT",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 35 , 58 , 140 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1013312537,"WATSON, EMILY, PARRISH",119 PARK ST   CANTON NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 26 , 39 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1013312537,"WATSON, EMILY, PARRISH",119 PARK ST   CANTON NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 88 , 158 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013313527,"KENEFICK, HEIDI, BERTHA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 69 , 85 , 155 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,1860 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1013313873,"BROWN, CAROLINE, TOWNSON",1860 SUGAR HILL RD STE A MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1013313873,"BROWN, CAROLINE, TOWNSON",186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 55 , 115 ," $13,146.02 ",,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013313873,"BROWN, CAROLINE, TOWNSON",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 74 , 134 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013322130,"MARTINEZ QUINONES, PATRICIA, ANGELLICE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 63 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013322130,"MARTINEZ QUINONES, PATRICIA, ANGELLICE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013322130,"MARTINEZ QUINONES, PATRICIA, ANGELLICE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 37 , 39 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1013323161,"IPOCK, JESSICA, MARIE",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 18 , 21 , 34 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1013323161,"IPOCK, JESSICA, MARIE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 17 , 27 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE F KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1013323310,"KASRAVI, PARISA",1008 BIG OAK CT   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 19 , 62 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,9201 LEESVILLE RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013323310,"KASRAVI, PARISA",9201 LEESVILLE RD STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 66 , 155 , 478 ," $21,864.38 ",,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013324334,"GALLAGHER, KIMBERLY, SMITH",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013324334,"GALLAGHER, KIMBERLY, SMITH",349 PENNY LN   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 35 , 56 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013324334,"GALLAGHER, KIMBERLY, SMITH",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013324334,"GALLAGHER, KIMBERLY, SMITH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,319 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013324334,"GALLAGHER, KIMBERLY, SMITH",319 PENNY LN   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013324722,"MACHAVARAPU, HARITHA",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 63 , 186 , 199 ,$#,,
MEDICAID DIRECT,1487809265,SOUND MEDICAL OF CAPE CATERET,~,3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1013324920,"BROWN, JENNIFER, NICOLE",3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013326776,"GALLAGHER, SEAN, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 54 , 69 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013326834,"TURNER, WESLEY, CHAD",10188 N MAIN ST   ARCHDALE NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1013326834,"TURNER, WESLEY, CHAD",10188 N MAIN ST   ARCHDALE NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 119 , 202 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013327105,"BULANOWSKI, CHRISTOPHER, MICHAEL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 64 , 64 ,$#,,
MEDICAID DIRECT,1558459602,PIEDMONT ENDOCRINOLOGY PA,PIEDMONT ENDOCRINOLOGY PA,311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013327162,"BARTON, AARON, WADE",311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 26 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1013327485,"MCMILLAN, DANIEL, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1013327485,"MCMILLAN, DANIEL, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013327485,"MCMILLAN, DANIEL, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013327485,"MCMILLAN, DANIEL, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1013327485,"MCMILLAN, DANIEL, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1013327550,"NEWKIRK, CALBEE, DEIONA",1705 TARBORO ST SW   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 45 , 45 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013327550,"NEWKIRK, CALBEE, DEIONA",1705 TARBORO ST SW   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 102 , 102 ,$#,,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013328020,"DANFORD, KATY, DEMANIGOLD",1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 36 , 51 ,$#,,
MEDICAID DIRECT,1144309949,THERAPY PLUS CLINIC INC,THERAPY PLUS CLINIC INC,247 OAK STREET EXT STE 145 FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013329358,"TATE, JOHN, PARKER",247 OAK STREET EXT STE 145 FOREST CITY NC,081,Rutherford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 19 , 25 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1013334705,"LOVE, ROSELYN, MARIE",3205 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 101 , 150 , 241 ," $21,809.66 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013334952,"YARRINGTON, MICHAEL, EDWARDS",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013334952,"YARRINGTON, MICHAEL, EDWARDS",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 19 , 44 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013334952,"YARRINGTON, MICHAEL, EDWARDS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 32 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013334952,"YARRINGTON, MICHAEL, EDWARDS",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1013335124,"ADAMSON, GREGORY, THOMAS",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013335280,"TENZEL, PAUL, LEVIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1831911650,NOVANT HEALTH WESTERN CAROLINA MEDI,NOVANT HEALTH PLASTIC & RECONSTRUCTIVE SURGERY - B,264 THETFORD ST STE 120 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013335280,"TENZEL, PAUL, LEVIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1831911650,NOVANT HEALTH WESTERN CAROLINA MEDI,NOVANT HEALTH PLASTIC & RECONSTRUCTIVE SURGERY - B,264 THETFORD ST STE 120 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013335280,"TENZEL, PAUL, LEVIN",264 THETFORD ST STE 120 ASHEVILLE NC,011,Buncombe,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013335280,"TENZEL, PAUL, LEVIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013335280,"TENZEL, PAUL, LEVIN",21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013335629,"BETHEA, JASON, JAMIER",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 32 , 45 , 55 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013335629,"BETHEA, JASON, JAMIER",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 49 , 75 , 76 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013335629,"BETHEA, JASON, JAMIER",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013335629,"BETHEA, JASON, JAMIER",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013335629,"BETHEA, JASON, JAMIER",3330 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 61 , 77 , 98 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013335801,"BECKER, NATALIA, KOHL",920 CHURCH ST. N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013335801,"BECKER, NATALIA, KOHL",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013335801,"BECKER, NATALIA, KOHL",920 CHURCH ST. N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013335801,"BECKER, NATALIA, KOHL",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013336015,"ORGEL, RYAN, MATTHEW",166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013336015,"ORGEL, RYAN, MATTHEW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 47 , 71 , 109 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1013336015,"ORGEL, RYAN, MATTHEW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013336015,"ORGEL, RYAN, MATTHEW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013336015,"ORGEL, RYAN, MATTHEW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013336015,"ORGEL, RYAN, MATTHEW",210 ASHVILLE AVE   CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013336015,"ORGEL, RYAN, MATTHEW",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1013336718,"ERASO, DANIEL, RUBEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013336718,"ERASO, DANIEL, RUBEN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013336718,"ERASO, DANIEL, RUBEN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1013336833,"NEWBILL, GEORGE, THOMAS",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 40 , 174 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013336833,"NEWBILL, GEORGE, THOMAS",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013336833,"NEWBILL, GEORGE, THOMAS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1013336833,"NEWBILL, GEORGE, THOMAS",STREET 1 7910 US HIGHWAY 117 S STE 120 ROCKY POINT NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 59 , 151 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1013336833,"NEWBILL, GEORGE, THOMAS",507 E FREMONT ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1013336833,"NEWBILL, GEORGE, THOMAS",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 94 , 172 , 482 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013337146,"REICHERT, RYAN, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 74 , 80 ,$#,,
MEDICAID DIRECT,1073822029,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1013337674,"SKIDMORE, ELIZABETH, FAYE",711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 30 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013343490,"TASHIE, CAROLYN, CHYU",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 29 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013343490,"TASHIE, CAROLYN, CHYU",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1013343961,WALGREEN CO,WALGREENS 16139,1821 HILLANDALE RD STE 23 DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1013343961,WALGREEN CO,1821 HILLANDALE RD STE 23 DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013346758,"SNOW, MATTHEW, RAYMOND",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 40 , 86 ,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013346758,"SNOW, MATTHEW, RAYMOND",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013348945,"MANDALL, MARIBETH, TERASA",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 40 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013348945,"MANDALL, MARIBETH, TERASA",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013350727,"DENG, AILEEN",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013350727,"DENG, AILEEN",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 18 , 42 , 67 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1013350917,"PASCHALL, JOSHUA, GODFREY",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 116 , 129 , 148 ,$#,,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1013350917,"PASCHALL, JOSHUA, GODFREY",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 35 , 53 , 53 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013350917,"PASCHALL, JOSHUA, GODFREY",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 143 , 205 , 249 ," $10,688.30 ",,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013350917,"PASCHALL, JOSHUA, GODFREY",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1013350917,"PASCHALL, JOSHUA, GODFREY",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 40 , 44 , 47 ,$#,,
MEDICAID DIRECT,1013350917,"PASCHALL, JOSHUA, GODFREY",,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1013350917,"PASCHALL, JOSHUA, GODFREY",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013351808,"KIM, TEDDY, EARL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1013351808,"KIM, TEDDY, EARL",10 AVIEMORE DR   PINEHURST NC,063,Moore,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 30 , 33 , 35 ,$#,,
MEDICAID DIRECT,1013351998,NATIONAL SEATING AND MOBILITY INC,,2600 ELTHAM AVE STE 110 NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1013351998,NATIONAL SEATING AND MOBILITY INC,2600 ELTHAM AVE STE 110 NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1013351998,NATIONAL SEATING AND MOBILITY INC,,3347 ENTERPRISE RD   NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1013351998,NATIONAL SEATING AND MOBILITY INC,3347 ENTERPRISE RD   NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 14 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013352087,"ALAVIAN, NASEEM, SARA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 20 , 28 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 28 , 29 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013355528,"JONES, JASON, DEFOREST",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 29 , 37 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 23 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 59 , 82 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 43 , 48 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 25 , 36 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1013356740,"SPYRIS, CONTANTINOS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 81 , 88 , 111 ,$#,,
MEDICAID DIRECT,1013356799,"BAILEY, NICHOLAS, ALAN",,2294 OCEAN HWY W   SUPPLY NC,010,Brunswick,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,1013356799,"BAILEY, NICHOLAS, ALAN",2294 OCEAN HWY W   SUPPLY NC,010,Brunswick,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1013356799,"BAILEY, NICHOLAS, ALAN",,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,1013356799,"BAILEY, NICHOLAS, ALAN",302 LIBERTY ST   WHITEVILLE NC,024,Columbus,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013357292,"WARD, JOSHUA, REMI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 189 , 189 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013359934,"BOOKER, KIMBERLY, RANDALL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 23 , 25 , 41 ,$#,,
MEDICAID DIRECT,1023784022,KIM M POWER DDS PLLC,SMITHFIELD FAMILY DENTISTRY,910 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1013360031,"POWER, KIM, MARIE",910 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice," 1,290 "," 2,489 "," 9,436 "," $497,499.96 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013361567,"PATEL, SWAPNA",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013361567,"PATEL, SWAPNA",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013361567,"PATEL, SWAPNA",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013361831,"CURATOLO, ADAM, SCOTT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 40 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013361831,"CURATOLO, ADAM, SCOTT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 39 , 60 ,$#,,
MEDICAID DIRECT,1871052597,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KILDAIRE FARM ROAD,,,Unknown,193200000X,Group,Multi-Specialty,,1013363514,"REYES, LUCIA, FERNANDA",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871052597,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KILDAIRE FARM ROAD,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013363514,"REYES, LUCIA, FERNANDA",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 21 , 28 ,$#,,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013364793,"WOODHAM, PAIGE, CRIBB",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 119 , 127 , 202 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013365428,"DUPREY, ROBERT, TYLER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 54 , 59 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013365428,"DUPREY, ROBERT, TYLER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 44 , 64 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1013365428,"DUPREY, ROBERT, TYLER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013368828,"MCDONOUGH, TALIA, FRANCESCA MARIE",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013368828,"MCDONOUGH, TALIA, FRANCESCA MARIE",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013369073,"TURKSON-OCRAN, CLAUDIA, NORKOR",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 41 , 51 , 153 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013369073,"TURKSON-OCRAN, CLAUDIA, NORKOR",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1013369818,"HERB, BRANDON, DAVID",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1013369818,"HERB, BRANDON, DAVID",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013369818,"HERB, BRANDON, DAVID",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 44 , 53 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013369818,"HERB, BRANDON, DAVID",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 73 , 71 , 80 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1013369818,"HERB, BRANDON, DAVID",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 42 , 52 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013369818,"HERB, BRANDON, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 63 , 75 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013369818,"HERB, BRANDON, DAVID",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013370089,"ROSSI, VINCENT, JACK",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 63 , 107 , 172 ," $18,852.23 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013370956,"WYANT, JAMES, RICHARD",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013371079,"RUDERMAN, ANNA, ALIZA JAFFE",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 47 , 103 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013371079,"RUDERMAN, ANNA, ALIZA JAFFE",5832 FAYETTEVILLE RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 25 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1013371426,"HEDGES, BRIAN, ZACHARY",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1013371426,"HEDGES, BRIAN, ZACHARY",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 81 , 80 , 109 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1013371426,"HEDGES, BRIAN, ZACHARY",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013371426,"HEDGES, BRIAN, ZACHARY",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013371426,"HEDGES, BRIAN, ZACHARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013371426,"HEDGES, BRIAN, ZACHARY",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013371426,"HEDGES, BRIAN, ZACHARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 25 , 32 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1013372390,"FARR, ERIN",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 26 , 71 , 71 ,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013375914,"MARTIN, SETH, TRAVIS",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1013375914,"MARTIN, SETH, TRAVIS",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1013379734,"THOMPSON, JOHN, WILLIAM",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 67 , 68 ," $13,026.25 ",,
MEDICAID DIRECT,1720364649,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1013379734,"THOMPSON, JOHN, WILLIAM",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013380393,"CLEARY-LYNCH, CAITLIN, MARIE",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 73 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013380633,"THAYIL, IRENE, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 47 , 47 ,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013382720,"PHILLIPS, TONYA, THOMPSON",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881651347,GOLDSBORO COUNSELING CENTER PA,Goldsboro Counseling Center PA,208 MALLOY ST STE E GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013383488,"MACDONALD, JOHN, RAYMOND",208 MALLOY ST STE E GOLDSBORO NC,096,Wayne,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013387018,"LEGGETT, LAUREN, AMANDA",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1790748218,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PULMONARY AND CRITICAL CARE,1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013387018,"LEGGETT, LAUREN, AMANDA",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1013388727,"MCCAIG, GAEA, ANNICE",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1013388727,"MCCAIG, GAEA, ANNICE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013388727,"MCCAIG, GAEA, ANNICE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013389451,"THOMAS, DANIELLE, DEPIERRO",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 44 , 77 ,$#,,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1013390228,"WHITELEY, ADAM, BROCK",1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 49 , 83 , 100 ," $17,520.72 ",,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1013390228,"WHITELEY, ADAM, BROCK",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 201 , 427 , 483 ," $86,237.14 ",,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013390574,"SWARINGEN, RAEGAN, JENNIFER",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013391663,"FISHER, CHERYL, NICOLE",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013391663,"FISHER, CHERYL, NICOLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013391762,"REID, MARY, KELLY",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 18 , 23 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013391762,"REID, MARY, KELLY",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 169 , 248 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013391762,"REID, MARY, KELLY",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013391861,"RASHID, FARHAN, DANYAL",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013393537,"APPLEBOME, BETHANY, MARIE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 88 , 112 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013393537,"APPLEBOME, BETHANY, MARIE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013393537,"APPLEBOME, BETHANY, MARIE",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013393537,"APPLEBOME, BETHANY, MARIE",310 LONG SHOALS RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013393537,"APPLEBOME, BETHANY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013394964,"ROBINSON, KYLE, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 109 , 208 , 298 ," $16,590.48 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013395193,"CHEN, WEI",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 98 , 101 , 145 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013395193,"CHEN, WEI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 27 , 29 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013395193,"CHEN, WEI",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013397405,"ALLEN, SHELBY, LYNN",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013397405,"ALLEN, SHELBY, LYNN",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 23 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013397405,"ALLEN, SHELBY, LYNN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013397405,"ALLEN, SHELBY, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 44 , 48 ,$#,,
MEDICAID DIRECT,1972220762,CAMILLA L MISKOVICH DMD PLLC,BIG LITTLE SMILES,1730 MATTHEWS TOWNSHIP PKWY STE D MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013398783,"MISKOVICH, CAMILLA, LIZ",1730 MATTHEWS TOWNSHIP PKWY STE D MATTHEWS NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,146 "," 2,471 "," 12,468 "," $597,913.47 ",,
MEDICAID DIRECT,1548620297,RHA BEHAVIORAL HEALTH NC LLC,,2732 ANN ELIZABETH DR   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013400621,"FUTRELL, PARIS, SADA",2732 ANN ELIZABETH DR   BURLINGTON NC,001,Alamance,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013402312,"SPEARMAN, JAMES, VANCE",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013404433,"BYERLY, BENJAMIN, LLOYD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 98 , 99 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013404532,"DUMBERGER, LUKAS, DAVID",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013404532,"DUMBERGER, LUKAS, DAVID",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 27 , 41 , 68 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013404607,"ALMEIDA LARREA, ALEXANDER, DANIEL",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 16 , 26 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1013404607,"ALMEIDA LARREA, ALEXANDER, DANIEL",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 71 , 110 , 147 ," $18,365.30 ",,
MEDICAID DIRECT,1255390225,WILSON OB GYN,WILSON OB GYN,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1013404607,"ALMEIDA LARREA, ALEXANDER, DANIEL",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 51 , 68 , 78 ," $10,333.68 ",,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013409051,"LIM, IDA, MAY",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013411032,"MCRARY, GRAHAM, PHILIP",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 56 , 140 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013411032,"MCRARY, GRAHAM, PHILIP",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 79 , 184 , 347 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013411032,"MCRARY, GRAHAM, PHILIP",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013411032,"MCRARY, GRAHAM, PHILIP",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1013411875,"MANASCO, CALEB, SCOTT",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1013411875,"MANASCO, CALEB, SCOTT",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013412477,"JOHNSON, SARAH, RUTH",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013412477,"JOHNSON, SARAH, RUTH",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013412477,"JOHNSON, SARAH, RUTH",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013412477,"JOHNSON, SARAH, RUTH",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 13 , 20 , 41 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013417799,"SIDES, AMIE, THOBURN",315 PARK RIDGE RD   ALBEMARLE NC,084,Stanly,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 83 , 88 ,$#,,
MEDICAID DIRECT,1750648077,ROBESON HEALTH CARE CORPORATION,SCOTLAND HEALTH CENTER,507 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013422344,"ONKUNDI, ROSELYNE, BONARERI",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013423722,"WOODRUFF, ALISON, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013425404,"MILLER, JESSICA, JO",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 29 , 36 ,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013425404,"MILLER, JESSICA, JO",161 WALKER ST   COLUMBUS NC,075,Polk,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013425404,"MILLER, JESSICA, JO",187 W MAIN ST   SPINDALE NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 120 , 141 ,$#,,
MEDICAID DIRECT,1013425933,REX SURGERY CENTER OF WAKEFIELD LL,,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1013425933,REX SURGERY CENTER OF WAKEFIELD LL,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 35 , 41 , 53 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013426972,"STROHECKER, KATHARINE, ANNE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1013426980,INTEGRATED PEDIATRIC THERAPIES LLC,KIDS AT PLAY,3260 OCEANIC BAY DR   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1013426980,INTEGRATED PEDIATRIC THERAPIES LLC,3260 OCEANIC BAY DR   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,, 67 , 889 , 892 ," $84,412.02 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013428317,"JOHNSON, HANNAH, DIMSDALE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1093758476,BRADLEY A SAMUEL DDS PA,BRADLEY A SAMUEL DDS PA,1001 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013432889,"GRILLO, DOMINICK, JOSEPH",1001 N LINDSAY ST   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 39 , 64 , 190 ," $13,175.23 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013434257,"SPAULDING, STEPHANIE, HOWARD",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 25 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013434257,"SPAULDING, STEPHANIE, HOWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 15 , 27 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013435080,"CLENDENIN, WHITNEY, BRADY",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 35 , 58 , 61 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013435080,"CLENDENIN, WHITNEY, BRADY",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1013435080,"CLENDENIN, WHITNEY, BRADY",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013435080,"CLENDENIN, WHITNEY, BRADY",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 234 , 261 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013435080,"CLENDENIN, WHITNEY, BRADY",230 E PRESNELL ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 227 , 241 ,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1013436435,"COUCH, CHRISTOPHER, EVAN",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013437342,"TEDLA, EDEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013439892,"DILLON, BRITTANY, FORREN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 45 , 45 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013439892,"DILLON, BRITTANY, FORREN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013439892,"DILLON, BRITTANY, FORREN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 30 , 30 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013440254,"HUDSON, ERICA, LYNN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013440569,"BRUNO, RICHARD, RAYMOND",2790 GODWIN BLVD STE 355 SUFFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013441112,"ZHANG, BO",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013441112,"ZHANG, BO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 52 , 55 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013441112,"ZHANG, BO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013443167,"PIRAINO, JAVIER, ANDRES",10650 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 17 , 30 , 51 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013443167,"PIRAINO, JAVIER, ANDRES",10650 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013443167,"PIRAINO, JAVIER, ANDRES",10650 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013443324,"AYOUB, CHAKIB, MAURICE",2301 ERWIN ROAD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013443324,"AYOUB, CHAKIB, MAURICE",2301 ERWIN ROAD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013443324,"AYOUB, CHAKIB, MAURICE",2301 ERWIN ROAD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 21 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013443324,"AYOUB, CHAKIB, MAURICE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 109 , 118 , 119 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013445410,"SCOTT, GABRIEL, RENE",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013445477,"BRANDT, KENDRA, NICOLE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 26 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013445477,"BRANDT, KENDRA, NICOLE",555 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013447549,"DORMAN, MATTHEW, ANTHONY",201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 91 , 102 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013448075,"FLEISCHMAN, ANNA, MARY",204 MEDSPRING DR   CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013448075,"FLEISCHMAN, ANNA, MARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013448075,"FLEISCHMAN, ANNA, MARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013448075,"FLEISCHMAN, ANNA, MARY",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013448075,"FLEISCHMAN, ANNA, MARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,192 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1013448216,"KHAN, FARID, MANSOOR",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013448216,"KHAN, FARID, MANSOOR",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 33 , 76 ,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013448216,"KHAN, FARID, MANSOOR",1998 HENDERSONVILLE RD STE 40 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013448216,"KHAN, FARID, MANSOOR",1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013449594,"NELSEN, DEREK, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 76 , 77 , 81 ," $10,980.77 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 42 , 43 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 47 , 47 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013454834,"RIDDLE, ZACHARY, COLE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013454974,"REYNOLDS, REBECCA, LLOYD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013454974,"REYNOLDS, REBECCA, LLOYD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013454974,"REYNOLDS, REBECCA, LLOYD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013454974,"REYNOLDS, REBECCA, LLOYD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013455039,"POTTICARY, DEBORAH, KRIST",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 100 , 100 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013458835,"PINGSTON, ALLISON, ANN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 24 , 50 ,$#,,
MEDICAID DIRECT,1013459643,POSITIVE LIFE STYLES,~,4805 GREEN WING RD   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1013459643,POSITIVE LIFE STYLES,4805 GREEN WING RD   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 785 , 815 ," $56,440.71 ",,
MEDICAID DIRECT,1306411228,SPARTANBURG MEDICAL CENTER,MEDICALGROPOFTHECAROLINAS-NEUROLOGY-SPARTANBURG,1650 SKYLYN DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1013460708,"JHUNJHUNWALA, KETAN, RAMAKANT",1650 SKYLYN DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1013460872,"BLACKBURN, ROBERT, JACKSON",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1013463157,ENDOSCOPY CENTER OF NORTH CAROLINA,,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1013463157,ENDOSCOPY CENTER OF NORTH CAROLINA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 230 , 250 , 358 ," $13,715.80 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013463470,"WEXLER, RACHEL, ELIZABETH",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013463470,"WEXLER, RACHEL, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013463470,"WEXLER, RACHEL, ELIZABETH",21 HOSPITAL DR FL 4 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013463603,"STEPHENS, TIFFANY",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1013463603,"STEPHENS, TIFFANY",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013463603,"STEPHENS, TIFFANY",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 26 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 123 , 123 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 120 , 120 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013463637,"ROBERTS, ADAM, MICHAEL",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013470368,"OLMSTED, RANDALL, ZACHARY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 31 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013470368,"OLMSTED, RANDALL, ZACHARY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013470368,"OLMSTED, RANDALL, ZACHARY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013470368,"OLMSTED, RANDALL, ZACHARY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 39 , 43 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013472232,"MATHIS, SHANNON, BONEY",13 MEDICAL CAMPUS DR NW STE 102 SUPPLY NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013472232,"MATHIS, SHANNON, BONEY",2950 PINE PLANTATION PKWY   OAK ISLAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 15 , 25 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013472232,"MATHIS, SHANNON, BONEY",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013472232,"MATHIS, SHANNON, BONEY",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,320 VETERANS PARKWAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013473180,"THOMAS, SARA, BETH LILES",320 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013473180,"THOMAS, SARA, BETH LILES",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013473180,"THOMAS, SARA, BETH LILES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 31 , 37 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1013473180,"THOMAS, SARA, BETH LILES",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 22 , 25 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013473180,"THOMAS, SARA, BETH LILES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,320 VETERANS PARKWAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013473180,"THOMAS, SARA, BETH LILES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1013473180,"THOMAS, SARA, BETH LILES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 27 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013473438,"NDUKA, BRIDGET, CHINELO",7752 GATEWAY LN NW STE 100 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 82 , 159 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013479864,"WILDA, SARAH, ELIZABETH KIRK",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1313 CAROLINA ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013482033,"DALE, TAYLOR, MACKENZIE",1313 CAROLINA ST STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013482033,"DALE, TAYLOR, MACKENZIE",1313 CAROLINA ST STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 81 , 91 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013482033,"DALE, TAYLOR, MACKENZIE",1313 CAROLINA ST STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1013483676,"BELL, KATRINA, BROOKSHIRE",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861268245,CALDWELL MEMORIAL HOSPITAL,PLUS URGENT CARE HICKORY,36 14TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013483676,"BELL, KATRINA, BROOKSHIRE",36 14TH AVE NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 18 , 36 ,$#,,
MEDICAID DIRECT,1013485705,"MORGAN, DOUGLAS, BOYCE",DOUGLAS B MORGAN,497 OLDE WATERFORD WAY STE 108 BELVILLE NC,010,Brunswick,111N00000X,Chiropractic Providers,Chiropractor,,1013485705,"MORGAN, DOUGLAS, BOYCE",497 OLDE WATERFORD WAY STE 108 BELVILLE NC,010,Brunswick,111N00000X,Chiropractic Providers,Chiropractor,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013488394,"MARTINEZ SEAGLE, LACEY, KENDALL",44 BONNIE LN   SYLVA NC,050,Jackson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013490770,"KUFEJI, OMOTARA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013490770,"KUFEJI, OMOTARA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013490770,"KUFEJI, OMOTARA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,14 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1013490994,"SPENCER, BROOKE, NICOLE",14 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 92 , 110 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013490994,"SPENCER, BROOKE, NICOLE",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013490994,"SPENCER, BROOKE, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013492180,"PENDERGRAFT, SAMUEL, SPARROW",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 56 , 75 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1013493147,"GREENWOOD, CATHY A",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013494970,"STANDISH, SHANNON, BUMGARDNER",2544 COURT DR STE F GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 53 , 69 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1013494970,"STANDISH, SHANNON, BUMGARDNER",2544 COURT DR STE F GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013494970,"STANDISH, SHANNON, BUMGARDNER",2544 COURT DR STE F GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013495407,"BUSAM, LAUREN, BROOKE",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013495407,"BUSAM, LAUREN, BROOKE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,100 CORNERSTONE DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013495407,"BUSAM, LAUREN, BROOKE",100 CORNERSTONE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1013495407,"BUSAM, LAUREN, BROOKE",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1013495407,"BUSAM, LAUREN, BROOKE",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013496967,"HOLCOMB, JACOB, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 35 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013497312,"SANTIAGO, ELIZABETH, HAYES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013497312,"SANTIAGO, ELIZABETH, HAYES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1053074369,MCPC 22 LLC,FIRSTHEALTH-SANDHILLS NEUROLOGISTS,295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1013500461,"GARDNER, JACOB, ERIK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 79 , 123 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013501980,"PAUL, PRINCY, ANNA",1357 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013501980,"PAUL, PRINCY, ANNA",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 88 , 228 , 248 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013501980,"PAUL, PRINCY, ANNA",510 TIMBER DR E STE 105 GARNER NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013502145,"HENRY, KIMBER, ALCESS",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013502145,"HENRY, KIMBER, ALCESS",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013502145,"HENRY, KIMBER, ALCESS",260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639661796,OPPORTUNITIES INDUSTRIALIZATION CEN,~,260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013502145,"HENRY, KIMBER, ALCESS",260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013502145,"HENRY, KIMBER, ALCESS",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417542556,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH ORTHOPEDICS AND SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1013505163,"CONRAD, BRIAN, EDWARD",503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 108 , 240 , 405 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013508258,"BRUMMER, DELANEY, LEE",4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 44 , 64 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013508258,"BRUMMER, DELANEY, LEE",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013509280,"MARTIN, MEAGAN, COLLINS",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1013509421,"COMEAU, CHELSEA, TAYLOR",,4803 FOX CHASE RD   GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1013509421,"COMEAU, CHELSEA, TAYLOR",4803 FOX CHASE RD   GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1013509454,"BRINKERHOFF, ADAM, LEVI",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013510825,"YOSHIZUKA, TOYEN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013514454,"DRAKER, STEPHANIE, CAUDLE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 35 , 35 ,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013514454,"DRAKER, STEPHANIE, CAUDLE",755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013514454,"DRAKER, STEPHANIE, CAUDLE",755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013514686,"LINNEY, JENNIFER, JEAN",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 124 , 390 , 404 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1013514686,"LINNEY, JENNIFER, JEAN",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013522424,"MORGAN, HANNAH, CHICOWLAS",5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1013522424,"MORGAN, HANNAH, CHICOWLAS",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 17 , 19 , 33 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1013524776,"HARRELL, TAYLOR, MICHAEL",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1013524776,"HARRELL, TAYLOR, MICHAEL",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013525310,"ST LOUIS THOMPSON, SANDRA",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1013525310,"ST LOUIS THOMPSON, SANDRA",401 W DECATUR ST   MADISON NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 103 , 143 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1013525849,"WEGENKA, EMILY, CAROLINE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013526037,"DUGAL, REBECCA, GRACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 49 , 49 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013530781,"SAUVEUR, ROCHARD, BENJAMIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013530781,"SAUVEUR, ROCHARD, BENJAMIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013530781,"SAUVEUR, ROCHARD, BENJAMIN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 118 , 118 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1013530781,"SAUVEUR, ROCHARD, BENJAMIN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 30 , 30 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013532894,"MILES, MEAGAN, RENEE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1699863068,CAROLINA EYE CARE OF LINCOLN COUNTY,CAROLINA EYE CARE OF LINCOLN COUNTY,231 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013532894,"MILES, MEAGAN, RENEE",231 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1699863068,CAROLINA EYE CARE OF LINCOLN COUNTY,CAROLINA EYE CARE OF LINCOLN COUNTY,623 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1013532894,"MILES, MEAGAN, RENEE",623 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1407958226,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013536341,"AUTRY-LOTT, SIMONE, ELIZABETH CORWINE",301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 15 , 28 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013536341,"AUTRY-LOTT, SIMONE, ELIZABETH CORWINE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 34 , 35 ," $10,815.43 ",,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013536341,"AUTRY-LOTT, SIMONE, ELIZABETH CORWINE",5921 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1407958226,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013536341,"AUTRY-LOTT, SIMONE, ELIZABETH CORWINE",301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013536341,"AUTRY-LOTT, SIMONE, ELIZABETH CORWINE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013536366,"RAJANAYAGAM, MELAINE, ROUSHINI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 117 , 119 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013536366,"RAJANAYAGAM, MELAINE, ROUSHINI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013536366,"RAJANAYAGAM, MELAINE, ROUSHINI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 14 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013538016,"YOUNG, TRAVIS, JAMES",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013541697,"HATCHER, ANNA, NICOLE",3960 VIRGINIA BEACH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780643999,CHADBOURN FAMILY PRACTICE CENTER PA,~,104 E 7TH AVE   CHADBOURN NC,024,Columbus,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013542315,"SIMMONS, KASSIE, JUJUAN",104 E 7TH AVE   CHADBOURN NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780643999,CHADBOURN FAMILY PRACTICE CENTER PA,~,104 E 7TH AVE   CHADBOURN NC,024,Columbus,193400000X,Group,Single Specialty,,1013542315,"SIMMONS, KASSIE, JUJUAN",104 E 7TH AVE   CHADBOURN NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 146 , 589 , 636 ," $10,391.81 ",,
MEDICAID DIRECT,1780643999,CHADBOURN FAMILY PRACTICE CENTER PA,~,104 E 7TH AVE   CHADBOURN NC,024,Columbus,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013542315,"SIMMONS, KASSIE, JUJUAN",104 E 7TH AVE   CHADBOURN NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 98 , 195 , 197 ," $12,329.81 ",,
MEDICAID DIRECT,1780643999,CHADBOURN FAMILY PRACTICE CENTER PA,~,104 E 7TH AVE   CHADBOURN NC,024,Columbus,193400000X,Group,Single Specialty,,1013542315,"SIMMONS, KASSIE, JUJUAN",104 E 7TH AVE   CHADBOURN NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013543636,"WOODY, BENJAMIN, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1013543651,WILSON COUNTY OFFICE OF SENIOR CITI,WILSON COUNTY OFFICE OF SENIOR CITIZENS AFFAIRS,2101 TARBORO ST SW STE C WILSON NC,098,Wilson,332U00000X,Suppliers,Home Delivered Meals,,1013543651,WILSON COUNTY OFFICE OF SENIOR CITI,2101 TARBORO ST SW STE C WILSON NC,098,Wilson,332U00000X,Suppliers,Home Delivered Meals,, 102 ," 22,064 "," 22,064 "," $169,871.10 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013545086,"LEWIS-BEVAN, SIAN, ELLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013545714,"VAIDYA, SHIVANI, H",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 22 , 33 , 34 ,$#,,
MEDICAID DIRECT,1467149823,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH EMERGENCY PHYSICIANS,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1013546076,"STEARNEY, ELAINE, RENAE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013546076,"STEARNEY, ELAINE, RENAE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 143 , 155 , 221 ," $11,169.16 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013546415,"CORTESE, KEVIN, TODD",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 53 , 58 ,$#,,
MEDICAID DIRECT,1386682367,EAST ASHEVILLE FAMILY HEALTH CARE,~,997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1013547553,"FORE, BRENDA, CHERYL",997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 212 , 494 ,$#,,
MEDICAID DIRECT,1013548072,HEALTHY SENIORS LLC,HEALTHY SENIORS PHYSICAL THERAPY AND WELLNESS,4829 CAROLINA BEACH RD STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013548072,HEALTHY SENIORS LLC,4829 CAROLINA BEACH RD STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,#,#, 19 ,$#,,
MEDICAID DIRECT,1013549302,EYECARECENTER OD PA,,303 SALISBURY AVE   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1013549302,EYECARECENTER OD PA,303 SALISBURY AVE   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,, 96 , 96 , 192 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013550763,"BACHMAN, BRENT, FRANCIS",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 26 , 33 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1013550763,"BACHMAN, BRENT, FRANCIS",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1013550763,"BACHMAN, BRENT, FRANCIS",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 33 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013551886,"SALEFSKY, HANNAH, KIRSTEN",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013551886,"SALEFSKY, HANNAH, KIRSTEN",51 LEE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013552256,"SUCH, MORGAN, LEIGH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 16 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1013552439,"BOGULSKI, MIKAYLA, LEEANNE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154765832,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH APPEL & WORMER PLASTIC SURGERY,1901 BRUNSWICK AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013554153,"CARONIS, ALEXANDRA, CHARLOTTE",1901 BRUNSWICK AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013554153,"CARONIS, ALEXANDRA, CHARLOTTE",1901 BRUNSWICK AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1013554393,"SNYDER, BRITTANY, MARIE",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 162 , 298 , 372 ," $97,710.05 ",,
MEDICAID DIRECT,1730325473,APEX VISION CENTER OD PA,CLARITY VISION OF APEX,1049 BEAVER CREEK COMMONS DR CLARITY VISION APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1013556133,"YANG, MAO",1049 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013559210,"ZIMMERS, LYNN, TON",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 20 , 22 , 57 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013560697,"RECKER, KIM, LOCKLEAR",923 W 3RD ST STE B PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 69 , 107 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013560697,"RECKER, KIM, LOCKLEAR",4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013560697,"RECKER, KIM, LOCKLEAR",923 W 3RD ST STE B PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013560697,"RECKER, KIM, LOCKLEAR",923 W 3RD ST STE B PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831687912,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN WOMENS HEALTHCARE AT THE OAKS,,,Unknown,193200000X,Group,Multi-Specialty,,1013560697,"RECKER, KIM, LOCKLEAR",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013560697,"RECKER, KIM, LOCKLEAR",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1447829726,DRS REIMELS AND RONCAGLIONE PLLC,,9115 SAMLEN LN APT 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013560739,"RONCAGLIONE, LOUIS, MCCOY",9115 SAMLEN LN APT 105 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013561646,"BOJANOWSKI, ANDREW, JOSEPH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 54 , 70 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013563774,"FINCH, CRISTI, MARIE",400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013563774,"FINCH, CRISTI, MARIE",4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 22 , 31 , 73 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1013563774,"FINCH, CRISTI, MARIE",23 SUNNYBROOK RD STE 116 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1013565290,A PRIMARY CHOICE INC,,727 S BROADWAY ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,,1013565290,A PRIMARY CHOICE INC,727 S BROADWAY ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 3,760 "," 3,760 "," $239,812.52 ",,
MEDICAID DIRECT,1184197063,LUZ A CHAVEZ DDS II PC,,816 E ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013569573,"SITARAS, JOANNIS, TERRY",816 E ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1538978531,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - INDEPENDEN,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013576735,"KONERU, PRATHEEK, CHOUDARY",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538978531,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - INDEPENDEN,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013576735,"KONERU, PRATHEEK, CHOUDARY",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013576735,"KONERU, PRATHEEK, CHOUDARY",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 186 , 236 , 559 ," $32,776.22 ",,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013578038,"AGLADZE, MARIAM",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1013581818,"SHRESTHA, SUMNIMA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1013581818,"SHRESTHA, SUMNIMA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 126 , 127 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013582022,"AJIBOLA, ENE, ANNE",1236 HUFFMAN MILL RD STE 1500 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013583673,"CORNETTE, LAUREN, WOOTEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013583673,"CORNETTE, LAUREN, WOOTEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013583673,"CORNETTE, LAUREN, WOOTEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013584382,"TANNENBAUM, NICHOLAS, HENRY",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013587286,"THOMAS, SHANE, MATTHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1013587286,"THOMAS, SHANE, MATTHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1013587286,"THOMAS, SHANE, MATTHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013587963,"ELLIS, CAITLYN, MICHELLE",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 35 , 67 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013589092,"MEYER, KELLY, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013589175,"KHALIL, SHUMAILA",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 16 , 23 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013589886,"MAYBERRY, GRAYSON, BRENT",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 36 , 68 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013589886,"MAYBERRY, GRAYSON, BRENT",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013589886,"MAYBERRY, GRAYSON, BRENT",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 40 , 72 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013589886,"MAYBERRY, GRAYSON, BRENT",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013589886,"MAYBERRY, GRAYSON, BRENT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013589886,"MAYBERRY, GRAYSON, BRENT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013593417,MED-TRANS CORPORATION,,200 MEDICAL PARK BLVD UNIT 1 PETERSBURG VA,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1013593417,MED-TRANS CORPORATION,200 MEDICAL PARK BLVD UNIT 1 PETERSBURG VA,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1487879177,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - KER,861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013596055,"WEAVER, BARTLEY, ANDERSON",861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 19 , 42 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1013597053,"MARTS, COLIN, HILLARD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013598390,"IBANGA, ADEIMA, UBOKUDOM",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 39 , 66 ,$#,,
MEDICAID DIRECT,1487845020,AVANCE CARE PA,,1821 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1013601475,"SCOTT, BREE, LAUREN",300 MARKET ST STE 112 CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013602200,"GRAY, ASHLEY, RENEE",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 38 , 72 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,725 OAKRIDGE BLVD STE A1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013603257,"BROOKS, MARGARET, DANIELLE",725 OAKRIDGE BLVD STE A1 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 75 , 129 , 188 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013603257,"BROOKS, MARGARET, DANIELLE",725 OAKRIDGE BLVD STE A1 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 42 , 47 ,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,7021 HARPS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013603489,"BOVENDER, AUDRA, HELENA",5920 SANDY FORKS RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,5920 SANDY FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013603489,"BOVENDER, AUDRA, HELENA",5920 SANDY FORKS RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013606037,"KITCHEN, ROSHAUNDA, MORENO",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 984 ," 1,322 "," 4,378 "," $263,894.63 ",,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013606037,"KITCHEN, ROSHAUNDA, MORENO",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013606037,"KITCHEN, ROSHAUNDA, MORENO",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 37 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1013609643,"FLORES, DENNIS, ANTHONY",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013609643,"FLORES, DENNIS, ANTHONY",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1013609643,"FLORES, DENNIS, ANTHONY",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1013609643,"FLORES, DENNIS, ANTHONY",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013621499,"TOLER, CRYSTAL, BLACKBURN",4007 M L KING JR BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073572822,ONSLOW PEDIATRIC ASSOCIATES,~,51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1013621796,"NACE, CHELSEA, JO",51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 37 , 114 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013622398,"BRISBEN, ASHLYNN, VICTORIA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 17 , 37 , 47 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013622398,"BRISBEN, ASHLYNN, VICTORIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013627488,"WINDHAM, CAROLINE, HAAS",1470 E GASTON ST   LINCOLNTON NC,055,Lincoln,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1013631647,"BOONE, ELIZABETH, REVIS",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 187 , 190 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1013633155,"LORDY, KATHERYN, ANGEL",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013633155,"LORDY, KATHERYN, ANGEL",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1013633619,"RUCKER, KALEN",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1013635887,HEAVENS ANOINTED TOUCH HOME CARE,,1685 S MAIN ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1013635887,HEAVENS ANOINTED TOUCH HOME CARE,1685 S MAIN ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 78 ," 6,667 "," 7,233 "," $711,490.96 ",,
MEDICAID DIRECT,1013635887,HEAVENS ANOINTED TOUCH HOME CARE,,127 FAIRLY ST UNIT B LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1013635887,HEAVENS ANOINTED TOUCH HOME CARE,127 FAIRLY ST UNIT B LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 87 ," 12,026 "," 12,957 "," $1,298,951.15 ",,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013636463,"BARRON-GRAHAM, CHRISTOPHER, VICTOR",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 49 , 56 ,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013636521,"WOOD, ROBYN, JEAN",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 119 , 119 ,$#,,
MEDICAID DIRECT,1104500701,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT JONESVILLE ELEMENTARY,101 CEDARBROOK RD   JONESVILLE NC,099,Yadkin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013636539,"MAYA, JACQUELINNE, AGUILERA",3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 72 , 72 ," $19,132.37 ",,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013636539,"MAYA, JACQUELINNE, AGUILERA",3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013639459,"FORREST, SIMONICA, URIAH",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 121 , 154 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013641430,"OLDHAM, KELLI, STARR",517 MOYE BLVD   GREENVILLE NC,074,Pitt,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013641976,"IBRAHIM, AMANDA, ALLESSIO",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386158616,CAROLINA ELITE WOMENS CARE,,901 US 70 HWY W STE 100 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1013641976,"IBRAHIM, AMANDA, ALLESSIO",901 US 70 HWY W STE 100 GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1316023443,HIGGINS MANI & WATSON IV DDS PA,THE DENTAL CARE CENTER,545 VENTURE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013644848,"BALDWIN, FIONDRA, DEMITA",545 VENTURE DR   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice," 1,100 "," 1,818 "," 5,803 "," $311,113.24 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013644962,"BLITCH, DEBBIE, M",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013644962,"BLITCH, DEBBIE, M",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013644962,"BLITCH, DEBBIE, M",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 22 , 54 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1013644962,"BLITCH, DEBBIE, M",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013647155,"BELCHER, REBECCA, CHRISTINE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1013651256,A CARING HAND HOME CARE,,2537 RAEFORD RD STE D FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1013651256,A CARING HAND HOME CARE,2537 RAEFORD RD STE D FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 41 ," 6,142 "," 6,200 "," $596,632.28 ",,
MEDICAID DIRECT,1750155545,THE DAWSON CENTER PLLC,,4904 WATERS EDGE DR STE 154 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013653609,"DAWSON, ALISA, FAW",4904 WATERS EDGE DR STE 154 RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013654045,"ST JOHN, SAMANTHA, MICHELLE",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 33 , 67 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013654045,"ST JOHN, SAMANTHA, MICHELLE",208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 129 , 301 ,$#,,
MEDICAID DIRECT,1013660612,PEACE OF MIND COMMUNITY CARE,~,2216 W MEADOWVIEW RD STE 269 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1013660612,PEACE OF MIND COMMUNITY CARE,2216 W MEADOWVIEW RD STE 269 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1730367467,HOSPICE & PALLIATIVE CARECENTER,TRELLIS SUPPORTIVE CARE,101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013661339,"MARKLAND, JENNIFER, JONES",101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1598839474,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS,146 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1013662204,"BOROWICZ, ALLISON, NICOLE",146 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1053570234,HANGER PROSTHETICS & ORTHOTICS EAST,FAITH PROSTHETIC-ORTHOTIC SERVICES INC,10320 FELD FARM LN STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1013662204,"BOROWICZ, ALLISON, NICOLE",10320 FELD FARM LN STE 200 CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1013670595,"HELGESON, KRYSTENE, LYNN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,440 TYVOLA RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013671734,"REBER, STEPHEN, JAMES",440 TYVOLA RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013671734,"REBER, STEPHEN, JAMES",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013671734,"REBER, STEPHEN, JAMES",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013671734,"REBER, STEPHEN, JAMES",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013673987,"SALIBA, BRIDGETT, AMANDA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013679950,LIFESPAN THERAPY PLLC,LIFESPAN THERAPY,4020 HENDERSONVILLE RD STE E FLETCHER NC,045,Henderson,193400000X,Group,Single Specialty,,1013679950,LIFESPAN THERAPY PLLC,4020 HENDERSONVILLE RD STE E FLETCHER NC,045,Henderson,193400000X,Group,Single Specialty,, 25 , 442 , 471 ," $34,534.22 ",,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013681071,"GICHUHI, GRACE, WANJIRU",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 174 , 306 , 383 ," $26,028.77 ",,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013681089,"HORIO, MEGHAN, KIYOMI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013682350,"ADAMS, CARA, NICOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013682350,"ADAMS, CARA, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1013683911,"SIMMONS-SHERLOCK, MARY, ELIZABETH",6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1013683911,"SIMMONS-SHERLOCK, MARY, ELIZABETH",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013683911,"SIMMONS-SHERLOCK, MARY, ELIZABETH",210 ASHVILLE AVE   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013691328,"PALDINO, ASHLEY, NICOLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013691328,"PALDINO, ASHLEY, NICOLE",517 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 25 , 50 , 51 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013692755,"CHABER, ASHLEY, LINDA",803 BERMUDA BAY BLVD   KILL DEVIL HILLS NC,028,Dare,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 35 , 94 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013693969,"REIL, JASON, MITCHELL",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013693969,"REIL, JASON, MITCHELL",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780752394,"MILNER, WILLIAM, EDWIN",~,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,1013694306,"WALKER, JOSHUA, JAMES",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023177151,ACCESS DENTAL CARE,ACCESS DENTAL CARE,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1013694306,"WALKER, JOSHUA, JAMES",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice," 1,226 "," 1,399 "," 3,875 "," $218,813.08 ",,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013697945,"LIAPIS, MARIA, NICOLA",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 27 , 35 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1013697945,"LIAPIS, MARIA, NICOLA",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1013697945,"LIAPIS, MARIA, NICOLA",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013697945,"LIAPIS, MARIA, NICOLA",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255851424,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FORESTVILLE CROSSING,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013698851,"VILLAZOR, CLARA-JADE, RAYMUNDO",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1265723597,UNC PHYSICIANS NETWORK LLC,~,1515 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013699115,"CAREY, MARIAH, LALIBERTE",1515 SW CARY PKWY STE 200 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 18 , 30 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1013699511,"CHOPLIN, MALLORY, ALEXA",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 64 ,$#,,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013699966,"CHANDRAMOULY, MEENA",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 2,052 "," 2,726 "," 9,808 "," $641,235.57 ",,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013699966,"CHANDRAMOULY, MEENA",3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 49 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1013721133,"WILLIAMS, CHRISTINA, SYMONE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 24 ,$#,,
MEDICAID DIRECT,1922353838,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,1423 E FRANKLIN ST STE D MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013722255,"AZMEH, MAYCE",1423 E FRANKLIN ST STE D MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013740919,"HUSSEINI, ALYSSA, HELENE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1013741974,"BRINKER, CALLIE, ALEXIS FAITH",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013742741,"BUMANGLAG, ERIC, LABRADOR",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013742824,"VAN STADEN, MATTHEW, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013743749,"CLAPPER, JOSHUA, CALEB",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 57 , 158 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",3610 PETERS CT   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",3605 PETERS CT   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 26 , 67 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 124 , 246 , 537 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",3610 PETERS CT   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",3604 PETERS CT   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013753508,"YOUNGER, ANTHONY, TODD",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 94 , 159 ,$#,,
MEDICAID DIRECT,1619342706,ROANOKE CHOWAN COMMUNITY HEALTH CEN,CRESWELL PRIMARY CARE,9500 NC HIGHWAY 94 N   CRESWELL NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013756451,"HILL, CHARLES, DONALD",9500 NC HIGHWAY 94 N   CRESWELL NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 122 , 135 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013756451,"HILL, CHARLES, DONALD",9500 NC HIGHWAY 94 N   CRESWELL NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538270814,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,157 HEALTH SERVICES RD   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1013762020,"JENKINS, GINA, GILLEY",157 HEALTH SERVICES RD   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 39 ,$#,,
MEDICAID DIRECT,1437653359,SANDHILLS BEHAVIORAL CARE PLLC,SANDHILLS BEST CARE,523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1013765189,"PASSLEY, TRACY ANN, BEVERLY",523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013782648,"KEMENY, LAUREN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013782648,"KEMENY, LAUREN, ELIZABETH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013782648,"KEMENY, LAUREN, ELIZABETH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1013788801,"PHELPS, BRANDON, ZACHARY",100 W H ST   BUTNER NC,039,Granville,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013788991,"HENRY, CATHELIN, MCCARTHY",2100 RIDGEFIELD BLVD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013788991,"HENRY, CATHELIN, MCCARTHY",1 HOSPITAL DR STE 4100 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1013789734,"NUTTER, KYLEE, JO",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 31 , 52 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1013789734,"NUTTER, KYLEE, JO",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 39 ,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1013789734,"NUTTER, KYLEE, JO",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1013789734,"NUTTER, KYLEE, JO",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 33 , 123 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1013789734,"NUTTER, KYLEE, JO",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013790096,"COOK, KENDRA, JORDAN",123 WEAVER RD STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013790096,"COOK, KENDRA, JORDAN",123 WEAVER RD STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1376893008,CAROLINA CHIROPRACTIC PLUS OF POLK,CAROLINA CHIROPRACTIC PLUS OF POLK COUNTY,96 WALKER ST   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1013790815,"MANNING, CAYLA, JENELLE",96 WALKER ST   COLUMBUS NC,075,Polk,111N00000X,Chiropractic Providers,Chiropractor,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1013798602,"MIJANGOS, LISBETH, DAVILA",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 71 , 104 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013900216,"CRAM, GARY, PAUL",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 42 , 105 , 120 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013900216,"CRAM, GARY, PAUL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 13 , 25 , 43 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013900216,"CRAM, GARY, PAUL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013900216,"CRAM, GARY, PAUL",3812 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1013901164,"FARINA, NICHOLAS",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 99 , 243 ,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013902154,"LEVINSON, STACY, L J",7808 S TRYON ST STE D CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1063648533,ANKLE AND FOOT SURGICAL AND PODIATR,~,200 WESTGATE DR STE A WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1013902865,"HARO III, ALFONSO, ANTHONY",200 WESTGATE DR STE A WEST END NC,063,Moore,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 117 , 257 , 338 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013903202,"JOHNSON, DESIREE, BATRICE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013903202,"JOHNSON, DESIREE, BATRICE",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 46 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013903202,"JOHNSON, DESIREE, BATRICE",201 WOODSON ST STE A SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 128 , 295 , 584 ," $13,251.25 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013903202,"JOHNSON, DESIREE, BATRICE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013903350,"MORELLI-SAGER, PATRICIA",817 VOLVO PKWY   CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1013904614,"HARUM, KIRK, EDWARD",~,2111 NEUSE BLVD STE J NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1013904614,"HARUM, KIRK, EDWARD",2111 NEUSE BLVD STE J NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 48 , 102 ,$#,,
MEDICAID DIRECT,1790747988,CRYSTAL COAST PAIN MANAGEMENT,CRYSTAL COAST PAIN MANAGEMENT CENTER,2111 NEUSE BLVD STE J NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1013904614,"HARUM, KIRK, EDWARD",2111 NEUSE BLVD STE J NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 112 , 310 , 602 ,$#,,
MEDICAID DIRECT,1013904614,"HARUM, KIRK, EDWARD",~,57 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1013904614,"HARUM, KIRK, EDWARD",57 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 30 , 58 ,$#,,
MEDICAID DIRECT,1194240671,WRIGHT AND ASSOCIATES IX DDS PA,,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013906486,"DUNN, HUYEN CHAU, VU",3020 S MIAMI BLVD   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 125 , 178 , 715 ," $67,976.76 ",,
MEDICAID DIRECT,1568999118,WRIGHT AND ASSOCIATES III DDS PA,,4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013906486,"DUNN, HUYEN CHAU, VU",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 33 , 44 , 222 ," $21,364.47 ",,
MEDICAID DIRECT,1194240671,WRIGHT AND ASSOCIATES IX DDS PA,,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013906486,"DUNN, HUYEN CHAU, VU",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013907765,"MEADS, KELLY, WEEKS",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1013907765,"MEADS, KELLY, WEEKS",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013907765,"MEADS, KELLY, WEEKS",701 LUKE ST STE C EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1013907765,"MEADS, KELLY, WEEKS",701 LUKE ST STE C EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1013907765,"MEADS, KELLY, WEEKS",701 LUKE ST STE C EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013907765,"MEADS, KELLY, WEEKS",701 LUKE ST STE C EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 24 , 51 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013910850,"CALLAWAY, GEORGE, HADLEY",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 20 , 34 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013910850,"CALLAWAY, GEORGE, HADLEY",6715 MCCRIMMON PKWY STE 205 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013910850,"CALLAWAY, GEORGE, HADLEY",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1013910850,"CALLAWAY, GEORGE, HADLEY",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013911494,"REITNAUER, PAMELA, JEAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013911494,"REITNAUER, PAMELA, JEAN",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013911494,"REITNAUER, PAMELA, JEAN",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1013911742,"PANTEN, ROBERT, RICHARD",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1013911742,"PANTEN, ROBERT, RICHARD",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013911742,"PANTEN, ROBERT, RICHARD",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013911965,"JOHNSON, SABENA, ADEPEJU",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 35 , 36 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1013911965,"JOHNSON, SABENA, ADEPEJU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 27 , 27 ,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1013911965,"JOHNSON, SABENA, ADEPEJU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013912229,"WARD, MICHAEL, MUNDY",958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013912427,"RIVERA, RAFAEL",3212 S WILMINGTON ST   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 40 , 195 ,$#,,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013912427,"RIVERA, RAFAEL",1400 WALTER REED ROAD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice," 2,011 "," 2,229 "," 9,941 "," $365,744.82 ",,
MEDICAID DIRECT,1366611279,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013912427,"RIVERA, RAFAEL",247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 364 , 369 ," 1,787 "," $80,418.12 ",,
MEDICAID DIRECT,1982873899,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,900 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013912427,"RIVERA, RAFAEL",900 SUMMIT AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1952721375,RAFAEL RIVERA JR DDS PLLC,,2520 N COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013912427,"RIVERA, RAFAEL",2520 N COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 179 , 176 , 761 ," $29,738.91 ",,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013912427,"RIVERA, RAFAEL",3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 54 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013913128,"WILSON, PATRICK, ALOYSIUS",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013913128,"WILSON, PATRICK, ALOYSIUS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013913128,"WILSON, PATRICK, ALOYSIUS",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013913128,"WILSON, PATRICK, ALOYSIUS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 70 , 72 , 107 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013913128,"WILSON, PATRICK, ALOYSIUS",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265446132,INTERNAL MEDICINE AND PEDIATRICS AS,~,224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013913219,"OUTLAW, DAVID, THOMAS",224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1013913276,"HAGAN, DANIEL, M",~,237 WHITE ST   JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,1013913276,"HAGAN, DANIEL, M",237 WHITE ST   JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1811717655,LEWC PLLC,,237 WHITE ST STE 2 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1013913276,"HAGAN, DANIEL, M",237 WHITE ST STE 2 JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1013913276,"HAGAN, DANIEL, M",~,237 WHITE ST STE 2 JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,1013913276,"HAGAN, DANIEL, M",237 WHITE ST STE 2 JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1013913276,"HAGAN, DANIEL, M",~,237 WHITE ST   JACKSONVILLE NC,067,Onslow,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1013913276,"HAGAN, DANIEL, M",237 WHITE ST   JACKSONVILLE NC,067,Onslow,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 38 , 48 ,$#,,
MEDICAID DIRECT,1811717655,LEWC PLLC,,237 WHITE ST STE 2 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1013913276,"HAGAN, DANIEL, M",237 WHITE ST   JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013914407,"BRAY, EMILY, LOUISE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013914407,"BRAY, EMILY, LOUISE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914415,"HARRIS, ROBERT, PAUL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914415,"HARRIS, ROBERT, PAUL",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 20 , 33 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914415,"HARRIS, ROBERT, PAUL",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914415,"HARRIS, ROBERT, PAUL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914415,"HARRIS, ROBERT, PAUL",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1013914456,"WOLFSTEIN, JUDITH",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914837,"HICKS, SARAH, ELIZABETH",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914837,"HICKS, SARAH, ELIZABETH",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013914837,"HICKS, SARAH, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043272784,GREENSBORO DERMATOLOGY ASSOCIATES P,GREENSBORO DERMATOLOGY ASSOCIATES PA,,,Unknown,193200000X,Group,Multi-Specialty,,1013914910,"GOODRICH, ROBERT, GERARD",2704 SAINT JUDE ST   GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1043272784,GREENSBORO DERMATOLOGY ASSOCIATES P,GREENSBORO DERMATOLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1013914910,"GOODRICH, ROBERT, GERARD",2704 SAINT JUDE ST   GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,,,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013915388,"BULLOCK, SONYA, SIMMONS",1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013915388,"BULLOCK, SONYA, SIMMONS",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 106 , 169 , 182 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1013915388,"BULLOCK, SONYA, SIMMONS",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,113 VIRGINIA RD   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1013915479,"NEUMAN, PAUL, CHRISTOPHER",113 VIRGINIA RD   EDENTON NC,021,Chowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013915479,"NEUMAN, PAUL, CHRISTOPHER",113 VIRGINIA RD   EDENTON NC,021,Chowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 88 , 147 , 283 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 18 , 26 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 52 , 62 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 138 , 202 , 292 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 67 , 79 , 113 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 82 , 103 , 132 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 57 , 72 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013915552,"ATKESON, BENJAMIN, GRANGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 143 , 224 ,$#,,
MEDICAID DIRECT,1194757583,PINEHURST RADIATION ONCOLOGY INC,PINEHURST RADIATION ONCOLOGY INC,135 PAGE RD N   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013916543,"ACKER, JEFFREY, CHARLES",135 PAGE RD N   PINEHURST NC,063,Moore,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1194757583,PINEHURST RADIATION ONCOLOGY INC,PINEHURST RADIATION ONCOLOGY INC,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1013916543,"ACKER, JEFFREY, CHARLES",135 PAGE RD N   PINEHURST NC,063,Moore,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1194757583,PINEHURST RADIATION ONCOLOGY INC,PINEHURST RADIATION ONCOLOGY INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1013916543,"ACKER, JEFFREY, CHARLES",135 PAGE RD N   PINEHURST NC,063,Moore,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 21 , 95 , 117 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1013916956,"DAVIS, LEESA, F",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013917673,"ARN, ANTHONY, RAYMOND",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 120 , 130 , 171 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,4235 S NEW HOPE RD STE F GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013917673,"ARN, ANTHONY, RAYMOND",4235 S NEW HOPE RD STE F GASTONIA NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 66 , 86 , 105 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013917673,"ARN, ANTHONY, RAYMOND",2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 44 , 51 , 77 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013917855,"SUYDERHOUD, JOHAN, PEITER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 46 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013918333,"HOBGOOD, STEVEN, TODD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1013920123,"ROSE, GEOFFREY, ANDREW",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013920123,"ROSE, GEOFFREY, ANDREW",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013920123,"ROSE, GEOFFREY, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013920123,"ROSE, GEOFFREY, ANDREW",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013920123,"ROSE, GEOFFREY, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1821474628,MELISSA THINGVOLL MD PLLC,,100 DISTRICT DR APT 218 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1013920198,"THINGVOLL, MELISSA, ANN",100 DISTRICT DR APT 218 ASHEVILLE NC,011,Buncombe,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 15 , 25 , 39 ,$#,,
MEDICAID DIRECT,1013921121,COASTAL EYE CLINIC PA,COASTAL EYE CLINIC PA,802 MCCARTHY BLVD   NEW BERN NC,025,Craven,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1013921121,COASTAL EYE CLINIC PA,802 MCCARTHY BLVD   NEW BERN NC,025,Craven,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 151 , 146 , 280 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013922608,"NOLAN, BRADFORD, WINSLOW",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1013924018,WALGREEN CO,WALGREENS 06690,3634 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1013924018,WALGREEN CO,3634 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013925767,"ANDERSON, ZACHARY, JOHN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 135 , 135 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013925809,"EATON, CHRISTINE, ANNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013925809,"EATON, CHRISTINE, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013928472,"YEH, STEPHEN, MING-JYE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013928472,"YEH, STEPHEN, MING-JYE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013928472,"YEH, STEPHEN, MING-JYE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013928472,"YEH, STEPHEN, MING-JYE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013928472,"YEH, STEPHEN, MING-JYE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 32 , 42 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013930312,"EHLERT, KURT, JONATHAN",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013930312,"EHLERT, KURT, JONATHAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821866112,DREAM PRIMARY CARE SERVICES PC,,118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1013931013,"WEILAND, PAUL, JEROME",118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 143 , 144 ," $13,163.83 ",,
MEDICAID DIRECT,1609421775,HEALTHWORX PARTNERS PC,,118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1013931013,"WEILAND, PAUL, JEROME",1201 CAROLINA AVE   WASHINGTON NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 555 , 555 ," $56,029.90 ",,
MEDICAID DIRECT,1821866112,DREAM PRIMARY CARE SERVICES PC,,118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1013931013,"WEILAND, PAUL, JEROME",1201 CAROLINA AVE   WASHINGTON NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1033130117,UWHARRIE REGIONAL PEDIATRICS P A,ALBEMARLE PEDIATRICS,1420 US 52 N STE A ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1013932029,"LAWRENCE, LINDA, WILLIAMSON",1420 US 52 N STE A ALBEMARLE NC,084,Stanly,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 83 , 239 , 487 ," $20,417.79 ",,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013932284,"ESPADA, JASON, ALEX",9965 POPLAR TENT RD   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013932284,"ESPADA, JASON, ALEX",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1013932284,"ESPADA, JASON, ALEX",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013932284,"ESPADA, JASON, ALEX",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013932284,"ESPADA, JASON, ALEX",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013932565,"DAY, TEMPLE, VASHTI",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013932565,"DAY, TEMPLE, VASHTI",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 46 , 55 ,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013932896,"ADAMS, BRYAN, CHARLES",101 E WT HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013932896,"ADAMS, BRYAN, CHARLES",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1013934264,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1261,4601 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1013934264,WAL-MART STORES EAST LP,4601 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1013934264,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1261,4601 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1013934264,WAL-MART STORES EAST LP,4601 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1013934413,WAL-MART STORES EAST LP,WALMART PHARMACY 10-5315,9600 PARKSOUTH CT STE 120 ORLANDO FL,102,Out of State > 40 miles,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1013934413,WAL-MART STORES EAST LP,9600 PARKSOUTH CT STE 120 ORLANDO FL,102,Out of State > 40 miles,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1013935519,"ANDERSEN, JANE, ELIZABETH",1506 E FRANKLIN ST STE 104 CHAPEL HILL NC,068,Orange,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 26 , 51 , 133 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1013935519,"ANDERSEN, JANE, ELIZABETH",1506 E FRANKLIN ST STE 104 CHAPEL HILL NC,068,Orange,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1346861614,FOOT AND ANKLE SPECIALISTS OF THE M,,1506 E FRANKLIN ST STE 104 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1013935519,"ANDERSEN, JANE, ELIZABETH",1506 E FRANKLIN ST STE 104 CHAPEL HILL NC,068,Orange,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,,,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013939446,"KHAN, SHAHEEN",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 216 , 216 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1013939446,"KHAN, SHAHEEN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013941277,"NORCROSS, WILLIAM, PATTERSON",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013941277,"NORCROSS, WILLIAM, PATTERSON",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 30 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013941277,"NORCROSS, WILLIAM, PATTERSON",7921 ACC BLVD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013941913,"NAPOLI, DAVID, CHARLES",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 51 , 74 , 123 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013942762,"LARACH, MARY, WALKER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 40 , 44 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013942762,"LARACH, MARY, WALKER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1013943299,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,9729 NORTHEAST PKWY STE 500&600 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1013943299,BAYADA HOME HEALTH CARE INC,9729 NORTHEAST PKWY STE 500&600 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 1,885 "," 1,964 "," $513,740.12 ",,
MEDICAID DIRECT,1013943299,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,9729 NORTHEAST PKWY STE 500&600 MATTHEWS NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1013943299,BAYADA HOME HEALTH CARE INC,9729 NORTHEAST PKWY STE 500&600 MATTHEWS NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 38 ," 4,750 "," 5,535 "," $2,887,826.49 ",,
MEDICAID DIRECT,1013943356,BAYADA HOME HEALTH CARE INC,~,1500 PINECROFT RD STE 204B&404 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1013943356,BAYADA HOME HEALTH CARE INC,1500 PINECROFT RD STE 204B&404 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 7,590 "," 7,599 "," $942,436.96 ",,
MEDICAID DIRECT,1013943356,BAYADA HOME HEALTH CARE INC,~,1500 PINECROFT RD STE 204B GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1013943356,BAYADA HOME HEALTH CARE INC,1500 PINECROFT RD STE 204B GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 1,077 "," 1,077 "," $130,553.80 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013943752,"EINSTEIN, ARUNACHALAM",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013944248,"SPITZ, ADAM, FREDERICK",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 60 , 107 , 222 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013944685,"FERNANDES, CRISTINA, ESPINDULA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 20 , 70 , 73 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013944974,"PENNER, KEITH, EDWIN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1013944974,"PENNER, KEITH, EDWIN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013945831,"MCCARTY, KERRY, JAMES",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013945831,"MCCARTY, KERRY, JAMES",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013945831,"MCCARTY, KERRY, JAMES",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013945997,"MIXON, CAROL, RENEE",146 HWY 64 E   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811145014,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GASTONIA CHILDRENS,2544 COURT DR STE C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1013947480,"COOK, JEFFREY, MICHAEL",2544 COURT DR STE C GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 62 , 127 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1013947589,"GRUBB, LARRY, DOUGLAS",338 DEERFIELD RD   BOONE NC,095,Watauga,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 53 , 80 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013948421,"TYNER, MICHAEL, ANTHONY",3000 HOLSTON LN   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013948421,"TYNER, MICHAEL, ANTHONY",160 MACGREGOR PINES DR STE 109 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013948421,"TYNER, MICHAEL, ANTHONY",509 W GANNON AVE   ZEBULON NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 150 , 184 ,$#,,
MEDICAID DIRECT,1306583620,BRUCE MEDICAL PLLC,,160 MACGREGOR PINES DR STE 109 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1013948421,"TYNER, MICHAEL, ANTHONY",160 MACGREGOR PINES DR STE 109 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013948421,"TYNER, MICHAEL, ANTHONY",411 S LASALLE ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 59 , 73 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013948421,"TYNER, MICHAEL, ANTHONY",1515 W PETTIGREW ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 81 , 121 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013948421,"TYNER, MICHAEL, ANTHONY",204 DAIRY RD   CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 56 , 73 ,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013948587,"RAUF, ZAHID",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#, 27 , 42 ,$#,,
MEDICAID DIRECT,1760417570,WAYNESBORO FAMILY CLINIC PA,WAYNESBORO FAMILY CLINIC PA,1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1013948587,"RAUF, ZAHID",1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1013948843,"ROMNEY, SHARON, DENISE",WEE CARE PEDIATRICS PLLC,210 E THOMAS ST   ROCKY MOUNT NC,033,Edgecombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1013948843,"ROMNEY, SHARON, DENISE",210 E THOMAS ST   ROCKY MOUNT NC,033,Edgecombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 63 , 148 ,$#,,
MEDICAID DIRECT,1013949403,COUNTY OF HAYWOOD,Haywood County EMS,141 HEMLOCK ST   WAYNESVILLE NC,044,Haywood,3416L0300X,Transportation Services,Ambulance,Land Transport,1013949403,COUNTY OF HAYWOOD,141 HEMLOCK ST   WAYNESVILLE NC,044,Haywood,3416L0300X,Transportation Services,Ambulance,Land Transport, 547 ," 1,163 "," 2,142 "," $50,925.66 ",,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013949478,"VEGA, CHRISTOPHER, STEVEN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013949759,"CHOINIERE, G, LAURENT",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013949759,"CHOINIERE, G, LAURENT",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013949759,"CHOINIERE, G, LAURENT",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013949817,"YANG, QING",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013950377,"BABCOCK, PETER, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013950377,"BABCOCK, PETER, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013950377,"BABCOCK, PETER, EDWARD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013950377,"BABCOCK, PETER, EDWARD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013951003,"KRAMER, JAMES, SCOTT",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 146 , 168 , 238 ," $17,456.81 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013951680,"STRATTON, SUZONNE, IJAMES",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 57 , 121 ,$#,,
MEDICAID DIRECT,1013953876,"HARRIS, JERRY, WAYNE",~,4805 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1013953876,"HARRIS, JERRY, WAYNE",4805 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 578 ," 4,642 "," 4,642 "," $100,483.66 ",,
MEDICAID DIRECT,1013953876,"HARRIS, JERRY, WAYNE",~,4805 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,1013953876,"HARRIS, JERRY, WAYNE",4805 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,,,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1013954304,"LYNN, WILLIAM, ANDREW",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 91 , 98 , 126 ,$#,,
MEDICAID DIRECT,1568415586,SOUTHERN DERMATOLOGY PA,Southern Dermatology PA,,,Unknown,193400000X,Group,Single Specialty,,1013954742,"WILMOTH, GREGORY, JENNINGS",4201 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1013955525,TOWN OF WILLIAMSTON OFFICE IF THE T,WILLIAMSTON FIRE RESCUE EMS,901 WASHINGTON ST   WILLIAMSTON NC,058,Martin,3416L0300X,Transportation Services,Ambulance,Land Transport,1013955525,TOWN OF WILLIAMSTON OFFICE IF THE T,901 WASHINGTON ST   WILLIAMSTON NC,058,Martin,3416L0300X,Transportation Services,Ambulance,Land Transport, 199 , 304 , 586 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1013955962,"HALL, AUSTIN, BARRETT",200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013955962,"HALL, AUSTIN, BARRETT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 39 , 120 , 133 ,$#,,
MEDICAID DIRECT,1013956150,"KELLY, MICHAEL, WALKER",~,8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1013956150,"KELLY, MICHAEL, WALKER",560 DABNEY DR   HENDERSON NC,091,Vance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1013956150,"KELLY, MICHAEL, WALKER",~,8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1013956150,"KELLY, MICHAEL, WALKER",11009 INGLESIDE PL STE 104 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1013956150,"KELLY, MICHAEL, WALKER",~,8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1013956150,"KELLY, MICHAEL, WALKER",8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 49 , 81 , 93 ,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013956457,"DALLDORF, PETER, GILBERT",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1013956457,"DALLDORF, PETER, GILBERT",1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 38 , 89 , 205 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013958115,"MULLER, ANGELA, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 32 , 69 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013958156,"ROCCHI, WILLIAM, DOMONIC",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1013958156,"ROCCHI, WILLIAM, DOMONIC",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013958156,"ROCCHI, WILLIAM, DOMONIC",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013958495,"TIFFANY, KENNETH, FRANCIS",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013958495,"TIFFANY, KENNETH, FRANCIS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013958495,"TIFFANY, KENNETH, FRANCIS",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1013958677,"AUSTIN, AMANDA, CALDWELL",2522 S CROATAN HWY STE 1B NAGS HEAD NC,028,Dare,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013961069,"MELTON, NORMAN, RONNIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 152 , 176 , 271 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1013963222,"HODGES, MARCUS, ARENDELL",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 15 , 29 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1013963222,"HODGES, MARCUS, ARENDELL",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1013963222,"HODGES, MARCUS, ARENDELL",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 12 , 32 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1013963222,"HODGES, MARCUS, ARENDELL",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437311933,CARTERET MEDICAL SPECIALISTS PLLC,CARTERET MEDICAL SPECIALISTS PLLC,147 NC HIGHWAY 24 STE 102 MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1013964303,"VETTICHIRA, SAJEEV, PAILEE",147 NC HIGHWAY 24 STE 102 MOREHEAD CITY NC,016,Carteret,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 102 , 185 , 289 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013964485,"FARRUG, JOSEPH, ANDREW",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1013964485,"FARRUG, JOSEPH, ANDREW",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 40 , 45 ,$#,,
MEDICAID DIRECT,1932652492,NHCS PHYSICIANS INC,UNC MEDICAL AND HEMATOLOGY ONCOLOGY AT NASH,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1013964766,"CHOUFANI, ELIE, BOULOS",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 135 , 257 , 257 ,$#,,
MEDICAID DIRECT,1326031485,COASTAL CAROLINA FAMILY PRACTICE PA,~,600 S CHURCH ST   HERTFORD NC,072,Perquimans,193400000X,Group,Single Specialty,,1013965060,"MADIGAN, TIMOTHY, CHARLES",795 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 89 , 177 ,$#,,
MEDICAID DIRECT,1962650762,CAH ACQUISITION COMPANY 1 LLC,PLYMOUTH PRIMARY CARE RURAL HEALTH CLINIC,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013965060,"MADIGAN, TIMOTHY, CHARLES",795 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1811502818,CENTENNIAL HOUSING & COMMUNITY SERV,PLYMOUTH PRIMARY CARE RURAL HEALTH CLINIC,795 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013965060,"MADIGAN, TIMOTHY, CHARLES",795 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1902412729,CENTENNIAL HOUSING & COMMUNITY SERV,WASHINGTON REGIONAL MEDICAL CENTER,958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,193200000X,Group,Multi-Specialty,,1013965060,"MADIGAN, TIMOTHY, CHARLES",958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 27 , 29 ,$#,,
MEDICAID DIRECT,1649547761,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PRIMARY CARE SEACOAST,3980 HIGHWAY 9 E STE 100A LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013965532,"COMIANOS, MARC, JAMES",3980 HIGHWAY 9 E STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013967199,"ARCHER, STACEY, HAYNES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 26 , 26 , 26 ," $17,331.08 ",,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013968627,"QAYYUM, REHAN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013968650,"SPIERS, LATESSA, SMITH",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013968650,"SPIERS, LATESSA, SMITH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 102 , 320 ,$#,,
MEDICAID DIRECT,1013969732,"PIRRALLO, RONALD, GERALD",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1013969732,"PIRRALLO, RONALD, GERALD",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013969955,"RING, ALLISON, MARIE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013969955,"RING, ALLISON, MARIE",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013969955,"RING, ALLISON, MARIE",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013969955,"RING, ALLISON, MARIE",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 20 , 41 ,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1013970417,"THOMPSON, JULIE, ANN",702 N MAIN ST   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427227024,ASHE OPTOMETRIC EYECARE CENTER PA,,306 S JEFFERSON AVE   W JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1013970474,"RYAN JR, JOHN, OLIVER",306 S JEFFERSON AVE   WEST JEFFERSON NC,005,Ashe,152W00000X,Eye and Vision Services Providers,Optometrist,, 49 , 65 , 75 ,$#,,
MEDICAID DIRECT,1013970474,"RYAN JR, JOHN, OLIVER",DR JOHN O RYAN JR OD PA,306 S JEFFERSON AVE   WEST JEFFERSON NC,005,Ashe,152W00000X,Eye and Vision Services Providers,Optometrist,,1013970474,"RYAN JR, JOHN, OLIVER",306 S JEFFERSON AVE   WEST JEFFERSON NC,005,Ashe,152W00000X,Eye and Vision Services Providers,Optometrist,, 30 , 32 , 56 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013971654,"LONG, RONALD, MORGAN",1208 PARKWAY DR STE C GOLDSBORO NC,096,Wayne,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 26 , 45 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013971654,"LONG, RONALD, MORGAN",1208 PARKWAY DR STE C GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013971654,"LONG, RONALD, MORGAN",1208 PARKWAY DR STE C GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 26 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013971670,"KNECHTLE, STUART, JOHNSTON",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013971670,"KNECHTLE, STUART, JOHNSTON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 21 , 24 ,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1013972025,"LATZ JR, JOHN, EDWARD",201 W MARION ST STE 100 SHELBY NC,023,Cleveland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1861449464,MORGANTON INTERNAL MEDICINE PA,MORGANTON INTERNAL MEDICINE,607 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1013972587,"STUTESMAN, MICHAEL, STEVEN",607 E PARKER RD   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 53 , 67 ,$#,,
MEDICAID DIRECT,1316791247,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MORGANTON INTERNAL MEDICINE,607 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1013972587,"STUTESMAN, MICHAEL, STEVEN",607 E PARKER RD   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 33 , 46 ,$#,,
MEDICAID DIRECT,1013973866,CARIS MPI INC,CARIS LIFE SCIENCES,4610 S 44TH PL   PHOENIX AZ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1013973866,CARIS MPI INC,4610 S 44TH PL   PHOENIX AZ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 33 , 41 , 237 ," $76,924.55 ",,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1013975481,"COLE, CHAD, ALLEN",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 55 , 111 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1013975721,"STORTO, DOMINIC, LOUIS",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 18 , 21 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1013975721,"STORTO, DOMINIC, LOUIS",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013975937,"KOVALIK, EUGENE, CAMBIERI",615 RIDGE RD   ROXBORO NC,073,Person,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 47 , 116 , 161 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013975937,"KOVALIK, EUGENE, CAMBIERI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 90 , 231 , 268 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013975937,"KOVALIK, EUGENE, CAMBIERI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 26 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1703 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1013975937,"KOVALIK, EUGENE, CAMBIERI",1706 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013975937,"KOVALIK, EUGENE, CAMBIERI",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 50 , 136 , 143 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013976646,"TAT, DAVID",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013976646,"TAT, DAVID",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 55 , 147 , 147 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1013976760,"NICHOLS, LI, TAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 164 , 166 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013977263,"WILLIAMS, CHRISTINE, VEIGA",601 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 26 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013977263,"WILLIAMS, CHRISTINE, VEIGA",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013977610,"JAMISON, CYNTHIA, REYNOLDS",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,332 N TRADE ST STE 2000A MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013977610,"JAMISON, CYNTHIA, REYNOLDS",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013977610,"JAMISON, CYNTHIA, REYNOLDS",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013977610,"JAMISON, CYNTHIA, REYNOLDS",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 69 , 102 ,$#,,
MEDICAID DIRECT,1619664869,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY URGENT CARE,961 E STUART DR   GALAX VA,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1013978022,"RADFORD GOAD, LINDA, MARIE",961 E STUART DR   GALAX VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013978253,"VOGLER, SCOTT, LINDSEY",216 MOORE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 35 , 50 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013979228,"MONTGOMERY, KIMBERLY, NESBITT",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 62 , 98 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013979228,"MONTGOMERY, KIMBERLY, NESBITT",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 21 , 37 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013979228,"MONTGOMERY, KIMBERLY, NESBITT",4105 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013979228,"MONTGOMERY, KIMBERLY, NESBITT",4105 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1013979855,"EDWARDS, TRACY, LEE",~,129 S MAIN ST STE A HIAWASSEE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1013979855,"EDWARDS, TRACY, LEE",129 S MAIN ST STE A HIAWASSEE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1013980929,BLUE RIDGE HOME CARE,,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1013980929,BLUE RIDGE HOME CARE,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1013980929,BLUE RIDGE HOME CARE,,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1013980929,BLUE RIDGE HOME CARE,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1013980929,BLUE RIDGE HOME CARE,,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1013980929,BLUE RIDGE HOME CARE,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 168 ," 1,105 "," 1,911 "," $33,222.34 ",,
MEDICAID DIRECT,1013980929,BLUE RIDGE HOME CARE,,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1013980929,BLUE RIDGE HOME CARE,189 OAK AVE   SPRUCE PINE NC,061,Mitchell,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 30 , 51 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013981885,"FALCON, JOHN, GARY",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013981885,"FALCON, JOHN, GARY",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013981885,"FALCON, JOHN, GARY",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013982800,"HAYES, ESTHER REBECCA, LANDIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013982800,"HAYES, ESTHER REBECCA, LANDIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 25 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1013982800,"HAYES, ESTHER REBECCA, LANDIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 50 , 65 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013985811,"DIXON, THOMAS, BRADLEY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 65 , 142 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1013985811,"DIXON, THOMAS, BRADLEY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1558126276,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY SURGERY & CANCER CENTER,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013985860,"PABST, SUSAN, JANIS",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 62 , 76 ,$#,,
MEDICAID DIRECT,1124083753,CAROLINA SURGERY AND CANCER CENTER,CAROLINA SURGERY AND CANCER CENTER PLLC,1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013985860,"PABST, SUSAN, JANIS",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 27 , 31 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013988682,"DEGELE, BRIDGET, MCNAMARA",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 24 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013988682,"DEGELE, BRIDGET, MCNAMARA",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 13 , 15 , 42 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1013988989,"FARRIS, KATHERINE, ANN",3000 MAPLEWOOD AVE STE 112 WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013989094,"KISS, ANDREA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 111 , 263 ,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,7021 HARPS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013989094,"KISS, ANDREA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 23 , 47 ,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,5920 SANDY FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013989094,"KISS, ANDREA",5920 SANDY FORKS RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 67 , 125 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013989862,"GRANT, WILLIAM, HOWARD",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 50 , 92 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013989862,"GRANT, WILLIAM, HOWARD",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1013989862,"GRANT, WILLIAM, HOWARD",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1013989862,"GRANT, WILLIAM, HOWARD",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1013989862,"GRANT, WILLIAM, HOWARD",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013990324,"WILLIAMS, JULIE, ANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 150 , 215 , 367 ,$#,,
MEDICAID DIRECT,1780645812,SISTASIS FAMILY PRACTICE INC,SISTASIS FAMILY PRACTICE INC,147 E ACADEMY ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1013990506,"SISTASIS, ROWENA, MARIA",147 E ACADEMY ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 121 , 251 ,$#,,
MEDICAID DIRECT,1487879177,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - KER,861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1013990712,"DARTY, SHELLY, WARREN",861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 38 , 100 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013991066,"ANDERSON, DAVID, SCOTT",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 61 , 128 ,$#,,
MEDICAID DIRECT,1487325940,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ROBINHOOD PEDIATRICS & ADOLESCENT ME,1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013991066,"ANDERSON, DAVID, SCOTT",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013991066,"ANDERSON, DAVID, SCOTT",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013991090,"SMALL, MARIA, JACQUELINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013991090,"SMALL, MARIA, JACQUELINE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 129 , 144 , 173 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013991090,"SMALL, MARIA, JACQUELINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 34 , 35 , 38 ," $18,378.56 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013991090,"SMALL, MARIA, JACQUELINE",600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1013991090,"SMALL, MARIA, JACQUELINE",11001 DURANT RD STE 114 RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013991439,"COATES, MICHAEL, LEE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1013991439,"COATES, MICHAEL, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 49 , 56 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013991488,"GAYEN, TAPAN, KUMAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 76 , 76 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013991579,"DIEHL, LANCE, EARLE",1550 FAULK ST STE 3100 MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 57 , 80 , 117 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1013991579,"DIEHL, LANCE, EARLE",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013991579,"DIEHL, LANCE, EARLE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 75 , 104 ,$#,,
MEDICAID DIRECT,1619464559,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1013991579,"DIEHL, LANCE, EARLE",146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1013991579,"DIEHL, LANCE, EARLE",146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 14 , 16 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1013991579,"DIEHL, LANCE, EARLE",146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 21 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013991744,"GERKIN, TODD, MICHAEL",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013991744,"GERKIN, TODD, MICHAEL",509 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013991744,"GERKIN, TODD, MICHAEL",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013991744,"GERKIN, TODD, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013991744,"GERKIN, TODD, MICHAEL",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 19 , 20 ,$#,,
MEDICAID DIRECT,1013992593,"DULAI, SARBJOT, SINGH",ASTIR OATH NEURODIAGNOSTICS LLC,227 W 4TH ST OFC 204 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1013992593,"DULAI, SARBJOT, SINGH",227 W 4TH ST OFC 204 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 20 , 20 ," $21,151.60 ",,
MEDICAID DIRECT,1013992593,"DULAI, SARBJOT, SINGH",ASTIR OATH NEURODIAGNOSTICS LLC,19415 DEERFIELD AVE STE 310 LANSDOWNE VA,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1013992593,"DULAI, SARBJOT, SINGH",19415 DEERFIELD AVE STE 310 LANSDOWNE VA,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013992635,"QADIR, MISBAH, UL AHSAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 96 , 222 , 316 ," $11,557.04 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013992635,"QADIR, MISBAH, UL AHSAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013992635,"QADIR, MISBAH, UL AHSAN",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013992635,"QADIR, MISBAH, UL AHSAN",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1013992635,"QADIR, MISBAH, UL AHSAN",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013992635,"QADIR, MISBAH, UL AHSAN",313 AIRPORT RD   KINSTON NC,054,Lenoir,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1013992635,"QADIR, MISBAH, UL AHSAN",1209 BROWN ST   WASHINGTON NC,007,Beaufort,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1013992668,"HARRIS, ANGELA, STACK",LAKE NORMAN EYE OD PA,197 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,1013992668,"HARRIS, ANGELA, STACK",197 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013993906,"KUTELIA, RAJDEN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1013993906,"KUTELIA, RAJDEN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013994797,"RAMASWAMY, MURALI",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 32 , 46 , 83 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013994797,"RAMASWAMY, MURALI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013994797,"RAMASWAMY, MURALI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013994797,"RAMASWAMY, MURALI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013994797,"RAMASWAMY, MURALI",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013994797,"RAMASWAMY, MURALI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1093787608,SYLVA FAMILY PRACTICE PA,SYLVA FAMILY PRACTICE PA,430 FISHER CREEK RD   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1013996362,"MACKEY, DANIEL, JOHN",430 FISHER CREEK RD   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 157 , 247 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1013996396,"REHMAN, SAEED, UR",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1013996651,"REDDY, VIJAYA KUMAR, KONDA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 30 , 31 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1013996727,"PETERSON, CARRIE, MARIE",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1013996727,"PETERSON, CARRIE, MARIE",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013996727,"PETERSON, CARRIE, MARIE",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1013996727,"PETERSON, CARRIE, MARIE",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1013997402,"WELLMAN, TERRY, C",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997402,"WELLMAN, TERRY, C",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997402,"WELLMAN, TERRY, C",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997402,"WELLMAN, TERRY, C",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013997402,"WELLMAN, TERRY, C",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1013997402,"WELLMAN, TERRY, C",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1013997485,"GRANT, THOMAS, RICHARD",3110 WELLONS BLVD   NEW BERN NC,025,Craven,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 25 , 27 , 38 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1013997485,"GRANT, THOMAS, RICHARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1013997485,"GRANT, THOMAS, RICHARD",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 20 , 32 , 44 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1013997485,"GRANT, THOMAS, RICHARD",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 127 , 141 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 38 , 39 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1013997709,"BROWN, DONALD, HUGH",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1013999408,"RHYNE, ALFRED, LEONARD",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 85 , 117 ,$#,,
MEDICAID DIRECT,1467449728,LEXINGTON FAMILY PHYSICIANS,LEXINGTON FAMILY PHYSICIANS PA,102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1023000213,"DOMENECH, MELISSA, CORRAL",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023000338,"MCCORMACK, STEVEN, TODD",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023000858,"DEATON, DAVID, HUGO",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 20 , 26 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023001484,"NORMAN, SOENDA, PADMORE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023001484,"NORMAN, SOENDA, PADMORE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023001484,"NORMAN, SOENDA, PADMORE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023001484,"NORMAN, SOENDA, PADMORE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1023001500,"LANE, ROBERT, EARL",600 S CHURCH ST   HERTFORD NC,072,Perquimans,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1023001500,"LANE, ROBERT, EARL",600 S CHURCH ST   HERTFORD NC,072,Perquimans,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 54 , 54 ," $21,276.93 ",,
MEDICAID DIRECT,1326031485,COASTAL CAROLINA FAMILY PRACTICE PA,~,600 S CHURCH ST   HERTFORD NC,072,Perquimans,193400000X,Group,Single Specialty,,1023001500,"LANE, ROBERT, EARL",600 S CHURCH ST   HERTFORD NC,072,Perquimans,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 178 , 351 , 748 ,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1023002466,"CLARKE, ERIC, PETER",75 MEDICAL PARK LN STE B MURPHY NC,020,Cherokee,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 41 , 67 ,$#,,
MEDICAID DIRECT,1619903481,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023002912,"LASZEWSKI, MARZENA, TERESA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 51 , 51 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023002912,"LASZEWSKI, MARZENA, TERESA",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023002912,"LASZEWSKI, MARZENA, TERESA",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 34 , 66 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023002912,"LASZEWSKI, MARZENA, TERESA",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 130 , 279 ,$#,,
MEDICAID DIRECT,1598911885,BOICE WILLIS CLINIC PA,,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,291U00000X,Laboratories,Clinical Medical Laboratory,,1023002912,"LASZEWSKI, MARZENA, TERESA",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942445762,CAROLINA WOUND CARE SPECIALISTS PL,CAROLINA WOUND CARE SPECIALISTSMD,101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023002979,"MULLER, PETER",101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 35 , 50 ,$#,,
MEDICAID DIRECT,1093883852,CAROLINA FAMILY HEALTH CENTERS INC,HARVEST FAMILY HEALTH CENTER,8250 NC 58 S   ELM CITY NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023002979,"MULLER, PETER",8250 NC 58 S   ELM CITY NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023002979,"MULLER, PETER",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023002979,"MULLER, PETER",303 GREEN ST E   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 37 , 38 ,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023003910,"KRESHO, CHARLES, FRANCIS",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 133 , 290 ,$#,,
MEDICAID DIRECT,1447355755,SMOKY MOUNTAIN FOOT CLINIC PA,SMOKY MOUNTAIN FOOT CLINIC PA,289 ACCESS RD   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1023004447,"DELBENE, ROBERT, TODD",289 ACCESS RD   WAYNESVILLE NC,044,Haywood,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 79 , 145 , 220 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1023004637,"JORDAN, LINDA, RAY",627 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1023004637,"JORDAN, LINDA, RAY",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 106 , 112 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023006558,"NEWBY, STEPHANIE, FRANCES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine, 23 , 37 , 38 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023006558,"NEWBY, STEPHANIE, FRANCES",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1023006707,CAROLINAS PHYSICIANS NETWORK INC,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023006707,CAROLINAS PHYSICIANS NETWORK INC,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1407188600,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PULMONARY & SLEEP CENTER,2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1023009271,"SOFI, UMAR, FAROOQ",2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1023009321,"WATKINS, JAMES, ALLISON",JAMES A WATKINS MD,1601 ABBEY PL STE 105 CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,1023009321,"WATKINS, JAMES, ALLISON",1601 ABBEY PL STE 105 CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 24 , 48 , 69 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023012010,"BRITT, PETER, MICHAEL",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023012010,"BRITT, PETER, MICHAEL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023012010,"BRITT, PETER, MICHAEL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1023013836,HORNSBY REHABILITATION SERVICES INC,~,235 JIM BERRY RD   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1023013836,HORNSBY REHABILITATION SERVICES INC,235 JIM BERRY RD   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,#,#, 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023014149,"UNKS, DENNIS, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1194757583,PINEHURST RADIATION ONCOLOGY INC,PINEHURST RADIATION ONCOLOGY INC,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1023017191,"PATEL, SUSHMA, MANUBHAI",155 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1194757583,PINEHURST RADIATION ONCOLOGY INC,PINEHURST RADIATION ONCOLOGY INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1023017191,"PATEL, SUSHMA, MANUBHAI",155 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 22 , 84 , 100 ,$#,,
MEDICAID DIRECT,1194757583,PINEHURST RADIATION ONCOLOGY INC,PINEHURST RADIATION ONCOLOGY INC,135 PAGE RD N   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023017191,"PATEL, SUSHMA, MANUBHAI",155 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 13 ,$#,,
MEDICAID DIRECT,1124188651,ROANOKE MEDICAL ASSOCIATES PA,~,239 GREEN ST   WILLIAMSTON NC,058,Martin,193400000X,Group,Single Specialty,,1023017233,"SKAHILL, STEVEN, EARL",239 GREEN ST   WILLIAMSTON NC,058,Martin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 153 , 947 , 947 ," $20,127.36 ",,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 21 , 32 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",190 INTERSTATE DR   MOCKSVILLE NC,030,Davie,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 51 , 146 , 154 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 78 , 152 , 209 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1023017563,"LAURIENTI, JANNA, DENISE",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023018041,"SULLIVAN, ROBERT, LEE",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 129 , 144 , 178 ,$#,,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1023018041,"SULLIVAN, ROBERT, LEE",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1023018041,"SULLIVAN, ROBERT, LEE",~,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,1023018041,"SULLIVAN, ROBERT, LEE",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023018454,"CANTARUTTI, STEVEN, LOUIS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023019056,"BISWAS, ABHIK, KUMAR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1083002232,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PEDIATRIC INPATIENT SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023019056,"BISWAS, ABHIK, KUMAR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 37 , 85 , 89 ," $13,186.74 ",,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023022795,"KUHN, MARCIA, ANN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023023025,WALGREEN CO,WALGREENS 07398,1411 OXFORD RD   HENDERSON NC,091,Vance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1023023025,WALGREEN CO,1411 OXFORD RD   HENDERSON NC,091,Vance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1023023975,INGLES MARKETS INC,INGLES PHARMACY 004,1141 TUNNEL RD   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1023023975,INGLES MARKETS INC,1141 TUNNEL RD   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1679294946,WILEY L EDWARDS JR DDS PLLC,EDWARDS DENTURES AND IMPLANTS,3700 W VERNON AVE   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1023025608,"WILLIAMS, JOHN, STUART",1107 NEW POINTE BLVD UNIT 1314 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1801232244,MILLER AND ASSOCIATES FOUR PLLC,MILLER AND ASSOCIATES,1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1023025608,"WILLIAMS, JOHN, STUART",1107 NEW POINTE BLVD UNIT 1314 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 249 , 337 , 939 ," $46,308.08 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023025699,"CLANCY LARIMER, MARISA, COLLEEN",9615 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023025814,"HANSALIA, SACHIN, JAMNADAS",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 51 , 61 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023025814,"HANSALIA, SACHIN, JAMNADAS",11840 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023025814,"HANSALIA, SACHIN, JAMNADAS",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 34 , 44 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023025814,"HANSALIA, SACHIN, JAMNADAS",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 36 , 55 , 94 ,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023027406,"SHAFFER, BARBARA, JEAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1023028552,MORGANTON EYE PHYSICIANS PA,~,40 E MEDICAL CT   MARION NC,059,McDowell,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1023028552,MORGANTON EYE PHYSICIANS PA,40 E MEDICAL CT   MARION NC,059,McDowell,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 157 , 157 , 314 ,$#,,
MEDICAID DIRECT,1598841868,OWEN DRIVE SURGICAL CLINIC FAYETTEV,OWEN DRIVE SURGICAL CLINIC OF FAYETTEVILLE PLLC,513 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023030004,"MORFESIS, FLORIAS, ANDREW",513 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 59 , 75 ,$#,,
MEDICAID DIRECT,1831189992,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF COASTAL CAROLINA,2321 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023030459,"LUCAS, SEAN, RICHARD",2321 DELANEY AVE   WILMINGTON NC,065,New Hanover,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 61 , 65 ,$#,,
MEDICAID DIRECT,1831189992,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF COASTAL CAROLINA,1017 ASHES DR STE 206 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023030459,"LUCAS, SEAN, RICHARD",1017 ASHES DR STE 206 WILMINGTON NC,065,New Hanover,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 40 , 121 , 137 ,$#,,
MEDICAID DIRECT,1023031572,"LIBFRAIND, SIDNEY, NMN",SIDNEY LIBFRAIND,106 N 1ST AVE   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1023031572,"LIBFRAIND, SIDNEY, NMN",106 N 1ST AVE   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 119 , 139 , 462 ," $31,500.41 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023031598,"FRAMM, DAVID, JONATHAN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023031598,"FRAMM, DAVID, JONATHAN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023031598,"FRAMM, DAVID, JONATHAN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023031598,"FRAMM, DAVID, JONATHAN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023031804,"WHITLEY, DONALD, ROBERT",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 13 , 26 ,$#,,
MEDICAID DIRECT,1023034055,"SIMMONS, LARRY, DEAN",LARRY DEAN SIMMONS,1007 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,1023034055,"SIMMONS, LARRY, DEAN",1007 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 14 , 31 ,$#,,
MEDICAID DIRECT,1023035557,NORTH POINT PARTNERS LLC,NORTH POINTE,1195 PINEVIEW RD   RANDLEMAN NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023035557,NORTH POINT PARTNERS LLC,1195 PINEVIEW RD   RANDLEMAN NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 32 ," 8,765 "," 8,765 "," $639,142.69 ",,
MEDICAID DIRECT,1821653288,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC MINOR PROCEDURES,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023036779,"CHILTON, KAREN, NEFF",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023036779,"CHILTON, KAREN, NEFF",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023037447,"LEWIN, MARC, ROBERT",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1164453726,CARMEL FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE CARMEL FAMILY MEDICINE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023037447,"LEWIN, MARC, ROBERT",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023037447,"LEWIN, MARC, ROBERT",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023038999,"WOODSON, JAMES, VINCENT",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023038999,"WOODSON, JAMES, VINCENT",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 52 , 78 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1023038999,"WOODSON, JAMES, VINCENT",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1023038999,"WOODSON, JAMES, VINCENT",2700 PROVIDENCE ROAD SOUTH   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023038999,"WOODSON, JAMES, VINCENT",2700 PROVIDENCE ROAD SOUTH   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023039179,"ADGENT, JAMES, KEVIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023039179,"ADGENT, JAMES, KEVIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 64 , 64 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023040094,"ROCHA LIMA, CAIO MAX, SAO PEDRO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 32 , 62 , 62 ,$#,,
MEDICAID DIRECT,1023041316,"STOVALL III, ORLANDO, RICHARD",~,200 N LESLIE ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,1023041316,"STOVALL III, ORLANDO, RICHARD",200 N LESLIE ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 95 , 301 ," $16,517.85 ",,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023041787,"EICHELBERGER, MICHELLE, DAVIS",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1023042504,"HYLAND, JEFFREY, DAVID",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 78 , 80 , 119 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1023042504,"HYLAND, JEFFREY, DAVID",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 34 , 41 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023044351,"UFFINDELL, SARAH, HELEN",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 51 , 87 , 87 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1023044864,"NIJHER, HARPREET, KAUR",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1023044864,"NIJHER, HARPREET, KAUR",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023044864,"NIJHER, HARPREET, KAUR",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023045135,"MAXWELL, TANYA, KAPP",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023045135,"MAXWELL, TANYA, KAPP",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 26 , 129 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023045135,"MAXWELL, TANYA, KAPP",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1818 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023045135,"MAXWELL, TANYA, KAPP",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 45 , 106 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023045689,"ROBERTS, BENJAMIN, JOEL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023045689,"ROBERTS, BENJAMIN, JOEL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023045689,"ROBERTS, BENJAMIN, JOEL",14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1023046307,"HARRELSON, ANNA, QUINN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023046307,"HARRELSON, ANNA, QUINN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 31 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023047230,"SLOWIK, MAY, KUO",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 41 , 103 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023047230,"SLOWIK, MAY, KUO",2100 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023047255,"ROYSTER, ROBERT, ALLYN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023048022,"BOCKENEK, WILLIAM, LOUIS",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023048022,"BOCKENEK, WILLIAM, LOUIS",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 32 , 55 , 75 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023048022,"BOCKENEK, WILLIAM, LOUIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",300 BLAKE BLVD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 237 , 249 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",300 BLAKE BLVD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",300 BLAKE BLVD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 33 , 35 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",300 BLAKE BLVD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 111 , 113 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",515 BARBOUR RD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",515 BARBOUR RD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",101 CAROLINA AVE   WELDON NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 47 , 49 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,515 BARBOUR RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",515 BARBOUR RD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",101 CAROLINA AVE   WELDON NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,101 CAROLINA AVE   WELDON NC,042,Halifax,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",101 CAROLINA AVE   WELDON NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 98 , 100 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,280 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",280 S BECKFORD DR   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 98 , 110 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,280 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",280 S BECKFORD DR   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 178 , 179 ," $13,899.32 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023048741,"PRATHER, TRINA, DUGGER",280 S BECKFORD DR   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790830487,CHILDRENS MEDICAL GROUP INC,SUFFOLK PEDIATRICS,1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023048766,"ROBERTSON, JANE, MELINDA",1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023049699,"HARRIS, TINA, GRIFFIN",3521 HAWORTH DR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023049699,"HARRIS, TINA, GRIFFIN",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1023049954,"BROWNING, SHARON, TRACY",6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 66 , 86 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023050515,"EZIEME, JONAH, ANYAOGU ULU",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023050622,"EGAN, NANCY, TURNER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023050622,"EGAN, NANCY, TURNER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 40 , 40 , 42 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1023051216,"ARNO JR, CHARLES, DOUGLAS",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023051216,"ARNO JR, CHARLES, DOUGLAS",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023051216,"ARNO JR, CHARLES, DOUGLAS",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023052586,"DUGGAN, GREGORY, ANTHONY",800 W MEETING ST   LANCASTER SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023052586,"DUGGAN, GREGORY, ANTHONY",800 W MEETING ST   LANCASTER SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023053006,"HERRMAN, SHAUNNA, LORENE",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 45 , 51 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023054673,"WHITE, DALE, EVERETT",217 GLENSFORD DR 217 GLENSFORD DRIVE FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 384 , 397 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023054673,"WHITE, DALE, EVERETT",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023055761,"PRITCHETT, MICHAEL, ANDREW",205 PAGE RD   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 178 , 266 , 540 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023055761,"PRITCHETT, MICHAEL, ANDREW",205 PAGE RD   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 122 , 166 , 298 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023055761,"PRITCHETT, MICHAEL, ANDREW",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 45 , 50 , 118 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1023055761,"PRITCHETT, MICHAEL, ANDREW",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1962435529,VIEWMONT UROLOGY CLINIC,VIEWMONT UROLOGY CLINIC,1202 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1023057049,"GERRARD, EDWARD, ROLLAND",1202 N CENTER ST   HICKORY NC,018,Catawba,208800000X,Allopathic & Osteopathic Physicians,Urology,, 106 , 217 , 443 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057452,"ARMISTEAD, LACEY, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057452,"ARMISTEAD, LACEY, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 27 , 27 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 27 , 35 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,6199 LAKE BRANDT RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 15 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023057619,"BLIETZ, MELINDA, ANN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 42 , 44 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",2544 COURT DR STE F GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 37 , 48 , 66 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",5010 MEDICAL CARE CT   BELMONT NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",5010 MEDICAL CARE CT   BELMONT NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",1510 LOWER DALLAS HWY   DALLAS NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",1510 LOWER DALLAS HWY   DALLAS NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 33 , 86 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 36 , 51 , 128 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023058245,"NIGBOR, DOUGLAS, ALAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023058369,"BROOKS, WERNER, COMMODORE",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 96 , 217 , 398 ," $10,691.15 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1023058369,"BROOKS, WERNER, COMMODORE",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 63 , 136 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023059136,"ADAM, NAZIR, AHMED",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023060068,"LEE, BARRY, RUSSELL",2525 COURT DR   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023060068,"LEE, BARRY, RUSSELL",2525 COURT DR   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023060068,"LEE, BARRY, RUSSELL",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 72 , 114 , 218 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023060068,"LEE, BARRY, RUSSELL",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 35 , 83 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023060068,"LEE, BARRY, RUSSELL",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 70 , 98 , 175 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023060068,"LEE, BARRY, RUSSELL",9735 KINCEY AVE SET 200   HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023061629,"LINDBACK, ERIC, ORR",1403 S KING ST   WINDSOR NC,008,Bertie,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 23 , 27 , 43 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023061629,"LINDBACK, ERIC, ORR",850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 94 , 185 , 330 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023061629,"LINDBACK, ERIC, ORR",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 15 , 26 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023061629,"LINDBACK, ERIC, ORR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 20 , 23 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023064896,"COLLINS, TIMOTHY, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023064896,"COLLINS, TIMOTHY, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023064896,"COLLINS, TIMOTHY, SCOTT",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 21 , 30 , 30 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023064896,"COLLINS, TIMOTHY, SCOTT",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 43 , 87 , 91 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023065240,"MANGONE, PETER, GEORGE",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 19 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1023065240,"MANGONE, PETER, GEORGE",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366598807,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,2100 ERWIN RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1023065612,"COUSINS, SCOTT, WILLIAM",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1366598807,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,2100 ERWIN RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1023065612,"COUSINS, SCOTT, WILLIAM",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1023084936,WATAUGA RADIOLOGICAL SERVICES PA,WATAUGA RADIOLOGICAL SERVICES PA,155 FURMAN RD STE 101A BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1023065661,"CRUMPLER, TAMMY, NORTH",155 FURMAN RD STE 200 BOONE NC,095,Watauga,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 51 , 80 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023065828,"SRIVASTAVA, NALIN, KUMAR",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,60 SHUFORD RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1023066461,"ALLEY, ERIN, MAGUIRE",60 SHUFORD RD   COLUMBUS NC,075,Polk,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 15 , 47 , 148 ,$#,,
MEDICAID DIRECT,1023066545,"NEWMAN, JASON, LEE",JASON NEWMAN,648 W ACADEMY ST   RANDLEMAN NC,076,Randolph,111N00000X,Chiropractic Providers,Chiropractor,,1023066545,"NEWMAN, JASON, LEE",648 W ACADEMY ST   RANDLEMAN NC,076,Randolph,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023067733,"MILLER, JAMES, RICHARD",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023067733,"MILLER, JAMES, RICHARD",1708 OLD DONATION PKWY   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023068046,"SIMCOE LEVINE, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447790662,METROLINA MEDICAL CLINIC,,5501 EXECUTIVE CENTER DR STE 241 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023070547,"OGU, DONATUS, ONYEMAECHI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 115 , 115 ,$#,,
MEDICAID DIRECT,1407807092,THE NEUROLOGY INSTITUTE PA,THE NEUROLOGICAL INSTITUTE PA,2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023070745,"RAO, T HEMANTH, PRABHAKAR",2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 115 , 383 , 517 ," $80,491.59 ",,
MEDICAID DIRECT,1407807092,THE NEUROLOGY INSTITUTE PA,THE NEUROLOGICAL INSTITUTE PA,2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023070745,"RAO, T HEMANTH, PRABHAKAR",7000 SHANNON WILLOW RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 16 , 64 , 104 ,$#,,
MEDICAID DIRECT,1407807092,THE NEUROLOGY INSTITUTE PA,THE NEUROLOGICAL INSTITUTE PA,2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023070745,"RAO, T HEMANTH, PRABHAKAR",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 37 , 39 ,$#,,
MEDICAID DIRECT,1407807092,THE NEUROLOGY INSTITUTE PA,THE NEUROLOGICAL INSTITUTE PA,10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023070745,"RAO, T HEMANTH, PRABHAKAR",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1407807092,THE NEUROLOGY INSTITUTE PA,THE NEUROLOGICAL INSTITUTE PA,2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023070745,"RAO, T HEMANTH, PRABHAKAR",1501 E FRANKLIN ST   MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 24 , 28 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,510 N ELAM AVE STE 303 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023072618,"RIVARD, SANDRA, ANNE",510 N ELAM AVE STE 303 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023073376,"PERRUQUET, JAMES, LEONARD",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023073376,"PERRUQUET, JAMES, LEONARD",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,,,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023073376,"PERRUQUET, JAMES, LEONARD",702 NEWMAN RD   NEW BERN NC,025,Craven,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 28 , 41 , 87 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023073376,"PERRUQUET, JAMES, LEONARD",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023073376,"PERRUQUET, JAMES, LEONARD",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1023291234,ROY O FAGAN III MD PA,~,419 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1023075140,"FAGAN III, ROY, OTHO",419 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023075140,"FAGAN III, ROY, OTHO",ROY OTHO FAGAN III,419 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1023075140,"FAGAN III, ROY, OTHO",419 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023075942,"KRUER, RICHARD, DONALD",2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1376963439,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER GOLDSBORO,2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023075942,"KRUER, RICHARD, DONALD",2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 943 ," 1,253 "," 6,590 "," $763,739.99 ",,
MEDICAID DIRECT,1376963439,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER GOLDSBORO,2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1023075942,"KRUER, RICHARD, DONALD",2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1669892725,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER WILSON,1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1023075942,"KRUER, RICHARD, DONALD",2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023075942,"KRUER, RICHARD, DONALD",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1376963439,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER GOLDSBORO,2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023075942,"KRUER, RICHARD, DONALD",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023076148,"CALFEE, JENNIFER",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 14 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 16 , 22 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 37 , 42 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023076353,"PRENDIVILLE, SIMON, ST JOHN",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023076429,"PELINO, DAVID, EDWARD",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 20 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023076494,"NELSON, JAMES, GREGORY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1023076494,"NELSON, JAMES, GREGORY",7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023076494,"NELSON, JAMES, GREGORY",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 53 , 101 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023076494,"NELSON, JAMES, GREGORY",600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 238 , 526 ," 1,231 "," $10,351.30 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023076494,"NELSON, JAMES, GREGORY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023077054,"SLUDER, TODD, YOST",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023077054,"SLUDER, TODD, YOST",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023077054,"SLUDER, TODD, YOST",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023077054,"SLUDER, TODD, YOST",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023077054,"SLUDER, TODD, YOST",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023077054,"SLUDER, TODD, YOST",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023077054,"SLUDER, TODD, YOST",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023077385,"GOODRICH, EMILY, EDWARDS",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1023078193,"MOSS, DEREK, WILLIAM",600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 98 , 172 , 474 ," $22,564.27 ",,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1023078193,"MOSS, DEREK, WILLIAM",157 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 40 , 133 ,$#,,
MEDICAID DIRECT,1851531602,HENRY W BURNETT MD PA,~,110 OAKWOOD DR STE 380 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023078821,"BURNETT, HENRY, WARREN",110 OAKWOOD DR   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 92 , 285 , 813 ," $49,644.45 ",,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1023079001,"HOFFMAN, BYRON, JAY",900 W DOLPHIN ST   SILER CITY NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 71 , 513 , 515 ," $16,722.02 ",,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1023079001,"HOFFMAN, BYRON, JAY",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 61 , 149 ,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1023079001,"HOFFMAN, BYRON, JAY",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023079308,"FERGUSON, CYNTHIA, ANN",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 126 , 249 ,$#,,
MEDICAID DIRECT,1770825390,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST CLINICAL PHARMAC,1208 EASTCHESTER DR STE 107 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023079308,"FERGUSON, CYNTHIA, ANN",1208 EASTCHESTER DR STE 107 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 31 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023079316,"ROTTA, ALEXANDRE, TELLECHEA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 37 , 103 , 118 ," $18,942.27 ",,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023079381,"BAUMGARTEN, ALAN, SOL",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1023079381,"BAUMGARTEN, ALAN, SOL",19 N ANN ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023079746,"HUFFMAN, KIM, MARIE",3475 ERWIN RD PEPSICO FITNESS CENTER DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023079787,"FOILES, ANDREA, CHRISTINE",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023080066,"SOUCIE, CAROL, JEAN",6555 KEE LN STE 200 HARRISBURG NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 27 , 63 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023080454,"DEDMAN, KAREN, LEDWITH",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 90 , 90 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023080454,"DEDMAN, KAREN, LEDWITH",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023080454,"DEDMAN, KAREN, LEDWITH",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 23 , 23 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023080454,"DEDMAN, KAREN, LEDWITH",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 32 , 32 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023080975,"BRITT, REBECCA, CAPERTON",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023080975,"BRITT, REBECCA, CAPERTON",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023080975,"BRITT, REBECCA, CAPERTON",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437112612,WNC DERMATOLOGICAL ASSOCIATES PA,~,281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023081130,"SMITH, DANIEL, JUDSON",281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 13 , 23 ,$#,,
MEDICAID DIRECT,1437112612,WNC DERMATOLOGICAL ASSOCIATES PA,~,281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023081130,"SMITH, DANIEL, JUDSON",841 CASE ST   HENDERSONVILLE NC,045,Henderson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1023081270,"CROUSE, JOSEPH, MATTHEW",JOSEPH MATTHEW CROUSE,915 TATE BLVD SE STE 112 HICKORY NC,018,Catawba,111N00000X,Chiropractic Providers,Chiropractor,,1023081270,"CROUSE, JOSEPH, MATTHEW",915 TATE BLVD SE STE 112 HICKORY NC,018,Catawba,111N00000X,Chiropractic Providers,Chiropractor,, 14 , 256 , 262 ,$#,,
MEDICAID DIRECT,1083951339,CROUSE CHIROPRACTIC,CROUSE CHIROPRACTIC,915 TATE BLVD SE STE 112 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1023081270,"CROUSE, JOSEPH, MATTHEW",915 TATE BLVD SE STE 112 HICKORY NC,018,Catawba,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023082344,"REYNAUD, MICHAEL, SEAN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1023082344,"REYNAUD, MICHAEL, SEAN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1023082344,"REYNAUD, MICHAEL, SEAN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225515547,CAROLINA PHYSICAL THERAPY ASSOCIATE,~,9660 FALLS OF NEUSE RD STE 167 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023083003,"LLOYD, KRISTIN, VERNICE",9660 FALLS OF NEUSE RD STE 167 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1023083599,"HERBER, RICHARD, RAY",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1023083599,"HERBER, RICHARD, RAY",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 153 , 346 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,105 N CRUTCHFIELD ST   DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1023083599,"HERBER, RICHARD, RAY",105 N CRUTCHFIELD ST   DOBSON NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1023083599,"HERBER, RICHARD, RAY",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023083789,"ELLIOTT, AARON, ROBERT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 48 , 49 , 49 ,$#,,
MEDICAID DIRECT,1023084399,HOSPICE & PALL OF THE BLUE RIDGE,THE HOSPICE & PALLIATIVE CARE,236 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,251B00000X,Agencies,Case Management,,1023084399,HOSPICE & PALL OF THE BLUE RIDGE,236 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,251B00000X,Agencies,Case Management,, 152 ," 1,455 "," 1,455 "," $531,694.33 ",,
MEDICAID DIRECT,1023084399,HOSPICE & PALL OF THE BLUE RIDGE,THE HOSPICE & PALLIATIVE CARE,236 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,253Z00000X,Agencies,In Home Supportive Care,,1023084399,HOSPICE & PALL OF THE BLUE RIDGE,236 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,253Z00000X,Agencies,In Home Supportive Care,, 76 ," 10,940 "," 10,941 "," $1,667,518.11 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023084431,"BEAM, ROBERT, KENNETH",6161 LAKE BRANDT RD UNIT B GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 40 , 82 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023084431,"BEAM, ROBERT, KENNETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 52 ,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023084431,"BEAM, ROBERT, KENNETH",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023084431,"BEAM, ROBERT, KENNETH",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1023084886,"NAJI, YOUSEF, MOHAMMAD",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 59 , 72 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1023084886,"NAJI, YOUSEF, MOHAMMAD",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023084886,"NAJI, YOUSEF, MOHAMMAD",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1023084886,"NAJI, YOUSEF, MOHAMMAD",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023085016,"JENKINS, ALMA, FAYE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 26 , 44 , 53 ,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023086972,"MORTON, KIMBERLY, MICHELLE",1309 LEES CHAPEL RD TRIAD PRIMARY CARE GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023086972,"MORTON, KIMBERLY, MICHELLE",1309 LEES CHAPEL RD TRIAD PRIMARY CARE GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 55 , 91 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023088994,"THOMPSON, STEVAN, HAYDEN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 14 , 14 , 25 ,$#,,
MEDICAID DIRECT,1760423503,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS GASTROENTEROLOGY,853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023089000,"FRANCE, HAYWOOD, GORDON",853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023089109,"EGBERT JR, JAMES, MICHAEL",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1023089109,"EGBERT JR, JAMES, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023089109,"EGBERT JR, JAMES, MICHAEL",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023089109,"EGBERT JR, JAMES, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1023089109,"EGBERT JR, JAMES, MICHAEL",615 E 12TH ST   WASHINGTON NC,007,Beaufort,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023089109,"EGBERT JR, JAMES, MICHAEL",615 E 12TH ST   WASHINGTON NC,007,Beaufort,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1023089109,"EGBERT JR, JAMES, MICHAEL",615 E 12TH ST   WASHINGTON NC,007,Beaufort,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1023091147,"COAN, MICHAEL, ROBERT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 435 , 474 , 571 ,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023091147,"COAN, MICHAEL, ROBERT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023091147,"COAN, MICHAEL, ROBERT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 352 , 371 , 471 ," $16,103.02 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023091444,"SINGER, RONALD, WAYNE",15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 18 , 24 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 271 , 282 , 342 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1992284327,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH BREAST IMAGING CENTER LANGTREE,106 LANGTREE VILLAGE DR STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023092095,"BLACK, JOHN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023092566,"WINTERS, MELISSA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 22 , 23 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1023092921,"WOLVERTON, KATHY, MARIE MABE",445 PINEVIEW DR STE 240 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023092921,"WOLVERTON, KATHY, MARIE MABE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023093846,"ANUKWUEM, OBIOMA, IKECHUKWU",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 74 , 225 , 228 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023094026,"KILDE, JOHN, DAVID",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,1908 HILCO ST STE A ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1023094026,"KILDE, JOHN, DAVID",1908 HILCO ST STE A ALBEMARLE NC,084,Stanly,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023094026,"KILDE, JOHN, DAVID",1908 HILCO ST STE A ALBEMARLE NC,084,Stanly,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 120 , 241 , 297 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023094448,"DONOUGHE, JOHN, SCOTT",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023094562,"BELDING, NANCY, NELSON",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",20 MEDICAL CAMPUS DR NW STE 203 SUPPLY NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 33 , 33 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,620 JOHNS RD   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",20 MEDICAL CAMPUS DR NW STE 203 SUPPLY NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1821112673,BRUNSWICK CARDIOLOGY,~,20 MEDICAL CAMPUS DR NW STE 203 SUPPLY NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",20 MEDICAL CAMPUS DR NW STE 203 SUPPLY NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 39 , 74 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 204 , 204 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,310 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 62 , 62 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,310 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1023094653,"SEDER, JEFFREY, DAVID",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 47 , 47 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1023094661,"HILDEBRAN, TRACY, LOWIE",611 MOCKSVILLE AVE ROWAN DIAGNOSTIC CLINIC SALISBURY NC,080,Rowan,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 31 , 46 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023094950,"DAUGHERTY, WILSON, PARRISH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023094950,"DAUGHERTY, WILSON, PARRISH",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023096146,"BRENNAN, DANIEL, PATRICK",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023096781,"DEWEESE, RENEE, RAIMONDI",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,,,$#,,
MEDICAID DIRECT,1023097177,"UHLIK, ALLEN, STEPHEN",ALLEN STEPHEN UHLIK,2708 HIGHWAY 68   TURTLETOWN TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1023097177,"UHLIK, ALLEN, STEPHEN",2708 HIGHWAY 68   TURTLETOWN TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023097516,"WAGNER, JILL, MICHELLE",306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 59 , 103 ,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023097516,"WAGNER, JILL, MICHELLE",601 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 21 , 25 ,$#,,
MEDICAID DIRECT,1336317692,KENNETH B LEWIS DDS PA,LEWIS FAMILY DENTISTRY,4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023097870,"LEWIS, KENNETH, BOYD",4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 27 , 87 ,$#,,
MEDICAID DIRECT,1023097870,"LEWIS, KENNETH, BOYD",~,4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1023097870,"LEWIS, KENNETH, BOYD",4140 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 64 , 208 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023098126,"CLIFTON, MEREDITH, GORDON",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 36 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023098324,"BEBB, GREGORY, GERARD",2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 21 , 36 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023098324,"BEBB, GREGORY, GERARD",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 64 , 102 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023098324,"BEBB, GREGORY, GERARD",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 23 , 53 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023099165,"MORRISON, JOHN, GORDON",2015 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023100930,"ADAMS, DAVID, FREDERICK",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1821653288,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC MINOR PROCEDURES,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023100930,"ADAMS, DAVID, FREDERICK",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023100930,"ADAMS, DAVID, FREDERICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164872487,G ABRAMS & R COHEN XII PC,~,415 E WOODLAWN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023103629,"WOOLSTON, DAVID, EDWARD",5710R W GATE CITY BLVD STE R GREENSBORO NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 545 , 812 ," 2,658 "," $126,514.73 ",,
MEDICAID DIRECT,1689031783,M THOMAS JONES DMD PA,ADAMS FARM FAMILY DENTAL,5710 W GATE CITY BLVD STE R GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023103629,"WOOLSTON, DAVID, EDWARD",5710R W GATE CITY BLVD STE R GREENSBORO NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 20 , 50 ,$#,,
MEDICAID DIRECT,1851783385,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL INTERNAL MEDICINE SPECIALISTS,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1023104049,"STARK, RICHARD, REY",194 DOCTORS DR   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 82 , 102 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023104502,"TCHENG, JAMES, ENLOU",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023104502,"TCHENG, JAMES, ENLOU",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023104981,"FARMER, TRACIE, CHRISTINE",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023104981,"FARMER, TRACIE, CHRISTINE",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 34 , 48 , 85 ,$#,,
MEDICAID DIRECT,1538783915,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE PSYCHIATRIC SPECIALISTS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023105434,"ROBBINS, BRIAN, VERNON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1023107281,LIFELINE SYSTEMS COMPANY,~,5540 CENTERVIEW DR STE 200 RALEIGH NC,092,Wake,333300000X,Suppliers,Emergency Response System Companies,,1023107281,LIFELINE SYSTEMS COMPANY,5540 CENTERVIEW DR STE 200 RALEIGH NC,092,Wake,333300000X,Suppliers,Emergency Response System Companies,, 904 ," 8,364 "," 8,370 "," $252,248.47 ",,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023109147,"WRIGHT, ERIC",444 SW CENTER ST   FAISON NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023109147,"WRIGHT, ERIC",360 E CHARITY RD   ROSE HILL NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023109535,"SHAHEEN, AMY, WIEGNER",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023109535,"SHAHEEN, AMY, WIEGNER",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023111713,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07021,2203 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1023111713,NORTH CAROLINA CVS PHARMACY LLC,2203 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023113032,"DONAHUE, KATRINA, ERIKA",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023113032,"DONAHUE, KATRINA, ERIKA",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 20 , 47 ,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023114089,"MARTIN, MARY, MARGARET",401 W DECATUR ST   MADISON NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 198 , 301 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023114089,"MARTIN, MARY, MARGARET",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023114261,"AUSTIN, CHAMAIN, DOROTHY",303 GREEN ST E # A WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023114766,"TUNNESSEN, MARY",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023114972,"OXENDINE, LAUREN, MICHELLE",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1023114972,"OXENDINE, LAUREN, MICHELLE",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1023114972,"OXENDINE, LAUREN, MICHELLE",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 750 ," 1,002 "," 3,062 "," $119,129.08 ",,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1023115128,"POSTON, ROBERT, LEWIS",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023115128,"POSTON, ROBERT, LEWIS",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023115136,"SMITH, CAROLINE, CLEMENTS",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 25 , 46 ,$#,,
MEDICAID DIRECT,1114351095,MCPC-16 LLC,FIRSTHEALTH PRIMARY CARE AND CARDIOLOGY,6322 FAYETTEVILLE RD OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1023116142,"MERGY, JAMES, ARTHUR",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 90 , 218 , 392 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1023119757,"ESTELLA, FAUSTINO, FALGUI",255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023120185,"NWAMARA-AKA, EMMANUEL, OKECHUKWU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023120342,"TAJ-ELDIN, SAMER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023120342,"TAJ-ELDIN, SAMER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 41 , 79 , 91 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023120342,"TAJ-ELDIN, SAMER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023120342,"TAJ-ELDIN, SAMER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023120342,"TAJ-ELDIN, SAMER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1023120755,"WANER, MATTHEW, ROBERT",~,300 NC HIGHWAY 24   MOREHEAD CITY NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,,1023120755,"WANER, MATTHEW, ROBERT",300 NC HIGHWAY 24   MOREHEAD CITY NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023124682,"ARTIS, GLENDA, SALTER",3207 CAREY RD   KINSTON NC,054,Lenoir,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 105 , 206 ,$#,,
MEDICAID DIRECT,1083729701,NORTHLAKE PEDIATRIC CARE PA,NORTHLAKE PEDIATRIC CARE PA,2117 SIMONTON RD STE 402 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023125861,"BORJA, MICHAEL, GREGORY G.",2117 SIMONTON RD STE 402 STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 25 , 49 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023127123,"STEWART, VANESSA, SIMS",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 49 , 130 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023127123,"STEWART, VANESSA, SIMS",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1962478362,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE,327 1ST AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023128287,"SANTOSO, RUDY",327 1ST AVE NW   HICKORY NC,018,Catawba,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023129152,"LINDSEY, TYWAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023129152,"LINDSEY, TYWAN",1730 KERNERSVILLE MEDICAL PKWY STE 101 KERNERSVILLE NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023129152,"LINDSEY, TYWAN",16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023129285,"ZHU, LEE-CHING",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 79 , 82 , 141 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023129285,"ZHU, LEE-CHING",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023129285,"ZHU, LEE-CHING",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023129285,"ZHU, LEE-CHING",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1023132651,"BONNER, SHERI, NELSON",SHERI N BONNER & ASSOCIATES,912 N ELM ST   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1023132651,"BONNER, SHERI, NELSON",912 N ELM ST   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 100 , 100 ,$#,,
MEDICAID DIRECT,1023132693,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE GROUP HOME 1,401 N 4TH AVE   MAIDEN NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023132693,THE MENTAL HEALTH FUND INC,401 N 4TH AVE   MAIDEN NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023134079,"MCCARTHY, SHAWN, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 29 , 39 ,$#,,
MEDICAID DIRECT,1023134509,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY DEPARTMENT OF SOCIAL SERVICES,,,Unknown,251B00000X,Agencies,Case Management,,1023134509,COUNTY OF JOHNSTON NORTH CAROLINA,806 NORTH ST STE C SMITHFIELD NC,051,Johnston,251B00000X,Agencies,Case Management,,#,#,#,$#,,
MEDICAID DIRECT,1023134509,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY DEPARTMENT OF SOCIAL SERVICES,714 NORTH ST   SMITHFIELD NC,051,Johnston,251B00000X,Agencies,Case Management,,1023134509,COUNTY OF JOHNSTON NORTH CAROLINA,714 NORTH ST   SMITHFIELD NC,051,Johnston,251B00000X,Agencies,Case Management,, 72 , 552 , 552 ," $195,247.15 ",,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023135894,"KEUSKI, BRIAN, MICHAEL",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023135894,"KEUSKI, BRIAN, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023138161,WELLMAN CENTER,WELLMAN RETIREMENT CENTER,410 GARNER ST W   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023138161,WELLMAN CENTER,410 GARNER ST W   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 1,233 "," 1,233 "," $77,419.93 ",,
MEDICAID DIRECT,1598013781,TERESA G BIGGERSTAFF DDS MD PA,TERESA G BIGGERSTAFF DDS MD PA,900 OLD WINSTON RD STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1023138435,"BIGGERSTAFF, TERESA, GEHRET",900 OLD WINSTON RD STE 204 KERNERSVILLE NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1598013781,TERESA G BIGGERSTAFF DDS MD PA,TERESA G BIGGERSTAFF DDS MD PA,122 E KINDERTON WAY   BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1023138435,"BIGGERSTAFF, TERESA, GEHRET",900 OLD WINSTON RD STE 204 KERNERSVILLE NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023138799,"LAVIGNE, CHARLES, MICHEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023138799,"LAVIGNE, CHARLES, MICHEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023144193,"MESA, GREGORY, ROBERT",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184759102,FANELLI EYE ASSOCIATES OD PA,~,5526B CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023144383,"FANELLI, JAMES, LOUIS",5526B CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1023144383,"FANELLI, JAMES, LOUIS",~,5526B CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1023144383,"FANELLI, JAMES, LOUIS",5526B CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 127 , 138 , 259 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023146248,"IVEY, AMANDA, LYNN MCDOWELL",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 12 , 22 ,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023146248,"IVEY, AMANDA, LYNN MCDOWELL",101 E WT HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 40 , 97 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST STE 203 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023146289,"CATHEY, REGINALD, LAMONT",117 E KINGS HWY   EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023146289,"CATHEY, REGINALD, LAMONT",117 E KINGS HWY   EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 52 , 70 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023146289,"CATHEY, REGINALD, LAMONT",618 S PIERCE ST STE 203 EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST STE 203 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023146289,"CATHEY, REGINALD, LAMONT",618 S PIERCE ST STE 203 EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 125 , 154 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023146289,"CATHEY, REGINALD, LAMONT",117 E KINGS HWY   EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,4501 CAMERON VALLEY PKWY STE 200-B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023146388,"PUBANTZ, DAVID, JERRET",4501 CAMERON VALLEY PKWY STE 200-B CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023146388,"PUBANTZ, DAVID, JERRET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023146420,"KOHI, MAUREEN, PEARL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 24 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023146677,"TROIANO, JASON, JOSEPH",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023146677,"TROIANO, JASON, JOSEPH",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023146677,"TROIANO, JASON, JOSEPH",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 27 , 39 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023146677,"TROIANO, JASON, JOSEPH",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023148434,JACKSONVILLE CARE LLC,LIGHTHOUSE VILLAGE,182 VILLAGE DR   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023148434,JACKSONVILLE CARE LLC,182 VILLAGE DR   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 23 ," 7,044 "," 7,044 "," $449,448.93 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023152501,"FLANAGAN, CATHERINE, JENNIFER",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023152501,"FLANAGAN, CATHERINE, JENNIFER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023152501,"FLANAGAN, CATHERINE, JENNIFER",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023152501,"FLANAGAN, CATHERINE, JENNIFER",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023157047,"DEEN, CODY, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 90 , 130 , 162 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1023157047,"DEEN, CODY, SCOTT",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 47 , 62 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 104 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1023157047,"DEEN, CODY, SCOTT",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023157047,"DEEN, CODY, SCOTT",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 118 , 173 , 184 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023157229,"HAWKINS, MARK, DOUGLAS",3221 W MAIN ST   CLAREMONT NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 37 , 57 ,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023159647,"BINION-BROWN, KAREEN, MAUREEN",104 RHODES AVE   WINDSOR NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 95 , 132 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1023159647,"BINION-BROWN, KAREEN, MAUREEN",104 RHODES AVE   WINDSOR NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 58 , 58 ," $32,806.54 ",,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1023159647,"BINION-BROWN, KAREEN, MAUREEN",104 RHODES AVE   WINDSOR NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023159647,"BINION-BROWN, KAREEN, MAUREEN",307 S MAIN ST   LEWISTON NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 39 , 39 ,$#,,
MEDICAID DIRECT,1023162716,"EISBERG II, ROBERT, WILLIAM",ROBERT W EISBERG II DDS PA DBA ATLANTIC FAMILY DEN,1001 W WILLIAMS ST STE 101 APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1023162716,"EISBERG II, ROBERT, WILLIAM",1001 W WILLIAMS ST STE 101 APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 296 , 385 ," 1,604 "," $79,865.49 ",,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,429 COMMONWEALTH BLVD E   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023163573,"PARIKH, AMAR, ANILKUMAR",429 COMMONWEALTH BLVD E   MARTINSVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023163896,"CULBERTSON, BRENDA, LEA",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023163896,"CULBERTSON, BRENDA, LEA",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 28 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023165289,"RUDYK, MARY, KATHRYN",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 126 , 453 , 610 ," $11,047.15 ",,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023165289,"RUDYK, MARY, KATHRYN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 165 , 165 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023165289,"RUDYK, MARY, KATHRYN",2305 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 210 , 210 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1023165289,"RUDYK, MARY, KATHRYN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 44 , 44 ," $29,023.00 ",,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023165289,"RUDYK, MARY, KATHRYN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 34 , 45 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1023165289,"RUDYK, MARY, KATHRYN",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023165289,"RUDYK, MARY, KATHRYN",3800 INDEPENDENCE BLVD   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023165289,"RUDYK, MARY, KATHRYN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023165289,"RUDYK, MARY, KATHRYN",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558776997,ONSLOW AMBULATORY SERVICES INC,ONSLOW SURGICAL CLINIC,255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1023166071,"BELZBERG, GARY",255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 66 , 115 , 127 ,$#,,
MEDICAID DIRECT,1023166741,INTERIM HEALTHCARE OF THE EASTERN C,INTERIM HEALTHCARE,4145 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1023166741,INTERIM HEALTHCARE OF THE EASTERN C,4145 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,711 "," 1,711 "," $105,891.32 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023167046,"MOEDE, DONALD, RAY",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023167046,"MOEDE, DONALD, RAY",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023167046,"MOEDE, DONALD, RAY",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518008861,MONARCH,~,820 GRIMES BLVD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1023169950,"SMITH, DOUGLAS, GRAHAM",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023170271,"CHANG, CHERYLEE, WAI JUN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023170271,"CHANG, CHERYLEE, WAI JUN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 64 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023170271,"CHANG, CHERYLEE, WAI JUN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023171899,"D AMICO, THOMAS, ANTHONY",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023171899,"D AMICO, THOMAS, ANTHONY",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023171899,"D AMICO, THOMAS, ANTHONY",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1851694160,ELITE HANDS WOUND CARE & SURGICAL A,~,7930 SKYLAND RIDGE PKWY STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023173002,"RAMSEY, NATHANIEL, JAY",7930 SKYLAND RIDGE PKWY STE 203 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023173028,"KRALL, VALERIE, LYN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023173028,"KRALL, VALERIE, LYN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,600 GRESHAM DR STE 700 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023173143,"VACHHANI, NEIL, PURSHOTTAM",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1023174687,SOUTHERN ASSISTED LIVING INC,BROOKDALE EAST BROAD,2441 E BROAD ST   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023174687,SOUTHERN ASSISTED LIVING INC,2441 E BROAD ST   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 3,233 "," 3,233 "," $215,994.02 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023178142,"ROBB, JEFFREY, WALLACE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023179975,"POTTER, STEVEN, MCNEAL",144 FOREST HILL RD STE 144&146 LEXINGTON NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 42 , 60 , 137 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023179975,"POTTER, STEVEN, MCNEAL",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 121 , 206 , 415 ,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023180544,"MADLINGER, ROBERT, VINCENT",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023187762,"GISE, STACEY, HUDSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023187762,"GISE, STACEY, HUDSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023188448,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 1632,9628 REA RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1023188448,NORTH CAROLINA CVS PHARMACY LLC,9628 REA RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1023188448,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 1632,9628 REA RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1023188448,NORTH CAROLINA CVS PHARMACY LLC,9628 REA RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1023190469,"KHAN, SUPRIYA",364 WHITE OAK STREET   ASHEBORO NC,076,Randolph,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023190477,"DAVIS, HEATHER, HANES",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 54 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023191277,"CRAWFORD, JEFFREY",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023192184,"KOEBERL, DWIGHT, DUDLEY",3000 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023192184,"KOEBERL, DWIGHT, DUDLEY",DUKE HOSP SOUTH TRENT DR DUKE PRIVATE DIAG CL DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023192184,"KOEBERL, DWIGHT, DUDLEY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023192911,"MOYA, FRANK, JOSEPH",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 20 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023192911,"MOYA, FRANK, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 35 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023192911,"MOYA, FRANK, JOSEPH",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023192911,"MOYA, FRANK, JOSEPH",1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 66 , 139 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023193505,"PACE, JACKIE, BAILEY",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 22 , 33 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,319 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023193505,"PACE, JACKIE, BAILEY",319 PENNY LN   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023193505,"PACE, JACKIE, BAILEY",349 PENNY LN   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023194479,"CALLWOOD, DWAYNE, DENNIS",1236 HUFFMAN MILL RD STE 1000 BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023194479,"CALLWOOD, DWAYNE, DENNIS",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023194479,"CALLWOOD, DWAYNE, DENNIS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 57 , 122 , 200 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023194479,"CALLWOOD, DWAYNE, DENNIS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 68 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023194479,"CALLWOOD, DWAYNE, DENNIS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 178 , 352 , 598 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023194479,"CALLWOOD, DWAYNE, DENNIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1023197126,"JORDAN III, GEORGE, LEE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 266 , 324 , 419 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023197126,"JORDAN III, GEORGE, LEE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 144 , 170 , 212 ,$#,,
MEDICAID DIRECT,1023197399,MEDICAL EMERGENCY AMBULANCE TRANSPO,~,5 W HAVEN DR   ARDEN NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport,1023197399,MEDICAL EMERGENCY AMBULANCE TRANSPO,5 W HAVEN DR   ARDEN NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport, 19 , 21 , 41 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023197993,"MULLALY, SHANNON, MARIE",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023205218,"PATEL, AJAYKUMAR, NARANDAS",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 68 , 68 ,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023211489,"WRIGHT, VIRGINIA, FREDERICKA",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023211489,"WRIGHT, VIRGINIA, FREDERICKA",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 100 , 127 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023211489,"WRIGHT, VIRGINIA, FREDERICKA",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023212842,"LICAJ, SKERDILAID",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023212842,"LICAJ, SKERDILAID",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023212933,"ONEILL, STACEY, SHEASLEY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023212974,"VOTANOPOULOS, KONSTANTINOS, IOANNIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 22 , 28 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023213428,"TURNER, SUZANNE, BOGGS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023213428,"TURNER, SUZANNE, BOGGS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023213428,"TURNER, SUZANNE, BOGGS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023214566,"WAACK, KIMBERLY, JOY",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023216298,"THOMAS, ANITA, JOYCE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085N0904X,Allopathic & Osteopathic Physicians,Radiology,Nuclear Radiology,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023217338,"CARLSON, DYNA, PARAOAN",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1023218781,"REID, RO LYAN, AROKAS",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 318 , 320 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023221199,"MUDVARI, SACHIN, SHARMA",106 RIDGE VIEW DR STE 101 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 29 , 70 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023221199,"MUDVARI, SACHIN, SHARMA",11200 GOVERNOR MANLY WAY   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023221199,"MUDVARI, SACHIN, SHARMA",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 30 , 77 ," $13,888.43 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023221199,"MUDVARI, SACHIN, SHARMA",120 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 31 , 72 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023224839,"ROBERTS, GREGORY, JOHN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 125 , 167 , 325 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023224839,"ROBERTS, GREGORY, JOHN",8108B MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023224938,"YI, PETER, KANG",4309 MEDICAL PARK DR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 63 , 83 , 100 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023224938,"YI, PETER, KANG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023224938,"YI, PETER, KANG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023224938,"YI, PETER, KANG",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 23 , 27 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023227527,"MILLER, KIMBERLY, RENEE STONEHOUSE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 39 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023227527,"MILLER, KIMBERLY, RENEE STONEHOUSE",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 54 , 149 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023227626,"GREYWOODE, JEWEL, DUNAMIS",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 28 , 35 , 47 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023227626,"GREYWOODE, JEWEL, DUNAMIS",400 E BROOKLYN VILLAGE AVE STE A1 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 18 , 27 , 35 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023227758,"CHANDLER, NICOLE, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023227758,"CHANDLER, NICOLE, LYNN",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 31 , 66 ,$#,,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023228293,"PAREKH, PREETI, HASMUKH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 104 , 108 , 172 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023234036,"LEMYRE, MARTIN, STEPHEN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 140 , 148 ,$#,,
MEDICAID DIRECT,1154018323,MONARCH,,193 LOWES DR STE 101&102 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1023234937,"HERRON, ANNE, C",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1720426067,MONARCH,~,300 ASHVILLE AVE STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023234937,"HERRON, ANNE, C",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1154018323,MONARCH,,193 LOWES DR STE 101&102 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1023234937,"HERRON, ANNE, C",193 LOWES DR STE 101&102 PITTSBORO NC,019,Chatham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023237229,"STITZENBERG, KAREN, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 34 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023238037,"DANCEL, RIA, DRAPETE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 40 , 99 , 108 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 152 , 216 , 304 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 30 , 44 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 21 , 24 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023240132,"PAUDEL, RAJIV",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1000 BLYTHE BLVD FL 4 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 24 , 57 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 14 , 19 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023246485,"SINGH, JAI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881797066,KENDALYN LUTZ-CRAVER DDS PA,CORNERSTONE DENTAL ASSOCIATES,101 LIFE ENRICHMENT BLVD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1023248002,"MASSEY-WILLIAMS, LAUREN, NICOLE",101 LIFE ENRICHMENT BLVD   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 197 , 439 ," 1,443 "," $62,762.60 ",,
MEDICAID DIRECT,1437102381,CENTER FOR PEDIATRIC AND ADOLESCENT,CENTER FOR PEDIATRIC AND ADOLESCENT MEDICINE PA,136 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1023250669,"RECCHI, LAURA, THERESE",136 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 29 , 48 ,$#,,
MEDICAID DIRECT,1023250941,"WILSON, STACY, ELIZABETH",~,13500 HIGHWAY 50 STE 106A HOLLY RIDGE NC,071,Pender,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1023250941,"WILSON, STACY, ELIZABETH",13500 HIGHWAY 50 STE 106A HOLLY RIDGE NC,071,Pender,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 27 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023252608,"SUTTON, ASHLEY, GOODWIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1023253440,WILDWOOD OCCUPATIONAL THERAPY INC,~,245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1023253440,WILDWOOD OCCUPATIONAL THERAPY INC,245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,, 13 , 116 , 117 ,$#,,
MEDICAID DIRECT,1023253440,WILDWOOD OCCUPATIONAL THERAPY INC,~,245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1023253440,WILDWOOD OCCUPATIONAL THERAPY INC,245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,193400000X,Group,Single Specialty,, 46 , 714 , 753 ," $61,690.39 ",,
MEDICAID DIRECT,1023253440,WILDWOOD OCCUPATIONAL THERAPY INC,~,245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,251S00000X,Agencies,Community/Behavioral Health,,1023253440,WILDWOOD OCCUPATIONAL THERAPY INC,245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,251S00000X,Agencies,Community/Behavioral Health,,#, 42 , 42 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023255122,"EARNHEART, AMY",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1023257300,CAROLINA DIGESTIVE DISEASES PA,CAROLINA DIGESTIVE DISEASES PA,704 W H SMITH BLVD   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1023257300,CAROLINA DIGESTIVE DISEASES PA,704 W H SMITH BLVD   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 117 , 132 , 132 ," $10,003.31 ",,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023257615,"RICHARDS, LISA, CAMILLE PRUITT",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2544 COURT DR STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023257615,"RICHARDS, LISA, CAMILLE PRUITT",2544 COURT DR STE A GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 47 , 47 ,$#,,
MEDICAID DIRECT,1427773316,MARATHON CHIROPRACTIC CLINIC PLLC,,330 W KING ST STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1023257805,"WOODS, RYAN, JOSEPH",330 W KING ST STE 101 BOONE NC,095,Watauga,111N00000X,Chiropractic Providers,Chiropractor,, 26 , 212 , 212 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023258696,"EVITTS, EMMA, RUFF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 93 , 94 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023258696,"EVITTS, EMMA, RUFF",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023259611,"GILMER, SUMMER, KIMBERLY",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023259611,"GILMER, SUMMER, KIMBERLY",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043494784,ORTHOPAEDIC TRAUMA SPECIALISTS PC,ORTHOPAEDIC TRAUMA SPECIALISTS PC,1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023260833,"PAUL, KEITH, WILLIAM",1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 21 , 36 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023264710,"CAPPS, JENNIFER, NEIFELD",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 23 ,$#,,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1023265113,"HALCOMB, CELESTE, ELIZABETH",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 87 , 270 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023266640,"BATOO, SAMEER, AHMAD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 95 , 212 , 231 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023270972,"COOLEEN, LISA, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023270972,"COOLEEN, LISA, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023273927,"CRISTANTE, SARAH, HORNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023273927,"CRISTANTE, SARAH, HORNE",1995 WELLNESS BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 23 , 60 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023273927,"CRISTANTE, SARAH, HORNE",1995 WELLNESS BLVD STE 110 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023275138,"DONNELLY, ANGELA, MARIE",312 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023276797,"SANTANA, NELSON, MANUEL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 37 , 38 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023276797,"SANTANA, NELSON, MANUEL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023276797,"SANTANA, NELSON, MANUEL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 66 , 67 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023278793,"CARNES, JASON, ANTHONY",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023278793,"CARNES, JASON, ANTHONY",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023278868,"MIKULASOVICH, MICHAEL, PETER",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023283017,"ANTONELLI, JODI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023283017,"ANTONELLI, JODI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 43 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023283017,"ANTONELLI, JODI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023283017,"ANTONELLI, JODI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 17 , 29 ,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023284353,"JERRY, JASON, MATTHEW",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023284353,"JERRY, JASON, MATTHEW",35 MEMORIAL DR   PINEHURST NC,063,Moore,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023284494,"URRUTIA, RACHEL, PERAGALLO",7535 CARPENTER FIRE STATION RD STE 105 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023284494,"URRUTIA, RACHEL, PERAGALLO",7535 CARPENTER FIRE STATION RD STE 105 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023284494,"URRUTIA, RACHEL, PERAGALLO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023285582,"JACKSON, LARRY, RONALD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023285582,"JACKSON, LARRY, RONALD",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 27 , 30 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023285582,"JACKSON, LARRY, RONALD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1902489347,TRIANGLE EYE CONSULTANTS PC,,110 CAPCOM AVE   WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1023285988,"GUPTA, PREEYA, KSHETTRY",238 CRIMSON OAK DR   DURHAM NC,019,Chatham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1902489347,TRIANGLE EYE CONSULTANTS PC,,238 CRIMSON OAK DR   DURHAM NC,019,Chatham,193400000X,Group,Single Specialty,,1023285988,"GUPTA, PREEYA, KSHETTRY",9650 BRIER CREEK PKWY STE 103 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1902489347,TRIANGLE EYE CONSULTANTS PC,,110 CAPCOM AVE   WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1023285988,"GUPTA, PREEYA, KSHETTRY",110 CAPCOM AVE   WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023288743,"BALLARD, NATASHA",10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023289378,"JAFFE, JONATHAN, DOUGLAS",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023289378,"JAFFE, JONATHAN, DOUGLAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023289378,"JAFFE, JONATHAN, DOUGLAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023289378,"JAFFE, JONATHAN, DOUGLAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023289378,"JAFFE, JONATHAN, DOUGLAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023289378,"JAFFE, JONATHAN, DOUGLAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023291879,"STOKHUYZEN, ANDRE, ROLF",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023291879,"STOKHUYZEN, ANDRE, ROLF",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 72 , 73 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023293818,"GILMER, CASI, PARRISH",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477197168,DIVINE FAMILY PRACTICE AND URGENT C,,3616 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023294261,"OGUNLEYE, ABIMBOLA, ADEBIMPLE",3616 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 150 , 364 , 487 ," $17,972.18 ",,
MEDICAID DIRECT,1477197168,DIVINE FAMILY PRACTICE AND URGENT C,,3616 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023294261,"OGUNLEYE, ABIMBOLA, ADEBIMPLE",3616 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 48 , 52 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1023294691,"AGARAM, AARTHI, SRINIVASAN",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1023294691,"AGARAM, AARTHI, SRINIVASAN",6845 KNIGHTDALE BLVD STE 100 KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 31 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023295102,"HALSEY, CORAZON, IGNACIO",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 64 , 136 ,$#,,
MEDICAID DIRECT,1801843925,ARTHRITIS AND OSTEOPOROSIS CONSULTA,ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CARO,1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023296670,"HOLDEN, HEATHER, ELIZABETH",1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 18 , 40 , 69 ," $12,479.81 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023297546,"EWING, NEIL, ROBERT",4709 CREEKSTONE DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023297546,"EWING, NEIL, ROBERT",4709 CREEKSTONE DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023297546,"EWING, NEIL, ROBERT",3475 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 55 , 94 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023297546,"EWING, NEIL, ROBERT",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 32 ,$#,,
MEDICAID DIRECT,1023298718,ANT MARYS FAMILY CARE INC,ANT MARYS FAMILY CARE 3,3713 HERRING RD   LA GRANGE NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023298718,ANT MARYS FAMILY CARE INC,3713 HERRING RD   LA GRANGE NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 85 , 85 ," $35,505.59 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023299559,"BOGER, DEBORAH, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 69 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023300589,"TAYLOR, REBECCA, VICTORIA",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023300589,"TAYLOR, REBECCA, VICTORIA",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023300589,"TAYLOR, REBECCA, VICTORIA",101 MANNING DR CB 7160 CHAPEL HILL NC,019,Chatham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",140 BROOKSTONE LN   PITTSBORO NC,019,Chatham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 16 , 121 , 121 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",3100 TRAMWAY RD   SANFORD NC,053,Lee,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 19 , 54 , 57 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",310 COMMERCE DR   SANFORD NC,053,Lee,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 16 , 55 , 55 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",204 DAIRY RD   CLAYTON NC,051,Johnston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 19 , 49 , 49 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",195 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",4210 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 12 , 36 , 36 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",1101 HARTWELL ST   GARNER NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",1101 HARTWELL ST   GARNER NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 24 , 126 , 126 ," $12,698.66 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",8200 LITCHFORD RD   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 19 , 108 , 109 ," $14,676.14 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",1000 TANDAL PL   KNIGHTDALE NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 20 , 62 , 62 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023301124,"WILLIAMS, THALIA, NATALIE",8200 LITCHFORD RD   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023301264,"HAO, QING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023301264,"HAO, QING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023302593,"VALTSIS, VLADISLAV",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 87 , 295 , 295 ,$#,,
MEDICAID DIRECT,1881033009,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB NORTH,487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023302593,"VALTSIS, VLADISLAV",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023302981,"MCCLARTY, LASHAUNDA, RAE",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023302981,"MCCLARTY, LASHAUNDA, RAE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1023302981,"MCCLARTY, LASHAUNDA, RAE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 53 , 54 , 54 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023303583,"HAMERSLEY, ERIN, RAE SPADARO",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023305109,"MOORE, JEFFREY, GEORGE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1023306693,"CRANE, NICOLE, VANNEST",11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1023306693,"CRANE, NICOLE, VANNEST",186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023306693,"CRANE, NICOLE, VANNEST",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023307139,"SULLIVAN, JUSTIN, LEE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 219 , 220 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023307550,"HAUCK, JENNIFER, NOWAK",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023307550,"HAUCK, JENNIFER, NOWAK",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023307550,"HAUCK, JENNIFER, NOWAK",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 16 , 19 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023308194,"FREELIN, JAMIE, DAVIS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023308194,"FREELIN, JAMIE, DAVIS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1023308194,"FREELIN, JAMIE, DAVIS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 31 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023308194,"FREELIN, JAMIE, DAVIS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 72 , 74 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1023309325,"BARR, KELSEY, JEANINE",532 WEBB BLVD   HAVELOCK NC,025,Craven,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1023309325,"BARR, KELSEY, JEANINE",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 96 , 124 , 271 ,$#,,
MEDICAID DIRECT,1902289648,SINDHURA CITINENI DDS PA,SMILE FIRST DENTAL,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023310810,"CITINENI, SINDHURA",2301 ERWIN RD   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 113 , 115 ," 1,789 "," $178,242.77 ",,
MEDICAID DIRECT,1902289648,SINDHURA CITINENI DDS PA,SMILE FIRST DENTAL,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023310810,"CITINENI, SINDHURA",3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,718 "," 2,315 "," 9,830 "," $446,632.72 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 210 , 213 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 47 , 47 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023312733,"LAUGHLIN, DAVID, STEPHEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023314655,"CHAVDA, CHIRAG, BHARATKUMAR",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023314655,"CHAVDA, CHIRAG, BHARATKUMAR",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023314655,"CHAVDA, CHIRAG, BHARATKUMAR",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023314655,"CHAVDA, CHIRAG, BHARATKUMAR",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023314655,"CHAVDA, CHIRAG, BHARATKUMAR",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023315611,"SCARLETT, MEAGHAN, RAE",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023315611,"SCARLETT, MEAGHAN, RAE",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023315785,"CROWSON, JULIE, DAWN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023316122,"PEATTIE, BETHANY, SUANN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023316122,"PEATTIE, BETHANY, SUANN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023316387,"PARKER, ERIC, WAYNE",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1023316387,"PARKER, ERIC, WAYNE",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1023316387,"PARKER, ERIC, WAYNE",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1023316387,"PARKER, ERIC, WAYNE",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023316387,"PARKER, ERIC, WAYNE",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 22 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 28 , 30 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023317260,"MENON, LAILA, NOOR",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023317971,"SWEAT, TNESHIA, JANEEN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023317971,"SWEAT, TNESHIA, JANEEN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023317971,"SWEAT, TNESHIA, JANEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023318631,"CASTORO, COURTNEY, ANN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023318631,"CASTORO, COURTNEY, ANN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023318631,"CASTORO, COURTNEY, ANN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1023319266,"GRAHAM, PAMELA, JANE",~,141 N MAIN ST   FUQUAY VARINA NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1023319266,"GRAHAM, PAMELA, JANE",141 N MAIN ST   FUQUAY VARINA NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 13 , 101 , 101 ,$#,,
MEDICAID DIRECT,1023321767,"ROY, KRIS, JANIK",SOUTHERN EYE CARE OD PLLC,2114 S MAIN ST   WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,1023321767,"ROY, KRIS, JANIK",2114 S MAIN ST   WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 14 , 23 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1023326550,"SABIN, RICHARD, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023326550,"SABIN, RICHARD, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023326550,"SABIN, RICHARD, CHRISTOPHER",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023326550,"SABIN, RICHARD, CHRISTOPHER",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083971485,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEPHROLOGY - PRE,4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023327426,"LUFADEJU, ADETOYE, ADEDOLAPO",601 N ELM ST   HIGH POINT NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 44 , 249 , 251 ,$#,,
MEDICAID DIRECT,1083971485,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEPHROLOGY - PRE,4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023327426,"LUFADEJU, ADETOYE, ADEDOLAPO",4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 123 , 314 , 347 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023332020,"LILLEY, BROOKE, REGISTER",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023332020,"LILLEY, BROOKE, REGISTER",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 39 , 60 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023332020,"LILLEY, BROOKE, REGISTER",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 111 , 188 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1023332020,"LILLEY, BROOKE, REGISTER",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 50 , 83 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023334679,"CHUANG, ELISEU, YUNG",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 33 , 33 ,$#,,
MEDICAID DIRECT,1477704443,WAKE MEDICAL LABORATORY CONSULTANTS,WAKE MEDICAL LABORATORY CONSULTANTS INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023335072,"JOHNSON, RYAN, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023335072,"JOHNSON, RYAN, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 60 , 65 , 94 ,$#,,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1023335072,"JOHNSON, RYAN, CHRISTOPHER",1135 CARTHAGE ST   SANFORD NC,053,Lee,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023336096,"PATEL, DUPAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 46 , 52 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023336096,"PATEL, DUPAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023336096,"PATEL, DUPAL",5151 SARDIS RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 126 , 126 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023336096,"PATEL, DUPAL",5151 SARDIS RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 90 , 90 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023336096,"PATEL, DUPAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 56 , 75 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023339173,"PATIL, SHIVAJIRAO, PRAKASH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 228 , 343 , 583 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023339173,"PATIL, SHIVAJIRAO, PRAKASH",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023340205,DIVERSE CARE SERVICES LLC,~,205 WALNUT ST STE 209 STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1023340205,DIVERSE CARE SERVICES LLC,205 WALNUT ST STE 209 STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,, 79 ," 16,265 "," 16,591 "," $1,922,223.03 ",,
MEDICAID DIRECT,1023340205,DIVERSE CARE SERVICES LLC,~,205 WALNUT ST STE 209 STATESVILLE NC,049,Iredell,252Y00000X,Agencies,Early Intervention Provider Agency,,1023340205,DIVERSE CARE SERVICES LLC,205 WALNUT ST STE 209 STATESVILLE NC,049,Iredell,252Y00000X,Agencies,Early Intervention Provider Agency,,#, 54 , 54 ,$#,,
MEDICAID DIRECT,1942633482,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1023340551,"MARK, STEVEN, KAR FAI",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1023340551,"MARK, STEVEN, KAR FAI",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1538563473,EAST CAROLINA UNIVERSITY,~,600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1023340551,"MARK, STEVEN, KAR FAI",600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 397 , 727 ," 1,686 "," $102,847.62 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023341013,"REALI, ERICA, LYNN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023341013,"REALI, ERICA, LYNN",9104 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023341013,"REALI, ERICA, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023341013,"REALI, ERICA, LYNN",200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023341013,"REALI, ERICA, LYNN",200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023341427,"PATEL, TRUPTI, TEENA RAMESH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023341427,"PATEL, TRUPTI, TEENA RAMESH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023341799,"SHEPANSKI, LAURA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 58 , 85 ,$#,,
MEDICAID DIRECT,1336599547,PREMIUM WELLNESS & PRIMARY CARE,,308 POMONA DR STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023342144,"ANDERSON, TAKELA, NAQUAY",308 POMONA DR STE A GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1336599547,PREMIUM WELLNESS & PRIMARY CARE,,308 POMONA DR STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023342144,"ANDERSON, TAKELA, NAQUAY",308 POMONA DR STE A GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 107 , 212 , 283 ," $10,639.75 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023342284,"SHAHED, CYNTHIA, GAIL",250 HOSPITAL DR   HIGHLANDS NC,056,Macon,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023342284,"SHAHED, CYNTHIA, GAIL",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 58 , 62 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023342284,"SHAHED, CYNTHIA, GAIL",250 HOSPITAL DR   HIGHLANDS NC,056,Macon,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 28 , 65 , 65 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",2304 WESVILL CT   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",10000 FALLS NEUSE RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",10000 FALLS NEUSE RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",10000 FALLS NEUSE RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023342938,"MANICKAM, NISHA, THANNIKKARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 21 , 56 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023349503,"ELURI, SWATHI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,213 BARDEN ST   PRINCETON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023354024,"BRUTON, ANNA, SULLIVAN",213 BARDEN ST   PRINCETON NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 86 , 107 , 191 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,400 N ENGLEWOOD DR   KENLY NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023354024,"BRUTON, ANNA, SULLIVAN",400 N ENGLEWOOD DR   KENLY NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 135 , 216 , 388 ,$#,,
MEDICAID DIRECT,1699322388,HOPE HEALTH FAMILY PRACTICE,,201 E MAIN ST   ROWLAND NC,078,Robeson,193200000X,Group,Multi-Specialty,,1023355195,"LOCKLEAR, MELISSA, HOPE",204 W MAIN ST   ROWLAND NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 70 , 83 ,$#,,
MEDICAID DIRECT,1699322388,HOPE HEALTH FAMILY PRACTICE,,201 E MAIN ST   ROWLAND NC,078,Robeson,193200000X,Group,Multi-Specialty,,1023355195,"LOCKLEAR, MELISSA, HOPE",201 E MAIN ST   ROWLAND NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 169 , 189 ,$#,,
MEDICAID DIRECT,1699322388,HOPE HEALTH FAMILY PRACTICE,,204 W MAIN ST   ROWLAND NC,078,Robeson,193200000X,Group,Multi-Specialty,,1023355195,"LOCKLEAR, MELISSA, HOPE",204 W MAIN ST   ROWLAND NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 29 , 32 ,$#,,
MEDICAID DIRECT,1699322388,HOPE HEALTH FAMILY PRACTICE,,204 W MAIN ST   ROWLAND NC,078,Robeson,193400000X,Group,Single Specialty,,1023355195,"LOCKLEAR, MELISSA, HOPE",204 W MAIN ST   ROWLAND NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 220 , 258 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023355500,"CLEMENTS, MARY, SHARON",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023360260,"LEE, JESSE, NEWTON",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023360260,"LEE, JESSE, NEWTON",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023361649,"PORTERFIELD, AMBER, LAUREN",1915 LENDEW ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023362712,"DELLINGER, MELISSA, CALHOUN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023362712,"DELLINGER, MELISSA, CALHOUN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023362712,"DELLINGER, MELISSA, CALHOUN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,133N00000X,Dietary & Nutritional Service Providers,Nutritionist,,#,,,$#,,
MEDICAID DIRECT,1023363371,STERLING THERAPY,~,120 KENILWORTH RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1023363371,STERLING THERAPY,120 KENILWORTH RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1023363520,CARRISMA HOME CARE LLC,CARRISMA HOME CARE LLC,1384 WESTGATE CENTER DR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1023363520,CARRISMA HOME CARE LLC,1384 WESTGATE CENTER DR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,048 "," 2,048 "," $224,062.43 ",,
MEDICAID DIRECT,1023363983,MAGIC KITCHEN INC,,11310 W 80TH ST   LENEXA KS,102,Out of State > 40 miles,332U00000X,Suppliers,Home Delivered Meals,,1023363983,MAGIC KITCHEN INC,11310 W 80TH ST   LENEXA KS,102,Out of State > 40 miles,332U00000X,Suppliers,Home Delivered Meals,,#, 884 , 884 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023364627,"PEGRAM, HOLLY, CLARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 24 , 31 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023364627,"PEGRAM, HOLLY, CLARK",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023364627,"PEGRAM, HOLLY, CLARK",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023364908,"RICE, KRISTIN, LEA",9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023364908,"RICE, KRISTIN, LEA",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 14 , 18 , 52 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023364908,"RICE, KRISTIN, LEA",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023364908,"RICE, KRISTIN, LEA",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023364908,"RICE, KRISTIN, LEA",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023371077,"MCGARRY, WILLIAM, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023371077,"MCGARRY, WILLIAM, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023371077,"MCGARRY, WILLIAM, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023371077,"MCGARRY, WILLIAM, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 195 , 203 , 265 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023371077,"MCGARRY, WILLIAM, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023371077,"MCGARRY, WILLIAM, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023371077,"MCGARRY, WILLIAM, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1023374691,"MANN, NATHANIEL, RONALD",~,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1023374691,"MANN, NATHANIEL, RONALD",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023377918,"PATEL, PULAK, DILIPKUMAR",2400 SOUTH BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 63 , 158 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023379237,"WALLS, MORGAN, BREON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 18 , 33 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023379237,"WALLS, MORGAN, BREON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023382785,"BROWN, BOBBI, LYN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023384633,"SPIEWAK, BRANDI, DAVIS",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023384633,"SPIEWAK, BRANDI, DAVIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1023384674,"NGUYEN, PHUONG, MINH VIEN",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1023384674,"NGUYEN, PHUONG, MINH VIEN",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023384781,"CHOU, JEFFREY, CHIEH-LI",1830 FORDHAM BLVD STE 100 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023384781,"CHOU, JEFFREY, CHIEH-LI",117 E KINGS HWY   EDEN NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023384781,"CHOU, JEFFREY, CHIEH-LI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 43 , 43 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023384781,"CHOU, JEFFREY, CHIEH-LI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023384781,"CHOU, JEFFREY, CHIEH-LI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023386901,"GEBREANANYA, ZELALEM, ATAKILT",1500 MATTHEWS TOWNSHIP PKWY STE 410 MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 84 , 90 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023386901,"GEBREANANYA, ZELALEM, ATAKILT",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023389681,"TAYLOR, VALERIE, DENISE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 53 , 53 ,$#,,
MEDICAID DIRECT,1023389830,TENDER HEARTS HOME CARE LLC,~,401 E 3RD ST   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1023389830,TENDER HEARTS HOME CARE LLC,401 E 3RD ST   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 93 ," 14,466 "," 14,591 "," $1,601,504.08 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023392032,"BYSTRZYCKI, MEAGAN, ANN",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 27 , 48 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023392032,"BYSTRZYCKI, MEAGAN, ANN",3149 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 127 , 262 , 601 ," $11,854.81 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023392032,"BYSTRZYCKI, MEAGAN, ANN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023393667,"BUSH, AMY",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023393667,"BUSH, AMY",125 QUEENS RD STE 560 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023393667,"BUSH, AMY",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 35 , 40 ,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1023393667,"BUSH, AMY",276 OLD MOCKSVILLE RD STE 800 STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023394269,"WILTSHIRE, VERONICA, NICOLA",2101 PETERS CREEK PKWY STE 16 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023397080,"FRONHEISER, REBECCA, LYN",2064 NC HIGHWAY 125   JACKSON NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 148 , 162 , 573 ," $21,151.49 ",,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023397080,"FRONHEISER, REBECCA, LYN",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1194899542,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023399094,"ATKINS, CHRISTOPHER, MARTIN",665 CARVER DR   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023399771,THOMASENE WILSON,SISTERS CARE HOME CARE AGENCY,127A W MAIN ST   SPRING HOPE NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1023399771,THOMASENE WILSON,127A W MAIN ST   SPRING HOPE NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 6,795 "," 6,991 "," $552,183.80 ",,
MEDICAID DIRECT,1023399771,THOMASENE WILSON,SISTERS CARE HOME CARE AGENCY,8025 N POINT BLVD STE 213 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1023399771,THOMASENE WILSON,8025 N POINT BLVD STE 213 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 681 , 681 ," $49,619.32 ",,
MEDICAID DIRECT,1023399771,THOMASENE WILSON,SISTERS CARE HOME CARE AGENCY,8025 N POINT BLVD STE 209 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1023399771,THOMASENE WILSON,8025 N POINT BLVD STE 209 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 276 , 276 ," $22,749.32 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023399896,"WILSON, LISA, MARIE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023399896,"WILSON, LISA, MARIE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023400249,"EKRAM, ADNAN",2525 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 68 , 241 , 241 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1023402104,"EBERT, DAVID, SCOTT",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 68 , 71 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023402385,"HAMZI, RAWAD, IMAD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023402385,"HAMZI, RAWAD, IMAD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023402385,"HAMZI, RAWAD, IMAD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023402385,"HAMZI, RAWAD, IMAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023402385,"HAMZI, RAWAD, IMAD",210 ASHVILLE AVE   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023402385,"HAMZI, RAWAD, IMAD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023402385,"HAMZI, RAWAD, IMAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023402997,"CURTISS, JOHN, SUTTER",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 83 , 272 , 276 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023403516,"STEINER, MEGHAN, REBECCA",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 27 , 60 , 60 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023404746,"VYAS, KARAN, RAJESH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023405131,"LI, WENCHENG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 83 , 88 , 156 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1023405164,"AMIN, RAKESH, DEVENDRA",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 239 , 268 , 342 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023405164,"AMIN, RAKESH, DEVENDRA",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 184 , 185 , 223 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023405859,"LYON, LORA, EVE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1740480888,MONIQUE BROWN M D P C,~,154 SW MAIN ST   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1023406329,"STEVENSON, CHRISTINA, LANETTE",5540 CENTERVIEW DR STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023407129,"ROSENBERGER, JORDAN, LEANNE",803 BERMUDA BAY BLVD   KILL DEVIL HILLS NC,028,Dare,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 23 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023407384,"SEWALISH, ANDREW, JOHN",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023407384,"SEWALISH, ANDREW, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 52 , 76 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023407384,"SEWALISH, ANDREW, JOHN",16525 HOLLY CREST LN STE 150 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023407384,"SEWALISH, ANDREW, JOHN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023408168,"MASSRY, MARWA",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023408168,"MASSRY, MARWA",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023413267,"ROBERTSON, SAMANTHA, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1023413267,"ROBERTSON, SAMANTHA, MARIE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023418373,"ROSE, JESSICA, SAVIDGE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023418373,"ROSE, JESSICA, SAVIDGE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1023419272,DESTINY PURSUITS INC,FAITH HOMES & HABILITATION III,4014 SUITT RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023419272,DESTINY PURSUITS INC,4014 SUITT RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 623 , 623 ," $54,210.55 ",,
MEDICAID DIRECT,1023420635,"HARRIS, JASON, ROBERT",JASON R HARRIS DDS PA,8838 US HIGHWAY 70 W STE 100 CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1023420635,"HARRIS, JASON, ROBERT",8838 US HIGHWAY 70 W STE 100 CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 417 , 735 ," 3,162 "," $143,091.60 ",,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023420718,"SHOGBESAN, OLUWASEUN, DAMILOLA",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 43 , 56 , 60 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023420718,"SHOGBESAN, OLUWASEUN, DAMILOLA",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023420718,"SHOGBESAN, OLUWASEUN, DAMILOLA",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 19 , 20 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023420718,"SHOGBESAN, OLUWASEUN, DAMILOLA",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023420718,"SHOGBESAN, OLUWASEUN, DAMILOLA",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023420718,"SHOGBESAN, OLUWASEUN, DAMILOLA",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023420841,"DAWSON, ROLITTA, MARSHALL",930 3RD ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023420841,"DAWSON, ROLITTA, MARSHALL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023421500,"WILLIAMS, JAMIESE, MORGAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 145 , 145 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023422490,"EL-KARA, MOHAMED",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 60 , 60 , 94 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023422490,"EL-KARA, MOHAMED",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 35 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023422490,"EL-KARA, MOHAMED",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023422490,"EL-KARA, MOHAMED",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023422490,"EL-KARA, MOHAMED",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023422490,"EL-KARA, MOHAMED",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023422490,"EL-KARA, MOHAMED",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932353208,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAYETTEVILLE,1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023423795,"HENDREN, ELENA, LOUISE",1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 129 , 368 ," $15,878.47 ",,
MEDICAID DIRECT,1932353208,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAYETTEVILLE,1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023423795,"HENDREN, ELENA, LOUISE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1023423795,"HENDREN, ELENA, LOUISE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023423969,"VEER, MANIK",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023423969,"VEER, MANIK",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023423969,"VEER, MANIK",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023423969,"VEER, MANIK",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023425196,"SMITH, ALLYSON, RAZZETO",AR SMITH SPEECH THERAPY,245 WINKLERS CREEK RD UNIT C BOONE NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1023425196,"SMITH, ALLYSON, RAZZETO",245 WINKLERS CREEK RD UNIT C BOONE NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 54 , 54 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023427267,"RANKIN, CHRISTOPHER, DAVID",3333 SILAS CREEK PKWY MAILBOX 83 WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023427267,"RANKIN, CHRISTOPHER, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 60 , 60 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023429966,"CARACCIO, DONALD, MICHAEL",100 EASTOWNE DR STE 420 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 48 , 71 , 107 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023429966,"CARACCIO, DONALD, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023429966,"CARACCIO, DONALD, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 39 , 72 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023429966,"CARACCIO, DONALD, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 18 , 36 , 37 ,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023433125,"TAGGE, ERIN, LEIGH",175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023435831,"EDWARDS, LAURIE, ANN",178 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023436177,"GONZALEZ, NATALIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 28 , 32 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023436177,"GONZALEZ, NATALIA",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023436177,"GONZALEZ, NATALIA",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023436482,"GOODMAN, ABIGAIL, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 84 , 87 , 123 ,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023437738,"SCOTT, BRIANA, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023437811,"RUBINSTEIN, SAMUEL, MATTHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 41 , 114 , 132 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023438678,"PAWLIKOWSKI, ZACHARY",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023438678,"PAWLIKOWSKI, ZACHARY",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023442126,"SRIKANTH, POOJA",2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023442126,"SRIKANTH, POOJA",2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023442126,"SRIKANTH, POOJA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 87 , 136 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023442126,"SRIKANTH, POOJA",2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114420254,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,600 W TRADE ST STE A DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1023445087,"PAXTON, KELLY, JO",600 W TRADE ST   DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 50 , 65 ,$#,,
MEDICAID DIRECT,1548217755,PATTY VISION CENTER OD PA,Patty Vision Center,2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023446382,"VIRNIG, KEVIN, WILLIAM",2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1184871626,"JACKSON, ERIN, ATWATER",~,2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1023446382,"VIRNIG, KEVIN, WILLIAM",2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023446424,"SMITH, DANA, NICHOLS",2150 HERBERT CT   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023446481,"FROMAL, KRISTEN, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023446481,"FROMAL, KRISTEN, MARIE",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023448396,"PHILLIPS, KELLY, JONES",1550 FAULK ST STE 1100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 32 , 32 ,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023448396,"PHILLIPS, KELLY, JONES",1550 FAULK ST STE 1100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023448396,"PHILLIPS, KELLY, JONES",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST STE 1100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023448396,"PHILLIPS, KELLY, JONES",1550 FAULK ST STE 1100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023450558,"LANE, SARA, CATHERINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023450558,"LANE, SARA, CATHERINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1023450558,"LANE, SARA, CATHERINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023453008,"GREEN, ASHLEY, NOISETTE",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 19 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023453008,"GREEN, ASHLEY, NOISETTE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023453008,"GREEN, ASHLEY, NOISETTE",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 28 , 50 , 99 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023453008,"GREEN, ASHLEY, NOISETTE",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 70 , 114 , 174 ,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,319 N GRAHAM HOPEDALE RD FL B   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023453214,"NEWTON, KIMBERLY, NILES",319 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 61 , 175 ,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,,,Unknown,193200000X,Group,Multi-Specialty,,1023453214,"NEWTON, KIMBERLY, NILES",319 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 43 , 124 ,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023453214,"NEWTON, KIMBERLY, NILES",319 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 129 , 193 , 519 ," $29,774.00 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023453214,"NEWTON, KIMBERLY, NILES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 55 , 70 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023453214,"NEWTON, KIMBERLY, NILES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023453214,"NEWTON, KIMBERLY, NILES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023454014,"NICHOLS, CAREY, BROOKS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023454162,"SULLIVAN, JESSICA, LAUREL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 52 , 56 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023455425,"BUSH, COLLEEN, MEGAN",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023455425,"BUSH, COLLEEN, MEGAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 14 , 23 , 24 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023455425,"BUSH, COLLEEN, MEGAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023455425,"BUSH, COLLEEN, MEGAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 11 , 55 , 56 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023455425,"BUSH, COLLEEN, MEGAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023455425,"BUSH, COLLEEN, MEGAN",600 HOSPITAL DR   MONROE NC,090,Union,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023455425,"BUSH, COLLEEN, MEGAN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1023456258,"BOWER, ALEC, DOUGLAS",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 78 , 84 , 126 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023458205,"WOOD, ALICE, SMITH",910 WORTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 39 , 54 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1023460862,"WOYTEK, SARAH, CHARLENE",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 89 , 91 , 111 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023463668,"FINN, ERIN, MARIE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023463668,"FINN, ERIN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 62 , 76 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023463668,"FINN, ERIN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 62 , 63 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023464062,"KALABIN, ALEKSANDR",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023464195,"RAHMANI, ELHAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023464195,"RAHMANI, ELHAM",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023466406,"XHIHANI, ERVIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1023466406,"XHIHANI, ERVIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1023466406,"XHIHANI, ERVIS",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1023466406,"XHIHANI, ERVIS",441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 93 , 120 , 150 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023466406,"XHIHANI, ERVIS",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1023466406,"XHIHANI, ERVIS",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 31 , 51 , 69 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1023466406,"XHIHANI, ERVIS",202 E GROVER ST   SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023467313,"HERMAN, CARRIE, CHESTNUT",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023467313,"HERMAN, CARRIE, CHESTNUT",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023467313,"HERMAN, CARRIE, CHESTNUT",50 MACEDONIA CHURCH RD STE A TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932486503,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE TAYLORSVILLE,,,Unknown,193200000X,Group,Multi-Specialty,,1023467313,"HERMAN, CARRIE, CHESTNUT",50 MACEDONIA CHURCH RD STE A TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023468188,"SITTON, SUSANNAH, FRANCIS",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023468188,"SITTON, SUSANNAH, FRANCIS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 181 , 198 , 212 ," $11,810.58 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023468303,"OMOHUNDRO, JENNIFER, COREY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1093064958,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - RALEIGH FA,4400 FALLS OF NEUSE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023468642,"SOLANKI, RIMA, HITENDRA",13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023468642,"SOLANKI, RIMA, HITENDRA",13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023468642,"SOLANKI, RIMA, HITENDRA",13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 322 , 541 ," 2,172 "," $102,395.45 ",,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1023469772,"SHERRILL, ROBIN, JOHNSON",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023469772,"SHERRILL, ROBIN, JOHNSON",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023469848,"MEELER, WHITNEY, LYNANNE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 61 , 126 , 250 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023469848,"MEELER, WHITNEY, LYNANNE",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023470028,"JEONG, CHRISTINA, YI-ANN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023471455,"JOHNSON, ERIK, RICHARD",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 33 , 43 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023471521,"PATEL, ROHAN, VIJAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023471521,"PATEL, ROHAN, VIJAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 33 , 63 , 79 ," $10,894.74 ",,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1023471521,"PATEL, ROHAN, VIJAY",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 17 , 23 , 32 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023472438,"SOLDATOVA, LIUBA",1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023472438,"SOLDATOVA, LIUBA",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023472438,"SOLDATOVA, LIUBA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 44 , 63 , 111 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023472438,"SOLDATOVA, LIUBA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023472693,"ABDULHALEEM, MOHAMMED, NASER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023474756,"FLETCHER, JUSTIN, LEE",300 BILLINGSLEY RD STE 200-B CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023474756,"FLETCHER, JUSTIN, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023474764,"COFFIN, KEALIN, JERROD",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 24 , 27 ,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023474764,"COFFIN, KEALIN, JERROD",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 30 , 35 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,2709 WATER RIDGE PKWY STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023474764,"COFFIN, KEALIN, JERROD",2709 WATER RIDGE PKWY STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023474897,"FLEENOR, JASON, ERIC",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,5200 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1023474897,"FLEENOR, JASON, ERIC",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1023474897,"FLEENOR, JASON, ERIC",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023477411,"ROOKARD, ALAINA, ALEVIZATOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023480357,"WALKER, ERIC, TIMOTHY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023480357,"WALKER, ERIC, TIMOTHY",34 GRANBY ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023480357,"WALKER, ERIC, TIMOTHY",111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023480357,"WALKER, ERIC, TIMOTHY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023480357,"WALKER, ERIC, TIMOTHY",310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023481421,"COMO-LESKO, NANCY, JEAN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1023481520,LIBERTY HEALTHCARE GROUP LLC,WOODLANDS NURSING & REHABILITATION CENTER,400 PELT DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023481520,LIBERTY HEALTHCARE GROUP LLC,400 PELT DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 31 , 31 ," $49,408.40 ",,
MEDICAID DIRECT,1023483740,RITE HOME HEALTH CARE SERVICES LLC,RITE HOME HEALTH CARE LLC,10069 WEDDINGTON ROAD EXT   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1023483740,RITE HOME HEALTH CARE SERVICES LLC,10069 WEDDINGTON ROAD EXT   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,143 "," 1,143 "," $121,286.00 ",,
MEDICAID DIRECT,1023483740,RITE HOME HEALTH CARE SERVICES LLC,RITE HOME HEALTH CARE LLC,10069 WEDDINGTON ROAD EXT   CONCORD NC,013,Cabarrus,251J00000X,Agencies,Nursing Care,,1023483740,RITE HOME HEALTH CARE SERVICES LLC,10069 WEDDINGTON ROAD EXT   CONCORD NC,013,Cabarrus,251J00000X,Agencies,Nursing Care,,#, 156 , 171 ," $129,168.00 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023484276,"ROSERO, MICHELLE, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 35 , 85 , 93 ,$#,,
MEDICAID DIRECT,1023486602,RAISE THE BAR THERAPY SERVICES LLC,,18676 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1023486602,RAISE THE BAR THERAPY SERVICES LLC,18676 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,, 52 , 721 ," 1,025 "," $69,027.95 ",,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1023487444,"RODNEY, LAHEART, MARIE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1023487444,"RODNEY, LAHEART, MARIE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1023487444,"RODNEY, LAHEART, MARIE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023489937,"POWELL, JACK, RYNE",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023489937,"POWELL, JACK, RYNE",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023491388,"TALBOTT, DENISE, LORRAINE",117 E KINGS HWY   EDEN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023491388,"TALBOTT, DENISE, LORRAINE",117 E KINGS HWY   EDEN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023491388,"TALBOTT, DENISE, LORRAINE",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1023491503,"STEEL, ELEANOR, ABBOTT",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 488 , 517 ," 2,025 "," $57,776.51 ",,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1023491503,"STEEL, ELEANOR, ABBOTT",280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 3,333 "," 4,088 "," 18,427 "," $522,214.93 ",,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023492048,"RIPLEY, ERIN, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023495108,"MEDDA, SUMAN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 35 , 35 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023495108,"MEDDA, SUMAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023495108,"MEDDA, SUMAN",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 39 , 65 ," $18,861.76 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023495108,"MEDDA, SUMAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1881614170,ASSOCIATED MEDICAL SPECIALISTS PA,COASTAL CANCER CENTER,8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023499076,"PATEL, NIKHIL, BALDEVBHAI",3008 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023499621,"KISELEV, BORIS, MAXIMOVICH",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023499621,"KISELEV, BORIS, MAXIMOVICH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023499621,"KISELEV, BORIS, MAXIMOVICH",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 17 , 34 , 35 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023499621,"KISELEV, BORIS, MAXIMOVICH",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023499621,"KISELEV, BORIS, MAXIMOVICH",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023499621,"KISELEV, BORIS, MAXIMOVICH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023501764,"SELBY, CHRISTIAN, DALE",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1023501764,"SELBY, CHRISTIAN, DALE",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023501764,"SELBY, CHRISTIAN, DALE",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1023502911,"HEADDEN, TRIXY, MITCHELL",2501 DOWNING ST SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1023502911,"HEADDEN, TRIXY, MITCHELL",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 77 , 77 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1023502911,"HEADDEN, TRIXY, MITCHELL",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 84 , 84 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1023502911,"HEADDEN, TRIXY, MITCHELL",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1023502911,"HEADDEN, TRIXY, MITCHELL",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1023502911,"HEADDEN, TRIXY, MITCHELL",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1023502911,"HEADDEN, TRIXY, MITCHELL",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023502937,"JORDAN, JESSICA, ANN",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023504222,"BRACKEN, ANGELA, CHYRISSE",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023504222,"BRACKEN, ANGELA, CHYRISSE",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1023504685,"COMBS, EMILY, HUFFMAN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 133 , 153 , 155 ,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1023504685,"COMBS, EMILY, HUFFMAN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1023504685,"COMBS, EMILY, HUFFMAN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 46 , 56 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 29 , 39 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 38 , 49 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023504735,"COOKE, BRIDGETTE, ANN",340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 38 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023504743,"BREEN, MADELEINE, REBECCA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023504743,"BREEN, MADELEINE, REBECCA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023504743,"BREEN, MADELEINE, REBECCA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023504834,"SMITH, NATALIE, REID",327 ROCK CRUSHER RD   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 37 , 39 ,$#,,
MEDICAID DIRECT,1790881076,WEITZEL AND ASSOCIATES PA,2020 VISION CENTER,1212 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1023504974,"MYERS, SAMANTHA, ELIZABETH",1212 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1790881076,WEITZEL AND ASSOCIATES PA,2020 VISION CENTER,116 REGENCY BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023504974,"MYERS, SAMANTHA, ELIZABETH",1212 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023506011,"SUROVEC, MICHELLE, LYNN",104 MEDSPRING DR   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023506011,"SUROVEC, MICHELLE, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023506011,"SUROVEC, MICHELLE, LYNN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 19 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 39 , 54 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 60 , 60 , 70 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 38 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023506169,"NGUYEN, CHRISTOPHER, JASON",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023506318,"BASTUG, NICHOLAS, DEMIR",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 119 , 123 , 130 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",4220 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 27 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 57 , 105 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513280,"HUNGERFORD, JUSTIN, JOHN",3475 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513769,"KUMAR, ARJUN, SADAGOPAN",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023513769,"KUMAR, ARJUN, SADAGOPAN",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023513769,"KUMAR, ARJUN, SADAGOPAN",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023513769,"KUMAR, ARJUN, SADAGOPAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 31 , 31 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1023513769,"KUMAR, ARJUN, SADAGOPAN",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023513769,"KUMAR, ARJUN, SADAGOPAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023514874,"RABE, TIMOTHY, GORDON",250 SMITH CHURCH RD STE RHG ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023514874,"RABE, TIMOTHY, GORDON",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 116 , 328 , 328 ," $11,619.15 ",,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023514874,"RABE, TIMOTHY, GORDON",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023516754,"WALSH, SAMANTHA, JOLINE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 108 , 157 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1023518412,"GRISSOM, NEIJIA, VINTON",3214 CHARLES B ROOT WYND STE 213 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 108 , 920 , 963 ," $43,806.29 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023518909,"DIXON, STEPHANIE, NICOLE",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 89 , 139 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023519543,"KERTH, JULIE, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 68 , 142 , 152 ," $10,421.10 ",,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1023520301,"CAHN, DAWN, MARIE",610 W FISHER ST   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,128 ARGUS LN STE G   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023522281,"HAYES, ELIZABETH, RUDISILL",128 ARGUS LN STE G MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 23 , 31 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,128 ARGUS LN STE G   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023522281,"HAYES, ELIZABETH, RUDISILL",128 ARGUS LN STE G MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023525557,"MOSONIK, RACHEL, CHEPNGENO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 25 ,$#,,
MEDICAID DIRECT,1952940926,LANE AND ASSOCIATES XXXVI DDS PA,,900 S GARNETT ST   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1023526837,"PARK, HEE, JIN",3020 S MIAMI BLVD   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1295990406,LANE AND ASSOCIATES VI DDS PA,Lane and Associates VI DDS PA,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023526837,"PARK, HEE, JIN",3020 S MIAMI BLVD   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023162716,"EISBERG II, ROBERT, WILLIAM",ROBERT W EISBERG II DDS PA DBA ATLANTIC FAMILY DEN,1001 W WILLIAMS ST STE 101 APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1023526837,"PARK, HEE, JIN",3020 S MIAMI BLVD   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 629 ," 1,075 "," 4,417 "," $226,172.33 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023529609,"FROISETH, MEGHAN, KATELIN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023531316,"SMOLKO, JAMIE, STEIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 14 , 55 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1023531316,"SMOLKO, JAMIE, STEIN",200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023533486,"WASHINGTON-LAPRESTA, AMBER, ROSE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689870941,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023533486,"WASHINGTON-LAPRESTA, AMBER, ROSE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 79 , 85 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1023534401,"THOMAS, CANDACE, DANIELLE",1998 HENDERSONVILLE RD STE 53 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023537099,"SHETLEY, SHERRI, DIANE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023537099,"SHETLEY, SHERRI, DIANE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023537099,"SHETLEY, SHERRI, DIANE",601 N ELM ST   HIGH POINT NC,041,Guilford,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1023539277,"SNYDER, GARRETT, WADE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 94 , 103 , 154 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023540002,"STALLARD, STEVEN, ANDREW",155 MEMORIAL DR   PINEHURST NC,063,Moore,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023540002,"STALLARD, STEVEN, ANDREW",8401 MEDICAL PLAZA DR STE 250 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 42 , 57 ,$#,,
MEDICAID DIRECT,1285644500,NEW CENTURY OPHTHALMOLOGY PC,~,1610 WILLIAMSBORO ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1023540010,"JINDAL, SUMEET",1610 WILLIAMSBORO ST   OXFORD NC,039,Granville,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 25 , 53 ,$#,,
MEDICAID DIRECT,1285644500,NEW CENTURY OPHTHALMOLOGY PC,~,1610 WILLIAMSBORO ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1023540010,"JINDAL, SUMEET",7901 ACC BLVD STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023541349,"PARKER, GREGORY, MCCARTHY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023542149,"GOLDSTEIN, CARMA, HELEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 36 , 40 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023542354,"LYNCH, KEVIN, TYLER",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023542354,"LYNCH, KEVIN, TYLER",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023542354,"LYNCH, KEVIN, TYLER",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023542354,"LYNCH, KEVIN, TYLER",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023542669,"DUNLAP, MATTHEW, ROBERT",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 28 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023542669,"DUNLAP, MATTHEW, ROBERT",2000 WELLNESS BLVD STE 140 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023543386,"DALKIN, WILLIAM, ALBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 41 , 47 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023543386,"DALKIN, WILLIAM, ALBERT",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1023547353,"ELVIS, BRANDON, ARON",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 63 , 65 , 65 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1023547353,"ELVIS, BRANDON, ARON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023547585,"FORTEZZO, AUDREY, CATHERINE",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 18 , 23 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023547585,"FORTEZZO, AUDREY, CATHERINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 64 , 88 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023548211,"KOZMAN, DIANA, METRY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 24 , 24 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023548211,"KOZMAN, DIANA, METRY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 117 , 118 , 147 ,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023549979,"DABRUSCO, ANYA, SARAH",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 65 , 166 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023553096,"BULLOCK, KRISTINA, LYNNE",40 DUKE MEDICINE CIR # 2D DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023553096,"BULLOCK, KRISTINA, LYNNE",958 VANDORA SPRINGS RD   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023553096,"BULLOCK, KRISTINA, LYNNE",958 VANDORA SPRINGS RD   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1437286291,ALLCARE CLINICAL ASSOCIATES PA,ASHEVILLE ANESTHESIA ASSOCIATES PA,34 GRANBY ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1023554839,"AUTRY, EMMA, GREEAR",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023554839,"AUTRY, EMMA, GREEAR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1023557691,"ADAMS, JOIA, ELIZABETH",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1023559937,"GRIFFITHS, SARAH, ASHCRAFT",2076 HIGHWAY 69 S   HAYESVILLE NC,022,Clay,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 ,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023562956,"DENIO, ERIN, BRETT",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 18 , 34 , 47 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1023564283,"KYGER, LINDY, NOELLE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023564283,"KYGER, LINDY, NOELLE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1023564283,"KYGER, LINDY, NOELLE",7810 NC 751 STE 100 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023564283,"KYGER, LINDY, NOELLE",100 PERKINS DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1023566544,"COGGINS, JULIE, TAYLOR",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922734375,MCPC-24 LLC,FIRSTHEALTH TELEMEDICINE,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023566544,"COGGINS, JULIE, TAYLOR",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 35 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1023567302,"FUSILIER, CANDICE, LANIER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023567302,"FUSILIER, CANDICE, LANIER",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023567302,"FUSILIER, CANDICE, LANIER",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023567914,"DEL VALLE DE LAOSA, ALBERTO, EDWIN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023567914,"DEL VALLE DE LAOSA, ALBERTO, EDWIN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 39 , 39 ,$#,,
MEDICAID DIRECT,1598085227,EDWARD F SCAMMON DMD PA,EDWARD F SCAMMON DMD PA,327 TEAL DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1023570322,"HASTIE, HUSTON, LEWIS",327 TEAL DR   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 661 ," 1,008 "," 3,245 "," $168,319.41 ",,
MEDICAID DIRECT,1114247822,EDWARD F SCAMMON DMD PA,~,115 SOUTHERN DUNES DR   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1023570322,"HASTIE, HUSTON, LEWIS",115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 568 , 895 ," 2,851 "," $156,135.90 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023570538,"VISSER, JACQUELYN, DIANE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023570629,"DURBIN, BREANNA, LYNN",257 HOSPITAL DR NE STE 200 BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 32 , 40 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1023573037,"ORMOND, KATIE, ELIZABETH",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 33 , 65 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023573037,"ORMOND, KATIE, ELIZABETH",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 19 , 47 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023573037,"ORMOND, KATIE, ELIZABETH",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023573037,"ORMOND, KATIE, ELIZABETH",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1023573037,"ORMOND, KATIE, ELIZABETH",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 25 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023574720,"ADAMS, DAVID, MICHAEL",9 WALDEN RIDGE DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1023574720,"ADAMS, DAVID, MICHAEL",9 WALDEN RIDGE DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 27 , 31 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1023577186,"WINGLER, MEAGAN, REYNOLDS",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 64 , 134 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023578176,"GLENN, ZACHARY, DILLON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 149 , 149 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023578176,"GLENN, ZACHARY, DILLON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 81 , 81 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023578176,"GLENN, ZACHARY, DILLON",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1023578176,"GLENN, ZACHARY, DILLON",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1023578176,"GLENN, ZACHARY, DILLON",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1023579125,"SILVERSTEIN, MARLEE, HANNAH",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 34 , 39 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1023579125,"SILVERSTEIN, MARLEE, HANNAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1023579125,"SILVERSTEIN, MARLEE, HANNAH",781 AVENT FERRY RD STE 202 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 20 , 26 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1023582525,"TURNER, AARIKA, LIESKE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023582525,"TURNER, AARIKA, LIESKE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 74 , 78 ,$#,,
MEDICAID DIRECT,1023584893,"RIEHL, BRIAN, GREGORY",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1023584893,"RIEHL, BRIAN, GREGORY",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023586997,"DINSMORE, DANIELLE, KAITLYN",13557 STEELECROFT PKWY STE 2200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023586997,"DINSMORE, DANIELLE, KAITLYN",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 71 , 80 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023586997,"DINSMORE, DANIELLE, KAITLYN",106 W MEDICAL PARK DR STE A LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1023590502,"WHELAN, CHASE, JONATHAN",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023590502,"WHELAN, CHASE, JONATHAN",1102 B US 601   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1023590502,"WHELAN, CHASE, JONATHAN",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 56 , 56 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023590502,"WHELAN, CHASE, JONATHAN",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023590973,"CARR, SUMMER, GRAHAM",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 114 ," 1,848 "," 1,907 "," $27,556.09 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023590973,"CARR, SUMMER, GRAHAM",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 220 , 233 ," $11,427.85 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023590973,"CARR, SUMMER, GRAHAM",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1721 BALD HILL LOOP   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1023590973,"CARR, SUMMER, GRAHAM",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023591013,"GUDZIK, THOMAS, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 31 , 60 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023591807,"MCDANIEL, JILL, DOLLAR",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023592979,"GLASS, STEPHANIE, CHI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023592979,"GLASS, STEPHANIE, CHI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023592979,"GLASS, STEPHANIE, CHI",21 HOSPITAL DR LOWR LEVEL ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023594470,TENDER CARE HEALTH SERVICES PLLC,~,1612 ARAPAHOE RIDGE DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1023594470,TENDER CARE HEALTH SERVICES PLLC,1612 ARAPAHOE RIDGE DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,332 "," 1,332 "," $121,374.41 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023594884,"MARTIN, KATHRYN, ROBERTSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 27 , 27 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023594884,"MARTIN, KATHRYN, ROBERTSON",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023594884,"MARTIN, KATHRYN, ROBERTSON",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 22 , 56 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023594884,"MARTIN, KATHRYN, ROBERTSON",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023597697,"PUNZALAN, NOLI, MONTALBO",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 120 , 381 , 422 ," $21,382.53 ",,
MEDICAID DIRECT,1023597697,"PUNZALAN, NOLI, MONTALBO",,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1023597697,"PUNZALAN, NOLI, MONTALBO",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023597697,"PUNZALAN, NOLI, MONTALBO",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023600632,"WITT, LARRY, JOE",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1023600632,"WITT, LARRY, JOE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 20 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023600632,"WITT, LARRY, JOE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1912085648,CHOICE PHYSICAL THERAPY WELLNESS,~,847 WESTLAKE DR   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023600756,"PELFREY, KELSEY, MARIAH",847 WESTLAKE DR   MOUNT AIRY NC,086,Surry,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 47 ,$#,,
MEDICAID DIRECT,1023609237,SWEET MAGNOLIA SPEECH THERAPY PLLC,,112 CURRITUCK COMMERICAL DR STE A MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1023609237,SWEET MAGNOLIA SPEECH THERAPY PLLC,112 CURRITUCK COMMERICAL DR STE A MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023613478,"STRINGFELLOW, SAMANTHA, CLAIRE",40 DUKE MEDICINE CIR # 2J DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",3032 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 115 , 115 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 82 , 82 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 31 , 31 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",4174 SHOOK RD   CLAREMONT NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 66 , 66 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 61 , 61 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 79 , 79 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",4174 SHOOK RD   CLAREMONT NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 67 , 67 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",3032 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 45 , 45 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,485 VETERANS WAY   KERNERSVILLE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 95 , 95 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1023614906,"WELBORN, SHARON, ALENE",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023615077,TALKABILITIES SPEECH AND LANGUAGE S,,1002 CAMBRIDGE RIVER CT   KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1023615077,TALKABILITIES SPEECH AND LANGUAGE S,1002 CAMBRIDGE RIVER CT   KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023618063,"TAYLOR, AMBER, JUSTINE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023624251,"ROGERS, CHADWICK, GORDON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 64 , 87 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023631199,"HOOKS, CHERYL, LYNETTE",1235 RAMSEY ST FL 2 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1023631199,"HOOKS, CHERYL, LYNETTE",1235 RAMSEY ST FL 2 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5641 S HWY 41   WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1023631199,"HOOKS, CHERYL, LYNETTE",125 RIVER VINE PKWY   WALLACE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023632742,"GRIFFIN, REBECCA, DEMPRE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023632742,"GRIFFIN, REBECCA, DEMPRE",2308 WESVILL CT   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023632742,"GRIFFIN, REBECCA, DEMPRE",2308 WESVILL CT   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023633930,"KANOSKY, MARCIE, LYNNE",,3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,1023633930,"KANOSKY, MARCIE, LYNNE",3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 76 , 120 , 323 ," $24,457.33 ",,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1023636933,"QUALHEIM, CHRISTINA, MARIE",1909 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 21 , 37 , 37 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023636933,"QUALHEIM, CHRISTINA, MARIE",1909 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 14 , 20 , 21 ,$#,,
MEDICAID DIRECT,1023637436,CARE CONNECTION,CAREHEARTEDLY,114 NATURE DR   HENDERSONVILLE NC,045,Henderson,253Z00000X,Agencies,In Home Supportive Care,,1023637436,CARE CONNECTION,114 NATURE DR   HENDERSONVILLE NC,045,Henderson,253Z00000X,Agencies,In Home Supportive Care,,#, 48 , 48 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023637444,"KHALILULLAH, MOHAMMAD, ZAFAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023637444,"KHALILULLAH, MOHAMMAD, ZAFAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023638665,"EDDEN, ELIZABETH, RUTH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023638665,"EDDEN, ELIZABETH, RUTH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023638665,"EDDEN, ELIZABETH, RUTH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023638665,"EDDEN, ELIZABETH, RUTH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023638665,"EDDEN, ELIZABETH, RUTH",1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023640109,"FLYNT, ELIZABETH, TINA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023641206,"MILLER, MALIK, D'MAR",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023641206,"MILLER, MALIK, D'MAR",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023645215,"LOGAN, ORAN, FRANKLIN",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023645215,"LOGAN, ORAN, FRANKLIN",3129 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 24 , 41 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023645538,"AKELEY, KATHERINE, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023645538,"AKELEY, KATHERINE, ELIZABETH",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 13 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023646338,"NAASZ, HAYLEY, NEWSOM",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023646569,"SANDIFER, DONNA, CROWDER",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 14 , 17 , 29 ,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023646569,"SANDIFER, DONNA, CROWDER",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023646569,"SANDIFER, DONNA, CROWDER",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023646569,"SANDIFER, DONNA, CROWDER",3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023646569,"SANDIFER, DONNA, CROWDER",3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023646858,"WILSON, KELLY, COMOLLI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023647146,"GREGORY, THOMAS, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023647146,"GREGORY, THOMAS, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023647468,"WEEKLEY, CAMERON, JOSEF",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023647468,"WEEKLEY, CAMERON, JOSEF",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023647468,"WEEKLEY, CAMERON, JOSEF",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 44 , 46 ,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023647617,"SEITZ, EMILIE, KATHLEEN",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205893435,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023647617,"SEITZ, EMILIE, KATHLEEN",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205893435,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023647617,"SEITZ, EMILIE, KATHLEEN",9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1538350640,"PAYNICH, JOSHUA, DAIN",~,11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1023647773,"JAMISON, ALICE, ROSE",11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 100 , 104 , 436 ," $17,116.52 ",,
MEDICAID DIRECT,1023647773,"JAMISON, ALICE, ROSE",,11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1023647773,"JAMISON, ALICE, ROSE",11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 3,196 "," 4,763 "," 19,997 "," $842,819.84 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023649720,"MEYER, TESSA, ROSE",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 71 , 74 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023654068,"KING, CORA, SHANTE",102 SOUTHERN AVE   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285291211,GOSHEN MEDICAL CENTER INCORPORATED,~,102 SOUTHERN AVE   RAEFORD NC,047,Hoke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023654068,"KING, CORA, SHANTE",102 SOUTHERN AVE   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023654068,"KING, CORA, SHANTE",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1023657202,LASTING IMPACT SPEECH THERAPY,,8627 MINERAL RIDGE WAY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023657202,LASTING IMPACT SPEECH THERAPY,8627 MINERAL RIDGE WAY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023658077,"WHITE, ALTHEA, ELENA",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023658077,"WHITE, ALTHEA, ELENA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023658077,"WHITE, ALTHEA, ELENA",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023658077,"WHITE, ALTHEA, ELENA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1023658077,"WHITE, ALTHEA, ELENA",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023661014,"KIM, ANDY, YOUNG JIN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023661014,"KIM, ANDY, YOUNG JIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023661014,"KIM, ANDY, YOUNG JIN",101 E WT HARRIS BLVD BLDG 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023661014,"KIM, ANDY, YOUNG JIN",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023661014,"KIM, ANDY, YOUNG JIN",10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023664026,"SMITH, KATHRYN, MCKELVEY",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 175 , 988 ," 1,065 "," $19,059.15 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023664026,"SMITH, KATHRYN, MCKELVEY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 63 , 63 ,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023664414,"BERGEN, CHRISTINA, LYNN STAUBER",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902124647,DOCTORS EXPRESS PLLC,~,101 MAYNARD CROSSING CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023664554,"SHERPA, RESHMA",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1023664554,"SHERPA, RESHMA",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093586273,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE UNIVERSIT,237 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023664554,"SHERPA, RESHMA",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023664554,"SHERPA, RESHMA",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1023664554,"SHERPA, RESHMA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043080732,ACCESS CARE ANESTHESIA OF NORTH CAR,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023667029,"ANDERSON, STEVEN, MAIRS",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 109 , 131 , 135 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1023669272,"LACKAYE, AMANDA, JEANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023670064,"KANDEMIRLI, SEDAT, GIRAY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 83 , 85 , 107 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023670064,"KANDEMIRLI, SEDAT, GIRAY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 24 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023670064,"KANDEMIRLI, SEDAT, GIRAY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023670064,"KANDEMIRLI, SEDAT, GIRAY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023670064,"KANDEMIRLI, SEDAT, GIRAY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 104 , 117 , 178 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023670064,"KANDEMIRLI, SEDAT, GIRAY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023670064,"KANDEMIRLI, SEDAT, GIRAY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1053442210,LINER WARD & SHOBE DDS PA,SOUTHERN DENTAL ASSOCIATES,1690 RIVER ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1023670890,"HUCK, EILZABETH",1690 RIVER ST   WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 115 , 130 , 489 ," $16,046.14 ",,
MEDICAID DIRECT,1255152872,JONATHAN LINER DDS,SOUTHERN DENTAL,1690 RIVER STREET   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1023670890,"HUCK, EILZABETH",1690 RIVER ST   WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 36 , 112 ,$#,,
MEDICAID DIRECT,1578139499,LINER WARD & SHOBE DDS PA,SOUTHERN DENTAL ASSOCIATES,1370 PIEDMONT DR STE 200 LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1023670890,"HUCK, EILZABETH",1370 PIEDMONT DR STE 200 LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 69 , 202 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023671070,"COOK, JENNIFER, LEIGH",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 49 , 87 ,$#,,
MEDICAID DIRECT,1477589158,EASTRIDGE FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE EASTRIDGE FAMILY MEDICI,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1023671070,"COOK, JENNIFER, LEIGH",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 33 , 60 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023671070,"COOK, JENNIFER, LEIGH",808 SCHENCK ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023671070,"COOK, JENNIFER, LEIGH",808 SCHENCK ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1669443487,CLECO PRIMARY CARE NETWORK,CLECO MEDICAL CENTER OF SHELBY,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1023671070,"COOK, JENNIFER, LEIGH",808 SCHENCK ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1164792016,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ENT SEACOAST,3980 HIGHWAY 9 E STE 120 LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1023671641,"LANGLEY, RHIANA, BANKSTON",3980 HIGHWAY 9 E STE 120 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023673183,"BROWN, ALEXIS, CARISMA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023673993,"LACKEY, HEATHER, TAYLOR",401 N MORGAN ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 23 , 24 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023673993,"LACKEY, HEATHER, TAYLOR",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 615 , 617 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023673993,"LACKEY, HEATHER, TAYLOR",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023673993,"LACKEY, HEATHER, TAYLOR",401 N MORGAN ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 155 , 155 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1023673993,"LACKEY, HEATHER, TAYLOR",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 98 , 696 , 701 ," $24,973.17 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1023673993,"LACKEY, HEATHER, TAYLOR",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 82 , 82 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023674371,"WALKER, HELEN, LUCY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1790242345,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS SPECIALTY- CLAYTON,31 OLEANDER DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023676434,"MARTIN, CORNELIUS, DEVANTE",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 20 , 24 , 96 ,$#,,
MEDICAID DIRECT,1467507640,COUNTY OF WILSON,WILSON COUNTY DEPARTMENT OF PUBLIC HEALTH,1801 GLENDALE DR SW   WILSON NC,098,Wilson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1023676434,"MARTIN, CORNELIUS, DEVANTE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 22 , 82 ,$#,,
MEDICAID DIRECT,1306545033,CORNELIUS D MARTIN DMD PLLC,SUNNY SKIES PEDIATRIC DENTISTRY,2605 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1023676434,"MARTIN, CORNELIUS, DEVANTE",2605 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,196 "," 2,333 "," 9,723 "," $378,505.88 ",,
MEDICAID DIRECT,1467507640,COUNTY OF WILSON,WILSON COUNTY DEPARTMENT OF PUBLIC HEALTH,1801 GLENDALE DR SW   WILSON NC,098,Wilson,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1023676434,"MARTIN, CORNELIUS, DEVANTE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 32 , 106 ,$#,,
MEDICAID DIRECT,1306545033,CORNELIUS D MARTIN DMD PLLC,SUNNY SKIES PEDIATRIC DENTISTRY,2605 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1023676434,"MARTIN, CORNELIUS, DEVANTE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1255597480,JONATHAN A LINDSEY DDS PA,~,1632 MILLERS GAP HWY   NEWLAND NC,006,Avery,193400000X,Group,Single Specialty,,1023676475,"LINDSEY, JENNA, ELIZABETH",1632 MILLERS GAP HWY   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice, 289 , 439 ," 1,380 "," $74,723.71 ",,
MEDICAID DIRECT,1023678315,CABARRUS AL HOLDINGS LLC,THE LANDINGS OF CABARRUS,4968 MILESTONE AVE   KANNAPOLIS NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023678315,CABARRUS AL HOLDINGS LLC,4968 MILESTONE AVE   KANNAPOLIS NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 21 ," 4,174 "," 4,174 "," $377,186.77 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023679024,"HAFSA, SAMI, MOHAMMOD",1135 CARTHAGE ST   SANFORD NC,053,Lee,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4810 S CROATAN HWY STE 210 NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1023681178,"CASE, LAURA, COCKERHAM",4810 S CROATAN HWY STE 100 NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1023681178,"CASE, LAURA, COCKERHAM",4810 S CROATAN HWY STE 100 NAGS HEAD NC,028,Dare,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1023681970,HEARTS OF GOLD HOME CARE LLC,HEARTS OF GOLD HOME CARE LLC,2504 RAEFORD RD STE 201 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1023681970,HEARTS OF GOLD HOME CARE LLC,2504 RAEFORD RD STE 201 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,902 "," 2,970 "," $182,976.12 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023683075,"KOUL, ROSEMARY, HYNES",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023683745,"GREGORY, AMY, LYNN",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 20 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023683745,"GREGORY, AMY, LYNN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023683745,"GREGORY, AMY, LYNN",3193 W HIGHWAY 74   MONROE NC,090,Union,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023684040,"BLACKBURN, HEATHER, PATTERSON",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 26 , 43 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023684040,"BLACKBURN, HEATHER, PATTERSON",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 49 , 65 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023684966,"SANDKUHLER, CAROLINE, LEWIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023684966,"SANDKUHLER, CAROLINE, LEWIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1023684966,"SANDKUHLER, CAROLINE, LEWIS",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023685716,"ESPERSEN, JORDAN, LAYNE",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1023686086,"MILLER, TIFFANY, ANN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023686185,"BLUM, LEAH, MIRA",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 100 , 135 , 319 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023688116,"BLACK, MEGAN, KATHLEEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023688116,"BLACK, MEGAN, KATHLEEN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023688116,"BLACK, MEGAN, KATHLEEN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023688652,"COZZARELLI, ROBERT, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023689478,"ADAMS, MIRIAH, CATHERINE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 32 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023696382,"LAWS, MATTHEW, ALLEN",312 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 29 , 41 ,$#,,
MEDICAID DIRECT,1801838677,MANN EAR NOSE THROAT CLINIC PA,Mann Ear Nose & Throat Clinic PA,601 KEISLER DR STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023699386,"NASSAR, SARAH",601 KEISLER DR STE 200 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023700655,"HIJDUK, RONALD, NORMAN",404 HATFIELD CT   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 32 , 33 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1023700804,"STEELE, MACKENZIE, CAROLINE WALKER",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 28 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1023700804,"STEELE, MACKENZIE, CAROLINE WALKER",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 42 , 55 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023700804,"STEELE, MACKENZIE, CAROLINE WALKER",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023700804,"STEELE, MACKENZIE, CAROLINE WALKER",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1023700804,"STEELE, MACKENZIE, CAROLINE WALKER",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023700804,"STEELE, MACKENZIE, CAROLINE WALKER",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023708773,GINNIE MAE RESIDENCE CARE LLC,,514 DUKE ST   THOMASVILLE NC,029,Davidson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023708773,GINNIE MAE RESIDENCE CARE LLC,514 DUKE ST   THOMASVILLE NC,029,Davidson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 78 , 101 ," $45,057.74 ",,
MEDICAID DIRECT,1023711595,HENDRICKSON TRANSPORTATION GROUP LL,~,1901 TARBORO ST SW STE 201 WILSON NC,098,Wilson,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1023711595,HENDRICKSON TRANSPORTATION GROUP LL,1901 TARBORO ST SW STE 201 WILSON NC,098,Wilson,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 441 ," 11,425 "," 22,138 "," $570,013.08 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023712866,"BELL, BENJAMIN, AARON",4515 PREMIER DR STE 307   WINSTON SALEM NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023715521,"SCHAEFFER, STEPHANIE, ANN",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023715521,"SCHAEFFER, STEPHANIE, ANN",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023715539,"PRIDGEN, TAYLAR, PATRICIA",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1023715539,"PRIDGEN, TAYLAR, PATRICIA",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 24 , 34 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023715588,"TESCHEMAKER, LAKISHA, Y",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 174 , 561 , 568 ," $17,158.15 ",,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023719887,"CARSON, MICHELE, KAY",1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 118 , 174 , 178 ,$#,,
MEDICAID DIRECT,1023720851,CBRS YOUTH LLC,~,4615 W GATE CITY BLVD # 7147 GREENSBORO NC,041,Guilford,251S00000X,Agencies,Community/Behavioral Health,,1023720851,CBRS YOUTH LLC,4615 W GATE CITY BLVD # 7147 GREENSBORO NC,041,Guilford,251S00000X,Agencies,Community/Behavioral Health,, 110 ," 2,064 "," 2,064 "," $133,714.80 ",,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023721503,"COX, SETH, MITCHELL",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 27 , 45 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023722030,"HAWKINS, TAYLOR, SANDLIN",101 S CAREY ST   LA GRANGE NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 35 , 57 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023723020,"NGUYEN, NGOC, BAO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023723020,"NGUYEN, NGOC, BAO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 59 , 59 ,$#,,
MEDICAID DIRECT,1023723798,ABUNDANT LIFE PHYSICAL THERAPY LLC,,1531 CINEMA DR STE C STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1023723798,ABUNDANT LIFE PHYSICAL THERAPY LLC,1531 CINEMA DR STE C STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1023730512,AUTRY BEHAVIORAL CONSULTANTS & RESO,,201 S MCPHERSON CHURCH RD STE 226 FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,1023730512,AUTRY BEHAVIORAL CONSULTANTS & RESO,201 S MCPHERSON CHURCH RD STE 226 FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023732385,"MURPHY, BRIANNA, LYNNE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 16 , 16 , 31 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023736857,"MAY, AARON, ANDREW",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 71 , 80 ,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023736857,"MAY, AARON, ANDREW",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 55 , 71 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023738333,"WILKES, KELSEY, ELAINE",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023738333,"WILKES, KELSEY, ELAINE",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023741774,"VARNER, ARIANNA, NICOLE",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 32 , 38 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023741774,"VARNER, ARIANNA, NICOLE",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 44 , 44 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023741774,"VARNER, ARIANNA, NICOLE",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1023741774,"VARNER, ARIANNA, NICOLE",,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1023741774,"VARNER, ARIANNA, NICOLE",3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023741774,"VARNER, ARIANNA, NICOLE",3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 21 , 22 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1023741774,"VARNER, ARIANNA, NICOLE",3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023743606,"HUTCHENS, AERIKA, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1710427091,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN CARDIOLOGY,708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1023743606,"HUTCHENS, AERIKA, NICOLE",708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 121 , 276 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023743606,"HUTCHENS, AERIKA, NICOLE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023746484,"NIYONKURU, GRACE, PEACE",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 49 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023746484,"NIYONKURU, GRACE, PEACE",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 23 , 29 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023746633,"WOOD, HOPE, MANCINI",1000 HEALING WAY   MATTHEWS NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1023746633,"WOOD, HOPE, MANCINI",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1023746633,"WOOD, HOPE, MANCINI",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023752094,SPRING ARBOR ALBEMARLE NC TENANT LL,SPRING ARBOR OF ALBEMARLE,315 PARK RIDGE RD   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023752094,SPRING ARBOR ALBEMARLE NC TENANT LL,315 PARK RIDGE RD   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,369 "," 1,369 "," $92,827.00 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023753407,"KING, RYAN, SCOTT",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023753407,"KING, RYAN, SCOTT",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 33 , 68 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4680 US HIGHWAY 117 N   PIKEVILLE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1023753407,"KING, RYAN, SCOTT",4680 US HIGHWAY 117 N   PIKEVILLE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 120 , 266 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1023753407,"KING, RYAN, SCOTT",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1023753407,"KING, RYAN, SCOTT",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1023758620,"REECE, AMERICA, BERENICE",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1023758620,"REECE, AMERICA, BERENICE",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 108 , 114 , 216 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1023758620,"REECE, AMERICA, BERENICE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1023758620,"REECE, AMERICA, BERENICE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023758620,"REECE, AMERICA, BERENICE",150 IVEY LN STE A PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1023758620,"REECE, AMERICA, BERENICE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 17 , 29 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1023758620,"REECE, AMERICA, BERENICE",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1023763679,"TRAYWICK, ANNA, NICOLE",10 AVIEMORE DRIVE   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 29 , 31 ,$#,,
MEDICAID DIRECT,1023764909,REDEFINED STAFFING LLC,,915 BRIDGE ST   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1023764909,REDEFINED STAFFING LLC,915 BRIDGE ST   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,593 "," 1,618 "," $191,211.00 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1023765237,"AGLIECO, ALEXANDRA, VICTORIA",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 34 , 50 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023765237,"AGLIECO, ALEXANDRA, VICTORIA",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 30 ,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023765435,"CLARK, MICHAEL, ALEXANDER",1316 SPENCER MOUNTAIN RD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1639857477,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WARLICK ACADEMY,1316 SPENCER MOUNTAIN RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023765435,"CLARK, MICHAEL, ALEXANDER",1316 SPENCER MOUNTAIN RD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 14 , 73 , 73 ," $23,384.09 ",,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023773942,"ROESCH, KELLIE, CHRISTINE",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 36 , 56 ,$#,,
MEDICAID DIRECT,1023776648,BLUE RIDGE LABORATORIES LLC,,573 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1023776648,BLUE RIDGE LABORATORIES LLC,573 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,, 90 , 480 ," 1,335 "," $46,582.63 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023778776,"MARTINEZ, SARAH, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 18 , 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023778776,"MARTINEZ, SARAH, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 37 , 37 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023778776,"MARTINEZ, SARAH, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023778776,"MARTINEZ, SARAH, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023778776,"MARTINEZ, SARAH, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023778776,"MARTINEZ, SARAH, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023778776,"MARTINEZ, SARAH, ANN",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023781184,"LAUPP, KYRA, JANICE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1023781184,"LAUPP, KYRA, JANICE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 50 , 50 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023782315,"FARAWI, DANIA, MAHMOUD",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1023782315,"FARAWI, DANIA, MAHMOUD",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1023782315,"FARAWI, DANIA, MAHMOUD",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1023782315,"FARAWI, DANIA, MAHMOUD",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 27 ,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1023782315,"FARAWI, DANIA, MAHMOUD",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1023782315,"FARAWI, DANIA, MAHMOUD",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023782315,"FARAWI, DANIA, MAHMOUD",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,752 E CENTER AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",752 E CENTER AVE   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",752 E CENTER AVE   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 189 , 189 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 96 , 96 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",4801 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 46 , 46 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 95 , 95 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 35 , 35 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 31 , 31 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,4801 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",4801 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 35 , 35 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 28 , 28 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 35 , 35 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1285 W A ST   KANNAPOLIS NC,080,Rowan,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023786605,"KYEI, SANDRA, BAFFOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023792074,"HARTYE, ELLIE, SEAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023792074,"HARTYE, ELLIE, SEAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 42 , 99 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1023792074,"HARTYE, ELLIE, SEAN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023793148,ZENITH HOME CARE SERVICES,,612 POWELL ST   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1023793148,ZENITH HOME CARE SERVICES,612 POWELL ST   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,#, 107 , 107 ,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023796547,"RUSTEIKAS, MELISSA, PAIGE",3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1639697790,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023796547,"RUSTEIKAS, MELISSA, PAIGE",2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023798808,"JOHNSTON, SYDNEY, HAYS",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023831112,"RICH, JENNIFER, LYNN",5241 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023831112,"RICH, JENNIFER, LYNN",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1023852217,"BRIDGES, JENNA, GRACE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 72 , 72 ,$#,,
MEDICAID DIRECT,1023852357,ONTRACK SOLUTIONS,,7161 BARLEYWOOD DR   LOCUST NC,084,Stanly,251S00000X,Agencies,Community/Behavioral Health,,1023852357,ONTRACK SOLUTIONS,7161 BARLEYWOOD DR   LOCUST NC,084,Stanly,251S00000X,Agencies,Community/Behavioral Health,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023853371,"POPOVNAK, KELCI, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 46 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1023854775,"O'NEILL, ALLISON, PAIGE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023858982,"LEAVITT, MARA, HANNIGAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1023859477,"EDMOND, JUSTICE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023859626,"DAVIS, LIA, MARIE LAN",40 AUTUMN FERN TRAIL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023869310,"DIAZ, GABRIELA, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023871258,"CHOE, SUZIE, HEARAN",1634 N MAIN ST   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 30 ,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1023871373,"BOCKLET, MARISA, COLLEEN",100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023871829,"HUNKE, KRISTIN, LYNNE",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023872751,"NOWELL, DIAMOND",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023873056,"HUFFMAN-ROWE, BRENDETTA, SCARLETT",10211 ALM ST STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10211 ALM ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1023873056,"HUFFMAN-ROWE, BRENDETTA, SCARLETT",10211 ALM ST STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 27 , 71 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1023875846,"AUTRY, AMBER, MORGAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1023875846,"AUTRY, AMBER, MORGAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1023879632,DOC HILLS FAMILY CARE HOME,,302 SPRING ST   HAMLET NC,077,Richmond,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1023879632,DOC HILLS FAMILY CARE HOME,302 SPRING ST   HAMLET NC,077,Richmond,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1194481416,CENTER FOR INTEGRATED MEDICINE,,3822 N ELM ST # 102 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1023880531,"ADEGBENJO, SUSANAH, ADEBOLA",3822 N ELM ST STE 102 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023882461,"ANZINGER, KATHERINE, CAROLINE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1023882461,"ANZINGER, KATHERINE, CAROLINE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1023882461,"ANZINGER, KATHERINE, CAROLINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023883857,INSPIRA PEDIATRIC THERAPY PLLC,INSPIRA PEDIATRIC THERAPY,4752 SWORDFISH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1023883857,INSPIRA PEDIATRIC THERAPY PLLC,4752 SWORDFISH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#, 246 , 251 ," $16,951.18 ",,
MEDICAID DIRECT,1043771371,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CATAWBA COUNTY PUBLIC HEALTH,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023884095,"TURNER, MELANIE, MARIE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1467123091,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - HICKORY,858 2ND ST NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1023884095,"TURNER, MELANIE, MARIE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1992947766,FAITH MEDICAL CENTER PC,~,3626 LATROBE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1023885944,"OLIGBO, CHIDINMA",3626 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023886199,MORGANS CARE LLC,,600 PARK OFFICES DR STE 300-45 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1023886199,MORGANS CARE LLC,600 PARK OFFICES DR STE 300-45 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 155 , 155 ," $15,591.36 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1023886637,"MACK, STEFFANIE, MICHELLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 192 ," 1,096 "," 1,144 "," $24,568.39 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1023891702,"BURROWS, KATHLEEN, LAPLACA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 35 , 35 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033100177,"WASHBURN, SCOTT, ALAN",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 35 , 46 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033100177,"WASHBURN, SCOTT, ALAN",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1033100177,"WASHBURN, SCOTT, ALAN",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 23 , 31 ,$#,,
MEDICAID DIRECT,1558848093,DERMATOLOGY CONSULTANTS OF ASHEVILL,~,218 ELKWOOD AVE STE 104 WOODFIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1033101175,"MENDEZ, JOSE, EDWARD",218 ELKWOOD AVE   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 13 , 28 ,$#,,
MEDICAID DIRECT,1811151244,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE MOORESVILLE INTERNAL ME,170 MEDICAL PARK RD STE 140A MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1033101555,"FRY, PATRICK, LOUIS",170 MEDICAL PARK RD STE 140A MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 36 , 57 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033102389,"PETRI, LISA, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033102389,"PETRI, LISA, ANNE",167 MOORE RD STE 201 KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033102389,"PETRI, LISA, ANNE",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 70 , 113 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033102413,"SMITH, MICHAEL, KEVIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 385 , 480 , 592 ," $11,128.01 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033102413,"SMITH, MICHAEL, KEVIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033102413,"SMITH, MICHAEL, KEVIN",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033102413,"SMITH, MICHAEL, KEVIN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 33 , 49 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033102413,"SMITH, MICHAEL, KEVIN",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881979011,NATURAL BEGINNINGS BIRTH AND WELLNE,NATURAL BEGINNINGS BIRTH AND WELLNESS CENTER,1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1033104112,"ENSMINGER, MARCIA",1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1013329929,MOUNTAIN LAUREL DERMATOLOGY PLLC,,600 ALLIANCE CT STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033104369,"SINGLETON, GINA, RAE",11 FALCON CREST LN   CLYDE NC,044,Haywood,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 29 , 34 , 75 ,$#,,
MEDICAID DIRECT,1033104369,"SINGLETON, GINA, RAE",~,11 FALCON CREST LN   CLYDE NC,044,Haywood,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1033104369,"SINGLETON, GINA, RAE",11 FALCON CREST LN   CLYDE NC,044,Haywood,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1013329929,MOUNTAIN LAUREL DERMATOLOGY PLLC,,600 ALLIANCE CT STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033104369,"SINGLETON, GINA, RAE",600 ALLIANCE CT STE 200 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 28 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033104682,"ADAMSON, ANDREW, JAMES",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 118 , 124 , 150 ," $11,818.23 ",,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033104682,"ADAMSON, ANDREW, JAMES",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1033105507,"GEBRAIL, AYMAN, GERGY",2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 42 , 42 ," $28,039.55 ",,
MEDICAID DIRECT,1437146800,COASTAL INTERNAL MEDICINE PA,~,2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033105507,"GEBRAIL, AYMAN, GERGY",2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 214 , 709 ," 1,266 "," $22,445.17 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033105739,"JOHN, JOHN, KUNNUTHARA",744 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 224 , 404 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1033105739,"JOHN, JOHN, KUNNUTHARA",744 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1033105739,"JOHN, JOHN, KUNNUTHARA",152 CROSSOVER RD   BEULAVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033105739,"JOHN, JOHN, KUNNUTHARA",152 CROSSOVER RD   BEULAVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 35 , 51 ,$#,,
MEDICAID DIRECT,1033106216,KCI USA INC,3M MEDICAL SOLUTIONS,200 TRANS AIR DR STE 500 MORRISVILLE NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033106216,KCI USA INC,200 TRANS AIR DR STE 500 MORRISVILLE NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 146 , 408 , 804 ," $118,638.98 ",,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033106745,"PANGARKAR, SANDEEP, SHARAD",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033106778,"WHITE, RONDA, SNOW",601 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033106778,"WHITE, RONDA, SNOW",306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 46 , 63 , 99 ,$#,,
MEDICAID DIRECT,1215464227,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,906 MEDICAL CIR   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033107180,"BECKER, GREGORY, LEE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1508853698,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033107180,"BECKER, GREGORY, LEE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,303 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1033107800,"PONS, LARA, JUNINE",303 YADKIN ST   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588178370,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH CABARRUS TRANSITION SERVICES,200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033107800,"PONS, LARA, JUNINE",200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 81 , 81 ,$#,,
MEDICAID DIRECT,1588178370,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH CABARRUS TRANSITION SERVICES,200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033107800,"PONS, LARA, JUNINE",8560 COOK ST   MT PLEASANT NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033108964,FIRST CHOICE HOME CARE INC,FIRST CHOICE HOME CARE INC,506 CARTHAGE ST   SANFORD NC,053,Lee,251J00000X,Agencies,Nursing Care,,1033108964,FIRST CHOICE HOME CARE INC,506 CARTHAGE ST   SANFORD NC,053,Lee,251J00000X,Agencies,Nursing Care,,#, 681 , 711 ," $301,568.96 ",,
MEDICAID DIRECT,1033108964,FIRST CHOICE HOME CARE INC,FIRST CHOICE HOME CARE INC,506 CARTHAGE ST   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,1033108964,FIRST CHOICE HOME CARE INC,506 CARTHAGE ST   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,#, 352 , 352 ," $48,276.00 ",,
MEDICAID DIRECT,1033108964,FIRST CHOICE HOME CARE INC,FIRST CHOICE HOME CARE INC,506 CARTHAGE ST   SANFORD NC,053,Lee,385H00000X,Respite Care Facility,Respite Care,,1033108964,FIRST CHOICE HOME CARE INC,506 CARTHAGE ST   SANFORD NC,053,Lee,385H00000X,Respite Care Facility,Respite Care,,#, 104 , 104 ," $39,962.00 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,645 AMALIA ST NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033108980,"DZIADZIOLA, JAMES, KENNETH",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033108980,"DZIADZIOLA, JAMES, KENNETH",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033108980,"DZIADZIOLA, JAMES, KENNETH",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 95 , 136 , 176 ,$#,,
MEDICAID DIRECT,1649881145,WNC OPHTHALMOLOGY PLLC,,900 HENDERSONVILLE RD STE 302 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033109111,"KARO, JASON, EDWARD",900 HENDERSONVILLE RD STE 302 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 52 , 67 , 97 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033109194,"BOYD, TIMOTHY, ALLEN",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 91 , 158 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033111315,"FONTANA, UMBERTO, GAETANO",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033111315,"FONTANA, UMBERTO, GAETANO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033111315,"FONTANA, UMBERTO, GAETANO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1033111315,"FONTANA, UMBERTO, GAETANO",850 W H SMITH BLVD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 17 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033111315,"FONTANA, UMBERTO, GAETANO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 42 , 44 ,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033111315,"FONTANA, UMBERTO, GAETANO",850 W H SMITH BLVD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033111315,"FONTANA, UMBERTO, GAETANO",2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 172 , 326 , 509 ,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033111505,"STAHL, TAMMIE, ANN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033111760,"WALSH, ZANE, THOMAS",2930 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1548262165,HIGHLAND HEALTH OF NORTH CAROLINA P,~,2930 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1033111760,"WALSH, ZANE, THOMAS",2930 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 175 ," 1,349 "," 1,838 "," $20,445.97 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1033111919,"HUGGINS, ARTHUR, EUGENE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 35 , 43 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033111919,"HUGGINS, ARTHUR, EUGENE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 37 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033112081,"FOGARTY, JOHN, PATRICK",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 179 , 272 , 392 ," $11,577.80 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1033112123,"MILKOWSKI, DEBORAH, ANN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033112123,"MILKOWSKI, DEBORAH, ANN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033112123,"MILKOWSKI, DEBORAH, ANN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 22 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033112123,"MILKOWSKI, DEBORAH, ANN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1033112123,"MILKOWSKI, DEBORAH, ANN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1437627346,VAXCARE NORTH CAROLINA,VAXCARE LLC FKA VAXCARE CORPORATION,,,Unknown,193400000X,Group,Single Specialty,,1033112164,"SMITH, KAREN, LINNEAR",929 W PROSPECT RD   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1437627346,VAXCARE NORTH CAROLINA,VAXCARE LLC FKA VAXCARE CORPORATION,929 W PROSPECT RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1033112164,"SMITH, KAREN, LINNEAR",929 W PROSPECT RD   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 383 , 466 , 702 ," $70,089.37 ",,
MEDICAID DIRECT,1134286321,COUNTY OF HOKE,HOKE COUNTY HEALTH DEPARTMENT,683 E PALMER ST   RAEFORD NC,047,Hoke,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033112164,"SMITH, KAREN, LINNEAR",683 E PALMER ST   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 32 , 60 ,$#,,
MEDICAID DIRECT,1609066158,KAREN L SMITH MD PA,~,929 W PROSPECT RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1033112164,"SMITH, KAREN, LINNEAR",929 W PROSPECT RD   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 251 ," 1,060 "," 2,383 "," $43,037.80 ",,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033112875,"BOONE, DAVID, WARNER",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1033112875,"BOONE, DAVID, WARNER",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033112875,"BOONE, DAVID, WARNER",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033113816,"GOVEA, CHRISTOPHER, JOHN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033113899,"SHAH, NIRMISH, RAMESH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033113899,"SHAH, NIRMISH, RAMESH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033113899,"SHAH, NIRMISH, RAMESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033113949,"RHOTON, ERIC, LOREN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 18 , 26 ," $13,454.26 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033113949,"RHOTON, ERIC, LOREN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033113949,"RHOTON, ERIC, LOREN",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710021811,ABC PEDIATRICS OF ASHEVILLE PA,ABC PEDIATRICS OF ASHEVILLE PA,64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033114186,"VO, MARY BETH, DIXON",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 45 , 135 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033114590,"DALTON, THOMAS, MAXWELL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 41 , 46 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033114590,"DALTON, THOMAS, MAXWELL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033114590,"DALTON, THOMAS, MAXWELL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033114590,"DALTON, THOMAS, MAXWELL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033114590,"DALTON, THOMAS, MAXWELL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 39 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1033115761,"ARCOT, ANURADHA, NARENDER",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1033116389,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER CLINIC,470 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033116389,HANGER PROSTHETICS & ORTHOTICS EAST,470 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 105 , 149 , 844 ," $121,740.40 ",,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1033117585,"CURD, THOMAS, EUGENE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 54 , 77 , 98 ,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033117585,"CURD, THOMAS, EUGENE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 15 , 13 , 24 ,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,,,Unknown,193400000X,Group,Single Specialty,,1033117585,"CURD, THOMAS, EUGENE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1033118518,"RUIZ, ANTONIO, JOSE",2518 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,5116 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1033118518,"RUIZ, ANTONIO, JOSE",5116 N CROATAN HWY   KITTY HAWK NC,028,Dare,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033118518,"RUIZ, ANTONIO, JOSE",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,844 BATTLEFIELD BLVD N STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033118518,"RUIZ, ANTONIO, JOSE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1033118518,"RUIZ, ANTONIO, JOSE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 31 , 39 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1033118518,"RUIZ, ANTONIO, JOSE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 21 , 32 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033119425,"JONES, DEANNA, CRAVEN",3940 ARROWHEAD BLVD STE 225 MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 22 , 23 ,$#,,
MEDICAID DIRECT,1093017154,ARMC PHYSICIANS CARE INC,MEBANE MEDICAL CLINIC,3940 ARROWHEAD BLVD STE 225 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033119425,"JONES, DEANNA, CRAVEN",3940 ARROWHEAD BLVD STE 225 MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 57 , 88 ,$#,,
MEDICAID DIRECT,1033120035,"SCHREINER, VIRGINIA, JEANETTE",~,5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1033120035,"SCHREINER, VIRGINIA, JEANETTE",5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730154857,PEDIATRIC PARTNERS PA,~,5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033120035,"SCHREINER, VIRGINIA, JEANETTE",5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 19 , 41 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033120290,"GUILLEN, DAVID, RAFAEL",1072 X RAY DR   GASTONIA NC,036,Gaston,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 186 , 210 , 238 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033120290,"GUILLEN, DAVID, RAFAEL",1072 X RAY DR   GASTONIA NC,036,Gaston,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033121751,"JEANGILLES, FRITZ, EDMOND",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033122288,"HENSON, GALA, CURETON",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 95 , 104 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033122288,"HENSON, GALA, CURETON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 ,#, 43 ,$#,,
MEDICAID DIRECT,1033125489,INGLES MARKETS INC,INGLES PHARMACY 011,1980 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1033125489,INGLES MARKETS INC,1980 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033125927,"WCISEL, GREGORY, JAMES",1168 FIRST COLONIAL RD STE 101 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033126156,"AROS, HOWIS, YVETTE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033126156,"AROS, HOWIS, YVETTE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 28 , 37 ,$#,,
MEDICAID DIRECT,1558551671,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS BRUNSWICK,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1033126156,"AROS, HOWIS, YVETTE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033126560,"SMITH, LAURIE",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033126560,"SMITH, LAURIE",264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033126560,"SMITH, LAURIE",161 WALKER ST   COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033126560,"SMITH, LAURIE",187 W MAIN ST   SPINDALE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1083345664,LANE AND ASSOCIATES XLVII DDS PA,,515 S CASWELL ST   LA GRANGE NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1033127501,"MARCHESE JR, JOSEPH, ANTHONY",515 S CASWELL ST   LA GRANGE NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice," 1,223 "," 2,237 "," 6,943 "," $330,372.26 ",,
MEDICAID DIRECT,1659642395,LANE AND ASSOCIATES XXV DDS PA,,1117 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1033127501,"MARCHESE JR, JOSEPH, ANTHONY",515 S CASWELL ST   LA GRANGE NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033130422,"FERRIS, CHRISTOPHER, DEAN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033130422,"FERRIS, CHRISTOPHER, DEAN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 18 , 32 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033132121,"RIGSBEE, WILLIAM, EDISON",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 45 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033132121,"RIGSBEE, WILLIAM, EDISON",8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033132121,"RIGSBEE, WILLIAM, EDISON",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 68 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033132121,"RIGSBEE, WILLIAM, EDISON",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033132121,"RIGSBEE, WILLIAM, EDISON",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033132121,"RIGSBEE, WILLIAM, EDISON",1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1033132485,"KAUFFMAN, KAREN, ELISE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1033132485,"KAUFFMAN, KAREN, ELISE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1013351824,S ROSS PENLAND DMD PA,~,110 N CENTER ST STE 200 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033132667,"BRIDGES, SUSAN, HORLDT",110 N CENTER ST STE 200 HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice," 1,604 "," 2,078 "," 6,502 "," $227,297.20 ",,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1033132923,"BRASINGTON, CHADWICK, REGINALD",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033132923,"BRASINGTON, CHADWICK, REGINALD",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 141 , 282 , 392 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033134416,"HULL, CAROLYN, COSPER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033134416,"HULL, CAROLYN, COSPER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 11 , 25 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033134416,"HULL, CAROLYN, COSPER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033134416,"HULL, CAROLYN, COSPER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033134713,"ALEXANDER, ROBERT, MCAULEY",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033134978,"SHIELDS, KATHY, SHARON",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033134978,"SHIELDS, KATHY, SHARON",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033134978,"SHIELDS, KATHY, SHARON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033134978,"SHIELDS, KATHY, SHARON",9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1659695781,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033134978,"SHIELDS, KATHY, SHARON",16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1932125564,GROAT EYECARE ASSOCS PA,GROAT EYECARE ASSOCIATES PA,1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033135108,"GROAT, ROBERT, LANIER",1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1932125564,GROAT EYECARE ASSOCS PA,GROAT EYECARE ASSOCIATES PA,1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1033135108,"GROAT, ROBERT, LANIER",1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 308 , 355 , 661 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033135868,"HENRETTA, JOHN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 51 , 80 , 119 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033135868,"HENRETTA, JOHN, PATRICK",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 16 , 25 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033135868,"HENRETTA, JOHN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 33 , 52 ," $12,541.63 ",,
MEDICAID DIRECT,1649298548,ONSLOW OPHTHALMOLOGY PA,OFFICE PARK EYE CENTER,6 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1033136551,"JOHNSTON, CAROL, ANN",6 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 77 , 119 , 237 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033138441,"YOUNG, ANJANA, MENON",301 YADKIN ST   ALBEMARLE NC,084,Stanly,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 41 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245859453,TRIAD BREAST IMAGING CENTER LLC,NOVANT HEALTH BREAST IMAGING CENTER GREENSBORO,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033140439,"BUTLER, MARCELLA, MARIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033140892,"ZOUZOULAS, STEPHEN, SEAN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 30 , 32 , 52 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033140892,"ZOUZOULAS, STEPHEN, SEAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 24 , 43 , 46 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033140892,"ZOUZOULAS, STEPHEN, SEAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033143466,"EKUBAN GORDON, EDNA, EKVA",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033144357,"MACHIN, LISSETTE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033144357,"MACHIN, LISSETTE",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 32 , 46 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033144357,"MACHIN, LISSETTE",5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033144357,"MACHIN, LISSETTE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033147962,"SNYDER, GAVIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1033148325,NORTH POINT PARTNERS LLC,NORTH POINTE OF MAYODAN,6970 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1033148325,NORTH POINT PARTNERS LLC,6970 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 41 ," 11,772 "," 11,772 "," $1,035,193.80 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033148788,"BEANE, LORI, LASSITER",4510 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 85 , 152 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033149299,"JOBE, DANIEL, BRIAN",1226 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033149299,"JOBE, DANIEL, BRIAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356368708,CAMPUS HEALTH PHARMACY,CAMPUS HEALTH SERVICES,320 EMERGENCY ROOM DR JAMES A TAYLOR BLDG CB 7470 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033149299,"JOBE, DANIEL, BRIAN",320 EMERGENCY ROOM DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1306018346,HOWARD YEE DMD PA,HOWARD YEE DMD PA,112 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1033149653,"YEE, HOWARD, GENE",112 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice," 1,238 "," 2,581 "," 11,213 "," $468,714.85 ",,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1033149653,"YEE, HOWARD, GENE",112 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033150008,"COLLINS, STEVEN, BRYAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033150008,"COLLINS, STEVEN, BRYAN",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1033150008,"COLLINS, STEVEN, BRYAN",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1033155148,COUNTY OF PITT OFFICE OF AUDITOR,~,1717 W 5TH ST   GREENVILLE NC,074,Pitt,3416L0300X,Transportation Services,Ambulance,Land Transport,1033155148,COUNTY OF PITT OFFICE OF AUDITOR,1717 W 5TH ST   GREENVILLE NC,074,Pitt,3416L0300X,Transportation Services,Ambulance,Land Transport, 383 , 577 ," 1,020 "," $17,479.19 ",,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1033156245,"MONROE, LANNY, LEE",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 79 , 111 , 249 ," $12,698.47 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033157318,"BOLDEN, JASON, EDWARD",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033157318,"BOLDEN, JASON, EDWARD",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033157318,"BOLDEN, JASON, EDWARD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033157318,"BOLDEN, JASON, EDWARD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033157318,"BOLDEN, JASON, EDWARD",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033157318,"BOLDEN, JASON, EDWARD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033157318,"BOLDEN, JASON, EDWARD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 26 , 35 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 55 , 79 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 82 , 128 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",310 LONG SHOALS RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 105 , 109 , 157 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033157409,"DICKERSON, BRYON, ANTHONY",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 23 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,200 S HERLONG AVE STE A ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033157623,"BHEND, ERNEST, MERROW",601 SUTTON RD S STE 201 FORT MILL SC,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,601 SUTTON RD S STE 201 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033157623,"BHEND, ERNEST, MERROW",601 SUTTON RD S STE 201 FORT MILL SC,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033157888,"ZWICK, MATTHEW, DAVID",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 35 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033158456,"CORMIER, NALBERTA, MONTOYA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033159041,"MEDFORD, MARK, FREDERIC",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 94 , 260 , 260 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033159678,"IKE, DAVID, GEORGE",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1063151678,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1409 ASHEVILLE HIGHWAY,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033160346,"SHEA, TIMOTHY, JOHN",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 143 , 215 ,$#,,
MEDICAID DIRECT,1821142845,COUNTY OF TRANSYLVANIA,TRANSYLVANIA COUNTY HEALTH DEPT,106 E MORGAN STREET STE. 105 BREVARD NC,088,Transylvania,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033160346,"SHEA, TIMOTHY, JOHN",106 E MORGAN ST   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720546732,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,,,Unknown,251B00000X,Agencies,Case Management,,1033160346,"SHEA, TIMOTHY, JOHN",98 E MORGAN ST STE 1 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033160353,"MASIER, TERRI, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033160353,"MASIER, TERRI, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033160353,"MASIER, TERRI, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033160353,"MASIER, TERRI, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033160817,"BOLIEK, BRUCE, STEPHEN",3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 55 , 89 , 107 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033161310,"MAYER, DAVID, CRISLER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 101 , 105 , 107 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1033161435,"MUHAMMAD, TRACY, LARKINS",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033161435,"MUHAMMAD, TRACY, LARKINS",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033161435,"MUHAMMAD, TRACY, LARKINS",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033161435,"MUHAMMAD, TRACY, LARKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033161542,"MONNIG, ANGELA, SUSAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033161542,"MONNIG, ANGELA, SUSAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033161864,"SEITER, RAYMOND, THOMAS",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,132 W CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1033162714,"EMMETT, MICHAEL, DARREN",132 W CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033162896,"CAMPBELL, DONALD, ALEXANDER",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033163159,"FOX, SCOTT, EDWARD",232 SHARON AVE NW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 162 , 299 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033163159,"FOX, SCOTT, EDWARD",232 SHARON AVE NW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 29 , 58 ,$#,,
MEDICAID DIRECT,1952819575,SAMPSON REGIONAL EMERGENCY PROFESSI,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1033163993,"OCCHINO, CHRISTOPHER, MICHAEL",607 BEAMAN ST   CLINTON NC,082,Sampson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 212 , 261 , 267 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033164835,"NOWACEK, GEORGE, EDWARD",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033164835,"NOWACEK, GEORGE, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033164835,"NOWACEK, GEORGE, EDWARD",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033164835,"NOWACEK, GEORGE, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033164835,"NOWACEK, GEORGE, EDWARD",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033164835,"NOWACEK, GEORGE, EDWARD",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 14 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033164835,"NOWACEK, GEORGE, EDWARD",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1033165246,"GORMAN JR, RICHARD, FORBES",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 50 , 85 , 89 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033165329,"RATLEY, JENNIFER, ANNE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 57 , 171 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1033165329,"RATLEY, JENNIFER, ANNE",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 79 , 144 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1033165329,"RATLEY, JENNIFER, ANNE",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033165329,"RATLEY, JENNIFER, ANNE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 87 , 215 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033165329,"RATLEY, JENNIFER, ANNE",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 26 , 82 ,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033166335,"TRINIDAD, SALVADOR, BERNARD",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033167184,"DEAL, STEPHEN, BRADLEY",3948 FOREST OAKS LN BLDG E MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033167184,"DEAL, STEPHEN, BRADLEY",3948 FOREST OAKS LN BLDG E MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 62 , 116 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033167697,"FREEMAN, ANDREW, MILLER",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033167697,"FREEMAN, ANDREW, MILLER",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1033167697,"FREEMAN, ANDREW, MILLER",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1215314778,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM WOMENS CENTER,150 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1033167945,"BYRD, BEVERLY, ANN",150 PARKWOOD DR   ELKIN NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043691595,ROCKY MOUNT EYE PA,~,450 JONES RD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1033170154,"SHEPHERD, WILLARD, NELSON",450 JONES RD   ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,, 276 , 317 , 485 ," $15,051.64 ",,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033170774,"SHERROD, TARA, TRAVIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033170774,"SHERROD, TARA, TRAVIS",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033170774,"SHERROD, TARA, TRAVIS",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003863580,ASSOCIATED PATHOLOGISTS LLC,PATHGROUP,5301 VIRGINIA WAY   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1033170998,"HUDDLESTON, DAVID, JOHN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 52 , 61 , 90 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033171590,"LAUER, BRIAN, ERIC",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 30 , 39 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033172283,"STEVENS, LISA, LAJUANA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033172895,"GOWIN, KRISTIN, MARIE",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 37 , 46 , 122 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033173240,"MCCASKILL, RODNEY, LEE",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1033173240,"MCCASKILL, RODNEY, LEE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033173240,"MCCASKILL, RODNEY, LEE",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033173240,"MCCASKILL, RODNEY, LEE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033173240,"MCCASKILL, RODNEY, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033174206,"DUNCAN, KELLI, PENEGAR",2000 WELLNESS BLVD STE 140 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 45 , 69 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033174206,"DUNCAN, KELLI, PENEGAR",14215 BALLANTYNE CORPORATE PL STE 230 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033174206,"DUNCAN, KELLI, PENEGAR",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033175401,"EMOKPAE, COURAGE, OSIFO",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033175401,"EMOKPAE, COURAGE, OSIFO",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 133 , 135 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033176201,"ENRIGHT, MICHAEL, JOSEPH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033176201,"ENRIGHT, MICHAEL, JOSEPH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1114592219,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT PETREE ELEMENTARY,3815 OLD GREENSBORO RD   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033176714,"WILSON-DAVIS, STEPHANIE",1215 N CAMERON AVE   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1033177647,"MOSTELLER, GREGORY, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033177647,"MOSTELLER, GREGORY, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 85 , 89 , 116 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033178694,"STUGART, RICKY, HOWARD",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 69 , 106 ,$#,,
MEDICAID DIRECT,1942258843,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH MAPLEWOOD FAMILY MEDICINE,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033178694,"STUGART, RICKY, HOWARD",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033180856,"BROWDER, ROBYN, ROUTH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033180856,"BROWDER, ROBYN, ROUTH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033180856,"BROWDER, ROBYN, ROUTH",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1033180856,"BROWDER, ROBYN, ROUTH",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356802300,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - MOCKSVILLE,172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033181557,"YODER, REBECCA, TAYLOR",172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 14 , 50 , 50 ," $15,334.80 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033182217,"EVANS, ADRIENNE, COKER",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033182217,"EVANS, ADRIENNE, COKER",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033182217,"EVANS, ADRIENNE, COKER",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033182217,"EVANS, ADRIENNE, COKER",10816 BLACK DOG LN STE 160 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033182217,"EVANS, ADRIENNE, COKER",1904 JAKE ALEXANDER BLVD W STE 301 SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033182787,"WARD, JENNIFER, ROBIN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033183314,"BAKER, KAREN, CHRISTINE",5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033183314,"BAKER, KAREN, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033183314,"BAKER, KAREN, CHRISTINE",5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 18 , 19 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033183660,"CALL, SETH, ANDREW",2660 TATE BLVD SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679589212,CONCORD CHILDRENS CLINIC,CONCORD CHILDREN CLINIC,1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033185053,"MOCK, LAURA, JEAN",1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 25 , 68 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1033185368,"NARSINGHANI, UMESH, SUNDERSINGH",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033185905,"RUDOLPH, ANNE, DUNHAM",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033186044,"HUNKELE, ERIC, CARL",1530 PROVIDENCE RD S   WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033186044,"HUNKELE, ERIC, CARL",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033186044,"HUNKELE, ERIC, CARL",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033186044,"HUNKELE, ERIC, CARL",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033186044,"HUNKELE, ERIC, CARL",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033186044,"HUNKELE, ERIC, CARL",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 18 , 39 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8036 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033186044,"HUNKELE, ERIC, CARL",8036 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295193340,ASHE FINANCIAL SERVICES LLC,ASHE FINANCIAL SERVICES LLC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1033187323,"DILLEY, SHARON, PATRICIA",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 157 , 193 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1033187448,"WILLIAMS, DAVID, ROBERT",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1033187448,"WILLIAMS, DAVID, ROBERT",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 88 , 97 , 189 ," $10,369.30 ",,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1033187448,"WILLIAMS, DAVID, ROBERT",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 19 , 69 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1033187448,"WILLIAMS, DAVID, ROBERT",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 11 , 16 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033188487,"ALLEN, HERBERT, RICHARD",10540 LIGON MILL RD   WAKE FOREST NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 19 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033188487,"ALLEN, HERBERT, RICHARD",10540 LIGON MILL RD   WAKE FOREST NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 15 , 19 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033188537,"COCKERILL, MARK, LEWIS",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033188537,"COCKERILL, MARK, LEWIS",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033188537,"COCKERILL, MARK, LEWIS",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104819754,SHELBY MEDICAL ASSOCIATES PA,~,711 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1033189253,"MOREHEAD, BETTY, CABANISS",711 N DEKALB ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1861433013,RETINA INSTITURE OF THE CAROLINA,RETINA INSTITUTE OF THE CAROLINAS,724 ARDEN LN STE 220 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033189501,"TUCKER, CHARLES, LEONARD",561 COX RD   GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 20 , 32 ,$#,,
MEDICAID DIRECT,1861433013,RETINA INSTITURE OF THE CAROLINA,RETINA INSTITUTE OF THE CAROLINAS,724 ARDEN LN STE 220 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033189501,"TUCKER, CHARLES, LEONARD",561 COX RD   GASTONIA NC,036,Gaston,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1861433013,RETINA INSTITURE OF THE CAROLINA,RETINA INSTITUTE OF THE CAROLINAS,724 ARDEN LN STE 220 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033189501,"TUCKER, CHARLES, LEONARD",4101 CAMPUS RIDGE RD STE 100 MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 18 , 32 ,$#,,
MEDICAID DIRECT,1568400174,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,281 E MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1033189717,"BENNETT, JOHN, MARK",281 E MAIN ST   FOREST CITY NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 82 , 168 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033191077,"LENOX, DAPHNE, MICHELLE",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033191077,"LENOX, DAPHNE, MICHELLE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033191325,HEALTH HORIZONS INC,SOUTHEASTERN HOME MEDICAL EQUIPMENT,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033191325,HEALTH HORIZONS INC,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 87 , 295 , 534 ," $83,354.55 ",,
MEDICAID DIRECT,1033191325,HEALTH HORIZONS INC,SOUTHEASTERN HOME MEDICAL EQUIPMENT,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1033191325,HEALTH HORIZONS INC,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 36 ,,,$#,,
MEDICAID DIRECT,1033191325,HEALTH HORIZONS INC,SOUTHEASTERN HOME MEDICAL EQUIPMENT,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1033191325,HEALTH HORIZONS INC,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 298 , 982 ," 1,836 "," $99,520.55 ",,
MEDICAID DIRECT,1033191325,HEALTH HORIZONS INC,SOUTHEASTERN HOME MEDICAL EQUIPMENT,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1033191325,HEALTH HORIZONS INC,2002 N CEDAR ST STE A LUMBERTON NC,078,Robeson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 122 ," 1,709 "," 3,039 "," $230,832.76 ",,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1033192182,"ROSANIA, RICHARD, ALAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 51 , 57 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1033193578,"COTTRELL, DEANNA, LYN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1033193578,"COTTRELL, DEANNA, LYN",511 PENNY LN   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 42 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033193578,"COTTRELL, DEANNA, LYN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 66 , 119 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1033193578,"COTTRELL, DEANNA, LYN",3100 WELLONS BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1033193586,"LUCAS, STEVEN, EDWARD",123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 69 , 108 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1033193941,"BAKER, DANIEL, MARK",7762 CHETWOOD CLOSE   NEW ALBANY OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1033193941,"BAKER, DANIEL, MARK",7762 CHETWOOD CLOSE   NEW ALBANY OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 21 , 25 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1033193941,"BAKER, DANIEL, MARK",7762 CHETWOOD CLOSE   NEW ALBANY OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 60 , 64 , 85 ,$#,,
MEDICAID DIRECT,1487633780,SHELBY RADIOLOGICAL ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1033193941,"BAKER, DANIEL, MARK",7762 CHETWOOD CLOSE   NEW ALBANY OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033194311,"HAISTY, WESLEY, KENNETH",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 14 , 14 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033194402,"KATHRESAL, AMARNATH, AHOBALA RAO",4016 FREEDOM LAKE DR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 114 , 114 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033194402,"KATHRESAL, AMARNATH, AHOBALA RAO",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 103 , 341 , 420 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033194402,"KATHRESAL, AMARNATH, AHOBALA RAO",1507 W PETTIGREW ST   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 40 , 40 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033194402,"KATHRESAL, AMARNATH, AHOBALA RAO",4917 OLD FARM RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 30 , 30 ,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033194857,"SYED, TAUSEEF, GILANI",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 36 , 92 , 134 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033194931,"WHITAKER, SHANNON, MICHELLE",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 54 , 60 ,$#,,
MEDICAID DIRECT,1689757007,COASTAL CAROLINA ENT DO PA,COASTAL CAROLINA ENT DO PA,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1033195144,"KENYON, ERIK, LAMONT",2298 OCEAN HWY W # 17 SUPPLY NC,010,Brunswick,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 18 , 40 , 59 ,$#,,
MEDICAID DIRECT,1689757007,COASTAL CAROLINA ENT DO PA,COASTAL CAROLINA ENT DO PA,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1033195144,"KENYON, ERIK, LAMONT",302 LIBERTY ST   WHITEVILLE NC,024,Columbus,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1689757007,COASTAL CAROLINA ENT DO PA,COASTAL CAROLINA ENT DO PA,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1033195144,"KENYON, ERIK, LAMONT",302 LIBERTY ST   WHITEVILLE NC,024,Columbus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 53 , 109 , 160 ,$#,,
MEDICAID DIRECT,1689757007,COASTAL CAROLINA ENT DO PA,COASTAL CAROLINA ENT DO PA,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1033195144,"KENYON, ERIK, LAMONT",2298 OCEAN HWY W # 17 SUPPLY NC,010,Brunswick,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 40 , 39 , 65 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1237 HARDING PL STE 1300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 26 , 44 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 54 , 115 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033195565,"ALEGRIA, JORGE",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1033196001,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDINGS,1904 TW ALEXANDER DR STE C DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,1033196001,LABORATORY CORPORATION OF AMERICA H,1904 TW ALEXANDER DR STE C DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,, 48 , 50 , 115 ," $33,657.36 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033200597,"KEITH, HARRISON, LEONIDAS",1932 S 16TH ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1033205182,PENDER EMS AND FIRE INC,PENDER VOLUNTEER EMS AND RESCUE,805 RIDGEWOOD AVE   BURGAW NC,071,Pender,3416L0300X,Transportation Services,Ambulance,Land Transport,1033205182,PENDER EMS AND FIRE INC,805 RIDGEWOOD AVE   BURGAW NC,071,Pender,3416L0300X,Transportation Services,Ambulance,Land Transport, 363 , 540 ," 1,008 "," $11,316.06 ",,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033206461,"MELSON, STEPHEN, JOSEPH",181 DANIEL RD   FOREST CITY NC,081,Rutherford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 124 , 164 , 209 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033209838,"FAHEEM, UZMA, SHAMIM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033209838,"FAHEEM, UZMA, SHAMIM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033211131,"VAN SOESTBERGEN, GUSTAAF, CORNELIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033211131,"VAN SOESTBERGEN, GUSTAAF, CORNELIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033211248,"SCHULTZ, DAVID, MARTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033211248,"SCHULTZ, DAVID, MARTIN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",1226 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",3515 W MARKET ST STE 200 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",1712 S STRATFORD RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",1471 JAG BRANCH BLVD UNIT 103 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",1926 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",4705 S HIGHWAY 150 STE B&C LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",2133 ROCKFORD ST STE 1400 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",201 WOODSON ST STE A SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",2133 ROCKFORD ST STE 1400 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033212287,"GIBSON, TIFFANY, SHANTE",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033214259,"LITTLE JR, WILDER, GLOVER",1216 6TH AVE W   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,1216 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033214259,"LITTLE JR, WILDER, GLOVER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033214259,"LITTLE JR, WILDER, GLOVER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,1216 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033214259,"LITTLE JR, WILDER, GLOVER",1216 6TH AVE W   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 28 , 50 , 55 ,$#,,
MEDICAID DIRECT,1104156108,MOORE ORTHOPEDICS AND SPORTS MEDICI,MOORE ORTHOPEDICS AND SPORTS MEDICINE PA,4218 ARENDELL ST STE M MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1033217583,"PFAFF, CHARLES, ANDREWW",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 55 , 108 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1033218193,"MILLER, COLLEEN, CASEY",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033218193,"MILLER, COLLEEN, CASEY",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033218193,"MILLER, COLLEEN, CASEY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 38 , 59 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1033218193,"MILLER, COLLEEN, CASEY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033221072,"LEVINSON, HOWARD",301 RIVERVIEW AVE STE 400 NORFOLK VA,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1033221775,"OHARA, MARTHA, JANE",MARTHA J OHARA DDS,922 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,1033221775,"OHARA, MARTHA, JANE",922 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 943 ," 1,956 "," 5,814 "," $202,385.19 ",,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033222849,"BYUN, KATHY",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033222864,"DALE-SHALL, AMANDA, WATSON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 21 , 30 , 30 ,$#,,
MEDICAID DIRECT,1568464386,GREENE COUNTY HEALTH CARE INC,GREENE DENTAL SERVICES,6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033224209,"TASCA, ROBERT, RUSSELL",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice, 168 , 185 , 569 ," $20,915.42 ",,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033224209,"TASCA, ROBERT, RUSSELL",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033224209,"TASCA, ROBERT, RUSSELL",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 155 , 169 , 503 ," $16,546.38 ",,
MEDICAID DIRECT,1033224209,"TASCA, ROBERT, RUSSELL",,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,1033224209,"TASCA, ROBERT, RUSSELL",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1033226253,"CONGER, LAWRENCE, KENDALL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033226253,"CONGER, LAWRENCE, KENDALL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1033226253,"CONGER, LAWRENCE, KENDALL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1033226253,"CONGER, LAWRENCE, KENDALL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033228911,MEDICAL CENTER PHARMACY INC OF HICK,~,126 N CENTER ST   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033228911,MEDICAL CENTER PHARMACY INC OF HICK,126 N CENTER ST   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 13 , 39 ,$#,,
MEDICAID DIRECT,1104849884,"DAVIS, KEITH, CHANDLER",,975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1033229042,"GREGORY, DONALD, G",975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1063689503,PALMETTO DENTURE CARE PA,Palmetto Denture Care PA,975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033229042,"GREGORY, DONALD, G",975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 28 , 85 ," $10,495.18 ",,
MEDICAID DIRECT,1033229695,LINGRAPHICARE AMERICA INC,LINGRAPHICARE AMERICA INC,700 ALEXANDER PARK STE 101 PRINCETON NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033229695,LINGRAPHICARE AMERICA INC,700 ALEXANDER PARK STE 101 PRINCETON NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 18 , 18 , 21 ," $57,599.13 ",,
MEDICAID DIRECT,1033230339,"MILLER, CHRISTOPHER",,1421 SMOKY PARK HWY   CANDLER NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1033230339,"MILLER, CHRISTOPHER",1421 SMOKY PARK HWY   CANDLER NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 126 , 267 , 606 ," $29,726.37 ",,
MEDICAID DIRECT,1033232020,COUNTY OF PERSON OFFICE OF COUNTY F,PERSON COUNTY DSS,355B S MADISON BOULEVA   ROXBORO NC,073,Person,251B00000X,Agencies,Case Management,,1033232020,COUNTY OF PERSON OFFICE OF COUNTY F,355B S MADISON BOULEVA   ROXBORO NC,073,Person,251B00000X,Agencies,Case Management,, 34 , 298 , 298 ," $112,346.00 ",,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033233606,"POWELL, LAURA, J",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033233606,"POWELL, LAURA, J",300 BETHESDA DR   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 17 ,$#,,
MEDICAID DIRECT,1033239330,WALGREEN CO,WALGREENS 10133,1505 E INNES ST   SALISBURY NC,080,Rowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1033239330,WALGREEN CO,1505 E INNES ST   SALISBURY NC,080,Rowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1033239413,THYROID SPECIALTY LABORATORY INC,,1636 HEADLAND DR   FENTON MO,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1033239413,THYROID SPECIALTY LABORATORY INC,1636 HEADLAND DR   FENTON MO,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 242 , 319 ," 2,487 "," $182,708.31 ",,
MEDICAID DIRECT,1033242425,PRN NURSING SERVICES INC,~,5250 US 74 E   SYLVA NC,050,Jackson,253Z00000X,Agencies,In Home Supportive Care,,1033242425,PRN NURSING SERVICES INC,5250 US 74 E   SYLVA NC,050,Jackson,253Z00000X,Agencies,In Home Supportive Care,, 42 ," 10,418 "," 10,702 "," $1,840,364.68 ",,
MEDICAID DIRECT,1033242425,PRN NURSING SERVICES INC,~,5250 US 74 E   SYLVA NC,050,Jackson,251J00000X,Agencies,Nursing Care,,1033242425,PRN NURSING SERVICES INC,5250 US 74 E   SYLVA NC,050,Jackson,251J00000X,Agencies,Nursing Care,,#, 703 , 802 ," $425,009.00 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1033242581,"MILLENDER, TARRA, WRIGHT",1223 CARTHAGE ST   SANFORD NC,053,Lee,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 16 , 27 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1033242581,"MILLENDER, TARRA, WRIGHT",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1033242581,"MILLENDER, TARRA, WRIGHT",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1033242581,"MILLENDER, TARRA, WRIGHT",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 96 , 149 , 239 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1033242581,"MILLENDER, TARRA, WRIGHT",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 64 , 106 , 162 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1033242581,"MILLENDER, TARRA, WRIGHT",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033246764,"HOLLEY, CHRISTOPHER, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 15 , 62 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033246764,"HOLLEY, CHRISTOPHER, LEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033246764,"HOLLEY, CHRISTOPHER, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 11 , 55 , 55 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033248273,"HAUSCHKA, JENNIE, JARVIS",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1033248273,"HAUSCHKA, JENNIE, JARVIS",700 S TORRENCE ST   CHARLOTTE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033249529,"FRANKS, WHITNEY, MICHELLE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033249529,"FRANKS, WHITNEY, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 32 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033249529,"FRANKS, WHITNEY, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033249529,"FRANKS, WHITNEY, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033249560,"MADJAROV, JEKO, METODIEV",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033249560,"MADJAROV, JEKO, METODIEV",1912 TRADD CT   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356368708,CAMPUS HEALTH PHARMACY,CAMPUS HEALTH SERVICES,320 EMERGENCY ROOM DR JAMES A TAYLOR BLDG CB 7470 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033251186,"HUSSAIN, SONIA",320 EMERGENCY ROOM DR TAYLOR STUDENT HEALTH SERVICES CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1033255252,"SHROPSHIRE-ATKINS, WENDY, YVONNE",1911 S 17TH ST STE 130A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1588105001,ATKINS FAMILY PRACTICE PA,,1911 S 17TH ST STE 130A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033255252,"SHROPSHIRE-ATKINS, WENDY, YVONNE",1911 S 17TH ST STE 130A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 122 , 392 , 516 ," $11,625.65 ",,
MEDICAID DIRECT,1821168055,SENIOR CARE SYSTEMS PA,SENIOR CARE SYSTEMS PA,1013 PORTERS NECK RD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033255369,"PEARSALL, EDITH, LYNETTE",1013 PORTERS NECK RD STE 100 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 298 , 298 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033256839,"MOBLEY, VICTORIA, LN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033258157,"BILBRO, SCOTT, CARTER",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033258157,"BILBRO, SCOTT, CARTER",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1033259320,"EATON, PHILIP, ANTHONY",525 CORPORATE CIR   SALISBURY NC,080,Rowan,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 49 , 66 , 144 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,2101 OAKHEART RD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033259361,"CRILL, RICHARD, JOSEPH",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1033259361,"CRILL, RICHARD, JOSEPH",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033259361,"CRILL, RICHARD, JOSEPH",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033259361,"CRILL, RICHARD, JOSEPH",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 45 , 59 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1033259361,"CRILL, RICHARD, JOSEPH",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033261060,"DAUB, CLIFFORD, WADE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033261060,"DAUB, CLIFFORD, WADE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1033261060,"DAUB, CLIFFORD, WADE",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548553589,AMY C DAVIDIAN DDS PA,SOUTHPOINT PEDIATRIC DENTISTRY,249 E NC HIGHWAY 54 STE 300 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1033261615,"DAVIDIAN, AMY, CUMMINGS",249 E NC HIGHWAY 54 STE 300 DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,145 "," 2,716 "," 21,924 "," $1,340,996.74 ",,
MEDICAID DIRECT,1033263876,SERENITY NURSING SERVICES,18,6636 E W T HARRIS BLVD STE H CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1033263876,SERENITY NURSING SERVICES,6636 E W T HARRIS BLVD STE H CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 945 , 985 ," $164,103.60 ",,
MEDICAID DIRECT,1033266705,ASHE SERVICES FOR AGING INC,GENERATIONS ASHE,180 CHATTYROB LN   WEST JEFFERSON NC,005,Ashe,253Z00000X,Agencies,In Home Supportive Care,,1033266705,ASHE SERVICES FOR AGING INC,180 CHATTYROB LN   WEST JEFFERSON NC,005,Ashe,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033266994,"PECOT, CHAD, VICTOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 19 , 30 ,$#,,
MEDICAID DIRECT,1679576763,COUNTY OF BEAUFORT,BEAUFORT COUNTY HEALTH DEPT,1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033267752,"BRINN, PAMELA, LYNN",1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 133 , 340 ," $13,835.74 ",,
MEDICAID DIRECT,1033268800,MICHAEL PAUL DOVE,COMFORT LIVING FAMILY CARE HOME,7264 NC 211 HWY W   BLADENBORO NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1033268800,MICHAEL PAUL DOVE,7264 NC 211 HWY W   BLADENBORO NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,435 "," 1,436 "," $91,863.89 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033273636,"DELLINGER, KATHERINE, DAVIGNON",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1033273636,"DELLINGER, KATHERINE, DAVIGNON",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033276811,"KASULA, ANIL, KUMAR",CARY CHILDRENS CLINIC PC,155 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1033276811,"KASULA, ANIL, KUMAR",155 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 36 , 66 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033277090,"BYRD, SAMANTHA, JOAN",314 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033277090,"BYRD, SAMANTHA, JOAN",58 PHYSICIANS DR NW STE 103 SUPPLY NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 39 , 43 ,$#,,
MEDICAID DIRECT,1033277900,HOME LIFE CARE INC,~,2835 DAISY LN N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1033277900,HOME LIFE CARE INC,2835 DAISY LN N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 6,886 "," 7,190 "," $628,388.07 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033278163,"NAYLOR, JENTRY, ELLON",2809 MCLAMB PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033278163,"NAYLOR, JENTRY, ELLON",2809 MCLAMB PL   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033278163,"NAYLOR, JENTRY, ELLON",511 PALADIN DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 33 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033278163,"NAYLOR, JENTRY, ELLON",511 PALADIN DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 83 , 127 , 279 ,$#,,
MEDICAID DIRECT,1033279401,CHARLOTTE MECKLENBURG SCHOOLS,CHARLOTTE MECKLENBURG SCHOOLS,4421 STUART ANDREW BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,251300000X,Agencies,Local Education Agency (LEA),,1033279401,CHARLOTTE MECKLENBURG SCHOOLS,4421 STUART ANDREW BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,251300000X,Agencies,Local Education Agency (LEA),," 3,920 "," 70,755 "," 72,568 "," $2,469,819.32 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033279682,"MENEZES, PREMA, RITA",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033283643,"FERNANDEZ, ANA MARIA, ARCINIEGA",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033283643,"FERNANDEZ, ANA MARIA, ARCINIEGA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033284203,MCDOWELL COUNTY SCHOOLS,MCDOWELL COUNTY SCHOOLS,334 S MAIN ST   MARION NC,059,McDowell,251300000X,Agencies,Local Education Agency (LEA),,1033284203,MCDOWELL COUNTY SCHOOLS,334 S MAIN ST   MARION NC,059,McDowell,251300000X,Agencies,Local Education Agency (LEA),, 362 ," 6,708 "," 6,833 "," $309,943.17 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033284377,"ARENAS, DANIEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033284377,"ARENAS, DANIEL",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033284377,"ARENAS, DANIEL",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033284377,"ARENAS, DANIEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1033284559,"BOYTE, SABRINA",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1033284559,"BOYTE, SABRINA",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033284716,"OSBORNE, MICHAEL, WAYNE",4220 CAROLINA EXCHANGE DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033284716,"OSBORNE, MICHAEL, WAYNE",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033284716,"OSBORNE, MICHAEL, WAYNE",4220 CAROLINA EXCHANGE DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033284716,"OSBORNE, MICHAEL, WAYNE",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 29 , 76 ,$#,,
MEDICAID DIRECT,1336405471,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST AUDIOLOGY - GREE,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1033286208,"NANCE, STEPHANIE, GARRETT",1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1033288303,"LEAVELL, ELLEN, FREDERICA",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 77 , 103 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1033288303,"LEAVELL, ELLEN, FREDERICA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093974404,GRANVILLE HEALTH SYSTEM,GRANVILLE PHYSICIANS GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1033289004,"BAUM, STEPHAN, FREDRICK",1010 COLLEGE ST   OXFORD NC,039,Granville,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1710089164,GRANVILLE HEALTH SYSTEM,BEHAVIORAL HEALTH SERVICES,102 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1033289004,"BAUM, STEPHAN, FREDRICK",1010 COLLEGE ST   OXFORD NC,039,Granville,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1710089164,GRANVILLE HEALTH SYSTEM,BEHAVIORAL HEALTH SERVICES,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1033289004,"BAUM, STEPHAN, FREDRICK",1010 COLLEGE ST   OXFORD NC,039,Granville,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033291190,"CHAWLA, NEAL, KAMAL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033291190,"CHAWLA, NEAL, KAMAL",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033291455,"MARKEL, LARRY, PHILIP",3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 890 , 973 ," 4,612 "," $394,714.82 ",,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033291455,"MARKEL, LARRY, PHILIP",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 21 , 405 ," $41,629.78 ",,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033291455,"MARKEL, LARRY, PHILIP",3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1740459650,RAFAEL RIVERA JR DDS PLLC,,2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033291455,"MARKEL, LARRY, PHILIP",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 576 , 634 ," 1,800 "," $145,301.37 ",,
MEDICAID DIRECT,1841583176,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,655 LENOIR RHYNE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033291455,"MARKEL, LARRY, PHILIP",655 LENOIR RHYNE BLVD SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 34 , 34 , 660 ," $62,767.59 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033292297,"GERARDO, CHARLES, JOHN",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033292297,"GERARDO, CHARLES, JOHN",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1033293030,CLAY COUNTY,Clay County Health Department,345 COURTHOUSE DR   HAYESVILLE NC,022,Clay,251B00000X,Agencies,Case Management,,1033293030,CLAY COUNTY,345 COURTHOUSE DR   HAYESVILLE NC,022,Clay,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1033293477,"NORWOOD, JAMES, BARRON",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1033293477,"NORWOOD, JAMES, BARRON",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 51 , 52 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033293477,"NORWOOD, JAMES, BARRON",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 W WOODCROFT PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293923,"MIDDLETON, JOHN, PAUL",415 W HIGHWAY 54   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293923,"MIDDLETON, JOHN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293923,"MIDDLETON, JOHN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 29 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293923,"MIDDLETON, JOHN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 50 , 121 , 124 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10211 ALM ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033293923,"MIDDLETON, JOHN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293949,"HABIB, ASHRAF, SAMIR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 55 , 56 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293949,"HABIB, ASHRAF, SAMIR",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293949,"HABIB, ASHRAF, SAMIR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033293949,"HABIB, ASHRAF, SAMIR",~,2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1033293949,"HABIB, ASHRAF, SAMIR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033293949,"HABIB, ASHRAF, SAMIR",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033295100,"STOLLERY, PENNY, PENLAND",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 33 , 54 , 56 ,$#,,
MEDICAID DIRECT,1033302401,PAMELA ANDERSON-LUKE OD PA,DR PAMELA ANDERSON,3000 W US HIGHWAY 64 STE 121 MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1033302401,PAMELA ANDERSON-LUKE OD PA,3000 W US HIGHWAY 64 STE 121 MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033302575,"BACKER, FARNEL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033308564,"MUNYON, CHARLES, NELSON",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 26 , 39 , 44 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033308564,"MUNYON, CHARLES, NELSON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 15 , 19 , 20 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033308564,"MUNYON, CHARLES, NELSON",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1487020020,NOVANT HEALTH MEDICAL GROUP LLC,~,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033308564,"MUNYON, CHARLES, NELSON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033310701,"STEFANOVIC, ALEXANDRA",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033310701,"STEFANOVIC, ALEXANDRA",2400 PRATT ST NORTH PAVILION SUITE 1100 DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033310701,"STEFANOVIC, ALEXANDRA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 23 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033310776,"KWAN, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 52 , 157 , 157 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033310776,"KWAN, WILLIAM",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033310776,"KWAN, WILLIAM",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1033311204,"SAHA, DALIA",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033312657,"SHARKADY, KAVITHA, TUMMALA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033312657,"SHARKADY, KAVITHA, TUMMALA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033312657,"SHARKADY, KAVITHA, TUMMALA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033312657,"SHARKADY, KAVITHA, TUMMALA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 43 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033312657,"SHARKADY, KAVITHA, TUMMALA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 18 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033312657,"SHARKADY, KAVITHA, TUMMALA",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033314463,KIDZZONE,KIDZZONE,562 SANDERS RD   RAEFORD NC,047,Hoke,251S00000X,Agencies,Community/Behavioral Health,,1033314463,KIDZZONE,562 SANDERS RD   RAEFORD NC,047,Hoke,251S00000X,Agencies,Community/Behavioral Health,, 35 , 650 , 650 ," $42,120.00 ",,
MEDICAID DIRECT,1033315395,"BOOKOUT, KELLYE, RABB",~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1033315395,"BOOKOUT, KELLYE, RABB",1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033315395,"BOOKOUT, KELLYE, RABB",1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 82 , 127 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033316773,"HALVORSON, JASON, JEFFREY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 97 , 111 , 169 ," $49,401.62 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033317581,"GLOYER, KATHRYN, LEIGH",8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760202303,NOVANT HEALTH TRIANGLE MEDICAL GROU,CAROLINA FAMILY PRACTICE & SPORTS MEDICINE,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033317581,"GLOYER, KATHRYN, LEIGH",8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033317581,"GLOYER, KATHRYN, LEIGH",8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033318704,"CHANGAPPA, SUNNY",420 N CENTER ST   HICKORY NC,018,Catawba,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 177 , 181 ,$#,,
MEDICAID DIRECT,1033319264,STALLS MEDICAL INC,STALLS MEDICAL INC,3 WENDY CT STE C GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033319264,STALLS MEDICAL INC,3 WENDY CT STE C GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 122 , 316 , 929 ," $204,981.56 ",,
MEDICAID DIRECT,1033319264,STALLS MEDICAL INC,STALLS MEDICAL INC,3 WENDY CT STE C GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1033319264,STALLS MEDICAL INC,3 WENDY CT STE C GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033319967,"CROTTY, JENNIFER, ERIN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 61 , 72 , 156 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033319975,"VAN GOMPLE, RYAN, JOHN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033320403,"RAMBERAN, HEMCHAND",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033321021,"HURT, CHRISTOPHER, BROWNING",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 23 , 52 , 67 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033321021,"HURT, CHRISTOPHER, BROWNING",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 20 , 28 , 55 ,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033323191,"REITZ, JENNIFER, LYNN",3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033324611,"BROWN, KELAN, JAMES",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033324611,"BROWN, KELAN, JAMES",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033325345,"FLORIDA, HANNAH, HUBAHIB",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 89 , 107 , 107 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,604 MEDICAL DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033325345,"FLORIDA, HANNAH, HUBAHIB",604 MEDICAL DR   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033325345,"FLORIDA, HANNAH, HUBAHIB",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 39 , 112 , 114 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033325345,"FLORIDA, HANNAH, HUBAHIB",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 54 , 54 ,$#,,
MEDICAID DIRECT,1033326186,INTERIM HEALTHCARE OF THE TRIAD,,2100 W CORNWALLIS DR STE T GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1033326186,INTERIM HEALTHCARE OF THE TRIAD,2100 W CORNWALLIS DR STE T GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 767 , 767 ," $47,632.32 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033329941,"RAVEL, DANIEL, RAYMOND",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,006 "," 2,666 "," 11,271 "," $373,616.95 ",,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033329941,"RAVEL, DANIEL, RAYMOND",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 196 , 198 ," 3,068 "," $291,236.47 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033329941,"RAVEL, DANIEL, RAYMOND",1031 WEISS AVE STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 27 , 25 , 74 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033329941,"RAVEL, DANIEL, RAYMOND",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033329941,"RAVEL, DANIEL, RAYMOND",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1033329941,"RAVEL, DANIEL, RAYMOND",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 50 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033341565,"MATCHA, ANUPAMA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 32 , 115 , 115 ,$#,,
MEDICAID DIRECT,1033343157,KINGS MOUNTAIN MEMORY CARE CENTER,~,115 FERGUSON DR   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1033343157,KINGS MOUNTAIN MEMORY CARE CENTER,115 FERGUSON DR   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 17 ," 3,888 "," 3,888 "," $372,492.01 ",,
MEDICAID DIRECT,1033343157,KINGS MOUNTAIN MEMORY CARE CENTER,~,429 CROCKER RD   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1033343157,KINGS MOUNTAIN MEMORY CARE CENTER,429 CROCKER RD   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 20 , 20 ," $31,745.42 ",,
MEDICAID DIRECT,1033343801,HOMECARE FOR THE CAROLINAS LLC,~,4301 MORRIS PARK DR STE 14 MINT HILL NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1033343801,HOMECARE FOR THE CAROLINAS LLC,4301 MORRIS PARK DR STE 14 MINT HILL NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1033343801,HOMECARE FOR THE CAROLINAS LLC,~,9414 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1033343801,HOMECARE FOR THE CAROLINAS LLC,9414 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 183 , 183 ," $43,627.20 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033344742,"WOOD, JENNIFER, LEANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 27 ,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1033344866,"YOUNG, THOMAS, JAMES",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 65 , 66 ,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1033344866,"YOUNG, THOMAS, JAMES",322 MULBERRY ST SW STE H LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1033344866,"YOUNG, THOMAS, JAMES",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 33 , 40 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033346176,"COPE, JUDIT, ANDREA",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1972373751,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL PAIN SPECIALISTS,1205 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1033346176,"COPE, JUDIT, ANDREA",1205 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 80 , 137 , 200 ,$#,,
MEDICAID DIRECT,1972373751,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL PAIN SPECIALISTS,1205 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033346176,"COPE, JUDIT, ANDREA",1205 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 41 , 55 , 88 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033346176,"COPE, JUDIT, ANDREA",6000 RAMSEY ST STE 108 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 14 , 16 , 31 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033346390,"GINSKI, JOSEPH, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 30 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033346390,"GINSKI, JOSEPH, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 39 , 39 ," $10,895.19 ",,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033347141,"GUO, YIFAN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033347265,"KUZICH, MARK, AARON",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 66 , 69 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033347463,"BHATIA, MEENA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 52 , 76 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1033348586,"GUTOVITZ, CARON, DAWN",381 DEERFIELD RD   BOONE NC,095,Watauga,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1033348586,"GUTOVITZ, CARON, DAWN",381 DEERFIELD RD   BOONE NC,095,Watauga,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033348586,"GUTOVITZ, CARON, DAWN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 22 , 23 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1033348586,"GUTOVITZ, CARON, DAWN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033349261,"NGUYEN, MAI-TRANG, LE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033350061,"HAYNIE, ANGELA, WILSON",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1033350558,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04846,3302 MARKET ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033350558,NORTH CAROLINA CVS PHARMACY LLC,3302 MARKET ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033352547,"HALL, REBECCA, LEIGH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033354246,"ANDERSON, CHAD, NICKOLAS",ANDERSON CHIROPRACTIC CENTER,131 W HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,1033354246,"ANDERSON, CHAD, NICKOLAS",131 W HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033357868,"SCOTT, LORI, GRISSETT",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033357868,"SCOTT, LORI, GRISSETT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 31 , 40 , 41 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1033364062,"ORDRONNEAU, DELISA, SMITH",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033364062,"ORDRONNEAU, DELISA, SMITH",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033364062,"ORDRONNEAU, DELISA, SMITH",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 121 , 913 , 913 ," $24,261.15 ",,
MEDICAID DIRECT,1922004852,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCS INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033366570,"HAMLER, SARAH, ELIZABETH",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 153 , 173 , 267 ,$#,,
MEDICAID DIRECT,1194998781,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCIATES INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033366570,"HAMLER, SARAH, ELIZABETH",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 22 , 25 , 32 ,$#,,
MEDICAID DIRECT,1124556063,WRIGHT AND ASSOCIATES V DDS PA,,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033368386,"KRYN, NATHAN, JAMES",12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033368386,"KRYN, NATHAN, JAMES",12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1740705219,WRIGHT AND ASSOCIATES VI,,12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1033368386,"KRYN, NATHAN, JAMES",12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033370150,"COBB, KATHRYN, WATSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033370150,"COBB, KATHRYN, WATSON",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033370150,"COBB, KATHRYN, WATSON",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033370150,"COBB, KATHRYN, WATSON",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033370192,"ASBURY, JUSTIN, EDWARD",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033370192,"ASBURY, JUSTIN, EDWARD",584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1033370192,"ASBURY, JUSTIN, EDWARD",584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033370192,"ASBURY, JUSTIN, EDWARD",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 58 , 127 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033370192,"ASBURY, JUSTIN, EDWARD",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033371240,"CHANG, WEILI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033371240,"CHANG, WEILI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 11 , 53 , 53 ,$#,,
MEDICAID DIRECT,1033374517,HOVEROUND CORPORATION,HOVEROUND MOBILITY SOLUTIONS HMS,4913 CHASTAIN AVE STE 33 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033374517,HOVEROUND CORPORATION,4913 CHASTAIN AVE STE 33 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1033374517,HOVEROUND CORPORATION,HOVEROUND MOBILITY SOLUTIONS HMS,4913 CHASTAIN AVE STE 33 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033374517,HOVEROUND CORPORATION,4913 CHASTAIN AVE STE 33 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 185 , 726 ," 1,204 "," $54,043.92 ",,
MEDICAID DIRECT,1619979226,PHYSICIANS TOTAL REHAB OF FAYETTEVI,~,2930 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033374723,"YOUNG, CARLINA, DIANE",2930 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033377403,"ABERN, MICHAEL, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033377403,"ABERN, MICHAEL, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033377403,"ABERN, MICHAEL, RYAN",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033377403,"ABERN, MICHAEL, RYAN",20 DUKE MEDICINE CIR # 51 DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033378344,"OJO-CARONS, AKINWUNMI",7185 HARBOUR TOWNE PKWY S STE 200 SUFFOLK VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033378971,"GREEN, PATRICK, DANIEL",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033378971,"GREEN, PATRICK, DANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 48 , 50 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033378971,"GREEN, PATRICK, DANIEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033379078,"JONES, PHILLIP, BRYCE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033379078,"JONES, PHILLIP, BRYCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 19 , 46 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033379078,"JONES, PHILLIP, BRYCE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 16 , 29 , 29 ,$#,,
MEDICAID DIRECT,1649757568,PRIVATE DIAGNOSTIC CLINIC PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1033379078,"JONES, PHILLIP, BRYCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033379078,"JONES, PHILLIP, BRYCE",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033381793,"CORBETT, NICOLA, SHAMSEY",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 51 , 100 , 218 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033383013,"SHIREY, KRISTEN, GRACE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033383013,"SHIREY, KRISTEN, GRACE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 18 , 48 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033383013,"SHIREY, KRISTEN, GRACE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033383013,"SHIREY, KRISTEN, GRACE",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 23 , 53 , 53 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033383351,"OLSON, RYAN",2848 CENTER POINTE DR FL 2 FORT MYERS FL,102,Out of State > 40 miles,207ZH0000X,Allopathic & Osteopathic Physicians,Pathology,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,2848 CENTER POINTE DR FL 2 FORT MYERS FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1033383351,"OLSON, RYAN",2848 CENTER POINTE DR FL 2 FORT MYERS FL,102,Out of State > 40 miles,207ZH0000X,Allopathic & Osteopathic Physicians,Pathology,Hematology,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033384516,"MCSWAIN, STEVEN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 16 , 33 , 38 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1033385950,"MCCALL, JENNIFER, MARIE",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 63 , 65 ,$#,,
MEDICAID DIRECT,1285118802,PERIOPERATIVE SPECIALISTS OF NC,,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1033386776,"SELIG, SEAN, CHRISTOPHER",1010 COLLEGE ST   OXFORD NC,039,Granville,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 57 , 60 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033391248,"RELLER, LARA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033391321,"GEERSEN, DANIEL, FRANKLIN",10207 CERNY ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 34 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033391321,"GEERSEN, DANIEL, FRANKLIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1659349041,HOUSE OF LIFE FAMILY PRACTICE,~,7781 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033392774,"POWELL, MICHELE, DENISE",7781 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 35 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033393665,"HARKNESS, KIMBERLY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033393665,"HARKNESS, KIMBERLY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033393665,"HARKNESS, KIMBERLY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033394267,DR RALPH W MAYNARD III OD PA,~,124 CEDAR VALLEY RD   HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1033394267,DR RALPH W MAYNARD III OD PA,124 CEDAR VALLEY RD   HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,, 12 , 12 , 24 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033394721,"VIRAG, JESSICA, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033394721,"VIRAG, JESSICA, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033399860,"GUPTA, NIDHI, AZAD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033400353,"ZUGHBI, CINDY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033400981,"EICHENBERGER, JOSHUA, LEE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 72 , 72 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033401286,"REED, STEFANIE, ROSE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 71 , 71 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033401401,"BRANTON, ANDREA, NICOLE",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 90 , 133 , 133 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033401765,"ARORA, VIKRAM",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 76 , 207 , 270 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033403456,"MORTENSON, ASHLEY, MCBRIDE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033403456,"MORTENSON, ASHLEY, MCBRIDE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033403456,"MORTENSON, ASHLEY, MCBRIDE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 76 , 113 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033403456,"MORTENSON, ASHLEY, MCBRIDE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 27 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033403456,"MORTENSON, ASHLEY, MCBRIDE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033403456,"MORTENSON, ASHLEY, MCBRIDE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033404256,"GUHWE, MARY",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033404256,"GUHWE, MARY",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 28 , 31 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033406095,"BRONAUGH, STEPHEN, MICHAEL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033406236,"WISE, MARSHALL, SCOTT",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033406236,"WISE, MARSHALL, SCOTT",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881289932,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR DIVISION OF PSYCHIATRY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033406798,"YOKOCHI-FUNKHOUSER, NINA, LEAH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033408208,"RAWLS, ASHLEY, RYAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033408208,"RAWLS, ASHLEY, RYAN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1033408208,"RAWLS, ASHLEY, RYAN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 60 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1033408208,"RAWLS, ASHLEY, RYAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033408968,"SHANITKVICH, ZACHARY, ALAN",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033408968,"SHANITKVICH, ZACHARY, ALAN",1450 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1033409156,"PORTER, ELAINE, ANTHONETTE",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 62 , 89 , 221 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033409842,"FRASER, JAMES, FERRIGAN",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 57 , 95 , 154 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033409842,"FRASER, JAMES, FERRIGAN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 155 , 296 , 532 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033409842,"FRASER, JAMES, FERRIGAN",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 30 , 44 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",216 N BICKETT BLVD STE 5 LOUISBURG NC,035,Franklin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 35 , 53 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",835 S NEW HOPE RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 87 , 87 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",835 S NEW HOPE RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 31 , 138 , 138 ," $12,532.03 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 29 , 55 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 43 , 43 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",835 S NEW HOPE RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 19 , 19 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033413760,"NAYAK, RUSHI, KAMLESH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 84 , 84 ,$#,,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033413877,"LALANDE, SHERRIE, ANN",308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 27 , 31 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,10 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1033413877,"LALANDE, SHERRIE, ANN",10 ONE CENTER CT   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 ,#, 23 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1033413877,"LALANDE, SHERRIE, ANN",11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033416151,"LONG, JASON, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 55 , 89 , 101 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 65 , 68 , 92 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 54 , 67 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 56 , 60 , 71 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 48 , 57 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 24 , 31 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 28 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033418710,"PATEL, DELIP, VIKRAM",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033419056,"HOPPENOT, REGIS, GEORGES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 88 , 122 , 170 ," $14,083.95 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033420062,"GART, MICHAEL, STEVEN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033420062,"GART, MICHAEL, STEVEN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 29 , 48 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033420211,"MENDELSON, BRIAN, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 47 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033420211,"MENDELSON, BRIAN, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033420211,"MENDELSON, BRIAN, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033420922,"ARORA, SURAJ",10030 GILEAD RD STE 300 HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 24 , 32 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033420922,"ARORA, SURAJ",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033420922,"ARORA, SURAJ",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 31 , 35 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033422910,"TURNBULL, KARA, MARIE",160 RIVER BEND DR STE C GRANITE FALLS NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033422910,"TURNBULL, KARA, MARIE",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033422910,"TURNBULL, KARA, MARIE",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 54 , 122 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033426150,"HUGHES, MARYBETH, SCAVONE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033426150,"HUGHES, MARYBETH, SCAVONE",825 FAIRFAX AVE STE 610 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033426846,"STREICHER, ANDREW, JOHN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1033426846,"STREICHER, ANDREW, JOHN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033426846,"STREICHER, ANDREW, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 28 , 28 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033426846,"STREICHER, ANDREW, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033426846,"STREICHER, ANDREW, JOHN",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1033426846,"STREICHER, ANDREW, JOHN",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1033426846,"STREICHER, ANDREW, JOHN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1033427588,"EDWARDS, ANDREA, MARIE",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033428016,"BRYANT, MICHAELLE",125 QUEENS RD STE 610&640 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679687586,GASTROENTEROLOGY ASSOCIATES OF THE,SALEM ENDOSCOPY CENTER,,,Unknown,193200000X,Group,Multi-Specialty,,1033430285,"REED, COURTNEY, WORKS",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033430285,"REED, COURTNEY, WORKS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 32 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033430285,"REED, COURTNEY, WORKS",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 29 , 30 ,$#,,
MEDICAID DIRECT,1679687586,GASTROENTEROLOGY ASSOCIATES OF THE,SALEM ENDOSCOPY CENTER,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033430285,"REED, COURTNEY, WORKS",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033430285,"REED, COURTNEY, WORKS",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033430426,"RUSK, LINDSEY, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033431358,"PAV, BRECKON, DANIEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 43 , 57 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033431358,"PAV, BRECKON, DANIEL",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033431358,"PAV, BRECKON, DANIEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033431358,"PAV, BRECKON, DANIEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033431358,"PAV, BRECKON, DANIEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 86 , 104 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033431358,"PAV, BRECKON, DANIEL",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033432711,"DAILEY, VIRGINIA, LITTLE",VLD PLLC,643 GREENWAY RD STE J7 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1033432711,"DAILEY, VIRGINIA, LITTLE",643 GREENWAY RD STE J7 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",3116 N DUKE ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",3116 N DUKE ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",3116 N DUKE ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 18 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033436423,"BARRETT, DANE, MICHAEL",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033437322,"CLEGG, AMY, DUNBAR",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033437322,"CLEGG, AMY, DUNBAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 41 , 43 , 45 ,$#,,
MEDICAID DIRECT,1033437975,"SIGMON, RYAN, CHRISTOPHER",COMPASS DENTAL,1330 4TH STREET DR NW   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,1033437975,"SIGMON, RYAN, CHRISTOPHER",1330 4TH STREET DR NW   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 84 , 293 ," $13,516.28 ",,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033441480,"TILLER, CHAD, ETHAN",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1033441480,"TILLER, CHAD, ETHAN",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033441480,"TILLER, CHAD, ETHAN",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 43 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1033442140,"HENNINGS, ASHLEY, GAYE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1578144747,ELEVATION REHAB LLC,~,3420 HOLLOWAY ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1033444807,"SPARGER, MEGAN, LEIGH SEARS",3905 UNIVERSITY DR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033445879,"KLITCH, CHERRYL, LAI",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1033445879,"KLITCH, CHERRYL, LAI",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 26 , 52 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1033445879,"KLITCH, CHERRYL, LAI",1530 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790825206,COUNTY OF SURRY & SURRY COUNTY WELF,SURRY CO HEALTH & NUTRITION CTR,118 HAMBY RD   DOBSON NC,086,Surry,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033447156,"SMITH, WENDY, DIANNE",118 HAMBY RD   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 12 , 20 ,$#,,
MEDICAID DIRECT,1336292556,TRIAD BEHAVIORAL RESOURCES PC,,12 N 5TH AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033447156,"SMITH, WENDY, DIANNE",12 N 5TH AVE   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033450010,"RICKENBAKER, TAYLOR, KANE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033451463,"VOGT, MATTHEW, RAYMOND",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033452321,"WILLIAMS, LINDSEY, CARLISLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1033452321,"WILLIAMS, LINDSEY, CARLISLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1033452321,"WILLIAMS, LINDSEY, CARLISLE",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033453907,"MCILWAIN, LAURA, LYN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 51 , 65 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1033456991,"ANTHONY, KATIE, MICHELLE",114 E RAILROAD ST   LA GRANGE NC,054,Lenoir,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1033456991,"ANTHONY, KATIE, MICHELLE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 56 , 90 , 201 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1033460019,"PATTERSON, LATISHA, DARSHA",546 W RIDGEWAY ST   WARRENTON NC,093,Warren,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1033460019,"PATTERSON, LATISHA, DARSHA",546 W RIDGEWAY ST   WARRENTON NC,093,Warren,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1710448006,HOPE REGIONAL MEDICAL CLINIC,,546 W RIDGEWAY ST   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1033460019,"PATTERSON, LATISHA, DARSHA",546 W RIDGEWAY ST   WARRENTON NC,093,Warren,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 137 , 310 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1033460019,"PATTERSON, LATISHA, DARSHA",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033460084,"CRAWFORD, DARA, MCCASKILL",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 37 , 40 ,$#,,
MEDICAID DIRECT,1962042416,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PEDIATRIC VIRTUAL VISIT,2709 WATER RIDGE PKWY STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033460084,"CRAWFORD, DARA, MCCASKILL",1653 CAMPUS PARK DR STE A MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033460084,"CRAWFORD, DARA, MCCASKILL",1653 CAMPUS PARK DR STE A MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1033460084,"CRAWFORD, DARA, MCCASKILL",3173 W HIGHWAY 74   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033461819,"LAROIA, ANDREA, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 74 , 74 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033461868,"WALSH, CHRISTIN, LIPSCOMB",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033461868,"WALSH, CHRISTIN, LIPSCOMB",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033461934,"RIVERA ROMAN, GERARDO",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033468772,"LEAP, JAMES, DOUGLAS",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 28 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033468772,"LEAP, JAMES, DOUGLAS",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033470513,"BROWN, MATTHEW, WILLIAM",BROWN ORTHODONTICS,304 DARBY AVE   KINSTON NC,054,Lenoir,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1033470513,"BROWN, MATTHEW, WILLIAM",304 DARBY AVE   KINSTON NC,054,Lenoir,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 24 , 87 , 87 ," $23,038.56 ",,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1033471768,"DE BOER, GABRIELA, RODRIGUEZ",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 70 , 128 , 130 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1033471768,"DE BOER, GABRIELA, RODRIGUEZ",2060 HICKORY BLVD SE   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 49 , 56 , 78 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1033471768,"DE BOER, GABRIELA, RODRIGUEZ",2060 HICKORY BLVD SE   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 118 , 133 , 178 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1033471768,"DE BOER, GABRIELA, RODRIGUEZ",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 201 , 325 , 403 ," $17,642.52 ",,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1033471768,"DE BOER, GABRIELA, RODRIGUEZ",2060 HICKORY BLVD SE   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033472139,"CONDE ZUEGE, RENATA, ANNE",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033473293,"ALAM, TAWFIKUL",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033473293,"ALAM, TAWFIKUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033473293,"ALAM, TAWFIKUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033473293,"ALAM, TAWFIKUL",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1033473293,"ALAM, TAWFIKUL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033473293,"ALAM, TAWFIKUL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1740626605,CAROLINA BREAST IMAGING SPECIALISTS,~,990 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033475124,"EVANS, ALAN, EMERSON",990 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 26 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033476213,"MILLER, STACEY, HARRELSON",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 40 , 75 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033476213,"MILLER, STACEY, HARRELSON",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 27 , 49 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033476213,"MILLER, STACEY, HARRELSON",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1033476999,"PATEL, VEDANG, RAJIV",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1033476999,"PATEL, VEDANG, RAJIV",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033477781,"KUMAR, DILEEP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033477781,"KUMAR, DILEEP",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033477781,"KUMAR, DILEEP",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033477781,"KUMAR, DILEEP",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033477781,"KUMAR, DILEEP",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 107 , 448 , 449 ," $15,869.31 ",,
MEDICAID DIRECT,1033480488,PALMETTO OXYGEN LLC,MEDBRIDGE HOME MEDICAL,1231 NE MAYNARD RD   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033480488,PALMETTO OXYGEN LLC,1231 NE MAYNARD RD   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,679 "," 9,371 "," 15,689 "," $526,427.79 ",,
MEDICAID DIRECT,1033480488,PALMETTO OXYGEN LLC,MEDBRIDGE HOME MEDICAL,1231 NE MAYNARD RD   CARY NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1033480488,PALMETTO OXYGEN LLC,1231 NE MAYNARD RD   CARY NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 63 , 401 , 505 ," $168,187.79 ",,
MEDICAID DIRECT,1033480488,PALMETTO OXYGEN LLC,MEDBRIDGE HOME MEDICAL,1231 NE MAYNARD RD   CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1033480488,PALMETTO OXYGEN LLC,1231 NE MAYNARD RD   CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1033484563,"FURR, STACEY, EVELYN POPE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 142 , 142 ,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033484563,"FURR, STACEY, EVELYN POPE",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679868426,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS BEHAVIORAL MEDICINE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033486378,"ANDERSON, HILLARY, ERIN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 23 , 33 , 33 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033487806,"ANDERSON, GREGORY, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033489240,"TSUMURA, HIDEYO",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033489943,"NOWAK, BROOK, PAYNE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1033489943,"NOWAK, BROOK, PAYNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033489943,"NOWAK, BROOK, PAYNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1033492954,"ULOKO, EMMANUEL, OLUSHOLA",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1033499801,ACON HEALTH CARE SERVICES INC,ACON HEALTH CARE SERVICES INC,1708 TRAWICK RD STE 200 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1033499801,ACON HEALTH CARE SERVICES INC,1708 TRAWICK RD STE 200 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 496 , 496 ," $51,089.45 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033503131,"FEDERSPIEL, JEROME, JEFFREY",2301 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 28 , 32 , 36 ," $10,789.59 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033503131,"FEDERSPIEL, JEROME, JEFFREY",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 37 , 37 , 45 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033503164,"WU, SAM, BRUCE",1072 X RAY DR   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 83 , 95 , 115 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,315 19TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1033503164,"WU, SAM, BRUCE",1072 X RAY DR   GASTONIA NC,036,Gaston,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033503164,"WU, SAM, BRUCE",1072 X RAY DR   GASTONIA NC,036,Gaston,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 16 , 17 , 28 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033503164,"WU, SAM, BRUCE",1072 X RAY DR   GASTONIA NC,036,Gaston,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033503164,"WU, SAM, BRUCE",309 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033503164,"WU, SAM, BRUCE",309 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 31 , 44 , 54 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033503164,"WU, SAM, BRUCE",309 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 15 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,,,Unknown,193200000X,Group,Multi-Specialty,,1033503164,"WU, SAM, BRUCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033504733,"COLMER, HENRY, GERALD",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033504733,"COLMER, HENRY, GERALD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033504733,"COLMER, HENRY, GERALD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033504733,"COLMER, HENRY, GERALD",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033505938,CAROLINA CONCIERGE THERAPEUTICS,~,11201 LIVINGSTON MILL RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033505938,CAROLINA CONCIERGE THERAPEUTICS,11201 LIVINGSTON MILL RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1033505938,CAROLINA CONCIERGE THERAPEUTICS,~,11201 LIVINGSTON MILL RD   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1033505938,CAROLINA CONCIERGE THERAPEUTICS,11201 LIVINGSTON MILL RD   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1033505938,CAROLINA CONCIERGE THERAPEUTICS,~,308 GREENVILLE BLVD SE STE C GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033505938,CAROLINA CONCIERGE THERAPEUTICS,308 GREENVILLE BLVD SE STE C GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1033505938,CAROLINA CONCIERGE THERAPEUTICS,~,1698 HIGHWAY 160 W STE 240 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033505938,CAROLINA CONCIERGE THERAPEUTICS,1698 HIGHWAY 160 W STE 240 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,, 203 ," 2,952 "," 3,475 "," $264,074.45 ",,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1033508866,"GODSEY, JESSICA, MICHELE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033509955,ROSALIND CURRENCE BLAND,ABUNDANT LOVE HOME CARE SERVICES,1981 J N PEASE PL STE 204 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1033509955,ROSALIND CURRENCE BLAND,1981 J N PEASE PL STE 204 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 1,691 "," 1,692 "," $177,041.80 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033511274,"FOX, HEATHER, DAVIS",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 80 , 80 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033511274,"FOX, HEATHER, DAVIS",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 29 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033511654,"WIENER, JONATHAN",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 22 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033511654,"WIENER, JONATHAN",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033511803,"LINK, JENNIFER, STUTTS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 37 , 37 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033515358,"CAMPBELL, CHRISTOPHER, RYAN",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033515358,"CAMPBELL, CHRISTOPHER, RYAN",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1033515358,"CAMPBELL, CHRISTOPHER, RYAN",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033515499,SPEECH MATTERS,,16147 LANCASTER HWY STE 130 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033515499,SPEECH MATTERS,16147 LANCASTER HWY STE 130 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#, 50 , 56 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033518311,"LIZANO, MICHELE, MARIANO",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033518311,"LIZANO, MICHELE, MARIANO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033518311,"LIZANO, MICHELE, MARIANO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033518311,"LIZANO, MICHELE, MARIANO",167 MOORE RD STE 201 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 96 , 113 , 265 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033519764,"BELL, SARAH, TURNER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033519764,"BELL, SARAH, TURNER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033519764,"BELL, SARAH, TURNER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033521133,"THOMPSON, LESLIE, FRANKS",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1629412184,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033522958,"BOWEN, LYNNEICE, LASINDA",16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1629412184,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033522958,"BOWEN, LYNNEICE, LASINDA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033522958,"BOWEN, LYNNEICE, LASINDA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003969874,"KNOWLTON, STEPHEN, DANA",~,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1033523626,"MARSHALL, ALISON, ARRINGTON",601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1033523626,"MARSHALL, ALISON, ARRINGTON",,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,1033523626,"MARSHALL, ALISON, ARRINGTON",601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1003969874,"KNOWLTON, STEPHEN, DANA",~,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1033523626,"MARSHALL, ALISON, ARRINGTON",601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1659777282,STEPHEN KNOWLTON MD,~,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1033523626,"MARSHALL, ALISON, ARRINGTON",601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1659777282,STEPHEN KNOWLTON MD,~,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1033523626,"MARSHALL, ALISON, ARRINGTON",601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033524707,"VELEZ RIVERA, JONATHAN, DANIEL",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033524707,"VELEZ RIVERA, JONATHAN, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 27 , 40 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033524707,"VELEZ RIVERA, JONATHAN, DANIEL",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 17 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033524707,"VELEZ RIVERA, JONATHAN, DANIEL",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033524814,"JUTTANAHALLI, VANITHA, VEERABHADRACHARY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 21 , 24 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033526405,"ACEVEDO, VERONICA",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033526405,"ACEVEDO, VERONICA",3901 N ROXBORO ST STE 101 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033526405,"ACEVEDO, VERONICA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902834658,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE HILLSBOROUGH,267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1033529219,"PECK, ERIN, CAMPBELL",267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 77 , 137 ,$#,,
MEDICAID DIRECT,1053570234,HANGER PROSTHETICS & ORTHOTICS EAST,FAITH PROSTHETIC-ORTHOTIC SERVICES INC,10320 FELD FARM LN STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033529821,"PARKER, JOSHUA, LEO",10502 PARK RD STE 170 CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1093774416,PROSTHETIC AND ORTHOTIC INSTITUTE I,PROSTHETIC AND ORTHOTIC INSTITUTE INC,223 HERLONG AVE S STE 110 ROCK HILL SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033529821,"PARKER, JOSHUA, LEO",10502 PARK RD STE 170 CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 29 ,$#,,
MEDICAID DIRECT,1740794288,PROSTHETIC AND ORTHOTIC INSTITUTE I,,223 HERLONG AVE S STE 110 ROCK HILL SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033529821,"PARKER, JOSHUA, LEO",10502 PARK RD STE 170 CHARLOTTE NC,060,Mecklenburg,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1972683126,BLUE RIDGE HEALTHCARE MEDICAL GROUP,FAMILY MEDICAL ASSOCIATES,2209 S STERLING ST STE 300 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1033531421,"MULL, LISA, LINETTE",2209 S STERLING ST STE 300 MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 132 , 204 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033532411,"FEREBEE DESAI, SARAH, COVINGTON",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 24 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033537774,"CHANDRASEKHAR, MAHESH, ANAND",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033537774,"CHANDRASEKHAR, MAHESH, ANAND",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033537774,"CHANDRASEKHAR, MAHESH, ANAND",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 96 , 126 , 170 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033537774,"CHANDRASEKHAR, MAHESH, ANAND",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033537774,"CHANDRASEKHAR, MAHESH, ANAND",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 16 , 24 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033537774,"CHANDRASEKHAR, MAHESH, ANAND",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 22 , 28 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033537774,"CHANDRASEKHAR, MAHESH, ANAND",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033538251,"IDEN, REBECCA, KATHERINE",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1720557002,KIDS RULE PEDIATRICS PA,,3604 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1033539192,"HARRELL, JESSICA, BRITT",3604 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 112 , 275 , 567 ," $36,591.31 ",,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1033539192,"HARRELL, JESSICA, BRITT",3604 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033539259,"DICKERSON, JOAN, VAUGHN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033539259,"DICKERSON, JOAN, VAUGHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 83 , 318 , 319 ," $22,870.82 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033539499,"KARANIKAS, HRISTOS, CHRISTOPHER",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033539499,"KARANIKAS, HRISTOS, CHRISTOPHER",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1033539549,"KERSTETER, MATTHEW, MICHAEL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 88 , 94 , 102 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033539754,"BOTTY VAN DEN BRUELE, ASTRID, MARIE ROSE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033539754,"BOTTY VAN DEN BRUELE, ASTRID, MARIE ROSE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033539754,"BOTTY VAN DEN BRUELE, ASTRID, MARIE ROSE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033539754,"BOTTY VAN DEN BRUELE, ASTRID, MARIE ROSE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033539754,"BOTTY VAN DEN BRUELE, ASTRID, MARIE ROSE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1528398286,CHISHOLM CHIROPRACTIC CENTER PA,Chisholm Chiropractic Center PA,301 GLENWOOD AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033541453,"WARD, BRUCE, MICHAEL",301 GLENWOOD AVE STE 200 RALEIGH NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",215 LASH DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 183 , 187 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,215 COLLEGE ST   GRAHAM NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",215 LASH DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",215 LASH DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 95 , 97 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,215 LASH DR   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",215 LASH DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083447890,ALIGNMED MEDICAL GROUP NC PC,,877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",2280 HWY 70 SE   HICKORY NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 38 , 39 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",2280 HWY 70 SE   HICKORY NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 88 , 90 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1033545272,"WASHINGTON, LYDIA, MAYES",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033545926,"AVERILL, ELIZABETH, JOHNSTON",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 83 , 219 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033546494,"LORD, JAMISON, YVONNE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033546494,"LORD, JAMISON, YVONNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1851805022,STARMED URGENT & FAMILY CARE PA,,4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033548151,"ALLMAN, ALICIA, KATHERINE",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 45 , 114 ,$#,,
MEDICAID DIRECT,1790282853,STARMED URGENT & FAMILY CARE PA,,4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033548151,"ALLMAN, ALICIA, KATHERINE",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033550850,"BARTON, LAURA, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033550850,"BARTON, LAURA, ANNE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033550850,"BARTON, LAURA, ANNE",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033550850,"BARTON, LAURA, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033550850,"BARTON, LAURA, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033550850,"BARTON, LAURA, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,415 N CENTER ST STE 203 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033551502,"ROBINSON, BRIAN, JAMES",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033551502,"ROBINSON, BRIAN, JAMES",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 25 , 26 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033551502,"ROBINSON, BRIAN, JAMES",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 84 , 84 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,415 N CENTER ST STE 203 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033551502,"ROBINSON, BRIAN, JAMES",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1861592271,ASHE MEMORIAL HOSPITAL INC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1033551502,"ROBINSON, BRIAN, JAMES",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1033552518,"NOLES, MARK, RANDALL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033553664,"QIAO, XIAN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033553664,"QIAO, XIAN",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,600 GRESHAM DR STE 8620 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033553664,"QIAO, XIAN",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1164833851,MOORESVILLE EYE CARE OD PLLC,MOORESVILLE EYE CARE OD PLLC,404 E CENTER AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1033554068,"BUCHANAN, LAURA, ELIZABETH",404 E CENTER AVE   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1568163723,REX HOSPITAL INC,NORTH CAROLINA PAIN MANAGEMENT,4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033554597,"HU, WAYNE, CALVIN",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 28 , 33 ,$#,,
MEDICAID DIRECT,1568163723,REX HOSPITAL INC,NORTH CAROLINA PAIN MANAGEMENT,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033554597,"HU, WAYNE, CALVIN",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033554811,"BLOMBERG, BEN, ADAM",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033554811,"BLOMBERG, BEN, ADAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033554811,"BLOMBERG, BEN, ADAM",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033555974,"HABEGGER, MARTHA, FEREBEE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033555974,"HABEGGER, MARTHA, FEREBEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 31 , 31 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033557806,"PATKA, JAVED, FIROZ",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033557806,"PATKA, JAVED, FIROZ",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033563192,"DAVIS, NATHAN, GRANT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 64 , 68 , 71 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033563192,"DAVIS, NATHAN, GRANT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033563192,"DAVIS, NATHAN, GRANT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033563705,"MORREL, WILLIAM, GRIFFIN",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033563705,"MORREL, WILLIAM, GRIFFIN",2051 RALPH STEPHENS RD   HOLLY SPRINGS NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033563705,"MORREL, WILLIAM, GRIFFIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033563705,"MORREL, WILLIAM, GRIFFIN",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033563705,"MORREL, WILLIAM, GRIFFIN",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 14 , 32 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033563705,"MORREL, WILLIAM, GRIFFIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033563705,"MORREL, WILLIAM, GRIFFIN",781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033564844,"LEWIS, AMANDA, DEUNGER",101 KELLIE DR   SMITHFIELD NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1851449540,RADIOTHERAPY CLINICS OF GEORGIA LLC,,308 DEEP SOUTH FARM RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033566534,"PEACOCK, JEFFREY, SUIL",308 DEEP SOUTH FARM RD STE 100 BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1033567102,"CHANANIE, BRITTNEY, SURLES",800 TILGHMAN DR   DUNN NC,043,Harnett,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1033568258,RGM AL HOLDINGS LLC,ROSE GLEN MANOR,240 INDEPENDENCE AVE   N WILKESBORO NC,097,Wilkes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1033568258,RGM AL HOLDINGS LLC,240 INDEPENDENCE AVE   N WILKESBORO NC,097,Wilkes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 23 ," 8,044 "," 8,231 "," $464,804.84 ",,
MEDICAID DIRECT,1033568258,RGM AL HOLDINGS LLC,ROSE GLEN MANOR,240 INDEPENDENCE AVE   N WILKESBORO NC,097,Wilkes,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1033568258,RGM AL HOLDINGS LLC,240 INDEPENDENCE AVE   N WILKESBORO NC,097,Wilkes,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 15 , 70 , 74 ,$#,,
MEDICAID DIRECT,1770639171,"BOOTH, MICHAEL, SCOTT",MICHAEL SCOTT BOOTH,52 OFFICE PARK DR STE A JACKSONVILLE NC,067,Onslow,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1033569926,"LEMMON, STEVEN, THOMAS",52 OFFICE PARK DR STE A JACKSONVILLE NC,067,Onslow,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 27 ,$#,,
MEDICAID DIRECT,1811033137,CAROLINAS ORAL FACIAL SURGERY CEN,Carolinas Oral & Facial Surgery Center Inc,1305 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033569926,"LEMMON, STEVEN, THOMAS",1305 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 372 , 426 ," 3,075 "," $325,835.33 ",,
MEDICAID DIRECT,1811033137,CAROLINAS ORAL FACIAL SURGERY CEN,Carolinas Oral & Facial Surgery Center Inc,1305 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033569926,"LEMMON, STEVEN, THOMAS",9020 SENCA DR STE 230 WILMINGTON NC,065,New Hanover,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1770639171,"BOOTH, MICHAEL, SCOTT",MICHAEL SCOTT BOOTH,1305 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1033569926,"LEMMON, STEVEN, THOMAS",1305 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 58 ,$#,,
MEDICAID DIRECT,1811033137,CAROLINAS ORAL FACIAL SURGERY CEN,Carolinas Oral & Facial Surgery Center Inc,1305 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033569926,"LEMMON, STEVEN, THOMAS",52 OFFICE PARK DR STE A JACKSONVILLE NC,067,Onslow,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1770639171,"BOOTH, MICHAEL, SCOTT",MICHAEL SCOTT BOOTH,9020 SENCA DR STE 230 WILMINGTON NC,065,New Hanover,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1033569926,"LEMMON, STEVEN, THOMAS",9020 SENCA DR STE 230 WILMINGTON NC,065,New Hanover,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 37 ,$#,,
MEDICAID DIRECT,1811033137,CAROLINAS ORAL FACIAL SURGERY CEN,Carolinas Oral & Facial Surgery Center Inc,1305 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033569926,"LEMMON, STEVEN, THOMAS",709 JEFFERSON ST   WHITEVILLE NC,024,Columbus,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1770639171,"BOOTH, MICHAEL, SCOTT",MICHAEL SCOTT BOOTH,709 JEFFERSON ST   WHITEVILLE NC,024,Columbus,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1033569926,"LEMMON, STEVEN, THOMAS",709 JEFFERSON ST   WHITEVILLE NC,024,Columbus,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 29 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033571724,"HOLLENBECK, JACOB, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 302 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033571807,"PATEL, TULSI, DARSHAN",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033571807,"PATEL, TULSI, DARSHAN",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033571807,"PATEL, TULSI, DARSHAN",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033571906,"MILANI, ELISE, LAUREN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033571906,"MILANI, ELISE, LAUREN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 46 , 66 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033571906,"MILANI, ELISE, LAUREN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 55 , 68 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033571906,"MILANI, ELISE, LAUREN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033571906,"MILANI, ELISE, LAUREN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033571906,"MILANI, ELISE, LAUREN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033572003,"NICOTRA, ALAN, JOSEPH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033572003,"NICOTRA, ALAN, JOSEPH",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033572003,"NICOTRA, ALAN, JOSEPH",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033572003,"NICOTRA, ALAN, JOSEPH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033572201,"EGLINTON, PATRICE, DASON",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 51 , 128 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033572201,"EGLINTON, PATRICE, DASON",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 37 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033572201,"EGLINTON, PATRICE, DASON",144 MERCHANTS CIR STE 100 HAMPSTEAD NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 28 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033572664,"PRISTERA, NICOLE, MARIE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 24 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033572664,"PRISTERA, NICOLE, MARIE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033572664,"PRISTERA, NICOLE, MARIE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 88 , 115 , 147 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033572664,"PRISTERA, NICOLE, MARIE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033572664,"PRISTERA, NICOLE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 61 , 74 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033572664,"PRISTERA, NICOLE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033572664,"PRISTERA, NICOLE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033573407,"JAIN, ASHWIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 143 , 152 , 168 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033573407,"JAIN, ASHWIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 197 , 209 , 237 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033573464,"SHEALY, JORDAN, ANDREW",130 GLENDALE DR W   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 46 , 52 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,6602 KNIGHTDALE BLVD STE 201 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1033573464,"SHEALY, JORDAN, ANDREW",130 GLENDALE DR W   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,130 GLENDALE DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1033573464,"SHEALY, JORDAN, ANDREW",130 GLENDALE DR W   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 83 , 88 ,$#,,
MEDICAID DIRECT,1831306992,HOPSCOTCH PRIMARY CARE GROUP PA,HOPSCOTCH PRIMARY CARE,113 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1033573506,"LONG, MICHELLE, BUCHANAN",88 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 69 , 133 , 285 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033573506,"LONG, MICHELLE, BUCHANAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 49 , 117 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033573902,"GALVIN, DEREK, SEAN",430 RANKIN DR   MARION NC,059,McDowell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 14 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033573985,"PEARCE, DAVID, THOMAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 68 , 249 , 251 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033574694,"TAYLOR, JANZE, RAMON",40 DUKE MEDICINE CIR # 2D DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033574694,"TAYLOR, JANZE, RAMON",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033574694,"TAYLOR, JANZE, RAMON",40 DUKE MEDICINE CIR # 2D DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033576020,PRESTIGE HOME HEALTH CARE INC,,525 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1033576020,PRESTIGE HOME HEALTH CARE INC,525 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 5,882 "," 5,882 "," $504,072.96 ",,
MEDICAID DIRECT,1295012565,MED FIRST IMMEDIATE CARE AND FAMILY,Med First Immediate Care and Family Practice PA,325 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1033580253,"ROBERTS, ELIZABETH, BARLOW",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 36 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1033580253,"ROBERTS, ELIZABETH, BARLOW",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 17 , 44 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033580832,"JONES, PENNY, SUE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 81 , 87 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033580832,"JONES, PENNY, SUE",40 DUKE MEDICINE CIR CLINIC 3J DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 34 , 38 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1033582606,"NUNES, STEVE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 139 , 162 ,$#,,
MEDICAID DIRECT,1033583653,SHELTON PROSTHETICS AND ORTHOTICS,,2800 ASHTON DR STE 201 WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1033583653,SHELTON PROSTHETICS AND ORTHOTICS,2800 ASHTON DR STE 201 WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 12 , 17 , 70 ,$#,,
MEDICAID DIRECT,1033583828,"CARTER, SHANNA, HUGHES",IMAGINATION STATION THERAPY,91 LINDSAY LN   MARSHALL NC,057,Madison,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1033583828,"CARTER, SHANNA, HUGHES",91 LINDSAY LN   MARSHALL NC,057,Madison,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033584750,"STILES, DENISE, WILSON",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,401 N MORGAN ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1033584750,"STILES, DENISE, WILSON",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033584750,"STILES, DENISE, WILSON",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1033584750,"STILES, DENISE, WILSON",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033584750,"STILES, DENISE, WILSON",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 341 , 341 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033584750,"STILES, DENISE, WILSON",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1033584750,"STILES, DENISE, WILSON",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 572 , 572 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033585054,"HARTZ, LACEY, EDWARDS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033589098,"NUHMAN, NAZRA",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033589098,"NUHMAN, NAZRA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033589098,"NUHMAN, NAZRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 36 , 37 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033589098,"NUHMAN, NAZRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033589098,"NUHMAN, NAZRA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033589577,"MCGRAW, ANDREW, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033589577,"MCGRAW, ANDREW, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 32 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1033590187,"RODRIGUEZ, ALFONSO, HUESCA",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033590187,"RODRIGUEZ, ALFONSO, HUESCA",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730285511,WAYNE INTIATIVES FOR SCHOOL HEALTH,~,801 LIONEL ST   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1033590401,"LANCASTER, LAUREN, JONES",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033591656,"BOWE, REBECCA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033591995,"ROUSE, KELSEY, BLAINE",540 NEW WAVERLY PL STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033591995,"ROUSE, KELSEY, BLAINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033591995,"ROUSE, KELSEY, BLAINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 22 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1033592654,"LINBERG, VINCENT, SCHEFFER",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1033592654,"LINBERG, VINCENT, SCHEFFER",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033592654,"LINBERG, VINCENT, SCHEFFER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 45 , 62 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033592654,"LINBERG, VINCENT, SCHEFFER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 31 , 42 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033592654,"LINBERG, VINCENT, SCHEFFER",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033592654,"LINBERG, VINCENT, SCHEFFER",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033592654,"LINBERG, VINCENT, SCHEFFER",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033597547,"EVILLE, ASHLEY, CHRISTINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 47 , 66 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033597547,"EVILLE, ASHLEY, CHRISTINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 54 , 82 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1033597547,"EVILLE, ASHLEY, CHRISTINE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033597547,"EVILLE, ASHLEY, CHRISTINE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033597547,"EVILLE, ASHLEY, CHRISTINE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1033597547,"EVILLE, ASHLEY, CHRISTINE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033597745,TRIUMPH THERAPY SERVICES,~,111 N FERN ABBEY LN   CARY NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1033597745,TRIUMPH THERAPY SERVICES,111 N FERN ABBEY LN   CARY NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1033597745,TRIUMPH THERAPY SERVICES,~,111 N FERN ABBEY LN   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033597745,TRIUMPH THERAPY SERVICES,111 N FERN ABBEY LN   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 14 , 349 , 393 ," $30,411.68 ",,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1033600085,"BRIDGES, SAMANTHA, LYNN HORVATH",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 51 , 64 , 101 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1033600085,"BRIDGES, SAMANTHA, LYNN HORVATH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033600085,"BRIDGES, SAMANTHA, LYNN HORVATH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 24 , 25 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033600085,"BRIDGES, SAMANTHA, LYNN HORVATH",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457055246,SHANE WINGLER DDS PLLC,CAROLINA PINES DENTISTRY,1 WEAVER DR STE 1 LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1033600945,"WINGLER, KENNETH, SHANE",1 WEAVER DR STE 1 LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 17 , 66 ,$#,,
MEDICAID DIRECT,1447845052,OYEGUNWA & ASSOCIATES III PLLC,O2 DENTAL GROUP OF SILER CITY,103 FOOD LION PLZ   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1033601323,"SHAVERS, CHARLES, JEROME",103 FOOD LION PLZ   SILER CITY NC,019,Chatham,1223G0001X,Dental Providers,Dentist,General Practice, 969 ," 2,225 "," 8,126 "," $454,170.65 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033602198,"BAUER, LAUREN, ELIZABETH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033606520,"BEALL, STEPHANIE, ALYSE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033606520,"BEALL, STEPHANIE, ALYSE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033606520,"BEALL, STEPHANIE, ALYSE",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033606520,"BEALL, STEPHANIE, ALYSE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",505 OBERLIN RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 20 , 35 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",120 HEALTHPLEX WAY   APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",400 US 70 HWY E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 25 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033607643,"PRATSON, LINCOLN, FREDERICK",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194459461,AUTHORACARE COLLECTIVE,,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033607650,"FOSTER, TIFFANY, RENEE",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033608484,"PINOTTI, CAITLAN, SWAFFAR",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033608484,"PINOTTI, CAITLAN, SWAFFAR",101 MANNING DR STE 420 CHAPEL HILL NC,068,Orange,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033609268,"ISAAC, JESSICA, KAROL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 105 , 249 , 249 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033609326,"HARDER, BRIANNA, CLARE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 30 , 84 , 102 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033609326,"HARDER, BRIANNA, CLARE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033609326,"HARDER, BRIANNA, CLARE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 14 , 31 , 57 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1033609813,"PEARCE, LORETTA, MAE",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 112 , 148 , 438 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033611264,"RASK, DAWN, MICHELLE GORAL",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033613443,"KNEAR-BELL, ROBERT, NICHOLAS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033613526,"ROOT, GARRETT, BRADLEY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033613526,"ROOT, GARRETT, BRADLEY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033614805,"WHITE, KENDRICK, CARROL",303 GREEN ST E   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 98 , 192 , 226 ," $19,827.72 ",,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033614946,"DILALLO, MARCUS",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 43 , 68 , 119 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",6620 OLD STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 46 , 46 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",6620 OLD STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 30 , 40 , 91 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 23 , 38 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",348 BURTONWOOD DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",2544 COURT DR STE F GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",348 BURTONWOOD DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",348 BURTONWOOD DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 43 , 45 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",2544 COURT DR STE F GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 44 , 62 , 98 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033615034,"ZHANG, YI",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033615042,"BERKOWITZ, CALLIE, MERRIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033615042,"BERKOWITZ, CALLIE, MERRIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033615042,"BERKOWITZ, CALLIE, MERRIAM",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033615042,"BERKOWITZ, CALLIE, MERRIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1033615323,"MCLYNN, RYAN, PATRICK",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033615323,"MCLYNN, RYAN, PATRICK",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 21 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033615323,"MCLYNN, RYAN, PATRICK",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 17 , 45 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033615323,"MCLYNN, RYAN, PATRICK",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033615323,"MCLYNN, RYAN, PATRICK",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1467123091,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - HICKORY,858 2ND ST NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033615935,"ABERNATHY, RACHEL, VIRGINIA",858 2ND ST NE   HICKORY NC,018,Catawba,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health, 16 , 50 , 50 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033616628,"SHORAKA, MASSOUD, B",10320 MALLARD CREEK RD STE 260A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033616628,"SHORAKA, MASSOUD, B",4815 JOHNSTON OEHLER RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 24 , 35 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033616628,"SHORAKA, MASSOUD, B",10320 MALLARD CREEK RD STE 260A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033616669,"YGLESIAS, BENJAMIN, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1033618301,ABC123 EARLY INTERVENTION LLC,,123 ALBERTVILLE LN   SHELBY NC,023,Cleveland,251S00000X,Agencies,Community/Behavioral Health,,1033618301,ABC123 EARLY INTERVENTION LLC,123 ALBERTVILLE LN   SHELBY NC,023,Cleveland,251S00000X,Agencies,Community/Behavioral Health,,#, 95 , 95 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033618848,"BLACKWELL, MACY, SLOAN",605 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1033618848,"BLACKWELL, MACY, SLOAN",605 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033619549,"STRICKLAND, BLYTHE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033622527,"DAVINI, BANDI, LEA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 38 , 39 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1033625843,"VANCE, NATALIE, DANIELLE FORD",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 33 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033627450,"ENYINNAYA, NICOLE, MAJETTE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#, 13 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033628581,"POWIDZKI, MELISSA, REBECCA",303 AIRPORT RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 23 , 27 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033628581,"POWIDZKI, MELISSA, REBECCA",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 70 , 71 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1033628581,"POWIDZKI, MELISSA, REBECCA",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033628581,"POWIDZKI, MELISSA, REBECCA",187 W MAIN ST   SPINDALE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 57 , 57 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,7780 BRIER CREEK PKWY STE 330 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033629118,"DIETTE, STACIE, ANNE",7780 BRIER CREEK PKWY STE 330 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1033629993,"CARNWATH, KAITLYN, GASKINS",1001 NEWMAN RD   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 47 , 49 , 90 ,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033632112,"RAMOS, LYDIA, KYMBERLIE SPARKS",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033634886,LIASIONS COMMUNITY CARE,~,21 W COLONY PL STE 140-B DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1033634886,LIASIONS COMMUNITY CARE,21 W COLONY PL STE 140-B DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 636 , 636 ," $139,916.96 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033638317,"RHINEHART, ALLYSON, JULIA",30 DUKE MEDICINE CIR CLINIC 1A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 17 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033638317,"RHINEHART, ALLYSON, JULIA",30 DUKE MEDICINE CIR CLINIC 1A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033638317,"RHINEHART, ALLYSON, JULIA",30 DUKE MEDICINE CIR CLINIC 1A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033638317,"RHINEHART, ALLYSON, JULIA",10207 CERNY ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 33 , 99 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033639703,"HINES, CISLEY, CASSMIRRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 109 , 108 , 152 ,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1033640040,"STEWART, HANNAH, MICHAELA",336 DEERFIELD RD   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 41 , 43 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033640610,"MURRAY, JACQUELYNE, ELIZABETH",1480 WESLEY CHAPEL RD   INDIAN TRAIL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 58 , 100 ,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033641212,"MAHADY, STACEY, ANN",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033641212,"MAHADY, STACEY, ANN",11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033641428,"JONES, SARAH, BROWN",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033641428,"JONES, SARAH, BROWN",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,310 LONG SHOALS RD STE 202 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033641428,"JONES, SARAH, BROWN",310 LONG SHOALS RD STE 202 ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033641667,"MACKLIN, NICHOLAS, WAYNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 166 , 186 , 211 ," $18,006.64 ",,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1033643416,"LINDSAY, WAYNE, JOSEPH",300 W 27TH ST   LUMBERTON NC,078,Robeson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1033643507,"ARMBRUSTER, JEREMY, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 16 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1033643507,"ARMBRUSTER, JEREMY, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033643507,"ARMBRUSTER, JEREMY, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 38 , 49 ,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033643812,"YANG, YI",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1023084936,WATAUGA RADIOLOGICAL SERVICES PA,WATAUGA RADIOLOGICAL SERVICES PA,155 FURMAN RD STE 101A BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1033643812,"YANG, YI",336 DEERFIELD RD   BOONE NC,095,Watauga,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033644398,"CONLEY, DANA, WESTERKAM",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 59 , 153 , 173 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033644398,"CONLEY, DANA, WESTERKAM",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033644612,"MORRIS, CHRISTOPHER, MARTIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 125 , 125 ,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033648076,"ATIBA, CHARISE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033648076,"ATIBA, CHARISE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1851177539,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033648076,"ATIBA, CHARISE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033649819,"LEE, TAEWOO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033649819,"LEE, TAEWOO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 70 , 175 , 180 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033650486,"SUMNER, JENNIFER, ANDREWS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1033653316,BLIZZARD FAMILY CARE HOME,,1051 FIRE TOWER RD   ROSE HILL NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1033653316,BLIZZARD FAMILY CARE HOME,1051 FIRE TOWER RD   ROSE HILL NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,190 "," 1,190 "," $77,722.68 ",,
MEDICAID DIRECT,1033653316,BLIZZARD FAMILY CARE HOME,,1051 FIRE TOWER RD   ROSE HILL NC,031,Duplin,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1033653316,BLIZZARD FAMILY CARE HOME,1051 FIRE TOWER RD   ROSE HILL NC,031,Duplin,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 684 , 696 ," $144,544.26 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033655105,"BROADBRIDGE, MELANIE, ELAINE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033655741,"VARNER, GINA, LOVELL",207 E MEADOW RD STE 6 EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 20 ,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033655741,"VARNER, GINA, LOVELL",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033656715,"JUPITER, GABOY",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033656905,"JOHNSON, ROBIN, THOMPSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033658257,"AVANTS, CHERIE, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 63 , 63 ,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1033659180,"CHAUDHURY, ARKA",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 136 , 281 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033660741,"ZAGER, TAYLOR, ELIZABETH",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 29 , 46 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033660741,"ZAGER, TAYLOR, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033660741,"ZAGER, TAYLOR, ELIZABETH",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033660741,"ZAGER, TAYLOR, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033660741,"ZAGER, TAYLOR, ELIZABETH",401 N MAIN ST   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033660741,"ZAGER, TAYLOR, ELIZABETH",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033661632,"COLEMAN, MAY, ANN GAVIOLA",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033663356,"LOWE, ASHLEY, ELIZABETH",10030 GILEAD RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 41 , 57 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033663356,"LOWE, ASHLEY, ELIZABETH",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1033665104,"BURNS, DESTINY, DENISE",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033666227,"GAUDINO, ASHLEY, MARIE",3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033666227,"GAUDINO, ASHLEY, MARIE",3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1033667621,"HOUGHTON, HILLARY, JEAN",10211 ALM ST STE 212 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1033667621,"HOUGHTON, HILLARY, JEAN",10211 ALM ST STE 212 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033667621,"HOUGHTON, HILLARY, JEAN",10211 ALM ST STE 212 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033667621,"HOUGHTON, HILLARY, JEAN",10211 ALM ST STE 212 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 34 , 80 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1033667621,"HOUGHTON, HILLARY, JEAN",10211 ALM ST STE 212 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033667621,"HOUGHTON, HILLARY, JEAN",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1033670617,"PATTON, JOSHUA, DOUGLAS",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 30 , 40 , 83 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1033670617,"PATTON, JOSHUA, DOUGLAS",80 HEALTHCARE DR STE 203 SYLVA NC,050,Jackson,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 98 , 157 , 320 ," $10,239.32 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1033670617,"PATTON, JOSHUA, DOUGLAS",80 HEALTHCARE DR STE 203 SYLVA NC,050,Jackson,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 17 , 26 , 53 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1033670914,"PARK, SUNG, WOONG",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033670914,"PARK, SUNG, WOONG",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659396893,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033671946,"CARUSO, ARIANNA, MARIE",7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033671946,"CARUSO, ARIANNA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033671946,"CARUSO, ARIANNA, MARIE",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033671946,"CARUSO, ARIANNA, MARIE",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,7810 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033671946,"CARUSO, ARIANNA, MARIE",7810 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033671946,"CARUSO, ARIANNA, MARIE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1902622749,UWHARRIE ABA LLC,,12356 PRINCE RD   NORWOOD NC,084,Stanly,193400000X,Group,Single Specialty,,1033674858,"MAULDIN, JENNIFER, SUE-LUCAS",9130 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#,,,$#,,
MEDICAID DIRECT,1033677240,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - MAIDEN,137 ISLAND FORD RD   MAIDEN NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033677240,GASTON FAMILY HEALTH SERVICES INC,137 ISLAND FORD RD   MAIDEN NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 155 , 389 , 389 ," $15,800.64 ",,
MEDICAID DIRECT,1124451182,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROPSYCHOLOGY,1814 WESTCHESTER DR STE 402 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033677794,"FRAZIER, REBECCA, LYNN",1814 WESTCHESTER DR STE 402 HIGH POINT NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 17 , 17 , 73 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033679824,"SHI, KEVIN, YANG",5 REGIONAL CIR   PINEHURST NC,063,Moore,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 20 , 27 , 52 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1033680053,"RAINS, BRITTNEY, ANNMARIETTA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 18 , 31 , 35 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033681002,"MCMANUS, JENNIFER, JEAN",8401 UNIVERSITY EXEC PARK DR STE 130 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 51 , 51 ,$#,,
MEDICAID DIRECT,1508887076,COUNTY OF PENDER,PENDER COUNTY HEALTH DEPT,803 S WALKER ST   BURGAW NC,071,Pender,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033683834,"BATTS, ASHLEY, CLAIR",803 S WALKER ST   BURGAW NC,071,Pender,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 104 , 163 , 589 ," $27,192.48 ",,
MEDICAID DIRECT,1124450226,PIEDMONT HEALTH SERVICES INC,~,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033689039,"OGUNLEYE, OLUBUKOLA, ADETOLA",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 145 , 194 , 530 ," $21,286.38 ",,
MEDICAID DIRECT,1144652249,PIEDMONT HEALTH SERVICES INC,~,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033689039,"OGUNLEYE, OLUBUKOLA, ADETOLA",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 353 , 500 ," 1,379 "," $55,150.56 ",,
MEDICAID DIRECT,1851723951,PIEDMONT HEALTH SERVICES INC,MONCURE CHC DENTAL,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033689039,"OGUNLEYE, OLUBUKOLA, ADETOLA",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 76 , 93 , 249 ," $10,471.65 ",,
MEDICAID DIRECT,1497187595,PIEDMONT HEALTH SERVICES INC,~,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033689039,"OGUNLEYE, OLUBUKOLA, ADETOLA",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033700026,"WILLIFORD, PATRICK, SCOTT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033702527,"AKINS, ASYA, MARCELLE",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033702527,"AKINS, ASYA, MARCELLE",1704 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033702527,"AKINS, ASYA, MARCELLE",4551 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 42 , 54 , 106 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033702527,"AKINS, ASYA, MARCELLE",105 NEWSOM ST   DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1033703905,CHS PHARMACY SERVICES INC,ATRIUM HEALTH PHARMACY MEDICAL CENTER PLAZA,1001 BLYTHE BLVD STE 201 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1033703905,CHS PHARMACY SERVICES INC,1001 BLYTHE BLVD STE 201 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy, 16 , 57 , 150 ,$#,,
MEDICAID DIRECT,1225200843,AVNI C RAMPERSAUD DDS PA,CHAPEL HILL PEDIATRIC DENTISTRY,205 SAGE RD STE 202 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1033704028,"SHAH, SETU, HITESH",205 SAGE RD STE 202 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 513 , 867 ," 3,378 "," $129,899.23 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033706189,"MYERS, OLIVIA, BRYCE NANETTE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033707856,"CORTEZ-ROLBAND, KORRINE",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 22 , 25 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033707856,"CORTEZ-ROLBAND, KORRINE",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033710926,"CHAUDHARI, AKSHAY",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033710926,"CHAUDHARI, AKSHAY",2025 GLENN MITCHELL DR   VA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033716634,"BUTLER, SARAH, LYNNERAVEN PETTY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033722202,"ADCOCK, SARAH, ANNETTE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033722202,"ADCOCK, SARAH, ANNETTE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 24 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033722970,"GREGORY, LAURA, HELEN",4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1154518678,EASTOWNE FAMILY PHYSICIANS,~,4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033722970,"GREGORY, LAURA, HELEN",4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1841741014,RDMG ASSOCIATES PA,,304 S GREEN ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1033725585,"HOUSTON, MISTY, DAWN",304 S GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1033725585,"HOUSTON, MISTY, DAWN",304 S GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 70 , 272 , 596 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1033731088,"SUBRAMANIAN, ANITA, MEENAKSHI",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033732037,"GOLD, ERIN, MICHELLE",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033732037,"GOLD, ERIN, MICHELLE",601 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1033732037,"GOLD, ERIN, MICHELLE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033732037,"GOLD, ERIN, MICHELLE",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1033732037,"GOLD, ERIN, MICHELLE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346781721,EYECARECENTER OD PA,EYECARE CENTER,1575 NC HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1033732649,"MEHTA, PRITAL",1575 NC-66 S   KENERSVILLE NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1346781721,EYECARECENTER OD PA,EYECARE CENTER,1575 NC HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1033732649,"MEHTA, PRITAL",1300 EASTCHESTER DR   HIGH POINT NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033737853,"LOWTHER, AMY, DIANE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033737853,"LOWTHER, AMY, DIANE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033737853,"LOWTHER, AMY, DIANE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033737853,"LOWTHER, AMY, DIANE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033738125,"TAHIR, HUMA",801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033738125,"TAHIR, HUMA",1101 WEAVER DAIRY RD STE 102 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033738323,"CALDWELL, EMILY, RANDALL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033738323,"CALDWELL, EMILY, RANDALL",322 N PINE ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801188941,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2550 COURT DR STE 202 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1033739040,"GIEDD, ALEXANDRA, JILLAYNE",2550 COURT DR STE 202 GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033739040,"GIEDD, ALEXANDRA, JILLAYNE",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 19 , 20 ,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033739040,"GIEDD, ALEXANDRA, JILLAYNE",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 63 , 66 ,$#,,
MEDICAID DIRECT,1801188941,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2550 COURT DR STE 202 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1033739040,"GIEDD, ALEXANDRA, JILLAYNE",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033739230,"VANFLETEREN, MICHAEL, JOHN",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1033739230,"VANFLETEREN, MICHAEL, JOHN",101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 49 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1033739230,"VANFLETEREN, MICHAEL, JOHN",1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033739586,"O'NEIL, ELIZABETH, MARIE",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033743372,"MOONEY, NATHAN, ANTHONY",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 35 ,$#,,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1033746292,"LADAPO, OLAJUMOKE, KOFOWOROLA JOSEPHINE",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 105 , 211 , 220 ," $12,076.15 ",,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1033746292,"LADAPO, OLAJUMOKE, KOFOWOROLA JOSEPHINE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033746557,"TURNER, ADAM, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033746557,"TURNER, ADAM, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 158 , 169 ,$#,,
MEDICAID DIRECT,1740225929,DUKE UNIVERSITY AFFILIATED PHYSICIA,,2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033747316,"BEENINGA, FRANKLIN, TRENT",2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 52 , 138 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033747407,"THROWER, ASHLEY, INEZ",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033747407,"THROWER, ASHLEY, INEZ",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 51 , 52 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033747506,"WOLMARANS, BERNHARD",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1033747613,"SINGH, AMANDEEP",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 269 , 272 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033748934,"MIRZAI, SAEID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1790436228,THE HEALTH AND WELLNESS CENTER OF L,THE HEALTH AND WELLNESS CENTER OF LUMBERTON PLLC,581 FARRINGDOM ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1033752415,"ROZIER, TARA, NICOLE",581 FARRINGDOM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 76 , 106 ,$#,,
MEDICAID DIRECT,1326036138,SOUTHEASTERN INTEGRATED CARE,~,3005 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1033752415,"ROZIER, TARA, NICOLE",3005 N ELM ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033752639,THE FAMILY OT PLLC,,192 E CHESTNUT ST STE C ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1033752639,THE FAMILY OT PLLC,192 E CHESTNUT ST STE C ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,, 65 , 662 , 666 ," $55,759.81 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033756531,"GARAVITO, DRAIA, MCKINNEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1033756598,"ROMEIS, JULIE, ANNE",530 NEW WAVERLY PL STE 314 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1033756598,"ROMEIS, JULIE, ANNE",249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033757646,"SHULER, KRISTEN, BEASLEY",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033757646,"SHULER, KRISTEN, BEASLEY",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033757646,"SHULER, KRISTEN, BEASLEY",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 135 , 389 , 636 ," $97,139.70 ",,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1033760582,"RUEBHAUSEN, JAMIE, MARIE",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 23 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1033760582,"RUEBHAUSEN, JAMIE, MARIE",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1033760582,"RUEBHAUSEN, JAMIE, MARIE",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033760582,"RUEBHAUSEN, JAMIE, MARIE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1033760582,"RUEBHAUSEN, JAMIE, MARIE",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 28 ,$#,,
MEDICAID DIRECT,1033762943,SOUTHEASTERN HOME CARE LLC,,30040 E LAKE RD   WAGRAM NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1033762943,SOUTHEASTERN HOME CARE LLC,30040 E LAKE RD   WAGRAM NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,#, 387 , 387 ," $25,687.60 ",,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033763537,"BANNER, DALLAS, CAMILLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033764402,"FLOWERS, KATLYN, LOUISE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033764402,"FLOWERS, KATLYN, LOUISE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033771019,"TOLLEY, ROBYN, JOYE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 24 , 31 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033772595,"ZIMMERMAN, JESSICA, LEE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 155 , 220 , 374 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033772595,"ZIMMERMAN, JESSICA, LEE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033772595,"ZIMMERMAN, JESSICA, LEE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033772843,"NING, ANGELA, TIANSHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033773593,"ZAYAS, HECTOR, JORDAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033775226,"STRONG, WILLIAM, PATRICK",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1033776059,"PRATT, CRISTINA, MARIE",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 18 , 57 , 59 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1033776059,"PRATT, CRISTINA, MARIE",400 SHADOWLINE DR STE 201 BOONE NC,095,Watauga,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 42 , 117 , 135 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033776240,"THOMAS, HEATHER, ROSS",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033776240,"THOMAS, HEATHER, ROSS",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 67 , 148 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1033776240,"THOMAS, HEATHER, ROSS",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1033776240,"THOMAS, HEATHER, ROSS",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1033776240,"THOMAS, HEATHER, ROSS",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033776240,"THOMAS, HEATHER, ROSS",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033776299,"PASCOE, ALEXIS, RENEE",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033776299,"PASCOE, ALEXIS, RENEE",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033776299,"PASCOE, ALEXIS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033776299,"PASCOE, ALEXIS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033776299,"PASCOE, ALEXIS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1033776299,"PASCOE, ALEXIS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033778360,"SULLIVAN, JENNIFER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033778360,"SULLIVAN, JENNIFER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033778618,"NGUYEN, KATHERINE, PHUONG-KHANH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1033778881,"SHIRLEY, VICTORIA, RENEE",14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1033784681,"GOLD, DANIELL, MILLER",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 128 ," 1,020 "," 1,270 "," $14,312.41 ",,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1033784681,"GOLD, DANIELL, MILLER",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 28 , 33 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1033784681,"GOLD, DANIELL, MILLER",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 312 , 382 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1033785845,"POPE, MORGAN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033785845,"POPE, MORGAN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033792577,"POWERS, MACKENZIE, ELIZABETH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033792577,"POWERS, MACKENZIE, ELIZABETH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 51 ," $11,570.48 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033792577,"POWERS, MACKENZIE, ELIZABETH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033792577,"POWERS, MACKENZIE, ELIZABETH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 36 ,$#,,
MEDICAID DIRECT,1366984403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-JOHN SMITH,2356 JOHN SMITH RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033793807,"NEEDELL, ABIGAIL, RAE",2356 JOHN SMITH RD STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 101 , 124 ,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033796537,"FISHER, ZACHARY, BRITT",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 68 , 89 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033797592,"VOITKOV, ALEXANDER, ALEXANDROVICH",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1033797592,"VOITKOV, ALEXANDER, ALEXANDROVICH",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1033797592,"VOITKOV, ALEXANDER, ALEXANDROVICH",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 66 , 95 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033799861,"LOOK LOY, KAYLA, ANN",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800578,"EISENHOOTH, ALAINA, BROOKE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800578,"EISENHOOTH, ALAINA, BROOKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800578,"EISENHOOTH, ALAINA, BROOKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 35 , 62 , 66 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800578,"EISENHOOTH, ALAINA, BROOKE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800578,"EISENHOOTH, ALAINA, BROOKE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800578,"EISENHOOTH, ALAINA, BROOKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800578,"EISENHOOTH, ALAINA, BROOKE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033800883,"ARMSTRONG, MARY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1033804299,"SAGERS, ERIN, LYNN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 45 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033804299,"SAGERS, ERIN, LYNN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 81 , 148 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033804299,"SAGERS, ERIN, LYNN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033808530,"HARLAN, KRISTY, MAE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 296 ," 1,145 "," 1,265 "," $26,566.58 ",,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1033808993,"SAVAGE, KYLEE, ANN",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 41 ,$#,,
MEDICAID DIRECT,1154042992,RDMG ASSOCIATES PA,,7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1033809843,"YATES, ELIZABETH, PAIGE",7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 56 , 101 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033810056,"LUMSDEN, ALEXIA, PATRICE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 26 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033810056,"LUMSDEN, ALEXIA, PATRICE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033814405,A PEACEFUL MIND HOME CARE,,301 S CHURCH ST STE 1 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1033814405,A PEACEFUL MIND HOME CARE,301 S CHURCH ST STE 1 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 556 , 648 ," $86,014.72 ",,
MEDICAID DIRECT,1821623620,LANE AND ASSOCIATES XXXVIII DDS PA,,101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033819248,"KHATTAK, SANABIL, MANZOOR",108 PICCADILLY DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538776455,LANE AND ASSOCIATES XXXIX,,161 KODIAK LN   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1033819248,"KHATTAK, SANABIL, MANZOOR",108 PICCADILLY DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 78 , 89 , 251 ," $19,767.93 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033820915,"SCHUMAN, JAMES, THOMAS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033821236,"SEMINARA, LUKE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033821236,"SEMINARA, LUKE",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033821236,"SEMINARA, LUKE",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 47 , 47 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033821236,"SEMINARA, LUKE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033821236,"SEMINARA, LUKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033823604,"BRADDOCK, HALEY, CARSON",115 HEART DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1033823604,"BRADDOCK, HALEY, CARSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033831581,"RUTH, KIRSTEN, ELIZABETH",555 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1033831581,"RUTH, KIRSTEN, ELIZABETH",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 71 , 183 ,$#,,
MEDICAID DIRECT,1033837224,ABUNDANCE OF HOME CARE LLC,,138 W MAIN ST STE 110 WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1033837224,ABUNDANCE OF HOME CARE LLC,138 W MAIN ST STE 110 WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,770 "," 2,939 "," $279,899.08 ",,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033840640,"BOCTOR, CHRISTINA, BADIE",12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 543 , 835 ," 2,809 "," $116,737.28 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033842505,"HARWOOD, JARED, WYLLYS",2800 DARROW RD   WALKERTOWN NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 172 , 345 ,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,2050 MERCANTILE DR   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1033843388,"CATE, AMY, ELIZABETH",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033843388,"CATE, AMY, ELIZABETH",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033844071,"O'CONNOR, ARNOLD, ERIC",1801 OLIVE CHAPEL RD STE 103 APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 30 ,$#,,
MEDICAID DIRECT,1033846522,IMPACT HOME CARE SOLUTIONS LLC,IMPACT HOME CARE SOLUTIONS,200 W ASH ST STE 102 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1033846522,IMPACT HOME CARE SOLUTIONS LLC,200 W ASH ST STE 102 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 47 ," 4,276 "," 4,276 "," $412,936.74 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033848361,"FRANCIS, ANA, BELEN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1811319171,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,5330B SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033848502,"PATEL, MISHALI",5330 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1811319171,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,5330B SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033848502,"PATEL, MISHALI",2015 RANDOLPH RD STE 108 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1811319171,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,5330B SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033848502,"PATEL, MISHALI",4101 CAMPUS RIDGE RD   MATTHEWS NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1033848627,"EIBELER, KAITLIN, KAROL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033848627,"EIBELER, KAITLIN, KAROL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 16 , 25 , 25 ,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033848627,"EIBELER, KAITLIN, KAROL",101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1033848627,"EIBELER, KAITLIN, KAROL",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1033848627,"EIBELER, KAITLIN, KAROL",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 16 , 27 , 28 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033849278,"MAUNEY, ERICA, LYNN",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033849278,"MAUNEY, ERICA, LYNN",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 49 , 63 ,$#,,
MEDICAID DIRECT,1386960177,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033849278,"MAUNEY, ERICA, LYNN",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033849773,COMFORTING ANGELS INC,,5736 N TRYON ST STE 223A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1033849773,COMFORTING ANGELS INC,5736 N TRYON ST STE 223A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,162 "," 1,162 "," $84,473.76 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033852959,"DEMETRIUS, ANGELA, BETH",2502 S NC HIGHWAY 119   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 24 , 24 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033852959,"DEMETRIUS, ANGELA, BETH",2502 S NC HIGHWAY 119   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033852959,"DEMETRIUS, ANGELA, BETH",1704 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033852959,"DEMETRIUS, ANGELA, BETH",1704 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 38 , 38 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033852959,"DEMETRIUS, ANGELA, BETH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033852959,"DEMETRIUS, ANGELA, BETH",3609 BOND ST   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1033852959,"DEMETRIUS, ANGELA, BETH",3609 BOND ST   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033854807,GOOD ANGEL HOME HEALTH INC,,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1033854807,GOOD ANGEL HOME HEALTH INC,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 779 , 779 ," $48,397.44 ",,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,1501 N BICKETT BLVD STE E LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1033855473,"TAYLOR, GINA, WYNNE",1501 N BICKETT BLVD STE E LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184318297,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM FRANKLIN PRIMARY AND WOMENS CARE,1501 N BICKETT BLVD STE E LOUISBURG NC,035,Franklin,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1033855473,"TAYLOR, GINA, WYNNE",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 200 , 224 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033855531,"SCHRAMM, MELISSA, ANNE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033855531,"SCHRAMM, MELISSA, ANNE",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 78 , 113 ,$#,,
MEDICAID DIRECT,1437459021,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH UROLOGY LINCOLN,441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1033855531,"SCHRAMM, MELISSA, ANNE",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1033859467,"BROWN, BRITTANY, ALEXANDRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033861117,"FADEYI, OLUWATOYIN, ALABA",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 125 , 211 , 406 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033861984,"MARTIN, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033863493,OZAH HOME CARE INC,,900 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1033863493,OZAH HOME CARE INC,900 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 17 , 101 , 101 ," $10,805.48 ",,
MEDICAID DIRECT,1033863717,THE CONWAY GROUP LLC,HOMEWATCH CAREGIVERS OF MOORESVILLE,344 ROLLING HILL RD STE 102C MOORESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1033863717,THE CONWAY GROUP LLC,344 ROLLING HILL RD STE 102C MOORESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,#, 708 , 803 ," $84,447.04 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033868484,"LUU, RAY, HO",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033869631,"BOPPANA, RAMA, DEVI",4230 N ROXBORO ST   DURHAM NC,032,Durham,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 23 , 25 , 55 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1033869631,"BOPPANA, RAMA, DEVI",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 79 , 90 , 208 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1033870068,"SCHMIDT, DANIELLE, SHARON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1033870654,"BURNS, SCOTT",2790 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033870670,"CATES, VIRGINIA, GRACE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033870670,"CATES, VIRGINIA, GRACE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 47 , 48 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033870670,"CATES, VIRGINIA, GRACE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033871025,"BLANCHARD, CHELSEA, KAYLAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1033871025,"BLANCHARD, CHELSEA, KAYLAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033871728,"KLINE WEBER, KYRA, ANDERS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033871728,"KLINE WEBER, KYRA, ANDERS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1033871728,"KLINE WEBER, KYRA, ANDERS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033873294,"BRODERICK, JAMILAH, AISHA",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033876099,"NELSON, DEANNE, RENE",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033876099,"NELSON, DEANNE, RENE",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 25 , 25 ,$#,,
MEDICAID DIRECT,1063953602,RDMG ASSOCIATES PA,,6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1033876628,"HOWELL, CAMERON, REBECCA",6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033877246,"MCHARGUE, KARA, DANIELLE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033877246,"MCHARGUE, KARA, DANIELLE",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033877246,"MCHARGUE, KARA, DANIELLE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033877246,"MCHARGUE, KARA, DANIELLE",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 90 , 261 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1102 B US 601   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1033877246,"MCHARGUE, KARA, DANIELLE",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 52 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1033877246,"MCHARGUE, KARA, DANIELLE",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619099256,FAMILY MEDICAL ASSOCS OF RALEIGH,,3500 BUSH ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1033879150,"COLVIN, ALAN, SHUDA",3500 BUSH ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 31 ,$#,,
MEDICAID DIRECT,1033880059,JACKSON CONSULTING AND SERVICES,,9008 BROAD RIDGE CT   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1033880059,JACKSON CONSULTING AND SERVICES,9008 BROAD RIDGE CT   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 11 , 839 , 839 ," $60,936.57 ",,
MEDICAID DIRECT,1033880943,CASSIOPEIAS HOME CARE AGENCY LLC,,150 PRESTON EXECUTIVE DR STE 231 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1033880943,CASSIOPEIAS HOME CARE AGENCY LLC,150 PRESTON EXECUTIVE DR STE 231 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,458 "," 2,458 "," $195,875.27 ",,
MEDICAID DIRECT,1720292261,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1033882691,"BENTLEY, AMANDA, JOY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1033884796,ZION HOME HEALTHCARE LLC,ZION HOME HEALTHCARE LLC,5425 TRALEE PL   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1033884796,ZION HOME HEALTHCARE LLC,5425 TRALEE PL   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 730 , 740 ," $81,590.93 ",,
MEDICAID DIRECT,1033885801,MT AIRY OPCO LLC,TWELVE OAKS,1297 GALAX TRL   MOUNT AIRY NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1033885801,MT AIRY OPCO LLC,1297 GALAX TRL   MOUNT AIRY NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 56 ," 7,996 "," 8,003 "," $846,893.57 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033887765,"PUGH, KARLY, SUZANNE",209 PARK ST   BELMONT NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1194263087,DLP FRYE MEDICAL GROUP,FRYECARE WOMENS SERVICES,1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033887823,"EVANS, TAYLOR, DAWN",1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 65 , 97 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033888359,"EDIE, REBEKAH, HESTER",10211 ALM ST STE 2400 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033889357,"YANG, LISA, VANG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 90 , 93 ,$#,,
MEDICAID DIRECT,1922000892,CLAREMONT OPTOMETRIC EYECARE CENTER,MOUNTAIN VIEW EYE CENTER,,,Unknown,193200000X,Group,Multi-Specialty,,1033889787,"GLENN, HANNAH, ELIZABETH",3038 HWY 127 S   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780686659,NEWTON OPTOMETRIC CENTER PLLC,NEWTON VISION CENTER,750 IRIS LN   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1033889787,"GLENN, HANNAH, ELIZABETH",750 IRIS LN   NEWTON NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780686659,NEWTON OPTOMETRIC CENTER PLLC,NEWTON VISION CENTER,750 IRIS LN   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033889787,"GLENN, HANNAH, ELIZABETH",750 IRIS LN   NEWTON NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1578565305,MAIDEN OPTOMETRIC EYE CARE CENTER P,MAIDEN EYE CLINIC,503 ISLAND FORD RD   MAIDEN NC,018,Catawba,193200000X,Group,Multi-Specialty,,1033889787,"GLENN, HANNAH, ELIZABETH",503 ISLAND FORD RD   MAIDEN NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1780686659,NEWTON OPTOMETRIC CENTER PLLC,NEWTON VISION CENTER,750 IRIS LN   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1033889787,"GLENN, HANNAH, ELIZABETH",503 ISLAND FORD RD   MAIDEN NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033890140,"BURCH, ALYSON",109 W GANNON AVE   ZEBULON NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 39 , 118 ,$#,,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1033890306,"CAMPBELL, MADELINE, GRACE",1206 BROWN ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 96 , 134 , 445 ," $16,728.05 ",,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033893136,"PHAM, MATTHEW, VAN",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice," 2,006 "," 3,766 "," 10,707 "," $549,339.58 ",,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1033894084,"BARRY, BENJAMIN",6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033894399,ELLIOTT &HICKS ASSISTED CARE AGENCY,,507 SANDHURST DR 102 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1033894399,ELLIOTT &HICKS ASSISTED CARE AGENCY,507 SANDHURST DR 102 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 947 , 947 ," $51,669.84 ",,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1033897301,"BLUMBERG, MEREDITH, HANNA",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 31 , 45 , 45 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,249 E NC HIGHWAY 54 STE 330 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033897798,"STEPPS, JESSICA, KESLER",249 E NC HIGHWAY 54 STE 330 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1033897798,"STEPPS, JESSICA, KESLER",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 83 , 93 , 242 ," $10,320.88 ",,
MEDICAID DIRECT,1265148944,PRIMARY CARE AND URGENT CARE OF NAS,,107 W NASHVILLE DR STE A NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1033898937,"FRAZIER, HALEY, JUDD",107 W NASHVILLE DR STE A NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 100 , 131 , 315 ,$#,,
MEDICAID DIRECT,1033899422,"O'CONNOR, CHRISTINA, MARIE",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1033899422,"O'CONNOR, CHRISTINA, MARIE",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1033924873,"TINNEY, SHELBY, LOUISE",100 S 10TH ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 60 , 140 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1033930243,"RIVAS, ANDREW, NOE",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1821059650,POLYCLINIC MEDICAL CENTER INC,POLYCLINIC MEDICAL CENTER INC,9705 NORTHEAST PKWY STE 400 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1033937933,"SLIWOSKI, LILLIAN",9705 NORTHEAST PARKWAY SUITE 400   MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 19 , 30 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1033948435,"OYOLA GUZMAN, DANIEL, ALEJANDRO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033948625,DIRECT MEDICAL TRANSPORT,,110 N MITCHELL ST   AHOSKIE NC,046,Hertford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1033948625,DIRECT MEDICAL TRANSPORT,110 N MITCHELL ST   AHOSKIE NC,046,Hertford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 13 , 25 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033955190,"SCHOMBURG, HALEY, MCCRACKEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1033955190,"SCHOMBURG, HALEY, MCCRACKEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1033955364,"KIM, HALEY, HWAJEONG",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice, 562 , 878 ," 2,430 "," $110,545.12 ",,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1033955364,"KIM, HALEY, HWAJEONG",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1033955364,"KIM, HALEY, HWAJEONG",2029 VALLEYGATE DR SUITE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1235148529,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS ROCK HILL PEDIATRIC,1656 RIVERCHASE BLVD STE 3400 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033970462,"LIGHT, JADEN, BREYANNE",1656 RIVERCHASE BLVD STE 3400 ROCK HILL SC,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1235148529,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS ROCK HILL PEDIATRIC,1935 HOLBROOK RD STE 2200 FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1033970462,"LIGHT, JADEN, BREYANNE",1935 HOLBROOK RD STE 2200 FORT MILL SC,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1033971049,MOUNTAIN COMMUNITY HEALTH PARTNERSH,MCHP THERAPY SERVICES,621 MICAVILLE LOOP STE 500 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1033971049,MOUNTAIN COMMUNITY HEALTH PARTNERSH,621 MICAVILLE LOOP STE 500 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,#, 26 , 45 ,$#,,
MEDICAID DIRECT,1659828291,RESERVE HEALTH PC,,135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1033979257,"LOHSE, ALICIA, JEAN",135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 86 , 131 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1033982665,"JENKINS, THOMAS, WALKER",166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1033982665,"JENKINS, THOMAS, WALKER",166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 38 , 68 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1033986336,"ROBINSON, ARIAN, MINTON",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 74 , 87 ,$#,,
MEDICAID DIRECT,1033990882,BEST REHAB LLC,,506 W ACADEMY ST   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1033990882,BEST REHAB LLC,506 W ACADEMY ST   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,#, 239 , 239 ," $22,604.48 ",,
MEDICAID DIRECT,1861675357,HIGH ROCK INTERNAL MEDICINE PA,~,104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1033997382,"JOHNSON, EMILY, LOUISE",104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 190 , 259 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043004518,"BATESKI, EMMA, CATHERINE",2675 COURT DR   GASTONIA NC,036,Gaston,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1043057714,"BROTT, HAYLEY, MARIE",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 20 , 31 , 103 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043065212,"MCGINN, STEPHANIE, SWOPE",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043065238,"ALEXANDER, CHRISTINA, ANN",1220 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,159 E DALLAS RD   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1043065238,"ALEXANDER, CHRISTINA, ANN",159 E DALLAS RD   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043065238,"ALEXANDER, CHRISTINA, ANN",1220 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043065238,"ALEXANDER, CHRISTINA, ANN",4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1043068331,"FRANCE, MEGAN, MICHELLE",17228 FORDHAM BLVD STE 151 CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 74 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043069479,"ROHANI, SHAYAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043069479,"ROHANI, SHAYAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 33 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 39 , 44 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043086416,"GUETZ, EMILY, CLARE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1043089626,"STEPHENS, TORI, SHAYE",4117 OLEANDER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 30 , 141 ,$#,,
MEDICAID DIRECT,1265420335,HANGER PROSTHETICS & ORTHOTICS EAST,~,1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043092349,"JOHNSON, MICHAELA, JULIET",1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1730362641,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043095870,"WRIGHT, KAITLIN, SIMPSON",16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 23 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1043096282,"HINSON, LEIGH, BARNHILL",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1043096282,"HINSON, LEIGH, BARNHILL",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 31 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043096282,"HINSON, LEIGH, BARNHILL",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558351726,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE PIEDMONT,1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043200207,"MCPHERSON, HOLLY, MURRELL",1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 92 , 293 , 381 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043200264,"SWEENEY, MICHAEL, FRANCIS",1450 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043201361,"BURGESS, JASON, SHADE",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 67 , 81 , 115 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043201361,"BURGESS, JASON, SHADE",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043201361,"BURGESS, JASON, SHADE",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043201361,"BURGESS, JASON, SHADE",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 139 , 247 , 337 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043201361,"BURGESS, JASON, SHADE",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 68 , 101 , 136 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043202419,"AMENDOLA, ANNUNZIATO",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043202419,"AMENDOLA, ANNUNZIATO",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043202419,"AMENDOLA, ANNUNZIATO",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639407737,STATESVILLE HMA MEDICAL GROUP LLC,STATESVILLE HMA MEDICAL GROUP LLC,1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1043202542,"RADER, DALE, KANTRICE",1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043202542,"RADER, DALE, KANTRICE",1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 98 , 212 , 412 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043202542,"RADER, DALE, KANTRICE",1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 20 , 45 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043202963,"DE HOFF, PHILIP, WILLIAM",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043202963,"DE HOFF, PHILIP, WILLIAM",1718 E 4TH ST STE 907 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 31 , 54 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043202963,"DE HOFF, PHILIP, WILLIAM",13557 STEELECROFT PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043202963,"DE HOFF, PHILIP, WILLIAM",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1043203003,"HAVAS, JEREMY, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104819754,SHELBY MEDICAL ASSOCIATES PA,~,711 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1043203441,"ALDINGER, KYLE, ANTHONY",711 N DEKALB ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 56 , 151 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043203797,"MEBANE, ANGELA, BALLANCE",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043203797,"MEBANE, ANGELA, BALLANCE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 169 , 380 , 765 ," $15,304.65 ",,
MEDICAID DIRECT,1043203813,"COGGINS, PAUL",PAUL E COGGINS DDS MPH,1203 RIDGE RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1043203813,"COGGINS, PAUL",1203 RIDGE RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 45 , 104 ,$#,,
MEDICAID DIRECT,1912962697,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043204449,"SANDERS, KENTON, LEE",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1043206709,"HUX, ALLISON, BARNETT",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1902087927,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1043206709,"HUX, ALLISON, BARNETT",1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 39 , 63 ,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043206782,"GORE, SHAWNYA, AYERS",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 69 , 106 ,$#,,
MEDICAID DIRECT,1225307713,SOUTHEASTERN REGIONAL MEDICAL CENTE,SOUTHEASTERN BEHAVIORAL HEALTH SERVICES,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1043206998,"PINA, DESIDERIO",300 W 27TH ST   LUMBERTON NC,078,Robeson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043207442,"LUGO SOMOLINOS, AIDA, MARIA",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 33 , 43 , 66 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043207442,"LUGO SOMOLINOS, AIDA, MARIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 17 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043207442,"LUGO SOMOLINOS, AIDA, MARIA",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043207764,"PETRUSKA, MYRON, JAY",4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043209224,"DEIGAN, ERIC, ARTHUR",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043209224,"DEIGAN, ERIC, ARTHUR",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 24 , 25 , 29 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043209224,"DEIGAN, ERIC, ARTHUR",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 60 , 71 , 98 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043209224,"DEIGAN, ERIC, ARTHUR",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043209596,"KALLAY, NICHOLAS",512 VILLAGE RD STE 101 SHALLOTTE NC,010,Brunswick,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 43 , 72 , 102 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043209596,"KALLAY, NICHOLAS",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1649376369,BRANDY E HICKS O DPA,~,400 E MAIN ST   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1043210933,"HICKS, BRANDY, EDALGO",400 E MAIN ST   SYLVA NC,050,Jackson,152W00000X,Eye and Vision Services Providers,Optometrist,, 43 , 52 , 54 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1043211212,"SINHA, SAURABH, RANJAN",40 DUKE MEDICINE CIR CLINIC 1L DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1043211212,"SINHA, SAURABH, RANJAN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043211402,"CALABRESE, MARC",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 105 , 115 , 117 ,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043211998,"ROBERSON, JENNIFER",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043211998,"ROBERSON, JENNIFER",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 116 , 197 , 211 ,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043211998,"ROBERSON, JENNIFER",324 N QUEEN ST   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043211998,"ROBERSON, JENNIFER",324 N QUEEN ST   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1043212616,"BANISTER, PAMELA, KAY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043212616,"BANISTER, PAMELA, KAY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043212616,"BANISTER, PAMELA, KAY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 78 , 139 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043212616,"BANISTER, PAMELA, KAY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 136 , 144 , 261 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1123 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043212616,"BANISTER, PAMELA, KAY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1123 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043212616,"BANISTER, PAMELA, KAY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043212616,"BANISTER, PAMELA, KAY",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043212764,"HOLLAND, DANIEL, LEE",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043212764,"HOLLAND, DANIEL, LEE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1043212764,"HOLLAND, DANIEL, LEE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043214687,"BARTLE, BRYAN, KURT",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 22 , 24 ,$#,,
MEDICAID DIRECT,1518910033,EYECARECENTER OD PA,EYECARE CENTER,7510 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043214844,"BAILEY, ALISON, ANNE",7510 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043215080,"AMOS, BARRY, DEAN",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 29 , 30 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043215080,"AMOS, BARRY, DEAN",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 34 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043215080,"AMOS, BARRY, DEAN",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1043215767,"DEFILIPP, GARY, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043215767,"DEFILIPP, GARY, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 215 , 222 , 248 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043215767,"DEFILIPP, GARY, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 188 , 202 , 235 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1043215767,"DEFILIPP, GARY, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1043217656,"BEASLEY, CHARLES, RONALD",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437542206,SOUTHEASTERN REGIONAL PHYSICIAN SER,LUMBERTON MEDICAL CLINIC,395 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1043217656,"BEASLEY, CHARLES, RONALD",395 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 124 , 318 , 383 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1043220775,"DAVIS, CLAYTON, HOUSTON",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 46 , 81 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1043220775,"DAVIS, CLAYTON, HOUSTON",176 WALMART PLZ   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1497100721,GREENSBORO RHEUMATOLOGY PA,,2835 HORSE PEN CREEK RD STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043221013,"BEEKMAN, JAMES, FREDERIC",2835 HORSE PEN CREEK RD STE 101 GREENSBORO NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 17 , 31 , 47 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 716 ," 3,330 "," 4,363 "," $86,048.18 ",,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,,,Unknown,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",809 S LONG DR   ROCKINGHAM NC,077,Richmond,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 20 , 27 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,224 HIGH HOUSE RD STE 104 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",224 HIGH HOUSE RD STE 104 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",3001 EDWARDS MILL RD FL 2 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,630 TIMBER DR EAST STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",630 TIMBER DR EAST STE 120 GARNER NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 37 , 61 , 71 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1043221328,"SINGH, PAUL, GULSHARAN",224 HIGH HOUSE RD STE 104 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 25 , 30 , 44 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043221658,"WOHLRAB, KURT, PATRICK",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043221658,"WOHLRAB, KURT, PATRICK",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 85 , 156 , 304 ,$#,,
MEDICAID DIRECT,1841460102,AFTER HOURS URGENT CARE PA,AFTER HOURSURGENT CARE PA,1220 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1043222730,"PATEL, RAMESH, VELABHAI",1220 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 36 , 66 , 116 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 49 , 49 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 35 , 67 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 32 , 49 , 120 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",111 DORSETT DR   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",111 DORSETT DR   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",111 DORSETT DR   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043223977,"JOHNSON, ERNEST, FRANK",611 MOCKSVILLE AVE STE 202 SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043224058,"TSENG, HENRY, HSIEN CHUN",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 20 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043224058,"TSENG, HENRY, HSIEN CHUN",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 49 , 119 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043224058,"TSENG, HENRY, HSIEN CHUN",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 37 , 45 , 112 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043224082,"VANMATER, HEATHER, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology, 14 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043224082,"VANMATER, HEATHER, ANN",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE N KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1043226574,"IQBAL, MOHAMMAD, OMER",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1043226574,"IQBAL, MOHAMMAD, OMER",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043226574,"IQBAL, MOHAMMAD, OMER",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 319 ," 1,022 "," 2,152 "," $43,687.36 ",,
MEDICAID DIRECT,1043227002,WALGREEN CO,WALGREENS 06813,4701 W MARKET ST   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1043227002,WALGREEN CO,4701 W MARKET ST   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1043228729,"BOWMAN, TRACY, MARIE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043228836,"LEWIS, DEQUINCY, ANDREW",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 99 , 220 , 221 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043230998,"WOLFE, JON, RICHARD",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043230998,"WOLFE, JON, RICHARD",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043230998,"WOLFE, JON, RICHARD",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 42 , 103 ,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,53 S FRENCH BROAD AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1043231376,"LARSEN, MEGAN",53 S FRENCH BROAD AVE STE 200 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,2315 ASHEVILLE HWY STE 40 HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1043231376,"LARSEN, MEGAN",2315 ASHEVILLE HWY STE 40 HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043231434,"ALEXANDER, JAMES, CHESTER",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043231434,"ALEXANDER, JAMES, CHESTER",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043231707,"COOK, AMANDA, LYNN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043231707,"COOK, AMANDA, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 30 , 48 , 78 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043231707,"COOK, AMANDA, LYNN",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043231707,"COOK, AMANDA, LYNN",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 64 , 81 , 186 ," $13,824.45 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043232127,"PUROHIT, AMITABH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043232127,"PUROHIT, AMITABH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043232127,"PUROHIT, AMITABH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 66 , 66 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 33 , 33 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",601 N ELM ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 427 , 886 ," 2,739 "," $25,986.95 ",,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",3604 PETERS CT   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",3801 W MARKET ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 17 , 51 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",3610 PETERS CT   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043232606,"BEAUFORD, WAYNE",3605 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 49 , 66 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043232879,"GORDON, JONATHAN, PAUL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043232887,"HUYNH, TOAN, THIET",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043232887,"HUYNH, TOAN, THIET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 66 , 170 , 187 ," $16,035.03 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043232887,"HUYNH, TOAN, THIET",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043232887,"HUYNH, TOAN, THIET",600 HOSPITAL DR   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043232887,"HUYNH, TOAN, THIET",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043233299,"LEWIS, EDWARD, ALAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 85 , 104 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1043233299,"LEWIS, EDWARD, ALAN",310 OVERLOOK RD   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 137 , 209 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,5718 HIGHWAY 64 W STE 10 MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1043233299,"LEWIS, EDWARD, ALAN",310 OVERLOOK RD   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043233299,"LEWIS, EDWARD, ALAN",310 OVERLOOK RD   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 47 , 70 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1043233299,"LEWIS, EDWARD, ALAN",310 OVERLOOK RD   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043234370,"SALMON, JOHN, STUART",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043234370,"SALMON, JOHN, STUART",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 37 , 79 , 105 ,$#,,
MEDICAID DIRECT,1720033988,MCLEOD MEDICAL CENTER DILLION,MCLEOD MEDICAL CENTER DILLON,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043234834,"ERUCHALU, IFEANYICHUKWU, MADUBOBI",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043234834,"ERUCHALU, IFEANYICHUKWU, MADUBOBI",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043235542,"VERFURTH, FRANCIS, THEODORE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043235591,"ANTONIAZZI, JILL, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 147 , 148 , 194 ," $13,076.66 ",,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043236037,"WELLS, SARAH, MARGARET",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043236037,"WELLS, SARAH, MARGARET",410 N MAIN ST   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043236318,"YAVORSKI JR, ROBERT, THOMAS",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 42 , 45 , 45 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043236318,"YAVORSKI JR, ROBERT, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1043237209,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1661,4101 W VERNON AVE   KINSTON NC,054,Lenoir,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1043237209,WAL-MART STORES EAST LP,4101 W VERNON AVE   KINSTON NC,054,Lenoir,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1043237209,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1661,4101 W VERNON AVE   KINSTON NC,054,Lenoir,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1043237209,WAL-MART STORES EAST LP,4101 W VERNON AVE   KINSTON NC,054,Lenoir,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043237472,"SOUTH, STEPHEN, ALAN",2703 HENRY ST   GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 20 , 49 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1043238587,"FREDERICK, SUSAN, FLOWERS",152 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043238587,"FREDERICK, SUSAN, FLOWERS",152 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 62 , 84 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043241763,"NICHOLS III, JAMES, COVINGTON",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 84 , 148 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043244809,"SMITH, VINCENT, NICHOLAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043244809,"SMITH, VINCENT, NICHOLAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043244809,"SMITH, VINCENT, NICHOLAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1043244809,"SMITH, VINCENT, NICHOLAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1043245004,"LONGBINE, TIMOTHY, WAYNE",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043245004,"LONGBINE, TIMOTHY, WAYNE",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1386319473,FRAZELLE LEE & WINNEBERGERASSOCPLLC,ATLANTIC DENTAL GROUP,1301 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043246705,"FRAZELLE, GRAHAM, BARRY",1301 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 50 , 137 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043248958,"FERRANTI, JEFFREY, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043249592,"OWEN, LAURA, BORDERS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1174714034,PATIENT CENTERED CARE PLLC,~,5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043249741,"ADAMS WINGATE, DEBORAH, ANN",5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 70 , 111 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043250111,"DICKERSON, JANICE, FISHER",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 42 , 101 ,$#,,
MEDICAID DIRECT,1841526837,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATR,5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043250293,"TAKAHASHI, REBECCA, LYNN",5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 34 ,$#,,
MEDICAID DIRECT,1043250350,FORSYTH COUNTY,Forsyth County Ambulance,911 E 5TH ST   WINSTON SALEM NC,034,Forsyth,3416L0300X,Transportation Services,Ambulance,Land Transport,1043250350,FORSYTH COUNTY,911 E 5TH ST   WINSTON SALEM NC,034,Forsyth,3416L0300X,Transportation Services,Ambulance,Land Transport," 2,662 "," 4,795 "," 8,384 "," $144,468.43 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043250590,"BERRY, WILLIAM, ROSSER",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 28 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043250590,"BERRY, WILLIAM, ROSSER",313 AIRPORT RD   KINSTON NC,054,Lenoir,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043250590,"BERRY, WILLIAM, ROSSER",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1043250590,"BERRY, WILLIAM, ROSSER",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1659418515,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE TIMBERLYNE,77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043250996,"MCMENEMY, JOHN, WILLIAM",77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 27 , 55 ,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1043251291,"BOYD, KRISTINE, DEE",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043251291,"BOYD, KRISTINE, DEE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043251291,"BOYD, KRISTINE, DEE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043251325,"BENECK, JOHN, JOSEPH",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043251325,"BENECK, JOHN, JOSEPH",850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 36 , 59 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043251341,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,547 "," 1,765 "," 1,807 "," $40,508.57 ",,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1043251341,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043255219,"MAYNOR JR, BOBBY, RAY",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043255219,"MAYNOR JR, BOBBY, RAY",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 104 , 204 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043255219,"MAYNOR JR, BOBBY, RAY",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043256258,"MURRAY, JOHN, CARROLL",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 26 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043256258,"MURRAY, JOHN, CARROLL",2100 ERWIN RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043256258,"MURRAY, JOHN, CARROLL",2100 ERWIN RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043256258,"MURRAY, JOHN, CARROLL",2100 ERWIN RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043256258,"MURRAY, JOHN, CARROLL",2100 ERWIN RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1720592413,ICARD AND STREIN PLLC,ICARD AND STREIN FAMILY DENTISTRY,5500 NC HIGHWAY 49 S STE 500 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1043256985,"ICARD, MARK",5500 NC HIGHWAY 49 S STE 500 HARRISBURG NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 45 , 149 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1043257090,"SQUIRES, SHAYNE, ROGER",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1043257090,"SQUIRES, SHAYNE, ROGER",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1043257090,"SQUIRES, SHAYNE, ROGER",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1043257090,"SQUIRES, SHAYNE, ROGER",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 117 , 177 , 224 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043257603,"PSIKULA, STACEY, LEIGH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043257603,"PSIKULA, STACEY, LEIGH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043259500,"CAMMOCK, CHARLES, DANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 61 , 61 , 70 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043261076,"JOHNSON, HOLLY, PUGH",3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 36 , 56 , 77 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043261076,"JOHNSON, HOLLY, PUGH",451 RUIN CREEK RD STE 204 HENDERSON NC,091,Vance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 77 , 91 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043262371,"LE, THUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043262371,"LE, THUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043262371,"LE, THUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 48 , 60 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043263361,"ANGLEMYER, BRADLEY, LAMAR",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 25 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 28 , 64 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043263387,"LIANG, JAMES, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437459021,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH UROLOGY LINCOLN,441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1043264484,"REINE, ALDEN, HENRY",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,208800000X,Allopathic & Osteopathic Physicians,Urology,, 33 , 51 , 72 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043264484,"REINE, ALDEN, HENRY",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043264484,"REINE, ALDEN, HENRY",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043264484,"REINE, ALDEN, HENRY",101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043265051,"PLYMYER, MATTHEW, RAY",200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 14 , 28 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1043265051,"PLYMYER, MATTHEW, RAY",200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 427 , 435 ," 1,166 "," $32,433.11 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1043265051,"PLYMYER, MATTHEW, RAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1295772903,MECKLENBURG HEART SPECIALISTS PA,~,2711 RANDOLPH RD STE 305 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043266943,"QURESHI, AAMER, ASGHAR",2711 RANDOLPH RD STE 305 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 222 ," 1,249 "," 1,998 "," $82,010.30 ",,
MEDICAID DIRECT,1295772903,MECKLENBURG HEART SPECIALISTS PA,~,2711 RANDOLPH RD STE 305 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043266943,"QURESHI, AAMER, ASGHAR",2711 RANDOLPH RD STE 305 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193400000X,Group,Single Specialty,,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,1302 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,, 16 ,#,#,$#,,
MEDICAID DIRECT,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193200000X,Group,Multi-Specialty,,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,1302 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043269681,"PRABHAKAR, JOSIE, DANIELLE",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043269681,"PRABHAKAR, JOSIE, DANIELLE",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1043269681,"PRABHAKAR, JOSIE, DANIELLE",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043269681,"PRABHAKAR, JOSIE, DANIELLE",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043270846,"GOUCH, JOHN, B",~,3616 MICHIGAN AVE   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1043270846,"GOUCH, JOHN, B",3616 MICHIGAN AVE   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 787 ," 1,398 "," 4,492 "," $260,004.86 ",,
MEDICAID DIRECT,1043271539,SMA MEDICAL INC,SMA SPECIALTY MEDICAL LAB,940 PENNSYLVANIA BLVD   FEASTERVILLE TREVOSE PA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1043271539,SMA MEDICAL INC,940 PENNSYLVANIA BLVD   FEASTERVILLE TREVOSE PA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 23 , 30 , 328 ,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1043271778,"JOHNSON, DELORES, LORRAINE",105 MCALPINE LN   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043271778,"JOHNSON, DELORES, LORRAINE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043272339,"MOORE, REGINALD, GRAHAM",1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1962941773,DLP FRYE MEDICAL GROUP,FRYECARE URGENT CARE,1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043272339,"MOORE, REGINALD, GRAHAM",1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043273493,"COOK, ROBIN, SUZETTE",1995 WELLNESS BLVD BLDG B MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 138 , 300 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043273675,"SILEO, DANIEL, ROBERT",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043273675,"SILEO, DANIEL, ROBERT",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043273675,"SILEO, DANIEL, ROBERT",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043274244,"MEIER, JOHN, HARVEY",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 44 , 75 , 85 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043274335,"CRAIG III, WILLIAM, LEWIS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043274335,"CRAIG III, WILLIAM, LEWIS",3311 JESSIE VILLAGE DR   CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043274335,"CRAIG III, WILLIAM, LEWIS",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043274335,"CRAIG III, WILLIAM, LEWIS",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 63 , 111 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043274335,"CRAIG III, WILLIAM, LEWIS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 25 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 33 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1043275878,"MERRITT, JAMES, MITCHELL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043277304,"GUHA, PRABAL, KUMAR",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043277304,"GUHA, PRABAL, KUMAR",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043277882,"MEHTA, TEJAL, VIJAY",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 34 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043277882,"MEHTA, TEJAL, VIJAY",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043277882,"MEHTA, TEJAL, VIJAY",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 39 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043278864,"KOKICHASHVILI, MAIA",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1043279755,"RIDDLE, CHARLOTTE, THOMAS",50 HOSPITAL DR STE 5D HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 61 , 94 ,$#,,
MEDICAID DIRECT,1235514456,TRANQUIL ANESTHESIOLOGY LLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1043280027,"YOUNGER, JEFFREY, WAYNE",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043280241,"RICH, KELLY, GARDNER",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043281256,"MANN, CHRISTOPHER, DARIN",1325 SPRING ST   GREENWOOD SC,102,Out of State > 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043281314,"GIVENS, DAVIDSON, HOWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043283211,"RAMSAY, LAURA, BEST",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043283211,"RAMSAY, LAURA, BEST",4130 CLEMMONS RD   CLEMMONS NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043283211,"RAMSAY, LAURA, BEST",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 30 , 47 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043283211,"RAMSAY, LAURA, BEST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043283229,"FERRIS, LAURA, KORB",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043283229,"FERRIS, LAURA, KORB",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 16 , 17 , 26 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043285166,"SCHNEIDER, ALEXANDER, TARO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 72 , 109 , 109 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043285620,"CALDWELL, JOHN, AIKMAN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1346624590,KIDZCARE PEDIATRICS PC,,1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1043285844,"BURKE, SHARON, ANN",1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 27 ,$#,,
MEDICAID DIRECT,1760865760,KIDZCARE PEDIATRICS PC,,1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043285844,"BURKE, SHARON, ANN",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 66 , 186 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 759 , 893 ," 1,661 "," $22,486.33 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,645 AMALIA ST NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,645 AMALIA ST NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,#, 13 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,400 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,400 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043287766,"BARNHARDT, VIRGINIA, JOHNSTON",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 323 , 323 ," $11,416.97 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1043288210,"DALTON, DOUGLAS",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1043288210,"DALTON, DOUGLAS",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 67 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1043288210,"DALTON, DOUGLAS",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1043288210,"DALTON, DOUGLAS",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 53 , 135 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043288962,"ALEXANDER, WELLESLEY, EVANS",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043289028,"FENSTERMACHER, WILLIAM, LEE",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1043290331,"ERLANDSON, STEPHEN, ERIC",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356852511,GRACE CLINIC OF YADKIN VALLEY,,948 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1043290331,"ERLANDSON, STEPHEN, ERIC",948 JOHNSON RIDGE RD   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 80 , 126 ,$#,,
MEDICAID DIRECT,1356852511,GRACE CLINIC OF YADKIN VALLEY,,948 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1043290331,"ERLANDSON, STEPHEN, ERIC",948 JOHNSON RIDGE RD   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043290539,"DEJOURNETT, LEON, MARTIN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043290539,"DEJOURNETT, LEON, MARTIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 96 , 96 ," $19,646.22 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043290539,"DEJOURNETT, LEON, MARTIN",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1245587534,FRENCH BROAD PEDIATRIC ASSOCIATES P,FRENCH BROAD PEDICATRIC ASSOCIATES PLLC,40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1043290695,"TEMPLETON, JOHN, DOUGLAS",40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 68 , 106 , 269 ," $10,692.59 ",,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043290794,"NTIM, WILLIAM, OFORI",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043290794,"NTIM, WILLIAM, OFORI",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 63 , 77 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043290794,"NTIM, WILLIAM, OFORI",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 45 , 45 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043290794,"NTIM, WILLIAM, OFORI",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 38 , 50 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043292345,"LANCE, ERIC, DOUGLAS",1219 LEXINGTON AVE STE A THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 57 , 69 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1043292345,"LANCE, ERIC, DOUGLAS",1219 LEXINGTON AVE STE A THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043292345,"LANCE, ERIC, DOUGLAS",1219 LEXINGTON AVE STE A THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 40 , 68 , 74 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043292386,"LONGSHORE, SHANNON, WRIGHT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 29 , 29 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043292386,"LONGSHORE, SHANNON, WRIGHT",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 33 , 35 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043294382,"JOHNSON, ASHTON, FOX",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043294382,"JOHNSON, ASHTON, FOX",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043294598,"WATTENBARGER, JOHN, MICHAEL",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 212   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043294663,"BAKER, JOHN",300 MEDICAL PKWY STE 212 CHESAPEAKE VA,101,Out of State <= 40 miles,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043294663,"BAKER, JOHN",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043295488,"KOOLE, HENDRIKA, F.",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043295488,"KOOLE, HENDRIKA, F.",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1760865760,KIDZCARE PEDIATRICS PC,,1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043296734,"NUDELMAN, MARC, HOWARD",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164657532,KIDZCARE PEDIATRICS PC,~,5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043296734,"NUDELMAN, MARC, HOWARD",5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346624590,KIDZCARE PEDIATRICS PC,,1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1043296734,"NUDELMAN, MARC, HOWARD",1035 GRANDIFLORA DR   LELAND NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 107 , 219 , 573 ," $28,702.65 ",,
MEDICAID DIRECT,1063896132,KIDZCARE PEDIATRICS PC,,20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1043296734,"NUDELMAN, MARC, HOWARD",20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1043297310,"CHANDLER, JAMES, THORNTON",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1043297310,"CHANDLER, JAMES, THORNTON",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 38 , 55 , 89 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1043298417,"BURTON, DENNIS, MORGAN",5206 SW SAVAGE ST   PALM CITY FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 50 , 57 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043298417,"BURTON, DENNIS, MORGAN",5206 SW SAVAGE ST   PALM CITY FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043299175,"CAMPBELL, WILLIAM, EGBERT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043299175,"CAMPBELL, WILLIAM, EGBERT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 24 , 47 ,$#,,
MEDICAID DIRECT,1487633780,SHELBY RADIOLOGICAL ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1043299175,"CAMPBELL, WILLIAM, EGBERT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043299290,"PANUSKI, REBECCA, MCELHANNON",106 CORPORATE PARK DR STE 200&300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 47 ,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043299761,"ENGLISH, MICHELLE, DENISE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043304215,GREENSBORO OPHTHAMOLOGY ASSOCIATES,GREENSBORO OPHTHAMOLOGY ASSOCIATES,8 N POINTE CT   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043304215,GREENSBORO OPHTHAMOLOGY ASSOCIATES,8 N POINTE CT   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1609461748,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH INTERNAL MEDICINE - DR DOUGLAS SCH,237 N FAYETTEVILLE ST STE D ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1043305121,"MOON, AMY, ASBILL",237 N FAYETTEVILLE ST STE D ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 201 , 312 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043305675,"ZEILENDER, STUART, BRUCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 45 , 45 ," $13,213.59 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043305675,"ZEILENDER, STUART, BRUCE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043305675,"ZEILENDER, STUART, BRUCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 64 , 73 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1043306012,"SCOTT, DUSTY, LYNN",1001 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 27 , 27 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1043306012,"SCOTT, DUSTY, LYNN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 38 , 52 ,$#,,
MEDICAID DIRECT,1104066794,CAROLINAEAST PHYSICIANS,CAROLINAEAST HEART CENTER,1001 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1043306012,"SCOTT, DUSTY, LYNN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 48 , 71 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6901 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043309198,"WILSON, COURTNEY, WATSON",6901 MARKET ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1043309669,"GOODWIN, GREGORY, WAYNE",1269 US HIGHWAY 221A   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1063196327,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD EAST FAMILY CARE RHC,605 NC 120 HWY   MOORESBORO NC,023,Cleveland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1043309669,"GOODWIN, GREGORY, WAYNE",212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639853997,DLP RUTHERFORD PHYSICIAN PRACTICES,CHASE FAMILY CARE RHC,1269 US HIGHWAY 221A   FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1043309669,"GOODWIN, GREGORY, WAYNE",212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 144 , 334 , 359 ," $14,366.52 ",,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1043309669,"GOODWIN, GREGORY, WAYNE",212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 31 ,$#,,
MEDICAID DIRECT,1790895126,BARRETT & COLLINS DDS PLLC,,313 HOSPITAL RD   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1043311012,"BARRETT, MARK, SHAWVER",313 HOSPITAL RD   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 45 , 82 , 144 ,$#,,
MEDICAID DIRECT,1043313489,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05757,124 QUBEIN AVE   HIGH POINT NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1043313489,NORTH CAROLINA CVS PHARMACY LLC,124 QUBEIN AVE   HIGH POINT NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1043313489,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05757,124 QUBEIN AVE   HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043313489,NORTH CAROLINA CVS PHARMACY LLC,124 QUBEIN AVE   HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1043313547,"MCCARTY, ELIZABETH, TRIPP",120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043313547,"MCCARTY, ELIZABETH, TRIPP",1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043313547,"MCCARTY, ELIZABETH, TRIPP",1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043313547,"MCCARTY, ELIZABETH, TRIPP",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043313547,"MCCARTY, ELIZABETH, TRIPP",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043313547,"MCCARTY, ELIZABETH, TRIPP",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 23 , 30 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,140 W MILLS ST STE A COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1043313547,"MCCARTY, ELIZABETH, TRIPP",140 W MILLS ST STE A COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043313893,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03529,520 N CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043313893,NORTH CAROLINA CVS PHARMACY LLC,520 N CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043314461,"RAFFERTY, MAUREEN",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043314461,"RAFFERTY, MAUREEN",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043317126,"MARTINIE, DANIEL, JASON",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043317688,"GUANGA, JOYCE, PORTAL",JOYCE P GUANGA DDS PA,640 HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1043317688,"GUANGA, JOYCE, PORTAL",640 HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 138 , 316 ," 1,511 "," $71,022.42 ",,
MEDICAID DIRECT,1669187522,TRISHA-LORAY ABARO APRECIO DDS PC,AIRA DENTAL,1609 W ARLINGTON BLVD STE 107 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043317688,"GUANGA, JOYCE, PORTAL",1609 W ARLINGTON BLVD STE 107 GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 318 , 342 ," 1,383 "," $70,706.65 ",,
MEDICAID DIRECT,1669187522,TRISHA-LORAY ABARO APRECIO DDS PC,AIRA DENTAL,1609 W ARLINGTON BLVD STE 107 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043317688,"GUANGA, JOYCE, PORTAL",640 HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1487809265,SOUND MEDICAL OF CAPE CATERET,~,3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1043319684,"STERN, ANDREW, EVAN",300 PENNY LN   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1487809265,SOUND MEDICAL OF CAPE CATERET,~,3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1043319684,"STERN, ANDREW, EVAN",3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043321011,"SARWAL, AARTI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1083751127,ROBERT L YOUNG JR DDS PLLC,YOUNG AND POLITE CHILDRENS DENTISTRY,11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043321730,"YOUNG, ROBERT, LOUIS",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,850 "," 2,531 "," 9,055 "," $338,416.09 ",,
MEDICAID DIRECT,1083751127,ROBERT L YOUNG JR DDS PLLC,YOUNG AND POLITE CHILDRENS DENTISTRY,11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043321730,"YOUNG, ROBERT, LOUIS",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 19 , 19 , 70 ,$#,,
MEDICAID DIRECT,1366971384,YOUNG AND POLITE YOUNG DDS PA,~,3010 BAUCOM RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043321730,"YOUNG, ROBERT, LOUIS",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 899 ," 1,698 "," 6,962 "," $274,212.86 ",,
MEDICAID DIRECT,1114210531,LORETTE POLITE YOUNG DDS PA,~,2514 CUTHBERTSON RD STE B WAXHAW NC,090,Union,193400000X,Group,Single Specialty,,1043321730,"YOUNG, ROBERT, LOUIS",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 279 , 332 ," 1,209 "," $49,529.22 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043325046,"KING, TIMOTHY, COOPER",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043326465,"ARMSTRONG, DON, MICHAEL",204 MEDSPRING DR   CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043326465,"ARMSTRONG, DON, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043326465,"ARMSTRONG, DON, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043326465,"ARMSTRONG, DON, MICHAEL",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 24 , 40 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043326465,"ARMSTRONG, DON, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043326465,"ARMSTRONG, DON, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 31 , 32 , 34 ," $15,685.14 ",,
MEDICAID DIRECT,1043328214,TRIAD ORTHOTICS AND PEDORTHICS INC,TRIAD O AND P,2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043328214,TRIAD ORTHOTICS AND PEDORTHICS INC,2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 17 ,$#,,
MEDICAID DIRECT,1942319595,CHOICE PEDIATRIX PA,~,308 S LAWRENCE ST   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1043329691,"EGBE, PATRICK, EYAYE",308 S LAWRENCE ST   ROCKINGHAM NC,077,Richmond,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 51 , 104 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043330012,"ZHANG, DEKUI",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043330012,"ZHANG, DEKUI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 186 , 186 ,$#,,
MEDICAID DIRECT,1417499112,CAROLINA PHYSICAL THERAPY ASSOCIATE,CAROLINA PHYSICAL THERAPY ASSOCIATES - LOUISBURG,1501 N BICKETT BLVD STE F LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1043330020,"JENKINS, KELLY, SHAFFER",627 E WASHINGTON ST   NASHVILLE NC,064,Nash,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1891237673,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,627 E WASHINGTON ST   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1043330020,"JENKINS, KELLY, SHAFFER",627 E WASHINGTON ST   NASHVILLE NC,064,Nash,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043330558,"CLARK, JOSEPH, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 ,#, 11 ," $10,823.65 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043330921,"CHANDLER, LEON, MAKESI",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043330921,"CHANDLER, LEON, MAKESI",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043330921,"CHANDLER, LEON, MAKESI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 60 , 88 , 114 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043331044,"SAFTA, ANCA, MIHAELA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 63 , 131 , 142 ," $13,547.71 ",,
MEDICAID DIRECT,1780758664,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER CLINIC,916 COX RD STE 209 GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043332786,"RAJ, AMAN",916 COX RD STE 209 GASTONIA NC,036,Gaston,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1780758664,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER CLINIC,916 COX RD STE 209 GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043332786,"RAJ, AMAN",916 COX RD STE 209 GASTONIA NC,036,Gaston,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1043334667,"GRUGAN, KIMBERLY, ANNE",472 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760676035,DR CHRISTOPHER K MAUNEY OPTOMETRY,,355 MAIN ST   MC ADENVILLE NC,036,Gaston,193400000X,Group,Single Specialty,,1043336878,"MAUNEY, CHRISTOPHER, KENNEDY",355 MAIN ST   MC ADENVILLE NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043337405,"CALE, SHAWN, MATTHEW",1470 E GASTON ST   LINCOLNTON NC,055,Lincoln,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 38 ,$#,,
MEDICAID DIRECT,1043338247,BURLINGTON CARE CENTER,BURLINGTON CARE CENTER,2201 BURCH BRIDGE RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1043338247,BURLINGTON CARE CENTER,2201 BURCH BRIDGE RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 2,509 "," 2,588 "," $190,389.71 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,190 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1043342405,"WRIGHT, JAMES, FRANCIS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043342405,"WRIGHT, JAMES, FRANCIS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043342405,"WRIGHT, JAMES, FRANCIS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1043342405,"WRIGHT, JAMES, FRANCIS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1043344328,"OLCOTT, SUSAN, LOUISE",SUSAN LOUISE OLCOTT,520 S ALLEN RD STE 4 FLAT ROCK NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,1043344328,"OLCOTT, SUSAN, LOUISE",520 S ALLEN RD STE 4 FLAT ROCK NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice, 582 ," 1,154 "," 6,018 "," $212,891.71 ",,
MEDICAID DIRECT,1043344435,BIOTHERANOSTICS INC,,6333 SEQUENCE DR   SAN DIEGO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1043344435,BIOTHERANOSTICS INC,6333 SEQUENCE DR   SAN DIEGO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043346877,"RIZZIERI, DAVID, ALAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1043351448,"BEANE, ALICE, DIANN",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 19 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1043351448,"BEANE, ALICE, DIANN",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 113 , 121 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1043351448,"BEANE, ALICE, DIANN",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1043351448,"BEANE, ALICE, DIANN",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043356868,"LJUNG, TOR, MARTIN",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 12 , 16 , 21 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043356868,"LJUNG, TOR, MARTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1043357031,"CREECH, TIMOTHY, RAY",TIMOTHY RAY CREECH DDS PA,812 N ARENDELL AVE   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1043357031,"CREECH, TIMOTHY, RAY",812 N ARENDELL AVE   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 136 , 314 ," $15,452.89 ",,
MEDICAID DIRECT,1043357643,CARLYLE DUKES HAYWOOD JR,DOCTORS VISION CENTER,326 ALBEMARLE RD   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1043357643,CARLYLE DUKES HAYWOOD JR,326 ALBEMARLE RD   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,, 50 , 49 , 98 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043358344,"KELLY, MAUREEN, MULLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 69 , 97 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1043359532,"ELMS, JULIE, COOPER",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 65 , 65 , 65 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043361108,"FITZGERALD, MILISSA, JOHNSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1043361553,"COSTA, VIVIAN, CAMILLE",Vivian Camille Costa,476 NAHUNTA RD   PIKEVILLE NC,096,Wayne,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1043361553,"COSTA, VIVIAN, CAMILLE",476 NAHUNTA RD   PIKEVILLE NC,096,Wayne,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043367915,"CARPENTER, CODY, GARRETT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 51 , 55 , 58 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043367915,"CARPENTER, CODY, GARRETT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1043368533,AGING DISABILITY & TRANSIT SERVICE,AGING DISABILITY & TRANSIT SERVICES OF ROCKINGHAM,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,332U00000X,Suppliers,Home Delivered Meals,,1043368533,AGING DISABILITY & TRANSIT SERVICE,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,332U00000X,Suppliers,Home Delivered Meals,, 18 , 378 , 378 ," $11,434.50 ",,
MEDICAID DIRECT,1043368533,AGING DISABILITY & TRANSIT SERVICE,AGING DISABILITY & TRANSIT SERVICES OF ROCKINGHAM,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,332U00000X,Suppliers,Home Delivered Meals,,1043368533,AGING DISABILITY & TRANSIT SERVICE,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1043368533,AGING DISABILITY & TRANSIT SERVICE,AGING DISABILITY & TRANSIT SERVICES OF ROCKINGHAM,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1043368533,AGING DISABILITY & TRANSIT SERVICE,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 666 ," 13,868 "," 14,016 "," $2,366,461.10 ",,
MEDICAID DIRECT,1043368533,AGING DISABILITY & TRANSIT SERVICE,AGING DISABILITY & TRANSIT SERVICES OF ROCKINGHAM,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1043368533,AGING DISABILITY & TRANSIT SERVICE,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1043368533,AGING DISABILITY & TRANSIT SERVICE,AGING DISABILITY & TRANSIT SERVICES OF ROCKINGHAM,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,251B00000X,Agencies,Case Management,,1043368533,AGING DISABILITY & TRANSIT SERVICE,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,251B00000X,Agencies,Case Management,, 383 ," 19,156 "," 19,746 "," $1,744,875.14 ",,
MEDICAID DIRECT,1043368533,AGING DISABILITY & TRANSIT SERVICE,AGING DISABILITY & TRANSIT SERVICES OF ROCKINGHAM,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1043368533,AGING DISABILITY & TRANSIT SERVICE,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 79 , 98 , 100 ," $149,771.77 ",,
MEDICAID DIRECT,1043368533,AGING DISABILITY & TRANSIT SERVICE,AGING DISABILITY & TRANSIT SERVICES OF ROCKINGHAM,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,,1043368533,AGING DISABILITY & TRANSIT SERVICE,105 LAWSONVILLE AVE   REIDSVILLE NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,, 176 ," 31,959 "," 32,035 "," $5,055,424.68 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043369069,"MADDEN, JOHN, FRANCIS",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043369069,"MADDEN, JOHN, FRANCIS",2301 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 15 , 17 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043369069,"MADDEN, JOHN, FRANCIS",2301 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 36 , 38 , 66 ,$#,,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1043370521,"SCHEFFLER, NICOLE, MARIE",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 49 , 80 , 92 ," $18,939.00 ",,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1043370521,"SCHEFFLER, NICOLE, MARIE",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 188 , 358 , 419 ," $87,187.59 ",,
MEDICAID DIRECT,1073891719,CAROMONT MEDICAL GROUP INC,CAROMONT PATHOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1043371420,"NGUYEN, CHRIS, BRIAN",2525 COURT DR   GASTONIA NC,036,Gaston,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1073891719,CAROMONT MEDICAL GROUP INC,CAROMONT PATHOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043371420,"NGUYEN, CHRIS, BRIAN",2525 COURT DR   GASTONIA NC,036,Gaston,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 93 , 94 , 115 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043373038,"DENEVE, JEREMIAH, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 31 , 38 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043373087,"STACY, SHANNON, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1043373087,"STACY, SHANNON, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 13 , 20 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043373087,"STACY, SHANNON, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043373087,"STACY, SHANNON, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043373087,"STACY, SHANNON, MARIE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043373087,"STACY, SHANNON, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 45 , 62 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043373087,"STACY, SHANNON, MARIE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 21 , 26 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043374135,"PAQUETTE, DAVID, WAYNE",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0300X,Dental Providers,Dentist,Periodontics, 34 , 50 , 77 ,$#,,
MEDICAID DIRECT,1043375009,SOUTHERN ASSISTED LIVING INC,BROOKDALE LAWNDALE PARK,4400 LAWNDALE DR   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1043375009,SOUTHERN ASSISTED LIVING INC,4400 LAWNDALE DR   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 962 , 962 ," $69,293.62 ",,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043376999,"BAJAJ, JASDIP, GINA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043376999,"BAJAJ, JASDIP, GINA",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 22 , 32 , 32 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 30 , 30 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043377591,"RAMIAH, VESHANA, SINTHAL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 30 , 30 ,$#,,
MEDICAID DIRECT,1043379746,COUNTY OF CABARRUS OFFICE OF TREASU,CABARRUS COUNTY DEPARTMENT OF HUMAN SERVICES,1303 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1043379746,COUNTY OF CABARRUS OFFICE OF TREASU,1303 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 490 ," 12,057 "," 12,308 "," $664,303.15 ",,
MEDICAID DIRECT,1689031783,M THOMAS JONES DMD PA,ADAMS FARM FAMILY DENTAL,5710 W GATE CITY BLVD STE R GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043381999,"MOORING, RONALD, EDWARD",5710 W GATE CITY BLVD STE R GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 55 , 67 , 207 ,$#,,
MEDICAID DIRECT,1710056635,J SELIG COOPER DDS PA,~,1515 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043382096,"COOPER, JAVON, SELIG",1515 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 131 , 286 , 900 ," $37,983.97 ",,
MEDICAID DIRECT,1043382096,"COOPER, JAVON, SELIG",~,1515 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1043382096,"COOPER, JAVON, SELIG",1515 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043382526,"HUANG, DAVID, YU YIAO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 50 , 50 ,$#,,
MEDICAID DIRECT,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,~,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,2716 HENRY ST   GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,~,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 199 , 240 ," 1,453 "," $212,144.96 ",,
MEDICAID DIRECT,1629730130,STATESVILLE AMY KINLAW PLLC,IREDELL PEDIATRIC DENTISTRY,1316 DAVIE AVE STE C STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1043385313,"RANKIN, GEORGE, RICHARD",1316 DAVIE AVE STE C STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1043385990,HEAVENLY HANDS FAMILY SERVICES,HEAVENLY HANDS HOME CARE LTD,8501 TOWER POINT DR STE D-9 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1043385990,HEAVENLY HANDS FAMILY SERVICES,8501 TOWER POINT DR STE D-9 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 2,681 "," 2,714 "," $246,708.24 ",,
MEDICAID DIRECT,1043385990,HEAVENLY HANDS FAMILY SERVICES,HEAVENLY HANDS HOME CARE LTD,8501 TOWER POINT DR STE D1 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1043385990,HEAVENLY HANDS FAMILY SERVICES,8501 TOWER POINT DR STE D1 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 631 , 631 ," $42,888.16 ",,
MEDICAID DIRECT,1043386477,"HENAO, PAULA, ANDREA",PAULA A HENAO DDS PA,5731 ROBIN WOOD LN   WINSTON SALEM NC,034,Forsyth,1223P0700X,Dental Providers,Dentist,Prosthodontics,1043386477,"HENAO, PAULA, ANDREA",5731 ROBIN WOOD LN   WINSTON SALEM NC,034,Forsyth,1223P0700X,Dental Providers,Dentist,Prosthodontics, 577 ," 1,481 "," 4,487 "," $293,646.71 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043388739,"MORAITIS, LAURA, BETH",165 LOWES FOOD DRIVE   LEWISVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 40 , 79 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043388739,"MORAITIS, LAURA, BETH",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043388739,"MORAITIS, LAURA, BETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 27 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043390305,"GULATI, AJAY, SUJAN",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043390305,"GULATI, AJAY, SUJAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 15 , 37 , 38 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1043390925,"DITTY, JACK, FOSTER",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 83 , 88 , 90 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043391063,"TAYLOR, ANNA GRETA, BIRCH",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043391063,"TAYLOR, ANNA GRETA, BIRCH",600 HOSPITAL DR   MONROE NC,090,Union,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043391063,"TAYLOR, ANNA GRETA, BIRCH",6068 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043392145,"MAURO, MATTHEW, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 85 , 88 , 94 ,$#,,
MEDICAID DIRECT,1043392418,"THAKKAR, JAGRUTI, PRADIP",~,1600 CURTIS BRIDGE RD   WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,1043392418,"THAKKAR, JAGRUTI, PRADIP",1600 CURTIS BRIDGE RD   WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 274 , 595 ," 2,605 "," $134,226.70 ",,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043393200,"GARWOOD, DAWN, MARIE",250 HOSPICE CIR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255932828,LABORATORY MEDICINE PC,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043393820,"CAUDELL, PATRICIA, BREED",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1043394901,"SHANAHAN, JOSEPH",~,2222 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,1043394901,"SHANAHAN, JOSEPH",2222 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 30 , 49 , 80 ,$#,,
MEDICAID DIRECT,1912235268,SHANAHAN RHEUMATOLOGY AND IMMUNOTHE,SHANAHAN RHEUMATOLOGY AND IMMUNOTHERAPY PLLC,2222 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1043394901,"SHANAHAN, JOSEPH",2222 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 16 , 29 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043394950,"GRAFFAGNINO, CARMELO",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043394950,"GRAFFAGNINO, CARMELO",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 33 , 34 ,$#,,
MEDICAID DIRECT,1780822098,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF RALEIGH,10880 DURANT RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043395171,"DEOGUN, GURVINDER, KAUR",10880 DURANT RD STE 200 RALEIGH NC,092,Wake,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 25 , 65 , 90 ,$#,,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043395585,"PINCKNEY, JOSEPH, DELACY",9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 85 , 117 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043395585,"PINCKNEY, JOSEPH, DELACY",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043395585,"PINCKNEY, JOSEPH, DELACY",9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 48 , 62 ,$#,,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043395585,"PINCKNEY, JOSEPH, DELACY",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1518906700,CHARLES A CANNON JR MEMORIAL HOSPIT,,436 HOSPITAL DR STE 235 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1043395965,"MARKLAND, ELLA, TRIVETT",436 HOSPITAL DR STE 235 LINVILLE NC,006,Avery,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1518906700,CHARLES A CANNON JR MEMORIAL HOSPIT,,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1043395965,"MARKLAND, ELLA, TRIVETT",434 HOSPITAL DR   LINVILLE NC,006,Avery,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1538538509,MUSTARD SEED COMMUNITY HEALTH,,238 S ENGLISH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043398969,"MULBERRY, ELIZABETH, MARIE",238 S ENGLISH ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 34 , 41 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043403637,"COTTLE, KEITH, BRYAN",3803 ROBERT PORCHER WAY   GREENSBORO NC,041,Guilford,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043408008,"POSTON, HOLLY, ELIZABETH",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043408008,"POSTON, HOLLY, ELIZABETH",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043408008,"POSTON, HOLLY, ELIZABETH",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043408008,"POSTON, HOLLY, ELIZABETH",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124568688,NORTHERN HOSPITAL OF SURRY COUNTY,~,100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1043413693,"YOUELL, LAUREN, BLYTHE",100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 50 , 74 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1043414626,"MUMMADI, SRINIVAS, REDDY",45 PLATEAU ST   BRYSON CITY NC,087,Swain,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1043414626,"MUMMADI, SRINIVAS, REDDY",45 PLATEAU ST   BRYSON CITY NC,087,Swain,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043414865,"FLETCHER, JAMES, COLIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 78 , 78 , 82 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043414865,"FLETCHER, JAMES, COLIN",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043416118,"BARHAMS, AKIRA, LANESE",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 22 , 36 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043416357,"SAUCEDO, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 55 , 55 ,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1043417496,"ISBISTER, BRADLEY, DAGGETT",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043417850,"CARR, JENNIFER, COURTNEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043417850,"CARR, JENNIFER, COURTNEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043417850,"CARR, JENNIFER, COURTNEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043417850,"CARR, JENNIFER, COURTNEY",55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 18 , 26 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043417850,"CARR, JENNIFER, COURTNEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043417850,"CARR, JENNIFER, COURTNEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043418759,"ANAKWENZE, OKE, ADRIAN",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043418759,"ANAKWENZE, OKE, ADRIAN",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043418759,"ANAKWENZE, OKE, ADRIAN",4709 CREEKSTONE DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245231364,HAYWOOD PEDIATRIC AND ADOLESCENT,HAYWOOD PEDIATRICS,15 FACILITY DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1043419666,"VEREEN, TYLER, BAGLEY",15 FACILITY DR   CLYDE NC,044,Haywood,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 73 , 120 , 269 ," $11,397.35 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043420557,"BHAJU, SAJUMA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1043420607,"DURAND SMITH, JENNIFER, ALYS",316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1043420607,"DURAND SMITH, JENNIFER, ALYS",316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 86 , 182 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043424732,"ORNDORFF, DOUGLAS, GEORGE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1043424732,"ORNDORFF, DOUGLAS, GEORGE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043424732,"ORNDORFF, DOUGLAS, GEORGE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043424732,"ORNDORFF, DOUGLAS, GEORGE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043426158,"JAMES, IYORE, AMY-OTABOR",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 21 , 27 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043426158,"JAMES, IYORE, AMY-OTABOR",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 38 , 38 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043426158,"JAMES, IYORE, AMY-OTABOR",8201 HEALTHCARE LOOP STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043429137,"OCONNELL, ELIZABETH, SULLIVAN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 48 , 89 ,$#,,
MEDICAID DIRECT,1235592874,FLEXOGENIX NORTH CAROLINA PC,,1414 YANCEYVILLE ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043429152,"WHALEN, SEAN, PATRICK",400 ASHVILLE AVE STE 330 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 42 ,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1043429152,"WHALEN, SEAN, PATRICK",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1043430911,"MADSEN, MICHAEL, WAYNE",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043430911,"MADSEN, MICHAEL, WAYNE",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 84 , 134 , 187 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043430911,"MADSEN, MICHAEL, WAYNE",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 32 , 41 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043430911,"MADSEN, MICHAEL, WAYNE",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 18 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043430911,"MADSEN, MICHAEL, WAYNE",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043430911,"MADSEN, MICHAEL, WAYNE",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 23 , 37 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043431455,"CLARKE-POUNDER, JESSICA, PEASE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 41 , 42 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043431901,"OXFORD, MOLLY, TALCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205001757,LARISSA M MASTRO DDS PA,AFFORDABLE DENTURES & IMPLANTS - CONOVER,211 ROCK BARN RD NE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1043432396,"STRAKA, WILLIAM, FRANK",211 ROCK BARN RD NE   CONOVER NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 50 , 86 ," $18,347.82 ",,
MEDICAID DIRECT,1205001757,LARISSA M MASTRO DDS PA,AFFORDABLE DENTURES & IMPLANTS - CONOVER,211 ROCK BARN RD NE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043432396,"STRAKA, WILLIAM, FRANK",211 ROCK BARN RD NE   CONOVER NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1144283888,L A LORENZO MD PATHOLOGY CONSULT SE,L A Lorenzo MD Pathology Consult Services,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1043432701,"KOEHLER, ALISON",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 19 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043433790,"CHOWDHURY, KISHORE, ROY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 20 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043433790,"CHOWDHURY, KISHORE, ROY",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1043433790,"CHOWDHURY, KISHORE, ROY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1043433790,"CHOWDHURY, KISHORE, ROY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629123211,COUNTY OF HAYWOOD,~,157 PARAGON PKWY STE 800 CLYDE NC,044,Haywood,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1043436611,"MORGAN, BRAD, CLINTON",157 PARAGON PKWY STE 700 CLYDE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice, 243 , 388 , 730 ," $44,600.70 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043437775,"PAQUIN, VICTOR, CONRAD",1366 NC HIGHWAY 16 S CRESCENT SHOPPING PLAZA NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578668711,"BUJOLD, EDWARD, JAMES",~,4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1043437775,"PAQUIN, VICTOR, CONRAD",4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 33 , 45 ,$#,,
MEDICAID DIRECT,1861685364,EDWARD J BUJOLD MD,GRANITE FALLS FAMILY MEDICAL CENTER,4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1043437775,"PAQUIN, VICTOR, CONRAD",4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 46 , 59 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043437775,"PAQUIN, VICTOR, CONRAD",1366 NC HIGHWAY 16 S CRESCENT SHOPPING PLAZA NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043437775,"PAQUIN, VICTOR, CONRAD",1366 NC HIGHWAY 16 S CRESCENT SHOPPING PLAZA NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1043437775,"PAQUIN, VICTOR, CONRAD",1366 NC HIGHWAY 16 S CRESCENT SHOPPING PLAZA NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043440415,"MOELLER, MOLLY, KATHLEEN",2630 E 7TH ST STE 101 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#, 26 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1043440951,"JOHNSON, MELISSA, LOFTIN",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1043440951,"JOHNSON, MELISSA, LOFTIN",1213 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 23 , 45 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1043440951,"JOHNSON, MELISSA, LOFTIN",106 W MEDICAL PARK DR STE A LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 32 , 61 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1043440951,"JOHNSON, MELISSA, LOFTIN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043441736,"MOUNT, MICHAEL, GORDON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1043441918,CAROLINAS PHYSICIANS NETWORK INC,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043443583,"HARRIS, KIRA, BRICE",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043443583,"HARRIS, KIRA, BRICE",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043444151,"NOBLE, MARK, STEPHEN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 59 , 97 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 22 , 40 , 92 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 14 , 30 ,$#,,
MEDICAID DIRECT,1962727388,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,9625 NORTHCROSS CENTER CT STE 102 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",9625 NORTHCROSS CENTER CT STE 102 HUNTERSVILLE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013232438,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013232438,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",23 SUNNYBROOK RD STE 200 RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043444722,"BORUTA, RICHARD, JUSTIN",23 SUNNYBROOK RD STE 200 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1043446081,"NATARAJ, ANAND, GOPALAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 75 , 78 , 104 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1043446081,"NATARAJ, ANAND, GOPALAN",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 14 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043446404,"SPANHEIMER, PHILIP, MERLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 25 , 32 ,$#,,
MEDICAID DIRECT,1043446453,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07941,8420 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043446453,NORTH CAROLINA CVS PHARMACY LLC,8420 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043447337,"MAGILL, CHRISTYN, FRANCESCA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 72 , 82 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043447410,"JACKSON, CELESTE, TERESE",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043447410,"JACKSON, CELESTE, TERESE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 72 , 171 , 307 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1043448129,"FORREST, TRACY, SALISBURY",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 42 , 65 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043448129,"FORREST, TRACY, SALISBURY",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255390225,WILSON OB GYN,WILSON OB GYN,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1043448129,"FORREST, TRACY, SALISBURY",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 39 , 57 ," $13,189.94 ",,
MEDICAID DIRECT,1235430976,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE PEDIATRICS,2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1043448582,"EVANS, COLIN, MARK",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1043448582,"EVANS, COLIN, MARK",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1043448582,"EVANS, COLIN, MARK",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043449911,"HOLLINS, TABITHA, MICHELLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 64 , 67 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043449911,"HOLLINS, TABITHA, MICHELLE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 60 , 60 ,$#,,
MEDICAID DIRECT,1043451321,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,1349 S MADISON ST STE A WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1043451321,AVID HEALTH AT HOME NORTH CAROLINA,1349 S MADISON ST STE A WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,#, 125 , 125 ," $10,733.96 ",,
MEDICAID DIRECT,1043451321,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,58 PHYSICIAN DR STE 106 SUPPLY NC,010,Brunswick,253Z00000X,Agencies,In Home Supportive Care,,1043451321,AVID HEALTH AT HOME NORTH CAROLINA,58 PHYSICIAN DR STE 106 SUPPLY NC,010,Brunswick,253Z00000X,Agencies,In Home Supportive Care,,#, 429 , 429 ," $43,233.84 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043451966,"CIRIGLIANO, VITO, VINCENZO",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043451966,"CIRIGLIANO, VITO, VINCENZO",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 18 , 21 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043451966,"CIRIGLIANO, VITO, VINCENZO",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 23 , 24 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043451966,"CIRIGLIANO, VITO, VINCENZO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 39 , 48 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043451966,"CIRIGLIANO, VITO, VINCENZO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043451966,"CIRIGLIANO, VITO, VINCENZO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1194744532,MOSES CONE MEDICAL SERVICES INC,LEBAUER ENDOSCOPY CENTER,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1043451966,"CIRIGLIANO, VITO, VINCENZO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1235478694,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-ORTHOPAEDICTRAUMASERVS,480 FLOYD RD   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043452741,"BLACK, JAMES, CLINTON",480 FLOYD RD STE A SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043453004,CATINO EYE CARE CENTER OD PA,CATINO EYE CARE CENTER OD PA,8116 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043453004,CATINO EYE CARE CENTER OD PA,8116 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 46 , 51 , 94 ,$#,,
MEDICAID DIRECT,1861031544,WATAUGA MEDICAL CENTER INC,PULMONOLOGY INPATIENT,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1043457674,"DINKELS, MICHAEL, JUSTIN",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043459498,"SHERRILL, JONATHAN, GEORGE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 45 , 46 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043460991,"CHAUDHARY, NUSRAT, AHMAD",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 15 , 29 , 40 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043460991,"CHAUDHARY, NUSRAT, AHMAD",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043460991,"CHAUDHARY, NUSRAT, AHMAD",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043460991,"CHAUDHARY, NUSRAT, AHMAD",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043460991,"CHAUDHARY, NUSRAT, AHMAD",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043467665,"KODUMAGULLA, MRINALINI, SUJALA",Mrinalini Sujala Kodumagulla,1831 LAKE PINE DR STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1043467665,"KODUMAGULLA, MRINALINI, SUJALA",1831 LAKE PINE DR STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215162466,WAKE FAMILY MEDICINE PC,Wake Family Medicine PC,1831 LAKE PINE DR STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043467665,"KODUMAGULLA, MRINALINI, SUJALA",1831 LAKE PINE DR STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 162 , 316 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1043469992,"PILIKA, ASTI",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1043469992,"PILIKA, ASTI",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 34 ,$#,,
MEDICAID DIRECT,1164500575,CHILDRENS HEALTH SERVICES PA,~,1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043471063,"WOOTEN, ERIN, LEIGH",1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 70 , 163 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043471063,"WOOTEN, ERIN, LEIGH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043471071,"LAMPMAN, ROBERT, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 91 , 96 ,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1043471329,"HOLT, LYNLEY, SUZANNE",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 88 , 249 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043471444,"KIHLSTROM, MARGARET, JACKSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043471444,"KIHLSTROM, MARGARET, JACKSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 37 , 85 , 106 ," $24,220.37 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043471444,"KIHLSTROM, MARGARET, JACKSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 VETERANS PKWY STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1043473168,"MAJITHIA, RAJIV, TUSHAR",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1043473168,"MAJITHIA, RAJIV, TUSHAR",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 57 , 59 , 106 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043473168,"MAJITHIA, RAJIV, TUSHAR",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 30 , 32 , 49 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,,,Unknown,193400000X,Group,Single Specialty,,1043473168,"MAJITHIA, RAJIV, TUSHAR",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 14 , 28 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043473168,"MAJITHIA, RAJIV, TUSHAR",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1043473168,"MAJITHIA, RAJIV, TUSHAR",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 32 , 33 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 NC HIGHWAY 42 W STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1043473168,"MAJITHIA, RAJIV, TUSHAR",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1043474265,"MATHEWS, KELLEY, JEANNE",2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 66 , 153 ," $11,740.37 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 38 , 39 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 233 , 241 ,$#,,
MEDICAID DIRECT,1881033009,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB NORTH,487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",1010 LAKEVIEW DR   PINEVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 190 , 206 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",205 RATTLESNAKE TRL   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 203 , 218 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 50 , 50 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",205 RATTLESNAKE TRL   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 90 , 90 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 77 , 78 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",215 LASH DR   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,620 JOHNS RD   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",620 JOHNS RD   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",215 LASH DR   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",620 JOHNS RD   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 125 , 151 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043475049,"THIYAGARAJAN, THANIGAIARSU",620 JOHNS RD   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 30 , 45 ,$#,,
MEDICAID DIRECT,1740213321,GOLDSBORO PHYSICAL THERAPY,GOLDSBORO PHYSICAL THERAPY,2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1043476765,"KEESEE, KENNETH, DAVID",2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043477425,"LEVARGE, BARBARA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 39 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043477425,"LEVARGE, BARBARA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043477425,"LEVARGE, BARBARA, LEE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 42 , 56 , 83 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043477425,"LEVARGE, BARBARA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043477425,"LEVARGE, BARBARA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 25 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043477425,"LEVARGE, BARBARA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043478795,"JACOBS, BRET, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 26 , 38 ,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043481773,"WHALEN, URSULA, POEHLING",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043481914,"HAMLIN, DANIEL, FULTON",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043482508,"RUND, CHAD, RICHARD",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 58 , 57 , 74 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043482508,"RUND, CHAD, RICHARD",30 PAGE ST   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 44 , 47 , 56 ,$#,,
MEDICAID DIRECT,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,,1043482508,"RUND, CHAD, RICHARD",30 PAGE ST   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043482508,"RUND, CHAD, RICHARD",30 PAGE ST   PINEHURST NC,063,Moore,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 41 , 53 , 53 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043485261,"MEHTA, SHIVANI, PATEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043485261,"MEHTA, SHIVANI, PATEL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043485261,"MEHTA, SHIVANI, PATEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 15 , 31 ,$#,,
MEDICAID DIRECT,1538214713,CHILDRENS MEDICAL GROUP INC,TIDEWATER CHILDRENS ASSOCIATES,171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043486566,"BAKER, MONICA, GRACE",171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043489834,"CORGILL COX, MELANIE",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 106 , 137 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 43 , 45 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 22 , 30 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",855 SAM NEWELL RD STE 206 MATTHEWS NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 14 , 35 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1043490113,"CAICEDO, JENNIFER, LAIACONA",~,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,1043490113,"CAICEDO, JENNIFER, LAIACONA",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",620 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 94 , 94 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043490113,"CAICEDO, JENNIFER, LAIACONA",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1043491012,"KEFFER, CHARMAINE, ELIZABETH",400 OLD SMITHFIELD RD   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice," 1,486 "," 1,542 "," 5,847 "," $157,274.43 ",,
MEDICAID DIRECT,1790941755,PRIVATE DIAGNOSTIC CLINIC PLLC,Durham Regional Hospital Intensivist,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043492960,"AL HEGELAN, MASHAEL, SALEH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043492960,"AL HEGELAN, MASHAEL, SALEH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 25 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043492960,"AL HEGELAN, MASHAEL, SALEH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043492960,"AL HEGELAN, MASHAEL, SALEH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043493505,"TRAUNERO, JUSTIN, RYAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 43 , 50 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",7850 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",7850 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",7850 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",7850 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043498553,"HALLOWS, RHETT, KENDALL",7850 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043500168,"WILLIAMS, SHARLYN, ANNE",511 PALADIN DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 84 , 165 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043501968,"HAUCK, MARGARET, GIPSON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043501968,"HAUCK, MARGARET, GIPSON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043501968,"HAUCK, MARGARET, GIPSON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043501968,"HAUCK, MARGARET, GIPSON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 20 , 24 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043501968,"HAUCK, MARGARET, GIPSON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043504152,"KING, BRADLEY, MARK",102 MEDICAL PARK DR STE B MEBANE NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043504152,"KING, BRADLEY, MARK",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 83 , 151 , 233 ,$#,,
MEDICAID DIRECT,1043504251,"ONUOHA, BERTHRAND, CHUKWUEMEKA",,1330 TAYLOR ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1043504251,"ONUOHA, BERTHRAND, CHUKWUEMEKA",1330 TAYLOR ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043505092,"JOHNSON, KATY, FLINN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 101 , 226 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043505415,"WOLFE, STEPHANIE, MANNING",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 82 , 141 , 166 ," $14,005.14 ",,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043505415,"WOLFE, STEPHANIE, MANNING",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 11 ,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043505415,"WOLFE, STEPHANIE, MANNING",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043505415,"WOLFE, STEPHANIE, MANNING",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,,,$#,,
MEDICAID DIRECT,1043507197,ONE CARE NC INC,ONE CARE INC,10418 N MAIN ST   ARCHDALE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1043507197,ONE CARE NC INC,10418 N MAIN ST   ARCHDALE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,, 97 ," 15,247 "," 15,247 "," $1,356,378.78 ",,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,501 DOUGLAS ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043508633,"HOLLER, ELIZABETH, ASHLEY MARGARET",501 DOUGLAS ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 37 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043509250,"GENTRY, MICHAEL, BENJAMIN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043509250,"GENTRY, MICHAEL, BENJAMIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 87 , 93 , 133 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043509250,"GENTRY, MICHAEL, BENJAMIN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043509250,"GENTRY, MICHAEL, BENJAMIN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1043509250,"GENTRY, MICHAEL, BENJAMIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043512734,"REGAN, BRIAN, CHRISTOPHER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1105 S MAIN ST   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043512924,"BYNUM, SHAN, DRUMEL",605 COLLEGE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#, 15 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043512924,"BYNUM, SHAN, DRUMEL",605 COLLEGE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043516503,"PUNJABI, KELASH, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 216 , 216 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043516503,"PUNJABI, KELASH, KUMAR",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043516503,"PUNJABI, KELASH, KUMAR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043516503,"PUNJABI, KELASH, KUMAR",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1043516503,"PUNJABI, KELASH, KUMAR",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043516644,"DECARLO, VALERIE, MUMM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1043516644,"DECARLO, VALERIE, MUMM",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043516644,"DECARLO, VALERIE, MUMM",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811637366,360 ANESTHESIA PLLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1043516644,"DECARLO, VALERIE, MUMM",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1043516644,"DECARLO, VALERIE, MUMM",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043518087,"BAILEY, DAMIEN, LAFOUN",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1043518087,"BAILEY, DAMIEN, LAFOUN",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1740459650,RAFAEL RIVERA JR DDS PLLC,,2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043519390,"BATES, ANTWAN, DEVON",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 2,846 "," 3,716 "," 14,519 "," $1,385,128.80 ",,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043519390,"BATES, ANTWAN, DEVON",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043519879,"WILSON, AARON, MARSHALL",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043520802,"PATERSON, TRACY, COLLINS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 75 , 75 ,$#,,
MEDICAID DIRECT,1912942665,SOUTHEASTERN INTENSIVIST SERVICES P,,7101 JAHNKE RD   RICHMOND VA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043521800,"PATEL, ASHISH, CHHOTUBHAI",7101 JAHNKE RD   RICHMOND VA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043522246,"SKAGGS, JOSHUA, BENJAMIN",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1043522246,"SKAGGS, JOSHUA, BENJAMIN",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043522410,"CHU, CHRISTINE, MIRNG-EN",4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043522410,"CHU, CHRISTINE, MIRNG-EN",4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 21 , 25 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043522410,"CHU, CHRISTINE, MIRNG-EN",4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043522410,"CHU, CHRISTINE, MIRNG-EN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#, 15 , 27 ,$#,,
MEDICAID DIRECT,1043524325,PARTNERS IN THERAPY PLLC,~,4924 HOLLAND CHURCH RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043524325,PARTNERS IN THERAPY PLLC,4924 HOLLAND CHURCH RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 152 ," 2,901 "," 2,951 "," $260,847.48 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043530512,"PALAKSHAPPA, JESSICA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 34 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,200 CHARLOIS BLVD STE 250 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043530512,"PALAKSHAPPA, JESSICA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 39 , 47 , 73 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 16 , 21 ,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,320 VETERANS PKWY STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",320 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,320 VETERANS PARKWAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",320 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,920 S LOMBARD ST STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 14 , 52 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,920 S LOMBARD ST STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 20 , 23 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043530553,"HALL, MICHAEL, RAYMOND",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 59 , 95 , 185 ,$#,,
MEDICAID DIRECT,1740331164,AZALEA GYNECOLOGY,,736 MEDICAL CENTER DR STE 102 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043533540,"BOITNOTT, AMANDA, KAY",736 MEDICAL CENTER DR STE 102 WILMINGTON NC,065,New Hanover,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043534605,"TERRELL, NICOLE, LAUREN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043534605,"TERRELL, NICOLE, LAUREN",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043535602,"BHENDE, SIDDHARTH, KISHORE",2790 GODWIN BLVD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043535602,"BHENDE, SIDDHARTH, KISHORE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 29 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043535651,"MCDANIEL, MATTHEW, RAMSEUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043535651,"MCDANIEL, MATTHEW, RAMSEUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043535651,"MCDANIEL, MATTHEW, RAMSEUR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 39 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043535651,"MCDANIEL, MATTHEW, RAMSEUR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043535933,"LEWIS-KENSAH, RENEE, LIZETTE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 33 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043536907,"BALDWIN, MELODY, ANITA",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043536907,"BALDWIN, MELODY, ANITA",5324 MCFARLAND RD STE 200 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043536907,"BALDWIN, MELODY, ANITA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 37 , 40 , 50 ," $15,323.56 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043536907,"BALDWIN, MELODY, ANITA",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043538200,"SOTO, ROBIN, IVAN TEJEDA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 66 , 68 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043539257,"KNAPP, JESSICA, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 35 , 35 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043539257,"KNAPP, JESSICA, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 49 , 79 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043541220,"STALLINGS III, HOWARD, WRIGHT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518532126,MOUNTCASTLE MEDICAL & MED SPA PLLC,,701 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1043541659,"MOUNTCASTLE, BRANDY, NORRIS",701 S MAIN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 270 , 470 ,$#,,
MEDICAID DIRECT,1568523371,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1043545304,"DOWDLE, MORROW, MCCAULEY",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1043546740,"LAZUR, MEGAN, ELIZABETH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1043546740,"LAZUR, MEGAN, ELIZABETH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043548381,"HANSEN, CECILIA",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043548647,"THOMAS, MELISSA, ANN",114 W 30TH ST STE 800 WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043553290,FRANKLIN OPERATIONS LLC,FRANKLIN MANOR ASSISTED LIVING CENTER,100 SUNSET DR   YOUNGSVILLE NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1043553290,FRANKLIN OPERATIONS LLC,100 SUNSET DR   YOUNGSVILLE NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,886 "," 1,886 "," $163,958.79 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043554249,"KOCJANCIC, KELSEY, JOE",1000 BLYTHE BLVD ANETHESIA SERVICES CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1043555139,"VARGA, CINDY, IRIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043555139,"VARGA, CINDY, IRIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 11 , 21 , 22 ,$#,,
MEDICAID DIRECT,1164726105,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1043555642,"BERRY, ELIZABETH, ANNE GRIFFIN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083039176,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MED-W MTN VIEW,1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043557069,"MATLOCK, PENNY, JAMES",1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083039176,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MED-W MTN VIEW,1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043557069,"MATLOCK, PENNY, JAMES",50 MACEDONIA CHURCH RD STE A TAYLORSVILLE NC,002,Alexander,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1043558224,"MAXWELL, WHITNEY, SIROIS",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043558224,"MAXWELL, WHITNEY, SIROIS",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1215022926,B & D INTEGRATED HEALTH SERVICES,~,249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043558539,"GODWIN, ROBIN, NICOLE",249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 27 , 31 ,$#,,
MEDICAID DIRECT,1215022926,B & D INTEGRATED HEALTH SERVICES,~,249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043558539,"GODWIN, ROBIN, NICOLE",620 DR CALVIN JONES HWY STE 100 WAKE FOREST NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 11 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043558968,"STEINHAUSER, CAROLYN, MARIE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 55 , 61 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043558968,"STEINHAUSER, CAROLYN, MARIE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043558992,PERSONAL GENOME DIAGNOSTICS,,3600 BOSTON ST STE 10 BALTIMORE MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1043558992,PERSONAL GENOME DIAGNOSTICS,3600 BOSTON ST STE 10 BALTIMORE MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043559271,"RODGERS, DAVID, SHERWOOD",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1083169569,F SMITH STRICKLAND DDS PLLC,~,5504 ADAMS FARM LN   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043561319,"STRICKLAND, FONDA, SMITH",5504 ADAMS FARM LN   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 428 , 781 ," 2,208 "," $112,775.28 ",,
MEDICAID DIRECT,1285201848,"WALKER, JESSICA, MARIKO",,1572 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1043561319,"STRICKLAND, FONDA, SMITH",1572 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 24 , 67 ,$#,,
MEDICAID DIRECT,1083169569,F SMITH STRICKLAND DDS PLLC,~,5504 ADAMS FARM LN   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043561319,"STRICKLAND, FONDA, SMITH",1572 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 315 , 614 ," 1,554 "," $89,828.59 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043562150,"STOKES, MARIAN, JEANETTE",401 N MORGAN ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,706 ROSANNE DR   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1043568314,"KANDEL, SAROJ, PRAKASH",706 ROSANNE DR   KINSTON NC,054,Lenoir,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 302 , 528 , 669 ," $18,640.97 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043568314,"KANDEL, SAROJ, PRAKASH",706 ROSANNE DR   KINSTON NC,054,Lenoir,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 103 , 268 , 305 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1043568314,"KANDEL, SAROJ, PRAKASH",706 ROSANNE DR   KINSTON NC,054,Lenoir,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1043570450,"HOBDY, NATALIE, ADELE",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 118 , 131 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1043570450,"HOBDY, NATALIE, ADELE",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265430854,GRANVILLE HEALTH SYSTEM,SOUTH GRANVILLE PRIMARY CARE,1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1043570450,"HOBDY, NATALIE, ADELE",1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1043570948,"WARD, MATTHEW, CHRISTOPHER",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043570948,"WARD, MATTHEW, CHRISTOPHER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043570948,"WARD, MATTHEW, CHRISTOPHER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043570948,"WARD, MATTHEW, CHRISTOPHER",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 33 , 112 , 137 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043570948,"WARD, MATTHEW, CHRISTOPHER",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043570948,"WARD, MATTHEW, CHRISTOPHER",201 E GROVER ST   SHELBY NC,023,Cleveland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043571573,"BOOKHOUT, CHRISTINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 82 , 87 , 114 ,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043573322,"LESTER, JAMES, SCOTT",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 173 , 260 , 484 ,$#,,
MEDICAID DIRECT,1720177140,COUNTY OF DAVIE OFFICE OF FINANCE A,DAVIE COUNTY HEALTH DEPARTMENT,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1043575780,"SIEGRIST, KIMBERLY, RAE",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 33 , 78 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043575954,"STERLINA, MEGAN, KATHRYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 53 , 87 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043576051,"DEERING, JAMES, PETER",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043576051,"DEERING, JAMES, PETER",7825 BALLANTYNE COMMONS PKWY STE 150 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 49 , 96 , 120 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043576051,"DEERING, JAMES, PETER",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043576382,"WATSON, SAMANTHA, SAUNDERS",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043576382,"WATSON, SAMANTHA, SAUNDERS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043576382,"WATSON, SAMANTHA, SAUNDERS",1120 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 40 , 70 , 104 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043576382,"WATSON, SAMANTHA, SAUNDERS",9020 SENCA DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 15 , 24 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043577646,"PATEL, AMIT, MAHESH",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1679090468,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH RHEUMATOLOGY AND ARTHRITIS,12311 COPPER WAY STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043577646,"PATEL, AMIT, MAHESH",12311 COPPER WAY STE 100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043577646,"PATEL, AMIT, MAHESH",12311 COPPER WAY STE 100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 47 , 77 , 143 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043577646,"PATEL, AMIT, MAHESH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 16 , 23 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043578370,"SUTTON, SCOTT, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 84 , 93 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043578370,"SUTTON, SCOTT, WILLIAM",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043578370,"SUTTON, SCOTT, WILLIAM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043578438,"FAJARDO, JOHANA, ROCIO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 47 , 87 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,730 MALCOLM BLVD STE 220 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1043578453,"MISHOE, MATTHEW, TRAVIS",730 MALCOLM BLVD STE 220 CONNELLY SPRINGS NC,012,Burke,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 34 , 39 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1043578453,"MISHOE, MATTHEW, TRAVIS",2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 16 , 23 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1043578453,"MISHOE, MATTHEW, TRAVIS",2201 S STERLING ST   MORGANTON NC,012,Burke,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 63 , 68 , 114 ,$#,,
MEDICAID DIRECT,1396017752,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC MARION,2293 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1043578453,"MISHOE, MATTHEW, TRAVIS",2201 S STERLING ST   MORGANTON NC,012,Burke,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1396017752,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC MARION,2293 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1043578453,"MISHOE, MATTHEW, TRAVIS",2293 SUGAR HILL RD STE A MARION NC,059,McDowell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 37 , 39 , 42 ,$#,,
MEDICAID DIRECT,1770827388,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,810 MITCHELL AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1043581812,"REILLY, CULLAN, ROBERT",1035 LINCOLNTON RD STE F SALISBURY NC,080,Rowan,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043581812,"REILLY, CULLAN, ROBERT",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 13 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043581812,"REILLY, CULLAN, ROBERT",1035 LINCOLNTON RD STE F SALISBURY NC,080,Rowan,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 136 , 235 , 308 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043581812,"REILLY, CULLAN, ROBERT",810 MITCHELL AVE   SALISBURY NC,080,Rowan,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 28 , 48 , 68 ,$#,,
MEDICAID DIRECT,1952579807,CEDAR CREEK FAMILY MEDICINE PLLC,~,11492 OLD US HIGHWAY 52   WINSTON SALEM NC,029,Davidson,193400000X,Group,Single Specialty,,1043586605,"NIFONG, NANCY, ALEXIS",11492 OLD US HIGHWAY 52   WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 83 , 209 , 460 ," $10,648.60 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043589401,"DEAN, CATHERINE, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 21 , 36 , 43 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043589401,"DEAN, CATHERINE, ELIZABETH",2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043589401,"DEAN, CATHERINE, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043589914,ALLIANCE HEALTH AND HOMECARE LLC,ALLIANCE HEALTH AND HOMECARE LLC,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1043589914,ALLIANCE HEALTH AND HOMECARE LLC,1919 W MAIN ST   ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 2,138 "," 2,176 "," $251,860.56 ",,
MEDICAID DIRECT,1043589914,ALLIANCE HEALTH AND HOMECARE LLC,ALLIANCE HEALTH AND HOMECARE LLC,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1043589914,ALLIANCE HEALTH AND HOMECARE LLC,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 1,799 "," 1,801 "," $213,457.40 ",,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043595200,"TAFT, NATALIE, ALISON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043595523,"HUESKE, AMY, REBECCA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1043595523,"HUESKE, AMY, REBECCA",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043595523,"HUESKE, AMY, REBECCA",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043595838,"ENDICOTT, LINDA, ADAMS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1043595960,"CARLSON, SAMANTHA, RAE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1043595960,"CARLSON, SAMANTHA, RAE",2020 WATERSCAPE WAY   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 292 , 644 ,$#,,
MEDICAID DIRECT,1043597180,CHANGING LIVES RESIDENTIAL CARE,~,111 N GUTHRIE AVE   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1043597180,CHANGING LIVES RESIDENTIAL CARE,111 N GUTHRIE AVE   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 201 , 201 ," $82,661.01 ",,
MEDICAID DIRECT,1801115266,LOWERY GARDEN & HENDRICK DDS PLLC,RUTHERFORD COUNTY FAMILY & CHILDRENS DENTISTRY,1637 COLLEGE AVE STE A SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1043598733,"LOWERY, ASHLEY, NICOLE",1637 US HIGHWAY 74A BYP   SPINDALE NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1801115266,LOWERY GARDEN & HENDRICK DDS PLLC,RUTHERFORD COUNTY FAMILY & CHILDRENS DENTISTRY,1637 COLLEGE AVE STE A SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1043598733,"LOWERY, ASHLEY, NICOLE",1637 COLLEGE AVE STE A SPINDALE NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice," 2,006 "," 3,230 "," 10,138 "," $305,151.90 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043599806,"HELMS, MARCUS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043601479,"NOONAN, KARYL, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 100 , 602 , 602 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043601479,"NOONAN, KARYL, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 78 , 78 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043601479,"NOONAN, KARYL, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 278 , 278 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1043601479,"NOONAN, KARYL, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 465 , 468 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1043602634,"BOWERS, KAITLIN, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 54 , 60 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1043602634,"BOWERS, KAITLIN, MARIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 28 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1043602634,"BOWERS, KAITLIN, MARIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 61 , 65 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043602634,"BOWERS, KAITLIN, MARIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043604259,"MARTINEZ DUARTE, ERNESTO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 79 , 80 , 133 ,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1043606940,"KENNEDY, FORREST, BRUCE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 35 , 35 ,$#,,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043607203,"ROBEY, BENJAMIN, SCOTT",3100 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043607542,"BUCKLEY, MARY, MCGOWAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology, 13 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043607542,"BUCKLEY, MARY, MCGOWAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043607542,"BUCKLEY, MARY, MCGOWAN",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043607542,"BUCKLEY, MARY, MCGOWAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043608409,"MATHEWS, SARAH, WOLFE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043608409,"MATHEWS, SARAH, WOLFE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043609472,"CALOTT, CHRISTINA, REBECCA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 43 , 48 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043613011,"ANDERSON, TYLER, MATTHEW",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 53 , 98 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043613011,"ANDERSON, TYLER, MATTHEW",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295729747,THE CHILD HEALTH CENTER,THE CHILD HEALTH CENTER,1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043614670,"CLINE, MISTY, SETZER",1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 39 , 50 , 167 ,$#,,
MEDICAID DIRECT,1871854828,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043617079,"PAYNE, KAREN, ADELE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1043620719,"POWELL, JONATHAN, MICHAEL",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 60 , 72 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043621246,"DOUGHTON, JOHN, MICHAEL",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043621246,"DOUGHTON, JOHN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 32 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043621246,"DOUGHTON, JOHN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1043622301,BETHEL HOMECARE INC,,4801 E INDEPENDENCE BLVD STE 301 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1043622301,BETHEL HOMECARE INC,4801 E INDEPENDENCE BLVD STE 301 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 115 ," 23,906 "," 23,948 "," $1,628,780.56 ",,
MEDICAID DIRECT,1043623408,AT HOME PEDIATRIC THERAPY,~,182 BUMPS CREEK RD   SNEADS FERRY NC,067,Onslow,193200000X,Group,Multi-Specialty,,1043623408,AT HOME PEDIATRIC THERAPY,182 BUMPS CREEK RD   SNEADS FERRY NC,067,Onslow,193200000X,Group,Multi-Specialty,, 17 , 160 , 162 ," $10,244.34 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043623713,"ALEEM, SAMIA",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043623713,"ALEEM, SAMIA",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 15 , 50 , 50 ," $12,137.36 ",,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043624513,"BARNETTE, STEPHANIE, RAMSEY",1085 NE GATEWAY CT NE STE 300 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 141 , 161 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1043625080,"SEVERTSON, MERWIN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043625361,"BOSTIAN, PHILLIP, ANDREW",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 28 , 43 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043625361,"BOSTIAN, PHILLIP, ANDREW",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 100 , 180 , 280 ," $12,029.71 ",,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043625965,"GARCIA, KELLY, ERIN",490 HOSPITAL DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 93 , 229 , 248 ," $15,717.66 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043628969,"RASCH, JENNIFER, IRENE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1912577628,MERTZ MFM CENTER,,3815 FORRESTGATE DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043628969,"RASCH, JENNIFER, IRENE",3815 FORRESTGATE DR   WINSTON SALEM NC,034,Forsyth,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1043629421,RELIANCE HOME HEALTH SERVICES LLC,,9700 RESEARCH DR STE 138 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1043629421,RELIANCE HOME HEALTH SERVICES LLC,9700 RESEARCH DR STE 138 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 30 ," 4,564 "," 4,723 "," $321,779.46 ",,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043629504,"NASEHI, LEYLA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043630502,"DZIAMSKI, KONRAD, MICHAEL",205 PAGE RD   PINEHURST NC,063,Moore,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 40 , 90 , 240 ," $11,866.90 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043630502,"DZIAMSKI, KONRAD, MICHAEL",1411 GREENWAY CT   SANFORD NC,053,Lee,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043630502,"DZIAMSKI, KONRAD, MICHAEL",1816 DOCTORS DR   SANFORD NC,053,Lee,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043630502,"DZIAMSKI, KONRAD, MICHAEL",110 FIELDS DR   SANFORD NC,053,Lee,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043631344,"GROSSMAN-ORR, MAREIDA, JO",700 WALTER REED DR   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043631344,"GROSSMAN-ORR, MAREIDA, JO",1200 N ELM ST   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043632946,"LITTLEJOHN, ROBERT, GASTON",1225 HARDING PL   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1043632946,"LITTLEJOHN, ROBERT, GASTON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1043632946,"LITTLEJOHN, ROBERT, GASTON",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043632946,"LITTLEJOHN, ROBERT, GASTON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1043632946,"LITTLEJOHN, ROBERT, GASTON",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043632946,"LITTLEJOHN, ROBERT, GASTON",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043633167,"CRAMER, MARY, SUZANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 43 , 68 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043634926,"DRAPER, DANIELLE, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043634926,"DRAPER, DANIELLE, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043638273,"MACPHERSON, STEPHANIE, CHRISTINE",901 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#, 13 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1043638273,"MACPHERSON, STEPHANIE, CHRISTINE",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043638273,"MACPHERSON, STEPHANIE, CHRISTINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043638794,"PATEL, DIVYANG, R",1031 LOFTIS BLVD STE 100 NEWPORT NEWS VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043638794,"PATEL, DIVYANG, R",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043638794,"PATEL, DIVYANG, R",1101 FIRST COLONIAL RD STE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043638794,"PATEL, DIVYANG, R",1101 FIRST COLONIAL RD STE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043638794,"PATEL, DIVYANG, R",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043639800,"PALMER, ROBERT, CARLTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1043639917,"KRUEGER, ALYSSA, RAE",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1043639917,"KRUEGER, ALYSSA, RAE",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 124 , 271 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043641822,"KONZEM, DAVID, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 52 , 55 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1043641822,"KONZEM, DAVID, ANTHONY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 24 , 26 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043641822,"KONZEM, DAVID, ANTHONY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 24 , 26 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043642366,"CUPP, LEAH, HOWE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043642366,"CUPP, LEAH, HOWE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043642903,"ZANI, MAGAN, PARKER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043642903,"ZANI, MAGAN, PARKER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043642903,"ZANI, MAGAN, PARKER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043645443,BEYOND WORDS SPEECH THERAPY,BEYOND WORDS PEDIATRIC SPEECH THERAPY PLLC,671 OAK ST STE 2 FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1043645443,BEYOND WORDS SPEECH THERAPY,671 OAK ST STE 2 FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,, 45 , 491 , 492 ," $33,883.90 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1043648470,"RAMSEY, REBECCA, CARBONELL",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043648470,"RAMSEY, REBECCA, CARBONELL",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,666 W CORBETT AVE   SWANSBORO NC,067,Onslow,193200000X,Group,Multi-Specialty,,1043648470,"RAMSEY, REBECCA, CARBONELL",666 W CORBETT AVE   SWANSBORO NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043653991,"NG, ANTHONY, TIN-LUNG",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104804459,CATAWBA PEDIATRIC ASSOCIATES PA,~,240 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043654809,"KLINE, AUSTIN, WAYNE",240 18TH STREET CIR SE   HICKORY NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 88 , 157 , 390 ," $18,676.12 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043655285,"OKOLO, FRANCES, CHINENYE",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 43 , 50 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043655434,"MALOY, CHARLES, BRANDON",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1043655434,"MALOY, CHARLES, BRANDON",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 53 , 74 , 150 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043655434,"MALOY, CHARLES, BRANDON",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043655434,"MALOY, CHARLES, BRANDON",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1043655434,"MALOY, CHARLES, BRANDON",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 23 , 38 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043655434,"MALOY, CHARLES, BRANDON",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043656044,"JOHNSON, SEAN, MICHAEL",2610 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 91 , 141 ,$#,,
MEDICAID DIRECT,1801223482,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY BIRKDALE LANDING,16645 BIRKDALE COMMONS PKWY STE 200C HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043656770,"CAMERON, THOMAS, CARY",16645 BIRKDALE COMMONS PKWY STE 200C HUNTERSVILLE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 40 , 61 , 96 ,$#,,
MEDICAID DIRECT,1801223482,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY BIRKDALE LANDING,16645 BIRKDALE COMMONS PKWY STE 200C HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043656770,"CAMERON, THOMAS, CARY",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 16 , 26 , 42 ,$#,,
MEDICAID DIRECT,1528495108,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - CONCORD,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1043656770,"CAMERON, THOMAS, CARY",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 59 , 60 ,$#,,
MEDICAID DIRECT,1275638512,GRANVILLE HEALTH SYSTEM,GRANVILLE HEALTH SYSTEM CRNA GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1043659220,"BILICHKA, COLIN, DAVID",1010 COLLEGE ST   OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043659220,"BILICHKA, COLIN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1659495133,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043661432,"PODRAZA, COLE",4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 73 , 88 ,$#,,
MEDICAID DIRECT,1396725743,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,195 CAMLELOT CT   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1043662448,"VINSON, KIMBERLY, RENEE",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 47 , 174 ,$#,,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1043662448,"VINSON, KIMBERLY, RENEE",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 88 , 89 , 394 ," $11,725.05 ",,
MEDICAID DIRECT,1003364589,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,131 NC HIGHWAY 109 S   MOUNT GILEAD NC,062,Montgomery,193400000X,Group,Single Specialty,,1043662448,"VINSON, KIMBERLY, RENEE",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 51 , 240 ,$#,,
MEDICAID DIRECT,1003364589,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,131 NC HIGHWAY 109 S   MOUNT GILEAD NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1043662448,"VINSON, KIMBERLY, RENEE",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 33 , 140 ,$#,,
MEDICAID DIRECT,1396725743,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,195 CAMLELOT CT   BISCOE NC,062,Montgomery,193400000X,Group,Single Specialty,,1043662448,"VINSON, KIMBERLY, RENEE",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 295 , 482 ," 1,873 "," $58,130.14 ",,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1043662448,"VINSON, KIMBERLY, RENEE",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 2,338 "," 4,832 "," 19,915 "," $613,074.79 ",,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1043663743,"KREMER, NICOLE, ELIZABETH",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043663743,"KREMER, NICOLE, ELIZABETH",7021 HARPS MILL RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1043663743,"KREMER, NICOLE, ELIZABETH",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 28 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1043663743,"KREMER, NICOLE, ELIZABETH",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043663743,"KREMER, NICOLE, ELIZABETH",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043663743,"KREMER, NICOLE, ELIZABETH",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043663743,"KREMER, NICOLE, ELIZABETH",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 43 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 56 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,325 HOLLY HILL LN   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",325 HOLLY HILL LN   BURLINGTON NC,001,Alamance,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 16 , 16 , 70 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,1013 SPRING LN   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",1013 SPRING LN   SANFORD NC,053,Lee,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 68 , 68 , 287 ," $34,478.08 ",,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,2600 OAKCREST AVE STE A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",2600 OAKCREST AVE   GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 16 , 16 , 68 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,400 TEW CT # 106 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",400 TEW CT # 106 CLAYTON NC,051,Johnston,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 21 , 21 , 84 ," $10,855.60 ",,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,,,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#, 11 , 43 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,2401 WOOTEN BLVD SW STE F WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",2401 WOOTEN BLVD SW STE F WILSON NC,098,Wilson,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",1008 BIG OAK CT STE D KNIGHTDALE NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 15 , 15 , 75 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 32 , 32 , 136 ," $18,272.98 ",,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,451 RUIN CREEK RD STE 205 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",451 RUIN CREEK RD STE 205 HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice, 66 , 66 , 284 ," $38,387.34 ",,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,1705 HIGH HOUSE RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",1705 HIGH HOUSE RD   CARY NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 33 , 33 , 131 ," $20,556.63 ",,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,10411 MONCREIFFE RD STE 105B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",10411 MONCREIFFE RD STE 105B RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,310 MILLSTONE DR STE 1 HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",310 MILLSTONE DR   HILLSBOROUGH NC,068,Orange,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,2810 WAKEFIELD PINES DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",2810 WAKEFIELD PINES DR STE 100 RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,451 RUIN CREEK RD STE 205 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",451 RUIN CREEK RD STE 105 HENDERSON NC,091,Vance,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,1008 BIG OAK CT STE D KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1043664188,"HENDERSON, BRAXTON, MAXWELL",1008 BIG OAK CT STE D KNIGHTDALE NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 17 , 17 , 68 ," $10,390.63 ",,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043664451,"SNOW, ELIZABETH, ANNE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043664451,"SNOW, ELIZABETH, ANNE",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043664451,"SNOW, ELIZABETH, ANNE",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043664451,"SNOW, ELIZABETH, ANNE",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043664451,"SNOW, ELIZABETH, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1043664451,"SNOW, ELIZABETH, ANNE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043665201,"WIDMER, KRISTEN, MCCARTNEY",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 19 , 33 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043665201,"WIDMER, KRISTEN, MCCARTNEY",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043665219,"AGARI, KIMIKO, MASAKO",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1164500575,CHILDRENS HEALTH SERVICES PA,~,1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043666514,"CLIFTON, TIMOTHY, VERNON",1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 52 , 82 , 195 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043666514,"CLIFTON, TIMOTHY, VERNON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043667025,ROYAL ORTHOTICS LLC,~,1028 LEE ANN DR NE STE 50 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043667025,ROYAL ORTHOTICS LLC,1028 LEE ANN DR NE STE 50 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 51 , 99 , 670 ," $131,042.42 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043667470,"CHEN, MENG",101 MANNING DR   CHAPEL HILL NC,068,Orange,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043667470,"CHEN, MENG",101 MANNING DR   CHAPEL HILL NC,068,Orange,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1043667470,"CHEN, MENG",101 MANNING DR   CHAPEL HILL NC,068,Orange,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1043667611,"HIRANO, MIKI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043667629,"ALDERMAN, JUDSON, GREGORY",,830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1043667629,"ALDERMAN, JUDSON, GREGORY",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043668916,"FRAZIER, KELLIE, HYBARGER",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 31 , 31 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043670201,"DERBY, AMANDA, MEADE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043670201,"DERBY, AMANDA, MEADE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 33 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 24 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 112 , 118 , 183 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043671977,"CALABRESE, EVAN, DARCY COZZENS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 84 , 89 , 124 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043673163,"PATEL, HERSH, RAJESH",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 23 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043673387,"JACKSON, CHRISTOPHER, HATHAWAY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043673577,"KOMISAR, JONATHAN, REED",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043673577,"KOMISAR, JONATHAN, REED",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 45 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043673577,"KOMISAR, JONATHAN, REED",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043673577,"KOMISAR, JONATHAN, REED",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 78 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043673577,"KOMISAR, JONATHAN, REED",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043673593,"DE NARDO, ANAMARIA",303 AIRPORT RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043673593,"DE NARDO, ANAMARIA",2595 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043673593,"DE NARDO, ANAMARIA",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043673593,"DE NARDO, ANAMARIA",264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043674146,"COVERT, LAUREN, TAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043675291,"BIBEY, ROBERT, ANDREW",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 108 , 179 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043675291,"BIBEY, ROBERT, ANDREW",10 AVIEMORE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043675341,"SALTER, MEGAN, LAUREN",201 SAGE RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043675341,"SALTER, MEGAN, LAUREN",201 SAGE RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 29 , 52 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043678170,"CLARK, KATHERINE, KENDAL",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043678170,"CLARK, KATHERINE, KENDAL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 22 , 39 , 114 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043681067,"SMITHSON, CAROLINE, RICHARDS",8090 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043681067,"SMITHSON, CAROLINE, RICHARDS",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043683188,MOUNT EAGLE HEALTH CARE - CLEMMONS,,2554 LEWISVILLE CLEMMONS RD STE 212 CLEMMONS NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1043683188,MOUNT EAGLE HEALTH CARE - CLEMMONS,2554 LEWISVILLE CLEMMONS RD STE 212 CLEMMONS NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 4,007 "," 4,012 "," $261,250.64 ",,
MEDICAID DIRECT,1699171868,PREMIER FOOT AND ANKLE PLLC,,821 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1043688286,"THOMAS, JACQUELINE, ARANAS",821 S HORNER BLVD   SANFORD NC,053,Lee,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 18 , 20 , 25 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043690480,"MONTAGUE-FARWELL, ELIZABETH, LINDSAY",2400 SOUTH BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043690480,"MONTAGUE-FARWELL, ELIZABETH, LINDSAY",1450 MATTHEWS TOWNSHIP PKWY STE 300 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1801318944,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GOLDSBORO,2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1043691330,"JOHNSON, BROOKE, BURNETTE",2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#, 12 , 53 ,$#,,
MEDICAID DIRECT,1043691595,ROCKY MOUNT EYE PA,~,450 JONES RD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1043691595,ROCKY MOUNT EYE PA,450 JONES RD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,, 256 , 260 , 518 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043691660,"SABA, KASSER",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 38 , 71 , 71 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043691660,"SABA, KASSER",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043691660,"SABA, KASSER",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043693765,"SHEW, DONNA, GRASMEHR",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 15 , 161 , 161 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043695471,"CURRENCE, CRAGIN, DALE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043695869,"SHAW, CATHERINE, MCCALLEY",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 27 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1043697311,"MODAN, NADEEM, Y",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 42 , 65 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 23 , 24 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1043697311,"MODAN, NADEEM, Y",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 26 ,$#,,
MEDICAID DIRECT,1063696375,THE CAROUSEL CENTER INC,The Carousel Center Inc,1501 DOCK ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043697865,"KELLERMANN, KENDRA, ERIN",1501 DOCK ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 22 ,$#,,
MEDICAID DIRECT,1205105491,THE CENTER FOR RURAL HEALTH INNOVAT,THE CENTER FOR RURAL HEALTH INNOVATION,167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1043697865,"KELLERMANN, KENDRA, ERIN",167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043701220,"ANDERSEN, ELIZABETH, ANNE",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1043701972,"EDWARDS, WILEY, LOREN",~,3700 W VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,1043701972,"EDWARDS, WILEY, LOREN",3700 W VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 403 , 550 ," 2,583 "," $333,068.16 ",,
MEDICAID DIRECT,1679294946,WILEY L EDWARDS JR DDS PLLC,EDWARDS DENTURES AND IMPLANTS,3700 W VERNON AVE   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1043701972,"EDWARDS, WILEY, LOREN",3700 W VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 174 , 204 , 961 ," $119,600.87 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043702392,"LONG, BENJAMIN, DANIEL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043702392,"LONG, BENJAMIN, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043702392,"LONG, BENJAMIN, DANIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043702392,"LONG, BENJAMIN, DANIEL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043702459,"RANADE, TEJAS, SANJAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043702459,"RANADE, TEJAS, SANJAY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1043702673,"CLAUNCH, APRIL, NICOLE",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 150 , 394 ," $10,757.41 ",,
MEDICAID DIRECT,1124402946,IREDELL PHYSICIAN NETWORK,FAMILY CARE CENTER,1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1043702954,"BASNIGHT, CAITLIN, DANIELLE",1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1124402946,IREDELL PHYSICIAN NETWORK,FAMILY CARE CENTER,1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1043702954,"BASNIGHT, CAITLIN, DANIELLE",1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 51 , 58 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043703523,"SHILLINGLAW, MEREDITH, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043703523,"SHILLINGLAW, MEREDITH, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 39 , 44 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043703556,"CASEY, DILLON, WALKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 102 , 99 , 114 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043704737,"LINBERG, SALENA, ELISABETH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 81 , 82 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1043705031,"GORDON, AMANDA, RENEE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1043705031,"GORDON, AMANDA, RENEE",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 106 , 113 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043706070,"SATTERFIELD, CHELSEA, LYNNE",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 150 , 223 , 381 ," $29,747.62 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1043706070,"SATTERFIELD, CHELSEA, LYNNE",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043707151,"LEE, HAESUNG",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043707813,"WELLS, VICTORIA, ANN",6301 HERNDON RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043707813,"WELLS, VICTORIA, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043707813,"WELLS, VICTORIA, ANN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043707813,"WELLS, VICTORIA, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043707813,"WELLS, VICTORIA, ANN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 66 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043709652,"VASILEFF, CHRISTOPHER, CLARKE",2345 COURT DR   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 44 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043709793,"KASERA, SURABHI",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043710312,"HAEUSLER ROSSAVIK, CAROLIN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043710312,"HAEUSLER ROSSAVIK, CAROLIN",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043715030,"FAULKNER, JUSTIN, DANIEL",2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043715030,"FAULKNER, JUSTIN, DANIEL",2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 48 , 50 ,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043716756,"LELAND, PARKER, WELLS",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043716756,"LELAND, PARKER, WELLS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043716756,"LELAND, PARKER, WELLS",1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 34 , 54 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043716756,"LELAND, PARKER, WELLS",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043717176,"HAMID, MARYAM",200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 81 , 105 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043717176,"HAMID, MARYAM",200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043717432,"MACDONALD, SERENA, LOUISE",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 157 , 258 ,$#,,
MEDICAID DIRECT,1427309608,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1043717788,"DILBONE, ERIC, STEPHEN",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 25 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1043717788,"DILBONE, ERIC, STEPHEN",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043717788,"DILBONE, ERIC, STEPHEN",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043717788,"DILBONE, ERIC, STEPHEN",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043717788,"DILBONE, ERIC, STEPHEN",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043717788,"DILBONE, ERIC, STEPHEN",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043717788,"DILBONE, ERIC, STEPHEN",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003818485,HERITAGE FAMILY PHYSICIANS,HLTH PAVILION FAMILY CARE,6387 RAMSEY ST UNIT 210 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1043717838,"PURUSHUTTAM, RAVI, VISHRAM",6387 RAMSEY ST UNIT 210 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 16 , 20 ,$#,,
MEDICAID DIRECT,1043725104,COMPLETE HOME MEDICAL LLC,MOBILITY & MORE,2301 CROWNPOINT EXECUTIVE DR STE A CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043725104,COMPLETE HOME MEDICAL LLC,2301 CROWNPOINT EXECUTIVE DR STE A CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 50 , 134 ," $15,166.38 ",,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1043725112,"RYAN, EMILY, ELIZABETH RADFORD",414 E MAIN ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043728660,"BARDEN, HOLLY, ANN",1401 MATTHEWS TOWNSHIP PKWY STE 212 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043728660,"BARDEN, HOLLY, ANN",307 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043728660,"BARDEN, HOLLY, ANN",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 65 , 118 ,$#,,
MEDICAID DIRECT,1477073641,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,1401 MATTHEWS TOWNSHIP PKWY STE 212&312 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043728660,"BARDEN, HOLLY, ANN",307 YADKIN ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942378187,VISION INTERNATIONAL PA,CAROLINA VISION CENTER,2047 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1043728843,"HURTADO, IVETTE, ELISA",2047 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 43 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1043729361,"AKAMNONU, SOMTOCHI, OLIVIA",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,275 "," 1,634 "," 6,878 "," $232,563.37 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043729361,"AKAMNONU, SOMTOCHI, OLIVIA",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 31 , 31 , 119 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1043729361,"AKAMNONU, SOMTOCHI, OLIVIA",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043729361,"AKAMNONU, SOMTOCHI, OLIVIA",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,154 "," 1,363 "," 5,616 "," $179,689.54 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043729361,"AKAMNONU, SOMTOCHI, OLIVIA",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043729502,"SINGH, BRUCE, SHAUN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1043729882,"CARROLL, JAIME, EVANS",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043729882,"CARROLL, JAIME, EVANS",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043729882,"CARROLL, JAIME, EVANS",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1043729882,"CARROLL, JAIME, EVANS",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043729882,"CARROLL, JAIME, EVANS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043736713,"CARTWRIGHT, LAUREN, PAIGE",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 23 , 24 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043736713,"CARTWRIGHT, LAUREN, PAIGE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043738800,"JONES, MEGHAN, WHELAN",2301 ERWIN   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043738800,"JONES, MEGHAN, WHELAN",2301 ERWIN   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043741978,"WRENCH, MATTHEW, GREGORY",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 399 , 445 , 705 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043741978,"WRENCH, MATTHEW, GREGORY",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1124568688,NORTHERN HOSPITAL OF SURRY COUNTY,~,100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1043742208,"TALLMAN, NICHOLAS, RAYMOND",100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 17 , 27 ,$#,,
MEDICAID DIRECT,1740225929,DUKE UNIVERSITY AFFILIATED PHYSICIA,,2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043743958,"SENDAK, MYA, DEBOER",2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 24 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043744873,"MURPHY, LAURA, SHANNON",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043744873,"MURPHY, LAURA, SHANNON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 101 , 109 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043747470,"PIOPPO PHELAN, LAUREN, DANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043747470,"PIOPPO PHELAN, LAUREN, DANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043747470,"PIOPPO PHELAN, LAUREN, DANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 23 , 25 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043747470,"PIOPPO PHELAN, LAUREN, DANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043747470,"PIOPPO PHELAN, LAUREN, DANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043748007,"SPRADLEY, EMILY, ANNE",101 E W T HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043748007,"SPRADLEY, EMILY, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 27 , 33 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043748007,"SPRADLEY, EMILY, ANNE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801561741,MEDIQ PHYSICAL THERAPY LLC,~,204 MATTHEWS DR   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1043748957,"QAYUMI, JIBRAN",204 MATTHEWS DR   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 110 , 294 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043749245,"JARRETT, SHAUNA, EMBLER",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 37 , 41 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1043749773,"MOE, LAURENT, AIESHA",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1043751480,"PHAM, MINH, NGUYEN",163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 27 , 42 , 80 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1043751480,"PHAM, MINH, NGUYEN",163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 17 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043751480,"PHAM, MINH, NGUYEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 39 , 47 , 71 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1043751480,"PHAM, MINH, NGUYEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1689372187,SURRY MEDICAL MINISTRIES FOUNDATION,SURRY MEDICAL MINISTRIES FOUNDATION INC,951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1043752850,"HARMON, AMANDA, JOHNSON",951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043753312,"LENARD, LAURA, KATHERINE",6555 KEE LN STE 200 HARRISBURG NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043753312,"LENARD, LAURA, KATHERINE",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043753312,"LENARD, LAURA, KATHERINE",8201 HEALTHCARE LOOP STE 302 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 32 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043755614,"EMBLER, BROOKE, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043755614,"EMBLER, BROOKE, ELIZABETH",250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043755978,PEACEFUL LIVING HOME CARE,,35 OLDE LIBERTY DR   YOUNGSVILLE NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,,1043755978,PEACEFUL LIVING HOME CARE,35 OLDE LIBERTY DR   YOUNGSVILLE NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,,#," 1,141 "," 1,141 "," $81,127.52 ",,
MEDICAID DIRECT,1124207725,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,910 E CHURCH ST STE A CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043756794,"DAGENHART, BILLIE JO, LEE",910 E CHURCH ST STE A CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 83 , 117 ,$#,,
MEDICAID DIRECT,1174124614,HOSPICE OF STANLY COUNTY INC,TILLERY COMPASSIONATE CARE,960 N 1ST ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1043762719,"WILTCHER, ASHLEY, MICHELLE",960 N 1ST ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 28 , 48 ,$#,,
MEDICAID DIRECT,1538978531,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - INDEPENDEN,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043764996,"PATEL, RAJIV",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 27 , 85 ,$#,,
MEDICAID DIRECT,1538978531,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - INDEPENDEN,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043764996,"PATEL, RAJIV",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 48 , 58 , 165 ,$#,,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043764996,"PATEL, RAJIV",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 541 , 789 ," 2,043 "," $133,396.25 ",,
MEDICAID DIRECT,1043766686,GRANVILLE HEALTH INC,GRANVILLE ENT,102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1043766686,GRANVILLE HEALTH INC,102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,#,#, 16 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043767346,"VAZQUEZ-MONTESINO, LUIS, MIGUEL",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043767346,"VAZQUEZ-MONTESINO, LUIS, MIGUEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043767346,"VAZQUEZ-MONTESINO, LUIS, MIGUEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043767346,"VAZQUEZ-MONTESINO, LUIS, MIGUEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 17 , 22 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043767346,"VAZQUEZ-MONTESINO, LUIS, MIGUEL",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043767346,"VAZQUEZ-MONTESINO, LUIS, MIGUEL",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043767346,"VAZQUEZ-MONTESINO, LUIS, MIGUEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1043769615,CHILDREN S THERAPY CONCEPTS,,107 E 3RD AVE   FRANKLIN VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043769615,CHILDREN S THERAPY CONCEPTS,107 E 3RD AVE   FRANKLIN VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,#, 93 , 101 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043770241,"MOON, PEROUNSACK, X",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1073070728,HAMMOCK DMD & LOTAKIS DDS IV PLLC,~,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1043770373,"SACKOS, SAMANTHA, LUISE",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 606 , 870 ," 2,848 "," $170,085.72 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1043770522,"WILSON, JAMES, DAVID",3110 WELLONS BLVD   NEW BERN NC,025,Craven,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 15 , 19 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1043770522,"WILSON, JAMES, DAVID",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043770944,"FROST, ANDREA, NICOLE",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 33 , 55 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1043770944,"FROST, ANDREA, NICOLE",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 61 , 107 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 11 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 24 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 129 , 141 , 206 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 131 , 142 , 236 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1043771991,"PASSIOURA, IGOR",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 78 , 82 , 104 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043772460,"BROOKS, DANA, WILFORD",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 133 , 280 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043772957,"COSIANO, MICHAEL, FRANCIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1043773336,"BROWNSTEAD, HILARY, ANNE",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 82 , 95 , 105 ,$#,,
MEDICAID DIRECT,1992754311,MEADOWS LUTCACAGE SMITH VINTON FIDL,Meadows Schaberg Lutcacage DBA Drs Lutcavage & Fi,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1043773427,"CANNON, DARRIEL, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 142 , 174 , 441 ," $43,456.93 ",,
MEDICAID DIRECT,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",~,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1043773427,"CANNON, DARRIEL, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 31 , 36 , 80 ,$#,,
MEDICAID DIRECT,1992754311,MEADOWS LUTCACAGE SMITH VINTON FIDL,Meadows Schaberg Lutcacage DBA Drs Lutcavage & Fi,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1043773427,"CANNON, DARRIEL, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223P0106X,Dental Providers,Dentist,Oral and Maxillofacial Pathology,#,#,#,$#,,
MEDICAID DIRECT,1043773427,"CANNON, DARRIEL, JOSEPH",,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223P0106X,Dental Providers,Dentist,Oral and Maxillofacial Pathology,1043773427,"CANNON, DARRIEL, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1043773427,"CANNON, DARRIEL, JOSEPH",,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1043773427,"CANNON, DARRIEL, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 175 , 224 , 531 ," $49,314.68 ",,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043773658,"DEROOS, DAVID, THOMAS",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1063554517,MECKLENBURG COUNTY,MECKLENBURG COUNTY,3205 FREEDOM DR STE 7000 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1043774912,"BLUE, EDNA, RENEE",10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 47 , 301 , 301 ," $113,872.85 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043781339,"SCHAFER, CHELSEA, MAE NAVARRETT",1001 BLYTHE BLVD STE 601 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043781339,"SCHAFER, CHELSEA, MAE NAVARRETT",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 37 , 63 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1043784978,"CRENSHAW, MARTHA, STONE",1264 AIRPORT RD   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 131 , 132 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1043784978,"CRENSHAW, MARTHA, STONE",1264 AIRPORT RD   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 302 , 304 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1264 AIRPORT RD   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1043784978,"CRENSHAW, MARTHA, STONE",1264 AIRPORT RD   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1264 AIRPORT RD   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1043784978,"CRENSHAW, MARTHA, STONE",1264 AIRPORT RD   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 163 , 165 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1043784978,"CRENSHAW, MARTHA, STONE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043784978,"CRENSHAW, MARTHA, STONE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043793789,"BOUCHERLE, LESLIE, JEAN",1287 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043793789,"BOUCHERLE, LESLIE, JEAN",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043797756,BAYADA HOME HEALTH CARE INC,~,2944 BREEZEWOOD AVE STE 203 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1043797756,BAYADA HOME HEALTH CARE INC,2944 BREEZEWOOD AVE STE 203 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 51 ," 7,464 "," 7,621 "," $800,323.72 ",,
MEDICAID DIRECT,1043799463,PRICE FAMILY CARE HOME LLC,PRICE FAMILY CARE HOME LLC,1385 BROWN RD   JAMESVILLE NC,058,Martin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1043799463,PRICE FAMILY CARE HOME LLC,1385 BROWN RD   JAMESVILLE NC,058,Martin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 596 , 596 ," $46,202.46 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1043803455,"WEAVER, SARAH, ELIZABETH",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 58 , 127 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043808835,"MOSS, CHRISTOPHER, ERIC",1099 MEDICAL CENTER DR STE 101 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043808835,"MOSS, CHRISTOPHER, ERIC",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 38 , 68 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043808835,"MOSS, CHRISTOPHER, ERIC",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 36 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043809528,"COMBS, LAUREN, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 35 , 38 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043809528,"COMBS, LAUREN, LEE",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043811243,ALLY HEALTH SERVICES LLC,,3811 TARHEEL DR STE 106 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1043811243,ALLY HEALTH SERVICES LLC,3811 TARHEEL DR STE 106 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 8,791 "," 9,140 "," $804,409.28 ",,
MEDICAID DIRECT,1043811243,ALLY HEALTH SERVICES LLC,,3811 TARHEEL DR STE 106 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1043811243,ALLY HEALTH SERVICES LLC,3811 TARHEEL DR STE 106 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1043812506,PERKINS CARE HOME LLC,PERKINS CARE HOME,2015 SUNNYSIDE DR   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1043812506,PERKINS CARE HOME LLC,2015 SUNNYSIDE DR   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 814 , 814 ," $162,016.34 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043817620,"CORNELISON, KELLY, LYNN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043817620,"CORNELISON, KELLY, LYNN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043819741,"TOLAN, BRAD, RUSSELL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 130 , 130 ,$#,,
MEDICAID DIRECT,1477538254,PORT HEALTH SERVICES,~,2602 COURTIER DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043824998,"HAMBIDGE, BERTHA, BOWEN",2602 COURTIER DR   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043825680,"EARLEY, MIRANDA, GRESKO",4048 E US HIGHWAY 64 ALT STE 1 MURPHY NC,020,Cherokee,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043825680,"EARLEY, MIRANDA, GRESKO",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043825680,"EARLEY, MIRANDA, GRESKO",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 35 , 136 , 136 ," $26,655.33 ",,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043825680,"EARLEY, MIRANDA, GRESKO",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1043827413,"MAMOOZADEH, SONYA, GRACE",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043829534,"BROWN, SAMANTHA, TALBOT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043829534,"BROWN, SAMANTHA, TALBOT",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043829534,"BROWN, SAMANTHA, TALBOT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043830078,"DELVADIA, NEAL, RASIKLAL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1043830078,"DELVADIA, NEAL, RASIKLAL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043830078,"DELVADIA, NEAL, RASIKLAL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043830078,"DELVADIA, NEAL, RASIKLAL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043830078,"DELVADIA, NEAL, RASIKLAL",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043830078,"DELVADIA, NEAL, RASIKLAL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 234 , 313 , 430 ,$#,,
MEDICAID DIRECT,1043831001,THRIVE NOW THERAPY LLC,,9624 BAILEY RD STE 273 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043831001,THRIVE NOW THERAPY LLC,9624 BAILEY RD STE 273 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1043831001,THRIVE NOW THERAPY LLC,,10210 HICKORYWOOD HILL AVE STE 220 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043831001,THRIVE NOW THERAPY LLC,10210 HICKORYWOOD HILL AVE STE 220 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043831274,"PATEL, PRUTHA, MINESH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043831274,"PATEL, PRUTHA, MINESH",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1043832454,"VERHAEGHE, IAN, FRANK MARC",148 HIGHWAY 105 EXT STE 104 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 204 ," 1,702 "," 1,702 "," $28,184.00 ",,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043832686,"ODOM, SARAH, BRUGGERS",2051 RALPH STEPHENS RD   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043832686,"ODOM, SARAH, BRUGGERS",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043832686,"ODOM, SARAH, BRUGGERS",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043833023,"ERBSEN, RITA, MARIE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 50 , 61 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043834500,"ANDRAOS, HELEN, KALIM",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093065229,MCPC-6 LLC,FIRSTHEALTH BACK AND NECK PAIN CENTER HOKE,4565 FAYETTEVILLE RD B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1043835796,"PERRY, JOSHUA, STEVEN",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 34 , 51 ,$#,,
MEDICAID DIRECT,1093065229,MCPC-6 LLC,FIRSTHEALTH BACK AND NECK PAIN CENTER HOKE,809 S LONG DR STE G ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1043835796,"PERRY, JOSHUA, STEVEN",809 S LONG DR STE G ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 115 , 408 , 659 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043839855,"IBENEME, KENECHUKWU, HILARY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1043839855,"IBENEME, KENECHUKWU, HILARY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043840234,"JIMENEZ, YVONNE, CHAU",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043840234,"JIMENEZ, YVONNE, CHAU",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043840721,"GARDNER, JOHANNA, ROSSITCH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043840721,"GARDNER, JOHANNA, ROSSITCH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043840721,"GARDNER, JOHANNA, ROSSITCH",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043840721,"GARDNER, JOHANNA, ROSSITCH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043840721,"GARDNER, JOHANNA, ROSSITCH",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043840721,"GARDNER, JOHANNA, ROSSITCH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1043843543,"IZZELL, LAUREN, ASHLEY",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 51 , 56 ,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043847049,"TRAN, NGA, THI",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 44 , 48 , 121 ," $10,871.90 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043848252,"KUNZELMAN, LANDON, JOSPEH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043848252,"KUNZELMAN, LANDON, JOSPEH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043848385,"RAEZ, JOSE, ALEJANDRO",3000 ERWIN RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043848880,"IMANI, SABA",1942 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 57 , 160 ,$#,,
MEDICAID DIRECT,1093438244,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN PRIMARY CARE CLINICS,1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043848880,"IMANI, SABA",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043848880,"IMANI, SABA",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043848880,"IMANI, SABA",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043849144,"PANCOAST, MELANIE, NANETTE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 65 , 72 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1043849680,"SHAUKAT, TANVEER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043849680,"SHAUKAT, TANVEER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 93 , 195 , 195 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1043849680,"SHAUKAT, TANVEER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043850456,"GORDON, LINDSEY, MANERS",391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1043850456,"GORDON, LINDSEY, MANERS",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 56 , 113 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5701 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043850456,"GORDON, LINDSEY, MANERS",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043850456,"GORDON, LINDSEY, MANERS",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1043850605,"DODD, DIANA, MARIE",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043850605,"DODD, DIANA, MARIE",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 32 , 32 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,140 W MILLS ST STE A COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1043850605,"DODD, DIANA, MARIE",140 W MILLS ST STE A COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043850605,"DODD, DIANA, MARIE",~,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1043850605,"DODD, DIANA, MARIE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1043850605,"DODD, DIANA, MARIE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043850605,"DODD, DIANA, MARIE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 128 , 225 , 236 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1043850605,"DODD, DIANA, MARIE",23A TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1043850605,"DODD, DIANA, MARIE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1043850605,"DODD, DIANA, MARIE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1043850605,"DODD, DIANA, MARIE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 30 , 30 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1043850605,"DODD, DIANA, MARIE",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043851801,"MYRICK, CODY, ADAM",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043851801,"MYRICK, CODY, ADAM",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043851801,"MYRICK, CODY, ADAM",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043851801,"MYRICK, CODY, ADAM",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 243 ," 1,112 "," 3,225 "," $31,531.34 ",,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043851801,"MYRICK, CODY, ADAM",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043851801,"MYRICK, CODY, ADAM",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 30 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1043861438,"FORCEY, SHERIFAT, I",700 WALTER REED DR   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043862642,"BAILEY, MATTHEW, EDWIN",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1043865314,"CROWDER, GRACIE, PITCHFORD",709 N DEKALB ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 76 , 164 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043868060,"JINDAL, VRINDA, PUNJABI",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",210 ASHVILLE AVE   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043868284,"BUCKNER, JESSICA, ANN",210 ASHVILLE AVE   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",210 ASHVILLE AVE   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",210 ASHVILLE AVE   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346658531,CALDWELL MEMORIAL HOSPITAL,FOOTHILLS DIALYSIS ACCESS,1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 30 , 30 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 70 , 70 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 90 , 96 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 49 , 52 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 93 , 97 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 51 , 51 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 74 , 75 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW STE B LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1043868284,"BUCKNER, JESSICA, ANN",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043868565,"MCGEE, ASHLEY, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 131 , 133 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043869589,"HARVILLE, MATTHEW, SHANE",234 CROOKED CREEK PKWY STE 310 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 26 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043869811,"RILEY, SCOTT, MICHAEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1043871700,"MONTGOMERY, SARAH, YODER",400 SHADOWLINE DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 99 , 99 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043871866,"GRAY, SARAH, ELIZABETH",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043871866,"GRAY, SARAH, ELIZABETH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 66 , 119 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043872005,"TASNEEM, ZAHRA",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1043872005,"TASNEEM, ZAHRA",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043872740,"SANCHEZ-EREBIA, LUIS, ALEXANDER",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1043873524,"CONNER, DAVID, JOSHUA",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 30 , 39 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1043873524,"CONNER, DAVID, JOSHUA",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 98 , 104 , 135 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043874605,"CORRIHER, TRAVIS, DEAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 37 , 52 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043874605,"CORRIHER, TRAVIS, DEAN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043874605,"CORRIHER, TRAVIS, DEAN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043874605,"CORRIHER, TRAVIS, DEAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 35 , 45 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043874605,"CORRIHER, TRAVIS, DEAN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043876493,HOME AGAIN SENIOR LIVING COMMUNITIE,HOME AGAIN HOME CARE,1311 WESTBROOK PLAZA DR STE 109 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1043876493,HOME AGAIN SENIOR LIVING COMMUNITIE,1311 WESTBROOK PLAZA DR STE 109 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,736 "," 1,739 "," $185,264.80 ",,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1043876725,"HARDAWAY, HUNTER, ATKINSON",420 N CENTER ST   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 108 , 115 , 160 ,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043880073,"SHEEHY, GWENDOLYN",1994 WELLNESS BLVD STE 210 MONROE NC,090,Union,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1043881253,"GULLETT, JESSE, LOVINS",3060 HICKORY BLVD   HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 141 , 267 ,$#,,
MEDICAID DIRECT,1598482630,PRONTO HEALTH PLLC,,4101 BURLINGTON RD STE D GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1043881386,"KIRK, KEHINDE, GIWA",4101 BURLINGTON RD STE D GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 19 , 33 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043882764,"CLARK, SHEA, RANDI",301 YADKIN ST   ALBEMARLE NC,084,Stanly,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 37 , 37 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043882855,"HILLMAN, ELISA, LINDHOLM",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1043883903,"MCCANN, KYLE, BRYANT",311 S CAMPBELL ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 678 , 696 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,311 S CAMPBELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1043883903,"MCCANN, KYLE, BRYANT",311 S CAMPBELL ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1043883903,"MCCANN, KYLE, BRYANT",311 S CAMPBELL ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 119 , 122 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043885692,"HUBELI, MORGAN, WALKER",620 SUMMIT CROSSING PL STE 202 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 62 , 98 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043885692,"HUBELI, MORGAN, WALKER",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043885692,"HUBELI, MORGAN, WALKER",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043885692,"HUBELI, MORGAN, WALKER",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942301957,BLUE RIDGE HEALTHCARE MEDICAL GROUP,DREXEL MEDICAL PRACTICE,2659 US HIGHWAY 70 E   VALDESE NC,012,Burke,193400000X,Group,Single Specialty,,1043887649,"JONAS, SARAH, ESTRIDGE",2659 US HIGHWAY 70 E   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 70 , 170 , 245 ,$#,,
MEDICAID DIRECT,1043891849,HELPING OTHER PEOPLE EMPOWER THEMSE,,1400 BATTLEGROUND AVE STE 209C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1043891849,HELPING OTHER PEOPLE EMPOWER THEMSE,1400 BATTLEGROUND AVE STE 209C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 204 , 225 ," $13,911.40 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043896079,"CLARK, HUNTER, KELSEY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043896079,"CLARK, HUNTER, KELSEY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1043899123,"CANTWELL, CELESTE, CRAFT",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 67 , 124 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043899123,"CANTWELL, CELESTE, CRAFT",1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 33 ,$#,,
MEDICAID DIRECT,1710388772,SCHUSTER PHYSICAL THERAPY INC,,419 E MAIN ST UNIT 4 JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1043899982,"MULLEN, CARMEN, DANIELLE",419 E MAIN ST UNIT 4 JEFFERSON NC,005,Ashe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 23 , 57 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043902299,"BRITTINGHAM, ETHAN, HUGH",11081 FOREST PINES DR STE 112 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043910185,"COLEMAN, MIKAELA, REESE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043910185,"COLEMAN, MIKAELA, REESE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1992459515,MONTERA HEALTH TEXAS LLC,,3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1043910672,"SCHATZ, AVERY",3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 156 , 165 ," $49,883.42 ",,
MEDICAID DIRECT,1194302901,APPALACHIAN REGIONAL BEHAVIORAL HEA,ARBH PROVIDERS,432 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1043911969,"ANDING, JOSHUA, DAVID",432 HOSPITAL DR   LINVILLE NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043914146,"GRIFFITH, ALEXANDRA, NOEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043914146,"GRIFFITH, ALEXANDRA, NOEL",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043914146,"GRIFFITH, ALEXANDRA, NOEL",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043917354,"DISANZO, TIFFANY, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043917354,"DISANZO, TIFFANY, KELLY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043917354,"DISANZO, TIFFANY, KELLY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043917586,"HODGES, ANNA, SHERIDAN",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1043919095,MED-TRANS CORPORATION,,800 W MEETING ST RM 401 LANCASTER SC,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1043919095,MED-TRANS CORPORATION,800 W MEETING ST RM 401 LANCASTER SC,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1043925571,"PEELE, GARRISON, GRAY",8700 PINEVILLE MATTHEWS RD STE 540 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 30 , 48 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043925571,"PEELE, GARRISON, GRAY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1043928203,A PRIMARY CHOICE INC,,1595 E GARRISON BLVD STE B GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1043928203,A PRIMARY CHOICE INC,1595 E GARRISON BLVD STE B GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#, 688 , 688 ," $42,470.96 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1043930316,"CRUTE, ALLISON, LINDSAY",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043931926,"GONZALEZ, JENNIFER, ESTHER",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043931926,"GONZALEZ, JENNIFER, ESTHER",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043932403,"KEENAN, KYRIAKI, MARGARET",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043932593,"URSUY, NATALIE, ANN",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 50 , 78 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043934284,"MASTERS, SUZANNE, LAMBERT",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1043934284,"MASTERS, SUZANNE, LAMBERT",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 20 , 37 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043938343,"JONES, TAYLOR, DANIELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043938343,"JONES, TAYLOR, DANIELLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043939630,RESTORATIVE CARE HOMECARE LLC,,110 E ARLINGTON BLVD STE L GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1043939630,RESTORATIVE CARE HOMECARE LLC,110 E ARLINGTON BLVD STE L GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 671 , 671 ," $43,847.22 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1043939895,"ALI, FABEN",11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043941933,"ABRAHAM, ARUNA, RAMSAYWACK",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1043941933,"ABRAHAM, ARUNA, RAMSAYWACK",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1043942741,"DELIVUK, JAIME, LEE",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 76 , 79 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1043942741,"DELIVUK, JAIME, LEE",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 24 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1043942741,"DELIVUK, JAIME, LEE",220 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1043942741,"DELIVUK, JAIME, LEE",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043943863,"BARBER, KATHLEEN, WHITLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 47 , 59 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043943863,"BARBER, KATHLEEN, WHITLEY",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1043945041,"BLIZZARD, MARK, ASHFORD",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 117 , 205 , 349 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1043948722,"NICKEL, THOMAS, ROSS",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1043949415,"WOODWARD, NATHAN, TYLER",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 57 , 66 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043949415,"WOODWARD, NATHAN, TYLER",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043950348,"RADEMACHER, VICTORIA, LYNN",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 70 , 70 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043950348,"RADEMACHER, VICTORIA, LYNN",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639661796,OPPORTUNITIES INDUSTRIALIZATION CEN,~,260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043950348,"RADEMACHER, VICTORIA, LYNN",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043950348,"RADEMACHER, VICTORIA, LYNN",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1043952062,"DIGIOVANNANTONIO, NICHOLAS, VINCENT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043965742,"CALDWELL, SARAH, ELISABETH",,3821 ED DR   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1043965742,"CALDWELL, SARAH, ELISABETH",3821 ED DR   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 18 , 25 , 35 ,$#,,
MEDICAID DIRECT,1043965742,"CALDWELL, SARAH, ELISABETH",,110 KILDAIRE PARK DR STE 500 CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1043965742,"CALDWELL, SARAH, ELISABETH",110 KILDAIRE PARK DR STE 500 CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1043965981,"HALSCH, BRENT, JAMES",6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1043966906,"JONES, CHRISTINA, CHERYL",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 20 , 36 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1043966906,"JONES, CHRISTINA, CHERYL",300 BIRCH ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 47 , 137 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1043966906,"JONES, CHRISTINA, CHERYL",300 BIRCH ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1043966906,"JONES, CHRISTINA, CHERYL",300 BIRCH ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1043966906,"JONES, CHRISTINA, CHERYL",300 BIRCH ST   RAEFORD NC,047,Hoke,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1043966906,"JONES, CHRISTINA, CHERYL",300 BIRCH ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1043966906,"JONES, CHRISTINA, CHERYL",300 BIRCH ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 29 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1043971757,"CASEY, MICHELLE, CHRISTINE",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1043971757,"CASEY, MICHELLE, CHRISTINE",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 37 , 58 ,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043971757,"CASEY, MICHELLE, CHRISTINE",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1043971757,"CASEY, MICHELLE, CHRISTINE",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 31 , 101 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1043971757,"CASEY, MICHELLE, CHRISTINE",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043972888,"FLEMING, HUNTER, LAUREN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043972888,"FLEMING, HUNTER, LAUREN",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043974884,"BASKIN, JEANINE",6371 JESSIE LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043974884,"BASKIN, JEANINE",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1043974884,"BASKIN, JEANINE",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043982002,PRUITTHEALTH DIAGNOSTICS SERVICES I,,1626 JEURGENS CT   NORCROSS GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1043982002,PRUITTHEALTH DIAGNOSTICS SERVICES I,1626 JEURGENS CT   NORCROSS GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 52 , 172 , 565 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043982713,"SOTTILE, ROBERT, MICHAEL",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043982713,"SOTTILE, ROBERT, MICHAEL",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1131 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043983489,"CLARKE, JACQUELINE, JANICE",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 27 , 136 , 136 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,5533 BURLINGTON RD   MC LEANSVILLE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043983489,"CLARKE, JACQUELINE, JANICE",5533 BURLINGTON RD   MC LEANSVILLE NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 11 , 60 , 60 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,5100 MACKAY RD   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1043983489,"CLARKE, JACQUELINE, JANICE",5100 MACKAY RD   JAMESTOWN NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 15 , 90 , 92 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1043983810,"DUNNAHOO, FORREST, CHADWICK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1043983810,"DUNNAHOO, FORREST, CHADWICK",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1043983810,"DUNNAHOO, FORREST, CHADWICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1043983810,"DUNNAHOO, FORREST, CHADWICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033677240,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - MAIDEN,137 ISLAND FORD RD   MAIDEN NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043991680,"BRADSHAW, MONICA, FOX",137 ISLAND FORD RD   MAIDEN NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 37 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1043992076,"BEHMAN, AMY, LILIAN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043992076,"BEHMAN, AMY, LILIAN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043992076,"BEHMAN, AMY, LILIAN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1043992076,"BEHMAN, AMY, LILIAN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649615741,HEARING SOLUTIONS OF NORTH CAROLINA,~,464 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1043992084,"MUSSLER, SADIE, LENKEWICZ",464 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1184219222,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PEDIATRICS,713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1043992530,"WEST, KAITLIN, MICHELE",713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 44 , 103 ,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1043992548,"GOTTSCHALK, ALYSSA, CATHERINE",400 S CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1043992548,"GOTTSCHALK, ALYSSA, CATHERINE",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043993959,"LOCKLEAR, CANDACE, BROOKE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043993959,"LOCKLEAR, CANDACE, BROOKE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 20 ,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043993959,"LOCKLEAR, CANDACE, BROOKE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043993959,"LOCKLEAR, CANDACE, BROOKE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 35 , 47 ,$#,,
MEDICAID DIRECT,1851177539,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1043993959,"LOCKLEAR, CANDACE, BROOKE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1043996218,FARRAHS HOMECARE AGENCY LLC,,1606 E DIXON BLVD STE B SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1043996218,FARRAHS HOMECARE AGENCY LLC,1606 E DIXON BLVD STE B SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,668 "," 1,668 "," $110,396.16 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1043998297,"LENKER, NICHOLAS, DEAN",8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 15 , 42 ,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,193400000X,Group,Single Specialty,,1043998297,"LENKER, NICHOLAS, DEAN",1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,13068 NC HIGHWAY 50   SURF CITY NC,071,Pender,193400000X,Group,Single Specialty,,1043998297,"LENKER, NICHOLAS, DEAN",1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 24 , 71 ,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1043998297,"LENKER, NICHOLAS, DEAN",14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 517 , 820 ," 2,315 "," $125,546.45 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,1108 PARKWAY DR STE A GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1043998297,"LENKER, NICHOLAS, DEAN",14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1619517976,MOUNTAIN COMMUNITY HEALTH PARTNERSH,MOUNTAIN COMMUNITY HEALTH PARTNERSHIP DENTAL CENTE,89 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,193400000X,Group,Single Specialty,,1053000315,"VAN DER VORST, MARGUERITE, MARIE",89 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 177 , 199 , 461 ," $24,649.97 ",,
MEDICAID DIRECT,1053005801,CAT GROUP LLC,CULTIVATE HOME CARE,2506 W NASH ST STE B WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1053005801,CAT GROUP LLC,2506 W NASH ST STE B WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,#, 667 , 667 ," $41,052.48 ",,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053006296,"WILLIAMS, LOREAL, SHERIAN",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1053007500,"ASHLEY, WENDY, AKUA AMA",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1053012013,LP HOME CARE LLC,,4242 SIX FORKS RD STE 1550 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1053012013,LP HOME CARE LLC,4242 SIX FORKS RD STE 1550 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,122 "," 3,331 "," $444,342.92 ",,
MEDICAID DIRECT,1053012567,ABLE CARE HOME HEALTH,,2606 RAEFORD RD STE 7 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1053012567,ABLE CARE HOME HEALTH,2606 RAEFORD RD STE 7 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 565 , 646 ," $112,445.04 ",,
MEDICAID DIRECT,1598762940,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053014118,"SHAH, RUDRA, DEVANG",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 17 , 35 ,$#,,
MEDICAID DIRECT,1073914024,LITTLE OAKS PEDIATRICS PLLC,,13200 STRICKLAND RD STE 120 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053014118,"SHAH, RUDRA, DEVANG",13200 STRICKLAND RD STE 120 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 12 ,$#,,
MEDICAID DIRECT,1598007445,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE - VASS,3349 US HIGHWAY 1   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1053015255,"MOORE, JENNIFER, EVANS",3349 US 1 HWY   VASS NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 125 , 238 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053017442,"THOMAS, WHITNEY, IMAN",2818 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 80 , 21 , 70 ,$#,,
MEDICAID DIRECT,1518397587,CAROLINA CARDIOLOGY SLEEP & OBESITY,,3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1053021717,"SNYDER, MICHELLE, L",3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053021956,RELIANCE HOME CARE AGENCY OF OXFORD,,614 RALEIGH ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1053021956,RELIANCE HOME CARE AGENCY OF OXFORD,614 RALEIGH ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 3,807 "," 3,807 "," $232,815.61 ",,
MEDICAID DIRECT,1053023416,"JENNINGS, BREANNA, MICHELLE",~,498 PUETT COVE RD   MARBLE NC,020,Cherokee,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1053023416,"JENNINGS, BREANNA, MICHELLE",498 PUETT COVE RD   MARBLE NC,020,Cherokee,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 13 , 60 , 60 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053024414,"SUITS, PATRICIA, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053024414,"SUITS, PATRICIA, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1053024414,"SUITS, PATRICIA, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 49 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053035824,"MCKEE, RACHEL, CHRISTINE",4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053035824,"MCKEE, RACHEL, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053035824,"MCKEE, RACHEL, CHRISTINE",4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 39 , 44 , 54 ,$#,,
MEDICAID DIRECT,1053036160,TENDER LOVING TOUCH SENIOR CARE SER,AT HOME ELDERCARE,1057 BULLARD CT STE B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1053036160,TENDER LOVING TOUCH SENIOR CARE SER,1057 BULLARD CT STE B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 2,618 "," 2,677 "," $254,270.84 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053036830,"AUSTIN, HANNAH, MACKENZIE",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 5,429 "," 6,372 "," 35,406 "," $954,895.55 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053036830,"AUSTIN, HANNAH, MACKENZIE",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1053036830,"AUSTIN, HANNAH, MACKENZIE",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1053036830,"AUSTIN, HANNAH, MACKENZIE",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053036830,"AUSTIN, HANNAH, MACKENZIE",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1053038638,"COOPER, DARBY, ELISABETH",125 MEDICAL PARK LN   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 49 , 49 ," $19,404.00 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053039800,"SAUVAGEOT, KATHERINE, ELIZABETH",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053039800,"SAUVAGEOT, KATHERINE, ELIZABETH",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053039800,"SAUVAGEOT, KATHERINE, ELIZABETH",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386960342,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053039800,"SAUVAGEOT, KATHERINE, ELIZABETH",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053042077,"GILLIS, LUKE, ALEXANDER",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053042689,"POTTER, JENNIFER, DAUGHETY",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1053042689,"POTTER, JENNIFER, DAUGHETY",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053042689,"POTTER, JENNIFER, DAUGHETY",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053042689,"POTTER, JENNIFER, DAUGHETY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1053042689,"POTTER, JENNIFER, DAUGHETY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053042960,"STOCKS, JESSICA, JOANN",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053042960,"STOCKS, JESSICA, JOANN",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1053042960,"STOCKS, JESSICA, JOANN",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053042960,"STOCKS, JESSICA, JOANN",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053046607,"PACHECO, CALI, ANGEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053046607,"PACHECO, CALI, ANGEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053048710,"CLAY, MARTHA, MALLARY",240 BROAD ST   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 60 , 138 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053056325,"KEEFE, SUSAN, HUANG",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 285 , 309 ," 1,257 "," $136,077.95 ",,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053056325,"KEEFE, SUSAN, HUANG",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053057588,"HACKNEY, CROSSLEY, RAE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053057588,"HACKNEY, CROSSLEY, RAE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053057729,"BALEK, EMMA, JANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053059279,CAN I LIVE ENTERPRISE LLC,L & M TRANSPORTATION,963 NC HIGHWAY 57 N   MILTON NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1053059279,CAN I LIVE ENTERPRISE LLC,963 NC HIGHWAY 57 N   MILTON NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 22 , 35 , 36 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053060814,"CARRIER, MACKENZIE, GROMLOVITS",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053060814,"CARRIER, MACKENZIE, GROMLOVITS",319 VILLAGE RD NE   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053060814,"CARRIER, MACKENZIE, GROMLOVITS",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053064048,"SISKA, LINDSEY, JAE",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 52 , 77 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053069187,"CAMERON, MARY, MARGARET",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 27 , 68 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053069187,"CAMERON, MARY, MARGARET",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 58 , 100 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053070128,"OLIVER, JULIE, MACKENZIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1700287695,REGENT PLLC,,906 BURCH AVE   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053071134,"WILLIAMS, KIMBERLY, DANIELLE",906 BURCH AVE   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 14 , 27 ,$#,,
MEDICAID DIRECT,1700287695,REGENT PLLC,,4469 VERANDA LAKE CT   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053071134,"WILLIAMS, KIMBERLY, DANIELLE",906 BURCH AVE   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 17 , 338 , 561 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053075663,"MOYNIHAN, RACHEL, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053075663,"MOYNIHAN, RACHEL, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053088914,"FRICKE, SEAN, POWERS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053088914,"FRICKE, SEAN, POWERS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053089045,"GILBERT, LINDSAY, RENEE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053089045,"GILBERT, LINDSAY, RENEE",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1053091900,"HUNT, FAITH, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1053091900,"HUNT, FAITH, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 39 , 39 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053094268,"MONTALVO, ROBYN, DANIELLE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053149435,"NDURE, ISATTA",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053149435,"NDURE, ISATTA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053149435,"NDURE, ISATTA",652 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053152355,"DAUBERT, MAIRIN, WENLEY",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053152355,"DAUBERT, MAIRIN, WENLEY",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053152355,"DAUBERT, MAIRIN, WENLEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053152355,"DAUBERT, MAIRIN, WENLEY",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053153668,"BRIDGEMAN, MICHELLE, MARIN",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053154740,"MCKINNEY, LAVONA, DION",769 HWY 177 S   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 402 , 402 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053154740,"MCKINNEY, LAVONA, DION",400 VISION DR   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 374 , 374 ," $10,214.88 ",,
MEDICAID DIRECT,1225445331,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - THOMASVILLE,611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053155986,"SULLIVAN, ANDREW, LEWIS",611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053156521,"PREBIS, SHANE, CRUZ",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 33 , 38 ,$#,,
MEDICAID DIRECT,1053163451,A BETTER WAY HOME CARE INC,,1121 S WESLEYAN BLVD   ROCKY MOUNT NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1053163451,A BETTER WAY HOME CARE INC,1121 S WESLEYAN BLVD   ROCKY MOUNT NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,#, 76 , 76 ,$#,,
MEDICAID DIRECT,1053166694,SAINT LYFE HOME CARE LLC,,4232 COGHILL DR N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1053166694,SAINT LYFE HOME CARE LLC,4232 COGHILL DR N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 3,319 "," 3,447 "," $245,981.12 ",,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053167130,"WARE, CELESTE, CHANTEL",2555 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",1306 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 240 , 240 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1306 S KING ST   WINDSOR NC,008,Bertie,193400000X,Group,Single Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",1306 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",1306 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 88 , 88 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",1306 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 142 , 142 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 24 , 24 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 25 , 25 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1053169946,"SMILING, TIFFANY, MICHELLE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 36 ,$#,,
MEDICAID DIRECT,1174124614,HOSPICE OF STANLY COUNTY INC,TILLERY COMPASSIONATE CARE,960 N 1ST ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1053172205,"CLARK, KORTNEY, WILSON",960 N 1ST ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 25 , 30 ,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1053179804,"HURLEY, TEKARIA, TASHIANA-MONIQUE",683 E PALMER ST   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 76 ,$#,,
MEDICAID DIRECT,1134286321,COUNTY OF HOKE,HOKE COUNTY HEALTH DEPARTMENT,683 E PALMER ST   RAEFORD NC,047,Hoke,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053179804,"HURLEY, TEKARIA, TASHIANA-MONIQUE",683 E PALMER ST   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 27 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1053184143,"JOHNSON-EADY, DEBORAH, RENA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053184648,"FERGUSON, CHELSEA, LEAH",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053184648,"FERGUSON, CHELSEA, LEAH",319 VILLAGE RD NE   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4600 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053184648,"FERGUSON, CHELSEA, LEAH",901 DOW RD   CAROLINA BCH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6901 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053184648,"FERGUSON, CHELSEA, LEAH",901 DOW RD   CAROLINA BCH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053190405,"SOLEIMANI, MOHAMMAD",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 61 , 78 , 117 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053190405,"SOLEIMANI, MOHAMMAD",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053190405,"SOLEIMANI, MOHAMMAD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053190405,"SOLEIMANI, MOHAMMAD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 37 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053190405,"SOLEIMANI, MOHAMMAD",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 22 , 24 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053197459,"WALTERS, SHANNA, MICHELLE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1053198069,"EDMUNDSON, RONNIE, ELAINE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 103 , 115 , 319 ," $12,304.10 ",,
MEDICAID DIRECT,1053199729,CHRISTIAN FAITH HOME CARE AGENCY,,120 JAMES ST OFC 1-B LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1053199729,CHRISTIAN FAITH HOME CARE AGENCY,120 JAMES ST OFC 1-B LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,351 "," 1,359 "," $93,097.61 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053300087,"CHUMPITAZI, CORRIE, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 26 , 28 , 29 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053303768,"HACK, JASON, BENJAMIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 35 , 37 ,$#,,
MEDICAID DIRECT,1326006438,A WOMANS PLACE IN FAYETTEVILLE,A WOMANS PLACE IN FAYETTEVILLE,2053 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1053303891,"GORDON, LAKSHMI, VADLAMUDI",2053 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 55 , 87 , 109 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1053304097,"MOELLER, MARK, BOLTON",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 72 , 140 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053304212,"LEPERA, PAMELA, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 58 , 102 , 102 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053305052,"BRANTLEY, DAVID, SPENCER",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",3900 E 10TH ST   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 41 , 140 , 153 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",3900 E 10TH ST   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 12 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,604 MEDICAL DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",604 MEDICAL DR   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 16 , 23 , 30 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 35 , 143 , 144 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 62 , 93 , 118 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053305425,"MILLAN, RAYMUNDO, DOMINADOR VASQUEZ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 39 , 123 , 124 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053305722,"CHAMBERLAIN, MATTHEW, PAUL",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 118 , 231 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053305722,"CHAMBERLAIN, MATTHEW, PAUL",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 62 , 102 ,$#,,
MEDICAID DIRECT,1619903481,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053305722,"CHAMBERLAIN, MATTHEW, PAUL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053305722,"CHAMBERLAIN, MATTHEW, PAUL",2221 W RALEIGH BLVD   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 240 , 240 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053305722,"CHAMBERLAIN, MATTHEW, PAUL",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053305722,"CHAMBERLAIN, MATTHEW, PAUL",2221 W RALEIGH BLVD   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 61 , 61 ,$#,,
MEDICAID DIRECT,1053305888,"ISSA, ELIAS, GEORGES",~,101 RIVERSTONE VIS STE 207 BLUE RIDGE GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1053305888,"ISSA, ELIAS, GEORGES",101 RIVERSTONE VIS STE 207 BLUE RIDGE GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1487891933,APPALACHIAN REGIONAL MEDICAL ASSOCI,ELK RIVER MEDICAL ASSOCIATES,150 PARK AVE   BANNER ELK NC,006,Avery,193400000X,Group,Single Specialty,,1053306092,"KIMMEL, DAVID, PAUL",150 PARK AVE   BANNER ELK NC,006,Avery,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1487891933,APPALACHIAN REGIONAL MEDICAL ASSOCI,ELK RIVER MEDICAL ASSOCIATES,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1053306092,"KIMMEL, DAVID, PAUL",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487891933,APPALACHIAN REGIONAL MEDICAL ASSOCI,ELK RIVER MEDICAL ASSOCIATES,150 PARK AVE   BANNER ELK NC,006,Avery,193200000X,Group,Multi-Specialty,,1053306092,"KIMMEL, DAVID, PAUL",150 PARK AVE   BANNER ELK NC,006,Avery,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 120 , 265 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053306944,"PALTZER, JENNIFER, LYNN",2 YORKSHIRE ST   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053308288,"CLARK, JOSEPH, MADISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053308288,"CLARK, JOSEPH, MADISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053308288,"CLARK, JOSEPH, MADISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",2275 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 143 , 175 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",24724 US HIGHWAY 52 S   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",901 RIDGE RD   ROXBORO NC,073,Person,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 61 , 69 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",901 RIDGE RD   ROXBORO NC,073,Person,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",542 ALLRED MILL RD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",44 HOSPITAL DR STE 1A COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 203 , 217 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",333 E LEE AVE   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 29 , 43 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",903 W MAIN ST   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 51 , 75 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",1101 N MORGAN ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 98 , 112 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 50 , 62 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",322 NUWAY CIR   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 147 , 227 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",1403 CONNER DR   WINDSOR NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 36 , 46 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",1101 N MORGAN ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 131 , 153 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",1306 S KING ST   WINDSOR NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 58 , 74 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",7449 FAIR OAKS DR   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 65 , 76 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",2600 CROASDAILE FARM PKWY   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 82 , 85 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 34 , 35 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053308635,"HOLLEMAN, JAMES, BENNETT",485 VETERANS WAY   KERNERSVILLE NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053309419,"AKHTAR, AFAQUE",AFAQUE AKHTAR,409 WAKE CHAPEL RD   FUQUAY VARINA NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1053309419,"AKHTAR, AFAQUE",409 WAKE CHAPEL RD   FUQUAY VARINA NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1982933131,PREMIER HEALTH CENTER PLLC,PREMIER HEALTH CENTERPLLC,409 WAKE CHAPEL RD   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1053309419,"AKHTAR, AFAQUE",409 WAKE CHAPEL RD   FUQUAY VARINA NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 128 , 857 ," 1,396 "," $57,415.70 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1053310276,"BROWN, GREGORY, PATRICK",186 MEDICAL PARK LOOP STE 503 SYLVA NC,050,Jackson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 40 , 66 , 100 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1053310276,"BROWN, GREGORY, PATRICK",560 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 104 , 152 , 252 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1053310383,"LIN, JAMES, WEISHI",309 NEW ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 177 , 441 , 692 ," $19,951.92 ",,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1053310383,"LIN, JAMES, WEISHI",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1821545633,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD SPINE CENTER,800 E CHEVES ST STE 480-B FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053311134,"CHOKSHI, RAKESH, PRAVIN",800 E CHEVES ST STE 480-B FLORENCE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053312082,"WILLIAMS, KEVIN, ROLANDO",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 34 , 54 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053312082,"WILLIAMS, KEVIN, ROLANDO",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 23 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053312082,"WILLIAMS, KEVIN, ROLANDO",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 46 , 65 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053312082,"WILLIAMS, KEVIN, ROLANDO",214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629122528,LANE & ASSOCIATES XIV DDS PA,LANE & ASSOCIATES XIV DDS PA,1200 BROAD ST STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053312322,"HA, QUANG",1242 S FIFTH ST STE D MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 15 , 34 ,$#,,
MEDICAID DIRECT,1578114732,LANE AND ASSOCIATES XXXIV DDS PA,,6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053312322,"HA, QUANG",1242 S FIFTH ST STE D MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 822 ," 1,109 "," 4,084 "," $214,861.37 ",,
MEDICAID DIRECT,1578114732,LANE AND ASSOCIATES XXXIV DDS PA,,6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053312322,"HA, QUANG",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 712 , 932 ," 3,530 "," $192,032.94 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053314609,"JORDAN, SHERYL, GILLIKIN",1331 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 23 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053314922,"ALBRIGHT, DANIEL, JAMES",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 21 , 42 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1053314922,"ALBRIGHT, DANIEL, JAMES",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 19 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053314922,"ALBRIGHT, DANIEL, JAMES",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 33 , 54 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053314922,"ALBRIGHT, DANIEL, JAMES",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053314922,"ALBRIGHT, DANIEL, JAMES",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053315499,"AASSAR, OLE, SAMI",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 117 , 120 , 148 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053315499,"AASSAR, OLE, SAMI",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 88 , 92 , 106 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053316281,"GACHA, SAMUEL, ALFREDO",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1053316562,"IRVIN, STEPHEN, BRIAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1053316562,"IRVIN, STEPHEN, BRIAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 45 , 45 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053318246,"BRITTON, MARY, JINJOO",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 16 , 22 ,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053318246,"BRITTON, MARY, JINJOO",1205 N CENTER ST   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 101 , 245 ,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053318246,"BRITTON, MARY, JINJOO",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 47 , 104 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1053319020,"DEPAS, LAURA, LOUISE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1053319020,"DEPAS, LAURA, LOUISE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053319020,"DEPAS, LAURA, LOUISE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1053319020,"DEPAS, LAURA, LOUISE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1053319178,"UNTCH, WANDA, COLLEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1053319327,"MCDONALD JR, THOMAS, JOSEPH",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1053319327,"MCDONALD JR, THOMAS, JOSEPH",105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 63 , 87 , 135 ,$#,,
MEDICAID DIRECT,1053320630,APRIA HEALTHCARE LLC,~,3845 SHOPTON RD STE 300 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1053320630,APRIA HEALTHCARE LLC,3845 SHOPTON RD STE 300 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1053320630,APRIA HEALTHCARE LLC,~,3845 SHOPTON RD STE 300 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1053320630,APRIA HEALTHCARE LLC,3845 SHOPTON RD STE 300 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 469 ," 1,528 "," 3,137 "," $67,817.84 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053322073,"CZECH, JULIE, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 163 , 163 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053323303,"LLOYD, ALLEN, JAMES",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053323303,"LLOYD, ALLEN, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 152 , 153 ," $10,060.24 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053324913,"ALIBRAHIM, OMAR, SHUKRI",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053324913,"ALIBRAHIM, OMAR, SHUKRI",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 56 , 172 , 176 ," $37,852.08 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 277 , 883 ," 1,048 "," $16,737.69 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,341 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 49 , 53 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053325803,"PEREZ, JOSE, EDUARDO",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1871652875,COASTAL EYE CENTER,~,1855 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1053326777,"VERDI, VINCENT, JAMES",1855 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 59 , 121 , 241 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053329458,"LANE, JOHN, FRANCIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053329912,"DORR, VICTORIA, JOAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 128 , 128 ,$#,,
MEDICAID DIRECT,1023254497,PORT CITY URGENT CARE,~,706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053330480,"PRICE, CLINT, DAVID",706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 26 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053330480,"PRICE, CLINT, DAVID",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053330480,"PRICE, CLINT, DAVID",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053330480,"PRICE, CLINT, DAVID",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053330480,"PRICE, CLINT, DAVID",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053330480,"PRICE, CLINT, DAVID",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053330811,"VANCE, TED, BRYAN",752 HARTNESS RD   STATESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 78 , 80 , 84 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,3643 N ROXBORO ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1053331330,"STOLL, MICHAEL, PATRICK",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1053331330,"STOLL, MICHAEL, PATRICK",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1053332932,RANDOLPH COUNTY SCHOOLS,RANDOLPH COUNTY SCHOOLS,2222 S FAYETTEVILLE ST STE C ASHEBORO NC,076,Randolph,251300000X,Agencies,Local Education Agency (LEA),,1053332932,RANDOLPH COUNTY SCHOOLS,2222 S FAYETTEVILLE ST STE C ASHEBORO NC,076,Randolph,251300000X,Agencies,Local Education Agency (LEA),, 215 ," 3,153 "," 3,190 "," $145,941.40 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053334367,"GASTON, RAYMOND, GLENN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 45 , 74 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053334938,"LEE, JINOO, TOMMY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053334938,"LEE, JINOO, TOMMY",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760652150,EVERETTE B THOMBS SR MD,,711 W MOUNTAIN ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1053335281,"THOMBS, EVERETTE, BERNARD",711 W MOUNTAIN ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 27 ,$#,,
MEDICAID DIRECT,1053335729,MOLECULAR PATHOLOGY LABORATORY NETW,MOLECULAR PATHOLOGY LABORATORY,250 E BROADWAY AVE   MARYVILLE TN,101,Out of State <= 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1053335729,MOLECULAR PATHOLOGY LABORATORY NETW,250 E BROADWAY AVE   MARYVILLE TN,101,Out of State <= 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1053335919,"MCGUIRT, WYMAN, T",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053335919,"MCGUIRT, WYMAN, T",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 63 , 101 , 157 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1053336321,"HARTZOG, TIMOTHY, HILLERY",1010 COLLEGE ST   OXFORD NC,039,Granville,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1053336925,"BATTULA, RAJAMANI, CHOUDARY",117 E KINGS HWY   EDEN NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 61 , 64 , 66 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053336925,"BATTULA, RAJAMANI, CHOUDARY",117 E KINGS HWY   EDEN NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053336925,"BATTULA, RAJAMANI, CHOUDARY",117 E KINGS HWY   EDEN NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053336925,"BATTULA, RAJAMANI, CHOUDARY",117 E KINGS HWY   EDEN NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1053337048,WESTERN CAROLINA UNIVERSITY,WESTERN CAROLINA UNIVERSITY SPEECH AND HEARING CEN,3971 LITTLE SAVANNAH RD RM 132 CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1053337048,WESTERN CAROLINA UNIVERSITY,3971 LITTLE SAVANNAH RD RM 132 CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,, 18 , 98 , 104 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053337774,"CORDORA, MICHAEL",140 DENTAL CIR   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1053338228,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3595,7701 S RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1053338228,WAL-MART STORES EAST LP,7701 S RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053339267,"LEE, MITCHELL, DOUGLAS",6752 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053339267,"LEE, MITCHELL, DOUGLAS",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053339283,"WILLIAMS TOONE, DEITRA, LETRICE",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053339283,"WILLIAMS TOONE, DEITRA, LETRICE",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053339283,"WILLIAMS TOONE, DEITRA, LETRICE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053339283,"WILLIAMS TOONE, DEITRA, LETRICE",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 67 , 132 , 287 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053339465,"BELL, ZAKIA, DIANE ANTHANETTE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053340059,"MCCAMMON, CAROL, FOSS",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053341651,"KARRIKER, MARY, MARTHA",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053341651,"KARRIKER, MARY, MARTHA",179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 28 ,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1053343293,"DUPLER, RONALD, LEROY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 60 , 64 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1053343293,"DUPLER, RONALD, LEROY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 106 , 114 , 167 ,$#,,
MEDICAID DIRECT,1053346783,"PICKENS, TRAVIS",Travis L Pickens,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1053346783,"PICKENS, TRAVIS",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053346783,"PICKENS, TRAVIS",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 67 , 79 , 119 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053346783,"PICKENS, TRAVIS",5211 EASON ST STE 1 SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053346783,"PICKENS, TRAVIS",1176 E CUTLAR XING   LELAND NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1053347344,ACCURATE HEALTHCARE INC,,,,Unknown,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1053347344,ACCURATE HEALTHCARE INC,493 CAVE RD   NASHVILLE TN,102,Out of State > 40 miles,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1053348375,"FISCHER, KEVIN, ROBERT",45 PLATEAU ST   BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1043752363,SWAIN INTEGRATED SERVICES PC,,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1053348375,"FISCHER, KEVIN, ROBERT",45 PLATEAU ST   BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 128 , 147 , 156 ," $12,879.10 ",,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1053348375,"FISCHER, KEVIN, ROBERT",45 PLATEAU ST   BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053348524,"WOODS, RICHARD, LEE",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053348524,"WOODS, RICHARD, LEE",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1053348524,"WOODS, RICHARD, LEE",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 28 , 28 ,$#,,
MEDICAID DIRECT,1407960354,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053348524,"WOODS, RICHARD, LEE",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 48 , 57 , 57 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053348607,"CALHOUN, JILL, SUZANNE",738 BRYANT ST STE A STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 48 , 78 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053349118,"MOUGH, RHONDA, BLOOM",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1699483586,EYECARE SPECIALTIES OF NORTH CAROLI,,504 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1053349803,"BRYAN, ADAM, BURTON",504 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053350629,"MARCHESCHI, DAVID, G",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053351544,"ARSLAN, GOHAR",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 22 , 41 , 41 ,$#,,
MEDICAID DIRECT,1114293818,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST EAR NOSE & THRO,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053351965,"BATES, DWIGHT, DAVID",1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 78 , 113 , 142 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053352435,"MIYAZAKI, DOUGLAS, WAYNE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053352435,"MIYAZAKI, DOUGLAS, WAYNE",770 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 46 , 70 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053352435,"MIYAZAKI, DOUGLAS, WAYNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053352435,"MIYAZAKI, DOUGLAS, WAYNE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053353136,"GOLDSTEIN, BRADLEY, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 20 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053353136,"GOLDSTEIN, BRADLEY, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053353136,"GOLDSTEIN, BRADLEY, JOHN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053353136,"GOLDSTEIN, BRADLEY, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053353136,"GOLDSTEIN, BRADLEY, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053354118,"MITCHELL, PAUL, BRUCE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053354118,"MITCHELL, PAUL, BRUCE",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053354118,"MITCHELL, PAUL, BRUCE",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053354118,"MITCHELL, PAUL, BRUCE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053354142,"COLLINS JR, FRANCIS, FARRELL",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 167 , 460 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053354142,"COLLINS JR, FRANCIS, FARRELL",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 16 , 41 ,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1053354241,"OSBORN, RICHARD, WAYNE",101 HOSPITAL DR   COLUMBUS NC,075,Polk,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053354894,"TOLA, DENISE, HIRSCH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053354894,"TOLA, DENISE, HIRSCH",40 DUKE MEDICINE CIR # 2H DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053354894,"TOLA, DENISE, HIRSCH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053354894,"TOLA, DENISE, HIRSCH",40 DUKE MEDICINE CIR # 2H DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1053356360,PICKLED HERRING INC,MEDICAL VILLAGE PHARMACY,517 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1053356360,PICKLED HERRING INC,517 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053356600,"MIKLOUCICH, FRANCIS, JEROME",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 57 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053357202,"READING, JEREMY, KENNETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053357202,"READING, JEREMY, KENNETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 26 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053357202,"READING, JEREMY, KENNETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053357202,"READING, JEREMY, KENNETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053357368,"OWENS, JAMES, MICHAEL",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 126 , 190 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053357368,"OWENS, JAMES, MICHAEL",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053357905,ADVANCED RESPIRATORY INC,,1020 COUNTY ROAD F W   SAINT PAUL MN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053357905,ADVANCED RESPIRATORY INC,1020 COUNTY ROAD F W   SAINT PAUL MN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1053357905,ADVANCED RESPIRATORY INC,,1020 COUNTY ROAD F W   SAINT PAUL MN,102,Out of State > 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1053357905,ADVANCED RESPIRATORY INC,1020 COUNTY ROAD F W   SAINT PAUL MN,102,Out of State > 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 107 , 350 , 350 ," $184,065.49 ",,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053359364,"TATA, JOHN, ANTHONY",123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053359364,"TATA, JOHN, ANTHONY",125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 76 , 78 , 89 ,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053359364,"TATA, JOHN, ANTHONY",123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1053360982,"RHOLL, JAMES, CORNELL",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053361402,"KESSLER, BENJAMIN, JOE",310 S MCCASKEY RD   WILLIAMSTON NC,058,Martin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 30 ,$#,,
MEDICAID DIRECT,1053362269,"MANFREDI, JOSEPH, ANDREW",,1005 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,1053362269,"MANFREDI, JOSEPH, ANDREW",1005 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1992757827,PIEDMONT INTERNAL MEDICINE,~,3214 CHARLES B ROOT WYND STE 211 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053363325,"MASOOD, SYED, AHMED",3214 CHARLES B ROOT WYND STE 211 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 91 , 93 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053363325,"MASOOD, SYED, AHMED",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053363325,"MASOOD, SYED, AHMED",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053363846,"ADAMS, GREGORY, FRANKLIN",150 KINGSLEY LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053363846,"ADAMS, GREGORY, FRANKLIN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 28 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",3116 N DUKE ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 53 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053364141,"VORENKAMP, KEVIN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 27 , 27 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053364745,"CAMNITZ, PAUL, SAMUEL",850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 21 , 28 , 63 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053365320,"FAVARO, JUSTIN, PETER",7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 20 , 146 , 328 ," $17,838.76 ",,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053365320,"FAVARO, JUSTIN, PETER",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 37 , 114 , 342 ," $16,156.98 ",,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053365320,"FAVARO, JUSTIN, PETER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053365874,"JOOSTE, EDMUND, HILTON",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053365874,"JOOSTE, EDMUND, HILTON",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 46 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053366294,"SANOFF, HANNA, KELLY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 17 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053366294,"SANOFF, HANNA, KELLY",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 27 , 44 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1053368043,"MAURICE, KETTY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 69 , 69 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1053368043,"MAURICE, KETTY",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053368464,"WEINGOLD, MATTHEW, ADAM",2718 HENRY ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 15 , 20 ,$#,,
MEDICAID DIRECT,1255672473,PRIVATE DIAGNOSTIC CLINIC PLLC,KERNODLE CLINIC - WEST,,,Unknown,193200000X,Group,Multi-Specialty,,1053368704,"TROXLER, MATTHEW",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053368944,"MCGUIRE, TIMOTHY, WILLIAM",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 35 , 48 ,$#,,
MEDICAID DIRECT,1891959094,DENTON HEALTHCARE,~,18539 S NC HIGHWAY 109   DENTON NC,029,Davidson,193400000X,Group,Single Specialty,,1053370098,"BAKER, CLIFTON, AYRES",18539 S NC HIGHWAY 109   DENTON NC,029,Davidson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 47 , 166 , 194 ,$#,,
MEDICAID DIRECT,1861451437,NEWTON FAMILY PHYSICIANS,~,767 W 1ST ST   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1053370288,"PELTZER, DAVID, ERIC",767 W 1ST ST   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 43 , 87 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1053371070,"PERRIN, JEFFREY, BRAXTON",2007 WALNUT ST   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1053371070,"PERRIN, JEFFREY, BRAXTON",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1053371070,"PERRIN, JEFFREY, BRAXTON",8841 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1053372185,SUN MEDICAL SUPPLY INC,SUN MEDICAL SUPPLY,946 W ANDREWS AVE STE P HENDERSON NC,091,Vance,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1053372185,SUN MEDICAL SUPPLY INC,946 W ANDREWS AVE STE P HENDERSON NC,091,Vance,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 243 , 826 ," 1,549 "," $26,791.42 ",,
MEDICAID DIRECT,1053372185,SUN MEDICAL SUPPLY INC,SUN MEDICAL SUPPLY,946 W ANDREWS AVE STE P HENDERSON NC,091,Vance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1053372185,SUN MEDICAL SUPPLY INC,946 W ANDREWS AVE STE P HENDERSON NC,091,Vance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1053372185,SUN MEDICAL SUPPLY INC,SUN MEDICAL SUPPLY,946 W ANDREWS AVE STE P HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053372185,SUN MEDICAL SUPPLY INC,946 W ANDREWS AVE STE P HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 265 , 875 ," 1,759 "," $38,595.10 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053372474,"AKBARY, ALI",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053372474,"AKBARY, ALI",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 162 , 394 , 461 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053372474,"AKBARY, ALI",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1073609665,GRAYBAR CHIROPRACTIC INC,GRAYBAR CHIROPRACTIC INC,2110 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053372540,"GRAYBAR, MICHAEL, FRANCIS",2110 S 17TH ST   WILMINGTON NC,065,New Hanover,111N00000X,Chiropractic Providers,Chiropractor,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 477 , 616 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 53 , 53 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",322 NUWAY CIR   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 45 , 45 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",3430 LESTER ST   CONOVER NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 75 , 75 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,4174 SHOOK RD   CLAREMONT NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",4174 SHOOK RD   CLAREMONT NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",107 MAGNOLIA DR   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 69 , 81 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",4174 SHOOK RD   CLAREMONT NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 69 , 70 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 279 , 446 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",420 N CENTER ST STE 20 HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 155 , 186 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",401 N MORGAN ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 126 , 126 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",322 NUWAY CIR   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 42 , 42 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",4174 SHOOK RD   CLAREMONT NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 68 , 68 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",3430 LESTER ST   CONOVER NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",401 N MORGAN ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",420 N CENTER ST STE 20 HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 80 , 82 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 71 , 71 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 50 , 74 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053373399,"CLARK, KEVIN, RICHARD",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 87 , 110 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,110 TURNER ST   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1053374157,"KISHBAUGH, DAVID",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 33 , 40 , 43 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1053374157,"KISHBAUGH, DAVID",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 158 , 279 , 357 ," $14,542.45 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,190 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1053374330,"BURT, TERRENCE, WILLIAM",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1053374330,"BURT, TERRENCE, WILLIAM",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1053375170,"VANDERHAVE, KELLY, LYNN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 42 , 53 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 42 , 50 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1053375261,"JOHNSON, PHILIP, BYRON",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 21 ,$#,,
MEDICAID DIRECT,1124161252,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIVISIONOFSURGEY-NORTHG,1330 BOILING SPRINGS RD STE 2300 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053375592,"JAMES SR, HUGH, TILLMAN",1330 BOILING SPRINGS RD STE 2300 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053378984,"FINA, MICHAEL, FRANCIS",500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1053379487,"BECKER, ANDREW, MOSS",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053379487,"BECKER, ANDREW, MOSS",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 28 , 28 ,$#,,
MEDICAID DIRECT,1053379982,"HARRIS, LAKAJAI, HILL",KIDZ SPEECH & BEYOND PLLC,4004 JARED CT   GREENVILLE NC,074,Pitt,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1053379982,"HARRIS, LAKAJAI, HILL",4004 JARED CT   GREENVILLE NC,074,Pitt,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053379990,"FRUGONE-LARREA, LUIGI, PAOLO",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 148 , 148 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053380964,"BLUMBERG, KIM, RITA",131 PROVIDENCE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 36 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 34 , 57 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",710 PARK CENTER DR   MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053381046,"CLARK, CHRISTIAN",703 COMFORT LN   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053381806,"LETTERLE, SUSAN, J",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053381863,"NASH, ALLAN, DALE",DALE NASH MD,1664 PROBART ST   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1053381863,"NASH, ALLAN, DALE",1664 PROBART ST   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 32 , 34 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053381921,"GARWOOD, SUSAN, RENEE",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053381921,"GARWOOD, SUSAN, RENEE",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1396166088,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB - MT,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053382804,"DEAN, DONNA, MICHELLE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 55 , 55 ,$#,,
MEDICAID DIRECT,1710908041,YADKIN RIVER RADIOLOGY PA,YADKIN RIVER RADIOLOGY PA,122 WYNDHAM WAY   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1053383786,"BROWN, THOMAS, LARRY",180 PARKWOOD DR   ELKIN NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 42 , 56 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1053384149,"NITSCHE, JOSHUA, FRANKLIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053384149,"NITSCHE, JOSHUA, FRANKLIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053384149,"NITSCHE, JOSHUA, FRANKLIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 109 , 138 , 169 ," $28,038.15 ",,
MEDICAID DIRECT,1912085648,CHOICE PHYSICAL THERAPY WELLNESS,~,847 WESTLAKE DR   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053384438,"VEDDER, CASEY, AARON",847 WESTLAKE DR   MOUNT AIRY NC,086,Surry,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053386078,"MUNN, WILLIAM, ANTHONY",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 47 , 67 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1053386078,"MUNN, WILLIAM, ANTHONY",155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 196 , 416 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053387217,"CASEY, MICHELE, ROBERTS",13300 STRICKLAND RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053387217,"CASEY, MICHELE, ROBERTS",13300 STRICKLAND RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 89 , 234 ,$#,,
MEDICAID DIRECT,1134170822,VALLEY HYPERTENSION NEPHREOLOGY ASS,VALLEY HYPERTENSION NEPHREOLOGY ASSOCIATES PA,937 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1053388710,"GUO, DAQING",937 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 227 , 563 , 570 ," $12,174.21 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 88 , 157 , 294 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 112 , 212 , 265 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 444 , 697 ," 1,281 "," $32,457.85 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 35 , 44 , 83 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 33 , 42 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 189 , 314 , 700 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1053389668,"AKHTAR, MATEEN",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 40 , 62 , 104 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1053390039,"SCHUTZER, DAVID, ALAN",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1053390039,"SCHUTZER, DAVID, ALAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 46 , 51 ," $10,991.63 ",,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1053390039,"SCHUTZER, DAVID, ALAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 104 , 121 , 130 ," $30,991.44 ",,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1053390039,"SCHUTZER, DAVID, ALAN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053390641,"SAGARDIA, MIGUEL, JOSE",102 POMONA DR   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 40 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053390641,"SAGARDIA, MIGUEL, JOSE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 92 , 196 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053390641,"SAGARDIA, MIGUEL, JOSE",102 POMONA DR   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053390641,"SAGARDIA, MIGUEL, JOSE",709 GREEN VALLEY RD FL 2 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053391409,"LAKE, ANNE, FOWLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 53 , 63 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053391409,"LAKE, ANNE, FOWLER",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053391409,"LAKE, ANNE, FOWLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053391607,HOME MEDICAL SYSTEMS INC,HOME MEDICAL SYSTEMS,1347 S MADISON ST   WHITEVILLE NC,024,Columbus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1053391607,HOME MEDICAL SYSTEMS INC,1347 S MADISON ST   WHITEVILLE NC,024,Columbus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 193 , 621 ," 1,044 "," $22,669.94 ",,
MEDICAID DIRECT,1053391607,HOME MEDICAL SYSTEMS INC,HOME MEDICAL SYSTEMS,1347 S MADISON ST   WHITEVILLE NC,024,Columbus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053391607,HOME MEDICAL SYSTEMS INC,1347 S MADISON ST   WHITEVILLE NC,024,Columbus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 184 , 702 ," 1,208 "," $20,626.44 ",,
MEDICAID DIRECT,1053391607,HOME MEDICAL SYSTEMS INC,HOME MEDICAL SYSTEMS,1347 S MADISON ST   WHITEVILLE NC,024,Columbus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1053391607,HOME MEDICAL SYSTEMS INC,1347 S MADISON ST   WHITEVILLE NC,024,Columbus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053392779,"ADAYAPALAM, SRINIVASAN, VENKATASWAMY",600 HOSPITAL DR   MONROE NC,090,Union,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053393306,"THOMAS, JAMES, BOYD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053393595,"MACBETH, RONALD, ALYN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 32 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053393595,"MACBETH, RONALD, ALYN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1487684122,UNION COUNTY HOSPITAL AUTHORITY,UNION GENERAL HOSPITAL,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053393595,"MACBETH, RONALD, ALYN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053394254,"KIRSTEINS, ANDREW, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 80 , 213 , 254 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053394254,"KIRSTEINS, ANDREW, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 22 , 83 , 104 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053394700,"LONG, MICHAEL, HARRISON",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 20 , 48 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053394767,"MARTIN, TIMOTHY, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1053394775,TWIN STATE HOME HEALTH CARE SERVICE,MEDICINE MART HOME HEALTH,218 S MAIN ST   TABOR CITY NC,024,Columbus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1053394775,TWIN STATE HOME HEALTH CARE SERVICE,218 S MAIN ST   TABOR CITY NC,024,Columbus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1053394775,TWIN STATE HOME HEALTH CARE SERVICE,MEDICINE MART HOME HEALTH,218 S MAIN ST   TABOR CITY NC,024,Columbus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053394775,TWIN STATE HOME HEALTH CARE SERVICE,218 S MAIN ST   TABOR CITY NC,024,Columbus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 402 ," 2,092 "," 3,766 "," $200,864.12 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053394999,"MARTIN, LADONNA, SMITH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053395236,"OLEINIK, EVELEEN, MARY",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053395434,"RUDICIL, HAROLD, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053396101,"MARTIN, KRISTIE, COLLINS",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 45 , 119 ,$#,,
MEDICAID DIRECT,1053396705,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDIN,8300 HEALTH PARK STE 223 RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1053396705,LABORATORY CORPORATION OF AMERICA H,8300 HEALTH PARK STE 223 RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053397182,"STELLAR, WILLIAM, ARNOLD",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 31 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053397539,"ATKINSON, HAL, HUNTLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053397539,"ATKINSON, HAL, HUNTLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 32 , 33 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053397562,"PATEL, NILESH, VITHALBHAI",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1053397562,"PATEL, NILESH, VITHALBHAI",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 272 , 691 , 897 ," $23,767.06 ",,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1053397562,"PATEL, NILESH, VITHALBHAI",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053397588,"SPECHT, ADAM, WAYNE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1710021811,ABC PEDIATRICS OF ASHEVILLE PA,ABC PEDIATRICS OF ASHEVILLE PA,64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1053397984,"ERRICO, ROBERT, ANDREW",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 42 , 132 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1053398149,"CHURCH, SAMUEL, LEROY",85 SEASONS LN   HIAWASSEE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023153244,SAMUEL L CHURCH MD PC,,85 SEASONS LN   HIAWASSEE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053398149,"CHURCH, SAMUEL, LEROY",85 SEASONS LN   HIAWASSEE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 46 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053399071,"MATHER, BRUCE, SCOTT",106 CORPORATE PARK DR STE 200&300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 44 , 91 ,$#,,
MEDICAID DIRECT,1104804459,CATAWBA PEDIATRIC ASSOCIATES PA,~,240 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1053399212,"HARRILL, KIRAN, CUMMINGS",240 18TH STREET CIR SE   HICKORY NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 107 , 150 , 383 ," $16,692.28 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053400499,"TANNER, LAURA, STEFFEN",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 19 , 31 ,$#,,
MEDICAID DIRECT,1093737975,NOVA MEDICAL ASSOCIATES,NOVA MEDICAL ASSOCIATES,2991 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053401430,"KHAN, FOZIA, MUSHTAQ",2991 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 167 , 188 ,$#,,
MEDICAID DIRECT,1053402099,SPRINGWELL NETWORK INC,SPRINGWELL NETWORK INDEPENDENCE ROAD GROUP HOME,2001 INDEPENDENCE RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053402099,SPRINGWELL NETWORK INC,2001 INDEPENDENCE RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 226 , 226 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053403261,"SCHONTZ, MARK, WESLEY",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053403261,"SCHONTZ, MARK, WESLEY",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053403261,"SCHONTZ, MARK, WESLEY",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,211 DUPLIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1053405746,"MILLER, DYREK, EVERETH",211 DUPLIN ST   KENANSVILLE NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053405746,"MILLER, DYREK, EVERETH",211 DUPLIN ST   KENANSVILLE NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053405746,"MILLER, DYREK, EVERETH",417 N MAIN ST STE B KENANSVILLE NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 68 , 75 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053406462,"FISHER, SUSAN, WALKER",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053406462,"FISHER, SUSAN, WALKER",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 26 ,$#,,
MEDICAID DIRECT,1053408286,CARE PROVIDERS OF WILMINGTON INC,CARE PROVIDERS OF WILMINGTON INC,2527 DELANEY AVE   WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1053408286,CARE PROVIDERS OF WILMINGTON INC,2527 DELANEY AVE   WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 82 ," 13,572 "," 13,983 "," $1,780,642.28 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053408591,"WILSON, TRAVIS, BRYAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053408591,"WILSON, TRAVIS, BRYAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053408591,"WILSON, TRAVIS, BRYAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1982075388,OBSERVATION MEDICINE PHYSICIANS OF,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053408591,"WILSON, TRAVIS, BRYAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053409367,CAROLINA REHABILITATION SPECIALISTS,CAROLINA PEDIATRIC THERAPY,9 W SUMMIT AVE STE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053409367,CAROLINA REHABILITATION SPECIALISTS,9 W SUMMIT AVE STE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,, 349 ," 4,369 "," 4,828 "," $347,257.76 ",,
MEDICAID DIRECT,1053409367,CAROLINA REHABILITATION SPECIALISTS,CAROLINA PEDIATRIC THERAPY,9 SUMMIT AVE STE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053409367,CAROLINA REHABILITATION SPECIALISTS,9 SUMMIT AVE STE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1053409367,CAROLINA REHABILITATION SPECIALISTS,CAROLINA PEDIATRIC THERAPY,9 W SUMMIT AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053409367,CAROLINA REHABILITATION SPECIALISTS,9 W SUMMIT AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053409854,"MESSICK, PETER, CARSON",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053409854,"MESSICK, PETER, CARSON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 22 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053409854,"MESSICK, PETER, CARSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 28 , 43 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053409854,"MESSICK, PETER, CARSON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 23 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053409854,"MESSICK, PETER, CARSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053409953,"MALLOY, ERIN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1053410092,"TURNER, MINDY, MORGAN",1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,1223G0001X,Dental Providers,Dentist,General Practice," 1,395 "," 2,412 "," 9,160 "," $409,620.67 ",,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1053410092,"TURNER, MINDY, MORGAN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 49 ,$#,,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1053410092,"TURNER, MINDY, MORGAN",1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 15 , 19 , 65 ,$#,,
MEDICAID DIRECT,1811274558,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM CARDIOLOGY,568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 73 , 89 , 107 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811274558,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM CARDIOLOGY,568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 22 , 25 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 31 , 39 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053411165,"SHORT, SYDNEY, GLEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053413773,"WOLFE, DANA, JO",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053413773,"WOLFE, DANA, JO",420 PARK ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 64 , 112 ,$#,,
MEDICAID DIRECT,1053414748,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06407,1017 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1053414748,NORTH CAROLINA CVS PHARMACY LLC,1017 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1053414748,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06407,1017 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053414748,NORTH CAROLINA CVS PHARMACY LLC,1017 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 26 , 50 ,$#,,
MEDICAID DIRECT,1053414748,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06407,1017 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1053414748,NORTH CAROLINA CVS PHARMACY LLC,1017 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1053414755,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03918,402 S MAIN ST   ROLESVILLE NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1053414755,NORTH CAROLINA CVS PHARMACY LLC,402 S MAIN ST   ROLESVILLE NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1053416255,"COLBERT, PATRICK, DENNIS",507 E FREMONT ST   BURGAW NC,071,Pender,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 44 , 57 , 64 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053416255,"COLBERT, PATRICK, DENNIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 18 , 20 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053416255,"COLBERT, PATRICK, DENNIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1740391283,AMERICAN NEUROMONITORING ASSOCIATES,,10275 LITTLE PATUXENT PKWY STE 300 COLUMBIA MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1053417709,"ANSEVIN, CARL, DANIEL",812 ELMWOOD RD   ROCKY RIVER OH,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053418509,"JAGADEESAN, SINGARAVELU",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053418509,"JAGADEESAN, SINGARAVELU",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 107 , 176 , 186 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053418509,"JAGADEESAN, SINGARAVELU",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053420190,"EDMISTON, WILLIAM, JOHNSTON",766 HARTNESS RD STE C STATESVILLE NC,049,Iredell,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#, 27 , 32 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053420190,"EDMISTON, WILLIAM, JOHNSTON",774 HARTNESS RD   STATESVILLE NC,049,Iredell,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 50 , 164 , 194 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,,,Unknown,193200000X,Group,Multi-Specialty,,1053420190,"EDMISTON, WILLIAM, JOHNSTON",774 HARTNESS RD   STATESVILLE NC,049,Iredell,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",139 APEX LN   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 283 , 290 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 188 , 188 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",711 W ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 42 , 42 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",139 APEX LN   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",700 JOHNSON RIDGE RD   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1053424598,"CULLER, MICHAEL, DEAN",139 APEX LN   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 30 , 30 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",1297 GALAX TRL   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1053424598,"CULLER, MICHAEL, DEAN",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 124 , 124 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1053424598,"CULLER, MICHAEL, DEAN",340 SNOWHILL DR   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 81 , 81 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1053424598,"CULLER, MICHAEL, DEAN",711 W ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 44 , 44 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",340 SNOWHILL DR   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 54 , 54 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1053424598,"CULLER, MICHAEL, DEAN",1297 GALAX TRL   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 40 , 40 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053424598,"CULLER, MICHAEL, DEAN",1297 GALAX TRL   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053424929,"GAY III, WALTER, CARLTON",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053426346,"BEAMER, MARK, EDWARD",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 133 , 232 , 368 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1053426346,"BEAMER, MARK, EDWARD",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053426346,"BEAMER, MARK, EDWARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053428326,"ZOMORODI, ALI, REZA",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053428326,"ZOMORODI, ALI, REZA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053428326,"ZOMORODI, ALI, REZA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053428326,"ZOMORODI, ALI, REZA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053428326,"ZOMORODI, ALI, REZA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 20 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053428326,"ZOMORODI, ALI, REZA",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053429373,"SMITH, DAVID, JOHN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053429373,"SMITH, DAVID, JOHN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053430058,LANCASTER HEALTH CARE INC,Rosewood Rest Home No Two,721 DR MARTIN LUTHER KING JR WAY   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053430058,LANCASTER HEALTH CARE INC,721 DR MARTIN LUTHER KING JR WAY   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 27 ," 1,121 "," 1,121 "," $381,293.28 ",,
MEDICAID DIRECT,1053431346,"GEER, ANDREW, CHRISTIAN",~,3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1053431346,"GEER, ANDREW, CHRISTIAN",3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1447679956,ANDREW C GEER DDS,,3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053431346,"GEER, ANDREW, CHRISTIAN",3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 235 , 305 , 852 ," $37,376.16 ",,
MEDICAID DIRECT,1053431619,MCCULLOUGHS REST HOME INC,McCulloughs Rest Home Inc,720 ORRS CAMP RD   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053431619,MCCULLOUGHS REST HOME INC,720 ORRS CAMP RD   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,615 "," 2,662 "," $162,415.36 ",,
MEDICAID DIRECT,1750931994,W CHRISTOPHER CLAYPOOLE DDS PA,ALL PEOPLE DENTISTRY,7980 ARCO CORPORATE DR STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053438432,"CLAYPOOLE, WILLIAM, CHRISTOPHER",7980 ARCO CORPORATE DR STE 102 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 897 ," 2,399 "," 11,119 "," $775,312.24 ",,
MEDICAID DIRECT,1053438697,GLENVILLE CASHIERS RESCUE SQUAD,GLENVILLE CASHIERS RESCUE SQUAD,63 N NORTON RD   CASHIERS NC,050,Jackson,3416L0300X,Transportation Services,Ambulance,Land Transport,1053438697,GLENVILLE CASHIERS RESCUE SQUAD,63 N NORTON RD   CASHIERS NC,050,Jackson,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#, 15 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1053439802,"KENDALL, SHELLIE, MARIE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053439802,"KENDALL, SHELLIE, MARIE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 20 , 23 , 58 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053439802,"KENDALL, SHELLIE, MARIE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 17 , 34 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053439802,"KENDALL, SHELLIE, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1053440792,"RYMESKI, BETH, ANNE",3333 BURNET AVE ML 2023 CINCINNATI OH,102,Out of State > 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053441865,"HUTSON, BRENT, JOHN",1000 HEALING WAY   MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871854752,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053441865,"HUTSON, BRENT, JOHN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 92 , 112 ,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1225 HARDING PL # 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053441865,"HUTSON, BRENT, JOHN",1225 HARDING PL STE 1100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1871854828,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053441865,"HUTSON, BRENT, JOHN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053449751,"SCHOONOVER, BRANDON, WARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1053451179,THE CROSS ROAD REST AND RETIREMENT,CROSS ROAD RETIREMENT COMMUNITY,1302 OLD COX RD   ASHEBORO NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053451179,THE CROSS ROAD REST AND RETIREMENT,1302 OLD COX RD   ASHEBORO NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 76 , 78 ," $190,504.64 ",,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1053453399,"SABOLOVIC, JEFFREY, CHARLES",446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 60 , 84 , 140 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1053453399,"SABOLOVIC, JEFFREY, CHARLES",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1053453399,"SABOLOVIC, JEFFREY, CHARLES",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1053453399,"SABOLOVIC, JEFFREY, CHARLES",110 W GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 25 , 28 , 34 ,$#,,
MEDICAID DIRECT,1053454306,LIBERTY HEALTHCARE GROUP LLC,LIBERTY HEALTHCARE SERVICES OF MARY GRAN NURSING,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053454306,LIBERTY HEALTHCARE GROUP LLC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 40 , 40 ," $72,467.64 ",,
MEDICAID DIRECT,1053454595,COUNTY OF BURKE,BURKE COUNTY DEPARTMENT OF SOCIAL SERVICES,700 E PARKER RD   MORGANTON NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1053454595,COUNTY OF BURKE,700 E PARKER RD   MORGANTON NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 17 , 20 , 20 ," $16,899.18 ",,
MEDICAID DIRECT,1053454595,COUNTY OF BURKE,BURKE COUNTY DEPARTMENT OF SOCIAL SERVICES,700 E PARKER RD   MORGANTON NC,012,Burke,251B00000X,Agencies,Case Management,,1053454595,COUNTY OF BURKE,700 E PARKER RD   MORGANTON NC,012,Burke,251B00000X,Agencies,Case Management,, 162 ," 1,691 "," 1,698 "," $631,340.40 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053455444,"CLARK, CLANCY, JAKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 58 , 60 ,$#,,
MEDICAID DIRECT,1053459685,SALISBURY AUDIOLOGY AND HEARING AID,SALISBURY AUDIOLOGY AND HEARING AID SERVCS,310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1053459685,SALISBURY AUDIOLOGY AND HEARING AID,310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053460063,"KAUR, SUNEET",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 191 , 274 , 305 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053460063,"KAUR, SUNEET",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053461319,"WALTERS, CHRISTOPHER, RONALD",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 183 , 208 , 271 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,812 CANDY PARK RD STE 5103 PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053461319,"WALTERS, CHRISTOPHER, RONALD",812 CANDY PARK RD STE 5103 PEMBROKE NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 28 , 29 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053461319,"WALTERS, CHRISTOPHER, RONALD",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 190 , 264 , 299 ," $10,630.11 ",,
MEDICAID DIRECT,1053463927,"OKOROJI, SUNNY, O",~,1312 E GARRISON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1053463927,"OKOROJI, SUNNY, O",1312 E GARRISON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 736 ," 1,884 "," 7,291 "," $567,863.24 ",,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1053464438,"SANTORO, CYNTHIA, LYNN",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053464438,"SANTORO, CYNTHIA, LYNN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 30 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053468918,"STARKS, MONIQUE, LATOYA ANDERSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1053468918,"STARKS, MONIQUE, LATOYA ANDERSON",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053468918,"STARKS, MONIQUE, LATOYA ANDERSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 19 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1053468918,"STARKS, MONIQUE, LATOYA ANDERSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053474080,"CLARK, EDWARD, JOSEPH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1053474718,"HUGHES, LINDA",1021 W HAMLET AVE   HAMLET NC,077,Richmond,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1720161334,COUNTY OF MACON,MACON CO PUBLIC HEALTH CENTER,1830 LAKESIDE DR   FRANKLIN NC,056,Macon,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053479121,"CHANG, DIVINA, CAMELIA",1830 LAKESIDE DR   FRANKLIN NC,056,Macon,1223G0001X,Dental Providers,Dentist,General Practice, 839 ," 2,276 "," 7,453 "," $258,465.67 ",,
MEDICAID DIRECT,1720161334,COUNTY OF MACON,MACON CO PUBLIC HEALTH CENTER,1830 LAKESIDE DR   FRANKLIN NC,056,Macon,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053479121,"CHANG, DIVINA, CAMELIA",1830 LAKESIDE DR   FRANKLIN NC,056,Macon,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1053480962,"KIM, HONGJAE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 70 , 70 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1053480962,"KIM, HONGJAE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 31 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,95 SPRINGBROOK AVE STE 111 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053488502,"FAKADEJ, MARIA, MARGARET",11617 US HWY 70 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 75 , 105 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053488502,"FAKADEJ, MARIA, MARGARET",11617 US HWY 70 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053491670,"LOVE, JEFFREY, LEON",JEFFREY L LOVE DDS,1400 GREENWAY CT   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,1053491670,"LOVE, JEFFREY, LEON",1400 GREENWAY CT   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 353 , 950 ," 2,361 "," $130,515.18 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053493924,"SNYDER, LAURIE",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053494211,"FRIEDMAN, KELLIE, ELYCE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053494211,"FRIEDMAN, KELLIE, ELYCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053495119,"JUEL, VERN, CHARLES",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 18 , 18 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053495119,"JUEL, VERN, CHARLES",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1053495119,"JUEL, VERN, CHARLES",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053495481,"LEWIS, LYNDA, WILLIAMS",600 HOSPITAL DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,201 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053496307,"GLOWACKI, DAVID, M",2134 14TH AVENUE CIR NW STE B HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 82 , 87 , 100 ,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053496307,"GLOWACKI, DAVID, M",2134 14TH AVENUE CIR NW STE B HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 126 , 142 , 174 ,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1053496307,"GLOWACKI, DAVID, M",2134 14TH AVENUE CIR NW STE B HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053496307,"GLOWACKI, DAVID, M",2134 14TH AVENUE CIR NW STE B HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 29 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1053496349,"HOLMES, ROBERT, ORIN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 108 , 213 , 491 ," $39,153.15 ",,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053497073,"HILL, CYNTHIA, ROCHELLE",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 162 , 291 , 417 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053497073,"HILL, CYNTHIA, ROCHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053498725,"NIXON, TRAVIS, LEE",TRAVIS L NIXON DDS PA,309 WESLEYAN DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1053498725,"NIXON, TRAVIS, LEE",309 WESLEYAN DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 40 , 104 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053499343,"WOODARD, JENNIFER, WEINSTOCK",101 MANNING DR   CHAPEL HILL NC,068,Orange,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,245 E ROOSEVELT AVE   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1053500363,"HUPP, DEBORAH, ANN",245 E ROOSEVELT AVE   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053501015,"MOOBERRY, REBECCA, ANNE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053504399,"KRAMER, BENJAMIN, CHARLES",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 38 , 37 , 60 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053504399,"KRAMER, BENJAMIN, CHARLES",1800 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053504399,"KRAMER, BENJAMIN, CHARLES",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist, 96 , 105 , 192 ," $11,646.32 ",,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053504399,"KRAMER, BENJAMIN, CHARLES",1800 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053504399,"KRAMER, BENJAMIN, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053505545,"CALLARD, WILLIAM, JEFFERY",8115 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 19 , 66 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053505545,"CALLARD, WILLIAM, JEFFERY",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053505545,"CALLARD, WILLIAM, JEFFERY",1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053505545,"CALLARD, WILLIAM, JEFFERY",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053507731,"LEWIS, BRIAN, DAVID",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053507731,"LEWIS, BRIAN, DAVID",3643 N ROXBORO ST   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1053507731,"LEWIS, BRIAN, DAVID",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053507731,"LEWIS, BRIAN, DAVID",4709 CREEKSTONE DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053507731,"LEWIS, BRIAN, DAVID",4709 CREEKSTONE DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1053507731,"LEWIS, BRIAN, DAVID",4709 CREEKSTONE DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265703607,MCPHERSON FAMILY EYE CARE,MCPHERSON FAMILY EYE CARE,3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1053510065,"MCPHERSON, LEE, DOYLE",3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1053510065,"MCPHERSON, LEE, DOYLE",~,3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,1053510065,"MCPHERSON, LEE, DOYLE",3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053510404,"FISH, LAURA, RENEE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053510404,"FISH, LAURA, RENEE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 89 , 94 , 99 ,$#,,
MEDICAID DIRECT,1548525470,BAILLIARD HENRY PEDIATRIC CARDIOLOG,~,4301 LAKE BOONE TRL STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053510529,"BAILLIARD, FREDERIQUE, CLAUDE",4301 LAKE BOONE TRL STE 300 RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 18 , 19 , 68 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053510701,"PROESCHEL, KRIS, ELISABETH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053510701,"PROESCHEL, KRIS, ELISABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 94 , 94 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1053511436,"BEACHAM, BRIAN, LEE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1053511436,"BEACHAM, BRIAN, LEE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,270 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1053511436,"BEACHAM, BRIAN, LEE",270 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1053511436,"BEACHAM, BRIAN, LEE",270 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053511543,"HO, JASON, GRIFFITH",104 MEDSPRING DR   CLAYTON NC,051,Johnston,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053511543,"HO, JASON, GRIFFITH",120 HEALTHPLEX WAY   APEX NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 12 , 14 , 33 ,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053511543,"HO, JASON, GRIFFITH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053511543,"HO, JASON, GRIFFITH",1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 43 ,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1053511543,"HO, JASON, GRIFFITH",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053511543,"HO, JASON, GRIFFITH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053511543,"HO, JASON, GRIFFITH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 26 , 32 , 65 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053511592,"KORNEGAY, JEFFREY, TODD",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 37 , 80 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053511592,"KORNEGAY, JEFFREY, TODD",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053511642,"BOONE, MIRA, MARGARET",1534 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053511642,"BOONE, MIRA, MARGARET",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053511642,"BOONE, MIRA, MARGARET",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053511642,"BOONE, MIRA, MARGARET",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 67 , 71 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1053513721,"TALBERT, PHILLIP, RICHARD",651 WITHROW RD   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 29 ,$#,,
MEDICAID DIRECT,1710940887,DERMATOLOGY CENTER OF SHELBY,DERMATOLOGY CENTER OF SHELBY PA,935 WYKE RD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1053513721,"TALBERT, PHILLIP, RICHARD",935 WYKE RD   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053514612,"IONNO, JESSICA, LEIGH",3236 HOLMESTOWN RD UNIT E1 MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1053515692,"BEST, STEVEN, PATRICK",STEVEN P BEST DMD PA,1015 NC HIGHWAY 150 W STE B SUMMERFIELD NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1053515692,"BEST, STEVEN, PATRICK",1015 NC HIGHWAY 150 W STE B SUMMERFIELD NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 818 ," 1,405 "," 4,796 "," $543,858.43 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053519017,"GREENBERG, TYLER, KESSLER",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053519405,A NEW BEGINNING,~,300 E LENOIR AVE   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053519405,A NEW BEGINNING,300 E LENOIR AVE   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,091 "," 1,091 "," $66,076.24 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053522854,"THORNE, NYREE, KIMBERLY",500 SHEPHERD ST   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 57 , 65 , 75 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053524967,"ALLI, OLUSEUN, OLUKAYODE",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053524967,"ALLI, OLUSEUN, OLUKAYODE",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053524967,"ALLI, OLUSEUN, OLUKAYODE",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 32 , 36 , 37 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053524967,"ALLI, OLUSEUN, OLUKAYODE",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 13 , 19 , 27 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053524967,"ALLI, OLUSEUN, OLUKAYODE",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1053525501,"BOYD, LILLIAN, KIZER",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 27 , 52 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053525501,"BOYD, LILLIAN, KIZER",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053525584,"GALLOWAY, KENNETH, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 97 , 97 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1053525584,"GALLOWAY, KENNETH, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 171 , 171 ,$#,,
MEDICAID DIRECT,1912588476,DAVID E THOME XII,DUNN PEDIATRIC DENTISTRY,711 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1053526442,"GARCIA SOTO, CARLOS, EDUARDO",711 TILGHMAN DR   DUNN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 935 ," 1,104 "," 4,615 "," $131,837.55 ",,
MEDICAID DIRECT,1396388096,THOME & KANKASH DDS PLLC I,FUQUAY PEDIATRIC DENTISTRY,401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1053526442,"GARCIA SOTO, CARLOS, EDUARDO",401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,009 "," 1,267 "," 4,864 "," $152,036.47 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053528554,"ARIDA, MUHAMMAD, ABDELKARIM",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053528554,"ARIDA, MUHAMMAD, ABDELKARIM",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053528554,"ARIDA, MUHAMMAD, ABDELKARIM",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 21 , 32 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053528554,"ARIDA, MUHAMMAD, ABDELKARIM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053528554,"ARIDA, MUHAMMAD, ABDELKARIM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 103 , 143 , 246 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053528554,"ARIDA, MUHAMMAD, ABDELKARIM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1033523709,MOSES CONE AFFILIATED PHYSICIANS IN,CHMG CARDIOVASCULAR DIVISION,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053528554,"ARIDA, MUHAMMAD, ABDELKARIM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457600504,MCPC-10 LLC,FIRSTHEALTH CARDIOVASCULAR AND THORACIC SERVICES,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1053529214,"ELLMAN, PETER, ISAAC",155 MEMORIAL DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 24 , 26 ,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1053531004,"BERSTLER, YVONNE, EN-WAN",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 142 , 334 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1053531004,"BERSTLER, YVONNE, EN-WAN",2527 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1053531004,"BERSTLER, YVONNE, EN-WAN",2527 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841350824,AMY-JO FISCHER DDS PA,SMILES BY DESIGN,406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1053531889,"FISCHER, AMY JO",406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 49 , 95 , 232 ,$#,,
MEDICAID DIRECT,1053531889,"FISCHER, AMY JO",AMY JOFISCHER DDS PA,406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1053531889,"FISCHER, AMY JO",406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 26 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053532861,"HO, JONATHAN, NGOC",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1053532861,"HO, JONATHAN, NGOC",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922061654,"DUCKETT, OLLY, CHRISTOPHER",~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1053532861,"HO, JONATHAN, NGOC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053532861,"HO, JONATHAN, NGOC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053532861,"HO, JONATHAN, NGOC",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1053532861,"HO, JONATHAN, NGOC",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 49 , 57 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053532861,"HO, JONATHAN, NGOC",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1053532861,"HO, JONATHAN, NGOC",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053532861,"HO, JONATHAN, NGOC",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053534479,"WILLIAMS, TANEKA, MARIE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1053534669,"HARDY, VICKI",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 185 , 318 , 562 ," $10,257.58 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053536508,"WESTBROOK, KELLY, ELIZABETH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053536508,"WESTBROOK, KELLY, ELIZABETH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053536508,"WESTBROOK, KELLY, ELIZABETH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 12 , 23 , 37 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053537589,"MEHTA, SIMA, RAVIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 165 , 165 ,$#,,
MEDICAID DIRECT,1053538330,"BROOKS, RICHARD, FRANKLIN",,120 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1053538330,"BROOKS, RICHARD, FRANKLIN",120 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 179 , 338 ," 1,076 "," $36,408.55 ",,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053541003,"CYR, MELISSA, EMILY",5603 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,101 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 73 , 75 , 94 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,703 COMFORT LN   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1053541771,"AVUTU, HIMA, BINDU REDDY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053542423,"TAYLOR, DANA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053542423,"TAYLOR, DANA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053542423,"TAYLOR, DANA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053542423,"TAYLOR, DANA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 50 , 50 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 101 , 101 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053543710,"RUSSELL GOINGS, DAREE, ELAINE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053545533,"OCONNOR, SIOBHAN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 15 , 15 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053545533,"OCONNOR, SIOBHAN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 16 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053545533,"OCONNOR, SIOBHAN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 13 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053545533,"OCONNOR, SIOBHAN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 16 , 16 , 29 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,3030 RANDOLPH RD STE 102A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053545624,"ADEGBAMIGBE, TEMITAYO, ADETUNJI",3030 RANDOLPH RD STE 102A CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 99 , 144 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053545624,"ADEGBAMIGBE, TEMITAYO, ADETUNJI",501 BILLINGSLEY RD COTTAGE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 53 , 77 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053545681,"GILLIS, LAUREN, NICOLE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053545681,"GILLIS, LAUREN, NICOLE",600 GRESHAM DR STE 8600 NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558308080,THE C W WILLIAMS COMMUNITY HEALTH C,~,5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053546507,"MACKIE, CRYSTAL, MONIQUE",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 59 , 67 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053546861,"COLAVITA, PAUL, DOMINICK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 16 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053546861,"COLAVITA, PAUL, DOMINICK",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053546861,"COLAVITA, PAUL, DOMINICK",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 51 , 51 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053546861,"COLAVITA, PAUL, DOMINICK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053547042,"HALL, JEFFREY, DAVID",JEFFREY D HALL DND PA,621 S BROADWAY ST   FOREST CITY NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice,1053547042,"HALL, JEFFREY, DAVID",621 S BROADWAY ST   FOREST CITY NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice, 229 , 484 ," 1,225 "," $58,113.15 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053549493,"RUCKER, ALETHEA, YVETTE",518 S VAN BUREN RD STE 2 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053549493,"RUCKER, ALETHEA, YVETTE",518 S VAN BUREN RD STE 2 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",44 HOSPITAL DR STE 1A COLUMBUS NC,075,Polk,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 34 , 39 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",5201 CLARKS FORK DR   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",3000 HOLSTON LN   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",8200 LITCHFORD RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",25 SUNNYBROOK RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 157 , 195 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",509 W GANNON AVE   ZEBULON NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 62 , 80 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",1000 TANDAL PL   KNIGHTDALE NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 72 , 100 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",160 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 241 , 359 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",1515 W PETTIGREW ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 21 , 29 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053555102,"BERNSTEIN, LAURA, SHAUNA",202 SMOKETREE WAY   LOUISBURG NC,035,Franklin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,971 GOLD HILL RD   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053556399,"JACKSON, TIFFANY, DENISE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053556480,"CREECH, RACHEL, ELAINE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053559054,"CAPUTO, MICHAEL, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053560672,"RILLING, CARLA, ANNETTE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 92 , 93 , 93 ,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1053562413,"RAPOLLA, ALLEN, RICHARD",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1053562413,"RAPOLLA, ALLEN, RICHARD",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,204 "," 2,820 "," 3,581 "," $500,175.41 ",,
MEDICAID DIRECT,1235340803,LARRY J MORAY DDS MS PA,MYORTHODONTIST,120 CLINTON CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1053562413,"RAPOLLA, ALLEN, RICHARD",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 24 , 25 , 35 ,$#,,
MEDICAID DIRECT,1720014152,LARRY J MORAY DDS MS PA,MYORTHODONTIST,150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1053562413,"RAPOLLA, ALLEN, RICHARD",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 124 , 124 , 150 ," $24,422.97 ",,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1053562413,"RAPOLLA, ALLEN, RICHARD",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 38 , 38 , 40 ,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1053562413,"RAPOLLA, ALLEN, RICHARD",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,137 "," 2,342 "," 2,770 "," $381,588.53 ",,
MEDICAID DIRECT,1235340803,LARRY J MORAY DDS MS PA,MYORTHODONTIST,120 CLINTON CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1053562413,"RAPOLLA, ALLEN, RICHARD",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053565804,"SARMA, DEBA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053565804,"SARMA, DEBA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053565804,"SARMA, DEBA",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1699074112,HENDERSON PEDIATRIC DENTISTRY,HENDERSON PEDIATRIC DENTISTRY,451 RUIN CREEK RD STE 205 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1053567024,"ANTHONY, BONNYE, RICHARDS",451 RUIN CREEK RD STE 205 HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice," 1,214 "," 1,616 "," 5,618 "," $211,478.22 ",,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1053567024,"ANTHONY, BONNYE, RICHARDS",3219 WATKINS RD   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 216 , 252 ," 1,038 "," $39,592.80 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",5241 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053568287,"FROHOCK, JEFFREY, INNES",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1053570234,HANGER PROSTHETICS & ORTHOTICS EAST,FAITH PROSTHETIC-ORTHOTIC SERVICES INC,10320 FELD FARM LN STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053570234,HANGER PROSTHETICS & ORTHOTICS EAST,10320 FELD FARM LN STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 23 , 24 , 140 ," $25,052.04 ",,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053570697,"DISSER, HOLLACE, MARIE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 29 , 42 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053570697,"DISSER, HOLLACE, MARIE",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 52 , 76 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053571620,"GILLIS, MARCUM, GLENN",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 47 , 57 , 72 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053571620,"GILLIS, MARCUM, GLENN",195 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053571620,"GILLIS, MARCUM, GLENN",434 KIRBY RD   KING NC,085,Stokes,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 49 , 56 , 72 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053571638,"LEWIS, JODY, PARKS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 36 , 72 , 82 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053571638,"LEWIS, JODY, PARKS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1053572537,"KENNEDY, AMANTIA",1030 SIENA DR   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053572537,"KENNEDY, AMANTIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053572537,"KENNEDY, AMANTIA",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053572537,"KENNEDY, AMANTIA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053572537,"KENNEDY, AMANTIA",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053573857,"LOVEGREEN, MARY, THERESE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 45 , 46 ," $11,221.84 ",,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053573857,"LOVEGREEN, MARY, THERESE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1154820934,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS NEONATAL FOLLOW-UP CLINIC,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053573857,"LOVEGREEN, MARY, THERESE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053573857,"LOVEGREEN, MARY, THERESE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053573857,"LOVEGREEN, MARY, THERESE",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1891002374,BLUE RIDGE HEALTHCARE MEDICAL GROUP,LENOIR FAMILY MEDICINE,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1053574707,"ALM, STEPHANIE, SHANNON MORGAN",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 176 , 360 ,$#,,
MEDICAID DIRECT,1881614170,ASSOCIATED MEDICAL SPECIALISTS PA,COASTAL CANCER CENTER,8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053577718,"TOULOUKIAN, EMILY, ZARUHI",8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 20 , 105 ,$#,,
MEDICAID DIRECT,1881614170,ASSOCIATED MEDICAL SPECIALISTS PA,COASTAL CANCER CENTER,8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053577718,"TOULOUKIAN, EMILY, ZARUHI",3008 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 14 , 38 ,$#,,
MEDICAID DIRECT,1881614170,ASSOCIATED MEDICAL SPECIALISTS PA,COASTAL CANCER CENTER,8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053577718,"TOULOUKIAN, EMILY, ZARUHI",817 FARRAR DR   CONWAY SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053578054,"SURANA, NEERAJ, K",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053578385,"WALL, JASON, TODD",139 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 26 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053579417,"ISAACS, PHILLIP, ALLAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 52 , 84 ,$#,,
MEDICAID DIRECT,1255360459,SMITHFIELD RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT SMITHFIELD,514 N BRIGHTLEAF BLVD STE 1200 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1053579870,"WRIGHT, JEAN, LUNDBERG",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053579870,"WRIGHT, JEAN, LUNDBERG",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053583294,"ALLEN, TYLER, DAVID",1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 327 , 327 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053583294,"ALLEN, TYLER, DAVID",1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 90 , 90 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,514 OLD MOUNT HOLLY RD   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053583294,"ALLEN, TYLER, DAVID",1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053583294,"ALLEN, TYLER, DAVID",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,485 VETERANS WAY   KERNERSVILLE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053583294,"ALLEN, TYLER, DAVID",1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1053583294,"ALLEN, TYLER, DAVID",1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1053583294,"ALLEN, TYLER, DAVID",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053583823,"MAVIS, ALISHA, MICHELLE",2301 ERWIN RD   DURHAM NC,032,Durham,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053583823,"MAVIS, ALISHA, MICHELLE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053583823,"MAVIS, ALISHA, MICHELLE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology, 23 , 26 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053585620,"NORTHROP, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 64 , 90 ," $17,141.57 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053585638,"BLAKE, STEPHANIE, MCCALLUM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053585638,"BLAKE, STEPHANIE, MCCALLUM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 19 , 30 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 52 , 90 , 194 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,110 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1053586032,"LEWIS, ASHLEY, MOORE",110 PINE STATE ST   LILLINGTON NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 95 , 176 , 325 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053587758,"HURWITZ, AMY, SAMARA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 101 , 104 , 110 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1053588848,"PATTANAYAK, AMANDA, SEVIGNY",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053588848,"PATTANAYAK, AMANDA, SEVIGNY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053588848,"PATTANAYAK, AMANDA, SEVIGNY",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053589663,"NAROTAM, VINAY, KUMAR",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 66 , 77 , 100 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053589663,"NAROTAM, VINAY, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1053589663,"NAROTAM, VINAY, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053589663,"NAROTAM, VINAY, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053589663,"NAROTAM, VINAY, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053589663,"NAROTAM, VINAY, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 40 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053589663,"NAROTAM, VINAY, KUMAR",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 44 , 45 , 59 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053589663,"NAROTAM, VINAY, KUMAR",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 28 , 40 ,$#,,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053600460,"VU, PHUONG-MAI JENNIFER, THI",10880 DURANT RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053601054,"MILLER, BRIAN, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053601351,"HAKIMA, LALEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 93 , 94 , 157 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053601815,"SCHROCK, MELINDA, MAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1053601815,"SCHROCK, MELINDA, MAY",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053602805,"SHERWIN, JENNIFER, IRENE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053603217,"HELING, ANDREW, ZACHARY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053603217,"HELING, ANDREW, ZACHARY",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053604165,"CLINKSCALES, JEFFREY, DURANT",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1053604546,"SHARPTON, KEITH, THOMAS",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4100 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053604751,"WATSON, BRADLEY, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053607697,"WALLS, TIMOTHY, BERNARD",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053607697,"WALLS, TIMOTHY, BERNARD",600 GRESHAM DR PSMG NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053608695,"CRANE, SANDRINE, UWASE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043965429,NOVANT HEALTH THOMASVILLE MEDICAL C,NOVANT HEALTH CANCER INSTITUTE KERNERSVILLE,1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053608695,"CRANE, SANDRINE, UWASE",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,,,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053608695,"CRANE, SANDRINE, UWASE",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 62 , 115 , 115 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053608695,"CRANE, SANDRINE, UWASE",3515 W MARKET ST STE 300 GREENSBORO NC,041,Guilford,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1477664001,BLAND CLINIC PA,,1317 N ELM ST STE 7 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1053610170,"THOMPSON, ANJANETTE, MILES",1317 N ELM ST STE & GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 56 , 77 ,$#,,
MEDICAID DIRECT,1972766459,NORTH GEORGIA MEDICINE LLC,NORTH GEORGIA FAMILY MEDICINE,346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053612291,"JOHNSON, MARGI, LU",346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1972266237,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SHALLOTTE,301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1053614289,"MARONE, ANGELA, LEHMAN",301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 101 , 162 , 484 ," $17,339.51 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053617837,"SEEMAB, FARZANA",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1386960177,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053617837,"SEEMAB, FARZANA",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 28 , 40 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053617837,"SEEMAB, FARZANA",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053623082,"SALMON, JESSICA, LIN",1511 WESTOVER TER STE 107 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 456 , 486 ,$#,,
MEDICAID DIRECT,1053623140,TENDER LOVING CARE HOMES INC,BROOKHAVEN BEHAVIORAL HEALTH,2 WALDEN RIDGE DR STE 30 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1053623140,TENDER LOVING CARE HOMES INC,2 WALDEN RIDGE DR STE 30 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053623520,"SANTIAGO VAZQUEZ, ALEXANDRA",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 47 , 47 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053623520,"SANTIAGO VAZQUEZ, ALEXANDRA",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624270,LEICESTER VOLUNTEER FIRE DEPARTMENT,Leicester Volunteer Fire Department Inc,2852 NEW LEICESTER HWY   LEICESTER NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport,1053624270,LEICESTER VOLUNTEER FIRE DEPARTMENT,2852 NEW LEICESTER HWY   LEICESTER NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport, 34 , 41 , 75 ,$#,,
MEDICAID DIRECT,1053625830,BAILEY HOME HEALTH CARE SERVICES IN,~,4701 WRIGHTSVILLE AVE STE 2-105 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1053625830,BAILEY HOME HEALTH CARE SERVICES IN,4701 WRIGHTSVILLE AVE STE 2-105 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,903 "," 2,903 "," $178,380.44 ",,
MEDICAID DIRECT,1053625830,BAILEY HOME HEALTH CARE SERVICES IN,~,5202 CAROLINA BEACH RD STE 13 # A WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1053625830,BAILEY HOME HEALTH CARE SERVICES IN,5202 CAROLINA BEACH RD STE 13 # A WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 12 , 66 , 66 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1053626192,"KASTLER, KAREN, CLAUDIA",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053626192,"KASTLER, KAREN, CLAUDIA",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053631192,"BECK, MATTHEW, BRANDON",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 35 , 65 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053632570,"ALKADHI, REEM",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053632570,"ALKADHI, REEM",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 23 , 54 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053632570,"ALKADHI, REEM",2406 BLUE RIDGE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053632570,"ALKADHI, REEM",2406 BLUE RIDGE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1053632570,"ALKADHI, REEM",7124 KNIGHTDALE BLVD   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 38 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053632570,"ALKADHI, REEM",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053632570,"ALKADHI, REEM",2406 BLUE RIDGE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053634063,"BURNETT, LUKMAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053634063,"BURNETT, LUKMAN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053634063,"BURNETT, LUKMAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053634063,"BURNETT, LUKMAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 302 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053635516,"BARRETT, MEGAN, REBECCA",10207 CERNY ST STE 302 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053635516,"BARRETT, MEGAN, REBECCA",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053635516,"BARRETT, MEGAN, REBECCA",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053635516,"BARRETT, MEGAN, REBECCA",2400 PRATT ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053635516,"BARRETT, MEGAN, REBECCA",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 80 , 108 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,320 VETERANS PARKWAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 78 , 117 , 183 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 41 , 64 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053636894,"NANEZ, LILIANA",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053637181,"LYKES, JOHN, BRYAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053637181,"LYKES, JOHN, BRYAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 53 , 90 , 90 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053637850,"HAYS, BRANDON, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 96 , 147 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053641571,"STEWART, CATHERINE, JEAN",303 AIRPORT RD   ARDEN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 47 , 56 ,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053641571,"STEWART, CATHERINE, JEAN",161 WALKER ST   COLUMBUS NC,075,Polk,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 11 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053648451,"BROWN, LISA, MARIE",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053648451,"BROWN, LISA, MARIE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053648451,"BROWN, LISA, MARIE",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053653337,"SUMMERVILLE, GREGORY, BARR",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 15 , 31 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053653337,"SUMMERVILLE, GREGORY, BARR",75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 35 , 50 , 90 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053653337,"SUMMERVILLE, GREGORY, BARR",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 21 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053653337,"SUMMERVILLE, GREGORY, BARR",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053653337,"SUMMERVILLE, GREGORY, BARR",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 25 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053653337,"SUMMERVILLE, GREGORY, BARR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053653410,"HERBERT, JAMES, TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053653410,"HERBERT, JAMES, TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 21 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053653410,"HERBERT, JAMES, TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 41 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053653410,"HERBERT, JAMES, TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 22 , 23 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053653576,"THAO, CHOUA",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 26 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053654699,"SHAH, SUMA",234 CROOKED CREEK PKWY STE 420 DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 15 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053654699,"SHAH, SUMA",234 CROOKED CREEK PKWY STE 420 DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053654699,"SHAH, SUMA",234 CROOKED CREEK PKWY STE 420 DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 26 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053654699,"SHAH, SUMA",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053654772,"COUTURE, ROSANNA, PATRICE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053654863,"SAVITSKI, ALIAKSANDR",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053655035,THEOPHILOS III INTERGENERATIONAL DI,THEOPHILOS III INTERGENERATIONAL DIVERSIFIED OUTRE,100 WINCHESTER AVE STE A MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1053655035,THEOPHILOS III INTERGENERATIONAL DI,100 WINCHESTER AVE STE A MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 45 ," 10,662 "," 11,091 "," $1,155,973.12 ",,
MEDICAID DIRECT,1053655035,THEOPHILOS III INTERGENERATIONAL DI,THEOPHILOS III INTERGENERATIONAL DIVERSIFIED OUTRE,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1053655035,THEOPHILOS III INTERGENERATIONAL DI,206 N HAYNE ST STE A MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1053655928,"KELLY, DANIELLE, RAE",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 , 33 , 56 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053660530,"BRISCOE-BRIMMAGE, JENIFER, RAE",4414 LAKE BOONE TRL STE 405 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1578742177,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1053660613,"PINEDA, JESSICA, MARIA",214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 40 , 60 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053661934,"GUNN-NOLAN, SHERANDA, CAROL",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053661934,"GUNN-NOLAN, SHERANDA, CAROL",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053663625,"GRANT, CRYSTAL, ANNEQUA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053663625,"GRANT, CRYSTAL, ANNEQUA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053663625,"GRANT, CRYSTAL, ANNEQUA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053664458,"NIXON, TARA, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053666594,"ANTHONY, CRAIG, LINCOLN",106 CORPORATE PARK DR STE 200 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 39 , 78 ,$#,,
MEDICAID DIRECT,1639182231,HANGER PROSTHETICS & ORTHOTICS EAST,,3806 S CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053668848,"WOZNICKI, AMY, LYNN",3806 S CHURCH ST   BURLINGTON NC,001,Alamance,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053670422,"CHASNOVITZ, REBECCA, RYANE",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 32 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,893 EAST ST   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053670422,"CHASNOVITZ, REBECCA, RYANE",893 EAST ST   PITTSBORO NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053670554,"KARENZ, ANDREW, ROBERT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053670554,"KARENZ, ANDREW, ROBERT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 51 , 55 ,$#,,
MEDICAID DIRECT,1417542556,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH ORTHOPEDICS AND SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1053670786,"STOVER, TITORYA, TIYOYKIYA",2721 X RAY DR   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1417542556,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH ORTHOPEDICS AND SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1053670786,"STOVER, TITORYA, TIYOYKIYA",503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 49 , 88 , 135 ,$#,,
MEDICAID DIRECT,1417542556,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH ORTHOPEDICS AND SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1053670786,"STOVER, TITORYA, TIYOYKIYA",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053671586,"JIMOH, OLANREWAJU, YUSUF",1105 SPRUCE ST STE 101 BELMONT NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053671586,"JIMOH, OLANREWAJU, YUSUF",1105 SPRUCE ST STE 101 BELMONT NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053671586,"JIMOH, OLANREWAJU, YUSUF",10520 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053671586,"JIMOH, OLANREWAJU, YUSUF",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053671586,"JIMOH, OLANREWAJU, YUSUF",101 E WT HARRIS BLVD STE 3215 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053671586,"JIMOH, OLANREWAJU, YUSUF",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 52 , 127 , 198 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053671586,"JIMOH, OLANREWAJU, YUSUF",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1063584415,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE ENDOSCOPY CENTER,300 BILLINGSLEY RD # 200B CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1053671586,"JIMOH, OLANREWAJU, YUSUF",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053673442,"CHOW, STEPHEN, CJ",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053673442,"CHOW, STEPHEN, CJ",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 111 , 111 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053673442,"CHOW, STEPHEN, CJ",1000 BLYTHE BLVD CMC ANNEX CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053673442,"CHOW, STEPHEN, CJ",920 CHURCH ST N STE 255D CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053673483,"ZEITOUNI, RAGHID, ATEF",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 103 , 103 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053674903,"TSAI, YI JOU",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053674903,"TSAI, YI JOU",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053674903,"TSAI, YI JOU",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114228475,MOSES CONE AFFILIATED PHYSICIANS IN,PREMIER PEDIATRICS OF EDEN,509 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1053676742,"QAYUMI, ZAINAB",509 S VAN BUREN RD STE B EDEN NC,079,Rockingham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 99 , 242 ," $11,421.82 ",,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1053677286,"CHAMBERLAIN, REID, CAMERON",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053677286,"CHAMBERLAIN, REID, CAMERON",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 23 , 46 , 54 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1053677427,"ELMER, DONALD, ARIC",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053677427,"ELMER, DONALD, ARIC",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1053677427,"ELMER, DONALD, ARIC",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053677930,"DHINGRA, VIBHU, OM",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053677930,"DHINGRA, VIBHU, OM",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 44 , 62 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053677930,"DHINGRA, VIBHU, OM",10545 BLAIR RD STE 2100 MINT HILL NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053677930,"DHINGRA, VIBHU, OM",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 52 , 71 ,$#,,
MEDICAID DIRECT,1902412729,CENTENNIAL HOUSING & COMMUNITY SERV,WASHINGTON REGIONAL MEDICAL CENTER,958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,193200000X,Group,Multi-Specialty,,1053680892,"STOWE, CHRYSTIE, LEE",958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 57 , 69 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053682831,"HESLOP, JACLYN, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053687012,"PARKER, JENNIFER, LYNN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 37 , 43 , 56 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053687012,"PARKER, JENNIFER, LYNN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053687012,"PARKER, JENNIFER, LYNN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053687012,"PARKER, JENNIFER, LYNN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518549393,IREDELL PHYSICIAN NETWORK,IREDELL SURGERY AT MOORESVILLE,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1053687012,"PARKER, JENNIFER, LYNN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053687012,"PARKER, JENNIFER, LYNN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 22 , 36 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",114 W 30TH ST STE 800 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 58 , 63 , 63 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",2025 FRONTIS PLAZA BLVD STE 100 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 117 , 161 , 234 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 22 , 42 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 16 , 31 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053687954,"HARIKRISHNAN, PRAKASH",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053688549,"ANDANI, MAHESH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053688549,"ANDANI, MAHESH",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 54 , 124 , 124 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053693523,"SOMERVILLE, ANNE MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053699439,"NSIAH, ISSAKA, ODOI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053699439,"NSIAH, ISSAKA, ODOI",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 138 , 139 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053699439,"NSIAH, ISSAKA, ODOI",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1053700757,"HIGGS, WILLIAM, DARRELL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1053700757,"HIGGS, WILLIAM, DARRELL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053701144,"MURRAY, ESTHER, ROCHELLE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053701144,"MURRAY, ESTHER, ROCHELLE",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053701144,"MURRAY, ESTHER, ROCHELLE",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 86 , 144 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053701144,"MURRAY, ESTHER, ROCHELLE",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053702076,"PERCIVAL, JENNIFER, LOUISE",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 65 , 123 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053702076,"PERCIVAL, JENNIFER, LOUISE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 17 , 37 ,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1053703785,"HICKS, ASHLEY, NICHOLE",3193 W HIGHWAY 74   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 24 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053705640,"SHROFF, HERSH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 66 , 98 , 125 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053705640,"SHROFF, HERSH",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 14 , 20 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053707109,"CHEN, SHOUJUN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 95 , 94 , 176 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053707257,"LAROSA, SARA, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053707307,"FREDERICK, BRENT, DANIEL",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053707307,"FREDERICK, BRENT, DANIEL",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 74 , 179 , 179 ,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053707984,"OFEI, AGATHA, YAWAH AGBO",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053708891,"BYRD, GRAYLAN, DWIGHT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053708891,"BYRD, GRAYLAN, DWIGHT",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053708891,"BYRD, GRAYLAN, DWIGHT",810 MITCHELL AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 34 , 68 ,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053710285,"SINGLA, SONIA",1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 124 , 417 , 451 ,$#,,
MEDICAID DIRECT,1053710285,"SINGLA, SONIA",,1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,1053710285,"SINGLA, SONIA",1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053710285,"SINGLA, SONIA",640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053714006,"ANDERSON, CHRISTINE, SUSANNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 60 , 90 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053715599,"GREER, LEAH, CAROL",303 AIRPORT RD   ARDEN NC,011,Buncombe,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053715599,"GREER, LEAH, CAROL",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 34 , 41 , 52 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053717660,"MISUNINA, TATJANA",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1053720730,"WILSON, MICAH, LOREN",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 137 , 400 ," $16,129.31 ",,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1053721068,"COKER, AMY, CHRISTINE",1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 51 , 101 , 102 ,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053721282,"PARKER, PAIGE, KIMBRELL",1205 N CENTER ST   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 37 ,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1053721282,"PARKER, PAIGE, KIMBRELL",24 2ND AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 63 , 140 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053721647,"BRACEY, DANIEL, NICHOLAS",4741 RANDOLPH RD STE 100&200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053721647,"BRACEY, DANIEL, NICHOLAS",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 26 , 49 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053721647,"BRACEY, DANIEL, NICHOLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053721647,"BRACEY, DANIEL, NICHOLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1053721647,"BRACEY, DANIEL, NICHOLAS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053721647,"BRACEY, DANIEL, NICHOLAS",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104845270,PEDIATRIC DENTISTRY OF MATTHEWS,~,1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053722074,"FRANK, MOLLY, TESCH",1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 176 , 229 , 764 ," $33,943.11 ",,
MEDICAID DIRECT,1104845270,PEDIATRIC DENTISTRY OF MATTHEWS,~,1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053722074,"FRANK, MOLLY, TESCH",1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1568624344,PEDIATRIC DENTISTRY OF STEELE CREEK,STEELE CREEK PEDIATRIC DENTISTRY,13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053722074,"FRANK, MOLLY, TESCH",13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 80 , 97 , 317 ," $11,553.81 ",,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053724146,"HANEY, JENNIFER, LEIGH",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053725051,"HONART, ANNE, ELIZABETH WEST",2301 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 37 , 45 , 49 ," $18,817.56 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053725051,"HONART, ANNE, ELIZABETH WEST",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053725051,"HONART, ANNE, ELIZABETH WEST",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 43 , 46 , 56 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053725473,"MCQUELLON, BRENDAN, THOMAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 46 , 203 , 203 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053726521,"YI, JAMES, CHUN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1053726521,"YI, JAMES, CHUN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053727503,"AL-KHALISY, HASSAN, MAHDI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 27 , 37 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053727503,"AL-KHALISY, HASSAN, MAHDI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053727503,"AL-KHALISY, HASSAN, MAHDI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053727503,"AL-KHALISY, HASSAN, MAHDI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 34 , 57 , 76 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053727503,"AL-KHALISY, HASSAN, MAHDI",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053731042,"OHMES, LUCAS, BENJAMIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053731133,"BAYOUTH, LILLY, ANN",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053731513,"XU, BAOGANG, JONATHAN",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053732164,"EARP, CHERYL, CONINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053735142,"DEARDORFF, REBECCA, ANNE",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053738344,"HOOD PISHCHANY, MARGUERITE, INDRIATI",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 13 , 28 , 28 ,$#,,
MEDICAID DIRECT,1962858662,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,1201 COLONIAL COMMONS CT   LANCASTER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053739730,"DAVE, AJAL, M",1656 RIVERCHASE BLVD STE 3200 ROCK HILL SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053739730,"DAVE, AJAL, M",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1962858662,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,1201 COLONIAL COMMONS CT   LANCASTER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053739730,"DAVE, AJAL, M",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739854,"KAUR, AMARPREET",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739854,"KAUR, AMARPREET",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739854,"KAUR, AMARPREET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 25 , 37 , 42 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739854,"KAUR, AMARPREET",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739854,"KAUR, AMARPREET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739854,"KAUR, AMARPREET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739854,"KAUR, AMARPREET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739870,"HOULIHAN, BRENNA, KATE",505 OBERLIN RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739870,"HOULIHAN, BRENNA, KATE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739870,"HOULIHAN, BRENNA, KATE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 19 , 21 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739870,"HOULIHAN, BRENNA, KATE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739870,"HOULIHAN, BRENNA, KATE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739870,"HOULIHAN, BRENNA, KATE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053739870,"HOULIHAN, BRENNA, KATE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053739946,"SHOFF, CHRISTOPHER, JOHN",40 DUKE MEDICINE CIR # 1K DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053739946,"SHOFF, CHRISTOPHER, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053739946,"SHOFF, CHRISTOPHER, JOHN",40 DUKE MEDICINE CIR # 1K DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,,,$#,,
MEDICAID DIRECT,1053740654,SUANNAH CARE INC,,8701 WADFORD DR RM 200 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1053740654,SUANNAH CARE INC,8701 WADFORD DR RM 200 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 2,511 "," 2,511 "," $157,093.76 ",,
MEDICAID DIRECT,1053743237,"WADE, CASSANDRA, MARIO",CAROLINA COMMUNICATION AND DYSPHAGIA PLLC,192 LONG FARM RD   GARYSBURG NC,066,Northampton,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1053743237,"WADE, CASSANDRA, MARIO",192 LONG FARM RD   GARYSBURG NC,066,Northampton,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053744961,"KNAPP, NATHAN, ROBERT",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053745190,"NAEGEL, MATTHEW, JOHN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 53 , 80 ,$#,,
MEDICAID DIRECT,1053748780,"SCHAUBACH, HEATHER, LEE",,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1053748780,"SCHAUBACH, HEATHER, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053748780,"SCHAUBACH, HEATHER, LEE",,3821 ED DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1053748780,"SCHAUBACH, HEATHER, LEE",3821 ED DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053749820,"PHELPS-COPELAND, LINDSEY, DALE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053749820,"PHELPS-COPELAND, LINDSEY, DALE",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053749820,"PHELPS-COPELAND, LINDSEY, DALE",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 19 , 54 , 54 ,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053750059,"MUNCIE, COLIN, BRUCE",104 MEDSPRING DR   CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053750059,"MUNCIE, COLIN, BRUCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053750059,"MUNCIE, COLIN, BRUCE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053750059,"MUNCIE, COLIN, BRUCE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053750059,"MUNCIE, COLIN, BRUCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 31 , 41 ," $10,905.60 ",,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053751115,"HILTON, GINLY, LAU",201 MCCULLOUGH DR STE 180 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,365 "," 2,349 "," 4,750 "," $274,961.01 ",,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053751230,"SELFE, ANDREW, TRUMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053751230,"SELFE, ANDREW, TRUMAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053751230,"SELFE, ANDREW, TRUMAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053751412,"CAREY, STEPHEN, GIRARD",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053751412,"CAREY, STEPHEN, GIRARD",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 71 , 71 , 71 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053751412,"CAREY, STEPHEN, GIRARD",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053751750,"HORTON, MATTHEW, CARROLL",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 25 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053751750,"HORTON, MATTHEW, CARROLL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053751750,"HORTON, MATTHEW, CARROLL",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 77 , 113 , 165 ,$#,,
MEDICAID DIRECT,1053752055,"HENDERSON, KATELYN, JOYCE",STOKES DENTISTRY,626 KIRBY RD   KING NC,085,Stokes,1223G0001X,Dental Providers,Dentist,General Practice,1053752055,"HENDERSON, KATELYN, JOYCE",626 KIRBY RD   KING NC,085,Stokes,1223G0001X,Dental Providers,Dentist,General Practice, 93 , 204 , 544 ," $22,748.16 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053754325,"SYED, FATIMA, ZAHARA",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 20 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053754325,"SYED, FATIMA, ZAHARA",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,501 DOUGLAS ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053754325,"SYED, FATIMA, ZAHARA",501 DOUGLAS ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053755074,"GONCHIKAR, SWAROOP, SADASHIV",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 99 , 155 , 223 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1053755181,"RICHARDSON, CHARLOTTE, AMY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053755744,"FREASIER, BENJAMIN, TODD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 58 , 169 , 170 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053756577,"BATEMAN, JAMES, RUSELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053757054,"HARTZLER, MOLLY, AMANDA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 41 , 59 , 62 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053757054,"HARTZLER, MOLLY, AMANDA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1053758524,"ATLURI, MAHESH, GAUTAM",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",1607 N MAIN ST   KANNAPOLIS NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",1607 N MAIN ST   KANNAPOLIS NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 34 , 35 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",611 MOCKSVILLE AVE STE 202 SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 66 , 66 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",9562 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 32 , 76 , 115 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",9562 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 28 , 79 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 44 , 120 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053758714,"SHABAN, MONA, WALID",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 12 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,,,Unknown,193400000X,Group,Single Specialty,,1053759795,"BROWN, MICHAEL, WILLIAM JOSEPH",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053759795,"BROWN, MICHAEL, WILLIAM JOSEPH",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053759795,"BROWN, MICHAEL, WILLIAM JOSEPH",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053759795,"BROWN, MICHAEL, WILLIAM JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 50 , 66 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1053759795,"BROWN, MICHAEL, WILLIAM JOSEPH",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053759795,"BROWN, MICHAEL, WILLIAM JOSEPH",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053759795,"BROWN, MICHAEL, WILLIAM JOSEPH",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053759837,"MOSTARD, SANDRA, JOHANNA",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053759837,"MOSTARD, SANDRA, JOHANNA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053759837,"MOSTARD, SANDRA, JOHANNA",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053759837,"MOSTARD, SANDRA, JOHANNA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 85 , 85 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053759837,"MOSTARD, SANDRA, JOHANNA",1333 S DICKINSON DR UNIT 200 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053762179,"BENNETT, GERALD, WILLIAM",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 17 , 18 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1053762179,"BENNETT, GERALD, WILLIAM",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1053765305,"WINSTEAD-DERLEGA, CHRISTOPHER, EVAN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053765305,"WINSTEAD-DERLEGA, CHRISTOPHER, EVAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 20 ,$#,,
MEDICAID DIRECT,1881127298,S ROSS PENLAND DMDPA MORGANTON PLLC,,110 JUNIPER ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1053765925,"LEACH, MATTHEW",110 JUNIPER ST STE 200 MORGANTON NC,012,Burke,1223G0001X,Dental Providers,Dentist,General Practice," 3,743 "," 5,353 "," 18,652 "," $631,793.90 ",,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1053765990,"CATANIA, KRISTINA, MARIA",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1053765990,"CATANIA, KRISTINA, MARIA",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 22 , 66 , 69 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053765990,"CATANIA, KRISTINA, MARIA",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053767012,"VOLLMER, MICHAEL, FRANCIS",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053767012,"VOLLMER, MICHAEL, FRANCIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1053768622,"KNUTSON, STEPHANIE, MARIE",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053768622,"KNUTSON, STEPHANIE, MARIE",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 22 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1053768622,"KNUTSON, STEPHANIE, MARIE",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 45 , 68 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1053768622,"KNUTSON, STEPHANIE, MARIE",1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 28 , 40 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053768622,"KNUTSON, STEPHANIE, MARIE",1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053768739,"WANG, EUGENE, YUXIN",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 31 , 70 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053768739,"WANG, EUGENE, YUXIN",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053768739,"WANG, EUGENE, YUXIN",3149 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 85 , 121 , 197 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053768739,"WANG, EUGENE, YUXIN",2225 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053768739,"WANG, EUGENE, YUXIN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1053769448,"ANDERS, CHERITA, MONIQUE",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1053769448,"ANDERS, CHERITA, MONIQUE",6845 KNIGHTDALE BLVD STE 100 KNIGHTDALE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 37 , 56 , 139 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053770032,"LOCKLEAR, ERICA, KAY",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053770032,"LOCKLEAR, ERICA, KAY",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 102 , 189 ,$#,,
MEDICAID DIRECT,1053772269,"VAUGHAN, ASHLEY, NICHOLE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,1053772269,"VAUGHAN, ASHLEY, NICHOLE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1033877592,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DILLON FAMILY MEDICINE,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053773259,"GILBERT, RYAN, DOUGLAS",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 12 , 43 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1053773812,"OBRAZTSOVA, MARIA, VIKTOROVNA",307 YADKIN ST   ALBEMARLE NC,084,Stanly,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 11 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1053773812,"OBRAZTSOVA, MARIA, VIKTOROVNA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053773812,"OBRAZTSOVA, MARIA, VIKTOROVNA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 18 , 19 , 30 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053773812,"OBRAZTSOVA, MARIA, VIKTOROVNA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 25 , 37 , 37 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053774992,"SHAH, PARTH, NIPUR",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 181 , 192 , 219 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1053774992,"SHAH, PARTH, NIPUR",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053774992,"SHAH, PARTH, NIPUR",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 150 , 156 , 196 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1053775726,"ANDERSON, HILARY, BRYAN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1053775726,"ANDERSON, HILARY, BRYAN",975 E 3RD ST # 376 CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053779504,"RISPOLI, JESSICA, SCHMOYER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053780767,"RAYMER, JILL, LEE",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 103 , 143 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1053780767,"RAYMER, JILL, LEE",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1053781088,"CROOK, KRISTEN, SHAYANNE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 111 , 129 , 359 ," $14,018.31 ",,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1053781088,"CROOK, KRISTEN, SHAYANNE",327 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1053783134,"SHAW, SHENNA, JOHNSON",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053783415,"COGGIN, MELISSA, YEUNG",13557 STEELECROFT PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053783415,"COGGIN, MELISSA, YEUNG",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 33 , 65 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,168 NORMAN STATION BLVD STE Q MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",168 NORMAN STATION BLVD STE Q MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053786558,"ROYSTON, LINDA, GONZALEZ",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053788422,"OLIVACCE, LUCKRICIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 124 , 155 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1053789586,"ENGLISH, STEPHANIE, DANETTE",102 POMONA DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 22 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1053789586,"ENGLISH, STEPHANIE, DANETTE",102 POMONA DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053789586,"ENGLISH, STEPHANIE, DANETTE",102 POMONA DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1053789586,"ENGLISH, STEPHANIE, DANETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1053790436,"MCGARR, AMANDA, MARIE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053792309,"FORET, CLAYTON, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 66 , 66 , 92 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053792309,"FORET, CLAYTON, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1053792309,"FORET, CLAYTON, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053792309,"FORET, CLAYTON, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 36 , 48 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053793265,"HA, JEWOOK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 39 , 95 , 95 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053793265,"HA, JEWOOK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053798660,"GAY, LAURA, CONE",7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 18 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053800474,"TAUS, PATRICK, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 45 , 96 , 99 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3325 GARDEN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053800474,"TAUS, PATRICK, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053800474,"TAUS, PATRICK, JONATHAN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 16 , 20 ,$#,,
MEDICAID DIRECT,1992172134,G ABRAMS AND R COHEN XI PC,,6807 FAYETTEVILLE RD STE 119 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053802660,"MAHMUD, ABDULLAH, MAHMUD",117 N MYRTLE SCHOOL RD STE 170 GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 169 , 228 ," 1,143 "," $77,002.10 ",,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053802660,"MAHMUD, ABDULLAH, MAHMUD",117 N MYRTLE SCHOOL RD STE 170 GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 55 , 288 ," $29,927.63 ",,
MEDICAID DIRECT,1427326867,G ABRAMS R COHEN IV PC,GABRAMS AND R COHEN IV PC,117 N MYRTLE SCHOOL RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053802660,"MAHMUD, ABDULLAH, MAHMUD",117 N MYRTLE SCHOOL RD STE 170 GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 303 , 413 ," 1,327 "," $72,577.84 ",,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053802660,"MAHMUD, ABDULLAH, MAHMUD",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 451 , 540 ," 1,757 "," $209,752.48 ",,
MEDICAID DIRECT,1386903995,G ABRAMS R COHEN SC II PC,FRIENDLY DENTAL GROUP INDIAN LAND,10092 CHARLOTTE HWY STE 107 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053802702,"EFTEKHAR, KIMIA",11840 SOUTHMORE DR STE 150 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 281 , 602 ," 2,081 "," $105,781.83 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053802876,"DUNN, SALLY, MAE",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1053803601,"HINES, GENESIS, VICTORIA",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 43 , 55 ,$#,,
MEDICAID DIRECT,1417610627,MOSES CONE AFFILIATED PHYSICIANS IN,GYNECOLOGY CENTER OF GREENSBORO,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053803601,"HINES, GENESIS, VICTORIA",719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 25 , 42 ,$#,,
MEDICAID DIRECT,1417610627,MOSES CONE AFFILIATED PHYSICIANS IN,GYNECOLOGY CENTER OF GREENSBORO,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053803601,"HINES, GENESIS, VICTORIA",719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053804542,"STOFFORD, BRITTANY, CHARLENE",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 548 , 649 ," 2,289 "," $79,461.06 ",,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053804542,"STOFFORD, BRITTANY, CHARLENE",280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,778 "," 2,073 "," 7,771 "," $240,830.47 ",,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053805523,"DEATON, ANNA BETH, SPARKS",1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053805523,"DEATON, ANNA BETH, SPARKS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053805523,"DEATON, ANNA BETH, SPARKS",1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053805523,"DEATON, ANNA BETH, SPARKS",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053805978,"OHARA, ANNE, HUITT DAVIS",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 39 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1053805978,"OHARA, ANNE, HUITT DAVIS",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 104 , 202 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 340 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053809350,"KOTZEN, MOLLIE, ELIZABETH",234 CROOKED CREEK PKWY STE 340 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2609 N DUKE ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053809350,"KOTZEN, MOLLIE, ELIZABETH",2609 N DUKE ST STE 204 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053809350,"KOTZEN, MOLLIE, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053809350,"KOTZEN, MOLLIE, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053811570,"PORTER, YVETTE, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053815134,"COOK, JULIA, ANN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053815134,"COOK, JULIA, ANN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 33 , 58 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1053815910,"MALARA, ASHLEY, LAURA",5710 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 43 , 74 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1053815910,"MALARA, ASHLEY, LAURA",114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1053815910,"MALARA, ASHLEY, LAURA",114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 28 ,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053816645,"WONS, JONATHAN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 24 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",1090 NE GATEWAY CT NE STE 2020 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053817619,"PEOPLES, JESSICA, ANN",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053817791,"FREMPONG, STEPHEN, KEHINDE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 213 , 214 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053817791,"FREMPONG, STEPHEN, KEHINDE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053818534,"STETLER, JEFFREY, RYAN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 123 , 190 , 238 ," $12,076.07 ",,
MEDICAID DIRECT,1053821728,ABS UT PC,,420 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1053821728,ABS UT PC,420 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1053821728,ABS UT PC,,300 BILLINGSLEY RD STE 107 CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1053821728,ABS UT PC,300 BILLINGSLEY RD STE 107 CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1053821728,ABS UT PC,,420 GALLIMORE DAIRY RD STE B GREENSBORO NC,041,Guilford,251S00000X,Agencies,Community/Behavioral Health,,1053821728,ABS UT PC,420 GALLIMORE DAIRY RD STE B GREENSBORO NC,041,Guilford,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 29 , 38 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1053821843,"APPLEGATE, MELISSA, KOBYLARZ",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053824078,"COLVIN, ANDREA, DAWN",444 WILLIAMSON RD STE B MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 56 , 92 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053824078,"COLVIN, ANDREA, DAWN",444 WILLIAMSON RD STE B MOORESVILLE NC,049,Iredell,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053826370,"YANICKO, CHRISTINA, LEE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053826370,"YANICKO, CHRISTINA, LEE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053826370,"YANICKO, CHRISTINA, LEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053829291,"MADER, MINDY, ROBIN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053829986,"IRWIN, DAKOTA, GARRON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053830448,"MATHEW, HEATHER, JEAN",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 28 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053830588,"MARVDASHTI, SHEEVA",20 DUKE MEDICINE CIR CLINIC 2 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053830588,"MARVDASHTI, SHEEVA",20 DUKE MEDICINE CIR CLINIC 2 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1053830760,"CAREY, BRYAN, JAMES",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1053830760,"CAREY, BRYAN, JAMES",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053830877,"MCQUEEN, TRACY, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053831008,"MULAT, BARUH, BRUCK",808 N WASHINGTON ST   SHELBY NC,023,Cleveland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 40 , 59 , 71 ,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,3762 DURHAM RD STE A ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1053831750,"RAYMER, CHRISTIN, HEVERLY",3762 DURHAM RD STE A ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1053831750,"RAYMER, CHRISTIN, HEVERLY",3762 DURHAM RD STE A ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053832717,"MITCHELL-FULLWOOD, TISA",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053833996,"SUDE, ASHA, BALU",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#, 11 ,$#,,
MEDICAID DIRECT,1790212462,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053833996,"SUDE, ASHA, BALU",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053838193,"CARTER, AMY, LYNN",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053838193,"CARTER, AMY, LYNN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811761349,CAROMONT MEDICAL GROUP INC,CAROMONT HEALTH MATERNITY CLINIC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053838193,"CARTER, AMY, LYNN",991 W HUDSON BLVD STE 70B GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053838193,"CARTER, AMY, LYNN",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1053838326,"GLOSSIP, JESSICA, SINCLAIR",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 37 , 95 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053839779,"GUPTA, SAVITA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053839779,"GUPTA, SAVITA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 79 , 101 , 157 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,CB #7450 UNC SCHOOL OF DENTISTRY CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1053839779,"GUPTA, SAVITA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053840371,"ALLEN, ERIKA, MARGARET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 22 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053840371,"ALLEN, ERIKA, MARGARET",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053840371,"ALLEN, ERIKA, MARGARET",101 E W T HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053840371,"ALLEN, ERIKA, MARGARET",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053841841,"PUGH, CAITLIN, MILLER",~,803 E CENTER ST   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,1053841841,"PUGH, CAITLIN, MILLER",803 E CENTER ST   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 17 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053843334,"REISSMANN, MOLLY, ELIZABETH",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 93 , 136 , 267 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053843334,"REISSMANN, MOLLY, ELIZABETH",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053843441,"VAIOS, KRISTEN, BATICH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1053843664,"GRAVES, BROOKE, MIESHA",5935 MOUNT SINAI RD   DURHAM NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 54 , 62 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1053843664,"GRAVES, BROOKE, MIESHA",5935 MOUNT SINAI RD   DURHAM NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 475 , 589 ," $17,052.16 ",,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1053843664,"GRAVES, BROOKE, MIESHA",5935 MOUNT SINAI RD   DURHAM NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 408 , 648 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053844175,"MARA, ALEXANDRIA, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053844175,"MARA, ALEXANDRIA, ANN",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 27 , 74 , 75 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053844423,"BROUGHMAN, JAMES, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053844423,"BROUGHMAN, JAMES, RICHARD",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 29 , 34 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053844423,"BROUGHMAN, JAMES, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 15 , 74 , 102 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053845461,"MEYER, JESSICA, ASHLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 53 , 57 , 71 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1053845461,"MEYER, JESSICA, ASHLEY",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053845685,"STONE, CASSIE, ELIZABETH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053845685,"STONE, CASSIE, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1053846287,"THEOBALD, BENJAMIN, DAVID",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1505 SW CARY PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053846667,"AL-GHANDOUR, DEEMA, MAJED",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053846667,"AL-GHANDOUR, DEEMA, MAJED",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 23 , 25 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053846667,"AL-GHANDOUR, DEEMA, MAJED",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053846667,"AL-GHANDOUR, DEEMA, MAJED",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053846758,"PELTZ, JOSHUA, WOLF",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568999118,WRIGHT AND ASSOCIATES III DDS PA,,4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053847343,"BRADER, THOMAS, HAYDEN",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 380 , 559 ," 2,247 "," $215,085.52 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",5156 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 33 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",529 S VAN BUREN RD   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 34 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,252 TURNERSBURG HWY STE E STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",252 TURNERSBURG HWY STE E STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 18 , 38 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053847954,"ADORNETTO, RENEE, LYNN",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1053852277,"DIAZ, CHRISTOPHER, JUAN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053852400,"THREADGILL, RYAN, SPENCER","CB# 7020, 130 MASON FARM ROAD 4TH FLOOR BIOINFORMATICS BUILDING CHAPEL HILL NC",019,Chatham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 20 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053852400,"THREADGILL, RYAN, SPENCER","CB# 7020, 130 MASON FARM ROAD 4TH FLOOR BIOINFORMATICS BUILDING CHAPEL HILL NC",019,Chatham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 27 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053852400,"THREADGILL, RYAN, SPENCER",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 18 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1053856880,"MERRITT, WILLIAM, BENJAMIN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053856880,"MERRITT, WILLIAM, BENJAMIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053856880,"MERRITT, WILLIAM, BENJAMIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053859108,"JOSEPH, MICHAEL, EVANS",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 20 , 24 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1053859330,"MUI, KELLY, KINLAE",5397 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1053859330,"MUI, KELLY, KINLAE",5397 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053859330,"MUI, KELLY, KINLAE",5397 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1053859330,"MUI, KELLY, KINLAE",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053861906,"WILSON, ALLIE, THOMPSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 41 , 44 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053867374,"ZAMORA, KRISTOPHER, LEE",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 16 , 17 , 53 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053867374,"ZAMORA, KRISTOPHER, LEE",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053867374,"ZAMORA, KRISTOPHER, LEE",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 19 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053867960,"CLAYTON, TAY-LEA, SIKEYA",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053868356,"CHIANG, YUN-HUA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053868356,"CHIANG, YUN-HUA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053868356,"CHIANG, YUN-HUA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1053869206,"WADE, JONATHAN, BRADLEY",335 E PARKER RD   MORGANTON NC,012,Burke,152W00000X,Eye and Vision Services Providers,Optometrist,, 104 , 114 , 151 ,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053871996,"BABINSKA HOGAN, MAGDALENA, MALGORZATA",4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053871996,"BABINSKA HOGAN, MAGDALENA, MALGORZATA",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053871996,"BABINSKA HOGAN, MAGDALENA, MALGORZATA",5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053871996,"BABINSKA HOGAN, MAGDALENA, MALGORZATA",4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 31 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053872770,"THOMPSON, RUSSELL, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 25 , 29 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053872770,"THOMPSON, RUSSELL, EDWARD",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053872770,"THOMPSON, RUSSELL, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 14 , 15 , 19 ,$#,,
MEDICAID DIRECT,1023142122,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1053873273,"GREEN, ELISSA, CLAIR",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 53 , 62 ,$#,,
MEDICAID DIRECT,1053873620,MED-TRANS CORPORATION,,716 TILGHMAN DR   DUNN NC,043,Harnett,3416A0800X,Transportation Services,Ambulance,Air Transport,1053873620,MED-TRANS CORPORATION,716 TILGHMAN DR   DUNN NC,043,Harnett,3416A0800X,Transportation Services,Ambulance,Air Transport, 28 , 28 , 56 ," $22,626.82 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053874065,"HEPPER, KATHRYN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 26 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053874180,"GOMBASH, AMBER, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 43 , 65 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053874180,"GOMBASH, AMBER, MARIE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053874180,"GOMBASH, AMBER, MARIE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053874180,"GOMBASH, AMBER, MARIE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053874180,"GOMBASH, AMBER, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 30 , 46 ,$#,,
MEDICAID DIRECT,1700952637,COUNTY OF COLUMBUS OFFICE OF ACCOUN,COLUMBUS CO HEALTH DEPT,304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053877084,"JONES, STEPHANIE, TYNER",304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1053878603,"GOUGE, JARED, DOUGLAS",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1053878603,"GOUGE, JARED, DOUGLAS",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053878603,"GOUGE, JARED, DOUGLAS",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053879460,"MOONEY, CHRISTOPHER, BRADSHER",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 61 , 116 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1053879460,"MOONEY, CHRISTOPHER, BRADSHER",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 34 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053879460,"MOONEY, CHRISTOPHER, BRADSHER",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053880757,"CHAWLA, GUNEET, KAUR",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053883223,"DEVRIES, LISA, ANNETTE",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 120 , 181 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1053884650,"SWANSON, KIMBERLY, SEMONES",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053884650,"SWANSON, KIMBERLY, SEMONES",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053887539,"PEIFFER, RICHARD, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053891960,"CRAVEN, LAURA, EDWARDS",10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053891960,"CRAVEN, LAURA, EDWARDS",3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1265992713,MARSHIRL LOCKLEAR-FNP PLLC,,4303 LUDGATE ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1053897611,"LOCKLEAR, MARSHIL, BULLARD",4303 LUDGATE ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 97 , 314 , 753 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053897645,"PADILLA MARQUEZ, AMANDA, RAE",15825 BALLANTYNE MEDICAL PL STE 220 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 68 , 179 ,$#,,
MEDICAID DIRECT,1053903971,MONTGOMERY CARE SERVICES LLC,~,4035 UNIVERSITY PKWY STE 120 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1053903971,MONTGOMERY CARE SERVICES LLC,4035 UNIVERSITY PKWY STE 120 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 5,217 "," 5,217 "," $309,667.72 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053908004,"PHARR, LA'SHIEKA, SHACONDRA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 17 , 19 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053908004,"PHARR, LA'SHIEKA, SHACONDRA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053910547,"COOK, DEVON, VIRGINIA DENESEUS",2525 COURT DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053910596,"DAO, SARAH, XIAO JENG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053910596,"DAO, SARAH, XIAO JENG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 31 , 32 ,$#,,
MEDICAID DIRECT,1891429593,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE HOPE VALL,7021 NC HIGHWAY 751   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053912345,"GRUBER, ASHLYN, ANNE",7021 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1891429593,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE HOPE VALL,7021 NC HIGHWAY 751   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053912345,"GRUBER, ASHLYN, ANNE",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497918338,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - LOUISBURG,111 S CHURCH ST   LOUISBURG NC,035,Franklin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053913020,"BRACAMONTE LOPEZ, KARLA, ELIZABETH",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 138 , 258 , 283 ," $15,343.68 ",,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053913020,"BRACAMONTE LOPEZ, KARLA, ELIZABETH",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 117 , 122 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053913020,"BRACAMONTE LOPEZ, KARLA, ELIZABETH",110 CAPCOM AVE STE 103 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497918338,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - LOUISBURG,111 S CHURCH ST   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1053913020,"BRACAMONTE LOPEZ, KARLA, ELIZABETH",111 S CHURCH ST   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497918338,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - LOUISBURG,111 S CHURCH ST   LOUISBURG NC,035,Franklin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053913020,"BRACAMONTE LOPEZ, KARLA, ELIZABETH",111 S CHURCH ST   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053913376,"ROBERTS, ELIZABETH, MARIE",932 MORREENE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053913376,"ROBERTS, ELIZABETH, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1053913483,"AVERY, JAMIE, JONES",8210 RICHLANDS HWY   RICHLANDS NC,067,Onslow,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053914275,"WHITON, KIMBERLY, DUVALL",154 S MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053914275,"WHITON, KIMBERLY, DUVALL",154 S MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,154 S MAIN ST   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053914275,"WHITON, KIMBERLY, DUVALL",154 S MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 99 , 179 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053914275,"WHITON, KIMBERLY, DUVALL",154 S MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053914275,"WHITON, KIMBERLY, DUVALL",154 S MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053914275,"WHITON, KIMBERLY, DUVALL",154 S MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 63 , 223 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1053914275,"WHITON, KIMBERLY, DUVALL",154 S MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053917732,LEGACY HOMECARE SERVICES LLC,,3326 GUESS RD STE 106 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1053917732,LEGACY HOMECARE SERVICES LLC,3326 GUESS RD STE 106 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 1,759 "," 1,837 "," $175,906.36 ",,
MEDICAID DIRECT,1053917732,LEGACY HOMECARE SERVICES LLC,,3511 SHANNON RD STE 321 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1053917732,LEGACY HOMECARE SERVICES LLC,3511 SHANNON RD STE 321 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 12 , 908 , 908 ," $83,976.40 ",,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1053917831,"ANDREWS, KAYLA, N.",1200 HARGETT ST   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 349 , 718 ,$#,,
MEDICAID DIRECT,1669797700,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER NEW RIVER,1200 HARGETT ST   JACKSONVILLE NC,067,Onslow,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053917831,"ANDREWS, KAYLA, N.",1200 HARGETT ST   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053918979,"ALI, AMJAD",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053918979,"ALI, AMJAD",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053918979,"ALI, AMJAD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1053918979,"ALI, AMJAD",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053918979,"ALI, AMJAD",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053918979,"ALI, AMJAD",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053918979,"ALI, AMJAD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 33 , 60 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 21 , 49 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,, 14 , 47 , 101 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 17 , 79 , 136 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 13 , 59 , 148 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 15 , 65 , 132 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053919712,"GREEN, DANA, FRANCES",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 36 , 59 ,$#,,
MEDICAID DIRECT,1912220690,ACTIVE LIVING CHIROPRACTIC INC,~,704 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1053928283,"BRESSLER, HANNAH, ELIZABETH",704 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,111N00000X,Chiropractic Providers,Chiropractor,,#, 59 , 61 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053930263,"MOHN, TAYLOR, ANNE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1053930263,"MOHN, TAYLOR, ANNE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053932525,KINDCARE LLC,,30 THREE HUNTS DR   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1053932525,KINDCARE LLC,30 THREE HUNTS DR   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 44 ," 8,355 "," 8,440 "," $1,000,935.90 ",,
MEDICAID DIRECT,1053933952,GASTROENTEROLOGY ASSOCIATES OF THE,,445 PINEVIEW DR STE 240 KERNERSVILLE NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1053933952,GASTROENTEROLOGY ASSOCIATES OF THE,445 PINEVIEW DR STE 240 KERNERSVILLE NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 17 , 17 , 31 ,$#,,
MEDICAID DIRECT,1053935502,IN LOVING HANDS HOME CARE,,5509B W FRIENDLY AVE STE 202 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1053935502,IN LOVING HANDS HOME CARE,5509B W FRIENDLY AVE STE 202 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 3,459 "," 3,519 "," $311,862.94 ",,
MEDICAID DIRECT,1053935502,IN LOVING HANDS HOME CARE,,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1053935502,IN LOVING HANDS HOME CARE,1608 CEDAR HILL WAY   COLFAX NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 64 , 64 ,$#,,
MEDICAID DIRECT,1053936930,UNICKZ HOME CARE SERVICES INC,AFFIRM HOMECARE SERVICES,5237 ALBEMARLE RD STE 221A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1053936930,UNICKZ HOME CARE SERVICES INC,5237 ALBEMARLE RD STE 221A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 11,816 "," 12,377 "," $1,002,400.82 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053940551,"WALTERS, STEPHANIE, CATHERINE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053940551,"WALTERS, STEPHANIE, CATHERINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053940882,"BUCIO, ELSA, CAMPOS",250 W KINGS HWY   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 24 , 33 ,$#,,
MEDICAID DIRECT,1487633053,ALEXANDER COUNTY,ALEXANDER COUNTY HEALTH DEPARTMENT,338 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1053943126,"HALL, LAUREN, KIRBY",338 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 36 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053943647,"EDGE, AMAYA",2797 NC 55 HWY   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053947150,"BENSON, CHASTITY, CAULDER",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 89 , 98 , 101 ,$#,,
MEDICAID DIRECT,1326036138,SOUTHEASTERN INTEGRATED CARE,~,3005 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1053947150,"BENSON, CHASTITY, CAULDER",3005 N ELM ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 22 , 50 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053947473,"GARLAND, JOHN, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053947473,"GARLAND, JOHN, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1053947911,"VELICKOVIC, MARKO",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053947911,"VELICKOVIC, MARKO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1053947911,"VELICKOVIC, MARKO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053947911,"VELICKOVIC, MARKO",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1053947911,"VELICKOVIC, MARKO",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053948083,"CHAO, COLIN, NEILS",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053948448,"KIM, CHRISTIAN, UENSEOK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 21 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053948448,"KIM, CHRISTIAN, UENSEOK",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053948448,"KIM, CHRISTIAN, UENSEOK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1053948448,"KIM, CHRISTIAN, UENSEOK",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053948653,"CRAWFORD, ANNA, ELIZABETH",7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 19 , 39 ,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053948653,"CRAWFORD, ANNA, ELIZABETH",5270 UNION RIDGE RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1013014596,PIEDMONT HEALTH SERVICES INC,SCOTT COMMUNITY HEALTH CENTER,5270 UNION RIDGE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053948653,"CRAWFORD, ANNA, ELIZABETH",5270 UNION RIDGE RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 54 , 66 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053948653,"CRAWFORD, ANNA, ELIZABETH",5270 UNION RIDGE RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053949354,"JACOBS, KIMURA, GARCIA CHERMEZ'S",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053949446,"DO, MICHELLE, QUYEN",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 18 , 23 ,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053949446,"DO, MICHELLE, QUYEN",455 S MAIN ST   DAVIDSON NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053950345,"COLAIANNI, CHRISTINE, GABRIELA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 74 , 89 , 132 ," $12,502.74 ",,
MEDICAID DIRECT,1053952010,SILER CITY OPCO LLC,DUNMORE SENIOR LIVING,260 VILLAGE LAKE RD   SILER CITY NC,019,Chatham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053952010,SILER CITY OPCO LLC,260 VILLAGE LAKE RD   SILER CITY NC,019,Chatham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 805 , 805 ," $55,751.96 ",,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053956326,"LABREC, CASSIDY, MARIE",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053956326,"LABREC, CASSIDY, MARIE",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053956326,"LABREC, CASSIDY, MARIE",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053956326,"LABREC, CASSIDY, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053956326,"LABREC, CASSIDY, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053956326,"LABREC, CASSIDY, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053958918,"DICK, BRITTANY, BLANTON",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 95 , 95 ,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1053958918,"DICK, BRITTANY, BLANTON",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 32 , 32 ,$#,,
MEDICAID DIRECT,1053961995,MCNEILLS HOME HEALTH CARE SERVICES,,1201 AVERSBORO RD   GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1053961995,MCNEILLS HOME HEALTH CARE SERVICES,1201 AVERSBORO RD   GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 6,132 "," 6,132 "," $354,013.04 ",,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053965491,"MILLER, MICHELLE, H",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1053966242,"LOCKLEY, DEVYN, MARIE",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1053966242,"LOCKLEY, DEVYN, MARIE",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 52 , 56 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053967141,"AGAD, ASMA, IDREES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1053968354,"MAYES, JONATHAN, TRENT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 53 , 53 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053968461,"VEAL, KATELYN, REBEKAH",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053968461,"VEAL, KATELYN, REBEKAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053968461,"VEAL, KATELYN, REBEKAH",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053968461,"VEAL, KATELYN, REBEKAH",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1386183408,MARY ELIZABETH STARNES HUFFMAN DDS,LENOIR FAMILY DENTISTRY,342 HARPER AVE NW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1053971150,"WHITE, LINDSEY, NICOLE",342 HARPER AVE NW STE A LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice, 181 , 283 , 899 ," $32,868.54 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053971226,"AGUSTIN, MONIQUE, CLYTIE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1053971606,"WILSON, MARCUS, JOHN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073911822,COASTAL CAROLINA HEALTH CARE PA,CCHC CREEKSIDE PRIMARY CARE,1010 LATHAN LN   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1053971606,"WILSON, MARCUS, JOHN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891013181,DEL BIANCO ENTERPRISES,DEL BIANCO PROSTHETICS & ORTHOTICS,1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053973057,"SCHWEITZER, JAMES, FITZGERALD",3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 23 ,$#,,
MEDICAID DIRECT,1316217359,DEL BIANCO ENTERPRISES,Del Bianco Prosthetics and Orthotics,3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053973057,"SCHWEITZER, JAMES, FITZGERALD",3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1891013181,DEL BIANCO ENTERPRISES,DEL BIANCO PROSTHETICS & ORTHOTICS,1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053973057,"SCHWEITZER, JAMES, FITZGERALD",1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1891013181,DEL BIANCO ENTERPRISES,DEL BIANCO PROSTHETICS & ORTHOTICS,3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053973057,"SCHWEITZER, JAMES, FITZGERALD",3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1891013181,DEL BIANCO ENTERPRISES,DEL BIANCO PROSTHETICS & ORTHOTICS,1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053973057,"SCHWEITZER, JAMES, FITZGERALD",3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 340 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053975284,"BUCHSER, RENEE, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2609 N DUKE ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053975284,"BUCHSER, RENEE, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053975284,"BUCHSER, RENEE, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053975284,"BUCHSER, RENEE, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1053975318,"KOKAYEFF, NINA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 199 , 201 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053975318,"KOKAYEFF, NINA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 77 , 77 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1053976217,"D'ALONZO, CAITLIN, RAFTER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 51 , 88 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053976407,"GREEN, NORMAN, JAROD",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 44 , 126 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1053976407,"GREEN, NORMAN, JAROD",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053976415,WAKEMED SPECIALISTS GROUP LLC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053976415,WAKEMED SPECIALISTS GROUP LLC,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#, 21 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1053976415,WAKEMED SPECIALISTS GROUP LLC,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,, 13 , 14 , 33 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053976415,WAKEMED SPECIALISTS GROUP LLC,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 17 , 17 , 36 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053976415,WAKEMED SPECIALISTS GROUP LLC,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 18 , 18 , 35 ,$#,,
MEDICAID DIRECT,1740628734,MONARCH,,103B MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1053977140,"CURTISS, MELISSA, MARY",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053978213,"SASS, KATIE, LYNN",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 52 , 81 , 139 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1053978213,"SASS, KATIE, LYNN",7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 33 ,$#,,
MEDICAID DIRECT,1053978346,GREENE OPCO LLC,SNOW HILL ASSISTED LIVING,1328 SE SECOND ST   SNOW HILL NC,040,Greene,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1053978346,GREENE OPCO LLC,1328 SE SECOND ST   SNOW HILL NC,040,Greene,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 107 , 107 ," $10,177.41 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,345 MANOR RD   MARS HILL NC,057,Madison,193200000X,Group,Multi-Specialty,,1053980938,"WEBB, HALEY, BROOKE",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 95 , 95 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1053980938,"WEBB, HALEY, BROOKE",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1053983445,"MAGLIO, BRIANNA, ELZABETH",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053983445,"MAGLIO, BRIANNA, ELZABETH",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 34 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1053984138,"BECKMAN, ALLISON, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053984732,"HEDGES, LAUREN, RENEE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053984732,"HEDGES, LAUREN, RENEE",29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 29 , 49 , 50 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1053984732,"HEDGES, LAUREN, RENEE",303 AIRPORT RD   ARDEN NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053988592,"HILL, REBECCA, MANCE",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 104 , 113 , 228 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1053988592,"HILL, REBECCA, MANCE",6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1053988592,"HILL, REBECCA, MANCE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1053988592,"HILL, REBECCA, MANCE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 17 , 30 ,$#,,
MEDICAID DIRECT,1659970770,SURVIVOR FRIENDLY LLC,SURVIVOR FRIENDLY,527 KEISLER DR STE 104 CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1053989657,"ANDREWS, LISA, MARIE",527 KEISLER DR   CARY NC,092,Wake,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1053991554,"ZHU, QIUYU",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1053995514,"JACKSON, BRITTANY, OLIVER",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053995514,"JACKSON, BRITTANY, OLIVER",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1053995514,"JACKSON, BRITTANY, OLIVER",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 35 , 49 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1053995514,"JACKSON, BRITTANY, OLIVER",2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1053999896,"KOMORIAN, AMBER, NICOLE",5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 41 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1053999896,"KOMORIAN, AMBER, NICOLE",5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063000164,"AMEDUITE, LEONNA, SYLVITRICE",101 HEART DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063000164,"AMEDUITE, LEONNA, SYLVITRICE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 161 , 232 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063000164,"AMEDUITE, LEONNA, SYLVITRICE",101 HEART DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1063018109,"SCHROEDER, CARRIE, ELLEN",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 42 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1063018109,"SCHROEDER, CARRIE, ELLEN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1063018109,"SCHROEDER, CARRIE, ELLEN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063019420,"PIERSING, KARL, AUGUST",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1063019420,"PIERSING, KARL, AUGUST",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063019628,"HOUCK, ANDREW, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063019628,"HOUCK, ANDREW, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063019628,"HOUCK, ANDREW, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063022143,"FOUTY, LAUREN, ASHLEY",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 59 , 59 ," $17,461.32 ",,
MEDICAID DIRECT,1477692606,COUNTY OF ONSLOW,ONSLOW COUNTY HEALTH DEPARTMENT,612 COLLEGE ST   JACKSONVILLE NC,067,Onslow,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063024677,"JOHNSON, PAULA, LEANN",612 COLLEGE ST   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 131 , 155 , 556 ," $25,434.96 ",,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1063025179,"BELOTE, HOLLY, MARIE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1063025179,"BELOTE, HOLLY, MARIE",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,1032 COLLEGE ST   OXFORD NC,039,Granville,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063025237,"SATTERWHITE, PEYTON, ROBERSON",1032 COLLEGE ST   OXFORD NC,039,Granville,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 32 , 60 ,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063025237,"SATTERWHITE, PEYTON, ROBERSON",115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 26 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063026003,"DILULLO, LAUREN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063027373,"CALLAWAY, KAREN, ELAINE",817 VOLVO PKWY   CHESAPEAKE VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1629843933,OPTUM BEHAVIORAL CARE OF NORTH CARO,CAROLINA BEHAVIORAL CARE CENTERS,1101 MARCO DR STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1063032209,"BORTO, NATALIE, SUE",8512 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063032639,"BUMANN, COLIN, ROBERT",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063032639,"BUMANN, COLIN, ROBERT",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063032654,"CLEMENS, ELISE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063032654,"CLEMENS, ELISE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063032654,"CLEMENS, ELISE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063032654,"CLEMENS, ELISE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 32 , 33 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063035772,"KOVACH, ELIZABETH",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063035814,"PATEL, PRIYA, JITENDRA",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063035814,"PATEL, PRIYA, JITENDRA",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063035814,"PATEL, PRIYA, JITENDRA",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063035814,"PATEL, PRIYA, JITENDRA",1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063040129,"FLORES, ANDREA",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 35 , 52 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063040129,"FLORES, ANDREA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 31 , 85 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1063040129,"FLORES, ANDREA",1800 E FRANKLIN ST STE 11A CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063040467,"WANG, WEILUN",330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1063041358,"PROFFITT, LOGAN, DARYL",1220 SPRUCE ST   BELMONT NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 32 , 53 ,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,159 E DALLAS RD   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1063041358,"PROFFITT, LOGAN, DARYL",159 E DALLAS RD   STANLEY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 33 , 56 ,$#,,
MEDICAID DIRECT,1730416801,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063042174,"MORRISON, HAYDEN, BYRD",4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 40 , 58 ,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063044063,"SHORT, SUSANNAH, KELLY",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063044063,"SHORT, SUSANNAH, KELLY",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 44 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1063044568,"LANCSEK, LORI, ANN",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1063046001,"KEHAYA, JULIAN, WILLIAMS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063046001,"KEHAYA, JULIAN, WILLIAMS",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063046001,"KEHAYA, JULIAN, WILLIAMS",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063046001,"KEHAYA, JULIAN, WILLIAMS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 68 , 79 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063046001,"KEHAYA, JULIAN, WILLIAMS",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1063046001,"KEHAYA, JULIAN, WILLIAMS",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063046001,"KEHAYA, JULIAN, WILLIAMS",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063047322,"HECTOR, MICHAEL, COLLINS",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1063047322,"HECTOR, MICHAEL, COLLINS",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1063047322,"HECTOR, MICHAEL, COLLINS",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1063047322,"HECTOR, MICHAEL, COLLINS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063048965,"JOHNSTON, TYLER, ROBERT",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063048965,"JOHNSTON, TYLER, ROBERT",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063049716,"LOFTIS, ASHLEY, DAWN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1063049716,"LOFTIS, ASHLEY, DAWN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063049732,"ATTAR, TAYLOR, AMIEL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1427048172,ASHE MEMORIAL HOSPITAL INC,AMH MOUNTAIN FAMILY CARE CENTER,310 HOSPITAL AVENUE   JEFFERSON NC,005,Ashe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1063049963,"BUNDY, AMANDA, DANCY",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295193340,ASHE FINANCIAL SERVICES LLC,ASHE FINANCIAL SERVICES LLC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1063049963,"BUNDY, AMANDA, DANCY",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 157 , 196 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1063049989,"FERNANDEZ, AMANDA, MICHELE",98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 66 , 109 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1063049989,"FERNANDEZ, AMANDA, MICHELE",98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 31 , 46 ,$#,,
MEDICAID DIRECT,1063050524,GA HC REIT II DURHAM ALF TRS SUB LL,THE ADDISON OF DURHAM,4713 GARRETT RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063050524,GA HC REIT II DURHAM ALF TRS SUB LL,4713 GARRETT RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 381 , 381 ," $24,253.37 ",,
MEDICAID DIRECT,1063051670,EUPHONY SPEECH AND OROFACIAL MYOLOG,,7206 AUSTIN SMILES CT STE 101 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1063051670,EUPHONY SPEECH AND OROFACIAL MYOLOG,7206 AUSTIN SMILES CT STE 101 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1063051670,EUPHONY SPEECH AND OROFACIAL MYOLOG,,129 SWAMP ROSE DR   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1063051670,EUPHONY SPEECH AND OROFACIAL MYOLOG,129 SWAMP ROSE DR   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1063051670,EUPHONY SPEECH AND OROFACIAL MYOLOG,,16501 NORTHCROSS DR STE D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063051670,EUPHONY SPEECH AND OROFACIAL MYOLOG,16501 NORTHCROSS DR STE D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063052132,"CROCKER, ELIZABETH, MENZEL",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063052132,"CROCKER, ELIZABETH, MENZEL",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063052132,"CROCKER, ELIZABETH, MENZEL",4415 SCHOOL HOUSE CMNS   HARRISBURG NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,601 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1063052132,"CROCKER, ELIZABETH, MENZEL",601 ATTAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235682022,PLEASURE ISLAND HEALTH PLLC,,1328 LAKE PARK BLVD N STE 102 CAROLINA BEACH NC,065,New Hanover,193400000X,Group,Single Specialty,,1063052561,"CRAWFORD IV, DONALD, RUSSEL",1328 LAKE PARK BLVD N STE 102 CAROLINA BCH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063053155,"AVENT, STEPHANIE, RENEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063054278,"VON HOLTEN, NICHOLAS, RAY",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1063054278,"VON HOLTEN, NICHOLAS, RAY",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1063054278,"VON HOLTEN, NICHOLAS, RAY",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063054278,"VON HOLTEN, NICHOLAS, RAY",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063054278,"VON HOLTEN, NICHOLAS, RAY",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063054278,"VON HOLTEN, NICHOLAS, RAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063054278,"VON HOLTEN, NICHOLAS, RAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 32 ,$#,,
MEDICAID DIRECT,1063056067,BEATITUDES HOME CARE LLC,,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1063056067,BEATITUDES HOME CARE LLC,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 3,368 "," 3,368 "," $209,875.44 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063056877,"KILLETTE, CHRISTINA, VICKSTROM",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063057925,"WOOLARD, BROOKE, ELIZABETH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063057925,"WOOLARD, BROOKE, ELIZABETH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063058972,"BAXLEY, MARDEE, LYNN",11016 RED SPRINGS RD   RED SPRINGS NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063058972,"BAXLEY, MARDEE, LYNN",2560 LEGION RD   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 52 , 54 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063058972,"BAXLEY, MARDEE, LYNN",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 37 , 66 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063058972,"BAXLEY, MARDEE, LYNN",1000 E 4TH AVE   RED SPRINGS NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063058972,"BAXLEY, MARDEE, LYNN",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063058972,"BAXLEY, MARDEE, LYNN",1327 HARRY WEST LN   PEMBROKE NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 32 , 32 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1063063766,"TREXLER, MICHELLE, MARIE",921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 113 , 246 , 464 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1063063766,"TREXLER, MICHELLE, MARIE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 61 , 100 ,$#,,
MEDICAID DIRECT,1063064319,"DOWNEY, KRISTEN, LEIGH",SPEECH WAVES PLLC,2002 EASTWOOD RD STE 106A WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1063064319,"DOWNEY, KRISTEN, LEIGH",2002 EASTWOOD RD STE 106A WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063065605,"MANDEVILLE, COURTNEY, LYNNE",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1063065605,"MANDEVILLE, COURTNEY, LYNNE",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063065605,"MANDEVILLE, COURTNEY, LYNNE",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063065605,"MANDEVILLE, COURTNEY, LYNNE",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063065605,"MANDEVILLE, COURTNEY, LYNNE",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1063065605,"MANDEVILLE, COURTNEY, LYNNE",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063068302,NASHVILLE OPCO LLC,GARDENS OF NASHVILLE,1022 EASTERN AVE   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063068302,NASHVILLE OPCO LLC,1022 EASTERN AVE   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 47 ," 10,777 "," 10,780 "," $783,109.96 ",,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063068781,"WOODARD, AUTUMN, SHERE",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 151 , 151 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063072130,"STOVALL, DANIELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063072130,"STOVALL, DANIELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 145 , 150 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063072130,"STOVALL, DANIELLE",250 HOPKINS RD   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770191421,AMY ANN KINLAW DMD PLLC,TAYLORSVILLE PEDIATRIC DENTISTRY,167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",556 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,1223G0001X,Dental Providers,Dentist,General Practice, 728 ," 1,056 "," 4,451 "," $160,434.73 ",,
MEDICAID DIRECT,1366917056,SCOTT SMITH DMD PA,~,556 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",556 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,1223G0001X,Dental Providers,Dentist,General Practice, 182 , 257 , 915 ," $47,726.12 ",,
MEDICAID DIRECT,1811412562,SNOW & SNOW DDS PLLC,~,5306 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",5306 SOUTH BLVD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 373 ," $35,272.57 ",,
MEDICAID DIRECT,1841626835,R COREY SNOW DMD AND JASON K SNOW,KIDZ DENTAL CENTRAL,2620 CENTRAL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",2620 CENTRAL AVE   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 189 ," $19,100.01 ",,
MEDICAID DIRECT,1770191421,AMY ANN KINLAW DMD PLLC,TAYLORSVILLE PEDIATRIC DENTISTRY,167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 30 , 129 ,$#,,
MEDICAID DIRECT,1518557354,KINLAW PLLC,MOUNT AIRY PEDIATRIC DENTISTRY,202 RAWLEY AVE STE 100 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 275 , 288 ," 1,230 "," $42,852.50 ",,
MEDICAID DIRECT,1104530658,MCLAREN DDS MINT HILL PLLC,SMILE BUILDERS PEDIATRIC DENTISTRY,7215 LEBANON RD STE G MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 30 , 229 ," $15,557.46 ",,
MEDICAID DIRECT,1730841289,SCOTT MCLAREN DDS PLLC,BRIGHT PEDIATRIC DENTISTRY,134 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 107 , 117 , 617 ," $29,940.52 ",,
MEDICAID DIRECT,1114571981,DENNIS GARTH STODDARD DDS PLLC,EASTFIELD PEDIATRIC DENTISTRY & ORTHODONTICS,8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 512 , 624 ," 3,026 "," $125,607.93 ",,
MEDICAID DIRECT,1104530658,MCLAREN DDS MINT HILL PLLC,SMILE BUILDERS PEDIATRIC DENTISTRY,7215 LEBANON RD STE G MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063075414,"LILLENBERG, CHRISTOPHER, MAYES VON",7215 LEBANON RD STE G MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063075497,"PEARCE, JESSE, ARTHUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063075935,"HASHEMI, AMIR, REZA",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,971 GOLD HILL RD   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063075935,"HASHEMI, AMIR, REZA",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063075935,"HASHEMI, AMIR, REZA",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063075935,"HASHEMI, AMIR, REZA",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063075935,"HASHEMI, AMIR, REZA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063075935,"HASHEMI, AMIR, REZA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063075935,"HASHEMI, AMIR, REZA",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063076032,"RITTENHOUSE, KATELYN, JOY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063076552,"PRITCHARD, LESLEY, ANNE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063076552,"PRITCHARD, LESLEY, ANNE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 32 , 32 ,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1063077469,"PERSON, CECILIA, RUZENA ROLDAN",730 NEWMAN RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1063077469,"PERSON, CECILIA, RUZENA ROLDAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1063077469,"PERSON, CECILIA, RUZENA ROLDAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1114351095,MCPC-16 LLC,FIRSTHEALTH PRIMARY CARE AND CARDIOLOGY,6322 FAYETTEVILLE RD OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1063083566,"WENDENBURG, AMANDA, BROOKE",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 118 , 178 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063084119,"JACKSON, JORDAN, LEIGH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063084119,"JACKSON, JORDAN, LEIGH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063085751,"KARAM, STEPHANIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063087419,"CROSIO, STEFANO",150 E DAVIE ST   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063088326,"GASTON, SATAVIA, SIMONE",6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1063088326,"GASTON, SATAVIA, SIMONE",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063088326,"GASTON, SATAVIA, SIMONE",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 22 , 30 , 53 ,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063088862,"STEVENS, JAMIE, ELIZABETH",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063089753,"UNG, RANDALL, LEE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063089753,"UNG, RANDALL, LEE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063089753,"UNG, RANDALL, LEE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 40 , 49 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063089753,"UNG, RANDALL, LEE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063089753,"UNG, RANDALL, LEE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063092310,STAR CARE NETWORK - CYPRESS MANOR L,CYPRESS MANOR,503 W BUNCOMBE ST   ROPER NC,094,Washington,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063092310,STAR CARE NETWORK - CYPRESS MANOR L,503 W BUNCOMBE ST   ROPER NC,094,Washington,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 24 ," 4,803 "," 4,803 "," $420,299.20 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063092823,"MULVIHILL, CAITLIN, MARIE",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 38 , 48 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063106052,"BROWN, ALESSANDRA, HARDIGAN",216 MOORE RD   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 62 , 85 , 113 ,$#,,
MEDICAID DIRECT,1285165266,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER ROCKINGHAM,125 BILTMORE DR STE 1 ROCKINGHAM NC,077,Richmond,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063106284,"CARPENTER, TAMMY, LANNETTE MYRICK",125 BILTMORE DR STE 1 ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063106284,"CARPENTER, TAMMY, LANNETTE MYRICK",106 JEFFERSON ST   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063106284,"CARPENTER, TAMMY, LANNETTE MYRICK",125 BILTMORE DR STE 1 ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1023549094,GOSHEN MEDICAL CENTER INCORPORATED,~,106 JEFFERSON ST   HAMLET NC,077,Richmond,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063106284,"CARPENTER, TAMMY, LANNETTE MYRICK",125 BILTMORE DR STE 1 ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063110419,"CORNATZER, ANNA",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063110419,"CORNATZER, ANNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063110419,"CORNATZER, ANNA",2525 COURT DRIVE   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063110419,"CORNATZER, ANNA",2525 COURT DRIVE   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063110419,"CORNATZER, ANNA",2525 COURT DRIVE   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063110419,"CORNATZER, ANNA",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 TECHNOLOGY DR STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063115772,"HOLDER, AUSTIN, MARK",100 TECHNOLOGY DR STE A ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1063118115,"CANTERBURY, SHANNON, LOGEL",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063120152,"COOPER, VICTORIA, LASHEA",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063120152,"COOPER, VICTORIA, LASHEA",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 26 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063121960,"CLUNE, STEPHANIE, DIANA",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063121960,"CLUNE, STEPHANIE, DIANA",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063124873,"SMITH, MEGAN, ALAINE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063126571,"ISBELL, ANNETTE, PATRICE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063129500,"BARBER, KAYLA, MILES",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063129500,"BARBER, KAYLA, MILES",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063129500,"BARBER, KAYLA, MILES",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063129500,"BARBER, KAYLA, MILES",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063129500,"BARBER, KAYLA, MILES",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063129500,"BARBER, KAYLA, MILES",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063131662,"OLESKEY, SABRINA, RENEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063131662,"OLESKEY, SABRINA, RENEE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 16 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063131910,"EHRISMAN, JESSIE, ANACELIA",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548740038,INDYCARE MEDICAL NORTH CAROLINA,~,1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063131910,"EHRISMAN, JESSIE, ANACELIA",1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1063133874,"KELLEY-MONTES, MYKAYLA, GRACE",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063136638,HOME CARE DELIVERED INC,,6000 FAIRVIEW RD STE 1273 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063136638,HOME CARE DELIVERED INC,6000 FAIRVIEW RD STE 1273 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,462 "," 4,577 "," 8,989 "," $592,877.43 ",,
MEDICAID DIRECT,1063136885,ST JUDE HOME HEALTHCARE SERVICES,,3900 MERTON DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1063136885,ST JUDE HOME HEALTHCARE SERVICES,3900 MERTON DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,400 "," 1,400 "," $81,198.54 ",,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1063143188,"OKOYE, MAKUACHUKWU, SOMTO",3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,028 "," 2,347 "," 8,326 "," $269,539.86 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063143188,"OKOYE, MAKUACHUKWU, SOMTO",2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,145 "," 1,349 "," 4,858 "," $168,822.68 ",,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063143188,"OKOYE, MAKUACHUKWU, SOMTO",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,721 "," 3,179 "," 11,361 "," $362,987.79 ",,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063143626,"DENISON, CRYSTAL, REIN",760 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 73 , 116 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063143626,"DENISON, CRYSTAL, REIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063144418,"MCLEAN, MICHAEL, JOHN",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 45 , 91 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063148336,"LEE, CHRISTINA, HOPE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063151371,"DETWEILER, OLIVIA, WULF",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 46 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063151371,"DETWEILER, OLIVIA, WULF",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1659828291,RESERVE HEALTH PC,,135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063154292,"CONDIANO, THOMAS, FRANK",135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 34 ,$#,,
MEDICAID DIRECT,1063160687,SCOG HOME MEDICAL SUPPLY,,9635 SOUTHERN PINE BLVD STE 110 CHARLOTTE NC,060,Mecklenburg,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1063160687,SCOG HOME MEDICAL SUPPLY,9635 SOUTHERN PINE BLVD STE 110 CHARLOTTE NC,060,Mecklenburg,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#, 18 , 25 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063161628,"TEETER, KATHERINE, ELIZABETH JEANNE",105 NEWSOM ST SUITE 101 DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063167138,"BURLEYSON, LORA, LOSEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063167138,"BURLEYSON, LORA, LOSEY",128 E PLAZA DR STE 3 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427128651,COUNTY OF ROWAN,ROWAN COUNTY HEALTH DEPT,1811 E INNES ST   SALISBURY NC,080,Rowan,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063167138,"BURLEYSON, LORA, LOSEY",1811 E INNES ST   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063170504,SKYS INFUSION AND HEALTHCARE SERV,SKYS HEALTHCARE SERVICES,2444 CEDAR ROCK DR   WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1063170504,SKYS INFUSION AND HEALTHCARE SERV,2444 CEDAR ROCK DR   WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 510 , 519 ," $82,184.94 ",,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1063171270,"LOCKLEAR, MARY, KATHRYN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 21 ,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1063171270,"LOCKLEAR, MARY, KATHRYN",730 NEWMAN RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1063171270,"LOCKLEAR, MARY, KATHRYN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063171775,GUIDING ONE PERSONAL CARE SERVICES,,102 E GRANVILLE ST   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,1063171775,GUIDING ONE PERSONAL CARE SERVICES,102 E GRANVILLE ST   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,#," 2,146 "," 2,291 "," $305,938.72 ",,
MEDICAID DIRECT,1386928083,KYLE J ROTH III DDS PA,CAROLINA DENTAL OF GOLDSBORO,2720 GRAVES DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1063173581,"WU, CHIEN-YU, KEVIN",2720 GRAVES DR   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice," 1,264 "," 2,330 "," 8,447 "," $356,259.26 ",,
MEDICAID DIRECT,1174197297,ROTH & POWELL IV DDS PA,CAROLINA DENTAL ARTS DURHAM,415 DUNSTAN AVE   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1063173581,"WU, CHIEN-YU, KEVIN",2720 GRAVES DR   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 55 , 255 ," $16,584.05 ",,
MEDICAID DIRECT,1407350465,ROTH & POWELL III DDS PA,~,3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063173581,"WU, CHIEN-YU, KEVIN",2720 GRAVES DR   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 278 , 342 ," 1,448 "," $58,759.30 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063177459,"COLLIGAN-DUNNE, VICTORIA, RENAY",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063178622,"BUMGARDNER, KELLY, DAWKINS",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063178622,"BUMGARDNER, KELLY, DAWKINS",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063185759,"REYES, SEAN, DEVIN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063185759,"REYES, SEAN, DEVIN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063185759,"REYES, SEAN, DEVIN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 28 , 30 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1063185759,"REYES, SEAN, DEVIN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 62 , 71 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063185759,"REYES, SEAN, DEVIN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063187870,"KANAN, MARYNA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1063187870,"KANAN, MARYNA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 59 , 59 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063189215,"MANN, NATALYA, VICTOROVNA",510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 15 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063189215,"MANN, NATALYA, VICTOROVNA",510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1063189678,CCJ ADULT CARE LLC,ST MARKS ROAD CARE HOME,1230 SAINT MARKS CHURCH RD   CROUSE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063189678,CCJ ADULT CARE LLC,1230 SAINT MARKS CHURCH RD   CROUSE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 492 , 495 ," $30,375.13 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063195493,"LACEY, TAYLOR, JUSTINA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063195493,"LACEY, TAYLOR, JUSTINA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093706111,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - SOUTHEAST RALEIGH DENTA,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063195964,"ARYAL, JYOTI",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,156 "," 1,694 "," 5,483 "," $197,516.30 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063197408,"MADERIA, AMANDA, CATHERINE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 35 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063197408,"MADERIA, AMANDA, CATHERINE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710307327,STEPHANIE MYLES PC,MYLES FAMILY DENTISTRY,404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063198992,"VEXLER, MAYA, DANIELLE",404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 11 ,#, 20 ,$#,,
MEDICAID DIRECT,1063199206,BRIDGING THE GAP HOME HEALTH CARE,BRIDGING THE GAP HOME HEALTH CARE,906 E ELM ST STE B GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1063199206,BRIDGING THE GAP HOME HEALTH CARE,906 E ELM ST STE B GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#, 585 , 585 ," $37,060.77 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1063199727,"AHMED, HAMZA",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1063199727,"AHMED, HAMZA",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 1,967 "," 2,117 "," 11,926 "," $305,111.31 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1063199727,"AHMED, HAMZA",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 3,023 "," 3,497 "," 19,408 "," $484,382.27 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063199727,"AHMED, HAMZA",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1902452139,BRADLEY ROBERTS & ASSOCIATES PLLC,,1135 N CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1063199727,"AHMED, HAMZA",1135 N CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 572 , 599 ," 3,352 "," $91,172.67 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063220358,"SAWYER, ANDREW, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063242568,PROVIDENCE PLACE LLC,WESTCHESTER HARBOUR AT PROVIDENCE PLACE,630 WHITTIER AVE   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063242568,PROVIDENCE PLACE LLC,630 WHITTIER AVE   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 18 ," 3,183 "," 3,184 "," $271,709.12 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063250462,"CAVANAUGH, SUSAN, JACQUELYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063250462,"CAVANAUGH, SUSAN, JACQUELYN",102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063250462,"CAVANAUGH, SUSAN, JACQUELYN",102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063255099,"LICARI, BRIANNA, NICOLE",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063255479,SILVA SPEECH SERVICES PLLC,,412 TRAMWAY WEST RD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1063255479,SILVA SPEECH SERVICES PLLC,412 TRAMWAY WEST RD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,#, 177 , 177 ," $12,791.42 ",,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063263234,"FLYNN, HANNAH, RAE",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063266435,"TINSLEY, BRITTANY, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 12 , 22 , 39 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1102 B US 601   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1063267268,"CATOE, SHAWNA, NICOLE",1085 NE GATEWAY CT NE STE 100 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 13 , 38 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063269439,"BRYANT, KHIANNA, NICHOLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063269439,"BRYANT, KHIANNA, NICHOLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 118 , 118 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063271468,"MULLINS, CARLEEN, ELEANOR",2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063273274,"MILLEN, MONIKA, NICOLE",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1063273274,"MILLEN, MONIKA, NICOLE",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063273274,"MILLEN, MONIKA, NICOLE",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 11 , 27 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14221 BOREN ST   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063273274,"MILLEN, MONIKA, NICOLE",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063273274,"MILLEN, MONIKA, NICOLE",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 30 , 73 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063273274,"MILLEN, MONIKA, NICOLE",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063274942,"GIEL, CAROLINE, LOUISE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063275683,"TRIBOU, LAUREN, KENDALL",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063275683,"TRIBOU, LAUREN, KENDALL",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225690290,WEE CARE PEDIATRICS OF SANFORD PLLC,~,207 GORDON ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1063275691,"FOSTER, LISA, MARIE",207 GORDON ST   SANFORD NC,053,Lee,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,3030 RANDOLPH RD STE 105   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063275782,"MCGEE, CAMERON, TAYLOR",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1063282010,"BROWN, KELLIE, LEIGH",113 A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1427176866,COUNTY OF PAMLICO,PAMLICO COUNTY HEALTH DEPT,203 NORTH ST   BAYBORO NC,069,Pamlico,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063290906,"DECKARD, NANCIE, DENISE",203 NORTH ST   BAYBORO NC,069,Pamlico,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063294445,"VINSON, MACQUINTON",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063294445,"VINSON, MACQUINTON",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 30 , 48 , 48 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063295293,"CLARK, ASHLEY, HUDGINS",309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 88 , 143 , 183 ,$#,,
MEDICAID DIRECT,1063298255,TRUE ANGELS IN-HOME HEALTHCARE LLC,,10801 JOHNSTON RD STE 210A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1063298255,TRUE ANGELS IN-HOME HEALTHCARE LLC,10801 JOHNSTON RD STE 210A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1053305011,PATHOLOGY ASSOCIATES OF KINSTON PA,~,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1063400596,"SEGLETES, LORI, ANN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 65 , 67 , 102 ,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1063400679,"MCCARTHY, KEVIN, FRANCIS",8174 NORMANDY RD   DENVER NC,055,Lincoln,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063400679,"MCCARTHY, KEVIN, FRANCIS",8174 NORMANDY RD   DENVER NC,055,Lincoln,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1063400844,"SHEPHERD, JAMES, HARRISON",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 70 , 114 ,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1063400844,"SHEPHERD, JAMES, HARRISON",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063402998,"LUCAS, SHANTAE, LADON",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1063402998,"LUCAS, SHANTAE, LADON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063402998,"LUCAS, SHANTAE, LADON",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 44 , 58 , 146 ," $21,693.86 ",,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063402998,"LUCAS, SHANTAE, LADON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1063402998,"LUCAS, SHANTAE, LADON",11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1063402998,"LUCAS, SHANTAE, LADON",45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 26 , 51 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063403327,"PAPIER, KENNETH, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063404283,"KINCAID, SHIVA, JARRAHI",1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063404283,"KINCAID, SHIVA, JARRAHI",1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447726989,GESTALT PAIN CONSULTANTS,,10450 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063405306,"AKANDE, ADEWUNMI, ABIODUN",10450 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 49 , 253 , 375 ,$#,,
MEDICAID DIRECT,1447726989,GESTALT PAIN CONSULTANTS,,10450 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063405306,"AKANDE, ADEWUNMI, ABIODUN",10450 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,,,$#,,
MEDICAID DIRECT,1447726989,GESTALT PAIN CONSULTANTS,,,,Unknown,193200000X,Group,Multi-Specialty,,1063405306,"AKANDE, ADEWUNMI, ABIODUN",10035 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063405793,"BARISONI-THOMAS, LAURA, MARIACHIARA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063405793,"BARISONI-THOMAS, LAURA, MARIACHIARA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1447604376,EASTWAY MEDICAL CLINIC AND URGENT C,~,1220 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063407625,"OKOYE, JOSEPH, CHISO",1220 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 167 , 376 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063408235,"BEARSS, DAVID, JONATHAN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063408235,"BEARSS, DAVID, JONATHAN",825 W HENDERSON ST   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 88 , 213 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063408235,"BEARSS, DAVID, JONATHAN",1035 LINCOLNTON RD STE E SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 150 , 300 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063408300,"EDWARDS, BRYAN, TODD",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063408607,"MOORE JR, ELWOOD, DANIEL",2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 120 , 128 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063410264,"PINO, JOSEPH, ANTHONY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063410264,"PINO, JOSEPH, ANTHONY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063410264,"PINO, JOSEPH, ANTHONY",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 18 , 26 ,$#,,
MEDICAID DIRECT,1184022253,LAWRENCE D SINGER MD & ASSOCIATES P,,63 OFFICE PARK DR   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1063410454,"SINGER, LAWRENCE, DAVID",63 OFFICE PARK DR   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 31 , 44 , 58 ,$#,,
MEDICAID DIRECT,1184022253,LAWRENCE D SINGER MD & ASSOCIATES P,,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1063410454,"SINGER, LAWRENCE, DAVID",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1184022253,LAWRENCE D SINGER MD & ASSOCIATES P,,63 OFFICE PARK DR   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1063410454,"SINGER, LAWRENCE, DAVID",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 48 , 77 , 93 ," $12,830.46 ",,
MEDICAID DIRECT,1184022253,LAWRENCE D SINGER MD & ASSOCIATES P,,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1063410454,"SINGER, LAWRENCE, DAVID",63 OFFICE PARK DR   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1063410868,"CHANIN, MATTHEW, PENN",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 35 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063412377,"NG, PETER, CONRAD",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 69 , 69 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063412377,"NG, PETER, CONRAD",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063412377,"NG, PETER, CONRAD",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063412377,"NG, PETER, CONRAD",11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063413243,"MARR, ALBERT, WOODALL",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 46 , 65 , 96 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063413243,"MARR, ALBERT, WOODALL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063413243,"MARR, ALBERT, WOODALL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063413243,"MARR, ALBERT, WOODALL",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063413508,"NAIDU, ASWANI, SUBBARAM",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 45 , 64 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,224 FAYETTEVILLE ST STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063413508,"NAIDU, ASWANI, SUBBARAM",224 FAYETTEVILLE ST STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 24 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063413508,"NAIDU, ASWANI, SUBBARAM",224 FAYETTEVILLE ST STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063413508,"NAIDU, ASWANI, SUBBARAM",4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 20 , 31 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1063416329,"SKLADAN, LEE ANN, BRADLEY",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 94 , 148 , 358 ," $15,431.43 ",,
MEDICAID DIRECT,1063416998,WILMINGTON SURGERY CENTER LP,~,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1063416998,WILMINGTON SURGERY CENTER LP,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 170 , 221 , 287 ," $32,128.99 ",,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063417707,"SAMAN, SHAKER, GEORGE",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063417707,"SAMAN, SHAKER, GEORGE",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063417707,"SAMAN, SHAKER, GEORGE",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063417806,"CONKLING, PAUL, ROBERT",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063417806,"CONKLING, PAUL, ROBERT",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063417806,"CONKLING, PAUL, ROBERT",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063418101,"OCONNOR, KEVIN, MICHAEL",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 34 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063418101,"OCONNOR, KEVIN, MICHAEL",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063422244,APRIA HEALTHCARE LLC,,4859 CUMBERLAND RD   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1063422244,APRIA HEALTHCARE LLC,4859 CUMBERLAND RD   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1063422244,APRIA HEALTHCARE LLC,,4859 CUMBERLAND RD   FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1063422244,APRIA HEALTHCARE LLC,4859 CUMBERLAND RD   FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 519 ," 3,275 "," 6,678 "," $98,862.10 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063423341,"BISHOP, ANDREW, HAYWARD",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 84 , 117 , 201 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063423341,"BISHOP, ANDREW, HAYWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063423341,"BISHOP, ANDREW, HAYWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1063424034,"YELTON, LATRICIA, NELON",LATRICIA NELON YELTON DBA THERAPYLAND PLLC,303 SPINDALE PLAZA DR   SPINDALE NC,081,Rutherford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1063424034,"YELTON, LATRICIA, NELON",303 SPINDALE PLAZA DR   SPINDALE NC,081,Rutherford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 42 , 400 , 500 ," $44,892.81 ",,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063429132,"EMBREY, JEFFREY, ROSS",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 46 , 42 , 64 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063429132,"EMBREY, JEFFREY, ROSS",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063429132,"EMBREY, JEFFREY, ROSS",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063430460,"HOUCK III, WILLIAM, STOKES",2711 RANDOLPH RD STE 301 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 75 , 119 , 134 ," $14,333.78 ",,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063430460,"HOUCK III, WILLIAM, STOKES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003966185,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC GASTROENTEROLOGY,2711 RANDOLPH RD STE 301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063430460,"HOUCK III, WILLIAM, STOKES",2711 RANDOLPH RD STE 301 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063431633,"CHRISTMAN, VIRGINIA, REECE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063431633,"CHRISTMAN, VIRGINIA, REECE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 54 , 55 ,$#,,
MEDICAID DIRECT,1962728923,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063431997,"DUNIGAN, ASHLEY, PAIGE WILSON",4525 CAMERON VALLEY PKWY STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1962728923,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063431997,"DUNIGAN, ASHLEY, PAIGE WILSON",200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922140169,DIABETES & ENDOCRINOLOGY,~,623 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1063432318,"CHANG, KU-LANG",623 N 35TH ST   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 43 , 136 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063433803,"FRUNZA, ANA, ANTOANETA",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 95 , 184 , 254 ,$#,,
MEDICAID DIRECT,1063434330,THOMASVILLE CITY SCHOOLS,,400 TURNER ST   THOMASVILLE NC,029,Davidson,251300000X,Agencies,Local Education Agency (LEA),,1063434330,THOMASVILLE CITY SCHOOLS,400 TURNER ST   THOMASVILLE NC,029,Davidson,251300000X,Agencies,Local Education Agency (LEA),, 111 , 921 , 934 ," $50,143.28 ",,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063437168,"MARKS, HOWARD, FISHER",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063437168,"MARKS, HOWARD, FISHER",1912 TRADD CT   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063437168,"MARKS, HOWARD, FISHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063437317,"COLUCCIELLO, STEPHEN, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 53 , 75 ,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063437580,"FOWLER, AMY, MARIE",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063437580,"FOWLER, AMY, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063437580,"FOWLER, AMY, MARIE",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1366598807,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1063437580,"FOWLER, AMY, MARIE",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063437580,"FOWLER, AMY, MARIE",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063437580,"FOWLER, AMY, MARIE",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1063438877,"THOMAS, LAURA, OLIVER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063438877,"THOMAS, LAURA, OLIVER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1063438877,"THOMAS, LAURA, OLIVER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063438877,"THOMAS, LAURA, OLIVER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1063438877,"THOMAS, LAURA, OLIVER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063438877,"THOMAS, LAURA, OLIVER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063439206,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1179,60 AIRPORT RD   ARDEN NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1063439206,WAL-MART STORES EAST LP,60 AIRPORT RD   ARDEN NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063439982,"BADREDDINE, RAMI, JAMIL",4515 PREMIER DR STE 405 HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063439982,"BADREDDINE, RAMI, JAMIL",601 N ELM ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 38 , 42 , 62 ,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063439982,"BADREDDINE, RAMI, JAMIL",1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 51 , 53 , 53 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063440055,"OVERBEY, WARREN, MCLEOD",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 18 , 23 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 20 , 45 , 61 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 21 , 33 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063440634,"LESHER, JOHN, MICHAEL",170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063441202,"GLIGOROVIC, PREDRAG, VUKMAN",601 N ELM ST   HIGH POINT NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063441202,"GLIGOROVIC, PREDRAG, VUKMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063441574,"SUMMERFIELD, DAVID, LEE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063441574,"SUMMERFIELD, DAVID, LEE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 87 , 135 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1063442648,"LONG, JOHN, JACOB",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063443331,"JOHNSON, CHELSEA, DAWN",1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063444198,"KEITH, DOUGLAS, CHARLES",130 N. JUDD PKWY NE   FUQUAY-VARINA NC,092,Wake,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063444198,"KEITH, DOUGLAS, CHARLES",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063444198,"KEITH, DOUGLAS, CHARLES",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063444198,"KEITH, DOUGLAS, CHARLES",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1063444198,"KEITH, DOUGLAS, CHARLES",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 12 , 119 , 119 ," $46,908.21 ",,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063444198,"KEITH, DOUGLAS, CHARLES",1403 S KING ST   WINDSOR NC,008,Bertie,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 17 , 18 , 19 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1063444198,"KEITH, DOUGLAS, CHARLES",1403 S KING ST   WINDSOR NC,008,Bertie,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063444198,"KEITH, DOUGLAS, CHARLES",1403 S KING ST   WINDSOR NC,008,Bertie,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063445377,"READING, FUMIKO, CATRINA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 134 , 145 , 235 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063445724,"SUSI, BETH, ELISA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063445724,"SUSI, BETH, ELISA",2810 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063445724,"SUSI, BETH, ELISA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1063445724,"SUSI, BETH, ELISA",101 E W T HARRIS BLVD BLDG 1000 SUITE 1214 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063445724,"SUSI, BETH, ELISA",101 E W T HARRIS BLVD BLDG 1000 SUITE 1214 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063445724,"SUSI, BETH, ELISA",101 E W T HARRIS BLVD BLDG 1000 SUITE 1214 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063445724,"SUSI, BETH, ELISA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063446672,"ECKERT, MATTHEW, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 79 , 147 , 166 ," $14,840.02 ",,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063447886,"WALTERS, MARNIE, MYERS",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063447886,"WALTERS, MARNIE, MYERS",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063448231,"ADEDIRAN, ABAYOMI, SEGUN",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1063448231,"ADEDIRAN, ABAYOMI, SEGUN",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063451078,"TEDLA, KEDIST",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063451078,"TEDLA, KEDIST",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063451078,"TEDLA, KEDIST",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 114 , 114 ,$#,,
MEDICAID DIRECT,1063452753,BLADENBORO RESCUE SQUAD,BLADENBORO EMS INC,12896 HWY 242 S   BLADENBORO NC,009,Bladen,3416L0300X,Transportation Services,Ambulance,Land Transport,1063452753,BLADENBORO RESCUE SQUAD,12896 HWY 242 S   BLADENBORO NC,009,Bladen,3416L0300X,Transportation Services,Ambulance,Land Transport, 65 , 83 , 150 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063454049,"SHUGOLL, RICHARD, ALAN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 34 , 41 , 78 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063454049,"SHUGOLL, RICHARD, ALAN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 16 , 16 , 41 ,$#,,
MEDICAID DIRECT,1235526229,INTRACOASTAL EYE PHYSICIANS PLLC,JOHNSON LASER EYE,8115 MARKET ST STE 312 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063455020,"JOHNSON, GREGORY, JAMES",8115 MARKET ST STE 312 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 17 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063455749,"BUDENZ, DONALD, LYLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1063455749,"BUDENZ, DONALD, LYLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063455749,"BUDENZ, DONALD, LYLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1063455749,"BUDENZ, DONALD, LYLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1063455749,"BUDENZ, DONALD, LYLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1063455749,"BUDENZ, DONALD, LYLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 20 , 26 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1063456069,"MARTIN, DAVID, FARRA",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,,,Unknown,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1063456069,"MARTIN, DAVID, FARRA",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063456069,"MARTIN, DAVID, FARRA",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 26 , 27 , 38 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063456069,"MARTIN, DAVID, FARRA",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 34 , 60 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063456069,"MARTIN, DAVID, FARRA",205 PAGE RD   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 49 , 68 , 101 ,$#,,
MEDICAID DIRECT,1285966200,CAROLINA ANESTHESIA AND PAIN CARE P,CAROLINA ANESTHESIA AND PAIN CARE PLLC,2961 CROUSE LN STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063457208,"KHAN, FAROOQUE, SULTAN AHMED",2961 CROUSE LN STE D BURLINGTON NC,001,Alamance,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 50 , 316 , 326 ,$#,,
MEDICAID DIRECT,1306397575,RDMG ASSOCIATES PA,,1908 MEETING CT   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063457844,"GEORGIEV, BOYAN",1908 MEETING CT   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 44 ,$#,,
MEDICAID DIRECT,1134565872,DAVID J MOCK MD PA,~,93 FAMILY CHURCH RD STE A MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1063458032,"MOCK, DAVID, JOHN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1063458032,"MOCK, DAVID, JOHN",93 FAMILY CHURCH RD STE A MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134565872,DAVID J MOCK MD PA,~,93 FAMILY CHURCH RD STE A MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1063458032,"MOCK, DAVID, JOHN",93 FAMILY CHURCH RD STE A MURPHY NC,020,Cherokee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063458842,"HODGKISS, OLIVER, JAY",8108B MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 26 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063458941,"GAINES, CATHERINE, LYN",3001 N ELM ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 37 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1063458941,"GAINES, CATHERINE, LYN",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 120 , 158 , 158 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063459352,"HODGES, KATHRYN, RENA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1063459352,"HODGES, KATHRYN, RENA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063459352,"HODGES, KATHRYN, RENA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063459352,"HODGES, KATHRYN, RENA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1063459352,"HODGES, KATHRYN, RENA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063459352,"HODGES, KATHRYN, RENA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063459352,"HODGES, KATHRYN, RENA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063459907,CLAY COUNTY,CLAY COUNTY EMS,41 COURTHOUSE DR   HAYESVILLE NC,022,Clay,3416L0300X,Transportation Services,Ambulance,Land Transport,1063459907,CLAY COUNTY,41 COURTHOUSE DR   HAYESVILLE NC,022,Clay,3416L0300X,Transportation Services,Ambulance,Land Transport, 51 , 86 , 172 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063460228,"MASIUS, WILLIAM, GLENN",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 38 , 73 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063460228,"MASIUS, WILLIAM, GLENN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063460228,"MASIUS, WILLIAM, GLENN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063460228,"MASIUS, WILLIAM, GLENN",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063462729,"OSSEY, KEVIN, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063463024,"HAGLER, BRIAN, NEAL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 71 , 141 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063463024,"HAGLER, BRIAN, NEAL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 47 , 85 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063463024,"HAGLER, BRIAN, NEAL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063463024,"HAGLER, BRIAN, NEAL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063463024,"HAGLER, BRIAN, NEAL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063463388,"PATEL, CHAITALI, SHARADBHAI",1120 SE CARY PKWY STE 101 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063463388,"PATEL, CHAITALI, SHARADBHAI",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063463982,"BROWN, TERRILL, FRANCES",145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063463982,"BROWN, TERRILL, FRANCES",145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 12 , 82 , 110 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063463982,"BROWN, TERRILL, FRANCES",145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 31 , 41 , 53 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063463982,"BROWN, TERRILL, FRANCES",145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 147 , 343 , 425 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063463982,"BROWN, TERRILL, FRANCES",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 23 , 58 , 76 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1063465128,"PARIS, CLAIRE, DE MARCELLUS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1063465128,"PARIS, CLAIRE, DE MARCELLUS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1063465128,"PARIS, CLAIRE, DE MARCELLUS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063465128,"PARIS, CLAIRE, DE MARCELLUS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 38 , 38 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063465128,"PARIS, CLAIRE, DE MARCELLUS",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740225929,DUKE UNIVERSITY AFFILIATED PHYSICIA,,2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063465227,"SESSIONS, FADRIENNE, HUDSON",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 42 , 108 ,$#,,
MEDICAID DIRECT,1790881076,WEITZEL AND ASSOCIATES PA,2020 VISION CENTER,116 REGENCY BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063465300,"WEITZEL, EILEEN, MARGARET",116 REGENCY BLVD   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 23 , 59 ,$#,,
MEDICAID DIRECT,1790881076,WEITZEL AND ASSOCIATES PA,2020 VISION CENTER,1212 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1063465300,"WEITZEL, EILEEN, MARGARET",1212 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1790881076,WEITZEL AND ASSOCIATES PA,2020 VISION CENTER,116 REGENCY BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063465300,"WEITZEL, EILEEN, MARGARET",1212 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1063465300,"WEITZEL, EILEEN, MARGARET",EILEEN MARGARET WEITZEL,1212 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,1063465300,"WEITZEL, EILEEN, MARGARET",1212 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063465532,"WARNDAHL, DEBRA, ANN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1063465920,"TODORA, MICHAEL, ANTHONY",3691 ENCANTO DR   FORT WORTH TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,3600 MINNESOTA DR STE 800 EDINA MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1063465920,"TODORA, MICHAEL, ANTHONY",3691 ENCANTO DR   FORT WORTH TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063467132,"CLIFTON, BOBBY, GLENN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 33 , 40 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063467769,"COX, PAMELA, GAYE",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063467769,"COX, PAMELA, GAYE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063467769,"COX, PAMELA, GAYE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063467769,"COX, PAMELA, GAYE",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063467769,"COX, PAMELA, GAYE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1063468601,"BRANTLEY, CYNTHIA, ROPER",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1063468601,"BRANTLEY, CYNTHIA, ROPER",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1063468601,"BRANTLEY, CYNTHIA, ROPER",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063468601,"BRANTLEY, CYNTHIA, ROPER",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1245745587,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PRIMARY CARE - ERWIN,518 E H ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063468809,"RAO, LAKSHMAN",604 LUCAS RD   DUNN NC,043,Harnett,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1245745587,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PRIMARY CARE - ERWIN,518 E H ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063468809,"RAO, LAKSHMAN",711 SUSAN TART RD   DUNN NC,043,Harnett,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 27 , 54 , 54 ,$#,,
MEDICAID DIRECT,1245745587,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PRIMARY CARE - ERWIN,518 E H ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063468809,"RAO, LAKSHMAN",518 E H ST   ERWIN NC,043,Harnett,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 86 , 265 , 388 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",41 BAIN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,6310 BEACH DR SW   OCEAN ISLE BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",5156 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 25 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",8116 NC 711   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1063468999,"ANTHONY, ALEXIS, RAE",529 S VAN BUREN RD   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1063469856,"KUZMA, CHARLES, SAMUEL",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1063469856,"KUZMA, CHARLES, SAMUEL",135 PAGE RD N   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 47 , 86 , 108 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,1212 CENTRAL DR STE 201 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1063469856,"KUZMA, CHARLES, SAMUEL",1212 CENTRAL DR STE 201 SANFORD NC,053,Lee,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083236137,INTEGRITY WELLNESS CENTER PLLC,,2116 N CEDAR ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1063469864,"OKEEFE, SHAWN, MICHAEL",340 SIGNAL HILL DR STE A STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841697,TWENTY-ONE MEDICAL PLLC,,11940 CAROLINA PLACE PKWY STE 100 PINEVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063469864,"OKEEFE, SHAWN, MICHAEL",11940 CAROLINA PLACE PKWY STE 100 PINEVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1063471167,"SCOTT, VICKY, MARIE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1063471167,"SCOTT, VICKY, MARIE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063471654,"SATTERWHITE III, WILLIAM, MADISON",9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1265711956,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MCALISTER PEDIATRI,447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1063471654,"SATTERWHITE III, WILLIAM, MADISON",447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063472462,"ZALDIVAR, MARIE, LUISE",127 E MARKET ST   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,127 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063472462,"ZALDIVAR, MARIE, LUISE",127 E MARKET ST   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 65 , 119 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063472686,"JONES, PAULA, YVONNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063472686,"JONES, PAULA, YVONNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 67 , 69 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063473049,"MOORE, ROBERT, BRIAN",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 74 , 103 , 179 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1063473049,"MOORE, ROBERT, BRIAN",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 19 , 37 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063474047,"BLEIER, SETH, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 19 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063474047,"BLEIER, SETH, JASON",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063474047,"BLEIER, SETH, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 49 , 65 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063474047,"BLEIER, SETH, JASON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063474047,"BLEIER, SETH, JASON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1063474047,"BLEIER, SETH, JASON",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063474047,"BLEIER, SETH, JASON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1063474047,"BLEIER, SETH, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1063474047,"BLEIER, SETH, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1063474419,"KELLY, PATRICK, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 41 , 92 , 106 ,$#,,
MEDICAID DIRECT,1750718243,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE NORTHEA,1090 NE GATEWAY CT NE STE 201 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1063474419,"KELLY, PATRICK, THOMAS",1090 NE GATEWAY CT NE STE 201 CONCORD NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 73 , 97 , 179 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063474526,"HOPKINS, MICHAEL, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 53 , 113 , 113 ,$#,,
MEDICAID DIRECT,1699372243,URGENT CARE OF WALLACE PLLC,,112 MEDICAL VILLAGE DR STE G WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1063474559,"AUTRY, JEFFREY, WAYNE",112 MEDICAL VILLAGE DR STE G WALLACE NC,031,Duplin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 68 , 167 ,$#,,
MEDICAID DIRECT,1841259025,WALLACE URGENT CARE,~,112 MEDICAL VILLAGE DR STE G   WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1063474559,"AUTRY, JEFFREY, WAYNE",112 MEDICAL VILLAGE DR STE G WALLACE NC,031,Duplin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 13 , 34 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063474971,"BAXLEY, MARY, JOHN",403 PARKWAY ST STE B GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,403 PARKWAY ST STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063474971,"BAXLEY, MARY, JOHN",403 PARKWAY ST STE B GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475200,"SPENCER, SARA, CARTER",3833 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475200,"SPENCER, SARA, CARTER",6161 LAKE BRANDT RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 30 , 67 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475226,"DOWNEY, WILLIAM, EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 15 , 15 , 34 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475226,"DOWNEY, WILLIAM, EDWARD",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475226,"DOWNEY, WILLIAM, EDWARD",1237 HARDING PL STE 1300 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475226,"DOWNEY, WILLIAM, EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475226,"DOWNEY, WILLIAM, EDWARD",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063475226,"DOWNEY, WILLIAM, EDWARD",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 28 , 39 , 51 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1063475226,"DOWNEY, WILLIAM, EDWARD",111 W GROVER ST   SHELBY NC,023,Cleveland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063475705,"RAY, MICHAEL, RICHARD",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1417190646,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS -WEIGHTLOSSSERVICES,100 E WOOD ST STE 202 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1063476588,"ROSS, JOSEPH, PAUL",100 E WOOD ST STE 202 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1063476992,"LANGFORD, JOSEPH, SCOTT",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063476992,"LANGFORD, JOSEPH, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1063477107,"MAHAR, COLLEEN, PATRICIA",2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 145 , 202 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063478634,"BOINAPALLY, ARAVIND, RAO",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 170 , 178 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063479004,"MCCABE, BEVERLY, DAWN",2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 155 , 252 , 651 ," $16,939.13 ",,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1063479004,"MCCABE, BEVERLY, DAWN",2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063479327,"OBRIEN, DAVID, REESE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 70 , 106 , 178 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063480028,"HUGHES, BETH, JEANETTE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063481240,"LINETT, MICHAEL, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1063481240,"LINETT, MICHAEL, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063481240,"LINETT, MICHAEL, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 24 , 31 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1063481240,"LINETT, MICHAEL, LEE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 49 , 62 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063481240,"LINETT, MICHAEL, LEE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 37 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063481240,"LINETT, MICHAEL, LEE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1063481240,"LINETT, MICHAEL, LEE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063481497,"DOYLE, ROSE, KORDICH",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063481497,"DOYLE, ROSE, KORDICH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063481554,"MCGAUVRAN, RITA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063481851,"CANONIZADO, CARMENCITA, MOJARES",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1063482719,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063482719,HOME MEDICAL SYSTEMS INC,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 212 , 672 ," 1,130 "," $19,797.08 ",,
MEDICAID DIRECT,1063482719,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1063482719,HOME MEDICAL SYSTEMS INC,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1063482719,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1063482719,HOME MEDICAL SYSTEMS INC,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 233 , 970 ," 1,610 "," $29,002.52 ",,
MEDICAID DIRECT,1063482719,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1063482719,HOME MEDICAL SYSTEMS INC,224 ROLLING HILL RD STE 6A MOORESVILLE NC,049,Iredell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063482883,"TUCKER, ANTHONY, ARTAMUS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063482883,"TUCKER, ANTHONY, ARTAMUS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1063482883,"TUCKER, ANTHONY, ARTAMUS",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1821059650,POLYCLINIC MEDICAL CENTER INC,POLYCLINIC MEDICAL CENTER INC,9705 NORTHEAST PKWY STE 400 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063483113,"GARUBA, ABDUL, KARIM",9705 NORTHEAST PKWY STE 400 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 197 , 295 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1063487130,"LISTROM, CHAD, DAVID",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063487130,"LISTROM, CHAD, DAVID",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063487130,"LISTROM, CHAD, DAVID",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 48 , 74 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1063487130,"LISTROM, CHAD, DAVID",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 22 , 27 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063487130,"LISTROM, CHAD, DAVID",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063487130,"LISTROM, CHAD, DAVID",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1063487130,"LISTROM, CHAD, DAVID",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 31 , 37 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,276 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 153 , 207 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 79 , 363 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 34 , 44 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063488104,"JOSHI, RAJ, KUMAR",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063488914,"KATZ, MARK, ANDREW",214 18TH ST SE   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 37 , 68 , 102 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063489748,"MCLAMB, MICHAEL, ANDREW",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063489748,"MCLAMB, MICHAEL, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063489748,"MCLAMB, MICHAEL, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063489748,"MCLAMB, MICHAEL, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",375 SUNSET AVE   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 26 , 32 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 36 , 43 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 86 , 95 , 111 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1126 N CHURCH ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1063490076,"GREEN, JAMES, JUDD",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 59 , 75 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 131 , 137 , 154 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 28 , 36 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1063490076,"GREEN, JAMES, JUDD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 41 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063490076,"GREEN, JAMES, JUDD",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 33 ,$#,,
MEDICAID DIRECT,1063492726,ADVANCED HOME CARE INC,ADVANCED HOME CARE INC,,,Unknown,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1063492726,ADVANCED HOME CARE INC,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1063492726,ADVANCED HOME CARE INC,ADVANCED HOME CARE INC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063492726,ADVANCED HOME CARE INC,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1114110509,COASTAL ORTHOPAEDICS SPINAL SURGE,COASTAL ORTHOPAEDICS SPINAL SURGERY PA,612B MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1063493708,"BATTERSBY, BRIAN, JOHN",612B MCCARTHY BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 51 , 116 ,$#,,
MEDICAID DIRECT,1114110509,COASTAL ORTHOPAEDICS SPINAL SURGE,COASTAL ORTHOPAEDICS SPINAL SURGERY PA,612B MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1063493708,"BATTERSBY, BRIAN, JOHN",612B MCCARTHY BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063493880,"MOORE, RYAN, THOMAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,,,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063493880,"MOORE, RYAN, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063493880,"MOORE, RYAN, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255334181,BELMONT MEDICAL ASSOCIATES,BELMONT MEDICAL ASSOCIATESPLLC,1818 RICHARDSON DR STE A REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1063494151,"GOLDING, JOHN, CABOT",1818 RICHARDSON DR STE A REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 138 , 330 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063494417,"KIGER, LISA, ANN",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 18 , 23 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063494763,"SCHULTZ, JEFFREY",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 99 , 106 , 142 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063494763,"SCHULTZ, JEFFREY",2311 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,640 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063495117,"VANDERMEER, CHRISTOPHER, JOHANNUS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063495117,"VANDERMEER, CHRISTOPHER, JOHANNUS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 151 , 157 , 203 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063495117,"VANDERMEER, CHRISTOPHER, JOHANNUS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063495117,"VANDERMEER, CHRISTOPHER, JOHANNUS",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 107 , 123 , 146 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063496461,"SPANGLER, JOHN, GIVEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 109 , 132 ,$#,,
MEDICAID DIRECT,1063497451,LABORATORY CORPORATION OF AMERICA H,~,69 1ST AVE   RARITAN NJ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1063497451,LABORATORY CORPORATION OF AMERICA H,69 1ST AVE   RARITAN NJ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063497881,"DANGELO, ROBERT",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063497881,"DANGELO, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063497923,"ROSS, GREGORY, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 60 , 80 ," $14,804.09 ",,
MEDICAID DIRECT,1710021811,ABC PEDIATRICS OF ASHEVILLE PA,ABC PEDIATRICS OF ASHEVILLE PA,64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063498137,"DEPHOUSE, DEREK, HOLT",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 43 , 113 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2130 FOREST HILLS RD W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 16 , 17 , 29 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 150 , 173 , 297 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 127 , 217 , 280 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 41 , 48 , 61 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 44 , 43 , 100 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 424 , 647 ," 1,090 "," $23,940.34 ",,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 11 ,#, 22 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 194 , 284 , 519 ," $10,492.49 ",,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 92 , 114 , 225 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2130 FOREST HILLS RD W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 21 , 23 , 38 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063498301,"KINARD, STEPHEN, AGUSTUS",2130 FOREST HILLS RD W STE C WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1508853698,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063498335,"MYERS, JOCELYN, ANNETTE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063498418,"MANCUSO, MARC, ANGELO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 542 , 825 , 986 ," $16,877.47 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063498418,"MANCUSO, MARC, ANGELO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063498822,"PATEL, RIG, SUBHASH",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063498822,"PATEL, RIG, SUBHASH",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063498822,"PATEL, RIG, SUBHASH",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063498822,"PATEL, RIG, SUBHASH",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1063500668,"MORGAN, KIMBERLY, MCGEE",105 MCALPINE LN   LAURINBURG NC,083,Scotland,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 52 , 65 , 84 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1063500783,"INCATASCIATO, RUSSELL, ANTHONY",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1710049515,HOLLY SPRINGS CHIROPRACTIC,,125 HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1063502391,"ADAMSON, RANDALL",125 HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1255805065,CAREPARTNERS HHA LLLP,CAREPARTNERS PRIVATE DUTY SERVICES,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1063502805,"MARTE, VENECIA, MERCEDES",1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700548377,WESTERN NC COMMUNITY HEALTH SVCS,,1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063502805,"MARTE, VENECIA, MERCEDES",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 143 , 143 ,$#,,
MEDICAID DIRECT,1700548377,WESTERN NC COMMUNITY HEALTH SVCS,,1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063502805,"MARTE, VENECIA, MERCEDES",1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063502862,"SWEET, NICHOLAS, NATHAN",27 HONEY BLOSSOM RD   SAINT JOHNS FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063504231,"FOREMAN, TONYA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1063504231,"FOREMAN, TONYA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063505394,"OLSON, CARROLL, BROWD",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1063505394,"OLSON, CARROLL, BROWD",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 33 , 36 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063505394,"OLSON, CARROLL, BROWD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063505394,"OLSON, CARROLL, BROWD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1063505394,"OLSON, CARROLL, BROWD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144326125,NEW HANOVER CHIROPRACTIC CLINIC,~,2470 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063506301,"GENTHER, WILLIAM, CHARLES",2470 DELANEY AVE   WILMINGTON NC,065,New Hanover,111N00000X,Chiropractic Providers,Chiropractor,,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1063506301,"GENTHER, WILLIAM, CHARLES",~,2470 DELANEY AVE   WILMINGTON NC,065,New Hanover,111N00000X,Chiropractic Providers,Chiropractor,,1063506301,"GENTHER, WILLIAM, CHARLES",2470 DELANEY AVE   WILMINGTON NC,065,New Hanover,111N00000X,Chiropractic Providers,Chiropractor,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063507556,"YOUNG, KARLON, JUNHUNG",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 18 , 24 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1063507739,"MAXWELL, KEITH, MELVIN",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",6301 HERNDON RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",6301 HERNDON RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 38 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 40 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063507770,"SPRITZER, CHARLES, EDWARD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063508232,"GHATE, SUJATA, VIJAY",2301 ERWIN RD DEPT OF RADIOLOGY DUKE S DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063508232,"GHATE, SUJATA, VIJAY",20 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063508232,"GHATE, SUJATA, VIJAY",20 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 40 , 40 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063508232,"GHATE, SUJATA, VIJAY",2301 ERWIN RD DEPT OF RADIOLOGY DUKE S DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063508232,"GHATE, SUJATA, VIJAY",2301 ERWIN RD DEPT OF RADIOLOGY DUKE S DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063508232,"GHATE, SUJATA, VIJAY",2301 ERWIN RD DEPT OF RADIOLOGY DUKE S DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063511806,"MATHUR, SAMEER",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063511806,"MATHUR, SAMEER",1110 SE CARY PKWY STE 103 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 24 , 32 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063511806,"MATHUR, SAMEER",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063511806,"MATHUR, SAMEER",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063512093,"PROUSE, DEBORAH, MARISA",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063512093,"PROUSE, DEBORAH, MARISA",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 29 , 55 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063512093,"PROUSE, DEBORAH, MARISA",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063512093,"PROUSE, DEBORAH, MARISA",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 109 , 152 , 308 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063512093,"PROUSE, DEBORAH, MARISA",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 25 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063513190,"ANNOH, EMELIA, ANIMAH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 71 , 71 ,$#,,
MEDICAID DIRECT,1447214242,TRIANGLE PEDIATRIC CENTER,TRIANGLE PEDIATRIC CENTER,105 RIDGE VIEW DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1063514206,"GESSNER, SARAH, YOUNG",105 RIDGE VIEW DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 22 , 35 ,$#,,
MEDICAID DIRECT,1063515542,NORTH CAROLINA CVS PHARMACY LLC,~,240 SPARTA RD   NORTH WILKESBORO NC,097,Wilkes,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1063515542,NORTH CAROLINA CVS PHARMACY LLC,240 SPARTA RD   NORTH WILKESBORO NC,097,Wilkes,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1063515757,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07046,14636 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063515757,NORTH CAROLINA CVS PHARMACY LLC,14636 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1063515757,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07046,14636 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1063515757,NORTH CAROLINA CVS PHARMACY LLC,14636 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1619243300,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY PEDIATRICS,606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063517159,"MEYERS, MARY, CASSEBAUM",606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063517258,"HAUSER, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 55 , 55 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063517449,"RAY, CRYSTAL, ANN",418B W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 11 , 28 ,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1063518660,"WEBSTER, GLENN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063519197,"SINNER, GREGORY, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 30 , 37 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063519197,"SINNER, GREGORY, JAMES",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063519197,"SINNER, GREGORY, JAMES",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063519197,"SINNER, GREGORY, JAMES",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 40 , 114 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063519197,"SINNER, GREGORY, JAMES",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063519197,"SINNER, GREGORY, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 12 , 22 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063519197,"SINNER, GREGORY, JAMES",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063520005,"LEAVERY, MARY, KATHERINE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063520005,"LEAVERY, MARY, KATHERINE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1063520070,EAST CAROLINA GASTRO ENDOSCOPY,~,4 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1063520070,EAST CAROLINA GASTRO ENDOSCOPY,4 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 40 , 60 , 72 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063521623,"TAYLOR, AMANDA, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 14 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063521623,"TAYLOR, AMANDA, TODD",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063521623,"TAYLOR, AMANDA, TODD",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063521623,"TAYLOR, AMANDA, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 77 , 126 , 760 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063521623,"TAYLOR, AMANDA, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063521623,"TAYLOR, AMANDA, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063521623,"TAYLOR, AMANDA, TODD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 153 , 599 ," 1,759 "," $11,121.19 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063521821,"PINEIRO-CARRERO, VICTOR, MANUEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 16 , 26 , 32 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063521821,"PINEIRO-CARRERO, VICTOR, MANUEL",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063521821,"PINEIRO-CARRERO, VICTOR, MANUEL",2550 COURT DR   GASTONIA NC,036,Gaston,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063521821,"PINEIRO-CARRERO, VICTOR, MANUEL",1781 TATE BLVD SE   HICKORY NC,018,Catawba,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 15 , 21 , 22 ,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063522175,"WELCH, DAWN, WEBB",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1023723798,ABUNDANT LIFE PHYSICAL THERAPY LLC,,1531 CINEMA DR STE C STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1063522647,"STEWART, RICHARD, KEITH",1531 CINEMA DR STE C STATESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 21 , 73 ,$#,,
MEDICAID DIRECT,1629123211,COUNTY OF HAYWOOD,~,157 PARAGON PKWY STE 800 CLYDE NC,044,Haywood,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063522787,"RAIFORD, DANIEL, MORGAN",4226 E US 64 ALT   MURPHY NC,020,Cherokee,1223G0001X,Dental Providers,Dentist,General Practice, 389 , 615 ," 1,111 "," $49,827.25 ",,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063522787,"RAIFORD, DANIEL, MORGAN",7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 67 , 112 , 183 ," $11,167.84 ",,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063522787,"RAIFORD, DANIEL, MORGAN",4226 E US 64 ALT   MURPHY NC,020,Cherokee,1223D0001X,Dental Providers,Dentist,Dental Public Health, 138 , 324 , 573 ," $28,634.76 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063523603,"LICHTMAN, STEVEN, NATHAN",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 58 , 68 , 68 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063523603,"LICHTMAN, STEVEN, NATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 25 , 55 , 55 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063526010,"SWAMINATHAN, BALASUBRAMANIAN",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063530137,KANNAPOLIS CITY SCHOOLS,KANNAPOLIS CITY SCHOOLS,100 DENVER ST   KANNAPOLIS NC,013,Cabarrus,251300000X,Agencies,Local Education Agency (LEA),,1063530137,KANNAPOLIS CITY SCHOOLS,100 DENVER ST   KANNAPOLIS NC,013,Cabarrus,251300000X,Agencies,Local Education Agency (LEA),, 276 ," 4,044 "," 4,154 "," $162,889.14 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063531119,"BEAN, ADRIENNE, CHANDLER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 21 , 22 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063531119,"BEAN, ADRIENNE, CHANDLER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063531119,"BEAN, ADRIENNE, CHANDLER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 522 , 647 , 772 ," $13,267.57 ",,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063532455,"RAI, RIPUDEEP",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 130 , 130 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063532455,"RAI, RIPUDEEP",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 38 , 38 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",3605 PETERS CT   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",3610 PETERS CT   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 93 , 182 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 225 , 461 , 930 ," $11,799.25 ",,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 39 , 94 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",3801 W MARKET ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",3604 PETERS CT   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 18 , 32 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 83 , 137 , 262 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",495 ARBOR HILL RD STE M KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063533875,"CAHILL, JOHN, MICHAEL",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1063535482,"JOHNES, TERESA",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1063537660,CRANIAL TECHNOLOGIES INC,~,9300 HARRIS CORNERS PKWY STE 340 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063537660,CRANIAL TECHNOLOGIES INC,9300 HARRIS CORNERS PKWY STE 340 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#," $21,779.52 ",,
MEDICAID DIRECT,1013175132,LELAND PEDIATRICS PC,,509 OLDE WATERFORD WAY STE 203 LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1063538585,"AUSTRIA, MARIA LOURDES, C",509 OLDE WATERFORD WAY STE 203 LELAND NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 52 , 84 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063543163,"WEINRIB, STEPHEN, LOUIS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 17 , 44 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063543163,"WEINRIB, STEPHEN, LOUIS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063548915,"THORP, MARY, BUTLER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063548915,"THORP, MARY, BUTLER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063548915,"THORP, MARY, BUTLER",1010 COLLEGE ST   OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063549517,ORANGE COUNTY,ORANGE COUNTY DSS,113 MAYO ST   HILLSBOROUGH NC,068,Orange,251B00000X,Agencies,Case Management,,1063549517,ORANGE COUNTY,113 MAYO ST   HILLSBOROUGH NC,068,Orange,251B00000X,Agencies,Case Management,, 49 , 510 , 511 ," $190,581.74 ",,
MEDICAID DIRECT,1063550762,LIVING WATERS HOME CARE LLC,LIVING WATERS HOME CARE LLC DBA SERVICES UNLIMITED,623 HENDRIX RD   SPARTA NC,003,Alleghany,253Z00000X,Agencies,In Home Supportive Care,,1063550762,LIVING WATERS HOME CARE LLC,623 HENDRIX RD   SPARTA NC,003,Alleghany,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 4,539 "," 4,546 "," $555,776.64 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063552099,"CAMASTRA, DANIELLE, FLORENCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063552834,"TELFORD, ANNE MARIE, DEFRANCO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1063552834,"TELFORD, ANNE MARIE, DEFRANCO",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063554517,MECKLENBURG COUNTY,MECKLENBURG COUNTY,3205 FREEDOM DR STE 7000 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1063554517,MECKLENBURG COUNTY,3205 FREEDOM DR STE 7000 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 378 ," 4,151 "," 4,151 "," $1,560,252.08 ",,
MEDICAID DIRECT,1063554517,MECKLENBURG COUNTY,MECKLENBURG COUNTY,3205 FREEDOM DR STE 7000 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1063554517,MECKLENBURG COUNTY,3205 FREEDOM DR STE 7000 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 11 , 13 , 13 ," $87,712.66 ",,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1063556496,"KENNEDY, STACY, DENISE",611 MOCKSVILLE AVE ROWAN DIAGNOSTIC CLINIC SALISBURY NC,080,Rowan,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 64 , 179 , 283 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063557775,"PHILLIPS, ALDEN, KEITH",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063559441,"DEVORE, AMY, ELIZABETH",314 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 59 , 98 , 178 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,314 S SOUTH ST STE 400   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1063559441,"DEVORE, AMY, ELIZABETH",314 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063559615,"DAVIS, DAVID, MICHAEL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063559615,"DAVIS, DAVID, MICHAEL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 31 , 32 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063559615,"DAVIS, DAVID, MICHAEL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063559664,"ISHIZAWAR, RUMEY, CHANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063559664,"ISHIZAWAR, RUMEY, CHANG",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 45 , 59 , 95 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063559664,"ISHIZAWAR, RUMEY, CHANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063559664,"ISHIZAWAR, RUMEY, CHANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 18 , 20 , 27 ,$#,,
MEDICAID DIRECT,1063559920,PERQUIMANS COUNTY SCHOOLS,PERQUIMANS COUNTY SCHOOLS,411 EDENTON ROAD ST   HERTFORD NC,072,Perquimans,251300000X,Agencies,Local Education Agency (LEA),,1063559920,PERQUIMANS COUNTY SCHOOLS,411 EDENTON ROAD ST   HERTFORD NC,072,Perquimans,251300000X,Agencies,Local Education Agency (LEA),, 71 ," 1,071 "," 1,106 "," $48,684.47 ",,
MEDICAID DIRECT,1265719512,PIRATE PEDIATRICS PA,~,118 OAKMONT DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063563468,"HENSLEE, MARY, ROSEANN",118 OAKMONT DR   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 49 , 112 , 255 ," $10,431.34 ",,
MEDICAID DIRECT,1871577197,KINSTON PEDIATRIC ASSOCIATES PA,Kinston Pediatric Associates PA,2509 N QUEEN ST   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1063563468,"HENSLEE, MARY, ROSEANN",2509 N QUEEN ST   KINSTON NC,054,Lenoir,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 16 ,$#,,
MEDICAID DIRECT,1063564003,UNITY HOME CARE INC,UNITY HOME CARE INC,2565 RAVENHILL DR STE 2C FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1063564003,UNITY HOME CARE INC,2565 RAVENHILL DR STE 2C FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,094 "," 1,094 "," $67,812.88 ",,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,310 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063567626,"TEETER, KACIE, MILLER",310 DAVIE AVE   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063567626,"TEETER, KACIE, MILLER",310 DAVIE AVE   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 22 , 35 ,$#,,
MEDICAID DIRECT,1063568285,"HINCKS, THOMAS, CLARKE",THOMAS C HINCKS DDS PA,304 HAWKINS AVE   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,1063568285,"HINCKS, THOMAS, CLARKE",304 HAWKINS AVE   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 34 , 66 , 170 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063568541,"BADALYAN, RUPAL, NARESH",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 37 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063568541,"BADALYAN, RUPAL, NARESH",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1063568541,"BADALYAN, RUPAL, NARESH",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1619517976,MOUNTAIN COMMUNITY HEALTH PARTNERSH,MOUNTAIN COMMUNITY HEALTH PARTNERSHIP DENTAL CENTE,89 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,193400000X,Group,Single Specialty,,1063570091,"DUBOIS, DAVID, JOHN",89 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 647 , 942 ," 2,095 "," $97,238.61 ",,
MEDICAID DIRECT,1619517976,MOUNTAIN COMMUNITY HEALTH PARTNERSH,MOUNTAIN COMMUNITY HEALTH PARTNERSHIP DENTAL CENTE,89 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063570091,"DUBOIS, DAVID, JOHN",89 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 664 , 828 ," 1,892 "," $72,268.81 ",,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1063570091,"DUBOIS, DAVID, JOHN",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 178 , 213 , 504 ," $27,301.17 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063570117,"SILBERSTEIN, KRISTINA, ALEXANDRA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063570117,"SILBERSTEIN, KRISTINA, ALEXANDRA",1313 HALLEY ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 26 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063570117,"SILBERSTEIN, KRISTINA, ALEXANDRA",815 BROAD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1063573426,"PATEL, KIRIT",101 HOSPITAL DR   COLUMBUS NC,075,Polk,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1063573897,"GLOVER, LEKECIA, DIANA",~,422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,1063573897,"GLOVER, LEKECIA, DIANA",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1386889434,LEKECIA D MCGEE DDS AND TIARRA R RO,LEKECIA MCGEE AND TIARRA RORIE DDS,422 N CHURCH ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1063573897,"GLOVER, LEKECIA, DIANA",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice," 2,659 "," 4,108 "," 15,975 "," $653,539.46 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1063575249,"GOLDFUSS, HEATHER, LYLES",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1063575249,"GOLDFUSS, HEATHER, LYLES",5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 57 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1063575249,"GOLDFUSS, HEATHER, LYLES",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063575843,"MARTIN, GAVIN",TRENT DR DUKE INTERNATIONAL PHYS DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063575843,"MARTIN, GAVIN",TRENT DR DUKE INTERNATIONAL PHYS DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063575843,"MARTIN, GAVIN",TRENT DR DUKE INTERNATIONAL PHYS DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063579563,"MARIN, MELISSA, MARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1063582658,"ABERNATHY, LEA, ANNE",120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 28 , 51 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1300 2 BRIDGE BARRIER RD   CAROLINA BEACH NC,065,New Hanover,193400000X,Group,Single Specialty,,1063582658,"ABERNATHY, LEA, ANNE",1300 BRIDGE BARRIER RD STE 2 CAROLINA BEACH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063582658,"ABERNATHY, LEA, ANNE",1300 BRIDGE BARRIER RD STE 2 CAROLINA BEACH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063582658,"ABERNATHY, LEA, ANNE",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063582658,"ABERNATHY, LEA, ANNE",1201 PATTON AVE ASHEVILLE ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 24 ,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063582658,"ABERNATHY, LEA, ANNE",187 W MAIN ST   SPINDALE NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063584415,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE ENDOSCOPY CENTER,300 BILLINGSLEY RD # 200B CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1063584415,CAROLINA DIGESTIVE HEALTH ASSOCIATE,300 BILLINGSLEY RD # 200B CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 44 , 41 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063584548,"FELIX, ANA, CRISTINA GONCALVES",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 35 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063584548,"FELIX, ANA, CRISTINA GONCALVES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 20 , 28 ,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063584654,"CHARLES-PIERRE, MONIQUE, HUDSON",201 MCCULLOUGH DR STE 180 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 192 , 272 , 604 ," $36,709.22 ",,
MEDICAID DIRECT,1063587095,"GARG, SHYAM, LAL",SHYAM LAL GARG,14980 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,1063587095,"GARG, SHYAM, LAL",14980 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235286204,HAMPSTEAD MEDICAL CENTER PA,HAMPSTEAD MEDICAL CENTER PC,14980 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1063587095,"GARG, SHYAM, LAL",14980 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 85 , 735 ," 1,053 "," $24,077.18 ",,
MEDICAID DIRECT,1063587095,"GARG, SHYAM, LAL",SHYAM LAL GARG,14980 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1063587095,"GARG, SHYAM, LAL",14980 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1063587095,"GARG, SHYAM, LAL",14980 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063592442,ALLEGHANY COUNTY SCHOOL DISTRICT,~,85 PEACHTREE ST   SPARTA NC,003,Alleghany,251300000X,Agencies,Local Education Agency (LEA),,1063592442,ALLEGHANY COUNTY SCHOOL DISTRICT,85 PEACHTREE ST   SPARTA NC,003,Alleghany,251300000X,Agencies,Local Education Agency (LEA),, 82 ," 1,936 "," 1,978 "," $85,403.87 ",,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063594620,"SANDAGATO, TODD, ANTHONY",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063594620,"SANDAGATO, TODD, ANTHONY",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 41 , 82 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063594745,"COSTELLO ISHAK, MEGHAN, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063594745,"COSTELLO ISHAK, MEGHAN, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063594745,"COSTELLO ISHAK, MEGHAN, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063594745,"COSTELLO ISHAK, MEGHAN, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063595213,"CLOWSE, MEGAN, ELIZABETH BOWLES",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063595213,"CLOWSE, MEGAN, ELIZABETH BOWLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063595437,"KOZAK, BRYAN, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063595437,"KOZAK, BRYAN, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 48 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063595437,"KOZAK, BRYAN, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619099256,FAMILY MEDICAL ASSOCS OF RALEIGH,,3500 BUSH ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063596120,"JO, JENNIFER",3500 BUSH ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596930,"WANG, ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 21 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596930,"WANG, ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596930,"WANG, ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 33 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596930,"WANG, ANDREW",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 18 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596948,"MARCUS, JEFFREY, ROBERT",2400 PRATT ST   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596948,"MARCUS, JEFFREY, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596971,"AMES, WARWICK, AUBREY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596971,"AMES, WARWICK, AUBREY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 40 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596971,"AMES, WARWICK, AUBREY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063596971,"AMES, WARWICK, AUBREY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063597508,"DESANTIS, ANDREA, MARY",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063597508,"DESANTIS, ANDREA, MARY",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 136 , 149 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063598977,"EL SAYED, HOSAM, FAROUK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 19 , 32 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063598977,"EL SAYED, HOSAM, FAROUK",600 GRESHAM DR STE 8620 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063598977,"EL SAYED, HOSAM, FAROUK",397 LITTLE NECK RD STE 120 VIRGINIA BEACH VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1952579807,CEDAR CREEK FAMILY MEDICINE PLLC,~,11492 OLD US HIGHWAY 52   WINSTON SALEM NC,029,Davidson,193400000X,Group,Single Specialty,,1063599587,"NIFONG, TED, JAMES",11492 OLD US HIGHWAY 52   WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 108 , 280 , 660 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 49 , 104 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1063602332,"EVANS, JULIA, SUDJAI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063605285,"ROTHMAN, JENNIFER, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 27 , 67 , 67 ,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063605285,"ROTHMAN, JENNIFER, ANN",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,,,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063605756,"REDDY, VEDIRE, VIJAYSEN",300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063607901,"SHAH, EKTA",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063607901,"SHAH, EKTA",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063607901,"SHAH, EKTA",4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 14 , 25 , 31 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063608388,"INDURU, RAGHAVA, REDDY",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 26 , 65 , 65 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063608388,"INDURU, RAGHAVA, REDDY",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023455987,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,945 N 5TH ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1063608388,"INDURU, RAGHAVA, REDDY",945 N 5TH ST   ALBEMARLE NC,084,Stanly,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 52 , 100 , 100 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063608388,"INDURU, RAGHAVA, REDDY",945 N 5TH ST   ALBEMARLE NC,084,Stanly,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1063609931,"STASKELUNAS, REBECCA, WOODARD",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 22 , 23 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063609931,"STASKELUNAS, REBECCA, WOODARD",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 26 ,$#,,
MEDICAID DIRECT,1447792148,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,401 ATTAIN ST STE 121 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1063612158,"SONSKI, AMY, MARIE",401 ATTAIN ST STE 121 FUQUAY VARINA NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063612786,"MARTIN, BARBARA, ANN",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063614998,"BELL, JEFFREY, KENT",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063615821,"SCRUGGS, JUSTIN, RICHARD",3480 WAKE FOREST RD STE 208 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063615821,"SCRUGGS, JUSTIN, RICHARD",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 31 , 59 , 120 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063616555,"HOOPER, AMANDA, BROOKE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1063616837,"ELLIOTT, WILLIAM, EDWARD",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 146 , 236 , 461 ," $16,620.49 ",,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063617439,"ROPER, STACEY, SCHILLER",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063617439,"ROPER, STACEY, SCHILLER",2615 LAKE DR STE 301 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063617439,"ROPER, STACEY, SCHILLER",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 99 , 112 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063617470,"ABOUASSI, HIBA, NAJIB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063617470,"ABOUASSI, HIBA, NAJIB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 25 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063617470,"ABOUASSI, HIBA, NAJIB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 13 , 26 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,6237 CAROLINA COMMONS DR STE 110 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063617561,"WENDT, MATTHEW, CYRIL",601 S SUTTON RD STE 101 FORT MILL SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063618312,"AHMED, ASAAD, ELSAYED",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 22 , 61 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063618312,"AHMED, ASAAD, ELSAYED",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063618312,"AHMED, ASAAD, ELSAYED",6324 FAIRVIEW RD STE 310 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 141 , 313 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063618700,"MENDOLA, MICHAEL, ROSOLINO",2669 KINARD ST   NEWBERRY SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 23 , 24 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063624286,"HTWE, TIN, HAN",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063624286,"HTWE, TIN, HAN",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063626877,"GARCIA, RYAN, MICHAEL",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 68 , 100 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063626877,"GARCIA, RYAN, MICHAEL",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063626877,"GARCIA, RYAN, MICHAEL",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063626877,"GARCIA, RYAN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#, 21 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",110 KILDAIRE PARK DR   CARY NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",110 KILDAIRE PARK DR   CARY NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 29 , 47 , 114 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",505 OBERLIN RD   RALEIGH NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 41 , 55 , 118 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 24 , 31 , 59 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063629392,"GREER, CHAD, CHRISTOPHER",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 12 , 12 , 32 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063630648,"RICHARDSON, RUTH, EVAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063630648,"RICHARDSON, RUTH, EVAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063630648,"RICHARDSON, RUTH, EVAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1922771799,KELLY FAMILY MEDICINE PA,,2298 US 70 HWY UNIT A SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1063631745,"KELLY, JOHN, JAY",2298 US HIGHWAY 70 UNIT A SWANNANOA NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 48 , 61 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063633576,"BALFOUR, PELBRETON, COLLYMORE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,222 W MAIN ST   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1063636728,"BROWN, DIANE, LYNN",222 W MAIN ST   HAMLET NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 31 , 65 ,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1063636728,"BROWN, DIANE, LYNN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 94 , 142 , 310 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063640720,"BLAJKEVICH, MARINA, YEVGENYEVA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1063641801,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE OUTPATIENT SURGERY,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1063641801,PRESBYTERIAN SAMEDAY SURGERY CENTER,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 105 , 140 , 151 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063642130,"RUBIO, JESSICA, ANNA",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 146 , 161 ," $20,868.89 ",,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063642130,"RUBIO, JESSICA, ANNA",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,363LC1500X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Community Health,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063642353,"RAYMOND, KEVIN, MICHAEL",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063642353,"RAYMOND, KEVIN, MICHAEL",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063643336,"MCKEARNEY, ERICA, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063643336,"MCKEARNEY, ERICA, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063643336,"MCKEARNEY, ERICA, MICHELLE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1063643849,"OXENDINE, LESLIE, KENDRA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 233 , 284 , 526 ," $20,655.58 ",,
MEDICAID DIRECT,1124552310,SCOTLAND MEMORIAL HOSPITAL INC,WOLONICK FAMILY PRACTICE CENTER,106 MCALPINE LN   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1063643849,"OXENDINE, LESLIE, KENDRA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063648400,"ZIMMERMAN JORDAN, AUNDREA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851354260,CAPE FEAR OTOLARYNGOLOGY,CAPE FEAR OTOLARYNGOLOGY,2053 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063650737,"HONEYCUTT, HEATHER, SAULS",2053 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 29 , 31 , 59 ,$#,,
MEDICAID DIRECT,1679916035,LIMBIONICS OF DURHAM INC,~,5007 SOUTHPARK DR STE 110 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1063652014,"STRESING, BRITTANY, LAINE",5007 SOUTHPARK DR STE 110 DURHAM NC,032,Durham,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 74 ,$#,,
MEDICAID DIRECT,1467507640,COUNTY OF WILSON,WILSON COUNTY DEPARTMENT OF PUBLIC HEALTH,1801 GLENDALE DR SW   WILSON NC,098,Wilson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063652675,"WEPPLER, LISA, MARIE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 90 , 200 , 605 ," $20,973.61 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063654259,"ABAJAS, YASMINA, LAURA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 14 , 28 , 33 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1063657823,"GREEN, AMANDA, SUZANNE",111 W GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063658250,MILLCREEK FIRE ASSOCIATION INC,MILL CREEK FIRE & RESCUE DEPT,2370 MILL CREEK RD   NEWPORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1063658250,MILLCREEK FIRE ASSOCIATION INC,2370 MILL CREEK RD   NEWPORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,601 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1063662971,"NUNOO, ROBERT, HUGO OFORI",601 ATTAIN ST   FUQUAY VARINA NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063662971,"NUNOO, ROBERT, HUGO OFORI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063662971,"NUNOO, ROBERT, HUGO OFORI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063662971,"NUNOO, ROBERT, HUGO OFORI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063662971,"NUNOO, ROBERT, HUGO OFORI",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063662971,"NUNOO, ROBERT, HUGO OFORI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063662971,"NUNOO, ROBERT, HUGO OFORI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063664993,"WEN, JOANNE, CHIA HO",3300 EXECUTIVE DR   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063664993,"WEN, JOANNE, CHIA HO",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2000 REGENCY PKWY   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063664993,"WEN, JOANNE, CHIA HO",2000 REGENCY PKWY   CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 20 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063664993,"WEN, JOANNE, CHIA HO",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 15 , 40 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063667608,"KHALID, HAMZA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1821718925,CARENOW PEDIATRICS PLLC,CARENOW PEDIATRICS PLLC,6402 MCCRIMMON PKWY STE 300 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1063667772,"DAVE TRIVEDI, SHILPA, SAMIR",6402 MCCRIMMON PKWY STE 300 MORRISVILLE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 45 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063667889,"GRIMM, BRADFORD, PIERCE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 33 , 33 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063674034,"FINNEGAN, EILEEN, CONNOR",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063677847,"ARDAIOLO, SHANNON, GABRIELA",1196 SKYLAND DR   SYLVA NC,050,Jackson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063677847,"ARDAIOLO, SHANNON, GABRIELA",95 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063677847,"ARDAIOLO, SHANNON, GABRIELA",2311 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 18 , 22 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063677847,"ARDAIOLO, SHANNON, GABRIELA",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1063677847,"ARDAIOLO, SHANNON, GABRIELA",2001 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063677847,"ARDAIOLO, SHANNON, GABRIELA",2001 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 54 , 60 , 79 ,$#,,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063687564,"HUTCHINSON, CHARLES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 120 , 122 , 200 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063687747,"LEWIS, JERONA, ALYSSE",1995 WELLNESS BLVD STE 110&210 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063687747,"LEWIS, JERONA, ALYSSE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063687747,"LEWIS, JERONA, ALYSSE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063687747,"LEWIS, JERONA, ALYSSE",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1063688117,"LIN, STEPHEN, HSIANG HIN",534 CARATOKE HWY   MOYOCK NC,027,Currituck,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063688117,"LIN, STEPHEN, HSIANG HIN",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063688117,"LIN, STEPHEN, HSIANG HIN",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063688117,"LIN, STEPHEN, HSIANG HIN",113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063688646,"DESAUGUSTE, ROLLIN",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063689248,"BREUER, CHRISTOPHER, D",1420 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,2415 SANDY PORTER RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",2415 SANDY PORTER RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",1420 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 48 , 167 , 167 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",1420 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063689248,"BREUER, CHRISTOPHER, D",1420 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",2415 SANDY PORTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 20 , 60 , 61 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063689248,"BREUER, CHRISTOPHER, D",700 HOWIE MINE RD   WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063689826,"GREYSHOCK, NICOLE, GASKINS",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 64 , 85 , 126 ,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063689826,"GREYSHOCK, NICOLE, GASKINS",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063689826,"GREYSHOCK, NICOLE, GASKINS",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063689826,"GREYSHOCK, NICOLE, GASKINS",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 86 , 137 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063691657,"MCGOWAN, KAREN, SORIO",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063691657,"MCGOWAN, KAREN, SORIO",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063691657,"MCGOWAN, KAREN, SORIO",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063692721,"EVANS, ANDREW, BENNETT",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 86 , 107 , 167 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063692721,"EVANS, ANDREW, BENNETT",1219 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1023349404,NOVANT HEALTH MEDICAL GROUP LLC,~,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063692721,"EVANS, ANDREW, BENNETT",1471 JAG BRANCH BLVD UNIT 105 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063692721,"EVANS, ANDREW, BENNETT",1471 JAG BRANCH BLVD UNIT 105 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 82 , 154 , 174 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063692721,"EVANS, ANDREW, BENNETT",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063692721,"EVANS, ANDREW, BENNETT",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063692721,"EVANS, ANDREW, BENNETT",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 19 , 23 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 28 , 42 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 35 , 45 ,$#,,
MEDICAID DIRECT,1457309221,CABARRUS EMERGENCY MEDICINE ASSOCIA,CABARRUS EMERGENCY MEDICINE ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1063693026,"LANGENBRUNNER, ADAM, DAVID",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",600 W TRADE ST STE B DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1223 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548997893,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2101 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4415 SCHOOL HOUSE CMNS   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,168 NORMAN STATION BLVD STE Q MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2728 W MALLARD CREEK CHURCH RD STE 30 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1063693109,"SMITH, ALEXIS, LAVERNE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1063693182,"MALAK, EMAD, FOUAD MASSOUD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 61 , 61 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063693182,"MALAK, EMAD, FOUAD MASSOUD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063694784,"MELISKI, PAMELA, GUTBIER",111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 19 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063694784,"MELISKI, PAMELA, GUTBIER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063694784,"MELISKI, PAMELA, GUTBIER",310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063694784,"MELISKI, PAMELA, GUTBIER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1063694784,"MELISKI, PAMELA, GUTBIER",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063696557,"WHITLOW, CHRISTOPHER, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 17 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063698686,"HADZIKADIC GUSIC, LEJLA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063699437,"NICHOLS, KIMBERLY, SPARROW",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1063699437,"NICHOLS, KIMBERLY, SPARROW",809 N LAFAYETTE ST STE A SHELBY NC,023,Cleveland,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1063699437,"NICHOLS, KIMBERLY, SPARROW",201 W MARION ST   SHELBY NC,023,Cleveland,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063699460,"LEE, PHILIP, CHEUNG",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 89 , 116 , 176 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063699460,"LEE, PHILIP, CHEUNG",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063699460,"LEE, PHILIP, CHEUNG",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 44 , 44 ,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063699460,"LEE, PHILIP, CHEUNG",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063700383,"GERBI, TEKLU, BEKELE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 96 , 350 , 353 ," $18,533.55 ",,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063701019,"HILL, TERENCE, EDWARD",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 36 , 40 , 59 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063701019,"HILL, TERENCE, EDWARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 42 , 52 , 97 ," $10,930.16 ",,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063701019,"HILL, TERENCE, EDWARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063701514,"MARRAZZO, GERARDO, ANTHONY",1899 TATE BLVD SE STE 2110 HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063701514,"MARRAZZO, GERARDO, ANTHONY",1985 TATE BLVD SE STE 755 HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 38 , 52 , 139 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063701514,"MARRAZZO, GERARDO, ANTHONY",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 20 , 26 , 62 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1063702165,"STUP, BRYAN, DWAYNE",114 E RAILROAD ST   LA GRANGE NC,054,Lenoir,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 ,,,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1063702165,"STUP, BRYAN, DWAYNE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 37 , 37 ," $14,844.85 ",,
MEDICAID DIRECT,1063702165,"STUP, BRYAN, DWAYNE",,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1063702165,"STUP, BRYAN, DWAYNE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1063702165,"STUP, BRYAN, DWAYNE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 147 , 226 , 495 ," $25,152.30 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063702306,"PARKER, JESSICA, RANKINS",9929 REA RD STE 101 WAXHAW NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 26 , 40 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063702306,"PARKER, JESSICA, RANKINS",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 14 ,$#,,
MEDICAID DIRECT,1235148529,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS ROCK HILL PEDIATRIC,1656 RIVERCHASE BLVD STE 3400 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1063702744,"ASHFAQ, AHMAD",1656 RIVERCHASE BLVD STE 3400 ROCK HILL SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063704724,"CRUZ, EUCLID, ANGELES",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1063705663,"MASIS, RAMSES, CARLOS",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063705663,"MASIS, RAMSES, CARLOS",1000 HEALING WAY   MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891523122,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH POLK,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1063705663,"MASIS, RAMSES, CARLOS",101 HOSPITAL DR   COLUMBUS NC,075,Polk,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1295132009,ST LUKES PHYSICIAN NETWORK INC,CAROLINAS HOSPITALIST GROUP-ST LUKES,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1063705663,"MASIS, RAMSES, CARLOS",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063706638,"LAVALLEY, AMANDA, DAWN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063706638,"LAVALLEY, AMANDA, DAWN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063707354,"PASULA, SMITHA, REDDY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 263 , 268 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063707354,"PASULA, SMITHA, REDDY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1063707412,"ROY, KATHERINE, CHANDLER BART",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 30 , 61 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063707578,"SOTO, JOSE, RAUL",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063707578,"SOTO, JOSE, RAUL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1063708246,CUNNINGHAM PHYSICAL THERAPY INC,~,219 CROOKED GULLEY CIR   SUNSET BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1063708246,CUNNINGHAM PHYSICAL THERAPY INC,219 CROOKED GULLEY CIR   SUNSET BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,, 45 , 997 , 998 ," $95,918.04 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063708287,"KITCH, BRYAN, BENJAMIN",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 37 , 37 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063708287,"KITCH, BRYAN, BENJAMIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 60 , 64 , 65 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063708378,"JOHNSON, MEGAN, PAYSEUR",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 36 , 49 ,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,214 E ELM ST   GRAHAM NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063708378,"JOHNSON, MEGAN, PAYSEUR",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 77 , 123 ,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,1041 KIRKPATRICK RD STE 250 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063708378,"JOHNSON, MEGAN, PAYSEUR",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 26 , 39 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063713097,"KETTNER, ALISHA, LYNN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063713097,"KETTNER, ALISHA, LYNN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063720993,"SARDA, PAWAN, DAMODHAR",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 21 , 27 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063720993,"SARDA, PAWAN, DAMODHAR",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063720993,"SARDA, PAWAN, DAMODHAR",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 74 , 128 ,$#,,
MEDICAID DIRECT,1750625356,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,1640 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063720993,"SARDA, PAWAN, DAMODHAR",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 26 , 50 , 50 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 41 , 46 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",2304 WESVILL CT   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 17 , 22 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",2304 WESVILL CT   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 20 , 22 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063721223,"BULLINGTON, JOHN, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063722908,AA BETTER CHOICE IN HOME AIDE SERVI,AA BETTER CHOICE IN HOME AIDE SERVICES,1913 J N PEASE PL STE 103 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1063722908,AA BETTER CHOICE IN HOME AIDE SERVI,1913 J N PEASE PL STE 103 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 208 , 265 ," $69,810.54 ",,
MEDICAID DIRECT,1063722908,AA BETTER CHOICE IN HOME AIDE SERVI,AA BETTER CHOICE IN HOME AIDE SERVICES,8305 UNIVERSITY EXEC PARK DR STE 335A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1063722908,AA BETTER CHOICE IN HOME AIDE SERVI,8305 UNIVERSITY EXEC PARK DR STE 335A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 933 , 933 ," $178,425.22 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063722957,"FORBES, CHARLES, STUART",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 82 , 92 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063723625,"SILVER, REBECCA, DEVONNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063723625,"SILVER, REBECCA, DEVONNE",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063723625,"SILVER, REBECCA, DEVONNE",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063723625,"SILVER, REBECCA, DEVONNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063723971,"BENNETT, MATTHEW, THOMAS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 197 , 210 , 247 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063723971,"BENNETT, MATTHEW, THOMAS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 139 , 149 , 178 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1063723971,"BENNETT, MATTHEW, THOMAS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063725067,"OVERDIEK, RONDA, MICHELE",420 NORTH CENTER STREET   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1063725067,"OVERDIEK, RONDA, MICHELE",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1063725067,"OVERDIEK, RONDA, MICHELE",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063725067,"OVERDIEK, RONDA, MICHELE",420 NORTH CENTER STREET   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1063725067,"OVERDIEK, RONDA, MICHELE",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063727212,"COCKERHAM, JESSICA, DANYEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 66 , 68 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",50 HOSPITAL DR STE 3B-2 HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 57 , 72 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 159 , 201 , 250 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063727659,"DEVARAPALLY, SANTHOSH REDDY",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245895697,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OUTPATIENT BEHAVIORAL HEALTH,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063729614,"CHANCEY, LEIGH, PATTERSON",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1063731453,"LOVINGS, TINA, LEA",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 79 , 111 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063732055,"ASSERES, BROOKTIETE",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1063732055,"ASSERES, BROOKTIETE",1010 COLLEGE ST   OXFORD NC,039,Granville,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1063732055,"ASSERES, BROOKTIETE",1135 CARTHAGE ST   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1063732162,"KHAN, SHUJAAT, ALI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 135 , 135 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1255670014,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VASCULAR DIAGNOSTICS,2827 LYNDHURST AVE STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",1710 KERNERSVILLE MEDICAL PKWY STE 210 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 76 , 98 , 117 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",2827 LYNDHURST AVE STE 201 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 76 , 81 , 89 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",2827 LYNDHURST AVE STE 206 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063732634,"RICKEY, ASHLEY, KAISER",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063733053,"ROTH, BENJAMIN, STEELE",,830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1063733053,"ROTH, BENJAMIN, STEELE",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063733053,"ROTH, BENJAMIN, STEELE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1063733053,"ROTH, BENJAMIN, STEELE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,~,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,#, 23 , 27 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063733517,"GREAR, KARRIE, ELIZABETH",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063733517,"GREAR, KARRIE, ELIZABETH",512 VILLAGE RD STE 207 SHALLOTTE NC,010,Brunswick,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063733517,"GREAR, KARRIE, ELIZABETH",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 23 , 44 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063733517,"GREAR, KARRIE, ELIZABETH",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 94 , 164 , 368 ," $20,825.93 ",,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063733517,"GREAR, KARRIE, ELIZABETH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 13 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063733517,"GREAR, KARRIE, ELIZABETH",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1871507699,CUMBERLAND HOSPITAL,,9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1063733962,"MCNEIL-GLASSFORD, JAN, MACHELLE",9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 130 , 130 ,$#,,
MEDICAID DIRECT,1063734564,DESTINY FAMILY CARE HOME,DESTINY FAMILY CARE HOME,5818 POOLE RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063734564,DESTINY FAMILY CARE HOME,5818 POOLE RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 296 , 296 ," $115,405.50 ",,
MEDICAID DIRECT,1063734564,DESTINY FAMILY CARE HOME,DESTINY FAMILY CARE HOME,1486 DR MARTIN LUTHER KING JR BLVD   WARRENTON NC,093,Warren,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063734564,DESTINY FAMILY CARE HOME,1486 DR MARTIN LUTHER KING JR BLVD   WARRENTON NC,093,Warren,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 293 , 293 ," $108,980.10 ",,
MEDICAID DIRECT,1063734564,DESTINY FAMILY CARE HOME,DESTINY FAMILY CARE HOME,3509 ALLENDALE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063734564,DESTINY FAMILY CARE HOME,3509 ALLENDALE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 24 , 24 ," $39,574.40 ",,
MEDICAID DIRECT,1063734564,DESTINY FAMILY CARE HOME,DESTINY FAMILY CARE HOME,1108 SEABROOK RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063734564,DESTINY FAMILY CARE HOME,1108 SEABROOK RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 170 , 170 ," $44,969.31 ",,
MEDICAID DIRECT,1063734564,DESTINY FAMILY CARE HOME,DESTINY FAMILY CARE HOME,1238 FAIRLANE RD   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063734564,DESTINY FAMILY CARE HOME,1108 SEABROOK RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1063734564,DESTINY FAMILY CARE HOME,DESTINY FAMILY CARE HOME,1238 FAIRLANE RD   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063734564,DESTINY FAMILY CARE HOME,1238 FAIRLANE RD   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 411 , 411 ," $120,682.85 ",,
MEDICAID DIRECT,1063734564,DESTINY FAMILY CARE HOME,DESTINY FAMILY CARE HOME,1108 SEABROOK RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063734564,DESTINY FAMILY CARE HOME,1486 DR MARTIN LUTHER KING JR BLVD   WARRENTON NC,093,Warren,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1063735504,"CLARK, MEREDITH, RENAE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1063735504,"CLARK, MEREDITH, RENAE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063735504,"CLARK, MEREDITH, RENAE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 65 , 80 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063737518,"CICCOTTO, SARAH, EMILY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 74 , 99 , 117 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063737518,"CICCOTTO, SARAH, EMILY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 47 , 52 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063737518,"CICCOTTO, SARAH, EMILY",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1063737518,"CICCOTTO, SARAH, EMILY",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063738763,"KLINGER, REBECCA, YASMIN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063738763,"KLINGER, REBECCA, YASMIN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063738763,"KLINGER, REBECCA, YASMIN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063739100,"SANDBULTE, ZACHARY, W",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 48 , 136 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063739100,"SANDBULTE, ZACHARY, W",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 37 , 71 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063739100,"SANDBULTE, ZACHARY, W",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 70 , 205 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063739100,"SANDBULTE, ZACHARY, W",167 MOORE RD STE 202 KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 44 , 122 ,$#,,
MEDICAID DIRECT,1063739274,PREMIER FAMILY EYE CARE,PREMIER FAMILY EYE CARE,6044 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1063739274,PREMIER FAMILY EYE CARE,6044 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,, 54 , 54 , 109 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1063741221,"IDEM, EMEM, JOSIAH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063742328,"MULLAN, PAUL, CHRISTOPHER",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063742401,"BREAREY, CRISTEN, VAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063743912,ANGEL HOUSE FCH LLC,ANGEL HOUSE FAMILY CARE HOMES,60 HORNOT CIR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063743912,ANGEL HOUSE FCH LLC,60 HORNOT CIR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,406 "," 1,406 "," $89,613.18 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063746253,"GERLACH, TERRI",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063746444,"BRANDT, SARAH, NOELLE",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063746444,"BRANDT, SARAH, NOELLE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1063746444,"BRANDT, SARAH, NOELLE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356802300,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - MOCKSVILLE,172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063751451,"KNIGHT-HARRIS, BRANDI, NICOLE",172 SOUTH CLEMENT ST   MOCKSVILLE NC,030,Davie,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health, 14 , 99 , 99 ," $31,206.64 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063754430,"FARRIS, MICHAEL, KEITH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 58 , 164 , 201 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1063754430,"FARRIS, MICHAEL, KEITH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063757144,"JONES-PARKER, KRISTINA, ANNE",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063757144,"JONES-PARKER, KRISTINA, ANNE",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 24 , 38 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063757144,"JONES-PARKER, KRISTINA, ANNE",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 98 , 98 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063757144,"JONES-PARKER, KRISTINA, ANNE",138 DUBLIN SQUARE RD STE B ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 64 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063758175,"SCHWEITZER, SAMANTHA, DELORES",3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063758175,"SCHWEITZER, SAMANTHA, DELORES",3320 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063758175,"SCHWEITZER, SAMANTHA, DELORES",3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063759751,"TURK, RYAN, CHARLES",300 BILLINGSLEY RD STE 200B CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063759751,"TURK, RYAN, CHARLES",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063759751,"TURK, RYAN, CHARLES",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063759751,"TURK, RYAN, CHARLES",9965 POPLAR TENT RD   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1689726101,OCRACOKE HEALTH CENTER INC,OCRACOKE HEALTH CENTER INC,305 BACK RD   OCRACOKE NC,048,Hyde,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063760577,"JERNIGAN, JOLENE, CROUCH",305 BACK RD   OCRACOKE NC,048,Hyde,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063761351,"WANKHEDKAR, KASHMIRA, PRAMOD",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063761351,"WANKHEDKAR, KASHMIRA, PRAMOD",12311 COPPER WAY STE 100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 21 , 34 , 55 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063761351,"WANKHEDKAR, KASHMIRA, PRAMOD",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063764140,"LAXTON, ADRIAN, WALTER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 41 , 72 , 94 ," $10,892.84 ",,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1063764413,"MARLOWE, ASHLEY, BILLUPS",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 113 , 346 , 348 ," $16,761.01 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 136 , 153 , 233 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",101 CLINIC DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063765345,"WYNN, STEPHANIE, MILLS",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063766319,"LEONARD, MEG, ELIZABETH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063766319,"LEONARD, MEG, ELIZABETH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063766319,"LEONARD, MEG, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063766319,"LEONARD, MEG, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1063766319,"LEONARD, MEG, ELIZABETH",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1063766319,"LEONARD, MEG, ELIZABETH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063766848,"LAYENI, OMOLARA, OLAJUMOKE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9628 REA RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063766848,"LAYENI, OMOLARA, OLAJUMOKE",2728 W MALLARD CREEK CHURCH RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13845 CONLAN CIR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063766848,"LAYENI, OMOLARA, OLAJUMOKE",2728 W MALLARD CREEK CHURCH RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063766848,"LAYENI, OMOLARA, OLAJUMOKE",9101 PINEVILLE MATTHEWS RD STE C4 PINEVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063766848,"LAYENI, OMOLARA, OLAJUMOKE",9930 KINCEY AVE STE 130 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1063770758,"MINCEY, ANDREW, JULIAN",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 97 , 168 , 218 ," $11,406.78 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1063770758,"MINCEY, ANDREW, JULIAN",725 HIGHLAND OAKS DR STE 101 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 39 , 44 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063771079,"TRINIDAD, JOSHUA, SYLVANO",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 27 , 47 , 48 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063771079,"TRINIDAD, JOSHUA, SYLVANO",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063771079,"TRINIDAD, JOSHUA, SYLVANO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1063771079,"TRINIDAD, JOSHUA, SYLVANO",276 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 16 , 32 , 33 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063772341,"HULGAN, CHRISTINA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 17 , 60 , 62 ," $20,010.62 ",,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063772374,"KWON, STEPHANIE, PETTUS",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063772374,"KWON, STEPHANIE, PETTUS",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1063774982,CHERRYS FAMILY CARE,~,106 HARMON ST   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063774982,CHERRYS FAMILY CARE,106 HARMON ST   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 60 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063775054,"PITTS, RICHARD, BRIAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063775054,"PITTS, RICHARD, BRIAN",2308 WESVILL CT   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063775591,"BUPPAJARNTHAM, SARANYA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 95 , 356 , 356 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063778058,"HERNANDEZ, HERMES, XAVIER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 110 , 114 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063779759,"DURONVILLE, JOHN, VEDO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 40 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063779759,"DURONVILLE, JOHN, VEDO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 160 , 165 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063779759,"DURONVILLE, JOHN, VEDO",234 CROOKED CREEK PKWY STE 400 DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 15 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063779759,"DURONVILLE, JOHN, VEDO",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 23 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063779759,"DURONVILLE, JOHN, VEDO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1101 N MIAMI BLVD STE 500A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063779759,"DURONVILLE, JOHN, VEDO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1891002374,BLUE RIDGE HEALTHCARE MEDICAL GROUP,LENOIR FAMILY MEDICINE,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1063781144,"GERRALD, LAURA, CAITLIN",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 121 , 201 ,$#,,
MEDICAID DIRECT,1295303139,SCHRYER AND ASSOCIATES,,1611 GREENFIELD ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063783215,"MORGAN, TIFFANY, DANELLE",1611 GREENFIELD ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice," 1,481 "," 2,290 "," 8,367 "," $394,110.09 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063784783,"PHINNEY, TAMMY, VIRGINIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1952534778,MCPC-1 LLC,FIRSTHEALTH RICHMOND MEDICAL GROUP WOMENS CENTER,921 S LONG DR STE 205 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1063785186,"MARKS, LAURA, STUTTS",921 S LONG DR STE 205 ROCKINGHAM NC,077,Richmond,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 36 , 43 , 54 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063785251,"BAPTISTE, BRYANNA, MARIE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063785251,"BAPTISTE, BRYANNA, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063785251,"BAPTISTE, BRYANNA, MARIE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063788248,"BENRASHID, EHSAN",300 MEADOWMONT VILLAGE CIR STE 313 CHAPEL HILL NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063788248,"BENRASHID, EHSAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 82 , 132 , 180 ,$#,,
MEDICAID DIRECT,1063789501,MONROE MANOR ASSISTED LIVING INC,~,1101 BAUCOM RD   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063789501,MONROE MANOR ASSISTED LIVING INC,1101 BAUCOM RD   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063791036,"BILTZ, LISA, TATKO",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063796340,"ALLEN, COLETTE, SWEVIA",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063796340,"ALLEN, COLETTE, SWEVIA",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063798031,ABOUND HEALTH LLC,~,438 OLD WILKESBORO RD   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063798031,ABOUND HEALTH LLC,438 OLD WILKESBORO RD   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 283 , 283 ," $17,669.09 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1063798742,"SHARIATI, RAMIN",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063801173,"WOODARD, JANICE, BRIDGES",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 55 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063801173,"WOODARD, JANICE, BRIDGES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063801793,"LAZECKO, EILEEN, ANNE",2905 CROUSE LN   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063801793,"LAZECKO, EILEEN, ANNE",2905 CROUSE LN   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063801793,"LAZECKO, EILEEN, ANNE",2905 CROUSE LN   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063802148,"FALLAHZADEH ABARGHOUEI, MOHAMMAD KAZEM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 53 , 137 , 138 ,$#,,
MEDICAID DIRECT,1063802593,TEAL PEDIATRIC THERAPY PLLC,,101 E CENTER ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063802593,TEAL PEDIATRIC THERAPY PLLC,101 E CENTER ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063803740,"SULLIVAN, TIYIKA, JANAYE",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063803740,"SULLIVAN, TIYIKA, JANAYE",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 79 , 573 , 573 ," $25,743.01 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063803740,"SULLIVAN, TIYIKA, JANAYE",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1063803740,"SULLIVAN, TIYIKA, JANAYE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063803740,"SULLIVAN, TIYIKA, JANAYE",250 HOPKINS RD   KERNERSVILLE NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063803740,"SULLIVAN, TIYIKA, JANAYE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 55 , 121 , 123 ,$#,,
MEDICAID DIRECT,1780969667,"LOCEY, RACHEL, ANNE",~,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1063805471,"RIDGE, NAUREEN, NAMBALA KAMULLA",100 E SANDERS ST   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376899252,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF MCGEES CROSSROADS,70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063805471,"RIDGE, NAUREEN, NAMBALA KAMULLA",70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376899252,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF MCGEES CROSSROADS,70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063805471,"RIDGE, NAUREEN, NAMBALA KAMULLA",70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 178 , 229 , 892 ," $29,520.59 ",,
MEDICAID DIRECT,1780969667,"LOCEY, RACHEL, ANNE",~,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1063805471,"RIDGE, NAUREEN, NAMBALA KAMULLA",1508 MAPLE GROVE CHURCH RD UNIT 1 DUNN NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1790815611,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL DENTAL OF NEWTON GROVESPIVEYS CORNER,1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063805471,"RIDGE, NAUREEN, NAMBALA KAMULLA",500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1063807253,"HWANG, CHRISTOPHER, JAEYON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1063807253,"HWANG, CHRISTOPHER, JAEYON",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063807253,"HWANG, CHRISTOPHER, JAEYON",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063807253,"HWANG, CHRISTOPHER, JAEYON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 24 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1063807253,"HWANG, CHRISTOPHER, JAEYON",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 29 , 35 , 48 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063808046,"HEATHCOTE, SAMUEL, ALLEN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 64 , 105 , 138 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063808053,"WOOD, ALLISON, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 29 , 31 , 32 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063808053,"WOOD, ALLISON, ELIZABETH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063808988,"NANCE, RYAN, BRITTON",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063808988,"NANCE, RYAN, BRITTON",155 MEMORIAL DR   PINEHURST NC,063,Moore,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 85 , 112 ," $21,431.00 ",,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1063809713,"MOFFAT, DAVID, DOUGLAS",965 STATE FARM RD   BOONE NC,095,Watauga,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063810976,"BECKER, ANNA, GREULICH",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063810976,"BECKER, ANNA, GREULICH",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063810976,"BECKER, ANNA, GREULICH",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063810976,"BECKER, ANNA, GREULICH",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1063814010,"WEBSTER, MEGAN, PRESLEY",4622 JAMES CROSSING DR   JAMESTOWN NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1063815827,"GONZALES, ROBYN, ELIZABETH",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 45 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063822146,"SIMS, MORGAN, JONES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1063822732,"SHAH, DISHA",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 64 , 104 , 166 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 43 , 52 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 30 , 41 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063822765,"SACKMANN, ROBERT, KYLE",,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1063822765,"SACKMANN, ROBERT, KYLE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 33 , 45 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1063822765,"SACKMANN, ROBERT, KYLE",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063823466,"NETTEY, RALPH, AKAI-KOFI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 99 , 99 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063823466,"NETTEY, RALPH, AKAI-KOFI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 60 , 60 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063823714,"ANZOLA, SASKIA, COFFEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 68 , 80 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063824092,"GRADY, MARY, THERESA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 32 , 37 , 37 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063824092,"GRADY, MARY, THERESA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 35 , 36 , 40 ,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063824324,"SCHILLING, ANN, DIDOMENICO",1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063824324,"SCHILLING, ANN, DIDOMENICO",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063824779,"ROGERS, RALPH, DANIEL",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063824894,"TUCKER, JASMINE, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063824894,"TUCKER, JASMINE, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063827582,"ELLSWORTH, JESSE, HOMER",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 52 , 59 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1063827582,"ELLSWORTH, JESSE, HOMER",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063830578,"SENGUPTA, SWETA",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063830578,"SENGUPTA, SWETA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 25 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063830578,"SENGUPTA, SWETA",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 27 , 40 , 46 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063831907,"YUN, ETHAN, SUNGEUN",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 26 , 33 , 44 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063831907,"YUN, ETHAN, SUNGEUN",1219 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 162 , 242 , 370 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063832053,"STRAUBE, TOBIAS, LUZIUS",2301 ERWIN ROAD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063832053,"STRAUBE, TOBIAS, LUZIUS",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 62 , 174 , 176 ," $34,012.57 ",,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 35 , 41 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 30 , 33 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063832459,"SCOTT, JONATHAN, EDWARD",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 ,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063833325,"COURSEY, JENNIFER, KATHERINE GONDA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 12 , 15 ,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063833325,"COURSEY, JENNIFER, KATHERINE GONDA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063833838,"THOMPSON, MATTHEW, OLEN",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063833838,"THOMPSON, MATTHEW, OLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063833838,"THOMPSON, MATTHEW, OLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 466 , 701 , 872 ," $13,629.97 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063833838,"THOMPSON, MATTHEW, OLEN",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063833838,"THOMPSON, MATTHEW, OLEN",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063833838,"THOMPSON, MATTHEW, OLEN",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063834463,"RUSTON, ANDREA, DENISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063834463,"RUSTON, ANDREA, DENISE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063834463,"RUSTON, ANDREA, DENISE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063845444,"MATTHEWS, JACOB, ANDREW",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1063848620,WALGREEN CO,WALGREENS 16253,1630 ANDREWS RD   MURPHY NC,020,Cherokee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1063848620,WALGREEN CO,1630 ANDREWS RD   MURPHY NC,020,Cherokee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063849198,"THOMPSON, MICHELLE, LYNN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063850105,"MCSHANE, CARRIE, ANNE",420 N CENTER ST STE 20 HICKORY NC,018,Catawba,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063850105,"MCSHANE, CARRIE, ANNE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 49 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063851038,"MCCARTT, MATTHEW, MOODY",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063851038,"MCCARTT, MATTHEW, MOODY",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063851160,"BORKAR, DURGA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 29 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063851160,"BORKAR, DURGA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063851160,"BORKAR, DURGA",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 42 , 94 ," $50,263.55 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063851574,"MARCIANO, HEIDI, CHRISTINE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1063852572,"CLARK, CANDICE, PIKE",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1063852572,"CLARK, CANDICE, PIKE",421 N HOLLY AVE STE C SILER CITY NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 196 , 374 ,$#,,
MEDICAID DIRECT,1063853158,OUTER PLANETARY TOUCH,BRIGHTERDAY THERAPLAY,2715 PLANTATION WAY   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1063853158,OUTER PLANETARY TOUCH,2715 PLANTATION WAY   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063854354,"HALLMARK, CHRISTOPHER, ALAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063855583,"ALBERT, MAZIN, THOMAS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 76 , 83 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063855971,"PORTER, LAURA, LEIGH",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063855971,"PORTER, LAURA, LEIGH",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063855971,"PORTER, LAURA, LEIGH",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 22 , 33 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063855971,"PORTER, LAURA, LEIGH",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063856284,"PARYANI, VIJAY, GULABRAI",4101 MACON POND RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 23 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063856284,"PARYANI, VIJAY, GULABRAI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063856284,"PARYANI, VIJAY, GULABRAI",4101 MACON POND RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 25 , 57 , 101 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063856284,"PARYANI, VIJAY, GULABRAI",4101 MACON POND RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1063856318,"SUAREZ, LISBET, DE LA CARIDAD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1063857860,"ANDERSON, NICOLE, HELEN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063857902,"DOVER, KENTON, LANE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063857902,"DOVER, KENTON, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063857902,"DOVER, KENTON, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 69 , 79 ," $10,162.13 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063857902,"DOVER, KENTON, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 32 , 34 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063859361,"WILSON, COREY, STEPHEN",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 17 , 19 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063861631,"RASHA, SHIMIKA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 184 , 184 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063862399,"WILLIAMSON, KAITLIN, FRANKIE HOOVER",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063862399,"WILLIAMSON, KAITLIN, FRANKIE HOOVER",110 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 67 , 155 ,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1063862902,"MARSHALL, MARIA, NICOLE",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1063862902,"MARSHALL, MARIA, NICOLE",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 52 , 118 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1063862902,"MARSHALL, MARIA, NICOLE",2115 S MAIN ST STE A WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 132 , 238 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1063863298,"EPSTEIN, ADRIAN, ARYEH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1063863298,"EPSTEIN, ADRIAN, ARYEH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1437200417,LANE AND ASSOCIATES IV DDS PA,~,315 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1063863496,"SEGAL, SCOTT, WILLIAM",900 S GARNETT ST   HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,295 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063865525,"JAMMEL, BRIAN, NICHOLAS",295 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063865525,"JAMMEL, BRIAN, NICHOLAS",295 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063865525,"JAMMEL, BRIAN, NICHOLAS",295 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063865525,"JAMMEL, BRIAN, NICHOLAS",295 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063865525,"JAMMEL, BRIAN, NICHOLAS",295 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063865632,"WILLIAMS, KIRK, JAMES",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 235 , 235 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063868735,"FARIS, MOHAMED, MEDHAT M",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063868875,"GERTSCH, DUSTIN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 27 , 27 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063868875,"GERTSCH, DUSTIN, MICHAEL",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 28 , 29 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063869469,"HICKS-THIBODEAU, AMBER, NICOLE",798 OAK RIDGE FARM HWY STE A MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 30 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,798 OAK RIDGE FARM HWY STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1063869469,"HICKS-THIBODEAU, AMBER, NICOLE",798 OAK RIDGE FARM HWY STE A MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 26 , 40 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,294 N HIGHWAY 16   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1063869469,"HICKS-THIBODEAU, AMBER, NICOLE",294 N NC 16 BUSINESS HWY SUITE A DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063873479,"ROBERTS, LAUREN, DAWN",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1063873479,"ROBERTS, LAUREN, DAWN",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063873669,"HERFEL, EMILY, SARA",100 DUKE HEALTH CARY PL   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1063873669,"HERFEL, EMILY, SARA",401 IRVING PKWY STE 310 HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063873669,"HERFEL, EMILY, SARA",2608 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063874204,"DANG, ANTHONY, TRUNG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 53 , 53 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063874204,"DANG, ANTHONY, TRUNG",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 103 , 103 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063875409,"JINADU, SAMIAT, MODUPEOLA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063875409,"JINADU, SAMIAT, MODUPEOLA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063875409,"JINADU, SAMIAT, MODUPEOLA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063875748,"RAMCHAL, TALISHA",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063875748,"RAMCHAL, TALISHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063875748,"RAMCHAL, TALISHA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063875771,"CORE, ANDREW, CHRISTIAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013303080,ACCESS TELECARE PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1063875847,"ADAMS, MALAIKA, ROSE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063876035,"VELLALA, SNEHA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 75 , 75 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876472,"KING, BENJAMIN, FRANKLIN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063876472,"KING, BENJAMIN, FRANKLIN",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1063876472,"KING, BENJAMIN, FRANKLIN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876472,"KING, BENJAMIN, FRANKLIN",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 341 , 441 , 556 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 35 , 50 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 49 , 69 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1063876555,"VASKO, IRENE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 42 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 34 , 46 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 58 , 66 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 33 , 41 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 51 , 68 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063876555,"VASKO, IRENE",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1063877967,"IMGRUND-FLORA, ASHLEY",201 WILLIAMSBURG PKWY   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1063877967,"IMGRUND-FLORA, ASHLEY",738 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 28 , 39 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063880185,"RIVIECCIO, LEA, DANIELLE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 66 , 66 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063881274,"AMEH, MARY, HABIBA",1814 WESTCHESTER DR STE 400 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063882512,MOUNT EAGLE HEALTH CARE-CHARLOTTE,,4917 ALBEMARLE RD STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1063882512,MOUNT EAGLE HEALTH CARE-CHARLOTTE,4917 ALBEMARLE RD STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 3,255 "," 3,255 "," $202,991.64 ",,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 22 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063884237,"PAGANO, CELIA, ELIZABETH",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043691595,ROCKY MOUNT EYE PA,~,450 JONES RD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1063884575,"LESNOFF, CALEB",450 JONES RD   ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,, 413 , 491 , 685 ," $20,847.74 ",,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063888386,"MUNIR, NAVED",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 89 , 89 ,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1063891034,"MYERS, LESLIE, HERMAN",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 23 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063891166,"MUMMA, SHANNON, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063891166,"MUMMA, SHANNON, NICOLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 49 , 71 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063891166,"MUMMA, SHANNON, NICOLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 64 , 89 ,$#,,
MEDICAID DIRECT,1063892396,OTOGENETICS CORPORATION,,4553 WINTERS CHAPEL RD STE 100 ATLANTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1063892396,OTOGENETICS CORPORATION,4553 WINTERS CHAPEL RD STE 100 ATLANTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 54 , 52 , 122 ," $57,405.21 ",,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063895332,"PEREZ, ALEX",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063895332,"PEREZ, ALEX",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 70 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063896256,"VIJAYAKANTHI, NANDINI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 34 , 73 , 74 ,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063897429,"CAMPBELL, ALEXIS, JAIXEN",490 HOSPITAL DR   CLYDE NC,044,Haywood,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063897429,"CAMPBELL, ALEXIS, JAIXEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063897429,"CAMPBELL, ALEXIS, JAIXEN",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063899284,"COKER, CAMERON, TYLER WARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063899284,"COKER, CAMERON, TYLER WARD",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063899284,"COKER, CAMERON, TYLER WARD",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063899284,"COKER, CAMERON, TYLER WARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063899284,"COKER, CAMERON, TYLER WARD",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063901684,"HAMILTON, SUSAN, CHAMBERS",3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1063901684,"HAMILTON, SUSAN, CHAMBERS",6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 26 , 32 , 58 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063904118,"YACENDA, MARY, CRAVER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 129 , 129 ,$#,,
MEDICAID DIRECT,1316160641,MOUNT ZION MEDICAL AND NURSING SERV,THE MOUNT ZION MEDICAL CLINICS PA,6608 E WT HARRIS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063905677,"SEATON, JULIAN, MONTAGUE",6608 E W T HARRIS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 178 ," 1,006 "," 1,053 "," $31,288.15 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063906584,"BURNETTE, CASEY, SMITH",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 53 , 53 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063906584,"BURNETTE, CASEY, SMITH",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 66 , 75 , 81 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063906584,"BURNETTE, CASEY, SMITH",15 REGIONAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1063906584,"BURNETTE, CASEY, SMITH",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063907111,"ASSAKER, JEAN PIERRE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 22 , 27 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063907111,"ASSAKER, JEAN PIERRE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063907111,"ASSAKER, JEAN PIERRE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063907111,"ASSAKER, JEAN PIERRE",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 37 , 64 , 81 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063907152,"CHAVES, KRISTEN, NICOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1063909059,"KINZER, JOHNATHAN, PAUL",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063909059,"KINZER, JOHNATHAN, PAUL",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063910149,"PRICE, MARSHALL, DAVID",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063910149,"PRICE, MARSHALL, DAVID",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 48 , 96 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1063910149,"PRICE, MARSHALL, DAVID",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063910149,"PRICE, MARSHALL, DAVID",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063910503,"JOHNSON, ALEXANDRA, KESLER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1063910503,"JOHNSON, ALEXANDRA, KESLER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063910974,"PRICE, SAMANTHA, ELLEN",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12016 LEMMOND FARM DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063910974,"PRICE, SAMANTHA, ELLEN",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063910974,"PRICE, SAMANTHA, ELLEN",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063910974,"PRICE, SAMANTHA, ELLEN",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 27 , 39 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063910974,"PRICE, SAMANTHA, ELLEN",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477589158,EASTRIDGE FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE EASTRIDGE FAMILY MEDICI,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063910974,"PRICE, SAMANTHA, ELLEN",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 31 , 43 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063910974,"PRICE, SAMANTHA, ELLEN",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 233 , 238 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 79 , 79 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,551 KENT ST   ANDREWS NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3195 OLD MURPHY RD   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",3195 OLD MURPHY RD   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1134791676,SMOKY MOUNTAIN URGENT CARE,,195 FRANKLIN PLAZA DR   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1063916385,"LEADBETTER, ELIZABETH, ANN",3195 OLD MURPHY RD   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",3195 OLD MURPHY RD   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",3195 OLD MURPHY RD   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 44 , 44 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,410 BUCKNER BRANCH RD   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",410 BUCKNER BRANCH RD   BRYSON CITY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",410 BUCKNER BRANCH RD   BRYSON CITY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 77 , 77 ,$#,,
MEDICAID DIRECT,1407428931,SMOKY MOUNTAIN URGENT CARE,,80 VETERANS BLVD   BRYSON CITY NC,087,Swain,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1063916385,"LEADBETTER, ELIZABETH, ANN",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,410 BUCKNER BRANCH RD   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",410 BUCKNER BRANCH RD   BRYSON CITY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 225 , 229 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1063916385,"LEADBETTER, ELIZABETH, ANN",410 BUCKNER BRANCH RD   BRYSON CITY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063916468,"KUPRENAS, ALYSSA, HUGGINS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326472812,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PRIMARY CARE CONCORD INTERNAL MEDICI,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063916468,"KUPRENAS, ALYSSA, HUGGINS",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063916468,"KUPRENAS, ALYSSA, HUGGINS",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 75 , 96 ,$#,,
MEDICAID DIRECT,1417355629,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT SURGICAL ASSOCIATES,803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1063916823,"NZUNA, JANE, SONG",803 TILGHMAN DR   DUNN NC,043,Harnett,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063918068,"MOURAD, AHMAD",40 DUKE MEDICINE CIR # 1K DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 16 , 40 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063918068,"MOURAD, AHMAD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063918068,"MOURAD, AHMAD",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1811145014,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GASTONIA CHILDRENS,2544 COURT DR STE C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1063918605,"HOSSENLOPP, CASSADY, MICHELAINA",2544 COURT DR STE C GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 73 , 108 , 278 ," $12,999.53 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063918944,"PEREIRA, GREGORY, FRANK FLOREY",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063918944,"PEREIRA, GREGORY, FRANK FLOREY",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063918944,"PEREIRA, GREGORY, FRANK FLOREY",124 WELTON WAY   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 45 , 70 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063919868,"LOCKAMY, TIMOTHY, LEE",4430 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 50 , 96 ,$#,,
MEDICAID DIRECT,1619317823,MONARCH,~,2693 FOREST HILLS RD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1063921930,"NWADIGO, ROSELINE, OBIAGERI",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1063921930,"NWADIGO, ROSELINE, OBIAGERI",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063923076,"CULLIPHER, CHARLOTTE, AMANDA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063923076,"CULLIPHER, CHARLOTTE, AMANDA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 86 , 102 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063923720,"BYRNE, HOLLY, USHER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 22 , 31 , 32 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1063924660,"BURNS, JENNIFER, ELIZABETH",301 S OKELLY AVE   ELON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1063924660,"BURNS, JENNIFER, ELIZABETH",301 S OKELLY AVE   ELON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 49 , 66 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063925352,"MOHIUDDIN, MOHAMMED, OMAR",2351 ERWIN RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063925352,"MOHIUDDIN, MOHAMMED, OMAR",2351 ERWIN RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063925451,"SUNDHOLM, GABRIELLE, LEIGH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 37 , 44 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1063925451,"SUNDHOLM, GABRIELLE, LEIGH",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 25 , 32 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063925451,"SUNDHOLM, GABRIELLE, LEIGH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 17 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063925923,"CARRIGER, OLIVIA, MARIE",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 60 , 91 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063925923,"CARRIGER, OLIVIA, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1063926640,"BIGGS AYERS, STEPHANIE, NICOLE",1213 CHESHIRE LN   ROCKY MOUNT NC,064,Nash,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1063926640,"BIGGS AYERS, STEPHANIE, NICOLE",2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 16 , 44 , 45 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1063927549,"JOHNSON, DETTY, THOMAS",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063927549,"JOHNSON, DETTY, THOMAS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063927549,"JOHNSON, DETTY, THOMAS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1063931897,"HUGHES, JON, MICHAEL",5156 US ROUTE 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1063931897,"HUGHES, JON, MICHAEL",5156 US ROUTE 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 27 , 81 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063932432,"SHELTON, CHRISTY, ROBINSON",32 APEX CIR   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063932473,"THOMPSON, IVEY, DENICE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 17 , 20 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,13825 HUNTON LN   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063932473,"THOMPSON, IVEY, DENICE",1101 BAUCOM RD   MONROE NC,090,Union,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1063932473,"THOMPSON, IVEY, DENICE",1101 BAUCOM RD   MONROE NC,090,Union,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 129 ," 1,045 "," 1,258 "," $46,412.46 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063932473,"THOMPSON, IVEY, DENICE",1101 BAUCOM RD   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 125 , 136 , 148 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",117 E KINGS HWY   EDEN NC,079,Rockingham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",117 E KINGS HWY   EDEN NC,079,Rockingham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 42 , 42 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",323 BALDWIN RD   BURLINGTON NC,001,Alamance,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 35 , 305 , 305 ," $42,575.42 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 35 , 143 , 144 ," $15,125.58 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",1 MARITHE CT   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 137 , 137 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063933539,"WOMACK, JAZMON, LATRAC",1 MARITHE CT   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1063933828,"STATON, HANNAH, ROSE",1211A IRELAND DR   FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 73 , 360 , 361 ," $26,585.82 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063935377,"SCHAFFER, ANNA, ELIZABETH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 32 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063935377,"SCHAFFER, ANNA, ELIZABETH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063935377,"SCHAFFER, ANNA, ELIZABETH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 30 , 49 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1063936045,"FRERICH, MICHELLE, ANN",1 HOSPITAL RD   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1073155032,BURKHART PEDIATRIC & ADOLESCENT DER,,135 PARKWAY OFFICE CT STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1063937688,"MASSEY, LAUREN, DEMBNICKI",135 PARKWAY OFFICE CT STE 201 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 314 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063937753,"WALLACE, TALIA, NICOLE",300 MEDICAL PKWY STE 314 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063938660,"OCONNOR, ALANA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1063939106,WALGREEN CO,WALGREENS 19002,868 N GREEN ST   MORGANTON NC,012,Burke,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1063939106,WALGREEN CO,868 N GREEN ST   MORGANTON NC,012,Burke,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063940989,"TOLBERT, NORA, FRANCES",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 18 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063940989,"TOLBERT, NORA, FRANCES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 88 , 143 , 164 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063940989,"TOLBERT, NORA, FRANCES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 34 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063940989,"TOLBERT, NORA, FRANCES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1063943017,"ORBAN, MOLLY, WILLIAMS",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 39 , 66 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063943314,"XIE, JESSE, JUNCONG",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063943314,"XIE, JESSE, JUNCONG",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1063943538,"YOUNG, JESSICA, DARA WEBB",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 36 , 88 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063943777,"SALISBURY, CHERIE, SUSAN",416 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 54 , 135 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063944718,"FUNKE, MARY, ELIZABETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 44 , 70 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063944718,"FUNKE, MARY, ELIZABETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 26 , 34 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063945467,"OKEEFE, KAITLYN, ELIZABETH",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063945467,"OKEEFE, KAITLYN, ELIZABETH",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 23 , 56 , 154 ," $12,134.02 ",,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063945467,"OKEEFE, KAITLYN, ELIZABETH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063945467,"OKEEFE, KAITLYN, ELIZABETH",7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 61 , 122 ,$#,,
MEDICAID DIRECT,1063945988,"TAYLOR, LA TONYA, RENEE",LA TONYA R TAYLOR DBA LET US TALK,2719 BUCKINGHAM CT   KINSTON NC,054,Lenoir,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1063945988,"TAYLOR, LA TONYA, RENEE",2719 BUCKINGHAM CT   KINSTON NC,054,Lenoir,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063946846,"SORAH, JONATHAN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 28 , 41 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1063946846,"SORAH, JONATHAN, DAVID",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 16 , 20 , 28 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063947612,"BAKER, ALLISON, MCALPINE",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 43 , 55 , 82 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063947612,"BAKER, ALLISON, MCALPINE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063947612,"BAKER, ALLISON, MCALPINE",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 96 , 143 , 194 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,645 AMALIA ST NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063947612,"BAKER, ALLISON, MCALPINE",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063948727,"AVERY, BRADLEY, MARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,700 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063948990,"PARKER, ANTHONY, JEROME",700 TILGHMAN DR   DUNN NC,043,Harnett,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 86 , 168 , 266 ,$#,,
MEDICAID DIRECT,1861213225,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY ORTHOPEDICS AND SPORTS MEDICINE,700 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063948990,"PARKER, ANTHONY, JEROME",700 TILGHMAN DR   DUNN NC,043,Harnett,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 39 , 55 , 104 ,$#,,
MEDICAID DIRECT,1861213225,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY ORTHOPEDICS AND SPORTS MEDICINE,225 BRIGHTWATER DR STE 200 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063948990,"PARKER, ANTHONY, JEROME",716 S 10TH ST   LILLINGTON NC,043,Harnett,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 30 , 70 ,$#,,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,716 S 10TH ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1063948990,"PARKER, ANTHONY, JEROME",700 TILGHMAN DR   DUNN NC,043,Harnett,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063951606,"BROWN, JARED, WESLEY",16455 STATESVILLE RD STE 420 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 37 , 83 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1063951606,"BROWN, JARED, WESLEY",16455 STATESVILLE RD STE 420 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 19 , 32 ,$#,,
MEDICAID DIRECT,1245670298,FIRSTHEALTH OF THE CAROLINAS INC,~,2925 BEECHTREE DR STE 145 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1063951754,"KROL, ALYSSA, CATHERINE",2925 BEECHTREE DR STE 145 SANFORD NC,053,Lee,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063957009,"JOHNSON, JACQUELINE, RENEE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063957009,"JOHNSON, JACQUELINE, RENEE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063957009,"JOHNSON, JACQUELINE, RENEE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1063957009,"JOHNSON, JACQUELINE, RENEE",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1063958015,"ASHBY, WILLIAM, SCOTT",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1134286321,COUNTY OF HOKE,HOKE COUNTY HEALTH DEPARTMENT,683 E PALMER ST   RAEFORD NC,047,Hoke,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1063958577,"MCNEILL, AMANDA, CIERRA",683 E PALMER ST   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1063958577,"MCNEILL, AMANDA, CIERRA",683 E PALMER ST   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 36 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063962710,"OFORI, OYAKHIRE, CALLISTUS",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 141 , 141 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1063962710,"OFORI, OYAKHIRE, CALLISTUS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063963866,"PUSKARICH, JESSICA, ROSE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063963866,"PUSKARICH, JESSICA, ROSE",1718 E 4TH ST STE 307 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063964823,NORTHLAKE AL HOLDINGS LLC,NORTHLAKE HOUSE,9108 REAMES RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1063964823,NORTHLAKE AL HOLDINGS LLC,9108 REAMES RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 3,896 "," 3,898 "," $813,832.00 ",,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063968410,"O'CORRAGAIN, OISIN, AOGHAN",159 EXECUTIVE DR STE F DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063971364,"CARROLL, KATELYN, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1063971364,"CARROLL, KATELYN, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063971364,"CARROLL, KATELYN, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063971364,"CARROLL, KATELYN, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1063971364,"CARROLL, KATELYN, NOEL",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",331 TATE BLVD SE   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",380 BREVARD RD   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 86 , 119 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",24724 US HIGHWAY 52 S   ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1063972164,"DECKER, KATHRYN, TULLEY",70 OAK ST   TRYON NC,075,Polk,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063972180,"VANDOMMELEN, KAYLEE, ANNE",1450 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 29 , 39 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063972180,"VANDOMMELEN, KAYLEE, ANNE",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063973147,"HARDING, CESHAE, CEMONIQUE ALEXIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063973147,"HARDING, CESHAE, CEMONIQUE ALEXIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063973147,"HARDING, CESHAE, CEMONIQUE ALEXIA",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1063973147,"HARDING, CESHAE, CEMONIQUE ALEXIA",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1063974889,"SANTILLANA, CESAR, ABRAHAM",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,604 MEDICAL DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063975852,"LOMBARD, ROBERT, THOMAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063975852,"LOMBARD, ROBERT, THOMAS",604 MEDICAL DR   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 69 , 149 , 185 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063975852,"LOMBARD, ROBERT, THOMAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 94 , 176 , 315 ," $17,986.38 ",,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,604 MEDICAL DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063975852,"LOMBARD, ROBERT, THOMAS",604 MEDICAL DR   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1063975852,"LOMBARD, ROBERT, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 33 , 145 , 152 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1063976421,"BALLARD, STACY, LEIGH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063976421,"BALLARD, STACY, LEIGH",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063976421,"BALLARD, STACY, LEIGH",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1063976421,"BALLARD, STACY, LEIGH",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1063979771,"KAMINER, JULIA, RUTH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1114116944,CAROLINA PSYCHIATRY PC,~,548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063982734,"BIELLER, DERRICK, RICHARD",548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1114116944,CAROLINA PSYCHIATRY PC,~,548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1063982734,"BIELLER, DERRICK, RICHARD",7212 GB ALFORD HWY   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1063985117,"LARKIN, REBECCA, COX",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 67 , 78 , 116 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1063985117,"LARKIN, REBECCA, COX",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063986883,"MILLARD, NICOLE, MICHELLE",910 WORTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 94 , 130 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,910 WORTH ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1063986883,"MILLARD, NICOLE, MICHELLE",910 WORTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164725842,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY CARY,1000 CRESCENT GRN STE 202 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063990299,"WAHAB, ZEESHAN",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982076071,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CARY WEST,1203 NW MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063990299,"WAHAB, ZEESHAN",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 69 , 242 ,$#,,
MEDICAID DIRECT,1982076071,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CARY WEST,1203 NW MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063990299,"WAHAB, ZEESHAN",3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982076071,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CARY WEST,1203 NW MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063990299,"WAHAB, ZEESHAN",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063994200,"POWELL, CHRISTINA, TONAE",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 35 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063994200,"POWELL, CHRISTINA, TONAE",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 102 , 139 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1063995249,"OAKES, DIANA, MICHELLE",1611 ANDREWS RD   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1063998243,"BENNETT, KAYLEIGH, HUDSON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083144992,LANE AND ASSOCIATES XXXII DDS PA,,411 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1063999167,"SILVA LOPES, JOSEPHINA, JADE",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 224 , 362 ," 1,285 "," $46,831.97 ",,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1063999167,"SILVA LOPES, JOSEPHINA, JADE",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 105 , 127 , 406 ," $16,510.84 ",,
MEDICAID DIRECT,1952940926,LANE AND ASSOCIATES XXXVI DDS PA,,900 S GARNETT ST   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1063999167,"SILVA LOPES, JOSEPHINA, JADE",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1063999712,"HART SCHNEIDER, KIERSTEN, MARIAN",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073000790,"FRUSH, BENJAMIN, WADE",5003 OLD CLINIC CB # 7550   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 24 , 24 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073000790,"FRUSH, BENJAMIN, WADE",5003 OLD CLINIC CB # 7550   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073000790,"FRUSH, BENJAMIN, WADE",5003 OLD CLINIC CB # 7550   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 39 , 39 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073001335,"HARBRECHT, LAWRENCE, EDWARD",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700650371,LONDRY MODLIN TUCKER II DDS PLLC,DASH CITY PEDIATRIC AND ADULT DENTISTRY,705 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073001400,"TUCKER, STUART, WEBSTER",705 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 236 , 280 ," 1,395 "," $67,056.72 ",,
MEDICAID DIRECT,1588409296,LONDRY MODLIN TUCKER ZIMMER DDS,HAPPY TEETH PEDIATRIC DENTISTRY - MOORESVILLE,108 LEANING OAK DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073001400,"TUCKER, STUART, WEBSTER",705 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1588409296,LONDRY MODLIN TUCKER ZIMMER DDS,HAPPY TEETH PEDIATRIC DENTISTRY - MOORESVILLE,108 LEANING OAK DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073001400,"TUCKER, STUART, WEBSTER",108 LEANING OAK DR   MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 82 ,$#,,
MEDICAID DIRECT,1689427767,LONDRY MODLIN TUCKER IV DDS PLLC,CAROLINA KIDS DENTISTRY - BLAKENEY,9817 SUZANNE CT STE B WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1073001400,"TUCKER, STUART, WEBSTER",701 HARTNESS RD   STATESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 23 , 23 , 103 ,$#,,
MEDICAID DIRECT,1205617826,LONDRY MODLIN TUCKER DDS PLLC,HAPPY TEETH PEDIATRIC DENTISTRY,701 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073001400,"TUCKER, STUART, WEBSTER",701 HARTNESS RD   STATESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,259 "," 1,761 "," 9,919 "," $630,170.43 ",,
MEDICAID DIRECT,1164281275,LONDRY MODLIN TUCKER III DDS PLLC,CAROLINA KIDS DENTISTRY MINT HILL,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073001400,"TUCKER, STUART, WEBSTER",5829 PHYLISS LN UNIT A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 228 , 238 ," 1,005 "," $41,192.20 ",,
MEDICAID DIRECT,1164281275,LONDRY MODLIN TUCKER III DDS PLLC,CAROLINA KIDS DENTISTRY MINT HILL,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073001400,"TUCKER, STUART, WEBSTER",5829 PHYLISS LN UNIT A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 14 , 14 , 45 ,$#,,
MEDICAID DIRECT,1598572042,LONDRY MODLIN TUCKER & ZIMMER II DD,HAPPY TEETH PEDIATRIC DENTISTRY HUNTERSVILLE,9920 KINCEY AVE STE 220 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073001400,"TUCKER, STUART, WEBSTER",9920 KINCEY AVE STE 220 HUNTERSVILLE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 43 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073001897,"GARDNER, ROBERT, ANDREW",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 18 , 21 , 29 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073001897,"GARDNER, ROBERT, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 17 , 24 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073001897,"GARDNER, ROBERT, ANDREW",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073001897,"GARDNER, ROBERT, ANDREW",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 16 , 23 , 24 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073002622,"KATSAKHYAN, LEVON, NORIK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 71 , 74 , 120 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073003018,"HOOTEN, CICELY, BAUGH",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073003299,"KINGBERG, MICHAEL, JOSEPH",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073003299,"KINGBERG, MICHAEL, JOSEPH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073003299,"KINGBERG, MICHAEL, JOSEPH",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073003299,"KINGBERG, MICHAEL, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073003299,"KINGBERG, MICHAEL, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 222 , 242 , 340 ," $18,977.56 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073003448,"SHNAYDER-ADAMS, MICHELLE, MAGGIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 28 , 80 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073003448,"SHNAYDER-ADAMS, MICHELLE, MAGGIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 35 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073003448,"SHNAYDER-ADAMS, MICHELLE, MAGGIE",310 LONG SHOALS RD STE 203 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073003877,"DAVE, AMI, ATULKUMAR",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1134264195,JASPER L LEWIS JR DDS PA,~,1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073005336,"DAVIS, MEREDITH, PERDUE",1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 302 , 381 ," 1,543 "," $82,314.53 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073005781,"KHETPAL, REENA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 33 , 80 , 80 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073005781,"KHETPAL, REENA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1073006144,WAKE DIAGNOSTICS INC,~,5129 NC HIGHWAY 55 STE 103-104 DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,1073006144,WAKE DIAGNOSTICS INC,5129 NC HIGHWAY 55 STE 103-104 DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,, 96 , 265 , 517 ," $45,551.93 ",,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073008033,"SHAIK, BUSHRA FIRDOUS",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073008686,"SEPE, KIMBERLY, HUTTER",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 59 , 59 ,$#,,
MEDICAID DIRECT,1124891205,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT UWHARRIE CHARTER ACADEMY - ELEMENTARY,5326 US HIGHWAY 220 BUS S   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073008785,"TROGDON, BROOKE, LEIGH",5326 US HIGHWAY 220 BUS S   ASHEBORO NC,076,Randolph,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073009445,"SINGH, AMBARIS",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 62 , 88 ," $15,379.67 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073010484,"SNYDER, LAUREN, ELIZABETH",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 78 , 94 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073010484,"SNYDER, LAUREN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073015046,"KAUFMAN, CHRISTIAN, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 42 , 50 , 50 ," $14,316.52 ",,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073015046,"KAUFMAN, CHRISTIAN, ANN",187 W MAIN ST   SPINDALE NC,081,Rutherford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,,,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073017042,"TUCKER, MCKENZIE, DENISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073017042,"TUCKER, MCKENZIE, DENISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 47 , 56 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073017042,"TUCKER, MCKENZIE, DENISE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 36 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073017042,"TUCKER, MCKENZIE, DENISE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 36 , 42 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1073017042,"TUCKER, MCKENZIE, DENISE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1073017042,"TUCKER, MCKENZIE, DENISE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 16 , 18 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073017042,"TUCKER, MCKENZIE, DENISE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073017836,"CALLESE, TYLER, EUGENE",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 126 , 140 , 177 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073017836,"CALLESE, TYLER, EUGENE",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 108 , 142 , 178 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073018081,"PRENDERGAST, NICOLE, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073018081,"PRENDERGAST, NICOLE, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 100 , 107 , 121 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073018750,"GUIDO, CHRISTOPHER, MICHAEL",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 53 , 88 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073019857,"CULP, CROSBY, MITCHELL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073019857,"CULP, CROSBY, MITCHELL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073019857,"CULP, CROSBY, MITCHELL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 12 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073020145,"PARRALES, CAROL, ALEJANDRA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 32 , 53 ,$#,,
MEDICAID DIRECT,1952557241,BOICE WILLIS CLINIC PA,~,2413 PROFESSIONAL DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073026266,"LANIER, ASHLEY, PEARSALL",2413 PROFESSIONAL DR   ROCKY MOUNT NC,064,Nash,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073032496,"THOMAS, JOHN, STEPHENSON",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073032496,"THOMAS, JOHN, STEPHENSON",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 38 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073033320,"LOW, BETHANY, RENA",6301 STADIUM DR STE 500 CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 74 , 121 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073033320,"LOW, BETHANY, RENA",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073034278,"HARTZOG, MICHELLE, HICKS",3116 N DUKE ST   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073034278,"HARTZOG, MICHELLE, HICKS",783 DOCTORS CT STE C ROXBORO NC,073,Person,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1508903477,HANGER PROSTHETICS & ORTHOTICS EAST,~,401 WESTWOOD AVE STE 102 HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073034443,"STUART, SAMUEL",401 WESTWOOD AVE   HIGH POINT NC,041,Guilford,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 28 ,$#,,
MEDICAID DIRECT,1508903477,HANGER PROSTHETICS & ORTHOTICS EAST,~,401 WESTWOOD AVE STE 102 HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073034443,"STUART, SAMUEL",401 WESTWOOD AVE   HIGH POINT NC,041,Guilford,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073036802,"NOVICKI, KELSEY, PARRISH",417 N MAIN ST   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,417 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1073036802,"NOVICKI, KELSEY, PARRISH",417 N MAIN ST   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073036802,"NOVICKI, KELSEY, PARRISH",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 61 , 96 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073037461,"CHANUMOLU, PRAMODH",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073038279,"WULFF, KACEY, KATHLEEN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073039848,"MILLAR, RYAN, KELLAN",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 41 , 56 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1073039913,"DOYLE, EDWARD",1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 22 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073039947,"AQUINO, KATRINA, CARBONELL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1073039947,"AQUINO, KATRINA, CARBONELL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073039947,"AQUINO, KATRINA, CARBONELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073039947,"AQUINO, KATRINA, CARBONELL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073040218,"BLAIR, THOMAS, FRANCIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 65 , 65 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073040218,"BLAIR, THOMAS, FRANCIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 60 , 60 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073040218,"BLAIR, THOMAS, FRANCIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073040218,"BLAIR, THOMAS, FRANCIS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043218944,PITT COUNTY MEMORIAL HOSPITAL INC,ECU HEALTH MEDICAL CENTER,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073040218,"BLAIR, THOMAS, FRANCIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073040218,"BLAIR, THOMAS, FRANCIS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073040218,"BLAIR, THOMAS, FRANCIS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1073040325,"HILLER, HUGH, MERRIGAN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 50 , 71 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073040325,"HILLER, HUGH, MERRIGAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073043600,"GREEAR, ELLEN, ASENATH",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 29 , 90 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073043600,"GREEAR, ELLEN, ASENATH",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073043600,"GREEAR, ELLEN, ASENATH",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1073044038,"INGRAM, AMANDA, RAE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 17 , 21 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1073044038,"INGRAM, AMANDA, RAE",705 NEWMAN RD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 43 , 66 , 105 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1073044178,"APPLEBAUM, MATTHEW, AARON",959 COX RD   GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 54 , 85 , 185 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1073044178,"APPLEBAUM, MATTHEW, AARON",959 COX RD   GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073044541,"COLSON, ANDREW, SCOTT",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073044541,"COLSON, ANDREW, SCOTT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 114 , 134 , 140 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073044988,"MCCALMON, SEAN, PATRICK",9101 OCEAN HWY E   LELAND NC,010,Brunswick,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073044988,"MCCALMON, SEAN, PATRICK",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 61 , 95 , 170 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073044988,"MCCALMON, SEAN, PATRICK",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 33 , 43 , 110 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073044988,"MCCALMON, SEAN, PATRICK",8114 MARKET ST   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1386268324,WATAUGA MEDICAL CENTER INC,APPPEDS,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1073045332,"TRAN, LAURA, BETH",336 DEERFIELD RD   BOONE NC,095,Watauga,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 36 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073045704,"METZGER, GREGOR, AARON",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073045704,"METZGER, GREGOR, AARON",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 60 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073045704,"METZGER, GREGOR, AARON",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073045704,"METZGER, GREGOR, AARON",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073046157,"ROWLAND, KRISTIN, DEMOSTHENES",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073047379,"MULLINS, KANI, MICHELE",4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 19 , 22 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1073047528,"MASOUD, HANNAH, MALIHA",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073047528,"MASOUD, HANNAH, MALIHA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1073047528,"MASOUD, HANNAH, MALIHA",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073047528,"MASOUD, HANNAH, MALIHA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073047528,"MASOUD, HANNAH, MALIHA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073047528,"MASOUD, HANNAH, MALIHA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 36 , 36 ,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073048021,"HILSCHER, CHELSEY, JO",4201 LAKE BOONE TRL   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1528704236,JOURNEY HEALTH TECHNOLOGIES US INC,FINNI HEALTH,1220 ARGONNE BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073049110,"ALFORD, JADE, ALEXANDRIA MARIE",3409 TERRY LN   GREENSBORO NC,041,Guilford,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 101 , 128 ," $31,463.11 ",,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073054896,"HAMRICK, AMY, VINSON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073058517,"MAGUIRE, MEREDITH, ALANNA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073058517,"MAGUIRE, MEREDITH, ALANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073060679,"SADOWSKY, AMANDA, SUE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#, 13 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1073060679,"SADOWSKY, AMANDA, SUE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073060679,"SADOWSKY, AMANDA, SUE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1073060679,"SADOWSKY, AMANDA, SUE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073062733,"ROBBINS, COLBY, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 57 , 118 ,$#,,
MEDICAID DIRECT,1104925072,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,608 W ACADEMY ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1073062733,"ROBBINS, COLBY, ALAN",608 W ACADEMY ST   RANDLEMAN NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1073062733,"ROBBINS, COLBY, ALAN",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1073062808,"MERTZ, CHRISTOPHER, LEE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073693347,EASTERN CAROLINA PEDIATRICS,EASTERN CAROLINA PEDIATRICS,1702 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1073063111,"PITTMAN, KIMBERLY, BRIDGERS",1702 MEDICAL PARK DR W   WILSON NC,098,Wilson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 41 , 60 , 176 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073066429,"LINDQUIST, JOHN, PATRICK",310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073066429,"LINDQUIST, JOHN, PATRICK",1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073066429,"LINDQUIST, JOHN, PATRICK",104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 30 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073066429,"LINDQUIST, JOHN, PATRICK",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073066429,"LINDQUIST, JOHN, PATRICK",3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 59 , 112 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073066429,"LINDQUIST, JOHN, PATRICK",1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073069332,"AHMAD, MASOOD",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073069795,"KOOPMAN, HEATHER, ANNE",2000 BRABHAM AVE STE 100 JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073071908,"BARR, EMILEE, SMITH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073071908,"BARR, EMILEE, SMITH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093706111,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - SOUTHEAST RALEIGH DENTA,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073072245,"MASTROMARINO, SILVIANO, JOSEPH",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073072245,"MASTROMARINO, SILVIANO, JOSEPH",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice, 220 , 354 , 979 ," $51,331.97 ",,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073072245,"MASTROMARINO, SILVIANO, JOSEPH",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 34 ,$#,,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073072245,"MASTROMARINO, SILVIANO, JOSEPH",100 W PARKVIEW DR   HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073072245,"MASTROMARINO, SILVIANO, JOSEPH",100 W PARKVIEW DR   HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 28 , 68 ,$#,,
MEDICAID DIRECT,1093706111,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - SOUTHEAST RALEIGH DENTA,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073072245,"MASTROMARINO, SILVIANO, JOSEPH",100 W PARKVIEW DR   HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1407951221,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - PALLIATIVE CARE,100 E WOOD ST STE 300A SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073073896,"PUCKETT, TIFFANY, NICOLE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073074951,"FENDER, ALEXANDER, WILLIAM",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073074985,"BOOHER, KATHRYN, ELIZABETH RAND",318 S NORWOOD ST   WALLACE NC,031,Duplin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073075412,"STEWART, MAI, EMILY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 45 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073075412,"STEWART, MAI, EMILY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073075412,"STEWART, MAI, EMILY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 32 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073075719,"MOUW, SARAH, TURNER",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 35 , 39 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073076147,"NGUYEN, FRANCIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1073076923,"TATE, TABITHA, LECLAIRE",446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164887873,SIMPLECLINIC PLLC,,1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073083119,"BOWERS, MARY, ELIZABETH",1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457828253,COASTAL COMPREHENSIVE CARE PA,,710 SUNSET BLVD N STE A SUNSET BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073083119,"BOWERS, MARY, ELIZABETH",710 SUNSET BLVD N STE A SUNSET BEACH NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 81 , 199 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",1965 S US 29 HWY   CHINA GROVE NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 140 , 268 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",316 W MAIN ST   ROCKWELL NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",316 W MAIN ST   ROCKWELL NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",316 W MAIN ST   ROCKWELL NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1102 B US 601   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",316 W MAIN ST   ROCKWELL NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1073085593,"VAN METER, ALYSSA, ROSE",316 W MAIN ST   ROCKWELL NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,140 W MILLS ST STE A COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1073088134,"PATTERSON, ZACHARY, JAMES",140 W MILLS ST STE A COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073088134,"PATTERSON, ZACHARY, JAMES",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073088134,"PATTERSON, ZACHARY, JAMES",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 34 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073088134,"PATTERSON, ZACHARY, JAMES",1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 42 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073088134,"PATTERSON, ZACHARY, JAMES",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073088290,"HILLER, MARCUS, BENJAMIN",605 GROVE ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 125 , 267 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073088399,"WALKER, APRIL, MARIE",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1073102760,"GLASS, GRACE, LINDSEY",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 41 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2000 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1073102760,"GLASS, GRACE, LINDSEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1073102760,"GLASS, GRACE, LINDSEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 28 , 60 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1073102760,"GLASS, GRACE, LINDSEY",2000 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1073106258,"BAKER, CRYSTAL, LEIGH",101 CLINIC DR   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073106258,"BAKER, CRYSTAL, LEIGH",101 CLINIC DR   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 95 , 193 , 346 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073106688,"ZHANG, WENZHAO",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073106878,"HODGSON, OLIVIA, JEAN WELLS",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 22 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073123725,"GREGORY, CHINA, CAPRI",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073123790,"VICTORY, JACQUELIN, NICOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1073124558,TRUSTED HANDS HOME CARE AGENCY LLC,TRUSTED HANDS HOME CARE TRANSPORATION SERVICES,102 BROAD ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1073124558,TRUSTED HANDS HOME CARE AGENCY LLC,102 BROAD ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 6,494 "," 6,738 "," $707,634.52 ",,
MEDICAID DIRECT,1073125217,REFERENCE HOME CARE LLC,REFERENCE HOME CARE LLC,5500 EXECUTIVE CENTER DR STE 225 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1073125217,REFERENCE HOME CARE LLC,5500 EXECUTIVE CENTER DR STE 225 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,292 "," 1,292 "," $77,908.28 ",,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073132031,"HANA, DAVID, FARES NASSIF",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 113 , 113 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073132031,"HANA, DAVID, FARES NASSIF",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 191 , 193 ,$#,,
MEDICAID DIRECT,1255775938,COATS MEDICAL SERVICES LLC,CFV PRIMARY CARE FAMILY MEDICINE CONT CLINIC-COATS,25 N JOHNSON ST   COATS NC,043,Harnett,193400000X,Group,Single Specialty,,1073132262,"HERRING, ALEX, QUINTON",25 N JOHNSON ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 78 , 107 ,$#,,
MEDICAID DIRECT,1255775938,COATS MEDICAL SERVICES LLC,CFV PRIMARY CARE FAMILY MEDICINE CONT CLINIC-COATS,25 N JOHNSON ST   COATS NC,043,Harnett,193200000X,Group,Multi-Specialty,,1073132262,"HERRING, ALEX, QUINTON",25 N JOHNSON ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 85 , 154 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073133476,"TAPP, LAUREN, GABRIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1073136321,BLUE CIRCLE SERVICES INC,,7321 SWEET BAY LN   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073136321,BLUE CIRCLE SERVICES INC,7321 SWEET BAY LN   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 42 , 862 , 863 ," $60,266.51 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073136453,"GHATTAN, SHIMA",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073136453,"GHATTAN, SHIMA",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1962837153,STEVEN L HATCHER DDS PA,~,2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073136453,"GHATTAN, SHIMA",2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 875 , 996 ," 5,060 "," $131,786.91 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073136453,"GHATTAN, SHIMA",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 42 , 176 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073136453,"GHATTAN, SHIMA",2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 527 , 531 ," 2,124 "," $53,837.22 ",,
MEDICAID DIRECT,1346069085,HATCHER DDS PLLC,,2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073136453,"GHATTAN, SHIMA",2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 683 , 766 ," 3,600 "," $98,389.97 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073136453,"GHATTAN, SHIMA",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073137030,"WARD, ELIZABETH, RUTH",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134264195,JASPER L LEWIS JR DDS PA,~,1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073138475,"TAYLOR, CAMERON, SULLIVAN",1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 36 , 116 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1073139366,"COWELL, MEGAN, BOSSE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 73 , 73 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073139861,"SHERWIN, ERIN, HOPE",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073140091,"HERRING, KATHLEEN, CRAMER",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073140091,"HERRING, KATHLEEN, CRAMER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 16 , 17 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073140281,"RIEDERER, JUSTIN, WILLIAM",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 59 , 130 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073140281,"RIEDERER, JUSTIN, WILLIAM",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 57 , 57 ," $12,252.50 ",,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073140281,"RIEDERER, JUSTIN, WILLIAM",19 N ANN ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 58 , 58 ,$#,,
MEDICAID DIRECT,1316232598,RHA HEALTH SERVICES INC,RHA HEALTH SERVICES INC,2415 MORGANTON BLVD SW STE 100 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073140695,"GIST, JEWELL, ELISABETH",2415 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073143343,EASTERN THERAPY SOLUTIONS PLLC,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 28 , 656 ," 1,060 "," $77,532.77 ",,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073147146,"WHITE, ASHTON, ELIZABETH",2609 OLD SALISBURY RD   WINSTON SALEM NC,034,Forsyth,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5311 N ROXBORO RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073147393,"POTTER, KIMBERLY, ELIZABETH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598762940,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073147690,"RILEY, LIBERTY, DAWN",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#, 41 , 41 ," $11,823.47 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073151965,"SIMPSON, KATELYNNE, POOLE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 27 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073151965,"SIMPSON, KATELYNNE, POOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073151965,"SIMPSON, KATELYNNE, POOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073151965,"SIMPSON, KATELYNNE, POOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073151965,"SIMPSON, KATELYNNE, POOLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710933692,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH FULTON HEIGHTS FAMILY MEDICINE,860 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1073154423,"MOOSE, CHRISTINA, HERMAN",860 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073154423,"MOOSE, CHRISTINA, HERMAN",860 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 175 , 349 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073161196,"ESPINOZA, CHELSEA, CONSTANCE",4709 CREEKSTONE DR   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073161584,"MARTINELLI, EMMA",300 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073161584,"MARTINELLI, EMMA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073161584,"MARTINELLI, EMMA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073161584,"MARTINELLI, EMMA",300 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073161634,"SIMS, WHITNEY, LENORE",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073162319,"ABSHER, HILLARY, VANHOY",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073162319,"ABSHER, HILLARY, VANHOY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073162319,"ABSHER, HILLARY, VANHOY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073162319,"ABSHER, HILLARY, VANHOY",447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073163226,"MATTOX, BLAKE, ALEXANDER",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 69 , 78 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073163457,"RUHLAND, SARAH, LYN",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073163457,"RUHLAND, SARAH, LYN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073163457,"RUHLAND, SARAH, LYN",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1073163457,"RUHLAND, SARAH, LYN",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073163457,"RUHLAND, SARAH, LYN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1086 MAIN ST   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942904818,REVIVE CONCIERGE & WELLNESS PLLC,,906 S MAIN ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",906 S MAIN ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 142 , 153 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 72 , 74 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 197 , 200 ,$#,,
MEDICAID DIRECT,1629821681,POSITIVE PATHWAYS LLC,,108 N FRANKLIN ST STE C MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",906 S MAIN ST   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942904818,REVIVE CONCIERGE & WELLNESS PLLC,,906 S MAIN ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",906 S MAIN ST   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 106 , 106 ," $10,967.82 ",,
MEDICAID DIRECT,1942904818,REVIVE CONCIERGE & WELLNESS PLLC,,906 S MAIN ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",906 S MAIN ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629821681,POSITIVE PATHWAYS LLC,,108 N FRANKLIN ST STE C MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",906 S MAIN ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942904818,REVIVE CONCIERGE & WELLNESS PLLC,,906 S MAIN ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",906 S MAIN ST   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 66 , 73 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",906 S MAIN ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629821681,POSITIVE PATHWAYS LLC,,108 N FRANKLIN ST STE C MADISON NC,079,Rockingham,251S00000X,Agencies,Community/Behavioral Health,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629821681,POSITIVE PATHWAYS LLC,,108 N FRANKLIN ST STE C MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 27 ,$#,,
MEDICAID DIRECT,1629821681,POSITIVE PATHWAYS LLC,,108 N FRANKLIN ST STE C MADISON NC,079,Rockingham,193400000X,Group,Single Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,116 LANE DR   TRINITY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1073165148,"GAMMON, CHRYSTAL, DANNETTE GUNN",116 LANE DR   TRINITY NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1073167490,"DIONNE, NICOLE, BETH",70 OAK ST   TRYON NC,075,Polk,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073167490,"DIONNE, NICOLE, BETH",70 OAK ST   TRYON NC,075,Polk,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1073167490,"DIONNE, NICOLE, BETH",70 OAK ST   TRYON NC,075,Polk,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073167490,"DIONNE, NICOLE, BETH",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1073170551,"WHITFIELD, CHRISTIAN, HOPE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 32 , 32 ,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1073170551,"WHITFIELD, CHRISTIAN, HOPE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",109 FOOTHILLS DR   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 71 , 72 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 85 , 86 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 33 , 34 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1073172904,"HARRIS, MELISSA, BARLOWE",109 FOOTHILLS DR   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073174066,"MANALO, TRINA, MAGNO",8420 UNIVERSITY EXEC PARK DR STE 850 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 89 , 197 ,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073174934,"YU, GABRIEL, SHING",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 24 , 32 ,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073174934,"YU, GABRIEL, SHING",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073175055,"REY, EVAN, JONES",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073175055,"REY, EVAN, JONES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457696361,BLACK MOUNTAIN PHYSICAL THERAPY LLC,PHOENIX REHABILITATION AND HEALTH SERVICES INC,10610 METROMONT PKWY STE 108 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073175527,"MCCARTHY, SHANNON, ELIZABETH",10610 METROMONT PKWY STE 108 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 88 , 144 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073176301,"SIBLEY, JESSICA, JANE",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 30 , 30 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073177614,"KUMARI, POOJA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 293 , 293 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073177960,"ROBIN, DEANNA, LYN",3960 VIRGINIA BEACH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 22 , 29 ,$#,,
MEDICAID DIRECT,1174882344,CALDWELL MEMORIAL HOSPITAL,LAUREL PARK WOMENS HEALTH,4355 HICKORY BLVD STE 1 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073182325,"ERBY, BRITTANY, LYNN",4355 HICKORY BLVD STE 1 GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 38 , 44 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073183034,"VIGIL, CASSIDY, DANAE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 47 , 117 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073183034,"VIGIL, CASSIDY, DANAE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073183034,"VIGIL, CASSIDY, DANAE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 54 , 115 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1073183232,"MILLER, ANNA, MCCALLUM",1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073183232,"MILLER, ANNA, MCCALLUM",5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 43 ,$#,,
MEDICAID DIRECT,1295113371,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER TABOR CITY,270 N US HIGHWAY 701 BYP   TABOR CITY NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073184396,"KOLLING, CRYSTAL, MARIE",270 N US HIGHWAY 701 BYP   TABOR CITY NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073184396,"KOLLING, CRYSTAL, MARIE",270 N US HIGHWAY 701 BYP   TABOR CITY NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588614168,ASHEVILLE NEUROLOGY SPECIALISTS PA,~,731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1073185146,"LYMPANY, SARAH, HATTON",731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 165 , 209 , 340 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073187605,"KLINE, ADAM, ZACHARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 90 , 90 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073189841,"VANG, LISA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073189916,"RAHM, JESSICA, ANN",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 85 , 86 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073189916,"RAHM, JESSICA, ANN",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1073189916,"RAHM, JESSICA, ANN",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073189916,"RAHM, JESSICA, ANN",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 57 , 57 ,$#,,
MEDICAID DIRECT,1265430854,GRANVILLE HEALTH SYSTEM,SOUTH GRANVILLE PRIMARY CARE,1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073190203,"LATULIP, NICOLE, MARIE",1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 12 , 17 , 23 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073192506,"CADDELL, TAYLOR, RYAN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073192506,"CADDELL, TAYLOR, RYAN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073193355,"JACOB, GIUSEPPINA, ANDRAWIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073193355,"JACOB, GIUSEPPINA, ANDRAWIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1073193520,LIGHTPOINT CORPORATION,,5700 EXECUTIVE CENTER DR STE 214 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1073193520,LIGHTPOINT CORPORATION,5700 EXECUTIVE CENTER DR STE 214 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 113 ," 24,377 "," 24,379 "," $1,537,868.52 ",,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1073196499,"WOOLARD, TAYLOR, NICHOLE",2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1073196499,"WOOLARD, TAYLOR, NICHOLE",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 52 , 108 ,$#,,
MEDICAID DIRECT,1073198776,ROPHE OF THE CAROLINAS,,2108 CAPITAL DR STE 102 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1073198776,ROPHE OF THE CAROLINAS,2108 CAPITAL DR STE 102 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#, 564 , 568 ," $67,632.48 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073199808,"KOPER, JARRETT, ABRAM",2101 OAKHEART RD   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073203857,"GEORGE, WREN, MARIE",1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 59 , 94 ,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073203857,"GEORGE, WREN, MARIE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1073216297,AMERICARES ADULT HOMES INC,,103 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073216297,AMERICARES ADULT HOMES INC,103 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 1,672 "," 1,672 "," $122,240.76 ",,
MEDICAID DIRECT,1073216297,AMERICARES ADULT HOMES INC,,101 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073216297,AMERICARES ADULT HOMES INC,103 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1073216297,AMERICARES ADULT HOMES INC,,103 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073216297,AMERICARES ADULT HOMES INC,105 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1073216297,AMERICARES ADULT HOMES INC,,101 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073216297,AMERICARES ADULT HOMES INC,105 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1073216297,AMERICARES ADULT HOMES INC,,105 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073216297,AMERICARES ADULT HOMES INC,105 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,032 "," 1,032 "," $71,530.76 ",,
MEDICAID DIRECT,1073216297,AMERICARES ADULT HOMES INC,,103 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073216297,AMERICARES ADULT HOMES INC,101 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1073216297,AMERICARES ADULT HOMES INC,,101 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073216297,AMERICARES ADULT HOMES INC,101 ANNIE PARKER CIR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 28 ," 4,366 "," 4,366 "," $334,690.61 ",,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073217451,"CHAMBERLAIN, HEATHER, DANIELLE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073217451,"CHAMBERLAIN, HEATHER, DANIELLE",29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1073221248,"ORTEGA, KOURTNEY, QUINN",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073223632,"WOMBLE, EMILY, LOUISE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 114 , 125 , 418 ," $19,012.24 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1073223632,"WOMBLE, EMILY, LOUISE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,6310 BEACH DR SW   OCEAN ISLE BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073223632,"WOMBLE, EMILY, LOUISE",6310 BEACH DR SW   OCEAN ISLE BEACH NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073223632,"WOMBLE, EMILY, LOUISE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 48 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1073226668,"DIDIO, EMILY, A",534 CARATOKE HWY   MOYOCK NC,027,Currituck,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 24 , 42 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 222A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073226668,"DIDIO, EMILY, A",300 MEDICAL PKWY STE 222A CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073227583,"WASOWSKI, KATHERINE, MARYANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1073227583,"WASOWSKI, KATHERINE, MARYANN",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073227831,"GLOAD, TAYLOR, ALEXANDER",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073232476,"ELLIOTT, AMY, LOUISE",2525 COURT DR   GASTONIA NC,036,Gaston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1073235529,"WARREN, MARIA, PAULA",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073235529,"WARREN, MARIA, PAULA",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073235529,"WARREN, MARIA, PAULA",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1073235529,"WARREN, MARIA, PAULA",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073240578,"CAMASTRO, HANNAH, ROSE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073244356,"FUQUAY, JILLIAN, ANTONIA",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 38 , 66 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073244356,"FUQUAY, JILLIAN, ANTONIA",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073244356,"FUQUAY, JILLIAN, ANTONIA",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073244729,"HARVEY, ANNA, ELIZABETH",MEDICAL CENTER BLVD 7TH FLOOR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 41 , 43 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073246203,"GOODRUM, HANNAH, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073246203,"GOODRUM, HANNAH, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295460228,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT MOCKSVILLE ELEMENTARY,295 CEMETERY ST   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073247219,"YOUMANS, REGINA, ELIZABETH",3437 US HIGHWAY 601 N   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 39 , 39 ," $10,351.26 ",,
MEDICAID DIRECT,1750999496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT DAVIE COUNTY HIGH,180 WAR EAGLE DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073247219,"YOUMANS, REGINA, ELIZABETH",3437 US HIGHWAY 601 N   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073247219,"YOUMANS, REGINA, ELIZABETH",3437 US HIGHWAY 601 N   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073247466,"WEGMAN, MEGAN, ELISE",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 24 , 43 , 116 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073247466,"WEGMAN, MEGAN, ELISE",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1457833469,S VAKIL DDS MS II PA,GROWING SMILES PEDIATRIC DENTISTRY,11223 DAVINCI DR   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073247805,"COOPER, SHAMUS, LUKE",6331 CARMEL RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",6331 CARMEL RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 40 ,$#,,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 33 , 33 , 689 ," $58,004.78 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 32 , 32 , 695 ," $64,128.42 ",,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",6331 CARMEL RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 20 ,$#,,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 31 , 31 , 663 ," $57,405.39 ",,
MEDICAID DIRECT,1457833469,S VAKIL DDS MS II PA,GROWING SMILES PEDIATRIC DENTISTRY,11223 DAVINCI DR   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",6331 CARMEL RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 94 , 98 , 468 ," $15,183.20 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",6331 CARMEL RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 78 ,$#,,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1073247805,"COOPER, SHAMUS, LUKE",3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 355 , 362 ," 1,297 "," $46,075.37 ",,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073248472,"BAAH, VERONICA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073248472,"BAAH, VERONICA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073252532,"SCHWARTZ, ROBERT, LEWIS",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073252532,"SCHWARTZ, ROBERT, LEWIS",1090 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073255097,SPRING ARBOR ROCKY MOUNT NC TENANT,SPRING ARBOR OF ROCKY MOUNT,1251 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073255097,SPRING ARBOR ROCKY MOUNT NC TENANT,1251 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 3,738 "," 3,738 "," $260,714.24 ",,
MEDICAID DIRECT,1659642395,LANE AND ASSOCIATES XXV DDS PA,,1117 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1073255642,"FURIMSKY, TROY, DAVID",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 712 ," 1,065 "," 3,429 "," $148,997.16 ",,
MEDICAID DIRECT,1497465207,LANE AND ASSOCIATES XLV DDS PA,,1310 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073255642,"FURIMSKY, TROY, DAVID",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 115 , 181 , 413 ," $29,792.28 ",,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073257424,"SLUSSER, SCOTT, MICHAEL",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073260360,"SAGE, HALEY, BROOKE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073260360,"SAGE, HALEY, BROOKE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073260360,"SAGE, HALEY, BROOKE",1200 N ELM ST MOSES CONE MEMORIAL HOSPITAL GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073260477,"GASKINS JR, AARON, JOSEPH THOMAS",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073260626,"BEKAMPIS, ANGELA, NICOLE",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073260626,"BEKAMPIS, ANGELA, NICOLE",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073260626,"BEKAMPIS, ANGELA, NICOLE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073261640,"ADEWOYIN, ABIDEMI",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1073268413,"MCCREA, EMILY, RIDGELY",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4191 THE CIRCLE AT NORTH HILLS ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073268413,"MCCREA, EMILY, RIDGELY",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073269312,"COX, DANAE, AIMEE",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073270047,"SCHWEIGART, GABRIELLE, ANN",120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 142 , 146 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073270047,"SCHWEIGART, GABRIELLE, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 89 , 102 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073270047,"SCHWEIGART, GABRIELLE, ANN",1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 28 , 39 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073270047,"SCHWEIGART, GABRIELLE, ANN",1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 52 , 62 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073270047,"SCHWEIGART, GABRIELLE, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 26 ,$#,,
MEDICAID DIRECT,1336292556,TRIAD BEHAVIORAL RESOURCES PC,,12 N 5TH AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073270500,"MINTER, PRINCESS, PRICE",12 N 5TH AVE   WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1336292556,TRIAD BEHAVIORAL RESOURCES PC,,6626 GORDON RD STE C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073270500,"MINTER, PRINCESS, PRICE",6626 GORDON RD STE C WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#, 14 ,$#,,
MEDICAID DIRECT,1336292556,TRIAD BEHAVIORAL RESOURCES PC,,6626 GORDON RD STE C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073270500,"MINTER, PRINCESS, PRICE",3019 FALSTAFF RD   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#, 16 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1073281432,"RASMUSSEN, ELIZABETH, MOORE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 43 , 82 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1073281432,"RASMUSSEN, ELIZABETH, MOORE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 30 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073285193,"PALMER, HANNAH, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 29 , 30 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1073286001,"PAUDEL, RUBINA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073286001,"PAUDEL, RUBINA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 88 , 89 ,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073287264,"MARTINEZ, ALEX, COLBY",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073291233,"GOMEZ, CLAUDIA, LUCIA",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073291340,"KELLY, KAYTE, LEE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1073291340,"KELLY, KAYTE, LEE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073295473,"MORRIS, KRISTINA, GAYLE",322 MAIN ST   PROSPECT HILL NC,017,Caswell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073296786,"HOLDER, SKYLAR, SELENE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 21 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073296786,"HOLDER, SKYLAR, SELENE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1073296836,"BYRD, MCKENLEY, LANDRIS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 33 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073297081,"FOY-MORRISON, SHAMARRIA, JANEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 114 , 114 ,$#,,
MEDICAID DIRECT,1073297156,COMP SERV HEALTH NORTH CAROLINA,,3971 BUSINESS 17 E   BOLIVIA NC,010,Brunswick,253Z00000X,Agencies,In Home Supportive Care,,1073297156,COMP SERV HEALTH NORTH CAROLINA,3971 BUSINESS 17 E   BOLIVIA NC,010,Brunswick,253Z00000X,Agencies,In Home Supportive Care,,#, 71 , 71 ,$#,,
MEDICAID DIRECT,1073299921,HELPING IS SIMPLY CARING,SIMPLY CARING,117 N CENTER ST STE C STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1073299921,HELPING IS SIMPLY CARING,117 N CENTER ST STE C STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,#, 796 , 820 ," $111,167.44 ",,
MEDICAID DIRECT,1073321816,GRAYS HEALTH SOLUTIONS LLC,,9711 DAVID TAYLOR DR STE 213 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1073321816,GRAYS HEALTH SOLUTIONS LLC,9711 DAVID TAYLOR DR STE 213 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 350 , 350 ," $22,069.88 ",,
MEDICAID DIRECT,1073325445,"DOUB, ANDREA MAE, DORSCH",,607 S MAIN ST # E KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1073325445,"DOUB, ANDREA MAE, DORSCH",607 S MAIN ST # E KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073332631,"ROTHFUSS, JACOB, TODD",1319 SPERO RD STE 100-C   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 42 , 61 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073332631,"ROTHFUSS, JACOB, TODD",1319 SPERO RD STE 100-C   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073332821,"FAZZOLARE, MADISON, RENEE",322 MAIN ST   PROSPECT HILL NC,017,Caswell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073336285,"QUINNEY, GRACE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073345864,"RILEY, ASHLEY, JOAN",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1073347159,"PILEWSKI, KYLER, PATRICK",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255456794,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER GOLDSBORO,2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073350617,"BAILEY, BRITTANY, KIMBERLY-ANN",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477828788,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,2359 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073359345,"CRISP, MEGAN, HENTSCHEL",2359 SPRINGS RD NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1770858938,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1 TRADE ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073359345,"CRISP, MEGAN, HENTSCHEL",1 TRADE ST   GRANITE FALLS NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 26 , 40 ,$#,,
MEDICAID DIRECT,1770858938,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1 TRADE ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073359345,"CRISP, MEGAN, HENTSCHEL",2359 SPRINGS RD NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770858938,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1 TRADE ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073359345,"CRISP, MEGAN, HENTSCHEL",1 TRADE ST   GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 34 ,$#,,
MEDICAID DIRECT,1477828788,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,2359 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073359345,"CRISP, MEGAN, HENTSCHEL",2359 SPRINGS RD NE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073365284,"NUSBAUM, JENNIFER, FRANCES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1073365284,"NUSBAUM, JENNIFER, FRANCES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073365284,"NUSBAUM, JENNIFER, FRANCES",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073365284,"NUSBAUM, JENNIFER, FRANCES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1073367058,"MUSSELMAN, ROMAN, CHRISTOPHER",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073369138,"MIZELL, COLEY, BENTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073369138,"MIZELL, COLEY, BENTON",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073369138,"MIZELL, COLEY, BENTON",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073369138,"MIZELL, COLEY, BENTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073369138,"MIZELL, COLEY, BENTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073373338,"THOMAS, DANIELLA, MAE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 66 , 253 , 264 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073374559,"BEARDEN, KRISTIN, NOEL TOWNSEND",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1689125858,RDMG ASSOCIATES PA,SEASIDE WELLNESS OF SHALLOTTE,4503 MAIN ST UNIT 1 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073375481,"NICHOLSON, HANNAH, CARROLL",4503 MAIN ST STE 1 SHALLOTTE NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 33 , 67 , 117 ,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073375648,"JACKSON, BRITTANY, EVANS",514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 18 , 19 ,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073375648,"JACKSON, BRITTANY, EVANS",514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1073375648,"JACKSON, BRITTANY, EVANS",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1073375648,"JACKSON, BRITTANY, EVANS",1106 SUNSET AVE   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1073375648,"JACKSON, BRITTANY, EVANS",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1073376984,"BRUGGEMAN, TAMI, JO",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 33 , 95 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073378055,"HARRISON, MYAH, ABRIELLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073378055,"HARRISON, MYAH, ABRIELLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 ,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073380556,"HARRELL, BROOKE, MACKENZIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 59 , 60 ,$#,,
MEDICAID DIRECT,1073385902,CAPITAL HOME CARE LLC,,104 S WHITE ST STE 100 WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1073385902,CAPITAL HOME CARE LLC,104 S WHITE ST STE 100 WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,302 "," 1,302 "," $77,555.96 ",,
MEDICAID DIRECT,1730343922,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,136 S PARK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1073389391,"POHLHAUS, AMBER, NICOLE",136 S PARK ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 36 , 47 ,$#,,
MEDICAID DIRECT,1487487807,LOTUS CENTER OF HEALTH PLLC,,1721 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073389391,"POHLHAUS, AMBER, NICOLE",1721 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073393872,"ATKINSON, BRITTANY, YOUNTS",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 24 , 42 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073393872,"ATKINSON, BRITTANY, YOUNTS",1550 FAULK ST STE 3100 MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 119 , 201 ,$#,,
MEDICAID DIRECT,1952030652,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-611B FIFTH AVENUE WEST,611 B FIFTH AVE W   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073395711,"FOWLER, EMILY, BROOKE",611 5TH AVE W STE B HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 27 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1073395968,"DORESTANT, FRANTZ",555 FAYETTEVILLE ST   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 27 , 165 , 167 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3416 POOLE RD STE 120 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073399366,"GAITHER, NOELLE",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 105 , 173 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073399366,"GAITHER, NOELLE",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1568643583,CAROMONT MEDICAL GROUP INC,INFECTIOUS DISEASE ASSOCIATES,2555 COURT DR STE 350 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1073500765,"MARISIDDAIAH, HARISH",2525 COURT DR   GASTONIA NC,036,Gaston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 159 , 315 , 356 ,$#,,
MEDICAID DIRECT,1568643583,CAROMONT MEDICAL GROUP INC,INFECTIOUS DISEASE ASSOCIATES,2555 COURT DR STE 350 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073500765,"MARISIDDAIAH, HARISH",2525 COURT DR   GASTONIA NC,036,Gaston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,,,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1073501367,"BUEBEL, MICHAEL, SCOTT",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073501367,"BUEBEL, MICHAEL, SCOTT",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1073501367,"BUEBEL, MICHAEL, SCOTT",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073501367,"BUEBEL, MICHAEL, SCOTT",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1073502068,"CENDER, CRAIG, JOSEPH",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1073502068,"CENDER, CRAIG, JOSEPH",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 62 , 105 , 158 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1073502936,"CAMPBELL, MARIE, GRAHAM",619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 94 , 243 , 347 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1073502936,"CAMPBELL, MARIE, GRAHAM",4384 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1073503256,"MURPHY, LAURA, ANNE MARGARET",4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073503413,"FIALLO, AMPARITO, IVONE",303 GREEN ST E   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 234 , 637 , 646 ," $19,259.62 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073504221,"KRAUS, ERIC, MARSHALL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 44 , 73 , 87 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073506572,"BIRD, KIMBERLY, COATES",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1073507687,"PATTERSON, ROLVIX, HARLAN",200 STONEBRIDGE SQ   HAVELOCK NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1073507687,"PATTERSON, ROLVIX, HARLAN",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 35 , 52 , 88 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1073507687,"PATTERSON, ROLVIX, HARLAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 16 , 18 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1073509618,"CUPO, WILLIAM, WALTER",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073509618,"CUPO, WILLIAM, WALTER",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073509618,"CUPO, WILLIAM, WALTER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1073509618,"CUPO, WILLIAM, WALTER",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",111 DORSETT DR   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",203 NE CONNECTOR   ALBEMARLE NC,084,Stanly,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 21 , 21 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",611 MOCKSVILLE AVE STE 202 SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 16 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",203 NE CONNECTOR   ALBEMARLE NC,084,Stanly,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 44 , 44 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",203 NE CONNECTOR   ALBEMARLE NC,084,Stanly,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 66 , 68 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 38 , 66 , 98 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 42 , 61 , 150 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073510046,"WOOLWINE, NATHAN, ASHLEY",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 18 , 43 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073510657,"PATEL, SANDIP, JAYANT",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073510657,"PATEL, SANDIP, JAYANT",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 42 , 52 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073510657,"PATEL, SANDIP, JAYANT",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 684 , 708 , 881 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1073510848,"MILLER, WILLIAM, DONALD",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 28 , 39 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1073510848,"MILLER, WILLIAM, DONALD",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 73 , 100 , 104 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073510863,"HUDERLY, DEBERA, LYNNE",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073510863,"HUDERLY, DEBERA, LYNNE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 36 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073510863,"HUDERLY, DEBERA, LYNNE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1073510863,"HUDERLY, DEBERA, LYNNE",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 83 , 87 , 109 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1073510863,"HUDERLY, DEBERA, LYNNE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 23 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1073510863,"HUDERLY, DEBERA, LYNNE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 44 , 66 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073510863,"HUDERLY, DEBERA, LYNNE",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073511234,"MCDEVITT JR, GORDON, ROBERTS",409C COOPER DR   CLINTON NC,082,Sampson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174521330,CLINTON X RAY ASSOCIATES PA,Clinton X Ray Associates PA,409C COOPER DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1073511234,"MCDEVITT JR, GORDON, ROBERTS",409C COOPER DR   CLINTON NC,082,Sampson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1174521330,CLINTON X RAY ASSOCIATES PA,Clinton X Ray Associates PA,409C COOPER DR   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1073511234,"MCDEVITT JR, GORDON, ROBERTS",409C COOPER DR   CLINTON NC,082,Sampson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 466 , 894 ," 1,274 "," $16,074.83 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073511234,"MCDEVITT JR, GORDON, ROBERTS",409C COOPER DR   CLINTON NC,082,Sampson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073511382,"BOWER, EDWARD, BIRCH",600 HOSPITAL DRIVE   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 64 , 227 , 283 ,$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073511382,"BOWER, EDWARD, BIRCH",1423 E FRANKLIN ST STE B MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1073512984,"JONSSON, SVEN, THOMAS",123 E MAIN ST STE 102 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 35 , 47 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1073512984,"JONSSON, SVEN, THOMAS",123 E MAIN ST STE 102 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 61 , 86 ,$#,,
MEDICAID DIRECT,1720546732,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,,,Unknown,251B00000X,Agencies,Case Management,,1073512984,"JONSSON, SVEN, THOMAS",123 E MAIN ST STE 102 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073513388,"LESTER, SUSAN, MICHELLE STEPHEN",8930 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376893057,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PRIMARY CARE CHARLOTTE INTERNAL MEDI,400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073513388,"LESTER, SUSAN, MICHELLE STEPHEN",400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073513388,"LESTER, SUSAN, MICHELLE STEPHEN",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 49 , 75 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073513875,"SKASKIW, ANNA",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 33 , 111 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073513875,"SKASKIW, ANNA",1106 MAIN STREET EXT   SWANSBORO NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 66 , 126 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073513875,"SKASKIW, ANNA",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 18 , 32 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073513875,"SKASKIW, ANNA",319 WB MCLEAN DR.   CAPE CARTERET NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073517041,"CRAWFORD, MALORIE, SUSAN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 30 , 31 ,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073518064,"RICCIARDELLI, EDWARD, JOSEPH",1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",800 TILGHMAN DR   DUNN NC,043,Harnett,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 44 , 53 , 57 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 41 , 44 , 49 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",169 RAWLS RD   ANGIER NC,043,Harnett,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 33 , 34 , 40 ,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 38 , 44 , 50 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 25 , 27 , 33 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1073518254,"ROBERTS JR, LEROY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",3186 VILLAGE DRIVE   FAYETTEVILLE NC,026,Cumberland,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 256 , 307 , 357 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1073518254,"ROBERTS JR, LEROY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073518254,"ROBERTS JR, LEROY",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073518460,"REESE, KEVIN, JOHN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 66 , 76 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073518460,"REESE, KEVIN, JOHN",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073518460,"REESE, KEVIN, JOHN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1073518460,"REESE, KEVIN, JOHN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1831208867,CAROLINA NEUROLOGY ASSOCIATES PLLC,,2500 VILLAGE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073518494,"GADIPUDI, VENUGOPAL, NAIDU",2500 VILLAGE DR STE 102 FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 113 , 287 , 289 ,$#,,
MEDICAID DIRECT,1235134958,STANLY COUNTY IMAGING PLLC,~,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1073518700,"GREEN, JOHN, LINDSAY",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 267 , 369 , 515 ,$#,,
MEDICAID DIRECT,1073519062,"POWELL, JEFFREY, ALAN",JEFFREY ALAN POWELL DBA CALDWELL CHIROPRACTIC CENT,3330 HICKORY BLVD   HUDSON NC,014,Caldwell,111N00000X,Chiropractic Providers,Chiropractor,,1073519062,"POWELL, JEFFREY, ALAN",3330 HICKORY BLVD   HUDSON NC,014,Caldwell,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073519385,"CAMPBELL, PAUL, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 37 , 42 , 95 ," $10,045.11 ",,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073519385,"CAMPBELL, PAUL, THOMAS",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073519393,"GERADTS, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1073519450,"GONZALEZ, MICHAEL, BRYAN",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 67 , 131 , 425 ," $18,110.56 ",,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,111 HILLTOP ST   RUTHERFORD COLLEGE NC,012,Burke,193400000X,Group,Single Specialty,,1073519450,"GONZALEZ, MICHAEL, BRYAN",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,111 HILLTOP ST   RUTHERFORD COLLEGE NC,012,Burke,193400000X,Group,Single Specialty,,1073519450,"GONZALEZ, MICHAEL, BRYAN",111 HILLTOP ST   RUTHERFORD COLLEGE NC,012,Burke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073519542,"DEHLINGER, ERIK",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073519690,"GASKINS, RAYMOND, ALBERT",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073519690,"GASKINS, RAYMOND, ALBERT",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1073519690,"GASKINS, RAYMOND, ALBERT",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073519880,"EKANGAKI, RUTH, MOKEBA",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 21 , 22 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1073519880,"EKANGAKI, RUTH, MOKEBA",781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073519880,"EKANGAKI, RUTH, MOKEBA",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073519880,"EKANGAKI, RUTH, MOKEBA",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 17 , 22 ,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073521605,"BELTON, DARNIYA, POWE",3193 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073521605,"BELTON, DARNIYA, POWE",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1194714626,ATLANTIC PULMONARY ASSOCIATES PA,ATLANTIC PULMONARY ASSOCIATES PA,111 MEDICAL DR STE A ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073524146,"HEYDER, ALBRECHT, MARK",111 MEDICAL DR STE A ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 87 , 186 , 187 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073524443,"BARROW, KENNETH, WAYNE",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 38 , 39 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1073524443,"BARROW, KENNETH, WAYNE",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1073524443,"BARROW, KENNETH, WAYNE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073524443,"BARROW, KENNETH, WAYNE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 55 , 58 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073527792,"BATTLE, KATHRYN, LEE",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073528808,"BENDEZU II, LUIS, ARTURO",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073528808,"BENDEZU II, LUIS, ARTURO",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1073528808,"BENDEZU II, LUIS, ARTURO",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073528808,"BENDEZU II, LUIS, ARTURO",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1073528832,"ALZAMORA, FABIAN, EDUARDO",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 85 , 93 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073529269,"MILES, WILLIAM, SCHERER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 77 , 221 , 245 ," $26,637.95 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073529269,"MILES, WILLIAM, SCHERER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1073530218,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1027,150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1073530218,WAL-MART STORES EAST LP,150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1073530242,WAL-MART STORES EAST LP,WALMART PHARMACY 10-2704,1021 HIGH POINT ST   RANDLEMAN NC,076,Randolph,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1073530242,WAL-MART STORES EAST LP,1021 HIGH POINT ST   RANDLEMAN NC,076,Randolph,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073530655,"COOPERBERG, CHARLES, IAN",3516 TRICENTER BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 80 , 80 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1073530655,"COOPERBERG, CHARLES, IAN",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073530655,"COOPERBERG, CHARLES, IAN",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 83 , 254 , 305 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073530655,"COOPERBERG, CHARLES, IAN",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073530655,"COOPERBERG, CHARLES, IAN",4016 FREEDOM LAKE DR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 64 , 64 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1073530655,"COOPERBERG, CHARLES, IAN",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073530655,"COOPERBERG, CHARLES, IAN",1620 WILLIAMSBORO ST   OXFORD NC,039,Granville,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 114 , 114 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073531083,"SECORD, ANGELES, ALVAREZ",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073531083,"SECORD, ANGELES, ALVAREZ",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073531083,"SECORD, ANGELES, ALVAREZ",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 15 , 39 , 42 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073531083,"SECORD, ANGELES, ALVAREZ",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073531083,"SECORD, ANGELES, ALVAREZ",2301 ERWIN RD   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073532743,"CROCKETT, TERRI, ADDINGTON",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073532743,"CROCKETT, TERRI, ADDINGTON",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073532743,"CROCKETT, TERRI, ADDINGTON",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073532743,"CROCKETT, TERRI, ADDINGTON",1321 E SUNSET DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700901436,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1073533246,"KALISH, MICHAEL, JOHN",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 34 , 47 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073533410,"LICHT, JASON, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073533477,"GROH, CHRISTOPHER, PAUL",1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 79 , 79 ,$#,,
MEDICAID DIRECT,1013352137,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,4515 PREMIER DR STE 405 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073533477,"GROH, CHRISTOPHER, PAUL",4515 PREMIER DR STE 405 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1073534475,"MATTHEWS, SCOTT, BUTLER",SCOTT BUTLER MATTHEWS,306 DARBY AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,1073534475,"MATTHEWS, SCOTT, BUTLER",306 DARBY AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 74 , 133 , 350 ," $12,301.84 ",,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,2977 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073534897,"DEW, JASON, SCOTT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 65 , 150 ,$#,,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073534897,"DEW, JASON, SCOTT",2977 CROUSE LN   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,1236 HUFFMAN MILL RD STE 2100 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073534897,"DEW, JASON, SCOTT",1236 HUFFMAN MILL RD STE 2100 BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 181 , 279 , 444 ," $13,849.57 ",,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073534897,"DEW, JASON, SCOTT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,2977 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073534897,"DEW, JASON, SCOTT",2977 CROUSE LN   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073535548,COLUMBUS CO SCHOOLS,,817 WASHINGTON ST   WHITEVILLE NC,024,Columbus,251300000X,Agencies,Local Education Agency (LEA),,1073535548,COLUMBUS CO SCHOOLS,817 WASHINGTON ST   WHITEVILLE NC,024,Columbus,251300000X,Agencies,Local Education Agency (LEA),, 18 , 56 , 56 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073536074,"ELENDU, SEBASTINE, IZUCHUKWU",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 24 , 61 , 66 ,$#,,
MEDICAID DIRECT,1326031485,COASTAL CAROLINA FAMILY PRACTICE PA,~,600 S CHURCH ST   HERTFORD NC,072,Perquimans,193400000X,Group,Single Specialty,,1073536512,"WOODARD, NATALIE, BEASLEY",600 S CHURCH ST   HERTFORD NC,072,Perquimans,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073537494,NORTHWESTERN DRUG CO INC,PEOPLES DRUG STORE,255 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1073537494,NORTHWESTERN DRUG CO INC,255 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073538245,"SHORES, LILLIAN, CARLA",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073538245,"SHORES, LILLIAN, CARLA",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073538245,"SHORES, LILLIAN, CARLA",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 31 , 32 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073538245,"SHORES, LILLIAN, CARLA",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 50 , 64 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073538328,"BAILEY, DWIGHT, MERRITT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 25 , 60 , 83 ," $17,849.68 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073538328,"BAILEY, DWIGHT, MERRITT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073538344,"ROGERS, MARY, KATHRYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073538344,"ROGERS, MARY, KATHRYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1942637319,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS OF THE CAROLIN,2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073538591,"SUTTON, MONIQUE, ANGELA",2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 62 , 119 , 133 ," $13,796.11 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 29 , 41 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073540209,"WALLACE, TODD",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 26 ,$#,,
MEDICAID DIRECT,1982632915,UNC ORAL & MAXILLOFACIAL PATHOLOGY,~,140 DENTAL CIR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073540357,"PADILLA, RICARDO, JOSE",150 DENTAL CIR CB 7450 CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 24 , 25 , 32 ,$#,,
MEDICAID DIRECT,1982632915,UNC ORAL & MAXILLOFACIAL PATHOLOGY,~,140 DENTAL CIR   CHAPEL HILL NC,068,Orange,291U00000X,Laboratories,Clinical Medical Laboratory,,1073540357,"PADILLA, RICARDO, JOSE",150 DENTAL CIR CB 7450 CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073541678,"SWAYZE, AVA, MARLENE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073541678,"SWAYZE, AVA, MARLENE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073541678,"SWAYZE, AVA, MARLENE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 31 , 31 ,$#,,
MEDICAID DIRECT,1073542452,"WEEKS, HASSELL, HOWARD",H HOWARD WEEKS DDS PA,615 E NASH ST   SPRING HOPE NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,1073542452,"WEEKS, HASSELL, HOWARD",615 E NASH ST   SPRING HOPE NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 23 , 60 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073542502,"PRESTON, JENNIFER, HITCH",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 41 , 48 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1073543328,"MITCHELL, TROY, MICHAEL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 34 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073543443,"MCCAFFREY, SEAN, ANDREW",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 76 , 78 , 89 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 23 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 65 , 82 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073543609,"PLEASURE, JOSHUA, CHARLES",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073543831,"KELLY, JASON, PATRICK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073543831,"KELLY, JASON, PATRICK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073544359,"LOWDER, LAURA, HINES",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073544359,"LOWDER, LAURA, HINES",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073545612,"KNAPP, BARRY, J",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073545612,"KNAPP, BARRY, J",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073547071,"TEITELMAN, MELISSA, GAIL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073547071,"TEITELMAN, MELISSA, GAIL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073547071,"TEITELMAN, MELISSA, GAIL",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073547071,"TEITELMAN, MELISSA, GAIL",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073547071,"TEITELMAN, MELISSA, GAIL",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073547071,"TEITELMAN, MELISSA, GAIL",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1073548996,"CLARK, TRACI, DAWN MCDERMOTT",~,224 N FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,111N00000X,Chiropractic Providers,Chiropractor,,1073548996,"CLARK, TRACI, DAWN MCDERMOTT",224 N FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,111N00000X,Chiropractic Providers,Chiropractor,, 11 , 23 , 28 ,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073551859,"THOMPSON, FORREST, LEIGH",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1073551859,"THOMPSON, FORREST, LEIGH",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 34 , 34 ,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073551859,"THOMPSON, FORREST, LEIGH",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073553160,"STEVONS, ALISON, SHANNONHOUSE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 42 , 42 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073553178,"YODER, JONATHAN, SCOTT",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 88 , 128 , 216 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073553525,"PATTERSON, DAVID, WAYNE",2874 WARD BLVD   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 63 , 78 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073553525,"PATTERSON, DAVID, WAYNE",532 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073553913,"WOOD, JOHN, SCOTT",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 24 , 38 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073553913,"WOOD, JOHN, SCOTT",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073554176,"ISAACS, LAWRENCE, ERIC",,129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1073554176,"ISAACS, LAWRENCE, ERIC",129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770624637,FOOTHILLS CONSULTING ASSOCIATES PLL,FOOTHILLS CONSULTING ASSOCIATES LLC,1610 E MARION ST STE 250 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1073554663,"DUNLAP, ANDREA, MARIE",1610 E MARION ST STE 250 SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 94 , 96 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073556965,"LIPINSKI, MARIANN, STREUSSNIG",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073557195,"GOLDBLATT, EMILY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1073557195,"GOLDBLATT, EMILY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073557195,"GOLDBLATT, EMILY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073557195,"GOLDBLATT, EMILY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073557195,"GOLDBLATT, EMILY",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1073557195,"GOLDBLATT, EMILY",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073557633,"COLADONATO, JOSEPH, ANTHONY",309 NEW ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 182 , 537 , 567 ," $16,729.64 ",,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073557633,"COLADONATO, JOSEPH, ANTHONY",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 33 , 34 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073558011,"DONOVAN, MARGUERITA, ROSE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1073558193,"CHIU, DAVID",3812 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1073558193,"CHIU, DAVID",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1700052289,BLADEN HEALTHCARE LLC,CFV BLADEN SURGICAL SPECIALISTS,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,193400000X,Group,Single Specialty,,1073559654,"BEUTEL, WILLIAM, DEAN",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1700052289,BLADEN HEALTHCARE LLC,CFV BLADEN SURGICAL SPECIALISTS,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,193400000X,Group,Single Specialty,,1073559654,"BEUTEL, WILLIAM, DEAN",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073560272,"BENECK, STACEY, ANN",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 86 , 116 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD # 140 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073560272,"BENECK, STACEY, ANN",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073560538,"HENSEL, WILLIAM, ARTHUR",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073560538,"HENSEL, WILLIAM, ARTHUR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073561171,"MORSE, GARY, WAYNE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073561171,"MORSE, GARY, WAYNE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073561171,"MORSE, GARY, WAYNE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073562435,"OLIVER, PATRICIA, MARTELLE",600 HOSPITAL DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073562435,"OLIVER, PATRICIA, MARTELLE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073563011,"MOSES, VEDWATTIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073563011,"MOSES, VEDWATTIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073563557,"ARNETTE, RHONDA, KAYE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1609515220,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-6503 BREVARD ROAD,6503 BREVARD RD   ETOWAH NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073564100,"SALDUTTI, STEVEN, ROSS",6503 BREVARD RD   ETOWAH NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 85 , 95 ,$#,,
MEDICAID DIRECT,1730301037,JAIME E TRUJILLO MD PA,JAIME E TRUJILLO MD PA JAIME E TRUJILLO MD PA,3080 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073564399,"TRUJILLO, JAIME, EMILIO",3080 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 200 , 716 ," 1,426 "," $16,304.33 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073565552,"IDOL, JULIE, LYNN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073565552,"IDOL, JULIE, LYNN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 27 ,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1073566014,"TILT, ELIZABETH, ELLEN",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 13 , 37 ,$#,,
MEDICAID DIRECT,1437102381,CENTER FOR PEDIATRIC AND ADOLESCENT,CENTER FOR PEDIATRIC AND ADOLESCENT MEDICINE PA,136 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1073566014,"TILT, ELIZABETH, ELLEN",136 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 16 , 33 ,$#,,
MEDICAID DIRECT,1265719512,PIRATE PEDIATRICS PA,~,118 OAKMONT DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073566014,"TILT, ELIZABETH, ELLEN",136 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073566139,"HALES, EDWARD, WILLIAM",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073566139,"HALES, EDWARD, WILLIAM",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1073566766,"CAUDLE, ROBERT, JOSEPH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 24 , 30 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1073566766,"CAUDLE, ROBERT, JOSEPH",2007 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 26 , 35 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1073567764,"MIGNELLA, RONNIE, JOHN",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1073567764,"MIGNELLA, RONNIE, JOHN",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568200,"NABORS, EMILY, MARIE",142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 38 , 60 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568200,"NABORS, EMILY, MARIE",142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568200,"NABORS, EMILY, MARIE",142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568200,"NABORS, EMILY, MARIE",142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568200,"NABORS, EMILY, MARIE",142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568200,"NABORS, EMILY, MARIE",142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568200,"NABORS, EMILY, MARIE",142 PROFESSIONAL PARK DR STE 300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 48 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,417 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568283,"GROSS, THOMAS",417 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 66 , 108 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073568283,"GROSS, THOMAS",396 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1073569042,"COLOSIMO, BARBARA, ANNE-BERNATH",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 131 , 177 , 370 ," $14,673.49 ",,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073569158,"LEVIN, VADIM, A",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1033128822,UNIFOUR FAMILY PRACTICE PLLC,UNIFOUR FAMILY PRACTICE,2874 S NC 127 HWY   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1073569224,"ANDERSON, KENNETH, ALLEN",2874 S NC 127 HWY   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 35 , 73 ,$#,,
MEDICAID DIRECT,1073569679,LOVELL MEDICAL SUPPLY INC,~,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073569679,LOVELL MEDICAL SUPPLY INC,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 706 ," 5,006 "," 7,731 "," $156,243.95 ",,
MEDICAID DIRECT,1073569679,LOVELL MEDICAL SUPPLY INC,~,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1073569679,LOVELL MEDICAL SUPPLY INC,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1073569679,LOVELL MEDICAL SUPPLY INC,~,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073569679,LOVELL MEDICAL SUPPLY INC,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 11 ,,,$#,,
MEDICAID DIRECT,1073569679,LOVELL MEDICAL SUPPLY INC,~,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1073569679,LOVELL MEDICAL SUPPLY INC,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 115 , 583 ," 1,117 ",$#,,
MEDICAID DIRECT,1073571733,"SHAIKH, GHULAM, MURTAZA",~,171 MAST DR   GARNER NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1073571733,"SHAIKH, GHULAM, MURTAZA",171 MAST DR   GARNER NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 240 , 295 ,$#,,
MEDICAID DIRECT,1366124307,SHAIKH MEDICAL CLINIC PA,SHAIKH MEDICAL CLINIC PA,171 MAST DR   GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1073571733,"SHAIKH, GHULAM, MURTAZA",171 MAST DR   GARNER NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861451437,NEWTON FAMILY PHYSICIANS,~,767 W 1ST ST   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1073572210,"SHERFEY, SHANNON, MARIE HASZARD",767 W 1ST ST   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 42 , 80 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073572301,"CALHOUN, LINDA, PALMON",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 15 , 36 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073572301,"CALHOUN, LINDA, PALMON",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073572301,"CALHOUN, LINDA, PALMON",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073572301,"CALHOUN, LINDA, PALMON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 26 , 32 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073572301,"CALHOUN, LINDA, PALMON",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1073572301,"CALHOUN, LINDA, PALMON",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073572301,"CALHOUN, LINDA, PALMON",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073572301,"CALHOUN, LINDA, PALMON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073572301,"CALHOUN, LINDA, PALMON",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 24 , 55 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073572483,"KELLY, THERESA, LOUISE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 132 , 132 ,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073572533,"FEATHERSTON, MARK, WILLIAM",1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 34 , 47 ,$#,,
MEDICAID DIRECT,1073572533,"FEATHERSTON, MARK, WILLIAM",,1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1073572533,"FEATHERSTON, MARK, WILLIAM",1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073574604,"WILLIAMS, JOHN, TAYLOR",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 68 , 76 ,$#,,
MEDICAID DIRECT,1073574786,COUNTY OF BUNCOMBE OFFICE OF ACCOUN,BUNCOMBE COUNTY EMS,164 ERWIN HILLS RD   ASHEVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport,1073574786,COUNTY OF BUNCOMBE OFFICE OF ACCOUN,164 ERWIN HILLS RD   ASHEVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport," 1,879 "," 3,429 "," 5,974 "," $95,219.47 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073575908,"BROCK, ANDREA, GENTRY",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073575908,"BROCK, ANDREA, GENTRY",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073575908,"BROCK, ANDREA, GENTRY",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073575908,"BROCK, ANDREA, GENTRY",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073575908,"BROCK, ANDREA, GENTRY",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1073577326,"DEAN, SUSAN, JANE",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336382563,SPARTANBURG MEDICAL CENTER,MEDICAL GROUPOFTHECAROLINAS-VASCULARACCESSSERVICES,100 E WOOD ST STE 202 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073577698,"KRAMER, ARI, DAVID",100 E WOOD ST STE 202 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 88 , 110 ,$#,,
MEDICAID DIRECT,1073578019,BLUE RIDGE DAY SURGERY CENTER LP,BLUE RIDGE DAY SURGERY CENTER LP,2308 WESVILL CT   RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1073578019,BLUE RIDGE DAY SURGERY CENTER LP,2308 WESVILL CT   RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 117 , 146 , 193 ," $24,592.75 ",,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",100 W PARKVIEW DR   HENDERSON NC,091,Vance,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1881841518,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT SCOTLAND NECK,919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1952665929,RURAL HEALTH GROUP INC,Rural Health Group at Enfield,114 MARKET ST   ENFIELD NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",114 MARKET ST   ENFIELD NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 16 , 38 , 38 ,$#,,
MEDICAID DIRECT,1013157171,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT WHITAKERS,105 SE RAILROAD ST   WHITAKERS NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",105 SE RAILROAD ST   WHITAKERS NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962454447,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT RICH SQUARE,200 S MAIN ST   RICH SQUARE NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",200 S MAIN ST   RICH SQUARE NC,066,Northampton,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1689626178,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON,9425 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073578415,"STIMSON, KAREN, LEE",9425 NC HIGHWAY 305   JACKSON NC,066,Northampton,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1073578696,"DAVIS, BRENT, ALAN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073579066,"REYNOLDS, MICHAEL, LEROY",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 32 , 42 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073579066,"REYNOLDS, MICHAEL, LEROY",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 12 , 17 , 42 ,$#,,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073580338,"WILE, LAURA, HARGRAVES",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073580411,"STINE, RONALD, ARTHUR",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073580411,"STINE, RONALD, ARTHUR",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073580411,"STINE, RONALD, ARTHUR",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073580973,"SHEA, DAWN, MARIE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 107 , 176 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1073581898,"SMAROFF, GREGORY, GEORGE",960 NEWMAN RD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 27 , 27 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1073581898,"SMAROFF, GREGORY, GEORGE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073583548,"HERBERT, GARTH, STEPHEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073583548,"HERBERT, GARTH, STEPHEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073583548,"HERBERT, GARTH, STEPHEN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073583548,"HERBERT, GARTH, STEPHEN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,1550 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073584157,RISK OPTOMETRIC ASSOCIATES PA,1550 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 994 , 998 ," 1,982 "," $26,797.44 ",,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,7701 S RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073584157,RISK OPTOMETRIC ASSOCIATES PA,7701 S RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 830 , 859 ," 1,676 "," $22,738.32 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073585618,"SOLUM, ANNA, MELISSA",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 20 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073585618,"SOLUM, ANNA, MELISSA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 85 , 205 , 542 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073585618,"SOLUM, ANNA, MELISSA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 18 , 39 , 81 ,$#,,
MEDICAID DIRECT,1861881260,DANIEL GROSSMAN DDS PA,RALEIGH ORTHODONTICS,8200 CREEDMOOR RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073585915,"GROSSMAN, DANIEL, ELI",8200 CREEDMOOR RD   RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 163 ," 1,043 "," 1,235 "," $154,881.14 ",,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073586194,"SWIERSZ, ANGELICA, LYNN",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073586590,"CARTLEDGE, MICHAEL, HENRY",3106 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750482493,OPEN WATER MEDICAL PA,~,1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1073586590,"CARTLEDGE, MICHAEL, HENRY",1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4207 LAKE BOONE TRL STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073588000,"ST CLAIR, SAMUEL, KEITH",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073588000,"ST CLAIR, SAMUEL, KEITH",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073588620,"KOUBA, STEPHEN, HOWARD",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720793094,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY ORTHOPEDICS AND SPORTS MEDICINE,1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073588620,"KOUBA, STEPHEN, HOWARD",1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 88 , 143 , 284 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073589859,"LEONARD, SEAN, PATRICK",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 151 , 269 ,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073591806,"GILLESPIE, MAUREEN, MCLAUGHLIN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1073592200,"CARROLL, PAUL, JOSEPH",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1073592200,"CARROLL, PAUL, JOSEPH",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073592200,"CARROLL, PAUL, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 33 , 33 ,$#,,
MEDICAID DIRECT,1073592580,FEELING GREAT INC DBA,,4111 CAPITOL ST 4111 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073592580,FEELING GREAT INC DBA,4111 CAPITOL ST 4111 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 204 ," 1,082 "," 2,504 "," $46,388.58 ",,
MEDICAID DIRECT,1063151678,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1409 ASHEVILLE HIGHWAY,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073592770,"DE LA TORRE II, ERNESTO, ESTEBAN",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 80 , 109 ,$#,,
MEDICAID DIRECT,1720546732,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,,,Unknown,251B00000X,Agencies,Case Management,,1073592770,"DE LA TORRE II, ERNESTO, ESTEBAN",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073592903,"BISSETTE, STEPHEN, GLENN",165 LOWES FOODS DR   LEWISVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 39 , 81 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073592903,"BISSETTE, STEPHEN, GLENN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073592903,"BISSETTE, STEPHEN, GLENN",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073593067,"COLLINS, LAURA, BOOTH",SPEECH LANGUAGE ASSOCIATES,109 ASHTON LN   SALISBURY NC,080,Rowan,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1073593067,"COLLINS, LAURA, BOOTH",109 ASHTON LN   SALISBURY NC,080,Rowan,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 51 , 55 ,$#,,
MEDICAID DIRECT,1073593067,"COLLINS, LAURA, BOOTH",SPEECH LANGUAGE ASSOCIATES,310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1073593067,"COLLINS, LAURA, BOOTH",310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 86 , 86 ,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1073593646,"HARTMAN, ROBERT, ALLAN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 44 , 43 , 43 ,$#,,
MEDICAID DIRECT,1326669508,WESTERN CAROLINA SEDATION ASSOCIATE,,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073593646,"HARTMAN, ROBERT, ALLAN",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1073594412,"GOLDSTEIN, BETH, GOODRICH",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 33 , 82 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1073594412,"GOLDSTEIN, BETH, GOODRICH",1210 CENTRAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1210 CENTRAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1073594412,"GOLDSTEIN, BETH, GOODRICH",1210 CENTRAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1073595138,"TRIPP, MICHAEL, DAVID",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 107 , 119 , 177 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073595138,"TRIPP, MICHAEL, DAVID",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 69 , 81 , 116 ,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073595294,"SUAREZ, ELLIOT, DAMIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073595294,"SUAREZ, ELLIOT, DAMIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 35 , 36 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073595401,"CLARK, PETER, EARL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 18 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073595401,"CLARK, PETER, EARL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073595401,"CLARK, PETER, EARL",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 15 , 25 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1073596391,"SWITZER, BRUCE, DALE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 36 , 182 , 183 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073596391,"SWITZER, BRUCE, DALE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596516,"GENDRACHI JR, THOMAS, ERNEST",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 27 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596516,"GENDRACHI JR, THOMAS, ERNEST",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596516,"GENDRACHI JR, THOMAS, ERNEST",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596516,"GENDRACHI JR, THOMAS, ERNEST",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596516,"GENDRACHI JR, THOMAS, ERNEST",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596516,"GENDRACHI JR, THOMAS, ERNEST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596516,"GENDRACHI JR, THOMAS, ERNEST",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073596698,"TOROP, ANDRES, HENRY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073596698,"TOROP, ANDRES, HENRY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1604 MEDICAL DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1073596698,"TOROP, ANDRES, HENRY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073596698,"TOROP, ANDRES, HENRY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073596698,"TOROP, ANDRES, HENRY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,101 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1073596698,"TOROP, ANDRES, HENRY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073596698,"TOROP, ANDRES, HENRY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073596771,"ANZOLA, CARLOS, SAUL",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073597035,"KNUDSON, MARK, PAUL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1073598017,"DEFRANZO JR, ANTHONY, JOHN",10 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 20 , 30 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073598017,"DEFRANZO JR, ANTHONY, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 82 , 104 , 140 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073598686,"BUNDLE, MARY, ELIZABETH",107 S WILMINGTON ST   RICHLANDS NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073598686,"BUNDLE, MARY, ELIZABETH",114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 51 , 86 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073598868,"DIMMIG, THOMAS, ALVA",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073598934,"SWAFFORD, LESLIE, EUGENE",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 32 , 64 ,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073598934,"SWAFFORD, LESLIE, EUGENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710908041,YADKIN RIVER RADIOLOGY PA,YADKIN RIVER RADIOLOGY PA,122 WYNDHAM WAY   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1073599148,"STEARNS, BRENT, ASHLEY",180 PARKWOOD DR   ELKIN NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073599155,"MCNEIL, CHERYL, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 29 , 29 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073599155,"MCNEIL, CHERYL, LYNN",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073599569,"EAPEN, MARIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 58 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073601365,"VAN LE, LINDA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 18 , 26 , 32 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073601472,"GANTT, ANGELA, BRAWLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 171 , 176 , 186 ," $79,470.62 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073601472,"GANTT, ANGELA, BRAWLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073601472,"GANTT, ANGELA, BRAWLEY",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073601472,"GANTT, ANGELA, BRAWLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,520 MAPLE AVE STE C REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1073602348,"GRIFFIN, JENNIFER, APPLE",520 MAPLE AVE STE C REIDSVILLE NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1073602348,"GRIFFIN, JENNIFER, APPLE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 14 , 16 , 29 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073602348,"GRIFFIN, JENNIFER, APPLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 103 , 145 , 278 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 19 , 24 , 30 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 29 , 46 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073603486,"WILSON, JASON, AARON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1073606430,"MOSS, MARK, ERIC",100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 23 ,$#,,
MEDICAID DIRECT,1538563473,EAST CAROLINA UNIVERSITY,~,600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1073606430,"MOSS, MARK, ERIC",600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073606430,"MOSS, MARK, ERIC",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073608345,"LEE, CLARA, NAN HI",55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073608345,"LEE, CLARA, NAN HI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073608345,"LEE, CLARA, NAN HI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073608345,"LEE, CLARA, NAN HI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073608345,"LEE, CLARA, NAN HI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073608345,"LEE, CLARA, NAN HI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073608782,"BOYD, LAUREN, BROCK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073608782,"BOYD, LAUREN, BROCK",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073608782,"BOYD, LAUREN, BROCK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 53 , 56 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1073608782,"BOYD, LAUREN, BROCK",149 W PARKER RD   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073608782,"BOYD, LAUREN, BROCK",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1073611091,"NORTH, STEPHEN, WILLIAM",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073611091,"NORTH, STEPHEN, WILLIAM",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 30 , 30 ,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1073611091,"NORTH, STEPHEN, WILLIAM",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073611091,"NORTH, STEPHEN, WILLIAM",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073611091,"NORTH, STEPHEN, WILLIAM",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073612842,"BATES, THOMAS, EDWARD",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 26 , 46 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073612842,"BATES, THOMAS, EDWARD",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 64 , 129 , 230 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1073612842,"BATES, THOMAS, EDWARD",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073614400,"SHAH, SANJAY, BACHUBHAI",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073614400,"SHAH, SANJAY, BACHUBHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1073614400,"SHAH, SANJAY, BACHUBHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073614400,"SHAH, SANJAY, BACHUBHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 63 , 70 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073614400,"SHAH, SANJAY, BACHUBHAI",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1073614400,"SHAH, SANJAY, BACHUBHAI",800 TILGHMAN DR   DUNN NC,043,Harnett,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 39 , 42 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1073614400,"SHAH, SANJAY, BACHUBHAI",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1073614731,"BATTEN BRYAN, AMY, MICHELLE",~,2300 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,1073614731,"BATTEN BRYAN, AMY, MICHELLE",2300 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 78 , 198 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073615910,"BERENDT, LAWRENCE, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 81 , 86 ,$#,,
MEDICAID DIRECT,1073616843,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04299,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1073616843,NORTH CAROLINA CVS PHARMACY LLC,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1073616843,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04299,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073616843,NORTH CAROLINA CVS PHARMACY LLC,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1073616843,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04299,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1073616843,NORTH CAROLINA CVS PHARMACY LLC,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1689626178,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON,9425 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073621215,"CLARK, EILIS, KISIS",9425 NC HIGHWAY 305   JACKSON NC,066,Northampton,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073621215,"CLARK, EILIS, KISIS",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 47 , 74 , 74 ,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073621215,"CLARK, EILIS, KISIS",114 MARKET ST   ENFIELD NC,042,Halifax,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1073624508,"WILLIAMS, LAURA, MICHELLE",781 AVENT FERRY RD STE 206 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 34 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073624565,"STEVENS, JACQUELINE, BREWER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073624565,"STEVENS, JACQUELINE, BREWER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1841317112,HODGES FAMILY PRACTICE INC,HODGES FAMILY PRACTICE INC,610 N FAYETTEVILLE ST STE 202 ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1073624870,"HODGES, BETH, GILLEN",610 N FAYETTEVILLE ST STE 202 ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 184 , 669 ," 1,354 "," $21,435.45 ",,
MEDICAID DIRECT,1710512314,MIDTOWN RALEIGH ANESTHESIA PLLC,,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073624953,"LUTZ, MELANIE, BROOKE",344 ROLLING HILL RD STE 102 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1073624953,"LUTZ, MELANIE, BROOKE",~,344 ROLLING HILL RD STE 102 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1073624953,"LUTZ, MELANIE, BROOKE",344 ROLLING HILL RD STE 102 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1515 SW CARY PKWY STE 220 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073626974,"JOHNKUTTY, SOMA, SUSAN",1515 SW CARY PKWY STE 220 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073626974,"JOHNKUTTY, SOMA, SUSAN",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 32 , 70 ,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073627956,"HAYNES, LANA, MICHELLE OLIVER",58 PHYSICIANS DR NW STE 103 SUPPLY NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 23 , 42 ,$#,,
MEDICAID DIRECT,1720080070,CAPE FEAR NEUROSURGERY,CAPE FEAR NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073638185,"SLOFFER, CHRIS, ALAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073638714,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE GROUP HOME 4,722 8TH AVE SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073638714,THE MENTAL HEALTH FUND INC,722 8TH AVE SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 185 , 185 ,$#,,
MEDICAID DIRECT,1215029608,KURTZ CHIROPRACTIC INC,KURTZ CHIROPRACTIC INC,3011 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1073639589,"CARRAHER, JAMES, STEPHEN",3011 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,111N00000X,Chiropractic Providers,Chiropractor,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1073640199,"SHITTA-BEY, ABIOLA, AINA",417 N MAIN ST   KENANSVILLE NC,031,Duplin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 100 , 104 , 351 ," $15,546.35 ",,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 43 , 46 , 149 ,$#,,
MEDICAID DIRECT,1982076071,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CARY WEST,1203 NW MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 51 , 188 ,$#,,
MEDICAID DIRECT,1093064958,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - RALEIGH FA,4400 FALLS OF NEUSE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 102 , 127 , 485 ," $18,472.90 ",,
MEDICAID DIRECT,1346784089,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - DURHAM,1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 33 , 107 ,$#,,
MEDICAID DIRECT,1407499353,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SUNSET,3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 46 , 157 ,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 56 ,$#,,
MEDICAID DIRECT,1174067813,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - MEBANE,1931 S NC HIGHWAY 119   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 50 , 129 ,$#,,
MEDICAID DIRECT,1538589577,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY APEX,966 US 64 HWY W   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1447892906,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SIX FORKS,3614 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073642443,"GONZALES-MUGABURU, ROSE, BETH",107 E VERNON AVE   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 30 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073643367,"LUCE, CHRISTINE, ANNE",284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1962131656,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2695 HENDERSONVILLE ROAD SUITE 202,2695 HENDERSONVILLE RD STE 202 ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073644175,"LANE, WENDY, SUSAN",2695 HENDERSONVILLE RD STE 202 ARDEN NC,011,Buncombe,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 23 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073645073,"SHADE, LINDSAY, EILEEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073645073,"SHADE, LINDSAY, EILEEN",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073645073,"SHADE, LINDSAY, EILEEN",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073645073,"SHADE, LINDSAY, EILEEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073648465,"SATTERFIELD, THOMAS, BART",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 27 , 36 ,$#,,
MEDICAID DIRECT,1912085648,CHOICE PHYSICAL THERAPY WELLNESS,~,847 WESTLAKE DR   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1073649349,"KREGER, AMANDA, LYNN",847 WESTLAKE DR 847 WESTLAKE DRIVE MOUNT AIRY NC,086,Surry,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1164643441,MANMOHAN SINGH MD PA,MANMOHAN SINGH MD PA,713 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1073650222,"SINGH, MANMOHAN",713 NORTH ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 56 , 83 ,$#,,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,20 COLONIAL SQ   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1073650495,"BROWN, JENNIFER, MAZE",20 COLONIAL SQ   SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 35 ,$#,,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,1159 N MAIN ST   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1073650495,"BROWN, JENNIFER, MAZE",20 COLONIAL SQ   SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,330 W MAIN ST   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1073650495,"BROWN, JENNIFER, MAZE",20 COLONIAL SQ   SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1073650685,"KEKU, JOHN, KEHINDE",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 182 , 234 , 322 ," $12,115.97 ",,
MEDICAID DIRECT,1073651063,HEALTH INNOVATIONS PHARMACY,HEALTH INNOVATIONS PHARMACY,295 PINEHURST AVE BLDG 2 SOUTHERN PINES NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073651063,HEALTH INNOVATIONS PHARMACY,295 PINEHURST AVE BLDG 2 SOUTHERN PINES NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1376132571,FULLER & ASSOCIATES VII PLLC,CLINTON FAMILY & COSMETIC DENTISTRY,320 NORTHEAST BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1073653911,"DUTHIE, JOHN, DAVID",320 NORTHEAST BLVD   CLINTON NC,082,Sampson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 923 ," 3,104 "," 3,449 "," $480,734.07 ",,
MEDICAID DIRECT,1073656914,MOORE COUNTY SCHOOLS,MOORE COUNTY SCHOOLS,160 PINCKNEY RD   CARTHAGE NC,063,Moore,251300000X,Agencies,Local Education Agency (LEA),,1073656914,MOORE COUNTY SCHOOLS,160 PINCKNEY RD   CARTHAGE NC,063,Moore,251300000X,Agencies,Local Education Agency (LEA),, 281 ," 4,944 "," 5,197 "," $228,817.84 ",,
MEDICAID DIRECT,1518392125,BURROW WELCHEL CULP AND REIMELS DD,SIGNATURE SMILES ORTHODONTICS,2250 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1073657433,"BALL, CLIFTON, LEE",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1518392125,BURROW WELCHEL CULP AND REIMELS DD,SIGNATURE SMILES ORTHODONTICS,2250 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1073657433,"BALL, CLIFTON, LEE",117 VILLAGE RD NE STE H LELAND NC,010,Brunswick,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1750696910,LELAND FAMILY DENTISTRY,LELAND FAMILY DENTISTRY,117H VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073657433,"BALL, CLIFTON, LEE",117 VILLAGE RD NE STE H LELAND NC,010,Brunswick,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 74 , 138 , 188 ," $29,584.39 ",,
MEDICAID DIRECT,1518392125,BURROW WELCHEL CULP AND REIMELS DD,SIGNATURE SMILES ORTHODONTICS,2250 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1073657433,"BALL, CLIFTON, LEE",2250 NASH ST N   WILSON NC,098,Wilson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,256 "," 3,310 "," 4,114 "," $547,913.02 ",,
MEDICAID DIRECT,1073659595,TOWNS COUNTY,TOWNS COUNTY EMS,1400 JACK DAYTON CIR   YOUNG HARRIS GA,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,1073659595,TOWNS COUNTY,1400 JACK DAYTON CIR   YOUNG HARRIS GA,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073659769,"THORDSEN, JOHN, EDWARD",5900 SIX FORKS RD STE 105 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 84 , 192 ," $44,510.11 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073659769,"THORDSEN, JOHN, EDWARD",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 50 , 92 , 257 ," $31,764.08 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073659769,"THORDSEN, JOHN, EDWARD",3113 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 67 , 206 , 532 ," $64,708.10 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073659769,"THORDSEN, JOHN, EDWARD",2613 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073662888,"AZIEM, SAIYYED, OOMER",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 45 , 63 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073662888,"AZIEM, SAIYYED, OOMER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 19 , 24 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073662888,"AZIEM, SAIYYED, OOMER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073662888,"AZIEM, SAIYYED, OOMER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 34 , 44 , 53 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073662888,"AZIEM, SAIYYED, OOMER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 117 , 163 , 209 ," $10,192.22 ",,
MEDICAID DIRECT,1073663373,TEST ME OUT,SECOND NATURE,3262 WELLONS BLVD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073663373,TEST ME OUT,3262 WELLONS BLVD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 18 , 30 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073665550,"MCGIRT, MATTHEW, JOSEPH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073665550,"MCGIRT, MATTHEW, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073665550,"MCGIRT, MATTHEW, JOSEPH",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 71 , 128 , 173 ,$#,,
MEDICAID DIRECT,1073668232,PERSONAL HOMECARE SOLUTIONS INC,~,1708 WAYNE MEMORIAL DR STE B GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1073668232,PERSONAL HOMECARE SOLUTIONS INC,1708 WAYNE MEMORIAL DR STE B GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#," 2,711 "," 2,711 "," $384,467.68 ",,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1073668893,"FULMER, SHANNON, INGRAM",800 TILGHMAN DR   DUNN NC,043,Harnett,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 42 , 45 , 45 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073673240,"PILATO, MARC, ANTHONY",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 23 , 30 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073673240,"PILATO, MARC, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073673240,"PILATO, MARC, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 56 , 62 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073673240,"PILATO, MARC, ANTHONY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073673240,"PILATO, MARC, ANTHONY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073673240,"PILATO, MARC, ANTHONY",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073673240,"PILATO, MARC, ANTHONY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073677720,"MITCHELL, CYNTHIA, LOREE",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073677720,"MITCHELL, CYNTHIA, LOREE",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073677720,"MITCHELL, CYNTHIA, LOREE",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073677720,"MITCHELL, CYNTHIA, LOREE",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073679544,GWM ENTERPRISES INC,~,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1073679544,GWM ENTERPRISES INC,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 137 , 769 ," 1,353 "," $30,312.44 ",,
MEDICAID DIRECT,1073679544,GWM ENTERPRISES INC,~,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1073679544,GWM ENTERPRISES INC,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#, 24 ,$#,,
MEDICAID DIRECT,1073679544,GWM ENTERPRISES INC,~,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073679544,GWM ENTERPRISES INC,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 38 , 119 , 218 ,$#,,
MEDICAID DIRECT,1073679544,GWM ENTERPRISES INC,~,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1073679544,GWM ENTERPRISES INC,312 ACADEMY ST S   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1073680724,PERSONAL TOUCH CARE TEAM INC,~,137 JENNINGS RD STE B STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1073680724,PERSONAL TOUCH CARE TEAM INC,137 JENNINGS RD STE B STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 2,695 "," 3,046 "," $373,274.80 ",,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1073684015,"RICHARDS, RANDALL, GEORGE",444 SW CENTER ST   FAISON NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 61 , 61 ," $22,106.68 ",,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073684015,"RICHARDS, RANDALL, GEORGE",444 SW CENTER ST   FAISON NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 79 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073684379,"MEDLIN, LINDA, WOOD",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073684379,"MEDLIN, LINDA, WOOD",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194821520,AMERICAN CHIROPRACTIC CARE INC,REVELS CHIROPRACTIC,5511 RAEFORD RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073684452,"FLORITA, BRIAN, MACBRIDE",5511 RAEFORD RD STE 100 FAYETTEVILLE NC,026,Cumberland,111N00000X,Chiropractic Providers,Chiropractor,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1073684734,"POTTER, HILBERT, TRACY",6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1073684759,"PUTNAM, ELIZABETH",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1073684759,"PUTNAM, ELIZABETH",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073686374,"SISLER, SHEREA, JO",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073686374,"SISLER, SHEREA, JO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073688206,"RAY, TRACY, P.",,3911 MAIN ST   LORIS SC,101,Out of State <= 40 miles,152W00000X,Eye and Vision Services Providers,Optometrist,,1073688206,"RAY, TRACY, P.",3911 MAIN ST   LORIS SC,101,Out of State <= 40 miles,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 33 , 60 ,$#,,
MEDICAID DIRECT,1447383831,CLEMSON EYE PA,,3911 MAIN ST   LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073688206,"RAY, TRACY, P.",3911 MAIN ST   LORIS SC,101,Out of State <= 40 miles,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073690079,"KARIM, NAYEEM",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073690079,"KARIM, NAYEEM",1950 GLENN MITCHELL DR STE 200 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073693131,"MCCOY, MARSHALL, CLARKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073696217,"CALAKOS, NICOLE",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2084D0003X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Diagnostic Neuroimaging,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073696217,"CALAKOS, NICOLE",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2084D0003X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073696696,"MORK, KIMBER, LEE ASHLEY",301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073697728,"DUNCAN, RICHARD, DEAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2609 N DUKE ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073697728,"DUNCAN, RICHARD, DEAN",2609 N DUKE ST STE 204 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073697728,"DUNCAN, RICHARD, DEAN",2609 N DUKE ST STE 204 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 340 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073697728,"DUNCAN, RICHARD, DEAN",2609 N DUKE ST STE 204 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073697942,"HEINKEL, KATHARINE, SUZANNE",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073697942,"HEINKEL, KATHARINE, SUZANNE",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073697942,"HEINKEL, KATHARINE, SUZANNE",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073697991,"TAKLA, MEDHAT, WILLIAM",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073697991,"TAKLA, MEDHAT, WILLIAM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073699096,"MARTIN, LAURA, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1073703211,"PARKER, GLENDA, POWELL",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073703211,"PARKER, GLENDA, POWELL",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4300 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073703211,"PARKER, GLENDA, POWELL",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073704144,"COBURN SALTER, LINDSAY, ERIN",130 GLENDALE DR W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 65 , 84 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,130 GLENDALE DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1073704144,"COBURN SALTER, LINDSAY, ERIN",130 GLENDALE DR W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 172 , 216 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073704474,"BHOWMICK, SUMON, KUMAR",11840 SOUTHMORE DR STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 22 , 42 ,$#,,
MEDICAID DIRECT,1467507640,COUNTY OF WILSON,WILSON COUNTY DEPARTMENT OF PUBLIC HEALTH,1801 GLENDALE DR SW   WILSON NC,098,Wilson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1073707311,"BLEVINS, LISA, PATRICE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7201 US HIGHWAY 64 E   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1073707311,"BLEVINS, LISA, PATRICE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073707824,"HARRIS, MATTHEW, GREGORY",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073707824,"HARRIS, MATTHEW, GREGORY",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 17 , 16 , 61 ,$#,,
MEDICAID DIRECT,1083738645,COUNTY OF CARTERET COURTHOUSE SQUAR,~,3820 BRIDGES ST STE A MOREHEAD CITY NC,016,Carteret,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1073708418,"GROSSI, SARA, G",3820 BRIDGES ST STE A MOREHEAD CITY NC,016,Carteret,1223D0001X,Dental Providers,Dentist,Dental Public Health, 555 , 874 ," 3,748 "," $145,287.70 ",,
MEDICAID DIRECT,1073708491,SHRIDAYAL LLC,UNIVERSITY ADULT CARE,1324 JOHN KIRK DR   CHARLOTTE NC,060,Mecklenburg,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,1073708491,SHRIDAYAL LLC,1324 JOHN KIRK DR   CHARLOTTE NC,060,Mecklenburg,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,#," 2,150 "," 2,150 "," $92,063.16 ",,
MEDICAID DIRECT,1073708491,SHRIDAYAL LLC,UNIVERSITY ADULT CARE,1324 JOHN KIRK DR   CHARLOTTE NC,060,Mecklenburg,385H00000X,Respite Care Facility,Respite Care,,1073708491,SHRIDAYAL LLC,1324 JOHN KIRK DR   CHARLOTTE NC,060,Mecklenburg,385H00000X,Respite Care Facility,Respite Care,,#, 111 , 111 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1073709648,"MOTONAGA, KARA, SACHIE",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073713707,"JARIN, JEFFREY, DOMINGO",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073713707,"JARIN, JEFFREY, DOMINGO",1700 SKYLYN DR   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 166 , 671 ," 1,510 "," $21,466.04 ",,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",3605 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 69 , 158 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 132 , 540 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",3604 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",3801 W MARKET ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",3610 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",975 HIGHWAY 66 S   KERNERSVILLE NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073714937,"KAHOANO, HAKU, KEVIN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073716106,"GATA, RENATO, GARCIA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073716106,"GATA, RENATO, GARCIA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 129 , 129 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 45 , 45 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",829 S MAIN ST   GRAHAM NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",829 S MAIN ST   GRAHAM NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",1410 S THIRD ST   MEBANE NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",873 HEATHER RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",873 HEATHER RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 44 , 44 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",1410 S THIRD ST   MEBANE NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 43 , 49 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 102 , 102 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 69 , 204 , 214 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1073716742,"LATEEF, MUNSOOR, NAEEM",1702 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073717864,"WIRTZ, ERIC, DANIEL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073717864,"WIRTZ, ERIC, DANIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073718029,"WRIGHT-YOWELL, AVERY, KAY",86 OLD AIRPORT RD   FLETCHER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073718029,"WRIGHT-YOWELL, AVERY, KAY",1101 N MORGAN ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073718029,"WRIGHT-YOWELL, AVERY, KAY",149 FAIRHAVEN DR   BOSTIC NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073718029,"WRIGHT-YOWELL, AVERY, KAY",830 BETHANY CHURCH RD   FOREST CITY NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 32 , 45 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1073718268,"SHEPHERD, MICHELLE, LEIGH",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073719100,"THOMPSON, ANDREW, JOSEPH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073719746,"DZIEDZIC, THOMAS, SCOTT",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 548 , 543 , 722 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073719746,"DZIEDZIC, THOMAS, SCOTT",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 79 , 83 , 102 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073719746,"DZIEDZIC, THOMAS, SCOTT",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 31 , 37 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073719761,"STAMATO, STEPHAN, KLAUS",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073721460,"FRANK, NICHOLAS, LEWIS",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 52 , 52 , 52 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073721460,"FRANK, NICHOLAS, LEWIS",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073723086,"GREEN, JULIANNE, VERNADETTE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 15 , 28 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073727079,"SCHAFER, KATHERINE, RACHEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 42 , 91 , 91 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1073728697,"DYSON, MATTHEW, DALE",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 429 , 473 , 642 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073728788,"WEIN, SCOTT",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 23 , 36 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1073728788,"WEIN, SCOTT",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073728788,"WEIN, SCOTT",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 20 , 29 ,$#,,
MEDICAID DIRECT,1073728978,"UPTON, KEVIN, COMER",KEVIN COMER UPTON,101 BROOKS ST   WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1073728978,"UPTON, KEVIN, COMER",101 BROOKS ST   WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#, 19 , 54 ,$#,,
MEDICAID DIRECT,1073730107,"WIMBERLY, MICHAEL, KEITH",DR MICHAEL K WIMBERLY PC,1183 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,1073730107,"WIMBERLY, MICHAEL, KEITH",1183 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice," 1,685 "," 2,455 "," 7,995 "," $311,318.34 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073730958,"BENNER, ERIC, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 16 , 56 , 59 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073731857,"ZARZAR, THEODORE, RUDOLF",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073731857,"ZARZAR, THEODORE, RUDOLF",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1538783915,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE PSYCHIATRIC SPECIALISTS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073731857,"ZARZAR, THEODORE, RUDOLF",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073732392,"ALMAN, BENJAMIN, AARON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073732392,"ALMAN, BENJAMIN, AARON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1073732392,"ALMAN, BENJAMIN, AARON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1952075335,SMOKY MOUNTAIN URGENT CARE,,120 VETERANS BLVD   BRYSON CITY NC,087,Swain,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073735155,"CASTOR, DAVID, RANDALL",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407428931,SMOKY MOUNTAIN URGENT CARE,,80 VETERANS BLVD   BRYSON CITY NC,087,Swain,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073735155,"CASTOR, DAVID, RANDALL",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134791676,SMOKY MOUNTAIN URGENT CARE,,195 FRANKLIN PLAZA DR   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073735155,"CASTOR, DAVID, RANDALL",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407295447,SMOKY MOUNTAIN URGENT CARE,~,80 VETERANS BLVD   BRYSON CITY NC,087,Swain,193400000X,Group,Single Specialty,,1073735155,"CASTOR, DAVID, RANDALL",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 409 , 409 ,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073738084,"SETHI, HARTEJ, SINGH",4420 LAKE BOONE TRL STE 201 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 34 , 49 ,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073738084,"SETHI, HARTEJ, SINGH",4420 LAKE BOONE TRL STE 201 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 66 , 94 , 110 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1073738530,"NEELY, MARK, HOWARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1073738530,"NEELY, MARK, HOWARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,3643 N ROXBORO ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1073738530,"NEELY, MARK, HOWARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 253 , 293 , 428 ,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073738530,"NEELY, MARK, HOWARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1073738530,"NEELY, MARK, HOWARD",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 47 , 70 ,$#,,
MEDICAID DIRECT,1073739843,"KEIGHRON, JUDY, LACKEY",GREENBRIAR PRIMARY CARE,308C MOCKSVILLE HWY   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1073739843,"KEIGHRON, JUDY, LACKEY",308C MOCKSVILLE HWY   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 34 , 56 ,$#,,
MEDICAID DIRECT,1073740981,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-5743,5141 NC HIGHWAY 42 W   GARNER NC,051,Johnston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1073740981,WAL-MART STORES EAST LP,5141 NC HIGHWAY 42 W   GARNER NC,051,Johnston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073741153,"GERMEROTH, JOHN, RUSSUM",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073741153,"GERMEROTH, JOHN, RUSSUM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 43 , 59 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073741153,"GERMEROTH, JOHN, RUSSUM",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 11 , 12 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1073741153,"GERMEROTH, JOHN, RUSSUM",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073741484,"FERNANDEZ-MOURE, JOSEPH, STEVEN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1073741484,"FERNANDEZ-MOURE, JOSEPH, STEVEN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073741484,"FERNANDEZ-MOURE, JOSEPH, STEVEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073741484,"FERNANDEZ-MOURE, JOSEPH, STEVEN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 58 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073741484,"FERNANDEZ-MOURE, JOSEPH, STEVEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073742235,"HELM, JAMES, ARTHUR",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 33 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073742235,"HELM, JAMES, ARTHUR",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 58 , 124 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073742573,"WALKER, JUSTIN, WAYNE",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073742573,"WALKER, JUSTIN, WAYNE",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 98 , 179 , 242 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073742573,"WALKER, JUSTIN, WAYNE",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1073742573,"WALKER, JUSTIN, WAYNE",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 24 , 31 ,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073742912,"HUGHES, STACY, MITCHELL",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1073742912,"HUGHES, STACY, MITCHELL",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1073742912,"HUGHES, STACY, MITCHELL",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073742912,"HUGHES, STACY, MITCHELL",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1073742912,"HUGHES, STACY, MITCHELL",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,5111 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 144 , 154 , 194 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073745188,"ARYA, RAHUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1073746103,"TOOLS, TATYANA",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 121 , 290 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1073746103,"TOOLS, TATYANA",4204 MURDOCKSVILLE RD   WEST END NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073748117,"GILBERT, ABIGAIL, LEWIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073748117,"GILBERT, ABIGAIL, LEWIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073748117,"GILBERT, ABIGAIL, LEWIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073748117,"GILBERT, ABIGAIL, LEWIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073748117,"GILBERT, ABIGAIL, LEWIS",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 49 , 60 , 95 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073748117,"GILBERT, ABIGAIL, LEWIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 17 , 21 , 31 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073749156,"FAULKNER, MEREDITH, JAYNE",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1073749156,"FAULKNER, MEREDITH, JAYNE",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073749156,"FAULKNER, MEREDITH, JAYNE",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073749313,"WELTON, SUSAN, MONTGOMERY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073749313,"WELTON, SUSAN, MONTGOMERY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1073752036,"AYALEW, TARIKU, DAMTE",300 W 27TH ST   LUMBERTON NC,078,Robeson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 124 , 201 , 204 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1073752036,"AYALEW, TARIKU, DAMTE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 67 , 69 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073760260,"ZANTER, ASHLEY, KRISTEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 22 , 29 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073761771,"MACKELLAR, CAROLINE, WHITEHILL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073761771,"MACKELLAR, CAROLINE, WHITEHILL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073762795,"KESNER, NATHANIEL, JAMES",222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 3400 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073764296,"ULKE, AUDREY, ELLISTON",1 HOSPITAL DR STE 3400 MISSION WEIGHT MANAGEMENT CTR ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073764296,"ULKE, AUDREY, ELLISTON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073768164,"RUBACH, MATTHEW, PALMER",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073768164,"RUBACH, MATTHEW, PALMER",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073768990,"ANDERSON-RIDDELL, JESSICA, LYNN",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 30 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073768990,"ANDERSON-RIDDELL, JESSICA, LYNN",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073768990,"ANDERSON-RIDDELL, JESSICA, LYNN",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 16 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073769519,"PIZOLI, CAROLYN, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073770814,"BARFIELD, MICHAEL, EVERETT",1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073770814,"BARFIELD, MICHAEL, EVERETT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811421092,SUNRISE VASCULAR CENTER,~,2054 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073771309,"SASTRY, ASHWANI, PILLUTLA",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811421092,SUNRISE VASCULAR CENTER,~,152 S MOOREST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1073771309,"SASTRY, ASHWANI, PILLUTLA",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811421092,SUNRISE VASCULAR CENTER,~,2054 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073771309,"SASTRY, ASHWANI, PILLUTLA",75 MEDICAL PARK LN STE A MURPHY NC,020,Cherokee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 22 , 30 ,$#,,
MEDICAID DIRECT,1811421092,SUNRISE VASCULAR CENTER,~,2054 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073771309,"SASTRY, ASHWANI, PILLUTLA",35 NC HIGHWAY 141   MURPHY NC,020,Cherokee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 52 , 118 ," $110,604.68 ",,
MEDICAID DIRECT,1811421092,SUNRISE VASCULAR CENTER,~,821 S HORNER BLVD STE B SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1073771309,"SASTRY, ASHWANI, PILLUTLA",821 S HORNER BLVD STE B SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 45 , 81 , 241 ," $33,153.78 ",,
MEDICAID DIRECT,1811421092,SUNRISE VASCULAR CENTER,~,152 S MOOREST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1073771309,"SASTRY, ASHWANI, PILLUTLA",152 S MOORE ST   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 28 , 51 ,$#,,
MEDICAID DIRECT,1811421092,SUNRISE VASCULAR CENTER,~,821 S HORNER BLVD STE B SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1073771309,"SASTRY, ASHWANI, PILLUTLA",152 S MOORE ST   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073771663,"PADGETT, ADAM, ONEAL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 103 , 103 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1073771663,"PADGETT, ADAM, ONEAL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073771663,"PADGETT, ADAM, ONEAL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1073771663,"PADGETT, ADAM, ONEAL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 25 , 25 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1073771663,"PADGETT, ADAM, ONEAL",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 26 , 26 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073771663,"PADGETT, ADAM, ONEAL",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1477902989,MAGGIE WRIGHT FETNER DDS PLLC,RANDOLPH PEDIATRIC DENTISTRY,207 E SALISBURY ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1073771994,"FETNER, JAMES, PALMER",207 E SALISBURY ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 367 , 559 ," 1,807 "," $98,377.44 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 95 , 109 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",2575 W 5TH ST   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 78 , 110 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",2275 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",4796 OLD TAR RD   WINTERVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",3000 HOLSTON LN   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",1306 S KING ST   WINDSOR NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 51 , 69 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",1403 CONNER AVE   WINDSOR NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 39 , 53 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",3331 TATE BLVD SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",8990 HIGHWAY 17 S   POLLOCKSVILLE NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 50 , 96 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 38 , 52 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",160 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073774295,"HART, CHERRIE, CROWDER",801 PINEHURST AVE   CARTHAGE NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 101 , 119 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073774964,"CHADHA, SHANNON, NICOLE",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073774964,"CHADHA, SHANNON, NICOLE",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073774964,"CHADHA, SHANNON, NICOLE",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073774964,"CHADHA, SHANNON, NICOLE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073774964,"CHADHA, SHANNON, NICOLE",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073774964,"CHADHA, SHANNON, NICOLE",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 48 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073778627,"PAWAR, SWAROOP, ABHIMANYOO",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073778627,"PAWAR, SWAROOP, ABHIMANYOO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073778627,"PAWAR, SWAROOP, ABHIMANYOO",2301 ERWIN RD   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073780987,"NIENABER, JUHSIEN, JODI CHEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 35 , 78 , 78 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073780987,"NIENABER, JUHSIEN, JODI CHEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 38 , 80 , 82 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073780987,"NIENABER, JUHSIEN, JODI CHEN",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073781878,"KANAREK, VALBONA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174624498,EAST TENNESSEE ORAL MAXILLOFACIAL,EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY PC,1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073785010,"EVANS, BROCK, DON",1112 MEDICAL PARK CT   SEVIERVILLE TN,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 36 ,$#,,
MEDICAID DIRECT,1174624498,EAST TENNESSEE ORAL MAXILLOFACIAL,EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY PC,1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073785010,"EVANS, BROCK, DON",1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 29 , 31 , 281 ," $27,537.05 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073786893,"ANDERS, CAREY, KERNODLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 15 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073786893,"ANDERS, CAREY, KERNODLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073786893,"ANDERS, CAREY, KERNODLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073787065,"SHIN, MICHAEL",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 68 , 126 , 233 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073787065,"SHIN, MICHAEL",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 24 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073787065,"SHIN, MICHAEL",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 40 , 67 ,$#,,
MEDICAID DIRECT,1063179729,S VAKIL DDS MS V PA,GROWING SMILES PEDIATRIC DENTISTRY- MORRISVILLE,4181 DAVIS DR STE 100B MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",4181 DAVIS DR STE 100B MORRISVILLE NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 53 ,$#,,
MEDICAID DIRECT,1285343707,S VAKIL DDS MS VI PA,GROWING SMILES PEDIATRIC DENTISTRY- GARNER STATION,4446 FAYETTEVILLE RD STE B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",4446 FAYETTEVILLE RD STE B RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 42 , 42 , 728 ," $82,394.34 ",,
MEDICAID DIRECT,1336671809,S VAKIL DDS I PA,VAYA DENTAL- GARNER STATION,4446 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",4446 FAYETTEVILLE RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 174 , 235 , 983 ," $44,714.81 ",,
MEDICAID DIRECT,1265199921,S VAKIL DDS MS IV PA,GROWING SMILES PEDIATRIC DENTISTRY- MADISON PARK,5117 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",5117 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 152 , 246 ," 1,272 "," $49,191.17 ",,
MEDICAID DIRECT,1457833469,S VAKIL DDS MS II PA,GROWING SMILES PEDIATRIC DENTISTRY,11223 DAVINCI DR   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",11223 DAVINCI DR   DAVIDSON NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 203 , 227 ," 1,709 "," $134,489.93 ",,
MEDICAID DIRECT,1336630862,S VAKIL DDS II PA,~,4558 CAPITAL BLVD STE B RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",11223 DAVINCI DR   DAVIDSON NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 41 ,$#,,
MEDICAID DIRECT,1265199921,S VAKIL DDS MS IV PA,GROWING SMILES PEDIATRIC DENTISTRY- MADISON PARK,5117 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",11223 DAVINCI DR   DAVIDSON NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1598247579,S VAKIL DDS MS I PA,GROWING SMILES PEDIATRIC DENTISTRY,6331 CARMEL RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",6331 CARMEL RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 95 , 96 , 453 ," $21,887.22 ",,
MEDICAID DIRECT,1912507468,S VAKIL DDS MS III PA,GROWING SMILES PEDIATRIC DENTISTRY,181 N MAIN ST STE 202 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1073787487,"VAKIL, SHAMIK, SURESH",181 N MAIN ST STE 202 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 828 ," 1,463 "," 7,338 "," $281,130.38 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073791604,"LOEB, JEFFREY, SCOTT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073791604,"LOEB, JEFFREY, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 58 , 73 , 112 ," $10,117.42 ",,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073791943,"RICHARDSON, KAKEASHA, SHANIKA",1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1073791943,"RICHARDSON, KAKEASHA, SHANIKA",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073791943,"RICHARDSON, KAKEASHA, SHANIKA",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 143 , 156 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073792453,"GAROFALO, JENNA, ALICE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073792974,"WENTWORTH, STACY",4101 MACON POND RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073793048,"CHRYSOGELOS, ELLEN, THERESE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073793048,"CHRYSOGELOS, ELLEN, THERESE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1073793311,"KENNEDY, BURTON, LEE",336 DEERFIELD RD   BOONE NC,095,Watauga,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1144300286,HIGH COUNTRY NEUROLOGY,~,400 SHADOWLINE DR STE 202 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1073793311,"KENNEDY, BURTON, LEE",400 SHADOWLINE DR STE 202 BOONE NC,095,Watauga,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 64 , 84 , 131 ,$#,,
MEDICAID DIRECT,1073793311,"KENNEDY, BURTON, LEE",BURTON LEE KENNEDY MD,400 SHADOWLINE DR STE 202 BOONE NC,095,Watauga,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1073793311,"KENNEDY, BURTON, LEE",400 SHADOWLINE DR STE 202 BOONE NC,095,Watauga,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 37 , 55 ,$#,,
MEDICAID DIRECT,1073796264,OAK GROVE FAMILY CARE HOME,OAK GROVE FAMILY CARE HOME,583 SASSAFRAS RD   BLADENBORO NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073796264,OAK GROVE FAMILY CARE HOME,583 SASSAFRAS RD   BLADENBORO NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,648 "," 1,677 "," $103,617.43 ",,
MEDICAID DIRECT,1073796991,BRIAN J LANKFORD OD PA,~,807 WESTERN BLVD   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1073796991,BRIAN J LANKFORD OD PA,807 WESTERN BLVD   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,, 17 , 17 , 34 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073798419,"NGUYEN, THAO, PHUONG",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073798419,"NGUYEN, THAO, PHUONG",6404 ALBEMARLE RD STE J&K CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 37 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073798419,"NGUYEN, THAO, PHUONG",3614 S PROVIDENCE RD STE 200 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 54 , 106 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073799060,"MACLENNAN, ROBERT, NEAL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073799060,"MACLENNAN, ROBERT, NEAL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073799763,"MCLAUGHLIN, CHARLES, ALLAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073799763,"MCLAUGHLIN, CHARLES, ALLAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073799763,"MCLAUGHLIN, CHARLES, ALLAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 175 , 174 , 192 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073799763,"MCLAUGHLIN, CHARLES, ALLAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 141 , 151 , 169 ,$#,,
MEDICAID DIRECT,1447255328,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOKE FAMILY MEDICAL CENTER,405 S MAIN ST   RAEFORD NC,047,Hoke,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1073800041,"SAM, ABIGAIL, AKOMAH-GYAMFI",405 S MAIN ST   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 142 , 320 , 325 ," $14,210.42 ",,
MEDICAID DIRECT,1073800116,"YRUMA, MARIA EILEEN, MIRANDA",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1073800116,"YRUMA, MARIA EILEEN, MIRANDA",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073800967,"WILLIAMS, TYEASHA, DENAIE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073801098,"THOMAS, JESSICA, LYN",~,20 MEDICAL CAMPUS DR NW STE 204 SUPPLY NC,010,Brunswick,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1073801098,"THOMAS, JESSICA, LYN",20 MEDICAL CAMPUS DR NW STE 204 SUPPLY NC,010,Brunswick,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073801676,"NELSON, JENNIFER, RAE",434 HOSPITAL DR   LINVILLE NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073801676,"NELSON, JENNIFER, RAE",434 HOSPITAL DR   LINVILLE NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073801676,"NELSON, JENNIFER, RAE",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073801676,"NELSON, JENNIFER, RAE",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740702497,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE HOLLY SPRINGS,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1073801817,"NAZ, SHAHLA",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1740702497,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE HOLLY SPRINGS,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1073801817,"NAZ, SHAHLA",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1073802039,"GARRETT, DAVID, CLAYBOURNE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1073803854,CHLORIS GAIL ATKINSON,ST MARY ROSAA F C H,483 CARIBOU RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073803854,CHLORIS GAIL ATKINSON,483 CARIBOU RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 68 , 68 ," $21,916.92 ",,
MEDICAID DIRECT,1538412739,WEST CALDWELL HEALTH COUNCIL INC,WEST CALDWELL MOBILE HEALTH,4330 COLLETTSVILLE RD BASE OF OPERATIONS COLLETTSVILLE NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073806451,"MINTON, JANET, DENISE",4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1346302429,WEST CALDWELL HEALTH COUNCIL INC,COLLETTSVILLE MEDICAL CENTER,4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073806451,"MINTON, JANET, DENISE",4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073807236,"FRENKEL, CATHERINE, HEATHER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 45 , 62 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073807236,"FRENKEL, CATHERINE, HEATHER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073807541,"OQUINN, MICHAEL, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 18 , 39 , 58 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073807541,"OQUINN, MICHAEL, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073807541,"OQUINN, MICHAEL, PATRICK",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073809851,"JULICH, BRIAN, NICHOLAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073809851,"JULICH, BRIAN, NICHOLAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 121 , 128 , 176 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073809851,"JULICH, BRIAN, NICHOLAS",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073809851,"JULICH, BRIAN, NICHOLAS",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 40 , 42 ,$#,,
MEDICAID DIRECT,1972507440,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERNAL MEDICINE,101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073810537,"DISSANAYAKE, THUSITHA, RUWAN",101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 92 , 301 , 503 ,$#,,
MEDICAID DIRECT,1073810537,"DISSANAYAKE, THUSITHA, RUWAN",~,101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1073810537,"DISSANAYAKE, THUSITHA, RUWAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972507440,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERNAL MEDICINE,101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073810537,"DISSANAYAKE, THUSITHA, RUWAN",101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629658802,TDMD PRIMARY CARE PLLC,,1001 PEMBERTON HILL RD STE 202 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1073810537,"DISSANAYAKE, THUSITHA, RUWAN",1001 PEMBERTON HILL RD STE 202 APEX NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1073811287,"THONDAPI, CHANDRA SEKHARA RAO",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073811287,"THONDAPI, CHANDRA SEKHARA RAO",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 95 , 95 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073811287,"THONDAPI, CHANDRA SEKHARA RAO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073811311,"VOCI-HOLMES, CATHERINE, ANN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073811311,"VOCI-HOLMES, CATHERINE, ANN",420 PARK ST   BELMONT NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073813010,"KARRIKER, BRIAN, DENNIS",BRIAN DENNIS KARRIKER,1309 UNION RD   GASTONIA NC,036,Gaston,1223D0001X,Dental Providers,Dentist,Dental Public Health,1073813010,"KARRIKER, BRIAN, DENNIS",1309 UNION RD   GASTONIA NC,036,Gaston,1223D0001X,Dental Providers,Dentist,Dental Public Health, 477 ," 1,093 "," 4,008 "," $252,927.91 ",,
MEDICAID DIRECT,1073813010,"KARRIKER, BRIAN, DENNIS",BRIAN DENNIS KARRIKER,484 RIVER HWY STE E MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,1073813010,"KARRIKER, BRIAN, DENNIS",484 RIVER HWY STE E MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 135 , 262 , 991 ," $64,075.00 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073813705,"KRAMER, WHITNEY, MORGAN",162 LEGACY OAKS DR STE 2102 KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 21 , 29 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073813705,"KRAMER, WHITNEY, MORGAN",162 LEGACY OAKS DR STE 2102 KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073816500,"FLOOD, KRISTIN, ILENE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073816500,"FLOOD, KRISTIN, ILENE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073823589,"KILLEN, JULIA, NICHOLE",21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 41 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 18 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 19 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073824496,"LALLI, TRAPPER, ADAM JAMES",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1730413949,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD VASCULAR ASSOCIATES,101 WILLIAM H JOHNSON ST STE 100 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073826624,"PICCOLO, CARMEN, MICHAEL",101 WILLIAM H JOHNSON ST STE 100 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,901 N WINSTEAD AVE STE 430 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073827176,"ESPINOZA, CARLOS, ALBERTO",901 N WINSTEAD AVE STE 430 ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 84 , 109 , 147 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073827176,"ESPINOZA, CARLOS, ALBERTO",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 59 , 72 , 105 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073827176,"ESPINOZA, CARLOS, ALBERTO",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 90 , 140 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073829461,"BENNETT, CARLA, SUE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073829511,"SESSLER, DARREN, SCOTT",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073829511,"SESSLER, DARREN, SCOTT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073830725,"GHAZI, MUHAMMAD, AHMAD",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 33 , 79 ,$#,,
MEDICAID DIRECT,1134361272,DUKE UNIVERSITY AFFILIATED PHYSICIA,NORTH HILLS INTERNAL MEDICINE,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073830725,"GHAZI, MUHAMMAD, AHMAD",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 87 , 196 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073830725,"GHAZI, MUHAMMAD, AHMAD",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 19 , 39 ,$#,,
MEDICAID DIRECT,1043272784,GREENSBORO DERMATOLOGY ASSOCIATES P,GREENSBORO DERMATOLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1073831442,"WHITWORTH, WALTER, RICHARD",2704 SAINT JUDE ST   GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073833455,"ATKINSON, AMANDA, BETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073833455,"ATKINSON, AMANDA, BETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952061517,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH,1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073833463,"MORALES, NELLY, ANN",1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 42 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1073834123,"GIRONDA, VALERIE, MARIA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073834214,"SQUIRES, JENNIFER, CRUTCHFIELD",2630 E 7TH ST STE 101 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 19 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073834677,"CURTIN, MICHELLE, JACKLYN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 15 , 16 , 43 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073834677,"CURTIN, MICHELLE, JACKLYN",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 17 , 17 , 47 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073838926,"TOO, GLORIA, TING-JU",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1073845343,"LARISCY, WENDY, HILTON",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1073845343,"LARISCY, WENDY, HILTON",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1073845343,"LARISCY, WENDY, HILTON",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1073845343,"LARISCY, WENDY, HILTON",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073845343,"LARISCY, WENDY, HILTON",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1073845343,"LARISCY, WENDY, HILTON",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1073845343,"LARISCY, WENDY, HILTON",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073848149,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE 737 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1073848149,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE 737 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,, 54 ," 5,759 "," 5,773 "," $774,358.96 ",,
MEDICAID DIRECT,1073848149,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE C HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1073848149,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE C HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,, 56 ," 4,957 "," 4,968 "," $675,422.73 ",,
MEDICAID DIRECT,1073848149,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE 737 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1073848149,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE C HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073849337,"MIAN, NOREEN",2525 COURT DR   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073849451,"CHADWELL, JOSHUA, AIDEN",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",910 E INNES ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1073851770,"ANYANWU, RYAN, MICHAEL",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 130 , 140 , 201 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 73 , 86 , 124 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1073855318,"PATEL, SEJAL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073856092,"GALEOTTI, JONATHAN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073856092,"GALEOTTI, JONATHAN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology, 78 , 101 , 164 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073856092,"GALEOTTI, JONATHAN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology, 19 , 21 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073856092,"GALEOTTI, JONATHAN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology,#,#, 16 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073856506,"OVERCARSH, PATRICIA, MAE ENGEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073856506,"OVERCARSH, PATRICIA, MAE ENGEL",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 33 , 37 , 37 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073856506,"OVERCARSH, PATRICIA, MAE ENGEL",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 18 , 29 ,$#,,
MEDICAID DIRECT,1073856654,"FULTON, SHANEE",,2168 GREGOR OVERLOOK LN   APEX NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1073856654,"FULTON, SHANEE",2168 GREGOR OVERLOOK LN   APEX NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 14 , 77 , 77 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073856696,"OVERCARSH, BRYAN, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 82 , 82 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1073856696,"OVERCARSH, BRYAN, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 140 , 140 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073859633,"BOYD, SAMARA, EVANS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215508585,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WILLIAM R DAVIE ELEMENTARY,3437 US HIGHWAY 601 N   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073860326,"WILSON, BRITTANI, ELAINE",3437 US HIGHWAY 601 N   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 40 , 40 ," $12,813.20 ",,
MEDICAID DIRECT,1073861118,NOVANT HEALTH THOMASVILLE MEDICAL C,NOVANT HEALTH SPECIALTY PHARMCY,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1073861118,NOVANT HEALTH THOMASVILLE MEDICAL C,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1073866596,EDEN SPRING LIVING CENTER INC,~,3812 BOOKER AVE   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073866596,EDEN SPRING LIVING CENTER INC,3812 BOOKER AVE   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 893 , 893 ," $80,727.36 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073866927,"ECONOPOULY, MEGAN, ASHLEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 37 , 37 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1073866927,"ECONOPOULY, MEGAN, ASHLEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 30 , 30 ,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073870275,"BRAY, KEVIN, JAMES",10 DOCTORS CIR STE 1 SUPPLY NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 45 , 118 ," $14,018.49 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073870275,"BRAY, KEVIN, JAMES",402 N MAIN ST   KENANSVILLE NC,031,Duplin,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 31 , 76 ,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073870275,"BRAY, KEVIN, JAMES",1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 30 , 63 , 166 ," $18,191.40 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1073870275,"BRAY, KEVIN, JAMES",1098 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 54 , 83 , 198 ," $11,624.47 ",,
MEDICAID DIRECT,1073873824,I CAN PEDIATRIC THERAPIES LLC,I CAN PEDIATRIC THERAPIES LLC,407 OAKWOODS RD   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1073873824,I CAN PEDIATRIC THERAPIES LLC,407 OAKWOODS RD   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,, 60 ," 1,038 "," 1,237 "," $94,996.62 ",,
MEDICAID DIRECT,1073873865,"MINTON, JASON, MICHAEL",,530 S GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1073873865,"MINTON, JASON, MICHAEL",530 S GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1073873865,"MINTON, JASON, MICHAEL",,3141 GARDEN RD   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1073873865,"MINTON, JASON, MICHAEL",3141 GARDEN RD   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1073875498,"KEATING, KEVIN, CASEY",KEATING DENTAL,130 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1073875498,"KEATING, KEVIN, CASEY",130 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 107 , 223 , 698 ," $32,030.66 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073875654,"KRUPP, NATHANIEL, DEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 40 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073875951,"MAC GRORY, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073875951,"MAC GRORY, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073875951,"MAC GRORY, BRIAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073876462,"RADZOM, AMY, HUGHES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 31 , 41 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1073876462,"RADZOM, AMY, HUGHES",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073876462,"RADZOM, AMY, HUGHES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1073876462,"RADZOM, AMY, HUGHES",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1073876462,"RADZOM, AMY, HUGHES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073876462,"RADZOM, AMY, HUGHES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1073876462,"RADZOM, AMY, HUGHES",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1073876462,"RADZOM, AMY, HUGHES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1073876462,"RADZOM, AMY, HUGHES",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073876462,"RADZOM, AMY, HUGHES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073876462,"RADZOM, AMY, HUGHES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1073876462,"RADZOM, AMY, HUGHES",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073876462,"RADZOM, AMY, HUGHES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073876462,"RADZOM, AMY, HUGHES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073878252,"SEVERANCE, SUNNY, BAKALLI",2240 REMOUNT RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073878252,"SEVERANCE, SUNNY, BAKALLI",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073878252,"SEVERANCE, SUNNY, BAKALLI",9101 PINEVILLE MATTHEWS RD STE C4 PINEVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073878682,"STEPHENS, TIONA, KIMISHA",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 46 , 46 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073878682,"STEPHENS, TIONA, KIMISHA",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073878682,"STEPHENS, TIONA, KIMISHA",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073879680,"PAGE, SHANNON, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 25 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073879680,"PAGE, SHANNON, MARIE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 28 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2905 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073879680,"PAGE, SHANNON, MARIE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073879680,"PAGE, SHANNON, MARIE",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073879680,"PAGE, SHANNON, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073879680,"PAGE, SHANNON, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1073881439,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,102 CINEMA DR STE B WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1073881439,CNC-ACCESS INC,102 CINEMA DR STE B WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#," 1,258 "," 1,258 "," $82,733.12 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073887717,"GIBSON, RUTH, ROSETTE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073889598,"AHMED, MUHAMMAD, NAWAZ",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 49 , 49 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073889598,"AHMED, MUHAMMAD, NAWAZ",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 61 , 61 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073889671,"GRANT, KEYONA, MARSHAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073889853,"CROUCH, THOMAS, CLAY",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 74 , 84 , 94 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073891305,"BEYENE, JODIT, HAGOS",2797 NC 55 HWY   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073893186,"MONTEZ, KIMBERLY, GAYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073893186,"MONTEZ, KIMBERLY, GAYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073900551,"KOZAK, PATRICK, MICHAEL",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 53 , 56 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073900551,"KOZAK, PATRICK, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 96 , 104 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073901328,"BARNETTE-FETTY, KRISTEN, ELAINE",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 11 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073901328,"BARNETTE-FETTY, KRISTEN, ELAINE",900 DONTIA DR   LINCOLNTON NC,055,Lincoln,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 34 , 50 , 60 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1073902813,"JONES, JAMIE, LAUREN",3332 BRIDGES ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1073902813,"JONES, JAMIE, LAUREN",2115 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 51 , 75 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1073902813,"JONES, JAMIE, LAUREN",3332 BRIDGES ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 27 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1073902813,"JONES, JAMIE, LAUREN",2115 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073903290,"SIMKIN, DAREN, JOSHUA",77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073903290,"SIMKIN, DAREN, JOSHUA",77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 29 , 39 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073903290,"SIMKIN, DAREN, JOSHUA",77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 26 , 29 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073906715,"HUTCHINS, ADAM, EUGENE",200 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 21 , 69 , 69 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073906715,"HUTCHINS, ADAM, EUGENE",158 ZILLICOA ST   ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 50 , 150 , 150 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073906715,"HUTCHINS, ADAM, EUGENE",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 29 , 128 , 128 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073906715,"HUTCHINS, ADAM, EUGENE",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 29 , 118 , 118 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073906715,"HUTCHINS, ADAM, EUGENE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 42 , 204 , 204 ," $11,355.30 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073906715,"HUTCHINS, ADAM, EUGENE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073906715,"HUTCHINS, ADAM, EUGENE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 81 , 266 , 266 ," $14,082.85 ",,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1073906731,"EANES, ANDREA, SPARKS",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 28 , 134 , 134 ," $10,582.87 ",,
MEDICAID DIRECT,1518502103,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,560 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073907192,"BROWN, DANA, NICOLE",560 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1902366180,SOUNDSIDE ORTHOTICS & PROSTHETICS L,EVERGREEN PROSTHETICS & ORTHOTICS,4110 DR MARTIN LUTHER KING JR BLVD STE C NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073907747,"DAVIS, JAMES, CURTIS",4110 DR MARTIN LUTHER KING JR BLVD STE C NEW BERN NC,025,Craven,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1801531496,SOUNDSIDE ORTHOTICS & PROSTHETICS L,EVERGREEN PROSTHETICS & ORTHOTICS,209 N 35TH ST STE A1 MOREHEAD CITY NC,016,Carteret,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073907747,"DAVIS, JAMES, CURTIS",209 N 35TH ST STE A1 MOREHEAD CITY NC,016,Carteret,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",2461 LEGION RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 30 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",106 CAMERON ST   LAKE WACCAMAW NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 68 , 81 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",214 LANEFIELD RD   WARSAW NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 56 , 81 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 55 , 66 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 29 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 49 , 77 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 46 , 46 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",121 RACINE DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 32 , 54 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",311 S CAMPBELL ST   BURGAW NC,071,Pender,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 39 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073908828,"LINTULA, UDOAKU, EBERECHUKWU",1170 LINKHAW RD   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073909255,"LI, XIAOYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073909255,"LI, XIAOYAN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073909388,"JENSON, AMANDA, VILATE",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073909388,"JENSON, AMANDA, VILATE",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 30 , 45 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073909388,"JENSON, AMANDA, VILATE",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 19 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 36 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073909446,"LAM, PATRICK, QUOC-BAO",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073909958,"TODD, KEVIN, EDWARD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1073911202,"YEARY, SUSAN, SAYLOR",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902020308,NC DHHS CHILD AND FAMILY WELL-BEING,DURHAM CDSA,115 MARKET ST STE 201 DURHAM NC,032,Durham,252Y00000X,Agencies,Early Intervention Provider Agency,,1073914016,"CARSON, KATHRYN, GRIMM",115 MARKET ST STE 201 DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 121 , 121 , 188 ," $23,667.97 ",,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1073914511,"MESILIEN, FRITZ, GERALD",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1073914511,"MESILIEN, FRITZ, GERALD",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1073914511,"MESILIEN, FRITZ, GERALD",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073914511,"MESILIEN, FRITZ, GERALD",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073914511,"MESILIEN, FRITZ, GERALD",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073915344,"ELKIN, MCKENZIE, ELIZABETH MILLER",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073915344,"ELKIN, MCKENZIE, ELIZABETH MILLER",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073916839,"BROOKSHIRE, LAUREN, LONG",400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073916839,"BROOKSHIRE, LAUREN, LONG",400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073916839,"BROOKSHIRE, LAUREN, LONG",23 SUNNYBROOK RD STE 116 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073916839,"BROOKSHIRE, LAUREN, LONG",4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 34 , 110 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1073916839,"BROOKSHIRE, LAUREN, LONG",23 SUNNYBROOK RD STE 116 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073917209,"MICKEY, ADAM, DEAN",2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 55 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073917209,"MICKEY, ADAM, DEAN",3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 105 , 122 , 273 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073917589,"HAZELRIGS, ETHAN, JAMES",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073917589,"HAZELRIGS, ETHAN, JAMES",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073917589,"HAZELRIGS, ETHAN, JAMES",3735 GLENLAKE DR   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073918330,"VANCE, CRYSTAL, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 22 , 23 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073920286,"MODI, RITU",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 25 , 29 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073920286,"MODI, RITU",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 44 , 62 , 91 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073920286,"MODI, RITU",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073921060,"ROBINS, DAVID, JAMES",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376914283,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073921060,"ROBINS, DAVID, JAMES",3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 51 , 49 , 50 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1073921060,"ROBINS, DAVID, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073922845,"SULLIVAN, RACHEL, LOUISE",3719 UNION RD   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073922845,"SULLIVAN, RACHEL, LOUISE",8814 RACHEL FREEMAN WAY STE 103 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1073924163,"LONG, JOSHUA, GRAY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730256017,COUNTY OF PERSON OFFICE OF COUNTY F,PERSON COUNTY HEALTH DEPARTMENT,355 S MADISON BLVD STE A ROXBORO NC,073,Person,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1073925525,"WILSON, VANISHA, ROCHELLE",355 S MADISON BLVD STE A ROXBORO NC,073,Person,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073925525,"WILSON, VANISHA, ROCHELLE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073925525,"WILSON, VANISHA, ROCHELLE",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073925525,"WILSON, VANISHA, ROCHELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073925525,"WILSON, VANISHA, ROCHELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1073925525,"WILSON, VANISHA, ROCHELLE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1073925525,"WILSON, VANISHA, ROCHELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1073926838,"KHAN, NIMRA",11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 96 , 211 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,3643 N ROXBORO ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1073927208,"FOSTER, JUSTIN, CHRISTIAN",4323 BEN FRANKLIN BLVD STE 700 DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 240 , 293 , 414 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073928883,"LAMAR, JOSEPH, VINCENT",915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 68 , 81 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073928883,"LAMAR, JOSEPH, VINCENT",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 46 , 54 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073930020,"COYNOR, SETH, JAMES",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073931234,"WARREN, JAMES, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073931234,"WARREN, JAMES, SCOTT",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073931234,"WARREN, JAMES, SCOTT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 72 , 167 , 168 ,$#,,
MEDICAID DIRECT,1851331359,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS CHARLOTTE,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073931234,"WARREN, JAMES, SCOTT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073934063,"REEVEY, LAURA, BETH",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073934063,"REEVEY, LAURA, BETH",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 17 , 38 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073934113,"BEST, MELISSA, RENEE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073934113,"BEST, MELISSA, RENEE",7800 STEVENS MILL RD STE O MATTHEWS NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 86 , 155 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073935987,"BARBEE, SUSAN, MICHELLE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1073935987,"BARBEE, SUSAN, MICHELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1073935987,"BARBEE, SUSAN, MICHELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1073935987,"BARBEE, SUSAN, MICHELLE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1073935987,"BARBEE, SUSAN, MICHELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 26 , 26 ,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1073936936,"CRITZER, CHRISTOPHER, MORRIS",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073936936,"CRITZER, CHRISTOPHER, MORRIS",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1073936936,"CRITZER, CHRISTOPHER, MORRIS",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1073936936,"CRITZER, CHRISTOPHER, MORRIS",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073937132,"RUSSELL, TIMOTHY, GLENN",923 W 3RD ST   PEMBROKE NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073937132,"RUSSELL, TIMOTHY, GLENN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073937504,"RASHID, SHAFAQ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 41 , 48 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073938577,"MOORE, CLAYTON, RAY",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073941936,"YACOB, SAMMY, ABID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 263 , 305 , 394 ,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1073943155,"PITTMAN, KIMBERLY, BETH",131 W EDINBOROUGH AVE   RAEFORD NC,047,Hoke,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1073944195,ABSOLUTE HOME & COMMUNITY SERVICES,ABSOLUTE HOME 5,201 RAND MILL RD   GARNER NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073944195,ABSOLUTE HOME & COMMUNITY SERVICES,201 RAND MILL RD   GARNER NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 180 , 180 ," $11,443.20 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073946745,"PETRILLO, MICHAEL, ANTHONY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073946745,"PETRILLO, MICHAEL, ANTHONY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205222643,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1073947826,"WALKER, BENJAMIN, CHAD",1103 N ELM ST STE 201 GREENSBORO NC,041,Guilford,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1073948816,"HARDMON, LAPORSCHA, MICHELLE",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 141 ," 1,377 "," 1,456 "," $27,534.92 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073948998,"BALDWIN, EMILY, WARE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073948998,"BALDWIN, EMILY, WARE",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073950192,"MECHALSKE, CHRISTI, LYNN",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 12 ,$#,,
MEDICAID DIRECT,1992728950,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SALEMBURG,500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073951802,"CONNEL, STEFANI, MEAGAN",500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992171060,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF BOLIVIA,4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073951802,"CONNEL, STEFANI, MEAGAN",4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 16 , 18 ,$#,,
MEDICAID DIRECT,1003218439,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SHALLOTTE,341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073951802,"CONNEL, STEFANI, MEAGAN",341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 20 , 24 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1073951844,"MCCAULEY, TAYLOR, SUZETTE",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 27 , 46 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1073951844,"MCCAULEY, TAYLOR, SUZETTE",5 FIRSTVILLAGE DR STE 100 PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1073952081,"CHANDLER, MARK",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 15 , 24 ,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1073952081,"CHANDLER, MARK",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073952974,"BOHL, MICHAEL, AUSTIN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 60 , 112 , 209 ," $21,167.77 ",,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073953980,"MONSELL-GORBAS, VICKIE, ANN",19 NOBLE ST   SMITHFIELD NC,051,Johnston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073954590,"POLONSKY, KIMBERLY, HANSEN",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 44 , 83 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073954590,"POLONSKY, KIMBERLY, HANSEN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669537593,COUNTY OF BUNCOMBE OFFICE OF ACCOUN,BUNCOMBE COUNTY HEALTH DEPARTMENT,40 COXE AVE   ASHEVILLE NC,011,Buncombe,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1073955647,"RUNION FNP-C, BONNY, HYDER",40 COXE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 183 , 225 , 299 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 27 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 18 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073956637,"HARBERTSON, BRYCE, ALAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 279 , 315 , 415 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073957494,"COLUMBANO, HEATHER, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 68 , 139 , 227 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073957494,"COLUMBANO, HEATHER, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073958617,"AYOUBI, NASIB",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 130 , 359 , 362 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073958617,"AYOUBI, NASIB",625 BETHANY RD   ALBEMARLE NC,084,Stanly,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073961744,"SWEENEY, CAMERON, YOUNG",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 28 , 28 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073961744,"SWEENEY, CAMERON, YOUNG",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073961744,"SWEENEY, CAMERON, YOUNG",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407897119,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH MATTHEWS FAMILY PHYSICIANS,1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073962205,"DAVIS, ERICA, MARIE",1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073962205,"DAVIS, ERICA, MARIE",1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 39 , 72 ,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073963112,"KOTSOKALIS, STEFANOS",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073963112,"KOTSOKALIS, STEFANOS",8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073963443,"MCALISTER, NICHOLAS, W",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073965349,"BROWN CUNNINGHAM, SAMANTHA, KARLENE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073965349,"BROWN CUNNINGHAM, SAMANTHA, KARLENE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073965349,"BROWN CUNNINGHAM, SAMANTHA, KARLENE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073965679,"STARKE, TERESA, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1073965786,"DIAZ, CAMILA",250 HOSPICE CIR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073970539,"KEATTS, COURTNEY, STILL",7607 NC HIGHWAY 68 N STE B OAK RIDGE NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 83 , 198 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073970570,"BURKHARD, HANNA, SMITH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1073971347,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP FAMILY AND WOMENS HEALTH,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1073971347,RURAL HEALTH GROUP INC,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 83 , 139 , 140 ," $13,497.60 ",,
MEDICAID DIRECT,1073973640,BARNES GROUP HOMES LLC,,2201 RILEY RD   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073973640,BARNES GROUP HOMES LLC,2201 RILEY RD   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 207 , 207 ," $58,442.26 ",,
MEDICAID DIRECT,1073973640,BARNES GROUP HOMES LLC,,2017 EASTRIDGE CIR   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1073973640,BARNES GROUP HOMES LLC,2017 EASTRIDGE CIR   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 355 , 356 ," $116,540.40 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1073975215,"KLESICK, ELISE, MARIE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073975520,"RADWAN, TAREK, BASSAM",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 45 , 66 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073976668,"BROWN, ALISON, FLANAGAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073976668,"BROWN, ALISON, FLANAGAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 57 , 58 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073976718,"CAMPBELL, JOSHUA, STEPHENS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 114 , 117 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1073976718,"CAMPBELL, JOSHUA, STEPHENS",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073977377,"LAMM, KEVIN, MICHAEL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073977377,"LAMM, KEVIN, MICHAEL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073977377,"LAMM, KEVIN, MICHAEL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073977377,"LAMM, KEVIN, MICHAEL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 19 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1073977377,"LAMM, KEVIN, MICHAEL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 78 , 127 , 150 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1073977856,"THOMAS, JESSICA, BLAIR",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1073977948,"TIPTON, SHANE, CASEY",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 96 , 176 , 294 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1073978854,"ARRUDA, AMY, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073978854,"ARRUDA, AMY, LYNN",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2101 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073978854,"ARRUDA, AMY, LYNN",2101 N MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1073978854,"ARRUDA, AMY, LYNN",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1073979290,"SAWCHAK, REBECCA, KNOWLTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 40 , 63 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073984100,"BACHYRYCZ, ALEXANDRA, MARIE",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073984100,"BACHYRYCZ, ALEXANDRA, MARIE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073984100,"BACHYRYCZ, ALEXANDRA, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 42 , 52 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073984100,"BACHYRYCZ, ALEXANDRA, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1073984548,"OLSON, MICHELLE, PATRICIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1437653359,SANDHILLS BEHAVIORAL CARE PLLC,SANDHILLS BEST CARE,523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1073984878,"COUGHENOUR, JENNIFER, WEST",523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1073985594,"DORSEY, JENNIFER, LEE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1073985594,"DORSEY, JENNIFER, LEE",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1073986360,"PINTO, MARY, ELIZABETH",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073572822,ONSLOW PEDIATRIC ASSOCIATES,~,51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1073989752,"BEARD, DEANNA, BROOKE",51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 51 , 88 , 213 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1073989752,"BEARD, DEANNA, BROOKE",51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1073992343,"KALLUR, LAKSHMI, SOUJANYA",915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 65 , 137 , 183 ,$#,,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1073993788,"COULSON, ELISE, REBECCA",14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 91 , 374 , 466 ,$#,,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1073993788,"COULSON, ELISE, REBECCA",700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 15 , 27 , 45 ,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073994265,"MCDOWELL, CHRISTOPHER, MICHAEL",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 133 , 313 , 572 ,$#,,
MEDICAID DIRECT,1124285515,SURGICENTER OF EASTERN CAROLINA,ECU HEALTH SURGICENTER,102 BETHESDA DR   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1073994265,"MCDOWELL, CHRISTOPHER, MICHAEL",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1073996070,"BURDEN, JEWEL, DAVIDA",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,2420 LAKE WHEELER RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",2420 LAKE WHEELER RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",5533 BURLINGTON RD   MC LEANSVILLE NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 47 , 314 , 369 ,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",5533 BURLINGTON RD   MC LEANSVILLE NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",5533 BURLINGTON RD   MC LEANSVILLE NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 61 , 347 , 378 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 45 , 221 , 261 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 46 , 155 , 167 ,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 48 , 48 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1073999116,"DELMASTRO, SALLY, JENAY",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1073999686,"RICHARDSON, BRITTANY, MCGRATH",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 76 , 127 ,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083000954,"HUGHES, ASHLEY, CORINNE",500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 31 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083001465,"BRENNER, ERICA, JUNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083001887,"DAWSON, DESIREE, BARBARA",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083001887,"DAWSON, DESIREE, BARBARA",14035 GRANDIFLORA DR   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083001937,"SUMMERS, JOHN, CHRISTOPHER",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 39 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083001937,"SUMMERS, JOHN, CHRISTOPHER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 92 , 101 , 101 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083004840,"ADAMCHAK, STEPHANIE, ELENA",200 CAPE FEAR CIR STE 1 SNEADS FERRY NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 81 , 162 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083008395,"THURBER, BRIAN, WILLIAM",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083008650,"ZELLER, STEPHANIE, VANCE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083008650,"ZELLER, STEPHANIE, VANCE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 76 , 76 , 107 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083008650,"ZELLER, STEPHANIE, VANCE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083008650,"ZELLER, STEPHANIE, VANCE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083008650,"ZELLER, STEPHANIE, VANCE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083008650,"ZELLER, STEPHANIE, VANCE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073688123,EASTERN CAROLINA FOOT AND ANKLE SPE,~,2140 W ARLINGTON BLVD STE D GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083008981,"PRICE, MICHAEL, JOSEPH",2140 W ARLINGTON BLVD STE D GREENVILLE NC,074,Pitt,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 157 , 415 , 692 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1083009351,"HIN, NADY",100 S 10TH ST   LILLINGTON NC,043,Harnett,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1083009351,"HIN, NADY",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1083009351,"HIN, NADY",100 S 10TH ST   LILLINGTON NC,043,Harnett,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 15 , 23 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,959 EAST ST STE B PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1083009351,"HIN, NADY",959 EAST ST STE B PITTSBORO NC,019,Chatham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1063948297,RDMG ASSOCIATES PA,SPINDALE FAMILY PRACTICE,144 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1083015549,"EDGERTON, LAURA, YORK",144 RESERVATION DR   SPINDALE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 31 , 47 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083016547,"DANSBY, TIMANIKA",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083018295,SALVUSLABS LLC,,200 COBB PKWY N STE 124 MARIETTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1083018295,SALVUSLABS LLC,200 COBB PKWY N STE 124 MARIETTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 77 , 97 , 97 ," $10,738.73 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3150 ROGERS RD STE 220 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1083020788,"EHRHARDT, DOMINEE, CHRISTINA",3150 ROGERS RD STE 220 WAKE FOREST NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 39 , 54 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083020788,"EHRHARDT, DOMINEE, CHRISTINA",2824 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083021620,"WILLIAMS, AMBER, RENEE",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083021620,"WILLIAMS, AMBER, RENEE",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083021620,"WILLIAMS, AMBER, RENEE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083021620,"WILLIAMS, AMBER, RENEE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083023899,"WINTERS, LAURA, ANNE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 22 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083024228,"BROOTEN, JUSTIN, KENNETH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083024228,"BROOTEN, JUSTIN, KENNETH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083024228,"BROOTEN, JUSTIN, KENNETH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083024228,"BROOTEN, JUSTIN, KENNETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 48 , 52 ,$#,,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,2428 N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083027858,"STRAUGHAN, CHARLES, ARMWORTHY",100 GOODMAN CIR NE   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1083027858,"STRAUGHAN, CHARLES, ARMWORTHY",1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1083027858,"STRAUGHAN, CHARLES, ARMWORTHY",2428 N SHARON AMITY RD STE 301 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,2428 N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083027858,"STRAUGHAN, CHARLES, ARMWORTHY",2428 N SHARON AMITY RD STE 301 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 627 ," 1,314 "," 7,062 "," $581,885.81 ",,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,100 GOODMAN CIR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083027858,"STRAUGHAN, CHARLES, ARMWORTHY",2428 N SHARON AMITY RD STE 301 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083028153,"DORN, LAUREN, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083028807,"GLOVER, ADAM, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1083030894,"FIELD, BENJAMIN, STORER",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 155 , 155 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,521C MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083031546,"HOO-FATT, DANIELLE, TAMARA",521C MOYE BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083031546,"HOO-FATT, DANIELLE, TAMARA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 120 , 131 , 162 ," $10,467.71 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,910 N MADISON BLVD STE B ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",910 N MADISON BLVD STE B ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",1311 E MILLBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",11491 US HWY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",11491 US HWY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",11491 US HWY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",11491 US HWY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",11491 US HWY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",11491 US HWY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032197,"GRIPPON, NATHALIE, JULIENNE",11491 US HWY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972912285,UNIVERSITY OF NORTH CAROLINA AT CHA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1083032528,"WHITESIDES, DANIEL, BENNETT",107 SUNNYBROOK RD STE 159 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972912285,UNIVERSITY OF NORTH CAROLINA AT CHA,~,401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032528,"WHITESIDES, DANIEL, BENNETT",401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 117 , 341 , 561 ," $11,390.60 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083032528,"WHITESIDES, DANIEL, BENNETT",401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972912285,UNIVERSITY OF NORTH CAROLINA AT CHA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1083032528,"WHITESIDES, DANIEL, BENNETT",107 SUNNYBROOK RD STE 159 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1083032528,"WHITESIDES, DANIEL, BENNETT",401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083032528,"WHITESIDES, DANIEL, BENNETT",401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083033161,"PEKMAN, LAURA, KEMP",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1659396893,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083033161,"PEKMAN, LAURA, KEMP",7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083033161,"PEKMAN, LAURA, KEMP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083033161,"PEKMAN, LAURA, KEMP",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083033419,"FOSTER FABIANO, SARA, ANNE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 27 , 31 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083033971,"DIEFFENBAUGHER, SEAN, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 58 , 136 , 149 ," $16,168.08 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083034417,"MILLS, OLIVIA, MONEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 72 , 72 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083036487,"STARK, KRISTA, ELIZABETH",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235143231,SWETANG PATEL MD PA,~,2587 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1083037691,"BALLARD, STEPHANIE, TRENT",2587 HENDERSON DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 99 , 343 , 406 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1083039010,"FRYE, JENNIFER, HILTON",1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4300 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083039010,"FRYE, JENNIFER, HILTON",200 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740405745,LINCOLN COUNTY,LINCOLN CO HEALTH DEPT,200 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1083039010,"FRYE, JENNIFER, HILTON",200 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 20 , 51 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1083039010,"FRYE, JENNIFER, HILTON",200 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083039507,"JONES, DANIELLE, LAUGHLIN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083039507,"JONES, DANIELLE, LAUGHLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083040455,"GOINS, MEGAN, ELIZA",120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 33 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083040455,"GOINS, MEGAN, ELIZA",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083042444,"DEANS, MICHELLE, STILES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 24 , 28 ,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1083043970,"NODAL, AMBER, KAY",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 70 , 89 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083046999,"STANTON, MORGAN, MCCARTNEY",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083046999,"STANTON, MORGAN, MCCARTNEY",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083046999,"STANTON, MORGAN, MCCARTNEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083046999,"STANTON, MORGAN, MCCARTNEY",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083046999,"STANTON, MORGAN, MCCARTNEY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083049217,SENORA H WOODARD,WOODARDS HOME,1709 ATKINS RD   FUQUAY VARINA NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083049217,SENORA H WOODARD,1709 ATKINS RD   FUQUAY VARINA NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 242 , 242 ," $22,063.42 ",,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1083050595,"WALKER, ELISE, ADELE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 57 , 57 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083050595,"WALKER, ELISE, ADELE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 65 , 65 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1083050595,"WALKER, ELISE, ADELE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 115 , 115 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083052039,"TAYLOR, MERIDITH, MATTHIS",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 150 , 270 ,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083053029,"MORRIS, CLARK, LOGAN",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,321 "," 1,405 "," 6,486 "," $256,261.35 ",,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083053029,"MORRIS, CLARK, LOGAN",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,026 "," 1,152 "," 10,267 "," $880,434.59 ",,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083053029,"MORRIS, CLARK, LOGAN",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 15 ,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083053029,"MORRIS, CLARK, LOGAN",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 103 , 104 , 513 ," $25,892.94 ",,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1083053029,"MORRIS, CLARK, LOGAN",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083053029,"MORRIS, CLARK, LOGAN",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 81 , 61 , 248 ," $12,446.92 ",,
MEDICAID DIRECT,1902452139,BRADLEY ROBERTS & ASSOCIATES PLLC,,1135 N CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",1135 N CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 135 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 280 ," $24,023.55 ",,
MEDICAID DIRECT,1801442033,BRADLEY ROBERTS & ASSOCIATES PLLC,~,401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 15 , 313 ," $25,188.22 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 4,324 "," 5,147 "," 32,357 "," $1,209,095.02 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 94 , 94 , 898 ," $51,939.70 ",,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083054225,"HILL, ROLANDAS, LEMARC",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 103 , 103 , 610 ," $29,026.39 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083055396,"KELLEY, PHILLIP, ANTONIO",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083055396,"KELLEY, PHILLIP, ANTONIO",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083055396,"KELLEY, PHILLIP, ANTONIO",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 111 , 213 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083055396,"KELLEY, PHILLIP, ANTONIO",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083058622,"GHAZI, RABIA, AHMAD",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083058622,"GHAZI, RABIA, AHMAD",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 24 , 46 ,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1083058770,"PEREA, RICARDO, JOSE",197 RIVERVIEW ST   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 54 , 54 ,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1083058770,"PEREA, RICARDO, JOSE",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 35 , 35 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083058879,"AVERSANO, MICHAEL, WILLIAM",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 61 , 117 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083058879,"AVERSANO, MICHAEL, WILLIAM",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1083059497,"JORDAN, JENNIFER, FAYE",1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1083059497,"JORDAN, JENNIFER, FAYE",1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1083059497,"JORDAN, JENNIFER, FAYE",103 COX BLVD   GOLDSBORO NC,096,Wayne,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 159 , 230 , 352 ," $17,964.12 ",,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083060545,"CHISENHALL, EVGENIYA, NIKOLAEVNA",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083060545,"CHISENHALL, EVGENIYA, NIKOLAEVNA",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 37 , 95 ,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1083060545,"CHISENHALL, EVGENIYA, NIKOLAEVNA",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 35 , 75 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 51 , 58 , 76 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",114 W 30TH ST STE 800 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 18 , 26 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 48 , 70 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 26 , 33 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 24 , 42 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083061923,"ZHAO, JIN",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083065940,"RIEDELL, JAMIE, MARIE",4102 N ROXBORO ST   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083066310,"CLARK, DANA, MARIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083066310,"CLARK, DANA, MARIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083068464,"BUKHARI, AREEJ, FATIMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 28 , 50 , 50 ,$#,,
MEDICAID DIRECT,1255950325,NORTHERN HOSPITAL DISTRICT OF SURRY,NORTHERN URGENT CARE,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1083069082,"MERZ, MICHAEL, DAVID",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1083069082,"MERZ, MICHAEL, DAVID",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 162 , 314 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1083070106,"RAY, ALEXANDRA, BAGGSTROM",2007 WALNUT ST   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1083070106,"RAY, ALEXANDRA, BAGGSTROM",8841 SIX FORKS RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083070379,"OCONNOR, MELISSA, ELIZABETH",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 90 , 111 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083075535,"ABBOTT, LINDSEY, RENEE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083075535,"ABBOTT, LINDSEY, RENEE",3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083075535,"ABBOTT, LINDSEY, RENEE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083078067,"PATEL, VISHAL, RAMESH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083078067,"PATEL, VISHAL, RAMESH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083078224,"HARMON, JENNIFER, LINTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 54 , 51 , 69 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083078703,"HONG, RUI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083078703,"HONG, RUI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083078703,"HONG, RUI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760139323,COASTAL HEADACHE CLINIC PLLC,,1715 COUNTRY CLUB RD STE B JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1083079701,"KAMP, TERRA",1715 COUNTRY CLUB RD STE B JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 170 , 225 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083081996,"SANFORD, KATHRYN, SARAH",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 64 , 144 , 144 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083082838,"DYKES, AMBER, DENISE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1083082838,"DYKES, AMBER, DENISE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 45 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083082838,"DYKES, AMBER, DENISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083083950,REALO DISCOUNT DRUG STORES OF EAST,REALO DISCOUNT DRUGS,502 W THURMAN RD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083083950,REALO DISCOUNT DRUG STORES OF EAST,502 W THURMAN RD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083092167,"HARRIS, WALLACE, TAYLOR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 13 , 25 ," $10,114.51 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083092167,"HARRIS, WALLACE, TAYLOR",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 57 , 85 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083093900,"SLOAN, RUBEN, CARNELL",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083093900,"SLOAN, RUBEN, CARNELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 42 , 42 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083093900,"SLOAN, RUBEN, CARNELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 38 , 40 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083093900,"SLOAN, RUBEN, CARNELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083093942,"GLOVER, CARLTON, ISAIAH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 100 , 100 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083093942,"GLOVER, CARLTON, ISAIAH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1891002374,BLUE RIDGE HEALTHCARE MEDICAL GROUP,LENOIR FAMILY MEDICINE,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1083094304,"CHAMBERS, STEPHANIE, MICHELLE",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 134 , 212 ,$#,,
MEDICAID DIRECT,1770597486,HOWDY AND JONES DDS,~,1103 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1083097422,"COCHRAN, PHILIP, ELLIOT",1103 BROWN ST   WASHINGTON NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 29 , 75 ,$#,,
MEDICAID DIRECT,1083099394,CHILDRENS PLACE PEDIATRIC THERAPIES,,2783 NC HIGHWAY 68 S STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083099394,CHILDRENS PLACE PEDIATRIC THERAPIES,2783 NC HIGHWAY 68 S STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,, 30 , 710 , 722 ," $66,809.30 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083099568,"SMITH, MANDESA, MALIKA",4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083101364,"SANER, ERIN, MICHELLE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 93 , 125 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083102214,"GLOWACKI, CHRISTINE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083102453,"CAMARA, AMADOU",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083102453,"CAMARA, AMADOU",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083102453,"CAMARA, AMADOU",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 184 , 244 , 268 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083103717,"HAYES, AMANDA, WOODS",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083103717,"HAYES, AMANDA, WOODS",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083103717,"HAYES, AMANDA, WOODS",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 21 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083103717,"HAYES, AMANDA, WOODS",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083106504,"YOUNTS-DAVIS, BRANDY, LANETTE",306 WESTWOOD AVE STE 401 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 116 , 161 , 171 ,$#,,
MEDICAID DIRECT,1255022869,MANENTE NC PC,CLEAR SMILE DESIGN,2301 BATTLEGROUND AVE STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083107619,"ANDERSON, JOSEPH, TANNER",1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 192 ," 1,168 "," 1,173 "," $139,275.51 ",,
MEDICAID DIRECT,1255022869,MANENTE NC PC,CLEAR SMILE DESIGN,2301 BATTLEGROUND AVE STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083107619,"ANDERSON, JOSEPH, TANNER",2301 BATTLEGROUND AVE STE 101 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 210 , 963 ," 1,483 "," $237,182.22 ",,
MEDICAID DIRECT,1700579489,MANENTE NC PC,MCMILLIAN ORTHODONTICS,1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083107619,"ANDERSON, JOSEPH, TANNER",2301 BATTLEGROUND AVE STE 101 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1700579489,MANENTE NC PC,MCMILLIAN ORTHODONTICS,1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083107619,"ANDERSON, JOSEPH, TANNER",1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 201 , 336 , 372 ," $51,715.64 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083108419,"ERICKSON, BRIAN, ROY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083108419,"ERICKSON, BRIAN, ROY",1995 WELLNESS BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 45 , 93 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083109227,"D'ERRICO, CHRISTOPHER, BARTOLO",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 29 ,$#,,
MEDICAID DIRECT,1659961399,ZOHAIB MUNAF DMD MBS PLLC,TOOTHTOWN DENTISTRY FOR KIDS,4514 OLD MONROE RD STE CD INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1083109375,"KHAN, ZENAB, EJAZ",4514 OLD MONROE RD STE C INDIAN TRAIL NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 18 , 89 ,$#,,
MEDICAID DIRECT,1902631575,MUNAF GASTONIA DMD PLLC,TOOTHTOWN DENTISTRY FOR KIDS,2641 COURT DR STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1083109375,"KHAN, ZENAB, EJAZ",4514 OLD MONROE RD STE C INDIAN TRAIL NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 90 ,$#,,
MEDICAID DIRECT,1104530658,MCLAREN DDS MINT HILL PLLC,SMILE BUILDERS PEDIATRIC DENTISTRY,7215 LEBANON RD STE G MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083109375,"KHAN, ZENAB, EJAZ",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 72 , 74 , 377 ," $13,753.69 ",,
MEDICAID DIRECT,1700447307,NAGARANI NAGARAJAN DDS PLLC,VISTA FAMILY DENTISTRY,2510 VISTA DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083109375,"KHAN, ZENAB, EJAZ",2510 VISTA DR STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 41 , 44 , 177 ," $14,876.66 ",,
MEDICAID DIRECT,1811412562,SNOW & SNOW DDS PLLC,~,5306 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083109375,"KHAN, ZENAB, EJAZ",5306 SOUTH BLVD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083110415,"BLEW, KATHRYN, HORNADAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083110415,"BLEW, KATHRYN, HORNADAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083110415,"BLEW, KATHRYN, HORNADAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 25 , 31 , 37 ,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083112288,"SUTTLE, SONYA, MCCALL",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033170113,HART FAMILY PRACTICE,HART FAMILY PRACTICE,221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1083112288,"SUTTLE, SONYA, MCCALL",221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609515220,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-6503 BREVARD ROAD,6503 BREVARD RD   ETOWAH NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083113880,"HARRIS, JOSHUA, FREEMAN",6503 BREVARD RD   ETOWAH NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 79 , 99 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083114201,"SWARTWOOD, EMILY, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083118095,"ELZEIN, HASSAN, ALI",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083119275,"FINDLAY, MATTHEW, JOSEPH",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 112 , 178 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083119275,"FINDLAY, MATTHEW, JOSEPH",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1083119275,"FINDLAY, MATTHEW, JOSEPH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083119275,"FINDLAY, MATTHEW, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 23 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083119275,"FINDLAY, MATTHEW, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083119671,"ISBELL, ANDREW, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 31 , 50 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083121776,"DE SA, SHERYL, MARIA SAVITA",5325 VINNING ST NW STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 23 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083123319,"DEGRANGE, RACHEL, DAWN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1609115062,KID STRIDES THERAPY LLC,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,251S00000X,Agencies,Community/Behavioral Health,,1083124028,"LOPIENSKI, KATHRYN, NEEDHAM",5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1801116405,MONARCH,~,820 GRIMES BLVD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1083124317,"DION, JAMES, PHILLIP",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,,,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1083125322,"MAL, NAREE",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 64 , 200 , 200 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083125322,"MAL, NAREE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083127419,"ARREGUIN, JODI, ANN",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083127419,"ARREGUIN, JODI, ANN",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083128508,ALMARCH FAMILY CARE LLC,,1649 HARPER ST   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083128508,ALMARCH FAMILY CARE LLC,1649 HARPER ST   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 836 , 837 ," $112,888.13 ",,
MEDICAID DIRECT,1083132211,WALGREEN CO,WALGREENS 19992,205 SALISBURY AVE   ALBEMARLE NC,084,Stanly,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1083132211,WALGREEN CO,205 SALISBURY AVE   ALBEMARLE NC,084,Stanly,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083132773,"ISABWA, GREGORY, ATIKA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 46 , 50 , 50 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1083132773,"ISABWA, GREGORY, ATIKA",1010 COLLEGE ST   OXFORD NC,039,Granville,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083132773,"ISABWA, GREGORY, ATIKA",1010 COLLEGE ST   OXFORD NC,039,Granville,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,442 S HIGHWAY 27   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083132898,"MCKOY, RAVON, LAMONT",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083133417,"YANDLE, JILL, REBECCA",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083133417,"YANDLE, JILL, REBECCA",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 97 , 104 ,$#,,
MEDICAID DIRECT,1205170800,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083133417,"YANDLE, JILL, REBECCA",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083133417,"YANDLE, JILL, REBECCA",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 29 , 32 ,$#,,
MEDICAID DIRECT,1255380887,MARTINSVILLE PHYSICIAN PRACTICES,,319 HOSPITAL DR STE 202 MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083135354,"CRAWFORD, BRANDON, WAYNE",319 HOSPITAL DR STE 107 MARTINSVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083135354,"CRAWFORD, BRANDON, WAYNE",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083140321,"PEREZ, REINALDO",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083140321,"PEREZ, REINALDO",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083140321,"PEREZ, REINALDO",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 22 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083140321,"PEREZ, REINALDO",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083140735,"HANVEY, INDIA, BLAIRE",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 24 , 61 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083141774,"JAISINGHANI, SURAJ",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1083142095,"VAISHNANI, KUSHAL, CHANDULAL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 23 , 47 , 51 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083142095,"VAISHNANI, KUSHAL, CHANDULAL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 30 , 101 , 101 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083142095,"VAISHNANI, KUSHAL, CHANDULAL",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083142426,"BERNHARDSEN, BJORN, BENGT-GUNNAR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083142426,"BERNHARDSEN, BJORN, BENGT-GUNNAR",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083142525,"CARR, MATTHEW, TIMOTHY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1083145510,"SCARLOTTA, MATTHEW, JAMES",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 19 , 30 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1083145510,"SCARLOTTA, MATTHEW, JAMES",135 PAGE RD N   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 45 , 94 , 158 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083147375,"SMITH, BLAIRE, MARIE WILLIAM",201 E MATTHEWS ST STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 19 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083147615,"NEUSS, MICHAEL, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 80 , 84 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083147615,"NEUSS, MICHAEL, JAMES",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 30 , 39 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1083147748,"PHILLIPS, EMILY, ELIZABETH",2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1083148282,"KIKER, CAMERON, STEVENS",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 96 , 151 ,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1083148282,"KIKER, CAMERON, STEVENS",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083148639,"WARD, JEREMY, DEWAYNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1083151195,SWEET WATERS HOMECARE,,437 WESTERN BLVD STE C JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1083151195,SWEET WATERS HOMECARE,437 WESTERN BLVD STE C JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,972 "," 1,973 "," $201,120.20 ",,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083151559,"DEMORIER, EMMA, LYNN",19 NOBLE ST   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083151559,"DEMORIER, EMMA, LYNN",4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 70 , 130 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083153001,"GREENE, TIANNA, KATHRYN POWELL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083153001,"GREENE, TIANNA, KATHRYN POWELL",4414 LAKE BOONE TRL STE 311 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083160873,"SOLHEIM, JOSHUA, SALOMON",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 23 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083160873,"SOLHEIM, JOSHUA, SALOMON",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083160873,"SOLHEIM, JOSHUA, SALOMON",1730 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083161632,"GOOD, AMY, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 35 , 35 ,$#,,
MEDICAID DIRECT,1326313735,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,305 1ST ST E   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083162937,"HULCE, MELISSA, GRANSON",305 1ST ST E   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 66 , 86 ,$#,,
MEDICAID DIRECT,1578747077,COMPREHENSIVE REHAB AND PAIN SPECIA,COMPREHENSIVE REHAB AND PAIN SPECIALIST,135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1083164222,"JENNINGS, BROOKE, LOGAN",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 109 , 160 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083164222,"JENNINGS, BROOKE, LOGAN",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083170369,"ALBRITTON, HOPE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083170369,"ALBRITTON, HOPE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083170369,"ALBRITTON, HOPE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1083173926,"RUSSELL, CODY, THOMAS",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083173926,"RUSSELL, CODY, THOMAS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1083173926,"RUSSELL, CODY, THOMAS",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083174148,"SENSENBRENNER, ERIC, DANIEL",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083174148,"SENSENBRENNER, ERIC, DANIEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083174148,"SENSENBRENNER, ERIC, DANIEL",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083174148,"SENSENBRENNER, ERIC, DANIEL",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083174825,"PHELPS, KAITLYN, CIERRA",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083176358,"NAVA, HELLEN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083177612,"DUFFY, MOLLY, MILENE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083177612,"DUFFY, MOLLY, MILENE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 31 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083177612,"DUFFY, MOLLY, MILENE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 43 , 47 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1083177679,"GRAHAM, DUSTY, STAR",1303 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 42 , 78 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1083177679,"GRAHAM, DUSTY, STAR",4208 MURDOCKSVILLE RD   WEST END NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1083177679,"GRAHAM, DUSTY, STAR",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 39 , 78 ,$#,,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1083180814,"POWELL, COURTNEY, JENNINGS",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 110 , 520 ," $22,815.27 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083182992,"TUCKER, KATIE, WEATHERMAN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 86 , 191 , 191 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083186050,"CAMPBELL, KAITLIN, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1083189211,NEXT STEP PROSTHETICS LLC,,2826 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083189211,NEXT STEP PROSTHETICS LLC,2826 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 35 ," $18,258.17 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083190052,"BOWSER, GRACE, ELIZABETH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083190052,"BOWSER, GRACE, ELIZABETH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083190052,"BOWSER, GRACE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083190052,"BOWSER, GRACE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083191142,"HAIDER, SYED, SAMI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 108 , 110 ,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083193536,"HELD, ZACHARY, DAVID",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1083197115,"BOWYER, JENNIFER, PICERNO",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1083197115,"BOWYER, JENNIFER, PICERNO",7473 C HWY 22   CARTHAGE NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1922734375,MCPC-24 LLC,FIRSTHEALTH TELEMEDICINE,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1083197115,"BOWYER, JENNIFER, PICERNO",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1083197115,"BOWYER, JENNIFER, PICERNO",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1083197115,"BOWYER, JENNIFER, PICERNO",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083197651,"CUMMINGS, ERIKA",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 105 , 106 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1083201461,"MOHAMMED, MORTADA, AWADALKAREEM MUSTAFA",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 248 , 248 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083201594,"RAMSEY, ANNA, KATE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083201594,"RAMSEY, ANNA, KATE",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 32 , 38 ,$#,,
MEDICAID DIRECT,1265403042,NORTH CAROLINA NEUROPSYCHIATRY,NORTH CAROLINA NEUROPSYCHIATRY PA,1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083202147,"GILLETTE, PATRICK, GREY",1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265403042,NORTH CAROLINA NEUROPSYCHIATRY,NORTH CAROLINA NEUROPSYCHIATRY PA,13251 FALLS OF NEUSE RD SUITE 121 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083202147,"GILLETTE, PATRICK, GREY",13251 FALLS OF NEUSE RD STE 121 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1083204994,"BAYSAL, SARAH, IZEL",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 36 , 47 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1083204994,"BAYSAL, SARAH, IZEL",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1083204994,"BAYSAL, SARAH, IZEL",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 41 , 51 ,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083205561,"GOLD, AMBER, LYNN",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 35 , 36 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083206718,"SAWICKI, CAROLINE, MARIA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 75 , 81 , 226 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083206718,"SAWICKI, CAROLINE, MARIA",140 DENTAL CIR   CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 69 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083206718,"SAWICKI, CAROLINE, MARIA",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 15 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083206734,"DUNN, EMILY, COLLINS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 23 , 49 , 56 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083206734,"DUNN, EMILY, COLLINS",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083208664,"FALLS, CHASITI, JORDAN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811761349,CAROMONT MEDICAL GROUP INC,CAROMONT HEALTH MATERNITY CLINIC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083208664,"FALLS, CHASITI, JORDAN",991 W HUDSON BLVD STE 70B GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083208664,"FALLS, CHASITI, JORDAN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 14 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1083209001,"NIEMEYER, KIMBERLY, MARIE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1083209001,"NIEMEYER, KIMBERLY, MARIE",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1306583620,BRUCE MEDICAL PLLC,,160 MACGREGOR PINES DR STE 109 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1083209217,"VAN ESSENDELFT, JILLIAN, HERMA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1083211486,"BYRD, WILLIAM, CODY",1072 NC HIGHWAY 210 STE A SNEADS FERRY NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 39 ,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,1072 NC HIGHWAY 210 STE A SNEADS FERRY NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083211486,"BYRD, WILLIAM, CODY",1072 NC HIGHWAY 210 STE A SNEADS FERRY NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1083211486,"BYRD, WILLIAM, CODY",15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083215255,"MELTZER, DANIEL, NACY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083215495,"MASSEY, KRISTEN, FONTELA",3116 N DUKE ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 16 , 41 , 59 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083215529,"DASCANIO, GABRIEL, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 65 , 70 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1083219067,"GOODMAN, KIMBERLY, TWEEDY",110 W GROVER ST   SHELBY NC,023,Cleveland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 30 , 32 , 47 ,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1083219067,"GOODMAN, KIMBERLY, TWEEDY",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083223655,"BARBER, RUTH, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1689309619,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PIEDMONT HIGH,2596 ROBINWOOD RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083224653,"DELANY, RACHEL, MARIE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1922730142,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PIEDMONT ELEMENTARY,119 E 2ND AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083224653,"DELANY, RACHEL, MARIE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083224653,"DELANY, RACHEL, MARIE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1538890793,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PIEDMONT MIDDLE,2970 S NEW HOPE RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083224653,"DELANY, RACHEL, MARIE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 32 , 32 ," $10,250.56 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083226062,"TYO, JAMIE, LYNN",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083227896,"MCLAUGHLIN, KASEY, E.T.",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083227896,"MCLAUGHLIN, KASEY, E.T.",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1083230197,"NEWELL, BRITTANY, HICKS",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1083230197,"NEWELL, BRITTANY, HICKS",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 135 , 330 , 851 ," $10,410.34 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083234496,"MOLOSKY, JULIANA, MARY",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083236608,"NGUYEN, SUMMER, HIEN-NGOC",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 47 , 48 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083236608,"NGUYEN, SUMMER, HIEN-NGOC",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1083237309,W3 HOME CARE HEALTH ASSISTANCE,W3 CARE HOME HEALTH ASSISTANCE,618 PATRICK ST   EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,,1083237309,W3 HOME CARE HEALTH ASSISTANCE,618 PATRICK ST   EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,, 91 ," 21,318 "," 22,220 "," $2,821,431.99 ",,
MEDICAID DIRECT,1912121393,ADAM T DORSETT DDS AND JASON T MOOR,ADAM T DORSETT AND JASON T MOORE DDS PA,127 ROYAL TROON LN   ADVANCE NC,030,Davie,193200000X,Group,Multi-Specialty,,1083238315,"ROSE, COURTNEY, HARRIOTT",127 ROYAL TROON LN   ADVANCE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice, 427 , 521 ," 1,824 "," $58,674.08 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083242598,"COAXUM, LAUREN, ALEXANDRIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083242598,"COAXUM, LAUREN, ALEXANDRIA",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 57 , 59 ,$#,,
MEDICAID DIRECT,1326594995,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD FAMILY MEDICINE CAROLINA FOREST 1,101 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083242960,"GHIASI, NOMAN",101 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1003818485,HERITAGE FAMILY PHYSICIANS,HLTH PAVILION FAMILY CARE,6387 RAMSEY ST UNIT 210 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083245476,"ROUSE, JAMILA, DEVORA",6387 RAMSEY ST UNIT 210 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 113 , 225 , 242 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 34 , 71 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083246029,"ISRAEL CASTLE, DAWN, ROCHELLE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6901 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083246177,"MOORE, BETTY, MAUNEY",901 DOW RD   CAROLINA BEACH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1083247308,"HALE, EMILY, CATHERINE",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 167 , 441 , 695 ," $10,001.44 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083248470,"MATTHEWS, STEPHANIE, LITTLE",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 28 , 60 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083248470,"MATTHEWS, STEPHANIE, LITTLE",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083249437,"BROCKWAY, KATHRYN, ELIZABETH",5325 VINNING ST NW STE 101 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 48 , 97 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083249437,"BROCKWAY, KATHRYN, ELIZABETH",4136 CLEMMONS RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083249916,"DOUTHETT, PAIGE, CHESSMAN",816 INPENDENCE BLVD STE 2H VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285186080,ADVANCE COMMUNITY HEALTH INC,~,112 COX AVE   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",212 S SALEM ST   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",173 HIGH HOUSE RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114479011,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1430 S WILMINGTON ST   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",1430 S WILMINGTON ST   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114479011,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1430 S WILMINGTON ST   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952760290,ADVANCE COMMUNITY HEALTH INC,,187 HIGH HOUSE RD   CARY NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083250500,"WARD, MERIAH, PAIGE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1083251383,DEFINED HOME CARE LLC,DEFINED HOME CARE LLC,8007 N POINT BLVD STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1083251383,DEFINED HOME CARE LLC,8007 N POINT BLVD STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 4,507 "," 4,639 "," $622,899.17 ",,
MEDICAID DIRECT,1083251383,DEFINED HOME CARE LLC,DEFINED HOME CARE LLC,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1083251383,DEFINED HOME CARE LLC,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 11 , 301 , 314 ," $43,173.04 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1083252282,"CHASE, REBECCA, LAUREN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1083252282,"CHASE, REBECCA, LAUREN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083252282,"CHASE, REBECCA, LAUREN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 27 , 28 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1083252282,"CHASE, REBECCA, LAUREN",227 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083252282,"CHASE, REBECCA, LAUREN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083252282,"CHASE, REBECCA, LAUREN",227 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295196780,LLD LABORATORIES LLC,,249 E NC HIGHWAY 54 STE 310 DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,1083252357,"ROTHENBERG, KELSEY, ANN",249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215022926,B & D INTEGRATED HEALTH SERVICES,~,249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083252357,"ROTHENBERG, KELSEY, ANN",249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 53 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1083253033,"GARTRELL, BRENDA, LEE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083253033,"GARTRELL, BRENDA, LEE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083253033,"GARTRELL, BRENDA, LEE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,,,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083253033,"GARTRELL, BRENDA, LEE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083253033,"GARTRELL, BRENDA, LEE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 23 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083255046,"HYLER, JORDAN, NICOLE",590 MANNING DR   CHAPEL HILL NC,068,Orange,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083255046,"HYLER, JORDAN, NICOLE",590 MANNING DR   CHAPEL HILL NC,068,Orange,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083255228,"ZICH, KARI, MICHELLE",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083255228,"ZICH, KARI, MICHELLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083256549,"GOLDEN, SYDNEY, RAE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083256549,"GOLDEN, SYDNEY, RAE",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1083256549,"GOLDEN, SYDNEY, RAE",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 31 , 72 ,$#,,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083258347,"VAN HORN, RACHEL, LAUREN",1000 JOHNSON FY RD NE   ATLANTA GA,102,Out of State > 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083258347,"VAN HORN, RACHEL, LAUREN",308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083259212,"AKERLEY, LAURA, PICA",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083266480,"CASPER, GINA, MARIE",210 SMITH CHURCH RD STE A ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 85 , 91 , 163 ,$#,,
MEDICAID DIRECT,1417303629,WESTWOOD MEDICAL,,1201 W LEBANON ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1083268254,"SNOW, TABETHA, ASHLEYMARIE",505 SAMARITANS RIDGE CT STE 100 ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083272835,"O'NEAL, HAYDEN",2609 OLD SALISBURY RD   WINSTON SALEM NC,034,Forsyth,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083273874,"SCHWEIZER, TIMARI, CAITLIN",1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1538922950,DR TIMARI SCHWEIZER DMD MPH PLLC,CONFIDENT KIDS PEDIATRIC DENTISTRY,1696 NC HIGHWAY 68 N   OAK RIDGE NC,041,Guilford,193400000X,Group,Single Specialty,,1083273874,"SCHWEIZER, TIMARI, CAITLIN",1696 NC HIGHWAY 68 N   OAK RIDGE NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 519 , 897 ," 4,427 "," $217,731.28 ",,
MEDICAID DIRECT,1083273874,"SCHWEIZER, TIMARI, CAITLIN",~,510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1083273874,"SCHWEIZER, TIMARI, CAITLIN",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 13 ,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083273874,"SCHWEIZER, TIMARI, CAITLIN",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 355 , 401 ," 1,917 "," $92,169.65 ",,
MEDICAID DIRECT,1891809893,MICHAEL CHRISTOPHER DESANTIS,MICHAEL CHRISTOPHER DESANTIS,608 46TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1083274575,"EDWARDS, MORGAN, KELSEY",10 3RD AVE NE STE 500 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 136 , 136 ,$#,,
MEDICAID DIRECT,1568763795,DESANTIS FAMILY PRACTICE,DESANTIS FAMILY PRACTICE,10 3RD AVE NE STE 500 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083274575,"EDWARDS, MORGAN, KELSEY",10 3RD AVE NE STE 500 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 25 ,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1083275119,"CROOKS, CLARISSA, DAWN",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 124 , 354 ," $15,720.92 ",,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1083277008,"BEGLEY, REBECCA, ANNE EVANS",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 186 , 368 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1083278600,"FOXWORTH, KELLIE, JASMINE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1083278600,"FOXWORTH, KELLIE, JASMINE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1083278600,"FOXWORTH, KELLIE, JASMINE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1083278600,"FOXWORTH, KELLIE, JASMINE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1083278816,"SHELLEY, DAVID, BRIAN",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1083278816,"SHELLEY, DAVID, BRIAN",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1083278816,"SHELLEY, DAVID, BRIAN",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 37 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2200 TREELIGHT WAY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1083278816,"SHELLEY, DAVID, BRIAN",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1083278816,"SHELLEY, DAVID, BRIAN",2200 TREELIGHT WAY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326325994,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE SHERRILLS FORD,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083279392,"STOLORENA, REBECCA, STREICH",6127 HIGHWAY 16 S   DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326325994,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE SHERRILLS FORD,,,Unknown,193200000X,Group,Multi-Specialty,,1083279392,"STOLORENA, REBECCA, STREICH",6127 HIGHWAY 16 S   DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326325994,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE SHERRILLS FORD,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083279392,"STOLORENA, REBECCA, STREICH",3900 TERRELL PARK DR   SHERRILLS FORD NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 70 , 156 ,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1083279541,"PENDEM, UMA, BHARGAVI",801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1083279541,"PENDEM, UMA, BHARGAVI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1659418515,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE TIMBERLYNE,77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083279541,"PENDEM, UMA, BHARGAVI",77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 46 , 98 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1083279988,"BROWN, SAMUEL, PAUL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093013351,PROPTNC LLC,RESOLVE PHYSICAL THERAPY AND REHABILITATION,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1083282826,"GRANT, ALEXANDER, CHARLES",10102 S MAIN ST STE S ARCHDALE NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1093013351,PROPTNC LLC,RESOLVE PHYSICAL THERAPY AND REHABILITATION,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1083282826,"GRANT, ALEXANDER, CHARLES",112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 22 , 50 ,$#,,
MEDICAID DIRECT,1083283683,PURE MAGIC HEALTH SOLUTIONS LLC,,8501 TOWER POINT DR STE C-11 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1083283683,PURE MAGIC HEALTH SOLUTIONS LLC,8501 TOWER POINT DR STE C-11 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,192 "," 1,192 "," $75,817.16 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083284020,"COLLINS, RACHEL, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,192 CAMPUS DR   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1083284020,"COLLINS, RACHEL, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,7021 HARPS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083289235,"ROBINSON, SHAMIKA, KAYO",5920 SANDY FORKS RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,5920 SANDY FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083289235,"ROBINSON, SHAMIKA, KAYO",5920 SANDY FORKS RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 25 , 53 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083292148,"MUDDA, CONSTANCE, AUDRIANNA",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083294540,"YATES, ALEXANDRIA, JORDAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083296479,"LESAVAGE, LINDSAY, KATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 88 , 122 , 145 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083296479,"LESAVAGE, LINDSAY, KATHERINE",1814 WESTCHESTER DR STE 300 HIGH POINT NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083296479,"LESAVAGE, LINDSAY, KATHERINE",601 N ELM ST   HIGH POINT NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083296867,"MUMFORD, MONIQUE, MITCHELL",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 69 , 71 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083296867,"MUMFORD, MONIQUE, MITCHELL",190 KIMEL PARK DR STE 121 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083297022,"TAYES, CARLA, DYANN",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1083297022,"TAYES, CARLA, DYANN",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083297022,"TAYES, CARLA, DYANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083305627,"HILE, LLOREN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 51 , 51 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083308571,"ATCHISON, LOUIS, DWAYNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 59 , 65 ,$#,,
MEDICAID DIRECT,1164726105,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,1600 MEDICAL DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1083309462,"TUCKER, JORDAN, RYAN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1164726105,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1083309462,"TUCKER, JORDAN, RYAN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 172 , 243 , 246 ,$#,,
MEDICAID DIRECT,1891135067,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,410 S JONES ST   PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1083309462,"TUCKER, JORDAN, RYAN",410 S JONES ST STE D PEMBROKE NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083314983,"PARHAM, LYNDSEY, MICHELE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1083315303,D AND M LLC,ANGELS OF HOME HEALTH,2505 OLD MONROE RD UNIT A MATTHEWS NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1083315303,D AND M LLC,2505 OLD MONROE RD UNIT A MATTHEWS NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#, 585 , 757 ," $191,988.64 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083321681,"COCKERHAM, ALICIA, M",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083321681,"COCKERHAM, ALICIA, M",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1083323042,"FERGUSON, THOMAS, JAMEL",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4917 S CROATAN HWY STE 1A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1083323042,"FERGUSON, THOMAS, JAMEL",4917 S CROATAN HWY STE 1A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1083323042,"FERGUSON, THOMAS, JAMEL",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1083323042,"FERGUSON, THOMAS, JAMEL",4917 S CROATAN HWY STE 1A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1083323042,"FERGUSON, THOMAS, JAMEL",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083324354,"FORLAN, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 14 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1083336416,"SETZER, COURTNEY, ADAIR",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 63 , 110 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1083338198,"OUTLAW, JUANITA, SHAWNTA",132 NC 581 HWY N   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 27 , 94 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083340756,"MATTHEWS, LUKE, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083340756,"MATTHEWS, LUKE, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083340756,"MATTHEWS, LUKE, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083340756,"MATTHEWS, LUKE, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083341432,EYECARECENTER OD PA,EYECARE CENTER,1669 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083341432,EYECARECENTER OD PA,1669 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083346472,"CHUNG, HANNAH, SOPHIA BOKYO",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083346472,"CHUNG, HANNAH, SOPHIA BOKYO",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083346472,"CHUNG, HANNAH, SOPHIA BOKYO",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083348080,"BIVENS, JENNA, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 104 , 104 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083360341,"AFRIYIE, ENFINITI, AFRICA",120 HEALTH CENTER DRIVE   AHOSKIE NC,046,Hertford,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1083360689,RSS KING OPERATIONS LLC,PRIDDY MANOR ASSISTED LIVING,1294 PRIDDY RD   KING NC,085,Stokes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083360689,RSS KING OPERATIONS LLC,1294 PRIDDY RD   KING NC,085,Stokes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 153 , 153 ," $63,037.54 ",,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1083367023,"DIANDERAS PAREJA, ANDREA, LUISA",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083367023,"DIANDERAS PAREJA, ANDREA, LUISA",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083367023,"DIANDERAS PAREJA, ANDREA, LUISA",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1083367023,"DIANDERAS PAREJA, ANDREA, LUISA",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 33 , 33 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1083367304,"LOUPE, ASHLEY, NICOLE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1639661796,OPPORTUNITIES INDUSTRIALIZATION CEN,~,260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083372049,"SEBHATU, RAHWA, TEKIE",260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083372049,"SEBHATU, RAHWA, TEKIE",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083372049,"SEBHATU, RAHWA, TEKIE",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 179 , 410 , 450 ," $17,218.08 ",,
MEDICAID DIRECT,1578219424,OPPORTUNITIES INDUSTRIALIZATION CEN,,2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083372049,"SEBHATU, RAHWA, TEKIE",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083372049,"SEBHATU, RAHWA, TEKIE",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083374078,"FULCHER, KRISTEN, NICOLE",3116 N DUKE ST   DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 36 , 42 , 42 ,$#,,
MEDICAID DIRECT,1881289932,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR DIVISION OF PSYCHIATRY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083377253,"KNOX, ROKIMA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083378947,"ZYABLITSKAYA, MARIYA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033488994,GREGORY R ABRAMS DMD II PA,GREGORY R ABRAMS DMD II PA,1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083379994,"SUNDMARK, LAURA, DAWN",16511 NORTHCROSS DR   HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 277 , 282 ," 1,508 "," $56,570.08 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083382634,"KIMBALL, JOHN, CHARLES",40 DUKE MEDICINE CIR # 2B2C DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083382634,"KIMBALL, JOHN, CHARLES",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083382634,"KIMBALL, JOHN, CHARLES",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083382634,"KIMBALL, JOHN, CHARLES",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083382634,"KIMBALL, JOHN, CHARLES",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1457477820,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WARSAW WELLNESS,113 S PINE ST   WARSAW NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083384804,"OKOLI, OBIAGELI, NGOZIKA",113 S PINE ST   BOWDENS NC,031,Duplin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083384804,"OKOLI, OBIAGELI, NGOZIKA",113 S PINE ST   BOWDENS NC,031,Duplin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083385660,"MCLAUGHLIN, RAYENA, FRANCES",260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639661796,OPPORTUNITIES INDUSTRIALIZATION CEN,~,260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083385660,"MCLAUGHLIN, RAYENA, FRANCES",260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 15 ,$#,,
MEDICAID DIRECT,1164710810,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 202 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083386445,"GROW, REBECCA, MARIE",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083386445,"GROW, REBECCA, MARIE",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083389431,"EHART, KAYLEE, REBECCA",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 45 , 45 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083389464,"KRAMER, KELSEY, ANN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1083389464,"KRAMER, KELSEY, ANN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083390538,"TRAMONDO, ALEXIS, NICOLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083390538,"TRAMONDO, ALEXIS, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083390538,"TRAMONDO, ALEXIS, NICOLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083390538,"TRAMONDO, ALEXIS, NICOLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083390538,"TRAMONDO, ALEXIS, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 27 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083390538,"TRAMONDO, ALEXIS, NICOLE",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083390876,"MEADOWS, OLIVIA, ADCOX",2906 N MAIN ST   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 137 , 226 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1083391304,"RIVERA, CARLO, HUGO",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1821403957,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1083391304,"RIVERA, CARLO, HUGO",434 HOSPITAL DR   LINVILLE NC,006,Avery,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 18 , 39 , 39 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083391304,"RIVERA, CARLO, HUGO",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1083391304,"RIVERA, CARLO, HUGO",336 DEERFIELD RD   BOONE NC,095,Watauga,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083391304,"RIVERA, CARLO, HUGO",336 DEERFIELD RD   BOONE NC,095,Watauga,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083394118,"RAMIREZ GARCIA, ROMEL, ORLANDO",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083394118,"RAMIREZ GARCIA, ROMEL, ORLANDO",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083394118,"RAMIREZ GARCIA, ROMEL, ORLANDO",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 42 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083394118,"RAMIREZ GARCIA, ROMEL, ORLANDO",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083394142,"SAWYER, ALISON, BUCHANAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1083394142,"SAWYER, ALISON, BUCHANAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083394811,GRAND VISION LLC,ATTENTIVE HOME CARE SERVICES,893 US 70 HWY W STE 200 GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1083394811,GRAND VISION LLC,893 US 70 HWY W STE 200 GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,394 "," 1,394 "," $94,856.96 ",,
MEDICAID DIRECT,1083396923,ALL CAN BE SAFE HOME HEALTH CARE,,8929 J M KEYNES DR STE 315 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1083396923,ALL CAN BE SAFE HOME HEALTH CARE,8929 J M KEYNES DR STE 315 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 5,682 "," 5,692 "," $334,940.08 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083398739,"LASSETER, SABRINA, LYNN",608A AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 106 , 134 , 200 ,$#,,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083423602,"WILLIAMS, ELIZABETH, JEWELL",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1083431100,"STARON, ANDY, JAMES",1915 WEST PARK DRIVE SUITE 104   N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice," 1,322 "," 2,289 "," 6,326 "," $325,381.15 ",,
MEDICAID DIRECT,1174996359,HAMPTON ROADS PEDIATRIC DENTISTRY,FRIENDLY FACES PEDIATRIC DENTISTRY,446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083431647,"EDWARDS, JULIEN, DARRYL",2336 ELSON GREEN AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083435457,"PARKER, JANICE, ANN",102 LEONARD AVE   NEWTON NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083440481,"TODD, MELISSA, SHEREE",652 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083456354,"STELLY, HOPE, DRYDEN",234 CROOKED CREEK PKWY STE 310 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 31 , 49 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083458566,"SUNIL, RANJANI",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 29 , 29 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1083458566,"SUNIL, RANJANI",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083459143,"BARON, LAUREN, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083459614,"RILEY, KATHLEEN, EMILIA",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 27 , 99 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083459614,"RILEY, KATHLEEN, EMILIA",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 38 ,$#,,
MEDICAID DIRECT,1447255328,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOKE FAMILY MEDICAL CENTER,405 S MAIN ST   RAEFORD NC,047,Hoke,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1083460349,"HEADLEY, NATALIE",405 S MAIN ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 173 , 174 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083461339,"GREENE, ANNE, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083470090,"CHRISTY, CHANDLER, JAMES",7540 RAMBLE WAY STE 101 BRENTWOOD NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083472435,"LORD, MADISON, JEAN HOBSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 28 , 36 ,$#,,
MEDICAID DIRECT,1083479968,PREEMINENT HOME AND SENIOR CARE SER,~,4921 PROFESSIONAL CT   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1083479968,PREEMINENT HOME AND SENIOR CARE SER,4921 PROFESSIONAL CT   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 429 , 429 ," $28,424.50 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083481568,"TUCK, ELLEN, JORDAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083484463,"KENNEDY, CARRIE, FRASURE",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 609 , 609 ," $31,267.77 ",,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,517 B HWY 210 N   SPRING LAKE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083484901,"LAVIN, AMBER, LOUISE",517 B HWY 210 N   SPRING LAKE NC,,Unknown,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 25 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083484901,"LAVIN, AMBER, LOUISE",517 B HWY 210 N   SPRING LAKE NC,,Unknown,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 26 , 38 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083485858,"MASON, BRITTNEY, SIERRA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 142 , 715 , 723 ," $20,551.80 ",,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083486039,"HARRISON, CHARLOTTE, GRACE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083486039,"HARRISON, CHARLOTTE, GRACE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1033565007,STAR MEDICAL CLINIC PLLC,,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1083486138,"STOSSEL, EMMA, PATRICIA",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 38 , 72 ,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1083486534,"KOFLER, KYLIE, JENNIFER",1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528406519,MONARCH,~,2003 GODWIN AVE STE C LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1083488225,"WALKER, BROOKE, DIONNE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1952089799,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PAGE PRIMARY,215 EWING DR   BELMONT NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083488803,"LIDE, SHANNON, MORGAN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1740915552,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT HOLBROOK MIDDLE,418 S CHURCH ST   LOWELL NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083488803,"LIDE, SHANNON, MORGAN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1043998883,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT NEW HOPE ELEMENTARY,137 STOWE RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083488803,"LIDE, SHANNON, MORGAN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1083490247,JENNIFER LYNN BAILESS,BUILDING BLOCKS DEVELOPMENTAL THERAPY LLC,5687 SALEM FARM RD   OXFORD NC,039,Granville,251S00000X,Agencies,Community/Behavioral Health,,1083490247,JENNIFER LYNN BAILESS,5687 SALEM FARM RD   OXFORD NC,039,Granville,251S00000X,Agencies,Community/Behavioral Health,, 31 , 394 , 395 ," $25,460.24 ",,
MEDICAID DIRECT,1073204715,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA COMMUNITY FAMILY CARE,2412 WILKINS DR   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1083491872,"KIRBY, KELLY, SCOTT",2412 WILKINS DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 150 , 191 ," $10,461.09 ",,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1083496970,"ADCOCK, GERALD, WAYNE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1083496970,"ADCOCK, GERALD, WAYNE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083499453,"BERTUS, ELLYSSE, MYRJA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710002159,ADVANCED HEALTH AND CHIROPRACTIC,ADVANCED HEALTH AND CHIROPRACTIC CENTER,191A W PLAZA DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083600373,"ROBINSON, RYAN, SCOTT",191A W PLAZA DR   MOORESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,,#, 52 , 52 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1083600738,"BECKER, STEVEN, GEORGE",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 29 ,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083601751,"HORNBUCKLE, HOBSON, WAYNE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083602148,"PLOTKIN, JEFFREY, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 20 , 22 ,$#,,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 2,350 "," 2,359 "," $205,128.24 ",,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 33 ," 6,735 "," 6,790 "," $2,424,552.52 ",,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 85 , 197 , 241 ," $993,766.91 ",,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#,,,$#,,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#, 283 , 283 ," $28,977.92 ",,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,385H00000X,Respite Care Facility,Respite Care,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#,,,$#,,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 436 ," 4,720 "," 4,747 "," $1,762,166.23 ",,
MEDICAID DIRECT,1083602577,QUALITY HEALTH CARE SERVICES INC,~,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,385H00000X,Respite Care Facility,Respite Care,,1083602577,QUALITY HEALTH CARE SERVICES INC,11535 CARMEL COMMONS BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,385H00000X,Respite Care Facility,Respite Care,, 12 , 261 , 261 ," $87,022.00 ",,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083602866,"TIGNOR, DAVID, COWDEN",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 81 , 185 ,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083602866,"TIGNOR, DAVID, COWDEN",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1083603096,"SETTLE, KATHY, SANDERS",300 BIRCH ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family," 1,736 "," 3,091 "," 9,349 "," $169,370.34 ",,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1083603096,"SETTLE, KATHY, SANDERS",300 BIRCH ST   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 58 ,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083603120,"LIGHTNER, MICHELLE, L",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 79 , 110 ,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083603120,"LIGHTNER, MICHELLE, L",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 27 , 44 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083604284,"BOWLES, CLAIRE, STALLINGS",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083604300,SUNMED MEDICAL SYSTEMS LLC,,36 ROUTE 70 W STE 214 MARLTON NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083604300,SUNMED MEDICAL SYSTEMS LLC,36 ROUTE 70 W STE 214 MARLTON NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 32 , 74 , 107 ," $19,497.32 ",,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083605026,"HOLLOWAY, ELLEN, ROBIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083605539,"JENKINS IV, HENRY, AVNER",700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 16 , 38 , 39 ,$#,,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083605539,"JENKINS IV, HENRY, AVNER",14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 73 , 216 , 264 ,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083607717,"THOMAS, RANDALL, KEAN",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1083607824,"EASTERLING, WILLIAM, ROSS",~,201 W ASH ST STE 7 GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,,1083607824,"EASTERLING, WILLIAM, ROSS",201 W ASH ST STE 7 GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,, 104 , 104 , 166 ,$#,,
MEDICAID DIRECT,1417061011,ABC PEDIATRICS OF DUNN PA,~,104 TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1083607899,"CHIODO, VINCENT, MICHAEL",104 TILGHMAN DR   DUNN NC,043,Harnett,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 48 , 51 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083607972,"OZIMEK, CHRISTOPHER, LOUIS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164500575,CHILDRENS HEALTH SERVICES PA,~,1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083607972,"OZIMEK, CHRISTOPHER, LOUIS",1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 65 , 142 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083608210,"WEAVER, JAMES, PAUL",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1083610513,"MEDINA, RUDY, TOM",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 66 , 147 , 407 ," $19,549.79 ",,
MEDICAID DIRECT,1083611149,"SINGH, ASHISH",ASHISH SINGH,568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1083611149,"SINGH, ASHISH",568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083611149,"SINGH, ASHISH",ASHISH SINGH,568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,1083611149,"SINGH, ASHISH",568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1083201040,ASHISH SINGH,HENDERSON PULMONARY & SLEEP MEDICINE PLLC,568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1083611149,"SINGH, ASHISH",568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 177 , 682 , 877 ," $15,278.72 ",,
MEDICAID DIRECT,1083611149,"SINGH, ASHISH",ASHISH SINGH,568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,1083611149,"SINGH, ASHISH",568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 163 , 473 , 549 ," $11,377.69 ",,
MEDICAID DIRECT,1598894495,SOUTHEASTERN NEUROLOGY INC,~,4850 FAYETTEVILLE RD STE E LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1083611446,"ZENG, JIANFENG",4850 FAYETTEVILLE RD STE E LUMBERTON NC,078,Robeson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 167 , 259 , 282 ," $12,370.82 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,725 OAKRIDGE BLVD STE A1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1083611586,"HEGDE, SADANANDA, BELINJE",725 OAKRIDGE BLVD STE A1 LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 71 , 168 , 178 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083611586,"HEGDE, SADANANDA, BELINJE",4384 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 59 , 63 ,$#,,
MEDICAID DIRECT,1043510696,HARNETT OBGYN LLC,CAPE FEAR VALLEY OB GYN-DUNN,805 TILGHMAN DR STE C DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1083611909,"ZICH, MICHAEL, JOHN",700 TILGHMAN DR STE 700 DUNN NC,043,Harnett,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043510696,HARNETT OBGYN LLC,CAPE FEAR VALLEY OB GYN-DUNN,805 TILGHMAN DR STE C DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1083611909,"ZICH, MICHAEL, JOHN",805 TILGHMAN DR STE C DUNN NC,043,Harnett,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 36 , 41 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083613749,"PEARSON, DARREN, JACK",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 41 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1083615058,"KAARIAINEN, ISMO, MIKAEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467672204,BLUE RIDGE NEPHROLOGY AND,BLUE RIDGE NEPHROLOGY PA,400 SHADOWLINE DR STE 203 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1083615058,"KAARIAINEN, ISMO, MIKAEL",400 SHADOWLINE DR STE 203 BOONE NC,095,Watauga,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 42 , 66 , 66 ,$#,,
MEDICAID DIRECT,1730583600,THE BONE AND JOINT SURGERY CLINIC,,3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083615694,"JONES, DAVID, TURNER",3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 41 , 66 ,$#,,
MEDICAID DIRECT,1083616809,GREENE COUNTY HEALTH CARE INC,STUDENT HEALTH SERVICES - GREENE,140 SCHOOL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083616809,GREENE COUNTY HEALTH CARE INC,140 SCHOOL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083617161,"KELSEY, ANITA, MCILVEEN",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083617161,"KELSEY, ANITA, MCILVEEN",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 75 , 81 , 117 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083617161,"KELSEY, ANITA, MCILVEEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 90 , 171 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1083617161,"KELSEY, ANITA, MCILVEEN",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 20 , 46 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083619472,"OTT, MICHAEL, ROBERT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083619472,"OTT, MICHAEL, ROBERT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 82 , 88 , 98 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1083619472,"OTT, MICHAEL, ROBERT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083619472,"OTT, MICHAEL, ROBERT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487899902,LOVE CHIROPRACTIC CENTER,LOVE CHIROPRACTIC CENTER,215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083619514,"LOVE, TIMOTHY, WAYNE",215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,111N00000X,Chiropractic Providers,Chiropractor,,#, 19 , 21 ,$#,,
MEDICAID DIRECT,1083620009,"SINGH, RAVI, KENT",,,,Unknown,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1083620009,"SINGH, RAVI, KENT",110 CAPCOM AVE STE 201 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1083620280,"ATKINSON JR, CLINTON, KESLER",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1083620280,"ATKINSON JR, CLINTON, KESLER",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083620462,"LOPEZ SHIRLEY, KEVIN, ANTONIO",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083620462,"LOPEZ SHIRLEY, KEVIN, ANTONIO",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083620462,"LOPEZ SHIRLEY, KEVIN, ANTONIO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1083620462,"LOPEZ SHIRLEY, KEVIN, ANTONIO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 45 , 114 , 116 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083620462,"LOPEZ SHIRLEY, KEVIN, ANTONIO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1083620462,"LOPEZ SHIRLEY, KEVIN, ANTONIO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 26 , 27 , 28 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083621205,"OTT, DANIEL, DAVID",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083621205,"OTT, DANIEL, DAVID",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083621205,"OTT, DANIEL, DAVID",4320 HENSON DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1083621205,"OTT, DANIEL, DAVID",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083621205,"OTT, DANIEL, DAVID",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083621205,"OTT, DANIEL, DAVID",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 43 , 93 ,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1083623268,"FERGUSON, MICHAEL, OWEN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083623268,"FERGUSON, MICHAEL, OWEN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 20 , 30 , 34 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083623268,"FERGUSON, MICHAEL, OWEN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083623268,"FERGUSON, MICHAEL, OWEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 19 , 28 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083623268,"FERGUSON, MICHAEL, OWEN",505 OBERLIN RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083623268,"FERGUSON, MICHAEL, OWEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083623268,"FERGUSON, MICHAEL, OWEN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1083624704,"NECHYBA, CHRISTIAN, ALEXANDER",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 40 , 92 , 220 ,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1083626105,"MURPHY, GEOFFREY, SCOTT",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 55 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083626402,"IBOAYA, EHIMEMEN, OJEABULU",131 PROVIDENCE RD STE 201 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 19 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083626402,"IBOAYA, EHIMEMEN, OJEABULU",131 PROVIDENCE RD STE 201 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 23 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083626402,"IBOAYA, EHIMEMEN, OJEABULU",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083627012,"NIEWOLD, DAMON, ERIK",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1083627012,"NIEWOLD, DAMON, ERIK",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1083627012,"NIEWOLD, DAMON, ERIK",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083627012,"NIEWOLD, DAMON, ERIK",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083628176,"CHU, VIVIAN, HOU",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 17 , 34 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083628176,"CHU, VIVIAN, HOU",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083628176,"CHU, VIVIAN, HOU",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 33 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083628176,"CHU, VIVIAN, HOU",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1770597486,HOWDY AND JONES DDS,~,1103 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1083628564,"JONES, MARCUS, HARDEE",1103 BROWN ST   WASHINGTON NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 186 , 508 ," $18,859.33 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083629927,"VESER, BELYNDA, DUNN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084P0805X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Geriatric Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1083631832,"MORAYATI, SHAMIL, JASSIM",BURLINGTON MEDICAL CENTER,2921 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1083631832,"MORAYATI, SHAMIL, JASSIM",2921 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 16 , 27 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083632830,"LANGLEY, ADRIAN, DORAN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083636104,"SEMPLE, ROXANNE, DENISE",9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 43 , 72 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083636286,"BRAUN, MARK, EDWARD",1085 NE GATEWAY CT NE STE 200A CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083636286,"BRAUN, MARK, EDWARD",1085 NE GATEWAY CT NE STE 200A CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 67 , 88 ,$#,,
MEDICAID DIRECT,1902124647,DOCTORS EXPRESS PLLC,~,101 MAYNARD CROSSING CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083636542,"MCCABE, COREY",320 EMERGENCY ROOM DR TAYLOR STUDENT HEALTH SERVICES CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083636948,"FONTANA, LISA, POWELL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083636948,"FONTANA, LISA, POWELL",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083636948,"FONTANA, LISA, POWELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083636948,"FONTANA, LISA, POWELL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1083637128,"AZIKIWE, NDIDI, NELLY",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083637128,"AZIKIWE, NDIDI, NELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083637128,"AZIKIWE, NDIDI, NELLY",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083637128,"AZIKIWE, NDIDI, NELLY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083637128,"AZIKIWE, NDIDI, NELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083637128,"AZIKIWE, NDIDI, NELLY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1548495914,KIDZCARE PEDIATRICS PC,~,3115 BORDEAUX PARK DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",3115 BORDEAUX PARK DR   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 37 ,$#,,
MEDICAID DIRECT,1164934485,KIDZCARE PEDIATRICS PC,,132 SYLVA PLZ   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164657532,KIDZCARE PEDIATRICS PC,~,5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 35 ,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 38 , 36 , 87 ,$#,,
MEDICAID DIRECT,1679529051,KIDZCARE PEDIATRICS PC,~,3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 26 ,$#,,
MEDICAID DIRECT,1164657532,KIDZCARE PEDIATRICS PC,~,5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",132 SYLVA PLZ   SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 11 , 23 ,$#,,
MEDICAID DIRECT,1164934485,KIDZCARE PEDIATRICS PC,,132 SYLVA PLZ   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",132 SYLVA PLZ   SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 11 , 36 ,$#,,
MEDICAID DIRECT,1629327671,KIDZCARE PEDIATRICS PC,~,427 HARRISON AVE   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1083639256,"RICE, PETER, ANTHONY",427 HARRISON AVE   FRANKLIN NC,056,Macon,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 81 , 149 , 446 ," $20,106.24 ",,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083639439,"STERN, THOMAS, PATRICK",16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 31 , 37 ,$#,,
MEDICAID DIRECT,1083639439,"STERN, THOMAS, PATRICK",~,16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,1083639439,"STERN, THOMAS, PATRICK",16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1417282039,ADVANCED RESPIRATORY AND SLEEP MEDI,ADVANCED RESPIRATORY AND SLEEP MEDICINE PLLC,16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083639439,"STERN, THOMAS, PATRICK",16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,1344 N CENTER ST STE B HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083639439,"STERN, THOMAS, PATRICK",1344 N CENTER ST STE B HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 33 , 45 , 53 ,$#,,
MEDICAID DIRECT,1083642458,"RICKABAUGH, JEFF, L",JEFFREY L RICKABAUGH,1551 WESTBROOK PLAZA DR STE 103 WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1083642458,"RICKABAUGH, JEFF, L",1551 WESTBROOK PLAZA DR STE 103 WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 127 , 835 , 878 ," $96,411.62 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083642995,"GORDON, CHRISTINA, LYNN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083643357,"NASLUND, PATRICIA, KEOGH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083643357,"NASLUND, PATRICIA, KEOGH",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 68 , 87 , 118 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083644264,"ARIDA, MUAMMAR, ABDELKARIM",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 46 , 49 , 64 ,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083644678,"GILLESPIE JR, RICHARD, RAMAS",8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 17 , 21 , 44 ,$#,,
MEDICAID DIRECT,1083644678,"GILLESPIE JR, RICHARD, RAMAS",~,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,1083644678,"GILLESPIE JR, RICHARD, RAMAS",8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083644678,"GILLESPIE JR, RICHARD, RAMAS",1994 WELLNESS BLVD STE 210 MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,1994 WELLNESS BLVD STE 210 MONROE NC,090,Union,193400000X,Group,Single Specialty,,1083644678,"GILLESPIE JR, RICHARD, RAMAS",1994 WELLNESS BLVD STE 210 MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083644678,"GILLESPIE JR, RICHARD, RAMAS",6068 W HIGHWAY 74 STE J INDIAN TRAIL NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083645477,"SHAH, ASHISH, PRABODH",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083645477,"SHAH, ASHISH, PRABODH",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 26 , 39 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083645477,"SHAH, ASHISH, PRABODH",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083645477,"SHAH, ASHISH, PRABODH",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083645477,"SHAH, ASHISH, PRABODH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",222 ASHVILLE AVE   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 27 , 54 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 31 , 67 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083646657,"RUBENS, BRANDON, STACY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083648117,"GALLAGHER, DENISE, MARIE",1106 MAIN STREET EXT   SWANSBORO NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083648117,"GALLAGHER, DENISE, MARIE",319 WB MCLEAN DR   CAPE CARTERET NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 85 , 168 , 322 ," $12,970.76 ",,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083648117,"GALLAGHER, DENISE, MARIE",319 WB MCLEAN DR   CAPE CARTERET NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083649289,"GHIM, MICHAEL, YOUNSHIK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083649289,"GHIM, MICHAEL, YOUNSHIK",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083649289,"GHIM, MICHAEL, YOUNSHIK",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083649289,"GHIM, MICHAEL, YOUNSHIK",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083649289,"GHIM, MICHAEL, YOUNSHIK",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083649289,"GHIM, MICHAEL, YOUNSHIK",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1083649768,"DOWDALL, MICHELLE, MARIE",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083649768,"DOWDALL, MICHELLE, MARIE",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1083649768,"DOWDALL, MICHELLE, MARIE",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083649768,"DOWDALL, MICHELLE, MARIE",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083651434,COUNTY OF YADKIN OFFICE OF TREASURE,~,108 GEORGE ST   YADKINVILLE NC,099,Yadkin,3416L0300X,Transportation Services,Ambulance,Land Transport,1083651434,COUNTY OF YADKIN OFFICE OF TREASURE,108 GEORGE ST   YADKINVILLE NC,099,Yadkin,3416L0300X,Transportation Services,Ambulance,Land Transport, 290 , 527 ," 1,024 "," $12,669.56 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083651822,"SHIH, CHIE YOUN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083652705,"FALEWEE, DOMINIQUE, ANDRE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 64 , 70 , 83 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083652705,"FALEWEE, DOMINIQUE, ANDRE",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083652705,"FALEWEE, DOMINIQUE, ANDRE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 80 , 115 , 143 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083652705,"FALEWEE, DOMINIQUE, ANDRE",1237 HARDING PL STE 1300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1083653778,"PETERSON, VIVIAN, MARIE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 41 , 64 , 64 ,$#,,
MEDICAID DIRECT,1083654248,"SIMHACHALAM, MORRIS, NAIDU",,1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 11 , 16 , 17 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",600 CAROLINA VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083654248,"SIMHACHALAM, MORRIS, NAIDU",,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1083654248,"SIMHACHALAM, MORRIS, NAIDU",,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 26 , 32 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 205 , 205 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 171 , 174 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083654248,"SIMHACHALAM, MORRIS, NAIDU",501 ESSEOLA DR   SALUDA NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700888542,GREENE COUNTY HEALTH CARE INC,KATE B REYNOLDS MEDICAL CENTER,205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083655005,"BARKER, MARSHALL, JAY",205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,666 W CORBETT AVE   SWANSBORO NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083655161,"JOHNSON, THERESA, MONTEITH",666 W CORBETT AVE   SWANSBORO NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1083655161,"JOHNSON, THERESA, MONTEITH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 20 , 27 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083655161,"JOHNSON, THERESA, MONTEITH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083655211,"DORTON, PETER, JOHN",330 BILLINGSLEY RD STE 101 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518312073,MCPC-17 LLC,FIRSTHEALTH PRIMARY CARE,293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1083655211,"DORTON, PETER, JOHN",293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 35 , 66 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083655211,"DORTON, PETER, JOHN",7804 FAIRVIEW RD STE A CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558544957,HOLLY RIDGE HEALTHCARE,HOLLY RIDGE HEALTHCARE,119 HOLLY ST   HOLLY RIDGE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083656698,"ROBINSON, GAIL, LENORA",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 76 , 239 , 366 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 24 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 35 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083657266,"MCALARNEY, JONAS, JOSEPH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 110 , 196 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",2701 STATESVILLE AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447824065,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,2701 STATESVILLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",2701 STATESVILLE AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083657522,"ROBERTS, JAMES, WAYNE",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1073537627,YVETTE MCALISTER STOKES DDS PA,HIGHLAND PEDIATRIC DENTAL,1367 WALTER REED RD STE 103 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083657597,"STOKES, YVETTE, MCALISTER",1367 WALTER REED RD STE 103 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,446 "," 4,452 "," 18,134 "," $775,963.85 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 29 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 24 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 23 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 47 , 73 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 21 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1083658561,"BROWN, KIRK, KELLY",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083658942,"KIM, DONG, HYUCK",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083658942,"KIM, DONG, HYUCK",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1992482079,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON PRIMARY CARE RHC,1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1083660146,"DONTHIREDDI, USHA, RANI",1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",301 E WENDOVER AVE STE 100 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",509 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1083662084,"STAHL, JOHN, ALLEN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 38 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 20 , 27 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 94 , 95 , 107 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 40 , 45 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1083662084,"STAHL, JOHN, ALLEN",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1083662084,"STAHL, JOHN, ALLEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083662084,"STAHL, JOHN, ALLEN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083662548,"JAMESON, RUTH, ANN",15830 BALLANTYNE MEDICAL PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083662548,"JAMESON, RUTH, ANN",15830 BALLANTYNE MEDICAL PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083662548,"JAMESON, RUTH, ANN",15830 BALLANTYNE MEDICAL PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083662548,"JAMESON, RUTH, ANN",15830 BALLANTYNE MEDICAL PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083662811,"TRANTER, MARGENE, CAROL",1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 20 , 41 ,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083662811,"TRANTER, MARGENE, CAROL",14057 US HIGHWAY 17 STE 130 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 20 , 45 ,$#,,
MEDICAID DIRECT,1164470134,MOUNTAIN AREA PEDIATRICS ASSOCIATES,Mountain Area Pediatric Associates PA,500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083662829,"CHILDERS, TERRY, CELY",500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 65 , 98 , 345 ," $15,900.63 ",,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083663454,"BYRD, LARRY, JASON",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083663454,"BYRD, LARRY, JASON",325 HAWTHORNE LN STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 51 , 87 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083664825,"BROUSE, GREGORY, MICHAEL",1550 FAULK ST STE 1500 MONROE NC,090,Union,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 64 , 140 , 140 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083664825,"BROUSE, GREGORY, MICHAEL",600 HOSPITAL DR   MONROE NC,090,Union,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083665228,"HIXSON, PAULINE, FRANCES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083665392,"DAR, MOAHAD, SAEED",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 13 , 14 , 20 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083665392,"DAR, MOAHAD, SAEED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083665863,"SLEATER, JOSEPH, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 11 , 12 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083665863,"SLEATER, JOSEPH, PATRICK",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083665863,"SLEATER, JOSEPH, PATRICK",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083665863,"SLEATER, JOSEPH, PATRICK",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1477519148,PATHOLOGISTS MEDICAL LABORATORY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1083665863,"SLEATER, JOSEPH, PATRICK",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083666028,"VOTA, AMY, ROSS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083666028,"VOTA, AMY, ROSS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083666028,"VOTA, AMY, ROSS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184174542,CALDWELL MEMORIAL HOSPITAL,CALDWELL SLEEP MEDICINE,270 PINE MOUNTAIN RD STE 5 HUDSON NC,014,Caldwell,193400000X,Group,Single Specialty,,1083666135,"TOMSKI, STEVEN, MICHAEL",270 PINE MOUNTAIN RD STE 1 HUDSON NC,014,Caldwell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1588943278,CALDWELL MEMORIAL HOSPITAL,ROBBINS PULMONOLOGY,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1083666135,"TOMSKI, STEVEN, MICHAEL",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 47 , 73 , 73 ,$#,,
MEDICAID DIRECT,1831965201,CALDWELL MEMORIAL HOSPITAL,DIGESTIVE HEALTH CENTER HICKORY,36 14TH AVE NE STE 2B HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083666135,"TOMSKI, STEVEN, MICHAEL",36 14TH AVE NE STE 2B HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083666135,"TOMSKI, STEVEN, MICHAEL",50 HOSPITAL DR STE 1C HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083668495,"NIX, JERRY, DALE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083668495,"NIX, JERRY, DALE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 83 , 108 ,$#,,
MEDICAID DIRECT,1740989516,ONSITE NEONATAL NC PC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1083668537,"DIMAGUILA, MARY ANN, VT",628 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 19 , 56 , 58 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1083669956,"HALVERSON, KATHY, DIANE",197 PLAZA DR   FOREST CITY NC,081,Rutherford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,197 PLAZA DR   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1083669956,"HALVERSON, KATHY, DIANE",197 PLAZA DR   FOREST CITY NC,081,Rutherford,152W00000X,Eye and Vision Services Providers,Optometrist,, 49 , 47 , 82 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,320 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083669956,"HALVERSON, KATHY, DIANE",197 PLAZA DR   FOREST CITY NC,081,Rutherford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1104880723,WNC EYE SURGERY CENTER,,8B MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1083670269,"BROSNAN, THOMAS, MOCK",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1083670269,"BROSNAN, THOMAS, MOCK",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083670269,"BROSNAN, THOMAS, MOCK",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 70 , 74 , 94 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083670269,"BROSNAN, THOMAS, MOCK",2001 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083670921,"JERNIGAN, LISA, MARIE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336542067,DLP HAYWOOD REGIONAL MEDICAL CENTER,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083670921,"JERNIGAN, LISA, MARIE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 142 , 185 , 191 ," $11,104.62 ",,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083670921,"JERNIGAN, LISA, MARIE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,709 GREEN VALLEY RD FL 2 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083671036,"PLOTNIKOV, ALEKSEI, VIKTOROVICH",709 GREEN VALLEY RD FL 2 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083671036,"PLOTNIKOV, ALEKSEI, VIKTOROVICH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 64 , 139 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083671036,"PLOTNIKOV, ALEKSEI, VIKTOROVICH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 26 , 54 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083671614,"POSTON, HAROLD, CHALMERS",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083671614,"POSTON, HAROLD, CHALMERS",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 103 , 123 , 183 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083671614,"POSTON, HAROLD, CHALMERS",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1740225929,DUKE UNIVERSITY AFFILIATED PHYSICIA,,2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083674105,"TROUTMAN, JAMES, MICHAEL",2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 23 , 47 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083674329,"TOWNSEND, JOHN, DAVID",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 100 , 128 , 303 ," $14,211.06 ",,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1083674428,"RHENEY, THEODORE, BRANCH",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083674428,"RHENEY, THEODORE, BRANCH",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 84 , 131 , 199 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1083674428,"RHENEY, THEODORE, BRANCH",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 33 , 57 , 84 ,$#,,
MEDICAID DIRECT,1245272657,COUNTY OF GUILFORD,GUILFORD CO DEPT PUBLIC HEALTH,1203 MAPLE ST   GREENSBORO NC,041,Guilford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1083675433,"BLAND, VEITA, JOYCE",1317 N ELM ST STE 7 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477664001,BLAND CLINIC PA,,1317 N ELM ST STE 7 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083675433,"BLAND, VEITA, JOYCE",1317 N ELM ST STE 7 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 182 , 243 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083675896,"HORD, CHARLES, DAVID",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083675896,"HORD, CHARLES, DAVID",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083675896,"HORD, CHARLES, DAVID",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215942933,STRATA PATHOLOGY SERVICES INC,STRATADX,1 CRANBERRY HL STE 303 LEXINGTON MA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1083676431,"COHEN, LISA, MICHELE",1 CRANBERRY HL STE 105 LEXINGTON MA,102,Out of State > 40 miles,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083676613,"HENDERSON, HEATHER, MARIE",16747 HWY 17 US HWY   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083676613,"HENDERSON, HEATHER, MARIE",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 31 , 68 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1083676613,"HENDERSON, HEATHER, MARIE",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 13 ," $20,845.78 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083678866,"WINSLOW, TERESA, WALLACE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1699047514,PALLADIUM PRIMARY CARE INC,PALLADIUM PRIMARY CARE INC,2510 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083679864,"OSEI BONSU, GEORGE",2510 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 290 ," 1,108 "," 1,867 "," $41,014.53 ",,
MEDICAID DIRECT,1376574004,PREMIERE HEALTH CARE PLUS PA,PALLADIUM PRIMARY CARE,3750 ADMIRAL DR STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1083679864,"OSEI BONSU, GEORGE",3750 ADMIRAL DR STE 101 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 121 , 507 , 665 ," $11,289.75 ",,
MEDICAID DIRECT,1376574004,PREMIERE HEALTH CARE PLUS PA,PALLADIUM PRIMARY CARE,3750 ADMIRAL DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083679864,"OSEI BONSU, GEORGE",3750 ADMIRAL DR STE 101 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083680953,"SCHLANGER, LAURENCE, WILLIAM",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083681068,CAROLINA HOME MEDICAL INC,,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083681068,CAROLINA HOME MEDICAL INC,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 77 , 163 , 278 ,$#,,
MEDICAID DIRECT,1083681068,CAROLINA HOME MEDICAL INC,,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1083681068,CAROLINA HOME MEDICAL INC,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1083681068,CAROLINA HOME MEDICAL INC,,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1083681068,CAROLINA HOME MEDICAL INC,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 342 ," 1,402 "," 2,470 "," $152,242.84 ",,
MEDICAID DIRECT,1083681068,CAROLINA HOME MEDICAL INC,,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1083681068,CAROLINA HOME MEDICAL INC,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 25 , 41 , 50 ," $39,467.20 ",,
MEDICAID DIRECT,1083681068,CAROLINA HOME MEDICAL INC,,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083681068,CAROLINA HOME MEDICAL INC,1913 E FIRE TOWER RD STE G GREENVILLE NC,074,Pitt,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083681969,"TISCHLER, JANIE, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083681969,"TISCHLER, JANIE, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083683189,"DAIGLE, PATRICK, JOSEPH",7901 EMERALD DR STE 7 EMERALD ISLE NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 169 , 329 ,$#,,
MEDICAID DIRECT,1841285293,ALBEMARLE ENT ASTHMA AND ALLERGY AS,~,1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1083683650,"DONOHOE, MARGARET, ROSE",1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 29 , 77 , 137 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083683726,"PUGH III, VERNON, WATSON",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 34 , 40 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083683726,"PUGH III, VERNON, WATSON",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 15 , 25 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083683726,"PUGH III, VERNON, WATSON",3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083683726,"PUGH III, VERNON, WATSON",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083683726,"PUGH III, VERNON, WATSON",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 27 ,$#,,
MEDICAID DIRECT,1750339933,DURHAM DIAGNOSTIC IMAGING LLC,TRIANGLE MEDICAL PARK,5107 SOUTHPARK DR STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1083683916,"MERRITT, ASHLEY, GRANT",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1083683916,"MERRITT, ASHLEY, GRANT",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083683916,"MERRITT, ASHLEY, GRANT",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,3643 N ROXBORO ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1083683916,"MERRITT, ASHLEY, GRANT",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 371 , 469 , 700 ,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1083683916,"MERRITT, ASHLEY, GRANT",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1083683916,"MERRITT, ASHLEY, GRANT",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 52 , 75 ,$#,,
MEDICAID DIRECT,1801223482,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY BIRKDALE LANDING,16645 BIRKDALE COMMONS PKWY STE 200C HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083684385,"HOLT, JAMES, ANTHONY",16645 BIRKDALE COMMONS PKWY STE 200C HUNTERSVILLE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 44 , 59 , 103 ,$#,,
MEDICAID DIRECT,1801223482,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY BIRKDALE LANDING,16645 BIRKDALE COMMONS PKWY STE 200C HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083684385,"HOLT, JAMES, ANTHONY",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 15 , 21 , 35 ,$#,,
MEDICAID DIRECT,1528495108,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - CONCORD,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083684385,"HOLT, JAMES, ANTHONY",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 12 ,$#,,
MEDICAID DIRECT,1528495108,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - CONCORD,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083684385,"HOLT, JAMES, ANTHONY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 72 , 72 ,$#,,
MEDICAID DIRECT,1265403042,NORTH CAROLINA NEUROPSYCHIATRY,NORTH CAROLINA NEUROPSYCHIATRY PA,1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083684732,"GUALTIERI, CAMILLO, THOMAS",1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1427604149,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE - MORRISVILLE MEDICAL PARK,7560 CARPENTER FIRE STATION RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083685002,"MOORE, MICHAEL, CHRISTOPHER",7560 CARPENTER FIRE STATION RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427604149,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE - MORRISVILLE MEDICAL PARK,101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083685002,"MOORE, MICHAEL, CHRISTOPHER",101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083685598,"ONOFREY, DAVID",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083685598,"ONOFREY, DAVID",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083685598,"ONOFREY, DAVID",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083685598,"ONOFREY, DAVID",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1588091904,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS PIEDMONT PEDIATRIC,1085 NE GATEWAY CT NE STE 290 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083685754,"LEVIN, LAURA, ANN",1085 NE GATEWAY CT NE STE 290 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 29 , 49 ,$#,,
MEDICAID DIRECT,1528051935,PIGEON VALLEY REST HOME LLC,,55 LAKE DR   CANTON NC,044,Haywood,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083686646,"LAFATA, JOHN, ANTHONY",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 30 , 30 ," $58,359.12 ",,
MEDICAID DIRECT,1336542067,DLP HAYWOOD REGIONAL MEDICAL CENTER,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083686646,"LAFATA, JOHN, ANTHONY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083686646,"LAFATA, JOHN, ANTHONY",100 SILVER BLUFF DR   CANTON NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1083686646,"LAFATA, JOHN, ANTHONY",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 84 , 176 , 182 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083686646,"LAFATA, JOHN, ANTHONY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 146 , 305 , 385 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1083686646,"LAFATA, JOHN, ANTHONY",100 SILVER BLUFF DR   CANTON NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083687081,"MARTINELLI, ANNE",120 CONNER DR STE 101 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083687552,"HAZELWOOD, WILLIAM, MADISON",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083688204,"HARP, CHRISTIE, QUIETMEYER",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083690036,"THOMAS SLADE HARTMAN, VENEZELA, ETHELBESSIE",1795 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083690036,"THOMAS SLADE HARTMAN, VENEZELA, ETHELBESSIE",1795 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 25 , 25 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083690036,"THOMAS SLADE HARTMAN, VENEZELA, ETHELBESSIE",2502 S NC HIGHWAY 119   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 63 , 63 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083690036,"THOMAS SLADE HARTMAN, VENEZELA, ETHELBESSIE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 56 , 57 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083690036,"THOMAS SLADE HARTMAN, VENEZELA, ETHELBESSIE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003351651,"WADE, JASMINE, DAWN",,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1083690036,"THOMAS SLADE HARTMAN, VENEZELA, ETHELBESSIE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205014909,AHOSKIE EYE CARE OD PA,AHOSKIE EYE CARE OD PA,500 CHURCH ST W   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1083690218,"HAUSER, BRAD, ERIC",500 CHURCH ST W   AHOSKIE NC,046,Hertford,152W00000X,Eye and Vision Services Providers,Optometrist,, 162 , 190 , 203 ," $10,711.90 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083690325,"LACKEY, PHILIP, CARLYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 68 , 104 , 111 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083690515,"MIKHAIL, ASHRAF, GAD",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083690572,"JOHNSON, MICHAEL, DONALD",2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 35 , 61 , 71 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1083690572,"JOHNSON, MICHAEL, DONALD",2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1083690572,"JOHNSON, MICHAEL, DONALD",2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 154 , 390 , 459 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,417 VANCE ST STE A CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1083690572,"JOHNSON, MICHAEL, DONALD",417 VANCE ST STE A CLINTON NC,082,Sampson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 35 , 98 , 102 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083690622,"PEDERSON, LEE, CARL",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083690622,"PEDERSON, LEE, CARL",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083690622,"PEDERSON, LEE, CARL",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 28 , 29 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083690622,"PEDERSON, LEE, CARL",10030 GILEAD RD STE 245 HUNTERSVILLE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083692131,"NEWMAN III, EDWIN, CARRAWAY",142 PARACLETE DR STE 301 RAEFORD NC,047,Hoke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 14 , 29 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083692131,"NEWMAN III, EDWIN, CARRAWAY",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 130 , 221 , 477 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083692131,"NEWMAN III, EDWIN, CARRAWAY",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 79 , 123 , 224 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083692396,"POGGI, JOHN, JEFFREY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083692396,"POGGI, JOHN, JEFFREY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 27 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083692396,"POGGI, JOHN, JEFFREY",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083692396,"POGGI, JOHN, JEFFREY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 60 , 100 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083692396,"POGGI, JOHN, JEFFREY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 26 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083692396,"POGGI, JOHN, JEFFREY",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083692453,"CALICOTT, RANDY, WAYNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 68 , 68 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083692917,"ZHU, WYLIE, HUNG",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083692917,"ZHU, WYLIE, HUNG",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083692917,"ZHU, WYLIE, HUNG",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083692917,"ZHU, WYLIE, HUNG",1080 FIRST COLONIAL RD STE 400 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083693527,"KAUFMANN, JAMES, GREGORY",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 105 , 146 , 199 ,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083693535,"JUAREZ, JASON, JESSE",525 N TRYON ST STE 1600 PMB 209 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 53 , 333 ," $10,981.27 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083693972,"WILLIAMS, STACY, J",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083693980,"BURTON, MICHAEL, PAUL",24 2ND AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 87 , 154 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083694038,"FISHER, TAMSY, ELLEN",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083694038,"FISHER, TAMSY, ELLEN",250 HOPKINS RD   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083694038,"FISHER, TAMSY, ELLEN",316 NC HIGHWAY 801 S   ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083694038,"FISHER, TAMSY, ELLEN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 62 , 63 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083694038,"FISHER, TAMSY, ELLEN",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 180 , 180 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083694038,"FISHER, TAMSY, ELLEN",250 HOPKINS RD   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 220 , 220 ,$#,,
MEDICAID DIRECT,1265014849,REHAB MEDICINE OF THE CAROLINAS,,2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083694038,"FISHER, TAMSY, ELLEN",2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083694038,"FISHER, TAMSY, ELLEN",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457565848,GREATER CHARLOTTE ORAL FACIAL SURG,,10042 PARK CEDAR DR STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083695043,"MARASHI, AMIR, HOSSEIN",10935 WINDS CROSSING DR STE 400 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457565848,GREATER CHARLOTTE ORAL FACIAL SURG,,10042 PARK CEDAR DR STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083695043,"MARASHI, AMIR, HOSSEIN",10042 PARK CEDAR DR STE B CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 77 , 83 , 428 ," $48,267.63 ",,
MEDICAID DIRECT,1295170330,GREATER CHARLOTTE ORAL FACIAL SURG,~,10935 WINDS CROSSING DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083695043,"MARASHI, AMIR, HOSSEIN",10042 PARK CEDAR DR STE B CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1295170330,GREATER CHARLOTTE ORAL FACIAL SURG,~,10935 WINDS CROSSING DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083695043,"MARASHI, AMIR, HOSSEIN",10935 WINDS CROSSING DR STE 400 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 35 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083695159,"SHANK, KENNETH, DOUGLAS",929 N 2ND ST STE 201 ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 82 , 299 , 672 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083696587,"MARTIN, ERIC, MEYER",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 521 , 582 , 744 ," $24,518.41 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1083696587,"MARTIN, ERIC, MEYER",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 587 , 703 , 950 ,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083696587,"MARTIN, ERIC, MEYER",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1083696595,"BRYAN, ANGELA, JEAN",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 95 , 190 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1083696595,"BRYAN, ANGELA, JEAN",5920 US HIGHWAY 70 E   NEBO NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083696892,"VANDERNOORD, RONALD",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 133 , 237 , 321 ,$#,,
MEDICAID DIRECT,1104156108,MOORE ORTHOPEDICS AND SPORTS MEDICI,MOORE ORTHOPEDICS AND SPORTS MEDICINE PA,4218 ARENDELL ST STE M MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1083696918,"KIRBY, DAVID, JESSIE",4218 ARENDELL ST STE M MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 136 , 306 ,$#,,
MEDICAID DIRECT,1104156108,MOORE ORTHOPEDICS AND SPORTS MEDICI,MOORE ORTHOPEDICS AND SPORTS MEDICINE PA,4218 ARENDELL ST STE M MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1083696918,"KIRBY, DAVID, JESSIE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1083696918,"KIRBY, DAVID, JESSIE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083697395,"MCCLUNG, JEFFREY, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083697395,"MCCLUNG, JEFFREY, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 64 , 64 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1083697858,"HURLBURT, JANET, MARGARET",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083697908,"TAURO, ALLEN, PATRICK",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 38 , 94 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083697908,"TAURO, ALLEN, PATRICK",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083697908,"TAURO, ALLEN, PATRICK",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 44 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083697908,"TAURO, ALLEN, PATRICK",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912995630,THE PURCELL CLINIC PA,THE PURCELL CLINIC PA,418 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1083697940,"O DONNELL, MICHAEL, PATRICK",418 S KING ST   LAURINBURG NC,083,Scotland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 127 , 202 , 384 ," $24,294.64 ",,
MEDICAID DIRECT,1912995630,THE PURCELL CLINIC PA,THE PURCELL CLINIC PA,418 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1083697940,"O DONNELL, MICHAEL, PATRICK",125 BILTMORE DR STE 2 ROCKINGHAM NC,077,Richmond,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083698005,"MADRID, GIANNA, DEMOS",133 WELTON WAY STE C MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 31 , 88 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083698427,"HSU, JOSEPH, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 30 , 55 ," $19,471.27 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083698427,"HSU, JOSEPH, ROBERT",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 36 , 36 ,$#,,
MEDICAID DIRECT,1083698534,LABORATORY CORPORATION OF AMERICA,,150 SPRING LAKE DR   ITASCA IL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1083698534,LABORATORY CORPORATION OF AMERICA,150 SPRING LAKE DR   ITASCA IL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 27 , 30 , 367 ,$#,,
MEDICAID DIRECT,1083698823,QUALITY HOME HEALTH CARE INC,~,106 PARK AVE   SANFORD NC,053,Lee,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083698823,QUALITY HOME HEALTH CARE INC,106 PARK AVE   SANFORD NC,053,Lee,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 132 , 630 ," 1,434 "," $112,005.23 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083699417,"DAEIHAGH, PIROUZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083699417,"DAEIHAGH, PIROUZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 113 , 292 , 295 ,$#,,
MEDICAID DIRECT,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,DRS JOHNSON & JOHNSON EYEWORKS,2800 N ELM ST STE 1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1083699458,"JOHNSON, RICHARD, GENE",2800 N ELM ST   LUMBERTON NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 14 , 39 ,$#,,
MEDICAID DIRECT,1083699607,DUDLEYS HOME HEALTH INC,~,147 MARKET PLACE AVE   MOORESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1083699607,DUDLEYS HOME HEALTH INC,147 MARKET PLACE AVE   MOORESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,, 72 ," 16,454 "," 16,545 "," $2,551,606.22 ",,
MEDICAID DIRECT,1992703540,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 165 , 200 , 250 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1235702754,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE IMAGING ARRINGDON MOBILE MRI,5601 ARRINGDON PARK DR STE 110 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 264 , 292 , 376 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1417540337,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE IMAGING ARRINGDON,5601 ARRINGDON PARK DR STE 110 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 176 , 184 , 261 ," $16,016.63 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083703359,"CAMP, MORGAN, DEWITT",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083705636,"RUIZ VALDEZ, ELIAS, DAVID",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1083705636,"RUIZ VALDEZ, ELIAS, DAVID",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083705636,"RUIZ VALDEZ, ELIAS, DAVID",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 164 , 164 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083706030,"VILLANUEVA, RODNEY, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084F0202X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Forensic Psychiatry, 11 , 22 , 25 ,$#,,
MEDICAID DIRECT,1063647394,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - FOR,2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1083706816,"MASTERS, DAVID, LEE",2933 MAPLEWOOD AVE STE 1 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 48 , 89 ,$#,,
MEDICAID DIRECT,1124265236,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - BER,114 KINDERTON BLVD   BERMUDA RUN NC,030,Davie,193200000X,Group,Multi-Specialty,,1083706816,"MASTERS, DAVID, LEE",114 KINDERTON BLVD   BERMUDA RUN NC,030,Davie,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083706857,"MASTERS, TRICIA, KINSEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083706857,"MASTERS, TRICIA, KINSEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 80 , 100 , 166 ," $28,202.73 ",,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083707285,"COURSEY, JOY",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1083707475,"MCCONVILLE, GLYNDA, REIMANN",GLYNDA REIMANN MCCONVILLE,1129 CARTHAGE ST   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1083707475,"MCCONVILLE, GLYNDA, REIMANN",1129 CARTHAGE ST   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 51 , 181 , 222 ," $37,269.52 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083709737,"LANDIS, MICHAEL, EDWARD",3000 COLISEUM DR STE 200 HAMPTON VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518502103,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,560 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083713812,"MEEK II, THOMAS, EDWIN",560 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194351536,CLAY WILSON & ASSOCIATES,THE COGNITIVE CONNECTION,929 15TH ST NE STE 100 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1083713812,"MEEK II, THOMAS, EDWIN",929 15TH ST NE STE 100 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780127431,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,301 E MEETING ST STE 101 MORGANTON NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083713812,"MEEK II, THOMAS, EDWIN",301 E MEETING ST STE 101 MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457003386,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH WAUGHTOWN PEDIATRICS,648 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083714364,"ERICKSON, LIA, SIMPSON",648 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083714364,"ERICKSON, LIA, SIMPSON",2001 TODAYS WOMAN AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083714364,"ERICKSON, LIA, SIMPSON",648 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 23 , 50 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083714364,"ERICKSON, LIA, SIMPSON",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003660663,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1083714711,"CRAIN, CARLTON, ANDREW",107 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 161 , 309 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083714711,"CRAIN, CARLTON, ANDREW",107 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1083714711,"CRAIN, CARLTON, ANDREW",107 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1083716690,"NICHOLSON, JAMES, EVANS",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 41 , 46 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083716690,"NICHOLSON, JAMES, EVANS",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 78 , 104 , 109 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083717045,"EPPERSON, JONATHAN, MATTHEW",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 82 , 89 , 97 ,$#,,
MEDICAID DIRECT,1083717854,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03899,902 GASTONIA HWY   BESSEMER CITY NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1083717854,NORTH CAROLINA CVS PHARMACY LLC,902 GASTONIA HWY   BESSEMER CITY NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1083717854,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03899,902 GASTONIA HWY   BESSEMER CITY NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083717854,NORTH CAROLINA CVS PHARMACY LLC,902 GASTONIA HWY   BESSEMER CITY NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1083719538,FAMILY MEDICAL SUPPLY LLC,~,311 ASHVILLE AVE STE A CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083719538,FAMILY MEDICAL SUPPLY LLC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1083719538,FAMILY MEDICAL SUPPLY LLC,~,311 ASHVILLE AVE STE A CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1083719538,FAMILY MEDICAL SUPPLY LLC,311 ASHVILLE AVE STE A CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1083719538,FAMILY MEDICAL SUPPLY LLC,~,311 ASHVILLE AVE STE A CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083719538,FAMILY MEDICAL SUPPLY LLC,311 ASHVILLE AVE STE A CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,454 "," 6,511 "," 11,525 "," $217,148.96 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083720015,"FRISCH, HAROLD, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083720015,"FRISCH, HAROLD, MICHAEL",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083720015,"FRISCH, HAROLD, MICHAEL",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 41 , 57 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083720916,"JARRETT, CHRISTOPHER, AYODELE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 83 , 139 , 200 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083720916,"JARRETT, CHRISTOPHER, AYODELE",8114 MARKET ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 39 , 66 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083720916,"JARRETT, CHRISTOPHER, AYODELE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720080070,CAPE FEAR NEUROSURGERY,CAPE FEAR NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083721971,"BOONE, PAUL, DALE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1083722623,"MCVEAN, MARY, THERESA",400 S CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 ,#,#,$#,,
MEDICAID DIRECT,1083724868,FAMILY MEDICAL SUPPLY LLC,~,2810 MERIDIAN PKWY STE 152 DURHAM NC,032,Durham,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1083724868,FAMILY MEDICAL SUPPLY LLC,2810 MERIDIAN PKWY STE 152 DURHAM NC,032,Durham,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1083724868,FAMILY MEDICAL SUPPLY LLC,~,2810 MERIDIAN PKWY STE 152 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1083724868,FAMILY MEDICAL SUPPLY LLC,2810 MERIDIAN PKWY STE 152 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,656 "," 7,147 "," 12,065 "," $228,787.06 ",,
MEDICAID DIRECT,1083724868,FAMILY MEDICAL SUPPLY LLC,~,2810 MERIDIAN PKWY STE 152 DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1083724868,FAMILY MEDICAL SUPPLY LLC,2810 MERIDIAN PKWY STE 152 DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 16 , 80 , 81 ," $19,739.38 ",,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083728745,"WILES, GRANT, DOUGLAS",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083728745,"WILES, GRANT, DOUGLAS",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 407 , 587 ," 1,705 "," $72,706.72 ",,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1083728745,"WILES, GRANT, DOUGLAS",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083728745,"WILES, GRANT, DOUGLAS",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 34 , 129 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083728745,"WILES, GRANT, DOUGLAS",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 26 , 74 ,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083728745,"WILES, GRANT, DOUGLAS",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1083728752,"HOLLAND, MICHAEL, VERNON",~,603 NEW BERN AVE   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,1083728752,"HOLLAND, MICHAEL, VERNON",603 NEW BERN AVE   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 777 , 789 ," 1,453 "," $27,000.12 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083728752,"HOLLAND, MICHAEL, VERNON",603 NEW BERN AVE   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720033988,MCLEOD MEDICAL CENTER DILLION,MCLEOD MEDICAL CENTER DILLON,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083728778,"MITCHELL III, BENJAMIN, THOMAS",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 63 , 66 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083729412,"YANEZ, MIGUEL, ANGEL",5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083729412,"YANEZ, MIGUEL, ANGEL",309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083729412,"YANEZ, MIGUEL, ANGEL",309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1083729412,"YANEZ, MIGUEL, ANGEL",309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1083729412,"YANEZ, MIGUEL, ANGEL",5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1083729412,"YANEZ, MIGUEL, ANGEL",959 COX RD   GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083731749,CHATHAM COUNTY GROUP HOMES INC,,506 W 5TH ST   SILER CITY NC,019,Chatham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083731749,CHATHAM COUNTY GROUP HOMES INC,506 W 5TH ST   SILER CITY NC,019,Chatham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 138 , 138 ,$#,,
MEDICAID DIRECT,1780014761,CAROLINA CHILD NEUROLOGY,CAROLINA CHILD NEUROLOGY PLLC1,1540 PURDUE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083732804,"MASOTTI, VALERIE, ANN",1540 PURDUE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 119 , 122 ," $10,286.23 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083733273,"CAIN, BRIAN, KRISTIAN",7752 GATEWAY LN NW STE 100 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 35 , 116 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083733273,"CAIN, BRIAN, KRISTIAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 34 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083733273,"CAIN, BRIAN, KRISTIAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588309439,DR CAMERON AND ASSOCIATES OF WAYNES,SMOKY MOUNTAIN DENTISTRY,30 MIAMI DR   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1083733299,"LAMBERT, JEDIDIAH, WINN",30 MIAMI DR   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 39 , 101 ,$#,,
MEDICAID DIRECT,1083733299,"LAMBERT, JEDIDIAH, WINN",,30 MIAMI DR   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice,1083733299,"LAMBERT, JEDIDIAH, WINN",30 MIAMI DR   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 48 , 126 ,$#,,
MEDICAID DIRECT,1659413748,"FERGUSON, ELIZABETH, MARIE",~,30 MIAMI DR   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice,1083733299,"LAMBERT, JEDIDIAH, WINN",30 MIAMI DR   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice, 39 , 63 , 162 ,$#,,
MEDICAID DIRECT,1588309439,DR CAMERON AND ASSOCIATES OF WAYNES,SMOKY MOUNTAIN DENTISTRY,30 MIAMI DR   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083733299,"LAMBERT, JEDIDIAH, WINN",30 MIAMI DR   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1083733885,HEAVENLY TOUCH LLC,HEAVENLY TOUCH LLC,636 PROSPECT RD   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1083733885,HEAVENLY TOUCH LLC,636 PROSPECT RD   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,659 "," 2,711 "," $432,116.70 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083734040,"HANSEN, JONATHAN, JAMES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083734040,"HANSEN, JONATHAN, JAMES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083734040,"HANSEN, JONATHAN, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 27 , 41 , 64 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1083734040,"HANSEN, JONATHAN, JAMES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083734040,"HANSEN, JONATHAN, JAMES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083737449,"GITHAIGA, ANDREW, NDIRANGU",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1083737522,"KARSHNER, CHRISTOPHER, ALLEN",~,4309 LUDGATE ST   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,1083737522,"KARSHNER, CHRISTOPHER, ALLEN",4309 LUDGATE ST   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 22 , 26 , 66 ,$#,,
MEDICAID DIRECT,1942420179,GANE & KARSHNER DDS PA,LUDGATE FAMILY DENTISTRY,4309 LUDGATE ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1083737522,"KARSHNER, CHRISTOPHER, ALLEN",4309 LUDGATE ST   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 63 , 88 , 254 ,$#,,
MEDICAID DIRECT,1083737621,"GRANDITS, HEATHER, DAWN",~,2305 RIVERBANK RD   WAXHAW NC,090,Union,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1083737621,"GRANDITS, HEATHER, DAWN",2305 RIVERBANK RD   WAXHAW NC,090,Union,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 251 , 251 ," $16,964.89 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083740260,"SWAIN, KELLY, ANNE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083743074,"RANKEN, LESLIE, PACK",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 140 , 207 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083743074,"RANKEN, LESLIE, PACK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083743074,"RANKEN, LESLIE, PACK",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083743074,"RANKEN, LESLIE, PACK",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 20 , 44 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083743074,"RANKEN, LESLIE, PACK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 63 ," $20,278.57 ",,
MEDICAID DIRECT,1659418515,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE TIMBERLYNE,77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083743249,"BORUN, ALEXANDER, GREGORY",77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083743546,"COPLAND, JESSICA, CAMPBELL",2630 WILLARD DAIRY RD STE 200 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083743546,"COPLAND, JESSICA, CAMPBELL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 29 , 78 ,$#,,
MEDICAID DIRECT,1083750608,"PATEL, KUNJAL, YOGESH",PEDS CARE INC,7000 JOYFUL NOISE LN   INDIAN TRAIL NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1083750608,"PATEL, KUNJAL, YOGESH",7000 JOYFUL NOISE LN   INDIAN TRAIL NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 221 , 221 ," $16,870.00 ",,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1083751044,"BIZZELL, CARY, FREDERICK",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1083751044,"BIZZELL, CARY, FREDERICK",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 693 , 985 ," 1,323 "," $23,920.90 ",,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1083751366,"GROSSMAN, JEFFREY, WAYNE",2031 E MOUNTAIN VISTA DR   COEUR D ALENE ID,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 25 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1083751366,"GROSSMAN, JEFFREY, WAYNE",2031 E MOUNTAIN VISTA DR   COEUR D ALENE ID,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1083754923,"HECKERT, REED, MITCHELL",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083754923,"HECKERT, REED, MITCHELL",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1083755763,"LEARY, MARK, EMERSON",13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,, 17 , 19 , 21 ,$#,,
MEDICAID DIRECT,1083755763,"LEARY, MARK, EMERSON",MARK E LEARY,13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,,1083755763,"LEARY, MARK, EMERSON",13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1083755763,"LEARY, MARK, EMERSON",MARK E LEARY,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,1083755763,"LEARY, MARK, EMERSON",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1083755763,"LEARY, MARK, EMERSON",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1336280544,C & S OPTOMETRIC SERVICES PLLC,NEW BERN FAMILY EYE CARE,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1083755763,"LEARY, MARK, EMERSON",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1083757298,"RUVO, ANDREW, THOMAS",ANDREW T RUVO,2823 N DUKE ST   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1083757298,"RUVO, ANDREW, THOMAS",2823 N DUKE ST   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1083757298,"RUVO, ANDREW, THOMAS",ANDREW T RUVO,501 EASTOWNE DR STE 110 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1083757298,"RUVO, ANDREW, THOMAS",501 EASTOWNE DR STE 110 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083757892,"FINNEGAN, TIMOTHY, JOHN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083757892,"FINNEGAN, TIMOTHY, JOHN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 72 , 155 , 157 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083760417,"DANIEL, KURT, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 90 , 131 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083760417,"DANIEL, KURT, ROBERT",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 94 , 114 , 140 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 40 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1083762603,"LITTLE, BURNIE, ROY",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598350647,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH FAMILY PRACTICE - LIBERTY,525 W SWANNANOA AVE   LIBERTY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1083762710,"PHILLIPS, TRACEY, BOYKIN",525 W SWANNANOA AVE   LIBERTY NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083766265,WELCOME HOME CARE AGENCY INC,WELCOME HOME CARE AGENCY INC,416 N MAIN ST   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1083766265,WELCOME HOME CARE AGENCY INC,416 N MAIN ST   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 48 ," 10,004 "," 10,022 "," $838,738.68 ",,
MEDICAID DIRECT,1083768980,GATES COUNTY SCHOOLS,GATES COUNTY SCHOOLS,709 MAIN ST   GATESVILLE NC,037,Gates,251300000X,Agencies,Local Education Agency (LEA),,1083768980,GATES COUNTY SCHOOLS,709 MAIN ST   GATESVILLE NC,037,Gates,251300000X,Agencies,Local Education Agency (LEA),, 44 ," 1,046 "," 1,093 "," $55,922.67 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083770911,"HERTEL, KRISTIE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1942685458,DURANT ROAD PEDIATRICS,,10940 RAVEN RIDGE RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083771653,"ARORA, PRIYANKA",10940 RAVEN RIDGE RD STE 200 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 25 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083776025,"YOUNG, LAURA, ANNE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 21 , 26 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083776025,"YOUNG, LAURA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 24 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083776025,"YOUNG, LAURA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 15 , 15 ,$#,,
MEDICAID DIRECT,1083776884,LINCARE INC,~,643 GREENWAY RD   BOONE NC,095,Watauga,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1083776884,LINCARE INC,643 GREENWAY RD   BOONE NC,095,Watauga,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 391 ," 2,925 "," 4,831 "," $123,197.72 ",,
MEDICAID DIRECT,1083776884,LINCARE INC,~,643 GREENWAY RD   BOONE NC,095,Watauga,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1083776884,LINCARE INC,643 GREENWAY RD   BOONE NC,095,Watauga,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1083778914,"MCCREA, BRUCE",~,216 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1083778914,"MCCREA, BRUCE",216 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831341866,GREENVILLE MEDICAL CARE PA,~,216 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083778914,"MCCREA, BRUCE",216 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 136 , 234 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083781173,"DENENNY, JENNIFER, THERESE",509 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083781173,"DENENNY, JENNIFER, THERESE",509 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265949788,MARGARET BOWEN MD PLLC,,1449 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1083781207,"BOWEN, MARGARET MARY, PHILLIPE",210 E LEXINGTON AVE   HIGH POINT NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1265949788,MARGARET BOWEN MD PLLC,,1449 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1083781207,"BOWEN, MARGARET MARY, PHILLIPE",1449 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 29 , 54 , 66 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1083781363,"VALLENI, LAURA, ANNE",155 MEMORIAL DR   PINEHURST NC,063,Moore,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 53 , 53 ,$#,,
MEDICAID DIRECT,1376605394,SKIN CANCER AND COSMETIC DERMATOLOG,,136 BATTLEFIELD CROSSING CT   RINGGOLD GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1083783021,"PIETRANGELO, DEBORAH, COLLINS",101 RIVERSTONE VIS STE 215 BLUE RIDGE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1083783021,"PIETRANGELO, DEBORAH, COLLINS",~,101 RIVERSTONE VIS STE 215 BLUE RIDGE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1083783021,"PIETRANGELO, DEBORAH, COLLINS",101 RIVERSTONE VIS STE 215 BLUE RIDGE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083783245,"MALLONEY, STEPHEN, JAMES",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083783245,"MALLONEY, STEPHEN, JAMES",134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083783245,"MALLONEY, STEPHEN, JAMES",134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 128 , 250 ," $11,335.24 ",,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1083783799,"BECKHAM, PATRICIA",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 81 , 89 , 89 ,$#,,
MEDICAID DIRECT,1801966395,KINSTON HEAD AND NECK PHYSICIANS AN,KINSTON HEAD & NECK PHYSICIANS AND SURGEONS PA,701 DOCTORS DR STE K KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1083784557,"HOSEA, ROBERT, HAYWOOD",701 DOCTORS DR STE K KINSTON NC,054,Lenoir,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 57 , 100 , 155 ,$#,,
MEDICAID DIRECT,1295766079,SOUTH LAKE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS SOUTH LAKE PEDIATRI,9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083784565,"RUBINOS, MARCIA",9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 25 , 63 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083784862,"HUTCHINSON, JON, RYAN",558 KITCHINGS DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083784862,"HUTCHINSON, JON, RYAN",558 KITCHINGS DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 32 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,558 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083784862,"HUTCHINSON, JON, RYAN",558 KITCHINGS DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 82 , 227 ," $12,049.99 ",,
MEDICAID DIRECT,1174624498,EAST TENNESSEE ORAL MAXILLOFACIAL,EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY PC,1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083785091,"CONNER, GREGORY, A",1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 59 , 64 , 565 ," $54,902.63 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083787725,"FALK, RONALD, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083787725,"FALK, RONALD, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 47 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083787725,"FALK, RONALD, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083791586,"VANVOORHIS, KEVIN, CURTIS",214 18TH ST SE   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083796262,"PERRY, STEPHANIE, LORRAINE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 101 , 118 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083796262,"PERRY, STEPHANIE, LORRAINE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 115 , 219 , 239 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083798979,"POLASCIK, THOMAS, JAMES",2400 PRATT ST   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083798979,"POLASCIK, THOMAS, JAMES",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083798979,"POLASCIK, THOMAS, JAMES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 18 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083798979,"POLASCIK, THOMAS, JAMES",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083798979,"POLASCIK, THOMAS, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 23 , 27 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1083799118,"PAPPAS, SUSAN, THOMPSON",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1164690731,PULMONOLOGY AND BRONCHOLOGY PC,Pulmonology And Bronchology PC,8878 US 70 W BUSINESS STE 400A CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1083800965,"ALI, MIR, OMAR",8878 US HIGHWAY 70 W STE 400A CLAYTON NC,051,Johnston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 45 , 49 ,$#,,
MEDICAID DIRECT,1164690731,PULMONOLOGY AND BRONCHOLOGY PC,Pulmonology And Bronchology PC,222 MAST DR STE 102 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1083800965,"ALI, MIR, OMAR",222 MAST DR STE 102 GARNER NC,051,Johnston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 64 , 242 ,$#,,
MEDICAID DIRECT,1164690731,PULMONOLOGY AND BRONCHOLOGY PC,Pulmonology And Bronchology PC,222 MAST DR STE 102 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1083800965,"ALI, MIR, OMAR",8878 US HIGHWAY 70 W STE 400A CLAYTON NC,051,Johnston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 30 , 112 , 112 ,$#,,
MEDICAID DIRECT,1164690731,PULMONOLOGY AND BRONCHOLOGY PC,Pulmonology And Bronchology PC,8878 US 70 W BUSINESS STE 400A CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1083800965,"ALI, MIR, OMAR",222 MAST DR STE 102 GARNER NC,051,Johnston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083802557,"HUGHES, COURTNEY, SAMS",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083802557,"HUGHES, COURTNEY, SAMS",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 61 , 73 ,$#,,
MEDICAID DIRECT,1053338947,JAGDISH LAL MD PA,RAYCONDA INTERNAL MEDICINE,6977 NEXUS CT STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083802763,"LAL, JAGDISH",6977 NEXUS CT STE 10 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 101 , 494 , 697 ," $13,838.70 ",,
MEDICAID DIRECT,1053338947,JAGDISH LAL MD PA,RAYCONDA INTERNAL MEDICINE,6977 NEXUS CT STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083802763,"LAL, JAGDISH",6977 NEXUS CT STE 10 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 197 , 253 ,$#,,
MEDICAID DIRECT,1689628729,NURSE ANESTHESIA OF NC PLLC,~,180 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1083803639,"ROUSER, TONIA, ANN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083803639,"ROUSER, TONIA, ANN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083803639,"ROUSER, TONIA, ANN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083804058,"KEELER, CAROLYN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 25 , 48 , 74 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083804058,"KEELER, CAROLYN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 11 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1083805006,"WERTMAN II, GARY, VAN",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083805006,"WERTMAN II, GARY, VAN",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 140 , 258 , 502 ," $11,488.20 ",,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1083805006,"WERTMAN II, GARY, VAN",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083805006,"WERTMAN II, GARY, VAN",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 23 , 49 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083805006,"WERTMAN II, GARY, VAN",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083805006,"WERTMAN II, GARY, VAN",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 19 , 29 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083805725,"RHEINBOLT, JOSHUA, ANDREW",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083805725,"RHEINBOLT, JOSHUA, ANDREW",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 131 , 187 , 253 ," $12,541.03 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,645 AMALIA ST NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083805725,"RHEINBOLT, JOSHUA, ANDREW",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,530 CORPORATE CIR   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1083805725,"RHEINBOLT, JOSHUA, ANDREW",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083805725,"RHEINBOLT, JOSHUA, ANDREW",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 41 , 43 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083808000,"BHARGAVA, CHUDARATNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 79 , 205 , 205 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083811053,"DIXON, CHRISTINA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083811053,"DIXON, CHRISTINA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083811053,"DIXON, CHRISTINA",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083811897,"HADEN, DOUGLAS, WILLIAM",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083811897,"HADEN, DOUGLAS, WILLIAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083814149,"WOOD, FRANCES, OLIVER",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083814149,"WOOD, FRANCES, OLIVER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083814149,"WOOD, FRANCES, OLIVER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083814149,"WOOD, FRANCES, OLIVER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083814149,"WOOD, FRANCES, OLIVER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 77 , 97 , 124 ,$#,,
MEDICAID DIRECT,1346078425,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH CARDIOLOGY,373 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1083814149,"WOOD, FRANCES, OLIVER",373 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083815401,"STOGNER, KIMBERLY, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 133 , 140 , 201 ,$#,,
MEDICAID DIRECT,1083816797,LAKEWOOD CARE CENTER INC,LAKEWOOD CARE CENTER INC,7981 OPTIMIST CLUB RD   DENVER NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083816797,LAKEWOOD CARE CENTER INC,7981 OPTIMIST CLUB RD   DENVER NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 25 ," 3,829 "," 3,852 "," $486,259.08 ",,
MEDICAID DIRECT,1629327671,KIDZCARE PEDIATRICS PC,~,427 HARRISON AVE   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1083816912,"PELLETIER, MARRISSA, CANDICE",427 HARRISON AVE   FRANKLIN NC,056,Macon,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 114 , 218 , 632 ," $26,400.76 ",,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083817084,"BAILEY, SHARLENE, ELIZABETH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 59 , 83 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 65 , 70 , 84 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 60 , 76 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 27 , 37 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 15 , 17 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 34 , 39 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 63 , 65 , 82 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1083820617,"NASIM, ALI, KHALID",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 19 , 27 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",1301 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1083820617,"NASIM, ALI, KHALID",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 387 , 485 , 610 ," $10,962.28 ",,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 34 , 52 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083820617,"NASIM, ALI, KHALID",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811262579,BUGLISI EYE CARE PLLC,BUGLISI EYE CARE,250 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1083821789,"BUGLISI JR, JOSEPH, ANTHONY",250 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 149 , 277 , 413 ," $13,323.55 ",,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083824163,"SCHMITT, JAMES, LOUIS",905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083824163,"SCHMITT, JAMES, LOUIS",1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 38 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083827554,"SAHA, MANISH, KANTI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083827554,"SAHA, MANISH, KANTI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 27 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083827554,"SAHA, MANISH, KANTI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 48 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083827554,"SAHA, MANISH, KANTI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083829378,"MITCHELL, MYROSIA, TOMIAK",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 216 , 254 , 360 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083829378,"MITCHELL, MYROSIA, TOMIAK",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 168 , 269 , 356 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083830137,"JOHNSON, AMANDA, FORSYTHE",7990 ARCO CORPORATE DR STE 110 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1083833826,"DILLARD, THOMAS, WAYNE",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 20 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1083833826,"DILLARD, THOMAS, WAYNE",2754 HWY 68 S STE 111 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 38 , 66 ,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083834212,"MAIER, ALDEN, BERKELEY",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083834212,"MAIER, ALDEN, BERKELEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 18 , 27 ,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1083835060,"BUSBY, BRET, RUDY",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 91 , 92 , 112 ," $15,140.87 ",,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083835060,"BUSBY, BRET, RUDY",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 264 , 304 , 381 ," $51,940.72 ",,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1083835060,"BUSBY, BRET, RUDY",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 151 , 156 , 176 ," $22,336.49 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083835078,"RAVANOS, SALLY, CATHLEEN ROHRER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 31 , 31 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1083835078,"RAVANOS, SALLY, CATHLEEN ROHRER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083835078,"RAVANOS, SALLY, CATHLEEN ROHRER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 115 , 115 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083836001,"ATKINS, MATTHEW, ELLIOT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 29 , 45 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083836555,"SIMON, STEPHANIE, YOUNG",10545 BLAIR RD STE 2100 MINT HILL NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083836555,"SIMON, STEPHANIE, YOUNG",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083836555,"SIMON, STEPHANIE, YOUNG",10545 BLAIR RD STE 2100 MINT HILL NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1558543884,EAST CAROLINA OPTOMETRIC CARE PA,~,2322 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1083837546,"JACKSON, TIFFANY, LAYNE",2322 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,152W00000X,Eye and Vision Services Providers,Optometrist,, 73 , 100 , 193 ,$#,,
MEDICAID DIRECT,1083837546,"JACKSON, TIFFANY, LAYNE",~,2322 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,152W00000X,Eye and Vision Services Providers,Optometrist,,1083837546,"JACKSON, TIFFANY, LAYNE",2322 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,152W00000X,Eye and Vision Services Providers,Optometrist,, 964 ," 1,028 "," 1,950 "," $31,525.06 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083839674,"HONEYCUTT, ANDREA, LAKEBINGHAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 114 , 114 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083842819,"ROBERTS, JASON, SCOTT",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083844666,"COLLINS, RACHAEL, MARIE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1083844666,"COLLINS, RACHAEL, MARIE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083844666,"COLLINS, RACHAEL, MARIE",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1083844666,"COLLINS, RACHAEL, MARIE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083844666,"COLLINS, RACHAEL, MARIE",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083844666,"COLLINS, RACHAEL, MARIE",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1083844666,"COLLINS, RACHAEL, MARIE",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1083849632,"CAMPOREALE, JAYNE, MARY",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083849632,"CAMPOREALE, JAYNE, MARY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083849723,"WESTMORELAND, KATHERINE, DOUGLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 28 , 37 ,$#,,
MEDICAID DIRECT,1083850606,BOONE TRAIL OPTOMETRIC EYE CARE,,48 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1083850606,BOONE TRAIL OPTOMETRIC EYE CARE,48 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,, 203 , 203 , 405 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083853311,"MOLINA, ALBERT, MANUEL",210 SMITH CHURCH RD BLDG 1 ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1083853956,"THOMPSON, PETER, MICHAEL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1083854467,"ALEXANDER DANKS, LISA, CAROL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1083857015,"GARRIS, WINSTON, JOSEPH",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 73 , 108 , 167 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1083857015,"GARRIS, WINSTON, JOSEPH",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1649349291,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,923 N 2ND ST STE 201 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1083857015,"GARRIS, WINSTON, JOSEPH",923 N 2ND ST STE 201 ALBEMARLE NC,084,Stanly,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1083857015,"GARRIS, WINSTON, JOSEPH",923 N 2ND ST STE 201 ALBEMARLE NC,084,Stanly,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 47 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083857791,"PRIETO GRANADA, CARLOS, NICOLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083857791,"PRIETO GRANADA, CARLOS, NICOLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083857890,"GIBBS, KEVIN, WARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 45 , 89 , 95 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083858047,"PATEL, PRIYESH, ASHOK",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 23 , 26 , 46 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083858047,"PATEL, PRIYESH, ASHOK",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 22 , 30 , 32 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083858047,"PATEL, PRIYESH, ASHOK",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083858047,"PATEL, PRIYESH, ASHOK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1083858047,"PATEL, PRIYESH, ASHOK",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1346486891,SEASIDE PEDIATRICS PA,SEASIDE PEDIATRICS PA,1606 WELLINGTON AVE STE E WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083858559,"PUTNEY, ASHLEY",1606 WELLINGTON AVE STE E WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 14 , 24 , 46 ,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083858914,"ONASH, NICHOLE, MICHELLE",1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 63 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083859482,"WENNERBERG, SAMANTHA, RENE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083859482,"WENNERBERG, SAMANTHA, RENE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 57 , 94 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083859482,"WENNERBERG, SAMANTHA, RENE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083860126,"ARYAL, GOVINDA",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 47 , 111 , 207 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1083862650,"MARCISAK, SHARYN, RANDI",400 US HIGHWAY 70 E   GARNER NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083862650,"MARCISAK, SHARYN, RANDI",3009 NEW BERN AVE   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083863237,"MUZYKA, BRIAN, CHARLES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083863237,"MUZYKA, BRIAN, CHARLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083863237,"MUZYKA, BRIAN, CHARLES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 119 , 154 , 387 ," $20,848.57 ",,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083863237,"MUZYKA, BRIAN, CHARLES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 70 , 81 , 229 ," $11,075.37 ",,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083863237,"MUZYKA, BRIAN, CHARLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083864953,"FRANKS, CAROLYN",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 17 , 17 , 32 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083864953,"FRANKS, CAROLYN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083866065,"DEDMOND, KEVIN, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1083866677,"SKELTON, THOMAS, SPENCER",701 NEWMAN RD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 29 , 36 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1083866677,"SKELTON, THOMAS, SPENCER",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083871362,"SERRANO DONADO, RICARDO, ADOLFO",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1083871362,"SERRANO DONADO, RICARDO, ADOLFO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083871362,"SERRANO DONADO, RICARDO, ADOLFO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 53 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1083871362,"SERRANO DONADO, RICARDO, ADOLFO",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083871362,"SERRANO DONADO, RICARDO, ADOLFO",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1083873541,"COTTEN, MARVIN, CHANCELLOR",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083874416,"NGUYEN, CUONG, THO",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083874416,"NGUYEN, CUONG, THO",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083874416,"NGUYEN, CUONG, THO",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083874416,"NGUYEN, CUONG, THO",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 173 , 177 , 219 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083874416,"NGUYEN, CUONG, THO",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083874416,"NGUYEN, CUONG, THO",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083874416,"NGUYEN, CUONG, THO",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083874630,"KOHAN, LUKE, CHARLES",850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083874630,"KOHAN, LUKE, CHARLES",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083875058,"THERUVATH, TOM, PRAKASH",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083875058,"THERUVATH, TOM, PRAKASH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083875223,"CALLAHAN, SIDNEY, LEE",719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1295766079,SOUTH LAKE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS SOUTH LAKE PEDIATRI,9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083875355,"DAVIS, MARY, KATHERINE",9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 39 , 90 ,$#,,
MEDICAID DIRECT,1598148801,TRUCARE FAMILY PRACTICE PLLC,,4314 LUDGATE ST STE B LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1083875793,"LOCKLEAR, CHARLENE, RESHELL",4314 LUDGATE ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 106 , 342 , 425 ,$#,,
MEDICAID DIRECT,1083876049,VONI M GOODSON-SIMPSON,BRIDGES OF WILMINGTON,202 S 5TH AVE UNIT C-4 WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1083876049,VONI M GOODSON-SIMPSON,202 S 5TH AVE UNIT C-4 WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1083877930,"WODOWSKI, STEPHANIE, ANN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720457567,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DIGESTIVE HEALTH CENTER SEACOAST,3980 HIGHWAY 9 E STE 320 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083878813,"EDMISON, LACIE, ERIN",3980 HIGHWAY 9 E STE 320 LITTLE RIVER SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083881445,"JENKINS, JAIME, JEYUSON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 51 , 172 , 172 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1083882419,"VERGUN, ANNA, DIMITRIOVNA",1301 CENTRAL DR   SANFORD NC,053,Lee,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 33 , 44 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083882419,"VERGUN, ANNA, DIMITRIOVNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 33 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083882419,"VERGUN, ANNA, DIMITRIOVNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 92 , 137 ," $28,671.39 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083882419,"VERGUN, ANNA, DIMITRIOVNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 24 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083882419,"VERGUN, ANNA, DIMITRIOVNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1083882419,"VERGUN, ANNA, DIMITRIOVNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083882419,"VERGUN, ANNA, DIMITRIOVNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 44 , 52 , 55 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083885610,"SMITH, MELISSA, RAYLENE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 61 , 117 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1083885644,"CANCEL, QUINTON, VICTOR",430 RANKIN DR   MARION NC,059,McDowell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1083885644,"CANCEL, QUINTON, VICTOR",472 RANKIN DR   MARION NC,059,McDowell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083885644,"CANCEL, QUINTON, VICTOR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083885644,"CANCEL, QUINTON, VICTOR",100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083885644,"CANCEL, QUINTON, VICTOR",100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083885644,"CANCEL, QUINTON, VICTOR",1 HOSPITAL DR STE 4100 ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083885644,"CANCEL, QUINTON, VICTOR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083888739,"CACERES, CATHERINE, MARIEL",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1083888739,"CACERES, CATHERINE, MARIEL",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1083888739,"CACERES, CATHERINE, MARIEL",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 31 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083888739,"CACERES, CATHERINE, MARIEL",10211 ALM STREET   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1083888739,"CACERES, CATHERINE, MARIEL",162 LEGACY OAKS DRIVE   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548221856,CHAPEL HILL PEDIATRICS,CHAPEL HILL PEDIATRICS,205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083889364,"JOHNSON, CHARLES, DAVID",205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 32 , 87 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083889745,"WHEATLEY, GREGORY, VAL",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083890891,"HAYES, TAMARA, FAYE",1168 E CUTLAR XING   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1083890891,"HAYES, TAMARA, FAYE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083890891,"HAYES, TAMARA, FAYE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 21 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10208 CERNY ST STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083891089,"NEELAGIRI, RAM",10208 CERNY ST STE 110 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 43 , 79 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083891089,"NEELAGIRI, RAM",10208 CERNY ST STE 110 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 42 , 59 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1083891568,"WALTHER, BRIAN, SCOTT",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 59 , 80 , 147 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083891808,"OMER, DIAB, SIDAHMED",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083891808,"OMER, DIAB, SIDAHMED",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083891808,"OMER, DIAB, SIDAHMED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083891808,"OMER, DIAB, SIDAHMED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083891808,"OMER, DIAB, SIDAHMED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 55 , 55 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083891808,"OMER, DIAB, SIDAHMED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083891808,"OMER, DIAB, SIDAHMED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 32 , 48 , 48 ,$#,,
MEDICAID DIRECT,1083894554,CAROLINA LEARN & PLAY LLC,CAROLINBA EARLY INTERVENTION THERAPY,1340 WALL RD STE 100 WAKE FOREST NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1083894554,CAROLINA LEARN & PLAY LLC,1340 WALL RD STE 100 WAKE FOREST NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,, 39 , 588 , 588 ," $39,034.34 ",,
MEDICAID DIRECT,1003199316,WENDY K BRITT DDS PLLC,~,310 WILKINSON DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1083895817,"BRITT, WENDY, KOREN",310 WILKINSON DR   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice, 496 ," 1,127 "," 3,719 "," $156,017.71 ",,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083895817,"BRITT, WENDY, KOREN",1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083900062,"ADAMS, JOANNA, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 107 , 110 , 113 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083903595,"BIERSBACH, RAYMOND, JOSEPH",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1083903595,"BIERSBACH, RAYMOND, JOSEPH",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083903595,"BIERSBACH, RAYMOND, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 34 , 43 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1083903595,"BIERSBACH, RAYMOND, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 33 , 41 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083903595,"BIERSBACH, RAYMOND, JOSEPH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083903975,"DUTTA, SIMANTA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083905061,"SHATAGOPAM, KARTIK",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083905061,"SHATAGOPAM, KARTIK",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083905061,"SHATAGOPAM, KARTIK",1718 E 4TH ST STE 604 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1639179393,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1083905061,"SHATAGOPAM, KARTIK",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083905061,"SHATAGOPAM, KARTIK",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 225 , 298 , 484 ," $14,179.01 ",,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1083905061,"SHATAGOPAM, KARTIK",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083905061,"SHATAGOPAM, KARTIK",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083905087,"BOOLE, LINDSAY, CAROL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083905087,"BOOLE, LINDSAY, CAROL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083905087,"BOOLE, LINDSAY, CAROL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083905087,"BOOLE, LINDSAY, CAROL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083905087,"BOOLE, LINDSAY, CAROL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 59 , 61 ,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083905087,"BOOLE, LINDSAY, CAROL",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1902308984,UNION MEDICAL CENTER,UMC CENTER FOR FAMILY MEDICINE,322 W SOUTH ST   UNION SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083909121,"HRAY, ALEXANDER",322 W SOUTH ST   UNION SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083909170,"WARD, KRISTEN, NICOLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 30 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083909170,"WARD, KRISTEN, NICOLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 51 , 70 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083909246,"WILSON, ROBERT, BROOKS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 53 , 67 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1083909246,"WILSON, ROBERT, BROOKS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 39 , 58 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083909246,"WILSON, ROBERT, BROOKS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 354 , 307 , 414 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1083909493,"NAVEJAR, SOMYA, MUTYALA",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 23 , 28 ,$#,,
MEDICAID DIRECT,1902934292,NEW HANOVER COUNTY,NEW HANOVER COUNTY HEALTH DEPT,1650 GREENFIELD ST   WILMINGTON NC,065,New Hanover,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1083909493,"NAVEJAR, SOMYA, MUTYALA",1650 GREENFIELD ST   WILMINGTON NC,065,New Hanover,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083909949,"VALENTINE, MEGHAN, LOUISE",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083909949,"VALENTINE, MEGHAN, LOUISE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083909949,"VALENTINE, MEGHAN, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 74 , 76 , 78 ," $12,254.04 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083909949,"VALENTINE, MEGHAN, LOUISE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 167 , 180 , 187 ," $32,285.46 ",,
MEDICAID DIRECT,1093703886,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER FAMILY PRACTICE,301 S CAMPBELL ST   BURGAW NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083909972,"WITKOWSKI, JENNIFER, ANNE",301 S CAMPBELL ST   BURGAW NC,071,Pender,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1083911259,"PRATT, JOSHUA, DANIEL",98 DOCTORS DR STE 320 SYLVA NC,050,Jackson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 36 , 43 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083911259,"PRATT, JOSHUA, DANIEL",98 DOCTORS DR STE 320 SYLVA NC,050,Jackson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 54 , 89 , 111 ," $13,178.57 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083913339,"BERNENS, MATTHEW, DONALD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083913339,"BERNENS, MATTHEW, DONALD",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1425 PROMISE BEACON CIR STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083914550,"ALIN, TARA, RENAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1083914550,"ALIN, TARA, RENAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083914550,"ALIN, TARA, RENAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 22 , 43 , 69 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083914550,"ALIN, TARA, RENAY",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 30 , 52 , 76 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1083914550,"ALIN, TARA, RENAY",1301 CENTRAL DR   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083916167,"HERRMANN, TARA, RAE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083916167,"HERRMANN, TARA, RAE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 34 ,$#,,
MEDICAID DIRECT,1083919518,BLACKWELL HOUSE,BLACKWELL HOUSE INC,2805 N OHENRY BLVD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083919518,BLACKWELL HOUSE,2805 N OHENRY BLVD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 358 , 360 ," $13,205.72 ",,
MEDICAID DIRECT,1124361100,ELITE FAMILY EYE CARE OD PLLC,ELITE FAMILY EYE CARE,2340 15TH AVE SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1083922306,"LOR, DOUA, CHEE",2340 15TH AVE SE SUITE 101 HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083923262,"FAIRCLOTH, PAULINE, DEANNIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902614464,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY UROLOGY,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083923262,"FAIRCLOTH, PAULINE, DEANNIA",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083923262,"FAIRCLOTH, PAULINE, DEANNIA",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 57 , 67 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083923262,"FAIRCLOTH, PAULINE, DEANNIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 35 , 35 ,$#,,
MEDICAID DIRECT,1407958226,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083925770,"TRIMBLE, SARAH, EDMUNDSON",301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 19 , 29 , 46 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1083927909,"JOHNSON, BROOKE, CATHERINE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1083927909,"JOHNSON, BROOKE, CATHERINE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083930580,"DAVID, JAMALIA, JUNELLE",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083930580,"DAVID, JAMALIA, JUNELLE",3315 SPRINGBANK LN STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 40 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083930663,"SPENCER, DUSTIN, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083931935,"LYON, WESLEY, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 40 , 48 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083931935,"LYON, WESLEY, JOHN",310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083931935,"LYON, WESLEY, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 28 , 33 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083931935,"LYON, WESLEY, JOHN",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083931935,"LYON, WESLEY, JOHN",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083932990,"PATEL, MUKTI, JAYANT",3134 WENDELL BLVD   WENDELL NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083933790,"NYE, BARBARA, LUDMILA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 49 , 64 , 85 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083934079,"AGUILAR, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 33 , 99 , 108 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083934079,"AGUILAR, JOHN",601 N ELM ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083934343,"HAYNES, ELIZABETH, MILES",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083934343,"HAYNES, ELIZABETH, MILES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083934343,"HAYNES, ELIZABETH, MILES",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083935357,"TILDEN, SAMUEL, GREY",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,,,Unknown,193200000X,Group,Multi-Specialty,,1083935357,"TILDEN, SAMUEL, GREY",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083935928,"WARREN, MILDRED, PELLETIER",1840 HIGHWAY 24   NEWPORT NC,016,Carteret,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 22 , 45 , 91 ,$#,,
MEDICAID DIRECT,1568132777,ROWAN HEALTH AND WELLNESS,,417 N MAIN ST STE F SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1083936710,"NIXON, TRACI",417 N MAIN ST STE F SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 43 , 65 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083938419,"CLYMER, SARA, ELIZABETH",911 W HENDERSON ST STE 300 SALISBURY NC,080,Rowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083938419,"CLYMER, SARA, ELIZABETH",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1083943773,"DYER, ELIZABETH, MARIE",146 HWY 64 E   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1083943773,"DYER, ELIZABETH, MARIE",146 HWY 64 E   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1326028978,CHATUGE REGIONAL HOSPITAL INC,CHATUGE REGIONAL HOSPITAL,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1083943773,"DYER, ELIZABETH, MARIE",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326028978,CHATUGE REGIONAL HOSPITAL INC,CHATUGE REGIONAL HOSPITAL,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083943773,"DYER, ELIZABETH, MARIE",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1083945257,"WILLIAMS, ALLISON, RUTH",534 CARATOKE HWY   MOYOCK NC,027,Currituck,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 28 , 57 ,$#,,
MEDICAID DIRECT,1083945778,PORTER PEDIATRIC THERAPY PC,~,110 SCOTT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1083945778,PORTER PEDIATRIC THERAPY PC,110 SCOTT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,, 204 ," 2,779 "," 5,404 "," $366,497.77 ",,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1083947444,"ALI, ZULFIQAR",1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1083947444,"ALI, ZULFIQAR",1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 60 , 79 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083947535,"THUAHNAI, STEPHEN, T",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083947535,"THUAHNAI, STEPHEN, T",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083947535,"THUAHNAI, STEPHEN, T",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 38 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083947535,"THUAHNAI, STEPHEN, T",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083947535,"THUAHNAI, STEPHEN, T",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 67 , 85 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083947535,"THUAHNAI, STEPHEN, T",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 16 , 23 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083947535,"THUAHNAI, STEPHEN, T",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 57 , 78 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083947535,"THUAHNAI, STEPHEN, T",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 107 , 117 , 151 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083947535,"THUAHNAI, STEPHEN, T",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1083947535,"THUAHNAI, STEPHEN, T",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1083947535,"THUAHNAI, STEPHEN, T",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083950935,"FOSTER, CORY, JO",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376819037,MCPC-6 LLC,FIRSTHEALTH BACK AND NECK PAIN CENTER,2919 BEECHTREE DR STE 3300 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1083951610,"ALBRIGHT, WHITNEY, RICHARDSON",2919 BEECHTREE DR STE 3300 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 107 , 300 , 524 ,$#,,
MEDICAID DIRECT,1376819037,MCPC-6 LLC,FIRSTHEALTH BACK AND NECK PAIN CENTER,2919 BEECHTREE DR STE 3300 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1083951610,"ALBRIGHT, WHITNEY, RICHARDSON",2919 BEECHTREE DR STE 3100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407295447,SMOKY MOUNTAIN URGENT CARE,~,80 VETERANS BLVD   BRYSON CITY NC,087,Swain,193400000X,Group,Single Specialty,,1083951958,"MCDONALD, ELIZABETH, COLEMAN",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083952410,"CASTELLANOS CASTILLO, GISSELLE, DALILA",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083952410,"CASTELLANOS CASTILLO, GISSELLE, DALILA",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1083953152,"MARR, SAMANTHA, JUDITH",7473 C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083954549,"YOUNG, MAUREEN, VALENTINE",~,4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1083954549,"YOUNG, MAUREEN, VALENTINE",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 22 , 40 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083954689,"MILLS, KATHY, KOEHN",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 262 , 263 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083954689,"MILLS, KATHY, KOEHN",333 E LEE AVE   YADKINVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 149 , 149 ,$#,,
MEDICAID DIRECT,1932628187,LOCKLEAR FAMILY PRACTICE PLLC,,17 LIVERMORE DR   PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1083956577,"LOCKLEAR, NATALIE, PIERCE",17 LIVERMORE DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 85 , 367 , 674 ,$#,,
MEDICAID DIRECT,1932628187,LOCKLEAR FAMILY PRACTICE PLLC,,,,Unknown,193400000X,Group,Single Specialty,,1083956577,"LOCKLEAR, NATALIE, PIERCE",17 LIVERMORE DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083959670,"ALFORD, CAROLINA, CASTRO",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083962971,"KEBEDE, HAILU, MINUTA",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 74 , 74 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083962971,"KEBEDE, HAILU, MINUTA",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083962971,"KEBEDE, HAILU, MINUTA",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083962971,"KEBEDE, HAILU, MINUTA",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083962971,"KEBEDE, HAILU, MINUTA",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1083962971,"KEBEDE, HAILU, MINUTA",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083962971,"KEBEDE, HAILU, MINUTA",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083964290,"HELMS, SARAH, TENCH",9835 MONROE RD B CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083964290,"HELMS, SARAH, TENCH",824 LOWER DALLAS HIGHWAY   DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 164 , 235 ," $11,225.37 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083964480,"AZIZ, TASNIA, ZARIFA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083964480,"AZIZ, TASNIA, ZARIFA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1083964480,"AZIZ, TASNIA, ZARIFA",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083964480,"AZIZ, TASNIA, ZARIFA",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083964480,"AZIZ, TASNIA, ZARIFA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1083964480,"AZIZ, TASNIA, ZARIFA",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1083964480,"AZIZ, TASNIA, ZARIFA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 19 , 20 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 43 , 43 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 102 , 103 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 30 , 30 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083966113,"JOHNSON, KRISTAN, LEEANN",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083968622,"BILLUPS, MELISSA, EVONNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083968622,"BILLUPS, MELISSA, EVONNE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 15 , 19 ,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1083968622,"BILLUPS, MELISSA, EVONNE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083969752,"YOUNG, WILLIAM, ALEXANDER",231 MT HOLLY HUNTERSVILLE RD STE 140 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 41 , 96 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1083969752,"YOUNG, WILLIAM, ALEXANDER",2675 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1083970032,"TRAU, STEVEN, PATRICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 57 , 86 , 93 ," $10,112.86 ",,
MEDICAID DIRECT,1326394990,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1083970156,"LIN, JONATHAN, LEE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 35 ,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1083971451,"WILLIAMS, LAURA, GOWDER",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 14 , 15 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1083971451,"WILLIAMS, LAURA, GOWDER",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083972046,"MOISE, ANNA, MARIETA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083972046,"MOISE, ANNA, MARIETA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1083972194,MEADOWVIEW AL OPERATIONS LLC,MEADOWVIEW ASSISTED LIVING CENTER,250 NC 210 HWY   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083972194,MEADOWVIEW AL OPERATIONS LLC,250 NC 210 HWY   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 27 ," 6,791 "," 6,791 "," $494,405.22 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083978043,"TOMLIN, KEITH, FRANK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1083979082,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 147 , 613 , 642 ," $69,776.33 ",,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 63 , 64 , 81 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 40 , 50 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1083980270,"BOBRYSHEV, PAUL, VIKTOROVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1083983928,MILDREDS FAMILY CARE INC,MILDREDS FAMILY CARE,3592 MARSHALL GRAVES RD   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1083983928,MILDREDS FAMILY CARE INC,3592 MARSHALL GRAVES RD   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,520 "," 1,520 "," $89,503.28 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083993224,"MARACAJA, LUIZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083993224,"MARACAJA, LUIZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1083993224,"MARACAJA, LUIZ",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 28 ,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1083993323,"HICKMAN, KATIE, CREECH",1730 CAROLINA AVE   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,, 66 , 60 , 66 ,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1083993323,"HICKMAN, KATIE, CREECH",2511 N QUEEN ST   KINSTON NC,054,Lenoir,152W00000X,Eye and Vision Services Providers,Optometrist,, 77 , 83 , 98 ,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1083993323,"HICKMAN, KATIE, CREECH",1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,152W00000X,Eye and Vision Services Providers,Optometrist,, 151 , 170 , 235 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1083997621,"DIRITO, DAVID, LOUIS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083998702,"KAHN, NATALIE, ANDERSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1083998702,"KAHN, NATALIE, ANDERSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1083998702,"KAHN, NATALIE, ANDERSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093000556,"SONG, FINE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093000879,"WYSS, BRANDON, KEITH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1093001232,"BENTLEY, PASHA, LAUREL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 37 , 38 , 64 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1093001232,"BENTLEY, PASHA, LAUREL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 17 , 27 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093001323,"WALKER-GALLEGO, EDWARD, RANDAL",441 MCALISTER RD STE 1100A LINCOLNTON NC,055,Lincoln,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 87 , 148 , 220 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",409 HEFLIN ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",409 HEFLIN ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 58 , 58 ,$#,,
MEDICAID DIRECT,1093001760,"BATES, JAMES, MYRICK",,409 HEFLIN ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1093001760,"BATES, JAMES, MYRICK",409 HEFLIN ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 170 , 710 , 715 ," $21,676.68 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093001760,"BATES, JAMES, MYRICK",,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1093001760,"BATES, JAMES, MYRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093001760,"BATES, JAMES, MYRICK",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 200 , 200 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093003493,"GOTTSHALL, ASHLEY, CUMMINS",2345 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 135 , 149 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093004392,"GREENE, JOHN, WALKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 40 , 97 , 97 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093004392,"GREENE, JOHN, WALKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1043304215,GREENSBORO OPHTHAMOLOGY ASSOCIATES,GREENSBORO OPHTHAMOLOGY ASSOCIATES,8 N POINTE CT   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093006892,"BOWEN, BRADLEY, EDWARD",8 N POINTE CT   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1093006892,"BOWEN, BRADLEY, EDWARD",~,8 N POINTE CT   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1093006892,"BOWEN, BRADLEY, EDWARD",8 N POINTE CT   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 29 , 47 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 48 , 84 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 183 , 181 , 247 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1093006967,"JIMOH, NNEKA, TOLULOPE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093007320,SERAPHIM CHILDRENS THERAPY,SERAPHIM CHILDRENS THERAPY,69 WILDFLOWER MOUNTAIN TRL   CANDLER NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1093007320,SERAPHIM CHILDRENS THERAPY,69 WILDFLOWER MOUNTAIN TRL   CANDLER NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,, 33 , 285 , 285 ," $19,666.80 ",,
MEDICAID DIRECT,1093007320,SERAPHIM CHILDRENS THERAPY,SERAPHIM CHILDRENS THERAPY,69 WILDFLOWER MOUNTAIN TRL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093007320,SERAPHIM CHILDRENS THERAPY,69 WILDFLOWER MOUNTAIN TRL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,, 58 ," 1,018 "," 1,233 "," $91,453.87 ",,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093009698,"CHOO, HOO, FENG",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093009698,"CHOO, HOO, FENG",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 64 , 70 ,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1093011074,"BATEMAN, ERIN, KRISTIN",169 DOCTORS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518606136,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-156 CROSS ROAD DRIVE,156 CROSS ROAD DR   MILLS RIVER NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093011710,"BULLOCK, BRADY, TIMOTHY",156 CROSS ROAD DR   MILLS RIVER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 71 , 83 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093012239,"LAUGHLIN, AMANDA, CHARLOTTE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 12 , 16 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093013260,"ATKINSON, CHRISTOPHER, JAMES",3 GARDEN SQ   SAN ANTONIO TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093013351,PROPTNC LLC,RESOLVE PHYSICAL THERAPY AND REHABILITATION,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1093013351,PROPTNC LLC,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,, 124 , 988 ," 1,407 "," $18,399.10 ",,
MEDICAID DIRECT,1093017956,"KIM, SAE, KYU",SHIN AND KIM DDS PLLC,501 EASTOWNE DR STE 230A CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,1093017956,"KIM, SAE, KYU",501 EASTOWNE DR STE 230A CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 621 ," 1,124 "," 4,430 "," $196,696.78 ",,
MEDICAID DIRECT,1831748458,SHIN AND KIM DDS PLLC,EASTOWNE FAMILY DENTISTRY,501 EASTOWNE DR STE 230A CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1093017956,"KIM, SAE, KYU",501 EASTOWNE DR STE 230A CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1093022048,"REED, HEATHER",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 29 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093022048,"REED, HEATHER",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 NC HIGHWAY 42 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1093024663,"SWANSON, TROY, PHILIP",5638 NC HIGHWAY 42 W STE 207 GARNER NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 VETERANS PKWY STE 207 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093024663,"SWANSON, TROY, PHILIP",5638 VETERANS PKWY STE 207 GARNER NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205925914,DR ALAN L BYRD AND ASSOCIATES,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1093024663,"SWANSON, TROY, PHILIP",104 S MAIN ST   LILLINGTON NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,, 44 , 46 , 54 ,$#,,
MEDICAID DIRECT,1669561320,DR ALAN L BYRD ASSOCS OF ERWIN,~,2332 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1093024663,"SWANSON, TROY, PHILIP",2332 W CUMBERLAND ST   DUNN NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720169220,DR ALAN L BYRD ASSOCIATES OF ANGIER,DR ALAN L BYRD & ASSOCIATES OF ANGIER,8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,193200000X,Group,Multi-Specialty,,1093024663,"SWANSON, TROY, PHILIP",5638 NC HIGHWAY 42 W STE 207 GARNER NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720169220,DR ALAN L BYRD ASSOCIATES OF ANGIER,DR ALAN L BYRD & ASSOCIATES OF ANGIER,8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,193200000X,Group,Multi-Specialty,,1093024663,"SWANSON, TROY, PHILIP",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 66 , 70 , 90 ,$#,,
MEDICAID DIRECT,1205925914,DR ALAN L BYRD AND ASSOCIATES,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1093024663,"SWANSON, TROY, PHILIP",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093024671,ALLIED HOME HEALTH CARE SERVICES IN,ALLIED HOME HEALTH CARE SERVICES INC,2609 ATLANTIC AVE STE 101C RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1093024671,ALLIED HOME HEALTH CARE SERVICES IN,2609 ATLANTIC AVE STE 101C RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,099 "," 3,099 "," $252,445.40 ",,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093026007,"BORGER, JUDITH, HAUG",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 41 , 42 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093026767,"BRADBY, CASSANDRA, KIM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 60 , 61 , 63 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093027369,"QUEEN, SARAH, ELIZABETH",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093027369,"QUEEN, SARAH, ELIZABETH",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518393560,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1093029498,"EDWARDS, ROBIN, ARLENE",151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 104 , 144 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093029886,"TAYE MAKURIA, ADDISALEM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1558695288,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY SERVICES,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093029886,"TAYE MAKURIA, ADDISALEM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093030264,"YAO, MARGUERITE, MARTHA",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 38 , 47 ,$#,,
MEDICAID DIRECT,1457600504,MCPC-10 LLC,FIRSTHEALTH CARDIOVASCULAR AND THORACIC SERVICES,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093030314,"DAVIES, STEPHEN, WAYNE",155 MEMORIAL DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 26 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093030496,"DEEL, MICHAEL, DEAN",2301 ERWIN ROAD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL OF DANBURY,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093032328,"SCHMIDT, BENJAMIN, SAMSON",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1841733714,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE COMMUNITY HOSPITAL OF STOKES,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1093032328,"SCHMIDT, BENJAMIN, SAMSON",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 16 , 15 , 18 ,$#,,
MEDICAID DIRECT,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL OF DANBURY,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1093032328,"SCHMIDT, BENJAMIN, SAMSON",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1093033011,"PALKO, JILL, MARIE",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1093035602,"SEAL, JAMES, HARGETT",1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 101 , 275 ," $11,596.96 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1093035602,"SEAL, JAMES, HARGETT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093036246,"ZUZO, AMRA",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 28 , 78 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1093036337,"GUNADASA, KOSHILIE, CHRISTINA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 46 , 57 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1093036337,"GUNADASA, KOSHILIE, CHRISTINA",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 151 , 225 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093036493,"BURNHAM, BONNIE, NEAL",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 42 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093036493,"BURNHAM, BONNIE, NEAL",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 42 , 110 ,$#,,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1093041865,"WORLEY, MIRANDA, GILLEY",723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,112 PERKINS DR STE 400 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093042095,"FIACCO, NICHOLAS, RYAN",112 PERKINS DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1093042178,"EFROS, VERONICA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 82 , 89 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1316335128,RAPHA HEALTHCARE SERVICES LLC,,4701 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",300 CORPORATE DR   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1093042640,"UCHENDU, CHINENYE, AMBI",8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710659008,GRACE HEALTH CARE CENTER PLLC,GRACE HEALTH AND URGENT CARE CENTER,8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316335128,RAPHA HEALTHCARE SERVICES LLC,,4701 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 18 , 39 ,$#,,
MEDICAID DIRECT,1316335128,RAPHA HEALTHCARE SERVICES LLC,,4411 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 31 , 33 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1710659008,GRACE HEALTH CARE CENTER PLLC,GRACE HEALTH AND URGENT CARE CENTER,8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 68 , 85 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 25 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1316335128,RAPHA HEALTHCARE SERVICES LLC,,207 S BROAD ST   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",8590 FAYETTEVILLE RD STE 4 RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093042640,"UCHENDU, CHINENYE, AMBI",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1326785551,HEALTHY KIDZ,,10410 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093047664,"PALLIMALLI, SAI, LAKSHMI",10410 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 26 ,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1093047664,"PALLIMALLI, SAI, LAKSHMI",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093047664,"PALLIMALLI, SAI, LAKSHMI",3173 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 25 , 43 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093057028,"ROBERTS, STEPHANIE, NICOLE",1100 HOLLY SPRINGS RD STE 212 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1100 HOLLY SPRINGS RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093057028,"ROBERTS, STEPHANIE, NICOLE",1100 HOLLY SPRINGS RD STE 212 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093057390,"WERNIKOFF, ALEX, MICHAEL",710 PARK CENTER DR STE 200 MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093057788,"BUTLER, MIRANDA, KRISTINE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 37 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1093057788,"BUTLER, MIRANDA, KRISTINE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093057788,"BUTLER, MIRANDA, KRISTINE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093057788,"BUTLER, MIRANDA, KRISTINE",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093057788,"BUTLER, MIRANDA, KRISTINE",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093058307,"BABA, TILAK, RAJ",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 39 , 53 , 64 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093058307,"BABA, TILAK, RAJ",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093058307,"BABA, TILAK, RAJ",137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 44 , 64 , 82 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093058307,"BABA, TILAK, RAJ",280 BROAD ST STE G KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 174 , 198 , 241 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 103 , 123 , 155 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",640 MCCARTHY BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 37 , 56 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093058620,"RODRIGUEZ, ENRIQUE",923 W 3RD ST   PEMBROKE NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1093060360,"LEE, CHRISTOPHER, NOU",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1164021051,ONESPOTMD PRIMARY AND URGENT CARE P,,2017 CENTRAL AVE STE 103 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093060360,"LEE, CHRISTOPHER, NOU",2017 CENTRAL AVE STE 103 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 26 , 64 ,$#,,
MEDICAID DIRECT,1750001749,ONESPOTMD PRIMARY AND URGENT CARE P,,2114 FREEMAN PARK DR STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093060360,"LEE, CHRISTOPHER, NOU",2114 FREEMAN PARK DR STE 105 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922193622,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1093060360,"LEE, CHRISTOPHER, NOU",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104925072,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,608 W ACADEMY ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1093060360,"LEE, CHRISTOPHER, NOU",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093060360,"LEE, CHRISTOPHER, NOU",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093060360,"LEE, CHRISTOPHER, NOU",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235148529,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS ROCK HILL PEDIATRIC,1656 RIVERCHASE BLVD STE 3400 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093061459,"KAMRA, PALLAVI",1656 RIVERCHASE BLVD STE 3400 ROCK HILL SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093064149,"FANTONY, JOSEPH, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093065880,"PATRICK, CAROLYN, BETH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093065880,"PATRICK, CAROLYN, BETH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1093065880,"PATRICK, CAROLYN, BETH",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1093065914,"THOMAS, SUSAN, LYNN",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 99 , 217 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1093065914,"THOMAS, SUSAN, LYNN",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093067761,"DAHAL, BINAYA, RAMAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 80 , 80 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093067761,"DAHAL, BINAYA, RAMAN",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 66 , 66 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093068538,"DUFFY, ELIZABETH, MARIA",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093070138,"DESAI, SAARANSH, RAKESH",2075 GLENN MITCHELL DR STE 400 PRINCESS ANNE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093070138,"DESAI, SAARANSH, RAKESH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1093072654,"HOLMES, BENJAMIN, BRINDLEY",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,1093072654,"HOLMES, BENJAMIN, BRINDLEY",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093073348,"KHAYLOMSKY, SINEM",1995 WELLNESS BLVD STE 110&210 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 70 , 164 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093073991,"BARZIN, AMIR, HOMAYOUN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093073991,"BARZIN, AMIR, HOMAYOUN",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 43 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093073991,"BARZIN, AMIR, HOMAYOUN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093073991,"BARZIN, AMIR, HOMAYOUN",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093076044,"PLECZKOWSKI, RACHAEL, ELIZABETH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093076044,"PLECZKOWSKI, RACHAEL, ELIZABETH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093076044,"PLECZKOWSKI, RACHAEL, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093076184,"SMALL, DAVID, EARL",5815 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 28 , 71 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093079048,"TOQEER, QAISER",3330 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093079048,"TOQEER, QAISER",2525 COURT DR   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093079048,"TOQEER, QAISER",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 75 , 125 , 141 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093079048,"TOQEER, QAISER",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093079634,"BERRY, LAUREL, KATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093079634,"BERRY, LAUREL, KATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 29 , 63 , 81 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093079634,"BERRY, LAUREL, KATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093084410,"BABB, MELISSA, SUZANNE",1821 HILLANDALE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093084410,"BABB, MELISSA, SUZANNE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1093084410,"BABB, MELISSA, SUZANNE",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093084410,"BABB, MELISSA, SUZANNE",162 LEGACY OAKS DR STE 101 KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093084410,"BABB, MELISSA, SUZANNE",10211 ALM ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 29 , 64 ,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",704 GOLD HILL RD STE 1200 FORT MILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093087538,"BAUR, CHRISTINA, THERESE",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093089575,"GROSE, MALLORY, WILLIAMS",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093089575,"GROSE, MALLORY, WILLIAMS",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 25 , 34 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093089575,"GROSE, MALLORY, WILLIAMS",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 155 , 267 , 482 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093091423,"SHUKLA, KARAN, PRABODH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093091423,"SHUKLA, KARAN, PRABODH",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 114 , 270 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093091910,"HOEFER, TIFFANI, ANN",2605 HOSPITAL RD   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 60 , 83 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1093093155,"MORGAN BAEHR, SHANNON, KATHLEEN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1093093155,"MORGAN BAEHR, SHANNON, KATHLEEN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,301 PARK ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1093094344,"HANNON, STEPHANIE, ANN THERESA",525 S NEW HOPE RD   GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,301 PARK ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1093094344,"HANNON, STEPHANIE, ANN THERESA",301 PARK ST   BELMONT NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 125 , 207 , 225 ," $37,048.44 ",,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,525 S NEW HOPE RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093094344,"HANNON, STEPHANIE, ANN THERESA",301 PARK ST   BELMONT NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,525 S NEW HOPE RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093094344,"HANNON, STEPHANIE, ANN THERESA",525 S NEW HOPE RD   GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 198 , 324 , 421 ," $69,312.59 ",,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,4741 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093094344,"HANNON, STEPHANIE, ANN THERESA",4741 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093096422,"BENSON, MELISSA, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093096422,"BENSON, MELISSA, ANNE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093096422,"BENSON, MELISSA, ANNE",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093098774,"HEEDEN, MATTHEW",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093100943,"VALDEZ, JESUS, AMADEO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093100943,"VALDEZ, JESUS, AMADEO",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 57 ,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093100943,"VALDEZ, JESUS, AMADEO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 415 , 564 ," 1,207 "," $59,665.63 ",,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093100943,"VALDEZ, JESUS, AMADEO",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093100943,"VALDEZ, JESUS, AMADEO",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093100943,"VALDEZ, JESUS, AMADEO",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093101446,"MOZINGO, LAUREN, KAYE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093101446,"MOZINGO, LAUREN, KAYE",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 27 , 83 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093101446,"MOZINGO, LAUREN, KAYE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 14 , 14 ,$#,,
MEDICAID DIRECT,1093104531,WELLNESS WATCHERS HOME CARE AGENCY,~,13124 IDLEWILD RD # 1B MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1093104531,WELLNESS WATCHERS HOME CARE AGENCY,13124 IDLEWILD RD # 1B MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 4,173 "," 4,453 "," $533,064.66 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093105512,"STREET, MERCEDES, STRUPP",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 38 , 38 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093105512,"STREET, MERCEDES, STRUPP",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093107831,"GRANEY, ERIN, TINUVIEL",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 28 , 106 , 106 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093107831,"GRANEY, ERIN, TINUVIEL",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1093108797,"RATCLIFFE, SCOTT, EVANS",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093109001,"TZAVARAS, THEODORE, JON",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093110322,"JONES, WENDY, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,,,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093110322,"JONES, WENDY, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 17 , 19 , 24 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093110322,"JONES, WENDY, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730376492,PREMIER INTERNAL MEDICINE AND URGEN,PREMIER INTERNAL MEDICINE AND URGENT CARE,610 N FAYETTEVILLE ST STE 103 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1093111924,"ROSE, MELISSA",610 N FAYETTEVILLE ST STE 103 ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 18 , 27 ,$#,,
MEDICAID DIRECT,1043357791,RANDOLPH PULMONARY AND SLEEP CLINIC,RANDOLPH PULMONARY AND SLEEP CLINIC,610 N FAYETTEVILLE ST STE 300 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1093111924,"ROSE, MELISSA",610 N FAYETTEVILLE ST STE 300 ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 24 , 55 ,$#,,
MEDICAID DIRECT,1730376492,PREMIER INTERNAL MEDICINE AND URGEN,PREMIER INTERNAL MEDICINE AND URGENT CARE,610 N FAYETTEVILLE ST STE 103 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1093111924,"ROSE, MELISSA",702 S MAIN ST   RANDLEMAN NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1093112245,"GIESEY, AMY, LEIGH",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093112294,"PERRY, JENNIFER, JOY",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 24 , 35 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093112385,"GASIM, ADIL, MOHAMED HUSSEIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 46 , 51 , 217 ,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093112898,"MCDERMOTT, SHANTAI, RENEI",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093115669,"NARDIN, ANA LISA, BARO",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093115669,"NARDIN, ANA LISA, BARO",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093115669,"NARDIN, ANA LISA, BARO",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093121543,"SHRESTHA, RITESH, PRASAD",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093121543,"SHRESTHA, RITESH, PRASAD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093121543,"SHRESTHA, RITESH, PRASAD",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 41 , 63 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093121543,"SHRESTHA, RITESH, PRASAD",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093121543,"SHRESTHA, RITESH, PRASAD",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093121998,"MORECRAFT, DORIT",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093123119,"GUERRERO, ARMANDO, JORGE JESSE",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1093125585,"WILDER, CLAIRE, ANNE EVANS",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093125585,"WILDER, CLAIRE, ANNE EVANS",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 23 , 37 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093125585,"WILDER, CLAIRE, ANNE EVANS",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093125619,"FENTO, ASHLEY, MARTINEZ",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093125619,"FENTO, ASHLEY, MARTINEZ",2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 16 , 24 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093125619,"FENTO, ASHLEY, MARTINEZ",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1093125692,"BIGGERSTAFF, CAITLIN, JANE",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093125692,"BIGGERSTAFF, CAITLIN, JANE",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093126161,"GLADMAN, CHRISTINE, DAO",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 137 , 300 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093126161,"GLADMAN, CHRISTINE, DAO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 33 , 60 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1093126294,"CARR, CHRISTIE, ARINE",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1093126294,"CARR, CHRISTIE, ARINE",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 64 , 64 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093126310,"FARMER, ZACHARY, LUKE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 64 , 162 , 163 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093126310,"FARMER, ZACHARY, LUKE",600 HOSPITAL DR   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093126310,"FARMER, ZACHARY, LUKE",600 HOSPITAL DR   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1093127318,"MASSEY, PRISCILLA, FAYE",101 HOSPITAL DR   COLUMBUS NC,075,Polk,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093128944,"KODISH, BRETT, COLIN",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093128944,"KODISH, BRETT, COLIN",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699197012,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,720 MALCOLM BLVD STE 200 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1093129207,"BAIG, SAMEER, MIRZA",720 MALCOLM BLVD STE 200 CONNELLY SPRINGS NC,012,Burke,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093129520,"ONABANJO, BABAFEMI, SIJABULISO",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 93 , 134 , 403 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093129520,"ONABANJO, BABAFEMI, SIJABULISO",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 82 , 125 , 184 ," $10,322.30 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093129520,"ONABANJO, BABAFEMI, SIJABULISO",414 E MAIN ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 32 , 41 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093133084,"EWART, ZACHARY, THOMAS",109 BRIDGE ST STE 202 DANVILLE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093133159,"ALLRED, MICHAEL, LINDSAY",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 22 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093133159,"ALLRED, MICHAEL, LINDSAY",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 55 , 140 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093133464,"ROBBINS, GREGORY, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 30 , 42 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1093134389,"CARNES, LINDSAY, ANTONE",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093134389,"CARNES, LINDSAY, ANTONE",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 28 ,$#,,
MEDICAID DIRECT,1093136418,NATIONAL LABS INC,,3948 TRUST WAY   HAYWARD CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1093136418,NATIONAL LABS INC,3948 TRUST WAY   HAYWARD CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093136939,"MOORE, AMY, VISCHETTI",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093136939,"MOORE, AMY, VISCHETTI",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093136939,"MOORE, AMY, VISCHETTI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093136939,"MOORE, AMY, VISCHETTI",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093137200,"JONES, SHERI, ANNETTE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 41 , 42 , 42 ,$#,,
MEDICAID DIRECT,1093137564,PUBLIX NORTH CAROLINA LP,PUBLIX PHARMACY 1442,11222 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1093137564,PUBLIX NORTH CAROLINA LP,11222 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093137986,"FLYTHE, KALEISHA, CAI",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093137986,"FLYTHE, KALEISHA, CAI",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1093138166,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,2432 S CHURCH ST STE A BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1093138166,CNC-ACCESS INC,2432 S CHURCH ST STE A BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,015 "," 1,015 "," $61,369.52 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093138802,"ZECHINATI, ELIZABETH, MARIE",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093138802,"ZECHINATI, ELIZABETH, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1093140071,"HOYLE, CYNTHIA, MARIE",1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093140550,"SHEARS, GAYLE, LAUREN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093141913,"HUANG, JAMES, EUIZEAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093142283,"SHARTLE, SAMANTHA, RAE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093142283,"SHARTLE, SAMANTHA, RAE",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093142283,"SHARTLE, SAMANTHA, RAE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093142283,"SHARTLE, SAMANTHA, RAE",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093142283,"SHARTLE, SAMANTHA, RAE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093143646,"LANIER, JESSICA, HOLLAR",306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1093143646,"LANIER, JESSICA, HOLLAR",306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",110 BOONE SQUARE ST STE 29A HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",212 S SALEM ST   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",1110 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093144719,"KOTECHA, NISHA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1093144784,"LOCKLEAR, MILLICENT, JOY",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 75 , 99 , 284 ," $12,025.49 ",,
MEDICAID DIRECT,1023870508,LOCKLEAR PRIME AND URGENT CARE,~,10461 NC HIGHWAY 711   PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1093144784,"LOCKLEAR, MILLICENT, JOY",10461 NC HIGHWAY 711   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 28 , 32 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1093144784,"LOCKLEAR, MILLICENT, JOY",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093151086,"BOOTHE, JASON, ADRIAN",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093151086,"BOOTHE, JASON, ADRIAN",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 86 , 170 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093151086,"BOOTHE, JASON, ADRIAN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093152084,"JAHOO, SONIA, TEIXEIRA",3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 44 , 49 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093153041,"TRIPLETT, ANDREA, DAVIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1093153231,"KELLER, CAMERON, WATKINS",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1093153231,"KELLER, CAMERON, WATKINS",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1093153231,"KELLER, CAMERON, WATKINS",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 28 , 31 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093153231,"KELLER, CAMERON, WATKINS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093153231,"KELLER, CAMERON, WATKINS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1093153231,"KELLER, CAMERON, WATKINS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093153231,"KELLER, CAMERON, WATKINS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093153454,"WORKMAN, ADRIENNE, D'ANNE",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093153454,"WORKMAN, ADRIENNE, D'ANNE",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093155012,"SIGDEL, SANTOSH",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 122 , 122 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093155806,"CASTELLANO, LUCINDA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093155806,"CASTELLANO, LUCINDA, ANN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 23 , 46 , 46 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093157513,"MOKASHI, VIJAYASHREE, SHRINIVAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093157828,"BEST, KATHRYN, ANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093158875,"ASTORGA, FERNANDO",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 27 ,$#,,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093158875,"ASTORGA, FERNANDO",1325 BRADFORD VIEW DR   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 305 , 416 ," 1,221 "," $70,919.82 ",,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093158966,"MAZZONI, ANDREA, ROSE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 48 , 50 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093158966,"MAZZONI, ANDREA, ROSE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467972703,NORTH CAROLINA SPECIALTY HOSPITALS,,3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1093160111,"HENDERSON, JAMES, WILLIAM",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1093160582,"HOLCOMB, TIMOTHY, SCOTT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 30 , 38 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093160582,"HOLCOMB, TIMOTHY, SCOTT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093160582,"HOLCOMB, TIMOTHY, SCOTT",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093160582,"HOLCOMB, TIMOTHY, SCOTT",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 14 ,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1093161440,"POLLEY, DENNIS, CHARLES",1806 GLENDALE DR SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 98 , 146 ,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1093161440,"POLLEY, DENNIS, CHARLES",110 BARCELONA DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1093161440,"POLLEY, DENNIS, CHARLES",106 BARCELONA DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 216 , 330 , 425 ," $12,926.38 ",,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093161564,"OBENDORF, KYLE, GLENN",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 79 , 110 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093161739,"CAMPANO, ROXANA, BUTTON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093161739,"CAMPANO, ROXANA, BUTTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 19 , 24 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093161739,"CAMPANO, ROXANA, BUTTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093161739,"CAMPANO, ROXANA, BUTTON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 18 , 27 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093162059,"SHAH, MANASI, SANJIV",855 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093162059,"SHAH, MANASI, SANJIV",855 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1093162596,"LAFRANCE, JUSTIN, JUDD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093162596,"LAFRANCE, JUSTIN, JUDD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093162596,"LAFRANCE, JUSTIN, JUDD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1093162596,"LAFRANCE, JUSTIN, JUDD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 68 , 76 , 100 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1093162661,"DOLAN, RUSSELL, DAVID",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 77 , 127 , 176 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1093163594,"RICHARDSON, LISA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 20 , 34 , 34 ,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093165425,"DAVIS PRABHU, JENNIFER, SUSAN",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 34 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 11 , 15 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",839 DURHAM RD # A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093165664,"PARRA, LAURA, ANN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093166068,"COLE, MORGAN, WHITTANY",651 WITHROW RD   FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093166068,"COLE, MORGAN, WHITTANY",651 WITHROW RD   FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 84 , 122 , 242 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1093166753,"RIHTER, SASHA",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 58 , 67 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093166753,"RIHTER, SASHA",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 38 , 46 ,$#,,
MEDICAID DIRECT,1093497521,ALLES DDS HUNTERSVILLE PLLC,IDEAL DENTAL HUNTERSVILLE,14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",4815 BEREWICK TOWN CENTER DR STE I& CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",4815 BEREWICK TOWN CENTER DR STE I& CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 34 , 159 ,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 38 , 129 ,$#,,
MEDICAID DIRECT,1184325102,ALLES DDS WAKE FOREST PLLC,IDEAL DENTAL WAKE FOREST,515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 94 , 103 , 332 ," $15,393.14 ",,
MEDICAID DIRECT,1184325102,ALLES DDS WAKE FOREST PLLC,IDEAL DENTAL WAKE FOREST,515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205595998,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WILSON,3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1851050918,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF MORRISVILLE,9648 CHAPEL HILL RD STE 100 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093167413,"KAKADIA, RAHEN, PRAGJIBHAI",9648 CHAPEL HILL RD STE 100 MORRISVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1487020020,NOVANT HEALTH MEDICAL GROUP LLC,~,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093168171,"PERRY, MARGARET, ANNE",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093168171,"PERRY, MARGARET, ANNE",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1144652330,UNIVERSITY SURGERY CENTER LLC,MALLARD CREEK SURGERY CENTER,9848 N TRYON ST STE 200 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1093169278,"MCKNIGHT, RICHARD, RANDALL",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093169278,"MCKNIGHT, RICHARD, RANDALL",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 46 , 93 , 145 ,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1093171126,"REEVES, OLIVIA, KIRK",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093171472,"LEE, MEGAN, SMITH",5160 OCEAN HWY W   SHALLOTTE NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 36 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093172256,"HANNAH, JOANN, HAYES",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093177032,"MANNAN, ZARIYAT, MOHSENA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177032,"MANNAN, ZARIYAT, MOHSENA",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177032,"MANNAN, ZARIYAT, MOHSENA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177032,"MANNAN, ZARIYAT, MOHSENA",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 18 , 27 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177032,"MANNAN, ZARIYAT, MOHSENA",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177032,"MANNAN, ZARIYAT, MOHSENA",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 18 , 53 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177453,"ROEDERSHEIMER, KYLE, MICHAEL",16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177453,"ROEDERSHEIMER, KYLE, MICHAEL",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093177453,"ROEDERSHEIMER, KYLE, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 28 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093177453,"ROEDERSHEIMER, KYLE, MICHAEL",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 42 , 54 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1093177453,"ROEDERSHEIMER, KYLE, MICHAEL",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1093177453,"ROEDERSHEIMER, KYLE, MICHAEL",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093177453,"ROEDERSHEIMER, KYLE, MICHAEL",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093177545,"LIN, CHENYU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093177545,"LIN, CHENYU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093177545,"LIN, CHENYU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",201 E GROVER ST   SHELBY NC,023,Cleveland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 12 ,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 23 , 50 ,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 17 , 98 , 160 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",10650 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093177727,"MOHIUDDIN, JAHAN, JOYCE",600 HOSPITAL DR   MONROE NC,090,Union,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093178691,"VISWANATHAN, VYAS, TENKASI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 87 , 92 ," $11,032.69 ",,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093178691,"VISWANATHAN, VYAS, TENKASI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 33 , 57 , 57 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1093178691,"VISWANATHAN, VYAS, TENKASI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093179038,"TARASARIA, KARAN, NAYANESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1093179657,"KAMOUN, CAMILIA, LAYLA",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093179657,"KAMOUN, CAMILIA, LAYLA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 32 , 54 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1093179889,"SNOW, SARAH, CEBRON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093179889,"SNOW, SARAH, CEBRON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093179889,"SNOW, SARAH, CEBRON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093179889,"SNOW, SARAH, CEBRON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093179889,"SNOW, SARAH, CEBRON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 23 , 40 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093183642,"BERGEN, KELLY, MARIE",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 16 ,$#,,
MEDICAID DIRECT,1093184343,"HUDSON, MARY, KATHERINE",,3489 BARRETT RD   ENNICE NC,003,Alleghany,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1093184343,"HUDSON, MARY, KATHERINE",3489 BARRETT RD   ENNICE NC,003,Alleghany,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093184889,"HOMESLEY, CHRISTOPHER, CALE",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093184889,"HOMESLEY, CHRISTOPHER, CALE",1401 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093184889,"HOMESLEY, CHRISTOPHER, CALE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093189011,"GRANT, KONTIA, JONTAE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 34 , 58 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093189011,"GRANT, KONTIA, JONTAE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093189011,"GRANT, KONTIA, JONTAE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 49 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093190795,"LUDWIG WORTHEN, RUSSELL, NATHAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093190795,"LUDWIG WORTHEN, RUSSELL, NATHAN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093193641,"BACIGALUPO, ANGELA, MARIE",1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 27 , 53 ,$#,,
MEDICAID DIRECT,1083917249,ARMC PHYSICIANS CARE INC,BURLINGTON FAMILY PRACTICE,1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093193641,"BACIGALUPO, ANGELA, MARIE",1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 56 , 116 ,$#,,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093194995,"MORRONE, MATTHEW, JOSEPH",5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 3,734 "," 10,951 "," 13,415 "," $1,878,823.19 ",,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093194995,"MORRONE, MATTHEW, JOSEPH",5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093194995,"MORRONE, MATTHEW, JOSEPH",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 55 , 92 , 112 ," $18,343.32 ",,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093194995,"MORRONE, MATTHEW, JOSEPH",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093198954,"PUCKETT, RITCHIE, DALE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093200248,"OLAGOKE, OMOBOLAWA, OREOLUWA",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 40 , 40 ,$#,,
MEDICAID DIRECT,1255054409,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE SPECIALTY CLINICS,1551 WESTBROOK PLAZA DR STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093200248,"OLAGOKE, OMOBOLAWA, OREOLUWA",1730 KERNERSVILLE MEDICAL PKWY STE 201 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093200248,"OLAGOKE, OMOBOLAWA, OREOLUWA",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093200248,"OLAGOKE, OMOBOLAWA, OREOLUWA",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093203952,"DJIGROVA, RADOSLAVA, HRISTOVA",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093203952,"DJIGROVA, RADOSLAVA, HRISTOVA",9930 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 52 , 110 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1093205452,"KOSTIC, MAJA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1093205452,"KOSTIC, MAJA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205452,"KOSTIC, MAJA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1124771985,WAKEMED SURGERY CENTER - CARY LLC,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1093205478,"NGUYEN, JUSTIN, VAN MINH",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",400 US 70 HWY E   GARNER NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 24 , 32 , 48 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",210 ASHVILLE AVE   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093205478,"NGUYEN, JUSTIN, VAN MINH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 36 , 78 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093205957,"FENTON, CLINT, RICHARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 53 , 75 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093210858,"ABADEER, ANDREW, IHAB",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093210858,"ABADEER, ANDREW, IHAB",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093211013,"REDDY, ALEXANDER, TERRY",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093211013,"REDDY, ALEXANDER, TERRY",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093211013,"REDDY, ALEXANDER, TERRY",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093211013,"REDDY, ALEXANDER, TERRY",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093211013,"REDDY, ALEXANDER, TERRY",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093211039,"NELSON, TOBY, EISENBERG",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093211039,"NELSON, TOBY, EISENBERG",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093211815,"OSWALT, CAMERON, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093211815,"OSWALT, CAMERON, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093211815,"OSWALT, CAMERON, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093211815,"OSWALT, CAMERON, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093219834,"WYKER, ANDREW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 196 , 196 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1093219834,"WYKER, ANDREW, WILLIAM",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1093225229,"GEORGEFF, CHRISTOPHER, SHANE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 19 , 25 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1093225229,"GEORGEFF, CHRISTOPHER, SHANE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1093225229,"GEORGEFF, CHRISTOPHER, SHANE",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 44 , 68 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1093225229,"GEORGEFF, CHRISTOPHER, SHANE",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 113 , 182 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093226524,"MARKI, JULIA, CANAAN",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 143 , 149 ,$#,,
MEDICAID DIRECT,1720364649,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1093226649,"IGBIDE, AIDEVO, SANDRA",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093226649,"IGBIDE, AIDEVO, SANDRA",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093226649,"IGBIDE, AIDEVO, SANDRA",4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 37 , 57 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093230401,"JOYNER, RACHAEL, LEIGH",20 DUKE MEDICINE CIR DUKE CANCER CENTER 2 FL DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093230401,"JOYNER, RACHAEL, LEIGH",20 DUKE MEDICINE CIR DUKE CANCER CENTER 2 FL DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093230401,"JOYNER, RACHAEL, LEIGH",20 DUKE MEDICINE CIR DUKE CANCER CENTER 2 FL DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 38 , 46 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093230401,"JOYNER, RACHAEL, LEIGH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 21 , 32 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093230401,"JOYNER, RACHAEL, LEIGH",20 DUKE MEDICINE CIR DUKE CANCER CENTER 2 FL DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598891665,HIGHLAND MEDICAL ASSOCIATES PA,~,165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093230633,"WHICKER, RONALD, EUGENE",165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 132 , 132 ,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093234213,"COOPER, HUNTER, BROOKS",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093235137,"DELOZIER, ROBERT, ELDRIDGE",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1093235137,"DELOZIER, ROBERT, ELDRIDGE",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 15 , 15 , 24 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1093235194,"ROSENTHAL, SHOSHANA, EVE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093235194,"ROSENTHAL, SHOSHANA, EVE",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265403042,NORTH CAROLINA NEUROPSYCHIATRY,NORTH CAROLINA NEUROPSYCHIATRY PA,1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093238123,"GROVE, KRISTEN, NOELLE",1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1255853412,"HAN, KYOUNG, SOO",KO DDS & HAN DDS PLLC,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1093238537,"KO, MIN, JUNG",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1093238537,"KO, MIN, JUNG",DURHAM DENTAL STUDIO,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1093238537,"KO, MIN, JUNG",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1356197412,KO DDS & HAN DDS PLLC,DURHAM DENTAL STUDIO,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1093238537,"KO, MIN, JUNG",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 371 , 508 ," 2,111 "," $85,129.56 ",,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1093240764,"PRETKO, RACHEL, LEA",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093240764,"PRETKO, RACHEL, LEA",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093242190,"MARTIN, COURTNEY, MARIE",110 DIVISION ST   NORLINA NC,093,Warren,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902995145,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT TWIN COUNTY,204 EVANS RD   HOLLISTER NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093242190,"MARTIN, COURTNEY, MARIE",204 EVANS RD   HOLLISTER NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 114 , 231 , 275 ," $10,927.65 ",,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093242190,"MARTIN, COURTNEY, MARIE",108 MOSBY AVE   LITTLETON NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093245409,"MCMULLEN, JAMES, MICHAEL",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093245409,"MCMULLEN, JAMES, MICHAEL",2025 GLENN MITCHELL DR.   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093245409,"MCMULLEN, JAMES, MICHAEL",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093245409,"MCMULLEN, JAMES, MICHAEL",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093246076,"DERMARKARIAN, CHRISTOPHER, ROBERT",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093246076,"DERMARKARIAN, CHRISTOPHER, ROBERT",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093246076,"DERMARKARIAN, CHRISTOPHER, ROBERT",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 28 , 41 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1093246076,"DERMARKARIAN, CHRISTOPHER, ROBERT",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093248718,"QUILLEN, CHARLES, BRADLEY",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1093250094,AMERICARES HEALTH SERVICES LLC,HOUSE OF BLESSINGS,2916 JASON DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093250094,AMERICARES HEALTH SERVICES LLC,2916 JASON DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,003 "," 1,003 "," $69,923.35 ",,
MEDICAID DIRECT,1093250094,AMERICARES HEALTH SERVICES LLC,HOUSE OF BLESSINGS,48 CHEATHAM LN   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093250094,AMERICARES HEALTH SERVICES LLC,1359 SUTTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1093250094,AMERICARES HEALTH SERVICES LLC,HOUSE OF BLESSINGS,123 VINEYARD DR   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093250094,AMERICARES HEALTH SERVICES LLC,123 VINEYARD DR   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 49 , 49 ,$#,,
MEDICAID DIRECT,1093250094,AMERICARES HEALTH SERVICES LLC,HOUSE OF BLESSINGS,1359 SUTTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093250094,AMERICARES HEALTH SERVICES LLC,1359 SUTTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,296 "," 1,296 "," $96,649.71 ",,
MEDICAID DIRECT,1093250094,AMERICARES HEALTH SERVICES LLC,HOUSE OF BLESSINGS,1421 ROSS MILL RD   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093250094,AMERICARES HEALTH SERVICES LLC,1359 SUTTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1093250094,AMERICARES HEALTH SERVICES LLC,HOUSE OF BLESSINGS,1421 ROSS MILL RD   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093250094,AMERICARES HEALTH SERVICES LLC,1421 ROSS MILL RD   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 882 , 882 ," $64,196.46 ",,
MEDICAID DIRECT,1093250094,AMERICARES HEALTH SERVICES LLC,HOUSE OF BLESSINGS,48 CHEATHAM LN   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093250094,AMERICARES HEALTH SERVICES LLC,48 CHEATHAM LN   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 665 , 665 ," $49,236.81 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093252447,"HUNT, ALBERT, FOSTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093252447,"HUNT, ALBERT, FOSTER",628 E 12TH ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 102 , 115 , 125 ,$#,,
MEDICAID DIRECT,1265462659,PALMETTO INFUSION SERVICES LLC,,1551 WESTBROOK PLAZA DR STE 100 WINSTON SALEM NC,034,Forsyth,261QI0500X,Ambulatory Health Care Facilities,Clinic/Center,Infusion Therapy,1093253189,"PASSER, ELIZABETH, ANN",1551 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093253288,CAROLINA CLASSIC SENIOR CARE LLC,~,1922 S MARTIN LUTHER KING JR DR STE 47 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1093253288,CAROLINA CLASSIC SENIOR CARE LLC,1922 S MARTIN LUTHER KING JR DR STE 47 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,081 "," 2,081 "," $143,531.92 ",,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093254104,"ROPER, KARIS, KEVORKIAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 25 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093254104,"ROPER, KARIS, KEVORKIAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 22 , 33 ,$#,,
MEDICAID DIRECT,1215977194,CALDWELL MEMORIAL HOSPITAL,WESTPOINTE MEDICAL PRACTICE,2651 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1093254567,"SEALS, KIRSTEN, PRINCE WATSON",2651 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 106 , 110 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1093260549,"SCHNITZER, LILLIAN, GRACE",145 APPLECROSS RD   PINEHURST NC,063,Moore,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1093260549,"SCHNITZER, LILLIAN, GRACE",5 FIRSTVILLAGE DR STE 100 PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619904430,SOUTH CHARLOTTE PRIMARY CARE,ATRIUM HEALTH PRIMARY CARE SOUTH CHARLOTTE INTERNA,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093263311,"TRUSLOW, RICHARD, KENT",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 42 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093263311,"TRUSLOW, RICHARD, KENT",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1821195868,HUFF ORTHOPAEDIC GROUP PA,HUFF ORTHOPAEDIC GROUP PA,520 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1093264020,"HAWKINS, DANIEL, GERARD",520 BEAMAN ST   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 49 , 88 ,$#,,
MEDICAID DIRECT,1851153183,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV HUFF ORTHOPEDICS AND SPORTS MEDICINE,417B VANCE ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1093264020,"HAWKINS, DANIEL, GERARD",520 BEAMAN ST   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 81 , 146 , 262 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1093264020,"HAWKINS, DANIEL, GERARD",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093264152,"COLDREN, SYDNEY, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093264459,"LICATA, JOSEPH, ISAAC",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 31 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093264459,"LICATA, JOSEPH, ISAAC",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093264459,"LICATA, JOSEPH, ISAAC",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093264459,"LICATA, JOSEPH, ISAAC",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093264459,"LICATA, JOSEPH, ISAAC",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2503 N QUEEN ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093271496,"BAKER, SHEMICA, NICOLE",2503 N QUEEN ST   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 85 , 108 , 120 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093271496,"BAKER, SHEMICA, NICOLE",2503 N QUEEN ST   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093271496,"BAKER, SHEMICA, NICOLE",204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 42 , 48 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093271496,"BAKER, SHEMICA, NICOLE",2503 N QUEEN ST   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 49 , 50 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093271546,"MAY, DEANNA, JEAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093271546,"MAY, DEANNA, JEAN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 24 , 31 ,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093271975,"HARRIS, CLARE",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1093272908,"RILEY, TRACIE, JONES",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 67 , 72 , 253 ," $11,654.68 ",,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 36 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 767 , 957 ," 3,687 "," $135,594.80 ",,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice," 1,218 "," 1,665 "," 6,559 "," $253,290.48 ",,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093275414,"OLIVERIO, LAUREN, HALEY",5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093275869,"MANNION, ERIC, MICHAEL MAX",2402 CAMDEN ST SW STE 200 WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093275869,"MANNION, ERIC, MICHAEL MAX",2402 CAMDEN ST SW STE 200 WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093275885,"BURRA, BHASKARI",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 49 , 53 ," $15,264.64 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 73 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 65 , 65 , 90 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1093276057,"FORREST, ALLISON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093276248,"HARLAN, ELIZABETH, ESTELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,11530 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093276248,"HARLAN, ELIZABETH, ESTELLE",11530 PROVIDENCE RD STE 2300 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093276248,"HARLAN, ELIZABETH, ESTELLE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1659970770,SURVIVOR FRIENDLY LLC,SURVIVOR FRIENDLY,527 KEISLER DR STE 104 CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1093279838,"BARNES, LATISHA, LAWANDA",527 KEISLER DR STE 104 CARY NC,092,Wake,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 61 , 72 , 111 ,$#,,
MEDICAID DIRECT,1659970770,SURVIVOR FRIENDLY LLC,SURVIVOR FRIENDLY,1100 S LAFAYETTE ST   SHELBY NC,023,Cleveland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1093279838,"BARNES, LATISHA, LAWANDA",527 KEISLER DR STE 104 CARY NC,092,Wake,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093280117,"NUAMAH, ISAAC, YAW BOADI",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 30 , 30 ,$#,,
MEDICAID DIRECT,1255456794,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER GOLDSBORO,2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093280117,"NUAMAH, ISAAC, YAW BOADI",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1093280927,"MURPHY, GEORGE, CLARENCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 183 , 183 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1093280927,"MURPHY, GEORGE, CLARENCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 32 , 32 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1093282113,"ECKERSON, EMILY, ANN",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 37 , 39 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093283301,"MCDOWELL, KERRITH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 62 , 83 ,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093283301,"MCDOWELL, KERRITH",250 HOSPICE CIR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093286767,"BARDEN, DIANA, ALISON",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093286767,"BARDEN, DIANA, ALISON",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093288946,"ALBERT, BRITTANY, MICHELLE",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093291213,"BIGHAM, BRITTANY, CAUSEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 59 , 59 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1093291213,"BIGHAM, BRITTANY, CAUSEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 68 , 68 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093292278,"CARNEY, BRANDON, RYAN",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 151 , 311 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093292278,"CARNEY, BRANDON, RYAN",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093292278,"CARNEY, BRANDON, RYAN",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 84 , 117 ,$#,,
MEDICAID DIRECT,1750068219,DLP RUTHERFORD PHYSICIAN PRACTICES,FOREST CITY FAMILY CARE RHC,212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093293177,"WILSON, DEEANNA, LOWERY",4048 E U S HIGHWAY 64 ALTERNATE STE 1 MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1093293177,"WILSON, DEEANNA, LOWERY",4048 E U S HIGHWAY 64 ALTERNATE STE 1 MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1639853997,DLP RUTHERFORD PHYSICIAN PRACTICES,CHASE FAMILY CARE RHC,1269 US HIGHWAY 221A   FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093293177,"WILSON, DEEANNA, LOWERY",4048 E U S HIGHWAY 64 ALTERNATE STE 1 MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 139 , 303 , 339 ," $15,373.62 ",,
MEDICAID DIRECT,1093300683,ROYAL HOME CARE LLC,,134 SKEET CLUB RD   HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1093300683,ROYAL HOME CARE LLC,134 SKEET CLUB RD   HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 4,501 "," 4,501 "," $343,802.60 ",,
MEDICAID DIRECT,1093300683,ROYAL HOME CARE LLC,,2415 PENNY RD STE 204 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1093300683,ROYAL HOME CARE LLC,2415 PENNY RD STE 204 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 7,050 "," 7,050 "," $513,573.20 ",,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1093303042,"EUBANKS, KIMBERLY, ANNETTE",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 94 , 117 ,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1093303042,"EUBANKS, KIMBERLY, ANNETTE",269 S MAIN ST   NORWOOD NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 24 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093307845,"KOSIER, MADISON, NEWSOM",2205 OAK RIDGE RD STE BB OAK RIDGE NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093307845,"KOSIER, MADISON, NEWSOM",240 BROAD ST   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 56 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093310294,"CHRIST, CAITLIN, COLLEEN",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1093310294,"CHRIST, CAITLIN, COLLEEN",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093310799,"PACKER, TREVOR, SCOTT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093310799,"PACKER, TREVOR, SCOTT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093310799,"PACKER, TREVOR, SCOTT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093311789,ASHEVILLE GERIATRIC LLC,RICHMOND HILL ASSISTED LIVING 5,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093311789,ASHEVILLE GERIATRIC LLC,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 14 ," 1,947 "," 1,947 "," $135,465.56 ",,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093313546,"MCDONALD, MATTHEW, RYAN",1417 S POLLOCK ST   SELMA NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 54 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093313546,"MCDONALD, MATTHEW, RYAN",1317 N BRIGHTLEAF BLVD STE A SMITHFIELD NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 29 , 81 ,$#,,
MEDICAID DIRECT,1093316697,HOPE OF SOLACE GROUP LLC,HOPE OF SOLACE,5440 ATLANTIC SPRINGS RD STE 109 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1093316697,HOPE OF SOLACE GROUP LLC,5440 ATLANTIC SPRINGS RD STE 109 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 336 , 350 ," $46,701.61 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093317760,"HARRIS, TODD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 42 , 44 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093317760,"HARRIS, TODD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093317760,"HARRIS, TODD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1093321846,"BROOKSHIRE, JESSICA, RAE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1093321846,"BROOKSHIRE, JESSICA, RAE",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 107 , 214 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1093321846,"BROOKSHIRE, JESSICA, RAE",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1093321846,"BROOKSHIRE, JESSICA, RAE",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093322703,"GORDON, STEPHENIE, MATTHEWS",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427309608,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1093322737,"LE, JULIA, NGUYEN",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 35 ,$#,,
MEDICAID DIRECT,1093323727,EASTCARE HOME HEALTH&TRANSPORTATION,,1290 E ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1093323727,EASTCARE HOME HEALTH&TRANSPORTATION,1290 E ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 53 ," 8,815 "," 9,264 "," $670,371.76 ",,
MEDICAID DIRECT,1093323727,EASTCARE HOME HEALTH&TRANSPORTATION,,108 W FIRE TOWER RD STE G WINTERVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1093323727,EASTCARE HOME HEALTH&TRANSPORTATION,108 W FIRE TOWER RD STE G WINTERVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 3,161 "," 3,316 "," $264,998.64 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093324691,"WOLFE, AMANDA, JOY",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093327561,"CURLEY, DANIELLE",3643 N ROXBORO ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093328460,"TURBYFILL, CORBIN, NOAH COSTNER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093329864,GERVITA HOME CARE,~,101 S ELM ST STE 23 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1093329864,GERVITA HOME CARE,101 S ELM ST STE 23 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 1,843 "," 1,843 "," $193,341.18 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093331936,"ATIK, ADAM, AYDIN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093331936,"ATIK, ADAM, AYDIN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457086498,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PLEASANT RIDGE ELEMENTARY,1260 FLOYD LN   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093334724,"LOCKETT, FELECIA, ANN",21 16TH AVE NW   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 110 , 110 ," $34,523.74 ",,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093335044,"LEVIERE, ANNA, FINESTONE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 35 , 37 ,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,220 PAGE RD STE 300 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093335044,"LEVIERE, ANNA, FINESTONE",220 PAGE RD N STE 300 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548702186,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SKIN CENTER,1734 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093335820,"SMITH, COLLIN-JAMAL",1734 WESTBROOK AVE   BURLINGTON NC,001,Alamance,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 72 , 122 , 172 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093335945,"SHITTU, SHERIFF, OLUFEMI",250 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 49 , 123 , 123 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1093336075,"SHARTLE, ERICA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1093336075,"SHARTLE, ERICA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093336075,"SHARTLE, ERICA",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093336075,"SHARTLE, ERICA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093336075,"SHARTLE, ERICA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093336075,"SHARTLE, ERICA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1093336075,"SHARTLE, ERICA",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093336075,"SHARTLE, ERICA",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1093336075,"SHARTLE, ERICA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093336075,"SHARTLE, ERICA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1093336075,"SHARTLE, ERICA",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093336406,"KLETT, NATALIA",1852 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649525619,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHILAND FAMILY MEDICINE,704 GOLD HILL RD STE 107 FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093336406,"KLETT, NATALIA",1852 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093336463,"LEMOINE, ELIZABETH, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093337081,"JONES, GEOFFREY, ALEXANDER REID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093337081,"JONES, GEOFFREY, ALEXANDER REID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093337081,"JONES, GEOFFREY, ALEXANDER REID",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 34 , 60 ,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093340317,"CONEY, ALTONETTE, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 39 , 39 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",3434 EDWARDS MILL RD STE 112-398 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 31 , 31 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093340531,"STANIFER, HANNAH, HALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093340648,"SHAW, MILDRED, ALEXANDRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093340648,"SHAW, MILDRED, ALEXANDRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093340648,"SHAW, MILDRED, ALEXANDRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093343709,"CUNDRA, LINDSEY, BLAIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093343717,"SEABACK, JORDAN, CAUSEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 46 , 59 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093343717,"SEABACK, JORDAN, CAUSEY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093343717,"SEABACK, JORDAN, CAUSEY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093343717,"SEABACK, JORDAN, CAUSEY",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093343717,"SEABACK, JORDAN, CAUSEY",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 30 , 36 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093343717,"SEABACK, JORDAN, CAUSEY",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093343717,"SEABACK, JORDAN, CAUSEY",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093344186,"MCCLUNG, HAYLIE, RAY",1200 NAVAHO DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 92 , 211 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093344186,"MCCLUNG, HAYLIE, RAY",1200 NAVAHO DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 31 , 65 ,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093344830,"O'REAR, CODY, SCHLEY",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093344830,"O'REAR, CODY, SCHLEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093347197,"EDWARDS, SHARON, GLENN",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760458657,HOSPICE OF YANCEY COUNTY INC,COMPASSIONATE CARE WESTERN NORTH CAROLINA,856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1093347197,"EDWARDS, SHARON, GLENN",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760458657,HOSPICE OF YANCEY COUNTY INC,COMPASSIONATE CARE WESTERN NORTH CAROLINA,856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1093347197,"EDWARDS, SHARON, GLENN",856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093348302,"MCMANUS, BRENNA, KATHLEEN",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093348302,"MCMANUS, BRENNA, KATHLEEN",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093348609,"NOLAN, LAUREN, BARRETT",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093349656,"CARNICK LEDFORD, LEAH, RACHEL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093349656,"CARNICK LEDFORD, LEAH, RACHEL",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093349656,"CARNICK LEDFORD, LEAH, RACHEL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093349656,"CARNICK LEDFORD, LEAH, RACHEL",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093349789,"MCCREA, ALEXIS, NIANI",5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1093350779,FOX HEALTH CORP,,2320 REDBRIDGE LN   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093350779,FOX HEALTH CORP,2320 REDBRIDGE LN   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,, 348 ," 4,248 "," 4,313 "," $329,550.40 ",,
MEDICAID DIRECT,1093354391,HOME CARE FREEDOM LLC,,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1093354391,HOME CARE FREEDOM LLC,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,538 "," 1,919 "," $205,643.84 ",,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093355901,"THOMAS, CINDY, LYNN",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 129 , 234 , 240 ," $17,005.78 ",,
MEDICAID DIRECT,1093356933,A PRIMARY CHOICE INC,,20 W 5TH AVE UNIT 4 LEXINGTON NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,,1093356933,A PRIMARY CHOICE INC,20 W 5TH AVE UNIT 4 LEXINGTON NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,312 "," 1,312 "," $86,580.92 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093358483,"KLAUBER, MARY, BELLINGER",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093358483,"KLAUBER, MARY, BELLINGER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093358483,"KLAUBER, MARY, BELLINGER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1093362063,MIND AND BODY HOME CARE,~,2990 BETHESDA PL STE 604DS WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1093362063,MIND AND BODY HOME CARE,2990 BETHESDA PL STE 604DS WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,835 "," 4,968 "," $612,797.68 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093363095,"IVAN, ALLISON, MARIE",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1093363772,"SAVOY, APRIL, RENEE",,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1093363772,"SAVOY, APRIL, RENEE",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093363772,"SAVOY, APRIL, RENEE",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 776 ," 1,540 "," 4,983 "," $307,958.94 ",,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093363772,"SAVOY, APRIL, RENEE",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093364119,"CARRICO, KATHARINE, PRESTON",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093364119,"CARRICO, KATHARINE, PRESTON",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093364119,"CARRICO, KATHARINE, PRESTON",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093364119,"CARRICO, KATHARINE, PRESTON",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093364119,"CARRICO, KATHARINE, PRESTON",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 98 , 176 ,$#,,
MEDICAID DIRECT,1972079127,MH TRANSYLVANIA REGIONAL HOSPITAL L,,360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093365058,"LUCAS, JULIA, LOCKAMY",360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093368052,"BATHANI, SHREE, NAVINCHANDRA",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 28 , 28 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1093368086,"BACANTO, EDELROSE, FORTEA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093368433,"BENNETT, JESSICA, SOPHIA",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093368433,"BENNETT, JESSICA, SOPHIA",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093368433,"BENNETT, JESSICA, SOPHIA",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093368433,"BENNETT, JESSICA, SOPHIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093369977,"SMALLWOOD, RENITA, DELOATCH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 75 , 84 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093369977,"SMALLWOOD, RENITA, DELOATCH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821054339,NORTHEASTERN ORTHOPEDICS PA,~,602 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1093369977,"SMALLWOOD, RENITA, DELOATCH",602 ACADEMY ST S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 96 , 153 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093369977,"SMALLWOOD, RENITA, DELOATCH",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093369977,"SMALLWOOD, RENITA, DELOATCH",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093370710,"VOGEL, MARIE, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 22 , 45 ,$#,,
MEDICAID DIRECT,1376290239,IVX HEALTH OF NORTH CAROLINA PC,IVX HEALTH,9200 HARRIS CORNERS PKWY STE A CHARLOTTE NC,060,Mecklenburg,261QI0500X,Ambulatory Health Care Facilities,Clinic/Center,Infusion Therapy,1093374985,"STRICKLAND, KATIE, MICHELLE",500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 25 ,$#,,
MEDICAID DIRECT,1376290239,IVX HEALTH OF NORTH CAROLINA PC,IVX HEALTH,2309 MATTHEWS TOWNSHIP PKWY STE 101 MATTHEWS NC,060,Mecklenburg,261QI0500X,Ambulatory Health Care Facilities,Clinic/Center,Infusion Therapy,1093374985,"STRICKLAND, KATIE, MICHELLE",500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093378291,"BOSTIAN, CHARIS, CRAIG",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093378291,"BOSTIAN, CHARIS, CRAIG",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093378291,"BOSTIAN, CHARIS, CRAIG",330 JAKE ALEXANDER BLVD W STE 101A SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 104 , 118 , 164 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093378291,"BOSTIAN, CHARIS, CRAIG",1965 S US 29 HWY   CHINA GROVE NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 26 ,$#,,
MEDICAID DIRECT,1366984403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-JOHN SMITH,2356 JOHN SMITH RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093379356,"WALKER, ERIC, ALFONSO",2356 JOHN SMITH RD STE 101 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 37 , 41 ,$#,,
MEDICAID DIRECT,1366984403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-JOHN SMITH,2356 JOHN SMITH RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093379356,"WALKER, ERIC, ALFONSO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093379356,"WALKER, ERIC, ALFONSO",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 100 , 133 , 155 ,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093379356,"WALKER, ERIC, ALFONSO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 31 , 33 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093379471,"LINCHUCK, BENJAMIN, LEONARD",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093379471,"LINCHUCK, BENJAMIN, LEONARD",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093380495,"CAIN, MARISSA, ELIZABETH",1901 MOONEY ST   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093380867,"SARICI, KUBRA",2301 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093380867,"SARICI, KUBRA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093381774,"HENLEY, MADDISON, OLINGER",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1093385122,"HEFNER, MADISON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 48 , 48 , 48 ,$#,,
MEDICAID DIRECT,1679568992,GASTONIA PEDIATRIC ASSOCIATES PA,GASTONIA PEDIATRIC ASSOCIATES PA,1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093385163,"JOHANSEN, BRITTANY, ANNA",1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 18 , 48 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093385437,"GARRISON, HANNAH, ELIZABETH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 36 , 37 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093387490,"FISCHER, NEAL, ANDERSON",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093389157,"PHILLIPS, DAVIS, FREDERICK",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 92 , 92 ,$#,,
MEDICAID DIRECT,1093391385,SPENCER SPEECH THERAPY,,245 WINKLERS CREEK RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1093391385,SPENCER SPEECH THERAPY,245 WINKLERS CREEK RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,, 16 , 165 , 165 ," $11,651.10 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093392839,"MONTGOMERY, CONNOR, MECH",2006 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093394652,"WINSLOW, EMMA, NICHOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 41 , 69 , 87 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093395121,"MCCAMMON, REAGIN, BRADLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093395519,"PATEL, GUNJAN, KANAIYALAL",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093395519,"PATEL, GUNJAN, KANAIYALAL",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790535987,ABC KIDS PEDIATRIC HEALTH CARE,,1310 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093395741,"ALMEYDA ALEJO, YAMILKA",1310 E ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093398273,"NGUYEN, QUAN, TUONG",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 92 , 92 ,$#,,
MEDICAID DIRECT,1083144992,LANE AND ASSOCIATES XXXII DDS PA,,411 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1093404493,"YATES, ANNA, O'BRIEN",1233 CARTHAGE ST   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 40 ,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1093404493,"YATES, ANNA, O'BRIEN",1233 CARTHAGE ST   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 407 , 670 ," 2,180 "," $95,855.56 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093407371,"ELLIS, JOHN, STEVEN",13835 BOREN ST   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093407371,"ELLIS, JOHN, STEVEN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 180 , 193 ,$#,,
MEDICAID DIRECT,1093407371,"ELLIS, JOHN, STEVEN",,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1093407371,"ELLIS, JOHN, STEVEN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,4230 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093410581,"EZE, NGOZI, REGINA",4411 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093410581,"EZE, NGOZI, REGINA",2011 GOLDEN BELT PKWY   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 58 , 186 , 186 ," $14,064.29 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093410581,"EZE, NGOZI, REGINA",4411 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093410581,"EZE, NGOZI, REGINA",207 S BROAD ST   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093412058,"CRATER, MEGHAN, PREVETTE",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 80 , 157 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1093413098,"HUDSON, ASHLEIGH, STONE",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 132 , 330 , 549 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1093413098,"HUDSON, ASHLEIGH, STONE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 59 , 87 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093414484,"DUNCAN, KATHERINE, GRACE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093414484,"DUNCAN, KATHERINE, GRACE",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093414484,"DUNCAN, KATHERINE, GRACE",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 50 , 61 ,$#,,
MEDICAID DIRECT,1093417842,TOWN OF LAKE WACCAMAW,LAKE WACCAMAW FIRE AND RESCUE,203 FLEMINGTON DR   LAKE WACCAMAW NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,1093417842,TOWN OF LAKE WACCAMAW,203 FLEMINGTON DR   LAKE WACCAMAW NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport, 51 , 83 , 134 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093420572,"BOHANON, ROBIN, LAMB",210 SMITH CHURCH RD BLDG 1 ROANOKE RAPID NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 88 , 150 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093420697,"HEAVNER, AYDAN, LUKE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093420697,"HEAVNER, AYDAN, LUKE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 50 , 51 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1093420697,"HEAVNER, AYDAN, LUKE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1093422768,"DIMAS, MOISES, JAIME",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 30 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093422768,"DIMAS, MOISES, JAIME",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 33 , 40 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093422768,"DIMAS, MOISES, JAIME",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093424046,"MEYER, MATTHEW, EDWARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 47 , 58 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093424046,"MEYER, MATTHEW, EDWARD",517 MOYE BLVD FL 3 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093424723,DFENDER PHYSICAL THERAPY LLC,,310 ROANOKE AVE   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1093424723,DFENDER PHYSICAL THERAPY LLC,310 ROANOKE AVE   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,, 77 , 585 ," 1,023 "," $10,132.99 ",,
MEDICAID DIRECT,1346098134,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - STATESVILLE,1450 FERN CREEK DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093428013,"DANKWA, ESENAM",1450 FERN CREEK DR   STATESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 30 , 48 , 49 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093428013,"DANKWA, ESENAM",1450 FERN CREEK DR   STATESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093428013,"DANKWA, ESENAM",1703 DAVIE AVE   STATESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1346098134,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - STATESVILLE,1450 FERN CREEK DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093428013,"DANKWA, ESENAM",1703 DAVIE AVE   STATESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1922661750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA INTEGRATED MEDICINE - STATESVILLE,1703 DAVIE AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093428013,"DANKWA, ESENAM",1703 DAVIE AVE   STATESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 54 , 63 , 63 ," $10,182.49 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093429367,"KOPS, MARY, LINTON",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 96 ," 1,041 "," 1,083 "," $27,687.46 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093431736,"SHAW, PATRICE, LASHAY",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 30 , 34 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093434425,"ZOECKLER, LAUREN",612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE F KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093441164,"VASIREDDY, POORNIMA",903 N ARENDELL AVE   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,903 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1093441164,"VASIREDDY, POORNIMA",903 N ARENDELL AVE   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 531 , 889 ," 3,173 "," $117,975.37 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093441164,"VASIREDDY, POORNIMA",1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 97 , 106 , 381 ," $13,862.62 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1093449381,"OKAFOR, FRANCISCA, NKECHI",5100 MACKAY RD   JAMESTOWN NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 37 , 118 , 119 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1093449381,"OKAFOR, FRANCISCA, NKECHI",5100 MACKAY RD   JAMESTOWN NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 23 , 57 , 58 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093449472,"O'CONNELL, KASIE, POPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093449571,"CARMICHAEL, CAROLINE, ROBINSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093449753,"FOSTER, EMMA, BLY BECK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093449753,"FOSTER, EMMA, BLY BECK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 38 , 39 ,$#,,
MEDICAID DIRECT,1093450348,CAREMOSPHERE INC,,8404 SIX FORKS RD STE 203 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1093450348,CAREMOSPHERE INC,8404 SIX FORKS RD STE 203 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 115 , 115 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1093453045,"WHEELER, ADAM, ROBERT COLTON",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1093458663,"BALOS, STEVE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 122 , 176 , 381 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093461246,"PEREIRA, TANYA, LEAL",5820 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 131 , 728 , 740 ," $22,257.79 ",,
MEDICAID DIRECT,1659642395,LANE AND ASSOCIATES XXV DDS PA,,1117 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1093464174,"ASKEW, DARIAN, JERMAINE",2140 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1790446672,LANE & ASSOCIATES XLIV DDS PA,~,7430 RICHLANDS HWY   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093464174,"ASKEW, DARIAN, JERMAINE",2140 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 170 , 238 , 764 ," $45,799.09 ",,
MEDICAID DIRECT,1851931257,LANE AND ASSOCIATES XXXV DDS PA,,11180 E FINCH AVE   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1093464174,"ASKEW, DARIAN, JERMAINE",2140 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 161 , 217 , 883 ," $48,973.82 ",,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093464174,"ASKEW, DARIAN, JERMAINE",2140 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538267224,H J BROWN AND ASSOCIATES DDS PA,H J BROWN AND ASSOCIATES DDS PA,410 W 14TH ST STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093464174,"ASKEW, DARIAN, JERMAINE",410 W 14TH ST STE B GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 86 , 91 , 307 ," $20,839.85 ",,
MEDICAID DIRECT,1770183436,COUNTY OF PITT OFFICE OF AUDITOR,PITT COUNTY HEALTH DEPARTMENT - DENTAL,201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1093464174,"ASKEW, DARIAN, JERMAINE",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 164 , 224 ," 1,499 "," $54,596.19 ",,
MEDICAID DIRECT,1932283421,HIGGINS MANI & WATSON I DDS PA,THE DENTAL CARE CENTER,2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093464174,"ASKEW, DARIAN, JERMAINE",2140 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 84 , 102 , 315 ," $15,233.17 ",,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",1501 DOCK ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",1501 DOCK ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",1501 DOCK ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093466971,"HEGARTY, LONI, TYNDALL",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1093467599,"TART, BRANTLEY, AUSTIN",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 17 , 25 , 49 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1093467599,"TART, BRANTLEY, AUSTIN",16747 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 19 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093468662,"JONES, JOSEPH, DAVID ALLEN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093469066,"JONES, JAMES, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093469066,"JONES, JAMES, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093469066,"JONES, JAMES, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093469066,"JONES, JAMES, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093469066,"JONES, JAMES, CHRISTOPHER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093469066,"JONES, JAMES, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093470726,"STINE, ALEXANNA, KRISTINE",75A LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093472144,"SPEAR, MEREDITH, HERBERT",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093475006,"BINZER, ANNA, MARIE",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093476822,"FERRELL, AMANDA, RUTH",448 CRANBERRY ST   NEWLAND NC,006,Avery,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093476822,"FERRELL, AMANDA, RUTH",935 STATE FARM RD   BOONE NC,095,Watauga,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1093478729,RESTORED HOPE THERAPY SERVICES,RESTORED HOPE THERAPY SERVICES,1364 WASHINGTON ST   MT PLEASANT NC,013,Cabarrus,193400000X,Group,Single Specialty,,1093478729,RESTORED HOPE THERAPY SERVICES,1364 WASHINGTON ST   MT PLEASANT NC,013,Cabarrus,193400000X,Group,Single Specialty,, 51 , 352 , 354 ," $33,342.23 ",,
MEDICAID DIRECT,1093478729,RESTORED HOPE THERAPY SERVICES,RESTORED HOPE THERAPY SERVICES,8594 PARK DR   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093478729,RESTORED HOPE THERAPY SERVICES,8594 PARK DR   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 40 , 288 , 290 ," $26,585.87 ",,
MEDICAID DIRECT,1093478729,RESTORED HOPE THERAPY SERVICES,RESTORED HOPE THERAPY SERVICES,1364 WASHINGTON ST   MT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093478729,RESTORED HOPE THERAPY SERVICES,1364 WASHINGTON ST   MT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1093478729,RESTORED HOPE THERAPY SERVICES,RESTORED HOPE THERAPY SERVICES,8594 PARK DR   MOUNT PLEASANT NC,013,Cabarrus,193400000X,Group,Single Specialty,,1093478729,RESTORED HOPE THERAPY SERVICES,8594 PARK DR   MOUNT PLEASANT NC,013,Cabarrus,193400000X,Group,Single Specialty,, 56 , 515 , 515 ," $47,946.66 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093480238,"WEST, SHELA, AQUAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093483307,"LAPINSKY, ALEXIS",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093483307,"LAPINSKY, ALEXIS",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 89 , 101 , 187 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093484602,"KIM, SAEJIN",1801 OLIVE CHAPEL RD STE 103 APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 32 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093489866,"ROBINSON, THOMAS, DANE",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154352938,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE RIVERBEND FAMILY MEDICI,215 S MAIN ST   MT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093489866,"ROBINSON, THOMAS, DANE",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 49 , 85 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093492902,"JONES, KENNETH, RAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1093494874,"HARO GONZALEZ, MONICA, SELENE",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 96 , 249 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1093497083,"MILLER, TAYLOR, MARCHANA",212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750068219,DLP RUTHERFORD PHYSICIAN PRACTICES,FOREST CITY FAMILY CARE RHC,212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093497083,"MILLER, TAYLOR, MARCHANA",212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 125 , 252 , 356 ," $16,176.24 ",,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1093497760,"BUTLER, EMILY, GRACE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1093497760,"BUTLER, EMILY, GRACE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 20 , 33 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093524464,"EDWARDS, ANDREW, PAUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1093527905,"GRIFFIN, ALEXA, TAYLOR",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093537839,"LU, YI",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1093537839,"LU, YI",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1093542029,"DOWNS, DESIRAE",610 W FISHER ST   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1093542656,"BRYANT, MELISSA, WILLARD",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1447373063,HUGH CHATHAM MEMORIAL HOSPITAL,CLINGMAN MEDICAL CENTER,3369 CLINGMAN RD   RONDA NC,097,Wilkes,193400000X,Group,Single Specialty,,1093542656,"BRYANT, MELISSA, WILLARD",3369 CLINGMAN RD   RONDA NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093544512,"FARKAS, PERSIDA",955 2ND ST NE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 23 , 41 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1093544512,"FARKAS, PERSIDA",955 2ND ST NE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 17 , 48 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093544512,"FARKAS, PERSIDA",955 2ND ST NE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 35 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1093546756,"BLACKWELL, SHELBY, LAYNE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 183 , 184 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093546756,"BLACKWELL, SHELBY, LAYNE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093546756,"BLACKWELL, SHELBY, LAYNE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 94 , 94 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093546756,"BLACKWELL, SHELBY, LAYNE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 330 , 331 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1011 PORTERS NECK RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093546756,"BLACKWELL, SHELBY, LAYNE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093547168,HEART IN HAND HOME CARE AGENCY LLC,,3011 S MEMORIAL DR STE 3 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1093547168,HEART IN HAND HOME CARE AGENCY LLC,3011 S MEMORIAL DR STE 3 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 545 , 545 ," $34,732.07 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1093550527,"BLEVINS, CHELSEA, FAITH",116 3RD ST NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 226 , 238 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093554131,"GALLO, MADISON, NICOLE",2545 COURT DRIVE   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093554131,"GALLO, MADISON, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093554131,"GALLO, MADISON, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093554131,"GALLO, MADISON, NICOLE",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093554131,"GALLO, MADISON, NICOLE",2545 COURT DRIVE   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275195679,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT HH BEAM ELEMENTARY,200 DAVIS PARK RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093557829,"KIZINGA, SIVI, CERUTI",200 DAVIS PARK RD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1093558785,"TURNER, KATE, MARIE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1093559247,"RAVAL, MITESHBHAI, JAYANTILAL",571 S. ALLEN ROAD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 122 , 140 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093565558,"WEATHERS, ELIZABETH, ANNE",1730 KERNERSVILLE MEDICAL PKWY STE 101 KERNERSVILLE NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093568719,"KANE, ERIN, KATHERINE",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093568719,"KANE, ERIN, KATHERINE",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093570350,"OBERRY, KAMNA",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1588626865,PREMIER PEDIATRICS PA,PREMIER PEDIATRICS PA,135 TURNER ST   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1093583429,"FEDDER, KATHRYN, ROSE",135 TURNER ST   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1336629765,CAROLINA CHIROPRACTIC PLUS OF BURKE,CAROLINA CHIROPRACTIC PLUS OF BURKE PA,105 BOUCHELLE ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1093587255,"RAWLS, CAMARA, NAEEM",105 BOUCHELLE ST   MORGANTON NC,012,Burke,111N00000X,Chiropractic Providers,Chiropractor,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093588782,"STONE, MORGAN, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093590382,"HORN, ALEXIS, TANT",210 SMITH CHURCH RD BLDG 1 ROANOKE RAPID NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 72 , 74 , 107 ,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093592354,"EARLY, COURTNEY, ELIZABETH",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326627399,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES- PLYMOUTH,115 ADAMS ST   PLYMOUTH NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093592354,"EARLY, COURTNEY, ELIZABETH",115 ADAMS ST   PLYMOUTH NC,094,Washington,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093594079,"BAKHSH, ABRAR, KHALID",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 114 , 137 , 272 ," $10,628.88 ",,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093595399,"GREENE, HANNA, LOUISE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093595399,"GREENE, HANNA, LOUISE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1093595399,"GREENE, HANNA, LOUISE",155 MEMORIAL DRIVE   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093700460,"HEFFNER, ALAN, CHRISTOPHER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 30 , 55 , 75 ," $10,814.64 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093700676,"BERTRAND, DAVID, SCOTT",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093700676,"BERTRAND, DAVID, SCOTT",3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 60 , 113 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093700676,"BERTRAND, DAVID, SCOTT",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 19 , 38 ,$#,,
MEDICAID DIRECT,1013962307,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH CROWN POINT FAMILY PHYSICIANS,9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093701666,"MCMILLAN, MARSHALL, POULNOT",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609827393,BILTMORE MEDICAL ASSOCIATES,BILTMORE MEDICAL ASSOCIATES,147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1093701930,"DEITZ, PEGGY, WRIGHT",147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093702201,"CHAI, SEUNGJEAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1093702201,"CHAI, SEUNGJEAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093702201,"CHAI, SEUNGJEAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 27 , 51 , 57 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093702201,"CHAI, SEUNGJEAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093702508,"ALLEN, SCOTT, HAGOOD",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093703514,"HOLWAY, BRENT, PATRICK",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 68 , 68 ,$#,,
MEDICAID DIRECT,1093703886,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER FAMILY PRACTICE,301 S CAMPBELL ST   BURGAW NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093703886,BLACK RIVER HEALTH SERVICES INC,301 S CAMPBELL ST   BURGAW NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 36 , 133 , 133 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 13 , 25 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1007 NC HIGHWAY 150 W STE G SUMMERFIELD NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093706038,"BROWN, ELIZABETH, DENNY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1417235805,CARY ENDOCRINE AND DIABETES CENTER,,6750 TRYON RD STE 103 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1093706103,"YOO, SUNG EUN",6750 TRYON RD STE 103 CARY NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 28 , 47 ,$#,,
MEDICAID DIRECT,1467449728,LEXINGTON FAMILY PHYSICIANS,LEXINGTON FAMILY PHYSICIANS PA,102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1093707291,"SUNDARARAJAN, SUNDARARAJ",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 36 , 47 ,$#,,
MEDICAID DIRECT,1093708315,ASSOCIATED HEALTH SERVICES INC,JAMES E DAVIS AMBULATORY SURGICAL CENTER,120 E CARVER ST   DURHAM NC,032,Durham,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1093708315,ASSOCIATED HEALTH SERVICES INC,120 E CARVER ST   DURHAM NC,032,Durham,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 145 , 175 , 236 ," $11,394.38 ",,
MEDICAID DIRECT,1104819754,SHELBY MEDICAL ASSOCIATES PA,~,711 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1093708406,"RABINDRAN, EVELYN, ANGELINA",711 N DEKALB ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 126 , 379 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093710493,"WORD SIMS, WINFIELD, STRICKLAND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 39 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093710493,"WORD SIMS, WINFIELD, STRICKLAND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093710493,"WORD SIMS, WINFIELD, STRICKLAND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 56 , 58 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1093710618,"RABINOVITZ, HAROLD, STEVEN",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093713117,"BEAMAN JR, CARLTON, REID",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1093713117,"BEAMAN JR, CARLTON, REID",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992755680,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING INDIAN TRAIL,6030 W HIGHWAY 74 STE C INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1093714123,"RAIBLE JR, ROBERT, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1093714123,"RAIBLE JR, ROBERT, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093714123,"RAIBLE JR, ROBERT, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 90 , 92 , 104 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093714123,"RAIBLE JR, ROBERT, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 93 , 94 , 113 ,$#,,
MEDICAID DIRECT,1093714685,ACCUCARE INC,ACCUCARE INC,1 RESORT DR   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1093714685,ACCUCARE INC,1 RESORT DR   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 16 , 76 , 100 ," $77,313.44 ",,
MEDICAID DIRECT,1093714685,ACCUCARE INC,ACCUCARE INC,1 RESORT DR   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1093714685,ACCUCARE INC,1 RESORT DR   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 353 ," 2,856 "," 4,691 "," $403,426.20 ",,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093715039,"FAZIA, ROBERT, BRIAN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 26 , 40 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093715039,"FAZIA, ROBERT, BRIAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1093715039,"FAZIA, ROBERT, BRIAN",911 W HENDERSON ST STE 230 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093715039,"FAZIA, ROBERT, BRIAN",911 W HENDERSON ST STE 230 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 38 , 52 , 79 ,$#,,
MEDICAID DIRECT,1639179393,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1093715039,"FAZIA, ROBERT, BRIAN",911 W HENDERSON ST STE 230 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093715039,"FAZIA, ROBERT, BRIAN",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 121 , 161 , 296 ,$#,,
MEDICAID DIRECT,1639179393,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1093715039,"FAZIA, ROBERT, BRIAN",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1093716482,"MCENANEY, KEVIN, FRANCIS",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,500 GATEWAY DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093716482,"MCENANEY, KEVIN, FRANCIS",500 GATEWAY DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 67 , 118 , 238 ," $12,826.52 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093716797,"OTT, BENJAMIN, THOMAS",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 49 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093716797,"OTT, BENJAMIN, THOMAS",650 JULIAN RD   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 76 , 211 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093716896,"GORDON, KATHLEEN, GERALDINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,320 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093719080,"ELLINGTON, TERRY",320 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 21 , 33 ,$#,,
MEDICAID DIRECT,1639781776,CLEAR VIEW OPTOMETRY PLLC,,2910 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093719080,"ELLINGTON, TERRY",2910 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 31 , 32 , 32 ,$#,,
MEDICAID DIRECT,1093720195,WALGREEN CO,WALGREENS 06579,671 S MEMORIAL DR   GREENVILLE NC,074,Pitt,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1093720195,WALGREEN CO,671 S MEMORIAL DR   GREENVILLE NC,074,Pitt,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093721052,"BAUER, AMANDA, FELDMAN",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093721052,"BAUER, AMANDA, FELDMAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093721052,"BAUER, AMANDA, FELDMAN",1331 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 23 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093721052,"BAUER, AMANDA, FELDMAN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093721052,"BAUER, AMANDA, FELDMAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1093721714,"GIBSON, JACQUELINE, GAILLARD",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 29 , 39 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093724288,"RODMAN, MICHAEL, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 54 , 54 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093729444,"SANDS, MARY, KAREN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093729444,"SANDS, MARY, KAREN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093731085,SAWYERS CREEK & COMPANY INC,SAWYERS HOME CARE,533 SWEETWATER RD   ROBBINSVILLE NC,038,Graham,253Z00000X,Agencies,In Home Supportive Care,,1093731085,SAWYERS CREEK & COMPANY INC,533 SWEETWATER RD   ROBBINSVILLE NC,038,Graham,253Z00000X,Agencies,In Home Supportive Care,, 47 ," 10,239 "," 10,937 "," $1,723,633.81 ",,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1093731168,"POLO, JAMES, MICHAEL",2115 NEUSE BLVD   NEW BERN NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 ,#, 12 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1093731168,"POLO, JAMES, MICHAEL",3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 24 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093732182,"FRAUENPREIS, KURT, ERNEST",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093732182,"FRAUENPREIS, KURT, ERNEST",232 GREEN ST   WILLIAMSTON NC,058,Martin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 152 , 312 , 630 ," $12,362.08 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093733404,"BARNARD, ANNE, ELIZABETH",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1093733404,"BARNARD, ANNE, ELIZABETH",10344 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093733404,"BARNARD, ANNE, ELIZABETH",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 44 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093733727,"BOYLE, WALTER, ALAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093733891,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1385,3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1093733891,WAL-MART STORES EAST LP,3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1093734030,THERAPY WORKS OF WILMINGTON,~,4114 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093734030,THERAPY WORKS OF WILMINGTON,4114 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 195 ," 3,156 "," 3,699 "," $253,245.51 ",,
MEDICAID DIRECT,1003239096,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST BEHAVIORAL MEDIC,1208 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093734295,"KIRCH, MICHAEL, V",1208 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093734667,"AHMAD, FUAD, RAFIQUE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 39 , 39 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1093734923,"LOPEZ, FERNANDO",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 100 , 107 , 137 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1093734923,"LOPEZ, FERNANDO",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1093734923,"LOPEZ, FERNANDO",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 26 , 36 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093735953,"DIMOVSKI, JENNIFER, MARIE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 68 , 72 , 80 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093735953,"DIMOVSKI, JENNIFER, MARIE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 76 , 107 ,$#,,
MEDICAID DIRECT,1093736944,NASH ROCKY MOUNT SCHOOLS,NASH ROCKY MOUNT SCHOOLS,930 EASTERN AVE   NASHVILLE NC,064,Nash,251300000X,Agencies,Local Education Agency (LEA),,1093736944,NASH ROCKY MOUNT SCHOOLS,930 EASTERN AVE   NASHVILLE NC,064,Nash,251300000X,Agencies,Local Education Agency (LEA),, 509 ," 9,055 "," 9,276 "," $353,807.34 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093738304,"WOLFMAN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1093739575,"COWAN, JAMES, BENJAMIN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 22 , 22 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1093740714,"BOEVE, THOMAS, JAMES",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 29 , 39 , 50 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093740771,"COHEN, DANIEL, AARON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093740771,"COHEN, DANIEL, AARON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1508117185,CAMPBELL UNIVERSITY HEALTH CENTER,~,129 T T LANIER ST   BUIES CREEK NC,043,Harnett,193200000X,Group,Multi-Specialty,,1093743817,"CACIOPPO, JOSEPH, DINO",129 T T LANIER ST   BUIES CREEK NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1093743973,"HAYES, CECILIA, KAY",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1093743973,"HAYES, CECILIA, KAY",146 HWY 64 E   HAYESVILLE NC,022,Clay,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1093743973,"HAYES, CECILIA, KAY",146 HWY 64 E   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093743973,"HAYES, CECILIA, KAY",146 HWY 64 E   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 88 , 90 ,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1093743973,"HAYES, CECILIA, KAY",146 HWY 64 E   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093744419,"JOHNSON, ROLINDA, YVONNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 17 , 23 ,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093744419,"JOHNSON, ROLINDA, YVONNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093744419,"JOHNSON, ROLINDA, YVONNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093744419,"JOHNSON, ROLINDA, YVONNE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093744419,"JOHNSON, ROLINDA, YVONNE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1093744880,"SPIRITOS, MICHAEL, DAVID",4927 S CROATAN HWY   NAGS HEAD NC,028,Dare,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1093744880,"SPIRITOS, MICHAEL, DAVID",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093744880,"SPIRITOS, MICHAEL, DAVID",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093744880,"SPIRITOS, MICHAEL, DAVID",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093746489,"HASSAN, SAMEENA, SHIREEN",1315 EAST BLVD STE 280 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 17 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7100 KIT CREEK RD 9 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093746570,"GUPTILL, ALISON, PRESTIA",7100 KIT CREEK RD STE 9 MORRISVILLE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1093746661,"GESSNER, MARTIN, THOMAS",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 84 , 282 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1093748303,"ROUCHARD, JOHN, SCOTT",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 19 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1093748303,"ROUCHARD, JOHN, SCOTT",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 40 , 46 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1093750093,"BOSTIC, ROBERT, DEAN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1093750093,"BOSTIC, ROBERT, DEAN",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093750093,"BOSTIC, ROBERT, DEAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1093750093,"BOSTIC, ROBERT, DEAN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093751422,"HARTMAN, LISA, MCAVEY",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093751836,"GRANT, MICHELLE, M.",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093752354,"ENDERSON III, LAURENCE, WILLIAM",1080 FIRST COLONIAL RD STE 200 VIRGINIA BCH VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093752818,COUNTY OF CLEVELAND NORTH CAROLINA,COUNTY OF CLEVELAND NORTH CAROLINA,1333 FALLSTON RD   SHELBY NC,023,Cleveland,3416L0300X,Transportation Services,Ambulance,Land Transport,1093752818,COUNTY OF CLEVELAND NORTH CAROLINA,1333 FALLSTON RD   SHELBY NC,023,Cleveland,3416L0300X,Transportation Services,Ambulance,Land Transport, 281 , 573 ," 1,144 ",$#,,
MEDICAID DIRECT,1902950769,LANE & ASSOCIATES XV DDS PA,LANE & ASSOCIATES XV DDS PA,2617 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1093752958,"HOWARTH, GREGG",2617 S HORNER BLVD   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 537 ," 1,050 "," 3,288 "," $191,129.20 ",,
MEDICAID DIRECT,1154336642,LANE AND ASSOCIATES I DDS PA,LANE AND ASSOCIATES I DDS PA,1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1093752958,"HOWARTH, GREGG",2617 S HORNER BLVD   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 315 , 551 ," 1,802 "," $115,007.39 ",,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093753311,"ELIAS, MICHAEL, JOSEPH",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 108 , 137 ," $29,273.77 ",,
MEDICAID DIRECT,1770815300,PREMIER SPINE PAIN AND REHABILITATI,PREMIER SPINE PAIN AND REHABILITATION,2315 W ARBORS DR STE 115 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093753329,"OVERTON, EDWARD, ANTHONY",2315 W ARBORS DR STE 115 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 51 , 187 , 280 ,$#,,
MEDICAID DIRECT,1134185184,CAROLINA SPINE PAIN AND REHABILITA,CAROLINA SPINE PAIN AND REHABILITATION,900 COX RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093753329,"OVERTON, EDWARD, ANTHONY",2315 W ARBORS DR STE 115 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 78 , 183 , 377 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1093753436,"OKEKE, ALFRED, EJIKE",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 182 , 294 , 746 ," $10,001.42 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1093753436,"OKEKE, ALFRED, EJIKE",2607 MEDICAL OFFICE PL STE B GOLDSBORO NC,096,Wayne,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093753436,"OKEKE, ALFRED, EJIKE",208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 44 , 68 , 143 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093755910,"ALMENGUAL, TERRENCE, PATRICK",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1093758930,"PARDUE, LORI, COPPLE",2007 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1093758930,"PARDUE, LORI, COPPLE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 23 , 24 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759243,"ROBERTS, RICHARD, SCOTT",620 SUMMIT CROSSING PL STE 202 GASTONIA NC,036,Gaston,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 24 , 43 , 61 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759243,"ROBERTS, RICHARD, SCOTT",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 21 , 45 , 61 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759243,"ROBERTS, RICHARD, SCOTT",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 39 , 40 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759243,"ROBERTS, RICHARD, SCOTT",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759243,"ROBERTS, RICHARD, SCOTT",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 23 , 26 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759300,"SHEPPERSON, KIRSTEN, ALDERBERGER",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759300,"SHEPPERSON, KIRSTEN, ALDERBERGER",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093759300,"SHEPPERSON, KIRSTEN, ALDERBERGER",6161 LAKE BRANDT RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 34 , 70 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093760324,"WENTZ, JULIE, MARIE",14330 OAKHILL PARK LN STE 200B HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 45 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093760324,"WENTZ, JULIE, MARIE",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE N KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093763237,"BAKER, DAVID, ALLEN",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093763237,"BAKER, DAVID, ALLEN",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093763237,"BAKER, DAVID, ALLEN",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093763237,"BAKER, DAVID, ALLEN",1207 HIGHLAND DR   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093763237,"BAKER, DAVID, ALLEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 167 , 260 , 559 ," $10,244.94 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093763237,"BAKER, DAVID, ALLEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093763351,"CASSIDY VU, LISA, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316914534,COUNTY OF STOKES,~,1009 N MAIN ST   DANBURY NC,085,Stokes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1093763351,"CASSIDY VU, LISA, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 38 , 64 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093764441,"ORTIZ, CARLOS, ERNESTO",1225 HARDING PL   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093764441,"ORTIZ, CARLOS, ERNESTO",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093764565,"BLOOMER, COURTNAY, WILLCOX",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093764565,"BLOOMER, COURTNAY, WILLCOX",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1093765851,CAROLINAS IMAGING SERVICES LLC,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,, 150 , 177 , 211 ," $17,951.15 ",,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1093765851,CAROLINAS IMAGING SERVICES LLC,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,, 497 , 580 , 673 ," $39,202.27 ",,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1093765851,CAROLINAS IMAGING SERVICES LLC,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,, 267 , 336 , 384 ," $23,381.26 ",,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1093765851,CAROLINAS IMAGING SERVICES LLC,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,, 395 , 488 , 554 ," $34,222.40 ",,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,1401 MATTHEWS TOWNSHIP PKWY STE 310 MATTHEWS NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1093765851,CAROLINAS IMAGING SERVICES LLC,1401 MATTHEWS TOWNSHIP PKWY STE 310 MATTHEWS NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,, 196 , 234 , 262 ," $13,620.27 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093766164,"CARROLL, BRIAN, MATTHEW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093766164,"CARROLL, BRIAN, MATTHEW",180 PARKWOOD DR   ELKIN NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093766511,"MURRAY, MELONIE, ALLEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093766511,"MURRAY, MELONIE, ALLEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093766511,"MURRAY, MELONIE, ALLEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093767535,RURAL HEALTH GROUP INC,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 109 , 224 , 225 ," $14,496.84 ",,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093768012,DR CHRISTOPHER J MOSHOURES,1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,#,#, 12 ,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093768012,DR CHRISTOPHER J MOSHOURES,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,, 148 , 144 , 286 ,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093768012,DR CHRISTOPHER J MOSHOURES,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093768376,"GREEN, NEIL, B",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093769754,"RATTERREE, JASPER, CALHOUN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093769754,"RATTERREE, JASPER, CALHOUN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093769754,"RATTERREE, JASPER, CALHOUN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 35 , 46 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093769754,"RATTERREE, JASPER, CALHOUN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 35 , 52 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093773699,"BUGAJ, GREGORY, MICHAEL",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 39 , 39 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093773699,"BUGAJ, GREGORY, MICHAEL",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 132 , 244 , 249 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093773699,"BUGAJ, GREGORY, MICHAEL",1704 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 157 , 157 ,$#,,
MEDICAID DIRECT,1093773749,"DEESE, JOHN, ASHLEY",~,812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,111N00000X,Chiropractic Providers,Chiropractor,,1093773749,"DEESE, JOHN, ASHLEY",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,111N00000X,Chiropractic Providers,Chiropractor,, 17 , 102 , 106 ,$#,,
MEDICAID DIRECT,1366635989,DEESE AND LOCKLEAR CHIROPRACTIC CEN,~,812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1093773749,"DEESE, JOHN, ASHLEY",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,111N00000X,Chiropractic Providers,Chiropractor,,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,53 S FRENCH BROAD AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1093774234,"WILLIAMS, NATHAN, EDWARD",53 S FRENCH BROAD AVE   ASHEVILLE NC,011,Buncombe,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093774234,"WILLIAMS, NATHAN, EDWARD",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,53 S FRENCH BROAD AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1093774234,"WILLIAMS, NATHAN, EDWARD",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,53 S FRENCH BROAD AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1093774234,"WILLIAMS, NATHAN, EDWARD",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,2315 ASHEVILLE HWY STE 40 HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1093774234,"WILLIAMS, NATHAN, EDWARD",2315 ASHEVILLE HWY STE 40 HENDERSONVILLE NC,045,Henderson,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 28 , 47 , 177 ," $16,302.36 ",,
MEDICAID DIRECT,1093774416,PROSTHETIC AND ORTHOTIC INSTITUTE I,PROSTHETIC AND ORTHOTIC INSTITUTE INC,223 HERLONG AVE S STE 110 ROCK HILL SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1093774416,PROSTHETIC AND ORTHOTIC INSTITUTE I,223 HERLONG AVE S STE 110 ROCK HILL SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 39 ,$#,,
MEDICAID DIRECT,1093774614,AUTHORACARE COLLECTIVE,~,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,251B00000X,Agencies,Case Management,,1093774614,AUTHORACARE COLLECTIVE,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,251B00000X,Agencies,Case Management,, 200 ," 1,867 "," 1,878 "," $906,046.99 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 40 , 56 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 290 , 357 , 415 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174823066,PRIVATE DIAGNOSTIC CLINIC PLLC,TRIANGLE HEART ASSOCIATES,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 134 , 183 , 231 ,$#,,
MEDICAID DIRECT,1174823066,PRIVATE DIAGNOSTIC CLINIC PLLC,TRIANGLE HEART ASSOCIATES,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093775009,"KOMADA, MICHAEL, RUDOLPH",540 NEW WAVERLY PL   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093775793,"MUNLEY, BRIAN, JAMES",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093775793,"MUNLEY, BRIAN, JAMES",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093775793,"MUNLEY, BRIAN, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093775793,"MUNLEY, BRIAN, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 140 , 189 , 269 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093775793,"MUNLEY, BRIAN, JAMES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 16 , 21 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093775926,"BRITANISKY, ROBERT, GREGG",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,WESTERN CAROLINA EYE ASSOCIATES,610 STATE FARM RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,610 STATE FARM RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,, 476 , 475 , 950 ," $13,157.37 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093776502,"CRAWFORD, MICHAEL, BRETT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",1220 MAGNOLIA ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 75 , 84 , 114 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093778227,"CRENSHAW, BRIAN, SANDERS",2360 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1790748960,OMNI CLINIC PA,~,22 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1093778276,"OJEBUOBOH, IBIKUNLE, ADEOLA",22 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 273 ," 1,028 "," 1,460 "," $29,753.43 ",,
MEDICAID DIRECT,1093778375,"ENGEL, STEVEN, MARK",STEVEN M ENGEL MD,1700 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1093778375,"ENGEL, STEVEN, MARK",1700 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 22 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093779191,"DILLARD, NAIMA, ALEIJAN",3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 18 , 35 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093779662,"STOKES, LAMONICA, KEITH",1795 WESTCHESTER DR   HIGH POINT NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 38 , 95 , 95 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093779662,"STOKES, LAMONICA, KEITH",1795 WESTCHESTER DR   HIGH POINT NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093779662,"STOKES, LAMONICA, KEITH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 44 , 137 , 138 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093779662,"STOKES, LAMONICA, KEITH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 47 , 49 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093779662,"STOKES, LAMONICA, KEITH",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 73 , 73 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093779662,"STOKES, LAMONICA, KEITH",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093779662,"STOKES, LAMONICA, KEITH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093779662,"STOKES, LAMONICA, KEITH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093779951,EYE SURGERY AND LASER CLINIC INC,EYE SURGERY AND LASER CLINIC INC,500 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1093779951,EYE SURGERY AND LASER CLINIC INC,500 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093780009,"SHILLINGLAW, WILLIAM, RICHARDCARNEGIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 21 , 23 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093780009,"SHILLINGLAW, WILLIAM, RICHARDCARNEGIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093780785,"MACHAN, MELISSA, DAWN",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1093780785,"MACHAN, MELISSA, DAWN",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093780785,"MACHAN, MELISSA, DAWN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093780785,"MACHAN, MELISSA, DAWN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093780785,"MACHAN, MELISSA, DAWN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093781411,"SUGG, NORMAN, KEITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093781411,"SUGG, NORMAN, KEITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 13 ,$#,,
MEDICAID DIRECT,1942278411,PATHOLOGISTS DIAGNOSTIC SERVICES PL,,,,Unknown,193400000X,Group,Single Specialty,,1093781411,"SUGG, NORMAN, KEITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1093781411,"SUGG, NORMAN, KEITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093781411,"SUGG, NORMAN, KEITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 11 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093782484,"MANSY, JAN, AWADALLA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 67 , 67 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093782484,"MANSY, JAN, AWADALLA",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1093782690,"ARMSTRONG, AMY, NICOLE",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093782690,"ARMSTRONG, AMY, NICOLE",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639757974,ASHE MEMORIAL HOSPITAL INC,FLEETWOOD FAMILY MEDICINE,13300 13290 HWY 221 S   FLEETWOOD NC,005,Ashe,193400000X,Group,Single Specialty,,1093782773,"MORGAN, BRIGID",310 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 19 ,$#,,
MEDICAID DIRECT,1427048172,ASHE MEMORIAL HOSPITAL INC,AMH MOUNTAIN FAMILY CARE CENTER,310 HOSPITAL AVENUE   JEFFERSON NC,005,Ashe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093782773,"MORGAN, BRIGID",310 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093782955,"MULLEN, GARY, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 42 , 51 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093782955,"MULLEN, GARY, JOHN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093782955,"MULLEN, GARY, JOHN",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1093782955,"MULLEN, GARY, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093782955,"MULLEN, GARY, JOHN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 33 , 34 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093782955,"MULLEN, GARY, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1093782955,"MULLEN, GARY, JOHN",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093782955,"MULLEN, GARY, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093782955,"MULLEN, GARY, JOHN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093782955,"MULLEN, GARY, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1417203381,CAROLINA MEDICAL ASSOCIATES,CAROLINA MEDICAL ASSOCIATES,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093783474,"AGHA, MAHER, SALAH",7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 217 , 339 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093783722,"MCCORMICK, TERESA, GAYLE",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093783722,"MCCORMICK, TERESA, GAYLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,1212 SPRUCE ST STE 211 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093785099,"WATKINS, WILLIAM, SPENCER",2544 COURT DR STE G GASTONIA NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093785099,"WATKINS, WILLIAM, SPENCER",2544 COURT DR STE G GASTONIA NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 74 , 94 , 117 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093785842,"ALIMARD, RAMIN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093785842,"ALIMARD, RAMIN",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093785842,"ALIMARD, RAMIN",612 KINGSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093785974,"HOOK, MATTHEW, ALAN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 57 , 70 , 108 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093785974,"HOOK, MATTHEW, ALAN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 132 , 161 , 273 ," $14,673.13 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093785974,"HOOK, MATTHEW, ALAN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093785974,"HOOK, MATTHEW, ALAN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093785974,"HOOK, MATTHEW, ALAN",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1851362503,PIEDMONT ADULT AND PEDIATRIC MEDICI,PIEDMONT ADULT AND PEDIATRIC MEDICINE PA,640 SUMMIT CROSSING PL STE 204 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093786360,"SCHEITLER, JOHN, LAWRENCE",640 SUMMIT CROSSING PL STE 204 GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 105 , 236 , 474 ," $14,240.46 ",,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1093786808,"LINDSTROM LEIFER, LORRAINE, ANNETTE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1093786808,"LINDSTROM LEIFER, LORRAINE, ANNETTE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1093789323,"HAMILTON, BRIAN, HUGH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093789323,"HAMILTON, BRIAN, HUGH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093789323,"HAMILTON, BRIAN, HUGH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 29 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093789323,"HAMILTON, BRIAN, HUGH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 553 , 614 , 695 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093789323,"HAMILTON, BRIAN, HUGH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093789323,"HAMILTON, BRIAN, HUGH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093789323,"HAMILTON, BRIAN, HUGH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093789414,"BLAU, MICHAEL, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093791329,"KOLASKI, KATHLEEN, MARY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093791329,"KOLASKI, KATHLEEN, MARY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 236 , 528 , 771 ," $47,468.52 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093791329,"KOLASKI, KATHLEEN, MARY",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093791329,"KOLASKI, KATHLEEN, MARY",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1285732453,SHELBY EYE CENTERS PA,~,1170 WYKE RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1093791352,"CLINE, NANCY, ELLEN",1170 WYKE RD   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 116 , 185 , 212 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1093791709,"JONES, GREGORY, LEE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1588614168,ASHEVILLE NEUROLOGY SPECIALISTS PA,~,731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1093793192,"SONI-PATEL, PAYAL, HASMUKH",731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 42 , 62 ,$#,,
MEDICAID DIRECT,1407025406,CASTLE HEALTHCARE INC,~,12108 RANLEIGH CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093794679,"TEAGUE, MARLYN, CASTILLO",12108 RANLEIGH CT   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 47 , 47 ,$#,,
MEDICAID DIRECT,1407025406,CASTLE HEALTHCARE INC,~,12108 RANLEIGH CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093794679,"TEAGUE, MARLYN, CASTILLO",12108 RANLEIGH CT   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1093794778,"QUIGLEY, BRIAN, STEVEN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1093794778,"QUIGLEY, BRIAN, STEVEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093794778,"QUIGLEY, BRIAN, STEVEN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093794778,"QUIGLEY, BRIAN, STEVEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 29 , 33 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1093794778,"QUIGLEY, BRIAN, STEVEN",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1093795312,"HUPERT, CARLA, LYNNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 87 , 112 ,$#,,
MEDICAID DIRECT,1427604149,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE - MORRISVILLE MEDICAL PARK,7560 CARPENTER FIRE STATION RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093795775,"AFZAL, ASMA",7560 CARPENTER FIRE STATION RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427604149,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE - MORRISVILLE MEDICAL PARK,101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093795775,"AFZAL, ASMA",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427604149,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE - MORRISVILLE MEDICAL PARK,101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1093795775,"AFZAL, ASMA",101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104499474,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WESTERN WAKE SURGICAL,155 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093796203,"DUBERMAN, ERIC, DAVID",155 PARKWAY OFFICE CT   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1104499474,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WESTERN WAKE SURGICAL,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093796203,"DUBERMAN, ERIC, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104499474,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WESTERN WAKE SURGICAL,155 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093796203,"DUBERMAN, ERIC, DAVID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104499474,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WESTERN WAKE SURGICAL,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093796203,"DUBERMAN, ERIC, DAVID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093797045,"MCMULLEN, KEVIN, PATRICK",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 52 , 71 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093797045,"MCMULLEN, KEVIN, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 16 , 64 , 91 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093798225,"JOHNSON, WALTER, WALLACE",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 116 , 163 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093798225,"JOHNSON, WALTER, WALLACE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1093800062,"FLOWER, KORI, BRIDGET",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 110 , 163 ," $15,096.58 ",,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,893 EAST ST   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1093800062,"FLOWER, KORI, BRIDGET",893 EAST ST   PITTSBORO NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093800062,"FLOWER, KORI, BRIDGET",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 47 , 59 ,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1093800245,"BLAKE, SIDNEY, ALLEN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 89 , 369 , 369 ," $16,018.83 ",,
MEDICAID DIRECT,1467152496,ALLES DDS KANNAPOLIS PLLC,IDEAL DENTAL KANNAPOLIS,582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093801490,"ALFORD, TAMEKO, LASHON",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093801490,"ALFORD, TAMEKO, LASHON",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 44 , 99 ,$#,,
MEDICAID DIRECT,1538776455,LANE AND ASSOCIATES XXXIX,,161 KODIAK LN   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1093801490,"ALFORD, TAMEKO, LASHON",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1821623620,LANE AND ASSOCIATES XXXVIII DDS PA,,101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093801490,"ALFORD, TAMEKO, LASHON",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 356 , 592 ," 1,507 "," $74,916.41 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093802696,"PHIRI-TUCKER, RITA, MTHUNDUWATHA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093802696,"PHIRI-TUCKER, RITA, MTHUNDUWATHA",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 81 , 240 ," $10,709.24 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093802696,"PHIRI-TUCKER, RITA, MTHUNDUWATHA",1735 CITY CENTER BLVD   ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093806481,"ALEXANDER, JOSHUA, JACOB",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 178 , 234 , 284 ," $53,716.32 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093806481,"ALEXANDER, JOSHUA, JACOB",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093806481,"ALEXANDER, JOSHUA, JACOB",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 25 , 28 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 20 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376899252,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF MCGEES CROSSROADS,70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093807307,"BENDFELDT, CARLOS, FERNANDO",70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 17 , 20 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093807307,"BENDFELDT, CARLOS, FERNANDO",507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1356998181,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH BURKE DENTAL,500 E PARKER RD STE 200 MORGANTON NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093808263,"NULLMAN, JEFFREY, HOWARD",504 PINEOLA ST   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1588366355,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,108 DOCTORS DR   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093808263,"NULLMAN, JEFFREY, HOWARD",504 PINEOLA ST   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1841992617,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,504 PINEOLA ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093808263,"NULLMAN, JEFFREY, HOWARD",504 PINEOLA ST   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice, 181 , 222 , 577 ," $26,040.64 ",,
MEDICAID DIRECT,1093096141,SUNSHINE PEDIATRICS PA,,1519 E BOOKER DAIRY RD STE A SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1093809782,"FOX, KIMBERLY, DAWNE",1519 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 49 , 62 , 149 ,$#,,
MEDICAID DIRECT,1285064972,NITELITE PEDIATRIC URGENT CARE PA,,1519 E BOOKER DAIRY RD STE B SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093809782,"FOX, KIMBERLY, DAWNE",1519 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 33 ,$#,,
MEDICAID DIRECT,1093999682,LESLIE S BRIGHT DDS PA,LESLIE S BRIGHT DDS PA,5621 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093810061,"BRIGHT JR, LESLIE, SAMUEL",5621 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 96 , 232 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093811556,"GOLDSTEIN, AMI, LENA",3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093811556,"GOLDSTEIN, AMI, LENA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093811929,"WILES, MEREDITH, SMITH",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 68 , 107 , 291 ," $15,935.10 ",,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093815755,"HARTYE, JAMES, KILCOIN",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1093817389,"LARGENT, LISA, INELL",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 23 , 23 , 51 ,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1093817389,"LARGENT, LISA, INELL",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 29 ,$#,,
MEDICAID DIRECT,1093818775,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07540,404 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1093818775,NORTH CAROLINA CVS PHARMACY LLC,404 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1093818775,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07540,404 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1093818775,NORTH CAROLINA CVS PHARMACY LLC,404 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1093818775,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07540,404 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1093818775,NORTH CAROLINA CVS PHARMACY LLC,404 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1093826042,"EDMONDSON, DONALD, AUSBON",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1093826042,"EDMONDSON, DONALD, AUSBON",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1093826224,"SYKES, KASSELL, EUGENE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 54 , 75 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,630 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1093826224,"SYKES, KASSELL, EUGENE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093828378,"HAWK, ROBERTA, JO",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 26 , 32 , 43 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093828378,"HAWK, ROBERTA, JO",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 27 , 30 , 48 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,105 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1093828378,"HAWK, ROBERTA, JO",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1093828378,"HAWK, ROBERTA, JO",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 24 , 29 , 59 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1093828600,"HUSTED, THOMAS, LEE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093830291,"TANN, SAMANDRA, NADINE",306 WESTWOOD AVE STE 401 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 27 , 30 ,$#,,
MEDICAID DIRECT,1093831976,ADMINISTRATIVE CARE SERVICES OF MAD,HOT SPRINGS FAMILY CARE HOME 1,311 N SERPENTINE AVE # 1 HOT SPRINGS NC,057,Madison,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093831976,ADMINISTRATIVE CARE SERVICES OF MAD,311 N SERPENTINE AVE # 1 HOT SPRINGS NC,057,Madison,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 197 , 197 ," $13,922.56 ",,
MEDICAID DIRECT,1093834020,PURFOODS LLC,MOMS MEALS,3210 SE CORPORATE WOODS DR   ANKENY IA,102,Out of State > 40 miles,332U00000X,Suppliers,Home Delivered Meals,,1093834020,PURFOODS LLC,3210 SE CORPORATE WOODS DR   ANKENY IA,102,Out of State > 40 miles,332U00000X,Suppliers,Home Delivered Meals,, 691 ," 108,053 "," 108,053 "," $840,382.62 ",,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1093836215,"COVINGTON, CHRISTOPHER, DAVID",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 66 , 102 , 134 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093845059,"NWACHUKWU, IKENNA, ANTHONY",250 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093848434,"CHERAN, SENDHIL, KUMAR",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 489 , 547 , 747 ," $12,889.96 ",,
MEDICAID DIRECT,1093850620,JAGS RESIDENTIAL SERVICES,JAGS RESIDENTIAL SERVICES,1005 LAUREL LEAF RD   ZEBULON NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093850620,JAGS RESIDENTIAL SERVICES,1005 LAUREL LEAF RD   ZEBULON NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 365 , 365 ," $35,351.71 ",,
MEDICAID DIRECT,1447314075,MORCOM MEDICAL CONSULTANTS PLLC,MORCOM MEDICAL CONSULTANTS PLLC,235 JENKINS RD   DOVER NC,052,Jones,193200000X,Group,Multi-Specialty,,1093851891,"ROYALS, HOOVER, MCGY",235 JENKINS RD   DOVER NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 795 ," 4,557 "," 4,560 "," $126,636.33 ",,
MEDICAID DIRECT,1093851891,"ROYALS, HOOVER, MCGY",MORCOM MEDICAL CONSULTANTS PLLC,235 JENKINS RD   DOVER NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1093851891,"ROYALS, HOOVER, MCGY",235 JENKINS RD   DOVER NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093852097,"BROWN, RANDOLPH, NICHOLAS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093852097,"BROWN, RANDOLPH, NICHOLAS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 110 , 115 , 116 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093852139,"MILTENBERGER, AMY, JO",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093852139,"MILTENBERGER, AMY, JO",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1093854754,"JOHNSON, CHERYL, ANN",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093854911,"MALCOLM, WILLIAM, FERRIS",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093854911,"MALCOLM, WILLIAM, FERRIS",3000 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093856536,"GREGORY, RICHARD, BLAINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 33 , 34 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 55 , 55 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 45 , 45 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 343 , 345 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 114 , 114 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1478 RIVER RD SE   WINNABOW NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1478 RIVER RD SE   WINNABOW NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 273 , 273 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 118 , 118 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 26 , 26 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1093856767,"DEAL, KAREN, LYNETTE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 38 , 38 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093857765,"ST CLAIR, ROBIN, SUSANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093858979,"BARBOUR, MEREDITH, FAYE",7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 146 , 342 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093862807,"FISCHER, KEVIN, MICHAEL",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 31 , 66 , 80 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093862807,"FISCHER, KEVIN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 15 , 26 , 27 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093862898,"SMITH, BRIAN, STANLEY",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093862898,"SMITH, BRIAN, STANLEY",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 24 , 30 , 31 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093862898,"SMITH, BRIAN, STANLEY",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 17 , 27 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093862898,"SMITH, BRIAN, STANLEY",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 68 , 91 , 100 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093862898,"SMITH, BRIAN, STANLEY",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093862898,"SMITH, BRIAN, STANLEY",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093862898,"SMITH, BRIAN, STANLEY",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1093863268,MCLAMBS REST HOME,,998 FIVE POINTS RD   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093863268,MCLAMBS REST HOME,998 FIVE POINTS RD   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 3,306 "," 3,306 "," $220,474.77 ",,
MEDICAID DIRECT,1801184932,LIMBIONICS OF SANFORD INC,~,615 WICKER ST   SANFORD NC,053,Lee,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1093863839,"LOVERSO, FRANK, JOSEPH",615 WICKER ST   SANFORD NC,053,Lee,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093864001,"CRABTREE, AMI, SEITZ",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093864001,"CRABTREE, AMI, SEITZ",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093864001,"CRABTREE, AMI, SEITZ",3213 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 69 , 165 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1093864076,"COMBS, JAMIE, MCLEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1093864076,"COMBS, JAMIE, MCLEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1093866659,"MALONEY, PATRICK, JOSEPH",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093866659,"MALONEY, PATRICK, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,190 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1093866659,"MALONEY, PATRICK, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093866659,"MALONEY, PATRICK, JOSEPH",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1093866659,"MALONEY, PATRICK, JOSEPH",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1093866659,"MALONEY, PATRICK, JOSEPH",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 25 , 32 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1093866659,"MALONEY, PATRICK, JOSEPH",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 33 , 38 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 22 , 29 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 30 , 35 , 41 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 36 , 42 , 56 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 29 , 31 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093868929,"ALVA, RAKESH, VISHWANATH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1093870123,SOUTHERN ASSISTED LIVING INC,BROOKDALE EDEN,314 W KINGS HWY   EDEN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093870123,SOUTHERN ASSISTED LIVING INC,314 W KINGS HWY   EDEN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 516 , 516 ," $31,521.88 ",,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093871188,"LEONARD, SUSAN, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1093871949,SOUTHERN ASSISTED LIVING INC,BROOKDALE UNION,1717 UNION RD   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093871949,SOUTHERN ASSISTED LIVING INC,1717 UNION RD   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 27 ," 5,787 "," 5,787 "," $357,390.41 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1904 FRONT ST STE 530 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1093873762,"BENCHARIT, SOMPOP",1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093873762,"BENCHARIT, SOMPOP",1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093876260,"MCGUIRE, LEAH, HEWETT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093876260,"MCGUIRE, LEAH, HEWETT",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 51 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093876260,"MCGUIRE, LEAH, HEWETT",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093876260,"MCGUIRE, LEAH, HEWETT",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1093877292,"BUCKLEN, KEITH, ROBERT",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 61 , 132 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1093877292,"BUCKLEN, KEITH, ROBERT",333 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1093877326,"WHITFIELD, THOMAS, PUSATERI",CHARLOTTE FOOT CLINIC,4300 PARK RD   CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1093877326,"WHITFIELD, THOMAS, PUSATERI",4300 PARK RD   CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 340 ," 1,079 "," 1,602 "," $22,895.21 ",,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093878159,"NAZIR, TARIQ",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093878159,"NAZIR, TARIQ",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 70 , 158 , 158 ,$#,,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093878159,"NAZIR, TARIQ",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1093878530,"FLEMING, GEORGE, EDWARDS",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 100 , 114 , 136 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 47 , 52 , 60 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 66 , 123 , 187 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,128 DR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",430 RANKIN DR   MARION NC,059,McDowell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,128 DR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",430 RANKIN DR   MARION NC,059,McDowell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093879074,"KERSEY, TERRY, WAYNE",472 RANKIN DR   MARION NC,059,McDowell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,128 DR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",290 N MAIN ST   RUTHERFORDTON NC,081,Rutherford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 22 , 25 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,128 DR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1093879074,"KERSEY, TERRY, WAYNE",128 DR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 15 , 17 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093879249,"FESTE, AIMEE, ADAMS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 23 , 25 , 25 ,$#,,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093880643,"CLARK, CHRISTOPHER, JAMES",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 1,633 "," 2,213 "," 8,289 "," $525,215.34 ",,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093880643,"CLARK, CHRISTOPHER, JAMES",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1093880643,"CLARK, CHRISTOPHER, JAMES",~,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1093880643,"CLARK, CHRISTOPHER, JAMES",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,6333 CENTER DR BLDG 16 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093881567,"KRATOVIL, KRISTINA, REA BLACK",6333 CENTER DR BLDG 16 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093881567,"KRATOVIL, KRISTINA, REA BLACK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093881567,"KRATOVIL, KRISTINA, REA BLACK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093886996,"JEFFERSON, BRIAN, KEITH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093886996,"JEFFERSON, BRIAN, KEITH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093886996,"JEFFERSON, BRIAN, KEITH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093886996,"JEFFERSON, BRIAN, KEITH",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093886996,"JEFFERSON, BRIAN, KEITH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093886996,"JEFFERSON, BRIAN, KEITH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093887960,"JACKSON, BROOKE, ASHLEY-ANN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 23 , 28 , 37 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093887960,"JACKSON, BROOKE, ASHLEY-ANN",517 MOYE BLVD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093888398,"SINGLETON, PEGI, PRITCHARD",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093888398,"SINGLETON, PEGI, PRITCHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093888398,"SINGLETON, PEGI, PRITCHARD",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 15 , 15 ,$#,,
MEDICAID DIRECT,1093889651,SANDRA JERMILLS MILLER,FAITHFUL SERVANT HOME CARE SERVICES,6047 TYVOLA GLEN CIR STE 236 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1093889651,SANDRA JERMILLS MILLER,6047 TYVOLA GLEN CIR STE 236 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,796 "," 1,796 "," $109,693.80 ",,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093890287,"BALAN, BINDUBAL, KALTHUMPADIKAL",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093890287,"BALAN, BINDUBAL, KALTHUMPADIKAL",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 28 , 53 , 69 ,$#,,
MEDICAID DIRECT,1154518678,EASTOWNE FAMILY PHYSICIANS,~,4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093890535,"EKWONU, TAGBO, JOHN",4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1154518678,EASTOWNE FAMILY PHYSICIANS,~,4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093890535,"EKWONU, TAGBO, JOHN",4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 254 , 708 , 979 ," $26,816.56 ",,
MEDICAID DIRECT,1972766459,NORTH GEORGIA MEDICINE LLC,NORTH GEORGIA FAMILY MEDICINE,4799 BLUE RIDGE DR STE 104 BLUE RIDGE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093891921,"GARY, THOMAS, DILLARD",4799 BLUE RIDGE DR STE 104 BLUE RIDGE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972766459,NORTH GEORGIA MEDICINE LLC,NORTH GEORGIA FAMILY MEDICINE,346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093891921,"GARY, THOMAS, DILLARD",346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 28 , 49 ,$#,,
MEDICAID DIRECT,1093897340,WARREN COUNTY RESCUE SQUAD,WARREN COUNTY RESCUE SQUAD,672 ENTERPRISE RD   LITTLETON NC,042,Halifax,3416L0300X,Transportation Services,Ambulance,Land Transport,1093897340,WARREN COUNTY RESCUE SQUAD,672 ENTERPRISE RD   LITTLETON NC,042,Halifax,3416L0300X,Transportation Services,Ambulance,Land Transport, 12 , 22 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899155,"LEWIS, JENNIFER, HENRY",1309 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899155,"LEWIS, JENNIFER, HENRY",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899718,"CHOI, MINA, NUI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899718,"CHOI, MINA, NUI",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899718,"CHOI, MINA, NUI",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899718,"CHOI, MINA, NUI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899718,"CHOI, MINA, NUI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899908,"MUIR, ANDREW, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899908,"MUIR, ANDREW, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 29 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093899908,"MUIR, ANDREW, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093899908,"MUIR, ANDREW, JOSEPH",10441 MONCREIFFE RD STE 100 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1093900276,"GOUGE, COURTNEY, ANNE",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 24 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093900276,"GOUGE, COURTNEY, ANNE",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 175 , 207 , 511 ," $13,833.12 ",,
MEDICAID DIRECT,1093902652,WALGREEN CO,WALGREENS 10276,3601 DAVIS DR   MORRISVILLE NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1093902652,WALGREEN CO,3601 DAVIS DR   MORRISVILLE NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1093903544,"ROBERTS, ROXSANN, LEE",975 E 3RD ST # 376 CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1093903544,"ROBERTS, ROXSANN, LEE",975 E 3RD ST # 376 CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1093903544,"ROBERTS, ROXSANN, LEE",975 E 3RD ST # 376 CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093903718,"PRIESTAF, AMY, CHRISTINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093903718,"PRIESTAF, AMY, CHRISTINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093903718,"PRIESTAF, AMY, CHRISTINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 34 , 67 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093904575,"MISNER, GAVIN, ISAAC",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 20 , 28 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093904575,"MISNER, GAVIN, ISAAC",911 W HENDERSON ST KISER BUILDING STE 410 SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 47 , 55 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093904575,"MISNER, GAVIN, ISAAC",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093904575,"MISNER, GAVIN, ISAAC",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093906281,"KAPOOR, KAPIL, GOPAL",1855 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 30 , 84 ,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093906281,"KAPOOR, KAPIL, GOPAL",809 GREENBRIER PKWY STE 109 CHESAPEAKE VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093906281,"KAPOOR, KAPIL, GOPAL",6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093906281,"KAPOOR, KAPIL, GOPAL",1800 REPUBLIC RD STE 102 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093906281,"KAPOOR, KAPIL, GOPAL",828 HEALTHY WAY STE 115 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1093907545,NECHELLE L SAMUEL,PASSIONATE CNA HOME CARE SERVICE LLC,3000 BETHESDA PL STE 302 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1093907545,NECHELLE L SAMUEL,3000 BETHESDA PL STE 302 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 680 , 727 ," $125,289.70 ",,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4113 CAPITOL ST STE A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093908097,"MCNULTY, KATE, BERRY",4113 CAPITOL ST STE A DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093908097,"MCNULTY, KATE, BERRY",1100 N RALEIGH BLVD STE 130 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093908311,"WEAVER-LEE, LASHAWN, ANTOINETTE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093908311,"WEAVER-LEE, LASHAWN, ANTOINETTE",324 N QUEEN ST   KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 38 , 50 ,$#,,
MEDICAID DIRECT,1326326133,SHIFA PEDIATRIC CLINIC PLLC,SHIFA PEDIATRIC CLINIC PLLC,1001 W WILLIAMS ST STE 102 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093909137,"SULTANA, AYESHA",1001 W WILLIAMS ST STE 102 APEX NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 20 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093910101,"HERTZ, CARYN, MARJORIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 67 , 67 ,$#,,
MEDICAID DIRECT,1467149823,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH EMERGENCY PHYSICIANS,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1093917072,"SNYDER, RYAN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 270 , 357 , 500 ," $11,394.98 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093917981,"KIM, GRACE, JEWEL",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093917981,"KIM, GRACE, JEWEL",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 20 , 90 , 159 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093917981,"KIM, GRACE, JEWEL",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093919730,"NORTHROP, SARAH, ALLISON WILLIAMS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093919730,"NORTHROP, SARAH, ALLISON WILLIAMS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093919870,"LINEBERRY, JEFFREY, TODD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 60 , 60 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093921744,"BELL, JESSICA, AMY FU",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 12 , 19 , 40 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093921744,"BELL, JESSICA, AMY FU",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1962635540,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY MORGANTON,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1093923187,"DE LA SERNA, FERNANDO, ALBERTO",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 372 , 564 , 730 ," $10,480.08 ",,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1093928376,"ROWELL, JENNIFER",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093928376,"ROWELL, JENNIFER",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 21 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093928376,"ROWELL, JENNIFER",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093928376,"ROWELL, JENNIFER",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 18 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093928376,"ROWELL, JENNIFER",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093928376,"ROWELL, JENNIFER",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1093929754,KNIGHTS FAMILY CARE HOME,~,312 CLEO ST   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093929754,KNIGHTS FAMILY CARE HOME,312 CLEO ST   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 817 , 880 ," $51,224.47 ",,
MEDICAID DIRECT,1093929754,KNIGHTS FAMILY CARE HOME,~,3305 GREENFIELD DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1093929754,KNIGHTS FAMILY CARE HOME,3305 GREENFIELD DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 246 , 246 ," $17,165.23 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093935058,"REDDY, VINAY, CHINTALA",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 40 , 67 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093935058,"REDDY, VINAY, CHINTALA",100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 92 , 190 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093935058,"REDDY, VINAY, CHINTALA",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093936577,"MACNEILL, EMILY, CHAMPE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 52 , 63 ,$#,,
MEDICAID DIRECT,1497098420,NEUROPSYCHIATRIC CARE CENTER PLLC,NEUROPSYCHIATRIC CARE CENTER,3822 N ELM ST STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093936676,"AKINTAYO, MOJEED, A.",3822 N ELM ST STE 101 GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093936676,"AKINTAYO, MOJEED, A.",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093936676,"AKINTAYO, MOJEED, A.",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093940413,"REES, ELIZABETH, ANN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093940413,"REES, ELIZABETH, ANN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093940413,"REES, ELIZABETH, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093940413,"REES, ELIZABETH, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 20 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093940413,"REES, ELIZABETH, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 21 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1093940413,"REES, ELIZABETH, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093940413,"REES, ELIZABETH, ANN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437465648,"IMAFIDON, TIMOTHY, OSAGIE",~,300 S CENTER ST   GOLDSBORO NC,096,Wayne,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1093941163,"CERON, FRANCISCA",300 S CENTER ST   GOLDSBORO NC,096,Wayne,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 25 ,$#,,
MEDICAID DIRECT,1720521982,TIMOTHY O IMAFIDON JR DDS PA,GOLDSBORO PEDIATRIC DENTISTRY & ORTHODONTICS,300 S CENTER ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1093941163,"CERON, FRANCISCA",300 S CENTER ST   GOLDSBORO NC,096,Wayne,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 4,100 "," 5,091 "," 25,837 "," $906,381.80 ",,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1093941353,"KAMMER, DAVID, JACOB",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093941353,"KAMMER, DAVID, JACOB",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093941353,"KAMMER, DAVID, JACOB",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1093941353,"KAMMER, DAVID, JACOB",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1093941353,"KAMMER, DAVID, JACOB",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 32 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1093941353,"KAMMER, DAVID, JACOB",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093941353,"KAMMER, DAVID, JACOB",~,2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1093941353,"KAMMER, DAVID, JACOB",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093942211,"MOSER, CHRISTOPHER, PAUL",344 ROLLING HILL RD STE 102 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093942211,"MOSER, CHRISTOPHER, PAUL",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093942211,"MOSER, CHRISTOPHER, PAUL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 80 , 81 , 92 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093942211,"MOSER, CHRISTOPHER, PAUL",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1093942211,"MOSER, CHRISTOPHER, PAUL",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093942534,"JAIN, ANSHU, KUMAR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093942534,"JAIN, ANSHU, KUMAR",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093942534,"JAIN, ANSHU, KUMAR",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093942534,"JAIN, ANSHU, KUMAR",10650 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093942534,"JAIN, ANSHU, KUMAR",201 E GROVER ST   SHELBY NC,023,Cleveland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093942534,"JAIN, ANSHU, KUMAR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1093942674,"THORN, LINDSAY, MEGAN",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1093942674,"THORN, LINDSAY, MEGAN",1210 CENTRAL DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1210 CENTRAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1093942674,"THORN, LINDSAY, MEGAN",1210 CENTRAL DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 22 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1093942674,"THORN, LINDSAY, MEGAN",1301 CASTLEPOINTE DR   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1093942690,"HUNT JR, HAL, MARSH",412 S JONES ST   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093942708,"KUMAR, ABHAY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093942708,"KUMAR, ABHAY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093943250,"NUSSMAN, NAN, STOCKTON",24 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093944001,"MANDHADI, RANADEEP, REDDY",660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 49 , 99 , 144 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093944001,"MANDHADI, RANADEEP, REDDY",2525 COURT DR   GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 16 , 40 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093944407,"SANDERSON, KEIA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093944407,"SANDERSON, KEIA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093944407,"SANDERSON, KEIA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093944407,"SANDERSON, KEIA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 32 , 58 , 59 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093944787,"ARDHANARI, SIVAKUMAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 269 , 310 , 441 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093944787,"ARDHANARI, SIVAKUMAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 81 , 88 , 91 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093944787,"ARDHANARI, SIVAKUMAR",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1093944787,"ARDHANARI, SIVAKUMAR",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 106 , 114 , 189 ,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1093945115,"APOLLO, LYDIA, BULLOCK",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1093945115,"APOLLO, LYDIA, BULLOCK",105 MCALPINE LN   LAURINBURG NC,083,Scotland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 17 , 18 , 24 ,$#,,
MEDICAID DIRECT,1831687912,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN WOMENS HEALTHCARE AT THE OAKS,,,Unknown,193200000X,Group,Multi-Specialty,,1093945115,"APOLLO, LYDIA, BULLOCK",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,,,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,17 LIVERMORE DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1093945115,"APOLLO, LYDIA, BULLOCK",2053 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093946832,"KHETPAL, VANESH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 187 , 187 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093946832,"KHETPAL, VANESH",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1093946832,"KHETPAL, VANESH",300 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1093947798,NUVISION HOME CARE INC,~,1549 RIVER RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1093947798,NUVISION HOME CARE INC,1549 RIVER RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 5,661 "," 5,751 "," $486,277.36 ",,
MEDICAID DIRECT,1093948663,KAROLINAS HOME CARE LLC,KAROLINAS HOME CARE LLC,5820 E WT HARRIS BLVD STE 118 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1093948663,KAROLINAS HOME CARE LLC,5820 E WT HARRIS BLVD STE 118 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 41 ," 9,968 "," 10,242 "," $1,039,229.88 ",,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093949463,"HOLDER, JOHN, CLAUDE",250 HUFF DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 73 , 96 ,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093949463,"HOLDER, JOHN, CLAUDE",14057 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 88 , 116 ,$#,,
MEDICAID DIRECT,1093951311,"WINDSOR, ROBERT, BLAKE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1093951311,"WINDSOR, ROBERT, BLAKE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093951691,"YU, HILLARY, YABO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 24 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093951691,"YU, HILLARY, YABO",932 MORREENE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 66 , 122 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093953127,MOSES CONE PHYSICIAN SERVICES INC,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,, 18 , 15 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093955494,"JONES, KEVIN, MICHAEL",604 W MAIN ST   JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 112 , 164 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093957326,"LEHPAMER, BRIAN, PHILIP",220 SPRINGBROOK AVE STE 100 CLAYTON NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 71 , 127 , 249 ," $28,435.39 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093957326,"LEHPAMER, BRIAN, PHILIP",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 55 , 79 , 199 ," $21,456.82 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093957326,"LEHPAMER, BRIAN, PHILIP",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093957326,"LEHPAMER, BRIAN, PHILIP",1006 PROCURE ST STE 300 FUQUAY VARINA NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093957326,"LEHPAMER, BRIAN, PHILIP",11200 GOVERNOR MANLY WAY   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1093957326,"LEHPAMER, BRIAN, PHILIP",2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 122 , 257 , 654 ," $70,889.11 ",,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1093958308,"KELLY, KRISTINA, LYSELL",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 58 , 125 ,$#,,
MEDICAID DIRECT,1093959801,HEALTH SERVICES PERSONNEL,ALL WAYS CARING HOMECARE,1825 W CITY DR STE E ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1093959801,HEALTH SERVICES PERSONNEL,1825 W CITY DR STE E ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,#, 502 , 502 ," $36,100.48 ",,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 18 , 20 , 21 ,$#,,
MEDICAID DIRECT,1093960882,PRO STEP THERAPY,PRO STEP THERAPY,410 NEW BRIDGE ST STE 7A JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093960882,PRO STEP THERAPY,410 NEW BRIDGE ST STE 7A JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,, 65 , 686 , 902 ," $61,964.66 ",,
MEDICAID DIRECT,1093960882,PRO STEP THERAPY,PRO STEP THERAPY,7011 GUM BRANCH RD   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1093960882,PRO STEP THERAPY,7011 GUM BRANCH RD   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,, 107 ," 1,596 "," 1,877 "," $157,995.78 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093961120,"LEE, JONG HOON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 63 , 66 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093962045,"AGRESTA, DOMINIC, EDWARD",300 E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 201 , 211 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1093962045,"AGRESTA, DOMINIC, EDWARD",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1093962045,"AGRESTA, DOMINIC, EDWARD",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 65 , 132 ,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1093962045,"AGRESTA, DOMINIC, EDWARD",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1093962367,"SHREWSBURY, KRISTI, ANN",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093962367,"SHREWSBURY, KRISTI, ANN",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093965899,"TARIQ, MUHAMMAD, FAWAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 29 , 29 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093965899,"TARIQ, MUHAMMAD, FAWAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 24 , 25 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1093967630,"ALEXANDER, MAIRE, THERESA",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093967630,"ALEXANDER, MAIRE, THERESA",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 72 , 72 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1093967630,"ALEXANDER, MAIRE, THERESA",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093967630,"ALEXANDER, MAIRE, THERESA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1093967960,SMALL TALK SPEECH AND LANGUAGE SERV,SMALL TALK SPEECH & LANGUAGE SERVICES,3603 WOODS MYRTLE CT N   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1093967960,SMALL TALK SPEECH AND LANGUAGE SERV,3603 WOODS MYRTLE CT N   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,#, 303 , 303 ," $20,474.37 ",,
MEDICAID DIRECT,1093967960,SMALL TALK SPEECH AND LANGUAGE SERV,SMALL TALK SPEECH & LANGUAGE SERVICES,3603 WOODS MYRTLE CT N   WILSON NC,098,Wilson,251S00000X,Agencies,Community/Behavioral Health,,1093967960,SMALL TALK SPEECH AND LANGUAGE SERV,3603 WOODS MYRTLE CT N   WILSON NC,098,Wilson,251S00000X,Agencies,Community/Behavioral Health,, 26 , 549 , 549 ," $38,037.60 ",,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093971038,"REIS, ERIN, BENNEK",811 US 70 HWY W   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093971038,"REIS, ERIN, BENNEK",811 US 70 HWY W   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1093971038,"REIS, ERIN, BENNEK",811 US 70 HWY W   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 14 , 21 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1093972531,"ROWE, SEAN, ANDREW",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 132 , 147 , 186 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1093973075,"CONVERY, PATRICIA, ANN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1093973075,"CONVERY, PATRICIA, ANN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1093973075,"CONVERY, PATRICIA, ANN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 34 , 43 ," $11,216.22 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093973075,"CONVERY, PATRICIA, ANN",1900 KILDAIRE FARM ROAD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093973273,"BROZZETTI-CRONIN, KELLY, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 37 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1093973273,"BROZZETTI-CRONIN, KELLY, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,937 RIVERWALK PKWY STE 101 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1093976995,"CHEATLE, JOSEPH, THOMAS",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093976995,"CHEATLE, JOSEPH, THOMAS",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 15 , 30 , 34 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093976995,"CHEATLE, JOSEPH, THOMAS",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 14 , 22 , 33 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093977274,"BARNES, FANTEEMA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 18 , 71 , 72 ,$#,,
MEDICAID DIRECT,1871589762,ADVANCE COMMUNITY HEALTH INC,~,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1093977274,"BARNES, FANTEEMA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093977571,"BERRY, TODD, MATTHEW",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1093977571,"BERRY, TODD, MATTHEW",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1093979759,"HACKER, ELIZABETH, THERESE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558684985,RONDELL L BLAKEY DDS PA,CAROLINA ORTHODONTIC SOLUTIONS,3877 JAMES ST   BETHEL NC,074,Pitt,193400000X,Group,Single Specialty,,1093980336,"BLAKEY, RONDELL, LUCIAN",1506 WAYNE MEMORIAL DR STE A GOLDSBORO NC,096,Wayne,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1558684985,RONDELL L BLAKEY DDS PA,CAROLINA ORTHODONTIC SOLUTIONS,1504 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1093980336,"BLAKEY, RONDELL, LUCIAN",1506 WAYNE MEMORIAL DR STE A GOLDSBORO NC,096,Wayne,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1558684985,RONDELL L BLAKEY DDS PA,CAROLINA ORTHODONTIC SOLUTIONS,3877 JAMES ST   BETHEL NC,074,Pitt,193400000X,Group,Single Specialty,,1093980336,"BLAKEY, RONDELL, LUCIAN",3877 JAMES ST   BETHEL NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1558684985,RONDELL L BLAKEY DDS PA,CAROLINA ORTHODONTIC SOLUTIONS,3877 JAMES ST   BETHEL NC,074,Pitt,193400000X,Group,Single Specialty,,1093980336,"BLAKEY, RONDELL, LUCIAN",3877 JAMES ST   BETHEL NC,074,Pitt,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 297 , 585 , 760 ," $112,446.33 ",,
MEDICAID DIRECT,1558684985,RONDELL L BLAKEY DDS PA,CAROLINA ORTHODONTIC SOLUTIONS,1504 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1093980336,"BLAKEY, RONDELL, LUCIAN",3877 JAMES ST   BETHEL NC,074,Pitt,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",1000 HEALING WAY   MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598135188,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH TRANSITION CLINIC,1237 HARDING PL # 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",920 CHURCH ST N STE 255B CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1093980765,"CULPEPPER, JAMAYLA, JESSICA",201 E GROVER ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093981094,"DESIMONE, NOELLE, ANNETTE",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093981094,"DESIMONE, NOELLE, ANNETTE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 101 , 111 , 134 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 22 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 20 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1093981300,"RALSTON, EMILIE, CAMILLE",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1093984569,"LYNCH, LAURA, BROCK",1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1093984569,"LYNCH, LAURA, BROCK",1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093987794,"YOUNG, JAMES, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1093987794,"YOUNG, JAMES, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 48 , 49 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093987828,"PATEL, ASHIT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093987828,"PATEL, ASHIT",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1093987828,"PATEL, ASHIT",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1093988933,"WALLACE ELEY, TONIALATOYA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 83 , 87 , 153 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1093988933,"WALLACE ELEY, TONIALATOYA",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093989030,"TAYROSE, GREGORY, ABRAM",166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 92 , 162 , 259 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093989030,"TAYROSE, GREGORY, ABRAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1093989030,"TAYROSE, GREGORY, ABRAM",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093989030,"TAYROSE, GREGORY, ABRAM",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093989030,"TAYROSE, GREGORY, ABRAM",166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 57 , 82 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093989030,"TAYROSE, GREGORY, ABRAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093990814,"GOLSHAYAN, ALI, REZA",2406 CENTURY PL SE   HICKORY NC,018,Catawba,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 58 , 194 ," $19,117.90 ",,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1093990814,"GOLSHAYAN, ALI, REZA",2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 54 , 140 , 350 ," $31,772.83 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093992893,"SAYLOR, DEANNA, RAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,193200000X,Group,Multi-Specialty,,1093993008,"BOESHORE, ERIC, RUSSELL",75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093993727,CAROLINA MOUNTAIN GASTROENTEROLOGY,,1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1093993727,CAROLINA MOUNTAIN GASTROENTEROLOGY,1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 81 , 84 , 153 ,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1093997645,"HEMPHILL, SHANE, DONALD",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1093997645,"HEMPHILL, SHANE, DONALD",1515 SW CARY PKWY STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1093997645,"HEMPHILL, SHANE, DONALD",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 43 , 58 , 90 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 13 , 27 , 36 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1093998361,"CHAN, PETER, GAR-JUN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093999369,"FOREST, DANIEL, JORDAN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093999369,"FOREST, DANIEL, JORDAN",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093999369,"FOREST, DANIEL, JORDAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093999369,"FOREST, DANIEL, JORDAN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1093999369,"FOREST, DANIEL, JORDAN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104002864,"TYSON, CRYSTAL, CENELL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104002864,"TYSON, CRYSTAL, CENELL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104002864,"TYSON, CRYSTAL, CENELL",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1104002864,"TYSON, CRYSTAL, CENELL",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104004654,"DUGAN, ERIN, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104007319,"GINGERICH, TROY, CURTIS",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 37 , 57 , 82 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104009745,"PHARR, EMILY, POOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1215629886,OCRACOKE HEALTH CENTER INC,MANTEO COMMUNITY HEALTH CENTER,402 BUDLEIGH ST   MANTEO NC,028,Dare,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104014976,"LEEGINS-VINSON, KATIE, JANE",402 BUDLEIGH ST   MANTEO NC,028,Dare,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1063472116,OCRACOKE HEALTH CENTER INC,ENGELHARD MEDICAL CENTER,33270 US 264   ENGELHARD NC,048,Hyde,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104014976,"LEEGINS-VINSON, KATIE, JANE",33270 US HIGHWAY 264   ENGELHARD NC,048,Hyde,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104018969,"YATES, PATRICIA, KPAN",2041 WILLOW RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104018969,"YATES, PATRICIA, KPAN",2041 WILLOW RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 61 , 63 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1104018969,"YATES, PATRICIA, KPAN",1987 HILTON RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780127431,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,301 E MEETING ST STE 101 MORGANTON NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104019827,"STARR, JAMMIE, MICHELLE",301 E MEETING ST STE 101 MORGANTON NC,012,Burke,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104020692,"ISAAK, ROBERT, SCOTT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104020692,"ISAAK, ROBERT, SCOTT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104020692,"ISAAK, ROBERT, SCOTT",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104020692,"ISAAK, ROBERT, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104020692,"ISAAK, ROBERT, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 53 , 59 ,$#,,
MEDICAID DIRECT,1598320830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROGYNECOLOGY,10880 DURANT RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104021559,"CRANE, ANDREA, KUNTARAF",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1598320830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROGYNECOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104021559,"CRANE, ANDREA, KUNTARAF",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,,,$#,,
MEDICAID DIRECT,1598320830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROGYNECOLOGY,10880 DURANT RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104021559,"CRANE, ANDREA, KUNTARAF",10880 DURANT RD   RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 21 , 33 , 58 ,$#,,
MEDICAID DIRECT,1598320830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROGYNECOLOGY,10880 DURANT RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104021559,"CRANE, ANDREA, KUNTARAF",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 113 , 126 , 254 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",2301 ERWIN RD FL 3 DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 32 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 43 , 45 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104022987,"VEMULAPALLI, SREEKANTH",2301 ERWIN RD FL 3 DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104023951,"HUEMAN, ELIZABETH, MCCURDY",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 14 , 24 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104023951,"HUEMAN, ELIZABETH, MCCURDY",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104023951,"HUEMAN, ELIZABETH, MCCURDY",300 HEALTH PARK DR STE 210 GARNER NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104023951,"HUEMAN, ELIZABETH, MCCURDY",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104025832,"GREGORIE, WILLIAM, DOUGLAS",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104026103,"HONGALGI, ANAND",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104026103,"HONGALGI, ANAND",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 36 , 36 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104026103,"HONGALGI, ANAND",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1023610987,NATHANIEL P HIFKO DDS PLLC,ROBBINS FAMILY DENTAL,300 S MIDDLETON ST   ROBBINS NC,063,Moore,193200000X,Group,Multi-Specialty,,1104027507,"POWERS, DARRELL, LEE",300 S MIDDLETON ST   ROBBINS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 37 , 90 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104030063,"PALOSKI, MICHAEL, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104030063,"PALOSKI, MICHAEL, DAVID",1450 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104030063,"PALOSKI, MICHAEL, DAVID",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104030063,"PALOSKI, MICHAEL, DAVID",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104030063,"PALOSKI, MICHAEL, DAVID",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 15 , 25 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104030063,"PALOSKI, MICHAEL, DAVID",10030 GILEAD RD STE 140 HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 15 , 27 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104030063,"PALOSKI, MICHAEL, DAVID",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 40 , 66 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104030089,"PASCHKE, JOSHUA, KANE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1104030089,"PASCHKE, JOSHUA, KANE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104030089,"PASCHKE, JOSHUA, KANE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447526389,DAVID C SLAWISNKI DDS PA,MIDTOWN PEDIATRIC DENTISTRY,5041 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104033232,"SLAWINSKI, DAVID, CHARLES",5041 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 115 , 221 , 740 ," $24,737.86 ",,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104033281,"WONG, MATTHEW, HARRY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104033281,"WONG, MATTHEW, HARRY",624 QUAKER LN STE D201 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104033281,"WONG, MATTHEW, HARRY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 26 , 35 , 35 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104035476,"VENKAT, VIDYA",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 67 , 146 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104036524,"VALLABHANENI, GEETHA, DEVI",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 59 , 145 , 149 ,$#,,
MEDICAID DIRECT,1104041540,NC DHHS CHILD AND FAMILY WELL-BEING,ROCKY MOUNT CDSA,141 STORAGE RD   ROCKY MOUNT NC,064,Nash,252Y00000X,Agencies,Early Intervention Provider Agency,,1104041540,NC DHHS CHILD AND FAMILY WELL-BEING,141 STORAGE RD   ROCKY MOUNT NC,064,Nash,252Y00000X,Agencies,Early Intervention Provider Agency,, 985 ," 4,711 "," 5,594 "," $519,821.63 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104041672,"OSSMAN, PAUL, DOUGLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 47 , 47 , 62 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104042365,"KENDRICK, SCOTT, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 60 , 95 , 147 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104042365,"KENDRICK, SCOTT, ALAN",510 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104042365,"KENDRICK, SCOTT, ALAN",4302 S MAIN ST   FARMVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 79 , 79 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104042365,"KENDRICK, SCOTT, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 32 , 32 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104042365,"KENDRICK, SCOTT, ALAN",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 110 , 187 , 383 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104042365,"KENDRICK, SCOTT, ALAN",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104042365,"KENDRICK, SCOTT, ALAN",101 CLINIC DR   TARBORO NC,033,Edgecombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1104042936,"KLEM, IGOR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104042936,"KLEM, IGOR",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 32 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104042936,"KLEM, IGOR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104042936,"KLEM, IGOR",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1104043058,"BREWINGTON, SARAH, LOCKLEAR",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 ,#, 18 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1104043058,"BREWINGTON, SARAH, LOCKLEAR",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#, 21 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1104043058,"BREWINGTON, SARAH, LOCKLEAR",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 89 , 150 , 367 ," $16,850.11 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104046515,"TURNER, LEE, LEATHERWOOD",121 RACINE DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104046515,"TURNER, LEE, LEATHERWOOD",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104046515,"TURNER, LEE, LEATHERWOOD",214 LANEFIELD RD   WARSAW NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104046515,"TURNER, LEE, LEATHERWOOD",1403 CONNER DR   WINDSOR NC,008,Bertie,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104046515,"TURNER, LEE, LEATHERWOOD",3031 TATE BLVD SE   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104046515,"TURNER, LEE, LEATHERWOOD",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104049139,EMMANUEL SENIOR ENRICHMENT CENTER I,~,1401 HEATHCLIFF RD   HIGH POINT NC,041,Guilford,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,1104049139,EMMANUEL SENIOR ENRICHMENT CENTER I,1401 HEATHCLIFF RD   HIGH POINT NC,041,Guilford,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care, 11 ," 1,531 "," 1,531 "," $65,924.86 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104051481,"BELCHER, WILLIAM, ALEXANDER",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 48 , 97 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1104052232,"HERNANDEZ, JOSEPH, DEMETRIUS",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104052612,"OLABISI, OPEYEMI, AYODEJI",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104052612,"OLABISI, OPEYEMI, AYODEJI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104052612,"OLABISI, OPEYEMI, AYODEJI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1104053180,"TUTERA, DOMINIC, FREDRICK",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1104053180,"TUTERA, DOMINIC, FREDRICK",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 65 , 79 ,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1104053180,"TUTERA, DOMINIC, FREDRICK",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336363704,CARY VISION CARE OD PA,,1100 NW MAYNARD RD STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1104054964,"DANTINI, MEGAN, LEIGH",1100 NW MAYNARD RD STE 120 CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104056167,"DRAKE, JENNIFER, MCLANE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 55 , 216 , 321 ,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104056167,"DRAKE, JENNIFER, MCLANE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 73 , 136 ,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104056498,"DUBOSE, JOHN, WYLDER",10650 PARK RD STE 420 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 30 , 35 , 38 ,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104056498,"DUBOSE, JOHN, WYLDER",1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104056498,"DUBOSE, JOHN, WYLDER",10650 PARK RD STE 420 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,215 S MAIN ST STE 100 MT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104056498,"DUBOSE, JOHN, WYLDER",215 S MAIN ST STE 100 MOUNT HOLLY NC,036,Gaston,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,,,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104056498,"DUBOSE, JOHN, WYLDER",215 S MAIN ST STE 100 MOUNT HOLLY NC,036,Gaston,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1104058130,"SETHI, BHAWNA",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",106 CAMERON ST   LAKE WACCAMAW NC,024,Columbus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 107 , 157 ," $10,296.37 ",,
MEDICAID DIRECT,1336229384,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SURGICAL ASSOCIATES,584 HOSPITAL DR NE UNIT A BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",584 HOSPITAL DR NE UNIT A BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",257 HOSPITAL DR NE STE 200 BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",509 OLDE WATERFORD WAY STE 200 LELAND NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",584 HOSPITAL DR NE UNIT A BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",121 RACINE DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 42 , 66 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",2006 S 16TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",83 CAVALIER DR STE 200 WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 23 , 47 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",1011 PORTERS NECK RD   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 43 , 50 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",2305 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 58 , 89 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104058817,"BENENATI, MATTHEW, AARON",311 S CAMPBELL ST   BURGAW NC,071,Pender,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104062967,TABONO CARE SERVICES,TABONO CARE SERVICES,3701 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1104062967,TABONO CARE SERVICES,3701 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 44 ," 2,578 "," 2,658 "," $211,049.56 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104063007,"STRICKLAND, TIFFANY, COX",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 61 , 74 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104064377,"CAUSEY, HEATHER, ELIZABETH",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 57 , 55 , 55 ,$#,,
MEDICAID DIRECT,1104065739,PREMIER HOME HEALTH CARE SERVICES I,PREMIER HOME HEALTH CARE SERVICES INC,2783 NC HIGHWAY 68 S STE 101 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1104065739,PREMIER HOME HEALTH CARE SERVICES I,2783 NC HIGHWAY 68 S STE 101 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 2,582 "," 2,602 "," $260,785.76 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104066117,"KERLEY, JENNIFER, NILAND",7130 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 73 , 108 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104066117,"KERLEY, JENNIFER, NILAND",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 25 ,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104067040,"HOWELL, CANDACE, AFRIKA",3173 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,705 GRIFFITH ST   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104067040,"HOWELL, CANDACE, AFRIKA",705 GRIFFITH ST   DAVIDSON NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 22 , 33 ,$#,,
MEDICAID DIRECT,1902837073,DAVIDSON CLINIC,ATRIUM HEALTH PRIMARY CARE DAVIDSON CLINIC,705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104067040,"HOWELL, CANDACE, AFRIKA",705 GRIFFITH ST   DAVIDSON NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104068220,"ASANTE, DONALD, DARKO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 42 , 42 ,$#,,
MEDICAID DIRECT,1689096349,MEDICS PRIMARY AND URGENT CARE,,504 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104068220,"ASANTE, DONALD, DARKO",504 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 58 , 67 ,$#,,
MEDICAID DIRECT,1689096349,MEDICS PRIMARY AND URGENT CARE,,504 OWEN DR   FAYETTEVILLE NC,026,Cumberland,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1104068220,"ASANTE, DONALD, DARKO",504 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 154 , 284 , 459 ,$#,,
MEDICAID DIRECT,1265942403,UBYLEE HEALTHCARE GROUP,,9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104070820,"MARINO, BAPTISTE, STEVEN",9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 67 , 106 , 318 ,$#,,
MEDICAID DIRECT,1447478771,MOHAMED & ASSOCIATES UROLOGY CTR PA,~,507 N BRIGHTLEAF BLVD STE 205 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1104071034,"SLATE, ASHLEY, BLAIRE",507 N BRIGHTLEAF BLVD STE 205 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1104071034,"SLATE, ASHLEY, BLAIRE",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104071034,"SLATE, ASHLEY, BLAIRE",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104071034,"SLATE, ASHLEY, BLAIRE",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 80 , 199 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1104074517,"YOUNG, ROBERT, LEE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104074517,"YOUNG, ROBERT, LEE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104074517,"YOUNG, ROBERT, LEE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104074517,"YOUNG, ROBERT, LEE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104074517,"YOUNG, ROBERT, LEE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104074517,"YOUNG, ROBERT, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 42 , 59 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104074780,"COOMBE, COURTNEY, FICKLE",179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 38 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104074780,"COOMBE, COURTNEY, FICKLE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104074780,"COOMBE, COURTNEY, FICKLE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1104075712,"PERDUE, KENSLEY, BRUMLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104075712,"PERDUE, KENSLEY, BRUMLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104075712,"PERDUE, KENSLEY, BRUMLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104075712,"PERDUE, KENSLEY, BRUMLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104078211,"FAVRET, JENNY, CAUBLE",3116 N DUKE ST   DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104078757,"EDWARDS, SHERIE, MAE",5160 OCEAN HWY W   SHALLOTTE NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104082874,"LOCKWOOD, ROBERT, PETER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 40 , 59 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104082874,"LOCKWOOD, ROBERT, PETER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104082874,"LOCKWOOD, ROBERT, PETER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 33 , 40 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104082874,"LOCKWOOD, ROBERT, PETER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104083021,"BLACK, MITCHELL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 112 , 117 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104083021,"BLACK, MITCHELL",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104083021,"BLACK, MITCHELL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 43 , 43 ,$#,,
MEDICAID DIRECT,1073003752,GOODEN MOBILE POD NC PLLC,,311 MCFADYEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104083427,"RICHARDSON, REGINALD, BARNETTE",311 MCFADYEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 141 , 146 , 167 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104087717,"LAMM, YEN-JWU, OLIVE",3031 TATE BLVD SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 30 , 31 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104087717,"LAMM, YEN-JWU, OLIVE",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 137 , 164 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104087717,"LAMM, YEN-JWU, OLIVE",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 322 , 446 ," $14,300.02 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104089002,"RHYNER, JOHN, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104089002,"RHYNER, JOHN, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 43 , 108 , 188 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104089002,"RHYNER, JOHN, DAVID",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 47 , 59 ,$#,,
MEDICAID DIRECT,1417061011,ABC PEDIATRICS OF DUNN PA,~,104 TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1104089374,"ROMERO, VERONICA",104 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 39 , 146 ,$#,,
MEDICAID DIRECT,1104093186,JONES ADAPTIVE MOBILITY,,3441 HIGHWAY 126   BLOUNTVILLE TN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1104093186,JONES ADAPTIVE MOBILITY,3441 HIGHWAY 126   BLOUNTVILLE TN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 31 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104094028,"BRISKEY, PAMELA, BLAKELY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104094028,"BRISKEY, PAMELA, BLAKELY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1932599248,EAST CAROLINA UNIVERSITY,ECU PHYSICAL THERAPY SERVICES,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104096676,"JOHNSON, SARAH, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104096676,"JOHNSON, SARAH, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1225399397,CAROLINA EYE CARE ON MERRIMON OD PA,CAROLINA EYE CARE ON MERRIMON OD PA,825 MERRIMON AVE STE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104098045,"BROOKS, LESLEY, NESMITH",825 MERRIMON AVE STE B ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1104098045,"BROOKS, LESLEY, NESMITH",~,825 MERRIMON AVE STE B ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,1104098045,"BROOKS, LESLEY, NESMITH",825 MERRIMON AVE STE B ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104099761,"STARNES, HOLLY, HALL",1540 SUNDAY DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 61 , 81 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104099936,"WARREN, WARD, RANDALL",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1104100171,"JEROME, CRAIG, HANSON",1525 APEX PEAKWAY   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 22 , 35 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1104100171,"JEROME, CRAIG, HANSON",1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 16 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104100171,"JEROME, CRAIG, HANSON",3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 22 , 36 ,$#,,
MEDICAID DIRECT,1104102540,LABORATORY CORPORATION OF AMERICA H,,1385 MEDICAL CENTER DR AT ROANOKE CLINIC ROANOKE RAPID NC,042,Halifax,291U00000X,Laboratories,Clinical Medical Laboratory,,1104102540,LABORATORY CORPORATION OF AMERICA H,1385 MEDICAL CENTER DR AT ROANOKE CLINIC ROANOKE RAPID NC,042,Halifax,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104104454,"STEIGERWALD, CHRISTINA, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1104104637,"JALAB, FERAS",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1104104637,"JALAB, FERAS",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1104104637,"JALAB, FERAS",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1104104637,"JALAB, FERAS",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1104104637,"JALAB, FERAS",6799 COLLINS AVE   MIAMI FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 29 , 33 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1104104637,"JALAB, FERAS",6799 COLLINS AVE   MIAMI FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 60 , 65 , 87 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1104104637,"JALAB, FERAS",6799 COLLINS AVE   MIAMI FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1104105337,"CHANEY, CHRISTIN, COOPER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1104105337,"CHANEY, CHRISTIN, COOPER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104105337,"CHANEY, CHRISTIN, COOPER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1104105857,"CALOMADRE, JASON, ROJAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1104105857,"CALOMADRE, JASON, ROJAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104105857,"CALOMADRE, JASON, ROJAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154042992,RDMG ASSOCIATES PA,,7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104107507,"RISEDEN, JENNIFER, CLARK",7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104108414,"HILL, STACEY, NICOLE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1104108414,"HILL, STACEY, NICOLE",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 157 , 314 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104111574,"SINGH, HARPREET, KAUR",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104111574,"SINGH, HARPREET, KAUR",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 48 , 112 , 112 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104111574,"SINGH, HARPREET, KAUR",40 DUKE MEDICINE CIR CLINIC 2B 2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 W WOODCROFT PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104111574,"SINGH, HARPREET, KAUR",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104111574,"SINGH, HARPREET, KAUR",40 DUKE MEDICINE CIR CLINIC 2B 2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 44 , 126 , 136 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1104111574,"SINGH, HARPREET, KAUR",40 DUKE MEDICINE CIR CLINIC 2B 2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104111574,"SINGH, HARPREET, KAUR",40 DUKE MEDICINE CIR CLINIC 2B 2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 51 , 51 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104112788,"CLARK, ROBERT, BRANDON",101 E WT HARRIS BLVD STE 5101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104112788,"CLARK, ROBERT, BRANDON",1830 FORDHAM BLVD STE 100 CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1073693347,EASTERN CAROLINA PEDIATRICS,EASTERN CAROLINA PEDIATRICS,1702 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1104115211,"DROHAN, SHANNON, MICHELLE",1702 MEDICAL PARK DR W   WILSON NC,098,Wilson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 43 , 116 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104115385,"BOND, AARON, EUGENE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 43 , 79 , 90 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104115682,"KELLY, DANIEL, RORY",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104115682,"KELLY, DANIEL, RORY",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 13 , 18 , 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104115682,"KELLY, DANIEL, RORY",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 45 , 77 , 104 ," $10,103.97 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104116227,"RUTHERFORD, RICHARD, WOODSON",7810 NC 751   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104116227,"RUTHERFORD, RICHARD, WOODSON",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 35 , 62 , 90 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104116227,"RUTHERFORD, RICHARD, WOODSON",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 26 , 46 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1104116227,"RUTHERFORD, RICHARD, WOODSON",7810 NC 751   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104116334,"SARICICEK, JESSICA, MARIAN FURR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 53 , 96 , 100 ,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1104116565,"ANDERSON, CAROL, FLETCHER",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649355595,DANVILLE DIAGNOSTIC IMAGING CENTER,DANVILLE DIAGNOSTIC IMAGING,125 EXECUTIVE DR STE D DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1104116730,"BELL, LEE, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104117191,"SHAH, KEVIN, PRADIP",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104122266,"LOY, CHELSEA",1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104122266,"LOY, CHELSEA",14057 HIGHWAY 17 N STE 130 HAMPSTEAD NC,071,Pender,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104129113,"BURNS, KRISTINE, HEATHER",12000 RETAIL DR   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104129113,"BURNS, KRISTINE, HEATHER",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 29 , 47 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104129139,"LANE, JEFFERY, DALE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104129139,"LANE, JEFFERY, DALE",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104130806,"WILLIAMS, BRIDGETTE, ELAINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 27 , 27 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104130806,"WILLIAMS, BRIDGETTE, ELAINE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104130806,"WILLIAMS, BRIDGETTE, ELAINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104135128,"BAUZA FELICIANO, PEDRO, A",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104135706,"WOOTEN, AARON, BARNETT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 39 , 62 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104137405,"BOATENG, STEPHEN, ASANTE",210 ASHVILLE AVE   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 68 , 105 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104137405,"BOATENG, STEPHEN, ASANTE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 37 , 53 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104137405,"BOATENG, STEPHEN, ASANTE",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104137405,"BOATENG, STEPHEN, ASANTE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 30 , 40 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104137405,"BOATENG, STEPHEN, ASANTE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 36 , 39 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1104137405,"BOATENG, STEPHEN, ASANTE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104138254,"KILIMENT, IULIANA",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,~,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104139492,"GABRIEL, ADAM, BOYD",1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1104140474,PHILLIPS HOME HEALTH CARE,PHILLIPS HOME HEALTH CARE,197C N PINE ST   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,,1104140474,PHILLIPS HOME HEALTH CARE,197C N PINE ST   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 6,659 "," 6,659 "," $422,510.28 ",,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104140821,"HENSLER, LINDSAY, MICHELLE",1912 TRADD CT   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104140821,"HENSLER, LINDSAY, MICHELLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104144625,"PAVLIS, MICHELLE, BERNADETTE",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104144625,"PAVLIS, MICHELLE, BERNADETTE",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104144625,"PAVLIS, MICHELLE, BERNADETTE",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1104145051,PROSPECT HOMECARE SERVICES LLC,~,685 N CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1104145051,PROSPECT HOMECARE SERVICES LLC,685 N CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 4,746 "," 5,339 "," $512,464.64 ",,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1104146190,"ACEVEDO, HEATHER, BRADDOCK",6845 KNIGHTDALE BLVD STE 100 KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 16 , 39 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104147867,"KINNER, ROBERT, LUKE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 41 , 53 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104147867,"KINNER, ROBERT, LUKE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 41 , 56 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104147867,"KINNER, ROBERT, LUKE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104149400,"WALKER, THANH, JENNIFER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1033344080,HUGH CHATHAM MEMORIAL HOSPITAL,YADKIN VALLEY GASTROENTEROLOGY,201 W MAIN ST   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1104150234,"ARGENTA, JOSEPH, LOUIS",201 W MAIN ST   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 151 , 214 , 248 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104151729,"VANBENCOTEN, HOLLY, MARIE OGRADY",1315 GREENSBORO RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104151729,"VANBENCOTEN, HOLLY, MARIE OGRADY",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 67 , 88 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104151794,"TODD, JUELENA, RENEE LALONE",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104151794,"TODD, JUELENA, RENEE LALONE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 82 , 94 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104151919,"MADDEN, LYNDSAY, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 69 , 105 , 150 ,$#,,
MEDICAID DIRECT,1104154202,UNITY HOME CARE INC,UNITY HOME CARE INC,4608 CEDAR AVE STE 109A WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1104154202,UNITY HOME CARE INC,4608 CEDAR AVE STE 109A WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#, 508 , 508 ," $32,273.40 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104155530,"BOONE, ANNA, WENTZ",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104155530,"BOONE, ANNA, WENTZ",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 58 , 87 , 88 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104155530,"BOONE, ANNA, WENTZ",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104155530,"BOONE, ANNA, WENTZ",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1104159540,"COOPER, REBECCA, LYNN",13741 NC HIGHWAY 50 STE A SURF CITY NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1821681271,SANDY SHORES MEDICAL CENTER AND URG,,13741 NC HIGHWAY 50 STE A HOLLY RIDGE NC,071,Pender,193200000X,Group,Multi-Specialty,,1104159540,"COOPER, REBECCA, LYNN",13741 NC HIGHWAY 50 STE A SURF CITY NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104160001,"DANA, MICHAEL, PAUL",31 CALIFORNIA AVE   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 43 , 50 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1104160001,"DANA, MICHAEL, PAUL",31 CALIFORNIA AVE   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 25 , 39 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1104160001,"DANA, MICHAEL, PAUL",31 CALIFORNIA AVE   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104160001,"DANA, MICHAEL, PAUL",57 HOWARD GAP RD   FLETCHER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1104160001,"DANA, MICHAEL, PAUL",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1104160001,"DANA, MICHAEL, PAUL",1340 PATTON AVE STE J ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 41 , 63 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104160001,"DANA, MICHAEL, PAUL",1340 PATTON AVE STE J ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 24 , 26 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,1340 PATTON AVE STE J ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104160001,"DANA, MICHAEL, PAUL",1340 PATTON AVE STE J ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1104160001,"DANA, MICHAEL, PAUL",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 118 , 199 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104160001,"DANA, MICHAEL, PAUL",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 38 , 53 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104161421,"KRINGS, JEFFREY, OWEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104161421,"KRINGS, JEFFREY, OWEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 47 , 66 ,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,60 SHUFORD RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1104162460,"PATEL, HETVI, VINODBHAI",60 SHUFORD RD   COLUMBUS NC,075,Polk,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 11 , 44 , 139 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104162981,"STEGER, MICHAEL, JOHN",7535 CARPENTER FIRE STATION RD STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 27 , 38 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1104162981,"STEGER, MICHAEL, JOHN",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 55 , 99 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104162981,"STEGER, MICHAEL, JOHN",115 KILDAIRE PARK DR STE 301 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL OF DANBURY,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1104163856,"SANDERS, DAVID, ROBERTS",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1104369081,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE PEDIATRIC CLINIC OF DANBURY,1030 HOSPICE DR   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1104163856,"SANDERS, DAVID, ROBERTS",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 25 , 41 ,$#,,
MEDICAID DIRECT,1740762160,SAVED HEALTH INC,,3755 ADMIRAL DR STE 105A HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104163856,"SANDERS, DAVID, ROBERTS",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL OF DANBURY,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1104163856,"SANDERS, DAVID, ROBERTS",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 319 , 320 ," $13,383.35 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 38 , 38 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1104164367,"SHETH, DEVAM, PARESHKUMAR",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 51 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104166099,"RAMSEY, RANDLE, WILLIAM",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104166099,"RAMSEY, RANDLE, WILLIAM",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1104166099,"RAMSEY, RANDLE, WILLIAM",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1104166099,"RAMSEY, RANDLE, WILLIAM",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104166099,"RAMSEY, RANDLE, WILLIAM",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104166099,"RAMSEY, RANDLE, WILLIAM",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 120 , 253 , 457 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104166099,"RAMSEY, RANDLE, WILLIAM",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 41 , 74 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104166172,"CUEVAS, JONATHAN, TRENT",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104166172,"CUEVAS, JONATHAN, TRENT",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104166172,"CUEVAS, JONATHAN, TRENT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 16 , 20 ,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104166172,"CUEVAS, JONATHAN, TRENT",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104166172,"CUEVAS, JONATHAN, TRENT",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1104167592,"MELVIN, BARBARA, FRANCES",50 HOSPITAL DR STE 5D HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 31 , 38 ,$#,,
MEDICAID DIRECT,1902382146,DAVIS OPHTHALMOLOGY PLLC,DAVIS OPHTHALMOLOGY PLLC,408 8TH ST STE 2 NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1104169366,"DAVIS, RONALD, TYLER",408 8TH ST STE 2 NORTH WILKESBORO NC,097,Wilkes,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 127 , 173 , 195 ,$#,,
MEDICAID DIRECT,1104169366,"DAVIS, RONALD, TYLER",~,408 8TH ST STE 2 NORTH WILKESBORO NC,097,Wilkes,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1104169366,"DAVIS, RONALD, TYLER",408 8TH ST STE 2 NORTH WILKESBORO NC,097,Wilkes,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 96 , 133 , 144 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104179720,"TART, LINDSAY, BROWN",514 N BRIGHTLEAF BLVD STE 1620 SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 21 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,127 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104179720,"TART, LINDSAY, BROWN",127 E MARKET ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 46 , 71 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104179720,"TART, LINDSAY, BROWN",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 27 , 35 ,$#,,
MEDICAID DIRECT,1104182005,COUNTRY LIVING GUEST HOME INC,Country Living Guest Home 8,618 PLANT ST   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1104182005,COUNTRY LIVING GUEST HOME INC,618 PLANT ST   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 398 , 398 ," $31,027.76 ",,
MEDICAID DIRECT,1104182005,COUNTRY LIVING GUEST HOME INC,Country Living Guest Home 8,618 PLANT ST   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1104182005,COUNTRY LIVING GUEST HOME INC,618 PLANT ST   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 921 , 921 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104182195,"BONAVENTURE, MATTHEW, EUGENE",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477395960,ACTIVE LIFE HEALTH OF CARY PLLC,ARTHRITIS KNEE PAIN CENTERS,400 ASHVILLE AVE STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104182195,"BONAVENTURE, MATTHEW, EUGENE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1104182195,"BONAVENTURE, MATTHEW, EUGENE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306202296,FLEXOGENIX NORTH CAROLINA PC,,400 ASHVILLE AVE STE 330 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104182195,"BONAVENTURE, MATTHEW, EUGENE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1104182385,"MCCARTHY, DIANA, SPAHLINGER",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104182385,"MCCARTHY, DIANA, SPAHLINGER",210 ASHVILLE AVE   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104182385,"MCCARTHY, DIANA, SPAHLINGER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104183466,"HUGHES, RACHEL, HELEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 46 , 46 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104183615,"MENOCAL, ELLEN, MARIE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104184464,"GOMEZ MENDEZ, LILIANA, MICHELLE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 29 , 77 , 123 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104184464,"GOMEZ MENDEZ, LILIANA, MICHELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 11 , 79 , 81 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104185347,"ROBERTS, CAROLINE, COLLINS",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104185347,"ROBERTS, CAROLINE, COLLINS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104185347,"ROBERTS, CAROLINE, COLLINS",322 MAIN ST   PROSPECT HILL NC,017,Caswell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 56 , 56 ,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104185396,"WALKER, JONATHAN, PIERCE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,11530 PROVIDENCE RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104185396,"WALKER, JONATHAN, PIERCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,11530 PROVIDENCE RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104185396,"WALKER, JONATHAN, PIERCE",11530 PROVIDENCE RD STE 2100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104185396,"WALKER, JONATHAN, PIERCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104185396,"WALKER, JONATHAN, PIERCE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 23 , 30 , 31 ,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104185396,"WALKER, JONATHAN, PIERCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 22 , 28 , 35 ,$#,,
MEDICAID DIRECT,1770781999,G ABRAMS DMD PA,G ABRAMS DMD PA,8170 S TRYON ST STE C CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104186261,"LAPENNA, ELIZABETH, ALLISON",7868 REA RD STE B CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,844 "," 3,610 "," 13,610 "," $671,946.03 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104187327,"CONNOR, CHELSEA, AMANDA",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 33 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104187327,"CONNOR, CHELSEA, AMANDA",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104187327,"CONNOR, CHELSEA, AMANDA",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104187327,"CONNOR, CHELSEA, AMANDA",509 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104187327,"CONNOR, CHELSEA, AMANDA",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104187699,"ANDERSON, HEATHER, KIM",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104188903,"ZHOU, JING",~,1939 HIGH HOUSE RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1104188903,"ZHOU, JING",1939 HIGH HOUSE RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 39 , 72 , 333 ," $12,042.15 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1104189497,"PFEIFFER, ANTHONY, JAMES",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 52 , 63 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104189497,"PFEIFFER, ANTHONY, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104189745,"DISHAROON, MEREDITH, LYNN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1104189745,"DISHAROON, MEREDITH, LYNN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104190925,"RIOS, NORBERT, JOEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 17 , 31 ,$#,,
MEDICAID DIRECT,1104191907,DUPLIN COUNTY PUBLIC SCHOOLS,DUPLIN COUNTY PUBLIC SCHOOLS,315 N MAIN ST   KENANSVILLE NC,031,Duplin,251300000X,Agencies,Local Education Agency (LEA),,1104191907,DUPLIN COUNTY PUBLIC SCHOOLS,315 N MAIN ST   KENANSVILLE NC,031,Duplin,251300000X,Agencies,Local Education Agency (LEA),, 233 ," 5,694 "," 6,137 "," $243,094.68 ",,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,145 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1104200815,"SANTORI, HEATHER, ANN",145 TILGHMAN DR   DUNN NC,043,Harnett,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104200815,"SANTORI, HEATHER, ANN",300 KEISLER DR STE 204 CARY NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 11 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1104200815,"SANTORI, HEATHER, ANN",400 ATTAIN ST STE 101 FUQUAY VARINA NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104200815,"SANTORI, HEATHER, ANN",300 KEISLER DR STE 204 CARY NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104200815,"SANTORI, HEATHER, ANN",300 KEISLER DR STE 204 CARY NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104200815,"SANTORI, HEATHER, ANN",300 KEISLER DR STE 204 CARY NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1104201474,"WANG, CHARLES, WEI",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 318 , 435 ," 1,178 "," $58,649.98 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1104201474,"WANG, CHARLES, WEI",104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,1223D0001X,Dental Providers,Dentist,Dental Public Health, 62 , 66 , 177 ," $10,960.39 ",,
MEDICAID DIRECT,1730362641,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104203728,"HAMLIN, CARLY, RIVET",16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 28 , 36 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104204031,"HENRY, MICHAEL, PATRICK",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104204031,"HENRY, MICHAEL, PATRICK",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104204031,"HENRY, MICHAEL, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 32 , 44 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104204031,"HENRY, MICHAEL, PATRICK",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104204031,"HENRY, MICHAEL, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 87 , 116 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104204031,"HENRY, MICHAEL, PATRICK",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104205160,"EDLUND, WENDY, SUE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104205160,"EDLUND, WENDY, SUE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104205350,"ELESWARPU, SARADA, SIVAGAMI",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104205350,"ELESWARPU, SARADA, SIVAGAMI",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 40 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104205350,"ELESWARPU, SARADA, SIVAGAMI",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104205350,"ELESWARPU, SARADA, SIVAGAMI",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1518371301,GREGORY R ABRAMS DMD IV PA,,1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104205889,"ALLEN, WILLIAM, BANKS",10125 PERIMETER PKWY STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 369 , 432 ," 2,579 "," $92,039.46 ",,
MEDICAID DIRECT,1881127942,SOUTHLAND CHATUGE EMERGENCY MEDICAL,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104207125,"CODY, WILLIAM, KYLE",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104207125,"CODY, WILLIAM, KYLE",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,75 PAINT TOWN RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1104207125,"CODY, WILLIAM, KYLE",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104207802,"MCGRAW, MARGEAUX, ROMAN",14330 OAKHILL PARK LN   HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1598474801,MCLEOD PHYSICIAN ASSOCIATES II,FLORENCE NEUROSURGERY AND SPINE AT MCLEOD HEALTH,1204 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104208776,"HINES, THOMAS, KEITH",1204 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104208800,"SCHECTER, MICHAEL, HUGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 36 , 100 , 102 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104208800,"SCHECTER, MICHAEL, HUGH",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104208800,"SCHECTER, MICHAEL, HUGH",1437 SCOTT AVE   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104208800,"SCHECTER, MICHAEL, HUGH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104208800,"SCHECTER, MICHAEL, HUGH",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104209329,"BOAZAK, MINA, MAHER",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104209329,"BOAZAK, MINA, MAHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104210558,"MAPHIS, REBECCA, BENNETT",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 76 , 136 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104210558,"MAPHIS, REBECCA, BENNETT",8114 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104210582,"EFFIONG, UTIBE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104210582,"EFFIONG, UTIBE",4105 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 34 , 59 ,$#,,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,524 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104212026,"BURKE, AIDAN",524 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 38 , 272 , 551 ," $24,131.34 ",,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,,,Unknown,193400000X,Group,Single Specialty,,1104212026,"BURKE, AIDAN",524 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 24 , 38 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",300 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 26 , 32 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104212091,"DEOCHAND, OSMANI",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 141 , 153 , 201 ,$#,,
MEDICAID DIRECT,1053142265,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL RADIOLOGY,101 ROBESON ST STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 40 , 57 , 124 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1053142265,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL RADIOLOGY,101 ROBESON ST STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104212091,"DEOCHAND, OSMANI",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104212315,"PRUETTE, MEGAN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104212711,"LYMAN, WILLIAM, BUCKLEY",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104212711,"LYMAN, WILLIAM, BUCKLEY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104212711,"LYMAN, WILLIAM, BUCKLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104212711,"LYMAN, WILLIAM, BUCKLEY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104212745,"THOMAS, KRYSTIN, LANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104212745,"THOMAS, KRYSTIN, LANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1104214337,"BAKER, RYAN, HAMILTON",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104214337,"BAKER, RYAN, HAMILTON",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104214337,"BAKER, RYAN, HAMILTON",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104214337,"BAKER, RYAN, HAMILTON",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104215649,"FLYNN, JACQUELINE, BLAIR",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104215649,"FLYNN, JACQUELINE, BLAIR",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104215649,"FLYNN, JACQUELINE, BLAIR",404 WESTWOOD AVE STE 101 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104215649,"FLYNN, JACQUELINE, BLAIR",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1104219641,"PERRET, GERARD, ANTHONY",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1104219641,"PERRET, GERARD, ANTHONY",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 313 , 401 , 695 ," $87,735.97 ",,
MEDICAID DIRECT,1235340803,LARRY J MORAY DDS MS PA,MYORTHODONTIST,120 CLINTON CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1104219641,"PERRET, GERARD, ANTHONY",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1104219641,"PERRET, GERARD, ANTHONY",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 715 , 885 ," 1,121 "," $152,666.39 ",,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1104219641,"PERRET, GERARD, ANTHONY",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1104219641,"PERRET, GERARD, ANTHONY",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 87 , 95 , 136 ," $22,615.12 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104224021,"LONOW, STEPHANIE, JO",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 269 ," 1,673 "," 1,713 "," $42,107.86 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104224021,"LONOW, STEPHANIE, JO",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104224021,"LONOW, STEPHANIE, JO",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104224203,"DORN, MATTHEW, ROBERT",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104224203,"DORN, MATTHEW, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,4016 BATTLEGROUND AVE STE G&H GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1104224906,"MACRAE, ENIKO",513 WHITE OAK ST   ASHEBORO NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,513 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104224906,"MACRAE, ENIKO",513 WHITE OAK ST   ASHEBORO NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,069 "," 2,239 "," 2,592 "," $437,968.15 ",,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,513 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104224906,"MACRAE, ENIKO",209 BALFOUR DR   ARCHDALE NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,209 BALFOUR DR   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1104224906,"MACRAE, ENIKO",513 WHITE OAK ST   ASHEBORO NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,4016 BATTLEGROUND AVE STE G&H GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1104224906,"MACRAE, ENIKO",4016 BATTLEGROUND AVE STE G&H GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 347 , 908 ," 1,064 "," $156,377.48 ",,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,513 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104224906,"MACRAE, ENIKO",4016 BATTLEGROUND AVE STE G&H GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1104225507,AGAPE IN HOME HEALTHCARE LLC,,3010 MONROE RD STE 107C CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1104225507,AGAPE IN HOME HEALTHCARE LLC,3010 MONROE RD STE 107C CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 3,265 "," 3,265 "," $200,650.87 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104230705,"SULAIMAN, TAISEER, ABDULHAQ",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104230705,"SULAIMAN, TAISEER, ABDULHAQ",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1104235803,HARRIS TEETER LLC,HARRIS TEETER PHARMACY,885 WALNUT ST   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1104235803,HARRIS TEETER LLC,885 WALNUT ST   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#, 18 ,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104236223,"FIREBAUGH, HEATHER, ANDERSON",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 33 , 57 ,$#,,
MEDICAID DIRECT,1730413949,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD VASCULAR ASSOCIATES,101 WILLIAM H JOHNSON ST STE 100 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104237338,"JACKSON, WILLIAM, CARRINGTON",101 WILLIAM H JOHNSON ST STE 100 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104237395,"COLETTI, RUSSELL, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 91 , 126 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104237395,"COLETTI, RUSSELL, JAMES",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 78 , 165 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104237486,"HENISER, ERICA, ANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 21 , 28 ,$#,,
MEDICAID DIRECT,1952486946,REGIONAL ANESTHESIA PLLC,,1 COPLEY PKWY STE 310 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1104237486,"HENISER, ERICA, ANNE",2138 NC 42   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104237486,"HENISER, ERICA, ANNE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 33 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2905 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104237486,"HENISER, ERICA, ANNE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104237486,"HENISER, ERICA, ANNE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104237486,"HENISER, ERICA, ANNE",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 14 , 16 , 18 ,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 102 , 144 , 148 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 122 , 169 , 178 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 26 , 28 , 32 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 201 , 279 , 279 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 21 , 29 , 30 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 36 , 40 , 44 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1104246115,"PATEL, NEEL, JAIPRAKASH",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1104250919,MEDTRAC SOLUTIONS,~,1801 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1104250919,MEDTRAC SOLUTIONS,1801 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,, 16 , 71 , 71 ," $119,883.00 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104250968,"DAVIS, HOLLY, WARREN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 35 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104250976,"BRALICH, LORNA, FRANCES-JACQUELINE",309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1104252154,"WORTHINGTON, PHILIP, MICHAEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1104254952,"ALLEN, TONYA, LO",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104255215,ETHOS HOLDING CORP,ETHOS LABORATORIES,29 E 6TH ST   NEWPORT KY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1104255215,ETHOS HOLDING CORP,29 E 6TH ST   NEWPORT KY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1104258995,KEYSTONE LABORATORIES INC,,3 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1104258995,KEYSTONE LABORATORIES INC,3 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,, 374 ," 1,268 "," 1,969 "," $182,349.96 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,930 3RD ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104260439,"YUEN, HOI TIK, HYDE",930 3RD ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104260439,"YUEN, HOI TIK, HYDE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 24 , 49 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104261593,"PELUSO, CHRISTOPHER, FRANCIS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 47 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104261593,"PELUSO, CHRISTOPHER, FRANCIS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 32 ,$#,,
MEDICAID DIRECT,1649201146,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ARDREY KELL FAMILY MEDI,8930 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104263946,"LAWRENCE, KATHRYN, VIRGINIA",8930 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 25 ,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104265891,"TAYLOR, DESTRY, GABRIELLE",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1104265909,"SMITH, NAKIA",600 HOSPITAL DR   MONROE NC,090,Union,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104265909,"SMITH, NAKIA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104265909,"SMITH, NAKIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104265909,"SMITH, NAKIA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104265909,"SMITH, NAKIA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104265909,"SMITH, NAKIA",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104266071,"MCINTYRE, BRITTANY, JOHNSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 122 , 210 , 327 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104266071,"MCINTYRE, BRITTANY, JOHNSON",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104266071,"MCINTYRE, BRITTANY, JOHNSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104266428,"MUNJAL, SAHIL",791 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 43 , 51 , 53 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104266683,"CLEMENTS, KIMBERLY, MAE",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 126 , 512 , 513 ," $13,589.41 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1142 N BROOME ST   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1104268663,"CHIMERA, JENNIFER, KATHRYN",1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104270974,"DUGAL, TABITHA",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104270974,"DUGAL, TABITHA",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104270974,"DUGAL, TABITHA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 49 , 110 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104271030,"GALLAGHER, CAITLYN, MOONEYHAM",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 28 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104271030,"GALLAGHER, CAITLYN, MOONEYHAM",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 16 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104271097,"HALSEY-NICHOLS, REBA, MAGLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 55 , 60 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104271303,"WINBORNE, COURTLAND, DAVIS",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 54 , 83 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104271584,"SCHLEICHER, EMILY, GROVES",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104271584,"SCHLEICHER, EMILY, GROVES",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104271584,"SCHLEICHER, EMILY, GROVES",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1477318541,LINDSAY NICHOLE LEE RAMSBOTTOM DMD,MARITIME PEDIATRIC DENTISTRY,4252 ARENDELL ST STE I MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1104271915,"LEE-RAMSBOTTOM, LINDSAY, NICHOLE",4252 ARENDELL ST STE I MOREHEAD CITY NC,016,Carteret,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1104271915,"LEE-RAMSBOTTOM, LINDSAY, NICHOLE",,4252 ARENDELL ST STE I MOREHEAD CITY NC,016,Carteret,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1104271915,"LEE-RAMSBOTTOM, LINDSAY, NICHOLE",4252 ARENDELL ST STE I MOREHEAD CITY NC,016,Carteret,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 969 ," 2,049 "," 8,686 "," $380,465.95 ",,
MEDICAID DIRECT,1114598612,HARRINGTON & WILHARM DDS PA,COASTAL PEDIATRIC DENTISTRY,3067 SOUTHPORT SUPPLY RD SE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1104271915,"LEE-RAMSBOTTOM, LINDSAY, NICHOLE",3067 SOUTHPORT SUPPLY RD SE   BOLIVIA NC,010,Brunswick,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272285,"NARAYANAN, ARVIND, SAI",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272285,"NARAYANAN, ARVIND, SAI",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272285,"NARAYANAN, ARVIND, SAI",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272285,"NARAYANAN, ARVIND, SAI",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104272285,"NARAYANAN, ARVIND, SAI",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272285,"NARAYANAN, ARVIND, SAI",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272285,"NARAYANAN, ARVIND, SAI",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1104272400,"WILSON, AXIA, LEAH",1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 22 ,$#,,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1104272400,"WILSON, AXIA, LEAH",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 44 , 66 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272582,"COTTON, CARY, CHRISTOPHER",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272582,"COTTON, CARY, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 49 , 73 , 83 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1104272582,"COTTON, CARY, CHRISTOPHER",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104273549,"FEINBERG, SEAN, ALEXANDER",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104273549,"FEINBERG, SEAN, ALEXANDER",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104273549,"FEINBERG, SEAN, ALEXANDER",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 79 , 86 , 114 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 39 , 47 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 15 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104275528,"WALTZ, JEFFREY, THOMAS",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,180 FOY DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104276823,"SRIDHAR, AKSHAY",180 FOY DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,, 136 , 263 , 605 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104276823,"SRIDHAR, AKSHAY",180 FOY DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,, 39 , 75 , 135 ,$#,,
MEDICAID DIRECT,1902869530,CARY SKIN CENTER PA,~,200 WELLESLEY TRADE LN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1104278803,"JAGET, WENDY, LEIGH",200 WELLESLEY TRADE LN   CARY NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 14 ,$#,,
MEDICAID DIRECT,1891287520,DLP PERSON PHYSICIAN PRACTICES LLC,~,503 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104280155,"TRAN, JONATHAN, NAM-HAI",503 RIDGE RD   ROXBORO NC,073,Person,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 57 , 112 , 227 ,$#,,
MEDICAID DIRECT,1558750893,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM ORTHOPAEDICS,120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1104280155,"TRAN, JONATHAN, NAM-HAI",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104280585,"BUTLER, JOHN, MICHAEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 125 , 138 , 151 ," $11,792.45 ",,
MEDICAID DIRECT,1841733714,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE COMMUNITY HOSPITAL OF STOKES,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1104280585,"BUTLER, JOHN, MICHAEL",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104280825,"MITCHELL, JERRELL, LEE",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104285030,"KAYS, DAVID, MICHAEL",270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 173 , 288 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1104285709,"VERINK, SARAH, MULKEY",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1104288604,"COLE, DEVON, JACOB",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 130 , 147 , 187 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1104288604,"COLE, DEVON, JACOB",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 102 , 118 , 156 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1104288604,"COLE, DEVON, JACOB",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 54 , 73 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 47 , 58 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1104288604,"COLE, DEVON, JACOB",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 67 , 71 , 83 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1104288604,"COLE, DEVON, JACOB",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104288604,"COLE, DEVON, JACOB",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1104288604,"COLE, DEVON, JACOB",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104289107,"MARTINEZ, JULIO, FERNANDO",5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104289107,"MARTINEZ, JULIO, FERNANDO",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 12 , 40 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104289164,"RAMANATHAN, DEEPAK",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 40 , 101 , 191 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104289164,"RAMANATHAN, DEEPAK",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 28 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104289289,"GARBARINO, STEPHANIE, MICHELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104289289,"GARBARINO, STEPHANIE, MICHELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 20 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104289289,"GARBARINO, STEPHANIE, MICHELLE",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104293992,"STITES, KIMBERLY, SUSAN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1104294230,"NAVEY, ASHLEY, TRIPLETT",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104303254,"DURLING, JENNIFER, ANN-LOUISE",200 TRENT DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 224 , 224 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104303254,"DURLING, JENNIFER, ANN-LOUISE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1104303361,"PRICE, TISHA, QUARLES",1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1104303361,"PRICE, TISHA, QUARLES",1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104303361,"PRICE, TISHA, QUARLES",1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104303361,"PRICE, TISHA, QUARLES",1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104311109,"FRENZEL, ZACHARY, ARTHUR",101 E W T HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104311109,"FRENZEL, ZACHARY, ARTHUR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104311109,"FRENZEL, ZACHARY, ARTHUR",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104311109,"FRENZEL, ZACHARY, ARTHUR",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1104311539,"BRADSHAW, MICHAEL",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104311539,"BRADSHAW, MICHAEL",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104314467,"SHARMA CHAPAGAIN, DIPENDRA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609386424,SPARTANBURG MEDICAL CENTER,MGC-ORTHOPAEDIC SURGERY- NORTH GROVE,1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1104315118,"MACDONELL, ROBERT, THOMPSON",1330 BOILING SPRINGS ROAD SUITE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1104315688,"ARTHUR, OMOFOLARIN, ABDUL-HAKEEM",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1104315688,"ARTHUR, OMOFOLARIN, ABDUL-HAKEEM",1411 GREENWAY CT   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1104315688,"ARTHUR, OMOFOLARIN, ABDUL-HAKEEM",555 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1104316207,"QUOW, KRYSTINA, LAUREN",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 55 , 79 , 124 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104316223,"RUPNARAIN, SASKIA, ANNETTE",2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 87 , 172 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104316223,"RUPNARAIN, SASKIA, ANNETTE",2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104316397,"CABRALES, ARIANNA, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 31 , 34 ,$#,,
MEDICAID DIRECT,1881278299,ARCHWELL HEALTH PROFESSIONAL SERVIC,,3022 EASTWAY DR STE 1-3 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104318831,"ESUNJU, SPORA, MBOE",3022 EASTWAY DR STE 1-3 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 18 , 39 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104318831,"ESUNJU, SPORA, MBOE",3022 EASTWAY DR STE 1-3 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104318831,"ESUNJU, SPORA, MBOE",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104318831,"ESUNJU, SPORA, MBOE",1420 E FRANKLIN ST   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1194801852,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CLAYTON,31 OLEANDER DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104319516,"BEHAIRY, RADWA, SAMY",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 27 , 91 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104320563,"BALAVAGE, KRISTI, THERESA",1718 E 4TH ST STE 907 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104320563,"BALAVAGE, KRISTI, THERESA",6324 FAIRVIEW RD STE 430 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 19 , 32 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104320563,"BALAVAGE, KRISTI, THERESA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104321538,"PATTON, SERGIO, RODRIGO",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 118 , 252 ,$#,,
MEDICAID DIRECT,1376870832,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH PRESBYTERIAN INTERNAL MEDICINE,1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104321538,"PATTON, SERGIO, RODRIGO",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104321595,"DILIZIA, E, MATTHEW",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 16 , 31 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104321595,"DILIZIA, E, MATTHEW",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 28 , 41 , 78 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104322312,"MCCALLUM, LINDSAY, RUTH",101 BETHESDA DR   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 59 , 107 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104323401,"FOSTER, ROBERT, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 14 , 22 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104323997,"KOPENITZ, JASON, LEE",N2198 UNC HOSPITALS CB# 7010 CHAPEL HILL NC,019,Chatham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 57 , 63 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104325463,"WESSEL, JANE, ALEXANDRA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1104325463,"WESSEL, JANE, ALEXANDRA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104325463,"WESSEL, JANE, ALEXANDRA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104337021,"BLACK, KAYLAH, MCKINLEY",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104337021,"BLACK, KAYLAH, MCKINLEY",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891287520,DLP PERSON PHYSICIAN PRACTICES LLC,~,503 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104338094,"DEPASQUALE, MICHAEL, CHARLES",503 RIDGE RD   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104338094,"DEPASQUALE, MICHAEL, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 74 , 74 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104338094,"DEPASQUALE, MICHAEL, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 41 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104338094,"DEPASQUALE, MICHAEL, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104339084,"MAYNARD, MARK, CURRY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 92 , 97 , 103 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104341213,"MOORE, HEATHER, LYNNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003239096,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST BEHAVIORAL MEDIC,1208 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104342617,"PALMER, SUSANNE, LAREE",1208 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1790212462,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104344241,"SHEBA, MOAMEN, ESMAT",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#, 22 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104344241,"SHEBA, MOAMEN, ESMAT",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#, 17 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1104345180,"LANDON, LAURA, FOX",703 NEWMAN RD   NEW BERN NC,025,Craven,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 51 , 64 , 177 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104349000,"EMERMAN, MICHELLE, ALYSSA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 50 , 52 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104349000,"EMERMAN, MICHELLE, ALYSSA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104350438,"MILLER, JAMISON, COLE",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 29 , 42 , 87 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104350438,"MILLER, JAMISON, COLE",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104350768,"NOMAAN, YAHYA, RAHMAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104352384,"FIRTHA, MICHAEL, ELI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 56 , 80 , 113 ," $11,076.37 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104352384,"FIRTHA, MICHAEL, ELI",503 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1104352954,"MOORE, CLEA, J",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104352954,"MOORE, CLEA, J",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104352954,"MOORE, CLEA, J",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104352954,"MOORE, CLEA, J",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104352954,"MOORE, CLEA, J",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 21 , 28 ,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104352954,"MOORE, CLEA, J",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104352954,"MOORE, CLEA, J",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104352954,"MOORE, CLEA, J",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104352954,"MOORE, CLEA, J",8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104354356,"APTE, POORVA, JAYANT",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104354356,"APTE, POORVA, JAYANT",40 DUKE MEDICINE CIR # 1J DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104354356,"APTE, POORVA, JAYANT",10207 CERNY ST STE 102 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104354356,"APTE, POORVA, JAYANT",10207 CERNY ST STE 102 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 28 , 35 , 65 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 131 , 143 , 180 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1104354729,"ZERONA, NICHOLAS, MICHALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649428194,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES,800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104354760,"KAUFMAN, MATTHEW, ERIC",800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104356393,"CHAPPELL, MISTY, SEVERT",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104356393,"CHAPPELL, MISTY, SEVERT",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 55 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104356393,"CHAPPELL, MISTY, SEVERT",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 95 , 179 , 268 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104356393,"CHAPPELL, MISTY, SEVERT",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104356393,"CHAPPELL, MISTY, SEVERT",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104356393,"CHAPPELL, MISTY, SEVERT",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104356393,"CHAPPELL, MISTY, SEVERT",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104356518,"BOCANEGRA ENGLISH, LINDA, VANESSA",1975 GLENN MITCHELL DR STE 202 PRINCESS ANNE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104356518,"BOCANEGRA ENGLISH, LINDA, VANESSA",1975 GLENN MITCHELL DR STE 202 PRINCESS ANNE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104356518,"BOCANEGRA ENGLISH, LINDA, VANESSA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104356625,"LANDRETH, MICHAEL, BRANDON",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice," 1,473 "," 2,169 "," 6,564 "," $367,209.63 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104357706,"BOYLE, JOHN, VINCENT",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 51 , 69 , 94 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104357706,"BOYLE, JOHN, VINCENT",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104358910,"JACOB, ANCY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 122 , 122 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104358910,"JACOB, ANCY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 94 , 94 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104358944,"GODFREY, TAMARA, FAITH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 70 , 147 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104358944,"GODFREY, TAMARA, FAITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 65 , 71 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104365121,"WARD, JESSICA, ZANETTO",2105 BRAXTON LN   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 27 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104365121,"WARD, JESSICA, ZANETTO",2105 BRAXTON LN   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104365121,"WARD, JESSICA, ZANETTO",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104365121,"WARD, JESSICA, ZANETTO",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104365121,"WARD, JESSICA, ZANETTO",2105 BRAXTON LN   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104365121,"WARD, JESSICA, ZANETTO",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 16 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104365121,"WARD, JESSICA, ZANETTO",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,214 E ELM ST   GRAHAM NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104366038,"CANNADY, JOLENE, TADZIA",214 E ELM ST   GRAHAM NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 58 , 141 , 197 ,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,1041 KIRKPATRICK RD STE 250 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104366038,"CANNADY, JOLENE, TADZIA",214 E ELM ST   GRAHAM NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 23 , 30 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104366038,"CANNADY, JOLENE, TADZIA",214 E ELM ST   GRAHAM NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 56 , 64 ,$#,,
MEDICAID DIRECT,1104366335,ENHANCED CARE LLC,,1102 W HAMLET AVE   HAMLET NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1104366335,ENHANCED CARE LLC,1102 W HAMLET AVE   HAMLET NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,, 80 ," 17,997 "," 18,591 "," $1,724,573.68 ",,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104368281,"ALMEIDA, ALLISON, SHEA",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 41 , 41 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1104368281,"ALMEIDA, ALLISON, SHEA",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 105 , 120 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 VETERANS PKWY STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1104368281,"ALMEIDA, ALLISON, SHEA",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104368281,"ALMEIDA, ALLISON, SHEA",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 64 , 64 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104368281,"ALMEIDA, ALLISON, SHEA",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 65 , 65 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104368281,"ALMEIDA, ALLISON, SHEA",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 NC HIGHWAY 42 W STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1104368281,"ALMEIDA, ALLISON, SHEA",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104370782,"CAROTHERS, BRITTANY, NOLAN",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104370782,"CAROTHERS, BRITTANY, NOLAN",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104370782,"CAROTHERS, BRITTANY, NOLAN",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104370782,"CAROTHERS, BRITTANY, NOLAN",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1104370782,"CAROTHERS, BRITTANY, NOLAN",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3420 TEN TEN RD STE 318 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104370782,"CAROTHERS, BRITTANY, NOLAN",3420 TEN TEN RD STE 318 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1104370782,"CAROTHERS, BRITTANY, NOLAN",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104375112,"GREEN HARMAN, KELSEY, ELENA",1995 WELLNESS BLVD STE 110&210 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 110 , 231 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104375112,"GREEN HARMAN, KELSEY, ELENA",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104375112,"GREEN HARMAN, KELSEY, ELENA",6404 ALBEMARLE RD STE JM CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 51 , 92 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104375211,"LOVE, RYAN, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104377720,"PATEL, VAISHALI",510 TIMBER DR E STE 102 GARNER NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 67 , 192 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104379502,"BUCHANAN, DEREK, JOHN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104379502,"BUCHANAN, DEREK, JOHN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104379502,"BUCHANAN, DEREK, JOHN",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104379502,"BUCHANAN, DEREK, JOHN",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 17 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104381375,"NAGY, KASEY, BRIGGS",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386158616,CAROLINA ELITE WOMENS CARE,,901 US 70 HWY W STE 100 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1104381375,"NAGY, KASEY, BRIGGS","901 US 70 HWY W, STE 100   GARNER NC",092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316296635,CAPE FEAR CLINIC INC,,1605 DOCTORS CIR   WILMINGTON NC,065,New Hanover,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1104382308,"GIBSON, CAITLIN, GALLAGHER",1605 DOCTORS CIR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1316296635,CAPE FEAR CLINIC INC,,1605 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104382308,"GIBSON, CAITLIN, GALLAGHER",1605 DOCTORS CIR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 34 , 62 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104383744,"TUSHEK, BRANDON, WILLIAM",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1104383744,"TUSHEK, BRANDON, WILLIAM",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104383744,"TUSHEK, BRANDON, WILLIAM",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104386358,"WU, SHUO-CHIEH",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104386523,"GINN, ELEANOR, CHRISTINE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104386523,"GINN, ELEANOR, CHRISTINE",7110 LAWYERS RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 83 , 176 ,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104386614,"PHILLIPS, JORDAN, COLEMAN",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,1430 FELICITY LN   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104386614,"PHILLIPS, JORDAN, COLEMAN",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104386614,"PHILLIPS, JORDAN, COLEMAN",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104386614,"PHILLIPS, JORDAN, COLEMAN",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104387133,"CHERRY, KIESHA, NICOLE",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104387133,"CHERRY, KIESHA, NICOLE",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 41 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104387133,"CHERRY, KIESHA, NICOLE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104387133,"CHERRY, KIESHA, NICOLE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104388263,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - TAYLORSVILLE,50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104388263,GASTON FAMILY HEALTH SERVICES INC,50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 80 , 203 , 203 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104388933,"ALIMOHAMED, SAIF, IQBAL",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104389782,"WYATT, NICOLE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104389782,"WYATT, NICOLE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104389782,"WYATT, NICOLE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104389782,"WYATT, NICOLE, ELIZABETH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104391556,"WILLIAMS, JAMES",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104391556,"WILLIAMS, JAMES",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104391556,"WILLIAMS, JAMES",1650 LIBERTY DR STE 100 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 46 , 86 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104391556,"WILLIAMS, JAMES",1650 LIBERTY DR STE 100 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 123 , 203 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104391754,"STINGONE, TAMMY, LEE",288 SIXTH ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,551 KENT ST   ANDREWS NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1104391754,"STINGONE, TAMMY, LEE",288 SIXTH ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1104391754,"STINGONE, TAMMY, LEE",288 SIXTH ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1104391754,"STINGONE, TAMMY, LEE",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104391754,"STINGONE, TAMMY, LEE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1104391754,"STINGONE, TAMMY, LEE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1649430489,LIVING WELL BEHAVIORALHEALTH INC,,502 MCKNIGHT DR STE 201-202 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1104392588,"KOHUTH, KRISTINA, ALYSE",502 MCKNIGHT DR STE 202 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 259 , 409 ," $25,968.51 ",,
MEDICAID DIRECT,1649430489,LIVING WELL BEHAVIORALHEALTH INC,,502 MCKNIGHT DR STE 201-202 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104392588,"KOHUTH, KRISTINA, ALYSE",502 MCKNIGHT DR STE 202 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 24 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104392588,"KOHUTH, KRISTINA, ALYSE",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1104396753,LABORATORY CORPORATION OF AMERICA H,,2500 HORTON BLVD SW   WILSON NC,098,Wilson,291U00000X,Laboratories,Clinical Medical Laboratory,,1104396753,LABORATORY CORPORATION OF AMERICA H,2500 HORTON BLVD SW   WILSON NC,098,Wilson,291U00000X,Laboratories,Clinical Medical Laboratory,, 24 , 25 , 26 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104402189,"BRIDGETT, SHELBY, LEE",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 23 , 30 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104402189,"BRIDGETT, SHELBY, LEE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104405067,"NOORALI, ANIKA, ANWAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 46 , 46 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104405067,"NOORALI, ANIKA, ANWAR",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,3541 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104405927,"KHASHMANIAN, ROZIE, ANNA",3541 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104406131,"ARTIS, JAMES, DECARLO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104406131,"ARTIS, JAMES, DECARLO",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104406230,"ISAACS, MATTHEW",7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 49 , 112 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1104408657,"GRAY MILLER, MELANIE, DOLORES",203 EARNHART DR STE A EDENTON NC,021,Chowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104408657,"GRAY MILLER, MELANIE, DOLORES",203 EARNHART DR STE A EDENTON NC,021,Chowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 19 , 32 ,$#,,
MEDICAID DIRECT,1104408988,HOMECHOICE OF THE SANDHILLS LLC,~,340 COMMERCE AVE STE 14A SOUTHERN PINES NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,1104408988,HOMECHOICE OF THE SANDHILLS LLC,340 COMMERCE AVE STE 14A SOUTHERN PINES NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 11,681 "," 11,784 "," $963,167.56 ",,
MEDICAID DIRECT,1104409911,SIDE BY SIDE SENIOR SERVICES LLC,,9635 SOUTHERN PINE BLVD STE 106 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1104409911,SIDE BY SIDE SENIOR SERVICES LLC,9635 SOUTHERN PINE BLVD STE 106 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,415 "," 3,415 "," $196,931.76 ",,
MEDICAID DIRECT,1154721272,URGENT CARE DOWN EAST INC,,853 WASHINGTON SQUARE MALL   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1104411479,"SATTERWHITE, MARIAH, JEAN",853 WASHINGTON SQUARE MALL   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104412493,"STANFORD, ELISE, DESJARDINS",227 W 4TH ST STE 308 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104412816,"DECKER, KASAUNDRA, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104413251,"COBB, CAMERON, DANIEL",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104413251,"COBB, CAMERON, DANIEL",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104413251,"COBB, CAMERON, DANIEL",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1104413814,"WILKINS, EMILY, GRACE",38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 110 , 199 , 214 ,$#,,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1104413814,"WILKINS, EMILY, GRACE",91 WESTRIDGE MARKET PL # 20 CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104414549,HEAVENLY SENT HOME CARE,,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1104414549,HEAVENLY SENT HOME CARE,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 850 , 850 ," $56,280.24 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104417302,"WALKER, MAGHAN, PLACE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 82 , 100 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104417302,"WALKER, MAGHAN, PLACE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 34 , 39 ,$#,,
MEDICAID DIRECT,1811151244,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE MOORESVILLE INTERNAL ME,170 MEDICAL PARK RD STE 140A MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104417799,"HARRIS, PAULA, GLOVER",170 MEDICAL PARK RD STE 140A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 36 , 58 ,$#,,
MEDICAID DIRECT,1689445520,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY LEGACY PEDIATRICS,556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104419472,"WISE, ELIZABETH, ANN",556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 38 , 71 ,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104419472,"WISE, ELIZABETH, ANN",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689445520,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY LEGACY PEDIATRICS,1095 N BRAGG BLVD STE 104 SPRING LAKE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104419472,"WISE, ELIZABETH, ANN",1095 N BRAGG BLVD STE 104 SPRING LAKE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013086321,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5500 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104419498,"BLATT, ABBEY, JO",5500 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 23 , 52 ,$#,,
MEDICAID DIRECT,1669808143,SYLVA EMERGENCY GROUP LLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1104419894,"SAWYER, KENNETH, WALTER",68 HOSPITAL RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 50 , 53 ,$#,,
MEDICAID DIRECT,1396041075,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH CENTRA CARE,436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104419894,"SAWYER, KENNETH, WALTER",436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 68 , 147 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104421510,"GRAHAM, TAMMY, TERESA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104421510,"GRAHAM, TAMMY, TERESA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104421510,"GRAHAM, TAMMY, TERESA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104421510,"GRAHAM, TAMMY, TERESA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104428614,"FOGLE, KATHERINE, MCGRATH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104428614,"FOGLE, KATHERINE, MCGRATH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 46 , 77 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104434703,"BROWN, WILLIAM, LUKE",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 65 , 111 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104434703,"BROWN, WILLIAM, LUKE",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104434703,"BROWN, WILLIAM, LUKE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104434703,"BROWN, WILLIAM, LUKE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104434703,"BROWN, WILLIAM, LUKE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104434703,"BROWN, WILLIAM, LUKE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104435114,"LEBLANC, AMY, FELICE",3311 BEAM RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104435114,"LEBLANC, AMY, FELICE",3311 BEAM RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1104435163,"VERDEYEN, ELYSE, MARIE",41 BAIN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 106 ,$#,,
MEDICAID DIRECT,1104435635,BRIDGE TO CARE HOME CARE LLC,,910 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1104435635,BRIDGE TO CARE HOME CARE LLC,910 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 434 , 434 ," $35,044.80 ",,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104437284,"LUCEY, SAMANTHA",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104437326,"CLARKE, NICOLE, DEANNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1104441781,"TANEJA, ISHITA, ZEM",1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 89 , 186 , 236 ," $39,310.32 ",,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1104441781,"TANEJA, ISHITA, ZEM",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 189 , 345 , 392 ," $94,819.59 ",,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1104441781,"TANEJA, ISHITA, ZEM",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1376768424,DRS SCHEFFLER AND WHITELEY,DRS SCHEFFLER & WHITELEY,373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1104441781,"TANEJA, ISHITA, ZEM",1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 66 , 66 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",3031 TATE BLVD SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 55 , 55 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",3430 LESTER ST   CONOVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 33 , 33 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 114 , 116 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",279 BRIAN CENTER DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,279 BRIAN CENTER DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1104441922,"GAUSE, OLIVIA, MARIE",279 BRIAN CENTER DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104441930,"RAMPHAL, VASHTI, WANDA",105 MARK DR   EDENTON NC,021,Chowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 81 , 146 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104443100,"LYERLY, CHARLES, JONATHAN",1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 26 , 30 , 38 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104447366,"MANDHAN, WARSHA KUMARI",11840 SOUTHMORE DR STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 30 , 75 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104447705,"BASARABA, IULIA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 57 , 57 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104447705,"BASARABA, IULIA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104447705,"BASARABA, IULIA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104448042,"SUNDIL, SUBRINA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 29 , 29 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104448042,"SUNDIL, SUBRINA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",3211 BISHOPS WAY LN STE 2000 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 21 , 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104448166,"PHARRIS, MEGAN, CORIELL",3211 BISHOPS WAY LN STE 2000 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104450998,"CALPIN, KRISTIN, EILEEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 34 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104450998,"CALPIN, KRISTIN, EILEEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104451061,"FRAZER, ANGELA, MARIE",2340 SPRING FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326416116,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD VASCULAR ASSOCIATES SEACOAST,107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104451483,"LEWIS, TRACEY, MICHELLE",3980 HIGHWAY 9 E STE 310 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1104451830,"POWERS, JEREMIAH, DAVID",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 41 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 34 , 44 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 32 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104452184,"PATERSON, ROBERT, CLAYTON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 31 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1104454339,"SKINNER, JASMINE, CIERA BRYANT",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104454339,"SKINNER, JASMINE, CIERA BRYANT",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 111 , 192 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104454750,"HARDILO, HENOK, DESTA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,214 E ELM ST   GRAHAM NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104454842,"HOLDSWORTH, KAREN, LEIGH",214 E ELM ST   GRAHAM NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 80 , 133 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104454842,"HOLDSWORTH, KAREN, LEIGH",214 E ELM ST   GRAHAM NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 58 , 70 ,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,1041 KIRKPATRICK RD STE 250 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104454842,"HOLDSWORTH, KAREN, LEIGH",214 E ELM ST   GRAHAM NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104455385,"MOORE, COREY, SCOTT",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 26 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104455385,"MOORE, COREY, SCOTT",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 45 , 49 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104455385,"MOORE, COREY, SCOTT",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104457001,RURAL CAROLINA AMBULANCE SERVICE,,312 ACADEMY ST S STE B AHOSKIE NC,046,Hertford,3416L0300X,Transportation Services,Ambulance,Land Transport,1104457001,RURAL CAROLINA AMBULANCE SERVICE,312 ACADEMY ST S STE B AHOSKIE NC,046,Hertford,3416L0300X,Transportation Services,Ambulance,Land Transport, 244 , 357 , 684 ," $26,088.66 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1104457068,"FRAZER, TOD, WARD",1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 89 , 96 , 206 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104457068,"FRAZER, TOD, WARD",1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 22 , 52 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104461656,"WILLIAMSON, LORI, REBECCA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104461656,"WILLIAMSON, LORI, REBECCA",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104461656,"WILLIAMSON, LORI, REBECCA",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1104462506,ARTIS MEDICAL EQUIPMENT LLC,,1047 MURCHISON RD STE 106 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1104462506,ARTIS MEDICAL EQUIPMENT LLC,1047 MURCHISON RD STE 106 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 86 , 686 ," 1,368 "," $106,795.91 ",,
MEDICAID DIRECT,1104462506,ARTIS MEDICAL EQUIPMENT LLC,,1047 MURCHISON RD STE 106 FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1104462506,ARTIS MEDICAL EQUIPMENT LLC,1047 MURCHISON RD STE 106 FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 59 , 262 , 262 ," $125,876.63 ",,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104467802,"DRUMM, TONI, ANNE",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 23 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104468966,"RUSEV, DAVID, PETROVICH",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104468966,"RUSEV, DAVID, PETROVICH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104468966,"RUSEV, DAVID, PETROVICH",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104468966,"RUSEV, DAVID, PETROVICH",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104468966,"RUSEV, DAVID, PETROVICH",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104468966,"RUSEV, DAVID, PETROVICH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 50 , 53 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104470392,"DUBOSE, CLAIRE, LAWSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104470392,"DUBOSE, CLAIRE, LAWSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104470392,"DUBOSE, CLAIRE, LAWSON",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104470392,"DUBOSE, CLAIRE, LAWSON",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104478395,"FANA, MEAGAN, LEIGH",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 32 ,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104478882,"LYTLE, KAITLYN, KIRBY",702 N MAIN ST   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104480862,"BROWN, KATIE, DAWN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245734995,CALDWELL MEMORIAL HOSPITAL,CALDWELL ONCOLOGY ASSOCIATES,212 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104480862,"BROWN, KATIE, DAWN",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861268245,CALDWELL MEMORIAL HOSPITAL,PLUS URGENT CARE HICKORY,36 14TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104480862,"BROWN, KATIE, DAWN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104480862,"BROWN, KATIE, DAWN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104480862,"BROWN, KATIE, DAWN",160 RIVER BEND DR STE D GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104480862,"BROWN, KATIE, DAWN",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104480862,"BROWN, KATIE, DAWN",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 77 , 97 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104481001,"LINDSEY, CONNOR, WILLARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104482694,"DAY, TAYLOR, JAMES",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 73 , 92 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1104482694,"DAY, TAYLOR, JAMES",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 28 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104488188,"HALL, BIANCA, ELENA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 31 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104488188,"HALL, BIANCA, ELENA",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104488188,"HALL, BIANCA, ELENA",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104489657,"NIGATU, HANNA, YAYNSHET",5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104489657,"NIGATU, HANNA, YAYNSHET",5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104489798,"MADIGAN, KATELYN, ELAINE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104490218,"GOWDA, VENKATESH, DODDE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104490218,"GOWDA, VENKATESH, DODDE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578987848,UNC PHYSICIANS NETWORK LLC,~,7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104490366,"BOUTROS-KHOURY, HANNAH",7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 16 , 51 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104490630,"VU, THU THUY, THI",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 33 , 57 , 61 ,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104492081,"MILLS, JAMIE, ESTELLE",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104493097,"SNYDER, ASHLYN, BASSETT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104493097,"SNYDER, ASHLYN, BASSETT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1104497171,"REISSER, TIFFANY, BRINTLE",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104497171,"REISSER, TIFFANY, BRINTLE",13460 PLAZA ROAD EXT STE 100 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 50 , 94 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104497171,"REISSER, TIFFANY, BRINTLE",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104497171,"REISSER, TIFFANY, BRINTLE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104498336,"FRAYSIER, KATHLEEN, WALSH",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 15 , 15 , 51 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104500495,"BARBER, CHELSEA, BRIANNA",760 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",1224 E MAIN ST   HAVELOCK NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 45 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",1224 E MAIN ST   HAVELOCK NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 37 , 102 ,$#,,
MEDICAID DIRECT,1891282638,COASTAL CAROLINA HEALTH CARE PA,CCHC HAVELOCK PRIMARY AND URGENT CARE,1224 E MAIN ST   HAVELOCK NC,025,Craven,193400000X,Group,Single Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 29 ,$#,,
MEDICAID DIRECT,1891282638,COASTAL CAROLINA HEALTH CARE PA,CCHC HAVELOCK PRIMARY AND URGENT CARE,1224 E MAIN ST   HAVELOCK NC,025,Craven,193400000X,Group,Single Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",1224 E MAIN ST   HAVELOCK NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 32 , 54 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104500891,"FAUST, CALLIE, ROBINSON",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104501402,"FERLAZZO, MADALYN, RAE",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 31 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104501972,"OKEY AGOH, CHIGOZIRIM, AMARA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104501972,"OKEY AGOH, CHIGOZIRIM, AMARA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 26 ,$#,,
MEDICAID DIRECT,1548389125,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - 3RD AVE,111 E THIRD AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104513258,"TRAVIS, DARIAN, CHRISTINE",111 E 3RD AVE   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 24 , 26 , 26 ,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104513258,"TRAVIS, DARIAN, CHRISTINE",111 E 3RD AVE   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104513258,"TRAVIS, DARIAN, CHRISTINE",111 E 3RD AVE   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104513258,"TRAVIS, DARIAN, CHRISTINE",111 E 3RD AVE   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104513258,"TRAVIS, DARIAN, CHRISTINE",111 E 3RD AVE   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104513258,"TRAVIS, DARIAN, CHRISTINE",111 E 3RD AVE   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104513860,"CARSWELL, HEATHER, LEIGH",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 13 , 34 ,$#,,
MEDICAID DIRECT,1558750893,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM ORTHOPAEDICS,120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1104515162,"PERNELL, SAMANTHA, CAROLE",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 139 , 180 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104516152,"EVERHART, KRISTINA",316 W MAIN ST   ROCKWELL NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 76 , 205 , 339 ," $15,322.61 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104516152,"EVERHART, KRISTINA",1965 S US 29 HWY   CHINA GROVE NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1104524271,"DESILLIER, NANCY, SUSAN",584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 32 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1104524271,"DESILLIER, NANCY, SUSAN",75 EMERSON BAY RD STE 104 CAROLINA SHORES NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1104524271,"DESILLIER, NANCY, SUSAN",257 HOSPITAL DR NE STE 100 BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1104524271,"DESILLIER, NANCY, SUSAN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104525062,"NEUFANG, KATHERINE, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 39 , 42 ,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104525625,"DAVIS, LINDSAY, REA",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 59 , 67 ,$#,,
MEDICAID DIRECT,1326627399,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES- PLYMOUTH,115 ADAMS ST   PLYMOUTH NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104525625,"DAVIS, LINDSAY, REA",115 ADAMS ST   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 31 , 35 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104536176,"KEHRLEY, ANGELA, HOWLETT",533 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104536176,"KEHRLEY, ANGELA, HOWLETT",533 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,533 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104536176,"KEHRLEY, ANGELA, HOWLETT",533 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 83 , 141 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104536176,"KEHRLEY, ANGELA, HOWLETT",533 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 30 , 101 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104536176,"KEHRLEY, ANGELA, HOWLETT",533 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104538396,ROXBORO ASSISTED LIVING OPCO LLC,ROXBORO ASSISTED LIVING,5660 DURHAM RD   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1104538396,ROXBORO ASSISTED LIVING OPCO LLC,5660 DURHAM RD   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 30 ," 8,038 "," 8,038 "," $534,311.86 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104538495,"THOMAS, LAUREN, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104538495,"THOMAS, LAUREN, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104538495,"THOMAS, LAUREN, ELIZABETH",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104541598,"O'CONNELL, ERIN, NICOLE",,316 W MAIN ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1104541598,"O'CONNELL, ERIN, NICOLE",316 W MAIN ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 26 ,$#,,
MEDICAID DIRECT,1720121825,"SPARLING, PATTI, ANN",~,316 W MAIN ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1104541598,"O'CONNELL, ERIN, NICOLE",316 W MAIN ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1447784095,MOUNTAIN ADVANCED PRACTICE PLLC,MOUNTAIN ADVANCED PRACTICE PLLC,316 W MAIN ST   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1104541598,"O'CONNELL, ERIN, NICOLE",316 W MAIN ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 70 , 124 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104543545,"PRUITT, WHITNEY, BONI",270 N US 701 HWY BYP   TABOR CITY NC,024,Columbus,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 14 , 24 , 24 ,$#,,
MEDICAID DIRECT,1295113371,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER TABOR CITY,270 N US HIGHWAY 701 BYP   TABOR CITY NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104543545,"PRUITT, WHITNEY, BONI",270 N US 701 HWY BYP   TABOR CITY NC,024,Columbus,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104548718,"HESTER ALLEY, SHANNON",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 231 , 372 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104548932,"RIMAL, SHILPA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104551209,"BANZ, DOUGLAS, JOSEPH",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 59 , 59 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104551209,"BANZ, DOUGLAS, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356802300,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - MOCKSVILLE,172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104551407,"JENNINGS, CAITLIN, EVEY",552 CORNATZER RD   MOCKSVILLE NC,030,Davie,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1285270868,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CENTRAL DAVIE ACADEMY,160 MARTIN LUTHER KING JR RD   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104551407,"JENNINGS, CAITLIN, EVEY",552 CORNATZER RD   MOCKSVILLE NC,030,Davie,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104551530,"SODERBLOM, ZACHARY, CHARLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104551530,"SODERBLOM, ZACHARY, CHARLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104551530,"SODERBLOM, ZACHARY, CHARLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 30 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104552835,"TALLENT, MADISON, BLAKE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104557529,"BRITT, VICTORIA, ALICE",652 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 121 , 228 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104557529,"BRITT, VICTORIA, ALICE",114 W 30TH ST STE 800 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104557529,"BRITT, VICTORIA, ALICE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972163848,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT LONGVIEW ELEMENTARY,737 12TH ST SW   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104557701,"OAKES, LAUREN, ANNE",737 12TH ST SW   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104569201,"ISRAEL, ANASTASIIA, S",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104571652,"IANNUZZELLI, GINA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104571652,"IANNUZZELLI, GINA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104571652,"IANNUZZELLI, GINA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619443827,MH MISSION HOSPITAL MCDOWELL LLLP,,387 US 70 W   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1104572122,"LYON, BRANDI, LEIGH",387 US 70 W   MARION NC,059,McDowell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 86 , 168 , 308 ," $43,032.30 ",,
MEDICAID DIRECT,1073204715,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA COMMUNITY FAMILY CARE,2412 WILKINS DR   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1104572452,"MOTLEY, AMIE, RENAE",2412 WILKINS DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 121 , 144 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104573336,"KIM, JONATHAN, KIMIN",910 W WILLIAMS ST   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 55 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104574052,"LORDEN, DANIEL, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104574052,"LORDEN, DANIEL, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104579069,"WILSON, KIMBERLEY, MAE",6333 CENTER DR BLDG 16 NORFOLK VA,101,Out of State <= 40 miles,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104584168,"BISHOP, BRITTANY, NICHOLE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1518575265,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT BUNKER HILL HIGH,4675 OXFORD SCHOOL RD   CLAREMONT NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104584168,"BISHOP, BRITTANY, NICHOLE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 67 , 67 ," $21,462.11 ",,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1104585124,"GOMEZ, LAUREN, ELIZABETH DEMO",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104585124,"GOMEZ, LAUREN, ELIZABETH DEMO",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 27 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104585124,"GOMEZ, LAUREN, ELIZABETH DEMO",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 37 , 62 ,$#,,
MEDICAID DIRECT,1144981366,REX HEALTHCARE INC,UNC HEALTH PROSTHETICS AND ORTHOTICS LLC,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1104587369,"CHIEU, KELLIE, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104587419,"PORFILIO-STITT, COURTNEY, LYNN",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104587419,"PORFILIO-STITT, COURTNEY, LYNN",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104591874,"BERGSTROM, MAX, FREDERICK",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,118 KIRKMAN CT   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104591874,"BERGSTROM, MAX, FREDERICK",118 KIRKMAN CT   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104591874,"BERGSTROM, MAX, FREDERICK",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 64 , 121 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104591874,"BERGSTROM, MAX, FREDERICK",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104591874,"BERGSTROM, MAX, FREDERICK",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 59 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104591874,"BERGSTROM, MAX, FREDERICK",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104591874,"BERGSTROM, MAX, FREDERICK",9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104592187,"THORNBERRY, STEFAN, WILLIAM",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104594845,"WILLIAMS, KETURAH, DANYELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104594845,"WILLIAMS, KETURAH, DANYELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104596980,"SEIER, ASHLEY, ELIZABETH",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 69 , 103 ,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104601020,"KING, JOSHUA, ROBERT",8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104601871,"GALLOWAY, SHATAZAMINE, SHANNETTE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 18 , 29 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104601871,"GALLOWAY, SHATAZAMINE, SHANNETTE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104602382,"TYSON, CHELSEA, NICOLE",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730325473,APEX VISION CENTER OD PA,CLARITY VISION OF APEX,1049 BEAVER CREEK COMMONS DR CLARITY VISION APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1104602598,"BOLLENBECKER, ANNIE, JANE",1049 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1104603745,"TROWBRIDGE, KRISTIN, DOUGHTY",225 WHITE ST   JACKSONVILLE NC,067,Onslow,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 16 , 19 , 21 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1104603745,"TROWBRIDGE, KRISTIN, DOUGHTY",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 56 , 584 , 615 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1104603745,"TROWBRIDGE, KRISTIN, DOUGHTY",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 31 , 205 , 214 ," $12,656.80 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1104603745,"TROWBRIDGE, KRISTIN, DOUGHTY",225 WHITE ST   JACKSONVILLE NC,067,Onslow,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104603745,"TROWBRIDGE, KRISTIN, DOUGHTY",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1104603745,"TROWBRIDGE, KRISTIN, DOUGHTY",312 WARREN AVE   KINSTON NC,054,Lenoir,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 25 , 28 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1104603745,"TROWBRIDGE, KRISTIN, DOUGHTY",312 WARREN AVE   KINSTON NC,054,Lenoir,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 44 , 65 , 70 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104604271,"SPARKS, CHRISTY, BARKER",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,138 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104604271,"SPARKS, CHRISTY, BARKER",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 38 , 72 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104604271,"SPARKS, CHRISTY, BARKER",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104604271,"SPARKS, CHRISTY, BARKER",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 16 , 85 ,$#,,
MEDICAID DIRECT,1104605583,HOME LIFE CARE INC,,1866 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1104605583,HOME LIFE CARE INC,1866 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 75 ," 6,675 "," 6,678 "," $555,519.68 ",,
MEDICAID DIRECT,1104625037,WNC SPROUTS PEDIATRIC THERAPY PLLC,,276 TRIMONT TRL   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1104625037,WNC SPROUTS PEDIATRIC THERAPY PLLC,276 TRIMONT TRL   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1104641794,"GITTO, KRISTIE, PERNELL",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104654532,"WILLIAMS, AMANDA, DOUB",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104655869,"HAAS, LAUREN, JESSICA",1380 EASTCHESTER DR STE 103 HIGH POINT NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104656511,AUTHENTIC LOVE ROSE LLC,,2007 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1104656511,AUTHENTIC LOVE ROSE LLC,2007 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,230 "," 1,314 "," $126,917.52 ",,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104658483,"ANDERSON, MANDY, LEE",1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104658483,"ANDERSON, MANDY, LEE",1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104663624,"RIGGS, VICTORIA, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104663947,"CLIFTON, KELLIE, ANNE",1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1083917249,ARMC PHYSICIANS CARE INC,BURLINGTON FAMILY PRACTICE,1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104663947,"CLIFTON, KELLIE, ANNE",1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1104683812,"ALTMAN, MARY, KATHERINE GRAY",400 LIBERTY HILL ROAD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 59 , 188 ,$#,,
MEDICAID DIRECT,1104685585,HEPHER CARE SERVICES LLC,,186 MAJESTIC PEAK DR   GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1104685585,HEPHER CARE SERVICES LLC,186 MAJESTIC PEAK DR   GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 327 , 327 ," $47,644.24 ",,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1104688753,"HEDRICK, MARY, MCEVILLY",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 30 , 41 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1104688753,"HEDRICK, MARY, MCEVILLY",911 E ATKINS ST   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1104688753,"HEDRICK, MARY, MCEVILLY",911 E ATKINS ST   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 47 , 59 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104800135,"COOMES, KATHRYN, ELIZABETH",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104800184,"WILLIAMS, DANIEL, WALTER",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104800184,"WILLIAMS, DANIEL, WALTER",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104800184,"WILLIAMS, DANIEL, WALTER",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 257 , 268 , 382 ," $15,370.06 ",,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104800184,"WILLIAMS, DANIEL, WALTER",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104800184,"WILLIAMS, DANIEL, WALTER",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 34 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1104802859,"CRAM, MICHAEL, RAYMOND",9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",128 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 34 , 64 , 132 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104802859,"CRAM, MICHAEL, RAYMOND",128 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 33 , 47 ,$#,,
MEDICAID DIRECT,1750735064,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS HEALTHCARE SYSTEM WOUND CARE PHYSICIANS-,101 E W T HARRIS BLVD STE 5203 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104803154,"WILSON, SHEELA, BHAT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 137 , 181 ,$#,,
MEDICAID DIRECT,1184219222,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PEDIATRICS,713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1104803519,"RILEY, KATHLEEN, ANN",713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 59 , 91 , 159 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104803998,"MOULTON, ANN, MICHELLE",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104803998,"MOULTON, ANN, MICHELLE",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 20 , 20 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104803998,"MOULTON, ANN, MICHELLE",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104804467,"MINER, DANIEL, GORE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1104805670,"KAHAI, JUGTA",619-36 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104805670,"KAHAI, JUGTA",619-36 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104805670,"KAHAI, JUGTA",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 78 , 120 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104805670,"KAHAI, JUGTA",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 19 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104805670,"KAHAI, JUGTA",5710 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 59 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104805670,"KAHAI, JUGTA",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 33 ,$#,,
MEDICAID DIRECT,1154857662,PRESBYTERIAN SAMEDAY SURGERY CENTER,~,14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104806652,"JARVIS, JAYSON, SCOTT",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104806652,"JARVIS, JAYSON, SCOTT",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104808476,"ATKINS, JAMES, NORMAN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 86 , 131 , 132 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104808476,"ATKINS, JAMES, NORMAN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1104808476,"ATKINS, JAMES, NORMAN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1104810167,"DART, BENJAMIN, WALL",~,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1104810167,"DART, BENJAMIN, WALL",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104810985,"CHRIST CLEMENT, TRACY, ANN",162 LEGACY OAKS DR STE 102 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1104810985,"CHRIST CLEMENT, TRACY, ANN",3000 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 26 ,$#,,
MEDICAID DIRECT,1104811629,A 2 Z HOME MEDICAL SUPPLIES INC,US MED EXPRESS,1733 DAWSON ST   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1104811629,A 2 Z HOME MEDICAL SUPPLIES INC,1733 DAWSON ST   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 230 ," 1,975 "," 1,975 "," $216,479.97 ",,
MEDICAID DIRECT,1104811629,A 2 Z HOME MEDICAL SUPPLIES INC,US MED EXPRESS,1733 DAWSON ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1104811629,A 2 Z HOME MEDICAL SUPPLIES INC,1733 DAWSON ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 2,399 "," 21,698 "," 35,767 "," $3,542,821.87 ",,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104811959,"STEVENS, KELLY, KAROLE",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104811959,"STEVENS, KELLY, KAROLE",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104811959,"STEVENS, KELLY, KAROLE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104811959,"STEVENS, KELLY, KAROLE",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104812932,"JACKSON MOORE, LISA, ANNE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104813625,"POLITI, BARRY, JOSEPH",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 65 , 76 ,$#,,
MEDICAID DIRECT,1104814508,THE ROANOKE VALLEY RESCUE SQUAD INC,The Roanoke Valley Rescue Squad Inc,201 WASHINGTON ST   ROANOKE RAPIDS NC,042,Halifax,3416L0300X,Transportation Services,Ambulance,Land Transport,1104814508,THE ROANOKE VALLEY RESCUE SQUAD INC,201 WASHINGTON ST   ROANOKE RAPIDS NC,042,Halifax,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104815091,"MYERS, LEE, THOMAS",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 211 , 257 , 610 ," $31,069.87 ",,
MEDICAID DIRECT,1104816677,HAMLET RESCUE AND EMS,~,302 CHAMPLAIN ST   HAMLET NC,077,Richmond,3416L0300X,Transportation Services,Ambulance,Land Transport,1104816677,HAMLET RESCUE AND EMS,302 CHAMPLAIN ST   HAMLET NC,077,Richmond,3416L0300X,Transportation Services,Ambulance,Land Transport, 39 , 64 , 128 ,$#,,
MEDICAID DIRECT,1104818475,HEALTHWISE PHARMACY OF GREENVILLE I,HEALTHWISE PHARMACY,615B S MEMORIAL DR   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1104818475,HEALTHWISE PHARMACY OF GREENVILLE I,615B S MEMORIAL DR   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 789 ," 4,176 "," 6,203 "," $424,400.26 ",,
MEDICAID DIRECT,1104818475,HEALTHWISE PHARMACY OF GREENVILLE I,HEALTHWISE PHARMACY,615B S MEMORIAL DR   GREENVILLE NC,074,Pitt,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1104818475,HEALTHWISE PHARMACY OF GREENVILLE I,615B S MEMORIAL DR   GREENVILLE NC,074,Pitt,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1215476908,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE,1125 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1104820133,"MCCONVILLE, ROBERT, HOWARD",1125 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174208813,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE RHC,1125 CARTHAGE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1104820133,"MCCONVILLE, ROBERT, HOWARD",1125 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 96 , 305 , 319 ," $13,392.14 ",,
MEDICAID DIRECT,1104820752,LANCASTER COUNTY EMS,LANCASTER COUNTY EMS,3758 CHARLOTTE HWY   LANCASTER SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,1104820752,LANCASTER COUNTY EMS,3758 CHARLOTTE HWY   LANCASTER SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport, 16 , 17 , 34 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104821412,"DULA, FREDERICK, MAST",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104821412,"DULA, FREDERICK, MAST",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104821412,"DULA, FREDERICK, MAST",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104821412,"DULA, FREDERICK, MAST",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104821412,"DULA, FREDERICK, MAST",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1104821412,"DULA, FREDERICK, MAST",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104821412,"DULA, FREDERICK, MAST",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 346 , 378 , 437 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104821669,"THIES, STEVEN, DAVID",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427597111,DLP FRYE MEDICAL GROUP,FRYECARE HICKORY FAMILY PRACTICES ASSOCIATES,52 12TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104822196,"FISHER, MICHAEL, LAWRENCE",52 12TH AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427597111,DLP FRYE MEDICAL GROUP,FRYECARE HICKORY FAMILY PRACTICES ASSOCIATES,210 13TH AVENUE PL NW STE 120 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104822196,"FISHER, MICHAEL, LAWRENCE",52 12TH AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427597111,DLP FRYE MEDICAL GROUP,FRYECARE HICKORY FAMILY PRACTICES ASSOCIATES,210 13TH AVENUE PL NW STE 120 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104822196,"FISHER, MICHAEL, LAWRENCE",210 13TH AVENUE PL NW STE 120 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 53 , 62 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104822592,"WIEGERT, MICHAEL, EDWARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104822592,"WIEGERT, MICHAEL, EDWARD",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 31 , 38 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104822592,"WIEGERT, MICHAEL, EDWARD",3324 SIX FORKS RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104822733,"SZOKA, LAURIE, KAREN",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104822733,"SZOKA, LAURIE, KAREN",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1104822733,"SZOKA, LAURIE, KAREN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104822733,"SZOKA, LAURIE, KAREN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 37 , 37 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1104822733,"SZOKA, LAURIE, KAREN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,640 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",108 S STATE ST   YADKINVILLE NC,099,Yadkin,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,1909 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",1909 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 72 , 129 , 141 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",108 S STATE ST   YADKINVILLE NC,099,Yadkin,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 85 , 129 , 134 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",1909 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",737 PENN ST   MOUNT AIRY NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1801617881,KRISKA HEALTH PLLC,BLUE RIDGE SLEEP MEDICINE,708 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",708 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 81 , 151 , 171 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",640 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1801617881,KRISKA HEALTH PLLC,BLUE RIDGE SLEEP MEDICINE,1814 N BRIDGE ST   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",1814 N BRIDGE ST   ELKIN NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 14 , 19 , 20 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,640 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",640 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 28 , 45 , 47 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,,,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,640 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1104823327,"KRISKA, JAN",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104825926,"KIPREOS, NICHOLAS, THEOPHILOS",865 W LAKE DR   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 84 , 132 ,$#,,
MEDICAID DIRECT,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193400000X,Group,Single Specialty,,1104826387,"HARRIS, KIRK, RANDALL",1302 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193200000X,Group,Multi-Specialty,,1104826387,"HARRIS, KIRK, RANDALL",1302 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1104826528,"VITO, PHILLIP",PHILLIP MARION VITO DBA HOLLY SPRINGS EYE ASSOCIAT,608 HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,1104826528,"VITO, PHILLIP",608 HOLLY SPRINGS RD   HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 22 , 35 ,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1104826841,"MERRILL, PAULINE, TOWNSEND",188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1104828342,ORTHOPEDIC APPLIANCE CO INC,ORTHOPEDIC APPLICANCE COMPANY INCORPORATED,75 VICTORIA RD   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1104828342,ORTHOPEDIC APPLIANCE CO INC,75 VICTORIA RD   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 206 , 231 , 868 ," $41,232.41 ",,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104828516,"VOLLBRECHT, MARLAR, ANNE",215 S MAIN ST   MT HOLLY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 27 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104828516,"VOLLBRECHT, MARLAR, ANNE",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104828516,"VOLLBRECHT, MARLAR, ANNE",9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 52 , 74 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104828516,"VOLLBRECHT, MARLAR, ANNE",9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 24 , 34 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104829142,"TRIPP, HENRY, FRANKLIN",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 112 , 222 , 238 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104829142,"TRIPP, HENRY, FRANKLIN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104829993,"TUTTLE, HARRISON, GRAY",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104829993,"TUTTLE, HARRISON, GRAY",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 23 , 45 ,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104830165,"PANTEA, CRISTIAN, EMANUIL",4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 144 , 445 , 629 ," $12,825.09 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104831072,"DABOVA-MISSOVA, SEVDALINA, METODIEVA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104831072,"DABOVA-MISSOVA, SEVDALINA, METODIEVA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104831205,WALGREEN CO,WALGREENS 09730,207 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1104831205,WALGREEN CO,207 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104831858,"WOO, GREGORY, WESLEY",2525 COURT DR   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104831858,"WOO, GREGORY, WESLEY",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 181 , 460 , 514 ," $10,225.99 ",,
MEDICAID DIRECT,1720051154,RICHARD D ADELMAN MD,RICHARD D ADELMAN MD,7320 SIX FORKS RD STE 260 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104832534,"ADELMAN, RICHARD, D",7320 SIX FORKS RD STE 260 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 94 , 236 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104832542,"OBERMEYER, ROBERT, JOHN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104841121,"VOGEL, JOSHUA, IAN",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104841121,"VOGEL, JOSHUA, IAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073250445,CAROLINA VASCULAR CARE PLLC,,45 GUARDIAN CT STE 100 ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1104841436,"GUPTA, KARN",45 GUARDIAN CT STE 100 ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 320 , 847 ," 2,502 "," $294,842.21 ",,
MEDICAID DIRECT,1104841436,"GUPTA, KARN",~,45 GUARDIAN CT STE 100 ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,1104841436,"GUPTA, KARN",45 GUARDIAN CT STE 100 ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104841485,"KLIPSTEIN, CHRISTOPHER, AUGUST",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104841485,"KLIPSTEIN, CHRISTOPHER, AUGUST",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 59 , 64 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104842012,"MESSINA, DOUGLAS, FRANK",1717 SHIPYARD BLVD STE 350 WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 28 , 62 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104842012,"MESSINA, DOUGLAS, FRANK",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 21 , 32 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104842244,"LINDBLOM, SCOTT, SHANNON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104842244,"LINDBLOM, SCOTT, SHANNON",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 31 , 49 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104842244,"LINDBLOM, SCOTT, SHANNON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104842244,"LINDBLOM, SCOTT, SHANNON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104842244,"LINDBLOM, SCOTT, SHANNON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104842244,"LINDBLOM, SCOTT, SHANNON",1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104843556,"BUKOWSKI, TIMOTHY, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104843556,"BUKOWSKI, TIMOTHY, PAUL",505 OBERLIN RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 25 , 31 ,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104843556,"BUKOWSKI, TIMOTHY, PAUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104843556,"BUKOWSKI, TIMOTHY, PAUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104843556,"BUKOWSKI, TIMOTHY, PAUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1104844067,"WHITE, DAVID, MICHAEL",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104845049,"WOOD, CHARLES, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1104845049,"WOOD, CHARLES, CHRISTOPHER",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104845049,"WOOD, CHARLES, CHRISTOPHER",~,2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1104845049,"WOOD, CHARLES, CHRISTOPHER",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1104845049,"WOOD, CHARLES, CHRISTOPHER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 20 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 30 , 32 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 37 , 47 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 46 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 24 , 32 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 247 , 324 , 393 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",609 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",1301 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",3186 VILLAGE DRIVE   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 25 , 30 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",3186 VILLAGE DRIVE   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 29 , 36 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104845528,"AMEREDES, HARRY, THEODORE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104846369,"FRAZIER, HEATHER, BOWEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104846369,"FRAZIER, HEATHER, BOWEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 49 , 50 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104849132,"LEVER, ROGER, GUY",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104849132,"LEVER, ROGER, GUY",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063689503,PALMETTO DENTURE CARE PA,Palmetto Denture Care PA,975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1104849884,"DAVIS, KEITH, CHANDLER",975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 82 , 101 , 347 ," $37,279.00 ",,
MEDICAID DIRECT,1902837073,DAVIDSON CLINIC,ATRIUM HEALTH PRIMARY CARE DAVIDSON CLINIC,705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104851880,"MANGE, STEPHEN, KENNEDY",705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104853365,"REGAN, TYCE, LEE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 79 , 86 , 88 ,$#,,
MEDICAID DIRECT,1720716814,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ENDOCRINOLOGY,8110 HEALTHCARE LOOP STE 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104853811,"WEHMEIER, KENT, RAY",8110 HEALTHCARE LOOP STE 1 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104853811,"WEHMEIER, KENT, RAY",8110 HEALTHCARE LOOP STE 1 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 45 , 65 , 117 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104853811,"WEHMEIER, KENT, RAY",13460 PLAZA ROAD EXT STE 100 CHARLOTTE NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 33 , 46 , 94 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1104853845,"CUMMINGS, DE LORA, BERTHA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104854173,"ZOLZER, JAMES, GERARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1669809158,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS OBGYN HOSPITALISTS,920 CHURCH ST N STE 255E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104854173,"ZOLZER, JAMES, GERARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104854173,"ZOLZER, JAMES, GERARD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104854173,"ZOLZER, JAMES, GERARD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104854173,"ZOLZER, JAMES, GERARD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104854173,"ZOLZER, JAMES, GERARD",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104854173,"ZOLZER, JAMES, GERARD",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1396847422,COMMUNITY URGENT CARE PA,COMMUNITY FAMILY MEDICINE,2469 WENDELL BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1104854504,"FARRINGER, GINA, MILLS",2469 WENDELL BLVD   WENDELL NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 41 , 44 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1104856137,"MACKSEY, LYNN, FITZGERALD",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104856368,"PHILLIPS, ASHLEY, BRITT",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 34 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104856368,"PHILLIPS, ASHLEY, BRITT",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 29 , 54 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104856368,"PHILLIPS, ASHLEY, BRITT",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104856368,"PHILLIPS, ASHLEY, BRITT",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1104856988,"MARSON, REBECCA, ELAINE",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104856988,"MARSON, REBECCA, ELAINE",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104856988,"MARSON, REBECCA, ELAINE",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104857358,"ZWACK, GREGORY, CHARLES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104857358,"ZWACK, GREGORY, CHARLES",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 50 , 58 , 75 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104857358,"ZWACK, GREGORY, CHARLES",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104857358,"ZWACK, GREGORY, CHARLES",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 38 , 42 , 58 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104857358,"ZWACK, GREGORY, CHARLES",9104 MARKET ST   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1104857937,"DUGGAN, THOMAS, MICHAEL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 71 , 71 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104859305,"ESKEW, LAWRENCE, ANDREW",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 38 , 50 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104859305,"ESKEW, LAWRENCE, ANDREW",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104859305,"ESKEW, LAWRENCE, ANDREW",1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 34 , 49 , 56 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104859305,"ESKEW, LAWRENCE, ANDREW",911 W HENDERSON ST STE 110 SALISBURY NC,080,Rowan,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1104859313,KINSTON COMMUNITY HEALTH CENTER,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 387 , 843 , 843 ," $161,158.31 ",,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1104859313,KINSTON COMMUNITY HEALTH CENTER,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,,,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104859917,"LODS, TARA, BETH",101 E WT HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 12 , 31 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104859917,"LODS, TARA, BETH",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 22 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104860295,"BATES, PHILIP, DEAN",615 E 12TH ST   WASHINGTON NC,007,Beaufort,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104860295,"BATES, PHILIP, DEAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 45 , 55 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104860527,"STANLEY, ANGELA, JOLENE",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 52 , 116 ,$#,,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1104860642,"TAYLOR, JENNIFER, LAVOIE",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1104860717,"JONES, KAMLYN, GREY",670 CARDINAL RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1104860717,"JONES, KAMLYN, GREY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 45 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1104860717,"JONES, KAMLYN, GREY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 28 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1104860972,"MCLEAN, REBECCA, NOSS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104863778,TOUCHED BY ANGELS HOME HEALTHCARE I,TOUCHED BY ANGELS II,116 W PINE ST   GRAHAM NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1104863778,TOUCHED BY ANGELS HOME HEALTHCARE I,116 W PINE ST   GRAHAM NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 6,268 "," 6,975 "," $813,177.00 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104865278,"DAUBERT, JAMES, PATRICK",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1104865278,"DAUBERT, JAMES, PATRICK",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 35 , 40 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104865278,"DAUBERT, JAMES, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 18 , 22 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104865278,"DAUBERT, JAMES, PATRICK",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104865278,"DAUBERT, JAMES, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1104865963,"ADCOCK, RUSTAN, ONEAL",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 158 , 311 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,1219 SMOKY PARK HWY   CANDLER NC,011,Buncombe,193400000X,Group,Single Specialty,,1104865963,"ADCOCK, RUSTAN, ONEAL",1219 SMOKEY PARK HWY   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104866482,"SOTO GUERRERO, YAZMIN, JOHANNA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1104869007,"SMITH, CARL, LYNWOOD",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104869007,"SMITH, CARL, LYNWOOD",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 23 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1104869007,"SMITH, CARL, LYNWOOD",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 40 , 129 , 255 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104869007,"SMITH, CARL, LYNWOOD",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 12 , 32 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104869007,"SMITH, CARL, LYNWOOD",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 27 , 98 , 154 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1104869007,"SMITH, CARL, LYNWOOD",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 116 , 274 , 594 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104869288,"ALDRIDGE, HEIDI, DEBOT",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 47 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104869288,"ALDRIDGE, HEIDI, DEBOT",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1811128168,EAST COAST ON SITE MEDICAL,EAST COAST ON SITE MEDICAL,3105 EVANS ST STE F GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104869718,"TURNAGE, DENISE, COSTELL",323 MEDICAL ARTS DR   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811128168,EAST COAST ON SITE MEDICAL,EAST COAST ON SITE MEDICAL,3105 EVANS ST STE F GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104869718,"TURNAGE, DENISE, COSTELL",716 WALL ST   GRIFTON NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811128168,EAST COAST ON SITE MEDICAL,EAST COAST ON SITE MEDICAL,3105 EVANS ST STE F GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104869718,"TURNAGE, DENISE, COSTELL",3105 EVANS ST STE F GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 215 , 860 , 907 ," $26,322.94 ",,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104870328,"PENNINGTON, STACEY, ERIN",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 48 , 73 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104870328,"PENNINGTON, STACEY, ERIN",2580 PICKARD RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104871367,"PETERSON, ANDREW, CHARLES",1000 TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 29 , 39 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104871367,"PETERSON, ANDREW, CHARLES",1000 TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104871367,"PETERSON, ANDREW, CHARLES",1000 TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104871367,"PETERSON, ANDREW, CHARLES",1000 TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1972529329,CENTER FOR INFECTIOUS DISEASES,~,276 OLD MOCKSVILLE RD STE 1100 STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104871581,"ARYEETEY, ROBERT, ADJAMAH",276 OLD MOCKSVILLE RD STE 1100 STATESVILLE NC,049,Iredell,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 30 , 40 , 40 ,$#,,
MEDICAID DIRECT,1972529329,CENTER FOR INFECTIOUS DISEASES,~,276 OLD MOCKSVILLE RD STE 1100 STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104871581,"ARYEETEY, ROBERT, ADJAMAH",170 MEDICAL PARK RD STE 311 MOORESVILLE NC,049,Iredell,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 46 , 46 ,$#,,
MEDICAID DIRECT,1972529329,CENTER FOR INFECTIOUS DISEASES,~,276 OLD MOCKSVILLE RD STE 1100 STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104871581,"ARYEETEY, ROBERT, ADJAMAH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 67 , 536 , 536 ," $13,050.07 ",,
MEDICAID DIRECT,1972529329,CENTER FOR INFECTIOUS DISEASES,~,276 OLD MOCKSVILLE RD STE 1100 STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104871581,"ARYEETEY, ROBERT, ADJAMAH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 72 , 72 ,$#,,
MEDICAID DIRECT,1093790859,COUNTY OF IREDELL,IREDELL COUNTY HEALTH DEPARTMENT,318 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1104871581,"ARYEETEY, ROBERT, ADJAMAH",318 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104871730,"OYESIKU, NELSON, MOBOLANLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104871730,"OYESIKU, NELSON, MOBOLANLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104871730,"OYESIKU, NELSON, MOBOLANLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104871730,"OYESIKU, NELSON, MOBOLANLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1104872316,"KIRBY, MARY, BANASZAK",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 61 , 161 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1104872316,"KIRBY, MARY, BANASZAK",2600 OLD CHERRY POINT RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1104872316,"KIRBY, MARY, BANASZAK",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 33 , 93 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1104872316,"KIRBY, MARY, BANASZAK",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 28 , 68 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1104872316,"KIRBY, MARY, BANASZAK",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 86 , 158 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104872837,"SIDDEN, CHRISTOPHER, RICHARD",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 39 , 56 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104872837,"SIDDEN, CHRISTOPHER, RICHARD",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1407499353,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SUNSET,3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104873066,"FINNEGAN, CRYSTAL, CREW",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 400 , 536 ," 1,761 "," $80,786.56 ",,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1104873066,"FINNEGAN, CRYSTAL, CREW",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104873066,"FINNEGAN, CRYSTAL, CREW",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104873454,"NORCROSS, JASON, PATRICK",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104873454,"NORCROSS, JASON, PATRICK",214 18TH ST SE   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104873454,"NORCROSS, JASON, PATRICK",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1104873454,"NORCROSS, JASON, PATRICK",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104873959,"WEVER, AARON, SIDSCOTT",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 59 , 90 , 199 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,525 CORPORATE CIR   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1104873959,"WEVER, AARON, SIDSCOTT",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104873959,"WEVER, AARON, SIDSCOTT",525 CORPORATE CIR   SALISBURY NC,080,Rowan,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 13 , 34 ,$#,,
MEDICAID DIRECT,1881127942,SOUTHLAND CHATUGE EMERGENCY MEDICAL,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104874197,"DAVIDSON, BRENT, WILLIAM",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104874296,"GREEN, CAROLYN, MAI",101 BETHESDA DR   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740989516,ONSITE NEONATAL NC PC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1104875582,"OJEDA, FRANCISCO, JAVIER",2201 S STERLING ST   MORGANTON NC,012,Burke,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 23 , 83 , 91 ," $12,230.79 ",,
MEDICAID DIRECT,1417446691,MECKLENBURG NEUROLOGY GROUP,,70 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1104877224,"NAHOURAII, ROBERT, ATAOLLAH",70 LAKE CONCORD LAKE RD   CONCORD NC,013,Cabarrus,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 61 , 109 , 141 ," $12,814.46 ",,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 32 , 32 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 37 , 40 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104878362,"GARZONE, STEVEN, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104878685,"MURPHY, BRYANT, ARMOND",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104878685,"MURPHY, BRYANT, ARMOND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 43 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104878685,"MURPHY, BRYANT, ARMOND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1104878685,"MURPHY, BRYANT, ARMOND",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104878685,"MURPHY, BRYANT, ARMOND",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104879691,"BRODISH, BRIAN, NATHANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104879691,"BRODISH, BRIAN, NATHANIEL",850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 114 , 193 , 304 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104879691,"BRODISH, BRIAN, NATHANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 22 , 41 , 53 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104879691,"BRODISH, BRIAN, NATHANIEL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104880079,"SHARP, JACK, KEVIN",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104880079,"SHARP, JACK, KEVIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104880079,"SHARP, JACK, KEVIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104880079,"SHARP, JACK, KEVIN",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104880079,"SHARP, JACK, KEVIN",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104880079,"SHARP, JACK, KEVIN",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 29 , 51 , 63 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104880608,"ANG, DENNIS, CHUA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 42 , 54 , 93 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104880608,"ANG, DENNIS, CHUA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1104880723,WNC EYE SURGERY CENTER,,8B MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1104880723,WNC EYE SURGERY CENTER,8B MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 114 , 166 , 176 ," $14,128.27 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1104881788,"NOGUEIRA, JOSEPH, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104881788,"NOGUEIRA, JOSEPH, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1104884279,"BAKER, SCOTT, WILLIAM",~,3318 HEALY DR   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1104884279,"BAKER, SCOTT, WILLIAM",3318 HEALY DR   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1689849325,SUZANNE E BIRD DDS MS PA,SUZANNE E BIRD DDS MS PA,16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104884774,"BIRD, SUZANNE, ELIZABETH",16614 RIVERSTONE WAY   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1689849325,SUZANNE E BIRD DDS MS PA,SUZANNE E BIRD DDS MS PA,16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104884774,"BIRD, SUZANNE, ELIZABETH",16614 RIVERSTONE WAY   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1689849325,SUZANNE E BIRD DDS MS PA,SUZANNE E BIRD DDS MS PA,16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104884774,"BIRD, SUZANNE, ELIZABETH",16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 200 , 231 , 926 ," $29,066.76 ",,
MEDICAID DIRECT,1689849325,SUZANNE E BIRD DDS MS PA,SUZANNE E BIRD DDS MS PA,16614 RIVERSTONE WAY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104884774,"BIRD, SUZANNE, ELIZABETH",16614 RIVERSTONE WAY   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104886829,"GROSSINGER, SAMUEL, MARC",3643 N ROXBORO ST DUKE REGIONAL HOSPITAL EMERGENCY DEPT DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 96 , 97 , 100 ,$#,,
MEDICAID DIRECT,1851830541,DLP FRYE MEDICAL GROUP,FRYECARE HEART LUNG AND VASCULAR,415 N CENTER ST STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104887850,"CARLTON, RICHARD, ALAN",415 N CENTER ST STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1851830541,DLP FRYE MEDICAL GROUP,FRYECARE HEART LUNG AND VASCULAR,415 N CENTER ST STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1104887850,"CARLTON, RICHARD, ALAN",420 N CENTER ST   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104888593,"ADAMS, SARAH, PENDLETON",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 44 , 79 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1104888593,"ADAMS, SARAH, PENDLETON",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104888593,"ADAMS, SARAH, PENDLETON",16747 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1962833343,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,375 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104889351,"DOUGH, ROBERT, LYLE",375 SUNSET AVE   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 170 , 299 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1104890060,"STORY, ELLEN, SHANNON",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 14 , 18 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104890060,"STORY, ELLEN, SHANNON",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 22 , 31 , 35 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,123 WEAVER RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104890573,"HARRIS, BENJAMIN, JEPPESON",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104890573,"HARRIS, BENJAMIN, JEPPESON",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 38 , 42 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104890573,"HARRIS, BENJAMIN, JEPPESON",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1104968627,PIEDMONT FAMILY MEDICINE PA,PIEDMONT FAMILY MEDICINE PA,1401 W INNES ST STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1104892249,"AMIN, CHETAN, NAVIN",1401 W INNES ST STE B SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 126 , 126 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,209 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104892470,"FRENDUTO, FRANK, ALAN",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104892470,"FRENDUTO, FRANK, ALAN",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1952809576,LAMBOY AND RUBIO DDS PA,~,2563 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104893783,"RUBIO, MAYRA, K AYALA",111 GATEWOOD AVE   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1104937010,LAMBOY AND RUBIO DDS PA,LAMBOY AND RUBIO DDS PA,111 GATEWOOD AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104893783,"RUBIO, MAYRA, K AYALA",111 GATEWOOD AVE   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 7,720 "," 13,110 "," 58,963 "," $1,764,484.26 ",,
MEDICAID DIRECT,1952809576,LAMBOY AND RUBIO DDS PA,~,2563 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1104893783,"RUBIO, MAYRA, K AYALA",111 GATEWOOD AVE   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 76 , 76 , 444 ," $12,642.92 ",,
MEDICAID DIRECT,1356595227,LAMBOY AND RUBIO DDS PA,,930 EXECUTIVE WAY   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1104893783,"RUBIO, MAYRA, K AYALA",111 GATEWOOD AVE   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 26 , 131 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104893916,"HENSON, AUTUMN, NORMAN",250 HOPKINS RD   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104893916,"HENSON, AUTUMN, NORMAN",7449 FAIR OAKS DR   CLEMMONS NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104893916,"HENSON, AUTUMN, NORMAN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104893916,"HENSON, AUTUMN, NORMAN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 20 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104893916,"HENSON, AUTUMN, NORMAN",849 WATERWORKS RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1104893916,"HENSON, AUTUMN, NORMAN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366589483,COUNTY OF DAVIDSON,~,915 N GREENSBORO ST   LEXINGTON NC,029,Davidson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1104894674,"REEDY, FRANK, EDWARD",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1104894674,"REEDY, FRANK, EDWARD",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 26 , 52 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1104894674,"REEDY, FRANK, EDWARD",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 64 , 151 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1104894674,"REEDY, FRANK, EDWARD",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 22 , 73 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1104894674,"REEDY, FRANK, EDWARD",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1104894948,PEDIATRIC PHYSICAL THERAPY SERVICES,PEDIATRIC PHYSICAL THERAPY SRVCS,221 COUNTRY PLACE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104894948,PEDIATRIC PHYSICAL THERAPY SERVICES,221 COUNTRY PLACE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 11 , 513 , 513 ," $49,180.59 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104896547,"ADAMI, RICHARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104896547,"ADAMI, RICHARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104896547,"ADAMI, RICHARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1104897396,"HUNTER, JAMES, ARTHUR",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 161 , 200 , 240 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1104897396,"HUNTER, JAMES, ARTHUR",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 304 , 398 , 526 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1104897537,"MANNING, STEWART, CLEAVES",1121 N ROAD ST STE A ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1891908422,STEWART CLEAVES MANNING MD PA,~,1121 N ROAD ST STE A ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1104897537,"MANNING, STEWART, CLEAVES",1121 N ROAD ST STE A ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 257 , 300 ,$#,,
MEDICAID DIRECT,1528495108,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - CONCORD,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1104898170,"WALDEN, TONY, LEE",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 167 , 303 , 361 ," $12,696.58 ",,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1104898717,"MURPHY, SEAN, JAMES",3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1104898717,"MURPHY, SEAN, JAMES",3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 95 , 262 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1104898717,"MURPHY, SEAN, JAMES",2145 COUNTRY CLUB RD   JACKSONVILLE NC,067,Onslow,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 26 , 29 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900075,"STOLP, BRYANT, WALTER",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900075,"STOLP, BRYANT, WALTER",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 263 , 295 , 296 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 40 , 47 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 194 , 243 , 244 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104900265,"KONTOS, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1104900802,"KAYSER, DANIEL, ANTHONY",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1801086558,SAMPSON REG MED SERVICES ANESTHESIA,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1104902840,"HILL, PATRICIA, LYTLE",1010 COLLEGE ST 1010 COLLEGE STREET OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275638512,GRANVILLE HEALTH SYSTEM,GRANVILLE HEALTH SYSTEM CRNA GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1104902840,"HILL, PATRICIA, LYTLE",1010 COLLEGE ST 1010 COLLEGE STREET OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1104902964,BETTER DAYS AHEAD OF ROCKY MOUNT,~,501 CASCADE AVE   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1104902964,BETTER DAYS AHEAD OF ROCKY MOUNT,501 CASCADE AVE   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1104902964,BETTER DAYS AHEAD OF ROCKY MOUNT,~,1713 KING CIR   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1104902964,BETTER DAYS AHEAD OF ROCKY MOUNT,1713 KING CIR   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 304 , 304 ," $12,082.32 ",,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1104903566,"VOEDISCH, CARRIE, BETH",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 70 , 70 ,$#,,
MEDICAID DIRECT,1609248251,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS SPECIALTY- KNIGHTDALE,1001 WIDEWATERS PKWY STE B KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104907617,"CLARK, DORRANCE, DEAN",966 US 64 HWY W   APEX NC,092,Wake,1223P0300X,Dental Providers,Dentist,Periodontics,#,#,#,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1104907617,"CLARK, DORRANCE, DEAN",966 US 64 HWY W   APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1104907765,"BUCKMAN, BRIDGETT, LEIGH",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 28 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1104908409,"LAMPKIN, VICTORIA, GARRIETT",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 36 , 169 , 175 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,604 STOKES ST E   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1104908409,"LAMPKIN, VICTORIA, GARRIETT",300 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1104908409,"LAMPKIN, VICTORIA, GARRIETT",2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 21 , 131 , 193 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1104908409,"LAMPKIN, VICTORIA, GARRIETT",2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1104908409,"LAMPKIN, VICTORIA, GARRIETT",300 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 69 , 71 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1104908748,"GRANZOW, PAUL, RUSSELL",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 46 , 46 ,$#,,
MEDICAID DIRECT,1104913326,CAROLINAS UNION HEALTHCARE INC,~,1403 DOVE ST   MONROE NC,090,Union,3416L0300X,Transportation Services,Ambulance,Land Transport,1104913326,CAROLINAS UNION HEALTHCARE INC,1403 DOVE ST   MONROE NC,090,Union,3416L0300X,Transportation Services,Ambulance,Land Transport, 705 ," 1,275 "," 2,335 "," $29,851.69 ",,
MEDICAID DIRECT,1205249539,OCHSNER EYE PA,OCHSNER EYE PA,700 MILITARY CUTOFF RD STE 202 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104917657,"OCHSNER, KATHERINE",700 MILITARY CUTOFF RD STE 202 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 63 , 119 , 227 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104921659,"COLLAZO BATISTA, LINDA, INES",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 43 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1104921659,"COLLAZO BATISTA, LINDA, INES",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1515 SW CARY PKWY STE 220 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104921659,"COLLAZO BATISTA, LINDA, INES",1515 SW CARY PKWY STE 220 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1104921998,LIBERTY MEDICAL SPECIALTIES INC,,612-10 JEFFERSON ST   WHITEVILLE NC,024,Columbus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1104921998,LIBERTY MEDICAL SPECIALTIES INC,612-10 JEFFERSON ST   WHITEVILLE NC,024,Columbus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 557 ," 2,386 "," 3,938 "," $148,216.50 ",,
MEDICAID DIRECT,1104921998,LIBERTY MEDICAL SPECIALTIES INC,,612-10 JEFFERSON ST   WHITEVILLE NC,024,Columbus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1104921998,LIBERTY MEDICAL SPECIALTIES INC,612-10 JEFFERSON ST   WHITEVILLE NC,024,Columbus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 13 , 44 , 44 ,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104922095,"SINAI, LAURA, NAN",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104922095,"SINAI, LAURA, NAN",3193 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104925254,"CICCOLINI, ANNA, JEANNE",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1104925254,"CICCOLINI, ANNA, JEANNE",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104925254,"CICCOLINI, ANNA, JEANNE",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 212   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104927458,"SHUTACK, JOHN",300 MEDICAL PKWY STE 206 CHESAPEAKE VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194240671,WRIGHT AND ASSOCIATES IX DDS PA,,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104928449,"ARNETTE, MICHAEL, DAVID",6480 TRYON RD   CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 79 , 117 , 595 ," $56,346.03 ",,
MEDICAID DIRECT,1437200417,LANE AND ASSOCIATES IV DDS PA,~,315 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1104928449,"ARNETTE, MICHAEL, DAVID",6480 TRYON RD   CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 522 , 781 ," 2,943 "," $285,995.25 ",,
MEDICAID DIRECT,1083345664,LANE AND ASSOCIATES XLVII DDS PA,,515 S CASWELL ST   LA GRANGE NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1104928449,"ARNETTE, MICHAEL, DAVID",6480 TRYON RD   CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 210 , 268 ," 1,013 "," $101,643.69 ",,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104928449,"ARNETTE, MICHAEL, DAVID",6480 TRYON RD   CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 88 , 94 , 365 ," $35,337.68 ",,
MEDICAID DIRECT,1124556063,WRIGHT AND ASSOCIATES V DDS PA,,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1104928449,"ARNETTE, MICHAEL, DAVID",6480 TRYON RD   CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 94 , 126 , 529 ," $52,308.00 ",,
MEDICAID DIRECT,1104929645,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03816,4600 OLEANDER DR   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1104929645,NORTH CAROLINA CVS PHARMACY LLC,4600 OLEANDER DR   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 223 , 485 , 610 ," $10,667.92 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",1000 TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",1000 TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",1000 TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",4709 CREEKSTONE DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 43 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",1000 TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",1000 TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",1000 TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",3480 WAKE FOREST ROAD SUITE 10 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",3480 WAKE FOREST ROAD SUITE 10 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104930262,"MAXFIELD, CHARLES, MASON",3480 WAKE FOREST ROAD SUITE 10 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104936046,"KRUYER, LAUREE, SUSAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 21 , 21 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104937549,"GARRABRANT III, EDGAR, CORNELIUS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 25 , 27 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104937549,"GARRABRANT III, EDGAR, CORNELIUS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1083336564,G ABRAMS & R COHEN XXIV PC,FRANKLIN SQUARE ORTHODONTICS & PEDIATRIC DENTISTRY,2930 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",202 RAWLEY AVE STE 100 MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 29 ,$#,,
MEDICAID DIRECT,1083336564,G ABRAMS & R COHEN XXIV PC,FRANKLIN SQUARE ORTHODONTICS & PEDIATRIC DENTISTRY,2930 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",130 HARBOUR PLACE DR STE 180 DAVIDSON NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1083336564,G ABRAMS & R COHEN XXIV PC,FRANKLIN SQUARE ORTHODONTICS & PEDIATRIC DENTISTRY,2930 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",8415 MEDICAL PLAZA DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1811412562,SNOW & SNOW DDS PLLC,~,5306 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 19 , 263 ," $22,964.39 ",,
MEDICAID DIRECT,1700236023,G ABRAMS & R COHEN XV PC,,11840 SOUTHMORE DR STE 150 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 79 , 99 , 444 ," $15,282.82 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 95 , 95 , 375 ," $13,491.84 ",,
MEDICAID DIRECT,1902631575,MUNAF GASTONIA DMD PLLC,TOOTHTOWN DENTISTRY FOR KIDS,2641 COURT DR STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 94 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 64 , 498 ," $32,364.65 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 198 , 198 ," 3,160 "," $279,981.84 ",,
MEDICAID DIRECT,1770781999,G ABRAMS DMD PA,G ABRAMS DMD PA,8170 S TRYON ST STE C CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 76 , 90 , 414 ," $14,210.76 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 36 ,$#,,
MEDICAID DIRECT,1659961399,ZOHAIB MUNAF DMD MBS PLLC,TOOTHTOWN DENTISTRY FOR KIDS,4514 OLD MONROE RD STE CD INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 112 ,$#,,
MEDICAID DIRECT,1730841289,SCOTT MCLAREN DDS PLLC,BRIGHT PEDIATRIC DENTISTRY,134 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1083336564,G ABRAMS & R COHEN XXIV PC,FRANKLIN SQUARE ORTHODONTICS & PEDIATRIC DENTISTRY,2930 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 454 , 627 ," 3,301 "," $128,787.20 ",,
MEDICAID DIRECT,1114571981,DENNIS GARTH STODDARD DDS PLLC,EASTFIELD PEDIATRIC DENTISTRY & ORTHODONTICS,8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 64 ,$#,,
MEDICAID DIRECT,1720479876,G ABRAMS & R COHEN XIII PC,,901 OAK FOREST DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1104937721,"DUNLAP, EMILY, CATHERINE",8415 MEDICAL PLAZA DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 152 , 152 ," 2,085 "," $190,312.51 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104938109,"REGER-ZOUZOULAS, JILL, ELIZABETH",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104938109,"REGER-ZOUZOULAS, JILL, ELIZABETH",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104938109,"REGER-ZOUZOULAS, JILL, ELIZABETH",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 13 , 21 , 44 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104943893,"MORRISEY, SHERYL, KIRK",410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 147 , 339 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104943893,"MORRISEY, SHERYL, KIRK",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1104943893,"MORRISEY, SHERYL, KIRK",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 68 , 136 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104943893,"MORRISEY, SHERYL, KIRK",410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 27 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104945864,"PABON, DIEGO, FERNANDO",3940 ARROWHEAD BLVD STE 230 MEBANE NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104945864,"PABON, DIEGO, FERNANDO",1236 HUFFMAN MILL RD STE 2900 BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1104945864,"PABON, DIEGO, FERNANDO",1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 43 , 47 ,$#,,
MEDICAID DIRECT,1659418515,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE TIMBERLYNE,77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104948892,"GRANDIS, HEIDI, MARIE",77 VILCOM CIR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 32 ,$#,,
MEDICAID DIRECT,1104950765,DGS HEALTHCARE ELKIN INC,CHATHAM NURSING & REHABILITATION,700 JOHNSON RIDGE RD   ELKIN NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1104950765,DGS HEALTHCARE ELKIN INC,700 JOHNSON RIDGE RD   ELKIN NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 192 , 192 ," $11,574.15 ",,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,1601 ABBEY PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104955293,"NEAL, CHIMERE, DANIELLE",1601 ABBEY PL   CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1226 E DIXIE DR   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1104955335,"PATEL, NILPA, VIPINBHAI",2406 W ROOSEVELT BLVD   MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,2406 W ROOSEVELT BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1104955335,"PATEL, NILPA, VIPINBHAI",2406 W ROOSEVELT BLVD   MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,, 32 , 32 , 59 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104955632,"WHITLEY, AMANDA, JOY",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 27 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104955632,"WHITLEY, AMANDA, JOY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104955632,"WHITLEY, AMANDA, JOY",13460 PLAZA ROAD EXT STE 100 CHARLOTTE NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 43 , 94 ,$#,,
MEDICAID DIRECT,1104959055,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104959055,WAKE FOREST HEALTH NETWORK LLC,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,, 13 , 13 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104959311,"ADAIR, JENNIFER, HINSHAW",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1104959311,"ADAIR, JENNIFER, HINSHAW",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104959311,"ADAIR, JENNIFER, HINSHAW",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 32 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1104959311,"ADAIR, JENNIFER, HINSHAW",2406 BLUE RIDGE RD STE 220 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104959428,"MCCORMICK, TARA, LINETTE",TARA MCCORMICK DBA O T X 3,1178 RIVER HWY STE B MOORESVILLE NC,049,Iredell,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1104959428,"MCCORMICK, TARA, LINETTE",1178 RIVER HWY STE B MOORESVILLE NC,049,Iredell,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 128 , 209 ," $13,776.50 ",,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1104964048,"ROYAL, ANITA, VANN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801086558,SAMPSON REG MED SERVICES ANESTHESIA,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1104964048,"ROYAL, ANITA, VANN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 14 , 15 ,$#,,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1104970102,"KNOX, JILL, HARDIN",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 114 , 184 , 291 ,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104973072,"BRANNER, CHRISTOPHER, MALCOLM",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 14 , 30 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104974526,"APPLEGATE, STACEY, ELAINE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104974526,"APPLEGATE, STACEY, ELAINE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104974526,"APPLEGATE, STACEY, ELAINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104974526,"APPLEGATE, STACEY, ELAINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1104974526,"APPLEGATE, STACEY, ELAINE",115 HEART DR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104974526,"APPLEGATE, STACEY, ELAINE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 33 , 40 , 76 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1104975515,"DELESTOWICZ, VICTORIA, ANN",175 TRYON RD STE A RUTHERFORDTON NC,081,Rutherford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 21 , 54 ,$#,,
MEDICAID DIRECT,1104977198,COASTAL MEDICAL TRANSPORT INC,COASTAL MEDICAL TRANSPORT INC,101 S GRANVILLE ST   WINDSOR NC,008,Bertie,3416L0300X,Transportation Services,Ambulance,Land Transport,1104977198,COASTAL MEDICAL TRANSPORT INC,101 S GRANVILLE ST   WINDSOR NC,008,Bertie,3416L0300X,Transportation Services,Ambulance,Land Transport, 445 ," 1,646 "," 2,796 "," $480,563.88 ",,
MEDICAID DIRECT,1104979368,PEMBROKE RESCUE SQUAD INC,~,564 CANDY PARK RD   PEMBROKE NC,078,Robeson,3416L0300X,Transportation Services,Ambulance,Land Transport,1104979368,PEMBROKE RESCUE SQUAD INC,564 CANDY PARK RD   PEMBROKE NC,078,Robeson,3416L0300X,Transportation Services,Ambulance,Land Transport, 302 , 483 , 973 ," $13,564.76 ",,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1104980374,"TRAYWICK, MARLEEN, PRYCHODKO",6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 72 , 99 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1104983212,"BUONANNO, NICOLE, THERESA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104983394,"MARCENARO, JANINA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1104983394,"MARCENARO, JANINA",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104983477,"ROBINSON, JI YUN, REBEKAH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1104983477,"ROBINSON, JI YUN, REBEKAH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1700882388,ALLERGY ASTHMA AND SINUS CENTER PC,ALLERGY ASTHMA AND SINUS CENTER PC,800 E CHEVES ST STE 420 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1104983550,"MOYER, JOSEPH, G",800 E CHEVES ST STE 420 FLORENCE SC,101,Out of State <= 40 miles,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1033242235,SOUTHEAST ANESTHESIOLOGY CONSULTANT,SOUTHEAST ANESTHESIOLOGY CONSULTANTS OF VIRGINIA P,814 KEMPSVILLE RD STE 104 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1104988328,"WEAVER, BRIAN, SHANKLIN",814 KEMPSVILLE RD STE 104 NORFOLK VA,101,Out of State <= 40 miles,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine,#,#, 20 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104989128,"LEONARD, TIMOTHY, JAMES",1450 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104989128,"LEONARD, TIMOTHY, JAMES",2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104989128,"LEONARD, TIMOTHY, JAMES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1104989128,"LEONARD, TIMOTHY, JAMES",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104990829,"SULLIVAN, SEAN, DANIEL",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104990829,"SULLIVAN, SEAN, DANIEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104990829,"SULLIVAN, SEAN, DANIEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 26 , 36 , 41 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104990829,"SULLIVAN, SEAN, DANIEL",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1104990829,"SULLIVAN, SEAN, DANIEL",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 55 , 129 , 141 ,$#,,
MEDICAID DIRECT,1104991462,SUPERIOR HOME CARE INC,SUPERIOR HOME CARE INC,1709 N LONG ST   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1104991462,SUPERIOR HOME CARE INC,1709 N LONG ST   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,, 23 ," 5,491 "," 5,491 "," $478,099.28 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104991900,"HENDERSON, ASHLEY, GLYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104991900,"HENDERSON, ASHLEY, GLYN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 20 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1104991900,"HENDERSON, ASHLEY, GLYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 16 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104993666,"KRINGS, ELIZABETH, PEARSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1104993997,"LEIB, ARI, DAVID",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104993997,"LEIB, ARI, DAVID",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1104993997,"LEIB, ARI, DAVID",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1104993997,"LEIB, ARI, DAVID",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 44 , 66 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104994813,"LEWIS, LESLIE, SHARP",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 92 , 135 , 135 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104994813,"LEWIS, LESLIE, SHARP",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104994813,"LEWIS, LESLIE, SHARP",233 GILMER ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104994813,"LEWIS, LESLIE, SHARP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1104994813,"LEWIS, LESLIE, SHARP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1104994813,"LEWIS, LESLIE, SHARP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114000684,"HALL, JORDAN, MANUEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 18 , 36 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114000791,"HARRIS, KELVIN, CREWS",620 SUMMIT CROSSING PL STE 108 GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 43 , 65 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114000791,"HARRIS, KELVIN, CREWS",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114000791,"HARRIS, KELVIN, CREWS",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001005,"MOUL, JUDD, WENDELL",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001005,"MOUL, JUDD, WENDELL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 20 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001005,"MOUL, JUDD, WENDELL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001021,"KISHNANI, PRIYA, SUNIL",3000 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001021,"KISHNANI, PRIYA, SUNIL",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001260,"LONG, GWYNN, DOUGLAS",2400 PRATT ST   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001260,"LONG, GWYNN, DOUGLAS",2400 PRATT ST   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 27 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114001260,"LONG, GWYNN, DOUGLAS",1000 TRENT DR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1114001583,"DAVIS, ALONZO, JAMES",221A PROFESSIONAL CIR   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114002847,NC ORTHOTIC AND PROSTHETICS OF RR,NC ORTHOTIC AND PROSTHETICS OF RR,725 HAMILTON ST STE D ROANOKE RAPIDS NC,042,Halifax,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114002847,NC ORTHOTIC AND PROSTHETICS OF RR,725 HAMILTON ST STE D ROANOKE RAPIDS NC,042,Halifax,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1215048459,COUNTY OF HARNETT,HARNETT COUNTY HEALTH DEPT,307 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1114003449,"ELDRIDGE, SHELEY, BUTLER",307 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 122 , 241 ," 1,090 "," $32,423.11 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114007325,"LARSON, JAMES, LIONEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 48 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 15 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3821 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114007903,"GANDIKOTA, GIRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 348 , 400 , 540 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114008364,"KRISHNA, VIBHOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 16 , 22 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114008364,"KRISHNA, VIBHOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 25 , 35 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114008364,"KRISHNA, VIBHOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114008364,"KRISHNA, VIBHOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114010816,"TAYLOR, CLAYTON, SOLOMON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1114010816,"TAYLOR, CLAYTON, SOLOMON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114010816,"TAYLOR, CLAYTON, SOLOMON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023013836,HORNSBY REHABILITATION SERVICES INC,~,235 JIM BERRY RD   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1114011202,"HORNSBY, THOMAS, MARION",235 JIM BERRY RD   FRANKLIN NC,056,Macon,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114012127,"GIBBS, MICHAEL, ALFRED",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 62 , 102 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 47 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 82 , 90 , 111 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114012341,"KEENE SHORTELL, CYNTHIA, ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114014511,"ARNAEZ ZAPATA, GERARDO, ENRIQUE",849 WATERWORKS RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 175 , 177 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114014511,"ARNAEZ ZAPATA, GERARDO, ENRIQUE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 62 , 215 , 219 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114014511,"ARNAEZ ZAPATA, GERARDO, ENRIQUE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114014511,"ARNAEZ ZAPATA, GERARDO, ENRIQUE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 12 , 70 , 71 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114014511,"ARNAEZ ZAPATA, GERARDO, ENRIQUE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 151 , 153 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1114014990,"SONG, ARLEEN, HYONSOOK",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1114014990,"SONG, ARLEEN, HYONSOOK",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114014990,"SONG, ARLEEN, HYONSOOK",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114014990,"SONG, ARLEEN, HYONSOOK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114014990,"SONG, ARLEEN, HYONSOOK",1200 NAVAHO DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528704004,PITT COUNTY MEMORIAL HOSPITAL INC,ECU HEALTH BEAUFORT HOSPITAL,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1114015799,"RESPESS, SUZANNE, PASCHALL",628 E 12TH ST   WASHINGTON NC,007,Beaufort,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,295 MIDLAND PKWY   SUMMERVILLE SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114017118,"MCCRAE, CHRISTOPHER, ANDREW",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033977327,GODEL & ASSOCIATES III PLLC,RALEIGH FAMILY DENTAL CARE,1617 RONALD DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114017456,"LIU, LI-MING",1617 RONALD DR   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 758 ," 1,809 "," 7,205 "," $371,710.71 ",,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114017498,"PUGLISI, JANIS, PANZENHAGEN",3803 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114017498,"PUGLISI, JANIS, PANZENHAGEN",2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 87 , 123 ,$#,,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1114018413,"SCHWENKE DINGES, STACY, LYNN",1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,1223G0001X,Dental Providers,Dentist,General Practice, 383 , 441 ," 1,406 "," $41,240.89 ",,
MEDICAID DIRECT,1114020807,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07597,803 S MAIN ST   LILLINGTON NC,043,Harnett,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114020807,NORTH CAROLINA CVS PHARMACY LLC,803 S MAIN ST   LILLINGTON NC,043,Harnett,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1114020807,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07597,803 S MAIN ST   LILLINGTON NC,043,Harnett,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114020807,NORTH CAROLINA CVS PHARMACY LLC,803 S MAIN ST   LILLINGTON NC,043,Harnett,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1114020807,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07597,803 S MAIN ST   LILLINGTON NC,043,Harnett,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1114020807,NORTH CAROLINA CVS PHARMACY LLC,803 S MAIN ST   LILLINGTON NC,043,Harnett,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1114024106,"HAMBY, MIKE, PRESTON",~,7628 PURFOY RD   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1114024106,"HAMBY, MIKE, PRESTON",7628 PURFOY RD   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 59 , 117 , 308 ," $13,297.54 ",,
MEDICAID DIRECT,1114025764,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 01742,2901 WESLEY CHAPEL STOUTS RD   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114025764,NORTH CAROLINA CVS PHARMACY LLC,2901 WESLEY CHAPEL STOUTS RD   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1114025764,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 01742,2901 WESLEY CHAPEL STOUTS RD   MONROE NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114025764,NORTH CAROLINA CVS PHARMACY LLC,2901 WESLEY CHAPEL STOUTS RD   MONROE NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114027497,"DILORENZO, ROBERT, ALAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 20 , 23 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1114027497,"DILORENZO, ROBERT, ALAN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1114027497,"DILORENZO, ROBERT, ALAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114027497,"DILORENZO, ROBERT, ALAN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114027588,"CHELTENHAM, MARK, PHILLIP",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114036431,"TROCHE, MILTON",417 N MAIN ST   KENANSVILLE NC,031,Duplin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1114038189,"MORGAN, SHANNON, SIMPSON",180 PARKWOOD DR   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 30 , 35 ,$#,,
MEDICAID DIRECT,1114038619,"HARDEE, JASON, CHRISTOPHER",Drs Warren & Hardee PA,3467 N MAIN ST   FARMVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,1114038619,"HARDEE, JASON, CHRISTOPHER",3467 N MAIN ST   FARMVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 38 , 93 ,$#,,
MEDICAID DIRECT,1538241518,APPALACHIAN EYE ASSOCIATES OD PA,~,54 HILL ST   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1114038767,"WALKER, DIANE, WOOLBRIGHT",54 HILL ST   SPRUCE PINE NC,061,Mitchell,152W00000X,Eye and Vision Services Providers,Optometrist,, 36 , 56 , 70 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114039278,"CLASSEN JR, CHARLES, HENRY",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE G KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1114039278,"CLASSEN JR, CHARLES, HENRY",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 52 , 117 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114040516,"RYAN, PATRICK, THOMAS",1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114040516,"RYAN, PATRICK, THOMAS",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114046141,"BROWN, LAUREN, CALDER",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114052149,WHITE OAK MEDICAL TRANSPORT SERVICE,White Oak Medical Transport Services,446 WHITE OAK RD   WINDSOR NC,008,Bertie,3416L0300X,Transportation Services,Ambulance,Land Transport,1114052149,WHITE OAK MEDICAL TRANSPORT SERVICE,446 WHITE OAK RD   WINDSOR NC,008,Bertie,3416L0300X,Transportation Services,Ambulance,Land Transport, 194 , 750 ," 1,396 "," $87,360.53 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114060944,"YOPP, JUSTIN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1619342706,ROANOKE CHOWAN COMMUNITY HEALTH CEN,CRESWELL PRIMARY CARE,9500 NC HIGHWAY 94 N   CRESWELL NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114064045,"TAYLOR, EMMIE, LOU",9500 NC HIGHWAY 94 N   CRESWELL NC,094,Washington,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1790851004,ROANOKE CHOWAN COMMUNITY HEALTH CEN,COLERAIN PRIMARY CARE,109 W RIVER ST   COLERAIN NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114064045,"TAYLOR, EMMIE, LOU",109 W RIVER ST   COLERAIN NC,008,Bertie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114064045,"TAYLOR, EMMIE, LOU",108 W MAIN ST   WOODLAND NC,066,Northampton,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114064045,"TAYLOR, EMMIE, LOU",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114064045,"TAYLOR, EMMIE, LOU",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114064045,"TAYLOR, EMMIE, LOU",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 24 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114066784,"CHAPPELL, JONATHAN, DOUGLAS",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1114067154,"NAZARIO CORREA, LUCAS, J",1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 649 , 906 ," 3,321 "," $150,590.07 ",,
MEDICAID DIRECT,1114069689,SOUNDVIEW FAMILY CARE HOMES INC,SOUNDVIEW FAMILY CARE HOMES INC,24 EAST MONET COURT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1114069689,SOUNDVIEW FAMILY CARE HOMES INC,24 EAST MONET COURT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#," $17,164.80 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114074820,"DANIEL, KAREN, ERICKSON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 33 , 34 , 34 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114074820,"DANIEL, KAREN, ERICKSON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114076130,"MILLS, JEFFREY, LUTHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114076130,"MILLS, JEFFREY, LUTHER",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114076130,"MILLS, JEFFREY, LUTHER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114076395,"FRAZIER, DAVID, WORTH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114080991,"OSTROVSKY, DANIEL",3116 N DUKE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 100 , 119 , 235 ,$#,,
MEDICAID DIRECT,1083930671,PRIVATE DIAGNOSTIC CLINIC PLLC,DUKE MED PEDS AT ROXBORO ST,,,Unknown,193200000X,Group,Multi-Specialty,,1114080991,"OSTROVSKY, DANIEL",4020 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114080991,"OSTROVSKY, DANIEL",4020 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1114082922,ABC PEDIATRIC REHAB,,601 SMALL COUNTRY LN   MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114082922,ABC PEDIATRIC REHAB,601 SMALL COUNTRY LN   MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 57 , 720 , 726 ," $67,985.90 ",,
MEDICAID DIRECT,1114083284,COMMUNITY ACCESS THERAPY SERVICES I,~,5 DUNDAS CIR STE BCD GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114083284,COMMUNITY ACCESS THERAPY SERVICES I,5 DUNDAS CIR STE BCD GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,, 72 ," 1,044 "," 1,090 "," $81,046.74 ",,
MEDICAID DIRECT,1114085081,HOME LIFE CARE INC,~,567 US HIGHWAY 64 W   PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,,1114085081,HOME LIFE CARE INC,567 US HIGHWAY 64 W   PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,, 81 ," 17,811 "," 18,284 "," $1,570,889.12 ",,
MEDICAID DIRECT,1114085321,"HAMILTON, VALENTINE, T",~,29 OFFICE PARK DR STE B JACKSONVILLE NC,067,Onslow,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1114085321,"HAMILTON, VALENTINE, T",29 OFFICE PARK DR STE B JACKSONVILLE NC,067,Onslow,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114085354,"CARR, SANDRA, MICHELE",7118 MAIN ST   WADE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1609186790,THE STEDMAN WADE HEALTH SERVICES IN,~,2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114085354,"CARR, SANDRA, MICHELE",2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114086378,"BINFORD, THOMAS, SCOTT",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114086378,"BINFORD, THOMAS, SCOTT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114086378,"BINFORD, THOMAS, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 45 , 45 ,$#,,
MEDICAID DIRECT,1114088416,STAT ETC INC,QUEEN CITY HOME CARE,4917 ALBEMARLE RD STE 206 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1114088416,STAT ETC INC,4917 ALBEMARLE RD STE 206 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 61 , 61 ,$#,,
MEDICAID DIRECT,1265658132,THE ALLERGY CENTER,~,2395 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114092962,"MEHLHOP, PAUL, DAVID",2395 HEMBY LN   GREENVILLE NC,074,Pitt,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 99 , 292 , 357 ," $12,723.55 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114093598,"GOLDHABER, NEIL, GARY",1914 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 48 , 60 , 130 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1114094323,"HENSON, SUSAN, ELAINE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 84 , 85 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114095841,"WILSON, KATHY, TINGLE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114095841,"WILSON, KATHY, TINGLE",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 26 , 26 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,2386 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114095841,"WILSON, KATHY, TINGLE",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114095841,"WILSON, KATHY, TINGLE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 77 , 193 , 199 ," $20,399.94 ",,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,2386 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114095841,"WILSON, KATHY, TINGLE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114096039,"SHELDON, CHARLES, BRYAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114096039,"SHELDON, CHARLES, BRYAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114096039,"SHELDON, CHARLES, BRYAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 34 ,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114096641,"COOPER, ALAN, WILSON",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 39 , 101 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114098290,"HOLLAND, ANN-MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114098290,"HOLLAND, ANN-MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114098381,"VIENNAS, ZAHAROULA, ANGELA",817 VOLVO PKWY   CHESAPEAKE VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1023256518,CAROLINA HEADACHE INSTITUTE PA,CAROLINA HEADACHE INSTITUTE PA,6114 FAYETTEVILLE RD STE 109 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114098530,"FINKEL, ALAN, GLEN",6114 FAYETTEVILLE RD STE 109 DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 21 , 46 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1114098647,"BALLA, SOMASEKHARA, RAJU",220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1114098647,"BALLA, SOMASEKHARA, RAJU",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114098647,"BALLA, SOMASEKHARA, RAJU",220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114098647,"BALLA, SOMASEKHARA, RAJU",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 448 , 776 , 974 ," $15,090.36 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114098647,"BALLA, SOMASEKHARA, RAJU",220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1114098647,"BALLA, SOMASEKHARA, RAJU",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1114098647,"BALLA, SOMASEKHARA, RAJU",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114099041,"LATHAM, VICKI, LEGRAND",3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114100237,"HUFFSTETLER, NICOLA, RASCHELLA",250 18TH ST SE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114100237,"HUFFSTETLER, NICOLA, RASCHELLA",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114100237,"HUFFSTETLER, NICOLA, RASCHELLA",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114100237,"HUFFSTETLER, NICOLA, RASCHELLA",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114103520,"JOSEPH, SINDHU, LIZ",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1386960177,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114103520,"JOSEPH, SINDHU, LIZ",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 35 , 63 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114103520,"JOSEPH, SINDHU, LIZ",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1114108891,BRIANA J SHELTON OD PA,PROFESSIONAL VISION CENTERS,364 US 70 W STE 4 MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1114108891,BRIANA J SHELTON OD PA,364 US 70 W STE 4 MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114108917,"MACDONALD, CAROLYN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114108917,"MACDONALD, CAROLYN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114109048,"SIMS, RYAN, CHRISTOPHER",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114109048,"SIMS, RYAN, CHRISTOPHER",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1114109048,"SIMS, RYAN, CHRISTOPHER",1720 DAVIE AVE   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114109840,WAL-MART STORES EAST LP,WALMART PHARMACY 10-4274,7131 HIGHWAY 73   DENVER NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1114109840,WAL-MART STORES EAST LP,7131 HIGHWAY 73   DENVER NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114110392,"PIRZADEH, AFSANEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 39 , 79 , 98 ," $23,992.98 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114110392,"PIRZADEH, AFSANEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114111770,"ANDREWS, MEGAN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 91 , 146 ,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114115821,"COLE, JUSTIN, MICHAEL",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,, 85 , 103 , 148 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1114118353,"BARNUM, LAMONICA, YVETTE",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 112 , 205 ," $11,981.51 ",,
MEDICAID DIRECT,1659828366,ARCADIA PATHOLOGY NETWORK PLLC,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1114120938,"LI, HONG, CATHERINE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 181 , 206 , 359 ,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114120938,"LI, HONG, CATHERINE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1114122496,ALAMANCE COUNTY MEALS ON WHEELS INC,ALAMANCE COUNTY MEALS ON WHEELS INC,411 W 5TH ST STE A BURLINGTON NC,001,Alamance,332U00000X,Suppliers,Home Delivered Meals,,1114122496,ALAMANCE COUNTY MEALS ON WHEELS INC,411 W 5TH ST STE A BURLINGTON NC,001,Alamance,332U00000X,Suppliers,Home Delivered Meals,,#," 1,781 "," 1,781 "," $13,395.50 ",,
MEDICAID DIRECT,1114122975,SOUNDVIEW FAMILY CARE HOMES INC,Soundview Family Care Homes Inc,34 MONET CT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1114122975,SOUNDVIEW FAMILY CARE HOMES INC,34 MONET CT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 195 , 195 ," $89,112.71 ",,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 31 , 35 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 23 , 43 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 30 , 30 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114124716,"THOMPSON, JOSEPH, JENKINS",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1114125036,"GRAHAM, RETA, BRASHEARS",105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114125036,"GRAHAM, RETA, BRASHEARS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114125929,"MAYNOR, LOUISE, DAVIS",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 57 , 73 , 98 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 130 , 148 , 206 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 162 , 186 , 245 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 31 , 57 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114126588,"ALLEN, BRIAN, CHRISTOPHER",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114127123,"ROESER, MARK, ELLIOT",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114131588,"HAWK, HARRIS, EMORY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 19 , 22 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114131588,"HAWK, HARRIS, EMORY",2076 HIGHWAY 69 S   HAYESVILLE NC,022,Clay,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1114131588,"HAWK, HARRIS, EMORY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 36 , 56 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114131588,"HAWK, HARRIS, EMORY",975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114131612,"BOTTIGER, BRANDI, ANNE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114131612,"BOTTIGER, BRANDI, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114131612,"BOTTIGER, BRANDI, ANNE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1114131612,"BOTTIGER, BRANDI, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114131786,"ZOOK, JASON, DAVID",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 50 , 79 , 140 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114131786,"ZOOK, JASON, DAVID",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1114131786,"ZOOK, JASON, DAVID",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 39 , 76 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114131984,"VAHABZADEH, ALI",2555 COURT DR STE 270 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 146 , 148 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114132255,"PATHAN, AYAZ",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1114132255,"PATHAN, AYAZ",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114133097,"ARMSTRONG, MATTHEW, DAVID",3719 UNION RD   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 43 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114133097,"ARMSTRONG, MATTHEW, DAVID",7427 MATTHEWS MINT HILL RD STE 103 MINT HILL NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114133097,"ARMSTRONG, MATTHEW, DAVID",13024 EASTFIELD RD STE A600 HUNTERSVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114133758,"CARROLL, EBEN, AGAVE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114133758,"CARROLL, EBEN, AGAVE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 77 , 90 , 134 ," $28,213.53 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114134780,"TAYLOR, JONATHAN, HARRIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 21 , 28 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114134780,"TAYLOR, JONATHAN, HARRIS",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 84 , 164 , 264 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114137031,"BLAND, WENDY, WHITEHURST",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114138195,"ALI, ASRA, AHNED",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 39 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114138401,"CANOS, MICHAEL, RICHARD",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 29 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114138401,"CANOS, MICHAEL, RICHARD",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114138401,"CANOS, MICHAEL, RICHARD",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114139235,"DE BECK, CHRISTIAN, THOMAS",52 OFFICE PARK DR STE B JACKSONVILLE NC,067,Onslow,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 37 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114139235,"DE BECK, CHRISTIAN, THOMAS",815 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,815 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114139235,"DE BECK, CHRISTIAN, THOMAS",815 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 147 , 267 , 342 ,$#,,
MEDICAID DIRECT,1083650881,COLLINS & SAMPSON DDS PA,COLLINS JEFF,312 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114141363,"SAMPSON, JESSICA",312 E WARDELL DR   PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 332 , 654 ," 2,192 "," $89,316.70 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,105 MARK DR   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1114142213,"BILICKI, BRADFORD, KARSTEN",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114142213,"BILICKI, BRADFORD, KARSTEN",101 CLINIC DR   TARBORO NC,033,Edgecombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 82 , 128 , 151 ,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,417 W WARREN ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",417 W WARREN ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",417 W WARREN ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",417 W WARREN ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,417 W WARREN ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",417 W WARREN ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 48 , 68 ,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 207 , 686 , 913 ," $21,460.43 ",,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,417 W WARREN ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 50 , 59 ,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,527 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",527 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538682216,PAIN CLINIC OF NORTH CAROLINA PA,,16511 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114145554,"GRAY III, LEE, VIRDIS",500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114146487,"SOMMER, COURTNEY, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114146487,"SOMMER, COURTNEY, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114146487,"SOMMER, COURTNEY, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114147022,"EBERT JR, CHARLES, STEPHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 23 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1114147022,"EBERT JR, CHARLES, STEPHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 35 , 63 , 81 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114147303,"DENLINGER, CRAIG, WESLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 17 , 30 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114147303,"DENLINGER, CRAIG, WESLEY",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114147303,"DENLINGER, CRAIG, WESLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 34 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114150612,"KATHPAL, MADEERA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1063890176,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM RADIATION ONCOLOGY,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1114150612,"KATHPAL, MADEERA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 17 , 89 , 113 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114150612,"KATHPAL, MADEERA",4101 MACON POND RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 19 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114152469,"TRAVELLI, FRANCES, CHEN",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114152469,"TRAVELLI, FRANCES, CHEN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114152469,"TRAVELLI, FRANCES, CHEN",1918 RANDOLPH RD STE 700 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 26 , 31 , 86 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114152469,"TRAVELLI, FRANCES, CHEN",1718 E 4TH ST STE 605 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 15 , 31 ,$#,,
MEDICAID DIRECT,1265488407,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC CARDIOLOGY,1918 RANDOLPH RD STE 700 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114152469,"TRAVELLI, FRANCES, CHEN",1918 RANDOLPH RD STE 700 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114152469,"TRAVELLI, FRANCES, CHEN",17810 STATESVILLE RD STE 311 CORNELIUS NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114152469,"TRAVELLI, FRANCES, CHEN",1718 E 4TH ST STE 605 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 28 , 35 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 44 , 52 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",120 HEALTHPLEX WAY   APEX NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",210 ASHVILLE AVE   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",210 ASHVILLE AVE   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 39 , 57 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 40 , 63 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114152675,"TOLIA, SHEEL, YESHWANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1114152832,"MALKA, SARAH, TEREZ",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114154663,"FALLS, WILLIAM, LEONARD",304 10TH AVE NE   HICKORY NC,018,Catawba,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 182 , 398 , 521 ," $11,967.93 ",,
MEDICAID DIRECT,1063617199,SCHOOL OF DENTISTRY UNIVERSITY OF,UNC ORTHODONTICS,UNC SCHOOL OF DENTISTRY BRAUER HALL CHAPEL HILL NC,019,Chatham,193400000X,Group,Single Specialty,,1114155280,"NGUYEN, TUNG, THANH",BRAUER HL   CHAPEL HILL NC,019,Chatham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 461 ," 2,416 "," 2,951 "," $423,820.05 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114155280,"NGUYEN, TUNG, THANH",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1063617199,SCHOOL OF DENTISTRY UNIVERSITY OF,UNC ORTHODONTICS,UNC SCHOOL OF DENTISTRY BRAUER HALL CHAPEL HILL NC,019,Chatham,193400000X,Group,Single Specialty,,1114155280,"NGUYEN, TUNG, THANH",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114155371,"STONESTREET, BRYAN, STEPHEN",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1114155371,"STONESTREET, BRYAN, STEPHEN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1114155371,"STONESTREET, BRYAN, STEPHEN",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114155371,"STONESTREET, BRYAN, STEPHEN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 44 , 55 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114155371,"STONESTREET, BRYAN, STEPHEN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 31 , 46 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114155447,"MILLER, SUSAN, NEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 78 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114156130,"GALLAGHER, KRISTALYN, KAY",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114156130,"GALLAGHER, KRISTALYN, KAY",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114156130,"GALLAGHER, KRISTALYN, KAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 20 , 29 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114156155,"BURHOP, JAMES, EDWARD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114157260,"BROWNLEE, DARLENE",24724 S BUSINESS 52   ALBEMARLE NC,084,Stanly,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114157260,"BROWNLEE, DARLENE",24724 S BUSINESS 52   ALBEMARLE NC,084,Stanly,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 29 , 97 , 97 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114157260,"BROWNLEE, DARLENE",13825 HUNTON LN   HUNTERSVILLE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 13 , 48 , 48 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114157260,"BROWNLEE, DARLENE",13825 HUNTON LN   HUNTERSVILLE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114157260,"BROWNLEE, DARLENE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 19 , 22 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 22 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 14 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 22 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114158599,"WOODY, JENNIFER, RHODES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1114160082,"JACOBS, RYAN, WAYNE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114160082,"JACOBS, RYAN, WAYNE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114160520,"GREER, KEVIN, WARREN",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 58 , 60 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114160520,"GREER, KEVIN, WARREN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 39 , 41 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114160652,"GANGAM, MEERA",2525 COURT DR   GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 18 , 19 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114160652,"GANGAM, MEERA",660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 51 , 105 , 118 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114160736,"KAYATHI, KAVITHA",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 51 , 51 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114161361,"KIRBY, CONRAD, QUINTON",2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 32 , 36 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",200 BELLAROSE LAKE WAY   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 55 , 62 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",3000 HOLSTON LN   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",1101 HARTWELL ST   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",6590 TRYON RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 95 , 167 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",616 WADE AVE   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 169 , 261 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",8200 LITCHFORD RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",2275 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",968 WAIT AVE   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 133 , 150 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",4000 GLENAIRE CIR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 38 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",2059 TORREDGE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 142 , 175 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",6000 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 202 , 262 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",2059 TORREDGE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114165321,"GIORDANO, BRIAN, MICHAEL",333 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1114167913,"LATEEF, MAHVESH, ZUBAIR",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114172483,OVERFLOW ENTERPRISES INC,THE READING ROOM,2990 CRYSTAL LN   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1114172483,OVERFLOW ENTERPRISES INC,2990 CRYSTAL LN   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,, 21 , 633 , 633 ," $43,482.12 ",,
MEDICAID DIRECT,1194285734,PT BIRTH 2 BOOMERS LLC,,364 US 70 W STE 3 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1114173382,"GOODFRED, ADRIENNE, STEARNS",364 US 70 W STE 3 MARION NC,059,McDowell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 20 , 40 ,$#,,
MEDICAID DIRECT,1194285734,PT BIRTH 2 BOOMERS LLC,,136 N LOGAN ST STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1114173382,"GOODFRED, ADRIENNE, STEARNS",364 US 70 W STE 3 MARION NC,059,McDowell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1194285734,PT BIRTH 2 BOOMERS LLC,,136 N LOGAN ST STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1114173382,"GOODFRED, ADRIENNE, STEARNS",136 N LOGAN ST   MARION NC,059,McDowell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,112 GAINSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114173846,"GRAHAM, TAMARA, NICOLE",112 GAINSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205579059,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC SUBSTANCE TREATMENT AND RECOVERY,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114174745,"CARRIER, ERIN, HEATHER",1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1114175528,"GORDON, LATONYA, COWSER",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1427516830,BHAVANA JAYARAM DMD PLLC,KANNAPOLIS PEDIATRIC DENTISTRY,1706 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114175528,"GORDON, LATONYA, COWSER",1706 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,527 "," 2,393 "," 7,825 "," $435,511.61 ",,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1114175528,"GORDON, LATONYA, COWSER",1706 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114181419,"SILWAL, ADWAIT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 57 , 184 , 191 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114181419,"SILWAL, ADWAIT",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114181419,"SILWAL, ADWAIT",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 52 , 78 , 84 ,$#,,
MEDICAID DIRECT,1194873901,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INFECTIOUS DISEASE SPECIALISTS,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114181419,"SILWAL, ADWAIT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114182771,"GUPTA, SANDHYA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114184918,"GROSS, JESSICA, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 101 , 144 , 161 ," $20,353.13 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114186368,"PARR, JONATHAN, BOYD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 21 , 65 , 65 ,$#,,
MEDICAID DIRECT,1306894597,MACON COLLIE PRETZER KORNSTEIN AND,WAKE ORTHODONTICS AND PEDIATRIC DENTISTRY,100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1114187812,"HICKS, TRAVIS, MARTIN",100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 936 ," 1,309 "," 4,650 "," $164,818.19 ",,
MEDICAID DIRECT,1306894597,MACON COLLIE PRETZER KORNSTEIN AND,WAKE ORTHODONTICS AND PEDIATRIC DENTISTRY,7401 CREEDMOOR RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114187812,"HICKS, TRAVIS, MARTIN",7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 236 , 284 , 953 ," $32,414.80 ",,
MEDICAID DIRECT,1306894597,MACON COLLIE PRETZER KORNSTEIN AND,WAKE ORTHODONTICS AND PEDIATRIC DENTISTRY,508 N 7TH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1114187812,"HICKS, TRAVIS, MARTIN",508 N 7TH ST   SMITHFIELD NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 13 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114188323,"SHELTON, MELISSA, JOY",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114188323,"SHELTON, MELISSA, JOY",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114188323,"SHELTON, MELISSA, JOY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 156 , 362 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114188323,"SHELTON, MELISSA, JOY",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114188323,"SHELTON, MELISSA, JOY",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 24 , 49 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114188323,"SHELTON, MELISSA, JOY",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 24 , 39 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114189974,"ARMENTROUT, RACHEL, AYNE",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114189974,"ARMENTROUT, RACHEL, AYNE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114189974,"ARMENTROUT, RACHEL, AYNE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114190774,"HARRY, ONENGIYA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114191244,"THOMAS, SARA-MAIZ, AFSANI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114191244,"THOMAS, SARA-MAIZ, AFSANI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 11 , 11 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114191244,"THOMAS, SARA-MAIZ, AFSANI",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114191244,"THOMAS, SARA-MAIZ, AFSANI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114191244,"THOMAS, SARA-MAIZ, AFSANI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376132571,FULLER & ASSOCIATES VII PLLC,CLINTON FAMILY & COSMETIC DENTISTRY,320 NORTHEAST BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1114191806,"HELMER, BLAKE, NATHAN",320 NORTHEAST BLVD   CLINTON NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice," 1,709 "," 2,905 "," 11,123 "," $531,075.32 ",,
MEDICAID DIRECT,1326443870,GOSHEN MEDICAL CENTER INCORPORATED,~,104 ADAIR DR   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114191806,"HELMER, BLAKE, NATHAN",104 ADAIR DR # C GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 23 , 62 ,$#,,
MEDICAID DIRECT,1114192358,NORTH CAROLINA BAPTIST HOSPITAL,BAPTIST HOSPITAL SPECIALTY RX,MEDICAL CENTER BLVD NORTH TOWER GROUND FLOOR WINSTON SALEM NC,034,Forsyth,251F00000X,Agencies,Home Infusion,,1114192358,NORTH CAROLINA BAPTIST HOSPITAL,MEDICAL CENTER BLVD NORTH TOWER GROUND FLOOR WINSTON SALEM NC,034,Forsyth,251F00000X,Agencies,Home Infusion,,#, 56 , 176 ," $55,780.28 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114193224,"TUREK, JOSEPH, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114193224,"TUREK, JOSEPH, WILLIAM",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114193844,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY EMS,120 S 3RD ST   SMITHFIELD NC,051,Johnston,3416L0300X,Transportation Services,Ambulance,Land Transport,1114193844,COUNTY OF JOHNSTON NORTH CAROLINA,120 S 3RD ST   SMITHFIELD NC,051,Johnston,3416L0300X,Transportation Services,Ambulance,Land Transport," 1,591 "," 2,838 "," 5,200 "," $68,049.93 ",,
MEDICAID DIRECT,1114193943,ABERDEEN PRESCRIPTION SHOPPE,ABERDEEN PRESCRIPTION SHOPPE,1389 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114193943,ABERDEEN PRESCRIPTION SHOPPE,1389 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114194099,"PRZYBYSZ II, THOMAS, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 13 , 30 , 39 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 24 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 21 , 27 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 17 , 27 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 37 , 58 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",839 DURHAM RD SUITE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114194537,"WATTS V, JOHN, ALEXANDER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 21 , 26 ,$#,,
MEDICAID DIRECT,1114209889,BLESSED HANDS HOME CARE,~,3325 WASHBURN AVE STE 218 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1114209889,BLESSED HANDS HOME CARE,3325 WASHBURN AVE STE 218 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 2,974 "," 2,974 "," $177,560.32 ",,
MEDICAID DIRECT,1114210218,SECOND TO NATURE BOUTIQUE LLC,~,4123 LAWNDALE DR STE 101 GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114210218,SECOND TO NATURE BOUTIQUE LLC,4123 LAWNDALE DR STE 101 GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114210366,"NAZARETH-PIDGEON, KRISTINA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 153 , 158 ," $13,215.49 ",,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1114211794,"PARKER, BENJAMIN, RAYMOND",232 BOONE HEIGHTS DR   BOONE NC,095,Watauga,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 30 , 89 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1114211794,"PARKER, BENJAMIN, RAYMOND",135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 26 , 48 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1114211794,"PARKER, BENJAMIN, RAYMOND",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 35 , 48 ," $10,184.79 ",,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114213113,"VISHNUMOLAKALA, PARDHA SARADHI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 100 , 317 , 318 ," $15,370.11 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1114213162,"WILFORD, RUSSELL, RAYMOND",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114213162,"WILFORD, RUSSELL, RAYMOND",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114213162,"WILFORD, RUSSELL, RAYMOND",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1114213162,"WILFORD, RUSSELL, RAYMOND",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114213162,"WILFORD, RUSSELL, RAYMOND",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 38 , 39 ,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114213790,"PEREZ-SANTOS, JORGE, ENRIQUE",1725 S MAIN ST   WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 13 , 19 , 81 ,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,1725 S MAIN ST STE 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1114213790,"PEREZ-SANTOS, JORGE, ENRIQUE",1725 S MAIN ST   WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 12 ,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114214459,"SHARMA, MANU",1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 47 , 68 , 107 ,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114214459,"SHARMA, MANU",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114215670,"STUART, JILL, ZUKERMAN",932 MORREENE RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 21 , 37 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114215670,"STUART, JILL, ZUKERMAN",932 MORREENE RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114215670,"STUART, JILL, ZUKERMAN",1829 E FRANKLIN ST STE 500 CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1114216918,"LEDFORD, CHERIE, LYNETTE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 23 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114216918,"LEDFORD, CHERIE, LYNETTE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114217288,"PICKENS JR, CHARLIE",945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114217288,"PICKENS JR, CHARLIE",520 N ELAM AVE 2ND FLOOR STE A GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114217288,"PICKENS JR, CHARLIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114217288,"PICKENS JR, CHARLIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 59 , 62 , 80 ," $12,231.65 ",,
MEDICAID DIRECT,1700323557,GREENVILLE HEALTH CARE PA,,3121 MOSELEY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114218492,"RUSSELL, DEMAURA, HAWKINS",702 N MAIN ST   ROXBORO NC,073,Person,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710448006,HOPE REGIONAL MEDICAL CLINIC,,546 W RIDGEWAY ST   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1114218492,"RUSSELL, DEMAURA, HAWKINS",546 W RIDGEWAY ST   WARRENTON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 113 , 184 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114219367,"JOHNSON, MARGARET, OLGA",20 DUKE MEDICINE CIR CLINIC 3 DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114219367,"JOHNSON, MARGARET, OLGA",2301 ERWIN ROAD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114219367,"JOHNSON, MARGARET, OLGA",2301 ERWIN ROAD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1851177539,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114220613,"STEVENS, BRUCE, JAMIE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114220613,"STEVENS, BRUCE, JAMIE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1689870941,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114220613,"STEVENS, BRUCE, JAMIE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114220613,"STEVENS, BRUCE, JAMIE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 19 , 37 , 37 ,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114220613,"STEVENS, BRUCE, JAMIE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114220613,"STEVENS, BRUCE, JAMIE",330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114221074,"MCGINTY, KATRINA, ANNE",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114221074,"MCGINTY, KATRINA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114221074,"MCGINTY, KATRINA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114221074,"MCGINTY, KATRINA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114221074,"MCGINTY, KATRINA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 201 , 231 , 276 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114221074,"MCGINTY, KATRINA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114221074,"MCGINTY, KATRINA, ANNE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114222940,"WIELAND, ALISON, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114222940,"WIELAND, ALISON, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 36 , 73 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 86 , 141 , 183 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 31 , 38 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 63 , 76 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 298 , 508 , 633 ," $10,709.57 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114226354,"RAJPER, NAVEED, ALI",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 30 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114230422,"SIMS, NATHAN, KYLE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114233590,PEDIATRIC BOULEVARD PLLC,~,2814 GRAY FOX RD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114233590,PEDIATRIC BOULEVARD PLLC,2814 GRAY FOX RD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,, 82 , 682 , 935 ," $64,953.54 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114239126,"DOWNING, TREVOR, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 25 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114239126,"DOWNING, TREVOR, MICHAEL",310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114239126,"DOWNING, TREVOR, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 58 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114239126,"DOWNING, TREVOR, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 106 , 121 , 248 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114239126,"DOWNING, TREVOR, MICHAEL",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114243433,"AKINKUOTU, ADESOLA, CYNTHIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 82 , 90 ," $15,711.75 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114243987,"KRAM, DAVID, ERIC",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 14 , 50 , 51 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114245446,"BYRD, BARI, MARISSA EBERHARDT",3805 COMPUTER DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114245933,"CLARK, MARSHA, SMITH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114245933,"CLARK, MARSHA, SMITH",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114245933,"CLARK, MARSHA, SMITH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114245933,"CLARK, MARSHA, SMITH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114246717,"ROSALES, NANCY, DOMINIQUE",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114246717,"ROSALES, NANCY, DOMINIQUE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 19 , 24 ,$#,,
MEDICAID DIRECT,1255054409,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE SPECIALTY CLINICS,1551 WESTBROOK PLAZA DR STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114246717,"ROSALES, NANCY, DOMINIQUE",1730 KERNERSVILLE MEDICAL PKWY STE 201 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 31 , 42 , 43 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114246717,"ROSALES, NANCY, DOMINIQUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1114248051,"SETH, ISHITA",ISHITA SETH DMD PLLC,11318 N COMMUNITY HOUSE RD STE 210 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1114248051,"SETH, ISHITA",11318 N COMMUNITY HOUSE RD STE 210 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 53 , 210 ,$#,,
MEDICAID DIRECT,1801481965,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR WRIGHTSVILLE BEACH FAMILY MEDICINE,1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114252988,"LOMAX, KATHRYN, GARDNER",1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 67 , 165 ,$#,,
MEDICAID DIRECT,1801481965,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR WRIGHTSVILLE BEACH FAMILY MEDICINE,1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114252988,"LOMAX, KATHRYN, GARDNER",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 23 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114256963,"NEWSOME, ELIZABETH, CICELY",1704 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 14 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114256963,"NEWSOME, ELIZABETH, CICELY",105 NEWSOM ST STE 101 DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114256963,"NEWSOME, ELIZABETH, CICELY",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114256963,"NEWSOME, ELIZABETH, CICELY",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114257284,"BURNE, BRIAN, ALAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114257284,"BURNE, BRIAN, ALAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114257821,"SARTOR, NICOLE, FARA",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 65 , 290 , 574 ," $120,141.14 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114257821,"SARTOR, NICOLE, FARA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 11 , 15 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114257821,"SARTOR, NICOLE, FARA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114257821,"SARTOR, NICOLE, FARA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114258191,"XU, ZI, RONG",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114259660,"STRAUBE, JESSICA, SLAUGHTER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114259660,"STRAUBE, JESSICA, SLAUGHTER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 31 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114261039,"STRICKLAND, SARA, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114261039,"STRICKLAND, SARA, ANNE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 46 , 62 , 62 ,$#,,
MEDICAID DIRECT,1114263845,WP-BREVARD HEALTH HOLDINGS II LLC,KINGSBRIDGE HOUSE,10 SUGAR LOAF RD   BREVARD NC,088,Transylvania,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1114263845,WP-BREVARD HEALTH HOLDINGS II LLC,10 SUGAR LOAF RD   BREVARD NC,088,Transylvania,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 20 ," 4,985 "," 4,987 "," $495,705.55 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114264066,"FINNIE, AIMEE, KRISTEN-IRVIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114264066,"FINNIE, AIMEE, KRISTEN-IRVIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1114264066,"FINNIE, AIMEE, KRISTEN-IRVIN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114266632,"CHILDERS, TYLER, KEITH",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114269594,"TRZEBUCKI, ALEX, MARSHAL",3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1912784406,REX HOSPITAL INC,NORTH CAROLINA INFECTIOUS DISEASES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114269594,"TRZEBUCKI, ALEX, MARSHAL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114271392,"SCHUPP, PETER, JOSEPH",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114272473,"PARROTT, EMILIA, ANNA",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 26 , 85 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114272473,"PARROTT, EMILIA, ANNA",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114272473,"PARROTT, EMILIA, ANNA",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114272473,"PARROTT, EMILIA, ANNA",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 63 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114272473,"PARROTT, EMILIA, ANNA",1423 GREENFIELD ST.   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 69 , 128 ,$#,,
MEDICAID DIRECT,1114272481,"MCCALLISTER, EMILY, ANN",~,14 S WILDWOOD LN   FLETCHER NC,045,Henderson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1114272481,"MCCALLISTER, EMILY, ANN",14 S WILDWOOD LN   FLETCHER NC,045,Henderson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114272838,"RAPE, TAMARA, WATERS",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 50 , 56 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114272838,"RAPE, TAMARA, WATERS",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114274586,"PULLA, JYOSTNA, DEEPIKA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114274586,"PULLA, JYOSTNA, DEEPIKA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 25 , 25 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1114274586,"PULLA, JYOSTNA, DEEPIKA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114274586,"PULLA, JYOSTNA, DEEPIKA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114274586,"PULLA, JYOSTNA, DEEPIKA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114274586,"PULLA, JYOSTNA, DEEPIKA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114274586,"PULLA, JYOSTNA, DEEPIKA",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114276409,"KENT, AMANDA, ARTHUR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 25 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1114280096,"ARON, JENNIFER, LYNN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 16 , 49 , 53 ,$#,,
MEDICAID DIRECT,1104918754,SCOTLAND MEMORIAL HOSPITAL INC,~,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1114280468,"MILLER, ELIZABETH, ANN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114281128,"MCCORMACK, LAUREN, KATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 58 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114281383,"PUSULURI, BHASKAR",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114281383,"PUSULURI, BHASKAR",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 110 , 110 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114281383,"PUSULURI, BHASKAR",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114281383,"PUSULURI, BHASKAR",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,310 LONG SHOALS RD STE 202 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114281755,"LARRABEE, JON, WARE",310 LONG SHOALS RD STE 202 ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114281755,"LARRABEE, JON, WARE",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114281755,"LARRABEE, JON, WARE",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114281805,"KUE-A-PAI, PONGSATHORN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 227 , 227 ,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114285350,"ROSS, MALCOLM, STRACHAN",885 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 18 , 26 , 58 ,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114285350,"ROSS, MALCOLM, STRACHAN",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#, 17 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114285350,"ROSS, MALCOLM, STRACHAN",1918 RANDOLPH RD STE 175 CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#, 16 ,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114285350,"ROSS, MALCOLM, STRACHAN",1918 RANDOLPH RD STE 175 CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114285350,"ROSS, MALCOLM, STRACHAN",125 QUEENS RD STE 540 CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 14 , 23 , 40 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114285350,"ROSS, MALCOLM, STRACHAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114286390,"MALAND, DANIEL, WILLIAM",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1114286390,"MALAND, DANIEL, WILLIAM",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114286390,"MALAND, DANIEL, WILLIAM",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659340636,IMAGING SPECIALISTS PLLC,,750 OLD HICKORY BLVD BLDG 1-260 BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1114286390,"MALAND, DANIEL, WILLIAM",750 OLD HICKORY BLVD STE 1-260 BRENTWOOD TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114286390,"MALAND, DANIEL, WILLIAM",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114287117,"BUCH, ASHESH, NARENDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1114287117,"BUCH, ASHESH, NARENDRA",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1114287117,"BUCH, ASHESH, NARENDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114287117,"BUCH, ASHESH, NARENDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114290855,"WERDEL, JESSICA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 15 , 23 , 39 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1114292653,"FAKIH, FAISAL, MOHAMMAD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 152 , 152 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114292653,"FAKIH, FAISAL, MOHAMMAD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 77 , 77 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114293172,"WACKS, MARGOT, ALEXANDRA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114293172,"WACKS, MARGOT, ALEXANDRA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114293172,"WACKS, MARGOT, ALEXANDRA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114293172,"WACKS, MARGOT, ALEXANDRA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 27 , 35 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114293172,"WACKS, MARGOT, ALEXANDRA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,522 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1114293172,"WACKS, MARGOT, ALEXANDRA",522 S VAN BUREN RD   EDEN NC,079,Rockingham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558800722,EYECARECENTER OD PA,,212 S MAIN ST   DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1114295789,"KEENE, AMY, BUCHANAN",220 S MAIN ST   DOBSON NC,086,Surry,152W00000X,Eye and Vision Services Providers,Optometrist,, 42 , 50 , 61 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1114300464,"SANDLIN, KEIVA, SUMNER",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 71 , 214 , 227 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114300464,"SANDLIN, KEIVA, SUMNER",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 29 , 181 , 191 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1114300464,"SANDLIN, KEIVA, SUMNER",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1114300464,"SANDLIN, KEIVA, SUMNER",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1114300464,"SANDLIN, KEIVA, SUMNER",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 56 , 175 , 187 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114300464,"SANDLIN, KEIVA, SUMNER",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114301850,"FENAR, CHRISTOPHER, STEPHEN",1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114301850,"FENAR, CHRISTOPHER, STEPHEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 19 , 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114302817,"MARTYAK, JENNIFER, STARNES",2049 MOORE RD   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 52 , 212 , 213 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114302817,"MARTYAK, JENNIFER, STARNES",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114302817,"MARTYAK, JENNIFER, STARNES",6300 ROBERTA RD   HARRISBURG NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 156 , 156 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 18 , 23 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114303989,"THAKKAR, ASTHA, DIPAN",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114305273,"HOFMAN, ARIEL, RENAYE",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 19 , 23 , 24 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114305398,"SHAH, RAVI, SHAILESH",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 23 , 36 , 37 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1114305398,"SHAH, RAVI, SHAILESH",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114308392,"WALTER, JONATHAN, DAVID",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 54 , 54 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114308392,"WALTER, JONATHAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 73 , 73 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114308392,"WALTER, JONATHAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1275595639,PITT COUNTY MEMORIAL HOSPITAL INC,ECU HEALTH MEDICAL CENTER,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1114309093,"BECKER, AMY, ROGERS",2100 STANTONSBURG RD AUDIOLOGY DEPARTMENT GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114309259,"SHEETS, TAYLOR, NORMAN",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114309259,"SHEETS, TAYLOR, NORMAN",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 53 , 54 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114310232,"HAWKS, CHRISTY, ANN",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 20 , 20 ,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1114310232,"HAWKS, CHRISTY, ANN",401 W DECATUR ST   MADISON NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 90 , 252 , 376 ,$#,,
MEDICAID DIRECT,1124595475,GREATER CHARLOTTE ORAL FACIAL SURG,,527 S NEW HOPE RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1114310943,"SABOOREE, SEPIDEH",10042 PARK CEDAR DR STE B CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457565848,GREATER CHARLOTTE ORAL FACIAL SURG,,10042 PARK CEDAR DR STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114310943,"SABOOREE, SEPIDEH",10042 PARK CEDAR DR STE B CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 59 , 64 , 382 ," $38,503.88 ",,
MEDICAID DIRECT,1114311628,AMOR HOME CARE LLC,,524 ATKINSON ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1114311628,AMOR HOME CARE LLC,524 ATKINSON ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 57 ," 12,597 "," 12,729 "," $993,996.88 ",,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1114311966,"MOVAGHAR, SARA, MINAI",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 127 , 175 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114312436,"EDINGTON, HOLLY, JANE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114312436,"EDINGTON, HOLLY, JANE",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 18 , 62 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114313574,"GYAWALI, SAROJ",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114313574,"GYAWALI, SAROJ",2525 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 50 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114314135,"ALFORD, MEGAN, PIKE",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114314820,"STOLTZFUS, GREGORY, PAUL",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 29 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114314820,"STOLTZFUS, GREGORY, PAUL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 102 , 106 , 122 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114314820,"STOLTZFUS, GREGORY, PAUL",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114314820,"STOLTZFUS, GREGORY, PAUL",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114315264,"MEYERS, BRANDON, VINCENT",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114315264,"MEYERS, BRANDON, VINCENT",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1114315264,"MEYERS, BRANDON, VINCENT",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114318409,"GOCA, MARYAM, KHAYAMI",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1114323011,"MORRISON, KEVIN, GATEWOOD",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1114323011,"MORRISON, KEVIN, GATEWOOD",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1114323011,"MORRISON, KEVIN, GATEWOOD",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114323011,"MORRISON, KEVIN, GATEWOOD",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114323011,"MORRISON, KEVIN, GATEWOOD",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1083616809,GREENE COUNTY HEALTH CARE INC,STUDENT HEALTH SERVICES - GREENE,140 SCHOOL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114325651,"STOVER, ERIN, JOYCE",140 SCHOOL DR   SNOW HILL NC,040,Greene,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114327467,"EDATHIL, ROSHEN, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114327640,"JARVELA, JOSHUA, RYAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114327640,"JARVELA, JOSHUA, RYAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548801681,EMRICH & WOOD DDS PLLC,THE CLAYTON DENTAL CENTER,660 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114330503,"WOOD, EDWARD, WOOTEN",660 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114331964,"BRIGHT, JACOB, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114331964,"BRIGHT, JACOB, MICHAEL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 72 , 76 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1114332731,"MILLIGAN, NICHOLAS, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 39 , 40 , 60 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1114332731,"MILLIGAN, NICHOLAS, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",1712 S STRATFORD RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 13 , 28 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",600 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 60 , 109 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",4012B BATTLEGROUND AVE STE 1020 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114334794,"FAWCETT-HARDY, JUNE, ANNE",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114337607,"VAKKALANKA, SUJIT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114337607,"VAKKALANKA, SUJIT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 62 , 62 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114338696,"DISSER, ANDREW, LOUIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114338696,"DISSER, ANDREW, LOUIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114338993,"HARRIS, RYAN, GENE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 33 , 102 , 102 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114338993,"HARRIS, RYAN, GENE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114338993,"HARRIS, RYAN, GENE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1114339355,"BALLARD, JOSEPH, MARSHALL",,5811 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,1114339355,"BALLARD, JOSEPH, MARSHALL",5811 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 32 , 58 ,$#,,
MEDICAID DIRECT,1730804337,NORTHSIDE FAMILY EYE CARE OPTOMETRY,NORTHSIDE FAMILY EYE CARE OPTOMETRY PA,5811 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1114339355,"BALLARD, JOSEPH, MARSHALL",5811 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 71 , 93 , 226 ,$#,,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114339447,"RIDDER, KAITLIN, CLAIRE",4222 LONG BEACH RD SE STE B SOUTHPORT NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114339447,"RIDDER, KAITLIN, CLAIRE",1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 75 , 136 , 353 ,$#,,
MEDICAID DIRECT,1114339447,"RIDDER, KAITLIN, CLAIRE",,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114339447,"RIDDER, KAITLIN, CLAIRE",1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114340163,"DEVANE, PATRICK, BOYD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 23 , 24 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114340163,"DEVANE, PATRICK, BOYD",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114342615,ABC SPEECH THERAPY SOLUTIONS PLLC,,6448 MAIN CIRCLE ST   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1114342615,ABC SPEECH THERAPY SOLUTIONS PLLC,6448 MAIN CIRCLE ST   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,, 148 ," 1,613 "," 1,799 "," $124,954.75 ",,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114343746,"MILLER, NICOLE, ELIZABETH",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114343993,"MCNALLY, TARA, ANN MARGARET",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 191 , 193 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114344207,"WILLIAMSON, PRERANA, AGHAMKAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 62 , 89 , 92 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114344413,"MILLER, JORDAN, HUNT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 31 , 46 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114344413,"MILLER, JORDAN, HUNT",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114344413,"MILLER, JORDAN, HUNT",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114344413,"MILLER, JORDAN, HUNT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 65 , 65 , 80 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1114344413,"MILLER, JORDAN, HUNT",800 TILGHMAN DR   DUNN NC,043,Harnett,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1114344413,"MILLER, JORDAN, HUNT",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 28 , 39 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 33 , 38 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 30 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1114347952,"HUMPHREY, JORDAN, CHRISTOPHER",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1114353471,"SHIPLEY, JACLYN, BENTHALL",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4207 LAKE BOONE TRL STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114357274,"VASSALLO, SHANNON, DOROTHEA",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114357274,"VASSALLO, SHANNON, DOROTHEA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114358371,"WHALEY, SHERRY, RENEE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1114358371,"WHALEY, SHERRY, RENEE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114358371,"WHALEY, SHERRY, RENEE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1114358371,"WHALEY, SHERRY, RENEE",4810 S CROATAN HWY   NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114684941,COLUMBUS REGIONAL DIAGNOSTICS,ADVANCED IMAGING,509 OLDE WATERFORD WAY STE 104 LELAND NC,010,Brunswick,293D00000X,Laboratories,Physiological Laboratory,,1114358652,"SNOW, CHAD, ALLEN",144 POOLE RD STE 102 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801126479,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST UROLOGY,144 POOLE RD STE 102 LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1114358652,"SNOW, CHAD, ALLEN",144 POOLE RD STE 102 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 76 , 123 ,$#,,
MEDICAID DIRECT,1639556004,TERRIE HESS CHILD ADVOCACY CENTER,PREVENT CHILD ABUSE ROWAN,130 WOODSON ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1114359726,"BLAKE, MANDY, SHERMAN",130 WOODSON ST   SALISBURY NC,080,Rowan,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 20 , 20 , 55 ," $10,550.34 ",,
MEDICAID DIRECT,1639556004,TERRIE HESS CHILD ADVOCACY CENTER,PREVENT CHILD ABUSE ROWAN,130 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1114359726,"BLAKE, MANDY, SHERMAN",130 WOODSON ST   SALISBURY NC,080,Rowan,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114360187,"SHENSKY, KEITHE, SACLAYAN",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 30 , 81 , 101 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114360187,"SHENSKY, KEITHE, SACLAYAN",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 26 , 82 , 100 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114360187,"SHENSKY, KEITHE, SACLAYAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114360799,"HOWARD, JAMES, STANLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 43 , 44 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114360799,"HOWARD, JAMES, STANLEY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 38 , 40 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114360799,"HOWARD, JAMES, STANLEY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114361110,"DOLAN, STEPHANIE, IWALANI",3116 N DUKE ST   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 18 , 26 , 46 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114362480,"WILLIAMS, CARLI, DANIELLE",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457512691,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER AT CALHOUN DRIVE,240 CALHOUN DR   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114362480,"WILLIAMS, CARLI, DANIELLE",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 37 , 42 ,$#,,
MEDICAID DIRECT,1457512691,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER AT CALHOUN DRIVE,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114362480,"WILLIAMS, CARLI, DANIELLE",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114362621,"PARSONS, MICHAEL, RESNICK",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114362696,"ALLMAN, CAROLYN, ANTOINETTE",3150 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 37 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 58 , 114 , 185 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114362746,"SETHI, NEETA, JAIN",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1114362860,"JORDAN, RYAN, MICHAEL",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114362860,"JORDAN, RYAN, MICHAEL",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114362860,"JORDAN, RYAN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 128 , 145 , 155 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114362860,"JORDAN, RYAN, MICHAEL",521C MOYE BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1295118628,MICHAEL J A MAGNOTTA DDS PLLC,MAGNOTTA & ASSOCIATES,801 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1114363975,"MAGNOTTA, MICHAEL, JOHN ANTHONY",801 W FLEMING DR   MORGANTON NC,012,Burke,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 61 ,$#,,
MEDICAID DIRECT,1114364304,DAWN M MOORE MA CCC SLP INC,EXPRESSIONS SPEECH LANGUAGE MYOFUNCTIONAL CTR,3102 S CHURCH ST STE 102 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114364304,DAWN M MOORE MA CCC SLP INC,3102 S CHURCH ST STE 102 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,, 107 ," 1,982 "," 2,000 "," $135,701.34 ",,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114365160,"AFSHAR, KATTY, VICTORIA",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114365749,"HEARTY, ELLEN, LEIGH",430 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114365749,"HEARTY, ELLEN, LEIGH",472 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 50 , 65 ," $13,749.04 ",,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114365749,"HEARTY, ELLEN, LEIGH",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740702497,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE HOLLY SPRINGS,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1114365905,"BARTKOSKI, SCOTT, JACOB",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114366101,"MCCANN, EVA, MARIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114366101,"MCCANN, EVA, MARIA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114366101,"MCCANN, EVA, MARIA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114367984,"PIERRIE, SARAH, NICHOLLS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 45 , 50 , 77 ," $23,841.85 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114367984,"PIERRIE, SARAH, NICHOLLS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114367984,"PIERRIE, SARAH, NICHOLLS",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1689601130,MOBILE AUDIOLOGY ASSOCIATES PC,HEALTHDRIVE AUDIOLOGY GROUP,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114368214,"REHRER, KATHLEEN, RAFAEL",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 19 , 19 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114369212,"KARIVEDU, VIDHYA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114369212,"KARIVEDU, VIDHYA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114369212,"KARIVEDU, VIDHYA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1114369576,"SANFORD, JOANNA, GLORIA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1114369576,"SANFORD, JOANNA, GLORIA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1114369576,"SANFORD, JOANNA, GLORIA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 49 , 57 ,$#,,
MEDICAID DIRECT,1114369923,LILYS BLESSINGS FAMILY CARE HOME,~,1246 WEEKSVILLE RD   ELIZABETH CITY NC,070,Pasquotank,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1114369923,LILYS BLESSINGS FAMILY CARE HOME,1246 WEEKSVILLE RD   ELIZABETH CITY NC,070,Pasquotank,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,550 "," 1,550 "," $121,402.41 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1114370749,"YURIDULLAH, RUHIN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1114370749,"YURIDULLAH, RUHIN",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114371762,"ROSE, SCOTT, WILSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 35 , 50 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114371762,"ROSE, SCOTT, WILSON",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 25 , 38 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1114372323,"STEINMEYER, LAURA, ANN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 86 , 89 , 123 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114372323,"STEINMEYER, LAURA, ANN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 144 , 149 , 208 ," $12,580.35 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114373784,"MILLER, JAMES, THOMAS",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1194263087,DLP FRYE MEDICAL GROUP,FRYECARE WOMENS SERVICES,1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114373784,"MILLER, JAMES, THOMAS",1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 48 , 72 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",1403 S KING ST   WINDSOR NC,008,Bertie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",211 VIRGINIA RD   EDENTON NC,021,Chowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 78 , 80 , 95 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 39 , 45 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 73 , 86 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114373966,"SNYDER, DOUGLAS, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538340559,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,2711 X RAY DR STE 3106 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1114375300,"LONDON, TRENEICE, CHARLETTE",2711 X RAY DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114376209,"GUPTA, VISHAL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114376738,"MIMS, LAUREN, WHITNEY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 18 , 46 , 47 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114376738,"MIMS, LAUREN, WHITNEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1114378759,"WALLACE, BRIAN, CHARLES",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 35 , 38 ,$#,,
MEDICAID DIRECT,1306269691,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1656 RIVERCHASE BLVD STE 1400 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114378775,"BANO, KULSUM",1656 RIVERCHASE BLVD   ROCK HILL SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1114378940,"CARIAS ZUNIGA, SANDRA, GABRIELA",1530 S LAFAYETTE ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 65 , 65 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1114378940,"CARIAS ZUNIGA, SANDRA, GABRIELA",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 82 , 109 , 165 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1114378940,"CARIAS ZUNIGA, SANDRA, GABRIELA",201 E GROVER ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 72 , 72 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1114378940,"CARIAS ZUNIGA, SANDRA, GABRIELA",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 49 , 63 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1114378940,"CARIAS ZUNIGA, SANDRA, GABRIELA",1016 N LAFAYETTE ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1114378940,"CARIAS ZUNIGA, SANDRA, GABRIELA",1010 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 73 , 73 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114378999,"MACIK, JASON",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114378999,"MACIK, JASON",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 21 , 31 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,107 W NAOMI ST   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,,1114378999,"MACIK, JASON",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 35 , 111 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 88 , 88 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 152 , 152 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1114380490,"CROOKS, MICHAEL, JESSE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114380524,"SCHWARTZ, ANDREW, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114380524,"SCHWARTZ, ANDREW, MICHAEL",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 23 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114380524,"SCHWARTZ, ANDREW, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114380524,"SCHWARTZ, ANDREW, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114380888,"TURNER, DANIEL, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 23 , 30 , 40 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114380888,"TURNER, DANIEL, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 ,#, 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114380888,"TURNER, DANIEL, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114380888,"TURNER, DANIEL, JOSEPH",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 46 , 71 , 126 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114380888,"TURNER, DANIEL, JOSEPH",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114380888,"TURNER, DANIEL, JOSEPH",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114381134,"MCNEELY, PETER, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114381134,"MCNEELY, PETER, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114381738,"CAUDILL, ELIZABETH, MITCHELL",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 36 , 41 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1114381738,"CAUDILL, ELIZABETH, MITCHELL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114383528,"RHODES, KATLYN, ELOSHWAY",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1114383528,"RHODES, KATLYN, ELOSHWAY",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 22 , 52 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1114383668,"ENSLEY, ALISON, MACDONALD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 21 , 28 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114383668,"ENSLEY, ALISON, MACDONALD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 42 , 50 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1114383668,"ENSLEY, ALISON, MACDONALD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1114383668,"ENSLEY, ALISON, MACDONALD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114385283,"JACKSON, MORGAN, PARKS",208 COX BLVD STE 201 GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 76 , 96 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,208 COX BLVD STE 201 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1114385283,"JACKSON, MORGAN, PARKS",208 COX BLVD STE 201 GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 156 , 228 , 295 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114386224,"MAYO, LINDA, MAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114386224,"MAYO, LINDA, MAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2400 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114389608,"ABDOU, MICHAEL, ANTOUN",4901 DAWN DR STE 2400 LUMBERTON NC,078,Robeson,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 21 , 33 , 39 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114389608,"ABDOU, MICHAEL, ANTOUN",4901 DAWN DR STE 2400 LUMBERTON NC,078,Robeson,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114389608,"ABDOU, MICHAEL, ANTOUN",4901 DAWN DR STE 2400 LUMBERTON NC,078,Robeson,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114395175,"WHITTON, KATHERINE, EMILY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114395175,"WHITTON, KATHERINE, EMILY",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114395175,"WHITTON, KATHERINE, EMILY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 52 , 77 , 83 ,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1114396496,"PURCELL, EMILY, CRABTREE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 38 , 38 ,$#,,
MEDICAID DIRECT,1003288093,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1656 RIVERCHASE BLVD STE 1800 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114402245,"CLINTON, AMY, CABANISS",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114402245,"CLINTON, AMY, CABANISS",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114407939,"WALKER, JESSICA, CLARK",308 US HIGHWAY 17 N   HOLLY RIDGE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1114407939,"WALKER, JESSICA, CLARK",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 25 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114408861,"IVEY, JESSICA, CLEMENTS",210 SMITH CHURCH RD BLDG 1 ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 52 , 77 ,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114409836,"FIELDS, MEGHAN, BYNUM",11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114410396,CONNECT SPEECH AND LANGUAGE SERVICE,,1473 BIG LEAF LOOP   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1114410396,CONNECT SPEECH AND LANGUAGE SERVICE,1473 BIG LEAF LOOP   APEX NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114411105,"REDDY, KEERTAN, GUNNA",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114412475,"PATEL, RAJ, ASHOK",1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 22 ,$#,,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114412475,"PATEL, RAJ, ASHOK",1176 E CUTLAR XING STE C LELAND NC,010,Brunswick,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114413606,"ALLRED, BRADEN, LEE",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114413606,"ALLRED, BRADEN, LEE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114413606,"ALLRED, BRADEN, LEE",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114413606,"ALLRED, BRADEN, LEE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619606316,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2775 HENDERSONVILLE ROAD,2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114414729,"AUSTIN, SOPHIE, LEIGH",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 135 , 200 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1114414729,"AUSTIN, SOPHIE, LEIGH",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114414729,"AUSTIN, SOPHIE, LEIGH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1114415585,"LORENTSEN, MICHAEL, KENNETH",300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 21 , 29 , 31 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114415585,"LORENTSEN, MICHAEL, KENNETH",300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 46 , 56 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",5601 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 31 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 2101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",5601 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 22 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 49 , 49 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114416583,"WANG, XUEXIANG",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1114416971,"SLAWTER, MATTHEW, JON",388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,302 STONE RIDGE BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1114416971,"SLAWTER, MATTHEW, JON",388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1114416971,"SLAWTER, MATTHEW, JON",110 DUTCHMAN CT   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1114416971,"SLAWTER, MATTHEW, JON",110 DUTCHMAN CT   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,302 STONE RIDGE BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1114416971,"SLAWTER, MATTHEW, JON",110 DUTCHMAN CT   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1801813712,REVIVAL PAIN MANAGEMENT INC,REVIVAL PAIN MANAGEMENT INC,1925 N BRIDGE ST STE 101 ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1114416971,"SLAWTER, MATTHEW, JON",110 DUTCHMAN CT   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114418050,"ECKENSWEILER, LUTING, SUN",100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 28 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114418050,"ECKENSWEILER, LUTING, SUN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 21 , 29 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114418522,"PIERCE, MANDI, KRISTINA",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 70 , 70 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114418522,"PIERCE, MANDI, KRISTINA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114419231,"GN, MARTUS, ZHENG QUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 20 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114419231,"GN, MARTUS, ZHENG QUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 30 , 46 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114419231,"GN, MARTUS, ZHENG QUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 17 , 23 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114419231,"GN, MARTUS, ZHENG QUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 48 , 48 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",345 MANOR RD   MARS HILL NC,057,Madison,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",345 MANOR RD   MARS HILL NC,057,Madison,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 114 , 114 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",345 MANOR RD   MARS HILL NC,057,Madison,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114419728,"EMERY, ALICIA, SUSANNE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114422003,"STEWART, SARAH, JANE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,716 SIPES ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114422003,"STEWART, SARAH, JANE",3975 ROBINSON RD   NEWTON NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1114422003,"STEWART, SARAH, JANE",3975 ROBINSON RD   NEWTON NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1114422003,"STEWART, SARAH, JANE",3975 ROBINSON RD   NEWTON NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 80 , 80 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114422003,"STEWART, SARAH, JANE",3975 ROBINSON RD   NEWTON NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 37 , 37 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114422177,"CARLON, TIMOTHY, ANDREW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 84 , 102 , 148 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114422177,"CARLON, TIMOTHY, ANDREW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 107 , 118 , 153 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114422219,"FISCHER, DAVID, SHI",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114422219,"FISCHER, DAVID, SHI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 22 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114422219,"FISCHER, DAVID, SHI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1114422219,"FISCHER, DAVID, SHI",1530 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1114422219,"FISCHER, DAVID, SHI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 21 , 23 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423100,"KAYASTHA, NEHA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 30 , 55 , 70 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423100,"KAYASTHA, NEHA",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 19 , 20 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423100,"KAYASTHA, NEHA",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114423183,"KIM, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 72 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114423183,"KIM, JOHN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 30 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423704,"PONDER, MICHELLE, MERIWEATHER",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423704,"PONDER, MICHELLE, MERIWEATHER",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 17 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423704,"PONDER, MICHELLE, MERIWEATHER",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 17 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423704,"PONDER, MICHELLE, MERIWEATHER",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114423704,"PONDER, MICHELLE, MERIWEATHER",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 11 , 14 ,$#,,
MEDICAID DIRECT,1124757836,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-3334 BOYLSTON HIGHWAY SUITE 20,3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114423720,"DRECHSLER, DANIEL, THOMAS",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 42 , 47 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114423720,"DRECHSLER, DANIEL, THOMAS",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1114423720,"DRECHSLER, DANIEL, THOMAS",3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114423720,"DRECHSLER, DANIEL, THOMAS",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 19 , 25 ,$#,,
MEDICAID DIRECT,1124757836,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-3334 BOYLSTON HIGHWAY SUITE 20,3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114423720,"DRECHSLER, DANIEL, THOMAS",3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114426251,"WIGNALL, ALEX, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114426251,"WIGNALL, ALEX, MICHAEL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 128 , 128 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114427499,"SPENCER, SHANNA, KENEISHA",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114427499,"SPENCER, SHANNA, KENEISHA",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1447373063,HUGH CHATHAM MEMORIAL HOSPITAL,CLINGMAN MEDICAL CENTER,3369 CLINGMAN RD   RONDA NC,097,Wilkes,193400000X,Group,Single Specialty,,1114428034,"WATTS, KENDRA, PEARL",3369 CLINGMAN RD   RONDA NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 206 , 336 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114430816,"SPRAGUE, TAYLOR, CLAIRE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114430816,"SPRAGUE, TAYLOR, CLAIRE",,108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1114430816,"SPRAGUE, TAYLOR, CLAIRE",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114430816,"SPRAGUE, TAYLOR, CLAIRE",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 41 ,$#,,
MEDICAID DIRECT,1114431319,BRIGHT OUTSTANDING STARS,~,107 SEEVIEW LN   HERTFORD NC,072,Perquimans,251S00000X,Agencies,Community/Behavioral Health,,1114431319,BRIGHT OUTSTANDING STARS,107 SEEVIEW LN   HERTFORD NC,072,Perquimans,251S00000X,Agencies,Community/Behavioral Health,, 40 , 765 , 765 ," $44,533.80 ",,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114434255,"KOCH, DANIELLE, LEE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114434255,"KOCH, DANIELLE, LEE",1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 26 , 32 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114434255,"KOCH, DANIELLE, LEE",1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114435492,DX SOLUTIONS LLC,SOLARIS DIAGNOSTICS,110 DEWEY DR STE A NICHOLASVILLE KY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1114435492,DX SOLUTIONS LLC,110 DEWEY DR STE A NICHOLASVILLE KY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 163 , 449 ," 1,230 "," $23,012.66 ",,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114440559,"LEWIS, CHARLES, PATRICK",1317 N BRIGHTLEAF BLVD STE A SMITHFIELD NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1114442563,LITTLE FIGHTERS LLC,,1408 DELLWOOD RD   WAYNESVILLE NC,044,Haywood,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114442563,LITTLE FIGHTERS LLC,1408 DELLWOOD RD   WAYNESVILLE NC,044,Haywood,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 227 ," 2,393 "," 4,366 "," $462,952.75 ",,
MEDICAID DIRECT,1114442563,LITTLE FIGHTERS LLC,,1408 DELLWOOD RD   WAYNESVILLE NC,044,Haywood,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114442563,LITTLE FIGHTERS LLC,1408 DELLWOOD RD   WAYNESVILLE NC,044,Haywood,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1114442563,LITTLE FIGHTERS LLC,,1408 DELLWOOD RD   WAYNESVILLE NC,044,Haywood,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1114442563,LITTLE FIGHTERS LLC,1408 DELLWOOD RD   WAYNESVILLE NC,044,Haywood,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 41 , 620 , 931 ," $261,657.90 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114447232,"GREENE, COURTNEY, PADRICK",101 CLINIC DR   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 24 , 29 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114447331,"STEVENSON, PHILIP, EDWARD",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1114447612,INTEGRITY-MCALPINE ADULT CARE LLC,MCALPINE ADULT CARE,3806 KATHY RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1114447612,INTEGRITY-MCALPINE ADULT CARE LLC,3806 KATHY RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 41 ," 8,063 "," 8,066 "," $562,951.71 ",,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,500 HOLLY SPRINGS RD STE 101 HOLLY SPRINGS NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114449550,"CRUZ, YENNY, ALTAGRACIA",500 HOLLY SPRINGS RD STE 101 HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1700205515,STARLIGHT PEDIATRICS PLLC,,500 HOLLY SPRINGS RD STE 101 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1114449550,"CRUZ, YENNY, ALTAGRACIA",500 HOLLY SPRINGS RD STE 101 HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114450301,"LADEW, ERIN, MILLER",3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 17 , 59 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114450590,"GLASSER, TIMOTHY, AUSTIN",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114450590,"GLASSER, TIMOTHY, AUSTIN",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114451101,"GREENBERG, SYDNEY, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 14 ,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114451671,"CUMMINGS, DANA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114451671,"CUMMINGS, DANA, MARIE",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114451671,"CUMMINGS, DANA, MARIE",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114451671,"CUMMINGS, DANA, MARIE",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114453594,"SULLIVAN, KIMBERLY, SIMMONS",1806 S HAWTHORNE RD STE 200 WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 20 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114456688,"RICE, REBECCA, ANNE",2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 25 , 29 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114456688,"RICE, REBECCA, ANNE",2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114457769,"AZU, CRYSTAL, NNENNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114458338,"SOLOMON, ALEX, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 41 , 44 , 108 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114458338,"SOLOMON, ALEX, JOSEPH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 23 , 24 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114458601,"VILLALOBOS, ALEXANDER, AARON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 139 , 161 , 308 ," $11,822.71 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1114458601,"VILLALOBOS, ALEXANDER, AARON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1851331359,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS CHARLOTTE,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114458965,"HARVEY, JEREMY, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114458965,"HARVEY, JEREMY, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 42 , 42 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114459757,"ROONEY, EMMA, GOLDSMITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 62 , 89 , 125 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114459757,"ROONEY, EMMA, GOLDSMITH",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 30 , 35 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114459757,"ROONEY, EMMA, GOLDSMITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 22 , 27 ,$#,,
MEDICAID DIRECT,1245587534,FRENCH BROAD PEDIATRIC ASSOCIATES P,FRENCH BROAD PEDICATRIC ASSOCIATES PLLC,40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1114467321,"MASON, HOLLY, MELISSA",40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 74 , 133 ,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114467446,"HOLLOWAY, HUNTER, THOMAS",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 100 , 204 ,$#,,
MEDICAID DIRECT,1114467701,POLARIS REHABILITATION LLC,,1620 US 1 HWY   YOUNGSVILLE NC,035,Franklin,193400000X,Group,Single Specialty,,1114467701,POLARIS REHABILITATION LLC,1620 US 1 HWY   YOUNGSVILLE NC,035,Franklin,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114468303,"BRYANT, LATICIA, JANEA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114468345,"ABUKAR, SULEKHA, ASHIR",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114468345,"ABUKAR, SULEKHA, ASHIR",5815 BLAKENEY PARK DR STE 200B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 40 , 126 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114468378,"LEE HING, ROBYN-ANN, CHERIE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114468626,"ATKINSON, SHANAH, ANTOINETTE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114468626,"ATKINSON, SHANAH, ANTOINETTE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114470648,"MEWHA, ALYSSA, SUE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114470648,"MEWHA, ALYSSA, SUE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972650059,HARDISON & BURGETTE PA,~,121 DUPLIN PROFESSIONAL CT   WARSAW NC,031,Duplin,193200000X,Group,Multi-Specialty,,1114473402,"BURGETTE, CHRISTA, JONES",121 DUPLIN PROFESSIONAL CT   WARSAW NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice, 640 ," 1,259 "," 3,630 "," $171,463.87 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114473725,"DANEK, FRANCIS, GALLENT",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114473725,"DANEK, FRANCIS, GALLENT",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114474319,"PARSON, JULIA, RUTH",152 SHERLOCK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114474319,"PARSON, JULIA, RUTH",152 SHERLOCK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114474319,"PARSON, JULIA, RUTH",152 SHERLOCK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,152 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114474319,"PARSON, JULIA, RUTH",152 SHERLOCK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 41 , 67 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114475373,"HENSLEY, JAMES, RYAN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1114475373,"HENSLEY, JAMES, RYAN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1114475373,"HENSLEY, JAMES, RYAN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 18 , 20 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1114475373,"HENSLEY, JAMES, RYAN",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1114475373,"HENSLEY, JAMES, RYAN",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",1910 JAKE ALEXANDER BLVD W STE 201 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",1910 JAKE ALEXANDER BLVD W STE 201 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",911 W HENDERSON ST KISER BLDG STE 410 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",1910 JAKE ALEXANDER BLVD W STE 201 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",311 CODDLE MARKET DR NW STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 27 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114475605,"JOPP, GRETCHEN, DIANE",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114476447,"HOSTETLER, ALEXANDREA, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114476488,"ZACK, ZOE, BURDETTE",1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 62 , 62 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114480456,"DEEBEL, NICHOLAS, ALLEN",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 15 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114480456,"DEEBEL, NICHOLAS, ALLEN",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 85 , 140 , 230 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114483013,"SAMS, KANDI, BYRD",799 HICKORY TREE RD   WINSTON SALEM NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,799 HICKORY TREE RD STE A WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1114483013,"SAMS, KANDI, BYRD",799 HICKORY TREE RD   WINSTON SALEM NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 46 , 58 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,799 HICKORY TREE RD STE A WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1114483013,"SAMS, KANDI, BYRD",799 HICKORY TREE RD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 24 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114483013,"SAMS, KANDI, BYRD",799 HICKORY TREE RD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114483641,"OLIVE, LINDSEY, BARRETT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114483641,"OLIVE, LINDSEY, BARRETT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1114483641,"OLIVE, LINDSEY, BARRETT",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114484946,"HIGGINS, MADISON, ROSE",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093772410,ROBESON HEALTH CARE CORPORATION,MAXTON MEDICAL CENTER,610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114485505,"RITCHIE, NIKIA, DELORES",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 30 , 46 , 46 ," $11,131.06 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114485539,"WORKMAN, TRACY, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114485539,"WORKMAN, TRACY, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114485539,"WORKMAN, TRACY, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114487212,"PATEL, NIYATI, SHYAM",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 181 , 181 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1114487212,"PATEL, NIYATI, SHYAM",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 141 , 141 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,300 ASHVILLE AVE STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114487873,"SU, WILLIAM, WILLIE",300 ASHVILLE AVE STE 110 CARY NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 20 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114487873,"SU, WILLIAM, WILLIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114488376,"LATTERMAN, PAUL, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1861244477,EASTER SEALS UCP NORTH CAROLINA & V,EASTERSEALS PORT HEALTH,203 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114488640,"TAYLOR, DAVID, DUNCAN",3715 GUARDIAN AVE   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114489127,"HIRSHMAN, NATHAN, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114489127,"HIRSHMAN, NATHAN, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114489127,"HIRSHMAN, NATHAN, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 125 , 125 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114490687,"JOHNSON SMITH, ELIZABETH, BROOKE",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 38 , 121 , 121 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",1 MARITHE CT   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 38 , 74 , 74 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",1 MARITHE CT   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",1 MARITHE CT   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",1 MARITHE CT   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 69 , 69 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 27 , 148 , 150 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114493111,"KILLIAN, CRYSTAL, SHAUNDALE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114497807,"ROBERTS, JESSICA, ANN",3004 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 83 , 104 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114497807,"ROBERTS, JESSICA, ANN",3004 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114497807,"ROBERTS, JESSICA, ANN",3004 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 71 , 99 ,$#,,
MEDICAID DIRECT,1629843933,OPTUM BEHAVIORAL CARE OF NORTH CARO,CAROLINA BEHAVIORAL CARE CENTERS,1101 MARCO DR STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1114504016,"PALMGREN, KATHERINE, SMITH",7400 CARMEL EXECUTIVE PARK DR STE 155 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1023142122,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114505674,"RAMSEY, MORGAN, ELLISON",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023142122,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114505674,"RAMSEY, MORGAN, ELLISON",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 21 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1114506904,"PAPPOPPULA, LAKSHMI, PRIYANKA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 92 , 92 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1114506904,"PAPPOPPULA, LAKSHMI, PRIYANKA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114512100,"TOMLINSON, SARA, CAYLIN",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114513124,"HA, GIANG, THUY",1800 E FRANKLIN ST STE 11A CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114514049,"MULCAHY, BETH, MARGARET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1114519428,"WILKS, BRITTANY, THOMPSON",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114519428,"WILKS, BRITTANY, THOMPSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114519428,"WILKS, BRITTANY, THOMPSON",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114519428,"WILKS, BRITTANY, THOMPSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114519428,"WILKS, BRITTANY, THOMPSON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114519428,"WILKS, BRITTANY, THOMPSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1114519428,"WILKS, BRITTANY, THOMPSON",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114521374,"HUTCHINSON, ANDREA, MOZELLE",604 W MAIN ST   JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 83 , 108 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114522141,"HOUGH, CAITLYN, GRACE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 62 , 62 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114523305,"NASSOIY, OLIVIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114523305,"NASSOIY, OLIVIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114524469,"WALKER, JAMILLA, ROSE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1114524527,ABUNDANT LIFE IN-HOME SERVICES,ABUNDANT LIFE IN-HOME SERVICES,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1114524527,ABUNDANT LIFE IN-HOME SERVICES,301 MCCULLOUGH DR STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114526316,"BENNIE, JANET, LYNN",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 43 , 49 ,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114526316,"BENNIE, JANET, LYNN",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 79 , 101 ,$#,,
MEDICAID DIRECT,1376510875,HOT SPRINGS HEALTH PROGRAM,HOT SPRINGS MEDICAL AND DENTAL CENTER,66 NW US 25 70 HIGH   HOT SPRINGS NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114526316,"BENNIE, JANET, LYNN",66 NW US 25 70 HWY   HOT SPRINGS NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 60 , 71 ,$#,,
MEDICAID DIRECT,1811964729,HOT SPRINGS HEALTH PROGRAM,LAUREL MEDICAL CENTER,80 GUNTERTOWN RD   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114526316,"BENNIE, JANET, LYNN",80 GUNTERTOWN RD   MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114528429,"TRICARICO, NICHOLAS, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1114528429,"TRICARICO, NICHOLAS, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114528429,"TRICARICO, NICHOLAS, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114528429,"TRICARICO, NICHOLAS, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1114528650,KAITLIN DENE LAYDEN,GRACE PROGRESSIONS,916 HAPPY HOME RD   TYNER NC,021,Chowan,251S00000X,Agencies,Community/Behavioral Health,,1114528650,KAITLIN DENE LAYDEN,916 HAPPY HOME RD   TYNER NC,021,Chowan,251S00000X,Agencies,Community/Behavioral Health,,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114529070,"HARRIS, GWEN, CHRISTINE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1114529070,"HARRIS, GWEN, CHRISTINE",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114529070,"HARRIS, GWEN, CHRISTINE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114533742,HELPING ANGELS HOME CARE LLC,HELPING ANGELS HOME CARE,201 LIVERMORE DR STE C PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1114533742,HELPING ANGELS HOME CARE LLC,201 LIVERMORE DR STE C PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 78 , 457 , 466 ," $37,327.48 ",,
MEDICAID DIRECT,1114533742,HELPING ANGELS HOME CARE LLC,HELPING ANGELS HOME CARE,204 W 3RD ST   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1114533742,HELPING ANGELS HOME CARE LLC,204 W 3RD ST   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 135 ," 20,383 "," 20,795 "," $1,626,203.88 ",,
MEDICAID DIRECT,1114533742,HELPING ANGELS HOME CARE LLC,HELPING ANGELS HOME CARE,204 W 3RD ST   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1114533742,HELPING ANGELS HOME CARE LLC,201 LIVERMORE DR STE C PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1114946332,CRABTREE CHIROPRACTIC CENTER PA,CRABTREE CHIROPRACTIC CENTER PA,4517 LEAD MINE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114536869,"ANDERSEN, THOMAS, KERVIN",4517 LEAD MINE RD   RALEIGH NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,, 18 , 82 , 85 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114537693,"WAGNER, RYAN, AUSTIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114537693,"WAGNER, RYAN, AUSTIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1891409322,CENTERWELL SENIORPRIMARYCARENC JVPC,,3901 CAPITAL BLVD STE 113 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114539814,"ADDAI, NANA YAA, SERWAA",3901 CAPITAL BLVD STE 113 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114540036,"BATTLE, CAROLYN, DANIELLE",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 21 ,$#,,
MEDICAID DIRECT,1255456794,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER GOLDSBORO,2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114540036,"BATTLE, CAROLYN, DANIELLE",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114540572,"NGUYEN, DUSTIN",3940 ARROWHEAD BLVD STE 270 MEBANE NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1114540572,"NGUYEN, DUSTIN",530 W WEBB AVE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1114540853,LOTS OF LOVE HOME CARE LLC,,2020 REMOUNT RD STE W-116 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1114540853,LOTS OF LOVE HOME CARE LLC,2020 REMOUNT RD STE W-116 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#," 1,094 "," 1,094 "," $75,245.00 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,635 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",635 MCCARTHY BLVD   NEW BERN NC,025,Craven,1223G0001X,Dental Providers,Dentist,General Practice, 167 , 225 , 947 ," $41,653.27 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 174 , 213 , 720 ," $50,486.54 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 169 , 225 , 672 ," $39,190.43 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,13068 NC HIGHWAY 50   SURF CITY NC,071,Pender,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 45 , 45 , 166 ,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,1108 PARKWAY DR STE A GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",1108 PARKWAY DR STE A GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 225 , 305 , 921 ," $59,586.27 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",1108 PARKWAY DR STE A GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 23 , 72 ,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,13068 NC HIGHWAY 50   SURF CITY NC,071,Pender,193400000X,Group,Single Specialty,,1114542727,"PEACHEE, DAKOTA, JAMES",13068 NC HIGHWAY 50   SURF CITY NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 51 , 158 ,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114543295,"DIAL, TINA, CHAVIS",412 S JONES ST   PEMBROKE NC,078,Robeson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 49 , 49 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114543295,"DIAL, TINA, CHAVIS",101 PLAZA RD   LAURINBURG NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,MAXTON FAMILY PRACTICE CENTER,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114543295,"DIAL, TINA, CHAVIS",1001 W DR MLK JR DR   MAXTON NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1891789970,SCOTLAND MEMORIAL HOSPITAL INC,WAGRAM FAMILY PRACTICE,24420 MARLBORO ST   WAGRAM NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114543295,"DIAL, TINA, CHAVIS",24420 MARLBORO ST   WAGRAM NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114543295,"DIAL, TINA, CHAVIS",700A PROGRESS PL   LAURINBURG NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1588238463,DAVID E THOME DDS PLLC XI,HICKORY PEDIATRIC DENTISTRY,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 66 , 67 , 273 ,$#,,
MEDICAID DIRECT,1811695554,DAVID E THOME DDS PLLC L1,,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 16 ,$#,,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 349 , 418 ," 1,649 "," $52,757.25 ",,
MEDICAID DIRECT,1477251411,DAVID E THOME DDS PLLC L1,,7856 VILLAGE CTR N STE 200 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 68 , 68 ," 1,394 "," $127,150.84 ",,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 245 , 253 ," 1,174 "," $40,529.53 ",,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",9055 CRESSWIND BLVD ST 104 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",202 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 392 , 411 ," 1,822 "," $61,404.19 ",,
MEDICAID DIRECT,1477251411,DAVID E THOME DDS PLLC L1,,7856 VILLAGE CTR N STE 200 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 58 , 58 , 883 ," $58,532.63 ",,
MEDICAID DIRECT,1811695554,DAVID E THOME DDS PLLC L1,,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 11 , 11 , 212 ," $16,332.36 ",,
MEDICAID DIRECT,1356730741,DAVID E THOME DDS PLLC IV,STATESVILLE PEDIATRIC DENTISTRY,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,966 "," 2,853 "," 12,535 "," $425,165.90 ",,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",7856 VILLAGE CENTER NORTH   SHERRILLS FORD NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 444 , 578 ," 2,493 "," $84,325.68 ",,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",7856 VILLAGE CENTER NORTH   SHERRILLS FORD NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477251411,DAVID E THOME DDS PLLC L1,,7856 VILLAGE CTR N STE 200 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114545654,"HORNER, DESTYNEE, JABRAE",7856 VILLAGE CENTER NORTH   SHERRILLS FORD NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 27 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1114546579,"WYATT, ELIJAH, CALEB",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 34 , 40 ,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114546579,"WYATT, ELIJAH, CALEB",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114547577,"AFZAL, ARSLAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 75 , 197 , 198 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114547775,"WILLIAMS, XAVIER, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1114547775,"WILLIAMS, XAVIER, JOSEPH",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 21 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114547775,"WILLIAMS, XAVIER, JOSEPH",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114550993,"CASTILLO, FAITH, LYNN",215 COLLEGE ST   GRAHAM NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 109 , 110 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1114550993,"CASTILLO, FAITH, LYNN",215 COLLEGE ST   GRAHAM NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 240 , 250 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114554318,"NOVOTNY, CLARA, BETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 102 , 102 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1114554318,"NOVOTNY, CLARA, BETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1487845020,AVANCE CARE PA,,1821 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1114554656,"HENDRICK, ASA, GOLD",300 MARKET ST STE 112 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 23 , 33 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1114555257,"BROTZMAN, WRENN, SHOULARS",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114555257,"BROTZMAN, WRENN, SHOULARS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1114555257,"BROTZMAN, WRENN, SHOULARS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1114555257,"BROTZMAN, WRENN, SHOULARS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 27 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114555257,"BROTZMAN, WRENN, SHOULARS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114555448,"LUCHETTI, JEFFREY, MICHAEL",8305 FALLS OF NEUSE RD STE 105   RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 21 , 26 , 118 ," $12,601.44 ",,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114555448,"LUCHETTI, JEFFREY, MICHAEL",1711 S MAIN ST   WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114555448,"LUCHETTI, JEFFREY, MICHAEL",7920 ACC BLVD STE 130 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1114558202,PREFERRED INCORPORATED,,3812 TARHEEL DR STE I RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1114558202,PREFERRED INCORPORATED,3812 TARHEEL DR STE I RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,714 "," 1,714 "," $113,317.48 ",,
MEDICAID DIRECT,1447373063,HUGH CHATHAM MEMORIAL HOSPITAL,CLINGMAN MEDICAL CENTER,3369 CLINGMAN RD   RONDA NC,097,Wilkes,193400000X,Group,Single Specialty,,1114558236,"ALLEN, STEPHANIE, EDWARDS",3369 CLINGMAN RD   RONDA NC,097,Wilkes,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114558236,"ALLEN, STEPHANIE, EDWARDS",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114559283,"GLENN, ALICIA, WILSON",1575 JOHN KNOX DR   COLFAX NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 62 , 91 , 91 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114559283,"GLENN, ALICIA, WILSON",1575 JOHN KNOX DR   COLFAX NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1114561800,WAR MEMORIAL HOME HEALTHCARE AGENCY,WAR MEMORIAL HOME HEALTHCARE AGENCY LLC,12336 TETONS CT   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1114561800,WAR MEMORIAL HOME HEALTHCARE AGENCY,12336 TETONS CT   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 2,759 "," 2,826 "," $214,324.87 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114565496,"MCMAKIN, KENDAL, BRIANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1114565686,CENTER POINT HOME HEALTH SERVICES L,,4801 E INDEPENDENCE BLVD STE 1000 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1114565686,CENTER POINT HOME HEALTH SERVICES L,4801 E INDEPENDENCE BLVD STE 1000 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,393 "," 2,512 "," $277,272.88 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114566841,"GROFF, STACIE, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114567229,DIVINE NURSE CONSULTANT LLC,DIVINE HOME CARE SERVICES,5633 MONROE RD STE G CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1114567229,DIVINE NURSE CONSULTANT LLC,5633 MONROE RD STE G CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 217 , 217 ," $15,257.60 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114569951,"MAKHIJANI, SAPNA, SHIVAJI",2797 NC 55 HWY   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1114574431,"OLLIFF, HANNAH, HAILEY",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1114574753,"PRITCHARD, STACY, CARTWRIGHT",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1805 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1114574753,"PRITCHARD, STACY, CARTWRIGHT",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 21 , 39 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114575511,"RAASCH, STACIE, LYNN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 116 , 132 ,$#,,
MEDICAID DIRECT,1871577197,KINSTON PEDIATRIC ASSOCIATES PA,Kinston Pediatric Associates PA,2509 N QUEEN ST   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1114578259,"HARDISON, JESSICA, HECKART",2509 N QUEEN ST   KINSTON NC,054,Lenoir,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 12 , 13 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114580263,"DIGENAKIS, ALEXANDRA",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114580263,"DIGENAKIS, ALEXANDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 78 , 79 ,$#,,
MEDICAID DIRECT,1114580487,"RUSSELL, NICHOLAS, HYATT",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1114580487,"RUSSELL, NICHOLAS, HYATT",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114581212,"GLOWACKI, ELIZABETH, HOPE CAIN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114581212,"GLOWACKI, ELIZABETH, HOPE CAIN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1114581444,"COOK, ERIN, LEWCHUK",1001 CRESCENT GRN   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 39 , 100 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114581568,"BUI, DEREK, HUY-QUANG",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114581568,"BUI, DEREK, HUY-QUANG",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 28 , 39 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114581568,"BUI, DEREK, HUY-QUANG",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 12 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1114583630,"GRIFFIN, JACQUELINE, LORRAINE",38 CARTERS RD   GATESVILLE NC,037,Gates,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 51 , 51 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1114583630,"GRIFFIN, JACQUELINE, LORRAINE",38 CARTERS RD   GATESVILLE NC,037,Gates,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 123 , 123 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114583945,"AGGARWAL, ARJUN, VINOD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1114584521,"STOCKSTAD, MARISSA, MARIE",~,2918 CEDARWOOD DR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1114584521,"STOCKSTAD, MARISSA, MARIE",2918 CEDARWOOD DR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1376132571,FULLER & ASSOCIATES VII PLLC,CLINTON FAMILY & COSMETIC DENTISTRY,320 NORTHEAST BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1114585486,"KEARNEY, RYAN, THOMAS",320 NORTHEAST BLVD   CLINTON NC,082,Sampson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 168 , 176 , 178 ," $22,235.72 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114586690,"HITPAS, COURTNEY, ANNE-MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114586690,"HITPAS, COURTNEY, ANNE-MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 29 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114586690,"HITPAS, COURTNEY, ANNE-MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114586948,"THIAM, HADJA, FADIMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 56 , 104 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114586948,"THIAM, HADJA, FADIMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114586948,"THIAM, HADJA, FADIMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 21 , 40 ,$#,,
MEDICAID DIRECT,1841733714,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE COMMUNITY HOSPITAL OF STOKES,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1114589884,"DICKEY, KIRKLAND, MCKINNEY",3853 US 311 HWY N   PINE HALL NC,085,Stokes,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1346775285,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL & URGENT CARE OF PINE HAL,3853 US 311 HWY N   PINE HALL NC,085,Stokes,193200000X,Group,Multi-Specialty,,1114589884,"DICKEY, KIRKLAND, MCKINNEY",3853 US 311 HWY N   PINE HALL NC,085,Stokes,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1346775285,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL & URGENT CARE OF PINE HAL,3853 US 311 HWY N   PINE HALL NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114589884,"DICKEY, KIRKLAND, MCKINNEY",3853 US 311 HWY N   PINE HALL NC,085,Stokes,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 54 , 164 , 164 ," $11,715.57 ",,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114590486,"DILLARD, MIKALA, J.",175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 59 , 65 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114590601,"WERTH, HANNAH, NIKKI",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114590601,"WERTH, HANNAH, NIKKI",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114591807,"JENKINS-ROSALES, HEATHER, LYN",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114591807,"JENKINS-ROSALES, HEATHER, LYN",2711 RANDOLPH RD STE 301 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 71 , 71 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114594371,"MULKERN, CHRISTINE, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1114594900,PHD LABORATORY LLC,,5104 REAGAN DR STE 8 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1114594900,PHD LABORATORY LLC,5104 REAGAN DR STE 8 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 146 , 307 , 733 ," $60,879.91 ",,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114596723,"HUEGEL, MARIE, ELIZABETH",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 21 , 25 , 28 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1830 GALLERIA BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114596723,"HUEGEL, MARIE, ELIZABETH",1830 GALLERIA BLVD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1114596723,"HUEGEL, MARIE, ELIZABETH",2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,320 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114596723,"HUEGEL, MARIE, ELIZABETH",2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114596723,"HUEGEL, MARIE, ELIZABETH",9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1114596723,"HUEGEL, MARIE, ELIZABETH",197 PLAZA DR   FOREST CITY NC,081,Rutherford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,197 PLAZA DR   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1114596723,"HUEGEL, MARIE, ELIZABETH",197 PLAZA DR   FOREST CITY NC,081,Rutherford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114596822,"PALMER, KRISTINA, DOROTHY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 38 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114596822,"PALMER, KRISTINA, DOROTHY",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114598950,"SHAW, CATHERINE, DEWALD",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1114598950,"SHAW, CATHERINE, DEWALD",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 51 , 122 ,$#,,
MEDICAID DIRECT,1144284548,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH RAEFORD,206 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1114598950,"SHAW, CATHERINE, DEWALD",206 SOUTHERN AVE   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 30 ,$#,,
MEDICAID DIRECT,1801116405,MONARCH,~,350 PEE DEE AVE STE 101 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1114599214,"GOOLSBY, NAKEYA, SANTWONE",350 PEE DEE AVE STE 101 ALBEMARLE NC,084,Stanly,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114603537,"JONES, ELIZABETH, PRICE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1114604204,ENDURANCE SERVICES LLC LINDA HOUGH,,322 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1114604204,ENDURANCE SERVICES LLC LINDA HOUGH,322 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,#," 1,551 "," 1,551 "," $98,154.51 ",,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1114604246,"COYLE, KAITLYN, ANN",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 17 , 31 ,$#,,
MEDICAID DIRECT,1114605367,"MITCHUM, NATHANIEL, EDWARD",NATHANIEL MITCHUM DMD PLLC,608 E PINE ST   GRAHAM NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,1114605367,"MITCHUM, NATHANIEL, EDWARD",608 E PINE ST   GRAHAM NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 43 , 86 , 228 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114605771,"TURAGA, ANA, DEBORA",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114605771,"TURAGA, ANA, DEBORA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114605771,"TURAGA, ANA, DEBORA",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1114607603,A NEW HORIZON LLC,~,208 UNION CHAPEL RD STE B PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1114607603,A NEW HORIZON LLC,208 UNION CHAPEL RD STE B PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 3,707 "," 4,400 "," $433,989.76 ",,
MEDICAID DIRECT,1184284754,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT VIEWMONT ELEMENTARY,21 16TH AVE NW   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114608049,"MELCHER, SHAINA, MAE",21 16TH AVE NW   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 37 , 37 ," $11,809.07 ",,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114612348,"HERRING, JULIA, BIANCA",1104 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114612348,"HERRING, JULIA, BIANCA",19 NOBLE ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114612348,"HERRING, JULIA, BIANCA",4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 70 , 89 ,$#,,
MEDICAID DIRECT,1750621603,BLUE RIDGE COMMUNITY HEALTH SERVICE,~,29 W FRENCH BROAD ST STE 203 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114622412,"STOLL, AUBREY, NOEL",29 W FRENCH BROAD ST STE 203 BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 134 , 150 , 422 ," $16,299.62 ",,
MEDICAID DIRECT,1619468766,BLUE RIDGE COMMUNITY HEALTH SERVICE,~,158 WHITE DR   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114622412,"STOLL, AUBREY, NOEL",158 WHITE DR   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 45 , 140 ,$#,,
MEDICAID DIRECT,1457332421,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114622412,"STOLL, AUBREY, NOEL",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1457332421,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114622412,"STOLL, AUBREY, NOEL",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice, 659 , 926 ," 2,650 "," $113,452.84 ",,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114622966,"OPARA, KRYSTAL, UZOAMAKA",150 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114623030,"LEVIGNE, CASSIE, PAIGE",969 COX RD   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114623030,"LEVIGNE, CASSIE, PAIGE",2700 ROYAL COMMONS LN   MATTHEWS NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 36 , 169 , 170 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114623030,"LEVIGNE, CASSIE, PAIGE",10011 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 20 , 56 , 56 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114623030,"LEVIGNE, CASSIE, PAIGE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 69 , 130 , 131 ," $10,892.34 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114623030,"LEVIGNE, CASSIE, PAIGE",1310 GLENN AVE   KANNAPOLIS NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 44 , 105 , 105 ,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114623139,"JONES, MAURA, LILLIAN GEST",14057 US HIGHWAY 17 STE 130 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114623139,"JONES, MAURA, LILLIAN GEST",1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 44 , 75 ,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114623139,"JONES, MAURA, LILLIAN GEST",58 PHYSICIANS DR NW STE 103 SUPPLY NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1114627015,SCION HOME CARE INC,,8376 SIX FORKS RD STE 203 RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1114627015,SCION HOME CARE INC,8376 SIX FORKS RD STE 203 RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#, 338 , 360 ," $345,317.96 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114627312,"HERRICK, RACHEL, MARKELL",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 93 , 93 ," $26,741.80 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114638343,"KRUG, SYLVIA",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114638343,"KRUG, SYLVIA",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114638343,"KRUG, SYLVIA",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 104 , 591 , 605 ," $13,850.99 ",,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114639192,"LUNSFORD, ELIZABETH, WARREN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114641966,"HAMLET, ARIES, KENYA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114641966,"HAMLET, ARIES, KENYA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 48 , 55 ,$#,,
MEDICAID DIRECT,1952760290,ADVANCE COMMUNITY HEALTH INC,,187 HIGH HOUSE RD   CARY NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114641966,"HAMLET, ARIES, KENYA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114479011,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1430 S WILMINGTON ST   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114641966,"HAMLET, ARIES, KENYA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114646429,A&T CARE NURSING LLC,A&T HOME CARE,608 E FRANKLIN ST   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1114646429,A&T CARE NURSING LLC,608 E FRANKLIN ST   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#," 1,016 "," 1,163 "," $108,189.78 ",,
MEDICAID DIRECT,1013329929,MOUNTAIN LAUREL DERMATOLOGY PLLC,,600 ALLIANCE CT STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1114647120,"STERRY, JACOB, ALAN",600 ALLIANCE CT STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 31 , 65 ,$#,,
MEDICAID DIRECT,1013329929,MOUNTAIN LAUREL DERMATOLOGY PLLC,,11 FALCON CREST LN   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1114647120,"STERRY, JACOB, ALAN",11 FALCON CREST LN   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013329929,MOUNTAIN LAUREL DERMATOLOGY PLLC,,600 ALLIANCE CT STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1114647120,"STERRY, JACOB, ALAN",11 FALCON CREST LN   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 58 , 113 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,411 S LASALLE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114650272,"HARRIS, TANGEE, RENEE",411 S LASALLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 21 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114650272,"HARRIS, TANGEE, RENEE",796 DOCTORS CT   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1114650272,"HARRIS, TANGEE, RENEE",796 DOCTORS CT   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 66 , 66 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114651437,"SEERY, MEGHAN, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 28 , 32 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114652559,"LIPSEY, AUSTIN, KEITH",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114653938,"JONES, CAROLYN, ELIZABETH",1110 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114653938,"JONES, CAROLYN, ELIZABETH",1110 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,417 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1114654530,"ISBELL, AMANDA, WARD",417 N MAIN ST   KENANSVILLE NC,031,Duplin,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114654530,"ISBELL, AMANDA, WARD",417 N MAIN ST   KENANSVILLE NC,031,Duplin,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 41 , 43 , 61 ," $12,134.64 ",,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114658937,"RODNEY, OCTAVIA, SAMONE",44 BONNIE LN   SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962171041,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN WALNUT,131 WALNUT ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114658937,"RODNEY, OCTAVIA, SAMONE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396414488,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN 69 NORTH BROAD,69 N BROAD ST   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114658937,"RODNEY, OCTAVIA, SAMONE",69 N BROAD ST   BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1851354260,CAPE FEAR OTOLARYNGOLOGY,CAPE FEAR OTOLARYNGOLOGY,2053 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1114659471,"HUNT, BELINDA",4384 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 107 , 251 , 269 ,$#,,
MEDICAID DIRECT,1851354260,CAPE FEAR OTOLARYNGOLOGY,CAPE FEAR OTOLARYNGOLOGY,2053 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1114659471,"HUNT, BELINDA",4314 LUDGATE ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 204 , 215 ,$#,,
MEDICAID DIRECT,1851354260,CAPE FEAR OTOLARYNGOLOGY,CAPE FEAR OTOLARYNGOLOGY,2053 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1114659471,"HUNT, BELINDA",2053 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 99 , 296 , 307 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114665692,"SOLOMON, DAVID, LAMBERT",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1962638395,"COLLATZ, LAURA",~,360 WEST ST STE 100 PITTSBORO NC,019,Chatham,1223G0001X,Dental Providers,Dentist,General Practice,1114666930,"SALO, PETTERI, TAPANI",360 WEST ST STE 100 PITTSBORO NC,019,Chatham,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114672540,"DANIELS, JESSICA, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 39 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114672664,"WILSON, MAXWELL, FRANKLIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1508632035,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CLOVER GARDEN,5806 PAGETOWN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114674637,"KNIGHT, CHANDLER, NASH",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114680311,"CHRISTENSEN, CHRISTINA, FRANCES",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 39 , 39 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114680311,"CHRISTENSEN, CHRISTINA, FRANCES",10620 PARK RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114680311,"CHRISTENSEN, CHRISTINA, FRANCES",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114680311,"CHRISTENSEN, CHRISTINA, FRANCES",10620 PARK RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 24 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114680675,"JEMIOLO, SAMANTHA, LYNNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 17 , 25 , 39 ,$#,,
MEDICAID DIRECT,1770615114,PROMED HEALTHCARE PLLC,~,7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114683687,"PRICE, SUSAN, HONEYCUTT",7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 37 , 66 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114684172,"WULF WOOD, CORINNE, LEE",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 19 , 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114684172,"WULF WOOD, CORINNE, LEE",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114684941,COLUMBUS REGIONAL DIAGNOSTICS,ADVANCED IMAGING,509 OLDE WATERFORD WAY STE 104 LELAND NC,010,Brunswick,293D00000X,Laboratories,Physiological Laboratory,,1114684941,COLUMBUS REGIONAL DIAGNOSTICS,509 OLDE WATERFORD WAY STE 104 LELAND NC,010,Brunswick,293D00000X,Laboratories,Physiological Laboratory,, 14 , 16 , 17 ,$#,,
MEDICAID DIRECT,1912465311,SHIVAG DIABETIC SHOES AND ORTHOTICS,~,3100 DURALEIGH RD STE 207 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114689155,"RAINEY, JOHN, JOSEPH",3100 DURALEIGH RD STE 207 RALEIGH NC,092,Wake,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 19 , 23 , 90 ," $13,053.14 ",,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114689791,"RABON, HOLLY, TADLOCK",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,1900 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114689791,"RABON, HOLLY, TADLOCK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114689791,"RABON, HOLLY, TADLOCK",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 90 , 99 ,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114689791,"RABON, HOLLY, TADLOCK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114689791,"RABON, HOLLY, TADLOCK",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114690989,"WOLFKILL, ADDISON, REBEKKAH",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 21 , 36 , 43 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114694429,"BARNHARDT, LAUREN, SMITH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114694429,"BARNHARDT, LAUREN, SMITH",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114694429,"BARNHARDT, LAUREN, SMITH",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 58 , 112 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114700358,"MERCER, KEVIN, M",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114700358,"MERCER, KEVIN, M",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114701364,SERENITY AT HEART LLC,~,314 W MILLBROOK RD STE 19 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1114701364,SERENITY AT HEART LLC,314 W MILLBROOK RD STE 19 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 609 , 645 ," $104,395.08 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114736964,"RYAN, JENARO, ADAM",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1114748183,"BARNES, AKIRA, CHANEL",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 57 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114749462,"BOWERS, BRIGITTA, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114749736,"WARM, KAYDE, IRENE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1114751161,CAPE FEAR PEDIATRIC SPEECH THERAPY,CAPE FEAR PEDIATRIC SPEECH THERAPY SERVICES PLLC,5135 MORGANTON ROAD 103 ROOM 111 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1114751161,CAPE FEAR PEDIATRIC SPEECH THERAPY,5135 MORGANTON ROAD 103 ROOM 111 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,#, 242 , 242 ," $16,275.13 ",,
MEDICAID DIRECT,1114751161,CAPE FEAR PEDIATRIC SPEECH THERAPY,CAPE FEAR PEDIATRIC SPEECH THERAPY SERVICES PLLC,5135 MORGANTON ROAD 103 ROOM 111 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114751161,CAPE FEAR PEDIATRIC SPEECH THERAPY,5135 MORGANTON ROAD 103 ROOM 111 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114751377,"SHAH, KRISHA, VIPULKUMAR",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 46 , 46 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1114752847,"RUFF, SHEA, MOBLEY",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 216 , 220 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114752847,"RUFF, SHEA, MOBLEY",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 221 , 225 ," $12,126.41 ",,
MEDICAID DIRECT,1003218439,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SHALLOTTE,341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114756335,"SCHROEDER, HEIDI, ANN",341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1992728950,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SALEMBURG,500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114756335,"SCHROEDER, HEIDI, ANN",500 SOUTH FAYETTEVILLE STREET   SALEMBURG NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114761640,"PRITCHARD, MISTIE, RHENA",220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 166 , 166 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1114761640,"PRITCHARD, MISTIE, RHENA",3031 TATE BLVD SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1114761640,"PRITCHARD, MISTIE, RHENA",3031 TATE BLVD SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1114761640,"PRITCHARD, MISTIE, RHENA",220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 709 , 721 ," $12,004.42 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114763612,"BOKA, BAILEY, JENE",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1114764396,"ANDERSON, JANIAYA",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1114764396,"ANDERSON, JANIAYA",9040 NATIONS FORD RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1114764396,"ANDERSON, JANIAYA",404 S SUTHERLAND AVE   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1114764396,"ANDERSON, JANIAYA",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1114772183,"WOLF, KENDALL, AIKO",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114780640,CARING CONNECTIONS PEDIATRIC THERAP,,1014 TRADITIONS RIDGE DR   WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1114780640,CARING CONNECTIONS PEDIATRIC THERAP,1014 TRADITIONS RIDGE DR   WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1114786795,"BOOKER, SHATAESIA, SOMOIRE",17228 FORDHAM BLVD STE 151 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 64 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1114793221,"HARRIS, KIRSTI, LYNN",2818 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 98 , 128 , 327 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114794120,"GREGG, LILIANA, MARIE",95 LOCUST ST   CONNELLY SPG NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 193 , 194 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114794120,"GREGG, LILIANA, MARIE",95 LOCUST ST   CONNELLY SPG NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114794120,"GREGG, LILIANA, MARIE",95 LOCUST ST   CONNELLY SPG NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 118 , 118 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114794120,"GREGG, LILIANA, MARIE",95 LOCUST ST   CONNELLY SPG NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1114900552,"KOLLI, MADHU, KRISHNA",828 HEALTHY WAY STE 270 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114900586,"GRINER, RICHMOND, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114901089,"HINSHAW, JEFFREY, WARREN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 34 , 35 ,$#,,
MEDICAID DIRECT,1164719415,PIONEER HEALTH SERVICES OF STOKES C,PIONEER COMMUNITY HOSPITAL OF STOKES,,,Unknown,193200000X,Group,Multi-Specialty,,1114901089,"HINSHAW, JEFFREY, WARREN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114901089,"HINSHAW, JEFFREY, WARREN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 30 , 32 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114902244,"NELSON, KENNETH, EDWARD",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 33 , 36 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114902244,"NELSON, KENNETH, EDWARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114902244,"NELSON, KENNETH, EDWARD",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114902244,"NELSON, KENNETH, EDWARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114902244,"NELSON, KENNETH, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1255070868,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2695 HENDERSONVILLE ROAD SUITE 200,2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114902277,"PITTILLO, DEBORAH, WHITMIRE",2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 56 , 62 ,$#,,
MEDICAID DIRECT,1710021811,ABC PEDIATRICS OF ASHEVILLE PA,ABC PEDIATRICS OF ASHEVILLE PA,64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1114903382,"MUSTOE, MARGARET, HOPE",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 25 , 64 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114903432,"BENNETT, DAVID, GEORGE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 21 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1114903515,"KUPERMAN, PAUL, MAKOTO",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 16 , 17 ,$#,,
MEDICAID DIRECT,1114904653,COUNTY OF ONSLOW,,4024 RICHLANDS HWY   JACKSONVILLE NC,067,Onslow,251B00000X,Agencies,Case Management,,1114904653,COUNTY OF ONSLOW,4024 RICHLANDS HWY   JACKSONVILLE NC,067,Onslow,251B00000X,Agencies,Case Management,, 142 ," 1,513 "," 1,526 "," $557,127.14 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114905395,"COGGINS, JASON, MACDONALD",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 29 , 73 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1114905395,"COGGINS, JASON, MACDONALD",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 28 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114905395,"COGGINS, JASON, MACDONALD",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1114905551,"GOERTZEN, GERALDINE, FLORENCE",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114905551,"GOERTZEN, GERALDINE, FLORENCE",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114905551,"GOERTZEN, GERALDINE, FLORENCE",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 34 , 37 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1114905551,"GOERTZEN, GERALDINE, FLORENCE",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 30 , 34 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1114905551,"GOERTZEN, GERALDINE, FLORENCE",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1114905551,"GOERTZEN, GERALDINE, FLORENCE",117 E KINGS HWY   EDEN NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114905601,"GASTON, THOMAS",653 BLUEFIELD RD   MOORESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1114905601,"GASTON, THOMAS",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 265 , 340 , 419 ,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114905601,"GASTON, THOMAS",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 30 , 36 ,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1114905601,"GASTON, THOMAS",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 224 , 394 , 552 ,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114905981,"WHALEY, LINDA, BOSWELL",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114905981,"WHALEY, LINDA, BOSWELL",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,,,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114907060,"NABORS, ERIC, DAVID",3793 MCDOWELL LN STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114907060,"NABORS, ERIC, DAVID",115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 31 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114907656,"IGLESIAS, DANA, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1114907656,"IGLESIAS, DANA, MICHELLE",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 25 , 28 ,$#,,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114907656,"IGLESIAS, DANA, MICHELLE",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 33 , 38 ,$#,,
MEDICAID DIRECT,1477591089,CAROLINA RETINA INSTITUTE PC,CAROLINA RETINA INSTITUTE PC,940 SE CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1114907870,"KUMAR, AMIT",940 SE CARY PKWY STE 100 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 65 , 166 , 417 ," $12,001.52 ",,
MEDICAID DIRECT,1922094895,MEDICAL EYE ASSOCIATES PA,MEDICAL EYE ASSOCIATES PA,1707 MEDICAL PARK DR W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1114907870,"KUMAR, AMIT",940 SE CARY PKWY STE 100 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 53 , 160 , 283 ," $39,417.72 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114907888,"BOLICK, ELIZABETH, FRANKLIN",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114907888,"BOLICK, ELIZABETH, FRANKLIN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1114907888,"BOLICK, ELIZABETH, FRANKLIN",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114907888,"BOLICK, ELIZABETH, FRANKLIN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1114907888,"BOLICK, ELIZABETH, FRANKLIN",250 18TH ST SE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114907888,"BOLICK, ELIZABETH, FRANKLIN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1114907888,"BOLICK, ELIZABETH, FRANKLIN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114909397,"PERSON, LUTHER, GILL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1114909397,"PERSON, LUTHER, GILL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114909397,"PERSON, LUTHER, GILL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1114909397,"PERSON, LUTHER, GILL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598891665,HIGHLAND MEDICAL ASSOCIATES PA,~,165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1114910767,"STONE, TODD, IVERSON",165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 380 , 448 ," $12,849.23 ",,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114911401,"ALSPAUGH, CARRIE, DEENER",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114911401,"ALSPAUGH, CARRIE, DEENER",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114911401,"ALSPAUGH, CARRIE, DEENER",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114911823,"WESONGA, SAMUEL, M",162 LEGACY OAKS DR STE 201 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114911823,"WESONGA, SAMUEL, M",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 25 , 30 ,$#,,
MEDICAID DIRECT,1619903481,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114911930,"SHIVER, GERRIE, MICHELLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114911930,"SHIVER, GERRIE, MICHELLE",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 73 , 111 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114911930,"SHIVER, GERRIE, MICHELLE",1051 NOELL LN   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 454 , 455 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114912706,"HAYNES, RALPH, LEWIS",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 16 , 24 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114912706,"HAYNES, RALPH, LEWIS",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114913670,"REINSTEIN, LEON, JULIO",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114913670,"REINSTEIN, LEON, JULIO",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609833490,CARTERET CLINIC FOR ADOLESCENTS AND,CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN,312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1114913738,"MOOREHEAD, KATHARINE, SAYEKO",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 45 , 80 , 167 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1114913738,"MOOREHEAD, KATHARINE, SAYEKO",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1114914223,"PERRY, KEVIN, PATRICK",ASSOCIATED UROLOGISTS OF NC PA,700 TILGHMAN DR STE 702 DUNN NC,043,Harnett,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",700 TILGHMAN DR STE 702 DUNN NC,043,Harnett,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 16 , 20 ,$#,,
MEDICAID DIRECT,1114914223,"PERRY, KEVIN, PATRICK",ASSOCIATED UROLOGISTS OF NC PA,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",358 NORTHEAST BLVD   CLINTON NC,082,Sampson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1114914223,"PERRY, KEVIN, PATRICK",ASSOCIATED UROLOGISTS OF NC PA,358 NORTHEAST BLVD   CLINTON NC,082,Sampson,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",358 NORTHEAST BLVD   CLINTON NC,082,Sampson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1114914223,"PERRY, KEVIN, PATRICK",ASSOCIATED UROLOGISTS OF NC PA,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1811965825,"KHOUDARY, KEVIN, PAUL",ASSOCIATED UROLOGISTS OF NC PA,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1114914223,"PERRY, KEVIN, PATRICK",ASSOCIATED UROLOGISTS OF NC PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1114914223,"PERRY, KEVIN, PATRICK",ASSOCIATED UROLOGISTS OF NC PA,358 NORTHEAST BLVD   CLINTON NC,082,Sampson,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1114914223,"PERRY, KEVIN, PATRICK",ASSOCIATED UROLOGISTS OF NC PA,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1114914223,"PERRY, KEVIN, PATRICK",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 60 , 92 , 131 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114914488,"JENKINS-BAH, HARVETTE, CARMELLE",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114914488,"JENKINS-BAH, HARVETTE, CARMELLE",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 62 , 62 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1114914488,"JENKINS-BAH, HARVETTE, CARMELLE",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114914488,"JENKINS-BAH, HARVETTE, CARMELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114914488,"JENKINS-BAH, HARVETTE, CARMELLE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114915618,"FORDYCE, JAMES, WILLIAM",506 NC 69   HAYESVILLE NC,022,Clay,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114915618,"FORDYCE, JAMES, WILLIAM",506 NC 69   HAYESVILLE NC,022,Clay,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 19 , 36 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,4048 E US 64 ALT STE 6 MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1114915618,"FORDYCE, JAMES, WILLIAM",506 NC 69   HAYESVILLE NC,022,Clay,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 29 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1114915758,"BADIKA, NDOFUNSU, MABEKA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1114915758,"BADIKA, NDOFUNSU, MABEKA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 178 , 178 ,$#,,
MEDICAID DIRECT,1255450235,FREEDOM MEDICAL CLINIC PA,FREEDOM MEDICAL CLINIC PA,2905 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114915758,"BADIKA, NDOFUNSU, MABEKA",2905 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 75 , 197 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1114915758,"BADIKA, NDOFUNSU, MABEKA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1114915758,"BADIKA, NDOFUNSU, MABEKA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114915790,"SIERACKI, MICHAEL, ANTHONY",804 ENGLISH RD STE 200 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 53 , 77 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114915790,"SIERACKI, MICHAEL, ANTHONY",400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 142 , 211 , 311 ,$#,,
MEDICAID DIRECT,1114917770,"KHURANA, RAJESH, K",RAJESH KHURANA MD,382 ECHO LN   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1114917770,"KHURANA, RAJESH, K",382 ECHO LN   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 108 , 491 , 491 ," $13,613.40 ",,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114917770,"KHURANA, RAJESH, K",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 133 , 270 , 370 ,$#,,
MEDICAID DIRECT,1114919206,SKYLAND PROSTHETICS AND ORTHOTICS I,SKYLAND PROSTHETICS AND ORTHOTICS INC,3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114919206,SKYLAND PROSTHETICS AND ORTHOTICS I,3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 33 , 44 , 163 ," $70,234.23 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114919727,"KISTNER, LISA, MARIE",1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114919743,"FRANTZ, STEVEN, CRAIG",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 41 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114919743,"FRANTZ, STEVEN, CRAIG",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114919743,"FRANTZ, STEVEN, CRAIG",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 83 , 154 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1114920519,"LEMEL, MARK, STEVEN",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114920519,"LEMEL, MARK, STEVEN",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1114922622,"TONDO, LEWIS, JOHN",510 N MAIN ST   TROUTMAN NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 82 , 100 ,$#,,
MEDICAID DIRECT,1598926743,GRACE HEMATOLOGY AND ONCOLOGY,,3159 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114923299,"KIM, PAUL, SUNG",3159 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1598926743,GRACE HEMATOLOGY AND ONCOLOGY,,3159 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,193400000X,Group,Single Specialty,,1114923299,"KIM, PAUL, SUNG",3159 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 21 , 135 , 399 ,$#,,
MEDICAID DIRECT,1114924123,COUNTY OF SURRY & SURRY COUNTY WELF,Surry County Case Management Services,118 HAMBY RD   DOBSON NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114924123,COUNTY OF SURRY & SURRY COUNTY WELF,118 HAMBY RD   DOBSON NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 68 , 120 , 122 ," $43,825.03 ",,
MEDICAID DIRECT,1114924123,COUNTY OF SURRY & SURRY COUNTY WELF,Surry County Case Management Services,118 HAMBY RD   DOBSON NC,086,Surry,251B00000X,Agencies,Case Management,,1114924123,COUNTY OF SURRY & SURRY COUNTY WELF,118 HAMBY RD   DOBSON NC,086,Surry,251B00000X,Agencies,Case Management,, 158 ," 1,626 "," 1,626 "," $636,703.76 ",,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1114924503,"BEARD JR, LARRY, NEAL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114924503,"BEARD JR, LARRY, NEAL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 25 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114924503,"BEARD JR, LARRY, NEAL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 228 , 217 , 266 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114924545,"KANAMORI, CESAR, IVAN",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114924644,SCOTLAND COUNTY HEALTH DEPT,,1403 WEST BLVD   LAURINBURG NC,083,Scotland,3416L0300X,Transportation Services,Ambulance,Land Transport,1114924644,SCOTLAND COUNTY HEALTH DEPT,1403 WEST BLVD   LAURINBURG NC,083,Scotland,3416L0300X,Transportation Services,Ambulance,Land Transport, 382 , 616 ," 1,101 "," $15,026.44 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114924818,"LEE, JAMES, DONALD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114924818,"LEE, JAMES, DONALD",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114924818,"LEE, JAMES, DONALD",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114925435,"ARNOLD, SARA, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114925435,"ARNOLD, SARA, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114925435,"ARNOLD, SARA, LYNN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1477840791,ALLEGHANY EMERGENCY GROUP LLC,ALLEGHANY EMERGENCY GROUP LLC,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1114926557,"GLENN, DAVID, LOCKE",233 DOCTORS ST   SPARTA NC,003,Alleghany,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 66 , 79 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114927126,"EDDLEMAN, DAVID, BEAUCHAMP",11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114927126,"EDDLEMAN, DAVID, BEAUCHAMP",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114927126,"EDDLEMAN, DAVID, BEAUCHAMP",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114927126,"EDDLEMAN, DAVID, BEAUCHAMP",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 18 , 20 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114927399,"MOORE, MERCY, ROSSANA BAYOT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114927399,"MOORE, MERCY, ROSSANA BAYOT",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 76 , 98 , 185 ,$#,,
MEDICAID DIRECT,1114927514,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114927514,MEDICAL SERVICES OF AMERICA INC,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 320 ," 1,327 "," 2,059 "," $47,934.29 ",,
MEDICAID DIRECT,1114927514,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114927514,MEDICAL SERVICES OF AMERICA INC,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1114927514,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1114927514,MEDICAL SERVICES OF AMERICA INC,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1114927514,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114927514,MEDICAL SERVICES OF AMERICA INC,976 DAVIE AVE   STATESVILLE NC,049,Iredell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1245585009,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE WAXHAW FAMILY MEDICINE,2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1114928611,"HOLLER, JODY, DALE",2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 58 , 94 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114928736,"DRAKE, ALMOND, JERKINS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 25 , 88 , 88 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114928736,"DRAKE, ALMOND, JERKINS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 189 , 217 , 289 ,$#,,
MEDICAID DIRECT,1114928934,"BUTTERWORTH, GEORGE, NATHAN",~,3316 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,1114928934,"BUTTERWORTH, GEORGE, NATHAN",3316 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114929056,"BRITT, BONNIE, GRACE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114929056,"BRITT, BONNIE, GRACE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114929346,"MONTERO, MANUEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 36 , 36 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114929346,"MONTERO, MANUEL",2113B NEUSE BLVD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 36 , 230 , 230 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114929346,"MONTERO, MANUEL",970 NEWMAN RD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 49 , 122 , 250 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114929924,"SMITH, KEVIN, SCOTT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1285697086,THE PAIN RELIEF CENTERS PA,,,,Unknown,193400000X,Group,Single Specialty,,1114931318,"WOOD, ELIZABETH, ANN",1035 LINCOLNTON RD FL 2 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114931425,"HOBGOOD, KELLY, REDDEN",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114931425,"HOBGOOD, KELLY, REDDEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114931425,"HOBGOOD, KELLY, REDDEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1114932068,INGLES MARKETS INC,INGLES PHARMACY 033,125 GREENWOOD RD   SPRUCE PINE NC,061,Mitchell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114932068,INGLES MARKETS INC,125 GREENWOOD RD   SPRUCE PINE NC,061,Mitchell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114933256,"MARSHALL, BRUCE, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 26 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1114934387,"GOULAH, RICHARD, DANIEL",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114934932,"GARNIER, KATHARINE, MUSER",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 29 , 79 ,$#,,
MEDICAID DIRECT,1730263211,HIGGINS MANI & WATSON III DDS PA,THE DENTAL CARE CENTER,3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 32 , 117 ,$#,,
MEDICAID DIRECT,1093475998,HIGGINS MANI & WATSON IX DDS PA,THE DENTAL CARE CENTER,23 NC 98 HWY E STE 200 BUNN NC,035,Franklin,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 41 ,$#,,
MEDICAID DIRECT,1942509534,HIGGINS MANI & WATSON VI DDS PA,THE DENTAL CARE CENTER,1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 231 , 272 ," 1,021 "," $43,799.28 ",,
MEDICAID DIRECT,1316023443,HIGGINS MANI & WATSON IV DDS PA,THE DENTAL CARE CENTER,545 VENTURE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 601 , 712 ," 2,345 "," $90,395.57 ",,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1932283421,HIGGINS MANI & WATSON I DDS PA,THE DENTAL CARE CENTER,2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,343 "," 1,815 "," 6,517 "," $262,633.16 ",,
MEDICAID DIRECT,1306491444,HIGGINS MANI AND WATSON VIII DDS PA,THE DENTAL CARE CENTER,877 E GANNON AVE STE 401 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1114935194,"MANI, GEORGE",1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 110 , 116 , 426 ," $15,837.39 ",,
MEDICAID DIRECT,1386960177,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114935715,"SHORT, TERRY, BERNARD",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114935715,"SHORT, TERRY, BERNARD",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114935749,"MOSCA, PAUL, JOSEPH",20 DUKE MEDICINE CIR CLINIC 3 DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114935749,"MOSCA, PAUL, JOSEPH",20 DUKE MEDICINE CIR CLINIC 3 DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114935772,"SAINI, KANWARPREET, SINGH",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",613 E ROOSEVELT BLVD   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902223076,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 11 , 12 ,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114936606,"GRIGGS, JAMES, PHILIP",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1114943693,"CRUELL, RANDY, ANTHONY",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 33 ,$#,,
MEDICAID DIRECT,1750339933,DURHAM DIAGNOSTIC IMAGING LLC,TRIANGLE MEDICAL PARK,5107 SOUTHPARK DR STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1114943693,"CRUELL, RANDY, ANTHONY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114943693,"CRUELL, RANDY, ANTHONY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1114943693,"CRUELL, RANDY, ANTHONY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1114943693,"CRUELL, RANDY, ANTHONY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,3643 N ROXBORO ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1114943693,"CRUELL, RANDY, ANTHONY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 376 , 474 , 631 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1114943693,"CRUELL, RANDY, ANTHONY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1114944378,WAL-MART STORES EAST LP,WALMART PHARMACY 10-2005,2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114944378,WAL-MART STORES EAST LP,2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114945524,"LOUK, DOUGLAS, KEITH",400 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 79 , 119 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114945524,"LOUK, DOUGLAS, KEITH",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114945524,"LOUK, DOUGLAS, KEITH",601 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1114945953,"HALL, LISA, MCCASKILL",110 DENNIS DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1114945953,"HALL, LISA, MCCASKILL",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1114945953,"HALL, LISA, MCCASKILL",1506 WAYNE MEMORIAL DR STE D GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 136 , 188 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114946001,"TAYLOR, DEBORAH, JO",300 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1114946001,"TAYLOR, DEBORAH, JO",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114946001,"TAYLOR, DEBORAH, JO",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1114946001,"TAYLOR, DEBORAH, JO",2555 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1114946001,"TAYLOR, DEBORAH, JO",2555 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 72 , 72 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1114946001,"TAYLOR, DEBORAH, JO",2555 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114946951,"MCPHEE, SHERRYL, ANN",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114946951,"MCPHEE, SHERRYL, ANN",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619904430,SOUTH CHARLOTTE PRIMARY CARE,ATRIUM HEALTH PRIMARY CARE SOUTH CHARLOTTE INTERNA,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114946951,"MCPHEE, SHERRYL, ANN",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 32 , 43 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114947983,"MCCONVILLE, JOSEPH, FRANCIS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1114948205,AMERICAN HEALTHCARE SERVICES INC,AMERICAN HEALTHCARE SERVICES INC,915 ROCKFORD ST   MOUNT AIRY NC,086,Surry,253Z00000X,Agencies,In Home Supportive Care,,1114948205,AMERICAN HEALTHCARE SERVICES INC,915 ROCKFORD ST   MOUNT AIRY NC,086,Surry,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 8,004 "," 8,008 "," $1,298,929.00 ",,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114949369,"BLAIR, DIANE, WINN",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 29 , 29 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114951860,"MASTERSON, JESSICA-LYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114951860,"MASTERSON, JESSICA-LYN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 14 , 90 , 92 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",912 2ND ST NE   HICKORY NC,018,Catawba,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 26 , 220 , 221 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",620 SUMMIT CROSSING PL STE 202 GASTONIA NC,036,Gaston,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 25 , 154 , 223 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",15940 NORTHCROSS DR STE C HUNTERSVILLE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 42 , 85 , 85 ," $10,228.53 ",,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 35 , 156 , 196 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 18 , 161 , 203 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",19475 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 96 , 112 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",311 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952322,"NORRIS, JOHN, GRAY",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952553,"JOHNSON, JANICE, CRAVEN",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114952553,"JOHNSON, JANICE, CRAVEN",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 46 , 89 ,$#,,
MEDICAID DIRECT,1982632915,UNC ORAL & MAXILLOFACIAL PATHOLOGY,~,140 DENTAL CIR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114954211,"MURRAH, VALERIE, ANN",150 DENTAL CIR CB 7450 CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 50 , 49 , 62 ,$#,,
MEDICAID DIRECT,1982632915,UNC ORAL & MAXILLOFACIAL PATHOLOGY,~,140 DENTAL CIR   CHAPEL HILL NC,068,Orange,291U00000X,Laboratories,Clinical Medical Laboratory,,1114954211,"MURRAH, VALERIE, ANN",150 DENTAL CIR CB 7450 CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023366242,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023366242,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114954591,"KUWADA, TIMOTHY, SHIG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1114954872,"BEASLEY, CAREN, DENISE",1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 77 , 119 ,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114955242,"MORAN, KELLY, RAE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 19 , 23 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114955291,"CHINIWALLA, NIRAV, PARESH",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 17 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114955291,"CHINIWALLA, NIRAV, PARESH",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 113 , 153 , 186 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114955291,"CHINIWALLA, NIRAV, PARESH",522 CORPORATE CIR   SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114955291,"CHINIWALLA, NIRAV, PARESH",510 CORPORATE CIR STE 1000 SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114955291,"CHINIWALLA, NIRAV, PARESH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1114955309,PEDIATRIC SERVICES OF AMERICA LLC,AVEANNA HEALTHCARE,110 HORIZON DR STE 100 RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1114955309,PEDIATRIC SERVICES OF AMERICA LLC,110 HORIZON DR STE 100 RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,, 40 ," 7,834 "," 9,346 "," $4,248,830.04 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114955374,"NEEL, SUSAN, DANKO",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114955986,"SMITH, JONATHAN, CHARLES",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 52 , 52 , 52 ,$#,,
MEDICAID DIRECT,1609191121,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1656 RIVERCHASE BLVD STE 3600 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114958295,"DEMCHAK, SUSAN, MCBRAYER",1656 RIVERCHASE BLVD STE 3600 ROCK HILL SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114958295,"DEMCHAK, SUSAN, MCBRAYER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114958295,"DEMCHAK, SUSAN, MCBRAYER",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124501085,SELECT MEDICAL SERVICES PLLC,~,10931 RAVEN RIDGE RD STE 115 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114960036,"HATEFI, REZA, JOHN",10931 RAVEN RIDGE RD STE 115 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 71 , 137 ,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1114961000,"PHILLIPS, THOMAS, WALTER",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114962289,"ANKRAH, SHELIA, DELOISE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114962289,"ANKRAH, SHELIA, DELOISE",2630 E 7TH ST STE 101 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 38 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114962313,"SELIM, MARIA, ANGELICA",S TRENT DR DUKE INTERNATIONAL PHYS DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 28 , 28 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114962313,"SELIM, MARIA, ANGELICA",S TRENT DR DUKE INTERNATIONAL PHYS DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114962313,"SELIM, MARIA, ANGELICA",S TRENT DR DUKE INTERNATIONAL PHYS DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114963774,"BRAMLETT, JIMMY, LEWIS",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114964491,PIEDMONT MEDICAL SUPPLY INC,~,752 4TH ST SW   HICKORY NC,018,Catawba,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1114964491,PIEDMONT MEDICAL SUPPLY INC,752 4TH ST SW   HICKORY NC,018,Catawba,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 16 , 58 , 72 ," $20,520.91 ",,
MEDICAID DIRECT,1114964491,PIEDMONT MEDICAL SUPPLY INC,~,752 4TH ST SW   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114964491,PIEDMONT MEDICAL SUPPLY INC,752 4TH ST SW   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 133 , 417 , 746 ," $144,508.41 ",,
MEDICAID DIRECT,1114964491,PIEDMONT MEDICAL SUPPLY INC,~,752 4TH ST SW   HICKORY NC,018,Catawba,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1114964491,PIEDMONT MEDICAL SUPPLY INC,752 4TH ST SW   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1114964491,PIEDMONT MEDICAL SUPPLY INC,~,752 4TH ST SW   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114964491,PIEDMONT MEDICAL SUPPLY INC,752 4TH ST SW   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 34 , 167 , 282 ," $23,957.43 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1114967189,"GOEBEL, MICHAEL, JAMES",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 94 , 132 , 240 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1114967189,"GOEBEL, MICHAEL, JAMES",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 33 , 63 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114967429,"NASRALLAH, VICTOR, NASH",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114968237,"GLAZER, CATHERINE, STIX",110 KILDAIRE PARK DR   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114968237,"GLAZER, CATHERINE, STIX",601 OBERLIN RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 27 , 36 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1114968237,"GLAZER, CATHERINE, STIX",811 US 70 HWY W   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114969268,"SAPASETTY, RAM, ANAND",608 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 223 , 618 ," 1,157 "," $24,448.43 ",,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114969433,"MOHIUDDIN, ISHTIAQUE, HOSSAIN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1114969433,"MOHIUDDIN, ISHTIAQUE, HOSSAIN",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 35 , 59 ,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114969565,"VACHINO, TAMMY, DENISE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1114969706,COMPLETE EYE CARE OD PA,COMPLETE EYE CARE OD PA,1200 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1114969706,COMPLETE EYE CARE OD PA,1200 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,, 392 , 395 , 787 ," $10,692.21 ",,
MEDICAID DIRECT,1477664001,BLAND CLINIC PA,,1317 N ELM ST STE 7 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1114971009,"HILL, GERALD, KENNETH",1317 N ELM ST STE 7 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 104 , 152 ,$#,,
MEDICAID DIRECT,1114972411,SPEECH KIDZ INC,~,58 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1114972411,SPEECH KIDZ INC,58 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,, 39 , 148 , 157 ," $10,807.16 ",,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1114972585,"ERDEM, NURUM, FILIZ",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114972585,"ERDEM, NURUM, FILIZ",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 20 , 25 , 36 ,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1114972585,"ERDEM, NURUM, FILIZ",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114974268,"CORSE, ANDREA, MARKL",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 25 , 32 , 52 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1114974300,"LAMONT, DANIEL, JOHN",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114974300,"LAMONT, DANIEL, JOHN",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 30 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114974300,"LAMONT, DANIEL, JOHN",1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114974300,"LAMONT, DANIEL, JOHN",8115 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 31 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1114974300,"LAMONT, DANIEL, JOHN",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1114974300,"LAMONT, DANIEL, JOHN",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1114974300,"LAMONT, DANIEL, JOHN",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1114975273,"THARRINGTON, CHRISTOPHER, L",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 404 , 698 ," 1,030 ",$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1114975273,"THARRINGTON, CHRISTOPHER, L",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 260 , 323 , 428 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1114975273,"THARRINGTON, CHRISTOPHER, L",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1003882937,NASH X RAY ASSOCIATES PA,NASH X RAY ASSOCIATES PA,117 ROUNDABOUT CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1114975273,"THARRINGTON, CHRISTOPHER, L",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114976032,"CORCORAN, MELISSA, CHARLENE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 31 , 31 ,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114976032,"CORCORAN, MELISSA, CHARLENE",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 32 , 61 , 61 ,$#,,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114976032,"CORCORAN, MELISSA, CHARLENE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114979283,"FLUECH, DAVID, WILLIAM",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114979283,"FLUECH, DAVID, WILLIAM",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 68 , 82 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114979283,"FLUECH, DAVID, WILLIAM",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114979283,"FLUECH, DAVID, WILLIAM",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 76 , 93 ,$#,,
MEDICAID DIRECT,1689210585,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1114982048,"BRIGNONI, CATHERINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1114982048,"BRIGNONI, CATHERINE",4000 COLISEUM DR STE 200 HAMPTON VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114982220,"FROMKE, MARK, KWEN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 67 , 91 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114982220,"FROMKE, MARK, KWEN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 76 , 78 , 96 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114982220,"FROMKE, MARK, KWEN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1114983723,"THROCKMORTON, JOHN, KERSEY",111 E 3RD AVE   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1063517415,ALBEMARLE PULMONARY MEDICINE ASSOCI,~,1507 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1114985686,"SINGH, JASVINDER, PAL",1507 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 120 , 209 , 480 ,$#,,
MEDICAID DIRECT,1114987344,SME INC USA,SME INC USA,5949 CAROLINA BEACH RD STE 11 WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114987344,SME INC USA,5949 CAROLINA BEACH RD STE 11 WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 616 , 650 , 713 ," $47,976.42 ",,
MEDICAID DIRECT,1114987344,SME INC USA,SME INC USA,5949 CAROLINA BEACH RD STE 11 WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114987344,SME INC USA,5949 CAROLINA BEACH RD STE 11 WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1114987344,SME INC USA,SME INC USA,5949 CAROLINA BEACH RD STE 11 WILMINGTON NC,065,New Hanover,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1114987344,SME INC USA,5949 CAROLINA BEACH RD STE 11 WILMINGTON NC,065,New Hanover,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114987807,"WALLS, JEFFREY, GLEN",11840 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114987807,"WALLS, JEFFREY, GLEN",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 68 , 98 , 144 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114987807,"WALLS, JEFFREY, GLEN",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114987807,"WALLS, JEFFREY, GLEN",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 29 , 59 , 74 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114988292,"JETHRO, VIRGINIA, ANN",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 78 , 109 ,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1114988789,"WINKEL, JODI, MERA",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 31 , 82 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114989100,"GIMENEZ, DAVID, GERARDO",171 MACARTHUR ST   ASHEBORO NC,076,Randolph,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114989100,"GIMENEZ, DAVID, GERARDO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 58 , 64 ," $10,271.63 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114989324,"RARDIN, DUFF, ANDREW",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 50 , 61 , 77 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114989324,"RARDIN, DUFF, ANDREW",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114989324,"RARDIN, DUFF, ANDREW",890 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 34 , 45 , 53 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114989324,"RARDIN, DUFF, ANDREW",890 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1114989324,"RARDIN, DUFF, ANDREW",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 24 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 34 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1114989795,"SINGLETARY, KIMBERLY, REENEA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,824 S VAN BUREN RD STE F EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1114991916,"KIRK, JOHN, AARON",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1114991916,"KIRK, JOHN, AARON",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1114991916,"KIRK, JOHN, AARON",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1114991916,"KIRK, JOHN, AARON",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114992062,"LECROY, CHARLES, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 37 , 53 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1114992062,"LECROY, CHARLES, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 19 , 41 ," $10,621.10 ",,
MEDICAID DIRECT,1114994555,CAROLINA HOME MEDICAL INC,~,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114994555,CAROLINA HOME MEDICAL INC,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1114994555,CAROLINA HOME MEDICAL INC,~,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1114994555,CAROLINA HOME MEDICAL INC,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1114994555,CAROLINA HOME MEDICAL INC,~,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1114994555,CAROLINA HOME MEDICAL INC,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 345 ," 1,450 "," 2,416 "," $144,697.92 ",,
MEDICAID DIRECT,1114994555,CAROLINA HOME MEDICAL INC,~,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1114994555,CAROLINA HOME MEDICAL INC,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1114994555,CAROLINA HOME MEDICAL INC,~,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114994555,CAROLINA HOME MEDICAL INC,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 102 , 254 , 397 ,$#,,
MEDICAID DIRECT,1114994555,CAROLINA HOME MEDICAL INC,~,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1114994555,CAROLINA HOME MEDICAL INC,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 89 , 549 , 648 ," $115,304.43 ",,
MEDICAID DIRECT,1114994555,CAROLINA HOME MEDICAL INC,~,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1114994555,CAROLINA HOME MEDICAL INC,2680 HENDERSON DR STE 2 JACKSONVILLE NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114995909,"MARIENCHECK, WILLIAM, IRVIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 71 , 119 , 143 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1114996170,"MORAES, MANOEL, ARY",516 S VAN BUREN RD   EDEN NC,079,Rockingham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1114996170,"MORAES, MANOEL, ARY",516 S VAN BUREN RD   EDEN NC,079,Rockingham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 29 , 39 , 39 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114996725,"STOUT, THOMAS, FRANKLIN",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 36 , 64 , 64 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1114996725,"STOUT, THOMAS, FRANKLIN",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1114996824,"ADELOYE, DAVID, ADEDAYO AKINSOJI",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1114996824,"ADELOYE, DAVID, ADEDAYO AKINSOJI",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114996824,"ADELOYE, DAVID, ADEDAYO AKINSOJI",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1114996824,"ADELOYE, DAVID, ADEDAYO AKINSOJI",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114996824,"ADELOYE, DAVID, ADEDAYO AKINSOJI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114996824,"ADELOYE, DAVID, ADEDAYO AKINSOJI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114998044,"AKHTER, SHAHAB, ALI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1114998044,"AKHTER, SHAHAB, ALI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114998366,"BRADLEY, YONG, CHOL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085N0904X,Allopathic & Osteopathic Physicians,Radiology,Nuclear Radiology, 53 , 53 , 53 ,$#,,
MEDICAID DIRECT,1043309917,SPARTANBURG MEDICAL CENTER,MGC-SPINE AND PAINMANANGEMENT - NORTH GROVE,1330 BOILING SPRINGS RD STE 1300 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1114998671,"MOURTADA, HUSAM",1330 BOILING SPRINGS RD STE 1800 SPARTANBURG SC,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1114999471,"SALIM, SARWAT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist, 11 , 16 , 37 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1114999539,"MCMURRY, DAVID, WILLIS",200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 111 , 123 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1114999539,"MCMURRY, DAVID, WILLIS",200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124000419,"LEWIS, BRIAN, CHRISTOPHER",1219 LEXINGTON AVE STE A THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 34 , 40 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124000419,"LEWIS, BRIAN, CHRISTOPHER",1219 LEXINGTON AVE STE A THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 22 , 27 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124001433,"WRIGHT, TONY, MARRONE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 54 , 56 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124001557,"REEDY, MYLES, LAWSON",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124002209,"MCLEAN, THOMAS, WILLIAMS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 46 , 51 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124002225,"MORROW, BRIAN, MCCLELLAN",3940 H ST APT 206 SACRAMENTO CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 22 ,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1124002225,"MORROW, BRIAN, MCCLELLAN",3940 H ST APT 206 SACRAMENTO CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124003256,"PAN, PETER, HAO HSIANG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124003256,"PAN, PETER, HAO HSIANG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 90 , 90 , 93 ," $16,189.38 ",,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124004122,"DUNCAN, DAVID, ALLEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124004122,"DUNCAN, DAVID, ALLEN",4622 COUNTRY CLUB RD STE 180 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124004122,"DUNCAN, DAVID, ALLEN",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124004197,"KANZLER, JOAN, ELIZABETH PACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124004627,"KRATZER, JOSEPH, HAROLD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124004627,"KRATZER, JOSEPH, HAROLD",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124005897,"YOUNG, CAROL, RAY",186 MEDICAL PARK LOOP STE 503 SYLVA NC,050,Jackson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124005897,"YOUNG, CAROL, RAY",512 VILLAGE RD STE 101 SHALLOTTE NC,010,Brunswick,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 38 , 62 , 105 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124006416,"ALEXANIAN, AMY, LOWERY",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 33 , 41 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,16525 HOLLY CREST LN STE 150   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124006416,"ALEXANIAN, AMY, LOWERY",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124006416,"ALEXANIAN, AMY, LOWERY",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 50 ,$#,,
MEDICAID DIRECT,1871780254,ASHEVILLE MEDICINE AND PEDIATRICS L,ASHEVILLE MEDICINE AND PEDIATRICS LTD,600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1124006424,"BUBB, LORI, CATHERINE",600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 23 ,$#,,
MEDICAID DIRECT,1124006986,MATTHEWS INC,~,408 NORTHEAST BLVD   CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124006986,MATTHEWS INC,408 NORTHEAST BLVD   CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124007372,"STOFFEL, ELISABETH, ANNE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 32 , 37 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124007372,"STOFFEL, ELISABETH, ANNE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 47 , 71 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124008321,"HANSON, ERIC, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1124009121,CAREMARK LLC,CVS SPECIALTY,10700 WORLD TRADE BLVD STE 110 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1124009121,CAREMARK LLC,10700 WORLD TRADE BLVD STE 110 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 11 , 50 , 101 ," $12,096.51 ",,
MEDICAID DIRECT,1871894519,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,2604 DR MARTIN LUTHER KING STE B NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124011523,"WHALEY, MARCUS, CRAIG",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1124011523,"WHALEY, MARCUS, CRAIG",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1235430976,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE PEDIATRICS,2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124011523,"WHALEY, MARCUS, CRAIG",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 16 , 33 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1124011523,"WHALEY, MARCUS, CRAIG",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1013147909,SMILES OF CAROLINA,SMILES OF CAROLINA,6807 KNIGHTDALE BLVD STE E KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124012141,"PCOLINSKY, MARK, PAUL",6807 KNIGHTDALE BLVD STE E KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 119 , 572 ," $18,049.03 ",,
MEDICAID DIRECT,1124012380,WARREN EYE CARE OPTOMETRY PA,WARREN EYE CARE OPTOMETRY PA,601 W BROAD ST   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1124012380,WARREN EYE CARE OPTOMETRY PA,601 W BROAD ST   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,, 172 , 173 , 330 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 33 , 33 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",115 EXETER ST   MANTEO NC,028,Dare,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",312 MEDICAL ARTS DR   EDENTON NC,021,Chowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 45 , 45 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",211 VIRGINIA RD   EDENTON NC,021,Chowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 45 , 45 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",101 DAVITA LN   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 59 , 59 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",1840 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 54 , 54 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 85 , 219 , 229 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124012406,"RAMSAMOOJ, RAVI",210 OCEAN HWY S   HERTFORD NC,072,Perquimans,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124013032,"KORDIS, ALEX, MARSHALL",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1124014071,"NEWBERG, BARBARA",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1124015086,KCI USA INC,3M MEDICAL SOLUTIONS,6132 BROOKSHIRE BLVD STE H CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124015086,KCI USA INC,6132 BROOKSHIRE BLVD STE H CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 179 , 545 ," 1,097 "," $255,816.91 ",,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1124017751,"PITTA, JEFFREY, MICHAEL",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 23 , 25 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1124017751,"PITTA, JEFFREY, MICHAEL",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1124017751,"PITTA, JEFFREY, MICHAEL",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104899145,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOTHORACIC SURGICAL ASSOCIATES,101 WILLIAM H JOHNSON ST STE 370 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124019518,"HUBER, STEPHEN, CARY",101 WILLIAM H JOHNSON ST STE 370 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1124020078,"WELLS, MARION, TIMOTHY",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 71 , 98 , 126 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1124020078,"WELLS, MARION, TIMOTHY",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1124020078,"WELLS, MARION, TIMOTHY",436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 17 , 19 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124024112,"LIM, CHANG, SUN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 53 , 61 , 77 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124024112,"LIM, CHANG, SUN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 22 , 29 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124024112,"LIM, CHANG, SUN",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124024112,"LIM, CHANG, SUN",360 HOSPITAL DR STE 202 CLYDE NC,044,Haywood,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124024112,"LIM, CHANG, SUN",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124024112,"LIM, CHANG, SUN",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 20 , 28 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124024112,"LIM, CHANG, SUN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124024443,"SLEDGE, SCOTT, CHARLES",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 229 , 229 ,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1124024666,"CLAPP, CHRISTOPHER, RANDOLPH",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 110 , 274 ," $13,733.67 ",,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124025556,"LEWIS, MARGARET, SUSAN",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 85 , 85 ,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1124025556,"LEWIS, MARGARET, SUSAN",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124025556,"LEWIS, MARGARET, SUSAN",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 56 , 59 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124025655,"DOVE, MYRA, CARPENTER",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124025655,"DOVE, MYRA, CARPENTER",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1962086793,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA PEDIATRIC MEDICINE - SHELBY,1019 N LAFAYETTE ST   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124025671,"AHMED, NAJLA",1019 N LAFAYETTE ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 39 , 81 ,$#,,
MEDICAID DIRECT,1366631087,KING PODIATRY AND ASSOCIATES PLLC,,1121 N ROAD ST STE B ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1124025846,"KING, RICHARD, CHRISTAIN",1121 N ROAD ST STE B ELIZABETH CITY NC,070,Pasquotank,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 67 , 158 , 245 ,$#,,
MEDICAID DIRECT,1366631087,KING PODIATRY AND ASSOCIATES PLLC,,1121 N ROAD ST STE B ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1124025846,"KING, RICHARD, CHRISTAIN",1121 N ROAD ST STE B ELIZABETH CITY NC,070,Pasquotank,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124027123,"DUNBAR, ALSTON, ELMO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 36 , 134 , 136 ," $23,941.85 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124027123,"DUNBAR, ALSTON, ELMO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 61 , 61 ," $14,433.11 ",,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124028014,"HOLT, FRANK, L",13 MEDICAL CAMPUS DR NW STE 102 SUPPLY NC,010,Brunswick,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124028014,"HOLT, FRANK, L",10 DOCTORS CIR STE 4 HOLDEN BEACH NC,010,Brunswick,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124028014,"HOLT, FRANK, L",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124029129,"PATRONE, VINCENT, JOSEPH",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1124029129,"PATRONE, VINCENT, JOSEPH",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 29 , 39 , 55 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124029129,"PATRONE, VINCENT, JOSEPH",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 119 , 149 , 211 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124029244,"CREASY, JOHN, DAVID",336 BURTONWOOD DR   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124029244,"CREASY, JOHN, DAVID",336 BURTONWOOD DR   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 140 , 176 , 220 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124029244,"CREASY, JOHN, DAVID",336 BURTONWOOD DR   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 169 , 185 , 231 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,974 S POINT RD UNIT D BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1124029707,"MANTOOTH, GREGORY, ALLEN",974 S POINT RD UNIT D BELMONT NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124029707,"MANTOOTH, GREGORY, ALLEN",959 COX RD   GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 31 , 49 , 88 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124029822,"GREENE, TRESHELL, NICOLE",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 59 , 129 ,$#,,
MEDICAID DIRECT,1174208813,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE RHC,1125 CARTHAGE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1124029954,"CHAPIN, SALLY, JANE",1125 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 54 , 59 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124034756,"HORSTMANN, SARA, ELIZABETH HOWLAND",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124034756,"HORSTMANN, SARA, ELIZABETH HOWLAND",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124034756,"HORSTMANN, SARA, ELIZABETH HOWLAND",920 CHURCH ST N STE 255-D CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1669624540,MILLER CHIROPRACTIC OF ROCKY MOUNT,MILLER CHIROPRACTIC OF ROCKY MOUNT PC,2747 SUNSET AVE STE 107 ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1124036058,"CLARK, STEVEN, ALAN",2747 SUNSET AVE STE 107 ROCKY MOUNT NC,064,Nash,111N00000X,Chiropractic Providers,Chiropractor,, 20 , 42 , 48 ,$#,,
MEDICAID DIRECT,1881927648,CAROLINA SPORTS AND SPINE PA,~,3101 ZEBULON RD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1124036694,"ANTONY, ALVIN, KANDANATT",1026 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 50 ,#,#,$#,,
MEDICAID DIRECT,1881927648,CAROLINA SPORTS AND SPINE PA,~,3101 ZEBULON RD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1124036694,"ANTONY, ALVIN, KANDANATT",3101 ZEBULON RD   ROCKY MOUNT NC,064,Nash,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 81 , 273 , 288 ,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124037544,"PATEL, SANJAY, MANIBHAI",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124037585,"BETZ, KATHRYN, ODOM",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124037585,"BETZ, KATHRYN, ODOM",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 70 , 90 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124037585,"BETZ, KATHRYN, ODOM",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 62 , 73 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124037585,"BETZ, KATHRYN, ODOM",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124037692,"PETTIGREW, DAVID, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 24 , 143 , 144 ," $31,086.80 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124037692,"PETTIGREW, DAVID, CHARLES",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124040605,"HUTCHINSON, MARY, HELEN",420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 14 , 38 , 82 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124042197,"PETTY, SCOTT, MILLER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 32 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124042197,"PETTY, SCOTT, MILLER",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 71 , 74 , 101 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124043310,"BADGER, MICHAEL, CHANNING",4901 AUBURN RD   SUMMERFIELD NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 16 , 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124043310,"BADGER, MICHAEL, CHANNING",6161 LAKE BRANDT RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124043310,"BADGER, MICHAEL, CHANNING",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124043971,"ROSE, PAUL, RICHARD",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124044771,"GORREY, PURUSHOTHAM",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124044771,"GORREY, PURUSHOTHAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 22 , 22 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124044771,"GORREY, PURUSHOTHAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124044771,"GORREY, PURUSHOTHAM",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124044771,"GORREY, PURUSHOTHAM",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 21 , 64 , 64 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1124044771,"GORREY, PURUSHOTHAM",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 47 , 47 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124046420,"OJEDA, AISLINN, RIPLEY",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124046420,"OJEDA, AISLINN, RIPLEY",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124046586,"PATTY, JANET, YOUNTZ",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124046826,"KOROLUK, LORNE, DAVID",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124048111,"ASBURY, JEFFREY, BLAKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 123 , 201 , 276 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124048111,"ASBURY, JEFFREY, BLAKE",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124048863,"ROBINETTE, GEORGE, DAVE",105 YADKIN ST STE 302 ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124048863,"ROBINETTE, GEORGE, DAVE",5427 HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124048863,"ROBINETTE, GEORGE, DAVE",380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124048863,"ROBINETTE, GEORGE, DAVE",380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124049408,"KIRK, TRIPURANENI, DEEPA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 26 , 38 , 63 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124049408,"KIRK, TRIPURANENI, DEEPA",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 54 , 84 , 149 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1124050026,"HART, WILLIAM, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124050026,"HART, WILLIAM, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 27 ,$#,,
MEDICAID DIRECT,1083643290,GOLDENBERG PIERCE & APPLEBAUM DDS P,THE GREENSBORO CENTER FOR PEDIATRIC DENTISTRY,5408 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124050877,"GOLDENBERG, MARC, E",5408 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 193 , 360 ," 1,286 "," $29,323.52 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124051487,"MAHLER, SIMON, A.",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 33 , 35 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124052758,"CHRISTIE, NATHAN",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 74 , 125 , 348 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1124052758,"CHRISTIE, NATHAN",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124052758,"CHRISTIE, NATHAN",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124052758,"CHRISTIE, NATHAN",100 PERKINS DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124055819,"BERNARDO, SHERRY, LYNNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639364227,WENDELL MEDICAL CENTER PA,~,217 COOK ST   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1124057856,"HASHEMEE, SAYED, ABDUL RAHMAN",217 COOK ST   WENDELL NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 51 , 61 ,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124058003,"TONUZI, RACQUEL, MARIE",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 28 , 68 ,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124058003,"TONUZI, RACQUEL, MARIE",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124060777,"HERNDON, CAROLYN, WINBOURNE",1000 W HAMLET AVE   HAMLET NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124061569,"VALERI, FRANK, SCOTT",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 57 , 86 , 132 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1124061569,"VALERI, FRANK, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124061569,"VALERI, FRANK, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124061569,"VALERI, FRANK, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 69 , 91 , 114 ,$#,,
MEDICAID DIRECT,1669797189,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,,,Unknown,193200000X,Group,Multi-Specialty,,1124061569,"VALERI, FRANK, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124061569,"VALERI, FRANK, SCOTT",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124061569,"VALERI, FRANK, SCOTT",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124061569,"VALERI, FRANK, SCOTT",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124061593,"CLEVELAND, TONYA, POWERS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 67 , 69 , 72 ,$#,,
MEDICAID DIRECT,1487969507,FOREFRONT DERMATOLOGY SC,,801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1124061619,"HANSEN, DOUGLAS, ALAN",801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1487969507,FOREFRONT DERMATOLOGY SC,,801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1124061619,"HANSEN, DOUGLAS, ALAN",801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,34 HEALTHPARK WAY STE 100C CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124061783,"JOHNSON, KENNETH, LEE",34 HEALTHPARK WAY STE 100D CLAYTON NC,051,Johnston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,34 HEALTHPARK WAY STE 100D CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124061783,"JOHNSON, KENNETH, LEE",34 HEALTHPARK WAY STE 100D CLAYTON NC,051,Johnston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 109 , 143 , 186 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124062674,"PAYNE, WILLIAM, SIDNEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124062674,"PAYNE, WILLIAM, SIDNEY",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 63 , 64 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1124062674,"PAYNE, WILLIAM, SIDNEY",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1124062674,"PAYNE, WILLIAM, SIDNEY",1545 ORCHARD VILLAS AVE   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124063052,"CARTLEDGE, KENNETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124065172,"DUDA, MARCUS, VALENTINE",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 152 , 289 , 416 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124065172,"DUDA, MARCUS, VALENTINE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124065172,"DUDA, MARCUS, VALENTINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 38 , 59 , 79 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124065339,"SMALL, STEPHEN, ANDREW",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124065339,"SMALL, STEPHEN, ANDREW",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124065339,"SMALL, STEPHEN, ANDREW",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 25 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124065339,"SMALL, STEPHEN, ANDREW",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124065339,"SMALL, STEPHEN, ANDREW",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 12 , 16 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1124066535,"OTI, CHRISTOPHER, NNANNA",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1124066535,"OTI, CHRISTOPHER, NNANNA",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124066535,"OTI, CHRISTOPHER, NNANNA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 88 , 88 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1124066535,"OTI, CHRISTOPHER, NNANNA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 177 , 177 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1124066568,"PEAK, EDWIN, LOUIS",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124066881,"KIMMERLE, LISA, YONG",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124066881,"KIMMERLE, LISA, YONG",1321 E SUNSET DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124067707,"ZEYFANG, DAVID, WILLIAM",309 NEW ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124068432,"WILSON, RUSSELL, CHAPMAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 87 , 87 , 105 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124068432,"WILSON, RUSSELL, CHAPMAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 38 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124070529,"KEIL, JEFFREY, MARK",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124070529,"KEIL, JEFFREY, MARK",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124070529,"KEIL, JEFFREY, MARK",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 29 , 60 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124070651,"GREENE, JEFFREY, RICHARD",102 POMONA DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 35 , 73 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124070651,"GREENE, JEFFREY, RICHARD",102 POMONA DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124071212,"BOWMAN, BRIAN, PATRICK",1021 W WILLIAMS ST STE 105 APEX NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 40 , 85 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124072483,"GOODMAN, DAVID, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124073804,"SAUNDERS, SARAH, ANN",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 30 , 57 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124075403,"MCCARTHY, MAUREEN, MARIE",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 42 ,$#,,
MEDICAID DIRECT,1124075635,ASSOCIATED PATHOLOGISTS LLC,ASSOCIATED PATHOLOGISTS LLC,1010 AIRPARK CENTER DR   NASHVILLE TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1124075635,ASSOCIATED PATHOLOGISTS LLC,1010 AIRPARK CENTER DR   NASHVILLE TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 527 , 706 ," 1,298 "," $41,010.48 ",,
MEDICAID DIRECT,1124075635,ASSOCIATED PATHOLOGISTS LLC,ASSOCIATED PATHOLOGISTS LLC,4071 S ACCESS RD   CHATTANOOGA TN,101,Out of State <= 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1124075635,ASSOCIATED PATHOLOGISTS LLC,4071 S ACCESS RD   CHATTANOOGA TN,101,Out of State <= 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#, 12 ,$#,,
MEDICAID DIRECT,1124076856,"KAVANAUGH, BARRY, LAURENCE",BARRY L KAVANAUGH JR OD PA,1110 7 LAKES DR   WEST END NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,1124076856,"KAVANAUGH, BARRY, LAURENCE",1110 7 LAKES DR   WEST END NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 56 , 66 , 118 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124077599,"MESSNER, KEITH, HAROLD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 164 , 176 , 228 ," $12,395.66 ",,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1124077664,"ABO KAMIL, TARIQ",205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 41 , 102 , 200 ,$#,,
MEDICAID DIRECT,1801172820,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM NEPHROLOGY & HYPERTENSION CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1124077664,"ABO KAMIL, TARIQ",568 RUIN CREEK RD STE 3 HENDERSON NC,091,Vance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1801172820,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM NEPHROLOGY & HYPERTENSION CLINIC,568 RUIN CREEK RD STE 3 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1124077664,"ABO KAMIL, TARIQ",568 RUIN CREEK RD STE 3 HENDERSON NC,091,Vance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 225 , 866 , 866 ," $20,917.23 ",,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1124077664,"ABO KAMIL, TARIQ",568 RUIN CREEK RD STE 3 HENDERSON NC,091,Vance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 29 ,$#,,
MEDICAID DIRECT,1831157833,KERNERSVILLE REHAB SPECIALISTS LLC,,1027 E MOUNTAIN ST #101   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124078464,"FISH, THOMAS, CHARLES",1027 E MOUNTAIN ST #101   KERNERSVILLE NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 57 , 120 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124079017,"INGRAM, MARK, WILLIAM",300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124079256,"EATON, MARK, THOMAS",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124079256,"EATON, MARK, THOMAS",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124079256,"EATON, MARK, THOMAS",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124079256,"EATON, MARK, THOMAS",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 37 , 84 , 104 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124079256,"EATON, MARK, THOMAS",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124079256,"EATON, MARK, THOMAS",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124079256,"EATON, MARK, THOMAS",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 158 , 595 , 794 ," $18,887.81 ",,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1124079827,"MUNOZ, PAUL",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1124079827,"MUNOZ, PAUL",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 74 , 75 , 101 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1124079827,"MUNOZ, PAUL",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1861824385,WHITEVILLE ADULT MEDICINE PA,,116 MEMORY PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1124081930,"FLEMING, RICHARD, CARL",116 MEMORY PLZ   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 53 , 60 ,$#,,
MEDICAID DIRECT,1124081930,"FLEMING, RICHARD, CARL",~,116 MEMORY PLZ   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1124081930,"FLEMING, RICHARD, CARL",116 MEMORY PLZ   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124081955,"GOODEN, GAY, MARIE",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1124081955,"GOODEN, GAY, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1124081955,"GOODEN, GAY, MARIE",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 23 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1124081955,"GOODEN, GAY, MARIE",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1124081955,"GOODEN, GAY, MARIE",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124081955,"GOODEN, GAY, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124081955,"GOODEN, GAY, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 14 , 19 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1124081955,"GOODEN, GAY, MARIE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1124081955,"GOODEN, GAY, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124081955,"GOODEN, GAY, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 38 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124081955,"GOODEN, GAY, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 32 , 44 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124081955,"GOODEN, GAY, MARIE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,, 46 , 52 , 95 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124084306,"MATHEWS, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 54 , 54 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1124084447,"WEILER, MICHAEL, BENJAMIN",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124084447,"WEILER, MICHAEL, BENJAMIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 78 , 78 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1124084447,"WEILER, MICHAEL, BENJAMIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 152 , 152 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124085246,"TAPPOUNI, RAFEL, FIAZ RAPHAEL",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124085246,"TAPPOUNI, RAFEL, FIAZ RAPHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 361 , 417 , 524 ," $13,072.97 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124085246,"TAPPOUNI, RAFEL, FIAZ RAPHAEL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124085246,"TAPPOUNI, RAFEL, FIAZ RAPHAEL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 39 , 43 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124085246,"TAPPOUNI, RAFEL, FIAZ RAPHAEL",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215994371,FOX EYE CARE GROUP,FOX EYE CARE GROUP,642 FRIENDLY CENTER RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124086319,"FOX, WILLIAM, EDWARD",642 FRIENDLY CENTER RD   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215994371,FOX EYE CARE GROUP,FOX EYE CARE GROUP,330 FOUR SEASONS TOWN CTR   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124086319,"FOX, WILLIAM, EDWARD",330 FOUR SEASONS TOWN CTR   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215994371,FOX EYE CARE GROUP,FOX EYE CARE GROUP,642 FRIENDLY CENTER RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124086319,"FOX, WILLIAM, EDWARD",330 FOUR SEASONS TOWN CTR   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215994371,FOX EYE CARE GROUP,FOX EYE CARE GROUP,3320 SILAS CREEK PKWY STE 404 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124086319,"FOX, WILLIAM, EDWARD",3320 SILAS CREEK PKWY STE 404 WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215994371,FOX EYE CARE GROUP,FOX EYE CARE GROUP,4325 GLENWOOD AVE STE F RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124086319,"FOX, WILLIAM, EDWARD",4325 GLENWOOD AVE STE F RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215994371,FOX EYE CARE GROUP,FOX EYE CARE GROUP,611 N BERKELEY BLVD STE A GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1124086319,"FOX, WILLIAM, EDWARD",611 N BERKELEY BLVD STE A GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1124086822,ABC PEDIATRIC THERAPY LLC,,6616 LITTLE SATTERWHITE RD   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1124086822,ABC PEDIATRIC THERAPY LLC,6616 LITTLE SATTERWHITE RD   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,, 52 ," 1,185 "," 1,225 "," $99,866.82 ",,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124087432,"FINK, PHILLIP, ALEN",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124087432,"FINK, PHILLIP, ALEN",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1073554689,EYECARECENTER OD PA,EYECARE CENTER OD PA,3044 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1124090170,"AKERS, THOMAS, ADIE",3044 SUNSET AVE   ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124090279,"HESS, TERRY, DOUGLAS",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124090279,"HESS, TERRY, DOUGLAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124090279,"HESS, TERRY, DOUGLAS",1225 LEWISVILLE CLEMMONS RD   LEWISVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 59 , 113 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124090774,"CONWELL, WESLEY, SHAWN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124090774,"CONWELL, WESLEY, SHAWN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124091889,"MATTHEWS, DAVID, CARY",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124091889,"MATTHEWS, DAVID, CARY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124091889,"MATTHEWS, DAVID, CARY",1719 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518221829,TRILLIUM FAMILY MEDICINE PLLC,TRILLIUM FAMILY MEDICINE PLLC,3 DOCTORS PARK STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124092465,"MCNEILL, STEPHEN, MARK",3 DOCTORS PARK STE A ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 75 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1124094537,"HAREWOOD, LISA, KNIGHT",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 25 , 31 ,$#,,
MEDICAID DIRECT,1124096292,ALBEMARLE ORTHOTICS & PROSTHETICS I,COASTAL CAROLINA PROSTHETICS & ORTH,106 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124096292,ALBEMARLE ORTHOTICS & PROSTHETICS I,106 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 29 , 35 , 131 ," $33,447.22 ",,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124097118,"MUGHARBIL, ZIYAD, HASAN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124097118,"MUGHARBIL, ZIYAD, HASAN",178 HOSPITAL RD STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124097118,"MUGHARBIL, ZIYAD, HASAN",178 HOSPITAL RD STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,4048 E US 64 ALT STE 6 MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1124097118,"MUGHARBIL, ZIYAD, HASAN",4048 E US 64 ALT STE 6 MURPHY NC,020,Cherokee,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 20 , 34 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124097118,"MUGHARBIL, ZIYAD, HASAN",4048 E US 64 ALT STE 6 MURPHY NC,020,Cherokee,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 29 , 58 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1124097670,"MURRAY, KEVIN, PATRICK",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124097670,"MURRAY, KEVIN, PATRICK",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 228 , 508 , 696 ," $14,927.64 ",,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124097944,"DAVIS, GEORGE, KEVIN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 94 , 95 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124098298,"SCOTT, SHIRLEY, KATE",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124101381,"GEORGE, DANIEL, JAMES",1000 TRENT DR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124101381,"GEORGE, DANIEL, JAMES",1000 TRENT DR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124101381,"GEORGE, DANIEL, JAMES",1000 TRENT DR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124101597,"HYATT, SHIRLEY, REESE",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 21 , 25 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1124101597,"HYATT, SHIRLEY, REESE",11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,1860 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1124101597,"HYATT, SHIRLEY, REESE",1860 SUGAR HILL RD STE A MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1124101597,"HYATT, SHIRLEY, REESE",45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 70 , 107 , 190 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 150 , 176 , 195 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1952334120,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Cardiology of Raleigh,,,Unknown,193400000X,Group,Single Specialty,,1124102272,"LIAO, LAWRENCE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 123 , 181 , 278 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 27 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124102272,"LIAO, LAWRENCE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124102892,"TESONIERO, JOHANNA, JULIA",5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 60 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124102892,"TESONIERO, JOHANNA, JULIA",5002 HIGH POINT RD STE A GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124102892,"TESONIERO, JOHANNA, JULIA",5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 33 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1124102892,"TESONIERO, JOHANNA, JULIA",5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124102991,"WILSON, RAELEEN, ALISE",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124102991,"WILSON, RAELEEN, ALISE",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124108303,"ANENE, CHARLES, AZUBUIKE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124108303,"ANENE, CHARLES, AZUBUIKE",300 W 27TH ST   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 31 , 47 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124108303,"ANENE, CHARLES, AZUBUIKE",2936 N ELM ST 102 LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 39 , 39 ,$#,,
MEDICAID DIRECT,1487809265,SOUND MEDICAL OF CAPE CATERET,~,3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1124108881,"DOLAN, MARGARET, ANNE",3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 27 , 49 ,$#,,
MEDICAID DIRECT,1124110994,"WOODYEAR JR, JOHN, MONTGOMERY",~,507 N MAIN ST   TROY NC,062,Montgomery,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,1124110994,"WOODYEAR JR, JOHN, MONTGOMERY",507 N MAIN ST   TROY NC,062,Montgomery,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1710963335,FAMILY CARE ASSOCIATES OF MONTGOMER,FAMILY CARE ASSOCIATES OF MONTGOMERY COUNTY PA,507 N MAIN ST   TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1124110994,"WOODYEAR JR, JOHN, MONTGOMERY",507 N MAIN ST   TROY NC,062,Montgomery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 310 ," 1,211 "," 4,345 "," $47,131.97 ",,
MEDICAID DIRECT,1124110994,"WOODYEAR JR, JOHN, MONTGOMERY",~,507 N MAIN ST   TROY NC,062,Montgomery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1124110994,"WOODYEAR JR, JOHN, MONTGOMERY",507 N MAIN ST   TROY NC,062,Montgomery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 81 , 120 , 174 ,$#,,
MEDICAID DIRECT,1710963335,FAMILY CARE ASSOCIATES OF MONTGOMER,FAMILY CARE ASSOCIATES OF MONTGOMERY COUNTY PA,507 N MAIN ST   TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1124110994,"WOODYEAR JR, JOHN, MONTGOMERY",507 N MAIN ST   TROY NC,062,Montgomery,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#, 28 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1124111919,"MCCRANEY, DAVID, PATRICK",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 35 , 60 , 66 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124111919,"MCCRANEY, DAVID, PATRICK",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 44 , 50 , 50 ,$#,,
MEDICAID DIRECT,1124114178,"PATHAK, AMAN, JITENDRA",~,2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,1124114178,"PATHAK, AMAN, JITENDRA",2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1124114178,"PATHAK, AMAN, JITENDRA",~,2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1124114178,"PATHAK, AMAN, JITENDRA",2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1528154473,COASTAL INFECTIOUS DISEASE CONSULTA,COASTAL INFECTIOUS DISEASE CONSULTANTS,2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124114178,"PATHAK, AMAN, JITENDRA",2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 94 , 603 , 641 ," $22,113.37 ",,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124115084,"DUPUY, GARY, PAUL",316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 81 , 175 ,$#,,
MEDICAID DIRECT,1124115324,HUIE PHARMACY LLC,BRAME HUIE PHARMACY,1920 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1124115324,HUIE PHARMACY LLC,1920 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 48 , 345 , 353 ," $19,458.86 ",,
MEDICAID DIRECT,1124115324,HUIE PHARMACY LLC,BRAME HUIE PHARMACY,1920 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124115324,HUIE PHARMACY LLC,1920 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 384 ," 1,962 "," 4,630 "," $277,379.29 ",,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124115977,"VOLMAR, KEITH, EBERHARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 157 , 164 , 268 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1124120290,"RODEBERG, DAVID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124120290,"RODEBERG, DAVID",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 27 , 29 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124121348,"PARK, ROBERT, SANGHOON",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 25 , 28 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124121348,"PARK, ROBERT, SANGHOON",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1124121819,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY,1924 STATESVILLE BLVD   SALISBURY NC,080,Rowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124121819,NORTH CAROLINA CVS PHARMACY LLC,1924 STATESVILLE BLVD   SALISBURY NC,080,Rowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1124121819,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY,1924 STATESVILLE BLVD   SALISBURY NC,080,Rowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1124121819,NORTH CAROLINA CVS PHARMACY LLC,1924 STATESVILLE BLVD   SALISBURY NC,080,Rowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1124121819,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY,1924 STATESVILLE BLVD   SALISBURY NC,080,Rowan,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1124121819,NORTH CAROLINA CVS PHARMACY LLC,1924 STATESVILLE BLVD   SALISBURY NC,080,Rowan,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1124123070,FAMILY MEDICAL SUPPLY LLC,~,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124123070,FAMILY MEDICAL SUPPLY LLC,329 NORTH BLVD   CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 18 ,#,#,$#,,
MEDICAID DIRECT,1124123070,FAMILY MEDICAL SUPPLY LLC,~,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124123070,FAMILY MEDICAL SUPPLY LLC,329 NORTH BLVD   CLINTON NC,082,Sampson,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124123310,"CATZ, MICHAEL, MOSHE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 63 , 75 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,630 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124123310,"CATZ, MICHAEL, MOSHE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,630 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124123310,"CATZ, MICHAEL, MOSHE",630 MCCARTHY BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1124124953,BIOTAB,~,11701 BORMAN DR STE 107 SAINT LOUIS MO,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124124953,BIOTAB,11701 BORMAN DR STE 107 SAINT LOUIS MO,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 112 , 164 , 274 ," $61,768.90 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124129119,"LASSITER JR, TALLY, EDWARD",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 22 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124129119,"LASSITER JR, TALLY, EDWARD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124129119,"LASSITER JR, TALLY, EDWARD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124129119,"LASSITER JR, TALLY, EDWARD",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 17 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124129119,"LASSITER JR, TALLY, EDWARD",810 W H SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1124129119,"LASSITER JR, TALLY, EDWARD",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1124129119,"LASSITER JR, TALLY, EDWARD",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1124129341,"MCKINNON, JOHNNY, LONZO",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 67 , 68 , 255 ,$#,,
MEDICAID DIRECT,1124129341,"MCKINNON, JOHNNY, LONZO",,407 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice,1124129341,"MCKINNON, JOHNNY, LONZO",407 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 623 ," 1,375 "," 3,548 "," $206,911.81 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124129663,"WEBB, CRAIG, ELBERT",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 57 , 126 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124129663,"WEBB, CRAIG, ELBERT",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 118 , 196 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124129671,"WEBSTER, BRIAN, RICHARD",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 29 , 59 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1124129671,"WEBSTER, BRIAN, RICHARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124129671,"WEBSTER, BRIAN, RICHARD",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124129671,"WEBSTER, BRIAN, RICHARD",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 34 , 57 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124130356,"GIZZO, PAMELA, JEAN",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1124132642,"PATEL, SHEETAL, HARESH",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1124132642,"PATEL, SHEETAL, HARESH",920 CHURCH ST N STE 255B CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1124132642,"PATEL, SHEETAL, HARESH",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124134010,"MAYS, BROOKS, BELLAMY",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124134010,"MAYS, BROOKS, BELLAMY",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 14 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124134010,"MAYS, BROOKS, BELLAMY",205 PAGE RD   PINEHURST NC,063,Moore,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 139 , 206 , 377 ," $13,429.07 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124137393,"ALVI, SOHAIL, IMRAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 26 , 94 , 95 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124137393,"ALVI, SOHAIL, IMRAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124137716,"NAZEMZADEH, REZA",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124137716,"NAZEMZADEH, REZA",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1114293495,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124137716,"NAZEMZADEH, REZA",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 29 , 29 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124138383,"SIEGEL, MARGARET, PAYNE",1315 EAST BLVD STE 280 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 44 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124139050,"GORE, RONALD, GENE",11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124139050,"GORE, RONALD, GENE",11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1124142229,"HART, JENNIFER, ADELE",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124142229,"HART, JENNIFER, ADELE",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1124142229,"HART, JENNIFER, ADELE",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124142229,"HART, JENNIFER, ADELE",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124142369,"ESTEPAN, HECTOR, CRISTINO",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124142625,"BARRY, MAUREEN, THERESA",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124145214,"FLORIDA, AUDIE, CAILING",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 12 , 28 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124145214,"FLORIDA, AUDIE, CAILING",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 155 , 201 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124147665,"DEGUIRE, JEFFREY, SAMUEL",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1124147848,"JENKINS, LAURA, ANN",122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 95 , 96 , 164 ," $29,397.92 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124148317,"KWAK, JIN, SHIN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124148317,"KWAK, JIN, SHIN",16455 STATESVILLE RD STE 100 HUNTERSVILLE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124148317,"KWAK, JIN, SHIN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124148317,"KWAK, JIN, SHIN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 28 ,$#,,
MEDICAID DIRECT,1124151477,WE CARE FOR YOU HOME CARE CORP,WE CARE FOR YOU HOME CARE INC,1548 NC HIGHWAY 211 W   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1124151477,WE CARE FOR YOU HOME CARE CORP,1548 NC HIGHWAY 211 W   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 87 ," 15,451 "," 15,451 "," $1,006,466.08 ",,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,5200 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1124151840,"ROBERTSON, JILL, HARGETT",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124151840,"ROBERTSON, JILL, HARGETT",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 24 , 25 ,$#,,
MEDICAID DIRECT,1124152046,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER CAPCARE,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,251B00000X,Agencies,Case Management,,1124152046,NOVANT HEALTH ROWAN MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,251B00000X,Agencies,Case Management,, 198 ," 2,020 "," 2,020 "," $802,446.45 ",,
MEDICAID DIRECT,1124152277,PROFESSIONAL FAMILY CARE SERVICES I,~,1012 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1124152277,PROFESSIONAL FAMILY CARE SERVICES I,1012 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 576 , 576 ," $41,707.52 ",,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124154026,"ROBINSON, HEATHER, LEMBKE",1760 E DIXON BLVD   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 85 , 123 , 132 ,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124154026,"ROBINSON, HEATHER, LEMBKE",1840 OWEN DR STE 105 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699471839,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY - DIXON BLVD,1758 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124154026,"ROBINSON, HEATHER, LEMBKE",1760 E DIXON BLVD   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124155858,"BHAVE, PRASHANT, DATTATRAYA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 64 , 88 , 93 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124155858,"BHAVE, PRASHANT, DATTATRAYA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124156229,"EAKER, KATHYRN, GRACE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124156229,"EAKER, KATHYRN, GRACE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124156229,"EAKER, KATHYRN, GRACE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 26 , 68 ,$#,,
MEDICAID DIRECT,1225578792,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN GASTROENTEROLOGY,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1124161476,"ORLI, TOM",708 S SOUTH ST STE 100 MOUNT AIRY NC,086,Surry,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 179 , 268 , 308 ,$#,,
MEDICAID DIRECT,1225578792,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN GASTROENTEROLOGY,,,Unknown,193400000X,Group,Single Specialty,,1124161476,"ORLI, TOM",708 S SOUTH ST STE 100 MOUNT AIRY NC,086,Surry,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1225578792,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN GASTROENTEROLOGY,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1124161476,"ORLI, TOM",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124162581,"HENSLER, ROBERT, SEAN",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 170 , 170 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124162581,"HENSLER, ROBERT, SEAN",4130 OLEANDER DR STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124164173,"JACKSON, PHARNETHIA, GOODMAN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124164173,"JACKSON, PHARNETHIA, GOODMAN",2760 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265430854,GRANVILLE HEALTH SYSTEM,SOUTH GRANVILLE PRIMARY CARE,1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1124167358,"JEAN-GRACIA, JOLENE",1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 65 , 72 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124169479,"ELYA, MARWAN, KAMIL",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1124170071,ALAMANCE REGIONAL MEDICAL CENTER,HOMECARE PROVIDERS,1225 HUFFMAN MILL RD STE 102 BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1124170071,ALAMANCE REGIONAL MEDICAL CENTER,1225 HUFFMAN MILL RD STE 102 BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 52 ," 1,539 "," 1,584 "," $216,169.92 ",,
MEDICAID DIRECT,1124170071,ALAMANCE REGIONAL MEDICAL CENTER,HOMECARE PROVIDERS,1225 HUFFMAN MILL RD STE 102 BURLINGTON NC,001,Alamance,251B00000X,Agencies,Case Management,,1124170071,ALAMANCE REGIONAL MEDICAL CENTER,1225 HUFFMAN MILL RD STE 102 BURLINGTON NC,001,Alamance,251B00000X,Agencies,Case Management,, 60 , 239 , 241 ," $192,416.66 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124170196,"WELLS, KELLY, RENEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124170196,"WELLS, KELLY, RENEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124171558,"TURBAY, MONICA, MARIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124171814,A BRIGHTER FUTURE HEALTHCARE SERVIC,~,4140 FERNCREEK DR STE 300 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1124171814,A BRIGHTER FUTURE HEALTHCARE SERVIC,4140 FERNCREEK DR STE 300 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 256 , 256 ," $31,850.24 ",,
MEDICAID DIRECT,1124171921,ASHEBORO CITY SCHOOLS,ASHEBORO CITY SCHOOLS,1126 S PARK ST   ASHEBORO NC,076,Randolph,251300000X,Agencies,Local Education Agency (LEA),,1124171921,ASHEBORO CITY SCHOOLS,1126 S PARK ST   ASHEBORO NC,076,Randolph,251300000X,Agencies,Local Education Agency (LEA),, 188 ," 4,333 "," 4,404 "," $159,403.44 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124178942,"CHABO, TRAVIS, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124178942,"CHABO, TRAVIS, LEE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124181995,"CARLSON, ALAN, NEIL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 20 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124181995,"CARLSON, ALAN, NEIL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1124183710,"ABDEL-KHALEK, IHAB, ABDEL-AZIZ",CLAYTON PEDIATRIC CENTER,11708 US 70 HWY W   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1124183710,"ABDEL-KHALEK, IHAB, ABDEL-AZIZ",11708 US 70 HWY W   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 36 , 89 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1124183710,"ABDEL-KHALEK, IHAB, ABDEL-AZIZ",11708 US 70 HWY W   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1306902416,JAMES D DOUGLASS DDS PA,~,101 WALL ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124184239,"DOUGLASS III, JAMES, DAVIS",101 WALL ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 331 , 606 ," 2,080 "," $78,427.82 ",,
MEDICAID DIRECT,1124184791,SOUTHERN ASSISTED LIVING INC,BROOKDALE MONROE SQUARE 2,919 FITZGERALD ST   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124184791,SOUTHERN ASSISTED LIVING INC,919 FITZGERALD ST   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 23 ," 5,543 "," 5,543 "," $579,078.19 ",,
MEDICAID DIRECT,1124184882,SURE CARE HEALTH SERVICES INC,~,3804 GOVERNORS RD   KELFORD NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,1124184882,SURE CARE HEALTH SERVICES INC,3804 GOVERNORS RD   KELFORD NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 4,036 "," 4,036 "," $479,809.80 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124185186,"PANZETER, DANNIELLE, CATHLEEN",10030 GILEAD RD STE 3 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124185186,"PANZETER, DANNIELLE, CATHLEEN",10030 GILEAD RD STE 3 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124185186,"PANZETER, DANNIELLE, CATHLEEN",10030 GILEAD RD STE 3 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124191267,"GALYON, STEVEN, WAYNE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124191267,"GALYON, STEVEN, WAYNE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 67 , 67 , 79 ,$#,,
MEDICAID DIRECT,1124191804,STATESVILLE ASSISTED LIVING,STATESVILLE ASSISTED LIVING,2147 DAVIE AVE   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124191804,STATESVILLE ASSISTED LIVING,2147 DAVIE AVE   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,498 "," 2,498 "," $186,191.95 ",,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124192406,"KELLER, DAVID, VANCE",349 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659494292,TOTAL WOMAN CARE LLC,,942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1124192737,"MCILVEEN, PETER, FRANCIS",942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 52 , 89 , 140 ," $10,874.52 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124197082,"INMAN, CHARLES, THOMAS",404 S MAIN ST   RAEFORD NC,047,Hoke,152W00000X,Eye and Vision Services Providers,Optometrist,, 186 , 243 , 309 ,$#,,
MEDICAID DIRECT,1164595757,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124197090,"MITCHELL, LEWIS, DEAN",301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1962560284,BACK 2 BACK CHIROPRACTIC GROUP LLC,BACK 2 BACK CHIROPRACTIC,206 JOE KNOX AVE STE C MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1124198593,"BALTICH, DERIK, NELSON",JOE V KNOX AVE STE C MOORESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124201298,"WHALEN, SEAN, PATRICK",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 56 , 135 , 225 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124201298,"WHALEN, SEAN, PATRICK",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124201298,"WHALEN, SEAN, PATRICK",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 19 , 22 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124201298,"WHALEN, SEAN, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 52 , 81 , 89 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124201298,"WHALEN, SEAN, PATRICK",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 39 , 48 , 49 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124201298,"WHALEN, SEAN, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124202114,"LAW, JENNIFER, RACHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 50 , 72 , 73 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124203138,"BRATHWAITE, CONSTANCE, MALIKAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124203880,"JOHNSON, TRACY, DIANNE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124203880,"JOHNSON, TRACY, DIANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124203880,"JOHNSON, TRACY, DIANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 58 , 58 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 37 , 54 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 58 , 85 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124204060,"D ALONZO, RICHARD, CONCEZIO",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 36 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 23 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 49 , 68 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1124204151,"PERRIN, JOHN, FITZGERALD",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1124205190,ANGEL HOUSE FCH LLC,ANGEL HOUSE III,60 HORNOT CIR APT A ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124205190,ANGEL HOUSE FCH LLC,60 HORNOT CIR APT A ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,141 "," 1,141 "," $78,159.94 ",,
MEDICAID DIRECT,1124206230,"KOONTZ, CURTIS, STOKES",~,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1124206230,"KOONTZ, CURTIS, STOKES",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497100721,GREENSBORO RHEUMATOLOGY PA,,2835 HORSE PEN CREEK RD STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1124206388,"HAWKES, ANGELA, DAWN",2835 HORSE PEN CREEK RD STE 101 GREENSBORO NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 32 , 70 , 105 ,$#,,
MEDICAID DIRECT,1124209747,TRIAD ORTHOTICS AND PROSTHETICS,TRIAD ORTHOTICS AND PROSTHETICS,560 MALCOLM BLVD STE C CONNELLY SPRINGS NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124209747,TRIAD ORTHOTICS AND PROSTHETICS,560 MALCOLM BLVD STE C CONNELLY SPRINGS NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124210133,"BRESLEY, THOMAS, DEAN",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 301 , 320 ," $10,864.33 ",,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124210133,"BRESLEY, THOMAS, DEAN",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124210133,"BRESLEY, THOMAS, DEAN",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 68 , 91 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124210133,"BRESLEY, THOMAS, DEAN",704A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1124210133,"BRESLEY, THOMAS, DEAN",704A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 54 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124210810,"KATAKAM, LAKSHMI, ISWARYA",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 12 , 33 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124210810,"KATAKAM, LAKSHMI, ISWARYA",2100 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124210950,"COUTURE, DANIEL, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 123 , 215 , 255 ," $39,177.46 ",,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124216502,"FISHER, DAVID, CHARLES ALEXANDER",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 21 , 23 , 23 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124216502,"FISHER, DAVID, CHARLES ALEXANDER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124216502,"FISHER, DAVID, CHARLES ALEXANDER",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124216502,"FISHER, DAVID, CHARLES ALEXANDER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 27 , 32 , 76 ," $22,012.24 ",,
MEDICAID DIRECT,1316485410,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA GENERAL SURGERY,1139 CARTHAGE ST STE 110-B SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1124218169,"ERNEST, ROGER, CHARLES",709 WICKER ST STE B SANFORD NC,053,Lee,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 34 , 38 ,$#,,
MEDICAID DIRECT,1316485410,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA GENERAL SURGERY,1139 CARTHAGE ST STE 110-B SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1124218169,"ERNEST, ROGER, CHARLES",1139 CARTHAGE ST STE 110-B SANFORD NC,053,Lee,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 50 , 50 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124220090,"SPAEDER, GWYNETH, ANNE",10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 29 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124221981,"CRABTREE, SHANA, ALEXANDER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124222898,"PLONK, TIMOTHY, MATTHEW",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 77 , 83 , 83 ,$#,,
MEDICAID DIRECT,1124223078,LOVE WITHIN HOME CARE SERVICES LLC,LOVE WITHIN HOME CARE SERVICES LLC,8401 UNIVERSITY EXEC PARK DR STE 114 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1124223078,LOVE WITHIN HOME CARE SERVICES LLC,8401 UNIVERSITY EXEC PARK DR STE 114 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 991 ," 1,184 "," $244,196.48 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124224274,"RAMOS, LISETTE, MARIE",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124224274,"RAMOS, LISETTE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124224274,"RAMOS, LISETTE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 19 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124224274,"RAMOS, LISETTE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 36 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124224274,"RAMOS, LISETTE, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 28 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124224274,"RAMOS, LISETTE, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124224357,"SHAH, TUSHAR, ASHVIN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124224357,"SHAH, TUSHAR, ASHVIN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124224357,"SHAH, TUSHAR, ASHVIN",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124224639,"FERGUS, NATHAN, PATRICK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124224639,"FERGUS, NATHAN, PATRICK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1992755680,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING INDIAN TRAIL,6030 W HIGHWAY 74 STE C INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1124224639,"FERGUS, NATHAN, PATRICK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124224639,"FERGUS, NATHAN, PATRICK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 117 , 122 , 152 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124224639,"FERGUS, NATHAN, PATRICK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 178 , 184 , 236 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124224639,"FERGUS, NATHAN, PATRICK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124224993,"GOLDING, ELIZABETH, LLOYD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124224993,"GOLDING, ELIZABETH, LLOYD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124225263,"BAKER, LESLIE, WEED",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124225263,"BAKER, LESLIE, WEED",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124225263,"BAKER, LESLIE, WEED",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124225313,"HSU, JOHANN, HSIN-HENG",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124225313,"HSU, JOHANN, HSIN-HENG",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124225313,"HSU, JOHANN, HSIN-HENG",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1801481940,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PHYSICAL THERAPY & SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1124226337,"SINGH, MINI, HANSPAL",191 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1801481940,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PHYSICAL THERAPY & SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1124226337,"SINGH, MINI, HANSPAL",701 LIBERTY ST   RAMSEUR NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1801481940,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PHYSICAL THERAPY & SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1124226337,"SINGH, MINI, HANSPAL",600 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 22 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124227483,"WIEDUWILT, MATTHEW, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 91 , 92 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 122 , 129 , 145 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1124229018,"PATEL, ASHESH, HEMANT",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 212 , 259 , 295 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1124229018,"PATEL, ASHESH, HEMANT",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1124229513,"MYERS, TROY, DEAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 54 , 67 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 18 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 22 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124229679,"TENNANT, JOSHUA, NEAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003150798,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - PR,4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 20 , 22 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003150798,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - PR,4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 11 , 33 ,$#,,
MEDICAID DIRECT,1508987447,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - WE,1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 49 , 80 , 105 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1508987447,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - WE,1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 27 , 33 ,$#,,
MEDICAID DIRECT,1003150798,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - PR,4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124230776,"MCQUAID, DOUGLAS, BRENT",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124231600,"NAGLE, RICHARD, ANDREW",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124231600,"NAGLE, RICHARD, ANDREW",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124231600,"NAGLE, RICHARD, ANDREW",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,, 12 , 40 , 40 ,$#,,
MEDICAID DIRECT,1225445331,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - THOMASVILLE,611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124231600,"NAGLE, RICHARD, ANDREW",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124231600,"NAGLE, RICHARD, ANDREW",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1124233911,"GIBSON, KEISHA, LASHAN",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#, 21 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124233911,"GIBSON, KEISHA, LASHAN",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124233911,"GIBSON, KEISHA, LASHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124233911,"GIBSON, KEISHA, LASHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124233911,"GIBSON, KEISHA, LASHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 29 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124233911,"GIBSON, KEISHA, LASHAN",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 19 , 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124233911,"GIBSON, KEISHA, LASHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124233952,"KHAN, MOHAMMAD, ALEEM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 19 , 27 , 27 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124233952,"KHAN, MOHAMMAD, ALEEM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124233952,"KHAN, MOHAMMAD, ALEEM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1124234901,"DAVE, SEJAL, BUDDHISAGAL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 63 , 107 , 107 ,$#,,
MEDICAID DIRECT,1073693347,EASTERN CAROLINA PEDIATRICS,EASTERN CAROLINA PEDIATRICS,1702 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1124235114,"BRINSON, AMANDA, BRAY",1702 MEDICAL PARK DR W   WILSON NC,098,Wilson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 41 , 109 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124236641,"TURNER, SUSAN, JORDAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 44 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124236641,"TURNER, SUSAN, JORDAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124236641,"TURNER, SUSAN, JORDAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124236641,"TURNER, SUSAN, JORDAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124238373,"PARK, YARA, AUDEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124238373,"PARK, YARA, AUDEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 27 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124238373,"PARK, YARA, AUDEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124238373,"PARK, YARA, AUDEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 N GREENSBORO ST   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1124238373,"PARK, YARA, AUDEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124239355,"JANJUA, RASHID, MAZHAR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 21 , 25 , 56 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124239355,"JANJUA, RASHID, MAZHAR",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 78 , 116 , 138 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124239355,"JANJUA, RASHID, MAZHAR",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124239355,"JANJUA, RASHID, MAZHAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 24 , 26 , 34 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124239355,"JANJUA, RASHID, MAZHAR",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124239462,BRADLEY HOME CARING FOR WAKE COMMUN,PKEDS HOUSE,907 FRANCES DR   GARNER NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124239462,BRADLEY HOME CARING FOR WAKE COMMUN,907 FRANCES DR   GARNER NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,430 "," 1,432 "," $137,319.01 ",,
MEDICAID DIRECT,1124242839,ADVANCED BUSINESS CONCEPTS INC,CATAWBA VALLEY MEDICAL SERVICES,409 S STERLING ST   MORGANTON NC,012,Burke,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1124242839,ADVANCED BUSINESS CONCEPTS INC,409 S STERLING ST   MORGANTON NC,012,Burke,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 113 ," 2,884 "," 5,689 "," $202,486.64 ",,
MEDICAID DIRECT,1124242839,ADVANCED BUSINESS CONCEPTS INC,CATAWBA VALLEY MEDICAL SERVICES,409 S STERLING ST   MORGANTON NC,012,Burke,253Z00000X,Agencies,In Home Supportive Care,,1124242839,ADVANCED BUSINESS CONCEPTS INC,409 S STERLING ST   MORGANTON NC,012,Burke,253Z00000X,Agencies,In Home Supportive Care,, 67 ," 12,974 "," 13,040 "," $1,962,317.35 ",,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124243035,"BRICKHOUSE MURPHY, MARY, AMANDA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124243035,"BRICKHOUSE MURPHY, MARY, AMANDA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1124246467,"DUNNIGAN, JEFFREY, AARON",DR JEFFREY A DUNNIGAN CHIROPRACTIC PHYSICIAN,1520 SOUTH BLVD STE 228 CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,1124246467,"DUNNIGAN, JEFFREY, AARON",1520 SOUTH BLVD STE 228 CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1124248786,"STAINBACK, PATRICIA, ADELEKE",PATRICIA A STAINBACK DMD PA,798 CHURCH ST N   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,1124248786,"STAINBACK, PATRICIA, ADELEKE",798 CHURCH ST N   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 293 , 641 ," 2,429 "," $96,850.50 ",,
MEDICAID DIRECT,1235801812,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH DENTAL,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1124248786,"STAINBACK, PATRICIA, ADELEKE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1194358770,CABARRUS ROWAN COMMUNITY HEALTH CEN,LOGAN FAMILY DENTAL,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1124248786,"STAINBACK, PATRICIA, ADELEKE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 66 , 119 , 219 ," $13,266.30 ",,
MEDICAID DIRECT,1124248984,GUILFORD ADULT CARE,GUILFORD ADULT CARE 1,2322 NEWTON ST   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124248984,GUILFORD ADULT CARE,2322 NEWTON ST   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 29 , 29 ," $46,095.20 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124249016,"SRINIVASAKUMAR, PREETHI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 30 , 98 , 98 ," $21,365.34 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124249016,"SRINIVASAKUMAR, PREETHI",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124249016,"SRINIVASAKUMAR, PREETHI",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1124252697,"BHAT, DAYA",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,125Q00000X,Dental Providers,Dentist,Oral Medicine, 91 , 112 , 134 ," $19,343.76 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124254560,"MILLER, SHANDA, CHRISTINE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1124254560,"MILLER, SHANDA, CHRISTINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124254560,"MILLER, SHANDA, CHRISTINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124255435,"FRIEND, REED, NOVY",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114293495,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124255435,"FRIEND, REED, NOVY",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124255435,"FRIEND, REED, NOVY",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124255435,"FRIEND, REED, NOVY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124255435,"FRIEND, REED, NOVY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124255435,"FRIEND, REED, NOVY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124255435,"FRIEND, REED, NOVY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124255658,"DRESCHER, CAROL, ANN",4420 LAKE BOONE TRL STE 201 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124255658,"DRESCHER, CAROL, ANN",4420 LAKE BOONE TRL STE 201 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 34 , 54 ,$#,,
MEDICAID DIRECT,1124256722,"ROBINSON, SPENCER, FOX",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1124256722,"ROBINSON, SPENCER, FOX",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124257142,"TOMPKINS, KEVIN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 27 , 27 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124257142,"TOMPKINS, KEVIN, MICHAEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 71 , 71 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124257142,"TOMPKINS, KEVIN, MICHAEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 38 , 109 , 109 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124257894,"HUANG, XIUFEN",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124257894,"HUANG, XIUFEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558057034,PATRICK KELLY BROWN DDS PLLC,BEACHSIDE FAMILY DENTISTRY,1300 BRIDGE BARRIER RD STE 4 CAROLINA BCH NC,065,New Hanover,193400000X,Group,Single Specialty,,1124258215,"BROWN, PATRICK, KELLY",1300 BRIDGE BARRIER RD STE 4 CAROLINA BCH NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 341 , 721 ," 2,210 "," $114,830.35 ",,
MEDICAID DIRECT,1124258785,SHINING STARS THERAPY PA,~,304 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1124258785,SHINING STARS THERAPY PA,304 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,, 50 , 491 , 649 ," $51,946.03 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124264288,"MACINTYRE, NEIL, ROSS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124264288,"MACINTYRE, NEIL, ROSS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 32 , 46 ," $15,781.59 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124264288,"MACINTYRE, NEIL, ROSS",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 20 , 30 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124264288,"MACINTYRE, NEIL, ROSS",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 48 , 70 , 119 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124268834,"KWOK, EVELYN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 16 , 83 , 83 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124268834,"KWOK, EVELYN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 88 , 471 , 471 ," $13,093.16 ",,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124269022,RURAL HEALTH GROUP INC,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 196 , 450 , 460 ," $41,227.69 ",,
MEDICAID DIRECT,1124269915,A PRIMARY CHOICE INC,~,3705 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1124269915,A PRIMARY CHOICE INC,3705 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#," 1,646 "," 1,646 "," $103,370.24 ",,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1124270731,"HOLBERT, ALISHA, VEREEN",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124270731,"HOLBERT, ALISHA, VEREEN",601 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124270731,"HOLBERT, ALISHA, VEREEN",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124273461,"ROPER, JATIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124273461,"ROPER, JATIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124273461,"ROPER, JATIN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124275748,"SANTOS, RACHAEL",2790 GODWIN BLVD STE 360 SUFFOLK VA,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124279054,"EKATAN, JULIET, ANYOKOT",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 163 , 393 , 395 ," $13,417.63 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124281845,"STRATHMAN, ANDREA, JENNINGS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 43 , 78 , 131 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 69 , 119 , 198 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 21 , 21 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124282413,"POKORNEY, SEAN, DAVID",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124282587,"TAPSCOTT, ASHLEY, HALL",9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124283783,"SMITH, MICHAEL, LOREN",2126 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124285002,"MEADE, KRISTIN, ELINOR",2100 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 26 , 28 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124285002,"MEADE, KRISTIN, ELINOR",2301 ERWIN ROAD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124285002,"MEADE, KRISTIN, ELINOR",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 34 , 68 , 94 ,$#,,
MEDICAID DIRECT,1124285515,SURGICENTER OF EASTERN CAROLINA,ECU HEALTH SURGICENTER,102 BETHESDA DR   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1124285515,SURGICENTER OF EASTERN CAROLINA,102 BETHESDA DR   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 441 , 513 , 649 ," $122,910.15 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124285572,"LUDDY, ALYSSA, COWELL",250 HOSPICE CIR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124285572,"LUDDY, ALYSSA, COWELL",250 HOSPICE CIR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 27 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1124285572,"LUDDY, ALYSSA, COWELL",2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124285572,"LUDDY, ALYSSA, COWELL",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124285572,"LUDDY, ALYSSA, COWELL",2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124286810,"GORE, SARAH, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1487487807,LOTUS CENTER OF HEALTH PLLC,,1721 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124286810,"GORE, SARAH, MARIE",1721 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124286810,"GORE, SARAH, MARIE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356747299,TRIPOINT DIAGNOSTICS PLLC,,627 DAVIS DR STE 600 MORRISVILLE NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1124287198,"SOLOMON, GARRON, JOSEPH",627 DAVIS DR STE 600 MORRISVILLE NC,092,Wake,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 28 , 28 , 37 ,$#,,
MEDICAID DIRECT,1215942933,STRATA PATHOLOGY SERVICES INC,STRATADX,1 CRANBERRY HL STE 303 LEXINGTON MA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1124287198,"SOLOMON, GARRON, JOSEPH",1 CRANBERRY HL STE 105 LEXINGTON MA,102,Out of State > 40 miles,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 20 , 20 , 34 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124288006,"SAUVE, KENNETH, JOSEPH",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 112 , 118 , 131 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124289079,"BAUTISTA-OTANEZ, FELIPE, SEBASTIAN",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 14 , 41 , 88 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124289285,"ASBURY, TORI, ELIZABETH",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124289285,"ASBURY, TORI, ELIZABETH",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 97 , 229 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1124289285,"ASBURY, TORI, ELIZABETH",1456 N HOWE ST STE 201 SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124289285,"ASBURY, TORI, ELIZABETH",1456 N HOWE ST STE 201 SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124289715,"BUCK, MATTHEW, VANCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 40 , 44 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124290283,"CASE, KELLI, NICHOLS",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 115 , 222 , 347 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124291380,"CHAND, PREM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124291380,"CHAND, PREM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 184 , 184 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124291562,"ROBBINS, JARED, REX",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124291562,"ROBBINS, JARED, REX",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124292214,"OBRIANT, DAVID, MILES",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124292693,"BOUSSIOS, HELEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 110 , 110 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124293014,"MEYER, LAURA, TAMIKO",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 108 , 109 , 125 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124293014,"MEYER, LAURA, TAMIKO",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 284 , 303 , 351 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124293089,"POPOLI, DAVID, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 23 , 33 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 84 , 91 , 145 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 45 , 71 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2100 ERWIN RD   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1619431277,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ROGERS RD STE 120 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 19 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124293550,"KRANZ, PETER, GEORGE",2301 ERWIN RD   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124293881,"INGLE, JENIFER, WEATHERLY",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124293881,"INGLE, JENIFER, WEATHERLY",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 39 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1124293881,"INGLE, JENIFER, WEATHERLY",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124293881,"INGLE, JENIFER, WEATHERLY",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124294194,WEST STANLY IMAGING LLC,ATRIUM HEALTH IMAGING LOCUST,103 STANLY PKWY STE E LOCUST NC,084,Stanly,293D00000X,Laboratories,Physiological Laboratory,,1124294194,WEST STANLY IMAGING LLC,103 STANLY PKWY STE E LOCUST NC,084,Stanly,293D00000X,Laboratories,Physiological Laboratory,, 112 , 129 , 148 ,$#,,
MEDICAID DIRECT,1023568995,RED MILL PEDIATRIC DENTISTRY AND BE,,2336 ELSON GREEN AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124295175,"SKRBA-TURKOVIC, SLADJANA",2336 ELSON GREEN AVE STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 18 , 77 ,$#,,
MEDICAID DIRECT,1174996359,HAMPTON ROADS PEDIATRIC DENTISTRY,FRIENDLY FACES PEDIATRIC DENTISTRY,446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124295175,"SKRBA-TURKOVIC, SLADJANA",446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 39 , 43 , 229 ,$#,,
MEDICAID DIRECT,1346613528,HAMPTON ROADS PEDIATRIC DENTISTRY,HANBURY PEDIATRIC DENTISTRY & BEHL ORTHODONTICS,1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124295175,"SKRBA-TURKOVIC, SLADJANA",1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 627 , 763 ," 3,432 "," $120,548.28 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124300801,"SCHILLACI, LORI ANNE, PATRICIA",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124300801,"SCHILLACI, LORI ANNE, PATRICIA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 44 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124300801,"SCHILLACI, LORI ANNE, PATRICIA",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124300801,"SCHILLACI, LORI ANNE, PATRICIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 53 , 55 , 59 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",101 E W T HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",101 E W T HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 57 , 89 , 105 ," $14,655.05 ",,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124301189,"TORRES FAJARDO, RAFAEL, ALBERTO",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1800 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",1800 N SANDHILLS BLVD STE B ABERDEEN NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 45 , 97 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",724 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1124301312,"SPEIGHT, JAMIE, LEA",1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1124303755,"NORRIS, LAURA, WILKINSON",1420 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 70 , 95 , 106 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124304282,"WADLINGER, REBECCA",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124304282,"WADLINGER, REBECCA",100 DUKE HEALTH CARY PL   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124311329,"HARRIS, LILLIAN, ROGERS",3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124311329,"HARRIS, LILLIAN, ROGERS",10208 CERNY ST STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1124311410,"CHASE, SHANA, NOEL",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124311410,"CHASE, SHANA, NOEL",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124313051,"JONES, KELI, BECK",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124313051,"JONES, KELI, BECK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 51 , 76 ,$#,,
MEDICAID DIRECT,1124315411,"AREHART, ERIC, JAMES",,103 CROFTON SPRINGS PL   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1124315411,"AREHART, ERIC, JAMES",103 CROFTON SPRINGS PL   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1124316658,"BOIN, MARKUS, ALEXANDER",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124316658,"BOIN, MARKUS, ALEXANDER",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124316658,"BOIN, MARKUS, ALEXANDER",155 MEMORIAL DR EMERGENCY DEPT PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 57 , 79 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1124316658,"BOIN, MARKUS, ALEXANDER",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 22 ,$#,,
MEDICAID DIRECT,1669809158,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS OBGYN HOSPITALISTS,920 CHURCH ST N STE 255E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1124316757,"TIRUMALA, RADHIKA",920 CHURCH ST N STE 255E CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 60 , 70 ," $14,877.23 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124319553,"HORTON, COURTNEY, FAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 29 ,$#,,
MEDICAID DIRECT,1194964379,WAKE FOREST UNIVERSITY HEALTH SCIEN,Wake Forest University Health Sciences,,,Unknown,193400000X,Group,Single Specialty,,1124319553,"HORTON, COURTNEY, FAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124319553,"HORTON, COURTNEY, FAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124319553,"HORTON, COURTNEY, FAY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124319553,"HORTON, COURTNEY, FAY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124319553,"HORTON, COURTNEY, FAY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1194964379,WAKE FOREST UNIVERSITY HEALTH SCIEN,Wake Forest University Health Sciences,,,Unknown,193400000X,Group,Single Specialty,,1124319553,"HORTON, COURTNEY, FAY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124319553,"HORTON, COURTNEY, FAY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124321831,"PRIZIGLEY, ANDREW, VALERYEVICH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124321831,"PRIZIGLEY, ANDREW, VALERYEVICH",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124321831,"PRIZIGLEY, ANDREW, VALERYEVICH",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124321831,"PRIZIGLEY, ANDREW, VALERYEVICH",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 63 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124321831,"PRIZIGLEY, ANDREW, VALERYEVICH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 287 , 287 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",2727 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,2727 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",2727 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 83 , 83 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 136 , 138 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124323316,"TAMBA, MARTU, TENNIH",~,635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1124323316,"TAMBA, MARTU, TENNIH",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,411 S LASALLE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124323316,"TAMBA, MARTU, TENNIH",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124323381,MY BLUE SKY PC,SANDHILLS THERAPY SOLUTIONS,1762 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1124323381,MY BLUE SKY PC,1762 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,, 13 , 74 , 74 ,$#,,
MEDICAID DIRECT,1659156388,CAROLINA CHIROPRACTIC GROUP OF GAST,,528 UNION RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124324108,"BEGLEY, CHRISTOPHER, MICHAEL",528 UNION RD   GASTONIA NC,036,Gaston,111N00000X,Chiropractic Providers,Chiropractor,,#, 22 , 24 ,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1124327499,"GRAMS, NOAH, DAVID",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043307887,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - CARDIOTHORACIC &,225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124330014,"PETERSON, SUSAN, GRIZZARD",225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1124330311,"ZIA, SAYYAD, YASEEN",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 16 , 27 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1124330311,"ZIA, SAYYAD, YASEEN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 27 , 37 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#, 17 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 123 , 132 , 229 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1124331582,"KHAN, MUSTAFA, SARDAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124335674,"JUNKINS, SAVANNAH, DAWN",303 GREEN ST E   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124335674,"JUNKINS, SAVANNAH, DAWN",303 GREEN ST E   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 24 , 30 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124335674,"JUNKINS, SAVANNAH, DAWN",303 GREEN ST E   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1124335674,"JUNKINS, SAVANNAH, DAWN",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1093883852,CAROLINA FAMILY HEALTH CENTERS INC,HARVEST FAMILY HEALTH CENTER,8250 NC 58 S   ELM CITY NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124335674,"JUNKINS, SAVANNAH, DAWN",8250 NC 58 S   ELM CITY NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124335674,"JUNKINS, SAVANNAH, DAWN",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 331 , 379 ," $29,546.65 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124335872,"OFORI, KWADWO, AMOATENG",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124335872,"OFORI, KWADWO, AMOATENG",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1124337571,"AVERETT, PHYLLIS, CASH",1010 COLLEGE ST   OXFORD NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124337571,"AVERETT, PHYLLIS, CASH",1010 COLLEGE ST   OXFORD NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1124337571,"AVERETT, PHYLLIS, CASH",1010 COLLEGE ST   OXFORD NC,039,Granville,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124339783,"EMMERT, KATY, SUZANNE",605 COLLEGE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 24 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124339783,"EMMERT, KATY, SUZANNE",605 COLLEGE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 31 , 40 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124339890,"TRIVEDI, VIVEK, MAHESH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 98 , 168 , 216 ,$#,,
MEDICAID DIRECT,1124341276,INTEGRATION STATION,~,2110 BEN CRAIG DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124341276,INTEGRATION STATION,2110 BEN CRAIG DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 129 ," 1,718 "," 1,730 "," $147,775.94 ",,
MEDICAID DIRECT,1124342746,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06769,471 WEAVERVILLE RD   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1124342746,NORTH CAROLINA CVS PHARMACY LLC,471 WEAVERVILLE RD   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1124342746,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06769,471 WEAVERVILLE RD   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124342746,NORTH CAROLINA CVS PHARMACY LLC,471 WEAVERVILLE RD   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1124342860,"METCALF, MEGAN, WALD",98 DOCTORS DR STE 320 SYLVA NC,050,Jackson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124345160,"MILLER, CHARLENE, RENE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",1600 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 14 , 31 , 32 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",329 MERRIMON AVE   WEAVERVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",329 MERRIMON AVE   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",1600 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",329 MERRIMON AVE   WEAVERVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124345954,"WINTERS, MARLENE, ELIZABETH",226 COMMERCIAL ST   FOREST CITY NC,081,Rutherford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124346390,"JOHNSON, ADAM, BARRETT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 56 , 64 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124346390,"JOHNSON, ADAM, BARRETT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124347349,"HILDEBRAND, JASON, PAUL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 16 , 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124347349,"HILDEBRAND, JASON, PAUL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124347349,"HILDEBRAND, JASON, PAUL",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124347349,"HILDEBRAND, JASON, PAUL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 80 , 78 , 87 ," $36,883.60 ",,
MEDICAID DIRECT,1124347422,"BESHEL, TIMOTHY, JOSEPH",TJC HEALTCARE PC,101 IVEY RD   GRAHAM NC,001,Alamance,111N00000X,Chiropractic Providers,Chiropractor,,1124347422,"BESHEL, TIMOTHY, JOSEPH",101 IVEY RD   GRAHAM NC,001,Alamance,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1316008626,RICHMOND PEDIATRICS PA,RICHMOND PEDIATRICS PA,921 S LONG DR STE 206 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1124347984,"KHAN, SHAMSUL, ALAM",921 S LONG DR STE 206 ROCKINGHAM NC,077,Richmond,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 127 , 227 ," $13,346.48 ",,
MEDICAID DIRECT,1124347984,"KHAN, SHAMSUL, ALAM",~,921 S LONG DR STE 206 ROCKINGHAM NC,077,Richmond,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1124347984,"KHAN, SHAMSUL, ALAM",921 S LONG DR STE 206 ROCKINGHAM NC,077,Richmond,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 49 , 66 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124348404,"RUSSELL, RENO, MORELLY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124348404,"RUSSELL, RENO, MORELLY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124348404,"RUSSELL, RENO, MORELLY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124348404,"RUSSELL, RENO, MORELLY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124348404,"RUSSELL, RENO, MORELLY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 26 , 50 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124349154,"BOLES, WILLIAM, HARDIN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 196 , 291 , 502 ," $11,073.78 ",,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124349154,"BOLES, WILLIAM, HARDIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124349154,"BOLES, WILLIAM, HARDIN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124349154,"BOLES, WILLIAM, HARDIN",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124349428,"ROPER, JENNIFER, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 40 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124352612,"ROWE, STEVEN, PATRICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207UN0902X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Imaging & Therapy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124352612,"ROWE, STEVEN, PATRICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207UN0902X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Imaging & Therapy, 83 , 84 , 106 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124354014,"CASATI, ALDEN, KENNEDY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1124355326,"STOMBAUGH, LAURETTA, GINEX",157 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 70 , 128 , 310 ," $17,314.48 ",,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1124355326,"STOMBAUGH, LAURETTA, GINEX",600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124360276,"JOHNSON, MARY, AMANDA",448 CRANBERRY ST   NEWLAND NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1124361100,ELITE FAMILY EYE CARE OD PLLC,ELITE FAMILY EYE CARE,2340 15TH AVE SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1124361100,ELITE FAMILY EYE CARE OD PLLC,2340 15TH AVE SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,, 35 , 37 , 104 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124364070,"IBANEZ, ALICIA, LYNNE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 23 , 23 ,$#,,
MEDICAID DIRECT,1124365929,INFINITY HEALTHCARE SERVICES INC,INFINITY HEALTHCARE SERVICES INC,118 E ELIZABETH ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1124365929,INFINITY HEALTHCARE SERVICES INC,118 E ELIZABETH ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,#," 1,414 "," 1,414 "," $203,981.00 ",,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,123 BRYAN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 350 , 357 ," 1,334 "," $57,245.96 ",,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 263 , 275 , 929 ," $29,680.53 ",,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 33 , 35 , 53 ,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 528 , 594 ," 2,140 "," $70,185.31 ",,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,123 BRYAN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",123 BRYAN ST   KENANSVILLE NC,031,Duplin,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 12 , 44 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 146 , 155 , 658 ," $25,013.38 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124366794,"PREMPEH, CRYSTAL, HAYES",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 68 , 73 , 359 ," $13,358.84 ",,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124370945,"LEBRON FIGUEROA, DORA, ALEXANDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 21 , 41 , 41 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124370945,"LEBRON FIGUEROA, DORA, ALEXANDRA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 38 , 56 , 62 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124374939,"TARIQ, MUHAMMAD, UMER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124374939,"TARIQ, MUHAMMAD, UMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 156 , 190 , 232 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124374939,"TARIQ, MUHAMMAD, UMER",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124374939,"TARIQ, MUHAMMAD, UMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 51 , 54 , 75 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124374939,"TARIQ, MUHAMMAD, UMER",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124374939,"TARIQ, MUHAMMAD, UMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124375084,"GOODMAN, HEATHER, MACLAUGHLIN",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124375415,"KUKKADAPU, PRITHVI",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124375456,"JOHNSON, CHRISTINA, BOWLING",~,2000 BEAR CAT WAY STE 105 MORRISVILLE NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1124375456,"JOHNSON, CHRISTINA, BOWLING",2000 BEAR CAT WAY STE 105 MORRISVILLE NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124377247,"STOUT, SARAH, ANN",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124377247,"STOUT, SARAH, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124378781,"RODGERS, SUSAN, RENE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 38 , 68 ,$#,,
MEDICAID DIRECT,1124379318,"TAYLOR, JADA, FIELDS",~,4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1124379318,"TAYLOR, JADA, FIELDS",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 27 , 57 ,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,516 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1124380936,"FERRELL, JOSHUA",516 BEAMAN ST   CLINTON NC,082,Sampson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1710209234,SAMPSON REGIONAL PROFESSIONAL SERVI,~,1004 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1124380936,"FERRELL, JOSHUA",1004 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902126444,SAMPSON REGIONAL HOSPITALISTS LLC,SAMPSON REGIONAL HOSPITALISTS LLC,607 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1124380936,"FERRELL, JOSHUA",607 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710209234,SAMPSON REGIONAL PROFESSIONAL SERVI,~,1004 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1124380936,"FERRELL, JOSHUA",1004 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,516 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1124380936,"FERRELL, JOSHUA",516 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 62 , 75 ,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,516 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1124380936,"FERRELL, JOSHUA",607 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124382130,"TRAPANI, DOMINICK, PAUL",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 38 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124383062,"CROUSE, MARY, KATHERINE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124384003,"CHADWICK, JESSICA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124384789,"SHANKER-PATEL, KAVITA",3614 PROVIDENCE RD S STE 100 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 62 , 126 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124384789,"SHANKER-PATEL, KAVITA",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124384888,"MARION, BRANDON, TERRELL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124384888,"MARION, BRANDON, TERRELL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124384888,"MARION, BRANDON, TERRELL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 128 , 212 , 251 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124384888,"MARION, BRANDON, TERRELL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124384888,"MARION, BRANDON, TERRELL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124384920,"GILLELAND, AMY, RENEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124384920,"GILLELAND, AMY, RENEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 42 , 42 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1124385927,"MCREE, CHAD, WARREN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124385927,"MCREE, CHAD, WARREN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 103 , 117 , 140 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124385927,"MCREE, CHAD, WARREN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 49 , 69 , 97 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124387113,"PISCITELLO, JOSEPH, KING",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124387113,"PISCITELLO, JOSEPH, KING",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 65 , 67 , 70 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,9820 CALLABRIDGE CT   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124388525,"HANNON, JACOB, EUGENE",9820 CALLABRIDGE CT   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124389796,"HAIRFORD, AMBER, MOSER",216 MOORE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124389796,"HAIRFORD, AMBER, MOSER",216 MOORE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 78 , 139 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124389796,"HAIRFORD, AMBER, MOSER",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497713234,FORSYTH MEMORIAL HOSPITAL INC,Novant Health Mountainview Medical,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1124389796,"HAIRFORD, AMBER, MOSER",216 MOORE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,243 JONES COVE RD   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1124392154,"KRISPINSKY, MALLORY, ERIN",243 JONES COVE RD   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,61 BONNIE LN   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1124392154,"KRISPINSKY, MALLORY, ERIN",243 JONES COVE RD   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 84 , 130 ,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,61 BONNIE LN   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1124392154,"KRISPINSKY, MALLORY, ERIN",61 BONNIE LN   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 48 , 88 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1124394986,"YOUNGBLOOD, KATRINA, LYNN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124394986,"YOUNGBLOOD, KATRINA, LYNN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124396171,LAKE JAMES LODGE ASSISTED LIVING,Lake James Lodge Assisted Living Inc,63 LAKEVIEW DR N   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124396171,LAKE JAMES LODGE ASSISTED LIVING,63 LAKEVIEW DR N   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 32 ," 6,921 "," 6,992 "," $513,563.12 ",,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 27 , 29 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",10650 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 30 , 124 , 153 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124397328,"WILD, AARON, TYLER",600 HOSPITAL DR   MONROE NC,090,Union,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124401393,"SAFTNER, KATE, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124401419,"PORTER, ALLISON, LINSEY",2700 N COLLEGE RD   WILMINGTON NC,065,New Hanover,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124401419,"PORTER, ALLISON, LINSEY",4005 OLEANDER DR   WILMINGTON NC,065,New Hanover,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124401419,"PORTER, ALLISON, LINSEY",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124401609,"GOPAL, AARON",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1427452283,EAST CAROLINA UNIVERSITY,~,100 BRUNSWICK MEDICAL CENTER PKWY NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1124401617,"SHAYA, ANAHITA, SARAH",803 S WALKER ST   BURGAW NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1508887076,COUNTY OF PENDER,PENDER COUNTY HEALTH DEPT,803 S WALKER ST   BURGAW NC,071,Pender,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1124401617,"SHAYA, ANAHITA, SARAH",803 S WALKER ST   BURGAW NC,071,Pender,1223D0001X,Dental Providers,Dentist,Dental Public Health, 334 , 606 ," 1,531 "," $66,731.28 ",,
MEDICAID DIRECT,1508887076,COUNTY OF PENDER,PENDER COUNTY HEALTH DEPT,803 S WALKER ST   BURGAW NC,071,Pender,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1124401617,"SHAYA, ANAHITA, SARAH",803 S WALKER ST   BURGAW NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124402508,"DAWKINS, SARAH, HOLBROOKS",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124402508,"DAWKINS, SARAH, HOLBROOKS",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 ,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124402508,"DAWKINS, SARAH, HOLBROOKS",10207 CERNY ST STE 210 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124402508,"DAWKINS, SARAH, HOLBROOKS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 37 , 58 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1124402508,"DAWKINS, SARAH, HOLBROOKS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1124404637,ORTHOPEDIC APPLIANCE CO INC,~,910 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124404637,ORTHOPEDIC APPLIANCE CO INC,910 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 48 , 59 , 315 ," $48,181.34 ",,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124404686,"HOANG, HANG, LINDA",5325 VINNING ST NW STE 101 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 17 , 29 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124404686,"HOANG, HANG, LINDA",5325 VINNING ST NW STE 101 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124404686,"HOANG, HANG, LINDA",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124404686,"HOANG, HANG, LINDA",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124404686,"HOANG, HANG, LINDA",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124406004,"SCHLIENTZ, DAVID, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124406004,"SCHLIENTZ, DAVID, MICHAEL",3300 EXECUTIVE DR   RALEIGH NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124406004,"SCHLIENTZ, DAVID, MICHAEL",3300 EXECUTIVE DR   RALEIGH NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124406079,"HANSELL, MAGGIE, CAMERON WOMACK",1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 64 , 94 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124406251,"GOODIN, JASON, EDGAR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1659337046,COASTAL SURGICAL SPECIALIST,Coastal Surgical Specialist,2203 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124409461,"GREGORY, LYNELLEN, BENNETT",2203 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 86 , 207 , 709 ," $71,112.63 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124410881,"ROCKER, SAMUEL, ANDREW",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 31 , 32 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124410881,"ROCKER, SAMUEL, ANDREW",101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124411343,PARAMOUNT MEDICAL SUPPLY LLC,,6012 OLD PINEVILLE RD STE D CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1124411343,PARAMOUNT MEDICAL SUPPLY LLC,6012 OLD PINEVILLE RD STE D CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 12 , 53 , 87 ," $26,155.46 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124413349,"MANGUBAT, MICHAEL, NICCOLO RAMOS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 34 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124413497,"SHEARER, SABRINA, MICHELLE",5324 MCFARLAND RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124413497,"SHEARER, SABRINA, MICHELLE",5324 MCFARLAND RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124413497,"SHEARER, SABRINA, MICHELLE",5324 MCFARLAND RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124413497,"SHEARER, SABRINA, MICHELLE",5324 MCFARLAND RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124413919,"MODY, MOHIT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124413919,"MODY, MOHIT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124413919,"MODY, MOHIT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124413919,"MODY, MOHIT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124413919,"MODY, MOHIT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 43 , 67 , 72 ,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1124414693,"RAINBOLT, MATTHEW, PRESTON",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1124414693,"RAINBOLT, MATTHEW, PRESTON",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124414693,"RAINBOLT, MATTHEW, PRESTON",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 28 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124414693,"RAINBOLT, MATTHEW, PRESTON",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316160641,MOUNT ZION MEDICAL AND NURSING SERV,THE MOUNT ZION MEDICAL CLINICS PA,6608 E WT HARRIS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124414750,"FOMUNUNG, COLLINS, FOKUM",6608 E WT HARRIS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 238 , 948 ," 1,009 "," $33,313.77 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124415294,"BEELER, MEREDITH, LOWRY",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124415955,"WOODRUM, TYLER, STANLEY",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 70 , 71 , 75 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124415955,"WOODRUM, TYLER, STANLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124415955,"WOODRUM, TYLER, STANLEY",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124415955,"WOODRUM, TYLER, STANLEY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124415955,"WOODRUM, TYLER, STANLEY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124416110,"TROUTMAN, BLAIR, KEITH",14330 OAKHILL PARK LN STE 200B HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 33 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124416110,"TROUTMAN, BLAIR, KEITH",14330 OAKHILL PARK LN STE 115 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 60 , 96 ,$#,,
MEDICAID DIRECT,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,SOUNDVIEW II,36 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,36 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 204 , 204 ," $49,082.43 ",,
MEDICAID DIRECT,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,SOUNDVIEW II,34 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,34 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 188 , 189 ," $71,346.00 ",,
MEDICAID DIRECT,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,SOUNDVIEW II,30 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,30 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 142 , 142 ," $45,776.52 ",,
MEDICAID DIRECT,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,SOUNDVIEW II,94 MILLBROOK RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,94 MILLBROOK RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 212 , 212 ," $64,848.93 ",,
MEDICAID DIRECT,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,SOUNDVIEW II,32 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124416235,SOUNDVIEW FAMILY CARE HOMES INC,32 SMITH GRAVEYARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 223 , 223 ," $86,899.95 ",,
MEDICAID DIRECT,1124418595,MERCYS SUPPORTIVE LIVING,,932 COBBLE RIDGE RD   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124418595,MERCYS SUPPORTIVE LIVING,932 COBBLE RIDGE RD   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 728 , 728 ," $46,085.60 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124419882,"BULKLEY, ALLAN, DANIEL",430 RANKIN DR   MARION NC,059,McDowell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124421573,"MCELHANEY, KRISTEN, KEITH",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124426218,"STAPLES, KEVIN, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1124428008,"SCANDONE, GIANPIERO",6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1124429451,BIG WHEEL TRANSPORTATION INC,,2025 MARTIN LUTHER KING JR DR STE D GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1124429451,BIG WHEEL TRANSPORTATION INC,2025 MARTIN LUTHER KING JR DR STE D GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 628 ," 19,564 "," 19,690 "," $3,305,679.00 ",,
MEDICAID DIRECT,1669920609,DAVID E THOME DDS PLLC VII,DENVER PEDIATRIC DENTISTRY,275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124432349,"OTOUDE, LISA, RAE",275 HIGHWAY 16 S 204B DENVER NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 806 ," 1,045 "," 4,656 "," $164,282.10 ",,
MEDICAID DIRECT,1588238463,DAVID E THOME DDS PLLC XI,HICKORY PEDIATRIC DENTISTRY,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124432349,"OTOUDE, LISA, RAE",5708 N SHARON AMITY RD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 574 , 692 ," 3,064 "," $98,492.77 ",,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124432349,"OTOUDE, LISA, RAE",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 600 , 730 ," 3,185 "," $105,356.82 ",,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124432349,"OTOUDE, LISA, RAE",5708 N SHARON AMITY RD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 383 , 443 ," 1,927 "," $65,471.93 ",,
MEDICAID DIRECT,1669920609,DAVID E THOME DDS PLLC VII,DENVER PEDIATRIC DENTISTRY,275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124432349,"OTOUDE, LISA, RAE",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 764 ," 1,010 "," 4,403 "," $156,264.22 ",,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124432349,"OTOUDE, LISA, RAE",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1083751127,ROBERT L YOUNG JR DDS PLLC,YOUNG AND POLITE CHILDRENS DENTISTRY,11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124432349,"OTOUDE, LISA, RAE",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 34 ,$#,,
MEDICAID DIRECT,1588238463,DAVID E THOME DDS PLLC XI,HICKORY PEDIATRIC DENTISTRY,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124432349,"OTOUDE, LISA, RAE",11010 S TRYON ST STE 101 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 556 , 680 ," 3,013 "," $98,592.22 ",,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1124432349,"OTOUDE, LISA, RAE",3010 BAUCOM RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124433370,"WINN, JOHN, DAVID",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124433370,"WINN, JOHN, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1124433982,"DICKSON, MEREDITH, WARD",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 100 , 174 , 246 ,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1124433982,"DICKSON, MEREDITH, WARD",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1225195746,MOORE FOOT AND ANKLE SPECIALISTS PA,~,136 MIMOSA DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124433982,"DICKSON, MEREDITH, WARD",136 MIMOSA DR   ASHEVILLE NC,011,Buncombe,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 89 , 131 , 199 ,$#,,
MEDICAID DIRECT,1225195746,MOORE FOOT AND ANKLE SPECIALISTS PA,~,136 MIMOSA DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124433982,"DICKSON, MEREDITH, WARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 28 , 49 , 50 ,$#,,
MEDICAID DIRECT,1124434865,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY,32 VILLAGE CENTER DR   CLAYTON NC,051,Johnston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1124434865,NORTH CAROLINA CVS PHARMACY LLC,32 VILLAGE CENTER DR   CLAYTON NC,051,Johnston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1124434865,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY,32 VILLAGE CENTER DR   CLAYTON NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1124434865,NORTH CAROLINA CVS PHARMACY LLC,32 VILLAGE CENTER DR   CLAYTON NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1124437371,RELIANCE HEALTH SOURCE LLC,IN HOME QUALITY CARE,300 S WESTGATE DR STE A GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1124437371,RELIANCE HEALTH SOURCE LLC,300 S WESTGATE DR STE A GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 53 ," 10,802 "," 10,930 "," $1,021,733.82 ",,
MEDICAID DIRECT,1861934895,B BRENDA GONG DDS PA,~,86 E DEPOT ST   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1124439559,"GONG, BOKSOON, BRENDA",86 E DEPOT ST   ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 414 ," 1,031 "," 4,214 "," $219,797.33 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1124442488,"CODY, SALLY, IRENE",241 CHURCH ST   HAYESVILLE NC,022,Clay,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 30 , 30 ," $11,589.93 ",,
MEDICAID DIRECT,1659362911,CLAY COMPREHENSIVE HEALTH SERVICES,CHATUGE FAMILY PRACTICE,241 CHURCH ST   HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,,1124442488,"CODY, SALLY, IRENE",241 CHURCH ST   HAYESVILLE NC,022,Clay,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 96 , 114 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1124442488,"CODY, SALLY, IRENE",241 CHURCH ST   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1659362911,CLAY COMPREHENSIVE HEALTH SERVICES,CHATUGE FAMILY PRACTICE,241 CHURCH ST   HAYESVILLE NC,022,Clay,193200000X,Group,Multi-Specialty,,1124442488,"CODY, SALLY, IRENE",241 CHURCH ST   HAYESVILLE NC,022,Clay,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 63 , 120 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124445275,"JACOB, BOBBY, MATTHEW",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 50 , 89 ,$#,,
MEDICAID DIRECT,1871931253,MONARCH,~,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1124445796,"WHITE, DORIAN, MARIE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124446513,"SANCHEZ, HECTOR, IVAN",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 51 , 64 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124446513,"SANCHEZ, HECTOR, IVAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 51 , 92 , 130 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124446513,"SANCHEZ, HECTOR, IVAN",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 210 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124447396,"KLEIN, MIA, KATHERINE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 430 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124447396,"KLEIN, MIA, KATHERINE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124448758,"COSOLITO, RACHEL, THYRA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124448758,"COSOLITO, RACHEL, THYRA",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124448758,"COSOLITO, RACHEL, THYRA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124448758,"COSOLITO, RACHEL, THYRA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124450028,"BERKOWITZ, DANIELLE, PAIGE",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 653 , 668 ," 3,608 "," $146,616.09 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124455704,"SULLIVAN, LAURA, NASTASSJA",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1124455704,"SULLIVAN, LAURA, NASTASSJA",1011 PEMBERTON HILL RD STE 101 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1124455704,"SULLIVAN, LAURA, NASTASSJA",1011 PEMBERTON HILL RD STE 101 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124455704,"SULLIVAN, LAURA, NASTASSJA",1011 PEMBERTON HILL RD STE 101 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1124455704,"SULLIVAN, LAURA, NASTASSJA",1011 PEMBERTON HILL RD STE 101 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1124456355,SHELBY HOUSE LLC,CLEVELAND HOUSE,950 HARDIN DR   SHELBY NC,023,Cleveland,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1124456355,SHELBY HOUSE LLC,950 HARDIN DR   SHELBY NC,023,Cleveland,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 14 , 47 , 47 ,$#,,
MEDICAID DIRECT,1124456355,SHELBY HOUSE LLC,CLEVELAND HOUSE,950 HARDIN DR   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124456355,SHELBY HOUSE LLC,950 HARDIN DR   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 47 ," 12,130 "," 12,131 "," $806,030.38 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124457650,"WARDEN, AMANDA, DIANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 32 , 34 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124457650,"WARDEN, AMANDA, DIANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 30 , 32 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1124457650,"WARDEN, AMANDA, DIANE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1124457650,"WARDEN, AMANDA, DIANE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1124457650,"WARDEN, AMANDA, DIANE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124457718,CROSSROADS TREATMENT CENTERS,~,6 ROBERTS RD STE 103 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1124457718,CROSSROADS TREATMENT CENTERS,6 ROBERTS RD STE 103 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124461645,"GROENWALD, MATTHEW, THOMAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 79 , 89 , 128 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124461991,"GILKEY, ANNE, VALENTE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124462379,"ZHAO, YAN",2525 COURT DR   GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 22 , 55 , 73 ,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124462379,"ZHAO, YAN",2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 57 , 137 , 183 ,$#,,
MEDICAID DIRECT,1194263087,DLP FRYE MEDICAL GROUP,FRYECARE WOMENS SERVICES,1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124463336,"SIMON, JILL, KATHERINE",1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 13 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124463351,"HARPER, SHELLEY, MCKAY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124463351,"HARPER, SHELLEY, MCKAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 16 , 18 , 29 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124463781,"MILBOURN, DAVID, EDWARD",2630 E 7TH ST STE 101 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 32 , 90 ,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124466164,"RICHARDSON, KATHERINE, MARIE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124467725,"STONEROCK, GREGORY, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124467725,"STONEROCK, GREGORY, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124468293,"OJEVWE, FIDELIS, OBUKOWHO",5 E MAIN ST   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124469549,"STOLLDORF, SARAH, DALY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124470265,"JENNINGS, COURTNEY, RAE",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124470265,"JENNINGS, COURTNEY, RAE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124472014,"LEVISTE, EDGAR MILES, CIANCAGLINI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 62 , 121 , 122 ," $10,046.17 ",,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124472014,"LEVISTE, EDGAR MILES, CIANCAGLINI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 34 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124472014,"LEVISTE, EDGAR MILES, CIANCAGLINI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124472170,"DE WITT, MICHELLE, ELIZABETH",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 58 , 90 , 116 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124472170,"DE WITT, MICHELLE, ELIZABETH",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124472170,"DE WITT, MICHELLE, ELIZABETH",1226 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 24 , 28 , 33 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124472337,"SHAH, GAURAV, MUKESH",4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1114293495,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124472337,"SHAH, GAURAV, MUKESH",4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 25 , 45 , 46 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124472337,"SHAH, GAURAV, MUKESH",4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124473152,"STELMACH, SAMUEL, JORDAN",1942 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 27 , 34 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124473152,"STELMACH, SAMUEL, JORDAN",757 BRYANT ST   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 30 , 37 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1124475017,"HUNTER, JEFFREY, LYNN",6341 COOK AVE   CLEMMONS NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 15 , 21 , 37 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1124475017,"HUNTER, JEFFREY, LYNN",147 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1124475017,"HUNTER, JEFFREY, LYNN",367 S ANDY GRIFFITH PKWY STE 200 MOUNT AIRY NC,086,Surry,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 94 , 127 , 283 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124476908,"ATHA, ROBIN, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124477781,"BAILEY SANDERS, BRIDGETTE, SHAVON",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 16 , 30 , 30 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1124478094,"SLEE, EVELYN, PATRICK",133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1124478094,"SLEE, EVELYN, PATRICK",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 51 , 51 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1124478094,"SLEE, EVELYN, PATRICK",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1124478094,"SLEE, EVELYN, PATRICK",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124478680,"TAMIMI, IMAN, ABDALLAH",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124478680,"TAMIMI, IMAN, ABDALLAH",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124478680,"TAMIMI, IMAN, ABDALLAH",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124478680,"TAMIMI, IMAN, ABDALLAH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124481379,"DAVIS, BENJAMIN, JOSEPH",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 33 , 60 , 92 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124481379,"DAVIS, BENJAMIN, JOSEPH",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 23 , 38 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1124482377,"FLING, SEAN, NATASHA",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 62 , 85 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1124482377,"FLING, SEAN, NATASHA",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 35 , 39 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124482377,"FLING, SEAN, NATASHA",16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124482583,"SARAIYA, PARTH",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine, 21 , 79 , 79 ," $16,704.48 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124482880,"SWEETMAN, SARAH, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124482906,"CHANCY, STEPHANIE, RENEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 62 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124482906,"CHANCY, STEPHANIE, RENEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124483169,"SHERRY, ALEX, SCOTT",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124483169,"SHERRY, ALEX, SCOTT",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124484696,"ROUX, LAUREN, ELROD",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,310 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,620 JOHNS RD   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 129 , 129 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 138 , 138 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,106 CAMERON ST   LAKE WACCAMAW NC,024,Columbus,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,310 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 327 , 327 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,310 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 34 , 34 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1124485883,"MCQUHAE, VIRGINIA, HUGGINS",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124488325,"Burch, April, D'TONYA",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124490008,"DIESO, TIFFANY, LEANN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 23 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124490008,"DIESO, TIFFANY, LEANN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124490008,"DIESO, TIFFANY, LEANN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124493945,TENACITY CARE HOMES,COMMUNITY CARE HOME,1104 S CHURCH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124493945,TENACITY CARE HOMES,1104 S CHURCH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,618 "," 1,618 "," $114,739.04 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1124495205,"KORELITZ, KATHERINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1255851424,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FORESTVILLE CROSSING,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124496633,"ATKINS, KYLE, WESLEY",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1255851424,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FORESTVILLE CROSSING,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124496633,"ATKINS, KYLE, WESLEY",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124502356,"NELSON, HANNAH, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 28 , 53 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 20 , 39 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124505219,"NELSON, THERESA, JOAN",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 32 , 65 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124505219,"NELSON, THERESA, JOAN",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124505219,"NELSON, THERESA, JOAN",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",1602 WESTOVER DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1124505219,"NELSON, THERESA, JOAN",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1124505219,"NELSON, THERESA, JOAN",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1124506134,"NORMILE, ADAM, MICHAEL",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124507439,"KOOP, KENYN, LAWRENCE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 50 , 179 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1124507439,"KOOP, KENYN, LAWRENCE",730 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1124507439,"KOOP, KENYN, LAWRENCE",730 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 90 , 249 , 490 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 71 , 82 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 66 , 75 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124510367,"ROTTER, ZACHARY, BRYAN CAMENS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124514351,"HILLSINGER, MATTHEW, JAMES",1545 ORCHARD VILLAS AVE   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 25 ,$#,,
MEDICAID DIRECT,1124516737,BRYSON CITY NOTE HOLDINGS LLC,BRYSON SENIOR LIVING,314 HUGHES BRANCH RD   BRYSON CITY NC,087,Swain,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124516737,BRYSON CITY NOTE HOLDINGS LLC,314 HUGHES BRANCH RD   BRYSON CITY NC,087,Swain,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 7,171 "," 7,171 "," $524,970.21 ",,
MEDICAID DIRECT,1124516737,BRYSON CITY NOTE HOLDINGS LLC,BRYSON SENIOR LIVING,314 HUGHES BRANCH RD   BRYSON CITY NC,087,Swain,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1124516737,BRYSON CITY NOTE HOLDINGS LLC,314 HUGHES BRANCH RD   BRYSON CITY NC,087,Swain,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 15 , 51 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124516745,"LEWIS, SCOTT, MARSHALL",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1124516745,"LEWIS, SCOTT, MARSHALL",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 35 , 45 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1124517016,"WRIGHT, BRANDON, WAYNE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124520440,"GRAVELY, GRAYSON, MASSEY",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 33 , 40 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124520440,"GRAVELY, GRAYSON, MASSEY",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 67 , 86 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1124520440,"GRAVELY, GRAYSON, MASSEY",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 97 , 106 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124520440,"GRAVELY, GRAYSON, MASSEY",204 MEDSPRING DR   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522057,"PATEL, BHAVESH, DIPAK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522057,"PATEL, BHAVESH, DIPAK",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522057,"PATEL, BHAVESH, DIPAK",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 18 , 42 , 46 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522057,"PATEL, BHAVESH, DIPAK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522057,"PATEL, BHAVESH, DIPAK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 26 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522057,"PATEL, BHAVESH, DIPAK",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522461,"KEENE, BROOKS, ALAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 16 , 19 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124522461,"KEENE, BROOKS, ALAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 26 , 27 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124522594,"COX, ALICIA, SHIRLEY",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1124522594,"COX, ALICIA, SHIRLEY",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1124522594,"COX, ALICIA, SHIRLEY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124522594,"COX, ALICIA, SHIRLEY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124523188,"CLARK, TYIA, SHAY",6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 68 , 137 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124523428,"MASSENGILL, NATHAN, WASSON",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124523964,"TORREALBA-ACOSTA, GABRIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124523964,"TORREALBA-ACOSTA, GABRIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124524145,"CUI, XIAOXI",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 120 , 190 , 322 ," $14,751.45 ",,
MEDICAID DIRECT,1790212462,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124524145,"CUI, XIAOXI",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649240698,PIEDMONT ACCESS TO HEALTH SERVICES,PIEDMONT ACCESS TO HEALTH SERVICES INC,705 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124525472,"BATSON, ABIGAIL, PATRICIA CHERISH",705 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1720344047,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF CHAPEL HILL,101 CONNOR DR STE 301 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1124525506,"SULLIVAN, JULIANA, BAPTISTA",101 CONNOR DR STE 301 CHAPEL HILL NC,068,Orange,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1720344047,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF CHAPEL HILL,101 COSGROVE AVE STE 110 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1124525506,"SULLIVAN, JULIANA, BAPTISTA",101 COSGROVE AVE STE 110 CHAPEL HILL NC,068,Orange,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1952030652,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-611B FIFTH AVENUE WEST,611 B FIFTH AVE W   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124535919,"THOMPSON, CATHERINE, ELLEN",611 5TH AVE W STE B HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1124536107,ESOTERIX GENETIC LABORATORIES LLC,,3 FOREST PKWY   SHELTON CT,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1124536107,ESOTERIX GENETIC LABORATORIES LLC,3 FOREST PKWY   SHELTON CT,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124538178,"VARGHESE, AMANDA, MARIE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 41 , 41 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124539762,"FLEMMING, ROSEMARY",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124539762,"FLEMMING, ROSEMARY",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,320 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124542345,"WEIFENBACH, STEVEN, ANDREW",8180 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124542345,"WEIFENBACH, STEVEN, ANDREW",8180 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124542345,"WEIFENBACH, STEVEN, ANDREW",7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,8180 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124542345,"WEIFENBACH, STEVEN, ANDREW",8180 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 32 , 60 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124545843,"HEATH, TAIJA, AUQUINETTE",9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 11 , 164 , 337 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124546510,"WILCZYNSKI, ALISA, ANNE",3116 N DUKE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124546510,"WILCZYNSKI, ALISA, ANNE",3116 N DUKE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 47 , 76 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124548391,"WALKER, DAVID, THOMAS",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 264 , 276 , 372 ," $12,854.22 ",,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124548391,"WALKER, DAVID, THOMAS",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 32 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1124548391,"WALKER, DAVID, THOMAS",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 301 , 330 , 418 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124548599,"EXLINE, TIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1124550074,"KROM, RUSSELL-JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124550074,"KROM, RUSSELL-JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 33 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124550074,"KROM, RUSSELL-JOHN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124550074,"KROM, RUSSELL-JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 16 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124550074,"KROM, RUSSELL-JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124550074,"KROM, RUSSELL-JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124550074,"KROM, RUSSELL-JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1124550256,"SINGLETON, TAYLOR, NICHOLE",4351 S MAIN ST   FARMVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 359 , 471 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1124550256,"SINGLETON, TAYLOR, NICHOLE",4351 S MAIN ST   FARMVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 240 , 309 ," $15,999.47 ",,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1124550256,"SINGLETON, TAYLOR, NICHOLE",4351 S MAIN ST   FARMVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 51 , 58 ,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1124550256,"SINGLETON, TAYLOR, NICHOLE",4351 S MAIN ST   FARMVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 20 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 386 , 508 , 697 ," $10,844.25 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 40 , 49 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 35 , 46 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 47 , 58 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124550496,"COSTELLO, JUSTIN, ALEXANDER",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124551650,"CINDERELLA, MARGARET, ANNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124551650,"CINDERELLA, MARGARET, ANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124551650,"CINDERELLA, MARGARET, ANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124551650,"CINDERELLA, MARGARET, ANNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124553789,"SANDERS, AMANDA, BLAU",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124554381,"LANE, RACHEL, ELIZABETH",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 37 , 54 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124554381,"LANE, RACHEL, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 110 , 122 , 195 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124554381,"LANE, RACHEL, ELIZABETH",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1124556675,EARLY INTERVENTION WORKS LLC,,138 IVY TRL   ROCKINGHAM NC,077,Richmond,251S00000X,Agencies,Community/Behavioral Health,,1124556675,EARLY INTERVENTION WORKS LLC,138 IVY TRL   ROCKINGHAM NC,077,Richmond,251S00000X,Agencies,Community/Behavioral Health,, 17 , 203 , 204 ," $13,154.40 ",,
MEDICAID DIRECT,1124556675,EARLY INTERVENTION WORKS LLC,,138 IVY TRL   ROCKINGHAM NC,077,Richmond,252Y00000X,Agencies,Early Intervention Provider Agency,,1124556675,EARLY INTERVENTION WORKS LLC,138 IVY TRL   ROCKINGHAM NC,077,Richmond,252Y00000X,Agencies,Early Intervention Provider Agency,,#,#,#,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1124557616,"MALPASS, SHARRY, JACKSON",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 89 , 210 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124558135,"BAYLESS, JAKE, HAMILTON",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 32 , 62 , 62 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124558135,"BAYLESS, JAKE, HAMILTON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124564901,"ALLAN, HILLARY, FAHYE",6324 FAIRVIEW RD STE 460 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1124565684,"MCCAFFERTY, LINDA, MICHELLE",68 HOSPITAL RD STE 201 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124569082,"SANTANA, MICHELLE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124569082,"SANTANA, MICHELLE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124569082,"SANTANA, MICHELLE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 19 , 19 ,$#,,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1124570239,"OLIVERIO, SARA",101 N TRYON ST STE 112 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124571674,"BEAVER, LAUREN, RAY",3610 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124571674,"BEAVER, LAUREN, RAY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 101 , 163 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124571674,"BEAVER, LAUREN, RAY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 296 , 877 ," 1,409 "," $17,236.90 ",,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124571674,"BEAVER, LAUREN, RAY",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124571674,"BEAVER, LAUREN, RAY",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124571674,"BEAVER, LAUREN, RAY",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 49 , 49 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124575972,"HORNER, ROBERT, DANIEL",1101 N GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1124575972,"HORNER, ROBERT, DANIEL",1101 N GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1124575972,"HORNER, ROBERT, DANIEL",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 87 , 132 , 143 ,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1124575972,"HORNER, ROBERT, DANIEL",1101 N GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 32 , 33 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124577168,"HUDSON, LUKE, WILLIAM",7700 PERRY CREEK RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124580097,"STEWART, KIM, CRAWFORD",129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 41 , 84 ,$#,,
MEDICAID DIRECT,1538561865,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM MEDICAL ONCOLOGY,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1124584206,"KAPLAN, CRYSTAL, YOUNG",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 134 , 229 , 229 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124584610,"OBREGON, CAROLINE, CHRISTINA",2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124584610,"OBREGON, CAROLINE, CHRISTINA",128 SNOW HILL ST   AYDEN NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1538276100,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1124586581,"LONG, JOHN, HUNTER",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538276100,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1124586581,"LONG, JOHN, HUNTER",401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 46 , 49 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124588272,"MAXWELL, JOSEPH, LAMAR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124588272,"MAXWELL, JOSEPH, LAMAR",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124588629,"NDON, SIFON, UDEME",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124589148,"SINHA, ANNIKA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124589148,"SINHA, ANNIKA",1200 NAVAHO DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124594338,CHARLOTTE SURGERY CENTER,CHARLOTTE SURGERY CENTER WENDOVER CAMPUS,3621 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1124594338,CHARLOTTE SURGERY CENTER,3621 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 18 , 19 , 34 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124598982,"ROSS, CAROLYN, MEIGHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124598982,"ROSS, CAROLYN, MEIGHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124598982,"ROSS, CAROLYN, MEIGHAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124600143,ETHEREAL CARE,,2216 W MEADOWVIEW RD STE 264 GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1124600143,ETHEREAL CARE,2216 W MEADOWVIEW RD STE 264 GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1124600143,ETHEREAL CARE,,2216 W MEADOWVIEW RD STE 264 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1124600143,ETHEREAL CARE,2216 W MEADOWVIEW RD STE 264 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124602321,"NLEYA, PORTIA, MPONYANA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 76 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124602321,"NLEYA, PORTIA, MPONYANA",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1588091904,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS PIEDMONT PEDIATRIC,1085 NE GATEWAY CT NE STE 290 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1124604616,"PRABHU, SANJANA, GANESH",1085 NE GATEWAY CT NE STE 290 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 15 , 41 ,$#,,
MEDICAID DIRECT,1124605142,GLOBAL NURSES SERVICES,,6514 OLD WAKE FOREST RD STE 120 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1124605142,GLOBAL NURSES SERVICES,6514 OLD WAKE FOREST RD STE 120 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 417 , 417 ," $36,820.00 ",,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1124606405,"EDWARDS, TRENT, CORUM",2201 S STERLING ST   MORGANTON NC,012,Burke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 117 , 117 ,$#,,
MEDICAID DIRECT,1124606660,GIRASOL PEDIATRIC SPEECH THERAPY,,102 SHADOW HAWK DR   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1124606660,GIRASOL PEDIATRIC SPEECH THERAPY,102 SHADOW HAWK DR   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,, 11 , 149 , 149 ," $10,526.22 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124606702,"PRUITT, ZACHARY, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 86 , 115 , 116 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124606702,"PRUITT, ZACHARY, DAVID",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1124607304,MITCHELL MEDICS,,121 FOREST SERVICE DR   BAKERSVILLE NC,061,Mitchell,3416L0300X,Transportation Services,Ambulance,Land Transport,1124607304,MITCHELL MEDICS,121 FOREST SERVICE DR   BAKERSVILLE NC,061,Mitchell,3416L0300X,Transportation Services,Ambulance,Land Transport, 96 , 164 , 330 ,$#,,
MEDICAID DIRECT,1124607981,F & W HOME CARE SOLUTIONS,,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1124607981,F & W HOME CARE SOLUTIONS,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 363 , 514 ," $67,389.72 ",,
MEDICAID DIRECT,1518392125,BURROW WELCHEL CULP AND REIMELS DD,SIGNATURE SMILES ORTHODONTICS,2250 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1124608047,"KNOTT, EMILY, WILLETT",2250 NASH ST N   WILSON NC,098,Wilson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124608096,"HOLLEY, VANESSA, RENEE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124608518,"WELCH, CHRISTOPHER, ELI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124608518,"WELCH, CHRISTOPHER, ELI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124608518,"WELCH, CHRISTOPHER, ELI",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124608518,"WELCH, CHRISTOPHER, ELI",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124608518,"WELCH, CHRISTOPHER, ELI",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124609516,"ANWAR-PEALSTROM, DUNIA, LAITH",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124609516,"ANWAR-PEALSTROM, DUNIA, LAITH",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 35 , 51 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,573 "," 3,102 "," 13,361 "," $487,871.43 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 18 , 15 , 79 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 75 , 76 , 510 ," $27,018.59 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 108 ," $10,166.33 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 19 , 19 , 390 ," $36,920.84 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 809 , 868 ," 3,659 "," $131,074.82 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1023326287,BEVIN K MALLEY DDS PA,CAROLINA KIDS DENTISTRY,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 96 , 100 , 404 ," $15,096.38 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 97 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 186 ," $15,945.12 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124610001,"MANCHERY, CYRIL, VARGHESE",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124610902,"DANNEMILLER, MARIANNE, NICOLE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124610902,"DANNEMILLER, MARIANNE, NICOLE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124610902,"DANNEMILLER, MARIANNE, NICOLE",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 26 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124610902,"DANNEMILLER, MARIANNE, NICOLE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124611942,"MCLAWHORN, MORGAN, DAWSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124611942,"MCLAWHORN, MORGAN, DAWSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124611942,"MCLAWHORN, MORGAN, DAWSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124612452,"BREEZE, SHANTELLE, NICOLLE",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1124612452,"BREEZE, SHANTELLE, NICOLLE",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1124625504,"SWANSON, TIFFANY, ANNE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 241 , 241 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1124625504,"SWANSON, TIFFANY, ANNE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 154 , 155 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1124625504,"SWANSON, TIFFANY, ANNE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124627112,"MCCALL, DARBY, SHEA",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124627112,"MCCALL, DARBY, SHEA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 58 , 67 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124627112,"MCCALL, DARBY, SHEA",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124627112,"MCCALL, DARBY, SHEA",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1124627112,"MCCALL, DARBY, SHEA",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124627112,"MCCALL, DARBY, SHEA",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124627112,"MCCALL, DARBY, SHEA",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124628219,RIVERS EDGE OF LUMBERTON LLC,RIVERS EDGE OF LUMBERTON,550 BAILEY RD   LUMBERTON NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124628219,RIVERS EDGE OF LUMBERTON LLC,550 BAILEY RD   LUMBERTON NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 83 ," 21,291 "," 21,366 "," $1,689,458.97 ",,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124629019,"CHAUDHARY, SHWETA, BHAGVANBHAI",2025 GLENN MITCHELL DR   VA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,303 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124629910,"COYLE, RHEA, JUANITA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,3322 VILLAGE RD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1124629910,"COYLE, RHEA, JUANITA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 98 ," 1,675 "," 1,684 "," $18,291.84 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124629910,"COYLE, RHEA, JUANITA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,303 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124629910,"COYLE, RHEA, JUANITA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 413 , 413 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1124632146,"GODWIN, BRANDON, GRANT",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1124632146,"GODWIN, BRANDON, GRANT",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 46 , 52 ,$#,,
MEDICAID DIRECT,1124634399,AMBER HOUSE STAFFING LLC,AMBER HOUSE STAFFING LLC,611 SUMMIT AVE STE 4 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1124634399,AMBER HOUSE STAFFING LLC,611 SUMMIT AVE STE 4 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 211 , 211 ," $14,709.28 ",,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124635586,"MAIMAI, LUBABATU, INUWA",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689870941,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124635586,"MAIMAI, LUBABATU, INUWA",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124635586,"MAIMAI, LUBABATU, INUWA",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124635586,"MAIMAI, LUBABATU, INUWA",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 29 , 33 ,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124635586,"MAIMAI, LUBABATU, INUWA",330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124638317,"STRONG, JAKITA, CHARELLE",404 S SUTHERLAND AVE   MONROE NC,090,Union,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1124638317,"STRONG, JAKITA, CHARELLE",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 36 , 48 , 94 ,$#,,
MEDICAID DIRECT,1477589158,EASTRIDGE FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE EASTRIDGE FAMILY MEDICI,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124638317,"STRONG, JAKITA, CHARELLE",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 64 , 105 , 180 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124645593,"KANG, JISUN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124645593,"KANG, JISUN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1124645627,"AYAPATI, VIKRAM, AIMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 79 , 79 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1124645627,"AYAPATI, VIKRAM, AIMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 158 , 160 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124645916,"LOEHRKE, ALLISON, MARIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1124646088,"DUNZWEILER, MEREDITH, PAIGE",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 16 , 30 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1124646088,"DUNZWEILER, MEREDITH, PAIGE",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1124646088,"DUNZWEILER, MEREDITH, PAIGE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 37 , 66 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1124646088,"DUNZWEILER, MEREDITH, PAIGE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 28 , 46 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124646237,"WISEMAN, JOANNA",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1124646328,COMPLETE WELL-CARE SOURCE LLC,,512 KLUMAC RD STE 9 SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1124646328,COMPLETE WELL-CARE SOURCE LLC,512 KLUMAC RD STE 9 SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1124649769,"JONES, CHELSEY, ERICA",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124650155,"SMITH, AUDRIANNA, SHAUNTERA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 43 , 52 , 52 ,$#,,
MEDICAID DIRECT,1790298024,CHALLIE MINTON MD,,113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1124652433,"LOWE, TEIRRAHA, CHANNEL",113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 67 , 176 , 246 ," $15,759.72 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124655030,"BOWMAN, MEAGAN, ALICIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 32 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124657655,"MENDES, JOCELYN, TISCH",410 MARKET ST STE 400 CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124659982,"RUSSELL, EMILY, LYNNE",3609 SW DURHAM DR   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1124663547,GREEN PASTURES HOME CARE,,10130 MALLARD CREEK RD STE 342 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1124663547,GREEN PASTURES HOME CARE,10130 MALLARD CREEK RD STE 342 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 33 ," 6,435 "," 6,778 "," $548,609.60 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124667126,"BROOKS, KENDALL, SUZANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124667126,"BROOKS, KENDALL, SUZANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124667480,"LEGGETT, JUSTIN, CHARLES",2126 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 37 ,$#,,
MEDICAID DIRECT,1598431710,MCPC-6 LLC,FIRSTHEALTH BACK AND NECK PAIN CENTER,3716 MORGANTON RD STE 1 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124668231,"HALEY, SUSANNA, LONG",3716 MORGANTON RD STE 1 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 206 , 223 ,$#,,
MEDICAID DIRECT,1316296635,CAPE FEAR CLINIC INC,,1605 DOCTORS CIR   WILMINGTON NC,065,New Hanover,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1124670641,"SMITH, REBECCA, ELIZABETH",1605 DOCTORS CIR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124670641,"SMITH, REBECCA, ELIZABETH",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 61 , 61 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124670641,"SMITH, REBECCA, ELIZABETH",511 PALADIN DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 57 , 134 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124673090,"SHIPP, MEGAN, ALYSSA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124673090,"SHIPP, MEGAN, ALYSSA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 15 , 20 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124673090,"SHIPP, MEGAN, ALYSSA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,,,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124673090,"SHIPP, MEGAN, ALYSSA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124673090,"SHIPP, MEGAN, ALYSSA",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 36 , 38 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124673728,"CHASE, MELANIE, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 54 , 77 ,$#,,
MEDICAID DIRECT,1124675210,AAA HEALTHCARE SERVICES,,5710 SIX FORKS RD STE 201 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1124675210,AAA HEALTHCARE SERVICES,5710 SIX FORKS RD STE 201 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 275 , 348 ," $75,734.48 ",,
MEDICAID DIRECT,1124675210,AAA HEALTHCARE SERVICES,,308 W MILLBROOK RD STE A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1124675210,AAA HEALTHCARE SERVICES,308 W MILLBROOK RD STE A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 328 , 330 ," $64,982.12 ",,
MEDICAID DIRECT,1124676648,INSPIRING HANDS HOME CARE LLC,~,175 NORTHPOINT AVE STE 108 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1124676648,INSPIRING HANDS HOME CARE LLC,175 NORTHPOINT AVE STE 108 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 3,611 "," 3,611 "," $210,966.12 ",,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1124679204,"FENN, HANNAH, CATHERINE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 45 , 102 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1124679204,"FENN, HANNAH, CATHERINE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 33 , 56 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124679402,"GRAHAM, LANDRY, SCHOFIELD",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124679402,"GRAHAM, LANDRY, SCHOFIELD",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 22 , 26 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124679402,"GRAHAM, LANDRY, SCHOFIELD",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124679402,"GRAHAM, LANDRY, SCHOFIELD",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124679402,"GRAHAM, LANDRY, SCHOFIELD",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 89 , 117 , 152 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124679402,"GRAHAM, LANDRY, SCHOFIELD",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1578219424,OPPORTUNITIES INDUSTRIALIZATION CEN,,2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124679683,"SUTTON, BENESSA, MITCHELL",2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1992482079,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON PRIMARY CARE RHC,1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1124679683,"SUTTON, BENESSA, MITCHELL",1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 49 , 60 , 65 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1124679683,"SUTTON, BENESSA, MITCHELL",1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124679683,"SUTTON, BENESSA, MITCHELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1124680186,"RICHARD, KELSEY, ELIZABETH",348 S COLLEGE RD STE A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1124680186,"RICHARD, KELSEY, ELIZABETH",348 S COLLEGE RD STE A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 34 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1124680186,"RICHARD, KELSEY, ELIZABETH",2145 COUNTRY CLUB RD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 35 , 57 ,$#,,
MEDICAID DIRECT,1467947127,DLP MARIA PARHAM PHYSICIAN PRACTICE,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1124681507,"HENRY, PANYA, ASABI",171 NC HIGHWAY 125 STE A ROANOKE RAPID NC,042,Halifax,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 60 , 60 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124682257,"SURTI, PURVI, DILIP",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 75 , 84 ,$#,,
MEDICAID DIRECT,1013329929,MOUNTAIN LAUREL DERMATOLOGY PLLC,,600 ALLIANCE CT STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1124682950,"SAVILLE, HANNAH, ELIZABETH",11 FALCON CREST LN   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124683958,"HANSON, TAYLOR, MARIE",100 SENTARA CIR RM 2C WILLIAMSBURG VA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 14 ,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 537 , 546 ," 2,960 "," $134,340.79 ",,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 178 , 136 , 603 ," $24,009.09 ",,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 63 , 64 , 335 ," $16,644.31 ",,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1205617826,LONDRY MODLIN TUCKER DDS PLLC,HAPPY TEETH PEDIATRIC DENTISTRY,701 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",701 HARTNESS RD   STATESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 288 , 298 ," 1,315 "," $52,184.44 ",,
MEDICAID DIRECT,1104496124,MARGARET ANN FLOOR DDS PLLC,CREATIVE KIDS PEDIATRIC DENTISTRY,5203 ROBINHOOD VILLAGE DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",5203 ROBINHOOD VILLAGE DR   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 980 ," 1,486 "," 9,008 "," $353,137.46 ",,
MEDICAID DIRECT,1104496124,MARGARET ANN FLOOR DDS PLLC,CREATIVE KIDS PEDIATRIC DENTISTRY,5203 ROBINHOOD VILLAGE DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124688973,"KALASKEY, MIRANDA, RAE",5203 ROBINHOOD VILLAGE DR   WINSTON SALEM NC,034,Forsyth,122300000X,Dental Providers,Dentist,,#,#,#,$#,,
MEDICAID DIRECT,1730147984,MYEYEDR OPTOMETRY OF NORTH CAROLINA,~,,,Unknown,193400000X,Group,Single Specialty,,1124691092,"BUTERBAUGH, DAVID, HUNTER",201 RACINE DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1124692496,"SAYRE, WESLEY, MULLES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124692496,"SAYRE, WESLEY, MULLES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 50 , 50 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124693031,"MILLS, JAKE, HENRY",630 5TH AVE W   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124693031,"MILLS, JAKE, HENRY",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 53 , 103 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1124693049,"KANAAN, GRACE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124696422,CRAVEN OPCO LLC,THE VIRIDIAN,3003 WATERSCAPE WAY   NEW BERN NC,025,Craven,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1124696422,CRAVEN OPCO LLC,3003 WATERSCAPE WAY   NEW BERN NC,025,Craven,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,066 "," 1,066 "," $77,069.71 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124697206,"SHIRLEY, AMANDA, LEIGH",2950 PINE PLANTATION PKWY   OAK ISLAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 23 , 41 ,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124699293,"KALEN, HERBERT, JOSEPH",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124699814,"TUNING, ALISHA, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 24 , 35 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124699814,"TUNING, ALISHA, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124702832,"KELLAM, MOLLY, CLAIRE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1215077201,HARNETT HEALTH SYSTEM INC,CAPE FEAR VALLEY PEDIATRIC CARE,716 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1124703541,"DUNN SCHLIEMAN, MADISON, JUNE",716 S 10TH ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 55 , 128 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124703855,"VERIAN, MICHAEL, GEORGE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124703855,"VERIAN, MICHAEL, GEORGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124703855,"VERIAN, MICHAEL, GEORGE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124703855,"VERIAN, MICHAEL, GEORGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE N KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1124704796,"LAKE, JAMES, BRYAN",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124704796,"LAKE, JAMES, BRYAN",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 60 , 111 , 209 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124705843,"HYATT, DELANEY, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 70 , 92 ," $19,941.82 ",,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1124707732,"WALKER, DANESHIA, DORSEY",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 35 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124707997,"CRANFORD, TYLER, LEE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124707997,"CRANFORD, TYLER, LEE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1124707997,"CRANFORD, TYLER, LEE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 40 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124708599,"EVANS, MARY, MICHELE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1124708631,PLAYFULLY SPEAKING LLC,PLAYFULLY SPEAKING,1206 SCHOOL ST STE A WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1124708631,PLAYFULLY SPEAKING LLC,1206 SCHOOL ST STE A WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1124709001,"THOMAS, MARISSA, ROSE",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 123 , 237 , 337 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1124712989,"LUTTRELL, ASHLEIGH, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 16 , 35 , 67 ,$#,,
MEDICAID DIRECT,1346784089,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - DURHAM,1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124719133,"CHURCH, WILLIAM, ROBERT",12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 115 , 173 , 529 ," $35,776.66 ",,
MEDICAID DIRECT,1124719778,NC PHYSICAL THERAPY AND BALANCE LLC,FYZICAL THERAPY AND BALANCE CENTERS,3008 ANDERSON DR STE 290 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124719778,NC PHYSICAL THERAPY AND BALANCE LLC,3008 ANDERSON DR STE 290 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#,,,$#,,
MEDICAID DIRECT,1124722731,KMH BUSINESS VENTURES LLC,KMH HOME CARE,1631 MIDTOWN PL STE 104-115 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1124722731,KMH BUSINESS VENTURES LLC,1631 MIDTOWN PL STE 104-115 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 30 ," 5,486 "," 5,486 "," $355,979.60 ",,
MEDICAID DIRECT,1841694254,LANE AND ASSOCIATES XXVIII DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 377 , 481 ," 1,483 "," $64,353.99 ",,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 88 , 104 , 337 ," $12,763.63 ",,
MEDICAID DIRECT,1639502727,LANE AND ASSOCIATES XXVII DDS PA,,4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1902950769,LANE & ASSOCIATES XV DDS PA,LANE & ASSOCIATES XV DDS PA,2617 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 31 , 102 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 39 , 124 ,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 24 , 76 ,$#,,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 335 , 511 ," 1,707 "," $84,071.85 ",,
MEDICAID DIRECT,1154954550,LANE AND ASSOCIATES XXXVII DDS PA,,473 WOOD ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1124725635,"YOUNG, JAMIL, BRIAN",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 19 , 72 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1124726526,"MOORE, DE'ANNA, SHATRICE",5156 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1124726526,"MOORE, DE'ANNA, SHATRICE",41 BAIN ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1124726526,"MOORE, DE'ANNA, SHATRICE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114269677,BLADEN HEALTHCARE LLC,BLADEN EXPRESS CARE,107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1124726526,"MOORE, DE'ANNA, SHATRICE",107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 96 , 96 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1124726526,"MOORE, DE'ANNA, SHATRICE",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1124726526,"MOORE, DE'ANNA, SHATRICE",5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124730494,"WITHERSPOON, CRYSTAL, KILLIAN",1424B FERN CREEK DR   STATESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1124730494,"WITHERSPOON, CRYSTAL, KILLIAN",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1124731294,"BURCHETTE, EMILY, ANNE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124732102,"SHOTWELL, MARNIE, LOWE",2502 S NC HIGHWAY 119   MEBANE NC,001,Alamance,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124732102,"SHOTWELL, MARNIE, LOWE",2502 S NC HIGHWAY 119   MEBANE NC,001,Alamance,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 16 , 62 , 64 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124732102,"SHOTWELL, MARNIE, LOWE",1704 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124732102,"SHOTWELL, MARNIE, LOWE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124732102,"SHOTWELL, MARNIE, LOWE",1704 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 44 , 123 , 123 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124732102,"SHOTWELL, MARNIE, LOWE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 27 , 49 , 49 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 20 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1124733035,"COBB, AUSTIN, GABRIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124738331,"MCCLELLAN, LORI, NARRAMORE",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124738331,"MCCLELLAN, LORI, NARRAMORE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 500 , 978 ," 1,026 "," $25,018.06 ",,
MEDICAID DIRECT,1124743794,CAROLINA BLUE CARE SERVICES LLC,HOMEWELL CARE SERVICES,2504 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1124743794,CAROLINA BLUE CARE SERVICES LLC,2504 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 779 , 779 ," $114,753.84 ",,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124744750,"MARTIN, SHELBY, LAUREN",9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1124746086,"DAO, TRINH, THUC",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124636873,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT GRANDVIEW MIDDLE,451 CATAWBA VALLEY BLVD   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124746979,"DEBNAM, JESSICA, LORENE",451 CATAWBA VALLEY BLVD   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124746979,"DEBNAM, JESSICA, LORENE",451 CATAWBA VALLEY BLVD   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124749155,"HAQ, FUZAIL, UI",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124749155,"HAQ, FUZAIL, UI",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 76 , 216 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124749155,"HAQ, FUZAIL, UI",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124749155,"HAQ, FUZAIL, UI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 35 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124749155,"HAQ, FUZAIL, UI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 126 , 314 , 850 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124749155,"HAQ, FUZAIL, UI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124749155,"HAQ, FUZAIL, UI",3801 W MARKET ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124749452,"WONG, FONG",2301 ERWIN RD   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 79 , 260 , 260 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124749452,"WONG, FONG",2301 ERWIN RD   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 61 , 61 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1124749783,"BEENE, RASHYNDA, JADE",15 BRETTWOOD TRCE   CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 141 , 248 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1124749783,"BEENE, RASHYNDA, JADE",15 BRETTWOOD TRCE   CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 50 , 53 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124750088,"DATOR, DOROTHY, MARIE",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1124750088,"DATOR, DOROTHY, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1649820093,OYEGUNWA AND ASSOCIATES II PLLC,O2 DENTAL GROUP OF DURHAM,3219 WATKINS RD STE 103 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1124750989,"CROSS, VANESSA, CORINA OLIVIA",3219 WATKINS RD STE 103 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 248 , 459 ," 1,486 "," $70,524.32 ",,
MEDICAID DIRECT,1265446132,INTERNAL MEDICINE AND PEDIATRICS AS,~,224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124756242,"IMMLER, KATHLEEN, ELAINE",224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124757349,"HALL, SYDNEY, DAWN",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1124757349,"HALL, SYDNEY, DAWN",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1124758198,"DICKINSON, LEE, PATRICK",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 46 ,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1124758198,"DICKINSON, LEE, PATRICK",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 572 , 774 ," 2,513 "," $125,161.63 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,1108 PARKWAY DR STE A GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1124758198,"DICKINSON, LEE, PATRICK",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 127 , 191 , 673 ," $39,573.66 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,193400000X,Group,Single Specialty,,1124758198,"DICKINSON, LEE, PATRICK",1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,193400000X,Group,Single Specialty,,1124758198,"DICKINSON, LEE, PATRICK",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,13068 NC HIGHWAY 50   SURF CITY NC,071,Pender,193400000X,Group,Single Specialty,,1124758198,"DICKINSON, LEE, PATRICK",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1124760137,"LONG, ALYSSA, MICHELLE",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124760236,"RICHARDSON, LOGAN, STANMORE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124761689,"BALLESTERO, ALYSSA, LAUREN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 48 , 51 ,$#,,
MEDICAID DIRECT,1124764576,HOME CARE PARTNERS LLC,HOME CARE PARTNERS LLC,4401 E INDEPENDENCE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1124764576,HOME CARE PARTNERS LLC,4401 E INDEPENDENCE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 3,326 "," 3,326 "," $224,659.56 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124766134,"LARA-ENSSLIN, CHRISTIAN, PAUL",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 30 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124766134,"LARA-ENSSLIN, CHRISTIAN, PAUL",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124766134,"LARA-ENSSLIN, CHRISTIAN, PAUL",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1124766134,"LARA-ENSSLIN, CHRISTIAN, PAUL",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124768288,"OWUSU, DEBORAH, LINDA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 115 , 185 , 395 ," $17,027.53 ",,
MEDICAID DIRECT,1124771985,WAKEMED SURGERY CENTER - CARY LLC,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1124771985,WAKEMED SURGERY CENTER - CARY LLC,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1124772702,"POTTER, KARA, ANN",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 29 , 77 ,$#,,
MEDICAID DIRECT,1124776554,AMARIS HOME CARE,,2530 MERIDIAN PKWY STE 300 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1124776554,AMARIS HOME CARE,2530 MERIDIAN PKWY STE 300 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 34 ," 6,098 "," 6,123 "," $789,112.08 ",,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1124779640,"JERNIGAN, ALEXUS, STANCIL",109 W GANNON AVE   ZEBULON NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 50 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124783626,"BRYAN, STEPHEN, WHITNEY",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 23 , 28 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1124783626,"BRYAN, STEPHEN, WHITNEY",1180 WYKE RD   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 44 , 54 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124784533,"AMBROSIO, ELAINE, PATRICE",10021 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 84 , 84 ,$#,,
MEDICAID DIRECT,1063896132,KIDZCARE PEDIATRICS PC,,20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1124790449,"BARNES, MICHELLE, LOUISE",20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,864 BLACK CREEK RD   FOUR OAKS NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124790985,"BRAME, HANNAH, GILBERT",864 BLACK CREEK RD   FOUR OAKS NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1124790985,"BRAME, HANNAH, GILBERT",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 40 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124793120,"DORN, SARA, URIBE",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1124793120,"DORN, SARA, URIBE",2301 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 125 , 126 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 857 , 868 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 76 , 76 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1124794847,"GREENE, TAMMY, MICHELLE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124799747,CONVENIENCE HOME CARE SERVICES,,201 E PITT ST STE 100 TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1124799747,CONVENIENCE HOME CARE SERVICES,201 E PITT ST STE 100 TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 4,566 "," 4,680 "," $477,170.50 ",,
MEDICAID DIRECT,1124799747,CONVENIENCE HOME CARE SERVICES,,4030 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1124799747,CONVENIENCE HOME CARE SERVICES,4030 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124801899,"POOLE, TREVOR, RAY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 67 , 70 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1124801899,"POOLE, TREVOR, RAY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1124803606,"MILLER, LAKEESHA, DAWN",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 60 , 101 ,$#,,
MEDICAID DIRECT,1124803713,BLULEAF SENIOR TRANSPORTATION,,506 RAMSEUR ST   DURHAM NC,032,Durham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1124803713,BLULEAF SENIOR TRANSPORTATION,506 RAMSEUR ST   DURHAM NC,032,Durham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 172 ," 2,690 "," 2,712 "," $177,667.50 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1124806237,"HENDERSON, ANDREW, SCOTT",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 81 , 136 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124807268,"DUQUETTE, LAUREN, ELIZABETH",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124808894,"GYAMFI, VIDA, KENA DANKWAH",906 N US HIGHWAY 421   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1073638557,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER CLINTON,906 N US 421 HWY   CLINTON NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124808894,"GYAMFI, VIDA, KENA DANKWAH",906 N US HIGHWAY 421   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1124809090,"HILL, ETHAN, MCCOY",2280 HEMBY LN   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 82 , 108 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124841010,"THAKKAR, SHRIYA, PRADIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1124841010,"THAKKAR, SHRIYA, PRADIP",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710388772,SCHUSTER PHYSICAL THERAPY INC,,419 E MAIN ST UNIT 4 JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1124845862,"HENRY, SAVANNAH, CHRISTINE",419 E MAIN ST   JEFFERSON NC,005,Ashe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 24 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124854708,"DOYLE, NICOLE, BETH",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124857164,"BANKETOV, ALEXANDER, DMITRY",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124857164,"BANKETOV, ALEXANDER, DMITRY",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124857164,"BANKETOV, ALEXANDER, DMITRY",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 67 , 151 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1124857164,"BANKETOV, ALEXANDER, DMITRY",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1124857164,"BANKETOV, ALEXANDER, DMITRY",104 SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1124859129,"MANNING, OKSANA, KOVALYOVA",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1124859129,"MANNING, OKSANA, KOVALYOVA",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124859129,"MANNING, OKSANA, KOVALYOVA",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124859129,"MANNING, OKSANA, KOVALYOVA",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1124859129,"MANNING, OKSANA, KOVALYOVA",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1124860408,"BRADFORD, ROBERT, ROLAND",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1235886870,ABOVE AND BEYOND WELLNESS MEDSPA,,505 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1124862677,"BILLUPS, HANNAH, JONELL",505 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124865209,"VIDAL, LEAH, MARIE",5 FIRST VILLAGE DRIVE   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 52 , 69 ,$#,,
MEDICAID DIRECT,1356802300,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - MOCKSVILLE,172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124865258,"PRILLAMAN, HANNAH, ROBERTSON",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 33 , 33 ," $10,570.89 ",,
MEDICAID DIRECT,1417525999,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE MOCKSVILLE,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124865258,"PRILLAMAN, HANNAH, ROBERTSON",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124868369,"MCCLANE, CAMERON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124873773,"WILEY, BRITTANY, SIMONE",303 GREEN ST E # A WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 108 , 108 ,$#,,
MEDICAID DIRECT,1124875117,A LOT OF LUV HOMECARE LLC,,6328 PENNACOOK DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1124875117,A LOT OF LUV HOMECARE LLC,6328 PENNACOOK DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 111 , 111 ,$#,,
MEDICAID DIRECT,1376899252,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF MCGEES CROSSROADS,70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124876016,"PEREZ, ELIZABETH, ESMERALDA",70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1992728950,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SALEMBURG,500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1124876016,"PEREZ, ELIZABETH, ESMERALDA",500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1124877733,"COCKERAM, CHLOE, BLAINE",501 N MAIN ST   SALISBURY NC,080,Rowan,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1124887716,UNLIMITED ACCESS HOME CARE AGENCY,,6674 PLAIN VIEW HWY   DUNN NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1124887716,UNLIMITED ACCESS HOME CARE AGENCY,6674 PLAIN VIEW HWY   DUNN NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,#, 691 , 691 ," $42,751.08 ",,
MEDICAID DIRECT,1275280513,HOMETOWN HEALTHCARE,,163 HWY 64 W WESTGATE PLAZA SUITE 4 HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,,1124889076,"WHITEFORD, KATI, SUZANNE",163 HWY 64 W STE 4 HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 31 ,$#,,
MEDICAID DIRECT,1932521630,COVENANT PEDIATRICS,,10806 MONROE RD STE A MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1124890454,"MURATORE, BRIELLE, MICKELA",10806 MONROE RD STE A MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 48 , 133 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124892153,"HILL, MELISSA, CHARLES",1135 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1124892153,"HILL, MELISSA, CHARLES",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124893771,"PEARCE, TRAVIS, JARROD AUSTIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1124893771,"PEARCE, TRAVIS, JARROD AUSTIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1134100779,"DAY, HEATHER, HILL",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1134100779,"DAY, HEATHER, HILL",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1134100779,"DAY, HEATHER, HILL",2424 CENTURY PL SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 110 , 115 , 134 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1134100779,"DAY, HEATHER, HILL",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,152W00000X,Eye and Vision Services Providers,Optometrist,, 18 , 21 , 25 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1134100779,"DAY, HEATHER, HILL",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,152W00000X,Eye and Vision Services Providers,Optometrist,, 42 , 43 , 45 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134101165,"FEHRING, THOMAS, KEITH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134101165,"FEHRING, THOMAS, KEITH",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134101165,"FEHRING, THOMAS, KEITH",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134102353,"ZIGLAR, SUSAN, KIMBERLY",25 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134102353,"ZIGLAR, SUSAN, KIMBERLY",812 W HAGGARD AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,812 W HAGGARD AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134102353,"ZIGLAR, SUSAN, KIMBERLY",812 W HAGGARD AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 35 , 57 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134102353,"ZIGLAR, SUSAN, KIMBERLY",812 W HAGGARD AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134102353,"ZIGLAR, SUSAN, KIMBERLY",131 MILLSTEAD DR   MEBANE NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 62 , 98 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134103468,"BROWN, KEVIN, RICHARD",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 70 , 127 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134104086,"SULLIVAN, TOBY, MICHAEL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 60 , 86 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134104086,"SULLIVAN, TOBY, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134104086,"SULLIVAN, TOBY, MICHAEL",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134104177,"MCMICHAEL, AMY, JO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 95 , 108 , 135 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134104227,"GILLILAND, J DAVID",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134104417,"MILLER, RACHEL, CEILANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 85 , 112 , 124 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134105216,"ROMBLAD, JASON, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 86 , 175 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134105216,"ROMBLAD, JASON, SCOTT",510 EMERGENCY DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134105307,"WELCH, CHERRIE, DAWN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 102 , 102 ," $17,391.98 ",,
MEDICAID DIRECT,1720546732,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,,,Unknown,251B00000X,Agencies,Case Management,,1134105406,"MATHEWS, JENNIFER, LEE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1134105406,"MATHEWS, JENNIFER, LEE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 29 , 42 ,$#,,
MEDICAID DIRECT,1134105406,"MATHEWS, JENNIFER, LEE",~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1134105406,"MATHEWS, JENNIFER, LEE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 32 , 38 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134105562,"KELLEY, ELIZABETH, ANN",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134105612,"RICE, JOHN, LANIER",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134106834,"MOHAN, MEENA, KUMARI",615 DOUGLAS ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 315 , 324 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1134107022,"HAQUE, IMRAN, PASHA",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134107022,"HAQUE, IMRAN, PASHA",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,," 1,430 "," 8,711 "," 12,003 "," $233,390.96 ",,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134107022,"HAQUE, IMRAN, PASHA",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 621 ," 6,329 "," 20,395 "," $107,784.06 ",,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,,,Unknown,193400000X,Group,Single Specialty,,1134107022,"HAQUE, IMRAN, PASHA",138 DUBLIN SQUARE RD STE B ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 45 , 45 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134107022,"HAQUE, IMRAN, PASHA",138 DUBLIN SQUARE RD STE B ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,," 1,000 "," 8,493 "," 8,787 "," $224,942.52 ",,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1134107022,"HAQUE, IMRAN, PASHA",138 DUBLIN SQUARE RD STE B ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134107022,"HAQUE, IMRAN, PASHA",138 DUBLIN SQUARE RD STE B ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,," 1,345 "," 6,171 "," 8,964 "," $178,463.03 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1134108426,"SINGLETON, BRIAN, ANTHONY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134108426,"SINGLETON, BRIAN, ANTHONY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1134109085,"WILKINS, THOMAS, LAWSON",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851710388,FHPG LLC,FIRSTHEALTH PRIMARY CARE - WHISPERING PINES,7473 B HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1134109085,"WILKINS, THOMAS, LAWSON",10 AVIEMORE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 64 , 102 ,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1134109085,"WILKINS, THOMAS, LAWSON",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1134109085,"WILKINS, THOMAS, LAWSON",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134109770,"DELLINGER, CHRISTOPHER, WAYNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134109770,"DELLINGER, CHRISTOPHER, WAYNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1326669508,WESTERN CAROLINA SEDATION ASSOCIATE,,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134109770,"DELLINGER, CHRISTOPHER, WAYNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134110562,"RASHLEY, ELIZABETH, WHITLEY FICKLING",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 78 , 164 , 428 ," $19,918.33 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134110562,"RASHLEY, ELIZABETH, WHITLEY FICKLING",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,105 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1134111289,"EMERSON, ERIC, TOMSON",105 DELTA PARK DR   SHELBY NC,023,Cleveland,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134111289,"EMERSON, ERIC, TOMSON",105 DELTA PARK DR   SHELBY NC,023,Cleveland,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 18 , 26 , 43 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134111289,"EMERSON, ERIC, TOMSON",959 COX RD   GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 36 , 55 , 97 ,$#,,
MEDICAID DIRECT,1558320895,FAMILY MEDICINE ASSOCIATES,,1531 N ASPEN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1134111719,"KIEFER, MARK, LEWIS",1531 N ASPEN ST   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 145 , 398 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,9 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134112436,"ALLEN, WILLIAM, PAUL",9 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 43 , 90 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134112436,"ALLEN, WILLIAM, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134113004,"PICO, AARON, GAETANO",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 66 , 88 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134113004,"PICO, AARON, GAETANO",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 328 , 606 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134113004,"PICO, AARON, GAETANO",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 118 , 179 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134113335,"MOORE, DANIEL, PAUL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 21 ,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,2402 S MIAMI BLVD STE 101 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134113871,"EVANS, REGINA, RAE",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134113871,"EVANS, REGINA, RAE",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134114341,"HOWARD, WILLIAM, STONE",~,5612 HIGHWAY 68   TURTLETOWN TN,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1134114341,"HOWARD, WILLIAM, STONE",5612 HIGHWAY 68   TURTLETOWN TN,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 182 , 375 ," 1,362 "," $70,791.83 ",,
MEDICAID DIRECT,1134114341,"HOWARD, WILLIAM, STONE",~,415 VETERANS MEMORIAL DR   TELLICO PLAINS TN,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1134114341,"HOWARD, WILLIAM, STONE",415 VETERANS MEMORIAL DR   TELLICO PLAINS TN,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 42 , 153 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134116437,"GOLEY, APRIL, LYNNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134116437,"GOLEY, APRIL, LYNNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 96 , 96 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134116437,"GOLEY, APRIL, LYNNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 59 , 59 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119605,"SYRACUSE, ROYCE, ROSARIO",185 JOE KNOX AVE   MOORESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119605,"SYRACUSE, ROYCE, ROSARIO",15419 HODGES CIR STE 100 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119605,"SYRACUSE, ROYCE, ROSARIO",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119605,"SYRACUSE, ROYCE, ROSARIO",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 41 , 58 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119787,"DAUGHERTY, STEPHEN, ANTHONY",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist, 45 , 49 , 70 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119787,"DAUGHERTY, STEPHEN, ANTHONY",11835 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119787,"DAUGHERTY, STEPHEN, ANTHONY",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119787,"DAUGHERTY, STEPHEN, ANTHONY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119787,"DAUGHERTY, STEPHEN, ANTHONY",10520 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134119787,"DAUGHERTY, STEPHEN, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134120306,"NITKA, JAMES, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1467449728,LEXINGTON FAMILY PHYSICIANS,LEXINGTON FAMILY PHYSICIANS PA,102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1134120413,"MORGAN, RUFFIN, SMITH",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 84 , 175 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1134120595,"KIMMEL, STEPHEN, WARNER",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1134120595,"KIMMEL, STEPHEN, WARNER",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1134120595,"KIMMEL, STEPHEN, WARNER",360 SUNSET AVE   ASHEBORO NC,076,Randolph,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 34 , 51 , 115 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1134120595,"KIMMEL, STEPHEN, WARNER",360 SUNSET AVE   ASHEBORO NC,076,Randolph,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 32 , 33 , 70 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134120660,"JONES, PERRY, EUGENE",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134120660,"JONES, PERRY, EUGENE",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134120660,"JONES, PERRY, EUGENE",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 47 , 49 ,$#,,
MEDICAID DIRECT,1134121015,"GERACI, MARIANNE, STEPHANIE",~,1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1134121015,"GERACI, MARIANNE, STEPHANIE",1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1134121015,"GERACI, MARIANNE, STEPHANIE",~,486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1134121015,"GERACI, MARIANNE, STEPHANIE",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1134121015,"GERACI, MARIANNE, STEPHANIE",1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1134121015,"GERACI, MARIANNE, STEPHANIE",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1134121015,"GERACI, MARIANNE, STEPHANIE",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1134121015,"GERACI, MARIANNE, STEPHANIE",~,137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1134121015,"GERACI, MARIANNE, STEPHANIE",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1134121015,"GERACI, MARIANNE, STEPHANIE",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 134 , 162 , 200 ,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1134121015,"GERACI, MARIANNE, STEPHANIE",1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1881095784,REGINALD CENTER OF TURN AROUND,,124 S MEBANE ST STE A BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134121221,"WILSON, LARRY, TERRELL",709 E MARKET ST STE 100B GREENSBORO NC,041,Guilford,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine, 39 , 745 ," 1,404 "," $189,712.28 ",,
MEDICAID DIRECT,1013971308,WOMENS WELLNESS CENTER PA,Womens Wellness Center PA,2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134122385,"MEEKS, ROBERT, EARL",2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 41 , 53 ,$#,,
MEDICAID DIRECT,1033935853,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE ELITECARE,3622 N MAIN ST   HOPE MILLS NC,026,Cumberland,193400000X,Group,Single Specialty,,1134122500,"RAY, JOHN, MAKE",3625 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295583797,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE PINNACLE,3625 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1134122500,"RAY, JOHN, MAKE",3625 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 56 , 112 ,$#,,
MEDICAID DIRECT,1114116076,PINNACLE FAMILY CARE PLLC,~,3625 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1134122500,"RAY, JOHN, MAKE",3625 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 20 , 32 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1134124860,"SOLTIS, CRAIG, ALLAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1134124860,"SOLTIS, CRAIG, ALLAN",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 32 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134125503,"HAMSTEAD, STEVEN, LYNN",3681 N MAIN ST   FARMVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 311 , 561 ," $12,112.15 ",,
MEDICAID DIRECT,1134125818,"CHOWDHURY, SAEEDA, ZAMAN",,65 INTERNATIONAL DR   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1134125818,"CHOWDHURY, SAEEDA, ZAMAN",65 INTERNATIONAL DR   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134126493,HANGER PROSTHETICS & ORTHOTICS EAST,~,350 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134126493,HANGER PROSTHETICS & ORTHOTICS EAST,350 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 51 , 62 , 303 ," $61,500.36 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134127905,"TURNER, ELIZABETH, JAYNES",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134127905,"TURNER, ELIZABETH, JAYNES",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1134127905,"TURNER, ELIZABETH, JAYNES",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1134128028,"JOHNSON, RONALD, WAYNE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 56 , 87 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1134128028,"JOHNSON, RONALD, WAYNE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1821545633,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD SPINE CENTER,800 E CHEVES ST STE 480-B FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134129216,"EDWARDS JR, WILLIE, STANLEY",800 E CHEVES ST STE 480-B FLORENCE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1093779951,EYE SURGERY AND LASER CLINIC INC,EYE SURGERY AND LASER CLINIC INC,500 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1134129513,"HARPER, DAVID, KEITH",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134129513,"HARPER, DAVID, KEITH",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 23 , 30 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134130925,"KORNBLUTH, CRAIG, MARC",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1134131584,"TYNDALL, ALICIA, HOPE",14 DOCTORS CIR STE 3 SUPPLY NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1134131584,"TYNDALL, ALICIA, HOPE",14 DOCTORS CIR STE 3 SUPPLY NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750420428,SHORE FUN PEDIATRICS,~,14 DOCTORS CIR STE 3 SUPPLY NC,010,Brunswick,193400000X,Group,Single Specialty,,1134131584,"TYNDALL, ALICIA, HOPE",14 DOCTORS CIR STE 3 SUPPLY NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 70 , 162 ,$#,,
MEDICAID DIRECT,1134135213,MORGANTON EYE PHYSICIANS PA,,335 E PARKER RD   MORGANTON NC,012,Burke,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1134135213,MORGANTON EYE PHYSICIANS PA,335 E PARKER RD   MORGANTON NC,012,Burke,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 146 , 213 , 226 ," $47,513.39 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134137052,"REIDENBACH, ADAM, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134137052,"REIDENBACH, ADAM, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134137052,"REIDENBACH, ADAM, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134138118,"BRONOLD, MELODY, ALGER",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134138506,"LASZLO, RENEE, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 25 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134138506,"LASZLO, RENEE, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134138753,"BOWERS, JAMES, RONALD",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134138753,"BOWERS, JAMES, RONALD",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 89 , 145 , 283 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134138753,"BOWERS, JAMES, RONALD",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 42 , 53 , 117 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134139595,"HERR, MARC, WILLIAM",624 QUAKER LN STE 208C HIGH POINT NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 67 , 101 , 130 ,$#,,
MEDICAID DIRECT,1407277536,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134142433,"KENDALL, MICHAEL, WILLIAM",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1134142433,"KENDALL, MICHAEL, WILLIAM",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134142433,"KENDALL, MICHAEL, WILLIAM",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1134142433,"KENDALL, MICHAEL, WILLIAM",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134143530,"AZIZ, KHALID",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 83 , 162 , 424 ,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134143530,"AZIZ, KHALID",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356440663,PIEDMONT COSMETIC SURGERY AND DERMA,~,765 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134143605,"SPENCER, DAVID, MCCAUGHEY",765 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 14 , 30 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1134144520,"HAYS, EDWARD, PARKER",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 14 , 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134144520,"HAYS, EDWARD, PARKER",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134144637,"KIHLSTROM, LAURA, JILL",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134144637,"KIHLSTROM, LAURA, JILL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134144637,"KIHLSTROM, LAURA, JILL",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1134146301,WAL-MART STORES EAST LP,~,2114 S MAIN ST   WAKE FOREST NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1134146301,WAL-MART STORES EAST LP,2114 S MAIN ST   WAKE FOREST NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1134146392,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1579,1015 LEWIS ST   OXFORD NC,039,Granville,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1134146392,WAL-MART STORES EAST LP,1015 LEWIS ST   OXFORD NC,039,Granville,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134147796,"PATEL, DIVYANG, RAMBHAI",805 TILGHMAN DR STE B DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 61 , 67 , 84 ,$#,,
MEDICAID DIRECT,1275354615,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY HEART AND VASCULAR,225 BRIGHTWATER DR STE 220 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134147796,"PATEL, DIVYANG, RAMBHAI",100 S 10TH ST   LILLINGTON NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134147796,"PATEL, DIVYANG, RAMBHAI",100 S 10TH ST   LILLINGTON NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 26 , 33 , 44 ,$#,,
MEDICAID DIRECT,1275354615,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY HEART AND VASCULAR,225 BRIGHTWATER DR STE 220 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134147796,"PATEL, DIVYANG, RAMBHAI",805 TILGHMAN DR STE B DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 16 , 20 , 22 ,$#,,
MEDICAID DIRECT,1518063064,FAYETTEVILLE HEART CENTER PC,FAYETTEVILLE HEART CENTER,2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134147796,"PATEL, DIVYANG, RAMBHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 61 , 75 , 94 ,$#,,
MEDICAID DIRECT,1518063064,FAYETTEVILLE HEART CENTER PC,FAYETTEVILLE HEART CENTER,2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134147796,"PATEL, DIVYANG, RAMBHAI",2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 557 ," 1,084 "," 1,492 "," $39,745.07 ",,
MEDICAID DIRECT,1518063064,FAYETTEVILLE HEART CENTER PC,FAYETTEVILLE HEART CENTER,2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134147796,"PATEL, DIVYANG, RAMBHAI",2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134148646,"STELLA, MICHAEL",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 27 , 36 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134148646,"STELLA, MICHAEL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134148646,"STELLA, MICHAEL",7921 ACC BLVD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1134150345,"BAZINET, SUSAN, ELIZABETH",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 20 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1134150345,"BAZINET, SUSAN, ELIZABETH",135 PAGE RD N   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 97 , 164 ,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134151723,"GESSNER, RICHARD, RYAN",10208 CERNY ST STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134151723,"GESSNER, RICHARD, RYAN",3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134151814,"GOLWYN, DANIEL, HOWARD",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134151814,"GOLWYN, DANIEL, HOWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 88 , 88 , 113 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134151814,"GOLWYN, DANIEL, HOWARD",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1609101666,PIEDMONT GYNECOLOGICAL AND OBSTERIC,PIEDMONT GYNECOLOGICAL AND OBSTETRICAL ASSOCIATES,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134151921,"REVELL, WILLIAM",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134152002,"GWINN, MICHAEL, DALE",10 AVIEMORE DR   PINEHURST NC,063,Moore,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 30 , 55 , 123 ," $12,459.57 ",,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134152002,"GWINN, MICHAEL, DALE",10 AVIEMORE DR   PINEHURST NC,063,Moore,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 48 , 48 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134152002,"GWINN, MICHAEL, DALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 28 , 66 , 74 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134152002,"GWINN, MICHAEL, DALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 22 , 56 , 73 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1134152168,"SPELL, NATHAN, O'NEAL",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134152168,"SPELL, NATHAN, O'NEAL",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134152333,"DUCKETT, RALPH, HOWARD",401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1538276100,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1134152333,"DUCKETT, RALPH, HOWARD",401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 74 , 159 , 207 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134153067,"ONEIL, KEVIN, MICHEAL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 69 , 140 , 161 ," $11,931.88 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134153067,"ONEIL, KEVIN, MICHEAL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134153067,"ONEIL, KEVIN, MICHEAL",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134153067,"ONEIL, KEVIN, MICHEAL",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134153067,"ONEIL, KEVIN, MICHEAL",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 58 , 64 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134153067,"ONEIL, KEVIN, MICHEAL",1227 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134154123,"RUSHER, JOHN, WALLIS",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134154198,"MATTHEW, MATTHEW, THOMAS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134154198,"MATTHEW, MATTHEW, THOMAS",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134154198,"MATTHEW, MATTHEW, THOMAS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1134154370,G AND J BREWER LLC,RIGHT AT HOME,3314 HEALY DR STE 105 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1134154370,G AND J BREWER LLC,3314 HEALY DR STE 105 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 680 , 709 ," $49,887.79 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134157654,"LEE, PATTI, HOOKS",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 53 , 53 ,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134158280,"MEARES, BEN, MILLER",3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134158280,"MEARES, BEN, MILLER",10208 CERNY ST STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 23 ,$#,,
MEDICAID DIRECT,1124309463,ROCKINGHAM MEDICAL CLINIC PC,~,101 E MATTHEWS ST STE 400 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134161714,"CAMARGO, JOHNNY, EDGAR",101 E MATTHEWS ST STE 400 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 31 ,$#,,
MEDICAID DIRECT,1801945571,WILMINGTON ENDOCRINOLOGY PA,Wilmington Endocrinology PA,1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134162464,"AZIZI, GHOBAD",1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 17 , 18 , 34 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134162654,"ROBERTS, JANE, BLAIR",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134162654,"ROBERTS, JANE, BLAIR",200 W WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134163553,"ROSE, RICHARD, HARLOWE",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1831501261,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE UROLOGY,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1134163553,"ROSE, RICHARD, HARLOWE",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208800000X,Allopathic & Osteopathic Physicians,Urology,, 100 , 193 , 222 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1134164239,"GLEASON, THOMAS, GILLETTE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 37 , 62 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1134164239,"GLEASON, THOMAS, GILLETTE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 44 , 81 ," $32,338.58 ",,
MEDICAID DIRECT,1225449168,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KNIGHTDALE,901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1134164304,"SOBOEIRO, MICHAEL, FRANCIS",901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134164304,"SOBOEIRO, MICHAEL, FRANCIS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134164304,"SOBOEIRO, MICHAEL, FRANCIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 109 , 111 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134164502,"DRAVLAND, JONAS, ERIC",906 COLLEGE AVE SW STE C LENOIR NC,014,Caldwell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1437337136,OPTOMETRIC EYE SITE,,200 N COOPER DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1134166986,"COWARD, DAVID, JAMES",200 N COOPER DR   HENDERSON NC,091,Vance,152W00000X,Eye and Vision Services Providers,Optometrist,, 92 , 120 , 212 ,$#,,
MEDICAID DIRECT,1134170715,"COOPER, NATALIE",~,245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1134170715,"COOPER, NATALIE",245 WINKLERS CREEK RD UNIT B BOONE NC,095,Watauga,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",928 BAXTER ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 26 , 26 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 26 , 35 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134171382,"GRITTER, NANCY, JO",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 21 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134172372,"WOOD, MARK, LYNDON",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 16 , 29 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134172372,"WOOD, MARK, LYNDON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134172372,"WOOD, MARK, LYNDON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134172372,"WOOD, MARK, LYNDON",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134172372,"WOOD, MARK, LYNDON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1134172372,"WOOD, MARK, LYNDON",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134172372,"WOOD, MARK, LYNDON",505 OBERLIN RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134172554,"PITZALIS, MARIAVITTORIA",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134172554,"PITZALIS, MARIAVITTORIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 421 , 606 , 672 ," $11,790.18 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134172554,"PITZALIS, MARIAVITTORIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 32 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134172554,"PITZALIS, MARIAVITTORIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1134172554,"PITZALIS, MARIAVITTORIA",~,115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1134172554,"PITZALIS, MARIAVITTORIA",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134172554,"PITZALIS, MARIAVITTORIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 39 , 39 ,$#,,
MEDICAID DIRECT,1053340109,SPANGLER LAMBERT AND LIPP DDS PLLC,SPANGLER LAMBERT & LIPP DDS PLLC,900 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1134172729,"SPANGLER, GINA, SHROPSHIRE",900 OLD WINSTON RD STE 210 KERNERSVILLE NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 11 , 17 , 61 ,$#,,
MEDICAID DIRECT,1053340109,SPANGLER LAMBERT AND LIPP DDS PLLC,SPANGLER LAMBERT & LIPP DDS PLLC,1544 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134172729,"SPANGLER, GINA, SHROPSHIRE",1544 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 39 , 63 , 225 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134172851,"MALINDA, PAUL, FRANCIS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 44 , 72 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134172851,"MALINDA, PAUL, FRANCIS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134172851,"MALINDA, PAUL, FRANCIS",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 25 , 35 ,$#,,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134173123,"GARCIA, FLORENCIO",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,429 COMMONWEALTH BLVD E   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134173123,"GARCIA, FLORENCIO",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 12 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134173347,"GARRELL, ROBIN, FELICE",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 53 , 53 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134173933,"GIBBONS, JOSEPH, GERALD",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 101 , 250 , 250 ,$#,,
MEDICAID DIRECT,1144524190,SOUTH CHARLOTTE GENERAL AND VASCULA,SOUTH CHARLOTTE GENERAL AND VASCULAR SURGERY PLLC,10512 PARK RD STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134174436,"ANTEZANA, JAMES, NELSON",13430 HOOVER CREEK BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144524190,SOUTH CHARLOTTE GENERAL AND VASCULA,SOUTH CHARLOTTE GENERAL AND VASCULAR SURGERY PLLC,13430 HOOVER CREEK BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134174436,"ANTEZANA, JAMES, NELSON",13430 HOOVER CREEK BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 176 , 318 ," $22,070.79 ",,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1134175128,"ALMOND, CHARLES, MALCOLM",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",1285 W A ST   KANNAPOLIS NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",1212 E SUNSET DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",215 LASH DR   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 98 , 162 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",311 W PHIFER ST   MARSHVILLE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 176 , 223 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",4801 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 52 , 107 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",6001 WILORA LAKE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 50 , 88 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",2700 ROYAL COMMONS LN   MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 292 , 481 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",10011 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 95 , 128 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",4009 CRAIG AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 82 , 133 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",3800 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",430 BROOKWOOD AVE NE   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134175227,"REED KILLOREN, VIRGINIA, ELIZABETH",4414 WILKINSON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134176019,"ROUGIER-CHAPMAN, DUNCAN, PETER",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 308 , 343 , 393 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134176019,"ROUGIER-CHAPMAN, DUNCAN, PETER",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 117 , 118 , 165 ,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134177033,"KNIGHT, VALERIE, DENISE",420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 56 , 98 ,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134177033,"KNIGHT, VALERIE, DENISE",204 EARNHART DR   EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134177751,"WELCH, STEVEN, THOMAS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134177751,"WELCH, STEVEN, THOMAS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134177751,"WELCH, STEVEN, THOMAS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 163 , 194 , 239 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134177959,"TRIOZZI, PIERRE, LORENZO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 20 , 68 , 69 ,$#,,
MEDICAID DIRECT,1134179161,EASTERN BAND OF CHEROKEE INDIANS,CHEROKEE TRIBAL EMS,969 ACQUONI RD   CHEROKEE NC,087,Swain,3416L0300X,Transportation Services,Ambulance,Land Transport,1134179161,EASTERN BAND OF CHEROKEE INDIANS,969 ACQUONI RD   CHEROKEE NC,087,Swain,3416L0300X,Transportation Services,Ambulance,Land Transport, 499 , 878 ," 1,583 "," $97,943.63 ",,
MEDICAID DIRECT,1760669709,R COHEN DDS AND ASSOCIATES PA,R COHEN DDS AND ASSOCIATES PA,2482 WONDER DR   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134181035,"SONCEAU, JACQUELINE, BRUNETTE",2482 WONDER DR   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 41 ,$#,,
MEDICAID DIRECT,1841965738,JACQUELINE SONCEAU,GREAT SMILES 4 YOU,1610 VAUGHN RD STE J BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1134181035,"SONCEAU, JACQUELINE, BRUNETTE",2482 WONDER DR   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 34 , 36 , 116 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134181118,"GUTHMANN, HOWARD, MILTON",311 CODDLE MARKET DR NW STE 100 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134181118,"GUTHMANN, HOWARD, MILTON",3614 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1134181191,"ARKO, FRANK, ROBERT",111 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 38 , 45 , 73 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134181191,"ARKO, FRANK, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 11 , 33 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134181191,"ARKO, FRANK, ROBERT",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134181191,"ARKO, FRANK, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1134181191,"ARKO, FRANK, ROBERT",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134181191,"ARKO, FRANK, ROBERT",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 53 , 63 , 89 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134181225,"FOREHAND, MARY, LEIGH",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 40 , 60 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1134181225,"FOREHAND, MARY, LEIGH",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134181225,"FOREHAND, MARY, LEIGH",16747 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1134182207,MMI HOLDINGS LLC,MEDICAL MODALITIES,325 MCGILL AVE NW STE 195 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134182207,MMI HOLDINGS LLC,325 MCGILL AVE NW STE 195 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 206 , 918 ," 1,122 "," $521,891.32 ",,
MEDICAID DIRECT,1134182207,MMI HOLDINGS LLC,MEDICAL MODALITIES,325 MCGILL AVE NW STE 195 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134182207,MMI HOLDINGS LLC,325 MCGILL AVE NW STE 195 CONCORD NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134182413,"JARRETT, WILLIAM, ANDREW",304 10TH AVE NE   HICKORY NC,018,Catawba,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 106 , 169 , 217 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 31 , 38 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 36 , 42 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134182736,"SWIERSZ, PAUL, JOSEPH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134185291,"RUEDA, LUIS, JAIME",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1134189251,"WAGNER, JOANNE, ESTELLE",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 56 , 116 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,116 E HORTON ST   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1134189251,"WAGNER, JOANNE, ESTELLE",116 E HORTON ST   ZEBULON NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164719415,PIONEER HEALTH SERVICES OF STOKES C,PIONEER COMMUNITY HOSPITAL OF STOKES,,,Unknown,193200000X,Group,Multi-Specialty,,1134189517,"HARRIS, MARK, HAMPTON",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1841733714,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE COMMUNITY HOSPITAL OF STOKES,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1134189517,"HARRIS, MARK, HAMPTON",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 53 , 82 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134190622,"OBRIEN, SEAN, PATRICK",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134191273,"HARRIS, CHARLES, WALKER",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 17 , 28 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134191273,"HARRIS, CHARLES, WALKER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 21 , 21 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134191273,"HARRIS, CHARLES, WALKER",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134191273,"HARRIS, CHARLES, WALKER",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134191273,"HARRIS, CHARLES, WALKER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 41 , 46 , 73 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134191273,"HARRIS, CHARLES, WALKER",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 27 , 43 ,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134191380,"HIX, MARK, TIMOTHY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1134193113,"MCCANN, VINETTA, MARIE",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 74 , 83 ,$#,,
MEDICAID DIRECT,1639697790,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,193400000X,Group,Single Specialty,,1134196009,"SHERRILL, STEPHANIE, BUNDY",2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 39 , 66 ,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1134196009,"SHERRILL, STEPHANIE, BUNDY",3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134197338,"KOTOFF, SUSAN, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 71 , 71 , 71 ," $12,293.75 ",,
MEDICAID DIRECT,1558459602,PIEDMONT ENDOCRINOLOGY PA,PIEDMONT ENDOCRINOLOGY PA,311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1134198740,"DONEPUDI, VENKATARAMA, SEKHER",311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 67 , 115 , 246 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134199383,"STOLLDORF, HUNTER, SCOTT",185 JOE KNOX AVE   MOORESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134199383,"STOLLDORF, HUNTER, SCOTT",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 24 , 24 , 31 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134199383,"STOLLDORF, HUNTER, SCOTT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 20 , 20 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134199813,"MERRITT, DEBRA, ROSE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1134199813,"MERRITT, DEBRA, ROSE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083684898,ELKIN PEDIATRIC AND ADULT MEDICINE,ELKIN PEDIATRIC AND ADULT MEDICINE PA,124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1134199938,"SPAGNOLETTI, ALLISON, MERCHANT",124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 35 , 75 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134201296,"RAHN, KARYN, WESTON",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1713 S CHURCH ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134201296,"RAHN, KARYN, WESTON",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134201296,"RAHN, KARYN, WESTON",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134201387,COMPASSION HEALTH CARE INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1134201684,"AGUIRRE, LORI, LERAE",,3360 JAECKLE DR STE 120 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1134201684,"AGUIRRE, LORI, LERAE",3360 JAECKLE DR STE 120 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538836655,PEDRAM MALEK DDS PA,ELAN DENTAL,310A S MAIN ST   ROLESVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1134202302,"MALEK, PEDRAM",7100 SIX FORKS RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 26 , 57 ,$#,,
MEDICAID DIRECT,1538836655,PEDRAM MALEK DDS PA,ELAN DENTAL,310A S MAIN ST   ROLESVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1134202302,"MALEK, PEDRAM",310 S MAIN ST STE A ROLESVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134202393,"GARST, JENNIFER, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134203011,"WOODWARD, JULIE, ANN",S TRENT DR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 15 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203011,"WOODWARD, JULIE, ANN",S TRENT DR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203011,"WOODWARD, JULIE, ANN",S TRENT DR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203029,"MESSERSMITH, JAMES, EDWARD",3609 SW DURHAM DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203029,"MESSERSMITH, JAMES, EDWARD",3609 SW DURHAM DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 58 , 119 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203094,"SHAH, SVATI, HASMUKH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203094,"SHAH, SVATI, HASMUKH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 23 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203094,"SHAH, SVATI, HASMUKH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 45 , 49 , 107 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134203094,"SHAH, SVATI, HASMUKH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134204464,"PHELPS, ANNE, FRANCES",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912054974,ANDREW J HUTCHINSON DO PA,~,711 N FRANKLIN ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1134206816,"HUTCHINSON, ANDREW, JOHN",711 N FRANKLIN ST   WHITEVILLE NC,024,Columbus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 272 , 722 , 839 ," $17,831.70 ",,
MEDICAID DIRECT,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL OF DANBURY,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1134208994,"KAPLAN, DAVID, MANN",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1346775285,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL & URGENT CARE OF PINE HAL,3853 US 311 HWY N   PINE HALL NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134208994,"KAPLAN, DAVID, MANN",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 275 , 282 ," $12,761.04 ",,
MEDICAID DIRECT,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL OF DANBURY,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134208994,"KAPLAN, DAVID, MANN",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346775285,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL & URGENT CARE OF PINE HAL,3853 US 311 HWY N   PINE HALL NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134208994,"KAPLAN, DAVID, MANN",3801 W MARKET ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134209117,"HIESTAND, BRIAN, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 41 , 46 ,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1134209398,"PHILLIPS, DOUGLAS, ANTHONY",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1134209398,"PHILLIPS, DOUGLAS, ANTHONY",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 102 , 108 , 108 ,$#,,
MEDICAID DIRECT,1467921023,HESTER OPHTHALMOLOGY PC,,1604 PHYSICIANS DR STE 103 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134210586,"HESTER, DARRELL, ERNEST",1604 PHYSICIANS DR STE 103 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 88 , 176 , 224 ," $10,623.71 ",,
MEDICAID DIRECT,1467921023,HESTER OPHTHALMOLOGY PC,,1604 PHYSICIANS DR STE 103 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134210586,"HESTER, DARRELL, ERNEST",409 E BROAD ST   ELIZABETHTOWN NC,009,Bladen,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,2402 S MIAMI BLVD STE 101 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134211881,"RUNKLE, ANDREW, WILLIAM",2402 S MIAMI BLVD STE 101 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,2402 S MIAMI BLVD STE 101 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134211881,"RUNKLE, ANDREW, WILLIAM",3711 UNIVERSITY DR STE B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134211881,"RUNKLE, ANDREW, WILLIAM",3711 UNIVERSITY DR STE B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134211881,"RUNKLE, ANDREW, WILLIAM",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134212244,"GRIGGS, RICHARD, CHARLEY",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 32 , 37 ,$#,,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1134213283,"BELL, KETURAH, CHESBROUGH",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134213283,"BELL, KETURAH, CHESBROUGH",708 MCBRAYER HOMESTEAD RD   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1679915615,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,708 MCBRAYER HOMESTEAD RD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1134213283,"BELL, KETURAH, CHESBROUGH",708 MCBRAYER HOMESTEAD RD   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 113 , 151 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134213630,"HINSON, JOAN, BALDWIN",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 53 , 53 ,$#,,
MEDICAID DIRECT,1134215957,"KRISHINGNER, JOHN, ANTHONY",,123 E MAIN ST STE 300 BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice,1134215957,"KRISHINGNER, JOHN, ANTHONY",123 E MAIN ST STE 300 BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205997053,DRS KRISHINGNER ROOT & ASSOCIATE PL,~,123 E MAIN ST STE 300 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1134215957,"KRISHINGNER, JOHN, ANTHONY",123 E MAIN ST STE 300 BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 213 , 297 , 851 ," $40,347.28 ",,
MEDICAID DIRECT,1205997053,DRS KRISHINGNER ROOT & ASSOCIATE PL,~,344 GALLIMORE RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1134215957,"KRISHINGNER, JOHN, ANTHONY",123 E MAIN ST STE 300 BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 237 , 360 , 956 ," $46,373.42 ",,
MEDICAID DIRECT,1346387883,COUNTY OF MOORE,MOORE COUNTY HEALTH DEPARTMENT,705 PINEHURST AVE   CARTHAGE NC,063,Moore,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1134217086,"CASTANO, LOURDES, MARIA",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134217086,"CASTANO, LOURDES, MARIA",145 APPLECROSS RD   PINEHURST NC,063,Moore,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 19 , 20 , 33 ,$#,,
MEDICAID DIRECT,1346387883,COUNTY OF MOORE,MOORE COUNTY HEALTH DEPARTMENT,705 PINEHURST AVE   CARTHAGE NC,063,Moore,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1134217086,"CASTANO, LOURDES, MARIA",705 PINEHURST AVE   CARTHAGE NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 44 , 150 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134217664,"COHEN, EMILY, AHYUN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134217664,"COHEN, EMILY, AHYUN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134217664,"COHEN, EMILY, AHYUN",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760797773,THOMAS J ROJY JR MD PA,~,43 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1134217839,"ROJY, THOMAS, JOSEPH",43 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134222573,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03973,1630 BENVENUE RD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134222573,NORTH CAROLINA CVS PHARMACY LLC,1630 BENVENUE RD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1134222995,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03864,3100 LEGION RD   HOPE MILLS NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134222995,NORTH CAROLINA CVS PHARMACY LLC,3100 LEGION RD   HOPE MILLS NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1134223571,"DOSS, BRIAN, WESLEY",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134223571,"DOSS, BRIAN, WESLEY",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134223571,"DOSS, BRIAN, WESLEY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134225246,"MILLER, MONICA, CHHEDA",14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1326078072,PROVIDENCE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS PROVIDENCE PEDIATR,14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134225246,"MILLER, MONICA, CHHEDA",14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1134227465,ABLE HOME HEALTH CARE LLC,~,1078 NC HIGHWAY 48   ROANOKE RAPIDS NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,,1134227465,ABLE HOME HEALTH CARE LLC,1078 NC HIGHWAY 48   ROANOKE RAPIDS NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,, 76 ," 14,906 "," 15,218 "," $1,337,990.20 ",,
MEDICAID DIRECT,1134228265,"DOUGHERTY, MICHAEL, JAMES",~,200 PATEWOOD DR   GREENVILLE SC,101,Out of State <= 40 miles,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,1134228265,"DOUGHERTY, MICHAEL, JAMES",200 PATEWOOD DR   GREENVILLE SC,101,Out of State <= 40 miles,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134229230,"POTEAT, TONIA, COLETTE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 26 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134229230,"POTEAT, TONIA, COLETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,502 MCKNIGHT DR STE 103 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,502 MCKNIGHT DR STE 103 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,#, 35 , 89 ,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#,#, 24 ,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8838 US HIGHWAY 70 W STE 300 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,8838 US HIGHWAY 70 W STE 300 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,#, 13 , 34 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134230527,"RIKARD, BRENDA SUE, JOYNER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 13 , 16 ,$#,,
MEDICAID DIRECT,1437795465,WAKE FOREST UNIVERSITY HEALTH SCIEN,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134230741,"MESSURA, JUDITH, KAYE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 37 , 171 ,$#,,
MEDICAID DIRECT,1437795465,WAKE FOREST UNIVERSITY HEALTH SCIEN,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134230741,"MESSURA, JUDITH, KAYE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 732 ," 1,068 "," 4,571 "," $230,005.49 ",,
MEDICAID DIRECT,1760417570,WAYNESBORO FAMILY CLINIC PA,WAYNESBORO FAMILY CLINIC PA,1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1134230857,"SRIRAMAN, VELLORE, RAMASWAMY",1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 52 , 73 , 288 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134230956,"CHEN, HSIUPEI",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 26 , 29 , 37 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1134230956,"CHEN, HSIUPEI",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134230956,"CHEN, HSIUPEI",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134230956,"CHEN, HSIUPEI",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 23 , 38 , 54 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134230956,"CHEN, HSIUPEI",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134230956,"CHEN, HSIUPEI",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1194966903,FIRST PEDIATRIC CARE CENTER PA,FIRST PEDIATRIC CARE CENTER PA,2644 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134233034,"LUBEGA, MARGARET",2644 COURT DR   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 125 , 239 , 794 ," $26,185.57 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134233224,"ABBRUZZESE, JAMES, LEWIS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134233224,"ABBRUZZESE, JAMES, LEWIS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134234958,"SHELTON, DOYLE, LYN",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134234958,"SHELTON, DOYLE, LYN",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1730472671,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MEDICAL GROUP NEUROLOGY,2209 S STERLING ST STE 330 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",2209 S STERLING ST STE 330 MORGANTON NC,012,Burke,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 47 , 61 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134235138,"LAROCHE, SUZETTE, MARIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 31 , 46 , 46 ,$#,,
MEDICAID DIRECT,1104154988,CAROLINA MERCY MEDICAL CLINIC,CAROLINA MERCY MEDICAL CLINIC,2101 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134235369,"OKONKWO, CORNELIUS, SUNDAY",917 N LAFAYETTE ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134235369,"OKONKWO, CORNELIUS, SUNDAY",~,2101 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1134235369,"OKONKWO, CORNELIUS, SUNDAY",2101 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 48 , 48 ,$#,,
MEDICAID DIRECT,1104154988,CAROLINA MERCY MEDICAL CLINIC,CAROLINA MERCY MEDICAL CLINIC,2101 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134235369,"OKONKWO, CORNELIUS, SUNDAY",2101 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 62 , 66 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134236508,"LE, FRANCIS, KIET",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134236508,"LE, FRANCIS, KIET",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134237878,"ZIEZIULA, JEFFREY, FRANK",4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 5,310 "," 7,082 "," 31,728 "," $825,024.47 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134238371,"MCNABB, DANIEL, MARK",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134240682,"ELHAIMER, AHMED",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 66 , 73 , 74 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 26 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 417 , 487 , 579 ," $12,004.34 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134241474,"YEBOAH, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 12 , 15 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134243645,"DEPAULIS, ANNA, INGEBORG",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 227 , 227 ," $10,735.26 ",,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134245343,"MARTIN WATSON, BETTY, LOUISE",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134245343,"MARTIN WATSON, BETTY, LOUISE",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134245343,"MARTIN WATSON, BETTY, LOUISE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134245343,"MARTIN WATSON, BETTY, LOUISE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134245343,"MARTIN WATSON, BETTY, LOUISE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134245343,"MARTIN WATSON, BETTY, LOUISE",3610 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134249501,"ARTHUR, GODFRIED, ANTWI",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 69 , 139 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1134249501,"ARTHUR, GODFRIED, ANTWI",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 120 , 317 , 816 ," $11,008.45 ",,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1134249501,"ARTHUR, GODFRIED, ANTWI",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 20 , 28 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1134250707,"THOMAS, MEGAN, RAY",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 42 , 99 ,$#,,
MEDICAID DIRECT,1134252018,CAROLINAEAST HEALTH SYSTEM AUXILIAR,CAROLINAEAST HEALTH SYSTEM AUXILIARY,2000 NEUSE BLVD   NEW BERN NC,025,Craven,333300000X,Suppliers,Emergency Response System Companies,,1134252018,CAROLINAEAST HEALTH SYSTEM AUXILIAR,2000 NEUSE BLVD   NEW BERN NC,025,Craven,333300000X,Suppliers,Emergency Response System Companies,, 106 ," 1,045 "," 1,045 "," $32,505.02 ",,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1134256134,"PAITSEL, BRIAN, WAYNE",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134257199,"LAGUERRE, JACQUES, PHILIPPE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134257199,"LAGUERRE, JACQUES, PHILIPPE",1995 WELLNESS BLVD STE 110 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134257199,"LAGUERRE, JACQUES, PHILIPPE",1995 WELLNESS BLVD   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 37 , 80 ,$#,,
MEDICAID DIRECT,1134257785,COUNTY OF CATAWBA OFFICE OF ACCOUNT,CATAWBA COUNTY SOCIAL SERVICES,3030 11TH AVENUE DR SE   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1134257785,COUNTY OF CATAWBA OFFICE OF ACCOUNT,3030 11TH AVENUE DR SE   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 20 , 22 , 22 ," $53,646.19 ",,
MEDICAID DIRECT,1134257785,COUNTY OF CATAWBA OFFICE OF ACCOUNT,CATAWBA COUNTY SOCIAL SERVICES,3030 11TH AVENUE DR SE   HICKORY NC,018,Catawba,332U00000X,Suppliers,Home Delivered Meals,,1134257785,COUNTY OF CATAWBA OFFICE OF ACCOUNT,3030 11TH AVENUE DR SE   HICKORY NC,018,Catawba,332U00000X,Suppliers,Home Delivered Meals,, 24 ," 2,618 "," 2,618 "," $21,584.51 ",,
MEDICAID DIRECT,1134257785,COUNTY OF CATAWBA OFFICE OF ACCOUNT,CATAWBA COUNTY SOCIAL SERVICES,3030 11TH AVENUE DR SE   HICKORY NC,018,Catawba,251B00000X,Agencies,Case Management,,1134257785,COUNTY OF CATAWBA OFFICE OF ACCOUNT,3030 11TH AVENUE DR SE   HICKORY NC,018,Catawba,251B00000X,Agencies,Case Management,, 159 ," 1,717 "," 1,717 "," $646,818.00 ",,
MEDICAID DIRECT,1134260649,EASTERN BAND OF CHEROKEE INDIANS,CHEROKEE HOME HEALTH SERVICES,73 KAISER WILNOTY DR   CHEROKEE NC,087,Swain,253Z00000X,Agencies,In Home Supportive Care,,1134260649,EASTERN BAND OF CHEROKEE INDIANS,73 KAISER WILNOTY DR   CHEROKEE NC,087,Swain,253Z00000X,Agencies,In Home Supportive Care,,#, 494 , 494 ," $36,859.82 ",,
MEDICAID DIRECT,1134260649,EASTERN BAND OF CHEROKEE INDIANS,CHEROKEE HOME HEALTH SERVICES,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1134260649,EASTERN BAND OF CHEROKEE INDIANS,73 KAISER WILNOTY RD   CHEROKEE NC,087,Swain,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134262389,"SHAFER, VERONICA, INEZ",3719 UNION RD   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134262389,"SHAFER, VERONICA, INEZ",2675 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 26 , 86 , 157 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134262389,"SHAFER, VERONICA, INEZ",8814 RACHEL FREEMAN WAY STE 103 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134262389,"SHAFER, VERONICA, INEZ",1428 E MAIN ST STE B LINCOLNTON NC,055,Lincoln,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134262694,"HARPER, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 80 , 132 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134263460,"KHAN, MUSAID, AHMED",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1134265176,GREENSBORO CEREBRAL PALSY ASSOCIATE,~,3205 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134265176,GREENSBORO CEREBRAL PALSY ASSOCIATE,3205 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,, 16 , 393 , 658 ," $48,014.22 ",,
MEDICAID DIRECT,1134266281,SHALOM HOME HEALTH INC,~,2821 N ROXBORO ST UNIT A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1134266281,SHALOM HOME HEALTH INC,2821 N ROXBORO ST UNIT A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 4,131 "," 4,131 "," $340,906.04 ",,
MEDICAID DIRECT,1609115062,KID STRIDES THERAPY LLC,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,251S00000X,Agencies,Community/Behavioral Health,,1134266315,"PEARCE, AMANDA, BETH",5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134268261,"MARSONI, NICOLO",1969 WELLNESS BLVD   MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 33 , 33 ,$#,,
MEDICAID DIRECT,1245850700,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH TELE-INTENSIVE CARE,1969 WELLNESS BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1134268261,"MARSONI, NICOLO",1969 WELLNESS BLVD   MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134268261,"MARSONI, NICOLO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134268261,"MARSONI, NICOLO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134268261,"MARSONI, NICOLO",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134268261,"MARSONI, NICOLO",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1134269020,"COTTEN, AARON, RODNEY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 103 , 114 , 143 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1134269038,"RISK, GREGORY, CONWAY",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1558773770,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN ORTHOPEDICS,,,Unknown,193200000X,Group,Multi-Specialty,,1134270374,"DAVIS, MATTHEW, SCOTT",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1134270374,"DAVIS, MATTHEW, SCOTT",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 214 , 447 ," 1,005 ",$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134270374,"DAVIS, MATTHEW, SCOTT",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 64 , 104 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134271729,"OXENDINE, DINAH, HUNT",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 30 ,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134271729,"OXENDINE, DINAH, HUNT",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134271729,"OXENDINE, DINAH, HUNT",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 67 , 142 ,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134271729,"OXENDINE, DINAH, HUNT",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 96 , 96 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1134273014,"SMITH, MATTHEW, DONALD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134273014,"SMITH, MATTHEW, DONALD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1134273014,"SMITH, MATTHEW, DONALD",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134273014,"SMITH, MATTHEW, DONALD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134273014,"SMITH, MATTHEW, DONALD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134277304,"BIOLA, HOLLY, ROSE ROBERTS",3901 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134277304,"BIOLA, HOLLY, ROSE ROBERTS",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134277304,"BIOLA, HOLLY, ROSE ROBERTS",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 160 , 266 , 625 ," $11,394.61 ",,
MEDICAID DIRECT,1134277494,BIOREFERENCE HEALTH LLC,~,481 EDWARD H ROSS DR   ELMWOOD PARK NJ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1134277494,BIOREFERENCE HEALTH LLC,481 EDWARD H ROSS DR   ELMWOOD PARK NJ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 65 , 158 , 438 ,$#,,
MEDICAID DIRECT,1427106186,PINEHURST WOMENS CLINIC PA,PINEHURST WOMENS CLINIC PA,125 BILTMORE DR STE 3 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1134277866,"PULEO, JOEL, GREGG",125 BILTMORE DR STE 3 ROCKINGHAM NC,077,Richmond,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1427106186,PINEHURST WOMENS CLINIC PA,PINEHURST WOMENS CLINIC PA,70 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1134277866,"PULEO, JOEL, GREGG",125 BILTMORE DR STE 3 ROCKINGHAM NC,077,Richmond,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 54 , 69 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134278799,"RYAN, MICHAEL, WHITING",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 20 , 22 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134278799,"RYAN, MICHAEL, WHITING",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134278799,"RYAN, MICHAEL, WHITING",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1134278799,"RYAN, MICHAEL, WHITING",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134278799,"RYAN, MICHAEL, WHITING",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134278799,"RYAN, MICHAEL, WHITING",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134278799,"RYAN, MICHAEL, WHITING",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134279235,"WAINER, ANNE, ELIZABETH",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134279235,"WAINER, ANNE, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134279235,"WAINER, ANNE, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134282916,"MOFFET, JERELYN, ROBERSON",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134282916,"MOFFET, JERELYN, ROBERSON",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134284391,SAMS EAST INC,SAMS CLUB PHARMACY 10-4946,300 TARRYTOWN CTR   ROCKY MOUNT NC,064,Nash,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1134284391,SAMS EAST INC,300 TARRYTOWN CTR   ROCKY MOUNT NC,064,Nash,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,930 3RD ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134284466,"FANG, YU MING VICTOR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1134284466,"FANG, YU MING VICTOR",930 3RD ST STE 200 GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,930 3RD ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134284466,"FANG, YU MING VICTOR",930 3RD ST STE 200 GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 40 , 61 , 98 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134285810,"WALLACE, DAVID, MICHAEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134286784,VICTORY HEALTHCARE INC,VICTORY HEALTHCARE INC,314 W MILLBROOK RD STE 9 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1134286784,VICTORY HEALTHCARE INC,314 W MILLBROOK RD STE 9 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 46 ," 8,068 "," 8,106 "," $856,042.02 ",,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134288376,"COTTERELL, MARK, SAMUEL",825 FAIRFAX AVE STE 710 NORFOLK VA,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1134293012,HANGER PROSTHETICS & ORTHOTICS EAST,,3031 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134293012,HANGER PROSTHETICS & ORTHOTICS EAST,3031 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 37 , 44 , 338 ," $76,836.11 ",,
MEDICAID DIRECT,1164599866,ASWAD SURGICAL GROUP PC,~,441 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1134296932,"ASWAD, MARGO, ANDREA",441 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 54 , 58 ,$#,,
MEDICAID DIRECT,1699023648,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS REA VILLAGE PEDIATR,11530 PROVIDENCE RD STE 2200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134297377,"DOSHI, RENU",11530 PROVIDENCE RD STE 2200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 38 , 78 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134298052,"FRYE, NANCY, ELIZABETH",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134298052,"FRYE, NANCY, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134298243,"MILLS, KIMBERLY, ANN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134298243,"MILLS, KIMBERLY, ANN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134298243,"MILLS, KIMBERLY, ANN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 42 , 74 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134298771,"SLAWSON, DAVID, CRAIG",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134298771,"SLAWSON, DAVID, CRAIG",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134301864,WAL-MART STORES EAST LP,WALMART PHARMACY 10-3825,566 US HIGHWAY 70 W   HAVELOCK NC,025,Craven,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1134301864,WAL-MART STORES EAST LP,566 US HIGHWAY 70 W   HAVELOCK NC,025,Craven,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134301922,"LEIGHTON, JOSHUA, CHAMAN",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1407499353,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SUNSET,3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134303738,"LISK, PHILIP, ALAN",3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 113 , 124 , 399 ," $13,027.15 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134306756,"MENSER III, DANIEL, WEBSTER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134308158,"VOHRA, NASREEN, ADAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 19 , 20 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1134313406,"HUENING, MICHAEL, ANDREW",200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,207ZC0500X,Allopathic & Osteopathic Physicians,Pathology,Cytopathology, 25 , 25 , 80 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134313406,"HUENING, MICHAEL, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZC0500X,Allopathic & Osteopathic Physicians,Pathology,Cytopathology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134315575,"MELTON, M., STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134315575,"MELTON, M., STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1134315575,"MELTON, M., STEPHEN",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 27 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134315575,"MELTON, M., STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134316136,"KOONCE, ROBIN, DELOACH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 52 , 60 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134317241,"SIMMONS, LANA, KELLY",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1134317241,"SIMMONS, LANA, KELLY",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 107 , 193 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134317241,"SIMMONS, LANA, KELLY",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134317241,"SIMMONS, LANA, KELLY",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 34 , 144 ,$#,,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1134317241,"SIMMONS, LANA, KELLY",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1134320526,"MYERS, JUSTIN, GUY",210 TOWNE VILLAGE DR   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1134320526,"MYERS, JUSTIN, GUY",210 TOWNE VILLAGE DR   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134320526,"MYERS, JUSTIN, GUY",210 TOWNE VILLAGE DR   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 71 , 75 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1134320526,"MYERS, JUSTIN, GUY",210 TOWNE VILLAGE DR   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134320658,"MARCINKOWSKI, EMILY, FONTENOT",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134320658,"MARCINKOWSKI, EMILY, FONTENOT",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 19 , 26 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134320658,"MARCINKOWSKI, EMILY, FONTENOT",2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1134323223,"MATTERA, PAUL, ANTHONY",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 28 , 30 ,$#,,
MEDICAID DIRECT,1134324775,"EDWARDS, ZENO",ZENO L EDWARDS III,1103 BROWN ST STE 1 WASHINGTON NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice,1134324775,"EDWARDS, ZENO",1103 BROWN ST STE 1 WASHINGTON NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice, 235 , 452 , 998 ," $46,097.00 ",,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,193200000X,Group,Multi-Specialty,,1134326879,"MCGRAW, NADINE, MARIE",700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,3762 DURHAM RD STE A ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134326879,"MCGRAW, NADINE, MARIE",3762 DURHAM RD   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134326879,"MCGRAW, NADINE, MARIE",615 RIDGE RD   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 30 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1134328719,"HAMMOUD HAMMOUD, RAMADAN",617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1447999057,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-643 FIFTH AVENUE WEST,643 5TH AVE W   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134328719,"HAMMOUD HAMMOUD, RAMADAN",643 5TH AVE W   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,,,Unknown,193200000X,Group,Multi-Specialty,,1134333636,"BAKER, ERIN, BRIE",305 BACK RD   OCRACOKE NC,048,Hyde,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1134333636,"BAKER, ERIN, BRIE",305 BACK RD   OCRACOKE NC,048,Hyde,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 54 , 82 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134337843,"WILKES, RYAN, BARR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134337843,"WILKES, RYAN, BARR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134339104,"PAYVAR, SAEED",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134339369,"FUH, BENG, RICHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 11 , 119 , 121 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134339369,"FUH, BENG, RICHARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134339369,"FUH, BENG, RICHARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 39 , 41 ,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134339393,"POST, JAMES, DAVID",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134339393,"POST, JAMES, DAVID",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134339849,"MOSER, ERIN, LAVALLEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134339849,"MOSER, ERIN, LAVALLEY",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134339849,"MOSER, ERIN, LAVALLEY",1225 HARDING PL   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134341761,"LENTZ, AARON, CLAUDE",2100 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134341761,"LENTZ, AARON, CLAUDE",2100 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134341761,"LENTZ, AARON, CLAUDE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134341761,"LENTZ, AARON, CLAUDE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134341761,"LENTZ, AARON, CLAUDE",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 20 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134341761,"LENTZ, AARON, CLAUDE",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134341993,"BHAVE, RUPALI, ROY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 26 , 119 , 125 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134343452,"FREIJI, RULA, MUSA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134343452,"FREIJI, RULA, MUSA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134343452,"FREIJI, RULA, MUSA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134343452,"FREIJI, RULA, MUSA",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134348485,"BLACKWELL, DERRICK, LEWIS",4500 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134354814,"MIEDEMA, JAYSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 47 , 58 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134354814,"MIEDEMA, JAYSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1134354814,"MIEDEMA, JAYSON",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 43 , 67 , 118 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134354814,"MIEDEMA, JAYSON",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134354814,"MIEDEMA, JAYSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 32 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1134355399,"MOUSTARAH, FADY",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 20 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134355399,"MOUSTARAH, FADY",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134355456,"CAREW, KHARY, STEPHEN",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 14 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134355456,"CAREW, KHARY, STEPHEN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 65 , 110 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134355977,"MCCRERY, STEPHANIE, MICHELLE",8 REGIONAL CIR   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134355977,"MCCRERY, STEPHANIE, MICHELLE",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 66 , 167 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134356652,"SIADECKI, SEBASTIAN, DANIEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 33 , 47 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134356652,"SIADECKI, SEBASTIAN, DANIEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 50 , 73 ,$#,,
MEDICAID DIRECT,1134356751,BYRD HEALTHCAE GROUP OF NORTH CAROL,INTERIM HEALTHCARE,1977 HENDERSONVILLE RD STE 1 ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,1134356751,BYRD HEALTHCAE GROUP OF NORTH CAROL,1977 HENDERSONVILLE RD STE 1 ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,#, 267 , 267 ," $39,920.08 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134357726,"GULYANICH, TARAS, M",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 28 , 28 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134357726,"GULYANICH, TARAS, M",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134358054,"HOPPING, AUDREY, ANN SOVA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134358054,"HOPPING, AUDREY, ANN SOVA",616 WADE AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134358054,"HOPPING, AUDREY, ANN SOVA",3000 HOLSTON LN   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134358054,"HOPPING, AUDREY, ANN SOVA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134358054,"HOPPING, AUDREY, ANN SOVA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134358054,"HOPPING, AUDREY, ANN SOVA",500 PROSPECT AVE   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134358682,"BODOKY, ANETTE",9101 OCEAN HWY E   LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 31 ,$#,,
MEDICAID DIRECT,1619606316,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2775 HENDERSONVILLE ROAD,2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134359045,"SANDER, CHRISTOPHER, PAUL",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 68 , 87 ,$#,,
MEDICAID DIRECT,1942223318,TRI COUNTY COMMUNITY HEALTH COUNCIL,~,194 TOMAHAWK HWY   HARRELLS NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134359516,"ZIBELIN, KEVEN, TERESA",194 TOMAHAWK HWY   HARRELLS NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 40 , 49 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134360605,"GOSSETT, LINDSAY, KASPER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 85 , 91 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134360605,"GOSSETT, LINDSAY, KASPER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 52 , 57 ,$#,,
MEDICAID DIRECT,1134362957,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,4804 PAGE CREEK LN STE 230 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1134362957,CNC-ACCESS INC,4804 PAGE CREEK LN STE 230 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 749 , 749 ," $59,568.46 ",,
MEDICAID DIRECT,1134367345,DURAMED EQUIPMENT LLC,~,33 BURGIN ST STE D MARION NC,059,McDowell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1134367345,DURAMED EQUIPMENT LLC,33 BURGIN ST STE D MARION NC,059,McDowell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 15 , 22 , 75 ," $10,140.85 ",,
MEDICAID DIRECT,1134367345,DURAMED EQUIPMENT LLC,~,33 BURGIN ST STE D MARION NC,059,McDowell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1134367345,DURAMED EQUIPMENT LLC,33 BURGIN ST STE D MARION NC,059,McDowell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 39 , 61 , 257 ," $23,216.76 ",,
MEDICAID DIRECT,1255449534,RUSSELL J BARONE DPM PA,RUSSELL J BARONE DPM PA,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1134367394,"STOVER, PAMELA, BARONE",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1255449534,RUSSELL J BARONE DPM PA,RUSSELL J BARONE DPM PA,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1134367394,"STOVER, PAMELA, BARONE",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255449534,RUSSELL J BARONE DPM PA,RUSSELL J BARONE DPM PA,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1134367394,"STOVER, PAMELA, BARONE",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 96 , 127 , 192 ,$#,,
MEDICAID DIRECT,1134367394,"STOVER, PAMELA, BARONE",~,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1134367394,"STOVER, PAMELA, BARONE",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1134370414,VILLAGE PHYSICAL THERAPY,VILLAGE PHYSICAL THERAPY,251 W CENTER ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1134370414,VILLAGE PHYSICAL THERAPY,251 W CENTER ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 84 , 102 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134373806,"COHEN, IAN, STUART",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 51 , 54 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134373962,"EICHMAN, DAVE, STEVEN",1130 N CHURCH ST   GREENSBORO NC,041,Guilford,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 153 , 406 , 654 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1134375488,"YARBROUGH, DEMETRIA, LASHAWN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 29 , 29 ,$#,,
MEDICAID DIRECT,1134376700,"ARNOLD, WILLIAM, BRANDON",,40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice,1134376700,"ARNOLD, WILLIAM, BRANDON",40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 63 , 206 ," $10,313.21 ",,
MEDICAID DIRECT,1538529474,WILLIAM BRANDON ARNOLD DMD PLLC,~,40 GRAYSON ST   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1134376700,"ARNOLD, WILLIAM, BRANDON",40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice, 152 , 211 , 763 ," $47,334.26 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,915 PEE DEE RD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1134376817,"PHILLIPS, SUZANNE, DAWN",310 COMMERCE DR   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1134376817,"PHILLIPS, SUZANNE, DAWN",310 COMMERCE DR   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 45 , 45 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,310 COMMERCE DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1134376817,"PHILLIPS, SUZANNE, DAWN",310 COMMERCE DR   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 47 , 47 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,915 PEE DEE RD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1134376817,"PHILLIPS, SUZANNE, DAWN",915 PEE DEE RD   ABERDEEN NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 62 , 62 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134376817,"PHILLIPS, SUZANNE, DAWN",300 BLAKE BLVD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1134376817,"PHILLIPS, SUZANNE, DAWN",915 PEE DEE RD   ABERDEEN NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 82 , 82 ,$#,,
MEDICAID DIRECT,1134377781,EUROFINS DIATHERIX LABORATORIES LLC,~,601 GENOME WAY STE 2100 HUNTSVILLE AL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1134377781,EUROFINS DIATHERIX LABORATORIES LLC,601 GENOME WAY STE 2100 HUNTSVILLE AL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 716 , 889 ," 2,969 "," $185,747.79 ",,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1134379746,"MOOREFIELD, CHERYL, BYRD",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 137 , 230 ," $21,242.40 ",,
MEDICAID DIRECT,1104303668,GEORGE & DEST DDS PLLC,~,107 E MOUNTAIN ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1134380355,"GEORGE, RONNIE",107 E MOUNTAIN ST   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 182 , 206 , 640 ," $24,587.61 ",,
MEDICAID DIRECT,1083650881,COLLINS & SAMPSON DDS PA,COLLINS JEFF,312 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1134380389,"COLLINS, TYLER, JEFFREY",312 E WARDELL DR   PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 278 , 461 ," 1,516 "," $74,550.30 ",,
MEDICAID DIRECT,1881192631,COLLINS AND ASSOCIATES DDS PA,,714 E 4TH AVE   RED SPRINGS NC,078,Robeson,193400000X,Group,Single Specialty,,1134380389,"COLLINS, TYLER, JEFFREY",714 E 4TH AVE   RED SPRINGS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 155 , 277 , 913 ," $47,196.96 ",,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134380603,"MURPHY, TIMOTHY, DANIEL",640 S VAN BUREN RD   EDEN NC,079,Rockingham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134380603,"MURPHY, TIMOTHY, DANIEL",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134380603,"MURPHY, TIMOTHY, DANIEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134380603,"MURPHY, TIMOTHY, DANIEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134380603,"MURPHY, TIMOTHY, DANIEL",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 100 , 221 , 466 ,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1134382179,"WRENN, ANNE, SIDBURY",25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134383292,"PLICHTA, JENNIFER, KAY",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134383292,"PLICHTA, JENNIFER, KAY",20 DUKE MEDICINE CIR CLINIC 2 DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134383292,"PLICHTA, JENNIFER, KAY",20 DUKE MEDICINE CIR CLINIC 2 DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134383292,"PLICHTA, JENNIFER, KAY",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699784660,ONSITE NEONATAL PC,~,1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1134385644,"TIBREWAL, MAHIMA",1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205889185,CLAUDE LUVIS MD PA,,2682 COURT DR STE B GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134385776,"LUVIS, CHARMAINE, NIRMALEE",2682 COURT DR STE B GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 96 , 141 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134386683,"BANDARUPALLI, NAVEEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 92 , 93 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 29 , 53 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 20 , 57 , 97 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 26 , 58 , 58 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134388051,"CHAUDHARY, VIJAY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134391063,"MOORE, ANDREW, WAYNE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134391063,"MOORE, ANDREW, WAYNE",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1134391253,"RAJAGOPAL, SUDARSHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134391253,"RAJAGOPAL, SUDARSHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 40 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134391253,"RAJAGOPAL, SUDARSHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 42 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134391253,"RAJAGOPAL, SUDARSHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134391931,"WHITLEY, KORI, BUCKNER",101 BETHESDA DR   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 17 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,249 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134393200,"REIN, MATTHEW, GORDON",249 E NC HIGHWAY 54 STE 210 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,249 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134393200,"REIN, MATTHEW, GORDON",249 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134393200,"REIN, MATTHEW, GORDON",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134393200,"REIN, MATTHEW, GORDON",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134395114,"EICHNER, BRIAN, HOWARD",2100 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 45 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134395114,"EICHNER, BRIAN, HOWARD",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10211 ALM ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134395114,"EICHNER, BRIAN, HOWARD",10211 ALM ST STE 200 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 44 , 88 , 177 ," $10,765.65 ",,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134396187,"FICKENSCHER, BEN, ALAN",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1265150494,COVENANT SPINE AND NEUROLOGY PLLC,~,280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134397714,"POWERS, ALEXANDER, KENDRICK",280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 60 , 111 , 116 ,$#,,
MEDICAID DIRECT,1265150494,COVENANT SPINE AND NEUROLOGY PLLC,~,280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134397714,"POWERS, ALEXANDER, KENDRICK",3333 BROOKVIEW HILLS BLVD STE 104 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 24 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134400799,"HILL, MONICA, NANCY",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 19 , 45 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134400799,"HILL, MONICA, NANCY",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134400799,"HILL, MONICA, NANCY",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 24 , 25 ,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1134402837,"DUNNING, KATHRYN, GRABLE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 23 , 24 , 29 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1134404122,"BERRY PRICE, HOLLY, MARIE",1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1134404122,"BERRY PRICE, HOLLY, MARIE",317 N KING ST STE B HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 42 , 95 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1134404122,"BERRY PRICE, HOLLY, MARIE",317 N KING ST STE B HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134404304,"ZIRPOLI, MARGARET, SAWYER",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 109 , 182 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134407133,"PIERCE, BRADLEY, ROBERT",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134407869,"KIM, YOON, MI",1427 NC HIGHWAY 68 N UNIT A OAK RIDGE NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 67 , 133 , 179 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1134407869,"KIM, YOON, MI",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134408297,"ADAMS, JOHN, CLAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 37 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134408297,"ADAMS, JOHN, CLAY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134408297,"ADAMS, JOHN, CLAY",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134408776,"GANDHI MEHTA, RACHANA, KAUSHAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 44 , 52 , 86 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134410186,"RAO, VEENA, SHIVA",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 38 , 56 , 104 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134410186,"RAO, VEENA, SHIVA",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134410186,"RAO, VEENA, SHIVA",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 51 , 83 , 120 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134410186,"RAO, VEENA, SHIVA",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811274558,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM CARDIOLOGY,568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1134410566,"RYMER, JENNIFER, ANNE",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 28 , 29 ,$#,,
MEDICAID DIRECT,1811274558,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM CARDIOLOGY,568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1134410566,"RYMER, JENNIFER, ANNE",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134410566,"RYMER, JENNIFER, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 18 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134410566,"RYMER, JENNIFER, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 21 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1134410566,"RYMER, JENNIFER, ANNE",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134410566,"RYMER, JENNIFER, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1134411184,"WALSH, KRISTEN, ELIZABETH",701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,509 OLDE WATERFORD WAY STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1134411184,"WALSH, KRISTEN, ELIZABETH",509 OLDE WATERFORD WAY STE 102 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 33 , 55 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1134411390,"PACE, MARYELLEN, DOLAT",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1134411390,"PACE, MARYELLEN, DOLAT",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 82 , 143 , 293 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134411390,"PACE, MARYELLEN, DOLAT",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1134411390,"PACE, MARYELLEN, DOLAT",1200 N ELM ST   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1295766079,SOUTH LAKE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS SOUTH LAKE PEDIATRI,9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134412406,"HOPKINS, JILL, ALLISON",9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134412406,"HOPKINS, JILL, ALLISON",9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1295766079,SOUTH LAKE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS SOUTH LAKE PEDIATRI,9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134412406,"HOPKINS, JILL, ALLISON",9625 NORTHCROSS CENTER CT STE 102 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134412943,"BROWN, MICHAEL, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134412943,"BROWN, MICHAEL, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 58 , 97 , 97 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134414527,"CHARTIER, ANDRE, LIN-FUNG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134415359,"LEONARD, KENJI, LAWRENCE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 81 , 90 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134415359,"LEONARD, KENJI, LAWRENCE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134416969,"VIAMONTE, LOUIS, DAVID",380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134416969,"VIAMONTE, LOUIS, DAVID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1505 SW CARY PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 151 , 204 , 256 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 55 , 77 , 112 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",10207 CERNY ST STE 114 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 23 , 61 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1134417660,"PATEL, AMIT, VIPIN",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 28 , 40 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134418221,"EINHORN, LISA, MICHELE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134418221,"EINHORN, LISA, MICHELE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134418221,"EINHORN, LISA, MICHELE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134418221,"EINHORN, LISA, MICHELE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 59 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134419252,"THADEN, JOSHUA, THOMAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 22 , 33 ,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1134419633,"WOODARD, BRANDON, KEITH",520 NORTH ST   SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 46 , 49 , 53 ," $23,725.07 ",,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1134419633,"WOODARD, BRANDON, KEITH",2076 NC HIGHWAY 42 W STE 110 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 25 , 47 , 80 ,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1134419633,"WOODARD, BRANDON, KEITH",2076 VETERANS PKWY STE 110 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134421134,"MEADOWS, LINDA, MORRIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134422751,"WILT, KATHRYN, ANN",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396083820,LJP ANESTHESIA SERVICES PLLC,LJP ANESTHESIA SERVICES,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134424401,"CHEEK, KATRINA, LYNETTE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134429269,"SABLAR, JILL, ANN",1540 SUNDAY DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134429269,"SABLAR, JILL, ANN",1540 SUNDAY DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134429756,"PAHWANI, RAVI",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134429756,"PAHWANI, RAVI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 144 , 144 ,$#,,
MEDICAID DIRECT,1134429764,DIVINE FAMILY CARE HOME III INC,DIVINE FAMILY CARE HOME III INC,45 CANNADY WAY   FRANKLINTON NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1134429764,DIVINE FAMILY CARE HOME III INC,45 CANNADY WAY   FRANKLINTON NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 689 , 718 ," $46,636.97 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134430614,"WILKINSON, LOIS, ONKOBA",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 11 , 11 , 23 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134430614,"WILKINSON, LOIS, ONKOBA",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 93 , 103 , 243 ,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1134430614,"WILKINSON, LOIS, ONKOBA",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1134431059,"DAHAL, PARDEEP",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 170 , 170 ," $11,417.94 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134431059,"DAHAL, PARDEEP",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 241 , 248 ,$#,,
MEDICAID DIRECT,1326627399,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES- PLYMOUTH,115 ADAMS ST   PLYMOUTH NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134431117,"PRICE, RENEA, SWAIN",543 US HIGHWAY 64 W   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134431117,"PRICE, RENEA, SWAIN",543 US HIGHWAY 64 W   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 22 , 37 ,$#,,
MEDICAID DIRECT,1427682640,WILLIAMSTON HOSPITAL CORPORATION,ROANOKE CLINICS A PART OF MARTIN GENERAL HOSPITAL,543 US HIGHWAY 64 W   PLYMOUTH NC,094,Washington,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134431117,"PRICE, RENEA, SWAIN",543 US HIGHWAY 64 W   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1578541660,EAST CAROLINA HEALTH BERTIE,Cashie Medical Center Windsor,1403 S KING ST   WINDSOR NC,008,Bertie,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134431117,"PRICE, RENEA, SWAIN",1403 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134431810,"BYNUM, WILLIAM, EDWARDS",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 37 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134431810,"BYNUM, WILLIAM, EDWARDS",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134431810,"BYNUM, WILLIAM, EDWARDS",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134433576,SHIPMAN FAMILY HOME CARE INC,SHIPMAN FAMILY HOMECARE INC,1424 N CHURCH ST STE B-1 BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1134433576,SHIPMAN FAMILY HOME CARE INC,1424 N CHURCH ST STE B-1 BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 3,207 "," 3,209 "," $312,363.60 ",,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134434210,"KHALID, FATIMA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134436652,"REID, TERESA, NECOLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134436652,"REID, TERESA, NECOLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134438377,"SNYDER, DAVID, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 61 , 64 ,$#,,
MEDICAID DIRECT,1134438427,VERACYTE INC,,6000 SHORELINE CT STE 100 SOUTH SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1134438427,VERACYTE INC,6000 SHORELINE CT STE 100 SOUTH SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1134438427,VERACYTE INC,,12357 RIATA TRACE PKWY STE A100 AUSTIN TX,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1134438427,VERACYTE INC,12357 RIATA TRACE PKWY STE A100 AUSTIN TX,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 14 , 14 , 28 ,$#,,
MEDICAID DIRECT,1609206580,WESLEY L ROBINSON DMD PA,SMILES FOR LIFE ORTHODONTICS,7215 LEBANON RD STE B MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134440233,"KOVACH, JOHN, DANE",7215 LEBANON RD STE B MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 2,119 "," 9,435 "," 11,176 "," $1,595,359.79 ",,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134440738,"MCCALLUM, JEREMY, ROBIN",3793 MCDOWELL LN STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 31 , 55 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134440837,"GEIPLE, JOSHUA, SCOTT",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134440837,"GEIPLE, JOSHUA, SCOTT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134440837,"GEIPLE, JOSHUA, SCOTT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134440837,"GEIPLE, JOSHUA, SCOTT",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134440837,"GEIPLE, JOSHUA, SCOTT",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134440837,"GEIPLE, JOSHUA, SCOTT",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1134443252,FAITH HOMES AND HABILITATION LLC,~,2711 FAYETTEVILLE ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1134443252,FAITH HOMES AND HABILITATION LLC,2711 FAYETTEVILLE ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,310 "," 1,310 "," $133,595.85 ",,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1134445042,"KAHMKE, RUSSEL, ROY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134445042,"KAHMKE, RUSSEL, ROY",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 16 , 21 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134445042,"KAHMKE, RUSSEL, ROY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134445042,"KAHMKE, RUSSEL, ROY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 37 , 61 , 105 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1134445364,"TABONE, MICHAEL, FRANK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134445364,"TABONE, MICHAEL, FRANK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 148 , 160 , 189 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134445364,"TABONE, MICHAEL, FRANK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 149 , 159 , 183 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1134445364,"TABONE, MICHAEL, FRANK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326589649,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - WELLNESS CENTER,3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134449291,"VAUGHAN, KRISTOS, NEKTARIOS",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 26 , 26 ,$#,,
MEDICAID DIRECT,1881797066,KENDALYN LUTZ-CRAVER DDS PA,CORNERSTONE DENTAL ASSOCIATES,101 LIFE ENRICHMENT BLVD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1134449325,"KARNER, SARA, HAMMEL",101 LIFE ENRICHMENT BLVD   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 118 , 255 , 835 ," $35,402.70 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,152 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134449622,"SAWARDEKAR, SHILPA, SATISH",152 SHERLOCK DR   STATESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134450042,"KENDALL, CAROLYN, BETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134451206,"PUCKETT-LAWSON, AMY, LEIGH",865 WESTLAKE DR   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 61 , 148 , 187 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134453970,"SOKOLSKY, LAUREN, PAIGE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 147 , 148 , 154 ,$#,,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1134454523,"SMITH, EMILY, SUZANNE",1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,1223G0001X,Dental Providers,Dentist,General Practice," 1,219 "," 1,975 "," 5,674 "," $209,936.54 ",,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134455371,"HIENDLMAYR, KARA, LEE",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831809755,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV HOSPITAL SPECIALTY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134455371,"HIENDLMAYR, KARA, LEE",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1134455371,"HIENDLMAYR, KARA, LEE",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134458359,"RAGAN, MICHAEL, CHRISTOPHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 28 , 32 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134458359,"RAGAN, MICHAEL, CHRISTOPHER",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134458359,"RAGAN, MICHAEL, CHRISTOPHER",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134462526,"FRAGA, DENISE, NICOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 75 , 77 , 102 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,501 N HARRINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134465586,"JONES, JESSICA, RENEE",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134465586,"JONES, JESSICA, RENEE",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134465586,"JONES, JESSICA, RENEE",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 41 , 117 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1134465693,"OLEXY, RENEE, MARIE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1134465693,"OLEXY, RENEE, MARIE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134475650,"KAMBOJ, SUKRITI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 120 , 357 , 847 ," $62,730.35 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,313 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1134475650,"KAMBOJ, SUKRITI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134475650,"KAMBOJ, SUKRITI",313 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,313 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1134475650,"KAMBOJ, SUKRITI",313 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1134475650,"KAMBOJ, SUKRITI",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134475650,"KAMBOJ, SUKRITI",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE N KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1134475650,"KAMBOJ, SUKRITI",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1134477961,"LACKEY, ALLISON, PIERCE",1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 11 , 35 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134479454,"MILLER, MEGAN, ELIZABETH",11001 DURANT RD STE 114 RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134479454,"MILLER, MEGAN, ELIZABETH",600 NEW WAVERLY PL STE 205 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134479454,"MILLER, MEGAN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1134479645,"FORD, ANGELA, BORDEN",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1134479645,"FORD, ANGELA, BORDEN",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 29 , 29 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1134479645,"FORD, ANGELA, BORDEN",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1134480197,"RYBNICEK, DAVID, ANDREW",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 71 , 117 , 181 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134480668,"CLARK, CHRISTOPHER, JEROME",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134480668,"CLARK, CHRISTOPHER, JEROME",501 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134480668,"CLARK, CHRISTOPHER, JEROME",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 100 , 129 , 202 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134480668,"CLARK, CHRISTOPHER, JEROME",2704 HENRY ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 94 , 106 , 154 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134480668,"CLARK, CHRISTOPHER, JEROME",601 S MAIN ST   REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134480668,"CLARK, CHRISTOPHER, JEROME",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134481062,"FORD, JENNIFER, LAUREN",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1760839757,NAZIR H AHMAD DDS IV PA,,3150 ROGERS RD STE 111 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1134482482,"HOLMAN, MATTHEW, ROBERT",3150 ROGERS RD STE 111 WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 500 , 780 ," 3,365 "," $391,996.30 ",,
MEDICAID DIRECT,1528314689,NAZIR AHMAD DDS PA,NAZIR AHMAD DDS PA,5904 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134482482,"HOLMAN, MATTHEW, ROBERT",5904 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 354 , 508 ," 2,390 "," $295,691.13 ",,
MEDICAID DIRECT,1134482482,"HOLMAN, MATTHEW, ROBERT",~,3150 ROGERS RD STE 111 WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1134482482,"HOLMAN, MATTHEW, ROBERT",3150 ROGERS RD STE 111 WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1720675960,NAZIR AHMAD DDS 6 PA,,8851 ELLSTREE LN STE 116 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134482482,"HOLMAN, MATTHEW, ROBERT",3150 ROGERS RD STE 111 WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1760839757,NAZIR H AHMAD DDS IV PA,,3150 ROGERS RD STE 111 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1134482482,"HOLMAN, MATTHEW, ROBERT",8851 ELLSTREE LN STE 116 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1518063064,FAYETTEVILLE HEART CENTER PC,FAYETTEVILLE HEART CENTER,2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 34 , 39 ,$#,,
MEDICAID DIRECT,1275354615,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY HEART AND VASCULAR,225 BRIGHTWATER DR STE 220 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",100 S 10TH ST   LILLINGTON NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 26 , 33 ,$#,,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",800 TILGHMAN DR   DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 55 , 58 ,$#,,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",805 TILGHMAN DR STE B DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 108 , 108 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",80 HEALTHCARE DR STE 101 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 37 , 38 ,$#,,
MEDICAID DIRECT,1275354615,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY HEART AND VASCULAR,225 BRIGHTWATER DR STE 220 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",800 TILGHMAN DR   DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134482623,"BAVYER, VARUN, KUMAR",100 S 10TH ST   LILLINGTON NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 32 , 45 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134483431,"SERJI, SARA, ANDREA",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134487168,"KEHOE, MICHAEL, PATRICK",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134487168,"KEHOE, MICHAEL, PATRICK",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 36 , 72 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134487168,"KEHOE, MICHAEL, PATRICK",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 278 , 564 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134487168,"KEHOE, MICHAEL, PATRICK",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 53 , 129 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134487168,"KEHOE, MICHAEL, PATRICK",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134487168,"KEHOE, MICHAEL, PATRICK",975 NC HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134487168,"KEHOE, MICHAEL, PATRICK",975 NC HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134487341,"PLAKKE, MICHAEL, J",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 34 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134487341,"PLAKKE, MICHAEL, J",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134487341,"PLAKKE, MICHAEL, J",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134487341,"PLAKKE, MICHAEL, J",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134487341,"PLAKKE, MICHAEL, J",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134487341,"PLAKKE, MICHAEL, J",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134487341,"PLAKKE, MICHAEL, J",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134487341,"PLAKKE, MICHAEL, J",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134487341,"PLAKKE, MICHAEL, J",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134489602,"VINCENT, CAROL, LOGAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 33 , 133 , 137 ,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134495138,"BLAKER, BRIAN, DAVID",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134495138,"BLAKER, BRIAN, DAVID",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134495229,"VADLAMUDI, CHARITA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 90 , 91 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3821 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,350 E HOLDING AVE   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134501976,"MODY, PRIYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 100 , 105 , 180 ,$#,,
MEDICAID DIRECT,1265150494,COVENANT SPINE AND NEUROLOGY PLLC,~,280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134502289,"ROBINSON, UNIQUE, CATHERINE",219 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265150494,COVENANT SPINE AND NEUROLOGY PLLC,~,280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134502289,"ROBINSON, UNIQUE, CATHERINE",3333 BROOKVIEW HILLS BLVD STE 104 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265150494,COVENANT SPINE AND NEUROLOGY PLLC,~,280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134502289,"ROBINSON, UNIQUE, CATHERINE",280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 151 , 367 , 640 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134505738,"ANDREWS, JULIE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134505738,"ANDREWS, JULIE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 31 , 35 , 35 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134505738,"ANDREWS, JULIE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134505738,"ANDREWS, JULIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134505738,"ANDREWS, JULIE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 60 , 71 ,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134507254,"CARROLL, ALYSSA, BRIANNE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134507254,"CARROLL, ALYSSA, BRIANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134507254,"CARROLL, ALYSSA, BRIANNE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",270 COPPERFIELD BLVD NE STE 202 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 26 , 27 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134508633,"PATEL, ACHINT, DINDAYAL",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 51 , 51 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134508708,"STUART, CHRISTOPHER, THOMAS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134508708,"STUART, CHRISTOPHER, THOMAS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 41 , 51 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134508708,"STUART, CHRISTOPHER, THOMAS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 172 , 163 , 221 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134509003,"DEBAUN, MALCOLM, RUTLEDGE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 39 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134509003,"DEBAUN, MALCOLM, RUTLEDGE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 63 , 76 ," $36,786.51 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134509003,"DEBAUN, MALCOLM, RUTLEDGE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134510183,"EMLY, JESSICA, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 31 , 33 , 46 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134513583,"DEVANE, MARY, CARNES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 15 , 32 , 32 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134513583,"DEVANE, MARY, CARNES",4525 CAMERON VALLEY PKWY STE 1600 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 14 , 34 , 34 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134513583,"DEVANE, MARY, CARNES",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134513583,"DEVANE, MARY, CARNES",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134514011,"KNOWLSON, KYLE, VANCE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487940268,OUR FAMILY DOCTOR PLLC,OUR FAMILY DOCTOR PLLC,43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134514011,"KNOWLSON, KYLE, VANCE",43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 38 , 72 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1134514532,"FARIDI, JEESHAN, ALI",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1134514532,"FARIDI, JEESHAN, ALI",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134514540,"FELLER, SOPHIE, CLAIRE",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134514540,"FELLER, SOPHIE, CLAIRE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134514607,"MATHEWS, TIMOTHY, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 118 , 118 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1134514607,"MATHEWS, TIMOTHY, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 181 , 181 ,$#,,
MEDICAID DIRECT,1134516594,"MILLER, DERY, ANN",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,1134516594,"MILLER, DERY, ANN",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1134516727,"SCHAFER, ANGELA, MARIE",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134516727,"SCHAFER, ANGELA, MARIE",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 17 , 25 ,$#,,
MEDICAID DIRECT,1134518038,THE ADOLPHUS GROUP LLC,RIVERWOOD ASSISTED LIVING,711 W ATKINS ST   DOBSON NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1134518038,THE ADOLPHUS GROUP LLC,711 W ATKINS ST   DOBSON NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 4,849 "," 4,863 "," $327,106.49 ",,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134518780,"GRIFFIN, KELSEY, DUNCAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 22 , 23 ,$#,,
MEDICAID DIRECT,1134520638,EMIZEN HOME CARE,~,13124 IDLEWILD RD STE 2 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1134520638,EMIZEN HOME CARE,13124 IDLEWILD RD STE 2 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 2,834 "," 2,920 "," $236,165.60 ",,
MEDICAID DIRECT,1043661671,PETERSON OPTOMETRIC GROUP,FAMILY VISION CLINIC,4514 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134520687,"PETERSON, CAROLINE, THERESE",4514 OLEANDER DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 27 , 28 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134521719,"UMPHLET, JENNIFER, SESSOMS",2610 STANTONSBURG RD   GREENVILLE NC,074,Pitt,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1134522345,"CLARKSON, CHRISTINA, SPINARIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134522345,"CLARKSON, CHRISTINA, SPINARIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1134522345,"CLARKSON, CHRISTINA, SPINARIS",447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134527518,"WOODSON, ROQUELLE, ANN",19 NOBLE ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 32 , 33 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134527518,"WOODSON, ROQUELLE, ANN",4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134528185,"KIMANI, STEPHEN, MBURU",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 21 , 22 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134530272,"PARISE, DANIELE, CARLO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1134530272,"PARISE, DANIELE, CARLO",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1134530272,"PARISE, DANIELE, CARLO",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1164710810,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 202 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1134530819,"HIGGINS, CAITLIN, MARIE",6602 KNIGHTDALE BLVD STE 202 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 58 , 104 ,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4207 LAKE BOONE TRL STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134530876,"LOEWENSTEIN, JOSHUA, EVAN",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1134530876,"LOEWENSTEIN, JOSHUA, EVAN",781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134530876,"LOEWENSTEIN, JOSHUA, EVAN",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134530876,"LOEWENSTEIN, JOSHUA, EVAN",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 35 , 44 , 51 ,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134531304,"WILLIAMS, ALISHA, SHANTE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 28 , 75 , 77 ," $12,051.76 ",,
MEDICAID DIRECT,1821653288,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC MINOR PROCEDURES,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134531304,"WILLIAMS, ALISHA, SHANTE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134532526,"UMAR, ELIZABETH, SMITH",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134532526,"UMAR, ELIZABETH, SMITH",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134532898,"SUE, VERONICA",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 40 , 41 , 46 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134533730,"WENTWORTH, SEAN, SAWYER",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1134533730,"WENTWORTH, SEAN, SAWYER",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134533730,"WENTWORTH, SEAN, SAWYER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134533730,"WENTWORTH, SEAN, SAWYER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1134533730,"WENTWORTH, SEAN, SAWYER",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 50 , 66 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1134533730,"WENTWORTH, SEAN, SAWYER",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134534399,"BLOCKER, COURTNEY, VANN",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134534399,"BLOCKER, COURTNEY, VANN",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134534399,"BLOCKER, COURTNEY, VANN",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134534746,"WILCOX, GARRETT, EDWARD",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932137080,NORTHCROSS FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE NORTHCROSS FAMILY MEDIC,9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134534746,"WILCOX, GARRETT, EDWARD",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 34 , 50 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134535701,"SHAH, RAVI, J.",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134535701,"SHAH, RAVI, J.",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 75 , 272 , 273 ," $10,381.12 ",,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134538283,"HURD, ERIN, MCGILLICUDDY",420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 97 , 166 ,$#,,
MEDICAID DIRECT,1134538713,MAKO MEDICAL LABORATORIES LLC,MAKO MEDICAL LABORATORIES,8461 GARVEY DR   RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1134538713,MAKO MEDICAL LABORATORIES LLC,1 INDUSTRY DR   HENDERSON NC,091,Vance,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1134538713,MAKO MEDICAL LABORATORIES LLC,MAKO MEDICAL LABORATORIES,8461 GARVEY DR   RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1134538713,MAKO MEDICAL LABORATORIES LLC,8461 GARVEY DR   RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,," 4,974 "," 9,007 "," 26,918 "," $445,556.50 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134539166,"SPECHT, BRIAN, JEFFREY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 70 , 73 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1134539638,"HOOVER, WILLIAM, DAVID",9735 KINCEY AVE STE 102 HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 29 , 34 , 53 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1134540354,"DAVDA, GARGI, NAVINCHANDRA",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 55 , 55 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134540354,"DAVDA, GARGI, NAVINCHANDRA",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 145 , 145 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134541410,"WISE, CHRISTINA, MARIE",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134544596,"HYLER, RACHEL, HAZELWOOD",1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1134544596,"HYLER, RACHEL, HAZELWOOD",1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134546013,"WALCH, JOSEPH, DAVID",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134546013,"WALCH, JOSEPH, DAVID",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134546013,"WALCH, JOSEPH, DAVID",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134546278,"JOHNSON, JENNIFER, WOOTTON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134546278,"JOHNSON, JENNIFER, WOOTTON",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 107 , 107 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134546443,"AL-QUDSI, OMAR, HASSAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134546443,"AL-QUDSI, OMAR, HASSAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134546443,"AL-QUDSI, OMAR, HASSAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 22 , 27 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 31 ,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 84 , 86 , 114 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 35 , 51 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 32 , 44 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 38 , 57 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 24 , 31 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1134546930,"LOPEZ, EDWARD",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134547128,"WILLIAMSON, SARAH, HOLZMAN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134547201,"REITMAN, ZACHARY, JAMES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 46 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134547201,"REITMAN, ZACHARY, JAMES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1134548092,"GRAF, ANDREW, CLIFFORD",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1134548258,"JASPER, JOHN, BRIAN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 154 , 340 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1134548258,"JASPER, JOHN, BRIAN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 11 , 44 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134548811,"TAYLOR, TREVOR, MARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 22 , 25 ,$#,,
MEDICAID DIRECT,1245231364,HAYWOOD PEDIATRIC AND ADOLESCENT,HAYWOOD PEDIATRICS,15 FACILITY DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1134551435,"SHAW, KAREN, LYNN",15 FACILITY DR   CLYDE NC,044,Haywood,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 129 , 280 , 711 ," $27,938.74 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134551807,"WARD, PATRICK, THOMAS",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134555139,"BULLOCK, MARLISA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 35 , 44 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134555139,"BULLOCK, MARLISA",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 13 , 20 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134555139,"BULLOCK, MARLISA",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 92 , 115 , 140 ,$#,,
MEDICAID DIRECT,1134557713,ACCOMPLISH SPEECH THERAPY PLLC,ACCOMPLISH SPEECH THERAPY PLLC,17 APPLEBLOSSOM CT   PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1134557713,ACCOMPLISH SPEECH THERAPY PLLC,17 APPLEBLOSSOM CT   PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,, 50 , 896 , 910 ," $63,230.53 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134558083,"WATKINS, SAVANNA, HANCOCK",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 79 , 127 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134558083,"WATKINS, SAVANNA, HANCOCK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 30 , 48 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134559891,"LEMARIER, AMANDA, ELIZABETH",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134559891,"LEMARIER, AMANDA, ELIZABETH",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1134563422,"LENTSCHER, JESSICA, ANN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134564669,"APTE, POOJA, JAYANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 92 , 92 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134564669,"APTE, POOJA, JAYANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134564669,"APTE, POOJA, JAYANT",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134564883,"CASTELLINO, CANDICE, NADIA",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 22 , 76 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134565377,"ELIASON, ANNE, HAWTHORNE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134565377,"ELIASON, ANNE, HAWTHORNE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1134565526,"CAUDLE, KELLIE, SHAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1134565526,"CAUDLE, KELLIE, SHAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134565526,"CAUDLE, KELLIE, SHAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134566268,"MILLER, JUSTIN, ALAN",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 73 , 103 , 151 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 20 ," $20,751.74 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,1041 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,149 PLANTATION RIDGE DR STE 170 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,411 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,411 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 VANDERBILT PARK DR STE 210 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134566326,"DAILEY, MATTHEW, THOMAS",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134566441,"STEELE, JACQUELENE, RENEE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134566441,"STEELE, JACQUELENE, RENEE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134567787,"BRIMMAGE, BRIAN, CONRAD",4414 LAKE BOONE TRL STE 405 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134568314,"SZULEWSKI, JOSEPH, RICHARD",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134568421,"KUBAS, MARC, ADAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 243 , 245 ," $10,603.16 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134568421,"KUBAS, MARC, ADAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134568678,"DANIEL, JULIE, ELIZABETH",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134568678,"DANIEL, JULIE, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 68 , 156 , 156 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1134570450,"ROBEY, ALLISON, BROOKE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134570450,"ROBEY, ALLISON, BROOKE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134570450,"ROBEY, ALLISON, BROOKE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134570450,"ROBEY, ALLISON, BROOKE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134570773,"PATEL, KEVIN, PARESH",1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 97 , 140 , 215 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134570773,"PATEL, KEVIN, PARESH",2001 N CHURCH ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 40 , 46 , 63 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,2001 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134570773,"PATEL, KEVIN, PARESH",2001 N CHURCH ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 129 , 206 , 283 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134572878,"DGAYLI, KHABIB",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 60 , 103 , 143 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134572878,"DGAYLI, KHABIB",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134572878,"DGAYLI, KHABIB",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 21 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134576101,"COOKE, MARY, KATHERINE CRAVEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 46 , 47 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134577240,"SAITTA, BRADLEY, HART",11200 GOVERNOR MANLY WAY   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134577240,"SAITTA, BRADLEY, HART",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 30 , 53 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1134577240,"SAITTA, BRADLEY, HART",11200 GOVERNOR MANLY WAY   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1134577240,"SAITTA, BRADLEY, HART",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 19 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134577240,"SAITTA, BRADLEY, HART",6715 MCCRIMMON PKWY STE 205 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134577406,"GLISSEN BROWN, JEREMY, ROMEK",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134577406,"GLISSEN BROWN, JEREMY, ROMEK",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134577406,"GLISSEN BROWN, JEREMY, ROMEK",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134577406,"GLISSEN BROWN, JEREMY, ROMEK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134577406,"GLISSEN BROWN, JEREMY, ROMEK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1649735127,SPARTANBURG MEDICAL CENTER,MGC-WOUNDHEALINGSERVICES-MARYBLACKCAMPUS,11 DOCTORS PARK DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134579048,"SAWICKI, LAWRENCE, ADAM",853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972513679,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - WOUND HEALING SER,853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134579048,"SAWICKI, LAWRENCE, ADAM",853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134579147,"KNOWLES, TYLER, HENDERSON",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134579147,"KNOWLES, TYLER, HENDERSON",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558776997,ONSLOW AMBULATORY SERVICES INC,ONSLOW SURGICAL CLINIC,255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134579584,"BACHELLER, ASHLEY, GROGAN",255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134581655,"KOVACS, ANDREW, PETER",510 CAROLINA BAY DR STE 100 WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134581655,"KOVACS, ANDREW, PETER",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134582125,"SHAH, ROHAN, VIPULKUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 55 , 181 , 181 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134582208,"HAYDEK, JOHN, PAUL",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134582208,"HAYDEK, JOHN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134582208,"HAYDEK, JOHN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 36 , 47 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134582562,"CARLSON, JULIA, MARION",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 43 , 125 , 140 ," $10,476.46 ",,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1134583180,"ANUGOM, CHIDI, EUGENE",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134583180,"ANUGOM, CHIDI, EUGENE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 53 , 53 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134583180,"ANUGOM, CHIDI, EUGENE",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 30 , 30 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134583701,"BAGLEY, SARAH, KATHRYN",1450 MATTHEWS TOWNSHIP PKWY STE 170 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134583701,"BAGLEY, SARAH, KATHRYN",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 52 , 89 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134583768,"NUNNS, STEVEN, CHRISTOPHER",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 32 , 40 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134583768,"NUNNS, STEVEN, CHRISTOPHER",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134583768,"NUNNS, STEVEN, CHRISTOPHER",509 OLDE WATERFORD WAY STE 301 LELAND NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 19 , 31 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134583768,"NUNNS, STEVEN, CHRISTOPHER",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 46 , 59 ,$#,,
MEDICAID DIRECT,1205884970,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH BRUNSWICK OBGYN MIDWIFERY,584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1134583768,"NUNNS, STEVEN, CHRISTOPHER",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134585326,"MAY, MICHAEL, JOHN",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134585409,"COLL, JAMES, MICHAEL",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 60 , 130 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134585409,"COLL, JAMES, MICHAEL",3475 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134585896,"CRESS, LAUREN, BENNETT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134585896,"CRESS, LAUREN, BENNETT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134585896,"CRESS, LAUREN, BENNETT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134585896,"CRESS, LAUREN, BENNETT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134585896,"CRESS, LAUREN, BENNETT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134585896,"CRESS, LAUREN, BENNETT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134585896,"CRESS, LAUREN, BENNETT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5214 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134587645,"HANCOCK, KATIE, GOULD",104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134588478,"ROESER, SARAH, TART",2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 39 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134589971,"ROGERS, DEBORAH, MARIE",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134589971,"ROGERS, DEBORAH, MARIE",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134589971,"ROGERS, DEBORAH, MARIE",434 HOSPITAL DR   LINVILLE NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134589971,"ROGERS, DEBORAH, MARIE",434 HOSPITAL DR   LINVILLE NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1134595994,"LILES, LINDSEY, TYNDALL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134595994,"LILES, LINDSEY, TYNDALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134598212,"HOLLAND, HEATHER, RAE",208 COX BLVD STE 202 GOLDSBORO NC,096,Wayne,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 43 , 160 , 189 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,208 COX BLVD STE 202 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1134598212,"HOLLAND, HEATHER, RAE",208 COX BLVD STE 202 GOLDSBORO NC,096,Wayne,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 100 , 397 , 465 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134599541,"KOCSIS, NIKOLETT",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134599541,"KOCSIS, NIKOLETT",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134599541,"KOCSIS, NIKOLETT",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134599541,"KOCSIS, NIKOLETT",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134599541,"KOCSIS, NIKOLETT",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134601941,"MOREIRA, NIALL, ANTHONY",1236 GUILFORD COLLEGE RD STE 117 JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 99 , 194 ,$#,,
MEDICAID DIRECT,1649750183,CARNAGGIO AND PIPER DMD MS PA,~,275 N MAIN ST STE B TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134602253,"ZHOU, HAN",275 N MAIN ST STE B TROUTMAN NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134602881,"ROGERS, VERONICA, CASEY",945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1134603996,"ROSS, ALEXANDRIA, POWERS",108 ENDO LN STE 1 HAMLET NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134605199,"SMITH, SAMUEL, ALAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952354458,EYECARECENTER OD PA,EYECARE CENTER,4170 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134606916,"PATEL, ROSHANI",4170 FAYETTEVILLE RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134607336,"RUSH, KRISTIN, ELIZABETH",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 55 , 69 ,$#,,
MEDICAID DIRECT,1134607435,HOLLAND MANAGEMENT LLC,,122 N SALEM ST STE 201-I APEX NC,092,Wake,251B00000X,Agencies,Case Management,,1134607435,HOLLAND MANAGEMENT LLC,122 N SALEM ST STE 201-I APEX NC,092,Wake,251B00000X,Agencies,Case Management,, 306 ," 3,468 "," 3,481 "," $1,588,798.91 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134610108,"OVERSTREET, KARI, ANN",4020 N ROXBORO ST   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 20 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134610108,"OVERSTREET, KARI, ANN",2302 ERWIN ROAD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134613003,"KELLY, VICTORIA, ELIZABETH",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134613003,"KELLY, VICTORIA, ELIZABETH",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134614050,"COUTURE, SHANNON, DOROTHY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1134616618,"CAMANGUIAN, AIDA, GARCIA",2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134617012,"HE, JEAN, JINGPENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134617012,"HE, JEAN, JINGPENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 51 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134617012,"HE, JEAN, JINGPENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1134618945,"DOMENIG, PETER, JOSEPH",584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1134618945,"DOMENIG, PETER, JOSEPH",911 W HENDERSON ST STE 110 SALISBURY NC,080,Rowan,208800000X,Allopathic & Osteopathic Physicians,Urology,, 102 , 274 , 448 ,$#,,
MEDICAID DIRECT,1275918138,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SALISBURY UROLOGY,911 W HENDERSON ST STE 110 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1134618945,"DOMENIG, PETER, JOSEPH",911 W HENDERSON ST STE 110 SALISBURY NC,080,Rowan,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134619745,"SHAKESPEARE, MATTHEW, JUDD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 40 , 42 , 45 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1134619745,"SHAKESPEARE, MATTHEW, JUDD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1134619745,"SHAKESPEARE, MATTHEW, JUDD",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1861217846,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY OBGYN-HPN,6387 RAMSEY ST UNIT 240 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134619745,"SHAKESPEARE, MATTHEW, JUDD",6387 RAMSEY ST UNIT 240 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134619745,"SHAKESPEARE, MATTHEW, JUDD",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 43 , 41 , 43 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134619745,"SHAKESPEARE, MATTHEW, JUDD",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1134619745,"SHAKESPEARE, MATTHEW, JUDD",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 23 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134621337,"MEEHAN, KATHRYN, DEVILLERS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 175 , 180 ," $14,240.80 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134621337,"MEEHAN, KATHRYN, DEVILLERS",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134621337,"MEEHAN, KATHRYN, DEVILLERS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902183759,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD NEUROLOGY SEACOAST,3980 HIGHWAY 9 E STE 300 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134622913,"KORONEOS, NICHOLAS",3980 HIGHWAY 9 E STE 300 LITTLE RIVER SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134623796,"BRENNEMAN, TYLER, JOSEPH",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134623796,"BRENNEMAN, TYLER, JOSEPH",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134623796,"BRENNEMAN, TYLER, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134625718,"SUTTON, ZACHARY, GLENN",401A N MAIN ST   KENANSVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 106 , 106 ,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134626096,"DOVE, STEPHANIE, MCCORQUODAL",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 130 , 188 , 201 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134626955,"BILLINGS, JENNIFER, GAIL",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder), 21 , 183 , 183 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134631187,"BOND, TIMOTHY, EDWARD AVILEZ",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134631989,"ROWE, CHRYSTAL, DAWN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134631989,"ROWE, CHRYSTAL, DAWN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134636046,"PEOPLES, ALIEDJAWON, BENIN",615 WHEAT MILL RD   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 13 , 61 , 61 ," $18,177.78 ",,
MEDICAID DIRECT,1134638133,A PRIMARY CHOICE INC,,621 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1134638133,A PRIMARY CHOICE INC,621 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 3,273 "," 3,273 "," $204,660.44 ",,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134639867,"LYTHGOE, JEANNE, MARIE",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1134639867,"LYTHGOE, JEANNE, MARIE",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134639867,"LYTHGOE, JEANNE, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134640295,"PARMAR, MRIDUL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 89 , 89 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134640295,"PARMAR, MRIDUL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 149 , 151 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134640295,"PARMAR, MRIDUL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134647688,"MAJACHANI, EVELYN, RUDO",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750088571,MANSI SHAH DMD PC DBA MYDENTALVILLE,MY DENTAVILLE,4423 S NC HIGHWAY 150 STE E LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1134648660,"SHAH, KUSHAN, KIRANKUMAR",6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750088571,MANSI SHAH DMD PC DBA MYDENTALVILLE,MY DENTAVILLE,4423 S NC HIGHWAY 150 STE E LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1134648660,"SHAH, KUSHAN, KIRANKUMAR",4423 S NC HIGHWAY 150 STE E LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 593 ," 1,030 "," 3,674 "," $216,790.17 ",,
MEDICAID DIRECT,1962861278,ALAN A GODEL & JUSTIN P HANNON,~,1228 W ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1134648660,"SHAH, KUSHAN, KIRANKUMAR",1228 W ROOSEVELT BLVD STE B MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1922547793,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134649817,"MUNAWAR, TOOBA",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 21 , 50 , 51 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134650211,"BRENNER, TARA, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 199 , 211 , 238 ," $91,701.06 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134650211,"BRENNER, TARA, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134650211,"BRENNER, TARA, FAYE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134650211,"BRENNER, TARA, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134650211,"BRENNER, TARA, FAYE",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134650641,"DEFREITAS, MARIANA, REGINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134650641,"DEFREITAS, MARIANA, REGINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134650641,"DEFREITAS, MARIANA, REGINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1134650641,"DEFREITAS, MARIANA, REGINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134650641,"DEFREITAS, MARIANA, REGINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 461 , 503 , 838 ," $17,153.47 ",,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134651599,"MCKENZIE, GRANT, WALKER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 18 , 26 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134651599,"MCKENZIE, GRANT, WALKER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1134651599,"MCKENZIE, GRANT, WALKER",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 40 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134651961,"BEY, ALEXANDRA, LYNDON",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134651961,"BEY, ALEXANDRA, LYNDON",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134652159,"DAVIS, WADE, THOMAS",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 124 , 243 , 286 ," $41,205.11 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134652324,"DISTEFANO, KATHERINE, MARY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134652332,"GUERTIN, PETER, FREDERICK",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134652332,"GUERTIN, PETER, FREDERICK",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134652332,"GUERTIN, PETER, FREDERICK",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 41 , 45 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134652332,"GUERTIN, PETER, FREDERICK",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 24 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134652332,"GUERTIN, PETER, FREDERICK",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134652332,"GUERTIN, PETER, FREDERICK",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1134652753,"KIHIRA, SHINGO",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134653421,"ODONNELL, KATHRYN, ELIZABETH HUTCHINS",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134653421,"ODONNELL, KATHRYN, ELIZABETH HUTCHINS",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 13 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134653421,"ODONNELL, KATHRYN, ELIZABETH HUTCHINS",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 26 , 37 , 43 ,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1134653637,"LONG, ELIZABETH, MARIE",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 47 , 88 , 117 ," $13,339.93 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1134654056,"PAYLOR, ANNA, CAITLIN",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 97 , 170 , 271 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 210 , 222 , 289 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134654544,"DESAI, HEMANT, ARUN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134654544,"DESAI, HEMANT, ARUN",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1023177151,ACCESS DENTAL CARE,ACCESS DENTAL CARE,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1134654742,"LEONE, SIENA, MARIE",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 466 , 645 ," 1,643 "," $104,571.43 ",,
MEDICAID DIRECT,1023177151,ACCESS DENTAL CARE,ACCESS DENTAL CARE,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1134654742,"LEONE, SIENA, MARIE",4704 MAIN ST   SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 61 , 145 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134655673,"DAVIS, SHANE, ROBERT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134655673,"DAVIS, SHANE, ROBERT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134655673,"DAVIS, SHANE, ROBERT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134655673,"DAVIS, SHANE, ROBERT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134655673,"DAVIS, SHANE, ROBERT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134655673,"DAVIS, SHANE, ROBERT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134655673,"DAVIS, SHANE, ROBERT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134656200,"SUNDARAM, SUNEHA, SHANTHI",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114351095,MCPC-16 LLC,FIRSTHEALTH PRIMARY CARE AND CARDIOLOGY,6322 FAYETTEVILLE RD OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1134658081,"RIDDLEY, DIANA, ELIZABETH",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 125 , 181 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 36 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 91 , 113 , 134 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 112 , 145 , 251 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134659246,"HOKE, CARA, NICOLE",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1134659527,"MULLEN, KENNETH, JAMES",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1134659527,"MULLEN, KENNETH, JAMES",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134660764,"LUCAS, MARGARET, KATHARINE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134660970,CAROLINA AMBULANCE SPECIALTY TRANSP,,130 PAUL ED DAIL RD   KENANSVILLE NC,031,Duplin,3416L0300X,Transportation Services,Ambulance,Land Transport,1134660970,CAROLINA AMBULANCE SPECIALTY TRANSP,130 PAUL ED DAIL RD   KENANSVILLE NC,031,Duplin,3416L0300X,Transportation Services,Ambulance,Land Transport, 64 , 137 , 274 ," $15,094.81 ",,
MEDICAID DIRECT,1134660970,CAROLINA AMBULANCE SPECIALTY TRANSP,,130 PAUL ED DAIL RD   KENANSVILLE NC,031,Duplin,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1134660970,CAROLINA AMBULANCE SPECIALTY TRANSP,130 PAUL ED DAIL RD   KENANSVILLE NC,031,Duplin,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 53 , 520 , 524 ," $382,655.20 ",,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1134661440,"ROBERSON, MALLORY, SHAW",106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1134663834,"WILLIS, AUDRIANA, KATHERINE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1134663834,"WILLIS, AUDRIANA, KATHERINE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 87 , 94 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134664667,"BILLINGS, JOSHUA, DEAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134664667,"BILLINGS, JOSHUA, DEAN",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134665995,"RATNER, BRIDGET, MCHOUL",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 26 , 28 ,$#,,
MEDICAID DIRECT,1023455987,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,945 N 5TH ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1134666464,"PIGGOTT, TAMARA, BETH",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134666464,"PIGGOTT, TAMARA, BETH",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 41 , 41 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134668007,"CRIST, GERALD, DEE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 123 , 180 , 410 ,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134669336,"PHILLIPS, SHAWN, RENAE",303 GREEN ST E   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134675564,"SAHA, ARNAB, KUMAR",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 29 , 41 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134680895,"BAUER, JOSEPH, MATTHEW",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 90 , 91 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134680895,"BAUER, JOSEPH, MATTHEW",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 116 , 116 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134680895,"BAUER, JOSEPH, MATTHEW",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134687601,"JONES, TRENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134687601,"JONES, TRENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134687601,"JONES, TRENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134688443,"BLAKE, TERYNN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134688443,"BLAKE, TERYNN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134688443,"BLAKE, TERYNN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134688443,"BLAKE, TERYNN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1134689524,"JOSE, JEREMY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134689524,"JOSE, JEREMY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134689524,"JOSE, JEREMY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 35 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134689524,"JOSE, JEREMY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134689524,"JOSE, JEREMY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 49 , 65 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134689615,"BELL, KERRI, LYNNE",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134689615,"BELL, KERRI, LYNNE",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 34 , 41 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134691959,"MAJKA, JILLIAN, KATHLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134691959,"MAJKA, JILLIAN, KATHLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134695729,"FALCON, JOELLE, WICKER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 20 , 41 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134695729,"FALCON, JOELLE, WICKER",63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134697691,"MCCRACKEN, CHRISTOPHER, JOHN",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 49 , 64 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134697691,"MCCRACKEN, CHRISTOPHER, JOHN",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1134697691,"MCCRACKEN, CHRISTOPHER, JOHN",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134699267,"CLAYTON, JORDAN, ASHLEY",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 26 , 35 ,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134699267,"CLAYTON, JORDAN, ASHLEY",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134701964,"QIU, QIONG",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134702053,"SZAR, MADISON, LEILANI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 29 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134706591,"FADEM, BRONWYN, ELIZABETH",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 32 , 33 ,$#,,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1134709397,"ZEHRI, ASIM, HYDER",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134712755,"BAIR, ASHLEIGH, LYN",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1134713019,LIVELY THERAPY SERVICES,,,,Unknown,193200000X,Group,Multi-Specialty,,1134713019,LIVELY THERAPY SERVICES,1 BUFFALO AVE NW STE 2207 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1134713019,LIVELY THERAPY SERVICES,,1401 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134713019,LIVELY THERAPY SERVICES,1401 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 124 ," 2,544 "," 3,527 "," $263,218.87 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134713688,"MAYO, KAREN, ALLRED",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 46 , 46 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134716897,"VAUGHN, LONDON, ELIZABETH",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1134720766,"DE LA ROCA, MACKENSIE, GRANT",181 DANIEL RD   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 122 , 280 , 427 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134723802,"HOLMES, CHRISTY, TEUNNA",4009 BARRETT DR STE 1000 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 71 , 97 ,$#,,
MEDICAID DIRECT,1093029563,ONSLOW COUNTY PARTNERSHIP FOR CHIL,ONE PLACE,900 DENNIS RD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134728850,"MERULLI, SARAH, ELIZABETH",900 DENNIS RD   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 25 , 25 , 64 ," $17,059.57 ",,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1134736135,"DAVIS, JENNAYA, LYNN",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 158 , 215 , 473 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134737265,"FLEMING, JOSHUA",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134737265,"FLEMING, JOSHUA",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1649759341,EYECARECENTER OD PA,,275 E KING ST STE A BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1134738610,"SCULLY, EMILY",275 E KING ST STE 1 BOONE NC,095,Watauga,152W00000X,Eye and Vision Services Providers,Optometrist,, 25 , 26 , 30 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134740137,"GREGORY, TRACI, KELLY",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 228 , 242 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134742117,"FERGUSON, ROBERT, HAYES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134742117,"FERGUSON, ROBERT, HAYES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134742547,"ALBOGA, AWAD",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 147 , 154 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134742547,"ALBOGA, AWAD",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 51 , 194 , 196 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134746092,"DEO, MADEEHA, IKRAM",825 FAIRFAX AVE STE 445 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134747637,"SCHWARTZ, JEREMY, CLINTON",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 16 , 16 , 33 ,$#,,
MEDICAID DIRECT,1720198369,ROANOKE VALLEY HEALTH SERVICES INC,ROANOKE CLINIC,1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1134751738,"KEETER, ROBERT, ALLEN",1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 105 , 247 , 258 ," $11,397.86 ",,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134752181,"HARRIS-CLAXTON, PAMELA, LIANE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1425 PROMISE BEACON CIR STE 109 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134752181,"HARRIS-CLAXTON, PAMELA, LIANE",1425 PROMISE BEACON CIR STE 109 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134752181,"HARRIS-CLAXTON, PAMELA, LIANE",1425 PROMISE BEACON CIR STE 109 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134752181,"HARRIS-CLAXTON, PAMELA, LIANE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 176 , 194 ," $13,334.24 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134752181,"HARRIS-CLAXTON, PAMELA, LIANE",4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1134754377,"COTTO-RODRIGUEZ, JONATHAN, DAVID",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 116 , 151 , 175 ,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134754377,"COTTO-RODRIGUEZ, JONATHAN, DAVID",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 126 , 185 , 221 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134756182,"MOSER, RACHEL, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 40 , 43 ,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134757024,"MIRMOW, BLAIRE, ELIZABETH",5 DOCTORS PARK STE F ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 341 , 357 ," 2,288 "," $65,790.31 ",,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134757164,"DESYATNIKOV, OLEG, VADIMOVICH",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134757164,"DESYATNIKOV, OLEG, VADIMOVICH",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1134757164,"DESYATNIKOV, OLEG, VADIMOVICH",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 39 , 40 ,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1134758246,"TOBIN, JOHN, PETER",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 36 , 37 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1134758246,"TOBIN, JOHN, PETER",434 HOSPITAL DR   LINVILLE NC,006,Avery,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1134758246,"TOBIN, JOHN, PETER",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134758246,"TOBIN, JOHN, PETER",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1134758246,"TOBIN, JOHN, PETER",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1134762149,"ELOSHWAY, CLAIRE, KORNEGAY",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 44 , 141 , 150 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134762149,"ELOSHWAY, CLAIRE, KORNEGAY",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 21 , 126 , 130 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1134762149,"ELOSHWAY, CLAIRE, KORNEGAY",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 32 , 67 , 70 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1134762149,"ELOSHWAY, CLAIRE, KORNEGAY",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1952475832,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS EAST INCORPORATED,314 CRUTCHFIELD ST   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134764459,"ROGGOW, ZACHARY, DAVID",314 CRUTCHFIELD ST   DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1952475832,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS EAST INCORPORATED,314 CRUTCHFIELD ST   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1134764459,"ROGGOW, ZACHARY, DAVID",314 CRUTCHFIELD ST   DURHAM NC,032,Durham,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134765324,"CIANCI, GAVIN, CHRISTOPHER",810 MITCHELL AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 57 , 89 ,$#,,
MEDICAID DIRECT,1457477820,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WARSAW WELLNESS,113 S PINE ST   WARSAW NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134765423,"PAGE, TATEISHA, LYNELLE",113 S PINE ST   WARSAW NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1134765423,"PAGE, TATEISHA, LYNELLE",113 S PINE ST   WARSAW NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134765720,EC OPCO SHELBY LP,TERRABELLA SHELBY,1550 CHARLES RD   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1134765720,EC OPCO SHELBY LP,1550 CHARLES RD   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,592 "," 1,592 "," $157,235.82 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134770480,"ETTLIN, DANIEL, KEVIN",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 70 , 133 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134770480,"ETTLIN, DANIEL, KEVIN",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134770480,"ETTLIN, DANIEL, KEVIN",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154340149,CARRBORO FAMILY VISION LLC,CARRBORO FAMILY VISION OD PLLC,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,,1134773534,"KIRCHMER, SHANNON",200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1134773534,"KIRCHMER, SHANNON",,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,1134773534,"KIRCHMER, SHANNON",200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134773609,"PARKER, LORAE, MARIE",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134773609,"PARKER, LORAE, MARIE",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 44 ,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1134774235,"OXIDINE, JESSICA, LYNN",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 38 , 52 , 151 ,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1134776214,"LANKFORD, AMY, TENILLE",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 56 , 75 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134776214,"LANKFORD, AMY, TENILLE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 102 , 295 , 612 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134776214,"LANKFORD, AMY, TENILLE",190 INDEPENDENCE AVE STE B NORTH WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1134777832,PETERS ENDOSCOPY CENTER LLC,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1134777832,PETERS ENDOSCOPY CENTER LLC,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 159 , 175 , 199 ," $14,120.00 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134779580,"SLABACH, JASON, MONROE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 29 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134779861,"NARRON, JACQUELINE, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134779861,"NARRON, JACQUELINE, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1134780570,"TRAITOR, CARMEN, GREGG",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1134780570,"TRAITOR, CARMEN, GREGG",3382 HENDERSON DR   JACKSONVILLE NC,067,Onslow,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1164710810,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 202 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1134781453,"NWEKE, GODWIN, CHIMAZURU",6602 KNIGHTDALE BLVD STE 202 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 88 , 130 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134781511,"NYARURI, GLADYS, KERUBO",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 61 , 352 , 354 ," $10,781.26 ",,
MEDICAID DIRECT,1134781958,EPIPHANY CARE,~,1935 J N PEASE PL STE 201 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1134781958,EPIPHANY CARE,1935 J N PEASE PL STE 201 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,, 34 , 487 , 487 ," $31,547.88 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134783897,"CHOUCAIR, AMIRA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 51 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134783897,"CHOUCAIR, AMIRA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 138 , 145 , 154 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134783897,"CHOUCAIR, AMIRA",N2198 UNC HOSPITALS CB# 7010 CHAPEL HILL NC,019,Chatham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134787617,"PRESNELL, MICHELLE, LEE GWALTNEY",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134787617,"PRESNELL, MICHELLE, LEE GWALTNEY",621 MICAVILLE LOOP STE 600 BURNSVILLE NC,100,Yancey,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134787617,"PRESNELL, MICHELLE, LEE GWALTNEY",285 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134787617,"PRESNELL, MICHELLE, LEE GWALTNEY",1128 CANE RIVER SCHOOL RD   BURNSVILLE NC,100,Yancey,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134788409,"DOW, NIKKI-TAYLOR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 19 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134788409,"DOW, NIKKI-TAYLOR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134792211,"ABEL, WHITNEY, MESSER",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134792211,"ABEL, WHITNEY, MESSER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134792211,"ABEL, WHITNEY, MESSER",20 DUKE MEDICINE CIR # 22 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134792211,"ABEL, WHITNEY, MESSER",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 41 , 41 ,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1134795859,"HANSON, PATRICIA, IPPOLITO",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356351548,"PHAM, ALEX, HOA-DUC",~,414 S YORK ST LOWR LEVEL GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1134796204,"GE, VERONICA, RAN",414 S YORK ST   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 39 , 115 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134796238,"RODGERS, CAITLIN, JERNIGAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 22 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134796238,"RODGERS, CAITLIN, JERNIGAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1134797152,"BROWN, ALLISON, ANNETTE",2115 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1134797152,"BROWN, ALLISON, ANNETTE",3700 SYMI CIR   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 31 , 34 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1134797152,"BROWN, ALLISON, ANNETTE",3700 SYMI CIR   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1134797152,"BROWN, ALLISON, ANNETTE",3700 SYMI CIR   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1134797152,"BROWN, ALLISON, ANNETTE",2145 COUNTRY CLUB RD STE 400 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134797467,ALL SAINTS HOMECARE AGENCY LLC,ALL SAINTS HOMECARE AGENCY LLC,2801 CARRIAGE MEADOWS DR   WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1134797467,ALL SAINTS HOMECARE AGENCY LLC,2801 CARRIAGE MEADOWS DR   WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 219 , 219 ," $13,677.94 ",,
MEDICAID DIRECT,1194351536,CLAY WILSON & ASSOCIATES,THE COGNITIVE CONNECTION,929 15TH ST NE STE 100 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134797780,"CROUSE, JUSTIN, WAYNE",929 15TH ST NE STE 100 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 71 , 99 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1134798390,"LEDFORD, JACQUELINE, SULLIVAN",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134800477,"HOLMES, BRITTANY, SMITH",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 23 , 22 , 30 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1134800477,"HOLMES, BRITTANY, SMITH",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1073693347,EASTERN CAROLINA PEDIATRICS,EASTERN CAROLINA PEDIATRICS,1702 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1134801533,"MAGSINO, SHELLEY MARIE, CARO",1702 MEDICAL PARK DR W   WILSON NC,098,Wilson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 47 , 75 , 209 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1134801632,"KOWALEWSKI, DYLAN, JOSEPH",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134801632,"KOWALEWSKI, DYLAN, JOSEPH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134801632,"KOWALEWSKI, DYLAN, JOSEPH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134801632,"KOWALEWSKI, DYLAN, JOSEPH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134801632,"KOWALEWSKI, DYLAN, JOSEPH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134801632,"KOWALEWSKI, DYLAN, JOSEPH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1134802333,"RIES, TAYLOR, SUE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 29 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134802333,"RIES, TAYLOR, SUE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134802333,"RIES, TAYLOR, SUE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1134805674,"DE LA ROSA, BEVERLY, ANN",207 GORDON ST   SANFORD NC,053,Lee,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 48 , 131 ,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1134806649,"LE, LAURA, HO",104 SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 423 , 499 ," 1,609 "," $55,656.33 ",,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1134806649,"LE, LAURA, HO",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 28 ,$#,,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1134806649,"LE, LAURA, HO",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice, 401 , 541 ," 1,552 "," $62,959.17 ",,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1134809825,"MARTIN, LINDA, JEAN",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 97 , 151 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,4429 W HIGHWAY 27   VALE NC,055,Lincoln,193400000X,Group,Single Specialty,,1134809825,"MARTIN, LINDA, JEAN",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 33 ,$#,,
MEDICAID DIRECT,1134811607,GRAYS HOME CARE LLC,,1830 OWEN DR STE 10-11 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1134811607,GRAYS HOME CARE LLC,1830 OWEN DR STE 10-11 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,052 "," 1,052 "," $73,814.50 ",,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1134812506,"AUNON, TAYLOR, HOLLINGSWORTH",653 BLUEFIELD RD STE F MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 43 , 53 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1134813199,"LEE, SANDIE, PEIYU",97 NC HIGHWAY 125   ROANOKE RAPID NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346392248,EARL R CROUCH JR MD FACS PC,VIRGINIA PEDIATRIC EYE CENTER,4665 SOUTH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134817158,"KU, ANNIE, H",4665 SOUTH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134819352,"JOHNSON, TAYLOR, VERHAGE",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 27 , 57 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134819352,"JOHNSON, TAYLOR, VERHAGE",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 130 , 245 , 471 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134819352,"JOHNSON, TAYLOR, VERHAGE",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1134819352,"JOHNSON, TAYLOR, VERHAGE",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1134819352,"JOHNSON, TAYLOR, VERHAGE",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154772150,"PRASKALA, SOPHIA, MARGARETA",,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1134825433,"ELY, NICOLE, MARIE",3875 BUSINESS 17 E   BOLIVIA NC,010,Brunswick,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134825433,"ELY, NICOLE, MARIE",3875 BUSINESS 17 E   BOLIVIA NC,010,Brunswick,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 54 , 289 , 292 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134825433,"ELY, NICOLE, MARIE",3875 BUSINESS 17 E   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134825433,"ELY, NICOLE, MARIE",3875 BUSINESS 17 E   BOLIVIA NC,010,Brunswick,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 50 , 50 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134825433,"ELY, NICOLE, MARIE",3875 BUSINESS 17 E   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 165 , 165 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1134825433,"ELY, NICOLE, MARIE",5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134825433,"ELY, NICOLE, MARIE",5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134825433,"ELY, NICOLE, MARIE",5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134826340,"MUNDAY, SARAH, MAGDALINE",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134826340,"MUNDAY, SARAH, MAGDALINE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 35 , 54 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1134826340,"MUNDAY, SARAH, MAGDALINE",41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 50 , 95 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1134831274,"TURNER, MAURA, JAYNE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1134831274,"TURNER, MAURA, JAYNE",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134831274,"TURNER, MAURA, JAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1134831274,"TURNER, MAURA, JAYNE",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1134831274,"TURNER, MAURA, JAYNE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1134833262,"DILLY, SARA, ANN",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 26 , 32 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1134833262,"DILLY, SARA, ANN",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 34 , 38 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134835101,"RISING, REBECCA, CARRINGTON",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134835101,"RISING, REBECCA, CARRINGTON",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 68 , 109 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134835101,"RISING, REBECCA, CARRINGTON",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 60 , 100 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1134835101,"RISING, REBECCA, CARRINGTON",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 25 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1134837453,"CLONINGER, CANDACE, LEIGH",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 23 , 29 ,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1134837453,"CLONINGER, CANDACE, LEIGH",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1134839590,"MYERS, CATHERINE, ROSE",GATE CITY SPEECH THERAPY PLLC,4005 CASCADE DR   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1134839590,"MYERS, CATHERINE, ROSE",4005 CASCADE DR   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 13 , 93 , 93 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134840812,"FURST, BRIANNA, ELIZABETH",15 REGIONAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1134840812,"FURST, BRIANNA, ELIZABETH",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 66 , 140 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1134848302,"MUKASHEV, MIKAYLA, LYNN PRICE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1134848302,"MUKASHEV, MIKAYLA, LYNN PRICE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,901 N WINSTEAD AVE STE 430 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134849672,"CLARK, CLAIRE, BRICELY",901 N WINSTEAD AVE STE 430 ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 21 , 35 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134849672,"CLARK, CLAIRE, BRICELY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 112 , 228 , 329 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1134849672,"CLARK, CLAIRE, BRICELY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 63 , 86 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134852031,"HEINKS, JANELLE, LYNN",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134852031,"HEINKS, JANELLE, LYNN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134852593,"KEOUGH, PAIGE, NICOLE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1134852593,"KEOUGH, PAIGE, NICOLE",1085 NE GATEWAY CT NE STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 24 , 33 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134852593,"KEOUGH, PAIGE, NICOLE",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134852593,"KEOUGH, PAIGE, NICOLE",1085 NE GATEWAY CT NE STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 35 , 63 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134854565,"BOLICK, ANDREW, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134854565,"BOLICK, ANDREW, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134854565,"BOLICK, ANDREW, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1134854839,"BROOKS, NICALA, NOELL",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 89 , 109 , 294 ," $11,546.72 ",,
MEDICAID DIRECT,1558546184,JACKSONVILLE PHYSICAL THERAPY CENTE,~,2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1134857170,"WEINTRAUB, JOSHUA, M",2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 28 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134859051,"BAZEMORE, BROOKE, KERAE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134859051,"BAZEMORE, BROOKE, KERAE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1134860307,"ST GEORGE, LAUREN, LEWIS",5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 33 , 72 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1134860307,"ST GEORGE, LAUREN, LEWIS",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1134860307,"ST GEORGE, LAUREN, LEWIS",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588216253,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE CLAYTON,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134861404,"SKILLMAN, SARA, LYNN",204 MEDSPRING DR   CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 18 , 26 , 51 ,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134861404,"SKILLMAN, SARA, LYNN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134865918,"BOYD, CHELSEA, NICHOLETTE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1043765183,KIDZCARE PEDIATRICS PC,,609 ATTAIN ST STE 181 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1134865918,"BOYD, CHELSEA, NICHOLETTE",609 ATTAIN ST STE 181 FUQUAY VARINA NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 29 ,$#,,
MEDICAID DIRECT,1861947905,KIDZCARE PEDIATRICS PC,,1001 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1134865918,"BOYD, CHELSEA, NICHOLETTE",1001 W CUMBERLAND ST   DUNN NC,043,Harnett,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1629394614,KIDZCARE PEDIATRICS PC,~,1022 N BRAGG BLVD   SPRING LAKE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134865918,"BOYD, CHELSEA, NICHOLETTE",1022 N BRAGG BLVD   SPRING LAKE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 22 , 23 , 89 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134866825,"SHEAN, JENNIFER, MARIE",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1134870066,"SOARES, FREDERICO JOSE, REIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134870066,"SOARES, FREDERICO JOSE, REIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 57 , 57 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134872203,"MCGINNIS, ABIGAIL, JOHNSTON",6555 KEE LN STE 200 HARRISBURG NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 22 , 40 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134872203,"MCGINNIS, ABIGAIL, JOHNSTON",1904 JAKE ALEXANDER BLVD W STE 301 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992464002,HNI MEDICAL SERVICES OF NORTH CAROL,,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1134873466,"SHEILDS, BETHANY, JOAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 83 , 85 ,$#,,
MEDICAID DIRECT,1134873649,SRS 2 LLC,,235 W LORENZ BLVD STE C JACKSON MS,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1134873649,SRS 2 LLC,235 W LORENZ BLVD STE C JACKSON MS,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 78 , 86 , 228 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1134873961,"RICKERTS, SHAUNA, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134876212,"CHRISTIAN, MELANIE, ROSE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1134876212,"CHRISTIAN, MELANIE, ROSE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1134877137,COMPASSION 1ST HOME CARE LLC,,5318 HIGHGATE DR STE 231 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1134877137,COMPASSION 1ST HOME CARE LLC,5318 HIGHGATE DR STE 231 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 378 , 378 ," $23,327.44 ",,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1134886682,"MULL, KENDYL, TAYLOR",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1134886682,"MULL, KENDYL, TAYLOR",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134887706,QUALITY FAITH HOME CARE AGENCY,,1163 PHELPS CT   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1134887706,QUALITY FAITH HOME CARE AGENCY,1163 PHELPS CT   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,162 "," 2,162 "," $308,491.52 ",,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134889579,"SCHMITT, SAMANTHA, MARIE",1910 JAKE ALEXANDER BLVD W STE 202 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487727459,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1134891344,"DENNY, EMILY, MICHELLE",126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 21 ,$#,,
MEDICAID DIRECT,1427121144,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,413 MCCONNELL ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1134891344,"DENNY, EMILY, MICHELLE",413 MCCONNELL ST   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 74 , 180 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1134895386,"COKER, KELLY, MEAGAN BREWER",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 131 , 185 , 633 ,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134895832,"WOLF, TANNER, JAMES",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 73 , 151 ,$#,,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1134895832,"WOLF, TANNER, JAMES",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1134896731,SPOT-ON NORTH CAROLINA LLC,SPOT-ON THERAPY GROUP,7349 SPRINGWATER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1134896731,SPOT-ON NORTH CAROLINA LLC,7349 SPRINGWATER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,, 13 , 135 , 135 ,$#,,
MEDICAID DIRECT,1215048145,VIBRANCE MED SPA & WELLNESS CTR,,1025 W H SMITH BLVD STE 106 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1134900236,"MAHMOUD, NADIAH",1025 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134901697,"LINVELL, ALYSSA",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 35 , 56 , 56 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1134906795,"MUJAKOVIC, LEJLA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134906795,"MUJAKOVIC, LEJLA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134906795,"MUJAKOVIC, LEJLA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1134906795,"MUJAKOVIC, LEJLA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14221 BOREN ST   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134906795,"MUJAKOVIC, LEJLA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,440 TYVOLA RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134906795,"MUJAKOVIC, LEJLA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 26 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134909914,"CEPHAS, ELEESHA, YVETTE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 26 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134939689,"MCKILLOP, COURTNEY, THACKER",490 PINEVIEW DR STE A KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134945959,"LEARO, COURTNEY, ALYSSA ARRIANE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134945959,"LEARO, COURTNEY, ALYSSA ARRIANE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134948805,"HORSEY, MEGHAN, ELIZABETH",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134950777,BROOKS HOME CARE LLC,BROOKS HOME CARE LLC,8025 N POINT BLVD STE 282 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1134950777,BROOKS HOME CARE LLC,8025 N POINT BLVD STE 282 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 86 , 86 ,$#,,
MEDICAID DIRECT,1356998181,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH BURKE DENTAL,500 E PARKER RD STE 200 MORGANTON NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134957343,"JOHANSON, ASHTON, JAY",504 PINEOLA ST   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1841992617,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,434 HOSPITAL DR STE 105 NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134957343,"JOHANSON, ASHTON, JAY",504 PINEOLA ST   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 55 , 167 ,$#,,
MEDICAID DIRECT,1841992617,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,504 PINEOLA ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134957343,"JOHANSON, ASHTON, JAY",504 PINEOLA ST   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice, 321 , 519 ," 1,474 "," $73,060.28 ",,
MEDICAID DIRECT,1588366355,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,108 DOCTORS DR   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134957343,"JOHANSON, ASHTON, JAY",504 PINEOLA ST   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1134958671,"HONDROS, THERESA, ANNE",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1134961709,"TIEHEN, EMILY, LOUISE",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1134961709,"TIEHEN, EMILY, LOUISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1134961709,"TIEHEN, EMILY, LOUISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1134969611,"GREENWAY, APRIL, CHRISTINE",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 39 , 124 ,$#,,
MEDICAID DIRECT,1134969926,TRUWEALTH CONSULTING LLC,TRUWEALTH HOME CARE AGENCY,201 W ASH ST STE 4 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1134969926,TRUWEALTH CONSULTING LLC,201 W ASH ST STE 4 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 2,436 "," 2,533 "," $198,765.94 ",,
MEDICAID DIRECT,1134970320,CATAWBA OPERATOR LLC,CATAWBA VALLEY ASSISTED LIVING,4174 SHOOK RD   CLAREMONT NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1134970320,CATAWBA OPERATOR LLC,4174 SHOOK RD   CLAREMONT NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 28 ," 1,562 "," 1,562 "," $314,914.05 ",,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1134978661,"MOORE, VICTORIA, SOMERVAIL HOLMES",130 JAMES AVE   LOCUST NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134986722,"CHAPMAN, CHRISTOPHER, ELLIS",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1134986722,"CHAPMAN, CHRISTOPHER, ELLIS",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1134987175,"ADEKU, JOY, OLUWATOBILOBA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1134997463,REX HOSPITAL INC,UNC REX PELVIC HEALTH THERAPY,1515 SW CARY PKWY STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1134997463,REX HOSPITAL INC,1515 SW CARY PKWY STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,#, 31 , 67 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1134997703,"PHILLIPS, MEGAN, ELIZABETH",1809 BRENNER AVE STE 202 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144000878,"LANIER, JOHN, ADAM",401 N MAIN ST   KENANSVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 24 , 24 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7496 ROCKFISH RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144005463,"TEAGUE, LAUREN, THOMAS",522 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1144006024,"WOODS, JESSICA, LYN",2277 NC 24-87   CAMERON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1144006024,"WOODS, JESSICA, LYN",6801 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144009788,"PERALTA, MARIA, YERALDIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 58 , 119 , 119 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144050279,"HYATT, MARY, CATHERINE",12208 N NC HWY 150   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 16 , 20 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144050279,"HYATT, MARY, CATHERINE",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144050949,"SOKOLOWSKI, MEREDITH, CLAIRE",1910 JAKE ALEXANDER BLVD W STE 201 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144050949,"SOKOLOWSKI, MEREDITH, CLAIRE",911 W HENDERSON ST KISER BLDG STE 410 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1144051251,"DANIEL, TRAMAYNE, SHAKIA",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1144051251,"DANIEL, TRAMAYNE, SHAKIA",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1144057787,"WILLIAMS, SHAMEKA, L",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1144057787,"WILLIAMS, SHAMEKA, L",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144057787,"WILLIAMS, SHAMEKA, L",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588003032,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144065558,"ALBRECHT, SARAH, ASHLEY",1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 29 , 44 ,$#,,
MEDICAID DIRECT,1144068172,A DIFFERENT DIRECTION HOME CARE LLC,,9243 SHANNON RD SUITE B SHANNON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1144068172,A DIFFERENT DIRECTION HOME CARE LLC,9243 SHANNON RD SUITE B SHANNON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,#, 287 , 287 ," $16,820.96 ",,
MEDICAID DIRECT,1144072547,ACCOUNTABLE SOLUTIONS LLC,,757 S MAIN ST   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1144072547,ACCOUNTABLE SOLUTIONS LLC,757 S MAIN ST   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,#, 241 , 241 ," $16,199.16 ",,
MEDICAID DIRECT,1144076514,HIS MERCIES HOMES,,105 PRIMROSE LN   CLAYTON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144076514,HIS MERCIES HOMES,105 PRIMROSE LN   CLAYTON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,430 "," 1,430 "," $89,780.94 ",,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1144082603,"ENGMAN, BRITTANY, AMBER LEIGH",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1144082603,"ENGMAN, BRITTANY, AMBER LEIGH",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1972123537,MURPHY MEDICAL CENTER INC,,2751 BUSINESS 19   ANDREWS NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144090432,"WELLER, LAINEY, JO",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 71 , 71 ," $10,442.81 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1144090432,"WELLER, LAINEY, JO",146 HWY 64 E   HAYESVILLE NC,022,Clay,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1144090432,"WELLER, LAINEY, JO",183 LEDFORD ST STE A&B MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144096496,"SAULS, BRYNNAN, ELIZABETH",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144096496,"SAULS, BRYNNAN, ELIZABETH",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144097023,"FARRAR, CANDACE, LETARA",1380 EASTCHESTER DR STE 103 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1144097023,"FARRAR, CANDACE, LETARA",1380 EASTCHESTER DR STE 103 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144200189,"DAVIS, BRADLEY, DUANE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144200429,"HALL, TIMOTHY, JAMES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144200429,"HALL, TIMOTHY, JAMES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 22 , 29 ,$#,,
MEDICAID DIRECT,1750735064,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS HEALTHCARE SYSTEM WOUND CARE PHYSICIANS-,101 E W T HARRIS BLVD STE 5203 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144200429,"HALL, TIMOTHY, JAMES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 386 , 567 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144200429,"HALL, TIMOTHY, JAMES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144200429,"HALL, TIMOTHY, JAMES",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144200429,"HALL, TIMOTHY, JAMES",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144200734,"ALHOSAINI, HASSAN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144200734,"ALHOSAINI, HASSAN",2025 FRONTIS PLAZA BLVD STE 100 WINSTON SALEM NC,034,Forsyth,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144200734,"ALHOSAINI, HASSAN",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144200734,"ALHOSAINI, HASSAN",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 17 , 35 , 35 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144200734,"ALHOSAINI, HASSAN",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144201187,"ELLINGTON, AMY, LYNNE",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144202235,"LAMPHEAR, JAMES, GEORGE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144202235,"LAMPHEAR, JAMES, GEORGE",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 53 , 70 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144202755,"HODGES, STEVE, JAMES",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144202755,"HODGES, STEVE, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 128 , 233 , 284 ," $20,487.48 ",,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144202755,"HODGES, STEVE, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144202755,"HODGES, STEVE, JAMES",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 12 , 24 ,$#,,
MEDICAID DIRECT,1144203217,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,3022 S CROATAN HWY UNIT 10 NAGS HEAD NC,028,Dare,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1144203217,MEDICAL SERVICES OF AMERICA INC,3022 S CROATAN HWY UNIT 10 NAGS HEAD NC,028,Dare,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 30 , 128 , 234 ,$#,,
MEDICAID DIRECT,1144203217,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,3022 S CROATAN HWY UNIT 10 NAGS HEAD NC,028,Dare,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1144203217,MEDICAL SERVICES OF AMERICA INC,3022 S CROATAN HWY UNIT 10 NAGS HEAD NC,028,Dare,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1144203696,"ROGERS, CHRISTINA, PAXTON",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 69 , 93 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1144203696,"ROGERS, CHRISTINA, PAXTON",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 59 , 62 ,$#,,
MEDICAID DIRECT,1609914100,CARLYLE DUKES HAYWOOD JR,,211 W BROAD AVE   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1144204579,"HAYWOOD, CARLYLE, DUKES",326 ALBEMARLE RD   TROY NC,062,Montgomery,152W00000X,Eye and Vision Services Providers,Optometrist,, 30 , 34 , 47 ,$#,,
MEDICAID DIRECT,1043357643,CARLYLE DUKES HAYWOOD JR,DOCTORS VISION CENTER,326 ALBEMARLE RD   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1144204579,"HAYWOOD, CARLYLE, DUKES",326 ALBEMARLE RD   TROY NC,062,Montgomery,152W00000X,Eye and Vision Services Providers,Optometrist,, 130 , 149 , 192 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144204587,"DEVENTE, JAMES, EDWARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144204587,"DEVENTE, JAMES, EDWARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 37 , 37 , 40 ," $10,627.12 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144204587,"DEVENTE, JAMES, EDWARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144204587,"DEVENTE, JAMES, EDWARD",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144204587,"DEVENTE, JAMES, EDWARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144204587,"DEVENTE, JAMES, EDWARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 54 , 68 ,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1144204645,"BRYANT, DENISE, ABSHER",233 DOCTORS ST   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 100 , 162 ,$#,,
MEDICAID DIRECT,1477840791,ALLEGHANY EMERGENCY GROUP LLC,ALLEGHANY EMERGENCY GROUP LLC,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1144204645,"BRYANT, DENISE, ABSHER",233 DOCTORS ST   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144204868,"SHASHI, VANDANA",2100 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144204868,"SHASHI, VANDANA",3000 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 22 , 31 ,$#,,
MEDICAID DIRECT,1467706705,FHPG LLC,FIRSTHEALTH FAMILIY MEDICINE CANDOR,210 E MAIN ST   CANDOR NC,062,Montgomery,193400000X,Group,Single Specialty,,1144205089,"BARBER, ALVIN, FLOYD",210 E MAIN ST   CANDOR NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366180374,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,1001 MONROE ST STE D CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1144205089,"BARBER, ALVIN, FLOYD",7473-C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548290265,FHPG LLC,FIRST HEALTH FAMILY MEDICINE SEVEN LAKES,1035C 7 LAKES DR   WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1144205089,"BARBER, ALVIN, FLOYD",7473-C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972060796,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,304 E SAUNDERS ST   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1144205089,"BARBER, ALVIN, FLOYD",7473-C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861838039,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE BISCOE,104 PROFESSIONAL DR   BISCOE NC,062,Montgomery,193400000X,Group,Single Specialty,,1144205089,"BARBER, ALVIN, FLOYD",104 PROFESSIONAL DR   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972060796,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,304 E SAUNDERS ST   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1144205089,"BARBER, ALVIN, FLOYD",304 SAUNDERS ST   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1366180374,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,1001 MONROE ST STE D CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1144205089,"BARBER, ALVIN, FLOYD",1001 MONROE ST STE D CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144205287,"KENDALL, JAMES, EUGENE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1144205287,"KENDALL, JAMES, EUGENE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2704 N MAIN ST STE B TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1144205287,"KENDALL, JAMES, EUGENE",2704 N MAIN ST   TARBORO NC,033,Edgecombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144205287,"KENDALL, JAMES, EUGENE",2704 N MAIN ST   TARBORO NC,033,Edgecombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 66 , 77 , 97 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1144205287,"KENDALL, JAMES, EUGENE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1144205287,"KENDALL, JAMES, EUGENE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144205428,"HIGH, KEVIN, PAUL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 32 , 61 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144205584,"MOOSSAVI, SHAHRIAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144205584,"MOOSSAVI, SHAHRIAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 147 , 460 , 506 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144206301,"POTTI, DEEPA, RETNEM",12208 N NC HIGHWAY 150   WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 103 , 121 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144206301,"POTTI, DEEPA, RETNEM",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144206319,"KRAKOVER, BRIAN, ALAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 148 , 158 , 197 ," $10,360.35 ",,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144206319,"KRAKOVER, BRIAN, ALAN",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144206749,"PRANIKOFF, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 52 , 129 , 142 ," $15,369.14 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144207010,"STEVENS, HOLLY, ANN",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144207010,"STEVENS, HOLLY, ANN",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1689680332,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS,6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144207010,"STEVENS, HOLLY, ANN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144207010,"STEVENS, HOLLY, ANN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 24 , 24 ,$#,,
MEDICAID DIRECT,1538501903,CAROLINA PEDIATRIC CENTER PLLC,CAROLINA PEDIATRIC CENTER PLLC,239 WILMOT DR STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144208000,"MIJUMBI, OLIVIA, BRIDGET",239 WILMOT DR STE A GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 54 , 146 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1144211418,"CUSTER, TIMOTHY, JOHN",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144211418,"CUSTER, TIMOTHY, JOHN",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 18 , 21 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1144211483,"THRONEBURG, DAVID, BRENNEN",1223 CARTHAGE ST   SANFORD NC,053,Lee,152W00000X,Eye and Vision Services Providers,Optometrist,, 27 , 28 , 38 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1144211483,"THRONEBURG, DAVID, BRENNEN",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1144211483,"THRONEBURG, DAVID, BRENNEN",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 78 , 102 , 153 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1144211483,"THRONEBURG, DAVID, BRENNEN",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 40 , 51 , 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144211905,"ALLEN, PETER, JOHN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144211905,"ALLEN, PETER, JOHN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144211905,"ALLEN, PETER, JOHN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821076589,EAST CAROLINA HEALTH HERITAGE INC,Vidant Family Medicine Pinetops,1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144212754,"COLTRANE, LISA, YANCEY",1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1821076589,EAST CAROLINA HEALTH HERITAGE INC,Vidant Family Medicine Pinetops,1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144212754,"COLTRANE, LISA, YANCEY",101 CLINIC DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 73 , 85 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144213026,"BREMER, CELESTE, ANN",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144213026,"BREMER, CELESTE, ANN",1950 GLENN MITCHELL DR STE 102 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1922198977,HIGH POINT PEDIATRICS,~,404 WESTWOOD AVE STE 103 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1144213414,"GORDON, KARYN, BAYYINAH",404 WESTWOOD AVE STE 103 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 32 , 74 ,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144213661,"LEONARD, KEVIN, JAMES",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,201 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1144213661,"LEONARD, KEVIN, JAMES",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 78 , 83 , 99 ,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1144213661,"LEONARD, KEVIN, JAMES",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 172 , 185 , 236 ,$#,,
MEDICAID DIRECT,1144213778,COUNTY OF AVERY OFFICE OF ACCOUNTAN,AVERY COUNTY EMS,456 A ST   NEWLAND NC,006,Avery,3416L0300X,Transportation Services,Ambulance,Land Transport,1144213778,COUNTY OF AVERY OFFICE OF ACCOUNTAN,456 A ST   NEWLAND NC,006,Avery,3416L0300X,Transportation Services,Ambulance,Land Transport, 69 , 163 , 312 ,$#,,
MEDICAID DIRECT,1942445762,CAROLINA WOUND CARE SPECIALISTS PL,CAROLINA WOUND CARE SPECIALISTSMD,101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1144214883,"HARRISON, WALTER, DOUGLAS",101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 38 , 128 , 263 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144214917,"RABIL, DONALD, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 58 , 123 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144214917,"RABIL, DONALD, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1497771992,PRIVATE DIAGNOSTIC CLINIC PLLC,Raleigh Pulmonary and Allergy,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144214917,"RABIL, DONALD, MICHAEL",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 303 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144214917,"RABIL, DONALD, MICHAEL",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144214917,"RABIL, DONALD, MICHAEL",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 129 , 161 , 295 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144214917,"RABIL, DONALD, MICHAEL",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144216078,"CASEY, PHILIP, COGAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144216078,"CASEY, PHILIP, COGAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740989516,ONSITE NEONATAL NC PC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1144219296,"SHEPARD, ARTHUR, J",2201 S STERLING ST   MORGANTON NC,012,Burke,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144219569,"HYSONG, REBECCA, SUZANNE",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104475219,CAROLINA NEUROLOGICAL CONSULTI,,1061 X RAY DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144220161,"DUBISKY, GARY, LYNN",1061 X RAY DR   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 60 , 78 , 93 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1144220856,"MARINELLI, SCOTT, ANTHONY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1144220856,"MARINELLI, SCOTT, ANTHONY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 91 , 102 , 142 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144221540,"MORRIS, SARAH, NALL",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144221540,"MORRIS, SARAH, NALL",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144221540,"MORRIS, SARAH, NALL",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144222860,"O MALLEY, JOHN, SCOTT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144222860,"O MALLEY, JOHN, SCOTT",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 52 , 87 , 137 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144222860,"O MALLEY, JOHN, SCOTT",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144223330,DARE COUNTY ADMINISTRATIVE OFFICES,DARE COUNTY EMS,1632 N CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,3416A0800X,Transportation Services,Ambulance,Air Transport,1144223330,DARE COUNTY ADMINISTRATIVE OFFICES,1632 N CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1144223330,DARE COUNTY ADMINISTRATIVE OFFICES,DARE COUNTY EMS,1632 N CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,3416L0300X,Transportation Services,Ambulance,Land Transport,1144223330,DARE COUNTY ADMINISTRATIVE OFFICES,1632 N CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,3416L0300X,Transportation Services,Ambulance,Land Transport, 89 , 225 , 435 ,$#,,
MEDICAID DIRECT,1144223504,"SHELTON, BRIANA, JOHNSON",~,2285 RUTHERFORD RD   MARION NC,059,McDowell,152W00000X,Eye and Vision Services Providers,Optometrist,,1144223504,"SHELTON, BRIANA, JOHNSON",2285 RUTHERFORD RD   MARION NC,059,McDowell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1114108891,BRIANA J SHELTON OD PA,PROFESSIONAL VISION CENTERS,364 US 70 W STE 4 MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1144223504,"SHELTON, BRIANA, JOHNSON",364 US 70 W STE 4 MARION NC,059,McDowell,152W00000X,Eye and Vision Services Providers,Optometrist,, 26 , 25 , 27 ,$#,,
MEDICAID DIRECT,1144223504,"SHELTON, BRIANA, JOHNSON",~,364 US 70 W STE 4 MARION NC,059,McDowell,152W00000X,Eye and Vision Services Providers,Optometrist,,1144223504,"SHELTON, BRIANA, JOHNSON",364 US 70 W STE 4 MARION NC,059,McDowell,152W00000X,Eye and Vision Services Providers,Optometrist,, 41 , 41 , 79 ,$#,,
MEDICAID DIRECT,1114108891,BRIANA J SHELTON OD PA,PROFESSIONAL VISION CENTERS,2285 RUTHERFORD RD   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1144223504,"SHELTON, BRIANA, JOHNSON",2285 RUTHERFORD RD   MARION NC,059,McDowell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1770825390,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST CLINICAL PHARMAC,1208 EASTCHESTER DR STE 107 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144224890,"KLEIN, STEVEN, RUSSELL",1208 EASTCHESTER DR STE 107 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144224890,"KLEIN, STEVEN, RUSSELL",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144224890,"KLEIN, STEVEN, RUSSELL",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144224890,"KLEIN, STEVEN, RUSSELL",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477671980,NEUROLOGY CENTER OF LUMBERTON,~,785 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1144227638,"GATIWALA, INDRAVADAN, SAKARLAL",785 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 246 , 444 , 627 ," $16,515.79 ",,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144227729,"ETTEFAGH, KEIVAN",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 44 , 54 , 136 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144228008,"FULLER, CARO, ELIZABETH",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144229758,"KLEIN, JEFFREY, LAWRENCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 116 , 201 , 304 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144234592,"EDWARDS, ANDREA, HOBGOOD",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144234592,"EDWARDS, ANDREA, HOBGOOD",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144234592,"EDWARDS, ANDREA, HOBGOOD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144234592,"EDWARDS, ANDREA, HOBGOOD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144234923,"ELLIS, COURTNEY, LYNN",332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 31 , 75 ,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144234923,"ELLIS, COURTNEY, LYNN",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144234923,"ELLIS, COURTNEY, LYNN",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 36 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144237306,"COCHRAN, STEPHEN, GEORGE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144237306,"COCHRAN, STEPHEN, GEORGE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 50 , 138 , 147 ," $16,514.98 ",,
MEDICAID DIRECT,1144652330,UNIVERSITY SURGERY CENTER LLC,MALLARD CREEK SURGERY CENTER,9848 N TRYON ST STE 200 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1144238338,"STANLEY, KEVIN, JON",150 FAIRVIEW RD STE 230 MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144238338,"STANLEY, KEVIN, JON",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144238338,"STANLEY, KEVIN, JON",150 FAIRVIEW RD STE 230 MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144238338,"STANLEY, KEVIN, JON",124 WELTON WAY   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 38 , 62 ,$#,,
MEDICAID DIRECT,1144239518,APRIA HEALTHCARE LLC,,1207A 16TH ST NE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1144239518,APRIA HEALTHCARE LLC,1207A 16TH ST NE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 397 ," 2,123 "," 4,419 "," $58,465.16 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1144240250,"WHITMAN, BRUCE, STEVEN",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144241993,EASTERN CAROLINA PHARMACY CARE INC,REALO DISCOUNT DRUG,1302 W VERNON AVE   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1144241993,EASTERN CAROLINA PHARMACY CARE INC,1302 W VERNON AVE   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1376092056,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH DIABETES MANAGEMENT,1400 WESTGATE CENTER DR STE 130 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144242256,"RUSHTON, WANDA, ELAINE",1400 WESTGATE CENTER DR STE 130 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1144244112,"ELLINGTON, KENNETH, RAYNOR",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144244112,"ELLINGTON, KENNETH, RAYNOR",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144244112,"ELLINGTON, KENNETH, RAYNOR",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1144245242,"SMITH, JOHN, RUTHERFOORD",38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144245333,"HURST, BRADLEY, SHAWN",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207VE0102X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Reproductive Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,2668 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144245713,"BAKER, BARBARA, JEAN CALKINS",2668 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 45 , 77 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144245713,"BAKER, BARBARA, JEAN CALKINS",2668 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144245853,"SIMS, STEPHEN, HUBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1336543495,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,105 YADKIN ST STE 101 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1144245853,"SIMS, STEPHEN, HUBERT",105 YADKIN ST STE 101 ALBEMARLE NC,084,Stanly,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144247313,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3503,1585 LIBERTY DR STE 1 THOMASVILLE NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1144247313,WAL-MART STORES EAST LP,1585 LIBERTY DR STE 1 THOMASVILLE NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1144247313,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3503,1585 LIBERTY DR STE 1 THOMASVILLE NC,029,Davidson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1144247313,WAL-MART STORES EAST LP,1585 LIBERTY DR STE 1 THOMASVILLE NC,029,Davidson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 70 , 115 , 288 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 55 , 84 , 209 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",10710 SIKES PL STE 100 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 37 , 92 , 130 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144247750,"MAHALE, ADIT, SHRIKRISHNA",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144248188,"TATE, TIFFANY, GREEN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144248188,"TATE, TIFFANY, GREEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144248949,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1166,1347 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1144248949,WAL-MART STORES EAST LP,1347 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144249244,"ABRAMS, MARC, JASON",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144249244,"ABRAMS, MARC, JASON",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144249244,"ABRAMS, MARC, JASON",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144250820,"VARADARAJAN, RUPASHREE",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 143 , 276 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144251240,"PILLAI, PRIYA, BAJAJ",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144251240,"PILLAI, PRIYA, BAJAJ",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144251364,"KAUFFMAN, PETER, JOSEPH",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 192 , 216 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1144251364,"KAUFFMAN, PETER, JOSEPH",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144251364,"KAUFFMAN, PETER, JOSEPH",522 ALLEN ST STE 201 TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144251364,"KAUFFMAN, PETER, JOSEPH",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 39 , 40 ,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144251398,"BATHULA, SAILATHA",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 220 , 264 ,$#,,
MEDICAID DIRECT,1467099127,CAROLINA ACUTE CARE & WELLNESS CENT,,2601 N ELM ST STE A LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1144252081,"STEPHENS, GINA, SCOTT",2601 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144252750,"SMITH, LANE, MCNEIL",2525 COURT DR   GASTONIA NC,036,Gaston,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 44 , 83 , 105 ," $11,169.35 ",,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1144253436,"KATHARD, HARESH, MANILALL",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144253436,"KATHARD, HARESH, MANILALL",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144253436,"KATHARD, HARESH, MANILALL",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144254442,"MARIANO, ROWENA, BLAS",120 E CARVER ST   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1144254442,"MARIANO, ROWENA, BLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144254442,"MARIANO, ROWENA, BLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144254442,"MARIANO, ROWENA, BLAS",3643 N ROXBORO ST   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144255100,"BAER, CLAXTON, ALLEN",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 20 , 44 ,$#,,
MEDICAID DIRECT,1144256066,"CRAWFORD, PATRICIA, ANN",,215 HALTON RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1144256066,"CRAWFORD, PATRICIA, ANN",215 HALTON RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144256488,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1200 RIDGEFIELD BLVD STE 110A ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,1144256488,BAYADA HOME HEALTH CARE INC,1200 RIDGEFIELD BLVD STE 110A ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,, 63 ," 9,348 "," 9,377 "," $1,419,010.44 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144257643,"CASINGAL, VINCENT, PHILIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1356735336,SOUTHLAND BAINBRIDGE HOSPITALIST GR,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144258831,"STARKE, CINDY, BUCKNER",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144260233,"PIERCE, JEANNE, CATHERINE",154 S MAIN ST   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144260233,"PIERCE, JEANNE, CATHERINE",154 S MAIN ST   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144260233,"PIERCE, JEANNE, CATHERINE",154 S MAIN ST   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 30 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144260233,"PIERCE, JEANNE, CATHERINE",154 S MAIN ST   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,154 S MAIN ST   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144260233,"PIERCE, JEANNE, CATHERINE",154 S MAIN ST   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 58 , 85 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144260233,"PIERCE, JEANNE, CATHERINE",154 S MAIN ST   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 24 , 72 ,$#,,
MEDICAID DIRECT,1437189784,WESTERN NC COMMUNITY HEALTH SVCS,WESTERN NC COMMUNITY HEALTH SERVICES INC,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144260506,"GARRISON, HILARY",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 160 , 243 , 687 ," $33,119.39 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 34 , 41 , 57 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 33 , 37 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144260803,"MORGAN, MICHELE, LYNN",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1144261355,"DORLON JR, ROBERT, EDWIN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 34 , 34 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144261355,"DORLON JR, ROBERT, EDWIN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 177 , 177 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1144263690,"WEST, MARK, WARREN",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 37 , 37 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1144263690,"WEST, MARK, WARREN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1144265109,"SWANTKOWSKI, THOMAS, MARIAN",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144265109,"SWANTKOWSKI, THOMAS, MARIAN",205 PAGE RD   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 36 , 45 , 61 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144265109,"SWANTKOWSKI, THOMAS, MARIAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 16 , 25 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144265109,"SWANTKOWSKI, THOMAS, MARIAN",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 28 , 43 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,,,Unknown,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1144265109,"SWANTKOWSKI, THOMAS, MARIAN",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1144265455,"AIKAWA, TARO",4210 TAYLOR HALL PL   CHAPEL HILL NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,3600 MINNESOTA DR STE 800 EDINA MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1144265455,"AIKAWA, TARO",4210 TAYLOR HALL PL   CHAPEL HILL NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1144266826,"MARAMRAJ, KISHAN, RAO",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1144266826,"MARAMRAJ, KISHAN, RAO",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 192 , 584 ," 1,076 "," $16,168.57 ",,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1144268616,"REICHLING, ROBERT, JOSEPH",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 172 , 218 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144268707,"NAGAPPAN, SURESH",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#, 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144268707,"NAGAPPAN, SURESH",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 44 , 44 ,$#,,
MEDICAID DIRECT,1366067233,ST LUKES PHYSICIAN NETWORK INC,ST LUKES UROLOGY ASSOCIATES,54 HOSPITAL DR STE 3B COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1144268939,"CARGILL, JOHN, GEORGE",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366067233,ST LUKES PHYSICIAN NETWORK INC,ST LUKES UROLOGY ASSOCIATES,54 HOSPITAL DR STE 3B COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1144268939,"CARGILL, JOHN, GEORGE",54 HOSPITAL DR STE 3B COLUMBUS NC,075,Polk,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1912267402,GLAUCOMA AND CATARACT ASSOC OF NORT,GLAUCOMA AND CATARACT ASSOCIATES OF NORTH CAROLINA,4201 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144270083,"SIDDIQUI, NOUMAN",4201 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 49 , 100 , 163 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144272790,"WELLS, MATTHEW, KENT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 135 , 151 , 181 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1144272790,"WELLS, MATTHEW, KENT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1568544492,HUGH CHATHAM MEMORIAL HOSPITAL,YADKIN VALLEY ADULT MEDICINE,500 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1144272840,"GULLEY, PAUL, HUDSON",500 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 49 , 78 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1144273400,"LEVINE, MARC, LAURENCE",50 HOSPITAL DR STE 3B HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144273400,"LEVINE, MARC, LAURENCE",50 HOSPITAL DR STE 3B HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1144273400,"LEVINE, MARC, LAURENCE",50 HOSPITAL DR STE 3B HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 61 , 70 , 94 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1144273400,"LEVINE, MARC, LAURENCE",80 HEALTHCARE DR STE 101 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 58 , 71 , 78 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144273418,"KATZ, CRYSTAL, DUNCAN",3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144273418,"KATZ, CRYSTAL, DUNCAN",3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 36 , 37 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144273418,"KATZ, CRYSTAL, DUNCAN",3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144273418,"KATZ, CRYSTAL, DUNCAN",3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1144273632,"SAYLES, WILLIAM, ALEXANDER",WILLIAM ALEXANDER SAYLES,601 N BICKETT BLVD   LOUISBURG NC,035,Franklin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,1144273632,"SAYLES, WILLIAM, ALEXANDER",601 N BICKETT BLVD   LOUISBURG NC,035,Franklin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1144273632,"SAYLES, WILLIAM, ALEXANDER",WILLIAM ALEXANDER SAYLES,601 N BICKETT BLVD   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1144273632,"SAYLES, WILLIAM, ALEXANDER",601 N BICKETT BLVD   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 42 , 84 ,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1144273681,"DUFOUR, HAROLD, CHARLES",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144273681,"DUFOUR, HAROLD, CHARLES",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144273681,"DUFOUR, HAROLD, CHARLES",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992857841,COUNTY OF CATAWBA OFFICE OF ACCOUNT,CATAWBA COUNTY PUBLIC HEALTH,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144273681,"DUFOUR, HAROLD, CHARLES",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1144275165,"HORTON, TIFFANY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144275223,"FRANKLIN, RICHARD, CLIFTON",201 E GROVER ST   SHELBY NC,023,Cleveland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144275223,"FRANKLIN, RICHARD, CLIFTON",1100 N LAFAYETTE ST   SHELBY NC,023,Cleveland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 77 , 79 , 84 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144275223,"FRANKLIN, RICHARD, CLIFTON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144275439,"SMOLENYAK, SEAN, WINSTON",101 MARK DR   EDENTON NC,021,Chowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 180 , 242 , 367 ,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144275439,"SMOLENYAK, SEAN, WINSTON",8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1144276346,"BASILE, VITO",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 39 , 41 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 20 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 27 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 22 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 49 , 60 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 16 , 19 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 69 , 70 , 96 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 21 , 29 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 25 , 37 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144276965,"HECK, DONALD, VINCENT",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1134454853,CAROLINA PAIN ASSOCIATES PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1144277930,"ARONOFF, GERALD, MARTIN",9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1265942403,UBYLEE HEALTHCARE GROUP,,9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144277930,"ARONOFF, GERALD, MARTIN",9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 20 , 41 ,$#,,
MEDICAID DIRECT,1134454853,CAROLINA PAIN ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1144277930,"ARONOFF, GERALD, MARTIN",9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144279456,"WHEELER, JAY, BRENT",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144279761,"TOWER, MARNE, ANN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 32 , 78 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144279761,"TOWER, MARNE, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972513679,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - WOUND HEALING SER,853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144279860,"MILLER COX, DEBRA, LAUREN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1144281403,"TARASKA, GREGORY, JOHN",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 86 , 108 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144281841,"WILSON II, CLARENCE",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 24 , 50 ,$#,,
MEDICAID DIRECT,1144281858,LINCOLN COUNTY,Lincoln County EMS,720 JOHN HOWEL MEMORIAL DR   LINCOLNTON NC,055,Lincoln,3416L0300X,Transportation Services,Ambulance,Land Transport,1144281858,LINCOLN COUNTY,720 JOHN HOWEL MEMORIAL DR   LINCOLNTON NC,055,Lincoln,3416L0300X,Transportation Services,Ambulance,Land Transport, 603 ," 1,100 "," 2,045 "," $26,496.61 ",,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1144282435,"PLEASANTS, GREGORY, TODD",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 59 ,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144282971,"PUZIO, LAWRENCE, STANLEY",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 44 , 59 , 104 ,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144283797,"BUTLAK, LINDA, MARIE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144283797,"BUTLAK, LINDA, MARIE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1144283870,"SUBRAMANIAM, GEETA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144283870,"SUBRAMANIAM, GEETA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144283870,"SUBRAMANIAM, GEETA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 41 , 55 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1144283870,"SUBRAMANIAM, GEETA",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144283870,"SUBRAMANIAM, GEETA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 35 ,$#,,
MEDICAID DIRECT,1811637366,360 ANESTHESIA PLLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1144284639,"ORME, HEIDI, ANNE",117 E KINGS HWY   EDEN NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144284803,"FRIZZELL, ERIC, RAYMOND",205 PAGE RD   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 45 , 64 , 79 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144284803,"FRIZZELL, ERIC, RAYMOND",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 26 , 26 , 39 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144284803,"FRIZZELL, ERIC, RAYMOND",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144284803,"FRIZZELL, ERIC, RAYMOND",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 39 , 41 , 58 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1144284803,"FRIZZELL, ERIC, RAYMOND",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 ,#, 12 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144285123,"WILEY, THOMAS, MICHAEL",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 58 , 98 , 148 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144285123,"WILEY, THOMAS, MICHAEL",1771 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 13 , 15 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144285123,"WILEY, THOMAS, MICHAEL",1771 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 31 , 56 , 83 ,$#,,
MEDICAID DIRECT,1144285578,FAMILY CARE PHARMACY,FAMILY CARE PHARMACY,606 S CHURCH ST   HERTFORD NC,072,Perquimans,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1144285578,FAMILY CARE PHARMACY,606 S CHURCH ST   HERTFORD NC,072,Perquimans,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 20 , 22 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1144285594,"HULSMAN, LAURIE",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144285750,"SCHURR, MICHAEL, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144285750,"SCHURR, MICHAEL, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144285750,"SCHURR, MICHAEL, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144285750,"SCHURR, MICHAEL, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 38 , 41 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144286287,"HOOPER, RICHELLE, NUGENT",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 39 , 45 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144286287,"HOOPER, RICHELLE, NUGENT",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144286592,"MOORE, SLADE, CURTIS",1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 15 , 25 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144286592,"MOORE, SLADE, CURTIS",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144286592,"MOORE, SLADE, CURTIS",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144286592,"MOORE, SLADE, CURTIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144286592,"MOORE, SLADE, CURTIS",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 46 , 74 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144286592,"MOORE, SLADE, CURTIS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144286592,"MOORE, SLADE, CURTIS",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 57 , 79 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1144286691,"LUTTERMAN, JOEL",1135 CARTHAGE ST   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144286691,"LUTTERMAN, JOEL",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 158 , 202 , 296 ," $17,146.06 ",,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144286691,"LUTTERMAN, JOEL",350 E HOLDING AVE   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144286691,"LUTTERMAN, JOEL",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144286691,"LUTTERMAN, JOEL",5809 DEPARTURE DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144286691,"LUTTERMAN, JOEL",1002 DOGWOOD DR   ZEBULON NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144286964,"HUGHES, GARLAND, LYNN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 232 , 233 ,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144286964,"HUGHES, GARLAND, LYNN",1771 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487940268,OUR FAMILY DOCTOR PLLC,OUR FAMILY DOCTOR PLLC,43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144287293,"SCHWAB, JODI, ERIN",43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 42 , 71 ,$#,,
MEDICAID DIRECT,1447214242,TRIANGLE PEDIATRIC CENTER,TRIANGLE PEDIATRIC CENTER,105 RIDGE VIEW DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1144289109,"HOROWITZ, DAVID, ALFRED",105 RIDGE VIEW DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 21 , 36 ,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1144289752,"MACK, YVONNE",182 VIRGINIA ST   BOONE NC,095,Watauga,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144289752,"MACK, YVONNE",182 VIRGINIA ST   BOONE NC,095,Watauga,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 25 , 53 , 68 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144289752,"MACK, YVONNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1144289752,"MACK, YVONNE",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 16 , 29 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144289752,"MACK, YVONNE",10030 GILEAD RD STE B120 HUNTERSVILLE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144289752,"MACK, YVONNE",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144289752,"MACK, YVONNE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1790568046,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA GYNECOLOGY AND AESTHETICS,127 N STEELE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144290669,"SILER, GWENDOLYN, WOODS",127 N STEELE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1952665929,RURAL HEALTH GROUP INC,Rural Health Group at Enfield,114 MARKET ST   ENFIELD NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144291410,"GALLOWAY, AYANNA, SARAN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144291410,"GALLOWAY, AYANNA, SARAN",100 COLLEGE DR BLDG 700 WELDON NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144291410,"GALLOWAY, AYANNA, SARAN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 213 , 221 ,$#,,
MEDICAID DIRECT,1689626178,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON,9425 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144291410,"GALLOWAY, AYANNA, SARAN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144291410,"GALLOWAY, AYANNA, SARAN",707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144292459,"CLAYTON, STEVEN, BRIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 86 , 123 , 173 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144292459,"CLAYTON, STEVEN, BRIAN",500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144293143,"GILCHRIST, RUSSELL, VERNON",214 18TH ST SE   HICKORY NC,018,Catawba,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 163 , 551 , 808 ," $14,204.37 ",,
MEDICAID DIRECT,1629674106,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH EAR NOSE & THROAT,805 TILGHMAN DR STE A DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1144294117,"STALLMAN, JOHN, BARRON",805 TILGHMAN DR STE A DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 76 , 97 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144294356,"CHINTALAPATI, SITARAMA, RAJU",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 90 , 94 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144294356,"CHINTALAPATI, SITARAMA, RAJU",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1144294943,"JABARI, JAWANZA, NYAHUMA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 154 , 172 , 179 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144295593,"JONES, TAMARA, ALETTA",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144295593,"JONES, TAMARA, ALETTA",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 203 , 203 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144295783,"LAWING, WILLIAM, LANDER",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 31 , 31 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144295783,"LAWING, WILLIAM, LANDER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 66 , 67 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144295783,"LAWING, WILLIAM, LANDER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1144295908,"ROOT, CHRISTOPHER, ROBIN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1215904909,JOSEPH M STILL BURN CENTERS INC,,3675 J DEWEY GRAY CIR STE 300 AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1144297466,"HASSAN, S M ABU ZAHEED",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,,,$#,,
MEDICAID DIRECT,1518927318,SUNDAR INTERNAL MEDICINE ASSOCIATES,~,511 RUIN CREEK RD STE 203 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1144298886,"SUNDAR, VEERAPPAN",511 RUIN CREEK RD STE 203 HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 102 , 395 , 659 ," $12,872.32 ",,
MEDICAID DIRECT,1669997144,WRIGHT AND ASSOCIATES VII DDS PA,,120 NE MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144300211,"MCGROGAN, RITA, BETH",120 NE MAYNARD RD   CARY NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 79 , 232 , 284 ," $45,454.12 ",,
MEDICAID DIRECT,1124556063,WRIGHT AND ASSOCIATES V DDS PA,,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144300211,"MCGROGAN, RITA, BETH",120 NE MAYNARD RD   CARY NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1740705219,WRIGHT AND ASSOCIATES VI,,12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1144300211,"MCGROGAN, RITA, BETH",12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 143 , 301 , 315 ," $49,172.76 ",,
MEDICAID DIRECT,1669997144,WRIGHT AND ASSOCIATES VII DDS PA,,120 NE MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144300211,"MCGROGAN, RITA, BETH",12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1144300211,"MCGROGAN, RITA, BETH",12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 15 , 52 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144304015,"WEIGEL, WADE, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144304015,"WEIGEL, WADE, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 49 , 53 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144304015,"WEIGEL, WADE, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144304049,"ROBINSON, STEPHEN, ERIC",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 19 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144304049,"ROBINSON, STEPHEN, ERIC",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 42 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144304049,"ROBINSON, STEPHEN, ERIC",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 88 , 99 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144304049,"ROBINSON, STEPHEN, ERIC",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 65 , 98 , 152 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1144304049,"ROBINSON, STEPHEN, ERIC",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1972656262,ASHEVILLE ENDOCRINOLOGY CONSULTANTS,ASHEVILLE ENDOCRINOLOGY CONSULTANTS PA,750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144304288,"CUMBIE, BRIAN, CHRISTOPHER",750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1972656262,ASHEVILLE ENDOCRINOLOGY CONSULTANTS,ASHEVILLE ENDOCRINOLOGY CONSULTANTS PA,750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144304288,"CUMBIE, BRIAN, CHRISTOPHER",750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 133 , 253 ," 1,042 "," $12,852.86 ",,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1144304734,"AUDU, RAYMOND, OCHE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144304734,"AUDU, RAYMOND, OCHE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 35 , 35 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1144304734,"AUDU, RAYMOND, OCHE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144307422,"PRATT, DOUGLAS, BRANNON",50 BOWMAN DR   WAYNESVILLE NC,044,Haywood,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 31 , 32 , 197 ," $14,978.41 ",,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144307422,"PRATT, DOUGLAS, BRANNON",10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 298 , 453 ," 2,116 "," $113,831.85 ",,
MEDICAID DIRECT,1144309949,THERAPY PLUS CLINIC INC,THERAPY PLUS CLINIC INC,247 OAK STREET EXT STE 145 FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1144309949,THERAPY PLUS CLINIC INC,247 OAK STREET EXT STE 145 FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,#, 21 , 35 ,$#,,
MEDICAID DIRECT,1124235205,MICHAEL A IGNELSI JR DDS PHD PA,LAKE JEANETTE ORTHO PED DENT,3901 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144310517,"IGNELZI, MICHAEL, ANTHONY",3901 N ELM ST   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 219 , 270 , 965 ," $25,690.48 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144311291,"SIDDIQUI, NAZEMA, YUSUF",1000 TRENT DR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144311291,"SIDDIQUI, NAZEMA, YUSUF",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144311291,"SIDDIQUI, NAZEMA, YUSUF",2400 PRATT ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144311291,"SIDDIQUI, NAZEMA, YUSUF",2400 PRATT ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144312604,"ABBOTT, JENNIFER, LYNN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 30 , 56 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144312604,"ABBOTT, JENNIFER, LYNN",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144312604,"ABBOTT, JENNIFER, LYNN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 47 , 47 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144312604,"ABBOTT, JENNIFER, LYNN",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 137 , 296 , 303 ," $16,539.08 ",,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144313172,"BEVINS, MELISSA, HAIKAL",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144313172,"BEVINS, MELISSA, HAIKAL",7901 ENGLAND ST STE 2225 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144313172,"BEVINS, MELISSA, HAIKAL",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144313172,"BEVINS, MELISSA, HAIKAL",7901 ENGLAND ST STE 2225 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144313172,"BEVINS, MELISSA, HAIKAL",7901 ENGLAND ST STE 2225 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1144313578,FUTRELL PHARMACY SERVICE INC,FUTRELL PHARMACY SERVICES INC,119 W JEFFERSON ST   JACKSON NC,066,Northampton,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1144313578,FUTRELL PHARMACY SERVICE INC,119 W JEFFERSON ST   JACKSON NC,066,Northampton,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144316100,"WECK TAYLOR, KAREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144316100,"WECK TAYLOR, KAREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 24 , 32 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144316100,"WECK TAYLOR, KAREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144316100,"WECK TAYLOR, KAREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144317470,BOICE WILLIS CLINIC PA,~,901 N WINSTEAD AVE STE 310 ROCKY MOUNT NC,064,Nash,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1144317470,BOICE WILLIS CLINIC PA,901 N WINSTEAD AVE STE 310 ROCKY MOUNT NC,064,Nash,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 34 , 35 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144318445,"VISCO, ANTHONY",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144318445,"VISCO, ANTHONY",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144318445,"VISCO, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144318445,"VISCO, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144318445,"VISCO, ANTHONY",1200 NAVAHO DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144318445,"VISCO, ANTHONY",1200 NAVAHO DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 25 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144318569,"IVESTER, THOMAS, STEVEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 12 , 11 , 13 ,$#,,
MEDICAID DIRECT,1295193340,ASHE FINANCIAL SERVICES LLC,ASHE FINANCIAL SERVICES LLC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1144319732,"JONES JR, CHARLES, BERNARD",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 54 , 76 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1144320060,"MESSERLY, DAVID, ROBERT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144320060,"MESSERLY, DAVID, ROBERT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 75 , 101 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1144320060,"MESSERLY, DAVID, ROBERT",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 26 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144320060,"MESSERLY, DAVID, ROBERT",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1144324583,"TAYLOR, LINDA, MORRIS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1144324583,"TAYLOR, LINDA, MORRIS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 ,#, 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144324583,"TAYLOR, LINDA, MORRIS",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 87 , 88 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144324724,"BOES, MATTHEW, THOMAS",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 24 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144324724,"BOES, MATTHEW, THOMAS",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 25 , 48 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1144324724,"BOES, MATTHEW, THOMAS",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144324724,"BOES, MATTHEW, THOMAS",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 31 , 63 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144326976,"CASARETT, DAVID, JONATHON",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144326976,"CASARETT, DAVID, JONATHON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144326976,"CASARETT, DAVID, JONATHON",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144329046,"BELISLE, WHITNEY, LEIGH",~,5503 OLEANDER DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1144329046,"BELISLE, WHITNEY, LEIGH",5503 OLEANDER DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 56 , 92 , 214 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144329251,"GUESS, COREY, ALLYSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 23 , 28 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144329251,"GUESS, COREY, ALLYSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1144329848,"AMESUR, SANDEEP, NIRMAL",3388 SAGE RD UNIT 2601 HOUSTON TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1144329848,"AMESUR, SANDEEP, NIRMAL",3388 SAGE RD UNIT 2601 HOUSTON TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1144329848,"AMESUR, SANDEEP, NIRMAL",3388 SAGE RD UNIT 2601 HOUSTON TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144331059,"TREADWAY, ROBERT, MORRIS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 58 , 61 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144331737,"MCKINNEY, DANNY",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144331737,"MCKINNEY, DANNY",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144331737,"MCKINNEY, DANNY",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144335787,"FAN, ZHENG",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 109 , 125 , 132 ," $11,152.89 ",,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144336587,CAROLINAS PHYSICIANS NETWORK INC,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144337049,"HOLT, DOUGLAS, ELDRED",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144337049,"HOLT, DOUGLAS, ELDRED",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144337049,"HOLT, DOUGLAS, ELDRED",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 42 , 60 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144337049,"HOLT, DOUGLAS, ELDRED",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1144337049,"HOLT, DOUGLAS, ELDRED",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144337049,"HOLT, DOUGLAS, ELDRED",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1144337411,"SADAKA, FARID, GHASSAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144338161,"SMITH IV, WILLIAM, THOMAS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 21 , 27 , 43 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144338161,"SMITH IV, WILLIAM, THOMAS",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 54 , 60 , 107 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144338161,"SMITH IV, WILLIAM, THOMAS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144338161,"SMITH IV, WILLIAM, THOMAS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144338161,"SMITH IV, WILLIAM, THOMAS",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144338161,"SMITH IV, WILLIAM, THOMAS",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144338161,"SMITH IV, WILLIAM, THOMAS",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 28 , 34 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144338195,"KING, DANA, EDWIN",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 27 , 41 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144338740,"BALLARD, TRACI, LYNN",431 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144338740,"BALLARD, TRACI, LYNN",431 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1144339383,"PALICKA, MATTHEW, JAMES",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 114 , 114 ,$#,,
MEDICAID DIRECT,1144340043,COUNTY OF NASH,NASH COUNTY HEALTH DEPARTMENT CAP,500 MEDICAL ARTS MALL STE 144 ROCKY MOUNT NC,064,Nash,251B00000X,Agencies,Case Management,,1144340043,COUNTY OF NASH,500 MEDICAL ARTS MALL STE 144 ROCKY MOUNT NC,064,Nash,251B00000X,Agencies,Case Management,, 120 ," 1,135 "," 1,135 "," $514,520.84 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144342445,"GALBREATH, ANDREW, DAVID",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1659487502,WILKES PEDIATRIC CLINIC,,1925 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1144344359,"MUMFORD, KRISTEN, MARIE",1925 W PARK DR   N WILKESBORO NC,097,Wilkes,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 61 , 161 , 438 ," $18,923.37 ",,
MEDICAID DIRECT,1144350216,"NICE, KEITH, BYRON",~,2603 HOLLY HILL ST   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1144350216,"NICE, KEITH, BYRON",2603 HOLLY HILL ST   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 48 , 66 , 111 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144352543,"GERLACH, STEPHAN, OSCAR",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 34 , 35 ,$#,,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1144353210,"WEBB, KIMBERLY, ANN",1211 IRELAND DR   FAYETTEVILLE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 87 , 88 , 88 ,$#,,
MEDICAID DIRECT,1144353954,SAMPSON COUNTY SCHOOLS,SAMPSON COUNTY SCHOOLS,437 ROWAN RD   CLINTON NC,082,Sampson,251300000X,Agencies,Local Education Agency (LEA),,1144353954,SAMPSON COUNTY SCHOOLS,437 ROWAN RD   CLINTON NC,082,Sampson,251300000X,Agencies,Local Education Agency (LEA),, 274 ," 5,819 "," 5,978 "," $214,188.56 ",,
MEDICAID DIRECT,1770637381,DARE COUNTY ADMINISTRATIVE OFFICES,Dare County Department of Public Health,109 EXETER ST   MANTEO NC,028,Dare,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144359670,"BOWEN, CHRISTINA, MICHELLE",109 EXETER ST   MANTEO NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 126 , 269 , 462 ," $26,640.36 ",,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1144359670,"BOWEN, CHRISTINA, MICHELLE",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1770637381,DARE COUNTY ADMINISTRATIVE OFFICES,Dare County Department of Public Health,109 EXETER ST   MANTEO NC,028,Dare,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144359670,"BOWEN, CHRISTINA, MICHELLE",5516 CENTRAL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144367780,"BORAWSKI, JOSEPH, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144367780,"BORAWSKI, JOSEPH, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144367780,"BORAWSKI, JOSEPH, BRIAN",2100 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 78 , 78 , 85 ,$#,,
MEDICAID DIRECT,1144367814,"WHITENACK, MARY, WATSON",MARY WHITENACK PT,18 TWIN FORKS RD   CANTON NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1144367814,"WHITENACK, MARY, WATSON",18 TWIN FORKS RD   CANTON NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 50 , 385 , 386 ," $33,246.24 ",,
MEDICAID DIRECT,1144369224,SHINING HOPE FARMS,SHINING HOPE FARMS,3701 KIDD LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144369224,SHINING HOPE FARMS,3701 KIDD LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1144369224,SHINING HOPE FARMS,SHINING HOPE FARMS,328 WHIPPOORWILL LN   MOUNT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144369224,SHINING HOPE FARMS,328 WHIPPOORWILL LN   MOUNT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,, 80 , 927 ," 1,281 "," $70,145.96 ",,
MEDICAID DIRECT,1144375916,SANDY RIDGE HOMES HOLDING CORP,SANDY RIDGE ASSISTED LIVING,326 BOWMAN RD   CANDOR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144375916,SANDY RIDGE HOMES HOLDING CORP,326 BOWMAN RD   CANDOR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 29 ," 8,259 "," 8,261 "," $815,384.52 ",,
MEDICAID DIRECT,1144375916,SANDY RIDGE HOMES HOLDING CORP,SANDY RIDGE ASSISTED LIVING,326 BOWMAN RD   CANDOR NC,062,Montgomery,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1144375916,SANDY RIDGE HOMES HOLDING CORP,326 BOWMAN RD   CANDOR NC,062,Montgomery,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 11 , 31 , 31 ,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144377623,"FORBES, KAROLYN, BETH",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 60 , 68 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144377946,"BRADSHAW, MARQUES, LEVAR",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144379157,"JORDAN, AIMEE, EDDY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144379157,"JORDAN, AIMEE, EDDY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144379157,"JORDAN, AIMEE, EDDY",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1478 RIVER RD SE   WINNABOW NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1144379314,"DICKERSON, FRANK, MONTGOMERY",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 36 , 36 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1144379314,"DICKERSON, FRANK, MONTGOMERY",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144379314,"DICKERSON, FRANK, MONTGOMERY",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 319 , 319 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144379314,"DICKERSON, FRANK, MONTGOMERY",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 61 , 62 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1144379314,"DICKERSON, FRANK, MONTGOMERY",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 109 , 109 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1478 RIVER RD SE   WINNABOW NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1144379314,"DICKERSON, FRANK, MONTGOMERY",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1144379314,"DICKERSON, FRANK, MONTGOMERY",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 108 , 108 ,$#,,
MEDICAID DIRECT,1619398997,BETHANY MEDICAL CENTER,,495 ARBOR HILL RD STE M KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144381401,"WAGNER- MICHAEL, DAVONIA",495 ARBOR HILL RD   KERNERSVILLE NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 25 , 29 , 66 ,$#,,
MEDICAID DIRECT,1619398997,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144381401,"WAGNER- MICHAEL, DAVONIA",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 54 , 64 , 144 ," $19,879.47 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144382730,"SINGLETON, ADRIENNE, HUTTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 52 , 56 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144382730,"SINGLETON, ADRIENNE, HUTTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144382730,"SINGLETON, ADRIENNE, HUTTON",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144382730,"SINGLETON, ADRIENNE, HUTTON",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 64 , 79 , 168 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144383910,"BARKER, PIERS, CHRISTOPHER ANDREW",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383928,"MCGEE, KARA, STACY",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144383928,"MCGEE, KARA, STACY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 24 , 41 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1144387044,"PERKINS, JENNIFER, ANN",104 COMMERCIAL DR   PRINCETON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1144387044,"PERKINS, JENNIFER, ANN",114 E RAILROAD ST   LA GRANGE NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1144387044,"PERKINS, JENNIFER, ANN",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 130 , 173 , 486 ," $18,337.35 ",,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144392044,"MATHER, MIRIAM, JOY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 53 , 56 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144392044,"MATHER, MIRIAM, JOY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144392044,"MATHER, MIRIAM, JOY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144392044,"MATHER, MIRIAM, JOY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 26 , 27 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1144396342,"TRAKIMAS, CAROL, ANN",2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 33 , 45 , 90 ,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1144397696,"BOSTELMAN, CATHERINA, MARIE",2527 E LYON STATION RD DUAP BUTNER CREEDMOOR CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 106 , 205 , 467 ,$#,,
MEDICAID DIRECT,1144398348,"LESAN, JON, DOUGLAS",~,123 COBIA CT   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,1144398348,"LESAN, JON, DOUGLAS",123 COBIA CT   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 295 , 652 ," 2,283 "," $95,934.29 ",,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144398413,"OHTA, TIFFANY, MADSEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144398413,"OHTA, TIFFANY, MADSEN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144398413,"OHTA, TIFFANY, MADSEN",3614 PROVIDENCE RD S STE 101 WAXHAW NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 30 , 54 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144398413,"OHTA, TIFFANY, MADSEN",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 16 , 23 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144398413,"OHTA, TIFFANY, MADSEN",1994 WELLNESS BLVD STE 110 MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144399080,"SCOTT, CHARLENE, SPANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144399080,"SCOTT, CHARLENE, SPANN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 23 , 50 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144399080,"SCOTT, CHARLENE, SPANN",1409 UNIVERSITY DR STE 105 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1144399395,"QUILES, CARMEN, LUISA",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1144399395,"QUILES, CARMEN, LUISA",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 47 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144399767,"BERG, CARL, LANSING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144399767,"BERG, CARL, LANSING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5870 SAMET DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144401902,"WEKONY, MELINDA, CAROL",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 18 , 32 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144401902,"WEKONY, MELINDA, CAROL",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144401902,"WEKONY, MELINDA, CAROL",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144401902,"WEKONY, MELINDA, CAROL",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144401951,"DALY, NEWELL, ALDRIDGE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 43 , 44 ,$#,,
MEDICAID DIRECT,1134172604,WESTERN PIEDMONT ANESTHESIA,WESTERN PIEDMONT ANESTHESIA,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1144401951,"DALY, NEWELL, ALDRIDGE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 55 , 63 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144403379,"PLUNKETT, WHITNEY, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 38 , 61 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144403379,"PLUNKETT, WHITNEY, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144403379,"PLUNKETT, WHITNEY, MARIE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144403379,"PLUNKETT, WHITNEY, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144403379,"PLUNKETT, WHITNEY, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144403379,"PLUNKETT, WHITNEY, MARIE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144403379,"PLUNKETT, WHITNEY, MARIE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1144404153,"BARLOW, MARY, STIRLING",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144404153,"BARLOW, MARY, STIRLING",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1144404153,"BARLOW, MARY, STIRLING",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1144404153,"BARLOW, MARY, STIRLING",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144404153,"BARLOW, MARY, STIRLING",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144404153,"BARLOW, MARY, STIRLING",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144404153,"BARLOW, MARY, STIRLING",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144404427,"HENSHAW, DARYL, STEVEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 61 , 75 ,$#,,
MEDICAID DIRECT,1144406539,PHYSICAL THERAPY FOR WOMEN,~,1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144406539,PHYSICAL THERAPY FOR WOMEN,1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144406604,"HORTON, DEYANIRA, LYNISE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144406604,"HORTON, DEYANIRA, LYNISE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144408204,ANGEL HOUSE FCH LLC,ANGEL HOUSE FAMILY CARE HOMES LLC VI,60 HORNOT CIR APT F ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144408204,ANGEL HOUSE FCH LLC,60 HORNOT CIR APT F ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 586 , 586 ," $38,084.73 ",,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144410283,"STEADMAN, BRENT, THOMAS",17 BANNER PL   MORGANTOWN WV,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1144410283,"STEADMAN, BRENT, THOMAS",17 BANNER PL   MORGANTOWN WV,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 39 , 45 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144411422,"SLAT, STACY, KING",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1144414061,"BALER, RICARDO, GUILLERMO",781 AVENT FERRY RD STE 200 HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,260 HORIZON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144415340,"BRIERE, ELIZABETH, ANN",260 HORIZON DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1144415340,"BRIERE, ELIZABETH, ANN",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 108 , 212 ," $12,632.36 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1144416413,"STINSON, AMY, ELIZABETH",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144416413,"STINSON, AMY, ELIZABETH",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 21 , 51 , 70 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1144416413,"STINSON, AMY, ELIZABETH",400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 77 , 112 , 159 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144416934,"MCKIMMIE, RYAN, LEE",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 14 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144416934,"MCKIMMIE, RYAN, LEE",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144416934,"MCKIMMIE, RYAN, LEE",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 58 , 73 , 81 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144416934,"MCKIMMIE, RYAN, LEE",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144416934,"MCKIMMIE, RYAN, LEE",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144416934,"MCKIMMIE, RYAN, LEE",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 20 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144417296,"CHAKSUPA, JOY",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144417296,"CHAKSUPA, JOY",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144417965,LEAPS BOUNDS INC,,17121 CLEMENTINE CT   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144417965,LEAPS BOUNDS INC,17121 CLEMENTINE CT   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#, 85 , 86 ,$#,,
MEDICAID DIRECT,1144422452,ROSES CASTLE RESIDENTIAL SERVICES I,ROSES CASTLE RESIDENTIAL SERVICES INC,505 COOK RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144422452,ROSES CASTLE RESIDENTIAL SERVICES I,505 COOK RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 985 , 985 ," $54,066.07 ",,
MEDICAID DIRECT,1144423229,HOME SWEET HOME INC,HOME SWEET HOME INCORPORATED,508 OLD LINWOOD RD   LEXINGTON NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,,1144423229,HOME SWEET HOME INC,508 OLD LINWOOD RD   LEXINGTON NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,, 34 ," 4,602 "," 4,618 "," $314,349.63 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144423542,"FAUCI, JANELLE, MARIE",125 QUEENS RD STE 540 CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 22 , 25 , 40 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144423542,"FAUCI, JANELLE, MARIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144424839,"KOPEC, KATHRYN, THERESE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207PT0002X,Allopathic & Osteopathic Physicians,Emergency Medicine,Medical Toxicology, 40 , 43 , 50 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144426123,"LATTA, JOANNE, MARIE",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1144426123,"LATTA, JOANNE, MARIE",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144426123,"LATTA, JOANNE, MARIE",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144427766,"ABOU ZEID, NUHAD, ELIAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 49 , 49 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144429630,"EDWARDS, JUSTIN, REID",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144429630,"EDWARDS, JUSTIN, REID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 36 , 38 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144429630,"EDWARDS, JUSTIN, REID",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144429630,"EDWARDS, JUSTIN, REID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144429630,"EDWARDS, JUSTIN, REID",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144429630,"EDWARDS, JUSTIN, REID",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144429630,"EDWARDS, JUSTIN, REID",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144429630,"EDWARDS, JUSTIN, REID",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 165 , 204 , 325 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144429630,"EDWARDS, JUSTIN, REID",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1144431420,"TAYLOR, RENEE, L.",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 39 , 73 , 80 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144431982,"FORD, ELLEN, CHALKLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144432584,"BARBARO, RICHARD, ROBERT",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,2202 CAROLINA PL STE 200 KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1144432667,"KPODO, ANITA, EMEFA",2202 CAROLINA PL STE 200 KINGS MOUNTAIN NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 82 , 120 , 272 ," $12,541.07 ",,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1144432667,"KPODO, ANITA, EMEFA",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144433681,"HANEY, TARESSA, GILLIG",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144433681,"HANEY, TARESSA, GILLIG",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 87 , 119 , 141 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144434820,"OETTEL, DAVID",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144435322,"LEWIS, JASON, JAMES",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144435322,"LEWIS, JASON, JAMES",1225 HARDING PL STE 5200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144435322,"LEWIS, JASON, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144435322,"LEWIS, JASON, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144435322,"LEWIS, JASON, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 26 , 29 , 32 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144435322,"LEWIS, JASON, JAMES",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144435322,"LEWIS, JASON, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1821142845,COUNTY OF TRANSYLVANIA,TRANSYLVANIA COUNTY HEALTH DEPT,106 E MORGAN STREET STE. 105 BREVARD NC,088,Transylvania,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144436106,"HIBBS, SANDRA, FRANCES",1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144436569,"PETERSON, KIRK, DARREL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 196 , 216 , 330 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",1705 TARBORO ST SW   WILSON NC,098,Wilson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 32 , 40 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1144436569,"PETERSON, KIRK, DARREL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1144436569,"PETERSON, KIRK, DARREL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144438037,"BLANCHARD, LAURA, THOMAS",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 20 , 46 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144438037,"BLANCHARD, LAURA, THOMAS",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1144454893,HICKORY HEALTH INVESTORS LLC,THE SPRINGS OF CATAWBA,2010 29TH AVENUE DR NE   HICKORY NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144454893,HICKORY HEALTH INVESTORS LLC,2010 29TH AVENUE DR NE   HICKORY NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 44 ," 10,503 "," 10,505 "," $1,001,764.75 ",,
MEDICAID DIRECT,1144456104,PROGRESSIVE RECOVERY RESOURCES LLC,PROGRESSIVE RECOVERY RESOURCES LLC,3129 CREIGHTON DR   CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1144456104,PROGRESSIVE RECOVERY RESOURCES LLC,3129 CREIGHTON DR   CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 22 , 138 , 138 ,$#,,
MEDICAID DIRECT,1144457086,"BONNO, ERIC, LE MINH DUC",Eric Le Minh Duc Bonno,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,1144457086,"BONNO, ERIC, LE MINH DUC",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144457086,"BONNO, ERIC, LE MINH DUC",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1144457201,"SMITH, GEORGE, DRENNAN",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 58 , 60 , 94 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1144457201,"SMITH, GEORGE, DRENNAN",1705 TARBORO ST SW   WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 13 , 31 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1144457201,"SMITH, GEORGE, DRENNAN",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 56 , 57 , 69 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1144457201,"SMITH, GEORGE, DRENNAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 33 , 35 , 48 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1144457201,"SMITH, GEORGE, DRENNAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 32 , 36 , 60 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1144457565,"GEIB-ROSCH, BETHANY, MARIA",100 W H ST   BUTNER NC,039,Granville,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1144457565,"GEIB-ROSCH, BETHANY, MARIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144459066,"MUKHIA, AMIT, MARTIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144459066,"MUKHIA, AMIT, MARTIN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1144459066,"MUKHIA, AMIT, MARTIN",9981 S HEALTHPARK DR   FORT MYERS FL,102,Out of State > 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144459066,"MUKHIA, AMIT, MARTIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 20 , 67 , 68 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1144459389,"OPREA, ANNA, BUTLER",4810 S CROATAN HWY STE 100 NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144461054,"SEGUENI, AMINE",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 48 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144461054,"SEGUENI, AMINE",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 32 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1144461054,"SEGUENI, AMINE",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1376870832,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH PRESBYTERIAN INTERNAL MEDICINE,1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144461054,"SEGUENI, AMINE",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144461054,"SEGUENI, AMINE",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144462342,"FOX, MATTHEW, DAVID",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144462342,"FOX, MATTHEW, DAVID",431 COPPERFIELD BLVD NE 431 COPPERFIELD BLVD CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 35 , 43 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144462342,"FOX, MATTHEW, DAVID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144462342,"FOX, MATTHEW, DAVID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144462342,"FOX, MATTHEW, DAVID",431 COPPERFIELD BLVD NE 431 COPPERFIELD BLVD CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144462672,"JOBE, TAKARA, SHOUROT",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144463993,"LEMMON, MONICA, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1144464801,"CAMPBELL, IAN, BREAR",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1144470519,"TORCHIO, RHONDA",104 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1417061011,ABC PEDIATRICS OF DUNN PA,~,104 TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1144470519,"TORCHIO, RHONDA",104 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 125 , 551 ," $15,551.04 ",,
MEDICAID DIRECT,1750871562,OBRIEN AND WEST DMD V PLLC,~,452 SHOTWELL RD   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1144472457,"BAKER, CHRISTOPHER, JAMES",452 SHOTWELL RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 442 , 587 ," 1,788 "," $81,743.86 ",,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144472457,"BAKER, CHRISTOPHER, JAMES",1325 BRADFORD VIEW DR STE 102 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144472804,"ALBERTSON, CASSANDRA, CLAY",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144472804,"ALBERTSON, CASSANDRA, CLAY",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 430 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1144472804,"ALBERTSON, CASSANDRA, CLAY",5601 ARRINGDON PARK DR STE 430 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881712842,NORTH CAROLINA STATE UNIVERSITY,,2815 CATES AVE   RALEIGH NC,092,Wake,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1144476318,"MINSLEY, KELLY, NEAL",2815 CATES AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144477159,"SJOLANDER, ANDREW, RYAN",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1619234028,CATAWBA VALLEY MEDICAL CENTER,CVMC PALLIATIVE CARE SERVICES,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144477316,"PARKER, LAURA, SIGMON",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 71 , 75 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144478736,"OGBULU, SHAMUSIDEEN, OLAYIBO",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 159 , 160 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144478736,"OGBULU, SHAMUSIDEEN, OLAYIBO",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144480716,"MYERS, STEPHANIE, JANE",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144480716,"MYERS, STEPHANIE, JANE",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144481029,"LIU, BAOGANG",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 17 , 21 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144481029,"LIU, BAOGANG",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 55 , 69 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144481029,"LIU, BAOGANG",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 40 , 50 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144481029,"LIU, BAOGANG",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144481409,"ALTOM, LAURA, KATHLEEN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 24 , 27 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1144481409,"ALTOM, LAURA, KATHLEEN",781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,1505 SW CARY PKWY STE 302 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144481409,"ALTOM, LAURA, KATHLEEN",1505 SW CARY PKWY STE 302 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144481409,"ALTOM, LAURA, KATHLEEN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 20 , 23 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144483223,"MACGREGOR, ROY",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144483728,"TROXELL, HOLLY, MAGNUM",Holly Magnum Troxell,4004 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1144483728,"TROXELL, HOLLY, MAGNUM",4004 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417422064,DS DENTAL LLC,CAROLINA DENTAL CARE,4004 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144483728,"TROXELL, HOLLY, MAGNUM",4004 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1376213256,GRAY CHIROPRACTIC OF HICKORY PLLC,WELLNESS ONE,36 14TH AVE NE STE 101 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1144485038,"GRAY, CHARLES, ROBERT",36 14TH AVE NE STE 101 HICKORY NC,018,Catawba,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144485707,"KNUTSON, JAMES, ERIC",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 42 , 49 , 98 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144485707,"KNUTSON, JAMES, ERIC",3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144485707,"KNUTSON, JAMES, ERIC",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1144485707,"KNUTSON, JAMES, ERIC",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1144485707,"KNUTSON, JAMES, ERIC",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144487364,"LUSICA, MELBETH",1200 FIRST COLONIAL RD STE 202 VIRGINIA BCH VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144487398,"PENZNER, JULIE, BETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144487398,"PENZNER, JULIE, BETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 38 , 69 , 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 73 , 100 , 121 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 46 , 75 , 96 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1144487562,"TUCKER JR, SONNY",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 44 , 49 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,190 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 36 , 36 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1144488586,"KOLB, TERENCE, WILLIAM",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144489667,"CARTER, SCOTT, CORY",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144489667,"CARTER, SCOTT, CORY",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144489667,"CARTER, SCOTT, CORY",861 OLD WINSTON ROAD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144489667,"CARTER, SCOTT, CORY",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144489667,"CARTER, SCOTT, CORY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 522 , 691 , 839 ," $12,570.82 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144492166,"MICHEL, CHENEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144492166,"MICHEL, CHENEL",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144492166,"MICHEL, CHENEL",9929 REA RD STE 201 WAXHAW NC,090,Union,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1437196318,FIRST IMAGING OF THE CAROLINAS,First Imaging of the Carolinas,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1144492372,"TOOMAYAN, GLEN, ALAN",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 24 ,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1144492372,"TOOMAYAN, GLEN, ALAN",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 339 , 390 , 494 ,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1144492372,"TOOMAYAN, GLEN, ALAN",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 60 , 67 ,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1144492372,"TOOMAYAN, GLEN, ALAN",555 CARTHAGE ST   SANFORD NC,053,Lee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1144492372,"TOOMAYAN, GLEN, ALAN",555 CARTHAGE ST   SANFORD NC,053,Lee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144492703,"MIR, SABINA, AHMED",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 30 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144492703,"MIR, SABINA, AHMED",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 43 , 48 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1144492711,"WHITMER, JEWELL, ELIZABETH",6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2616 E 5TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144494543,"CAVE, AUDRA, CATHLEEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,4801 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144494543,"CAVE, AUDRA, CATHLEEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144494543,"CAVE, AUDRA, CATHLEEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1144494543,"CAVE, AUDRA, CATHLEEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144494543,"CAVE, AUDRA, CATHLEEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144494543,"CAVE, AUDRA, CATHLEEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144494543,"CAVE, AUDRA, CATHLEEN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144495094,"PERKOWSKI, DAYNA, MARIE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144495094,"PERKOWSKI, DAYNA, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144495581,"YOUNG, OMAR, MAURICE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1144495581,"YOUNG, OMAR, MAURICE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144495581,"YOUNG, OMAR, MAURICE",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 57 , 59 , 85 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144495581,"YOUNG, OMAR, MAURICE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 39 , 46 , 64 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144495581,"YOUNG, OMAR, MAURICE",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144495581,"YOUNG, OMAR, MAURICE",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144495581,"YOUNG, OMAR, MAURICE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1447383773,ASHEVILLE PEDIATRIC ASSOCIATES PA,ASHEVILLE PEDIATRIC ASSOCIATES PA,2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144495938,"MARTIN, ELEANOR, ANNE",2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 74 , 268 ," $11,121.34 ",,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1144496191,"ODIBO, MICHAEL, CHUKWUMA",1215 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710334503,ODIBO MEDICAL GROUP PLLC,,1215 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144496191,"ODIBO, MICHAEL, CHUKWUMA",1215 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 90 , 206 , 474 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144496407,"JOLLY GRAHAM, AUBREY, DANIELLE",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144496407,"JOLLY GRAHAM, AUBREY, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 77 , 77 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144496407,"JOLLY GRAHAM, AUBREY, DANIELLE",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144497314,"RATTRAY, BENJAMIN, NAIRN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,810 FAIRGRV CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144497314,"RATTRAY, BENJAMIN, NAIRN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144497314,"RATTRAY, BENJAMIN, NAIRN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144497314,"RATTRAY, BENJAMIN, NAIRN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144497314,"RATTRAY, BENJAMIN, NAIRN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144497553,"BRANDER, DANIELLE, MARIE-UNDERKOFF",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144497553,"BRANDER, DANIELLE, MARIE-UNDERKOFF",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144497553,"BRANDER, DANIELLE, MARIE-UNDERKOFF",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144503434,"PEGUES, TAMIKA, READER",9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144504101,"PERKINS, BRANDY, RENAE",4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144504101,"PERKINS, BRANDY, RENAE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144504465,"DECROW, AMANDA, MAXWELL",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1730285511,WAYNE INTIATIVES FOR SCHOOL HEALTH,~,801 LIONEL ST   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1144504515,"CROOM, SUSAN, SUTTON",1135 E NEW HOPE RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730285511,WAYNE INTIATIVES FOR SCHOOL HEALTH,~,801 LIONEL ST   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1144504515,"CROOM, SUSAN, SUTTON",124 WALTER FULCHER RD   DUDLEY NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144507583,"KOPP, AARON, CHRISTOPHER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144507583,"KOPP, AARON, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144507583,"KOPP, AARON, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144508987,"BASS, AMBER",1917 W PARK DR   N WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 105 , 127 , 164 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1144510579,"SYEDA, SARA, YASMEEN",1705 TARBORO ST SW APOGEE MEDICAL GROUP NORTH CAROLINA WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144510579,"SYEDA, SARA, YASMEEN",1705 TARBORO ST SW APOGEE MEDICAL GROUP NORTH CAROLINA WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 33 , 33 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1144510579,"SYEDA, SARA, YASMEEN",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144510579,"SYEDA, SARA, YASMEEN",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 81 , 81 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144510579,"SYEDA, SARA, YASMEEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144510579,"SYEDA, SARA, YASMEEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510579,"SYEDA, SARA, YASMEEN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 65 , 65 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 ,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 185 , 185 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",1687 DAIRY DR   NEBO NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",1267 PINNACLE CHURCH RD   NEBO NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",5593 OLD HAYWOOD RD   MILLS RIVER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144510926,"ABERNETHY, ERIN, A",63 LAKEVIEW DR N   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144512823,"DALE, MAUREEN, CATHERINE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144512823,"DALE, MAUREEN, CATHERINE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144512823,"DALE, MAUREEN, CATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144512823,"DALE, MAUREEN, CATHERINE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 22 , 32 , 68 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144514704,"MORUMURU, RAVI KIRAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 325 , 327 ," $15,429.63 ",,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144514704,"MORUMURU, RAVI KIRAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144514894,"JAMES, MELISSA, ANN",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144514894,"JAMES, MELISSA, ANN",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 26 , 58 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144514894,"JAMES, MELISSA, ANN",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1144514894,"JAMES, MELISSA, ANN",10344 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144515800,"BASS, DIANA, SWILLING",DIANA S BASS DDS PLLC,219B WILMOT DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1144515800,"BASS, DIANA, SWILLING",219B WILMOT DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 27 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144515834,"CHEN, XI",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 43 , 58 , 101 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144515834,"CHEN, XI",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 23 , 45 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 32 , 32 , 44 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",601 N ELM ST   HIGH POINT NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 50 , 60 , 75 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1144515990,"HERMAN, KEVIN, OTEY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",301 E WENDOVER AVE STE 100 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1144515990,"HERMAN, KEVIN, OTEY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",117 E KINGS HWY   EDEN NC,079,Rockingham,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144515990,"HERMAN, KEVIN, OTEY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144517186,"RAND, ANDREW, JAMES",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 64 , 69 , 95 ,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144517186,"RAND, ANDREW, JAMES",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1144517707,"SHODUNKE, TEMITOPE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144518184,"WOLFE, ALLISON, KAY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144518184,"WOLFE, ALLISON, KAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 11 , 11 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1144519141,"BOIK-PRICE, LINDSAY, LEORA",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1144520792,ASHE SERVICES FOR AGING INC,GENERATIONS ASHE,182 CHATTYROB LN   WEST JEFFERSON NC,005,Ashe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144520792,ASHE SERVICES FOR AGING INC,182 CHATTYROB LN   WEST JEFFERSON NC,005,Ashe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 4,682 "," 4,682 "," $391,677.25 ",,
MEDICAID DIRECT,1659673838,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT SENIOR CARE,1309 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144522046,"MEDINA VARGAS, MONINA, CALAYAG",1309 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 31 , 51 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144531088,"BANSAL, SHALU",932 MORREENE RD   DURHAM NC,032,Durham,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 17 , 23 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144531088,"BANSAL, SHALU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 13 , 15 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,400 ELF ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144531088,"BANSAL, SHALU",932 MORREENE RD   DURHAM NC,032,Durham,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1144531591,"BURGON, ERIC, SHARP",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 VANDERBILT PARK DR STE 210 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144531591,"BURGON, ERIC, SHARP",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 14 , 15 , 35 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144531591,"BURGON, ERIC, SHARP",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 21 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144531591,"BURGON, ERIC, SHARP",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 100 , 154 , 453 ," $41,453.04 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,902 FLEMING ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144531591,"BURGON, ERIC, SHARP",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 12 , 16 , 45 ,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1144531880,"KEMPF, AVERI, LYNN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 29 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1144531880,"KEMPF, AVERI, LYNN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 34 ,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1144531880,"KEMPF, AVERI, LYNN",670 CARDINAL RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 28 , 50 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144532730,"MARDIS, STACEY, LEIGH",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1144532730,"MARDIS, STACEY, LEIGH",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 37 , 43 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144532730,"MARDIS, STACEY, LEIGH",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144533027,"JOGU, HANUMANTHA, RAO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 68 , 176 , 176 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144533225,"PETER, MARIA, LEEMA",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 253 , 253 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1144533324,"DICKERSON, SYLVIA, CHAMBERS",401 MOCKSVILLE AVE STE 200 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1144533324,"DICKERSON, SYLVIA, CHAMBERS",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 36 , 69 ,$#,,
MEDICAID DIRECT,1710933692,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH FULTON HEIGHTS FAMILY MEDICINE,860 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1144533324,"DICKERSON, SYLVIA, CHAMBERS",860 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1144534652,"LEWIS, JESSICA, SHEARL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144534652,"LEWIS, JESSICA, SHEARL",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457356651,COUNTY OF BURKE,BURKE COUNTY HEALTH DEPARTMENT,700 E PARKER RD UNIT A MORGANTON NC,012,Burke,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1144535642,"ZOOK, KATHRYN, ANNE",700 E PARKER RD   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144538083,"DUNN, RYAN, MICHAEL",102 POMONA DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144538083,"DUNN, RYAN, MICHAEL",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 70 , 118 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144538299,"SOBTI, ARJUN, KRISHAN",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144539404,"EARL, MAUREEN, SULLIVAN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1144539404,"EARL, MAUREEN, SULLIVAN",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144539404,"EARL, MAUREEN, SULLIVAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144539404,"EARL, MAUREEN, SULLIVAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144539404,"EARL, MAUREEN, SULLIVAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1144540147,"ADAMS, TARYN, STEFANICK",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 70 , 198 , 228 ," $25,686.82 ",,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144540600,"HARGIS, MITCH, JAMES",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144540600,"HARGIS, MITCH, JAMES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 36 , 37 ,$#,,
MEDICAID DIRECT,1972842086,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144540600,"HARGIS, MITCH, JAMES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144540667,"SMITH, ERIC, DAVIS",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144540667,"SMITH, ERIC, DAVIS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 48 , 121 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144540667,"SMITH, ERIC, DAVIS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 131 , 131 ," $27,648.69 ",,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144540667,"SMITH, ERIC, DAVIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 51 , 51 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144541475,"THOMPSON, CHRISTOPHER, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 92 , 92 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144541541,"LUEDKE, MATTHEW, WILLIAM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144541541,"LUEDKE, MATTHEW, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 31 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144541541,"LUEDKE, MATTHEW, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144541541,"LUEDKE, MATTHEW, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 88 , 120 , 185 ,$#,,
MEDICAID DIRECT,1144542994,EASTOVER DRUG LLC,EASTOVER DRUG,3591 DUNN RD   EASTOVER NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1144542994,EASTOVER DRUG LLC,3591 DUNN RD   EASTOVER NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144545674,"SHAPCOTT, LISA, MARIE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144545674,"SHAPCOTT, LISA, MARIE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1144545831,"JOHANSON, ERIK, FRANK",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144545831,"JOHANSON, ERIK, FRANK",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144545831,"JOHANSON, ERIK, FRANK",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144545831,"JOHANSON, ERIK, FRANK",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 38 , 88 ,$#,,
MEDICAID DIRECT,1144548215,WAL-MART STORES EAST LP,Wal-Mart Pharmacy 10-5787,4545 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1144548215,WAL-MART STORES EAST LP,4545 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1144548215,WAL-MART STORES EAST LP,Wal-Mart Pharmacy 10-5787,4545 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1144548215,WAL-MART STORES EAST LP,4545 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1144548876,"OCHOA, JOSE, MARIA",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1144550740,"SIMPSON, GLENN, CURTIS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1144550740,"SIMPSON, GLENN, CURTIS",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144552027,"VEAZEY, LINDSAY, CARLSON",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1144554395,"CLINKSCALES, TOMEKA, LATONYA",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1144554395,"CLINKSCALES, TOMEKA, LATONYA",349 PENNY LN   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144554395,"CLINKSCALES, TOMEKA, LATONYA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144554395,"CLINKSCALES, TOMEKA, LATONYA",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 56 , 57 ,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144554395,"CLINKSCALES, TOMEKA, LATONYA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1144554676,"IHEAGWARA, CHINEDU, MARTIN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144559659,"FUJIKURA, KANA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144562406,"TOTH, GEORGE, ABRAHAM",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 138 , 138 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144563529,"RUBINSTEIN, BENJAMIN, JOSEPH",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144563529,"RUBINSTEIN, BENJAMIN, JOSEPH",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144563529,"RUBINSTEIN, BENJAMIN, JOSEPH",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144564493,"JOLLEY, JANICE, PARKER",812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144564493,"JOLLEY, JANICE, PARKER",1001 N WASHINGTON ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144564493,"JOLLEY, JANICE, PARKER",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144564493,"JOLLEY, JANICE, PARKER",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144564832,"MURPHY, LAUREL, FISKE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144564832,"MURPHY, LAUREL, FISKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 26 , 37 , 39 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144564832,"MURPHY, LAUREL, FISKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 95 , 95 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,225 WHITE ST   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 167 , 246 , 246 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",319 WESTWOOD AVE UPPR LEVEL HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 47 , 47 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144566712,"KUMAR, MUKESH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144567660,"MCLOTT, JASON, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144567660,"MCLOTT, JASON, DANIEL",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144568577,"HERBERT, KRISTIN, ELIZABETH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144568726,KIDSPROUT THERAPY,~,10405 STALLION WAY   BAHAMA NC,032,Durham,193200000X,Group,Multi-Specialty,,1144568726,KIDSPROUT THERAPY,10405 STALLION WAY   BAHAMA NC,032,Durham,193200000X,Group,Multi-Specialty,, 36 , 831 , 833 ," $63,163.98 ",,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1144573197,"DRAPER, KENYON, LEE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 62 , 99 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144573197,"DRAPER, KENYON, LEE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144573486,"BOONE, CANDACE, ANJANEE",16525 HOLLY CREST LN STE 210 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 27 , 43 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144573486,"BOONE, CANDACE, ANJANEE",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144573486,"BOONE, CANDACE, ANJANEE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144574930,"BARNES, MARY, QUENTIN",113 MARKET PLACE DR   MOCKSVILLE NC,030,Davie,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 62 , 107 , 215 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1144575085,"CHINTA, SUMA",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144575085,"CHINTA, SUMA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 59 , 232 , 234 ," $10,308.80 ",,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144575176,"EICHHORN, EMILY, ANN",490 HOSPITAL DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144575176,"EICHHORN, EMILY, ANN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 43 , 47 ,$#,,
MEDICAID DIRECT,1801261391,BLUE RIDGE COMMUNITY HEALTH SERVICE,SEVENTH AVENUE HEALTH CENTER,628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144575176,"EICHHORN, EMILY, ANN",628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144575176,"EICHHORN, EMILY, ANN",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144575176,"EICHHORN, EMILY, ANN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 51 , 51 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144575176,"EICHHORN, EMILY, ANN",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144575457,"TALBERT, KATIE, STRINGFELLOW",10211 ALM ST STE 203 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144576257,"HO, JAMES, PHAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 39 , 53 , 99 ," $11,727.91 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144580614,"LINTHAVONG, OLIVIA, REID",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144584962,"UZL, JUSTIN, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144584962,"UZL, JUSTIN, JOHN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1144586181,"TARIQ, KHURRAM, BILAL",336 DEERFIELD RD   BOONE NC,095,Watauga,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 20 , 24 , 33 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,338 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1144586181,"TARIQ, KHURRAM, BILAL",336 DEERFIELD RD   BOONE NC,095,Watauga,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 12 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1144586181,"TARIQ, KHURRAM, BILAL",336 DEERFIELD RD   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1144586181,"TARIQ, KHURRAM, BILAL",336 DEERFIELD RD   BOONE NC,095,Watauga,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144586439,"HERTZBERG, BRIAN, PHILLIP",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 77 , 187 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144586439,"HERTZBERG, BRIAN, PHILLIP",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 17 , 31 , 47 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144586439,"HERTZBERG, BRIAN, PHILLIP",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,257 NC 125   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1144586439,"HERTZBERG, BRIAN, PHILLIP",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 31 , 45 , 56 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,3903 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144587072,"WHITE, SARAH, ELIZABETH",3903 N ELM ST   GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144587072,"WHITE, SARAH, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 103 , 119 , 164 ," $13,559.98 ",,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1144587072,"WHITE, SARAH, ELIZABETH",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144587643,"RAHI, SUKHDEEP, KAUR",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144589466,"SHAH, PRATIK, DILIP",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144589466,"SHAH, PRATIK, DILIP",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144589466,"SHAH, PRATIK, DILIP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 194 , 194 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1144589466,"SHAH, PRATIK, DILIP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144592353,"ENIOLA, KEHINDE, TEMITAYO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 152 , 235 , 318 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144592353,"ENIOLA, KEHINDE, TEMITAYO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144592353,"ENIOLA, KEHINDE, TEMITAYO",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1144594409,VISION OF HOPE,~,906 SHARPE AVE   EDEN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144594409,VISION OF HOPE,906 SHARPE AVE   EDEN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 324 , 324 ," $11,922.02 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144595380,"CUNNINGHAM, ALTHEA, MASCARENHAS",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144595380,"CUNNINGHAM, ALTHEA, MASCARENHAS",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144595380,"CUNNINGHAM, ALTHEA, MASCARENHAS",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 39 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1144595380,"CUNNINGHAM, ALTHEA, MASCARENHAS",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578987848,UNC PHYSICIANS NETWORK LLC,~,7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144600180,"DIXON, DERI-ANN, ROSHELLE",7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1932523206,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 210 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144600180,"DIXON, DERI-ANN, ROSHELLE",1181 WEAVER DAIRY RD STE 210 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 38 , 78 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144600180,"DIXON, DERI-ANN, ROSHELLE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144601139,"LIPPERT, WILLIAM, CHILDS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 30 , 113 , 113 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144601139,"LIPPERT, WILLIAM, CHILDS",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 21 , 74 , 76 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144601279,"PIANTI, RICHARD, MICHAEL",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 68 , 72 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 238 , 488 , 664 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1144601352,"CAO, JOSEPH, YI-QIAO",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144602459,"SHASHPAL, FNU",16525 HOLLY CREST LN STE 230 HUNTERSVILLE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 12 , 16 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144602459,"SHASHPAL, FNU",9920 KINCEY AVE STE 120 HUNTERSVILLE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 27 , 40 , 76 ,$#,,
MEDICAID DIRECT,1144603010,VEERAJ LLC,CANNON PHARMACY MAIN,1706 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1144603010,VEERAJ LLC,1706 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 468 ," 3,385 "," 6,914 "," $429,405.16 ",,
MEDICAID DIRECT,1144603010,VEERAJ LLC,CANNON PHARMACY MAIN,1706 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1144603010,VEERAJ LLC,1706 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 372 ," 2,570 "," 3,145 "," $471,161.13 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144604232,"LUCIANO FEIJOO, MARIECELY",170 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144604232,"LUCIANO FEIJOO, MARIECELY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 50 , 56 ,$#,,
MEDICAID DIRECT,1548625429,WESTMORELAND & OKANE PLLC,WNC DENTAL,3179 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144605494,"OKANE, RORY, JAMES",3179 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 54 , 176 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607029,"PAYNE, CHANDEE, LEIGH",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607029,"PAYNE, CHANDEE, LEIGH",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607029,"PAYNE, CHANDEE, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607029,"PAYNE, CHANDEE, LEIGH",10660 PARK RD STE 3200 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 26 , 31 , 38 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607029,"PAYNE, CHANDEE, LEIGH",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607029,"PAYNE, CHANDEE, LEIGH",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607581,"DOSHI, AMAR, HIRENDRA",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1237 HARDING PL STE 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607581,"DOSHI, AMAR, HIRENDRA",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607581,"DOSHI, AMAR, HIRENDRA",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607581,"DOSHI, AMAR, HIRENDRA",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144607581,"DOSHI, AMAR, HIRENDRA",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 30 , 37 , 39 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144607581,"DOSHI, AMAR, HIRENDRA",100 MEDICAL PARK DR STE 210 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144607581,"DOSHI, AMAR, HIRENDRA",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1144607623,ALL-AMERICAN HOME CARE LLC,~,813 HARDEE RD   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1144607623,ALL-AMERICAN HOME CARE LLC,813 HARDEE RD   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1144607623,ALL-AMERICAN HOME CARE LLC,~,992 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1144607623,ALL-AMERICAN HOME CARE LLC,992 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 182 ," 31,076 "," 31,233 "," $2,836,396.02 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144615238,"WONG, AN-KWOK, IAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144615238,"WONG, AN-KWOK, IAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144615238,"WONG, AN-KWOK, IAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 36 , 44 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 43 , 59 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1144616673,"RIESTER, MATTHEW, EDWARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144619776,"KAUFMAN, LAURA, JEAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 38 , 38 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144619776,"KAUFMAN, LAURA, JEAN",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 63 , 69 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144619776,"KAUFMAN, LAURA, JEAN",15 REGIONAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144623224,"ROEBUCK, NICOLE, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1699735951,GROWING UP PEDIATRICS PA,GROWING UP PEDIATRICS,8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144626003,"BYRD, VALORIE, STEWART",8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699735951,GROWING UP PEDIATRICS PA,GROWING UP PEDIATRICS,8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144626003,"BYRD, VALORIE, STEWART",8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,1141 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144627704,"DUKES, MONIFA",1141 N ROAD ST STE I ELIZABETH CITY NC,070,Pasquotank,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 15 , 25 ,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,1141 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1144627704,"DUKES, MONIFA",667 KINGSBOROUGH SQ STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,1101 MADISON PLZ STE 100&200 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144627704,"DUKES, MONIFA",667 KINGSBOROUGH SQ STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144628538,"OCCENAD, LILIETH",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3416 POOLE RD STE 120 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144628538,"OCCENAD, LILIETH",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144628538,"OCCENAD, LILIETH",6201 FAIRVIEW RD STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3416 POOLE RD STE 120 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144628538,"OCCENAD, LILIETH",6201 FAIRVIEW RD STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1144629767,"COLLINS, RACHEL, KATHLEEN",6845 KNIGHTDALE BLVD STE 100 KNIGHTDALE NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 14 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1144629767,"COLLINS, RACHEL, KATHLEEN",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 24 , 27 , 54 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144630534,"CANNON, NIHAN, KAYA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 48 , 48 ,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144631425,"DOWD, JOSHUA, EDMOND",250 HOSPICE CIR   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 26 , 71 , 80 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144631599,"NETZLEY, LAURA, MARIE",9224 ARDREY KELL RD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,MAXTON FAMILY PRACTICE CENTER,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144631805,"SMITH, CAROLYN, WHITLOCK",1001 W DR MLK JR DR   MAXTON NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144631805,"SMITH, CAROLYN, WHITLOCK",700A PROGRESS PL   LAURINBURG NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144631805,"SMITH, CAROLYN, WHITLOCK",700A PROGRESS PL   LAURINBURG NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1891789970,SCOTLAND MEMORIAL HOSPITAL INC,WAGRAM FAMILY PRACTICE,24420 MARLBORO ST   WAGRAM NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144631805,"SMITH, CAROLYN, WHITLOCK",24420 MARLBORO ST   WAGRAM NC,083,Scotland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1144631805,"SMITH, CAROLYN, WHITLOCK",412 S JONES ST   PEMBROKE NC,078,Robeson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144631912,"DAVITTE, MEREDITH, CALCINA",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 25 , 41 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1144633660,"ROSS, ADAM, MICHAEL",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144635012,"GARG, ANISHA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144635376,"GLISSON, KELLY, LEE",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144635376,"GLISSON, KELLY, LEE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 29 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144635376,"GLISSON, KELLY, LEE",8090 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144635376,"GLISSON, KELLY, LEE",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 25 , 32 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,825 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1144636481,"WRAY, BETHANY, GAYLE",825 BLOWING ROCK BLVD STE B LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2280 HWY 70 SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144636481,"WRAY, BETHANY, GAYLE",2280 HWY 70 SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1903 ADDISON AVE   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1144636481,"WRAY, BETHANY, GAYLE",1903 ADDISON AVE   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 33 , 86 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,178 HIGHWAY 105 EXT STE 101 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1144636481,"WRAY, BETHANY, GAYLE",178 HIGHWAY 105 EXT STE 101 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 28 , 67 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144636481,"WRAY, BETHANY, GAYLE",178 HIGHWAY 105 EXT STE 101 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 38 ,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144637216,"KAUR, LAKHBIR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 34 , 34 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144637216,"KAUR, LAKHBIR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144637216,"KAUR, LAKHBIR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1144640731,VELEKA Y BARBEE THERAPY SERVICES,~,124 E NORTH ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1144640731,VELEKA Y BARBEE THERAPY SERVICES,124 E NORTH ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,#, 70 , 72 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144641788,"SOUTHER, DUSTIN, MARK",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144644329,"RAUBE, PAULA, DAWN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144646134,"JONES, ABIGAIL, MURNICK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144646134,"JONES, ABIGAIL, MURNICK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1144646589,"RUNGE, DAVID, CHRISTOPHER",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1144646589,"RUNGE, DAVID, CHRISTOPHER",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144646589,"RUNGE, DAVID, CHRISTOPHER",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,1212 SPRUCE ST STE 305B BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144647041,"ELHAJ, AMAL, IDRIS AHMED",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 28 , 30 , 31 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144647041,"ELHAJ, AMAL, IDRIS AHMED",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,1212 SPRUCE ST STE 305B BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144647041,"ELHAJ, AMAL, IDRIS AHMED",1212 SPRUCE ST   BELMONT NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 40 , 44 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144647041,"ELHAJ, AMAL, IDRIS AHMED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 41 , 49 , 72 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 62 , 71 , 132 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144648270,"BAZEMORE, TAYLOR, CARLYLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 24 , 33 , 49 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144648890,"BROCK, THOMAS, EUGENE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 57 , 73 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144648890,"BROCK, THOMAS, EUGENE",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144648890,"BROCK, THOMAS, EUGENE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 33 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144649146,"JASTI, RAVI, KUMAR",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144649146,"JASTI, RAVI, KUMAR",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144649146,"JASTI, RAVI, KUMAR",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 12 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144649526,"WINTER, JONATHAN, WILLIAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144649526,"WINTER, JONATHAN, WILLIAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1144649526,"WINTER, JONATHAN, WILLIAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144649526,"WINTER, JONATHAN, WILLIAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144649526,"WINTER, JONATHAN, WILLIAM",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144649526,"WINTER, JONATHAN, WILLIAM",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 61 , 98 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144649526,"WINTER, JONATHAN, WILLIAM",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144651225,"COLE, SAMANTHA, KATHLEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144651811,SCOTTS FAMILY CARE HOME,SCOTTS FAMILY CARE HOME,43653 COLONIAL HEIGHTS RD   NEW LONDON NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144651811,SCOTTS FAMILY CARE HOME,43653 COLONIAL HEIGHTS RD   NEW LONDON NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 635 , 635 ," $35,682.00 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 388 , 390 , 390 ," $336,391.56 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,027 "," 1,261 "," 1,468 "," $186,852.58 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 45 , 45 , 45 ," $39,750.34 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1427169101,"BURROW, SAMUEL, JACK",~,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1144653205,"BURROW, SAMUEL, JACKSON",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 48 , 48 , 54 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144653205,"BURROW, SAMUEL, JACKSON",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 35 , 37 , 51 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1144655333,"WHITE, MELANIE, BLANKENSHIP",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 51 , 65 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144655333,"WHITE, MELANIE, BLANKENSHIP",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1144658014,"LEMNAH, MELISSA, LEIGH",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 47 , 67 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144658014,"LEMNAH, MELISSA, LEIGH",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 64 , 106 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144658014,"LEMNAH, MELISSA, LEIGH",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144659855,DEVELOPMENTAL PLAY SERVICES LLC,,14 WILLOWCROFT CT   DUNN NC,043,Harnett,251S00000X,Agencies,Community/Behavioral Health,,1144659855,DEVELOPMENTAL PLAY SERVICES LLC,14 WILLOWCROFT CT   DUNN NC,043,Harnett,251S00000X,Agencies,Community/Behavioral Health,, 388 ," 7,390 "," 7,390 "," $473,271.12 ",,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144661174,"BRAATEN, CONRAD, DONALD",340 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144661380,"BERRY, SOTHIDA",14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144661521,"KLUG, CHARISSE, LOUISE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144661521,"KLUG, CHARISSE, LOUISE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144661521,"KLUG, CHARISSE, LOUISE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 133 , 135 , 166 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",223 W WARD ST # B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 91 , 98 , 121 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144662636,"PARIKH, NISARG, ATULKUMAR",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 47 , 60 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144662982,"WILLIAMS, MICHELLE, RUTH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 36 , 37 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144665548,"BALEY, KATHERINE, WILCOX",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144667288,"IGUOBADIA, JOY, OSASERE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144667288,"IGUOBADIA, JOY, OSASERE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 106 , 106 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144668385,"ANCERAVAGE, MELISSA, RENAE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144668385,"ANCERAVAGE, MELISSA, RENAE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 13 , 15 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1144668997,"HE, ZHIHUA",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 53 , 54 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1144668997,"HE, ZHIHUA",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 281 , 282 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144669169,"VAQUERANO, CHRISTINA, DANIELLE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144669169,"VAQUERANO, CHRISTINA, DANIELLE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699784660,ONSITE NEONATAL PC,~,1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1144669714,"MELEK, MICHAEL, G",1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144670522,"LEVENTHAL, JARED, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144671942,"BAILEY, TONIA, DAVIS",4105 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 30 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144673179,"HARRINGTON, LESHARA, MALIKA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144673708,"HENSON, ELISABETH, HANEY",107B MICA AVE   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144673708,"HENSON, ELISABETH, HANEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144673708,"HENSON, ELISABETH, HANEY",107B MICA AVE   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144674953,INTEGRITY CARE SERVICES INC,,3626 LATROBE DR STE 300 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1144674953,INTEGRITY CARE SERVICES INC,3626 LATROBE DR STE 300 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 26 , 874 , 888 ," $68,462.52 ",,
MEDICAID DIRECT,1144674953,INTEGRITY CARE SERVICES INC,,1819 SARDIS RD N STE 350 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1144674953,INTEGRITY CARE SERVICES INC,1819 SARDIS RD N STE 350 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 9,717 "," 9,777 "," $659,366.72 ",,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1144675505,"SAN MIGUEL RUIZ, JOSE, ENRIQUE",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 101 , 147 , 150 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,2211 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144675547,"BREAKFIELD, LOGAN, RHYNE",2211 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144676347,"HUSAIN, IRMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144676347,"HUSAIN, IRMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 ,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144676347,"HUSAIN, IRMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 47 , 85 , 112 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144676347,"HUSAIN, IRMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144676347,"HUSAIN, IRMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144677220,"MITCHELL, MELANIE, LATHRUM",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144677220,"MITCHELL, MELANIE, LATHRUM",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1447355755,SMOKY MOUNTAIN FOOT CLINIC PA,SMOKY MOUNTAIN FOOT CLINIC PA,289 ACCESS RD   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1144677881,"DAWSON, DENNIS, ZACKARY",289 ACCESS RD   WAYNESVILLE NC,044,Haywood,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 120 , 213 , 265 ,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1144678566,"MILLER BLACKMON, NATALIE, GRACE",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 135 , 519 , 937 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144678764,"EVERETT, BRITTANY, BELL",13 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144678764,"EVERETT, BRITTANY, BELL",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 124 , 158 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144678764,"EVERETT, BRITTANY, BELL",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,13 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1144678764,"EVERETT, BRITTANY, BELL",13 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,13 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1144678764,"EVERETT, BRITTANY, BELL",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 74 , 90 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",633 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 24 , 78 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144679051,"PALMER, TIEDRE, SUSANNE",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144679218,"WHITE, KEVIN, MATTHEW",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 107 , 107 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144679218,"WHITE, KEVIN, MATTHEW",2301 ERWIN ROAD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144679218,"WHITE, KEVIN, MATTHEW",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 43 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 42 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 47 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144682386,"ANWAR, MUHAMMAD, AHMED FAROOQ",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144683137,"HAJIGHASEMI-OSSAREH, MOHAMMAD, REZA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144683681,"ADAMS, MICHAEL, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 29 , 35 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1144683855,"SZYMANSKI, ERIC, RAYMOND",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144683996,"HOOLEY, JARED, DOUGLAS",3609 SW DURHAM DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144683996,"HOOLEY, JARED, DOUGLAS",3609 SW DURHAM DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144684069,"HARKER, DAVID",1870 N CENTER ST   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 38 , 78 , 132 ,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144685637,"GATES, AUSTIN, DALE",1895 HOFFMAN RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720857220,URGENT MEDICAL 1 PLLC,ADVANCED URGENT CARE & WELLNESS,111 DAVE WARLICK DR   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1144685637,"GATES, AUSTIN, DALE",111 DAVE WARLICK DR   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144687278,"MIGUEZ, PATRICIA, ALMEIDA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0300X,Dental Providers,Dentist,Periodontics, 17 , 20 , 32 ,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1144690967,"EDINGTON, STEPHEN, CHARLES",3031 NEW BARN AVE STE 100 RALEIGH NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 46 , 47 , 47 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144691379,"WONG, TAMMY, SUEK-WUN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 33 , 34 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144691528,"KLEFFMAN UNDERWOOD, MARISSA, FERN",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144691528,"KLEFFMAN UNDERWOOD, MARISSA, FERN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 70 , 117 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144691726,"TENNYSON, CAROLINA, DIMSDALE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144691726,"TENNYSON, CAROLINA, DIMSDALE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174532972,CMG OF NORTH CAROLINA INC,COASTAL PEDIATRICS PA,1735 CITY CENTER BLVD   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1144692377,"FURCHES, KATHERINE, FALLS",1735 CITY CENTER BLVD   ELIZABETH CITY NC,070,Pasquotank,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 33 , 68 , 159 ,$#,,
MEDICAID DIRECT,1144692450,CAROMONT MEDICAL GROUP INC,CAROMONT PHYSICAL THERAPY,1212 SPRUCE ST STE 305D BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144692450,CAROMONT MEDICAL GROUP INC,1212 SPRUCE ST STE 305D BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1144694092,ADELANTE CHILDRENS THERAPIES,,236 WOODY CIR   TRYON NC,075,Polk,252Y00000X,Agencies,Early Intervention Provider Agency,,1144694092,ADELANTE CHILDRENS THERAPIES,236 WOODY CIR   TRYON NC,075,Polk,252Y00000X,Agencies,Early Intervention Provider Agency,, 12 , 127 , 127 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144694803,"GARWOOD, SARAH, WRAY",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 47 , 63 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144694803,"GARWOOD, SARAH, WRAY",1125 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144694803,"GARWOOD, SARAH, WRAY",1125 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,68 CROSSROAD HILL RD   CANTON NC,044,Haywood,193200000X,Group,Multi-Specialty,,1144699174,"ROUTH, TRAVIS, LEE",80 MAIN ST   CANTON NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 52 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,80 MAIN ST   CANTON NC,044,Haywood,193200000X,Group,Multi-Specialty,,1144699174,"ROUTH, TRAVIS, LEE",80 MAIN ST   CANTON NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 30 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144699174,"ROUTH, TRAVIS, LEE",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144699430,"WALKER, KARI, TATE",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 45 , 50 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144699653,"MAIN, AMANDA, IRENE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144699653,"MAIN, AMANDA, IRENE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1144701467,"MANN, STEPHANIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 48 , 48 , 48 ,$#,,
MEDICAID DIRECT,1669187522,TRISHA-LORAY ABARO APRECIO DDS PC,AIRA DENTAL,1609 W ARLINGTON BLVD STE 107 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144702705,"APRECIO, TRISH-LORAY, ABARO",1609 W ARLINGTON BLVD STE 107 GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 2,005 "," 2,926 "," 13,979 "," $692,233.36 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144704487,"ALFINO, LEAH",235 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922353838,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,1423 E FRANKLIN ST STE D MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144706011,"BRAGG, KRYSTA, COURTNEY",1423 E FRANKLIN ST STE D MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 159 , 209 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144707902,"HEBISHI, KARIM, ABDALLA REDA FETOUH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144707969,"DAVIS, CRISTINA, HELENA",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144707969,"DAVIS, CRISTINA, HELENA",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144708017,"CARLSEN, ERIC",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 15 , 19 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144708017,"CARLSEN, ERIC",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144708017,"CARLSEN, ERIC",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144708017,"CARLSEN, ERIC",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 173 , 213 , 351 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144708017,"CARLSEN, ERIC",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 67 , 106 , 225 ,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1144708553,"SCOTT, AMANDA, AN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1144708553,"SCOTT, AMANDA, AN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1144708553,"SCOTT, AMANDA, AN",730 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144709460,"STAUDER, AMANDA, KIMBERLY",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144709460,"STAUDER, AMANDA, KIMBERLY",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144709460,"STAUDER, AMANDA, KIMBERLY",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144711367,"WARREN, MORGAN, EMILY WHITAKER",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144712928,"WILSON, JENNA, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144713009,"MCEATHRON, RORY, DAVID",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 78 , 122 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144713280,"THOMAS, MICHELLE, YVONNE",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144713280,"THOMAS, MICHELLE, YVONNE",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 37 , 46 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 19 , 21 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144713512,"CHILDES, BENJAMIN, JEFFREY ROBERT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144716739,"COVER, LINDSAY, ALLISON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1144719006,"HOPPENS, MEGAN, FITZPATRICK",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 38 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1144719006,"HOPPENS, MEGAN, FITZPATRICK",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144723628,"MYERS, BRITANI, JOYE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144723628,"MYERS, BRITANI, JOYE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 30 , 34 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144723628,"MYERS, BRITANI, JOYE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144723628,"MYERS, BRITANI, JOYE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144723628,"MYERS, BRITANI, JOYE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144723909,"BROWN, AMANDA, MARY",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 38 , 39 , 43 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144724139,"FIRESTONE, ALICIA, CLAIRE",1405 WILLOW LN   NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144724139,"FIRESTONE, ALICIA, CLAIRE",1405 WILLOW LN   NORTH WILKESBORO NC,097,Wilkes,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144724139,"FIRESTONE, ALICIA, CLAIRE",930 3RD ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 37 , 62 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144724139,"FIRESTONE, ALICIA, CLAIRE",3518 DRAWBRIDGE PKWY STE 310 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 53 , 76 , 114 ,$#,,
MEDICAID DIRECT,1144724519,"ABBAS, SYED, MAISAM",,200 FLEETWOOD DRIVE   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1144724519,"ABBAS, SYED, MAISAM",200 FLEETWOOD DRIVE   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144724923,"LAUNGANI, NATASHA, NIRMAL",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144724923,"LAUNGANI, NATASHA, NIRMAL",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 25 , 34 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144724923,"LAUNGANI, NATASHA, NIRMAL",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144724923,"LAUNGANI, NATASHA, NIRMAL",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144724923,"LAUNGANI, NATASHA, NIRMAL",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144725003,"HILL, JEREMY, LOUIS",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144725003,"HILL, JEREMY, LOUIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 38 , 53 , 76 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144725300,"ZHYVOTOVSKA, ANGELINA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144725300,"ZHYVOTOVSKA, ANGELINA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144725300,"ZHYVOTOVSKA, ANGELINA",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144726241,"OWENS, JULIA, DEVITA",14215 BALLANTYNE CORPORATE PL STE 130 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1144726886,"SHUKLA, SHWETA",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144726886,"SHUKLA, SHWETA",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 39 , 45 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144726886,"SHUKLA, SHWETA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 23 , 30 , 41 ,$#,,
MEDICAID DIRECT,1144726928,EVANS PHYSICAL THERAPY & SPORT PERF,,2585 W ROOSEVELT BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1144726928,EVANS PHYSICAL THERAPY & SPORT PERF,2585 W ROOSEVELT BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,#, 25 , 67 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144726977,"EDWARDS, HUNTER, KEITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144726977,"EDWARDS, HUNTER, KEITH",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 33 , 33 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 129 , 190 , 341 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727645,"TANNENBAUM, JORDAN, ELIJAH ROTSTEIN",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 43 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144727686,"GARIWALA, VEER, MONISH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 19 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144727686,"GARIWALA, VEER, MONISH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144727686,"GARIWALA, VEER, MONISH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144727744,"MAHONEY, ANNE, BYRD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144740614,"HARTUNG, HILLARY, MICHELLE",825 FAIRFAX AVE # 4 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144740614,"HARTUNG, HILLARY, MICHELLE",825 FAIRFAX AVE # 4 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144740663,"SYNDERGAARD, SCOTT, NEIL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 77 , 98 , 150 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144740663,"SYNDERGAARD, SCOTT, NEIL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 96 , 100 , 148 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1144740663,"SYNDERGAARD, SCOTT, NEIL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1144740663,"SYNDERGAARD, SCOTT, NEIL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1144740788,"MENDSEN, MICHAEL, THOMAS",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1144740788,"MENDSEN, MICHAEL, THOMAS",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144740788,"MENDSEN, MICHAEL, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144740838,"CALDERON, ESTEBAN",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144740861,"WAGNER, SEAN, PETER",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 168 , 173 , 228 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144740861,"WAGNER, SEAN, PETER",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144740861,"WAGNER, SEAN, PETER",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 86 , 86 , 138 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144741794,"RUFFIN, KAITLIN, MIZE",10211 ALM ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144741794,"RUFFIN, KAITLIN, MIZE",10211 ALM ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144741794,"RUFFIN, KAITLIN, MIZE",10211 ALM ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 39 , 80 ,$#,,
MEDICAID DIRECT,1144309949,THERAPY PLUS CLINIC INC,THERAPY PLUS CLINIC INC,247 OAK STREET EXT STE 145 FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1144743865,"MELTON, MICHAEL, ALAN",247 OAK STREET EXT STE 145 FOREST CITY NC,081,Rutherford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 11 , 42 , 59 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144744517,"CAMPBELL, SARA, LYNN",3801 WAKE FOREST RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144744681,"KONOPKA, AMANDA, JAYNE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 39 , 43 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144744681,"KONOPKA, AMANDA, JAYNE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144744681,"KONOPKA, AMANDA, JAYNE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 18 , 29 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144745365,"HOLBROOK, JAMES, MARETT",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 141 , 294 , 296 ," $18,011.86 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144745365,"HOLBROOK, JAMES, MARETT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1144745365,"HOLBROOK, JAMES, MARETT",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 30 , 31 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",501 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144748500,"MALONE, WILLIAM, THOMAS",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144752072,"TORO BEJARANO, ALEJANDRA, MARIA",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144752072,"TORO BEJARANO, ALEJANDRA, MARIA",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144752072,"TORO BEJARANO, ALEJANDRA, MARIA",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 27 , 34 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,150 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144752072,"TORO BEJARANO, ALEJANDRA, MARIA",150 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144752072,"TORO BEJARANO, ALEJANDRA, MARIA",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144752072,"TORO BEJARANO, ALEJANDRA, MARIA",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144752072,"TORO BEJARANO, ALEJANDRA, MARIA",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144754508,"HINSHAW, KAITLYN, DAWN",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144754508,"HINSHAW, KAITLYN, DAWN",16000 JOHNSTON MEMORIAL DR   ABINGDON VA,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144754508,"HINSHAW, KAITLYN, DAWN",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144754508,"HINSHAW, KAITLYN, DAWN",16000 JOHNSTON MEMORIAL DR   ABINGDON VA,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144754755,"CURTI, MICHELLE, RENEE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144754755,"CURTI, MICHELLE, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144754755,"CURTI, MICHELLE, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144756248,"BOSTICK, JENNIFER, ASHLEY",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144756701,"CARDON, ZACHARY, EDWARD",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144756701,"CARDON, ZACHARY, EDWARD",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144756701,"CARDON, ZACHARY, EDWARD",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 95 , 110 , 113 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1144756701,"CARDON, ZACHARY, EDWARD",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 22 , 27 ,$#,,
MEDICAID DIRECT,1194260919,COMPASS PHYSICAL THERAPY LLC,,2170 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1144757584,"SHUMATE, RACHEL, LLOYD",2170 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144759069,"MODLIN, AMY, MICHELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 84 , 84 ,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1144759960,"PHILLIPS, CAMERON, SCOTT",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1144759960,"PHILLIPS, CAMERON, SCOTT",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1144759960,"PHILLIPS, CAMERON, SCOTT",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 122 , 151 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144759960,"PHILLIPS, CAMERON, SCOTT",601 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1144759960,"PHILLIPS, CAMERON, SCOTT",601 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144759960,"PHILLIPS, CAMERON, SCOTT",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144761602,MAKING VISIONS COME TRUE PLLC,MAKING VISIONS,2150 N CHURCH ST STE B BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1144761602,MAKING VISIONS COME TRUE PLLC,2150 N CHURCH ST STE B BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 48 ," 11,350 "," 11,350 "," $649,985.68 ",,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144764960,"YIN, SHUHUA",1141 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 42 , 54 ,$#,,
MEDICAID DIRECT,1144765520,ROSE-HILL FAMILY CARE HOME,~,1116 BEVERLY DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144765520,ROSE-HILL FAMILY CARE HOME,1116 BEVERLY DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 266 , 266 ," $85,878.57 ",,
MEDICAID DIRECT,1144765520,ROSE-HILL FAMILY CARE HOME,~,305 MYRTLE RD   SELMA NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144765520,ROSE-HILL FAMILY CARE HOME,305 MYRTLE RD   SELMA NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1144771874,TEMA HOME CARE SERVICES LLC,,1404 BEATTIES FORD RD STE 201 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1144771874,TEMA HOME CARE SERVICES LLC,1404 BEATTIES FORD RD STE 201 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 97 ," 24,519 "," 24,823 "," $2,017,557.44 ",,
MEDICAID DIRECT,1144775545,THE VILLAS AT BENSON II INC,~,606 E MORRIS AVE   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144775545,THE VILLAS AT BENSON II INC,606 E MORRIS AVE   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,065 "," 1,065 "," $65,822.39 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144775842,"NWOKEDI, NONYE, EVARISTA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144775842,"NWOKEDI, NONYE, EVARISTA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1144779331,"PETTIGREW, REBECCA, ELAINE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 153 , 218 ,$#,,
MEDICAID DIRECT,1093497521,ALLES DDS HUNTERSVILLE PLLC,IDEAL DENTAL HUNTERSVILLE,14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144779703,"MUNN, JOYCE, BIN-HONG",14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,1223E0200X,Dental Providers,Dentist,Endodontics, 18 , 19 , 36 ,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144779703,"MUNN, JOYCE, BIN-HONG",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223E0200X,Dental Providers,Dentist,Endodontics, 28 , 29 , 41 ,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144779703,"MUNN, JOYCE, BIN-HONG",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144779703,"MUNN, JOYCE, BIN-HONG",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144779703,"MUNN, JOYCE, BIN-HONG",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1467152496,ALLES DDS KANNAPOLIS PLLC,IDEAL DENTAL KANNAPOLIS,582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1144779703,"MUNN, JOYCE, BIN-HONG",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1467152496,ALLES DDS KANNAPOLIS PLLC,IDEAL DENTAL KANNAPOLIS,582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144779703,"MUNN, JOYCE, BIN-HONG",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223E0200X,Dental Providers,Dentist,Endodontics, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144780347,"BLUDOV, EMILY, JANE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144780347,"BLUDOV, EMILY, JANE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144780347,"BLUDOV, EMILY, JANE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1144780933,"CASTILLEJOS ELLENTHAL, ALEXANDRA, GOULART",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 45 , 73 , 146 ,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144780933,"CASTILLEJOS ELLENTHAL, ALEXANDRA, GOULART",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 89 , 145 , 227 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144780933,"CASTILLEJOS ELLENTHAL, ALEXANDRA, GOULART",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144781063,"CANELAS, CAROLINE, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144781063,"CANELAS, CAROLINE, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144781063,"CANELAS, CAROLINE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144781063,"CANELAS, CAROLINE, MARIE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144781071,"GARSON, NICKOLAS, KOTOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1144781071,"GARSON, NICKOLAS, KOTOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144781071,"GARSON, NICKOLAS, KOTOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 12 , 13 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144781071,"GARSON, NICKOLAS, KOTOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144781071,"GARSON, NICKOLAS, KOTOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 15 , 22 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1144781071,"GARSON, NICKOLAS, KOTOS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 16 , 24 , 34 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144781576,"LONG, KYLE, DAVID",1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144781576,"LONG, KYLE, DAVID",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1144782798,"DURAND-ROUGELY, CLARISSA, MIREILLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 22 , 42 , 45 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144782798,"DURAND-ROUGELY, CLARISSA, MIREILLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780090324,NORTH CAROLINA INSTITUTE OF SPORTS,BYOUNG PHYSICAL THERAPY,2121 E WILLIAMS ST STE 108 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1144786633,"THOMPSON, NATHANIEL, LEE",2121 E WILLIAMS ST STE 108 APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144787748,"PICHETTE, CHAZ, THOMAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144787748,"PICHETTE, CHAZ, THOMAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144787748,"PICHETTE, CHAZ, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144787748,"PICHETTE, CHAZ, THOMAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144787748,"PICHETTE, CHAZ, THOMAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144789322,"POPE, PHILLIP, READ",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144789322,"POPE, PHILLIP, READ",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144789322,"POPE, PHILLIP, READ",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821596115,GODEL AND ASSOCIATES II PLLC,CHARLOTTE FAMILY DENTAL CARE,5232 ALBEMARLE RD STE F CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144789553,"NUNEZ DIAZ GRANADOS, CARLA, FABIOLA",5232 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1821596115,GODEL AND ASSOCIATES II PLLC,CHARLOTTE FAMILY DENTAL CARE,5232 ALBEMARLE RD STE F CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144789553,"NUNEZ DIAZ GRANADOS, CARLA, FABIOLA",5232 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144795444,"RUMBAUGH, SARAH, MARIE",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144795444,"RUMBAUGH, SARAH, MARIE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144795444,"RUMBAUGH, SARAH, MARIE",2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144795865,"ROBERTS, CRYSTAL, PARSON",3521 HAWORTH DR FL 2 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1144795865,"ROBERTS, CRYSTAL, PARSON",3521 HAWORTH DR FL 2 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144796483,"SEPE, NICOLAS, JAMES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144796483,"SEPE, NICOLAS, JAMES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144800244,"FALLER, CARLY, MARIE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 24 , 40 ,$#,,
MEDICAID DIRECT,1093901696,CAROLINA CARING HEALTH PARTNERS,CAROLINA CARING HOUSE CALLS,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1144805466,"REGALADO, ANGELA, NICHOLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144807439,"BELMONTE, MARIE, ALYSSA MALAYA",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144807439,"BELMONTE, MARIE, ALYSSA MALAYA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144807439,"BELMONTE, MARIE, ALYSSA MALAYA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144807439,"BELMONTE, MARIE, ALYSSA MALAYA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144807686,"DOYLE, JONATHAN, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 69 , 69 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144808163,"BURL, TAYLOR, DUPRE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144808163,"BURL, TAYLOR, DUPRE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1144808262,"JOHN, LUCAS, COLLIER",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 35 , 42 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144808981,"SRIVASTAV, JIGISHA",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 39 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144808981,"SRIVASTAV, JIGISHA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 90 , 90 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144809435,"TAYLOR, INDIA, VICTORIA",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144809435,"TAYLOR, INDIA, VICTORIA",8401 MEDICAL PLAZA DR STE 220 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 26 , 58 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144809435,"TAYLOR, INDIA, VICTORIA",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487899902,LOVE CHIROPRACTIC CENTER,LOVE CHIROPRACTIC CENTER,215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1144812470,"COOPER, SEAN",215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1447975073,LOVE CHIROPRACTIC CENTER SALISBURY,LOVE CHIROPRACTIC CENTER SALISBURY,628 W INNES ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1144812470,"COOPER, SEAN",628 W INNES ST   SALISBURY NC,080,Rowan,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144817560,"CONKLIN, JULIE, ANNE",306 WESTWOOD AVE   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144820457,"CORCHO RAMIREZ, YUNIER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1144820457,"CORCHO RAMIREZ, YUNIER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144825944,"JOSAM, DAVID, MICHAEL",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144825944,"JOSAM, DAVID, MICHAEL",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144825944,"JOSAM, DAVID, MICHAEL",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144825944,"JOSAM, DAVID, MICHAEL",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144825944,"JOSAM, DAVID, MICHAEL",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1144825944,"JOSAM, DAVID, MICHAEL",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1144825944,"JOSAM, DAVID, MICHAEL",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144826736,CRESCENT GREEN INC,TREMORE MANOR ALF,6016 PINETOWN RD   OXFORD NC,039,Granville,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1144826736,CRESCENT GREEN INC,6016 PINETOWN RD   OXFORD NC,039,Granville,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,466 "," 1,466 "," $140,559.31 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144826744,"JOHNSON, HALEY, KENICIA COLEMAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1144826744,"JOHNSON, HALEY, KENICIA COLEMAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144826744,"JOHNSON, HALEY, KENICIA COLEMAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144831173,LIGHTHOUSE HOME CARE SERVICE LLC,,121 E WATER ST   PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,,1144831173,LIGHTHOUSE HOME CARE SERVICE LLC,121 E WATER ST   PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,, 47 ," 9,956 "," 9,972 "," $859,283.28 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144835307,"GRAY, JESSICA, DANIELLE MAH",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 24 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144838137,"FOLLANSBEE, CAITLIN, JAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 82 , 86 , 101 ,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144838327,"DROBOT, DANIELLE, TOWNSEND",301 LLOYD ST   CARRBORO NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,522 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144838517,"WAMBUA, JOSEPHINE, MWITHI",522 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144842303,"MARTINEZ, MICHELLE, COLON",815 COX RD   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144843459,"HERSBERGER, KATHERINE, ELAINE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1144843459,"HERSBERGER, KATHERINE, ELAINE",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144846627,"PICKETT, TIMOTHY, ALLEN",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1801442033,BRADLEY ROBERTS & ASSOCIATES PLLC,~,401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1144846627,"PICKETT, TIMOTHY, ALLEN",401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144846627,"PICKETT, TIMOTHY, ALLEN",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1902452139,BRADLEY ROBERTS & ASSOCIATES PLLC,,1135 N CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1144846627,"PICKETT, TIMOTHY, ALLEN",1135 N CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice," 3,790 "," 5,635 "," 28,891 "," $907,363.41 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144846627,"PICKETT, TIMOTHY, ALLEN",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 37 , 516 ," $46,460.25 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1144846627,"PICKETT, TIMOTHY, ALLEN",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 24 , 121 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144846940,"WELLS, CASEY, JACKSON",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1144851460,INGLES MARKETS INC,INGLES PHARMACY 060,625 W HENDERSON ST   MARION NC,059,McDowell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1144851460,INGLES MARKETS INC,625 W HENDERSON ST   MARION NC,059,McDowell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1508681750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT GROVER ELEMENTARY,206 CAROLINA AVE   GROVER NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144856899,"WHISNANT, SANTANA, AKEEM",526 DAVIS RD   SHELBY NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1710736582,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT TOWNSHIP THREE ELEMENTARY,526 DAVIS RD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144856899,"WHISNANT, SANTANA, AKEEM",526 DAVIS RD   SHELBY NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 69 , 69 ," $22,102.77 ",,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144856899,"WHISNANT, SANTANA, AKEEM",526 DAVIS RD   SHELBY NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144857574,"OCAMPO, JANCARLA, MARIE",2311 LEWISVILLE CLEMMONS RD FL 3 CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144858036,"POWELL, ALEX, AVERY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144858036,"POWELL, ALEX, AVERY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 43 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144858036,"POWELL, ALEX, AVERY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 33 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144858036,"POWELL, ALEX, AVERY",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1144858036,"POWELL, ALEX, AVERY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144861162,"WAGNER, HALEY, RAVNDAL",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1144863168,A PRIMARY CHOICE INC,,1148 S CHURCH ST   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1144863168,A PRIMARY CHOICE INC,1148 S CHURCH ST   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 2,994 "," 2,994 "," $154,423.10 ",,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144863507,"HEMINGWAY, COURTNEY, LYNN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144863507,"HEMINGWAY, COURTNEY, LYNN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144864885,"MITCHELL, RYAN, CHRISTOPHER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 98 , 104 , 113 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144864885,"MITCHELL, RYAN, CHRISTOPHER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710176979,ALDRIDGE EYE INSTITUTE OD PA,Aldridge Eye Institute OD PA,419 E MAIN ST   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1144870635,"MOORE, DOAN THUC, MINH",419 E MAIN ST   BURNSVILLE NC,100,Yancey,152W00000X,Eye and Vision Services Providers,Optometrist,, 80 , 84 , 130 ,$#,,
MEDICAID DIRECT,1144870635,"MOORE, DOAN THUC, MINH",,419 E MAIN ST   BURNSVILLE NC,100,Yancey,152W00000X,Eye and Vision Services Providers,Optometrist,,1144870635,"MOORE, DOAN THUC, MINH",419 E MAIN ST   BURNSVILLE NC,100,Yancey,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 21 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144873670,"ICENHOUR, SHANNON, BROOKE",2301 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 19 , 30 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1144873738,"CHRIST, KRYSTA, SINK",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144875667,"IANNOTTA, CAYLIN, MARIE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 37 , 37 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1144875758,"SZUGYE, ADRIAN, JOHN",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,75 PAINT TOWN RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1144875758,"SZUGYE, ADRIAN, JOHN",77 PAINT TOWN RD   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144879933,"GASKILL, LAURA, REICH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144880485,"ROTHKRUG, ALEXANDER, SCHNABEL",9735 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 20 , 36 , 45 ,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144880485,"ROTHKRUG, ALEXANDER, SCHNABEL",269 GILLMAN RD   DENVER NC,055,Lincoln,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144883802,"SEMPLE, ERIN, AMELIA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144883802,"SEMPLE, ERIN, AMELIA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1669561320,DR ALAN L BYRD ASSOCS OF ERWIN,~,2332 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1144889585,"WORRELL, STEPHANIE, ELIZABETH",2332 W CUMBERLAND ST   DUNN NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205925914,DR ALAN L BYRD AND ASSOCIATES,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1144889585,"WORRELL, STEPHANIE, ELIZABETH",104 S MAIN ST   LILLINGTON NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720169220,DR ALAN L BYRD ASSOCIATES OF ANGIER,DR ALAN L BYRD & ASSOCIATES OF ANGIER,8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,193200000X,Group,Multi-Specialty,,1144889585,"WORRELL, STEPHANIE, ELIZABETH",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205925914,DR ALAN L BYRD AND ASSOCIATES,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1144889585,"WORRELL, STEPHANIE, ELIZABETH",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1144890039,KEYS TO FREEDOM CAREGIVERS LLC,KEYS TO FREEDOM CAREGIVERS LLC,8929 J M KEYNES DR STE 340 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1144890039,KEYS TO FREEDOM CAREGIVERS LLC,8929 J M KEYNES DR STE 340 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 90 ," 21,468 "," 21,471 "," $1,427,255.92 ",,
MEDICAID DIRECT,1144891003,CAROLINA SPEECH THERAPY SERVICES PL,,341 WRIGHT RD   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1144891003,CAROLINA SPEECH THERAPY SERVICES PL,341 WRIGHT RD   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1144894973,HEAVENLY SENT HOME CARE SERVICES,,5909 FALLS OF NEUSE ROAD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1144894973,HEAVENLY SENT HOME CARE SERVICES,5909 FALLS OF NEUSE ROAD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 73 ," 10,916 "," 11,094 "," $967,352.11 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1144896929,"LEJMAN, ANDREW, CODY",509 OLDE WATERFORD WAY STE 300 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice," 1,941 "," 3,226 "," 10,022 "," $473,638.76 ",,
MEDICAID DIRECT,1538412739,WEST CALDWELL HEALTH COUNCIL INC,WEST CALDWELL MOBILE HEALTH,4330 COLLETTSVILLE RD BASE OF OPERATIONS COLLETTSVILLE NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144899865,"YAMOUTI, HANNAH, CHRISTINE",4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 54 , 54 ," $17,065.08 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144899964,"BRADY, JACQUELINE, DAVANZO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 31 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144901273,"CLARK, MEGHAN, ROSILAE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144903709,"JAMES, SHANNON, REBEKAH",1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 90 , 113 , 140 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144903709,"JAMES, SHANNON, REBEKAH",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144907676,WHOLE HEARTED HOME CARE LLC,,4819 EMPEROR BLVD STE 400 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1144907676,WHOLE HEARTED HOME CARE LLC,4819 EMPEROR BLVD STE 400 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 10,183 "," 10,183 "," $744,196.56 ",,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144909292,"HUTSON, HUNTER, LYNNETTE",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 79 , 79 ,$#,,
MEDICAID DIRECT,1225307713,SOUTHEASTERN REGIONAL MEDICAL CENTE,SOUTHEASTERN BEHAVIORAL HEALTH SERVICES,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1144910308,"MERRELL, ALEXANDRA, DAIS",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1144919168,"BARKETT, KELSEY, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 26 , 26 ,$#,,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1144920455,"BARAKAT, RANA",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 209 , 277 , 863 ," $41,463.80 ",,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1144920455,"BARAKAT, RANA",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 139 , 214 , 669 ," $31,371.97 ",,
MEDICAID DIRECT,1831820927,LANE AND ASSOCIATES XLVI DDS PA,,2201 CANDUN DR STE 202 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1144920455,"BARAKAT, RANA",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 37 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144928300,"CIL, OLIVIA, KISER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1144929597,"GEORGE, SIERRA, SHABREE",619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 33 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1144929597,"GEORGE, SIERRA, SHABREE",509 OLDE WATERFORD WAY STE 305 LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1144929597,"GEORGE, SIERRA, SHABREE",509 OLDE WATERFORD WAY STE 305 LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,509 OLDE WATERFORD WAY STE 305 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1144929597,"GEORGE, SIERRA, SHABREE",509 OLDE WATERFORD WAY STE 305 LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 33 , 45 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144929811,"WILLIS, SHELBY, DRITTLER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 24 ,$#,,
MEDICAID DIRECT,1083447890,ALIGNMED MEDICAL GROUP NC PC,,877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1144933458,"CORREIA, MARIA, SKYE",900 W DOLPHIN ST   SILER CITY NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 133 , 134 ,$#,,
MEDICAID DIRECT,1881109452,ALIGNMED PARTNERS PC,GPS PHYSICIAN GROUP PC,877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1144933458,"CORREIA, MARIA, SKYE",900 W DOLPHIN ST   SILER CITY NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2702 FARRELL RD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1144933458,"CORREIA, MARIA, SKYE",2702 FARRELL RD   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1144933458,"CORREIA, MARIA, SKYE",2702 FARRELL RD   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 42 , 43 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1144933458,"CORREIA, MARIA, SKYE",2702 FARRELL RD   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144934688,"MOSHER, JENNIFER, BOFINGER",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1144934688,"MOSHER, JENNIFER, BOFINGER",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 90 , 132 ,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1144934688,"MOSHER, JENNIFER, BOFINGER",10188 N MAIN ST   ARCHDALE NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1144692450,CAROMONT MEDICAL GROUP INC,CAROMONT PHYSICAL THERAPY,1212 SPRUCE ST STE 305D BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144935875,"ARTIS, YASMINE, TATYANA",1212 SPRUCE ST STE 305D BELMONT NC,036,Gaston,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 12 , 31 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144938218,"SIDWELL, CAROLINE, ANNE",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 58 , 137 ,$#,,
MEDICAID DIRECT,1144938663,THE TILLER SCHOOL OF CARTERET COUNT,,1950 LIVE OAK ST   BEAUFORT NC,016,Carteret,251300000X,Agencies,Local Education Agency (LEA),,1144938663,THE TILLER SCHOOL OF CARTERET COUNT,1950 LIVE OAK ST   BEAUFORT NC,016,Carteret,251300000X,Agencies,Local Education Agency (LEA),, 11 , 336 , 342 ," $17,173.22 ",,
MEDICAID DIRECT,1144938804,SUPERIOR HOME CARE AGENCY LLC,,2020 REMOUNT RD STE E-106 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1144938804,SUPERIOR HOME CARE AGENCY LLC,2020 REMOUNT RD STE E-106 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#, 320 , 320 ," $15,805.92 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144943473,"THOMAS, SALENA, DIANE",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144943473,"THOMAS, SALENA, DIANE",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1144949207,"BROWN PRICE, AMY, SUE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 17 , 40 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1144949207,"BROWN PRICE, AMY, SUE",5156 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1144949207,"BROWN PRICE, AMY, SUE",529 S VAN BUREN RD   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 57 , 135 ,$#,,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1144949744,"LINARES, RACHEL, MOORE",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 32 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144951914,"WARE, JONATHAN, BRANDON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 44 , 46 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144951914,"WARE, JONATHAN, BRANDON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1144953167,"HETTINGER, BENJAMIN, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1144953167,"HETTINGER, BENJAMIN, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1144953167,"HETTINGER, BENJAMIN, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1144953167,"HETTINGER, BENJAMIN, AUSTIN",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1144953167,"HETTINGER, BENJAMIN, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144953167,"HETTINGER, BENJAMIN, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 45 , 100 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1144953647,"TANG, LILY, MICHELLE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144953647,"TANG, LILY, MICHELLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144959529,"SILVERS, SARAH, ELIZABETH",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 42 , 79 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1144959529,"SILVERS, SARAH, ELIZABETH",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 46 , 68 ,$#,,
MEDICAID DIRECT,1144966334,NEW DIMENSION SCHOOL,,550 LENOIR RD   MORGANTON NC,012,Burke,251300000X,Agencies,Local Education Agency (LEA),,1144966334,NEW DIMENSION SCHOOL,550 LENOIR RD   MORGANTON NC,012,Burke,251300000X,Agencies,Local Education Agency (LEA),,#, 145 , 145 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144968959,"PASEDA, FOLASHADE, RUTH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 98 , 163 , 249 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1144968959,"PASEDA, FOLASHADE, RUTH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 36 , 55 ,$#,,
MEDICAID DIRECT,1144970427,IN GOOD HANDS HOME CARE SERVICE,IN GOOD HANDS HOME CARE SERVICE,8011 N POINT BLVD STE 206 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1144970427,IN GOOD HANDS HOME CARE SERVICE,8011 N POINT BLVD STE 206 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,328 "," 2,328 "," $154,129.44 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144973942,"ROTH, KELSEY, NICOLE",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1144973942,"ROTH, KELSEY, NICOLE",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 23 , 23 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1144976606,"ALEXOUDIS, MARIA",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 75 , 116 , 258 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144976937,"BURNETTE, LISA, ANN",2251 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144977216,"LAWSHE, JENNA, GROSS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 37 , 37 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1144977216,"LAWSHE, JENNA, GROSS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1144977216,"LAWSHE, JENNA, GROSS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144978628,"JONES, OLIVIA, JACKSON",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1144980418,"KELLER, TIFFANY, LYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144980418,"KELLER, TIFFANY, LYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 42 , 42 ,$#,,
MEDICAID DIRECT,1144981366,REX HEALTHCARE INC,UNC HEALTH PROSTHETICS AND ORTHOTICS LLC,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1144981366,REX HEALTHCARE INC,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 130 , 147 , 676 ," $143,359.89 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1144983602,"MAYO, KRISTIANNA, KATHERINE",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1144985714,ELIZABETH ALBRIGHT LLC,,315 OLD HAW CREEK RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1144985714,ELIZABETH ALBRIGHT LLC,315 OLD HAW CREEK RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#, 221 , 221 ," $20,871.86 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144986506,"FRIEND, NATALIE, KAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 33 , 33 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1144987264,"KOVACH, MARLOWE, ELIZA CREWS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144990680,"MARTINEAU, SAMANTHA, PEARL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1144990680,"MARTINEAU, SAMANTHA, PEARL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144990680,"MARTINEAU, SAMANTHA, PEARL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1144993288,"MEHTA, NITI, HEMANT",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1851931257,LANE AND ASSOCIATES XXXV DDS PA,,11180 E FINCH AVE   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1144993288,"MEHTA, NITI, HEMANT",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 303 , 459 ," 1,619 "," $82,204.50 ",,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1144993288,"MEHTA, NITI, HEMANT",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1144993288,"MEHTA, NITI, HEMANT",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 30 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1144995655,"JONES, RICHARD, ANTHONY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 31 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144995655,"JONES, RICHARD, ANTHONY",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1144995655,"JONES, RICHARD, ANTHONY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1144995655,"JONES, RICHARD, ANTHONY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 30 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1144996638,"HILL, KAITLYN, JEAN",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 49 , 75 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1144999525,"GLASCO, ADAM, DENNIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1144999525,"GLASCO, ADAM, DENNIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1144999525,"GLASCO, ADAM, DENNIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154003788,"ALLOCO, CARLY, ROSE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154003788,"ALLOCO, CARLY, ROSE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154003788,"ALLOCO, CARLY, ROSE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154004976,"LEWIS, WILLIAM, JOSHUA",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 25 , 71 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154004976,"LEWIS, WILLIAM, JOSHUA",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 45 , 52 , 155 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1154005353,"SCHMIT, LAURA, ELIZABETH",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154005353,"SCHMIT, LAURA, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 118 , 120 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154005353,"SCHMIT, LAURA, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154005353,"SCHMIT, LAURA, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154007052,"MCKEON, VALERIE, ALLETA",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1649216631,PIEDMONT EAR NOSE AND THROAT PA,PIEDMONT EAR NOSE AND THROAT ASSOCIATES,110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1154007318,"YOUNG, KATHRYN, SOBON",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154013035,"FAULKNER, KHADIJA, TROTTER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1154015154,"EARLIWINE, ABIGAIL, MICHELE",3110 WELLONS BLVD   NEW BERN NC,025,Craven,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1154015972,HEART 2 HEART HEALTHCARE LLC,HEART 2 HEART HEALTHCARE,110 E MAIN ST 200D CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1154015972,HEART 2 HEART HEALTHCARE LLC,110 E MAIN ST 200D CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,#, 436 , 436 ," $29,692.16 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154016384,"GONZALEZ, LUIS, COSME",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 75 , 81 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154017440,"ABAD, FRANCO",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 44 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154017440,"ABAD, FRANCO",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 71 , 88 ,$#,,
MEDICAID DIRECT,1841733714,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE COMMUNITY HOSPITAL OF STOKES,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1154017440,"ABAD, FRANCO",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154017440,"ABAD, FRANCO",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",801 PINEHURST AVE   CARTHAGE NC,063,Moore,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",801 PINEHURST AVE   CARTHAGE NC,063,Moore,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",6590 TRYON RD   CARY NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",6590 TRYON RD   CARY NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154020899,"ANDREWS, BENJAMIN, CHRISTOPHER",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154021905,"GRIFFIN, TAYLOR, ELIZABETH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154021905,"GRIFFIN, TAYLOR, ELIZABETH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154025120,"WHITTEMORE, SARAH, JANE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 22 , 33 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154025120,"WHITTEMORE, SARAH, JANE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 83 , 143 , 258 ,$#,,
MEDICAID DIRECT,1154028108,ABBA MEDICAL SUPPLY,ABBA MEDICAL SUPPLY,1900 S MAIN ST STE 108 WAKE FOREST NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154028108,ABBA MEDICAL SUPPLY,1900 S MAIN ST STE 108 WAKE FOREST NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 33 , 262 , 684 ," $64,142.48 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154033736,"IJAMS, CLAY, CORPENING",24724 S BUSINESS 52   ALBEMARLE NC,084,Stanly,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154033736,"IJAMS, CLAY, CORPENING",9200 GLENWATER DR   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154033736,"IJAMS, CLAY, CORPENING",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 41 , 41 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154042059,"ROSENBERGER, DARBY, NICOLE",303 AIRPORT RD   ARDEN NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 28 , 44 , 44 ,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154042059,"ROSENBERGER, DARBY, NICOLE",1207 EAST ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154042059,"ROSENBERGER, DARBY, NICOLE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 26 , 70 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154042331,"ROBISON, MARCUS, AUSTIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 20 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154044964,"BREWER, HALEY, JANE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 39 , 67 ,$#,,
MEDICAID DIRECT,1154048361,SPEECH STRATEGIES PLLC,,46 PARK AVE N   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1154048361,SPEECH STRATEGIES PLLC,46 PARK AVE N   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1154049005,"KEENER, MONICA, LEE",400 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1154049005,"KEENER, MONICA, LEE",631 CC CAMP RD   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1154049005,"KEENER, MONICA, LEE",911 E ATKINS ST   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 35 , 39 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1154049005,"KEENER, MONICA, LEE",400 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1154049005,"KEENER, MONICA, LEE",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1194343335,ERIC SEDERS DDS PLLC,SOUND DENTAL ASSOCIATES,306 PENNY LN   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1154050805,"HARDY, VICTORIA",306 PENNY LN   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice, 403 , 552 ," 2,163 "," $119,966.42 ",,
MEDICAID DIRECT,1518582709,"SEDERS, ERIC, FRANKLIN",,3110 ARENDELL ST STE 3 MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,1154050805,"HARDY, VICTORIA",306 PENNY LN   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154053981,"DUNAGAN, KELLI, AMANDA",2810 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154054914,"FLOOD, JOHN, CRAIG",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1154055135,"IRVIN, TAYLOR, THOMAS",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154055135,"IRVIN, TAYLOR, THOMAS",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 46 , 100 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154055135,"IRVIN, TAYLOR, THOMAS",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154056083,"CONNER, JORDAN, ALEXANDRA",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 105 , 125 , 149 ,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154056083,"CONNER, JORDAN, ALEXANDRA",108 W MAIN ST   WOODLAND NC,066,Northampton,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154058030,"SENKUMAR, LAKSHMI",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#, 12 ,$#,,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1154060473,"CHERNIN, ABIGAIL, SARAH",1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 642 , 900 ," 3,546 "," $150,253.05 ",,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1154060473,"CHERNIN, ABIGAIL, SARAH",1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124306675,LL BALLANCE DDS PLLC,CAROLINA WEST DENTAL,205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1154060473,"CHERNIN, ABIGAIL, SARAH",1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 47 , 97 ,$#,,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1154060473,"CHERNIN, ABIGAIL, SARAH",1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 124 , 132 , 510 ," $23,550.26 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154061067,"FARRELL, ANNA, JO ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154061067,"FARRELL, ANNA, JO ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114946332,CRABTREE CHIROPRACTIC CENTER PA,CRABTREE CHIROPRACTIC CENTER PA,4517 LEAD MINE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154061315,"PERSONS, MATTHEW, HAMLIN",4517 LEAD MINE RD   RALEIGH NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154065654,"BENSON, RACHEL, VICTORIA",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154065654,"BENSON, RACHEL, VICTORIA",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1710012174,PSYCHIATRIC SERVICES OF CAROLINAS,PSYCHIATRIC SERVICES OF CAROLINAS PC,1530 UNION RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1154068757,"SHIVE, CASSIDY, MICHAELA",1530 UNION RD STE A GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154072346,"TARLTON, MATTHEW, JACKSON",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 41 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154072346,"TARLTON, MATTHEW, JACKSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1154080307,"THOMAS, LINDA, STEEDLY",377 MACKTOWN RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 32 , 32 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154080307,"THOMAS, LINDA, STEEDLY",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 63 , 63 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1154080307,"THOMAS, LINDA, STEEDLY",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 23 , 23 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154080307,"THOMAS, LINDA, STEEDLY",377 MACKTOWN RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154080372,"WALES, PAUL, WILLIAM",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154083228,"TOBERMAN, STEVI, WILLIAMS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154089449,"FORBES, ERIN, LEIGH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154089449,"FORBES, ERIN, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1154089449,"FORBES, ERIN, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154089449,"FORBES, ERIN, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1154090413,"KNOWLES, CHRISTINE, LORRAINE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 61 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1154090413,"KNOWLES, CHRISTINE, LORRAINE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1154090413,"KNOWLES, CHRISTINE, LORRAINE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154091718,"MOORE, TAYLOR, ERIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 52 , 82 ,$#,,
MEDICAID DIRECT,1154091858,DIVINE GRACE HOMECARE SERVICES LLC,,189 WIND CHIME CT   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1154091858,DIVINE GRACE HOMECARE SERVICES LLC,189 WIND CHIME CT   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,847 "," 1,902 "," $291,986.70 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154094498,"QUINN, JACQUELINE, ANN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154094498,"QUINN, JACQUELINE, ANN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154094498,"QUINN, JACQUELINE, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154099521,"EVA, BRIANNE, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 59 , 64 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1154106268,"BISSETTE, MICHAEL, RUSH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 23 , 81 , 89 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1154106557,"LANDRETH, HEATHER, MARIE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 148 , 162 ,$#,,
MEDICAID DIRECT,1154106623,LITTLE CITY SPEECH THERAPY PLLC,,2800 BENDING TREE CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154106623,LITTLE CITY SPEECH THERAPY PLLC,2800 BENDING TREE CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 34 , 478 , 478 ," $34,167.17 ",,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154108421,"UMSTEAD, BRIONNA",307 E THOM ST   CHINA GROVE NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 85 , 99 ,$#,,
MEDICAID DIRECT,1659494292,TOTAL WOMAN CARE LLC,,942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1154132512,"STULL, ANNIS, OLIVIA FOWLER",942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154141521,"ERWIN, SAVANNAH, RUTH",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154146397,"LAWRENCE, SASHA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154148260,"BRINDLE, MIA, GRAHAM",1910 JAKE ALEXANDER BLVD W STE 202 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1346098134,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - STATESVILLE,1450 FERN CREEK DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154154466,"ANTHONY, BRANDI, HAMILTON",1450 FERN CREEK DR   STATESVILLE NC,049,Iredell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154161669,"HARRUP, KELBY, LEWIS",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 68 , 80 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154165629,"GROOTHUIS, SARAH, SUMMITT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154168367,"PENA, CATHARINE, CHU",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1154178960,"HOELL, CRYSTAL, LEIGH",390 US HIGHWAY 70 W   HAVELOCK NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 19 , 61 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154184281,"BARANYAI, ASHLEY, TAYLOR",3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154184281,"BARANYAI, ASHLEY, TAYLOR",3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13845 CONLAN CIR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154184281,"BARANYAI, ASHLEY, TAYLOR",3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831764836,CALDWELL MEMORIAL HOSPITAL,JONAS HILL CLINIC,407 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1154189538,"ADAMS, TRAVIS, BLAKE",407 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154197606,"MARCY, BRIANA, MARIE",5010 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 66 , 140 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154199321,"HOGGARD, ANN, SKULSKIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 39 , 43 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154300713,"SAGUIER, EDWARD, MANUEL",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154300713,"SAGUIER, EDWARD, MANUEL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 88 , 197 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 78 , 78 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",1450 SHAIRE CENTER DR.   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 208 , 261 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",1450 SHAIRE CENTER DR.   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 51 , 51 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 41 , 45 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 87 , 87 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154300820,"CORDER, JOHN, STEVEN",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 80 , 80 ,$#,,
MEDICAID DIRECT,1154301315,"KIMES, AMY, MELISSA",AMY MELISSA KIMES,236 SMITH CHAPEL RD   MOUNT OLIVE NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,1154301315,"KIMES, AMY, MELISSA",236 SMITH CHAPEL RD   MOUNT OLIVE NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 639 ," 1,107 "," 4,268 "," $175,844.12 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154301844,"SELF, CRAIG, STEPHEN",646 HARTNESS RD   STATESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 151 , 200 , 245 ," $11,329.44 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,646 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154301844,"SELF, CRAIG, STEPHEN",646 HARTNESS RD   STATESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154302560,"ISBEY, EDWARD, KENNETH",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154302826,"HASH, KENDALL, SIBLEY",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154302826,"HASH, KENDALL, SIBLEY",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154302826,"HASH, KENDALL, SIBLEY",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154303519,"LICHSTEIN, PETER, RIBACK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154303568,"BASINGER, SCOTT, LEE",12610 N COMMUNITY HOUSE RD STE 202 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245859453,TRIAD BREAST IMAGING CENTER LLC,NOVANT HEALTH BREAST IMAGING CENTER GREENSBORO,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 24 , 26 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,50 MILLER ST STE G WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 21 , 23 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,121 MEDICAL DR   ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1154303907,"YOUNG, GARRET, PICKNEY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154304863,"GREVEN, CRAIG, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 40 , 82 ,$#,,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154304889,"KIMBROUGH, CHAD, JEROME",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 688 , 716 ," 2,669 "," $77,445.02 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154305134,"FERGUSON, AMY, POTEAT",656 CARPENTER AVE   MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154306280,"LEVY, PAVEL, JACOB",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 79 , 119 , 119 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154306702,"LENTZ, SAMUEL, SMITH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 13 , 29 , 29 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154306819,"ORENSTEIN, RAPHAEL, SIMHA",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154306819,"ORENSTEIN, RAPHAEL, SIMHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154306819,"ORENSTEIN, RAPHAEL, SIMHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1417610627,MOSES CONE AFFILIATED PHYSICIANS IN,GYNECOLOGY CENTER OF GREENSBORO,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154307387,"LAVOIE, MARIE LYNE",719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154307445,"SEARS, JULIA",319 VILLAGE RD NE   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 43 , 68 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154307684,"GEORGE, ANIL",748 KENANSVILLE BYP   KENANSVILLE NC,031,Duplin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1154307684,"GEORGE, ANIL",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154307684,"GEORGE, ANIL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1154307684,"GEORGE, ANIL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 203 , 260 , 260 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154307684,"GEORGE, ANIL",8210 RICHLANDS HWY   RICHLANDS NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154307684,"GEORGE, ANIL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 432 , 693 , 829 ," $18,089.17 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154307684,"GEORGE, ANIL",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 254 , 301 , 347 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",3158 FREEDOM DR STE 2102 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 28 , 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",7901 ENGLAND ST STE 2225 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",3158 FREEDOM DR STE 2102 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",10710 SIKES PL STE 100 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",7901 ENGLAND ST STE 2225 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154308435,"MERTEN, GREGORY, JOHN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1154309060,"NEWMAN, MARK, STUART",~,2812 ERWIN RD STE 201 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,1154309060,"NEWMAN, MARK, STUART",2812 ERWIN RD STE 201 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154309094,"CHRONISTER, TARA, LEE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154309359,"ALLEN, ROBERT, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 29 , 31 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154309359,"ALLEN, ROBERT, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 25 , 25 ,$#,,
MEDICAID DIRECT,1073609665,GRAYBAR CHIROPRACTIC INC,GRAYBAR CHIROPRACTIC INC,2110 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154309904,"JOHNSON, KEVIN, MICHAEL",2110 S 17TH ST   WILMINGTON NC,065,New Hanover,111N00000X,Chiropractic Providers,Chiropractor,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154310043,"MIMS, JACQUELINE, HEDER",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154310043,"MIMS, JACQUELINE, HEDER",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154310043,"MIMS, JACQUELINE, HEDER",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154310043,"MIMS, JACQUELINE, HEDER",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 26 , 29 ,$#,,
MEDICAID DIRECT,1518990423,NEPHROLOGY ASSOCIATES OF TIDEWATER,NEPHROLOGY ASSOCIATES OF TIDEWATER LTD,6160 KEMPSVILLE CIR STE 302A NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154310050,"MCCUNE, THOMAS, ROBERT",301 RIVERVIEW AVE STE 600 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1912197237,ALLEN ORTHOPEDICS PA,~,404 HATFIELD CT   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154310290,"ALLEN, DAVID, ROGER",404 HATFIELD CT   LUMBERTON NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 247 ," 1,129 "," 3,449 "," $22,077.14 ",,
MEDICAID DIRECT,1780686659,NEWTON OPTOMETRIC CENTER PLLC,NEWTON VISION CENTER,750 IRIS LN   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1154311389,"HEFNER, CRYSTAL, SIPE",750 IRIS LN   NEWTON NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780686659,NEWTON OPTOMETRIC CENTER PLLC,NEWTON VISION CENTER,750 IRIS LN   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154311389,"HEFNER, CRYSTAL, SIPE",750 IRIS LN   NEWTON NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 29 , 30 , 44 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1154311694,"AQUINO, SUZANNE, LEI",97 LUMAHAI ST   HONOLULU HI,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1154311694,"AQUINO, SUZANNE, LEI",97 LUMAHAI ST   HONOLULU HI,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1154311694,"AQUINO, SUZANNE, LEI",97 LUMAHAI ST   HONOLULU HI,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 35 , 48 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154312734,"MEANS, TAMARA, ALLEN",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154312734,"MEANS, TAMARA, ALLEN",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 21 , 28 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154312734,"MEANS, TAMARA, ALLEN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154312734,"MEANS, TAMARA, ALLEN",1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154313575,"KNUPP, CHARLES, LEONARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 63 , 92 , 92 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1154313575,"KNUPP, CHARLES, LEONARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154314391,"SEAVERS, ABRAM, TIMOTHY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154314391,"SEAVERS, ABRAM, TIMOTHY",1403 S KING ST   WINDSOR NC,008,Bertie,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104818418,PAMLICO PODIATRY ASSOCIATES,PAMLICO PODIATRY ASSOCIATES,403 W 15TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1154314391,"SEAVERS, ABRAM, TIMOTHY",403 W 15TH ST   WASHINGTON NC,007,Beaufort,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 144 , 290 , 369 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1403 S KING ST   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1154314391,"SEAVERS, ABRAM, TIMOTHY",1403 S KING ST   WINDSOR NC,008,Bertie,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154314391,"SEAVERS, ABRAM, TIMOTHY",1403 S KING ST   WINDSOR NC,008,Bertie,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154316412,"BUCHANAN, DALE, CONWAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1194998781,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCIATES INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154316545,"BRINKMAN REUTTER, JASON",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 19 , 22 , 24 ,$#,,
MEDICAID DIRECT,1366650707,LAKESHORE PEDIATRIC CENTER PA,~,635 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1154318350,"NADRA, WISSAM, EDWARD",635 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 86 , 214 ," $10,159.17 ",,
MEDICAID DIRECT,1154318533,"NESTOR, JONATHAN",JONATHAN NESTOR,601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,1154318533,"NESTOR, JONATHAN",601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1154318533,"NESTOR, JONATHAN",JONATHAN NESTOR,601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1154318533,"NESTOR, JONATHAN",601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154318848,"HENSLEY, TYLER, SHEA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 63 , 64 , 65 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154320307,"ENGLEHARDT, JOHN, MARK",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154320307,"ENGLEHARDT, JOHN, MARK",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154320307,"ENGLEHARDT, JOHN, MARK",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 51 , 76 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154320307,"ENGLEHARDT, JOHN, MARK",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1154320307,"ENGLEHARDT, JOHN, MARK",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154320307,"ENGLEHARDT, JOHN, MARK",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154320307,"ENGLEHARDT, JOHN, MARK",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 17 , 33 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154320844,"HERMAN, TERI, JOHNSON",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154320844,"HERMAN, TERI, JOHNSON",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1043210099,CORNERSTONE MEDICAL CLINIC P C,,7704 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154321164,"HART, DARLINGTON",7704 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 61 , 156 ,$#,,
MEDICAID DIRECT,1043210099,CORNERSTONE MEDICAL CLINIC P C,,7704 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154321164,"HART, DARLINGTON",7704 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 67 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154321321,"POMERANTZ, RICHARD, WILLIAM",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 30 , 31 , 60 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154321321,"POMERANTZ, RICHARD, WILLIAM",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154321321,"POMERANTZ, RICHARD, WILLIAM",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154321321,"POMERANTZ, RICHARD, WILLIAM",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 161 , 247 , 403 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,2386 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154321321,"POMERANTZ, RICHARD, WILLIAM",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 36 , 38 , 58 ,$#,,
MEDICAID DIRECT,1336363704,CARY VISION CARE OD PA,,1100 NW MAYNARD RD STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1154321834,"STIKELEATHER, JEFFREY, STEVEN",1100 NW MAYNARD RD STE 120 CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154322089,"MAKAM, RAJENDRAPRASAD, VENKATANNASETTY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154322089,"MAKAM, RAJENDRAPRASAD, VENKATANNASETTY",2210 HEMBY LN   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 41 , 48 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154322089,"MAKAM, RAJENDRAPRASAD, VENKATANNASETTY",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154322089,"MAKAM, RAJENDRAPRASAD, VENKATANNASETTY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1154323335,"STERLING, ANTHONY, KEITH",45 PLATEAU ST   BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1154323335,"STERLING, ANTHONY, KEITH",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154323335,"STERLING, ANTHONY, KEITH",607 BEAMAN ST   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1154323335,"STERLING, ANTHONY, KEITH",45 PLATEAU ST   BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043752363,SWAIN INTEGRATED SERVICES PC,,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1154323335,"STERLING, ANTHONY, KEITH",45 PLATEAU ST   BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 128 , 147 , 150 ," $11,931.85 ",,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154323335,"STERLING, ANTHONY, KEITH",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154325553,"AGISIM, DEBORAH, GOULD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 58 , 58 , 97 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154325553,"AGISIM, DEBORAH, GOULD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 31 ,$#,,
MEDICAID DIRECT,1134184583,TRINITY HEALTH CARE,~,930 W WILSON AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154325660,"MACASIEB, ANTHONY, WAYNE",930 W WILSON AVE   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 258 , 372 ," $18,848.93 ",,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1154325728,"BERSINGER, DAVID, EMIL",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 20 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1154325728,"BERSINGER, DAVID, EMIL",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1720151525,COUNTY OF CLEVELAND NORTH CAROLINA,CLEVELAND COUNTY HEALTH DEPARTMENT,200 S POST RD   SHELBY NC,023,Cleveland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1154325728,"BERSINGER, DAVID, EMIL",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 31 ,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154325728,"BERSINGER, DAVID, EMIL",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1154326049,"AMESUR, PRADEEP, KUMAR",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1609018019,NOVA EYECARE,NOVA EYE CARE,328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1154326528,"KERNODLE, JAMES, MONROE",328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1154326528,"KERNODLE, JAMES, MONROE",JAMES MONROE KERNODLE,328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,,1154326528,"KERNODLE, JAMES, MONROE",328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1609018019,NOVA EYECARE,NOVA EYE CARE,328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1154326528,"KERNODLE, JAMES, MONROE",328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,, 71 , 79 , 102 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1154326718,"TAN, VALIANT, DEE",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1154326718,"TAN, VALIANT, DEE",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1154326718,"TAN, VALIANT, DEE",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154326718,"TAN, VALIANT, DEE",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1154326718,"TAN, VALIANT, DEE",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154326718,"TAN, VALIANT, DEE",744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 19 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1154326718,"TAN, VALIANT, DEE",744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205249539,OCHSNER EYE PA,OCHSNER EYE PA,700 MILITARY CUTOFF RD STE 202 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154327500,"ROBINSON, MATTHEW, JAMES",700 MILITARY CUTOFF RD STE 202 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 22 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154328581,"GROSS, HOLLY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154329670,"JOBE, ROBERT, LEE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154329670,"JOBE, ROBERT, LEE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 38 , 57 , 120 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1154329670,"JOBE, ROBERT, LEE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154329670,"JOBE, ROBERT, LEE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 22 , 31 , 51 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154330256,"THWAITES, BRIAN, KEITH",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 20 , 24 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154330256,"THWAITES, BRIAN, KEITH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 43 , 52 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154330256,"THWAITES, BRIAN, KEITH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154330256,"THWAITES, BRIAN, KEITH",35 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 42 , 43 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154330256,"THWAITES, BRIAN, KEITH",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,901 N WINSTEAD AVE STE 430 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154331148,"HARTMAN, ROBERT, JAMES",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154331148,"HARTMAN, ROBERT, JAMES",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 11 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154331148,"HARTMAN, ROBERT, JAMES",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1154331148,"HARTMAN, ROBERT, JAMES",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154331148,"HARTMAN, ROBERT, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 59 , 105 , 186 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154331148,"HARTMAN, ROBERT, JAMES",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1063472116,OCRACOKE HEALTH CENTER INC,ENGELHARD MEDICAL CENTER,33270 US 264   ENGELHARD NC,048,Hyde,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154331817,"SAWIN, SHANNON, MULLIS",33270 US HIGHWAY 264   ENGELHARD NC,048,Hyde,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 40 , 46 ,$#,,
MEDICAID DIRECT,1215629886,OCRACOKE HEALTH CENTER INC,MANTEO COMMUNITY HEALTH CENTER,402 BUDLEIGH ST   MANTEO NC,028,Dare,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154331817,"SAWIN, SHANNON, MULLIS",402 BUDLEIGH ST   MANTEO NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 41 , 53 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154332989,"HAMELIN, THOMAS, EDWARD",2001 VAIL AVE MERCY HOSP CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154333284,"ZERVOS, EMMANUEL, EMMANUEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 49 , 51 ,$#,,
MEDICAID DIRECT,1356642896,KENNETH L WESTBROOK DDS PA,~,3708 SYMI CIR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1154334571,"WESTBROOK, KENNETH, LEIGH",3708 SYMI CIR   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 18 , 52 ,$#,,
MEDICAID DIRECT,1356642896,KENNETH L WESTBROOK DDS PA,~,3708 SYMI CIR   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1154334571,"WESTBROOK, KENNETH, LEIGH",3708 SYMI CIR   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice, 59 , 133 , 365 ," $14,395.31 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154335115,"GRIEB, MARK, CHRISTIAN",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 44 , 45 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154335115,"GRIEB, MARK, CHRISTIAN",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154335115,"GRIEB, MARK, CHRISTIAN",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154335180,"MASSENGILL, SUSAN, FOSTER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 13 , 58 , 62 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154335180,"MASSENGILL, SUSAN, FOSTER",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 12 , 22 , 22 ,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154335800,"THIEDEMAN, STACY, CRISTMAN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801473087,WAKEMED SPECIALISTS GROUP LLC,WAKEMED TOBACCO CESSATION - SPECIALTY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154335800,"THIEDEMAN, STACY, CRISTMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154338713,"KAISER, KRISTIN, MARIE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 30 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154338713,"KAISER, KRISTIN, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 32 , 35 ,$#,,
MEDICAID DIRECT,1154340149,CARRBORO FAMILY VISION LLC,CARRBORO FAMILY VISION OD PLLC,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,,1154340149,CARRBORO FAMILY VISION LLC,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,, 217 , 217 , 434 ,$#,,
MEDICAID DIRECT,1578742177,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1154340537,"SALUKE, JULIA, KATHYRN",214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 80 , 194 , 229 ,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154341311,"WEAVER, JOHN, WAYNE",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1033877592,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DILLON FAMILY MEDICINE,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154341345,"VANCE, STEPHEN, GRANVILLE",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 53 , 199 ,$#,,
MEDICAID DIRECT,1154341345,"VANCE, STEPHEN, GRANVILLE",~,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1154341345,"VANCE, STEPHEN, GRANVILLE",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154342301,STANLY COUNTY SCHOOLS,~,1000 N 1ST ST STE 4 ALBEMARLE NC,084,Stanly,251300000X,Agencies,Local Education Agency (LEA),,1154342301,STANLY COUNTY SCHOOLS,1000 N 1ST ST STE 4 ALBEMARLE NC,084,Stanly,251300000X,Agencies,Local Education Agency (LEA),, 276 ," 4,986 "," 5,177 "," $241,931.74 ",,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1154344273,"HUGHES, JANET, MULL",141 TRYON RD STE A RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 34 , 58 ,$#,,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1154344273,"HUGHES, JANET, MULL",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 134 , 225 ,$#,,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1154344273,"HUGHES, JANET, MULL",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154344638,"LARABEE, EVERETT, WINSLOW",EVERETT WINSLOW LARABEE,205 ACADEMY ST S   AHOSKIE NC,046,Hertford,111N00000X,Chiropractic Providers,Chiropractor,,1154344638,"LARABEE, EVERETT, WINSLOW",205 ACADEMY ST S   AHOSKIE NC,046,Hertford,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154345288,"JAIKUMAR, SIVAKUMAR",6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154345288,"JAIKUMAR, SIVAKUMAR",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4207 LAKE BOONE TRL STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154345288,"JAIKUMAR, SIVAKUMAR",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154345288,"JAIKUMAR, SIVAKUMAR",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 30 , 37 , 40 ,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154345338,"JOHNSON, RONALD, EUGENE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1154345346,"GRANT, DORRETTE, PATRICE",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1154345346,"GRANT, DORRETTE, PATRICE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154345346,"GRANT, DORRETTE, PATRICE",6387 RAMSEY ST UNIT 210 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154345346,"GRANT, DORRETTE, PATRICE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 32 , 35 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154345346,"GRANT, DORRETTE, PATRICE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 29 , 30 , 34 ,$#,,
MEDICAID DIRECT,1861217846,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY OBGYN-HPN,6387 RAMSEY ST UNIT 240 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154345346,"GRANT, DORRETTE, PATRICE",6387 RAMSEY ST UNIT 240 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346096,"MAKEMSON, SCOTT, CHRISTOPHER",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 29 , 42 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346096,"MAKEMSON, SCOTT, CHRISTOPHER",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346096,"MAKEMSON, SCOTT, CHRISTOPHER",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1659695781,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346096,"MAKEMSON, SCOTT, CHRISTOPHER",16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY STE 2500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346096,"MAKEMSON, SCOTT, CHRISTOPHER",4525 CAMERON VALLEY PKWY STE 2500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1659396893,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346096,"MAKEMSON, SCOTT, CHRISTOPHER",7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346443,"SCHMELZER, ANNA, TAYLOR",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 17 , 46 ,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154346898,"BURKE, JENNIFER, WILLIS",101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 29 , 45 ,$#,,
MEDICAID DIRECT,1033877592,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DILLON FAMILY MEDICINE,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154347540,"SHEALY, ROBIN, C",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 88 ,$#,,
MEDICAID DIRECT,1154348399,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1133,781 LEONARD AVE   ALBEMARLE NC,084,Stanly,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1154348399,WAL-MART STORES EAST LP,781 LEONARD AVE   ALBEMARLE NC,084,Stanly,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154348670,"STOVER, EVA, GREEN",1656 RIVERCHASE BLVD STE 3500 ROCK HILL SC,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154349181,"BERCHUCK, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154349181,"BERCHUCK, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154349181,"BERCHUCK, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 20 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154349181,"BERCHUCK, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 18 , 22 , 38 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154349181,"BERCHUCK, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 13 , 16 , 25 ,$#,,
MEDICAID DIRECT,1912024308,SMALL AND PIERS LLP,,110 JUNIPER ST STE 300 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1154350114,"SMALL, DAVID, CHARLES",110 JUNIPER ST STE 300 MORGANTON NC,012,Burke,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 514 ," 1,113 "," 1,465 "," $256,943.92 ",,
MEDICAID DIRECT,1952319691,SMALL AND PIERS LLP,,382 10TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1154350114,"SMALL, DAVID, CHARLES",110 JUNIPER ST STE 300 MORGANTON NC,012,Burke,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1952319691,SMALL AND PIERS LLP,,382 10TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1154350114,"SMALL, DAVID, CHARLES",382 10TH AVENUE DR NE   HICKORY NC,018,Catawba,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 512 ," 1,686 "," 2,149 "," $362,817.86 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154352243,"KERCHER, KENT, WILLIAMS",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 ,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154352243,"KERCHER, KENT, WILLIAMS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154352334,"SILVA, ENRICO, ALEJANDRO",~,1505 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1154352334,"SILVA, ENRICO, ALEJANDRO",1505 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 592 ," 1,008 "," 2,348 "," $109,082.17 ",,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154352730,"MELVIN, BRENDA, KAY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154352730,"MELVIN, BRENDA, KAY",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 27 , 41 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1154352789,"BAILEY, RONALD, KEITH",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 74 , 115 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154352789,"BAILEY, RONALD, KEITH",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1154352789,"BAILEY, RONALD, KEITH",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 82 , 316 , 336 ," $11,409.13 ",,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1154352789,"BAILEY, RONALD, KEITH",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 39 , 42 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1154352789,"BAILEY, RONALD, KEITH",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154352946,"QUARFORDT, STEVEN, DANIEL",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 33 , 43 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1154352946,"QUARFORDT, STEVEN, DANIEL",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154352946,"QUARFORDT, STEVEN, DANIEL",2076 HIGHWAY 69 S   HAYESVILLE NC,022,Clay,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1154352946,"QUARFORDT, STEVEN, DANIEL",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 20 , 23 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154352946,"QUARFORDT, STEVEN, DANIEL",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 34 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154352961,"DAVIS, DIANE, MARIE",1313 HALLEY ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154352961,"DAVIS, DIANE, MARIE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154352961,"DAVIS, DIANE, MARIE",815 BROAD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154352961,"DAVIS, DIANE, MARIE",401 N DRIVER ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154353787,"ELDER, ROBERT",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154354785,"ADKINS, DANA, EDWIN",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154354785,"ADKINS, DANA, EDWIN",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154355790,"BRITTO, ERROL, JOHN",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154355790,"BRITTO, ERROL, JOHN",1901 S HAWTHORNE RD STE 220 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 32 , 125 , 133 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154357648,"BALLANTYNE, PETER, ANDREW",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154358083,"CONQUEST, ANNE, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154358083,"CONQUEST, ANNE, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154358083,"CONQUEST, ANNE, MARIE",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154358083,"CONQUEST, ANNE, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 35 , 36 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154358703,"FOSTER, MICHAEL, ALAN",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154358703,"FOSTER, MICHAEL, ALAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154358703,"FOSTER, MICHAEL, ALAN",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154358703,"FOSTER, MICHAEL, ALAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 54 , 61 ,$#,,
MEDICAID DIRECT,1184915639,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MOUNTAIN VALLEY ACADEMIC HEALTH CENTER,117 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1154358786,"GORDON, CAROLYN, VANCE",117 FOOTHILLS DR   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 81 , 118 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154359354,"MOORE, HARVEY, GORDEN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154359354,"MOORE, HARVEY, GORDEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154359354,"MOORE, HARVEY, GORDEN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154359354,"MOORE, HARVEY, GORDEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962435529,VIEWMONT UROLOGY CLINIC,VIEWMONT UROLOGY CLINIC,1202 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1154360121,"DELEARY, GEOFFREY, DONALD",1202 N CENTER ST   HICKORY NC,018,Catawba,208800000X,Allopathic & Osteopathic Physicians,Urology,, 129 , 201 , 407 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154360238,"HUGHES, ROBIN, REBECCA",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154360774,"MURPHY, STEPHEN, PHILLIP",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154360774,"MURPHY, STEPHEN, PHILLIP",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154361160,"OVERTON, CARROLL, CHRISTOPHER",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 116 , 121 , 146 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154361160,"OVERTON, CARROLL, CHRISTOPHER",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 472 , 501 , 606 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154361301,"KWONG, MICHAEL, DIEM",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 423 , 462 , 575 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154361301,"KWONG, MICHAEL, DIEM",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 42 , 43 , 58 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154361491,"SMITH, REBECCA, LEIGH",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,,,$#,,
MEDICAID DIRECT,1619271004,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PULMONARY AND CRITICAL CARE ASSOCIATES,101 S RAVENEL ST STE 230 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154361723,"JONA, VINOD, KUMAR",401 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1154362960,"AIKEN, LOREEN, ELIZABETH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1154362986,"EATON JONES, SUZANNE, ELIZABETH",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 59 ,$#,,
MEDICAID DIRECT,1154363380,WAYNE COUNTY DSS,WAYNE COUNTY EMS,134 N JOHN ST   GOLDSBORO NC,096,Wayne,3416L0300X,Transportation Services,Ambulance,Land Transport,1154363380,WAYNE COUNTY DSS,134 N JOHN ST   GOLDSBORO NC,096,Wayne,3416L0300X,Transportation Services,Ambulance,Land Transport, 697 ," 1,400 "," 2,774 "," $61,129.09 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154363646,"SEPE, CHRISTOPHER, D.",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972123537,MURPHY MEDICAL CENTER INC,,2751 BUSINESS 19   ANDREWS NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154364388,"ROPER, GARY, WAYNE",2751 BUSINESS 19 ANDREWS INTERNAL MED ANDREWS NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 85 , 174 , 179 ," $13,820.72 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1154364388,"ROPER, GARY, WAYNE",2751 BUSINESS 19 ANDREWS INTERNAL MED ANDREWS NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 211 , 211 ," $96,247.21 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1154364388,"ROPER, GARY, WAYNE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1154365658,"CHILDERS, JANET, ELLIS",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154366110,"HAKAS JR, JOSEPH, FRANCIS",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 94 , 150 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154366110,"HAKAS JR, JOSEPH, FRANCIS",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 34 , 56 , 69 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154366110,"HAKAS JR, JOSEPH, FRANCIS",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 53 , 73 , 89 ,$#,,
MEDICAID DIRECT,1386186120,JACKSON HM SERVICES PC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1154367142,"MOHAI, CARMEN, DANIELA",68 HOSPITAL RD   SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 179 , 184 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1154367530,"FUTH, STEPHEN, BARRY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 32 , 32 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1154367530,"FUTH, STEPHEN, BARRY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 72 , 72 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1154367530,"FUTH, STEPHEN, BARRY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457391542,CAH ACQUISITION COMPANY 1 LLC,WASHINGTON COUNTY HOSPITAL,,,Unknown,193200000X,Group,Multi-Specialty,,1154367530,"FUTH, STEPHEN, BARRY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1902412729,CENTENNIAL HOUSING & COMMUNITY SERV,WASHINGTON REGIONAL MEDICAL CENTER,958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,193200000X,Group,Multi-Specialty,,1154367530,"FUTH, STEPHEN, BARRY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 26 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1154367530,"FUTH, STEPHEN, BARRY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154367530,"FUTH, STEPHEN, BARRY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154368009,COLUMBUS COUNTY EMS INC,~,205 W MAIN ST   WHITEVILLE NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,1154368009,COLUMBUS COUNTY EMS INC,205 W MAIN ST   WHITEVILLE NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport, 170 , 586 , 937 ," $50,840.07 ",,
MEDICAID DIRECT,1831130798,BENSON AREA MEDICAL CENTER INC,BENSON HEALTH,3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154368322,"MATTHEWS, ROBERT, CHARLES",3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 215 , 464 , 552 ," $19,527.67 ",,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154369627,"RICO, ANTHONY, LOUIS",3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,630 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1154369817,"PANZA, WILLIAM, SEBASTIAN",630 MCCARTHY BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1154369817,"PANZA, WILLIAM, SEBASTIAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 35 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154369973,"BARBOZA, BRYAN, JAMES",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 29 , 35 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154369973,"BARBOZA, BRYAN, JAMES",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 33 , 44 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154370807,"AUSTIN, JONATHAN, GREGORY",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154370807,"AUSTIN, JONATHAN, GREGORY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154370807,"AUSTIN, JONATHAN, GREGORY",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 96 , 106 , 109 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154370807,"AUSTIN, JONATHAN, GREGORY",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154371151,"TEICH, STEVEN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154371151,"TEICH, STEVEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154371235,"PFEIFFER, MARCY, LYNN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154371235,"PFEIFFER, MARCY, LYNN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154371235,"PFEIFFER, MARCY, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154371235,"PFEIFFER, MARCY, LYNN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154371235,"PFEIFFER, MARCY, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154371235,"PFEIFFER, MARCY, LYNN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477840791,ALLEGHANY EMERGENCY GROUP LLC,ALLEGHANY EMERGENCY GROUP LLC,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1154371987,"GROGAN, JOSEPH, WILLIAM",233 DOCTORS ST   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 76 , 89 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,2630 WILLARD DAIRY RD STE 300 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154372738,"ENNEVER, PETER, ROBERT",2630 WILLARD DAIRY RD STE 300 HIGH POINT NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154372738,"ENNEVER, PETER, ROBERT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 58 , 160 , 160 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154372738,"ENNEVER, PETER, ROBERT",2630 WILLARD DAIRY RD STE 300 HIGH POINT NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1154372985,"KILDUFF, DAVID, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154372985,"KILDUFF, DAVID, JOHN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154372985,"KILDUFF, DAVID, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154372985,"KILDUFF, DAVID, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154373686,"TRBOVICH, JENNIFER, WALDEN",3009 NEW BERN AVE   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154373686,"TRBOVICH, JENNIFER, WALDEN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154373686,"TRBOVICH, JENNIFER, WALDEN",3009 NEW BERN AVE   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1134170822,VALLEY HYPERTENSION NEPHREOLOGY ASS,VALLEY HYPERTENSION NEPHREOLOGY ASSOCIATES PA,937 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1154373785,"SANTARINA, LORENZO, BORJA",937 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 217 , 657 , 659 ," $13,463.00 ",,
MEDICAID DIRECT,1003902313,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,1417 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1154373884,"TORREY, HENRY, CUTLER",1417 COLLEGE ST   OXFORD NC,039,Granville,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 18 , 14 , 33 ,$#,,
MEDICAID DIRECT,1902991698,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1154373884,"TORREY, HENRY, CUTLER",451 RUIN CREEK RD   HENDERSON NC,091,Vance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 43 , 45 , 106 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1154373983,"DYKSTRA, TODD, BRYAN",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 77 , 154 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154374593,"REED, JOHN, H",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 19 , 27 ,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1154375772,"VARNER, HOLLY, KNUDSEN",9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1154375772,"VARNER, HOLLY, KNUDSEN",9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1154375772,"VARNER, HOLLY, KNUDSEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 22 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1154377372,"KOSON, TERRI, LEE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1154378156,"GRIFFIN, SOLEDAD, CEBALLOS",555 CARTHAGE ST   SANFORD NC,053,Lee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1154378156,"GRIFFIN, SOLEDAD, CEBALLOS",555 CARTHAGE ST   SANFORD NC,053,Lee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1154378156,"GRIFFIN, SOLEDAD, CEBALLOS",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 46 , 50 ,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1154378156,"GRIFFIN, SOLEDAD, CEBALLOS",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 79 , 81 , 91 ,$#,,
MEDICAID DIRECT,1437196318,FIRST IMAGING OF THE CAROLINAS,First Imaging of the Carolinas,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1154378156,"GRIFFIN, SOLEDAD, CEBALLOS",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154379717,"KRUGER, RONALD, JEREMY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154379717,"KRUGER, RONALD, JEREMY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1154379717,"KRUGER, RONALD, JEREMY",507 E FREMONT ST   BURGAW NC,071,Pender,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154380111,"VALAORAS, THOMAS, GEORGE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 41 , 62 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154380111,"VALAORAS, THOMAS, GEORGE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1134558752,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VALAROAS & LEWIS OBGYN,245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154380111,"VALAORAS, THOMAS, GEORGE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154380798,"TAT, REBECCA, SUE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 29 , 35 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154380798,"TAT, REBECCA, SUE",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1043691595,ROCKY MOUNT EYE PA,~,450 JONES RD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154382612,"ROBERTSON, THOMAS, JACKSON",450 JONES RD   ROCKY MOUNT NC,064,Nash,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 289 , 541 , 769 ," $41,237.69 ",,
MEDICAID DIRECT,1043691595,ROCKY MOUNT EYE PA,~,450 JONES RD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154382612,"ROBERTSON, THOMAS, JACKSON",400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383065,"MANN, COURTNEY, HOPKINS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 45 , 53 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154383065,"MANN, COURTNEY, HOPKINS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",1366 NC HIGHWAY 16 S CRESCENT SHOPPING PLAZA NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 40 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 31 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154383073,"TEAGUE, KRISTIN, ALICIA",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730505462,DEAN INTERNAL MEDICINE,~,1409 YANCEYVILLE ST STE C GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154383461,"DEAN, ERIC",1409 YANCEYVILLE ST STE C GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154383503,"BULLARD, ANDREW, GRAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 75 , 86 , 86 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1154383768,"LUCAS, MIHA, SINGH",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1154383768,"LUCAS, MIHA, SINGH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154383768,"LUCAS, MIHA, SINGH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154383768,"LUCAS, MIHA, SINGH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1154383768,"LUCAS, MIHA, SINGH",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154383768,"LUCAS, MIHA, SINGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 35 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 18 , 20 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154383768,"LUCAS, MIHA, SINGH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487727459,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1154384139,"PERTALION, CARRINGTON, DOOLITTLE",126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154384428,"GONZALEZ, ARMANDO, PENA",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 31 , 44 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154384428,"GONZALEZ, ARMANDO, PENA",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 96 , 288 , 414 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154385177,"HWANG, EUN SIL, SHELLEY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154385177,"HWANG, EUN SIL, SHELLEY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154385441,"MORRISON, LUKE, LANCASTER",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 27 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154385441,"MORRISON, LUKE, LANCASTER",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1154385441,"MORRISON, LUKE, LANCASTER",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154385441,"MORRISON, LUKE, LANCASTER",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 29 , 48 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",3033 EASTWAY DR STE 202 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",5627 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",5627 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",6646 REGAL OAKS DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",10504 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",2321 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 33 , 39 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",3033 EASTWAY DR STE 202 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 39 , 53 , 90 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 31 , 42 , 105 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154387199,"BRUCE, JOEL, EDWARD",2321 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154387579,"HALL, HEATHER, DAWN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154388395,"GARBARINO, JUDSON, PAYNE",68 HOSPITAL RD   SYLVA NC,050,Jackson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 111 , 137 , 316 ,$#,,
MEDICAID DIRECT,1336542067,DLP HAYWOOD REGIONAL MEDICAL CENTER,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1154388866,"SHEELEY, REGAN, ROBERT",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 72 , 74 ,$#,,
MEDICAID DIRECT,1336542067,DLP HAYWOOD REGIONAL MEDICAL CENTER,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1154388866,"SHEELEY, REGAN, ROBERT",55 BUCKEYE COVE RD   CANTON NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336542067,DLP HAYWOOD REGIONAL MEDICAL CENTER,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1154388866,"SHEELEY, REGAN, ROBERT",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 132 , 150 , 157 ,$#,,
MEDICAID DIRECT,1154391803,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1154391803,HOME MEDICAL SYSTEMS INC,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1154391803,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1154391803,HOME MEDICAL SYSTEMS INC,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 322 ," 1,530 "," 2,587 "," $56,195.01 ",,
MEDICAID DIRECT,1154391803,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154391803,HOME MEDICAL SYSTEMS INC,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 301 , 902 ," 1,601 "," $32,078.66 ",,
MEDICAID DIRECT,1154391803,HOME MEDICAL SYSTEMS INC,AMERICAN HEALTH SERVICES,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154391803,HOME MEDICAL SYSTEMS INC,1446 E GASTON ST STE 202 LINCOLNTON NC,055,Lincoln,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154391829,"SCHROEDER, ASHLEY, ANDERS",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154391829,"SCHROEDER, ASHLEY, ANDERS",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154392520,"BRANNIN, SANDRA, SHOMATE",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154392520,"BRANNIN, SANDRA, SHOMATE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1154392520,"BRANNIN, SANDRA, SHOMATE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154393080,"MAY DEPAOLA, BRENDA, LOUISE",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 148 , 272 , 458 ,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154393080,"MAY DEPAOLA, BRENDA, LOUISE",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154393171,"IGBINIGIE, THEODORE, OSARUMWENSE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 129 , 130 ,$#,,
MEDICAID DIRECT,1659418515,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE TIMBERLYNE,77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154393874,"HUIN, ALEXANDRE",110 TIMBERHILL PL   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 27 , 47 ,$#,,
MEDICAID DIRECT,1154394575,BLUE RIDGE HOME CARE,,101 CARIBOU RD   ASHEVILLE NC,011,Buncombe,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1154394575,BLUE RIDGE HOME CARE,101 CARIBOU RD   ASHEVILLE NC,011,Buncombe,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1154394575,BLUE RIDGE HOME CARE,,101 CARIBOU RD   ASHEVILLE NC,011,Buncombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1154394575,BLUE RIDGE HOME CARE,101 CARIBOU RD   ASHEVILLE NC,011,Buncombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 195 ," 1,194 "," 2,517 "," $44,769.23 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154395879,"BARRITT IV, ALFRED, SIDNEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 50 , 71 , 92 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154396778,"RUSSELL, MARY, CATHERINE",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154396778,"RUSSELL, MARY, CATHERINE",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 41 , 62 ,$#,,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154396778,"RUSSELL, MARY, CATHERINE",301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154397016,"SELDEN, KYMBERLY, FLOYD",311 CODDLE MARKET DR NW STE 100 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 27 , 51 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154398501,"FREY, SASCHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 71 , 214 , 214 ,$#,,
MEDICAID DIRECT,1154401206,"JORGENSEN, JESSE, PAUL",Jesse Paul Jorgensen,1005 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,1154401206,"JORGENSEN, JESSE, PAUL",1005 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1154401206,"JORGENSEN, JESSE, PAUL",Jesse Paul Jorgensen,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,1154401206,"JORGENSEN, JESSE, PAUL",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1154401206,"JORGENSEN, JESSE, PAUL",Jesse Paul Jorgensen,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,1154401206,"JORGENSEN, JESSE, PAUL",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 494 , 638 , 639 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",3116 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 377 , 503 , 506 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",3116 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 23 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 98 , 121 , 123 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154404317,"FREEDMAN, NEIL, JONATHAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1154405058,"WEST, ELIZABETH, LEEANN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154405058,"WEST, ELIZABETH, LEEANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 22 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154405058,"WEST, ELIZABETH, LEEANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154405058,"WEST, ELIZABETH, LEEANN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154405066,"CHRISTY, EDANA, ESCOBEDO",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1154405066,"CHRISTY, EDANA, ESCOBEDO",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 31 , 33 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1154405207,"GARY, CRYSTAL, BAILEY",4799 BLUE RIDGE DR STE 104 BLUE RIDGE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972766459,NORTH GEORGIA MEDICINE LLC,NORTH GEORGIA FAMILY MEDICINE,346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154405207,"GARY, CRYSTAL, BAILEY",346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013251156,NEW DAY BEHAVIORAL HEALTH CENTER,NEW DAY BEHAVIORAL HEALTH CENTER,2139 VALLEYGATE DR STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154411452,"FRANCO, OSCAR, RAUL",2139 VALLEYGATE DR STE 203 FAYETTEVILLE NC,026,Cumberland,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1609967884,HOOPER-THURSTON ELITE CHIROPRACTIC,~,806 HINES ST W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1154412369,"THURSTON, MARK",800 HINES ST W   WILSON NC,098,Wilson,111N00000X,Chiropractic Providers,Chiropractor,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154414340,"THOMPSON, KARLA, LACKORE",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154414340,"THOMPSON, KARLA, LACKORE",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154415628,"ELKINS, LARRY, HENRY",448 CRANBERRY ST   NEWLAND NC,006,Avery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750999496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT DAVIE COUNTY HIGH,180 WAR EAGLE DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154416592,"TANKERSLEY, PATRICK, WAYNE",180 WAR EAGLE DR   MOCKSVILLE NC,030,Davie,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154417095,"WOODBRIDGE, MICHAEL, VINCENT",95 SPRINGBROOK AVE STE 111 CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,95 SPRINGBROOK AVE STE 111 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154417095,"WOODBRIDGE, MICHAEL, VINCENT",95 SPRINGBROOK AVE STE 111 CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 57 , 91 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154417525,"YEH, JEN JEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1154419265,"SLAUGHTER III, JOHN",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154420362,ABSOLUTELY DIVINE HOME CARE AGENCY,~,3530 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1154420362,ABSOLUTELY DIVINE HOME CARE AGENCY,3530 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 4,869 "," 4,869 "," $399,069.68 ",,
MEDICAID DIRECT,1750304002,CAROLINAS CENTER FOR ADVANCED MANAG,CAROLINAS CENTER FOR ADVANCED MANAGEMENT OF PAIN,1998 HENDERSONVILLE RD STE 45 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154421915,"HUTCHESON, JUSTIN, KELBY",1998 HENDERSONVILLE RD STE 45 ASHEVILLE NC,011,Buncombe,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1154424612,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04176,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154424612,NORTH CAROLINA CVS PHARMACY LLC,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1154424612,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04176,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1154424612,NORTH CAROLINA CVS PHARMACY LLC,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1154424638,NORTH CAROLINA CVS PHARMACY LLC,~,589 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154424638,NORTH CAROLINA CVS PHARMACY LLC,589 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1028 BLAIR ST   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 202 , 204 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1028 BLAIR ST   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1028 BLAIR ST   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 525 , 526 ," $30,943.97 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,752 E CENTER AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",752 E CENTER AVE   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",752 E CENTER AVE   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,752 E CENTER AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",752 E CENTER AVE   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 53 , 53 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",752 E CENTER AVE   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 76 , 76 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,2415 SANDY PORTER RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",2415 SANDY PORTER RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 163 , 164 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1285 W A ST   KANNAPOLIS NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 384 , 389 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1285 W A ST   KANNAPOLIS NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 36 , 36 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1285 W A ST   KANNAPOLIS NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",1285 W A ST   KANNAPOLIS NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 71 , 71 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 113 , 113 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,401 LAMBERT RD   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1154424661,"DOLACK, CHRISTINA, MARIE",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1154425460,"SYLVIA, JAMES, CRAIG",SYLVIA CHIROPRACTIC CENTER,2601 N HERRITAGE ST STE A KINSTON NC,054,Lenoir,111N00000X,Chiropractic Providers,Chiropractor,,1154425460,"SYLVIA, JAMES, CRAIG",2601 N HERRITAGE ST STE A KINSTON NC,054,Lenoir,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154426120,"BOWEN, LARAINE, REIBSON",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 28 , 32 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154426120,"BOWEN, LARAINE, REIBSON",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 149 , 178 ,$#,,
MEDICAID DIRECT,1912784406,REX HOSPITAL INC,NORTH CAROLINA INFECTIOUS DISEASES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154427441,"RADZIEWICZ, HENRY, THOMAS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,226 N OAKLAND AVE   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",226 N OAKLAND AVE   EDEN NC,079,Rockingham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",226 N OAKLAND AVE   EDEN NC,079,Rockingham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 51 , 89 , 89 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",226 N OAKLAND AVE   EDEN NC,079,Rockingham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,6000 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 66 , 120 , 120 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1086 MAIN ST   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 29 , 38 , 38 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,100 SUNSET ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",1086 MAIN ST   YANCEYVILLE NC,017,Caswell,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,707 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",707 N ELM ST   HIGH POINT NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",485 VETERANS WAY   KERNERSVILLE NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1154429850,"BLASS, JOEL, MITCHELL",485 VETERANS WAY   KERNERSVILLE NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154432862,"SPRY, HEATHER, MARIE LANCASTER",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 72 , 115 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154433613,"FORD, HUBERT, JAMES",1301 CENTRAL DR   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154433613,"FORD, HUBERT, JAMES",1301 CENTRAL DR   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154433613,"FORD, HUBERT, JAMES",1301 CENTRAL DR   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154433613,"FORD, HUBERT, JAMES",1301 CENTRAL DR   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154433613,"FORD, HUBERT, JAMES",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 31 , 66 , 84 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154433613,"FORD, HUBERT, JAMES",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154433613,"FORD, HUBERT, JAMES",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 51 , 70 ,$#,,
MEDICAID DIRECT,1659487502,WILKES PEDIATRIC CLINIC,,1925 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1154435402,"KOCH, JULIE, ABRAMS",1925 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 144 , 375 , 972 ," $39,756.60 ",,
MEDICAID DIRECT,1184928848,HANORA MEDICAL CENTER PLLC,~,2620 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154438455,"UDOH, BENJAMIN, CHIGBO",2620 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 156 , 219 ,$#,,
MEDICAID DIRECT,1154438455,"UDOH, BENJAMIN, CHIGBO",~,2620 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1154438455,"UDOH, BENJAMIN, CHIGBO",2620 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 99 , 121 , 194 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 19 , 38 , 47 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 23 , 23 , 27 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154439149,"FORRESTER, JAMES, SUMMERS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1154439297,"JAMISON, PHILIP, LEDFORD",~,571 COX RD STE C GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1154439297,"JAMISON, PHILIP, LEDFORD",571 COX RD STE C GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 13 , 13 , 64 ,$#,,
MEDICAID DIRECT,1154441681,CHOCOWINITY PHARMACY INC,ONEALS DRUG STORE,633 NC 33 E   CHOCOWINITY NC,007,Beaufort,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154441681,CHOCOWINITY PHARMACY INC,633 NC 33 E   CHOCOWINITY NC,007,Beaufort,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 45 , 364 , 364 ," $29,899.77 ",,
MEDICAID DIRECT,1154442630,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1154442630,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 58 , 60 , 87 ,$#,,
MEDICAID DIRECT,1093104929,LIFELINK MEDICAL GROUP PLLC,~,901 DENIM DR   ERWIN NC,043,Harnett,193400000X,Group,Single Specialty,,1154446854,"GAINEY, SARAH, DENTON",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154446888,"DIXON, RHONDA, WALLACE",4130 CLEMMONS RD   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 16 , 25 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154446888,"DIXON, RHONDA, WALLACE",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1154451078,MARY B HOME HEALTH CARE,~,1039 N FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1154451078,MARY B HOME HEALTH CARE,1039 N FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,#," 1,757 "," 1,763 "," $84,382.22 ",,
MEDICAID DIRECT,1154453025,SHIPMAN FAMILY HOME CARE INC,~,155 NORTHPOINT AVE STE 106 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1154453025,SHIPMAN FAMILY HOME CARE INC,155 NORTHPOINT AVE STE 106 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 9,238 "," 9,594 "," $886,079.16 ",,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154455962,"KOPECKY, SHANNON, LYNN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154455962,"KOPECKY, SHANNON, LYNN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154456143,JEFFREY L TAYLOR OD AND LYNN C TAYL,PEACHTREE FAMILY EYE CARE MURPHY,4295 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1154456143,JEFFREY L TAYLOR OD AND LYNN C TAYL,4295 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,, 456 , 465 , 929 ," $12,784.38 ",,
MEDICAID DIRECT,1154456986,COUNTY OF GUILFORD,~,1203 MAPLE ST   GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1154456986,COUNTY OF GUILFORD,1203 MAPLE ST   GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 68 , 84 , 85 ," $150,079.93 ",,
MEDICAID DIRECT,1154456986,COUNTY OF GUILFORD,~,1203 MAPLE ST   GREENSBORO NC,041,Guilford,251B00000X,Agencies,Case Management,,1154456986,COUNTY OF GUILFORD,1203 MAPLE ST   GREENSBORO NC,041,Guilford,251B00000X,Agencies,Case Management,, 16 , 50 , 50 ," $18,250.16 ",,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154457471,"GOODEN, JANET, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154457471,"GOODEN, JANET, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154457471,"GOODEN, JANET, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154457471,"GOODEN, JANET, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154459808,LINCARE INC,LINCARE INC,245 JAMES JACKSON AVE   CARY NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1154459808,LINCARE INC,245 JAMES JACKSON AVE   CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1154459808,LINCARE INC,LINCARE INC,245 JAMES JACKSON AVE   CARY NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1154459808,LINCARE INC,245 JAMES JACKSON AVE   CARY NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 335 ," 2,898 "," 5,328 "," $221,375.00 ",,
MEDICAID DIRECT,1154459808,LINCARE INC,LINCARE INC,245 JAMES JACKSON AVE   CARY NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1154459808,LINCARE INC,245 JAMES JACKSON AVE   CARY NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 144 , 556 , 904 ," $226,252.19 ",,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154466100,"NEWTON, FREDERIC, KENDALL",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 110 , 145 , 297 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154470177,"WOOD, SARAH, ELIZABETH YENSER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 24 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154470177,"WOOD, SARAH, ELIZABETH YENSER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154470813,TAYLOR FAMILY CARE HOME,TAYLOR FAMILY CARE HOME,2572 RIDGEVIEW DR   VALDESE NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1154470813,TAYLOR FAMILY CARE HOME,2572 RIDGEVIEW DR   VALDESE NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,232 "," 1,232 "," $174,257.52 ",,
MEDICAID DIRECT,1154472884,COUNTY OF CARTERET COURTHOUSE SQUAR,CARTERET COUNTY DEPARTMENT OF SOCIAL SERVICES,210 CRAVEN ST   BEAUFORT NC,016,Carteret,251B00000X,Agencies,Case Management,,1154472884,COUNTY OF CARTERET COURTHOUSE SQUAR,210 CRAVEN ST   BEAUFORT NC,016,Carteret,251B00000X,Agencies,Case Management,, 88 , 860 , 860 ," $321,676.75 ",,
MEDICAID DIRECT,1154475036,LANE & ASSOCIATES X DDS PA,~,407 TIFFANY DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1154472983,"CHUNG, SUNNY, SONG",598 E JACKSON BLVD STE 100 ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154475267,"KENNEDY, WILTON, CRAIG",2305 N MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154475267,"KENNEDY, WILTON, CRAIG",7851 ALEXANDER PROMENADE HILL PL STE 130 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154476125,"SEAGO, JUDITH, JONES",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 110 , 223 ," $18,464.68 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1154478949,"SAMPSON, UCHECHUKWU, KACHI AMAKWENTA",80 HEALTHCARE DR STE 101 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 109 , 145 , 168 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1154478949,"SAMPSON, UCHECHUKWU, KACHI AMAKWENTA",80 HEALTHCARE DR STE 101 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 116 , 178 , 210 ,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1154479541,"WHITE JR, ROBERT, GERALD",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154485043,"BOSS, EDWARD, GEORGE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154485043,"BOSS, EDWARD, GEORGE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1154489623,"PATTERSON, MELANIE, LEE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154490225,"KENNEDY, LATOSHA, MONIQUE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154490225,"KENNEDY, LATOSHA, MONIQUE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154491314,"CARTER, APRIL, WALL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154491314,"CARTER, APRIL, WALL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154491314,"CARTER, APRIL, WALL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154491314,"CARTER, APRIL, WALL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154491314,"CARTER, APRIL, WALL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154494227,"SMITH, MICHAEL, DALE",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154494227,"SMITH, MICHAEL, DALE",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801917190,MOHORN BELCHER & GOLLEHON DDS PA,PIEDMONT ORAL MAXILLFACIAL FAC CENTER,2105 BRAXTON LN STE 102 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154494284,"BELCHER, JAMES, WAYNE",3493 FORESTDALE DR   BURLINGTON NC,001,Alamance,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1801917190,MOHORN BELCHER & GOLLEHON DDS PA,PIEDMONT ORAL MAXILLFACIAL FAC CENTER,3493 FORESTDALE DR STE 102 BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1154494284,"BELCHER, JAMES, WAYNE",3493 FORESTDALE DR   BURLINGTON NC,001,Alamance,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 43 ,$#,,
MEDICAID DIRECT,1801917190,MOHORN BELCHER & GOLLEHON DDS PA,PIEDMONT ORAL MAXILLFACIAL FAC CENTER,2105 BRAXTON LN STE 102 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154494284,"BELCHER, JAMES, WAYNE",2105 BRAXTON LN STE 102 GREENSBORO NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 232 , 275 ," 1,758 "," $193,350.00 ",,
MEDICAID DIRECT,1558812594,ST LUKES HOSPITAL INC,FOOTHILLS MEDICAL ASSOCIATES,130 FOREST GLEN RD STE B COLUMBUS NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154496560,"HUTTO, JOHN, OXFORD",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1396573804,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH MULTISPECIALTY CLINIC FOOTHILLS,130 FOREST GLEN RD STE B COLUMBUS NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154496560,"HUTTO, JOHN, OXFORD",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477538254,PORT HEALTH SERVICES,~,2602 COURTIER DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154497220,"MIZELLE, WILLIAM, ASHLEY",2602 COURTIER DR   GREENVILLE NC,074,Pitt,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154498616,"BROWN, LAURA, MCGEACHY",11001 DURANT RD STE 114 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154498616,"BROWN, LAURA, MCGEACHY",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154498616,"BROWN, LAURA, MCGEACHY",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023486602,RAISE THE BAR THERAPY SERVICES LLC,,18676 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1154499796,"FERRIGGI, RICHARD, HENRY",18676 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154500577,"BOST, SARAH, JANE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154500577,"BOST, SARAH, JANE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154501419,"HASSON, DAVID, JOHN",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,, 79 , 96 , 132 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154502185,"OKONKWO, IFEYINWA, JILIANA",1700 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154502185,"OKONKWO, IFEYINWA, JILIANA",101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 20 , 20 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154502185,"OKONKWO, IFEYINWA, JILIANA",1700 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 225 , 225 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154502185,"OKONKWO, IFEYINWA, JILIANA",101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 193 , 573 , 607 ," $16,603.09 ",,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154503506,"TALENT, BETH, ANN",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154503506,"TALENT, BETH, ANN",2825 LYNDHURST AVE STE 101 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154503506,"TALENT, BETH, ANN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154503514,"THORNER, KIM, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 19 , 20 , 24 ,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154503514,"THORNER, KIM, MARIE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154503662,"PARKS, GRAHAM, ERIC",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,106 W MEDICAL PARK DR STE B LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154504181,"CHAPMAN, DAVID, BRANDON",106 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154504181,"CHAPMAN, DAVID, BRANDON",106 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154504181,"CHAPMAN, DAVID, BRANDON",106 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154506582,"JOSHI, DEEPAK",738 BRYANT ST STE A STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154506772,"BULATEK, CLARISSA, NICOLE",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154507689,"HUBBARD, APRIL, MICHELE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1154507689,"HUBBARD, APRIL, MICHELE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1154507689,"HUBBARD, APRIL, MICHELE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1154507689,"HUBBARD, APRIL, MICHELE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154507978,"HARTUNG, SARAH, SUZANNE",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 49 , 115 ,$#,,
MEDICAID DIRECT,1689870941,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154512309,"ADAMS, LYDIA, HEYEL",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 71 , 150 , 170 ,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154512309,"ADAMS, LYDIA, HEYEL",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154512309,"ADAMS, LYDIA, HEYEL",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 74 , 116 , 124 ,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154512309,"ADAMS, LYDIA, HEYEL",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 63 , 70 ,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154512309,"ADAMS, LYDIA, HEYEL",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 62 , 62 ,$#,,
MEDICAID DIRECT,1851177539,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154512309,"ADAMS, LYDIA, HEYEL",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 24 , 25 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154512820,"HALL, NATALIE, SUSANNE",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1154512820,"HALL, NATALIE, SUSANNE",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154514891,"BASS, COURTNEY, BROOKE",600 GRESHAM DR FL 7 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154515443,"YOUTH, AMANDA",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1154516573,"ARANYOS, JUDIT",1206 BROWN ST   WASHINGTON NC,007,Beaufort,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1154519577,"GINGRICH, KRISTA, JO",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154519577,"GINGRICH, KRISTA, JO",3000 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 53 , 60 ,$#,,
MEDICAID DIRECT,1225268170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1154520823,"KELLEY, THEODORE, MAXWELL",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1265869846,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154520823,"KELLEY, THEODORE, MAXWELL",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154520823,"KELLEY, THEODORE, MAXWELL",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1225268170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1154520823,"KELLEY, THEODORE, MAXWELL",123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 82 , 161 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154522951,"SHEPHERD-BANIGAN, DANIEL, BOWMAN",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 36 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154522951,"SHEPHERD-BANIGAN, DANIEL, BOWMAN",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 156 , 416 ,$#,,
MEDICAID DIRECT,1285351064,UNION ORTHOTICS & PROSTHETICS LLC,,104 E FRANKLIN ST   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154523363,"HUFFSTETLER, CHRISTOPHER, COLONEL",104 E FRANKLIN ST   MONROE NC,090,Union,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1285351064,UNION ORTHOTICS & PROSTHETICS LLC,,104 E FRANKLIN ST   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154523363,"HUFFSTETLER, CHRISTOPHER, COLONEL",104 E FRANKLIN ST   MONROE NC,090,Union,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154523546,"LOYALL, MARY, ELLEN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154523546,"LOYALL, MARY, ELLEN",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154527182,"MCCORMACK, ELIZABETH, PARKER",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 86 , 209 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154527182,"MCCORMACK, ELIZABETH, PARKER",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 22 , 36 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154527836,"FALLS, ASHLEY, WALTERS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 21 , 40 , 40 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154527836,"FALLS, ASHLEY, WALTERS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1154527950,PEGGYS HOME HEALTH CARE INC,~,413 MODICA STREET   ROBERSONVILLE NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1154527950,PEGGYS HOME HEALTH CARE INC,413 MODICA STREET   ROBERSONVILLE NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,#," 1,099 "," 1,099 "," $78,753.94 ",,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154527976,"COST, JAMEY, LYNN",304 10TH AVE NE   HICKORY NC,018,Catawba,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 172 , 327 , 438 ," $12,548.51 ",,
MEDICAID DIRECT,1225274897,CHRYSTAL T ROOKS DDS PA,ROOKS DENTISTRY,303 E BROADWAY ST   PINK HILL NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1154528602,"ROOKS, CHRYSTAL",303 E BROADWAY ST   PINK HILL NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 183 , 367 ," 1,071 "," $50,796.12 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154528941,"ZEIGLER, KELLY, GARMON",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,,,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154528941,"ZEIGLER, KELLY, GARMON",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154528941,"ZEIGLER, KELLY, GARMON",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154528941,"ZEIGLER, KELLY, GARMON",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154529626,"VIETA, PAUL, ANTHONY",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154530087,"KIRK, ERIC, ALAN",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 159 , 373 , 530 ," $11,006.68 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154530087,"KIRK, ERIC, ALAN",800 JEFFERSON ST STE 107 WHITEVILLE NC,024,Columbus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 39 , 42 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154530087,"KIRK, ERIC, ALAN",20 MEDICAL CAMPUS DR NW STE 101 SUPPLY NC,010,Brunswick,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154534477,"MATHYS, KENNETH, CLIFFORD",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 28 , 35 , 39 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154534477,"MATHYS, KENNETH, CLIFFORD",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 97 , 130 , 167 ,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1154536001,"SMID, KATHERINE, MARY",336 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821403957,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1154536001,"SMID, KATHERINE, MARY",434 HOSPITAL DR   LINVILLE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 60 , 60 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154537751,"BURBANK, SCOTT, ARTHUR",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154537751,"BURBANK, SCOTT, ARTHUR",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 55 , 85 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154537751,"BURBANK, SCOTT, ARTHUR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154540375,"VARLEY, REBECCA, JANE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 33 , 35 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154540375,"VARLEY, REBECCA, JANE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154540375,"VARLEY, REBECCA, JANE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 80 , 85 , 146 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154540938,"WISHON, CANDACE, CHAPLIN",970 NEWMAN RD   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 46 , 65 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 24 , 30 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 38 , 47 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1154543692,"LONGIN, HEATHER, MARIE",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154546067,"ARVESEN, THERESA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1154546315,"GAO, TAO",~,5318 NC HIGHWAY 55 STE 204 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1154546315,"GAO, TAO",5318 NC HIGHWAY 55 STE 204 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 99 , 192 , 728 ," $26,507.60 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154547354,"MCLEAN, SEAN, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 52 , 100 , 118 ," $19,110.59 ",,
MEDICAID DIRECT,1902953045,WHITE OAK PEDIATRIC ASSOCIATES PA,~,4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154548063,"SCHMITT, ALLISON, HART",4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 135 , 162 , 252 ," $37,439.00 ",,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 107 , 127 , 127 ," $12,781.28 ",,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1740539782,ORTHODONTIC CARE OF CAROLINA PA,ORTHOCARE ORTHODONTICS,,,Unknown,193400000X,Group,Single Specialty,,1154548436,"COOPER, FORD, SAWYER",8220 UNIVERSITY EXEC PARK DR STE 150 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 63 , 71 , 71 ,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",3010 BAUCOM RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 14 , 15 , 21 ,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",3010 BAUCOM RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 88 , 99 , 164 ," $23,326.55 ",,
MEDICAID DIRECT,1740539782,ORTHODONTIC CARE OF CAROLINA PA,ORTHOCARE ORTHODONTICS,,,Unknown,193400000X,Group,Single Specialty,,1154548436,"COOPER, FORD, SAWYER",9320 CENTER LAKE DR STE 100 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1740539782,ORTHODONTIC CARE OF CAROLINA PA,ORTHOCARE ORTHODONTICS,3010 BAUCOM RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154548436,"COOPER, FORD, SAWYER",3010 BAUCOM RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 484 ," 2,039 "," 2,366 "," $301,037.21 ",,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 197 , 208 , 249 ," $36,419.02 ",,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154548436,"COOPER, FORD, SAWYER",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154550077,"FORMYDUVAL-LEWIS, ANDREA, MORGAN",1307 MARKET ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154550077,"FORMYDUVAL-LEWIS, ANDREA, MORGAN",4005 OLEANDER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 12 , 36 ,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154550077,"FORMYDUVAL-LEWIS, ANDREA, MORGAN",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 49 , 111 ,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154550077,"FORMYDUVAL-LEWIS, ANDREA, MORGAN",613 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,120 COASTAL HORIZONS DR   SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1154550077,"FORMYDUVAL-LEWIS, ANDREA, MORGAN",4005 OLEANDER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154552081,"LIM, ANNIE, KYOUNG",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 121 , 138 , 177 ,$#,,
MEDICAID DIRECT,1154554681,MORNING GLORY FAMILY CARE,MORNING GLORY FAMILY CARE,112 S CHURCH ST   FREMONT NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1154554681,MORNING GLORY FAMILY CARE,112 S CHURCH ST   FREMONT NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 678 , 678 ," $36,087.56 ",,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154558997,"PATEL, PRIYANKA, AMIT",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1154559284,"FLEMING, PETER, SIMON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154559284,"FLEMING, PETER, SIMON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 96 , 96 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154559284,"FLEMING, PETER, SIMON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154559805,"TOBOLA, MACIEJ, STANISLAW",582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154559854,"FREILER, ANTHONY, DAVID",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 29 , 58 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154559854,"FREILER, ANTHONY, DAVID",1331 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 184 , 205 , 286 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154559854,"FREILER, ANTHONY, DAVID",1030 MECICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1154559854,"FREILER, ANTHONY, DAVID",1030 MECICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1154559904,"LONGO, THOMAS, ANDREW",,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1154559904,"LONGO, THOMAS, ANDREW",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 22 , 41 , 72 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,605 GROVE ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154560449,"SCHENK, TIMOTHY, RYAN",605 GROVE ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154560449,"SCHENK, TIMOTHY, RYAN",605 GROVE ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 206 , 395 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154560662,"CATANZARO, TINA, MARIE",2150 HERBERT CT   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#, 11 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154560662,"CATANZARO, TINA, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 46 , 67 , 81 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154561629,"BENTLEY, LINDSAY, SAWYER",10211 ALM ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154561629,"BENTLEY, LINDSAY, SAWYER",5213 S ALSTON AVE   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154561629,"BENTLEY, LINDSAY, SAWYER",5213 S ALSTON AVE   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154562528,"JACKSON, MELISSA, SHAREE",1400 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 40 , 168 ,$#,,
MEDICAID DIRECT,1982873899,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,900 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154562528,"JACKSON, MELISSA, SHAREE",900 SUMMIT AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 2,664 "," 3,415 "," 11,780 "," $857,601.76 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154563260,"DITTUS, CHRISTOPHER, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 30 , 75 , 96 ,$#,,
MEDICAID DIRECT,1154563591,"AUMAN, COURTNEY, MELTON",,57 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1154563591,"AUMAN, COURTNEY, MELTON",57 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 72 , 103 , 235 ,$#,,
MEDICAID DIRECT,1790747988,CRYSTAL COAST PAIN MANAGEMENT,CRYSTAL COAST PAIN MANAGEMENT CENTER,2111 NEUSE BLVD STE J NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1154563591,"AUMAN, COURTNEY, MELTON",57 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 127 , 290 , 666 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154563906,"ANCIANO GRANADILLO, CARLOS, JOSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 35 , 44 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154563906,"ANCIANO GRANADILLO, CARLOS, JOSE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154564813,"SOUTHERLAND, KEVIN, WILLIAM",10207 CERNY ST   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 45 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154564813,"SOUTHERLAND, KEVIN, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154564813,"SOUTHERLAND, KEVIN, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 30 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154564813,"SOUTHERLAND, KEVIN, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 27 , 36 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1154564813,"SOUTHERLAND, KEVIN, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1154564862,"YU, RUPAL, LAKHANI",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 92 , 150 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154564862,"YU, RUPAL, LAKHANI",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154564862,"YU, RUPAL, LAKHANI",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 44 , 78 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154564862,"YU, RUPAL, LAKHANI",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 101 , 161 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154565521,"OHLENDORF, BRIAN, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154565521,"OHLENDORF, BRIAN, JOSEPH",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154565521,"OHLENDORF, BRIAN, JOSEPH",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154565521,"OHLENDORF, BRIAN, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 34 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154565521,"OHLENDORF, BRIAN, JOSEPH",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1366086597,FORA DERMATOLOGY PLLC,~,653 BLUEFIELD RD STE G MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154565661,"AL DABAGH, BISHR, AHMAD",118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1154565661,"AL DABAGH, BISHR, AHMAD",~,118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1154565661,"AL DABAGH, BISHR, AHMAD",118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1366086597,FORA DERMATOLOGY PLLC,~,118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154565661,"AL DABAGH, BISHR, AHMAD",653 BLUEFIELD RD STE G MOORESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1366086597,FORA DERMATOLOGY PLLC,~,118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154565661,"AL DABAGH, BISHR, AHMAD",118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 35 , 100 , 151 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1154567915,"MCCRACKEN, CHRISTOPHER, LEE",148 HIGHWAY 105 EXT STE 104 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1154567915,"MCCRACKEN, CHRISTOPHER, LEE",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 60 , 119 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154568764,"MILEY, KATHRYN, LYNN",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1154568988,"MURPHY, JOSHUA, LEWIS",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 40 , 40 , 40 ,$#,,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1154575801,"PHELPS, TRACY, LEE",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 97 , 286 , 438 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154576221,"MUNGER, TANYA, JEAN",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 26 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154576221,"MUNGER, TANYA, JEAN",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 51 , 80 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154576221,"MUNGER, TANYA, JEAN",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154576221,"MUNGER, TANYA, JEAN",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154576288,"MARTIN, TIFFANY, MENDENHALL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154576288,"MARTIN, TIFFANY, MENDENHALL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154578797,"SICA, ROGER, SEBASTIAN",58 PHYSICIANS DR NW STE 103 SUPPLY NC,010,Brunswick,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154578797,"SICA, ROGER, SEBASTIAN",1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154578797,"SICA, ROGER, SEBASTIAN",14057 HIGHWAY 17 N STE 130 HAMPSTEAD NC,071,Pender,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154579167,"ROBINETTE, CONNIE, SUE",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,,,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154579696,"DOWUONA, NORTEI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154579696,"DOWUONA, NORTEI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 166 , 167 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154579696,"DOWUONA, NORTEI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154579696,"DOWUONA, NORTEI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1154580181,HAPPY HOMECARE STAFFING INC,HAPPY HOMECARE STAFFING INC,201 MOUNT WILLING RD   EFLAND NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,1154580181,HAPPY HOMECARE STAFFING INC,201 MOUNT WILLING RD   EFLAND NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,#," 1,598 "," 1,621 "," $256,968.76 ",,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154580389,"ARTHO, MELANIE, RENEE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 30 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154580389,"ARTHO, MELANIE, RENEE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154580389,"ARTHO, MELANIE, RENEE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154580389,"ARTHO, MELANIE, RENEE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 38 , 56 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154580389,"ARTHO, MELANIE, RENEE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154580389,"ARTHO, MELANIE, RENEE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184751372,CARY MEDICAL CLINIC PA,CARY MEDICAL CLINIC PA,6402 MCCRIMMON PKWY STE 200 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1154581411,"SOUNDARAPANDIAN, USHA",6402 MCCRIMMON PKWY STE 200 MORRISVILLE NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 46 ,$#,,
MEDICAID DIRECT,1184751372,CARY MEDICAL CLINIC PA,CARY MEDICAL CLINIC PA,155 PARKWAY OFFICE CT STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1154581411,"SOUNDARAPANDIAN, USHA",6402 MCCRIMMON PKWY STE 200 MORRISVILLE NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154581759,"FLETCHER, ALISON, JO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 107 , 228 , 234 ,$#,,
MEDICAID DIRECT,1790830487,CHILDRENS MEDICAL GROUP INC,SUFFOLK PEDIATRICS,1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154582054,"DRAMES, BRITTNEY, SUZANNE SALMON",1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1154582419,"COMPTON, ERIN, REBECCA",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 44 , 49 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154582419,"COMPTON, ERIN, REBECCA",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 42 , 50 ,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154583326,"PATHAN, SABANA, SHABBIRKHAN",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 106 , 233 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154583532,"LEVENSON, AMY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 26 , 43 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154584159,"LEIMAN, ERIN, ROXANNE HORN",2301 ERWIN RD STE 2600 DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154584159,"LEIMAN, ERIN, ROXANNE HORN",2301 ERWIN RD STE 2600 DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1376961839,DAVID A WILSON DDS PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1154584787,"WILSON, DAVID, ANTHONY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376961839,DAVID A WILSON DDS PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1154584787,"WILSON, DAVID, ANTHONY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154585750,"DAVIS, ELIZABETH, KIDD",5838 SIX FORKS RD STE 300 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 19 , 56 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154586345,"KAMIONEK, MICHAL",600 HOSPITAL DR   MONROE NC,090,Union,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154586345,"KAMIONEK, MICHAL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154586345,"KAMIONEK, MICHAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154586345,"KAMIONEK, MICHAL",101 E WT HARRIS BLVD STE 1212 CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 150 , 154 , 204 ,$#,,
MEDICAID DIRECT,1154587012,"GANDHI, SAGAR, SUBODHCHANDRA",~,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1154587012,"GANDHI, SAGAR, SUBODHCHANDRA",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1154589141,"HORNBUCKLE, STEPHANIE, BRADLEY",1 HOSPITAL RD   CHEROKEE NC,087,Swain,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1154589141,"HORNBUCKLE, STEPHANIE, BRADLEY",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1154589141,"HORNBUCKLE, STEPHANIE, BRADLEY",1 HOSPITAL RD   CHEROKEE NC,087,Swain,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1154589141,"HORNBUCKLE, STEPHANIE, BRADLEY",68 HOSPITAL RD   SYLVA NC,050,Jackson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1154590529,"STACK, IAN, CHRISTOPHER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 54 , 62 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1154590529,"STACK, IAN, CHRISTOPHER",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1154600633,"FUNKHOUSER, STEPHEN, KEITH",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1154600633,"FUNKHOUSER, STEPHEN, KEITH",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1154600633,"FUNKHOUSER, STEPHEN, KEITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 88 , 88 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154600633,"FUNKHOUSER, STEPHEN, KEITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154601342,"COOK, LAUREN, LEANDER",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 37 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154601342,"COOK, LAUREN, LEANDER",4115 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1154603140,"HALL, BENJAMIN, LEE",40 E MEDICAL CT   MARION NC,059,McDowell,152W00000X,Eye and Vision Services Providers,Optometrist,, 54 , 59 , 72 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1154603140,"HALL, BENJAMIN, LEE",335 E PARKER RD   MORGANTON NC,012,Burke,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 20 , 24 ,$#,,
MEDICAID DIRECT,1104968627,PIEDMONT FAMILY MEDICINE PA,PIEDMONT FAMILY MEDICINE PA,1401 W INNES ST STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1154603629,"INGOLD, TIFFANY, MARIE",1401 W INNES ST STE B SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 294 , 296 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154604171,"SU, LAUREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154608875,"PATEL, SAPNA, KIRITBHAL",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154609162,"BASKIN-MILLER, JACQUELYN, LISA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 17 , 37 , 37 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154609170,"ILO, IFEOMA, ANULIKA",1718 E 4TH ST STE 907 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154609170,"ILO, IFEOMA, ANULIKA",6324 FAIRVIEW RD STE 430 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154609931,"KYLE, BRANDON, NICHOLAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154610079,"HARDILL, MARIA, CAMILA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154610079,"HARDILL, MARIA, CAMILA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 24 , 59 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154610327,"LAU, BRIAN, CHEI-FAI",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 27 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154610327,"LAU, BRIAN, CHEI-FAI",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154610327,"LAU, BRIAN, CHEI-FAI",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154610327,"LAU, BRIAN, CHEI-FAI",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 48 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1154610327,"LAU, BRIAN, CHEI-FAI",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1154610327,"LAU, BRIAN, CHEI-FAI",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,,,$#,,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 14 ,,,$#,,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 933 ," 2,919 "," 5,198 "," $394,413.99 ",,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 26 ,,,$#,,
MEDICAID DIRECT,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOME CARE SPECIALISTS,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154611648,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 662 ," 2,199 "," 3,512 "," $145,071.59 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154613099,"SUBRAMANIAN, MEENAKSHISUNDARAM",220 SPRINGBROOK AVE STE 100 CLAYTON NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 20 , 29 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154613099,"SUBRAMANIAN, MEENAKSHISUNDARAM",120 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154613099,"SUBRAMANIAN, MEENAKSHISUNDARAM",2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 61 , 109 , 193 ," $20,647.54 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154613099,"SUBRAMANIAN, MEENAKSHISUNDARAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154613099,"SUBRAMANIAN, MEENAKSHISUNDARAM",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 50 , 94 ," $10,775.24 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154613099,"SUBRAMANIAN, MEENAKSHISUNDARAM",3113 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 16 , 30 ,$#,,
MEDICAID DIRECT,1760865760,KIDZCARE PEDIATRICS PC,,1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154615052,"MACKILLOP, YVONNE, NICOLE",615 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154615508,"DAWSON, STEPHANIE, ANGELA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 62 , 63 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154616209,"GOTO, TAFADZWA, PRECIOUS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,3030 RANDOLPH RD STE 105   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154616571,"PITT, BAN, SAADEH",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1154618601,"PEREZ, REBECCA, LYNN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1154618601,"PEREZ, REBECCA, LYNN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154618601,"PEREZ, REBECCA, LYNN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154618601,"PEREZ, REBECCA, LYNN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154618601,"PEREZ, REBECCA, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154620227,"SHEPHERD, MARK, MICHAEL",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154620227,"SHEPHERD, MARK, MICHAEL",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154620227,"SHEPHERD, MARK, MICHAEL",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 29 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154622165,"DAVIS, SHANNON, NEWTON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 44 , 47 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1154622835,"SNAPP, ANSLEY, MARIE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154623338,AMAZING KIDS OF NC INC,~,13 W COLLEGE ST   FRANKLINTON NC,035,Franklin,251B00000X,Agencies,Case Management,,1154623338,AMAZING KIDS OF NC INC,13 W COLLEGE ST   FRANKLINTON NC,035,Franklin,251B00000X,Agencies,Case Management,, 335 ," 3,688 "," 3,719 "," $1,772,964.77 ",,
MEDICAID DIRECT,1154623338,AMAZING KIDS OF NC INC,~,,,Unknown,251B00000X,Agencies,Case Management,,1154623338,AMAZING KIDS OF NC INC,100 HOLDEN RD STE H YOUNGSVILLE NC,035,Franklin,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1154623338,AMAZING KIDS OF NC INC,~,,,Unknown,251B00000X,Agencies,Case Management,,1154623338,AMAZING KIDS OF NC INC,100H HOLDEN RD   YOUNGSVILLE NC,035,Franklin,251B00000X,Agencies,Case Management,,#,#,#,$#,,
MEDICAID DIRECT,1265513329,ALBEMARLE REGIONAL HEALTH SERVICES,CAMDEN COUNTY HEALTH DEPARTMENT,160 US HIGHWAY 158 E BLDG B CAMDEN NC,015,Camden,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1154623965,"TATES, ARNETTE, OLIVIA",160 US HIGHWAY 158 E   CAMDEN NC,015,Camden,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1659468130,ALBEMARLE REGIONAL HEALTH SERVICES,ALBEMARLE REGIONAL HEALTH SERVICES,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1154623965,"TATES, ARNETTE, OLIVIA",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1508942848,ALBEMARLE REGIONAL HEALTH SERVICES,PASQUOTANK COUNTY HEALTH DEPARTMENT,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1154623965,"TATES, ARNETTE, OLIVIA",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 16 , 13 , 25 ,$#,,
MEDICAID DIRECT,1619058955,FRANKLIN COUNTY HEALTH DEPT,FRANKLIN CO HEALTH DEPT,107 INDUSTRIAL DR   LOUISBURG NC,035,Franklin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1154624617,"COOPER, LANA, JEAN",107 INDUSTRIAL DR STE C LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 197 , 605 ," $19,513.89 ",,
MEDICAID DIRECT,1154625929,A PLUS RESIDENTIAL CARE,~,7609 FIESTA WAY   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1154625929,A PLUS RESIDENTIAL CARE,7609 FIESTA WAY   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 162 , 162 ," $77,369.92 ",,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154626869,"KORMELINK, JENNIFER, LEIGH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154626869,"KORMELINK, JENNIFER, LEIGH",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1154628022,"CARNEY, MEGAN, ELIZABETH",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 36 , 38 ,$#,,
MEDICAID DIRECT,1730346974,BATISH FAMILY MEDICINE,BATISH FAMILY MEDICINE,51 LEE DR   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1154628527,"CROSSON, EMILY, ERIN",51 LEE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 147 , 251 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154629137,"REISINGER, ERIC, ISOM",40 AVIEMORE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154632529,"WARNE, STEVEN, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 152 , 178 , 264 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1015 WORTH ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1154632529,"WARNE, STEVEN, JOSEPH",1015 WORTH ST   MOUNT AIRY NC,086,Surry,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154633394,"OZAN, JENNIFER, MICHELLE",520 MAPLE AVE STE C REIDSVILLE NC,079,Rockingham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154633394,"OZAN, JENNIFER, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 74 , 97 , 120 ," $10,703.90 ",,
MEDICAID DIRECT,1083039176,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MED-W MTN VIEW,1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154634988,"KIHNEMAN, JASON, BRADLEY",1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 94 , 206 ,$#,,
MEDICAID DIRECT,1083039176,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MED-W MTN VIEW,1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1154634988,"KIHNEMAN, JASON, BRADLEY",50 MACEDONIA CHURCH RD STE A TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154637353,"KOTHAGUNDLA, CHANDRASEKHAR",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 122 , 125 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154637593,"TAQUI, ATHER, MOHAMMAD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 40 , 42 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154637593,"TAQUI, ATHER, MOHAMMAD",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1154637932,"PERKINS, IAN, NATHANIEL",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1154637932,"PERKINS, IAN, NATHANIEL",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 73 , 133 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1154637932,"PERKINS, IAN, NATHANIEL",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 53 , 67 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154637932,"PERKINS, IAN, NATHANIEL",2605 BLUE RIDGE RD STE 240 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154637932,"PERKINS, IAN, NATHANIEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154640324,"SIDDIQUE, KHURRUM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154641256,"HOLLINGSWORTH, JOHN, ZEIGLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 171 , 172 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154641256,"HOLLINGSWORTH, JOHN, ZEIGLER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154641256,"HOLLINGSWORTH, JOHN, ZEIGLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154641256,"HOLLINGSWORTH, JOHN, ZEIGLER",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154641769,"SAGALLA, NICOLE, ANDREA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 12 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154641769,"SAGALLA, NICOLE, ANDREA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 15 , 27 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154641769,"SAGALLA, NICOLE, ANDREA",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 15 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154641769,"SAGALLA, NICOLE, ANDREA",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154641769,"SAGALLA, NICOLE, ANDREA",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154641769,"SAGALLA, NICOLE, ANDREA",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154641769,"SAGALLA, NICOLE, ANDREA",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154641892,"BALEVIC, STEPHEN, JOSEPH",2301 ERWIN RD 2301 ERWIN ROAD DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#, 13 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154642239,"SANTA MARIA, JED, ALAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1962752881,HOKE HEALTHCARE LLC,HOKE PRIMARY CARE CLINIC,300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1154643898,"FAZEKAS, SARAH, ALLEN",300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447255328,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOKE FAMILY MEDICAL CENTER,405 S MAIN ST   RAEFORD NC,047,Hoke,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154643898,"FAZEKAS, SARAH, ALLEN",405 S MAIN ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 104 , 104 ,$#,,
MEDICAID DIRECT,1154644342,ROSHAUN WILLIAMS,ROSHAUNS HOUSE OF CARE,4012 GUESS RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1154644342,ROSHAUN WILLIAMS,4012 GUESS RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 624 , 624 ," $139,299.02 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154645893,"GRIGGS, CHRISTOPHER, ALLEN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154645893,"GRIGGS, CHRISTOPHER, ALLEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 43 , 51 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154646578,CHARLOTTE MEDICAL CLINIC,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154646586,"SLOCUM, KAREN, VALERIE",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154646586,"SLOCUM, KAREN, VALERIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154647352,"NORTON, DUSTIN, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 58 , 101 , 105 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154647394,"MOREL, BENJAMIN, MARTIN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154647394,"MOREL, BENJAMIN, MARTIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154647394,"MOREL, BENJAMIN, MARTIN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154647394,"MOREL, BENJAMIN, MARTIN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154647394,"MOREL, BENJAMIN, MARTIN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154647519,"WOODRUFF, RACHEL, KATHERINE FESPERMAN",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 41 , 56 ,$#,,
MEDICAID DIRECT,1912294687,PIONEER HEALTH SERVICES OF STOKES C,PIONEER FAMILY MEDICAL OF DANBURY,,,Unknown,193200000X,Group,Multi-Specialty,,1154648020,"HUNTER, KYLE, JOSEPH",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154648541,"SCHMEISSING, SCOTT, WILLIAM",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154649721,"STEWART, JACQUELINE, MARIE",3116 N DUKE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 122 , 299 ," $12,184.05 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154649721,"STEWART, JACQUELINE, MARIE",3116 N DUKE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154651008,"HURLEY, SUSIE, CARTIN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1154651008,"HURLEY, SUSIE, CARTIN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154653723,"FAN, RONGRONG",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154653723,"FAN, RONGRONG",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154653723,"FAN, RONGRONG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics, 78 , 87 , 103 ," $23,398.64 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1154654390,"BRUMBAUGH, MARCIA, LYNN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154654861,"KHOURI, YAZAN, SUHEL",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 22 , 23 , 26 ,$#,,
MEDICAID DIRECT,1154658508,PROGRESSIVE CARE LLC,PROGRESSIVE CARE LLC,3623 LATROBE DR STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1154658508,PROGRESSIVE CARE LLC,3623 LATROBE DR STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 4,194 "," 4,194 "," $244,952.65 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,518 S VAN BUREN RD STE 5 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1154661403,"ERSKINE, KELLY, BAKER",518 S VAN BUREN RD STE 5 EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,522 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1154661403,"ERSKINE, KELLY, BAKER",522 S VAN BUREN RD   EDEN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,522 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1154661403,"ERSKINE, KELLY, BAKER",522 S VAN BUREN RD   EDEN NC,079,Rockingham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154661403,"ERSKINE, KELLY, BAKER",522 S VAN BUREN RD   EDEN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154661403,"ERSKINE, KELLY, BAKER",522 S VAN BUREN RD   EDEN NC,079,Rockingham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1154661965,"THOMAS, CARRIE, HARRELL",15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 33 , 58 ,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1154661965,"THOMAS, CARRIE, HARRELL",15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 77 , 119 ,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1154661965,"THOMAS, CARRIE, HARRELL",1072 NC HIGHWAY 210 STE A SNEADS FERRY NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1154663482,"SCHUETT, ALYSSA, ANN JENKINS",2007 WALNUT ST   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1154665172,A PRIMARY CHOICE INC,~,3358B AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1154665172,A PRIMARY CHOICE INC,3358B AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 33 ," 7,233 "," 7,237 "," $441,177.08 ",,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1154666113,"BROWN, MICHELLE, JENNIFER",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154666113,"BROWN, MICHELLE, JENNIFER",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154666113,"BROWN, MICHELLE, JENNIFER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912008459,"WARREN ULANCH, JULIA, GLADYS",CREEDMOOR CENTRE ENDOCRINOLOGY,8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",1154666238,"PATEL, KOMAL, ROHITKUMAR",8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154666402,"LOVE, KAY, ANNE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154666402,"LOVE, KAY, ANNE",7752 GATEWAY LN NW STE 100 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 25 , 55 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154669364,"JUSTEN, LAURA, ANN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1154669364,"JUSTEN, LAURA, ANN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154671857,"BOLANOS, SAMANTHA, LEE",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 71 , 108 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154672426,"SURENDRA, CHRISTOPHER, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154672426,"SURENDRA, CHRISTOPHER, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154672426,"SURENDRA, CHRISTOPHER, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1154672426,"SURENDRA, CHRISTOPHER, MICHAEL",400 US HWY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154672426,"SURENDRA, CHRISTOPHER, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1154672426,"SURENDRA, CHRISTOPHER, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1154673713,"IBRAHIM, WALEED, MOHAMED KHALIL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 34 , 40 ,$#,,
MEDICAID DIRECT,1972060796,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,304 E SAUNDERS ST   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1154675866,"DONZE, KIMBERLY, SUE-HICKS",304 E SAUNDERS ST   CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 187 , 378 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154681062,"SCHWIND, VALARIE, MICHELLE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154681872,"HANCOCK, JESSICA, BEARDSLEY",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 20 , 37 ,$#,,
MEDICAID DIRECT,1700111515,CAROLINAS PHYSICIANS NETWORK INC,CAROLINA NEUROLOGICAL CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154681955,"JALALI, NAVID",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 35 , 51 , 69 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154682581,"DAVIS, RACHAEL, DELEE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154682581,"DAVIS, RACHAEL, DELEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,238 "," 2,569 "," 9,298 "," $325,522.92 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 31 , 31 , 628 ," $55,651.98 ",,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 24 , 24 , 484 ," $40,838.70 ",,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,629 "," 3,014 "," 11,800 "," $470,444.85 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,562 "," 1,926 "," 7,031 "," $273,615.99 ",,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",8415 MEDICAL PLAZA DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 143 ,$#,,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",8415 MEDICAL PLAZA DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 12 , 105 ,$#,,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154683209,"MUJICA, MARCELA, ROXANA",8415 MEDICAL PLAZA DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 11 , 11 , 173 ," $10,992.78 ",,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154683217,"BAKER, SUSAN, LEE",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154683217,"BAKER, SUSAN, LEE",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 122 , 124 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1154683217,"BAKER, SUSAN, LEE",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154686921,"SUNKARA, PADAGESHWAR, RAO",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 40 , 53 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154687200,"EHRLICH, MATTHEW, EVAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154687200,"EHRLICH, MATTHEW, EVAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 33 , 58 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154687200,"EHRLICH, MATTHEW, EVAN",3116 N DUKE ST   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154687200,"EHRLICH, MATTHEW, EVAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 17 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154687549,"SULLIVAN, THOMAS, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 26 , 41 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154687937,"HUDSON, LAURA, ELIZABETH",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 41 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154688026,"MISAGHIAN-XANTHOS, NEGIN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154688026,"MISAGHIAN-XANTHOS, NEGIN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154688026,"MISAGHIAN-XANTHOS, NEGIN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 17 , 29 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154688026,"MISAGHIAN-XANTHOS, NEGIN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 12 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154688026,"MISAGHIAN-XANTHOS, NEGIN",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154688349,"PADGETT, JOSEPH, BEARL",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 86 , 96 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154688455,"LENFESTEY, MARY, WINDHAM",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 61 , 65 , 167 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154688455,"LENFESTEY, MARY, WINDHAM",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154688455,"LENFESTEY, MARY, WINDHAM",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#, 26 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154688604,"QUERUBIN, JYES, ANNEMARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154688604,"QUERUBIN, JYES, ANNEMARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1174569529,"HANDY, MICHAEL, HARVEY",~,1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,1154689057,"HADDIX, KEVIN, PATRICK",1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043494784,ORTHOPAEDIC TRAUMA SPECIALISTS PC,ORTHOPAEDIC TRAUMA SPECIALISTS PC,1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154689057,"HADDIX, KEVIN, PATRICK",1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 48 , 72 , 129 ," $13,615.51 ",,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154689255,"ABU-RUB, MOHAMMAD, AHMAD TAWFIQ",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 63 , 77 , 114 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154689958,"CHAMBERS, KATHRYN, LOUISE",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154689982,"CRAMER, BRANDON, MITCHELL",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 33 , 40 ,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1154692143,"GOLD, BRANDON, MICHAEL",600 BARRETT LN   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1154692143,"GOLD, BRANDON, MICHAEL",600 BARRETT LN   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 19 , 24 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154692143,"GOLD, BRANDON, MICHAEL",600 BARRETT LN   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154694693,"CROOP, SARAH, ELIZABETH WIEBER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1154697381,"WEINER, ASHLEY, ASTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154697381,"WEINER, ASHLEY, ASTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 55 , 157 , 239 ," $10,592.41 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154697563,"SARACENO, ELLI, BONNETT",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1154697563,"SARACENO, ELLI, BONNETT",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1154697563,"SARACENO, ELLI, BONNETT",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1154697787,"CASAMALHUAPA, CARLOS, HERMES",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154697829,"TACKETT, JOAN, LAVONNE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1154697829,"TACKETT, JOAN, LAVONNE",,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1154697829,"TACKETT, JOAN, LAVONNE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154697829,"TACKETT, JOAN, LAVONNE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 325 , 358 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1154699718,"BARTLETT JR, TERRY, LEE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 277 , 790 , 790 ," $29,095.20 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154701696,"RIESBECK, MATTHEW, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 149 , 216 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154701696,"RIESBECK, MATTHEW, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 43 , 48 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154702314,"VRNAK, JOHN, DANIEL",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 31 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154703205,"EDWARDS, NALATHA, HEPSIBHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 66 , 67 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154703924,"JANES, AMANDA, TRAUGHBER",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 30 , 30 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154705697,"SINGH, MAYANKA",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154705697,"SINGH, MAYANKA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 69 , 117 , 134 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154705697,"SINGH, MAYANKA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 29 , 32 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154705788,"MCNEILL, SHANNON, MARIE",14215 BALLANTYNE CORPORATE PL STE 240 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154705788,"MCNEILL, SHANNON, MARIE",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154705911,"ELLIS, SYLVIA, WIESMANN",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154705911,"ELLIS, SYLVIA, WIESMANN",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 31 , 32 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154705911,"ELLIS, SYLVIA, WIESMANN",25 REYNOLDS MOUNTAIN BLVD   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154705911,"ELLIS, SYLVIA, WIESMANN",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 35 , 36 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154705911,"ELLIS, SYLVIA, WIESMANN",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154705911,"ELLIS, SYLVIA, WIESMANN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 38 , 149 , 157 ,$#,,
MEDICAID DIRECT,1851555734,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RIVERWOOD FAMILY MEDICI,3715 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154706299,"KEMMER, WENDY, LYNN",3715 UNION RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154707446,"CAMPBELL, DAVNEATRA, FOSTER",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 25 , 125 , 125 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154708402,"MCDOUGAL, KATHERINE, ELISE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 419 , 535 ," $14,388.56 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154708402,"MCDOUGAL, KATHERINE, ELISE",107 SUNNYBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154709459,"DAVIS, DEBORAH, DENISE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154710291,MYEYEDR OPTOMETRY OF NORTH CAROLINA,~,,,Unknown,193400000X,Group,Single Specialty,,1154710291,MYEYEDR OPTOMETRY OF NORTH CAROLINA,1033 RANDOLPH ST STE 4 THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,, 323 , 22 , 44 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1154715936,"SNEAD, DENA, ANN",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 16 , 30 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1154715936,"SNEAD, DENA, ANN",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",720 MALCOLM BLVD   VALDESE NC,012,Burke,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",1310 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 15 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",10650 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 25 , 37 , 49 ,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",600 HOSPITAL DR   MONROE NC,090,Union,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 27 , 31 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154716611,"GREWAL, AMARDEEP, SINGH",631 MOCKSVILLE AVE STE 1010 SALISBURY NC,080,Rowan,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 20 , 22 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154716769,"SMITH, BRODRICK, DARREN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154717098,"RUDIN, BRANDY, LYNN",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 44 , 77 ," $10,847.52 ",,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 VETERANS PKWY STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 VETERANS PKWY STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,,,Unknown,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 47 , 51 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 NC HIGHWAY 42 W STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 23 , 23 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,,,Unknown,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154717148,"SPIRITOS, ZACHARY, PETER",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 33 , 36 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154719722,"GUST, PAUL, STEVEN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154721074,"BRADBURY, ANDERSON, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 78 , 97 , 145 ,$#,,
MEDICAID DIRECT,1508158940,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER MEBANE,1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",431 KEISLER DR STE 101 CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1669892725,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER WILSON,1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",431 KEISLER DR STE 101 CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 55 ,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",431 KEISLER DR STE 101 CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery," 1,241 "," 1,359 "," 9,779 "," $1,092,955.97 ",,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",431 KEISLER DR STE 101 CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 21 ,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",2300 MEDICAL PARK DR STE G GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1669892725,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER WILSON,1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 20 ,$#,,
MEDICAID DIRECT,1508158940,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER MEBANE,1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154724169,"MUELLER, NICHOLAS",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154725604,"VASERMAN, SARIT",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154725604,"VASERMAN, SARIT",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154725604,"VASERMAN, SARIT",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 32 , 42 ,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1154730554,"HORNE, KELLY, DUTTON",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 199 , 376 , 377 ," $10,355.19 ",,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1154730554,"HORNE, KELLY, DUTTON",2301 US HIGHWAY 74 W 2301 US HIGHWAY 74W WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154732295,"NELSON, CLAY, GREGORY",600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 129 , 244 , 523 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154732295,"NELSON, CLAY, GREGORY",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1154732295,"NELSON, CLAY, GREGORY",7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154732295,"NELSON, CLAY, GREGORY",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 59 , 114 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154734507,"TAKEDDIN, JUMAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154735264,"GREENFIELD, MICHAEL, LURIE",123 S JOHNSON ST   BREVARD NC,088,Transylvania,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154735264,"GREENFIELD, MICHAEL, LURIE",704 OAKLAND ST   HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154735264,"GREENFIELD, MICHAEL, LURIE",704 OAKLAND ST   HENDERSONVILLE NC,045,Henderson,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 344 , 547 , 628 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154735264,"GREENFIELD, MICHAEL, LURIE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154735645,"SKARIAH, TINA, KOCHUPURACKAL",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1104918754,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1154736437,"KELLEY, THOMAS, MICHAEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1104918754,SCOTLAND MEMORIAL HOSPITAL INC,~,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1154736437,"KELLEY, THOMAS, MICHAEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154736437,"KELLEY, THOMAS, MICHAEL",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972513679,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - WOUND HEALING SER,853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154737294,"BROWN, MEGAN, LYNNE",853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730154857,PEDIATRIC PARTNERS PA,~,5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154737468,"HAYES, KELLY, BLANCHARD",5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 26 , 42 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154738326,"DAWLEY, TROY, CALE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 45 , 73 , 95 ,$#,,
MEDICAID DIRECT,1154739563,EYECARECENTER OD PA,EYECARE CENTER,190 INDEPENDENCE AVE STE A NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1154739563,EYECARECENTER OD PA,190 INDEPENDENCE AVE STE A NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,, 49 , 49 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154740421,"CAMPBELL, ROBERT, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 82 , 88 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1154749174,"RYU, JOHN, LEE",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 49 , 52 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1154751881,"NEWTON, REGINA, MARIE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154754679,"MAY, JESSICA, ANASTASIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154755726,"KALKHOF, COURTNEY, HINSON",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154755726,"KALKHOF, COURTNEY, HINSON",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154757748,WALGREEN CO,WALGREENS 16136,1006 MONROE ST   CARTHAGE NC,063,Moore,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1154757748,WALGREEN CO,1006 MONROE ST   CARTHAGE NC,063,Moore,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1154758670,"HERRING, AGEN, JAMAR",HERRING EYE ASSOCIATES,1525 BENVENUE RD   ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,,1154758670,"HERRING, AGEN, JAMAR",1525 BENVENUE RD   ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,, 60 , 65 , 92 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154760114,"CABANAS, CENSON LEMUEL, LIZARONDO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 46 , 46 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1154764025,"SCHIRNER, JENNIFER, ANN",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154765113,"WELLS, ADAM, HAYNSWORTH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 41 , 102 , 117 ," $13,649.78 ",,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154765113,"WELLS, ADAM, HAYNSWORTH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 17 , 28 , 28 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154765279,"WERBLOW, RYAN, JAMES",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154765279,"WERBLOW, RYAN, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154765345,"JOHNSON, KAROLINE, REGINA",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 105 , 269 , 269 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154768018,"JONES, JENNIFER, FAYE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154768018,"JONES, JENNIFER, FAYE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154769792,"COLE, ELIZABETH, KOCH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154772150,"PRASKALA, SOPHIA, MARGARETA",9200 GLENWATER DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154772150,"PRASKALA, SOPHIA, MARGARETA",9200 GLENWATER DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 101 , 101 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154772150,"PRASKALA, SOPHIA, MARGARETA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154772150,"PRASKALA, SOPHIA, MARGARETA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 91 , 91 ,$#,,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154772366,"WHITMIRE, DAWN, WILSON",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154772366,"WHITMIRE, DAWN, WILSON",1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1720794944,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE PHYSICIANS WELLNESS,104 POMONA DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154772366,"WHITMIRE, DAWN, WILSON",1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 45 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154772366,"WHITMIRE, DAWN, WILSON",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154775468,"SPENCER, LUKE, DANIEL",3020 BONBROOK DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 114 , 153 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,3020 BONBROOK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154775468,"SPENCER, LUKE, DANIEL",3020 BONBROOK DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154775559,"HASSANI, SARA",2301 ERWIN RD   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154775559,"HASSANI, SARA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1154775666,"MIUCIN, ALEKSANDRA, NICOLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154778769,"SMITH, ISAAC, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154778769,"SMITH, ISAAC, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154778769,"SMITH, ISAAC, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 51 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154778769,"SMITH, ISAAC, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 38 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154779304,"SHAH, ANKEET",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154779304,"SHAH, ANKEET",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154779304,"SHAH, ANKEET",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154779304,"SHAH, ANKEET",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1154779353,WAL-MART STORES EAST LP,WALMART PHARMACY 10-6958,2800 NC HIGHWAY 24-87   CAMERON NC,043,Harnett,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1154779353,WAL-MART STORES EAST LP,2800 NC HIGHWAY 24-87   CAMERON NC,043,Harnett,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1265011373,SITZMANN CHIROPRACTIC PLLC,SITZMANN CHIROPRACTIC,1607 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1154781912,"SITZMANN, DANIEL, ROBERT",1607 E MAIN ST   LINCOLNTON NC,055,Lincoln,111N00000X,Chiropractic Providers,Chiropractor,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 49 , 62 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 25 , 26 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 45 , 51 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 29 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154784122,"COVELL, BENJAMIN, BLAIR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154784536,"MCKEE, DAVID, GENE",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154784536,"MCKEE, DAVID, GENE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154784759,"UGOWE, FRANCIS, EFOSA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154785152,"TAYLOR, NICHOLAS",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1154785152,"TAYLOR, NICHOLAS",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 14 , 21 , 44 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1154785152,"TAYLOR, NICHOLAS",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154785939,"CLAY, GWENDOLYN, MARY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology, 16 , 19 , 23 ,$#,,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1154788347,"GAGLIO, DANIELLE, NICOLE",2359 HIGHWAY 105   BOONE NC,095,Watauga,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154789170,"DENNY, EMMA, BARE",380 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154792000,EAST CAROLINA REHAB & WELLNESS LLC,,2575 W 5TH ST   GREENVILLE NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1154792000,EAST CAROLINA REHAB & WELLNESS LLC,2575 W 5TH ST   GREENVILLE NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 950 , 950 ," $171,153.64 ",,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154795227,"DECKER, KRISTOPHER, WYATT",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1154795227,"DECKER, KRISTOPHER, WYATT",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1154795227,"DECKER, KRISTOPHER, WYATT",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 21 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2575 W 5TH ST   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1154803872,"JOHNSON, TERESA, MARIE",2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154804359,"PORRAS, CINDY, CAROLINA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154804359,"PORRAS, CINDY, CAROLINA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1154804623,"COFFIN, MATTHEW, CHARLES",10 AVIEMORE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 82 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154804722,"MITCHELL, JOSHUA, THOMAS",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154805448,"SUTTON, SHAVEGAS, ROBINSON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 42 , 114 , 114 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154805919,"MCCLANAHAN, KYRA, ANN",6161 LAKE BRANDT RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 60 , 99 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154806719,"MILLS, SHNESE, EVELYN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932729688,OBRIEN AND WEST DMD IX PLLC,NIGHT AND DAY DENTAL,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154807394,"LEMUS, VALERIE, GHISLAINE",40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1932729688,OBRIEN AND WEST DMD IX PLLC,NIGHT AND DAY DENTAL,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154807394,"LEMUS, VALERIE, GHISLAINE",40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,122300000X,Dental Providers,Dentist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154808707,"TALLY, ZACHARY, SHAD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1154810018,"METZGER, GREGORY, SCOTT",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 87 , 95 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154810380,"WONG, NATALIE, ZHEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154810380,"WONG, NATALIE, ZHEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154810380,"WONG, NATALIE, ZHEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154811545,"HINDS, MEREDITH, BRADLEE",604 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 12 , 17 , 42 ,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154811693,"PATTERSON, KIMBERELY, SHANNEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 50 , 78 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154812071,"DIKO, SINDI",505 OBERLIN RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154813681,QUEEN CITY THERAPY PLLC,LITTLE WONDERS PEDIATRIC THERAPY,5113 PIPER STATION DR STE 103 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154813681,QUEEN CITY THERAPY PLLC,5113 PIPER STATION DR STE 103 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 47 , 430 , 543 ," $38,482.26 ",,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1154813764,"SUNDLIE, SHANE, MEGAN",403 FAIRVIEW ST   CLINTON NC,082,Sampson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 103 , 236 ," $12,008.43 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154814572,"KOCHER, MEREDITH, WAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 35 , 35 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154815728,"PATEL, SUNNY, CHANDRAKANT",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154816312,"DURHAM, JANEL, REBECCA",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 53 , 92 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154816312,"DURHAM, JANEL, REBECCA",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154816312,"DURHAM, JANEL, REBECCA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154816312,"DURHAM, JANEL, REBECCA",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154819027,"GRAHAM, CHERE, ELIZABETH",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154819027,"GRAHAM, CHERE, ELIZABETH",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 78 , 124 , 136 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154819290,"LI, CHAO",10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154819290,"LI, CHAO",10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 52 , 63 , 103 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154819290,"LI, CHAO",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 62 , 90 , 118 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154819878,"KIM, JISOO",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154819878,"KIM, JISOO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154819878,"KIM, JISOO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 35 , 37 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1154820702,"ERNEST, DANIEL, JOSEPH",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 105 , 131 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1154820702,"ERNEST, DANIEL, JOSEPH",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 85 , 91 , 109 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154822468,"WELCH, KATELYN, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 58 , 60 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1154824498,"AMOS, SAMANTHA, ELIZABETH",665 S MAIN ST   SPARTA NC,003,Alleghany,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1154824498,"AMOS, SAMANTHA, ELIZABETH",665 S MAIN ST   SPARTA NC,003,Alleghany,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1154824498,"AMOS, SAMANTHA, ELIZABETH",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154824977,"EASTERDAY, PRESTON, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154826717,"HODGES, JACQUELINE, CELESTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154826717,"HODGES, JACQUELINE, CELESTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154826717,"HODGES, JACQUELINE, CELESTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154828895,"CHOKSI, VINAY, PANKAJ",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 131 , 132 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154828895,"CHOKSI, VINAY, PANKAJ",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 43 , 45 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154828895,"CHOKSI, VINAY, PANKAJ",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1154832020,"BOOKER, WENDY",420 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 52 , 59 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154834513,"DAVIS, CELESTE, WATTS",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 113 , 312 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154834513,"DAVIS, CELESTE, WATTS",101 E WT HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154839744,"DRAYTON, LAUREL, LYNNETTE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 53 , 53 ,$#,,
MEDICAID DIRECT,1154844694,CAROLINA PHYSICAL THERAPY ASSOCIATE,CAROLINA PHYSICAL THERAPY ASSOCIATES - CLAYTON,7277 NC HIGHWAY 42 STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154844694,CAROLINA PHYSICAL THERAPY ASSOCIATE,7277 NC HIGHWAY 42 STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154845279,"ELLISON, ANGELA, ELIZABETH",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154845279,"ELLISON, ANGELA, ELIZABETH",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154846343,TOGETHER WE CAN HOME CARE LLC,,600C COUNTRY CLUB DR   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1154846343,TOGETHER WE CAN HOME CARE LLC,600C COUNTRY CLUB DR   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 51 ," 8,611 "," 8,752 "," $756,141.44 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,707 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154846566,"BRADLEY, PAMELA, DENISE",707 N ELM ST   HIGH POINT NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 57 , 313 , 313 ," $12,919.80 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154846566,"BRADLEY, PAMELA, DENISE",2806 RANDLEMAN RD STE J GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,707 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154846566,"BRADLEY, PAMELA, DENISE",2806 RANDLEMAN RD STE J GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 31 , 31 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154846566,"BRADLEY, PAMELA, DENISE",877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 62 , 62 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1154846566,"BRADLEY, PAMELA, DENISE",877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1609598424,MAGNOLIA HEALTHCARE & AESTHETICS,,34 OLEANDER DR STE 107 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1154846608,"POUNDS, TONYA, ANNETTE",34 OLEANDER DR STE 107 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 45 , 63 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154849107,"JOYNER, JENNIFER, CASHION",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 21 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154849107,"JOYNER, JENNIFER, CASHION",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154849719,"BEHNKE, SCHUYLER, KARL",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154849719,"BEHNKE, SCHUYLER, KARL",125 CHATHAM ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154849719,"BEHNKE, SCHUYLER, KARL",125 CHATHAM ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154849719,"BEHNKE, SCHUYLER, KARL",125 CHATHAM ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1154849719,"BEHNKE, SCHUYLER, KARL",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154849719,"BEHNKE, SCHUYLER, KARL",10211 ALM ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 31 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1154850501,"FARBER, ERIN, EILEEN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 42 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154851079,"BARNES, JASON, HAWES",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 61 , 97 , 125 ,$#,,
MEDICAID DIRECT,1518549393,IREDELL PHYSICIAN NETWORK,IREDELL SURGERY AT MOORESVILLE,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1154851079,"BARNES, JASON, HAWES",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1154851079,"BARNES, JASON, HAWES",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154851079,"BARNES, JASON, HAWES",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154852465,"EHASZ, HANNAH, HUGHES",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154852465,"EHASZ, HANNAH, HUGHES",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 22 , 24 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154852606,"BARTON, SUNJAY, MAX",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154852606,"BARTON, SUNJAY, MAX",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 40 , 56 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154852606,"BARTON, SUNJAY, MAX",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154852606,"BARTON, SUNJAY, MAX",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 69 , 327 , 440 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1154852606,"BARTON, SUNJAY, MAX",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 40 , 145 , 168 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1154852606,"BARTON, SUNJAY, MAX",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154852606,"BARTON, SUNJAY, MAX",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154854990,"WELDY, ERIC, WARD",195 KIMEL PARK DRIVE STE 100 WINSTON-SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 17 , 17 , 32 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154854990,"WELDY, ERIC, WARD",195 KIMEL PARK DRIVE STE 100 WINSTON-SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,,,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154854990,"WELDY, ERIC, WARD",195 KIMEL PARK DRIVE STE 100 WINSTON-SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 34 , 73 , 135 ," $17,387.83 ",,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154854990,"WELDY, ERIC, WARD",195 KIMEL PARK DRIVE STE 100 WINSTON-SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1154854990,"WELDY, ERIC, WARD",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154854990,"WELDY, ERIC, WARD",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 17 , 34 , 89 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1154854990,"WELDY, ERIC, WARD",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 47 , 89 , 151 ," $26,085.43 ",,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1154855799,"SECHLER, MATTHEW, SCOTT",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 65 , 67 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1154856466,"PUCKETT, KIM, JEFFERY",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154856466,"PUCKETT, KIM, JEFFERY",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154856573,"NORVILLE, LESELLE, ANDREA",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 48 , 55 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154856573,"NORVILLE, LESELLE, ANDREA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154856573,"NORVILLE, LESELLE, ANDREA",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154856573,"NORVILLE, LESELLE, ANDREA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154856573,"NORVILLE, LESELLE, ANDREA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 306 , 335 , 437 ," $11,575.77 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154856573,"NORVILLE, LESELLE, ANDREA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154856573,"NORVILLE, LESELLE, ANDREA",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154856599,"DEANS, ELIZABETH, COTTON",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 109 , 107 , 142 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154856599,"DEANS, ELIZABETH, COTTON",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 53 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154856599,"DEANS, ELIZABETH, COTTON",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 21 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154856920,"MOORE, MICHAEL, ALBRECHT",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154856920,"MOORE, MICHAEL, ALBRECHT",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 107 , 206 , 295 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1154857274,"KRISSEL, JOSEPH, MICHAEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 52 , 56 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154857274,"KRISSEL, JOSEPH, MICHAEL",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154857597,"SINGLEY, PATRICK, MARCUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 26 ,$#,,
MEDICAID DIRECT,1437520392,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST STE B MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1154857985,"GILMORE, STACIE, LAUREN",183 LEDFORD ST STE A&B MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 72 , 175 , 175 ," $14,357.79 ",,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1154857985,"GILMORE, STACIE, LAUREN",183 LEDFORD ST STE A&B MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1154857985,"GILMORE, STACIE, LAUREN",146 HWY 64 E   HAYESVILLE NC,022,Clay,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1154857985,"GILMORE, STACIE, LAUREN",183 LEDFORD ST STE A&B MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 62 , 62 ," $24,552.00 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154858413,"EARNEST, MARSHAL, DYLAN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 239 , 285 , 756 ," $40,981.62 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154858413,"EARNEST, MARSHAL, DYLAN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 54 , 54 , 155 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1154858413,"EARNEST, MARSHAL, DYLAN",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 108 , 123 , 281 ," $13,369.64 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154858413,"EARNEST, MARSHAL, DYLAN",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154858959,"QUIST, MICHAEL, SENA",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 14 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2000 REGENCY PKWY   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154858959,"QUIST, MICHAEL, SENA",2000 REGENCY PKWY   CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 16 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154858959,"QUIST, MICHAEL, SENA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 33 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154858959,"QUIST, MICHAEL, SENA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1154859429,"VILLEGAS KASTNER, MARIA, ISABEL",1301 CENTRAL DR   SANFORD NC,053,Lee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 27 , 41 , 78 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1154859429,"VILLEGAS KASTNER, MARIA, ISABEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154859429,"VILLEGAS KASTNER, MARIA, ISABEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154859429,"VILLEGAS KASTNER, MARIA, ISABEL",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 83 , 85 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154859429,"VILLEGAS KASTNER, MARIA, ISABEL",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154860443,"FLETCHER, LAURYN, MCCURRY",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154860443,"FLETCHER, LAURYN, MCCURRY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 618 , 641 ," 2,350 "," $65,597.01 ",,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1093064958,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - RALEIGH FA,4400 FALLS OF NEUSE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497834642,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SELMA,1111 S POLLOCK ST   SELMA NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 18 , 115 ,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497834642,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SELMA,1111 S POLLOCK ST   SELMA NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 168 , 179 , 649 ," $21,688.00 ",,
MEDICAID DIRECT,1174067813,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - MEBANE,1931 S NC HIGHWAY 119   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 49 , 56 , 200 ,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 55 , 232 ,$#,,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 71 , 71 , 284 ,$#,,
MEDICAID DIRECT,1093064958,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - RALEIGH FA,4400 FALLS OF NEUSE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881165876,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- RAEFORD,6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 46 ,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1154863223,"ANDERSON, ALTON, RAY",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 40 , 138 ,$#,,
MEDICAID DIRECT,1154864890,TOUCHPOINT HEALTHCARE SERVICES INC,TOUCHPOINT HEALTHCARE - MONROE,110 MATTHEWS STATION ST STE 2E MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1154864890,TOUCHPOINT HEALTHCARE SERVICES INC,110 MATTHEWS STATION ST STE 2E MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 93 ," 21,584 "," 21,782 "," $1,552,419.08 ",,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154872927,"CAPODICASA, SYDNEY, MARIE",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154872927,"CAPODICASA, SYDNEY, MARIE",200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154872927,"CAPODICASA, SYDNEY, MARIE",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154872927,"CAPODICASA, SYDNEY, MARIE",200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154873164,"SHOVLIN, THERESA, ANNE",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 43 , 617 , 619 ," $42,831.62 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154873164,"SHOVLIN, THERESA, ANNE",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 45 , 345 , 347 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154873164,"SHOVLIN, THERESA, ANNE",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154873164,"SHOVLIN, THERESA, ANNE",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 31 , 95 , 95 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154873164,"SHOVLIN, THERESA, ANNE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154873164,"SHOVLIN, THERESA, ANNE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1555 WILLIS AVE   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154873164,"SHOVLIN, THERESA, ANNE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1073940433,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY INPATIENT CARE,600 HOSPITAL DR STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1154877405,"PALA, VARUN KUMAR",600 HOSPITAL DR   MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154877405,"PALA, VARUN KUMAR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1073940433,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY INPATIENT CARE,600 HOSPITAL DR STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1154877405,"PALA, VARUN KUMAR",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1154877405,"PALA, VARUN KUMAR",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154877868,"ABUZUAITER, JULIANNE, KIESEL",2505B COURT DR   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154877868,"ABUZUAITER, JULIANNE, KIESEL",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#, 11 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154878205,"GRIFFITH, CHRISTINA, LEUNG",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154878205,"GRIFFITH, CHRISTINA, LEUNG",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1154878205,"GRIFFITH, CHRISTINA, LEUNG",1530 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1154880201,"FREEMAN, HANNA, BETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 169 , 169 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1154880201,"FREEMAN, HANNA, BETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 119 , 119 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1154881076,"RUTZ, ADAM, PAUL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1154881076,"RUTZ, ADAM, PAUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154881076,"RUTZ, ADAM, PAUL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 29 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154881076,"RUTZ, ADAM, PAUL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1154881076,"RUTZ, ADAM, PAUL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1154881076,"RUTZ, ADAM, PAUL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1154881076,"RUTZ, ADAM, PAUL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154881076,"RUTZ, ADAM, PAUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 39 , 45 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154881076,"RUTZ, ADAM, PAUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154881076,"RUTZ, ADAM, PAUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154881076,"RUTZ, ADAM, PAUL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154881076,"RUTZ, ADAM, PAUL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1154881076,"RUTZ, ADAM, PAUL",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154881241,"CHEN, AMALIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology, 29 , 36 , 62 ,$#,,
MEDICAID DIRECT,1558173708,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PODIATRY,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1154881506,"TENLEY, JONATHAN, DAVID",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 17 , 35 , 36 ,$#,,
MEDICAID DIRECT,1457514143,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1154881506,"TENLEY, JONATHAN, DAVID",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 24 , 48 , 52 ,$#,,
MEDICAID DIRECT,1760109862,MSP BOONE CLINIC PLLC,,610 STATE FARM RD STE C BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1154881506,"TENLEY, JONATHAN, DAVID",610 STATE FARM RD STE C BOONE NC,095,Watauga,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 34 , 65 , 73 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1154882165,"DEVANNEY, ERIN, KATHRYN",4711 S CROATAN HWY STE 6B NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 66 , 149 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,4711 S CROATAN HWY STE 6B NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1154882165,"DEVANNEY, ERIN, KATHRYN",4711 S CROATAN HWY STE 6B NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 42 , 76 ,$#,,
MEDICAID DIRECT,1700921988,EDWARD F SCAMMON DMD PA,~,8159 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1154882363,"REAUME, HOLLY, LYNN",8159 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 106 , 123 , 356 ," $15,157.02 ",,
MEDICAID DIRECT,1114247822,EDWARD F SCAMMON DMD PA,~,115 SOUTHERN DUNES DR   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1154882363,"REAUME, HOLLY, LYNN",115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 201 , 283 , 916 ," $52,194.78 ",,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1154882363,"REAUME, HOLLY, LYNN",104 SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 155 , 184 , 617 ," $24,331.10 ",,
MEDICAID DIRECT,1598085227,EDWARD F SCAMMON DMD PA,EDWARD F SCAMMON DMD PA,327 TEAL DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1154882363,"REAUME, HOLLY, LYNN",327 TEAL DR   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 254 , 328 ," 1,062 "," $57,370.55 ",,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1154882363,"REAUME, HOLLY, LYNN",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice, 68 , 99 , 296 ," $15,409.47 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154884104,"PATEL, KUNJAN, BHARATBHAI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154884104,"PATEL, KUNJAN, BHARATBHAI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 52 , 85 , 142 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154884104,"PATEL, KUNJAN, BHARATBHAI",1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154887321,"BERNAL, GAIL, ANGELA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154889350,"EMERSON, CATHERINE, MARY",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1154889350,"EMERSON, CATHERINE, MARY",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265909980,KINSTON REGIONAL PAIN CENTER PLLC,,2100 PRESBYTERIAN LN   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1154889830,"STANDLEY, KERRY, TIMMINS",2100 PRESBYTERIAN LN   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 110 , 229 , 232 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154889996,"ELLIS, CHAD, WILLIAM",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154889996,"ELLIS, CHAD, WILLIAM",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154889996,"ELLIS, CHAD, WILLIAM",9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 17 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154889996,"ELLIS, CHAD, WILLIAM",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154890234,"JOHNSTON, MEGAN, BOST",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154890234,"JOHNSTON, MEGAN, BOST",911 W HENDERSON ST STE 120 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 68 , 69 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154890234,"JOHNSTON, MEGAN, BOST",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 72 , 74 ,$#,,
MEDICAID DIRECT,1861675357,HIGH ROCK INTERNAL MEDICINE PA,~,104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1154890838,"BRYANT, MATTHEW",104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 406 , 775 ,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154891646,"MEDELLIN, CATHLEEN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1154891646,"MEDELLIN, CATHLEEN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154895423,"MCKEEVER, JOHN, WAINWRIGHT",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 677 , 762 ," $18,928.48 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154895423,"MCKEEVER, JOHN, WAINWRIGHT",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 138 , 146 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154895829,"HOPKINS, HAYDEN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154895829,"HOPKINS, HAYDEN, MICHAEL",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154895829,"HOPKINS, HAYDEN, MICHAEL",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154895829,"HOPKINS, HAYDEN, MICHAEL",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1154895902,"STURM, MARTHA, SUSANNE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE B PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154900637,"CUMMINGS, KALEENA, SAMPSON",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154900637,"CUMMINGS, KALEENA, SAMPSON",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,217 W BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154900637,"CUMMINGS, KALEENA, SAMPSON",128 E BROAD ST   SAINT PAULS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154900637,"CUMMINGS, KALEENA, SAMPSON",302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 31 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE C PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1154900637,"CUMMINGS, KALEENA, SAMPSON",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 133 , 160 , 410 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1154901221,"ZELTZER, CAROL, ANN",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1750965257,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE KILDAIRE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154902377,"CHOPRA, AARUSHI",110 KILDAIRE PARK DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1154903623,PROFESSIONAL HOME CARE LLC,~,2216 W MEADOWVIEW RD STE 114 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1154903623,PROFESSIONAL HOME CARE LLC,2216 W MEADOWVIEW RD STE 114 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 23 ," 3,955 "," 4,037 "," $362,251.04 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1154906170,"CALCUTT, MATTHEW, AARON",960 NEWMAN RD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1427096528,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154908879,"EFSTATHIADES, JOHN, CHRISTOS",133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1154909042,AGAPE OUTREACH NETWORK LLC,,325 CLIFTON ST STE 4 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1154909042,AGAPE OUTREACH NETWORK LLC,325 CLIFTON ST STE 4 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 2,873 "," 2,873 "," $195,327.08 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154911519,"SMITH, ALLIE, STUGART",6301 STADIUM DR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 29 , 52 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154913010,"ANDERSON, BRYNLEE, PARKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 113 , 117 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154915510,"ELTZ, AMANDA, JOE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154915510,"ELTZ, AMANDA, JOE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154916930,"AGUILA, LAURA, CAROLINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154916930,"AGUILA, LAURA, CAROLINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154919488,"PARATHATTAL, PREETHA, KURIAS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 124 , 142 ," $13,596.61 ",,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154919488,"PARATHATTAL, PREETHA, KURIAS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154919488,"PARATHATTAL, PREETHA, KURIAS",212 S SALEM ST   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154919488,"PARATHATTAL, PREETHA, KURIAS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1154921641,"CORBETT, LINDSEY, TREXLER",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 52 , 69 , 82 ,$#,,
MEDICAID DIRECT,1477589158,EASTRIDGE FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE EASTRIDGE FAMILY MEDICI,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1154923795,"ADAMS, SHANA, NICOLE",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 84 , 140 ,$#,,
MEDICAID DIRECT,1114919206,SKYLAND PROSTHETICS AND ORTHOTICS I,SKYLAND PROSTHETICS AND ORTHOTICS INC,3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154927549,"WELTER, BENJAMIN",3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 54 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1154931657,"STAHL, KEVIN, ALBERT",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1659656916,CENTER FOR ORTHOTIC AND PROSTHETIC,HANGER CLINIC,4601 CREEKSTONE DR STE 112 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154933547,"ROGGOW, MARGARET, SPEARS",4702 CREEKSTONE DR   DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1710620935,PHARMING COMPANY,MATTHEWS DRUG STORE,408 NORTHEAST BLVD   CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1154936003,"HAMILTON, JACK, BRADLEY",408 NORTHEAST BLVD   CLINTON NC,082,Sampson,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#, 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154940427,"GROSS, ZACHARY, NORMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1154942035,"WAKEFIELD, BEAU, TIMOTHY",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 23 , 99 ,$#,,
MEDICAID DIRECT,1861274169,AFTER HOURS URGENT CARE CENTER PLLC,,9101 PINEVILLE MATTHEWS RD STE R PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154942035,"WAKEFIELD, BEAU, TIMOTHY",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1154944353,REYBOZE LLC,REYBOZE HOMECARE AGENCY,2860 FREEDOM DR STE B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1154944353,REYBOZE LLC,2860 FREEDOM DR STE B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 7,288 "," 7,292 "," $466,684.30 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154947141,"KAMARA, MEMU-IYE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154947141,"KAMARA, MEMU-IYE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 31 , 37 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1154949279,"MORROW, CRYSTAL, NICOLE",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 39 , 70 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1154949279,"MORROW, CRYSTAL, NICOLE",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 82 , 109 , 252 ,$#,,
MEDICAID DIRECT,1154950731,"COULTAS, RYAN, DOUGLAS",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1154950731,"COULTAS, RYAN, DOUGLAS",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154950863,"FESSEHA, MELLEY, ZERU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154950863,"FESSEHA, MELLEY, ZERU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 27 ,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",420 PARK ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1154951077,"CHANEY, RYAN, CHRISTOPHER",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154951770,TOTALLY CARED FOR LLC,~,111 WINDEL DR STE 217 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1154951770,TOTALLY CARED FOR LLC,111 WINDEL DR STE 217 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 54 ," 10,821 "," 11,072 "," $922,351.72 ",,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1154952182,"GENTRY, HILDA",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 137 , 155 , 187 ," $12,652.96 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1154952182,"GENTRY, HILDA",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1154952182,"GENTRY, HILDA",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154952182,"GENTRY, HILDA",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1154953495,LOVING HEARTS HOME CARE ONE LLC,LOVING HEARTS HOME CARE ONE,1914 J N PEASE PL STE 136 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1154953495,LOVING HEARTS HOME CARE ONE LLC,1914 J N PEASE PL STE 136 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 2,586 "," 2,621 "," $257,054.80 ",,
MEDICAID DIRECT,1154954097,OCTOBER ROAD INC,,119 TUNNEL RD STE E ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1154954097,OCTOBER ROAD INC,119 TUNNEL RD STE E ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154954998,"WARLICK, ALISSA, NICOLE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1154958056,"BABBITT, HOLLY, ELIZABETH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1063096345,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE GLENWOOD,6800 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154958353,"WILLIAMS, TYLER, DANIEL",6800 GLENWOOD AVE   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1548997893,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1154959211,"KABEMBA TSHITENGE, SARAH, KAPINGA",9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154959211,"KABEMBA TSHITENGE, SARAH, KAPINGA",1223 SPRUCE ST   BELMONT NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 23 ,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154959211,"KABEMBA TSHITENGE, SARAH, KAPINGA",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 36 , 73 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1154959211,"KABEMBA TSHITENGE, SARAH, KAPINGA",600 W TRADE ST STE B DALLAS NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 40 , 77 ,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1154959211,"KABEMBA TSHITENGE, SARAH, KAPINGA",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 21 , 49 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1154959211,"KABEMBA TSHITENGE, SARAH, KAPINGA",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1154959419,"ROBERTS, KAY, ARALYN KUANG",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154959914,"DELOSO, ERIC, PHILLIP",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154959914,"DELOSO, ERIC, PHILLIP",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154959914,"DELOSO, ERIC, PHILLIP",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154959914,"DELOSO, ERIC, PHILLIP",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154963833,"SEQUEIRA, VIVIA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#, 13 ,$#,,
MEDICAID DIRECT,1154964914,ROSALIND CURRENCE BLAND,ABUNDANT LOVE HOME CARE SERVICES,260 1ST AVE NW STE 218 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1154964914,ROSALIND CURRENCE BLAND,260 1ST AVE NW STE 218 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,#, 577 , 582 ," $35,390.48 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154969319,"JOHNSON, SHEILA, SIMONE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154969319,"JOHNSON, SHEILA, SIMONE",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154972461,"BRALEY, NOELLE, CHRISTINE",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154972461,"BRALEY, NOELLE, CHRISTINE",3444 S CONTENTNEA ST   FARMVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154972461,"BRALEY, NOELLE, CHRISTINE",300 BETHESDA DR   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 20 , 24 , 48 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1154973113,"OLES, JILL, MARIE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154973717,"KERR, SARAH, TAYLOR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093013351,PROPTNC LLC,RESOLVE PHYSICAL THERAPY AND REHABILITATION,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1154974434,"CAPRA, ALEXANDRA, PEPPER",112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1154975795,"THOMAS, JENNIFER, RENA",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 51 , 119 ,$#,,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154977916,"DAUGHTRY, KELLI, SAVANNA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1154977916,"DAUGHTRY, KELLI, SAVANNA",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 26 , 29 ,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1154979730,"GARZA, NOEMI",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1164710810,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 202 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1154979730,"GARZA, NOEMI",6602 KNIGHTDALE BLVD STE 202 KNIGHTDALE NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 46 , 88 , 144 ,$#,,
MEDICAID DIRECT,1346392248,EARL R CROUCH JR MD FACS PC,VIRGINIA PEDIATRIC EYE CENTER,4665 SOUTH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154980209,"KOHN, ADRIAN",4665 SOUTH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1154981496,"KING, KELLY, BRIANNE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1073816997,ARMC PHYSICIANS CARE INC,CORNERSTONE MEDICAL CENTER,1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1154982072,"ANDREWS, ELISABETH, KATHERINE",1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 112 , 186 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1154982072,"ANDREWS, ELISABETH, KATHERINE",1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 46 , 76 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1154982619,"TOEPFER, OLIVIA, STEWART",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1154982619,"TOEPFER, OLIVIA, STEWART",4002 ELTON WAY STE 105 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 100 , 213 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154984318,"D'ANGELO, THOMAS, JOSEPH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154984318,"D'ANGELO, THOMAS, JOSEPH",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154984318,"D'ANGELO, THOMAS, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1154985125,"BOYLES, GLENN, PATRICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1154985182,"WADE, MICHAEL, DENNIS",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1154986347,CENTER FOR VISUAL SURGICAL EXCELLEN,,208 CARMICHAEL WAY   CHESAPEAKE VA,101,Out of State <= 40 miles,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1154986347,CENTER FOR VISUAL SURGICAL EXCELLEN,208 CARMICHAEL WAY   CHESAPEAKE VA,101,Out of State <= 40 miles,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 49 , 73 , 76 ,$#,,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1154989879,"CURRENT, JONATHAN, LUKE",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 12 , 27 ,$#,,
MEDICAID DIRECT,1295294122,J CHANCE POWELL DDS PA,,373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1154989879,"CURRENT, JONATHAN, LUKE",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,286 "," 2,012 "," 9,184 "," $515,787.50 ",,
MEDICAID DIRECT,1053742205,MJ MAYHEW PA,,1922 W PARK DR   N WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1154989879,"CURRENT, JONATHAN, LUKE",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 103 , 116 , 373 ," $14,776.54 ",,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1154989879,"CURRENT, JONATHAN, LUKE",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 36 , 41 , 112 ,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154990471,"KAUR, GENES",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 19 , 37 ,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1154990471,"KAUR, GENES",702 N MAIN ST   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice, 243 , 383 , 839 ," $45,123.62 ",,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154990471,"KAUR, GENES",702 N MAIN ST   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1194899542,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1154990471,"KAUR, GENES",702 N MAIN ST   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice, 655 ," 1,112 "," 2,812 "," $148,303.13 ",,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1154991511,"MANGINI, MARISSA, GABRIELLA",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 14 , 39 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1154991511,"MANGINI, MARISSA, GABRIELLA",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 62 , 162 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1154991560,"LENNON, ZACHARY, YATES",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154991560,"LENNON, ZACHARY, YATES",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1154991917,"LATTIMORE, PAMELA, BARD",5311 N ROXBORO RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1154991917,"LATTIMORE, PAMELA, BARD",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 58 , 75 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1154991958,"IASIELLO, KATELYN, ANN",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1154991958,"IASIELLO, KATELYN, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154991958,"IASIELLO, KATELYN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1154991958,"IASIELLO, KATELYN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1154992337,"LAHR, MADISON, BLACKWELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 129 , 192 , 297 ,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1154993905,"AL-DABBAGH, ALAA, HAYMAN ABDULFATTAH",6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1154996221,"GRANADERO, COURTNEY, HALDEMAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154997120,GEMS FIRST STOP MEDICAL SOLUTIONS,FIRST STOP MEDICAL SOLUTIONS,5807 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,1154997120,GEMS FIRST STOP MEDICAL SOLUTIONS,5807 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,, 74 , 201 , 202 ," $27,204.65 ",,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164001301,"WEISGERBER, WILLIAM, BRIAN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 21 , 22 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164001301,"WEISGERBER, WILLIAM, BRIAN",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164001301,"WEISGERBER, WILLIAM, BRIAN",187 W MAIN ST   SPINDALE NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 82 , 96 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164004974,"MEEHAN, DAVID, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164004974,"MEEHAN, DAVID, PATRICK",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1164005385,AGAPE ORTHOTICS OF NC,,2139 VALLEYGATE DR STE 101A FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164005385,AGAPE ORTHOTICS OF NC,2139 VALLEYGATE DR STE 101A FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 15 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164009445,"MUNSCHAUER, MATTHEW, EDWARD",104 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 17 , 42 ,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164009585,"DE LA GUERRA, JUSTIN, ANDREW",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 132 , 287 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164011359,"HILDERBRAN, STEPHANIE, NICOLE",107 N SUMMEY ST   DALLAS NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164011359,"HILDERBRAN, STEPHANIE, NICOLE",107 N SUMMEY ST   DALLAS NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 27 , 65 , 65 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164015871,"FAY, JENNIFER, RAELYN",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 35 , 59 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1164015871,"FAY, JENNIFER, RAELYN",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 62 , 99 ,$#,,
MEDICAID DIRECT,1578747077,COMPREHENSIVE REHAB AND PAIN SPECIA,COMPREHENSIVE REHAB AND PAIN SPECIALIST,135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1164020392,"ALLEN, SAREE, NICOLE",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 109 , 361 , 536 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1164020392,"ALLEN, SAREE, NICOLE",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164027355,"BROWN, PAUL, BRYSON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164028908,HOME1ST,CAREHOME1ST LLC,4952 MCALPINE LN   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1164028908,HOME1ST,4952 MCALPINE LN   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 538 , 539 ," $37,481.52 ",,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,145 W PLAZA DR STE K WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1164031720,"ZEBULSKE, MORGAN, LOCKLEAR",145 W PLAZA DR STE K SEVEN LAKES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1164031720,"ZEBULSKE, MORGAN, LOCKLEAR",145 W PLAZA DR STE K SEVEN LAKES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 28 , 37 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1164031720,"ZEBULSKE, MORGAN, LOCKLEAR",530 NEW WAVERLY PL STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1164031720,"ZEBULSKE, MORGAN, LOCKLEAR",530 NEW WAVERLY PL STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1164031720,"ZEBULSKE, MORGAN, LOCKLEAR",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 22 , 27 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1164031720,"ZEBULSKE, MORGAN, LOCKLEAR",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 27 ,$#,,
MEDICAID DIRECT,1982071114,ABRAMS BARROWS COHEN & ASSOCIATES P,,160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164034369,"VIRDI, RENU, KAPOOR",518 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,711 "," 3,237 "," 12,484 "," $679,303.71 ",,
MEDICAID DIRECT,1891869780,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS EAST INC,2219 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164035952,"NUTTER, DREW, LEWIS",2219 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1770142390,KENNEY ORTHOPEDICS OF MONROE LLC,KENNEY ORTHOPEDICS OF CHARLOTTE,3816 LATROBE DR STE 103 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164035952,"NUTTER, DREW, LEWIS",3816 LATROBE DR STE 103 CHARLOTTE NC,060,Mecklenburg,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1891869780,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS EAST INC,2219 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164035952,"NUTTER, DREW, LEWIS",2219 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1164036752,TRAYNELL HOME CARE LLC,,305 S COLUMBIA ST   GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1164036752,TRAYNELL HOME CARE LLC,305 S COLUMBIA ST   GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,103 "," 2,195 "," $267,502.58 ",,
MEDICAID DIRECT,1164039913,QUEEN CITY HOME CARE LLC,QUEEN CITY HOME CARE LLC,1220 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1164039913,QUEEN CITY HOME CARE LLC,1220 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 502 , 528 ," $49,777.92 ",,
MEDICAID DIRECT,1205868080,DONALD R FORTNER JR DMD PA,DONALD R FORTNER JR DMD PA,1834 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1164042008,"BROWN, TYLER, JEFFREY",1834 JAKE ALEXANDER BLVD W 504 SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1205868080,DONALD R FORTNER JR DMD PA,DONALD R FORTNER JR DMD PA,1834 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1164042008,"BROWN, TYLER, JEFFREY",1834 JAKE ALEXANDER BLVD W 504 SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 46 , 117 ,$#,,
MEDICAID DIRECT,1255688958,KIDZCARE PEDIATRICS PC,~,145 W MAIN ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1164042057,"HAMPSON, JAMES, THOMAS",145 W MAIN ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 11 , 34 ,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164042719,"WHITLEY, MAHALIA, ANICE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164042719,"WHITLEY, MAHALIA, ANICE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 178 , 211 ,$#,,
MEDICAID DIRECT,1336299684,BLADEN EYE CENTER,BLADEN EYE CENTER,409 E BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1164044111,"SCHULTZ, KELSEY, E",818 PINE GROVE DR STE B WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1225188071,OMNI EYE SERVICES OD PA,OMNI EYE SPECIALISTS,818B PINE GROVE DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1164044111,"SCHULTZ, KELSEY, E",818 PINE GROVE DR STE B WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164044327,"CANAAN, JESSICA, RAPPE",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700104775,BURGAW MEDICAL CENTER PC,HAMPSTEAD FAMILY MEDICINE,306 S CAMPBELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1164044327,"CANAAN, JESSICA, RAPPE",306 S CAMPBELL ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1700104775,BURGAW MEDICAL CENTER PC,HAMPSTEAD FAMILY MEDICINE,25 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1164044327,"CANAAN, JESSICA, RAPPE",25 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 18 , 31 ,$#,,
MEDICAID DIRECT,1164046504,SOLUTIONS FOR PERSONAL CARE SERVICE,,101 SUTTON DR   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,1164046504,SOLUTIONS FOR PERSONAL CARE SERVICE,101 SUTTON DR   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,#, 51 , 51 ,$#,,
MEDICAID DIRECT,1285644500,NEW CENTURY OPHTHALMOLOGY PC,~,1610 WILLIAMSBORO ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1164047122,"PRABAKARAN, SAMANTHA, RENAE",1610 WILLIAMSBORO ST   OXFORD NC,039,Granville,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 16 , 39 ,$#,,
MEDICAID DIRECT,1285644500,NEW CENTURY OPHTHALMOLOGY PC,~,1610 WILLIAMSBORO ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1164047122,"PRABAKARAN, SAMANTHA, RENAE",7901 ACC BLVD STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",225 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",941 JOHNSON RIDGE RD   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",941 JOHNSON RIDGE RD   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",140 MOORE RD   KING NC,085,Stokes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",500 W HANES MILL RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",120 MILLER ST   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",10 LAURA LN   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003407586,QUICK DOC PARTNERS LLC,,3734 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164048385,"ALFORD, JASON, SCOTT",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",120 MILLER ST   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164048385,"ALFORD, JASON, SCOTT",10 LAURA LN   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 123 , 123 ,$#,,
MEDICAID DIRECT,1598584781,AMAN MASOOMI DDS PLLC,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1164048625,"MASOOMI, AMAN",3823 GUESS RD STE P DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 829 ," 1,096 "," 3,916 "," $186,293.48 ",,
MEDICAID DIRECT,1164048625,"MASOOMI, AMAN",,3823 GUESS RD STE P DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1164048625,"MASOOMI, AMAN",3823 GUESS RD STE P DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164049821,"PIPLANI, CHHAVI",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 623 , 936 ," 2,911 "," $135,474.63 ",,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164049821,"PIPLANI, CHHAVI",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164049821,"PIPLANI, CHHAVI",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 37 , 152 ,$#,,
MEDICAID DIRECT,1629122528,LANE & ASSOCIATES XIV DDS PA,LANE & ASSOCIATES XIV DDS PA,1200 BROAD ST STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164049821,"PIPLANI, CHHAVI",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 262 , 404 ," 1,171 "," $60,233.95 ",,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164050373,"SHEA, MICHAEL, JAMES",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 54 , 54 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164050506,"AMEEN, ROMESA, BINT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164050589,"MCCAIN, ELIZABETH, LYN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164050589,"MCCAIN, ELIZABETH, LYN",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1437754330,MILESTONES PEDIATRIC & MATERNAL NUT,,417 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164053559,"LETT, KERRY, MARIE",417 KILDAIRE FARM RD   CARY NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1164054730,"SPENCER, SARAH, ELIZABETH",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1164054730,"SPENCER, SARAH, ELIZABETH",3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164054730,"SPENCER, SARAH, ELIZABETH",3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 26 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164054730,"SPENCER, SARAH, ELIZABETH",3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 57 , 77 ,$#,,
MEDICAID DIRECT,1710388772,SCHUSTER PHYSICAL THERAPY INC,,1433 US HIGHWAY 21 S   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1164056511,"NAIL, CODY, SCOTT",419 E MAIN ST   JEFFERSON NC,005,Ashe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1710388772,SCHUSTER PHYSICAL THERAPY INC,,419 E MAIN ST UNIT 4 JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1164056511,"NAIL, CODY, SCOTT",419 E MAIN ST   JEFFERSON NC,005,Ashe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164056537,"LUCERO, JESSICA, COLBURN",965 STATE FARM RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 22 , 24 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164056537,"LUCERO, JESSICA, COLBURN",336 DEERFIELD RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 59 , 64 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164057857,"WILSON, BRANDI, BRIGGS",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 67 , 83 ,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164057857,"WILSON, BRANDI, BRIGGS",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 41 , 58 ,$#,,
MEDICAID DIRECT,1811964729,HOT SPRINGS HEALTH PROGRAM,LAUREL MEDICAL CENTER,80 GUNTERTOWN RD   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164057857,"WILSON, BRANDI, BRIGGS",80 GUNTERTOWN RD   MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 26 , 32 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164059184,"ADONNINO, ERIN, SHERIDAN",4320 HENSON DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 45 , 87 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164059184,"ADONNINO, ERIN, SHERIDAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164059481,"PATEL, BHAVI, NAILESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164061313,JADES-NISSI HOME CARE LLC,JADES NISSI HOME CARE,5710 SIX FORKS RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1164061313,JADES-NISSI HOME CARE LLC,5710 SIX FORKS RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 4,191 "," 4,245 "," $334,487.93 ",,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1164061404,"REECE, CHRISTOPHER, RYAN",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1164061404,"REECE, CHRISTOPHER, RYAN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1164061404,"REECE, CHRISTOPHER, RYAN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 32 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1164061404,"REECE, CHRISTOPHER, RYAN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164062352,"CHELOHA, SARA, KATHRYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1164066197,CARE FINITY HOME CARE,~,4312 WAKE FOREST RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1164066197,CARE FINITY HOME CARE,4312 WAKE FOREST RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,798 "," 4,803 "," $443,759.45 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164066775,"SEXTON, KAELYN, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811761349,CAROMONT MEDICAL GROUP INC,CAROMONT HEALTH MATERNITY CLINIC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164066775,"SEXTON, KAELYN, NICOLE",991 W HUDSON BLVD STE 70B GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164066775,"SEXTON, KAELYN, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 129 , 162 , 162 ," $34,380.51 ",,
MEDICAID DIRECT,1811761349,CAROMONT MEDICAL GROUP INC,CAROMONT HEALTH MATERNITY CLINIC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164066775,"SEXTON, KAELYN, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164067815,"KING, MICHELLE, JUSTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164067815,"KING, MICHELLE, JUSTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750734307,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT COMMUNITY HEALTH PLAZ,1041 NOELL LN MEDICAL PLAZA B   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164069415,"VIERA, GLADYS, ELENA",1041 NOELL LN   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164069415,"VIERA, GLADYS, ELENA",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164069415,"VIERA, GLADYS, ELENA",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164070413,"PRAHL, EMILY, MARSHALL",4505 FAIR MEADOWS LN STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164072203,"KATIC, CHRISTIAN, VID",3116 N DUKE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 70 , 121 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164072203,"KATIC, CHRISTIAN, VID",4020 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164075461,"GUERRA, ERIKA, RAYA",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 122 , 305 , 341 ," $15,287.39 ",,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164075461,"GUERRA, ERIKA, RAYA",303 GREEN ST E   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 21 ,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1164079638,"OPSAHL, LAUREN, REIKO",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 171 , 187 , 632 ," $23,449.37 ",,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164079638,"OPSAHL, LAUREN, REIKO",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 496 , 700 ," 2,194 "," $101,821.78 ",,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164081295,"EICK, JULIA, RUTH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 63 , 79 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164084885,"GOMEZ ZERPA, ADRIANA, MILAGROS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164085247,"BEG, MIRZA, ADAM",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164085247,"BEG, MIRZA, ADAM",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164085247,"BEG, MIRZA, ADAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164085247,"BEG, MIRZA, ADAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 68 , 68 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164087094,"HENSON, BYEOL AH",4214 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,923 N 2ND ST STE 204 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1164088829,"SELLS, KATHERINE, DRY",202 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1164088829,"SELLS, KATHERINE, DRY",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,923 N 2ND ST STE 204 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1164088829,"SELLS, KATHERINE, DRY",923 N 2ND ST STE 204 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 137 , 162 , 163 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164090015,"FRANCIS, KATHLEEN, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 66 , 66 ,$#,,
MEDICAID DIRECT,1699867283,"HARDIN, ANNELISE, CECILE",ANNELISE CECILE HARDIN,1504 E FRANKLIN ST STE 101 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1164091294,"SOHN, SUNGMIN",3901 N ELM ST   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 13 ,$#,,
MEDICAID DIRECT,1124235205,MICHAEL A IGNELSI JR DDS PHD PA,LAKE JEANETTE ORTHO PED DENT,3901 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1164091294,"SOHN, SUNGMIN",3901 N ELM ST   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 15 , 15 , 54 ,$#,,
MEDICAID DIRECT,1366561888,ANNELISE HARDIN DDS MS PA,FRANKLIN STREET PEDIATRIC DENTISTRY,1504 E FRANKLIN STREET STE 101 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1164091294,"SOHN, SUNGMIN",3901 N ELM ST   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 174 , 200 , 717 ," $21,664.46 ",,
MEDICAID DIRECT,1366561888,ANNELISE HARDIN DDS MS PA,FRANKLIN STREET PEDIATRIC DENTISTRY,1504 E FRANKLIN STREET STE 101 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1164091294,"SOHN, SUNGMIN",1504 E FRANKLIN ST STE 101 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 130 , 143 , 518 ," $15,884.92 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164091732,"MILLER, SARAH, SHEPHERD",1919 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 228 , 563 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164092110,"LIN, ZI YANG",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164092110,"LIN, ZI YANG",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164092110,"LIN, ZI YANG",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164092110,"LIN, ZI YANG",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164092110,"LIN, ZI YANG",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164094306,"YOUNG, JENNIFER, HUNDLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164094306,"YOUNG, JENNIFER, HUNDLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164094454,"YOUNG, CRYSTAL, DAWN",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1164094934,"WRIGHT, BROOK, LYN",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 116 , 247 , 397 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164097424,"GALLAGHER, GABRIELLE, THERESE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 145 , 181 , 254 ," $10,780.91 ",,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164097440,"TABATABAI-YAZDI, NEELOUFAR",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164097572,"ONIFFREY, THERESA, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164098752,"COLE, LYDIA, JOBE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164100111,"PEARSON, HEATHER, DAWN",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 91 , 139 , 194 ,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1164108304,"FOX, MELINDA, SMITH",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 28 , 55 ," $10,667.11 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1164108304,"FOX, MELINDA, SMITH",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1164108304,"FOX, MELINDA, SMITH",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1164108304,"FOX, MELINDA, SMITH",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1164108304,"FOX, MELINDA, SMITH",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 37 , 37 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1164109187,"COOK, CODY, HUNTER",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1164109187,"COOK, CODY, HUNTER",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 26 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164111027,"MOTYKA, KURT, RYAN",4430 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164114831,"FROMHOLZ, EMMA, MARIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164114963,REHOBOTH HOMECARE SERVICES LLC,,5530 BAVERHOF DR   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1164114963,REHOBOTH HOMECARE SERVICES LLC,5530 BAVERHOF DR   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 37 , 54 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,121 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164120085,"LAUGHTER, ESTELLA",612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1605 FOUR SEASONS BLVD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1164120085,"LAUGHTER, ESTELLA",612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164120085,"LAUGHTER, ESTELLA",612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164121208,"MCINTYRE, GRACE, CLAIRE GILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164121208,"MCINTYRE, GRACE, CLAIRE GILLIAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164121208,"MCINTYRE, GRACE, CLAIRE GILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164121208,"MCINTYRE, GRACE, CLAIRE GILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164121208,"MCINTYRE, GRACE, CLAIRE GILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164121208,"MCINTYRE, GRACE, CLAIRE GILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164121208,"MCINTYRE, GRACE, CLAIRE GILLIAM",3434 EDWARDS MILL RD STE 112 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164122453,"SHARP, JESSICA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1356405005,PISGAH PHYSICAL THERAPY AND SPORTS,PISGAH PHYSICAL THERAPY AND SPORTS REHAB,1635 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1164122933,"MONTEITH, R., CLIFTON",1635 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1801561741,MEDIQ PHYSICAL THERAPY LLC,~,204 MATTHEWS DR   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1164125167,"RHYNER, ZACHARY, JAMES",204 MATTHEWS DR   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 34 ,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1164128534,"DELLA ROCCA, KATHERINE, REID",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1164128534,"DELLA ROCCA, KATHERINE, REID",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164128534,"DELLA ROCCA, KATHERINE, REID",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164128534,"DELLA ROCCA, KATHERINE, REID",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 22 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164128534,"DELLA ROCCA, KATHERINE, REID",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164128534,"DELLA ROCCA, KATHERINE, REID",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164128534,"DELLA ROCCA, KATHERINE, REID",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1164129946,"BOYLES, VICTORIA, KATHERINE",129 WOODSON ST   SALISBURY NC,080,Rowan,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164131280,"SHOAF, JOSHUA, SETH",703 N US 29 HWY   CHINA GROVE NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 16 , 150 , 200 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164131637,"BARROW, JARED, RANDALL",111 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164131637,"BARROW, JARED, RANDALL",111 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164131637,"BARROW, JARED, RANDALL",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164131637,"BARROW, JARED, RANDALL",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1164131637,"BARROW, JARED, RANDALL",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164131637,"BARROW, JARED, RANDALL",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 24 , 44 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164134151,"SWAIN, ELLERY, MCKINLEY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 43 , 43 , 43 ,$#,,
MEDICAID DIRECT,1164148128,CARE A LOT ADULT DAY CARE,,1753 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,1164148128,CARE A LOT ADULT DAY CARE,1753 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1164724100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE MINT HILL COMMONS FAMIL,11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164148466,"HOUCK, SELENA, ROSE",11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164148573,"CARR, ELIZABETH, DINKINS",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1821496753,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1164148573,"CARR, ELIZABETH, DINKINS",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003500109,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1164148573,"CARR, ELIZABETH, DINKINS",568 RUIN CREEK RD STE 1 HENDERSON NC,091,Vance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164149357,"HAMMEL, RACHAEL, ANN",3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 179 , 290 , 454 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164150314,"MURPHY, RYAN, SCOTT",13024 EASTFIELD RD STE A600 HUNTERSVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 29 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164152245,"TALBERT, ALEXANDRA, JANE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164152245,"TALBERT, ALEXANDRA, JANE",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 42 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164152245,"TALBERT, ALEXANDRA, JANE",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 59 ,$#,,
MEDICAID DIRECT,1821623620,LANE AND ASSOCIATES XXXVIII DDS PA,,101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164155529,"BALDWIN, GLENN, CHRISTOPHER",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1760911689,LANE AND ASSOCIATES XXXI DDS PA,,1242 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164155529,"BALDWIN, GLENN, CHRISTOPHER",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 471 , 920 ," 3,348 "," $189,299.99 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164156055,"HUDSPETH, ERIC, ALLEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164156055,"HUDSPETH, ERIC, ALLEN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164156055,"HUDSPETH, ERIC, ALLEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164156055,"HUDSPETH, ERIC, ALLEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164157848,"KNIGHT, SOMER, VICTORIA",2544 COURT DR STE G GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1164157848,"KNIGHT, SOMER, VICTORIA",441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 39 , 39 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1164159471,"SMITH, CALEB, WARNER",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1164161519,"BLAND, NICOLE, CLARK",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164161519,"BLAND, NICOLE, CLARK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164161519,"BLAND, NICOLE, CLARK",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 38 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164161519,"BLAND, NICOLE, CLARK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 23 , 39 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1164165866,"CHILDERS, BRIANA, LEIGH",86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164165866,"CHILDERS, BRIANA, LEIGH",86 VALLEY HIDEAWAY DR   HAYESVILLE NC,022,Clay,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 15 , 36 , 36 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164165866,"CHILDERS, BRIANA, LEIGH",44 BONNIE LN   SYLVA NC,050,Jackson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164169397,"HAWLEY, LAUREN, NICHOLE",4207 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1164170429,"CRAWFORD, DAWN, SHIREE",2041 WILLOW RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1164170429,"CRAWFORD, DAWN, SHIREE",2041 WILLOW RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1164170429,"CRAWFORD, DAWN, SHIREE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 45 , 45 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1164170429,"CRAWFORD, DAWN, SHIREE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1164170429,"CRAWFORD, DAWN, SHIREE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1164170429,"CRAWFORD, DAWN, SHIREE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164170767,"BITTNER, KALISSA, MADISON",609 N. HIGHLAND ST   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 80 , 82 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164170767,"BITTNER, KALISSA, MADISON",609 N. HIGHLAND ST   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1164172615,"YAZDI, FARHAD, KOOCHEKZADEH",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1164172615,"YAZDI, FARHAD, KOOCHEKZADEH",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 454 , 567 , 734 ,$#,,
MEDICAID DIRECT,1437196318,FIRST IMAGING OF THE CAROLINAS,First Imaging of the Carolinas,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1164172615,"YAZDI, FARHAD, KOOCHEKZADEH",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 31 , 38 ,$#,,
MEDICAID DIRECT,1164172946,ASHEVILLE INFUSION SERVICES LLC,VITAL CARE OF ASHEVILLE,70 PEACHTREE RD STE 110 ASHEVILLE NC,011,Buncombe,251F00000X,Agencies,Home Infusion,,1164172946,ASHEVILLE INFUSION SERVICES LLC,70 PEACHTREE RD STE 110 ASHEVILLE NC,011,Buncombe,251F00000X,Agencies,Home Infusion,,#, 24 , 89 ," $34,863.74 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1164177820,"COWAN, KATHRYN, TAYLOR",207 LINDA VISTA DR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1164177820,"COWAN, KATHRYN, TAYLOR",207 LINDA VISTA DR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164178372,"BOUCTEB, HOSSAM, IDRISSI",4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 26 , 82 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164179123,"FEELEY, ASHLEY, LAUREN",2704 N MAIN ST   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 71 , 87 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164179123,"FEELEY, ASHLEY, LAUREN",101 CLINIC DR   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164180378,"PROVENZANO, EMMA, CATARINA",~,3971 MARKET ST STE B WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1164180378,"PROVENZANO, EMMA, CATARINA",3971 MARKET ST STE B WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164180626,"NELMS, KENDALL, LEE",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 37 , 68 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164181459,"BARRETT, JESSICA, ANNE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164182549,"BELK, KELLIE, LYNNE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 300 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164186169,"TERRY, SANDRA, RENEE",2460 CURTIS ELLIS DR BLDG 300 ROCKY MOUNT NC,064,Nash,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 34 , 59 , 59 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 300 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164186169,"TERRY, SANDRA, RENEE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 21 , 23 , 23 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164186169,"TERRY, SANDRA, RENEE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164186169,"TERRY, SANDRA, RENEE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 39 , 50 , 51 ,$#,,
MEDICAID DIRECT,1134311723,FAMILY HEALTHCARE PRACTICE PLLC,FAMILY HEALTHCARE PRACTICE PLLC,130 1ST ST W   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1164190476,"RAMSEY, TAYLOR, LEIGH",130 1ST ST W   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164191896,"VACA, CAMILLE, MARIA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",1028 BLAIR ST STE 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,915 PEE DEE RD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",915 PEE DEE RD   ABERDEEN NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",915 PEE DEE RD   ABERDEEN NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1201 CAROLINA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1201 CAROLINA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,900 W DOLPHIN ST   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 49 , 49 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,400 VISION DR   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164192597,"MEBANE, TAYLER, GABRIELLE",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366650707,LAKESHORE PEDIATRIC CENTER PA,~,635 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1164193900,"DENHOFF, KELSEY, LYNN",635 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 11 ,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164202529,"BOHRER, JASON, MAXWELL",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164202529,"BOHRER, JASON, MAXWELL",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1164202669,"TZIATZOS, HANNAH, KOEMI FRIGHT",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 42 , 59 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164203428,"ALLEN, LAUREN, ASHLEY",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164204871,"SANCHEZ CASTRO, FELIPE, EDWIN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 39 , 98 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164206447,"KNAUSS, JAQULIN, BEDNARCZYK",510 CAROLINA BAY DR STE 100 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1164209631,"MILLER, MEGAN, NAN",2818 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 20 , 55 ,$#,,
MEDICAID DIRECT,1154453496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT MINERAL SPRINGS,4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164239521,"GREENLEE, ERICA, MONIQUE",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1649090952,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT KERNERSVILLE ELEMENTARY,512 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164239521,"GREENLEE, ERICA, MONIQUE",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1801676994,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - JACKSONVILLE,158 MEMORIAL CT   JACKSONVILLE NC,067,Onslow,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164259602,"DUNCAN, ROSE, ANDREA",158 MEMORIAL CT   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164259818,"LEE, LAUREN, LOEHNERT",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164262119,"COLSON, SHENITA, RENEA",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 90 , 546 , 546 ," $37,355.86 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164264362,"HODGE, SUSANNA, NICOLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 17 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164267498,"MODI, ALOPI, ATISH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164267498,"MODI, ALOPI, ATISH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 26 , 31 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164267498,"MODI, ALOPI, ATISH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164267498,"MODI, ALOPI, ATISH",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164268876,"KANE, SHANNEN, MARIE",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164271862,"BEARD, LENORA, GABRIELLE",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164271862,"BEARD, LENORA, GABRIELLE",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1164271862,"BEARD, LENORA, GABRIELLE",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164271862,"BEARD, LENORA, GABRIELLE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1164271862,"BEARD, LENORA, GABRIELLE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164279105,"ALLISON, NATALIE, JOY",1965 S US 29 HWY   CHINA GROVE NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 28 , 47 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164279345,"DUNLAP, SCOTESIA, Y",110 S PARK TER STE A EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164279345,"DUNLAP, SCOTESIA, Y",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164291159,"JAGGARS, AMBER, ELIZABETH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 71 , 71 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164291159,"JAGGARS, AMBER, ELIZABETH",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164291159,"JAGGARS, AMBER, ELIZABETH",200 BELLAROSE LAKE WAY   GARNER NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 125 , 125 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164291159,"JAGGARS, AMBER, ELIZABETH",200 BELLAROSE LAKE WAY   GARNER NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 66 , 66 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1164295010,"LEATHERMAN, HALIE, JENETTE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 20 , 112 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1164295010,"LEATHERMAN, HALIE, JENETTE",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164297099,"CLARK, ASHLYN, CORINNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 28 , 39 , 48 ,$#,,
MEDICAID DIRECT,1164298253,BENEVOLENT CARE LLC,~,2215 MURCHISON RD STE F E FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1164298253,BENEVOLENT CARE LLC,2215 MURCHISON RD STE F E FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,740 "," 1,805 "," $155,974.68 ",,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164299202,"FRASER, JOHN, THOMAS",100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164299202,"FRASER, JOHN, THOMAS",100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164299202,"FRASER, JOHN, THOMAS",100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164299202,"FRASER, JOHN, THOMAS",100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740689538,NORTHERN PIEDMONT COUNSELING PLLC,~,125 OVERHILL DR STE 105 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164400297,"THORNBURG, ADRIAN, B",438 E LONG AVE STE 1 GASTONIA NC,036,Gaston,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164401071,"BERGER, JEFFREY, ALLEN",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164401071,"BERGER, JEFFREY, ALLEN",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 36 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1164401931,"DAMERY, MICHELLE, LYNNE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1164401931,"DAMERY, MICHELLE, LYNNE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164402186,"SMATHERS, SESALIE, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164402186,"SMATHERS, SESALIE, LYNN",21 HOSPITAL DR LOWR LEVEL ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164402186,"SMATHERS, SESALIE, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 13 , 87 , 127 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164402236,"GREGORY, CHERE, MONIQUE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164404000,"PICTON, DOUGLAS, WILLIAM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 29 , 49 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1164404000,"PICTON, DOUGLAS, WILLIAM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 39 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164404422,"INZERILLO, JOHN, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 74 , 128 , 128 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1164404422,"INZERILLO, JOHN, JOSEPH",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1209 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1164404422,"INZERILLO, JOHN, JOSEPH",1209 BROWN ST   WASHINGTON NC,007,Beaufort,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164404976,"IANNETTONI, MARK, DAVID",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164404976,"IANNETTONI, MARK, DAVID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164404984,"MCHALE, PATRICIA, LYNN",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 68 , 104 , 178 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164404984,"MCHALE, PATRICIA, LYNN",209 PARK ST   BELMONT NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 41 , 75 , 121 ,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164405189,"MCILWAIN, ANJANETTE, LAURICE",1262 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164405189,"MCILWAIN, ANJANETTE, LAURICE",1262 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 49 , 64 , 115 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164405718,"HEISEL JR, WILLIAM, DONALD",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164406542,"WRIGHT, STEPHEN, CARTER",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164406542,"WRIGHT, STEPHEN, CARTER",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 80 , 120 , 171 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164406690,"PETTY, WILLIAM, JEFFREY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 37 , 79 , 116 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164406690,"PETTY, WILLIAM, JEFFREY",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 18 , 31 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1164406922,"HOLLINGSWORTH, ROBERT, LEE",2905 N ELM ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1164406922,"HOLLINGSWORTH, ROBERT, LEE",101 MEDICAL CIR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1164406922,"HOLLINGSWORTH, ROBERT, LEE",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1164406922,"HOLLINGSWORTH, ROBERT, LEE",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 38 , 39 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1164406922,"HOLLINGSWORTH, ROBERT, LEE",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1164406922,"HOLLINGSWORTH, ROBERT, LEE",107 HUNT DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1164408225,"GAUCHER, JAY, PAUL",Jay Paul Gaucher,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1164408225,"GAUCHER, JAY, PAUL",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164408225,"GAUCHER, JAY, PAUL",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164408225,"GAUCHER, JAY, PAUL",Jay Paul Gaucher,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1164408225,"GAUCHER, JAY, PAUL",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164408423,"LANG, JOSEPH, PAUL",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 33 , 72 , 72 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164408423,"LANG, JOSEPH, PAUL",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164408423,"LANG, JOSEPH, PAUL",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 27 , 106 , 106 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164408423,"LANG, JOSEPH, PAUL",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1538978531,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - INDEPENDEN,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164408449,"PHILLIPS, DAVID, MICHAEL",10826 CHAMBERLAIN HALL CT   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1790370997,SDC KL LLC,,284 TADPOLE LN   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1164408449,"PHILLIPS, DAVID, MICHAEL",10826 CHAMBERLAIN HALL CT   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629472568,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1235 DCCC RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1164408480,"APGAR, JAMES, WILLIAM",1235 DAVIDSON COMMUNITY COLLEGE RD   THOMASVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 25 , 51 ,$#,,
MEDICAID DIRECT,1942633482,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164408480,"APGAR, JAMES, WILLIAM",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629472568,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1235 DCCC RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1164408480,"APGAR, JAMES, WILLIAM",1235 DCCC RD   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 288 , 620 ," 1,531 "," $110,562.30 ",,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1164408480,"APGAR, JAMES, WILLIAM",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164413027,"BLINMAN, THANE, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 79 , 86 ," $13,759.85 ",,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164413845,"ST CLAIR, WESLEY, SCOTT",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 86 , 128 , 358 ," $18,058.45 ",,
MEDICAID DIRECT,1740627835,WELLCARE SERVICES PLLC,~,215 KINLAW RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164414538,"IVEY, REAGAN, LEWIS",215 KINLAW RD   FAYETTEVILLE NC,026,Cumberland,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 122 ," 1,727 "," 1,727 "," $33,431.79 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 42 , 79 , 99 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 28 , 36 , 58 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 68 , 105 , 129 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 46 , 52 , 62 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164414819,"DUBOIS, CRAIG, DANIEL",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 34 , 48 , 64 ,$#,,
MEDICAID DIRECT,1164415378,PRO MED EQUIPMENT SUPPLY INC,,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164415378,PRO MED EQUIPMENT SUPPLY INC,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 216 , 819 ," 1,172 "," $29,113.30 ",,
MEDICAID DIRECT,1164415378,PRO MED EQUIPMENT SUPPLY INC,,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1164415378,PRO MED EQUIPMENT SUPPLY INC,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 84 , 522 , 770 ," $27,853.60 ",,
MEDICAID DIRECT,1164415378,PRO MED EQUIPMENT SUPPLY INC,,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1164415378,PRO MED EQUIPMENT SUPPLY INC,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1164415378,PRO MED EQUIPMENT SUPPLY INC,,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164415378,PRO MED EQUIPMENT SUPPLY INC,601 MEMORIAL DR E   AHOSKIE NC,046,Hertford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1104819754,SHELBY MEDICAL ASSOCIATES PA,~,711 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164415584,"BESSON, GIDEON",711 N DEKALB ST   SHELBY NC,023,Cleveland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164415618,"CAUNT, CALVIN, LESLIE",807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 93 , 132 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164415618,"CAUNT, CALVIN, LESLIE",711 N DEKALB ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 34 , 52 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164415618,"CAUNT, CALVIN, LESLIE",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 31 , 31 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1164415618,"CAUNT, CALVIN, LESLIE",711 N DEKALB ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164415659,"ATKINSON, KEITH, VINCENT",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1164415659,"ATKINSON, KEITH, VINCENT",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811658081,WATAUGA MEDICAL CENTER INC,ARHS HEART & VASCULAR CENTER - ASHE,200 HOSPITAL AVE SEGRAVES HALL 1 JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1164415659,"ATKINSON, KEITH, VINCENT",200 HOSPITAL AVE SEGRAVES HALL 1 JEFFERSON NC,005,Ashe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 28 , 48 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164415659,"ATKINSON, KEITH, VINCENT",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 100 , 135 , 183 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164416665,"IBE, ELENA, GASCON",2950 PINE PLANTATION PKWY   OAK ISLAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164416665,"IBE, ELENA, GASCON",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164416665,"IBE, ELENA, GASCON",1926 COTTON GROVE RD   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164416665,"IBE, ELENA, GASCON",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164416665,"IBE, ELENA, GASCON",7804 FAIRVIEW RD STE A CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164416665,"IBE, ELENA, GASCON",3149 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164416665,"IBE, ELENA, GASCON",7110 LAWYERS RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164416681,"CHUNG, MICHAEL, TAEHOON",844 KEMPSVILLE RD STE 104 NORFOLK VA,101,Out of State <= 40 miles,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164416681,"CHUNG, MICHAEL, TAEHOON",5253 PROVIDENCE RD STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164416681,"CHUNG, MICHAEL, TAEHOON",844 KEMPSVILLE RD STE 104 NORFOLK VA,101,Out of State <= 40 miles,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164416681,"CHUNG, MICHAEL, TAEHOON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1164416806,"OSUNKOYA, ABAYOMI, WILKINS",114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 23 , 54 , 87 ,$#,,
MEDICAID DIRECT,1245255488,EAST CAROLINA MEDICAL ASSOCIATES,~,,,Unknown,193200000X,Group,Multi-Specialty,,1164416806,"OSUNKOYA, ABAYOMI, WILKINS",25 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1164416806,"OSUNKOYA, ABAYOMI, WILKINS",25 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1164416806,"OSUNKOYA, ABAYOMI, WILKINS",114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 73 , 142 , 199 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164416806,"OSUNKOYA, ABAYOMI, WILKINS",3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,7701 S RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164417549,"LOVSIN, ANDREW, JOSEPH",250 TURNER ST   ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164417549,"LOVSIN, ANDREW, JOSEPH",~,250 TURNER ST   ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,1164417549,"LOVSIN, ANDREW, JOSEPH",250 TURNER ST   ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 269 , 284 , 539 ,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,1550 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164417549,"LOVSIN, ANDREW, JOSEPH",250 TURNER ST   ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,250 TURNER ST   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1164417549,"LOVSIN, ANDREW, JOSEPH",250 TURNER ST   ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 31 , 35 , 54 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1164417606,"TENBROOK, JULIE, ANN",700 WALTER REED DR   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164418331,"BROWN II, LESTER, GEORGE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164418331,"BROWN II, LESTER, GEORGE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164418331,"BROWN II, LESTER, GEORGE",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 128 , 275 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164418331,"BROWN II, LESTER, GEORGE",6555 KEE LN STE 200 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 108 , 211 ,$#,,
MEDICAID DIRECT,1164418406,"STRAUSS, KRISTINE",CHARLOTTE FOOT & ANKLE SPECIALISTS,2550 W ARROWOOD RD STE 102 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,1164418406,"STRAUSS, KRISTINE",2550 W ARROWOOD RD STE 102 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 71 , 149 , 211 ,$#,,
MEDICAID DIRECT,1164418406,"STRAUSS, KRISTINE",CHARLOTTE FOOT & ANKLE SPECIALISTS,2550 W ARROWOOD RD STE 102 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1164418406,"STRAUSS, KRISTINE",2550 W ARROWOOD RD STE 102 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1164421558,"JENKINS, JOSEPH, THOMAS",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164422424,"COLLIER, DAVID, NASH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 32 , 44 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164423992,"CAPPS, GERALD, WAYNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003882937,NASH X RAY ASSOCIATES PA,NASH X RAY ASSOCIATES PA,117 ROUNDABOUT CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164423992,"CAPPS, GERALD, WAYNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",145 TILGHMAN DR   DUNN NC,043,Harnett,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 107 , 176 , 183 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",145 TILGHMAN DR   DUNN NC,043,Harnett,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",145 TILGHMAN DR   DUNN NC,043,Harnett,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 24 , 27 , 27 ,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 21 , 35 , 40 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164425013,"SICELOFF, THURMOND, ERIC",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164426508,"LYNCH, SEAN, MICHAEL",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164426508,"LYNCH, SEAN, MICHAEL",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1750601803,KERNERSVILLE EYE SURGEONS PC,KERNERSVILLE EYE SURGEONS PC,210 N MAIN ST STE 144 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1164426730,"MURDOCK, KIRK, ALBERT",210 N MAIN ST STE 144 KERNERSVILLE NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1164426730,"MURDOCK, KIRK, ALBERT",~,210 N MAIN ST STE 144 KERNERSVILLE NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1164426730,"MURDOCK, KIRK, ALBERT",210 N MAIN ST STE 144 KERNERSVILLE NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164428041,"MURPHY, RYAN, CHRISTOPHER",5220 OLEANDER DR FL 2 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 80 , 140 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1164428041,"MURPHY, RYAN, CHRISTOPHER",5220 OLEANDER DR FL 2 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 22 , 39 ,$#,,
MEDICAID DIRECT,1073204715,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA COMMUNITY FAMILY CARE,2412 WILKINS DR   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1164429205,"CATES, DAPHNE, JOAN",2412 WILKINS DR   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 120 , 154 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 21 , 35 , 70 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,,,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 42 , 53 , 105 ," $10,410.89 ",,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",210 ASHVILLE AVE   CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164431284,"KETHA, SIVA, SANKAR",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 19 , 28 , 35 ,$#,,
MEDICAID DIRECT,1164431375,PRODUCTIVE PLAY,PRODUCTIVE PLAY,195 AUFFIE RD   ROBBINS NC,063,Moore,251S00000X,Agencies,Community/Behavioral Health,,1164431375,PRODUCTIVE PLAY,195 AUFFIE RD   ROBBINS NC,063,Moore,251S00000X,Agencies,Community/Behavioral Health,, 43 , 970 , 970 ," $63,277.20 ",,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,100 PLANK BRIDGE RD # B CAMDEN NC,015,Camden,193200000X,Group,Multi-Specialty,,1164431755,"CARTER, ELISA, MARIA-MARTA",100 PLANK BRIDGE RD CT UNIT B CAMDEN NC,015,Camden,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 46 , 76 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1164431755,"CARTER, ELISA, MARIA-MARTA",534 CARATOKE HWY   MOYOCK NC,027,Currituck,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164432399,"DAILEY, TIMOTHY, PATRICK",1879 OLD 421 S   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831306992,HOPSCOTCH PRIMARY CARE GROUP PA,HOPSCOTCH PRIMARY CARE,113 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1164432399,"DAILEY, TIMOTHY, PATRICK",1879 OLD 421 S   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003829821,GUILFORD MEDICAL CENTER PA,~,1593 YANCEYVILLE ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1164435103,"HUNG, PATRICK, DEAN TZO",1593 YANCEYVILLE ST STE 100 GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 83 , 151 , 162 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1164436606,"PATEL, SWETANG, MAHENDRABHAI",2587 HENDERSON DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1235143231,SWETANG PATEL MD PA,~,2587 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1164436606,"PATEL, SWETANG, MAHENDRABHAI",2587 HENDERSON DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 157 , 278 ,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1164436739,"KATH, PHILIP, DOUGLAS",40 E MEDICAL CT   MARION NC,059,McDowell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 17 , 23 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1164436739,"KATH, PHILIP, DOUGLAS",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164436739,"KATH, PHILIP, DOUGLAS",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164436739,"KATH, PHILIP, DOUGLAS",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 18 , 26 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1164436739,"KATH, PHILIP, DOUGLAS",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 29 , 36 ,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1164436739,"KATH, PHILIP, DOUGLAS",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164439238,"SANITATE, SCOTT, STEVEN",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164439238,"SANITATE, SCOTT, STEVEN",1110 SE CARY PKWY STE 103 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 14 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1164439956,"HESTER, LAURA, ANN",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 55 , 57 ,$#,,
MEDICAID DIRECT,1164440210,"ELLIOTT-BREWER, MICHELLE, LYNN",CARY CHIROPRACTIC AND MASSAGE PLLC,930 SE CARY PKWY STE 100 CARY NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,1164440210,"ELLIOTT-BREWER, MICHELLE, LYNN",930 SE CARY PKWY STE 100 CARY NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164441598,"HOSTLER, WAYNE, MATTHEW",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164442851,"BROWNLEE, JONATHAN, IRBY CALVIN",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 81 , 118 , 306 ," $14,597.25 ",,
MEDICAID DIRECT,1164442992,EASTERN CAROLINA PHARMACY CARE INC,REALO DISCOUNT DRUG,300 N QUEEN ST   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164442992,EASTERN CAROLINA PHARMACY CARE INC,300 N QUEEN ST   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 17 , 55 , 100 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164443552,"SMITH, DAVID, SCOTT",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164443552,"SMITH, DAVID, SCOTT",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164443974,"HUANG, SHIRLEY, HSEUE-YEE",104 MEDSPRING DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164443974,"HUANG, SHIRLEY, HSEUE-YEE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1164443974,"HUANG, SHIRLEY, HSEUE-YEE",120 HEALTHPLEX WAY   APEX NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 170 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164445961,"ZARZAR, DAVID, PAUL",77 VILCOM CENTER DR STE 170 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164445961,"ZARZAR, DAVID, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 14 , 26 , 27 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164446001,"HARLEY, ROBERT, EDWIN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 112 , 153 , 236 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164446381,"LEE, EUGENE, EUNSUK",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164446381,"LEE, EUGENE, EUNSUK",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 30 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164446381,"LEE, EUGENE, EUNSUK",600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164446381,"LEE, EUGENE, EUNSUK",7921 ACC BLVD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 30 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 51 , 58 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1164448973,"TABER, JULIA, KREAGER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164449302,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1039,2241 ROCKFORD ST   MOUNT AIRY NC,086,Surry,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1164449302,WAL-MART STORES EAST LP,2241 ROCKFORD ST   MOUNT AIRY NC,086,Surry,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1164449302,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1039,2241 ROCKFORD ST   MOUNT AIRY NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1164449302,WAL-MART STORES EAST LP,2241 ROCKFORD ST   MOUNT AIRY NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164450797,"BACON, DAVID, SCOTT",7921 ACC BLVD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164450797,"BACON, DAVID, SCOTT",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 34 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164450797,"BACON, DAVID, SCOTT",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1164452991,MAXIM HEALTHCARE SERVICES,~,4151 SYCAMORE DAIRY RD SUITE F   FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,1164452991,MAXIM HEALTHCARE SERVICES,4151 SYCAMORE DAIRY RD SUITE F   FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,, 22 ," 4,258 "," 4,393 "," $2,607,176.00 ",,
MEDICAID DIRECT,1164452991,MAXIM HEALTHCARE SERVICES,~,4151 SYCAMORE DAIRY RD SUITE F   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1164452991,MAXIM HEALTHCARE SERVICES,4151 SYCAMORE DAIRY RD SUITE F   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1164454849,"BELLANGER, TRACIE, MANUEL",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164454849,"BELLANGER, TRACIE, MANUEL",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1164454849,"BELLANGER, TRACIE, MANUEL",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1164456562,"GILLELAND, GEOFFREY, THOMAS",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164457446,"EVANS, DAVID, JAMES",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 32 , 39 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164457446,"EVANS, DAVID, JAMES",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164458121,"HAZEN, BRIAN, ALLEN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1083041404,THE CHARLOTTE-MECKLENBURG HOSPITAL,~,200 MEDICAL PARK DR STE 320 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164460465,"RAVIN, ADAM, GATES",200 MEDICAL PARK DR STE 320 CONCORD NC,013,Cabarrus,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 29 , 31 , 34 ,$#,,
MEDICAID DIRECT,1083041404,THE CHARLOTTE-MECKLENBURG HOSPITAL,~,200 MEDICAL PARK DR STE 320 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164460465,"RAVIN, ADAM, GATES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164460630,"TABRIZI, SARA, NASSEHZADEH",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 42 , 109 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1164461786,"POWELL, ALVIN, CALDWELL",1819 TENNYSON CT   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164465720,"SILVER, ROBERT, ADAM",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164465720,"SILVER, ROBERT, ADAM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164465720,"SILVER, ROBERT, ADAM",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,,,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1164466165,"GARZA, DAVID, BRIAN",970 NEWMAN RD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164466165,"GARZA, DAVID, BRIAN",970 NEWMAN RD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1164466165,"GARZA, DAVID, BRIAN",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1164466165,"GARZA, DAVID, BRIAN",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 48 , 52 , 52 ,$#,,
MEDICAID DIRECT,1750857421,G ANESTHESIA PLLC,,970 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1164466165,"GARZA, DAVID, BRIAN",521C MOYE BLVD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164467114,"KONIKOFF, MICHAEL, ROSS",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164467569,"MOYER, VIRGINIA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1164467718,"DEATLEY, RONALD, CLARK",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1194128991,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER ROSEWOOD,104 ADAIR DR   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164467775,"MURADI, NAJIBULLAH",104 ADAIR DR # A GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1164467775,"MURADI, NAJIBULLAH",104 RHODES AVE   WINDSOR NC,008,Bertie,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164467775,"MURADI, NAJIBULLAH",104 RHODES AVE   WINDSOR NC,008,Bertie,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 94 , 222 , 232 ," $13,585.84 ",,
MEDICAID DIRECT,1164468054,"DAILEY, RICHARD, LINWOOD",RICHARD L DAILEY DDS,807 HERMITAGE RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,1164468054,"DAILEY, RICHARD, LINWOOD",807 HERMITAGE RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 553 ," 1,006 "," 3,659 "," $278,441.75 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1164468880,"WASSERMAN, JEFFREY, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164468880,"WASSERMAN, JEFFREY, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1164468880,"WASSERMAN, JEFFREY, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1164469011,"GOULD, GLENN, MICHAEL",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 110 , 304 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1164469524,"SHARAWY, EHAB, MOHAMED",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164469524,"SHARAWY, EHAB, MOHAMED",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164469524,"SHARAWY, EHAB, MOHAMED",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164469524,"SHARAWY, EHAB, MOHAMED",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 70 , 85 ,$#,,
MEDICAID DIRECT,1417914722,ROBESON HEALTH CARE CORPORATION,SOUTH ROBESON MEDICAL CENTER,210 S WALNUT ST   FAIRMONT NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750648077,ROBESON HEALTH CARE CORPORATION,SCOTLAND HEALTH CENTER,507 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1750348538,ROBESON HEALTH CARE CORPORATION,JULIAN T PIERCE HEALTH CENTER,307 E WARDELL DR   PEMBROKE NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",307 E WARDELL DR   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 19 , 25 ,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 91 , 201 , 229 ,$#,,
MEDICAID DIRECT,1093772410,ROBESON HEALTH CARE CORPORATION,MAXTON MEDICAL CENTER,610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 138 , 155 ,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 60 , 67 ,$#,,
MEDICAID DIRECT,1417914722,ROBESON HEALTH CARE CORPORATION,SOUTH ROBESON MEDICAL CENTER,210 S WALNUT ST   FAIRMONT NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1417914722,ROBESON HEALTH CARE CORPORATION,SOUTH ROBESON MEDICAL CENTER,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164469920,"NOR, EUGENE, BASIL",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1164471165,"LAWRENCE KOENIG, JOYCE, ANNE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164471165,"LAWRENCE KOENIG, JOYCE, ANNE",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164471165,"LAWRENCE KOENIG, JOYCE, ANNE",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164472536,"MCCASLIN, ROBERT, IAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164472536,"MCCASLIN, ROBERT, IAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164474359,"BUSH, WENDY, PINEIRO",3940 ARROWHEAD BLVD   MEBANE NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164474359,"BUSH, WENDY, PINEIRO",3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164474359,"BUSH, WENDY, PINEIRO",3940 ARROWHEAD BLVD   MEBANE NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164474672,"MONTAGUE, STEPHANIE, JOYCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164474672,"MONTAGUE, STEPHANIE, JOYCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164475166,"MCARTHUR, HOLLY, KRISTIN",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 17 , 29 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164475166,"MCARTHUR, HOLLY, KRISTIN",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164476420,"GOODISON-OLLIVIERRE, RENEE",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 99 , 132 , 152 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164476420,"GOODISON-OLLIVIERRE, RENEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164476420,"GOODISON-OLLIVIERRE, RENEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 24 , 26 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164476420,"GOODISON-OLLIVIERRE, RENEE",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164476420,"GOODISON-OLLIVIERRE, RENEE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164477394,"ALLEN, LAURA, FITZGERALD HALL",107 W MEDICAL PARK DR STE 101 LEXINGTON NC,029,Davidson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 43 , 149 , 179 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164477691,"HARRISON, MYLEME, OJINA",19 NOBLE ST   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 15 , 27 , 27 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164477691,"HARRISON, MYLEME, OJINA",4009 BARRETT DR   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 80 , 194 , 344 ," $25,050.22 ",,
MEDICAID DIRECT,1164479770,BEAUFORT EMS INC,BEAUFORT EMS INC,683 W BEAUFORT RD   BEAUFORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1164479770,BEAUFORT EMS INC,683 W BEAUFORT RD   BEAUFORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport, 46 , 80 , 159 ,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,115 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164479960,"WESTPHAL, AARON, ADDISON",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1164479960,"WESTPHAL, AARON, ADDISON",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164479960,"WESTPHAL, AARON, ADDISON",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 35 , 77 ,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1164479960,"WESTPHAL, AARON, ADDISON",169 DOCTORS DR   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164480026,"COX, ROBERT, WAYNE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 104 , 218 ,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1164480612,"SMITH, JAMES, DAVID",1975 GLENN MITCHELL DRIVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1164480612,"SMITH, JAMES, DAVID",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,3107 BRASSFIELD RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164480927,"ALBERTINI, JOHN, GERALD",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164480927,"ALBERTINI, JOHN, GERALD",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 13 , 31 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,,,Unknown,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",2827 LYNDHURST AVE STE 201 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 58 , 64 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 23 , 44 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",1710 KERNERSVILLE MEDICAL PKWY STE 202 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",1710 KERNERSVILLE MEDICAL PKWY STE 210 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",2827 LYNDHURST AVE STE 201 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 82 , 83 , 100 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",2827 LYNDHURST AVE STE 206 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 23 , 26 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164481685,"WORKMAN, CLAUDE, RAYMOND",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1164481727,"FORD, CHARLES, WESLEY",436 HOSPITAL DR STE 240 LINVILLE NC,006,Avery,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1164481727,"FORD, CHARLES, WESLEY",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 30 , 31 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1164481727,"FORD, CHARLES, WESLEY",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 98 , 171 , 264 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",3193 W HIGHWAY 74   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",3193 W HIGHWAY 74   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,314 BLOWING ROCK BLVD STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 27 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164483343,"GIBSON-DETERING, CARLA, ANNETTE",231 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538127121,NORTH STATE MEDICAL CENTER,NORTH STATE MEDICAL CENTER PA,609 PROFESSIONAL DR   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1164483483,"GODWIN, PATRICK, LEE",609 PROFESSIONAL DR   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 150 , 355 , 468 ," $19,541.43 ",,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1164483483,"GODWIN, PATRICK, LEE",609 PROFESSIONAL DR   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1164484044,"FELTZ, TODD, ALAN",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 29 , 87 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1164484721,"BOARDMAN, JOHN, WORKS",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1164484721,"BOARDMAN, JOHN, WORKS",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1164484721,"BOARDMAN, JOHN, WORKS",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164485033,"MOORE, GLENNDALE",GLENNDALE MOORE,2949 NEW BERN AVE STE 112A RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1164485033,"MOORE, GLENNDALE",2949 NEW BERN AVE STE 112A RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 50 , 50 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164485264,"MCDONALD, CARRIE, LEIGH",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164485264,"MCDONALD, CARRIE, LEIGH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164487286,"CHAUHAN, SHAILENDRA, SINGH",1585 FORNEY CREEK PKWY STE 2350 DENVER NC,055,Lincoln,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164487286,"CHAUHAN, SHAILENDRA, SINGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 48 , 81 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164487286,"CHAUHAN, SHAILENDRA, SINGH",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164487286,"CHAUHAN, SHAILENDRA, SINGH",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164487286,"CHAUHAN, SHAILENDRA, SINGH",1225 HARDING PL STE 5200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1982669339,ADVANCED INTERVENTIONAL PAIN MANAGE,ADVANCED INTERVENTIONAL PAIN MANAGEMENT PA,,,Unknown,193400000X,Group,Single Specialty,,1164487526,"MELOY, THOMAS, STUART",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1366611279,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164487815,"SWITZER, MONICA, DEAUN",247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,949 "," 2,285 "," 11,237 "," $645,427.60 ",,
MEDICAID DIRECT,1316115488,CHARLES FERZLI ASSOCIATES,CHARLES FERZLI & ASSOCIATES,,,Unknown,193200000X,Group,Multi-Specialty,,1164488235,"FERZLI, CHARLES",1150 NW MAYNARD RD STE 120 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982022273,KATHERINE R STANLEY,ELEGANT PROFILE,2830 MAPLEWOOD AVE STE A WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164488755,"STANLEY, KATHERINE",2830 MAPLEWOOD AVE STE A WINSTON SALEM NC,034,Forsyth,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 23 , 45 , 76 ,$#,,
MEDICAID DIRECT,1538189279,FAYETTEVILLE OTOLARYNGOLOGY,FAYETTEVILLE OTOLARYNGOLOGY HEAD AND NECK SURGERY,1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164488797,"PANTELAKOS, STEVEN, THOMAS",1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 101 , 246 , 329 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164489753,"PERRY JR, JOHN, NICHOLAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164489753,"PERRY JR, JOHN, NICHOLAS",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 29 , 33 ,$#,,
MEDICAID DIRECT,1194744532,MOSES CONE MEDICAL SERVICES INC,LEBAUER ENDOSCOPY CENTER,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1164489753,"PERRY JR, JOHN, NICHOLAS",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164489753,"PERRY JR, JOHN, NICHOLAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164489753,"PERRY JR, JOHN, NICHOLAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164489753,"PERRY JR, JOHN, NICHOLAS",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164489753,"PERRY JR, JOHN, NICHOLAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164490330,"GUILLOT, RICHARD, JOSEPH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164490330,"GUILLOT, RICHARD, JOSEPH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1164490330,"GUILLOT, RICHARD, JOSEPH",152 MEMORIAL CT   JACKSONVILLE NC,067,Onslow,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1164490330,"GUILLOT, RICHARD, JOSEPH",152 MEMORIAL CT   JACKSONVILLE NC,067,Onslow,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 45 , 193 , 230 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164490934,"HARDY, STEPHEN, PETER",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 18 , 37 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164490934,"HARDY, STEPHEN, PETER",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 21 , 30 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164490934,"HARDY, STEPHEN, PETER",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 35 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164490934,"HARDY, STEPHEN, PETER",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1801838677,MANN EAR NOSE THROAT CLINIC PA,Mann Ear Nose & Throat Clinic PA,601 KEISLER DR STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164493342,"MANN, CHARLES, H",601 KEISLER DR STE 200 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 32 , 61 , 121 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1164493839,"HADNAGY, MICHAEL, JOHN",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164493839,"HADNAGY, MICHAEL, JOHN",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1164493839,"HADNAGY, MICHAEL, JOHN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1164493839,"HADNAGY, MICHAEL, JOHN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164493839,"HADNAGY, MICHAEL, JOHN",920 CHURCH ST N STE 255B CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1164493839,"HADNAGY, MICHAEL, JOHN",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689016628,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1010 E DIXON BLVD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164494621,"DRYZER, SCOTT, RANDALL",201 E GROVER ST   SHELBY NC,023,Cleveland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164494886,"HALL, DEBRA, JEAN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 86 , 750 , 761 ," $35,514.54 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164494886,"HALL, DEBRA, JEAN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1164495040,"DAVIS, THOMAS, PRESTON",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 23 , 32 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1164495040,"DAVIS, THOMAS, PRESTON",2007 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164495248,"COMPEAU, DEBORAH, MARIE",2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164496378,"SZURA, BRIAN, THOMAS",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164496378,"SZURA, BRIAN, THOMAS",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164496378,"SZURA, BRIAN, THOMAS",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164496378,"SZURA, BRIAN, THOMAS",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134176506,CHARLES D GODWIN,EASTERN CAROLINA PSYCHIATRIC SERVICES,2800 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1164496592,"GODWIN, CHARLES, DONALD",2800 VILLAGE WAY   TRENT WOODS NC,025,Craven,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1164496816,"MCKNIGHT JR, RODNEY, LEONARD",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164496956,"COLLINS, MELISSA, ANNE",8108B MARKET ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 25 , 39 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",100 SILVER BLUFF DR   CANTON NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 97 , 97 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",100 SILVER BLUFF DR   CANTON NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 34 , 34 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",81 MEDICAL PARK LOOP STE 202 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 23 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",81 MEDICAL PARK LOOP STE 202 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1164497012,"WELLIVER, IAN, THOMPSON",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1164497061,"WOLFE BIRCHFIELD, TRACY, LEA",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164498416,"MCDUNNAH, HEIDI, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 45 , 53 ,$#,,
MEDICAID DIRECT,1154820934,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS NEONATAL FOLLOW-UP CLINIC,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164499059,"MCMANUS, LAURA, DIGIACOMO",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 35 , 41 , 41 ,$#,,
MEDICAID DIRECT,1154820934,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS NEONATAL FOLLOW-UP CLINIC,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164499059,"MCMANUS, LAURA, DIGIACOMO",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164505400,"JOEFIELD, JERMAINE, ANGELA",324 N QUEEN ST   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033677240,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - MAIDEN,137 ISLAND FORD RD   MAIDEN NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164505400,"JOEFIELD, JERMAINE, ANGELA",137 ISLAND FORD RD   MAIDEN NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 15 , 19 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164505400,"JOEFIELD, JERMAINE, ANGELA",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164505400,"JOEFIELD, JERMAINE, ANGELA",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164506036,"VILLANI, JOHN, JOSPEH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 81 , 82 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164506036,"VILLANI, JOHN, JOSPEH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 36 , 36 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164506127,"GALIN, MARC, CHARLES",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 39 ,$#,,
MEDICAID DIRECT,1205001757,LARISSA M MASTRO DDS PA,AFFORDABLE DENTURES & IMPLANTS - CONOVER,211 ROCK BARN RD NE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1164507257,"MOREHOUSE, JENNIFER, MOORE",211 ROCK BARN RD NE   CONOVER NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 959 ," 1,183 "," 2,106 "," $373,039.30 ",,
MEDICAID DIRECT,1205001757,LARISSA M MASTRO DDS PA,AFFORDABLE DENTURES & IMPLANTS - CONOVER,211 ROCK BARN RD NE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1164507257,"MOREHOUSE, JENNIFER, MOORE",211 ROCK BARN RD NE   CONOVER NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 37 , 49 ,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164507646,"QURESHI, NOSHEEN, ARIF",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 88 , 191 , 195 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164507646,"QURESHI, NOSHEEN, ARIF",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 13 , 49 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164508578,"ZIA, SAIMA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164508578,"ZIA, SAIMA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164509360,"HADI, ZUFHAIR, AHMED",1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 487 , 494 ," 2,116 "," $67,156.74 ",,
MEDICAID DIRECT,1972893097,KAREN Y PETTY DDS PA,KAREN Y PETTY DDS PA,503 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1164509402,"PETTY, KAREN, YVETTE",503 CARTHAGE ST STE 101 SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 421 , 909 ," 2,125 "," $120,550.40 ",,
MEDICAID DIRECT,1972893097,KAREN Y PETTY DDS PA,KAREN Y PETTY DDS PA,503 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1164509402,"PETTY, KAREN, YVETTE",503 CARTHAGE ST STE 101 SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1164509402,"PETTY, KAREN, YVETTE",~,503 CARTHAGE ST STE 101 SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,1164509402,"PETTY, KAREN, YVETTE",503 CARTHAGE ST STE 101 SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972893097,KAREN Y PETTY DDS PA,KAREN Y PETTY DDS PA,310 W MILLBROOK RD STE 100   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164509402,"PETTY, KAREN, YVETTE",503 CARTHAGE ST STE 101 SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972893097,KAREN Y PETTY DDS PA,KAREN Y PETTY DDS PA,310 W MILLBROOK RD STE 100   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164509402,"PETTY, KAREN, YVETTE",310 W MILLBROOK RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 127 , 266 , 693 ," $37,407.02 ",,
MEDICAID DIRECT,1164509402,"PETTY, KAREN, YVETTE",~,310 W MILLBROOK RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1164509402,"PETTY, KAREN, YVETTE",310 W MILLBROOK RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972893097,KAREN Y PETTY DDS PA,KAREN Y PETTY DDS PA,310 W MILLBROOK RD STE 100   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164509402,"PETTY, KAREN, YVETTE",310 W MILLBROOK RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164510376,"BUCK, SCOTT, HARDING",300 ASHVILLE AVE   CARY NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 16 , 18 , 68 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164510376,"BUCK, SCOTT, HARDING",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1164510376,"BUCK, SCOTT, HARDING",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164510376,"BUCK, SCOTT, HARDING",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 78 , 121 , 164 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1164510376,"BUCK, SCOTT, HARDING",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164510376,"BUCK, SCOTT, HARDING",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 15 , 21 , 62 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164512836,"KOTLABA, DAVID",201 S MAIN ST STE 1100 DANVILLE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164517819,"WILDER, JOHN, A",606 WADE AVE STE 100 RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164517819,"WILDER, JOHN, A",2700 ROYAL COMMONS LN   MATTHEWS NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 62 , 62 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164517819,"WILDER, JOHN, A",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164518221,"NEECE, KATHRYN, VIRGINIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1427070523,MAHMOOD A SIDDIQUI MD PC,MAHMOOD A SIDDIQUI MD PC,144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164518502,"NELSON, STACIE, MARIE",144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1427070523,MAHMOOD A SIDDIQUI MD PC,MAHMOOD A SIDDIQUI MD PC,144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164518502,"NELSON, STACIE, MARIE",144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 18 , 27 ,$#,,
MEDICAID DIRECT,1164518585,"GOODSON, ERNEST, JEROME",,950 S MCPHERSON CHURCH RD   FAYETTEVILLE NC,026,Cumberland,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1164518585,"GOODSON, ERNEST, JEROME",950 S MCPHERSON CHURCH RD   FAYETTEVILLE NC,026,Cumberland,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 327 ," 1,529 "," 1,659 "," $183,971.96 ",,
MEDICAID DIRECT,1164518585,"GOODSON, ERNEST, JEROME",,14308 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1164518585,"GOODSON, ERNEST, JEROME",14308 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164521803,"MARSLAND, THOMAS, WILSON",7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164521803,"MARSLAND, THOMAS, WILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164521803,"MARSLAND, THOMAS, WILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164521803,"MARSLAND, THOMAS, WILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 22 ,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,864 BLACK CREEK RD   FOUR OAKS NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164524005,"WATSON, STANLEY, RUDOLPH",864 BLACK CREEK RD   FOUR OAKS NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164524005,"WATSON, STANLEY, RUDOLPH",~,864 BLACK CREEK RD   FOUR OAKS NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1164524005,"WATSON, STANLEY, RUDOLPH",864 BLACK CREEK RD   FOUR OAKS NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164524005,"WATSON, STANLEY, RUDOLPH",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 87 , 160 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164524278,"CUMMINGS II, JAMES, LEE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1164524278,"CUMMINGS II, JAMES, LEE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 35 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164524278,"CUMMINGS II, JAMES, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164524278,"CUMMINGS II, JAMES, LEE",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164524278,"CUMMINGS II, JAMES, LEE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 34 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1164524278,"CUMMINGS II, JAMES, LEE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 105 , 107 , 113 ,$#,,
MEDICAID DIRECT,1164525663,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04335,9539 CLIFFDALE RD   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164525663,NORTH CAROLINA CVS PHARMACY LLC,9539 CLIFFDALE RD   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1164525838,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05532,4601 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1164525838,NORTH CAROLINA CVS PHARMACY LLC,4601 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1164525929,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03806,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1164525929,NORTH CAROLINA CVS PHARMACY LLC,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1164525929,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03806,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1164525929,NORTH CAROLINA CVS PHARMACY LLC,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1164525937,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04294,309 E CENTER ST   LEXINGTON NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1164525937,NORTH CAROLINA CVS PHARMACY LLC,309 E CENTER ST   LEXINGTON NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164526109,PIEDMONT HEALTH SERVICES INC,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,,,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164526497,"CARDENOSA, GILDA",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164526836,NORTH CAROLINA CVS PHARMACY LLC,~,1990 NW CARY PKWY   MORRISVILLE NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1164526836,NORTH CAROLINA CVS PHARMACY LLC,1990 NW CARY PKWY   MORRISVILLE NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1164527149,SONOCARE LLC,~,125 WAMSUTTA MILL RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1164527149,SONOCARE LLC,125 WAMSUTTA MILL RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1760417570,WAYNESBORO FAMILY CLINIC PA,WAYNESBORO FAMILY CLINIC PA,1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1164529640,"ODANIEL, MARK, BARNARD",1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#, 58 ,$#,,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164530200,"ZEIGLER, JASON, CHAD",3812 N ELM ST   GREENSBORO NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 156 , 183 , 221 ,$#,,
MEDICAID DIRECT,1699171868,PREMIER FOOT AND ANKLE PLLC,,821 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1164530200,"ZEIGLER, JASON, CHAD",3812 N ELM ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1699171868,PREMIER FOOT AND ANKLE PLLC,,1410 PLAZA DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164530200,"ZEIGLER, JASON, CHAD",3812 N ELM ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 20 , 23 , 33 ,$#,,
MEDICAID DIRECT,1164535274,ZOLL SERVICES LLC,~,121 GAMMA DR   PITTSBURGH PA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164535274,ZOLL SERVICES LLC,121 GAMMA DR   PITTSBURGH PA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 96 , 164 , 165 ," $80,713.55 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1164537064,"BALLESTERO, JULIANA",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 20 , 42 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164537064,"BALLESTERO, JULIANA",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 30 , 48 ,$#,,
MEDICAID DIRECT,1396414488,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN 69 NORTH BROAD,69 N BROAD ST   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164537478,"AUSTIN, KIMBERLEY, MCCLAIN",69 N BROAD ST   BREVARD NC,088,Transylvania,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 35 , 103 , 104 ,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164537478,"AUSTIN, KIMBERLEY, MCCLAIN",1207 EAST ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1245907302,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN MACON,674 HIGHLANDS RD   FRANKLIN NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164537478,"AUSTIN, KIMBERLEY, MCCLAIN",674 HIGHLANDS RD   FRANKLIN NC,056,Macon,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1811233075,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,111 COMER ST   DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1164538567,"SHELBURNE, THOMAS, MAYNARD",111 COMER ST   DOBSON NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023354156,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1164538567,"SHELBURNE, THOMAS, MAYNARD",4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164539144,HOME LIFE CARE INC,~,1436 MEMORIAL DR E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1164539144,HOME LIFE CARE INC,1436 MEMORIAL DR E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,, 99 ," 11,491 "," 11,549 "," $1,213,145.21 ",,
MEDICAID DIRECT,1164539144,HOME LIFE CARE INC,~,613 MEMORIAL DR E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1164539144,HOME LIFE CARE INC,613 MEMORIAL DR E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,, 91 ," 7,374 "," 7,409 "," $772,541.16 ",,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1164539763,"WEBB, DEBRA, COX",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 22 , 37 ,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1164539763,"WEBB, DEBRA, COX",10195 BEACH DR SW   CALABASH NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164541264,"GLASS, CAROLYN, HYUNAH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 13 , 16 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164541264,"GLASS, CAROLYN, HYUNAH",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 26 , 31 , 68 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1164541637,"MCCARTNEY, MICHAEL, SEAN",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164541637,"MCCARTNEY, MICHAEL, SEAN",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164541637,"MCCARTNEY, MICHAEL, SEAN",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164541637,"MCCARTNEY, MICHAEL, SEAN",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 39 , 82 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164541637,"MCCARTNEY, MICHAEL, SEAN",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 30 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,924 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1164541637,"MCCARTNEY, MICHAEL, SEAN",924 COX RD   GASTONIA NC,036,Gaston,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,924 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1164541637,"MCCARTNEY, MICHAEL, SEAN",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164542221,"LEWIS, ROBERT, KENNETH",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 14 , 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164542221,"LEWIS, ROBERT, KENNETH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164542221,"LEWIS, ROBERT, KENNETH",508 FULTON ST   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164542221,"LEWIS, ROBERT, KENNETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164542221,"LEWIS, ROBERT, KENNETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 16 , 30 , 39 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1164545984,"YANDLE, MARC, STEPHEN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1164545984,"YANDLE, MARC, STEPHEN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1164545984,"YANDLE, MARC, STEPHEN",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1164545984,"YANDLE, MARC, STEPHEN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1366589483,COUNTY OF DAVIDSON,~,915 N GREENSBORO ST   LEXINGTON NC,029,Davidson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1164550919,"HOUSE, KAREN, ANNE",915 N GREENSBORO ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164551198,"JOHNSON, ALISON, JOAN",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164551198,"JOHNSON, ALISON, JOAN",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164551198,"JOHNSON, ALISON, JOAN",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 24 , 40 , 76 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1164551198,"JOHNSON, ALISON, JOAN",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1164551206,NEIGHBORHOOD NURSES HEALTHCARE,,1821 N ROCKY RIVER RD   MONROE NC,090,Union,251J00000X,Agencies,Nursing Care,,1164551206,NEIGHBORHOOD NURSES HEALTHCARE,1821 N ROCKY RIVER RD   MONROE NC,090,Union,251J00000X,Agencies,Nursing Care,,#, 209 , 209 ," $91,975.00 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1164551289,"OBRIEN, KIMBERLY, ANN",101 CLINIC DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164551289,"OBRIEN, KIMBERLY, ANN",101 CLINIC DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164552865,"KELSEY, CHRISTOPHER, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164552865,"KELSEY, CHRISTOPHER, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 19 , 43 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164552865,"KELSEY, CHRISTOPHER, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 24 , 34 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1164559829,"HOUSE, LAURA, KLATT",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164559829,"HOUSE, LAURA, KLATT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 26 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164559829,"HOUSE, LAURA, KLATT",1830 FORDHAM BLVD STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164559829,"HOUSE, LAURA, KLATT",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164559829,"HOUSE, LAURA, KLATT",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164562005,"SACHDEVA, NEERAJ, KUMAR",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 36 , 44 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164562005,"SACHDEVA, NEERAJ, KUMAR",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,2601 LAKE DR STE 201 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164562005,"SACHDEVA, NEERAJ, KUMAR",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164563912,"LIST, MELISSA, BATENIC",3609 SW DURHAM DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164563912,"LIST, MELISSA, BATENIC",3609 SW DURHAM DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 35 , 51 ,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1164563938,C & S OPTOMETRIC SERVICES PLLC,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,, 33 , 35 , 64 ,$#,,
MEDICAID DIRECT,1164565198,UNIQUE HEALTH SOLUTIONS INC,~,707 S PINEHURST ST STE C ABERDEEN NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,1164565198,UNIQUE HEALTH SOLUTIONS INC,707 S PINEHURST ST STE C ABERDEEN NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 7,366 "," 7,366 "," $454,587.08 ",,
MEDICAID DIRECT,1164567715,BEATRICE PETWAY,WE CARE FAMILY CARE HOME,1101 HILL ST   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1164567715,BEATRICE PETWAY,1101 HILL ST   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 725 , 725 ," $45,818.06 ",,
MEDICAID DIRECT,1205105491,THE CENTER FOR RURAL HEALTH INNOVAT,THE CENTER FOR RURAL HEALTH INNOVATION,167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1164568143,"BARRUS, ANNE, GRIFFITH",167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164569075,"WILDER, ELIZABETH, PARKS",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164569075,"WILDER, ELIZABETH, PARKS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164569075,"WILDER, ELIZABETH, PARKS",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164569075,"WILDER, ELIZABETH, PARKS",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164573226,"TAYLOR, SARAH, LYNN",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 75 , 82 , 103 ,$#,,
MEDICAID DIRECT,1902634231,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH MEDICAL GROUP,89 W MILLS ST STE A COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1164576369,"AZAR, GEORGE, ANIS",89 W MILLS ST STE A COLUMBUS NC,075,Polk,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154563385,ST LUKES PHYSICIAN NETWORK INC,ST LUKES ORTHOPEDICS AND SPORTS MEDICINE,89 W MILLS ST   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1164576369,"AZAR, GEORGE, ANIS",89 W MILLS ST STE A COLUMBUS NC,075,Polk,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 53 , 99 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164578704,"PALUKURU, AJITHA, REDDY",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 63 , 64 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164578704,"PALUKURU, AJITHA, REDDY",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1164579777,"MCNABB, MCKENDREE, EUGENE",~,352 2ND ST NW STE 102 HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,1164579777,"MCNABB, MCKENDREE, EUGENE",352 2ND ST NW STE 102 HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1164584710,"STANFIELD, BETH, PERRY",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 46 , 146 ,$#,,
MEDICAID DIRECT,1164585394,VALS HOME HEALTH CARE INC,~,232 MAIN ST E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1164585394,VALS HOME HEALTH CARE INC,232 MAIN ST E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,, 127 ," 35,618 "," 37,535 "," $3,009,386.32 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164586616,"LEIDERMAN, YANNEK, ISAAC",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164586616,"LEIDERMAN, YANNEK, ISAAC",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1871977249,CENTRAL PEDIATRICS & INTERNAL MED,,3040 EASTWAY DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164591400,"GHEBRESILASIE, EDEN, ASEFAW",3040 EASTWAY DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 70 , 212 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1164591418,"ISAACS, KIM, LUISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164591418,"ISAACS, KIM, LUISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 14 , 20 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538563473,EAST CAROLINA UNIVERSITY,~,600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 104 , 109 , 299 ," $14,713.85 ",,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 23 , 47 ,$#,,
MEDICAID DIRECT,1942633482,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 49 , 52 , 120 ,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 28 , 85 ,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 32 ,$#,,
MEDICAID DIRECT,1629472568,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1235 DCCC RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",1235 DAVIDSON COMMUNITY COLLEGE RD   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1427452283,EAST CAROLINA UNIVERSITY,~,100 BRUNSWICK MEDICAL CENTER PKWY NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1164591558,"ZALD, HAROLD, STEVEN",100 BRUNSWICK MEDICAL CENTER PKWY NE   BOLIVIA NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1215301569,PROSPECT BEHAVIORAL PEDIATRICS AND,,600 JULIAN LN STE 640 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164593604,"TROMBLEY, PAUL, ELLIOT",600 JULIAN LN STE 640 ARDEN NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1164593810,COUNTY OF HAYWOOD,HAYWOOD COUNTY DSS - MOW,157 PARAGON PKWY STE 300 CLYDE NC,044,Haywood,332U00000X,Suppliers,Home Delivered Meals,,1164593810,COUNTY OF HAYWOOD,157 PARAGON PKWY STE 300 CLYDE NC,044,Haywood,332U00000X,Suppliers,Home Delivered Meals,, 21 ," 2,589 "," 2,590 "," $19,842.90 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164595310,"ESCO, MIECHIA, ASHAWN",1901 S HAWTHORNE RD STE 220 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,401 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1164595310,"ESCO, MIECHIA, ASHAWN",401 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 40 , 67 ,$#,,
MEDICAID DIRECT,1164596193,"SHOOK, JASON, HAROLD",JASON HAROLD SHOOK,1847 HWY 64 BUSINESS   HAYESVILLE NC,022,Clay,1223G0001X,Dental Providers,Dentist,General Practice,1164596193,"SHOOK, JASON, HAROLD",1847 HWY 64 BUSINESS   HAYESVILLE NC,022,Clay,1223G0001X,Dental Providers,Dentist,General Practice, 108 , 207 , 604 ," $19,969.30 ",,
MEDICAID DIRECT,1164597936,LINCARE INC,~,946 W ANDREWS AVE STE W HENDERSON NC,091,Vance,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1164597936,LINCARE INC,946 W ANDREWS AVE STE W HENDERSON NC,091,Vance,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 248 ," 1,688 "," 2,943 "," $59,834.40 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164599130,"HASS, MICHELLE, LEA",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 82 , 118 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164600284,"VELAZQUEZ-RAMIREZ, GABRIELA, ABIGAIL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 233 , 269 , 317 ," $18,781.58 ",,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164605002,"SALIBA II, DAVID, LEE",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164605002,"SALIBA II, DAVID, LEE",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164605002,"SALIBA II, DAVID, LEE",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 25 , 25 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164605002,"SALIBA II, DAVID, LEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 28 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164605002,"SALIBA II, DAVID, LEE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164605002,"SALIBA II, DAVID, LEE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164606026,"BEADLE, THOMAS, JAMES",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164606026,"BEADLE, THOMAS, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 92 , 126 , 195 ,$#,,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164606026,"BEADLE, THOMAS, JAMES",1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 67 , 88 , 90 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164606604,"GRIMM, JOHN, PIPER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 297 , 317 , 368 ," $15,473.26 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164606604,"GRIMM, JOHN, PIPER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 130 , 141 , 187 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1164606604,"GRIMM, JOHN, PIPER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245907302,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN MACON,674 HIGHLANDS RD   FRANKLIN NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164608931,"SUTTON, AMY, MCCALL",674 HIGHLANDS RD   FRANKLIN NC,056,Macon,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder), 17 , 89 , 89 ," $21,295.46 ",,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164609731,"HERRING, RICHARD, SAMUEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164609731,"HERRING, RICHARD, SAMUEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 181 , 237 , 294 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164609731,"HERRING, RICHARD, SAMUEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085U0001X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Ultrasound,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164609731,"HERRING, RICHARD, SAMUEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 193 , 221 , 297 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 50 , 62 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 38 , 47 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164611364,"NAMDE, MADJIMBAYE, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 22 , 25 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1164612610,"FOLLROD, CINTHIA, EDWARDS",4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 11 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1164612610,"FOLLROD, CINTHIA, EDWARDS",6415 BROOKSTONE LN STE 101 FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 16 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1164612610,"FOLLROD, CINTHIA, EDWARDS",2035 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1457853079,HOSPITALIST SOLUTION PLLC,,338 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164614459,"PERLMAN, JASON, MATTHEW",2555 COURT DR STE 270 GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 78 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164615720,"UDOMTECHA, DANAI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 21 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164615720,"UDOMTECHA, DANAI",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164615720,"UDOMTECHA, DANAI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 60 , 74 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164615720,"UDOMTECHA, DANAI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164615720,"UDOMTECHA, DANAI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164618906,"BROWN, COURTNEY, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164618906,"BROWN, COURTNEY, ANNE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164622312,"BESTHA, DURGA, PRASAD",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 21 , 22 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164622312,"BESTHA, DURGA, PRASAD",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164622312,"BESTHA, DURGA, PRASAD",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164622312,"BESTHA, DURGA, PRASAD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1861213225,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY ORTHOPEDICS AND SPORTS MEDICINE,700 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164623518,"GREWAL, BIKRAMJIT, SINGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 20 , 29 ,$#,,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,700 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164623518,"GREWAL, BIKRAMJIT, SINGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 22 , 37 ,$#,,
MEDICAID DIRECT,1861213225,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY ORTHOPEDICS AND SPORTS MEDICINE,225 BRIGHTWATER DR STE 200 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164623518,"GREWAL, BIKRAMJIT, SINGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,716 S 10TH ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164623518,"GREWAL, BIKRAMJIT, SINGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1861213225,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY ORTHOPEDICS AND SPORTS MEDICINE,225 BRIGHTWATER DR STE 200 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164623518,"GREWAL, BIKRAMJIT, SINGH",716 S 10TH ST   LILLINGTON NC,043,Harnett,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 45 , 56 , 115 ,$#,,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,716 S 10TH ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164623518,"GREWAL, BIKRAMJIT, SINGH",716 S 10TH ST   LILLINGTON NC,043,Harnett,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 41 , 58 , 95 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164624854,"GRIFFITH, BRIAN, CAREY",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164624854,"GRIFFITH, BRIAN, CAREY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 91 , 91 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164624854,"GRIFFITH, BRIAN, CAREY",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164624946,"RAO, JYOTI, JULURU",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164624946,"RAO, JYOTI, JULURU",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 58 , 79 , 179 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 30 , 38 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",140 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245859453,TRIAD BREAST IMAGING CENTER LLC,NOVANT HEALTH BREAST IMAGING CENTER GREENSBORO,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,9848 N TRYON ST STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,50 MILLER ST STE G WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 18 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,703 COMFORT LN   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1900 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 33 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 22 , 25 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 32 , 46 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1164628293,"PLOOF, SEAN, MICHAEL",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164629267,"CUDNIK, ELAINE, LAMB",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1164629267,"CUDNIK, ELAINE, LAMB",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1164629267,"CUDNIK, ELAINE, LAMB",8841 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164629432,"GHERGHE, CRISTINA",301 E WENDOVER AVE STE 211 GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 17 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164629432,"GHERGHE, CRISTINA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 110 , 269 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1164629515,"HERPICH, BYRON, KENDALL",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164629515,"HERPICH, BYRON, KENDALL",300 W PENNSYLVANIA AVE   SOUTHERN PINES NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164630984,"CONKLIN, ROBERT, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 30 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164630984,"CONKLIN, ROBERT, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 135 , 149 , 217 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164630984,"CONKLIN, ROBERT, CHARLES",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 38 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164630984,"CONKLIN, ROBERT, CHARLES",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164632642,"YANAMADALA, MAMATA",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164632642,"YANAMADALA, MAMATA",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164632642,"YANAMADALA, MAMATA",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164632642,"YANAMADALA, MAMATA",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164633269,"CROCE, CLARA, MARIA",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164633269,"CROCE, CLARA, MARIA",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 14 , 24 ,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164633269,"CROCE, CLARA, MARIA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 20 , 25 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164633269,"CROCE, CLARA, MARIA",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,4320 HENSON DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164633988,"TUCKER, VICTORIA, DAWN",4320 HENSON DR   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1164633988,"TUCKER, VICTORIA, DAWN",4320 HENSON DR   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164633988,"TUCKER, VICTORIA, DAWN",4320 HENSON DR   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 42 , 55 , 152 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164635173,"GREEN, DOUGLAS, ALLEN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 40 , 45 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164635173,"GREEN, DOUGLAS, ALLEN",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 36 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1164635173,"GREEN, DOUGLAS, ALLEN",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164635173,"GREEN, DOUGLAS, ALLEN",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164635702,"WU, CHRISTINE, MARIE",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164635702,"WU, CHRISTINE, MARIE",6845 KNIGHTDALE BLVD STE 100 KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 25 , 59 ,$#,,
MEDICAID DIRECT,1942226386,DILLON FAMILY DENTAL CENTER,DILLON FAMILY DENTAL CENTER,101 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164638383,"FINCANNON, KEITH, ALAN",101 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 58 , 77 , 138 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164642120,"RODRIGUEZ, ANTONIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164642120,"RODRIGUEZ, ANTONIO",7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 54 , 111 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164644837,"FREIDINGER, BRAD, ALAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164644837,"FREIDINGER, BRAD, ALAN",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 49 , 71 , 151 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164644837,"FREIDINGER, BRAD, ALAN",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164644837,"FREIDINGER, BRAD, ALAN",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164644969,INGLES MARKETS INC,INGLES PHARMACY 121,2630 CONNELLY SPRINGS RD   GRANITE FALLS NC,014,Caldwell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1164644969,INGLES MARKETS INC,2630 CONNELLY SPRINGS RD   GRANITE FALLS NC,014,Caldwell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164645362,"RAHMAN, ABU AHMED, ZAHIDUR",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164645362,"RAHMAN, ABU AHMED, ZAHIDUR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 49 , 49 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164645362,"RAHMAN, ABU AHMED, ZAHIDUR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 55 , 55 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164647731,"DOUTOVA, ANASTASSIA, VLADIMIROVNA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164647731,"DOUTOVA, ANASTASSIA, VLADIMIROVNA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164648903,"LESTER, LEON, CLARK",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 267 , 604 ," 1,231 "," $70,368.23 ",,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164648903,"LESTER, LEON, CLARK",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 162 , 232 , 512 ," $21,473.55 ",,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164648903,"LESTER, LEON, CLARK",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1104959055,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164650263,"FORSEY, JAMES, ZACHARY",1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 167 , 188 , 281 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164650321,"SPENCER, DANIEL, BONNESON",400 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164650321,"SPENCER, DANIEL, BONNESON",400 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1245637701,NEW DAWN PSYCHIATRIC SERVICES PLLC,,111 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1164650420,"BENNETT, KAREN, WEBB",111 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1164650834,"AMIN, PARTHIV, RUSHIKESH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1558351726,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE PIEDMONT,1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164651956,"DINEEN, MIRIAM, PATTERSON",1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1033584917,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF ROWAN SALISBURY,420 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1164651956,"DINEEN, MIRIAM, PATTERSON",420 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164742870,VITALITY HEALTH AND WELLNESS PLLC,VITALITY HEALTH AND WELLNESS PLLC,1429 E FIRE TOWER RD STE 104 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164654893,"SPEECE, SHANNON, IVY",1429 E FIRE TOWER RD STE 104 GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 125 , 386 , 529 ," $12,083.19 ",,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164656922,"MILLS, SARAH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164656922,"MILLS, SARAH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 23 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164656922,"MILLS, SARAH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 33 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164656922,"MILLS, SARAH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164656922,"MILLS, SARAH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1164656922,"MILLS, SARAH",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164656922,"MILLS, SARAH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164656922,"MILLS, SARAH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1164656922,"MILLS, SARAH",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164657177,"HERRIN, NAISHAI, RENEE",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 70 , 182 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164657383,"SHAH, SHREYANISH, DINESHBHAI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 12 , 28 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164657383,"SHAH, SHREYANISH, DINESHBHAI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 34 , 126 , 137 ," $10,929.24 ",,
MEDICAID DIRECT,1043811128,FOOTHILLS FAMILY DERMATOLOGY,,109 E FLEMING DR STE 106 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1164657391,"EDHEGARD, ANNA, BURKHEAD",109 E FLEMING DR STE 106 MORGANTON NC,012,Burke,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1164657672,"JOHNS, DEBORAH, HILL",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#, 12 ,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164657821,"NGUYEN, THANG, XUAN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164657912,UNITED HOME CARE INC,~,343 WESTERN BLVD STE J JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1164657912,UNITED HOME CARE INC,343 WESTERN BLVD STE J JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,, 74 ," 9,456 "," 9,493 "," $819,237.76 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164659322,"LEWIS, KAREN, ELIZABETH",16525 HOLLY CREST LN STE 150 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164659686,"ROSE, TRACY, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 23 , 44 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 23 , 23 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,350 E HOLDING AVE   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164663688,"ZAMORA GONZALEZ, CARLOS, ARMANDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 245 , 274 , 378 ," $14,250.31 ",,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1164664090,"CLARK, PAIGE, DAVIS",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1164664090,"CLARK, PAIGE, DAVIS",200 STONEBRIDGE SQ   HAVELOCK NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1164664090,"CLARK, PAIGE, DAVIS",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 17 , 34 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1164664421,"IZGUR, VITALY, ZINOVY",35 BITTERSWEET DR   DOYLESTOWN PA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164666046,"HABERLE, SINISA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164666046,"HABERLE, SINISA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164666046,"HABERLE, SINISA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 300 , 316 , 393 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164666046,"HABERLE, SINISA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164666046,"HABERLE, SINISA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164666046,"HABERLE, SINISA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164666046,"HABERLE, SINISA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164670121,"SWARTZEL, JODY, AUGUSTUS",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164670121,"SWARTZEL, JODY, AUGUSTUS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164670121,"SWARTZEL, JODY, AUGUSTUS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 13 , 13 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164670253,"KINSEL, RICHARD, PAUL",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics, 62 , 66 , 106 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164671145,"ALI, RABIA, YUSAF",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 16 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2000 REGENCY PKWY   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164671145,"ALI, RABIA, YUSAF",2000 REGENCY PKWY   CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 15 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164671145,"ALI, RABIA, YUSAF",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 34 , 36 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164671145,"ALI, RABIA, YUSAF",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 47 , 50 , 76 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164672382,"ADAMS, TEREON, NACHON",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164673315,"ALUKO, BABAJIDE, OLUFEMI",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164673315,"ALUKO, BABAJIDE, OLUFEMI",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164673711,"BANWELL, JAMIE, AMBLER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 31 , 57 , 66 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164673992,"DILLON-SPRUILL, MARGARET, ANN",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164673992,"DILLON-SPRUILL, MARGARET, ANN",2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164673992,"DILLON-SPRUILL, MARGARET, ANN",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164674735,"MURPHY, LAURA, ANN",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164674735,"MURPHY, LAURA, ANN",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 31 , 32 ,$#,,
MEDICAID DIRECT,1164674941,TRINITY THERAPY SERVICES INC,Trinity Therapy Services Inc,2656 ROSEWOOD DR   WINTERVILLE NC,074,Pitt,251S00000X,Agencies,Community/Behavioral Health,,1164674941,TRINITY THERAPY SERVICES INC,2656 ROSEWOOD DR   WINTERVILLE NC,074,Pitt,251S00000X,Agencies,Community/Behavioral Health,,#, 82 , 82 ,$#,,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164678744,"BAVEJA, NAMRITA",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 57 , 60 ,$#,,
MEDICAID DIRECT,1164678744,"BAVEJA, NAMRITA",~,1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,1164678744,"BAVEJA, NAMRITA",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,429 COMMONWEALTH BLVD E   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164678744,"BAVEJA, NAMRITA",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164680674,"GUPTA, RAJESH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164683025,"ECKHOUSE, SHAINA, ROSE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164683025,"ECKHOUSE, SHAINA, ROSE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164683025,"ECKHOUSE, SHAINA, ROSE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164683025,"ECKHOUSE, SHAINA, ROSE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164683025,"ECKHOUSE, SHAINA, ROSE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 35 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164683025,"ECKHOUSE, SHAINA, ROSE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164683025,"ECKHOUSE, SHAINA, ROSE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164686333,"KHAN, SAAD, SAEED",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164686333,"KHAN, SAAD, SAEED",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 21 , 22 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164686333,"KHAN, SAAD, SAEED",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164686333,"KHAN, SAAD, SAEED",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 18 , 20 ,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164688644,"CHENNA, SWAPNA, VEERABHADRIAH",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164688644,"CHENNA, SWAPNA, VEERABHADRIAH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689006,"EWARD, WILLIAM, CURTIS",20 DUKE MEDICINE CIR CLINIC 00 1 DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689006,"EWARD, WILLIAM, CURTIS",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689006,"EWARD, WILLIAM, CURTIS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689105,"BRENNAN, JAMES, MATTHEW",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 229 , 281 , 324 ,$#,,
MEDICAID DIRECT,1174823066,PRIVATE DIAGNOSTIC CLINIC PLLC,TRIANGLE HEART ASSOCIATES,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689105,"BRENNAN, JAMES, MATTHEW",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689105,"BRENNAN, JAMES, MATTHEW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 116 , 158 , 181 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689105,"BRENNAN, JAMES, MATTHEW",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689105,"BRENNAN, JAMES, MATTHEW",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689105,"BRENNAN, JAMES, MATTHEW",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 58 , 64 , 115 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164689105,"BRENNAN, JAMES, MATTHEW",540 NEW WAVERLY PL STE 101 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164689402,"SALMONY, RICHARD, ORR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164691408,"PENCE, REAGAN, NEAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164691408,"PENCE, REAGAN, NEAL",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164691408,"PENCE, REAGAN, NEAL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,,,$#,,
MEDICAID DIRECT,1992802607,PEDIATRIX MEDICAL GROUP OF SOUTH CA,~,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164691937,"MOECKEL, DOUGLAS, MATTHEW",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164694162,"RAYMOND, JAMIE, LYNN",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164694162,"RAYMOND, JAMIE, LYNN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164694162,"RAYMOND, JAMIE, LYNN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164694162,"RAYMOND, JAMIE, LYNN",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164694162,"RAYMOND, JAMIE, LYNN",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164694873,"YOUNG, LINDSAY, SALLACH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1306481957,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT FRED T FOARD HIGH,3407 PLATEAU RD   NEWTON NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164697082,"SAPORITO, LORRAINE, NMN",3407 PLATEAU RD   NEWTON NC,018,Catawba,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1184302655,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT ST STEPHENS ELEMENTARY,684 30TH ST NE   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164697082,"SAPORITO, LORRAINE, NMN",3407 PLATEAU RD   NEWTON NC,018,Catawba,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164697520,"WAGNER, LORI, FINCH",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164697520,"WAGNER, LORI, FINCH",303 AIRPORT RD   ARDEN NC,011,Buncombe,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 48 , 77 , 128 ," $17,526.29 ",,
MEDICAID DIRECT,1164698387,THE HERITAGE OF SUGAR MOUNTAIN,,264 SUGAR MOUNTAIN 2 RD   NEWLAND NC,006,Avery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1164698387,THE HERITAGE OF SUGAR MOUNTAIN,264 SUGAR MOUNTAIN 2 RD   NEWLAND NC,006,Avery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 4,031 "," 4,031 "," $258,612.20 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164698437,"MIKATI, MOHAMAD, ABDUL GHANI",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 85 , 172 , 206 ," $14,315.10 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164698437,"MIKATI, MOHAMAD, ABDUL GHANI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 71 , 140 , 142 ," $16,501.15 ",,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1164698437,"MIKATI, MOHAMAD, ABDUL GHANI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1164698437,"MIKATI, MOHAMAD, ABDUL GHANI",2100 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1164698437,"MIKATI, MOHAMAD, ABDUL GHANI",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1164698437,"MIKATI, MOHAMAD, ABDUL GHANI",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,,,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164701223,"GIESEY, RACHAEL, MARIE",511 PALADIN DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 87 , 130 ,$#,,
MEDICAID DIRECT,1720151525,COUNTY OF CLEVELAND NORTH CAROLINA,CLEVELAND COUNTY HEALTH DEPARTMENT,200 S POST RD   SHELBY NC,023,Cleveland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1164702734,"HALL, CLARISSA, ROBERTS",200 S POST RD   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164708558,"EILBACHER, KRISTINA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164708558,"EILBACHER, KRISTINA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548785306,AW REYNOLDS JR- DURHAM PLLC,TROPHY SMILES DENTISTRY,601 FAYETTEVILLE ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164708673,"REYNOLDS JR, ARTHUR, WINSTON",601 FAYETTEVILLE ST STE 100 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 135 , 238 , 764 ," $37,423.41 ",,
MEDICAID DIRECT,1164708897,GREEN VALLEY HAVEN LLC,WICKER STREET GROUP HOME,2528 ANDERSON RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1164708897,GREEN VALLEY HAVEN LLC,2528 ANDERSON RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 394 , 394 ," $107,759.59 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164709705,"ROBINSON, DETRA, CHAMBERS",14215 BALLANTYNE CORPORATE PL STE 130 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164710174,"SALFITY, HAI, VIET-NGUYEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164710174,"SALFITY, HAI, VIET-NGUYEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164710174,"SALFITY, HAI, VIET-NGUYEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164710174,"SALFITY, HAI, VIET-NGUYEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164710174,"SALFITY, HAI, VIET-NGUYEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164710174,"SALFITY, HAI, VIET-NGUYEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164710950,"PARKER COTE, JENNIFER, LYNNE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164710950,"PARKER COTE, JENNIFER, LYNNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 87 , 88 , 91 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164711180,"MONTOYA, SIMONE, PATALINGHUG",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 51 , 71 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1164711180,"MONTOYA, SIMONE, PATALINGHUG",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 45 , 78 ,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164711180,"MONTOYA, SIMONE, PATALINGHUG",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 13 , 31 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 37 , 68 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376899252,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF MCGEES CROSSROADS,70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164711388,"MURY, JENNIFER, ANN",70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2076 VETERANS PKWY STE 250 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",2076 VETERANS PKWY STE 250 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164711388,"MURY, JENNIFER, ANN",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164713574,"THOMAS, JENNA, SEARCY",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164713574,"THOMAS, JENNA, SEARCY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164713574,"THOMAS, JENNA, SEARCY",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 61 , 71 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164713574,"THOMAS, JENNA, SEARCY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,120 CONNER DR STE 101 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164713822,"WILLIAMS, SONYA, ELIZABETH",120 CONNER DR STE 101 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164713947,"KLIFTO, CHRISTOPHER, SCOTT",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 31 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164713947,"KLIFTO, CHRISTOPHER, SCOTT",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164713947,"KLIFTO, CHRISTOPHER, SCOTT",120 E CARVER ST   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164713947,"KLIFTO, CHRISTOPHER, SCOTT",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 59 , 81 , 157 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164713947,"KLIFTO, CHRISTOPHER, SCOTT",120 E CARVER ST   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164715090,ASSISTING FAMILIES HOMECARE LLC,~,2818 QUEEN CITY DR STE E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1164715090,ASSISTING FAMILIES HOMECARE LLC,2818 QUEEN CITY DR STE E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 2,941 "," 2,941 "," $403,299.84 ",,
MEDICAID DIRECT,1164715090,ASSISTING FAMILIES HOMECARE LLC,~,5200 PARK RD STE 207D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1164715090,ASSISTING FAMILIES HOMECARE LLC,5200 PARK RD STE 207D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 1,326 "," 1,334 "," $185,268.68 ",,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,192 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1998 HENDERSONVILLE RD STE 40 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 67 , 157 , 401 ," $71,106.71 ",,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 49 , 116 ," $20,782.93 ",,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1998 HENDERSONVILLE RD STE 40 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,192 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",192 HOSPITAL DR   COLUMBUS NC,075,Polk,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,192 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1164715553,"PATEL, RAJ, NATVARLAL",192 HOSPITAL DR   COLUMBUS NC,075,Polk,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164715975,"STRAND, MATTHEW, SCOTT",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164715975,"STRAND, MATTHEW, SCOTT",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164715975,"STRAND, MATTHEW, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 16 , 18 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1164718250,"SAUCERMAN, ADAM, WESLEY",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164718250,"SAUCERMAN, ADAM, WESLEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164718250,"SAUCERMAN, ADAM, WESLEY",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164718250,"SAUCERMAN, ADAM, WESLEY",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164718250,"SAUCERMAN, ADAM, WESLEY",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164720934,"JORDAN, RACHEL, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164720934,"JORDAN, RACHEL, MARIE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164720934,"JORDAN, RACHEL, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164720934,"JORDAN, RACHEL, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 16 , 27 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164720934,"JORDAN, RACHEL, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1164880571,REX RADIATION ONCOLOGY LLC,UNC REX CANCER CARE OF EAST RALEIGH,117 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164721676,"SARAIYA, SIDDHARTH, AJAYBHAI",117 SUNNYBROOK RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164721676,"SARAIYA, SIDDHARTH, AJAYBHAI",2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 25 , 36 ,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164721676,"SARAIYA, SIDDHARTH, AJAYBHAI",2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 23 , 36 ,$#,,
MEDICAID DIRECT,1578885406,JOHNSTON RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT CLAYTON,2076 NC HIGHWAY 42 W STE 120 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164721676,"SARAIYA, SIDDHARTH, AJAYBHAI",2076 NC HIGHWAY 42 W STE 120 CLAYTON NC,051,Johnston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1255360459,SMITHFIELD RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT SMITHFIELD,514 N BRIGHTLEAF BLVD STE 1200 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1164721676,"SARAIYA, SIDDHARTH, AJAYBHAI",514 N BRIGHTLEAF BLVD STE 1200 SMITHFIELD NC,051,Johnston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 38 , 289 , 465 ," $17,743.45 ",,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164725180,"MDALA-GAUSI, MASIKU, AGATHA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164725180,"MDALA-GAUSI, MASIKU, AGATHA",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164725180,"MDALA-GAUSI, MASIKU, AGATHA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164725180,"MDALA-GAUSI, MASIKU, AGATHA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 88 , 88 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164725180,"MDALA-GAUSI, MASIKU, AGATHA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",1250 LINKHAW RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 35 , 86 , 87 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",720 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 47 , 318 , 318 ," $22,849.45 ",,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 52 , 52 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 156 , 185 , 299 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 81 , 81 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 51 , 142 , 147 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164725875,"PALIT, SHYAMAL, KANTI",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164730149,"ROCK, JENNIFER, KOWALSKY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 39 , 39 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164730149,"ROCK, JENNIFER, KOWALSKY",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164730487,"TEAGUE, KRISTIN, KATHLEEN",125 QUEENS RD STE 540 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 22 , 25 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164730487,"TEAGUE, KRISTIN, KATHLEEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164730487,"TEAGUE, KRISTIN, KATHLEEN",885 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164730487,"TEAGUE, KRISTIN, KATHLEEN",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164730735,"STICHEL, FRED, BARRY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164733374,"GEORGE, JOHN, DERRICK",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1295132009,ST LUKES PHYSICIAN NETWORK INC,CAROLINAS HOSPITALIST GROUP-ST LUKES,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1164734166,"SAVAGE, FRANK, WILLIAM",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 32 , 33 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164734935,"SAVARAPU, ANIL KUMAR",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 84 , 385 , 388 ," $20,922.66 ",,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164741724,"BECK, ELIZABETH, LEE",301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164741724,"BECK, ELIZABETH, LEE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164741724,"BECK, ELIZABETH, LEE",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164741724,"BECK, ELIZABETH, LEE",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742631,"LITTLE, BARRETT, ANTHONY",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742631,"LITTLE, BARRETT, ANTHONY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742748,"RICKEY, JOSHUA, SCOTT",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742748,"RICKEY, JOSHUA, SCOTT",1710 KERNERSVILLE MEDICAL PKWY STE 202 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742748,"RICKEY, JOSHUA, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742748,"RICKEY, JOSHUA, SCOTT",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 51 , 54 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742748,"RICKEY, JOSHUA, SCOTT",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164742748,"RICKEY, JOSHUA, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",216 N BICKETT BLVD STE 5 LOUISBURG NC,035,Franklin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 45 , 45 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 303 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 136 , 136 ," $14,771.49 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 80 , 80 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 13 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 51 , 88 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 303 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 303 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164742938,"HEGDE, AKHIL, SADANAND",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 52 , 57 , 119 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164743191,"GUY, MOLLY, SMITH",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164743191,"GUY, MOLLY, SMITH",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 287 , 450 , 868 ," $58,732.28 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164743191,"GUY, MOLLY, SMITH",1031 WEISS AVE STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164744702,"HAGGERTY, SEAN, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164744702,"HAGGERTY, SEAN, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760202303,NOVANT HEALTH TRIANGLE MEDICAL GROU,CAROLINA FAMILY PRACTICE & SPORTS MEDICINE,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164748166,"STROMBERG, JENNIFER, DANIELLE",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164748166,"STROMBERG, JENNIFER, DANIELLE",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164748166,"STROMBERG, JENNIFER, DANIELLE",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164748331,"PELLEGRINO, MELISSA, ELIZABETH",3012 FALSTAFF RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164748331,"PELLEGRINO, MELISSA, ELIZABETH",3012 FALSTAFF RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1467763797,SOUTHMOUNTAIN CHILDREN AND FAMILY S,Southmountain Children and Family Services,810 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1164748638,"BENTON, JENNIFER, DEANN",810 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 22 , 76 ," $14,332.70 ",,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164748794,"MCNAMARA, MEGAN, ANN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164748794,"MCNAMARA, MEGAN, ANN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 33 , 33 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164748794,"MCNAMARA, MEGAN, ANN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 27 , 44 , 44 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1164748794,"MCNAMARA, MEGAN, ANN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164748802,"CARLSON, LEAH, ASHLEY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 41 , 58 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164748802,"CARLSON, LEAH, ASHLEY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 71 , 71 , 114 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164748927,"BERRY VII, JOHN",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164748927,"BERRY VII, JOHN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 97 , 97 , 104 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164748927,"BERRY VII, JOHN",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164752200,"BUSCH, TRACY, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164752200,"BUSCH, TRACY, ELIZABETH",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164752200,"BUSCH, TRACY, ELIZABETH",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,110 DUTCHMAN CT   ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164756045,"GREGORY- LYLES, JENNIFER, BROOKE",1925 N BRIDGE ST   ELKIN NC,086,Surry,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health, 11 , 25 , 25 ,$#,,
MEDICAID DIRECT,1164756755,INNOVATIVE SUPPLY GROUP LLC,,585 PROSPECT ST UNIT 304 LAKEWOOD NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164756755,INNOVATIVE SUPPLY GROUP LLC,585 PROSPECT ST UNIT 304 LAKEWOOD NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 80 , 748 ," 1,303 "," $54,546.53 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164760476,"CLARK, CRYSTAL, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164760476,"CLARK, CRYSTAL, MARIE",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 24 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164760484,"GOEL, HERSH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164760484,"GOEL, HERSH",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164760484,"GOEL, HERSH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164760484,"GOEL, HERSH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164760484,"GOEL, HERSH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164762100,"MCLAURIN, CHARLES, DUNCAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164762100,"MCLAURIN, CHARLES, DUNCAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 113 , 122 , 127 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164764239,"KUSHWAHA, KRISTIN",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 21 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164764239,"KUSHWAHA, KRISTIN",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 27 , 33 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164764239,"KUSHWAHA, KRISTIN",104 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164764239,"KUSHWAHA, KRISTIN",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164764239,"KUSHWAHA, KRISTIN",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164766887,A PRIMARY CHOICE INC,~,100 MEMORY PLZ   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1164766887,A PRIMARY CHOICE INC,100 MEMORY PLZ   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 40 ," 6,447 "," 6,447 "," $412,461.80 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164773073,"PETRAITIS, CAMILLE, LYNN",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1164773073,"PETRAITIS, CAMILLE, LYNN",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164774121,"MCDANIEL, ASHLEY, VANESSA",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164774121,"MCDANIEL, ASHLEY, VANESSA",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164774121,"MCDANIEL, ASHLEY, VANESSA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164775888,"PARROTTE, JENNIFER, REYNOLDS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 38 , 88 , 90 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164775888,"PARROTTE, JENNIFER, REYNOLDS",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 75 , 110 , 225 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164775888,"PARROTTE, JENNIFER, REYNOLDS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,,,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164775888,"PARROTTE, JENNIFER, REYNOLDS",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1326006438,A WOMANS PLACE IN FAYETTEVILLE,A WOMANS PLACE IN FAYETTEVILLE,2053 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1164777389,"KILLMAN, NICOLE, RENEE",2053 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 64 , 106 , 143 ,$#,,
MEDICAID DIRECT,1326365081,HUGH CHATHAM MEMORIAL HOSPITAL,~,690 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1164779997,"KELLER, AMBER, BREWER",201A ELDON PARKS DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 48 , 74 ,$#,,
MEDICAID DIRECT,1326365081,HUGH CHATHAM MEMORIAL HOSPITAL,~,201A ELDON PARKS DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1164779997,"KELLER, AMBER, BREWER",201A ELDON PARKS DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164781415,"COPELAND, ANUREET, CHEEMA",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 30 , 48 , 48 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164781415,"COPELAND, ANUREET, CHEEMA",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 39 , 39 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164781936,"KHATRI, PARDEEP",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 72 , 72 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164781936,"KHATRI, PARDEEP",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 41 , 41 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164782678,"SOLIMAN, DINA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084P0015X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychosomatic Medicine, 13 , 50 , 52 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164782678,"SOLIMAN, DINA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084P0015X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychosomatic Medicine, 30 , 39 , 39 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164782678,"SOLIMAN, DINA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0015X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychosomatic Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164784039,"DOAN, HUONG, THI",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164784039,"DOAN, HUONG, THI",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 19 , 57 ,$#,,
MEDICAID DIRECT,1346784089,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - DURHAM,1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164784039,"DOAN, HUONG, THI",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 20 , 67 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1164784534,"REID, MICHAEL, ROBERT",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 179 , 263 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1164784534,"REID, MICHAEL, ROBERT",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 33 , 43 ,$#,,
MEDICAID DIRECT,1215967377,LINCOLN FAMILY PRACTICE,LINCOLN FAMILY PRACTICE,,,Unknown,193400000X,Group,Single Specialty,,1164784534,"REID, MICHAEL, ROBERT",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4760 INDEPENDENCE DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164785549,"MANTILLA, RONNIE, DANIEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 25 , 57 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4760 INDEPENDENCE DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164785549,"MANTILLA, RONNIE, DANIEL",725 OAKRIDGE BLVD STE C1 LUMBERTON NC,078,Robeson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 24 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4760 INDEPENDENCE DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164785549,"MANTILLA, RONNIE, DANIEL",4760 INDEPENDENCE DR   LUMBERTON NC,078,Robeson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 69 , 108 , 171 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164785549,"MANTILLA, RONNIE, DANIEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 21 , 45 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164785549,"MANTILLA, RONNIE, DANIEL",725 OAKRIDGE BLVD STE C1 LUMBERTON NC,078,Robeson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 34 , 54 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,725 OAKRIDGE BLVD STE C1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164785549,"MANTILLA, RONNIE, DANIEL",725 OAKRIDGE BLVD STE C1 LUMBERTON NC,078,Robeson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",1585 FORNEY CREEK PKWY STE 110 DENVER NC,055,Lincoln,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 52 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164788972,"DAVIS, NATHAN, SETH",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 28 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 254 , 314 , 394 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 34 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 25 , 30 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164789343,"MCPHERSON, AMIE, MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265904064,WHEELCHAIR CLINIC INC,,4307 WESTERN PARK PL STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164795100,"BAKER, MICHELLE, LENEE",4307 WESTERN PARK PL STE 204 DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1164795530,SUPERIOR INNOVATIVE SERVICES LLC,~,46 STONEY RD   CASTLE HAYNE NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1164795530,SUPERIOR INNOVATIVE SERVICES LLC,46 STONEY RD   CASTLE HAYNE NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 5,673 "," 5,673 "," $342,533.12 ",,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164795845,"VANHOY, KELLIE, ROBINSON",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164795845,"VANHOY, KELLIE, ROBINSON",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 13 , 13 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164798724,"REDDY, PALLAVI, DUNDUMALLA",1236 HUFFMAN MILL RD STE 1600 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164798724,"REDDY, PALLAVI, DUNDUMALLA",6 N POINTE CT STE 202 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609070648,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE SLEEP CENTER,6 N POINTE CT STE 202 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164798724,"REDDY, PALLAVI, DUNDUMALLA",6 N POINTE CT STE 202 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 25 , 27 ,$#,,
MEDICAID DIRECT,1164800355,FOOD LION LLC,FOOD LION PHARMACY 1660,1419 E ANDREWS AVE   HENDERSON NC,091,Vance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1164800355,FOOD LION LLC,1419 E ANDREWS AVE   HENDERSON NC,091,Vance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1164800355,FOOD LION LLC,FOOD LION PHARMACY 1660,1419 E ANDREWS AVE   HENDERSON NC,091,Vance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1164800355,FOOD LION LLC,1419 E ANDREWS AVE   HENDERSON NC,091,Vance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164800710,"CARPENTER, JULIE, SALEEBY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1164800710,"CARPENTER, JULIE, SALEEBY",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164800710,"CARPENTER, JULIE, SALEEBY",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164800710,"CARPENTER, JULIE, SALEEBY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164800710,"CARPENTER, JULIE, SALEEBY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164801098,"SMALLS, JACKIE, LEON",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,219 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164801296,"CREECH, VICTORIA, LIPPITT",219 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164801296,"CREECH, VICTORIA, LIPPITT",219 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164802849,"HODGES, LESLEY, CUTLER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164802849,"HODGES, LESLEY, CUTLER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164804415,"GHIDEI, LUWAM, A",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VE0102X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Reproductive Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164805925,"RABOLD, ERICA, ARCHANJO",1550 FAULK ST STE 3120 MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 32 , 41 , 60 ,$#,,
MEDICAID DIRECT,1598017212,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1100 HEALING WAY STE 21A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1164805925,"RABOLD, ERICA, ARCHANJO",1100 HEALING WAY STE 21A MATTHEWS NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 36 , 44 , 71 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164805925,"RABOLD, ERICA, ARCHANJO",600 HOSPITAL DR   MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164805925,"RABOLD, ERICA, ARCHANJO",1550 FAULK ST STE 3120 MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 55 , 99 , 162 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164805925,"RABOLD, ERICA, ARCHANJO",600 HOSPITAL DR   MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 31 , 34 ,$#,,
MEDICAID DIRECT,1164806899,PINNACLE INDEPENDENT RX INC,CANNON PHARMACY NORTH,1402 N CANNON BLVD   KANNAPOLIS NC,080,Rowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164806899,PINNACLE INDEPENDENT RX INC,1402 N CANNON BLVD   KANNAPOLIS NC,080,Rowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 38 , 84 , 139 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 34 , 62 , 78 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164809232,"DOTHARD, ANDREW, SHIPE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 40 , 53 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 24 , 45 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 87 , 104 , 150 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164809489,"VANDERMOLEN, JUSTIN, LEE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164815734,"DRURY TRAVERSO, KERRY, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164815734,"DRURY TRAVERSO, KERRY, ELIZABETH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164815734,"DRURY TRAVERSO, KERRY, ELIZABETH",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164815734,"DRURY TRAVERSO, KERRY, ELIZABETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1164816559,"STEMMLER, ROSS, ARTHUR",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164816559,"STEMMLER, ROSS, ARTHUR",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 38 , 97 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164816559,"STEMMLER, ROSS, ARTHUR",1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 86 , 130 ,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164817441,"SEGERS, MARJAHNA, CORINNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 28 , 33 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164817441,"SEGERS, MARJAHNA, CORINNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 32 , 36 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164817441,"SEGERS, MARJAHNA, CORINNE",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1164817441,"SEGERS, MARJAHNA, CORINNE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164818126,"RAMALINGAM, SENDHILNATHAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 32 , 79 , 115 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164818126,"RAMALINGAM, SENDHILNATHAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164818126,"RAMALINGAM, SENDHILNATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 16 , 38 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164818126,"RAMALINGAM, SENDHILNATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164818712,"FRANCIS, SOPHIA, FELISHA",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164818712,"FRANCIS, SOPHIA, FELISHA",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164818712,"FRANCIS, SOPHIA, FELISHA",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164818712,"FRANCIS, SOPHIA, FELISHA",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 20 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164818720,"HALL, CALTON, GIBSON",3475 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164818720,"HALL, CALTON, GIBSON",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164818720,"HALL, CALTON, GIBSON",3475 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,90 E MAIN ST STE 1 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1164820106,"MARQUART, RYAN, MICHAEL",90 E MAIN ST STE 1 SYLVA NC,050,Jackson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1164820106,"MARQUART, RYAN, MICHAEL",90 E MAIN ST STE 1 SYLVA NC,050,Jackson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164825568,"BIANCO, MARTA",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164825568,"BIANCO, MARTA",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164825956,"PUSEY, KYLE, JACOB",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164825956,"PUSEY, KYLE, JACOB",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164825956,"PUSEY, KYLE, JACOB",2183 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164825956,"PUSEY, KYLE, JACOB",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164829636,"SZURNICKI, PAWEL, P",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164832796,"ERLANDSSON, GARD, EVA",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 41 , 133 ,$#,,
MEDICAID DIRECT,1164833109,MILESTONE FAMILY SERVICES,MILESTONE FAMILY SERVICES,466 CHURCH ST N   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1164833109,MILESTONE FAMILY SERVICES,466 CHURCH ST N   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 4,023 "," 4,023 "," $273,389.15 ",,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164833554,"YOUNCE, NEIL, ANTHONY",1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 54 , 68 , 105 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164833554,"YOUNCE, NEIL, ANTHONY",8201 HEALTHCARE LOOP STE 202 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 41 , 56 , 80 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164833968,"FARKAS, AMY, BETH",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164833968,"FARKAS, AMY, BETH",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1982038683,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,15830 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164836318,"JANANIA MARTINEZ, MICHELLE",15830 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1114293495,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164836318,"JANANIA MARTINEZ, MICHELLE",4525 CAMERON VALLEY PKWY STE 3500 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164836631,"YOUNCE, JOHN, ROBERT",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 34 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164839387,"KASTNER, CANDACE, GRACE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 51 , 61 ,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164840781,"BEIDLER, ELENA, TERESE",6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 48 , 142 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164840831,"PIZZOLA, CHRISTOPHER, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 67 , 121 , 123 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164841102,"CLARK, GREGORY, SCOTT",306 WESTWOOD AVE STE 505 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164841102,"CLARK, GREGORY, SCOTT",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 20 , 23 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164841961,"CULLIGAN, EMMETT, HUGHES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164842167,"DO, TERESA, LAN",920 CHURCH ST N STE 255-D CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1164842167,"DO, TERESA, LAN",2525 COURT DR   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164842167,"DO, TERESA, LAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 68 , 503 , 503 ," $33,044.08 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164842167,"DO, TERESA, LAN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164842324,"SCHOTT, AARON, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164842548,"BROOKS, ANDREA, MARIE",2402 CAMDEN ST SW STE 200 WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164842548,"BROOKS, ANDREA, MARIE",2402 CAMDEN ST SW STE 200 WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164842555,"COE, CATHERINE, LOUW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164842555,"COE, CATHERINE, LOUW",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 59 , 85 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1164843413,"CIACCIO, LISA, MCAULEY",225 CAPITAL DR STE 225 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1164843413,"CIACCIO, LISA, MCAULEY",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1164843413,"CIACCIO, LISA, MCAULEY",7473-C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1164843413,"CIACCIO, LISA, MCAULEY",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1164843413,"CIACCIO, LISA, MCAULEY",7473-C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1164843413,"CIACCIO, LISA, MCAULEY",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1164843413,"CIACCIO, LISA, MCAULEY",540 NORTH ST   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164843710,"SZELWACH, MALGORZATA, ANNA",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164847091,"HARMAN, ROBERT, JOSHUA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164847091,"HARMAN, ROBERT, JOSHUA",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1164847752,LOLLY THERAPEUTICS LLC,PEDIATRIC ADVANCED THERAPY,1777 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164847752,LOLLY THERAPEUTICS LLC,1777 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1164847752,LOLLY THERAPEUTICS LLC,PEDIATRIC ADVANCED THERAPY,134 INFIELD CT   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1164847752,LOLLY THERAPEUTICS LLC,134 INFIELD CT   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,, 408 ," 3,448 "," 4,526 "," $325,348.31 ",,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164849295,"HAMMONS, CRYSTAL, BETH",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 68 , 76 , 100 ," $14,250.62 ",,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,251S00000X,Agencies,Community/Behavioral Health,,1164850525,MONARCH,2505 COURT DR   GASTONIA NC,036,Gaston,251S00000X,Agencies,Community/Behavioral Health,,#,,,$#,,
MEDICAID DIRECT,1164855748,WP-MT PLEASANT HEALTH HOLDINGS LLC,MT PLEASANT HOUSE,935 PAGE ST   MOUNT PLEASANT NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1164855748,WP-MT PLEASANT HEALTH HOLDINGS LLC,935 PAGE ST   MOUNT PLEASANT NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 32 ," 8,220 "," 8,220 "," $568,113.09 ",,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164856753,"SPICER, EMILY, DOBLE",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1164857322,"HARLAMERT, JULIE, ANNE",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1164857322,"HARLAMERT, JULIE, ANNE",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1164857322,"HARLAMERT, JULIE, ANNE",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164858106,"JACKSON, MEGAN, EZELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1164859377,"RIKKERS, JULIE, ANNE",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164859377,"RIKKERS, JULIE, ANNE",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164861118,"THOMAS, REBECCA, BOLDING",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164861118,"THOMAS, REBECCA, BOLDING",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164861118,"THOMAS, REBECCA, BOLDING",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164862629,"OLSEN, STEPHEN, PORTER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164862629,"OLSEN, STEPHEN, PORTER",1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164862629,"OLSEN, STEPHEN, PORTER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 126 , 129 , 262 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164863056,"MAYO, CARMEN, CHRISTINA PRESTON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 129 , 871 ," 2,253 "," $17,292.34 ",,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164863056,"MAYO, CARMEN, CHRISTINA PRESTON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164863056,"MAYO, CARMEN, CHRISTINA PRESTON",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 127 , 294 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164863056,"MAYO, CARMEN, CHRISTINA PRESTON",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164863056,"MAYO, CARMEN, CHRISTINA PRESTON",975 HIGHWAY 66 S   KERNERSVILLE NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 195 , 544 ," $10,368.74 ",,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164863056,"MAYO, CARMEN, CHRISTINA PRESTON",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164865507,"BROWN, RYAN, MILO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 44 , 99 , 119 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164865507,"BROWN, RYAN, MILO",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164865507,"BROWN, RYAN, MILO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 13 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164865507,"BROWN, RYAN, MILO",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 28 , 31 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164865747,"SALISBURY, STEVEN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164866588,"TIGHE, RYAN, CHRISTOPHER",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164866588,"TIGHE, RYAN, CHRISTOPHER",2950 PINE PLANTATION PKWY   OAK ISLAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 108 , 223 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164866588,"TIGHE, RYAN, CHRISTOPHER",1456 N HOWE ST STE 201 SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 52 , 123 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164866588,"TIGHE, RYAN, CHRISTOPHER",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1164866588,"TIGHE, RYAN, CHRISTOPHER",1456 N HOWE ST STE 201 SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164867453,"WOODARD, ALFLOYD",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164867594,"CARMICHAEL, SAMUEL, PATERSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 84 , 96 ," $14,479.66 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 28 , 34 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 34 , 45 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 54 , 59 , 90 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164867800,"FLOYD, DANIEL, PATRICK",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164867842,"THOMPSON, PEYTON, JESSIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164867842,"THOMPSON, PEYTON, JESSIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164869020,"CAVES, KYZWANA, NIA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164869053,"ROTH, KALE, JAMES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 158 , 161 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 186 , 194 , 285 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 108 , 114 , 168 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 46 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164869327,"DIXON, AUSTIN, XAVIER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1366557803,WHITE EYE ASSOCIATES PA,WHITE EYE ASSOCIATES PA,301 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164869475,"PRENSHAW, JOHN, WHITMAN",301 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164869640,"WHELAN, KARINA, ZAVERI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 25 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164869640,"WHELAN, KARINA, ZAVERI",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164869640,"WHELAN, KARINA, ZAVERI",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 33 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164869640,"WHELAN, KARINA, ZAVERI",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 30 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164870184,"HILDEBRAND, KRISTI, ILENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 22 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164870184,"HILDEBRAND, KRISTI, ILENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164870184,"HILDEBRAND, KRISTI, ILENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164870184,"HILDEBRAND, KRISTI, ILENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164870507,"EARLS, CHRISTA, LAUREN",711 N DEKALB ST   SHELBY NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 18 , 37 , 72 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1164870507,"EARLS, CHRISTA, LAUREN",807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 45 , 98 , 143 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1164871224,"GILES, WILLIAM, AUSTIN",3009 NEW BERN AVE   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1164872750,MORSE CLINIC OF NORTH RALEIGH,,3209 GRESHAM LAKE RD STE 113 RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1164872750,MORSE CLINIC OF NORTH RALEIGH,3209 GRESHAM LAKE RD STE 113 RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164873808,"NATSIS, CARLY, KATELYN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164873808,"NATSIS, CARLY, KATELYN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164873808,"NATSIS, CARLY, KATELYN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 32 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164873808,"NATSIS, CARLY, KATELYN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164873808,"NATSIS, CARLY, KATELYN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164873865,AFFORDABLE MEDICAL LLC,COMFORT MEDICAL,170 S BROAD ST STE 5 BREVARD NC,088,Transylvania,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164873865,AFFORDABLE MEDICAL LLC,170 S BROAD ST STE 5 BREVARD NC,088,Transylvania,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 320 ," 1,526 "," 3,021 "," $639,300.02 ",,
MEDICAID DIRECT,1073816997,ARMC PHYSICIANS CARE INC,CORNERSTONE MEDICAL CENTER,1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164876579,"TAPIA, LEISA, RENEE",1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 61 , 77 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164876579,"TAPIA, LEISA, RENEE",1200 NORTH ELM STREET   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 22 , 28 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164876579,"TAPIA, LEISA, RENEE",1200 NORTH ELM STREET   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164876611,"MEHTA, SACHIN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164876611,"MEHTA, SACHIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164876611,"MEHTA, SACHIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164877536,"CHRISTIAN, ANDREA, MARIE",267 S CHURTON ST STE 210 HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164884318,"LU, ANDREW, TACHUNG",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 39 , 39 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1164884318,"LU, ANDREW, TACHUNG",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 73 , 73 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1164884318,"LU, ANDREW, TACHUNG",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164884615,"ZEIN, MAZEN, KASSEM",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164884615,"ZEIN, MAZEN, KASSEM",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 34 , 53 , 76 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 32 , 51 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 24 , 35 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164884961,"BLACKSHAW, AARON, MICHAEL",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164886834,"WASHINGTON, TREY, ANTHONY",4709 CREEKSTONE DR   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1164889044,"HUNT, LOGAN, HALL",39 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164889044,"HUNT, LOGAN, HALL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164889044,"HUNT, LOGAN, HALL",77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1871854828,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164890281,"WATSON, CASEY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,16455 STATESVILLE RD STE 300   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164890364,"AESCHLIMAN, CHRISTOPHER, RYAN",16455 STATESVILLE RD STE 300 HUNTERSVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1164890745,CREATIVE PROSTHETICS AND ORTHOTICS,,3305 16TH AVE SE STE 101 CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164890745,CREATIVE PROSTHETICS AND ORTHOTICS,3305 16TH AVE SE STE 101 CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 119 , 281 ," 1,780 "," $342,632.33 ",,
MEDICAID DIRECT,1164895660,HEALTHKEEPERZ INC,,1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1164895660,HEALTHKEEPERZ INC,1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1164895660,HEALTHKEEPERZ INC,,1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1164895660,HEALTHKEEPERZ INC,1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 100 , 500 , 814 ," $54,950.07 ",,
MEDICAID DIRECT,1164895660,HEALTHKEEPERZ INC,,1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1164895660,HEALTHKEEPERZ INC,1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 39 , 221 , 224 ," $34,764.56 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164897864,"WAGNER, BONNIE, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 74 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164897864,"WAGNER, BONNIE, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164897864,"WAGNER, BONNIE, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164898508,"CHRISTENSEN, CHELSEA, ERICA",1101 FIRST COLONIAL RD STE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164898730,"DIXON, KIMBERLY, MADISON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164898730,"DIXON, KIMBERLY, MADISON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164898870,"REDA, FRANCES, COSGROVE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 20 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164898870,"REDA, FRANCES, COSGROVE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 36 , 63 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164899720,"DREW, ASHLEY, ANN",550 MOUNT HOLLY PKWY   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164899720,"DREW, ASHLEY, ANN",811 COX RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164899720,"DREW, ASHLEY, ANN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164899720,"DREW, ASHLEY, ANN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164900403,RBS CASE MANAGEMENT LLC,,273 2ND ST   ELLERBE NC,077,Richmond,251B00000X,Agencies,Case Management,,1164900403,RBS CASE MANAGEMENT LLC,273 2ND ST   ELLERBE NC,077,Richmond,251B00000X,Agencies,Case Management,, 249 ," 2,700 "," 2,720 "," $1,490,254.10 ",,
MEDICAID DIRECT,1174197297,ROTH & POWELL IV DDS PA,CAROLINA DENTAL ARTS DURHAM,415 DUNSTAN AVE   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1164900452,"WEBER, NATALIA",415 DUNSTAN AVE   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 587 , 933 ," 4,133 "," $290,435.51 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164900544,"XIONG, PAZOO",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871589762,ADVANCE COMMUNITY HEALTH INC,~,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164903324,"BOULUS, LAUREN, MARIA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164903324,"BOULUS, LAUREN, MARIA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1164903415,"WEIGAND, ELIZABETH, MORGAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164904611,"BUCKLEY, ALEXANDRA, LEE",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 166 , 187 , 265 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164904702,"GORDON, REBECCA, ANNE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 35 , 89 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164912655,"HARTMAN, KARLIE, BROOKS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 49 , 52 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1164912796,"FERRI, AMANDA, ASSUNTA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1164912796,"FERRI, AMANDA, ASSUNTA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1164912796,"FERRI, AMANDA, ASSUNTA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 20 , 42 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164912796,"FERRI, AMANDA, ASSUNTA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1164912796,"FERRI, AMANDA, ASSUNTA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164914156,"SHAH, POOJA, SUNIL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164914834,"WYNN, MALYNDA, SUZANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164914834,"WYNN, MALYNDA, SUZANNE",200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 20 , 26 ,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1164917431,"BAKER, DENISE, WOODBY",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 82 , 258 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1164918470,"MARIN, CANDACE, LUCIENNE",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 47 , 85 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1164918470,"MARIN, CANDACE, LUCIENNE",100 S 10TH ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1164918470,"MARIN, CANDACE, LUCIENNE",100 S 10TH ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164918470,"MARIN, CANDACE, LUCIENNE",1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 56 , 87 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1164918470,"MARIN, CANDACE, LUCIENNE",1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 30 , 36 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1164920245,"WILSON, NICOLE, ELYSE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164921862,REVOLUTION INCORPORATED,,5310 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164921862,REVOLUTION INCORPORATED,5310 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1164921862,REVOLUTION INCORPORATED,,4200 MORGANTON RD STE 207 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164921862,REVOLUTION INCORPORATED,4200 MORGANTON RD STE 207 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#, 72 , 90 ,$#,,
MEDICAID DIRECT,1164921862,REVOLUTION INCORPORATED,,5860 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1164921862,REVOLUTION INCORPORATED,5860 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#, 46 , 52 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164922092,"RICE, NATHAN, HOMER",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 16 , 62 , 62 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164922423,"BASTOS DE VASCONCELLOS, ADALBERTO",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 65 , 67 , 94 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164922423,"BASTOS DE VASCONCELLOS, ADALBERTO",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164923223,"MELLOTT, ELIZABETH, MARY NISTA",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 27 , 41 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164923223,"MELLOTT, ELIZABETH, MARY NISTA",2317 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1164923223,"MELLOTT, ELIZABETH, MARY NISTA",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164924858,"LY, KAO, JALAO",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164924858,"LY, KAO, JALAO",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 123 , 242 , 261 ,$#,,
MEDICAID DIRECT,1619524097,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SPINE SPECIALISTS,3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164924858,"LY, KAO, JALAO",3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164924858,"LY, KAO, JALAO",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164926895,"CHEN, EMILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164926895,"CHEN, EMILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164926895,"CHEN, EMILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164926895,"CHEN, EMILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 23 , 29 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164927836,"LODGEK, ERIKA, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 38 , 41 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 33 , 51 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 87 , 87 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 70 , 70 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 30 , 50 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",840 FLEMING ST STE 6 HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 27 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",374 US 70 W   MARION NC,059,McDowell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 77 , 78 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",374 US 70 W   MARION NC,059,McDowell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1164928503,"JONES, BRIAN, EDWARD",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 320 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1164928859,"KULKARNI, MONICA, SHAH",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1164929279,ACCURATE MEDICAL EQUIPMENT & SUPPLI,,206 NEW EDITION CT   CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1164929279,ACCURATE MEDICAL EQUIPMENT & SUPPLI,206 NEW EDITION CT   CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,446 "," 1,448 "," $153,742.82 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 54 , 69 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164929295,"BYRD, CLIFTON, NELSON",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164936852,"WEBSTER, LINDSAY, MARIE",10479 N NC HIGHWAY 109 STE 107A WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 93 , 173 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 59 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,100 CORNERSTONE DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164941977,"GRAHAM, KENNETH, DANIEL",4041 ED DR STE 108 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164942892,"WILKENS, WAYNE, DOUGLAS",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164942892,"WILKENS, WAYNE, DOUGLAS",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164942892,"WILKENS, WAYNE, DOUGLAS",7006 SHANNON WILLOW RD   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164942892,"WILKENS, WAYNE, DOUGLAS",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164942892,"WILKENS, WAYNE, DOUGLAS",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 11 , 45 , 45 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1164943320,"STOGNER, BRIAN, DOUGLAS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164944377,"ASHLEY, DAVID, MICHAEL",200 TRENT DR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164944377,"ASHLEY, DAVID, MICHAEL",200 TRENT DR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",498 MADISON RD   MOCKSVILLE NC,030,Davie,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 27 , 61 , 61 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",498 MADISON RD   MOCKSVILLE NC,030,Davie,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 25 , 25 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 47 , 179 , 179 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",5229 APPOMATTOX RD   PLEASANT GARDEN NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 24 , 90 , 90 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",1315 GREENSBORO RD   HIGH POINT NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",109 PENNY RD   HIGH POINT NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",1 MARITHE CT   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 33 , 119 , 119 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",206 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 20 , 88 , 88 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164947305,"CHIPMAN, TOSHIA, NICOLE",206 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1164948022,"BLOOM, KATHLEEN, ROCKHOLT",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164948022,"BLOOM, KATHLEEN, ROCKHOLT",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164948139,"RAPALO, DALILA",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 34 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164948139,"RAPALO, DALILA",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164949814,MOSES CONE PHYSICIAN SERVICES INC,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,, 31 , 31 , 52 ,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1164950267,"PIERSON, JEREMY, MICHAEL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 117 , 128 , 161 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164953055,"BALA, DAVID, OREOLUWA BALARABE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 22 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164953055,"BALA, DAVID, OREOLUWA BALARABE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 44 , 51 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1164953055,"BALA, DAVID, OREOLUWA BALARABE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 70 , 69 , 76 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164953097,"MASUCK, DAVID, JAMES",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 117 , 117 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164953097,"MASUCK, DAVID, JAMES",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1164953097,"MASUCK, DAVID, JAMES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 168 , 207 , 318 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1164953253,"QUINLAN, NICOLE, DURIG",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164953253,"QUINLAN, NICOLE, DURIG",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 18 , 29 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164953253,"QUINLAN, NICOLE, DURIG",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164953253,"QUINLAN, NICOLE, DURIG",6715 MCCRIMMON PKWY STE 205 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 33 , 58 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164953444,"CREPINSEK, ANTON, JOHN",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164953444,"CREPINSEK, ANTON, JOHN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164953444,"CREPINSEK, ANTON, JOHN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164953444,"CREPINSEK, ANTON, JOHN",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164953444,"CREPINSEK, ANTON, JOHN",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164953444,"CREPINSEK, ANTON, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164953444,"CREPINSEK, ANTON, JOHN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1164953550,"LALTOO, KEVIN",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 186 , 188 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1164954137,"KRISHNA, GOPIKA, RADHA",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164954137,"KRISHNA, GOPIKA, RADHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164954772,"SHOFFNER, JOSEPH, LEMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 60 , 115 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164955159,"ARBOGAST, MITCHELL, KEEGAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 109 , 110 , 167 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164955654,"SANG, JESSICA, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164955654,"SANG, JESSICA, LEE",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164955654,"SANG, JESSICA, LEE",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164955654,"SANG, JESSICA, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1164955654,"SANG, JESSICA, LEE",1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1750965257,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE KILDAIRE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164957502,"NGUYEN, BROOKE, PRESTRIDGE",110 KILDAIRE PARK DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164957502,"NGUYEN, BROOKE, PRESTRIDGE",1001 CRESCENT GRN   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1124405014,PIEDMONT HEALTH SERVICES INC,~,1315 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124450226,PIEDMONT HEALTH SERVICES INC,~,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1144652249,PIEDMONT HEALTH SERVICES INC,~,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 57 , 64 , 203 ,$#,,
MEDICAID DIRECT,1497187595,PIEDMONT HEALTH SERVICES INC,~,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376361204,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL CHC,105 CONNER DR STE 2100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 16 , 49 ,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 78 , 87 , 235 ," $10,833.16 ",,
MEDICAID DIRECT,1851723951,PIEDMONT HEALTH SERVICES INC,MONCURE CHC DENTAL,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164959813,"HARRISON, LAUREN, MICHEL",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,121 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1164961207,"GARCIA, JEAN, MICHELLE",121 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1164961884,"ELLIS, RACHEL, E",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164961918,"HOWELL-METHVIN, CAROLINE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 187 , 187 ,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164961918,"HOWELL-METHVIN, CAROLINE, ELIZABETH",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164961918,"HOWELL-METHVIN, CAROLINE, ELIZABETH",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164962858,"MYERS-REED, LINDA, LOUISE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 59 , 62 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1164962858,"MYERS-REED, LINDA, LOUISE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1164962858,"MYERS-REED, LINDA, LOUISE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1164962858,"MYERS-REED, LINDA, LOUISE",116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164966636,"WHITT, JULIA, REDMON",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1164966636,"WHITT, JULIA, REDMON",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 16 , 22 ,$#,,
MEDICAID DIRECT,1164967212,GOLDEN SUN HOME HEALTH LLC,GOLDEN SUN HOME CARE,437 MAIN AVE SW   HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1164967212,GOLDEN SUN HOME HEALTH LLC,437 MAIN AVE SW   HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,#," 2,043 "," 2,091 "," $317,512.15 ",,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1164968103,"KULIK, NATALIA",2125 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1164969614,"GREEN, CARRIE, LYNN",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 67 , 122 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164972790,"WRIGHT, RONDA, RENEE",1712 S STRATFORD RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1033565007,STAR MEDICAL CLINIC PLLC,,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1164974796,"THOMPSON, JEREMY, KEITH",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 95 , 185 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1164978516,"BATCHELOR, MORGAN, MACKENZIE",110 PATRICK CT   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 170 , 322 , 595 ,$#,,
MEDICAID DIRECT,1720120637,NORTH CAROLINA A T STATE UNIVERSITY,,112 N BENBOW RD   GREENSBORO NC,041,Guilford,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1164978920,"BROADNAX, NATASHIA, ANGELINE",112 N BENBOW RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164979365,"DESMOND, ELIZABETH, STRICKLAND",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164979779,EMPOWER THERAPY PLLC,,902 AVALON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164979779,EMPOWER THERAPY PLLC,902 AVALON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 33 , 410 , 413 ," $38,678.77 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164981445,"SULEIMAN, BELAL, ABDEL-KARIM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1164981478,"PLOTT, MATTHEW, THOMAS",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164982856,"MAJOR, MATTHEW, BRIAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164982872,"O'CONNOR, GREGORY, MICHAEL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 35 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164982872,"O'CONNOR, GREGORY, MICHAEL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164982872,"O'CONNOR, GREGORY, MICHAEL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164982872,"O'CONNOR, GREGORY, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 44 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1164982872,"O'CONNOR, GREGORY, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1164982880,"MULLUR, KIRAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 74 , 101 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164983094,"GROSS, ANDREW, WILLIAM",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164983094,"GROSS, ANDREW, WILLIAM",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1164983607,"EDMISTEN, KRISTIE, LANGLEY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1164983607,"EDMISTEN, KRISTIE, LANGLEY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 26 , 47 ,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164984274,"LYLE, ASHTON, BROOKE",251 GRANDE HEIGHTS DR   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 63 ,$#,,
MEDICAID DIRECT,1720727258,DR ROBERT SCHMIDT PLLC,DBA HARRISON POINTE DENTISTRY,251 GRANDE HEIGHTS DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1164984274,"LYLE, ASHTON, BROOKE",251 GRANDE HEIGHTS DR   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 169 , 324 ," 1,040 "," $49,500.86 ",,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164984571,"RYAN, MARILIA",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 253 , 424 ," 1,234 "," $61,678.64 ",,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1164984571,"RYAN, MARILIA",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1164984571,"RYAN, MARILIA",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 15 , 57 ,$#,,
MEDICAID DIRECT,1710427091,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN CARDIOLOGY,708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1164985008,"CRITTENDEN, AMY, LOUISE",708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164985412,"BARBER, CAMERON, AUSTIN KEALOHA",110 KILDAIRE PARK DR   CARY NC,092,Wake,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1750133781,WAKEMED SPECIALISTS GROUP LLC,WAKEMED SLEEP MEDICINE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164985412,"BARBER, CAMERON, AUSTIN KEALOHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1316943145,CENTRAL CAROLINA DERMATOLOGY,CENTRAL CAROLINA DERMATOLOGY CLINICINC,6 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1164985529,"CHEN, CYNTHIA",4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1316943145,CENTRAL CAROLINA DERMATOLOGY,CENTRAL CAROLINA DERMATOLOGY CLINICINC,4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164985529,"CHEN, CYNTHIA",4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 34 , 47 , 60 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164985693,"HORAN, TROY, RICHARD",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 131 , 383 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164985693,"HORAN, TROY, RICHARD",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 63 , 179 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1164985693,"HORAN, TROY, RICHARD",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386358877,CAROLINA REHAB CONSULTANTS PLLC,,2475 HILLCREST CENTER CIR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164985768,"CLEGG, PATRICK, CLELLAND",2475 HILLCREST CENTER CIR   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 35 , 210 , 210 ,$#,,
MEDICAID DIRECT,1386358877,CAROLINA REHAB CONSULTANTS PLLC,,2475 HILLCREST CENTER CIR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1164985768,"CLEGG, PATRICK, CLELLAND",2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164987251,"MARKHAM, MORGAN, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1164987251,"MARKHAM, MORGAN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1164987251,"MARKHAM, MORGAN, ANN",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164989794,PORT CITY SPEECH PLLC,,6906 FINIAN DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1164989794,PORT CITY SPEECH PLLC,6906 FINIAN DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,, 13 , 147 , 147 ," $10,008.33 ",,
MEDICAID DIRECT,1164990040,COASTAL PROSTHETICS ORTHOTICS,,433 NETWORK STA   CHESAPEAKE VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1164990040,COASTAL PROSTHETICS ORTHOTICS,433 NETWORK STA   CHESAPEAKE VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 24 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164991014,"TURMEL, CALEB, PETER",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 23 , 43 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164991014,"TURMEL, CALEB, PETER",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1164991014,"TURMEL, CALEB, PETER",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1164995759,"GOMEZ, ANN ELISABETH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1164995759,"GOMEZ, ANN ELISABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1164999843,"EMANUEL, HELENA, SMITH",725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 22 , 36 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164999843,"EMANUEL, HELENA, SMITH",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE B PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164999843,"EMANUEL, HELENA, SMITH",923 W 3RD ST STE B PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 102 , 109 , 158 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,217 W BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164999843,"EMANUEL, HELENA, SMITH",217 W BROAD ST   SAINT PAULS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 21 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE C PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164999843,"EMANUEL, HELENA, SMITH",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 150 , 188 , 517 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1164999843,"EMANUEL, HELENA, SMITH",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1174001937,ALLSTATE MEDICAL EQUIPMENT & SUPP,~,2108 E OZARK AVE   GASTONIA NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1174001937,ALLSTATE MEDICAL EQUIPMENT & SUPP,2108 E OZARK AVE   GASTONIA NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 62 , 232 , 317 ," $55,875.72 ",,
MEDICAID DIRECT,1174001937,ALLSTATE MEDICAL EQUIPMENT & SUPP,~,2108 E OZARK AVE   GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174001937,ALLSTATE MEDICAL EQUIPMENT & SUPP,2108 E OZARK AVE   GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 39 , 305 , 767 ," $61,096.10 ",,
MEDICAID DIRECT,1174001937,ALLSTATE MEDICAL EQUIPMENT & SUPP,~,,,Unknown,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1174001937,ALLSTATE MEDICAL EQUIPMENT & SUPP,607 W GROVER ST   SHELBY NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",2827 LYNDHURST AVE STE 206 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",1710 KERNERSVILLE MEDICAL PKWY STE 210 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 25 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720327729,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VASCULAR SPECIALISTS,2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174004568,"WRIGHT, KRISTEN, MARIE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174005854,"NEILL, CAROLINE, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174005854,"NEILL, CAROLINE, MICHELLE",1704 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 29 , 35 , 77 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174006035,"WILSON, TARA, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174009245,VIKOR SCIENTIFIC LLC,,22 WESTEDGE ST STE 800 CHARLESTON SC,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1174009245,VIKOR SCIENTIFIC LLC,22 WESTEDGE ST STE 800 CHARLESTON SC,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 21 , 35 , 239 ," $19,935.00 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174009807,"NARIMITI, ANVESH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 75 , 75 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174010813,"ROSE, HEATHER, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174010813,"ROSE, HEATHER, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174010813,"ROSE, HEATHER, LEE",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174010813,"ROSE, HEATHER, LEE",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174011340,"GREENBERG, MICHAEL, RICHARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174011340,"GREENBERG, MICHAEL, RICHARD",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174011340,"GREENBERG, MICHAEL, RICHARD",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174011381,"BABINSKI, KYLE, JAMES",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174011381,"BABINSKI, KYLE, JAMES",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174011381,"BABINSKI, KYLE, JAMES",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174011381,"BABINSKI, KYLE, JAMES",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184324345,ASCEND PEDIATRIC PULMONARY PLLC,,49 MCDOWELL ST STE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174012637,"SCOTT, ZENI",49 MCDOWELL ST STE B ASHEVILLE NC,011,Buncombe,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#, 22 , 37 ,$#,,
MEDICAID DIRECT,1821398512,GRAND STRAND SPECIALTY ASSOCIATES,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174015416,"VANELLS, LUKE, DOUGLAS",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1568127132,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - BARCLAY,1124 GALLERY PARK LN STE 101 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174015424,"TOOKER, DANIELLE, GOUGH",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174015762,"GIORDANO, JARED, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 79 , 238 , 238 ,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174015879,"TRANNGUYEN, BAOTRAN",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174015929,"HAMDAN, AMAL, ELIYAS",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1174015929,"HAMDAN, AMAL, ELIYAS",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174015929,"HAMDAN, AMAL, ELIYAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1295881712,PRIVATE DIAGNOSTIC CLINIC PLLC,GYN CLINIC,11001 DURANT RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174015929,"HAMDAN, AMAL, ELIYAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174016232,"SORENSEN, DINA, MARIE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720198369,ROANOKE VALLEY HEALTH SERVICES INC,ROANOKE CLINIC,1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1174016828,"HARVEY, KELLY, WARF",1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174016828,"HARVEY, KELLY, WARF",1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 228 , 404 , 776 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,97 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1174016828,"HARVEY, KELLY, WARF",97 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174017958,"MIROCKE, ANDREW, GEOFFREY",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1174017958,"MIROCKE, ANDREW, GEOFFREY",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174017958,"MIROCKE, ANDREW, GEOFFREY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174017958,"MIROCKE, ANDREW, GEOFFREY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174017958,"MIROCKE, ANDREW, GEOFFREY",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174018154,"MILLS, RACHEL, LEONARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1174018998,"CARMONA, RICHARD, KARL",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 25 , 33 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174018998,"CARMONA, RICHARD, KARL",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 27 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174018998,"CARMONA, RICHARD, KARL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 53 , 81 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1174018998,"CARMONA, RICHARD, KARL",170 MANNING DRIVE   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174020101,"SCHERR, KAREN, AMANDA",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174020101,"SCHERR, KAREN, AMANDA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174020473,"RUTH, NICHOLAS, CHARLES",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174020473,"RUTH, NICHOLAS, CHARLES",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1174020473,"RUTH, NICHOLAS, CHARLES",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174020473,"RUTH, NICHOLAS, CHARLES",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1174020473,"RUTH, NICHOLAS, CHARLES",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174020895,"ROZIER, RICHARD, TODD",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174020895,"ROZIER, RICHARD, TODD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 36 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174020895,"ROZIER, RICHARD, TODD",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 64 , 57 , 58 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174020895,"ROZIER, RICHARD, TODD",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174022743,"BRAKE, ANDREW, RONALD",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 26 , 76 ,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174022743,"BRAKE, ANDREW, RONALD",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 35 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174022743,"BRAKE, ANDREW, RONALD",5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174022743,"BRAKE, ANDREW, RONALD",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174022743,"BRAKE, ANDREW, RONALD",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174026991,"GOINS, ALLIE, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 53 , 54 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174027320,"KELLY, MARK, HUMPHREYS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 33 , 35 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174027320,"KELLY, MARK, HUMPHREYS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 276 , 300 , 352 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174027320,"KELLY, MARK, HUMPHREYS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 39 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174028971,"PENCE, ARI, ALEXANDRA",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1528495108,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - CONCORD,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174029169,"EL-AKAWI, JALAL, ZEYAD",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 108 , 219 , 284 ,$#,,
MEDICAID DIRECT,1528495108,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - CONCORD,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174029169,"EL-AKAWI, JALAL, ZEYAD",160 DENTAL CIR CB 7172 BURNETT-WOMACK 8027 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174029797,"HARRIS, NATHANIEL, JOSEPH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174029797,"HARRIS, NATHANIEL, JOSEPH",40 DUKE MEDICINE CIR CLINIC 1J DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 25 , 35 ,$#,,
MEDICAID DIRECT,1174030225,ALLEN BUTLER OD PA,FAMILY EYE CARE,200 DOCTORS DR STE K JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1174030225,ALLEN BUTLER OD PA,200 DOCTORS DR STE K JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,," 1,218 "," 1,237 "," 2,433 "," $33,109.68 ",,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1174031173,"CHAVIS, DANIELLE, NICOLE",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 72 , 147 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174031579,"CHAVEZ, CARMEN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 79 , 96 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174033146,"MULDOON, KAITLYN, GERALDINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174033146,"MULDOON, KAITLYN, GERALDINE",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174033146,"MULDOON, KAITLYN, GERALDINE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174038400,"ANKRAH, RICHARD, ASAFOATSE",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174038400,"ANKRAH, RICHARD, ASAFOATSE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174038400,"ANKRAH, RICHARD, ASAFOATSE",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 121 , 149 ,$#,,
MEDICAID DIRECT,1437643988,MOSES CONE AFFILIATED PHYSICIANS IN,COX FAMILY PRACTICE,350 N COX ST STE 28 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1174041867,"CRAFT, BRADY, KENT",350 N COX ST STE 28 ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 68 , 107 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174043418,"HEDGECOCK, ASHLYN, DUKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 64 , 68 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174046619,"REMENAR, DIANA, JO",206 JOE KNOX AVE STE F MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174046619,"REMENAR, DIANA, JO",206 JOE KNOX AVE STE F MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043210099,CORNERSTONE MEDICAL CLINIC P C,,7704 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174047070,"PUNGU, EOMBA, FRANCOISE",7704 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 43 , 49 , 108 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1174048037,"JAMES-DAVINROY, SHARON, PATRICIA",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174048037,"JAMES-DAVINROY, SHARON, PATRICIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 27 , 27 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1174048037,"JAMES-DAVINROY, SHARON, PATRICIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174048037,"JAMES-DAVINROY, SHARON, PATRICIA",2301 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 41 , 51 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174050140,"UTPALA, SRAVANTHI",2390 HEMBY LN   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174050140,"UTPALA, SRAVANTHI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 16 , 13 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174055719,"ANDHARIA, NEEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 35 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174055719,"ANDHARIA, NEEL",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174055719,"ANDHARIA, NEEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 40 , 44 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174055719,"ANDHARIA, NEEL",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174055719,"ANDHARIA, NEEL",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174058093,"WATSON, BRIAN, DANIEL",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174058093,"WATSON, BRIAN, DANIEL",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 106 , 117 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1174058093,"WATSON, BRIAN, DANIEL",2702 FARRELL RD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174063382,"WARD, CASEY, ROSS",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174063382,"WARD, CASEY, ROSS",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174063382,"WARD, CASEY, ROSS",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174066427,"SKERBETZ, RYAN, WILLIAM",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174066427,"SKERBETZ, RYAN, WILLIAM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 31 , 33 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174066427,"SKERBETZ, RYAN, WILLIAM",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174066427,"SKERBETZ, RYAN, WILLIAM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 35 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174066427,"SKERBETZ, RYAN, WILLIAM",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174066427,"SKERBETZ, RYAN, WILLIAM",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174068381,"BRITT, JENNIFER, THERESA",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 73 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174072391,"WOLEK, HEATHER, LYNNE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174074033,"BUSH, JEREMIAH, GABRIEL",7810 NC 751 STE 150 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1174074033,"BUSH, JEREMIAH, GABRIEL",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1174074033,"BUSH, JEREMIAH, GABRIEL",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 34 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174074033,"BUSH, JEREMIAH, GABRIEL",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1174076335,"BEHM, ZACHARY, SWAN",1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1174076335,"BEHM, ZACHARY, SWAN",113 A HOSPITAL LOOP   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1174076335,"BEHM, ZACHARY, SWAN",1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174077390,"BOSTWICK, TIFFANY, ESINHART",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174077390,"BOSTWICK, TIFFANY, ESINHART",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174077390,"BOSTWICK, TIFFANY, ESINHART",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174077390,"BOSTWICK, TIFFANY, ESINHART",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 28 , 28 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174077549,"TRANQUILLO, JULIA, KATHERINE",710 PARK CENTER DR STE 200 MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 30 ,$#,,
MEDICAID DIRECT,1174078588,THE VILLAS AT BENSON VII INC,,606 E MORRIS AVE   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174078588,THE VILLAS AT BENSON VII INC,606 E MORRIS AVE   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 849 , 849 ," $49,596.05 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174082614,"ALBOUY, JEAN-PIERRE, MARCEL",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics, 21 , 27 , 50 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174084370,"KESSLER, RAYMOND, AMANDUS",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1174084370,"KESSLER, RAYMOND, AMANDUS",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174084370,"KESSLER, RAYMOND, AMANDUS",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174084370,"KESSLER, RAYMOND, AMANDUS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 40 , 53 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174084370,"KESSLER, RAYMOND, AMANDUS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 41 , 60 ,$#,,
MEDICAID DIRECT,1184219222,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PEDIATRICS,713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1174086052,"CAMPBELL, ERIN, BILLUPS",713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 38 , 83 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1174087241,"MAIER, ZACHARY, DAVIS",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 15 , 15 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174087639,"WELLS, STEVEN, RAY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174088207,"ELIOT, EMILY, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 57 , 68 ," $10,059.97 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174088306,"ELMORE, ALEXIS, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174090302,A PRIMARY CHOICE INC,,1154A E CASWELL ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,1174090302,A PRIMARY CHOICE INC,1154A E CASWELL ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 3,876 "," 3,876 "," $245,820.20 ",,
MEDICAID DIRECT,1174092696,UNCONDITIONAL CARE SENIOR SERVICES,,106 EATON FERRY RD   MACON NC,093,Warren,253Z00000X,Agencies,In Home Supportive Care,,1174092696,UNCONDITIONAL CARE SENIOR SERVICES,106 EATON FERRY RD   MACON NC,093,Warren,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,783 "," 1,795 "," $201,818.88 ",,
MEDICAID DIRECT,1174096218,MARJORIE HOME CARE LLC,,8201 ARROWRIDGE BLVD STE 136 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1174096218,MARJORIE HOME CARE LLC,8201 ARROWRIDGE BLVD STE 136 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 454 , 454 ," $21,855.32 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174099873,"MCWILSON, COLLEEN, WARREN",1001 BLYTHE BLVD STE 601 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174099873,"MCWILSON, COLLEEN, WARREN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1174100044,"PETERS, DALLAS, JANE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174103147,"KAUFMAN, ASHLEY, JOANNE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174103626,"DE LAY, JORDAN, NICHOLAS",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 82 ,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1174103626,"DE LAY, JORDAN, NICHOLAS",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669107611,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE SPRING FO,815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174103626,"DE LAY, JORDAN, NICHOLAS",815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174103626,"DE LAY, JORDAN, NICHOLAS",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376893057,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PRIMARY CARE CHARLOTTE INTERNAL MEDI,400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174105258,"ANDERSON, ADRIENNE, NICOLE",400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174106702,"BERGER, ALYSE, MICHELLE",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 26 , 47 ,$#,,
MEDICAID DIRECT,1639607153,SPINE & PAIN ASSOCIATES PLLC,,1303 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1174111686,"COX, TONYA, CLAYTON",1303 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 133 , 249 ,$#,,
MEDICAID DIRECT,1174113468,LOYALTY HOME CARE AGENCY INC,,907 HAY ST STE 100B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1174113468,LOYALTY HOME CARE AGENCY INC,907 HAY ST STE 100B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 408 , 408 ," $41,457.76 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174113674,"HUSK, PHILIP, ISAAC",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174114110,HOLISTIC HOME CARE SERVICE,HOLISTIC HOMECARE SERVICE,1610 VAUGHN RD STE E BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1174114110,HOLISTIC HOME CARE SERVICE,1610 VAUGHN RD STE E BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 100 ," 15,991 "," 16,270 "," $1,268,771.34 ",,
MEDICAID DIRECT,1174114110,HOLISTIC HOME CARE SERVICE,HOLISTIC HOMECARE SERVICE,1738 HILLANDALE RD STE 102D DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1174114110,HOLISTIC HOME CARE SERVICE,1738 HILLANDALE RD STE 102D DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 58 , 58 ,$#,,
MEDICAID DIRECT,1750482493,OPEN WATER MEDICAL PA,~,1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1174116438,"PARKER JR, CALVIN, BERNARD",1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 78 , 197 , 278 ,$#,,
MEDICAID DIRECT,1750482493,OPEN WATER MEDICAL PA,~,1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1174116438,"PARKER JR, CALVIN, BERNARD",1209 E ASH ST   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,7100 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174116438,"PARKER JR, CALVIN, BERNARD",7100 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",839 DURHAM RD SUITE C WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 131 , 194 , 198 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",230 E PRESNELL ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 30 , 30 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",839 DURHAM RD SUITE C WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 75 , 159 , 166 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",230 E PRESNELL ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 63 , 63 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,311 S CAMPBELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",839 DURHAM RD SUITE C WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",839 DURHAM RD SUITE C WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1304 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",839 DURHAM RD SUITE C WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1101 HARTWELL ST   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",839 DURHAM RD SUITE C WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",215 COLLEGE ST   GRAHAM NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",3310 CROASDAILE DR STE 700 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1131 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174116578,"SAMWED, LORNA",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174120745,"XIONG, PA, CHIA",9930 KINCEY AVE STE 130 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 25 , 29 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174120745,"XIONG, PA, CHIA",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174135479,TRUSTED ANGELS HOME CARE,~,3622 LYCKAN PKWY STE 6006 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1174135479,TRUSTED ANGELS HOME CARE,3622 LYCKAN PKWY STE 6006 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 5,274 "," 5,350 "," $575,989.79 ",,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174138887,"MATHISEN, RACHEL, ELIZABETH",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 37 , 37 ,$#,,
MEDICAID DIRECT,1174138887,"MATHISEN, RACHEL, ELIZABETH",,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1174138887,"MATHISEN, RACHEL, ELIZABETH",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 24 , 35 ,$#,,
MEDICAID DIRECT,1174138887,"MATHISEN, RACHEL, ELIZABETH",,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1174138887,"MATHISEN, RACHEL, ELIZABETH",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174138887,"MATHISEN, RACHEL, ELIZABETH",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 24 , 31 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174140776,"SMITH, SAMANTHA, ELIZABETH",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174140776,"SMITH, SAMANTHA, ELIZABETH",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 105 , 143 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174140776,"SMITH, SAMANTHA, ELIZABETH",167 MOORE RD STE 201 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174143804,"RASMUS, DEBORAH, LYNN",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 31 , 42 ,$#,,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174144406,"SPENCER, EMILY, CHURCH",31 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 24 ,$#,,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174144406,"SPENCER, EMILY, CHURCH",536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 37 , 57 ,$#,,
MEDICAID DIRECT,1174146229,DEVOTED HOME HEALTH AGENCY,DEVOTED HOME HEALTH AGENCY,203 FOREST HILL AVE STE B ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1174146229,DEVOTED HOME HEALTH AGENCY,203 FOREST HILL AVE STE B ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 111 ," 22,120 "," 24,318 "," $1,993,452.23 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174147102,"STEFANICK, KAITLYN, COCKERHAM",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174147102,"STEFANICK, KAITLYN, COCKERHAM",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 24 , 24 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174148282,"ALLEN, CAROLINE, CROWE",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174148357,"GRUSHKIN, LAUREN, PEELER",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174148357,"GRUSHKIN, LAUREN, PEELER",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174150908,"ADEBEKUN, OLUWASEYI, TOLUWANI",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1174151237,"FOX, JONATHAN, EVERETTE BURTON",232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891886222,MARSHALL C MURREY MD,MARSHALL CARY MURREY MD,950 STATE FARM RD STE 300 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1174151237,"FOX, JONATHAN, EVERETTE BURTON",950 STATE FARM RD STE 300 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912022369,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WALLACE,110 EASTWOOD DR   WALLACE NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174151658,"FERGUSON, SAMANTHA, RUTH",110 EASTWOOD DR   WALLACE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174151658,"FERGUSON, SAMANTHA, RUTH",444 SW CENTER ST   FAISON NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174151658,"FERGUSON, SAMANTHA, RUTH",110 EASTWOOD DR   WALLACE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174151922,"BURYK, ALLISON, JULIA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1174159529,"WELCH, KRISTA, MARIE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1174159529,"WELCH, KRISTA, MARIE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174160774,"DEITZ, KYLE, AUSTIN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1174160774,"DEITZ, KYLE, AUSTIN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1174160774,"DEITZ, KYLE, AUSTIN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174162473,"HODGES, SAVANNAH, ROSE",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 87 , 106 ,$#,,
MEDICAID DIRECT,1174167381,CAROLINAS ALLIANCE FOR RESIDENTIAL,YADKIN VALLEY SENIOR LIVING,500 JOHNSON RIDGE RD   ELKIN NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174167381,CAROLINAS ALLIANCE FOR RESIDENTIAL,500 JOHNSON RIDGE RD   ELKIN NC,086,Surry,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 29 ," 7,172 "," 7,172 "," $458,887.14 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174170138,"MARTIN, ALLISON, PAIGE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1174170138,"MARTIN, ALLISON, PAIGE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174170138,"MARTIN, ALLISON, PAIGE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174170575,"MCCULLOUGH, KATHERINE, A A",6324 FAIRVIEW RD STE 420 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1174173520,"PHELPS, ANNA, RAE",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 42 , 176 , 176 ," $14,586.57 ",,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174175202,"CLARK, LYNDSAY, MARIE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174175491,"WANTHAL, JESSICA, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 82 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174175491,"WANTHAL, JESSICA, CHRISTINE",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 26 , 26 ,$#,,
MEDICAID DIRECT,1174176689,A HEART 2 CARE HOME LLC,A HEART 2 CARE HOME,307 N PINE ST   SPRING HOPE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174176689,A HEART 2 CARE HOME LLC,307 N PINE ST   SPRING HOPE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 672 , 672 ," $42,834.52 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174177869,"MAYFIELD, SETH, MICHAEL",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1174177869,"MAYFIELD, SETH, MICHAEL",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174178248,"SOETAERT, MAREN, ELISE",308 BRYNN MARR RD   JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 25 ,$#,,
MEDICAID DIRECT,1659966265,OYEGUNWA & ASSOCIATES IV PLLC,DINO KIDS DENTAL OF FAYETTEVILLE,1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1174182463,"AU, ANNA, THI",1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 372 , 429 ," 1,985 "," $58,597.22 ",,
MEDICAID DIRECT,1659966265,OYEGUNWA & ASSOCIATES IV PLLC,DINO KIDS DENTAL OF FAYETTEVILLE,1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1174182463,"AU, ANNA, THI",1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 292 , 375 ," 1,559 "," $62,802.94 ",,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1174183164,"HARDING, JAMES, BAUSS",2760 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 24 , 28 , 32 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 22 , 22 , 26 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174186183,"WOOD, JAMES, LAWTON",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,10000 CAMBRIDGE VILLAGE LOOP   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1174188494,WAKEMED SPECIALISTS GROUP LLC,10000 CAMBRIDGE VILLAGE LOOP   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#, 12 ,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174188494,WAKEMED SPECIALISTS GROUP LLC,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174188494,WAKEMED SPECIALISTS GROUP LLC,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174189153,"SCOTT, REBECCA, JO",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 50 , 54 ,$#,,
MEDICAID DIRECT,1174189625,LUVKUSH LLC,FOUR POINTS HOME MEDICAL,131 THIRD ST   AYDEN NC,074,Pitt,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1174189625,LUVKUSH LLC,131 THIRD ST   AYDEN NC,074,Pitt,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 168 , 952 ," 1,513 "," $140,088.49 ",,
MEDICAID DIRECT,1174189625,LUVKUSH LLC,FOUR POINTS HOME MEDICAL,131 THIRD ST   AYDEN NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1174189625,LUVKUSH LLC,131 THIRD ST   AYDEN NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1134661747,D H LEE DMD PA,LOUISBURG FAMILY DENTISTRY,531 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1174189906,"HONG, DAVID, JIOONG",531 S BICKETT BLVD   LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice, 129 , 163 , 590 ," $39,250.08 ",,
MEDICAID DIRECT,1619463429,FHPG LLC,~,2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1174192207,"GADDAM, ANUSHA, REDDY",2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 39 , 73 ,$#,,
MEDICAID DIRECT,1174193858,ROSEMANS IN-HOME CARE LLC,,3707 LATROBE DR STE 450 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1174193858,ROSEMANS IN-HOME CARE LLC,3707 LATROBE DR STE 450 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 5,171 "," 5,171 "," $322,048.60 ",,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174196919,"DEILY, MEREDITH",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 96 , 134 , 144 ,$#,,
MEDICAID DIRECT,1124593470,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES BALLANTYNE,7825 BALLANTYNE COMMONS PKWY STE 110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174199632,"DAVIS, MELISSA, ELIZABETH",7825 BALLANTYNE COMMONS PKWY STE 110 CHARLOTTE NC,060,Mecklenburg,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174204432,"ROBLES, BIANCA, ALMA",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174205330,EXPRESS CARE TRANSPORT,,555 S MANGUM ST STE 2056 DURHAM NC,032,Durham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1174205330,EXPRESS CARE TRANSPORT,555 S MANGUM ST STE 2056 DURHAM NC,032,Durham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 43 ," 1,070 "," 1,102 "," $90,813.00 ",,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174205389,"SADOU, REINATOU",229 TURNER DR   REIDSVILLE NC,079,Rockingham,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174206767,"BELCHER, SHANNON, ELIZABETH EVANS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 186 ," 1,288 "," 1,431 "," $27,148.41 ",,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1174207120,"MAZER, SYDNI, ALYSSA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 31 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174207120,"MAZER, SYDNI, ALYSSA",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174207120,"MAZER, SYDNI, ALYSSA",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174209126,"KEENAN, CHRISTINE, ELIZABETH",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 72 , 229 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174216428,"BALLAY, CODY, MICHAEL",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1174219638,"SHAW, CHAVONNE, NAKIA",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 22 , 69 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174219638,"SHAW, CHAVONNE, NAKIA",1357 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174219729,"WILCOX, ERIC, MICHAEL",11081 FOREST PINES DR STE 112 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1174220743,BRIGHT HOME CARE SERVICES LLC,,4016 VIEWMONT DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1174220743,BRIGHT HOME CARE SERVICES LLC,4016 VIEWMONT DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 319 , 319 ," $19,763.36 ",,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1174221576,"STEVENS, TONI, ROCHELLE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 51 , 51 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174226310,"CAMERON, TABITHA, HAMILTON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174226310,"CAMERON, TABITHA, HAMILTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174227276,"HEAPS, CHANDLER, HARDEE",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174230189,"JOHNSON, CHRISTIAN, WILLIAM",123 E MAIN ST STE 102 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174230189,"JOHNSON, CHRISTIAN, WILLIAM",123 E MAIN ST STE 102 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174234223,"CLARK, NA'ZAE, ATHENA",817 VOLVO PKWY   CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174237622,BRIGHTER PATH HOMES LLC,,10321 NC HIGHWAY 210   FOUR OAKS NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174237622,BRIGHTER PATH HOMES LLC,10321 NC HIGHWAY 210   FOUR OAKS NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,517 "," 1,517 "," $96,222.69 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174241061,"KOURI, ELYSE, RAE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 38 , 43 ,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1174242119,"KIRIAN, ALEXANDRIA, LEIGH",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 75 , 172 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1174242119,"KIRIAN, ALEXANDRIA, LEIGH",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 44 , 126 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174244339,"STYONS, PRISCILLA, WEBSTER",1308 HIGHLAND DR   GREENVILLE NC,074,Pitt,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1174250708,GMYND HOMECARE SERVICES,GMYND HOMECARE SERVICES,1140 KILDAIRE FARM RD STE 207 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1174250708,GMYND HOMECARE SERVICES,1140 KILDAIRE FARM RD STE 207 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,063 "," 1,063 "," $127,572.60 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174251193,"ADDINGTON, EMILY, NICOLE",113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174251193,"ADDINGTON, EMILY, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174251193,"ADDINGTON, EMILY, NICOLE",310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 11 , 23 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1174251524,"NIELSEN, NICOLE, ASHLEY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 161 , 197 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1174251524,"NIELSEN, NICOLE, ASHLEY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1174251524,"NIELSEN, NICOLE, ASHLEY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 75 , 75 ,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1174251888,"MICHELS, AUSTIN, EDWARD",910 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 717 ," 1,162 "," 5,390 "," $375,487.02 ",,
MEDICAID DIRECT,1174251888,"MICHELS, AUSTIN, EDWARD",~,910 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1174251888,"MICHELS, AUSTIN, EDWARD",910 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1174251888,"MICHELS, AUSTIN, EDWARD",311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice, 463 , 658 ," 2,769 "," $168,433.36 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174255095,"ERICSON, KATHRYN, STROPLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174255095,"ERICSON, KATHRYN, STROPLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174255590,"WILLIAMS, ASHLEY, NICOLE",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 47 , 169 ,$#,,
MEDICAID DIRECT,1174255632,"RECTOR, TAMMY, MOXLEY",SPEECH FROM THE HEART PLLC,6013 MONTICELLO DR NW   CONCORD NC,013,Cabarrus,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1174255632,"RECTOR, TAMMY, MOXLEY",6013 MONTICELLO DR NW   CONCORD NC,013,Cabarrus,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 17 , 198 , 202 ," $14,117.09 ",,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174258461,"VICTORIA, LALIA, MARIE",2721 XRAY DR   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174258461,"VICTORIA, LALIA, MARIE",2721 XRAY DR   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174258875,"CHUPITA, SARAH, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174260376,EMPOWER SPEECH THERAPY PLLC,,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174260376,EMPOWER SPEECH THERAPY PLLC,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 18 , 126 , 156 ," $10,847.88 ",,
MEDICAID DIRECT,1154453496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT MINERAL SPRINGS,4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174265987,"BLAIR, SALEM, MCGLAMERY",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1609696913,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT KERNERSVILLE MIDDLE,110 BROWN RD   KERNERSVILLE NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174265987,"BLAIR, SALEM, MCGLAMERY",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1386158475,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CLEMMONS,4168 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174269252,"ROBINSON, ADAM, GISSEL",201 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174271324,"VROOMAN, MEGAN, LEEANNE",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1174271720,MY SPEECH DESIGN PA,,46 SUNNYBROOK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174271720,MY SPEECH DESIGN PA,46 SUNNYBROOK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#, 124 , 124 ,$#,,
MEDICAID DIRECT,1174271720,MY SPEECH DESIGN PA,,105A CHARLOTTE HWY   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174271720,MY SPEECH DESIGN PA,105A CHARLOTTE HWY   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#, 60 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174273445,"SCOTT, CRYSTAL, NICOLE",4101 MACON POND RD   RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1174276695,CREATIVELY RENEWED LIVING LLC,,1006 RICHMOND AVE   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174276695,CREATIVELY RENEWED LIVING LLC,1006 RICHMOND AVE   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 64 , 64 ," $11,433.16 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174279418,"CENTURY, NIRMALA, GAUTAM",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4300 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174279418,"CENTURY, NIRMALA, GAUTAM",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,570 LOWER BRUSH CREEK RD   FLETCHER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174287833,"TUGMAN, CAITLIN, JOYCE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174287833,"TUGMAN, CAITLIN, JOYCE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 109 , 109 ," $17,757.71 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174287833,"TUGMAN, CAITLIN, JOYCE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 39 , 39 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,193200000X,Group,Multi-Specialty,,1174287833,"TUGMAN, CAITLIN, JOYCE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174287833,"TUGMAN, CAITLIN, JOYCE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 31 , 32 ,$#,,
MEDICAID DIRECT,1174291686,PRESTIGE HOME CARE LLC,,555 S MANGUM ST STE 100 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1174291686,PRESTIGE HOME CARE LLC,555 S MANGUM ST STE 100 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 667 , 667 ," $37,625.40 ",,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174293872,"BRADLEY, STACEY, ANN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 23 , 23 ,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174298947,"MINICK, HANNAH, GRACE",490 HOSPITAL DR   CLYDE NC,044,Haywood,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 62 , 62 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1174301329,"SHEPARD, REBECCA, JOAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 50 , 63 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1174302558,"TUOHY, NANCY, RODWELL",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174302558,"TUOHY, NANCY, RODWELL",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174302558,"TUOHY, NANCY, RODWELL",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 24 , 27 , 45 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174302558,"TUOHY, NANCY, RODWELL",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,5929 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174303341,"HOWARD, MAURA, ANN",5929 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1940 WEST BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174303341,"HOWARD, MAURA, ANN",1940 WEST BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 56 , 68 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174303614,"PRENTIS, JILLIAN, MEITRODT",300 BETHESDA DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 25 , 69 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174303614,"PRENTIS, JILLIAN, MEITRODT",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174307094,"FRATTO, CLAIRE, ANNA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174307094,"FRATTO, CLAIRE, ANNA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174330799,CARE CONCEPT LLC,,5300 SIX FORKS RD STE 205 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1174330799,CARE CONCEPT LLC,5300 SIX FORKS RD STE 205 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174345680,"ABEE THOMAS, MIKAYLA, AIKO",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1174348882,"PATRONE, LINDA, DIANE",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174359392,"SOBEJANA, JENNIFER, DIAZ",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174362735,"HEDWIN, VICTORIA, JEAN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1174362735,"HEDWIN, VICTORIA, JEAN",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174362735,"HEDWIN, VICTORIA, JEAN",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 31 , 31 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174376644,"THOMPSON, GWENDOLYN, VICTORIA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 153 , 153 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174377659,"TAYLOR, CORRINE, LEIGH",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174384861,"TAYLOR, HALEY, ANN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174384929,"WNUK, BRETT, ALEXANDRA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174386056,"MILLER, TIFFANY, DANIELLE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 102 , 147 , 220 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174386056,"MILLER, TIFFANY, DANIELLE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 62 , 79 ,$#,,
MEDICAID DIRECT,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,~,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174389720,"NEAL, OLIVIA, MORGAN",2716 HENRY ST   GREENSBORO NC,041,Guilford,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1174393532,"ADKINS, AMIE, LYNN",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 17 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1174399455,"KLEVINS, HANNAH, MARIE",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 37 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1174399455,"KLEVINS, HANNAH, MARIE",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174501142,"JORDAN, KATHLEEN, SANDERS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427142561,CAROLINA REHABILITATION INC,CAROLINA REHABILITATION INC,20 MEDICAL CAMPUS DR NW STE 204 SUPPLY NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1174502645,"BOEHMER, NIKOLOS, WILLIAM",20 MEDICAL CAMPUS DR NW STE 204 SUPPLY NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174503635,"WILSON, BRAD, ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174503635,"WILSON, BRAD, ALLEN",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1174503635,"WILSON, BRAD, ALLEN",45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497735179,CENTRAL CAROLINA MEDICAL ASSOCIATES,~,1908 HILCO ST STE B ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1174503718,"VEATCH, PHILIP, DEAN",1908 HILCO ST STE B ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 183 , 242 ,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1174504237,"HUNTER, JOSEPH, KEVIN",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 120 , 403 , 523 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174504609,"COPPOLINO, SARAH, MUELLER",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 50 , 98 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174504609,"COPPOLINO, SARAH, MUELLER",10441 MONCREIFFE RD STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174506216,"HALE, LISA, GAYE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174506216,"HALE, LISA, GAYE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174506216,"HALE, LISA, GAYE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174507537,"NAMAK, SHAHLA, YOUSIF",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,1430 FELICITY LN   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174507537,"NAMAK, SHAHLA, YOUSIF",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174507537,"NAMAK, SHAHLA, YOUSIF",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 24 , 26 ,$#,,
MEDICAID DIRECT,1174507990,"KLEIN, KENNETH, LEROY",~,600 MCCARTHY BLVD   NEW BERN NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1174507990,"KLEIN, KENNETH, LEROY",600 MCCARTHY BLVD   NEW BERN NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 43 , 68 , 122 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174508030,"MCGINNIS, HENDERSON, DWAYNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 76 , 81 , 83 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174508451,"SAGERMAN, PAUL, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174508451,"SAGERMAN, PAUL, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174510804,"CHUNG, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174510804,"CHUNG, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174510804,"CHUNG, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1174511976,BLACK RIVER HEALTH SERVICES INC,Black River Health Services,109 W CHURCH ST   ATKINSON NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174511976,BLACK RIVER HEALTH SERVICES INC,109 W CHURCH ST   ATKINSON NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 23 , 70 , 72 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,217 W BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1174512933,"KEITH, BARBARA, DUST",217 W BROAD ST   SAINT PAULS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174512933,"KEITH, BARBARA, DUST",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 89 , 182 , 372 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1174512933,"KEITH, BARBARA, DUST",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174512933,"KEITH, BARBARA, DUST",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 16 , 29 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174515290,"JOYNER, MICHAEL, WAYNE",606 E 12TH ST   WASHINGTON NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174515290,"JOYNER, MICHAEL, WAYNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 45 , 53 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174517049,"WOLFSON, KENNETH, ADAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 64 , 68 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174517049,"WOLFSON, KENNETH, ADAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 65 , 66 , 80 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174517049,"WOLFSON, KENNETH, ADAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174517189,"HARRILL, WILLARD, CARDWELL",304 10TH AVE NE   HICKORY NC,018,Catawba,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 122 , 268 , 362 ," $10,944.19 ",,
MEDICAID DIRECT,1679568992,GASTONIA PEDIATRIC ASSOCIATES PA,GASTONIA PEDIATRIC ASSOCIATES PA,1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1174518427,"WALKER, CONSTANCE, ELAINE",1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 63 , 159 ,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174518559,"PULITZER, DONALD, RICHARD",706 GREEN VALLEY RD STE 104   GREENSBORO NC,041,Guilford,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174518666,"NEWELL, MARK, ANTHONY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174518666,"NEWELL, MARK, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 89 , 99 ,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174519961,"OKEEFFE, MICHAEL, EDWARD",306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 56 , 90 ,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174519961,"OKEEFFE, MICHAEL, EDWARD",601 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 22 , 24 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174521587,"AVVA, RAMESH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 397 , 421 , 509 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174521587,"AVVA, RAMESH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1174521587,"AVVA, RAMESH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174521587,"AVVA, RAMESH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 297 , 319 , 377 ,$#,,
MEDICAID DIRECT,1174521686,"SHAVER, JAMES, WILLIAM",DR JAMES W SHAVER,301 S MAIN ST   LANDIS NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,,1174521686,"SHAVER, JAMES, WILLIAM",301 S MAIN ST   LANDIS NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 16 , 16 , 23 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174521694,"DAW, JEFFREY, RICHARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 58 , 69 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174521694,"DAW, JEFFREY, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 35 , 51 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174521694,"DAW, JEFFREY, RICHARD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174521694,"DAW, JEFFREY, RICHARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 42 , 55 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174521694,"DAW, JEFFREY, RICHARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174521694,"DAW, JEFFREY, RICHARD",210 ASHVILLE AVE   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 23 , 30 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174522528,"MITTL, ROBERT, LOUIS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 111 , 112 , 130 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174522528,"MITTL, ROBERT, LOUIS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 83 , 84 , 102 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174522817,"LUCAS, MICHAEL, JOHN",601 N ELM ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174522817,"LUCAS, MICHAEL, JOHN",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 112 , 180 , 385 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174522817,"LUCAS, MICHAEL, JOHN",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174522817,"LUCAS, MICHAEL, JOHN",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1174524292,"SPEIGHT, KEVIN, LEWIS",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1174524433,"SPINICCHIA, MATTHEW, FRANK",2153 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174524433,"SPINICCHIA, MATTHEW, FRANK",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174524433,"SPINICCHIA, MATTHEW, FRANK",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174524433,"SPINICCHIA, MATTHEW, FRANK",2153 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689673279,PIEDMONT NEPHROLOGY AND HYPERTENSIO,~,1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174524920,"PAUL, RICHARD, VINCENT",352 E PARKER RD STE B MORGANTON NC,012,Burke,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 50 , 50 ,$#,,
MEDICAID DIRECT,1689673279,PIEDMONT NEPHROLOGY AND HYPERTENSIO,~,1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174524920,"PAUL, RICHARD, VINCENT",1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 96 , 300 , 325 ," $10,265.36 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174525315,"BYRUM, GRAHAM, VANCE",1212 CHARLES ST   WINDSOR NC,008,Bertie,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 118 , 118 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174525315,"BYRUM, GRAHAM, VANCE",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 107 , 174 , 380 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174525315,"BYRUM, GRAHAM, VANCE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174526123,"HOEHN SARIC, EDWARD, WILLIAM",293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 107 , 276 , 323 ," $12,270.45 ",,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174526123,"HOEHN SARIC, EDWARD, WILLIAM",293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1174527592,"BELLAVIA, ROSS, JOSEPH",700 E MOREHEAD ST STE 300   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174527592,"BELLAVIA, ROSS, JOSEPH",700 E MOREHEAD ST STE 300   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174527592,"BELLAVIA, ROSS, JOSEPH",700 E MOREHEAD ST STE 300   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 181 , 193 , 239 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174527592,"BELLAVIA, ROSS, JOSEPH",700 E MOREHEAD ST STE 300   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 302 , 343 , 390 ," $11,075.09 ",,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1174527592,"BELLAVIA, ROSS, JOSEPH",700 E MOREHEAD ST STE 300   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174529879,"KREGER, HOWARD, LAWRENCE",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 145 , 243 , 289 ," $10,800.42 ",,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1174530075,"MOORE, JOHN, ROGER",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 152 , 263 , 397 ,$#,,
MEDICAID DIRECT,1487919973,MCPC-9 LLC,FIRSTHEALTH SURGICAL SPECIALTIES,809 S LONG DR STE K ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1174530075,"MOORE, JOHN, ROGER",809 S LONG DR   ROCKINGHAM NC,077,Richmond,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,1208 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174530562,"KISELLA, JOHN, DAVID",1208 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 11 , 14 , 77 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174530562,"KISELLA, JOHN, DAVID",1208 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 16 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174530562,"KISELLA, JOHN, DAVID",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 26 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174531602,"JULIUS, STEVEN, MARC",303 AIRPORT RD   ARDEN NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 100 , 102 ," $22,508.73 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174531990,"PAROLARI, PATRICIA, ANNE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1174532535,"SAN PEDRO, ELMER, CUNANAN",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 58 , 65 , 86 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174534416,"CATON, KATHERINE, POE",4927 S CROATAN HWY   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1174534416,"CATON, KATHERINE, POE",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174534499,"HORWITZ, JAMES, LAWRENCE",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 62 , 87 , 157 ," $15,931.51 ",,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1174534978,"JOHNSON, KIMBERLY, ANN",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,521 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1174534978,"JOHNSON, KIMBERLY, ANN",521 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 57 , 57 , 113 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174538672,"UNGERLEIDER, ROSS, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174538730,"STRANGE, CEDRIC, CARL WARREN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396762886,TRINITY WELLNESS CENTER INC,TRINITY WELLNESS CENTER INCORPORATED,200 HORIZON DR STE 115 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174540264,"BUFFUM, LUKE, HOOPER",200 HORIZON DR STE 115 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003472804,LOGINCLINICS PLLC,LOGINCLINICS PLLC,406 US 1 HWY STE A YOUNGSVILLE NC,035,Franklin,193400000X,Group,Single Specialty,,1174543730,"QUALTER, JACLYN, SUZANNE",406 US 1 HWY STE A YOUNGSVILLE NC,035,Franklin,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 18 ,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174543805,"SATER, RICHARD, ARNOLD",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 118 , 186 , 328 ," $25,445.05 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174544563,"CRUM, SHARON, DALE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174547129,"TURPIN, PAMELA, ANN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174547129,"TURPIN, PAMELA, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174547129,"TURPIN, PAMELA, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1174547202,"SLOOP, CATHERINE, MARIE",CATHERINE MARIE SLOOP,2425 HEMBY LN STE A GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1174547202,"SLOOP, CATHERINE, MARIE",2425 HEMBY LN STE A GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1689695751,GREENVILLE EYE CLINIC INC,GREENVILLE EYE CLINIC INC,2425 HEMBY LN   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174547202,"SLOOP, CATHERINE, MARIE",2425 HEMBY LN STE A GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 50 , 75 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174549968,"TAKACS, PETER",2075 GLENN MITCHELL DR STE 500 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174549968,"TAKACS, PETER",2075 GLENN MITCHELL DR STE 500 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174549984,"PERRIGNON, ALEXANDRA, MARY",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831174028,DRS JERNIGAN AND ASSOCIATES,DRS JERNIGAN AND ASSOCIATES,1427 N WESLEYAN BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1174550339,"JERNIGAN, EDWARD",1427 N WESLEYAN BLVD   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 217 , 315 , 910 ," $55,154.12 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174552020,"ARDELEAN, RHONDA, SUE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174552020,"ARDELEAN, RHONDA, SUE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 36 , 38 ,$#,,
MEDICAID DIRECT,1750160867,ZION HEALING CENTERS NC LLC,,4045 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174552079,"FARAH, BRIAN, ANDREW",601 N ELM ST   HIGH POINT NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1174552665,PEDIATRIC SERVICES OF AMERICA LLC,AVEANNA HEALTHCARE,220A N MCPHERSON CHURCH RD   FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,1174552665,PEDIATRIC SERVICES OF AMERICA LLC,220A N MCPHERSON CHURCH RD   FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,, 15 ," 1,848 "," 2,218 "," $1,308,957.00 ",,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174552707,"MCCLELLAND, WILLIAM, ALFRED",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174552707,"MCCLELLAND, WILLIAM, ALFRED",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174552707,"MCCLELLAND, WILLIAM, ALFRED",8035 PROVIDENCE RD STE 320 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174552707,"MCCLELLAND, WILLIAM, ALFRED",1107 REYNOLDS ST   MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 12 , 23 ,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174552707,"MCCLELLAND, WILLIAM, ALFRED",6068 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1174553853,"RANCK, ALLISON, BLAKELY",,298 MEMORIAL DR   SENECA SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1174553853,"RANCK, ALLISON, BLAKELY",298 MEMORIAL DR   SENECA SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174556906,"FRIDAY, NANCY, COMBS",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1174556906,"FRIDAY, NANCY, COMBS",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1174556906,"FRIDAY, NANCY, COMBS",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1174556906,"FRIDAY, NANCY, COMBS",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174556906,"FRIDAY, NANCY, COMBS",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174556906,"FRIDAY, NANCY, COMBS",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1174556906,"FRIDAY, NANCY, COMBS",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174556906,"FRIDAY, NANCY, COMBS",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174556906,"FRIDAY, NANCY, COMBS",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1174557128,"FANTA, TESFAYE, DEMISSIE",TESFAYE DEMISSIE FANTA,910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1174557128,"FANTA, TESFAYE, DEMISSIE",910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 100 , 467 , 494 ," $10,754.62 ",,
MEDICAID DIRECT,1033489216,TESFAYE D FANTA MD PLLC,TESFAYE D FANTA MD PLLC,910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1174557128,"FANTA, TESFAYE, DEMISSIE",910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 88 , 95 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174557292,"TELLIS ODOM, VALENCIA",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 107 , 230 , 435 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174557292,"TELLIS ODOM, VALENCIA",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 27 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174557292,"TELLIS ODOM, VALENCIA",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174557292,"TELLIS ODOM, VALENCIA",10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174560015,"DAMLE, SNEHAL, ANANT",3636 HIGH ST   PORTSMOUTH VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1174560544,WESTERN CARTERET FIRE AND EMS DEPAR,WESTERN CARTERET FIRE AND EMS DEPARTMENT INC,140 SHERWOOD AVE   CEDAR POINT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1174560544,WESTERN CARTERET FIRE AND EMS DEPAR,140 SHERWOOD AVE   CEDAR POINT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1376892539,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES ROCKINGHAM,106 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1174561187,"LAWAL, OLUJIDE, GBOLAHAN",705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1629327895,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES LAURINGBURG,705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1174561187,"LAWAL, OLUJIDE, GBOLAHAN",705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 205 , 336 , 487 ,$#,,
MEDICAID DIRECT,1376892539,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES ROCKINGHAM,108 ENDO LN STE 1 HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1174561187,"LAWAL, OLUJIDE, GBOLAHAN",705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1174561187,"LAWAL, OLUJIDE, GBOLAHAN",705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 83 , 91 , 109 ,$#,,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174561740,"POULOS, LISA, MARIE",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1174562102,"MCSHANE, DIANA, BORTON",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 20 , 29 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174562102,"MCSHANE, DIANA, BORTON",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 29 , 38 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174562102,"MCSHANE, DIANA, BORTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1174563035,"ANTIL, MICHAEL, ALAN",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1174563035,"ANTIL, MICHAEL, ALAN",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174565444,"ONEILL, OONA, LIKHYANI",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 28 , 34 , 39 ,$#,,
MEDICAID DIRECT,1720177140,COUNTY OF DAVIE OFFICE OF FINANCE A,DAVIE COUNTY HEALTH DEPARTMENT,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1174565444,"ONEILL, OONA, LIKHYANI",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 51 , 153 ,$#,,
MEDICAID DIRECT,1417019514,COUNTY OF YADKIN OFFICE OF TREASURE,YADKIN COUNTY HEALTH DEPT,320 W MAPLE ST   YADKINVILLE NC,099,Yadkin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1174565444,"ONEILL, OONA, LIKHYANI",638 W MAIN ST   YADKINVILLE NC,099,Yadkin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",2805 S MAIN ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 54 , 171 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",3610 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",3604 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",2805 S MAIN ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",2805 S MAIN ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174565568,"FLORENDO, OSCAR, FRANCIS PAUL ANDAYA",819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 126 , 413 , 968 ," $11,292.74 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174566202,"CLARK, KAREN, MCNEIL",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174566632,"ROWAN, FRANK, JOSEPH",1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 91 , 164 ,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174567077,"YOUNG, ERIC, SAMUEL",3980 HIGHWAY 9 E STE 220 LITTLE RIVER SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174567077,"YOUNG, ERIC, SAMUEL",3617 CASEY ST STE D LORIS SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174567473,"MUSGROVE, LESLIE, LONDON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174567473,"MUSGROVE, LESLIE, LONDON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174567754,"GRENKOSKI, MARK, EDWIN",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174568364,"DEERING, JAMEY, BILLY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1043494784,ORTHOPAEDIC TRAUMA SPECIALISTS PC,ORTHOPAEDIC TRAUMA SPECIALISTS PC,1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174569529,"HANDY, MICHAEL, HARVEY",1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 50 , 113 , 212 ," $25,759.55 ",,
MEDICAID DIRECT,1174569529,"HANDY, MICHAEL, HARVEY",~,1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,1174569529,"HANDY, MICHAEL, HARVEY",1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174570162,"FLEMING, TERENCE, JOHN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 20 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1174570162,"FLEMING, TERENCE, JOHN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1174570162,"FLEMING, TERENCE, JOHN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174570162,"FLEMING, TERENCE, JOHN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 70 , 72 , 102 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174571400,"KAPA, STEPHEN, STANLEY",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1174571772,"WHEELER, CAROL, SUE",FIRST ABILITIES,2814 ALDERMAN RD   FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1174571772,"WHEELER, CAROL, SUE",2814 ALDERMAN RD   FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 12 , 223 , 223 ," $20,967.02 ",,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174571855,"GETTINGER, JOSHUA, SELIG",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174571855,"GETTINGER, JOSHUA, SELIG",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 46 , 83 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174571855,"GETTINGER, JOSHUA, SELIG",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 39 , 39 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174572382,"BASS, WILLIAM, THOMAS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174572564,"MANN, CHRISTIAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174572564,"MANN, CHRISTIAN",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174572564,"MANN, CHRISTIAN",2465 EMERALD PL   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174572564,"MANN, CHRISTIAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174573513,BLUEDOT MEDICAL INC,~,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174573513,BLUEDOT MEDICAL INC,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1114370988,GAPOVER MD PLLC,,1805 SARDIS RD N STE 124 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174574149,"HALL BAKER, EVERLYN, LILEASE",10545 BLAIR RD STE 1200 MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 42 , 47 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174574149,"HALL BAKER, EVERLYN, LILEASE",10545 BLAIR RD STE 1200 MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1174574149,"HALL BAKER, EVERLYN, LILEASE",1426 CONSTITUTION BLVD   ROCK HILL SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174574156,"FITZGERALD, WILLIAM, EDMOND",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174574156,"FITZGERALD, WILLIAM, EDMOND",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174574156,"FITZGERALD, WILLIAM, EDMOND",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 44 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174574156,"FITZGERALD, WILLIAM, EDMOND",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 23 , 28 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1174574222,"AKBAR, SYED, ALI",1709 MIDWEST CLUB PKWY   OAK BROOK IL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 40 , 40 , 47 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1174574222,"AKBAR, SYED, ALI",1709 MIDWEST CLUB PKWY   OAK BROOK IL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174574222,"AKBAR, SYED, ALI",1709 MIDWEST CLUB PKWY   OAK BROOK IL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 20 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174574222,"AKBAR, SYED, ALI",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174574578,"WEST, CAROLEE, ANN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174574578,"WEST, CAROLEE, ANN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174574578,"WEST, CAROLEE, ANN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174574578,"WEST, CAROLEE, ANN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174574578,"WEST, CAROLEE, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174575799,"DAVIS, CHRISTI, MICHELLE",~,10411 MONCREIFFE RD STE 105B RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1174575799,"DAVIS, CHRISTI, MICHELLE",10411 MONCREIFFE RD STE 105B RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 198 , 354 ," 2,786 "," $225,961.63 ",,
MEDICAID DIRECT,1174576516,"GAINER, JAMES",~,3725 WRIGHTSVILLE AVE STE A WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1174576516,"GAINER, JAMES",3725 WRIGHTSVILLE AVE STE A WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 140 , 397 ," $20,582.42 ",,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174577142,"BAILEY-RILEY, LUNA, DESHAWN",1180 WYKE RD   SHELBY NC,023,Cleveland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 79 , 113 , 186 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174577142,"BAILEY-RILEY, LUNA, DESHAWN",209 PARK ST STE 500 BELMONT NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174577142,"BAILEY-RILEY, LUNA, DESHAWN",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 74 , 103 , 164 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174577407,"DALEY, CHRISTOPHER, THOMAS",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 39 , 87 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174577407,"DALEY, CHRISTOPHER, THOMAS",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 81 , 144 , 275 ,$#,,
MEDICAID DIRECT,1245587534,FRENCH BROAD PEDIATRIC ASSOCIATES P,FRENCH BROAD PEDICATRIC ASSOCIATES PLLC,40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174577746,"GAVALAKIS, NELLY",40 N MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174579031,"WORKMAN, JONATHAN, ROBERT",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174579031,"WORKMAN, JONATHAN, ROBERT",850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 77 , 122 , 234 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174579031,"WORKMAN, JONATHAN, ROBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1174579072,"LENOBEL, ROBERT, SIEVERS",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,220 PAGE RD STE 300 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174579726,"JAWANDA, JASPAUL, SINGH",220 PAGE RD N STE 300 PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174579726,"JAWANDA, JASPAUL, SINGH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 125 , 125 ,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174579726,"JAWANDA, JASPAUL, SINGH",35 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 79 , 86 ,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174579726,"JAWANDA, JASPAUL, SINGH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174579759,"HIGHTOW WEIDMAN, LISA, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174579940,"JOHNSON, CLIFFORD, PAUL",50 HOSPITAL DR STE 2A HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174579940,"JOHNSON, CLIFFORD, PAUL",50 HOSPITAL DR STE 2A HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 17 , 27 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174580393,"STEPHENSON, HALE, HAMPTON",101 BETHESDA DR   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174580450,"FERRARA, AMY, GARRETT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174581284,"SHACKELFORD, DONALD, PAUL",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174581284,"SHACKELFORD, DONALD, PAUL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174581284,"SHACKELFORD, DONALD, PAUL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1487633780,SHELBY RADIOLOGICAL ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1174581839,"GRUBB, KRISTEN, RAE",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1326416116,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD VASCULAR ASSOCIATES SEACOAST,107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174582183,"FEE, COLLEEN, ELLEN",3980 HIGHWAY 9 E STE 310 LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1174583595,"HORDES, ANDREW, RICHARD",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 69 , 120 , 169 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1174583595,"HORDES, ANDREW, RICHARD",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1174583595,"HORDES, ANDREW, RICHARD",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174583801,"FOUST, HAROLD, BRADLEY",~,6130 HANES WAY   CLEMMONS NC,029,Davidson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1174583801,"FOUST, HAROLD, BRADLEY",6130 HANES WAY   CLEMMONS NC,029,Davidson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 47 , 659 , 659 ," $63,463.06 ",,
MEDICAID DIRECT,1174584205,SAMPSON CONVALESCENT MEDICAL SUPPLY,ROTECH,201 NORTHEAST BLVD STE D CLINTON NC,082,Sampson,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1174584205,SAMPSON CONVALESCENT MEDICAL SUPPLY,201 NORTHEAST BLVD STE D CLINTON NC,082,Sampson,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 239 , 948 ," 1,474 "," $30,463.09 ",,
MEDICAID DIRECT,1174584205,SAMPSON CONVALESCENT MEDICAL SUPPLY,ROTECH,201 NORTHEAST BLVD STE D CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174584205,SAMPSON CONVALESCENT MEDICAL SUPPLY,201 NORTHEAST BLVD STE D CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 228 , 904 ," 1,487 "," $34,840.33 ",,
MEDICAID DIRECT,1174584205,SAMPSON CONVALESCENT MEDICAL SUPPLY,ROTECH,201 NORTHEAST BLVD STE D CLINTON NC,082,Sampson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1174584205,SAMPSON CONVALESCENT MEDICAL SUPPLY,201 NORTHEAST BLVD STE D CLINTON NC,082,Sampson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#, 11 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,1219 SMOKY PARK HWY   CANDLER NC,011,Buncombe,193400000X,Group,Single Specialty,,1174584437,"KUROWSKI, CAMERON, JOHN",1219 SMOKEY PARK HWY   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174584437,"KUROWSKI, CAMERON, JOHN",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 136 , 341 ,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1174584825,"SCOTT, TINA, HILL",801 POOLE DR   GARNER NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 24 , 33 ,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174584866,"LIESEGANG, GLEN, ROBERT",935 STATE FARM RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1184349987,APPALACHIAN PRIMARY CARE PLLC,,107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1174584866,"LIESEGANG, GLEN, ROBERT",107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 69 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174585194,"VOORHEES, KAREN, LYNN",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1174585699,"WEISGERBER, DAVID, WILLIAM",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1174585699,"WEISGERBER, DAVID, WILLIAM",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1174585699,"WEISGERBER, DAVID, WILLIAM",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174585699,"WEISGERBER, DAVID, WILLIAM",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174585947,"NEWSOME, GEORGE, BURGWYN",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 26 , 27 , 50 ,$#,,
MEDICAID DIRECT,1922094895,MEDICAL EYE ASSOCIATES PA,MEDICAL EYE ASSOCIATES PA,1707 MEDICAL PARK DR W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1174586507,"PUTMAN, SHAWN, CHRISTOPHER",3044 SUNSET AVE   ROCKY MOUNT NC,064,Nash,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 69 , 98 , 114 ,$#,,
MEDICAID DIRECT,1922094895,MEDICAL EYE ASSOCIATES PA,MEDICAL EYE ASSOCIATES PA,1707 MEDICAL PARK DR W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1174586507,"PUTMAN, SHAWN, CHRISTOPHER",1707 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 88 , 123 , 161 ,$#,,
MEDICAID DIRECT,1568425262,BLUE RIDGE PATHOLOGY ASSOCIATES,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1174586523,"BRANT, ANDREW, ROBERTSON",720 MALCOLM BLVD   RUTHERFORD COLLEGE NC,012,Burke,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1568425262,BLUE RIDGE PATHOLOGY ASSOCIATES,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1174586523,"BRANT, ANDREW, ROBERTSON",2201 S STERLING ST   MORGANTON NC,012,Burke,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 118 , 117 , 134 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174586622,"SCHAEPER, MARK, MATTHEW",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 41 , 77 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174586747,"BLOCKER, MICHAEL, EDWARD",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174586747,"BLOCKER, MICHAEL, EDWARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 43 , 246 , 254 ," $14,138.89 ",,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1174587695,"CHANG, RICHARD, INKI",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1174587695,"CHANG, RICHARD, INKI",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1174587695,"CHANG, RICHARD, INKI",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 142 , 207 , 240 ,$#,,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1174587695,"CHANG, RICHARD, INKI",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 40 , 56 , 56 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1174587794,"LEGRAND, SUSAN, BUCHANAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174587794,"LEGRAND, SUSAN, BUCHANAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 27 , 59 , 62 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1174588222,"HIPPS, JOHN, BATES",1301 CENTRAL DR   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174588222,"HIPPS, JOHN, BATES",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 27 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174589063,"KRISHNAMURTHY, SARADA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 23 , 67 , 67 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,3141 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",110 SHANNON VLG   LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,110 SHANNON VLG   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",110 SHANNON VLG   LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice, 310 , 597 ," 2,127 "," $91,659.46 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,319 E 2ND ST   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",319 E 2ND ST   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 26 , 89 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,400 S WALL ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",400 S WALL ST   BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,903 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",903 N ARENDELL AVE   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 24 , 79 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE F KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 242 , 315 ," 1,093 "," $51,291.74 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,400 S WALL ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",3141 CAPITAL BLVD STE 107 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,9201 LEESVILLE RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",9201 LEESVILLE RD STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,3141 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",3141 CAPITAL BLVD STE 107 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 447 , 924 ," 2,556 "," $155,415.83 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1174589907,"MALEK, MOHAMMAD, MIKE",1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 74 , 119 , 383 ," $19,856.14 ",,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174590004,"CROMER, AMANDA, NORVILLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174590590,"SMITH JR, HAROLD, TRUETT",10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174590590,"SMITH JR, HAROLD, TRUETT",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174590830,"CARDINALE, RHONDA, MARIE",RHONDA MARIE CARDINALE,227 N MARKET ST   WASHINGTON NC,007,Beaufort,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,1174590830,"CARDINALE, RHONDA, MARIE",227 N MARKET ST   WASHINGTON NC,007,Beaufort,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174593313,"WILSON, JAMES, DAVID",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 19 , 32 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174593313,"WILSON, JAMES, DAVID",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083255103,CHEROKEE MEDICAL CENTER,CMC - CENTER FOR INTERNAL MEDICINE,139 MEDICAL CENTER DR   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1174594477,"KLICKMAN, HOWARD, WILLIAM",139 MEDICAL CENTER DR   GAFFNEY SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174594501,"PLAUT, TIMOTHY, ARNOLD",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174594501,"PLAUT, TIMOTHY, ARNOLD",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1174594543,"DICK, KARINA, JULIA",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223E0200X,Dental Providers,Dentist,Endodontics, 193 , 235 , 560 ," $29,767.71 ",,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174594543,"DICK, KARINA, JULIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174594543,"DICK, KARINA, JULIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,1223E0200X,Dental Providers,Dentist,Endodontics,#,#, 13 ,$#,,
MEDICAID DIRECT,1710437322,"THOMPSON, KALEB, CONRAD",,153 WORTH GUARD RD   COINJOCK NC,027,Currituck,1223G0001X,Dental Providers,Dentist,General Practice,1174594543,"DICK, KARINA, JULIA",408 E COLONIAL AVE   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 18 , 46 ,$#,,
MEDICAID DIRECT,1235641341,KALEB C THOMPSON DMD PA,DENTAL TRANSFORMATIONS,408 E COLONIAL AVE   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1174594543,"DICK, KARINA, JULIA",408 E COLONIAL AVE   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 81 , 96 , 208 ," $32,000.23 ",,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1174594543,"DICK, KARINA, JULIA",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 27 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174594873,"ELLIS, PAUL, WILLIAM",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 55 , 82 ,$#,,
MEDICAID DIRECT,1174596472,"MASON, JOHN, STEVEN",John Steven Mason,402 N MAIN ST   KENANSVILLE NC,031,Duplin,152W00000X,Eye and Vision Services Providers,Optometrist,,1174596472,"MASON, JOHN, STEVEN",402 N MAIN ST   KENANSVILLE NC,031,Duplin,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1508845587,DUPLIN EYE ASSOCIATES OD PA,~,402 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1174596472,"MASON, JOHN, STEVEN",402 N MAIN ST   KENANSVILLE NC,031,Duplin,152W00000X,Eye and Vision Services Providers,Optometrist,, 176 , 219 , 359 ," $10,751.22 ",,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1174597389,"REINKE, DEREK, LAWRENCE",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174597389,"REINKE, DEREK, LAWRENCE",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174597389,"REINKE, DEREK, LAWRENCE",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 15 , 29 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1174597389,"REINKE, DEREK, LAWRENCE",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1174597389,"REINKE, DEREK, LAWRENCE",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174600449,"ALLEN, SANDRA, JEAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174600449,"ALLEN, SANDRA, JEAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1174601017,"BLEVINS, ANDREA, GAGNON",1500 NEELLEY RD   PLEASANT GARDEN NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174603492,"ROSS, CHARLES, ALAN",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174603492,"ROSS, CHARLES, ALAN",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 31 , 72 ,$#,,
MEDICAID DIRECT,1669808143,SYLVA EMERGENCY GROUP LLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1174603864,"MOSS, RITA, JENKINS",68 HOSPITAL RD   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386186120,JACKSON HM SERVICES PC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1174603864,"MOSS, RITA, JENKINS",68 HOSPITAL RD   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 97 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174604342,"WILSON, ERIC, MCADAMS",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174604342,"WILSON, ERIC, MCADAMS",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 26 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174604342,"WILSON, ERIC, MCADAMS",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174604342,"WILSON, ERIC, MCADAMS",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174604342,"WILSON, ERIC, MCADAMS",509 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174604342,"WILSON, ERIC, MCADAMS",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174604342,"WILSON, ERIC, MCADAMS",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558499046,AAA FAMILY FOOT CARE CENTER PLLC,,1322 W MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1174606156,"LONGOBARDO, JOHN, JOSEPH",1320 W MAIN ST   FOREST CITY NC,081,Rutherford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1558499046,AAA FAMILY FOOT CARE CENTER PLLC,,1322 W MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1174606156,"LONGOBARDO, JOHN, JOSEPH",1320 W MAIN ST   FOREST CITY NC,081,Rutherford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 73 , 121 , 160 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174606917,"GIBBS, CAROL",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 43 , 65 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174607055,"SABULSKY JR, RICHARD, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1174607063,"PIZZO, SALVATORE",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174607238,"HOFFMAN, BENSON, MARK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174608665,"CONGDON, MELISSA, CHEREE",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 36 , 39 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174609812,"TOMSO, SUSAN, KATHLEEN",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174611883,"GOODE, JAMES, BERNARD",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174613004,"NAZER, KARIM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174613004,"NAZER, KARIM",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174613004,"NAZER, KARIM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174613004,"NAZER, KARIM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1174613004,"NAZER, KARIM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1174613004,"NAZER, KARIM",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174614259,"PICKERING, VRINDA, VILLA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174614259,"PICKERING, VRINDA, VILLA",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174614697,"PATTERSON, ANTHONY, CURTIS",202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 14 , 23 , 24 ,$#,,
MEDICAID DIRECT,1689870941,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174614697,"PATTERSON, ANTHONY, CURTIS",202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 25 , 26 ,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174614697,"PATTERSON, ANTHONY, CURTIS",202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 13 , 21 , 21 ,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174614697,"PATTERSON, ANTHONY, CURTIS",202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174614697,"PATTERSON, ANTHONY, CURTIS",202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 11 , 24 , 24 ,$#,,
MEDICAID DIRECT,1851177539,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174614697,"PATTERSON, ANTHONY, CURTIS",202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1174614804,"VAZ, DEV, GERALD",Dev Gerald Vaz,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1174614804,"VAZ, DEV, GERALD",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174614804,"VAZ, DEV, GERALD",Dev Gerald Vaz,727 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1174614804,"VAZ, DEV, GERALD",727 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174614804,"VAZ, DEV, GERALD",Dev Gerald Vaz,830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1174614804,"VAZ, DEV, GERALD",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174615223,SENIOR SERVICES INC,SENIOR SERVICES INC,2895 SHOREFAIR DR   WINSTON SALEM NC,034,Forsyth,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1174615223,SENIOR SERVICES INC,2895 SHOREFAIR DR   WINSTON SALEM NC,034,Forsyth,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 25 , 30 , 30 ," $152,509.24 ",,
MEDICAID DIRECT,1174615223,SENIOR SERVICES INC,SENIOR SERVICES INC,2895 SHOREFAIR DR   WINSTON SALEM NC,034,Forsyth,251B00000X,Agencies,Case Management,,1174615223,SENIOR SERVICES INC,2895 SHOREFAIR DR   WINSTON SALEM NC,034,Forsyth,251B00000X,Agencies,Case Management,, 226 ," 12,849 "," 13,114 "," $1,079,493.10 ",,
MEDICAID DIRECT,1174615223,SENIOR SERVICES INC,SENIOR SERVICES INC,2895 SHOREFAIR DR   WINSTON SALEM NC,034,Forsyth,332U00000X,Suppliers,Home Delivered Meals,,1174615223,SENIOR SERVICES INC,2895 SHOREFAIR DR   WINSTON SALEM NC,034,Forsyth,332U00000X,Suppliers,Home Delivered Meals,,#, 139 , 139 ,$#,,
MEDICAID DIRECT,1194274886,EILEEN WANG REIDSVILLE PLLC,SOUTHWOOD DENTAL,207 TURNER DR   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1174616114,"WANG, XIAOJUN",101 EUROPA DR STE 160 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 38 ,$#,,
MEDICAID DIRECT,1083059893,EILEEN WANG PLLC,MYDENTIST,2601 OAKCREST AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174616114,"WANG, XIAOJUN",101 EUROPA DR STE 160 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 32 , 132 ,$#,,
MEDICAID DIRECT,1194274886,EILEEN WANG REIDSVILLE PLLC,SOUTHWOOD DENTAL,207 TURNER DR   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1174616114,"WANG, XIAOJUN",207 TURNER DR   REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice," 1,164 "," 2,306 "," 8,191 "," $509,690.13 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174618805,"RAO, NEERAJA",511 PALADIN DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 55 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174618987,"MILOWSKY, MATTHEW, IVAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 27 , 39 , 53 ,$#,,
MEDICAID DIRECT,1306061205,A K HEART CENTERS,AK HEART CENTERS,403 PARKWAY ST STE A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174619795,"KADAKIA, AJAY, S",403 PARKWAY ST STE A GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 71 , 86 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174621346,"JALISI, FARRUKH, MAHFUZ",201 S MAIN ST STE 1100 DANVILLE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174625024,"STARR, ERIC, WILLIAM",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174625024,"STARR, ERIC, WILLIAM",14330 OAKHILL PARK LN STE 115 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 47 , 106 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174625024,"STARR, ERIC, WILLIAM",14330 OAKHILL PARK LANE SUITE 200 B HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174625024,"STARR, ERIC, WILLIAM",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1174626873,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04467,128 CROSS ROAD DR   MILLS RIVER NC,045,Henderson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1174626873,NORTH CAROLINA CVS PHARMACY LLC,128 CROSS ROAD DR   MILLS RIVER NC,045,Henderson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 21 , 55 ,$#,,
MEDICAID DIRECT,1174626949,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03833,200 N GREENSBORO ST   CARRBORO NC,068,Orange,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1174626949,NORTH CAROLINA CVS PHARMACY LLC,200 N GREENSBORO ST   CARRBORO NC,068,Orange,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1962752881,HOKE HEALTHCARE LLC,HOKE PRIMARY CARE CLINIC,300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1174629414,"AJO, DONNA, MARIE",300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 107 , 136 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174633457,"CAPPIELLO, LINDA, DIANE",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174633457,"CAPPIELLO, LINDA, DIANE",211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174638423,"BENET, CHRISTINE, ELAINE",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174638712,"SUDAN, RANJAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174638712,"SUDAN, RANJAN",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174638712,"SUDAN, RANJAN",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1174638712,"SUDAN, RANJAN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174638712,"SUDAN, RANJAN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174638712,"SUDAN, RANJAN",120 E CARVER ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174639041,MEDICINE MART LTC LLC,MEDICINE MART LONG TERM CARE PHARMA,214 S MAIN ST   TABOR CITY NC,024,Columbus,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1174639041,MEDICINE MART LTC LLC,214 S MAIN ST   TABOR CITY NC,024,Columbus,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174640890,"ABNEY, JULIE, WILLINGHAM",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174640890,"ABNEY, JULIE, WILLINGHAM",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174640890,"ABNEY, JULIE, WILLINGHAM",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174640890,"ABNEY, JULIE, WILLINGHAM",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174640890,"ABNEY, JULIE, WILLINGHAM",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1174643092,"YAZAN, CHRISTY, BENNETT",852 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174643894,"GASLIN, MICHAEL, THOMAS",1180 WYKE RD   SHELBY NC,023,Cleveland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174643894,"GASLIN, MICHAEL, THOMAS",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 153 , 289 , 403 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 21 , 28 , 62 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 49 , 74 , 160 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1174644314,"MCPHAIL III, ERNEST, FREDERICK",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174645287,"ANTHONY, NAVIN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 29 , 31 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174645287,"ANTHONY, NAVIN",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 36 , 38 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1174645881,"PARIKH, ASHESH, SHIRISH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174645881,"PARIKH, ASHESH, SHIRISH",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174645881,"PARIKH, ASHESH, SHIRISH",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174645881,"PARIKH, ASHESH, SHIRISH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 246 , 261 , 332 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1174645881,"PARIKH, ASHESH, SHIRISH",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174645881,"PARIKH, ASHESH, SHIRISH",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174645881,"PARIKH, ASHESH, SHIRISH",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104679448,PHILLIP MCIVER DDS PA,~,304 IONA ST   FAIRMONT NC,078,Robeson,193200000X,Group,Multi-Specialty,,1174650527,"ROLLE, RICHARD, RAMON",304 IONA ST   FAIRMONT NC,078,Robeson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 91 , 93 , 509 ," $53,260.81 ",,
MEDICAID DIRECT,1649289760,S W WEBBER JR DDS PA,S W WEBBER DDS PA,2120 DR WEBBER AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174650527,"ROLLE, RICHARD, RAMON",2120 DR WEBBER AVE   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 30 , 31 , 165 ," $17,867.81 ",,
MEDICAID DIRECT,1104679448,PHILLIP MCIVER DDS PA,~,304 IONA ST   FAIRMONT NC,078,Robeson,193200000X,Group,Multi-Specialty,,1174650527,"ROLLE, RICHARD, RAMON",9615 CALDWELL COMMONS CIR STE B CORNELIUS NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 33 , 33 , 265 ," $26,334.68 ",,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174651376,"BARNARD, AARON, LEIF",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 85 , 105 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174652606,"ANDERSON, KEITH, ALAN",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 30 , 76 ,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,1542 CANE CREEK RD   FLETCHER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174656896,"GREENE, RITCHIE, WILLIAM",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174656896,"GREENE, RITCHIE, WILLIAM",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1174657951,CAROLINA VISIONCARE,CAROLINA VISIONCARE,703 ROSANNE DR   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1174657951,CAROLINA VISIONCARE,703 ROSANNE DR   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,, 62 , 64 , 127 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3150 ROGERS RD STE 220 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1174661110,"SUBRAMANIAN, KAVITHA",3150 ROGERS RD STE 220 WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 90 , 117 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174661110,"SUBRAMANIAN, KAVITHA",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 26 , 28 ,$#,,
MEDICAID DIRECT,1174662910,ATS OF NORTH CAROLINA LLC,CAROLINA TREATMENT CENTER OF GOLDSBORO,1700 E ASH ST   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,,1174662910,ATS OF NORTH CAROLINA LLC,1700 E ASH ST   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1174662910,ATS OF NORTH CAROLINA LLC,CAROLINA TREATMENT CENTER OF GOLDSBORO,2611 HOSPITAL RD   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,,1174662910,ATS OF NORTH CAROLINA LLC,2611 HOSPITAL RD   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,,#,#, 12 ,$#,,
MEDICAID DIRECT,1174673933,GRANDVIEW VILLA ASSISTED LIVING,,2544 GRANDVIEW CIR SW   LENOIR NC,014,Caldwell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174673933,GRANDVIEW VILLA ASSISTED LIVING,2544 GRANDVIEW CIR SW   LENOIR NC,014,Caldwell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 3,582 "," 3,582 "," $240,264.27 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174677462,"PIPELING, MATTHEW, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 31 , 40 ,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1174681258,"SMITH, DONNA, CORINNE",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 106 , 167 ,$#,,
MEDICAID DIRECT,1174682223,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05377,204 LIBERTY PLZ LIBERTY PLAZA SHOPPING CTR LIBERTY NC,076,Randolph,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1174682223,NORTH CAROLINA CVS PHARMACY LLC,204 LIBERTY PLZ LIBERTY PLAZA SHOPPING CTR LIBERTY NC,076,Randolph,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1174684591,SPEECH PATHOLOGY AND AUDIOLOGY SERV,~,765 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1174684591,SPEECH PATHOLOGY AND AUDIOLOGY SERV,765 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,, 62 , 604 , 626 ," $42,731.61 ",,
MEDICAID DIRECT,1174684716,"EASTON, WILEY, BEN",~,129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1174684716,"EASTON, WILEY, BEN",129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376132571,FULLER & ASSOCIATES VII PLLC,CLINTON FAMILY & COSMETIC DENTISTRY,320 NORTHEAST BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1174685788,"MOTT, WILLIAM, JAMES",320 NORTHEAST BLVD   CLINTON NC,082,Sampson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 24 , 42 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174687271,"TOLLE, MARY, ELIZABETH",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1174687271,"TOLLE, MARY, ELIZABETH",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 20 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1174687271,"TOLLE, MARY, ELIZABETH",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1174687271,"TOLLE, MARY, ELIZABETH",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 38 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1174687271,"TOLLE, MARY, ELIZABETH",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174689483,SOUTHERN ASSISTED LIVING INC,BROOKDALE SKEET CLUB,1560 SKEET CLUB RD   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174689483,SOUTHERN ASSISTED LIVING INC,1560 SKEET CLUB RD   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 361 , 361 ," $22,645.93 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1174690267,"MAIER, DANIELLE, MCCURRY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174690267,"MAIER, DANIELLE, MCCURRY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 53 , 53 ,$#,,
MEDICAID DIRECT,1174692479,"LEWIS, MARCIA, LOUISE",MARCIA L LEWIS DDS PA,505 N MAIN ST   CREEDMOOR NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,1174692479,"LEWIS, MARCIA, LOUISE",505 N MAIN ST   CREEDMOOR NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 359 , 714 ," 2,471 "," $145,881.10 ",,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1174692495,"BRINKE, PAIGE, SNOW",38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 220 , 825 , 885 ," $16,694.68 ",,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1174692495,"BRINKE, PAIGE, SNOW",4451 E US 64 ALT   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174692784,"KATZ, ADAM, JUDD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 17 , 27 , 38 ,$#,,
MEDICAID DIRECT,1174693592,SENTARA ENTERPRISES,~,535 INDEPENDENCE PKWY STE 300 CHESAPEAKE VA,101,Out of State <= 40 miles,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1174693592,SENTARA ENTERPRISES,535 INDEPENDENCE PKWY STE 300 CHESAPEAKE VA,101,Out of State <= 40 miles,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 13 , 35 ,$#,,
MEDICAID DIRECT,1730262817,TERRY V WOOD DMD,TERRY V WOOD DMD,201 N MAIN ST   TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1174694111,"WOOD, TERRY, VAN",201 N MAIN ST   TROY NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 43 , 87 , 203 ,$#,,
MEDICAID DIRECT,1346537180,ALAMANCE DERMATOLOGY PA,~,480 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174695456,"ADAMS, MELANIE, ANN",945 GOLF HOUSE RD W STE A WHITSETT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346537180,ALAMANCE DERMATOLOGY PA,~,480 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174695456,"ADAMS, MELANIE, ANN",480 W WEBB AVE   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 32 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174696363,"IDRISSI, RACHID",3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174696363,"IDRISSI, RACHID",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 22 , 25 , 47 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1174696363,"IDRISSI, RACHID",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174699607,"JOHNSON PATEL, SARAH, ELIZABETH",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 151 , 154 ,$#,,
MEDICAID DIRECT,1013014596,PIEDMONT HEALTH SERVICES INC,SCOTT COMMUNITY HEALTH CENTER,5270 UNION RIDGE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174699607,"JOHNSON PATEL, SARAH, ELIZABETH",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174699607,"JOHNSON PATEL, SARAH, ELIZABETH",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174701197,"DEP, RANITHA, HYACINTH",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174701197,"DEP, RANITHA, HYACINTH",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 168 , 243 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174701197,"DEP, RANITHA, HYACINTH",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174701197,"DEP, RANITHA, HYACINTH",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174705081,"CHIU, VERNON, SY",970 NEWMAN RD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,970 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1174705081,"CHIU, VERNON, SY",970 NEWMAN RD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174705081,"CHIU, VERNON, SY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 72 , 72 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174705081,"CHIU, VERNON, SY",608 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174705081,"CHIU, VERNON, SY",608 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 158 , 557 , 773 ," $12,897.27 ",,
MEDICAID DIRECT,1457600504,MCPC-10 LLC,FIRSTHEALTH CARDIOVASCULAR AND THORACIC SERVICES,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1174708283,"MCCALL, GARY, WALLACE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174709760,"BULAKOWSKI, NEILL",BRIGHTWOOD EYE CENTER,6611 BURLINGTON RD   WHITSETT NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,1174709760,"BULAKOWSKI, NEILL",6611 BURLINGTON RD   WHITSETT NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 56 , 59 , 96 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174710735,"HEWITT, STEPHAN, JUSTIN ANTHONY",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174710735,"HEWITT, STEPHAN, JUSTIN ANTHONY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 241 , 241 ,$#,,
MEDICAID DIRECT,1265719512,PIRATE PEDIATRICS PA,~,118 OAKMONT DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174713317,"MORGAN, CAROLINE, LEGGETT",118 OAKMONT DR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 87 , 173 ," $10,231.56 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174713689,"MATHUR, TUSHAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 91 , 214 , 214 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1174713689,"MATHUR, TUSHAR",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174713846,"ARTEH, JIHAD, OMER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174713846,"ARTEH, JIHAD, OMER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 35 , 35 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174713846,"ARTEH, JIHAD, OMER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 47 , 47 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174713879,"SEIF, FADI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 28 , 91 , 100 ," $10,073.66 ",,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1174714299,"TRIVEDI, BHAVIKA",635 WENDOVER WAY   RIDGELAND MS,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1174714299,"TRIVEDI, BHAVIKA",635 WENDOVER WAY   RIDGELAND MS,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 107 , 117 , 132 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174717649,"CLANCY, SHARON, LINDSAY",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174717649,"CLANCY, SHARON, LINDSAY",3100 DURALEIGH RD STE 203 RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174717649,"CLANCY, SHARON, LINDSAY",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174717755,"VENEZIANO, JOSEPH, ALFRED",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 42 , 54 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174717755,"VENEZIANO, JOSEPH, ALFRED",3817 FORRESTGATE DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 37 , 65 , 86 ,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174718266,"GORDON, KIMBERLY, ANNE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174718266,"GORDON, KIMBERLY, ANNE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174721377,"MEIER, JEFFREY, MARK",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1174722987,"ARISTY, NICOLE, EVANGELINE",5710 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 85 , 202 , 459 ," $21,649.97 ",,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1174722987,"ARISTY, NICOLE, EVANGELINE",5710 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174725584,"BURKS, ALLEN, COLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174725584,"BURKS, ALLEN, COLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174725584,"BURKS, ALLEN, COLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174726731,"STALLINGS, AMY, POLEN",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 15 , 17 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174726731,"STALLINGS, AMY, POLEN",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174726731,"STALLINGS, AMY, POLEN",2301 ERWIN RD   DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174730188,"MARIGOWDA, LOKESH, KEBBEHUNDI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 36 , 37 ,$#,,
MEDICAID DIRECT,1316486640,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PALLIATIVE CARE,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174730188,"MARIGOWDA, LOKESH, KEBBEHUNDI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 119 , 850 , 956 ," $15,405.00 ",,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174730436,"APPERT, GREGORY, CAMERON",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174733935,"TAYLOR, PAMELA, LYNN SHARPE",4320 HENSON DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174733935,"TAYLOR, PAMELA, LYNN SHARPE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 15 , 36 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174733935,"TAYLOR, PAMELA, LYNN SHARPE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174733935,"TAYLOR, PAMELA, LYNN SHARPE",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 115 , 262 ," $13,368.76 ",,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174733935,"TAYLOR, PAMELA, LYNN SHARPE",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1174733935,"TAYLOR, PAMELA, LYNN SHARPE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,301 E WENDOVER AVE STE 111   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174735070,"VAN DAM, CORNELIUS, NESTORE",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174735070,"VAN DAM, CORNELIUS, NESTORE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 112 , 195 , 309 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174735070,"VAN DAM, CORNELIUS, NESTORE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174735070,"VAN DAM, CORNELIUS, NESTORE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174736599,"RENAUD, STEFAN, ALAIN",209 PARK ST   BELMONT NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 53 , 67 , 98 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174736599,"RENAUD, STEFAN, ALAIN",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 63 , 92 , 118 ,$#,,
MEDICAID DIRECT,1689750663,ADVANTAGE BEHAVIORAL HEALTHCARE INC,~,732 DAVIS AVE   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1174740138,"EPPS, CLYDE, ANTHONY",732 DAVIS AVE   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053771717,RHA BEHAVIORAL HEALTH NC LLC,,24 HILL PLZ   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1174740138,"EPPS, CLYDE, ANTHONY",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1225307713,SOUTHEASTERN REGIONAL MEDICAL CENTE,SOUTHEASTERN BEHAVIORAL HEALTH SERVICES,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1174740138,"EPPS, CLYDE, ANTHONY",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 67 , 67 ,$#,,
MEDICAID DIRECT,1124487814,RHA BEHAVIORAL HEALTH NC LLC,,1779A S MAIN ST   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1174740138,"EPPS, CLYDE, ANTHONY",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174740963,"MILLER, ANSLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 52 , 52 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174741920,"NICHOLLS, JOHN, CAPEHART",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174741920,"NICHOLLS, JOHN, CAPEHART",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 106 , 141 , 141 ," $33,639.26 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174741920,"NICHOLLS, JOHN, CAPEHART",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 65 , 91 , 91 ," $22,508.85 ",,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1174745665,"HENDERSON, JESSICA, LYNN",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1174745665,"HENDERSON, JESSICA, LYNN",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174747059,"SHAH, VIPUL, CHANDRAHAS",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 16 , 30 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174747059,"SHAH, VIPUL, CHANDRAHAS",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174747059,"SHAH, VIPUL, CHANDRAHAS",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 23 , 34 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,1632 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174747059,"SHAH, VIPUL, CHANDRAHAS",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 20 , 23 , 40 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174747059,"SHAH, VIPUL, CHANDRAHAS",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 54 , 85 , 114 ,$#,,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174749253,"MILLER, CRAIG, DAVID",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice," 1,254 "," 1,689 "," 4,590 "," $302,668.38 ",,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1174751051,"ABRAHAMS, ROBERT, BRADFORD",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174751051,"ABRAHAMS, ROBERT, BRADFORD",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1174751051,"ABRAHAMS, ROBERT, BRADFORD",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1174751051,"ABRAHAMS, ROBERT, BRADFORD",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 641 , 988 ," 1,320 "," $21,786.86 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1174752976,"WOODWARD, KATHLEEN, MAY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174753727,"WALLACE, KELLEY, ANNETTE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174753727,"WALLACE, KELLEY, ANNETTE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 61 , 61 ,$#,,
MEDICAID DIRECT,1174754675,PROGRESSIVE HEALTHCARE AND COUNSELI,PROGRESSIVE HEALTHCARE & COUNSELING SERVICES INC,4086 BARRETT DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1174754675,PROGRESSIVE HEALTHCARE AND COUNSELI,4086 BARRETT DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 49 ," 6,012 "," 6,048 "," $485,843.14 ",,
MEDICAID DIRECT,1174758478,INTELLICHOICE STAFFING LLC,INTELLICHOICE HOME CARE,4735 REEDY BRANCH RD STE C WINTERVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1174758478,INTELLICHOICE STAFFING LLC,4735 REEDY BRANCH RD STE C WINTERVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 778 , 812 ," $93,935.56 ",,
MEDICAID DIRECT,1174758478,INTELLICHOICE STAFFING LLC,INTELLICHOICE HOME CARE,4735 REEDY BRANCH RD STE C WINTERVILLE NC,074,Pitt,251J00000X,Agencies,Nursing Care,,1174758478,INTELLICHOICE STAFFING LLC,4735 REEDY BRANCH RD STE C WINTERVILLE NC,074,Pitt,251J00000X,Agencies,Nursing Care,, 143 ," 19,021 "," 21,610 "," $9,664,951.11 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174758494,"RATHORE, ANIMESH",600 GRESHAM DR STE 8620 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174758494,"RATHORE, ANIMESH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 20 , 27 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,81 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174758726,"VAZQUEZ, KATHYA",81 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174758726,"VAZQUEZ, KATHYA",81 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 20 , 41 , 115 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174758726,"VAZQUEZ, KATHYA",81 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 15 , 27 ,$#,,
MEDICAID DIRECT,1962861278,ALAN A GODEL & JUSTIN P HANNON,~,1228 W ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174759146,"DO, VU, HUY",1228 W ROOSEVELT BLVD   MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 704 ," 1,558 "," 5,514 "," $314,228.35 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174763973,"HARRINGTON, MALINDA, CHAPMAN",511 PALADIN DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 74 , 120 , 277 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174763973,"HARRINGTON, MALINDA, CHAPMAN",2150 HERBERT CT   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 146 , 146 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1174766109,"MCMAHON, NICOLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 43 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174766851,"MCELROY, LISA, MARIE",40 DUKE MEDICINE CIR DUKE ABDOMINAL TRANSPLANT CLINIC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174767073,GASTON FAMILY HEALTH SERVICES INC,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 25 , 31 , 31 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174767982,"LEE, SHEILA, SETO",1126 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174767982,"LEE, SHEILA, SETO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174767982,"LEE, SHEILA, SETO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174770374,"MULLINAX, JENNIFER, ROSE",4226 E US 64 ALT   MURPHY NC,020,Cherokee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174773840,"LANGSTON, ELIZABETH, HOBBS",4207 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1174773923,"TERRY, ANDREA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 32 , 98 , 114 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174776157,"LEWIS, CARRIE, LYNN",1540 SUNDAY DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 47 , 47 ,$#,,
MEDICAID DIRECT,1548221856,CHAPEL HILL PEDIATRICS,CHAPEL HILL PEDIATRICS,205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174780548,"BRAITHWAITE, MARY, FOX",205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 35 , 96 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1174780605,"PIACENTINO, VALENTINO",117 E KINGS HWY   EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174780605,"PIACENTINO, VALENTINO",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1174782205,"COULTER, BENJAMIN, LEE",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1174782205,"COULTER, BENJAMIN, LEE",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 82 , 86 , 157 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1174782205,"COULTER, BENJAMIN, LEE",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 13 ,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174782205,"COULTER, BENJAMIN, LEE",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 80 , 89 , 139 ," $12,227.46 ",,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 30 , 30 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 35 , 37 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174782841,"SNOW, ROBERT, PACIFIC",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174784516,"SAGALLA, REX, WARNI BINGUIT",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 26 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174784516,"SAGALLA, REX, WARNI BINGUIT",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174784516,"SAGALLA, REX, WARNI BINGUIT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 21 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174784649,"NIZAMANI, RABIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174784839,"RAGHAVAN, DEEPAK",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174784839,"RAGHAVAN, DEEPAK",844 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174786248,"SPEAKS, JALEEMA, NANTON",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174786248,"SPEAKS, JALEEMA, NANTON",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 24 , 48 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174786248,"SPEAKS, JALEEMA, NANTON",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174786248,"SPEAKS, JALEEMA, NANTON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174786859,"MCKINNEY III, JAMES, STERLING",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174786859,"MCKINNEY III, JAMES, STERLING",512 VILLAGE RD STE 207 SHALLOTTE NC,010,Brunswick,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174786859,"MCKINNEY III, JAMES, STERLING",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174786859,"MCKINNEY III, JAMES, STERLING",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 43 , 66 , 67 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174786859,"MCKINNEY III, JAMES, STERLING",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 14 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174786859,"MCKINNEY III, JAMES, STERLING",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174786859,"MCKINNEY III, JAMES, STERLING",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174787428,"VEERAMREDDY, PADMAJA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174787774,"KEENAN, ALISON, CARROLL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 21 , 27 ,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,11530 PROVIDENCE RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174787774,"KEENAN, ALISON, CARROLL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174787774,"KEENAN, ALISON, CARROLL",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 31 , 40 , 49 ,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,11530 PROVIDENCE RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174787774,"KEENAN, ALISON, CARROLL",11530 PROVIDENCE RD STE 2100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174787774,"KEENAN, ALISON, CARROLL",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174787840,"BROWN, DANIEL, WILLIAM",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1174788814,"BERNSTEIN, REBECCA, HARRIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 89 , 89 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174788814,"BERNSTEIN, REBECCA, HARRIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 37 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174795058,"GEERS, GREGORY, LAWRENCE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 42 , 49 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174795058,"GEERS, GREGORY, LAWRENCE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1457309221,CABARRUS EMERGENCY MEDICINE ASSOCIA,CABARRUS EMERGENCY MEDICINE ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1174795058,"GEERS, GREGORY, LAWRENCE",1028 LEE ANN DR NE STE 200 CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1174796536,"BIVENS, GAYLA, RENEE",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice," 2,732 "," 4,938 "," 17,343 "," $577,916.76 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,193400000X,Group,Single Specialty,,1174796536,"BIVENS, GAYLA, RENEE",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1174796536,"BIVENS, GAYLA, RENEE",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1174796536,"BIVENS, GAYLA, RENEE",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1174796536,"BIVENS, GAYLA, RENEE",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 18 , 51 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174796585,"BARTON, JOEL, WELLS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1134661747,D H LEE DMD PA,LOUISBURG FAMILY DENTISTRY,531 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1174797013,"LEE, DONGHOON",531 S BICKETT BLVD   LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice, 445 , 596 ," 2,415 "," $137,068.71 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174797344,"ZEIDNER, JOSHUA, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 79 , 99 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174797963,"TRACY, ELISABETH, TOMLINSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 69 , 79 ," $10,020.97 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174797963,"TRACY, ELISABETH, TOMLINSON",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 28 , 29 ,$#,,
MEDICAID DIRECT,1194192294,REVIVE BOOST REBUILD PT,,1300 CORPORATION PKWY STE B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174798995,"CONTI, DAVID, JOSHUA",106 FARM BROOK DR UNIT C LUMBERTON NC,078,Robeson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1194192294,REVIVE BOOST REBUILD PT,,1300 CORPORATION PKWY STE B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174798995,"CONTI, DAVID, JOSHUA",1300 CORPORATION PKWY STE B RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 24 , 29 ,$#,,
MEDICAID DIRECT,1972963601,ARMSTRONG & BATES DDS PA,~,2710 HENRY ST STE 102 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174802722,"ARMSTRONG, ANN, LAUREN",2710 HENRY ST STE 102 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 286 , 549 ," 1,957 "," $66,001.98 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174805121,"DABKOWSKI, JEFFREY, MICHAEL",1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 31 , 43 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174807895,"CORBIN, JUSTIN, BLAKE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174807895,"CORBIN, JUSTIN, BLAKE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 27 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174807895,"CORBIN, JUSTIN, BLAKE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174810279,"LANDRETH, DORIS, JEAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1174810279,"LANDRETH, DORIS, JEAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 43 , 75 ,$#,,
MEDICAID DIRECT,1174811186,S AND H HOMECARE SERVICES,S AND H HOMECARE SERVICES LLC,8430 UNIVERSITY EXEC PARK DR STE 608 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1174811186,S AND H HOMECARE SERVICES,8430 UNIVERSITY EXEC PARK DR STE 608 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 112 ," 28,464 "," 28,959 "," $2,334,911.56 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174811848,"ONUEGBU, PATRICIA, CHINYERE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 49 , 51 ,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,50 CRAGGENMORE DR   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1174812788,"ILLATH, JASEELA",50 CRAGGENMORE DR   PITTSBORO NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 49 , 113 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174812788,"ILLATH, JASEELA",50 CRAGGENMORE DR   PITTSBORO NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 43 ,$#,,
MEDICAID DIRECT,1639182231,HANGER PROSTHETICS & ORTHOTICS EAST,,3806 S CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174812838,"GROVE, STEVEN, PATRICK",3806 S CHURCH ST   BURLINGTON NC,001,Alamance,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,~,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174812838,"GROVE, STEVEN, PATRICK",2716 HENRY ST   GREENSBORO NC,041,Guilford,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 25 ,$#,,
MEDICAID DIRECT,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,~,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174812838,"GROVE, STEVEN, PATRICK",2716 HENRY ST   GREENSBORO NC,041,Guilford,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1639182231,HANGER PROSTHETICS & ORTHOTICS EAST,,3806 S CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174812838,"GROVE, STEVEN, PATRICK",2716 HENRY ST   GREENSBORO NC,041,Guilford,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174813513,"HOPKINS, KACI, CAPPS",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174813513,"HOPKINS, KACI, CAPPS",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649525619,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHILAND FAMILY MEDICINE,704 GOLD HILL RD STE 107 FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174813513,"HOPKINS, KACI, CAPPS",1935 HOLBROOK RD STE 1100 FORT MILL SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174813570,"USOH, CHINENYENWA, OKECHI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 43 , 65 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174814230,"RAFF, LAUREN, DESIREE ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 68 , 164 , 217 ," $26,533.83 ",,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174815575,"SENEKER, TIMOTHY, JAMES",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 215 , 526 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174816847,"FOSTER, SHAUNA, ASHLEY",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 37 , 85 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174816847,"FOSTER, SHAUNA, ASHLEY",10816 BLACK DOG LN STE 160 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174817290,"STAFFORD, PHILLIP, ANDREW",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 43 , 58 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174817290,"STAFFORD, PHILLIP, ANDREW",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 68 , 92 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174817332,"ELSTER, ALLEN, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 46 , 92 , 125 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174817332,"ELSTER, ALLEN, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 13 , 13 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174819387,"HILL, MICHAEL, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174819387,"HILL, MICHAEL, JOSEPH",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174819387,"HILL, MICHAEL, JOSEPH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174819387,"HILL, MICHAEL, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174819387,"HILL, MICHAEL, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 89 , 200 , 200 ," $10,204.73 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174819387,"HILL, MICHAEL, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174819387,"HILL, MICHAEL, JOSEPH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1174819825,"SEXTON, JEREMY, ELLIOT",305 BACK RD   OCRACOKE NC,048,Hyde,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 64 , 64 ," $25,136.47 ",,
MEDICAID DIRECT,1689726101,OCRACOKE HEALTH CENTER INC,OCRACOKE HEALTH CENTER INC,305 BACK RD   OCRACOKE NC,048,Hyde,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1174819825,"SEXTON, JEREMY, ELLIOT",305 BACK RD   OCRACOKE NC,048,Hyde,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 26 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174820716,"SCARLETT, CHARLENE, NATALEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1174820716,"SCARLETT, CHARLENE, NATALEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 36 , 38 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174820849,"SAINT, FAITH, CAINE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 135 , 190 ,$#,,
MEDICAID DIRECT,1174821326,LIFETIME HOMECARE SERVICES LLC,LIFETIME HOMECARE SERVICES LLC,226 W COLLEGE ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1174821326,LIFETIME HOMECARE SERVICES LLC,226 W COLLEGE ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 82 ," 18,317 "," 18,482 "," $1,254,174.52 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174826952,"BAILEY, LORI, BETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174829980,"WITTMAN, CELIN, REID",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174829980,"WITTMAN, CELIN, REID",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1174831804,"BUCHKOVICH, JENNIE, BAIRD",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 19 , 36 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174831804,"BUCHKOVICH, JENNIE, BAIRD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174834808,"LOBONC, ANDREW, JACOB",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 60 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174834808,"LOBONC, ANDREW, JACOB",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 57 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174834808,"LOBONC, ANDREW, JACOB",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 14 , 20 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174840482,"LEWIS, BRIAN, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174840482,"LEWIS, BRIAN, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 26 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174842306,"PATTERSON, JONATHAN, RYAN",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 90 , 168 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174842306,"PATTERSON, JONATHAN, RYAN",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 19 , 30 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174842306,"PATTERSON, JONATHAN, RYAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174842363,"JENKINS, TRAVIS, CLARKE",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 47 , 67 , 83 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174842363,"JENKINS, TRAVIS, CLARKE",9020 SENCA DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174843056,"HALL, MARGARET, SANDBANK",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 24 , 24 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174844807,"NGUYEN, MARIE, VU",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174847586,ARIHANT PHARMACY LLC,~,6330 W MARSHVILLE BLVD STE A MARSHVILLE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1174847586,ARIHANT PHARMACY LLC,6330 W MARSHVILLE BLVD STE A MARSHVILLE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174847776,"NORTH, ABIGAIL, WEILAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174847776,"NORTH, ABIGAIL, WEILAND",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174847776,"NORTH, ABIGAIL, WEILAND",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,2929 MONROE WAY STE 120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174850168,ACCUVISION EYE CARE,2929 MONROE WAY STE 120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,#,#, 18 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,1830 GALLERIA BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174850168,ACCUVISION EYE CARE,1830 GALLERIA BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,9820 CALLABRIDGE CT   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174850168,ACCUVISION EYE CARE,9820 CALLABRIDGE CT   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#,#, 16 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1174850168,ACCUVISION EYE CARE,306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,#,#, 14 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,8455 PIT STOP CT NW STE 125 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174850168,ACCUVISION EYE CARE,8455 PIT STOP CT NW STE 125 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,2266 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174850168,ACCUVISION EYE CARE,2266 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,, 18 , 19 , 36 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174850168,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,, 56 , 56 , 112 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3732 CREEKSHIRE CT   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174850168,ACCUVISION EYE CARE,3732 CREEKSHIRE CT   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,223 N MYRTLE SCHOOL RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174850168,ACCUVISION EYE CARE,223 N MYRTLE SCHOOL RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,701 HAWLEY AVE   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1174850168,ACCUVISION EYE CARE,701 HAWLEY AVE   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,#,#, 16 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,132 W CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1174850168,ACCUVISION EYE CARE,132 W CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,#,#, 20 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174850713,"NASH, ANGELA, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 50 , 63 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174850853,"KRATZER, CYD, CHARISSE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174850853,"KRATZER, CYD, CHARISSE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174857429,"CALDERON, ENRIQUE, EDUARDO",2015 RANDOLPH RD STE 108 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 53 , 144 , 300 ," $32,090.55 ",,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174857429,"CALDERON, ENRIQUE, EDUARDO",630 COMFORT LN STE E MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 48 , 109 , 246 ," $18,003.09 ",,
MEDICAID DIRECT,1174863500,EARL ENTERPRISES INC,SPICEWOOD COTTAGES WILLOWS,65 LOVING WAY   CLYDE NC,044,Haywood,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174863500,EARL ENTERPRISES INC,65 LOVING WAY   CLYDE NC,044,Haywood,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 18 ," 4,199 "," 4,199 "," $282,508.34 ",,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174863542,"REGAN, DANIEL, NEALON",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1174864656,"MANN, CATHY, GAYLE",3004 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1174864656,"MANN, CATHY, GAYLE",338 HOWARD BLVD   NEWPORT NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 27 , 43 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1174864656,"MANN, CATHY, GAYLE",338 HOWARD BLVD   NEWPORT NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 42 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174866198,"PARKER, DANIEL, CHRISTOPHER",932 MORREENE RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174866198,"PARKER, DANIEL, CHRISTOPHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174866206,"PAK, ARLENE",4414 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174866487,"BATLEY, KATHLEEN, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174866487,"BATLEY, KATHLEEN, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 135 , 139 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174866487,"BATLEY, KATHLEEN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1174868566,ALL CARE LINKS INC,~,211 N LAFAYETTE ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1174868566,ALL CARE LINKS INC,211 N LAFAYETTE ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,371 "," 1,371 "," $179,690.08 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174869184,"LEFTWICH KIRBY, LISA, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 41 , 40 , 54 ,$#,,
MEDICAID DIRECT,1174875736,FOOTPRINTS CASE MANAGEMENT,~,115 UNIONVILLE INDIAN TRAIL RD W STE B6 INDIAN TRAIL NC,090,Union,251B00000X,Agencies,Case Management,,1174875736,FOOTPRINTS CASE MANAGEMENT,115 UNIONVILLE INDIAN TRAIL RD W STE B6 INDIAN TRAIL NC,090,Union,251B00000X,Agencies,Case Management,, 426 ," 4,826 "," 4,853 "," $2,000,258.07 ",,
MEDICAID DIRECT,1174875736,FOOTPRINTS CASE MANAGEMENT,~,115 UNIONVILLE INDIAN TRAIL RD W STE B6 INDIAN TRAIL NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1174875736,FOOTPRINTS CASE MANAGEMENT,115 UNIONVILLE INDIAN TRAIL RD W STE B6 INDIAN TRAIL NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 18 , 20 , 20 ," $186,157.94 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1174876114,"CELA, ARTENIDA",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174877443,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,251J00000X,Agencies,Nursing Care,,1174877443,BAYADA HOME HEALTH CARE INC,2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,251J00000X,Agencies,Nursing Care,, 36 ," 6,355 "," 7,080 "," $3,910,527.22 ",,
MEDICAID DIRECT,1174877443,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1174877443,BAYADA HOME HEALTH CARE INC,2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 22 , 729 , 730 ," $308,017.74 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174879415,"KANNALI, RAJASEKHAR",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174879415,"KANNALI, RAJASEKHAR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174882500,"KYLE, TYRONE, ALEXANDER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174884225,"SALIB, ANNA, COLLINS",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174884225,"SALIB, ANNA, COLLINS",3129 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174885719,"SHEA, JAMES, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174885719,"SHEA, JAMES, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 15 , 19 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174885719,"SHEA, JAMES, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 70 , 89 , 153 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174885719,"SHEA, JAMES, RYAN",300 ASHVILLE AVE   CARY NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174886485,"ACKROYD, BRITTANY",1000 BLYTHE BLVD FL 4 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174886485,"ACKROYD, BRITTANY",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 20 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174886485,"ACKROYD, BRITTANY",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1174888440,"PEARSON, KATHERINE, MARGARET",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 79 , 210 ," $11,795.39 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1174893135,"LUMSDEN, LAURA, BETH",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174895254,"KNOEDLER, SARAH, KATHLEEN",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,214 18TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174895254,"KNOEDLER, SARAH, KATHLEEN",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174899538,"LOFTON, MEGAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174899801,"GUTMAN, DANIEL",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174899801,"GUTMAN, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 54 , 90 , 112 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174899801,"GUTMAN, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 14 , 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174899801,"GUTMAN, DANIEL",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174901185,"RODRIGUEZ, JUSTIN, DEAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 78 , 84 , 138 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174901185,"RODRIGUEZ, JUSTIN, DEAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 140 , 154 , 205 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 24 , 30 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 35 , 40 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1174901276,"AURIE, REBEKAH, LOUISE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174902167,"GERBER, BRYAN, THOMAS",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 32 , 34 ,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",1311 E MILLBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 34 ,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 35 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1174903538,"PETERSON, STEPHANIE, CHRISTEN PRITCHETT",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 46 , 95 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174905160,"STEVENSON, NOVIA, CHANTEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1174907208,JFC MERIDIAN OPCO CHERRYVILLE LL,SOMERSET COURT OF CHERRYVILLE,401 W ACADEMY ST   CHERRYVILLE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1174907208,JFC MERIDIAN OPCO CHERRYVILLE LL,401 W ACADEMY ST   CHERRYVILLE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 61 ," 14,675 "," 14,681 "," $1,001,152.08 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174909998,"SCHMUTZ, CLARK, SPENCER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1174910152,"DEAN-APPASU, MELISSA, ROSEANN",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 33 , 36 ,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1174910152,"DEAN-APPASU, MELISSA, ROSEANN",1728 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174912109,"CLARK, SAIGE, MICHELLE",2001 S MAIN ST STE 200 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174912109,"CLARK, SAIGE, MICHELLE",10211 ALM ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174912109,"CLARK, SAIGE, MICHELLE",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174913511,"DESAI, RAHUL, PARESH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174913511,"DESAI, RAHUL, PARESH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174913511,"DESAI, RAHUL, PARESH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174913511,"DESAI, RAHUL, PARESH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174913685,"DOMINGO, MARIA, CECILIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174913685,"DOMINGO, MARIA, CECILIA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174913685,"DOMINGO, MARIA, CECILIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174916068,"ELLISON, CATHERINE, LEIGH",1900 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 27 , 27 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174916068,"ELLISON, CATHERINE, LEIGH",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174916068,"ELLISON, CATHERINE, LEIGH",1900 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174916068,"ELLISON, CATHERINE, LEIGH",1900 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1001 BLYTHE BLVD STE 403 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174916068,"ELLISON, CATHERINE, LEIGH",1900 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1174916365,"GLASS, ALEXANDRIA, BASS",~,412 E JOHNSON ST   CLINTON NC,082,Sampson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1174916365,"GLASS, ALEXANDRIA, BASS",412 E JOHNSON ST   CLINTON NC,082,Sampson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1184299034,GLASS DERMATOLOGY PLLC,,412 E JOHNSON ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1174916365,"GLASS, ALEXANDRIA, BASS",412 E JOHNSON ST   CLINTON NC,082,Sampson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 99 , 178 , 380 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174916407,"TAYLOR, JESSICA, ANN",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174916407,"TAYLOR, JESSICA, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174917017,"PARK, CAROLYN, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 352 , 426 , 501 ," $10,317.75 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174917017,"PARK, CAROLYN, JEAN",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174917165,"CHOI, CHARLES",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174917165,"CHOI, CHARLES",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 531 , 810 , 869 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174917165,"CHOI, CHARLES",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174917165,"CHOI, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 270 , 310 , 335 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174917165,"CHOI, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,314 BLOWING ROCK BLVD STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 57 , 72 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1174917173,"GRAHAM, CHARLES, DANIEL",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174918791,"JONES, CARRIE, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174918791,"JONES, CARRIE, ANN",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174918791,"JONES, CARRIE, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1174918791,"JONES, CARRIE, ANN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 302 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174918791,"JONES, CARRIE, ANN",10207 CERNY ST   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1174919195,"BENCIC, DEANNA, MARIE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1174919195,"BENCIC, DEANNA, MARIE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1174919195,"BENCIC, DEANNA, MARIE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174919195,"BENCIC, DEANNA, MARIE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174919195,"BENCIC, DEANNA, MARIE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 32 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 53 , 81 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174919880,"SPINRAD, KYLE, SCOTT",1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 72 , 94 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174922330,"WHITE, KIMBERLY, FRIEBERG",510 TIMBER DR E STE 102 GARNER NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174923965,"PRETTER, LESLIE, ANN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 37 , 70 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1174923965,"PRETTER, LESLIE, ANN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174925952,"STANBERY, MARY, LINDSEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174925952,"STANBERY, MARY, LINDSEY",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 81 , 143 ,$#,,
MEDICAID DIRECT,1700552270,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-ROBESON FAMILY PRACTICE,1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1174926612,"JONES, JAMIE, LEE",1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 134 , 477 , 710 ,$#,,
MEDICAID DIRECT,1174927057,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3600,970 STRICKLAND BRIDGE RD   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1174927057,WAL-MART STORES EAST LP,970 STRICKLAND BRIDGE RD   FAYETTEVILLE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1174929095,"GRAY, CARLY, JEAN",534 CARATOKE HWY   MOYOCK NC,027,Currituck,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 39 , 72 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1174930713,"WILLIAMS, BRITTANY, TAYLOR",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1174930713,"WILLIAMS, BRITTANY, TAYLOR",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174931034,"NOFTSGER, BRANDLYN, KENT",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1174931034,"NOFTSGER, BRANDLYN, KENT",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 11 ,$#,,
MEDICAID DIRECT,1720479876,G ABRAMS & R COHEN XIII PC,,901 OAK FOREST DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174932271,"HATTEN, ALESIA, ANATOLIEVNA",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,245 "," 2,576 "," 10,592 "," $614,580.27 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1174934798,"FORST, ERICA, LYNN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174935431,"WILSON, SAMUEL, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 48 , 71 , 98 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1425 PROMISE BEACON CIR STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174935431,"WILSON, SAMUEL, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1598260515,CONCORD RADIOLOGY PLLC,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1174937072,"ANDERSON, JOHN, ERICK",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174937262,"WITMAN, CAROLYN, ELIZABETH",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174937262,"WITMAN, CAROLYN, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174937262,"WITMAN, CAROLYN, ELIZABETH",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1174937262,"WITMAN, CAROLYN, ELIZABETH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174937262,"WITMAN, CAROLYN, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174937262,"WITMAN, CAROLYN, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174937262,"WITMAN, CAROLYN, ELIZABETH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174941355,"DOUGLAS, EMILY, HUGHES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 30 , 57 , 57 ,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1174941397,"PETRASZKO, ALEXANDRA, MICHELLE",8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 28 , 37 , 131 ," $11,058.95 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174942080,"FITZGERALD, CAITLIN, ANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 59 , 84 , 91 ," $12,301.76 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174942080,"FITZGERALD, CAITLIN, ANNE",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174942262,"ROMAN, KRISTEN, LEIGH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174942262,"ROMAN, KRISTEN, LEIGH",2351 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174942262,"ROMAN, KRISTEN, LEIGH",2351 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174943153,"FORBES, JONATHAN, LOWE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 30 , 52 , 61 ,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174943153,"FORBES, JONATHAN, LOWE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174943153,"FORBES, JONATHAN, LOWE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174943153,"FORBES, JONATHAN, LOWE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174943153,"FORBES, JONATHAN, LOWE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1174943153,"FORBES, JONATHAN, LOWE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174943153,"FORBES, JONATHAN, LOWE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174948046,"COLTRANE, JENA, LYNN WELCH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 32 , 32 ,$#,,
MEDICAID DIRECT,1174954671,ASHE MEDICS LP,,716 MOUNT JEFFERSON RD   WEST JEFFERSON NC,005,Ashe,3416L0300X,Transportation Services,Ambulance,Land Transport,1174954671,ASHE MEDICS LP,716 MOUNT JEFFERSON RD   WEST JEFFERSON NC,005,Ashe,3416L0300X,Transportation Services,Ambulance,Land Transport, 148 , 277 , 551 ," $11,756.43 ",,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL # 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174956205,"IRANI, FARIA, AMBER",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174956205,"IRANI, FARIA, AMBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174956205,"IRANI, FARIA, AMBER",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 26 , 35 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174956205,"IRANI, FARIA, AMBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 40 , 40 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174956205,"IRANI, FARIA, AMBER",181 DANIEL RD   FOREST CITY NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174956205,"IRANI, FARIA, AMBER",181 DANIEL RD   FOREST CITY NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 30 ,$#,,
MEDICAID DIRECT,1821112665,CAROLINAS REHABILITATION,~,1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174957609,"LEININGER, SHELLEY, LEIGH",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1902223076,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1174958037,"HANKINS, CASEY, DOUGLAS",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1174958037,"HANKINS, CASEY, DOUGLAS",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1174958037,"HANKINS, CASEY, DOUGLAS",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1174958037,"HANKINS, CASEY, DOUGLAS",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 85 , 90 , 159 ,$#,,
MEDICAID DIRECT,1902223076,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1174958037,"HANKINS, CASEY, DOUGLAS",181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1174958698,"JOSE, TOM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 57 , 57 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174958698,"JOSE, TOM",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 49 , 49 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1174958698,"JOSE, TOM",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1174958698,"JOSE, TOM",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1174958698,"JOSE, TOM",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 49 , 50 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",840 FLEMING ST STE 6 HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 16 , 24 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",575 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",575 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,78 BROAD ST   SPRUCE PINE NC,061,Mitchell,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",78 BROAD ST   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",78 BROAD ST   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 19 , 34 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 27 , 46 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 35 , 105 , 105 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 19 , 33 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 49 , 49 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",1611 ANDREWS RD   MURPHY NC,020,Cherokee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1174960058,"YATES, JAMES, ERIC",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 84 , 84 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1174961221,"PARRISH, JOSEPH, BRIAN",11635 NORTHPARK DR STE 200 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 84 , 199 , 427 ,$#,,
MEDICAID DIRECT,1225268170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1174962138,"HALL, JOSHUA, RANDAL",123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 89 , 152 ,$#,,
MEDICAID DIRECT,1942265301,WALTERS SURGICAL ASSOC PA,~,220 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1174962559,"THOMPSON, RICHARD, EDWARD",220 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174963359,"LAISURE, JOHN, ROLLAND",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 85 , 85 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174963789,"YOUNCE, ERIN, MARIE",1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174963789,"YOUNCE, ERIN, MARIE",8201 HEALTHCARE LOOP STE 202 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174963789,"YOUNCE, ERIN, MARIE",611 MOCKSVILLE AVE STE 200 SALISBURY NC,080,Rowan,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 27 , 39 , 67 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1174963854,"CLARKE, LINDSAY, DRIVER",7200 CREEDMOOR RD STE 104 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1174963953,"RAPPAPORT, MAXIMILIEN, JACOB",,877 W FARIS RD STE D GREENVILLE SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",1174963953,"RAPPAPORT, MAXIMILIEN, JACOB",877 W FARIS RD STE D GREENVILLE SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174966303,"STIRTON, JACOB, BENJAMIN",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174966303,"STIRTON, JACOB, BENJAMIN",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 28 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174966451,"LEES, BRITTANY, FLEMING",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 57 , 59 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174966451,"LEES, BRITTANY, FLEMING",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174966451,"LEES, BRITTANY, FLEMING",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 22 , 23 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174967673,"HOFFMAN, ROSS, MEREDITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 24 , 26 ," $10,626.07 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174967673,"HOFFMAN, ROSS, MEREDITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 46 , 93 , 109 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174967673,"HOFFMAN, ROSS, MEREDITH",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 17 , 22 ,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174968069,"BOUCHEZ, JONATHAN, DANIEL",1550 FAULK ST   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174968440,"DOUGHERTY, WILLIAM, MARK",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1174968440,"DOUGHERTY, WILLIAM, MARK",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912482787,BELONGING MEDICAL GROUP PLLC,,2501 BRAGG BLVD STE D FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1174971600,"BOOTH, ANGELA, LYNN",309 PROGRESS DR   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174971949,"WEBSTER, ERIKA, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 52 , 52 ,$#,,
MEDICAID DIRECT,1104597350,BURROW WELCHEL CULP MOORE PLLC KANN,~,1843 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1174972756,"RICHARDS, BRANDY, NICHELLE",1843 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1174972756,"RICHARDS, BRANDY, NICHELLE",~,354 GEO LILES PKWY NW STE 40 CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1174972756,"RICHARDS, BRANDY, NICHELLE",354 GEO LILES PKWY NW STE 40 CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 823 ," 1,702 "," 7,257 "," $327,795.54 ",,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174975387,"WHITE, LINDA, CANUP",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1174975387,"WHITE, LINDA, CANUP",507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 128 , 207 , 265 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174976195,"HAMILTON, ZACHARY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 60 , 66 , 73 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174976195,"HAMILTON, ZACHARY",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174976195,"HAMILTON, ZACHARY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 61 , 71 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174976195,"HAMILTON, ZACHARY",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1174976211,"SMID, REBECCA, JOANNE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 58 , 100 , 100 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174976856,"DOMINIC, LYDIA, MARIE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 16 , 20 , 26 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,301 E WENDOVER AVE STE 111   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174976856,"DOMINIC, LYDIA, MARIE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174976856,"DOMINIC, LYDIA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1174977185,"BEARD, JENNIFER, LYNN",1125 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1174977185,"BEARD, JENNIFER, LYNN",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 33 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174977714,"PRATT, ELIAS, HUBBARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 20 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174977714,"PRATT, ELIAS, HUBBARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1174977714,"PRATT, ELIAS, HUBBARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 57 , 61 ,$#,,
MEDICAID DIRECT,1013910330,ANESTHESIA SPECIALISTS,ANESTHESIA SPECIALISTS,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1174978563,"ROBERTS, JUSTIN, DOUGLAS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174981252,"BOYD, TRISHA, LYNN",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174981252,"BOYD, TRISHA, LYNN",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1174982391,"HOOVER, JENNA, WOODRUFF",89 HOSPITAL DR STE B BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 22 , 43 ,$#,,
MEDICAID DIRECT,1760458657,HOSPICE OF YANCEY COUNTY INC,COMPASSIONATE CARE WESTERN NORTH CAROLINA,856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1174983373,"YOUNG, LAURA, HASTINGS",856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 37 , 42 ,$#,,
MEDICAID DIRECT,1760458657,HOSPICE OF YANCEY COUNTY INC,COMPASSIONATE CARE WESTERN NORTH CAROLINA,856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1174983373,"YOUNG, LAURA, HASTINGS",856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1174983878,"BERRY, ANGELA, RENEE",3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 67 , 77 , 94 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,10211 ALM ST STE 1100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174985402,"BEBYN, CARLY, JO",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 29 , 69 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1174985402,"BEBYN, CARLY, JO",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174986517,"PETIT, NICHOLAS, PAUL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 19 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174986517,"PETIT, NICHOLAS, PAUL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1174986517,"PETIT, NICHOLAS, PAUL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 26 , 26 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174988992,"GROCE, SARAH, FRASER",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1174988992,"GROCE, SARAH, FRASER",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 38 , 51 , 61 ,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174989164,"GREENE, KAREN, B",8035 PROVIDENCE RD STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1174989164,"GREENE, KAREN, B",1107 REYNOLDS ST   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 33 ,$#,,
MEDICAID DIRECT,1093029563,ONSLOW COUNTY PARTNERSHIP FOR CHIL,ONE PLACE,900 DENNIS RD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1174991384,"JENSEN, SUSAN, BEADNELL",900 DENNIS RD   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174991590,"DOUCETTE, JACQUELINE, MARIE",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1174991590,"DOUCETTE, JACQUELINE, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174997738,"KACHO, AMY, MARIE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174997738,"KACHO, AMY, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174997738,"KACHO, AMY, MARIE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1174997738,"KACHO, AMY, MARIE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 42 , 43 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174997738,"KACHO, AMY, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1174997738,"KACHO, AMY, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174997738,"KACHO, AMY, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1174997738,"KACHO, AMY, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1174999312,"SINK, BIANCA, CAUDILL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 49 , 51 , 51 ,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184000820,"MOSES, JEREMY, BRYANT",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 90 , 125 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184001125,"BACA-ATLAS, MICHAEL, HOWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1972912285,UNIVERSITY OF NORTH CAROLINA AT CHA,~,401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184001125,"BACA-ATLAS, MICHAEL, HOWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 108 , 245 , 543 ," $13,746.72 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184001125,"BACA-ATLAS, MICHAEL, HOWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184001125,"BACA-ATLAS, MICHAEL, HOWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184001125,"BACA-ATLAS, MICHAEL, HOWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 28 , 29 ,$#,,
MEDICAID DIRECT,1972912285,UNIVERSITY OF NORTH CAROLINA AT CHA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1184001125,"BACA-ATLAS, MICHAEL, HOWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,315 19TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",959 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184003006,"SINGLA, PARTEEK",959 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1821183583,STOVER AND STOVER DDS PA,STOVER FAMILY DENTISTRY,1367A E GARRISON BOULEVARD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184004319,"STOVER, JENNA, LEIGH",1367 E GARRISON BLVD STE A GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 62 , 93 , 277 ," $10,623.96 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184005100,"NOHRIA, RAMAN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 44 , 67 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184005100,"NOHRIA, RAMAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184005100,"NOHRIA, RAMAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 39 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184005100,"NOHRIA, RAMAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 47 , 47 ,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184005654,"KUMAR, AMEET",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 40 , 40 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184005829,"GIGLIOTTI, ROSA, KATHARINE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 21 , 32 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1184005829,"GIGLIOTTI, ROSA, KATHARINE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 32 , 44 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184005829,"GIGLIOTTI, ROSA, KATHARINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1184005829,"GIGLIOTTI, ROSA, KATHARINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184005829,"GIGLIOTTI, ROSA, KATHARINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 28 , 41 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184006470,"WILLIAMS, DENNIS, RAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184006470,"WILLIAMS, DENNIS, RAY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184006470,"WILLIAMS, DENNIS, RAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184006470,"WILLIAMS, DENNIS, RAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366597114,CHILDRENS MEDICAL GROUP INC,GENERAL BOOTH PEDS,2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184006967,"BUCKINGHAM, AMY, JO",2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184007072,"VANNEMREDDY, SIDDHARTH, NIKHIL KRISHNA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 29 , 29 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1184007072,"VANNEMREDDY, SIDDHARTH, NIKHIL KRISHNA",800 TILGHMAN DR   DUNN NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184007072,"VANNEMREDDY, SIDDHARTH, NIKHIL KRISHNA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,149 PLANTATION RIDGE DR STE 170 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 68 , 74 , 139 ," $23,665.00 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,160 TURNBERRY WAY   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 41 , 48 , 84 ," $25,150.48 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,902 FLEMING ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184007312,"MCELROY, KELLY, ERIN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184008591,"RATIU, ANTONELA, KINGA",115 MCLEOD HEALTH BLVD BLDG 3 MYRTLE BEACH SC,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3112 CASEY ST UNIT A LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184008591,"RATIU, ANTONELA, KINGA",3112 CASEY ST   LORIS SC,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184008591,"RATIU, ANTONELA, KINGA",135 PROFESSIONAL PARK DR   CONWAY SC,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184008591,"RATIU, ANTONELA, KINGA",3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184009797,"ROBSON JR, JAMES, PAUL",1480 WESLEY CHAPEL RD   INDIAN TRAIL NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 79 , 158 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184011249,"FLANAGAN, BRENDAN, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 34 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184011249,"FLANAGAN, BRENDAN, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 82 , 88 , 95 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184011843,"HARVEY, JENNIFER, SUSANNE",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 26 , 45 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184011843,"HARVEY, JENNIFER, SUSANNE",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 107 , 179 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184011843,"HARVEY, JENNIFER, SUSANNE",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184012312,"STEARNS, BARTON, DANIEL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 117 , 120 , 122 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184012312,"STEARNS, BARTON, DANIEL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184013294,"KING, DANIELLE, GRACE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184013294,"KING, DANIELLE, GRACE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1184013294,"KING, DANIELLE, GRACE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184013294,"KING, DANIELLE, GRACE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184013971,"SCHULTZE, SUZANNE, SALEH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2460 CURTIS ELLIS DR # 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184013971,"SCHULTZE, SUZANNE, SALEH",2460 CURTIS ELLIS DR # 100 ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184013971,"SCHULTZE, SUZANNE, SALEH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1505 SW CARY PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184013971,"SCHULTZE, SUZANNE, SALEH",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184013971,"SCHULTZE, SUZANNE, SALEH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184013971,"SCHULTZE, SUZANNE, SALEH",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184013971,"SCHULTZE, SUZANNE, SALEH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 18 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184017881,"KOACHES MAHONY, HANNAH, C. M.",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184017881,"KOACHES MAHONY, HANNAH, C. M.",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184017881,"KOACHES MAHONY, HANNAH, C. M.",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184017881,"KOACHES MAHONY, HANNAH, C. M.",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184017881,"KOACHES MAHONY, HANNAH, C. M.",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 68 , 70 , 81 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184017881,"KOACHES MAHONY, HANNAH, C. M.",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 35 , 50 ,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184018202,"DOWLEN, HUGH, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184018202,"DOWLEN, HUGH, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184019036,"VARGHESE, MATHEW, SAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 40 , 50 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1184019101,"WILLIAMS, DARIN, SCOTT",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1184022964,"PENICK, JOSEPH, CLYDE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1184022964,"PENICK, JOSEPH, CLYDE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184028599,"BECKMAN, SHARON",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184028599,"BECKMAN, SHARON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184028599,"BECKMAN, SHARON",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 22 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184030322,"CLATTERBUCK, BRANT, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 35 , 39 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184030322,"CLATTERBUCK, BRANT, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 54 , 55 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184030322,"CLATTERBUCK, BRANT, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184030363,"ZINO, SHELLEY, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184030363,"ZINO, SHELLEY, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184030363,"ZINO, SHELLEY, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184030363,"ZINO, SHELLEY, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1184033623,"COUNTRYMAN, BRITTANY, ADAMS",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184033623,"COUNTRYMAN, BRITTANY, ADAMS",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1184034118,"CONTRERAS, FRANCISCO, JOSE",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 145 , 150 , 203 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 42 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 14 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",223 W WARD ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184034431,"WIGGINS, WALTER, FRANCIS",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184036212,"VIEAU, CHRISTOPHER, JOHN",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 32 , 43 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184036212,"VIEAU, CHRISTOPHER, JOHN",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 96 , 205 , 380 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184036212,"VIEAU, CHRISTOPHER, JOHN",10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184041279,"POCOCK, KRISTYN, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 27 , 44 , 63 ,$#,,
MEDICAID DIRECT,1174208813,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE RHC,1125 CARTHAGE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1184041345,"CALDWELL, ANDREW, CHARLES",1125 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 137 , 387 , 392 ," $18,664.18 ",,
MEDICAID DIRECT,1215476908,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE,1125 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1184041345,"CALDWELL, ANDREW, CHARLES",1125 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184041675,"MOORE, WILLIE, JR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184041675,"MOORE, WILLIE, JR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 45 , 158 , 158 ,$#,,
MEDICAID DIRECT,1184041949,PARADIGM LABS LLC,~,1302 FOUNTAIN PARK CIR   BRUNSWICK GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1184041949,PARADIGM LABS LLC,1302 FOUNTAIN PARK CIR   BRUNSWICK GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,," 1,014 "," 1,804 "," 2,905 "," $187,700.19 ",,
MEDICAID DIRECT,1184041949,PARADIGM LABS LLC,~,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1184041949,PARADIGM LABS LLC,249 REDFERN VLG   ST SIMONS ISLAND GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184043176,"BAUCHAT, ANDREA, LORENNE",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 48 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184043176,"BAUCHAT, ANDREA, LORENNE",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 31 , 35 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184043283,"FILLMORE, RYAN",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184043283,"FILLMORE, RYAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184043283,"FILLMORE, RYAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 48 , 75 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184043721,"WORTHINGTON, CAROLE, JANE",801 PINEHURST AVE   CARTHAGE NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184043721,"WORTHINGTON, CAROLE, JANE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184043721,"WORTHINGTON, CAROLE, JANE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184043721,"WORTHINGTON, CAROLE, JANE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 27 , 72 , 72 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184043721,"WORTHINGTON, CAROLE, JANE",305 E 14TH ST   ROANOKE RAPIDS NC,042,Halifax,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184043721,"WORTHINGTON, CAROLE, JANE",101 CAROLINA AVE   WELDON NC,042,Halifax,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184043721,"WORTHINGTON, CAROLE, JANE",2702 FARRELL RD   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184043721,"WORTHINGTON, CAROLE, JANE",5407 SKY LANE DR   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184043721,"WORTHINGTON, CAROLE, JANE",200 BELLAROSE LAKE WAY   GARNER NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184043721,"WORTHINGTON, CAROLE, JANE",3830 BLUE RIDGE RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184044331,"ABSHIRE, KYLE, JORDON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 98 , 104 , 110 ,$#,,
MEDICAID DIRECT,1831158245,DURHAM EMERGENCY PHYSICIANS PA,~,,,Unknown,193400000X,Group,Single Specialty,,1184044331,"ABSHIRE, KYLE, JORDON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184044596,"LEE, SAMUEL, KYLE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184044596,"LEE, SAMUEL, KYLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 84 , 87 ,$#,,
MEDICAID DIRECT,1265430854,GRANVILLE HEALTH SYSTEM,SOUTH GRANVILLE PRIMARY CARE,1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1184044950,"PESQUEIRA, JASON, MICHAEL",1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 169 , 196 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184045072,"MILLIAM, KIMBERIEY, ANNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184045213,"LIBBY, JEREMIAH, JOSH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184045619,GUARDANT HEALTH INC,,505 PENOBSCOT DR   REDWOOD CITY CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1184045619,GUARDANT HEALTH INC,505 PENOBSCOT DR   REDWOOD CITY CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 24 , 25 , 25 ," $42,606.69 ",,
MEDICAID DIRECT,1184046278,KIDSPROUT THERAPY,,10405 STALLION WAY   BAHAMA NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,1184046278,KIDSPROUT THERAPY,10405 STALLION WAY   BAHAMA NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,, 82 ," 1,179 "," 1,179 "," $77,068.40 ",,
MEDICAID DIRECT,1184046278,KIDSPROUT THERAPY,,10405 STALLION WAY   BAHAMA NC,032,Durham,193200000X,Group,Multi-Specialty,,1184046278,KIDSPROUT THERAPY,10405 STALLION WAY   BAHAMA NC,032,Durham,193200000X,Group,Multi-Specialty,,#, 97 , 97 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1184046294,"DEESE, VANESSA, PENTON",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184046294,"DEESE, VANESSA, PENTON",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1184046294,"DEESE, VANESSA, PENTON",916 S MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1184047136,"DELONG, AMY, LAURA",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 136 , 724 , 823 ," $20,812.73 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184047136,"DELONG, AMY, LAURA",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 , 229 , 250 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184047250,"HUPRICH, ERIN, ELISE",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 15 , 22 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184047250,"HUPRICH, ERIN, ELISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184047912,"ALBRIGHT, MICHAEL, JEFFREY",105 SW CARY PKWY STE 300 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,10226 COULOAK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184049389,"COLEMAN, MEGAN, LEE DUCKER",10226 COULOAK DR STE 100 CHARLOTTE NC,060,Mecklenburg,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1902557820,FOOT AND ANKLE SPECIALISTS OF THE M,,60 S MEDICAL CT   MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1184049827,"DAVIS, ELIZABETH, ANNE",60 S MEDICAL CT   MARION NC,059,McDowell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1184049827,"DAVIS, ELIZABETH, ANNE",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 15 , 23 , 49 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1184049827,"DAVIS, ELIZABETH, ANNE",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1184049827,"DAVIS, ELIZABETH, ANNE",60 S MEDICAL CT   MARION NC,059,McDowell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 11 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184049827,"DAVIS, ELIZABETH, ANNE",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 15 , 82 , 115 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1184049827,"DAVIS, ELIZABETH, ANNE",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 34 , 90 , 147 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184050288,"MEEKS, ANNA, FLETCHER",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1124089040,BIRTH AND WOMENS CARE PA,Birth and Womens Care PA,3601 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1184056939,"HELTON, KELLY, LYNN",3601 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 100 , 219 , 401 ," $10,187.18 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184059214,"PIERCE, BENJAMIN, DENT",40 DUKE MEDICINE CIR CLINIC 1F DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 59 , 89 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184059214,"PIERCE, BENJAMIN, DENT",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528376712,MATTHEWS INTERNAL MEDICINE PLLC,MATTHEWS INTERNAL MEDICINE PLLC,434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184059958,"SUNDBLADE, ALICJA, ERAZO",434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 33 , 66 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184061020,"CROSS, JENNIFER, ALICIA",349 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184061020,"CROSS, JENNIFER, ALICIA",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 24 , 34 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184061020,"CROSS, JENNIFER, ALICIA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184061020,"CROSS, JENNIFER, ALICIA",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1184062085,"DETTINGER, JOSHUA, AARON",401 W DECATUR ST   MADISON NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 79 , 223 , 314 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184062291,"LLEWELYN, ALISON, ANNE",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 19 , 50 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184062291,"LLEWELYN, ALISON, ANNE",4220 CAROLINA EXCHANGE DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184062416,"HOWINGTON, BRYAN, WAYNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184062564,"PATE, JAMES, BRYANT",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 31 , 39 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184062564,"PATE, JAMES, BRYANT",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 68 , 87 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184062564,"PATE, JAMES, BRYANT",306 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,306 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1184062564,"PATE, JAMES, BRYANT",306 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184064040,"KISBY, CASSANDRA, KAY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184064040,"KISBY, CASSANDRA, KAY",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184064040,"KISBY, CASSANDRA, KAY",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 30 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184064040,"KISBY, CASSANDRA, KAY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184064073,"SEEGARS, MARY, BETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 37 , 37 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184064123,"FORSHAY, BRITTANY, NICOLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 78 , 202 , 204 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184064123,"FORSHAY, BRITTANY, NICOLE",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184064123,"FORSHAY, BRITTANY, NICOLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1184065591,"GIBSON, SANDY, MICHELLE",75 MEDICAL PARK LN STE D MURPHY NC,020,Cherokee,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1184065591,"GIBSON, SANDY, MICHELLE",75 MEDICAL PARK LN STE D MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1184065591,"GIBSON, SANDY, MICHELLE",75 MEDICAL PARK LN STE D MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184067712,"LEE, MARY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184069478,"OH, PHILMO, YOUNGMIN",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 26 , 32 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184069478,"OH, PHILMO, YOUNGMIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 18 , 32 , 39 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1184069478,"OH, PHILMO, YOUNGMIN",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 32 , 45 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184069478,"OH, PHILMO, YOUNGMIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184070021,"PERALTA ESPINAL, PALOMA, JOSEFINA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184070021,"PERALTA ESPINAL, PALOMA, JOSEFINA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 119 , 119 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184070237,"MYERS, REBECCA, FAITH",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,3711 ELMSLEY ST STE 102 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184070237,"MYERS, REBECCA, FAITH",3711 ELMSLEY ST STE 102 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184070237,"MYERS, REBECCA, FAITH",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184070237,"MYERS, REBECCA, FAITH",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 107 , 156 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184070906,"TAMMINGA, KYLE, SCOTT",7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 25 , 43 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184070906,"TAMMINGA, KYLE, SCOTT",320 EMERGENCY ROOM DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184071797,"LYNCH, DAVID",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184071797,"LYNCH, DAVID",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 38 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1184071797,"LYNCH, DAVID",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184071797,"LYNCH, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184071987,"EVES, RACHEL, NICHOLE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 26 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184071987,"EVES, RACHEL, NICHOLE",3541 RANDOLPH RD STE 206 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184073918,"MCGHEE, MICHELLE, CHRISTINE",40 DUKE MEDICINE CIR STE 2B2C DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 70 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184074452,"RAMOS, JOHN, RAYMOND",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184074452,"RAMOS, JOHN, RAYMOND",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 19 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184075301,"DAY, CAROLINE, CORDELL",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184075301,"DAY, CAROLINE, CORDELL",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184075301,"DAY, CAROLINE, CORDELL",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184075301,"DAY, CAROLINE, CORDELL",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184076994,"FIKE, CALLAN, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184076994,"FIKE, CALLAN, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184077901,"PATEL, DARSHANA, ANIL",2000 PERIMETER PARK DR STE 200 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184077901,"PATEL, DARSHANA, ANIL",5317 HIGHGATE DR STE 117 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184078248,"THAKUR, GAURAV",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184078263,"TRIVEDI, SUMITA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 22 , 54 , 54 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184079360,"ALI, UZMA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 211 , 211 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1184079360,"ALI, UZMA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1184079360,"ALI, UZMA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 163 , 163 ," $11,511.68 ",,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 89 , 111 , 171 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 31 , 45 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184079519,"MANAM, RUPESH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184082968,"TAPPER, BARBARA, ANN",,101 WILLOW BRANCH CT   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1184082968,"TAPPER, BARBARA, ANN",101 WILLOW BRANCH CT   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 112 , 112 ," $10,796.80 ",,
MEDICAID DIRECT,1902020308,NC DHHS CHILD AND FAMILY WELL-BEING,DURHAM CDSA,115 MARKET ST STE 201 DURHAM NC,032,Durham,252Y00000X,Agencies,Early Intervention Provider Agency,,1184082968,"TAPPER, BARBARA, ANN",101 WILLOW BRANCH CT   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 12 , 12 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184086878,"BARRETT, PATRICK, JAMES",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184086878,"BARRETT, PATRICK, JAMES",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184086878,"BARRETT, PATRICK, JAMES",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184086878,"BARRETT, PATRICK, JAMES",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184086878,"BARRETT, PATRICK, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184086878,"BARRETT, PATRICK, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 17 , 19 , 21 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 16 , 19 , 25 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 27 , 30 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184086951,"ZIMMERMAN, MICHAEL, DONALD",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184087322,"HOANG, AMBER",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1184087322,"HOANG, AMBER",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184087322,"HOANG, AMBER",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184087637,"SWAHARI, VIJAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184089690,"CONNER, ERIKA, JUDITH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1184089690,"CONNER, ERIKA, JUDITH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851170906,SATYAM DENTAL INFRASTRUCTURE LLC,ARDEN MILL FAMILY DENTISTRY,5527 ARDEN MILL DR STE 105 FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184090755,"TAORI, NEHA, SATYANARAYAN",5527 ARDEN MILL DR STE 105 FORT MILL SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184096034,"RANDLES, JOSHUA, DAVID",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184096034,"RANDLES, JOSHUA, DAVID",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 21 , 23 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",575 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",11 PARK TERRACE DR   CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",100 SPAULDING RD STE 2 MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",80 WESTGATE PLZ   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",11 PARK TERRACE DR   CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 34 , 34 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",80 WESTGATE PLZ   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",100 SPAULDING RD STE 2 MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",1611 ANDREWS RD   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",1611 ANDREWS RD   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",53 ECHOTA CHURCH RD   CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",171 TSALI CARE WAY   CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",226 COMMERCIAL ST   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",226 COMMERCIAL ST   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",53 ECHOTA CHURCH RD   CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184096380,"PERTEE, AIJA, KATARINA",171 TSALI CARE WAY   CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184096463,"VIRGIL, ARVETTA, DIANE",119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184097974,"KEY, BRANDIE, HOLLIFIELD",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 67 , 67 ,$#,,
MEDICAID DIRECT,1184098063,OMNISEQ INC,,700 ELLICOTT ST   BUFFALO NY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1184098063,OMNISEQ INC,700 ELLICOTT ST   BUFFALO NY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184100547,"SACKENHEIM, JENNA, ROSE",910 N MADISON BLVD STE B ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 60 , 62 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184100547,"SACKENHEIM, JENNA, ROSE",16525 HOLLY CREST LN STE 220 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184100547,"SACKENHEIM, JENNA, ROSE",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,707 BRYANT ST   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184100570,"TURNER, AMANDA, JOHNSON",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 94 , 120 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184100570,"TURNER, AMANDA, JOHNSON",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184100570,"TURNER, AMANDA, JOHNSON",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 26 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184100570,"TURNER, AMANDA, JOHNSON",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184100570,"TURNER, AMANDA, JOHNSON",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578219424,OPPORTUNITIES INDUSTRIALIZATION CEN,,2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184101123,"DUNN-CERJA, DENISE, ALLISON",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,133N00000X,Dietary & Nutritional Service Providers,Nutritionist,,#,#,#,$#,,
MEDICAID DIRECT,1639661796,OPPORTUNITIES INDUSTRIALIZATION CEN,~,260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184101123,"DUNN-CERJA, DENISE, ALLISON",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,133N00000X,Dietary & Nutritional Service Providers,Nutritionist,,#,#,#,$#,,
MEDICAID DIRECT,1639661796,OPPORTUNITIES INDUSTRIALIZATION CEN,~,260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184101123,"DUNN-CERJA, DENISE, ALLISON",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184101123,"DUNN-CERJA, DENISE, ALLISON",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184101123,"DUNN-CERJA, DENISE, ALLISON",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,133N00000X,Dietary & Nutritional Service Providers,Nutritionist,,#,#,#,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184101123,"DUNN-CERJA, DENISE, ALLISON",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,133N00000X,Dietary & Nutritional Service Providers,Nutritionist,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184108037,"BAKER, JACLYN, FAITH",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 17 , 19 , 23 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184109431,"STOKAS, SARAH, SCHUILING",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184109431,"STOKAS, SARAH, SCHUILING",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184110744,"FEATHERSTONE, KALEIGH, BROOKE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184111213,"SNIPE, LEAH, DENYSE",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 37 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184111213,"SNIPE, LEAH, DENYSE",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184111213,"SNIPE, LEAH, DENYSE",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 165 , 169 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184111452,"RASLAN, RASHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184111452,"RASLAN, RASHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184111452,"RASLAN, RASHA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,601 FAYETTEVILLE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184111452,"RASLAN, RASHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 34 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184111452,"RASLAN, RASHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 31 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184111452,"RASLAN, RASHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 45 , 100 , 103 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184111452,"RASLAN, RASHA",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184111577,"CONTE, JORGE, ISAACS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184111577,"CONTE, JORGE, ISAACS",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184111577,"CONTE, JORGE, ISAACS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 23 , 23 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184111577,"CONTE, JORGE, ISAACS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 66 , 101 , 117 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3320 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184111841,"HARRIGAN, JAMES, JOSEPH",3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184111841,"HARRIGAN, JAMES, JOSEPH",3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1912784406,REX HOSPITAL INC,NORTH CAROLINA INFECTIOUS DISEASES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184111841,"HARRIGAN, JAMES, JOSEPH",3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1912784406,REX HOSPITAL INC,NORTH CAROLINA INFECTIOUS DISEASES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184111841,"HARRIGAN, JAMES, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184111916,"STOUT, JACOB, MORGAN",601 N ELM ST   HIGH POINT NC,041,Guilford,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 22 , 36 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184111916,"STOUT, JACOB, MORGAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184112559,"JIBOWU, DAMILOLA, FUNMILADE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184113169,"RYDER, CHRISTOPHER, WILLIAM",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 41 , 41 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184113169,"RYDER, CHRISTOPHER, WILLIAM",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184114100,"MURRAY, CHRISTINA, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184114100,"MURRAY, CHRISTINA, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 23 , 81 , 81 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184115230,"FUTCH, TANNER, KENDRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881979011,NATURAL BEGINNINGS BIRTH AND WELLNE,NATURAL BEGINNINGS BIRTH AND WELLNESS CENTER,1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184115834,"JOHNSON, JENNIFER, MICHELLE",1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1184118135,"WILLOUGHBY, BONNIE, JEAN",404 HATFIELD CT   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 69 , 69 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1601 PURDUE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184118135,"WILLOUGHBY, BONNIE, JEAN",404 HATFIELD CT   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 589 , 597 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184118952,"CAMPBELL, JENNIFER, LYNN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184118952,"CAMPBELL, JENNIFER, LYNN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184118952,"CAMPBELL, JENNIFER, LYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184120040,"ESTIN, MIRIAM, LAQUER",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184120321,"JOHNSON, RACHEL, MATHESON",530 W WEBB AVE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184120321,"JOHNSON, RACHEL, MATHESON",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 43 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184120941,"KENNEDY, KENDRICK, VANTARUS",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184120941,"KENNEDY, KENDRICK, VANTARUS",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 63 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184121899,"GORDON, EMILE, BRINK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184121899,"GORDON, EMILE, BRINK",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 32 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184121899,"GORDON, EMILE, BRINK",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184121899,"GORDON, EMILE, BRINK",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1184122145,"BROUSSARD, JAMILIA, LASHAWN",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 123 , 187 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184122145,"BROUSSARD, JAMILIA, LASHAWN",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 43 , 79 ,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184122145,"BROUSSARD, JAMILIA, LASHAWN",6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184122145,"BROUSSARD, JAMILIA, LASHAWN",35 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 159 , 226 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184122145,"BROUSSARD, JAMILIA, LASHAWN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1184122145,"BROUSSARD, JAMILIA, LASHAWN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 62 , 92 ,$#,,
MEDICAID DIRECT,1003183120,MCLEOD PHYSICIAN ASSOCIATES II,SOUTHERN MEDICAL ASSOCIATES,3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184123242,"HUCKS, JULIA, BATTEN",3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1184126484,LABORATORY CORPORATION OF AMERICA H,,113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,291U00000X,Laboratories,Clinical Medical Laboratory,,1184126484,LABORATORY CORPORATION OF AMERICA H,113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,291U00000X,Laboratories,Clinical Medical Laboratory,, 48 , 81 , 95 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184127565,"DOOLITTLE, TREVOR, JOHN",115 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1184127565,"DOOLITTLE, TREVOR, JOHN",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184127565,"DOOLITTLE, TREVOR, JOHN",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184127565,"DOOLITTLE, TREVOR, JOHN",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184128084,"WENTT, CHRISTA, LANAE",115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184128209,"NEGI, RUCHITA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184133068,"LYNCH, CHELSEA, RENEE",303 GREEN ST E   WILSON NC,098,Wilson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 70 , 111 , 112 ," $19,307.63 ",,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184141897,"GARRARD, CHRICAT, SUCHY",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4207 LAKE BOONE TRL STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184141897,"GARRARD, CHRICAT, SUCHY",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659700144,REX HOSPITAL INC,NORTH CAROLINA NEUROSURGERY AND SPINE,4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184141897,"GARRARD, CHRICAT, SUCHY",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184142713,ALLY HOME CARE SALISBURY LLC,ALLY HOME CARE,135 MOCKSVILLE AVE STE B SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1184142713,ALLY HOME CARE SALISBURY LLC,135 MOCKSVILLE AVE STE B SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,, 105 ," 21,070 "," 21,436 "," $1,853,048.74 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184144321,"WIGGINS-METCALF, ADRIENNE, ELIZABETH",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 23 , 39 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184144321,"WIGGINS-METCALF, ADRIENNE, ELIZABETH",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184144669,"FRANKLIN, CANDACE, NICOLE",3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,1860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184144669,"FRANKLIN, CANDACE, NICOLE",1860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 58 , 73 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184145658,"POALILLO, BRENDA, LOUISE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184145658,"POALILLO, BRENDA, LOUISE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1184145658,"POALILLO, BRENDA, LOUISE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184149338,"VOLLMER, JAMES, DAVID",10030 GILEAD RD STE 140 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184149338,"VOLLMER, JAMES, DAVID",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 36 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184149338,"VOLLMER, JAMES, DAVID",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184151482,"WEISENBERGER, JOSEPH, ANDREW",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184151482,"WEISENBERGER, JOSEPH, ANDREW",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184151482,"WEISENBERGER, JOSEPH, ANDREW",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801843925,ARTHRITIS AND OSTEOPOROSIS CONSULTA,ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CARO,1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184151730,"SULLIVAN, JEREMY, ISAIAH",1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 37 , 64 , 148 ,$#,,
MEDICAID DIRECT,1033677240,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - MAIDEN,137 ISLAND FORD RD   MAIDEN NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184152902,"OLEJARZ, ANNE, AZRAK",137 ISLAND FORD RD   MAIDEN NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 23 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 101 , 109 , 157 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 58 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184153231,"VASIREDDI, ANIL, KRISHNA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184153421,"SCICLUNA, VICTORIA, MAH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184153991,"WILSON WESTMARK, NANCY, ADALYN",40 DUKE MEDICINE CIR # 1F DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 65 , 87 , 176 ," $16,654.19 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184153991,"WILSON WESTMARK, NANCY, ADALYN",2301 ERWIN RD   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 36 , 46 , 274 ," $28,772.18 ",,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184154122,"ALMONY, STEPHANIE, RENEE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184154122,"ALMONY, STEPHANIE, RENEE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",2605 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 30 ,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",1705 HIGH HOUSE RD   CARY NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 27 , 27 , 80 ," $15,596.13 ",,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 31 , 31 , 92 ," $16,981.79 ",,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",310 MILLSTONE DR   HILLSBOROUGH NC,068,Orange,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 108 , 108 , 324 ," $54,307.62 ",,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,310 MILLSTONE DR STE 1 HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",310 MILLSTONE DR   HILLSBOROUGH NC,068,Orange,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 11 , 11 , 44 ,$#,,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",310 MILLSTONE DR   HILLSBOROUGH NC,068,Orange,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 232 , 231 , 690 ," $130,682.18 ",,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 36 ,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",1013 SPRING LN   SANFORD NC,053,Lee,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 162 , 162 , 483 ," $84,788.04 ",,
MEDICAID DIRECT,1154902021,BRAXTON M HENDERSON DMD PA,SOUTHERN OFFICE-BASED ANESTHESIA,1013 SPRING LN   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",1013 SPRING LN   SANFORD NC,053,Lee,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",2305 NC 24-87   CAMERON NC,043,Harnett,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 27 ,$#,,
MEDICAID DIRECT,1003675505,BENJAMIN PRITTS DMD PLLC,LUXE ANESTHESIA SERVICES,120 STONY HILL RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1184154387,"PRITTS, BENJAMIN, SAMUEL",2600 OAKCREST AVE STE A GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 26 , 26 , 78 ," $13,415.74 ",,
MEDICAID DIRECT,1710073606,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3800 ROBERT PORCHER WAY STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184155541,"TIMBERLAKE, KATHRYN, STEWART",3800 ROBERT PORCHER WAY   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 38 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184156887,"ACKER, LEAH, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184156887,"ACKER, LEAH, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184156887,"ACKER, LEAH, CHRISTINE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184156887,"ACKER, LEAH, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1841049913,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE BAPTIST IMAGING,3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184158610,"MALOUF, WILLIAM, TAYMANS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184158610,"MALOUF, WILLIAM, TAYMANS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 233 , 259 , 431 ," $13,157.36 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184158610,"MALOUF, WILLIAM, TAYMANS",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184158610,"MALOUF, WILLIAM, TAYMANS",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184158610,"MALOUF, WILLIAM, TAYMANS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184158610,"MALOUF, WILLIAM, TAYMANS",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184158958,"MCGHEE, MARISA, BARCLAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 71 , 119 , 135 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184159006,"BROWN, FLORENCE, KATHRYN",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184159006,"BROWN, FLORENCE, KATHRYN",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184159006,"BROWN, FLORENCE, KATHRYN",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 302 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184159006,"BROWN, FLORENCE, KATHRYN",10207 CERNY ST STE 302 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184159147,"TURNER, SCOTT, MICHAEL",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184159147,"TURNER, SCOTT, MICHAEL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184159147,"TURNER, SCOTT, MICHAEL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184159147,"TURNER, SCOTT, MICHAEL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 32 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1184161994,"COSTELLO, KEVIN, FRANCIS",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184162810,"MCLEAN, DARIUS, LAQUANN",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184163859,"PROBST, CARY, MICHELLE",6324 FAIRVIEW RD STE 420 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 80 , 134 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184163859,"PROBST, CARY, MICHELLE",6324 FAIRVIEW RD STE 390 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184163859,"PROBST, CARY, MICHELLE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184164162,PUBLIX NORTH CAROLINA LP,PUBLIX PHARMACY 1582,2005 N MAIN ST UNIT 101 HIGH POINT NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1184164162,PUBLIX NORTH CAROLINA LP,2005 N MAIN ST UNIT 101 HIGH POINT NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1184165607,EYECARECENTER OD PA,EYECARE CENTER,5121 REIDSVILLE RD   WALKERTOWN NC,034,Forsyth,193400000X,Group,Single Specialty,,1184165607,EYECARECENTER OD PA,5121 REIDSVILLE RD   WALKERTOWN NC,034,Forsyth,193400000X,Group,Single Specialty,, 19 , 19 , 37 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1184166068,"CHILDRESS, JENNIFER, JOHNSON",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144655903,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE WILKES,5229 ROCK CREEK RD   HAYS NC,097,Wilkes,193400000X,Group,Single Specialty,,1184166068,"CHILDRESS, JENNIFER, JOHNSON",5229 ROCK CREEK RD   HAYS NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 96 , 427 , 634 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1184166068,"CHILDRESS, JENNIFER, JOHNSON",631 CC CAMP RD   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1184166068,"CHILDRESS, JENNIFER, JOHNSON",911 E ATKINS ST   DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184170805,"FARBER, SAMUEL, HARRISON",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184170805,"FARBER, SAMUEL, HARRISON",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 23 ," $11,484.38 ",,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184170805,"FARBER, SAMUEL, HARRISON",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184175176,"TITUS-WELLS, KATHERINE, ADELE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1184175176,"TITUS-WELLS, KATHERINE, ADELE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 40 , 40 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184176133,"SWAILES, EDWARD, GERALD",227 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 113 , 205 , 397 ,$#,,
MEDICAID DIRECT,1184181018,JK2C LLC,~,312 ACADEMY ST S STE D AHOSKIE NC,046,Hertford,251S00000X,Agencies,Community/Behavioral Health,,1184181018,JK2C LLC,312 ACADEMY ST S STE D AHOSKIE NC,046,Hertford,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1326364100,LOWCOUNTRY URGENT CARE,LOWCOUNTRY URGENT CARE,501 RADFORD BLVD   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184181570,"GREEN, LASHANNA, SHREE",501 RADFORD BLVD   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184182057,"BROWN, MEGHAN, BURNS",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184182057,"BROWN, MEGHAN, BURNS",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184182057,"BROWN, MEGHAN, BURNS",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1184182065,"GREEN, TIARRA, NICHELLE",1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 40 , 40 , 75 ," $10,304.91 ",,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184182206,"GREEN, ASHLEY, DISEAN",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184182693,"DAVIS, ROCHELLE, NIEBLAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184183428,"JACKSON, DAVID, GEORGE",2150 HERBERT CT   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184183428,"JACKSON, DAVID, GEORGE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 31 , 48 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184183428,"JACKSON, DAVID, GEORGE",2150 HERBERT CT   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184183428,"JACKSON, DAVID, GEORGE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184183485,"MARCHAND, CHRISTOPHER, ROBERT",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 30 , 64 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184183907,"SELLERS, CHARITY, BRYANT",324 N QUEEN ST   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1184183907,"SELLERS, CHARITY, BRYANT",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184183907,"SELLERS, CHARITY, BRYANT",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 71 , 78 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184183907,"SELLERS, CHARITY, BRYANT",107 S QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184186611,"FLETCHER, ALEX, GRAYSON",257 HOSPITAL DR NE STE 200 BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 39 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184187387,"MCGOWAN, REBECCA, LYNNE",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 20 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184187387,"MCGOWAN, REBECCA, LYNNE",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184188021,"NHOR, CHERRY",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497158554,TIERNEY ORTHOTICS AND PROSTHETICS,~,1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184190266,"TIERNEY, EMILY, ELIZABETH",1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1497158554,TIERNEY ORTHOTICS AND PROSTHETICS,~,1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184190266,"TIERNEY, EMILY, ELIZABETH",1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1184191223,LIFELINE HOME CARE LLC,~,5710 SIX FORKS RD # 11B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1184191223,LIFELINE HOME CARE LLC,5710 SIX FORKS RD # 11B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 54 ," 11,948 "," 12,886 "," $1,861,626.64 ",,
MEDICAID DIRECT,1295166437,FAMILY PRESERVATION SERVICES OF NC,~,139 E TRADE ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184194532,"HUNDLEY, NATHANIEL, JAMES",1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184197121,"HUFFMAN, KIRSTEN, MICHELLE",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184197121,"HUFFMAN, KIRSTEN, MICHELLE",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184197121,"HUFFMAN, KIRSTEN, MICHELLE",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 26 , 42 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184197121,"HUFFMAN, KIRSTEN, MICHELLE",7825 BALLANTYNE COMMONS PKWY STE 150 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184197121,"HUFFMAN, KIRSTEN, MICHELLE",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184197121,"HUFFMAN, KIRSTEN, MICHELLE",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184199101,"FORREST, AMY, MELISSA",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447339767,CAROLINA DIGESTIVE DISEASES PA,CAROLINA DIGESTIVE DISEASES PA,704 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184199101,"FORREST, AMY, MELISSA",704 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 94 , 143 , 148 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1184201279,"NORVILLE, REGINA",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 27 , 39 , 137 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1184201279,"NORVILLE, REGINA",404 S SUTHERLAND AVE   MONROE NC,090,Union,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 49 , 67 , 217 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1184201279,"NORVILLE, REGINA",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 62 , 95 , 369 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1184201279,"NORVILLE, REGINA",9040 NATIONS FORD RD   CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184202277,"DOLBY, KAREN, RICH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 28 , 31 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184209959,"WILSON, FARRAH, MACHARRI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 148 , 148 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184211021,"ZAMORA-DUPREY, RAUL, ANDRES",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 28 , 85 , 86 ,$#,,
MEDICAID DIRECT,1184220873,ASHEVILLE GERIATRIC LLC,RICHMOND HILL ASSISTED LIVING 2,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184220873,ASHEVILLE GERIATRIC LLC,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 596 , 596 ," $37,127.37 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1184221186,"GOWER, PAIGE, MICHELLE",2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184221186,"GOWER, PAIGE, MICHELLE",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 31 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184221186,"GOWER, PAIGE, MICHELLE",300 HEALTH PARK DR STE 210 GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184222606,"MAPLES, TYLER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184224610,"BLANTON, KRYSTA, MARIE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 149 , 157 ,$#,,
MEDICAID DIRECT,1265194302,MITCHELL AND MITCHELL DMD PLLC,MITCHELL FAMILY DENTAL,1103 E COURT ST   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1184233819,"MITCHELL, RYAN, OLMSTED",1103 E COURT ST   MARION NC,059,McDowell,1223G0001X,Dental Providers,Dentist,General Practice," 1,215 "," 2,232 "," 8,066 "," $494,467.54 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184236218,"DETRIZIO, HEATHER, DAWN",9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184236218,"DETRIZIO, HEATHER, DAWN",8420 UNIVERSITY EXEC PARK DR STE 850 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 84 , 162 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184236218,"DETRIZIO, HEATHER, DAWN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821320334,SOUL CARE,~,5501 EXECUTIVE CENTER DR STE 215 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184236226,"CORPUS, ANDREA, ROSE",5501 EXECUTIVE CENTER DR STE 215 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 108 , 108 ,$#,,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1184236564,HEALTH & HOME SERVICES INC,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1184236564,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1184236564,HEALTH & HOME SERVICES INC,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 20 ," 1,850 "," 1,905 "," $842,451.53 ",,
MEDICAID DIRECT,1184236564,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1184236564,HEALTH & HOME SERVICES INC,2411 ROBESON ST STE 100 FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,#,,,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184239485,"SPENCER, HEATHER, LYNN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184246449,"ACKERMAN, ALIX, HELENE",3609 SW DURHAM DRIVE   DURHAM NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 13 , 32 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1184246449,"ACKERMAN, ALIX, HELENE",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 31 , 35 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184246449,"ACKERMAN, ALIX, HELENE",3609 SW DURHAM DRIVE   DURHAM NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 47 , 62 , 117 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1184246449,"ACKERMAN, ALIX, HELENE",3609 SW DURHAM DRIVE   DURHAM NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 15 , 25 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184248924,"EDWARDS, DUSTIN, JOHN",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184248924,"EDWARDS, DUSTIN, JOHN",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184249559,"WALO, RICHARD, RALPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184249559,"WALO, RICHARD, RALPH",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 58 , 125 , 125 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184249682,"WRIGHT, ALEXANDRA, GENNA",8201 HEALTHCARE LOOP STE 302 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 24 , 40 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184249682,"WRIGHT, ALEXANDRA, GENNA",6555 KEE LN STE 200 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184249856,"GRAY ENGLISH, DARA, LOUISE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 39 , 45 ,$#,,
MEDICAID DIRECT,1740238435,ATLANTIC GASTROENTEROLOGY PA,~,2465 EMERALD PL   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184249856,"GRAY ENGLISH, DARA, LOUISE",2465 EMERALD PL   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 33 , 33 ,$#,,
MEDICAID DIRECT,1760134746,BRAZILE AND MOOREHEAD PLLC,INFINITY SMILES,8700 PINEVILLE MATTHEWS RD STE 920 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184251068,"BRAZILE, BRIANA",8700 PINEVILLE MATTHEWS RD STE 920 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 279 , 467 ," 1,331 "," $94,514.19 ",,
MEDICAID DIRECT,1760134746,BRAZILE AND MOOREHEAD PLLC,INFINITY SMILES,8700 PINEVILLE MATTHEWS RD STE 920 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184251068,"BRAZILE, BRIANA",8700 PINEVILLE MATTHEWS RD STE 920 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 99 , 300 ," $16,837.97 ",,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184252389,"NABORS, CHADWICK, CHRISTIAN",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1184252389,"NABORS, CHADWICK, CHRISTIAN",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184255127,"CAJKA, KYLIE, HAWKINS",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184255127,"CAJKA, KYLIE, HAWKINS",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184258642,"SIMMONS, KEENAN, JALEEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184258642,"SIMMONS, KEENAN, JALEEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801086558,SAMPSON REG MED SERVICES ANESTHESIA,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1184258725,"BEST, MARIAH, BAREFOOT",607 BEAMAN ST   CLINTON NC,082,Sampson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1184258725,"BEST, MARIAH, BAREFOOT",607 BEAMAN ST   CLINTON NC,082,Sampson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184259822,GENTLE TOUCH SENIOR SERVICES LLC,,4822 ALBEMARLE RD STE 198 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1184259822,GENTLE TOUCH SENIOR SERVICES LLC,4822 ALBEMARLE RD STE 198 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 875 , 875 ," $54,390.96 ",,
MEDICAID DIRECT,1184262826,"HEIGEL, LINDSAY, ELIZABETH",WNC MOUNTAIN SPEECH,34 N MAIN ST   MARS HILL NC,057,Madison,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1184262826,"HEIGEL, LINDSAY, ELIZABETH",34 N MAIN ST   MARS HILL NC,057,Madison,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184265126,"SCHUMANN, NICHOLAS, PETER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 29 , 32 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184265126,"SCHUMANN, NICHOLAS, PETER",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184265126,"SCHUMANN, NICHOLAS, PETER",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184265126,"SCHUMANN, NICHOLAS, PETER",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184265126,"SCHUMANN, NICHOLAS, PETER",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184265126,"SCHUMANN, NICHOLAS, PETER",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1184265126,"SCHUMANN, NICHOLAS, PETER",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193400000X,Group,Single Specialty,,1184265563,"MARTINEZ, ALFREDO, VELASCO",3445 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1184265563,"MARTINEZ, ALFREDO, VELASCO",3445 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 39 ,$#,,
MEDICAID DIRECT,1467113332,LANE & ASSOCIATES XLIII DDS PA,~,3445 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1184265563,"MARTINEZ, ALFREDO, VELASCO",3445 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184272742,"SHECKLEY, ZACHARY, ROBERT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184272742,"SHECKLEY, ZACHARY, ROBERT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184272742,"SHECKLEY, ZACHARY, ROBERT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184272742,"SHECKLEY, ZACHARY, ROBERT",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184274516,"OWENS, JESSICA, C K",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 60 , 102 , 102 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184275562,"SMITH, LAUREN, POLK",10211 ALM ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184275562,"SMITH, LAUREN, POLK",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184275570,"KIENKER, STEFANIE, ANN",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 90 , 90 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184276677,"HODGKINS, KATRINA, JOY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184276677,"HODGKINS, KATRINA, JOY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 110 , 110 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184276677,"HODGKINS, KATRINA, JOY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184276677,"HODGKINS, KATRINA, JOY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184277071,"WOODARD, BRITTANY, NOEL",722 HYATT ST STE C GAFFNEY SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184280281,"HAREN, NICOLE, KALANI",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1184280281,"HAREN, NICOLE, KALANI",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184280281,"HAREN, NICOLE, KALANI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184280281,"HAREN, NICOLE, KALANI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 25 , 30 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1184282634,"JEAN, ISABEL, CRISTINA",2301 ERWIN RD   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184282634,"JEAN, ISABEL, CRISTINA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184282634,"JEAN, ISABEL, CRISTINA",1550 FAULK ST STE 2100 MONROE NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 34 , 37 , 43 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184286445,"NORRIS, KAYLA, MARIE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 52 , 75 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184286445,"NORRIS, KAYLA, MARIE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 181 , 259 ,$#,,
MEDICAID DIRECT,1447496112,WESTERN CARTERET MEDICAL CENTER PLL,WESTERN CARTERET MEDICAL CENTER PLLC,718 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,193400000X,Group,Single Specialty,,1184286775,"SINK, REBECCA, JANE",718 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447496112,WESTERN CARTERET MEDICAL CENTER PLL,WESTERN CARTERET MEDICAL CENTER PLLC,718 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1184286775,"SINK, REBECCA, JANE",718 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184288342,"DELK, JORDAN, THOMAS",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184288342,"DELK, JORDAN, THOMAS",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184288342,"DELK, JORDAN, THOMAS",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1184289332,"ALLEN, AUSTIN, TREY",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1184289332,"ALLEN, AUSTIN, TREY",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 161 , 161 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184289332,"ALLEN, AUSTIN, TREY",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184289332,"ALLEN, AUSTIN, TREY",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1184289332,"ALLEN, AUSTIN, TREY",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184290215,"KURZONTKOWSKI, CHELCIE, ALLANNE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467919126,HAMMOCK DMD & LOTAKIS DDS VI PLLC,~,2222 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184291213,"RAINS, COURTNEY, ELIZABETH",6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1467919126,HAMMOCK DMD & LOTAKIS DDS VI PLLC,~,2222 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184291213,"RAINS, COURTNEY, ELIZABETH",2222 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,403 "," 2,672 "," 8,508 "," $531,775.20 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184294233,"PASCHAL, CHRISTY, WIMMER",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184295412,"TUBBS, MEGAN, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 26 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184295412,"TUBBS, MEGAN, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184297012,"DODGE, REX, DANIEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184297012,"DODGE, REX, DANIEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184297418,EDWARDS HOME CARE SERVICES,,105 W CASWELL ST UNIT 203 KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1184297418,EDWARDS HOME CARE SERVICES,105 W CASWELL ST UNIT 203 KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,505 "," 3,594 "," $502,616.76 ",,
MEDICAID DIRECT,1184298747,A&A HOME CARE AGENCY LLC,,400 S ROAD ST STE 23 ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1184298747,A&A HOME CARE AGENCY LLC,400 S ROAD ST STE 23 ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,284 "," 4,284 "," $256,962.76 ",,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184302382,"PRINCE, KATHRYNNE, GEORGIE",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 41 , 101 ,$#,,
MEDICAID DIRECT,1750928321,GORDON AND SCHELLER DDS PLLC,TRI-CITY FAMILY DENTISTRY,136 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184308777,"LAMBERT, SPENCER, LEON",136 RESERVATION DR   SPINDALE NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice, 859 ," 2,208 "," 7,191 "," $497,153.00 ",,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184309783,"GRADY, CALLAWAY, BROOKE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184309783,"GRADY, CALLAWAY, BROOKE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184309783,"GRADY, CALLAWAY, BROOKE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184309783,"GRADY, CALLAWAY, BROOKE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184309783,"GRADY, CALLAWAY, BROOKE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184312183,"EWING, ALLISON, THERESE",1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1891429593,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE HOPE VALL,7021 NC HIGHWAY 751   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184323461,"RODRIGUEZ, ANITAMARIE, JOSEPHINE ESSENCE",7021 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063096345,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE GLENWOOD,6800 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184323461,"RODRIGUEZ, ANITAMARIE, JOSEPHINE ESSENCE",6800 GLENWOOD AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891429593,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE HOPE VALL,7021 NC HIGHWAY 751   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184323461,"RODRIGUEZ, ANITAMARIE, JOSEPHINE ESSENCE",6800 GLENWOOD AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669107611,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE SPRING FO,815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184323461,"RODRIGUEZ, ANITAMARIE, JOSEPHINE ESSENCE",815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1184323461,"RODRIGUEZ, ANITAMARIE, JOSEPHINE ESSENCE",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023050630,COURTVIEW OB GYN PA,COURTVIEW OB GYN PA,706 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184325037,"SCOTT, CARA, LYNN",706 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1184333163,"PARSON, KYLE, ZACKARIE",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 53 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1184333163,"PARSON, KYLE, ZACKARIE",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1184333163,"PARSON, KYLE, ZACKARIE",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184343311,"NICHOLS, LAUREN, TAYLOR",901 N. WINSTEAD AVENUE SUITE 510 ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 79 , 162 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184343584,"SPEIGHT, KANDICE, DI-ANN",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 181 , 994 ," 1,048 "," $32,490.36 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184343584,"SPEIGHT, KANDICE, DI-ANN",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184345316,"LASHMIT, CHEYENNE, ALICIA",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 86 , 89 , 157 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184348740,"FRANCOIS, VANIA",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 115 , 141 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184348740,"FRANCOIS, VANIA",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 29 , 36 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184348864,"WEBSTER, CAROLINE, WHITESIDES",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184349623,"HUNT, RAMANDA, ANN",923 W 3RD ST STE B PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 39 , 58 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE B PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1184349623,"HUNT, RAMANDA, ANN",923 W 3RD ST STE B PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 87 , 247 , 430 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184350688,"PARKER, JENNIFER, BARNHARDT",2240 REMOUNT RD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1881165876,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- RAEFORD,6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184351504,"ELKATTAN, ISRAA, FATHY",6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE F KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184351504,"ELKATTAN, ISRAA, FATHY",400 S WALL ST   BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 222 , 261 , 803 ," $47,758.59 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184351504,"ELKATTAN, ISRAA, FATHY",400 S WALL ST   BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,400 S WALL ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184351504,"ELKATTAN, ISRAA, FATHY",400 S WALL ST   BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 701 ," 1,137 "," 4,009 "," $176,511.85 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE F KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184351504,"ELKATTAN, ISRAA, FATHY",1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 385 , 509 ," 1,686 "," $71,807.61 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,400 S WALL ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184351504,"ELKATTAN, ISRAA, FATHY",1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1073148581,AMPUTATION PREVENTION CENTER OF NC,VASCULAR SOLUTIONS OF NORTH CAROLINA,1000 CRESCENT GRN STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1184355919,"D'LUGIN, ALYSSA, LORAYNE",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184355919,"D'LUGIN, ALYSSA, LORAYNE",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184355943,"DYER, JESSICA, CAROLINE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184355943,"DYER, JESSICA, CAROLINE",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184355943,"DYER, JESSICA, CAROLINE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184355943,"DYER, JESSICA, CAROLINE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184359523,"BRITTAN, DANIEL, JAMES",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184359523,"BRITTAN, DANIEL, JAMES",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 30 , 34 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184359523,"BRITTAN, DANIEL, JAMES",1550 FAULK ST STE 3100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184359564,"SMITH, RACHEL, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184359564,"SMITH, RACHEL, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184360026,"PERROTTI, ERIN, ELIZABETH",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1184360026,"PERROTTI, ERIN, ELIZABETH",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184360026,"PERROTTI, ERIN, ELIZABETH",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 72 , 87 ,$#,,
MEDICAID DIRECT,1700921988,EDWARD F SCAMMON DMD PA,~,8159 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184363905,"DAMEWORTH, TAYLOR, WILLIAM",8159 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 63 , 65 , 208 ," $10,206.25 ",,
MEDICAID DIRECT,1598085227,EDWARD F SCAMMON DMD PA,EDWARD F SCAMMON DMD PA,327 TEAL DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1184363905,"DAMEWORTH, TAYLOR, WILLIAM",327 TEAL DR   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 37 , 128 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184364507,"NETTLES, ASHLEY, STANBACK",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184364531,QNC HOME CARE SERVICES LLC,~,429 PERSON ST STE 6 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1184364531,QNC HOME CARE SERVICES LLC,429 PERSON ST STE 6 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 241 , 241 ," $18,660.73 ",,
MEDICAID DIRECT,1184366106,SPRING ARBOR GREENSBORO NC TENANT L,SPRING ARBOR OF GREENSBORO,5125 MICHAUX RD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184366106,SPRING ARBOR GREENSBORO NC TENANT L,5125 MICHAUX RD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 607 , 607 ," $37,983.08 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184366312,"HAMILTON, CLAIRE, CECILE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184368730,"SOLOMON, CARLENE, MARIE",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 16 , 26 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,8180 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184368730,"SOLOMON, CARLENE, MARIE",8180 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205893435,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184368730,"SOLOMON, CARLENE, MARIE",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205893435,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184368730,"SOLOMON, CARLENE, MARIE",9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184368730,"SOLOMON, CARLENE, MARIE",9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184369373,"MERCADANTE, MICHAEL, LAWRENCE",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184369373,"MERCADANTE, MICHAEL, LAWRENCE",150 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184369761,SOUNDSIDE ORTHOTICS & PROSTHETICS L,EVERGREEN PROSTHETICS & ORTHOTICS,2501 WAYNE MEMORIAL DR STE A GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184369761,SOUNDSIDE ORTHOTICS & PROSTHETICS L,2501 WAYNE MEMORIAL DR STE A GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 25 ,$#,,
MEDICAID DIRECT,1184369761,SOUNDSIDE ORTHOTICS & PROSTHETICS L,EVERGREEN PROSTHETICS & ORTHOTICS,1104 GRACIE PL   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184369761,SOUNDSIDE ORTHOTICS & PROSTHETICS L,1104 GRACIE PL   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184370892,"JAMES, BRITTANY, MILES",1188 YADKINVILLE RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 25 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184370892,"JAMES, BRITTANY, MILES",312 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184371783,"HATZISAVVAS, MICHAEL, JAMES",1638 OWEN DR CAPE FEAR VALLEY MEDICAL CENTER FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184371783,"HATZISAVVAS, MICHAEL, JAMES",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1184371783,"HATZISAVVAS, MICHAEL, JAMES",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1184371783,"HATZISAVVAS, MICHAEL, JAMES",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184371783,"HATZISAVVAS, MICHAEL, JAMES",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1184371783,"HATZISAVVAS, MICHAEL, JAMES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184371783,"HATZISAVVAS, MICHAEL, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 36 , 44 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184372898,"DREVENAK, MARISA, ALANA",3800 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184372898,"DREVENAK, MARISA, ALANA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184373177,"PURANAM, MEGHA, SAGAR",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 21 , 70 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184373177,"PURANAM, MEGHA, SAGAR",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184373177,"PURANAM, MEGHA, SAGAR",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184373177,"PURANAM, MEGHA, SAGAR",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184373177,"PURANAM, MEGHA, SAGAR",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 900 ," 1,248 "," 3,851 "," $219,685.67 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 847 , 848 ," $26,914.63 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184381659,"JETER, LATIFAH, QUANAH",,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1184381659,"JETER, LATIFAH, QUANAH",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 34 , 34 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",4801 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 185 , 185 ," $11,724.38 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",300 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184381659,"JETER, LATIFAH, QUANAH",279 BRIAN CENTER DR   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184382830,"PATTON, LISA, MICHELLE",24 2ND AVE NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 19 , 34 ,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184382830,"PATTON, LISA, MICHELLE",1000 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 24 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1184385296,"SPIVEY, ALEXANDRA, MARIE",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1184385296,"SPIVEY, ALEXANDRA, MARIE",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184385296,"SPIVEY, ALEXANDRA, MARIE",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 45 , 84 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD # 140 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1184385296,"SPIVEY, ALEXANDRA, MARIE",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184385296,"SPIVEY, ALEXANDRA, MARIE",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184388753,"LEAKE, ALEXIS, MICHELLE",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13845 CONLAN CIR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184388753,"LEAKE, ALEXIS, MICHELLE",13845 CONLAN CIR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1184392839,"MOORE, MEGAN, NIEMYER",135 PAGE RD N   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 89 , 162 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1184392839,"MOORE, MEGAN, NIEMYER",135 PAGE RD N   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 36 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1184392839,"MOORE, MEGAN, NIEMYER",921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184395444,"THAMES, KIMBERLY, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184395444,"THAMES, KIMBERLY, ANN",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184395444,"THAMES, KIMBERLY, ANN",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184395444,"THAMES, KIMBERLY, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184400954,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC AUDIOLOGY SERVICES,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184400954,UNIVERSITY OF NC HOSPITALS AT CHAPE,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 58 , 68 , 129 ,$#,,
MEDICAID DIRECT,1184401127,SILA SENIOR CARE LLC,SILA SENIOR CARE,313 WALNUT ST STE 103 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1184401127,SILA SENIOR CARE LLC,313 WALNUT ST STE 103 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#, 103 , 103 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184401648,"NELSON, NERISSA, CHERMAINE",5031 BEGONIA DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 141 , 722 , 740 ," $25,102.39 ",,
MEDICAID DIRECT,1184401648,"NELSON, NERISSA, CHERMAINE",FINESSE BEAUTY AND WELLNESS CENTER PLLC,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1184401648,"NELSON, NERISSA, CHERMAINE",5031 BEGONIA DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184401648,"NELSON, NERISSA, CHERMAINE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 296 , 330 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184402786,"BAKER, LAUREN, FAYE",1 HOSPITAL DR STE 4200   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184402786,"BAKER, LAUREN, FAYE",1 HOSPITAL DR STE 4200   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 ,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184431603,"ZIEGLER, OLIVIA, ROSE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1184432023,"BULLARD, HANNA, ELIZABETH",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 51 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184442634,"CHILTON, AMANDA, CREED",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184442634,"CHILTON, AMANDA, CREED",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184457764,HEALTHCARE RIDE SOLUTIONS,SURGE NON-EMERGENCY MEDICAL TRANSPORT,2017 N. CENTER ST. SUITE C HICKORY NC,018,Catawba,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1184457764,HEALTHCARE RIDE SOLUTIONS,2017 N. CENTER ST. SUITE C HICKORY NC,018,Catawba,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 194 ," 2,735 "," 2,862 "," $447,612.00 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184469033,"KEITH, KAYLA, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184469033,"KEITH, KAYLA, NICOLE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184469033,"KEITH, KAYLA, NICOLE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184469728,"BROWN, VICTORIA, KATHERINE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184471765,"DUNIGAN, KORI, SIMMONS",612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184474306,"ETZWEILER, CARLEY, ERIN",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 22 , 44 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184474306,"ETZWEILER, CARLEY, ERIN",3940 ARROWHEAD BLVD STE 270 MEBANE NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184474306,"ETZWEILER, CARLEY, ERIN",530 W WEBB AVE   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 14 , 15 , 44 ,$#,,
MEDICAID DIRECT,1184479164,THE 4C COMPANY OF NC,4C INTEGRATED HEALTH,238 CHURCH ST NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1184479164,THE 4C COMPANY OF NC,238 CHURCH ST NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1184482150,SIMPLICITY THERAPY SOLUTIONS PLLC,SIMPLICITY SPEECH THERAPY,8761 DILLARD RD   SCALY MOUNTAIN NC,056,Macon,193400000X,Group,Single Specialty,,1184482150,SIMPLICITY THERAPY SOLUTIONS PLLC,8761 DILLARD RD   SCALY MOUNTAIN NC,056,Macon,193400000X,Group,Single Specialty,, 37 , 197 , 202 ," $15,792.78 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184491425,"EVANS, ALEXANDRA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184491425,"EVANS, ALEXANDRA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1184491698,"HYMAN, TAHIRA, ABIOLA",120 HEALTHPLEX WAY   APEX NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184491698,"HYMAN, TAHIRA, ABIOLA",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184284754,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT VIEWMONT ELEMENTARY,21 16TH AVE NW   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184493132,"CHARLES, JANICE, OLIVIA",1112 SKYWAY DR   MONROE NC,090,Union,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1184494130,"FRANKENFIELD, DREW, MARIE",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184494296,"RICE, MARGRETTE, B",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 20 , 31 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184494296,"RICE, MARGRETTE, B",1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184494296,"RICE, MARGRETTE, B",1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184495822,ALBEMARLE MEDICAL TRANSPORT INC,ALBEMARLE MEDICAL TRANSPORT,417 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,3416L0300X,Transportation Services,Ambulance,Land Transport,1184495822,ALBEMARLE MEDICAL TRANSPORT INC,417 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,3416L0300X,Transportation Services,Ambulance,Land Transport, 44 , 190 , 364 ," $17,372.52 ",,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184496002,"LEHNER, ERIN, CASEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184600264,"CARESS, JAMES, BAYARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184600264,"CARESS, JAMES, BAYARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology, 37 , 62 , 68 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184600538,"KIM, YOONAH",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184600587,"LACKEY, JEFFREY, SCOTT",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184601536,"ROUTH, JONATHAN, CHARLES",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184601536,"ROUTH, JONATHAN, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 38 , 52 , 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184601536,"ROUTH, JONATHAN, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184601536,"ROUTH, JONATHAN, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184601536,"ROUTH, JONATHAN, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184601536,"ROUTH, JONATHAN, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1184602518,PRENTKE ROMICH COMPANY,PRC-SALTILLO,1022 HEYL RD   WOOSTER OH,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184602518,PRENTKE ROMICH COMPANY,1022 HEYL RD   WOOSTER OH,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 65 , 75 , 120 ," $406,810.10 ",,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1184602955,"TRATE, TUONG, CATE NGUYEN",232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 24 , 54 ,$#,,
MEDICAID DIRECT,1538128194,ASHEVILLE CHILDRENS MEDICALCENT,ASHEVILLE CHILDRENS MEDICAL CENTER PA,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184603409,"FOGLEMAN, BRIGETTE, DIANE",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 76 , 112 , 212 ," $12,236.71 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184603573,"GIBSON, WILLIAM, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 42 , 42 , 51 ,$#,,
MEDICAID DIRECT,1770858938,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1 TRADE ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1184603896,"KERR, KIRSTEN, SUZANNE",1 TRADE ST   GRANITE FALLS NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 136 , 213 ,$#,,
MEDICAID DIRECT,1184603938,"SHELOR, PAUL, DAVID",PAUL D SHELOR DDS PA,1401 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1184603938,"SHELOR, PAUL, DAVID",1401 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 286 , 474 ," 2,229 "," $161,194.80 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184604159,"BARNHARDT, CYNTHIA, WHITLEY",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 43 , 129 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1184604670,"MARTIN JR, CLYDE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184605420,"SMITH, ANTHONY, CROZART",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1558351726,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE PIEDMONT,1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184606147,"HARTMAN, JOEL, MICHAEL",1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 118 , 361 , 508 ," $12,263.60 ",,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,3636 HIGH ST   PORTSMOUTH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184608283,"DAVIS, KIRSTIN, FIONA",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184608283,"DAVIS, KIRSTIN, FIONA",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,193200000X,Group,Multi-Specialty,,1184608556,"CARUSO, FRANK",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184608556,"CARUSO, FRANK",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 101 , 138 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184608572,"POMPER, GREGORY, JAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1740562875,ONSLOW AMBULATORY SERVICES INC,ONSLOW EAR NOSE & THROAT,55 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1184610446,"YENCHA, MYRON, WILLIAM",55 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 64 , 98 , 136 ,$#,,
MEDICAID DIRECT,1699008144,PEMBROKE CENTER FOR WELLNESS INC,Pembroke Center for Wellness,773 OLD MAIN RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1184611139,"LOWERY LYNCH, ELLA, OLEHONNA",773 OLD MAIN RD   PEMBROKE NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1104384031,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CHRISTOPHERSON FAMILY M,319 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184611485,"CHRISTOPHERSON, DAVID, LEE",319 PENNY LN   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 158 , 221 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 27 , 35 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 17 , 22 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 43 , 55 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184611618,"FAIRBROTHER, SCOTT, NIELD",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184613135,"OH, EUGENE",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 29 , 35 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184613135,"OH, EUGENE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184613135,"OH, EUGENE",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 40 , 52 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184613135,"OH, EUGENE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1245335066,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RAEFORD,313 TEAL DR OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1184615817,"KIRBY, STEPHANIE, LYNN",313 TEAL DR   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184616435,"HILLSGROVE, DAVID, CURTIS",124 WELTON WAY   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 72 , 147 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184616435,"HILLSGROVE, DAVID, CURTIS",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275524621,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184617391,"PARMER, MICHAEL, DANIEL",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881169514,MACK PEDIATRICS PLLC,MACK PEDIATRICS,3721 LYNN RD STE 104 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184618019,"MACK, EMILI, RACHELE",3721 LYNN RD STE 104 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184618282,"TAYLOR, LORI, MCCAIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184618282,"TAYLOR, LORI, MCCAIN",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 27 , 82 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184618282,"TAYLOR, LORI, MCCAIN",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 24 ,$#,,
MEDICAID DIRECT,1336154129,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE ELLERBE,112 E BALLARD ST   ELLERBE NC,077,Richmond,193400000X,Group,Single Specialty,,1184619355,"KOPYNEC, BOHDAN, WILLIAM",1001 MONROE ST STE D CARTHAGE NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 44 , 101 ,$#,,
MEDICAID DIRECT,1861838039,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE BISCOE,104 PROFESSIONAL DR   BISCOE NC,062,Montgomery,193400000X,Group,Single Specialty,,1184619355,"KOPYNEC, BOHDAN, WILLIAM",104 PROFESSIONAL DR   BISCOE NC,062,Montgomery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336154129,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE ELLERBE,112 E BALLARD ST   ELLERBE NC,077,Richmond,193400000X,Group,Single Specialty,,1184619355,"KOPYNEC, BOHDAN, WILLIAM",112 E BALLARD ST   ELLERBE NC,077,Richmond,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 80 , 203 , 522 ,$#,,
MEDICAID DIRECT,1679568992,GASTONIA PEDIATRIC ASSOCIATES PA,GASTONIA PEDIATRIC ASSOCIATES PA,1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184619959,"GROSSMAN, SARAH, RONA",1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 67 , 167 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184620205,"MCGOVERN, JAMES, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 60 , 77 , 156 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184620205,"MCGOVERN, JAMES, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 24 , 68 , 120 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184620205,"MCGOVERN, JAMES, JOSEPH",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 69 , 105 , 172 ,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184621112,"JOHN, DEJIE",680 OYSTER POINT RD   NEWPORT NEWS VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184621534,"DUNCAN-BUTLER, SUSAN, OLIVE",3614 PROVIDENCE RD S STE 101 WAXHAW NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 50 , 111 ,$#,,
MEDICAID DIRECT,1770091290,EVERGREEN HEALTH CARE,EVERGREEN HEALTH CARE PLLC,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1184621534,"DUNCAN-BUTLER, SUSAN, OLIVE",3614 PROVIDENCE RD S STE 101 WAXHAW NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 148 , 148 ," $94,198.00 ",,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184622052,"CARROLL, RAYMOND, MCKAY",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184622052,"CARROLL, RAYMOND, MCKAY",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1184622052,"CARROLL, RAYMOND, MCKAY",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184622052,"CARROLL, RAYMOND, MCKAY",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 16 , 19 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1184622052,"CARROLL, RAYMOND, MCKAY",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1548242365,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,3361 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184622607,"WIELAND, RUTH, MARIE",3361 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 35 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184623415,"WATKINS, MACKENZIE, DAY",2001 TODAYS WOMAN AVE   WINSTON SALEM NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184623415,"WATKINS, MACKENZIE, DAY",2001 TODAYS WOMAN AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 33 , 74 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184623415,"WATKINS, MACKENZIE, DAY",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184625188,"PASPA, PHILIP, ALEXANDER",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184625188,"PASPA, PHILIP, ALEXANDER",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 256 , 548 , 779 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1184625188,"PASPA, PHILIP, ALEXANDER",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 43 , 63 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184625303,"EPPS, SEAN, MICHAEL",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 66 , 100 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1184625303,"EPPS, SEAN, MICHAEL",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184625303,"EPPS, SEAN, MICHAEL",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 158 , 427 , 824 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184625519,"WEIDA, CAROL, JEAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 144 , 175 , 320 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184625519,"WEIDA, CAROL, JEAN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184626178,"FICKLIN, KENT, CLIFFORD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043752363,SWAIN INTEGRATED SERVICES PC,,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1184626715,"YOUNGBLOOD, JULIE, ANN",45 PLATEAU ST   BRYSON CITY NC,087,Swain,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 60 , 64 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184626806,"STAFFORD, KELLY, LEIGH",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 40 , 84 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184626939,"HANRAHAN, PHILIP, ANTHONY",15825 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 25 , 46 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184626939,"HANRAHAN, PHILIP, ANTHONY",15825 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 37 , 88 ,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184628745,"KLEIN, PATRICIA, MILLS",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 34 ,$#,,
MEDICAID DIRECT,1144317470,BOICE WILLIS CLINIC PA,~,901 N WINSTEAD AVE STE 310 ROCKY MOUNT NC,064,Nash,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1184628844,"ANDERSON, MARK, WENDELL",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184628844,"ANDERSON, MARK, WENDELL",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 107 , 133 , 153 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184628844,"ANDERSON, MARK, WENDELL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 35 , 40 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184628851,"SHULTZABERGER, RICHARD, ZANE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 69 , 119 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184629065,"HALL, GREGORY, GRAYSON",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1184629065,"HALL, GREGORY, GRAYSON",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184629065,"HALL, GREGORY, GRAYSON",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1184629222,WENSLEY ORTHO LABS INC,~,1531 WESTBROOK PLAZA DR STE K WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184629222,WENSLEY ORTHO LABS INC,1531 WESTBROOK PLAZA DR STE K WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 11 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184630972,"BURBRIDGE, REBECCA, ANN",40 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184630972,"BURBRIDGE, REBECCA, ANN",40 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 59 , 65 , 94 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184630972,"BURBRIDGE, REBECCA, ANN",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184630972,"BURBRIDGE, REBECCA, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184630972,"BURBRIDGE, REBECCA, ANN",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184631335,"BRENNER, MARK, EARL",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 172 , 345 , 593 ," $11,542.07 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184631533,"PATEL, SANDEEP, BHIKHU",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 48 , 49 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184631533,"PATEL, SANDEEP, BHIKHU",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184631533,"PATEL, SANDEEP, BHIKHU",620 HEATHWOOD DR   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 56 , 61 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184631533,"PATEL, SANDEEP, BHIKHU",518 OLD US 221 HWY   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184632093,COASTAL EYE CLINIC PA,COASTAL EYE CLINIC PA,3504 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1184632093,COASTAL EYE CLINIC PA,3504 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 19 , 19 , 41 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1184634628,"PHILLIPS, WILLIAM, EUGENE",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 64 , 71 , 87 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 32 , 32 , 36 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD FL 4 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 120 , 128 , 140 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 1300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 52 , 55 , 55 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD FL 4 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 164 , 250 , 265 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184636532,"KOWALCHUK, GLEN, JOHN",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184636789,"ASHLEY, TIMOTHY, ANDREWS",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 49 , 102 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184638983,"KIM, CONNIE, EUNJUNG",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184638983,"KIM, CONNIE, EUNJUNG",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184638983,"KIM, CONNIE, EUNJUNG",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1184640096,"VELIZ, ARMANDO, ERICH",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1184640096,"VELIZ, ARMANDO, ERICH",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255672473,PRIVATE DIAGNOSTIC CLINIC PLLC,KERNODLE CLINIC - WEST,,,Unknown,193200000X,Group,Multi-Specialty,,1184641169,"PARASCHOS, ALEXANDER, THOMAS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184641169,"PARASCHOS, ALEXANDER, THOMAS",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184641169,"PARASCHOS, ALEXANDER, THOMAS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184641169,"PARASCHOS, ALEXANDER, THOMAS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 63 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184641169,"PARASCHOS, ALEXANDER, THOMAS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 88 , 167 , 277 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184641169,"PARASCHOS, ALEXANDER, THOMAS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 55 , 63 ,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184641524,ALAMANCE EYE CARE PA,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,, 404 , 417 , 794 ," $10,152.85 ",,
MEDICAID DIRECT,1184641813,BATTLEGROUND EYE CARE,BATTLEGROUND EYE CARE,3132 BATTLEGROUND AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184641813,BATTLEGROUND EYE CARE,3132 BATTLEGROUND AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,, 17 , 17 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184642233,"HEATH, JOHN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 47 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184642233,"HEATH, JOHN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184642233,"HEATH, JOHN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184642233,"HEATH, JOHN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184642415,"PREVETTE, ELIZABETH, RENEE",6324 FAIRVIEW RD STE 310 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184642415,"PREVETTE, ELIZABETH, RENEE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1184643454,"MITCHELL, KAMARI, DEMOND",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1184643454,"MITCHELL, KAMARI, DEMOND",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184643454,"MITCHELL, KAMARI, DEMOND",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 29 , 29 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184643454,"MITCHELL, KAMARI, DEMOND",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184643454,"MITCHELL, KAMARI, DEMOND",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 127 , 127 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184643454,"MITCHELL, KAMARI, DEMOND",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184645277,"PUHR, JOSHUA, STEPHEN",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184645277,"PUHR, JOSHUA, STEPHEN",2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1184648669,"RIDEAU, ALECIA, MARIAN",412 RED ROBIN TRL   LAFAYETTE LA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184649089,"FOSTER, MICHELLE, LYNETTE",1995 WELLNESS BLVD STE 110 MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 134 , 285 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184649089,"FOSTER, MICHELLE, LYNETTE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467790055,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVI,200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184649261,"TAYLOR, GERALD, BERNARD",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184650277,"TALERICO, PAUL, JOSEPH",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184650277,"TALERICO, PAUL, JOSEPH",11618 US HWY 70 W STE 106 CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184650277,"TALERICO, PAUL, JOSEPH",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 15 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184650277,"TALERICO, PAUL, JOSEPH",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 26 , 40 ,$#,,
MEDICAID DIRECT,1508182312,DR A KHARA DMD PA,~,1830 GARNER STATION BLVD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184650335,"KHARA, AMARDEEP",1830 GARNER STATION BLVD   RALEIGH NC,092,Wake,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1508182312,DR A KHARA DMD PA,~,1830 GARNER STATION BLVD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184650335,"KHARA, AMARDEEP",1830 GARNER STATION BLVD   RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 3,612 "," 15,022 "," 17,979 "," $2,458,614.33 ",,
MEDICAID DIRECT,1508182312,DR A KHARA DMD PA,~,4181 DAVIS DRIVE   MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1184650335,"KHARA, AMARDEEP",1830 GARNER STATION BLVD   RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 19 , 20 ,$#,,
MEDICAID DIRECT,1508182312,DR A KHARA DMD PA,~,4181 DAVIS DRIVE   MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1184650335,"KHARA, AMARDEEP",4181 DAVIS DR   MORRISVILLE NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 91 , 247 , 323 ," $43,134.81 ",,
MEDICAID DIRECT,1184650335,"KHARA, AMARDEEP",~,4181 DAVIS DR   MORRISVILLE NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1184650335,"KHARA, AMARDEEP",1830 GARNER STATION BLVD   RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1508182312,DR A KHARA DMD PA,~,1830 GARNER STATION BLVD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184650335,"KHARA, AMARDEEP",4181 DAVIS DR   MORRISVILLE NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 33 , 36 , 64 ,$#,,
MEDICAID DIRECT,1184650707,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1200 RIDGEFIELD BLVD STE 110 ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,1184650707,BAYADA HOME HEALTH CARE INC,1200 RIDGEFIELD BLVD STE 110 ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,#, 94 , 94 ," $50,786.40 ",,
MEDICAID DIRECT,1184650707,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1200 RIDGEFIELD BLVD STE 110 ASHEVILLE NC,011,Buncombe,251J00000X,Agencies,Nursing Care,,1184650707,BAYADA HOME HEALTH CARE INC,1200 RIDGEFIELD BLVD STE 110 ASHEVILLE NC,011,Buncombe,251J00000X,Agencies,Nursing Care,, 23 ," 3,198 "," 3,853 "," $1,802,009.77 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184650798,"THOHAN, VINAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 41 , 46 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184650798,"THOHAN, VINAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 101 , 142 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184651200,"WILLIAMS, ROBERT, EARL",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 80 , 141 , 153 ," $11,792.73 ",,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184651200,"WILLIAMS, ROBERT, EARL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 18 , 22 , 22 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184651200,"WILLIAMS, ROBERT, EARL",510 CAROLINA BAY DR   WILMINGTON NC,065,New Hanover,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184651200,"WILLIAMS, ROBERT, EARL",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184651226,"SWARTS, NATHANIEL, STEPHEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184652687,"ITO, KRISTIN, ELIZABETH",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 277 , 378 , 703 ," $16,176.84 ",,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184652950,"FRAZER, CHAD, ALLEN",10 AVIEMORE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184652950,"FRAZER, CHAD, ALLEN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 77 , 116 , 274 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1184653610,"PACK, KAREN, BOULANGER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184653610,"PACK, KAREN, BOULANGER",401 N MAIN ST   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1184653610,"PACK, KAREN, BOULANGER",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1184653610,"PACK, KAREN, BOULANGER",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1184653610,"PACK, KAREN, BOULANGER",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1184653610,"PACK, KAREN, BOULANGER",1106 SUNSET AVE   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205865987,UNIVERSAL MEDICAL ASSOCIATES,UNIVERSAL FAMILY HEALTH AND URGENT CARE,,,Unknown,193400000X,Group,Single Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",3396 SIX FORKS RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285722215,MED FAST PC,~,605 W CUMBERLAND ST   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",100 S 10TH ST   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 115 , 255 , 531 ,$#,,
MEDICAID DIRECT,1205865979,EDGEWATER MEDICAL CENTER AND URGENT,EDGEWATER MEDICAL CENTER AND URGENT CARE,,,Unknown,193400000X,Group,Single Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",100 S 10TH ST   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 71 , 67 , 108 ,$#,,
MEDICAID DIRECT,1285722215,MED FAST PC,~,605 W CUMBERLAND ST   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",605 W CUMBERLAND ST   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",100 S 10TH ST   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 111 , 291 , 716 ,$#,,
MEDICAID DIRECT,1285722215,MED FAST PC,~,602 S WALL ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",605 W CUMBERLAND ST   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1285722215,MED FAST PC,~,602 S WALL ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",100 S 10TH ST   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629007398,HEALTH ZONE PLLC,HEALTH ZONE PLLC,707 LASSITER ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184653834,"REYES, RODOLFO, CONSTANTINO",707 LASSITER ST   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 81 , 36 , 54 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184655391,"SENSECQUA, JAMES, ERNEST",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184655391,"SENSECQUA, JAMES, ERNEST",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184655391,"SENSECQUA, JAMES, ERNEST",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1184658254,GRAHAM COUNTY SCHOOLS,~,52 MOOSE BRANCH RD   ROBBINSVILLE NC,038,Graham,251300000X,Agencies,Local Education Agency (LEA),,1184658254,GRAHAM COUNTY SCHOOLS,52 MOOSE BRANCH RD   ROBBINSVILLE NC,038,Graham,251300000X,Agencies,Local Education Agency (LEA),, 87 , 691 , 701 ," $30,379.33 ",,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1184658544,"LAMB, RYAN, PHILIP",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 21 , 27 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1184658544,"LAMB, RYAN, PHILIP",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184658544,"LAMB, RYAN, PHILIP",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 64 , 63 , 90 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184658544,"LAMB, RYAN, PHILIP",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1184661050,LENOIR MEMORIAL HOSPITAL INC,DOWN EAST MEDICAL SUPPLY,2903 N HERRITAGE ST   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184661050,LENOIR MEMORIAL HOSPITAL INC,2903 N HERRITAGE ST   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 976 ," 4,939 "," 9,046 "," $482,507.38 ",,
MEDICAID DIRECT,1184661050,LENOIR MEMORIAL HOSPITAL INC,DOWN EAST MEDICAL SUPPLY,2903 N HERRITAGE ST   KINSTON NC,054,Lenoir,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1184661050,LENOIR MEMORIAL HOSPITAL INC,2903 N HERRITAGE ST   KINSTON NC,054,Lenoir,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 134 , 658 , 658 ," $62,266.40 ",,
MEDICAID DIRECT,1992286009,FHPG LLC,FIRSTHEALTH CARDIO PULMONARY REHAB,2925 BEECHTREE DR STE 143 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1184661258,"SIMPKINS, DARRELL, GORDON",2925 BEECHTREE DR STE 143 SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184661456,"CRIGLER JR, NORRIS, WOLF",310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184661456,"CRIGLER JR, NORRIS, WOLF",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 82 , 85 , 91 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184661456,"CRIGLER JR, NORRIS, WOLF",310 LONG SHOALS RD STE 203 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 ,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184661456,"CRIGLER JR, NORRIS, WOLF",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 39 , 42 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184661456,"CRIGLER JR, NORRIS, WOLF",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184662090,HARKERS ISLAND FIRE & RESCUE DEPART,HARKERS ISLAND FIRE & RESCUE DEPARTMENT INC,1219 ISLAND RD   HARKERS ISLAND NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1184662090,HARKERS ISLAND FIRE & RESCUE DEPART,1219 ISLAND RD   HARKERS ISLAND NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#, 20 ,$#,,
MEDICAID DIRECT,1184662751,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,3900 WESTPOINT BLVD STE A WINSTON SALEM NC,034,Forsyth,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1184662751,LINCARE INC,3900 WESTPOINT BLVD STE A WINSTON SALEM NC,034,Forsyth,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 300 ," 1,449 "," 2,608 "," $67,635.58 ",,
MEDICAID DIRECT,1184662751,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,3900 WESTPOINT BLVD STE A WINSTON SALEM NC,034,Forsyth,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1184662751,LINCARE INC,3900 WESTPOINT BLVD STE A WINSTON SALEM NC,034,Forsyth,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 70 , 220 , 367 ," $85,495.20 ",,
MEDICAID DIRECT,1184662751,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,3900 WESTPOINT BLVD STE A WINSTON SALEM NC,034,Forsyth,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1184662751,LINCARE INC,3900 WESTPOINT BLVD STE A WINSTON SALEM NC,034,Forsyth,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 20 , 33 , 52 ,$#,,
MEDICAID DIRECT,1609822287,EASTERN CAROLINA MEDICAL CENTER PC,EASTERN CAROLINA MEDICAL CENTER PC,1 MEDICAL DR   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1184663734,"REDDY, VISWANATHA, KURUKUNDHA",1 MEDICAL DR   BENSON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 295 ," 1,300 "," 7,232 "," $49,601.16 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184663841,"WORLEY, DANA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184663866,"CARTER, ERIC, JASON",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 33 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184663866,"CARTER, ERIC, JASON",1333 S DICKINSON DR UNIT 240 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 30 , 55 ,$#,,
MEDICAID DIRECT,1336148279,INNOVATIVE PHYSICAL THERAPY,~,503 CANVASBACK RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184667321,"DZIKOWSKI, SHIRLEY, JANE",503 CANVASBACK RD   MOORESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 108 , 108 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184667453,"CATTAMANCHI, ASHOK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 45 , 124 , 132 ," $16,238.15 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184668865,"KLAUSNER, MARI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 54 , 90 , 90 ," $10,574.64 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184668865,"KLAUSNER, MARI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 52 , 105 , 107 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184668865,"KLAUSNER, MARI",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184669715,"YAKEL, DEMIAN, MATTHEW",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184669715,"YAKEL, DEMIAN, MATTHEW",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184669715,"YAKEL, DEMIAN, MATTHEW",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 23 , 34 ,$#,,
MEDICAID DIRECT,1730325473,APEX VISION CENTER OD PA,CLARITY VISION OF APEX,1049 BEAVER CREEK COMMONS DR CLARITY VISION APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1184672859,"HOLLER, DAVID, JAMES",1049 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184673014,"PURVIS, DORIS, CARRIZALES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 58 , 58 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184673014,"PURVIS, DORIS, CARRIZALES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1184673378,QUADRANGLE ENDOSCOPY CENTER,QUADRANGLE ENDOSCOPY CENTER,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1184673378,QUADRANGLE ENDOSCOPY CENTER,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 66 , 73 , 86 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1184674707,"RICHARDSON, BERTHA, PARTHENIA",201 E GROVER ST   SHELBY NC,023,Cleveland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184675423,"KLINKNER, MICHAEL, WAYNE",601 OBERLIN RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184675423,"KLINKNER, MICHAEL, WAYNE",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184675423,"KLINKNER, MICHAEL, WAYNE",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1184675423,"KLINKNER, MICHAEL, WAYNE",212 ASHVILLE AVE   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184675597,"WAHLEN, JOHN, EDWARD",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 612 , 748 , 893 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184675977,"MELENDEZ, KAREN, LYNN",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 13 , 31 , 32 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184675977,"MELENDEZ, KAREN, LYNN",2525 COURT DR   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184675977,"MELENDEZ, KAREN, LYNN",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184675977,"MELENDEZ, KAREN, LYNN",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184675977,"MELENDEZ, KAREN, LYNN",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1184675977,"MELENDEZ, KAREN, LYNN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1306880224,CAROLINA ORTHOPAEDIC SPECIALIST,CAROLINA ORTHOPAEDIC SPECIALIST,,,Unknown,193400000X,Group,Single Specialty,,1184676272,"DERIENZIS, JOHN, JOSEPH",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184676272,"DERIENZIS, JOHN, JOSEPH",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 30 , 73 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184677395,"POWELL, DEBRA, DIANE",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 57 , 113 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184677668,"NAUMANN, JANICE, STELLJES",2711 RANDOLPH RD STE 512 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 33 , 54 ,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184678005,"COLADONATO, MICHAEL, JOSEPH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184678005,"COLADONATO, MICHAEL, JOSEPH",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,1542 CANE CREEK RD   FLETCHER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184678005,"COLADONATO, MICHAEL, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184678005,"COLADONATO, MICHAEL, JOSEPH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 38 , 80 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184679441,"ARD, JAMY, DARONE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 24 , 24 ,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1184680522,"DAVE, NAILESH, DILIPKUMAR",350 PINE STATE ST   LILLINGTON NC,043,Harnett,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 325 , 662 ," 1,216 "," $20,251.50 ",,
MEDICAID DIRECT,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,DRS JOHNSON & JOHNSON EYEWORKS,304 E MAIN ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184682312,"JOHNSON, MILLIE",304 E MAIN ST   BENSON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 42 , 64 ,$#,,
MEDICAID DIRECT,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,DRS JOHNSON & JOHNSON EYEWORKS,2800 N ELM ST STE 1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1184682312,"JOHNSON, MILLIE",2800 N ELM ST   LUMBERTON NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 18 , 36 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184682841,"JOHNSON, CHRISTOPHER, MCLAURIN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184682841,"JOHNSON, CHRISTOPHER, MCLAURIN",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 68 , 104 , 208 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 32 , 63 ,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1184683062,"PIELOW KROL, ALICIA, MARIE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683294,"BEWLEY, CHRISTOPHER, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184683294,"BEWLEY, CHRISTOPHER, SCOTT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184683294,"BEWLEY, CHRISTOPHER, SCOTT",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184683294,"BEWLEY, CHRISTOPHER, SCOTT",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184683294,"BEWLEY, CHRISTOPHER, SCOTT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184683294,"BEWLEY, CHRISTOPHER, SCOTT",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184684151,"CARROLL, BRIAN, HURD",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 98 , 179 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184684474,"MATTHEWS, REBECCA, RUTH HAMPTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184684474,"MATTHEWS, REBECCA, RUTH HAMPTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 39 , 41 , 41 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184685687,"SHELTON, BURTON, OTIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184685687,"SHELTON, BURTON, OTIS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184685687,"SHELTON, BURTON, OTIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 49 , 49 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184685778,"STARK, GREGORY, JAY",101 CLINIC DR   TARBORO NC,033,Edgecombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 53 , 113 ,$#,,
MEDICAID DIRECT,1790115533,MOSES CONE AFFILIATED PHYSICIANS IN,CROSSROADS PSYCHIATRIC GROUP,445 DOLLEY MADISON RD STE 410 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184685927,"HURST, TERESA, THOMPSON",445 DOLLEY MADISON RD STE 410 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184686008,"BOHMER, JAMES, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184686008,"BOHMER, JAMES, THOMAS",6324 FAIRVIEW RD STE 440 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184686008,"BOHMER, JAMES, THOMAS",2610 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1578987848,UNC PHYSICIANS NETWORK LLC,~,7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184686826,"KIRSCH, SUSAN, SUGARMAN",7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1184686933,"SUCHECKI, BRYAN, THOMAS",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184686933,"SUCHECKI, BRYAN, THOMAS",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 67 , 71 , 101 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 40 , 37 , 44 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 65 , 71 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 29 , 32 ," $13,645.80 ",,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 24 , 32 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184687444,"TEMPLE, RICHARD, WILSON",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184687659,"JARMAN, WAYNE, THOMAS",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1184687659,"JARMAN, WAYNE, THOMAS",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1184687659,"JARMAN, WAYNE, THOMAS",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184689382,"MCALLISTER, JOHN, DAVID",310 HARRIS AVE   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184689382,"MCALLISTER, JOHN, DAVID",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1205032984,"KIM, SEUNG, WON",~,8001 CREEDMOOR RD STE 107 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1184690885,"CROSS, HARRY, GILES",285 OLMSTED BLVD STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184690885,"CROSS, HARRY, GILES",285 OLMSTED BLVD STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 156 , 879 ," 1,057 "," $24,575.05 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184691685,"BUCKLEY, MICHAEL, FRANCIS",4414 LAKE BOONE TRL STE 308 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184692428,"LYNCH, RICHARD, ONEAL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1184692428,"LYNCH, RICHARD, ONEAL",1230 US HIGHWAY 70 E STE 1 NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1184692428,"LYNCH, RICHARD, ONEAL",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 34 , 39 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184693160,"ABDO, RAMI, ISKANDAR",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 202 , 202 ,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184694499,"PILATI, DAVID, MICHAEL",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 49 , 49 ,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184694499,"PILATI, DAVID, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184694499,"PILATI, DAVID, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184694499,"PILATI, DAVID, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184694630,"DODD, MARK, ALAN",865 W LAKE DR   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 81 , 118 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184694754,"BLOBE, GERARD, CONRAD",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 23 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184694754,"BLOBE, GERARD, CONRAD",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184694754,"BLOBE, GERARD, CONRAD",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184696247,"HOWE, CRISTIN, PARKER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 36 , 139 , 139 ,$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184696593,"WINKEL, GERHARDT, JULIUS",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 141 , 799 ," 1,019 ",$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184696593,"WINKEL, GERHARDT, JULIUS",615 E 12TH ST   WASHINGTON NC,007,Beaufort,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1164724100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE MINT HILL COMMONS FAMIL,11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184698508,"HARVEY, MARC, CHRISTOPHER",11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 86 , 113 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12016 LEMMOND FARM DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184698508,"HARVEY, MARC, CHRISTOPHER",12016 LEMMOND FARM DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184699621,"BYRD, ERIC, WAYNE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184701377,"KATOPES, CHARLES, PETER",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 23 , 27 , 34 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184701377,"KATOPES, CHARLES, PETER",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 46 , 60 , 73 ,$#,,
MEDICAID DIRECT,1548740038,INDYCARE MEDICAL NORTH CAROLINA,~,110 BOONE SQUARE ST STE 29A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1184703282,"GARVER, DENNIS, WAYNE",1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 14 , 30 ,$#,,
MEDICAID DIRECT,1548740038,INDYCARE MEDICAL NORTH CAROLINA,~,1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184703282,"GARVER, DENNIS, WAYNE",1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 108 , 134 , 218 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184703332,"WADLEY, ROBERT, DALE",1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184703332,"WADLEY, ROBERT, DALE",4214 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 30 , 30 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184703332,"WADLEY, ROBERT, DALE",121 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 232 , 321 , 583 ," $33,616.65 ",,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184703332,"WADLEY, ROBERT, DALE",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 112 , 188 , 188 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184703332,"WADLEY, ROBERT, DALE",1970 W ARLINGTON BLVD STE C GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 83 , 85 ,$#,,
MEDICAID DIRECT,1184703589,QUALITY HOME CARE SERVICES INC,QUALITY HOME CARE SERVICES INC,3552 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1184703589,QUALITY HOME CARE SERVICES INC,3552 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 14 , 67 , 67 ,$#,,
MEDICAID DIRECT,1184703910,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,1969 OLD CHARLOTTE HWY STE FGHJK MONROE NC,090,Union,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1184703910,LINCARE INC,,,Unknown,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 37 , 36 , 37 ,$#,,
MEDICAID DIRECT,1184703910,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,1969 OLD CHARLOTTE HWY STE FGHJK MONROE NC,090,Union,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1184703910,LINCARE INC,1969 OLD CHARLOTTE HWY STE FGHJK MONROE NC,090,Union,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 24 , 44 ,$#,,
MEDICAID DIRECT,1184703910,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,1969 OLD CHARLOTTE HWY STE FGHJK MONROE NC,090,Union,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1184703910,LINCARE INC,1969 OLD CHARLOTTE HWY STE FGHJK MONROE NC,090,Union,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 198 ," 1,650 "," 3,101 "," $77,974.19 ",,
MEDICAID DIRECT,1184705048,AM HEALTH CARE SERVICES INC,TRENT VILLAGE NURSING HOME,8990 HIGHWAY 17 S   POLLOCKSVILLE NC,052,Jones,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184705048,AM HEALTH CARE SERVICES INC,8990 HIGHWAY 17 S   POLLOCKSVILLE NC,052,Jones,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 140 , 140 ," $33,539.10 ",,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184705220,"KARTSIMARIS, EVELINA, GEORGIEVA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1154872315,RDMG ASSOCIATES PA,,10620 PARK RD STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184706806,"CUSTER, DALENA, MAE",10620 PARK RD STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1184706830,"BRUBECK, ELLEN, TEMPLE",~,1140 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1184706830,"BRUBECK, ELLEN, TEMPLE",1140 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 52 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184707325,"BRONNER, LESLIE, LARISSA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184707325,"BRONNER, LESLIE, LARISSA",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184708125,"SUNG, JADE, JYE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 104 , 127 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184708125,"SUNG, JADE, JYE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 82 , 93 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184709008,"SCOTT-HAYES, MARY, CAPERS",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184709008,"SCOTT-HAYES, MARY, CAPERS",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184709370,"REEVES DANIEL, AMBER, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 73 , 151 , 152 ,$#,,
MEDICAID DIRECT,1720151525,COUNTY OF CLEVELAND NORTH CAROLINA,CLEVELAND COUNTY HEALTH DEPARTMENT,200 S POST RD   SHELBY NC,023,Cleveland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1184710154,"LESTER, ROBERT, HILTON",200 S POST RD   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184713141,"CRESSWELL, BROOKE, LEONARD",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184713141,"CRESSWELL, BROOKE, LEONARD",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548276389,FIRSTHEALTH OF THE CAROLINAS INC,~,522 ALLEN ST STE 101 TROY NC,062,Montgomery,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1184713364,"FARRAH, VICTOR, BYRON",522 ALLEN ST STE 101 TROY NC,062,Montgomery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 89 , 89 ,$#,,
MEDICAID DIRECT,1194998781,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCIATES INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184713406,"PAYNE, KERRY, DANIEL",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1922004852,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCS INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184713406,"PAYNE, KERRY, DANIEL",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 132 , 141 , 213 ,$#,,
MEDICAID DIRECT,1184713505,"BRADLEY, JERRY",,512 COKE AVE   EDENTON NC,021,Chowan,1223G0001X,Dental Providers,Dentist,General Practice,1184713505,"BRADLEY, JERRY",512 COKE AVE   EDENTON NC,021,Chowan,1223G0001X,Dental Providers,Dentist,General Practice, 62 , 86 , 251 ," $10,858.49 ",,
MEDICAID DIRECT,1629172812,JERRY BRADLEY DDS ASSOC PLLC,JERRY BRADLEY DDS & ASSOC PLLC,512 COKE AVE   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1184713505,"BRADLEY, JERRY",512 COKE AVE   EDENTON NC,021,Chowan,1223G0001X,Dental Providers,Dentist,General Practice," 1,160 "," 2,583 "," 8,444 "," $395,983.02 ",,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184714495,"HATLEY, GEORGE, WESLEY",301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 116 , 127 ," $13,035.55 ",,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184714495,"HATLEY, GEORGE, WESLEY",301 MEDICAL PARK DR STE 20 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184714941,"JIRANEK, WILLIAM, ARTHUR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 15 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184714941,"JIRANEK, WILLIAM, ARTHUR",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1184714941,"JIRANEK, WILLIAM, ARTHUR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 17 , 29 ,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184715377,"BUCKNER JR, DONALD, THOMAS",1207 EAST ST   WAYNESVILLE NC,044,Haywood,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 17 , 33 , 34 ,$#,,
MEDICAID DIRECT,1245907302,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN MACON,674 HIGHLANDS RD   FRANKLIN NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184715377,"BUCKNER JR, DONALD, THOMAS",674 HIGHLANDS RD   FRANKLIN NC,056,Macon,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184715377,"BUCKNER JR, DONALD, THOMAS",44 BONNIE LN   SYLVA NC,050,Jackson,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 29 , 52 , 53 ,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184715377,"BUCKNER JR, DONALD, THOMAS",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184715377,"BUCKNER JR, DONALD, THOMAS",187 W MAIN ST   SPINDALE NC,081,Rutherford,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1528154473,COASTAL INFECTIOUS DISEASE CONSULTA,COASTAL INFECTIOUS DISEASE CONSULTANTS,2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184717183,"SANDERS, JOHN, WESLEY",2310 DELANEY AVE   WILMINGTON NC,065,New Hanover,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184718199,"LAPPIN, KATHLEEN, MARIE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 25 , 26 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1184718199,"LAPPIN, KATHLEEN, MARIE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184718199,"LAPPIN, KATHLEEN, MARIE",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1184718199,"LAPPIN, KATHLEEN, MARIE",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 45 , 48 ,$#,,
MEDICAID DIRECT,1184718629,"YANG, STEVE, WOO SUK",~,2290 STATESVILLE BLVD   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,1184718629,"YANG, STEVE, WOO SUK",2290 STATESVILLE BLVD   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 125 , 290 ," $12,878.91 ",,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,709 N DEKALB ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1184720815,"VOORHEES, SUSAN, CAROL",709 N DEKALB ST   SHELBY NC,023,Cleveland,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1184722068,REALO DISCOUNT DRUG STORES OF PINK,REALO DISCOUNT DRUG STORES OF PINK HILL INC,107 W BROADWAY ST   PINK HILL NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184722068,REALO DISCOUNT DRUG STORES OF PINK,107 W BROADWAY ST   PINK HILL NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1104329846,PHILLIP J KOHUT DMD PLLC,NORTHCHASE FAMILY DENTISTRY,2709 NORTHCHASE PKWY SE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184722266,"KOHUT, PHILLIP, JOSEPH",2709 NORTHCHASE PKWY SE   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 361 , 605 ," 1,926 "," $93,819.14 ",,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1184723405,"JACOB, SOPNA, ELIZABETH",1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184723959,"ALMEKINDERS, LOUIS, CORNELIS",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184723959,"ALMEKINDERS, LOUIS, CORNELIS",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 17 , 40 ,$#,,
MEDICAID DIRECT,1184726242,GUARDIAN MEDICAL MONITORING LLC,,11312 US 15 501 N   CHAPEL HILL NC,019,Chatham,333300000X,Suppliers,Emergency Response System Companies,,1184726242,GUARDIAN MEDICAL MONITORING LLC,11312 US 15 501 N   CHAPEL HILL NC,019,Chatham,333300000X,Suppliers,Emergency Response System Companies,, 85 , 904 , 904 ," $29,183.39 ",,
MEDICAID DIRECT,1184727851,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05567,1895 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1184727851,NORTH CAROLINA CVS PHARMACY LLC,1895 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1184727869,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07559,2017 W WEBB AVE   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184727869,NORTH CAROLINA CVS PHARMACY LLC,2017 W WEBB AVE   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 19 , 50 ,$#,,
MEDICAID DIRECT,1184728859,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02571,1235 PECAN AVE   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1184728859,NORTH CAROLINA CVS PHARMACY LLC,1235 PECAN AVE   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184729105,"FISCHER, JONATHAN, ELI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 41 , 56 ,$#,,
MEDICAID DIRECT,1992810626,CAROLINA NEUROLOGY PA,CAROLINA NEUROLOGY PA,750 HARTNESS RD STE E STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184731838,"GARCHA, TRISHWANT, SINGH",750 HARTNESS RD STE E STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 48 , 122 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1184735615,"SCHEIL, CHARLES, DAVID",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 577 , 642 , 812 ," $12,459.58 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184735938,"RIEKER, ROBERT, PAUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 50 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184737090,"HUANG, YUH-CHIN, TONY",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 62 , 74 , 130 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184737090,"HUANG, YUH-CHIN, TONY",2100 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184737090,"HUANG, YUH-CHIN, TONY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 37 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184737090,"HUANG, YUH-CHIN, TONY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 68 , 78 , 124 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184737090,"HUANG, YUH-CHIN, TONY",2100 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 25 ,$#,,
MEDICAID DIRECT,1124209747,TRIAD ORTHOTICS AND PROSTHETICS,TRIAD ORTHOTICS AND PROSTHETICS,560 MALCOLM BLVD STE C CONNELLY SPRINGS NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184737173,"KING, RANDY, ALAN",560 MALCOLM BLVD STE C CONNELLY SPRINGS NC,012,Burke,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1124209747,TRIAD ORTHOTICS AND PROSTHETICS,TRIAD ORTHOTICS AND PROSTHETICS,560 MALCOLM BLVD STE C CONNELLY SPRINGS NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184737173,"KING, RANDY, ALAN",560 MALCOLM BLVD STE C CONNELLY SPRINGS NC,012,Burke,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,, 12 , 15 , 147 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1184737678,"GAMBILL, CHRISTY, LIANNE",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1184737678,"GAMBILL, CHRISTY, LIANNE",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184738338,"MCCLURE, DEREK, ROBERT",ASHE FAMILY HEALTHCARE,952 US HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1184738338,"MCCLURE, DEREK, ROBERT",952 US HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 75 , 394 , 483 ," $12,206.19 ",,
MEDICAID DIRECT,1184738338,"MCCLURE, DEREK, ROBERT",ASHE FAMILY HEALTHCARE,952 US HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1184738338,"MCCLURE, DEREK, ROBERT",952 US HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 67 , 227 , 352 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184739872,"BUSH, SEAN, PAUL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1184739872,"BUSH, SEAN, PAUL",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184739872,"BUSH, SEAN, PAUL",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 76 , 156 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184739872,"BUSH, SEAN, PAUL",10211 ALM ST   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184739872,"BUSH, SEAN, PAUL",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184740862,"KABBE, ANGELA, MARIE",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184740862,"KABBE, ANGELA, MARIE",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184740862,"KABBE, ANGELA, MARIE",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 31 , 31 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184740862,"KABBE, ANGELA, MARIE",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1123 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184740862,"KABBE, ANGELA, MARIE",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1184745960,"POOLE, ELLIOT, JOSEPH",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 31 , 43 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1184745960,"POOLE, ELLIOT, JOSEPH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1184745960,"POOLE, ELLIOT, JOSEPH",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184746810,"KRASINSKI, KEVIN, LEO",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 49 , 97 , 157 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184746810,"KRASINSKI, KEVIN, LEO",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184749426,"SHUMI, MOUSHUMI, RAHMAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 88 , 252 , 252 ,$#,,
MEDICAID DIRECT,1578152773,FULLER & ASSOCIATES VI PLLC,BLADENBORO FAMILY DENTISTRY,104 4TH ST   BLADENBORO NC,009,Bladen,193200000X,Group,Multi-Specialty,,1184751463,"HAYMON, LEE, TATE",104 4TH ST   BLADENBORO NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice, 815 ," 1,018 "," 4,583 "," $121,528.83 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184752131,"HIGHTOWER, MICHAEL, DEAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#, 16 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184752131,"HIGHTOWER, MICHAEL, DEAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184752263,"ORAHOVATS, CHRISTINA, MARIE-CORSELLO",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1184755001,OUR HOUSE HOME CARE SERVICES INC,OUR HOUSE HOME CARE SERVICES INC,2807 NEUSE BLVD STE 6 NEW BERN NC,025,Craven,253Z00000X,Agencies,In Home Supportive Care,,1184755001,OUR HOUSE HOME CARE SERVICES INC,2807 NEUSE BLVD STE 6 NEW BERN NC,025,Craven,253Z00000X,Agencies,In Home Supportive Care,, 51 ," 7,777 "," 7,777 "," $481,240.20 ",,
MEDICAID DIRECT,1184755092,"MANN, KEITH, WALLACE",KEITH W MANN DDS,818A PINE GROVE DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1184755092,"MANN, KEITH, WALLACE",818A PINE GROVE DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 94 , 212 ,$#,,
MEDICAID DIRECT,1184756900,"DAVIS, DANIELLE, ELIZABETH",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1184756900,"DAVIS, DANIELLE, ELIZABETH",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1184761868,"MOYE, PHILLIP, WALKER",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1184761868,"MOYE, PHILLIP, WALKER",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 160 , 299 , 472 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1184761868,"MOYE, PHILLIP, WALKER",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184762262,"MULLIGAN, STEPHANE",2906 N MAIN ST   TARBORO NC,033,Edgecombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 61 , 97 , 156 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184767006,"REYES, AMBER, LYNN",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184767006,"REYES, AMBER, LYNN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1184771412,"RATCLIFFE, HEATHER, ROBIN",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 116 , 221 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1184771412,"RATCLIFFE, HEATHER, ROBIN",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1184771412,"RATCLIFFE, HEATHER, ROBIN",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184771412,"RATCLIFFE, HEATHER, ROBIN",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 37 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1184771412,"RATCLIFFE, HEATHER, ROBIN",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1184771479,COUNTY OF JONES,,794 HIGHWAY 58 S   TRENTON NC,052,Jones,3416L0300X,Transportation Services,Ambulance,Land Transport,1184771479,COUNTY OF JONES,794 HIGHWAY 58 S   TRENTON NC,052,Jones,3416L0300X,Transportation Services,Ambulance,Land Transport, 134 , 269 , 522 ,$#,,
MEDICAID DIRECT,1184771875,CROSSROADS HOME HEALTH INC,~,1622 DAVIE AVE   STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1184771875,CROSSROADS HOME HEALTH INC,1622 DAVIE AVE   STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,067 "," 3,175 "," $406,640.08 ",,
MEDICAID DIRECT,1184775371,"DAVIS, CHERRYL, ANNE",CHERRYL A DAVIS DDS PA,316 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,1184775371,"DAVIS, CHERRYL, ANNE",316 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1184776155,"GUFFEY, NEAL",158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1184776155,"GUFFEY, NEAL",158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 142 , 142 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1184777229,"SHEA, KATHERINE, DENISE",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184777229,"SHEA, KATHERINE, DENISE",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 23 , 23 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1184777229,"SHEA, KATHERINE, DENISE",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184777229,"SHEA, KATHERINE, DENISE",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184777229,"SHEA, KATHERINE, DENISE",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184780215,"WANG, YING",~,1617 MEMORIAL DR   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,1184780215,"WANG, YING",1617 MEMORIAL DR   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 77 , 152 , 398 ," $16,506.81 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184785701,"CLARK, MICHAEL, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1184786360,LINCARE INC,~,1111 IRELAND DR STE 106 FAYETTEVILLE NC,026,Cumberland,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1184786360,LINCARE INC,1111 IRELAND DR STE 106 FAYETTEVILLE NC,026,Cumberland,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 45 , 184 , 286 ," $92,592.85 ",,
MEDICAID DIRECT,1184786360,LINCARE INC,~,1111 IRELAND DR STE 106 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1184786360,LINCARE INC,1111 IRELAND DR STE 106 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 456 ," 2,579 "," 4,655 "," $238,105.05 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184789026,"FAIRCLOTH, WANDA, MARIE",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 49 , 65 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,725 OAKRIDGE BLVD STE A1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1184789026,"FAIRCLOTH, WANDA, MARIE",725 OAKRIDGE BLVD STE A1 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 102 , 260 , 459 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184789141,"MORONE, DANIELA, MARIE",1009 STADIUM DR STE 124 WAKE FOREST NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 42 ,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184792368,"RIGBY, EUREKA, AREDENE",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184792368,"RIGBY, EUREKA, AREDENE",2721 X RAY DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 27 , 30 ,$#,,
MEDICAID DIRECT,1245335066,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RAEFORD,313 TEAL DR OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1184793598,"FUNK, TRACY, LINN",313 TEAL DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 115 , 167 , 250 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184794703,"SEDEI, SCOTT, DAVID",166 SPRINGBROOK AVE STE 201 CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184795031,"DRIVER, ROBERT, EDWARD",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184795031,"DRIVER, ROBERT, EDWARD",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184795890,"MCGOWEN, SUSAN, COURTENY",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1922398080,CAROMONT MEDICAL GROUP INC,THE HAND CENTER OF THE CAROLINAS,,,Unknown,193200000X,Group,Multi-Specialty,,1184797219,"PHADKE, PARAG, MADHAV",1212 SPRUCE ST STE 209 BELMONT NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184797219,"PHADKE, PARAG, MADHAV",2391 COURT DR STE 120A GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 57 , 101 , 145 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184797219,"PHADKE, PARAG, MADHAV",1212 SPRUCE ST STE 209 BELMONT NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 39 , 53 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1184797219,"PHADKE, PARAG, MADHAV",2525 COURT DR   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 20 , 26 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,22 TRUST LN STE 101 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1184797276,"NEWCOMB, CHRISTOPHER, ELWYN",22 TRUST LN STE 101 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184800666,"ALMIRA SUAREZ, MARIA, ISABEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 84 , 84 , 133 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 32 , 48 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 34 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104151109,EMERGENCY MEDICINE PHYSICIANS OF IR,~,,,Unknown,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184801003,"MCCAMMON JR, GEORGE, WILLIAM",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 42 , 57 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 60 , 63 , 75 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 39 , 52 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 297 , 376 , 442 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 33 , 37 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 323 , 431 , 533 ," $10,652.81 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 19 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184801441,"BALLISTY, MARIANNE, MULLIN",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184804304,"BOSTIAN, NICOLE, KUHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1184804411,"MCCUTCHEON, DEBRA, REID",~,5053 EXECUTIVE DR STE B MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1184804411,"MCCUTCHEON, DEBRA, REID",5053 EXECUTIVE DR STE B MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 54 , 110 ,$#,,
MEDICAID DIRECT,1790747988,CRYSTAL COAST PAIN MANAGEMENT,CRYSTAL COAST PAIN MANAGEMENT CENTER,2111 NEUSE BLVD STE J NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1184804411,"MCCUTCHEON, DEBRA, REID",5053 EXECUTIVE DR STE B MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 66 , 165 , 321 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184807877,"AMANKONA, RAYMOND, KOFI",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184807877,"AMANKONA, RAYMOND, KOFI",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184808305,"SPRINGS III, HAROLD, LEON",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 12 , 21 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1184808305,"SPRINGS III, HAROLD, LEON",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184808305,"SPRINGS III, HAROLD, LEON",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 11 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184808305,"SPRINGS III, HAROLD, LEON",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1184808594,JOHNSON BETTER CARE FACILITY INC,JOHNSON BETTER CARE FACILITY INC,3485 US HIGHWAY 301 N   DUNN NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184808594,JOHNSON BETTER CARE FACILITY INC,3485 US HIGHWAY 301 N   DUNN NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 23 ," 5,808 "," 5,808 "," $397,927.94 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184809451,"STRICKLAND, TARA, MARIE",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1184809451,"STRICKLAND, TARA, MARIE",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184809451,"STRICKLAND, TARA, MARIE",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003130493,PEDIATRIC ENDOCRINOLOGY AND DIABETE,Pediatric Endocrinology and Diabetes Specialists,1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1184811937,"MIESZCZAK, JAKUB",1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1679582134,PEDIATRIC ENDOCRINOLOGY AND DIABETE,PEDIATRIC ENDOCRINOLOGY DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184811937,"MIESZCZAK, JAKUB",4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 38 , 56 , 84 ,$#,,
MEDICAID DIRECT,1962218057,ATRIUM HEALTH CHILDRENS SPECIALTY,PEDIATRIC ENDOCRINOLOGY AND DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184811937,"MIESZCZAK, JAKUB",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1962218057,ATRIUM HEALTH CHILDRENS SPECIALTY,PEDIATRIC ENDOCRINOLOGY AND DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184811937,"MIESZCZAK, JAKUB",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#, 13 ,$#,,
MEDICAID DIRECT,1679582134,PEDIATRIC ENDOCRINOLOGY AND DIABETE,PEDIATRIC ENDOCRINOLOGY DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184811937,"MIESZCZAK, JAKUB",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1184814014,BAKOTIC PATHOLOGY ASSOCIATES LLC,BAKO PATHOLOGY SERVICES,6240 SHILOH RD   ALPHARETTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1184814014,BAKOTIC PATHOLOGY ASSOCIATES LLC,6240 SHILOH RD   ALPHARETTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 48 , 50 , 148 ,$#,,
MEDICAID DIRECT,1184814600,GOLDSBORO ASSISTED LIVING AND ALZHE,GOLDSBORO ASSISTED LIVING AND ALZHEIMERS CARE,2201 ROYALL AVE   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184814600,GOLDSBORO ASSISTED LIVING AND ALZHE,2201 ROYALL AVE   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 36 ," 9,303 "," 9,304 "," $802,965.84 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184817371,"WALKER, LINDA, JEANNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184817371,"WALKER, LINDA, JEANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184818866,"SHNOUDA, JOSEPH, FAHMY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 36 , 37 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184818866,"SHNOUDA, JOSEPH, FAHMY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 47 , 47 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184818866,"SHNOUDA, JOSEPH, FAHMY",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184818890,"REAVILL, CHRISTOPHER, SCOTT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 28 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184818890,"REAVILL, CHRISTOPHER, SCOTT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 75 , 92 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184818890,"REAVILL, CHRISTOPHER, SCOTT",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184818890,"REAVILL, CHRISTOPHER, SCOTT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1184818890,"REAVILL, CHRISTOPHER, SCOTT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184818890,"REAVILL, CHRISTOPHER, SCOTT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1255627915,ANTONIO S BRAITHWAITE DDS MPH PA,SANFORD PEDIATRIC DENTISTRY,1013 SPRING LN   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1184820052,"BRAITHWAITE, ANTONIO, STANLEY",1013 SPRING LN   SANFORD NC,053,Lee,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 3,702 "," 4,323 "," 23,558 "," $1,112,219.87 ",,
MEDICAID DIRECT,1255627915,ANTONIO S BRAITHWAITE DDS MPH PA,SANFORD PEDIATRIC DENTISTRY,1013 SPRING LN   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1184820052,"BRAITHWAITE, ANTONIO, STANLEY",1013 SPRING LN   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 42 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184820250,"COX, JAMES, ROGER",430 RANKIN DR   MARION NC,059,McDowell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184820250,"COX, JAMES, ROGER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1184820250,"COX, JAMES, ROGER",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1184820250,"COX, JAMES, ROGER",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 34 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184821902,"DANILE, LAURA, ELAINE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 103 , 106 , 149 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184821902,"DANILE, LAURA, ELAINE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 63 , 75 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,1401 MATTHEWS TOWNSHIP PKWY STE 310 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184821902,"DANILE, LAURA, ELAINE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1184821902,"DANILE, LAURA, ELAINE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184822777,"AANONSEN, LINDA, RENEE",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851331359,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS CHARLOTTE,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184822959,"SAGUNARTHY, RABINDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184822959,"SAGUNARTHY, RABINDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 63 , 221 , 225 ," $11,031.62 ",,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184828030,"JACKS, SAMUEL, PORTER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184828030,"JACKS, SAMUEL, PORTER",4622 COUNTRY CLUB RD STE 180 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184829855,"SANTIN, AMY, JO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 45 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184829855,"SANTIN, AMY, JO",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831306992,HOPSCOTCH PRIMARY CARE GROUP PA,HOPSCOTCH PRIMARY CARE,113 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1184829855,"SANTIN, AMY, JO",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 43 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184830465,"JOHNSON, KERRIE, LYNN",700 WALTER REED DR   GREENSBORO NC,041,Guilford,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184831158,"GUIMARAES, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184831158,"GUIMARAES, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1184831158,"GUIMARAES, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184831158,"GUIMARAES, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 292 , 421 , 612 ," $14,127.65 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1184831158,"GUIMARAES, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184831158,"GUIMARAES, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184831158,"GUIMARAES, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184831950,"WILLIAMS, RENEE, DUSOLD",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1184832230,"BATTISTON, JOHN, JOSEPH",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 28 , 33 , 35 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 16 , 22 , 27 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 58 , 101 , 136 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840514,"WU, WILLIS, MICHAEL",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840688,"SHAH, SIDHARTH, ANIL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 122 , 267 , 396 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840688,"SHAH, SIDHARTH, ANIL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840688,"SHAH, SIDHARTH, ANIL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184840688,"SHAH, SIDHARTH, ANIL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 99 , 268 , 490 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184840688,"SHAH, SIDHARTH, ANIL",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2460 CURTIS ELLIS DR # 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1184840688,"SHAH, SIDHARTH, ANIL",2460 CURTIS ELLIS DR # 100 ROCKY MOUNT NC,064,Nash,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1316346976,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ENT,1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184844003,"GORE, MITCHELL, RAY",1565 PURDUE DR   FAYETTEVILLE NC,026,Cumberland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 134 , 159 , 228 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1184845026,"GEDDINGS, THOMAS, MAXWELL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 33 ,$#,,
MEDICAID DIRECT,1184846115,"WILLIAMS, JOHN, MICHAEL",J MICHAEL WILLIAMS DDS PA,600 ERWIN RD   DUNN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,1184846115,"WILLIAMS, JOHN, MICHAEL",600 ERWIN RD   DUNN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#, 13 , 39 ,$#,,
MEDICAID DIRECT,1538776455,LANE AND ASSOCIATES XXXIX,,161 KODIAK LN   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1184846867,"BAGHDASSARIAN, ROSEMARY",101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 736 ," 1,335 "," 4,398 "," $257,410.48 ",,
MEDICAID DIRECT,1538776455,LANE AND ASSOCIATES XXXIX,,161 KODIAK LN   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1184846867,"BAGHDASSARIAN, ROSEMARY",101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184847865,"CARLISLE, EMILY, STREYER",250 HOSPICE CIR   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184848525,"BARUA, ERIC",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 34 , 39 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184848798,"RAJA, ATIF, YASIN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184849382,"RAMIREZ, ARMANDO",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184849382,"RAMIREZ, ARMANDO",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 40 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184849382,"RAMIREZ, ARMANDO",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184849382,"RAMIREZ, ARMANDO",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184849382,"RAMIREZ, ARMANDO",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184849416,"STADLER, MICHAEL, D.",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184849416,"STADLER, MICHAEL, D.",911 W HENDERSON ST STE 300 SALISBURY NC,080,Rowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 40 , 62 , 94 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184849416,"STADLER, MICHAEL, D.",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 29 , 40 , 41 ," $11,516.15 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1184852154,"SEIB, DEREK, ANTHONY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1184852154,"SEIB, DEREK, ANTHONY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1184852154,"SEIB, DEREK, ANTHONY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1184852154,"SEIB, DEREK, ANTHONY",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1184852154,"SEIB, DEREK, ANTHONY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1184852154,"SEIB, DEREK, ANTHONY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184852154,"SEIB, DEREK, ANTHONY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1184853061,"EDWARDS, SHANA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1184854028,"GEORGE, JACOB",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 204 , 204 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184854291,"LINTHICUM, BENJAMIN, OVITT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184854291,"LINTHICUM, BENJAMIN, OVITT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184854291,"LINTHICUM, BENJAMIN, OVITT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1184854291,"LINTHICUM, BENJAMIN, OVITT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1184854291,"LINTHICUM, BENJAMIN, OVITT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,2406 W ROOSEVELT BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1184855561,"MCGINNIS, JULIE, HUTCHINSON",2406 W ROOSEVELT BLVD   MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1184855561,"MCGINNIS, JULIE, HUTCHINSON",1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1184855561,"MCGINNIS, JULIE, HUTCHINSON",1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,, 85 , 88 , 148 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1184855561,"MCGINNIS, JULIE, HUTCHINSON",1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1184857948,CASHFLOW SOLUTIONS LLC,LYMPHA PRESS,25 WOODS LAKE RD STE 815 GREENVILLE SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184857948,CASHFLOW SOLUTIONS LLC,25 WOODS LAKE RD STE 815 GREENVILLE SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 66 , 70 , 182 ," $52,664.79 ",,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1184860421,"MIRZAZADEH, MAJID",233 DOCTORS ST   SPARTA NC,003,Alleghany,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184860421,"MIRZAZADEH, MAJID",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184860421,"MIRZAZADEH, MAJID",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 154 , 249 , 382 ," $16,806.07 ",,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184860421,"MIRZAZADEH, MAJID",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184860421,"MIRZAZADEH, MAJID",1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184860421,"MIRZAZADEH, MAJID",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184860694,"MORRISON, ANNA, CHRISTINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184861353,ANDOR LABS LLC,ANDOR LABS LLC,1000 BEAR CAT WAY STE 107 MORRISVILLE NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1184861353,ANDOR LABS LLC,1000 BEAR CAT WAY STE 107 MORRISVILLE NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,, 311 , 587 ," 1,796 "," $51,687.73 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184865958,"BRICKLES, RENEE, ANN",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1184867558,"WOLFE, APRIL, BACIC",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 28 , 93 , 93 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184868465,"D'AMICO, BETH, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184868465,"D'AMICO, BETH, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 58 , 58 , 69 ,$#,,
MEDICAID DIRECT,1184871626,"JACKSON, ERIN, ATWATER",~,2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1184871626,"JACKSON, ERIN, ATWATER",2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1548217755,PATTY VISION CENTER OD PA,Patty Vision Center,2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184871626,"JACKSON, ERIN, ATWATER",2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 28 , 40 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184875171,"BISSELL, JACLYN, MARIE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184875171,"BISSELL, JACLYN, MARIE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 43 , 100 ,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1184878290,"KYLE, SEAN, LEONARD",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 40 , 50 ,$#,,
MEDICAID DIRECT,1235871146,FLORENCE NEPHROLOGY ASSOCIATES LLC,,101 WILLIAM H JOHNSON ST STE 430 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184880049,"ALSAKA, MHD, ADNAN",101 WILLIAM H JOHNSON ST STE 430 FLORENCE SC,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1184880130,"ROUSE, MISTY, LYNN",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 107 , 170 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1184880130,"ROUSE, MISTY, LYNN",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1184881310,"HOPKINS, THOMAS, JOSEPH",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184881823,"SINDRAM, ALIANA, PATRICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184881823,"SINDRAM, ALIANA, PATRICIA",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184881823,"SINDRAM, ALIANA, PATRICIA",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184881823,"SINDRAM, ALIANA, PATRICIA",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184881823,"SINDRAM, ALIANA, PATRICIA",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 22 , 22 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184881823,"SINDRAM, ALIANA, PATRICIA",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184881823,"SINDRAM, ALIANA, PATRICIA",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184882078,"OZMENT, CAROLINE, PINSON",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 48 , 133 , 133 ," $29,473.36 ",,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184882227,"SAUER, MARIAM, SHAHBAZIAN",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 55 , 79 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184884488,"ARRIEN, MAURICIO, DANIEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184884488,"ARRIEN, MAURICIO, DANIEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 138 , 138 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184884488,"ARRIEN, MAURICIO, DANIEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184885212,"MERCER, CYNTHIA, CECIL",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184885212,"MERCER, CYNTHIA, CECIL",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 24 , 32 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184885212,"MERCER, CYNTHIA, CECIL",123 WEAVER RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1184885501,"WANG, MICHAEL, JAN CHI",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184885501,"WANG, MICHAEL, JAN CHI",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 48 , 143 , 144 ,$#,,
MEDICAID DIRECT,1003860917,SURGERY CENTER OF PINEHURST LLC,SURGERY CENTER OF PINEHURST LLC,10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1184887234,"RIEFKOHL, WALDEMAR, LUIS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184887234,"RIEFKOHL, WALDEMAR, LUIS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 70 , 164 , 245 ," $10,153.79 ",,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184887291,"CADET, EDWIN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184887291,"CADET, EDWIN",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 22 , 41 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184887291,"CADET, EDWIN",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184888570,"WOODS, BRANDI, ANESHA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,,,$#,,
MEDICAID DIRECT,1831157833,KERNERSVILLE REHAB SPECIALISTS LLC,,1027 E MOUNTAIN ST #101   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184890279,"CAREY, SHAWN, WILLIAM",1027 E MOUNTAIN ST #101   KERNERSVILLE NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184890451,"MILLER, MICHAEL, SHANE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184890451,"MILLER, MICHAEL, SHANE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,945 FOLLY RD   CHARLESTON SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1184891012,"GRAY, GEOFFREY, MILTON",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184893166,THE HERITAGE OF RICHLANDS,,148 COX AVE   RICHLANDS NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184893166,THE HERITAGE OF RICHLANDS,148 COX AVE   RICHLANDS NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 18 ," 4,881 "," 4,881 "," $327,356.39 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184895948,"WILLIAMS, ANTONIO, FRANCISCO",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184896755,"LYNCH, PETRA, S",1101 FIRST COLONIAL RD STE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184896755,"LYNCH, PETRA, S",1031 LOFTIS BLVD STE 100 NEWPORT NEWS VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184896755,"LYNCH, PETRA, S",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184897134,"SURA, SIDDHARTH, PIYUSHKUMAR",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184897134,"SURA, SIDDHARTH, PIYUSHKUMAR",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184897134,"SURA, SIDDHARTH, PIYUSHKUMAR",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184897134,"SURA, SIDDHARTH, PIYUSHKUMAR",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184897134,"SURA, SIDDHARTH, PIYUSHKUMAR",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184897134,"SURA, SIDDHARTH, PIYUSHKUMAR",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184898413,"CURRY, KRISTIN",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 124 , 235 , 473 ,$#,,
MEDICAID DIRECT,1871640458,HOSPICE OF THE PIEDMONT INC,HOSPICE OF THE PIEDMONT INC,1801 WESTCHESTER DR   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1184898892,"COPELAND, MAIKE, NAUMANN",1801 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184902496,"CRAIG, MICHAEL, EUGENE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1184902496,"CRAIG, MICHAEL, EUGENE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1184903205,"CRAMER, CHRISTINA, KEHL",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184903205,"CRAMER, CHRISTINA, KEHL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 43 , 83 , 154 ,$#,,
MEDICAID DIRECT,1184904989,LABORATORY CORPORATION OF AMERICA H,~,7 MCDOWELL ST STE 300 ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1184904989,LABORATORY CORPORATION OF AMERICA H,7 MCDOWELL ST STE 300 ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184905754,"SMITH, COURTNEY, JANE",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184906638,"GUTMAN, DAVID, ALEX",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1184909897,"TOWNSEND, RAY, THOMAS",56 HOSPITAL ST   HIAWASSEE GA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1184910614,"DEDMON, MATTHEW, MORRIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 22 , 25 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184910614,"DEDMON, MATTHEW, MORRIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 26 , 28 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1184910614,"DEDMON, MATTHEW, MORRIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184910614,"DEDMON, MATTHEW, MORRIS",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1184910614,"DEDMON, MATTHEW, MORRIS",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1184910614,"DEDMON, MATTHEW, MORRIS",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 31 , 36 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1184910622,"RAMSDELL, KATHRYN, FITZGERALD",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1184910622,"RAMSDELL, KATHRYN, FITZGERALD",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184910622,"RAMSDELL, KATHRYN, FITZGERALD",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184910622,"RAMSDELL, KATHRYN, FITZGERALD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184910622,"RAMSDELL, KATHRYN, FITZGERALD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184911141,"FONEBI, GWENDOLINE, AKWEN",1333 S DICKINSON DR UNIT 200 LELAND NC,010,Brunswick,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184911141,"FONEBI, GWENDOLINE, AKWEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1184911141,"FONEBI, GWENDOLINE, AKWEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184913501,"KIEHL, ERICH, LEARNED",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184913501,"KIEHL, ERICH, LEARNED",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184915043,"TENINI, JOHN, ANGELO",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 30 , 54 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184915043,"TENINI, JOHN, ANGELO",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184915043,"TENINI, JOHN, ANGELO",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184915340,"TALBOTT, ASHLEY, LESCANEC",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 44 , 52 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184915845,"SMITS, RICHARD, ANTHONY",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 118 , 187 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1184920308,"KRYGER, CHRISTINE, GORDINEER",560 LEROY GEORGE DR   CLYDE NC,044,Haywood,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 40 , 59 , 69 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1184920308,"KRYGER, CHRISTINE, GORDINEER",186 MEDICAL PARK LOOP STE 503 SYLVA NC,050,Jackson,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 23 , 33 , 34 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184920712,"JAKUBEC, KAITLYN, HALAS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184920712,"JAKUBEC, KAITLYN, HALAS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184920910,"MULFORD, CHRISTINE, ANGELA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1184921389,MARY H FINCH TOTAL CARE LLC,MARY H FINCH TOTAL CARE LLC,124B S MAIN ST   BROADWAY NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,1184921389,MARY H FINCH TOTAL CARE LLC,124B S MAIN ST   BROADWAY NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,#," 1,470 "," 1,470 "," $112,093.36 ",,
MEDICAID DIRECT,1184922635,PREMIER HOME HEALTH CARE SERVICES I,PREMIER HOME HEALTH CARE SERVICES INC,2783 NC HIGHWAY 68 S STE 101 HIGH POINT NC,041,Guilford,251J00000X,Agencies,Nursing Care,,1184922635,PREMIER HOME HEALTH CARE SERVICES I,2783 NC HIGHWAY 68 S STE 101 HIGH POINT NC,041,Guilford,251J00000X,Agencies,Nursing Care,, 12 ," 1,451 "," 1,474 "," $757,263.00 ",,
MEDICAID DIRECT,1063960904,PACE HEALTH NETWORK LLC,,103 MILL POND RD   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1184923872,"PULLEY, JANICE, ALLEN",103 MILL POND RD   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 573 ," 2,424 "," 2,431 "," $55,329.84 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184924698,"WELBORN, ALICIA, GAINEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 31 , 41 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184924698,"WELBORN, ALICIA, GAINEY",2390 HEMBY LN   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184924698,"WELBORN, ALICIA, GAINEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184924698,"WELBORN, ALICIA, GAINEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184924698,"WELBORN, ALICIA, GAINEY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 33 , 62 , 64 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184924698,"WELBORN, ALICIA, GAINEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1184924698,"WELBORN, ALICIA, GAINEY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 39 , 44 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1184925075,"HATFIELD, STEFANIE, KAM",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1003687187,DLP WESTERN CAROLINA PHYSICIAN PRAC,HARRIS WOMENS CARE,70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1184925075,"HATFIELD, STEFANIE, KAM",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184925901,"MOORE, TANYA, ELIZABETH",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184925901,"MOORE, TANYA, ELIZABETH",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184929101,"KIRBY, AMELIA, JEANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 31 , 46 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184929739,"BIALZIK, NICHOLAS, PETER",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1184929739,"BIALZIK, NICHOLAS, PETER",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1184929739,"BIALZIK, NICHOLAS, PETER",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1184929739,"BIALZIK, NICHOLAS, PETER",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1184930133,"RAYI, APPAJI",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184930372,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 01944,606 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184930372,NORTH CAROLINA CVS PHARMACY LLC,606 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184934465,"JONES, NATASHA, NICOLE",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 15 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184935983,"HALL, KENT, MICHAEL",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184935983,"HALL, KENT, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 471 , 643 , 685 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184935983,"HALL, KENT, MICHAEL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184935983,"HALL, KENT, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184935983,"HALL, KENT, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184935983,"HALL, KENT, MICHAEL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 26 , 27 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184935983,"HALL, KENT, MICHAEL",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1184936213,"TURNAGE, STEPHANIE, LYNN",1206 BROWN ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 127 , 471 ," $15,967.42 ",,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184937542,"MOREA, CASEY, FOX",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 32 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1184937542,"MOREA, CASEY, FOX",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 28 , 39 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1184937542,"MOREA, CASEY, FOX",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184940058,"HURBAN, MICHAEL, S",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184940058,"HURBAN, MICHAEL, S",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1184940421,"ADCOCK, BRANDAN, RAULSTON",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,1219 SMOKY PARK HWY   CANDLER NC,011,Buncombe,193400000X,Group,Single Specialty,,1184940421,"ADCOCK, BRANDAN, RAULSTON",1219 SMOKY PARK HWY   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184940801,"BURBANK, ALLISON, JANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184940801,"BURBANK, ALLISON, JANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184940918,"SAKAI, ISAMI",203 EARNHART DR STE B EDENTON NC,021,Chowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184940918,"SAKAI, ISAMI",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 34 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184940918,"SAKAI, ISAMI",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 35 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184940918,"SAKAI, ISAMI",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184940918,"SAKAI, ISAMI",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184944290,"HARRIS, MATTHEW, JOEL",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 106 , 107 , 707 ," $29,332.81 ",,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184945503,"ENGLER, SARAH, KATHRYN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184945503,"ENGLER, SARAH, KATHRYN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184945503,"ENGLER, SARAH, KATHRYN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1184946311,"HOUGH, BRIAN, SAMUEL",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 76 , 100 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184946311,"HOUGH, BRIAN, SAMUEL",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 37 , 54 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184947707,"MCCORD, DOREEN, LEYBAG",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447462643,WAKE OPTHALMOLOGY ASSOCIATES PA,WAKE OPTHALMOLOGY ASSOCIATES PA,105 SW CARY PKWY STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1184949554,"COMPTON, MICHAEL, WILDER",105 SW CARY PKWY STE 200 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 25 , 41 ,$#,,
MEDICAID DIRECT,1184949810,REALO DISCOUNT DRUG STORES OF GREEN,~,104 PARKWOOD DR   SNOW HILL NC,040,Greene,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1184949810,REALO DISCOUNT DRUG STORES OF GREEN,104 PARKWOOD DR   SNOW HILL NC,040,Greene,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184957052,"HALL, ROBERT, FRANKLIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1184957052,"HALL, ROBERT, FRANKLIN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 29 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184957201,"GETTINGS, JUSTIN, LUKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1184957201,"GETTINGS, JUSTIN, LUKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184957201,"GETTINGS, JUSTIN, LUKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1184957516,"JOHNSON, DEBORAH, KORNEGAY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184957946,"AHLBERG, LISA, MARIE",201 E GROVER ST   SHELBY NC,023,Cleveland,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184957946,"AHLBERG, LISA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184957946,"AHLBERG, LISA, MARIE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184957946,"AHLBERG, LISA, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 21 , 38 , 49 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184957946,"AHLBERG, LISA, MARIE",600 HOSPITAL DR   MONROE NC,090,Union,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184957946,"AHLBERG, LISA, MARIE",600 HOSPITAL DR   MONROE NC,090,Union,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184957946,"AHLBERG, LISA, MARIE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184958035,"GUDURU, RAMANA, REDDY",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184960833,WP-YANCEYVILLE HEALTH HOLDINGS LLC,CASWELL HOUSE,535 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1184960833,WP-YANCEYVILLE HEALTH HOLDINGS LLC,535 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1184960833,WP-YANCEYVILLE HEALTH HOLDINGS LLC,CASWELL HOUSE,535 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184960833,WP-YANCEYVILLE HEALTH HOLDINGS LLC,535 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 43 ," 11,184 "," 11,184 "," $943,193.73 ",,
MEDICAID DIRECT,1184960858,WP-HAYESVILLE HEALTH HOLDINGS LLC,HAYESVILLE HOUSE,480 OLD HIGHWAY 64 W   HAYESVILLE NC,022,Clay,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1184960858,WP-HAYESVILLE HEALTH HOLDINGS LLC,480 OLD HIGHWAY 64 W   HAYESVILLE NC,022,Clay,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 24 ," 5,146 "," 5,146 "," $527,163.98 ",,
MEDICAID DIRECT,1184960858,WP-HAYESVILLE HEALTH HOLDINGS LLC,HAYESVILLE HOUSE,480 OLD HIGHWAY 64 W   HAYESVILLE NC,022,Clay,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1184960858,WP-HAYESVILLE HEALTH HOLDINGS LLC,480 OLD HIGHWAY 64 W   HAYESVILLE NC,022,Clay,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1184961187,"YODER, JAMES, AUSTIN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 33 , 54 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184961187,"YODER, JAMES, AUSTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 32 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184961187,"YODER, JAMES, AUSTIN",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184961187,"YODER, JAMES, AUSTIN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1184961187,"YODER, JAMES, AUSTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184961187,"YODER, JAMES, AUSTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184961187,"YODER, JAMES, AUSTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1184961187,"YODER, JAMES, AUSTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1184961435,"VEGA, KIRSTYN, LEE",701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1184961435,"VEGA, KIRSTYN, LEE",701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 122 , 222 , 421 ,$#,,
MEDICAID DIRECT,1861930984,PINNACLE DERMATOLOGY SC,PINNACLE DERMATOLOGY SC,701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1184961435,"VEGA, KIRSTYN, LEE",701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184961633,"RUSS, JOSHUA, DANIEL",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184961633,"RUSS, JOSHUA, DANIEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184961633,"RUSS, JOSHUA, DANIEL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 98 , 104 , 224 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184961633,"RUSS, JOSHUA, DANIEL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1184961633,"RUSS, JOSHUA, DANIEL",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1184961633,"RUSS, JOSHUA, DANIEL",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184963704,"HIGHSMITH, MICHELLE, DAWN",8990 HWY 17 S   POLLOCKSVILLE NC,052,Jones,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184963704,"HIGHSMITH, MICHELLE, DAWN",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 47 , 70 , 71 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184963704,"HIGHSMITH, MICHELLE, DAWN",225 WHITE ST   JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 15 , 32 , 32 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184963704,"HIGHSMITH, MICHELLE, DAWN",5490 ARBOR BRANCH DR   SHALLOTTE NC,010,Brunswick,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184963704,"HIGHSMITH, MICHELLE, DAWN",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 43 , 116 , 116 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184963704,"HIGHSMITH, MICHELLE, DAWN",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 44 , 114 , 115 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1184963704,"HIGHSMITH, MICHELLE, DAWN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 74 , 90 , 90 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184966715,"SHESHADRI, NAVANEETHA, KRISHNAN",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184966715,"SHESHADRI, NAVANEETHA, KRISHNAN",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 70 , 178 , 318 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184966715,"SHESHADRI, NAVANEETHA, KRISHNAN",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,920 S LOMBARD ST STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1184966715,"SHESHADRI, NAVANEETHA, KRISHNAN",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1184966715,"SHESHADRI, NAVANEETHA, KRISHNAN",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 107 , 226 , 347 ," $10,837.06 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1184966988,"RADDATZ, MELISSA, ANNE",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1184966988,"RADDATZ, MELISSA, ANNE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 31 , 79 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184966988,"RADDATZ, MELISSA, ANNE",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1184966988,"RADDATZ, MELISSA, ANNE",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 54 , 126 ,$#,,
MEDICAID DIRECT,1225372246,DUKE UNIVERSITY AFFILIATED PHYSICIA,DPC BLUE RIDGE,3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184967051,"BRINN, ASHLEY, WALKER",2406 BLUE RIDGE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 36 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184967051,"BRINN, ASHLEY, WALKER",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184967051,"BRINN, ASHLEY, WALKER",628 EAST ST STE B PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184967838,"OKAFOR, KENOSA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184967846,"DUDICK, STEVEN, JEFFREY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 31 , 33 ,$#,,
MEDICAID DIRECT,1316375140,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-MEDICALINTENSIVISTS,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1184967929,"LAPOINTE, RYAN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184976441,"NESTEL, KELLY, DUVALL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 49 , 49 ,$#,,
MEDICAID DIRECT,1184976797,DIGESTIVE HEALTH SPECIALISTS PA,~,280 BROAD ST STE G KERNERSVILLE NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1184976797,DIGESTIVE HEALTH SPECIALISTS PA,280 BROAD ST STE G KERNERSVILLE NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 32 , 32 , 42 ,$#,,
MEDICAID DIRECT,1700317096,MOSES CONE PHYSICIAN SERVICES INC,ROCKINGHAM SURGICAL ASSOCIATES,1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1184980054,"BRIDGES, LINDSAY, CHERYL",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 51 , 54 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184980062,"CROCKETT, ALLISON, KERIANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1184980062,"CROCKETT, ALLISON, KERIANNE",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6013 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1184980252,"ELLSWORTH, PATRICK, SHANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184980252,"ELLSWORTH, PATRICK, SHANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 16 , 24 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1184980252,"ELLSWORTH, PATRICK, SHANE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1184981623,"DRIVER, KELLY, CASON",155 MEMORIAL DR   PINEHURST NC,063,Moore,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1184981706,"WEARINS, STEPHANIE, LOCKLEAR",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 221 , 265 , 492 ," $19,996.59 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1184983157,"HUSEN, SRIE, DEWI",11803 JEFFERSON AVE STE 100 NEWPORT NEWS VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1184985335,"BLANKS, SHEILA, LANE",156 MEMORIAL CT   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 70 , 100 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1184985335,"BLANKS, SHEILA, LANE",156 MEMORIAL CT   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 88 , 101 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184985798,"MCMURTRY, JOHN, THOMAS",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 35 , 46 , 66 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184985798,"MCMURTRY, JOHN, THOMAS",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184985798,"MCMURTRY, JOHN, THOMAS",3311 JESSIE VILLAGE DR   CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 17 , 26 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184986028,"ROEDNER, CHANTEL, SPRINGE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184986028,"ROEDNER, CHANTEL, SPRINGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184986028,"ROEDNER, CHANTEL, SPRINGE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184986028,"ROEDNER, CHANTEL, SPRINGE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1184986028,"ROEDNER, CHANTEL, SPRINGE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1184987042,"LO, ZACHARY",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184987521,"CHACKO, SERENA, MARIA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184987521,"CHACKO, SERENA, MARIA",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184987521,"CHACKO, SERENA, MARIA",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1184987521,"CHACKO, SERENA, MARIA",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184987521,"CHACKO, SERENA, MARIA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 ,#, 17 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184987521,"CHACKO, SERENA, MARIA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1184987521,"CHACKO, SERENA, MARIA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1184987521,"CHACKO, SERENA, MARIA",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184987737,ORTHOPAEDIC SURGERY CENTER OF RALEI,RALEIGH ORTHOPAEDIC SURGERY CENTER,3001 EDWARDS MILL RD # 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1184987737,ORTHOPAEDIC SURGERY CENTER OF RALEI,3001 EDWARDS MILL RD # 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 37 , 38 , 50 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 183 , 183 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1184988776,"SITAMMAGARI, KRANTHI, KIRAN REDDY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184988990,"RAJAN, VIGNESH",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1184988990,"RAJAN, VIGNESH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 75 , 75 ,$#,,
MEDICAID DIRECT,1598260515,CONCORD RADIOLOGY PLLC,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1184990574,"FISHER, STEPHEN, MICHAEL",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1184993784,"BELL, CHARLES, WESLEY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 46 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1184993784,"BELL, CHARLES, WESLEY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 36 , 37 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1184994238,"BATES, JACLYN, WEST",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 17 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1184994238,"BATES, JACLYN, WEST",921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 86 , 136 , 168 ,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194002998,"MYLES, JENNIFER, JEANETTE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194002998,"MYLES, JENNIFER, JEANETTE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,213 BARDEN ST   PRINCETON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194006312,"BELL, KAY, PEARCE",213 BARDEN ST   PRINCETON NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 20 , 31 , 58 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194010835,"SMITH, GIGI, ANGELICA",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194010835,"SMITH, GIGI, ANGELICA",485 VALLEY RD   MOCKSVILLE NC,030,Davie,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 226 , 394 ,$#,,
MEDICAID DIRECT,1194012526,ALLIANCE PERSONAL CARE SERVICE,ALLIANCE OF PERSONAL CARE,543 COX RD STE D6 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1194012526,ALLIANCE PERSONAL CARE SERVICE,543 COX RD STE D6 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 23 ," 3,810 "," 3,929 "," $284,240.61 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194013839,"HENSEL, NADIA, EKSIR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 98 , 101 , 114 ,$#,,
MEDICAID DIRECT,1104679448,PHILLIP MCIVER DDS PA,~,304 IONA ST   FAIRMONT NC,078,Robeson,193200000X,Group,Multi-Specialty,,1194013862,"MAJEKODUNMI, JOSEPH, OLAYINKA",304 IONA ST   FAIRMONT NC,078,Robeson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194015131,"TALBOTT, SAMANTHA, LYNN",3020 BONBROOK DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 60 , 84 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,3020 BONBROOK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194015131,"TALBOTT, SAMANTHA, LYNN",3020 BONBROOK DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194015149,"ADAMS, BRANDI, NECOY",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194015149,"ADAMS, BRANDI, NECOY",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194015149,"ADAMS, BRANDI, NECOY",4815 JOHNSTON OEHLER RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 15 , 16 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194015149,"ADAMS, BRANDI, NECOY",10320 MALLARD CREEK RD STE 260A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194015149,"ADAMS, BRANDI, NECOY",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194015370,"COOK, STEVEN, HENRY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194015370,"COOK, STEVEN, HENRY",3643 N ROXBORO ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 19 , 25 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194015370,"COOK, STEVEN, HENRY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194015370,"COOK, STEVEN, HENRY",3116 N DUKE ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194015370,"COOK, STEVEN, HENRY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194015370,"COOK, STEVEN, HENRY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194017129,"LAMON, AGNES, MCNAMARA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 45 , 47 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194019554,"COKER, JAMES, WILLIS",650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194019554,"COKER, JAMES, WILLIS",650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 76 , 121 , 147 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194019760,"RIETZ, ASHLEY, MARIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 25 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194019760,"RIETZ, ASHLEY, MARIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 128 , 231 ," $11,897.40 ",,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194020784,"MCGOWAN, GABRIELLA, LOUISE",1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1194022616,"JONES, MIA",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 113 , 141 , 627 ," $25,419.96 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1194026120,"ABEL SR, DAVID, THOMAS",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194026120,"ABEL SR, DAVID, THOMAS",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1194026120,"ABEL SR, DAVID, THOMAS",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1194026120,"ABEL SR, DAVID, THOMAS",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1194026120,"ABEL SR, DAVID, THOMAS",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194028217,"SMITH, ERICA, CANTY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1194030288,"WHITENER, ANTHA, KIMBERLY",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1194031211,PETER K DUNN OD PA,PETER K DUNN OD PA,306 MUIRS CHAPEL RD STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1194031211,PETER K DUNN OD PA,306 MUIRS CHAPEL RD STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,, 337 , 342 , 684 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194033522,"KOGOY, JOHN, MARTIN",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194033522,"KOGOY, JOHN, MARTIN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194033522,"KOGOY, JOHN, MARTIN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194033522,"KOGOY, JOHN, MARTIN",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1720191661,MEDICAL ARTS PHARMACY,MEDICAL ARTS PHARMACY,253 RUIN CREEK RD   HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194033811,"KIRBY, CARA, WHITE",253 RUIN CREEK RD   HENDERSON NC,091,Vance,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1194034603,SPEAKEASY THERAPY LLC,SpeakEasy Therapy LLC,8800 BUCKEY CT   LEWISVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194034603,SPEAKEASY THERAPY LLC,8800 BUCKEY CT   LEWISVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194034934,"EDKINS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194034934,"EDKINS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194034934,"EDKINS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194034934,"EDKINS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194034934,"EDKINS, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194037507,"GANGIREDDY, VENU, GOPALA REDDY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194037507,"GANGIREDDY, VENU, GOPALA REDDY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194037507,"GANGIREDDY, VENU, GOPALA REDDY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 111 , 212 , 245 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194037507,"GANGIREDDY, VENU, GOPALA REDDY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194037507,"GANGIREDDY, VENU, GOPALA REDDY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194037507,"GANGIREDDY, VENU, GOPALA REDDY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 77 , 86 ,$#,,
MEDICAID DIRECT,1598271306,THE MOSES H CONE MEMORIAL HOSPITAL,RENAISSANCE FAMILY MEDICINE CENTER,2525C PHILLIPS AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194039164,"EDWARDS, MICHELLE, FRANKLIN",2525 PHILLIPS AVE STE C GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 43 , 58 , 76 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194039164,"EDWARDS, MICHELLE, FRANKLIN",2525 PHILLIPS AVE STE C GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194039636,"ALEMU, RAHEL, HAIMANOT",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194039636,"ALEMU, RAHEL, HAIMANOT",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 50 , 65 , 123 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194039636,"ALEMU, RAHEL, HAIMANOT",2025 FRONTIS PLAZA BLVD STE 100 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194039636,"ALEMU, RAHEL, HAIMANOT",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 20 , 38 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194039636,"ALEMU, RAHEL, HAIMANOT",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 61 , 78 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194039636,"ALEMU, RAHEL, HAIMANOT",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 22 , 35 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194039636,"ALEMU, RAHEL, HAIMANOT",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194041434,"HALE, JENNIFER, BROOKE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1194044032,"RAMSEY, SARAH, BRANUM",CONNECTED SPEECH & LANGUAGE PLLC,245 WINKLERS CREEK RD   BOONE NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1194044032,"RAMSEY, SARAH, BRANUM",245 WINKLERS CREEK RD   BOONE NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1619606316,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2775 HENDERSONVILLE ROAD,2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194045039,"MCDONALD, CHRISTINA, PIKE",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 137 , 249 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194045575,"WARD, JENNIFER, NICOLE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 116 , 117 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194045948,"BRACKMAN, MICHAEL, RYAN",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 108 , 245 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194045948,"BRACKMAN, MICHAEL, RYAN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194045948,"BRACKMAN, MICHAEL, RYAN",4208 MURDOCKSVILLE RD   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194046235,"MOORE, JOSHUA, AARON BRADLEY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 104 , 290 , 294 ," $14,876.21 ",,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1194050328,"THOMPSON, BENJAMIN, JAMES",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194051508,"FLOTT, MEGAN, LYNN",206 JOE V KNOX AVE STE F MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194051508,"FLOTT, MEGAN, LYNN",206 JOE V KNOX AVE STE F MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194056101,"MCBRIDE, KATE, ELAINE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 36 , 54 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1194056101,"MCBRIDE, KATE, ELAINE",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 34 , 64 ,$#,,
MEDICAID DIRECT,1902934292,NEW HANOVER COUNTY,NEW HANOVER COUNTY HEALTH DEPT,1650 GREENFIELD ST   WILMINGTON NC,065,New Hanover,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1194056143,"GOODWIN, KRISTEN, JOY",1650 GREENFIELD ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 53 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1194058024,"SODEN, KIMBERLY, TOWNES",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1194058024,"SODEN, KIMBERLY, TOWNES",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194058024,"SODEN, KIMBERLY, TOWNES",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194058024,"SODEN, KIMBERLY, TOWNES",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1194058024,"SODEN, KIMBERLY, TOWNES",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194058024,"SODEN, KIMBERLY, TOWNES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952626384,BLUE RIDGE HEALTHCARE MEDICAL GROUP,TABLE ROCK FAMILY MEDICINE,301 LINVILLE ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1194058081,"STEPHANIDES, MICHAEL, MILLER",301 LINVILLE ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1194058404,"GLASER, JORDAN, MICHAEL",170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1194058404,"GLASER, JORDAN, MICHAEL",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558773770,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN ORTHOPEDICS,,,Unknown,193200000X,Group,Multi-Specialty,,1194058404,"GLASER, JORDAN, MICHAEL",4901 DAWN DR STE 3400 LUMBERTON NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1194061820,WP-WILLIAMSTON HEALTH HOLDINGS LLC,WILLIAMSTON HOUSE,160 SANTREE DR   WILLIAMSTON NC,058,Martin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194061820,WP-WILLIAMSTON HEALTH HOLDINGS LLC,160 SANTREE DR   WILLIAMSTON NC,058,Martin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 39 ," 9,639 "," 9,641 "," $729,084.34 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194062208,"TURNIPSEED, JULEIDY, CONDE",125 QUEENS RD STE 640 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194062208,"TURNIPSEED, JULEIDY, CONDE",101 S RAVENEL ST STE 270 FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194062497,"GUPTA, SHAFALI",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 54 , 54 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194062497,"GUPTA, SHAFALI",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 42 , 42 ,$#,,
MEDICAID DIRECT,1194066209,PHI HEALTH LLC,PHI AIR MEDICAL,9990 WAKEMAN DR   MANASSAS VA,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1194066209,PHI HEALTH LLC,9990 WAKEMAN DR   MANASSAS VA,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,,,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194067306,"STOVER, JERRY, BOYD",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 32 , 36 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194067546,"BURKHART, KIMBERLY, GANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194067546,"BURKHART, KIMBERLY, GANN",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194067546,"BURKHART, KIMBERLY, GANN",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1689601130,MOBILE AUDIOLOGY ASSOCIATES PC,HEALTHDRIVE AUDIOLOGY GROUP,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194067686,"DAVIES, LAURA, MARY",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 103 , 103 , 197 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194067892,"NAIL, KIMBERLY, DAWN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194067892,"NAIL, KIMBERLY, DAWN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194068122,"KNITTEL, ANDREA, KATHLEEN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194068122,"KNITTEL, ANDREA, KATHLEEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194068122,"KNITTEL, ANDREA, KATHLEEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 19 , 21 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194068676,"BEZOLD, SAMUEL, LENSING",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 114 , 122 , 122 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194068684,"BROYLES, BRADLEY, KEITH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194068817,"MORIARTY, JOHN, DANIEL",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0300X,Dental Providers,Dentist,Periodontics, 40 , 47 , 92 ," $11,494.40 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194068940,"MEHTA, AMI, SATISH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080H0002X,Allopathic & Osteopathic Physicians,Pediatrics,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 47 , 59 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1194068981,"PAMULAPATI, HEMA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1194068981,"PAMULAPATI, HEMA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1902801244,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194070961,"LECLAIR, DOUGLAS, GILES",1677 WESTBROOK PLAZA DR STE 190 WINSTON SALEM NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1194077479,"KITCHINGS, JOSEPH, CRAIG",215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#,,,$#,,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,8509 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1194077479,"KITCHINGS, JOSEPH, CRAIG",8509 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#,,,$#,,
MEDICAID DIRECT,1609386424,SPARTANBURG MEDICAL CENTER,MGC-ORTHOPAEDIC SURGERY- NORTH GROVE,1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194079467,"MCDERMOTT, JAMES, DAVID",1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",10207 CERNY ST   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",10207 CERNY ST   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 27 , 28 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194083527,"LLOYD, BENJAMIN, REMBOLD",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194087346,"NADEAU DUY, LINDSAY, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 356 , 502 , 574 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194087346,"NADEAU DUY, LINDSAY, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194087346,"NADEAU DUY, LINDSAY, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194091389,"NATHAN, MARGO, DIANA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194091389,"NATHAN, MARGO, DIANA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194091488,"CAPPELLETI, GIACOMO, LUIS",844 KEMPSVILLE RD STE 104 NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194098947,"KEENE, CORI, ANN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 54 , 88 ,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194100529,"YADAV, PRIYANKA, OMPRAKASH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194100529,"YADAV, PRIYANKA, OMPRAKASH",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 183 , 309 , 348 ," $12,758.26 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194102103,"MAKRIS, ELEFTHERIOS, A",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194102566,"WAGNER, ERIN, LESLIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194102566,"WAGNER, ERIN, LESLIE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 187 , 188 ," $11,037.37 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194103598,"STEPIEN, DAVID, MICHAEL",3475 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194103598,"STEPIEN, DAVID, MICHAEL",3475 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194103598,"STEPIEN, DAVID, MICHAEL",3475 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194103598,"STEPIEN, DAVID, MICHAEL",3475 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194103598,"STEPIEN, DAVID, MICHAEL",3475 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194104091,"MCGEE, JOHN, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194104091,"MCGEE, JOHN, PATRICK",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194104091,"MCGEE, JOHN, PATRICK",2450 EMERALD PL   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 169 , 256 ,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194105221,"COOLIDGE, NICHOLAS",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194105981,"COLE, EMILY, FAHRIG",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194106674,"DOUTAZ, JESSICA, J",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1194106716,"LI, NEILL, YUN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194106716,"LI, NEILL, YUN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194106716,"LI, NEILL, YUN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1194106716,"LI, NEILL, YUN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 48 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194106716,"LI, NEILL, YUN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194106716,"LI, NEILL, YUN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194106989,"BAGLEY, KIMBERLY, ANN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194107623,"PRIAMVADA, GARGI, SHARMA",2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 84 , 98 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194107623,"PRIAMVADA, GARGI, SHARMA",2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 28 , 32 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194107623,"PRIAMVADA, GARGI, SHARMA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 15 ,$#,,
MEDICAID DIRECT,1568186096,LONDRY & MODLIN XI DDS PLLC,BROAD RIVER DENTAL,1210 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194108282,"WALSH, JESSE, JOSEPH",1210 E MARION ST   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 30 , 62 , 198 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194110593,"SANAIHA, YAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194110593,"SANAIHA, YAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1194110882,"CASEY, DANA, LYNNE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194110882,"CASEY, DANA, LYNNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 26 , 44 , 74 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194111757,"PAREDES, DANIEL, ADOLFO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194111757,"PAREDES, DANIEL, ADOLFO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194111757,"PAREDES, DANIEL, ADOLFO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 44 , 63 , 63 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194111757,"PAREDES, DANIEL, ADOLFO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 46 , 46 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194111757,"PAREDES, DANIEL, ADOLFO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,446 "," 3,179 "," 11,124 "," $399,016.10 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 21 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 26 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 217 , 224 ," 2,232 "," $210,316.10 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1194112599,"CRISP, JENNIFER, DURHAM",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 92 , 106 , 412 ,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1194112987,"OSINUGA, EMMANUEL, TUNDE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 100 , 348 , 349 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1194113860,"LOVETTE, LESLIE, GENEVA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 157 , 243 , 290 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1194113860,"LOVETTE, LESLIE, GENEVA",1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194113860,"LOVETTE, LESLIE, GENEVA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 74 , 147 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1194113860,"LOVETTE, LESLIE, GENEVA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 24 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194116756,"TROYER, JOSHUA, ISAAC",1370 W D ST   N WILKESBORO NC,097,Wilkes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 31 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194116756,"TROYER, JOSHUA, ISAAC",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194118950,"TOK, OGUZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194118950,"TOK, OGUZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194119776,"ISAACS, RICARDO, O'MAR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194119776,"ISAACS, RICARDO, O'MAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194119776,"ISAACS, RICARDO, O'MAR",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194119776,"ISAACS, RICARDO, O'MAR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1194119776,"ISAACS, RICARDO, O'MAR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 41 , 43 , 48 ,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1194123646,"STRUTT, MARK, ALLEN",3812 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1194123646,"STRUTT, MARK, ALLEN",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194124073,"CRAIG, MELINDA, MCGHEE",600 GRESHAM DR STE 8630A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194126813,"TIDD, MICHELLE, LOUISE",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1194130039,"HOUSER, WINONA, SUE",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1194130039,"HOUSER, WINONA, SUE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 73 , 128 ,$#,,
MEDICAID DIRECT,1700901436,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1194130419,"HUNTER, MEGAN, ANDERSON",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1700901436,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1194130419,"HUNTER, MEGAN, ANDERSON",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 37 , 39 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194131342,"KUMARI, POOJA",9920 KINCEY AVE STE 120 HUNTERSVILLE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 14 , 26 , 26 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194131342,"KUMARI, POOJA",16525 HOLLY CREST LN STE 230 HUNTERSVILLE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194132084,"EDGERTON, COLSTON, ARTHUR",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 22 , 24 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194132084,"EDGERTON, COLSTON, ARTHUR",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 39 , 43 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194132084,"EDGERTON, COLSTON, ARTHUR",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 30 , 30 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194133561,"BROOKS, SARAH, HALEY",234 CROOKED CREEK PKWY STE 310 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194134783,"CLANCY, BRENDAN, CIAMPA",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137612,"JARVIS, DOUGLAS, LANDRY",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137612,"JARVIS, DOUGLAS, LANDRY",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 23 , 35 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137612,"JARVIS, DOUGLAS, LANDRY",1450 MATTHEWS TOWNSHIP PKWY STE 170 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1194137687,"LENOIR, BRADLEY, JOHN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137687,"LENOIR, BRADLEY, JOHN",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137687,"LENOIR, BRADLEY, JOHN",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137687,"LENOIR, BRADLEY, JOHN",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137687,"LENOIR, BRADLEY, JOHN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137687,"LENOIR, BRADLEY, JOHN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194137687,"LENOIR, BRADLEY, JOHN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1053906115,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GYN ONC,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194138925,"BUCKINGHAM, LINDSEY, KATHRYN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 36 , 59 , 67 ,$#,,
MEDICAID DIRECT,1053906115,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GYN ONC,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194138925,"BUCKINGHAM, LINDSEY, KATHRYN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053906115,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GYN ONC,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194138925,"BUCKINGHAM, LINDSEY, KATHRYN",107 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194139873,"WAYNICK, JOSHUA, LIVINGSTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194139881,"BLUM, EVAN, STUART",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194141325,FAIRVIEW VOLUNTEER FIRE DEPARTMENT,,1586 CHARLOTTE HWY   FAIRVIEW NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport,1194141325,FAIRVIEW VOLUNTEER FIRE DEPARTMENT,1586 CHARLOTTE HWY   FAIRVIEW NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport, 41 , 55 , 106 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194141416,"ALBRECHT, JESSICA, LYNN",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194141416,"ALBRECHT, JESSICA, LYNN",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1194141507,"PITMAN, LUCAS, ALAN",328 NEW LEICESTER HWY STE 150 ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194141507,"PITMAN, LUCAS, ALAN",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 67 , 150 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194141861,"MEMA, WISH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194141861,"MEMA, WISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194144063,"SCHAUMBERG, JORDAN, ENNS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194144063,"SCHAUMBERG, JORDAN, ENNS",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194144063,"SCHAUMBERG, JORDAN, ENNS",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1194144063,"SCHAUMBERG, JORDAN, ENNS",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1194144329,"ALBRIGHT, AUSTIN, LEBRON",81 MEDICAL PARK LOOP STE 202 SYLVA NC,050,Jackson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 35 , 108 , 135 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194144329,"ALBRIGHT, AUSTIN, LEBRON",262 LEROY GEORGE DR 1ST FLOOR RADIOLOGY CLYDE NC,044,Haywood,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 173 , 495 , 589 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,,,Unknown,193200000X,Group,Multi-Specialty,,1194144329,"ALBRIGHT, AUSTIN, LEBRON",81 MEDICAL PARK LOOP STE 202 SYLVA NC,050,Jackson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10208 CERNY ST STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194147165,"OZYURT, SAKINE",10208 CERNY ST STE 110 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 97 , 150 , 220 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194147165,"OZYURT, SAKINE",10208 CERNY ST STE 110 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 39 , 66 , 82 ,$#,,
MEDICAID DIRECT,1477538254,PORT HEALTH SERVICES,~,2602 COURTIER DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194150060,"EDWARDS, CHRISTOPHER, NOEL",2602 COURTIER DR   GREENVILLE NC,074,Pitt,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194154328,"SALYER, JESSICA, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 83 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194154328,"SALYER, JESSICA, ELIZABETH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 59 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194154328,"SALYER, JESSICA, ELIZABETH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194156299,"KROGH, APRIL, SUZETTE",6020 FAYETTEVILLE RD TRIANGLE FAMILY PRACTICE DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 32 , 62 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1194159293,"CHUKKA, VARUN, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 131 , 132 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194159293,"CHUKKA, VARUN, KUMAR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1194159293,"CHUKKA, VARUN, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 28 , 28 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194159293,"CHUKKA, VARUN, KUMAR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194159293,"CHUKKA, VARUN, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 302 , 303 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1194159293,"CHUKKA, VARUN, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194159293,"CHUKKA, VARUN, KUMAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194159558,"BREWER, ELIZABETH, NYE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194159558,"BREWER, ELIZABETH, NYE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1194159681,"COX, RACHEL, LAMB",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1194159681,"COX, RACHEL, LAMB",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 51 , 61 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1194159681,"COX, RACHEL, LAMB",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194160457,"SINGH, NEERAJ",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 20 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 34 , 43 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194161182,"ROBERTSON, JOSHUA, NOELL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 17 , 24 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194161323,"SEMINARA, BRITTANY, VENCI",16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194161323,"SEMINARA, BRITTANY, VENCI",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194161323,"SEMINARA, BRITTANY, VENCI",101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194161323,"SEMINARA, BRITTANY, VENCI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194161323,"SEMINARA, BRITTANY, VENCI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194161323,"SEMINARA, BRITTANY, VENCI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1194161414,"LANGLEY, JILL, DEANNE",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 106 , 275 , 419 ," $25,695.21 ",,
MEDICAID DIRECT,1952075335,SMOKY MOUNTAIN URGENT CARE,,120 VETERANS BLVD   BRYSON CITY NC,087,Swain,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194161414,"LANGLEY, JILL, DEANNE",120 VETERANS BLVD   BRYSON CITY NC,087,Swain,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1407295447,SMOKY MOUNTAIN URGENT CARE,~,120 VETERANS BLVD   BRYSON CITY NC,087,Swain,193400000X,Group,Single Specialty,,1194161414,"LANGLEY, JILL, DEANNE",120 VETERANS BLVD   BRYSON CITY NC,087,Swain,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194161448,"HARMON, TANISHA, VONCHERE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 20 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,106 ALEXANDER BANK DR STE 300 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194162891,"CARPER, EMILY, FRANCES",106 ALEXANDER BANK DR STE 300 MOORESVILLE NC,049,Iredell,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,,,$#,,
MEDICAID DIRECT,1356802300,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - MOCKSVILLE,172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194164251,"VOGLER, SARAH, FARRELL",172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194168906,"MCQUINN, CHRISTOPHER, WILLIAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194168906,"MCQUINN, CHRISTOPHER, WILLIAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194168906,"MCQUINN, CHRISTOPHER, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 32 , 48 , 73 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3713 BENSON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194168906,"MCQUINN, CHRISTOPHER, WILLIAM",3713 BENSON DR   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 41 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194171223,"LESTER, RACHAEL, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194171223,"LESTER, RACHAEL, ANN",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 33 , 86 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 5200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194171272,"HALL, LANDON, FORREST",1 HOSPITAL DR STE 5200 ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194171272,"HALL, LANDON, FORREST",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 20 , 28 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194171660,"MEMARIAN, SHADMAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 56 , 56 ,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194171702,"VINOGRAD, MAX, JOSEPH",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 70 , 101 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194173310,"BHIMANI, SMEET, RAMESH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 89 , 91 , 96 ,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1194173997,"TENCH, DAPHNEY, MALONE",1220 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,159 E DALLAS RD   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1194173997,"TENCH, DAPHNEY, MALONE",159 E DALLAS RD   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 27 , 48 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194174474,"TAAM-AKELMAN, ROSALEA, KAI-JEN",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194174474,"TAAM-AKELMAN, ROSALEA, KAI-JEN",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 45 , 52 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194174474,"TAAM-AKELMAN, ROSALEA, KAI-JEN",719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194174474,"TAAM-AKELMAN, ROSALEA, KAI-JEN",719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194175505,"MAKOID, TERENCE, JOSEPH",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 51 , 51 , 64 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194175505,"MAKOID, TERENCE, JOSEPH",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1194175562,"CRISONA, FRANK, JOSEPH",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1194175562,"CRISONA, FRANK, JOSEPH",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194175729,"KING, CHASE, WILLIAM",1010 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194175729,"KING, CHASE, WILLIAM",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194176875,"MOIDEEN, NITHASHA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1194177089,"THOMPSON, JORDAN, BEAM",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 52 , 55 ,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1194179143,"DEACON, SARA, BROOKE",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1194179143,"DEACON, SARA, BROOKE",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 107 , 169 , 242 ,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1194179143,"DEACON, SARA, BROOKE",29 NETTLEWOOD DR   ASHEVILLE NC,011,Buncombe,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1194179432,INDIVIDUALIZED TREATMENT SOL LLC,WOODARDS ADULT DAY HEALTH CENTER,115 HOLDEN BEACH RD SW   SHALLOTTE NC,010,Brunswick,251B00000X,Agencies,Case Management,,1194179432,INDIVIDUALIZED TREATMENT SOL LLC,115 HOLDEN BEACH RD SW   SHALLOTTE NC,010,Brunswick,251B00000X,Agencies,Case Management,,#, 829 , 829 ," $35,516.74 ",,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1194179473,"BOTTOMS, PAIGE, RAY",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194179473,"BOTTOMS, PAIGE, RAY",2080 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194179473,"BOTTOMS, PAIGE, RAY",2080 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194179671,"LAWRENCE, CHRISTIAN, BLAKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 83 , 83 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194182170,"LE, MARCIE, WARNER",1321 E SUNSET DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1801481940,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PHYSICAL THERAPY & SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1194182915,"PATEL, MAHESH, KUMAR",701 LIBERTY ST   RAMSEUR NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1801481940,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PHYSICAL THERAPY & SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1194182915,"PATEL, MAHESH, KUMAR",503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 42 , 107 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194184077,"DIBBLE, QURRATUL-AYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194184077,"DIBBLE, QURRATUL-AYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194184432,"JONES, ALLISON, LOVE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 46 , 130 , 132 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194184432,"JONES, ALLISON, LOVE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1851331359,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS CHARLOTTE,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194184432,"JONES, ALLISON, LOVE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194184523,"QUAGRAINE, JULIANA, EFUA",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 24 , 27 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194188193,"FOLEY, ELIZA, J.",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194188557,"PRASADA, HECHU, LI",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1194188557,"PRASADA, HECHU, LI",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194189886,"KREAFLE, JOHANNA, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194189886,"KREAFLE, JOHANNA, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 59 , 89 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194189886,"KREAFLE, JOHANNA, ELIZABETH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194189886,"KREAFLE, JOHANNA, ELIZABETH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194189886,"KREAFLE, JOHANNA, ELIZABETH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194189886,"KREAFLE, JOHANNA, ELIZABETH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1194192294,REVIVE BOOST REBUILD PT,,1300 CORPORATION PKWY STE B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194192294,REVIVE BOOST REBUILD PT,1300 CORPORATION PKWY STE B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 54 , 581 ," 1,393 "," $53,660.30 ",,
MEDICAID DIRECT,1194192500,MOUNT EAGLE HEALTH CARE GREENSBORO,,925 S KERR AVE STE I-4 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1194192500,MOUNT EAGLE HEALTH CARE GREENSBORO,925 S KERR AVE STE I-4 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 5,562 "," 5,614 "," $389,421.64 ",,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194192864,"JEUTTER, KATHRYN, BAILEY",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 26 , 45 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1194192864,"JEUTTER, KATHRYN, BAILEY",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194192864,"JEUTTER, KATHRYN, BAILEY",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 42 , 59 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194196477,"TAMMENGA, AMY, MARIE",796 DOCTORS CT   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194196477,"TAMMENGA, AMY, MARIE",2400 PRATT ST STE 110 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194196477,"TAMMENGA, AMY, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194198234,"QU, YING",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194198234,"QU, YING",3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194198853,"REISNER, JESSICA, HEMBY",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,11530 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194198853,"REISNER, JESSICA, HEMBY",11530 PROVIDENCE RD STE 2300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194199349,"COFFMAN, JAKE, ANDREW",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 22 , 24 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194199349,"COFFMAN, JAKE, ANDREW",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 142 , 167 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194202879,"DESILLIER, JONATHAN, NICHOLAS",6 DOCTORS CIR STE 5 SUPPLY NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 67 , 129 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194202879,"DESILLIER, JONATHAN, NICHOLAS",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194207605,"PARNELL, KRISTEN, LEA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1700202066,DESIREE T PALMER DMD PA,~,105 NEWSOM ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194210153,"HARRIS, BRITTANIE, JANELL",105 NEWSOM ST STE 204 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 204 , 422 ," 1,390 "," $61,569.48 ",,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194210179,"BADU, IRISHA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 82 , 82 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194210179,"BADU, IRISHA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194210310,"WU, LINGLING",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 86 , 202 , 202 ," $10,469.69 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194210500,"TODD, MOLLY, JANE",738 NEWMAN RD   NEW BERN NC,025,Craven,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 28 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1194210526,"RAHMAN, MAHMUDUR",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194210526,"RAHMAN, MAHMUDUR",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1194210526,"RAHMAN, MAHMUDUR",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 23 , 23 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194210526,"RAHMAN, MAHMUDUR",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1194211672,"PRAKASH, AMULYA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194211672,"PRAKASH, AMULYA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194211672,"PRAKASH, AMULYA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194211672,"PRAKASH, AMULYA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 37 , 37 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194211672,"PRAKASH, AMULYA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 116 , 116 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1194211672,"PRAKASH, AMULYA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 141 , 141 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194211714,"KENNEDY, BRANDI, GALLAHER",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194211714,"KENNEDY, BRANDI, GALLAHER",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 48 , 60 ," $10,060.62 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194211714,"KENNEDY, BRANDI, GALLAHER",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194211714,"KENNEDY, BRANDI, GALLAHER",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194211714,"KENNEDY, BRANDI, GALLAHER",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194211714,"KENNEDY, BRANDI, GALLAHER",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 53 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194212001,"HENSON, SAMANTHA, MITCHELL",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194212001,"HENSON, SAMANTHA, MITCHELL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194212001,"HENSON, SAMANTHA, MITCHELL",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649216631,PIEDMONT EAR NOSE AND THROAT PA,PIEDMONT EAR NOSE AND THROAT ASSOCIATES,110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194213876,"CRENSHAW, JOHN, ANDREW",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 77 , 99 , 144 ,$#,,
MEDICAID DIRECT,1497187595,PIEDMONT HEALTH SERVICES INC,~,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194217638,"MCTIGUE, KATHRYN, DAVIS",301 LLOYD ST   CARRBORO NC,068,Orange,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1851723951,PIEDMONT HEALTH SERVICES INC,MONCURE CHC DENTAL,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194217638,"MCTIGUE, KATHRYN, DAVIS",301 LLOYD ST   CARRBORO NC,068,Orange,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#, 21 ,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194217638,"MCTIGUE, KATHRYN, DAVIS",301 LLOYD ST   CARRBORO NC,068,Orange,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1124450226,PIEDMONT HEALTH SERVICES INC,~,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194217638,"MCTIGUE, KATHRYN, DAVIS",301 LLOYD ST   CARRBORO NC,068,Orange,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1144652249,PIEDMONT HEALTH SERVICES INC,~,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194217638,"MCTIGUE, KATHRYN, DAVIS",301 LLOYD ST   CARRBORO NC,068,Orange,1223D0001X,Dental Providers,Dentist,Dental Public Health, 362 , 557 ," 1,542 "," $63,797.78 ",,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194219006,"HUFF, DANIEL, CHRISTOPHER",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194219006,"HUFF, DANIEL, CHRISTOPHER",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 14 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194219972,"NESARAJ, ALFRED",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194219972,"NESARAJ, ALFRED",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1194219972,"NESARAJ, ALFRED",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194219972,"NESARAJ, ALFRED",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1194219972,"NESARAJ, ALFRED",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194221192,"NOEL, TAYLOR, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194221929,"SHOEMAKER, EDWIN, NEAL",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 31 , 43 , 60 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194221929,"SHOEMAKER, EDWIN, NEAL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1194222067,"WHAM, BRADLEY, COMPTON",1915 LENDEW ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 45 , 69 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194222869,"BENTLEY, JESSICA, JANE",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 27 , 31 , 42 ," $16,911.16 ",,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1194222869,"BENTLEY, JESSICA, JANE",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1194222869,"BENTLEY, JESSICA, JANE",25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 54 , 73 , 274 ," $12,677.40 ",,
MEDICAID DIRECT,1114919206,SKYLAND PROSTHETICS AND ORTHOTICS I,SKYLAND PROSTHETICS AND ORTHOTICS INC,3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194224808,"SALYERS, JOHNSIE",3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,229N00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Anaplastologist,,#,#,#,$#,,
MEDICAID DIRECT,1114919206,SKYLAND PROSTHETICS AND ORTHOTICS I,SKYLAND PROSTHETICS AND ORTHOTICS INC,3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194224808,"SALYERS, JOHNSIE",3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194226514,"MOGER, MARIAH, JAE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1730225392,CHARLES W JONES MD PA,~,200 HOSPITAL AVE STE 5 JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1194228833,"PHILLIPS, SEBRINA, HAMM",200 HOSPITAL AVE STE 5 JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 108 , 110 ,$#,,
MEDICAID DIRECT,1194230573,VALLEYGATE DENTAL SURGERY CENTERS O,~,510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1194230573,VALLEYGATE DENTAL SURGERY CENTERS O,510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 69 , 70 , 73 ," $203,589.59 ",,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194232546,"AHMED, HAMZA",448 CRANBERRY ST   NEWLAND NC,006,Avery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194232546,"AHMED, HAMZA",448 CRANBERRY ST   NEWLAND NC,006,Avery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 72 , 91 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194234161,"TSENG, SWEIEMY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194234161,"TSENG, SWEIEMY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 31 , 73 , 83 ," $10,429.89 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194234161,"TSENG, SWEIEMY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1194234161,"TSENG, SWEIEMY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1194235671,"HOLCOMBE, ZACHARY, SCOTT",ZACHARY S HOLCOMBE DMD,1944 HENDERSONVILLE RD STE B2 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1194235671,"HOLCOMBE, ZACHARY, SCOTT",1944 HENDERSONVILLE RD STE B2 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 170 , 363 ," 1,037 "," $55,648.03 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194237750,"MORNING, LAQUEITA, QUARZETTE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194237750,"MORNING, LAQUEITA, QUARZETTE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194237750,"MORNING, LAQUEITA, QUARZETTE",2100 STANTONSBURG RD HOSPITALIST STE 1AD200 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 39 , 40 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194237750,"MORNING, LAQUEITA, QUARZETTE",2100 STANTONSBURG RD HOSPITALIST STE 1AD200 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194237750,"MORNING, LAQUEITA, QUARZETTE",2100 STANTONSBURG RD HOSPITALIST STE 1AD200 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194237750,"MORNING, LAQUEITA, QUARZETTE",2100 STANTONSBURG RD HOSPITALIST STE 1AD200 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194237750,"MORNING, LAQUEITA, QUARZETTE",2100 STANTONSBURG RD HOSPITALIST STE 1AD200 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,193200000X,Group,Multi-Specialty,,1194238352,"MCNALLY, CHELSEA, ROSE",700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194243204,"GLECKLER, ELIZABETH, KINCAID",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194243204,"GLECKLER, ELIZABETH, KINCAID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194245167,"MADIGAN, MICHAEL, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 138 , 178 , 208 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194245167,"MADIGAN, MICHAEL, JOSEPH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194245167,"MADIGAN, MICHAEL, JOSEPH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES PA,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1194245712,"CLINARD, CAMERON, WATERS",1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 22 , 29 ,$#,,
MEDICAID DIRECT,1750333126,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES,918 7TH AVE   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1194245712,"CLINARD, CAMERON, WATERS",918 7TH AVE   GARNER NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194247668,"PEPPERS, WALTER, JOHN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 48 , 48 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194247668,"PEPPERS, WALTER, JOHN",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194250704,"KLEIN, KLARA, RACHEL",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 18 , 23 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194250704,"KLEIN, KLARA, RACHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194250704,"KLEIN, KLARA, RACHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194250704,"KLEIN, KLARA, RACHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1972766459,NORTH GEORGIA MEDICINE LLC,NORTH GEORGIA FAMILY MEDICINE,346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194252783,"SOELIMTO, RONALD",346 DEEP SOUTH FARM RD STE A BLAIRSVILLE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194255000,"RIBEIRO, MELISSA, AMY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 42 , 72 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194255000,"RIBEIRO, MELISSA, AMY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194255000,"RIBEIRO, MELISSA, AMY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 49 , 69 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194255000,"RIBEIRO, MELISSA, AMY",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194255000,"RIBEIRO, MELISSA, AMY",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194255000,"RIBEIRO, MELISSA, AMY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1952611543,FAMILY FOOT AND ANKLE PHYSICIANS,FAMILY FOOT AND ANKLE PHYSICIANS,1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194257345,"JONES, BRIAN, LEE",1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 335 , 683 , 867 ," $16,255.79 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194257774,"REISER, JULIA, ALICE",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,800 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1194259341,"FERNANDEZ, MATTHEW, JORGE",800 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 20 , 22 , 34 ,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1194259341,"FERNANDEZ, MATTHEW, JORGE",150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 115 , 200 , 292 ,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,800 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1194259341,"FERNANDEZ, MATTHEW, JORGE",150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 21 , 22 , 31 ,$#,,
MEDICAID DIRECT,1194260919,COMPASS PHYSICAL THERAPY LLC,,2170 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1194260919,COMPASS PHYSICAL THERAPY LLC,2170 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,#, 52 , 81 ,$#,,
MEDICAID DIRECT,1669443487,CLECO PRIMARY CARE NETWORK,CLECO MEDICAL CENTER OF SHELBY,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194262436,"RODGERS, ANNE, TUCKER",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1043963564,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - FALLSTON,5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194262436,"RODGERS, ANNE, TUCKER",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194262436,"RODGERS, ANNE, TUCKER",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 81 , 90 ,$#,,
MEDICAID DIRECT,1659351724,CLECO PRIMARY CARE NETWORK,UPPER CLEVELAND MEDICAL CENTER,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194262436,"RODGERS, ANNE, TUCKER",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194262436,"RODGERS, ANNE, TUCKER",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043963564,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - FALLSTON,5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194262436,"RODGERS, ANNE, TUCKER",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 66 , 79 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194262675,"TAYLOR, BRADLEY, STEVEN",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194262675,"TAYLOR, BRADLEY, STEVEN",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 45 , 77 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194262675,"TAYLOR, BRADLEY, STEVEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194262675,"TAYLOR, BRADLEY, STEVEN",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194262675,"TAYLOR, BRADLEY, STEVEN",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194262675,"TAYLOR, BRADLEY, STEVEN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194262675,"TAYLOR, BRADLEY, STEVEN",1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194264382,"WILLIAMS, ROSS, MCKELVEY",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194264382,"WILLIAMS, ROSS, MCKELVEY",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194264382,"WILLIAMS, ROSS, MCKELVEY",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194264382,"WILLIAMS, ROSS, MCKELVEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194264382,"WILLIAMS, ROSS, MCKELVEY",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194240671,WRIGHT AND ASSOCIATES IX DDS PA,,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194266072,"ALBRECHT, ASHLEY, ROGERS",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1841694254,LANE AND ASSOCIATES XXVIII DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1194266072,"ALBRECHT, ASHLEY, ROGERS",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 314 , 623 , 713 ," $96,044.06 ",,
MEDICAID DIRECT,1194252874,WRIGHT AND ASSOCIATES IV DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1194266072,"ALBRECHT, ASHLEY, ROGERS",920 W HAMLET AVE   HAMLET NC,077,Richmond,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 334 ," 1,034 "," 1,237 "," $174,554.21 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194266965,"UMBEL, BENJAMIN, DAVID",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 43 , 76 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194266965,"UMBEL, BENJAMIN, DAVID",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 83 , 132 , 268 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194267815,"BRITTLE, JORDAN, CREE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194267815,"BRITTLE, JORDAN, CREE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194269241,"WARD, KIMBERLY, DAWN",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194269241,"WARD, KIMBERLY, DAWN",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 44 , 69 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194271932,"EVANS, ZACHARY, STEVEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194272476,"MAHAJAN, RUCHI GUPTA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194274100,"CANTER, JUSTIN, ADAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 55 , 55 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194274480,"POPOOLA, OLAPEJU, ADETAYO",512 VILLAGE RD STE 104 SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194274480,"POPOOLA, OLAPEJU, ADETAYO",204 SMITH AVE   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194280289,"YOUNG, REBECCA, KLEIN",150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1194280644,"MCCARTY, ERIN",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 34 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1194280644,"MCCARTY, ERIN",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194283416,"RICKETT, STEVEN, JAMES",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033877592,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DILLON FAMILY MEDICINE,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194284117,"SMALL, LAUREN, BAILEY",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194284216,"REVENIS, JESSE",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194284216,"REVENIS, JESSE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194284216,"REVENIS, JESSE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194284216,"REVENIS, JESSE",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194284216,"REVENIS, JESSE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194284216,"REVENIS, JESSE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194284216,"REVENIS, JESSE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194285171,"SPINARIS, REBECCA, MARIE",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194285171,"SPINARIS, REBECCA, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 63 , 115 , 168 ,$#,,
MEDICAID DIRECT,1841644531,APPALACHIAN MOUNTAIN COMMUNITY HEAL,SYLVA COMMUNITY HEALTH CENTER,154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194285510,"MUNJAL, ANJULI, ROSE",154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194285510,"MUNJAL, ANJULI, ROSE",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1356069819,APPALACHIAN MOUNTAIN COMMUNITY HEAL,,419 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194285510,"MUNJAL, ANJULI, ROSE",419 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194285510,"MUNJAL, ANJULI, ROSE",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 28 , 36 ,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194285510,"MUNJAL, ANJULI, ROSE",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194285601,"ARFEEN, SARAH, NAZIA",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1194285734,PT BIRTH 2 BOOMERS LLC,,364 US 70 W STE 3 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1194285734,PT BIRTH 2 BOOMERS LLC,364 US 70 W STE 3 MARION NC,059,McDowell,193400000X,Group,Single Specialty,, 44 , 371 , 739 ," $34,419.12 ",,
MEDICAID DIRECT,1194285734,PT BIRTH 2 BOOMERS LLC,,136 N LOGAN ST STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1194285734,PT BIRTH 2 BOOMERS LLC,136 N LOGAN ST STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,, 26 , 381 , 753 ," $34,460.62 ",,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194285973,"STIFF, KATHERINE, MARIE",9735 KINCEY AVE STE 102 HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194285973,"STIFF, KATHERINE, MARIE",335 PENNY LANE   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 15 , 16 , 33 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194286716,"MEOLA, DANIELLE, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194286716,"MEOLA, DANIELLE, MARIE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194287672,"ALTONJI, SAMUEL, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194287672,"ALTONJI, SAMUEL, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194287672,"ALTONJI, SAMUEL, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194288241,"FARMER, TONYA, DENISE",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 44 , 44 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1194288241,"FARMER, TONYA, DENISE",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 38 , 39 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1194288241,"FARMER, TONYA, DENISE",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194288241,"FARMER, TONYA, DENISE",447 S SHARON AMITY RD STE 250 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194288241,"FARMER, TONYA, DENISE",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194288308,"HARVEY, MARNI, KREHNBRINK",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 63 , 111 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1194288415,"BOOTH, CORTNEY, RAYE",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1194288415,"BOOTH, CORTNEY, RAYE",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1194288415,"BOOTH, CORTNEY, RAYE",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 28 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194288738,"DENGLER, ERIN, GRETCHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194288738,"DENGLER, ERIN, GRETCHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 43 , 49 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194294678,"KARDOUNI, NIKKI",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194294769,"MCCUE, JESSICA, LYNN",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194294769,"MCCUE, JESSICA, LYNN",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 91 , 116 , 127 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194297689,"LOCKLEAR, JONATHAN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194297689,"LOCKLEAR, JONATHAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194298554,"WHITMAN, KYLE, PHILLIP",12611 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194298554,"WHITMAN, KYLE, PHILLIP",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 41 , 64 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194298554,"WHITMAN, KYLE, PHILLIP",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194298554,"WHITMAN, KYLE, PHILLIP",1450 MATTHEWS TOWNSHIP PKWY STE 170 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194302265,"DANIEL, LIZA, WHITLI",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 50 , 98 , 100 ," $13,706.21 ",,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194302265,"DANIEL, LIZA, WHITLI",303 GREEN ST E   WILSON NC,098,Wilson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194302778,"WENGER, TYLER, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 30 , 30 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1194302778,"WENGER, TYLER, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 87 , 87 ,$#,,
MEDICAID DIRECT,1780637850,MIDWAY MEDICAL CENTER CANTON,MIDWAY MEDICAL CENTER,6750 CAROLINA BLVD   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194303461,"VARNER, JOSEPH, DAVID",6750 CAROLINA BLVD   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 24 , 53 ,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194304162,"GODWIN, CHARLES, EDWARD",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194307587,"HENDRICKS, SYDNEY, LAUREN",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194307587,"HENDRICKS, SYDNEY, LAUREN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194307918,"SIKES, VICKI, MARIE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1194307942,"DINKINS, QUINESHA, NAQUIE",106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033565007,STAR MEDICAL CLINIC PLLC,,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1194310078,"JEWELL, JENNIFER, LEIGH",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 84 , 156 ,$#,,
MEDICAID DIRECT,1194310235,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH EAR NOSE AND THROAT,124 N PARK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1194310235,AMERICAN HEALTHCARE SYSTEMS LLC,124 N PARK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,, 28 , 28 , 38 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1194310524,"BROOKS, JULIE, MICHELLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194310524,"BROOKS, JULIE, MICHELLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194311092,"STEFANOVIC, DANIJELA",485 VALLEY RD   MOCKSVILLE NC,030,Davie,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,,,Unknown,193200000X,Group,Multi-Specialty,,1194312496,"CULLOP, MEREDITH, ASHLEY OLDHAM",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194313627,"AGNER, LAUREN, ELIZABETH",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194313627,"AGNER, LAUREN, ELIZABETH",501 N MAIN ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 73 , 77 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194315135,"BRISTOL BARTLEY, PALOMA, ANTONIA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 56 , 58 , 178 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194315135,"BRISTOL BARTLEY, PALOMA, ANTONIA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 821 ," 1,328 "," 4,104 "," $180,818.43 ",,
MEDICAID DIRECT,1245441864,"BARNARD, JULIA, ANNE",,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1194315135,"BRISTOL BARTLEY, PALOMA, ANTONIA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194315135,"BRISTOL BARTLEY, PALOMA, ANTONIA",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 448 , 474 ," 2,243 "," $57,103.53 ",,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194317412,"CRAIG, LAURA, DEANNE",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 49 , 108 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194317412,"CRAIG, LAURA, DEANNE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1194317412,"CRAIG, LAURA, DEANNE",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194317412,"CRAIG, LAURA, DEANNE",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194319806,"REED, SANDRA, BENNETT",241 NC HIGHWAY16 S   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1104388263,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - TAYLORSVILLE,50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194319806,"REED, SANDRA, BENNETT",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,241 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1194319806,"REED, SANDRA, BENNETT",241 NC HIGHWAY16 S   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1194321760,INGLES MARKETS INC,INGLES PHARMACY 008,550 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1194321760,INGLES MARKETS INC,550 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1194324756,"CHURCH, RAEGAN, MCNEIL",8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1194331116,GREENLEAF HOMECARE LLC,~,1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1194331116,GREENLEAF HOMECARE LLC,1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 3,701 "," 3,701 "," $233,673.72 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194334417,"HARGETT, SARAH, LYNN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194334417,"HARGETT, SARAH, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710678941,ANDREW R TREECE OD PA,PROVISION FAMILY EYECARE OPTOMETRY,1808 E INNES ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1194336214,"FARLEY, BRIANNA, RHAYE",1808 E INNES ST   SALISBURY NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194338541,"ROWE, WILLIAM, BEAUREGARD",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194338541,"ROWE, WILLIAM, BEAUREGARD",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548740038,INDYCARE MEDICAL NORTH CAROLINA,~,1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194342352,"CUNNINGHAM, LAUREN, ABBY",1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 51 , 94 ,$#,,
MEDICAID DIRECT,1548740038,INDYCARE MEDICAL NORTH CAROLINA,~,110 BOONE SQUARE ST STE 29A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1194342352,"CUNNINGHAM, LAUREN, ABBY",930 W WILSON AVE   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194344341,HEART TO HEART FAMILY CARE HOME,,131 HUNTINGTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194344341,HEART TO HEART FAMILY CARE HOME,131 HUNTINGTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,844 "," 1,844 "," $115,159.55 ",,
MEDICAID DIRECT,1194344341,HEART TO HEART FAMILY CARE HOME,,221 E BARBEE ST   ZEBULON NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194344341,HEART TO HEART FAMILY CARE HOME,221 E BARBEE ST   ZEBULON NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 50 , 50 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194344762,"PENNINGTON-TRIPP, ELIZABETH, ASHLEY",35 FACILITY DR   CLYDE NC,044,Haywood,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 24 , 43 , 66 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1194344762,"PENNINGTON-TRIPP, ELIZABETH, ASHLEY",35 FACILITY DR   CLYDE NC,044,Haywood,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1578987848,UNC PHYSICIANS NETWORK LLC,~,7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194345587,"PARKER, WILLIAM, FRANCIS",7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 22 , 51 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1194345587,"PARKER, WILLIAM, FRANCIS",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194345587,"PARKER, WILLIAM, FRANCIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194348946,"POWE, JUAN, JUSTIN",2913 WAKE FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 34 ,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194348946,"POWE, JUAN, JUSTIN",2913 WAKE FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,115 KILDAIRE PARK DR STE 309 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194348946,"POWE, JUAN, JUSTIN",2913 WAKE FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194349340,"FEATHERSTONE, JANNA, KRISTEN",236 MARKET ST STE 110 LOCUST NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 67 , 152 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194349340,"FEATHERSTONE, JANNA, KRISTEN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295012565,MED FIRST IMMEDIATE CARE AND FAMILY,Med First Immediate Care and Family Practice PA,325 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194350827,"HARRINGTON, AMANDA, ALLISON",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194350827,"HARRINGTON, AMANDA, ALLISON",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194351262,"PELLETIER, DEIDRE, JEAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 233 , 237 ,$#,,
MEDICAID DIRECT,1154189694,A1 FAMILY MULTISPECIALTY CARE PLLC,A1 FAMILY MULTISPECIALTY CARE,1507 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1194352732,"SINGH, JASMIN",1507 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 19 , 27 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194353581,"DOMINGUEZ, COURTNEY, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194353581,"DOMINGUEZ, COURTNEY, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194355438,CARE YOU CAN AFFORD LLC,,604 MAGNOLIA DR   ABERDEEN NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,1194355438,CARE YOU CAN AFFORD LLC,604 MAGNOLIA DR   ABERDEEN NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,#, 829 , 983 ," $157,659.88 ",,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194356378,"OPACK, MELANIE, ANN",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 53 , 100 , 115 ," $13,244.03 ",,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194356378,"OPACK, MELANIE, ANN",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194360511,"SNOWDEN, SEAN, MICHAEL",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 90 , 90 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194360511,"SNOWDEN, SEAN, MICHAEL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194360511,"SNOWDEN, SEAN, MICHAEL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194360891,"IREGBU, STELLA, UGOCHI",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 140 , 181 ,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194360891,"IREGBU, STELLA, UGOCHI",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1578176723,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194371294,"CONSTANTINO, CARA, LYNNE",134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194371294,"CONSTANTINO, CARA, LYNNE",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194373217,"PETTYGROVE, LOUIS, WHEELER",3949 BROWNING PL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194374447,"HARNER, JESSICA, ANN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1194374447,"HARNER, JESSICA, ANN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194374793,"SHAH, CATHERINE, DUFFY",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194374793,"SHAH, CATHERINE, DUFFY",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194374793,"SHAH, CATHERINE, DUFFY",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194374793,"SHAH, CATHERINE, DUFFY",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689726101,OCRACOKE HEALTH CENTER INC,OCRACOKE HEALTH CENTER INC,305 BACK RD   OCRACOKE NC,048,Hyde,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194375584,"MILLER, ANGELA, KAYE",305 BACK RD   OCRACOKE NC,048,Hyde,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194375691,"DHALIWAL, AMANPREET, SINGH",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194375691,"DHALIWAL, AMANPREET, SINGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194376541,GAHC3 NORTH RALEIGH NC TRS SUB LLC,CADENCE NORTH RALEIGH,5219 OLD WAKE FOREST RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194376541,GAHC3 NORTH RALEIGH NC TRS SUB LLC,5219 OLD WAKE FOREST RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 241 , 241 ," $15,150.32 ",,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194379891,"DEMICHELE, DONALD, RICHARD",111 E INDUSTRY DR   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194379891,"DEMICHELE, DONALD, RICHARD",111 E INDUSTRY DR   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 104 , 116 , 392 ," $18,139.72 ",,
MEDICAID DIRECT,1013300383,"JOHNSON, JULIE, RANDOLPH",,236 N MEBANE ST STE 123 BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1194382945,MOBILE FNP JRJOHNSON PLLC,110 N FRANKLIN ST   MADISON NC,079,Rockingham,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1215176524,BLUE SKY PEDIATRICS ASHEVILLE PA,BLUE SKY PEDIATRICS ASHEVILLE PA,5 WALDEN RIDGE DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194383620,"HAMILTON, MARY, MORGAN",5 WALDEN RIDGE DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 52 , 117 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194384024,"BEJLERI, ULIND",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 40 , 41 ,$#,,
MEDICAID DIRECT,1235825514,RIVER OF HOPE BEHAVIORAL HEALTH AND,,79 WOODFIN PL STE 208 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194385229,"ISBELL, MARISA, ANNE",79 WOODFIN PL STE 208 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 33 , 55 ,$#,,
MEDICAID DIRECT,1235825514,RIVER OF HOPE BEHAVIORAL HEALTH AND,,,,Unknown,193400000X,Group,Single Specialty,,1194385229,"ISBELL, MARISA, ANNE",356 BILTMORE AVE STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235825514,RIVER OF HOPE BEHAVIORAL HEALTH AND,,79 WOODFIN PL STE 208 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194385229,"ISBELL, MARISA, ANNE",79 WOODFIN PL STE 212 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1194385872,"CLARK, ALEXANDER, JAY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1194385872,"CLARK, ALEXANDER, JAY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 51 , 61 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 90 , 85 , 96 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1194385872,"CLARK, ALEXANDER, JAY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194385872,"CLARK, ALEXANDER, JAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 99 , 110 , 126 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194386136,"STREET, BRITTANY, KNICELY",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 146 , 311 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1194386136,"STREET, BRITTANY, KNICELY",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194386136,"STREET, BRITTANY, KNICELY",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 21 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1194386243,"ROE, ALLISON, PATRICIA",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 100 , 168 , 239 ," $35,956.27 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194387100,"ZAKHIA, KARL",1208 EASTCHESTER DR STE 108 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 108 , 127 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194388165,"LOWERY, BLAIR, NEIMAN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1568822104,ANDREW R OBLINGER DDS PA,OBLINGER FAMILY DENTISTRY,225 S HAWTHORNE ST   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1194388785,"LEIGHTON, MORGAN, RACHEL",225 S HAWTHORNE ST   MOUNT HOLLY NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 37 , 104 ,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194389353,"SERAFEN, KATHERINE, MADISON",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194390823,"RODRIGUEZ, CHRISTIAN, ALBERTO",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194392225,"NAYLOR, LUKE, CHRISTOPHER",329 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194392225,"NAYLOR, LUKE, CHRISTOPHER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194392506,"MOONEY, RAVEEN, SHUNDRELL",1916 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518393560,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1194392506,"MOONEY, RAVEEN, SHUNDRELL",1916 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1194392969,"ZEKAR, LARA",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 93 , 102 , 148 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194395103,"PATTERSON, VICTORIA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 27 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194399709,"GARCIA, JOSELLINE, IVETH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1194400150,"HUYNH, TAYLOR, LAUREN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1194400150,"HUYNH, TAYLOR, LAUREN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 63 , 70 ,$#,,
MEDICAID DIRECT,1346624590,KIDZCARE PEDIATRICS PC,,1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194401539,"SORRENTINO, GINA",1035 GRANDIFLORA DR   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063896132,KIDZCARE PEDIATRICS PC,,20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1194401539,"SORRENTINO, GINA",20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 81 , 201 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194415752,"PADILLA, NATASHA, SUZIE",14135 BALLANTYNE CORPORATE PL STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710609961,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN SPECIALTY CLINICS,6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194415752,"PADILLA, NATASHA, SUZIE",14135 BALLANTYNE CORPORATE PL STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194415752,"PADILLA, NATASHA, SUZIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194415752,"PADILLA, NATASHA, SUZIE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710609961,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN SPECIALTY CLINICS,6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194415752,"PADILLA, NATASHA, SUZIE",6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1194415802,AES DREAMWORKS LLC,AES DREAMWORKS LLC,1251 STAFFORD ST UNIT 101 MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1194415802,AES DREAMWORKS LLC,1251 STAFFORD ST UNIT 101 MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#, 53 , 53 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194417097,"JOHNSON, JULIA, ELDER",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 114 , 114 ," $33,516.19 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194417246,"BYUNGURA, VERONIQUE, MUREBWAYIRE",700 WALTER REED DR   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1194421248,"MESSINGER, TAYLOR, MICHELLE",2450 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 75 , 227 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1194421248,"MESSINGER, TAYLOR, MICHELLE",9040 NATIONS FORD RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1194421248,"MESSINGER, TAYLOR, MICHELLE",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 28 , 107 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194421248,"MESSINGER, TAYLOR, MICHELLE",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 22 , 32 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1194421248,"MESSINGER, TAYLOR, MICHELLE",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1194421248,"MESSINGER, TAYLOR, MICHELLE",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 51 , 160 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194422329,"BUTLER, JADA, MCGIRT",512 VILLAGE RD STE 205 SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 78 , 175 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194422329,"BUTLER, JADA, MCGIRT",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 29 , 57 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194422329,"BUTLER, JADA, MCGIRT",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194423178,"LOCKLEAR, ALLISON, MARIE",2911 BREEZEWOOD AVE STE 101 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 292 , 361 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194423178,"LOCKLEAR, ALLISON, MARIE",4308 LUDGATE ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 178 , 219 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194425280,"CIRAR, JUSTIN, MICHAEL TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194425280,"CIRAR, JUSTIN, MICHAEL TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194425280,"CIRAR, JUSTIN, MICHAEL TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194431239,"HIGHSTONE, CAROLYN, JOHNSTON",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 34 , 341 , 355 ,$#,,
MEDICAID DIRECT,1417371154,AMARA PAIN & SPINE,,6429 BANNINGTON RD STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194431239,"HIGHSTONE, CAROLYN, JOHNSTON",6429 BANNINGTON RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194431239,"HIGHSTONE, CAROLYN, JOHNSTON",6429 BANNINGTON RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1265458251,SEASHORE PEDIATRICS PC,SEASHORE PEDIATRICS,2828 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194433052,"BRIX, TATIANA, OBRIST",3650 EXPRESS DR   SHALLOTTE NC,010,Brunswick,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 16 , 19 , 51 ,$#,,
MEDICAID DIRECT,1265458251,SEASHORE PEDIATRICS PC,SEASHORE PEDIATRICS,2828 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194433052,"BRIX, TATIANA, OBRIST",3650 EXPRESS DR   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 38 , 76 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194437806,"JUKKA, KENDALL, CHRISTINE",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1194437806,"JUKKA, KENDALL, CHRISTINE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1194438432,"SHORT, MORGAN, NICOLE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1194438432,"SHORT, MORGAN, NICOLE",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1194438432,"SHORT, MORGAN, NICOLE",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 22 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194447185,"SANDER, DANIELLE, RENEE",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 192 , 195 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194447185,"SANDER, DANIELLE, RENEE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 308 , 309 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,380 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194447185,"SANDER, DANIELLE, RENEE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1194447185,"SANDER, DANIELLE, RENEE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194447185,"SANDER, DANIELLE, RENEE",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 628 , 633 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194448175,"KIM, SO, YOUNG",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 32 , 33 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194449819,"FREELAND, CASSANDRA, FAY",134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194449819,"FREELAND, CASSANDRA, FAY",134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 91 , 166 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194449819,"FREELAND, CASSANDRA, FAY",134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194449819,"FREELAND, CASSANDRA, FAY",134 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1194453746,KLEIN SPEECH AND LANGUAGE THERAPY,KLEIN SPEECH AND LANGUAGE THERAPY PLLC,625 SWIFT CREEK XING   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1194453746,KLEIN SPEECH AND LANGUAGE THERAPY,625 SWIFT CREEK XING   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194455089,"GORDON, ALLISON, CLARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194455089,"GORDON, ALLISON, CLARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194455089,"GORDON, ALLISON, CLARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194455089,"GORDON, ALLISON, CLARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194458042,UNIQUE ASSISTED LIVING,,6320 SAYBROOKE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194458042,UNIQUE ASSISTED LIVING,6320 SAYBROOKE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,056 "," 1,086 "," $65,942.34 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194458356,"BENDER, DANA, MEADOWS",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 40 , 80 ,$#,,
MEDICAID DIRECT,1780900589,DAVID E GALATAS DDS PA,CAMERON FAMILY DENTISTRY,1054 NC 24/87   CAMERON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1194459255,"ADEI, EUGENE",1054 NC 24-87   CAMERON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 23 , 72 ,$#,,
MEDICAID DIRECT,1780900589,DAVID E GALATAS DDS PA,CAMERON FAMILY DENTISTRY,1054 NC 24/87   CAMERON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1194459255,"ADEI, EUGENE",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 107 , 143 , 566 ," $40,956.21 ",,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194459255,"ADEI, EUGENE",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 853 ," 1,062 "," 3,408 "," $272,532.22 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194459982,"NKWENTI ACHINA, DORIS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194463729,"ABBOTT, SAMANTHA, KAREN",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 42 , 46 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194463729,"ABBOTT, SAMANTHA, KAREN",2827 LYNDHURST AVE STE 206 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 35 , 37 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194463729,"ABBOTT, SAMANTHA, KAREN",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194463729,"ABBOTT, SAMANTHA, KAREN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194463729,"ABBOTT, SAMANTHA, KAREN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194465054,"KEISLER, KAREN, DEANNE",15 REGIONAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 79 , 236 ,$#,,
MEDICAID DIRECT,1265420335,HANGER PROSTHETICS & ORTHOTICS EAST,~,1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194465278,"STUART, WILLIAM, PATRICK",1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194470211,"EDWARDS, RACHEL, CASSANDRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 93 , 156 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194470211,"EDWARDS, RACHEL, CASSANDRA",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194471748,"MANKILLER, JAIMIE, LEIGH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194471748,"MANKILLER, JAIMIE, LEIGH",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 75 , 81 , 171 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194471870,"MOMANYI, WINNIE, NYANCHAMA",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194471870,"MOMANYI, WINNIE, NYANCHAMA",3322 VILLAGE RD   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194471870,"MOMANYI, WINNIE, NYANCHAMA",509 W GANNON AVE   ZEBULON NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1194471870,"MOMANYI, WINNIE, NYANCHAMA",509 W GANNON AVE   ZEBULON NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194471870,"MOMANYI, WINNIE, NYANCHAMA",509 W GANNON AVE   ZEBULON NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 41 , 149 , 149 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194471870,"MOMANYI, WINNIE, NYANCHAMA",6590 TRYON RD   CARY NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 83 , 289 , 289 ," $16,563.13 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194471870,"MOMANYI, WINNIE, NYANCHAMA",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1194471870,"MOMANYI, WINNIE, NYANCHAMA",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1194471870,"MOMANYI, WINNIE, NYANCHAMA",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194471870,"MOMANYI, WINNIE, NYANCHAMA",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194473702,"HARRIS, BLANCHE, NOELLE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 370 , 378 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194473702,"HARRIS, BLANCHE, NOELLE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1194473702,"HARRIS, BLANCHE, NOELLE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 44 , 110 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194473702,"HARRIS, BLANCHE, NOELLE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194474429,ROSE VISTA HOME CARE LLC,,2130 ROSE VISTA RD   KINSTON NC,054,Lenoir,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1194474429,ROSE VISTA HOME CARE LLC,2130 ROSE VISTA RD   KINSTON NC,054,Lenoir,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 257 ," 1,511 "," 1,511 "," $216,441.64 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194475822,"BLOUIN HUNTER, VALERIE",102 NEW EDITION CT   CARY NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 41 , 94 , 94 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194479683,"KOOMSON, DOMONIQUE, BATTLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194479683,"KOOMSON, DOMONIQUE, BATTLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194480962,"JACKSON, TYESHA, BROOKES",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 47 , 62 ,$#,,
MEDICAID DIRECT,1740562875,ONSLOW AMBULATORY SERVICES INC,ONSLOW EAR NOSE & THROAT,55 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1194485599,"DIMICK, ALEXIS, KATHRYN",55 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1194486365,RADIANT MOMENTS PEDIATRIC THERAPY P,,1009 BRADBURN DR   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1194486365,RADIANT MOMENTS PEDIATRIC THERAPY P,1009 BRADBURN DR   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,#, 35 , 37 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194490425,"ALLEN, AYAKO, NITANI",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 117 , 168 , 176 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194495507,"BROWN, LAUREN, NICOLE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194495507,"BROWN, LAUREN, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194497107,"GOLZIO, MELISSA, IVETTE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1194503045,"LYKE, LINDSAY, MORGAN",129 WOODSON ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 25 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1194504175,"RAY, ANDREW, MICHAEL",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194504175,"RAY, ANDREW, MICHAEL",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1194504175,"RAY, ANDREW, MICHAEL",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194504175,"RAY, ANDREW, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1168 E CUTLAR XING STE 201 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194508077,"EDWARDS, KELSEY, ELIZABETH",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194508077,"EDWARDS, KELSEY, ELIZABETH",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 38 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194534081,"JOHNSON, CALLIE, ROGERS",3681 N MAIN ST   FARMVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194540641,"D'ELIA, ALEXANDRA, EMILY",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1194543306,"BLACK, MATTHEW, WINFIELD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 32 , 42 ,$#,,
MEDICAID DIRECT,1558765313,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RICHFIELD FAMILY MEDICI,243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1194547232,"SMEDEK, EMILY, LAUREN",243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194557561,"SOURIS, KATHERINE, JANINE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194560813,"NGUYEN, JASMINE, CAO HOANG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194560813,"NGUYEN, JASMINE, CAO HOANG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1194560813,"NGUYEN, JASMINE, CAO HOANG",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194560813,"NGUYEN, JASMINE, CAO HOANG",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1194560813,"NGUYEN, JASMINE, CAO HOANG",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194560946,"MORROW, GRACE, VICTORIA",2311 LEWISVILLE CLEMMONS RD FL 3 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 20 ,$#,,
MEDICAID DIRECT,1194570044,PHENOMENAL HOME CARE LLC,,105 ONYX LN   KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1194570044,PHENOMENAL HOME CARE LLC,105 ONYX LN   KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 2,075 "," 2,075 "," $133,593.40 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194572966,"GARLAND, TESS, EDEN",2251 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1194577049,VANTAGE THERAPY SERVICES PLLC,VANTAGE THERAPY SERVICES PLLC,5028 RAINMAKER DR   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1194577049,VANTAGE THERAPY SERVICES PLLC,5028 RAINMAKER DR   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,, 38 , 756 , 758 ," $53,650.43 ",,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194578039,"SHOJI, AYUMI",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 35 , 35 , 35 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1194580670,"KIMURA, EMILY, ELIZABETH",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 21 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194580670,"KIMURA, EMILY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194580670,"KIMURA, EMILY, ELIZABETH",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194580670,"KIMURA, EMILY, ELIZABETH",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194580670,"KIMURA, EMILY, ELIZABETH",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194580670,"KIMURA, EMILY, ELIZABETH",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194594036,"KRICKOVIC, GAELYN, ELLIOTT YOUNG",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 20 , 30 ,$#,,
MEDICAID DIRECT,1194596254,MOONBEAM THERAPIES PLLC,,6609 SPRINGFIELD VILLAGE LN   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1194596254,MOONBEAM THERAPIES PLLC,6609 SPRINGFIELD VILLAGE LN   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,, 26 , 209 , 209 ," $19,688.06 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194700138,"MOLNAR, JOSEPH, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 60 , 117 , 174 ," $19,325.66 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194700138,"MOLNAR, JOSEPH, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1194700138,"MOLNAR, JOSEPH, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194700419,"BERTSCH, MICHELLE, MARIE",123 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194700419,"BERTSCH, MICHELLE, MARIE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194700419,"BERTSCH, MICHELLE, MARIE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,123 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194700419,"BERTSCH, MICHELLE, MARIE",123 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 20 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194700534,"BLOOMFELD, RICHARD, SETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 58 , 75 , 82 ,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194700575,"HANSEL, KEVAN, RICHARD",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 74 , 117 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194700799,"LITTLE, EDWIN, PAUL",103 S CENTRAL AVE   PINK HILL NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 130 , 214 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1194700799,"LITTLE, EDWIN, PAUL",103 S CENTRAL AVE   PINK HILL NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 26 ," $10,292.10 ",,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194701425,"HELTON, TODD, EDWARD",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",600 HOSPITAL DR MONROE   MONROE NC,090,Union,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",600 HOSPITAL DR MONROE   MONROE NC,090,Union,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 73 , 73 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 29 , 35 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 40 , 68 , 87 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,,,Unknown,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,,,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",201 E GROVER ST   SHELBY NC,023,Cleveland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194701466,"MCCURDY, LEWIS, HALL",201 E GROVER ST   SHELBY NC,023,Cleveland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194702910,"DILALLA, GAYLE, ACKERMAN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194702910,"DILALLA, GAYLE, ACKERMAN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194702910,"DILALLA, GAYLE, ACKERMAN",4101 MACON POND RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1386089662,GREGORY R ABRAMS DMD III PA,~,1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194703215,"GRANIER, JODY, LEE",2315 PENDER PL   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 3,439 "," 4,720 "," 28,113 "," $947,955.14 ",,
MEDICAID DIRECT,1255417358,MOUNTAIN LAURAL INTERNAL MEDICINE,~,2139 LINVILLE FALLS HWY   LINVILLE NC,006,Avery,193400000X,Group,Single Specialty,,1194704817,"BARKER, JOSEPH, DAVID",2139 LINVILLE FALLS HWY   LINVILLE NC,006,Avery,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 41 , 68 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194704981,"WHITE, WILLIAM, ANDREW",517 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194704981,"WHITE, WILLIAM, ANDREW",517 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 50 , 94 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194704981,"WHITE, WILLIAM, ANDREW",517 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 60 , 253 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194704981,"WHITE, WILLIAM, ANDREW",517 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194704981,"WHITE, WILLIAM, ANDREW",517 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194704981,"WHITE, WILLIAM, ANDREW",517 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,517 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194704981,"WHITE, WILLIAM, ANDREW",517 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 137 , 218 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194707638,"ROGERS, MELISSA, QUADER",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 35 , 86 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194707638,"ROGERS, MELISSA, QUADER",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1194708263,"CORREA, EDGAR, XAVIER",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194708263,"CORREA, EDGAR, XAVIER",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 67 , 131 , 179 ,$#,,
MEDICAID DIRECT,1194708727,ONDREA DIGNITY PRODUCTS INC,~,2200 SILAS CREEK PKWY STE 1A WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194708727,ONDREA DIGNITY PRODUCTS INC,2200 SILAS CREEK PKWY STE 1A WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 21 , 27 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 71 , 73 , 90 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 82 , 100 , 121 ,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 38 , 52 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194709154,"STEFFEN, SCOTT, TAYLOR",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 42 , 60 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194709568,"GEISINGER, KIM, ROBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 72 , 72 , 147 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194709576,"MIMS, JAMES, WHITMAN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 67 , 105 , 130 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194709576,"MIMS, JAMES, WHITMAN",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194709675,"JOHNSON III, ATLEE, ROLLINS",584 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194709675,"JOHNSON III, ATLEE, ROLLINS",911 W HENDERSON ST STE 110 SALISBURY NC,080,Rowan,208800000X,Allopathic & Osteopathic Physicians,Urology,, 86 , 145 , 255 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194710038,"PHILPOT, KELLY, WEMPE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 78 , 121 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194710038,"PHILPOT, KELLY, WEMPE",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194710186,"STRANICK, FRANCIS, JOSEPH",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 34 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194710855,"MCLAURIN, AMY, ELIZABETH",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,142 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194710855,"MCLAURIN, AMY, ELIZABETH",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 41 , 74 , 189 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194710855,"MCLAURIN, AMY, ELIZABETH",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194710855,"MCLAURIN, AMY, ELIZABETH",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 26 , 99 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194710855,"MCLAURIN, AMY, ELIZABETH",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194710855,"MCLAURIN, AMY, ELIZABETH",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194711036,"EVERMAN, ANNE, HAUET",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194711036,"EVERMAN, ANNE, HAUET",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194711036,"EVERMAN, ANNE, HAUET",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194711036,"EVERMAN, ANNE, HAUET",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1902663529,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES LORIS,3485 MITCHELL STREET   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194711036,"EVERMAN, ANNE, HAUET",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1740369982,SULLIVAN FAMILY CHIROPRACTIC PA,,2315 W ARBORS DR STE 208A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194711804,"SULLIVAN, MICHAEL, DOUGLAS",2315 W ARBORS DR STE 208A CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#, 67 , 67 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194712240,"LEVINE, JONATHAN, KEITH",411 BILLINGSLEY RD STE 103 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 40 , 52 , 53 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194712240,"LEVINE, JONATHAN, KEITH",1021 MOREHEAD MEDICAL DRIVE SUITE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1194712240,"LEVINE, JONATHAN, KEITH",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194712240,"LEVINE, JONATHAN, KEITH",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,,,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1194712240,"LEVINE, JONATHAN, KEITH",411 BILLINGSLEY RD STE 103 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194712240,"LEVINE, JONATHAN, KEITH",411 BILLINGSLEY RD STE 103 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194712240,"LEVINE, JONATHAN, KEITH",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194712604,"BENSON, STEVEN, PRESTON",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194712604,"BENSON, STEVEN, PRESTON",101 CLINIC DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 49 , 57 ,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194713610,"KURIAN, AJI",500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1932130390,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE CAROLINA FAMILY ME,104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1194713701,"KERN, JEFFREY, JUSTIN",7473 C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 54 , 109 ,$#,,
MEDICAID DIRECT,1932130390,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE CAROLINA FAMILY ME,104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1194713701,"KERN, JEFFREY, JUSTIN",104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 220 , 530 ,$#,,
MEDICAID DIRECT,1194714063,PEAK PERFORMANCE SPORTS AND PHYSICA,ALLIED REHAB,900 S FRANKLIN ST STE 201 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1194714063,PEAK PERFORMANCE SPORTS AND PHYSICA,900 S FRANKLIN ST STE 201 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,, 51 , 592 ," 1,234 "," $46,316.75 ",,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 510 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194714279,"TRULUCK, DAVID, BOWEN",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194714535,"SZALADOS, JAMES, EMERY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 25 , 27 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194715839,"PARKER, ROBERT, LAMAR",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194715839,"PARKER, ROBERT, LAMAR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194715839,"PARKER, ROBERT, LAMAR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194715839,"PARKER, ROBERT, LAMAR",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194715839,"PARKER, ROBERT, LAMAR",111 HANESTOWN CT   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194716050,"CALDWELL, WILLIAM, BRUCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 66 , 67 ,$#,,
MEDICAID DIRECT,1134176506,CHARLES D GODWIN,EASTERN CAROLINA PSYCHIATRIC SERVICES,2800 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1194716340,"KING, JODY, LEE",2800 VILLAGE WAY   TRENT WOODS NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 162 , 162 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194718403,"ELKINS, STEPHANIE, BANASZAK",106 CORPORATE PARK DR STE 200&300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 96 , 188 ,$#,,
MEDICAID DIRECT,1104819754,SHELBY MEDICAL ASSOCIATES PA,~,711 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1194718528,"RIBADENEYRA, MICHAEL, GEORGE",711 N DEKALB ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 60 , 177 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194719013,"MARCUM, STACY, MURPHY",305 PAGE RD N STE 6 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194719013,"MARCUM, STACY, MURPHY",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194719013,"MARCUM, STACY, MURPHY",15 REGIONAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194719104,"BROWDER, DAVID, ALLEN",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194719104,"BROWDER, DAVID, ALLEN",600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194719104,"BROWDER, DAVID, ALLEN",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 101 , 240 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1194719104,"BROWDER, DAVID, ALLEN",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 50 , 93 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194719344,"GORDIN, KRISTI, DAWN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1194719344,"GORDIN, KRISTI, DAWN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194719344,"GORDIN, KRISTI, DAWN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194719344,"GORDIN, KRISTI, DAWN",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 42 , 60 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194719559,"MILLER, MICHAEL, JOHN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 164 , 208 , 254 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1194719559,"MILLER, MICHAEL, JOHN",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 83 , 121 , 152 ,$#,,
MEDICAID DIRECT,1871894519,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,2604 DR MARTIN LUTHER KING STE B NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1194719591,"LORIO, WILLIAM, PAUL",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 30 , 67 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1194719591,"LORIO, WILLIAM, PAUL",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 15 , 36 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1194719591,"LORIO, WILLIAM, PAUL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194720565,"MARTIN, ANN, MICHELLE",4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194720912,"BENNETT, ROBERT, TODD",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,, 22 , 29 , 41 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194720912,"BENNETT, ROBERT, TODD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 19 , 27 , 31 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194720912,"BENNETT, ROBERT, TODD",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 62 , 85 , 136 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194720912,"BENNETT, ROBERT, TODD",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1194721092,"HEES, SCOTT, ANDREW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194721092,"HEES, SCOTT, ANDREW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 477 , 688 , 866 ," $10,912.80 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194721092,"HEES, SCOTT, ANDREW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 242 , 537 , 739 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194721498,"JACOBS, BRADLEY, EDGAR",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194721498,"JACOBS, BRADLEY, EDGAR",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 26 , 36 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194721498,"JACOBS, BRADLEY, EDGAR",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194721803,"HARTZ, WILLIAM, HARRY",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194722629,ASTON PARK HEALTHCARE CENTER INC,ASTON PARK HEALTH CARE CENTER INC,380 BREVARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194722629,ASTON PARK HEALTHCARE CENTER INC,380 BREVARD RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,513 "," 1,513 "," $88,727.15 ",,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1194723809,"MILLER, RICHARD, JOHN",10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 65 , 113 , 235 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1194723882,"CARLEY, RICHARD, SCOTT",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194723882,"CARLEY, RICHARD, SCOTT",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,6310 BEACH DR SW   OCEAN ISLE BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194723882,"CARLEY, RICHARD, SCOTT",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457320756,THE PEDIATRIC CENTER,THE PEDIATRIC CENTER PLLC,1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1194725036,"PLAYER, JENNIFER, FUDGE",1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 53 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1194726802,"SCHERER, MARIE-FRANCE, JEANINE",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1194726802,"SCHERER, MARIE-FRANCE, JEANINE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 33 , 33 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194726802,"SCHERER, MARIE-FRANCE, JEANINE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194727479,"ATASSI, NAWAF, GHATFAN",608 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 120 , 262 , 562 ," $10,080.98 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194727479,"ATASSI, NAWAF, GHATFAN",100 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 58 , 58 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194727479,"ATASSI, NAWAF, GHATFAN",604 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 58 , 423 , 423 ," $13,400.21 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194727966,"GARNER, LEON, COOPER",15825 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 47 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194727966,"GARNER, LEON, COOPER",15825 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 41 , 90 ,$#,,
MEDICAID DIRECT,1972060796,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,304 E SAUNDERS ST   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1194728949,"LEONARD, THOMAS, ROBERT",304 E SAUNDERS ST   CARTHAGE NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 124 , 355 , 793 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194729020,"VIG, DANIEL, ROBERT",11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194729020,"VIG, DANIEL, ROBERT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194729020,"VIG, DANIEL, ROBERT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194729020,"VIG, DANIEL, ROBERT",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1194729186,"WALKER, WILLIAM, THOMAS",306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 31 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1194729186,"WALKER, WILLIAM, THOMAS",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1194729186,"WALKER, WILLIAM, THOMAS",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1194729830,"ROWSON, JONATHAN, DAVID",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 45 , 61 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194729830,"ROWSON, JONATHAN, DAVID",101 PLAZA RD   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 70 , 97 ,$#,,
MEDICAID DIRECT,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,MAXTON FAMILY PRACTICE CENTER,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194729830,"ROWSON, JONATHAN, DAVID",1001 W DR MARTIN LUTHER KING JR DR   MAXTON NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427188176,SCOTLAND COUNTY HEALTH DEPT,SCOTLAND COUNTY HEALTH DEPT,1405 WEST BLVD   LAURINBURG NC,083,Scotland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1194729830,"ROWSON, JONATHAN, DAVID",1405 WEST BLVD   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 51 , 123 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194729830,"ROWSON, JONATHAN, DAVID",1001 W DR MARTIN LUTHER KING JR DR   MAXTON NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 20 , 28 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194729830,"ROWSON, JONATHAN, DAVID",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 159 , 267 , 375 ," $11,839.90 ",,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",226 COMMERCIAL DR   FOREST CITY NC,081,Rutherford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 40 , 189 , 189 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",141 LAUREL HILL DR STE 1 RUTHERFORDTON NC,081,Rutherford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 23 , 41 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",108 CREEKSIDE DR   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 143 , 264 , 333 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",201 E GROVER ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 51 , 196 , 198 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",1530 S LAFAYETTE ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",1010 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 146 , 444 , 564 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1194731224,"ALAM, MUHAMMAD, SHAH",1016 N LAFAYETTE ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194733980,"MARTINEZ-BIANCHI, VIVIANA, SANDRA",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194733980,"MARTINEZ-BIANCHI, VIVIANA, SANDRA",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194733980,"MARTINEZ-BIANCHI, VIVIANA, SANDRA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194733980,"MARTINEZ-BIANCHI, VIVIANA, SANDRA",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 28 , 45 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194733980,"MARTINEZ-BIANCHI, VIVIANA, SANDRA",815 BROAD ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194734228,"RHODES, DAVID, FRANKLIN",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 53 , 64 , 67 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194734228,"RHODES, DAVID, FRANKLIN",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194734228,"RHODES, DAVID, FRANKLIN",510 CORPORATE CIR STE 1000 SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194734947,"SEGOVIA, MARIA, CRISTINA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194734947,"SEGOVIA, MARIA, CRISTINA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 40 , 72 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194734947,"SEGOVIA, MARIA, CRISTINA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194734947,"SEGOVIA, MARIA, CRISTINA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194734947,"SEGOVIA, MARIA, CRISTINA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 17 , 24 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 49 , 67 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 52 , 53 , 84 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194737296,"MUSIALOWSKI, RICHARD, STANLEY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194737775,"LILE, ROBERT, LUTHER",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1326157215,FAMILY EYE CARE OF CAROLINAS,~,1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,193400000X,Group,Single Specialty,,1194737965,"BARTISS, MICHAEL, JOHN",1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 178 , 216 , 368 ," $21,889.22 ",,
MEDICAID DIRECT,1326157215,FAMILY EYE CARE OF CAROLINAS,~,1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,193400000X,Group,Single Specialty,,1194737965,"BARTISS, MICHAEL, JOHN",1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,207WX0110X,Allopathic & Osteopathic Physicians,Ophthalmology,Pediatric Ophthalmology and Strabismus Specialist,#,#,#,$#,,
MEDICAID DIRECT,1194737965,"BARTISS, MICHAEL, JOHN",~,1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1194737965,"BARTISS, MICHAEL, JOHN",1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1194740647,"KASTNER, ROBERT, JEFFREY",311 S CAMPBELL ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 22 , 27 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,311 S CAMPBELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1194740647,"KASTNER, ROBERT, JEFFREY",311 S CAMPBELL ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1194740647,"KASTNER, ROBERT, JEFFREY",311 S CAMPBELL ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 91 , 103 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",102 COLLEGE STATION DR STE 10 BREVARD NC,088,Transylvania,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",102 COLLEGE STATION DR STE 10 BREVARD NC,088,Transylvania,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",840 FLEMING ST STE 6 HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 31 , 47 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 48 , 96 , 139 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 28 , 54 , 87 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194740837,"CROSS, SARITA, KUMAR",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1194741066,COUNTY OF GRAHAM,GRAHAM COUNTY EMS,70 W FORT HL   ROBBINSVILLE NC,038,Graham,3416L0300X,Transportation Services,Ambulance,Land Transport,1194741066,COUNTY OF GRAHAM,70 W FORT HL   ROBBINSVILLE NC,038,Graham,3416L0300X,Transportation Services,Ambulance,Land Transport, 60 , 85 , 163 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194741991,"DOHENY, WILLAM, ROY",202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 45 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194741991,"DOHENY, WILLAM, ROY",202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 47 , 110 ,$#,,
MEDICAID DIRECT,1194742346,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1298,2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1194742346,WAL-MART STORES EAST LP,2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1194742346,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1298,2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1194742346,WAL-MART STORES EAST LP,2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1194743583,"GELBER, RICHARD, STEVEN",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1194743716,"PANDIT, SANDEEP, RAJ",516 S VAN BUREN RD   EDEN NC,079,Rockingham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194743716,"PANDIT, SANDEEP, RAJ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 73 , 122 , 122 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194743716,"PANDIT, SANDEEP, RAJ",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194743716,"PANDIT, SANDEEP, RAJ",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194743716,"PANDIT, SANDEEP, RAJ",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1194744342,NORTH VILLAGE PHARMACY INC,NORTH VILLAGE PHARMACY INC,1493 MAIN ST   YANCEYVILLE NC,017,Caswell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1194744342,NORTH VILLAGE PHARMACY INC,1493 MAIN ST   YANCEYVILLE NC,017,Caswell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 28 , 37 ,$#,,
MEDICAID DIRECT,1194744532,MOSES CONE MEDICAL SERVICES INC,LEBAUER ENDOSCOPY CENTER,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1194744532,MOSES CONE MEDICAL SERVICES INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 51 , 53 , 77 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1194745851,"CLARK, CHARLES",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194745893,"HOOTEN, JAMES, PHILMON",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194745893,"HOOTEN, JAMES, PHILMON",3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194745893,"HOOTEN, JAMES, PHILMON",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194745893,"HOOTEN, JAMES, PHILMON",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 36 , 61 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194747063,"DE PINTO, MARIO, JOSEPH",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952976003,CHARLES A CANNON JR MEMORIAL HOSPIT,,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1194747105,"WOLFE, KEVIN, WILEY",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1861031544,WATAUGA MEDICAL CENTER INC,PULMONOLOGY INPATIENT,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1194747105,"WOLFE, KEVIN, WILEY",336 DEERFIELD RD   BOONE NC,095,Watauga,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 65 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194747675,"WEST, THOMAS, GRAHAM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194747675,"WEST, THOMAS, GRAHAM",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 38 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194747675,"WEST, THOMAS, GRAHAM",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194747675,"WEST, THOMAS, GRAHAM",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194747675,"WEST, THOMAS, GRAHAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 212 , 226 , 353 ," $14,619.16 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194747675,"WEST, THOMAS, GRAHAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194747675,"WEST, THOMAS, GRAHAM",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194748327,"MURPHY, TIMOTHY, GERARD",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 48 , 48 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194748327,"MURPHY, TIMOTHY, GERARD",2305 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194748327,"MURPHY, TIMOTHY, GERARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1194748665,"ANGEL, LORRAINE, CLAUDIA",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 28 , 30 ,$#,,
MEDICAID DIRECT,1982873899,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,900 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194749440,"KIDROSKE, CHARLES, NOEL",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1740459650,RAFAEL RIVERA JR DDS PLLC,,2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194749440,"KIDROSKE, CHARLES, NOEL",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 6,091 "," 7,798 "," 36,550 "," $920,175.20 ",,
MEDICAID DIRECT,1912728353,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY GENERAL SURGERY,803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1194749648,"HAWKINS RIVERS, SANFORD, WILLIAM",803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 37 , 41 ,$#,,
MEDICAID DIRECT,1912728353,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY GENERAL SURGERY,803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1194749648,"HAWKINS RIVERS, SANFORD, WILLIAM",225 BRIGHTWATER DR STE 220 LILLINGTON NC,043,Harnett,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417355629,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT SURGICAL ASSOCIATES,803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1194749648,"HAWKINS RIVERS, SANFORD, WILLIAM",803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 51 , 90 , 104 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194750067,"WEINSTEIN, CHRISTINE, IDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194750182,"HUNT, SARAH, OGROSKY",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 38 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 157 , 164 , 222 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",4101 MACON POND RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 28 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194750794,"KREUZER, TAMMY, HELEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 106 , 127 , 168 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194753434,"LEEP, DANIEL, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 39 , 46 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194753434,"LEEP, DANIEL, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 38 , 46 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194753434,"LEEP, DANIEL, DAVID",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194753434,"LEEP, DANIEL, DAVID",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194753434,"LEEP, DANIEL, DAVID",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194753434,"LEEP, DANIEL, DAVID",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194753939,"RYAN, STEPHEN, EDWARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194754242,"LO, BRUCE, M",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194754275,"NASHATIZADEH, CECILIA, ROSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194754275,"NASHATIZADEH, CECILIA, ROSE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194754275,"NASHATIZADEH, CECILIA, ROSE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194754275,"NASHATIZADEH, CECILIA, ROSE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1194755207,"VAJEN, THOMAS, ROBERT",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1043752363,SWAIN INTEGRATED SERVICES PC,,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1194755207,"VAJEN, THOMAS, ROBERT",45 PLATEAU ST   BRYSON CITY NC,087,Swain,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 29 ,$#,,
MEDICAID DIRECT,1194756726,"COOK, REBECCA, PENDERGRASS",Rebecca P Cook,900 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,1194756726,"COOK, REBECCA, PENDERGRASS",900 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194757633,"LIN, JEN JAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194758821,"TAYAL, VIVEK, SHANTI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 56 , 81 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194759563,"SKINNER, ANN, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194759563,"SKINNER, ANN, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194760868,"TANG, JULIA, WAI CHI",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1194760868,"TANG, JULIA, WAI CHI",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194760868,"TANG, JULIA, WAI CHI",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194761932,"VUONG, DAO, QUYNH",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 21 , 32 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194761932,"VUONG, DAO, QUYNH",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194761932,"VUONG, DAO, QUYNH",10320 MALLARD CREEK RD STE 260A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194762419,"PURI, SANKALP, KUMAR",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1194762419,"PURI, SANKALP, KUMAR",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194762419,"PURI, SANKALP, KUMAR",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194762419,"PURI, SANKALP, KUMAR",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194762419,"PURI, SANKALP, KUMAR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 35 ,$#,,
MEDICAID DIRECT,1194763748,WHITEVILLE RESCUE UNIT INC,Whiteville Rescue Unit Inc,106 FLOWERS PRIDGEN RD   WHITEVILLE NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,1194763748,WHITEVILLE RESCUE UNIT INC,106 FLOWERS PRIDGEN RD   WHITEVILLE NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport, 210 , 350 , 641 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194764944,"EISENOFF, RICHARD, SCOTT",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194764944,"EISENOFF, RICHARD, SCOTT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 136 , 136 ,$#,,
MEDICAID DIRECT,1194765784,"BENEVIDES, MARC, DAVID",ASSOCIATED UROLOGISTS OF NORTH CAROLINA PA,160 MACGREGOR PINES DR STE 205 CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1194765784,"BENEVIDES, MARC, DAVID",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1194765784,"BENEVIDES, MARC, DAVID",ASSOCIATED UROLOGISTS OF NORTH CAROLINA PA,160 MACGREGOR PINES DR STE 205 CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1194765784,"BENEVIDES, MARC, DAVID",160 MACGREGOR PINES DR STE 205 CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1194765784,"BENEVIDES, MARC, DAVID",ASSOCIATED UROLOGISTS OF NORTH CAROLINA PA,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1194765784,"BENEVIDES, MARC, DAVID",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 31 , 58 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1194766378,"ANDERSON, MARSHALL, WILSON",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 140 , 594 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194766378,"ANDERSON, MARSHALL, WILSON",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 49 , 153 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194766477,"BRACKEN, CHRISTY, TUCKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194766477,"BRACKEN, CHRISTY, TUCKER",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1194766865,"DEEPE, ROBERT, MOSES",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1194767145,"DAVIS, DEBORAH, HOGAN",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 25 , 62 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194767244,"WHITTON, ALLISON, CURTIS",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194767244,"WHITTON, ALLISON, CURTIS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194767244,"WHITTON, ALLISON, CURTIS",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194767756,"SHARP-DALE, DEBORAH, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194767756,"SHARP-DALE, DEBORAH, ANNE",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 53 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194767756,"SHARP-DALE, DEBORAH, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194767756,"SHARP-DALE, DEBORAH, ANNE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194768283,"MONTEAGUDO, RALPH, ALBERT",5102 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 74 , 118 , 262 ,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194768283,"MONTEAGUDO, RALPH, ALBERT",5102 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 36 , 73 ,$#,,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1194768382,"WILLIAMS, GORDON, FRANK",723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 152 , 290 , 490 ," $14,700.15 ",,
MEDICAID DIRECT,1194769877,OCCUPATIONAL THERAPY PLUS INC,OCCUPATIONAL THERAPY PLUS INC,139 W 3RD ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1194769877,OCCUPATIONAL THERAPY PLUS INC,139 W 3RD ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194769893,"BROWN, VALERIE, LANGSTON",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 117 , 117 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194771063,"URSIN, GABRIELA, MARIA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 103 , 109 , 153 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194772368,"THAKKAR, NEHAL, PARESH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194772368,"THAKKAR, NEHAL, PARESH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 24 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194772368,"THAKKAR, NEHAL, PARESH",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194773408,"CARTER, KENNETH, CHARLES",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 17 , 18 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194774653,"BRANT, THOMAS, ALAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194774653,"BRANT, THOMAS, ALAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194774653,"BRANT, THOMAS, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194774653,"BRANT, THOMAS, ALAN",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194774653,"BRANT, THOMAS, ALAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1194774653,"BRANT, THOMAS, ALAN",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194775098,"ISRAEL, BRUCE, FREDERICK",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194775098,"ISRAEL, BRUCE, FREDERICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 36 , 64 , 68 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194775098,"ISRAEL, BRUCE, FREDERICK",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194775098,"ISRAEL, BRUCE, FREDERICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 20 , 36 , 36 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194775114,"SNIFF, DONALD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194775544,"ZAWODNIAK, KASEY, JO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194777052,"LOGEL, KEVIN",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1194777052,"LOGEL, KEVIN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194777052,"LOGEL, KEVIN",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194777052,"LOGEL, KEVIN",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 26 , 44 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194777474,"STEWARD, ROBERT, ISAAC",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 128 , 318 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194778423,"COHEN, PAUL, SYDNEY",7724 N KINGS HWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1184783284,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER,7724 N KINGS HWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194778423,"COHEN, PAUL, SYDNEY",7724 N KINGS HWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194779132,"FINIZIO II, TOBIN, ANDREW",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 505 , 586 , 747 ," $16,761.70 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1194779132,"FINIZIO II, TOBIN, ANDREW",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 670 , 829 ," 1,051 ",$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194779140,"BYERS, JOHN, MAXWELL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194779140,"BYERS, JOHN, MAXWELL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1194779298,"ISAACS, STEVEN, GREER",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 18 , 23 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194779926,"LATRIANO, BLAISE, PETER",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1194779991,"BURKE, CHARLES, THOMAS",2214 NELSON HWY   CHAPEL HILL NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 26 , 26 , 76 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1194779991,"BURKE, CHARLES, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194779991,"BURKE, CHARLES, THOMAS",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 30 , 30 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194779991,"BURKE, CHARLES, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 56 , 60 , 131 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194780346,"MURRAY, MAXINE, LORRAINE",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 32 , 88 ,$#,,
MEDICAID DIRECT,1871640458,HOSPICE OF THE PIEDMONT INC,HOSPICE OF THE PIEDMONT INC,1801 WESTCHESTER DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194780486,"MAGSI, HOMA",1801 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194782011,"NWILOH, JONATHAN, OSITA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194782011,"NWILOH, JONATHAN, OSITA",600 GRESHAM DR STE 8600 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 25 , 34 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 35 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 50 , 68 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1194783191,"LAUDER, CRAIG, THOMAS",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194784009,"MARTIN, GERALD, RANDALL",GERALD RANDALL MARTIN MD,317 CHESTNUT ST   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1194784009,"MARTIN, GERALD, RANDALL",317 CHESTNUT ST   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 84 , 114 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194785196,"PINDER, JULIE, MARIE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194785196,"PINDER, JULIE, MARIE",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 106 , 258 ," $14,474.10 ",,
MEDICAID DIRECT,1790143436,REVELSTONE FAMILY PRACTICE,,232 CONCORD RD   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1194785899,"KEPP, EDWARD, ALLEN",232 CONCORD RD   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 112 , 165 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194786616,"WONG, SIEW-JYU",600 HOSPITAL DR   MONROE NC,090,Union,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 16 , 35 , 37 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194786723,"WILLIAMS, JOAN, REBACK",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 108 , 120 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194786897,"CHASE, TIMOTHY, LEE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194786897,"CHASE, TIMOTHY, LEE",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 17 , 35 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194787176,"KWON, ANTHONY, JUN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 57 , 82 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194787481,"EDEL, KENNETH, PATRICK",885 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 25 , 49 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194787481,"EDEL, KENNETH, PATRICK",2290 REMOUNT RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 45 , 95 ,$#,,
MEDICAID DIRECT,1194788042,"ERUCHALU, OBINNAYA, NNAEMEKA",~,485 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1194788042,"ERUCHALU, OBINNAYA, NNAEMEKA",485 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 39 , 51 ,$#,,
MEDICAID DIRECT,1871551911,METROLINA SURGICAL SPECIALISTS PLLC,METROLINA SURGICAL SPECIALISTS PLLC,485 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194788042,"ERUCHALU, OBINNAYA, NNAEMEKA",485 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 92 , 424 , 573 ," $37,765.35 ",,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194788380,"FLAHERTY, DEBORAH, JOYCE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194788380,"FLAHERTY, DEBORAH, JOYCE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194788380,"FLAHERTY, DEBORAH, JOYCE",107B MICA AVE   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194788380,"FLAHERTY, DEBORAH, JOYCE",107B MICA AVE   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1194788380,"FLAHERTY, DEBORAH, JOYCE",1208 HICKORY BLVD SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194788554,"TOMES, DEREK, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 53 , 58 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194788554,"TOMES, DEREK, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194788760,"SEAL, STEPHEN, RANDALL",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 40 , 50 , 95 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1194788760,"SEAL, STEPHEN, RANDALL",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194789271,"GOOGE, PAUL, BUNTYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194789271,"GOOGE, PAUL, BUNTYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1194789271,"GOOGE, PAUL, BUNTYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,,,$#,,
MEDICAID DIRECT,1144283888,L A LORENZO MD PATHOLOGY CONSULT SE,L A Lorenzo MD Pathology Consult Services,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1194789578,"HARTLE, EDGAR, OWEN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 45 , 50 , 85 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194789776,"THOMAS, J GEORGE",10660 PARK RD STE 3200 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 29 , 39 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194789776,"THOMAS, J GEORGE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194789776,"THOMAS, J GEORGE",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194789776,"THOMAS, J GEORGE",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194789776,"THOMAS, J GEORGE",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194789784,"HAIRSTON, TAWANNA, LATRICE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194789784,"HAIRSTON, TAWANNA, LATRICE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 68 , 97 , 118 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1194789909,"BIERNACKI, GREGORY, JAMES",5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1194790881,"GRIMES, JEFFREY, ROBERT",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194791061,"WARD, MARK, EDWARD",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770615114,PROMED HEALTHCARE PLLC,~,7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194792093,"GENTLE, TAMARA, HEGLAR",7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 17 , 21 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194792424,"WOODWARD, CONNIE, DENISE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194792424,"WOODWARD, CONNIE, DENISE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,611 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194793240,"DIMKPA, RAJESHREE, TULLOO",611 CHURCH ST N   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 179 , 595 , 596 ," $41,202.58 ",,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,611 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194793240,"DIMKPA, RAJESHREE, TULLOO",1216 SCHOOL ST STE B WILKESBORO NC,097,Wilkes,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1194793240,"DIMKPA, RAJESHREE, TULLOO",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,611 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194793240,"DIMKPA, RAJESHREE, TULLOO",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194794644,"LAUFFENBURGER, MICHAEL, DAVID",3311 JESSIE VILLAGE DR   CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 23 , 41 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194794644,"LAUFFENBURGER, MICHAEL, DAVID",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 35 , 51 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194794644,"LAUFFENBURGER, MICHAEL, DAVID",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194794644,"LAUFFENBURGER, MICHAEL, DAVID",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194795260,"GARNER, DARRELL, THOMAS",865 WESTLAKE DR   MOUNT AIRY NC,086,Surry,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194796920,"VERGARA, JOSE, GERARDO",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1528559671,BLADEN HEALTHCARE LLC,CFV BLADEN MEDICAL ASSOCIATES-WHITE LAKE,273 WHITE LAKE DR   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194796920,"VERGARA, JOSE, GERARDO",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194796920,"VERGARA, JOSE, GERARDO",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 226 , 226 ," $14,108.30 ",,
MEDICAID DIRECT,1528559671,BLADEN HEALTHCARE LLC,CFV BLADEN MEDICAL ASSOCIATES-WHITE LAKE,273 WHITE LAKE DR   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194796920,"VERGARA, JOSE, GERARDO",273 WHITE LAKE DR   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 131 , 133 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1194797555,"KING, RUDOLPH, CARLO",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1194797597,"PARTI, NAVEEN, NATH",Naveen N Parti MD,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,1194797597,"PARTI, NAVEEN, NATH",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194799874,"GOODMAN, BENJAMIN, MITCHELL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1194800516,"ZIMMERMAN, SHERRI, ARTHUR",1001 CRESCENT GRN   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 35 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194804047,"SEMCHYSHYN, TARAS, MICHAEL",1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 34 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194804047,"SEMCHYSHYN, TARAS, MICHAEL",40 DUKE MEDICINE CIR DUKE SURGICAL PDC DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194804047,"SEMCHYSHYN, TARAS, MICHAEL",40 DUKE MEDICINE CIR DUKE SURGICAL PDC DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 22 , 23 ,$#,,
MEDICAID DIRECT,1902957954,COUNTY OF HENDERSON OFFICE OF ACCOU,HENDERSON CO DEPT PUBLIC HEALTH,1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1194805903,"HARDING-BREMNER, MEREDITH, ANNE",317 N WASHINGTON ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,317 N WASHINGTON ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1194805903,"HARDING-BREMNER, MEREDITH, ANNE",317 N WASHINGTON ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194808345,"DAVIS, EMILY, ADAIR",30 DUKE MEDICINE CIR CLINIC 1C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194808345,"DAVIS, EMILY, ADAIR",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194808543,"ZUST JR, DON, LEE",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 25 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194809087,"O NEILL, MARGOT, MAHON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 32 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194809087,"O NEILL, MARGOT, MAHON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194810465,"MARTINIE, JOHN, BENNETT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 38 , 46 ," $17,063.61 ",,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194810465,"MARTINIE, JOHN, BENNETT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194810465,"MARTINIE, JOHN, BENNETT",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194810465,"MARTINIE, JOHN, BENNETT",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194810465,"MARTINIE, JOHN, BENNETT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194810465,"MARTINIE, JOHN, BENNETT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 54 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194810887,"ENTERLINE, DAVID, SCOTT",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 34 , 49 ,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194811026,GREENE COUNTY HEALTH CARE INC,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 84 , 170 , 178 ," $16,853.27 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194811067,"JONES, TERRY, RUSSELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194811067,"JONES, TERRY, RUSSELL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194811067,"JONES, TERRY, RUSSELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194814079,"PITTS, SUSAN, SAJESKI",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 20 , 32 ,$#,,
MEDICAID DIRECT,1831505346,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - 905 N HOWE,905 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194814632,"MARTIN, JEFFREY, SCOTT",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831505346,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - 905 N HOWE,905 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1194814632,"MARTIN, JEFFREY, SCOTT",905 N HOWE ST   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326589649,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - WELLNESS CENTER,3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194814632,"MARTIN, JEFFREY, SCOTT",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194815688,"KIM, NICOLA, MARIA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 28 , 33 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194815688,"KIM, NICOLA, MARIA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 53 , 64 , 95 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1194815688,"KIM, NICOLA, MARIA",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1194815688,"KIM, NICOLA, MARIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1194816132,"LINS, MARK, DAVID",129 WOODSON ST   SALISBURY NC,080,Rowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 47 , 61 , 125 ,$#,,
MEDICAID DIRECT,1194817866,ROBERT M CURRIN OD PA,ROBERT M CURRIN OD PA,203 E INDUSTRY DR STE B OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1194817866,ROBERT M CURRIN OD PA,203 E INDUSTRY DR STE B OXFORD NC,039,Granville,193400000X,Group,Single Specialty,, 888 , 928 ," 1,792 "," $24,455.92 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194820308,"CHAPMAN, MILTON, CHARLES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194820639,FAMILY MEDICAL SUPPLY LLC,~,1637 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1194820639,FAMILY MEDICAL SUPPLY LLC,1637 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 16 , 83 , 88 ," $19,929.46 ",,
MEDICAID DIRECT,1194820639,FAMILY MEDICAL SUPPLY LLC,~,1637 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1194820639,FAMILY MEDICAL SUPPLY LLC,1637 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1194820639,FAMILY MEDICAL SUPPLY LLC,~,1637 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194820639,FAMILY MEDICAL SUPPLY LLC,1637 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 2,082 "," 11,127 "," 18,405 "," $538,679.20 ",,
MEDICAID DIRECT,1164755435,BRUCE M WHEELER DMD PA,~,3288 ROBINHOOD RD STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194821009,"WHEELER, BRUCE, MICHAEL",3288 ROBINHOOD RD STE 201 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 44 , 95 , 262 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194823526,"DIEZ, EDGARDO",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 98 , 98 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194823526,"DIEZ, EDGARDO",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194823526,"DIEZ, EDGARDO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1194823740,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02676,1220 US HIGHWAY 321 NW   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194823740,NORTH CAROLINA CVS PHARMACY LLC,1220 US HIGHWAY 321 NW   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,193200000X,Group,Multi-Specialty,,1194827170,"LEWIS, DAVID, SCOTT",700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,3762 DURHAM RD STE A ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194827170,"LEWIS, DAVID, SCOTT",3762 DURHAM RD STE A ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 22 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1194827907,"FOX, TARA, HOKE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194828681,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07031,2210 FLEMING RD   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1194828681,NORTH CAROLINA CVS PHARMACY LLC,2210 FLEMING RD   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1194828871,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07381,1703 LIVE OAK ST   BEAUFORT NC,016,Carteret,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1194828871,NORTH CAROLINA CVS PHARMACY LLC,1703 LIVE OAK ST   BEAUFORT NC,016,Carteret,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1700976701,PRIMECARE PHYSICIANS,~,201 COX BLVD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194829499,"ZARA, LEONARDO, MONTUYA",201 COX BLVD   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 202 , 661 , 701 ," $22,848.47 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1194832691,"MIHAILESCU, VIOLETA",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194832691,"MIHAILESCU, VIOLETA",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194832691,"MIHAILESCU, VIOLETA",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194832691,"MIHAILESCU, VIOLETA",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 47 ,$#,,
MEDICAID DIRECT,1083643290,GOLDENBERG PIERCE & APPLEBAUM DDS P,THE GREENSBORO CENTER FOR PEDIATRIC DENTISTRY,5408 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1194834135,"APPLEBAUM, MATTHEW, SCOTT",5408 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 311 , 590 ," 2,013 "," $57,797.85 ",,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194834911,"HUGHES, MEGHEN, ANN",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1194836528,"HARPER, KEITH, WILLIAM",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 37 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194836700,"CALIKOGLU, ALI, SUHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 14 , 22 , 22 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194836973,"TUCCI, KEITH, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 67 , 83 , 95 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194836973,"TUCCI, KEITH, ANTHONY",2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194836973,"TUCCI, KEITH, ANTHONY",701 DOCTORS DR STE H KINSTON NC,054,Lenoir,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1932562105,SANDPIPER PEDIATRICS PLLC,SANDPIPER PEDIATRICS,27417 ANDREW JACKSON HWY E   DELCO NC,024,Columbus,193400000X,Group,Single Specialty,,1194839811,"AMIN, RAAJ, ROMESH",27417 ANDREW JACKSON HWY E   DELCO NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 78 , 181 ,$#,,
MEDICAID DIRECT,1902020308,NC DHHS CHILD AND FAMILY WELL-BEING,DURHAM CDSA,115 MARKET ST STE 201 DURHAM NC,032,Durham,252Y00000X,Agencies,Early Intervention Provider Agency,,1194840132,"BUSCH, VIRGINIA, SMITH",115 MARKET ST STE 201 DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 85 , 87 , 117 ," $14,981.82 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194847707,"CLAREY, KRISTEN, SAMUHEL",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194847707,"CLAREY, KRISTEN, SAMUHEL",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760202303,NOVANT HEALTH TRIANGLE MEDICAL GROU,CAROLINA FAMILY PRACTICE & SPORTS MEDICINE,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194847707,"CLAREY, KRISTEN, SAMUHEL",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1194849992,"MITLEHNER, PATRICIA LYNN, GABRIELLE",1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 58 , 112 , 124 ," $12,692.76 ",,
MEDICAID DIRECT,1194850180,BAPTIST CHILDRENS HOME OF NC INC,HINKLE HOUSE AT BETHABARA,2030 CLYDE HAYES DR   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194850180,BAPTIST CHILDRENS HOME OF NC INC,2030 CLYDE HAYES DR   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194853457,"SCANNELL, KASEY, WYMER",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1194858498,CASWELL COUNTY HEALTH DEPARTMENT,COUNTY OF CASWELL,189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1194858498,CASWELL COUNTY HEALTH DEPARTMENT,189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 90 , 553 ," 1,120 "," $48,619.46 ",,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194862094,"HOOPER, IVENITA, MIGNON",301 LLOYD ST   CARRBORO NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 37 , 52 , 52 ,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194862094,"HOOPER, IVENITA, MIGNON",301 LLOYD ST   CARRBORO NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1194862177,MOOSE PHARMACY OF KANNAPOLIS,MOOSE PHARMACY OF KANNAPOLIS,1113 N MAIN ST   KANNAPOLIS NC,080,Rowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1194862177,MOOSE PHARMACY OF KANNAPOLIS,1113 N MAIN ST   KANNAPOLIS NC,080,Rowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1881165876,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- RAEFORD,6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194869263,"PAZOKIAN, SID",3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1366268542,LUIS GAMBOA DMD PC,,3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194869263,"PAZOKIAN, SID",3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1386115293,LUZ E ESTRADA DDS PLLC II,CARY DENTAL STUDIO,300 ASHVILLE AVE STE 270 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1194869263,"PAZOKIAN, SID",300 ASHVILLE AVE STE 270 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 55 , 197 ,$#,,
MEDICAID DIRECT,1881165876,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- RAEFORD,6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194869263,"PAZOKIAN, SID",933 ROCKFORD ST STE 1 MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1194869263,"PAZOKIAN, SID",Sid Pazokian,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1194869263,"PAZOKIAN, SID",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881165876,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- RAEFORD,6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194869263,"PAZOKIAN, SID",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 40 , 116 ,$#,,
MEDICAID DIRECT,1134536188,LUZ E ESTRADA DDS PLLC,DURHAM DENTAL STUDIO,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1194869263,"PAZOKIAN, SID",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 28 , 100 ,$#,,
MEDICAID DIRECT,1750877809,"MCADOO, EVITA, DANIELLE",,31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1194869263,"PAZOKIAN, SID",1419 COLLEGE ST STE B OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1366268542,LUIS GAMBOA DMD PC,,3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194869263,"PAZOKIAN, SID",1419 COLLEGE ST STE B OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1194869263,"PAZOKIAN, SID",1419 COLLEGE ST STE B OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881165876,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- RAEFORD,6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194869263,"PAZOKIAN, SID",1419 COLLEGE ST STE B OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 324 , 549 ," 1,964 "," $107,732.54 ",,
MEDICAID DIRECT,1245600931,RICCOBENE & ASSOCIATES XVI DDS PA,BRUSH AND FLOSS ORTHODONTICS,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1194869420,"PATTERSON, RICHARD, ANTHONY",1001 WIDEWATERS PKWY STE B KNIGHTDALE NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872044,"BURGESS, EARLE, FREDERICK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 18 , 48 , 48 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1194872044,"BURGESS, EARLE, FREDERICK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1194872275,"BOUGHMAN, ARVIS, BENNETT",~,1225 WATER WHEEL CV   CLYDE NC,044,Haywood,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1194872275,"BOUGHMAN, ARVIS, BENNETT",1225 WATER WHEEL CV   CLYDE NC,044,Haywood,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 51 ," 3,921 "," 3,924 "," $265,142.65 ",,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872903,"NGO, TUE, HOC",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872903,"NGO, TUE, HOC",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 34 , 58 , 82 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872903,"NGO, TUE, HOC",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 24 , 24 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872903,"NGO, TUE, HOC",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 30 , 72 , 72 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872903,"NGO, TUE, HOC",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872903,"NGO, TUE, HOC",4539 HEDGEMORE DR   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 21 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194872903,"NGO, TUE, HOC",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 17 , 85 , 85 ,$#,,
MEDICAID DIRECT,1427516830,BHAVANA JAYARAM DMD PLLC,KANNAPOLIS PEDIATRIC DENTISTRY,1706 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1194873489,"JAYARAM, BHAVANA",1706 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 5,056 "," 8,860 "," 37,096 "," $1,168,517.67 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1194874131,"CHARKOUDIAN, LEON, DAVID",6 DOCTORS CIR STE 2 SUPPLY NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1194874131,"CHARKOUDIAN, LEON, DAVID",10 DOCTORS CIR STE 1 SUPPLY NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 41 , 84 ,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1194874131,"CHARKOUDIAN, LEON, DAVID",1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 62 , 170 , 381 ," $32,409.26 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1194874131,"CHARKOUDIAN, LEON, DAVID",1098 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 40 , 88 ,$#,,
MEDICAID DIRECT,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL OAK ISLAND,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194874420,"GAUTHIER, LORRAINE, MARIE",4700 E OAK ISLAND DR   OAK ISLAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194875112,"WILSON, JIMMY JOHN, CLIFFORD",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1194875112,"WILSON, JIMMY JOHN, CLIFFORD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1699028589,G ABRAMS S NAGEL AND ASSOCIATES PC,G ABRAMS S NAGEL AND ASSOCIATES PC,10125 PERIMETER PKWY STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194877597,"NAGEL, SCOTT, HOLBROOK",10125 PERIMETER PKWY   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,516 "," 2,682 "," 9,446 "," $447,315.74 ",,
MEDICAID DIRECT,1619125804,G ROSS ABRAMS DMD,G ROSS ABRAMS DMD,591 RIVER HWY STE M MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194877597,"NAGEL, SCOTT, HOLBROOK",591 RIVER HWY STE M MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 919 ," 1,921 "," 6,482 "," $381,770.37 ",,
MEDICAID DIRECT,1194881581,SOUTHERN ASSISTED LIVING INC,BROOKDALE BURLINGTON,3619 S MEBANE ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1194881581,SOUTHERN ASSISTED LIVING INC,3619 S MEBANE ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 908 , 908 ," $76,132.04 ",,
MEDICAID DIRECT,1588859466,WAKE FOREST HEALTH NETWORK LLC,AHWFB INTERNAL MEDICINE - ASHEBORO,327 ROCK CRUSHER RD   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1194883538,"GRISSO, GREG, ALAN",327 ROCK CRUSHER RD   ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 69 , 84 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1194883736,"JUTTE, ANDREA, DOREEN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 36 , 41 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1194883736,"JUTTE, ANDREA, DOREEN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 31 , 37 ,$#,,
MEDICAID DIRECT,1669808143,SYLVA EMERGENCY GROUP LLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1194883736,"JUTTE, ANDREA, DOREEN",68 HOSPITAL RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 131 , 142 , 152 ," $13,102.21 ",,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1194883736,"JUTTE, ANDREA, DOREEN",68 HOSPITAL RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962544197,CHARLES R DISDIER DDS PA,IMMEDIATE DENTAL CARE,1468 TARBORO ST W STE F WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1194886937,"DISDIER, CHARLES, RANDAL",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice," 2,077 "," 2,915 "," 12,226 "," $638,464.18 ",,
MEDICAID DIRECT,1194886937,"DISDIER, CHARLES, RANDAL",~,1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,1194886937,"DISDIER, CHARLES, RANDAL",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 44 ,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194886937,"DISDIER, CHARLES, RANDAL",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 795 ," 1,086 "," 3,192 "," $159,797.99 ",,
MEDICAID DIRECT,1962544197,CHARLES R DISDIER DDS PA,IMMEDIATE DENTAL CARE,1468 TARBORO ST W STE F WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1194886937,"DISDIER, CHARLES, RANDAL",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 56 ,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1194886937,"DISDIER, CHARLES, RANDAL",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194888958,"ALOI, JOSEPH, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 39 , 49 , 58 ,$#,,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1194893438,HEALTH & HOME SERVICES INC,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,, 14 , 330 , 330 ," $112,099.00 ",,
MEDICAID DIRECT,1184236564,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1194893438,HEALTH & HOME SERVICES INC,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,#,#,#,$#,,
MEDICAID DIRECT,1184236564,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1194893438,HEALTH & HOME SERVICES INC,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1194893438,HEALTH & HOME SERVICES INC,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#, 29 , 29 ," $10,738.00 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194898122,"SANDOVAL, JOHN, JOSEPH",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 33 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1194899484,"HEALY, JOSEPH, STEPHEN",3100 WELLONS BLVD   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1194899484,"HEALY, JOSEPH, STEPHEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1194899484,"HEALY, JOSEPH, STEPHEN",3100 WELLONS BLVD   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 14 , 30 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1194899484,"HEALY, JOSEPH, STEPHEN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 26 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1194899484,"HEALY, JOSEPH, STEPHEN",975 NEWMAN RD   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1194899484,"HEALY, JOSEPH, STEPHEN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 12 , 19 ,$#,,
MEDICAID DIRECT,1194899542,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194899542,PERSON FAMILY MEDICAL CENTER,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1194899617,"MARNOCK, JAMES, JEROME",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1194899617,"MARNOCK, JAMES, JEROME",15 JANE JACOBS RD STE 101 BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 16 , 37 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1194899617,"MARNOCK, JAMES, JEROME",15 JANE JACOBS RD STE 101 BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194899633,"GUINE, MARCIA, LYNNETTE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194899633,"GUINE, MARCIA, LYNNETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 42 , 45 , 45 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194901967,"BLEJA, LAUREN, ELIZABETH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619244084,GREENE COUNTY HEALTH CARE INC,PAMLICO COMMUNITY HEALTH CENTER,313 MAIN ST   BAYBORO NC,069,Pamlico,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194904227,"ELLIOTT, ANNE, MARIE",313 MAIN ST   BAYBORO NC,069,Pamlico,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639125271,VANN-VIRGINIA CENTER FOR ORTHOPAEDI,ATLANTIC ORTHOPAEDIC SPECIALISTS,1309 EXECUTIVE BLVD STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194904474,"CAROFINO, BRADLEY, COX",1309 EXECUTIVE BLVD STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1194905455,"THOMAS, JESSIE, LYNN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1194905778,"MANAVI, CYRUS, KORESH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1194905778,"MANAVI, CYRUS, KORESH",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 59 , 59 , 101 ,$#,,
MEDICAID DIRECT,1356301725,ATLANTIC PATHOLOGY GROUP PA,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1194905778,"MANAVI, CYRUS, KORESH",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194905778,"MANAVI, CYRUS, KORESH",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 53 , 55 , 96 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",171 DANIEL RD   FOREST CITY NC,081,Rutherford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 87 , 160 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",70 NEELY RD   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",70 NEELY RD   BREVARD NC,088,Transylvania,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",70 NEELY RD   BREVARD NC,088,Transylvania,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,171 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",70 NEELY RD   BREVARD NC,088,Transylvania,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",600 HOSPITAL DR STE 10 CLYDE NC,044,Haywood,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,63 S MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",63 S MEDICAL CT   MARION NC,059,McDowell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",95 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 96 , 161 ," $21,031.76 ",,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,,,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1194905984,"BASEMAN, DANIEL, GARY",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 28 , 128 , 290 ," $12,028.33 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194906891,"TLHABANO, LETLHOGONOLO, BENNY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194906891,"TLHABANO, LETLHOGONOLO, BENNY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 104 , 167 , 189 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194906891,"TLHABANO, LETLHOGONOLO, BENNY",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194906891,"TLHABANO, LETLHOGONOLO, BENNY",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194907568,"DIGGS, TERESA, CHADWICK",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 94 , 201 , 282 ,$#,,
MEDICAID DIRECT,1114269677,BLADEN HEALTHCARE LLC,BLADEN EXPRESS CARE,107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1194908376,"GRAHAM, BRIANA, GAYLE",107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 100 , 118 , 118 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194910299,"REYNOLDS, STACY, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 42 , 49 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194911123,"DRANOVE, JASON, ERIC",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 41 , 54 , 67 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194911123,"DRANOVE, JASON, ERIC",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194911123,"DRANOVE, JASON, ERIC",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 20 , 21 , 29 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194911123,"DRANOVE, JASON, ERIC",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 22 , 27 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194911123,"DRANOVE, JASON, ERIC",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1194911727,"SHANKAR, VIJI",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 52 , 69 , 100 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1194912618,"KHAN, RANA, JAHANZAIB",534 CARATOKE HWY   MOYOCK NC,027,Currituck,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 222A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194912618,"KHAN, RANA, JAHANZAIB",300 MEDICAL PKWY STE 222A CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194912618,"KHAN, RANA, JAHANZAIB",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1194912618,"KHAN, RANA, JAHANZAIB",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1805 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1194912618,"KHAN, RANA, JAHANZAIB",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194914549,"STURCHIO, ELIZABETH, ASHLEY",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1124726377,LONGEVITY AND PERFORMANCE CLINIC,,2475 HILLCREST CENTER CIR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1194917732,"REITER, TODD, MICHAEL",2475 HILLCREST CENTER CIR   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 36 , 108 , 110 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1194917732,"REITER, TODD, MICHAEL",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 37 , 72 , 155 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1194917732,"REITER, TODD, MICHAEL",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 28 , 45 , 85 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1194917732,"REITER, TODD, MICHAEL",625 ASHLAND ST   ARCHDALE NC,076,Randolph,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1194917732,"REITER, TODD, MICHAEL",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 28 , 35 , 80 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1194917732,"REITER, TODD, MICHAEL",610 N FAYETTEVILLE ST STE 106 ASHEBORO NC,076,Randolph,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 41 , 102 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1194917732,"REITER, TODD, MICHAEL",704A PROGRESS PL   LAURINBURG NC,083,Scotland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 12 , 16 , 38 ,$#,,
MEDICAID DIRECT,1770515272,INTRACOASTAL INTERNAL MEDICINE,~,2580 PICKARD RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1194918052,"RICHARDSON, MICHELLE, WILLIAMS",2580 PICKARD RD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 22 , 39 ,$#,,
MEDICAID DIRECT,1710484811,THE MOSES H CONE MEMORIAL HOSPITAL,CHILD ADVOCACY MEDICAL CLINIC,201 S GREENE ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194918375,"SMITH, ESTHER, PAULINE",201 S GREENE ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194918631,"ECKRICH, MICHAEL, JAMES",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194918631,"ECKRICH, MICHAEL, JAMES",1001 BLYTHE BLVD STE 601 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780014761,CAROLINA CHILD NEUROLOGY,CAROLINA CHILD NEUROLOGY PLLC1,1540 PURDUE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1194919514,"INDULKAR, SHALAKA",1540 PURDUE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 140 , 236 , 256 ," $44,565.52 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194921767,"KIMMEL, MARY, CLAIRE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1194921767,"KIMMEL, MARY, CLAIRE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194921783,"IQBAL, TARIQ",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194921783,"IQBAL, TARIQ",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1881712842,NORTH CAROLINA STATE UNIVERSITY,,2815 CATES AVE   RALEIGH NC,092,Wake,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1194921981,"BOWEN PASFIELD, SARAH, DANIELLE",2815 CATES AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1194922005,"CEDILLOS, KEREN, ELIANY",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1194923466,"MONROE, PATRICIA, WILLIAMSON",1424B FERN CREEK DR   STATESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1225578511,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN UROLOGY,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194923474,"LEE, GEORGE, LEIGHTON",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194923474,"LEE, GEORGE, LEIGHTON",423 S SOUTH ST   MOUNT AIRY NC,086,Surry,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1225578511,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN UROLOGY,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1194923474,"LEE, GEORGE, LEIGHTON",423 S SOUTH ST   MOUNT AIRY NC,086,Surry,208800000X,Allopathic & Osteopathic Physicians,Urology,, 87 , 237 , 418 ,$#,,
MEDICAID DIRECT,1225578511,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN UROLOGY,,,Unknown,193400000X,Group,Single Specialty,,1194923474,"LEE, GEORGE, LEIGHTON",423 S SOUTH ST   MOUNT AIRY NC,086,Surry,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194924860,"CHIU, STEPHEN, KUN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194924860,"CHIU, STEPHEN, KUN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194924860,"CHIU, STEPHEN, KUN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 138 , 138 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1194924910,"MOZEIK, CARRIE, LEIGH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194924910,"MOZEIK, CARRIE, LEIGH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720415946,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PEDIATRIC NEUROLOGY CARE - MOREHEAD,1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194925396,"VAN POPPEL, KATHERINE, CRYAN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194925396,"VAN POPPEL, KATHERINE, CRYAN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194925396,"VAN POPPEL, KATHERINE, CRYAN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194925396,"VAN POPPEL, KATHERINE, CRYAN","101 EAST WT HARRIS BLVD BLDG 3000, SUITE 3301-B CHARLOTTE NC",060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194925396,"VAN POPPEL, KATHERINE, CRYAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 34 , 43 , 45 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194925396,"VAN POPPEL, KATHERINE, CRYAN",100 MEDICAL PARK DR STE 310F CONCORD NC,013,Cabarrus,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 32 , 40 , 41 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1194925396,"VAN POPPEL, KATHERINE, CRYAN",100 MEDICAL PARK DR STE 310F CONCORD NC,013,Cabarrus,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 76 , 120 , 148 ," $11,538.25 ",,
MEDICAID DIRECT,1043272784,GREENSBORO DERMATOLOGY ASSOCIATES P,GREENSBORO DERMATOLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1194926832,"STINEHELFER, SUSAN, ESTELLE",2704 SAINT JUDE ST   GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194926840,"ROMANOWSKI, JAMES, RICHARD",1918 RANDOLPH RD STE 700 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 26 , 52 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194926840,"ROMANOWSKI, JAMES, RICHARD",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 46 , 68 , 160 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194926840,"ROMANOWSKI, JAMES, RICHARD",1401 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 65 , 135 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194926840,"ROMANOWSKI, JAMES, RICHARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194927913,"STASHENKO, GREGG, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 71 , 91 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194927913,"STASHENKO, GREGG, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194927913,"STASHENKO, GREGG, JOSEPH",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194928713,"SHEIKH, SAIRA, ZAFAR",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 19 , 23 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194928713,"SHEIKH, SAIRA, ZAFAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194928713,"SHEIKH, SAIRA, ZAFAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1528704004,PITT COUNTY MEMORIAL HOSPITAL INC,ECU HEALTH BEAUFORT HOSPITAL,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1194931741,"ROWE, STEPHENE, FOREMAN",628 E 12TH ST   WASHINGTON NC,007,Beaufort,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194934810,"BRIGHT, RONI, JEAN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194934810,"BRIGHT, RONI, JEAN",855 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194934992,"ROZAN, LAUZE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194934992,"ROZAN, LAUZE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1194934992,"ROZAN, LAUZE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194938324,"KATOCH, ANAMIKA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1194938324,"KATOCH, ANAMIKA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 75 , 199 , 199 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194940288,"EURE, JOANNE, HAISLIP",1970 W ARLINGTON BLVD STE C GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 59 , 107 , 107 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194940288,"EURE, JOANNE, HAISLIP",121 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 53 , 110 , 138 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1194946186,"PRESTWOOD, JESSICA, JANE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1194946186,"PRESTWOOD, JESSICA, JANE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 21 , 41 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1194949883,"BRANDON, JONATHAN, LIGHTFOOT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194949883,"BRANDON, JONATHAN, LIGHTFOOT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 43 , 49 ,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 3 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1194950659,"TILTON, MCKENZIE, ERIN",711 EXECUTIVE PL FL 3 FAYETTEVILLE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194952192,"MADIREDDY, SREEDHAR, REDDY",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194952192,"MADIREDDY, SREEDHAR, REDDY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 114 , 177 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194952192,"MADIREDDY, SREEDHAR, REDDY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194952192,"MADIREDDY, SREEDHAR, REDDY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194952192,"MADIREDDY, SREEDHAR, REDDY",542 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194952267,"BAER, AARON, HEINRICH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 207 , 220 , 246 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1194952267,"BAER, AARON, HEINRICH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 187 , 200 , 247 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194957423,"MATTHEWS, JAMES, STEPHEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 95 , 98 ,$#,,
MEDICAID DIRECT,1871052597,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KILDAIRE FARM ROAD,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194959114,"EVANS, BRADLEY, HILTON",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730470592,ANMED HEALTH,ANMED CARDIOLOGY,100 HEALTHY WAY STE 1250 ANDERSON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194959239,"MEEHAN, JOHN, THOMAS",800 N FANT ST   ANDERSON SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1821643172,LONGLEAF WELLNESS PLLC,,1090 E CENTRAL AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1194962217,"TAYLOR, JAMES, BRADFORD",1090 E CENTRAL AVE   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 144 , 183 ,$#,,
MEDICAID DIRECT,1689637225,RAEFORD FAMILY CARE CENTER,,,,Unknown,193400000X,Group,Single Specialty,,1194962217,"TAYLOR, JAMES, BRADFORD",1090 E CENTRAL AVE   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1194967372,"AUGSBURGER, JACQUELINE, SUE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194967497,"MALINZAK, ELIZABETH, BURNEY",2400 A NORTH PAVILION   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194967497,"MALINZAK, ELIZABETH, BURNEY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194967497,"MALINZAK, ELIZABETH, BURNEY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194967497,"MALINZAK, ELIZABETH, BURNEY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1194967745,"MANNY, JULIA, SODEMAN",GREENSBORO PATHOLOGY LLC,2600 ATLANTIC AVE # 100 RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,1194967745,"MANNY, JULIA, SODEMAN",2600 ATLANTIC AVE # 100 RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1417911322,TRIANGLE GASTROENTEROLOGY LLC,TRIANGLE GASTROENTEROLOGY LLC,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1194967745,"MANNY, JULIA, SODEMAN",2600 ATLANTIC AVE # 100 RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 16 , 16 , 22 ,$#,,
MEDICAID DIRECT,1790830487,CHILDRENS MEDICAL GROUP INC,SUFFOLK PEDIATRICS,1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194967901,"LAMOTTE, BERNADETTE, ADRIANNE",1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1194968115,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,834 TYVOLA RD STE 108 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1194968115,CNC-ACCESS INC,834 TYVOLA RD STE 108 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 840 , 840 ," $57,098.98 ",,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1194969204,"GOURLEY, JEFFREY, RYAN",582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194969329,"HOLMES, BEVERLY, ELAINE",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194969329,"HOLMES, BEVERLY, ELAINE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1194973230,"HARLESS, JEREMY, LELAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1194973230,"HARLESS, JEREMY, LELAND",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 21 , 26 ,$#,,
MEDICAID DIRECT,1962097006,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR AFM,2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194974535,"ODIBO, IMELDA, NGOZI",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962097006,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR AFM,2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194974535,"ODIBO, IMELDA, NGOZI",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194974535,"ODIBO, IMELDA, NGOZI",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962097006,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR AFM,2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194974535,"ODIBO, IMELDA, NGOZI",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194974535,"ODIBO, IMELDA, NGOZI",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1962097006,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR AFM,2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1194974535,"ODIBO, IMELDA, NGOZI",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 107 , 185 , 321 ," $19,680.94 ",,
MEDICAID DIRECT,1194975854,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,415 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1194975854,LEVEL FOUR ORTHOTICS & PROSTHETICS,415 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 19 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1194976076,"JEFFERSON, DARLISHIA, LE'SHAWN",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 408 , 423 ," 1,034 "," $28,454.32 ",,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1194976076,"JEFFERSON, DARLISHIA, LE'SHAWN",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 55 , 76 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 79 , 91 , 131 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 35 , 50 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 498 , 589 , 765 ," $12,499.06 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194976142,"CHEN, PEIWENG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 29 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",310 LONG SHOALS RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1194976142,"CHEN, PEIWENG",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1194976142,"CHEN, PEIWENG",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 42 , 54 ,$#,,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,501 DOUGLAS ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1194980474,"TENEKJIAN, CHRISTINE, BAHIA",501 DOUGLAS ST   DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1194981340,"YEN, MAY, YUNG-YUN",2100 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1194981340,"YEN, MAY, YUNG-YUN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 84 , 88 , 95 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194982371,"TOLCHER, KELLY, L.",269 GILLMAN RD STE 200A DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 31 , 72 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1194982496,"DAUTEUIL, CORINNE, J.",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1851783385,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL INTERNAL MEDICINE SPECIALISTS,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1194983759,"NOWIKOWSKI, KELLI, DAVIS",194 DOCTORS DR   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 47 , 88 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 105 , 111 , 143 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1194984930,"MIR, FARHAAN, ROWSHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1194987073,"GHOBRIAL, MICHELLE, LYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 30 , 32 ,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194987115,"PLICHTA, RYAN, PATRICK",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 20 , 23 ,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1194987115,"PLICHTA, RYAN, PATRICK",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194987677,"KASAJI, MOHAMMAD, KHALIL",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194987677,"KASAJI, MOHAMMAD, KHALIL",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679263552,KASAJI MEDICAL PC,QUEEN CITY PRIMARY AND URGENT CARE,5820 E W T HARRIS BLVD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1194987677,"KASAJI, MOHAMMAD, KHALIL",5820 E W T HARRIS BLVD STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 28 , 62 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194989798,"SHALHOUB, GEORGE, JOSEPH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1194989798,"SHALHOUB, GEORGE, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1194990622,"CHISHOLM, JOEL, PATRICK",1 HOSPITAL RD   CHEROKEE NC,087,Swain,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1194990622,"CHISHOLM, JOEL, PATRICK",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 17 , 95 , 95 ,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1194992651,"ANDERSON, DONNA, RAY",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 136 , 206 , 274 ," $17,390.32 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194992909,"MORGAN, MICHAEL, LOUIS",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194992909,"MORGAN, MICHAEL, LOUIS",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1194992909,"MORGAN, MICHAEL, LOUIS",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205002649,"CLOUGH, JEFFREY, DAVID",3044 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 46 , 92 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205003274,"ESMAILI, BAHAR, EMILY",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205003274,"ESMAILI, BAHAR, EMILY",414 E MAIN ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205003316,"OKEKE, NWORA, LANCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 17 , 34 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205003316,"OKEKE, NWORA, LANCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205003316,"OKEKE, NWORA, LANCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205003316,"OKEKE, NWORA, LANCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205009248,"YOUNGE, NOELLE, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1205009420,"CHAPPELEAR, EMILY, ALEXANDRA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205009420,"CHAPPELEAR, EMILY, ALEXANDRA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205009420,"CHAPPELEAR, EMILY, ALEXANDRA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1205009420,"CHAPPELEAR, EMILY, ALEXANDRA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205009420,"CHAPPELEAR, EMILY, ALEXANDRA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 24 , 29 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1205009420,"CHAPPELEAR, EMILY, ALEXANDRA",116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1205009891,"RAMARAJ, RADHAKRISHNAN",511 RUIN CREEK RD STE 106 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 112 , 139 , 150 ,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1205009891,"RAMARAJ, RADHAKRISHNAN",1614 WILLIAMSBORO ST   OXFORD NC,039,Granville,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 112 , 218 , 272 ," $14,312.22 ",,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,1614 WILLIAMSBORO ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1205009891,"RAMARAJ, RADHAKRISHNAN",1614 WILLIAMSBORO ST   OXFORD NC,039,Granville,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1205009891,"RAMARAJ, RADHAKRISHNAN",710 ERWIN RD   DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 417 ," 1,503 "," 2,148 "," $105,486.66 ",,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1205009891,"RAMARAJ, RADHAKRISHNAN",710 ERWIN RD   DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205010758,"LIN, JESSICA, TINGSAN",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205010758,"LIN, JESSICA, TINGSAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 72 , 77 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205011087,"EDWARDS, JESSICA, AGATHA",601 N ELM ST   HIGH POINT NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205011087,"EDWARDS, JESSICA, AGATHA",445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205014909,AHOSKIE EYE CARE OD PA,AHOSKIE EYE CARE OD PA,500 CHURCH ST W   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1205014909,AHOSKIE EYE CARE OD PA,500 CHURCH ST W   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,, 186 , 187 , 371 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205021144,"GOSALA, SASHIVANI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 206 , 206 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205021144,"GOSALA, SASHIVANI",2001 VAIL AVENUE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205021144,"GOSALA, SASHIVANI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 50 , 50 ,$#,,
MEDICAID DIRECT,1205021631,HELPING HANDS ALTERNATIVE OF OXFORD,~,308 HILLSBORO ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1205021631,HELPING HANDS ALTERNATIVE OF OXFORD,308 HILLSBORO ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 3,081 "," 3,348 "," $454,985.48 ",,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1205022886,"WEBER, KATHRYN, JULIA",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205023025,"BELLINGER, CHRISTINA, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 69 , 80 , 109 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205023025,"BELLINGER, CHRISTINA, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205023744,"RITZ, TRISHA, OSBORN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205026903,"BISSELL, BRAD, JOSEPH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 75 , 475 , 678 ,$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205026903,"BISSELL, BRAD, JOSEPH",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 71 , 95 ,$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205026903,"BISSELL, BRAD, JOSEPH",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 147 , 194 ,$#,,
MEDICAID DIRECT,1851646756,CAROLINAS PHYSICIANS NETWORK INC,EDWARD B BOWER MD,1423 E FRANKLIN ST STE B MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205026903,"BISSELL, BRAD, JOSEPH",1423 E FRANKLIN ST STE B MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588166060,ALLCARE MEDICAL CENTER PC,ALLCARE MEDICAL CENTERPC,7401 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205029600,"EJINDU, UWADIOGBU, ODINAKA",7401 THE PLZ   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 86 , 449 , 972 ," $16,069.44 ",,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1205032984,"KIM, SEUNG, WON",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 112 , 274 , 417 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1205032984,"KIM, SEUNG, WON",7 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205032984,"KIM, SEUNG, WON",~,8001 CREEDMOOR RD STE 107 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1205032984,"KIM, SEUNG, WON",8001 CREEDMOOR RD STE 107 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205034147,"GONZALEZ, INGRID, RODOLFINA",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 50 , 67 , 77 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205034188,"BARTLETT, ROBERT, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1205034527,"KIM-SHAPIRO, JUNG WHA",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205034527,"KIM-SHAPIRO, JUNG WHA",10 MEDICAL PARK DR STE 5 LEXINGTON NC,029,Davidson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 105 , 111 , 157 ,$#,,
MEDICAID DIRECT,1811024979,EASTERN PEDIATRICS PA,Eastern Pediatrics PA,1901 STONEHENGE DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1205034576,"STRICKLAND ERWIN, JULIE, ANN",1901 STONEHENGE DR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 48 , 89 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205035102,"KHAN, PHILLIP, DAVID",1456 N HOWE ST STE 201 SOUTHPORT NC,010,Brunswick,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 11 , 16 , 20 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205035102,"KHAN, PHILLIP, DAVID",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205035466,"GHOSH, NILANJAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205035557,"GRANING, ROLF, EDWARD",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205036662,"TAYLOR, LISA, MARIE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 43 , 48 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205037116,"ELLISON, BRADLEY, SCOTT",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205037116,"ELLISON, BRADLEY, SCOTT",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205037116,"ELLISON, BRADLEY, SCOTT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205037116,"ELLISON, BRADLEY, SCOTT",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 41 , 57 , 90 ,$#,,
MEDICAID DIRECT,1356852511,GRACE CLINIC OF YADKIN VALLEY,,948 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1205037918,"KOLOVRAT JR, FRANK",1106 SUNSET AVE   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1205037918,"KOLOVRAT JR, FRANK",1106 SUNSET AVE   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205040813,"KAMATH, SAMEER, SHANTARAM",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 38 , 89 , 92 ," $15,158.33 ",,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1205041274,"CHAN, KATHERINE, HUBERT",1301 CENTRAL DR   SANFORD NC,053,Lee,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205041274,"CHAN, KATHERINE, HUBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 29 , 42 , 44 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205041969,"REDDY, MADHAVI, GADE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 27 , 71 ,$#,,
MEDICAID DIRECT,1205042678,BIO TECH PROSTHETICS AND ORTHOTICS,~,3909 SUNSET RIDGE RD STE 103 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1205042678,BIO TECH PROSTHETICS AND ORTHOTICS,3909 SUNSET RIDGE RD STE 103 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 20 , 23 , 137 ," $22,595.32 ",,
MEDICAID DIRECT,1205043411,DAVID L KING OD,KING EYE CENTER OD PA,312 E CENTERVIEW ST   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1205043411,DAVID L KING OD,312 E CENTERVIEW ST   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,, 47 , 47 , 94 ,$#,,
MEDICAID DIRECT,1205044799,"LOCKLEAR, CHERYL, RANSOM",~,239 S MAIN ST   RED SPRINGS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,1205044799,"LOCKLEAR, CHERYL, RANSOM",239 S MAIN ST   RED SPRINGS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice," 1,505 "," 3,505 "," 11,286 "," $484,896.17 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205046927,"KANG, YUBIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205046927,"KANG, YUBIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205046927,"KANG, YUBIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205047628,"JOYNER, SARAH, ELIZABETH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205047628,"JOYNER, SARAH, ELIZABETH",1708 OLD DONATION PKWY   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205048766,ACCESS HEALTH SYSTEM1 CORP,ACCESS HEALTH SYSTEM 1 CORP,5132 DICE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205048766,ACCESS HEALTH SYSTEM1 CORP,5132 DICE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,398 "," 1,398 "," $87,722.92 ",,
MEDICAID DIRECT,1205048766,ACCESS HEALTH SYSTEM1 CORP,ACCESS HEALTH SYSTEM 1 CORP,5208 COUNTRY PINES CT   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205048766,ACCESS HEALTH SYSTEM1 CORP,5208 COUNTRY PINES CT   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 369 , 369 ," $23,314.02 ",,
MEDICAID DIRECT,1205048766,ACCESS HEALTH SYSTEM1 CORP,ACCESS HEALTH SYSTEM 1 CORP,234 SEVEN OAKS RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205048766,ACCESS HEALTH SYSTEM1 CORP,234 SEVEN OAKS RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,020 "," 1,020 "," $63,983.56 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205049533,"ENGLERT DOGGETT, DANIELLE, E",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 36 , 57 , 79 ,$#,,
MEDICAID DIRECT,1205053444,INTERIM HEALTHCARE MORRIS GROUP INC,,419 S BROAD ST   EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,,1205053444,INTERIM HEALTHCARE MORRIS GROUP INC,419 S BROAD ST   EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,,#, 736 , 736 ," $49,136.36 ",,
MEDICAID DIRECT,1205054681,BOGER CITY REST HOME,BOGER CITY REST HOME,1428 LITTLE VALLEY LN   LINCOLNTON NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205054681,BOGER CITY REST HOME,1428 LITTLE VALLEY LN   LINCOLNTON NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 24 , 194 , 194 ," $343,812.80 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205056041,"COMER, ROBERT, WALLACE",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 110 , 171 , 271 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205058526,"SINGH, AMITA",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205060712,"SELLERS, CHRISTOPHER, JAMES",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 70 , 106 , 174 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205060712,"SELLERS, CHRISTOPHER, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 26 , 58 , 70 ,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205060902,"LANGSTON, JOSHUA, PAUL",225 CLEARFIELD AVE   VA BCH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205061678,"ROMMEL, JOHN, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 30 , 61 , 65 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205061678,"ROMMEL, JOHN, JAMES",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205061678,"ROMMEL, JOHN, JAMES",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205061678,"ROMMEL, JOHN, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205061678,"ROMMEL, JOHN, JAMES",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205061678,"ROMMEL, JOHN, JAMES",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 30 , 46 , 77 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205061678,"ROMMEL, JOHN, JAMES",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205061678,"ROMMEL, JOHN, JAMES",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 17 , 25 , 54 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205062064,"RANA, OMAR, RIAZ",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205062064,"RANA, OMAR, RIAZ",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205062064,"RANA, OMAR, RIAZ",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,9735 KINCEY AVE STE 300 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205063526,"STETLER, WILLIAM, RICHARD",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205063526,"STETLER, WILLIAM, RICHARD",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 73 , 120 , 214 ," $19,737.76 ",,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205063559,"DAVIES, DEREK, JOHN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205066016,INTERACTIVE HEALTH THERAPIES PLLC,INTERACTIVE HEALTH THERAPIES INC,709 NORTHEAST DR STE 23 DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205066016,INTERACTIVE HEALTH THERAPIES PLLC,709 NORTHEAST DR STE 23 DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 25 , 321 , 322 ," $22,833.30 ",,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205066065,"BAJRACHARYA, PRABESH",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 109 , 139 , 366 ," $16,347.20 ",,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205066453,"DUVERNOIS, DAVID, ALAN WINSTON",200 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 204 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205066453,"DUVERNOIS, DAVID, ALAN WINSTON",1700 TARBORO ST W STE 204 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 195 , 356 , 497 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205066453,"DUVERNOIS, DAVID, ALAN WINSTON",1700 TARBORO ST W STE 204 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 64 , 87 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",1530 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8036 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",8036 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205067428,"STARACE, KATHERINE, MARIE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205068186,"BEECHER, JEFFREY, STEWART",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 31 , 36 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205068723,"THOMASON, ELIZABETH, INNES DEANS",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205068723,"THOMASON, ELIZABETH, INNES DEANS",40 DUKE MEDICINE CIR # 1-J DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205069861,"MCPHERSON, DARLA, CHRISTINE",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 68 , 91 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205069861,"MCPHERSON, DARLA, CHRISTINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 27 , 39 ,$#,,
MEDICAID DIRECT,1851342141,CAROLINA WEST RADIOLOGY PA,Carolina West Radiology PA,87 EASTGATE DR STE 2 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1205070745,"ESCARAVAGE, BRADLEY, TODD",87 EASTGATE DR STE 2 SYLVA NC,050,Jackson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 388 , 530 , 702 ," $12,719.62 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205072030,"WOOLEY, CAREY, HUBERT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1205073491,"CAREY, ANTOINE, JERMEL",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205073491,"CAREY, ANTOINE, JERMEL",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1205073491,"CAREY, ANTOINE, JERMEL",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205073491,"CAREY, ANTOINE, JERMEL",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 55 ,$#,,
MEDICAID DIRECT,1245600931,RICCOBENE & ASSOCIATES XVI DDS PA,BRUSH AND FLOSS ORTHODONTICS,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1205074754,"LIU, YI-PING",15 RAWLS RD STE 200 ANGIER NC,043,Harnett,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205078078,"AUSTIN, FRANCES, TUCKER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205081353,"RAGARD, REBECCA, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205081460,"PUETT, KAREN, JONES",767 W 1ST ST   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205081528,"MCLAUGHLIN, KAREN, GAIL",1128 CANE RIVER SCHOOL RD   BURNSVILLE NC,100,Yancey,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205090115,"GUNDERSON, KAREN, MARIE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467972703,NORTH CAROLINA SPECIALTY HOSPITALS,,3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1205090768,"STRACHAN, KENNETH, FRANCIS",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205092376,ONE STEP FORWARD OUTREACH,ONE STEP FORWARD OUTREACH,10000 WOODY RIDGE RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205092376,ONE STEP FORWARD OUTREACH,10000 WOODY RIDGE RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 59 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205097078,"MAPLE, DAVID, ANDREW",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205097078,"MAPLE, DAVID, ANDREW",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205097219,"DEPLATCHETT, KATHRYN, MIDDLETON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205097219,"DEPLATCHETT, KATHRYN, MIDDLETON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 54 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205097748,"LINTHAVONG, KANHKA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205097748,"LINTHAVONG, KANHKA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 171 , 514 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205097748,"LINTHAVONG, KANHKA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205099645,"MICHAEL, DAHLIA, THERESA",2038 LITHO PL   FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205099645,"MICHAEL, DAHLIA, THERESA",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 565 , 752 ," 2,892 "," $101,584.09 ",,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205099645,"MICHAEL, DAHLIA, THERESA",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 156 , 156 ," 2,459 "," $273,130.55 ",,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205099645,"MICHAEL, DAHLIA, THERESA",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 105 , 161 , 601 ," $26,370.80 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205099645,"MICHAEL, DAHLIA, THERESA",1031 WEISS AVE STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 23 , 23 , 64 ,$#,,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1205099645,"MICHAEL, DAHLIA, THERESA",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1962171041,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN WALNUT,131 WALNUT ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205101078,"Cooper, Michelle, K",44 BONNIE LN   SYLVA NC,050,Jackson,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205101078,"Cooper, Michelle, K",44 BONNIE LN   SYLVA NC,050,Jackson,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205101771,"KASPERSKA, MALGORZATA, EWA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 148 , 154 , 169 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205101771,"KASPERSKA, MALGORZATA, EWA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 63 , 73 , 81 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205101771,"KASPERSKA, MALGORZATA, EWA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205106507,"AUSTIN, ADRIENNE, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205106507,"AUSTIN, ADRIENNE, MARIE",3031 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205106747,"GALBRAITH, CYNTHIA, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205106747,"GALBRAITH, CYNTHIA, LYNN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 53 , 54 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205106747,"GALBRAITH, CYNTHIA, LYNN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205110442,"FERNANDEZ, MICHELLE, MARIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881165876,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- RAEFORD,6950 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205110566,"KULHARI, SNEHLATA",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205115359,"GHIMIRE, KUBER, PRASAD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205115359,"GHIMIRE, KUBER, PRASAD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 43 , 43 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205115359,"GHIMIRE, KUBER, PRASAD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 118 , 118 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205115359,"GHIMIRE, KUBER, PRASAD",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205115680,"BOSEMANI, THANGAVIJAYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205117165,"MEIER, BROOKE, BENNETT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1205117165,"MEIER, BROOKE, BENNETT",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205117165,"MEIER, BROOKE, BENNETT",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205117967,"MURO, LEIGH, ANN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 43 , 55 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1205117967,"MURO, LEIGH, ANN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1205117967,"MURO, LEIGH, ANN",307 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1205121662,"SOMMER, NATHAN, WILLIAM",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 32 , 138 ,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205121662,"SOMMER, NATHAN, WILLIAM",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205121662,"SOMMER, NATHAN, WILLIAM",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1538589577,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY APEX,966 US 64 HWY W   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1205121662,"SOMMER, NATHAN, WILLIAM",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205121803,"WHITSON, JORDAN, WESLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205121803,"WHITSON, JORDAN, WESLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 37 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205121803,"WHITSON, JORDAN, WESLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",29 NETTLEWOOD DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",,75 LEROY GEORGE DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",75 LEROY GEORGE DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",,486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",75 LEROY GEORGE DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",68 HOSPITAL RD   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",,68 HOSPITAL RD   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",68 HOSPITAL RD   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 118 , 227 , 350 ," $13,214.35 ",,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",,137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1205122173,"CLEAVELAND, NATHANIEL, ARTHUR",137 MEDICAL PARK LOOP   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205123056,"ATTUPURATH, REJI, APPUKUTTAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205123056,"ATTUPURATH, REJI, APPUKUTTAN",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205123056,"ATTUPURATH, REJI, APPUKUTTAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 21 , 33 , 33 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1901 S SHADY ST   MOUNTAIN CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205123361,"KENWORTHY, MARY, ELLEN",1901 S SHADY ST   MOUNTAIN CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205123361,"KENWORTHY, MARY, ELLEN",1901 S SHADY ST   MOUNTAIN CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205125101,"WASIM, MARIAM",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 30 , 45 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205125101,"WASIM, MARIAM",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205125101,"WASIM, MARIAM",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205125101,"WASIM, MARIAM",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 23 , 30 , 39 ,$#,,
MEDICAID DIRECT,1427081611,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Neurology of Raleigh,3320 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205125101,"WASIM, MARIAM",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205125101,"WASIM, MARIAM",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205126034,"PHELPS, KEVIN, DANIEL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205126034,"PHELPS, KEVIN, DANIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 47 , 84 ," $22,380.36 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205126034,"PHELPS, KEVIN, DANIEL",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 34 , 49 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205126422,"PARIKH, RAVI, HEMANT",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 38 , 40 ,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205126422,"PARIKH, RAVI, HEMANT",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205127990,"SMITH, EVA, SZENTPETERY",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1205127990,"SMITH, EVA, SZENTPETERY",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205127990,"SMITH, EVA, SZENTPETERY",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205127990,"SMITH, EVA, SZENTPETERY",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205129830,"MALEK, JOSEPH, MICHAEL",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 17 , 29 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205129830,"MALEK, JOSEPH, MICHAEL",9930 KINCEY AVE STE 220 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 34 , 44 , 91 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205129830,"MALEK, JOSEPH, MICHAEL",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205135258,"NEWMAN, JESSICA, ELEANOR",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 140 , 230 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205135670,"BAI, PENG",100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 35 , 48 , 61 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1205135670,"BAI, PENG",100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,630 TIMBER DR EAST STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1205135670,"BAI, PENG",630 TIMBER DR EAST STE 120 GARNER NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1205135670,"BAI, PENG",3001 EDWARDS MILL RD FL 2 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1205135670,"BAI, PENG",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 25 , 34 ,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,50 CRAGGENMORE DR   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205135787,"CARRICO, JENI, LYN",50 CRAGGENMORE DR   PITTSBORO NC,019,Chatham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205136066,"WHITE, KIMMIKA",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205136066,"WHITE, KIMMIKA",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205136066,"WHITE, KIMMIKA",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1205140282,"OSHUNKOYA, ADEKUNLE, OPEYEMI",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1205143922,"BELL, MATTHEW, ARTHUR",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205143922,"BELL, MATTHEW, ARTHUR",1208 HICKORY BLVD SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205143922,"BELL, MATTHEW, ARTHUR",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205143922,"BELL, MATTHEW, ARTHUR",106 ALEXANDER BANK DR STE 101 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205143922,"BELL, MATTHEW, ARTHUR",106 ALEXANDER BANK DR STE 101 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205146206,PREMIER HOME HEALTH CARE SERVICES I,PREMIER HOME HEALTH CARE SERVICES INC,715 FAIRGROVE CHURCH RD SE STE 204 CONOVER NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1205146206,PREMIER HOME HEALTH CARE SERVICES I,715 FAIRGROVE CHURCH RD SE STE 204 CONOVER NC,018,Catawba,251J00000X,Agencies,Nursing Care,, 21 ," 4,229 "," 4,433 "," $1,174,578.00 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205146313,"FINNEGAN, KRISTY, DANIELLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 ,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205147121,"KRAKOWSKI, JAMES, CHRISTOPHER",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205147121,"KRAKOWSKI, JAMES, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 32 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1205148624,"MILES, MARY, PURCELL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205148624,"MILES, MARY, PURCELL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205150497,"PECORELLA, SHELLY, RAE HARRELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 80 , 80 , 81 ,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1205150638,"DEESE, ADRIAN, JACOBS",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 49 , 90 ,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1205150638,"DEESE, ADRIAN, JACOBS",142 PARACLETE DR STE 102 RAEFORD NC,047,Hoke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205152170,"STOPA, CRAIG, JOSEPH",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205152170,"STOPA, CRAIG, JOSEPH",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205152170,"STOPA, CRAIG, JOSEPH",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205153632,"ABSHIRE, MELISSA, BETTS",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205153632,"ABSHIRE, MELISSA, BETTS",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205153632,"ABSHIRE, MELISSA, BETTS",~,3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,1205153632,"ABSHIRE, MELISSA, BETTS",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 73 , 82 , 105 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 46 , 57 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 531 , 716 , 902 ," $10,974.29 ",,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 35 , 39 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 77 , 77 , 97 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1205154465,"METZGER, WALSON, KEHINDE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 80 , 88 , 107 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 47 , 58 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",300 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 92 , 98 , 124 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 71 , 79 , 90 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205154465,"METZGER, WALSON, KEHINDE",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205154812,"CRISTIANO, JOSEPH, ANTHONY",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205154812,"CRISTIANO, JOSEPH, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205154812,"CRISTIANO, JOSEPH, ANTHONY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205154812,"CRISTIANO, JOSEPH, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 74 , 74 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205154952,"MCAULEY, EMILY, ROSE",157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 17 , 26 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205154952,"MCAULEY, EMILY, ROSE",157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205156502,"QUINSEY, CAROLYN, SUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205156858,"OKAFOR, ADAORAH, ELIZABETH",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 37 , 37 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205156858,"OKAFOR, ADAORAH, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 25 , 25 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205156858,"OKAFOR, ADAORAH, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205159753,"HOLLOWELL, JAMIE, LINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 18 , 26 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1205160025,"VALENTINE, SUSAN, OXENDINE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205160587,"FARRELL-JOHNSON, KARR, LYNN",107 WEEKS DR   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992802607,PEDIATRIX MEDICAL GROUP OF SOUTH CA,~,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205160611,"CAPUTO, KAREN, ANN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205160801,"RAPPAPORT, MEREDITH",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205161072,ALPHA HOME CARE SERVICES INC,Alpha Home Care Services Inc II,4517 WATERBURY RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205161072,ALPHA HOME CARE SERVICES INC,4517 WATERBURY RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 686 , 686 ," $51,033.71 ",,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1205161627,"BALL, KIMBERLY, JUNE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205162674,"GORDON, JUSTIN, EDWARD",3150 ROGERS RD STE B WAKE FOREST NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205162674,"GORDON, JUSTIN, EDWARD",3150 ROGERS RD STE B WAKE FOREST NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,501 DOUGLAS ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205163045,"SMITH, DEBORAH, DAWN",3475 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 64 , 108 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205163144,"KOREDE, GEORGE, AYO OLUWA",660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 33 , 71 , 102 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205163144,"KOREDE, GEORGE, AYO OLUWA",2525 COURT DR   GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 30 , 74 , 89 ,$#,,
MEDICAID DIRECT,1205163185,MISSION MEDSTAFF,ANGELS OF CARE,1233 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1205163185,MISSION MEDSTAFF,1233 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 178 ," 20,501 "," 24,109 "," $10,725,016.60 ",,
MEDICAID DIRECT,1205163185,MISSION MEDSTAFF,ANGELS OF CARE,1233 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1205163185,MISSION MEDSTAFF,1233 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1205163185,MISSION MEDSTAFF,ANGELS OF CARE,1233 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1205163185,MISSION MEDSTAFF,1233 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 2,155 "," 2,259 "," $380,298.80 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205166519,"COWAN, KIMBERLY, LYNN",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639195241,MECKLENBURG COUNTY,~,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205167962,"NELSON, DANA, ELIZABETH",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223D0001X,Dental Providers,Dentist,Dental Public Health, 781 ," 1,245 "," 4,495 "," $148,763.60 ",,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205169547,"RAYBURN, SHAWN, MONTGOMERY",1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 104 , 105 ,$#,,
MEDICAID DIRECT,1992044473,DR JOANN TODD AND ASSOCIATES OF OPT,DR JOANN TODD AND ASSOCIATES OF OPTOMETRY PLLC,1122 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205169653,"TODD, JO'ANN",1122 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,, 55 , 66 , 109 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205171709,"JAJU, AMRUTA, SURENDRA",15825 BALLANTYNE MEDICAL PL STE 220 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 49 , 97 , 248 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1205172202,"DAGER, KATIE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 28 , 52 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1205172202,"DAGER, KATIE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 52 , 96 ,$#,,
MEDICAID DIRECT,1104068006,TRANSITIONS THERAPEUTIC CARE LLC,~,300 S WESTGATE DR STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205173911,"BLANKMANN, MEGHAN",300 S WESTGATE DR STE A GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1336382563,SPARTANBURG MEDICAL CENTER,MEDICAL GROUPOFTHECAROLINAS-VASCULARACCESSSERVICES,100 E WOOD ST STE 202 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205175122,"CUNNINGHAM, DAVID, TYLER",100 E WOOD ST STE 202 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 30 , 31 ,$#,,
MEDICAID DIRECT,1790212462,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205177797,"ABDELAAL, MAGED",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205177797,"ABDELAAL, MAGED",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1245665371,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1208 EASTCHESTER DR STE 205 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205178688,"TREADWELL, GILLIAN, GABRIELLE",1208 EASTCHESTER DR STE 205 HIGH POINT NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205178688,"TREADWELL, GILLIAN, GABRIELLE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 26 , 47 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205178688,"TREADWELL, GILLIAN, GABRIELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 82 , 111 , 203 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1205178928,"ALEXANDER, SARA, JAYNE",5100 MACKAY RD   JAMESTOWN NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1205178928,"ALEXANDER, SARA, JAYNE",5100 MACKAY RD   JAMESTOWN NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 45 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205179611,"TURKER, LAUREN, BETH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205179611,"TURKER, LAUREN, BETH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205179611,"TURKER, LAUREN, BETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205179611,"TURKER, LAUREN, BETH",4101 MACON POND RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 28 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205179611,"TURKER, LAUREN, BETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205179611,"TURKER, LAUREN, BETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992482079,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON PRIMARY CARE RHC,1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1205179959,"BRADY, JORDAN, THOMAS",1700 TARBORO ST W STE 204 WILSON NC,098,Wilson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205179959,"BRADY, JORDAN, THOMAS",105 SW CARY PKWY STE 300 CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 32 , 82 , 120 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 204 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205179959,"BRADY, JORDAN, THOMAS",1700 TARBORO ST W STE 204 WILSON NC,098,Wilson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 148 , 404 , 701 ," $13,126.05 ",,
MEDICAID DIRECT,1053981787,DAWSON MED URGENT CARE PC,,608 DAWSON ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205182359,"BOWERS, SHONDA, TIFFANY",608 DAWSON ST STE 101 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 110 , 208 ,$#,,
MEDICAID DIRECT,1053981787,DAWSON MED URGENT CARE PC,,608 DAWSON ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205182359,"BOWERS, SHONDA, TIFFANY",608 DAWSON ST STE 101 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487224283,DAWSON MED PC,,608 DAWSON ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205182359,"BOWERS, SHONDA, TIFFANY",608 DAWSON ST STE 103 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1053981787,DAWSON MED URGENT CARE PC,,608 DAWSON ST STE 101 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205182359,"BOWERS, SHONDA, TIFFANY",608 DAWSON ST STE 101 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 31 ,$#,,
MEDICAID DIRECT,1487224283,DAWSON MED PC,,608 DAWSON ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205182359,"BOWERS, SHONDA, TIFFANY",608 DAWSON ST STE 101 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 93 , 215 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205182979,"REMINGTON, DAVID, LAWRENCE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 52 , 65 , 89 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205182979,"REMINGTON, DAVID, LAWRENCE",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 34 , 36 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205182979,"REMINGTON, DAVID, LAWRENCE",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 53 , 65 , 68 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205182979,"REMINGTON, DAVID, LAWRENCE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205182979,"REMINGTON, DAVID, LAWRENCE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 35 , 50 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205184231,"POKHREL, ASHNA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 17 , 28 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205184231,"POKHREL, ASHNA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1205186319,"WEBB, BRITTANY, MEADOWS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 257 , 291 , 319 ," $27,993.46 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205186319,"WEBB, BRITTANY, MEADOWS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 82 , 97 , 105 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205188190,"NAULT, KATHERINE, ANNE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205188869,"MONROE, KATHRYN, JEAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 148 , 283 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205188869,"MONROE, KATHRYN, JEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598398653,ZAMMITTI GIDALY ABRAMS COHEN & ASS,CREEKSIDE DENTAL,8631 ARBOR CREEK DR STE D1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205190170,"TRIVEDI, JAGDEEP, SIBIA",10125 PERIMETER PKWY STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 985 ," 1,794 "," 6,187 "," $328,256.86 ",,
MEDICAID DIRECT,1891221107,G ABRAMS AND R COHEN XVIII PC,,8440 PIT STOP CT NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205190170,"TRIVEDI, JAGDEEP, SIBIA",10125 PERIMETER PKWY STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 985 ," 1,978 "," 7,232 "," $377,058.02 ",,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205190600,"WARREN, ALEX, JORDAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 94 , 94 , 101 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1205190600,"WARREN, ALEX, JORDAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1205190600,"WARREN, ALEX, JORDAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 54 , 58 , 63 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205190600,"WARREN, ALEX, JORDAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1205190600,"WARREN, ALEX, JORDAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205190600,"WARREN, ALEX, JORDAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205190600,"WARREN, ALEX, JORDAN",,3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1205190600,"WARREN, ALEX, JORDAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205190600,"WARREN, ALEX, JORDAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 82 , 97 , 109 ,$#,,
MEDICAID DIRECT,1083258115,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FOOT & ANKLE CENTER,1985 STARTOWN RD STE 101 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1205191640,"WEEKS, BLAKE, AUSTIN",1985 STARTOWN RD STE 101 HICKORY NC,018,Catawba,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1205191640,"WEEKS, BLAKE, AUSTIN",1985 STARTOWN RD STE 101 HICKORY NC,018,Catawba,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1083258115,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FOOT & ANKLE CENTER,1985 STARTOWN RD STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205191640,"WEEKS, BLAKE, AUSTIN",1985 STARTOWN RD STE 101 HICKORY NC,018,Catawba,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 225 , 576 , 624 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205192580,"LUTHRA, ANJULI, KRISTIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205192879,"ANDERSON, COLIN, JAMES",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205192879,"ANDERSON, COLIN, JAMES",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205193208,"SNYDER, LAURA, LYNN",220 SPRINGBROOK AVE STE 100 CLAYTON NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205193208,"SNYDER, LAURA, LYNN",2308 WESVILL CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205193208,"SNYDER, LAURA, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205193208,"SNYDER, LAURA, LYNN",11200 GOVERNOR MANLY WAY   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205193208,"SNYDER, LAURA, LYNN",1006 PROCURE ST STE 300 FUQUAY VARINA NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 59 , 128 ," $13,636.73 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205193208,"SNYDER, LAURA, LYNN",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 34 , 84 ," $10,793.15 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205193208,"SNYDER, LAURA, LYNN",106 RIDGE VIEW DR STE 100 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 53 , 130 ," $12,221.39 ",,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",225 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",225 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",941 JOHNSON RIDGE RD   ELKIN NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",941 JOHNSON RIDGE RD   ELKIN NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",140 MOORE RD   KING NC,085,Stokes,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 85 , 92 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",500 W HANES MILL RD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",120 MILLER ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 60 , 108 , 167 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",190 INTERSTATE DR   MOCKSVILLE NC,030,Davie,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",120 MILLER ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",500 W HANES MILL RD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205193331,"MCLEAN, NICHOLAS, OLIVER",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 26 , 45 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205193513,"LEVIN, ELINA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205194461,"WILLIAMS, KRISTIN, RENEE",1650 SKYLYN DR STE 240 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205194461,"WILLIAMS, KRISTIN, RENEE",600 HOSPITAL DR   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205194461,"WILLIAMS, KRISTIN, RENEE",1550 FAULK ST STE 1100 MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205194461,"WILLIAMS, KRISTIN, RENEE",1100 HEALING WAY STREET 2 STE 11A MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1205194461,"WILLIAMS, KRISTIN, RENEE",1100 HEALING WAY STREET 2 STE 11A MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 28 , 31 ,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205194461,"WILLIAMS, KRISTIN, RENEE",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205196037,"SELF, COURTNEY, GREGG",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205070984,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH TOWNSHIP PEDIATRICS,201 E MATTHEWS ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205196037,"SELF, COURTNEY, GREGG",201 E MATTHEWS ST STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205196037,"SELF, COURTNEY, GREGG",201 E MATTHEWS ST STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 18 , 42 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205196607,"GREEN, CHRISTOPHER, SELBY",301 E WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1710678941,ANDREW R TREECE OD PA,PROVISION FAMILY EYECARE OPTOMETRY,1808 E INNES ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1205196763,"TREECE, ANDREW, RYAN",1808 E INNES ST   SALISBURY NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 90 , 89 , 101 ,$#,,
MEDICAID DIRECT,1265202808,ANDREW R TREECE OD PA,TREECE FAMILY EYECARE,644 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1205196763,"TREECE, ANDREW, RYAN",1808 E INNES ST   SALISBURY NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205196920,"FRIEDMAN, EUGENE",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 45 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205196920,"FRIEDMAN, EUGENE",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205196920,"FRIEDMAN, EUGENE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205196920,"FRIEDMAN, EUGENE",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205196920,"FRIEDMAN, EUGENE",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 39 , 53 , 94 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205196953,"SINDELAR, BRIAN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205196953,"SINDELAR, BRIAN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205196953,"SINDELAR, BRIAN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205198975,"AUGUSTIN, NATACHA, LAUREN",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205199536,"JIANG, BO",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,718 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205199536,"JIANG, BO",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1205199536,"JIANG, BO",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1205199536,"JIANG, BO",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205199536,"JIANG, BO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 22 , 35 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,718 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205199536,"JIANG, BO",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 242 , 524 ," 1,155 "," $20,365.01 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205199536,"JIANG, BO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 56 , 100 , 241 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205201647,"TINGLEY, CARRIE, AMICI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 58 , 170 , 251 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1205201647,"TINGLEY, CARRIE, AMICI",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205201647,"TINGLEY, CARRIE, AMICI",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1932485943,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM SURGICAL ASSOCIATES,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1205204583,"DEAL, JESSICA, LEIGH",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 171 , 208 ,$#,,
MEDICAID DIRECT,1932485943,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM SURGICAL ASSOCIATES,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1205204583,"DEAL, JESSICA, LEIGH",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 205 , 226 ,$#,,
MEDICAID DIRECT,1205205218,AMEE PATEL OD PA,AMEE PATEL OD,1002 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1205205218,AMEE PATEL OD PA,1002 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,, 166 , 168 , 330 ,$#,,
MEDICAID DIRECT,1942685458,DURANT ROAD PEDIATRICS,,10940 RAVEN RIDGE RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205206836,"MARTIN, PAULETTE, GONZALEZ",10940 RAVEN RIDGE RD STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 58 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205212792,"WILLIAMSON, MEGUMI, AITA",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0300X,Dental Providers,Dentist,Periodontics,#,#, 13 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205214152,"TOUMA, DANIEL, CHRISTOPHER",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1205214848,"HUGHES, RYAN, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205214848,"HUGHES, RYAN, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 47 , 138 , 174 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205215464,"MOCOCK ADAMS, MERRITT, ALYSE",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 19 , 32 , 33 ,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205215894,"GREEN, MAYA, MARLENE",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326775404,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,9310 STRAUSE DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205215894,"GREEN, MAYA, MARLENE",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326775404,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,9310 STRAUSE DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205215894,"GREEN, MAYA, MARLENE",9310 STRAUSE DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 23 , 29 ,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1205217478,"DOWDALL, CHRISTINA, GELTZ",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1205217478,"DOWDALL, CHRISTINA, GELTZ",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205217478,"DOWDALL, CHRISTINA, GELTZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205217478,"DOWDALL, CHRISTINA, GELTZ",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922791151,KALYANI VELLANKI STARR DDS PA,AFFORDABLE DENTURES & IMPLANTS - HUNTERSVILLE,9747 SAM FURR RD STE B HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205219896,"STARR, KALYANI, VELLANKI",9747 SAM FURR RD STE B HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 118 , 127 , 938 ," $146,983.63 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,,,Unknown,193200000X,Group,Multi-Specialty,,1205221330,"ADAMS-DOOLITTLE, BENJAMIN, ROBERT",3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1386383909,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-805 FAIRVIEW ROAD SUITE 200,805 FAIRVIEW RD STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205221330,"ADAMS-DOOLITTLE, BENJAMIN, ROBERT",805 FAIRVIEW RD STE 200 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 25 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205222080,"DOTSON, ANDREA, BLAIRE",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 23 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205222080,"DOTSON, ANDREA, BLAIRE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205222080,"DOTSON, ANDREA, BLAIRE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205222585,"RICHARDS, JOHN, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 23 ," $10,402.78 ",,
MEDICAID DIRECT,1205222643,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1205222643,LEVEL FOUR ORTHOTICS & PROSTHETICS,1103 N ELM ST STE 201 GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 19 , 19 , 99 ," $17,315.59 ",,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205222882,"DALSANIA, RAJ, MANSUKH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 36 , 47 , 60 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205222882,"DALSANIA, RAJ, MANSUKH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 15 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205222882,"DALSANIA, RAJ, MANSUKH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205222882,"DALSANIA, RAJ, MANSUKH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205223393,"DONALD, REBECCA, RIGEL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 30 ,$#,,
MEDICAID DIRECT,1205224540,UMMAH CARE LLC,UMMAH CARE STAFFER & MEDICAL EQUIPMENT,537 W SUGAR CREEK RD STE 202 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1205224540,UMMAH CARE LLC,537 W SUGAR CREEK RD STE 202 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 11 , 97 , 97 ," $18,743.68 ",,
MEDICAID DIRECT,1205224540,UMMAH CARE LLC,UMMAH CARE STAFFER & MEDICAL EQUIPMENT,537 W SUGAR CREEK RD STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1205224540,UMMAH CARE LLC,537 W SUGAR CREEK RD STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,583 "," 1,587 "," $130,706.80 ",,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205225893,"EDENS, ROBERT, CREWS",150 E DAVIE ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 47 , 65 ,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205225893,"EDENS, ROBERT, CREWS",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205229697,"SANDERSON, ANN, GEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1205229697,"SANDERSON, ANN, GEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205229697,"SANDERSON, ANN, GEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205231792,"ALLAN, HASSAN, FAYEK",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1023048279,GASTONIA MEDICAL SPECIALTY CLINIC,GASTONIA MEDICAL SPECIALTY CLINIC PA,1021 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205232337,"STALLARD, EMILY, BARKER",1021 X RAY DR   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205233426,"BRITTON, ASHLEY, JOI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,1134 N ROAD ST STE 3 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1205235215,"CONKWRIGHT, CAROLINE, ELIZABETH",1134 N ROAD ST STE 3 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 19 , 39 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205235215,"CONKWRIGHT, CAROLINE, ELIZABETH",5589 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 17 , 40 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,5589 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1205235215,"CONKWRIGHT, CAROLINE, ELIZABETH",5589 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205236536,"VERDIEU, YVES, CHRISTIAN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 48 , 90 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205236536,"VERDIEU, YVES, CHRISTIAN",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205236536,"VERDIEU, YVES, CHRISTIAN",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1205236536,"VERDIEU, YVES, CHRISTIAN",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205236536,"VERDIEU, YVES, CHRISTIAN",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1205236536,"VERDIEU, YVES, CHRISTIAN",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1205238466,"MCGUIRT, BRITTNEY, FOREMAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205241221,"HUTCHINSON, LAUREN, ELIZABETH",959 COX RD STE 1 GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 21 , 31 , 49 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,105 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1205241221,"HUTCHINSON, LAUREN, ELIZABETH",105 DELTA PARK DR   SHELBY NC,023,Cleveland,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 17 , 20 , 32 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205241221,"HUTCHINSON, LAUREN, ELIZABETH",105 DELTA PARK DR   SHELBY NC,023,Cleveland,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 26 , 37 , 78 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205241601,"DOMBROWSKI, AMANDA, HAILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205241601,"DOMBROWSKI, AMANDA, HAILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205241601,"DOMBROWSKI, AMANDA, HAILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205241601,"DOMBROWSKI, AMANDA, HAILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205241601,"DOMBROWSKI, AMANDA, HAILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205241601,"DOMBROWSKI, AMANDA, HAILY",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 44 , 58 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205244464,"HOPKINS, TANYA, JEAN",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205245511,"REDINGER, KAYLIN, MARIE",154 BEULAVILLE HWY   RICHLANDS NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 267 , 598 ,$#,,
MEDICAID DIRECT,1477704443,WAKE MEDICAL LABORATORY CONSULTANTS,WAKE MEDICAL LABORATORY CONSULTANTS INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205245800,"NOMANI, LAILA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205245800,"NOMANI, LAILA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 48 , 51 , 79 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1205246741,"LEWIS, JONATHAN, DANIEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 287 , 364 , 451 ,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1205246741,"LEWIS, JONATHAN, DANIEL",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205248028,"SANCHEZ CONTRERAS, JESUS, ALBERTO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 47 , 53 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1205248028,"SANCHEZ CONTRERAS, JESUS, ALBERTO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 34 , 52 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205253127,"TSAHAKIS, JAMES, MICHAEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205253127,"TSAHAKIS, JAMES, MICHAEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205253127,"TSAHAKIS, JAMES, MICHAEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205253127,"TSAHAKIS, JAMES, MICHAEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 23 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205253127,"TSAHAKIS, JAMES, MICHAEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 17 , 25 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205253127,"TSAHAKIS, JAMES, MICHAEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 22 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205253127,"TSAHAKIS, JAMES, MICHAEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205254513,"DAVIS, CHRISTOPHER, ASHBY MACLEOD",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205254513,"DAVIS, CHRISTOPHER, ASHBY MACLEOD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 63 , 70 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205254513,"DAVIS, CHRISTOPHER, ASHBY MACLEOD",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205254513,"DAVIS, CHRISTOPHER, ASHBY MACLEOD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 67 , 74 , 141 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 102 , 132 , 180 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 22 , 23 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205254836,"GARRETT, ZACHARY, DAVID",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205255213,"VELLUCCI, JULIAN, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1801116405,MONARCH,~,820 GRIMES BLVD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1205255767,"SHUSTER, CORRINE, ELIZABETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205255767,"SHUSTER, CORRINE, ELIZABETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1346680543,MONARCH,~,809 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205255767,"SHUSTER, CORRINE, ELIZABETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205255767,"SHUSTER, CORRINE, ELIZABETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205256724,"MILAM, RONALD, WALDEN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 71 , 148 , 341 ," $13,187.85 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205256724,"MILAM, RONALD, WALDEN",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205256724,"MILAM, RONALD, WALDEN",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 23 , 57 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205256724,"MILAM, RONALD, WALDEN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,200 S HERLONG AVE STE A ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205256724,"MILAM, RONALD, WALDEN",120 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205256724,"MILAM, RONALD, WALDEN",120 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 19 , 44 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205256724,"MILAM, RONALD, WALDEN",100 PARKWAY OFFICE CT STE 104 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205262029,"SUROVCHAK, DAVID, JOHN",303 GREEN ST E   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 202 , 546 , 565 ," $22,017.55 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1205262029,"SUROVCHAK, DAVID, JOHN",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205262029,"SUROVCHAK, DAVID, JOHN",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205262029,"SUROVCHAK, DAVID, JOHN",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205262029,"SUROVCHAK, DAVID, JOHN",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205262904,"GUFFEY, HOLLY, MARIE LOUISE",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205262904,"GUFFEY, HOLLY, MARIE LOUISE",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205262904,"GUFFEY, HOLLY, MARIE LOUISE",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 30 , 30 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205262904,"GUFFEY, HOLLY, MARIE LOUISE",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205262904,"GUFFEY, HOLLY, MARIE LOUISE",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205267556,"MCCAULEY, SUELLEN, HOWELL",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 435 , 450 , 808 ," $26,487.29 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205267556,"MCCAULEY, SUELLEN, HOWELL",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 23 , 38 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205268448,"MIXTER, JENNIFER, ELLEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205268448,"MIXTER, JENNIFER, ELLEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205269065,"KUMAR, JAY",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 15 , 30 ,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205269065,"KUMAR, JAY",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 22 , 36 ,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205269065,"KUMAR, JAY",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205271145,"MOHAMMED, AMINU, ISYAKU",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 121 , 121 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1205271145,"MOHAMMED, AMINU, ISYAKU",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 291 , 291 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205271145,"MOHAMMED, AMINU, ISYAKU",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 121 , 124 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205271145,"MOHAMMED, AMINU, ISYAKU",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 170 , 170 ," $14,699.54 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205271145,"MOHAMMED, AMINU, ISYAKU",1700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205273760,"CIESIELSKI, JOSEPH, ANDREW",8961 HARVEST OAKS DR   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1205274461,"FRIEDE, KEVIN, ANDREW",518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 12 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205274461,"FRIEDE, KEVIN, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 38 , 74 , 105 ," $10,194.66 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1205274461,"FRIEDE, KEVIN, ANDREW",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 23 , 32 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205274461,"FRIEDE, KEVIN, ANDREW",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205274461,"FRIEDE, KEVIN, ANDREW",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205274859,"SOSKIS, ALYSSA",40 DUKE MEDICINE CIR # 2F2G DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 22 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205274859,"SOSKIS, ALYSSA",40 DUKE MEDICINE CIR # 2F2G DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 38 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205274859,"SOSKIS, ALYSSA",40 DUKE MEDICINE CIR # 2F2G DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205276052,"ABDALLAH, HATEM",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205276052,"ABDALLAH, HATEM",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164595757,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205276086,"SPARKS, ISAAC, SAMUEL",301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 26 , 74 ,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205276086,"SPARKS, ISAAC, SAMUEL",301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1205280864,"DOVICO, JACLYN, MELANIE",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 44 , 97 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1205281235,"FOSTER, KATHARINE, NICOLE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 57 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205281508,"LIU, YANG",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207ZN0500X,Allopathic & Osteopathic Physicians,Pathology,Neuropathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205281508,"LIU, YANG",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207ZN0500X,Allopathic & Osteopathic Physicians,Pathology,Neuropathology,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205282555,"MOORE, MELISSA, KEPKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 87 , 87 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1515 SW CARY PKWY STE 220 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205282761,"BEG, AMBER, MICHELLE",1515 SW CARY PKWY STE 220 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 20 , 35 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205283447,"DONAHUE, LAUREN, KATHERINE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,338 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1205284916,"JOHNSON, STEPHANIE, BROOKE BOWDEN",338 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1205284916,"JOHNSON, STEPHANIE, BROOKE BOWDEN",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205286382,"GIMPERT, REBECCA, ANN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205286382,"GIMPERT, REBECCA, ANN",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 188 , 188 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205286382,"GIMPERT, REBECCA, ANN",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205286382,"GIMPERT, REBECCA, ANN",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205287760,"COMAN, NICHOLAS, ANDREW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 39 , 39 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205288578,"ZIERLE-GHOSH, ASIA, BRISTINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205288578,"ZIERLE-GHOSH, ASIA, BRISTINE",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 34 , 34 ,$#,,
MEDICAID DIRECT,1205290269,PEACE HEALTHCARE INC,,627 DONALD ROSS DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205290269,PEACE HEALTHCARE INC,627 DONALD ROSS DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 236 , 243 ," $15,604.76 ",,
MEDICAID DIRECT,1205290269,PEACE HEALTHCARE INC,,1203 N WALL ST   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205290269,PEACE HEALTHCARE INC,1203 N WALL ST   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 239 , 239 ," $23,035.92 ",,
MEDICAID DIRECT,1205290269,PEACE HEALTHCARE INC,,223 ROBERT F HARGROVE RD   MOUNT OLIVE NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205290269,PEACE HEALTHCARE INC,223 ROBERT F HARGROVE RD   MOUNT OLIVE NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 , 983 ," 1,042 "," $96,861.65 ",,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1205290475,"LU, JING",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205290640,"FAY, JOSHUA, CHANDLER",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205292455,"JACKSON, TAYLOR, BUCHANAN",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205293958,"PORTER, JENNIFER, ERIN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205294568,"VANG, LINDSAY, ANN",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205294568,"VANG, LINDSAY, ANN",14135 BALLANTYNE CORPORATE PL STE 160 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 23 , 37 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205294568,"VANG, LINDSAY, ANN",14215 BALLANTYNE CORPORATE PL STE 230 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821623620,LANE AND ASSOCIATES XXXVIII DDS PA,,101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205295680,"JOHNSON, KIA, SHERETTE MARLEY",2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1205298072,"HANSON, LAURA, EMILY",220 PAGE RD   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 25 , 29 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1205298072,"HANSON, LAURA, EMILY",135 PAGE RD N   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 45 , 77 , 95 ,$#,,
MEDICAID DIRECT,1417661976,CALDWELL MEMORIAL HOSPITAL,UNC HEALTH HICKORY MEDICAL PARK,30 13TH AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205298338,"REWIS, MICHAEL, JOSEPH",30 13TH AVE NW   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 66 , 98 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205299708,"FARMER, PETER, FREDERICK",104 MEDSPRING DR   CLAYTON NC,051,Johnston,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1205299708,"FARMER, PETER, FREDERICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205299708,"FARMER, PETER, FREDERICK",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205299708,"FARMER, PETER, FREDERICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205299708,"FARMER, PETER, FREDERICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205299971,"JAWITZ, NICOLE, GONG",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205299971,"JAWITZ, NICOLE, GONG",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205299971,"JAWITZ, NICOLE, GONG",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 24 , 28 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205299971,"JAWITZ, NICOLE, GONG",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 21 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205299971,"JAWITZ, NICOLE, GONG",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205301108,"LANDA, RIO, MONIQUE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205301108,"LANDA, RIO, MONIQUE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 78 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205301108,"LANDA, RIO, MONIQUE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205301108,"LANDA, RIO, MONIQUE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205301108,"LANDA, RIO, MONIQUE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205303401,"FLANAGAN, KIRSTEN, ANN LEITE",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205303401,"FLANAGAN, KIRSTEN, ANN LEITE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205304409,"POULOSE, ELIZABETH, EDACHERIL",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205305463,"STEVENS, JOEY, SAVANAH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 91 , 91 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205305463,"STEVENS, JOEY, SAVANAH",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205305463,"STEVENS, JOEY, SAVANAH",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205305463,"STEVENS, JOEY, SAVANAH",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205305463,"STEVENS, JOEY, SAVANAH",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205305463,"STEVENS, JOEY, SAVANAH",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588296784,CITYBLOCK MEDICAL PRACTICE PA,~,4444 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205308418,"BRYAN, PATRICIA, NICOLE",4444 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205311081,"COBB, NANCY, CANNON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205311081,"COBB, NANCY, CANNON",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205316221,"HAVENS, MADELINE, CHASTAIN",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205316221,"HAVENS, MADELINE, CHASTAIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205316221,"HAVENS, MADELINE, CHASTAIN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205316742,"COTUGNO, DAYNA, MARIE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 105 , 116 ,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1205317260,"WIETERS, HALLIE, CHANSON",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1205317260,"WIETERS, HALLIE, CHANSON",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1205317260,"WIETERS, HALLIE, CHANSON",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205317260,"WIETERS, HALLIE, CHANSON",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1205317260,"WIETERS, HALLIE, CHANSON",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1205317260,"WIETERS, HALLIE, CHANSON",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1205317260,"WIETERS, HALLIE, CHANSON",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205319043,INOMANCY INC,THE MANOR HOME CARE AGENCY,133 S FRANKLIN ST   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1205319043,INOMANCY INC,133 S FRANKLIN ST   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 5,132 "," 5,132 "," $304,123.18 ",,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1205320892,"KANTETI, ARCHANA, PRASAD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1205320892,"KANTETI, ARCHANA, PRASAD",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 18 , 25 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205322062,"CONNER, JENNIFER, LOUISE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 43 , 43 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1205322062,"CONNER, JENNIFER, LOUISE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205323573,"HUNG, SHENG-CHE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205323573,"HUNG, SHENG-CHE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 290 , 314 , 399 ," $14,712.79 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,350 E HOLDING AVE   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1205323573,"HUNG, SHENG-CHE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205323573,"HUNG, SHENG-CHE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205325107,"FARRELL, BRADLEY, KEVIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 64 , 70 , 71 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205326014,"ABUBAKAR, SALAHADIN, A",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1205326527,"NICKS, CARL, MICHAEL",2007 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,509 OLDE WATERFORD WAY STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1205326527,"NICKS, CARL, MICHAEL",509 OLDE WATERFORD WAY STE 102 LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1205326527,"NICKS, CARL, MICHAEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1205326527,"NICKS, CARL, MICHAEL",2007 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1952819575,SAMPSON REGIONAL EMERGENCY PROFESSI,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1205327806,"ENRIQUEZ, FABIOLA, MAGDALENA",607 BEAMAN ST   CLINTON NC,082,Sampson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1205330024,"IQBAL, SABIH, HAMAD",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205330461,"HOLMES, ALEXANDRIA, DALLAS",,729 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1205330461,"HOLMES, ALEXANDRIA, DALLAS",729 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205331089,"KOUTSOGIANNIS, PETROS",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 89 , 149 , 223 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205331220,"WEYANT, AUSTIN, FREDERICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205331220,"WEYANT, AUSTIN, FREDERICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 33 , 41 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205331220,"WEYANT, AUSTIN, FREDERICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 235 , 261 , 308 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205333127,"KROKHMAL, ALEKSANDRA, AUGUSTYNOWICZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 37 , 38 ,$#,,
MEDICAID DIRECT,1205339223,NEW DISCOVERY SPEECH AND LANGUAGE,~,302 TRAIL FOUR   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1205339223,NEW DISCOVERY SPEECH AND LANGUAGE,302 TRAIL FOUR   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,, 12 , 105 , 105 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205340247,"SHEPHERD, JUSTIN, MICHAEL",200 S MAIN ST   RICH SQUARE NC,066,Northampton,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 45 ,$#,,
MEDICAID DIRECT,1962454447,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT RICH SQUARE,200 S MAIN ST   RICH SQUARE NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205340247,"SHEPHERD, JUSTIN, MICHAEL",200 S MAIN ST   RICH SQUARE NC,066,Northampton,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 289 , 325 ," $13,088.01 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205341419,"JOYNER, KATLYN, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205341419,"JOYNER, KATLYN, MARIE",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 59 , 113 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205341419,"JOYNER, KATLYN, MARIE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134723794,ADDICTION TREATMENT RECOVERY & EDUC,,121 GREENWICH RD STE 109 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205342052,"OWENS MOSLEY, ARLETTE, FRANCES",121 GREENWICH RD STE 109 CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1134723794,ADDICTION TREATMENT RECOVERY & EDUC,,5105 MONROE RD STE C CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205342052,"OWENS MOSLEY, ARLETTE, FRANCES",5105 MONROE RD STE C CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 30 , 63 , 63 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205342052,"OWENS MOSLEY, ARLETTE, FRANCES",5105 MONROE RD STE C CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205342052,"OWENS MOSLEY, ARLETTE, FRANCES",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205342052,"OWENS MOSLEY, ARLETTE, FRANCES",121 GREENWICH RD STE 109 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205344389,"GILBERT, STORMY, SUZANNE",114A MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 37 , 83 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1205347135,"DEESE, MADELEINE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 39 , 39 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205350931,"LORGE JOHNSON, AMANDA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205350931,"LORGE JOHNSON, AMANDA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205351756,"SEELIG, DARA, ADINA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 48 , 48 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205352762,"HOLLANDSWORTH, HEATHER, CATHLEEN",128 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205352762,"HOLLANDSWORTH, HEATHER, CATHLEEN",128 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205352762,"HOLLANDSWORTH, HEATHER, CATHLEEN",128 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205356722,"BOCK, MEGAN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205356722,"BOCK, MEGAN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205356722,"BOCK, MEGAN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205357480,"MCCOLLOUGH, AMANDA, BLALOCK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205357480,"MCCOLLOUGH, AMANDA, BLALOCK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205359619,"HUTCHINSON, CATHERINE, MARGARET",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205360260,"WACKERLE, HAROLD, DOUGLAS",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 40 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205361326,"JOHNSON, TELYCIA, MARIE",2760 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205361326,"JOHNSON, TELYCIA, MARIE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205361482,"GILL, KATHERINE, NICOLE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 141 , 315 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205361482,"GILL, KATHERINE, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 73 , 120 ,$#,,
MEDICAID DIRECT,1558482695,GOLDSBORO EYE CLINIC PLLC,OPHTHALMOLOGY EYE ASSOCIATES OF GOLDSBORO,2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205362993,"HWANG, BRICE, IN",2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1558482695,GOLDSBORO EYE CLINIC PLLC,OPHTHALMOLOGY EYE ASSOCIATES OF GOLDSBORO,2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1205362993,"HWANG, BRICE, IN",2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205363678,"KEYTON, DANIELLE, ROBERSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205364171,"MEYER, MELISSA, FAYE",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 15 , 37 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205364171,"MEYER, MELISSA, FAYE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205364296,"LINDSAY, CHRISTOPHER, PAUL",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 50 , 106 , 168 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205364296,"LINDSAY, CHRISTOPHER, PAUL",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 20 , 33 ,$#,,
MEDICAID DIRECT,1114143542,NC DHHS CHILD AND FAMILY WELL-BEING,MORGANTON HICKORY CDSA,145 W PARKER RD STE A MORGANTON NC,012,Burke,252Y00000X,Agencies,Early Intervention Provider Agency,,1205365277,"REYNOLDS, KATHERINE, GAIL",145 W PARKER RD STE A MORGANTON NC,012,Burke,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 91 , 93 , 102 ," $14,405.40 ",,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1205366309,"CONNELL, KAYLA, CHECKOVICH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,,,Unknown,193200000X,Group,Multi-Specialty,,1205366309,"CONNELL, KAYLA, CHECKOVICH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386206951,REX HOSPITAL INC,UNC REX GYNECOLOGIC ONCOLOGY,2901 BLUE RIDGE RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205366309,"CONNELL, KAYLA, CHECKOVICH",2901 BLUE RIDGE RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205366309,"CONNELL, KAYLA, CHECKOVICH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 34 , 35 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205367125,"MBONU, IKECHUKWU, VALENTINE",844 KEMPSVILLE RD STE 103B NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 32 , 43 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1205367471,"CHOI, SEUNG, SAMUEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 24 , 46 ,$#,,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205369915,"MCNEAL, BERLONDRIKA, JERTORIA",10208 CERNY ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 43 , 91 ,$#,,
MEDICAID DIRECT,1033548052,WATAUGA MEDICAL CENTER INC,APPALACHIAN REGIONAL PAIN MANAGEMENT CENTER,,,Unknown,193200000X,Group,Multi-Specialty,,1205373560,"CAPPONI, ASHLEE, LYN",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1669971826,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN GASTROENTEROLOGY,870 STATE FARM RD STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1205373560,"CAPPONI, ASHLEE, LYN",870 STATE FARM RD STE 102 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 67 , 68 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205375425,"RASHID KAZI, AMIR",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205377629,"FON NDIKUM, JANE, MANGWI",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205380078,"ESPE, BRIAN, LAWRENCE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1093013351,PROPTNC LLC,RESOLVE PHYSICAL THERAPY AND REHABILITATION,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1205382082,"SWYERS, CAROLINE, ELIZABETH",112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205382207,"MEYERS, KELSEY, TENA WEAVER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205382207,"MEYERS, KELSEY, TENA WEAVER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205384237,"SUCHAN, RICHARD, HOELSCHER",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 31 , 84 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205387016,"PATEL, SONYA, MODI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205387404,"BARRETT, JAMIE, NICHOLE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1205390473,"WILEY, LAURA, CHRISTINE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1205391166,"WORONOWICZ, SONYA, LEANN",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205391166,"WORONOWICZ, SONYA, LEANN",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205391711,"TILLEY, MELANIE, DIANE",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 74 , 164 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205391711,"TILLEY, MELANIE, DIANE",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 28 , 61 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205394178,"MARIN, JUSTIN, PAUL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 89 , 153 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205395886,"SOWANI, MOHANA, RAGHUNATH",308 BRYNN MARR RD   JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205396546,"ROSHAN, LEEDA, JUNE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205396546,"ROSHAN, LEEDA, JUNE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205396595,"LIN, ANTHONY, LEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205396595,"LIN, ANTHONY, LEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205397585,"GYAMFI, AFUA, ADUBEA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 15 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205397585,"GYAMFI, AFUA, ADUBEA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 42 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205397627,"FARAWI, AHMED, MAHMOUD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205397627,"FARAWI, AHMED, MAHMOUD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205397627,"FARAWI, AHMED, MAHMOUD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205397627,"FARAWI, AHMED, MAHMOUD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205397627,"FARAWI, AHMED, MAHMOUD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 43 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205397627,"FARAWI, AHMED, MAHMOUD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205398450,"COOPER, JEFFREY, AUSTIN",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205398492,"KO, JUNG HYUN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 105 , 133 , 144 ,$#,,
MEDICAID DIRECT,1932380953,CAROMONT MEDICAL GROUP INC,CAROMONT CRITICAL CARE SPECIALIST,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205399144,"MCCROSSAN, REBECCA, MARY",2525 COURT DR   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205399359,"SERGIO, C., CHRISTOPHER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205403185,"STEPNEY, KIMBERLY, MISKOW",101 CLINIC DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 92 , 224 , 445 ,$#,,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",3219 WATKINS RD STE 103 DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1659966265,OYEGUNWA & ASSOCIATES IV PLLC,DINO KIDS DENTAL OF FAYETTEVILLE,1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 202 , 211 , 975 ," $35,946.56 ",,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 323 , 384 ," 1,867 "," $72,687.37 ",,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,389 "," 2,213 "," 9,562 "," $362,244.55 ",,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 21 ,$#,,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205404480,"GAMBLE, JOANNA, MARIE",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1205405438,"SIMON, EMILY, ISABEL ZELLER",1211A IRELAND DR   FAYETTEVILLE NC,026,Cumberland,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 55 , 62 , 87 ," $10,864.17 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205405479,"KHAJURIA, VANI, SHANKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 93 , 93 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205405479,"KHAJURIA, VANI, SHANKER",329 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205406691,"GOODWIN, ALIX, THEODOSSIOU",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 15 , 16 ,$#,,
MEDICAID DIRECT,1689849325,SUZANNE E BIRD DDS MS PA,SUZANNE E BIRD DDS MS PA,16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205406774,"YANG, BRYAN, HUON EAR",16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 504 , 815 ," 3,084 "," $122,301.70 ",,
MEDICAID DIRECT,1689849325,SUZANNE E BIRD DDS MS PA,SUZANNE E BIRD DDS MS PA,16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205406774,"YANG, BRYAN, HUON EAR",16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 15 ,$#,,
MEDICAID DIRECT,1396567095,RAYNALD L DESAMEAU DMD P LLC III,CORAL REEF PEDIATRICS,10460 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205406774,"YANG, BRYAN, HUON EAR",16607 RIVERSTONE WAY STE 300 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 51 , 66 , 328 ," $14,236.19 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205407616,"PARDUS, KRISTINE, ASHLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205408465,"MCCRAW, MEGAN, LURAE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 14 , 28 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205412152,"WHITE, MATTHEW, DAVID",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205412152,"WHITE, MATTHEW, DAVID",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205412152,"WHITE, MATTHEW, DAVID",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205412152,"WHITE, MATTHEW, DAVID",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205412152,"WHITE, MATTHEW, DAVID",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205412152,"WHITE, MATTHEW, DAVID",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205412152,"WHITE, MATTHEW, DAVID",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 36 , 50 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205412673,"BARTON, STEPHEN, MICHAEL",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205412673,"BARTON, STEPHEN, MICHAEL",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205412673,"BARTON, STEPHEN, MICHAEL",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205412756,"WRIGHT, BRENT, JACKSON",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205414398,"BHIMMANAPALLI, CHANDANA",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 28 , 66 , 66 ,$#,,
MEDICAID DIRECT,1407600216,HOANG DMD & NGO DDS AND ASSOCIATES,FREMONT FAMILY DENTISTRY,102 S SYCAMORE ST   FREMONT NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205417540,"NGO, DUY, HOANG MINH",102 S SYCAMORE ST   FREMONT NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 117 , 177 , 561 ," $27,250.41 ",,
MEDICAID DIRECT,1407600216,HOANG DMD & NGO DDS AND ASSOCIATES,FREMONT FAMILY DENTISTRY,102 S SYCAMORE ST   FREMONT NC,096,Wayne,193400000X,Group,Single Specialty,,1205417540,"NGO, DUY, HOANG MINH",102 S SYCAMORE ST   FREMONT NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 229 , 419 ," 1,479 "," $72,775.03 ",,
MEDICAID DIRECT,1023177151,ACCESS DENTAL CARE,ACCESS DENTAL CARE,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1205417540,"NGO, DUY, HOANG MINH",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 154 , 158 , 375 ," $21,108.53 ",,
MEDICAID DIRECT,1407600216,HOANG DMD & NGO DDS AND ASSOCIATES,FREMONT FAMILY DENTISTRY,102 S SYCAMORE ST   FREMONT NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205417540,"NGO, DUY, HOANG MINH",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 38 , 112 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205417722,"BANNO, JIM JARALENE, PORQUEZ",748 KENANSVILLE BYP   KENANSVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 49 , 71 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205417805,"LECLAIR, ROSE, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1205418597,"GHANI, ZULAIKHA",800 TILGHMAN DR   DUNN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1205418597,"GHANI, ZULAIKHA",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205419520,"MECUM, ERIN, ELIZABETH",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205419520,"MECUM, ERIN, ELIZABETH",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 38 , 68 ,$#,,
MEDICAID DIRECT,1073816997,ARMC PHYSICIANS CARE INC,CORNERSTONE MEDICAL CENTER,1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205419520,"MECUM, ERIN, ELIZABETH",1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 54 , 65 ,$#,,
MEDICAID DIRECT,1881938405,ARMC PHYSICIANS CARE INC,SOUTH GRAHAM MEDICAL CENTER,1205 S MAIN ST   GRAHAM NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205419520,"MECUM, ERIN, ELIZABETH",1205 S MAIN ST   GRAHAM NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,214 E ELM ST   GRAHAM NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205419520,"MECUM, ERIN, ELIZABETH",214 E ELM ST   GRAHAM NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 32 , 36 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205419520,"MECUM, ERIN, ELIZABETH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,1041 KIRKPATRICK RD STE 250 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205419520,"MECUM, ERIN, ELIZABETH",1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1205421849,ALLCARERX MEDICAL SUPPLIES LLC,,5176 NC HIGHWAY 42 W STE H GARNER NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1205421849,ALLCARERX MEDICAL SUPPLIES LLC,5176 NC HIGHWAY 42 W STE H GARNER NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1205421849,ALLCARERX MEDICAL SUPPLIES LLC,,5176 NC HIGHWAY 42 W STE H GARNER NC,051,Johnston,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1205421849,ALLCARERX MEDICAL SUPPLIES LLC,5176 NC HIGHWAY 42 W STE H GARNER NC,051,Johnston,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1205421849,ALLCARERX MEDICAL SUPPLIES LLC,,5176 NC HIGHWAY 42 W STE H GARNER NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1205421849,ALLCARERX MEDICAL SUPPLIES LLC,5176 NC HIGHWAY 42 W STE H GARNER NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 19 , 141 , 265 ," $27,951.18 ",,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205422904,"LYGHTEL, KAITLIN, ANNE",125 QUEENS RD STE 150 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1720364649,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1205424660,"HESTER, CHERYL, HARRIS",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205425410,"CAMPBELL, MELISSA, WILKINSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205425410,"CAMPBELL, MELISSA, WILKINSON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1205425709,"WEEKS, BONNIE, CHRISTINE",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609833490,CARTERET CLINIC FOR ADOLESCENTS AND,CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN,312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1205425709,"WEEKS, BONNIE, CHRISTINE",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 61 , 106 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205427820,"BARRE, ALEXANDRA, ROSE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205436482,"CANNON, NATALIE, LOFLIN",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 64 , 64 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205437910,"BELLOW, EMILY, FAYE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205437910,"BELLOW, EMILY, FAYE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205437910,"BELLOW, EMILY, FAYE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205437910,"BELLOW, EMILY, FAYE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205437910,"BELLOW, EMILY, FAYE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205437936,"THOMPSON, JAMIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 22 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6330 QUADRANGLE DR STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1205437936,"THOMPSON, JAMIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 51 , 72 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205439189,"DABROWSKI, JANELLE, ALICE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205439189,"DABROWSKI, JANELLE, ALICE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205439189,"DABROWSKI, JANELLE, ALICE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205439189,"DABROWSKI, JANELLE, ALICE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205439189,"DABROWSKI, JANELLE, ALICE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205439189,"DABROWSKI, JANELLE, ALICE",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801838677,MANN EAR NOSE THROAT CLINIC PA,Mann Ear Nose & Throat Clinic PA,601 KEISLER DR STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205443991,"MENDEZ, KELSEY",601 KEISLER DR STE 200 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205448263,"ROSE, LORETTA, AURORA GALLEGOS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205448263,"ROSE, LORETTA, AURORA GALLEGOS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205448263,"ROSE, LORETTA, AURORA GALLEGOS",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205448263,"ROSE, LORETTA, AURORA GALLEGOS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205448263,"ROSE, LORETTA, AURORA GALLEGOS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205448263,"ROSE, LORETTA, AURORA GALLEGOS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205450400,"FONDAW, WYLDER, SHEPHERD",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205450400,"FONDAW, WYLDER, SHEPHERD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205450400,"FONDAW, WYLDER, SHEPHERD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205450400,"FONDAW, WYLDER, SHEPHERD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205450400,"FONDAW, WYLDER, SHEPHERD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1205450897,"MEAD, JULIE, ANN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1205450897,"MEAD, JULIE, ANN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1205450897,"MEAD, JULIE, ANN",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 18 , 29 ,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1205450897,"MEAD, JULIE, ANN",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 14 , 25 ,$#,,
MEDICAID DIRECT,1205451234,"GUNTER, ELIZABETH, GRACE",MOVING MOUNTAINS THERAPY PLLC,2037 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1205451234,"GUNTER, ELIZABETH, GRACE",2037 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 69 , 69 ,$#,,
MEDICAID DIRECT,1053973354,UNC PHYSICIANS NETWORK GROUP PRACTI,,1505 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205452281,"PIERSON, ZACHARY, JAMES",1505 SW CARY PKWY STE 200 CARY NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 17 , 29 , 32 ,$#,,
MEDICAID DIRECT,1053973354,UNC PHYSICIANS NETWORK GROUP PRACTI,,8305 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205452281,"PIERSON, ZACHARY, JAMES",8305 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 32 , 50 , 66 ,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205454121,"STEVENS, SERRINA, JANINE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1205454519,GOOD CHOICE HOME CARE SERVICES INCO,GOODCHOICE HOME CARE SERVICES INCORPORATED,3201 YORKTOWN AVE STE 215F DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1205454519,GOOD CHOICE HOME CARE SERVICES INCO,3201 YORKTOWN AVE STE 215F DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 591 , 591 ," $37,059.28 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1205456597,"SAKEEN, FAISAL, AKASHA RAMADAN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 33 , 33 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205456597,"SAKEEN, FAISAL, AKASHA RAMADAN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 360 , 363 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1205456597,"SAKEEN, FAISAL, AKASHA RAMADAN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1205456597,"SAKEEN, FAISAL, AKASHA RAMADAN",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 172 , 173 ,$#,,
MEDICAID DIRECT,1205457165,CAVASSINE ZATANE WALL,THE BEST CHOICE HEALTHCARE INC,228 E FRANKLIN ST STE B ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1205457165,CAVASSINE ZATANE WALL,228 E FRANKLIN ST STE B ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,#," 1,613 "," 1,613 "," $130,601.48 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205457439,"ZHUANG, IRIS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205457439,"ZHUANG, IRIS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205458304,"REGAN, KATHRYN, HANNON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205458593,"BROWER, CAROLINE, JANE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205458593,"BROWER, CAROLINE, JANE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205458775,"BAYLOR, JOHN, HAYES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1205458775,"BAYLOR, JOHN, HAYES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1205458775,"BAYLOR, JOHN, HAYES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1205458775,"BAYLOR, JOHN, HAYES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205458775,"BAYLOR, JOHN, HAYES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1205458775,"BAYLOR, JOHN, HAYES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205464039,"RAY, SCOTT, LOGAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 47 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205465952,"KASETTY, VENKATKRISH, MANOHAR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205465952,"KASETTY, VENKATKRISH, MANOHAR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205466323,SPEECH INSPIRATIONS PLLC,,4909 WATERS EDGE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205466323,SPEECH INSPIRATIONS PLLC,4909 WATERS EDGE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 39 , 47 ,$#,,
MEDICAID DIRECT,1205466323,SPEECH INSPIRATIONS PLLC,,4909 WATERS EDGE DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205466323,SPEECH INSPIRATIONS PLLC,4909 WATERS EDGE DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 58 , 892 , 939 ," $62,713.90 ",,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205466620,"THOMPSON, JEANNE, DORIS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093772410,ROBESON HEALTH CARE CORPORATION,MAXTON MEDICAL CENTER,610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205466620,"THOMPSON, JEANNE, DORIS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205466620,"THOMPSON, JEANNE, DORIS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 113 , 169 , 210 ," $13,798.25 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205467586,"KEARNEY, ERICA, BRASWELL",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205467586,"KEARNEY, ERICA, BRASWELL",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205467586,"KEARNEY, ERICA, BRASWELL",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205467586,"KEARNEY, ERICA, BRASWELL",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1205467586,"KEARNEY, ERICA, BRASWELL",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205468162,"EDWARDS, ERIN, LEIGH",3980 HIGHWAY 9 E STE 220 LITTLE RIVER SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205468162,"EDWARDS, ERIN, LEIGH",3617 CASEY ST STE D LORIS SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205468238,"WALKER, CAITLIN, SHEA",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 26 , 34 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205468238,"WALKER, CAITLIN, SHEA",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 52 , 72 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205468238,"WALKER, CAITLIN, SHEA",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205468238,"WALKER, CAITLIN, SHEA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1205468956,"MILLER, MICHAEL, GEORGE",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 89 , 109 , 211 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1205468956,"MILLER, MICHAEL, GEORGE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1205468956,"MILLER, MICHAEL, GEORGE",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1205468956,"MILLER, MICHAEL, GEORGE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205469178,"WELLS, BAILEY",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205469178,"WELLS, BAILEY",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205469178,"WELLS, BAILEY",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205469178,"WELLS, BAILEY",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205469178,"WELLS, BAILEY",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 39 , 123 ,$#,,
MEDICAID DIRECT,1205471430,WISE OPTOMETRY ASSOCIATES PA,WISE EYE CARE,15 JANE JACOBS RD STE 103 BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1205471430,WISE OPTOMETRY ASSOCIATES PA,15 JANE JACOBS RD STE 103 BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,, 307 , 316 , 608 ,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1205476165,"JACOBS, KAYLA, MARIE",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 117 , 162 , 499 ," $19,745.66 ",,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1205476165,"JACOBS, KAYLA, MARIE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205476843,"LOWE, DOUGLAS, KIRBY",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205476843,"LOWE, DOUGLAS, KIRBY",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205476843,"LOWE, DOUGLAS, KIRBY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205476843,"LOWE, DOUGLAS, KIRBY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205477676,"LULE, JOANA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 76 , 76 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205477940,"GIAMARINO, KATHRYN, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 17 , 29 , 40 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205480670,"MOORE, ALESHA, JOLENE NEWMAN",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1205480670,"MOORE, ALESHA, JOLENE NEWMAN",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 48 , 50 ,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205483922,"LAMB, ELIZABETH, DIANE",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205486081,"BARNES, LISA, MESMER",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 15 , 94 , 94 ,$#,,
MEDICAID DIRECT,1770577611,SCOTLAND MEMORIAL HOSPITAL INC,MARLBORO FAMILYPRACTICE AND URGENT CARE,957 CHERAW ST   BENNETTSVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205486818,"BRANCH, BRITTANY, STROUD",957 CHERAW ST   BENNETTSVILLE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003183120,MCLEOD PHYSICIAN ASSOCIATES II,SOUTHERN MEDICAL ASSOCIATES,3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205488848,"TIEBOUT, SHANNON, SMITH",3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205489291,"GARCIA, CAMILLE, ELIZABETH",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205489291,"GARCIA, CAMILLE, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205489291,"GARCIA, CAMILLE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1205489291,"GARCIA, CAMILLE, ELIZABETH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205489291,"GARCIA, CAMILLE, ELIZABETH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1205489291,"GARCIA, CAMILLE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1205489291,"GARCIA, CAMILLE, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205490919,"LYTTLE, JUSTIN, COLE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649428194,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES,800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205491180,"MILLER, MICHELLE, BUXTON",800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 302 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205493129,"HOOVER, MEREDITH, VIRGINIA",10207 CERNY ST STE 302 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205493129,"HOOVER, MEREDITH, VIRGINIA",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205493129,"HOOVER, MEREDITH, VIRGINIA",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1205493129,"HOOVER, MEREDITH, VIRGINIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205493129,"HOOVER, MEREDITH, VIRGINIA",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205496486,WE DO CARE HOME CARE AGENCY LLC,,118 SANDY CREEK LN   NORLINA NC,093,Warren,253Z00000X,Agencies,In Home Supportive Care,,1205496486,WE DO CARE HOME CARE AGENCY LLC,118 SANDY CREEK LN   NORLINA NC,093,Warren,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 5,212 "," 5,546 "," $421,083.02 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205498326,"MULO, KOSTIKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 32 , 75 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205499522,"SASINE, ERIC, PARKS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205499522,"SASINE, ERIC, PARKS",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205499522,"SASINE, ERIC, PARKS",230 MACNIDER BUILDING CB 7593 CHAPEL HILL NC,019,Chatham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 70 , 77 , 83 ,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205500147,"DETWILER, TASHANA, MONIQUE",280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,884 "," 2,239 "," 7,740 "," $259,575.40 ",,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205500147,"DETWILER, TASHANA, MONIQUE",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 782 , 940 ," 3,762 "," $120,036.03 ",,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205500147,"DETWILER, TASHANA, MONIQUE",280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 97 , 99 , 368 ," $27,843.56 ",,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205500147,"DETWILER, TASHANA, MONIQUE",280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 31 ,$#,,
MEDICAID DIRECT,1124158043,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF DUBLIN DENTAL,73 DIXON ST   DUBLIN NC,043,Harnett,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205501038,"MILLER-GREER, STEPHANIE, ANN",73 DIXON ST   DUBLIN NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417427642,CAROLINA FAMILY HEALTH CENTERS INC,CAROLINA FAMILY DENTAL CENTER,8282 NC 58 S   ELM CITY NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205501038,"MILLER-GREER, STEPHANIE, ANN",8282 NC 58 S   ELM CITY NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 230 , 412 ," 1,020 "," $47,565.94 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205506193,"NELSON, DIANA, CHRISTINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 21 , 39 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205510120,"HAUGE, LEAH, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205511789,"MEADOWS, LAUREN, THOMPSON",2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 ,#, 14 ,$#,,
MEDICAID DIRECT,1205524949,LOVELY HOME CARE LLC,,107 SE MAIN ST STE 405 ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1205524949,LOVELY HOME CARE LLC,107 SE MAIN ST STE 405 ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 2,597 "," 2,803 "," $231,087.08 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205525466,"DAIL, TAYLOR, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 37 , 37 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205530268,"FISHER, STEPHANIE, NICOLE",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205530268,"FISHER, STEPHANIE, NICOLE",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1205533718,"DANNEKER, MEGAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205533718,"DANNEKER, MEGAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598891665,HIGHLAND MEDICAL ASSOCIATES PA,~,165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1205535564,"AGRELLA-SEVILLA, LAUREN, JEAN",165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 66 , 66 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1205536851,"DUDLEY, VANESSA, JEAN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 39 , 49 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205538105,"BEUTLER, MORGAN, NOEL",1515 DOCTORS CIR BLDG A WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 27 , 32 ,$#,,
MEDICAID DIRECT,1205540242,OTTO BOCK PATIENT CARE LLC,ABILITY OTTOBOCK CARE,3 WALDEN RIDGE DR STE 400 ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1205540242,OTTO BOCK PATIENT CARE LLC,3 WALDEN RIDGE DR STE 400 ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 56 , 72 , 564 ," $116,358.69 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205540374,"VALENTIN, BRITTNEY, DENYCE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 124 , 124 ,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205540556,"KENDALL, JEMELIA, MARIA",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#, 25 , 25 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205541091,"STANSELL, EARL, BLAKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205541091,"STANSELL, EARL, BLAKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205541604,WELLNESS STRATEGIC HOMECARE SERVICE,,1510 QUAIL RIDGE RD APT I RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1205541604,WELLNESS STRATEGIC HOMECARE SERVICE,1510 QUAIL RIDGE RD APT I RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 242 , 243 ," $33,361.72 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205542610,"HUGGINS, LAUREN, MICHELE",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 22 , 23 , 40 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205542610,"HUGGINS, LAUREN, MICHELE",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205545159,"TIGLER, SHANAIRA, NICOLE",4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 26 , 40 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1205546207,"BRYANT, SANDY, HEMRIC",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 102 , 121 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1205546207,"BRYANT, SANDY, HEMRIC",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 75 , 167 , 181 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205552924,"GOOD-GREENE, TIARA, DANTRELL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 59 , 106 , 174 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#, 11 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 43 , 47 , 82 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 84 , 100 , 181 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#, 18 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,, 46 , 165 , 316 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,#, 42 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,, 14 , 18 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 18 , 42 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 74 , 84 , 159 ,$#,,
MEDICAID DIRECT,1073693347,EASTERN CAROLINA PEDIATRICS,EASTERN CAROLINA PEDIATRICS,1702 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205559283,"SHERROD, LAURA, MURRAY",1801 GLENDALE DR SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 44 , 108 ,$#,,
MEDICAID DIRECT,1205559598,AIPECK HEALTH GROUP INC,,5710 SIX FORKS RD STE 201-14 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1205559598,AIPECK HEALTH GROUP INC,5710 SIX FORKS RD STE 201-14 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 255 , 255 ," $16,837.00 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205560208,"BALLESTEROS-EDWARDS, AMELIA, ROSE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205560208,"BALLESTEROS-EDWARDS, AMELIA, ROSE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205560299,"HAZLETT, EMILY, RUTH",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 101 , 134 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1205561594,"BROCK, TIANGELA, DENISE",1510 HEBRON RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 322 , 322 ," $11,983.63 ",,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205561594,"BROCK, TIANGELA, DENISE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205561594,"BROCK, TIANGELA, DENISE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1205561594,"BROCK, TIANGELA, DENISE",213 RICHMOND HILL DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053142265,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL RADIOLOGY,101 ROBESON ST STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205563830,"THOMAS, APRIL, MICHELLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205563830,"THOMAS, APRIL, MICHELLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1205567245,"DEAVER, COLE, HOUSTON",910 E INNES ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 36 , 55 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1205571007,"SKIMAN, LYNNEA, MARIE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1205571007,"SKIMAN, LYNNEA, MARIE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1205571007,"SKIMAN, LYNNEA, MARIE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205571643,WAKE MEDICAL SUPPLY LLC,,1100 NAVAHO DR STE 122 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1205571643,WAKE MEDICAL SUPPLY LLC,1100 NAVAHO DR STE 122 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 31 , 616 ," 1,433 "," $169,899.23 ",,
MEDICAID DIRECT,1205571643,WAKE MEDICAL SUPPLY LLC,,1100 NAVAHO DR STE 122 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1205571643,WAKE MEDICAL SUPPLY LLC,1100 NAVAHO DR STE 122 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1204 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1205576915,"WHITE, DANIELLE, JARMAN",1204 BROWN ST   WASHINGTON NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205576915,"WHITE, DANIELLE, JARMAN",1204 BROWN ST   WASHINGTON NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 142 , 241 ,$#,,
MEDICAID DIRECT,1205577855,SERVICING WITH HEART HOME CARE LLC,,6125 ROXBURY CT   KERNERSVILLE NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1205577855,SERVICING WITH HEART HOME CARE LLC,6125 ROXBURY CT   KERNERSVILLE NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,275 "," 1,337 "," $164,636.64 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205580131,"REYNOLDS, LAKEISHA, MARIE",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205581980,N-OVATIVE CARE SERVICES,,1110 VINE CLIFF LN   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1205581980,N-OVATIVE CARE SERVICES,1110 VINE CLIFF LN   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 30 ," 5,123 "," 5,123 "," $316,788.04 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 68 , 87 , 137 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205584588,"TABBAL, JEAN ELIE",2301 ERWIN RD   DURHAM NC,032,Durham,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205587680,COMMUNITY PARTNERS HOMECARE LLC,,845 CHURCH ST N STE 208 # 14 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1205587680,COMMUNITY PARTNERS HOMECARE LLC,845 CHURCH ST N STE 208 # 14 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#, 517 , 517 ," $32,517.76 ",,
MEDICAID DIRECT,1205587680,COMMUNITY PARTNERS HOMECARE LLC,,10224 HICKORYWOOD HILL AVE STE 101A HUNTERSVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1205587680,COMMUNITY PARTNERS HOMECARE LLC,10224 HICKORYWOOD HILL AVE STE 101A HUNTERSVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 176 , 176 ," $11,246.52 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205589843,"PIERCE, CARLA, ELIZABETH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205589843,"PIERCE, CARLA, ELIZABETH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 195 , 651 , 687 ," $15,957.80 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205591641,"MORGAN, MORGAN, NICOLE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205592490,"MESSENGER, MARY, KATHLEEN",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205593605,"BOHANAN, ERIKAH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 226 ," 1,193 "," 1,283 "," $37,677.65 ",,
MEDICAID DIRECT,1205593910,TRULY GRATEFUL FAMILY CARE HOME LLC,,1313 ELRADO ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205593910,TRULY GRATEFUL FAMILY CARE HOME LLC,1313 ELRADO ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 12 , 494 , 494 ," $139,046.22 ",,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205614716,"KIMBERLIN, SARAH, ELIZABETH",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 32 , 99 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1205616463,"UPADHYAYA, RAMESH, CHANDRA",205 RATTLESNAKE TRL   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1205616463,"UPADHYAYA, RAMESH, CHANDRA",205 RATTLESNAKE TRL   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1205616463,"UPADHYAYA, RAMESH, CHANDRA",2706 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1205616463,"UPADHYAYA, RAMESH, CHANDRA",2706 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 34 , 34 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205616695,"TAMBUE, ALFREDA, GBIEH",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205616695,"TAMBUE, ALFREDA, GBIEH",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1205618642,"JOHNSON, MARY, JANE",2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 13 , 15 , 16 ,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205642816,"CLINCY, MARIE, ALEXANDRA",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205646577,"SOOTS, CARLIE, STEWART",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205666039,"HURD, MEGAN, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 92 , 121 , 170 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205669595,"NIX, MICHELLE, LEE",129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205669595,"NIX, MICHELLE, LEE",129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205672862,"MOYA, EMILY, CHRISTINE",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1205674934,"SACCHITELLA, KRISTEN, ALEXANDRA",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 38 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1205674934,"SACCHITELLA, KRISTEN, ALEXANDRA",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 26 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1205675220,"CARPENTER, SIERRA, DAWN",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 15 , 18 , 37 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205675493,"HUTCHINSON, JULIANA, DENMARK",11081 FOREST PINES DR STE 112 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1487800892,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT WINSTON-SALEM PREP ACADEMY,1215 N CAMERON AVE   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205681848,"MOWERY, KARMEN, MAUREEN",1215 N CAMERON AVE   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205692365,"LINEBERGER, EMILY, GRACE",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205692365,"LINEBERGER, EMILY, GRACE",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 65 , 86 , 296 ," $12,905.91 ",,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205698503,"BENSLEY, CRISTINA, ULULANI ROXANNE",75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205800380,"SHAIKH, KHAWAR, MUSHTAQ",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 43 , 55 , 65 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205800380,"SHAIKH, KHAWAR, MUSHTAQ",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205800380,"SHAIKH, KHAWAR, MUSHTAQ",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205800380,"SHAIKH, KHAWAR, MUSHTAQ",125 BALDWIN AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 12 , 15 , 36 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205800380,"SHAIKH, KHAWAR, MUSHTAQ",125 BALDWIN AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205800380,"SHAIKH, KHAWAR, MUSHTAQ",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",613 E ROOSEVELT BLVD   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",4525 CAMERON VALLEY PKWY STE 1500 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1205801628,"KOEWLER, THOMAS, JOSEPH",420 PARK ST   BELMONT NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205801685,"QUARANTA, ANTHONY, JOSEPH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205803194,"ONEILL, SANDRA, KEYS",707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 35 , 47 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205803194,"ONEILL, SANDRA, KEYS",2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205804135,"HUX, STEPHEN, MARSHALL",12208 N NC HIGHWAY 150   WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205804630,"WINTERS, DONALD, BRYANT",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 30 , 59 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205804630,"WINTERS, DONALD, BRYANT",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205804630,"WINTERS, DONALD, BRYANT",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1205804630,"WINTERS, DONALD, BRYANT",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 51 , 85 ,$#,,
MEDICAID DIRECT,1205804697,GOLDSBORO ENDOSCOPY CENTER INC,GOLDSBORO ENDOSCOPY CENTER INC,2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1205804697,GOLDSBORO ENDOSCOPY CENTER INC,2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 23 , 28 , 35 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205804739,"ISENHOUR, CHRISTOPHER, BRIAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 59 , 150 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1205804739,"ISENHOUR, CHRISTOPHER, BRIAN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205804739,"ISENHOUR, CHRISTOPHER, BRIAN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 103 , 248 , 542 ,$#,,
MEDICAID DIRECT,1710051123,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH OCEANSIDE FAMILY MEDICINE AND CONVEN,5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1205804739,"ISENHOUR, CHRISTOPHER, BRIAN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205804739,"ISENHOUR, CHRISTOPHER, BRIAN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205804945,"TARRY, WALLACE, CLEMENTS",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205804945,"TARRY, WALLACE, CLEMENTS",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1619464559,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205804945,"TARRY, WALLACE, CLEMENTS",146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 48 , 71 , 90 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205804945,"TARRY, WALLACE, CLEMENTS",146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 23 , 26 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205804945,"TARRY, WALLACE, CLEMENTS",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 47 , 74 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205804986,"CHEEK, VINCENT, KILMER",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205805371,"MORAN, JOSEPH, CONRAD",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 41 , 52 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205805371,"MORAN, JOSEPH, CONRAD",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 84 , 133 , 153 ," $13,097.11 ",,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1205806627,"BLOCK, SANDRA, ANN",9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205806742,"HOFFMAN-MARINO, MANDOLIN, DEBORAH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 37 , 45 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205806742,"HOFFMAN-MARINO, MANDOLIN, DEBORAH",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205807302,"GILLIAM, KAREN, ANNETTE",50 MILLER ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 31 , 36 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205808458,"GIBBONS, ELIZABETH, BARBEE",114 BRADY CT   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205808458,"GIBBONS, ELIZABETH, BARBEE",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205809084,"SHEPHERD, MATTHEW, SCOTT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 75 , 75 , 77 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205809118,"MCMAHON, KEVIN, EDWARD",2660 TATE BLVD SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205809936,"CHU, ALLEN, WEI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 94 , 303 , 304 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205810173,"LYNCH, MARY, ALICE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205810199,"CHAVES, ROBIN, LAIRD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205810215,"CONNOT, TONY, JAMES",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 49 , 79 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205810272,"MILLER, CHADWICK, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 33 , 40 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205810660,"LESSER, GLENN, JAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 49 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205810660,"LESSER, GLENN, JAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1205811684,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDIN,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,291U00000X,Laboratories,Clinical Medical Laboratory,,1205811684,LABORATORY CORPORATION OF AMERICA H,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,291U00000X,Laboratories,Clinical Medical Laboratory,, 22 , 27 , 61 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205812286,"RHYNE, SAMANTHA, J",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 47 , 47 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205812286,"RHYNE, SAMANTHA, J",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,2704 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205812286,"RHYNE, SAMANTHA, J",2704 HENRY ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205812542,"PHILLIPS, LESLIE, RALPH",3100 DURALEIGH RD   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205812666,"URSO, JASON, SCOT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 143 , 146 ,$#,,
MEDICAID DIRECT,1730368952,SEASIDE FAMILY PRACTICE OF BEAUFORT,SEASIDE FAMILY PRACTICE OF BEAUFORT,407 LIVE OAK ST STE 1 BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1205812799,"KENT, SHERRY, OUTLAND",407 LIVE OAK ST STE 1 BEAUFORT NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730368952,SEASIDE FAMILY PRACTICE OF BEAUFORT,SEASIDE FAMILY PRACTICE OF BEAUFORT,407 LIVE OAK ST STE 1 BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1205812799,"KENT, SHERRY, OUTLAND",407 LIVE OAK ST STE 1 BEAUFORT NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 113 , 138 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205812922,"MCCOY, ABRAHAM, LINCOLN",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205812922,"MCCOY, ABRAHAM, LINCOLN",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811145014,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GASTONIA CHILDRENS,2544 COURT DR STE C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205813375,"HURST, LAWRENCE, BRADFORD",2544 COURT DR STE C GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 52 , 70 , 166 ,$#,,
MEDICAID DIRECT,1881979011,NATURAL BEGINNINGS BIRTH AND WELLNE,NATURAL BEGINNINGS BIRTH AND WELLNESS CENTER,1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205815222,"COARSEY, STEPHEN, MCNEIL",1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205816394,"CLARK, KATHERINE, JEAN",309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 88 , 157 , 249 ,$#,,
MEDICAID DIRECT,1285682351,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH THOMASVILLE MEDICAL ASSOCIATES,309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1205816394,"CLARK, KATHERINE, JEAN",309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205816493,"MONTILUS, MARGARET, DANIEL",1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice," 4,058 "," 5,496 "," 24,696 "," $944,086.64 ",,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1205816493,"MONTILUS, MARGARET, DANIEL",68 THREE HUNTS DR STE C PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 110 , 113 , 423 ," $14,312.81 ",,
MEDICAID DIRECT,1205816493,"MONTILUS, MARGARET, DANIEL",~,68 THREE HUNTS DR STE C PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,1205816493,"MONTILUS, MARGARET, DANIEL",68 THREE HUNTS DR STE C PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 24 , 93 ,$#,,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205816493,"MONTILUS, MARGARET, DANIEL",68 THREE HUNTS DR STE C PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 11 ,#, 28 ,$#,,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1205816493,"MONTILUS, MARGARET, DANIEL",68 THREE HUNTS DR STE C PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1205817558,"FINK, KENNETH, IRWIN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 166 , 351 , 351 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205818226,"LORENTZEN, JAMES, CLIFFORD",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 179 , 216 , 273 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1205818226,"LORENTZEN, JAMES, CLIFFORD",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 163 , 172 , 233 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1205818564,"STOTER, SHANNA, GATES",1901 S HAWTHORNE RD STE 308 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1205818564,"STOTER, SHANNA, GATES",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1205818564,"STOTER, SHANNA, GATES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1205818564,"STOTER, SHANNA, GATES",445 PINEVIEW DR STE 240 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205818564,"STOTER, SHANNA, GATES",2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205818564,"STOTER, SHANNA, GATES",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205818606,"KARRIKER, CHARLOTTE, KECK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205818606,"KARRIKER, CHARLOTTE, KECK",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 37 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205820214,"BALIGA, VASANTH, BANTWAL",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 18 , 53 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1205821691,"VARNEY, ELLA, VLAD",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205821907,"REEVES JR, CURTIS, COLEMAN",CURTIS COLEMAN REEVES JR,824 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1205821907,"REEVES JR, CURTIS, COLEMAN",824 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205822434,"RYAN, AMY, GARRETT",517 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205824745,"GELLER, HARLEY, STEVEN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 28 , 29 ,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1205825601,"HARRISON, JEFFREY, G",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 63 , 104 ,$#,,
MEDICAID DIRECT,1205825759,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,1508 MILITARY CUTOFF RD STE 304 WILMINGTON NC,065,New Hanover,251J00000X,Agencies,Nursing Care,,1205825759,AVID HEALTH AT HOME NORTH CAROLINA,1508 MILITARY CUTOFF RD STE 304 WILMINGTON NC,065,New Hanover,251J00000X,Agencies,Nursing Care,,#, 710 , 787 ," $579,254.00 ",,
MEDICAID DIRECT,1205825759,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,1508 MILITARY CUTOFF RD STE 304 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1205825759,AVID HEALTH AT HOME NORTH CAROLINA,1508 MILITARY CUTOFF RD STE 304 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 2,068 "," 2,113 "," $206,049.41 ",,
MEDICAID DIRECT,1679878268,PHYSICIANS UNITY PA,,,,Unknown,193200000X,Group,Multi-Specialty,,1205827326,"REINKE, CAROLINE, BOCK",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679878268,PHYSICIANS UNITY PA,,5224 75TH ST STE D LUBBOCK TX,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1205827326,"REINKE, CAROLINE, BOCK",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 56 , 57 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205828886,"ROSE, DANIEL, TODD",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205828886,"ROSE, DANIEL, TODD",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 19 , 23 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205828886,"ROSE, DANIEL, TODD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 27 , 53 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,118 KIRKMAN CT   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",118 KIRKMAN CT   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 35 , 77 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,118 KIRKMAN CT   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 32 , 126 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205828969,"BELLINGHAM, DANIEL, DWIGHT",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 97 , 182 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",9266 US HIGHWAY 301 S   KENLY NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",102 DODD ST   SPRING HOPE NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",102 DODD ST   SPRING HOPE NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",102 DODD ST   SPRING HOPE NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",2833 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",1605 MEDICAL PARK DR W   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 138 , 138 ," $10,577.71 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",1605 MEDICAL PARK DR W   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",2833 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",1605 MEDICAL PARK DR W   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",1705 TARBORO ST SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 43 , 43 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",2833 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 107 , 107 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",1705 TARBORO ST SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 91 , 91 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",1705 TARBORO ST SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205829066,"AL HAIDARY, ANWAR, DARWISH",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 31 , 51 , 68 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205830221,"ROY, RANJAN, SHANTI",330 JAKE ALEXANDER BLVD W STE 104 SALISBURY NC,080,Rowan,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 64 , 91 , 110 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205830221,"ROY, RANJAN, SHANTI",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003050238,BRICK CITY PRIMARY CARE,~,125 CHATHAM ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1205830239,"GARRETT, DANA, LEANN",125 CHATHAM ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 37 , 40 ,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,611 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1205831369,"CARUSO, DIANE, MARIE",611 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245207356,CLEVELAND PEDIATRICS PC,CLEVELAND PEDIATRICS PC,11709 STATESVILLE BLVD   CLEVELAND NC,080,Rowan,193400000X,Group,Single Specialty,,1205831369,"CARUSO, DIANE, MARIE",11709 STATESVILLE BLVD   CLEVELAND NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 31 , 78 ,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1205831369,"CARUSO, DIANE, MARIE",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1083729701,NORTHLAKE PEDIATRIC CARE PA,NORTHLAKE PEDIATRIC CARE PA,2117 SIMONTON RD STE 402 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1205831369,"CARUSO, DIANE, MARIE",11709 STATESVILLE BLVD   CLEVELAND NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205831492,"JUMPA, TERI, CONSTANCE",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205831492,"JUMPA, TERI, CONSTANCE",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205831492,"JUMPA, TERI, CONSTANCE",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205831492,"JUMPA, TERI, CONSTANCE",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831414135,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205832193,"GOLDEN, THADDEUS, WHITMORE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1508853698,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205832193,"GOLDEN, THADDEUS, WHITMORE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1205832888,"PLOTKIN, MARC, STEVEN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205832888,"PLOTKIN, MARC, STEVEN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205832888,"PLOTKIN, MARC, STEVEN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205832888,"PLOTKIN, MARC, STEVEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 31 , 45 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205832888,"PLOTKIN, MARC, STEVEN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205832888,"PLOTKIN, MARC, STEVEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 32 , 53 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205833647,"WINSLOW, BRISTOL, ROUSE",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1205833647,"WINSLOW, BRISTOL, ROUSE",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205833647,"WINSLOW, BRISTOL, ROUSE",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376195230,FAKHRI INTERNAL MEDICINE PA,,741B TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1205835832,"FAKHRI, MOUHAMED, IYAD",741B TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 106 , 136 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 36 , 84 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205835840,"HU, BEN-HWA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205835915,"ANDRACCHI, SUSAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1619452612,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1205836525,"BECK, DANIEL, TURNEY",1007 W VERNON AVE   KINSTON NC,054,Lenoir,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205836541,"BALL, REBECCA, ANN",3746 VEST MILL RD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922434307,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205836541,"BALL, REBECCA, ANN",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 61 , 127 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205836541,"BALL, REBECCA, ANN",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205837721,"RAMM, ALLEN, PRESCOTT",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 27 , 64 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205837721,"RAMM, ALLEN, PRESCOTT",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 96 , 240 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205838455,"VENTURA BRASWELL, ADA, MARIA",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 114 , 119 , 121 ," $40,749.29 ",,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205838455,"VENTURA BRASWELL, ADA, MARIA",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205838455,"VENTURA BRASWELL, ADA, MARIA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 50 , 52 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205838455,"VENTURA BRASWELL, ADA, MARIA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205838455,"VENTURA BRASWELL, ADA, MARIA",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205840857,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOSPITALS CENTRAL OUTPATIENT PHARMACY,101 MANNING DR   CHAPEL HILL NC,068,Orange,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1205840857,UNIVERSITY OF NC HOSPITALS AT CHAPE,101 MANNING DR   CHAPEL HILL NC,068,Orange,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,, 103 , 121 , 196 ," $83,170.42 ",,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1205841079,"GRIEWE, GREG, LEWIS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208800000X,Allopathic & Osteopathic Physicians,Urology,, 151 , 298 , 630 ," $14,778.93 ",,
MEDICAID DIRECT,1205841152,INGLES MARKETS INC,INGLES PHARMACY 034,2299 US HIGHWAY 70   SWANNANOA NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1205841152,INGLES MARKETS INC,2299 US HIGHWAY 70   SWANNANOA NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1205841301,WALGREEN CO,WALGREENS 06742,2500 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1205841301,WALGREEN CO,2500 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205844669,"ROGERS, KENNETH, MCRAE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1205844834,"WIKSTROM, APRIL, MARIE",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205844834,"WIKSTROM, APRIL, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 28 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205844834,"WIKSTROM, APRIL, MARIE",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 88 , 108 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205846334,"ALBUSTAMI, OMAR, MAHMOUD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205846334,"ALBUSTAMI, OMAR, MAHMOUD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205849619,"TAYLOR, STEVEN, DEWAYNE",2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1346784089,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - DURHAM,1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205849619,"TAYLOR, STEVEN, DEWAYNE",2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1801318944,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GOLDSBORO,2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205849619,"TAYLOR, STEVEN, DEWAYNE",2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1497834642,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SELMA,1111 S POLLOCK ST   SELMA NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205849619,"TAYLOR, STEVEN, DEWAYNE",2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1205849619,"TAYLOR, STEVEN, DEWAYNE",2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 65 ,$#,,
MEDICAID DIRECT,1194267336,TRIAD MEDICAL GROUP PA,,2031 MARTIN LUTHER KING JR DR STE A GREENSBORO NC,041,Guilford,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1205850054,"ODEM, DONNA, SUZANNE",1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205850153,"CALDWELL, WILLIAM, MCKAMIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205850591,"FUQUA, JENNIFER, DOLAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205850591,"FUQUA, JENNIFER, DOLAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 35 , 37 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205851722,"WHITE, MARY, BLACKWELDER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205851722,"WHITE, MARY, BLACKWELDER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 33 , 55 , 55 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205852134,"ARMISTEAD, NITI, SINGH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1205852571,"SAUNDERS, ERIC, JACOB",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1205852571,"SAUNDERS, ERIC, JACOB",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1144259961,ALLCARE CLINICAL ASSOCIATES PA,~,34 GRANBY ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1205852571,"SAUNDERS, ERIC, JACOB",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205853462,WAL-MART STORES EAST LP,~,1725 NEW HOPE CHURCH RD   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1205853462,WAL-MART STORES EAST LP,1725 NEW HOPE CHURCH RD   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 87 , 87 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 25 , 25 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205853991,"GOPALAKRISHNAN, SANTOSH, KUMAR",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205854452,"PAYNE, JOSEPH, MINTER",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 19 , 30 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205854452,"PAYNE, JOSEPH, MINTER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 31 , 39 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205854452,"PAYNE, JOSEPH, MINTER",507 E FREMONT ST   BURGAW NC,071,Pender,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205856499,"JUSTIS, PETER, STINNETT",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205856499,"JUSTIS, PETER, STINNETT",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205856499,"JUSTIS, PETER, STINNETT",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205856499,"JUSTIS, PETER, STINNETT",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205856499,"JUSTIS, PETER, STINNETT",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1205857182,"KHAN, JABER, AMJAD",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 82 , 229 ,$#,,
MEDICAID DIRECT,1205858305,SWAIN COUNTY PUBLIC SCHOOLS,SWAIN COUNTY SCHOOLS,50 MAIN ST STE 2 BRYSON CITY NC,087,Swain,251300000X,Agencies,Local Education Agency (LEA),,1205858305,SWAIN COUNTY PUBLIC SCHOOLS,50 MAIN ST STE 2 BRYSON CITY NC,087,Swain,251300000X,Agencies,Local Education Agency (LEA),, 171 ," 3,816 "," 3,991 "," $205,734.03 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205860897,"HAGEN, TIMOTHY, LEE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1205860970,"BAUMAN, TED, ALBERT",403 FAIRVIEW ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 124 , 310 ,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205861085,"DELANEY, DEVON, BRIGGS",16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205861085,"DELANEY, DEVON, BRIGGS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1790003580,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OB,5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205861085,"DELANEY, DEVON, BRIGGS",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1790003580,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OB,5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205861085,"DELANEY, DEVON, BRIGGS",5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 20 , 24 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205861085,"DELANEY, DEVON, BRIGGS",5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1205861093,"BAKER, CHRISTINE, MARIE",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 24 , 53 ,$#,,
MEDICAID DIRECT,1255851424,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FORESTVILLE CROSSING,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205861093,"BAKER, CHRISTINE, MARIE",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1205861093,"BAKER, CHRISTINE, MARIE",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 100 , 191 , 470 ,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205861572,"HUGHES, MARK, CARROLL",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205861655,"ESPER, DARLENE, MICHELLE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205861655,"ESPER, DARLENE, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 154 , 162 , 170 ," $79,937.79 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205861655,"ESPER, DARLENE, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205861655,"ESPER, DARLENE, MICHELLE",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205862299,"TAYLOR, JEFFREY, NATHAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205862299,"TAYLOR, JEFFREY, NATHAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205862299,"TAYLOR, JEFFREY, NATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1083087837,CORNERSTONE FAMILY PRAC & URG CARE,,,,Unknown,193200000X,Group,Multi-Specialty,,1205862547,"BUCKLEY, GEORGIA, JAMILLAH",2573 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083087837,CORNERSTONE FAMILY PRAC & URG CARE,,1536 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205862547,"BUCKLEY, GEORGIA, JAMILLAH",1536 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 153 , 232 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205863487,"FRENCH, ANITA, SHAWN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1205863487,"FRENCH, ANITA, SHAWN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205864659,"AGRAWAL, MAMATHA, KAMATH",4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205864659,"AGRAWAL, MAMATHA, KAMATH",600 NEW WAVERLY PL STE 205 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 36 , 46 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205864659,"AGRAWAL, MAMATHA, KAMATH",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 104 , 176 ,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205864675,"NELSON, TIMOTHY, SCOTT",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205865995,"NG, WING, KEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 86 , 263 , 263 ," $11,476.12 ",,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205865995,"NG, WING, KEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 131 , 279 , 279 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205867827,"WILLIAMS, DAVID, COLLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 93 , 102 , 160 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205867827,"WILLIAMS, DAVID, COLLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205867827,"WILLIAMS, DAVID, COLLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 22 , 22 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205867827,"WILLIAMS, DAVID, COLLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 36 , 36 , 40 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205868015,"TIM, RICHARD, WALTER CHAN",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 76 , 76 , 168 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205868015,"TIM, RICHARD, WALTER CHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205868015,"TIM, RICHARD, WALTER CHAN",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205868684,"DORSEY, STEVEN, ELLIOTT",3129 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 15 , 32 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205869096,"TATARCHUK, ANNA, LEONIDOVNA",4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205869864,"MCMILLAN, JENNIFER, LEE",12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891726634,HARRISBURG FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE HARRISBURG FAMILY PHYSI,12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1205869864,"MCMILLAN, JENNIFER, LEE",12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 20 , 29 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205869864,"MCMILLAN, JENNIFER, LEE",12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205871738,"EDGLEY, HEATHER, GAYLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 31 , 35 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205872264,"ZAKHARY, BOSHRA, GEORGE",201 S MAIN ST STE 1100 DANVILLE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 22 ,$#,,
MEDICAID DIRECT,1205872850,"HALL, PATRICK, ANTHONY XAVIER",,1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,1205872850,"HALL, PATRICK, ANTHONY XAVIER",1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205873049,"LAMKIN, ANGELA, NUCKOLS",5627 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205873049,"LAMKIN, ANGELA, NUCKOLS",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 23 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205873049,"LAMKIN, ANGELA, NUCKOLS",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205873049,"LAMKIN, ANGELA, NUCKOLS",1334 CENTRAL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205873049,"LAMKIN, ANGELA, NUCKOLS",6646 REGAL OAKS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205873049,"LAMKIN, ANGELA, NUCKOLS",1334 CENTRAL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205874435,"ALMOND, MARY, ANGELA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205875234,"POOLE, DANIEL, THOMAS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 25 , 32 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205875234,"POOLE, DANIEL, THOMAS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1205875234,"POOLE, DANIEL, THOMAS",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 155 , 209 , 246 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205875234,"POOLE, DANIEL, THOMAS",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 69 , 95 , 109 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205875374,"POIRIER, MICHAEL, PATRICK",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205875374,"POIRIER, MICHAEL, PATRICK",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639209133,JOHN C BILDER DMD,~,410 S MAIN ST   MULLINS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205876273,"BILDER, JOHN, CUNNINGHAM",410 S MAIN ST   MULLINS SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 136 , 196 , 644 ," $29,796.29 ",,
MEDICAID DIRECT,1205876273,"BILDER, JOHN, CUNNINGHAM",~,410 S MAIN ST   MULLINS SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1205876273,"BILDER, JOHN, CUNNINGHAM",410 S MAIN ST   MULLINS SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205876471,"COPELAND, MARK, EDWARD",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205877412,"JOYCE, SUNNY, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 31 , 34 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205877990,"BELFORD, PETER, MATTHEW",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 102 , 123 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205877990,"BELFORD, PETER, MATTHEW",313 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205877990,"BELFORD, PETER, MATTHEW",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205877990,"BELFORD, PETER, MATTHEW",117 E KINGS HWY   EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1700918877,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - TRIA,145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205879558,"MEYER, DAVID, DAVIS",145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 34 , 63 , 92 ,$#,,
MEDICAID DIRECT,1700918877,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - TRIA,145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205879558,"MEYER, DAVID, DAVIS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 15 , 35 ,$#,,
MEDICAID DIRECT,1205879657,"MUELLER BRADY, SANDY, MARGARET",~,13500 HWY 50 STE 104 SURF CITY NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1205879657,"MUELLER BRADY, SANDY, MARGARET",13500 HWY 50 STE 104 SURF CITY NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 191 , 269 ,$#,,
MEDICAID DIRECT,1154733707,VALJOY BEACHCARE PA,,13500 NC HIGHWAY 50 STE 104 HOLLY RIDGE NC,071,Pender,193200000X,Group,Multi-Specialty,,1205879657,"MUELLER BRADY, SANDY, MARGARET",13500 NC HIGHWAY 50 STE 104 SURF CITY NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1154733707,VALJOY BEACHCARE PA,,13500 NC HIGHWAY 50 STE 104 HOLLY RIDGE NC,071,Pender,193400000X,Group,Single Specialty,,1205879657,"MUELLER BRADY, SANDY, MARGARET",13500 NC HIGHWAY 50 STE 104 SURF CITY NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 54 , 72 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205880077,"NEAL, STACEY, LYNN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 153 , 159 , 211 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205881612,"ESCARAVAGE JR, GEORGE, KEVIN",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 21 , 44 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205881612,"ESCARAVAGE JR, GEORGE, KEVIN",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205882230,"MUMFORD, AMANDA, MELVINA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205882230,"MUMFORD, AMANDA, MELVINA",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1518606136,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-156 CROSS ROAD DRIVE,156 CROSS ROAD DR   MILLS RIVER NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205882370,"COPENHAVER, CAROL ANNE, BORACK",156 CROSSROADS DR   MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 25 , 38 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1205883105,"BASSIOUNI, HISHAM, IBRAHIM",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",333 E LEE AVE   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 137 , 137 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",4412 S MAIN ST   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 92 , 92 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",625 ASHLAND ST   ARCHDALE NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 118 , 118 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",400 VISION DR   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 211 , 211 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 169 , 169 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 196 , 630 , 631 ," $15,286.64 ",,
MEDICAID DIRECT,1073380515,WOUNDSWIFT LLC,,5540 CENTERVIEW DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 38 , 38 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",707 N ELM ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 81 , 312 , 312 ," $18,091.62 ",,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205883113,"BERNARDINI, HOLLY, LAYMAN",308 W MEADOWVIEW RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 219 , 219 ,$#,,
MEDICAID DIRECT,1396414488,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN 69 NORTH BROAD,69 N BROAD ST   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205884129,"TRAYWICK, ANNE, ELIZABETH",69 N BROAD ST   BREVARD NC,088,Transylvania,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205887080,"PEINDL, PAUL, MICHAEL",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205887080,"PEINDL, PAUL, MICHAEL",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 70 , 96 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205887080,"PEINDL, PAUL, MICHAEL",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205888971,"KAPUR, JAIME",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 30 , 31 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205889292,"LIETZ, TIMOTHY, EDWARD",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205889292,"LIETZ, TIMOTHY, EDWARD",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205889292,"LIETZ, TIMOTHY, EDWARD",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1205889409,"CORBETT, BERNARD, AUGUSTUS",70 OAK ST   TRYON NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1205889409,"CORBETT, BERNARD, AUGUSTUS",70 OAK ST   TRYON NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1205889409,"CORBETT, BERNARD, AUGUSTUS",70 OAK ST   TRYON NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1205889409,"CORBETT, BERNARD, AUGUSTUS",70 OAK ST   TRYON NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205889409,"CORBETT, BERNARD, AUGUSTUS",70 OAK ST   TRYON NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 39 , 39 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1205889409,"CORBETT, BERNARD, AUGUSTUS",2829 E HIGHWAY 76   MULLINS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,5826 SAMET DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205889870,"DALLURA, SAL, ANTHONY",5826 SAMET DR STE 101 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205889870,"DALLURA, SAL, ANTHONY",1720 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 19 , 34 ,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1205889938,"RAUCK, RICHARD, LEE",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 40 , 51 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205890696,"LOWNE-CHASE, YVONNE, RENEE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 53 , 133 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205890696,"LOWNE-CHASE, YVONNE, RENEE",4810 W WENDOVER AVE   JAMESTOWN NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1205890795,"WINTER, JAMES, ANDREW",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 90 , 91 , 139 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,300 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1205890795,"WINTER, JAMES, ANDREW",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 61 , 66 , 101 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205891512,"SIMON, DANIEL, JONATHAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 65 , 75 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205891512,"SIMON, DANIEL, JONATHAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 35 , 48 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1205891512,"SIMON, DANIEL, JONATHAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205891512,"SIMON, DANIEL, JONATHAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205891512,"SIMON, DANIEL, JONATHAN",5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 28 , 31 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205891512,"SIMON, DANIEL, JONATHAN",1838 MARTIN KING JR BLVD   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1023050630,COURTVIEW OB GYN PA,COURTVIEW OB GYN PA,706 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205891843,"BURNS, CHRISTINE, LYNN",706 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 15 , 24 , 48 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205892171,"TYO, JOHN, MARSHALL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205892171,"TYO, JOHN, MARSHALL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 105 , 110 , 117 ," $11,967.21 ",,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205893062,"TALLMER, ENID, MATOS",8312 CREEDMOOR RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 31 , 90 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 13 , 15 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 ,#, 15 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1205893187,"WILLIAMS, DAVID, MORGAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205893435,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1205893435,UNIVERSITY EYE ASSOCIATES OD PA,9651 BROOKDALE DR STE 800 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,#, 17 ,$#,,
MEDICAID DIRECT,1396071577,ISIOMA A OKONMAH DDS MPH PA,~,408 STATESVILLE BLVD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1205893492,"OKONMAH, ISIOMA, ANTHONIA",408 STATESVILLE BLVD   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 360 , 635 ," 3,150 "," $179,006.68 ",,
MEDICAID DIRECT,1396383345,ISIOMA A OKONMAH DDS MPH PA CONCORD,VIDENT DENTISTRY,538 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1205893492,"OKONMAH, ISIOMA, ANTHONIA",408 STATESVILLE BLVD   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 132 , 258 ," 1,535 "," $114,111.25 ",,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205895513,"CANNADA, LISA, KAYE",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205895513,"CANNADA, LISA, KAYE",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205897295,"GOLDWAG, STUART, S",582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1578638078,PITT FAMILY PHYSICIANS PA,PITT FAMILY PHYSICIANS PA,137 THIRD ST   AYDEN NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205898426,"GALLOWAY JR, JAMES, MADISON",137 THIRD ST   AYDEN NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 69 , 116 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1205898483,"JACOBS, RONNIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1205898483,"JACOBS, RONNIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205898764,"BOGGUSS, JULIE, MEAD",6324 FAIRVIEW RD STE 350 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 25 , 89 ,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1205899036,"WATSON, ROGER, TED",1227 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1205899036,"WATSON, ROGER, TED",1302 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1205899036,"WATSON, ROGER, TED",601 GREENVILLE BLVD SE   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,, 49 , 48 , 48 ,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1205899036,"WATSON, ROGER, TED",795 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 25 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 58 , 74 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205899093,"HAMILTON GAERTNER, PENNY, JO",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1205899143,"VARGO, JILL, SCOTT",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 25 , 32 , 91 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205899234,"MICHEL, LISA, VOLLANO",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205899234,"MICHEL, LISA, VOLLANO",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1205899234,"MICHEL, LISA, VOLLANO",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 50 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205899309,"JONES, GREGORY",720 MALCOLM BLVD   VALDESE NC,012,Burke,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 26 , 88 , 108 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205899713,"COMPEGGIE, CINDY, ANN",108 LAKESIDE DR   SNEADS FERRY NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 27 , 43 , 71 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205899713,"COMPEGGIE, CINDY, ANN",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205899713,"COMPEGGIE, CINDY, ANN",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1205899796,"HOLZ, JULIE, ANNE",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205901493,"WALLINE, KATINA, DAWN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205901881,DOCTORS PARK PHARMACY,DOCTORS PARK PHARMACY,403 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1205901881,DOCTORS PARK PHARMACY,403 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205903408,"WHEELESS, CLIFFORD, ROBERTS",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 132 , 241 , 425 ,$#,,
MEDICAID DIRECT,1205903804,GASTON COUNTY SCHOOLS,GASTON COUNTY SCHOOLS,215 W THIRD AVE   GASTONIA NC,036,Gaston,251300000X,Agencies,Local Education Agency (LEA),,1205903804,GASTON COUNTY SCHOOLS,215 W THIRD AVE   GASTONIA NC,036,Gaston,251300000X,Agencies,Local Education Agency (LEA),," 1,193 "," 24,554 "," 25,501 "," $1,130,954.87 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205903945,"HARDY, ERIC",211 VIRGINIA RD   EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205903945,"HARDY, ERIC",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 50 , 79 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205904448,"NARANG, TARUN, KUMAR",300 BILLINGSLEY RD STE 200B CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 18 , 31 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205904448,"NARANG, TARUN, KUMAR",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 14 , 27 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205904448,"NARANG, TARUN, KUMAR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205904448,"NARANG, TARUN, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205904448,"NARANG, TARUN, KUMAR",10520 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 15 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205904448,"NARANG, TARUN, KUMAR",10620 PARK RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205904448,"NARANG, TARUN, KUMAR",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 57 , 173 , 279 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205904448,"NARANG, TARUN, KUMAR",10620 PARK RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 32 , 32 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205904448,"NARANG, TARUN, KUMAR",10520 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1205904448,"NARANG, TARUN, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 43 , 57 , 103 ,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1205908282,"BLUMHARDT, SHANNON, REED",2721 X RAY DR   GASTONIA NC,036,Gaston,111N00000X,Chiropractic Providers,Chiropractor,, 43 , 385 , 385 ," $14,404.16 ",,
MEDICAID DIRECT,1205908456,ENDOSCOPY CENTER - PINEVILLE LLC,ENDOSCOPY CENTER - PINEVILLE LLC,10520 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1205908456,ENDOSCOPY CENTER - PINEVILLE LLC,10520 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1548400526,A K SHARDA DMD PA,A K SHARDA DMD PA,5510 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205908597,"PENUMALLI, SHELLY, GUPTA",5510 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 272 , 491 ," 1,571 "," $103,251.53 ",,
MEDICAID DIRECT,1205909496,"MOHAMED, M HISHAM, ABDEL AZIZ",BLUE RIDGE MEDICAL GROUP PA,3214 CHARLES B ROOT WYND STE 217 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1205909496,"MOHAMED, M HISHAM, ABDEL AZIZ",3214 CHARLES B ROOT WYND STE 217 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 334 , 334 ," $15,209.67 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205910189,"ZIDAR, JAMES, PATRICK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205910189,"ZIDAR, JAMES, PATRICK",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205910189,"ZIDAR, JAMES, PATRICK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 80 , 100 , 149 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1205910189,"ZIDAR, JAMES, PATRICK",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1205910189,"ZIDAR, JAMES, PATRICK",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205910189,"ZIDAR, JAMES, PATRICK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1205910361,"KLEIN, STEPHEN, MATTHEW",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205910361,"KLEIN, STEPHEN, MATTHEW",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205910361,"KLEIN, STEPHEN, MATTHEW",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205910734,"LINVILLE, TIFFANY, MARIE",1781 TATE BLVD SE   HICKORY NC,018,Catawba,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205910734,"LINVILLE, TIFFANY, MARIE",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205910734,"LINVILLE, TIFFANY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205910734,"LINVILLE, TIFFANY, MARIE",9625 NORTHCROSS CENTER CT STE 102 HUNTERSVILLE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205911096,"KIELY, JAMES, MATTHEW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205914868,"HILL, EMILIE, JEANNE ALLEN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 60 , 94 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205921954,"KRASUSKI, RICHARD, ANDREW",6301 HERNDON RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 14 , 27 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205921954,"KRASUSKI, RICHARD, ANDREW",6301 HERNDON RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 24 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205921954,"KRASUSKI, RICHARD, ANDREW",6301 HERNDON RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1205921954,"KRASUSKI, RICHARD, ANDREW",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1205921954,"KRASUSKI, RICHARD, ANDREW",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,, 208 , 208 , 415 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1205925237,"MEDNICK, BRANDON, LOUIS",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1205925237,"MEDNICK, BRANDON, LOUIS",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205925393,YOUR HOME INC,ROSE HILL RETIREMENT COMMUNITY,120 FLEMING AVE   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205925393,YOUR HOME INC,120 FLEMING AVE   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 344 , 344 ," $22,039.87 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205925864,"BOE, JUSTIN, JOEL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205925864,"BOE, JUSTIN, JOEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1205925864,"BOE, JUSTIN, JOEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205925914,DR ALAN L BYRD AND ASSOCIATES,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1205925914,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,, 789 , 807 ," 1,600 "," $20,798.37 ",,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1205928223,"GILMORE, TEDRA, ELAINE",105 MCALPINE LN   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 38 , 56 , 66 ,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1205928223,"GILMORE, TEDRA, ELAINE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205929890,"YOUSSEF, AMAL, Y.A.",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 38 , 40 ,$#,,
MEDICAID DIRECT,1205930823,"HALL, MICHELLE, LYNETTE",BRUSHY MOUNTAIN CHIROPRACTIC CENTER,1702 W US HIGHWAY 421 STE A WILKESBORO NC,097,Wilkes,111N00000X,Chiropractic Providers,Chiropractor,,1205930823,"HALL, MICHELLE, LYNETTE",1702 W US HIGHWAY 421 STE A WILKESBORO NC,097,Wilkes,111N00000X,Chiropractic Providers,Chiropractor,,#, 115 , 116 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1205935236,"DELLARIA, JOSEPH, CARL",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 25 , 30 ,$#,,
MEDICAID DIRECT,1205937851,HEARTHSIDE HOMECARE LLC,FIRSTLIGHT HOME CARE OF JACKSONVILLE,99 VILLAGE DR STE 13 JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1205937851,HEARTHSIDE HOMECARE LLC,99 VILLAGE DR STE 13 JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1205937992,"ROBERTSON, NOELLE, CELINE",2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 39 , 76 ,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1205937992,"ROBERTSON, NOELLE, CELINE",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",1000 BLYTHE BLVD FL 4 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 83 , 95 , 121 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 47 , 102 ," $10,864.90 ",,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",111 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 18 , 24 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 14 , 27 ,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1205938255,"NUSSBAUM, TZVI, STEVE",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205940244,"BEHRENS, NANCY, VIRGINIA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205940244,"BEHRENS, NANCY, VIRGINIA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205940244,"BEHRENS, NANCY, VIRGINIA",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205940244,"BEHRENS, NANCY, VIRGINIA",14135 BALLANTYNE CORPORATE PL STE 160 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265622377,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SLEEP MEDICINE,14215 BALLANTYNE CORPORATE PL STE 230 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205940244,"BEHRENS, NANCY, VIRGINIA",1900 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1205940244,"BEHRENS, NANCY, VIRGINIA",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205942927,"JACKSON, MARY, LOUISE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205942927,"JACKSON, MARY, LOUISE",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 20 , 39 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205942927,"JACKSON, MARY, LOUISE",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205942927,"JACKSON, MARY, LOUISE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 43 , 89 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1205947009,"HORGER IV, EDGAR, OLIN",1606 WELLINGTON AVE STE E WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346486891,SEASIDE PEDIATRICS PA,SEASIDE PEDIATRICS PA,1606 WELLINGTON AVE STE E WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205947009,"HORGER IV, EDGAR, OLIN",1606 WELLINGTON AVE STE E WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 29 , 58 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1205947785,"MUHLEBACH, MARIANNE, SPONER",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205947785,"MUHLEBACH, MARIANNE, SPONER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 42 , 81 , 111 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205951720,"GBADEGESIN, RASHEED, ADEBAYO",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205951720,"GBADEGESIN, RASHEED, ADEBAYO",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 24 , 63 , 63 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1205954310,"SCANNELL, MARGARET, ANTOINETTE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 33 , 33 ,$#,,
MEDICAID DIRECT,1205956398,EVERGREEN LIVING HOME INC,EVERGREEN LIVING HOME 2,102 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1205956398,EVERGREEN LIVING HOME INC,102 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,703 "," 1,758 "," $136,367.24 ",,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205958220,"BURGER, JOHN, WILLIAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1205958220,"BURGER, JOHN, WILLIAM",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205958220,"BURGER, JOHN, WILLIAM",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205960309,"CANTON KANE, KIMBERLEY, CLAIRE MICHELLE",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,088 "," 1,472 "," 5,161 "," $190,330.20 ",,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205960309,"CANTON KANE, KIMBERLEY, CLAIRE MICHELLE",280 CONCORD PKWY S STE 110A CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,899 "," 2,160 "," 5,773 "," $198,813.46 ",,
MEDICAID DIRECT,1720643174,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR STRUCTURAL HEART,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205961521,"ENRIGHT, CARRIE, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205961521,"ENRIGHT, CARRIE, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134295850,COUNTY OF MONTGOMERY,MONTGOMERY COUNTY HEALTH DEPT,217 S MAIN ST STE B TROY NC,062,Montgomery,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205964046,"RAYNOR, TAMELA, MARIE",217 S MAIN ST STE B TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 87 ,$#,,
MEDICAID DIRECT,1134295850,COUNTY OF MONTGOMERY,MONTGOMERY COUNTY HEALTH DEPT,217 S MAIN ST STE B TROY NC,062,Montgomery,261QC1500X,Ambulatory Health Care Facilities,Clinic/Center,Community Health,1205964046,"RAYNOR, TAMELA, MARIE",217 S MAIN ST STE B TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 75 , 281 ," $12,135.51 ",,
MEDICAID DIRECT,1215143185,THE DEBNAM CLINIC PA,THE DEBNAM CLINIC PA,1501 POOLE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1205965068,"DEBNAM, MARIE, GEORGETTE",1501 POOLE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 117 , 117 ,$#,,
MEDICAID DIRECT,1205966942,QUALITY HOME CARE AND COMMUNITY SER,QUALITY HOME CARE AND COMMUNITY SERVICES INC,400 S MAIN ST   BLADENBORO NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,,1205966942,QUALITY HOME CARE AND COMMUNITY SER,400 S MAIN ST   BLADENBORO NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,, 49 ," 12,548 "," 12,638 "," $951,072.96 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205968732,"MOHAMED, NABEEL, ALI",2790 GODWIN BLVD STE 360 SUFFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1205968732,"MOHAMED, NABEEL, ALI",2790 GODWIN BLVD STE 360 SUFFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205969292,COUNTY OF DAVIDSON,,935 N MAIN ST   LEXINGTON NC,029,Davidson,3416L0300X,Transportation Services,Ambulance,Land Transport,1205969292,COUNTY OF DAVIDSON,935 N MAIN ST   LEXINGTON NC,029,Davidson,3416L0300X,Transportation Services,Ambulance,Land Transport, 231 , 413 , 821 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205969953,"WINTER III, DE, BENJAMIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 65 , 98 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205969953,"WINTER III, DE, BENJAMIN",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205969953,"WINTER III, DE, BENJAMIN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1205969953,"WINTER III, DE, BENJAMIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205969953,"WINTER III, DE, BENJAMIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205975166,"TOUPIN, WENDY, ANN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205975166,"TOUPIN, WENDY, ANN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205977451,"MATHEWS, JAMES, CHRISTOPHER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 114 , 120 , 122 ,$#,,
MEDICAID DIRECT,1720011729,COUNTY OF RANDOLPH,RANDOLPH COUNTY HEALTH DEPARTMENT,2222 S FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205979119,"LAMBETH, REBECCA, CHEEK",2222 S FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 26 , 36 , 126 ,$#,,
MEDICAID DIRECT,1205979259,PAMELA SPENCE DEVORE,PERSONAL TOUCH ASSISTED LIVING SERVICE,83 WILSON ST   ANDREWS NC,020,Cherokee,253Z00000X,Agencies,In Home Supportive Care,,1205979259,PAMELA SPENCE DEVORE,83 WILSON ST   ANDREWS NC,020,Cherokee,253Z00000X,Agencies,In Home Supportive Care,,#, 230 , 230 ," $15,352.96 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1205980034,"TAYLOR, PHYLLIS, KAY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1205980349,"HARRINGTON, ANNE, BOCHSLER",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205980349,"HARRINGTON, ANNE, BOCHSLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1205980513,"BRANDES, BARBARA, ANNE",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 47 , 102 ,$#,,
MEDICAID DIRECT,1205982006,"LOWRY, CRAIG, FRANKLIN",~,210 WILLOW ST   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1205982006,"LOWRY, CRAIG, FRANKLIN",210 WILLOW ST   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 73 , 128 , 343 ," $11,850.54 ",,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,115 HILLTOP VLG   OXFORD NC,039,Granville,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1205984341,"LAMBERT, DAVID, M HAAS",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 79 , 99 , 284 ," $15,362.37 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1205984416,"MURPHY, ROBERT, BRYAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205984416,"MURPHY, ROBERT, BRYAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1205984416,"MURPHY, ROBERT, BRYAN",105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1205984416,"MURPHY, ROBERT, BRYAN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1205987500,"NIELSEN, MATTHEW, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 21 , 31 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205987500,"NIELSEN, MATTHEW, EDWARD",4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205987500,"NIELSEN, MATTHEW, EDWARD",4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1710609961,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN SPECIALTY CLINICS,6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1205991502,"CONWAY, JILL, MARIE",6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 25 , 39 , 56 ,$#,,
MEDICAID DIRECT,1205991627,HOUSER DRUG CO,HOUSER DRUGS CO,302 E MAIN ST   CHERRYVILLE NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1205991627,HOUSER DRUG CO,302 E MAIN ST   CHERRYVILLE NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205992302,"CROW, AMANDA, RENEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 35 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1205993136,HEALTHACCESS INC,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 32 , 136 , 193 ," $125,502.20 ",,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1205993359,"COMER, CINDY, FOWLER",542 ALLRED MILL RD   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 356 , 356 ," $10,273.19 ",,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1205993359,"COMER, CINDY, FOWLER",314 S SOUTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1205993359,"COMER, CINDY, FOWLER",314 S SOUTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1205993359,"COMER, CINDY, FOWLER",1297 GALAX TRL   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1205993359,"COMER, CINDY, FOWLER",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1205993359,"COMER, CINDY, FOWLER",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073070728,HAMMOCK DMD & LOTAKIS DDS IV PLLC,~,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1205994894,"MARTI, FLOR, MARIA",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice," 2,455 "," 4,950 "," 18,751 "," $984,857.58 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205996998,"KERNER, NICOLE, PAZZAGLINI",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205996998,"KERNER, NICOLE, PAZZAGLINI",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205996998,"KERNER, NICOLE, PAZZAGLINI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205996998,"KERNER, NICOLE, PAZZAGLINI",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205996998,"KERNER, NICOLE, PAZZAGLINI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 29 , 32 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205999083,"NIEVES, ANGEL",5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205999083,"NIEVES, ANGEL",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205999083,"NIEVES, ANGEL",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1205999083,"NIEVES, ANGEL",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1205999083,"NIEVES, ANGEL",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 302 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1205999083,"NIEVES, ANGEL",10207 CERNY ST STE 302 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376132571,FULLER & ASSOCIATES VII PLLC,CLINTON FAMILY & COSMETIC DENTISTRY,320 NORTHEAST BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1215000864,"FULLER IV, RAWLEY, HARRISON",320 NORTHEAST BLVD   CLINTON NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 31 ,$#,,
MEDICAID DIRECT,1518556711,FULLER & ASSOCIATES X PLLC,WATERFORD FAMILY & COSMETIC DENTISTRY,509 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215000864,"FULLER IV, RAWLEY, HARRISON",3450 FORESTDALE DR   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 25 , 80 ,$#,,
MEDICAID DIRECT,1518556711,FULLER & ASSOCIATES X PLLC,WATERFORD FAMILY & COSMETIC DENTISTRY,509 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215000864,"FULLER IV, RAWLEY, HARRISON",509 OLDE WATERFORD WAY STE 300 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 303 , 536 ," 2,166 "," $63,990.18 ",,
MEDICAID DIRECT,1609949155,RAWLEY H FULLER IV,~,3450 FORESTDALE DR   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215000864,"FULLER IV, RAWLEY, HARRISON",3450 FORESTDALE DR   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 133 , 249 , 779 ," $29,526.87 ",,
MEDICAID DIRECT,1215003603,GENOMIC HEALTH INC,GENOMIC HEALTH INC,301 PENOBSCOT DR 301 PENOBSCOT DRIVE REDWOOD CITY CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1215003603,GENOMIC HEALTH INC,301 PENOBSCOT DR 301 PENOBSCOT DRIVE REDWOOD CITY CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#," $18,048.18 ",,
MEDICAID DIRECT,1013074574,MICHAEL L CAHN MD PA,,4503 MAIN ST FL 2 SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1215005459,"CAHN, MICHAEL, LOUIS",4503 MAIN ST FL 2 SHALLOTTE NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 28 , 41 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215006192,"JACKSON, MISHI, KAVON",1471 JAG BRANCH BLVD UNIT 103 KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 42 , 89 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215006192,"JACKSON, MISHI, KAVON",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215006192,"JACKSON, MISHI, KAVON",1226 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215006952,"BACH STYLES, TANYA, LEA",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215006952,"BACH STYLES, TANYA, LEA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215008545,"WETTREICH, HERBERT, LEE",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215008545,"WETTREICH, HERBERT, LEE",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 30 , 50 , 67 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215008545,"WETTREICH, HERBERT, LEE",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1518549393,IREDELL PHYSICIAN NETWORK,IREDELL SURGERY AT MOORESVILLE,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1215008545,"WETTREICH, HERBERT, LEE",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215008545,"WETTREICH, HERBERT, LEE",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215008545,"WETTREICH, HERBERT, LEE",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1427048172,ASHE MEMORIAL HOSPITAL INC,AMH MOUNTAIN FAMILY CARE CENTER,310 HOSPITAL AVENUE   JEFFERSON NC,005,Ashe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1215009758,"CLARK, CATHY, GRIFFITTS",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 51 , 54 ,$#,,
MEDICAID DIRECT,1295193340,ASHE FINANCIAL SERVICES LLC,ASHE FINANCIAL SERVICES LLC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1215009758,"CLARK, CATHY, GRIFFITTS",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215009998,"SMITH, NONA, MICHAUX",150 CHARLOIS BLVD STE 100 WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215009998,"SMITH, NONA, MICHAUX",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 20 , 43 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215009998,"SMITH, NONA, MICHAUX",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215010475,"GENTRY, JENNIFER, HIRSCHY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215010475,"GENTRY, JENNIFER, HIRSCHY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215010475,"GENTRY, JENNIFER, HIRSCHY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1265709612,NORTH MOORE FAMILY PRACTICE PA,~,301 S MIDDLETON ST   ROBBINS NC,063,Moore,193400000X,Group,Single Specialty,,1215011028,"REIVES, VONDA, HARRINGTON",301 S MIDDLETON ST   ROBBINS NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 174 , 384 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215011101,"MICOL, MELISSA, BURLESON",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 19 , 32 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215011101,"MICOL, MELISSA, BURLESON",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1215011101,"MICOL, MELISSA, BURLESON",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215011192,"WU, LAWRENCE, REGINALD",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215011192,"WU, LAWRENCE, REGINALD",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215013248,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 00187,14125 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1215013248,NORTH CAROLINA CVS PHARMACY LLC,14125 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 13 , 33 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215013602,"MOBERLY, DAVID, KENT",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 61 , 85 , 142 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215013602,"MOBERLY, DAVID, KENT",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1942428982,CAROLINA DERMATOLOGY AND SKIN CANCE,CAROLINA DERMATOLOGY AND SKIN CANCER SURGERY PA,1814 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215019351,"SULLIVAN, MICHAEL, DURGIN",1814 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 12 , 24 ,$#,,
MEDICAID DIRECT,1215019351,"SULLIVAN, MICHAEL, DURGIN",~,1814 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1215019351,"SULLIVAN, MICHAEL, DURGIN",1814 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1720292261,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1215019617,"MOORE, STACIA, DAWN",50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215019914,"CASTILLO, MAURICIO",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215019914,"CASTILLO, MAURICIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215019914,"CASTILLO, MAURICIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215019914,"CASTILLO, MAURICIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215019914,"CASTILLO, MAURICIO",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215023239,"SUHOCKI, PAUL, VINCENT",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 12 , 13 , 30 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215023239,"SUHOCKI, PAUL, VINCENT",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215023239,"SUHOCKI, PAUL, VINCENT",2301 ERWIN RD FL 1 DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 37 , 39 , 91 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1215023775,"BLEAU, TRACEY, AMANDA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 124 , 125 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1215023775,"BLEAU, TRACEY, AMANDA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 49 , 49 ,$#,,
MEDICAID DIRECT,1215024617,SENTARA HOSPITALS,SENTARA NORFOLK GENERAL PHARMACY,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1215024617,SENTARA HOSPITALS,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1215025127,"KNOLLMAN, MARK, ALLEN",MARK A KNOLLMAN,600B CENTREPARK DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1215025127,"KNOLLMAN, MARK, ALLEN",600B CENTREPARK DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 69 , 161 , 392 ," $20,376.72 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215026570,"LESLIE-BROWN, HEATHER, FAY MAUREEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 20 , 21 ,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215026570,"LESLIE-BROWN, HEATHER, FAY MAUREEN",600 HOSPITAL DR   MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1215028246,SPRINGWELL NETWORK INC,SPRINGWELL NETWORK EBERT STREET GROUP HOME,3830 EBERT RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215028246,SPRINGWELL NETWORK INC,3830 EBERT RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 303 , 303 ," $10,861.98 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 104 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1215029996,"KEAGY, BLAIR, ALLEN",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215029996,"KEAGY, BLAIR, ALLEN",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 28 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215029996,"KEAGY, BLAIR, ALLEN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 63 , 68 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215029996,"KEAGY, BLAIR, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 402 , 530 , 694 ," $11,303.55 ",,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1215030465,"MOORE, KENNETH, EARL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 56 , 60 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1215030465,"MOORE, KENNETH, EARL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 54 , 64 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1215030465,"MOORE, KENNETH, EARL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 49 , 53 ,$#,,
MEDICAID DIRECT,1699735951,GROWING UP PEDIATRICS PA,GROWING UP PEDIATRICS,8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215030648,"WESCOTT, CHRISTINA, ALICIA",8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699735951,GROWING UP PEDIATRICS PA,GROWING UP PEDIATRICS,8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215030648,"WESCOTT, CHRISTINA, ALICIA",8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1215035779,"MARTIN, KEVIN, CHARLES",306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1215035779,"MARTIN, KEVIN, CHARLES",306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215037791,"HILL, MARK, REGINALD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 121 , 126 , 129 ,$#,,
MEDICAID DIRECT,1972737195,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215038054,"COOK, MARCUS, PETER",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215038054,"COOK, MARCUS, PETER",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 35 , 52 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215038054,"COOK, MARCUS, PETER",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 71 , 140 ,$#,,
MEDICAID DIRECT,1366917056,SCOTT SMITH DMD PA,~,556 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1215038732,"MAUTNER, MARK, ANDY",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 35 , 123 ,$#,,
MEDICAID DIRECT,1184728339,WILKES DENTAL CONSORTIUM,WILKES DENTAL CONSORTIUM,1915 W PARK DR STE 104 NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1215038732,"MAUTNER, MARK, ANDY",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1215038732,"MAUTNER, MARK, ANDY",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 322 , 389 ," 1,028 "," $60,915.02 ",,
MEDICAID DIRECT,1215039466,TYCON MEDICAL SYSTEMS INC,,801 ORAPAX ST   NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1215039466,TYCON MEDICAL SYSTEMS INC,801 ORAPAX ST   NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1215040613,"COPE, RANDALL, KEVIN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 41 , 41 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215040613,"COPE, RANDALL, KEVIN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1215040613,"COPE, RANDALL, KEVIN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 79 , 80 ,$#,,
MEDICAID DIRECT,1184669053,SOUTHEASTERN MEDICAL GROUP PC,,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1215040613,"COPE, RANDALL, KEVIN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215042411,"BONO, ERIKA, LEE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215042411,"BONO, ERIKA, LEE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215042411,"BONO, ERIKA, LEE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215042411,"BONO, ERIKA, LEE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215044037,"SIGMON, KIRAN, RUTH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 19 , 27 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215044037,"SIGMON, KIRAN, RUTH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 23 , 23 ,$#,,
MEDICAID DIRECT,1639407737,STATESVILLE HMA MEDICAL GROUP LLC,STATESVILLE HMA MEDICAL GROUP LLC,35 RURITAN PARK RD   STONY POINT NC,002,Alexander,193200000X,Group,Multi-Specialty,,1215044045,"SWEDLUND, ROBERT, DEAN",602 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1326719055,FAMILY 1ST HEALTHCARE ASSOCIATES PL,~,602 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1215044045,"SWEDLUND, ROBERT, DEAN",602 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 97 , 137 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,1410 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215044045,"SWEDLUND, ROBERT, DEAN",1410 FERN CREEK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215047543,"SCALLION, RICHARD, RALPH",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215047543,"SCALLION, RICHARD, RALPH",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 24 , 30 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215047543,"SCALLION, RICHARD, RALPH",584 HOSPITAL DR NE UNIT A BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215047543,"SCALLION, RICHARD, RALPH",257 HOSPITAL DR NE STE 200 BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 35 , 39 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215048020,"ATASOY, ERHAN, CEMIL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 31 , 41 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215049242,"CORRINGTON, KIP, ALAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215049242,"CORRINGTON, KIP, ALAN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215049242,"CORRINGTON, KIP, ALAN",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215049242,"CORRINGTON, KIP, ALAN",7607 NC HIGHWAY 68 N STE B OAK RIDGE NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 69 , 161 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215050315,"ZIEWACZ, JOHN, EDWARD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215050315,"ZIEWACZ, JOHN, EDWARD",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215050315,"ZIEWACZ, JOHN, EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215050315,"ZIEWACZ, JOHN, EDWARD",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 17 , 23 , 33 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215050315,"ZIEWACZ, JOHN, EDWARD",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215050315,"ZIEWACZ, JOHN, EDWARD",1401 MATTHEWS TOWNSHIP PKWY STE 300 MATTHEWS NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 23 , 28 , 28 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215050315,"ZIEWACZ, JOHN, EDWARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215052113,"BYARS, NICOLE, HELEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 35 , 35 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215052113,"BYARS, NICOLE, HELEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 31 , 31 ,$#,,
MEDICAID DIRECT,1215055215,BURLINGTON CARE CENTER,TERRY CARE HOME,2446 CHERRY GROVE RD   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215055215,BURLINGTON CARE CENTER,2446 CHERRY GROVE RD   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,155 "," 1,176 "," $94,273.13 ",,
MEDICAID DIRECT,1720161334,COUNTY OF MACON,MACON CO PUBLIC HEALTH CENTER,1830 LAKESIDE DR   FRANKLIN NC,056,Macon,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1215058177,"SMITH, ALLISON, JOY",1830 LAKESIDE DR   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 95 , 190 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215058722,"BORJA, ALLISON, MILLER",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 38 , 99 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215058870,"BITTNER, JAMES, GRAHAM",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1215059100,WEAVERS PINEVIEW HOME,~,142 W LEWISTOWN RD   MURFREESBORO NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215059100,WEAVERS PINEVIEW HOME,142 W LEWISTOWN RD   MURFREESBORO NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 42 , 42 ," $63,040.43 ",,
MEDICAID DIRECT,1215059936,COUNTY OF CALDWELL,Caldwell County DSS,,,Unknown,251B00000X,Agencies,Case Management,,1215059936,COUNTY OF CALDWELL,2345 MORGANTON BLVD SW STE A LENOIR NC,014,Caldwell,251B00000X,Agencies,Case Management,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1215059936,COUNTY OF CALDWELL,Caldwell County DSS,,,Unknown,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1215059936,COUNTY OF CALDWELL,2345 MORGANTON BLVD SW STE A LENOIR NC,014,Caldwell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 27 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",16455 STATESVILLE   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215060835,"REYNOLDS, MICHAEL, WARREN",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215061049,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH BALLANTYNE OUTPATIENT SURGERY,14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1215061049,PRESBYTERIAN SAMEDAY SURGERY CENTER,14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 25 , 26 , 32 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215063920,"SHAPIRO, MICHAEL, DAVID",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215063920,"SHAPIRO, MICHAEL, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1215067251,BLESSED HOME LLC,~,3113 EDGETONE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215067251,BLESSED HOME LLC,3113 EDGETONE DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 718 , 718 ," $45,129.03 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215067541,"HONAKER, JASON, KYLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 21 , 43 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215067541,"HONAKER, JASON, KYLE",257 HOSPITAL DR NE STE 101 BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 39 , 108 ,$#,,
MEDICAID DIRECT,1265778278,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH OCEANSIDE FAMILY MEDICINE,584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215067541,"HONAKER, JASON, KYLE",584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215067541,"HONAKER, JASON, KYLE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215067541,"HONAKER, JASON, KYLE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215067699,"BHATIA, RINKU, MANOHAR",660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 44 , 173 , 298 ," $35,293.70 ",,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215067699,"BHATIA, RINKU, MANOHAR",2525 COURT DR   GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 15 , 56 , 69 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215070446,"PATERNO, STEVEN, ANDREW",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,319 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215070446,"PATERNO, STEVEN, ANDREW",319 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215070446,"PATERNO, STEVEN, ANDREW",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215070446,"PATERNO, STEVEN, ANDREW",349 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 35 , 40 , 58 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215070446,"PATERNO, STEVEN, ANDREW",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215071865,"KRANTZ, SANDRA",444 SW CENTER ST   FAISON NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700901287,GOSHEN MEDICAL CENTER INCORPORATED,COMMUNITY HEALTH SERVICES,325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215071865,"KRANTZ, SANDRA",325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215071865,"KRANTZ, SANDRA",325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1073638557,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER CLINTON,906 N US 421 HWY   CLINTON NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215071865,"KRANTZ, SANDRA",325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215071865,"KRANTZ, SANDRA",408 FAIRVIEW ST   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215072558,NEIGHBORHOOD NURSES HEALTHCARE,~,1821 N ROCKY RIVER RD   MONROE NC,090,Union,251J00000X,Agencies,Nursing Care,,1215072558,NEIGHBORHOOD NURSES HEALTHCARE,1821 N ROCKY RIVER RD   MONROE NC,090,Union,251J00000X,Agencies,Nursing Care,,#,#,#,$#,,
MEDICAID DIRECT,1215072558,NEIGHBORHOOD NURSES HEALTHCARE,~,1821 N ROCKY RIVER RD   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1215072558,NEIGHBORHOOD NURSES HEALTHCARE,1821 N ROCKY RIVER RD   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#," 2,030 "," 2,030 "," $328,473.48 ",,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215075171,"SAWYER, ELIZABETH, MARIE",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215075171,"SAWYER, ELIZABETH, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 47 , 51 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215075171,"SAWYER, ELIZABETH, MARIE",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215075171,"SAWYER, ELIZABETH, MARIE",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 22 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215077581,"BELDEN, ROSEMARY",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 71 , 99 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215077581,"BELDEN, ROSEMARY",115 KILDAIRE PARK DR STE 101 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215077581,"BELDEN, ROSEMARY",2815 CATES AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 18 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1215081245,"STOKES, RUSSELL, BRENT",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215081559,"CARTER, EBONY, BOYCE",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 20 , 20 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215081559,"CARTER, EBONY, BOYCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215081559,"CARTER, EBONY, BOYCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215081559,"CARTER, EBONY, BOYCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 13 , 26 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1215081559,"CARTER, EBONY, BOYCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1215082052,PERSONAL TOUCH CARE TEAM INC,,1909 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1215082052,PERSONAL TOUCH CARE TEAM INC,1909 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,#, 764 , 764 ," $45,790.68 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215082078,"BROWN, KATHY, GARNER",404 WESTWOOD AVE STE 203 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 19 , 31 ,$#,,
MEDICAID DIRECT,1003099409,SOUTHSIDE MEDICAL CENTER,SOUTHSIDE MEDICAL CENTER PA,1925A OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215083563,"PRIDGEN, JAMES",1925A OLEANDER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 108 , 297 , 682 ," $10,486.99 ",,
MEDICAID DIRECT,1558544957,HOLLY RIDGE HEALTHCARE,HOLLY RIDGE HEALTHCARE,119 HOLLY ST   HOLLY RIDGE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1215083563,"PRIDGEN, JAMES",308 U S HIGHWAY 17 NORTH   HOLLY RIDGE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 46 , 92 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1215083563,"PRIDGEN, JAMES",614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1639352032,NORTH WHITEVILLE URGENT CARE,NORTH WHITEVILLE URGENT CARE,614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1215083563,"PRIDGEN, JAMES",614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639352032,NORTH WHITEVILLE URGENT CARE,NORTH WHITEVILLE URGENT CARE,614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1215083563,"PRIDGEN, JAMES",614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 251 , 456 , 966 ," $19,400.25 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215084850,"MESCHER, BRADLEY, RICHARD",214 18TH ST SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 81 , 124 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215084850,"MESCHER, BRADLEY, RICHARD",214 18TH ST SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215084850,"MESCHER, BRADLEY, RICHARD",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 83 , 105 , 113 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 177 , 222 , 229 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 132 , 170 , 177 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1215086236,"MCADAMS, HOLMAN, PAGE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1902934292,NEW HANOVER COUNTY,NEW HANOVER COUNTY HEALTH DEPT,1650 GREENFIELD ST   WILMINGTON NC,065,New Hanover,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1215087812,"HUNTER, ZACHARY, CAMPBELL",1650 GREENFIELD ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 472 , 696 ," 3,232 "," $160,614.45 ",,
MEDICAID DIRECT,1215089222,EDEN DRUG,,103 W STADIUM DR   EDEN NC,079,Rockingham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1215089222,EDEN DRUG,103 W STADIUM DR   EDEN NC,079,Rockingham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215090089,"CARBONI, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 22 , 69 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215090089,"CARBONI, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1588705776,RICHMOND COUNTY DSS,~,127 CAROLINE ST   ROCKINGHAM NC,077,Richmond,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1215090204,"MIRIAN, FARNAZ",127 CAROLINE ST   ROCKINGHAM NC,077,Richmond,1223G0001X,Dental Providers,Dentist,General Practice, 649 ," 1,481 "," 4,172 "," $177,322.23 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2303 EXECUTIVE CIR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215094602,"PARSONS, ANN, LYNETTE",2303 EXECUTIVE CIR   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 , 23 , 43 ," $12,591.80 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,545 MICHAEL MARTIN RD   MOUNT OLIVE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1215094602,"PARSONS, ANN, LYNETTE",2303 EXECUTIVE CIR   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 12 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215094602,"PARSONS, ANN, LYNETTE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215096177,"KREISSMAN, SUSAN, GAIL",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215096177,"KREISSMAN, SUSAN, GAIL",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215096177,"KREISSMAN, SUSAN, GAIL",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1215096656,"LEE, MICHAEL, DEARMAN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1215096656,"LEE, MICHAEL, DEARMAN",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 63 , 68 ,$#,,
MEDICAID DIRECT,1215097498,WATAUGA COUNTY SCHOOLS,WATAUGA COUNTY SCHOOLS,175 PIONEER TRL   BOONE NC,095,Watauga,251300000X,Agencies,Local Education Agency (LEA),,1215097498,WATAUGA COUNTY SCHOOLS,175 PIONEER TRL   BOONE NC,095,Watauga,251300000X,Agencies,Local Education Agency (LEA),, 275 ," 7,712 "," 8,137 "," $299,789.43 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215097811,"NGO, LINH, TIEU",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 85 , 120 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215098686,"SINGH, HARBAX, TINA KAUR",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1215098686,"SINGH, HARBAX, TINA KAUR",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215098686,"SINGH, HARBAX, TINA KAUR",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215098686,"SINGH, HARBAX, TINA KAUR",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 37 , 41 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215098686,"SINGH, HARBAX, TINA KAUR",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 18 , 36 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215100664,"SHATTUCK, TRISHA, MILLER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215100664,"SHATTUCK, TRISHA, MILLER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 109 , 109 , 183 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215100664,"SHATTUCK, TRISHA, MILLER",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215101373,"STARR, ADAM, MATTHEW",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215101373,"STARR, ADAM, MATTHEW",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 57 , 112 , 191 ,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215101373,"STARR, ADAM, MATTHEW",18 MEDICAL PARK DR MEDICAL PARK DR ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 33 , 46 , 71 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215103403,"KANG, DAVID, EUGENE",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,208800000X,Allopathic & Osteopathic Physicians,Urology,, 33 , 56 , 116 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1215103403,"KANG, DAVID, EUGENE",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215103403,"KANG, DAVID, EUGENE",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,208800000X,Allopathic & Osteopathic Physicians,Urology,, 54 , 75 , 138 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1215103403,"KANG, DAVID, EUGENE",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1306484795,DR S WEIGHTLOSS & WELLNESS PLLC,,202 E ARLINGTON BLVD STE D GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215107156,"HAMIDI, NACHIDA",202 E ARLINGTON BLVD STE D GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 62 , 65 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1215109103,"POULOS, GEORGE, WILLIAM",1705 TARBORO ST SW   WILSON NC,098,Wilson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215109103,"POULOS, GEORGE, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1215109103,"POULOS, GEORGE, WILLIAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1215109103,"POULOS, GEORGE, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215109103,"POULOS, GEORGE, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215109103,"POULOS, GEORGE, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1215109103,"POULOS, GEORGE, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 82 , 131 , 182 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 20 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 243 , 251 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1505 SW CARY PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 19 , 27 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,110 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215111687,"WALKER, DAVID, BENSON",110 PINE STATE ST   LILLINGTON NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 89 , 145 , 255 ,$#,,
MEDICAID DIRECT,1215111695,HANDS WITH HEART THERAPY,~,204 MERRIWOOD LN   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1215111695,HANDS WITH HEART THERAPY,204 MERRIWOOD LN   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,, 47 , 713 , 714 ," $68,568.02 ",,
MEDICAID DIRECT,1255070868,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2695 HENDERSONVILLE ROAD SUITE 200,2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215114129,"ANTHONY, JAMIE, MUCKOM",2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 37 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1215114160,"BARSTOW, CRAIG, HAMILTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 103 , 103 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1215114160,"BARSTOW, CRAIG, HAMILTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 52 , 53 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215115332,"UPDAW, ROBERT, JAMES",101 E WT HARRIS BLVD STE 5101 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 37 , 55 , 106 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215115332,"UPDAW, ROBERT, JAMES",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215115332,"UPDAW, ROBERT, JAMES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 50 , 52 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215115332,"UPDAW, ROBERT, JAMES",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 61 , 62 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215115332,"UPDAW, ROBERT, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 18 , 50 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215115357,"ANDERSON, ELIZABETH, LEAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 29 , 43 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1215115357,"ANDERSON, ELIZABETH, LEAH",2007 WALNUT ST   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1215115357,"ANDERSON, ELIZABETH, LEAH",8841 SIX FORKS RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1215115357,"ANDERSON, ELIZABETH, LEAH",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 14 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215117122,"PERSON, JENNIFER, BEACHAM",310 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 18 , 37 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215117122,"PERSON, JENNIFER, BEACHAM",250 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1215117122,"PERSON, JENNIFER, BEACHAM",250 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 17 , 21 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255670014,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VASCULAR DIAGNOSTICS,2827 LYNDHURST AVE STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",2827 LYNDHURST AVE STE 201 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",1710 KERNERSVILLE MEDICAL PKWY STE 210 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",2827 LYNDHURST AVE STE 201 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 81 , 81 , 104 ,$#,,
MEDICAID DIRECT,1720327729,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VASCULAR SPECIALISTS,2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 46 , 53 , 61 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 27 , 39 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215119151,"MOORE, PHILLIP, SCHMITZ",2827 LYNDHURST AVE STE 206 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193400000X,Group,Single Specialty,,1215121017,"GIVANS, NATALIE, CECILE",1002 JENKINS AVE   MAYSVILLE NC,052,Jones,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 20 , 34 ,$#,,
MEDICAID DIRECT,1033794300,LANE AND ASSOCIATES XLI DDS PA,,571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1215121017,"GIVANS, NATALIE, CECILE",1002 JENKINS AVE   MAYSVILLE NC,052,Jones,1223G0001X,Dental Providers,Dentist,General Practice, 22 , 30 , 79 ,$#,,
MEDICAID DIRECT,1760911689,LANE AND ASSOCIATES XXXI DDS PA,,1242 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215121017,"GIVANS, NATALIE, CECILE",1002 JENKINS AVE   MAYSVILLE NC,052,Jones,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1790446672,LANE & ASSOCIATES XLIV DDS PA,~,7430 RICHLANDS HWY   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1215121017,"GIVANS, NATALIE, CECILE",1002 JENKINS AVE   MAYSVILLE NC,052,Jones,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 36 ,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1215121017,"GIVANS, NATALIE, CECILE",1002 JENKINS AVE   MAYSVILLE NC,052,Jones,1223G0001X,Dental Providers,Dentist,General Practice, 853 ," 1,177 "," 4,789 "," $232,732.53 ",,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1215121017,"GIVANS, NATALIE, CECILE",4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 707 , 867 ," 3,515 "," $160,280.08 ",,
MEDICAID DIRECT,1760911689,LANE AND ASSOCIATES XXXI DDS PA,,1242 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215121017,"GIVANS, NATALIE, CECILE",4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193400000X,Group,Single Specialty,,1215121017,"GIVANS, NATALIE, CECILE",4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 42 , 101 ," $12,057.24 ",,
MEDICAID DIRECT,1467113332,LANE & ASSOCIATES XLIII DDS PA,~,3445 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1215121017,"GIVANS, NATALIE, CECILE",4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1215122072,SENIOR MANAGEMENT INC,PINECREST GARDENS,1984 OLD US 421   LILLINGTON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215122072,SENIOR MANAGEMENT INC,1984 OLD US 421   LILLINGTON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 24 ," 6,069 "," 6,101 "," $435,452.42 ",,
MEDICAID DIRECT,1215128343,"SHRAGER, ALLA, ALEXIS",,8331 BANDFORD WAY STE 105 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1215128343,"SHRAGER, ALLA, ALEXIS",8331 BANDFORD WAY STE 105 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1669037834,DRS SHRAGER AND REIMELS PLLC,,8331 BANDFORD WAY STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215128343,"SHRAGER, ALLA, ALEXIS",8331 BANDFORD WAY STE 105 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 128 , 400 , 421 ," $39,840.75 ",,
MEDICAID DIRECT,1669037834,DRS SHRAGER AND REIMELS PLLC,,8331 BANDFORD WAY STE 105 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215128343,"SHRAGER, ALLA, ALEXIS",8331 BANDFORD WAY STE 105 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 167 , 435 , 492 ," $47,292.77 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215128459,"CHEN, ASHTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 31 , 131 , 136 ,$#,,
MEDICAID DIRECT,1942975776,OBRIEN AND WEST DMD XI PLLC,NIGHT AND DAY DENTAL,532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215128715,"LOUDERMILK, JOHN, KEVIN",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215130075,"STRAIN, ANGELA, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215132758,"MCDONALD, ANNA, GREENE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215134291,"GOTTSCH, ELIZABETH, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 20 ,$#,,
MEDICAID DIRECT,1891265831,DR DIEGO H GONZALEZ-ORTIZ DDS PLLC,SUPREME DENTAL OF WADESBORO,307 N GREEN ST   WADESBORO NC,004,Anson,193400000X,Group,Single Specialty,,1215135363,"WILLIAMS, DANIEL, NAKIA",501B WESTWOOD WAY   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1770727943,DANIEL N WILLIAMS DDS PA,DANIEL N WILLIAMS DDS,501B WESTWOOD WAY   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1215135363,"WILLIAMS, DANIEL, NAKIA",501B WESTWOOD WAY   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice, 912 ," 1,769 "," 6,439 "," $288,735.28 ",,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215137831,"MESSICK, BRENT, HAMILTON",8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215137831,"MESSICK, BRENT, HAMILTON",5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 15 , 22 ,$#,,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215137831,"MESSICK, BRENT, HAMILTON",8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215137831,"MESSICK, BRENT, HAMILTON",5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 30 , 48 , 76 ,$#,,
MEDICAID DIRECT,1679254163,WILLIAM V GIERIE DDS MS PA,PORT CITY ORTHO,2606 IRON GATE DR STE 101 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215142047,"GIERIE, WILLIAM, VINCENT",2606 IRON GATE DR STE 101 WILMINGTON NC,065,New Hanover,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 36 , 119 , 158 ," $18,502.55 ",,
MEDICAID DIRECT,1215144365,INTERIM HEALTHCARE OF THE TRIAD,,3325 HEALY DR STE C WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1215144365,INTERIM HEALTHCARE OF THE TRIAD,3325 HEALY DR STE C WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 83 , 83 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215145347,"SHUMAKER, NATHAN, RALPH",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215145347,"SHUMAKER, NATHAN, RALPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 102 , 81 , 129 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215145347,"SHUMAKER, NATHAN, RALPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215145347,"SHUMAKER, NATHAN, RALPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215145347,"SHUMAKER, NATHAN, RALPH",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215145545,"HOZUMI, OMID, JARRAHI",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1215145545,"HOZUMI, OMID, JARRAHI",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1215145545,"HOZUMI, OMID, JARRAHI",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215145735,"HAWFIELD, AMRET, THOMPSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 70 , 246 , 246 ,$#,,
MEDICAID DIRECT,1568400729,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH WAXHAW FAMILY & SPORTS MEDICINE,3614 PROVIDENCE RD S STE 100 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1215146535,"WALKER, ANTHONY, QUAY",3614 PROVIDENCE RD S STE 100 WAXHAW NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1568400729,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH WAXHAW FAMILY & SPORTS MEDICINE,3614 PROVIDENCE RD S STE 100 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1215146535,"WALKER, ANTHONY, QUAY",3614 S PROVIDENCE RD STE 200 WAXHAW NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215149414,"BARNOSKY, ADRIENNE, RUTH",10207 CERNY ST   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 12 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215149414,"BARNOSKY, ADRIENNE, RUTH",200 TRENT DR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215149414,"BARNOSKY, ADRIENNE, RUTH",200 TRENT DR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 13 , 19 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215149414,"BARNOSKY, ADRIENNE, RUTH",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215149414,"BARNOSKY, ADRIENNE, RUTH",200 TRENT DR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215149414,"BARNOSKY, ADRIENNE, RUTH",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1215149828,SPECTRUM SUPPORT SERVICES,Spectrum Support Services,6108 BIG SANDY DR   RALEIGH NC,092,Wake,251B00000X,Agencies,Case Management,,1215149828,SPECTRUM SUPPORT SERVICES,6108 BIG SANDY DR   RALEIGH NC,092,Wake,251B00000X,Agencies,Case Management,, 65 , 542 , 546 ," $303,830.09 ",,
MEDICAID DIRECT,1215149828,SPECTRUM SUPPORT SERVICES,Spectrum Support Services,6108 BIG SANDY DR   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1215149828,SPECTRUM SUPPORT SERVICES,6108 BIG SANDY DR   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1215153754,CAROLINA HEARTS HOME CARE LLC,~,1025 S MAIN ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1215153754,CAROLINA HEARTS HOME CARE LLC,1025 S MAIN ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 6,338 "," 6,675 "," $1,082,759.48 ",,
MEDICAID DIRECT,1215154208,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3701,308 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1215154208,WAL-MART STORES EAST LP,308 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215154331,"HERNDON, YALONDA, LANIECE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215154331,"HERNDON, YALONDA, LANIECE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215154331,"HERNDON, YALONDA, LANIECE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215154331,"HERNDON, YALONDA, LANIECE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215154331,"HERNDON, YALONDA, LANIECE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699023648,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS REA VILLAGE PEDIATR,2700 PROVIDENCE RD S STE 350 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1215154422,"CARR, CHPRYELLE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1538495767,CHARLOTTE PEDIATRIC CLINIC,CHARLOTTE PEDIATRIC CLINIC,6235 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215154422,"CARR, CHPRYELLE",6235 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 23 , 51 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,6235 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215154422,"CARR, CHPRYELLE",6235 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699023648,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS REA VILLAGE PEDIATR,11530 PROVIDENCE RD STE 2200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215154422,"CARR, CHPRYELLE",11530 PROVIDENCE RD STE 2200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215155197,"BLAIR, AMANDA, BOCK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 14 , 24 , 24 ,$#,,
MEDICAID DIRECT,1215156708,WALGREEN CO,WALGREENS 10287,9848 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1215156708,WALGREEN CO,9848 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215156815,"SCHNEIDER, JULIA, ELLEN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215156815,"SCHNEIDER, JULIA, ELLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1215158977,"WICKER, DALE, PRESCOTT",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215158977,"WICKER, DALE, PRESCOTT",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215160858,"BAKER, WENDY, MCNEELY",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215160858,"BAKER, WENDY, MCNEELY",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215161070,"O'CONNOR, KATHRYN, MARIE",3609 SW DURHAM DRIVE   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215161070,"O'CONNOR, KATHRYN, MARIE",3609 SW DURHAM DRIVE   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 26 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215161070,"O'CONNOR, KATHRYN, MARIE",3609 SW DURHAM DRIVE   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 59 , 96 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215161070,"O'CONNOR, KATHRYN, MARIE",3609 SW DURHAM DRIVE   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215161302,"WOODSIDE, JULIE, COLANTONI",2525 COURT DR   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 32 , 40 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215161302,"WOODSIDE, JULIE, COLANTONI",209 PARK ST   BELMONT NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 26 , 44 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215161302,"WOODSIDE, JULIE, COLANTONI",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 35 , 44 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215161302,"WOODSIDE, JULIE, COLANTONI",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215161781,"KESSLER, MICHELE, BETH",209 E CARVER ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,209 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215161781,"KESSLER, MICHELE, BETH",209 E CARVER ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215162359,"HONG, JENNIFER, NICOLE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215162359,"HONG, JENNIFER, NICOLE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649525619,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHILAND FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1215162359,"HONG, JENNIFER, NICOLE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215162359,"HONG, JENNIFER, NICOLE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215162359,"HONG, JENNIFER, NICOLE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215162359,"HONG, JENNIFER, NICOLE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 33 , 55 ,$#,,
MEDICAID DIRECT,1649525619,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHILAND FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1215162359,"HONG, JENNIFER, NICOLE",1852 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215165907,"ANTHONY, DONNA, FRASER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 36 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215167143,"JAIN, KOYAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215167143,"JAIN, KOYAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215167143,"JAIN, KOYAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215167143,"JAIN, KOYAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 26 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215167143,"JAIN, KOYAL",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1215167531,"PURKEY, NEHA, JOSHI",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1215168463,A PRIMARY CHOICE INC,~,3217 FRIENDLY RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1215168463,A PRIMARY CHOICE INC,3217 FRIENDLY RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 4,961 "," 4,961 "," $314,533.04 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215169305,"GALLAGHER, JAMIE, ORTOSKY",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215169305,"GALLAGHER, JAMIE, ORTOSKY",1006 PROCURE ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215169974,"IWUCHUKWU, IFEANYI, OBIANYO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1215169974,"IWUCHUKWU, IFEANYI, OBIANYO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1215169974,"IWUCHUKWU, IFEANYI, OBIANYO",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215169974,"IWUCHUKWU, IFEANYI, OBIANYO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",275 BEATTY DR   BELMONT NC,036,Gaston,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",275 BEATTY DR   BELMONT NC,036,Gaston,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",275 BEATTY DR   BELMONT NC,036,Gaston,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 12 , 15 , 21 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,101 E W T HARRIS BLVD STE 4001 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",275 BEATTY DR   BELMONT NC,036,Gaston,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1585 FORNEY CREEK PKWY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",275 BEATTY DR   BELMONT NC,036,Gaston,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 24 , 29 , 42 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215170204,"COSTELLO, KEVIN, FRANCIS",275 BEATTY DR   BELMONT NC,036,Gaston,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396206330,WILMINGTON MENTAL HEALTH,,3825 MARKET ST STE 4 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215171608,"OWEN, JACQUELINE",3825 MARKET ST STE 4 WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE B PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215173059,"HERSHBERGER, SHANNON, LESLIE",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 22 , 45 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215173059,"HERSHBERGER, SHANNON, LESLIE",923 W 3RD ST   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215173059,"HERSHBERGER, SHANNON, LESLIE",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE C PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215173059,"HERSHBERGER, SHANNON, LESLIE",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 158 , 184 , 464 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215173844,"COMANICIU, ANDRA, SILVINA",2790 GODWIN BLVD STE 360 SUFFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1508190067,CROSSROADS SEXUAL ASSAULT RESPONSE,CROSSROADS SEXUAL ASSAULT RESPONSE & RESOURCE CENT,1206 VAUGHN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215177498,"THEODORE, ADREA, DOREEN GIST",1206 VAUGHN RD   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215179247,"SELLERS, JAY, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 33 , 90 , 90 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215179247,"SELLERS, JAY, CHRISTOPHER",2304 WESVILL CT STE 240 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215179247,"SELLERS, JAY, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 18 , 64 , 70 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215179247,"SELLERS, JAY, CHRISTOPHER",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215179247,"SELLERS, JAY, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215179247,"SELLERS, JAY, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 13 , 25 , 25 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215179247,"SELLERS, JAY, CHRISTOPHER",2304 WESVILL CT STE 240 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215179759,"DARBY, JOHN, BYRON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 88 , 88 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215183918,"MCMICHAEL, MICHELE, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215183918,"MCMICHAEL, MICHELE, RENEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215183918,"MCMICHAEL, MICHELE, RENEE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215184791,"WARREN, NEIL, MICHAEL",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215184791,"WARREN, NEIL, MICHAEL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1215184858,"GURLEY, AMY",~,,,Unknown,152W00000X,Eye and Vision Services Providers,Optometrist,,1215184858,"GURLEY, AMY",5305 ROBINHOOD VILLAGE DR   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215186234,"ROBICHAUX, PETER, MATTHEW",13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",5627 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",5627 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 40 , 50 , 108 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 44 , 44 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 65 , 95 , 176 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",11308 HAWTHORNE DR   MINT HILL NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",11308 HAWTHORNE DR   MINT HILL NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",11308 HAWTHORNE DR   MINT HILL NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215191143,"ELLIOTT, MATTHEW, RYAN",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215191457,"DIAZ-ZAMORA, GIANCARLO, MARTIN",10207 CERNY ST STE 102 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1558765313,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RICHFIELD FAMILY MEDICI,243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1215192570,"LAMICHHANE, PRABIN",112 E 1ST ST   OAKBORO NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861896789,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE OAKBORO FAMILY MEDICINE,112 E 1ST ST   OAKBORO NC,084,Stanly,193200000X,Group,Multi-Specialty,,1215192570,"LAMICHHANE, PRABIN",112 E 1ST ST   OAKBORO NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 85 , 239 , 401 ,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1215193503,"LUCIANO, WILLIAM, NICHOLAS",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215198080,"ROSSI, EMMA, CAROLINE",4101 MACON POND RD   RALEIGH NC,092,Wake,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215198080,"ROSSI, EMMA, CAROLINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215198080,"ROSSI, EMMA, CAROLINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215198080,"ROSSI, EMMA, CAROLINE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215198080,"ROSSI, EMMA, CAROLINE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215198080,"ROSSI, EMMA, CAROLINE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 24 , 32 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215198080,"ROSSI, EMMA, CAROLINE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215198155,"WEATHERS, JOHN, ROUSE",105 STADIUM OAKS DR   CLEMMONS NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 25 , 32 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215198551,"KINGSLEY, EMILY, LOUISE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1215198734,"CONTARINO, MICHAEL, RENE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215198734,"CONTARINO, MICHAEL, RENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 69 , 69 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215198734,"CONTARINO, MICHAEL, RENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 55 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215199526,"SCHIFF, LAUREN, DALYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1215199526,"SCHIFF, LAUREN, DALYA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1215202734,FIRST CHOICE MEDICAL TRANSPORT LLC,FIRST CHOICE MEDICAL TRANSPORT LLC,123 SUMMER LAKES DR   CARY NC,092,Wake,3416L0300X,Transportation Services,Ambulance,Land Transport,1215202734,FIRST CHOICE MEDICAL TRANSPORT LLC,123 SUMMER LAKES DR   CARY NC,092,Wake,3416L0300X,Transportation Services,Ambulance,Land Transport, 284 , 387 , 774 ,$#,,
MEDICAID DIRECT,1215202734,FIRST CHOICE MEDICAL TRANSPORT LLC,FIRST CHOICE MEDICAL TRANSPORT LLC,4130 S ALSTON AVE   DURHAM NC,032,Durham,3416L0300X,Transportation Services,Ambulance,Land Transport,1215202734,FIRST CHOICE MEDICAL TRANSPORT LLC,4130 S ALSTON AVE   DURHAM NC,032,Durham,3416L0300X,Transportation Services,Ambulance,Land Transport, 54 , 70 , 139 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215203070,"PORTER, SALLIE, LYNN",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215203070,"PORTER, SALLIE, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215203070,"PORTER, SALLIE, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215203310,"NAVEEN, M.M.",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215203674,"KANG, KYUNGMIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215203781,"CLARK, ROBERT, EARL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215203781,"CLARK, ROBERT, EARL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 24 , 26 ,$#,,
MEDICAID DIRECT,1215205653,MOUNTAIN VIEW ASSISTED LIVING INC,Mountain View Assisted Living Inc,260 CENTERWAY DR   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215205653,MOUNTAIN VIEW ASSISTED LIVING INC,260 CENTERWAY DR   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 16 ," 4,391 "," 4,477 "," $425,115.51 ",,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215211032,"ESMADI, MOHAMMAD, ALI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 35 , 37 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215211032,"ESMADI, MOHAMMAD, ALI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 33 , 36 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215211032,"ESMADI, MOHAMMAD, ALI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215211032,"ESMADI, MOHAMMAD, ALI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215211032,"ESMADI, MOHAMMAD, ALI",110 KILDAIRE PARK DR   CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215211032,"ESMADI, MOHAMMAD, ALI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215211628,"CORCORAN, ALEXANDER, JAMES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 27 , 33 ,$#,,
MEDICAID DIRECT,1821076589,EAST CAROLINA HEALTH HERITAGE INC,Vidant Family Medicine Pinetops,1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1215211628,"CORCORAN, ALEXANDER, JAMES",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1215211628,"CORCORAN, ALEXANDER, JAMES",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215211628,"CORCORAN, ALEXANDER, JAMES",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 115 , 148 , 221 ,$#,,
MEDICAID DIRECT,1245653872,MEDREHAB SPECIALISTS OF NC PA,,6000 FAIRVIEW RD STE 1200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215212691,"WIECZOREK, NICHOLAS, SHEEHY",4009 CRAIG AVE   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1245653872,MEDREHAB SPECIALISTS OF NC PA,,6000 FAIRVIEW RD STE 1200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215212691,"WIECZOREK, NICHOLAS, SHEEHY",700 HOWIE MINE RD   WAXHAW NC,090,Union,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 16 , 61 , 61 ,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215213160,"MYNE, PUJA, KUMARI",1205 N CENTER ST   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 20 , 29 ,$#,,
MEDICAID DIRECT,1952678013,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE NORTH HICKORY,212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215213160,"MYNE, PUJA, KUMARI",212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215213160,"MYNE, PUJA, KUMARI",174 BOLICK LN STE 202 TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215214291,"LE PABIC, ELANA, ENGSTROM",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 36 , 76 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215214291,"LE PABIC, ELANA, ENGSTROM",16747 US HIGHWAY 17 N   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215217310,"BOYKIN, HEATHER, MICHELLE",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366597114,CHILDRENS MEDICAL GROUP INC,GENERAL BOOTH PEDS,2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1215220355,"DESOTO, MARYVAUGHN, SMITH",2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215222021,"CLARK, DYANNA",719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215222021,"CLARK, DYANNA",719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1215222039,"EL-AZEM, THABET, HASSEN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215222310,"WHITFIELD, ANGELA, DARKET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215222310,"WHITFIELD, ANGELA, DARKET",1021 MOREHEAD MEDICAL DRIVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215222310,"WHITFIELD, ANGELA, DARKET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215223615,"LABORDE, NATHAN, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215223615,"LABORDE, NATHAN, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215223615,"LABORDE, NATHAN, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 59 , 71 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215223615,"LABORDE, NATHAN, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215223615,"LABORDE, NATHAN, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 37 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 444 , 578 , 760 ," $11,310.84 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 55 , 79 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 40 , 54 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 72 , 87 , 109 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215224191,"RYBAK, SHAUN, RICHARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 27 , 37 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215225230,"LOUIE, REBECCA, ROSE",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 79 , 80 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215225230,"LOUIE, REBECCA, ROSE",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 35 , 36 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215225552,"BALANCHIVADZE, NINA",6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215225701,"KIM, EONSOO",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 935 ," 1,153 "," 3,770 "," $129,431.66 ",,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215225701,"KIM, EONSOO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 25 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215225701,"KIM, EONSOO",102 BETHESDA DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 141 ," $13,580.45 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215225701,"KIM, EONSOO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 112 ,$#,,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215225701,"KIM, EONSOO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 77 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215225701,"KIM, EONSOO",102 BETHESDA DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 12 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215225701,"KIM, EONSOO",102 BETHESDA DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215228036,"MALDONADO, RAMIRO, SERGIO",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 26 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215228036,"MALDONADO, RAMIRO, SERGIO",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 63 , 79 , 141 ,$#,,
MEDICAID DIRECT,1710609961,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN SPECIALTY CLINICS,6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215228655,"JARUGULA, SAHITHI",6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 42 , 77 , 109 ,$#,,
MEDICAID DIRECT,1396966412,NC KIDNEY CARE PA,NC KIDNEY CARE,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1215229612,"JASANI, NIRAV, MANUBHAI",2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 135 , 335 , 335 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215229638,"ALLEN, MEREDITH, PATRICE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 12 ,$#,,
MEDICAID DIRECT,1932353208,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAYETTEVILLE,1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215229638,"ALLEN, MEREDITH, PATRICE",1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 125 , 166 , 443 ," $18,294.15 ",,
MEDICAID DIRECT,1215231501,"AMBACHEW, MARIAMAWET",MARIAMAWET D AMBACHEW,150 FRANCAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1215231501,"AMBACHEW, MARIAMAWET",150 FRANCAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 555 ," 1,110 "," 3,223 "," $171,897.76 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215233002,"WONDAFRASH, WORKU, MENGESHA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 37 , 37 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1215233002,"WONDAFRASH, WORKU, MENGESHA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 63 , 63 ,$#,,
MEDICAID DIRECT,1215233135,RICHARD N RANDOLPH OD PA,~,2240 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1215233135,RICHARD N RANDOLPH OD PA,2240 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,, 190 , 190 , 380 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215234687,"MCCOOL, JESSICA, KRAMER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 56 , 60 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215234687,"MCCOOL, JESSICA, KRAMER",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215234687,"MCCOOL, JESSICA, KRAMER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215234687,"MCCOOL, JESSICA, KRAMER",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215235916,"COSTELLO, JUSTIN, ELLIS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215237979,"OTTAVIANO, CASSANDRA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215239611,BRIGHT BEGINNINGS PHYSICAL THERAPY,~,2684 RIVER RD SE   WINNABOW NC,010,Brunswick,193400000X,Group,Single Specialty,,1215239611,BRIGHT BEGINNINGS PHYSICAL THERAPY,2684 RIVER RD SE   WINNABOW NC,010,Brunswick,193400000X,Group,Single Specialty,, 13 , 125 , 200 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215240379,"ABERCROMBIE, TERRY, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265911937,BARON THOMAS DMD PLLC,BURKEMONT FAMILY DENTISTRY,500 BURKEMONT AVE   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1215240577,"THOMAS, NICHOLAS, BARON",500 BURKEMONT AVE   MORGANTON NC,012,Burke,1223G0001X,Dental Providers,Dentist,General Practice, 707 ," 1,672 "," 4,888 "," $349,185.41 ",,
MEDICAID DIRECT,1215244306,CHARLOTTE HEALTH HOLDINGS,WILLOW RIDGE MEMORY CARE,2040 MILTON RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215244306,CHARLOTTE HEALTH HOLDINGS,2040 MILTON RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 51 ," 11,738 "," 11,739 "," $1,155,111.49 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215246558,"WARDEN, TRACY, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215246558,"WARDEN, TRACY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215246558,"WARDEN, TRACY, MARIE",101 E WT HARRIS BLVD STE 5101 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1215246590,"CARSON, KAREN, ALDEN",276 OLD MOCKSVILLE RD STE 800 STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215246590,"CARSON, KAREN, ALDEN",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 51 , 51 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215248471,"REINHARD, KRISTEN, EAKES",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1215255773,"ZAPPITELLI, MEGAN, WHITE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,1215255773,"ZAPPITELLI, MEGAN, WHITE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1902447022,CHEROKEE MEDICAL CENTER,CMC - IMMEDIATE CARE CENTER - GAFFNEY,840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1215256839,"FISHER, BRENT, EDWARD",111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215256839,"FISHER, BRENT, EDWARD",111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 12 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215257183,"WANG, JIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 11 , 43 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215257183,"WANG, JIE",2400 PRATT ST NORTH PAVILION SUITE 1100 DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215257183,"WANG, JIE",2400 PRATT ST NORTH PAVILION SUITE 1100 DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215257514,"REID, TRISTA, DAY SNYDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 85 , 157 , 196 ," $20,325.54 ",,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1215258793,"MARSHBURN, MANDY, KING",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1215258793,"MARSHBURN, MANDY, KING",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1750333126,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES,918 7TH AVE   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1215260351,"MAY, ANDREW, RICHARD",918 7TH AVE   GARNER NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES PA,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1215260351,"MAY, ANDREW, RICHARD",1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 32 , 38 , 42 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1215260997,"LEE, MICHAEL, ANDREW",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1215260997,"LEE, MICHAEL, ANDREW",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215262597,WALGREEN CO,WALGREENS 12437,1250 FAIRVIEW DR   LEXINGTON NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1215262597,WALGREEN CO,1250 FAIRVIEW DR   LEXINGTON NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215266374,"TEEPLES, ALLISON, JOAN",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1215266374,"TEEPLES, ALLISON, JOAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1215266374,"TEEPLES, ALLISON, JOAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154693455,G ABRAMS R COHEN III PC,G ABRAMS & R COHEN III PC,401 COX RD STE 188 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215268784,"JOUBERT, FREDERICK, MICHAEL",160 CONCORD COMMONS PL SW STE D1 CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1215269170,"SCHLEGEL, SIMON",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1215269170,"SCHLEGEL, SIMON",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1215269170,"SCHLEGEL, SIMON",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1215269170,"SCHLEGEL, SIMON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1215269170,"SCHLEGEL, SIMON",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 60 , 112 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215271986,"BEHRLE, BARBARA, JANE",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215271986,"BEHRLE, BARBARA, JANE",68 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 19 , 23 , 44 ,$#,,
MEDICAID DIRECT,1215272406,GENOTOX,,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1215272406,GENOTOX,2170 WOODWARD ST   AUSTIN TX,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1215273024,"RINAUDO, CAROLINE, CANFIELD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1215273024,"RINAUDO, CAROLINE, CANFIELD",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215279989,"LIU, ANDREW",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215279989,"LIU, ANDREW",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215279989,"LIU, ANDREW",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215280201,"JUSTICE, MONICA, ERIN PRESSLEY",1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215280201,"JUSTICE, MONICA, ERIN PRESSLEY",640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1215284013,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,3205 RANDALL PKWY STE 204 WILMINGTON NC,065,New Hanover,251J00000X,Agencies,Nursing Care,,1215284013,BAYADA HOME HEALTH CARE INC,3205 RANDALL PKWY STE 204 WILMINGTON NC,065,New Hanover,251J00000X,Agencies,Nursing Care,, 35 ," 5,698 "," 6,788 "," $3,242,945.49 ",,
MEDICAID DIRECT,1215284013,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,3205 RANDALL PKWY STE 204 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1215284013,BAYADA HOME HEALTH CARE INC,3205 RANDALL PKWY STE 204 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 24 , 816 , 821 ," $369,319.62 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215285630,"LEWIS, JENNIFER, KATHERINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 45 , 68 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215285630,"LEWIS, JENNIFER, KATHERINE",63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 34 , 48 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1215286513,"BLACK, EKATERINA, VYACHESLAVOVNA",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1215286513,"BLACK, EKATERINA, VYACHESLAVOVNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1215286513,"BLACK, EKATERINA, VYACHESLAVOVNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1215286513,"BLACK, EKATERINA, VYACHESLAVOVNA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1215286513,"BLACK, EKATERINA, VYACHESLAVOVNA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215287636,"MABUTAS, SANDRA",14330 OAKHILL PARK LN STE 115 HUNTERSVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 181 , 498 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215287636,"MABUTAS, SANDRA",315 PARK RIDGE RD   ALBEMARLE NC,084,Stanly,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215289772,"MOSER, CHRISTINE, TODD",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1215289772,"MOSER, CHRISTINE, TODD",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215289798,"OBERMEYER, LAURA, JEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 26 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215289798,"OBERMEYER, LAURA, JEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215291133,"SHENOY, VIVEK, K",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215291133,"SHENOY, VIVEK, K",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215291265,"HOLTON, DAVID, ROBB",4003 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 23 , 38 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215291265,"HOLTON, DAVID, ROBB",1225 LEWISVILLE CLEMMONS RD   LEWISVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 24 , 50 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215291265,"HOLTON, DAVID, ROBB",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215293741,"HINE, KRISTIN, ASHLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 69 , 69 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215294483,"BRINGOLF, JONATHON, BODGER",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 24 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215294483,"BRINGOLF, JONATHON, BODGER",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215294483,"BRINGOLF, JONATHON, BODGER",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215294681,"MCWILLIAMS, MARY, DEVON",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 11 , 15 , 49 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215294681,"MCWILLIAMS, MARY, DEVON",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 16 , 36 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1215297106,"HILGENFELDT, ERIC, GLENN",10344 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215297106,"HILGENFELDT, ERIC, GLENN",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215297106,"HILGENFELDT, ERIC, GLENN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215297106,"HILGENFELDT, ERIC, GLENN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215297106,"HILGENFELDT, ERIC, GLENN",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215297106,"HILGENFELDT, ERIC, GLENN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1215297833,"BONAFE, TIFFANY, LEE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 429 , 502 , 686 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215297833,"BONAFE, TIFFANY, LEE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 283 , 322 , 429 ," $12,503.02 ",,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215298856,"KAUR, MANDEEP",510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215299029,"PETERS-BEEDOE, JANNEH, JOYOUS",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215299029,"PETERS-BEEDOE, JANNEH, JOYOUS",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 43 , 68 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215299029,"PETERS-BEEDOE, JANNEH, JOYOUS",4705 S HIGHWAY 150 STE B&C LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 27 , 53 ,$#,,
MEDICAID DIRECT,1215302245,BEECHTREE DIAGNOSTICS LLP,,12351 S GATEWAY PARK PL STE D-700 DRAPER UT,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1215302245,BEECHTREE DIAGNOSTICS LLP,12351 S GATEWAY PARK PL STE D-700 DRAPER UT,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 19 , 43 , 86 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215303680,"BARRS, MAEGAN",11840 SOUTHMORE DR STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215303979,"ELLENBERGER, BENJAMIN, PAUL",6602 KNIGHTDALE BLVD STE 310 KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 67 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215307202,"LEE, TIFFANY, MILLS",511 PALADIN DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 102 , 182 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215307665,"ASA, NICHOLAS, SHAWN",5950 FAIRVIEW RD STE 808 CHARLOTTE NC,060,Mecklenburg,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215310081,"CHESNUT, EMMA, BARNARD",106 W MEDICAL CENTER BLVD STE C LEXINGTON NC,029,Davidson,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215311436,"MYERS, JENNIFER, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 45 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215313010,"HAVENS, NATHANIEL, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215315569,"MOORE, KATHRYN, PAX LATTIMORE",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 24 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215315569,"MOORE, KATHRYN, PAX LATTIMORE",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 26 , 30 , 47 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215316047,"ZADORA, STEVEN, PATRICK",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215317557,"RILEY, JASON, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215320502,"CREEL, RACHEL, ELIZABETH ROHAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215320502,"CREEL, RACHEL, ELIZABETH ROHAN",5241 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215320502,"CREEL, RACHEL, ELIZABETH ROHAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215321120,"FLETCHER, JOHN, PAUL",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 145 , 299 ,$#,,
MEDICAID DIRECT,1144796301,MH MISSION HOSPITAL MCDOWELL LLLP,,339 NEBO SCHOOL RD   NEBO NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1215321120,"FLETCHER, JOHN, PAUL",339 NEBO RD   NEBO NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215321260,"ROE, MATTHEW, ALLAN",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215321260,"ROE, MATTHEW, ALLAN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 69 , 77 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1215321260,"ROE, MATTHEW, ALLAN",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215321260,"ROE, MATTHEW, ALLAN",187 W MAIN ST   SPINDALE NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 62 , 67 ,$#,,
MEDICAID DIRECT,1033149315,NORTH BUNCOMBE FAMILY MEDICINE,NORTH BUNCOMBE FAMILY MEDICINE,201 FLAT CREEK VILLAGE DR   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215321393,"GRAEME, KATELYNN, SCHULTZ",201 FLAT CREEK VILLAGE DR   WEAVERVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215321419,"AHEARN, MARSHALL, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 69 , 69 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215321732,"VALLURU, NEELIMA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 15 , 15 , 25 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215322409,"PRZYBYLOWSKI, EMILY, ARENA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215322714,"STEWART, DANIELLE, LEIGH",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1215322714,"STEWART, DANIELLE, LEIGH",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215323514,"SCHURR, KATHLEEN, RENEE",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215323514,"SCHURR, KATHLEEN, RENEE",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 25 , 31 , 32 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215324371,"ADLAKHA, NATASHA",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730343922,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,136 S PARK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1215324785,"BELLAMY, BRITTNEY, JEANE",136 S PARK ST   ASHEBORO NC,076,Randolph,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 45 , 63 ,$#,,
MEDICAID DIRECT,1518439546,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - BETHLEHEM,174 BOLICK LN STE 202 TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1215325113,"HEFNER, HANNAH, FOX",174 BOLICK LN STE 202 TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 26 , 40 ,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215326459,"NEILL, HUNTER, OWEN",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,284 "," 2,873 "," 3,621 "," $556,829.07 ",,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1215326459,"NEILL, HUNTER, OWEN",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215326459,"NEILL, HUNTER, OWEN",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215326459,"NEILL, HUNTER, OWEN",616 DOCTOR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,364 "," 3,001 "," 3,991 "," $627,668.42 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215330121,"EDWARDS, REBECCA, LYNNE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215330121,"EDWARDS, REBECCA, LYNNE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1215339635,"JIANG, FUDAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215339635,"JIANG, FUDAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215339635,"JIANG, FUDAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215340385,"PETERSON, ALLISON, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 31 , 32 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,509 N ELAM AVE FL 3 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215340872,"HOLLIS, LACHINA, MOORE",509 N ELAM AVE STE 3E GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215340872,"HOLLIS, LACHINA, MOORE",509 N ELAM AVE STE 3E GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215340872,"HOLLIS, LACHINA, MOORE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 136 , 140 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215340872,"HOLLIS, LACHINA, MOORE",509 N ELAM AVE STE 3E GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 28 , 39 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215340872,"HOLLIS, LACHINA, MOORE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 81 , 81 ,$#,,
MEDICAID DIRECT,1083201040,ASHISH SINGH,HENDERSON PULMONARY & SLEEP MEDICINE PLLC,724 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215342431,"SINGH, SHANTANU",724 TILGHMAN DR   DUNN NC,043,Harnett,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 173 , 712 ," 1,073 "," $20,222.41 ",,
MEDICAID DIRECT,1083201040,ASHISH SINGH,HENDERSON PULMONARY & SLEEP MEDICINE PLLC,724 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215342431,"SINGH, SHANTANU",568 RUIN CREEK RD STE 127 HENDERSON NC,091,Vance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 33 , 34 ,$#,,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215342779,"UKLEJA, ALEXANDRIA, MARIE",1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 44 , 69 ,$#,,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215342779,"UKLEJA, ALEXANDRIA, MARIE",801 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 35 ,$#,,
MEDICAID DIRECT,1215343223,"MATHUR, DIPTI, CHANDRA",,7283 NC HIGHWAY 42 STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1215343223,"MATHUR, DIPTI, CHANDRA",7283 NC HIGHWAY 42 STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 173 , 353 ," 1,241 "," $58,034.13 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215344619,"GANUCHEAU, SCOTT, CHRISTOPHER",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215344619,"GANUCHEAU, SCOTT, CHRISTOPHER",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 118 , 233 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215349006,"BHAMBRI, MELANIE, NOYES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215349006,"BHAMBRI, MELANIE, NOYES",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780240481,LOVING HANDS WELLNESS&PRIMARY CARE,,1006 N ARENDELL AVE STE 300 ZEBULON NC,092,Wake,193400000X,Group,Single Specialty,,1215349154,"ARKHURST-ARTHUR, NANA, FOSUWA",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215349154,"ARKHURST-ARTHUR, NANA, FOSUWA",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780240481,LOVING HANDS WELLNESS&PRIMARY CARE,,1006 N ARENDELL AVE STE 300 ZEBULON NC,092,Wake,193400000X,Group,Single Specialty,,1215349154,"ARKHURST-ARTHUR, NANA, FOSUWA",1006 N ARENDELL AVE STE 300 ZEBULON NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 85 , 115 ,$#,,
MEDICAID DIRECT,1497735179,CENTRAL CAROLINA MEDICAL ASSOCIATES,~,1908 HILCO ST STE B ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1215350988,"LOUIS, RACHEL, GARDNER",1908 HILCO ST STE B ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 48 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215355169,"MCLEAN, DUNCAN, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 57 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",854 S BECKFORD DR   HENDERSON NC,091,Vance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 43 , 112 , 112 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 25 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",40 DUKE MEDICINE CIR # 2B2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 41 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",40 DUKE MEDICINE CIR # 2B2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 63 , 220 , 229 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1274 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 44 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215355524,"MUSGROVE, JOHN, LARKIN",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 44 , 45 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215355912,"CLEMENTS, LYNDSEY, MARIE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215355920,"PHILIPS, SOMMER, EBDLAHAD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215355920,"PHILIPS, SOMMER, EBDLAHAD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215355920,"PHILIPS, SOMMER, EBDLAHAD",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 58 , 72 , 123 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215355920,"PHILIPS, SOMMER, EBDLAHAD",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 17 , 40 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215356274,"DMOCHOWSKI, JAKUB, MARCIN",703 COMFORT LN   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 91 , 145 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1215356407,"MIGLIACCIO, DANIEL, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215356407,"MIGLIACCIO, DANIEL, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 107 , 112 , 131 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215358288,"TOW, KYLE, KIDD",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1215358361,EVERYFIT INC,QMEDIC,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,333300000X,Suppliers,Emergency Response System Companies,,1215358361,EVERYFIT INC,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,333300000X,Suppliers,Emergency Response System Companies,, 415 ," 3,502 "," 3,502 "," $107,097.36 ",,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,22 TRUST LN STE 101 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1215360755,"ALEXANDER, KATHY, OWENS",22 TRUST LN STE 101 BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 20 , 40 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215360755,"ALEXANDER, KATHY, OWENS",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215362413,"CAUDLE, MEGAN, RAKLIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 28 , 32 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215362983,"BECKWITH, MARY, SHELDON",5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215362983,"BECKWITH, MARY, SHELDON",5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,925 THOMAS ST STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215364526,"TUTHILL, EMILY, CHEEK",925 THOMAS ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 33 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215364526,"TUTHILL, EMILY, CHEEK",925 THOMAS ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215364526,"TUTHILL, EMILY, CHEEK",925 THOMAS ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215367420,"HOWELL, ASHLEY, DANIELLE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215367420,"HOWELL, ASHLEY, DANIELLE",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215368634,PRESTIGE PATIENT TRANSPORT LLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,3416L0300X,Transportation Services,Ambulance,Land Transport,1215368634,PRESTIGE PATIENT TRANSPORT LLC,3990 E US 64 ALT   MURPHY NC,020,Cherokee,3416L0300X,Transportation Services,Ambulance,Land Transport, 96 , 111 , 221 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1215370309,"GOSHORN, STEPHANIE, DANILLE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 18 , 32 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1215370309,"GOSHORN, STEPHANIE, DANILLE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 62 , 166 ,$#,,
MEDICAID DIRECT,1215371612,LETS PLAY PEDATRIC THERAPY SERVICE,,6304 KIT CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1215371612,LETS PLAY PEDATRIC THERAPY SERVICE,6304 KIT CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 86 , 88 ,$#,,
MEDICAID DIRECT,1154739563,EYECARECENTER OD PA,EYECARE CENTER,190 INDEPENDENCE AVE STE A NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1215372065,"RENDON, ZOPHIA, LARISSA",190 INDEPENDENCE AVE STE A NORTH WILKESBORO NC,097,Wilkes,152W00000X,Eye and Vision Services Providers,Optometrist,, 27 , 26 , 26 ,$#,,
MEDICAID DIRECT,1154739563,EYECARECENTER OD PA,EYECARE CENTER,190 INDEPENDENCE AVE STE A NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1215372065,"RENDON, ZOPHIA, LARISSA",800 S STRATFORD RD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215372248,"HALE, DEVIN, CHARLES",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 38 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215372248,"HALE, DEVIN, CHARLES",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 75 , 87 ,$#,,
MEDICAID DIRECT,1437854403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY FAYETTEVILLE ORTHOPEDICS AND SPOR,1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215372834,"BAGSBY, DEREN, THOMAS",1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 145 , 326 , 536 ," $11,909.07 ",,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215374020,"MEISEL, AMANDA, WARD",781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215374160,"MONTOYA, JUAN, DAVID",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 59 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215374160,"MONTOYA, JUAN, DAVID",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1215374160,"MONTOYA, JUAN, DAVID",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1215374160,"MONTOYA, JUAN, DAVID",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215374160,"MONTOYA, JUAN, DAVID",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215374632,"CLOWER-MONEY, KAITLAN, MOUNTAIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 37 , 38 , 39 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1215374632,"CLOWER-MONEY, KAITLAN, MOUNTAIN",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215374632,"CLOWER-MONEY, KAITLAN, MOUNTAIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1215375324,"STREET, CHRISTOPHER, MICHAEL",197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1215375324,"STREET, CHRISTOPHER, MICHAEL",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 105 , 311 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215376959,"WU, ANGELA, YU-JYE",600 HOSPITAL DR   MONROE NC,090,Union,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215376959,"WU, ANGELA, YU-JYE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 67 , 67 , 100 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215376959,"WU, ANGELA, YU-JYE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215376959,"WU, ANGELA, YU-JYE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1144876590,MOUNTAIN PARK URGENT CARE & WALK-IN,,90 E MAIN ST STE 2 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1215377908,"MILLER, LAURA, SOUTHERN",90 E MAIN ST STE 2 SYLVA NC,050,Jackson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 32 , 40 , 66 ,$#,,
MEDICAID DIRECT,1144876590,MOUNTAIN PARK URGENT CARE & WALK-IN,,90 E MAIN ST STE 2 SYLVA NC,050,Jackson,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1215377908,"MILLER, LAURA, SOUTHERN",90 E MAIN ST STE 2 SYLVA NC,050,Jackson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 19 , 22 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215380662,"WOODBURN, ASHLEY, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215380662,"WOODBURN, ASHLEY, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215381645,"CRAIG, AMANDA, MICHELE",2608 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 71 , 73 , 89 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215381645,"CRAIG, AMANDA, MICHELE",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 59 , 61 , 73 ," $28,639.03 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215381645,"CRAIG, AMANDA, MICHELE",600 NEW WAVERLY PL   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215381678,"STEVENS, TRENTON, THOMAS",1168 E CUTLAR XING   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1215381678,"STEVENS, TRENTON, THOMAS",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 34 , 58 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215381678,"STEVENS, TRENTON, THOMAS",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 48 , 62 , 100 ," $12,851.66 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1215381769,"PIERSANTI, ALANA, DANIELE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1215381769,"PIERSANTI, ALANA, DANIELE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 122 , 122 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215383013,"JOHNSON, EMILY, AMBER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 42 , 42 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215383013,"JOHNSON, EMILY, AMBER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215383823,"TAGGAR, ARTI, AJMANI",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215387279,"STRADER, BRITTANY, MANNING",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215387279,"STRADER, BRITTANY, MANNING",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 83 , 102 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215387279,"STRADER, BRITTANY, MANNING",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215387279,"STRADER, BRITTANY, MANNING",110 S PARK TER STE A EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215387279,"STRADER, BRITTANY, MANNING",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215387279,"STRADER, BRITTANY, MANNING",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215387824,"DINOVO, JOHN, BENJAMIN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 85 , 91 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215387824,"DINOVO, JOHN, BENJAMIN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215387824,"DINOVO, JOHN, BENJAMIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215387824,"DINOVO, JOHN, BENJAMIN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 VETERANS PKWY STE 207 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215389812,"DEMARCO, JORDAN, THOMAS",5638 VETERANS PKWY STE 207 GARNER NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 NC HIGHWAY 42 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1215389812,"DEMARCO, JORDAN, THOMAS",5638 NC HIGHWAY 42 W STE 207 GARNER NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720169220,DR ALAN L BYRD ASSOCIATES OF ANGIER,DR ALAN L BYRD & ASSOCIATES OF ANGIER,8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,193200000X,Group,Multi-Specialty,,1215389812,"DEMARCO, JORDAN, THOMAS",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 VETERANS PKWY STE 207 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215389812,"DEMARCO, JORDAN, THOMAS",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215390422,SPECTOR SCIENTIFIC LAB,,160 SW 12TH AVE STE 103B DEERFIELD BEACH FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1215390422,SPECTOR SCIENTIFIC LAB,160 SW 12TH AVE STE 103B DEERFIELD BEACH FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#, 56 , 56 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215390794,"PARIKH, PARTH, KEYUR",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215390794,"PARIKH, PARTH, KEYUR",600 GRESHAM DR STE 8630A NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215390794,"PARIKH, PARTH, KEYUR",600 GRESHAM DR STE 8630A NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215390984,"WONG, ANDREW, HONG-YAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215390984,"WONG, ANDREW, HONG-YAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215390984,"WONG, ANDREW, HONG-YAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 27 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215390984,"WONG, ANDREW, HONG-YAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 24 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215390984,"WONG, ANDREW, HONG-YAN",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215391552,"GOFF, VANESSA, JUNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 75 , 77 , 79 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215393194,"CLAAR, MARK, CHRISTOPHER",35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215394390,BRADFORD HOUSE FAMILY CARE HOME,,581 HALEY DR   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215394390,BRADFORD HOUSE FAMILY CARE HOME,581 HALEY DR   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1215394390,BRADFORD HOUSE FAMILY CARE HOME,,703 BAYBERRY LN   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215394390,BRADFORD HOUSE FAMILY CARE HOME,703 BAYBERRY LN   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 76 , 76 ," $38,223.79 ",,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215399647,"MALONEY, SEAN, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1215399647,"MALONEY, SEAN, ROBERT",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 50 , 75 , 84 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215399647,"MALONEY, SEAN, ROBERT",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 25 , 30 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,1401 MATTHEWS TOWNSHIP PKWY STE 225 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215400387,"SARKISIAN, KATHERINE, ANN",1401 MATTHEWS TOWNSHIP PKWY STE 225 MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215411129,"SELLERS, DONNA, MICHELE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 54 , 54 ,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215411129,"SELLERS, DONNA, MICHELE",161 WALKER ST   COLUMBUS NC,075,Polk,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215411129,"SELLERS, DONNA, MICHELE",187 W MAIN ST   SPINDALE NC,081,Rutherford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215412689,"DELAVERN, COURTNEY, RENEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043891997,JARED MICHAEL LITTLE DBA MINT HILL,MINT HILL ORTHODONTICS,11300 CRESTHILL DR STE 115 MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215414511,"LITTLE, JARED, MICHAEL",11300 CRESTHILL DR STE 115 MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 384 ," 1,621 "," 2,161 "," $333,554.23 ",,
MEDICAID DIRECT,1215414511,"LITTLE, JARED, MICHAEL",~,11300 CRESTHILL DR STE 115 MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1215414511,"LITTLE, JARED, MICHAEL",11300 CRESTHILL DR STE 115 MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1841628518,MATTHEW W LINEBERGER DDS MS C SCHN,GASTON ORTHODONTICS,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1215414511,"LITTLE, JARED, MICHAEL",816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1215415112,"DUKE, CHELSEA, MARIE",1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215415112,"DUKE, CHELSEA, MARIE",1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 70 , 154 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215419825,"GATES, CAROL, JOSEPHINE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 131 , 264 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215421656,"DANG, ANNA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215421656,"DANG, ANNA",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 57 , 60 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215421888,"BROWN, JENNIFER, NICOLE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215422746,INSPIRE HOME CARE SERVICE,INSPIRE HOME CARE SERVICES,1213 GOSHEN ST STE B OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1215422746,INSPIRE HOME CARE SERVICE,1213 GOSHEN ST STE B OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 44 ," 9,715 "," 9,770 "," $747,922.95 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,417 MOUNTAIN TRACE RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",345 MANOR RD   MARS HILL NC,057,Madison,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",345 MANOR RD   MARS HILL NC,057,Madison,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",345 MANOR RD   MARS HILL NC,057,Madison,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 403 , 411 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 77 , 79 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215422951,"SWANSON, THAISA, ARAUJO",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 70 , 70 ,$#,,
MEDICAID DIRECT,1215423777,BROADWAY HOME CARE LLC,,107 WINDEL DR STE 105 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1215423777,BROADWAY HOME CARE LLC,107 WINDEL DR STE 105 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 34 ," 6,285 "," 6,478 "," $744,606.64 ",,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1215424072,"STROPE, MATTHEW",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215424270,"CLARK, HEATHER, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 41 , 74 , 74 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215424437,"SCHWARTZ, LEONARD, HAL",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 27 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215425053,"BERMUDEZ, ANA, LAURA",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 21 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215425053,"BERMUDEZ, ANA, LAURA",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 18 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215425053,"BERMUDEZ, ANA, LAURA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 106 , 137 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215425053,"BERMUDEZ, ANA, LAURA",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 54 , 111 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215425103,"SMITHWICK, JUDITH, TATE",1210 BROWN ST   WASHINGTON NC,007,Beaufort,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 41 , 46 , 64 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1210 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1215425103,"SMITHWICK, JUDITH, TATE",1210 BROWN ST   WASHINGTON NC,007,Beaufort,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,,,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215425988,"GERAGHTY, FEARGAL, JOHN PAUL",2001 VAIL AVE. STE. 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 50 , 55 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST # 102 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1215427018,"DYER, DEAUNDRE, ALFONZO",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 73 , 109 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215427018,"DYER, DEAUNDRE, ALFONZO",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1548510969,CUMBERLAND COUNTY HOSPITAL SYSTEM I,FERNCREEK GENERAL SURGERY,4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215427380,"HUTTINGER, RYAN, MICHAEL",4140 FERNCREEK DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 38 , 70 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 138 , 326 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 43 , 220 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 24 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",705 GAITHER RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 19 , 31 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,118 KIRKMAN CT   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215428891,"BELLINGHAM, DWIGHT, NICOLAS",118 KIRKMAN CT   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 41 , 109 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215428933,"PATEL, ANKUR, ANIL",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215428933,"PATEL, ANKUR, ANIL",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215428933,"PATEL, ANKUR, ANIL",144 FOREST HILL RD STE AND146 LEXINGTON NC,029,Davidson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 23 , 24 , 27 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215428933,"PATEL, ANKUR, ANIL",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 89 , 211 , 287 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215431994,"MEAD, BRITTANY, SHANNON",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215434170,"SAMUELS, BRIAN, ROSS",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 26 , 27 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1215434170,"SAMUELS, BRIAN, ROSS",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 31 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215434170,"SAMUELS, BRIAN, ROSS",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 66 , 73 ,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1215435987,"BROWN, MEGHAN, SLAUGHTER",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 127 , 182 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215440342,"POULSEN, DANIEL, ROGER",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 183 , 216 , 284 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215440342,"POULSEN, DANIEL, ROGER",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 135 , 162 , 211 ,$#,,
MEDICAID DIRECT,1215440813,INTEGRITY-PATRIOT LIVING LLC,PATRIOT LIVING OF YADKINVILLE,409 HARRISON AVE   YADKINVILLE NC,099,Yadkin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215440813,INTEGRITY-PATRIOT LIVING LLC,409 HARRISON AVE   YADKINVILLE NC,099,Yadkin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 30 ," 6,850 "," 6,850 "," $493,776.50 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215442264,"CASNETTIE, SAMANTHA, MARIE",1315 EAST BLVD STE 280 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 19 , 35 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1215445317,"ALWES, KATHERINE, ANNE",108 LAKESIDE DR   SNEADS FERRY NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 31 , 71 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1215445317,"ALWES, KATHERINE, ANNE",108 LAKESIDE DR   SNEADS FERRY NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215448444,TALK AND LEARN PLLC,,201 COVINGTON DR   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1215448444,TALK AND LEARN PLLC,201 COVINGTON DR   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,, 33 , 710 , 722 ," $51,504.10 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1215452883,"SAXON, NATHAN, RYAN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1215455266,ELKIN CITY SCHOOLS,,202 W SPRING ST   ELKIN NC,086,Surry,251300000X,Agencies,Local Education Agency (LEA),,1215455266,ELKIN CITY SCHOOLS,202 W SPRING ST   ELKIN NC,086,Surry,251300000X,Agencies,Local Education Agency (LEA),, 44 , 711 , 733 ," $29,374.31 ",,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215458559,"PATEL, SHRADDHA, THAKOR",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215458559,"PATEL, SHRADDHA, THAKOR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 40 , 95 , 95 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215461678,"CAMPBELL, ERIK, ALBERT",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1215461678,"CAMPBELL, ERIK, ALBERT",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215461694,"LATULIP, SCOTT, MICHAEL",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 56 , 90 , 161 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215463542,"ALSHAMMARI, HUSSEIN, ALI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 40 , 94 , 101 ," $12,800.93 ",,
MEDICAID DIRECT,1073940433,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY INPATIENT CARE,600 HOSPITAL DR STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1215463856,"MARIN, ERIC, LOURDES",600 HOSPITAL DR   MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215463856,"MARIN, ERIC, LOURDES",1000 HEALING WAY   MATTHEWS NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215463856,"MARIN, ERIC, LOURDES",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215463856,"MARIN, ERIC, LOURDES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215463856,"MARIN, ERIC, LOURDES",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215463856,"MARIN, ERIC, LOURDES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215463856,"MARIN, ERIC, LOURDES",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215463856,"MARIN, ERIC, LOURDES",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215463856,"MARIN, ERIC, LOURDES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 31 , 31 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215464565,"ALEXIS, AFE, DANIELLE NKESE",240 SMITH CHURCH RD STE A ROANOKE RAPID NC,042,Halifax,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,240 SMITH CHURCH RD STE A ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1215464565,"ALEXIS, AFE, DANIELLE NKESE",240 SMITH CHURCH RD STE A ROANOKE RAPID NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215464565,"ALEXIS, AFE, DANIELLE NKESE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215464565,"ALEXIS, AFE, DANIELLE NKESE",240 SMITH CHURCH RD STE A ROANOKE RAPID NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 87 , 129 , 247 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1215464961,"ROBINSON, KERRY, GUNTER",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 38 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215464961,"ROBINSON, KERRY, GUNTER",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 94 , 112 , 223 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215466917,"BARANAY, MELISSA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 125 , 125 ," $12,292.60 ",,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1215466958,"PHILIPS, ANTHONY, MICHAEL",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 164 , 164 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",7901 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 182 , 228 , 374 ," $10,453.38 ",,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",7901 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",7901 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 54 , 55 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 21 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",7901 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 23 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",7901 ENGLAND ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 50 , 79 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215468392,"GUERRERO NUNEZ, TOMAS, IGNACIO",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1215468483,"MATHAI, ABRAHAM",,101 RIVERSTONE VIS STE 211 BLUE RIDGE GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1215468483,"MATHAI, ABRAHAM",101 RIVERSTONE VIS STE 211 BLUE RIDGE GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,300 ASHVILLE AVE STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215469333,"FECTEAU, RYAN, EVERETT",300 ASHVILLE AVE   CARY NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215469333,"FECTEAU, RYAN, EVERETT",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 29 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215469333,"FECTEAU, RYAN, EVERETT",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 25 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215469820,"KUNYCKY, CHRISTINA, ANASTASIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215475793,"BOGHOSIAN, HANNAH, ELENA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215475793,"BOGHOSIAN, HANNAH, ELENA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215475793,"BOGHOSIAN, HANNAH, ELENA",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215476007,"SHELTON, SARAH, AUSTIN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 46 , 46 ," $12,492.64 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215476155,"YOON, ILSUP",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215476155,"YOON, ILSUP",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215477179,"THOMLINSON, REBECCA",2797 NC 55 HWY   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215477369,"TOWNSEND, EMILY, LOPES",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215477369,"TOWNSEND, EMILY, LOPES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1215478649,"DUGAN, CHARLES, ERWIN",104 N MAIN ST   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215478649,"DUGAN, CHARLES, ERWIN",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 108 , 297 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1215480181,"MAXWELL, CHARLES, ISAAC",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215480181,"MAXWELL, CHARLES, ISAAC",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215481361,"SHAHID, MUHAMMAD, SAAD",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215481361,"SHAHID, MUHAMMAD, SAAD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,214 18TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215484613,"JONES, KATHRYN, COULTER",214 18TH ST SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215484613,"JONES, KATHRYN, COULTER",214 18TH ST SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 54 , 69 ,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215485362,"ZERPA, MICHELLE, MARIE",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215485867,"WRIGHT, AYESHIA, IKEYA",9550 ROCKY RIVER RD STE 100 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 84 , 117 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215485867,"WRIGHT, AYESHIA, IKEYA",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215485867,"WRIGHT, AYESHIA, IKEYA",2000 WELLNESS BLVD STE 130 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 79 , 115 ,$#,,
MEDICAID DIRECT,1215486493,A PRIMARY CHOICE INC,,421 WARSAW RD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1215486493,A PRIMARY CHOICE INC,421 WARSAW RD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,, 65 ," 12,229 "," 12,229 "," $795,844.76 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215487087,"WHALEY, JENNIFER",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1215487087,"WHALEY, JENNIFER",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215487087,"WHALEY, JENNIFER",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215487087,"WHALEY, JENNIFER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861451437,NEWTON FAMILY PHYSICIANS,~,767 W 1ST ST   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1215488044,"LANEY, KATHERINE, LAYNE",767 W 1ST ST   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 53 , 141 ,$#,,
MEDICAID DIRECT,1184349987,APPALACHIAN PRIMARY CARE PLLC,,107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215489968,"SHIREY, LAURIE, MCLEAN",107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 159 , 382 ,$#,,
MEDICAID DIRECT,1841644531,APPALACHIAN MOUNTAIN COMMUNITY HEAL,SYLVA COMMUNITY HEALTH CENTER,154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215489968,"SHIREY, LAURIE, MCLEAN",44 BONNIE LN   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215490578,"BACHU, RAMYA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1215490578,"BACHU, RAMYA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215490578,"BACHU, RAMYA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215490578,"BACHU, RAMYA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1215490578,"BACHU, RAMYA",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1215493572,"DAVIS, DESIREE, TOWNSEND",620 FARM LIFE AVE   VANCEBORO NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 84 , 169 , 436 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1215493572,"DAVIS, DESIREE, TOWNSEND",620 FARM LIFE AVE   VANCEBORO NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215497102,"PATEL, RAJIV, CHANDUBHAI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215498605,"PENA, SALVADOR, ENRIQUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 46 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215498605,"PENA, SALVADOR, ENRIQUE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215502505,MERIT HOME CARE AGENCY LLC,,1 BUFFALO AVE NW STE 201A CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1215502505,MERIT HOME CARE AGENCY LLC,1 BUFFALO AVE NW STE 201A CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 3,787 "," 4,089 "," $358,237.54 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215504618,"LANNING, CYNTHIA, REYNOLDS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215507264,"MILFORD, JESSICA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 112 , 147 , 166 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215509831,"HOLMES, CHRISTINA, ALEXANDRA",166 SPRINGBROOK AVE STE 201 CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1215510680,KIDDS CONNECT OT LLC,,350 N COX ST STE 20 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1215510680,KIDDS CONNECT OT LLC,350 N COX ST STE 20 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,, 64 , 894 , 895 ," $83,733.80 ",,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215511662,"YONTZ, SARAH, OLIVIA",303 AIRPORT RD   ARDEN NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 22 , 22 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215511969,"BREWER, LINDSAY, JANE",68 ORANGE ST   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 26 , 32 ,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215512074,"FULLER, MONICA, MONIQUE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,,,$#,,
MEDICAID DIRECT,1619317823,MONARCH,~,2693 FOREST HILLS RD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1215512074,"FULLER, MONICA, MONIQUE",2693 FOREST HILLS RD SW   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215515606,"LITTLE, TRENEE, ASHLEY",9101 OCEAN HWY E   LELAND NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215515747,"CASSELL, MEGHAN, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215515911,"GICHUHI, JUDY, WAIRIMU",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215515911,"GICHUHI, JUDY, WAIRIMU",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215521208,"LLEWELLYN, TRACY, ANNE",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1265711956,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MCALISTER PEDIATRI,447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1215533823,"NANCE, MELANIE, KATHRYN",447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 57 , 148 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215534540,"MCMAHON, HALIE, ELLINGER",101 MANNING DR   CHAPEL HILL NC,068,Orange,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215536610,"JOERGER, GRANT, HOFFMAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215536784,"JARVIS, JESSICA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 38 , 38 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215538459,"LAMANNA, SARAH, JANE",4905 PINE CONE DR STE 9 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215538459,"LAMANNA, SARAH, JANE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1063753283,PRIVATE DIAGNOSTIC CLINIC PLLC,KERNODLE CLINIC - MEBANE,101 MEDICAL PARK DR STE C MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215542378,"MACKIE, ANNA, MICHELLE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215542378,"MACKIE, ANNA, MICHELLE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215542378,"MACKIE, ANNA, MICHELLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215542378,"MACKIE, ANNA, MICHELLE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215542378,"MACKIE, ANNA, MICHELLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1265043574,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE DENTAL,307 E THOM ST   CHINA GROVE NC,080,Rowan,193400000X,Group,Single Specialty,,1215544564,"NTABANA, UMUHIRE, LILIANE",330 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1235801812,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH DENTAL,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1215544564,"NTABANA, UMUHIRE, LILIANE",330 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 260 , 431 , 769 ," $46,702.47 ",,
MEDICAID DIRECT,1235846668,CABARRUS ROWAN COMMUNITY HEALTH CEN,MCGILL FAMILY DENTAL,202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215544564,"NTABANA, UMUHIRE, LILIANE",330 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1215544986,"BURRIS, TONYA, LYNN",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 57 , 112 ,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215544986,"BURRIS, TONYA, LYNN",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215544986,"BURRIS, TONYA, LYNN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1215544986,"BURRIS, TONYA, LYNN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215545884,"SALEH, SARA",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 60 ,$#,,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215545884,"SALEH, SARA",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 15 , 44 ,$#,,
MEDICAID DIRECT,1184325102,ALLES DDS WAKE FOREST PLLC,IDEAL DENTAL WAKE FOREST,515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1215545884,"SALEH, SARA",515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 54 , 64 , 221 ," $10,941.44 ",,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215545884,"SALEH, SARA",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 145 , 171 , 622 ," $33,735.25 ",,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215545884,"SALEH, SARA",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1215546312,PRIPHEMMA HOMECARE LLC,~,469 HOSPITAL DR STE E GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1215546312,PRIPHEMMA HOMECARE LLC,469 HOSPITAL DR STE E GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 6,402 "," 6,474 "," $502,469.58 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215551601,"WITTWER, KAITLYN, JANELL",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1215553730,"POWERS, MAURA",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215554951,"HERRIGES, DANIELLE, ROBUSTO",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215556550,"KHAN, SALMAN, ALI",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 83 , 123 , 125 ," $10,542.74 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215558689,"COATES, MARGARET, MARIE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 47 , 57 , 83 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215558689,"COATES, MARGARET, MARIE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 14 , 19 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215558689,"COATES, MARGARET, MARIE",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1215558788,"FERREIRA, MARINA, SILVA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 79 , 79 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215558788,"FERREIRA, MARINA, SILVA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 38 , 40 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1215562558,"OQUENDO-CLAUDIO, GABRIELA, ISABEL",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1215562558,"OQUENDO-CLAUDIO, GABRIELA, ISABEL",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 43 , 45 ,$#,,
MEDICAID DIRECT,1215562715,AH HOME HEALTH CARE LLC,,2801 CRISMAN ST STE 103E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1215562715,AH HOME HEALTH CARE LLC,2801 CRISMAN ST STE 103E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 2,093 "," 2,093 "," $125,440.12 ",,
MEDICAID DIRECT,1396041075,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH CENTRA CARE,436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215563564,"ANDERSON, MATTHEW",436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 74 , 142 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1215565270,"HERINGTON, JENNIFER, LYNN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 66 , 184 , 185 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215565577,"ZIEMINSKI, KRISTEN, MCKELLAR",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215565577,"ZIEMINSKI, KRISTEN, MCKELLAR",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215565577,"ZIEMINSKI, KRISTEN, MCKELLAR",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1215565577,"ZIEMINSKI, KRISTEN, MCKELLAR",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215565999,"NANAJIAN, ANTHONY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215565999,"NANAJIAN, ANTHONY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215566575,"ADAMS, JONATHAN, ALLEN",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 30 , 46 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215569421,"HAMEL, LISA, ANN",6316 OLD OAK RIDGE RD STE E GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215569421,"HAMEL, LISA, ANN",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 64 , 82 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1215570882,"SHELLY, ERICA, FIONA",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 34 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1215570882,"SHELLY, ERICA, FIONA",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215570882,"SHELLY, ERICA, FIONA",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1215575881,"REAGAN, STEVEN, WILLIAM",472 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 114 , 131 , 170 ," $38,668.48 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215576962,"D'ANGELO, DANIELLE, MARIE",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 34 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215576962,"D'ANGELO, DANIELLE, MARIE",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215578984,FENOMINAL HOME CARE INC,,160 CHARLOTTE AVE   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,1215578984,FENOMINAL HOME CARE INC,160 CHARLOTTE AVE   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,799 "," 1,799 "," $255,171.44 ",,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215579602,"JIMENEZ, CARLOS, ENRIQUE",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215584784,"DAMERON, MEAGAN, TREMBLAY",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215584784,"DAMERON, MEAGAN, TREMBLAY",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215585567,"CAMISA, JERRY, ANTHONY",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 22 , 27 ,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215585567,"CAMISA, JERRY, ANTHONY",3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215585567,"CAMISA, JERRY, ANTHONY",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346638483,LITTLE RIVER MEDICAL CENTER INC,,4220 CAROLINA EXCHANGE DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215585567,"CAMISA, JERRY, ANTHONY",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215586680,"VUKIN, LAUREN, NICOLE",3000 ERWIN RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1760417570,WAYNESBORO FAMILY CLINIC PA,WAYNESBORO FAMILY CLINIC PA,1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1215588173,"STRICKLAND-ROBINSON, ANDIE, LORIN",1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1215590450,"KAZAURE, AMAL, IBRAHIM",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 59 , 60 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215591946,"GAVIN, IRIAN, GISSELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215591946,"GAVIN, IRIAN, GISSELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215592951,"VOTH, DANIEL, ABRAM",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1215592951,"VOTH, DANIEL, ABRAM",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1215592951,"VOTH, DANIEL, ABRAM",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215592951,"VOTH, DANIEL, ABRAM",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215592951,"VOTH, DANIEL, ABRAM",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1215592951,"VOTH, DANIEL, ABRAM",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215593082,"PATEL, KHUSBUBEN, SHANTILAL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215593389,"BRADFORD, CALLI, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215593389,"BRADFORD, CALLI, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1326325994,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE SHERRILLS FORD,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215595103,"DEMPSTER, KATHERINE, LYN",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 54 , 102 ,$#,,
MEDICAID DIRECT,1548801681,EMRICH & WOOD DDS PLLC,THE CLAYTON DENTAL CENTER,660 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215598768,"JONES, MEREDITH, WIMBERLY",660 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 113 , 292 , 771 ," $37,605.29 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215599055,"KEMP, BRITTANY, JOYCE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 23 , 22 , 22 ,$#,,
MEDICAID DIRECT,1073572822,ONSLOW PEDIATRIC ASSOCIATES,~,51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1215599352,"MISHRA, ANANYA",51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174532972,CMG OF NORTH CAROLINA INC,COASTAL PEDIATRICS PA,1735 CITY CENTER BLVD   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1215599352,"MISHRA, ANANYA",1735 CITY CENTER BLVD   ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 32 , 68 ,$#,,
MEDICAID DIRECT,1215604822,CCJ ADULT CARE III LLC,GREENE HAVEN FAMILY CARE HOME,1833 STONY POINT RD   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215604822,CCJ ADULT CARE III LLC,1833 STONY POINT RD   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 785 , 804 ," $49,892.16 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215607155,"CERVANTES, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 43 , 51 ,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215607841,"ZIMEL, CATHERINE, REBECCA",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 36 , 39 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215609706,"RICE, RACHEL, LEAH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 27 , 42 , 42 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215609706,"RICE, RACHEL, LEAH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1740702497,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE HOLLY SPRINGS,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215611991,"HELFRICH, STEPHANIE, WATKINS",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1952940926,LANE AND ASSOCIATES XXXVI DDS PA,,900 S GARNETT ST   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1215612478,"SHARMA, VASU",4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215612478,"SHARMA, VASU",4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1215612478,"SHARMA, VASU",4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215612478,"SHARMA, VASU",4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 56 ,$#,,
MEDICAID DIRECT,1639502727,LANE AND ASSOCIATES XXVII DDS PA,,4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1215612478,"SHARMA, VASU",4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629122528,LANE & ASSOCIATES XIV DDS PA,LANE & ASSOCIATES XIV DDS PA,1200 BROAD ST STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215612478,"SHARMA, VASU",4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215612635,"BEVANS, JAMES, ZAKEE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215612635,"BEVANS, JAMES, ZAKEE",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215612635,"BEVANS, JAMES, ZAKEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 71 , 78 ,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215615000,"COLAVITA, RENAE, HARPER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1871295220,RFDEST DDS PLLC,MAGNOLIA DENTISTRY,910 DONTIA DR   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1215616909,"KUE, DANG, NENG",910 DONTIA DR   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice," 1,977 "," 3,626 "," 10,520 "," $680,513.67 ",,
MEDICAID DIRECT,1215618749,I WILL TAKE YOU THERE NON-MEDICAL T,I WILL TAKE YOU THERE NON-MEDICAL TRANSPORTATION L,23169 JUSTICE BRANCH RD   LITTLETON NC,042,Halifax,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1215618749,I WILL TAKE YOU THERE NON-MEDICAL T,23169 JUSTICE BRANCH RD   LITTLETON NC,042,Halifax,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 24 , 67 , 103 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215619317,"ROBERSON, LINDSAY, ALLENE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 70 , 113 , 113 ,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,27 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1215626957,"CLARK, ALDEN, EILEEN RENICK",27 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215627641,FALLING STARR HOME CARE LLC,,4612 RED HILL RD   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1215627641,FALLING STARR HOME CARE LLC,4612 RED HILL RD   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,#, 95 , 95 ," $10,944.52 ",,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215628177,"BERTHELOT, DANIELLE, MARIE",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215628177,"BERTHELOT, DANIELLE, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215628631,"POLLOCK, DAVIDSON, MCKINLEY",419 TWINS WAY   BERMUDA RUN NC,030,Davie,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1215628870,"ROSS, MICHAEL, CARMI",1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 28 , 48 ,$#,,
MEDICAID DIRECT,1215631056,FRESH START NEW BEGINNINGS,FRESH START NEW BEGINNINGS HOME CARE,3385 BUNNLEVEL ERWIN RD   ERWIN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,,1215631056,FRESH START NEW BEGINNINGS,3385 BUNNLEVEL ERWIN RD   ERWIN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,,#, 607 , 618 ," $111,500.02 ",,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215633490,"COOK, KIMBERLY, LAUREN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215635016,"KEPPLE, HANNAH",910 W WILLIAMS ST   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1215641782,KARING PARTNERS ENTERPRISES LLC,SENIOR HELPERS OF GASTONIA,635 COX RD UNIT F GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1215641782,KARING PARTNERS ENTERPRISES LLC,635 COX RD UNIT F GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 1,950 "," 1,950 "," $169,382.70 ",,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1215641915,"WORKS, AMANDA, WHITNEY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215642459,"HAMM, LILLIAN, KENDALL",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 27 ,$#,,
MEDICAID DIRECT,1215642509,LOVING GRACE HOME CARE LLC,,709 LAKELAND ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1215642509,LOVING GRACE HOME CARE LLC,709 LAKELAND ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#," 2,597 "," 2,597 "," $120,142.56 ",,
MEDICAID DIRECT,1780825539,MC FAMILY MEDICAL PLLC,MC FAMILY MEDICAL PLLC,6700 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215642624,"WILLIAMSON, BRANDIS, ALLYSON",6700 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 21 , 39 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215651823,"RAMIREZ-BALLESTEROS, DORA, MARCELA",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215651823,"RAMIREZ-BALLESTEROS, DORA, MARCELA",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,276 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215651823,"RAMIREZ-BALLESTEROS, DORA, MARCELA",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 78 , 150 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215651823,"RAMIREZ-BALLESTEROS, DORA, MARCELA",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215651823,"RAMIREZ-BALLESTEROS, DORA, MARCELA",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 18 , 92 ,$#,,
MEDICAID DIRECT,1457957938,HARNETT HEALTH SYSTEM INC,CAPE FEAR VALLEY PRIMARY CARE-BUFFALO LAKES,1619 BUFFALO LAKE RD   SANFORD NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215661558,"MOODY, SARA, MARIE",1619 BUFFALO LAKE RD   SANFORD NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1760717151,ANGIER MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE - ANGIER,1535 N RALEIGH ST   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215661558,"MOODY, SARA, MARIE",1619 BUFFALO LAKE RD   SANFORD NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 40 , 62 ,$#,,
MEDICAID DIRECT,1760717151,ANGIER MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE - ANGIER,185 RAWLS RD   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215661558,"MOODY, SARA, MARIE",1619 BUFFALO LAKE RD   SANFORD NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215661954,"PATEL, JALPA, DHARMNDRA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215661954,"PATEL, JALPA, DHARMNDRA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215663737,"WILSON, MACKENZIE, LESHA",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 38 , 42 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215663737,"WILSON, MACKENZIE, LESHA",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 77 , 80 ,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215663737,"WILSON, MACKENZIE, LESHA",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 94 , 163 , 184 ,$#,,
MEDICAID DIRECT,1437459021,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH UROLOGY LINCOLN,441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1215669635,"WILLETT, STUART, EDWARD",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215669635,"WILLETT, STUART, EDWARD",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215669635,"WILLETT, STUART, EDWARD",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 65 , 81 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1215675160,"HIGDON, HANNAH, BRITTAINY",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 44 , 52 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,110 TURNER ST   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1215675160,"HIGDON, HANNAH, BRITTAINY",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215685714,"OGLES, BENJAMIN, ROY",303 AIRPORT RD   ARDEN NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215688452,"POWELL, LINDSEY, BURNETTE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 22 , 25 ,$#,,
MEDICAID DIRECT,1215688452,"POWELL, LINDSEY, BURNETTE",~,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1215688452,"POWELL, LINDSEY, BURNETTE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215688452,"POWELL, LINDSEY, BURNETTE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215690599,"CHAPMAN, HEATHER, ROSE",1450 MATTHEWS TOWNSHIP PKWY STE 230 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215690599,"CHAPMAN, HEATHER, ROSE",1450 MATTHEWS TOWNSHIP PKWY STE 355 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215690862,CHRISTIAN FAITH HOME CARE LLC,CHRISTIAN FAITH HOME CARE,951 S MCPHERSON CHURCH RD STE 110 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1215690862,CHRISTIAN FAITH HOME CARE LLC,951 S MCPHERSON CHURCH RD STE 110 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 67 ," 13,309 "," 13,823 "," $1,331,750.57 ",,
MEDICAID DIRECT,1215691464,SH1 CARMEL OPCO LLC,THE PINES ON CARMEL SENIOR LIVING,5820 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215691464,SH1 CARMEL OPCO LLC,5820 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 36 ," 1,838 "," 1,838 "," $750,766.91 ",,
MEDICAID DIRECT,1326313735,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,305 1ST ST E   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215694997,"COLON, MARCUS, HENRY",305 1ST ST E   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 75 , 99 ,$#,,
MEDICAID DIRECT,1215696406,HALO PERSONAL CARE INC,,1829 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,1215696406,HALO PERSONAL CARE INC,1829 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,#, 564 , 564 ," $63,082.20 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215704945,"ZHENG, MICHELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1215706288,"OLOFIN, OLUWATOYIN, TOLULOPE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 62 , 62 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1215706288,"OLOFIN, OLUWATOYIN, TOLULOPE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 64 , 64 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1215706288,"OLOFIN, OLUWATOYIN, TOLULOPE",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1215706288,"OLOFIN, OLUWATOYIN, TOLULOPE",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1215706288,"OLOFIN, OLUWATOYIN, TOLULOPE",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215707096,"KHOKHAL, SHRADDHA, JAI",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215707096,"KHOKHAL, SHRADDHA, JAI",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 156 , 348 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215707096,"KHOKHAL, SHRADDHA, JAI",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215707096,"KHOKHAL, SHRADDHA, JAI",3605 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 61 , 139 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215707096,"KHOKHAL, SHRADDHA, JAI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 28 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215707096,"KHOKHAL, SHRADDHA, JAI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 139 , 691 ," 1,572 "," $13,399.87 ",,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215707096,"KHOKHAL, SHRADDHA, JAI",3605 PETERS CT   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215709878,"BASDEKIS, GABRIELLA, GEORGIA",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 113 , 146 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215713581,"DEESE, MEAGAN, DENISE",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 32 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215713581,"DEESE, MEAGAN, DENISE",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215713581,"DEESE, MEAGAN, DENISE",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215717525,"JOHNSON, JESSICA, MITCHELL",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 205 ," 1,060 "," 1,135 "," $23,621.93 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215741657,"WILLIAMS, ASHANTI, NICHELLE",4517 JESSUP GROVE RD FL 2 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,201 DALE EARNHARDT BLVD STE 201 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1215743877,"PATEL, POOJA, S",201 DALE EARNHARDT BLVD STE 201 KANNAPOLIS NC,013,Cabarrus,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215746698,"MARDIS, JONATHAN, BROCKMEYER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215749767,"BOUH, RITA, BIH",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215755442,"SWIGERT, MELISSA, ELLEN",309 E CORNWALLIS DR   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215756119,"KEETON, MICHELLE, THERESE",4705 S HIGHWAY 150 STE B & C LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215765698,"CAIN, ANDRUW, HAMILTON WOODROW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215770391,"JOHNSON, TRISTAN, LORAN",304 10TH AVE NE   HICKORY NC,018,Catawba,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1114780137,EDYN WELLNESS PLLC,,47 E FORK RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1215770466,"JONES, STEPHANIE, DENISE",47 E FORK RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 115 , 165 ,$#,,
MEDICAID DIRECT,1134258387,EYECARECENTER OD PA,EYECARECENTER,4325 GLENWOOD AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215771043,"GUADARRAMA, GERARDO",4325 GLENWOOD AVE   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215790068,"LEWIS, VANESSA, RENAY",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1528392289,RANDOLPH PRIMARY CARE PA,RANDOLPH PRIMARY CARE PA,350 N COX ST STE 6 ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1215793237,"BARNWELL, KIMBERLY, MYRICK",700 S HOLDEN RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1528392289,RANDOLPH PRIMARY CARE PA,RANDOLPH PRIMARY CARE PA,350 N COX ST STE 6 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1215793237,"BARNWELL, KIMBERLY, MYRICK",700 S HOLDEN RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528392289,RANDOLPH PRIMARY CARE PA,RANDOLPH PRIMARY CARE PA,350 N COX ST STE 6 ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1215793237,"BARNWELL, KIMBERLY, MYRICK",700 S HOLDEN RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215798913,"KAUR, BABLEEN",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215798913,"KAUR, BABLEEN",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 31 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1215900337,"RILEY, REBECCA, CHRISTINE HEIN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1235430976,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE PEDIATRICS,2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1215900337,"RILEY, REBECCA, CHRISTINE HEIN",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 46 , 80 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1215900337,"RILEY, REBECCA, CHRISTINE HEIN",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 37 , 72 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215902697,"KANTER, HARRY, LEE",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215902697,"KANTER, HARRY, LEE",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215904248,"NORMAN, ELIZABETH, SPONCLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 22 , 21 , 33 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215904248,"NORMAN, ELIZABETH, SPONCLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1215904248,"NORMAN, ELIZABETH, SPONCLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215904248,"NORMAN, ELIZABETH, SPONCLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215904248,"NORMAN, ELIZABETH, SPONCLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 24 , 26 , 55 ,$#,,
MEDICAID DIRECT,1942278411,PATHOLOGISTS DIAGNOSTIC SERVICES PL,,,,Unknown,193400000X,Group,Single Specialty,,1215904248,"NORMAN, ELIZABETH, SPONCLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1215904248,"NORMAN, ELIZABETH, SPONCLER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1437307832,LANDFALL FAMILY PRACTICE PLLC,,5710 OLEANDER DR STE 103 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215904818,"MCCONNELL, PATRICK, VERNE",5710 OLEANDER DR STE 103 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215904818,"MCCONNELL, PATRICK, VERNE",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215905195,"WEBER, STEPHEN, FLORIAN",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 13 , 17 , 18 ,$#,,
MEDICAID DIRECT,1194873901,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INFECTIOUS DISEASE SPECIALISTS,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215905195,"WEBER, STEPHEN, FLORIAN",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215905195,"WEBER, STEPHEN, FLORIAN",911 W HENDERSON ST STE 120 SALISBURY NC,080,Rowan,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215905492,"SPRINGER, LISA, MELANIE",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1215905492,"SPRINGER, LISA, MELANIE",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1215905492,"SPRINGER, LISA, MELANIE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215905492,"SPRINGER, LISA, MELANIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1215905492,"SPRINGER, LISA, MELANIE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215905492,"SPRINGER, LISA, MELANIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215906391,"MAYER, DAVID, PAUL",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215906391,"MAYER, DAVID, PAUL",6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215906607,"MILLS JR, WILLIAM, AYCOCK",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 34 , 35 , 38 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1215907902,"BUSTEED, TIMOTHY, ALAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1215907902,"BUSTEED, TIMOTHY, ALAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 53 , 53 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1215907902,"BUSTEED, TIMOTHY, ALAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 132 , 132 ,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,27 SCHENCK PKWY STE 140 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215907977,"KAMPE, FLOY, WRIGHT",27 SCHENCK PKWY STE 140 ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215907993,"GROTE, THOMAS, HOWARD",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215908199,"KOCH, RICHARD, ADAM",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 90 , 104 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1215908199,"KOCH, RICHARD, ADAM",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 54 , 59 , 62 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1215908199,"KOCH, RICHARD, ADAM",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215908199,"KOCH, RICHARD, ADAM",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1215908199,"KOCH, RICHARD, ADAM",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1215908199,"KOCH, RICHARD, ADAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467582999,BILTMORE DERMATOLOGY ASSOCIATES PA,BILTMORE DERMATOLOGY ASSOCIATES PA,80 PEACHTREE RD STE 106 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1215908215,"MAY, LISA, LUCAS",80 PEACHTREE RD STE 106 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215908637,"HUGHES, BRENNA, LYNNE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215908637,"HUGHES, BRENNA, LYNNE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215908637,"HUGHES, BRENNA, LYNNE",2301 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 54 , 57 , 59 ," $25,662.66 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215908637,"HUGHES, BRENNA, LYNNE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215908637,"HUGHES, BRENNA, LYNNE",600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215908637,"HUGHES, BRENNA, LYNNE",11001 DURANT RD STE 114 RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215909106,"KUMMER, ANTHONY, JOSEPH",50 MILLER ST   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215911615,"FITCH, MICHAEL, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 54 , 57 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215911698,"KIRSE, DANIEL, JEFFREY",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2341 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215911698,"KIRSE, DANIEL, JEFFREY",2341 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215911698,"KIRSE, DANIEL, JEFFREY",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 153 , 225 , 264 ," $22,054.88 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215911698,"KIRSE, DANIEL, JEFFREY",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215912175,"MOU, STEVEN, SHI TSEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 62 , 70 ," $16,174.10 ",,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215912258,"NEWTON, WILLIAM, BROCKENBROUGH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 19 , 48 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,770 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215912258,"NEWTON, WILLIAM, BROCKENBROUGH",770 HARTNESS RD   STATESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215912258,"NEWTON, WILLIAM, BROCKENBROUGH",770 HARTNESS RD   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 92 , 145 , 204 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,774 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1215912258,"NEWTON, WILLIAM, BROCKENBROUGH",770 HARTNESS RD   STATESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215912803,"ODONNELL, LAURA",656 CARPENTER AVE   MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 24 , 61 ,$#,,
MEDICAID DIRECT,1629405212,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215914080,"PICOT, FRANCOIS, JACQUES LEOPOLD",16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 55 , 104 , 147 ,$#,,
MEDICAID DIRECT,1629405212,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215914080,"PICOT, FRANCOIS, JACQUES LEOPOLD",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 32 , 66 ,$#,,
MEDICAID DIRECT,1215914288,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDINGS,1904 TW ALEXANDER DR   DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,1215914288,LABORATORY CORPORATION OF AMERICA H,1904 TW ALEXANDER DR   DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,, 723 , 792 ," 1,127 "," $105,782.63 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215914445,"SMITH, TRAVIS, L",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1215914585,ESOTERIX INC,ESOTERIX INC,8490 UPLAND DR STE 100 ENGLEWOOD CO,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1215914585,ESOTERIX INC,8490 UPLAND DR STE 100 ENGLEWOOD CO,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 13 , 13 , 48 ,$#,,
MEDICAID DIRECT,1790078038,ASHE PEDIATRICS PLLC,,303 E 2ND ST STE A WEST JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1215915046,"DRIVER, SHEILA, JEFFREYS",303 E 2ND ST STE A WEST JEFFERSON NC,005,Ashe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 58 , 58 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 52 , 52 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 28 , 121 , 121 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",2700 LEIGHTON RIDGE DR   WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 17 , 25 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 32 , 48 , 71 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",3604 BUSH ST FL 2 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215915269,"MOGHAZI, SAMMY, ABDEL MONEM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215915335,"ROLIH, CATHERINE, ANNE",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 21 , 52 , 123 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215915335,"ROLIH, CATHERINE, ANNE",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 13 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215915335,"ROLIH, CATHERINE, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215916119,"GARCIA, JOSEPH, ANTHONY",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215916119,"GARCIA, JOSEPH, ANTHONY",14330 OAKHILL PARK LN STE 115 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 88 , 148 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215916119,"GARCIA, JOSEPH, ANTHONY",14330 OAKHILL PARK LN STE 200B HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 42 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215916119,"GARCIA, JOSEPH, ANTHONY",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215916242,"COOK, CHRIS, CECIL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215916325,"KOHLER, DONALD, PAUL",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215916325,"KOHLER, DONALD, PAUL",8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215916531,"ESTRELLA, SHAILY, EVELYN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 31 , 31 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215917976,"MOON, MADGE, EVANS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215918685,"ORZA, FLORIN, M",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 44 , 49 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1215918842,"PEVERALL, ELIZABETH, MORRIS",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215918842,"PEVERALL, ELIZABETH, MORRIS",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 31 , 32 ,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215918842,"PEVERALL, ELIZABETH, MORRIS",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1215921994,"BERNSTEIN, HAROLD, ADAM",6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1215923347,TAYLORSVILLE HOUSE,TAYLORSVILLE HOUSE,350 SCHOOL DR   TAYLORSVILLE NC,002,Alexander,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1215923347,TAYLORSVILLE HOUSE,350 SCHOOL DR   TAYLORSVILLE NC,002,Alexander,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 19 , 75 , 75 ,$#,,
MEDICAID DIRECT,1215923347,TAYLORSVILLE HOUSE,TAYLORSVILLE HOUSE,350 SCHOOL DR   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1215923347,TAYLORSVILLE HOUSE,350 SCHOOL DR   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 43 ," 7,664 "," 7,677 "," $795,068.98 ",,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,20 COLONIAL SQ   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1215924071,"PATTERSON, MICHELE, EILEEN",20 COLONIAL SQ   SYLVA NC,050,Jackson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 12 , 13 , 51 ,$#,,
MEDICAID DIRECT,1174208664,DOVE HOUSE CHILDRENS ADVOCACY CENTE,,2407 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1215924071,"PATTERSON, MICHELE, EILEEN",2407 SIMONTON RD   STATESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,20 COLONIAL SQ   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1215924071,"PATTERSON, MICHELE, EILEEN",1159 N MAIN ST   WAYNESVILLE NC,044,Haywood,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215924071,"PATTERSON, MICHELE, EILEEN",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11314 US 15 501 N   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1215927082,"BAILEY, RHONDA, RENAEE",11314 US 15 501 N   CHAPEL HILL NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1306 S KING ST   WINDSOR NC,008,Bertie,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 28 , 42 , 42 ,$#,,
MEDICAID DIRECT,1093018095,CAROLINA MEDICAL MANAGEMENT CONSU,~,244 GOV EDEN HOUSE RD   MERRY HILL NC,008,Bertie,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1306 S KING ST   WINDSOR NC,008,Bertie,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 23 , 35 , 35 ,$#,,
MEDICAID DIRECT,1093018095,CAROLINA MEDICAL MANAGEMENT CONSU,~,244 GOV EDEN HOUSE RD   MERRY HILL NC,008,Bertie,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1084 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 37 , 58 , 58 ,$#,,
MEDICAID DIRECT,1093018095,CAROLINA MEDICAL MANAGEMENT CONSU,~,244 GOV EDEN HOUSE RD   MERRY HILL NC,008,Bertie,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 25 , 44 , 44 ,$#,,
MEDICAID DIRECT,1093018095,CAROLINA MEDICAL MANAGEMENT CONSU,~,244 GOV EDEN HOUSE RD   MERRY HILL NC,008,Bertie,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 18 , 34 , 34 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 33 , 40 , 40 ,$#,,
MEDICAID DIRECT,1093018095,CAROLINA MEDICAL MANAGEMENT CONSU,~,244 GOV EDEN HOUSE RD   MERRY HILL NC,008,Bertie,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1507 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 36 , 36 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",1507 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093018095,CAROLINA MEDICAL MANAGEMENT CONSU,~,244 GOV EDEN HOUSE RD   MERRY HILL NC,008,Bertie,193200000X,Group,Multi-Specialty,,1215928403,"SEVERA, JEFFREY, FRANCIS",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215928999,"HYLER, RANDELL, ALLEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 98 , 101 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215930417,"BARFIELD, RAYMOND, CARLTON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 34 , 105 , 109 ,$#,,
MEDICAID DIRECT,1427016138,ROXBORO INTERNAL MEDICINE AND PEDIA,~,796 DOCTORS CT   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1215931837,"SHORT, JAMES, WINN",796 DOCTORS CT   ROXBORO NC,073,Person,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1427016138,ROXBORO INTERNAL MEDICINE AND PEDIA,~,796 DOCTORS CT   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1215931837,"SHORT, JAMES, WINN",796 DOCTORS CT   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 177 , 327 ," $14,427.74 ",,
MEDICAID DIRECT,1528376712,MATTHEWS INTERNAL MEDICINE PLLC,MATTHEWS INTERNAL MEDICINE PLLC,434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215931894,"SANGMUAH, ELIZA, NORKOAH",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 89 , 227 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1215931894,"SANGMUAH, ELIZA, NORKOAH",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528376712,MATTHEWS INTERNAL MEDICINE PLLC,MATTHEWS INTERNAL MEDICINE PLLC,434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215931894,"SANGMUAH, ELIZA, NORKOAH",101 E MATTHEWS ST STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1215931936,"GORDON, PAUL, ANTHONY",300 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 111 , 352 , 352 ," $12,390.84 ",,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1215932140,"LAWRENCE, MARY, KATHERINE",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 34 , 58 , 197 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1215932140,"LAWRENCE, MARY, KATHERINE",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 64 , 112 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215932215,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 515 , 745 , 746 ," $25,668.81 ",,
MEDICAID DIRECT,1134190630,CAROLINA BREAST AND ONCOLOGIC SURGE,CAROLINA BREAST AND ONCOLOGIC SURGERY,2223 HEMBY LN   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215932223,"HABAL, NIZAR",2223 HEMBY LN   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 39 , 61 , 81 ,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215932298,"QUENG, JOAN, AIMEE",191 P AND J RD   ROBBINSVILLE NC,038,Graham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1215932298,"QUENG, JOAN, AIMEE",191 P AND J RD   ROBBINSVILLE NC,038,Graham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1669515953,COUNTY OF GRAHAM,GRAHAM COUNTY HEALTH DEPT,191 P AND J RD   ROBBINSVILLE NC,038,Graham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1215932298,"QUENG, JOAN, AIMEE",191 P AND J RD   ROBBINSVILLE NC,038,Graham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 32 , 56 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 47 , 67 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 83 , 85 , 107 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 67 , 85 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 505 , 678 , 834 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 81 , 87 , 120 ,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 23 ,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 62 , 74 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 34 , 40 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1215932983,"ROUX, RICHARD, EUGENE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215932983,"ROUX, RICHARD, EUGENE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 59 , 76 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1215932983,"ROUX, RICHARD, EUGENE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215933718,"HOUSTON, SHERARD, TREMAYN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215933809,"ARNOLD, JAMES, GORDON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 53 , 54 , 68 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215933809,"ARNOLD, JAMES, GORDON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215934930,"WATTS, JANA, CHRISTINA",2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1215934930,"WATTS, JANA, CHRISTINA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 27 , 45 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215936026,"LOWRY, RHONDA, SANDERSON",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 66 , 66 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215936026,"LOWRY, RHONDA, SANDERSON",565 BOYETTE RD   FOUR OAKS NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 70 , 70 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215936026,"LOWRY, RHONDA, SANDERSON",3485 US HIGHWAY 301 N   DUNN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 219 , 516 , 531 ," $24,783.00 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215936026,"LOWRY, RHONDA, SANDERSON",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 157 , 217 , 218 ," $11,665.15 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1215936026,"LOWRY, RHONDA, SANDERSON",703 S WALNUT ST   FAIRMONT NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 99 , 99 ,$#,,
MEDICAID DIRECT,1730275090,BOILING SPRING LAKES FAMILY MEDICIN,BOILING SPRING LAKES FAMILY MEDICINE PC,3599 GEORGE II HWY   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1215936356,"PALAGRUTO, DOMENIC, ANTHONY",3599 GEORGE II HWY   SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 34 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1215936398,"PASI, DEEPAK",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215936398,"PASI, DEEPAK",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 83 , 119 , 172 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,500 REDWOOD LN   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1215936398,"PASI, DEEPAK",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215936398,"PASI, DEEPAK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 25 , 30 , 42 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215936398,"PASI, DEEPAK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 44 , 79 , 120 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1215936398,"PASI, DEEPAK",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215936422,"BECK, NELDA, ELLEN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215936422,"BECK, NELDA, ELLEN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003982414,EYE MEDICS OPTOMETRY PA,EYE MEDICS OPTOMETRY PA,6970 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215936885,"SINGLETARY, JAMES, HARRISON",6970 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215937990,"ORR, RICHARD, KENNETH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215944616,"HALL, JAMES, BRYAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1215944616,"HALL, JAMES, BRYAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1558371286,CAROLINA KIDS PEDIATRIC,CAROLINA KIDS PEDIATRIC ASSOCIATES PLLC,2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1215947031,"WILLEY, LEANNA, BRUEN",2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 16 , 21 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1215947049,"JOSEPH, MATHUKUTTY",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1215947577,"OSBOURNE-SMART, DANETTE, ELEANOR",SMART ORTHODONTIST,8210 UNIVERSITY EXEC PARK DR STE 190 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1215947577,"OSBOURNE-SMART, DANETTE, ELEANOR",8210 UNIVERSITY EXEC PARK DR STE 190 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 615 ," 2,744 "," 3,464 "," $445,660.73 ",,
MEDICAID DIRECT,1215947577,"OSBOURNE-SMART, DANETTE, ELEANOR",SMART ORTHODONTIST,8210 UNIVERSITY EXEC PARK DR STE 190 CHARLOTTE NC,060,Mecklenburg,1223P0700X,Dental Providers,Dentist,Prosthodontics,1215947577,"OSBOURNE-SMART, DANETTE, ELEANOR",8210 UNIVERSITY EXEC PARK DR STE 190 CHARLOTTE NC,060,Mecklenburg,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215949086,"GORDON, LEANNE, C",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215949821,"BARGER JR, BARRY, DOUGLAS",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 534 , 799 ," 2,389 "," $103,464.42 ",,
MEDICAID DIRECT,1215949821,"BARGER JR, BARRY, DOUGLAS",BARRY DOUGLAS BARGER JR,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1215949821,"BARGER JR, BARRY, DOUGLAS",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215949821,"BARGER JR, BARRY, DOUGLAS",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 84 , 91 , 277 ," $11,361.80 ",,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215950035,"ALBRECHT, ROBERT, JOSEPH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356185631,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY-HORIZON,125 HOSPITAL AVE NW STE 200-C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1215950035,"ALBRECHT, ROBERT, JOSEPH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356185631,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY-HORIZON,125 HOSPITAL AVE NW STE 200-C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1215950035,"ALBRECHT, ROBERT, JOSEPH",1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215950035,"ALBRECHT, ROBERT, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 63 , 100 ,$#,,
MEDICAID DIRECT,1356185631,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY-HORIZON,125 HOSPITAL AVE NW STE 200-C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1215950035,"ALBRECHT, ROBERT, JOSEPH",125 HOSPITAL AVE NW STE 200-C LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497476642,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV VASCULAR SPECIALIST,1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1215950035,"ALBRECHT, ROBERT, JOSEPH",1251 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 48 , 58 , 58 ,$#,,
MEDICAID DIRECT,1215950597,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 16916,8830 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1215950597,NORTH CAROLINA CVS PHARMACY LLC,8830 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215951587,"CHAO, NELSON, JEN AN",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215951587,"CHAO, NELSON, JEN AN",2400 PRATT ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215951587,"CHAO, NELSON, JEN AN",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",5325 VINNING ST NW STE 101 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 45 , 77 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 35 , 48 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215953054,"VUONG, TRANG, TU-QUYNH",101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215953336,"TRIVETTE, DAYNA, DENISE",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1215953351,MED-TRANS CORPORATION,~,415 HIGHWAY 91   ELIZABETHTON TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1215953351,MED-TRANS CORPORATION,415 HIGHWAY 91   ELIZABETHTON TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215953427,"DUDEK, CARRIE, AMBER",825 FAIRFAX AVE STE 610 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215953807,"JOSEPH, PRAYRANA, CHHABRA",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 73 , 167 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1770827388,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,810 MITCHELL AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1215954052,"GINN, THOMAS, ADAM",810 MITCHELL AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215954052,"GINN, THOMAS, ADAM",810 MITCHELL AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 122 , 178 , 356 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215954052,"GINN, THOMAS, ADAM",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 37 , 55 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215954052,"GINN, THOMAS, ADAM",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215954052,"GINN, THOMAS, ADAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1215954474,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1774,3310 NC HIGHWAY 87 S   SANFORD NC,053,Lee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1215954474,WAL-MART STORES EAST LP,3310 NC HIGHWAY 87 S   SANFORD NC,053,Lee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215954847,"BURFORD, AMY, ELIZABETH",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1215954847,"BURFORD, AMY, ELIZABETH",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1215954847,"BURFORD, AMY, ELIZABETH",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215954847,"BURFORD, AMY, ELIZABETH",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417427642,CAROLINA FAMILY HEALTH CENTERS INC,CAROLINA FAMILY DENTAL CENTER,8282 NC 58 S   ELM CITY NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1215956628,"LEE, JASON, JONGHYUK",8282 NC 58 S   ELM CITY NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 190 , 323 , 757 ," $36,312.98 ",,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1215957204,"HENDRIX, NANCY, MOOSE",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 81 , 108 , 266 ," $11,223.00 ",,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215957303,"RUSSO, JOHN, MICHAEL",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215957360,"DENHAM, AMY, CATHERINE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215957808,HYGEIA INC,VANCEBORO PHARMACY,421 FARM LIFE AVE   VANCEBORO NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1215957808,HYGEIA INC,421 FARM LIFE AVE   VANCEBORO NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1215958293,ELIZABETH CITY PASQUOTANK PUBLIC SC,ELIZABETH CITY PASQUOTANK PUBLIC SCHOOLS,1200 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,251300000X,Agencies,Local Education Agency (LEA),,1215958293,ELIZABETH CITY PASQUOTANK PUBLIC SC,1200 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,251300000X,Agencies,Local Education Agency (LEA),, 195 ," 2,797 "," 2,800 "," $147,203.57 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215958715,"GRAY, JOHN, LAWRENCE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215960141,"ZOBA, JENNIFER, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215960141,"ZOBA, JENNIFER, LYNN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215960141,"ZOBA, JENNIFER, LYNN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215961131,"SCACCIA, NICOLE, MICHELLE",1525 W W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215961131,"SCACCIA, NICOLE, MICHELLE",1525 W W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215961131,"SCACCIA, NICOLE, MICHELLE",1525 W W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1215961131,"SCACCIA, NICOLE, MICHELLE",1525 W W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003075219,ZACK HALL MD PLLC,ZACK HALL MD PLLC,217 TURNER DR STE F REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1215961180,"HALL II, JOHN, ZACHARIAH",217 TURNER DR STE F REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 175 , 305 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215961883,"LOPEZ, RICHARD, DAYRIT",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215961883,"LOPEZ, RICHARD, DAYRIT",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215961883,"LOPEZ, RICHARD, DAYRIT",2400 PRATT ST   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1215962196,"MOSES, CHAD, ANTHONY",101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1215962196,"MOSES, CHAD, ANTHONY",101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215963343,"ONWUKWE, AUGUSTINE, NNANA",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215963343,"ONWUKWE, AUGUSTINE, NNANA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 51 , 51 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1215963343,"ONWUKWE, AUGUSTINE, NNANA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 47 , 47 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215963343,"ONWUKWE, AUGUSTINE, NNANA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1134226301,CAPE FEAR PHYSICAL MEDICINE AND REH,CAPE FEAR PHYSICAL MEDICINE AND REHAB ASSOCIATES P,1540 PURDUE DR STE 200 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1215964325,"RICHARDS, CYNTHIA, WILSON",1540 PURDUE DR STE 200 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 12 , 25 , 29 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1215965074,"STEVENS, LISA",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 222 , 329 , 999 ," $38,349.12 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215965363,"FILZ, JONATHAN, DAVID",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1376893057,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PRIMARY CARE CHARLOTTE INTERNAL MEDI,400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215969126,"FURNEY, SCOTT, LEO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215969126,"FURNEY, SCOTT, LEO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376893057,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PRIMARY CARE CHARLOTTE INTERNAL MEDI,400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215969126,"FURNEY, SCOTT, LEO",400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215971742,"HENDERSHOT, EDWARD, FERGUSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 28 , 72 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215971742,"HENDERSHOT, EDWARD, FERGUSON",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215971742,"HENDERSHOT, EDWARD, FERGUSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 15 , 32 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1215971742,"HENDERSHOT, EDWARD, FERGUSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215971742,"HENDERSHOT, EDWARD, FERGUSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 50 , 106 , 138 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215972732,"LATEFI, ALI, AKBAR",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1215973607,"SELDEN, ROBERT, MILTON",SELDEN ORTHODONTICS,2325 W ARBORS DR STE 106 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1215973607,"SELDEN, ROBERT, MILTON",2325 W ARBORS DR STE 106 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 101 , 277 , 319 ," $41,723.37 ",,
MEDICAID DIRECT,1215973607,"SELDEN, ROBERT, MILTON",SELDEN ORTHODONTICS,10125 HICKORYWOOD HILL AVE STE A HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1215973607,"SELDEN, ROBERT, MILTON",10125 HICKORYWOOD HILL AVE STE A HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 72 , 153 , 187 ," $28,983.73 ",,
MEDICAID DIRECT,1326318890,HARDWICK VISION CENTER,~,1502 E BROAD AVE STE A ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1215974548,"SMITH, ELVEN, CONRAD",720 E US HIGHWAY 74 STE A ROCKINGHAM NC,077,Richmond,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1790145423,SMITH OPTOMETRIC PLLC,,1502 E BROAD AVE STE A ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1215974548,"SMITH, ELVEN, CONRAD",1502 E BROAD AVE STE A   ROCKINGHAM NC,077,Richmond,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 ,#,#,$#,,
MEDICAID DIRECT,1790145423,SMITH OPTOMETRIC PLLC,,720 E US HIGHWAY 74 STE A ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1215974548,"SMITH, ELVEN, CONRAD",720 E US HIGHWAY 74 STE A ROCKINGHAM NC,077,Richmond,152W00000X,Eye and Vision Services Providers,Optometrist,, 90 , 93 , 113 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215974993,"ALYEA, EDWIN, PASCAL",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215974993,"ALYEA, EDWIN, PASCAL",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215974993,"ALYEA, EDWIN, PASCAL",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1215976006,"WERTHEIMER, THOMAS, ALBERT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215977889,"CLARK, GEORGE, THOMAS",3713 BENSON DR STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215977889,"CLARK, GEORGE, THOMAS",3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215977889,"CLARK, GEORGE, THOMAS",3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 50 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215977889,"CLARK, GEORGE, THOMAS",3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215978358,"BRONSTEIN, DAVID, MARVIN",908 S WILLIAMSON AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215978358,"BRONSTEIN, DAVID, MARVIN",908 S WILLIAMSON AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 38 , 161 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1215978358,"BRONSTEIN, DAVID, MARVIN",908 S WILLIAMSON AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 57 , 200 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215978739,"REDDING, JOHN, FULTON",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 19 , 37 ,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1215978739,"REDDING, JOHN, FULTON",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215978739,"REDDING, JOHN, FULTON",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215979240,"FRENCH, KIMBERLY, YVONNE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215979240,"FRENCH, KIMBERLY, YVONNE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215979240,"FRENCH, KIMBERLY, YVONNE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1215979240,"FRENCH, KIMBERLY, YVONNE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1215980701,EYECARECENTER OD PA,EYECARE CENTER,106 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1215980701,EYECARECENTER OD PA,106 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,, 14 , 14 , 28 ,$#,,
MEDICAID DIRECT,1215980701,EYECARECENTER OD PA,EYECARE CENTER,106 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1215980701,EYECARECENTER OD PA,106 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1215981600,"TANNER, PHILIP, EDWIN",197 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1215981600,"TANNER, PHILIP, EDWIN",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215981600,"TANNER, PHILIP, EDWIN",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215982442,"WINN, THOMAS, GREGORY",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215982442,"WINN, THOMAS, GREGORY",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1215982442,"WINN, THOMAS, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1215982442,"WINN, THOMAS, GREGORY",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760717151,ANGIER MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE - ANGIER,185 RAWLS RD   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215982475,"BUTLER, BRAD, EVERETT",185 RAWLS RD   ANGIER NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 40 ,$#,,
MEDICAID DIRECT,1760717151,ANGIER MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE - ANGIER,1535 N RALEIGH ST   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215982475,"BUTLER, BRAD, EVERETT",1535 N RALEIGH ST   ANGIER NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 30 , 47 ,$#,,
MEDICAID DIRECT,1760717151,ANGIER MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE - ANGIER,1535 N RALEIGH ST   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1215982475,"BUTLER, BRAD, EVERETT",185 RAWLS RD   ANGIER NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215982608,"GRANGER, DONNA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1215983044,"ROSE, CRYSTAL, SOWDER",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215983044,"ROSE, CRYSTAL, SOWDER",1710 KERNERSVILLE MEDICAL PKWY STE 220 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215983044,"ROSE, CRYSTAL, SOWDER",1901 S HAWTHORNE RD STE 220 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801874102,THE OUTER BANKS HOSPITAL INC,THE OUTER BANKS HOSPITAL,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1215983457,"HUNTER, GARY, JAMES",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215983887,"RODAK, DAVID, JAMES",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 35 , 45 ,$#,,
MEDICAID DIRECT,1215984075,BUCKHEAD VOLUNTEER FIRE DEPARTMENT,Buckhead Volunteer Fire Department,6810 OLD LAKE RD   BOLTON NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,1215984075,BUCKHEAD VOLUNTEER FIRE DEPARTMENT,6810 OLD LAKE RD   BOLTON NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport, 14 , 20 , 37 ,$#,,
MEDICAID DIRECT,1215984331,MID ATLANTIC EYE PHYSICIANS PA,,204 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1215984331,MID ATLANTIC EYE PHYSICIANS PA,204 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,, 100 , 101 , 202 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1215985098,"HOLLER, BERND",98 DOCTORS DR STE 300 SYLVA NC,050,Jackson,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 37 , 157 , 157 ," $19,429.49 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215985932,"DOMUSH, CHRISTOPHER, MICHAEL",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215985932,"DOMUSH, CHRISTOPHER, MICHAEL",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215985932,"DOMUSH, CHRISTOPHER, MICHAEL",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215985932,"DOMUSH, CHRISTOPHER, MICHAEL",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215986807,"DALAWARI, JASDEEP, SINGH",220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215986807,"DALAWARI, JASDEEP, SINGH",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215986807,"DALAWARI, JASDEEP, SINGH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 73 , 113 , 145 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1215987854,"GYURICSKO, ERIC, ORMONDE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1508894239,SANFORD SANDHILLS EMERGENCY PHYSICI,~,3072 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1215989660,"HARGETT, FRANKLIN",3072 S HORNER BLVD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1508894239,SANFORD SANDHILLS EMERGENCY PHYSICI,~,628 EAST ST STE B PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1215989660,"HARGETT, FRANKLIN",3072 S HORNER BLVD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 34 ,$#,,
MEDICAID DIRECT,1508894239,SANFORD SANDHILLS EMERGENCY PHYSICI,~,628 EAST ST STE B PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1215989660,"HARGETT, FRANKLIN",628 EAST ST STE B PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 33 , 62 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1215990072,"WRIGHT, DONNA, DARLENE",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215990072,"WRIGHT, DONNA, DARLENE",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1215990072,"WRIGHT, DONNA, DARLENE",1550 FAULK ST STE 2100 MONROE NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 30 , 33 , 34 ,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1215990072,"WRIGHT, DONNA, DARLENE",105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1568425262,BLUE RIDGE PATHOLOGY ASSOCIATES,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1215990296,"OGRODOWCZYK, TODD, ERIC",720 MALCOLM BLVD   RUTHERFORD COLLEGE NC,012,Burke,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1568425262,BLUE RIDGE PATHOLOGY ASSOCIATES,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1215990296,"OGRODOWCZYK, TODD, ERIC",2201 S STERLING ST   MORGANTON NC,012,Burke,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 80 , 88 , 125 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215990502,"PARISH, KENNETH, LEROY",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 43 , 43 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215990502,"PARISH, KENNETH, LEROY",420 N CENTER ST   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1215990502,"PARISH, KENNETH, LEROY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205892916,PINEHURST NEUROLOGY PA,PINEHURST NEUROLOGY PA,10 PAGE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1215993803,"SINCLAIR, MISTY, LARAINE",10 PAGE DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 31 , 65 , 114 ,$#,,
MEDICAID DIRECT,1659493930,SOHI EYE CARE OD PA,~,4400 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215994348,"SOHI, BALPREET",1525 BENVENUE RD   ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1659493930,SOHI EYE CARE OD PA,~,4400 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1215994348,"SOHI, BALPREET",4400 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 37 , 42 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215994439,"GAY, FRANK, LIPSCOMB",101 BETHESDA DR   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 19 , 28 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1215995675,"MCAVOY, GREIG, VINCENT",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 41 , 72 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1215995675,"MCAVOY, GREIG, VINCENT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1215995675,"MCAVOY, GREIG, VINCENT",600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 172 , 390 , 888 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1215995675,"MCAVOY, GREIG, VINCENT",7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215995899,"LIU, JOANN, JUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1215995899,"LIU, JOANN, JUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1215996236,"MITRO, GREGORY, CHARLES",631 MOCKSVILLE AVE STE 1010 SALISBURY NC,080,Rowan,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 32 , 204 , 275 ," $12,519.96 ",,
MEDICAID DIRECT,1447214242,TRIANGLE PEDIATRIC CENTER,TRIANGLE PEDIATRIC CENTER,105 RIDGE VIEW DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1215996285,"BAER, SAMANTHA",105 RIDGE VIEW DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 21 , 37 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1215997010,"SINGLETARY, ERNEST",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215998083,"MORRIS, DENNIS, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 45 , 103 , 103 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1215998083,"MORRIS, DENNIS, LYNN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 21 , 25 , 25 ,$#,,
MEDICAID DIRECT,1518081363,G & G HEALTHCARE PC,~,326 COLUMBUS CORNERS DR   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1215998760,"WOLF, HARVEY, HUGH",326 COLUMBUS CORNERS DR   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 87 , 118 ,$#,,
MEDICAID DIRECT,1215998760,"WOLF, HARVEY, HUGH",~,7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1215998760,"WOLF, HARVEY, HUGH",7490 ANDREW JACKSON HWY SW   CERRO GORDO NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 74 , 116 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1215999388,"GAUER, ROBERT, LEROY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1215999388,"GAUER, ROBERT, LEROY",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1215999388,"GAUER, ROBERT, LEROY",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1437112612,WNC DERMATOLOGICAL ASSOCIATES PA,~,281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225001324,"JABER, PETER, WILLIAM",6 E MEDICAL CT STE 2 MARION NC,059,McDowell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1437112612,WNC DERMATOLOGICAL ASSOCIATES PA,~,281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225001324,"JABER, PETER, WILLIAM",281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 32 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1225001357,"GRAFENBERG, MATTHEW",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225001357,"GRAFENBERG, MATTHEW",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 92 , 152 , 221 ,$#,,
MEDICAID DIRECT,1487919973,MCPC-9 LLC,FIRSTHEALTH SURGICAL SPECIALTIES,809 S LONG DR STE K ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1225001357,"GRAFENBERG, MATTHEW",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225001407,"FERRIS, JAMES, VINCENT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 85 , 85 , 99 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225001407,"FERRIS, JAMES, VINCENT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 137 , 141 , 164 ,$#,,
MEDICAID DIRECT,1235514209,LIL BO PEEP 3D-4D ULTRASOUND AND BO,PINEHURST DIAGNOSTIC ULTRASOUND,375 SE BROAD ST   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1225003320,"LALAJI, TEJAL, ANAND",163 HOSPITAL DR   TOCCOA GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 82 , 90 , 90 ," $13,571.58 ",,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1225003320,"LALAJI, TEJAL, ANAND",163 HOSPITAL DR   TOCCOA GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225003353,"BAZEL, SOHAIL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 62 , 153 ,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225003353,"BAZEL, SOHAIL",819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225003353,"BAZEL, SOHAIL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 87 , 338 , 850 ," $11,184.32 ",,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225003353,"BAZEL, SOHAIL",495 ARBOR HILL RD STE M KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 93 , 234 ,$#,,
MEDICAID DIRECT,1457320756,THE PEDIATRIC CENTER,THE PEDIATRIC CENTER PLLC,1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225004575,"EDWARDS, PATRICK, SCOTT",1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 18 , 41 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225004864,"COMBS, JASON, TODD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 196 , 196 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",801 PINEHURST AVE   CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",801 PINEHURST AVE   CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 194 , 195 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",3100 TRAMWAY RD   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 27 , 27 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",310 COMMERCE DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 29 , 29 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 19 , 20 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225005028,"DOUGLAS, KEMI, SATTERFIELD",1999 S NC HIGHWAY 119   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225005481,"BIJOOR, SANTOSH, MOHAN",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 18 , 25 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 14 , 23 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 57 , 68 , 95 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225005754,"DODDS, GEORGE, ALFRED",1900 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225008071,"ABUHAMAD, ALFRED, ZOUHEIR",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225008451,"BOLICK, CASEY, DALE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821496753,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1225009996,"BRADLEY, ESTENA, PATRICIA",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1003500109,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225009996,"BRADLEY, ESTENA, PATRICIA",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 50 , 72 , 77 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1225010606,"TRAPANOTTO, VICTORIA",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 68 , 74 , 77 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225010606,"TRAPANOTTO, VICTORIA",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 268 , 373 , 446 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225010671,"THOMAS, CHRISTOPHER, CRIM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 104 , 114 , 142 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1225010671,"THOMAS, CHRISTOPHER, CRIM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 126 , 134 , 185 ,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225011539,"DASANAYAKA, GAYANI, YAHAMPATH",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 78 , 112 , 190 ,$#,,
MEDICAID DIRECT,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES PA,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1225011570,"HOYE, KEVIN, PAUL",1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 36 , 41 , 50 ,$#,,
MEDICAID DIRECT,1750333126,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES,918 7TH AVE   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1225011570,"HOYE, KEVIN, PAUL",918 7TH AVE   GARNER NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 27 , 30 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1225012248,"SCHMITT, BRUCE, FREDERICK",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 12 , 23 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1225012248,"SCHMITT, BRUCE, FREDERICK",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 13 , 17 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1225012248,"SCHMITT, BRUCE, FREDERICK",275 NC 24 & 50 HWY   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225012248,"SCHMITT, BRUCE, FREDERICK",275 NC 24 & 50 HWY   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1225012248,"SCHMITT, BRUCE, FREDERICK",275 NC 24 & 50 HWY   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 38 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225012297,"RICH, RYAN, KEVIN",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 98 , 103 , 116 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225013352,"OWEN, MEDGE, DENISE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 36 , 39 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1225013428,"FANT, VANESSA, STURGILL",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225013741,"RECKER, STEVEN, DONALD",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 123 , 272 ,$#,,
MEDICAID DIRECT,1225013899,"NABORS, WILLIAM, KENT",WILLIAM K NABORS DDS PA,4929 W MARKET ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1225013899,"NABORS, WILLIAM, KENT",4929 W MARKET ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 36 ," $14,032.98 ",,
MEDICAID DIRECT,1225013899,"NABORS, WILLIAM, KENT",WILLIAM K NABORS DDS PA,3501 ASSOCIATE DR   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1225013899,"NABORS, WILLIAM, KENT",3501 ASSOCIATE DR   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 205 , 221 ," 1,729 "," $292,317.75 ",,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225014178,"MOORE, TODD, ANTHONY",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1023455987,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,945 N 5TH ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1225014178,"MOORE, TODD, ANTHONY",945 N 5TH ST   ALBEMARLE NC,084,Stanly,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 53 , 121 , 121 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225014178,"MOORE, TODD, ANTHONY",945 N 5TH ST   ALBEMARLE NC,084,Stanly,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1710021811,ABC PEDIATRICS OF ASHEVILLE PA,ABC PEDIATRICS OF ASHEVILLE PA,64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225014392,"LOVE, DOUGLAS, SCOTT",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 41 , 134 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225014491,"ANTHONY, EVELYN, YOUNG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,,,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225015928,"FARAG, AHMED, ADBELKADER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225015928,"FARAG, AHMED, ADBELKADER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 140 , 141 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225016496,"SCHRANZ, CRAIG, IAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 56 , 60 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1225016496,"SCHRANZ, CRAIG, IAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 45 , 46 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225016496,"SCHRANZ, CRAIG, IAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 61 , 64 ,$#,,
MEDICAID DIRECT,1154454825,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH NORTH POINT MEDICAL ASSOCIATES,1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225017544,"HULBERT, HARRY, TURNER",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225017627,"GULUR, PADMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225017627,"GULUR, PADMA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225017627,"GULUR, PADMA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225018435,"MOORE, THOMAS, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225018435,"MOORE, THOMAS, ROBERT",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1225018807,SELECT HOME HEALTH CARE INC,KELLEYS HOME HEALTH SERVICES,547 DEPOT ST   FRANKLIN NC,056,Macon,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1225018807,SELECT HOME HEALTH CARE INC,547 DEPOT ST   FRANKLIN NC,056,Macon,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 134 , 622 ," 1,094 "," $47,872.82 ",,
MEDICAID DIRECT,1225018807,SELECT HOME HEALTH CARE INC,KELLEYS HOME HEALTH SERVICES,547 DEPOT ST   FRANKLIN NC,056,Macon,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1225018807,SELECT HOME HEALTH CARE INC,547 DEPOT ST   FRANKLIN NC,056,Macon,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1225018807,SELECT HOME HEALTH CARE INC,KELLEYS HOME HEALTH SERVICES,547 DEPOT ST   FRANKLIN NC,056,Macon,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1225018807,SELECT HOME HEALTH CARE INC,547 DEPOT ST   FRANKLIN NC,056,Macon,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 124 , 459 , 805 ," $24,918.02 ",,
MEDICAID DIRECT,1548424104,OWEN PARK PEDIATRICS PA,,1520 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225019797,"ADHOLLA, PAUL, ODAK",1520 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 38 , 124 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225019862,"CLARK, TIMOTHY, JOSEPH",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1336131010,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOPE MILLS FAMILY CARE,5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225020068,"CHAO, ALBERT, CHUNG KUANG",5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 147 , 160 ,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225021413,"STAIB, NEIL, EDWARD",6898 WES CURT LN   GOSHEN OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225021413,"STAIB, NEIL, EDWARD",6898 WES CURT LN   GOSHEN OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093016024,BLUE RIDGE MEDICAL MANAGEMENT CORPO,BHMA TRAUMA SERVICES JC,410 N STATE OF FRANKLIN RD STE 130 JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225021454,"COBBLE, ANITA, DIANE",410 N STATE OF FRANKLIN RD STE 130 JOHNSON CITY TN,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225021801,"STACY HUMPHRIES, ROBYN, LEE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 54 , 86 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225021801,"STACY HUMPHRIES, ROBYN, LEE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 21 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225022056,"THAKKAR, MAITREYA, BHALCHANDRA",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3000 ROGERS RD STE 320 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225022056,"THAKKAR, MAITREYA, BHALCHANDRA",3000 ROGERS RD STE 320 WAKE FOREST NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 47 , 82 , 147 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225022056,"THAKKAR, MAITREYA, BHALCHANDRA",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3000 ROGERS RD STE 320 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225022056,"THAKKAR, MAITREYA, BHALCHANDRA",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225022056,"THAKKAR, MAITREYA, BHALCHANDRA",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1225023310,"CAUSBY, KRISTEL, WHITLEY",MOUNTAIN EYE ASSOCIATES,1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,152W00000X,Eye and Vision Services Providers,Optometrist,,1225023310,"CAUSBY, KRISTEL, WHITLEY",1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1225023310,"CAUSBY, KRISTEL, WHITLEY",486 HOSPITAL DR   CLYDE NC,044,Haywood,152W00000X,Eye and Vision Services Providers,Optometrist,, 65 , 70 , 107 ,$#,,
MEDICAID DIRECT,1225023310,"CAUSBY, KRISTEL, WHITLEY",MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,152W00000X,Eye and Vision Services Providers,Optometrist,,1225023310,"CAUSBY, KRISTEL, WHITLEY",486 HOSPITAL DR   CLYDE NC,044,Haywood,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1811982317,MOUNTAIN EYE ASSOCIATES,MOUNTAIN EYE ASSOCIATES,486 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1225023310,"CAUSBY, KRISTEL, WHITLEY",1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225023930,"KILLIAN, KEVIN, LEE",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 142 , 401 , 775 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225023930,"KILLIAN, KEVIN, LEE",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 85 , 130 , 223 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225023930,"KILLIAN, KEVIN, LEE",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 84 , 193 , 350 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225023930,"KILLIAN, KEVIN, LEE",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 35 , 46 , 82 ,$#,,
MEDICAID DIRECT,1255913182,FOOT AND ANKLE SPECIALISTS OF THE M,,534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225023930,"KILLIAN, KEVIN, LEE",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225023930,"KILLIAN, KEVIN, LEE",323 N BROOME ST   WAXHAW NC,090,Union,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 12 , 18 , 32 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225023930,"KILLIAN, KEVIN, LEE",323 N BROOME ST   WAXHAW NC,090,Union,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 22 , 44 , 83 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225024029,"BLAYLOCK, KIMBERLEE, BANKS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225024029,"BLAYLOCK, KIMBERLEE, BANKS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225024029,"BLAYLOCK, KIMBERLEE, BANKS",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194263087,DLP FRYE MEDICAL GROUP,FRYECARE WOMENS SERVICES,1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225024532,"BISHOPRIC, FRANCES, ALICE",1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225024540,"TANNENBAUM, SIGMUND, IAN",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 15 , 30 ,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225025034,"ANDERSEN, SUSAN, RUTH",8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 51 , 63 ,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225025034,"ANDERSEN, SUSAN, RUTH",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225025034,"ANDERSEN, SUSAN, RUTH",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225026289,"ISENHOWER, DENNIS, ALAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1225026289,"ISENHOWER, DENNIS, ALAN",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 77 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225026289,"ISENHOWER, DENNIS, ALAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225026289,"ISENHOWER, DENNIS, ALAN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1225026289,"ISENHOWER, DENNIS, ALAN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902447022,CHEROKEE MEDICAL CENTER,CMC - IMMEDIATE CARE CENTER - GAFFNEY,840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225026479,"WASHINGTON, MARCUS, ASHTON",840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245335066,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RAEFORD,313 TEAL DR OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1225028129,"TOWNSEND, ROBERT, GLENN",313 TEAL DR   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 126 , 273 , 461 ,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225028525,"STODDARD, JENNIFER, KATE",313 TEAL DR   RAEFORD NC,047,Hoke,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225028525,"STODDARD, JENNIFER, KATE",293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225028525,"STODDARD, JENNIFER, KATE",293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 92 , 238 , 284 ,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225028525,"STODDARD, JENNIFER, KATE",921 S LONG DR STE 102 ROCKINGHAM NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225031271,"SHEPHERD, JOHN, DAVID",921 S LONG DR STE 102 ROCKINGHAM NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225031271,"SHEPHERD, JOHN, DAVID",293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 114 , 260 , 321 ,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225031271,"SHEPHERD, JOHN, DAVID",293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225031271,"SHEPHERD, JOHN, DAVID",313 TEAL DR   RAEFORD NC,047,Hoke,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225033368,"HIJAZI, ALI, ATEF",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225033368,"HIJAZI, ALI, ATEF",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 79 , 87 , 98 ,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225033376,"SCHOLER, ANDREA, CUOMO",606 N ELM ST   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 29 , 66 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225033426,"CHANG, CHIEN CHUNG, PETER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 140 , 142 , 173 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225033426,"CHANG, CHIEN CHUNG, PETER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 141 , 149 , 165 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225033426,"CHANG, CHIEN CHUNG, PETER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194707901,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225034192,"DESALVO, DEBBY, THEODORA",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 14 , 14 , 30 ,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 197 , 226 , 410 ," $37,844.06 ",,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 64 , 67 , 188 ," $27,824.21 ",,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",150 DENTAL CIR SCHOOL OF DENTISTRY CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 26 , 28 , 33 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034572,"TURVEY, TIMOTHY, A",150 DENTAL CIR SCHOOL OF DENTISTRY CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034598,"RESIDE, GLENN, JAMES",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 120 , 140 , 423 ," $28,250.26 ",,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034598,"RESIDE, GLENN, JAMES",150 DENTAL CIR 115 BRAUER HL CB 7450 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 47 , 50 , 367 ," $45,546.00 ",,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034598,"RESIDE, GLENN, JAMES",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 263 , 305 , 693 ," $58,332.04 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225034598,"RESIDE, GLENN, JAMES",150 DENTAL CIR 115 BRAUER HL CB 7450 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 38 , 38 , 42 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",24724 US HIGHWAY 52 S   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",700 HOWIE MINE RD   WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 94 , 132 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",820 KLUMAC RD   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 59 , 80 ," $18,042.50 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",310 COMMERCE DR   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",4414 WILKINSON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 149 , 211 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",716 SIPES ST   KINGS MTN NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 39 , 40 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",514 OLD MOUNT HOLLY RD   STANLEY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 45 , 54 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",2300 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 30 , 58 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",1265 21ST ST NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 117 , 162 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",413 WINECOFF SCHOOL RD   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 133 , 180 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",401 N MORGAN ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 99 , 140 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",3031 TATE BLVD SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 30 , 39 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225035181,"ROWE, GLEN, DAVID",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 81 , 123 ,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1225037302,"STANLEY, RONALD, JAY",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1225037302,"STANLEY, RONALD, JAY",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 18 , 80 ,$#,,
MEDICAID DIRECT,1477006385,CHARLES A CANNON JR MEMORIAL HOSPIT,,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1225038060,"DENIER, DONNA, PATRICIA",175 MARY ST   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1225038060,"DENIER, DONNA, PATRICIA",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 58 , 77 , 96 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1225038060,"DENIER, DONNA, PATRICIA",434 HOSPITAL DR   LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1225038060,"DENIER, DONNA, PATRICIA",436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 44 , 63 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1225038060,"DENIER, DONNA, PATRICIA",436 HOSPITAL DR STE 210 LINVILLE NC,006,Avery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1225039340,"CHAMBERLAIN, LIONEL, NELSON",~,204 IONA ST   FAIRMONT NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,,1225039340,"CHAMBERLAIN, LIONEL, NELSON",204 IONA ST   FAIRMONT NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,, 210 , 237 , 412 ,$#,,
MEDICAID DIRECT,1366524910,ADVANTAGE VISION CENTER OD,Advantage Vision Center,1016 S CHURCH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225039993,"NEWSOME, PAULA, RENEE",1016 S CHURCH ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 193 , 312 ," 1,229 "," $48,682.00 ",,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225041569,"OEI, MONICA",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225044795,"LACEY, JOAN, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225044795,"LACEY, JOAN, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225045602,"ROBINSON, LASEAN, BOST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 187 , 187 ,$#,,
MEDICAID DIRECT,1073881694,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS RUTHERFORD PEDIATRI,141 TRYON RD STE A RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1225047152,"POWELL, ANITA, HILL",141 TRYON RD STE A RUTHERFORDTON NC,081,Rutherford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 22 , 42 ,$#,,
MEDICAID DIRECT,1225048861,CARELINK HOME HEALTH SERVICES LLC,~,304 WASHINGTON AVE   WELDON NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,,1225048861,CARELINK HOME HEALTH SERVICES LLC,304 WASHINGTON AVE   WELDON NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 4,462 "," 4,462 "," $311,899.67 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225049000,"JOHNSTON, ROBERT, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225052194,"TIGHE, THOMAS, VINCENT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1225052673,"GONCALVES, ROD, MANUEL",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 76 , 201 , 215 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1225053416,"GORMAN, AMY, CLAIRE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 24 , 45 ,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",613 E ROOSEVELT BLVD   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225054067,"SAVITSKY, IVAN",9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225055486,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1641,1529 WASHINGTON ST   WILLIAMSTON NC,058,Martin,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1225055486,WAL-MART STORES EAST LP,1529 WASHINGTON ST   WILLIAMSTON NC,058,Martin,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1225055494,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-5298,223 N MYRTLE SCHOOL RD   GASTONIA NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1225055494,WAL-MART STORES EAST LP,223 N MYRTLE SCHOOL RD   GASTONIA NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1295780781,KIDNEY CARE PC,KIDNEY CARE PC,2603 DAVIE AVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225059017,"LOHRMANN, WOLFGANG, ERICH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1295780781,KIDNEY CARE PC,KIDNEY CARE PC,2603 DAVIE AVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225059017,"LOHRMANN, WOLFGANG, ERICH",115 WESTBROOK LN   STATESVILLE NC,049,Iredell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 46 , 46 ,$#,,
MEDICAID DIRECT,1295780781,KIDNEY CARE PC,KIDNEY CARE PC,2603 DAVIE AVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225059017,"LOHRMANN, WOLFGANG, ERICH",2603 DAVIE AVE   STATESVILLE NC,049,Iredell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 109 , 109 ,$#,,
MEDICAID DIRECT,1295780781,KIDNEY CARE PC,KIDNEY CARE PC,2603 DAVIE AVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225059017,"LOHRMANN, WOLFGANG, ERICH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 184 , 184 ,$#,,
MEDICAID DIRECT,1295780781,KIDNEY CARE PC,KIDNEY CARE PC,2603 DAVIE AVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225059017,"LOHRMANN, WOLFGANG, ERICH",175 COMMERCE DR   TAYLORSVILLE NC,002,Alexander,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225059611,"BOWEN, ROBERT, CALVIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225059611,"BOWEN, ROBERT, CALVIN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 45 , 79 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225059611,"BOWEN, ROBERT, CALVIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225059611,"BOWEN, ROBERT, CALVIN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225059611,"BOWEN, ROBERT, CALVIN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1225059611,"BOWEN, ROBERT, CALVIN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225059884,"CANIPE, HILARY, LEATHERS",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225059934,"SZURGOT, JENNIFER, GLASS",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 71 , 164 , 373 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225059934,"SZURGOT, JENNIFER, GLASS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225059934,"SZURGOT, JENNIFER, GLASS",15 REGIONAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225060148,"CARROLL, JAMES, BRUCE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 140 , 144 ,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1225060148,"CARROLL, JAMES, BRUCE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225060148,"CARROLL, JAMES, BRUCE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1225060148,"CARROLL, JAMES, BRUCE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265014849,REHAB MEDICINE OF THE CAROLINAS,,2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225060288,"FAIRCLOTH, ELIZABETH, BIVENS",2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225060692,"ZIMMERMAN, EUGENIA, FAY",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225062102,"REICHERT, DELYSE, ANN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1225062102,"REICHERT, DELYSE, ANN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1225062102,"REICHERT, DELYSE, ANN",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225062102,"REICHERT, DELYSE, ANN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1225062102,"REICHERT, DELYSE, ANN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1225062102,"REICHERT, DELYSE, ANN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225063217,"BERNSTEIN, JERRY, CHARLES",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225063431,"SILTON, RICHARD, PHILIP",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225063431,"SILTON, RICHARD, PHILIP",620 SUMMIT CROSSING PL STE 202 GASTONIA NC,036,Gaston,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 11 , 43 , 44 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225063431,"SILTON, RICHARD, PHILIP",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225063431,"SILTON, RICHARD, PHILIP",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 27 , 28 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225063431,"SILTON, RICHARD, PHILIP",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225063431,"SILTON, RICHARD, PHILIP",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1629262050,SHARON LAKES MEDICAL ASSOCIATES PC,~,7631 SHARON LAKES RD STE P CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225063670,"ALLEYNE, YOLANDA, RENEE",7631 SHARON LAKES RD STE P CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 40 , 71 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225064132,"GOMEZ, RAMON, JOSON",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225064132,"GOMEZ, RAMON, JOSON",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225064249,"MUNRO, KIMBERLY, CARMEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225064249,"MUNRO, KIMBERLY, CARMEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225065519,"TOURVILLE, KRISTINA, CHAVES",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225065519,"TOURVILLE, KRISTINA, CHAVES",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225065519,"TOURVILLE, KRISTINA, CHAVES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225065519,"TOURVILLE, KRISTINA, CHAVES",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225065519,"TOURVILLE, KRISTINA, CHAVES",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225065519,"TOURVILLE, KRISTINA, CHAVES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225065519,"TOURVILLE, KRISTINA, CHAVES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225065550,"RESTREPO GARTNER, CLAUDIA",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225065550,"RESTREPO GARTNER, CLAUDIA",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225065550,"RESTREPO GARTNER, CLAUDIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1225065816,"HARPER, ANGELLE, SIMON",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225065816,"HARPER, ANGELLE, SIMON",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 571 , 646 , 765 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225068307,"DRESSER, LEE, POTTER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 108 , 167 , 234 ," $21,537.44 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225068331,"SATURLEY, JOSEPH, HOWARD",111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225068331,"SATURLEY, JOSEPH, HOWARD",9200 GLENWATER DR   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225068331,"SATURLEY, JOSEPH, HOWARD",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1225070790,"RORIE, TIARRA, RENEE",~,422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,1225070790,"RORIE, TIARRA, RENEE",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 69 , 74 , 658 ," $50,453.97 ",,
MEDICAID DIRECT,1386889434,LEKECIA D MCGEE DDS AND TIARRA R RO,LEKECIA MCGEE AND TIARRA RORIE DDS,422 N CHURCH ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1225070790,"RORIE, TIARRA, RENEE",422 N CHURCH ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice," 2,827 "," 4,539 "," 20,398 "," $748,239.76 ",,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225071517,"MONTY, STEVEN, JOSEPH",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225071517,"MONTY, STEVEN, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538561865,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM MEDICAL ONCOLOGY,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1225072648,"RANDHAWA, DEVINDERPAL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1225074875,"DAVIS, JOSEPH, ALTON",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 26 , 35 ,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1225074875,"DAVIS, JOSEPH, ALTON",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 46 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225076219,"BASS, DAVID, KURT",11882 TILDEN PL   WELLINGTON FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225076219,"BASS, DAVID, KURT",2920 APPALOOSA TRL   WELLINGTON FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 52 , 68 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225076219,"BASS, DAVID, KURT",2920 APPALOOSA TRL   WELLINGTON FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225076813,COUNTY OF SAMPSON,SAMPSON CO RESCUE AND EMS,107 UNDERWOOD ST   CLINTON NC,082,Sampson,3416L0300X,Transportation Services,Ambulance,Land Transport,1225076813,COUNTY OF SAMPSON,107 UNDERWOOD ST   CLINTON NC,082,Sampson,3416L0300X,Transportation Services,Ambulance,Land Transport, 165 , 264 , 445 ," $10,349.53 ",,
MEDICAID DIRECT,1225076813,COUNTY OF SAMPSON,SAMPSON CO RESCUE AND EMS,530 COMMERCE ST   CLINTON NC,082,Sampson,3416L0300X,Transportation Services,Ambulance,Land Transport,1225076813,COUNTY OF SAMPSON,530 COMMERCE ST   CLINTON NC,082,Sampson,3416L0300X,Transportation Services,Ambulance,Land Transport, 58 , 79 , 140 ,$#,,
MEDICAID DIRECT,1245587534,FRENCH BROAD PEDIATRIC ASSOCIATES P,FRENCH BROAD PEDICATRIC ASSOCIATES PLLC,40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225077423,"CARLISLE, LAUREN, KEELY",40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 56 , 80 , 217 ," $11,155.40 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1225077829,"TALBOT, KYLE, DARREN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 11 , 13 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1225077829,"TALBOT, KYLE, DARREN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",375 SUNSET AVE   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225077829,"TALBOT, KYLE, DARREN",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1225079411,"MILEWSKI, RONALD, JAMES",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1538214713,CHILDRENS MEDICAL GROUP INC,TIDEWATER CHILDRENS ASSOCIATES,171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225079619,"KALOJI, RAJESHWARI",171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1225080310,"SCHWARTZMAN, JONATHAN",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1225080310,"SCHWARTZMAN, JONATHAN",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 38 , 71 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1225080310,"SCHWARTZMAN, JONATHAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1225080310,"SCHWARTZMAN, JONATHAN",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1225080310,"SCHWARTZMAN, JONATHAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1225080310,"SCHWARTZMAN, JONATHAN",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1225080310,"SCHWARTZMAN, JONATHAN",436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225081664,"SIMPSON, MARGARET, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,621 S MAIN ST STE 201 REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1225081664,"SIMPSON, MARGARET, ELIZABETH",621 S MAIN ST STE 201 REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225081664,"SIMPSON, MARGARET, ELIZABETH",621 S MAIN ST STE 201 REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225081664,"SIMPSON, MARGARET, ELIZABETH",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 29 , 45 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,621 S MAIN ST STE 201 REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1225081664,"SIMPSON, MARGARET, ELIZABETH",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225081664,"SIMPSON, MARGARET, ELIZABETH",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 182 , 288 ,$#,,
MEDICAID DIRECT,1225083413,COUNTY OF RUTHERFORD FINANCE OFFICE,~,339 CALLAHAN KOON RD   SPINDALE NC,081,Rutherford,3416L0300X,Transportation Services,Ambulance,Land Transport,1225083413,COUNTY OF RUTHERFORD FINANCE OFFICE,339 CALLAHAN KOON RD   SPINDALE NC,081,Rutherford,3416L0300X,Transportation Services,Ambulance,Land Transport, 775 ," 1,779 "," 3,307 "," $42,479.53 ",,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1225083561,"PEYTON, CHRISTINA, RENEE",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 75 , 94 , 106 ," $14,584.28 ",,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1225084007,"BAKER, CAROL, CHRISTENSEN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225085988,"GAUGER, SARAH, KATHRYN",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225085988,"GAUGER, SARAH, KATHRYN",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 46 ,$#,,
MEDICAID DIRECT,1912228347,INTERNATIONAL CLINIC OF THE CAROLIN,INTERNATIONAL CLINIC OF THE CAROLINAS PLLC,2406 BLUE RIDGE RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225087307,"TONOS, ANTHONY",2406 BLUE RIDGE RD STE 205 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 89 , 117 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225087679,"DEW, TIMOTHY, YIU-CHUEN",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225087935,"ALDRIDGE, BARBARA, DARNELL",100 E DOGWOOD DR   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225087935,"ALDRIDGE, BARBARA, DARNELL",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225088081,"LAUT, DANIEL, EVAN",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225088081,"LAUT, DANIEL, EVAN",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 76 , 181 , 199 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225089360,"BELTHOFF, REBECCA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 28 , 28 ,$#,,
MEDICAID DIRECT,1093793473,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1225089402,"DOGRA, SUNIL",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225089691,"PIERCE, JENNIFER, NIXON",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225089691,"PIERCE, JENNIFER, NIXON",40 DUKE MEDICINE CIR CLINIC 2H DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225089691,"PIERCE, JENNIFER, NIXON",40 DUKE MEDICINE CIR CLINIC 2H DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225089691,"PIERCE, JENNIFER, NIXON",2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225090764,"SMITH, JANICE, SHERRILL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 42 , 45 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1619431277,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ROGERS RD STE 120 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1619462694,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 66 , 72 , 124 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 55 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 42 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1619431277,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ROGERS RD STE 120 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1619462694,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 35 ,$#,,
MEDICAID DIRECT,1992703540,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225090772,"BOYSE, TEDRIC, DALE",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1225091572,"MORRIS, VICKI, MORGAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225091796,"FREE, STEPHEN, JOHN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 95 , 138 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1225091796,"FREE, STEPHEN, JOHN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 39 , 51 ,$#,,
MEDICAID DIRECT,1942251251,WESTERN WAKE PEDIATRICS PA,WESTERN WAKE PEDIATRICS PA,940 SE CARY PKWY STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1225092265,"FERRALL, ROBERT, JOHN",940 SE CARY PKWY STE 200 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225093578,"STEWART III, DONALD, HOUSTON",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 44 , 47 , 98 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225093578,"STEWART III, DONALD, HOUSTON",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 40 , 82 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225093578,"STEWART III, DONALD, HOUSTON",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760640791,"CHANG, ANDREW",,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1225093966,"LIEPINS, ANDREW, PATRICK",3821 ED DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225093966,"LIEPINS, ANDREW, PATRICK",~,160 MACGREGOR PINES DR STE 205 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1225093966,"LIEPINS, ANDREW, PATRICK",160 MACGREGOR PINES DR STE 205 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225093966,"LIEPINS, ANDREW, PATRICK",~,3821 ED DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1225093966,"LIEPINS, ANDREW, PATRICK",3821 ED DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225094139,"MIQUEL, ANA, MARIA",242 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225094139,"MIQUEL, ANA, MARIA",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1225094139,"MIQUEL, ANA, MARIA",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225094907,"BLOOMFIELD, GERALD, SAMUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 64 , 67 , 127 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1225094907,"BLOOMFIELD, GERALD, SAMUEL",2400 PRATT ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1225094907,"BLOOMFIELD, GERALD, SAMUEL",2400 PRATT ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1225094907,"BLOOMFIELD, GERALD, SAMUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225094907,"BLOOMFIELD, GERALD, SAMUEL",2400 PRATT ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 55 , 80 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225094907,"BLOOMFIELD, GERALD, SAMUEL",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225096225,"SEAUX, LEROY, DAVID",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 82 , 104 , 153 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225096225,"SEAUX, LEROY, DAVID",190 KIMEL PARK DR STE 131 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225096225,"SEAUX, LEROY, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 15 , 22 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225096225,"SEAUX, LEROY, DAVID",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225096852,"JENKINS, LAURIE, GAIL",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225096852,"JENKINS, LAURIE, GAIL",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 31 , 37 , 37 ," $10,196.68 ",,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225096878,"BROWNE, LAUREN, INDIRA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225096878,"BROWNE, LAUREN, INDIRA",15110 JOHN J DELANEY DR STE 120 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225096878,"BROWNE, LAUREN, INDIRA",1225 HARDING PL STE 5200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225096878,"BROWNE, LAUREN, INDIRA",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1225096894,"SMITH, DAMAIN, ANTHONY",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 14 , 26 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1225097496,"SMITH, TIMOTHY, TED",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 98 , 108 , 166 ,$#,,
MEDICAID DIRECT,1619036399,COUNTY OF SAMPSON,~,360 COUNTY COMPLEX RD   CLINTON NC,082,Sampson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1225097496,"SMITH, TIMOTHY, TED",360 COUNTY COMPLEX RD STE 200 CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 159 , 363 ," 1,326 "," $48,207.28 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225098387,"RAMOS, ARLENE, GACUTAN",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225098387,"RAMOS, ARLENE, GACUTAN",903 RANDOLPH ST STE 1 THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 184 , 349 , 570 ," $12,086.29 ",,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1225100050,"SHELL, PETER, MATHES",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 114 , 114 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225100134,"RICKEY, COLLEEN, MOLLOY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 165 , 165 ,$#,,
MEDICAID DIRECT,1457983116,NORTH RALEIGH PLASTIC SURGERY PA,,9104 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225100308,"ORTIZ, JUAN",9104 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225100613,"OWENS WATTERSON, DAWN, PATRICE",1404 S SALISBURY AVE   SPENCER NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225100613,"OWENS WATTERSON, DAWN, PATRICE",4009 CRAIG AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 125 , 125 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225100613,"OWENS WATTERSON, DAWN, PATRICE",4009 CRAIG AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225100613,"OWENS WATTERSON, DAWN, PATRICE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 103 , 103 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225100613,"OWENS WATTERSON, DAWN, PATRICE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225100613,"OWENS WATTERSON, DAWN, PATRICE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225101389,"YATES, TERESA, SNAPP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225101389,"YATES, TERESA, SNAPP",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225101447,"OKAFOR, CHIKA, NWANDO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225101447,"OKAFOR, CHIKA, NWANDO",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225101447,"OKAFOR, CHIKA, NWANDO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 140 , 140 ,$#,,
MEDICAID DIRECT,1225101900,CHILD SPEAK TOO INC,CHILD SPEAK TOO INC,4821 WATER OAK RD APT 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225101900,CHILD SPEAK TOO INC,4821 WATER OAK RD APT 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225105026,"KENT, ASHLEY, DEANE",700 ACADEMY ST S   AHOSKIE NC,046,Hertford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 123 , 147 , 153 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,700 ACADEMY ST S   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1225105026,"KENT, ASHLEY, DEANE",700 ACADEMY ST S   AHOSKIE NC,046,Hertford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1225105026,"KENT, ASHLEY, DEANE",700 ACADEMY ST S   AHOSKIE NC,046,Hertford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1154656411,REGIONAL HEALTH DIAGNOSTICS INC,~,2922 TRENT RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225105026,"KENT, ASHLEY, DEANE",700 ACADEMY ST S   AHOSKIE NC,046,Hertford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225105026,"KENT, ASHLEY, DEANE",203 EARNHART DR STE B EDENTON NC,021,Chowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225106180,"LITTLE, NATALIE, WILSON",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,,,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1225106180,"LITTLE, NATALIE, WILSON",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1225106180,"LITTLE, NATALIE, WILSON",105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 57 , 87 , 146 ,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225110141,"NETZLER, PETER, CLIFFORD",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225110141,"NETZLER, PETER, CLIFFORD",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1225110141,"NETZLER, PETER, CLIFFORD",,1005 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,1225110141,"NETZLER, PETER, CLIFFORD",1005 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1225110141,"NETZLER, PETER, CLIFFORD",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,1225110141,"NETZLER, PETER, CLIFFORD",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1225110497,ACCU REFERENCE MEDICAL LAB,ACCU REFERENCE MEDICAL LAB,1901 E LINDEN AVE UNIT 4 LINDEN NJ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1225110497,ACCU REFERENCE MEDICAL LAB,1901 E LINDEN AVE UNIT 4 LINDEN NJ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,," 2,038 "," 3,643 "," 15,260 "," $671,082.54 ",,
MEDICAID DIRECT,1255597480,JONATHAN A LINDSEY DDS PA,~,1632 MILLERS GAP HWY   NEWLAND NC,006,Avery,193400000X,Group,Single Specialty,,1225110505,"LINDSEY, JONATHAN, ASHLEY",1632 MILLERS GAP HWY   NEWLAND NC,006,Avery,1223G0001X,Dental Providers,Dentist,General Practice, 276 , 327 ," 1,118 "," $38,125.70 ",,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225111560,"NOONE, ANGELA, MARIA",301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 53 , 71 , 75 ,$#,,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225111560,"NOONE, ANGELA, MARIA",101 E W T HARRIS BLVD STE 5100-A CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,101 E W T HARRIS BLVD STE 5100-A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225111560,"NOONE, ANGELA, MARIA",101 E W T HARRIS BLVD STE 5100-A CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1922434307,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225111743,"STRINGFIELD, BARRY, DEAN",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 34 , 47 ,$#,,
MEDICAID DIRECT,1083930671,PRIVATE DIAGNOSTIC CLINIC PLLC,DUKE MED PEDS AT ROXBORO ST,,,Unknown,193200000X,Group,Multi-Specialty,,1225112105,"WOODS, SUZANNE",4020 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225112113,"MELNICK, ABIGAIL, HANNAH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225112113,"MELNICK, ABIGAIL, HANNAH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225112113,"MELNICK, ABIGAIL, HANNAH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225112899,"KHAN, TOOBA",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1225112899,"KHAN, TOOBA",201 E GROVER ST   SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1225112899,"KHAN, TOOBA",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225112899,"KHAN, TOOBA",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225112899,"KHAN, TOOBA",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 43 , 62 , 71 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1225112899,"KHAN, TOOBA",600 HOSPITAL DR   MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1083011886,TOTAL RADIOLOGY SOLUTIONS PA,~,,,Unknown,193400000X,Group,Single Specialty,,1225113301,"ERICSON, DOUGLAS, PAUL",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1225113558,"MONICAL, CHERYL, JOYCE",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 59 , 96 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225113558,"MONICAL, CHERYL, JOYCE",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225115785,"DONALDSON, SCOTT, H",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 29 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225115785,"DONALDSON, SCOTT, H",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 23 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225115785,"DONALDSON, SCOTT, H",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 33 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225115785,"DONALDSON, SCOTT, H",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1225116593,"SKARIAH, ANITA, MARY",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 25 , 42 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225116593,"SKARIAH, ANITA, MARY",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1225118490,"BEVERLY, EDITH",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225118615,"REILLY, CYNTHIA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1225119373,"BAILEY, THOMAS, MICHAEL",835 ALBEMARLE RD   TROY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 24 , 38 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",921 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",921 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 51 , 290 , 317 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 15 , 78 , 84 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 23 , 30 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 78 , 309 , 407 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225119431,"BOX, KIMBERLY",20 MEDICAL CAMPUS DR NW STE 207 SUPPLY NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225124621,"VAN DUIN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 33 , 84 , 91 ,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225125123,"MCKOY, RACHELLE, PETTIT",1760 E DIXON BLVD   SHELBY NC,023,Cleveland,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225127301,"GRAHAM, KAREN, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1225127459,"RICH JR, ROBERT, LEE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225127459,"RICH JR, ROBERT, LEE",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 182 , 184 ," $10,573.54 ",,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225127459,"RICH JR, ROBERT, LEE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225127624,"INGRAM III, WILLIAM, FRANKLIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1225127624,"INGRAM III, WILLIAM, FRANKLIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225127624,"INGRAM III, WILLIAM, FRANKLIN",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225127624,"INGRAM III, WILLIAM, FRANKLIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 75 , 77 , 113 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225127624,"INGRAM III, WILLIAM, FRANKLIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1073609665,GRAYBAR CHIROPRACTIC INC,GRAYBAR CHIROPRACTIC INC,2110 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225133515,"WORKMAN, LUCCUS, LEE",2110 S 17TH ST   WILMINGTON NC,065,New Hanover,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1073609665,GRAYBAR CHIROPRACTIC INC,GRAYBAR CHIROPRACTIC INC,116 N NORWOOD ST   WALLACE NC,031,Duplin,193400000X,Group,Single Specialty,,1225133515,"WORKMAN, LUCCUS, LEE",116 N NORWOOD ST   WALLACE NC,031,Duplin,111N00000X,Chiropractic Providers,Chiropractor,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225134075,"THOMAS, MELANIE, BYRNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1225134075,"THOMAS, MELANIE, BYRNE",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 28 , 31 , 31 ,$#,,
MEDICAID DIRECT,1114073160,PRIVATE DIAGNOSTIC CLINIC PLLC,Private Diagnostic Clinic PLLC,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1225134075,"THOMAS, MELANIE, BYRNE",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,,,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225134588,"BRAILEY, ELLORES, ELBERTA",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 27 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1225134679,"GUO, HONGTAO, MICHAEL",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1225134679,"GUO, HONGTAO, MICHAEL",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225134679,"GUO, HONGTAO, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 22 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225134679,"GUO, HONGTAO, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 31 , 37 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1225134679,"GUO, HONGTAO, MICHAEL",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 16 , 43 ,$#,,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1225135601,"WESSINGER, LESLIE, ANN",1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,279 "," 1,582 "," 7,500 "," $263,835.46 ",,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1225135601,"WESSINGER, LESLIE, ANN",1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,201 "," 1,619 "," 7,434 "," $280,706.80 ",,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225136104,"BRANTLEY, JULIAN, CHISOLM",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1093883852,CAROLINA FAMILY HEALTH CENTERS INC,HARVEST FAMILY HEALTH CENTER,8250 NC 58 S   ELM CITY NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225136104,"BRANTLEY, JULIAN, CHISOLM",8250 NC 58 S   ELM CITY NC,064,Nash,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 19 , 20 ,$#,,
MEDICAID DIRECT,1942445762,CAROLINA WOUND CARE SPECIALISTS PL,CAROLINA WOUND CARE SPECIALISTSMD,101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225136104,"BRANTLEY, JULIAN, CHISOLM",101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942445762,CAROLINA WOUND CARE SPECIALISTS PL,CAROLINA WOUND CARE SPECIALISTSMD,101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225136104,"BRANTLEY, JULIAN, CHISOLM",101 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 59 , 166 , 320 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225136120,"KOKOSZKA, ANDRIA, KARA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225136120,"KOKOSZKA, ANDRIA, KARA",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 262 , 335 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",2780 X RAY DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 95 , 104 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",700 SELF ST   CHERRYVILLE NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 59 , 78 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",102 LEONARD AVE   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 31 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",515 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 50 , 62 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",1810 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 100 , 135 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",920 4TH ST SW   CONOVER NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 111 , 141 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",3031 TATE BLVD SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 53 , 73 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225136286,"EWY, MARVIN, FRANKLIN",1285 W A ST   KANNAPOLIS NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 94 , 104 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225142474,"HUDSPETH, RICHARD, WILLIAM",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225144231,"JOHNSON, ADRENA, ELAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225146095,DEVELOPMENTAL THERAPY ASSOCIATES IN,~,3624 SHANNON RD STE 104 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225146095,DEVELOPMENTAL THERAPY ASSOCIATES IN,3624 SHANNON RD STE 104 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 74 , 479 , 514 ," $36,354.98 ",,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225146210,"BUCHANAN, WILLIAM, PRESTON",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255165619,COASTAL CARDIOVASCULAR ASSOCIATESPA,~,1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225146210,"BUCHANAN, WILLIAM, PRESTON",1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 36 , 84 ,$#,,
MEDICAID DIRECT,1255165619,COASTAL CARDIOVASCULAR ASSOCIATESPA,~,1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225146210,"BUCHANAN, WILLIAM, PRESTON",1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 14 , 27 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225146210,"BUCHANAN, WILLIAM, PRESTON",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225147580,"RODRIGUEZ, RICARDO, JORGE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 92 , 92 ," $13,734.24 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225149784,"CORKEY, WILLIAM, BARNETTE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 31 , 42 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1225151152,"CHAN, MICHAEL, DAVID",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225151152,"CHAN, MICHAEL, DAVID",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 48 , 70 , 135 ,$#,,
MEDICAID DIRECT,1710170634,MICHAEL J ANDRESKI DDS PA,~,1511 RIVER ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1225151590,"ANDRESKI, MICHAEL, JOHN",1511 RIVER ST   WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 41 , 96 , 268 ,$#,,
MEDICAID DIRECT,1902993710,EAST COAST MEDICAL PLLC,~,22545 US HIGHWAY 17 STE B HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1225152200,"YOCUM, LISA, KAY",22545 US HIGHWAY 17 STE B HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 136 , 297 ,$#,,
MEDICAID DIRECT,1184921843,DUNN MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-DUNN,803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1225152911,"MCLAMB, CARRA, AVERY",803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 165 , 271 ,$#,,
MEDICAID DIRECT,1225153190,ALAMANCE ELDER CARE INC,ALAMANCE ELDERCARE INC,210 E ELM ST STE D GRAHAM NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1225153190,ALAMANCE ELDER CARE INC,210 E ELM ST STE D GRAHAM NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#," $45,478.83 ",,
MEDICAID DIRECT,1225153190,ALAMANCE ELDER CARE INC,ALAMANCE ELDERCARE INC,210 E ELM ST STE D GRAHAM NC,001,Alamance,251B00000X,Agencies,Case Management,,1225153190,ALAMANCE ELDER CARE INC,210 E ELM ST STE D GRAHAM NC,001,Alamance,251B00000X,Agencies,Case Management,, 40 , 434 , 434 ," $161,639.25 ",,
MEDICAID DIRECT,1225158793,BRUNSWICK COUNTY SCHOOLS,BRUNSWICK COUNTY SCHOOLS,35 REFERENDUM DR NE   BOLIVIA NC,010,Brunswick,251300000X,Agencies,Local Education Agency (LEA),,1225158793,BRUNSWICK COUNTY SCHOOLS,35 REFERENDUM DR NE   BOLIVIA NC,010,Brunswick,251300000X,Agencies,Local Education Agency (LEA),, 565 ," 11,333 "," 11,727 "," $478,656.12 ",,
MEDICAID DIRECT,1225163744,"PERKINS, JUANITA, CONSUELA",JUANITA C PERKINS FNP-BC HEALTHCARE,3209 GUESS RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1225163744,"PERKINS, JUANITA, CONSUELA",3209 GUESS RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1194842245,ALAMANCE FAMILY PRACTICE PLLC,ALAMANCE FAMILY PRACTICE PA,,,Unknown,193400000X,Group,Single Specialty,,1225168974,"NIEMEYER, MEINDERT, ALBERT",812 W HAGGARD AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1194842245,ALAMANCE FAMILY PRACTICE PLLC,ALAMANCE FAMILY PRACTICE PA,,,Unknown,193400000X,Group,Single Specialty,,1225168974,"NIEMEYER, MEINDERT, ALBERT",812 W HAGGARD AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1225170038,"WILLIAMS, TRACY",122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 97 , 97 , 180 ," $19,621.04 ",,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1225170731,"NIX, HARVEY, CLYDE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023124575,HAZELWOOD FAMILY MEDICINE PLLC,,1088 BROWN AVE   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1225171432,"JAMES, JANET, LEE",1088 BROWN AVE   WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1003883877,PATHOLOGIST DIAGNOSTIC LABORATORY P,~,1800 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225171622,"KISH, JOSHUA, BEDDINGFIELD",105 W 4TH ST STE 600 WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 34 , 36 , 43 ,$#,,
MEDICAID DIRECT,1225172299,LEE COUNTY SCHOOLS,Lee County Schools,106 GORDON ST   SANFORD NC,053,Lee,251300000X,Agencies,Local Education Agency (LEA),,1225172299,LEE COUNTY SCHOOLS,106 GORDON ST   SANFORD NC,053,Lee,251300000X,Agencies,Local Education Agency (LEA),, 364 ," 5,191 "," 5,261 "," $231,394.11 ",,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225174246,"PARHAM, KATHRYN, GLIBOWSKI",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1225174600,LTS HELPING HANDS,~,227 W 4TH ST # 220 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1225174600,LTS HELPING HANDS,227 W 4TH ST # 220 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,653 "," 1,653 "," $98,087.45 ",,
MEDICAID DIRECT,1548439839,INVISION FAMILY EYECARE,Invision Family Eyecare,6167 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225174865,"DAVID, LASHETA, PRICE",6167 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 23 , 27 ,$#,,
MEDICAID DIRECT,1225175326,"MARTON, MARLENE, MARIA",,4 LONG SHOALS RD   ARDEN NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1225175326,"MARTON, MARLENE, MARIA",4 LONG SHOALS RD   ARDEN NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 65 , 842 , 862 ," $59,789.51 ",,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225177868,"LAY, HARRY, HAMILTON",1540 SUNDAY DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 80 , 107 , 153 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225178114,"RADER, NANCY, GAIL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225178114,"RADER, NANCY, GAIL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225178114,"RADER, NANCY, GAIL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225178114,"RADER, NANCY, GAIL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225179344,"DAY, KELLY, ANN STAHL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225179526,"CURTIN, BRIAN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225179526,"CURTIN, BRIAN",15825 BALLANTYNE MEDICAL PL   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225179526,"CURTIN, BRIAN",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 50 , 64 , 100 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225179526,"CURTIN, BRIAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225182116,"SHIELDS, COLLEEN, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225182116,"SHIELDS, COLLEEN, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225182686,"ALDERMAN, JENNIFER, HARTSELL",111 S SALISBURY GQ AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225182686,"ALDERMAN, JENNIFER, HARTSELL",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699540203,GQ INTERNAL MEDICINE AND PEDIATRICS,,111 S SALISBURY GQ AVE   GRANITE QRY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1225182686,"ALDERMAN, JENNIFER, HARTSELL",111 S SALISBURY GQ AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 26 , 47 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225183791,"MCROBERTS, JERRY, WILLIAM",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225184187,"BARNES, CYNTHIA, DENISE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477785756,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - GRE,802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225185358,"WOOD, KELLY, LYNN",802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 13 , 40 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225186760,"KEENER, JANICE, MARIE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1225187180,ONE LOVE PERIODIC SERVICES INC,ONE LOVE PERIODIC SERVICESINC,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1225187180,ONE LOVE PERIODIC SERVICES INC,103 N GREEN ST   MORGANTON NC,012,Burke,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1225188071,OMNI EYE SERVICES OD PA,OMNI EYE SPECIALISTS,818B PINE GROVE DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1225188071,OMNI EYE SERVICES OD PA,818B PINE GROVE DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 57 , 60 , 117 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225191737,"SIPKINS, DOROTHY, ANNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225191737,"SIPKINS, DOROTHY, ANNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1225192800,ONSLOW PINES REST HOME,ONSLOW PINES REST HOME INC,1241 ONSLOW PINES RD   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225192800,ONSLOW PINES REST HOME,1241 ONSLOW PINES RD   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 17 ," 4,031 "," 4,038 "," $353,718.39 ",,
MEDICAID DIRECT,1225194632,"MEHLER, JASON, JACOB",~,42 MADELINE AVE   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1225194632,"MEHLER, JASON, JACOB",42 MADELINE AVE   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 19 , 258 , 258 ," $24,646.11 ",,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225195308,"STREILEIN, ANNAMARIE, FAUST",319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 46 , 133 ,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,319 N GRAHAM HOPEDALE RD FL B   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225195308,"STREILEIN, ANNAMARIE, FAUST",319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437556594,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH GASTROENTEROLOGY BRUNSWICK,13 MEDICAL CAMPUS DR NW STE 102 SUPPLY NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1225199409,"ANDREWS, ALLAN, HIROSHI",13 MEDICAL CAMPUS DR NW STE 102 SUPPLY NC,010,Brunswick,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225199409,"ANDREWS, ALLAN, HIROSHI",13 MEDICAL CAMPUS DR NW STE 102 SUPPLY NC,010,Brunswick,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 24 , 26 , 32 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225199409,"ANDREWS, ALLAN, HIROSHI",725 OAKRIDGE BLVD STE A3 LUMBERTON NC,078,Robeson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 45 , 59 , 77 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225204191,"RANGA, SIMBISO",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 51 , 51 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225204191,"RANGA, SIMBISO",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 23 , 61 , 61 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225204191,"RANGA, SIMBISO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225204191,"RANGA, SIMBISO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 38 , 38 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225204191,"RANGA, SIMBISO",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225204191,"RANGA, SIMBISO",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225204191,"RANGA, SIMBISO",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 18 , 18 , 29 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",204 ASHVILLE AVE   CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225205172,"STEMBRIDGE, JULIE, ANN",505 OBERLIN RD   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1225205818,"SNYDER, JONATHAN, REICH",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 39 , 60 , 81 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225206519,"TUCKER, GENNIE, LOU",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225206519,"TUCKER, GENNIE, LOU",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225206519,"TUCKER, GENNIE, LOU",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1225207715,APPALACHIAN SPEECH PATHOLOGY,,808 HARPER AVE NW STE 209 LENOIR NC,014,Caldwell,251S00000X,Agencies,Community/Behavioral Health,,1225207715,APPALACHIAN SPEECH PATHOLOGY,808 HARPER AVE NW STE 209 LENOIR NC,014,Caldwell,251S00000X,Agencies,Community/Behavioral Health,, 37 , 424 , 424 ," $27,442.80 ",,
MEDICAID DIRECT,1225207715,APPALACHIAN SPEECH PATHOLOGY,,214 RIDGE ST NW   LENOIR NC,014,Caldwell,251S00000X,Agencies,Community/Behavioral Health,,1225207715,APPALACHIAN SPEECH PATHOLOGY,214 RIDGE ST NW   LENOIR NC,014,Caldwell,251S00000X,Agencies,Community/Behavioral Health,, 14 , 91 , 91 ,$#,,
MEDICAID DIRECT,1225207715,APPALACHIAN SPEECH PATHOLOGY,,808 HARPER AVE NW STE 209 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1225207715,APPALACHIAN SPEECH PATHOLOGY,808 HARPER AVE NW STE 209 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,, 153 ," 2,287 "," 2,429 "," $161,088.63 ",,
MEDICAID DIRECT,1225207715,APPALACHIAN SPEECH PATHOLOGY,,214 RIDGE ST NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1225207715,APPALACHIAN SPEECH PATHOLOGY,214 RIDGE ST NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,, 64 , 552 , 566 ," $39,566.58 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225209133,"SCHLOSSER, TRACY, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225209133,"SCHLOSSER, TRACY, ANN",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225211105,"HOFFMAN, RACHEL, AMMONS",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 29 , 34 ,$#,,
MEDICAID DIRECT,1376510875,HOT SPRINGS HEALTH PROGRAM,HOT SPRINGS MEDICAL AND DENTAL CENTER,66 NW US 25 70 HIGH   HOT SPRINGS NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225211105,"HOFFMAN, RACHEL, AMMONS",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376510875,HOT SPRINGS HEALTH PROGRAM,HOT SPRINGS MEDICAL AND DENTAL CENTER,66 NW US 25 70 HIGH   HOT SPRINGS NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225211105,"HOFFMAN, RACHEL, AMMONS",66 NW US 25 70 HWY   HOT SPRINGS NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 90 , 97 ,$#,,
MEDICAID DIRECT,1811964729,HOT SPRINGS HEALTH PROGRAM,LAUREL MEDICAL CENTER,80 GUNTERTOWN RD   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225211105,"HOFFMAN, RACHEL, AMMONS",80 GUNTERTOWN RD   MARSHALL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 33 , 34 ,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225211105,"HOFFMAN, RACHEL, AMMONS",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 86 , 95 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225211238,"TSEREDIANI, GIORGI",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225211238,"TSEREDIANI, GIORGI",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225211600,"MILLICHAP, JOHN, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225211600,"MILLICHAP, JOHN, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1225214000,BARBARA DAVENPORT,HAWTHORN HOUSE,1025 HWY 45 N   MERRY HILL NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225214000,BARBARA DAVENPORT,1025 HWY 45 N   MERRY HILL NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 920 , 920 ," $108,689.42 ",,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 30 , 37 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 32 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 190 , 232 , 277 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 29 , 35 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 50 , 56 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 37 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 34 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 33 , 38 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 22 , 26 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225215155,"VANDER KOOI, DOUGLAS, CARL",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 38 , 49 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225217094,"ALDEN, MARGARET, STOKES",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225217094,"ALDEN, MARGARET, STOKES",1471 JAG BRANCH BLVD UNIT 101 KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 26 , 47 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225217094,"ALDEN, MARGARET, STOKES",240 BROAD ST   KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225217383,"WYNJA, ELIZABETH, JEAN",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1903 ADDISON AVE   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1225217383,"WYNJA, ELIZABETH, JEAN",1903 ADDISON AVE   WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 64 , 143 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225217672,"ISAAC-DOCKERY, ASHLEY, MICHELLE",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225217672,"ISAAC-DOCKERY, ASHLEY, MICHELLE",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225217672,"ISAAC-DOCKERY, ASHLEY, MICHELLE",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1225222896,DEVELOPMENTAL THERAPY OUTREACH SERV,DEVELOPMENTAL THERAPY OUTREACH SERVICES,4506 TYNE DR   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,1225222896,DEVELOPMENTAL THERAPY OUTREACH SERV,4506 TYNE DR   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,, 64 ," 1,218 "," 1,218 "," $78,715.32 ",,
MEDICAID DIRECT,1043061559,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN OBSTETRICS AND GYNECOLOGY,510 S SOUTH ST   MOUNT AIRY NC,086,Surry,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225224728,"EASTER, MOLLY, KAY",510 S SOUTH ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386184661,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN OBSTETRICS & GYNECOLOGY,510 S SOUTH ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1225224728,"EASTER, MOLLY, KAY",510 S SOUTH ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 43 , 56 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225224843,"THOMPSON, LINDA, BROOKE",2308 WESVILL CT   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1225224843,"THOMPSON, LINDA, BROOKE",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225225592,WESTERN CAROLINA ENDOSCOPY CENTER,WESTERN CAROLINA ENDOSCOPY CENTER LLC,197 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1225225592,WESTERN CAROLINA ENDOSCOPY CENTER,197 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 23 , 21 , 26 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 14 , 22 , 29 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 17 , 19 , 31 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 59 , 78 , 166 ," $10,445.72 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225226079,"POLLACK, REBECCA, IDA",10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 17 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 20 , 21 , 44 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225226079,"POLLACK, REBECCA, IDA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225226079,"POLLACK, REBECCA, IDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1225227440,"HILL, TINA-MARIE, ALMAS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 142 , 315 ,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1225227440,"HILL, TINA-MARIE, ALMAS",139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 34 , 81 ,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1225228463,EAST CAROLINA HEALTH,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,, 122 , 768 , 768 ," $25,506.81 ",,
MEDICAID DIRECT,1871996058,MYEYEDR OPTOMETRY OF NORTH CAROLINA,~,505 RETAIL WAY STE 118 LOUISBURG NC,035,Franklin,193400000X,Group,Single Specialty,,1225228497,"KEAVENEY, KATHERINE, MARY",3500 N DUKE ST STE 1 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225229974,"HSU, SHIAOWEN, DAVID",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 44 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225229974,"HSU, SHIAOWEN, DAVID",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 26 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225229974,"HSU, SHIAOWEN, DAVID",2100 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225231038,"KARLSSON, JONAS, LARS MIKAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 20 , 22 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225231038,"KARLSSON, JONAS, LARS MIKAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 26 , 26 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225231038,"KARLSSON, JONAS, LARS MIKAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225232747,"CLAVIN, NICHOLAS, WAYNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225232747,"CLAVIN, NICHOLAS, WAYNE",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1225233588,"LABER, PATRICK, WILLIAM",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225233588,"LABER, PATRICK, WILLIAM",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 20 , 27 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225233653,"LAN, BILLY, YU-ANG",120 E CARVER ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225233653,"LAN, BILLY, YU-ANG",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 25 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225233653,"LAN, BILLY, YU-ANG",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225233653,"LAN, BILLY, YU-ANG",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225235021,"TERLECKI, RYAN, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 52 , 65 , 140 ,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225235203,"LAUDENBACH, JOEL, MARTIN",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,1223D0001X,Dental Providers,Dentist,Dental Public Health, 19 , 19 , 40 ,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225235203,"LAUDENBACH, JOEL, MARTIN",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,1223D0001X,Dental Providers,Dentist,Dental Public Health, 36 , 47 , 47 ,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225235203,"LAUDENBACH, JOEL, MARTIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223D0001X,Dental Providers,Dentist,Dental Public Health, 50 , 52 , 108 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1225236094,"PAREKH, MURTAZA",400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225236094,"PAREKH, MURTAZA",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225236094,"PAREKH, MURTAZA",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225236094,"PAREKH, MURTAZA",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225237944,"WELLS, HAMILTON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225237944,"WELLS, HAMILTON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1225237944,"WELLS, HAMILTON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225237944,"WELLS, HAMILTON",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225237944,"WELLS, HAMILTON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 46 , 61 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225237944,"WELLS, HAMILTON",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 14 , 18 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 43 , 61 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 25 , 30 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 18 , 54 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225238272,"STANLEY, GREGORY, ALAN",111 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225238579,"GEORGE, SIONNE, ANHELICIA CID",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 184 , 438 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225241755,"WALLEN, ELIZABETH, A",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1679868426,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS BEHAVIORAL MEDICINE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225241755,"WALLEN, ELIZABETH, A",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225241755,"WALLEN, ELIZABETH, A",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225241755,"WALLEN, ELIZABETH, A",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225245301,"BROWN, MELANIE, KRISTINE",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225245707,"GILMORE, CHRISTOPHER, AARON",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 443 ," 1,040 "," 1,280 "," $18,401.36 ",,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1225245921,"BARRIOCANAL, JOSE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1225245921,"BARRIOCANAL, JOSE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1225245921,"BARRIOCANAL, JOSE",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225245921,"BARRIOCANAL, JOSE",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1225245921,"BARRIOCANAL, JOSE",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225245996,"JACKSON, KIMBERLY, RAE WARD",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 31 , 39 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225248933,"PETHEL, CANDICE, BARNHARDT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225249253,"HOOKS III, WILLIAM, BORDEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 26 , 31 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225249253,"HOOKS III, WILLIAM, BORDEN",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225249253,"HOOKS III, WILLIAM, BORDEN",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 22 , 23 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225249253,"HOOKS III, WILLIAM, BORDEN",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225249725,"BROWN, WYNNE, RENEE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 11 ,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225249725,"BROWN, WYNNE, RENEE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 ,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225249725,"BROWN, WYNNE, RENEE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,755 HIGHLAND OAKS DR STE 102 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225249725,"BROWN, WYNNE, RENEE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1225250814,ASA LIVING INC,ASA LIVING I,1308 BEN BREWINGTON CT   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225250814,ASA LIVING INC,1308 BEN BREWINGTON CT   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 152 , 152 ," $20,116.17 ",,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225251705,"ROMANO, RYAN, CHRISTOPHER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 22 , 22 , 23 ,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225251705,"ROMANO, RYAN, CHRISTOPHER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 77 , 81 , 109 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225251705,"ROMANO, RYAN, CHRISTOPHER",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225256076,"VILLANUEVA, IAN, ANTHONY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225260003,"JONES, KRISTEN, ELIZABETH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225260391,"BOWLINE, ISAI, GOPALAKRISHNAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 107 , 255 , 256 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225260391,"BOWLINE, ISAI, GOPALAKRISHNAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 127 , 127 ,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225263213,"CHADWICK, STEPHEN, GREGORY",10 YORKSHIRE ST # B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 576 ," 1,147 "," 4,723 "," $230,952.98 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225264948,"CASE, JORDAN, MILLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 129 , 212 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225264948,"CASE, JORDAN, MILLER",4515 PREMIER DR STE 307 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 91 , 92 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",10035 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851567663,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM INPATIENT MEDICINE SPECIALISTS,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1225265176,"JARSANIA, VIJAYKUMAR, RAMNIKLAL",180 PARKWOOD DR   ELKIN NC,086,Surry,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 113 , 113 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225265366,"SMITH, KIMBERLY, ROUSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225265366,"SMITH, KIMBERLY, ROUSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225265366,"SMITH, KIMBERLY, ROUSE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 70 , 78 ,$#,,
MEDICAID DIRECT,1154721272,URGENT CARE DOWN EAST INC,,853 WASHINGTON SQUARE MALL   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1225265366,"SMITH, KIMBERLY, ROUSE",853 WASHINGTON SQUARE MALL   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 599 , 993 ," 3,164 "," $44,122.19 ",,
MEDICAID DIRECT,1154721272,URGENT CARE DOWN EAST INC,,853 WASHINGTON SQUARE MALL   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1225265366,"SMITH, KIMBERLY, ROUSE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1841526837,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATR,5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225265531,"ELAHI, LUBNA, SIAL",5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 36 , 70 ,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225265531,"ELAHI, LUBNA, SIAL",101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225265531,"ELAHI, LUBNA, SIAL",5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225265663,"ROMASH, JONATHAN, AARON",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1225265903,"SAYED, CHRISTOPHER, JOHN",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 18 , 25 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225265903,"SAYED, CHRISTOPHER, JOHN",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 56 , 97 , 163 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225265903,"SAYED, CHRISTOPHER, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225265903,"SAYED, CHRISTOPHER, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 34 , 54 , 92 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225266158,"BRASHEAR, MICHAEL, SCOTT",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 38 , 39 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225266158,"BRASHEAR, MICHAEL, SCOTT",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1225266497,"STOVALL, KATHRYN, RISSE",622 INDUSTRIAL AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1225266497,"STOVALL, KATHRYN, RISSE",309 NEW ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1225266497,"STOVALL, KATHRYN, RISSE",3839 BURLINGTON RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1225267933,"GEBHARDT, CARRIE, ANN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225267933,"GEBHARDT, CARRIE, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225269566,"RUTKAI, ABIGAIL, LOU",111 S CHURCH ST   HUNTERSVILLE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 126 , 152 , 195 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 199 , 237 , 255 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 83 , 102 , 172 ,$#,,
MEDICAID DIRECT,1174823066,PRIVATE DIAGNOSTIC CLINIC PLLC,TRIANGLE HEART ASSOCIATES,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174823066,PRIVATE DIAGNOSTIC CLINIC PLLC,TRIANGLE HEART ASSOCIATES,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225269921,"MATHEWS, ROBIN, NMI",540 NEW WAVERLY PL   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316943145,CENTRAL CAROLINA DERMATOLOGY,CENTRAL CAROLINA DERMATOLOGY CLINICINC,6 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1225272040,"BUTLER, JOSHUA, STEPHEN",6 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1316943145,CENTRAL CAROLINA DERMATOLOGY,CENTRAL CAROLINA DERMATOLOGY CLINICINC,4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225272040,"BUTLER, JOSHUA, STEPHEN",4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 41 , 52 , 89 ,$#,,
MEDICAID DIRECT,1225273923,ALEXANDER COUNTY SCHOOLS,ALEXANDER COUNTY SCHOOLS,700 LILEDOUN RD   TAYLORSVILLE NC,002,Alexander,251300000X,Agencies,Local Education Agency (LEA),,1225273923,ALEXANDER COUNTY SCHOOLS,700 LILEDOUN RD   TAYLORSVILLE NC,002,Alexander,251300000X,Agencies,Local Education Agency (LEA),, 305 ," 8,591 "," 9,001 "," $333,003.87 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225275662,"THOMAS, JULIE, MEREDITH",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225275662,"THOMAS, JULIE, MEREDITH",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225275662,"THOMAS, JULIE, MEREDITH",15 REGIONAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 58 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225275761,"ALFANO, BRIAN, KNOX",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 51 , 51 ,$#,,
MEDICAID DIRECT,1225276868,ULTIMATE FAMILY CARE HOME INC,~,2508 SANDERS RD   WILLOW SPRING NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225276868,ULTIMATE FAMILY CARE HOME INC,2508 SANDERS RD   WILLOW SPRING NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,229 "," 1,280 "," $81,432.92 ",,
MEDICAID DIRECT,1225276868,ULTIMATE FAMILY CARE HOME INC,~,3310 NC HIGHWAY 210   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225276868,ULTIMATE FAMILY CARE HOME INC,3310 NC HIGHWAY 210   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 1,339 "," 1,339 "," $84,632.13 ",,
MEDICAID DIRECT,1225276868,ULTIMATE FAMILY CARE HOME INC,~,8936 NC HIGHWAY 96 S   BENSON NC,051,Johnston,251S00000X,Agencies,Community/Behavioral Health,,1225276868,ULTIMATE FAMILY CARE HOME INC,8936 NC HIGHWAY 96 S   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1225276868,ULTIMATE FAMILY CARE HOME INC,~,8936 NC HIGHWAY 96 S   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225276868,ULTIMATE FAMILY CARE HOME INC,8936 NC HIGHWAY 96 S   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 489 , 555 ," $34,221.33 ",,
MEDICAID DIRECT,1225276868,ULTIMATE FAMILY CARE HOME INC,~,2510 SANDERS RD   WILLOW SPRING NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225276868,ULTIMATE FAMILY CARE HOME INC,2510 SANDERS RD   WILLOW SPRING NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 90 , 90 ,$#,,
MEDICAID DIRECT,1225276868,ULTIMATE FAMILY CARE HOME INC,~,817 S 2ND ST   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225276868,ULTIMATE FAMILY CARE HOME INC,817 S 2ND ST   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,186 "," 1,269 "," $75,312.65 ",,
MEDICAID DIRECT,1225277163,WILSONS HOME CARE AGENCY INC,~,510 MAIN ST UNIT D   MAYSVILLE NC,052,Jones,253Z00000X,Agencies,In Home Supportive Care,,1225277163,WILSONS HOME CARE AGENCY INC,510 MAIN ST UNIT D   MAYSVILLE NC,052,Jones,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 4,661 "," 4,712 "," $519,682.20 ",,
MEDICAID DIRECT,1225277163,WILSONS HOME CARE AGENCY INC,~,511 MAIN ST UNIT D MAYSVILLE NC,052,Jones,253Z00000X,Agencies,In Home Supportive Care,,1225277163,WILSONS HOME CARE AGENCY INC,511 MAIN ST UNIT D MAYSVILLE NC,052,Jones,253Z00000X,Agencies,In Home Supportive Care,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225277296,"NAAR, CLAUDE, ANTON",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225277296,"NAAR, CLAUDE, ANTON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 35 , 38 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225277296,"NAAR, CLAUDE, ANTON",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225277296,"NAAR, CLAUDE, ANTON",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225277296,"NAAR, CLAUDE, ANTON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1225278849,"GINSBURG, AARON, JEROLD",100 W H ST   BUTNER NC,039,Granville,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1225279508,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,2850 VILLAGE DR STE 204 FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,1225279508,AVID HEALTH AT HOME NORTH CAROLINA,2850 VILLAGE DR STE 204 FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,#," 1,104 "," 1,314 "," $644,371.00 ",,
MEDICAID DIRECT,1225279508,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,2850 VILLAGE DR STE 204 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1225279508,AVID HEALTH AT HOME NORTH CAROLINA,2850 VILLAGE DR STE 204 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,090 "," 1,090 "," $72,144.52 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225283450,"EDWARDS, KELLY, GARDNER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225283450,"EDWARDS, KELLY, GARDNER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 24 , 34 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1225283815,"POTLURU, PRAVEEN",1144 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 36 , 40 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,5200 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1225283815,"POTLURU, PRAVEEN",1144 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1225284557,"PORTER, SAMUEL, GLENN",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1225284557,"PORTER, SAMUEL, GLENN",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1225284557,"PORTER, SAMUEL, GLENN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 16 , 25 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1225284557,"PORTER, SAMUEL, GLENN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#, 14 ,$#,,
MEDICAID DIRECT,1962404384,THE REGIONAL DIABETES AND ENDOCRINE,THE REGIONAL DIABETES AND ENDOCRINE CENTER,101 ROBESON ST STE 405 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1225285042,"GURUNG, ANJU",101 ROBESON ST STE 405 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 297 , 559 ," 1,025 "," $11,272.72 ",,
MEDICAID DIRECT,1659966265,OYEGUNWA & ASSOCIATES IV PLLC,DINO KIDS DENTAL OF FAYETTEVILLE,1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1225286636,"EVANS, TAMARA, NICOLE",1916 SKIBO RD STE C5 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 33 , 33 , 124 ,$#,,
MEDICAID DIRECT,1659961399,ZOHAIB MUNAF DMD MBS PLLC,TOOTHTOWN DENTISTRY FOR KIDS,4514 OLD MONROE RD STE CD INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1225286636,"EVANS, TAMARA, NICOLE",3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 15 , 15 , 59 ,$#,,
MEDICAID DIRECT,1750737102,WRIGHT AND ASSOCIATES I DDS PA,NC ORAL SURGERY AND ORTHODONTICS,5925 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225286636,"EVANS, TAMARA, NICOLE",3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 31 , 125 ,$#,,
MEDICAID DIRECT,1700650371,LONDRY MODLIN TUCKER II DDS PLLC,DASH CITY PEDIATRIC AND ADULT DENTISTRY,705 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225286636,"EVANS, TAMARA, NICOLE",3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 722 , 934 ," 4,010 "," $139,673.61 ",,
MEDICAID DIRECT,1477078954,WRIGHT AND ASSOCIATES VIII DDS PA,,108 PICCADILLY DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225286636,"EVANS, TAMARA, NICOLE",3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 33 ,$#,,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1225286636,"EVANS, TAMARA, NICOLE",3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 13 , 14 , 47 ,$#,,
MEDICAID DIRECT,1225745771,OYEGUNWA AND ASSOCIATES VI PLLC,DINO KIDS DENTAL OF RALEIGH,5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225286636,"EVANS, TAMARA, NICOLE",5321 TIN ROOF WAY STE 101 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 257 , 282 ," 1,098 "," $37,067.75 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225288632,"HUGELMEYER, ALEXIS",117 E KINGS HWY   EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225288632,"HUGELMEYER, ALEXIS",117 E KINGS HWY   EDEN NC,079,Rockingham,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1225288632,"HUGELMEYER, ALEXIS",117 E KINGS HWY   EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1225288632,"HUGELMEYER, ALEXIS",117 E KINGS HWY   EDEN NC,079,Rockingham,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225288632,"HUGELMEYER, ALEXIS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,5211 EASON ST STE 1 SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1225289952,"PITALE, SEAN",5211 EASON ST STE 1 SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225289952,"PITALE, SEAN",5211 EASON ST STE 1 SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225289952,"PITALE, SEAN",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 17 , 35 ,$#,,
MEDICAID DIRECT,1225289952,"PITALE, SEAN",~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1225289952,"PITALE, SEAN",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1225290380,"RAFIEI, POYAN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225290380,"RAFIEI, POYAN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1225290752,"GAY, ANDRE, NICOLAS",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1225290752,"GAY, ANDRE, NICOLAS",35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1225290752,"GAY, ANDRE, NICOLAS",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225290786,"PATIL, AJAY, ARUN",349 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 33 , 39 , 52 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225290786,"PATIL, AJAY, ARUN",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225290786,"PATIL, AJAY, ARUN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 16 , 17 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225290786,"PATIL, AJAY, ARUN",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1225291479,"PATEL, NIRLEP, ASHOK",NIRLEP A PATEL,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1225291479,"PATEL, NIRLEP, ASHOK",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225294275,"BAKER, EMILY, SIGMON",4601 PARK RD STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225294580,"STEARNS-PARR, GILLIAN, LIND",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225294580,"STEARNS-PARR, GILLIAN, LIND",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 17 , 22 ,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225294580,"STEARNS-PARR, GILLIAN, LIND",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225294580,"STEARNS-PARR, GILLIAN, LIND",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 60 , 122 , 208 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225294580,"STEARNS-PARR, GILLIAN, LIND",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 23 , 32 , 46 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225294580,"STEARNS-PARR, GILLIAN, LIND",1023 EDGEHILL RD S   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 47 , 89 , 116 ,$#,,
MEDICAID DIRECT,1356880801,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225294580,"STEARNS-PARR, GILLIAN, LIND",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1609833490,CARTERET CLINIC FOR ADOLESCENTS AND,CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN,312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1225295579,"ROWE, LORELI, LEE",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 14 , 41 ,$#,,
MEDICAID DIRECT,1043765183,KIDZCARE PEDIATRICS PC,,609 ATTAIN ST STE 181 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1225296510,"YATSENKO, NATALIYA, VOLODIMIRIVNA",609 ATTAIN ST STE 181 FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225296825,"COCKFIELD, WILLIAM, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 32 , 67 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,208 COX BLVD STE 201 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1225296999,"EHLERT, BRYAN, ALLEN",208 COX BLVD STE 201 GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 202 , 394 , 525 ," $25,325.62 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1225296999,"EHLERT, BRYAN, ALLEN",208 COX BLVD STE 201 GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225296999,"EHLERT, BRYAN, ALLEN",208 COX BLVD STE 201 GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 69 , 131 , 192 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225298490,"SHAHID, NAUMAN",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 69 , 120 , 283 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225298490,"SHAHID, NAUMAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 49 , 80 , 80 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225298490,"SHAHID, NAUMAN",510 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225298490,"SHAHID, NAUMAN",101 CLINIC DR   TARBORO NC,033,Edgecombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 117 , 117 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225298490,"SHAHID, NAUMAN",121 N CHURCH ST   CONWAY NC,066,Northampton,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225298490,"SHAHID, NAUMAN",612 MAIN ST   SCOTLAND NECK NC,042,Halifax,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225299746,"MCWILLIAMS, ANDREW, DAVID",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 65 , 65 ,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225299829,"BOWMAN, KEVIN, MICHAEL",34 HEALTHPARK WAY STE 102 CLAYTON NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225299829,"BOWMAN, KEVIN, MICHAEL",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 58 , 80 ,$#,,
MEDICAID DIRECT,1225300270,"ROSS, WILLIAM, ALEXANDER",ROSS DENTAL AND ASSOCIATES,1212 FREEWAY DR   REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1225300270,"ROSS, WILLIAM, ALEXANDER",1212 FREEWAY DR   REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 28 , 61 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225302961,"PREZIOSO, LINDA, LANG",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 44 , 56 ,$#,,
MEDICAID DIRECT,1962097626,BREECHES BUOY ADDICTION MEDICINE,~,300 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1225303746,"JACOBS, ALLISON, LOCKLEAR",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225304082,"GODFREY, JED, BRATTEN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225304082,"GODFREY, JED, BRATTEN",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225304504,"DANESHPAYEH, NEGIN",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1912270109,MOSES CONE AFFILIATED PHYSICIANS IN,~,1313 CAROLINA ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225304553,"ZAMORA, BRIAN, GRUEZO",1313 CAROLINA ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 74 , 306 , 978 ," $97,148.57 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225304793,"FLOOD, ADA, VANESSA",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 34 , 40 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1225304793,"FLOOD, ADA, VANESSA",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 40 , 49 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1225304793,"FLOOD, ADA, VANESSA",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225307549,"GREENE, TIFFANY, GAIL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 52 , 90 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,111 GATEWAY CENTER DR   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225307549,"GREENE, TIFFANY, GAIL",111 GATEWAY CENTER DR   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1225309594,"EASTER, ROBERT, SHANE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1225310774,"SHIELDS, RACHEL, AUDREY",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225311525,"PHARES, KATHRYN, WELDON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225312143,"TRAYNOR, MARY, MAGUIRE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225312192,"VIERELA, ANNE, MARIE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1225312192,"VIERELA, ANNE, MARIE",381 DEERFIELD RD   BOONE NC,095,Watauga,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1225312937,"SASS, ERIK, JAMES",923 N 2ND ST STE 204 ALBEMARLE NC,084,Stanly,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225312937,"SASS, ERIK, JAMES",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225312937,"SASS, ERIK, JAMES",441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1225312937,"SASS, ERIK, JAMES",441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1225312937,"SASS, ERIK, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225312937,"SASS, ERIK, JAMES",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 115 , 136 , 144 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225312937,"SASS, ERIK, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 46 , 88 , 96 ,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225316060,"GROVE, LATANE, HURDLE",3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 13 , 32 ,$#,,
MEDICAID DIRECT,1639697790,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225316060,"GROVE, LATANE, HURDLE",2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1235511536,SEASHORE EYE ASSOCIATES OD PLLC,,1612 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225316854,"STEPHENSON, JESSICA, LE",3910 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1225317175,"COWHERD, SAMUEL, NELSON",SAMUEL NELSON COWHERD,4136 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1225317175,"COWHERD, SAMUEL, NELSON",4136 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 931 ," 1,512 "," 5,707 "," $293,723.49 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225317274,"MILLER, WILLIAM, ERIC",1517 N HOWE ST STE 4 SOUTHPORT NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225318272,"HAWLEY, CATHERINE, RYAN",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 86 , 144 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,101 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1604 MEDICAL DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,703 COMFORT LN   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 35 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,9848 N TRYON ST STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 47 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1225318827,"LAM, KHOA, VU DANG",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1225320039,"NAIR, ASHA, GOPALAN",725 WELCH RD WELCH PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194707901,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225320666,"LAZAR, DAVID, LAWRENCE",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1407350465,ROTH & POWELL III DDS PA,~,3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225321995,"POWELL, CHRISTOPHER, TAYLOR",301 GLENWOOD AVE STE 210 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 76 , 101 , 242 ," $18,967.50 ",,
MEDICAID DIRECT,1245779123,ROTH POWELL & MANN DDS PA,~,301 GLENWOOD AVE STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225321995,"POWELL, CHRISTOPHER, TAYLOR",301 GLENWOOD AVE STE 210 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 191 , 352 ," 1,339 "," $62,256.74 ",,
MEDICAID DIRECT,1174197297,ROTH & POWELL IV DDS PA,CAROLINA DENTAL ARTS DURHAM,415 DUNSTAN AVE   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1225321995,"POWELL, CHRISTOPHER, TAYLOR",301 GLENWOOD AVE STE 210 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 526 , 857 ," 3,877 "," $266,591.54 ",,
MEDICAID DIRECT,1174197297,ROTH & POWELL IV DDS PA,CAROLINA DENTAL ARTS DURHAM,415 DUNSTAN AVE   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225321995,"POWELL, CHRISTOPHER, TAYLOR",301 GLENWOOD AVE STE 210 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 18 , 53 ,$#,,
MEDICAID DIRECT,1386928083,KYLE J ROTH III DDS PA,CAROLINA DENTAL OF GOLDSBORO,2720 GRAVES DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1225321995,"POWELL, CHRISTOPHER, TAYLOR",301 GLENWOOD AVE STE 210 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 298 , 532 ," 1,639 "," $92,266.07 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225324890,"LEONARD, ROBERT, ADAM",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 50 , 50 , 50 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225324890,"LEONARD, ROBERT, ADAM",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225324890,"LEONARD, ROBERT, ADAM",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225325202,"TEEL, NICKOLE, RUCKER",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225327414,"FARBER, FAYE, RACHEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 96 , 101 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225329816,"ROSS, SAMUEL, WADE",101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225329816,"ROSS, SAMUEL, WADE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225329816,"ROSS, SAMUEL, WADE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225329816,"ROSS, SAMUEL, WADE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225329816,"ROSS, SAMUEL, WADE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 39 , 108 , 118 ," $14,820.17 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225334030,"MIX, PAULA, ANNE",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225334030,"MIX, PAULA, ANNE",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225336993,"JOHNSON, KEVIN, SCOTT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,941 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225339518,"BEIERSCHMITT, KEAN, TIMOTHY",702 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225339518,"BEIERSCHMITT, KEAN, TIMOTHY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 16 , 41 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225339518,"BEIERSCHMITT, KEAN, TIMOTHY",702 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 81 , 202 ,$#,,
MEDICAID DIRECT,1346626587,FORSYTH COUNTY,~,501 N CLEVELAND AVE STE 1 WINSTON SALEM NC,034,Forsyth,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1225342017,"STANTON, KATHLEEN, ADELLE MOREY",501 N CLEVELAND AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 757 ," 1,693 "," 4,503 "," $231,581.55 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225344534,"FLIPPING, ERICKA, ANGEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 148 , 188 , 188 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225346851,"TODD, HEATHER, KRISTEN",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 182 , 373 , 586 ,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225347958,"HENSON, WILLIAM, CHADWICK",1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225347958,"HENSON, WILLIAM, CHADWICK",327 HILLSBOROUGH ST   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225352743,"HERNANDEZ-SORIA, ALEXIA",7850 BRIER CREEK PKWY STE AND300 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1225352743,"HERNANDEZ-SORIA, ALEXIA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225352743,"HERNANDEZ-SORIA, ALEXIA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1225352743,"HERNANDEZ-SORIA, ALEXIA",7810 NC HIGHWAY 751 STE 150 DURHAM NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225352743,"HERNANDEZ-SORIA, ALEXIA",7810 NC HIGHWAY 751 STE 150 DURHAM NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225352743,"HERNANDEZ-SORIA, ALEXIA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 25 , 41 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1225352743,"HERNANDEZ-SORIA, ALEXIA",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 29 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 42 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 75 , 90 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 24 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 93 , 99 , 115 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225352982,"TAILOR, TINA, DINESH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225353162,"CHU, ERIC, CHIANE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 72 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225353295,"KAYE, DEBORAH, REBECCA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225353295,"KAYE, DEBORAH, REBECCA",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 18 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225353295,"KAYE, DEBORAH, REBECCA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225353295,"KAYE, DEBORAH, REBECCA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1225353311,"DOLAN, KAREN, LOUISE",137 MOUNT CALVARY RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1225353311,"DOLAN, KAREN, LOUISE",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1225353311,"DOLAN, KAREN, LOUISE",434 KIRBY RD   KING NC,085,Stokes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225353311,"DOLAN, KAREN, LOUISE",434 KIRBY RD   KING NC,085,Stokes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1659307270,LINCOLN INTERNAL MEDICINE PA,LINCOLN INTERNAL MEDICINE PA,607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225353477,"MEYER, DAVID, STEPHEN",607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 320 , 364 ," $10,722.41 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225353626,"GUPTA, DIVAKAR",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 31 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225353626,"GUPTA, DIVAKAR",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 49 , 102 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225353626,"GUPTA, DIVAKAR",3300 EXECUTIVE DR   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225353626,"GUPTA, DIVAKAR",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 43 , 93 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225354301,"CARTOSKI, JESSICA, GRACE",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225354301,"CARTOSKI, JESSICA, GRACE",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225354301,"CARTOSKI, JESSICA, GRACE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225357098,"GALGANO, MICHAEL, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 20 , 25 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225357098,"GALGANO, MICHAEL, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 40 , 50 , 59 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225357098,"GALGANO, MICHAEL, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 15 , 20 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225357098,"GALGANO, MICHAEL, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 17 , 19 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225357825,"MARTINI, JENNIFER, MARIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 94 , 152 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225357825,"MARTINI, JENNIFER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 22 , 31 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225357957,"KIRBY, HAYDEN, PAPPAS",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225357957,"KIRBY, HAYDEN, PAPPAS",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225357957,"KIRBY, HAYDEN, PAPPAS",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1225357957,"KIRBY, HAYDEN, PAPPAS",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1225357957,"KIRBY, HAYDEN, PAPPAS",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225357957,"KIRBY, HAYDEN, PAPPAS",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 36 , 38 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225358237,"COORE, HUNTER, ALLEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 310 , 524 , 663 ," $12,882.88 ",,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 118 , 184 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225358237,"COORE, HUNTER, ALLEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225358484,"BELLAMY, LINDSEY, MARIA",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225358484,"BELLAMY, LINDSEY, MARIA",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1225359243,"DRAY, ELIZABETH, VAN HUFFEL",50 HOSPITAL DR STE 2A HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1225359243,"DRAY, ELIZABETH, VAN HUFFEL",50 HOSPITAL DR STE 2A HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1225359300,SHORE HOME CARE AGENCY INC,SHORE HOME CARE AGENCY INC,1386 WESTGATE CENTER DR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1225359300,SHORE HOME CARE AGENCY INC,1386 WESTGATE CENTER DR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 8,958 "," 8,958 "," $881,169.38 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 22 , 31 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 94 , 149 , 187 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 52 , 65 , 78 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 23 , 39 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225359920,"MCKENZIE, PATRICK, LEE",1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225360290,"SPENCER, VICTORIA, LYNNETTE SMITH",1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1427282045,SOUTHEASTERN REGIONAL PHYSICIAN SER,~,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225366453,"PRIEST, ALLISON, MILLER",9948 S WR LATHAM ST   CLARKTON NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1043759335,BLADEN HEALTHCARE LLC,~,9858 WR LATHAN DR   CLARKTON NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225366453,"PRIEST, ALLISON, MILLER",9948 S WR LATHAM ST   CLARKTON NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 219 , 231 ,$#,,
MEDICAID DIRECT,1114269677,BLADEN HEALTHCARE LLC,BLADEN EXPRESS CARE,107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225366453,"PRIEST, ALLISON, MILLER",107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205105491,THE CENTER FOR RURAL HEALTH INNOVAT,THE CENTER FOR RURAL HEALTH INNOVATION,167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1225366461,"STOFFER, KASSANDRA, JOYCE",167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558812594,ST LUKES HOSPITAL INC,FOOTHILLS MEDICAL ASSOCIATES,130 FOREST GLEN RD STE B COLUMBUS NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225367121,"KNOLHOFF, JOSH, BRUCE",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225368483,"BABISH, MATTHEW, SCOTT",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225368483,"BABISH, MATTHEW, SCOTT",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1225368483,"BABISH, MATTHEW, SCOTT",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 35 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225368483,"BABISH, MATTHEW, SCOTT",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 99 , 197 ,$#,,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225370216,"PHAIR, YONESHA, VAL",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice, 140 , 174 , 571 ," $22,620.15 ",,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225370216,"PHAIR, YONESHA, VAL",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice, 150 , 155 , 541 ," $20,367.40 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225370471,"AHMED, IMTIAZ",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164493615,COMMUNITY FAMILY PRACTICE PA,,260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225370646,"MAHOWALD, EMILY, LAUREL",260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164493615,COMMUNITY FAMILY PRACTICE PA,,260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1225370646,"MAHOWALD, EMILY, LAUREL",260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 66 , 149 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225370745,"KOCZELA, EDYTA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 33 , 34 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225371388,"FEDERSPIEL, MARY, CLAYTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 72 , 126 , 141 ," $10,436.81 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225373269,"LAMPILA, BEVERLY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225374952,WP-HENDERSONVILLE HEALTH HOLDINGS L,CHERRY SPRINGS VILLAGE,358 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225374952,WP-HENDERSONVILLE HEALTH HOLDINGS L,358 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 33 ," 8,319 "," 8,319 "," $657,254.94 ",,
MEDICAID DIRECT,1225374952,WP-HENDERSONVILLE HEALTH HOLDINGS L,CHERRY SPRINGS VILLAGE,358 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1225374952,WP-HENDERSONVILLE HEALTH HOLDINGS L,358 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 19 , 95 , 95 ,$#,,
MEDICAID DIRECT,1164500575,CHILDRENS HEALTH SERVICES PA,~,1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225376007,"EIBAN, MEREDITH, WRIGHT",1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 27 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225376007,"EIBAN, MEREDITH, WRIGHT",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225378011,"CHOI, HOWARD, WONYOONG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 80 , 91 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 21 ,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225387830,"PATEL, NISHA, JASHVANTKUMAR",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225390701,"STEVENS, NORMAN, BRADFORD",,701 GROVE RD STE 212 GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1225390701,"STEVENS, NORMAN, BRADFORD",701 GROVE RD STE 212 GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225390701,"STEVENS, NORMAN, BRADFORD",,701 GROVE RD STE 212 GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1225390701,"STEVENS, NORMAN, BRADFORD",701 GROVE RD STE 212 GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225390701,"STEVENS, NORMAN, BRADFORD",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 39 , 58 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 34 , 47 ,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 33 , 47 , 55 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1225390834,"MARGO, JORDAN, AMBROSE",40 E MEDICAL CT   MARION NC,059,McDowell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 39 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225391469,"MEHDIRATTA, JENNIFER, EUNA",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225391469,"MEHDIRATTA, JENNIFER, EUNA",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225391469,"MEHDIRATTA, JENNIFER, EUNA",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 41 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225391469,"MEHDIRATTA, JENNIFER, EUNA",2301 ERWIN ROAD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225392186,"RODBY, KATHERINE, ANNE",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225392186,"RODBY, KATHERINE, ANNE",55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225392186,"RODBY, KATHERINE, ANNE",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225392954,"ARNOLD, DYLAN, CAHILL",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225396336,"BURTON, CHRISTINA, RITTER",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 174 , 181 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1225396336,"BURTON, CHRISTINA, RITTER",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 547 , 571 ," $11,601.63 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225396690,"JACKSON, WESLEY, MATTHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1225397516,"PADGETT, SHAYLAR, PATRICIA",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 13 , 23 , 29 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225397516,"PADGETT, SHAYLAR, PATRICIA",400 N ELM ST   HIGH POINT NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 102 , 189 , 229 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225397516,"PADGETT, SHAYLAR, PATRICIA",104 E NORTHWOOD ST   GREENSBORO NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1225397516,"PADGETT, SHAYLAR, PATRICIA",400 N ELM ST   HIGH POINT NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1730407131,ARMC PHYSICIANS CARE INC,ALAMANCE REGIONAL PSYCHIATRIC ASSOCIATES,1236 HUFFMAN MILL RD STE 1500 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225397987,"EAPPEN, SARAMMA",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225397987,"EAPPEN, SARAMMA",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1730407131,ARMC PHYSICIANS CARE INC,ALAMANCE REGIONAL PSYCHIATRIC ASSOCIATES,1225 HUFFMAN MILL RD STE 205 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225397987,"EAPPEN, SARAMMA",1225 HUFFMAN MILL RD STE 202 BURLINGTON NC,001,Alamance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1730407131,ARMC PHYSICIANS CARE INC,ALAMANCE REGIONAL PSYCHIATRIC ASSOCIATES,,,Unknown,193200000X,Group,Multi-Specialty,,1225397987,"EAPPEN, SARAMMA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 11 ,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225398068,"MCEACHERN, MORGAN, ASHLEY",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 81 , 115 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225398068,"MCEACHERN, MORGAN, ASHLEY",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225398068,"MCEACHERN, MORGAN, ASHLEY",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225398068,"MCEACHERN, MORGAN, ASHLEY",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225398803,"FLYNN, DAVID, NEILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225398803,"FLYNN, DAVID, NEILSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225398803,"FLYNN, DAVID, NEILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225398803,"FLYNN, DAVID, NEILSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225398803,"FLYNN, DAVID, NEILSON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225398803,"FLYNN, DAVID, NEILSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225398803,"FLYNN, DAVID, NEILSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225398803,"FLYNN, DAVID, NEILSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225398803,"FLYNN, DAVID, NEILSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225398803,"FLYNN, DAVID, NEILSON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1225399397,CAROLINA EYE CARE ON MERRIMON OD PA,CAROLINA EYE CARE ON MERRIMON OD PA,825 MERRIMON AVE STE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225399397,CAROLINA EYE CARE ON MERRIMON OD PA,825 MERRIMON AVE STE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,, 17 , 17 , 33 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225399728,"HUNDLEY, JILLIAN, MICHELLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225399892,"CARTER, WILLIAM RANDALL, ADAM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 103 , 109 , 124 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225400716,"GODWIN, CHASITY, HILLLIARD",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 35 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 352 , 352 ," $14,221.53 ",,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225404635,"MARSICO, ROBERTO, ANTONIO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225408461,"WRIGHT, JACKSON, DAVIS",2721 X RAY DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 105 , 217 , 257 ," $19,293.70 ",,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225408461,"WRIGHT, JACKSON, DAVIS",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225408859,"YILMAZ, FURKAN, MUHAMMET",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225408859,"YILMAZ, FURKAN, MUHAMMET",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225408859,"YILMAZ, FURKAN, MUHAMMET",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 16 , 22 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225408859,"YILMAZ, FURKAN, MUHAMMET",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225408859,"YILMAZ, FURKAN, MUHAMMET",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225409485,"DECKER, ANTONIA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 43 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225409485,"DECKER, ANTONIA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225409485,"DECKER, ANTONIA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 27 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225409527,"SHIERTS, CYNTHIA, DEMAO",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225411457,"SIMMONS, MARK, ALAN",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225411556,"MALLINGER, WESLEY, DANIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225411556,"MALLINGER, WESLEY, DANIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 49 , 36 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225411556,"MALLINGER, WESLEY, DANIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225411556,"MALLINGER, WESLEY, DANIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225411556,"MALLINGER, WESLEY, DANIEL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225411556,"MALLINGER, WESLEY, DANIEL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 84 , 79 , 140 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225411762,"HOFFMANN, ZACHARY, SAMUEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225411838,"MAJEED, FAISAL",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 46 , 48 ,$#,,
MEDICAID DIRECT,1225412562,PANTHER HEALTH LLC,CANNON PHARMACY MOORESVILLE,521 E PLAZA DR   MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1225412562,PANTHER HEALTH LLC,521 E PLAZA DR   MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225412778,"CHRISCOE, LAUREN, BAILEY",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225412778,"CHRISCOE, LAUREN, BAILEY",205 PAGE RD   PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 42 , 195 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1225413990,"WALKER, ERIN, LINDSEY-DAY",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 22 , 44 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1225413990,"WALKER, ERIN, LINDSEY-DAY",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1225413990,"WALKER, ERIN, LINDSEY-DAY",612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1225413990,"WALKER, ERIN, LINDSEY-DAY",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1225413990,"WALKER, ERIN, LINDSEY-DAY",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1225415367,"MURRAY, COLLYN, TAMSEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225415367,"MURRAY, COLLYN, TAMSEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 46 , 49 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225418239,"HAULSEE, ZACHARY, MERLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225418239,"HAULSEE, ZACHARY, MERLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 42 , 151 , 151 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225418239,"HAULSEE, ZACHARY, MERLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1649525619,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHILAND FAMILY MEDICINE,1935 HOLBROOK RD STE 1100 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225418676,"SILVERTON, TRICIA, PATRICE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225418676,"SILVERTON, TRICIA, PATRICE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225418734,"EASAW, SAUMYA MARIAM",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225418734,"EASAW, SAUMYA MARIAM",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225418734,"EASAW, SAUMYA MARIAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225418734,"EASAW, SAUMYA MARIAM",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225419252,"WESTON, BENJAMIN, WELLS",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225419633,"WALL, LAUREN, ELIZABETH",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225419633,"WALL, LAUREN, ELIZABETH",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225419633,"WALL, LAUREN, ELIZABETH",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1225419633,"WALL, LAUREN, ELIZABETH",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023773751,TANYA RAJDEV DDS PLLC,ALLAY DENTAL GROUP,229 BRIARCLIFF DR STE C AND D CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1225419856,"RAJDEV, TANYA",229 BRIARCLIFF DR STE CANDD CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 132 , 226 , 925 ," $45,044.87 ",,
MEDICAID DIRECT,1023773751,TANYA RAJDEV DDS PLLC,ALLAY DENTAL GROUP,229 BRIARCLIFF DR STE C AND D CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1225419856,"RAJDEV, TANYA",229 BRIARCLIFF DR STE CANDD CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 24 , 112 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225421902,"SEMKOW, NISA, ITA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225422363,"CHUMAKOVA-ORIN, MARYNA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225422363,"CHUMAKOVA-ORIN, MARYNA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 52 , 64 , 66 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225422363,"CHUMAKOVA-ORIN, MARYNA",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225423254,"CHUNG, SO, YEON",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 27 , 45 ,$#,,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225423809,"HAM, JEFFREY, CHARLES",447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225423809,"HAM, JEFFREY, CHARLES",447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225423809,"HAM, JEFFREY, CHARLES",447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 30 , 62 , 94 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225423809,"HAM, JEFFREY, CHARLES",447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225423809,"HAM, JEFFREY, CHARLES",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 38 , 67 , 105 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225423809,"HAM, JEFFREY, CHARLES",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225424476,"HAN, JAMES, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 40 , 130 , 147 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1225424476,"HAN, JAMES, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225425317,"DEPENAFERNANDEZ, JULIO, EDUARDO",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 55 , 101 ,$#,,
MEDICAID DIRECT,1386960342,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225425317,"DEPENAFERNANDEZ, JULIO, EDUARDO",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 107 , 163 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225425317,"DEPENAFERNANDEZ, JULIO, EDUARDO",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 20 , 41 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225425572,"REGISTER, STEVEN, LANCE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 99 , 99 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225425572,"REGISTER, STEVEN, LANCE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801843925,ARTHRITIS AND OSTEOPOROSIS CONSULTA,ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CARO,1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225432735,"LISTON, LAURA, MARIE",1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 47 , 101 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225433311,"HARRISON, ALISON, DENISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 48 , 48 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225433311,"HARRISON, ALISON, DENISE",1550 FAULK ST   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225439128,"VAUGHT, LORI, WALKER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225439128,"VAUGHT, LORI, WALKER",447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225439128,"VAUGHT, LORI, WALKER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225441074,"QUILTER-CARR, KATY, ROSE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225441074,"QUILTER-CARR, KATY, ROSE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL OAK ISLAND,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225441785,"STRICKLAND, LAURA, CAITLIN",4700 E OAK ISLAND DR   OAK ISLAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL OAK ISLAND,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225441785,"STRICKLAND, LAURA, CAITLIN",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225442064,"FEEMAN, ASHLEY, GREESON",131 PROVIDENCE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1063739274,PREMIER FAMILY EYE CARE,PREMIER FAMILY EYE CARE,6044 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1225442767,"MACK, TIMOTHY, DANIEL",6044 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 17 , 26 ,$#,,
MEDICAID DIRECT,1063739274,PREMIER FAMILY EYE CARE,PREMIER FAMILY EYE CARE,6044 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1225442767,"MACK, TIMOTHY, DANIEL",6044 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225444847,"PEREKLITA, ALLISON, GILBOY",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225444847,"PEREKLITA, ALLISON, GILBOY",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 29 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225444847,"PEREKLITA, ALLISON, GILBOY",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1316023443,HIGGINS MANI & WATSON IV DDS PA,THE DENTAL CARE CENTER,545 VENTURE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1225445786,"BOC, JESSICA, KEREN",545 VENTURE DR   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023784022,KIM M POWER DDS PLLC,SMITHFIELD FAMILY DENTISTRY,910 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1225445786,"BOC, JESSICA, KEREN",910 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 675 , 983 ," 4,065 "," $216,958.00 ",,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1225445836,"JOHNSON, SHELBY, RHYS",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1225445836,"JOHNSON, SHELBY, RHYS",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225445836,"JOHNSON, SHELBY, RHYS",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225445836,"JOHNSON, SHELBY, RHYS",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1225445836,"JOHNSON, SHELBY, RHYS",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225445836,"JOHNSON, SHELBY, RHYS",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811041700,LANE AND ASSOCIATES XII DDS PA,LANE AND ASSOCIATES XII DDS PA,4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225446834,"DESAI, KRUTIBEN, YOGESHBHAI",8961 HARVEST OAKS DR   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 38 , 117 ,$#,,
MEDICAID DIRECT,1225447980,MEDPARTNERS CORP,,450 AIRPORT RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1225447980,MEDPARTNERS CORP,450 AIRPORT RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 272 ," 2,640 "," 2,653 "," $494,951.50 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225449069,"DONG, JUNLING",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 22 , 55 , 91 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225449069,"DONG, JUNLING",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225449200,"WEAVER, CHRISTIAN, DANIEL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225449200,"WEAVER, CHRISTIAN, DANIEL",825 FAIRFAX AVE # 4 NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225450059,"MCBRYDE, BRANDY, LEAH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225450059,"MCBRYDE, BRANDY, LEAH",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1225450059,"MCBRYDE, BRANDY, LEAH",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225450059,"MCBRYDE, BRANDY, LEAH",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225450059,"MCBRYDE, BRANDY, LEAH",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225453566,"CORSINO, CARLIN, BRUCE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1225453566,"CORSINO, CARLIN, BRUCE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 26 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225453566,"CORSINO, CARLIN, BRUCE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 52 , 72 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225453566,"CORSINO, CARLIN, BRUCE",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1225453566,"CORSINO, CARLIN, BRUCE",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225453566,"CORSINO, CARLIN, BRUCE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1225453566,"CORSINO, CARLIN, BRUCE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 26 , 32 ,$#,,
MEDICAID DIRECT,1770506149,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF TAR HEEL,16526 NC HIGHWAY 87 W   TAR HEEL NC,009,Bladen,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225454689,"MCCASKILL-GAINEY, TENESA, YASHICA SHEVON",906 N US HIGHWAY 421   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225455397,"BERICH, VANESSA, LEIGH",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225458599,"OWUSU, RICHMOND, ADUSEI",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 58 , 99 , 113 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225458599,"OWUSU, RICHMOND, ADUSEI",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 124 , 170 , 229 ,$#,,
MEDICAID DIRECT,1902614464,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY UROLOGY,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225458599,"OWUSU, RICHMOND, ADUSEI",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 45 , 53 , 55 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1225459134,"TURNER, KACI, MICHELLE",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 19 , 21 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1225459134,"TURNER, KACI, MICHELLE",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225459605,PEDIATRIC THERAPY NETWORK,,1040 SOUTHGATE CORPORATE PARK SW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225459605,PEDIATRIC THERAPY NETWORK,1040 SOUTHGATE CORPORATE PARK SW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,, 205 ," 2,357 "," 3,331 "," $229,855.99 ",,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225464126,"HARKEY, LEE MARIE, DAVIS",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 84 , 337 , 543 ,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1225464126,"HARKEY, LEE MARIE, DAVIS",440 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 61 , 68 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225465297,"GRAY, GEORGIA, LEIGH",1801 S 17TH STREET   WILMINTON NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225465297,"GRAY, GEORGIA, LEIGH",1801 S 17TH STREET   WILMINTON NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225465297,"GRAY, GEORGIA, LEIGH",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225467707,"CARDEN, BARBARA, H",4515 PREMIER DR STE 401 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 22 , 37 ,$#,,
MEDICAID DIRECT,1225467764,ANEW ME LLC,,2360 SPRINGS RD NE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1225467764,ANEW ME LLC,2360 SPRINGS RD NE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1437146800,COASTAL INTERNAL MEDICINE PA,~,2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225468119,"LAVOIE, BRYAN, JOSEPH",2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 314 , 471 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225471162,"HODGES, MAGGIE, MCQUEEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 63 , 69 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 35 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225471543,"TEE, ANDREW, RICHARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225474588,"LEE, JAY, SOONG-JIN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225474588,"LEE, JAY, SOONG-JIN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225474588,"LEE, JAY, SOONG-JIN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225474588,"LEE, JAY, SOONG-JIN",2400 PRATT ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225474588,"LEE, JAY, SOONG-JIN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225476120,"ALEXANDER, NATALIE, MARYA",102 POMONA DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 144 , 144 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225476609,"PETERS, ROBERT, DANIEL",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225476609,"PETERS, ROBERT, DANIEL",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225476609,"PETERS, ROBERT, DANIEL",835 WAKE FOREST BUSINESS PARK STE B WAKE FOREST NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225476609,"PETERS, ROBERT, DANIEL",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 28 , 35 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225476609,"PETERS, ROBERT, DANIEL",300 HEALTH PARK DR STE 210 GARNER NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225479520,"SMITH, BRANDON, WAYNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225479520,"SMITH, BRANDON, WAYNE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225479520,"SMITH, BRANDON, WAYNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225479520,"SMITH, BRANDON, WAYNE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225479520,"SMITH, BRANDON, WAYNE",1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 31 , 41 , 46 ,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1225479942,"KRUPINSKI, CATHERN, NICOLE",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225479942,"KRUPINSKI, CATHERN, NICOLE",1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,14544 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1225479942,"KRUPINSKI, CATHERN, NICOLE",14544 US HWY 17   HAMPSTEAD NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,13068 NC HIGHWAY 50   SURF CITY NC,071,Pender,193400000X,Group,Single Specialty,,1225479942,"KRUPINSKI, CATHERN, NICOLE",13068 NC HIGHWAY 50   SURF CITY NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 633 ," 1,231 "," 3,947 "," $189,315.60 ",,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",110 W GROVER ST   SHELBY NC,023,Cleveland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",335A W COLLEGE AVE   SHELBY NC,023,Cleveland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 26 , 33 , 51 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",110 W GROVER ST   SHELBY NC,023,Cleveland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",110 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",110 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1225480361,"JUSTICE, AMBER, JADE",335A W COLLEGE AVE   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 20 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225480445,"MCGRATH, JESSA, NICOLE",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225480445,"MCGRATH, JESSA, NICOLE",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225480445,"MCGRATH, JESSA, NICOLE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225481187,"BOYLE, TAYLOR, ANN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225482581,"KOSARAJU, ATEET",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 47 , 72 , 119 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1225482581,"KOSARAJU, ATEET",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 45 , 66 , 104 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 15 , 23 , 29 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 159 , 244 , 263 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225483084,"DOERR, PATRICIA, COWLEY",623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#, 16 ,$#,,
MEDICAID DIRECT,1881305605,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE AND OBSTETRICS,680 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1225484553,"ARBOLEDA, MEGAN, ABIGAIL",680 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 92 , 166 ,$#,,
MEDICAID DIRECT,1215314778,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM WOMENS CENTER,150 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1225484553,"ARBOLEDA, MEGAN, ABIGAIL",150 PARKWOOD DR   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225484603,"MORRISON, DANIEL, RHODES",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 82 , 120 , 162 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225485964,"KANNAN, KAVYA, KANNAMMA",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 18 , 21 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225485964,"KANNAN, KAVYA, KANNAMMA",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 55 , 76 , 127 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225485964,"KANNAN, KAVYA, KANNAMMA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225485964,"KANNAN, KAVYA, KANNAMMA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225486517,"FAY, LAUREN, LINDIGRIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225486806,"ROPER, CHANEL, BONDS",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225486806,"ROPER, CHANEL, BONDS",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 28 , 42 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,519 NAUTICAL DR STE 100C CLOVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225486806,"ROPER, CHANEL, BONDS",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1538783915,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE PSYCHIATRIC SPECIALISTS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225487390,"CHEN, JIMMY, BEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1225489875,"PROBST, JAMISON, CORY",,1170 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,1225489875,"PROBST, JAMISON, CORY",1170 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 43 , 103 , 250 ," $11,780.37 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225491020,"HOWELL, JOSHUA, ROBERT",600 HOSPITAL DR   MONROE NC,090,Union,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 52 , 56 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225491061,"JOHNSON, COURTNEY, MARIE",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225491319,"ROMERO, ADRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1225491319,"ROMERO, ADRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225491376,"LEE, ALEXANDRA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225491376,"LEE, ALEXANDRA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 52 , 52 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225491376,"LEE, ALEXANDRA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 111 , 111 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225491657,"PARSHALL, DEREK, MICHAEL",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 29 , 45 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225491657,"PARSHALL, DEREK, MICHAEL",134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518570761,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225491657,"PARSHALL, DEREK, MICHAEL",1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1578176723,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225491657,"PARSHALL, DEREK, MICHAEL",134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225492689,"REDDY, TANYA, LUKE",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1225492788,"HARNOIS, ROSANNE",545 E MARKET ST   SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225492788,"HARNOIS, ROSANNE",545 E MARKET ST   SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1225492788,"HARNOIS, ROSANNE",55 E MALIBU DR   GARNER NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225492788,"HARNOIS, ROSANNE",545 E MARKET ST   SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 24 , 25 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225492788,"HARNOIS, ROSANNE",55 E MALIBU DR   GARNER NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225492788,"HARNOIS, ROSANNE",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225492788,"HARNOIS, ROSANNE",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639698533,RALEIGH SEDATION ASSOCIATES LLC,,2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225494891,"EMBERTON, NICOLE, LYNN",2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1225494891,"EMBERTON, NICOLE, LYNN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225496896,"CISZEK, CHRISTINE, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225496896,"CISZEK, CHRISTINE, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225496896,"CISZEK, CHRISTINE, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225496896,"CISZEK, CHRISTINE, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225496987,"SPIVEY, DUSTIN, ROSSER",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225497118,"SCHMID, KAITLYN, BARGER",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 49 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225497118,"SCHMID, KAITLYN, BARGER",800 W MEETING ST   LANCASTER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1225499445,"COLE, JACOB, HENRY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225499635,"CROSS, BRIDGETTE, MARQUITA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225499635,"CROSS, BRIDGETTE, MARQUITA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1225500804,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,170 CHURCH ST   FRANKLIN NC,056,Macon,251B00000X,Agencies,Case Management,,1225500804,CAREPARTNERS HHA LLLP,170 CHURCH ST   FRANKLIN NC,056,Macon,251B00000X,Agencies,Case Management,, 46 , 270 , 270 ," $101,017.75 ",,
MEDICAID DIRECT,1659495133,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225501927,"BOLES, MADISON, HANCOCK",4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225507619,"WOLFE, DENISE, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225507619,"WOLFE, DENISE, ANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225515257,SPEECH BY THE BEACH INC,,2126 HIGHWAY 9 E STE C4 LONGS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225515257,SPEECH BY THE BEACH INC,2126 HIGHWAY 9 E STE C4 LONGS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1225515547,CAROLINA PHYSICAL THERAPY ASSOCIATE,~,9660 FALLS OF NEUSE RD STE 167 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225515547,CAROLINA PHYSICAL THERAPY ASSOCIATE,9660 FALLS OF NEUSE RD STE 167 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1225519291,"JOHNSON, BRANDON, WARREN",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 47 , 47 ,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1225519291,"JOHNSON, BRANDON, WARREN",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225519739,"THOMPSON, GWENNAELLE, MENNEAR",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225519739,"THOMPSON, GWENNAELLE, MENNEAR",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1720011729,COUNTY OF RANDOLPH,RANDOLPH COUNTY HEALTH DEPARTMENT,2222 S FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1225522592,"WILSON, ASHLEY, HUMBLE",2222 S FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225522758,"FREEMAN, KYLA, RAE",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 28 , 44 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225522758,"FREEMAN, KYLA, RAE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225522758,"FREEMAN, KYLA, RAE",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225524978,"ALIE-CUSSON, FANNY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 14 , 32 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225524978,"ALIE-CUSSON, FANNY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225524978,"ALIE-CUSSON, FANNY",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225524978,"ALIE-CUSSON, FANNY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 61 , 91 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225524978,"ALIE-CUSSON, FANNY",111 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 107 , 156 , 259 ," $10,326.82 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225525322,"KING, DORI, ANNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 18 , 21 , 36 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4680 US HIGHWAY 117 N   PIKEVILLE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1225525322,"KING, DORI, ANNA",4680 US HIGHWAY 117 N   PIKEVILLE NC,096,Wayne,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 61 , 76 , 184 ,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225525538,"PIERCE, JESSICA, MARIE",1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 11 ,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225525538,"PIERCE, JESSICA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225526809,"BEESON, SETH, THOMAS",2511 DELANEY AVE   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225526809,"BEESON, SETH, THOMAS",911 W HENDERSON ST KISER BLDG STE 410 SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 66 , 82 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225526809,"BEESON, SETH, THOMAS",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 19 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225527419,"FUNK, MACKENZIE, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225527419,"FUNK, MACKENZIE, LYNN",401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225527419,"FUNK, MACKENZIE, LYNN",401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,127 S MAIN ST   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225527617,"RESTREPO, CASSANDRA, DAWN",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225527856,"ALLEN, KATHERINE, RENEE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225527856,"ALLEN, KATHERINE, RENEE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225527856,"ALLEN, KATHERINE, RENEE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 34 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225527856,"ALLEN, KATHERINE, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 81 , 97 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225528060,"REDD, WALKER, DEHART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1225529498,"GRUNWALD, JAMES, HARRISON",401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 46 , 92 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225529498,"GRUNWALD, JAMES, HARRISON",401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 28 , 64 ,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1225532823,"PHAM, LAM, NGOC",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 72 , 92 , 102 ," $19,999.20 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1225532930,"MEDEIROS, ERIN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225532930,"MEDEIROS, ERIN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 76 , 81 , 111 ,$#,,
MEDICAID DIRECT,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,185 WIND CHIME CT STE 201A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,185 WIND CHIME CT STE 201A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 165 , 165 ," $18,505.80 ",,
MEDICAID DIRECT,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,185 WIND CHIME CT STE 201A RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,185 WIND CHIME CT STE 201A RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#, 108 , 113 ," $47,580.00 ",,
MEDICAID DIRECT,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,2640 WILLARD DAIRY RD STE 106 HIGH POINT NC,041,Guilford,251J00000X,Agencies,Nursing Care,,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,2640 WILLARD DAIRY RD STE 106 HIGH POINT NC,041,Guilford,251J00000X,Agencies,Nursing Care,,#, 315 , 328 ," $156,013.00 ",,
MEDICAID DIRECT,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,2640 WILLARD DAIRY RD STE 106 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1225533714,AVID HEALTH AT HOME NORTH CAROLINA,2640 WILLARD DAIRY RD STE 106 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 482 , 483 ," $67,008.84 ",,
MEDICAID DIRECT,1518392125,BURROW WELCHEL CULP AND REIMELS DD,SIGNATURE SMILES ORTHODONTICS,2250 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1225536402,"WONG, MEGAN, ALEXANDRA",2250 NASH ST N   WILSON NC,098,Wilson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,385 "," 3,658 "," 4,525 "," $574,941.03 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225538275,"STAPLETON, ADAM, BARRETT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225538275,"STAPLETON, ADAM, BARRETT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225538275,"STAPLETON, ADAM, BARRETT",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225538275,"STAPLETON, ADAM, BARRETT",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225538275,"STAPLETON, ADAM, BARRETT",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225538275,"STAPLETON, ADAM, BARRETT",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225540297,"CROWDER, STEPHANIE, LYNN",1240 HUFFMAN MILL ROAD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1225540297,"CROWDER, STEPHANIE, LYNN",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1225540297,"CROWDER, STEPHANIE, LYNN",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1225547268,"DIONNE, SUSAN, MARIE",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225547268,"DIONNE, SUSAN, MARIE",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225547268,"DIONNE, SUSAN, MARIE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 27 , 31 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225547268,"DIONNE, SUSAN, MARIE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 22 , 23 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1225547268,"DIONNE, SUSAN, MARIE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 23 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1225547268,"DIONNE, SUSAN, MARIE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225551047,"MORINO, JACLYN, LEIGH",4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1033150875,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - DIABETES AND ENDO,853 N CHURCH ST STE 720C SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225551781,"MURVELASHVILI, NATIA",853 N CHURCH ST STE 720C SPARTANBURG SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1225553506,"BICKFORD, HEIDI, CAROLINE",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 54 , 71 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 25 , 25 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 19 , 20 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225558166,"MCKEARN, DAVID, KENDRICK",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225558505,"SOM, ANIRUDDH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 169 , 172 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225558505,"SOM, ANIRUDDH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 91 , 92 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225559164,"GREISSINGER, APRIL, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 63 , 91 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225560576,"KILLEEN, OLIVIA, JOY",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225560816,"KHAN, KAMRAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 139 , 187 , 209 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 86 , 120 , 130 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",4220 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 193 , 221 , 245 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225561640,"HAROWICZ, MICHAEL, ROBERT",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 33 ,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1225562218,"TAGGE, DANIEL, GARTH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 68 , 100 , 100 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225562218,"TAGGE, DANIEL, GARTH",201 E GROVER ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1225562218,"TAGGE, DANIEL, GARTH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225562218,"TAGGE, DANIEL, GARTH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1225562218,"TAGGE, DANIEL, GARTH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225563646,"DASS, LORYN, WILSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 41 , 41 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225563646,"DASS, LORYN, WILSON",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1881614170,ASSOCIATED MEDICAL SPECIALISTS PA,COASTAL CANCER CENTER,8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225565666,"ALI, FARIA",8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 23 , 88 ,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1225566839,"RO, TERESA",203 E INDUSTRY DR STE A OXFORD NC,039,Granville,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1225566839,"RO, TERESA",3008 PICKETT RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 23 , 46 , 74 ,$#,,
MEDICAID DIRECT,1225568884,WAKE FOREST AMBULATORY VENTURES LLC,WAKE FOREST BAPTIST HEALTH OUTPATIENT SURGERY,6441 KINNAMON CT   WINSTON SALEM NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1225568884,WAKE FOREST AMBULATORY VENTURES LLC,6441 KINNAMON CT   WINSTON SALEM NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 52 , 51 , 73 ," $22,072.60 ",,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225569015,"DJAN, PRINCE, TANO",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225569015,"DJAN, PRINCE, TANO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 184 , 185 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225569106,"QUADRI, PABLO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225569106,"QUADRI, PABLO",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 34 , 59 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1225569122,"CRAWLEY, JOHN, DAVID",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225569122,"CRAWLEY, JOHN, DAVID",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 210 , 211 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,930 3RD ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225569890,"AJEWOLE, CHRISTANA, OLUWASOLA",930 3RD ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225569890,"AJEWOLE, CHRISTANA, OLUWASOLA",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225569890,"AJEWOLE, CHRISTANA, OLUWASOLA",930 3RD ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225569890,"AJEWOLE, CHRISTANA, OLUWASOLA",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 68 , 88 , 144 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225569965,"BEALL, DAVID, LAWRENCE",101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225569965,"BEALL, DAVID, LAWRENCE",16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 48 , 49 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225571300,"BARNES, LISHIA, MARIE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225574288,"WALKER, TEMPLE, MILLS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 51 , 54 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1225574288,"WALKER, TEMPLE, MILLS",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 24 , 27 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225574288,"WALKER, TEMPLE, MILLS",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225574288,"WALKER, TEMPLE, MILLS",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 24 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1225576119,"HOLLOWAY, KATHERINE, CANOY",1530 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225576218,"RODRIGUEZ MORENO, CHRISTELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 104 , 114 , 118 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225577034,"WHITMAN, HILARY, HOLMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 29 , 29 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225577034,"WHITMAN, HILARY, HOLMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1225577034,"WHITMAN, HILARY, HOLMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225577034,"WHITMAN, HILARY, HOLMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225577034,"WHITMAN, HILARY, HOLMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225577034,"WHITMAN, HILARY, HOLMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1225579014,"REAVES, NICHOLAS, JORDAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1225579014,"REAVES, NICHOLAS, JORDAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225579014,"REAVES, NICHOLAS, JORDAN",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1225579014,"REAVES, NICHOLAS, JORDAN",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225579584,"GREENAN, GARRETT, SETH",705 GRIFFITH ST STE 205 DAVIDSON NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 25 , 102 , 179 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225579584,"GREENAN, GARRETT, SETH",8210 UNIVERSITY EXEC PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 53 , 91 , 97 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225579584,"GREENAN, GARRETT, SETH",705 GRIFFITH ST STE 205 DAVIDSON NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225579667,"SHEVACH, JEFFREY, WILLIAM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225579667,"SHEVACH, JEFFREY, WILLIAM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225579667,"SHEVACH, JEFFREY, WILLIAM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225579667,"SHEVACH, JEFFREY, WILLIAM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1972266237,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SHALLOTTE,301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1225585060,"NEWKIRK, ZACHARY, WILLKINGS",709 N 4TH ST STE 107 WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 17 , 37 ,$#,,
MEDICAID DIRECT,1922661750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA INTEGRATED MEDICINE - STATESVILLE,1703 DAVIE AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225586555,"WALSH, AVEARY, OLIVIA",1703 DAVIE AVE   STATESVILLE NC,049,Iredell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750861308,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT NEWTON-CONOVER MIDDLE,873 NORTHERN DR NW   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225586555,"WALSH, AVEARY, OLIVIA",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225586555,"WALSH, AVEARY, OLIVIA",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750861308,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT NEWTON-CONOVER MIDDLE,873 NORTHERN DR NW   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225586555,"WALSH, AVEARY, OLIVIA",873 NORTHERN DR NW   CONOVER NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225586795,"TERRY, BRIANA, NICOLE",1925 TRADD CT   WILMINGTON NC,065,New Hanover,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 39 , 43 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225586902,"ARIZU, JESSICA, CASSATT",3404 WAKE FOREST RD STE 302 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295881712,PRIVATE DIAGNOSTIC CLINIC PLLC,GYN CLINIC,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225586902,"ARIZU, JESSICA, CASSATT",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1225586902,"ARIZU, JESSICA, CASSATT",3000 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225591076,"GREEN, KARL, ERIK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 248 , 248 ," $12,933.01 ",,
MEDICAID DIRECT,1316128580,SUMMIT FAMILY MEDICINE,SUMMIT FAMILY MEDICINE PLLC,515 W SALISBURY ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1225591118,"WILBURN, JESSICA",515 W SALISBURY ST STE D ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1225593411,"HOUSTON, JORDAN, LAMOT",300 BIRCH ST   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 250 , 353 ," 1,058 "," $13,628.15 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225593460,"JOHNSON, MATTHEW, QUAY",150 FAIRVIEW RD STE 230 MOORESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1053906115,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GYN ONC,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225593866,"JOHNSON, ALICIA, SUE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053906115,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GYN ONC,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225593866,"JOHNSON, ALICIA, SUE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 64 , 68 ,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1225595556,"FERRELL, KIRSTIE, BROOKS",311 HILL ST   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1225595556,"FERRELL, KIRSTIE, BROOKS",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1225595556,"FERRELL, KIRSTIE, BROOKS",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1225596638,"FISHER, EMILY, MICHALINA",1168 E CUTLAR XING   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225596638,"FISHER, EMILY, MICHALINA",1168 E CUTLAR XING   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 42 , 78 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225598204,"ENGLER, MORGAN, CASSANDRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225598204,"ENGLER, MORGAN, CASSANDRA",1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225598204,"ENGLER, MORGAN, CASSANDRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 43 , 129 , 139 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225600273,"SUTTON, ADAM, CHRISTOPHER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225600646,"ARIAS, ANA, GABRIELA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 35 , 36 ,$#,,
MEDICAID DIRECT,1225603442,ABOVE ALL HOME HEALTHCARE LLC,,3541 US 220 ALT S   CANDOR NC,062,Montgomery,253Z00000X,Agencies,In Home Supportive Care,,1225603442,ABOVE ALL HOME HEALTHCARE LLC,3541 US 220 ALT S   CANDOR NC,062,Montgomery,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 7,156 "," 7,237 "," $580,072.38 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225604655,"PENNA, MICHAEL, ANDREW",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538978531,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - INDEPENDEN,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225604903,"RILEY, KATHRYN, PARKER",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 18 , 58 ,$#,,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225604903,"RILEY, KATHRYN, PARKER",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 673 ," 1,092 "," 2,666 "," $178,563.33 ",,
MEDICAID DIRECT,1538978531,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - INDEPENDEN,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225604903,"RILEY, KATHRYN, PARKER",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 72 , 185 ," $11,401.05 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225607039,"SEWARD, MARIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225614225,"FAROOQ, SHAHRYAR, MIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225614225,"FAROOQ, SHAHRYAR, MIAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225614837,"GARDNER, AUSTIN, JOHN",3150 ROGERS RD STE 216 WAKE FOREST NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1225615172,"WALKER, MICHAEL, CLINTON",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1225615172,"WALKER, MICHAEL, CLINTON",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225615172,"WALKER, MICHAEL, CLINTON",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 97 , 92 , 248 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225615172,"WALKER, MICHAEL, CLINTON",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225616659,"MCILWAIN, JOSEPH, SAMUEL",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225616659,"MCILWAIN, JOSEPH, SAMUEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 31 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225616659,"MCILWAIN, JOSEPH, SAMUEL",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225617608,ACCESS HEALTHCARE SERVICES INC,ACCESS HEALTHCARE SERVICES,5624 EXECUTIVE CENTER DR STE 132 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1225617608,ACCESS HEALTHCARE SERVICES INC,5624 EXECUTIVE CENTER DR STE 132 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 7,535 "," 7,535 "," $457,775.68 ",,
MEDICAID DIRECT,1790830487,CHILDRENS MEDICAL GROUP INC,SUFFOLK PEDIATRICS,1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225618374,"TANWEER, NAZEELA, SUMER",1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225619307,"RYDER, REBECCA, EMILY",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225619307,"RYDER, REBECCA, EMILY",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 34 , 60 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1225619307,"RYDER, REBECCA, EMILY",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225619307,"RYDER, REBECCA, EMILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 25 , 45 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225619323,"OGBUNEKE, JUVAREZ, UCHENNA",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225619323,"OGBUNEKE, JUVAREZ, UCHENNA",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225620818,"DUNN, SARAH, ELIZABETH",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 71 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225622962,"HOOD, ALEXIS, NICOLE",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225622962,"HOOD, ALEXIS, NICOLE",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 34 , 67 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225622962,"HOOD, ALEXIS, NICOLE",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225624026,WARM HEARTS HOME HEALTH LLC,,4405 THOMASVILLE RD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1225624026,WARM HEARTS HOME HEALTH LLC,4405 THOMASVILLE RD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 5,391 "," 5,410 "," $430,845.57 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225626096,"LEASURE, MEGAN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225626096,"LEASURE, MEGAN, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225626096,"LEASURE, MEGAN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225626096,"LEASURE, MEGAN, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225628191,"BALLARD, JAMES, WARNER",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 93 , 167 ,$#,,
MEDICAID DIRECT,1699540203,GQ INTERNAL MEDICINE AND PEDIATRICS,,111 S SALISBURY GQ AVE   GRANITE QRY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1225630080,"GOODMAN, JESSICA, SMITH",111 S SALISBURY GQ AVE   GRANITE QRY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 47 , 109 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225630080,"GOODMAN, JESSICA, SMITH",111 S SALISBURY GQ AVE   GRANITE QRY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225630650,"HAYWOOD, JESSICA, LEIGH",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 104 , 307 ," $12,184.52 ",,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225630650,"HAYWOOD, JESSICA, LEIGH",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#, 20 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1225630650,"HAYWOOD, JESSICA, LEIGH",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225636848,"DIAZ, ALMA, LUCERO",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 48 , 55 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225637564,"ROGERS, AMANDA, ROSE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225637564,"ROGERS, AMANDA, ROSE",8108B MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225637564,"ROGERS, AMANDA, ROSE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 62 , 87 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225637564,"ROGERS, AMANDA, ROSE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225637564,"ROGERS, AMANDA, ROSE",8108B MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225637564,"ROGERS, AMANDA, ROSE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225637721,"WILSON, ALEXANDRIA, ROBINSON",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 25 ,$#,,
MEDICAID DIRECT,1225640188,FLOVI OF NC INC,,1916 SUNSET AVE   ROCKY MOUNT NC,064,Nash,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1225640188,FLOVI OF NC INC,1916 SUNSET AVE   ROCKY MOUNT NC,064,Nash,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 212 ," 2,135 "," 2,264 "," $204,197.40 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225640378,"POKHREL, ARPAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1225640378,"POKHREL, ARPAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 137 , 142 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225650294,"HUTCHINSON, SAVANNAH, ST CLAIR",15825 BALLANTYNE MEDICAL PL STE 120 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225651896,"LYNN, CATHERINE, MARY",319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 177 , 256 , 764 ," $38,320.00 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225652274,"MATHUR, ANIESHA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225652274,"MATHUR, ANIESHA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225652787,"KINNEMAN, BRANDON, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225652787,"KINNEMAN, BRANDON, SCOTT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225652787,"KINNEMAN, BRANDON, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225653314,"WANG, ANDERSON, GEOFFREY",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417061011,ABC PEDIATRICS OF DUNN PA,~,104 TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1225654759,"MCGEE, NICOLE, MIRANDA",104 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 57 , 197 ,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225656028,"PRESLEY, SARAH, MORGAN",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1225657208,"DAY, MASON, ZACHARY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 164 , 168 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225657208,"DAY, MASON, ZACHARY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1225657208,"DAY, MASON, ZACHARY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1225657208,"DAY, MASON, ZACHARY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225657257,"TIMTIM, ELISE, KARLAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225657257,"TIMTIM, ELISE, KARLAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225657257,"TIMTIM, ELISE, KARLAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1225657257,"TIMTIM, ELISE, KARLAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 306 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225657257,"TIMTIM, ELISE, KARLAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,138 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 147 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225658917,"KHAN, BILAL, SARWAR",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 44 , 123 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1225659154,"STROHSCHEIN, ADAM, JONATHAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 82 , 82 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1225659154,"STROHSCHEIN, ADAM, JONATHAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 103 , 104 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225660301,"GHODASARA, SUNIL, RANCHHOD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 165 , 165 ," $11,041.18 ",,
MEDICAID DIRECT,1225663586,INSPIRED HOME HEALTHCARE SERVICES,INSPIRED HOME HEALTHCARE SERVICES LLC,1200 BROAD ST STE 207 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1225663586,INSPIRED HOME HEALTHCARE SERVICES,1200 BROAD ST STE 207 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 80 , 80 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1225665540,"STROER, KENNETH, CONRAD",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1225665540,"STROER, KENNETH, CONRAD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225666852,"WOFFORD, MARIE, ANDERSON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 39 , 50 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225666852,"WOFFORD, MARIE, ANDERSON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225666852,"WOFFORD, MARIE, ANDERSON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225666852,"WOFFORD, MARIE, ANDERSON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225666852,"WOFFORD, MARIE, ANDERSON",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225668536,"BIGGS HOLLAND, ASHLEY, LYNN",1104 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225668536,"BIGGS HOLLAND, ASHLEY, LYNN",4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 132 , 200 ," $14,534.76 ",,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225669195,"TOWNSEND, HEATHER, LYNN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225669435,"SARRO, DINA, JANE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225669435,"SARRO, DINA, JANE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720793094,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY ORTHOPEDICS AND SPORTS MEDICINE,1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225669443,"NAGENGAST, ELIZABETH, ROGERS",1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 93 , 147 ,$#,,
MEDICAID DIRECT,1821195868,HUFF ORTHOPAEDIC GROUP PA,HUFF ORTHOPAEDIC GROUP PA,520 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1225669443,"NAGENGAST, ELIZABETH, ROGERS",520 BEAMAN ST   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 51 , 110 ,$#,,
MEDICAID DIRECT,1851153183,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV HUFF ORTHOPEDICS AND SPORTS MEDICINE,417B VANCE ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1225669443,"NAGENGAST, ELIZABETH, ROGERS",520 BEAMAN ST   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 57 , 108 ,$#,,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1225671597,"SCURRY, LAUREN, HAYES",1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225672959,"KINCAID, AMANDA, LYNN",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1225672959,"KINCAID, AMANDA, LYNN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225672959,"KINCAID, AMANDA, LYNN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1225672959,"KINCAID, AMANDA, LYNN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1225672959,"KINCAID, AMANDA, LYNN",8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 146 , 161 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225673585,"JOHNSON, LEIGH, R",113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225674088,"VASQUEZ, CARLA, SAMANTHA",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 94 , 159 , 238 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1225678758,"BOONE, RACHEL, WASHBURN",31 CALIFORNIA AVE   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225678758,"BOONE, RACHEL, WASHBURN",31 CALIFORNIA AVE   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1225682511,"DAVENPORT, WESLEY, ADAM",472 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 94 , 109 , 156 ," $36,010.79 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225684244,"KUMAR, KRISHAN, RAJ",55 BUCKEYE COVE RD   CANTON NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 40 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225684244,"KUMAR, KRISHAN, RAJ",55 BUCKEYE COVE RD   CANTON NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225685613,VERO DIAGNOSTICS,,3216 S ALSTON AVE   DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,1225685613,VERO DIAGNOSTICS,3216 S ALSTON AVE   DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#, 51 ,$#,,
MEDICAID DIRECT,1225686041,A PRIMARY CHOICE INC,,809 N LAFAYETTE ST STE G SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1225686041,A PRIMARY CHOICE INC,809 N LAFAYETTE ST STE G SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,311 "," 1,317 "," $82,110.92 ",,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225688112,"SHIRK, ANNE, GILLIES",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 51 , 137 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225688112,"SHIRK, ANNE, GILLIES",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 82 , 193 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225691926,"DEZII, ALEXANDRA, PAIGE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 63 , 63 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225691926,"DEZII, ALEXANDRA, PAIGE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225691926,"DEZII, ALEXANDRA, PAIGE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,3 S TUNNEL RD # 187 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225694334,"ISELY, SARA, JANE",3 S TUNNEL RD   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205892916,PINEHURST NEUROLOGY PA,PINEHURST NEUROLOGY PA,10 PAGE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225699853,"MONTANEZ, JOYIA",10 PAGE DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 73 , 81 ,$#,,
MEDICAID DIRECT,1366086597,FORA DERMATOLOGY PLLC,~,653 BLUEFIELD RD STE G MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225702871,"MESSINA, KIMBERLY, SUMNER",653 BLUEFIELD RD STE G MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1366086597,FORA DERMATOLOGY PLLC,~,118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225702871,"MESSINA, KIMBERLY, SUMNER",653 BLUEFIELD RD STE G MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366086597,FORA DERMATOLOGY PLLC,~,118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225702871,"MESSINA, KIMBERLY, SUMNER",118 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1225702871,"MESSINA, KIMBERLY, SUMNER",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225703630,"DUFFIN, JULIA, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225703630,"DUFFIN, JULIA, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 46 , 71 ,$#,,
MEDICAID DIRECT,1215048459,COUNTY OF HARNETT,HARNETT COUNTY HEALTH DEPT,307 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1225703853,"CLARK-LARUE, TRESTON, GRANT",307 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 99 , 352 ," $10,396.00 ",,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225705551,"FREEMAN, JESSICA, ANNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225705551,"FREEMAN, JESSICA, ANNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 896 , 901 ," $10,056.58 ",,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,1101 MAPLE CARE LN   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1225705551,"FREEMAN, JESSICA, ANNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225706237,"VOGEL, JACQUELYN, ALYSE",2001 TODAY'S WOMAN AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225706237,"VOGEL, JACQUELYN, ALYSE",114 W 30TH ST STE 800 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 31 ,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225706344,"MEARS, EMILY, JOSEPHINE",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225706344,"MEARS, EMILY, JOSEPHINE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225706344,"MEARS, EMILY, JOSEPHINE",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 131 , 152 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1225714124,"ROBLES, SHEILA",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 31 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1225715576,"LORDA TAYLOR, JOSEFINA",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225716103,MELS HELPING HANDS LLC,,910 E ASH ST STE C GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1225716103,MELS HELPING HANDS LLC,910 E ASH ST STE C GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#, 459 , 459 ," $26,170.36 ",,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1225721368,"JOHNSON, KAREN, MARIE",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 22 , 30 , 38 ," $10,575.21 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1225721368,"JOHNSON, KAREN, MARIE",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1225722309,"BRIDGES, TRAVIS, SCOTT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1225722929,"CLEMENS, PAUL, SLADE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225722929,"CLEMENS, PAUL, SLADE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1225722929,"CLEMENS, PAUL, SLADE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1225722929,"CLEMENS, PAUL, SLADE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225722929,"CLEMENS, PAUL, SLADE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225727456,"STEARNS, ZACHARY, SCOTT",703 COMFORT LN   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 97 , 166 ,$#,,
MEDICAID DIRECT,1861828022,MICHAEL O REIMELS DDS & CATHERINE S,THE SMILE ZONE,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1225727597,"PHILLIPS, MORGAN, LEIGH",816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 986 ," 1,359 "," 4,853 "," $204,846.30 ",,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1225729825,"PRESTON, ANDREW, ARTHUR",2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1225729825,"PRESTON, ANDREW, ARTHUR",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225729825,"PRESTON, ANDREW, ARTHUR",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 36 , 36 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,180 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1225729825,"PRESTON, ANDREW, ARTHUR",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1225729825,"PRESTON, ANDREW, ARTHUR",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1225729825,"PRESTON, ANDREW, ARTHUR",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 37 , 37 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1225729825,"PRESTON, ANDREW, ARTHUR",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 27 , 27 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225730591,"CLAYTON, TRENTON, GRAY",115 HEART DR   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1225737505,"ROBERTS, ANDREA, LYNN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225737935,"MGHAZLI, IKRAM",4315 LUDGATE ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1225737935,"MGHAZLI, IKRAM",,1781 S MAIN ST   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1225737935,"MGHAZLI, IKRAM",1781 S MAIN ST   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2344 S CHURCH ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225739352,"JOSEPH, MADINA, ALUAT",2344 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225739352,"JOSEPH, MADINA, ALUAT",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 52 , 64 , 69 ,$#,,
MEDICAID DIRECT,1073155032,BURKHART PEDIATRIC & ADOLESCENT DER,,135 PARKWAY OFFICE CT STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1225741176,"NEIGHBORS, KATHERINE, CORPENING",135 PARKWAY OFFICE CT STE 201 CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 18 , 26 , 28 ,$#,,
MEDICAID DIRECT,1750044897,ARBOR CARE SOLUTIONS LLC,,8025 N POINT BLVD STE 219 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225741762,"ROBERTS, RODRIKE, QUENTRELL",8025 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225742075,"NAGEL, CHRISTINE, CAMPBELL",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225742075,"NAGEL, CHRISTINE, CAMPBELL",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1225742075,"NAGEL, CHRISTINE, CAMPBELL",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225743107,"STANHOPE, CATHARINE, MICHELLE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225743107,"STANHOPE, CATHARINE, MICHELLE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 58 , 95 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225743107,"STANHOPE, CATHARINE, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 13 , 35 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225743107,"STANHOPE, CATHARINE, MICHELLE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225743107,"STANHOPE, CATHARINE, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 73 , 143 ,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225743354,"WACKER, ANNE, ELLEN",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 136 , 161 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225745995,"HOLTON, BRIANNA, HARRILL",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 113 , 113 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225750995,"CLARK, KENDALL, LEIGH",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 77 , 111 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225758717,"KAUR, CHARANPREET",1611 FLORA AVE   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 37 , 78 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1225758717,"KAUR, CHARANPREET",1611 FLORA AVE   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1972949949,MOSES CONE AFFILIATED PHYSICIANS IN,GLEN RAVEN MEDICAL CARE CENTER,1611 FLORA AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1225758717,"KAUR, CHARANPREET",1611 FLORA AVE   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225759038,"JABER, AMANIE",2225 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225759038,"JABER, AMANIE",1718 E 4TH ST STE 207 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225759475,"HARTNESS, CORTLIN, PAIGE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225761208,"LEGGETT, JENNIFER, GIBSON",656 CARPENTER AVE   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 30 , 77 ,$#,,
MEDICAID DIRECT,1841388626,"SWAIN, LINDA, PATTERSON",LINDA PATTERSON SWAIN,200 LOCKHART DR   BEAUFORT NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,1225761950,"RAY, KATELYNN, ALISE",200 LOCKHART DR   BEAUFORT NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 94 , 250 ," $12,203.98 ",,
MEDICAID DIRECT,1225762982,"AJAJ, MOHAMAD, HUSSEIN",CEDAR SPRINGS DENTAL,23 NC-98 HWY E SUITE 200 BUNN NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice,1225762982,"AJAJ, MOHAMAD, HUSSEIN",23 NC-98 HWY E SUITE 200 BUNN NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice, 211 , 394 ," 1,233 "," $88,972.70 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225766033,"MOON, SUKYUNG",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225766033,"MOON, SUKYUNG",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 294 , 552 ," 1,394 "," $51,582.63 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225766033,"MOON, SUKYUNG",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 191 ," $15,094.45 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1273 MAIN ST   SWANQUARTER NC,048,Hyde,193200000X,Group,Multi-Specialty,,1225766033,"MOON, SUKYUNG",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225766033,"MOON, SUKYUNG",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1225766033,"MOON, SUKYUNG",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 179 ," $14,474.07 ",,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1225767452,"MILLER, ALISSA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1225767452,"MILLER, ALISSA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 33 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225767452,"MILLER, ALISSA",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225767718,"FERMO, MADISON",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 107 , 127 ,$#,,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1225767973,"AUSTIN, DEVON, HILLIARD",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225767973,"AUSTIN, DEVON, HILLIARD",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 57 , 65 , 164 ,$#,,
MEDICAID DIRECT,1598584781,AMAN MASOOMI DDS PLLC,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1225767973,"AUSTIN, DEVON, HILLIARD",3823 GUESS RD STE P DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 655 , 745 ," 2,880 "," $116,311.53 ",,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225767973,"AUSTIN, DEVON, HILLIARD",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1598584781,AMAN MASOOMI DDS PLLC,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1225767973,"AUSTIN, DEVON, HILLIARD",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 41 , 116 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225768252,"FUQUA, COLLIN, ANDREW",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 27 ,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1225768484,"HARRISON, ELIZABETH, WILSON",209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225768815,"CHIESA, DAVID, MICHAEL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225768815,"CHIESA, DAVID, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225769490,"SHELDON, REBECCA, GARDNER",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1225769490,"SHELDON, REBECCA, GARDNER",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225769490,"SHELDON, REBECCA, GARDNER",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 61 , 99 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1225769656,"STOWE, JOSEY, ELIZABETH",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1225772064,SEVENSTARS FAMILY CARE HOME LLC,,3217 DEARBORN DR   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1225772064,SEVENSTARS FAMILY CARE HOME LLC,3217 DEARBORN DR   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 74 , 74 ," $11,109.44 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225772908,"REICH, MARY, MARGARET",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1770610602,COUNTY OF EDGECOMBE OFFICE OF AUDI,EDGECOMBE COUNTY HEALTH DEPARTMENT,122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1225778624,"WALSTON, CHRISTIE, SUMMERLIN",122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 14 , 27 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225779069,"PATEL, KRISHNA, KIRTI",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1225779069,"PATEL, KRISHNA, KIRTI",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 63 , 77 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1225779168,"HANCOCK, SADIE, GOSSELIN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225781768,KINGDOM 1ST HOME CARE LLC,,304A MAIN ST   BAYBORO NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,,1225781768,KINGDOM 1ST HOME CARE LLC,304A MAIN ST   BAYBORO NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,430 "," 2,849 "," $357,011.95 ",,
MEDICAID DIRECT,1720426067,MONARCH,~,300 ASHVILLE AVE STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225781859,"OWENS, CARLA, ELIZABETH",300 ASHVILLE AVE STE 200 CARY NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225781859,"OWENS, CARLA, ELIZABETH",319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1720426067,MONARCH,~,300 ASHVILLE AVE STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1225781859,"OWENS, CARLA, ELIZABETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1225781859,"OWENS, CARLA, ELIZABETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1225782519,MERCY HANDS HOMECARE INC,,3427 ARKLOW RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1225782519,MERCY HANDS HOMECARE INC,3427 ARKLOW RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,641 "," 1,641 "," $96,438.76 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1225783038,"PATE, LAUREN, WICKS",517 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225785009,"SWAIN, ABIGAIL, MARIE",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1225788623,COMPCARE PERSONAL SERVICES LLC,,1914 J N PEASE PL ST 135 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1225788623,COMPCARE PERSONAL SERVICES LLC,1914 J N PEASE PL ST 135 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,740 "," 1,741 "," $154,828.58 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225789241,"GREGORY, ELIZABETH, ANNE",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225789241,"GREGORY, ELIZABETH, ANNE",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225789662,"DILLNER, JADA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013956150,"KELLY, MICHAEL, WALKER",~,8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1225790462,"LITWAK, LISA, NICOLE",8851 ELLSTREE LN   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1013956150,"KELLY, MICHAEL, WALKER",~,8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1225790462,"LITWAK, LISA, NICOLE",11009 INGLESIDE PL STE 104 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1225790462,"LITWAK, LISA, NICOLE",,8851 ELLSTREE LN   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,1225790462,"LITWAK, LISA, NICOLE",8851 ELLSTREE LN   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1225791460,"SCHULMAN, ALLISON, MILLER",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225791882,"KING, OLIVIA",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 13 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1225791882,"KING, OLIVIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1225792799,EMBRACE THERAPY SERVICES PLLC,,166 FURMAN RD STE C BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1225792799,EMBRACE THERAPY SERVICES PLLC,166 FURMAN RD STE C BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1225794001,ATUM PROFESSIONAL LLC,,3623 LATROBE DR STE 110E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1225794001,ATUM PROFESSIONAL LLC,3623 LATROBE DR STE 110E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 365 , 371 ," $22,373.84 ",,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1225795040,"FILLINGAME, ERICK, JAMES",2277 NC 24-87   CAMERON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 33 ,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1225795040,"FILLINGAME, ERICK, JAMES",6801 FALLS OF NEUSE RD STE 104 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 60 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1225795750,"HICKS, OCTAVIA, ANNESSIA RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 30 ,$#,,
MEDICAID DIRECT,1225800022,A PRIMARY CHOICE INC,,227 E 4TH AVE   RED SPRINGS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1225800022,A PRIMARY CHOICE INC,227 E 4TH AVE   RED SPRINGS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 49 ," 7,545 "," 7,549 "," $493,923.08 ",,
MEDICAID DIRECT,1811760903,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT BESSEMER CITY PRIMARY,1320 N 12TH ST   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225800030,"MCPHERSON, HUNTER, BAILEY",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1649043738,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT BESSEMER CITY CENTRAL ELEMENTARY,1400 PUETTS CHAPEL RD   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225800030,"MCPHERSON, HUNTER, BAILEY",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1003665886,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT SOUTH CALDWELL HIGH,7035 SPARTAN DR   HUDSON NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225801871,"FRAZIER, JOHN, WESLEY",5040 E BANDYS XRD   CATAWBA NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225801871,"FRAZIER, JOHN, WESLEY",5040 E BANDYS XRD   CATAWBA NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1093323099,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT BANDYS HIGH,5040 E BANDYS XRD   CATAWBA NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225801871,"FRAZIER, JOHN, WESLEY",5040 E BANDYS XRD   CATAWBA NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1619548062,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CATAWBA VALLEY COMMUNITY COLLEGE,2550 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225801871,"FRAZIER, JOHN, WESLEY",5040 E BANDYS XRD   CATAWBA NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225805609,"NOVAK, DANIELLE, RENEE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386682367,EAST ASHEVILLE FAMILY HEALTH CARE,~,997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1225807233,"MOORE, CLAYTON, SHUFORD",997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 36 , 88 ,$#,,
MEDICAID DIRECT,1770342354,MAGNOLIA HEALTH PLLC,,127 E TRADE ST STE B100 FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1225807233,"MOORE, CLAYTON, SHUFORD",127 E TRADE ST STE B100 FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 104 , 199 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1225807738,"GASKIN, KATHRYN, BOUCHARD",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1225810427,"CASTANEDA, ERIC",5070 KENTWORTH DR   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1225810427,"CASTANEDA, ERIC",3150 ROGERS RD STE 218 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 30 , 37 ,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1225810427,"CASTANEDA, ERIC",1010 HIGH HOUSE RD STE 300 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1225816531,ANESI HOME HEALTHCARE,,504 GREEN ST E STE 210 WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1225816531,ANESI HOME HEALTHCARE,504 GREEN ST E STE 210 WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 1,676 "," 1,855 "," $153,813.56 ",,
MEDICAID DIRECT,1225816531,ANESI HOME HEALTHCARE,,504 GREEN ST E STE 101 WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1225816531,ANESI HOME HEALTHCARE,504 GREEN ST E STE 101 WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 3,755 "," 3,840 "," $311,367.80 ",,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1225816986,"JOCHUM, BRANDON, RUSSELL",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 248 , 273 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225817257,"CAMPBELL, AMANDA, KRISTEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225817257,"CAMPBELL, AMANDA, KRISTEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1225817257,"CAMPBELL, AMANDA, KRISTEN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1225830912,HARPER HOME HEALTH SERVICES LLC,,6306 LONG PINE DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1225830912,HARPER HOME HEALTH SERVICES LLC,6306 LONG PINE DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 24 , 28 ,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1225841364,"ZIDMAN, REBECCA, PETTIGREW",301 LLOYD ST   CARRBORO NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1225865124,"SANSOM, BRITNEY, GAIL",810 MITCHELL AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1225869068,"SMITH, PRISCILLA, WATERS",130 JAMES AVE   LOCUST NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 61 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1225886906,"POPE, ASHLEY, HOMER",4117 OLEANDER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 40 ,$#,,
MEDICAID DIRECT,1093787608,SYLVA FAMILY PRACTICE PA,SYLVA FAMILY PRACTICE PA,430 FISHER CREEK RD   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1235101858,"GALLINGER, ROY, PAUL",430 FISHER CREEK RD   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 128 , 490 , 819 ," $19,799.68 ",,
MEDICAID DIRECT,1851630172,MEDICAL PLAZA FAMILY AND GERIATRIC,~,8401 MEDICAL PLAZA DR STE 365 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235102187,"ABAQUETA, ALVIN, YAP",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1851630172,MEDICAL PLAZA FAMILY AND GERIATRIC,~,8401 MEDICAL PLAZA DR STE 365 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235102187,"ABAQUETA, ALVIN, YAP",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235102187,"ABAQUETA, ALVIN, YAP",ALVIN YAP ABAQUETA,302 S MAIN ST   CHINA GROVE NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1235102187,"ABAQUETA, ALVIN, YAP",302 S MAIN ST   CHINA GROVE NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 23 , 39 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235102971,"OLSON, ROBERT",2345 COURT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235104498,"LIS, KIMBERLY, JEAN",1225 LEWISVILLE CLEMMONS RD   LEWISVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 40 , 98 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235104498,"LIS, KIMBERLY, JEAN",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235104498,"LIS, KIMBERLY, JEAN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235105982,"BRESCIA, DONALD, MICHAEL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235105982,"BRESCIA, DONALD, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235105982,"BRESCIA, DONALD, MICHAEL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 17 , 37 , 37 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235105982,"BRESCIA, DONALD, MICHAEL",1969 WELLNESS BLVD   MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235106683,"WINSLOW, JOSHUA, BREWSTER",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235106683,"WINSLOW, JOSHUA, BREWSTER",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 21 , 25 , 57 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235106683,"WINSLOW, JOSHUA, BREWSTER",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#, 22 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1235106683,"WINSLOW, JOSHUA, BREWSTER",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 28 , 39 , 39 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235106683,"WINSLOW, JOSHUA, BREWSTER",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 42 , 60 , 82 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1235106683,"WINSLOW, JOSHUA, BREWSTER",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871800177,DRAGONFLY HOUSE CHILDRENS ADVOCACY,~,387 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1235107020,"SUTTLE, EVELYN, AMY",387 VALLEY RD   MOCKSVILLE NC,030,Davie,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 22 , 49 ," $11,145.07 ",,
MEDICAID DIRECT,1639556004,TERRIE HESS CHILD ADVOCACY CENTER,PREVENT CHILD ABUSE ROWAN,130 WOODSON ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1235107020,"SUTTLE, EVELYN, AMY",387 VALLEY RD   MOCKSVILLE NC,030,Davie,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1669107611,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE SPRING FO,815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235107178,"ELMAHDY, WAGDY, ABDELMONEM",1720 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669107611,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE SPRING FO,815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235107178,"ELMAHDY, WAGDY, ABDELMONEM",815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235108671,"CHRISTINO, ANNE, MARIE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1306904917,COUNTY OF PITT OFFICE OF AUDITOR,PITT COUNTY HEALTH DEPT,201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1235108762,"MATTHEWS, MELINDA, WORKMAN",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235111642,"SUMMERS, ERIK, CHRISTIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 29 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235111832,"ATALA, ANTHONY, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 29 , 34 , 85 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,140 CHARLOIS BLVD FL 2 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235111832,"ATALA, ANTHONY, JOHN",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235111832,"ATALA, ANTHONY, JOHN",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235112376,"MOORE, WENDY, COLLEEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 53 , 63 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235115106,"SMITHSON, ROBERT, HAMILTON",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235116880,"CALLAHAN, JOEL, TRAVIS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235116880,"CALLAHAN, JOEL, TRAVIS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235116880,"CALLAHAN, JOEL, TRAVIS",611 B 5TH AVE W   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235116880,"CALLAHAN, JOEL, TRAVIS",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 46 , 72 , 113 ," $17,077.03 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235116880,"CALLAHAN, JOEL, TRAVIS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 55 , 94 , 142 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235116880,"CALLAHAN, JOEL, TRAVIS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1126 N CHURCH ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 33 , 46 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 24 , 52 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1002 N CHURCH ST STE 401 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 12 , 15 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 26 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235117243,"ORMOND, DAVID, ELLIS",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235119231,"INSKEEP, SHANE, MATTHEW",5160 OCEAN HWY W   SHALLOTTE NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 66 ,$#,,
MEDICAID DIRECT,1366174682,ASHE MULTISPECIALTY GROUP LLC,ASHE UROLOGY,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1235121740,"GRAJEWSKI, ROBERT, SIGMUND",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 42 , 87 , 174 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235121740,"GRAJEWSKI, ROBERT, SIGMUND",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235121997,"ALLAN, JOHN, JOSEPH",925 THOMAS ST   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235121997,"ALLAN, JOHN, JOSEPH",653 BLUEFIELD RD STE F MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235121997,"ALLAN, JOHN, JOSEPH",925 THOMAS ST   STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 209 , 527 , 955 ," $19,327.81 ",,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235122656,"GAYLORD, KEVIN, MICHAEL",1520 PHYSICIANS DR STE A WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235122656,"GAYLORD, KEVIN, MICHAEL",1515 DOCTORS CIR BLDG A WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 33 ,$#,,
MEDICAID DIRECT,1962080853,NOVANT HEALTH WILMINGTON ENDOSCOPY,NOVANT HEALTH WILMINGTON ENDOSCOPY CENTER,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1235122656,"GAYLORD, KEVIN, MICHAEL",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235122656,"GAYLORD, KEVIN, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 38 , 59 , 79 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235122656,"GAYLORD, KEVIN, MICHAEL",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235123787,"NELSON, KEITH, HUNTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 21 , 24 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235123787,"NELSON, KEITH, HUNTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235123787,"NELSON, KEITH, HUNTER",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 33 , 40 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235123787,"NELSON, KEITH, HUNTER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 45 , 58 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235123787,"NELSON, KEITH, HUNTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 20 , 37 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235123787,"NELSON, KEITH, HUNTER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235124785,"PARKER, FRANK, MYLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 41 , 41 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235124785,"PARKER, FRANK, MYLES",115 HEART DR   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235124785,"PARKER, FRANK, MYLES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 166 , 208 , 295 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235124785,"PARKER, FRANK, MYLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 36 , 67 ,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235125170,"RAMACHANDRAN, AJITH",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 40 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235126004,"HAGOOD, JAMES, SMALL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 38 , 65 , 72 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235126111,"REEDER, TIMOTHY, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 46 , 51 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235127051,"ZAGAR, CHRISTOPHER, ALAN",9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 36 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235127051,"ZAGAR, CHRISTOPHER, ALAN",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1518990423,NEPHROLOGY ASSOCIATES OF TIDEWATER,NEPHROLOGY ASSOCIATES OF TIDEWATER LTD,6160 KEMPSVILLE CIR STE 302A NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235128133,"GRASSIA, MICHAEL, NMN",6160 KEMPSVILLE CIR STE 302A NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235129081,"DEORIO, JAMES, KEITH",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235129081,"DEORIO, JAMES, KEITH",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235129321,"DEVESHWAR, SANJEEV, KUMAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 20 , 27 , 35 ,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235129388,"BOLES, MARK, ALAN",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235129388,"BOLES, MARK, ALAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235129388,"BOLES, MARK, ALAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235129388,"BOLES, MARK, ALAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235129388,"BOLES, MARK, ALAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235129388,"BOLES, MARK, ALAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235129388,"BOLES, MARK, ALAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235129388,"BOLES, MARK, ALAN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1235129388,"BOLES, MARK, ALAN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235131095,"MEYER, PAUL, FREDRICK",6630 SHALLOWFORD RD   LEWISVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235131491,"MCMAHON, STEVEN, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235131491,"MCMAHON, STEVEN, JOHN",10208 CERNY ST STE 300 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235131491,"MCMAHON, STEVEN, JOHN",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235131491,"MCMAHON, STEVEN, JOHN",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 15 , 24 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235131491,"MCMAHON, STEVEN, JOHN",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1235132382,"WALKER, WILLIAM",~,971 S COX ST   ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,,1235132382,"WALKER, WILLIAM",971 S COX ST   ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,, 74 , 79 , 128 ,$#,,
MEDICAID DIRECT,1235133943,TOTAL REHAB ORTHOTICS AND PROSTHETI,Total Rehab Orthotics and Prosthetics Inc,2407 N ELM ST   LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235133943,TOTAL REHAB ORTHOTICS AND PROSTHETI,2407 N ELM ST   LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 12 , 31 ,$#,,
MEDICAID DIRECT,1356735336,SOUTHLAND BAINBRIDGE HOSPITALIST GR,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235134669,"HAYES, LANEAU",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235135211,"BARROW, ROY, DOUGLAS",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 35 , 45 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235135211,"BARROW, ROY, DOUGLAS",4796 OLD TAR RD   WINTERVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1992989669,KAREN J ARMSTRONG DMD & BETHANY K T,KAREN J ARMSTRONG DMD & BETHANY K TANT DDS PLLC,3160 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1235135757,"ARMSTRONG, KAREN, JEANNE",3160 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 123 , 206 , 713 ," $26,952.42 ",,
MEDICAID DIRECT,1235136060,ORTHOFIX US LLC,~,9121 ANSON WAY STE 200 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235136060,ORTHOFIX US LLC,9121 ANSON WAY STE 200 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 55 , 37 , 37 ," $91,684.02 ",,
MEDICAID DIRECT,1235136060,ORTHOFIX US LLC,~,3451 PLANO PKWY   LEWISVILLE TX,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235136060,ORTHOFIX US LLC,3451 PLANO PKWY   LEWISVILLE TX,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 60 , 59 , 59 ," $35,066.55 ",,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235139411,"MARTIN, JERRY, CLINTON",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 58 , 101 , 109 ,$#,,
MEDICAID DIRECT,1235142217,APRIA HEALTHCARE LLC,~,4249 PIEDMONT PKWY STE 101 GREENSBORO NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1235142217,APRIA HEALTHCARE LLC,4249 PIEDMONT PKWY STE 101 GREENSBORO NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 461 ," 2,440 "," 5,021 "," $79,622.80 ",,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235142357,"JOHNSON, MARK, STEPHEN",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1901 S SHADY ST   MOUNTAIN CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235142365,"LEE, CRISTY, MICHELLE",1901 S SHADY ST   MOUNTAIN CITY TN,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235142365,"LEE, CRISTY, MICHELLE",1901 S SHADY ST   MOUNTAIN CITY TN,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376510651,WEST CARY FAMILY PHYSICIANS,WEST CARY FAMILY PHYSICIANS,256 TOWNE VILLAGE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1235143546,"NIGAM, GUNJAN",103 PARKWAY OFFICE CT STE 104 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 256 , 298 ," $10,739.70 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235144692,"FRENETTE, GARY, PATRICK",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235145806,"GIBSON, LEONARD, HOWARD",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 287 , 317 , 395 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1235145806,"GIBSON, LEONARD, HOWARD",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 459 , 511 , 657 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235147059,"SIMON, JANICE, LOUISE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235147059,"SIMON, JANICE, LOUISE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1235149352,"GLENN, MOLLIE, BUTLER",~,100 N LYON ST STE A ELIZABETHTOWN NC,009,Bladen,152W00000X,Eye and Vision Services Providers,Optometrist,,1235149352,"GLENN, MOLLIE, BUTLER",100 N LYON ST STE A ELIZABETHTOWN NC,009,Bladen,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 33 , 55 ,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,4024 STIRRUP CREEK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235149428,"KURIAN, MATHEW",3019 FALSTAFF RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,10901 WORLD TRADE BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235149428,"KURIAN, MATHEW",3019 FALSTAFF RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235150624,"TAN, EHRLICH, CU",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235150624,"TAN, EHRLICH, CU",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 15 , 18 , 30 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1235150624,"TAN, EHRLICH, CU",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235150624,"TAN, EHRLICH, CU",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#, 18 ,$#,,
MEDICAID DIRECT,1235151036,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 17050,1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235151036,NORTH CAROLINA CVS PHARMACY LLC,1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1235151432,"WRIGHT-THOMASSON, DEBBIE, RUTH",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1114351095,MCPC-16 LLC,FIRSTHEALTH PRIMARY CARE AND CARDIOLOGY,6322 FAYETTEVILLE RD OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1235151432,"WRIGHT-THOMASSON, DEBBIE, RUTH",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235151432,"WRIGHT-THOMASSON, DEBBIE, RUTH",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 30 , 36 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235151432,"WRIGHT-THOMASSON, DEBBIE, RUTH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 24 , 43 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235151432,"WRIGHT-THOMASSON, DEBBIE, RUTH",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 49 , 63 ,$#,,
MEDICAID DIRECT,1790194322,CATAWBA VALLEY MEDICAL CENTER,,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235151432,"WRIGHT-THOMASSON, DEBBIE, RUTH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235154089,"HORST, JAMES",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1467449728,LEXINGTON FAMILY PHYSICIANS,LEXINGTON FAMILY PHYSICIANS PA,102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1235154501,"WILSON, BENJAMIN, LEWIS",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 40 , 93 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235154550,"TAYLOR, BRICE, SCOTT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235154550,"TAYLOR, BRICE, SCOTT",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013352137,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,4515 PREMIER DR STE 405 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235155748,"IZAJ, NICHOLAS, THOMAS",4515 PREMIER DR STE 405 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235155748,"IZAJ, NICHOLAS, THOMAS",1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 80 , 80 ,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235155748,"IZAJ, NICHOLAS, THOMAS",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235157033,WAL-MART STORES EAST LP,WALMART PHARMACY 10-948,2525 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1235157033,WAL-MART STORES EAST LP,2525 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 26 , 51 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235157603,"MCQUISTON, JAMES, WARREN",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235158338,"RICH, THOMAS, JONATHAN",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235158510,"NIGHTINGALE, DAVID, WILLIAM",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,260 "," 1,870 "," 6,024 "," $372,472.91 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235158866,"LESTER, WILLIAM, MCKINLEY",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235158866,"LESTER, WILLIAM, MCKINLEY",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235158866,"LESTER, WILLIAM, MCKINLEY",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235158866,"LESTER, WILLIAM, MCKINLEY",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235158866,"LESTER, WILLIAM, MCKINLEY",10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235159625,"BRATH, PETER, CHRISTIAN",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235159625,"BRATH, PETER, CHRISTIAN",201 E GROVER ST   SHELBY NC,023,Cleveland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235159906,"KIM, WILLIAM, YOUNGKWAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235161332,"OLSON, JEFFREY, J",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 27 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 28 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 37 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 14 , 21 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 37 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 28 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 181 , 196 , 260 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1235162546,"HINN, GREGORY, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203A EARNHART DR   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1235163213,"DURUMAN, BORA, ABDULLAH",203 EARNHART DR   EDENTON NC,021,Chowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203 EARNHART DR STE A EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1235163213,"DURUMAN, BORA, ABDULLAH",203 EARNHART DR   EDENTON NC,021,Chowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1194263087,DLP FRYE MEDICAL GROUP,FRYECARE WOMENS SERVICES,1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235163213,"DURUMAN, BORA, ABDULLAH",203 EARNHART DR   EDENTON NC,021,Chowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1235163213,"DURUMAN, BORA, ABDULLAH",35 FACILITY DR   CLYDE NC,044,Haywood,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1235164625,"SCHMIDT, MICHAEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235164666,"WILLIAMS, LAWRENCE, DALE",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 83 , 136 , 191 ,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1235164666,"WILLIAMS, LAWRENCE, DALE",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235166505,COUNTY OF SAMPSON,SAMPSON COUNTY DEPARTMENT OF AGING AND IN HOME SER,405 COUNTY COMPLEX RD STE 140 CLINTON NC,082,Sampson,251B00000X,Agencies,Case Management,,1235166505,COUNTY OF SAMPSON,405 COUNTY COMPLEX RD STE 140 CLINTON NC,082,Sampson,251B00000X,Agencies,Case Management,, 66 , 687 , 687 ," $257,398.00 ",,
MEDICAID DIRECT,1235166505,COUNTY OF SAMPSON,SAMPSON COUNTY DEPARTMENT OF AGING AND IN HOME SER,405 COUNTY COMPLEX RD STE 140 CLINTON NC,082,Sampson,332U00000X,Suppliers,Home Delivered Meals,,1235166505,COUNTY OF SAMPSON,405 COUNTY COMPLEX RD STE 140 CLINTON NC,082,Sampson,332U00000X,Suppliers,Home Delivered Meals,,#," 1,452 "," 1,452 "," $11,180.40 ",,
MEDICAID DIRECT,1235166505,COUNTY OF SAMPSON,SAMPSON COUNTY DEPARTMENT OF AGING AND IN HOME SER,405 COUNTY COMPLEX RD STE 140 CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1235166505,COUNTY OF SAMPSON,405 COUNTY COMPLEX RD STE 140 CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,#, 650 , 650 ," $110,368.04 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235167966,"BERMAN, LAWRENCE, MILLER",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 28 , 30 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1235167966,"BERMAN, LAWRENCE, MILLER",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235167966,"BERMAN, LAWRENCE, MILLER",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1235167966,"BERMAN, LAWRENCE, MILLER",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,5111 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 160 , 177 , 272 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1235168105,"LANIER, KARAH, MAHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235171752,"AKONG, JOANNE, FRANCES",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 102 , 102 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 213 , 305 , 356 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 45 , 51 , 52 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 29 , 29 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1235172123,"LEVINSKY, MATTHEW, JOHN",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235172396,"SINGH, RAN, VIJAI PRATAP",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235172396,"SINGH, RAN, VIJAI PRATAP",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235172396,"SINGH, RAN, VIJAI PRATAP",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235172396,"SINGH, RAN, VIJAI PRATAP",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235172834,"BRYANT, AUBREY, ALAN",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1235172834,"BRYANT, AUBREY, ALAN",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1235173444,"KINSER, JENNIFER",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 76 , 78 , 78 ,$#,,
MEDICAID DIRECT,1235173527,SILER CROSSING VISION CENTER OPTOME,SILER CROSSING VISION CENTER OPTOMETRY PA,1603 E 11TH ST   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235173527,SILER CROSSING VISION CENTER OPTOME,1603 E 11TH ST   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,, 58 , 58 , 173 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 161 , 162 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 35 , 35 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1235177593,"COZZARELLI, LISA, GAIL",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1316139397,MOHAMMAD LAWAL GARBA,LADAN MEDICAL CENTER,409 PARKWAY ST STE G GREENSBORO NC,041,Guilford,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1235177809,"GARBA, MOHAMMED, LAWAL",409 PARKWAY STE G GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 45 , 45 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 69 , 70 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1316139397,MOHAMMAD LAWAL GARBA,LADAN MEDICAL CENTER,409 PARKWAY ST STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",409 PARKWAY ST STE G GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 117 , 125 ,$#,,
MEDICAID DIRECT,1316139397,MOHAMMAD LAWAL GARBA,LADAN MEDICAL CENTER,409 PARKWAY ST STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",409 PARKWAY STE G GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 191 , 191 ,$#,,
MEDICAID DIRECT,1851567663,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM INPATIENT MEDICINE SPECIALISTS,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1235177809,"GARBA, MOHAMMED, LAWAL",180 PARKWOOD DR   ELKIN NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 106 , 107 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 102 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1235178302,"CAIN, JESSICA, MARIE",1700 TARBORO ST W STE 102 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 61 , 61 ,$#,,
MEDICAID DIRECT,1992126403,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM NEUROLOGY,101 ELDON PARKS DR STE B ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1235178302,"CAIN, JESSICA, MARIE",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235178302,"CAIN, JESSICA, MARIE",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 54 , 80 ,$#,,
MEDICAID DIRECT,1881295665,SCOTT MATTHEWS OD PA,,316 S MCCASKEY RD   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1235178989,"MILLS, ROBERT",316 S MCCASKEY RD   WILLIAMSTON NC,058,Martin,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235179102,"QUINTERO, TAMMI, TOLBERT",3903 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 45 , 47 ,$#,,
MEDICAID DIRECT,1518075712,KENLY MEDICAL ASSOCIATES PA,~,101 E 2ND ST   KENLY NC,051,Johnston,193400000X,Group,Single Specialty,,1235179128,"WOODALL, HAL, BREEN",101 E 2ND ST   KENLY NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 308 , 525 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235179482,"BOLDIZAR, JOHN, DAVID",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 43 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235179482,"BOLDIZAR, JOHN, DAVID",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 33 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235179482,"BOLDIZAR, JOHN, DAVID",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 39 , 93 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1235179698,"LAMSAL, SUMAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 82 , 250 ,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1235179698,"LAMSAL, SUMAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 89 , 265 , 475 ,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1235179698,"LAMSAL, SUMAN",606 MAIN ST   BAYBORO NC,069,Pamlico,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 56 , 98 ,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1235179698,"LAMSAL, SUMAN",290 KEEL RD   GRANTSBORO NC,069,Pamlico,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1235179698,"LAMSAL, SUMAN",606 MAIN ST   BAYBORO NC,069,Pamlico,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1235478694,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-ORTHOPAEDICTRAUMASERVS,480 FLOYD RD   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235180670,"BRODERICK, JOHN, SCOTT",480 FLOYD RD STE A SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235181090,"DANIEL, PAUL, COLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1053623140,TENDER LOVING CARE HOMES INC,BROOKHAVEN BEHAVIORAL HEALTH,2 WALDEN RIDGE DR STE 30 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235181447,"LOWE-HOYTE, CHARMAINE, PAMELA",2 WALDEN RIDGE DR STE 30 ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043264724,EASTERN CAROLINA CARDIOVASCULAR,EASTERN CAROLINA CARDIOVASCULAR PA,1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1235181538,"BRATTON, MICHAEL, JOHN",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 60 , 78 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 30 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1235182403,"SANCHEZ, IVAN, ORLANDO",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851342141,CAROLINA WEST RADIOLOGY PA,Carolina West Radiology PA,87 EASTGATE DR STE 2 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1235182684,"WILSON JR, NEILLE, ALFORD",68 HOSPITAL RD   SYLVA NC,050,Jackson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 137 , 157 , 205 ,$#,,
MEDICAID DIRECT,1528071453,AMERICARE HEALTH PC,Americare Health PC,6023 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235186545,"KAISER, APRIL, MARYAM",6023 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 28 , 60 ,$#,,
MEDICAID DIRECT,1881607893,AMERICARE HEALTH PC,BUDDY CONNECT INC,1805 MILTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235186545,"KAISER, APRIL, MARYAM",1805 MILTON RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881607893,AMERICARE HEALTH PC,BUDDY CONNECT INC,1805 MILTON RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235186545,"KAISER, APRIL, MARYAM",1805 MILTON RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 100 , 100 , 190 ,$#,,
MEDICAID DIRECT,1528071446,SUGAR CREEK MEDICAL CENTER,~,,,Unknown,193400000X,Group,Single Specialty,,1235186545,"KAISER, APRIL, MARYAM",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1184637902,AMERICARE HEALTH PC,AMERICARE HEALTH,905 N PEARL ST   PAGELAND SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235186545,"KAISER, APRIL, MARYAM",905 N PEARL ST   PAGELAND SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1235186800,PATHGROUP LABS LLC,,1010 AIRPARK CENTER DR STE C NASHVILLE TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1235186800,PATHGROUP LABS LLC,1010 AIRPARK CENTER DR STE C NASHVILLE TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 711 , 916 ," 3,044 "," $45,572.54 ",,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1235187535,"WIKE, WILLIAM, MICKEY",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1235187535,"WIKE, WILLIAM, MICKEY",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 64 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1235187535,"WIKE, WILLIAM, MICKEY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 21 , 65 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1235187535,"WIKE, WILLIAM, MICKEY",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 30 , 45 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1235187535,"WIKE, WILLIAM, MICKEY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 31 , 70 ,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,60 SHUFORD RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1235187626,"LAPLACA, DANIEL, JOSEPH",465 W MAIN ST   SPINDALE NC,081,Rutherford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,60 SHUFORD RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1235187626,"LAPLACA, DANIEL, JOSEPH",60 SHUFORD RD   COLUMBUS NC,075,Polk,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 19 , 80 , 277 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235188020,"CHOLIS III, THOMAS, JOSEPH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235188780,CREATIVE HANDS OCCUPATIONAL THERAPY,CREATIVE HANDS OCCUPATIONAL THERAPY INC,58 PHYSICIANS DR NW STE 106 SUPPLY NC,010,Brunswick,193400000X,Group,Single Specialty,,1235188780,CREATIVE HANDS OCCUPATIONAL THERAPY,58 PHYSICIANS DR NW STE 106 SUPPLY NC,010,Brunswick,193400000X,Group,Single Specialty,, 133 ," 1,323 "," 1,337 "," $119,229.67 ",,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235189945,"JESSEN, ROBERT, MANUEL",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235189945,"JESSEN, ROBERT, MANUEL",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235190778,"DANIEL, LISA, ANN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235190778,"DANIEL, LISA, ANN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235191099,"LUE, ALVIN, JOSEPH",7811 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235191115,"FEKRAT, SHARON",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235191115,"FEKRAT, SHARON",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 18 , 22 ,$#,,
MEDICAID DIRECT,1770722175,HAMPTON ROADS PROTON BEAM THERAPY I,HAMPTON UNIVERSITY PROTON CANCER CENTER,40 ENTERPRISE PKWY   HAMPTON VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235191677,"SINESI, CHRISTOPHER, CHARLES",40 ENTERPRISE PKWY   HAMPTON VA,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1235191826,"BLUMENTHAL, SUSAN, HYMAN",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1518910041,EYECARECENTER OD PA,EYECARE CENTER,819 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1235192071,"GREGG, KENNETH, ALLEN",819 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235192113,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 270 , 276 , 520 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235192170,"JELOVSEK, JOHN, ERIC",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235192170,"JELOVSEK, JOHN, ERIC",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235192170,"JELOVSEK, JOHN, ERIC",2400 PRATT ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235192170,"JELOVSEK, JOHN, ERIC",1200 NAVAHO DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 25 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235192170,"JELOVSEK, JOHN, ERIC",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235193293,"REITHER, MARGARET, CAIRNS",2160 HERBERT CT   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 36 , 40 , 56 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235193293,"REITHER, MARGARET, CAIRNS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 42 , 49 , 74 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235193293,"REITHER, MARGARET, CAIRNS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235193293,"REITHER, MARGARET, CAIRNS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235193541,"TAYLOR, CHERYL, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235193541,"TAYLOR, CHERYL, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235193541,"TAYLOR, CHERYL, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1235194580,"BELL, LINDA, RUTH",835 ALBEMARLE RD   TROY NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1902991698,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1235194671,"CATHCART, CORNELIUS, FITZHAROLD",451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1407137938,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,216 N BICKETT BLVD STE 3 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1235194671,"CATHCART, CORNELIUS, FITZHAROLD",216 N BICKETT BLVD STE 3 LOUISBURG NC,035,Franklin,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174940506,FAST BRAIIN OXFORD PLLC,INCREDIBLE MINDS HEALTH SERVICES,1415 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1235194671,"CATHCART, CORNELIUS, FITZHAROLD",1415 COLLEGE ST   OXFORD NC,039,Granville,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 124 , 137 ," $14,395.22 ",,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1235195827,"BLAKEMORE, WILLIAM, STEPHEN",1503 N ROAD ST   ELIZABETH CTY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235198656,"MCCREA, KIMBERLY, ANN",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 36 , 72 , 76 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235198656,"MCCREA, KIMBERLY, ANN",11840 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235198656,"MCCREA, KIMBERLY, ANN",10030 GILEAD RD STE 300 HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235198656,"MCCREA, KIMBERLY, ANN",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 33 , 66 , 93 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235198656,"MCCREA, KIMBERLY, ANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1235198946,"GARZA, TERESA, MARIE",970 NEWMAN RD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235198946,"GARZA, TERESA, MARIE",970 NEWMAN RD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1235198946,"GARZA, TERESA, MARIE",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 38 , 68 ,$#,,
MEDICAID DIRECT,1518252519,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH FORYSTH HEART AND WELLNESS,725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 50 , 66 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235199258,"POWERS, JOHN, CHARLES",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235201427,"GROSSGOLD, ERIK, TODD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235208976,"TOWLE, JUSTIN, ANTHONY",50 HOSPITAL DR STE 4A HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235208976,"TOWLE, JUSTIN, ANTHONY",50 HOSPITAL DR STE 4A HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1235208976,"TOWLE, JUSTIN, ANTHONY",50 HOSPITAL DR STE 4A HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 25 , 33 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1235208976,"TOWLE, JUSTIN, ANTHONY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235208976,"TOWLE, JUSTIN, ANTHONY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235208976,"TOWLE, JUSTIN, ANTHONY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235209420,"BRAHMI, DALIA",1765 DOBBINS DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235209990,"ANDREWS, KIPP",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 31 ,$#,,
MEDICAID DIRECT,1235211517,"MILLSAPS, JOSHUA, MCIVER",~,935 4TH STREET DR NE STE 2 HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,1235211517,"MILLSAPS, JOSHUA, MCIVER",935 4TH STREET DR NE STE 2 HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 57 , 180 ," $11,473.53 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235212481,"COX, CHRISTOPHER",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 57 , 75 ," $11,171.85 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235212481,"COX, CHRISTOPHER",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235213109,"WEIDNER, ALISON, CATHRINE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235213109,"WEIDNER, ALISON, CATHRINE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235213109,"WEIDNER, ALISON, CATHRINE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235213109,"WEIDNER, ALISON, CATHRINE",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235213109,"WEIDNER, ALISON, CATHRINE",1200 NAVAHO DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235213331,"ORRIS, MICHAEL, V",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235213331,"ORRIS, MICHAEL, V",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235213398,"JOWELL, PAUL, SIMON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235213398,"JOWELL, PAUL, SIMON",DUKE HOSP SOUTH TRENT DR DUKE PDC DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235213398,"JOWELL, PAUL, SIMON",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1235213422,COUNTY OF HARNETT,DIVISION ON AGING,309 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,251B00000X,Agencies,Case Management,,1235213422,COUNTY OF HARNETT,309 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,251B00000X,Agencies,Case Management,, 104 ," 1,018 "," 1,018 "," $414,011.22 ",,
MEDICAID DIRECT,1235213745,WILKES COUNTY BOARD OF EDUCATION,WILKES COUNTY SCHOOLS,613 CHERRY ST   NORTH WILKESBORO NC,097,Wilkes,251300000X,Agencies,Local Education Agency (LEA),,1235213745,WILKES COUNTY BOARD OF EDUCATION,613 CHERRY ST   NORTH WILKESBORO NC,097,Wilkes,251300000X,Agencies,Local Education Agency (LEA),, 518 ," 7,728 "," 7,903 "," $378,775.84 ",,
MEDICAID DIRECT,1235216029,UNITED HOME CARE INC,,323 N SPENCE AVE   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1235216029,UNITED HOME CARE INC,323 N SPENCE AVE   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 75 ," 11,338 "," 11,338 "," $930,010.32 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235221508,"WELLS, BRIAN, JAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 40 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235221524,"ARMISTEAD, PAUL, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235222431,"HARRIS, JAMES, ALAN",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235222431,"HARRIS, JAMES, ALAN",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235222704,"DUTTON, MARGARET, STEPHANIE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1235222837,"LAFEBER, THOMAS, EDWARD",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235222837,"LAFEBER, THOMAS, EDWARD",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1235223090,"KURTH BOWEN, CORNELIA, LIDA",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 89 , 561 , 583 ," $11,666.48 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235223090,"KURTH BOWEN, CORNELIA, LIDA",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 305 , 313 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235224478,"KIRBY, KRISTA, MIDKIFF",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1235224478,"KIRBY, KRISTA, MIDKIFF",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 26 ,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1235224924,"MCGOWAN, LEVI, SCOTTY",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1235224924,"MCGOWAN, LEVI, SCOTTY",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 50 , 73 , 95 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,341 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 34 , 35 , 37 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,341 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 202 , 330 , 455 ," $11,826.18 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235225681,"SHAH, DHARMEN, SUBODHCHANDRA",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235226507,"MAHAN, CHARLES, SCOTT",415 N CENTER ST   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE D HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235226507,"MAHAN, CHARLES, SCOTT",415 N CENTER ST   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235227547,"YOUNG, STEVEN, LAWRENCE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207VE0102X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Reproductive Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235227844,"RIEDEL, RICHARD, FRANCIS",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235227844,"RIEDEL, RICHARD, FRANCIS",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235227844,"RIEDEL, RICHARD, FRANCIS",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 18 , 23 ,$#,,
MEDICAID DIRECT,1417123993,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BMA BLADENBORO,1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1235228446,"PAIT, HEATHER, WALTERS",107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417123993,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BMA BLADENBORO,1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1235228446,"PAIT, HEATHER, WALTERS",1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 147 , 151 ,$#,,
MEDICAID DIRECT,1578628780,MASON & MINCEY OD PA,~,2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1235229543,"MINCEY, JOHN, SCOTT",2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 51 , 51 , 69 ,$#,,
MEDICAID DIRECT,1578628780,MASON & MINCEY OD PA,~,2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235229543,"MINCEY, JOHN, SCOTT",2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 93 , 98 , 138 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235230673,"ALLEN, MARCHELLE, ISYK",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235230673,"ALLEN, MARCHELLE, ISYK",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235230673,"ALLEN, MARCHELLE, ISYK",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235231838,"STANLEY, DANIEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1235232091,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04169,522 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235232091,NORTH CAROLINA CVS PHARMACY LLC,522 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1235232281,"MCLAUGHLIN, GENE, LYNDON",~,1709 BERWICK DR STE B LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1235232281,"MCLAUGHLIN, GENE, LYNDON",1709 BERWICK DR STE B LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386369809,FAITH FAMILY MEDICAL PLLC,,1709 BERWICK DR STE B LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1235232281,"MCLAUGHLIN, GENE, LYNDON",1709 BERWICK DR STE B LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 238 , 359 ," $10,024.57 ",,
MEDICAID DIRECT,1235232927,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06405,300 E GROVER ST   SHELBY NC,023,Cleveland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1235232927,NORTH CAROLINA CVS PHARMACY LLC,300 E GROVER ST   SHELBY NC,023,Cleveland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1235232927,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06405,300 E GROVER ST   SHELBY NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1235232927,NORTH CAROLINA CVS PHARMACY LLC,300 E GROVER ST   SHELBY NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1235232927,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06405,300 E GROVER ST   SHELBY NC,023,Cleveland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235232927,NORTH CAROLINA CVS PHARMACY LLC,300 E GROVER ST   SHELBY NC,023,Cleveland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1205205218,AMEE PATEL OD PA,AMEE PATEL OD,1002 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1235236688,"PATEL, AMEE, RAJNIKANT",1002 N SPENCE AVE   GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235236894,"COOK, JENNIFER, BETH",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235237926,"BERRY, JONATHAN, JORDAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235237926,"BERRY, JONATHAN, JORDAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235237926,"BERRY, JONATHAN, JORDAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235237926,"BERRY, JONATHAN, JORDAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235237926,"BERRY, JONATHAN, JORDAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 128 , 158 , 231 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235237926,"BERRY, JONATHAN, JORDAN",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235237926,"BERRY, JONATHAN, JORDAN",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235238171,"JOHNSON, SALLY, REBECCA",5317 HIGHGATE DR STE 117 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1235238171,"JOHNSON, SALLY, REBECCA",5317 HIGHGATE DR STE 117 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1235238957,LANDMARK ASSISTED LIVING LLC,~,6781 OLD US HIGHWAY 52   LEXINGTON NC,029,Davidson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235238957,LANDMARK ASSISTED LIVING LLC,6781 OLD US HIGHWAY 52   LEXINGTON NC,029,Davidson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 39 ," 11,286 "," 11,350 "," $829,734.86 ",,
MEDICAID DIRECT,1538117031,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,714 HIGHWAY ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1235239641,"JOHNSON, BRENT",3354 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1538117031,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,714 HIGHWAY ST   MADISON NC,079,Rockingham,193400000X,Group,Single Specialty,,1235239641,"JOHNSON, BRENT",3354 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1538117031,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,714 HIGHWAY ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1235239641,"JOHNSON, BRENT",714 HIGHWAY ST   MADISON NC,079,Rockingham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1538117031,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,714 HIGHWAY ST   MADISON NC,079,Rockingham,193400000X,Group,Single Specialty,,1235239641,"JOHNSON, BRENT",714 HIGHWAY ST   MADISON NC,079,Rockingham,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 28 , 29 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235240714,"KAMITSUKA, PAUL, FINLEY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 153 , 174 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1235240714,"KAMITSUKA, PAUL, FINLEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235244245,"SATHYAMOORTHY, MADHANKUMAR",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 142 , 161 , 171 ," $15,068.99 ",,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1235244401,"GUNN-HILL, ERICKA, LEE",730 MALCOLM BLVD STE 150 CONNELLY SPG NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1881327955,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - LONG VIEW,2336 1ST AVE SW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235247404,"HARVEY, JAY, WARREN",2336 1ST AVE SW   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 67 , 103 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235251828,"REED CRAWFORD, MAKEECHA",7800 STEVENS MILL RD STE O MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 63 , 115 ,$#,,
MEDICAID DIRECT,1235254822,"ROBERTI, GRACIELA",,6045 PRESCOTT POND DR   WAKE FOREST NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1235254822,"ROBERTI, GRACIELA",6045 PRESCOTT POND DR   WAKE FOREST NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 19 , 56 , 139 ," $12,988.28 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235255290,"EL-MAHDY, SHERIF, OMAR",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235255290,"EL-MAHDY, SHERIF, OMAR",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235259169,"GROSS, JANE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1235259847,BLESSED HOME LLC,BLESSED HOME II,7005 BRECKEN RIDGE AVE   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235259847,BLESSED HOME LLC,7005 BRECKEN RIDGE AVE   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 424 , 424 ," $26,521.91 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,8990 HIGHWAY 17 S   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1235261827,"LAWRENCE, LARRY, DOUGLAS",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1235262049,SHIPMAN FAMILY HOME CARE INC,SHIPMAN FAMILY HOME CARE INC,318 COURT SQ STE B SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,1235262049,SHIPMAN FAMILY HOME CARE INC,318 COURT SQ STE B SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 8,465 "," 8,483 "," $785,688.92 ",,
MEDICAID DIRECT,1619099256,FAMILY MEDICAL ASSOCS OF RALEIGH,,3500 BUSH ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235262718,"DRABICK, ANDREW, JOSEPH",3500 BUSH ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1356628283,LANE OPTOMETRY PLLC,,1231 BIRCH ST   CAMP LEJEUNE NC,067,Onslow,193400000X,Group,Single Specialty,,1235270174,"LANE, JUSTIN, DAVID",1231 BIRCH ST   CAMP LEJEUNE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356628283,LANE OPTOMETRY PLLC,,1345 WESTERN BLVD STE 120B JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1235270174,"LANE, JUSTIN, DAVID",1345 WESTERN BLVD STE 120B JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1457818262,HAMMOCK DMD & LOTAKIS DDS I PLLC,DENTISTRY OF THE CAROLINAS,6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235271321,"LOTAKIS, JAMES, PAUL",6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,727 "," 2,592 "," 10,235 "," $539,679.61 ",,
MEDICAID DIRECT,1841757507,HAMMOCK DMD & LOTAKIS DDS V PLLC,DENTISTRY OF THE CAROLINAS - STATESVILLE,730 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235271321,"LOTAKIS, JAMES, PAUL",730 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1457818262,HAMMOCK DMD & LOTAKIS DDS I PLLC,DENTISTRY OF THE CAROLINAS,6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235271321,"LOTAKIS, JAMES, PAUL",2641 COURT DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538626361,HAMMOCK DMD & LOTAKIS DDS III PLLC,DENTISTRY OF THE CAROLINAS - GASTONIA,2641 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235271321,"LOTAKIS, JAMES, PAUL",2641 COURT DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235276510,"MITCHELL, NIA, SCHWANN",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,501 DOUGLAS ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235276510,"MITCHELL, NIA, SCHWANN",501 DOUGLAS ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235276510,"MITCHELL, NIA, SCHWANN",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 55 , 99 ,$#,,
MEDICAID DIRECT,1235279894,ANGELIC HANDS HOME HEALTH AGENCY IN,~,130 HILLSBORO ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1235279894,ANGELIC HANDS HOME HEALTH AGENCY IN,130 HILLSBORO ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 34 ," 7,618 "," 7,618 "," $593,323.56 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235284084,"TARANTINO, HEATHER, NOELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 49 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235284084,"TARANTINO, HEATHER, NOELLE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 22 , 54 ,$#,,
MEDICAID DIRECT,1235285560,"FULTON JR, GEORGE",~,835 HEATHER RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,1235285560,"FULTON JR, GEORGE",835 HEATHER RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice," 1,150 "," 2,331 "," 5,985 "," $373,582.91 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235285974,"TREMBATH, DIMITRI, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235285974,"TREMBATH, DIMITRI, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 67 , 70 , 139 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235285974,"TREMBATH, DIMITRI, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235285974,"TREMBATH, DIMITRI, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235286279,"MCMILLEN, MICHAEL, LINDSAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235286279,"MCMILLEN, MICHAEL, LINDSAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1235286279,"MCMILLEN, MICHAEL, LINDSAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235286626,"JORDAN, PETER, MANNING",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235286626,"JORDAN, PETER, MANNING",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 61 , 75 , 115 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235286626,"JORDAN, PETER, MANNING",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1235290651,NC DEPT OF HEALTH AND HUMAN SERVICE,NC STATE LABORATORY OF PUBLIC HEALT,4312 DISTRICT DR   RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1235290651,NC DEPT OF HEALTH AND HUMAN SERVICE,4312 DISTRICT DR   RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,," 5,068 "," 5,757 "," 21,999 "," $410,233.53 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235292004,"BAKER, JEFFREY, PAUL",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235292004,"BAKER, JEFFREY, PAUL",4020 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235292004,"BAKER, JEFFREY, PAUL",4020 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235292384,"SANFORD, FRANCES, CAROLINE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235292384,"SANFORD, FRANCES, CAROLINE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5402 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235292384,"SANFORD, FRANCES, CAROLINE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 49 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235292384,"SANFORD, FRANCES, CAROLINE",3120 NORTHLINE AVE STE 103 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1235292715,"GUDURU, USHA, SUDHEER",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 91 , 215 , 634 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235296013,"SAFFO, EDITH, LYNNE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 75 , 101 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235296013,"SAFFO, EDITH, LYNNE",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 29 , 37 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235296013,"SAFFO, EDITH, LYNNE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1235297185,HERITAGE HOME CARE AGENCY INC,HERITAGE HOME CARE OF GREENSBORO,914 N. ELM ST STE. D GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1235297185,HERITAGE HOME CARE AGENCY INC,914 N. ELM ST STE. D GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 2,681 "," 2,681 "," $230,578.84 ",,
MEDICAID DIRECT,1235301946,"LEDFORD, CAMILLE",NSH CANCER INSTITUTE PROFESSIONAL SERVICES G LLC,101 RIVERSTONE VIS STE 206 BLUE RIDGE GA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1235301946,"LEDFORD, CAMILLE",101 RIVERSTONE VIS STE 206 BLUE RIDGE GA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235303132,"FARMER, JENNIFER, BURKE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 51 , 227 , 227 ," $20,407.88 ",,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235303132,"FARMER, JENNIFER, BURKE",1 HOSPITAL RD   CHEROKEE NC,087,Swain,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235304205,"CARROLL, MICHAEL, JOSEPH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 68 , 113 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235304205,"CARROLL, MICHAEL, JOSEPH",3605 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235304205,"CARROLL, MICHAEL, JOSEPH",495 ARBOR HILL RD STE M KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 34 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235304601,"THOMPSON, CYNTHIA, PAIGE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235304825,"MACDONALD, JAMES, ALEXIS",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 134 , 157 , 160 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235304825,"MACDONALD, JAMES, ALEXIS",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235304825,"MACDONALD, JAMES, ALEXIS",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235304825,"MACDONALD, JAMES, ALEXIS",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1629075973,HANGER PROSTHETICS & ORTHOTICS EAST,~,744 HARTNESS RD   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235311960,"CONSTANTINE, MICHAEL, THOMAS",744 HARTNESS RD   STATESVILLE NC,049,Iredell,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235312240,"NIZHARZDZE, MAIA",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235312679,"DAVIS, ROSS, PARKER",306 WESTWOOD AVE   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235312679,"DAVIS, ROSS, PARKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1771 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235312679,"DAVIS, ROSS, PARKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235312679,"DAVIS, ROSS, PARKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 314 , 329 , 369 ," $12,597.89 ",,
MEDICAID DIRECT,1063647394,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - FOR,2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235313081,"FLEMING, CHARLENE, MCCAIN",2933 MAPLEWOOD AVE STE 1 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 28 , 60 ,$#,,
MEDICAID DIRECT,1235314774,GRANTHAM FAMILY CARE HOME II,GRANTHAM FAMILY CARE HOME II,107 N GEORGIA AVE   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235314774,GRANTHAM FAMILY CARE HOME II,107 N GEORGIA AVE   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 81 , 81 ," $41,277.79 ",,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 31 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245859453,TRIAD BREAST IMAGING CENTER LLC,NOVANT HEALTH BREAST IMAGING CENTER GREENSBORO,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,703 COMFORT LN   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 31 , 40 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 28 , 34 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 45 , 50 ,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 75 , 88 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 31 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1235315052,"VAN DYKE, BRADLEY, STUART",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1235315771,"CLEMONS, EDWARD",EDWARD J CLEMONS JR DDS,5011 S PARK DR STE 110 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1235315771,"CLEMONS, EDWARD",5011 S PARK DR STE 110 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235316878,"WAREES, WAREES, MUHAMMAD",1638 OWEN DR PEDIATRIC EMERGENCY DEPT FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 98 , 106 , 116 ," $10,432.79 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235316977,"CIOTOLI, MARCIE, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1356727341,DR REIMELS UNIVERSITY PLLC,,8401 UNIVERSITY EXEC PARK DR STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235317801,"TARLTON, SANDY, BREWER",8401 UNIVERSITY EXEC PARK DR STE 120 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1861828022,MICHAEL O REIMELS DDS & CATHERINE S,THE SMILE ZONE,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235317801,"TARLTON, SANDY, BREWER",8401 UNIVERSITY EXEC PARK DR STE 120 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,201 "," 1,221 "," 6,176 "," $146,097.09 ",,
MEDICAID DIRECT,1598755910,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE FOOTHILLS,296 OAK ST   SPINDALE NC,081,Rutherford,193400000X,Group,Single Specialty,,1235321233,"LAGOS, JAMIE, ANDRES",296 OAK ST   SPINDALE NC,081,Rutherford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 35 , 103 , 114 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235328600,"KUNZ, ERIN, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235328600,"KUNZ, ERIN, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235329327,"BARTFIELD, JESSICA, KATHRYN",3903 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235332024,"LEWIS, DANIEL, ROBERT",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013298926,MATTHEWS SURGERY CENTER LLC,MATTHEWS SURGERY CENTER LLC,710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1235332024,"LEWIS, DANIEL, ROBERT",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235332024,"LEWIS, DANIEL, ROBERT",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 54 , 84 , 135 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1235333014,"FARRAR, AMY, TABORN",7010 NC HIGHWAY 751 STE 103 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1904 FRONT ST STE 530 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1235333014,"FARRAR, AMY, TABORN",7010 NC HIGHWAY 751 STE 103 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 59 , 166 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1235333014,"FARRAR, AMY, TABORN",7010 NC HIGHWAY 751 STE 103 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 89 , 295 ," $15,919.50 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235333014,"FARRAR, AMY, TABORN",7010 NC HIGHWAY 751 STE 103 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1235333014,"FARRAR, AMY, TABORN",1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 82 , 126 , 422 ," $19,836.47 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1904 FRONT ST STE 530 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1235333014,"FARRAR, AMY, TABORN",1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1093315574,HEALING HANDS FAMILY PRACTICE PLLC,,1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1235333675,"BLACKBURN, ANDREA, SUZETTE",1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 156 , 250 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235333899,"GLASS, MATTHEW, RICK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 25 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235333899,"GLASS, MATTHEW, RICK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235333899,"GLASS, MATTHEW, RICK",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235333899,"GLASS, MATTHEW, RICK",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2905 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235333899,"GLASS, MATTHEW, RICK",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235333899,"GLASS, MATTHEW, RICK",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 36 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235334046,"IVEY, NOEL",40 MEDICINE   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235334046,"IVEY, NOEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235334046,"IVEY, NOEL",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 43 , 43 ,$#,,
MEDICAID DIRECT,1588613756,NEPHROLOGY ASSOCIATES PA,NEPHROLOGY ASSOCIATES PA,1436 RIVERCHASE BLVD   ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235335456,"BHUPATHI, SATYA SAI, VENKATESH",1436 RIVERCHASE BLVD   ROCK HILL SC,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235337312,"ROSDAHL, JULLIA, ANN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 18 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235337312,"ROSDAHL, JULLIA, ANN",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 14 , 38 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235338385,"KAPOOR, RUPA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235339599,"MEHTA, HIREN, HARSHADRAY",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 42 , 60 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235339599,"MEHTA, HIREN, HARSHADRAY",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 101 , 147 , 255 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,,,Unknown,193200000X,Group,Multi-Specialty,,1235339599,"MEHTA, HIREN, HARSHADRAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235339730,"HOLLOWELL, KERRY, LYNN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 60 , 62 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235339870,"MOORE, JUSTIN, ROSS",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235340001,"JOWZA, MARYAM, WOODELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235340001,"JOWZA, MARYAM, WOODELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235340001,"JOWZA, MARYAM, WOODELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 88 , 118 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235340001,"JOWZA, MARYAM, WOODELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1013249796,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST SURGICAL SPECIAL,149 MACARTHUR ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1235341702,"MOORHEAD, ANDREW, SLEMMONS",149 MACARTHUR ST   ASHEBORO NC,076,Randolph,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 42 , 59 , 63 ,$#,,
MEDICAID DIRECT,1235341728,EAST VIEW FAMILY CARE,EAST VIEW FAMILY CARE,3208 TEXS FISH CAMP RD   CONNELLY SPRINGS NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235341728,EAST VIEW FAMILY CARE,3208 TEXS FISH CAMP RD   CONNELLY SPRINGS NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 360 , 360 ," $22,262.51 ",,
MEDICAID DIRECT,1942226386,DILLON FAMILY DENTAL CENTER,DILLON FAMILY DENTAL CENTER,101 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235345331,"BRACEY, RONALD, KENT",101 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 157 , 223 , 495 ," $28,769.76 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235346131,"TSAI, TOBIAS, JUNG MING",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235346131,"TSAI, TOBIAS, JUNG MING",6600 W WILKINSON BLVD   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235346131,"TSAI, TOBIAS, JUNG MING",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 21 , 157 , 162 ," $10,552.33 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235346131,"TSAI, TOBIAS, JUNG MING",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 32 , 40 , 43 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235346131,"TSAI, TOBIAS, JUNG MING",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 146 , 247 , 359 ," $22,707.23 ",,
MEDICAID DIRECT,1699471839,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY - DIXON BLVD,1758 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235346172,"JESSUP, REVONDA, LA SHAWN",2721 X RAY DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 58 , 86 , 86 ,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235346172,"JESSUP, REVONDA, LA SHAWN",2721 X RAY DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1548389125,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - 3RD AVE,111 E THIRD AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235346172,"JESSUP, REVONDA, LA SHAWN",2721 X RAY DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 91 , 177 , 180 ," $12,023.07 ",,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235346172,"JESSUP, REVONDA, LA SHAWN",2721 X RAY DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1235351578,CAROLINA HOME HEALTH CARE INC,CAROLINA HOME HEALTH CARE INC,1728 FUNNY CIDE DR   WAXHAW NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1235351578,CAROLINA HOME HEALTH CARE INC,1728 FUNNY CIDE DR   WAXHAW NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 80 ," 19,260 "," 19,434 "," $1,566,131.50 ",,
MEDICAID DIRECT,1457377954,STONE INSTITUTE OF THE CAROLINAS LL,~,215 SOUTH MAIN STREET SU 201 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235351867,"HUBBARD, JEREMY, SLADE",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1235351867,"HUBBARD, JEREMY, SLADE",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 20 , 28 , 60 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235351867,"HUBBARD, JEREMY, SLADE",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 40 , 54 , 137 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235351867,"HUBBARD, JEREMY, SLADE",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1962042416,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PEDIATRIC VIRTUAL VISIT,2709 WATER RIDGE PKWY STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235353673,"SHARP, JACQUELINE, DEE",2709 WATER RIDGE PKWY STE 500 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235353673,"SHARP, JACQUELINE, DEE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 37 , 37 , 47 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235353673,"SHARP, JACQUELINE, DEE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1235355918,"TAYLOE, DAVID, THOMAS",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1235355918,"TAYLOE, DAVID, THOMAS",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 64 , 79 , 173 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1235359696,"GHANI, MUHAMMAD, ABDUL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235359696,"GHANI, MUHAMMAD, ABDUL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 52 , 153 , 153 ,$#,,
MEDICAID DIRECT,1598584781,AMAN MASOOMI DDS PLLC,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1235360595,"LASANTA GARCIA, REINALDO",3823 GUESS RD STE P DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 175 , 189 , 741 ," $31,334.08 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235361353,"KHASRAW, MUSTAFA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235361353,"KHASRAW, MUSTAFA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235361353,"KHASRAW, MUSTAFA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1235363052,ASSUREX HEALTH INC,~,6000 S MASON MONTGOMERY RD   MASON OH,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1235363052,ASSUREX HEALTH INC,6000 S MASON MONTGOMERY RD   MASON OH,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235364118,"PANYKO, STEPHEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 33 , 38 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 261 , 413 ," 1,209 "," $229,159.62 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 169 , 176 , 251 ,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 81 , 131 , 738 ," $43,912.10 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,970 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,970 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",970 NEWMAN RD   NEW BERN NC,025,Craven,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1235364803,"CRIDDLE, JARED, MATTHEW",125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235365297,"KAPPUS, MATTHEW, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 39 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235365297,"KAPPUS, MATTHEW, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235365297,"KAPPUS, MATTHEW, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235365297,"KAPPUS, MATTHEW, ROBERT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235365297,"KAPPUS, MATTHEW, ROBERT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235365297,"KAPPUS, MATTHEW, ROBERT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235365313,"ULRICH, CAROLINE, POWELL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235365347,"HANDLY, BRIAN, DOUGLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235365388,"MESSER, JAMES, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 137 , 138 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235365388,"MESSER, JAMES, ROBERT",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235365446,"SCHREIBER, NICOLETTE, MARIE",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,7780 BRIER CREEK PKWY STE 330 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235365446,"SCHREIBER, NICOLETTE, MARIE",7780 BRIER CREEK PKWY STE 330 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1235365990,"WEIGLE, KERI, ELIZABETH",781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235365990,"WEIGLE, KERI, ELIZABETH",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366253,"BERGER, MILES",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366253,"BERGER, MILES",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366253,"BERGER, MILES",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1235366600,"KRAGEL, CRYSTEN, BRINKLEY",333 GASHES CREEK RD STE 111 ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235366600,"KRAGEL, CRYSTEN, BRINKLEY",333 GASHES CREEK RD STE 111 ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1235366600,"KRAGEL, CRYSTEN, BRINKLEY",50 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235366600,"KRAGEL, CRYSTEN, BRINKLEY",50 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1871854828,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235366832,"LING, SHUBIN, KOK YEW",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235366832,"LING, SHUBIN, KOK YEW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 28 , 84 , 94 ,$#,,
MEDICAID DIRECT,1871854752,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235366832,"LING, SHUBIN, KOK YEW",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235366832,"LING, SHUBIN, KOK YEW",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235366832,"LING, SHUBIN, KOK YEW",1000 HEALING WAY   MATTHEWS NC,090,Union,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 225 , 252 , 336 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 17 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 165 , 183 , 227 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 26 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235366899,"KUZMINSKI, SAMUEL, JOSEPH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235367152,"ROSENBERG, BROOKE, WHITLEY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235368358,"SAMAL, SUBHANKAR",606 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063712727,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1002 S EUGENE ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235368358,"SAMAL, SUBHANKAR",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1972050979,TRIAD ADULT AND PEDIATRIC MEDICINE,,2039 BRENTWOOD ST STE B109 HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235368358,"SAMAL, SUBHANKAR",2039 BRENTWOOD ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447980883,TRIAD ADULT AND PEDIATRIC MEDICINE,,300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235368358,"SAMAL, SUBHANKAR",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 43 , 50 ,$#,,
MEDICAID DIRECT,1063712727,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1002 S EUGENE ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235368358,"SAMAL, SUBHANKAR",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881059723,TRIAD ADULT AND PEDIATRIC MEDICINE,,1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235368358,"SAMAL, SUBHANKAR",1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1235368507,"SAXENA, NAKSHATRA",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 71 , 95 , 176 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1235368507,"SAXENA, NAKSHATRA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 212 , 720 , 721 ," $12,684.10 ",,
MEDICAID DIRECT,1235370750,UNIVERSAL HEALTH CARE LILLINGTON,~,1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235370750,UNIVERSAL HEALTH CARE LILLINGTON,1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 45 ," 1,852 "," 1,854 "," $463,811.95 ",,
MEDICAID DIRECT,1235372137,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-4334,25 NORTHRIDGE COMMONS PKWY   WEAVERVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1235372137,WAL-MART STORES EAST LP,25 NORTHRIDGE COMMONS PKWY   WEAVERVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235372822,"DICKS, KRISTEN, VIRGINIA",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235372822,"DICKS, KRISTEN, VIRGINIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 23 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235372822,"DICKS, KRISTEN, VIRGINIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 41 , 55 , 74 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235372822,"DICKS, KRISTEN, VIRGINIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 25 , 54 , 57 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235373218,"HOLLAND, CHRISTOPHER, MICHAEL",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 46 , 61 , 108 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,9735 KINCEY AVE STE 300 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235373218,"HOLLAND, CHRISTOPHER, MICHAEL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,9735 KINCEY AVE STE 300 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235373218,"HOLLAND, CHRISTOPHER, MICHAEL",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235373218,"HOLLAND, CHRISTOPHER, MICHAEL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 17 , 27 , 38 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235373754,"OSBORNE-RODDENBERRY, JENNIFER, NICHOLE",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235373754,"OSBORNE-RODDENBERRY, JENNIFER, NICHOLE",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1235373754,"OSBORNE-RODDENBERRY, JENNIFER, NICHOLE",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1235373754,"OSBORNE-RODDENBERRY, JENNIFER, NICHOLE",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235373994,"HAILEMICHAEL, TESHOME, ASSEFA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 103 , 279 , 280 ," $11,537.89 ",,
MEDICAID DIRECT,1235375742,AFYA GROUP LLC,AVANT PHARMACY AND WELLNESS,9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235375742,AFYA GROUP LLC,9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1235375742,AFYA GROUP LLC,AVANT PHARMACY AND WELLNESS,9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1235375742,AFYA GROUP LLC,9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1235375742,AFYA GROUP LLC,AVANT PHARMACY AND WELLNESS,9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235375742,AFYA GROUP LLC,9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 183 , 433 , 762 ," $47,586.77 ",,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1235381419,"SEFFELS, ALLAN, EDMUND",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1235381419,"SEFFELS, ALLAN, EDMUND",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235381435,"WILLIAMS, JEFFERSON, GARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235381435,"WILLIAMS, JEFFERSON, GARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 57 , 68 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235381609,"DIXON, ZAKIYA, BAAKO AFRICA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1730263211,HIGGINS MANI & WATSON III DDS PA,THE DENTAL CARE CENTER,3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235382136,"KONCZAL, KELLY, MARIE",545 VENTURE DR   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235382136,"KONCZAL, KELLY, MARIE",545 VENTURE DR   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376868398,WIGGINS & GILES DDS PA,Main Street Family Dentistry,5050 KENTWORTH DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1235382136,"KONCZAL, KELLY, MARIE",545 VENTURE DR   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1316023443,HIGGINS MANI & WATSON IV DDS PA,THE DENTAL CARE CENTER,545 VENTURE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235382136,"KONCZAL, KELLY, MARIE",545 VENTURE DR   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice," 1,650 "," 2,817 "," 9,521 "," $474,769.33 ",,
MEDICAID DIRECT,1306491444,HIGGINS MANI AND WATSON VIII DDS PA,THE DENTAL CARE CENTER,877 E GANNON AVE STE 401 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235382136,"KONCZAL, KELLY, MARIE",545 VENTURE DR   SMITHFIELD NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1962435529,VIEWMONT UROLOGY CLINIC,VIEWMONT UROLOGY CLINIC,1202 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1235383381,"WILLIS, HEATHER, LYNN",1202 N CENTER ST 1202 NORTH CENTER STREET HICKORY NC,018,Catawba,208800000X,Allopathic & Osteopathic Physicians,Urology,, 147 , 264 , 536 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235383753,"UNDERWOOD, STACIE, MARIE",232 SHARON AVE NW   LENOIR NC,014,Caldwell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235387028,"DEJONG, NEAL, ARLEDGE",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 40 , 72 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235387028,"DEJONG, NEAL, ARLEDGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235387028,"DEJONG, NEAL, ARLEDGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 40 , 50 , 52 ,$#,,
MEDICAID DIRECT,1679166821,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL FAMILY PRACTICE,20 S MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1235387820,"KINNINGER, ADAM, JOSEPH",20 S MEDICAL CT   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 70 , 194 , 400 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235388125,"KEMP, CHRISTOPHER, CHARLES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 32 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235388224,"KALAPURAKAL, MATHEW, SANY",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 25 , 38 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1235388794,"AGBARA, ONYINYECHI, BEVERLY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 57 , 73 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235388794,"AGBARA, ONYINYECHI, BEVERLY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235388794,"AGBARA, ONYINYECHI, BEVERLY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235388794,"AGBARA, ONYINYECHI, BEVERLY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 241 , 258 , 317 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1235388794,"AGBARA, ONYINYECHI, BEVERLY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235388794,"AGBARA, ONYINYECHI, BEVERLY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 150 , 159 , 198 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235389669,"ELLIOTT, ROBIN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 43 , 44 , 58 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235390691,"SMITH, JOSHUA, ROBERT",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 41 , 47 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235390691,"SMITH, JOSHUA, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235390691,"SMITH, JOSHUA, ROBERT",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 24 , 34 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235390691,"SMITH, JOSHUA, ROBERT",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 50 , 73 , 96 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235390972,"BAUSERMAN, MELISSA, SCHWEIKHART",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 29 , 30 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1235390972,"BAUSERMAN, MELISSA, SCHWEIKHART",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1235392994,"AHMAD, ZEESHAN, NASEER",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1235392994,"AHMAD, ZEESHAN, NASEER",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 102 , 229 , 293 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235393737,"TAHILRAMANI, REENA, NANDITA",113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,,,Unknown,193400000X,Group,Single Specialty,,1235394081,"JU, ANDREW, WENHUA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 31 , 39 ,$#,,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,,,Unknown,193400000X,Group,Single Specialty,,1235394081,"JU, ANDREW, WENHUA",524 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 36 , 85 ,$#,,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,524 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235394081,"JU, ANDREW, WENHUA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 33 , 51 ,$#,,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,,,Unknown,193400000X,Group,Single Specialty,,1235394081,"JU, ANDREW, WENHUA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,524 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235394081,"JU, ANDREW, WENHUA",524 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 45 , 350 , 731 ," $42,384.60 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235394479,"CHERUKURI, SANJAY",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1235394479,"CHERUKURI, SANJAY",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 178 , 250 , 476 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235394479,"CHERUKURI, SANJAY",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 63 , 128 , 235 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235396094,"CHAUVIERE, MATTHEW, VICTOR",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 46 , 60 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,908 EDEN WAY N STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235396649,"WHITEHURST-DOSS, SUE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,908 EDEN WAY N STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235396649,"WHITEHURST-DOSS, SUE",908 EDEN WAY N STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235396896,"HESTER-CLARKE, SISI, NJIA",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235396896,"HESTER-CLARKE, SISI, NJIA",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235396896,"HESTER-CLARKE, SISI, NJIA",9615 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 25 , 42 , 81 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235397431,"ALVAREZ, MANRIQUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235397431,"ALVAREZ, MANRIQUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 143 , 169 , 203 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235397472,"LARK, ROBERT, K.",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 48 , 49 , 73 ," $28,745.52 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235397472,"LARK, ROBERT, K.",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235397472,"LARK, ROBERT, K.",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235397472,"LARK, ROBERT, K.",3000 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 139 , 193 , 195 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235399023,"GOEL, ANUBHI",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003860917,SURGERY CENTER OF PINEHURST LLC,SURGERY CENTER OF PINEHURST LLC,10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1235399460,"MARINO, JAMES, THOMAS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235399460,"MARINO, JAMES, THOMAS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 79 , 166 , 249 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235402793,"HIGGINS, LISA, CHRISTINE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235403999,"LANDON, JAMES, ROBERT",435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL OAK ISLAND,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health, 17 , 23 , 23 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235406976,"COBLE, KATHRYN, GOSNELL",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235406976,"COBLE, KATHRYN, GOSNELL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235416272,"WALTER, EMILY, GIBSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235416272,"WALTER, EMILY, GIBSON",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 21 , 28 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235416272,"WALTER, EMILY, GIBSON",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 25 , 70 , 101 ,$#,,
MEDICAID DIRECT,1235418336,SANDHILLS HOME CARE LLC,SANDHILLS HOME CARE LLC,401 E 3RD ST UNIT 3C PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1235418336,SANDHILLS HOME CARE LLC,401 E 3RD ST UNIT 3C PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 94 ," 11,475 "," 11,475 "," $707,910.92 ",,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235420522,"GOLDEN, JAMIE, M",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1235421314,"OLMSTED, COURTNEY, LEHN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1235421314,"OLMSTED, COURTNEY, LEHN",701 NEWMAN RD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235422635,"FLEISCHMAN, GITANJALI, MADAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 19 , 22 , 30 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235422635,"FLEISCHMAN, GITANJALI, MADAN",505 OBERLIN RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235422635,"FLEISCHMAN, GITANJALI, MADAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1235422635,"FLEISCHMAN, GITANJALI, MADAN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1235424144,"BEHM, BRITTANY, BAIRD",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1780033233,INTEGRATED BEHAVIORAL HEALTH MANAGE,,8430 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235425323,"RICHARDSON, MARYANN, CATHERINE",8430 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235428103,"SMITH, ALEXIS, CHRISTINE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 17 , 35 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235428103,"SMITH, ALEXIS, CHRISTINE",125 QUEENS RD STE 640 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235428103,"SMITH, ALEXIS, CHRISTINE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235428103,"SMITH, ALEXIS, CHRISTINE",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235428103,"SMITH, ALEXIS, CHRISTINE",10030 GILEAD RD STE 300 HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 29 , 43 , 53 ,$#,,
MEDICAID DIRECT,1750068219,DLP RUTHERFORD PHYSICIAN PRACTICES,FOREST CITY FAMILY CARE RHC,212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1235432154,"HILL, RHONDA, BROOKS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 166 , 499 , 577 ," $23,160.03 ",,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235432154,"HILL, RHONDA, BROOKS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 13 , 25 ,$#,,
MEDICAID DIRECT,1235432881,CLIMBING JACOBS LADDER INC,~,3072 BAINBRIDGE DR   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1235432881,CLIMBING JACOBS LADDER INC,3072 BAINBRIDGE DR   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 873 , 873 ," $62,383.11 ",,
MEDICAID DIRECT,1487845020,AVANCE CARE PA,,1821 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1235433707,"NWANONYIRI, IKE, CHIDI",855 SAM NEWELL RD STE 205 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235433707,"NWANONYIRI, IKE, CHIDI",294 N NC 16 BUSINESS HWY STE A DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235434739,"THOMAS, ALLISON, LEE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235434739,"THOMAS, ALLISON, LEE",2605 HOSPITAL RD   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235434739,"THOMAS, ALLISON, LEE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 41 , 56 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1235434739,"THOMAS, ALLISON, LEE",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1235434929,"FLENNER, ZACHERY, RYAN",2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1235434929,"FLENNER, ZACHERY, RYAN",2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 28 , 28 ,$#,,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235438870,"JAMES, KIRK, ANDERSON",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1699311563,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DERMATOLOGY,4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235438870,"JAMES, KIRK, ANDERSON",4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 77 , 89 , 124 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235438870,"JAMES, KIRK, ANDERSON",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1699311563,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DERMATOLOGY,4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235438870,"JAMES, KIRK, ANDERSON",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235446766,"BRITTON, GORDON, ALAN",742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1235447517,"VIDYADHARAN, ANJANA",9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1235447517,"VIDYADHARAN, ANJANA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1235447558,"HAROON, NIVIN",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 202 , 751 , 767 ," $13,242.80 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235450396,"COONEY, JEFFREY, WARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235450396,"COONEY, JEFFREY, WARD",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 23 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235450396,"COONEY, JEFFREY, WARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235450453,"GALLAHER, THOMAS, RYAN",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235450453,"GALLAHER, THOMAS, RYAN",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 31 , 40 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235450453,"GALLAHER, THOMAS, RYAN",2390 HEMBY LN   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1083336564,G ABRAMS & R COHEN XXIV PC,FRANKLIN SQUARE ORTHODONTICS & PEDIATRIC DENTISTRY,2930 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235450735,"WILLIAMS, ROSSI, MIGUEL",160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 41 , 41 , 202 ,$#,,
MEDICAID DIRECT,1982071114,ABRAMS BARROWS COHEN & ASSOCIATES P,,160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235450735,"WILLIAMS, ROSSI, MIGUEL",160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 53 , 57 , 260 ," $10,795.00 ",,
MEDICAID DIRECT,1083336564,G ABRAMS & R COHEN XXIV PC,FRANKLIN SQUARE ORTHODONTICS & PEDIATRIC DENTISTRY,2930 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235450735,"WILLIAMS, ROSSI, MIGUEL",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 375 , 511 ," 2,571 "," $102,138.95 ",,
MEDICAID DIRECT,1700320850,R BARROWS & ASSOCIATES II,,7230 CALDWELL RD STE C-1 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235450735,"WILLIAMS, ROSSI, MIGUEL",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#, 11 , 47 ,$#,,
MEDICAID DIRECT,1982071114,ABRAMS BARROWS COHEN & ASSOCIATES P,,160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235450735,"WILLIAMS, ROSSI, MIGUEL",8415 MEDICAL PLAZA DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 108 , 108 ," 2,211 "," $183,850.15 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235451097,"DAVIS, CHARLOTTE, ANNE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235451808,"YU, MICHAEL, KUO-PIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 191 , 214 , 275 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235451808,"YU, MICHAEL, KUO-PIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235451808,"YU, MICHAEL, KUO-PIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 157 , 167 , 208 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235451808,"YU, MICHAEL, KUO-PIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235454240,"DOSIER, LAURA, BETH MANN",104 MEDSPRING DR   CLAYTON NC,051,Johnston,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235454240,"DOSIER, LAURA, BETH MANN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 32 , 45 , 57 ,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235454240,"DOSIER, LAURA, BETH MANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 14 , 33 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235454679,"WIRKA, ROBERT, CASEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 27 , 28 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235454935,"MENON, SHREEVINAYA, VATTAPARAMBIL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 70 , 70 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235454935,"MENON, SHREEVINAYA, VATTAPARAMBIL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 108 , 108 ,$#,,
MEDICAID DIRECT,1386158616,CAROLINA ELITE WOMENS CARE,,901 US 70 HWY W STE 100 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1235455361,"SCOTT, RANDOLPH, DANTE",901 US 70 HWY W STE 100 GARNER NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 37 , 39 , 57 ,$#,,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235455361,"SCOTT, RANDOLPH, DANTE",4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1235457714,"MOREE, MARY, CATHERINE",921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 83 , 138 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1235457714,"MOREE, MARY, CATHERINE",7473-C HWY 22   WHISPERING PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1598007445,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE - VASS,3349 US HIGHWAY 1   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1235457714,"MOREE, MARY, CATHERINE",7473-C HWY 22   WHISPERING PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598007445,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE - VASS,3349 US HIGHWAY 1   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1235457714,"MOREE, MARY, CATHERINE",3349 US 1 HWY   VASS NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235457748,"HAQUE, TANVIR, REZWAN",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 18 , 23 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235457748,"HAQUE, TANVIR, REZWAN",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1235457748,"HAQUE, TANVIR, REZWAN",6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1235457748,"HAQUE, TANVIR, REZWAN",781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235458423,"PECHTER, NADINE",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235458423,"PECHTER, NADINE",3521 HAWORTH DR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235460726,"PASUPALA, UMABALA",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235464017,"DIXON, JOSEPH, PATRICK",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235464017,"DIXON, JOSEPH, PATRICK",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 64 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235464017,"DIXON, JOSEPH, PATRICK",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649525619,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHILAND FAMILY MEDICINE,704 GOLD HILL RD STE 107 FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235465808,"MYERS, CHARLOTTE, HEAVER",1852 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235468976,"YATES, ANDREA, BRANHAM",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235468976,"YATES, ANDREA, BRANHAM",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235470261,"MCCLAIN, PAUL, DAVID",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 24 , 31 , 45 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235470261,"MCCLAIN, PAUL, DAVID",1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235470261,"MCCLAIN, PAUL, DAVID",1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235470261,"MCCLAIN, PAUL, DAVID",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 105 , 155 , 219 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235470261,"MCCLAIN, PAUL, DAVID",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1235471392,"TRIFAN, ANDREW, TUDOR",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 188 , 188 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1235475260,"JONES, SEAN, MATHEW",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 53 , 59 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235476417,"SHI, MARY, LANYING",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235476417,"SHI, MARY, LANYING",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235477134,"FOSTER, JOHN, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1235477134,"FOSTER, JOHN, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235477134,"FOSTER, JOHN, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235481748,"FRAZIER, BENJAMIN, JAMES",721 GROVE ST   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 98 , 98 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235481748,"FRAZIER, BENJAMIN, JAMES",316 NC HIGHWAY 801 S   ADVANCE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235481748,"FRAZIER, BENJAMIN, JAMES",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235481748,"FRAZIER, BENJAMIN, JAMES",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235481748,"FRAZIER, BENJAMIN, JAMES",250 HOPKINS RD   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235481748,"FRAZIER, BENJAMIN, JAMES",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235484213,"PARVATHAREDDY, SUNEEL, KUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 69 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235484213,"PARVATHAREDDY, SUNEEL, KUMAR",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235487497,"CACCHIO, PATRICK, BRADY",10207 CERNY ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235487497,"CACCHIO, PATRICK, BRADY",799 DOCTORS CT   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235487497,"CACCHIO, PATRICK, BRADY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235487497,"CACCHIO, PATRICK, BRADY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235487679,"LEE, HEATHER, BROWN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235487679,"LEE, HEATHER, BROWN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235487679,"LEE, HEATHER, BROWN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235488446,"JACOBS, HEATHER, JOAN",3821 ED DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 25 , 70 ,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235488446,"JACOBS, HEATHER, JOAN",3821 ED DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235489774,"SHAHLA, LEENA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235489774,"SHAHLA, LEENA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235489774,"SHAHLA, LEENA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 15 ,$#,,
MEDICAID DIRECT,1235490798,SPEECHFUNDAMENTALS PLLC,~,113 VANCE ST   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1235490798,SPEECHFUNDAMENTALS PLLC,113 VANCE ST   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,, 23 , 466 , 466 ," $32,156.85 ",,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235491226,"DIDIANO, DEANNA, MARIE",447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235491226,"DIDIANO, DEANNA, MARIE",447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 33 , 70 , 130 ,$#,,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235491226,"DIDIANO, DEANNA, MARIE",14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235491226,"DIDIANO, DEANNA, MARIE",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 22 , 32 , 72 ,$#,,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235491226,"DIDIANO, DEANNA, MARIE",14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#, 18 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235491226,"DIDIANO, DEANNA, MARIE",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235491226,"DIDIANO, DEANNA, MARIE",14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#, 17 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235491721,"FOJTIK, ELIZABETH, NORA",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 25 , 26 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235491721,"FOJTIK, ELIZABETH, NORA",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235491721,"FOJTIK, ELIZABETH, NORA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235491721,"FOJTIK, ELIZABETH, NORA",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235492240,"MCPHERSON, ALEX, STEWART",,1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1235492240,"MCPHERSON, ALEX, STEWART",1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235492349,"ONWUEMENE, OLAGBENRO, Y",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235492349,"ONWUEMENE, OLAGBENRO, Y",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235492554,"JENNINGS, KARSTEN, GOH",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235492554,"JENNINGS, KARSTEN, GOH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235492554,"JENNINGS, KARSTEN, GOH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235494196,"WALLACE, CLAIRE, COWEN MANNING",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235494196,"WALLACE, CLAIRE, COWEN MANNING",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609851138,MOUNT AIRY EMERGENCY PHYSICIANS,MOUNT AIRY EMERGENCY PHYSICIANS,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235494287,"MCHONE, ADAM, JERAD",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 74 , 106 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1235495011,"EVANS, JESSICA, MARIE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235495011,"EVANS, JESSICA, MARIE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1235495011,"EVANS, JESSICA, MARIE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235495011,"EVANS, JESSICA, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 53 , 86 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235495011,"EVANS, JESSICA, MARIE",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235495011,"EVANS, JESSICA, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 39 , 71 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235495896,"SMITH, JOSHUA, FRANK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235495896,"SMITH, JOSHUA, FRANK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235496282,"SWAMINATHAN, APARNA, CHANDRA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235496829,"DOBLER, MATTHEW, HENRY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 36 , 64 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235497116,"PRUDEN, BENJAMIN, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 137 , 149 , 156 ," $13,816.74 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235500893,"KENNEDY-NEWTON, PAULA, SUZANNE",20 DUKE MEDICAL CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235500893,"KENNEDY-NEWTON, PAULA, SUZANNE",20 DUKE MEDICAL CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235501719,"HEFLIN, LASHAWNA, BOWDEN",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 63 , 73 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235502188,"MAJESKI, CAROLANNE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235502188,"MAJESKI, CAROLANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235502188,"MAJESKI, CAROLANNE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 38 , 55 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235502188,"MAJESKI, CAROLANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235502188,"MAJESKI, CAROLANNE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235502188,"MAJESKI, CAROLANNE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1235502428,"NEVES, DEBORAH, DAVILA",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 42 , 190 , 190 ," $15,263.82 ",,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1235506569,"YOUNG, JAMIE, LYNN",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235506569,"YOUNG, JAMIE, LYNN",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1235506569,"YOUNG, JAMIE, LYNN",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235506569,"YOUNG, JAMIE, LYNN",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235506833,"GREENE, JILL",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1235506833,"GREENE, JILL",~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1235506833,"GREENE, JILL",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1285803189,J MARK SAUNDERS OD PA,,4637 MAIN ST   SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1235506833,"GREENE, JILL",75 EMERSON BAY RD STE 106 CAROLINA SHORES NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235506833,"GREENE, JILL",5211 EASON ST STE 1 SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235506833,"GREENE, JILL",75 EMERSON BAY RD STE 106 CAROLINA SHORES NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235507971,"MANI, MARIO",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235507971,"MANI, MARIO",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 107 , 114 , 175 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235507971,"MANI, MARIO",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235508722,"LINEBACK, STEPHANIE, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235508722,"LINEBACK, STEPHANIE, LEIGH",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1295729747,THE CHILD HEALTH CENTER,THE CHILD HEALTH CENTER,1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1235510009,"ABEL, SETH",1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 77 , 233 ,$#,,
MEDICAID DIRECT,1235510066,"JENKINS, ALEASIA, NICOLE",~,34 HILL PLZ   WHITEVILLE NC,024,Columbus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1235510066,"JENKINS, ALEASIA, NICOLE",34 HILL PLZ   WHITEVILLE NC,024,Columbus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235513995,"MCARTAN, KENNETH, RAY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 81 , 93 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235514340,"FELTS, KATHRYN, HOUSKA",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235514340,"FELTS, KATHRYN, HOUSKA",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 31 , 54 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235514340,"FELTS, KATHRYN, HOUSKA",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235514936,"MANDADI, NATISHA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235514936,"MANDADI, NATISHA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 23 , 32 ,$#,,
MEDICAID DIRECT,1235516055,CONTROL BIONICS INC,,745 CENTER ST STE 303 MILFORD OH,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235516055,CONTROL BIONICS INC,745 CENTER ST STE 303 MILFORD OH,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 14 , 13 , 31 ," $137,835.60 ",,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235517871,"PATEL, NEEL, ATUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235517871,"PATEL, NEEL, ATUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 40 , 69 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235518358,"JOHNSON, STEVEN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235518358,"JOHNSON, STEVEN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 54 , 56 , 95 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235518358,"JOHNSON, STEVEN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235518358,"JOHNSON, STEVEN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1235518952,"FLOWERS, STEPHANIE, ROSE ANN",,1536 CHIMNEY ROCK DR   KERNERSVILLE NC,034,Forsyth,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1235518952,"FLOWERS, STEPHANIE, ROSE ANN",1536 CHIMNEY ROCK DR   KERNERSVILLE NC,034,Forsyth,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235519596,"KELSEY, MICHELLE, DIANE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235519596,"KELSEY, MICHELLE, DIANE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235519596,"KELSEY, MICHELLE, DIANE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235519596,"KELSEY, MICHELLE, DIANE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235519596,"KELSEY, MICHELLE, DIANE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235520685,"LESKO, JOSHUA, DAVID",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235522426,"MAZHAR, AREEJ",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1235523291,"TRAN, VU, ANH",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1235523291,"TRAN, VU, ANH",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235524844,"BOLLINO, GIDEON, JUDE",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 163 , 175 , 206 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235524844,"BOLLINO, GIDEON, JUDE",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 110 , 113 , 179 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235524927,"KELLEHER, COLM, BRIAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524927,"KELLEHER, COLM, BRIAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 40 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524927,"KELLEHER, COLM, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524927,"KELLEHER, COLM, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524927,"KELLEHER, COLM, BRIAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524927,"KELLEHER, COLM, BRIAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 48 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524968,"RYAN, SEAN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524968,"RYAN, SEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 32 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524968,"RYAN, SEAN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 42 , 52 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524968,"RYAN, SEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235524968,"RYAN, SEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 36 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1235524968,"RYAN, SEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235525783,"SANCHEZ, GABRIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235526609,"MARTIN, AMELIA, KAYE",2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 17 , 27 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235526609,"MARTIN, AMELIA, KAYE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235526609,"MARTIN, AMELIA, KAYE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235528225,NSTX INC,,13011 MCCALLEN PASS STE 100 AUSTIN TX,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1235528225,NSTX INC,13011 MCCALLEN PASS STE 100 AUSTIN TX,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,," 1,688 "," 1,666 "," 6,163 "," $1,930,030.49 ",,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1235528415,"SKIPPER, DANIEL, BRYCE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1235528415,"SKIPPER, DANIEL, BRYCE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1235529926,"ROSS, CRYSTAL, LYNN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 38 , 41 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1235529926,"ROSS, CRYSTAL, LYNN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235529926,"ROSS, CRYSTAL, LYNN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 43 , 51 ,$#,,
MEDICAID DIRECT,1710551262,INSPIRATIONAL COMMUNITY HEALTH CENT,,801 SUMMIT AVE STE 1 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235530825,"HORTON, LOVIKA, LOWES",801 SUMMIT AVE STE 1 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1710551262,INSPIRATIONAL COMMUNITY HEALTH CENT,,801 SUMMIT AVE STE 1 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235530825,"HORTON, LOVIKA, LOWES",801 SUMMIT AVE STE 1 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 21 , 28 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235530973,"BISH, JEAN, KELLY",318 S NORWOOD ST   WALLACE NC,031,Duplin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 11 , 77 , 209 ,$#,,
MEDICAID DIRECT,1235533779,REALTOX LABS LLC,,200 BUSINESS CENTER DR   REISTERSTOWN MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1235533779,REALTOX LABS LLC,200 BUSINESS CENTER DR   REISTERSTOWN MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235536210,"LOFLAND, KATHRYN, ALICE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235536210,"LOFLAND, KATHRYN, ALICE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346279445,FHPG LLC,MONTGOMERY MEMORIAL HOSPITAL,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1235537598,"JAMES, JUDITH, JANUARY-LEE",520 ALLEN ST   TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 174 , 174 ,$#,,
MEDICAID DIRECT,1346279445,FHPG LLC,MONTGOMERY MEMORIAL HOSPITAL,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1235537598,"JAMES, JUDITH, JANUARY-LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1821432295,SENIORS MEDICAL SUPPLY,,124 W CRESCENT SQUARE DR   GRAHAM NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235539016,"COBLE, VANESSA",124 W CRESCENT SQUARE DR   GRAHAM NC,001,Alamance,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1609851138,MOUNT AIRY EMERGENCY PHYSICIANS,MOUNT AIRY EMERGENCY PHYSICIANS,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1235540089,"MARTIN, AMY, LELA",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 78 , 114 ,$#,,
MEDICAID DIRECT,1588145395,HAMILTON AND WHITECOTTON ORTHODONTI,,7482 WATERSIDE CROSSING BLVD STE 201 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1235542366,"WHITECOTTON, BRYAN, CURTIS",7482 WATERSIDE CROSSING BLVD STE 201 DENVER NC,055,Lincoln,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 276 , 734 , 840 ," $159,227.76 ",,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235542804,"WHITMORE, NATHAN, ROSS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235543356,"CHU, PHILIP",10207 CERNY ST STE 102 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 32 , 37 , 63 ,$#,,
MEDICAID DIRECT,1457526907,GRANVILLE HEALTH SYSTEM,GRANVILLE SPECIALTY CLINIC,103 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1235543356,"CHU, PHILIP",103 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235543356,"CHU, PHILIP",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235543356,"CHU, PHILIP",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235543356,"CHU, PHILIP",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 14 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1235543653,"BOWERS, JOSHUA, MARK",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1235543653,"BOWERS, JOSHUA, MARK",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 64 , 68 , 74 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1235543653,"BOWERS, JOSHUA, MARK",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 30 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1235543653,"BOWERS, JOSHUA, MARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 48 , 56 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235545658,"MITCHELL, HAZEL, FREIDA",502 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 124 , 141 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235547241,"CONN, YESHU",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 34 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235547241,"CONN, YESHU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235549718,"BATAS, BRIAN, GREGORY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 127 , 127 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235549783,"GAUTHIER, ELIZABETH, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235550054,"KYERE, BELINDA, KYEIWAH",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235550054,"KYERE, BELINDA, KYEIWAH",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 18 , 56 , 73 ,$#,,
MEDICAID DIRECT,1235550112,ROYALTY HEALTH & WELLNESS RESOURCES,ROYALTY ADULT & PEDIATRIC HOME CARE,201 E MEADOW RD STE 137 EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,,1235550112,ROYALTY HEALTH & WELLNESS RESOURCES,201 E MEADOW RD STE 137 EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 2,916 "," 2,916 "," $278,932.91 ",,
MEDICAID DIRECT,1235550112,ROYALTY HEALTH & WELLNESS RESOURCES,ROYALTY ADULT & PEDIATRIC HOME CARE,201 E MEADOW RD STE 137 EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,,1235550112,ROYALTY HEALTH & WELLNESS RESOURCES,412 N VAN BUREN RD   EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1235550112,ROYALTY HEALTH & WELLNESS RESOURCES,ROYALTY ADULT & PEDIATRIC HOME CARE,412 N VAN BUREN RD   EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,,1235550112,ROYALTY HEALTH & WELLNESS RESOURCES,412 N VAN BUREN RD   EDEN NC,079,Rockingham,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 1,610 "," 1,610 "," $148,997.70 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235554353,"GILLER, RACHEL, PRICE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235554353,"GILLER, RACHEL, PRICE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235554353,"GILLER, RACHEL, PRICE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235556697,"LAZAROW, FRANCES, BARBARA",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",210 ASHVILLE AVE   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",210 ASHVILLE AVE   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 23 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 26 , 39 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 47 , 63 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",1135 CARTHAGE ST   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",110 FIELDS DR   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235557034,"COWHERD, MICHAEL, PHILIP",1818 DOCTORS DR   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235557190,"IMIELSKI, BARTLOMIEJ, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 37 , 56 ," $15,160.77 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235557190,"IMIELSKI, BARTLOMIEJ, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235558636,"NIGAM, MANAS",600 GRESHAM DR STE 204 NORFOLK VA,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1235558966,LHCG L LLC,~,1027 US 70 HWY W STE 102B GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1235558966,LHCG L LLC,1027 US 70 HWY W STE 102B GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,316 "," 1,316 "," $108,901.12 ",,
MEDICAID DIRECT,1295107779,COUNTY OF COLUMBUS OFFICE OF ACCOUN,,304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1235559071,"GRAHAM, HASIFA",304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,1223D0001X,Dental Providers,Dentist,Dental Public Health, 132 , 259 , 955 ," $45,922.78 ",,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235559071,"GRAHAM, HASIFA",1400 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 81 , 81 , 235 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235559238,"JASINSKI, NOEL-GRACE, BADIOLA",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235559238,"JASINSKI, NOEL-GRACE, BADIOLA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 87 , 88 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235559717,"SAPP, CHRISTOPHER, STEWART",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235562133,"CAGLE, MICHELLE, COOPER",1 HOSPITAL RD   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235562133,"CAGLE, MICHELLE, COOPER",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235562133,"CAGLE, MICHELLE, COOPER",113 A HOSPITAL LOOP   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235563321,"GOWER, MICHAEL, WARREN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 162 , 162 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235563321,"GOWER, MICHAEL, WARREN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 92 , 92 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235567116,"WADE, NATHAN, LEWIS",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1609308113,RANGE URGENT CARE PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1235567116,"WADE, NATHAN, LEWIS",674 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235567116,"WADE, NATHAN, LEWIS",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 83 , 164 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235567116,"WADE, NATHAN, LEWIS",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235567116,"WADE, NATHAN, LEWIS",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235567116,"WADE, NATHAN, LEWIS",674 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477696656,"KISER, MELANIE, SUZANNE",,1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,1235567256,"FAULK, JOSEPH, BRYON",701 HAWLEY AVE   BELMONT NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235567256,"FAULK, JOSEPH, BRYON",306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235567751,"MAYER, JODI, RAE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235567751,"MAYER, JODI, RAE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 80 , 147 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235567751,"MAYER, JODI, RAE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235567751,"MAYER, JODI, RAE",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235567751,"MAYER, JODI, RAE",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235568189,"CHEVLI, PARAG, ANILKUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 17 , 22 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235569096,"BATTEN, ASHLEY, DAWN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235569096,"BATTEN, ASHLEY, DAWN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235571670,"MOSTAFA, OSMAN, NADIR",606 WALTER REED DR STE B GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235572298,"PATIDAR, VINAY, JAY",2305 N MAIN ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1481 RICHARDSON RD STE 118 APEX NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235572298,"PATIDAR, VINAY, JAY",1481 RICHARDSON RD STE 118 APEX NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235572298,"PATIDAR, VINAY, JAY",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 20 , 29 ,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235572801,"ROACH-GERALD, CIERREA, RASHONDA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1235572801,"ROACH-GERALD, CIERREA, RASHONDA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235573379,"CLARY, MEREDITH, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 39 , 53 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235573379,"CLARY, MEREDITH, MARIE",601 N ELM ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1952372500,GRANVILLE HEALTH INC,GRANVILLE SURGICAL ASSOCIATES,101 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1235574195,"SPRINKLE, SHANNA, RENAE",101 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1952372500,GRANVILLE HEALTH INC,GRANVILLE SURGICAL ASSOCIATES,102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1235574195,"SPRINKLE, SHANNA, RENAE",102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 65 , 75 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235575085,"ROGERS, JODIE, JOHNSON",841 MALCOLM BLVD   RUTHERFORD COLLEGE NC,012,Burke,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 20 , 51 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235575366,"HAYES, JOSHUA, DANIEL",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 99 , 99 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235575366,"HAYES, JOSHUA, DANIEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 89 , 89 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235576372,"ROBINSON, BRITTANI, LEDFORD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235576372,"ROBINSON, BRITTANI, LEDFORD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235576372,"ROBINSON, BRITTANI, LEDFORD",600 HOSPITAL DR   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235576372,"ROBINSON, BRITTANI, LEDFORD",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 49 , 49 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1235576372,"ROBINSON, BRITTANI, LEDFORD",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235576372,"ROBINSON, BRITTANI, LEDFORD",600 HOSPITAL DR   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235576596,"ARMBRUSTER, TIFFANY, SIMMONS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1235577602,"MACINNES, LESLEY, JANET JEAN",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 74 , 193 ," $10,059.95 ",,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1235577602,"MACINNES, LESLEY, JANET JEAN",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 36 , 94 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1235578246,"DEAN, MATTHEW, EDWIN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 108 , 114 , 156 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1235578246,"DEAN, MATTHEW, EDWIN",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 28 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235578824,"RAEBURN, SAMANTHA, LYNN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 14 , 15 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235578824,"RAEBURN, SAMANTHA, LYNN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1235578824,"RAEBURN, SAMANTHA, LYNN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235581687,"ALGHANIM, FAHID, ABDEL F.A",159 EXECUTIVE DR STE F DANVILLE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,4351 THE CIRCLE AT NORTH HILLS ST STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235582149,"BIAGGI, MICHELLE",4351 THE CIRCLE AT NORTH HILLS ST STE 107 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235582149,"BIAGGI, MICHELLE",4351 THE CIRCLE AT NORTH HILLS ST STE 107 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235582297,"KIRBY, DONNA, LYNN",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 75 , 130 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235582297,"KIRBY, DONNA, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1038 BETHANIA RURAL HALL RD   RURAL HALL NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235582297,"KIRBY, DONNA, LYNN",1038 BETHANIA RURAL HALL RD   RURAL HALL NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235583907,"WARREN, YANCEY, EVERETT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235583907,"WARREN, YANCEY, EVERETT",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235583907,"WARREN, YANCEY, EVERETT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235583907,"WARREN, YANCEY, EVERETT",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235583907,"WARREN, YANCEY, EVERETT",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235584335,"RICE, CHRISTOPHER, WILLIAM",1313 CAROLINA ST STE 101 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 20 , 24 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235584335,"RICE, CHRISTOPHER, WILLIAM",1313 CAROLINA ST STE 101 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 115 , 160 ,$#,,
MEDICAID DIRECT,1538783915,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE PSYCHIATRIC SPECIALISTS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235585233,"VITIELLO, EVAN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235585233,"VITIELLO, EVAN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1235586546,"HALLMAN, MATTHEW, JAY",250 HUFF DR   JACKSONVILLE NC,067,Onslow,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 29 , 65 , 94 ,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1235586546,"HALLMAN, MATTHEW, JAY",250 HUFF DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,750 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1235586546,"HALLMAN, MATTHEW, JAY",750 MCCARTHY BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1235586546,"HALLMAN, MATTHEW, JAY",750 MCCARTHY BLVD   NEW BERN NC,025,Craven,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 128 , 356 , 578 ,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235587890,"CHAZANOW, ASHLEY, RANDLEMAN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235591819,"MERCER, KATHERINE, ANNE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 19 , 63 , 64 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235591900,"KRAMER, SAGE, PHILLIP",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 472 , 524 , 654 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235591900,"KRAMER, SAGE, PHILLIP",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 305 , 336 , 523 ," $20,546.71 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235592080,"WILEN, JONATHAN, DILLON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235592205,"GROVE, OWEN, DAVID",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235593005,"SINGH, GURBAJ",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1235593005,"SINGH, GURBAJ",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235593005,"SINGH, GURBAJ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 95 , 122 , 141 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235593799,"PALLAS, CHRISTOPHER, RYAN",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 16 , 23 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235593799,"PALLAS, CHRISTOPHER, RYAN",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235593799,"PALLAS, CHRISTOPHER, RYAN",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235593799,"PALLAS, CHRISTOPHER, RYAN",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235593799,"PALLAS, CHRISTOPHER, RYAN",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 29 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235593799,"PALLAS, CHRISTOPHER, RYAN",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235593799,"PALLAS, CHRISTOPHER, RYAN",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 30 ,$#,,
MEDICAID DIRECT,1407117948,REGIONAL MEDICAL ONCOLOGY CENTER PA,~,2624 ORTHO DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1235598434,"MARTIN, LEIGHANNA, GRACE",2624 ORTHO DR W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 124 , 210 , 502 ,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235598632,"SALEH, YOSEPH, ABDULLAH",12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 567 , 869 ," 3,048 "," $128,821.21 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235599283,"MCKEE, TODD, ROBERT",222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427707660,LA SERENIDAD PLLC,LA SERENIDAD THERAPY SERVICES,178 TRIBUTARY CIR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235600057,"BRAILSFORD DE LOPEZ, ALAN, ROBERT",178 TRIBUTARY CIR   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235600537,"QUINN, KIMBERLY, PAIGE",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1235601543,"AUSTIN, BRITTANY, ELIZABETH",3205 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 190 , 203 , 282 ," $33,116.04 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235606575,"ALDERETE, VINCENT, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 80 , 82 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1235609629,"ALEXANDER, MARION, STOLTZFUS BRADEN",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 125 , 193 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235610528,"HARRIS, ALLYSE, BAILEY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235610528,"HARRIS, ALLYSE, BAILEY",850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235610528,"HARRIS, ALLYSE, BAILEY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235612441,"PETRUCELLI, SAMANTHA, RYAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235612441,"PETRUCELLI, SAMANTHA, RYAN",1200 N ELM ST 1200 NORTH ELM STREET GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235612813,"FISCHER, EMILY, MARION",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235612813,"FISCHER, EMILY, MARION",216 MOORE RD   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 144 , 245 ,$#,,
MEDICAID DIRECT,1235616392,LIMBTECH,,186 BUTLER RIDGE TRL   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1235616392,LIMBTECH,186 BUTLER RIDGE TRL   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1235620022,"ALI, VELLAYAT",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 70 , 256 , 257 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235622093,"KHANAL, AMIT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235622093,"KHANAL, AMIT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 63 , 180 , 180 ,$#,,
MEDICAID DIRECT,1114466802,DLP FRYE MEDICAL GROUP,FRYECARE GENERATIONS FAMILY MEDICINE,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235622515,"NELSON, CATHERINE, LEAH",2810 16TH ST NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 179 , 272 ,$#,,
MEDICAID DIRECT,1114466802,DLP FRYE MEDICAL GROUP,FRYECARE GENERATIONS FAMILY MEDICINE,2810 16TH ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235622515,"NELSON, CATHERINE, LEAH",2810 16TH ST NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,WESTERN CAROLINA EYE ASSOCIATES,610 STATE FARM RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1235623216,"DAVIS, SAVANNAH, SHEETS",183 DOCTORS PARK DR   JEFFERSON NC,005,Ashe,152W00000X,Eye and Vision Services Providers,Optometrist,, 30 , 29 , 39 ,$#,,
MEDICAID DIRECT,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,WESTERN CAROLINA EYE ASSOCIATES,183 DOCTORS PARK DR   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1235623216,"DAVIS, SAVANNAH, SHEETS",183 DOCTORS PARK DR   JEFFERSON NC,005,Ashe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,WESTERN CAROLINA EYE ASSOCIATES,610 STATE FARM RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1235623216,"DAVIS, SAVANNAH, SHEETS",610 STATE FARM RD STE A BOONE NC,095,Watauga,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 34 , 49 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1235623554,"RIORDEN, JEFFREY, THOMAS",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1235623554,"RIORDEN, JEFFREY, THOMAS",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1235623554,"RIORDEN, JEFFREY, THOMAS",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 68 , 127 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1235623554,"RIORDEN, JEFFREY, THOMAS",7473-C HWY 22   CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 23 , 41 ,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1235623554,"RIORDEN, JEFFREY, THOMAS",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235626789,"COX, AMY, NGOC THAO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 54 , 54 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235626789,"COX, AMY, NGOC THAO",1204 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235628306,"LUNSFORD, THOMAS, HENRY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 162 , 162 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1235632001,"COWELL, NICHOLAS, EUGENE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235632001,"COWELL, NICHOLAS, EUGENE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1235632001,"COWELL, NICHOLAS, EUGENE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1235632001,"COWELL, NICHOLAS, EUGENE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 150 , 162 , 186 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235635954,"YU, AMY, VALERIE",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235635954,"YU, AMY, VALERIE",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 31 ,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1235635954,"YU, AMY, VALERIE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235635954,"YU, AMY, VALERIE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1235635954,"YU, AMY, VALERIE",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1235635954,"YU, AMY, VALERIE",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 40 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235635970,"CORRAL, EDWIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235635970,"CORRAL, EDWIN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235639311,"LAMBERT, MEAGAN, SUZANNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235639311,"LAMBERT, MEAGAN, SUZANNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 20 , 34 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235639311,"LAMBERT, MEAGAN, SUZANNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1235639311,"LAMBERT, MEAGAN, SUZANNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700901436,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1235649989,"ROGERS, KRISTY, KAY MARTIN",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 53 , 58 ,$#,,
MEDICAID DIRECT,1518502103,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,560 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235650722,"WATSON, CRYSTAL, DAWN",560 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235652751,"MCSHEA, BRIANNA, LEIGH",124 WELTON WAY   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 43 ,$#,,
MEDICAID DIRECT,1720364649,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1235653452,"AHMED, EBTIHAL, AHMED MOHAMED",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1235654120,L & C FAMILY CARE HOME LLC,,6347 FAIRWAY DR   GRIFTON NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235654120,L & C FAMILY CARE HOME LLC,6347 FAIRWAY DR   GRIFTON NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 88 , 88 ," $43,891.06 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235658642,"MATTHEWS, KACIE, SUE-ELLEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 35 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235659087,"REYNOLDS, DANIEL, LEWIS",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235659087,"REYNOLDS, DANIEL, LEWIS",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 85 , 87 , 127 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235660028,"MEHTA, MILAP, PRAFUL",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1235660861,"SAN JOSE, RICARDO, JOSE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235661026,"XIAO, DAPHNE, YING",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 50 , 50 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235661026,"XIAO, DAPHNE, YING",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235661026,"XIAO, DAPHNE, YING",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 168 , 168 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235661059,"PALIN, HANNAH, SHAW",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235661786,"DOWNS, SARAH, GRACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 60 , 65 , 89 ," $10,583.34 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235661786,"DOWNS, SARAH, GRACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1235661786,"DOWNS, SARAH, GRACE",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235661786,"DOWNS, SARAH, GRACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1235661828,"DOSHI, NEHA, HIREMDRA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1992459515,MONTERA HEALTH TEXAS LLC,,3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235661885,"RUMPH, JODI, KIM",3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 46 , 47 ," $18,753.83 ",,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235662206,"KESLER, ALEX, MICHAEL",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235662206,"KESLER, ALEX, MICHAEL",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235662206,"KESLER, ALEX, MICHAEL",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235662206,"KESLER, ALEX, MICHAEL",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 23 , 38 , 45 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235662206,"KESLER, ALEX, MICHAEL",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235662792,"STURCHLER, MARIA DE LOURDES, LADINO",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 60 , 70 ,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235663170,"HERNANDEZ, EDWARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1891935599,JONATHAN WOOLFSON MD PC,~,1 TOWN SQUARE BLVD STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1235663204,"WILSON, BENJAMIN, DAVID",1 TOWN SQUARE BLVD STE 110 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 56 , 75 ,$#,,
MEDICAID DIRECT,1952832941,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PHYSICAL MEDICINE AND REHAB,3246 6TH AVE SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235666215,"BROWN, LAURA, ANN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235666215,"BROWN, LAURA, ANN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1952832941,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PHYSICAL MEDICINE AND REHAB,3246 6TH AVE SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235666215,"BROWN, LAURA, ANN",3246 6TH AVE SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 24 , 42 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235666215,"BROWN, LAURA, ANN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235666371,"PADGETT, JOSHUA, PAUL",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235666371,"PADGETT, JOSHUA, PAUL",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1235666868,"CHEN, XUGUANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235666868,"CHEN, XUGUANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 64 , 258 , 342 ,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,2076 NC HIGHWAY 42 W STE 300 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235667049,"VISHNUVARDHAN, NIVETHA",514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235667049,"VISHNUVARDHAN, NIVETHA",514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235667049,"VISHNUVARDHAN, NIVETHA",2076 NC HIGHWAY 42 W STE 130 CLAYTON NC,051,Johnston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235667049,"VISHNUVARDHAN, NIVETHA",514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,2076 NC HIGHWAY 42 W STE 300 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235667049,"VISHNUVARDHAN, NIVETHA",2076 NC HIGHWAY 42 W STE 130 CLAYTON NC,051,Johnston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 38 , 51 , 51 ,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235668419,"ANDERSON, NICOLE, THOMPSON",606 N ELM ST   HIGH POINT NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 23 , 48 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1235669789,"SHIM LOOK-FONG, NATALIE, ANN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235671827,INTEGRITY-HOMINY VALLEY LLC,~,2189 SMOKY PARK HWY   CANDLER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235671827,INTEGRITY-HOMINY VALLEY LLC,2189 SMOKY PARK HWY   CANDLER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 33 ," 7,964 "," 7,964 "," $617,375.96 ",,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235674276,"TRAN, DANIELLE, CHRISTINE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235674276,"TRAN, DANIELLE, CHRISTINE",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235674276,"TRAN, DANIELLE, CHRISTINE",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235674276,"TRAN, DANIELLE, CHRISTINE",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235674276,"TRAN, DANIELLE, CHRISTINE",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235674276,"TRAN, DANIELLE, CHRISTINE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1801953088,MEDICAL RESOURCE CENTER FOR RANDOLP,MEDICAL RESOURCE CENTER FOR RANDOLPH COUNTY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235676297,"COLE, DAWN, WATKINS",425 WHITE OAK ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1235676578,"BROWN, IAN, SHELLEY",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235676578,"BROWN, IAN, SHELLEY",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235676578,"BROWN, IAN, SHELLEY",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235676578,"BROWN, IAN, SHELLEY",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235676578,"BROWN, IAN, SHELLEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 56 , 59 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235676578,"BROWN, IAN, SHELLEY",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235676628,"ARONIN, ELIZABETH, HELEN",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 35 , 61 ,$#,,
MEDICAID DIRECT,1235679457,FOOTHILL MEDICAL,~,1065 DOROTHYS LN   GERMANTON NC,085,Stokes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1235679457,FOOTHILL MEDICAL,1065 DOROTHYS LN   GERMANTON NC,085,Stokes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 174 ," 1,643 "," 3,992 "," $291,346.35 ",,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,812 CANDY PARK RD STE 5103 PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1235680398,"GLASS, SHARLEEN, JACOBS",812 CANDY PARK RD STE 5103 PEMBROKE NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 72 , 89 , 94 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1235680398,"GLASS, SHARLEEN, JACOBS",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 73 , 78 , 78 ,$#,,
MEDICAID DIRECT,1093787608,SYLVA FAMILY PRACTICE PA,SYLVA FAMILY PRACTICE PA,430 FISHER CREEK RD   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1235680604,"HARRIS, THOMAS, CRAIG",430 FISHER CREEK RD   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235681180,"AUGUSTIN, KAREN, THERESA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 21 , 21 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235681180,"AUGUSTIN, KAREN, THERESA",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235681180,"AUGUSTIN, KAREN, THERESA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235681180,"AUGUSTIN, KAREN, THERESA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235687419,"DORIC, WENDY, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,AEROCARE,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 282 ," 1,460 "," 2,405 "," $36,142.70 ",,
MEDICAID DIRECT,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,AEROCARE,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,AEROCARE,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,AEROCARE,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1235691395,TRINITY HEALTHCARE OF WINSTON SALEM,606 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 33 , 152 , 294 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 23 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 23 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 28 , 47 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235691577,"DIXON, RYAN, ALAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 31 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235693979,"CHURCHWELL, WILLIAM, MORELAND",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235694076,"HASELMAN, JESSICA, MARIE",210 SMITH CHURCH RD BLDG 1 ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235694183,"LIGHTFOOT, CATHERINE, MARIAN",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 36 , 49 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1235694183,"LIGHTFOOT, CATHERINE, MARIAN",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 94 , 188 ,$#,,
MEDICAID DIRECT,1891789970,SCOTLAND MEMORIAL HOSPITAL INC,WAGRAM FAMILY PRACTICE,24420 MARLBORO ST   WAGRAM NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1235695230,"WEBER, TERRI, RENO",24420 MARLBORO ST   WAGRAM NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 185 , 263 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1235696261,"AMMONS, SANTANA, NICOLE",507 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1235696261,"AMMONS, SANTANA, NICOLE",507 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 33 , 33 ,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235696261,"AMMONS, SANTANA, NICOLE",60 COMMERCE PLAZA CIR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235696261,"AMMONS, SANTANA, NICOLE",60 COMMERCE PLAZA CIR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 59 , 68 ,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235696261,"AMMONS, SANTANA, NICOLE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235698531,"HURST, RYAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235699158,"TEDROW, MADISON, PAIGE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 50 , 52 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235699158,"TEDROW, MADISON, PAIGE",873 HEATHER RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235699158,"TEDROW, MADISON, PAIGE",1410 S THIRD ST   MEBANE NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1235699158,"TEDROW, MADISON, PAIGE",1702 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235699539,"YATES, JEREMY, GARNER",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 66 , 127 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235700386,"CROMER, AUSTIN, CHAPMAN-LOVETTE",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235700386,"CROMER, AUSTIN, CHAPMAN-LOVETTE",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235700667,"MALOY, SARAH, LUCILLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235702283,"OKUTA, MELVIN, APALE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1235702564,"GOBUSH, ALAINA, SUZANNE",1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 23 , 54 ,$#,,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1235702564,"GOBUSH, ALAINA, SUZANNE",1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 70 , 162 ,$#,,
MEDICAID DIRECT,1235702754,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE IMAGING ARRINGDON MOBILE MRI,5601 ARRINGDON PARK DR STE 110 MORRISVILLE NC,032,Durham,293D00000X,Laboratories,Physiological Laboratory,,1235702754,DUKE UNIVERSITY HEALTH SYSTEM INC,5601 ARRINGDON PARK DR STE 110 MORRISVILLE NC,032,Durham,293D00000X,Laboratories,Physiological Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235702952,"MIKESELL, MARY-BELLE, JO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235702952,"MIKESELL, MARY-BELLE, JO",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235702952,"MIKESELL, MARY-BELLE, JO",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1235706649,"JOHNSON, CARMEN, ELIZABETH",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 13 ,$#,,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,1003 OLDE WATERFORD WAY STE 1A LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1235707555,"MURRELL, JENNA, RUTH",1003 OLDE WATERFORD WAY STE 1A LELAND NC,010,Brunswick,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 249 , 265 , 822 ," $25,068.94 ",,
MEDICAID DIRECT,1235707555,"MURRELL, JENNA, RUTH",~,3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1235707555,"MURRELL, JENNA, RUTH",3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235707555,"MURRELL, JENNA, RUTH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235707555,"MURRELL, JENNA, RUTH",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,375 "," 1,482 "," 8,038 "," $324,425.65 ",,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,1165 E CUTLAR CROSSING STE 110 LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1235707555,"MURRELL, JENNA, RUTH",3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 191 , 206 , 682 ," $22,966.62 ",,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235707555,"MURRELL, JENNA, RUTH",3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 687 ," 1,076 "," 4,704 "," $269,395.25 ",,
MEDICAID DIRECT,1336405471,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST AUDIOLOGY - GREE,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1235708009,"SCHMIDT, ALLISON, ELIZABETH",1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE N KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1235711250,"ROBERSON, LINDSEY, PACKARD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235711250,"ROBERSON, LINDSEY, PACKARD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 104 , 233 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1235711250,"ROBERSON, LINDSEY, PACKARD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235714510,"FREEMAN, SHANA, MELINDA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1235718701,"CROSS, ANNE, MEREDITH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 60 , 65 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235718701,"CROSS, ANNE, MEREDITH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1235718701,"CROSS, ANNE, MEREDITH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1235718701,"CROSS, ANNE, MEREDITH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 47 , 54 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1235720434,"ARTHUR, DORIA, KOSMALA",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235721093,"DOR, FRANTZ, JOSEPH KERWIN",2718 HENRY ST   GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235721093,"DOR, FRANTZ, JOSEPH KERWIN",2718 HENRY ST   GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235721549,"FARREY, ALLISON, MARGARET",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235723958,"GOMEZ, ELISA",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235723958,"GOMEZ, ELISA",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235727686,"RICHARDSON, HEATHER, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235727686,"RICHARDSON, HEATHER, LEIGH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 19 , 17 , 18 ,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235737388,"DIGGAN, ALYSSA, BERTOLINO",3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,100 W FREMONT ST STE B BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1235737388,"DIGGAN, ALYSSA, BERTOLINO",100 W FREMONT ST # 100B BURGAW NC,071,Pender,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235739624,"JONES, JORDAN, CRAVEN",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235739624,"JONES, JORDAN, CRAVEN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457828253,COASTAL COMPREHENSIVE CARE PA,,710 SUNSET BLVD N STE A SUNSET BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1235739855,"BRITT, BRITTANY, DAVIS",710 SUNSET BLVD N STE A SUNSET BEACH NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235739855,"BRITT, BRITTANY, DAVIS",115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 17 , 20 ,$#,,
MEDICAID DIRECT,1871977249,CENTRAL PEDIATRICS & INTERNAL MED,,3040 EASTWAY DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235740945,"ACHARYA, RATNA",3040 EASTWAY DR STE A CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 11 , 14 , 41 ,$#,,
MEDICAID DIRECT,1891843967,PINNACLE MEDICAL CLINIC PA,PINNACLE MEDICAL CLINIC PA,2401 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235740945,"ACHARYA, RATNA",2401 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 19 , 26 , 62 ,$#,,
MEDICAID DIRECT,1447307384,GRACE PEDIATRICS CLINICS PA,,2401 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235740945,"ACHARYA, RATNA",2401 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 24 ,$#,,
MEDICAID DIRECT,1609978824,GRACE MEDICAL CLINIC PA,,2317 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235740945,"ACHARYA, RATNA",3040 EASTWAY DR STE A CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 25 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1235744467,"LAMAR, AMANDA, RICHEY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 66 , 68 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235745605,"MANTILLA, MATTHEW, ESTEBAN",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 60 , 81 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1235747999,"JACKSON, RACHEL, RENEE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1235747999,"JACKSON, RACHEL, RENEE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1235747999,"JACKSON, RACHEL, RENEE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1235747999,"JACKSON, RACHEL, RENEE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1235747999,"JACKSON, RACHEL, RENEE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1235751702,DIXON HOME CARE AGENCY LLC,,4224 PITT ST   AYDEN NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1235751702,DIXON HOME CARE AGENCY LLC,4224 PITT ST   AYDEN NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 930 , 938 ," $200,506.32 ",,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1235752825,"CHRISTIAN, RYLEE, MARIE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 77 , 78 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235752825,"CHRISTIAN, RYLEE, MARIE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 93 , 96 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1235752825,"CHRISTIAN, RYLEE, MARIE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 42 , 42 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235753591,"KOHNKE, LUANA, QUEVEDO",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 224 , 225 ,$#,,
MEDICAID DIRECT,1689360307,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,5023 CAROLINA FOREST BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235755984,"WARD, CHASIDY, LYNN",5023 CAROLINA FOREST BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235757659,"MATTHEWS, SHELBY",300 HEALTH PARK DR STE 210 GARNER NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235757659,"MATTHEWS, SHELBY",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235758053,"ADEDOYIN, JULIANA, DAMILOLA",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1235758053,"ADEDOYIN, JULIANA, DAMILOLA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235758053,"ADEDOYIN, JULIANA, DAMILOLA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235758053,"ADEDOYIN, JULIANA, DAMILOLA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235758053,"ADEDOYIN, JULIANA, DAMILOLA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 54 , 55 , 114 ,$#,,
MEDICAID DIRECT,1235760141,FIRST ONE CHOICE HOME CARE AGENCY,,2 CENTERVIEW DR STE 52 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1235760141,FIRST ONE CHOICE HOME CARE AGENCY,2 CENTERVIEW DR STE 52 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#," 2,003 "," 2,003 "," $123,176.11 ",,
MEDICAID DIRECT,1235764481,JUSTHEO HOME CARE LLC,,5710 SIX FORKS RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1235764481,JUSTHEO HOME CARE LLC,5710 SIX FORKS RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,533 "," 1,533 "," $94,405.25 ",,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1235765215,"RAMSEY, SEAN, MICHAEL ROBERT",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1235765215,"RAMSEY, SEAN, MICHAEL ROBERT",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235766312,"HUMBERT, CHRISTINA, GABRIELE",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235766312,"HUMBERT, CHRISTINA, GABRIELE",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 161 , 214 ," $18,639.62 ",,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1235767898,"USMAN, FARMAN, ALI",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 33 , 34 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1235767898,"USMAN, FARMAN, ALI",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 34 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235774118,"KAUR, HARPREET",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 26 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235774118,"KAUR, HARPREET",10207 CERNY ST STE 102 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235777913,"NOTTINGHAM, ELIZABETH, TILLEY",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 37 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235778317,"FREEMAN, COURTNEY, JAMES",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235778317,"FREEMAN, COURTNEY, JAMES",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235778317,"FREEMAN, COURTNEY, JAMES",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 52 , 65 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235778317,"FREEMAN, COURTNEY, JAMES",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235779646,"WILLIAMS, TARA, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 35 , 59 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235781782,"BESHEARS, WILLIAM, AUSTIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 24 , 28 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235781782,"BESHEARS, WILLIAM, AUSTIN",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 81 , 122 ,$#,,
MEDICAID DIRECT,1457696361,BLACK MOUNTAIN PHYSICAL THERAPY LLC,PHOENIX REHABILITATION AND HEALTH SERVICES INC,10610 METROMONT PKWY STE 108 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235784737,"GODFREY, SAMANTHA",10616 METROMONT PKWY STE 104A CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1245585009,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE WAXHAW FAMILY MEDICINE,2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1235785270,"HUDSON, KASEY, USHER",2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 47 , 75 ,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235787615,"POTTLE, DOROTHY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235789215,"GRAY, RACHEL, CAHOON",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235789215,"GRAY, RACHEL, CAHOON",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235789215,"GRAY, RACHEL, CAHOON",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235789793,"SLACK, SARAH, CLEGG",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 115 , 124 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235792268,"TIAN, YUN BO",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1235794751,"SONNENBERG, SHEILA, BETH",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750524781,BLUE RIDGE PSYCHOLOGICAL SERVICES L,BLUE RIDGE PSYCHOLOGICAL SERVICES LLC,9757 BLUE RIDGE DR   BLUE RIDGE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235796004,"JOHNSON, BRIAN, BURKE",9757 BLUE RIDGE DR   BLUE RIDGE GA,101,Out of State <= 40 miles,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1538935432,THOME & KENDRICK DDS PLLC,,9625 NORTHCROSS CENTER CT STE 101 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235797366,"WILLIAMS, SHARI",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 57 ,$#,,
MEDICAID DIRECT,1811695554,DAVID E THOME DDS PLLC L1,,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 18 , 18 , 330 ," $23,352.60 ",,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",236 MARKET ST STE 200 LOCUST NC,084,Stanly,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 743 , 805 ," 3,322 "," $109,599.37 ",,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 15 ,$#,,
MEDICAID DIRECT,1114566577,THOME LOWERY & HENDRICK DDS PLLC,RUTHERFORD PEDIATRIC DENTISTRY,1637 COLLEGE AVE STE B SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",1637 COLLEGE AVE STE B SPINDALE NC,081,Rutherford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1982302915,DAVID E THOME DDS PLLC L1,,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 20 ,$#,,
MEDICAID DIRECT,1922555689,DAVID E THOME DDS PLLC V,CABARRUS PEDIATRIC DENTISTRY,2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,374 "," 1,657 "," 6,457 "," $225,345.83 ",,
MEDICAID DIRECT,1174166359,THOME & ZIMMER DDS PLLC I,SHELBY PEDIATRIC DENTISTRY,221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,374 "," 2,991 "," 12,313 "," $446,489.17 ",,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1235797366,"WILLIAMS, SHARI",202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 494 , 554 ," 2,504 "," $86,452.24 ",,
MEDICAID DIRECT,1982302915,DAVID E THOME DDS PLLC L1,,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 16 ,$#,,
MEDICAID DIRECT,1114475159,DAVID E THOME DDS PLLC VI,LINCOLNTON PEDIATRIC DENTISTRY,701 S LAUREL ST STE 1 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",701 S LAUREL ST STE 1 LINCOLNTON NC,055,Lincoln,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1114475159,DAVID E THOME DDS PLLC VI,LINCOLNTON PEDIATRIC DENTISTRY,701 S LAUREL ST STE 1 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 22 , 22 , 85 ,$#,,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235797366,"WILLIAMS, SHARI",9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235799024,"SMITH, LOGAN, MICHAEL",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist, 25 , 38 , 62 ,$#,,
MEDICAID DIRECT,1235799263,J & S CARE INCORPORATED,MORNING STAR ASSISTED LIVING,3017 DUNN RD   EASTOVER NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235799263,J & S CARE INCORPORATED,3017 DUNN RD   EASTOVER NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 38 ," 9,026 "," 9,034 "," $896,653.43 ",,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235803362,"WHITE, ADRIENNE, RENEE",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 82 , 130 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235803362,"WHITE, ADRIENNE, RENEE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 30 , 46 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235803362,"WHITE, ADRIENNE, RENEE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235803362,"WHITE, ADRIENNE, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235803362,"WHITE, ADRIENNE, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235805516,"PARKER, GRACE, CLARE",510 TIMBER DR E   GARNER NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1235807009,"KORNBAUM, MACY, LAGARDE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1235807009,"KORNBAUM, MACY, LAGARDE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1235807009,"KORNBAUM, MACY, LAGARDE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851931257,LANE AND ASSOCIATES XXXV DDS PA,,11180 E FINCH AVE   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1235807520,"HINES, MITCHELL, BLAKE",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1235807520,"HINES, MITCHELL, BLAKE",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1639502727,LANE AND ASSOCIATES XXVII DDS PA,,4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1235807520,"HINES, MITCHELL, BLAKE",6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 591 , 969 ," 3,079 "," $144,195.84 ",,
MEDICAID DIRECT,1386321834,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WEST LINCOLN MIDDLE,260 SHOAL RD   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235810201,"REDNER, LISA, DAWN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 76 , 76 ," $23,032.46 ",,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235813650,"BANAWOE, GAETAN",9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,1900 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235813650,"BANAWOE, GAETAN",11025 CAROLINA PLACE PKWY STE A34 PINEVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235819038,"LEWIS, JORDAN, NICOLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1326447913,NUTRITION HEALTHWORKS LLC,,9216 BAILEYWICK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1235819665,"CASSETTA, NINA, MARIA",2221 ROBINWOOD RD   GASTONIA NC,036,Gaston,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326447913,NUTRITION HEALTHWORKS LLC,,172 WILLIAMSON RD UNIT 5205 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1235819665,"CASSETTA, NINA, MARIA",2221 ROBINWOOD RD   GASTONIA NC,036,Gaston,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326447913,NUTRITION HEALTHWORKS LLC,,2221 ROBINWOOD RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1235819665,"CASSETTA, NINA, MARIA",2221 ROBINWOOD RD   GASTONIA NC,036,Gaston,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235827973,"WHEELER, MEAGAN, CATHERINE",1450 MATTHEWS TOWNSHIP PKWY STE 350 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235829698,"HERRERA FARMAN, ASTRID, VIOLETA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235829698,"HERRERA FARMAN, ASTRID, VIOLETA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235834417,"FREY, HANNAH, NICOLE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1235834417,"FREY, HANNAH, NICOLE",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 17 , 18 , 41 ,$#,,
MEDICAID DIRECT,1235836230,MARYS AMAZEN HOMECARE LLC,~,4819 EMPEROR BLVD STE 400 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1235836230,MARYS AMAZEN HOMECARE LLC,4819 EMPEROR BLVD STE 400 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 2,938 "," 2,938 "," $249,200.53 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235836792,"JONES, ANGEL, REANN",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235836792,"JONES, ANGEL, REANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235836792,"JONES, ANGEL, REANN",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1235836792,"JONES, ANGEL, REANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1235837733,"LOOS, MCKENZIE, ANN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235837733,"LOOS, MCKENZIE, ANN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 56 , 58 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235837972,"KEOGH, MAE",3207 CAREY RD   KINSTON NC,054,Lenoir,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235843822,"OXENDINE, ADRIANNA, JADE",302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417914722,ROBESON HEALTH CARE CORPORATION,SOUTH ROBESON MEDICAL CENTER,210 S WALNUT ST   FAIRMONT NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235843822,"OXENDINE, ADRIANNA, JADE",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417914722,ROBESON HEALTH CARE CORPORATION,SOUTH ROBESON MEDICAL CENTER,210 S WALNUT ST   FAIRMONT NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235843822,"OXENDINE, ADRIANNA, JADE",302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 155 , 416 , 544 ," $21,830.63 ",,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235843822,"OXENDINE, ADRIANNA, JADE",302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 23 ,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235843822,"OXENDINE, ADRIANNA, JADE",302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1235847146,CLEVELANDS HOME CARE SERVICE INC,CLEVELANDS HOME CARE SERVICE INC,507 WOODSIDE AVE   KINGS MOUNTAIN NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1235847146,CLEVELANDS HOME CARE SERVICE INC,507 WOODSIDE AVE   KINGS MOUNTAIN NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,206 "," 1,206 "," $66,775.84 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235848656,"GRAINGER, KRISTIE, LEE",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235848656,"GRAINGER, KRISTIE, LEE",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235848656,"GRAINGER, KRISTIE, LEE",21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1235848656,"GRAINGER, KRISTIE, LEE",21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245542745,BOYS AND GIRLSHOMES OF NC,~,400 FLEMINGTON DR   LAKE WACCAMAW NC,024,Columbus,193200000X,Group,Multi-Specialty,,1235866831,"PAIT, TIFFANY, COLLINS",219 N LEE ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 23 , 45 ," $14,281.27 ",,
MEDICAID DIRECT,1245542745,BOYS AND GIRLSHOMES OF NC,~,219 N LEE ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1235866831,"PAIT, TIFFANY, COLLINS",219 N LEE ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1245542745,BOYS AND GIRLSHOMES OF NC,~,400 FLEMINGTON DR   LAKE WACCAMAW NC,024,Columbus,193200000X,Group,Multi-Specialty,,1235866831,"PAIT, TIFFANY, COLLINS",400 FLEMINGTON DR   LAKE WACCAMAW NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235869272,"ROPHAEL, PETTER, MAWAD",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 50 , 50 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235869272,"ROPHAEL, PETTER, MAWAD",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235869272,"ROPHAEL, PETTER, MAWAD",13825 HUNTON LN   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235869272,"ROPHAEL, PETTER, MAWAD",13825 HUNTON LN   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235869272,"ROPHAEL, PETTER, MAWAD",9200 GLENWATER DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 309 , 309 ," $10,294.46 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1235869272,"ROPHAEL, PETTER, MAWAD",9200 GLENWATER DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1023739281,ABOVE & BEYOND WELLNESS BLADEN PLLC,,101 S CRAIG ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1235875543,"HILBURN, SONJA, DURDEN",101 S CRAIG ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235877077,ELIZABETH HEPLER SPEECH THERAPY,~,8004 LINVILLE RD STE A1 OAK RIDGE NC,041,Guilford,193400000X,Group,Single Specialty,,1235877077,ELIZABETH HEPLER SPEECH THERAPY,8004 LINVILLE RD STE A1 OAK RIDGE NC,041,Guilford,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235877382,"UPCHURCH, CAROLYN, PROVIDENCE",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 61 , 71 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235877382,"UPCHURCH, CAROLYN, PROVIDENCE",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376510875,HOT SPRINGS HEALTH PROGRAM,HOT SPRINGS MEDICAL AND DENTAL CENTER,66 NW US 25 70 HIGH   HOT SPRINGS NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235877382,"UPCHURCH, CAROLYN, PROVIDENCE",66 NW US 25 70 HWY   HOT SPRINGS NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235877382,"UPCHURCH, CAROLYN, PROVIDENCE",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 25 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235878984,"SULLIVAN, BROOKE, FRANCIS",109 W GANNON AVE   ZEBULON NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235878984,"SULLIVAN, BROOKE, FRANCIS",6905 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1235883901,RSS CHARLOTTE OPERATIONS LLC,PRESTON HOUSE MEMORY CARE,4910 HARRIS WOODS BLVD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1235883901,RSS CHARLOTTE OPERATIONS LLC,4910 HARRIS WOODS BLVD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 50 , 50 ," $35,103.34 ",,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1235884339,"GARRIS, SAMANTHA, RENEE",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 106 , 190 ,$#,,
MEDICAID DIRECT,1235886086,NEW ERA INVESTMENT CORP,NEW ERA MEDICAL TRANSPORTATION,5501 EXECUTIVE CENTER DR STE 234 CHARLOTTE NC,060,Mecklenburg,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1235886086,NEW ERA INVESTMENT CORP,5501 EXECUTIVE CENTER DR STE 234 CHARLOTTE NC,060,Mecklenburg,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 59 , 60 ,$#,,
MEDICAID DIRECT,1235887365,PRIORITY CARE AT HOME LLC,PRIORITY CARE AT HOME LLC,216 NEWKIRK RD   BURGAW NC,071,Pender,253Z00000X,Agencies,In Home Supportive Care,,1235887365,PRIORITY CARE AT HOME LLC,216 NEWKIRK RD   BURGAW NC,071,Pender,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,203 "," 1,215 "," $118,533.44 ",,
MEDICAID DIRECT,1831748458,SHIN AND KIM DDS PLLC,EASTOWNE FAMILY DENTISTRY,501 EASTOWNE DR STE 230A CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1235887431,"LEE, YUNG, HYUN",501 EASTOWNE DR STE 230A CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235887431,"LEE, YUNG, HYUN",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 72 , 76 , 256 ," $14,049.80 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235894056,"CHURCH, VANESSA, RENEE",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 16 , 25 ,$#,,
MEDICAID DIRECT,1962941773,DLP FRYE MEDICAL GROUP,FRYECARE URGENT CARE,1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235894189,"MCNALLY, CHARLES, JOSEPH",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 22 , 55 ,$#,,
MEDICAID DIRECT,1962941773,DLP FRYE MEDICAL GROUP,FRYECARE URGENT CARE,1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235894189,"MCNALLY, CHARLES, JOSEPH",1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 84 , 90 , 209 ,$#,,
MEDICAID DIRECT,1235894338,QUALITY HANDS HOMECARE LLC,,1400 HARRIETTE DR A KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1235894338,QUALITY HANDS HOMECARE LLC,1400 HARRIETTE DR A KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,#, 508 , 508 ," $37,655.28 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1235896150,"JONES, JESSICA, MARIE",98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1235896150,"JONES, JESSICA, MARIE",98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 70 , 94 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1235896606,"SHANKLIN, KAITLIN, RENAE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235898875,"SIMMONS, CHELSEA, NICHOLE",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235906793,"THOMAS, UMI-AISHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1235906793,"THOMAS, UMI-AISHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235910332,"CARTER, ERICA, LYNNETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 21 , 43 , 65 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1235912049,"PROCTOR, HOBIE, DOUGLAS",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 26 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1235912049,"PROCTOR, HOBIE, DOUGLAS",210 SCHOOL RD   TRINITY NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1235912049,"PROCTOR, HOBIE, DOUGLAS",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 57 , 145 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1235912049,"PROCTOR, HOBIE, DOUGLAS",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 47 , 87 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1235912114,"YANELLO, BRIANA, ROSE",318 S NORWOOD ST   WALLACE NC,031,Duplin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 91 , 241 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1235915497,"LECHTENBERGER, CARRIE, LYNNE",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1235917311,"PLOTKIN, MEGAN, LOUISE",1 TOWN SQUARE BLVD STE 220 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1235917311,"PLOTKIN, MEGAN, LOUISE",1 TOWN SQUARE BLVD STE 220 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1235918103,"HABERMAN, LINDSEY, JOY",1895 HOFFMAN RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1235918103,"HABERMAN, LINDSEY, JOY",600 W TRADE ST   DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 44 , 85 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235918103,"HABERMAN, LINDSEY, JOY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235918103,"HABERMAN, LINDSEY, JOY",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235918103,"HABERMAN, LINDSEY, JOY",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1235938143,SERENITY HOME CARE LLC,~,18 SHARON ST   ROSEBORO NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1235938143,SERENITY HOME CARE LLC,18 SHARON ST   ROSEBORO NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,#, 317 , 317 ," $32,282.68 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235943200,"MCCULLEY, ALYSSA, BREANNA",5601 ARRINGDON PARK DR STE 430 MORRISVILLE NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1235943200,"MCCULLEY, ALYSSA, BREANNA",5601 ARRINGDON PARK DR STE 430 MORRISVILLE NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1235952763,"ROGERS, DALLAS, MARIE",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 43 , 76 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1235952763,"ROGERS, DALLAS, MARIE",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 38 , 167 , 412 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1235958174,"HARRIS, SARAH, BETH",107 WEEKS DRIVE   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 48 , 129 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235961772,"BICK, SAMANTHA, LEDER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235961772,"BICK, SAMANTHA, LEDER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1235963778,"STADLER, DANIELLE, EMILY",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 55 , 108 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235972621,"ARNOLD, MATTHEW, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1235972712,"LOFTIN, LESLIE, RENEE",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1235972712,"LOFTIN, LESLIE, RENEE",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1235974635,"PTASZNIK, MOLLY, ROSE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1235979469,"PULLIUM, MORGAN, SAMANTHA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1235984600,"RODRIGUEZ, ELIAS, GREGORY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1235984600,"RODRIGUEZ, ELIAS, GREGORY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 23 , 54 ,$#,,
MEDICAID DIRECT,1235985045,ABSOLUTE HOME CARE AGENCY LLC,,1921 N POINTE DR STE 200-10 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1235985045,ABSOLUTE HOME CARE AGENCY LLC,1921 N POINTE DR STE 200-10 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 147 , 147 ," $15,734.40 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235991597,"WEST, KATLYN, DANIELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 66 , 74 , 122 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235991597,"WEST, KATLYN, DANIELLE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1235991597,"WEST, KATLYN, DANIELLE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1235992553,"HUGGINS, BROOKE, MORGAN",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1235992553,"HUGGINS, BROOKE, MORGAN",1235 RAMSEY ST FL 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235992553,"HUGGINS, BROOKE, MORGAN",1235 RAMSEY ST FL 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1235992553,"HUGGINS, BROOKE, MORGAN",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 158 , 163 ,$#,,
MEDICAID DIRECT,1619058955,FRANKLIN COUNTY HEALTH DEPT,FRANKLIN CO HEALTH DEPT,107 INDUSTRIAL DR   LOUISBURG NC,035,Franklin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1235994237,"DANTZLER, RIEANN, DAVINA",30 ASHBERRY LN   FRANKLINTON NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245004886,"SEYMOUR, BENJAMIN, TAYLOR",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 133 , 150 ," $17,476.86 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1245004886,"SEYMOUR, BENJAMIN, TAYLOR",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 43 , 43 ," $16,434.00 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245007822,"WILKERSON, ASHLEY, OURS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 89 , 90 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245013150,"KANG, LENA, JOOYEON",1821 HILLANDALE RD STE 24B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245013150,"KANG, LENA, JOOYEON",1821 HILLANDALE RD STE 24B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 18 , 47 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1245013721,"TOOKER, FRANCES, KING",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 41 , 179 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245014299,"HINES, LATASHA, DEREE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1245058965,T&M HOME CARE LLC,T&M HOME CARE LLC,4004 BRIAR GLEN COURT   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1245058965,T&M HOME CARE LLC,4004 BRIAR GLEN COURT   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1144406539,PHYSICAL THERAPY FOR WOMEN,~,1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245060730,"BAILEY, CARRIE, ANN",1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1245061076,"STURDIVANT, LANDON, CLOVIS",335 E PARKER RD   MORGANTON NC,012,Burke,152W00000X,Eye and Vision Services Providers,Optometrist,, 72 , 73 , 91 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1245061076,"STURDIVANT, LANDON, CLOVIS",335 E PARKER RD   MORGANTON NC,012,Burke,152W00000X,Eye and Vision Services Providers,Optometrist,, 39 , 40 , 53 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245067966,"CARDOSO LAZARI CARVALHO, PRISCILLA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245072719,"FRANCESCHI, JOANI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245082411,TOP ANGELS HOMECARE LLC,TOP ANGELS HOMECARE LLC,845 CHURCH ST N STE 208-11 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1245082411,TOP ANGELS HOMECARE LLC,845 CHURCH ST N STE 208-11 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#, 61 , 61 ,$#,,
MEDICAID DIRECT,1245086164,EXCEPTIONAL IN HOME CARE PROVIDERS,,11020 DAVID TAYLOR DR STE 316 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1245086164,EXCEPTIONAL IN HOME CARE PROVIDERS,11020 DAVID TAYLOR DR STE 316 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 784 , 803 ," $46,482.04 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245088186,"IMMELMAN, TIMOTHY, DAVID",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 17 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245089440,"MCGEE, JONATHAN, MORRISSEY",2301 ERWIN RD   RALEIGH NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245089440,"MCGEE, JONATHAN, MORRISSEY",2301 ERWIN RD   RALEIGH NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245090059,"EURE, CARLA, DEE COOPER",108 W MAIN ST   WOODLAND NC,066,Northampton,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245090059,"EURE, CARLA, DEE COOPER",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245090059,"EURE, CARLA, DEE COOPER",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 125 , 149 , 185 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245200294,"BOGGS, JANE, GIBERT",601 N ELM ST   HIGH POINT NC,041,Guilford,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245200294,"BOGGS, JANE, GIBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245200294,"BOGGS, JANE, GIBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology, 113 , 174 , 221 ,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,816 GREENBRIER CIR STE G CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245200435,"WOOTTEN, AMY",667 KINGSBOROUGH SQ STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1588852487,HANDS ON PHYSICAL THERAPY,HANDS ON PHYSICAL THERAPY,1439 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1245200526,"WIEGERS, CATHERINE, ANN",1439 N MAIN ST   FUQUAY VARINA NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 57 , 122 ,$#,,
MEDICAID DIRECT,1659337046,COASTAL SURGICAL SPECIALIST,Coastal Surgical Specialist,2203 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245200567,"SINNING, MARK, ALAN",2203 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 66 , 159 , 475 ," $29,524.38 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245200948,"SIMPSON, GRACE, ANN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245200948,"SIMPSON, GRACE, ANN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245200948,"SIMPSON, GRACE, ANN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245200948,"SIMPSON, GRACE, ANN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245200948,"SIMPSON, GRACE, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851362503,PIEDMONT ADULT AND PEDIATRIC MEDICI,PIEDMONT ADULT AND PEDIATRIC MEDICINE PA,640 SUMMIT CROSSING PL STE 204 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245201557,"WILLIAMS, JOHNATHAN, DELEON",640 SUMMIT CROSSING PL STE 204 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 127 , 232 ,$#,,
MEDICAID DIRECT,1346613528,HAMPTON ROADS PEDIATRIC DENTISTRY,HANBURY PEDIATRIC DENTISTRY & BEHL ORTHODONTICS,1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245202670,"KELLY, LISA, DELAINE",446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 265 , 273 ," 1,168 "," $35,748.86 ",,
MEDICAID DIRECT,1174996359,HAMPTON ROADS PEDIATRIC DENTISTRY,FRIENDLY FACES PEDIATRIC DENTISTRY,446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245202670,"KELLY, LISA, DELAINE",446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 32 , 168 ,$#,,
MEDICAID DIRECT,1174575179,CROSS CREEK MEDICAL CLINIC,CROSS CREEK MEDICAL CLINIC,1309 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245202696,"DESAI, NITIN, DAHYABHAI",1309 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 97 , 351 , 444 ," $11,034.76 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245202696,"DESAI, NITIN, DAHYABHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245202738,"OMONDE, PETER",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 59 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 175 , 223 , 288 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 19 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 288 , 322 , 416 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1245202878,"VOGLER, ROBERT, CHEATHAM",114 WIND CHIME CT   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1245204379,"BLASKO, EDWARD, CONRAD",600 HOSPITAL DR   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 22 , 23 ,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1245204379,"BLASKO, EDWARD, CONRAD",1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245204379,"BLASKO, EDWARD, CONRAD",600 HOSPITAL DR   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1245204379,"BLASKO, EDWARD, CONRAD",919 E CASWELL ST   WADESBORO NC,004,Anson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1245204379,"BLASKO, EDWARD, CONRAD",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 38 , 66 , 112 ,$#,,
MEDICAID DIRECT,1154563385,ST LUKES PHYSICIAN NETWORK INC,ST LUKES ORTHOPEDICS AND SPORTS MEDICINE,89 W MILLS ST   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1245206036,"ROSENBERG, BRIAN, JAY",89 W MILLS ST   COLUMBUS NC,075,Polk,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245206234,"EATON, COY, LYNN",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245206341,"SCHNEIDER, KIRSTEN, MARIE",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245206341,"SCHNEIDER, KIRSTEN, MARIE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1245206697,SPECTRUM INFUSION INC,~,3221 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,251F00000X,Agencies,Home Infusion,,1245206697,SPECTRUM INFUSION INC,3221 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,251F00000X,Agencies,Home Infusion,,#, 13 , 31 ," $22,168.10 ",,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245207471,"JONES, RANDALL, STEPHON",4901 N. TRYON STREET   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245207471,"JONES, RANDALL, STEPHON",3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 7,589 "," 10,789 "," 48,955 "," $1,244,296.97 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245207703,"HENDERSON, LILLIAN, WAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245208628,"ECHTERLING, SUSAN, CATHERINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1245208628,"ECHTERLING, SUSAN, CATHERINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 37 , 48 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1245208628,"ECHTERLING, SUSAN, CATHERINE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245208628,"ECHTERLING, SUSAN, CATHERINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 32 , 48 ,$#,,
MEDICAID DIRECT,1932380953,CAROMONT MEDICAL GROUP INC,CAROMONT CRITICAL CARE SPECIALIST,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245209881,"JUSTICE, JASON, ROBERT",2525 COURT DR   GASTONIA NC,036,Gaston,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 89 , 145 , 174 ," $18,379.41 ",,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1245210566,"HARRELL, SHARON",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 97 ,$#,,
MEDICAID DIRECT,1396725743,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,195 CAMLELOT CT   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1245210566,"HARRELL, SHARON",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1003364589,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,131 NC HIGHWAY 109 S   MOUNT GILEAD NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1245210566,"HARRELL, SHARON",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 33 ,$#,,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1245210566,"HARRELL, SHARON",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1245211333,CAROLINA EYE ASSOCIATES INC,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,, 967 , 980 ," 1,754 "," $22,402.53 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,,,Unknown,193200000X,Group,Multi-Specialty,,1245211333,CAROLINA EYE ASSOCIATES INC,101 MEDICAL CIR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 314 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245211911,"PELLEGRINO, ANTHONY",300 MEDICAL PKWY STE 314 CHESAPEAKE VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1245214147,"KING, FRED, GILBERT",169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245214147,"KING, FRED, GILBERT",2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",1091 HIGHWAY 64 W   HAYESVILLE NC,022,Clay,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 54 , 93 ," $11,845.73 ",,
MEDICAID DIRECT,1104880723,WNC EYE SURGERY CENTER,,8B MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1245214410,"BRIDGES, WILLIAM, ZACHERY",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",21 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 81 , 179 , 293 ," $23,306.14 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",21 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",2311 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 31 , 52 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",95 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 47 , 120 , 202 ," $22,935.31 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",95 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245214410,"BRIDGES, WILLIAM, ZACHERY",1196 SKYLAND DR   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245214485,"MORRIS, STEVEN, JAMES",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245214485,"MORRIS, STEVEN, JAMES",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245214832,"GRUDEN, JAMES, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 504 , 720 , 754 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3821 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245214832,"GRUDEN, JAMES, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245214832,"GRUDEN, JAMES, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1245214832,"GRUDEN, JAMES, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1245214832,"GRUDEN, JAMES, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,350 E HOLDING AVE   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1245214832,"GRUDEN, JAMES, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245215037,"PORTELA, ROBERTO, CARLOS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 73 , 75 , 78 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245215300,"GEARY, RANDOLPH, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245215672,"FREEDMAN, BARRY, IRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 66 , 66 ,$#,,
MEDICAID DIRECT,1801966395,KINSTON HEAD AND NECK PHYSICIANS AN,KINSTON HEAD & NECK PHYSICIANS AND SURGEONS PA,702 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,193400000X,Group,Single Specialty,,1245215904,"CUNNINGHAM, JOHN, DAVID",702 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1801966395,KINSTON HEAD AND NECK PHYSICIANS AN,KINSTON HEAD & NECK PHYSICIANS AND SURGEONS PA,701 DOCTORS DR STE K KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1245215904,"CUNNINGHAM, JOHN, DAVID",701 DOCTORS DR STE K KINSTON NC,054,Lenoir,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245216266,"HUTZENBUHLER, ANGELA, NOEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245216266,"HUTZENBUHLER, ANGELA, NOEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245216266,"HUTZENBUHLER, ANGELA, NOEL",3200 BLUE RIDGE RD STE 226 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1245216449,"BROWN, PENNY, LYNN",144 COMMUNITY COLLEGE RD STE C AHOSKIE NC,046,Hertford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861244477,EASTER SEALS UCP NORTH CAROLINA & V,EASTERSEALS PORT HEALTH,203 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245216449,"BROWN, PENNY, LYNN",144 COMMUNITY COLLEGE RD STE C AHOSKIE NC,046,Hertford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1245216449,"BROWN, PENNY, LYNN",703 CATHERINE CREEK RD S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245216449,"BROWN, PENNY, LYNN",~,703 CATHERINE CREEK RD S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1245216449,"BROWN, PENNY, LYNN",703 CATHERINE CREEK RD S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 272 , 396 ,$#,,
MEDICAID DIRECT,1437112612,WNC DERMATOLOGICAL ASSOCIATES PA,~,281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245216514,"CASH, SARAH, HARRIS",281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245216555,"HETHERINGTON, RICHARD, GWYN",3735 GLENLAKE DR   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 30 , 30 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3411 W MILLBROOK RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3411 W MILLBROOK RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 61 , 61 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3411 W MILLBROOK RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 59 , 59 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 28 , 28 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 41 , 41 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",2700 LEIGHTON RIDGE DR   WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 24 , 31 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1245218288,"TIMMONS, PHILLIP, ZACHARY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245218387,"DIXON, KELLY, HERGER",371 NC HIGHWAY 65   REIDSVILLE NC,079,Rockingham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245218387,"DIXON, KELLY, HERGER",371 NC HIGHWAY 65   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 17 , 54 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245218387,"DIXON, KELLY, HERGER",371 NC HIGHWAY 65   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 18 , 69 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245218817,"REDDY, VENKATESHA, G S",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,,,Unknown,193200000X,Group,Multi-Specialty,,1245218817,"REDDY, VENKATESHA, G S",1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245218817,"REDDY, VENKATESHA, G S",1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1245218999,"BAUGHER, JULIE, GLENN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1245218999,"BAUGHER, JULIE, GLENN",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 62 , 85 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245219302,"VAN STAVEREN, GIJSBERTUS, FRANCISCUS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,306 DEER PARK RD   NEBO NC,059,McDowell,193200000X,Group,Multi-Specialty,,1245219567,"LAMSON, GARY, LESLIE",306 DEER PARK RD   NEBO NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1245220193,"MEADOWS, JOHN, DARRELL",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 26 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1245220193,"MEADOWS, JOHN, DARRELL",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 66 , 66 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1245220532,"MORGAN, ALAN, LEE",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245220680,"FLOWERS, GEORGE, ADAM",605 GROVE ST   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 80 , 132 , 235 ,$#,,
MEDICAID DIRECT,1245221092,VERUS HEALTHCARE LLC,~,1569 MALLORY LN BLDG 100 BRENTWOOD TN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245221092,VERUS HEALTHCARE LLC,1569 MALLORY LN BLDG 100 BRENTWOOD TN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 118 , 350 , 577 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1245221563,"WHITE, JEFFREY, JASON",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 37 , 55 , 89 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1245221563,"WHITE, JEFFREY, JASON",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 106 , 138 , 205 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245221993,"HART, LOWELL, LAMONT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245223197,"BANKER, MILLARD, FILLMORE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245223197,"BANKER, MILLARD, FILLMORE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245223783,ADVANCE COMMUNITY HEALTH INC,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245224534,"WHITEHEAD, MARJORIE, MCDOWELL",7110 LAWYERS RD   MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245224542,"GHATE, JAYASHRI, VIJAY",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245224542,"GHATE, JAYASHRI, VIJAY",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245224542,"GHATE, JAYASHRI, VIJAY",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1245224989,"CHAVARRIA-AGUILAR, MARCO",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245224989,"CHAVARRIA-AGUILAR, MARCO",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1245224989,"CHAVARRIA-AGUILAR, MARCO",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 16 , 22 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245224989,"CHAVARRIA-AGUILAR, MARCO",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 26 , 29 ,$#,,
MEDICAID DIRECT,1245225028,MMDS OF NORTH CAROLINA INC,~,,,Unknown,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,,1245225028,MMDS OF NORTH CAROLINA INC,251 DOMINION DR STE 112 MORRISVILLE NC,092,Wake,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1245227222,"SHAH, ABID, ALI",117 E KINGS HWY   EDEN NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 78 , 82 , 90 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1245227222,"SHAH, ABID, ALI",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1245227222,"SHAH, ABID, ALI",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245228162,MMDS OF ASHEVILLE,,,,Unknown,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,,1245228162,MMDS OF ASHEVILLE,38 ROSSCRAGGON RD STE M ASHEVILLE NC,011,Buncombe,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,,#,,,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1245228261,"NASCIMENTO, LUIZ",923 E CASWELL ST   WADESBORO NC,004,Anson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,1021 W HAMLET AVE STE 5 HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1245228261,"NASCIMENTO, LUIZ",923 E CASWELL ST   WADESBORO NC,004,Anson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,222 W MAIN ST   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1245228261,"NASCIMENTO, LUIZ",222 W MAIN ST   HAMLET NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 49 , 61 , 89 ,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1245228261,"NASCIMENTO, LUIZ",771 CHERAW RD   HAMLET NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1245228261,"NASCIMENTO, LUIZ",809 S LONG DR STE B ROCKINGHAM NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1245228261,"NASCIMENTO, LUIZ",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 167 , 250 , 492 ,$#,,
MEDICAID DIRECT,1508803214,MINDPATH CARE CENTERS NORTH CAROLIN,~,4 DOCTORS PARK STE H ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245228527,"ABU-SALHA, MOHAMMAD, YOUSIF",2076 NC HIGHWAY 42 W STE 220 CLAYTON NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1508803214,MINDPATH CARE CENTERS NORTH CAROLIN,~,3604 SHANNON RD STE 200 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245228527,"ABU-SALHA, MOHAMMAD, YOUSIF",2076 NC HIGHWAY 42 W STE 220 CLAYTON NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 17 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245229863,"EVERS, MICHAEL, DOLLISH",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740499714,CAROLINA FAMILY MEDICINE AND URGENT,CAROLINA FAMILY MEDICINE AND URGENT CARE,,,Unknown,193200000X,Group,Multi-Specialty,,1245231430,"VOULGAROPOULOS, MENELOAS, ATHANASIOS",349 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1245231430,"VOULGAROPOULOS, MENELOAS, ATHANASIOS",349 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 116 , 605 ," 1,738 "," $20,090.52 ",,
MEDICAID DIRECT,1740499714,CAROLINA FAMILY MEDICINE AND URGENT,CAROLINA FAMILY MEDICINE AND URGENT CARE,,,Unknown,193400000X,Group,Single Specialty,,1245231430,"VOULGAROPOULOS, MENELOAS, ATHANASIOS",349 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245231489,"SILVERMAN, JAN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 20 , 20 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245231489,"SILVERMAN, JAN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 13 , 14 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245231489,"SILVERMAN, JAN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 44 , 45 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245231489,"SILVERMAN, JAN, FRANKLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 20 , 20 , 26 ,$#,,
MEDICAID DIRECT,1942269451,TRIANGLE COMMUNITY PHYSICIANS PA,Triangle Community Physicians PA,4309 MEDICAL PARK DR STE 200 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245231588,"KALLIANOS, JOHN, ANDREW",4309 MEDICAL PARK DR STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 33 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245232123,"JOHNSON, WARREN, CHARLES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1669171369,LIVING WELL PEDIATRICS PC,LIVING WELL PEDIATRICS,289 OLMSTED BLVD STE 5 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1245232123,"JOHNSON, WARREN, CHARLES",300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 28 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1245232123,"JOHNSON, WARREN, CHARLES",155 MEMORIAL DR   PINEHURST NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245232743,"WOOD, KELLY, ELIZABETH",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245232743,"WOOD, KELLY, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 37 , 61 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 32 , 41 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 123 , 134 , 209 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 23 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 17 , 18 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 127 , 160 , 252 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 31 , 52 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 38 , 76 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1245232990,"SANCHEZ, RICHARD",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 36 ,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",1301 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 19 , 21 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 35 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 286 , 356 , 433 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 35 , 40 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 25 , 28 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 50 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 49 , 62 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245235001,"DISTELL, BRUCE, MICHAEL",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 38 , 52 ,$#,,
MEDICAID DIRECT,1710427091,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN CARDIOLOGY,708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245235167,"BALOGH, TAMAS, ISTVAN",708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 106 , 176 , 361 ,$#,,
MEDICAID DIRECT,1710427091,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN CARDIOLOGY,708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245235167,"BALOGH, TAMAS, ISTVAN",708 S SOUTH ST STE 200 MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1245235506,"AHMED, SAGIR",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 238 , 317 , 431 ," $15,236.19 ",,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1245235951,"DROTTS, DANIEL, LOWELL",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1245235951,"DROTTS, DANIEL, LOWELL",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 30 , 58 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1245235951,"DROTTS, DANIEL, LOWELL",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 57 , 66 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1245235951,"DROTTS, DANIEL, LOWELL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1184703589,QUALITY HOME CARE SERVICES INC,QUALITY HOME CARE SERVICES INC,3552 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245236249,"WARE, LESLIE, ANN",3607 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184703589,QUALITY HOME CARE SERVICES INC,QUALITY HOME CARE SERVICES INC,3607 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245236249,"WARE, LESLIE, ANN",3607 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184703589,QUALITY HOME CARE SERVICES INC,QUALITY HOME CARE SERVICES INC,3552 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245236249,"WARE, LESLIE, ANN",3552 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184703589,QUALITY HOME CARE SERVICES INC,QUALITY HOME CARE SERVICES INC,3552 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245236249,"WARE, LESLIE, ANN",301 S COLLEGE ST STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235333584,MANULI INTERNAL MEDICINE PLLC,MANULI INTERNAL MEDICINE PLLC,104 MILL END CT   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245236959,"MANULI, STEVEN, PHILIP",104 MILL END CT   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 42 , 44 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245237791,"ROBERTS ATWATER, BEVERLY, LAVERN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245237791,"ROBERTS ATWATER, BEVERLY, LAVERN",721 FAIRFAX AVE FL 3 NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1245238674,"CHAI, SUNGJI",381 DEERFIELD RD   BOONE NC,095,Watauga,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 36 , 51 ,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,261 LONGVUE DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1245238674,"CHAI, SUNGJI",261 LONGVUE DR   BOONE NC,095,Watauga,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239136,"ACHUKO, MAUREEN, NGOZI",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 53 , 53 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239136,"ACHUKO, MAUREEN, NGOZI",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239136,"ACHUKO, MAUREEN, NGOZI",2560 LEGION RD   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 89 , 482 , 484 ," $10,792.73 ",,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239136,"ACHUKO, MAUREEN, NGOZI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 65 , 174 , 174 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239136,"ACHUKO, MAUREEN, NGOZI",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239136,"ACHUKO, MAUREEN, NGOZI",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 131 , 159 , 241 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239144,"MCCONNELL, EZRA, LEE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 117 , 117 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239144,"MCCONNELL, EZRA, LEE",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 125 , 145 , 217 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239144,"MCCONNELL, EZRA, LEE",219 MARTIN LUTHER KING JR DR   BLADENBORO NC,009,Bladen,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239144,"MCCONNELL, EZRA, LEE",101 DIALYSIS DR   ELIZABETHTOWN NC,009,Bladen,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 66 , 67 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239144,"MCCONNELL, EZRA, LEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 74 , 79 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239144,"MCCONNELL, EZRA, LEE",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245239144,"MCCONNELL, EZRA, LEE",1327 HARRY WEST LN DIALYSIS CLINIC PEMBROKE NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 117 , 117 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245241108,"GEORGE, STEPHEN, GEORGE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 32 , 33 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245242718,"KAPITAN, RICHARD, ANDREW",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 13 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245242718,"KAPITAN, RICHARD, ANDREW",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 46 , 64 , 153 ," $43,944.06 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,149 PLANTATION RIDGE DR STE 170 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245242718,"KAPITAN, RICHARD, ANDREW",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245242718,"KAPITAN, RICHARD, ANDREW",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245242718,"KAPITAN, RICHARD, ANDREW",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 45 , 70 , 139 ," $31,242.97 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245242718,"KAPITAN, RICHARD, ANDREW",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 14 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245242718,"KAPITAN, RICHARD, ANDREW",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245246149,"PARHAM, MICHAEL, BLAKE",33 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245246149,"PARHAM, MICHAEL, BLAKE",59 WEAVER VILLAGE WAY   WEAVERVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245246149,"PARHAM, MICHAEL, BLAKE",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245246149,"PARHAM, MICHAEL, BLAKE",328 NEW LEICESTER HWY STE 150 ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245246362,"LITTLE, JENNIFER, LONG",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245246362,"LITTLE, JENNIFER, LONG",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245246362,"LITTLE, JENNIFER, LONG",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245246362,"LITTLE, JENNIFER, LONG",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1245246628,"BRIDGES, CAROL, MOSS",1622 E MARION ST   SHELBY NC,023,Cleveland,152W00000X,Eye and Vision Services Providers,Optometrist,, 16 , 18 , 21 ,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245248640,"DAUGHDRILLE, JOHN, ERNEST",1805 N ROAD ST STE H ELIZABETH CITY NC,070,Pasquotank,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245248640,"DAUGHDRILLE, JOHN, ERNEST",844 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245248640,"DAUGHDRILLE, JOHN, ERNEST",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#, 14 ,$#,,
MEDICAID DIRECT,1821191875,RUTHERFORD HOSPITAL INC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245248657,"RALPH, ROBERT, ALLEN",605 NC 120 HWY   MOORESBORO NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1245248673,MORGANTON EYE PHYSICIANS PA,~,335 E PARKER RD   MORGANTON NC,012,Burke,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1245248673,MORGANTON EYE PHYSICIANS PA,335 E PARKER RD   MORGANTON NC,012,Burke,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 333 , 336 , 672 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245248996,"WRIGHT, JOHN, TIMOTHY",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245248996,"WRIGHT, JOHN, TIMOTHY",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245248996,"WRIGHT, JOHN, TIMOTHY",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 329 , 390 ," 1,177 "," $35,866.89 ",,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245249929,"BORDEN, LESTER, STUART",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 52 , 90 , 152 ,$#,,
MEDICAID DIRECT,1396887428,OASIS EYE CARE OPTOMETRY PA,~,701 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1245251529,"SAID, AHMED",701 TILGHMAN DR   DUNN NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,, 71 , 113 , 604 ," $20,281.68 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245252717,"WASHBURN, RONALD, GLENN",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245252717,"WASHBURN, RONALD, GLENN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 46 , 69 , 75 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245253640,"PAL, SRIDHIR, EARNI",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245254010,"STAIR, RICHARD, WAYNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 88 , 90 , 98 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245256569,"PETERSEN, MAUREEN, MICHELE",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245257021,"KEY SOLLE, MIKELLE, LYNETTE",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 112 , 113 ,$#,,
MEDICAID DIRECT,1245257419,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-2908,201 MONTGOMERY XING   BISCOE NC,062,Montgomery,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1245257419,WAL-MART STORES EAST LP,201 MONTGOMERY XING   BISCOE NC,062,Montgomery,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1245257419,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-2908,201 MONTGOMERY XING   BISCOE NC,062,Montgomery,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1245257419,WAL-MART STORES EAST LP,201 MONTGOMERY XING   BISCOE NC,062,Montgomery,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1245257484,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1131,901 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1245257484,WAL-MART STORES EAST LP,901 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1245257484,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1131,901 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1245257484,WAL-MART STORES EAST LP,901 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245257682,"COGGINS, KENNETH, GERALD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 40 , 78 , 93 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245257682,"COGGINS, KENNETH, GERALD",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 45 , 63 , 116 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245257682,"COGGINS, KENNETH, GERALD",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 24 , 39 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245259365,"GANZON, RODOLFO, BAUTISTA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 37 , 124 , 124 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245261650,"SHAH, SANJAY, GUNVANTLAL",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598260515,CONCORD RADIOLOGY PLLC,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1245261783,"SLUSS, JAMES, ROGER",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245261783,"SLUSS, JAMES, ROGER",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245262096,"SMITH, DARON",8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 15 , 26 ,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245262096,"SMITH, DARON",6068 W HIGHWAY 74 STE J INDIAN TRAIL NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245262096,"SMITH, DARON",600 HOSPITAL DR   MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,8924 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245262096,"SMITH, DARON",1994 WELLNESS BLVD STE 210 MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1174183156,QUEEN CITY EAR NOSE AND THROAT PLLC,,1994 WELLNESS BLVD STE 210 MONROE NC,090,Union,193400000X,Group,Single Specialty,,1245262096,"SMITH, DARON",1994 WELLNESS BLVD STE 210 MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245263821,"GRIMSLEY, ASHLEY, NOELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1245263821,"GRIMSLEY, ASHLEY, NOELLE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 85 , 132 ,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245265149,"FARRUG, EUGENE, DANIEL",919 S FIFTH ST   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 74 , 134 ,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245265149,"FARRUG, EUGENE, DANIEL",400 MILLSTONE DR STE 100 HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245265461,"TESTA, CLAUDIA, MARIE",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 25 , 32 , 38 ,$#,,
MEDICAID DIRECT,1972930725,ROCKINGHAM FOOT AND ANKLE ASSOCIATE,,307 S MAIN ST   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1245266089,"MCKINNEY, BENJAMIN, IVAN",307 S MAIN ST   REIDSVILLE NC,079,Rockingham,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 20 , 81 , 120 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245267269,"SMITH, JOSHUA, ANDREW",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 49 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245267269,"SMITH, JOSHUA, ANDREW",3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245268861,"JONES, MICHAEL, EUGENE",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 47 , 52 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245268861,"JONES, MICHAEL, EUGENE",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245268861,"JONES, MICHAEL, EUGENE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245269141,"GORRIN-RIVAS, MANUEL, JOSE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245269141,"GORRIN-RIVAS, MANUEL, JOSE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245269141,"GORRIN-RIVAS, MANUEL, JOSE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245269141,"GORRIN-RIVAS, MANUEL, JOSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 28 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245269141,"GORRIN-RIVAS, MANUEL, JOSE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245269513,"YERRAMSETTY, PAVAN, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245269513,"YERRAMSETTY, PAVAN, KUMAR",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 127 , 225 , 390 ," $11,824.12 ",,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245270131,"WARREN, GREG, ANTHONY",206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 82 , 227 , 239 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245270131,"WARREN, GREG, ANTHONY",101 DAVITA LN   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 64 , 64 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245270131,"WARREN, GREG, ANTHONY",1840 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 126 , 126 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245270131,"WARREN, GREG, ANTHONY",129 HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 181 , 181 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245270131,"WARREN, GREG, ANTHONY",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 41 , 68 , 68 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245270131,"WARREN, GREG, ANTHONY",121 N CHURCH ST   CONWAY NC,066,Northampton,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245270131,"WARREN, GREG, ANTHONY",115 EXETER ST   MANTEO NC,028,Dare,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245270784,"CROMARTIE III, HENRY, LEROY",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245271220,"GREENBERG, CAPRICE, CHRISTIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1245271378,"PETERSON SURI, MARY, ELLEN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245271667,"KENDRICK, DEANNA, GATIE",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1245272582,"VEVERKA, JILL, ADELE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245274299,"WARD, MICHELE, TENNEY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245274455,"LALONDE, JOHN, CHARLES",1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245274455,"LALONDE, JOHN, CHARLES",1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,106 ALEXANDER BANK DR STE 300 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245275072,"HEIDER, TIMOTHY, RYAN",106 ALEXANDER BANK DR STE 300 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245275072,"HEIDER, TIMOTHY, RYAN",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,106 ALEXANDER BANK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245275072,"HEIDER, TIMOTHY, RYAN",106 ALEXANDER BANK DR STE 101 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245275072,"HEIDER, TIMOTHY, RYAN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245275072,"HEIDER, TIMOTHY, RYAN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1245275528,"THORDSEN-VELEZ, MARILU",1135 CARTHAGE ST   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245275619,"PYLANT, ANDREW, ORLAND",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245275619,"PYLANT, ANDREW, ORLAND",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 49 , 73 ,$#,,
MEDICAID DIRECT,1245275619,"PYLANT, ANDREW, ORLAND",~,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1245275619,"PYLANT, ANDREW, ORLAND",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245275619,"PYLANT, ANDREW, ORLAND",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245275619,"PYLANT, ANDREW, ORLAND",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 86 , 93 , 134 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245276633,"HINEDI, KAREEM, AREF",727 N MAIN ST   EMPORIA VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093234007,TRIAD PEDIATRIC EYE PHYSICIANS,~,2554 LEWISVILLE CLEMMONS RD STE 308 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1245277532,"HEIN, ERIC, WARREN",2554 LEWISVILLE CLEMMONS RD STE 308 CLEMMONS NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 148 , 172 , 290 ," $16,165.21 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245277615,"MAASKE, SHANNON, LEIGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245277615,"MAASKE, SHANNON, LEIGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1073822029,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1245282078,"GENTRY, DANIEL, EARL",711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245282441,"KINKAID, STANLEY, GORDON",160 KIMEL FOREST DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245282441,"KINKAID, STANLEY, GORDON",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245282441,"KINKAID, STANLEY, GORDON",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 26 , 26 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245282441,"KINKAID, STANLEY, GORDON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 103 , 162 , 163 ,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245282441,"KINKAID, STANLEY, GORDON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245282441,"KINKAID, STANLEY, GORDON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 147 , 962 ," 1,067 "," $24,577.85 ",,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245282458,"CARBONE, JOSEPH, MICHAEL",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,429 COMMONWEALTH BLVD E   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245282458,"CARBONE, JOSEPH, MICHAEL",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245282839,"MILLER, TIMOTHY, PATRICK",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 55 , 113 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245284058,"SHAVER, DAVID, CORYDON",1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1104513605,NMG HEALTH SERVICES LLC,NOVANT HEALTH MATERNAL-FETAL MEDICINE,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245284058,"SHAVER, DAVID, CORYDON",1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245284058,"SHAVER, DAVID, CORYDON",19475 OLD JETTON RD STE 101 CORNELIUS NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245284884,"BROCK, GAIL, PACHARIS",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245284884,"BROCK, GAIL, PACHARIS",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245284884,"BROCK, GAIL, PACHARIS",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 23 , 46 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245285402,"SURA, AMISH, CHANDRAKANT",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 91 , 136 , 177 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245285402,"SURA, AMISH, CHANDRAKANT",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 36 , 52 , 93 ,$#,,
MEDICAID DIRECT,1790194322,CATAWBA VALLEY MEDICAL CENTER,,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245285402,"SURA, AMISH, CHANDRAKANT",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 110 , 122 , 122 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245285402,"SURA, AMISH, CHANDRAKANT",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 21 ,$#,,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1245285402,"SURA, AMISH, CHANDRAKANT",805 TILGHMAN DR STE B DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,941 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245286467,"MAYBEE, DAVID, BRIAN",941 NEWMAN RD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 41 , 41 , 83 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245286467,"MAYBEE, DAVID, BRIAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245286467,"MAYBEE, DAVID, BRIAN",702 NEWMAN RD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 46 , 61 , 118 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245286467,"MAYBEE, DAVID, BRIAN",941 NEWMAN RD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 12 , 25 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,941 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245286467,"MAYBEE, DAVID, BRIAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1376582965,COASTAL CAROLINA HEALTH CARE PA,CCHC SLEEP LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1245286467,"MAYBEE, DAVID, BRIAN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 24 , 46 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245286467,"MAYBEE, DAVID, BRIAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245286905,"COLLINS, GARY, BERNARD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1932485943,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM SURGICAL ASSOCIATES,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1245287416,"BLELLOCH, LAWRENCE, ANDREW",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 180 , 204 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1245287416,"BLELLOCH, LAWRENCE, ANDREW",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1558328393,COASTAL PROSTHETICS ORTHOTICS,,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245288208,"SIVERD, STEPHEN, ANDREW",6330 N CENTER DR STE 125 NORFOLK VA,101,Out of State <= 40 miles,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1558328393,COASTAL PROSTHETICS ORTHOTICS,,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245288208,"SIVERD, STEPHEN, ANDREW",6330 N CENTER DR STE 125 NORFOLK VA,101,Out of State <= 40 miles,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1558328393,COASTAL PROSTHETICS ORTHOTICS,,6330 N CENTER DR STE 125 NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245288208,"SIVERD, STEPHEN, ANDREW",6330 N CENTER DR STE 125 NORFOLK VA,101,Out of State <= 40 miles,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1245288257,SURGICAL CENTER OF GREENSBORO,,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1245288257,SURGICAL CENTER OF GREENSBORO,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 313 , 402 , 452 ," $48,924.77 ",,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245288307,"IMBER, CHRISTOPHER, DEAN",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 98 , 125 ,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245288307,"IMBER, CHRISTOPHER, DEAN",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245289099,"CRONIN, DANIEL, CELLI",2345 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 24 ,$#,,
MEDICAID DIRECT,1245290220,"ROYAL, DENNIS, RAY",~,2810 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,111N00000X,Chiropractic Providers,Chiropractor,,1245290220,"ROYAL, DENNIS, RAY",2810 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245291087,"ONEIL, JOHN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,,,Unknown,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",410 COLLEGE RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 33 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 31 ,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",410 COLLEGE RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 74 , 114 , 347 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",410 COLLEGE RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,,,Unknown,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 20 , 72 ,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 199 , 381 , 980 ," $13,847.38 ",,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 112 , 326 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,,,Unknown,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",3801 W MARKET ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245291863,"JONES, ENRICO, GUY",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245292713,"GHEBREMEDHIN, ASTER, DERAR",6324 FAIRVIEW RD STE 350 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 35 , 76 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245292713,"GHEBREMEDHIN, ASTER, DERAR",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 105 , 182 , 235 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 39 , 54 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 37 , 58 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245293505,"BENSIMHON, DANIEL, ROBERT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245293786,"DESENA, CURTIS, WILLIAM",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 77 , 166 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294206,"RADOJICIC, CRISTINE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 17 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294206,"RADOJICIC, CRISTINE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294206,"RADOJICIC, CRISTINE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 13 , 23 , 30 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 22 , 24 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245294446,"PALOMBARO, JAMES, FRANK",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294479,"GUPTA, DHANESH, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294479,"GUPTA, DHANESH, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294479,"GUPTA, DHANESH, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294479,"GUPTA, DHANESH, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 17 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245294479,"GUPTA, DHANESH, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245294610,"GONZALEZ, CARMEN, LAURA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245294610,"GONZALEZ, CARMEN, LAURA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 47 , 112 , 133 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245294610,"GONZALEZ, CARMEN, LAURA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245294610,"GONZALEZ, CARMEN, LAURA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1245295195,"HAGA, EDWARD, WAYNE",1899 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 88 , 271 , 798 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245295542,"LEVI, DAVID, MARK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1245296227,"LI, JOHN, CHICHANG",515 THOMPSON ST STE B EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,332 N TRADE ST STE 2000A MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245297068,"GOPALI, SANTOSH, RAMACHANDRA",332 N TRADE ST STE 2000-A MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245297068,"GOPALI, SANTOSH, RAMACHANDRA",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245297068,"GOPALI, SANTOSH, RAMACHANDRA",9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245297316,"WINTER, JERALD, LUKE",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 109 , 111 , 137 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1245297811,"MACNICHOL, GLENN, EDWARD",2906 N MAIN ST   TARBORO NC,033,Edgecombe,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine, 19 , 27 , 62 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1245297811,"MACNICHOL, GLENN, EDWARD",110 PATRICK CT   ROCKY MOUNT NC,064,Nash,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine, 315 , 701 ," 1,553 "," $13,868.60 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245298249,"TEMPLE, LUCIE, LAUVE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245298249,"TEMPLE, LUCIE, LAUVE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 69 , 91 , 122 ,$#,,
MEDICAID DIRECT,1881877793,ANESTHESIA CONSULTANTS OF AUGUSTA,,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1245298520,"NESLEY, TODD, ANDREW",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245298546,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,812 S VAN BUREN RD   EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1245298546,MYEYEDR OPTOMETRY OF NORTH CAROLINA,812 S VAN BUREN RD   EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,, 424 , 315 , 636 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245298587,"HUFF, JASON, DOUGLAS",601 N ELM ST   HIGH POINT NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245298587,"HUFF, JASON, DOUGLAS",601 N ELM ST   HIGH POINT NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 83 , 230 , 232 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245298702,"ARFEEN, SYED, TAJ-UL",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245298702,"ARFEEN, SYED, TAJ-UL",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1750342820,ARDMORE FAMILY PRACTICE,ARDMORE FAMILY PRACTICE PA,2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245299262,"DIPERT SCOTT, SUSAN, MARIE",2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 58 , 116 ,$#,,
MEDICAID DIRECT,1710166327,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,520 N DEKALB ST STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1245299668,"ROOS, JULIA, KIRSTEN",520 N DEKALB ST STE B SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 151 , 216 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1245301803,"BROWN, DELORES, ELAINE",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245301886,"NYLUND, KARIN, SANDRA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245301886,"NYLUND, KARIN, SANDRA",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245302470,"HOWELL, ERIN, PERRY",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,," 2,006 "," 1,669 "," 3,346 "," $50,318.04 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245305598,"KIRBY, SUZANNE, LE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 11 , 32 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245305598,"KIRBY, SUZANNE, LE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245305598,"KIRBY, SUZANNE, LE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245305598,"KIRBY, SUZANNE, LE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 17 , 28 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245305598,"KIRBY, SUZANNE, LE",300 ASHVILLE AVE STE 310 CARY NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245305598,"KIRBY, SUZANNE, LE",300 ASHVILLE AVE STE 310 CARY NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1245305713,"WOMACK, BEVERLY, FORTNER",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 14 , 18 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1245305713,"WOMACK, BEVERLY, FORTNER",381 DEERFIELD RD   BOONE NC,095,Watauga,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,968 HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1245305713,"WOMACK, BEVERLY, FORTNER",968 HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245305911,"HOSSEINIPOUR, MINA, CHRISTINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245309947,"STUBBLEFIELD, HOWARD, GLENN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154179638,KIDZCARE PEDIATRICS PC,,904 MORVEN RD STE 100 WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1245311323,"ELLIOTT, SARAH, POWELL",904 MORVEN RD   WADESBORO NC,004,Anson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 59 , 110 , 345 ," $12,638.40 ",,
MEDICAID DIRECT,1225166804,ANSON PEDIATRICS PC,ANSON PEDIATRICS PC,904 MORVEN RD   WADESBORO NC,004,Anson,193400000X,Group,Single Specialty,,1245311323,"ELLIOTT, SARAH, POWELL",904 MORVEN RD   WADESBORO NC,004,Anson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314111,"WAITE, KATHLEEN, ANN",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314111,"WAITE, KATHLEEN, ANN",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314137,"QUE, LORETTA, GEORGINA",DUKE MEDICAL CTR   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314137,"QUE, LORETTA, GEORGINA",DUKE MEDICAL CTR   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314137,"QUE, LORETTA, GEORGINA",DUKE MEDICAL CTR   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314137,"QUE, LORETTA, GEORGINA",DUKE MEDICAL CTR   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314160,"WELSBY, IAN, JAMES",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314160,"WELSBY, IAN, JAMES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 19 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245314160,"WELSBY, IAN, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1578885406,JOHNSTON RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT CLAYTON,2076 NC HIGHWAY 42 W STE 120 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1245317767,"HARR, DEBRA, BASS",2076 NC HIGHWAY 42 W STE 120 CLAYTON NC,051,Johnston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 18 , 125 , 219 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245317767,"HARR, DEBRA, BASS",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1578885406,JOHNSTON RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT CLAYTON,2076 VETERANS PKWY STE 120 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1245317767,"HARR, DEBRA, BASS",2076 NC HIGHWAY 42 W STE 120 CLAYTON NC,051,Johnston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1255360459,SMITHFIELD RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT SMITHFIELD,514 N BRIGHTLEAF BLVD STE 1200 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1245317767,"HARR, DEBRA, BASS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245320019,"FRANTZ, ELMAN, GRADY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 39 , 50 , 114 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245320019,"FRANTZ, ELMAN, GRADY",300 ASHVILLE AVE   CARY NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1245320019,"FRANTZ, ELMAN, GRADY",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245320019,"FRANTZ, ELMAN, GRADY",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245320019,"FRANTZ, ELMAN, GRADY",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1245320043,"EMRICH, LISA, ANNE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1245320043,"EMRICH, LISA, ANNE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 26 , 66 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245324243,"HULTMAN, CHARLES, SCOTT",210 ASHVILLE AVE   CARY NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245324243,"HULTMAN, CHARLES, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 24 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245324243,"HULTMAN, CHARLES, SCOTT",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245324243,"HULTMAN, CHARLES, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 12 , 33 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245324243,"HULTMAN, CHARLES, SCOTT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245326586,"NELSON, RENDON, CLIVE",2301 ERWIN RD FL 1 DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 30 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245326586,"NELSON, RENDON, CLIVE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245326586,"NELSON, RENDON, CLIVE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245326586,"NELSON, RENDON, CLIVE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245326586,"NELSON, RENDON, CLIVE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245326586,"NELSON, RENDON, CLIVE",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",2604 DR MARTIN LUTHER KING JR BLVD STE B NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",1001 NEWMAN RD   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 29 , 43 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1104066794,CAROLINAEAST PHYSICIANS,CAROLINAEAST HEART CENTER,1001 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 27 , 49 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 49 , 69 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 24 , 39 ,$#,,
MEDICAID DIRECT,1104066794,CAROLINAEAST PHYSICIANS,CAROLINAEAST HEART CENTER,1001 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 73 , 116 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1245327170,"LEVINE, MATTHEW, ADAM",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 31 , 40 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245329804,"ALMIRANTE, CHERYL, LYDA DABON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245329804,"ALMIRANTE, CHERYL, LYDA DABON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245332915,"BEUSCHER, TARA, LYNN",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245332915,"BEUSCHER, TARA, LYNN",20 DUKE MEDICINE CIR # 51 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 38 , 38 ,$#,,
MEDICAID DIRECT,1245333004,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03531,900 N MADISON BLVD   ROXBORO NC,073,Person,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245333004,NORTH CAROLINA CVS PHARMACY LLC,900 N MADISON BLVD   ROXBORO NC,073,Person,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1245333004,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03531,900 N MADISON BLVD   ROXBORO NC,073,Person,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1245333004,NORTH CAROLINA CVS PHARMACY LLC,900 N MADISON BLVD   ROXBORO NC,073,Person,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1245333012,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04290,5311 N ROXBORO RD   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1245333012,NORTH CAROLINA CVS PHARMACY LLC,5311 N ROXBORO RD   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1245333012,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04290,5311 N ROXBORO RD   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245333012,NORTH CAROLINA CVS PHARMACY LLC,5311 N ROXBORO RD   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1245333707,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03808,2225 12TH AVE NE   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1245333707,NORTH CAROLINA CVS PHARMACY LLC,2225 12TH AVE NE   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1245333707,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03808,2225 12TH AVE NE   HICKORY NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1245333707,NORTH CAROLINA CVS PHARMACY LLC,2225 12TH AVE NE   HICKORY NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1245333707,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03808,2225 12TH AVE NE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245333707,NORTH CAROLINA CVS PHARMACY LLC,2225 12TH AVE NE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1245333723,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05586,320 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1245333723,NORTH CAROLINA CVS PHARMACY LLC,320 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1871676296,JONES CENTER FOR WOMENS HEALTH PLLC,JONES CENTER FOR WOMENS HEALTH,1261 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245334499,"MCMAHON, CONNETTE, PEARL",1261 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 90 , 144 , 231 ,$#,,
MEDICAID DIRECT,1346658531,CALDWELL MEMORIAL HOSPITAL,FOOTHILLS DIALYSIS ACCESS,1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1245335090,"BAST, RANDAL, PAUL",1031 MORGANTON BLVD SW STE C LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 176 , 406 , 678 ," $11,601.25 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245336791,"HUDNALL, LEIGH, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245336866,"BENZING, WILLIAM, THOMAS",3600 NW CARY PKWY STE 104 CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245336866,"BENZING, WILLIAM, THOMAS",100 OSTERVILLE DR   HOLLY SPRINGS NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1245338904,"MOHAMMED, ABID, KHAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 74 , 74 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245338904,"MOHAMMED, ABID, KHAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 206 , 206 ,$#,,
MEDICAID DIRECT,1235133943,TOTAL REHAB ORTHOTICS AND PROSTHETI,Total Rehab Orthotics and Prosthetics Inc,2407 N ELM ST   LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245339019,"MCNAUGHTEN, JASON, SAMUEL",234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 13 , 13 , 33 ,$#,,
MEDICAID DIRECT,1699779280,TOTAL REHAB ORTHOTICS AND PROSTHETI,Total Rehab Orthotics and Prosthetics Inc,234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245339019,"MCNAUGHTEN, JASON, SAMUEL",234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 28 , 28 , 75 ,$#,,
MEDICAID DIRECT,1699779280,TOTAL REHAB ORTHOTICS AND PROSTHETI,Total Rehab Orthotics and Prosthetics Inc,234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245339019,"MCNAUGHTEN, JASON, SAMUEL",234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 68 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245339282,"MORRIS, DAVID, ERIC",516 S VAN BUREN RD   EDEN NC,079,Rockingham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 33 , 294 , 370 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245340280,"BRATZKE, EDWARD, CHARLES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 46 , 47 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245341106,"BAKER, BONNIE, VIRGINIA",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",2007 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",2007 NEUSE BLVD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 18 , 27 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245343060,"VINING, NEIL, CARROLL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245346170,"PADILLA, BLANCA, IRIS",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245346170,"PADILLA, BLANCA, IRIS",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 46 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245346170,"PADILLA, BLANCA, IRIS",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245346600,"HOBSON, JOHN, RICHARD",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 24 , 30 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245346600,"HOBSON, JOHN, RICHARD",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 21 , 35 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245346600,"HOBSON, JOHN, RICHARD",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 15 , 42 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245346600,"HOBSON, JOHN, RICHARD",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 45 , 51 ,$#,,
MEDICAID DIRECT,1194707901,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245348390,"MATTHEWS, MARK, AARON",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245349497,"ROUSE, KELLEY, HOWARD",9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245349497,"ROUSE, KELLEY, HOWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245349497,"ROUSE, KELLEY, HOWARD",9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 18 , 25 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245349497,"ROUSE, KELLEY, HOWARD",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245352400,"LISS, JASON, AARON",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245352400,"LISS, JASON, AARON",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 23 , 27 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245352400,"LISS, JASON, AARON",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245352400,"LISS, JASON, AARON",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1245352400,"LISS, JASON, AARON",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245352400,"LISS, JASON, AARON",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245359728,"MCCAMMON, ROBERT, JEFFREY",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 21 , 157 , 287 ," $12,639.05 ",,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245359728,"MCCAMMON, ROBERT, JEFFREY",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 29 , 60 ," $11,613.16 ",,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245359728,"MCCAMMON, ROBERT, JEFFREY",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083738645,COUNTY OF CARTERET COURTHOUSE SQUAR,~,3820 BRIDGES ST STE A MOREHEAD CITY NC,016,Carteret,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1245359827,"RAFAEL, JAMES, GEORGE",2211 DELANEY DR   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 294 , 354 ," 1,300 "," $49,977.53 ",,
MEDICAID DIRECT,1124306675,LL BALLANCE DDS PLLC,CAROLINA WEST DENTAL,205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1245359827,"RAFAEL, JAMES, GEORGE",2211 DELANEY DR   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 50 , 88 ,$#,,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 84 , 84 , 116 ," $16,524.36 ",,
MEDICAID DIRECT,1720014152,LARRY J MORAY DDS MS PA,MYORTHODONTIST,150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 31 , 31 , 46 ,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1245362409,"DIETTERICK, BRUCE, CLYDE",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1245367325,JAMAR HOME CARE AGENCY INC,JAMAR HOME CARE AGENCY INC,2524 NC HWY 55 RM 7 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1245367325,JAMAR HOME CARE AGENCY INC,2524 NC HWY 55 RM 7 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#," 1,801 "," 1,801 "," $212,670.68 ",,
MEDICAID DIRECT,1245372689,SOUNDVIEW FAMILY CARE HOMES INC,SOUNDVIEW FAMILY CARE HOMES INC,69 OXBOW LN   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245372689,SOUNDVIEW FAMILY CARE HOMES INC,69 OXBOW LN   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 218 , 218 ," $84,310.19 ",,
MEDICAID DIRECT,1386787422,COUNTY OF UNION,UNION COUNTY HEALTH DEPARTMENT,2330 CONCORD AVE   MONROE NC,090,Union,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245373463,"RUKENBROD, MARY ELIZABETH, SALE",2330 CONCORD AVE   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 416 ," 1,067 "," 3,099 "," $111,148.15 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245378678,"HENRY, MARIANNA, MATTHEWS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 69 , 179 , 202 ," $14,607.02 ",,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1245378678,"HENRY, MARIANNA, MATTHEWS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1245379403,A AND D HOME HEALTH AGENCY CORPORAT,A AND D HOME HEALTH CARE AGENCY,622 ROANOKE AVE STE A ROANOKE RAPIDS NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,,1245379403,A AND D HOME HEALTH AGENCY CORPORAT,622 ROANOKE AVE STE A ROANOKE RAPIDS NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,, 42 ," 9,071 "," 9,327 "," $788,795.00 ",,
MEDICAID DIRECT,1598247843,N AHMAD DDS 1 PA,VAYA DENTAL,5117 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245382837,"BURLEY, ERIKA",2842 BOYER ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 75 , 90 , 279 ," $14,010.07 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245383108,"HYDER, SYED, SHIRAZ",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245385152,"SILVA, JASON, ANDREW",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245385152,"SILVA, JASON, ANDREW",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 44 , 59 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245385574,"TEREZIS, TERESA, NICOLE",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1245389261,"YAMADI, ASGHAR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 26 , 51 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245389261,"YAMADI, ASGHAR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 181 , 181 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245390483,"BIGGERSTAFF, MICHAEL, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245390483,"BIGGERSTAFF, MICHAEL, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 16 , 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245390483,"BIGGERSTAFF, MICHAEL, ANTHONY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245390483,"BIGGERSTAFF, MICHAEL, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 41 , 42 ,$#,,
MEDICAID DIRECT,1750442927,DOUGLAS C HAUSCHILD PLLC,WEAVERVILLE EYE ASSOCIATES,40 N MAIN ST   WEAVERVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1245390491,"HAUSCHILD, DOUGLAS",40 N MAIN ST   WEAVERVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 34 , 35 , 38 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245391085,"PUSCHINSKY, RICHARD, WILLIAM",624 QUAKER LN STE C103 HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1639285943,MEDICAL CENTER UROLOGY PA,MEDICAL CENTER UROLOGY PA,624 QUAKER LN STE C103 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1245391085,"PUSCHINSKY, RICHARD, WILLIAM",624 QUAKER LN STE C103 HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 139 , 406 , 649 ," $11,154.82 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245392703,"CURLIN, FARR, ANDREWS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 17 , 25 , 30 ,$#,,
MEDICAID DIRECT,1578118089,LIBERTY HEALTHCARE GROUP LLC,LIBERTY COMMONS NSGANDREHAB CTR OF FRANKLIN CO LLC,202 SMOKETREE WAY   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245394709,"WHITE, KRISTEN, LEE",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 24 ," $33,733.60 ",,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1245394709,"WHITE, KRISTEN, LEE",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 246 , 673 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245395185,"FERRIS, ANDREW, GILLETT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245395185,"FERRIS, ANDREW, GILLETT",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245395185,"FERRIS, ANDREW, GILLETT",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 29 , 52 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245395185,"FERRIS, ANDREW, GILLETT",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245395185,"FERRIS, ANDREW, GILLETT",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 39 , 47 , 92 ,$#,,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245395557,"ALEXANDER, MARY, MORRIS",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 54 , 114 ,$#,,
MEDICAID DIRECT,1245396365,PACIFIC STAFFING INC,~,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1245396365,PACIFIC STAFFING INC,100 E SIX FORKS RD STE 130 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1245396365,PACIFIC STAFFING INC,~,1110 NAVAHO DR STE 107 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1245396365,PACIFIC STAFFING INC,1110 NAVAHO DR STE 107 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 5,815 "," 6,365 "," $695,698.88 ",,
MEDICAID DIRECT,1245396928,"REID, RICHARD, BENTLEY",RICHARD BENTLEY REID,685 BLYTHE STREET CT STE B HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,1245396928,"REID, RICHARD, BENTLEY",685 BLYTHE STREET CT STE B HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245396928,"REID, RICHARD, BENTLEY",RICHARD BENTLEY REID,685 BLYTHE STREET CT STE B HENDERSONVILLE NC,045,Henderson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1245396928,"REID, RICHARD, BENTLEY",685 BLYTHE STREET CT STE B HENDERSONVILLE NC,045,Henderson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 481 ," 1,024 "," 3,308 "," $162,415.01 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245397447,"HARMON, JEFFREY, DALE",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1952534778,MCPC-1 LLC,FIRSTHEALTH RICHMOND MEDICAL GROUP WOMENS CENTER,921 S LONG DR STE 205 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1245404532,"IBRAHIM, MOHAMED, ABDELRAHIM YOUSIF",155 MEMORIAL DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 44 , 59 ," $12,979.75 ",,
MEDICAID DIRECT,1952534778,MCPC-1 LLC,FIRSTHEALTH RICHMOND MEDICAL GROUP WOMENS CENTER,921 S LONG DR STE 205 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1245404532,"IBRAHIM, MOHAMED, ABDELRAHIM YOUSIF",921 S LONG DR STE 205 ROCKINGHAM NC,077,Richmond,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 55 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245405174,"ELIADES, STEVEN, JEFFREY",40 DUKE MEDICINE CIR # 1F DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245405174,"ELIADES, STEVEN, JEFFREY",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245405174,"ELIADES, STEVEN, JEFFREY",40 DUKE MEDICINE CIR # 1F DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245405992,"GEGICK, STEPHEN, JOHN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245405992,"GEGICK, STEPHEN, JOHN",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245406388,"PERHAC, JOHN, STEPHEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1245409622,"CROWE, DANIEL, PATRICK",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 25 , 43 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1245409622,"CROWE, DANIEL, PATRICK",1000 BROWN ST   FAITH NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245410497,"SHIELDS, JOHN, SHEPHERD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 18 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245410497,"SHIELDS, JOHN, SHEPHERD",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 56 , 73 , 76 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245411131,"HARTWELL, EYDIE, HILL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245411131,"HARTWELL, EYDIE, HILL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1245412758,"BHUTANI, MANPREET, SINGH",1352 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245412758,"BHUTANI, MANPREET, SINGH",1352 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1801172820,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM NEPHROLOGY & HYPERTENSION CLINIC,568 RUIN CREEK RD STE 3 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1245412758,"BHUTANI, MANPREET, SINGH",568 RUIN CREEK RD STE 3 HENDERSON NC,091,Vance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1245412758,"BHUTANI, MANPREET, SINGH",~,1352 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,1245412758,"BHUTANI, MANPREET, SINGH",1352 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1659152700,HYPERTENSION AND KIDNEY SPECIALIST,,1352 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1245412758,"BHUTANI, MANPREET, SINGH",1352 W HARRISON ST   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 40 , 62 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245415132,"PEARCE, DANIEL, JENKINS",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 30 , 47 , 113 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1245415330,"SENGUPTA, SOMA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245415330,"SENGUPTA, SOMA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1245416528,FAMILY OPTICAL LLC,,121 RALEIGH ST   FUQUAY VARINA NC,092,Wake,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1245416528,FAMILY OPTICAL LLC,121 RALEIGH ST   FUQUAY VARINA NC,092,Wake,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 36 , 36 , 73 ,$#,,
MEDICAID DIRECT,1093063398,CAROMONT MEDICAL GROUP INC,CAROMONT BREAST SURGICAL SPECIALISTS,2391 COURT DR STE 105 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245417682,"ROBINSON, KRISTINA, BRITTON",2391 COURT DR STE 105 GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1245417682,"ROBINSON, KRISTINA, BRITTON",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1245417682,"ROBINSON, KRISTINA, BRITTON",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245417682,"ROBINSON, KRISTINA, BRITTON",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1245417682,"ROBINSON, KRISTINA, BRITTON",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 100 , 100 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1245417682,"ROBINSON, KRISTINA, BRITTON",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 25 , 25 ,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245418722,"RIVARD, THERESE, PIACENTE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245421049,"TROIANO GONZALEZ, JO-ANN, MICHELE",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 69 , 69 , 366 ," $10,034.29 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245421049,"TROIANO GONZALEZ, JO-ANN, MICHELE",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 27 , 145 ,$#,,
MEDICAID DIRECT,1902452139,BRADLEY ROBERTS & ASSOCIATES PLLC,,1135 N CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1245421049,"TROIANO GONZALEZ, JO-ANN, MICHELE",1135 N CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice," 2,977 "," 3,887 "," 20,118 "," $559,038.09 ",,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1245421072,"SKILLMAN, KATHERINE, ELIZABETH",723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245422526,"DELLINGER, MARIANNE, LOUISE COCHRAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 44 , 47 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245422526,"DELLINGER, MARIANNE, LOUISE COCHRAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245423441,"CONWAY, SHEILA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 24 , 30 ,$#,,
MEDICAID DIRECT,1245423870,SHELLEY WATERS MS CCC SLP,~,452 GATLIN HUNTING CLUB RD   HOBGOOD NC,042,Halifax,251S00000X,Agencies,Community/Behavioral Health,,1245423870,SHELLEY WATERS MS CCC SLP,452 GATLIN HUNTING CLUB RD   HOBGOOD NC,042,Halifax,251S00000X,Agencies,Community/Behavioral Health,, 69 ," 1,021 "," 1,022 "," $65,415.60 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245424886,"GREWAL, JASHANJEET, KAUR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 37 , 104 , 104 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245424886,"GREWAL, JASHANJEET, KAUR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245425131,"PRINZ, ALLISON, MARIE",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 37 , 55 , 55 ,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245425859,"LEAKE, JAMES, MICHAEL",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245428358,"WOOD, JEYHAN, SUZAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245430727,"CHAWLA, DHRUVA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 32 , 58 , 61 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245430727,"CHAWLA, DHRUVA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 95 , 96 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245431600,"SHILOH MALAWSKY, YAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 84 , 145 , 168 ," $17,758.33 ",,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245431600,"SHILOH MALAWSKY, YAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1245431840,"WHITLOCK, LESLIE, GAIL BRYAN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245433820,"EICHLER, DEREK, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 89 , 93 , 93 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245434141,"BURKE, LAUREN, MARIE BRUBAKER",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1245434141,"BURKE, LAUREN, MARIE BRUBAKER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245434141,"BURKE, LAUREN, MARIE BRUBAKER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245434141,"BURKE, LAUREN, MARIE BRUBAKER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 293 , 353 , 404 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245434141,"BURKE, LAUREN, MARIE BRUBAKER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245434141,"BURKE, LAUREN, MARIE BRUBAKER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245434141,"BURKE, LAUREN, MARIE BRUBAKER",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245435858,"FECCI, PETER, EDWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245435858,"FECCI, PETER, EDWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245435858,"FECCI, PETER, EDWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245435858,"FECCI, PETER, EDWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245435858,"FECCI, PETER, EDWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164595757,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245436203,"SHAW, KIMBERLEE, DILDA",5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164595757,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245436203,"SHAW, KIMBERLEE, DILDA",301 E WENDOVER AVE STE 215 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 79 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245436336,"CAMPBELL, LYNN, ANN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1245437094,"HILL, KEITH, TODD",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 148 , 322 ,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1245437094,"HILL, KEITH, TODD",139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 54 , 133 ,$#,,
MEDICAID DIRECT,1720849391,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD FAMILY CARE RHC,444 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1245437094,"HILL, KEITH, TODD",444 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245437615,"NIELSEN, ELIZABETH, ANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245438563,"HODIERNE, ADAM, SPENCER",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245438563,"HODIERNE, ADAM, SPENCER",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245438563,"HODIERNE, ADAM, SPENCER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 40 , 50 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245438563,"HODIERNE, ADAM, SPENCER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245441864,"BARNARD, JULIA, ANNE",,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 116 , 139 , 457 ," $17,414.07 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice," 1,406 "," 2,407 "," 7,660 "," $307,112.66 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245441864,"BARNARD, JULIA, ANNE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 62 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245441864,"BARNARD, JULIA, ANNE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245441864,"BARNARD, JULIA, ANNE",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245441948,"HEDERMAN, APRIL, DEMOSS",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245441948,"HEDERMAN, APRIL, DEMOSS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1245443126,"JAIN, NINA",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245443126,"JAIN, NINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 28 , 36 , 39 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245443936,"POOLE, BRENDA, LEWIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245447333,"WILBORN, AMY, TANNER",11783 ROCK LANDING DR STE 200 NEWPORT NEWS VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245447333,"WILBORN, AMY, TANNER",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245448125,"CASE, ASHLEY, STEPHENS",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245448125,"CASE, ASHLEY, STEPHENS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 41 , 50 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245448125,"CASE, ASHLEY, STEPHENS",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245448125,"CASE, ASHLEY, STEPHENS",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245448125,"CASE, ASHLEY, STEPHENS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1487265567,AHMADI & ALVAND DDS PA II,CAPITAL DENTAL CARE,3126 BLUE RIDGE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245448240,"ALVAND, MARJAN",4237 LOUISBURG RD STE 110 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 143 , 261 ," 1,103 "," $67,518.98 ",,
MEDICAID DIRECT,1275724643,AHMADI & ALVAND DDS PA,CAPITAL DENTAL CARE,4237 LOUISBURG RD STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245448240,"ALVAND, MARJAN",4237 LOUISBURG RD STE 110 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,414 "," 2,598 "," 10,589 "," $562,665.06 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245448737,"LYERLY, ELIZABETH, SUSAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245451079,"WARES, CATHERINE, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245451202,"MOOBERRY, MICAH, JOE",6013 FARRINGTON RD   CHAPEL HILL NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 47 , 69 , 85 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245452275,"MEUSE, MICHAEL, ANTHONY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 159 , 182 , 236 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245452275,"MEUSE, MICHAEL, ANTHONY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 113 , 120 , 152 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245452275,"MEUSE, MICHAEL, ANTHONY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073091658,SAMIR J NAIK DDS II PLLC,SOUTHPOINT FAMILY DENTISTRY,1208 RIDDLE RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245453281,"NAIK, SAMIR, JANAK",1208 RIDDLE RD   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 267 , 529 ," 1,729 "," $86,820.01 ",,
MEDICAID DIRECT,1073091658,SAMIR J NAIK DDS II PLLC,SOUTHPOINT FAMILY DENTISTRY,1208 RIDDLE RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245453281,"NAIK, SAMIR, JANAK",1208 RIDDLE RD STE A DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245454867,"SMITH, KATHLEEN, ANDERSEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 58 , 58 ,$#,,
MEDICAID DIRECT,1245455393,SURRY COUNTY SCHOOLS,~,209 N CRUTCHFIELD ST   DOBSON NC,086,Surry,251300000X,Agencies,Local Education Agency (LEA),,1245455393,SURRY COUNTY SCHOOLS,209 N CRUTCHFIELD ST   DOBSON NC,086,Surry,251300000X,Agencies,Local Education Agency (LEA),, 368 ," 6,031 "," 6,174 "," $268,494.28 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245456060,"KLAWITER-BENTON, MICHELLE, ELAINE",102 SOUTHTOWN CIR   ROLESVILLE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3150 ROGERS RD STE 220 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1245456060,"KLAWITER-BENTON, MICHELLE, ELAINE",3150 ROGERS RD STE 220 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 22 , 37 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1245456680,"CEPEDA, CHRISTOPHER, MIGUEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245456680,"CEPEDA, CHRISTOPHER, MIGUEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1750339933,DURHAM DIAGNOSTIC IMAGING LLC,TRIANGLE MEDICAL PARK,5107 SOUTHPARK DR STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245456680,"CEPEDA, CHRISTOPHER, MIGUEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,3643 N ROXBORO ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245456680,"CEPEDA, CHRISTOPHER, MIGUEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 317 , 371 , 519 ,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245456680,"CEPEDA, CHRISTOPHER, MIGUEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1245456680,"CEPEDA, CHRISTOPHER, MIGUEL",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 36 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245457290,"COOK, JEFFREY, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 30 , 39 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1245457290,"COOK, JEFFREY, JOHN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245457290,"COOK, JEFFREY, JOHN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245457290,"COOK, JEFFREY, JOHN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245457290,"COOK, JEFFREY, JOHN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1245457290,"COOK, JEFFREY, JOHN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 30 , 38 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1245457290,"COOK, JEFFREY, JOHN",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245457290,"COOK, JEFFREY, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 38 , 52 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1245457290,"COOK, JEFFREY, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1245457290,"COOK, JEFFREY, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245457290,"COOK, JEFFREY, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1245457365,"BREWER, NICHOLAS, MATTHEW",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 37 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245461128,"PHILIP, MATHEWS, KEECHERIL",309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 113 , 278 , 435 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245461243,"MALLESARA SUDHAKAR, SHWETHA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 24 , 26 ,$#,,
MEDICAID DIRECT,1407277536,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245461243,"MALLESARA SUDHAKAR, SHWETHA",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245461243,"MALLESARA SUDHAKAR, SHWETHA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 27 , 34 , 38 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245461557,"RUSHNELL, CHELSEA, HASBROOK",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245461557,"RUSHNELL, CHELSEA, HASBROOK",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1245461557,"RUSHNELL, CHELSEA, HASBROOK",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1245461557,"RUSHNELL, CHELSEA, HASBROOK",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801881883,DERMATOLOGY ASSOCIATES PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245463124,"ESCARAVAGE, VAISHALI, GUPTA",6781 PARKER FARM DR STE 300 WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1639572811,MYEYEDR OPTOMETRY OF NORTH CAROLINA,~,,,Unknown,193400000X,Group,Single Specialty,,1245464411,"ANGELI, TERESA, LYNNE",1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2108 UMSTEAD DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245465053,"NAFTEL, HERMAN, ARONOV",2108 UMSTEAD DR   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,194 FINLEY GOLF COURSE RD STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245465053,"NAFTEL, HERMAN, ARONOV",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245465053,"NAFTEL, HERMAN, ARONOV",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245465053,"NAFTEL, HERMAN, ARONOV",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245465053,"NAFTEL, HERMAN, ARONOV",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1073940433,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY INPATIENT CARE,600 HOSPITAL DR STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1245466937,"MADEY, JASON, JOHN",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245466937,"MADEY, JASON, JOHN",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245466937,"MADEY, JASON, JOHN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245466937,"MADEY, JASON, JOHN",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 37 , 37 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245466937,"MADEY, JASON, JOHN",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245466937,"MADEY, JASON, JOHN",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245466937,"MADEY, JASON, JOHN",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245466937,"MADEY, JASON, JOHN",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245466937,"MADEY, JASON, JOHN",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245466937,"MADEY, JASON, JOHN",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1245467414,"REED, CACHE, VANJA ALEXANDRA",50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1245467414,"REED, CACHE, VANJA ALEXANDRA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245468610,"LING, REBECCA, LASSETER",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 36 , 92 ,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245468610,"LING, REBECCA, LASSETER",101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245468685,"SHULTZ, JASON, GRIFFIN",125 QUEENS RD STE 640 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 16 , 23 , 24 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245468685,"SHULTZ, JASON, GRIFFIN",10905 PROVIDENCE RD W STE 300 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245468685,"SHULTZ, JASON, GRIFFIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245468685,"SHULTZ, JASON, GRIFFIN",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 59 , 210 , 337 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245468685,"SHULTZ, JASON, GRIFFIN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245469162,"DAVIDSON, BRITTANY, ANNE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245469162,"DAVIDSON, BRITTANY, ANNE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 19 , 29 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245469162,"DAVIDSON, BRITTANY, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 14 , 22 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245469162,"DAVIDSON, BRITTANY, ANNE",4101 MACON POND RD   RALEIGH NC,092,Wake,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1578325924,KOPPURAVURI DDS PLLC,SHOPTON DENTAL,4847 SHOPTON RD UNIT C-D CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245469618,"KOPPURAVURI, VENKATASUMAN",4847 SHOPTON RD # C-D CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 745 ," 1,611 "," 6,573 "," $378,565.35 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245469774,"TENPENNY, KENNETH, ELLIOTT",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245469774,"TENPENNY, KENNETH, ELLIOTT",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245470327,"BANSAL, RAJIV, VARUN",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245476860,"REGALADO ROMERO, BELKYS, ANIORIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 56 , 56 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245476860,"REGALADO ROMERO, BELKYS, ANIORIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 64 , 64 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245476860,"REGALADO ROMERO, BELKYS, ANIORIS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245481944,"BADIYE, AMIT",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245481944,"BADIYE, AMIT",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1245482793,CROSSROADS TREATMENT CENTER OF GREE,,2706 N CHURCH ST   GREENSBORO NC,041,Guilford,251S00000X,Agencies,Community/Behavioral Health,,1245482793,CROSSROADS TREATMENT CENTER OF GREE,2706 N CHURCH ST   GREENSBORO NC,041,Guilford,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1245484211,"VELASQUEZ, INDIRA",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1245484211,"VELASQUEZ, INDIRA",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245484211,"VELASQUEZ, INDIRA",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 32 , 32 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1245484211,"VELASQUEZ, INDIRA",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1245486109,"SHVARTS, ANITA",NORTH GEORGIA ALLERGY ASTHMA& IMMUNOLOGY LLC,85 SEASONS LN   HIAWASSEE GA,101,Out of State <= 40 miles,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy,1245486109,"SHVARTS, ANITA",85 SEASONS LN   HIAWASSEE GA,101,Out of State <= 40 miles,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245488261,"SIMONETTI, JENNIFER",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245488360,"MUHS, DOMINIQUE, MIA",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245488360,"MUHS, DOMINIQUE, MIA",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245488360,"MUHS, DOMINIQUE, MIA",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245488360,"MUHS, DOMINIQUE, MIA",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 42 , 79 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245488360,"MUHS, DOMINIQUE, MIA",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245488360,"MUHS, DOMINIQUE, MIA",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1245488360,"MUHS, DOMINIQUE, MIA",910 E INNES ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245488675,"KULKARNI, ANIRUDHA, PRADEEP",2536 LENGERS WAY   FORT MILL SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 68 , 70 , 76 ,$#,,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10130 MALLARD CREEK RD STE 240 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1245489517,HEALTH & HOME SERVICES INC,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,#,#,#,$#,,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1245489517,HEALTH & HOME SERVICES INC,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,, 12 , 175 , 175 ," $58,097.00 ",,
MEDICAID DIRECT,1245489517,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1245489517,HEALTH & HOME SERVICES INC,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,, 21 ," 2,929 "," 3,560 "," $1,668,380.20 ",,
MEDICAID DIRECT,1245489681,ADULT ENRICHMENT SERVICES OF WILKES,THE RUBY PARDUE BLACKBURN ADULT DAY HEALTHCARE CEN,1915 W PARK DR STE 200 NORTH WILKESBORO NC,097,Wilkes,251B00000X,Agencies,Case Management,,1245489681,ADULT ENRICHMENT SERVICES OF WILKES,1915 W PARK DR STE 200 NORTH WILKESBORO NC,097,Wilkes,251B00000X,Agencies,Case Management,, 13 ," 1,635 "," 1,635 "," $70,403.10 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245489889,"NAFTEL, SIGNE, BOUCHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",116 LANE DR   TRINITY NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,116 LANE DR   TRINITY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",116 LANE DR   TRINITY NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 47 , 47 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 70 , 70 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 62 , 63 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 100 , 101 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 76 , 77 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 32 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 32 , 48 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 60 , 62 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 117 , 120 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 81 , 82 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 18 , 19 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 62 , 63 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1201 CAROLINA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245490051,"STEWART, VIRGINIA, MEREDITH",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 84 , 85 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245490812,"WOODWARD, JENNIFER, MARIE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245490812,"WOODWARD, JENNIFER, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245490812,"WOODWARD, JENNIFER, MARIE",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245491083,"ELTARABOULSI, WALID, RAOUF",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 15 , 26 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245491083,"ELTARABOULSI, WALID, RAOUF",10320 FELD FARM LN STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 33 , 55 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245491083,"ELTARABOULSI, WALID, RAOUF",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245491083,"ELTARABOULSI, WALID, RAOUF",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245491083,"ELTARABOULSI, WALID, RAOUF",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245491083,"ELTARABOULSI, WALID, RAOUF",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245491174,"MCALPINE, CANDACE, NICOLE",15110 JOHN J DELANEY DR STE 120 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1245492750,"VANDERBRINK, BRIAN, ANDREW",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1336405471,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST AUDIOLOGY - GREE,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1245494335,"ALLEN, MARY, ANN",100 E NORTHWOOD ST   GREENSBORO NC,041,Guilford,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245496520,"NELSON, BENJAMIN, ELIOT",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245496645,"WALKO, MARALYN, ANN",600 HOSPITAL DR   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 162 , 164 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245496645,"WALKO, MARALYN, ANN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245496645,"WALKO, MARALYN, ANN",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498013,"SMITH, JOSEPH, ANDREW",509 OLDE WATERFORD WAY STE 200 LELAND NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498013,"SMITH, JOSEPH, ANDREW",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498013,"SMITH, JOSEPH, ANDREW",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498013,"SMITH, JOSEPH, ANDREW",257 HOSPITAL DR NE STE 200 BOLIVIA NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 27 , 32 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498054,"ROCHESTER, NATALIE, HATCHER",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498054,"ROCHESTER, NATALIE, HATCHER",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 38 , 49 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498054,"ROCHESTER, NATALIE, HATCHER",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245498377,"SAPP, LINDSEY, BRENT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 45 , 54 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245498443,"BUTALA, PARAG",959 COX RD   GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245498443,"BUTALA, PARAG",959 COX RD   GASTONIA NC,036,Gaston,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 67 , 141 , 326 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1053142265,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL RADIOLOGY,101 ROBESON ST STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 26 , 27 , 46 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 127 , 139 , 157 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1245498542,"MEKA, MURALI, KRISHNA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053142265,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL RADIOLOGY,101 ROBESON ST STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 12 , 14 , 29 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 16 , 16 , 22 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",300 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245498542,"MEKA, MURALI, KRISHNA",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245498997,"JOSHI, MRINALINI, ASHISH",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245501659,"KLABNIK, NICOLE, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 20 , 74 , 74 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245502822,"KARDAM, SHALINI, PRIYA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245502988,"KENNEY, MARTHA, OBENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 34 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245502988,"KENNEY, MARTHA, OBENG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245505437,"AFANADOR, HAYLEY, FISCHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 64 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245505437,"AFANADOR, HAYLEY, FISCHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1245506005,"HASLAM, JOHN, BRYAN",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245508696,"MINOR, KERRY, KING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245508696,"MINOR, KERRY, KING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245510486,"TRIPLETT, CARI, BETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245510486,"TRIPLETT, CARI, BETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245514538,"BUTLER, PHILIP, ELLIOTT",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245515048,"MATRIANO, JOHN PAUL, H",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,AUTUMN VIEW ASSISTED LIVING,234 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,234 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 141 , 141 ," $99,237.76 ",,
MEDICAID DIRECT,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,AUTUMN VIEW ASSISTED LIVING,231 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,231 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 146 , 146 ," $118,548.58 ",,
MEDICAID DIRECT,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,AUTUMN VIEW ASSISTED LIVING,232 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,232 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 154 , 154 ," $111,567.08 ",,
MEDICAID DIRECT,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,AUTUMN VIEW ASSISTED LIVING,230 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,230 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 20 , 756 , 756 ," $167,334.39 ",,
MEDICAID DIRECT,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,AUTUMN VIEW ASSISTED LIVING,233 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245518042,SOUNDVIEW FAMILY CARE HOMES INC,233 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 140 , 140 ," $120,271.66 ",,
MEDICAID DIRECT,1902869530,CARY SKIN CENTER PA,~,200 WELLESLEY TRADE LN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1245518281,"CRAVEN, SHANNON, MICHELLE",200 WELLESLEY TRADE LN   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,525 S NEW HOPE RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245519594,"HANNON, JUSTIN, PARKES",525 S NEW HOPE RD   GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 318 , 755 ," 1,146 "," $169,995.16 ",,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,301 PARK ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1245519594,"HANNON, JUSTIN, PARKES",525 S NEW HOPE RD   GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 13 ,$#,,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,525 S NEW HOPE RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245519594,"HANNON, JUSTIN, PARKES",301 PARK ST   BELMONT NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,301 PARK ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1245519594,"HANNON, JUSTIN, PARKES",301 PARK ST   BELMONT NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 169 , 381 , 596 ," $95,920.75 ",,
MEDICAID DIRECT,1841925898,HANNON PLLC,HANNON ORTHODONTICS,4741 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245519594,"HANNON, JUSTIN, PARKES",4741 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245520006,"WILSON, ELIZABETH, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245520006,"WILSON, ELIZABETH, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245520006,"WILSON, ELIZABETH, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245520147,"CAMPANILE, TERESA, JEAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245523380,"NELSON, RACHEL, MEREDITH",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245523398,"ANKNEY, CHRISTINA, LEANNE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1245523398,"ANKNEY, CHRISTINA, LEANNE",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245523398,"ANKNEY, CHRISTINA, LEANNE",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649216631,PIEDMONT EAR NOSE AND THROAT PA,PIEDMONT EAR NOSE AND THROAT ASSOCIATES,110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245523554,"CAMPBELL, ADAM, PRICE",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 51 , 66 , 122 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 68 , 81 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 53 , 73 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1245524057,"WALDEN, WILLIAM, BLAIR",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245525542,"LANGAN, NICHOLAS, ROBERT",10512 PARK RD STE 101 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 24 , 24 ,$#,,
MEDICAID DIRECT,1245526896,EFFICIENT CARE SERVICES INC,~,5820 E WT HARRIS BLVD STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1245526896,EFFICIENT CARE SERVICES INC,5820 E WT HARRIS BLVD STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 55 ," 13,791 "," 13,836 "," $1,001,208.48 ",,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245526920,"BECKMAN, MICHAEL, JOSEPH",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245526920,"BECKMAN, MICHAEL, JOSEPH",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 33 , 47 ," $10,823.13 ",,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245526920,"BECKMAN, MICHAEL, JOSEPH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245526920,"BECKMAN, MICHAEL, JOSEPH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245526920,"BECKMAN, MICHAEL, JOSEPH",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639634819,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY BEHAVIORAL HEALTH,107 S QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245532118,"JONES, WILLIAM, JOHEAVEN",324 N QUEEN ST   KINSTON NC,054,Lenoir,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1639634819,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY BEHAVIORAL HEALTH,107 S QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245532118,"JONES, WILLIAM, JOHEAVEN",607 WASHINGTON ST   WILLIAMSTON NC,058,Martin,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245532118,"JONES, WILLIAM, JOHEAVEN",607 WASHINGTON ST   WILLIAMSTON NC,058,Martin,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699067488,COASTAL SOUTHEASTERN FAMILY PRACTIC,~,205 W 3RD ST   PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1245532423,"CHAVIS, KATARA, SCOTT",205 W 3RD ST   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 94 , 371 , 810 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245533009,"MIDDLETON, TALISHA, NICOLE PEAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245534528,"KUMAR, KARAN, RAVINDRA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245534528,"KUMAR, KARAN, RAVINDRA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 57 , 168 , 195 ," $37,096.79 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1245535574,"TALLENT, NANCY, SWEATT",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 136 , 150 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245535574,"TALLENT, NANCY, SWEATT",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 65 , 66 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1245535574,"TALLENT, NANCY, SWEATT",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245535574,"TALLENT, NANCY, SWEATT",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245537026,"SHIPP, MICHELLE, MARIE REID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 221 , 221 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1245539964,"PROFITA, ELIZABETH, LOUDON",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1245541069,REJUVENATING LIVES LLC,~,4913 PROFESSIONAL CT STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1245541069,REJUVENATING LIVES LLC,4913 PROFESSIONAL CT STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,175 "," 1,401 "," $209,964.74 ",,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245542034,"SHUKLA, BINDI, UPENDRA",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1245542034,"SHUKLA, BINDI, UPENDRA",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1245542034,"SHUKLA, BINDI, UPENDRA",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245542034,"SHUKLA, BINDI, UPENDRA",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 132 , 143 , 321 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245542034,"SHUKLA, BINDI, UPENDRA",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245542380,"BORST, ALEXANDRA, JANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 18 , 34 , 38 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1245544196,"HIEBER, DAVID, WARREN",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1245544196,"HIEBER, DAVID, WARREN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 48 , 64 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245544196,"HIEBER, DAVID, WARREN",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1245544196,"HIEBER, DAVID, WARREN",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245544196,"HIEBER, DAVID, WARREN",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1245544196,"HIEBER, DAVID, WARREN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245544196,"HIEBER, DAVID, WARREN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1245544196,"HIEBER, DAVID, WARREN",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245546290,C & S HOME CARE INC,~,110 E ARLINGTON BLVD STEI GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1245546290,C & S HOME CARE INC,110 E ARLINGTON BLVD STEI GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 13 , 973 , 976 ," $116,082.02 ",,
MEDICAID DIRECT,1245546290,C & S HOME CARE INC,~,110 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1245546290,C & S HOME CARE INC,110 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,919 "," 1,930 "," $247,313.56 ",,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1245548999,"MILLER, KIMBERLY, DIANE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1245548999,"MILLER, KIMBERLY, DIANE",6324 FAIRVIEW RD STE 202 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245548999,"MILLER, KIMBERLY, DIANE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245550185,"POULTON, GINGER, JAFFERY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 21 , 36 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245550185,"POULTON, GINGER, JAFFERY",218 ELKWOOD AVE STE 102 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245550185,"POULTON, GINGER, JAFFERY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 26 , 26 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245550185,"POULTON, GINGER, JAFFERY",218 ELKWOOD AVE STE 102 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245550185,"POULTON, GINGER, JAFFERY",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245550185,"POULTON, GINGER, JAFFERY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1245551902,"HEATON, JAMES, DAVID",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245551902,"HEATON, JAMES, DAVID",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1245552165,"SPELL, PAUL, WESLEY",PAUL WESLEY SPELL,1313 N ELM ST   GREENSBORO NC,041,Guilford,111N00000X,Chiropractic Providers,Chiropractor,,1245552165,"SPELL, PAUL, WESLEY",1313 N ELM ST   GREENSBORO NC,041,Guilford,111N00000X,Chiropractic Providers,Chiropractor,, 28 , 92 , 92 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 31 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245554518,"MARKOWITZ, OREN, MARK",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245556745,"ZUROSKY, JENNIFER, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245556745,"ZUROSKY, JENNIFER, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245556877,"CAMERON, CHRISTIAN, BLAKE",10207 CERNY ST STE 210 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245556877,"CAMERON, CHRISTIAN, BLAKE",10207 CERNY ST STE 210 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 31 , 74 , 80 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245556877,"CAMERON, CHRISTIAN, BLAKE",10207 CERNY ST STE 210 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 306 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245556877,"CAMERON, CHRISTIAN, BLAKE",10207 CERNY ST STE 210 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245556877,"CAMERON, CHRISTIAN, BLAKE",10207 CERNY ST STE 210 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 27 , 71 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3901 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245556877,"CAMERON, CHRISTIAN, BLAKE",3901 N ROXBORO ST   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245557594,"FAGER, AMMON, MILTON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245557594,"FAGER, AMMON, MILTON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245564160,"STARBUCK, MANDY, FIELDS",1403 S KING ST   WINDSOR NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245564160,"STARBUCK, MANDY, FIELDS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245564160,"STARBUCK, MANDY, FIELDS",2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 53 , 72 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,24 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245564194,"TENAGLIA, MICHELLE, ANNETTE",24 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1245565126,CHAPEL HILL CHILDRENS THERAPY PA,CHAPEL HILL CHILDRENS THERAPY PA,703 HIGHLAND TRL   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1245565126,CHAPEL HILL CHILDRENS THERAPY PA,703 HIGHLAND TRL   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,#, 130 , 131 ," $11,963.65 ",,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1245567007,"PITTS, MELANIE, ANN",6415 BROOKSTONE LN STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 87 , 232 ,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,3762 DURHAM RD STE A ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245567247,"CLARK, JENNIFER, SELLECK",3762 DURHAM RD STE A ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427016138,ROXBORO INTERNAL MEDICINE AND PEDIA,~,796 DOCTORS CT   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1245567247,"CLARK, JENNIFER, SELLECK",796 DOCTORS CT   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912952672,DREAM PROVIDER CARE SERVICES,DREAM PROVIDER CARE SERVICES INC,216 STEWART PKWY   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1245572049,"SHERRILL, SHERMUNDA, LATOY",216 STEWART PKWY   WASHINGTON NC,007,Beaufort,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245572528,"PUECHL, ALLISON, MARSHALL",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245572528,"PUECHL, ALLISON, MARSHALL",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245572528,"PUECHL, ALLISON, MARSHALL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245572528,"PUECHL, ALLISON, MARSHALL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 23 , 49 , 50 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245572528,"PUECHL, ALLISON, MARSHALL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 11 , 26 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245572528,"PUECHL, ALLISON, MARSHALL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245573120,"LEE, JANET, WAIMIN",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 57 , 84 , 92 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245573120,"LEE, JANET, WAIMIN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1093064958,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - RALEIGH FA,4400 FALLS OF NEUSE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245574664,"BLESSING, JUSTIN, RANDOLPH",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 621 ," 1,221 "," 4,455 "," $203,894.12 ",,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1245574664,"BLESSING, JUSTIN, RANDOLPH",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1245575539,"PRUITT, TONYA, FISHER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871637975,COUNTY OF LEE NORTH CAROLINA,LEE COUNTY HEALTH DEPT,106 HILLCREST DR   SANFORD NC,053,Lee,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245575539,"PRUITT, TONYA, FISHER",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 25 ,$#,,
MEDICAID DIRECT,1568400174,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,281 E MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1245577154,"WANTUCH, KAREN, DENISE",281 E MAIN ST   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 87 , 177 ,$#,,
MEDICAID DIRECT,1245580745,"DAHIYA, ARTI",~,351 WELLESLEY TRADE LN STE 212 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1245580745,"DAHIYA, ARTI",351 WELLESLEY TRADE LN STE 212 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 264 , 476 ," 1,883 "," $77,027.74 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245581040,"PRIEUR, MARY, GRIMLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1104151109,EMERGENCY MEDICINE PHYSICIANS OF IR,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245582659,"DABKOWSKI, TABITHA, LYNN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245582659,"DABKOWSKI, TABITHA, LYNN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245582659,"DABKOWSKI, TABITHA, LYNN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245582659,"DABKOWSKI, TABITHA, LYNN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1245582956,"SARUBBI, SARAH, LYNN",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1245583442,"GAINER, JUDY, RAWLINS",506 NC 69 STE A HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245586551,"GIAMBARBERI, LUCIANA, BAPTIST",791 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245590173,"STOUDEMIRE, WILLIAM, SPRUNT",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 22 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245590173,"STOUDEMIRE, WILLIAM, SPRUNT",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 25 , 56 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245590173,"STOUDEMIRE, WILLIAM, SPRUNT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 32 , 58 , 61 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1245590264,"DOUGHERTY, MICHAEL, KEVIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245590264,"DOUGHERTY, MICHAEL, KEVIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 26 , 30 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1245590264,"DOUGHERTY, MICHAEL, KEVIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245590264,"DOUGHERTY, MICHAEL, KEVIN",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245590264,"DOUGHERTY, MICHAEL, KEVIN",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 19 , 22 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245590496,"FRADY, JACOB, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245590496,"FRADY, JACOB, ANDREW",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245593474,"PAINSCHAB, MATTHEW, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245596535,"MALLORY, PALEN, POWELSON",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 60 , 178 , 184 ," $41,170.08 ",,
MEDICAID DIRECT,1285158824,KIDZCARE PEDIATRICS PC,,801 W 3RD ST   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1245597129,"CHEEMA, SARAH, IJAZ",801 W 3RD ST   SILER CITY NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1679824676,KIDZCARE PEDIATRICS PC,~,2501 S MEBANE ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245597129,"CHEEMA, SARAH, IJAZ",2501 S MEBANE ST   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1679824676,KIDZCARE PEDIATRICS PC,~,2501 S MEBANE ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245597129,"CHEEMA, SARAH, IJAZ",801 W 3RD ST   SILER CITY NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1023420973,KIDZCARE PEDIATRICS PC,,1406 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1245597129,"CHEEMA, SARAH, IJAZ",1406 S MAIN ST   LILLINGTON NC,043,Harnett,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 33 ,$#,,
MEDICAID DIRECT,1477282424,TRIANGLE KIDS CARE PEDIATRICS PLLC,,216 ASHVILLE AVE STE 60 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1245597129,"CHEEMA, SARAH, IJAZ",216 ASHVILLE AVE STE 60 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245597129,"CHEEMA, SARAH, IJAZ",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245597178,"KALU, IBUKUNOLUWA, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1356366413,CRYSTAL COAST FAMILY PRACTICE,CRYSTAL COAST FAMILY PRACTICE,505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1245598929,"ODOM, SHELLY, BEE",505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 103 , 148 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245598952,"POSEY, JULIA, MCKNIGHT",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 121 , 190 , 236 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,11530 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",11530 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 71 , 84 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245599117,"PATEL, JAY, INDRAVADAN",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245602416,"BYRUM, LUBOV, ANGUELOVA",800 W MEETING ST   LANCASTER SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245604875,"WALTERS, VALENCIA, JANA'E",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1982462404,MONICA HENAO DMD PLLC,HAPPY MOLARS,618 LAKESTONE COMMONS AVE   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1245612282,"HENAO, MONICA",618 LAKESTONE COMMONS AVE   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 171 , 330 ," 1,451 "," $69,296.41 ",,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245612282,"HENAO, MONICA",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 521 , 592 ," 1,827 "," $77,800.26 ",,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245612506,"HUSKEY, SHAMIKA, BRYANT",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 35 , 41 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245614601,"FELEKE, RAHEL, BAYE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245614601,"FELEKE, RAHEL, BAYE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245614742,"GOODRICH, MATTHEW, PHILLIP",GOODRICH DENTAL,125 MURRAY HILL RD STE G SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,1245614742,"GOODRICH, MATTHEW, PHILLIP",125 MURRAY HILL RD STE G SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 428 , 738 ," 2,225 "," $125,893.32 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13845 CONLAN CIR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245614825,"FLEITES, LAURA, MICHELE",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9628 REA RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245614825,"FLEITES, LAURA, MICHELE",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245614825,"FLEITES, LAURA, MICHELE",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457696361,BLACK MOUNTAIN PHYSICAL THERAPY LLC,PHOENIX REHABILITATION AND HEALTH SERVICES INC,997 OLD HIGHWAY 70 W STE D BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1245615376,"TALLMAN, STEPHEN, GEOFREY",997 OLD US HWY 70 W   BLACK MOUNTAIN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 23 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245616598,"ABDUL-KARIM, ADILA, MUHSINA",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1245617372,"HUNT, ALESE, VICTORIA",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1245617372,"HUNT, ALESE, VICTORIA",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 72 , 106 , 348 ," $15,882.59 ",,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245618081,"SUNDAR, ANUPAMA",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245619279,"LEMON, ALLISON, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 85 , 265 , 345 ," $16,631.31 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245619808,"WANNAMAKER, ERIC, JOSEPH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245620079,"HARRISON, CHRISTINA, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245623594,"NEFF, ERICA, WIENEKE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245623594,"NEFF, ERICA, WIENEKE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245624576,1ST CHOICE CARE LLC,1ST CHOICE CARE LLC,2105 PRESBYTERIAN LN   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1245624576,1ST CHOICE CARE LLC,2105 PRESBYTERIAN LN   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 64 ," 15,655 "," 16,264 "," $1,310,686.20 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245625011,"BAEZ, AMY, REBECCA",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 36 , 59 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 36 , 52 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 61 , 93 , 129 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 51 , 56 , 82 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 111 , 156 , 232 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",108 W MAIN ST STE E JAMESTOWN NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 19 , 28 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",3610 PETERS CT   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",3801 W MARKET ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",3610 PETERS CT   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",3604 PETERS CT   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 25 , 32 , 47 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 15 , 37 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245625151,"HERLIHY, JOHN, DANIEL",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245625250,"HAMLIN, LESLIE, SHARONDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 43 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245625250,"HAMLIN, LESLIE, SHARONDA",1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 48 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 25 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 22 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1245625946,"RUBINSTEIN, DANIEL, ETHAN",781 AVENT FERRY RD STE 202 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1548436777,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS DILLON,705 N 8TH AVE STE 1B DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245626977,"SAYAN, ARDALAN, E.",705 N 8TH AVE STE 1B DILLON SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 210 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245627652,"PORTER, ELEAH, DANIELLE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 26 , 28 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 430 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245627652,"PORTER, ELEAH, DANIELLE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245628221,"CREWS-LLOYD, ASHLEY, NICOLE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 28 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245628932,"STANDARD, VENUS",3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245628932,"STANDARD, VENUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245630128,"JOLLY, CUMI, TALITHA",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245630250,"PARKER, LAUREN, MILES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245630250,"PARKER, LAUREN, MILES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 36 , 37 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245630854,"GILLIS, MARY, MEREDITH",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245630854,"GILLIS, MARY, MEREDITH",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245630854,"GILLIS, MARY, MEREDITH",6324 FAIRVIEW RD STE 310 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245632173,"PFLUG, ELIZABETH, HOPE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 38 , 38 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245634823,"OATES, LAURA, JUNE",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 , 26 , 47 ,$#,,
MEDICAID DIRECT,1154348597,WINSTON-SALEM PEDIATRICS HIGHROAD,~,2808 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245635184,"TODA, MOLLY, B",2808 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 ,#, 29 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245636414,"GILYARD, ANDREA, JOHNSON",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245636836,"WEINER, JESSICA, ERIN",850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245636836,"WEINER, JESSICA, ERIN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245637776,"LYNCH, JOEL, WADE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245638030,"TOMLINSON, BLAIR, STRANDBERG",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245640218,"ROMINE, MATTHEW, WARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 52 , 58 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245640218,"ROMINE, MATTHEW, WARD",628 E 12TH ST   WASHINGTON NC,007,Beaufort,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245641851,"GO, MICHELLE, SY",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245641851,"GO, MICHELLE, SY",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 51 , 73 , 133 ," $10,302.27 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245641851,"GO, MICHELLE, SY",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1245641851,"GO, MICHELLE, SY",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 52 , 69 , 125 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245641851,"GO, MICHELLE, SY",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245641851,"GO, MICHELLE, SY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1245641851,"GO, MICHELLE, SY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245642321,"CAULEY-HARVEY, AMANDA",850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 46 , 102 ,$#,,
MEDICAID DIRECT,1245642784,"GIBSON, CHRISTOPHER, GORDON",CHRISTOPHER G GIBSON DDS MS PLLC DBA REIDSVILLE OR,1429 FRONT ST   REIDSVILLE NC,079,Rockingham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1245642784,"GIBSON, CHRISTOPHER, GORDON",1429 FRONT ST   REIDSVILLE NC,079,Rockingham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 620 ," 2,524 "," 3,206 "," $556,237.40 ",,
MEDICAID DIRECT,1245642982,"TIPPETTE, MARY-ELIZABETH, BYORICK",MARY-ELIZABETH BYORICK TIPPETTE HEAR I AM SPEECH,4045 UNIVERSITY PKWY STE 241 WINSTON SALEM NC,034,Forsyth,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1245642982,"TIPPETTE, MARY-ELIZABETH, BYORICK",4045 UNIVERSITY PKWY STE 241 WINSTON SALEM NC,034,Forsyth,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245645647,"FRANK, ADAM, RICHARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 62 , 184 , 191 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245645647,"FRANK, ADAM, RICHARD",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245645647,"FRANK, ADAM, RICHARD",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1538309539,PERRY L JEFFRIES DDS PA,Perry Jeffries DDS,4400 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245646124,"CHOI, HAH NEUL",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538309539,PERRY L JEFFRIES DDS PA,Perry Jeffries DDS,4400 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245646124,"CHOI, HAH NEUL",4400 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1538309539,PERRY L JEFFRIES DDS PA,Perry Jeffries DDS,4400 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245646124,"CHOI, HAH NEUL",4400 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 371 , 521 ," 1,713 "," $69,684.35 ",,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245647643,"ALDAOUD, MATHHAR, FARIS TAWFIQ",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 140 , 190 , 233 ," $25,864.57 ",,
MEDICAID DIRECT,1265165518,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN MULTI-SPECIALTY CLINIC AT GIBSON CANC,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1245650159,"WORIAX, HANNAH, EUPHRATES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 21 , 24 ,$#,,
MEDICAID DIRECT,1265165518,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN MULTI-SPECIALTY CLINIC AT GIBSON CANC,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1245650159,"WORIAX, HANNAH, EUPHRATES",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 46 , 46 ,$#,,
MEDICAID DIRECT,1104918754,SCOTLAND MEMORIAL HOSPITAL INC,~,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1245650159,"WORIAX, HANNAH, EUPHRATES",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104918754,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1245650159,"WORIAX, HANNAH, EUPHRATES",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245650621,"HOFFMAN, ERIK, CHRISTIAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 177 , 291 , 459 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245651728,"SMITH, ALEXANDRA, NICOLE",5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 , 52 , 68 ,$#,,
MEDICAID DIRECT,1245654102,HORSE N AROUND TRC,,2593 N ROCKY RIVER RD   LANCASTER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1245654102,HORSE N AROUND TRC,2593 N ROCKY RIVER RD   LANCASTER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,#, 149 , 151 ," $14,459.59 ",,
MEDICAID DIRECT,1245654102,HORSE N AROUND TRC,,2593 N ROCKY RIVER RD   LANCASTER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245654102,HORSE N AROUND TRC,2593 N ROCKY RIVER RD   LANCASTER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,#, 61 , 61 ,$#,,
MEDICAID DIRECT,1245656578,NUANGELS HOME CARE,,10520 LIGON MILL RD STE 108 WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1245656578,NUANGELS HOME CARE,10520 LIGON MILL RD STE 108 WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 3,764 "," 4,457 "," $626,619.86 ",,
MEDICAID DIRECT,1245656578,NUANGELS HOME CARE,,6 CONSULTANT PL STE 200 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1245656578,NUANGELS HOME CARE,6 CONSULTANT PL STE 200 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 4,233 "," 4,233 "," $378,880.43 ",,
MEDICAID DIRECT,1245656578,NUANGELS HOME CARE,,105 E CENTER ST STE C MEBANE NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1245656578,NUANGELS HOME CARE,105 E CENTER ST STE C MEBANE NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,801 "," 1,802 "," $118,127.20 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245656958,"CLARK, CHIMERE, LEFEE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,910 WORTH ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245657105,"FORD, AMANDA",910 WORTH ST   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245657105,"FORD, AMANDA",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 101 , 129 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245658582,"MINTZ-COLE, RACHAEL, ANNA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245658582,"MINTZ-COLE, RACHAEL, ANNA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 22 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245658582,"MINTZ-COLE, RACHAEL, ANNA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245658582,"MINTZ-COLE, RACHAEL, ANNA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245659226,"STACK, COLLEEN, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 59 , 78 , 80 ,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245659226,"STACK, COLLEEN, MARIE",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245659226,"STACK, COLLEEN, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245659648,"PATEL, MIT, PRABHAKAR",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245659663,"HAMM, ERIC, MATTHEW",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245659663,"HAMM, ERIC, MATTHEW",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1245659663,"HAMM, ERIC, MATTHEW",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245659705,"ELLIS, JESSICA, DANIELLE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245659705,"ELLIS, JESSICA, DANIELLE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 74 , 101 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1245662774,"FRANCE, MEREDITH, MELISSA",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245662774,"FRANCE, MEREDITH, MELISSA",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 54 , 54 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245665017,"MALTESE, AMBER, PURDY",775 W CORBETT AVE STE 2 SWANSBORO NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245666320,"DOW, GEORGE, MATTHEW",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 61 , 80 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245666460,"BROOKS, JENNA, KINDLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 37 , 37 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1245667401,"STEEN, LAUREL, ANN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245667427,"GIORDANO, MEAGAN, LYN",293 HOSPITAL RD   SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245667468,"HARRIS, DESIREE, ALYSHA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667518,"SLOCUM, ANDREW, CHRISTOPHER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667518,"SLOCUM, ANDREW, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 45 , 45 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667518,"SLOCUM, ANDREW, CHRISTOPHER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 22 ,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1245667575,"PRAFKA, MICHAEL, RICHARDSON",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790212462,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245668185,"ELGENDY, HANAN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245668185,"ELGENDY, HANAN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 94 , 100 , 210 ," $12,984.65 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1245668938,"GIBSON, MARY JOYCE, BEASLEY",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245668938,"GIBSON, MARY JOYCE, BEASLEY",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245668938,"GIBSON, MARY JOYCE, BEASLEY",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245668938,"GIBSON, MARY JOYCE, BEASLEY",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245668938,"GIBSON, MARY JOYCE, BEASLEY",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245669498,"RUSSELL, REBECCA, JACLENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,911 S HUGHES ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1245669498,"RUSSELL, REBECCA, JACLENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245669845,"HALLORAN, MARYELLEN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 55 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245670066,"WARD, JONATHAN, PHILLIP",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 56 , 60 ,$#,,
MEDICAID DIRECT,1245670165,"BRADFORD, RANDOLPH, BROWN",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1245670165,"BRADFORD, RANDOLPH, BROWN",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1245670298,FIRSTHEALTH OF THE CAROLINAS INC,~,2925 BEECHTREE DR STE 145 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1245670298,FIRSTHEALTH OF THE CAROLINAS INC,2925 BEECHTREE DR STE 145 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,, 55 , 380 , 629 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245670488,"WELLS, KESHIA, DANIELLE",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245673250,"LOBURK, BRIDGETTE, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care", 43 , 124 , 124 ," $10,465.14 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245673284,"AGBOR-ETANG, BRIAN, BESONG",1220 MAGNOLIA ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245673284,"AGBOR-ETANG, BRIAN, BESONG",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 151 , 236 , 363 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245673284,"AGBOR-ETANG, BRIAN, BESONG",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245673284,"AGBOR-ETANG, BRIAN, BESONG",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 23 , 40 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245673284,"AGBOR-ETANG, BRIAN, BESONG",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245673284,"AGBOR-ETANG, BRIAN, BESONG",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1245673326,"YOUNG, VICTORIA, A",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245673458,"ARORA, HANS, CHIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 44 , 67 , 75 ," $10,914.19 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245673458,"ARORA, HANS, CHIN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245673458,"ARORA, HANS, CHIN",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1245673466,"FISCUS, GABRIEL, EVAN",,48 CENTENNIAL WAY   GREENVILLE SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,1245673466,"FISCUS, GABRIEL, EVAN",48 CENTENNIAL WAY   GREENVILLE SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245674225,"MCCLELLAN, JOHN, MASON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 68 , 85 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245674316,"FULLER, JESSICA, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 61 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245674316,"FULLER, JESSICA, SCOTT",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245674571,"TUCKER, KATHERINE, RHOADS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 15 , 29 , 32 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245674571,"TUCKER, KATHERINE, RHOADS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 36 , 51 , 62 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245676220,"JOHNSON, ANGELA, KATELYN",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1245676220,"JOHNSON, ANGELA, KATELYN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245676220,"JOHNSON, ANGELA, KATELYN",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 27 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245676220,"JOHNSON, ANGELA, KATELYN",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1245676220,"JOHNSON, ANGELA, KATELYN",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245676808,"BROWN, SANDRA, BETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245676808,"BROWN, SANDRA, BETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1245677103,"PITTMAN, GREGORY, SEAN",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 57 , 80 ," $14,020.84 ",,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245677111,"JAMISON, SHAUNDREAL, DESERE'E",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 79 , 88 , 209 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245678614,"GERST, PETER, CHARLES",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245679141,"ALQALYOOBI, SHEHABALDIN, MOHAMED HASAN ALI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 32 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245679141,"ALQALYOOBI, SHEHABALDIN, MOHAMED HASAN ALI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 65 , 90 , 149 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245679141,"ALQALYOOBI, SHEHABALDIN, MOHAMED HASAN ALI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245679141,"ALQALYOOBI, SHEHABALDIN, MOHAMED HASAN ALI",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245679141,"ALQALYOOBI, SHEHABALDIN, MOHAMED HASAN ALI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245679141,"ALQALYOOBI, SHEHABALDIN, MOHAMED HASAN ALI",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1245679422,"COLLINS, NATHANIEL, DAVID",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952830432,FHPG LLC,FIRSTHEALTH TROY CARE CLINIC,522 ALLEN ST STE 203 TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1245679422,"COLLINS, NATHANIEL, DAVID",522 ALLEN ST STE 203 TROY NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245587534,FRENCH BROAD PEDIATRIC ASSOCIATES P,FRENCH BROAD PEDICATRIC ASSOCIATES PLLC,40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1245680388,"MCDONOUGH LEOTA, MOLLY",40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 94 , 214 ," $11,306.23 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245681097,"KENNEDY, JEANINE",3903 N ELM ST   GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1245682038,"ESTELL, MATTHEW, DALE",106 HENDERSON CROSSING PLZ   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",106 HENDERSON CROSSING PLZ   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1245682038,"ESTELL, MATTHEW, DALE",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245682038,"ESTELL, MATTHEW, DALE",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245683275,"ARANDA AGUIRRE, ERNESTO, LUIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 54 , 85 , 88 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245683275,"ARANDA AGUIRRE, ERNESTO, LUIS",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 46 , 105 , 121 ,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245684026,"WATSON, BRITTANY, NICHOLE",2101 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245684026,"WATSON, BRITTANY, NICHOLE",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245684026,"WATSON, BRITTANY, NICHOLE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245684026,"WATSON, BRITTANY, NICHOLE",501 BILLINGSLEY RD COTTAGE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245684026,"WATSON, BRITTANY, NICHOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 54 , 75 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245684372,"EVELAND, MATTHEW",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 42 , 42 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245684372,"EVELAND, MATTHEW",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245684372,"EVELAND, MATTHEW",601 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245685759,"BARRETT, SPENCER, KEATON",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 116 , 125 , 141 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245685759,"BARRETT, SPENCER, KEATON",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 171 , 179 , 223 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1245685759,"BARRETT, SPENCER, KEATON",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245685759,"BARRETT, SPENCER, KEATON",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245685866,"MCGOWAN, MEGAN, ELIZABETH BROCK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 61 , 61 ," $18,232.14 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245685866,"MCGOWAN, MEGAN, ELIZABETH BROCK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1245687110,"GUESS, JOEL, MICHAEL",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245687714,"BARTOLO, KATHRYNE, BOUCHER",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245687714,"BARTOLO, KATHRYNE, BOUCHER",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245687714,"BARTOLO, KATHRYNE, BOUCHER",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 33 , 55 , 60 ,$#,,
MEDICAID DIRECT,1245689520,PFC CORPORATION,,4801 E INDEPENDENCE BLVD STE 307 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1245689520,PFC CORPORATION,4801 E INDEPENDENCE BLVD STE 307 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 90 ," 20,507 "," 20,511 "," $1,312,231.18 ",,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,730 MALCOLM BLVD STE 220 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1245690551,"KILPATRICK, DUSTIN, RICHARD",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1245690551,"KILPATRICK, DUSTIN, RICHARD",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 80 , 107 , 113 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1245690551,"KILPATRICK, DUSTIN, RICHARD",2201 S STERLING ST   MORGANTON NC,012,Burke,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 46 , 76 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1245690551,"KILPATRICK, DUSTIN, RICHARD",2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 15 ,$#,,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1245690551,"KILPATRICK, DUSTIN, RICHARD",2201 S STERLING ST   MORGANTON NC,012,Burke,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 26 , 26 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245693746,"COOPER, JENNIFER, YOUNGBLOOD",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1245695246,"SMITH, RACHAEL, BARTON",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1245695246,"SMITH, RACHAEL, BARTON",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 50 , 51 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1245697291,"DELANEY, CHRISTINE, BOYD",511 PENNY LN   MOREHEAD CITY NC,016,Carteret,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 12 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1245697291,"DELANEY, CHRISTINE, BOYD",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 46 , 50 , 88 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1245697291,"DELANEY, CHRISTINE, BOYD",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 18 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1245697291,"DELANEY, CHRISTINE, BOYD",3100 WELLONS BLVD   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 27 , 30 , 50 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245698620,"MARTIN, ASHLEIGH, PAPPADAKE",400 ATHLETIC CLUB BLVD   CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245698620,"MARTIN, ASHLEIGH, PAPPADAKE",400 ATHLETIC CLUB BLVD   CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 30 , 90 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245698620,"MARTIN, ASHLEIGH, PAPPADAKE",4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 20 , 27 , 66 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245698620,"MARTIN, ASHLEIGH, PAPPADAKE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1245701168,QUALITY LIFE HOME HEALTHCARE LLC,~,2726 CROASDAILE DR STE 213 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1245701168,QUALITY LIFE HOME HEALTHCARE LLC,2726 CROASDAILE DR STE 213 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 119 ," 23,207 "," 23,691 "," $1,936,370.18 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1245702836,"MOTGHARE, PRASENJEET, NARAYAN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1245702836,"MOTGHARE, PRASENJEET, NARAYAN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245703065,"PARKER, LESLIE, COBB",336 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 38 , 39 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245703065,"PARKER, LESLIE, COBB",336 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245703289,"BRAGG, SARAH, ELIZABETH",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245703289,"BRAGG, SARAH, ELIZABETH",1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 63 , 149 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245705060,"BAUGH, ABIGAIL, HILDEGARDE BUECHNER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1805 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1245705326,"HUGHES, ANITRA",1805 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 23 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1245705326,"HUGHES, ANITRA",446 CARATOKE HWY   MOYOCK NC,027,Currituck,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 49 , 50 ,$#,,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1245705367,"BRYANT, KRISTOPHER, SAMUEL",215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#,#,#," $32,426.40 ",,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1245707306,"YBARRA, JEFFREY, SIMON",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245707306,"YBARRA, JEFFREY, SIMON",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245707306,"YBARRA, JEFFREY, SIMON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245707306,"YBARRA, JEFFREY, SIMON",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245707306,"YBARRA, JEFFREY, SIMON",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245707306,"YBARRA, JEFFREY, SIMON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,17 LIVERMORE DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1245707611,"LOWERY, BRITTANY, MEAGAN",809 S LONG DR STE K ROCKINGHAM NC,077,Richmond,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,410D S JONES ST   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1245707611,"LOWERY, BRITTANY, MEAGAN",809 S LONG DR STE K ROCKINGHAM NC,077,Richmond,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245708395,"MAXWELL, LAUREN, ELIZABETH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1245708395,"MAXWELL, LAUREN, ELIZABETH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245708395,"MAXWELL, LAUREN, ELIZABETH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1245711084,"HAMPTON, DARRYL, ADRIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1245711407,"MCCLORY, ALEXANDRA, ASHLEY",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245711407,"MCCLORY, ALEXANDRA, ASHLEY",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1245711407,"MCCLORY, ALEXANDRA, ASHLEY",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457818262,HAMMOCK DMD & LOTAKIS DDS I PLLC,DENTISTRY OF THE CAROLINAS,6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245711514,"HUNEYCUTT, SAVANNAH, ELIZABETH",6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245712157,"GIBBS, KALEB, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1790212462,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245716661,"VENKAT, SHANKAR",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0106X,Dental Providers,Dentist,Oral and Maxillofacial Pathology,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245716661,"VENKAT, SHANKAR",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0106X,Dental Providers,Dentist,Oral and Maxillofacial Pathology, 117 , 125 , 307 ,$#,,
MEDICAID DIRECT,1245718642,BLIZZARD HEALTH SERVICES,ASSURANCE HEALTH SERVICES,167 OUTLAWS BRIDGE RD   ALBERTSON NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,1245718642,BLIZZARD HEALTH SERVICES,167 OUTLAWS BRIDGE RD   ALBERTSON NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,#, 361 , 361 ," $22,429.84 ",,
MEDICAID DIRECT,1245720820,TOTAL RENAL LABORATORIES INC,DAVITA LABS,3000 DAVITA WAY   DELAND FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1245720820,TOTAL RENAL LABORATORIES INC,3000 DAVITA WAY   DELAND FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 195 ," 1,511 "," 3,797 "," $82,947.90 ",,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245723170,"BARTLESON, PAUL, JOHN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 53 , 87 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1245723170,"BARTLESON, PAUL, JOHN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245723170,"BARTLESON, PAUL, JOHN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245723170,"BARTLESON, PAUL, JOHN",170 MANNING DRIVE   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1245723170,"BARTLESON, PAUL, JOHN",170 MANNING DRIVE   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1245724079,"NIELAND, ROBERT, VERNON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 89 , 89 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245724079,"NIELAND, ROBERT, VERNON",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1245724079,"NIELAND, ROBERT, VERNON",68 HOSPITAL RD   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669808143,SYLVA EMERGENCY GROUP LLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1245724079,"NIELAND, ROBERT, VERNON",68 HOSPITAL RD   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245724723,"HENRY, KELLY, JULIAN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1457356651,COUNTY OF BURKE,BURKE COUNTY HEALTH DEPARTMENT,700 E PARKER RD UNIT A MORGANTON NC,012,Burke,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245725480,"HAMM, SHAWN, MICHAEL",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 26 , 207 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1245725480,"HAMM, SHAWN, MICHAEL",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 98 , 211 , 330 ," $11,113.99 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245725605,"GERAGHTY, BRIAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245725605,"GERAGHTY, BRIAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245725878,"COLLINS, BETHANY, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245727080,"AUCOIN, CODY, WALLACE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1245728740,"ZABALA RAMIREZ, MARIA JOSE",1301 CENTRAL DR   SANFORD NC,053,Lee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 73 , 114 , 145 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245728740,"ZABALA RAMIREZ, MARIA JOSE",1301 CENTRAL DR   SANFORD NC,053,Lee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245728740,"ZABALA RAMIREZ, MARIA JOSE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 47 , 47 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1245728740,"ZABALA RAMIREZ, MARIA JOSE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245728740,"ZABALA RAMIREZ, MARIA JOSE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 50 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245728740,"ZABALA RAMIREZ, MARIA JOSE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245728815,"ALLENZARA, ASTIA, ROPER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245728815,"ALLENZARA, ASTIA, ROPER",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245728815,"ALLENZARA, ASTIA, ROPER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1245728864,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE THERAPY MARION,348 GRACE CORPENING DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1245728864,BLUE RIDGE HEALTHCARE MEDICAL GROUP,348 GRACE CORPENING DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,#, 40 , 63 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245729375,"PAYNE, MORGAN, HOLLAND",3515 W MARKET ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 41 , 81 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245729375,"PAYNE, MORGAN, HOLLAND",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245733773,"FOYE-FULLER, PATERA, ANITRA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1871589762,ADVANCE COMMUNITY HEALTH INC,~,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245733773,"FOYE-FULLER, PATERA, ANITRA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 42 , 112 ," $11,120.54 ",,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245733856,"CHUANG, JANICE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245734458,"WRUBLIK, SHAYNA, RACHEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245734474,"MORENA, JONATHAN, MARK",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245734474,"MORENA, JONATHAN, MARK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245734474,"MORENA, JONATHAN, MARK",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245734474,"MORENA, JONATHAN, MARK",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 28 , 30 , 54 ,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245734540,"DAUM, SARA, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245735018,"BODDU, KRISTIN, NICOLE",3940 ARROWHEAD BLVD STE 110 MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245735018,"BODDU, KRISTIN, NICOLE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245735315,"COURTS, KEVIN, ANDRE",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 57 , 117 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245736065,"STANGEBY, MEGAN, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 12 , 40 , 40 ," $10,782.70 ",,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245736222,"GHUSAYNI, RYAN, BADIH",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 71 , 101 , 162 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245736313,"WINFREY, AMANDA, CARRINGER",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 72 , 124 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245736404,"QAFITI, FRED, NAZEH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 22 , 22 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245736404,"QAFITI, FRED, NAZEH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245740141,"MORRISSEY, THOMAS, VINCENT",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245740141,"MORRISSEY, THOMAS, VINCENT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 35 , 43 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245740141,"MORRISSEY, THOMAS, VINCENT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 44 , 51 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245740141,"MORRISSEY, THOMAS, VINCENT",310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1245740141,"MORRISSEY, THOMAS, VINCENT",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245741149,"GREEN, TAYLOR, WINN",3949 BROWNING PL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245741149,"GREEN, TAYLOR, WINN",3949 BROWNING PL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245748045,"KIRKLEY, DANIEL, TERRELL",7804 FAIRVIEW RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 43 , 68 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245748946,"GARG, AVNI",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 52 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245748946,"GARG, AVNI",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245748946,"GARG, AVNI",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245749126,"GANZMAN, SUGAREE, GEORGIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1245749126,"GANZMAN, SUGAREE, GEORGIA",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 15 , 28 ,$#,,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1245749126,"GANZMAN, SUGAREE, GEORGIA",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1629843933,OPTUM BEHAVIORAL CARE OF NORTH CARO,CAROLINA BEHAVIORAL CARE CENTERS,1101 MARCO DR STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1245749126,"GANZMAN, SUGAREE, GEORGIA",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245749126,"GANZMAN, SUGAREE, GEORGIA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245749126,"GANZMAN, SUGAREE, GEORGIA",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245750231,"DENNIS, PATRICK, BRYAN",1710 KERNERSVILLE MEDICAL PKWY STE 202 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245750231,"DENNIS, PATRICK, BRYAN",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 79 , 106 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245750231,"DENNIS, PATRICK, BRYAN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245750231,"DENNIS, PATRICK, BRYAN",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245750561,"GRAHAM, ALEXANDER, ROBERT THOMAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245750561,"GRAHAM, ALEXANDER, ROBERT THOMAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245750769,"PURSLEY, RYAN, ELLIOTT",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 116 , 158 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245750769,"PURSLEY, RYAN, ELLIOTT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 89 , 95 , 128 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245750900,"ROSS, BRYAN, DANIEL",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245752468,"CALLAHAN, TAYLOR, WARREN",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 60 , 84 ,$#,,
MEDICAID DIRECT,1245752989,INTEGRITY-HOUSTON HOUSE LLC,HOUSTON HOUSE,9460 US HIGHWAY 64   UNION MILLS NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245752989,INTEGRITY-HOUSTON HOUSE LLC,9460 US HIGHWAY 64   UNION MILLS NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 1,723 "," 1,723 "," $134,070.20 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245753524,"AHMED, MUHAMMAD, FAIZAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 19 , 25 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245753524,"AHMED, MUHAMMAD, FAIZAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 20 , 29 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245753524,"AHMED, MUHAMMAD, FAIZAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245753524,"AHMED, MUHAMMAD, FAIZAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 39 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245755313,"LAHAV-VITENZON, SKY",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245755313,"LAHAV-VITENZON, SKY",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245756261,"PATEL, MIRAJ, BHUPENDRAKUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 18 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1245760024,"KURTZMAN, NICHOLAS, DAVID",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245761758,"WILLIAMS, SAMANTHA, LAVETTE",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1245761758,"WILLIAMS, SAMANTHA, LAVETTE",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245762830,"WOODWARD, RIVERS",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245762830,"WOODWARD, RIVERS",161 WALKER ST   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 29 ,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245762830,"WOODWARD, RIVERS",187 W MAIN ST   SPINDALE NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245762830,"WOODWARD, RIVERS",146 NESBITT RDG   LAKE LURE NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 153 , 186 ," $14,638.14 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1245762939,"WEISS, AUSTIN, LOUIS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245762939,"WEISS, AUSTIN, LOUIS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1245762939,"WEISS, AUSTIN, LOUIS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245762939,"WEISS, AUSTIN, LOUIS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1245762939,"WEISS, AUSTIN, LOUIS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 21 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1245762939,"WEISS, AUSTIN, LOUIS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1245762939,"WEISS, AUSTIN, LOUIS",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1710563176,MARTHA HARDAWAY DMD MS PA,BLUEBIRD PEDIATRIC DENTISTRY,895 STATE FARM RD STE 204 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1245769058,"TASHAKKORI, PARISA",247 MOUNT JEFFERSON STATE PARK RD STE 7 WEST JEFFERSON NC,005,Ashe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1710563176,MARTHA HARDAWAY DMD MS PA,BLUEBIRD PEDIATRIC DENTISTRY,895 STATE FARM RD STE 204 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1245769058,"TASHAKKORI, PARISA",895 STATE FARM RD STE 204 BOONE NC,095,Watauga,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 517 , 962 ," 4,658 "," $235,958.96 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245769199,"URUM, FELICIA, NNEOMA",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 104 , 104 ,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1245769199,"URUM, FELICIA, NNEOMA",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 225 , 228 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245769389,"KERN, MICHELLE, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 19 , 40 ,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1245771112,"WONG, DAVID",6910 FAYETTEVILLE RD STE 296 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1316943145,CENTRAL CAROLINA DERMATOLOGY,CENTRAL CAROLINA DERMATOLOGY CLINICINC,4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245771575,"THIBODEAUX, QUINN, GERALD",4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245773035,"BRUNNER, JESSICA, NOEL",3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245773498,"ADUSEI, AMA, BIRAGO",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1831465442,MONARCH,,3200 NORTHLINE AVE STE 132 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245773498,"ADUSEI, AMA, BIRAGO",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1801116405,MONARCH,~,820 GRIMES BLVD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1245773498,"ADUSEI, AMA, BIRAGO",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255769618,MONARCH,~,311 MCBEE ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245773498,"ADUSEI, AMA, BIRAGO",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1245773498,"ADUSEI, AMA, BIRAGO",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 40 , 43 ,$#,,
MEDICAID DIRECT,1346680543,MONARCH,~,809 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1245773498,"ADUSEI, AMA, BIRAGO",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245776814,"LUCAS, MATTHEW, JUSTIN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 61 , 171 , 397 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245776814,"LUCAS, MATTHEW, JUSTIN",512 VILLAGE RD STE 103 SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245776814,"LUCAS, MATTHEW, JUSTIN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245778570,"COATES, CASEY, OVERCASH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245778570,"COATES, CASEY, OVERCASH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1245778570,"COATES, CASEY, OVERCASH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245778570,"COATES, CASEY, OVERCASH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245778570,"COATES, CASEY, OVERCASH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245778570,"COATES, CASEY, OVERCASH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245781590,"WALL, LEIGH, ANNE",5900 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245781590,"WALL, LEIGH, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 23 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245781590,"WALL, LEIGH, ANNE",5900 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 52 , 98 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245783117,"RIVERA-CAMACHO, GABRIELA, MARIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245783745,"BOSTWICK, GARRETT, LLOYD",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245783745,"BOSTWICK, GARRETT, LLOYD",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 24 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245784404,"SINGH, CHARLENE",3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 42 , 47 , 84 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1130 S MAIN ST   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1245784404,"SINGH, CHARLENE",3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245784404,"SINGH, CHARLENE",3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,1116 CROSSROADS DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1245784404,"SINGH, CHARLENE",3000 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245784404,"SINGH, CHARLENE",7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1245784404,"SINGH, CHARLENE",169 NORMAN STATION BLVD   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245788827,"MERCER, KARI, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245788827,"MERCER, KARI, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1245788827,"MERCER, KARI, LYNN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245789379,"CARROLL, RADONNA, FIELDS",2818 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 52 , 171 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245789379,"CARROLL, RADONNA, FIELDS",2818 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 16 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245790138,"DAVIS, BENJAMIN, BRACEY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245790138,"DAVIS, BENJAMIN, BRACEY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245790138,"DAVIS, BENJAMIN, BRACEY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 56 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245790138,"DAVIS, BENJAMIN, BRACEY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 65 , 79 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1245790138,"DAVIS, BENJAMIN, BRACEY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598432643,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BROADVIEW,307 BROADVIEW RD   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245791177,"KLASSEN, ROSEMARY, ANN",307 BROADVIEW RD   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245791516,"CRILLEY, THOMAS, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 62 , 108 , 115 ,$#,,
MEDICAID DIRECT,1902323561,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1245791946,"BALL, ELIZABETH, GRACE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 45 ,$#,,
MEDICAID DIRECT,1902323561,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1245791946,"BALL, ELIZABETH, GRACE",150 IVEY LN STE B PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 59 , 124 ,$#,,
MEDICAID DIRECT,1548276389,FIRSTHEALTH OF THE CAROLINAS INC,~,522 ALLEN ST STE 101 TROY NC,062,Montgomery,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1245791946,"BALL, ELIZABETH, GRACE",522 ALLEN ST STE 101 TROY NC,062,Montgomery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245792837,"GREENWOOD, TIFFANY, ANNE",11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 45 , 45 ,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245792837,"GREENWOOD, TIFFANY, ANNE",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245793512,"KARUKONDA, POOJA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245793512,"KARUKONDA, POOJA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 19 , 34 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245793546,"ADKINS, LAURA, LYNN",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245793546,"ADKINS, LAURA, LYNN",15015 LANCASTER HWY STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245794148,"REBELLO, DAVID, KEITH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245794148,"REBELLO, DAVID, KEITH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245799386,"VAIOS, EUGENE, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245799386,"VAIOS, EUGENE, JOHN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 44 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245799386,"VAIOS, EUGENE, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245799733,"LOYD, MELISSA, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1487891933,APPALACHIAN REGIONAL MEDICAL ASSOCI,ELK RIVER MEDICAL ASSOCIATES,150 PARK AVE   BANNER ELK NC,006,Avery,193200000X,Group,Multi-Specialty,,1245801588,"MARQUEZ, GRAEME, DENNIS",150 PARK AVE   BANNER ELK NC,006,Avery,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1245801851,"HIBBERTS, ELLEN, CHRISTINE",600 W TRADE ST STE B DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245803469,"STEVENS, ERIN, TERESA FLETCHER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245803469,"STEVENS, ERIN, TERESA FLETCHER",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1245804103,"KAPLAN, BENJAMIN, JACOB",5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245804103,"KAPLAN, BENJAMIN, JACOB",5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1598186132,OLU OYEGUNWA DDS PA,~,1916 SKIBO RD STE C3 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1245808468,"JONES, VONTRISKA, RONIQUE",1916 SKIBO RD STE C3 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245809235,"CAMARGO, NATALIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245809235,"CAMARGO, NATALIE",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245809235,"CAMARGO, NATALIE",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 34 , 36 ,$#,,
MEDICAID DIRECT,1659494292,TOTAL WOMAN CARE LLC,,942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1245815752,"HALL, SHANNON, JOYNER",942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 52 , 56 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1245818038,"YEAGER, MATTHEW, MARTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245818038,"YEAGER, MATTHEW, MARTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245818038,"YEAGER, MATTHEW, MARTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245818038,"YEAGER, MATTHEW, MARTIN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245818038,"YEAGER, MATTHEW, MARTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 37 , 44 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245818038,"YEAGER, MATTHEW, MARTIN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245818038,"YEAGER, MATTHEW, MARTIN",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245820489,"MONDSCHEIN, MIKAELA, NICOLE",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 27 , 33 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245820489,"MONDSCHEIN, MIKAELA, NICOLE",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1245821420,"BROWNING, DANA",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 112 , 138 , 379 ,$#,,
MEDICAID DIRECT,1124501085,SELECT MEDICAL SERVICES PLLC,~,10931 RAVEN RIDGE RD STE 115 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245821560,"GREENBLATT, NOAH, AARON KELLY",10931 RAVEN RIDGE RD STE 115 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245821586,"FERNANDEZ-OSBORNE, AMY, JANINA",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 28 , 49 ,$#,,
MEDICAID DIRECT,1770897142,LILLINGTON MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-LILLINGTON,7 E DUNCAN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1245822865,"DEL VALLE, OLIVIA, MORA",7 E DUNCAN ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 97 , 147 ,$#,,
MEDICAID DIRECT,1245823954,HOLISTIC KIDS PLLC,,5015 SOUTHPARK DR STE 240 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245823954,HOLISTIC KIDS PLLC,5015 SOUTHPARK DR STE 240 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245824812,"BARTUV, NOAM",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245824812,"BARTUV, NOAM",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 19 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245824812,"BARTUV, NOAM",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 18 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245824812,"BARTUV, NOAM",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245824812,"BARTUV, NOAM",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1245826049,PASSION WELLCARE,,5 CENTERVIEW DR STE 160 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1245826049,PASSION WELLCARE,5 CENTERVIEW DR STE 160 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 529 , 529 ," $35,502.78 ",,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245829456,"MASON, KRISTEN, COLARELL",128 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245829456,"MASON, KRISTEN, COLARELL",128 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 305 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245829456,"MASON, KRISTEN, COLARELL",128 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245829670,"GERDING, HANNAH, ROSE",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245830215,"TAHERI, WHITNEY, RAINS",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 21 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245830215,"TAHERI, WHITNEY, RAINS",3004 TOWER BLVD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1245841246,360 CARE SOLUTION LLC,,1617 W ROOSEVELT BLVD STE H MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1245841246,360 CARE SOLUTION LLC,1617 W ROOSEVELT BLVD STE H MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 40 ," 7,461 "," 7,864 "," $643,836.67 ",,
MEDICAID DIRECT,1245841279,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH PHARMACY,125 QUEENS RD STE 180 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1245841279,THE PRESBYTERIAN HOSPITAL,125 QUEENS RD STE 180 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#, 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245843960,"PASHA, MOHAMMED, AFRAZ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 173 , 175 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245845684,"ALLEN, LATESHA, MILLER",101 CABARRUS AVE E STE 200 CONCORD NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 154 ," 1,256 "," 1,298 "," $28,977.77 ",,
MEDICAID DIRECT,1245847524,GRACELAND STUDENT SERVICES LLC,,2500 SAINT CHRISTOPHER CIR SW APT 1 WILSON NC,098,Wilson,252Y00000X,Agencies,Early Intervention Provider Agency,,1245847524,GRACELAND STUDENT SERVICES LLC,2500 SAINT CHRISTOPHER CIR SW APT 1 WILSON NC,098,Wilson,252Y00000X,Agencies,Early Intervention Provider Agency,, 45 , 715 , 715 ," $46,299.60 ",,
MEDICAID DIRECT,1245842178,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WILLIAM ELLIS MIDDLE,144 WILLIAM ELLIS DR   ADVANCE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245848043,"DAVIS, MICHALA, WASHBURN",144 WILLIAM ELLIS DR   ADVANCE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245849835,"CULBERTSON, ADAM, BEN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 47 , 48 , 192 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 106 , 108 , 415 ," $14,237.47 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,130 HARBOUR PLACE DR STE 180   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",130 HARBOUR PLACE DR STE 180 DAVIDSON NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,216 "," 2,155 "," 8,551 "," $298,062.48 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",130 HARBOUR PLACE DR STE 180 DAVIDSON NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 17 , 20 , 55 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,491 "," 1,679 "," 6,758 "," $247,449.25 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245850015,"DESAI, SHIVANI, KIRIT",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 115 , 114 , 420 ," $12,788.00 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1245850387,"WILLIAMS, TRAVIS, WHITT",241 CHURCH ST   HAYESVILLE NC,022,Clay,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1659362911,CLAY COMPREHENSIVE HEALTH SERVICES,CHATUGE FAMILY PRACTICE,241 CHURCH ST   HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,,1245850387,"WILLIAMS, TRAVIS, WHITT",241 CHURCH ST   HAYESVILLE NC,022,Clay,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 54 , 59 ,$#,,
MEDICAID DIRECT,1659362911,CLAY COMPREHENSIVE HEALTH SERVICES,CHATUGE FAMILY PRACTICE,241 CHURCH ST   HAYESVILLE NC,022,Clay,193200000X,Group,Multi-Specialty,,1245850387,"WILLIAMS, TRAVIS, WHITT",241 CHURCH ST   HAYESVILLE NC,022,Clay,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 36 , 59 ,$#,,
MEDICAID DIRECT,1205595998,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WILSON,3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1245851187,"HENRY, WENSHLEY, RAMEAU",3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245851922,"KISIEDU, ANITA, AFRIYIE",6555 KEE LN STE 200 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 61 , 101 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,1090 NE GATEWAY CT NE STE 204A CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245856186,"LEWIS, HAYDEN, SCHOBER",1090 NE GATEWAY CT NE STE 204A CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 27 , 56 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1245862168,"HARPER, KRISTEN, SESSIONS",621 S MAIN ST STE 201 REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245862168,"HARPER, KRISTEN, SESSIONS",233 GILMER ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245862168,"HARPER, KRISTEN, SESSIONS",233 GILMER ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 116 , 116 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245862424,"BULLARD, JORDAN, KATE",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1245862424,"BULLARD, JORDAN, KATE",340 SEMINARY ST   KENANSVILLE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1639294309,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER BEULAVILLE,119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245862424,"BULLARD, JORDAN, KATE",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 13 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1245862424,"BULLARD, JORDAN, KATE",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1245862424,"BULLARD, JORDAN, KATE",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1245864172,"PAREJA, VINCENT, AGUINOT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245864172,"PAREJA, VINCENT, AGUINOT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245864172,"PAREJA, VINCENT, AGUINOT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 13 ,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245864859,"CARROLL, ALEXANDRA, KAREN",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 405 , 547 ," 1,473 "," $65,445.97 ",,
MEDICAID DIRECT,1235801812,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH DENTAL,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1245864859,"CARROLL, ALEXANDRA, KAREN",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 242 , 484 , 889 ," $58,141.29 ",,
MEDICAID DIRECT,1235846668,CABARRUS ROWAN COMMUNITY HEALTH CEN,MCGILL FAMILY DENTAL,202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1245864859,"CARROLL, ALEXANDRA, KAREN",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265043574,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE DENTAL,307 E THOM ST   CHINA GROVE NC,080,Rowan,193400000X,Group,Single Specialty,,1245864859,"CARROLL, ALEXANDRA, KAREN",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 16 , 34 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245865260,"MORGAN, CHRISTINA, TYCHELLE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 118 , 154 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245868710,"ATTEH, ELIZABETH, OMOLADE",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245868710,"ATTEH, ELIZABETH, OMOLADE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245869155,"SMITH, JESSICA, BIVINS",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1245869155,"SMITH, JESSICA, BIVINS",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1245869155,"SMITH, JESSICA, BIVINS",1010 SHELBY RD   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1245869155,"SMITH, JESSICA, BIVINS",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1245869155,"SMITH, JESSICA, BIVINS",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 42 , 42 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1245869155,"SMITH, JESSICA, BIVINS",111 W GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 31 , 31 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1245869155,"SMITH, JESSICA, BIVINS",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 56 , 56 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1245869155,"SMITH, JESSICA, BIVINS",1530 S LAFAYETTE ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1245869155,"SMITH, JESSICA, BIVINS",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1245869155,"SMITH, JESSICA, BIVINS",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245870724,"NICHOLS, CAROLINE, ASHLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245870724,"NICHOLS, CAROLINE, ASHLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245870773,"TINGLING, STEPHANIE, SHALINI",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1245870773,"TINGLING, STEPHANIE, SHALINI",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 37 , 37 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1245870773,"TINGLING, STEPHANIE, SHALINI",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 79 , 79 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245870955,"JOHNSON, LAUREN, KIKER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245870955,"JOHNSON, LAUREN, KIKER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 79 , 82 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245870955,"JOHNSON, LAUREN, KIKER",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245872936,"MCGRATH, JILL, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245873223,"NORTHEIM, AMANDA, LEIGH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1245873223,"NORTHEIM, AMANDA, LEIGH",2007 WALNUT ST   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245874494,"CORREA, LAUREN, MARIE",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1245874494,"CORREA, LAUREN, MARIE",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245874494,"CORREA, LAUREN, MARIE",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1245875517,EC OPCO ASHEBORO LP,TERRABELLA ASHEBORO,2925 ZOO PKWY   ASHEBORO NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245875517,EC OPCO ASHEBORO LP,2925 ZOO PKWY   ASHEBORO NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 714 , 714 ," $72,734.83 ",,
MEDICAID DIRECT,1245875806,WILLEM LLC,AHOSKIE AMBULANCE SERVICE,119 RAILROAD ST N   AHOSKIE NC,046,Hertford,3416L0300X,Transportation Services,Ambulance,Land Transport,1245875806,WILLEM LLC,119 RAILROAD ST N   AHOSKIE NC,046,Hertford,3416L0300X,Transportation Services,Ambulance,Land Transport, 69 , 536 ," 1,059 ",$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245878487,"JONES, HALEY, ELIZABETH",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700918125,RHA HEALTH SERVICES INC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1245878883,"SIPOWICZ, JAMES, THOMAS",356 BILTMORE AVE STE 200 ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1245882844,"WEBB, CARRA, WAINWRIGHT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 46 , 44 , 44 ,$#,,
MEDICAID DIRECT,1164453726,CARMEL FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE CARMEL FAMILY MEDICINE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245884782,"GRABIEC, RUBY, LEE",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1245884782,"GRABIEC, RUBY, LEE",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1245892710,"BRETON, JILL, ANN",2818 NEUSE BLVD   NEW BERN NC,025,Craven,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 54 , 72 , 389 ," $17,190.44 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1245893015,"O'REGGIO, ABIGAIL, ROSEANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245893478,"EWING, JOHN, KELLY",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245894567,"DELGADO-ROBLES, JOSE, GUADALUPE",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 107 , 198 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245896422,"SCHERER, CHRISTIAN, PETER",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 85 , 167 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245897198,"DORRELL, ROBERT, DAVID",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245897198,"DORRELL, ROBERT, DAVID",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245897198,"DORRELL, ROBERT, DAVID",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245897198,"DORRELL, ROBERT, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 62 , 63 , 63 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245897198,"DORRELL, ROBERT, DAVID",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245899806,"SIZER, CHERYL, LYNNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 54 , 57 ,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245900646,"SIERRA, HERIBERTO",401 N MAIN ST   KENANSVILLE NC,031,Duplin,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1568523371,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1245900646,"SIERRA, HERIBERTO",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1245900646,"SIERRA, HERIBERTO",209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245901628,"HANSEN, KINSEY, LEA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 62 , 62 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245902097,"DRESSER, BRIAN, WILLIAM",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245902097,"DRESSER, BRIAN, WILLIAM",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245902097,"DRESSER, BRIAN, WILLIAM",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 39 , 110 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245902097,"DRESSER, BRIAN, WILLIAM",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245907989,"TOBEY, DANA, JEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245907989,"TOBEY, DANA, JEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245909639,GUARDIAN COMMUNITY CARE LLC,GUARDIAN TRANSPORTATION SERVICES,101 FOREST DR STE B KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1245909639,GUARDIAN COMMUNITY CARE LLC,101 FOREST DR STE B KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 616 , 733 ," $106,797.23 ",,
MEDICAID DIRECT,1245909639,GUARDIAN COMMUNITY CARE LLC,GUARDIAN TRANSPORTATION SERVICES,2005 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1245909639,GUARDIAN COMMUNITY CARE LLC,2005 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 284 , 284 ," $53,514.84 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245909837,"WHITAKER, AUDREY, BLAIRE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 90 , 107 , 119 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245912872,"REESE, SOPHIE, ELIZABETH",730 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1245913961,"HISCOCKS, SARAH, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922601764,WARE FAMILY MEDICINE PLLC,OLD FORT FAMILY MEDICINE,32 E MAIN ST   OLD FORT NC,059,McDowell,193200000X,Group,Multi-Specialty,,1245914274,"DALTON, KERRY, ELIZABETH",32 E MAIN ST   OLD FORT NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 62 , 95 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1245915271,"TATE, CHANDRA, ROCHELLE",969 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1245915271,"TATE, CHANDRA, ROCHELLE",969 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659307270,LINCOLN INTERNAL MEDICINE PA,LINCOLN INTERNAL MEDICINE PA,607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245916378,"HERRIN, STACEY, THOMAS",607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 25 , 27 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 153 , 695 ," 1,704 "," $17,638.59 ",,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 56 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",3610 PETERS CT   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 53 , 108 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 30 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 53 , 164 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 159 , 224 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,1103 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",1103 W D ST   NORTH WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",1103 W D ST   NORTH WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 127 , 241 , 519 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245916725,"RINGLEY, ERIN, MICHELLE",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245918762,"COLLIGAN, BROOKE, ANNE",13300 STRICKLAND RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 23 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245918762,"COLLIGAN, BROOKE, ANNE",13300 STRICKLAND RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245920040,"BRANNAN, CONNER, ELLIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245920040,"BRANNAN, CONNER, ELLIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 47 , 48 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245920040,"BRANNAN, CONNER, ELLIS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245920040,"BRANNAN, CONNER, ELLIS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1245924349,TBS UNIQUE HOMECARE INC,~,5736 N TRYON ST STE 118B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1245924349,TBS UNIQUE HOMECARE INC,5736 N TRYON ST STE 118B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 87 , 87 ,$#,,
MEDICAID DIRECT,1245925197,AMALIFE INC,,10931 E INDEPENDENCE BLVD STE A-5 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1245925197,AMALIFE INC,10931 E INDEPENDENCE BLVD STE A-5 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 2,125 "," 2,126 "," $153,186.60 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245927151,"PARRISH, BLAIRE, LANGDON",1040 US HIGHWAY 258N   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1245927151,"PARRISH, BLAIRE, LANGDON",1040 US HIGHWAY 258N   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 31 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1245927151,"PARRISH, BLAIRE, LANGDON",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 25 , 110 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1245928373,"ALVEY, REBECCA, DANIELLE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 33 , 60 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245928373,"ALVEY, REBECCA, DANIELLE",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245928373,"ALVEY, REBECCA, DANIELLE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245933472,"HULBERT, ABIGAIL, NICOLE",401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 19 , 29 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1245933472,"HULBERT, ABIGAIL, NICOLE",401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,442 S HIGHWAY 27   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1245938679,"BARKLEY, SHELBY, KERR",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245938679,"BARKLEY, SHELBY, KERR",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1245940097,BIONIC PROSTHETICS AND ORTHOTICS GR,,107 E WALKER ST   EAST FLAT ROCK NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1245940097,BIONIC PROSTHETICS AND ORTHOTICS GR,107 E WALKER ST   EAST FLAT ROCK NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 22 ," $14,351.85 ",,
MEDICAID DIRECT,1245943208,SGT HEALTH SERVICES,,210 13TH AVENUE PL NW STE 115 HICKORY NC,018,Catawba,251S00000X,Agencies,Community/Behavioral Health,,1245943208,SGT HEALTH SERVICES,210 13TH AVENUE PL NW STE 115 HICKORY NC,018,Catawba,251S00000X,Agencies,Community/Behavioral Health,, 25 , 394 , 394 ," $25,596.00 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245944206,"BALDWIN, JESSICA, RENE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245944842,"ORMOND, JADE, LEONARD",115 HEART DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245944842,"ORMOND, JADE, LEONARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245947639,"BURNS, CLAUDIA, MCCULLOUGH",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 121 , 338 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1245949593,"PITTMAN, KEITH, DANIEL",1530 S PROVIDENCE RD   WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245949593,"PITTMAN, KEITH, DANIEL",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245949593,"PITTMAN, KEITH, DANIEL",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134997463,REX HOSPITAL INC,UNC REX PELVIC HEALTH THERAPY,1515 SW CARY PKWY STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1245962372,"DAVILA, GIANNA, LYNN",1515 SW CARY PKWY STE 120 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1245962604,"HARRIS, CASEY, GREEN",210 SMITH CHURCH RD BLDG 1 ROANOKE RAPID NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 , 97 , 172 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1245962992,"STEARNS, KEVIN, THOMAS",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245964733,"TICE, DELANEY, MARIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245964782,"RUSSELL, SHANNON, MCKENZEE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1245964782,"RUSSELL, SHANNON, MCKENZEE",6333 CENTER DR BLDG 16 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245966118,"HARTELL, CASSANDRA, BROGLIO",2301 ERWIN RD   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1245967553,UWHARRIE FAMILY CARE HOME LLC,,4028 NC HIGHWAY 49 S   ASHEBORO NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1245967553,UWHARRIE FAMILY CARE HOME LLC,4028 NC HIGHWAY 49 S   ASHEBORO NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,277 "," 1,277 "," $79,978.44 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245967728,"BLUE, ALICIA, EVETTE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1245967728,"BLUE, ALICIA, EVETTE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1245974336,"BRASWELL, PENNY, WATSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1245974336,"BRASWELL, PENNY, WATSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 35 , 35 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245974336,"BRASWELL, PENNY, WATSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 140 , 140 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245974336,"BRASWELL, PENNY, WATSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 202 , 202 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245976117,"LORBACHER, JOSHUA, EARL",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1245976117,"LORBACHER, JOSHUA, EARL",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1245980549,"PETERSON, LINDSAY, MEREDITH",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 46 , 69 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1245984012,"ROCHE, DUSTIN, EDWARD",1 HOSPITAL RD   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1245984012,"ROCHE, DUSTIN, EDWARD",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245985092,"MCKEITHAN, JELENA",160 BAKER RD   HIGH POINT NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,160 BAKER RD   HIGH POINT NC,076,Randolph,193200000X,Group,Multi-Specialty,,1245985092,"MCKEITHAN, JELENA",160 BAKER RD   HIGH POINT NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245985092,"MCKEITHAN, JELENA",160 BAKER RD   HIGH POINT NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245985092,"MCKEITHAN, JELENA",400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 32 , 79 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245985092,"MCKEITHAN, JELENA",400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 73 , 156 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245985092,"MCKEITHAN, JELENA",121 COUNTRY LN   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 44 , 102 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1245985092,"MCKEITHAN, JELENA",121 COUNTRY LN   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 130 , 322 ," $18,298.08 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1245988377,"POWELL, CHRISTINA, PETA-GAIL",615 RIDGE RD   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1245988450,"BIVENS, HANNAH, JAYNE",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 49 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1245988450,"BIVENS, HANNAH, JAYNE",7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1245988450,"BIVENS, HANNAH, JAYNE",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1245988781,"REDDICK, JOHNATHAN, BRETT",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 41 , 74 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1245988781,"REDDICK, JOHNATHAN, BRETT",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1245988963,"HEGLAND, ELIZABETH, ANNE",2277 NC 24-87   CAMERON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 59 , 158 ,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1245988963,"HEGLAND, ELIZABETH, ANNE",6801 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245992544,"RISSELL, KRISTEN, MANUSSELIS",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 27 , 38 , 38 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245992544,"RISSELL, KRISTEN, MANUSSELIS",2001 WESTON PKWY   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 90 , 119 , 202 ," $10,646.98 ",,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1245992544,"RISSELL, KRISTEN, MANUSSELIS",4214 N ROXBORO ST STE 104 DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1245993153,AMOR HOMECARE INC OF NC,,1263 ARROW PINE DR STE D105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1245993153,AMOR HOMECARE INC OF NC,1263 ARROW PINE DR STE D105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 979 , 979 ," $68,116.84 ",,
MEDICAID DIRECT,1245995851,ANGELIC TOUCH INC,,118 WOODLEA DR   MORGANTON NC,012,Burke,253Z00000X,Agencies,In Home Supportive Care,,1245995851,ANGELIC TOUCH INC,118 WOODLEA DR   MORGANTON NC,012,Burke,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,979 "," 1,979 "," $169,377.24 ",,
MEDICAID DIRECT,1245996107,A GRACIOUS TOUCH HOME CARE AGENCY,,1830 OWEN DR STE 202-1 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1245996107,A GRACIOUS TOUCH HOME CARE AGENCY,1830 OWEN DR STE 202-1 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 42 ," 3,920 "," 3,952 "," $330,242.59 ",,
MEDICAID DIRECT,1255002580,JUNEBUG SPEECH AND LANGUAGE THERAPY,,211 E SIX FORKS RD STE 219 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255002580,JUNEBUG SPEECH AND LANGUAGE THERAPY,211 E SIX FORKS RD STE 219 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 80 ," 1,956 "," 1,956 "," $132,601.21 ",,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255003794,"MERRICK, SARIAH, EVANS",2800 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 74 , 74 ,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255004834,"SPARKS, LAUREN, SYLVIA",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1255004834,"SPARKS, LAUREN, SYLVIA",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255004834,"SPARKS, LAUREN, SYLVIA",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255004834,"SPARKS, LAUREN, SYLVIA",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255004834,"SPARKS, LAUREN, SYLVIA",472 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 93 , 97 , 135 ," $29,727.77 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255004834,"SPARKS, LAUREN, SYLVIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255004834,"SPARKS, LAUREN, SYLVIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255005781,"WOLFE, KYLE, MARK",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 15 , 37 , 54 ,$#,,
MEDICAID DIRECT,1144284548,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH RAEFORD,1940 CLUB POND RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1255007183,"HODGES, MEAGHAN, ROSE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 77 , 138 , 399 ," $15,626.08 ",,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255007829,"SCHMIDT, GABRIELLA, HOPE",510 TIMBER DR E STE 102 GARNER NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255008405,"STOKES, SHAMARRA, YVONNE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 162 ," 1,081 "," 1,246 "," $27,938.85 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255008405,"STOKES, SHAMARRA, YVONNE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245419845,CAROMONT MEDICAL GROUP INC,~,700 N MAIN ST   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1255009049,"LANE, TONYA, COLEMAN",700 N MAIN ST   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 21 , 31 ,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255010674,"HODGE, CARLY, ALLISON",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255010674,"HODGE, CARLY, ALLISON",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 32 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255011086,"SOUZA, JULIANA, GAERTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 27 , 30 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255011086,"SOUZA, JULIANA, GAERTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 33 , 34 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255011722,"FRANKLIN, CARLEY, ANNE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 88 , 160 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255011722,"FRANKLIN, CARLEY, ANNE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 32 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255012514,"GRAIN, JOHN, DAVID",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255014551,"SIERADZAN, MADISON, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255014551,"SIERADZAN, MADISON, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255014551,"SIERADZAN, MADISON, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1255016408,"WEINER, JAMIE, ALYSSE",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 21 , 52 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255018131,"HOOKER, KATHERINE, HOPE",2133 ROCKFORD ST STE 1400 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 105 , 139 , 331 ,$#,,
MEDICAID DIRECT,1306981550,"SCAMMON, EDWARD, FLOYD",~,115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,1255025490,"BAADE, BROCK, HUNTER",115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114247822,EDWARD F SCAMMON DMD PA,~,115 SOUTHERN DUNES DR   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1255025490,"BAADE, BROCK, HUNTER",115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 936 ," 1,654 "," 5,166 "," $298,332.70 ",,
MEDICAID DIRECT,1598085227,EDWARD F SCAMMON DMD PA,EDWARD F SCAMMON DMD PA,327 TEAL DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1255025490,"BAADE, BROCK, HUNTER",327 TEAL DR   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 415 , 543 ," 1,791 "," $96,420.54 ",,
MEDICAID DIRECT,1154336642,LANE AND ASSOCIATES I DDS PA,LANE AND ASSOCIATES I DDS PA,1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1255026613,"COVEY, MADISON, ELIZABETH",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1639502727,LANE AND ASSOCIATES XXVII DDS PA,,4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1255026613,"COVEY, MADISON, ELIZABETH",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 120 , 158 , 528 ," $28,069.01 ",,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1255026613,"COVEY, MADISON, ELIZABETH",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 26 , 110 ,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255026613,"COVEY, MADISON, ELIZABETH",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice," 1,336 "," 2,372 "," 7,963 "," $385,348.89 ",,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255026613,"COVEY, MADISON, ELIZABETH",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1851931257,LANE AND ASSOCIATES XXXV DDS PA,,11180 E FINCH AVE   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1255026613,"COVEY, MADISON, ELIZABETH",102 S MAIN ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 224 , 313 ," 1,053 "," $51,354.30 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255038733,"OLAVE, ROCIO, GISEL",3000 COLISEUM DR STE 200 HAMPTON VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255040564,"SPURLING, TREVOR, GENE",434 KIRBY RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 41 , 45 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255040564,"SPURLING, TREVOR, GENE",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 59 , 68 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255040564,"SPURLING, TREVOR, GENE",112 KINDERTON BLVD STE 100 ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255040564,"SPURLING, TREVOR, GENE",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255040564,"SPURLING, TREVOR, GENE",137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 16 ,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255043626,"GREENWALD, BRANDY, RENEE",2525 COURT DR   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255043626,"GREENWALD, BRANDY, RENEE",2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1255046637,4K HOME CARE INC,,804 S GARNETT ST   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1255046637,4K HOME CARE INC,804 S GARNETT ST   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,#, 90 , 90 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1255047569,"HOLLYFIELD, CHAD, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1255047569,"HOLLYFIELD, CHAD, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 24 , 26 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255047569,"HOLLYFIELD, CHAD, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255047569,"HOLLYFIELD, CHAD, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255047569,"HOLLYFIELD, CHAD, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255047569,"HOLLYFIELD, CHAD, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255055711,"HEINRICH, JONATHAN, NEIL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255057485,"JOHNSON, KATHLEEN, ROSE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255057485,"JOHNSON, KATHLEEN, ROSE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 25 , 37 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255057485,"JOHNSON, KATHLEEN, ROSE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255059374,MIDAS CORPORATION,,5501 EXECUTIVE CENTER DR STE 245 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1255059374,MIDAS CORPORATION,5501 EXECUTIVE CENTER DR STE 245 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,401 "," 2,401 "," $133,366.92 ",,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1255061230,"WINBOURNE, LAUREN, NICOLE",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 28 , 35 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255061230,"WINBOURNE, LAUREN, NICOLE",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1255064945,"BROWN, ANDRE, DUCHAIN",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255064945,"BROWN, ANDRE, DUCHAIN",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255064945,"BROWN, ANDRE, DUCHAIN",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255067898,"EDWARDS, EUGENE, RAY",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1255067898,"EDWARDS, EUGENE, RAY",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 19 , 96 , 97 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255067898,"EDWARDS, EUGENE, RAY",695 W FLEMING DR   MORGANTON NC,012,Burke,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1831414150,ISLAND FAMILY MEDICINE,~,2540 NC HIGHWAY 210 E   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1255080453,"MARTIN, HAILEE, ANN",2540 NC HIGHWAY 210 E   HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 66 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255082426,"ROCCHIO, GIANNA, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255082426,"ROCCHIO, GIANNA, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255082442,"PAPA, CHLOE, ALEXIS",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255086690,"STANLEY, ADAM, NICHOLAS",7427 MATTHEWS MINT HILL RD STE 103 MINT HILL NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255086690,"STANLEY, ADAM, NICHOLAS",7427 MATTHEWS MINT HILL RD STE 103 MINT HILL NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 42 , 59 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255086690,"STANLEY, ADAM, NICHOLAS",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255087516,"VENTERS, ASHLEY, NIXON",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 129 , 219 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255088126,"WOODALL, FELICIA, MARIE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255088126,"WOODALL, FELICIA, MARIE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255088126,"WOODALL, FELICIA, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1255088126,"WOODALL, FELICIA, MARIE",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255088175,"LANDRETH, RACHEL, MORGAN",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255088241,"TASSONE, MALLORY, CHRISTINE",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255088241,"TASSONE, MALLORY, CHRISTINE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255088241,"TASSONE, MALLORY, CHRISTINE",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538626361,HAMMOCK DMD & LOTAKIS DDS III PLLC,DENTISTRY OF THE CAROLINAS - GASTONIA,2641 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255093035,"PUTZEYS, OLIVER",2641 COURT DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice," 1,075 "," 1,916 "," 6,598 "," $418,084.13 ",,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255101606,"HUEBSCH, MARISA, DAWN",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255101606,"HUEBSCH, MARISA, DAWN",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255103511,"MABE, ALLISON, KRISTIN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255111779,"FESTA, SARAH, SPRADLIN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255111779,"FESTA, SARAH, SPRADLIN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 48 , 66 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1255117719,"FAREWELL, JORDAN, MICHALEA",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 32 , 137 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1255117719,"FAREWELL, JORDAN, MICHALEA",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 117 , 304 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1255117719,"FAREWELL, JORDAN, MICHALEA",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1255151023,"MORELLI, SYDNEY, MARIE",2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1255151023,"MORELLI, SYDNEY, MARIE",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 20 , 53 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255151346,"COMISKEY, KARIS, ROSE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255151346,"COMISKEY, KARIS, ROSE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346540101,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255159422,"CONDER, LAUREN, HOPE",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1255179511,"MORTON, DANIEL, JESUS",835 ALBEMARLE RD   TROY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 69 , 128 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255185880,"SMITH, TAYLOR, MICHELLE",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 34 , 73 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255188140,"DECKER, JENNA, MARIE",2610 STANTONSBURG RD   GREENVILLE NC,074,Pitt,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255188686,"TATE, EMILY, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1255191797,CITYWIDE TRANSPORTATION LLC,,3100 N ELM ST APT 6C GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1255191797,CITYWIDE TRANSPORTATION LLC,3100 N ELM ST APT 6C GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 20 , 167 , 208 ," $18,828.94 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255300364,"TUTTLE, PATRICIA, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1255300372,"HANSON, DAVID, COLE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 21 , 33 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255301032,"DODDS, DOUGLAS, ALAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255301032,"DODDS, DOUGLAS, ALAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 88 , 89 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255301032,"DODDS, DOUGLAS, ALAN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255301032,"DODDS, DOUGLAS, ALAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255301032,"DODDS, DOUGLAS, ALAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255301289,"ZAHN, ROLAND, MANFRED",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255301289,"ZAHN, ROLAND, MANFRED",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1033738299,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY NEUROLOGY,3246 6TH AVE SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255302352,"LARSON, SETH, EDWARD",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 22 , 39 , 45 ,$#,,
MEDICAID DIRECT,1033738299,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY NEUROLOGY,52 12TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255302352,"LARSON, SETH, EDWARD",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 31 , 35 ,$#,,
MEDICAID DIRECT,1033738299,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY NEUROLOGY,52 12TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255302352,"LARSON, SETH, EDWARD",3246 6TH AVE SE STE 101 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1104512276,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY FAMILY CARE CENTER INDEPENDENCE,217 S INDEPENDENCE AVE   INDEPENDENCE VA,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255302410,"BLEVINS SPRINKLE, JULIE, ANN",961 E STUART DR   GALAX VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104512276,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY FAMILY CARE CENTER INDEPENDENCE,217 S INDEPENDENCE AVE   INDEPENDENCE VA,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255302410,"BLEVINS SPRINKLE, JULIE, ANN",217 S INDEPENDENCE AVE   INDEPENDENCE VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255303137,"KEIGER, JENNIFER, LYNN",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255303137,"KEIGER, JENNIFER, LYNN",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 35 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255304341,"THACKER, JULIE KAY, MAROSKY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255304341,"THACKER, JULIE KAY, MAROSKY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255304341,"THACKER, JULIE KAY, MAROSKY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255304341,"THACKER, JULIE KAY, MAROSKY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1255304697,"PENDERGRAST, KENNETH, ROY",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1255304697,"PENDERGRAST, KENNETH, ROY",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1255304697,"PENDERGRAST, KENNETH, ROY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255304697,"PENDERGRAST, KENNETH, ROY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255305413,"PEOPLES, LISA, LYNN",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1255305413,"PEOPLES, LISA, LYNN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255305918,"MOSCHOS, STERGIOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 47 , 48 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255306809,"LAPHAM, ROSANNA, LORENA",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1851620702,DAVID D OLSON DDS MS,RALEIGH PEDIATRIC DENTISTRY,10931 RAVEN RIDGE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255306999,"OLSON, DAVID, DOUGLAS",10931 RAVEN RIDGE RD STE 105 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 323 , 570 ," 1,967 "," $58,989.24 ",,
MEDICAID DIRECT,1255306999,"OLSON, DAVID, DOUGLAS",David Douglas Olson,10931 RAVEN RIDGE RD STE 105 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1255306999,"OLSON, DAVID, DOUGLAS",10931 RAVEN RIDGE RD STE 105 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 96 ,$#,,
MEDICAID DIRECT,1255308516,"PIEPER, TERRY, LEE",TERRY L PIEPER,821 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1255308516,"PIEPER, TERRY, LEE",821 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1255309746,"CHILES, BILL, ROBERT",,298 MEMORIAL DR   SENECA SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1255309746,"CHILES, BILL, ROBERT",298 MEMORIAL DR   SENECA SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255310314,"PALMER, SCOTT, PATRICK",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255311916,"FARMER, VICKIE, LYNN",1090 E CENTRAL AVE   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255311916,"FARMER, VICKIE, LYNN",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 60 , 60 ,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255311916,"FARMER, VICKIE, LYNN",806 HAY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881871622,EASTOVER FAMILY CARE PC,,,,Unknown,193400000X,Group,Single Specialty,,1255311916,"FARMER, VICKIE, LYNN",3551 DUNN RD STE 101 EASTOVER NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255311916,"FARMER, VICKIE, LYNN",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255312898,"WHITAKER, ROBERT, NORTON",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255312898,"WHITAKER, ROBERT, NORTON",330 JAKE ALEXANDER BLVD W STE 101 SALISBURY NC,080,Rowan,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 197 , 454 , 589 ,$#,,
MEDICAID DIRECT,1679727978,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PINNACLE EAR NOSE THROAT & ALLERGY,330 JAKE ALEXANDER BLVD W STE 101 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1255312898,"WHITAKER, ROBERT, NORTON",330 JAKE ALEXANDER BLVD W STE 101 SALISBURY NC,080,Rowan,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255312898,"WHITAKER, ROBERT, NORTON",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 23 , 26 , 41 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255313136,"MEWBORNE, JEFFREY, DUNMAN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 33 , 44 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255313532,"HARRIS, JASON, RANDALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 208 , 240 , 292 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1255313532,"HARRIS, JASON, RANDALL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255314092,"HOER, JAMES, BRIAN",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265942403,UBYLEE HEALTHCARE GROUP,,9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255314134,"LABS, JOHN, KENNETH",9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 363 , 812 ," $12,226.53 ",,
MEDICAID DIRECT,1255314605,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,2948 S NC 127 HWY   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255314605,MEDICAL SERVICES OF AMERICA INC,2948 S NC 127 HWY   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 178 , 817 ," 1,116 "," $19,945.24 ",,
MEDICAID DIRECT,1255314605,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,2948 S NC 127 HWY   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1255314605,MEDICAL SERVICES OF AMERICA INC,2948 S NC 127 HWY   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1255314704,LABORATORY CORPORATION OF AMERICA,LABORATORY CORPORATION OF AMERICA,5610 W LA SALLE ST   TAMPA FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1255314704,LABORATORY CORPORATION OF AMERICA,5610 W LA SALLE ST   TAMPA FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255314845,"AGNER, DAVID, MARSHAL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255314845,"AGNER, DAVID, MARSHAL",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 21 , 112 , 133 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255314845,"AGNER, DAVID, MARSHAL",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255314845,"AGNER, DAVID, MARSHAL",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255315651,"HOEKSTRA, JAMES, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255316311,"PICHARDO, RITA, OTILIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 104 , 134 , 154 ,$#,,
MEDICAID DIRECT,1255316709,"THOMAS, DWAYNE",~,5527 MONROE RD   CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,1255316709,"THOMAS, DWAYNE",5527 MONROE RD   CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255316840,"DUNN, JONATHAN, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255316840,"DUNN, JONATHAN, RICHARD",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255317673,"HIGGINSON, JASON, DOMINIC",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255317673,"HIGGINSON, JASON, DOMINIC",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1609851138,MOUNT AIRY EMERGENCY PHYSICIANS,MOUNT AIRY EMERGENCY PHYSICIANS,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1255317939,"VROOMAN, PETER, SCHUYLER",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 116 , 131 , 193 ,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,816 GREENBRIER CIR STE G CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255318069,"POWERS, STEVEN, BRIAN",667 KINGSBOROUGH SQ STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,1141 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1255318069,"POWERS, STEVEN, BRIAN",667 KINGSBOROUGH SQ STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,1101 MADISON PLZ STE 100&200 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255318069,"POWERS, STEVEN, BRIAN",667 KINGSBOROUGH SQ STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255319398,"FRONAPFEL, PAUL, JACOB",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 33 ,$#,,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1255320875,"WITCHER, NANCY, C",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 61 , 59 , 114 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 28 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 33 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245859453,TRIAD BREAST IMAGING CENTER LLC,NOVANT HEALTH BREAST IMAGING CENTER GREENSBORO,3515 W MARKET ST STE 320 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1255321360,"DOVER, CARON, LEE BOYD",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255321469,"SCHNEIDER, SCOTT, MATTHEW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255321469,"SCHNEIDER, SCOTT, MATTHEW",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255321469,"SCHNEIDER, SCOTT, MATTHEW",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255321469,"SCHNEIDER, SCOTT, MATTHEW",6324 FAIRVIEW RD STE 440 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255321469,"SCHNEIDER, SCOTT, MATTHEW",150 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1326006438,A WOMANS PLACE IN FAYETTEVILLE,A WOMANS PLACE IN FAYETTEVILLE,2053 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255323176,"DICKERSON, ANDREA, KAREN",2053 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 47 , 59 ,$#,,
MEDICAID DIRECT,1194327155,MED ONE SLEEP CENTER PLLC,,1340 WALTER REED RD STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",1340 WALTER REED RD STE 201 FAYETTEVILLE NC,026,Cumberland,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 22 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 253 , 843 ," 1,056 "," $17,264.18 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,341 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255323804,"ELNAGGER, AHMED, ISMAIL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1255324000,"COSME-MONTALVO, OCTAVIO",336 DEERFIELD RD   BOONE NC,095,Watauga,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255324372,"MENDOZA LATTES, SERGIO, ANDRES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255324372,"MENDOZA LATTES, SERGIO, ANDRES",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255326526,"PERKIN, RONALD, MURRAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 18 , 33 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255326526,"PERKIN, RONALD, MURRAY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962635540,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY MORGANTON,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1255327045,"BHALLA, HARPREET, SINGH",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 37 , 54 , 71 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255328340,"PARIKH, RAJIV, SANAT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255328753,"THOMPSON, JACQUELINE",864 US HWY 158 BUSINESS W   WARRENTON NC,093,Warren,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 223 , 270 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255328753,"THOMPSON, JACQUELINE",2501 DOWNING ST SW   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 193 , 249 ," $13,160.66 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255328753,"THOMPSON, JACQUELINE",1705 TARBORO ST SW   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 109 , 151 ," $14,026.98 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255328753,"THOMPSON, JACQUELINE",2578 W 5TH ST   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255328753,"THOMPSON, JACQUELINE",907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 69 , 77 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255328753,"THOMPSON, JACQUELINE",97 HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1255329025,"SEYMOUR, LORI, JEAN",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 52 , 84 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255329025,"SEYMOUR, LORI, JEAN",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255329108,"THOMAS, KARL, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255329108,"THOMAS, KARL, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 36 , 34 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255329108,"THOMAS, KARL, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 36 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255329108,"THOMAS, KARL, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 20 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255329108,"THOMAS, KARL, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 41 , 79 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255329777,"HOUSER, STEPHEN, ANDREW",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255329777,"HOUSER, STEPHEN, ANDREW",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 33 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255329777,"HOUSER, STEPHEN, ANDREW",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255329777,"HOUSER, STEPHEN, ANDREW",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 36 , 39 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255330098,"HINMAN, STEPHEN, PAUL",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255330098,"HINMAN, STEPHEN, PAUL",5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 46 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255330353,"WEST, THREVIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 38 , 59 , 79 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255330353,"WEST, THREVIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 19 , 16 , 18 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255330353,"WEST, THREVIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598765935,HILDEBRAN MEDICAL CLINIC,~,107 S CENTER ST   HILDEBRAN NC,012,Burke,193400000X,Group,Single Specialty,,1255331609,"SWISHER, AARON, VU",107 S CENTER ST   HILDEBRAN NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 299 , 690 ," $11,036.83 ",,
MEDICAID DIRECT,1790194322,CATAWBA VALLEY MEDICAL CENTER,,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255332292,"TRIVEDI, ATUL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 131 , 147 , 147 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255332292,"TRIVEDI, ATUL",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 14 , 19 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255332292,"TRIVEDI, ATUL",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 43 , 64 , 81 ,$#,,
MEDICAID DIRECT,1790194322,CATAWBA VALLEY MEDICAL CENTER,,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255332292,"TRIVEDI, ATUL",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255332292,"TRIVEDI, ATUL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 110 , 141 , 196 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1255333191,"LIM, ALEXANDER, JUNG HWAN",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1255333191,"LIM, ALEXANDER, JUNG HWAN",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1255333191,"LIM, ALEXANDER, JUNG HWAN",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 69 , 74 ,$#,,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1255333464,"SASSER, PAUL, WILLIAM",723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 151 , 255 , 418 ," $14,545.23 ",,
MEDICAID DIRECT,1902323561,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255334736,"BULLARD, TRACY, ELIZABETH",150 IVEY LN STE B PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 35 , 92 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255334934,"PATTERSON, DWAYNE, EDWARD",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1063948297,RDMG ASSOCIATES PA,SPINDALE FAMILY PRACTICE,144 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1255335022,"WASHBURN, HARRILL, GENE",144 RESERVATION DR   SPINDALE NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 219 , 452 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255336632,"MCQUEEN, SHANNON, DUDLEY",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255336632,"MCQUEEN, SHANNON, DUDLEY",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 25 , 65 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255336632,"MCQUEEN, SHANNON, DUDLEY",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255336632,"MCQUEEN, SHANNON, DUDLEY",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255337150,"ZUKAITIS, KELLY, RACHELLE",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 128 , 136 , 610 ," $15,164.38 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255337150,"ZUKAITIS, KELLY, RACHELLE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 43 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255337150,"ZUKAITIS, KELLY, RACHELLE",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 76 , 77 , 493 ," $31,529.02 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255337150,"ZUKAITIS, KELLY, RACHELLE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 26 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255337358,"LAMM, JAMES, DOMINIC",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255338026,"MITTELMAN, MARK, ARTHUR",262 LEROY GEORGE DR STE X CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1255338026,"MITTELMAN, MARK, ARTHUR",262 LEROY GEORGE DR STE X CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255339834,"KORRAPATI, MADHU, RAO",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 29 , 29 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255339834,"KORRAPATI, MADHU, RAO",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 64 , 65 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1255342226,"GARRETT, JAMETTE, RENEE",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1215314778,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM WOMENS CENTER,150 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1255342226,"GARRETT, JAMETTE, RENEE",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255342226,"GARRETT, JAMETTE, RENEE",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1215314778,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM WOMENS CENTER,150 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1255342226,"GARRETT, JAMETTE, RENEE",150 PARKWOOD DR   ELKIN NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,816 GREENBRIER CIR STE G CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255342770,"MATHISON EZIEME, LINDA, JOY",1101 MADISON PLZ STE 201 CHESAPEAKE VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1255345088,"HARRISON, CHARLOTTE, MILLS",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255345187,"BEAN, SARAH, MUNTZING",2301 ERWIN RD   DURHAM NC,032,Durham,207ZC0500X,Allopathic & Osteopathic Physicians,Pathology,Cytopathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255345187,"BEAN, SARAH, MUNTZING",2351 ERWIN RD   DURHAM NC,032,Durham,207ZC0500X,Allopathic & Osteopathic Physicians,Pathology,Cytopathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255345187,"BEAN, SARAH, MUNTZING",2301 ERWIN RD   DURHAM NC,032,Durham,207ZC0500X,Allopathic & Osteopathic Physicians,Pathology,Cytopathology, 109 , 110 , 172 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255345187,"BEAN, SARAH, MUNTZING",2301 ERWIN RD   DURHAM NC,032,Durham,207ZC0500X,Allopathic & Osteopathic Physicians,Pathology,Cytopathology, 13 , 14 , 24 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1255345633,"WHEATLEY, SAMUEL, NALLY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1255345633,"WHEATLEY, SAMUEL, NALLY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1255345633,"WHEATLEY, SAMUEL, NALLY",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 28 , 52 , 53 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1255345633,"WHEATLEY, SAMUEL, NALLY",627 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1255347324,"CHAN, GERALD, BORJA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396484572,PRECISION HEALTH PC,PRECISION HEALTH PC,5511 RAEFORD RD STE 150 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255347324,"CHAN, GERALD, BORJA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255347324,"CHAN, GERALD, BORJA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255347324,"CHAN, GERALD, BORJA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 27 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255347324,"CHAN, GERALD, BORJA",1110 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255347324,"CHAN, GERALD, BORJA",1110 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376752618,EASTERN ONCOLOGY & HEMATOLOGY,~,855 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255349361,"ABDALLAH, JORGE, MARIA",855 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376752618,EASTERN ONCOLOGY & HEMATOLOGY,~,855 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255349361,"ABDALLAH, JORGE, MARIA",855 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 53 , 104 , 113 ,$#,,
MEDICAID DIRECT,1780900589,DAVID E GALATAS DDS PA,CAMERON FAMILY DENTISTRY,1054 NC 24/87   CAMERON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255350617,"GALATAS, DAVID, EDWARD",1054 NC 24#87   CAMERON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 187 , 271 , 986 ," $61,965.43 ",,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,750 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1255351110,"JOHNSTON, SCOTT, RICHARD",250 HUFF DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1255351110,"JOHNSTON, SCOTT, RICHARD",250 HUFF DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1255351110,"JOHNSTON, SCOTT, RICHARD",250 HUFF DR   JACKSONVILLE NC,067,Onslow,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 119 , 213 ,$#,,
MEDICAID DIRECT,1255352035,"LOWERY, JOHN, ALBERT",~,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1255352035,"LOWERY, JOHN, ALBERT",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 ,#,#,$#,,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1255352035,"LOWERY, JOHN, ALBERT",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 36 , 38 , 53 ,$#,,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255352035,"LOWERY, JOHN, ALBERT",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 157 , 266 , 377 ," $12,268.46 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255352647,"RODDEY, PATRICIA, KOURY",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255354130,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,#,#, 15 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,11783 ROCK LANDING DR   NEWPORT NEWS VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255354130,CHILDRENS SPECIALTY GROUP PLLC,11783 ROCK LANDING DR   NEWPORT NEWS VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255354130,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,, 11 , 14 , 37 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255355194,"PUGH, RODNEY, VANCE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255355194,"PUGH, RODNEY, VANCE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1255355194,"PUGH, RODNEY, VANCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255355194,"PUGH, RODNEY, VANCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1659396893,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255357521,"GOURLEY, BLANTON, CRAIG",7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255358495,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1036,197 PLAZA DR   FOREST CITY NC,081,Rutherford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1255358495,WAL-MART STORES EAST LP,197 PLAZA DR   FOREST CITY NC,081,Rutherford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1255359501,"LOMBARD, TRACI, NICOLE",24 FALCON CREST LN HAYWOOD PROFESSIONAL PARKS CLYDE NC,044,Haywood,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 144 , 268 ," $16,797.84 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,3141 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255360079,"PYLE, JAMES",3141 CAPITAL BLVD STE 107 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 32 , 86 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255361309,"BIGGERSTAFF, DANIEL, SCOTT",180 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255361309,"BIGGERSTAFF, DANIEL, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255361309,"BIGGERSTAFF, DANIEL, SCOTT",445 PINEVIEW DR STE 220 KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255361309,"BIGGERSTAFF, DANIEL, SCOTT",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255361309,"BIGGERSTAFF, DANIEL, SCOTT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255361309,"BIGGERSTAFF, DANIEL, SCOTT",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 54 , 84 , 143 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255361317,"WITTLER, MARY, ANNETTE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 76 , 83 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 510 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255361986,"KHOUZAM, RAMI, NADIM",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255363669,"MITLEHNER, RICHARD, JOHN",101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255363990,"HUGHES, GEORGE, CHARLES",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 25 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255363990,"HUGHES, GEORGE, CHARLES",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255363990,"HUGHES, GEORGE, CHARLES",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255365227,"DZIAK, JASON, FRANCIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255366357,"FIETS, GREGORY, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 20 , 43 , 56 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255366357,"FIETS, GREGORY, LEE",180 PARKWOOD DR   ELKIN NC,086,Surry,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255367694,"KAKANI, RAMANAIAH",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255367694,"KAKANI, RAMANAIAH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255367694,"KAKANI, RAMANAIAH",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1508305293,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA CARDIOLOGY,709 WICKER ST STE A SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1255371605,"DENARDO, SCOTT, JEFFREY",709 WICKER ST STE A SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 30 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255371720,"HODGES, SARAH, HOLSTE",5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 16 , 22 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255371720,"HODGES, SARAH, HOLSTE",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 97 , 116 , 206 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1255371720,"HODGES, SARAH, HOLSTE",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255371720,"HODGES, SARAH, HOLSTE",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 38 , 47 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255371720,"HODGES, SARAH, HOLSTE",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,16525 HOLLY CREST LN STE 150   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255372090,"BARNES, DANIEL, BERNARD",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 39 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255372090,"BARNES, DANIEL, BERNARD",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 35 , 71 ,$#,,
MEDICAID DIRECT,1255372801,"BALDWIN, CREIGHTON, WILBUR",~,8001 RAINTREE LN STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1255372801,"BALDWIN, CREIGHTON, WILBUR",8001 RAINTREE LN STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 75 , 156 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255373288,"JOHNSON, DEBORAH, BEVERLEY",301 E WENDOVER AVE STE 315 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 32 , 84 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1255373288,"JOHNSON, DEBORAH, BEVERLEY",201 E WENDOVER AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255373288,"JOHNSON, DEBORAH, BEVERLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 46 , 102 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255373288,"JOHNSON, DEBORAH, BEVERLEY",201 E WENDOVER AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 157 , 277 , 557 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255373288,"JOHNSON, DEBORAH, BEVERLEY",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255373288,"JOHNSON, DEBORAH, BEVERLEY",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255373916,"WARNSBY, CARON",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255373916,"WARNSBY, CARON",250 NASH MEDICAL ARTS MALL STE A ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 19 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255373916,"WARNSBY, CARON",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 84 , 87 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255373916,"WARNSBY, CARON",250 NASH MEDICAL ARTS MALL STE A ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 20 , 22 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255374765,"OXFORD, WILLIAM, JEROME",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 40 , 96 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1255374765,"OXFORD, WILLIAM, JEROME",12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1255374765,"OXFORD, WILLIAM, JEROME",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 45 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1255374765,"OXFORD, WILLIAM, JEROME",10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 84 , 149 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255377990,"MORENO, CAREY, HAGLER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 30 , 31 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255377990,"MORENO, CAREY, HAGLER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,, 11 , 70 , 137 ,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255381117,"LEONARD, ANITHA, MADHURE",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255381117,"LEONARD, ANITHA, MADHURE",7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",840 FLEMING ST STE 6 HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",11 PARK TERRACE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",11 PARK TERRACE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",100 SPAULDING RD STE 2 MARION NC,059,McDowell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 37 , 67 , 99 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 111 , 112 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",93 FAMILY CHURCH RD   MURPHY NC,020,Cherokee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 12 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",1600 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 113 , 114 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 42 , 64 , 90 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 85 , 85 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 82 , 128 , 194 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",1600 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255382214,"VO, NAM, DAI",53 ECHOTA CHURCH RD   CHEROKEE NC,087,Swain,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255382339,"GREEN, CHARLENE, EDWARDS",600 GREEN VALLEY RD STE 304 GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255382339,"GREEN, CHARLENE, EDWARDS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255382354,"BEAVER, JOHN",110 N BROWN ST   CHADBOURN NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1598143836,GOSHEN MEDICAL CENTER INCORPORATED,~,110 N BROWN ST   CHADBOURN NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255382354,"BEAVER, JOHN",110 N BROWN ST   CHADBOURN NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255382867,"SOUTH, BETHANY, JULY",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 34 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255382867,"SOUTH, BETHANY, JULY",650 JULIAN RD   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 121 , 322 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255383204,"COX, MARCUS, TIMOTHY",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",600 HOSPITAL DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 79 , 139 , 336 ," $10,171.48 ",,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",14166 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 38 , 38 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 59 , 84 , 237 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",14166 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",14166 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255383410,"FOTIADIS, CHRIS, NEIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255383428,"AGBEMABIESE, MARTIN, KWAKU",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 59 , 178 , 179 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255383428,"AGBEMABIESE, MARTIN, KWAKU",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255385068,"TSE, ALEX, YU CHOW",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,207RB0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Obesity Medicine,#,#,#,$#,,
MEDICAID DIRECT,1467093583,CHEROKEE MEDICAL CENTER,CMC - CENTER FOR FAMILY MEDICINE - GRASSY POND,517 CHESNEE HWY   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255386520,"MCCURRY, TROY, D",517 CHESNEE HWY STE A GAFFNEY SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255386629,"FANCEY, JASON, TERRENCE",601 N ELM ST   HIGH POINT NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255386629,"FANCEY, JASON, TERRENCE",601 N ELM ST   HIGH POINT NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 98 , 102 , 146 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255387098,"BRINSON, ALLYSON, BRIGHT",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255388096,"YOW, MARY, ELIZABETH",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255388096,"YOW, MARY, ELIZABETH",520 ALLEN ST   TROY NC,062,Montgomery,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1619099256,FAMILY MEDICAL ASSOCS OF RALEIGH,,3500 BUSH ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255390795,"CARR, JOSIAH, M",3500 BUSH ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 33 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255390803,"TRIPP, JOSEPH, ELLIOTT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 66 , 67 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255390803,"TRIPP, JOSEPH, ELLIOTT",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1255391314,"GILL, CHARLES, DENVER",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1255391991,"MCCLINTON, DIANA, CHRISTINE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 33 , 43 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255392536,"THONGTEUM, BOONPON",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 103 , 132 , 191 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1188 YADKINVILLE RD   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1255393831,"MCNEIL, ALISON, LEAH",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255393831,"MCNEIL, ALISON, LEAH",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 91 , 145 ,$#,,
MEDICAID DIRECT,1144259961,ALLCARE CLINICAL ASSOCIATES PA,~,34 GRANBY ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255394862,"LEIS, AARON, DANIEL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255396198,"GOLDSTEIN, RICHARD",RICHARD A GOLDSTEIN MD,857 S BECKFORD DR STE E HENDERSON NC,091,Vance,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,1255396198,"GOLDSTEIN, RICHARD",857 S BECKFORD DR STE E HENDERSON NC,091,Vance,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 98 , 137 , 243 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255396446,"FISHER, DOROTHY, RAE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255396446,"FISHER, DOROTHY, RAE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255396446,"FISHER, DOROTHY, RAE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255396446,"FISHER, DOROTHY, RAE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255397105,"AINOLHAYAT, CECILIA, VALERIA",2112 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255397105,"AINOLHAYAT, CECILIA, VALERIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255397105,"AINOLHAYAT, CECILIA, VALERIA",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 65 , 96 ,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255397105,"AINOLHAYAT, CECILIA, VALERIA",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255397477,"KOK, BOON, CHENG",6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 38 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255399069,"BLAKER, ALAN, MICHAEL",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255399069,"BLAKER, ALAN, MICHAEL",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255399705,"FISHER, STEPHEN",1975 GLENN MITCHELL DRIVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255399705,"FISHER, STEPHEN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255399705,"FISHER, STEPHEN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255399721,"ROY-CHAUDHURY, PRABIR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255399721,"ROY-CHAUDHURY, PRABIR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255399721,"ROY-CHAUDHURY, PRABIR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255399721,"ROY-CHAUDHURY, PRABIR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255400016,"MILLER, DAVID, EDWARD",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 142 ,$#,,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255400016,"MILLER, DAVID, EDWARD",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1801945118,CUMBERLAND MEDICAL ASSOCS,~,2125 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255400321,"DALVI, SUMEDHA, SANJIV",2125 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1801945118,CUMBERLAND MEDICAL ASSOCS,~,2125 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255400321,"DALVI, SUMEDHA, SANJIV",5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801945118,CUMBERLAND MEDICAL ASSOCS,~,2125 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255400321,"DALVI, SUMEDHA, SANJIV",5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801945118,CUMBERLAND MEDICAL ASSOCS,~,5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255400321,"DALVI, SUMEDHA, SANJIV",2125 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 132 , 226 ,$#,,
MEDICAID DIRECT,1801945118,CUMBERLAND MEDICAL ASSOCS,~,5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255400321,"DALVI, SUMEDHA, SANJIV",5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 144 , 255 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1255401501,"HILAMAN, BRAD, LEE",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255401758,"LOWE, MELANIE, MAYNOR",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255401758,"LOWE, MELANIE, MAYNOR",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255401758,"LOWE, MELANIE, MAYNOR",7921 ACC BLVD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255403788,"ALDRICH, SHELIA, KAY",1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255404067,"SAMAREL, MATTHEW, DAVID",8169 ARDREY KELL RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255408498,"BENESKY, WILLIAM, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255408498,"BENESKY, WILLIAM, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255408498,"BENESKY, WILLIAM, THOMAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255408498,"BENESKY, WILLIAM, THOMAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255408498,"BENESKY, WILLIAM, THOMAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255412144,"SOZA, FELICIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255412656,A PRIMARY CHOICE INC,~,302 N MAIN ST STE 2 KENANSVILLE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,1255412656,A PRIMARY CHOICE INC,302 N MAIN ST STE 2 KENANSVILLE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,, 42 ," 6,561 "," 6,561 "," $422,748.76 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255413852,"BULA, MELANIA, LIZA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 17 , 26 , 35 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255414413,"FERENCIK, CANDACE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255414413,"FERENCIK, CANDACE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255414496,"BYTOMSKI, JEFFREY, RYSZARD",3475 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 24 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255414496,"BYTOMSKI, JEFFREY, RYSZARD",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255415147,"PREMINGER, GLENN, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 20 , 25 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255415311,"JAFFE, GLENN, JAY",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 78 , 134 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255415311,"JAFFE, GLENN, JAY",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 35 , 80 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255417846,"CHRISTENSEN, JOHN, ROBERT",121 W WOODCROFT PKWY   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 146 , 373 , 470 ," $58,383.08 ",,
MEDICAID DIRECT,1255546420,JOHN R CHRISTENSEN DDS MS MS PA,DURHAM PEDIATRIC DENTISTRY,121 W WOODCROFT PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255417846,"CHRISTENSEN, JOHN, ROBERT",121 W WOODCROFT PKWY   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255418851,"CAMPBELL, FAYE, SHERWOOD",15825 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255418851,"CAMPBELL, FAYE, SHERWOOD",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 32 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255421434,"ELLIS, ALEXANDER, REED",500 DISCOVERY DR STE 300 CHESAPEAKE VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255421434,"ELLIS, ALEXANDER, REED",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 28 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1255422606,"SONG, HYUN, MIN",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255423778,"MCDONALD, CAROLYN, DIXON",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942412713,GEORGE R KILPATRICK JR MD PA,~,601 E MARKET ST STE A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1255426177,"KILPATRICK, GEORGE, ROOSEVELT",601 E MARKET ST STE A GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 225 , 227 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255428355,"BREAM, PETER, REYNOLDS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1255428355,"BREAM, PETER, REYNOLDS",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255428355,"BREAM, PETER, REYNOLDS",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255429502,"CARMAC, ELIZABETH, BEAUVAIS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255434023,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04196,115 RESERVOIR RD   BURNSVILLE NC,100,Yancey,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1255434023,NORTH CAROLINA CVS PHARMACY LLC,115 RESERVOIR RD   BURNSVILLE NC,100,Yancey,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1255434023,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04196,115 RESERVOIR RD   BURNSVILLE NC,100,Yancey,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1255434023,NORTH CAROLINA CVS PHARMACY LLC,115 RESERVOIR RD   BURNSVILLE NC,100,Yancey,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1255434023,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04196,115 RESERVOIR RD   BURNSVILLE NC,100,Yancey,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255434023,NORTH CAROLINA CVS PHARMACY LLC,115 RESERVOIR RD   BURNSVILLE NC,100,Yancey,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1255434379,"LOWE, TRAVIS, DANIEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 31 , 31 ,$#,,
MEDICAID DIRECT,1255434924,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07320,717 HIGHWAY ST   MADISON NC,079,Rockingham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255434924,NORTH CAROLINA CVS PHARMACY LLC,717 HIGHWAY ST   MADISON NC,079,Rockingham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1255434924,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07320,717 HIGHWAY ST   MADISON NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1255434924,NORTH CAROLINA CVS PHARMACY LLC,717 HIGHWAY ST   MADISON NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1255434924,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07320,717 HIGHWAY ST   MADISON NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1255434924,NORTH CAROLINA CVS PHARMACY LLC,717 HIGHWAY ST   MADISON NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255437117,"RODBERG, GARY, MICHAEL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 23 , 23 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255437117,"RODBERG, GARY, MICHAEL",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 47 , 61 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255437117,"RODBERG, GARY, MICHAEL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 25 , 30 , 34 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255437117,"RODBERG, GARY, MICHAEL",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 63 , 110 , 120 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255438081,"WILKINS, JENNIFER, CHRISTIAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255438081,"WILKINS, JENNIFER, CHRISTIAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255438081,"WILKINS, JENNIFER, CHRISTIAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255438081,"WILKINS, JENNIFER, CHRISTIAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1255440186,"BALDWIN, SARA, MARIE",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 39 , 90 ,$#,,
MEDICAID DIRECT,1255441333,"HOWELL-HASTINGS, ANIKA, LAWAYNE",~,1210 E MARION ST   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice,1255441333,"HOWELL-HASTINGS, ANIKA, LAWAYNE",1210 E MARION ST   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 21 , 54 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255443347,"BRIGGS, STEVEN, LAMAR",14035 GRANDIFLORA DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255443347,"BRIGGS, STEVEN, LAMAR",14035 GRANDIFLORA DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255443347,"BRIGGS, STEVEN, LAMAR",14035 GRANDIFLORA DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255443347,"BRIGGS, STEVEN, LAMAR",14035 GRANDIFLORA DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 29 ,$#,,
MEDICAID DIRECT,1912962697,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255444998,"BRAUNSTEINER, MELISSA",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255444998,"BRAUNSTEINER, MELISSA",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063689503,PALMETTO DENTURE CARE PA,Palmetto Denture Care PA,975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255445979,"FIELDS, JAMES, KEITH",975 N CHURCH ST   SPARTANBURG SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 55 , 68 , 295 ," $35,541.47 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255447165,"FIX, OREN, KADOURI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 61 , 86 , 98 ,$#,,
MEDICAID DIRECT,1255449922,PROVISION HOME CARE LLC,~,124 MAIN ST E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1255449922,PROVISION HOME CARE LLC,124 MAIN ST E   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,, 63 ," 13,735 "," 14,063 "," $1,198,122.24 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1255450532,"PYREDDY, PAVAN",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1255450532,"PYREDDY, PAVAN",1139 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1255450532,"PYREDDY, PAVAN",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1255450532,"PYREDDY, PAVAN",1139 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 30 , 30 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255450532,"PYREDDY, PAVAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 45 , 45 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255450532,"PYREDDY, PAVAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 45 , 45 ,$#,,
MEDICAID DIRECT,1255456380,HINES HOME INC,PARKVIEW FAMILY CARE HOME,2778 REYNOLDS PARK RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255456380,HINES HOME INC,2778 REYNOLDS PARK RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 117 , 117 ," $21,302.18 ",,
MEDICAID DIRECT,1255456380,HINES HOME INC,PARKVIEW FAMILY CARE HOME,2224 MANCHESTER ST   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255456380,HINES HOME INC,2224 MANCHESTER ST   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 234 , 234 ," $45,298.66 ",,
MEDICAID DIRECT,1255456513,PEDIATRIC HANDS ON THERAPY PC,PEDIATRIC HANDS ON THERAPY PC,2557 PEMBROKE RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255456513,PEDIATRIC HANDS ON THERAPY PC,2557 PEMBROKE RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,, 240 ," 3,688 "," 4,636 "," $335,982.31 ",,
MEDICAID DIRECT,1649615741,HEARING SOLUTIONS OF NORTH CAROLINA,~,464 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1255457511,"ODEN, LORIN, STAR",464 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1255457610,"HANACHI, FARID",FARID HANACHI,1377 E GARRISON BLVD STE A GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1255457610,"HANACHI, FARID",1377 E GARRISON BLVD STE A GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 507 ," 1,617 "," 1,913 "," $271,408.57 ",,
MEDICAID DIRECT,1255457610,"HANACHI, FARID",FARID HANACHI,367 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1255457610,"HANACHI, FARID",367 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 274 , 469 , 557 ," $87,636.20 ",,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",11 PARK TERRACE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",11 PARK TERRACE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 80 , 80 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",374 US 70 W   MARION NC,059,McDowell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 53 , 54 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",374 US 70 W   MARION NC,059,McDowell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 83 , 83 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 30 , 49 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",575 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 32 , 57 , 83 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",1600 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 30 , 88 , 88 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 52 , 52 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",171 TSALI CARE WAY   CHEROKEE NC,087,Swain,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",226 COMMERCIAL ST   FOREST CITY NC,081,Rutherford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",226 COMMERCIAL ST   FOREST CITY NC,081,Rutherford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255460200,"PRUITT, WESLEY, BLAKE",53 ECHOTA CHURCH RD   CHEROKEE NC,087,Swain,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1255462891,"EDWARDS, BO, KYUNG",~,26 SUNNYBROOK DR   SPRUCE PINE NC,061,Mitchell,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1255462891,"EDWARDS, BO, KYUNG",26 SUNNYBROOK DR   SPRUCE PINE NC,061,Mitchell,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 24 , 402 , 423 ," $29,519.40 ",,
MEDICAID DIRECT,1255468856,"MISTRY, LINABEN, VIPUL",~,10410 PARK RD STE 500A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1255468856,"MISTRY, LINABEN, VIPUL",10410 PARK RD STE 500A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 349 , 826 ," 3,045 "," $113,562.80 ",,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255469755,"CONNER, LONDYN, VICTORIA",1207 EAST ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 26 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255469755,"CONNER, LONDYN, VICTORIA",44 BONNIE LN   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 133 , 135 ," $12,821.25 ",,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255471181,"MAGOLAN, JEROME, JOSEPH",3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 82 , 139 ," $11,535.18 ",,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255471819,"DUNLAP, WILLIAM, MARSHALL",3521 HAWORTH DR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255471819,"DUNLAP, WILLIAM, MARSHALL",3521 HAWORTH DR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 484 , 484 ,$#,,
MEDICAID DIRECT,1306904917,COUNTY OF PITT OFFICE OF AUDITOR,PITT COUNTY HEALTH DEPT,201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1255472130,"SPAIN, RENEE, OAKLEY",201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 17 , 15 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1255475364,"THOMAS, KEVIN, LINDSEY",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 15 , 17 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255475364,"THOMAS, KEVIN, LINDSEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255475364,"THOMAS, KEVIN, LINDSEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 23 , 24 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255475364,"THOMAS, KEVIN, LINDSEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255476636,"UDWADIA, JAMIE",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255476636,"UDWADIA, JAMIE",608 ACADEMY ST S   AHOSKIE NC,046,Hertford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 183 , 816 , 838 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255476636,"UDWADIA, JAMIE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255476974,"VRANIC, GAYLE, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 55 , 101 , 135 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255476974,"VRANIC, GAYLE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1861003725,AMAZING ACHIEVEMENTS OCCUPATIONAL T,,8120 SIDBURY RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255477147,"DAVIS, JENNIFER, ANN",8120 SIDBURY RD   WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1326450743,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY & INTERNAL MEDICINE,2293 SUGAR HILL RD STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1255480182,"BREINER, ERIN, CHRISTINE",2293 SUGAR HILL RD STE A MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1326450743,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY & INTERNAL MEDICINE,2293 SUGAR HILL RD STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1255480182,"BREINER, ERIN, CHRISTINE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962635540,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY MORGANTON,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1255480182,"BREINER, ERIN, CHRISTINE",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 90 , 93 ,$#,,
MEDICAID DIRECT,1962635540,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY MORGANTON,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1255480182,"BREINER, ERIN, CHRISTINE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 39 , 41 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255481180,"LEVY, MATTHEW, EVAN",500 PINEVIEW DR STE 101 KERNERSVILLE NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 11 , 27 ,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255481180,"LEVY, MATTHEW, EVAN",500 PINEVIEW DR STE 101 KERNERSVILLE NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 28 , 40 , 68 ,$#,,
MEDICAID DIRECT,1710510490,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH TRIAD ENDOCRINE-GREENSBORO,3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255481180,"LEVY, MATTHEW, EVAN",3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255481180,"LEVY, MATTHEW, EVAN",3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 46 , 63 , 157 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255481180,"LEVY, MATTHEW, EVAN",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1689804106,NORTH CAROLINA ORTHOTICS AND PROSTH,North Carolina Orthotics and Prosthetics of Goldsb,1306 WAYNE MEMORIAL DR STE C GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255481347,"STAUFFER, WILLIAM, STANLEY",1306 WAYNE MEMORIAL DR STE C GOLDSBORO NC,096,Wayne,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 30 ,$#,,
MEDICAID DIRECT,1689804106,NORTH CAROLINA ORTHOTICS AND PROSTH,North Carolina Orthotics and Prosthetics of Goldsb,1306 WAYNE MEMORIAL DR STE C GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255481347,"STAUFFER, WILLIAM, STANLEY",1306 WAYNE MEMORIAL DR STE C GOLDSBORO NC,096,Wayne,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1710307327,STEPHANIE MYLES PC,MYLES FAMILY DENTISTRY,404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255484309,"MYLES, STEPHANIE, ANN",404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 770 ," 1,083 "," 3,466 "," $168,947.10 ",,
MEDICAID DIRECT,1427720739,"HOLMGREN, JORDAN, WALTER",JORDAN HOLMGREN DDS PLLC,404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1255484309,"MYLES, STEPHANIE, ANN",404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1255484309,"MYLES, STEPHANIE, ANN",MYLES FAMILY DENTISTRY,404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1255484309,"MYLES, STEPHANIE, ANN",404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 604 , 836 ," 3,477 "," $110,672.80 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255485645,"OVERBY, PHILIP, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 12 , 27 , 27 ,$#,,
MEDICAID DIRECT,1255485959,RENU LIFE LLC,,102 TINDERWOOD DR   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255485959,RENU LIFE LLC,102 TINDERWOOD DR   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 37 , 37 ," $34,822.59 ",,
MEDICAID DIRECT,1255485959,RENU LIFE LLC,,802 S TAYLOR ST   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255485959,RENU LIFE LLC,802 S TAYLOR ST   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 82 , 82 ," $102,732.24 ",,
MEDICAID DIRECT,1255485959,RENU LIFE LLC,,103 LAKEVIEW DR   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255485959,RENU LIFE LLC,103 LAKEVIEW DR   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1255488805,EASTERN RETIREMENT CENTERS INC,AUTUMNFIELD OF BELHAVEN,1345 SEED TICK NECK RD   PINETOWN NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255488805,EASTERN RETIREMENT CENTERS INC,1345 SEED TICK NECK RD   PINETOWN NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 3,157 "," 3,157 "," $212,798.56 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255491585,"PORTER, LEWIS, GORDON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1255491585,"PORTER, LEWIS, GORDON",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 63 , 68 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1255493953,"UBALDE, JOSE, LOPEZ",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255493953,"UBALDE, JOSE, LOPEZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255493953,"UBALDE, JOSE, LOPEZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538563473,EAST CAROLINA UNIVERSITY,~,600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1427452283,EAST CAROLINA UNIVERSITY,~,100 BRUNSWICK MEDICAL CENTER PKWY NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",100 BRUNSWICK MEDICAL CENTER PKWY NE   BOLIVIA NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1273 MAIN ST   SWANQUARTER NC,048,Hyde,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",1273 MAIN ST   SWANQUARTER NC,048,Hyde,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1942633482,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 23 ,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",1273 MAIN ST   SWANQUARTER NC,048,Hyde,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1255497582,"TEMPEL, THOMAS, ROBERT",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1255499737,"FRESHWATER, JAMES, WILLIS",~,6270 TOWNCENTER DR   CLEMMONS NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,1255499737,"FRESHWATER, JAMES, WILLIS",6270 TOWNCENTER DR   CLEMMONS NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 27 , 28 , 43 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255506515,"PERSONS, MARY ANNE",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 115 , 151 , 303 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255506515,"PERSONS, MARY ANNE",3518 DRAWBRIDGE PKWY STE 240 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255507521,"YANCEY, JOEL, BENTON",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255507521,"YANCEY, JOEL, BENTON",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255507521,"YANCEY, JOEL, BENTON",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255507521,"YANCEY, JOEL, BENTON",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1659695781,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255507521,"YANCEY, JOEL, BENTON",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1659695781,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255507521,"YANCEY, JOEL, BENTON",16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255508107,"SHAH, KEVIN, NARESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255508107,"SHAH, KEVIN, NARESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255509261,"GEARDING, DAVID, JOSEPH",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033622618,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CANCER INSTITUTE,,,Unknown,193200000X,Group,Multi-Specialty,,1255510970,"ELLIOTT, KATHLEEN, MARILYN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255510970,"ELLIOTT, KATHLEEN, MARILYN",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 12 , 19 , 32 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255510970,"ELLIOTT, KATHLEEN, MARILYN",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255510970,"ELLIOTT, KATHLEEN, MARILYN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 38 , 64 , 91 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255510970,"ELLIOTT, KATHLEEN, MARILYN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255510970,"ELLIOTT, KATHLEEN, MARILYN",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255511028,"ABDEL NOUR, SOUHEIL, MOUNIR",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255511028,"ABDEL NOUR, SOUHEIL, MOUNIR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255511028,"ABDEL NOUR, SOUHEIL, MOUNIR",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 44 , 86 , 106 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255511028,"ABDEL NOUR, SOUHEIL, MOUNIR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255513214,"PRESTOL, DIEGO, ESPAILLAT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 122 , 140 , 155 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255514071,"MZHAVANADZE, PATMAN",4000 COLISEUM DR STE 445 HAMPTON VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255514188,"LATA, ADRIAN, LUCIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 37 , 50 ,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1255514584,"HILL, JEREMY, RYAN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1255514584,"HILL, JEREMY, RYAN",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255517405,"KRAJEWSKI, LAUREN, LYNN",100 PERKINS DR   CHAPEL HILL NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,700 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255519708,"BURN, JENNIFER, LANE",721 TILGHMAN DR STE 100 DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 19 , 36 ,$#,,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,716 S 10TH ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255519708,"BURN, JENNIFER, LANE",716 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 122 , 185 ,$#,,
MEDICAID DIRECT,1861213225,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY ORTHOPEDICS AND SPORTS MEDICINE,225 BRIGHTWATER DR STE 200 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255519708,"BURN, JENNIFER, LANE",225 BRIGHTWATER DR STE 200 LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 63 , 112 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255521126,"GEORGE, AYODEJI, TOKUNBO",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1255521126,"GEORGE, AYODEJI, TOKUNBO",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1255522454,ADAPT INCORPORATED,~,1206 N ELLIS AVE   DUNN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,,1255522454,ADAPT INCORPORATED,1206 N ELLIS AVE   DUNN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 3,664 "," 3,664 "," $239,583.06 ",,
MEDICAID DIRECT,1255523429,THE AUTUMN GROUP INC,OAK HILL LIVING CENTER,9767 NC 210 N   ANGIER NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255523429,THE AUTUMN GROUP INC,9767 NC 210 N   ANGIER NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 144 , 144 ," $43,213.62 ",,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255523791,"ALTMAN, DAVID, ABRAHAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255523791,"ALTMAN, DAVID, ABRAHAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255523791,"ALTMAN, DAVID, ABRAHAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 25 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255523791,"ALTMAN, DAVID, ABRAHAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255523791,"ALTMAN, DAVID, ABRAHAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255523791,"ALTMAN, DAVID, ABRAHAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 27 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255523791,"ALTMAN, DAVID, ABRAHAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 355 , 382 , 465 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255524435,"WATSON, DEREK, PHILLIP",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 124 , 222 , 463 ,$#,,
MEDICAID DIRECT,1679913651,PINEVILLE PEDIATRICS PLLC,~,10700 KETTERING DR STE D CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255525614,"JAMMALAMADAKA, SATYA, SMITHA",10700 KETTERING DR STE D CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 69 , 149 ,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255526232,"SUTTON, JEFFREY, RICHARD",224 JORDAN RIDGE WAY   JAMESTOWN NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 163 , 163 , 168 ,$#,,
MEDICAID DIRECT,1255527453,NEXT STEP DEVELOPMENTAL LEARNING LL,NEXT STEP DEVELOPMENTAL LEARNING,581 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,1255527453,NEXT STEP DEVELOPMENTAL LEARNING LL,581 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,, 19 , 245 , 245 ," $15,876.00 ",,
MEDICAID DIRECT,1255527453,NEXT STEP DEVELOPMENTAL LEARNING LL,NEXT STEP DEVELOPMENTAL LEARNING,576 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,1255527453,NEXT STEP DEVELOPMENTAL LEARNING LL,576 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,, 28 , 395 , 395 ," $25,531.20 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255529558,"LANE, DOUGLAS, TIMOTHY",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 187 , 203 , 207 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255530978,"KANE, BRIAN, ROBERT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1255532081,"SISK, LISA, SMITH",201 E GROVER ST   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1255532081,"SISK, LISA, SMITH",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1255532081,"SISK, LISA, SMITH",110 W GROVER ST   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1255532537,BANKS EYE CARE OD PLLC,~,1401 E MAIN ST   HAVELOCK NC,025,Craven,193200000X,Group,Multi-Specialty,,1255532537,BANKS EYE CARE OD PLLC,1401 E MAIN ST   HAVELOCK NC,025,Craven,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255532883,"DURST, CHRISTOPHER, ROBERT",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1255533857,"VOGEL, ALEXANDER, ROSS",3421 CHEECHAKO DR   RENO NV,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",1307 FREEWAY DR   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",1307 FREEWAY DR   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 35 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",2019 N CHURCH ST   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",2019 N CHURCH ST   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",3325 GARDEN RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 46 , 97 , 166 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 73 , 73 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",3325 GARDEN RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255534004,"KOLLURU, SARATH, CHANDRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1518697127,SUMMIT MEDICAL CAROLINAS PLLC,,8430 REA RD STE E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255534343,"PATEL, PRADEEP, REDDY",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 206 , 465 , 515 ," $11,137.41 ",,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1255534376,"GABORIK, JEREMY, CARL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255536165,"LANDA, ISRAEL",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255536165,"LANDA, ISRAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 68 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255538088,"CASHEN, KATHERINE, O'BRIEN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255539326,"TRAN, NHA, PHONG",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255539326,"TRAN, NHA, PHONG",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255539326,"TRAN, NHA, PHONG",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 27 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255539706,"MURPHY, CHRISTINE, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207PT0002X,Allopathic & Osteopathic Physicians,Emergency Medicine,Medical Toxicology, 32 , 34 , 50 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255539706,"MURPHY, CHRISTINE, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255545448,"MYERS, ERINN, MICHELLE",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 13 , 23 ,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255545448,"MYERS, ERINN, MICHELLE",10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255545448,"MYERS, ERINN, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1255560546,"GOOD, NURICA, NICOLE",~,603 S AYERSVILLE RD   MAYODAN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1255560546,"GOOD, NURICA, NICOLE",603 S AYERSVILLE RD   MAYODAN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 105 , 253 , 657 ," $30,995.77 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255561189,"TAOUDI-BENCHEKROUN, MOHAMMED",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255561627,"HERNANDEZ, JOSE, JAVIER",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255561627,"HERNANDEZ, JOSE, JAVIER",3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255561627,"HERNANDEZ, JOSE, JAVIER",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 35 , 35 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255562419,"TITCHINER, DANIELA, MATIAS FEITOSA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 51 , 55 ," $16,078.53 ",,
MEDICAID DIRECT,1255564308,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 11349,1106B MAIN STREET EXT   SWANSBORO NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255564308,NORTH CAROLINA CVS PHARMACY LLC,1106B MAIN STREET EXT   SWANSBORO NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1255564308,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 11349,1106B MAIN STREET EXT   SWANSBORO NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1255564308,NORTH CAROLINA CVS PHARMACY LLC,1106B MAIN STREET EXT   SWANSBORO NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255564977,"POKHREL, LAXMAN, RAJ",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255564977,"POKHREL, LAXMAN, RAJ",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255564977,"POKHREL, LAXMAN, RAJ",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 94 , 95 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255564977,"POKHREL, LAXMAN, RAJ",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 59 , 59 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255566154,"GORE, TEDDIE, WAYNE",1403 S KING ST   WINDSOR NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1255566154,"GORE, TEDDIE, WAYNE",1403 S KING ST   WINDSOR NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 51 , 51 ," $20,344.56 ",,
MEDICAID DIRECT,1578541660,EAST CAROLINA HEALTH BERTIE,Cashie Medical Center Windsor,1403 S KING ST   WINDSOR NC,008,Bertie,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255566154,"GORE, TEDDIE, WAYNE",1403 S KING ST   WINDSOR NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 130 , 267 , 337 ," $11,133.56 ",,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1255566154,"GORE, TEDDIE, WAYNE",1403 S KING ST   WINDSOR NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255566345,"DOGGETT, RYAN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255566345,"DOGGETT, RYAN, PATRICK",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255566345,"DOGGETT, RYAN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255567269,"STROWD, LINDSAY, CHANEY",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 82 , 97 , 115 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,5826 SAMET DR STE 103 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255567269,"STROWD, LINDSAY, CHANEY",5826 SAMET DR STE 103 HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255567756,"PATEL, ANOOP, PREMSWAROOP",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255567756,"PATEL, ANOOP, PREMSWAROOP",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255567756,"PATEL, ANOOP, PREMSWAROOP",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255567756,"PATEL, ANOOP, PREMSWAROOP",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255568309,"POPE, KYLE, TILDEN",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255568309,"POPE, KYLE, TILDEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255568309,"POPE, KYLE, TILDEN",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 30 ,$#,,
MEDICAID DIRECT,1255571766,FAYETTEVILLE MANOR LLC,~,231 TREETOP DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255571766,FAYETTEVILLE MANOR LLC,231 TREETOP DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 55 ," 14,933 "," 14,951 "," $1,511,261.87 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255572996,"KIEL, BRENDAN, JOHN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 80 , 82 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255572996,"KIEL, BRENDAN, JOHN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 50 , 50 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1255572996,"KIEL, BRENDAN, JOHN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255572996,"KIEL, BRENDAN, JOHN",~,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1255572996,"KIEL, BRENDAN, JOHN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255572996,"KIEL, BRENDAN, JOHN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1255572996,"KIEL, BRENDAN, JOHN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 61 , 65 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255574612,"WALSH, DEBORAH, ANN",5100 E VIRGINIA BEACH BLVD   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255578373,"DUQUM, IBRAHIM, SALIM",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#, 13 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,934 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255578878,"NEUPANE, NARAYAN",934 COX RD   GASTONIA NC,036,Gaston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 109 , 181 , 224 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255578878,"NEUPANE, NARAYAN",2525 COURT DR   GASTONIA NC,036,Gaston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 29 , 59 , 77 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255584298,"WATKINS, BRANDI, DANETTE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982350237,COASTAL PRIMARY CARE AND WELLNESS,,7183 BEACH DR SW # 1 OCEAN ISLE BEACH NC,010,Brunswick,193400000X,Group,Single Specialty,,1255588778,"ANDERSON, MEREDITH, WILLIAMSON",7183 BEACH DR SW # 1 OCEAN ISLE BEACH NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 39 , 43 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255589099,"BROWN, SARAH, MARIE",1401 MATTHEWS TOWNSHIP PKWY STE 320 MATTHEWS NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,558 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255590667,"ROBERTS, GAIL, LYON",558 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 35 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255590667,"ROBERTS, GAIL, LYON",558 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255590667,"ROBERTS, GAIL, LYON",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255590667,"ROBERTS, GAIL, LYON",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 30 , 109 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1255590667,"ROBERTS, GAIL, LYON",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 60 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255590790,"REYES, RAQUEL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255590790,"REYES, RAQUEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 54 , 56 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255591434,"GRAF, DANIEL, ANTONIO",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255591434,"GRAF, DANIEL, ANTONIO",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255591434,"GRAF, DANIEL, ANTONIO",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255591434,"GRAF, DANIEL, ANTONIO",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255591434,"GRAF, DANIEL, ANTONIO",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255592176,"MARUCCI, LEONARDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 56 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255592481,"PYLES, DEREK, BRANDON",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 89 , 90 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255592481,"PYLES, DEREK, BRANDON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 30 , 33 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255593646,"MANSOURI, BITA",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255594271,"ISMAELI-CAMPBELL, ATTIYAH, TAYSEER",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316455223,MOSES CONE PHYSICIAN SERVICES INC,~,1248 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255596268,"ANNA, KIRAN",1248 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 77 , 101 , 120 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255597589,"SREEDHARALA, VAMSI, KRISHNA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255597589,"SREEDHARALA, VAMSI, KRISHNA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255597589,"SREEDHARALA, VAMSI, KRISHNA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255597589,"SREEDHARALA, VAMSI, KRISHNA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255597589,"SREEDHARALA, VAMSI, KRISHNA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 84 , 84 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255598694,"KISTLER, CARA, RUTH",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255598694,"KISTLER, CARA, RUTH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 79 , 80 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255598694,"KISTLER, CARA, RUTH",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 22 , 47 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255604013,"KRESSEN, JAYME, LYNN",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1255604013,"KRESSEN, JAYME, LYNN",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1255604013,"KRESSEN, JAYME, LYNN",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 47 , 47 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255606364,"SILLS, TIFFANY, MATOSKA",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 34 , 38 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255606364,"SILLS, TIFFANY, MATOSKA",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 42 , 53 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255606364,"SILLS, TIFFANY, MATOSKA",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 406 , 382 , 474 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255606554,"ROBINSON, LEVITA, YVETTE",3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 114 , 145 ,$#,,
MEDICAID DIRECT,1780637181,EYECARECENTER OD PA,EYECARE CENTER OD PA,1520 SOUTH BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255606596,"BALDINGER, MICHAEL, DARREN",1520 SOUTH BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 17 , 19 ,$#,,
MEDICAID DIRECT,1780637181,EYECARECENTER OD PA,EYECARE CENTER OD PA,1520 SOUTH BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255606596,"BALDINGER, MICHAEL, DARREN",1520 SOUTH BLVD STE 105 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1255606729,GURLEYS MEDICAL SUPPLY,GURLEYS MEDICAL SUPPLY,1720 GUESS RD STE 80 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255606729,GURLEYS MEDICAL SUPPLY,1720 GUESS RD STE 80 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 318 ," 1,459 "," 3,447 "," $293,404.32 ",,
MEDICAID DIRECT,1255606729,GURLEYS MEDICAL SUPPLY,GURLEYS MEDICAL SUPPLY,1720 GUESS RD STE 80 DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1255606729,GURLEYS MEDICAL SUPPLY,1720 GUESS RD STE 80 DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1003665696,ILLUMINATE EYE CARE OD PLLC,,7 E 13TH AVE   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1255608592,"GESFORD, HILARY, BETH",7 E 13TH AVE   LEXINGTON NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,, 60 , 60 , 61 ,$#,,
MEDICAID DIRECT,1710678941,ANDREW R TREECE OD PA,PROVISION FAMILY EYECARE OPTOMETRY,1808 E INNES ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1255608592,"GESFORD, HILARY, BETH",7 E 13TH AVE   LEXINGTON NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1255608592,"GESFORD, HILARY, BETH",~,7 E 13TH AVE   LEXINGTON NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,,1255608592,"GESFORD, HILARY, BETH",7 E 13TH AVE   LEXINGTON NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1710678941,ANDREW R TREECE OD PA,PROVISION FAMILY EYECARE OPTOMETRY,1808 E INNES ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1255608592,"GESFORD, HILARY, BETH",1808 E INNES ST   SALISBURY NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255611661,"ARNOLD, JEFFREY, LEON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 57 , 64 , 111 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255611661,"ARNOLD, JEFFREY, LEON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 21 , 22 , 38 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255620753,"EASON, MARGARET, KELLY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255620753,"EASON, MARGARET, KELLY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255621900,"MARTYAK, MICHAEL, THOMAS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255621900,"MARTYAK, MICHAEL, THOMAS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255621900,"MARTYAK, MICHAEL, THOMAS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255621900,"MARTYAK, MICHAEL, THOMAS",825 FAIRFAX AVE STE 610 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255622015,"EDGECOMBE, JAVON, MIGUEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255622015,"EDGECOMBE, JAVON, MIGUEL",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255622015,"EDGECOMBE, JAVON, MIGUEL",624 QUAKER LN STE D201 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255622346,"PIZZUTO, MATTHEW, FURLONG",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255622346,"PIZZUTO, MATTHEW, FURLONG",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 18 , 38 , 44 ," $10,828.19 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255622346,"PIZZUTO, MATTHEW, FURLONG",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 26 , 39 , 45 ,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1255622940,"COLE, SCOTT, CAMERON",188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 29 , 30 , 47 ,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1255622940,"COLE, SCOTT, CAMERON",215 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1255622940,"COLE, SCOTT, CAMERON",215 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255624490,"PARUK, NASEEM, SULEMAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255624490,"PARUK, NASEEM, SULEMAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255624490,"PARUK, NASEEM, SULEMAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255624490,"PARUK, NASEEM, SULEMAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1255625430,"GORDON, SARAH, MARGARET",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 102 , 102 ,$#,,
MEDICAID DIRECT,1902126444,SAMPSON REGIONAL HOSPITALISTS LLC,SAMPSON REGIONAL HOSPITALISTS LLC,607 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1255625430,"GORDON, SARAH, MARGARET",607 BEAMAN ST   CLINTON NC,082,Sampson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 78 , 81 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255625869,"KEFALAS, THOMAS, STEVE",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 55 , 55 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255625869,"KEFALAS, THOMAS, STEVE",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255627451,"CORLEY, SARAH, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255627451,"CORLEY, SARAH, BETH",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 15 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255627451,"CORLEY, SARAH, BETH",3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255627477,"MANCHENO REVELO, ADRIAN, ALEXANDER",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1831576719,PIEDMONT HEALTH SERVICES INC,INTERFAITH COUNCIL COMMUNITY HEALTH CENTER,1315 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255627477,"MANCHENO REVELO, ADRIAN, ALEXANDER",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255627477,"MANCHENO REVELO, ADRIAN, ALEXANDER",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255627477,"MANCHENO REVELO, ADRIAN, ALEXANDER",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255627477,"MANCHENO REVELO, ADRIAN, ALEXANDER",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255627477,"MANCHENO REVELO, ADRIAN, ALEXANDER",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255627477,"MANCHENO REVELO, ADRIAN, ALEXANDER",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255630927,"FERNANDO, ROHESH, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 61 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1255632006,CAROLINAEAST PHYSICIANS,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,, 69 , 198 , 485 ,$#,,
MEDICAID DIRECT,1255632824,STALLS MEDICAL INC,STALLS MEDICAL INC,3010 EATON AVE STE A INDIAN TRAIL NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1255632824,STALLS MEDICAL INC,3010 EATON AVE STE A INDIAN TRAIL NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 12 , 12 , 12 ," $36,371.59 ",,
MEDICAID DIRECT,1255632824,STALLS MEDICAL INC,STALLS MEDICAL INC,3010 EATON AVE STE A INDIAN TRAIL NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255632824,STALLS MEDICAL INC,3010 EATON AVE STE A INDIAN TRAIL NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 30 , 42 , 177 ," $117,896.43 ",,
MEDICAID DIRECT,1043307887,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - CARDIOTHORACIC &,225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255635389,"CLARK, ERICA, ROUSSEAU",225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255636031,"RUOFF, TERESITA, CLARET",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 63 , 104 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255636031,"RUOFF, TERESITA, CLARET",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255636031,"RUOFF, TERESITA, CLARET",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255638995,"DUBEY, PRITI",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255638995,"DUBEY, PRITI",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 49 , 60 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255638995,"DUBEY, PRITI",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255638995,"DUBEY, PRITI",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 55 , 66 ,$#,,
MEDICAID DIRECT,1255640645,EPIPHANY FAMILY SERVICES LLC,~,5801 EXECUTIVE CENTER DR STE 103 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1255640645,EPIPHANY FAMILY SERVICES LLC,5801 EXECUTIVE CENTER DR STE 103 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 26 , 91 , 91 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1255651477,"AHMAD, SHOAIB",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1255652467,"MORRIS, ALEXIS, REAGAN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255652467,"MORRIS, ALEXIS, REAGAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255652467,"MORRIS, ALEXIS, REAGAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255655296,"PODD, BRADLEY, STEPHEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 12 , 42 , 44 ," $11,894.81 ",,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1255657052,"SELIGMAN, ANGELA, MARY",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 36 , 49 ,$#,,
MEDICAID DIRECT,1861415804,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOSPITALS ORAL MEDICINE,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255657441,"HASAN, IQUEBAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255667127,"MACKIE, AMY, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 67 , 71 ,$#,,
MEDICAID DIRECT,1093734030,THERAPY WORKS OF WILMINGTON,~,4114 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255667200,"SCHLOSSER, STEPHANIE, ANN",4114 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1790115533,MOSES CONE AFFILIATED PHYSICIANS IN,CROSSROADS PSYCHIATRIC GROUP,445 DOLLEY MADISON RD STE 410 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255669529,"MOZINGO, REGINA, NATTALIE",445 DOLLEY MADISON RD STE 410 GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1255671582,"ROBINSON, AMY, MORGAN",135 CHICAHAUK TRL   KITTY HAWK NC,028,Dare,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1255672473,PRIVATE DIAGNOSTIC CLINIC PLLC,KERNODLE CLINIC - WEST,,,Unknown,193200000X,Group,Multi-Specialty,,1255672473,PRIVATE DIAGNOSTIC CLINIC PLLC,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255674412,"KOTZEN, ELIZABETH, STUDSTILL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255674412,"KOTZEN, ELIZABETH, STUDSTILL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255674412,"KOTZEN, ELIZABETH, STUDSTILL",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 27 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255674412,"KOTZEN, ELIZABETH, STUDSTILL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255674412,"KOTZEN, ELIZABETH, STUDSTILL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255674412,"KOTZEN, ELIZABETH, STUDSTILL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 68 , 127 , 173 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",202 E GROVER ST   SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",202 E GROVER ST   SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",202 E GROVER ST   SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",1225 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 28 , 34 , 34 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 25 , 29 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",1437 SCOTT AVE   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 41 , 54 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255674834,"FELDMAN, LAUREN, STACIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 27 , 39 , 40 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255678280,"CREEKMORE, FREDDY, MORRIS",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1255678280,"CREEKMORE, FREDDY, MORRIS",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255678280,"CREEKMORE, FREDDY, MORRIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255678280,"CREEKMORE, FREDDY, MORRIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497971949,CELIA MENDES MD PA,~,1357 WALTER REED RD STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1255678454,"COTHRAN, ASHLEY, LYNN",1357 WALTER REED RD STE 201 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 45 , 91 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255678884,"LEE, HEATHER, MICHELLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255678884,"LEE, HEATHER, MICHELLE",2501 S MEBANE ST   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 310 ," 2,141 "," 2,247 "," $45,696.61 ",,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255679049,"DUNCAN, LASHANDRA, NICOLE",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255680708,"BARTS, SARAH, HAMMERSMITH",~,7309B SUMMERFIELD RD   SUMMERFIELD NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,1255680708,"BARTS, SARAH, HAMMERSMITH",7309B SUMMERFIELD RD   SUMMERFIELD NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 58 , 61 , 118 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255681532,"ROGERS, MARGUERITE, PATRICIA",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255681532,"ROGERS, MARGUERITE, PATRICIA",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255681532,"ROGERS, MARGUERITE, PATRICIA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",2919 BEECHTREE DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 22 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 38 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1255682449,"KOBEISSI, ASHRAF, AHMAD",208 W SALISBURY ST   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255683157,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS PEDIATRICS,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255683157,RURAL HEALTH GROUP INC,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 44 , 72 , 72 ," $20,858.64 ",,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1255683405,"ENGLAND, WENDY, RAYFIELD",808 SCHENCK ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 112 , 893 , 901 ," $22,066.97 ",,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,2727 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255683405,"ENGLAND, WENDY, RAYFIELD",808 SCHENCK ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255686135,"SOSEBEE, NATALIE, BROOKE",8814 RACHEL FREEMAN WAY STE 103 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 117 , 117 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,411 S LASALLE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",535 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 45 , 88 , 88 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",535 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 40 , 118 , 118 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 20 , 22 , 22 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 30 , 109 , 109 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255691150,"PALOMBO, BENEDETTO, ALBERT",635 STATESVILLE BLVD   SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255693172,"SARKISSIAN, ALIESE, ANAHID",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology, 14 , 34 , 40 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1255693172,"SARKISSIAN, ALIESE, ANAHID",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255693529,"PATEL, SHEETAL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 44 , 62 , 82 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255693529,"PATEL, SHEETAL",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 42 , 63 , 66 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255693529,"PATEL, SHEETAL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 65 , 75 , 134 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255695847,"ARNOLD, CAYLYNE, RENE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255697744,"EMORY, CASHE, CHRISTINE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 117 , 155 ," $12,692.20 ",,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255697744,"EMORY, CASHE, CHRISTINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255699153,"GOODMAN, GRAYDON, SAMUEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 35 , 49 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255699153,"GOODMAN, GRAYDON, SAMUEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 74 , 105 ,$#,,
MEDICAID DIRECT,1730154857,PEDIATRIC PARTNERS PA,~,5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255699559,"LECOMPTE, NINA, FAGHRI",5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255703625,"PERRYMAN, GABRIELLE, CLARICE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255703625,"PERRYMAN, GABRIELLE, CLARICE",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 104 , 128 , 202 ,$#,,
MEDICAID DIRECT,1881619740,COASTAL CAROLINA INTERNAL MED PA,~,2420 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1255704045,"BARBER, DAINA, ELAINE",2420 HENDERSON DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1255710331,"DAIL, SAMUEL, JACKSON",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1255710331,"DAIL, SAMUEL, JACKSON",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 24 , 57 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1255710331,"DAIL, SAMUEL, JACKSON",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 67 , 118 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1255710331,"DAIL, SAMUEL, JACKSON",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 55 , 138 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1255710331,"DAIL, SAMUEL, JACKSON",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 20 , 89 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255711297,"SHEPHERD, TIFFANY, HOPE",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 28 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1255711297,"SHEPHERD, TIFFANY, HOPE",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1255712147,"GALLEGOS, DANIELLE, RENAE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1255712147,"GALLEGOS, DANIELLE, RENAE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255712147,"GALLEGOS, DANIELLE, RENAE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 205 , 208 , 230 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255712147,"GALLEGOS, DANIELLE, RENAE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1255712147,"GALLEGOS, DANIELLE, RENAE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1255715751,"COMPITELLO, CHELSEA, LYNEE",232 BOONE HEIGHTS DR   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 25 , 50 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255716445,"MANEY, SPENCER, GOERING",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255716445,"MANEY, SPENCER, GOERING",590 MEDICAL PARK DR 590 MEDICAL PARK DRIVE MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 29 , 34 ,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255716445,"MANEY, SPENCER, GOERING",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255716536,"PATEL, LEENA, JAYESH",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255716536,"PATEL, LEENA, JAYESH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255716536,"PATEL, LEENA, JAYESH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255718490,"STERN, ELIZABETH, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 66 , 79 ,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255719506,"SPAGNOLI, DANIEL, JOSEPH",201 MCCULLOUGH DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 409 , 567 ," 1,390 "," $76,983.26 ",,
MEDICAID DIRECT,1639475593,SAFECHILD,SAFECHILD,2841 KIDD RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255719910,"RAJ, ANISH, RAJENDRA",2815 KIDD RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 27 ,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255719910,"RAJ, ANISH, RAJENDRA",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255720801,"MONGER, KAREN, ALETHEA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1255720801,"MONGER, KAREN, ALETHEA",781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 85 , 89 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255721676,"NELSON, PATRICIA, MARIE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255721676,"NELSON, PATRICIA, MARIE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255723821,"CABLE, DAVID, ANDREW",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255723821,"CABLE, DAVID, ANDREW",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 32 , 32 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255723821,"CABLE, DAVID, ANDREW",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770506149,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF TAR HEEL,16526 NC HIGHWAY 87 W   TAR HEEL NC,009,Bladen,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255725008,"BANGI, RICHELLE, BALMES",16526 NC HIGHWAY 87 W   TAR HEEL NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255725552,"PUTNAM, REBECCA, THOMSON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255725552,"PUTNAM, REBECCA, THOMSON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 50 , 50 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255725552,"PUTNAM, REBECCA, THOMSON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 49 , 106 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1255725552,"PUTNAM, REBECCA, THOMSON",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255725552,"PUTNAM, REBECCA, THOMSON",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255725669,"ZIMMERMAN, ANDREW, RUSSELL",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1255725669,"ZIMMERMAN, ANDREW, RUSSELL",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 126 , 189 , 401 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255725669,"ZIMMERMAN, ANDREW, RUSSELL",799 DOCTORS CT   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 47 , 99 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255726071,"BADACZEWSKI, ADAM, JOSEPH",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1851776728,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH MOTHERSHED FOOT & ANKLE SPECIALISTS,3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255726071,"BADACZEWSKI, ADAM, JOSEPH",3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255726071,"BADACZEWSKI, ADAM, JOSEPH",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255726071,"BADACZEWSKI, ADAM, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 24 , 31 , 38 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255726071,"BADACZEWSKI, ADAM, JOSEPH",445 PINEVIEW DR STE 230 KERNERSVILLE NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 22 , 31 , 45 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255726071,"BADACZEWSKI, ADAM, JOSEPH",3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 61 , 115 , 180 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255726428,"GILL, HARAMOL, SINGH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255726428,"GILL, HARAMOL, SINGH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 27 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1255726709,"PARTRIDGE, JENITA, JOVONNE",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 69 , 159 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1255727004,"WORTHEN, DAVID, RYAN",604 AMANDA ST   MANTEO NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 29 , 35 ,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,1091 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1255727087,"FONTENOT, DANIELLE, TAYLOR",1091 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 15 , 26 ,$#,,
MEDICAID DIRECT,1215973672,VASCULAR SOLUTIONS PC,,7800 PROVIDENCE RD STE 209 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255727087,"FONTENOT, DANIELLE, TAYLOR",1091 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124402946,IREDELL PHYSICIAN NETWORK,FAMILY CARE CENTER,1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255728044,"BRADLEY, VERONICA, MARY",609B SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497139398,IREDELL PHYSICIAN NETWORK,HARMONY MEDICAL CARE,3210 HARMONY HWY   HARMONY NC,049,Iredell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255728044,"BRADLEY, VERONICA, MARY",609B SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255728044,"BRADLEY, VERONICA, MARY",609B SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255728200,"SHOOP, LYNNETTA, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255728200,"SHOOP, LYNNETTA, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255732608,"CUFFE, KERRIE, SAVERY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 22 , 37 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255732608,"CUFFE, KERRIE, SAVERY",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 11 , 12 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255732699,"KEMMERER, DIANA, MARIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255732699,"KEMMERER, DIANA, MARIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255732707,"JI, JINZHAO",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1902124647,DOCTORS EXPRESS PLLC,~,101 MAYNARD CROSSING CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255732707,"JI, JINZHAO",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 25 , 32 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255732731,"AIKEN, DARREN, EDWIN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1255732731,"AIKEN, DARREN, EDWIN",720 MALCOLM BLVD   VALDESE NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1255732731,"AIKEN, DARREN, EDWIN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1366180374,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,1001 MONROE ST STE D CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1255737045,"POKHAREL, TILAK, RAJ",1001 MONROE ST STE D CARTHAGE NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548290265,FHPG LLC,FIRST HEALTH FAMILY MEDICINE SEVEN LAKES,1035C 7 LAKES DR   WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1255737045,"POKHAREL, TILAK, RAJ",1001 MONROE ST STE D CARTHAGE NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 36 , 75 ,$#,,
MEDICAID DIRECT,1548290265,FHPG LLC,FIRST HEALTH FAMILY MEDICINE SEVEN LAKES,1035C 7 LAKES DR   WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1255737045,"POKHAREL, TILAK, RAJ",1035C 7 LAKES DR   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 122 , 313 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255740551,"BARBEE, KRISTAL, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356368708,CAMPUS HEALTH PHARMACY,CAMPUS HEALTH SERVICES,320 EMERGENCY ROOM DR JAMES A TAYLOR BLDG CB 7470 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255741419,"HODGES, STEPHANIE, CARRIER",320 EMERGENCY ROOM DR UNCCH   CHAPEL HILL NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255741757,"ACOSTA, STEPHEN, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255741757,"ACOSTA, STEPHEN, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255743696,"ORMAN, KATHERINE, ANDREA",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255743696,"ORMAN, KATHERINE, ANDREA",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 38 , 53 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255744124,"MADDOX, MARK, WILLIAM TOWERS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255744124,"MADDOX, MARK, WILLIAM TOWERS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 39 , 70 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255744702,"MITCHELL, CHARLES, HUGH",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255744702,"MITCHELL, CHARLES, HUGH",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255744702,"MITCHELL, CHARLES, HUGH",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 44 , 151 , 162 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255744876,"MAHESWARANATHAN, MITHUNAN",40 DUKE MEDICINE CIR # 1J DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 13 , 16 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255744876,"MAHESWARANATHAN, MITHUNAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255744876,"MAHESWARANATHAN, MITHUNAN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 25 , 31 , 45 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255747275,"DAVIDSON, AMANDA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 33 , 35 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255747713,"FERNANDES, ROBIN",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 125 , 160 , 201 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,4235 S NEW HOPE RD STE F GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255747713,"FERNANDES, ROBIN",4235 S NEW HOPE RD STE F GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255747713,"FERNANDES, ROBIN",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255747713,"FERNANDES, ROBIN",2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 22 , 32 ,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255750295,"GOOLSBY, BRYAN, WARREN",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1255750386,"SMITH, TOMMY, FREDERICK",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1255750386,"SMITH, TOMMY, FREDERICK",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255751467,"CARTER, JAMIE, LYNN",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 131 , 328 , 750 ," $18,398.25 ",,
MEDICAID DIRECT,1265430854,GRANVILLE HEALTH SYSTEM,SOUTH GRANVILLE PRIMARY CARE,1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255755740,"HAWKINS, PETER, WILSON",1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 65 , 79 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1255757936,"MCNAMARA, MEGAN, LENORE",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 27 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1255757936,"MCNAMARA, MEGAN, LENORE",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1255757936,"MCNAMARA, MEGAN, LENORE",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1255758595,"LOGAN, RACHEL, LYNNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255762365,"ASTORINO, SETH, JEFFERSON",2340 SPRING FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922198977,HIGH POINT PEDIATRICS,~,404 WESTWOOD AVE STE 103 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1255762860,"ALLEN, SHARON, DENISE",404 WESTWOOD AVE STE 103 HIGH POINT NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 44 , 103 ,$#,,
MEDICAID DIRECT,1255762878,MERCY MINE HOME CARE AGENCY,,2 BALIOL CT   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1255762878,MERCY MINE HOME CARE AGENCY,2 BALIOL CT   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 4,586 "," 4,796 "," $659,892.10 ",,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1255764536,"LOWRY, CANDACE, MICHELLE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 26 ,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1255764536,"LOWRY, CANDACE, MICHELLE",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 116 , 191 , 526 ," $23,490.50 ",,
MEDICAID DIRECT,1063696375,THE CAROUSEL CENTER INC,The Carousel Center Inc,1501 DOCK ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255765095,"KOEHLER, MARY, BETH",1501 DOCK ST   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 33 , 84 ," $23,462.94 ",,
MEDICAID DIRECT,1063696375,THE CAROUSEL CENTER INC,The Carousel Center Inc,1501 DOCK ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255765095,"KOEHLER, MARY, BETH",20 MEDICAL CAMPUS DR NW STE 106 SUPPLY NC,010,Brunswick,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1972266237,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SHALLOTTE,301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1255765574,"VIOLETTE, DAVID, PAUL",988 OCEAN HWY W   SUPPLY NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 24 , 71 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255767273,"TUSHABE, RACHEAL",201 SAGE RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 44 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255767273,"TUSHABE, RACHEAL",201 SAGE RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 64 , 146 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255767448,"RIERSON, NANCY, MARINETTE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255767448,"RIERSON, NANCY, MARINETTE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255767448,"RIERSON, NANCY, MARINETTE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255770327,"STEWART, AMBER, EGYPT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1255770855,"LINCOLN, CHRISTINE, SPRITKE",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 55 , 63 , 64 ," $23,542.90 ",,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1255772240,"PETRANKER, OREN, SKY",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255772240,"PETRANKER, OREN, SKY",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255772240,"PETRANKER, OREN, SKY",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1255772760,"WILLIAMS, ASHLEY, JONES",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1255772760,"WILLIAMS, ASHLEY, JONES",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 44 , 64 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1255772760,"WILLIAMS, ASHLEY, JONES",111 W GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 109 , 123 , 171 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1255772760,"WILLIAMS, ASHLEY, JONES",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1255773222,"PANICI, JACOB, ANTHONY",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1386289841,FOOT AND ANKLE SPECIALISTS OF THE M,,721 TILGHMAN DR STE 300 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1255773222,"PANICI, JACOB, ANTHONY",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255773222,"PANICI, JACOB, ANTHONY",1514 GLENWOOD AVE   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 16 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255773222,"PANICI, JACOB, ANTHONY",609 ATTAIN ST STE 131 FUQUAY VARINA NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1487299947,FOOT AND ANKLE SPECIALISTS OF THE M,,103 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1255773222,"PANICI, JACOB, ANTHONY",103 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255773222,"PANICI, JACOB, ANTHONY",7560 CARPENTER FIRE STATION RD STE 30 CARY NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255773222,"PANICI, JACOB, ANTHONY",103 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2994 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255773644,"SANJURJO, DAVID, DANIEL",7201 US HIGHWAY 64 E   KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255774014,"JOHANSEN, ANDREW, EDWARD",2101 W ARLINGTON BLVD STE 210 GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 109 , 116 , 173 ,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255774014,"JOHANSEN, ANDREW, EDWARD",2101 W ARLINGTON BLVD STE 210 GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1255774014,"JOHANSEN, ANDREW, EDWARD",2101 W ARLINGTON BLVD STE 210 GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 181 , 188 , 262 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255774170,"MORRIS, JESSICA, DIANE",2100 STANTONSBURG RD 3 SOUTH GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 43 , 63 , 66 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255774170,"MORRIS, JESSICA, DIANE",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 38 , 58 , 115 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255774170,"MORRIS, JESSICA, DIANE",2100 STANTONSBURG RD 3 SOUTH GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 37 , 63 , 63 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255774170,"MORRIS, JESSICA, DIANE",40 DUKE MEDCINE CLINIC   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1255774485,MARY REBECCAS VILLAGE,MARY REBECCAS VILLAGE,13605 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1255774485,MARY REBECCAS VILLAGE,13605 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 140 , 140 ," $68,182.68 ",,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255774683,"MILLER, MATTHEW, DOUGLAS",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255774683,"MILLER, MATTHEW, DOUGLAS",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255777603,"DINITTO, TARA-MARIE",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255777678,"BRAXTON, VAUGHN, GAMBLE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 312 , 383 , 467 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255777678,"BRAXTON, VAUGHN, GAMBLE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 410 , 474 , 625 ," $12,768.29 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255779302,"WOOD, JACOB, CLAUDE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 88 , 154 , 221 ," $12,520.27 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255779567,"KOERNER, MICHAEL, ROBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 83 , 145 , 229 ," $22,177.87 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255779567,"KOERNER, MICHAEL, ROBERT",503 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1750928321,GORDON AND SCHELLER DDS PLLC,TRI-CITY FAMILY DENTISTRY,136 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1255779963,"SCHELLER, JAMES, WILLIAM",136 RESERVATION DR   SPINDALE NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 16 , 35 ,$#,,
MEDICAID DIRECT,1699400978,HAMREN SCHELLER & ASSOCIATES PLLC,VIEWMONT FAMILY DENTISTRY,2782 2ND ST NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1255779963,"SCHELLER, JAMES, WILLIAM",2782 2ND ST NE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice," 2,567 "," 5,929 "," 17,245 "," $1,227,777.68 ",,
MEDICAID DIRECT,1265264170,SCHELLER HAMREN AND ASSOC DDS PLLC,SOUTH MOUNTAIN FAMILY DENTISTRY,600 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,193200000X,Group,Multi-Specialty,,1255779963,"SCHELLER, JAMES, WILLIAM",2782 2ND ST NE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 579 ," 1,218 "," 4,363 "," $300,694.53 ",,
MEDICAID DIRECT,1841642758,JAMES W SCHELLER HUDSON,~,3094 HICKORY BLVD   HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1255779963,"SCHELLER, JAMES, WILLIAM",155A HICKMAN AVE   HUDSON NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice, 814 ," 1,267 "," 4,146 "," $353,637.15 ",,
MEDICAID DIRECT,1205582624,GORDON AND SCHELLER DDS PLLC,DENTISTRY OF MOUNTAIN VIEW,2708 S NC 127 HWY   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255779963,"SCHELLER, JAMES, WILLIAM",2782 2ND ST NE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 335 , 623 ," 1,373 "," $114,037.48 ",,
MEDICAID DIRECT,1255779963,"SCHELLER, JAMES, WILLIAM",~,155A HICKMAN AVE   HUDSON NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice,1255779963,"SCHELLER, JAMES, WILLIAM",155A HICKMAN AVE   HUDSON NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1255780136,COUNTY OF BEAUFORT,BEAUFORT COUNTY EMS,1420 HIGHLAND DR   WASHINGTON NC,007,Beaufort,3416L0300X,Transportation Services,Ambulance,Land Transport,1255780136,COUNTY OF BEAUFORT,1420 HIGHLAND DR   WASHINGTON NC,007,Beaufort,3416L0300X,Transportation Services,Ambulance,Land Transport, 81 , 105 , 196 ,$#,,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,123 BRYAN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1255780177,"LORELLO, ERIN, MARGARET",123 BRYAN ST   KENANSVILLE NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice," 4,221 "," 5,944 "," 20,635 "," $864,693.97 ",,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255780375,"MOHR, TYLER, MATTHIAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1255780375,"MOHR, TYLER, MATTHIAS",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255780375,"MOHR, TYLER, MATTHIAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255780375,"MOHR, TYLER, MATTHIAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1255780375,"MOHR, TYLER, MATTHIAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255780375,"MOHR, TYLER, MATTHIAS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255780375,"MOHR, TYLER, MATTHIAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255780722,"SURESH, SHASHANK",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 25 , 43 , 53 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255780722,"SURESH, SHASHANK",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 15 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255780722,"SURESH, SHASHANK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255780722,"SURESH, SHASHANK",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255781738,"CONRAD, ROBERT, JOSEPH",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255781738,"CONRAD, ROBERT, JOSEPH",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 34 , 38 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255781738,"CONRAD, ROBERT, JOSEPH",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1952678013,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE NORTH HICKORY,212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1255783346,"KILLIAN-COBB, BONI, LEE",212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 26 , 49 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255783445,"SHEPPARD, CAITLIN, GOODMAN",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255783445,"SHEPPARD, CAITLIN, GOODMAN",2810 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 25 , 29 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255783445,"SHEPPARD, CAITLIN, GOODMAN",7210 VILLAGE MEDICAL CIR STE 100 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255785051,"WOFFORD, ANNE, MAUREEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 39 , 42 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1255785192,"DE VRIES, ARIS, RAMON",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255785192,"DE VRIES, ARIS, RAMON",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255785192,"DE VRIES, ARIS, RAMON",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255785192,"DE VRIES, ARIS, RAMON",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255785192,"DE VRIES, ARIS, RAMON",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 47 , 81 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255785192,"DE VRIES, ARIS, RAMON",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538564232,FORSYTH MEMORIAL HOSPITAL INC,~,694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255786273,"MCGEATHY, NATHAN, DE",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255786273,"MCGEATHY, NATHAN, DE",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 143 , 233 , 391 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1255786851,"BRENNAN, STEPHANIE, LAUREN",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255787842,"FAIZ, FILZA",4414 LAKE BOONE TRL STE 300 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1255788345,"BAUGHAM, SARAH, MICHELLE",2460 CURTIS ELLIS DR CURTIS ELLIS DRIVE ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1255789087,"TART, KELLI, ELIZABETH",801 W BARBEE CHAPEL RD   CHAPEL HILL NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1255789194,"RODRIGUEZ-CAPOTE, INES, JACQUELINE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255789673,"BERWANGER, SARAH",216 MOORE RD   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 58 , 135 , 218 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255789905,"LAROSSA, CASSENDRE, ANNIE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255789905,"LAROSSA, CASSENDRE, ANNIE",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255789905,"LAROSSA, CASSENDRE, ANNIE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255789905,"LAROSSA, CASSENDRE, ANNIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255789905,"LAROSSA, CASSENDRE, ANNIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255789905,"LAROSSA, CASSENDRE, ANNIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255791398,"SMITH, YOLANDA, CHERRY",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1255794152,"COLES, COREY, JAMAAL",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 156 , 347 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1255794152,"COLES, COREY, JAMAAL",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255794574,"BOTT, NATALIE, LYNN",1212 SPRUCE ST   BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255794574,"BOTT, NATALIE, LYNN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255794574,"BOTT, NATALIE, LYNN",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 20 , 25 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255794574,"BOTT, NATALIE, LYNN",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 32 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255794939,"THOMPSON, ELIZABETH, JACLYN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 173 , 180 , 241 ,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 35 ,$#,,
MEDICAID DIRECT,1831452622,PRESBYTERIAN BREAST CENTER LLC,PRESBYTERIAN MOBILE BREAST CENTER,1718 E 4TH ST STE 103 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255795118,"HARRELL, ALAN, DOUGLAS",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255795860,"HAYDEK, CAITLIN, GRESKOVICH",3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 16 , 28 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255795860,"HAYDEK, CAITLIN, GRESKOVICH",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255795860,"HAYDEK, CAITLIN, GRESKOVICH",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 38 , 46 , 50 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255795910,"LEE, STEWART, WILLIAM",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255797486,"SCHMIDT, DONALD, ANTHONY",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 44 , 101 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255797486,"SCHMIDT, DONALD, ANTHONY",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 31 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255797486,"SCHMIDT, DONALD, ANTHONY",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255797486,"SCHMIDT, DONALD, ANTHONY",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 56 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1255801452,"HORNICK, ASHLEE, ROSE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255801452,"HORNICK, ASHLEE, ROSE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 99 , 203 ,$#,,
MEDICAID DIRECT,1255805065,CAREPARTNERS HHA LLLP,CAREPARTNERS PRIVATE DUTY SERVICES,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1255805065,CAREPARTNERS HHA LLLP,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,, 48 , 452 , 452 ," $182,990.50 ",,
MEDICAID DIRECT,1396455267,NMG HEALTH SERVICES LLC,NHMG OBGYN URGENT CARE CLINICS,6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255806030,"FRAGER, EILEEN, CATHERINE",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255806030,"FRAGER, EILEEN, CATHERINE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255806030,"FRAGER, EILEEN, CATHERINE",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255806030,"FRAGER, EILEEN, CATHERINE",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255807269,"HAGAN, JENNIFER, RAE",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 647 , 681 ," $15,748.00 ",,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1255807269,"HAGAN, JENNIFER, RAE",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 32 , 33 ,$#,,
MEDICAID DIRECT,1962971051,RANDOLPH COUNTY FAMILY CRISIS CENTE,EMMYS HOUSE CHILD ADVOCACY CENTER,235 E ACADEMY ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1255812376,"KINTNER, JENNIFER, ADELE",235 E ACADEMY ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 28 ,$#,,
MEDICAID DIRECT,1962971051,RANDOLPH COUNTY FAMILY CRISIS CENTE,EMMYS HOUSE CHILD ADVOCACY CENTER,624 S FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1255812376,"KINTNER, JENNIFER, ADELE",235 E ACADEMY ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1407188600,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PULMONARY & SLEEP CENTER,2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1255815163,"PFEFFER, ANDREA, MICHELLE",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407188600,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PULMONARY & SLEEP CENTER,2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1255815163,"PFEFFER, ANDREA, MICHELLE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588115752,RDMG ASSOCIATES PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1255816450,"HEATH, TAYLOR, JEAN",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255820411,"OLIVER, LINDSAY, LEANNE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255821849,"WHEELER, EVAN, NEIL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 ,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255821849,"WHEELER, EVAN, NEIL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255821849,"WHEELER, EVAN, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 133 , 146 , 169 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1255821849,"WHEELER, EVAN, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 33 , 40 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255821849,"WHEELER, EVAN, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255821849,"WHEELER, EVAN, NEIL",,3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1255821849,"WHEELER, EVAN, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255821849,"WHEELER, EVAN, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255821849,"WHEELER, EVAN, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255821849,"WHEELER, EVAN, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255821849,"WHEELER, EVAN, NEIL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255823209,"CAMPANO, DOMINIC, PAUL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 39 , 67 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255824009,"PEARCE, REBECCA, ALLISON",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255824041,"HUETTEMANN, RICHARD, ERIC",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255824041,"HUETTEMANN, RICHARD, ERIC",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255824041,"HUETTEMANN, RICHARD, ERIC",770 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255824041,"HUETTEMANN, RICHARD, ERIC",7210 VILLAGE MEDICAL CIR STE 310 CLEMMONS NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255824041,"HUETTEMANN, RICHARD, ERIC",770 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255824520,"NESAB, NAVID",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255824520,"NESAB, NAVID",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1851723951,PIEDMONT HEALTH SERVICES INC,MONCURE CHC DENTAL,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255824520,"NESAB, NAVID",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,115 HILLTOP VLG   OXFORD NC,039,Granville,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1255824520,"NESAB, NAVID",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1346784089,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - DURHAM,1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255824520,"NESAB, NAVID",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,115 HILLTOP VLG   OXFORD NC,039,Granville,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1255824520,"NESAB, NAVID",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice," 1,094 "," 1,659 "," 6,221 "," $244,934.87 ",,
MEDICAID DIRECT,1194801852,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CLAYTON,31 OLEANDER DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255824520,"NESAB, NAVID",115 HILLTOP VLG   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1255825832,"SKAUG, SHANNON, LOUETTE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1255826947,"STUMP, ELISABETH, ANN",965 STATE FARM RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 39 , 42 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,4235 S NEW HOPE RD STE J GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255828752,"KHADIJA, SAIRAH",4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 22 , 39 , 40 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,1200 VILLAGE HARBOR DR STE B LAKE WYLIE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255828752,"KHADIJA, SAIRAH",2544 COURT DR   GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2544 COURT DR STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255828752,"KHADIJA, SAIRAH",2544 COURT DR   GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1255828752,"KHADIJA, SAIRAH",2525 COURT DR   GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 15 , 17 ,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1255829636,"STEWART, KEVIN, BLAINE",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255829636,"STEWART, KEVIN, BLAINE",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1255836995,"DIXON, ANITA, MCNEIL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255836995,"DIXON, ANITA, MCNEIL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255837019,"CARBALLO, CHRISTOPHER, JOSEPH",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 69 , 73 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255837019,"CARBALLO, CHRISTOPHER, JOSEPH",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255837019,"CARBALLO, CHRISTOPHER, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 50 , 63 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255837324,"GLAVICH, GARRISON, JOHN",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255837472,"MEZES, CHRISTINA, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1255838561,"BYARS, ELLEN, CATHERINE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255838561,"BYARS, ELLEN, CATHERINE",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 31 , 42 , 92 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255838561,"BYARS, ELLEN, CATHERINE",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 13 , 17 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 340 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255838561,"BYARS, ELLEN, CATHERINE",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255838561,"BYARS, ELLEN, CATHERINE",1200 NAVAHO DR   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 17 , 22 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255839551,"FINCH, ASHLEY, THORNBURG",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255844114,"PAINTER, BRICE, DILLARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255844114,"PAINTER, BRICE, DILLARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1255845178,"LAWHORN, JENKINS, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255845178,"LAWHORN, JENKINS, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255845178,"LAWHORN, JENKINS, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1255850079,WALGREEN CO,~,2400 LITTLE ROCK RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1255850079,WALGREEN CO,2400 LITTLE ROCK RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255850707,"DENNISON-HARWOOD, DARCY, ROBIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 22 , 24 ,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255851499,"LABRUYERE, JOHN, THOMAS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255851499,"LABRUYERE, JOHN, THOMAS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255851499,"LABRUYERE, JOHN, THOMAS",15 YORKSHIRE ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 30 , 67 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255851499,"LABRUYERE, JOHN, THOMAS",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 31 , 72 ,$#,,
MEDICAID DIRECT,1831306992,HOPSCOTCH PRIMARY CARE GROUP PA,HOPSCOTCH PRIMARY CARE,113 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1255851499,"LABRUYERE, JOHN, THOMAS",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,41 OAKLAND RD STE 100 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255851937,"SCRIPTURE, CONSTANCE, BROOKS",41 OAKLAND RD STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 21 , 38 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255851937,"SCRIPTURE, CONSTANCE, BROOKS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 36 , 88 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255852018,"TIJANI, SULAIMAN, MUSA",159 EXECUTIVE DR STE F DANVILLE VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356197412,KO DDS & HAN DDS PLLC,DURHAM DENTAL STUDIO,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1255853412,"HAN, KYOUNG, SOO",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 467 , 761 ," 3,111 "," $147,864.31 ",,
MEDICAID DIRECT,1255853412,"HAN, KYOUNG, SOO",KO DDS & HAN DDS PLLC,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1255853412,"HAN, KYOUNG, SOO",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255854964,"STRANGE, PAMELA, CAMERON",146 MEDICAL PARK RD STE 212 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,268 GILLMAN RD STE A DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1255854964,"STRANGE, PAMELA, CAMERON",146 MEDICAL PARK RD STE 212 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,268 GILLMAN RD STE A DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1255854964,"STRANGE, PAMELA, CAMERON",268 GILLMAN RD STE A DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,146 MEDICAL PARK RD STE 212 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1255854964,"STRANGE, PAMELA, CAMERON",146 MEDICAL PARK RD STE 212 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 38 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255854964,"STRANGE, PAMELA, CAMERON",10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,738 BRYANT ST   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255854964,"STRANGE, PAMELA, CAMERON",738 BRYANT ST   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 18 , 57 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255854964,"STRANGE, PAMELA, CAMERON",9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255855060,"SMITH, RACHAEL, CHRISTINA",14130 RIVERGATE PKWY STE C2-125 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255855060,"SMITH, RACHAEL, CHRISTINA",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255855300,"VAROSKOVIC, KYLE, ALAN",318 S NORWOOD ST   WALLACE NC,031,Duplin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 23 , 54 ,$#,,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1255858056,"GILBERT, SUSAN, MARIE",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 73 , 102 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255861712,"BYRNS, RYAN, MATTHEW",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255861712,"BYRNS, RYAN, MATTHEW",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255861712,"BYRNS, RYAN, MATTHEW",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255861712,"BYRNS, RYAN, MATTHEW",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174950752,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DERMATOLOGY,200 MEDICAL PARK DR STE 460 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1255862058,"OGUNSIAKAN, ADA, TOLUTOPE",200 MEDICAL PARK DR STE 460 CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1699311563,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DERMATOLOGY,4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255862058,"OGUNSIAKAN, ADA, TOLUTOPE",200 MEDICAL PARK DR STE 460 CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1811274558,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM CARDIOLOGY,568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1255863098,"OFOSU-SOMUAH, ARABA",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 150 , 245 , 290 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255863098,"OFOSU-SOMUAH, ARABA",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255863254,"UCIK, LAURA",100 W PARKVIEW DR   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 70 , 179 , 194 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255863650,"HUANG, MAX, LIN",9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255863650,"HUANG, MAX, LIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255863650,"HUANG, MAX, LIN",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 16 , 25 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255863650,"HUANG, MAX, LIN",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255863874,"GIFFORD, ABIGAIL, ROSE",624 QUAKER LN STE E100 HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 53 , 80 , 135 ,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1255865127,"SWECKER, STEFAN, DOBSON",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 29 , 29 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1255866919,"MCCOY, PHILIP, CHARLES",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255866919,"MCCOY, PHILIP, CHARLES",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,270 N HAYWOOD ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1255867032,"STEPHENSON, BENJAMIN, WADE",270 N HAYWOOD ST   WAYNESVILLE NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 306 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255867321,"KUO, DAVID, ER EN",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255867321,"KUO, DAVID, ER EN",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255872487,"DELANEY, PAUL, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255872487,"DELANEY, PAUL, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,2402 S MIAMI BLVD STE 101 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255872974,"VOLPE-BATES, KATHRYNE, LOUISE",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255872974,"VOLPE-BATES, KATHRYNE, LOUISE",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1255875571,"SAMUTSAKORN, DISNEY, KULACHATI",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255876314,"LANGDALE, KERSTIN, ELIZABETH",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255876314,"LANGDALE, KERSTIN, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1255876835,"METZ, ANDREW, DONALD",615 RIDGE RD   ROXBORO NC,073,Person,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",702 N MAIN ST   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",702 N MAIN ST   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 12 , 30 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,202 VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",702 N MAIN ST   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",702 N MAIN ST   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5214 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",702 N MAIN ST   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 19 , 47 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",702 N MAIN ST   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 17 , 39 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1255876983,"GUILLORY, APRYL, KAY",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255880746,"GILLIS, CHRISTEN, ELAINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 32 , 33 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255880746,"GILLIS, CHRISTEN, ELAINE",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255880746,"GILLIS, CHRISTEN, ELAINE",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255880746,"GILLIS, CHRISTEN, ELAINE",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1629428370,APPALACHIAN REGIONAL MEDICAL ASSOCI,THE HARRIET AND CHARLES DAVANT MEDICAL CLINIC,623 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1255883583,"ROBERTSON, HEIDI, LUSK",623 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255885612,"MAKER, CHAMIA, NICOLE",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255885612,"MAKER, CHAMIA, NICOLE",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255885612,"MAKER, CHAMIA, NICOLE",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255885612,"MAKER, CHAMIA, NICOLE",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,61 BONNIE LN   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1255885992,"MANRING, REBECCA, ELIZABETH",61 BONNIE LN   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 105 , 169 , 267 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1255890133,"ARRENDALE, CORINNE, BICKNESE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255890133,"ARRENDALE, CORINNE, BICKNESE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 34 , 53 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255890133,"ARRENDALE, CORINNE, BICKNESE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 34 , 47 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1255890133,"ARRENDALE, CORINNE, BICKNESE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255890133,"ARRENDALE, CORINNE, BICKNESE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255892568,"HARRIS, SPENCER, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255892568,"HARRIS, SPENCER, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1255892568,"HARRIS, SPENCER, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255892626,"HOBENSACK, MICHAEL, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255892626,"HOBENSACK, MICHAEL, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 38 , 53 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255892626,"HOBENSACK, MICHAEL, JAMES",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255892626,"HOBENSACK, MICHAEL, JAMES",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,10211 ALM ST STE 1100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255894192,"DILLON, SARAH, CARNEY",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 39 , 96 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 29 , 29 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 135 , 179 , 257 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1255897815,"CHAPMAN, JEANNA, BERGANDINE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255897989,"WEHRLE, ANDREA",2906 N MAIN ST   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255897989,"WEHRLE, ANDREA",2906 N MAIN ST   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255897989,"WEHRLE, ANDREA",2906 N MAIN ST   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255897989,"WEHRLE, ANDREA",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255897989,"WEHRLE, ANDREA",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255903217,"NAM, HYUN JOO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255903217,"NAM, HYUN JOO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1255905386,"WIKE, WILLIAM, AUSTIN",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 20 , 53 , 61 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1255905386,"WIKE, WILLIAM, AUSTIN",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 16 , 59 , 81 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1255911509,"TURNER, CRISSY, ANN",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 33 , 33 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255911525,"SCIARRETTA, CHRISTOPHER, ERIC",71 WHEELERTOWN AVE   PIKEVILLE TN,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255911574,STEARIE LLC,STEARIE,189 WIND CHIME CT STE 104 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255911574,STEARIE LLC,189 WIND CHIME CT STE 104 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 16 ,$#,,
MEDICAID DIRECT,1255911574,STEARIE LLC,STEARIE,189 WIND CHIME CT STE 104 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1255911574,STEARIE LLC,189 WIND CHIME CT STE 104 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#," $24,952.50 ",,
MEDICAID DIRECT,1255912192,SKY HEART HOME CARE SERVICES LLC,~,1135 KILDAIRE FARM RD STE 240 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1255912192,SKY HEART HOME CARE SERVICES LLC,1135 KILDAIRE FARM RD STE 240 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 13 , 364 , 374 ," $46,857.52 ",,
MEDICAID DIRECT,1255912192,SKY HEART HOME CARE SERVICES LLC,~,120 PRESTON EXECUTIVE DR STE 232 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1255912192,SKY HEART HOME CARE SERVICES LLC,120 PRESTON EXECUTIVE DR STE 232 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 1,585 "," 1,598 "," $180,921.76 ",,
MEDICAID DIRECT,1255912192,SKY HEART HOME CARE SERVICES LLC,~,31 CHURCH ST   WILLARD NC,071,Pender,253Z00000X,Agencies,In Home Supportive Care,,1255912192,SKY HEART HOME CARE SERVICES LLC,31 CHURCH ST   WILLARD NC,071,Pender,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1255913034,"SALAUN, WILLIAM, CORTEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255913034,"SALAUN, WILLIAM, CORTEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255913034,"SALAUN, WILLIAM, CORTEEN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 52 , 68 ,$#,,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255914495,"HSU, JENNIFER",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 400 , 730 ," 2,333 "," $153,964.67 ",,
MEDICAID DIRECT,1629122528,LANE & ASSOCIATES XIV DDS PA,LANE & ASSOCIATES XIV DDS PA,1200 BROAD ST STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255914495,"HSU, JENNIFER",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1578114732,LANE AND ASSOCIATES XXXIV DDS PA,,6320 CAPITAL BLVD STE 121 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255914495,"HSU, JENNIFER",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255914495,"HSU, JENNIFER",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1356917793,VICTORY-MEDICAL PLLC,VICTORY MEDICAL PLLC,305 S MAIN ST   BLADENBORO NC,009,Bladen,193400000X,Group,Single Specialty,,1255917746,"GREEN, DAPHNE, RUSS",305 S MAIN ST   BLADENBORO NC,009,Bladen,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 14 , 42 , 95 ,$#,,
MEDICAID DIRECT,1255917977,MOORE DIVINE CARE INC,,121 S ELM ST UNIT L GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1255917977,MOORE DIVINE CARE INC,121 S ELM ST UNIT L GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,621 "," 1,621 "," $122,132.88 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255918496,"GIORDANO, JAMES, VICTOR",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255918496,"GIORDANO, JAMES, VICTOR",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1255919452,"CRISP, CHARLES, DENNIS",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 27 , 29 ,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1255919452,"CRISP, CHARLES, DENNIS",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 37 , 38 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255920740,"MATTHEWS, JODI, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1255920740,"MATTHEWS, JODI, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255920740,"MATTHEWS, JODI, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1255921219,STEPHANIE HOME CARE & HOMESTYLE COO,,4316 W ARGYLE DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1255921219,STEPHANIE HOME CARE & HOMESTYLE COO,4316 W ARGYLE DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 3,657 "," 3,666 "," $255,801.80 ",,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1255922977,"KILMER, LAYLA, MARIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1255922977,"KILMER, LAYLA, MARIE",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1255922977,"KILMER, LAYLA, MARIE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1255922977,"KILMER, LAYLA, MARIE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255922977,"KILMER, LAYLA, MARIE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255922977,"KILMER, LAYLA, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255922977,"KILMER, LAYLA, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255922977,"KILMER, LAYLA, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1255922977,"KILMER, LAYLA, MARIE",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255922977,"KILMER, LAYLA, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255922977,"KILMER, LAYLA, MARIE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255923629,"EDWARDS, STACEY, JO",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255923629,"EDWARDS, STACEY, JO",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 76 , 103 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255923629,"EDWARDS, STACEY, JO",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184400954,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC AUDIOLOGY SERVICES,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255926028,"VANLOOY, LINDSEY, ANN",115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255928362,"ROBERTSON, JILL, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255928479,"BROADWELL, KIMBERLY, GILLIARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255928867,"GHETTE, VALERIYA, OLEGIVNA",707 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255929253,"JACKSON, SHATAMRA, DEVON",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255929253,"JACKSON, SHATAMRA, DEVON",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255931655,"HOUK, TAYLOR",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 48 , 51 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1255950119,"DAMISH-KEMP, ALEXIS, WILLIAMS",201 E GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1255950119,"DAMISH-KEMP, ALEXIS, WILLIAMS",110 W GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 35 , 48 ,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1255950119,"DAMISH-KEMP, ALEXIS, WILLIAMS",335A W COLLEGE AVE   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255950465,"WONG, JORDAN, EDWARD",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 74 , 135 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255950465,"WONG, JORDAN, EDWARD",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255950465,"WONG, JORDAN, EDWARD",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 119 , 229 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255950465,"WONG, JORDAN, EDWARD",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 33 , 50 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 68 , 77 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 37 , 42 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 40 , 55 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",117 E KINGS HWY   EDEN NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 50 , 60 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1255952651,"DECENSO, BRENDAN, MICHAEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194459461,AUTHORACARE COLLECTIVE,,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255954244,"LAWSON, AMANDA, TRAKAS",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255954244,"LAWSON, AMANDA, TRAKAS",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255955902,"EDELSON, WILLIAM, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780193557,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - DUNN,801 TILGHMAN DR   DUNN NC,043,Harnett,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255958385,"ORJI, CATHERINE, IJEOMA",801 TILGHMAN DR STE A DUNN NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255958385,"ORJI, CATHERINE, IJEOMA",801 TILGHMAN DR STE A DUNN NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1255959425,"MALONEY, APRIL, DAWN",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255959573,"ALLMAN, KATHRYN, ROSE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 68 , 76 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255960134,"PATRONE, ALEXANDER, PHILIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 178 , 178 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255960134,"PATRONE, ALEXANDER, PHILIP",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255960134,"PATRONE, ALEXANDER, PHILIP",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255962007,ELITE THERAPY SERVICES LLC,ELITE THERAPY SERVICES LLC,6034 HEATH VALLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255962007,ELITE THERAPY SERVICES LLC,6034 HEATH VALLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 87 ," 1,086 "," 1,088 "," $98,752.99 ",,
MEDICAID DIRECT,1255963021,PALMETTO OXYGEN LLC,,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1255963021,PALMETTO OXYGEN LLC,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 102 , 646 , 648 ," $122,611.16 ",,
MEDICAID DIRECT,1255963021,PALMETTO OXYGEN LLC,,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1255963021,PALMETTO OXYGEN LLC,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 2,673 "," 13,167 "," 20,632 "," $535,770.37 ",,
MEDICAID DIRECT,1255963021,PALMETTO OXYGEN LLC,,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1255963021,PALMETTO OXYGEN LLC,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1255963021,PALMETTO OXYGEN LLC,,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1255963021,PALMETTO OXYGEN LLC,4001 PIEDMONT PKWY   HIGH POINT NC,041,Guilford,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255965810,"BLAND, WESLEY, KEVIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 43 , 45 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1255965810,"BLAND, WESLEY, KEVIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 56 , 60 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1255965810,"BLAND, WESLEY, KEVIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255965885,BILINGUAL LITTLE MINDS LLC,,231 SANDERS RD   BENSON NC,051,Johnston,251S00000X,Agencies,Community/Behavioral Health,,1255965885,BILINGUAL LITTLE MINDS LLC,231 SANDERS RD   BENSON NC,051,Johnston,251S00000X,Agencies,Community/Behavioral Health,, 53 , 716 , 716 ," $44,793.00 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255967824,"NELSON, ROBERT, GEORGE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 145 , 228 , 286 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1255967824,"NELSON, ROBERT, GEORGE",1124 GALLERY PARK LN STE 103 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255968137,"WILSON REARDON, MIRYAM, HANNAH",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255968137,"WILSON REARDON, MIRYAM, HANNAH",25 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1255968137,"WILSON REARDON, MIRYAM, HANNAH",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 54 , 81 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255968137,"WILSON REARDON, MIRYAM, HANNAH",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255968350,"AMRHEIN, SCOTT, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 79 , 82 , 82 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255968376,"FURTH, CADENCE, HILARY ROSE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1255968376,"FURTH, CADENCE, HILARY ROSE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 87 , 146 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1255969457,"BARBE, MADELEINE, O'CONNOR",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1255969457,"BARBE, MADELEINE, O'CONNOR",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1255969457,"BARBE, MADELEINE, O'CONNOR",2000 NEUSE BLVD   NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1255970489,"CLAIRMONT, ANMOL, GRACE",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 92 , 323 , 517 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255970695,"MARSH, MOLLY, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 60 , 97 ," $17,673.64 ",,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1255971883,"NARDI, DANIEL, ROBERT",105 LISBON AVE   GARLAND NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,115 KILDAIRE PARK DR STE 309 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255971883,"NARDI, DANIEL, ROBERT",105 LISBON AVE   GARLAND NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 33 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255972568,"WALLACE, ROBERT, BOWMAN",5935 CARNEGIE BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1255975389,"THORNTON, RIAN, KENNETH",179 N BUNCOMBE SCHOOL RD STE 102 WEAVERVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 30 , 31 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1255975389,"THORNTON, RIAN, KENNETH",179 N BUNCOMBE SCHOOL RD STE 102 WEAVERVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1427487099,TRIANGLE GERIATRIC AND MEMORY CLINI,TRIANGLE GERIATRIC AND MEMORY CLINIC PLLC,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255977526,"ONGECHI, JANET, KEMUNTO",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 46 , 46 ,$#,,
MEDICAID DIRECT,1427487099,TRIANGLE GERIATRIC AND MEMORY CLINI,TRIANGLE GERIATRIC AND MEMORY CLINIC PLLC,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255977526,"ONGECHI, JANET, KEMUNTO",410 S JUDD PKWY SE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 40 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255978334,"RAPOPORT, ANNA",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255978334,"RAPOPORT, ANNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1255978334,"RAPOPORT, ANNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255978417,"MCGUIRE, WILLIAM, THOMAS",448 CRANBERRY ST   NEWLAND NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 27 , 37 ,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1255978417,"MCGUIRE, WILLIAM, THOMAS",448 CRANBERRY ST   NEWLAND NC,006,Avery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255978797,"HOLLOWAY, COURTNEY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255983821,"MCCUEN, ASHLEY, BLAIR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255986527,"DANGDA, SONAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 116 , 154 , 231 ," $16,016.65 ",,
MEDICAID DIRECT,1922577048,MH HIGHLANDS-CASHIERS MEDICAL CENTE,,57 WHITE OWL LN   CASHIERS NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1255987574,"LITCHFIELD, ALLISON, GRACE",57 WHITE OWL LN   CASHIERS NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285381103,FAITH FAMILY HEALTH PLLC,,14 ACADEMY ST   BURNSVILLE NC,100,Yancey,193400000X,Group,Single Specialty,,1255989158,"DOTTS, MISTY, LYNN",14 ACADEMY ST   BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 57 , 58 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255989943,"KOONTZ, KELLIE, PRESLAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 77 , 79 ,$#,,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1255990255,"VELEZ, JACQUELINE, ROSE",1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1255990255,"VELEZ, JACQUELINE, ROSE",,1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1255990255,"VELEZ, JACQUELINE, ROSE",1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1255990255,"VELEZ, JACQUELINE, ROSE",,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1255990255,"VELEZ, JACQUELINE, ROSE",1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 593 , 713 ," 2,731 "," $91,457.70 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1255990677,"BARNEY, HANNAH, MARIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1255990677,"BARNEY, HANNAH, MARIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1255990677,"BARNEY, HANNAH, MARIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255990719,"BLAKE, BRIA, NIKOLE WILLIAMS",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255990719,"BLAKE, BRIA, NIKOLE WILLIAMS",14215 BALLANTYNE CORPORATE PL STE 110 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255990719,"BLAKE, BRIA, NIKOLE WILLIAMS",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1255991295,"DELLINGER, HEATHER, LANNETTE",4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255991295,"DELLINGER, HEATHER, LANNETTE",4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1255991295,"DELLINGER, HEATHER, LANNETTE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1255993408,"GANDHI, ROOPALI, GOYAL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255993408,"GANDHI, ROOPALI, GOYAL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255994315,"REASOR, JORDAN, EMILY",230 MACNIDER HALL CAMPUS BOX 7593 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 16 , 31 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255995817,"OJHA, CHETHANA, KAMATH",100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 18 , 45 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255997920,"PATEL, MONALI",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1255997920,"PATEL, MONALI",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1255997920,"PATEL, MONALI",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 22 , 30 ,$#,,
MEDICAID DIRECT,1518906700,CHARLES A CANNON JR MEMORIAL HOSPIT,,436 HOSPITAL DR STE 235 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1255998027,"RAMSEY, BENJAMIN, SETH",436 HOSPITAL DR STE 235 LINVILLE NC,006,Avery,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1518906700,CHARLES A CANNON JR MEMORIAL HOSPIT,,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1255998027,"RAMSEY, BENJAMIN, SETH",434 HOSPITAL DR   LINVILLE NC,006,Avery,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255998134,"SHIN, LEAH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1255998134,"SHIN, LEAH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255998134,"SHIN, LEAH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255998134,"SHIN, LEAH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255998134,"SHIN, LEAH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255998134,"SHIN, LEAH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1255998134,"SHIN, LEAH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1255999041,"HENDERLY, BRITNI, AMBER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265003305,"ROBERTS, RACHEL, FRANCES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265003305,"ROBERTS, RACHEL, FRANCES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 25 , 45 ,$#,,
MEDICAID DIRECT,1245734995,CALDWELL MEMORIAL HOSPITAL,CALDWELL ONCOLOGY ASSOCIATES,212 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265003909,"WESSON, JESSICA, POTTER",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 85 , 103 , 103 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265005375,"PRICE, MATTIE, THOMPSON",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 103 , 145 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265005771,"MYERS, ERIN, KATHRYN",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265005771,"MYERS, ERIN, KATHRYN",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265005771,"MYERS, ERIN, KATHRYN",30 DUKE MEDICINE CIR # 1A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265007710,"HAN, WENTING",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265008577,ALLEGHANY HOUSE LLC,THE LANDINGS OF CHESTNUT GROVE,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265008577,ALLEGHANY HOUSE LLC,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 532 , 532 ," $44,170.72 ",,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1265008767,"TOMASZEWSKI, EMMA, KATHERINE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265008767,"TOMASZEWSKI, EMMA, KATHERINE",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1265008767,"TOMASZEWSKI, EMMA, KATHERINE",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265009849,"SMITH, KENDALL, LAMAR",2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265009849,"SMITH, KENDALL, LAMAR",2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265010698,"MELTON, BETH, ANDREA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265010896,"AGNEW, MATTHEW, ARNOLD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 42 , 150 , 158 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265013445,"YANG, YENG",8420 UNIVERSITY EXEC PARK DR STE 850 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 37 , 60 ,$#,,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1265013759,"BALLARD, HALEY, AMY-RENEE",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 37 , 151 ,$#,,
MEDICAID DIRECT,1265014849,REHAB MEDICINE OF THE CAROLINAS,,2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265014849,REHAB MEDICINE OF THE CAROLINAS,2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1265014930,"CARD, ALEXANDRIA, NICOLE",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265014930,"CARD, ALEXANDRIA, NICOLE",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265014930,"CARD, ALEXANDRIA, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 28 , 29 ,$#,,
MEDICAID DIRECT,1265015549,PRESTIGE CARING HANDS LLC,PCH STAFFING,2216 S MIAMI BLVD STE 204B DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1265015549,PRESTIGE CARING HANDS LLC,2216 S MIAMI BLVD STE 204B DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 5,057 "," 5,077 "," $574,577.42 ",,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265016380,"DASSAH, MARCUS, AMUSIERE",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 360 , 403 ," 1,059 "," $63,783.52 ",,
MEDICAID DIRECT,1265016851,HELPING HANDS & CARING HEARTS NURSI,HELPING HANDS & CARING HEARTS HOME CARE AGENCY,905 HALSTEAD BLVD STE 17A ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1265016851,HELPING HANDS & CARING HEARTS NURSI,905 HALSTEAD BLVD STE 17A ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,#, 141 , 141 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1265018196,"SHALLENBURG, KASEY, SENGER",2201 S STERLING ST   MORGANTON NC,012,Burke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 88 , 88 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1265018907,"JOHNSON, SAMANTHA, EMILIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1265018907,"JOHNSON, SAMANTHA, EMILIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265018907,"JOHNSON, SAMANTHA, EMILIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1265018907,"JOHNSON, SAMANTHA, EMILIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265018907,"JOHNSON, SAMANTHA, EMILIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265019970,"BLACKWELL, THOMAS, ALEXANDER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265019970,"BLACKWELL, THOMAS, ALEXANDER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265019970,"BLACKWELL, THOMAS, ALEXANDER",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265019970,"BLACKWELL, THOMAS, ALEXANDER",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265019970,"BLACKWELL, THOMAS, ALEXANDER",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265019970,"BLACKWELL, THOMAS, ALEXANDER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265019970,"BLACKWELL, THOMAS, ALEXANDER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 26 ,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265020770,"WILLIS, ROBERT, ALEXANDER",525 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,424 "," 1,647 "," 9,544 "," $282,956.83 ",,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265022180,"WAYNE, SHANNAH, RILEY",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 29 , 34 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265022776,"WARREN, ASHLEIGH, BROOKE",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 17 , 26 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265022776,"WARREN, ASHLEIGH, BROOKE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265022776,"WARREN, ASHLEIGH, BROOKE",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1265024475,"TURNER, KAYLA, NICOLE",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1265024475,"TURNER, KAYLA, NICOLE",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 35 , 38 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265025803,"FULTON, CYNTHIA, HEINTZ",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1265029706,"GENTILE, CHRISTINA",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 16 , 19 , 25 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265030654,"VINSON, VANESSA, KAY",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 28 , 42 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265030654,"VINSON, VANESSA, KAY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265030654,"VINSON, VANESSA, KAY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265030654,"VINSON, VANESSA, KAY",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 22 ,$#,,
MEDICAID DIRECT,1265030738,J & S CARE INCORPORATED,,416 N PARKER ST   ELM CITY NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265030738,J & S CARE INCORPORATED,416 N PARKER ST   ELM CITY NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 37 ," 9,419 "," 9,419 "," $608,025.21 ",,
MEDICAID DIRECT,1053074369,MCPC 22 LLC,FIRSTHEALTH-SANDHILLS NEUROLOGISTS,295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1265031413,"GRIMM, AUTUMN, CHRISTINE",3541 RANDOLPH RD STE 301 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 86 , 144 , 217 ,$#,,
MEDICAID DIRECT,1417446691,MECKLENBURG NEUROLOGY GROUP,,70 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265031413,"GRIMM, AUTUMN, CHRISTINE",3541 RANDOLPH RD STE 301 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1265032536,"JUMBERCOTTA, HEIDI, ELLEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265032536,"JUMBERCOTTA, HEIDI, ELLEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265033625,"THOMAS, ASHLEY, DANIELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265033625,"THOMAS, ASHLEY, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 30 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265033625,"THOMAS, ASHLEY, DANIELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912784406,REX HOSPITAL INC,NORTH CAROLINA INFECTIOUS DISEASES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265033625,"THOMAS, ASHLEY, DANIELLE",4420 LAKE BOONE TRL STE 100A RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265037477,"CRANFORD, JOHNNA, MCGINN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,294 N HIGHWAY 16   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1265041602,"GREGORY, JAMIE, NICOLE",294 N NC 16 BUSINESS HWY SUITE A DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 27 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265044200,"KENNEY, JENNA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265044200,"KENNEY, JENNA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730636028,ELOHIM HOUSECALL DOCTORS PA,,1320 N HAMILTON ST STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265046312,"ISSIFU, ADJARA",1320 N HAMILTON ST STE 105 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 17 , 18 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265047104,"RODESILER, JANIE, MARIE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1972217982,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1381 E GARRISON BLVD GASTONIA GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265047476,"HARLEY, LOGAN, BALLARD",1381 E GARRISON BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1265047989,INFINITY HOME CARE SERVICES LLC,,806 OLD LUMBERTON RD   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1265047989,INFINITY HOME CARE SERVICES LLC,806 OLD LUMBERTON RD   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 1,193 "," 1,209 "," $113,126.76 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265049316,"GODWIN, CHERITH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265049571,"MCCLELLAN, MARGARET, CLARKE",1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265049571,"MCCLELLAN, MARGARET, CLARKE",1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265049571,"MCCLELLAN, MARGARET, CLARKE",1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 43 , 59 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265050181,"BROWN, LAUREN, MORIAH",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053442210,LINER WARD & SHOBE DDS PA,SOUTHERN DENTAL ASSOCIATES,1690 RIVER ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1265050892,"CORNWELL, NICHOLAS, STEPHEN",1690 RIVER ST   WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1730574757,ACTIVE FOOT AND ANKLE OF CAROLINA,,1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1265051619,"CRANEY, KEVIN, LOUIS",1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1730574757,ACTIVE FOOT AND ANKLE OF CAROLINA,,1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1265051619,"CRANEY, KEVIN, LOUIS",1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1265052112,"TRUONG, AN, NGUYEN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 54 , 66 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265052112,"TRUONG, AN, NGUYEN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 166 , 191 , 239 ," $10,949.22 ",,
MEDICAID DIRECT,1265052112,"TRUONG, AN, NGUYEN",,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1265052112,"TRUONG, AN, NGUYEN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265052112,"TRUONG, AN, NGUYEN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265052112,"TRUONG, AN, NGUYEN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265052112,"TRUONG, AN, NGUYEN",,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1265052112,"TRUONG, AN, NGUYEN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,1032 COLLEGE ST   OXFORD NC,039,Granville,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265053714,"FAULK, MARGO, MCKENZIE",1032 COLLEGE ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265053714,"FAULK, MARGO, MCKENZIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265053714,"FAULK, MARGO, MCKENZIE",115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265054548,"BAUMGARTEN, IVANA, KADIC",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 20 , 23 ,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265054548,"BAUMGARTEN, IVANA, KADIC",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1265055099,BEST AMERICAN MEDICAL SUPPLIES LLC,BEST AMERICAN MEDICAL SUPPLIES,1100 NAVAHO DR STE 121 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265055099,BEST AMERICAN MEDICAL SUPPLIES LLC,1100 NAVAHO DR STE 121 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 48 , 109 , 277 ," $26,824.38 ",,
MEDICAID DIRECT,1265055099,BEST AMERICAN MEDICAL SUPPLIES LLC,BEST AMERICAN MEDICAL SUPPLIES,1100 NAVAHO DR STE 121 RALEIGH NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1265055099,BEST AMERICAN MEDICAL SUPPLIES LLC,1100 NAVAHO DR STE 121 RALEIGH NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 56 , 142 , 324 ," $27,641.32 ",,
MEDICAID DIRECT,1265055099,BEST AMERICAN MEDICAL SUPPLIES LLC,BEST AMERICAN MEDICAL SUPPLIES,1100 NAVAHO DR STE 121 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1265055099,BEST AMERICAN MEDICAL SUPPLIES LLC,1100 NAVAHO DR STE 121 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 29 , 35 , 35 ," $238,075.94 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265056378,"RUSCH, BRITTANY, LONDON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265056428,"BELL, BERNARD, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265056428,"BELL, BERNARD, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265056485,"YIN, PENG",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265056485,"YIN, PENG",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265056642,"HILL, ALYSSA, DAWN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 68 , 133 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265056642,"HILL, ALYSSA, DAWN",701 DOCTORS DR   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265056642,"HILL, ALYSSA, DAWN",313 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 221 , 434 ," $11,501.19 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,313 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1265056642,"HILL, ALYSSA, DAWN",313 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265058069,"DAVIS, WESLEY, ROSS",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265060404,"EDMINISTER, JOHN, ROBERT",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 66 , 80 , 101 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1265060552,"MOULTON, AARON, ISHKAAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 32 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1265060552,"MOULTON, AARON, ISHKAAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265060941,"RAFFLER, REBECCA, LYDIA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265060941,"RAFFLER, REBECCA, LYDIA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,465 W MAIN ST   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1265063275,"FLEMING, EMILY, DODD",465 W MAIN ST   SPINDALE NC,081,Rutherford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 35 ,$#,,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,60 SHUFORD RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1265063275,"FLEMING, EMILY, DODD",465 W MAIN ST   SPINDALE NC,081,Rutherford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1265065015,"TYAGI, SHUBHAM",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1265065015,"TYAGI, SHUBHAM",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265065015,"TYAGI, SHUBHAM",7021 HARPS MILL RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265065015,"TYAGI, SHUBHAM",10211 ALM ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265065015,"TYAGI, SHUBHAM",1821 HILLANDALE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689849200,NORTH CAROLINA BAPTIST HOSPITAL,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1265066286,"ADKINS, ERIN, WHITELY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265069710,"SORRENTINO, ANTHONY, DOMINIC",5102 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265069710,"SORRENTINO, ANTHONY, DOMINIC",5102 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265069975,"JUBAIR, DEWAN, NAHID",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265071658,"FARNSWORTH, VICTORIA, LOUISE",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265071658,"FARNSWORTH, VICTORIA, LOUISE",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265071658,"FARNSWORTH, VICTORIA, LOUISE",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265071658,"FARNSWORTH, VICTORIA, LOUISE",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1265078075,"LUEY GOMEZ, ALEXANDRIA, KENYE",113 A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#, 26 , 26 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1265078075,"LUEY GOMEZ, ALEXANDRIA, KENYE",1 HOSPITAL CALLER BOX C-268 CHEROKEE NC,087,Swain,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265079131,"DALY, MELINDA, HOUSE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265079503,"LUK, LAWRENCE, LINYEA",10208 CERNY ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 41 , 81 ,$#,,
MEDICAID DIRECT,1265079834,COMPASSIONATE TENDER CARE LLC,,1914 J N PEASE PL STE 146 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1265079834,COMPASSIONATE TENDER CARE LLC,1914 J N PEASE PL STE 146 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,735 "," 2,735 "," $164,504.56 ",,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265080071,"COOPER, JACQUELINE, DENISE",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,519 NAUTICAL DR STE 100C CLOVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265080071,"COOPER, JACQUELINE, DENISE",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265080071,"COOPER, JACQUELINE, DENISE",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265080071,"COOPER, JACQUELINE, DENISE",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265092860,"KIM, LAURA, KATHRYN FRYE",6721 SHALLOWFORD RD   LEWISVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 43 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,6721 SHALLOWFORD RD STE B LEWISVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1265092860,"KIM, LAURA, KATHRYN FRYE",6721 SHALLOWFORD RD   LEWISVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 69 , 132 , 559 ," $30,253.30 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265092860,"KIM, LAURA, KATHRYN FRYE",340 CAPITAL DR   CARTHAGE NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265092860,"KIM, LAURA, KATHRYN FRYE",5509 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265092860,"KIM, LAURA, KATHRYN FRYE",5509 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 70 , 92 , 324 ," $12,810.85 ",,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265095657,"MARQUES, DANIELA, HEALY",5318 NC HIGHWAY 55 STE 206 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265095830,"HUGHES, RACHEL, ELISE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265095830,"HUGHES, RACHEL, ELISE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1265095830,"HUGHES, RACHEL, ELISE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265095830,"HUGHES, RACHEL, ELISE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 31 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265095830,"HUGHES, RACHEL, ELISE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 33 , 37 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265095830,"HUGHES, RACHEL, ELISE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265097620,"PASWAN, RISHI, KUMAR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 91 , 91 ,$#,,
MEDICAID DIRECT,1265100044,JENTLE TOUCH PERSONAL CARE LLC,,5945 HIRAMS CT   HOPE MILLS NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1265100044,JENTLE TOUCH PERSONAL CARE LLC,5945 HIRAMS CT   HOPE MILLS NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 1,931 "," 1,931 "," $193,407.66 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265102669,"ASFOUR, RANA, AHMAD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265105365,"WARE, MINDY, MARIE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265105365,"WARE, MINDY, MARIE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265105365,"WARE, MINDY, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265105365,"WARE, MINDY, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265112114,"WILSON, GALAXI, ELISA",317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265112114,"WILSON, GALAXI, ELISA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1265949788,MARGARET BOWEN MD PLLC,,1449 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1265116750,"PAKA, JOJO, KIENGA",1449 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265120521,"SMITH, MICHAYLA, DESIREE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1265122204,"CAVE, MADISON, PARKER",1219 LEXINGTON AVE STE D THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 73 , 143 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1265122204,"CAVE, MADISON, PARKER",106 W MEDICAL PARK DR SUITE A LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 52 , 117 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265124192,"HERRING, BRIDGET, DYER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 60 , 74 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2470 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265124192,"HERRING, BRIDGET, DYER",2470 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265126957,KIPP ENC,,1107 HOLLOWAY ST   DURHAM NC,032,Durham,251300000X,Agencies,Local Education Agency (LEA),,1265126957,KIPP ENC,1107 HOLLOWAY ST   DURHAM NC,032,Durham,251300000X,Agencies,Local Education Agency (LEA),, 81 ," 1,513 "," 1,575 "," $55,977.09 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265130918,"CUMMINGS, KARA, BLANKENSHIP",98 DOCTORS DR STE 100 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 147 , 330 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1265130918,"CUMMINGS, KARA, BLANKENSHIP",98 DOCTORS DR STE 100 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 56 , 69 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,,,Unknown,193200000X,Group,Multi-Specialty,,1265130918,"CUMMINGS, KARA, BLANKENSHIP",98 DOCTORS DR STE 100 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265131346,"PALMER, CLARE, TIERNEY",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265139281,"MBUGUA, CAROLINE, WAMBUI",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 246 , 481 , 556 ," $11,282.09 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST # 102 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1265139281,"MBUGUA, CAROLINE, WAMBUI",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265139687,"MOSELEY, CHARLES, FREDERICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265139687,"MOSELEY, CHARLES, FREDERICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265139687,"MOSELEY, CHARLES, FREDERICK",705 GREEN VALLEY RD GREENSBORO GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265141790,"O'CONNOR, JAMES, THOMAS",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265143218,"RUMP, MATTHEW, THOMAS",146 HWY 64 E   HAYESVILLE NC,022,Clay,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 102 , 125 , 136 ," $20,137.03 ",,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1265143218,"RUMP, MATTHEW, THOMAS",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972123537,MURPHY MEDICAL CENTER INC,,2751 BUSINESS 19   ANDREWS NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265143218,"RUMP, MATTHEW, THOMAS",146 HWY 64 E   HAYESVILLE NC,022,Clay,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1265143218,"RUMP, MATTHEW, THOMAS",146 HWY 64 E   HAYESVILLE NC,022,Clay,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265143218,"RUMP, MATTHEW, THOMAS",146 HWY 64 E   HAYESVILLE NC,022,Clay,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902411499,SOLARI MENTAL AND BEHAVIORAL HEALTH,,5500 EXECUTIVE CENTER DR STE 235 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265143721,"MATTHEWS, ROHAN, WAYNE",5500 EXECUTIVE CENTER DR STE 235 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265143721,"MATTHEWS, ROHAN, WAYNE",,5500 EXECUTIVE CENTER DR STE 235 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,1265143721,"MATTHEWS, ROHAN, WAYNE",5500 EXECUTIVE CENTER DR STE 235 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1649735127,SPARTANBURG MEDICAL CENTER,MGC-WOUNDHEALINGSERVICES-MARYBLACKCAMPUS,11 DOCTORS PARK DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265144554,"LANE, DARA, ELISABETH",853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265148969,"HAN, SANG, RYEOL",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 1,641 "," 1,712 "," 9,146 "," $246,202.30 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265148969,"HAN, SANG, RYEOL",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265151765,HARMONY HOME CARE SERVICES LLC,,726 E 3RD AVE   GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1265151765,HARMONY HOME CARE SERVICES LLC,726 E 3RD AVE   GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 47 ," 6,662 "," 6,936 "," $776,444.84 ",,
MEDICAID DIRECT,1265159149,BATHROOM BREAKTHROUGHS OT PLLC,,203 CASTLEBURY CREEK CT   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1265159149,BATHROOM BREAKTHROUGHS OT PLLC,203 CASTLEBURY CREEK CT   CARY NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1205566379,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES SALISBURY,480 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1265161947,"STEWART, ROBERT, TENNYSON",480 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 541 ," 1,302 "," 3,589 "," $182,495.68 ",,
MEDICAID DIRECT,1649750183,CARNAGGIO AND PIPER DMD MS PA,~,275 N MAIN ST STE B TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265161947,"STEWART, ROBERT, TENNYSON",480 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265164669,"ILIZAROV, SIMONA, ANATOLEYVNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265164669,"ILIZAROV, SIMONA, ANATOLEYVNA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265164669,"ILIZAROV, SIMONA, ANATOLEYVNA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265164669,"ILIZAROV, SIMONA, ANATOLEYVNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265164669,"ILIZAROV, SIMONA, ANATOLEYVNA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265164867,"OBENG, NATALIE, SORENSEN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 70 , 106 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265166763,"LYNCH, SARA, DANIELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 30 , 30 ,$#,,
MEDICAID DIRECT,1750482493,OPEN WATER MEDICAL PA,~,1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1265166938,"BURTON, GERRIANN, L. B.",11 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033565007,STAR MEDICAL CLINIC PLLC,,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1265171219,"HOLMES, MICHELLE, DALILAH",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 99 , 132 , 227 ,$#,,
MEDICAID DIRECT,1265171219,"HOLMES, MICHELLE, DALILAH",,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1265171219,"HOLMES, MICHELLE, DALILAH",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1265171219,"HOLMES, MICHELLE, DALILAH",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 33 , 99 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265171763,"STAHR, ROBERT, WELLINGTON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265172191,"LUKASIK, JOANA, SILVA",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265172191,"LUKASIK, JOANA, SILVA",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265172191,"LUKASIK, JOANA, SILVA",4141 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 63 , 107 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265172191,"LUKASIK, JOANA, SILVA",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265172191,"LUKASIK, JOANA, SILVA",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1265172191,"LUKASIK, JOANA, SILVA",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1265172191,"LUKASIK, JOANA, SILVA",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518502103,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,560 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265174536,"RODRIGUEZ, BRANDY, HUNT",560 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 51 , 69 ," $12,021.86 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265174544,"FINDLEY, RACHEL, MARIE",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 98 , 111 , 238 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 41 , 96 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",5826 SAMET DR STE 101 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 17 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5701 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265185227,"BRAY, KRISTY, MCLEOD",1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265187223,"EDWARDS, KATELYN, VANN",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265187223,"EDWARDS, KATELYN, VANN",101 HEART DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265190847,"LYNCH, NATALIE, GORDON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1487845020,AVANCE CARE PA,,1821 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1265190979,"HARDEN, ANNA, ELYSE",2400 BROAD ST STE 1 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265192561,"MELVIN, SAVANNAH, CELINE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265192579,"LANCASTER, ANGELA, GURGANUS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1265192579,"LANCASTER, ANGELA, GURGANUS",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1265192579,"LANCASTER, ANGELA, GURGANUS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1265192579,"LANCASTER, ANGELA, GURGANUS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1265192579,"LANCASTER, ANGELA, GURGANUS",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 284 , 314 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1265192579,"LANCASTER, ANGELA, GURGANUS",2401 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 112 , 742 , 789 ," $36,910.41 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 21 , 23 , 24 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 13 , 23 , 26 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 39 , 154 , 164 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",401 LAMBERT RD   BISCOE NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 21 , 128 , 129 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",401 LAMBERT RD   BISCOE NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 177 , 179 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,401 LAMBERT RD   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",401 LAMBERT RD   BISCOE NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,401 LAMBERT RD   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",401 LAMBERT RD   BISCOE NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 44 , 45 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,5100 MACKAY RD   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,5100 MACKAY RD   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1201 CAROLINA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,707 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",707 N ELM ST   HIGH POINT NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 14 , 52 , 56 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265192702,"MCCARTHY, PAMELA, MAE",707 N ELM ST   HIGH POINT NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1437553302,RALEIGH DURHAM MEDICAL GROUP PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1265193510,"FONTAINE, RITA, ILSE",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588115752,RDMG ASSOCIATES PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1265193510,"FONTAINE, RITA, ILSE",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528470325,RENEW COUNSELING CENTER OF NC LLC,~,2212 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265194682,"MCALLISTER, KIMBERLY, LYNETTE",2212 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265194898,"RITTLER, JESSICA, NICOLE",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 38 , 65 ,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265194898,"RITTLER, JESSICA, NICOLE",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 40 , 69 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265197495,"JENNINGS, ZOE, ELIZABETH",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 69 , 78 , 78 ," $20,277.93 ",,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265202220,"ROBERTSON, CHELSIE, ADRIANNA RENEE",2810 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265202220,"ROBERTSON, CHELSIE, ADRIANNA RENEE",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265202220,"ROBERTSON, CHELSIE, ADRIANNA RENEE",730 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265204507,"MARGIOTTA, JENNA, MARIE",6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,14125 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265204507,"MARGIOTTA, JENNA, MARIE",6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1265205538,"MOHAMED, DALIA, MAGZOUB",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1023162716,"EISBERG II, ROBERT, WILLIAM",ROBERT W EISBERG II DDS PA DBA ATLANTIC FAMILY DEN,1001 W WILLIAMS ST STE 101 APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1265205538,"MOHAMED, DALIA, MAGZOUB",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265211379,YELLOW BUTTERFLY HOME CARE LLC,YELLOW BUTTERFLY HOME CARE LLC,540 SANFORD AVE STE B MOCKSVILLE NC,030,Davie,253Z00000X,Agencies,In Home Supportive Care,,1265211379,YELLOW BUTTERFLY HOME CARE LLC,540 SANFORD AVE STE B MOCKSVILLE NC,030,Davie,253Z00000X,Agencies,In Home Supportive Care,,#, 187 , 187 ," $27,505.40 ",,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265213185,"PARSONS, REBECCA, LYNN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265213185,"PARSONS, REBECCA, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265213185,"PARSONS, REBECCA, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1265214324,"MERRITT, STEPHANIE, LINETTE",8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265214324,"MERRITT, STEPHANIE, LINETTE",270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 99 , 132 , 143 ,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265214324,"MERRITT, STEPHANIE, LINETTE",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265214324,"MERRITT, STEPHANIE, LINETTE",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1265216857,JJ HOME CARE LLC,,1201 AVERSBORO RD STE H-200A GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1265216857,JJ HOME CARE LLC,1201 AVERSBORO RD STE H-200A GARNER NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 647 , 647 ," $37,714.79 ",,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265217806,"BROWER, DANIELLE, BRIANA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265217806,"BROWER, DANIELLE, BRIANA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 22 , 26 ,$#,,
MEDICAID DIRECT,1447319454,HECKER OPHTHALMOLOGY PA,~,1507 WESTOVER TER STE C GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265218481,"FRAZIER, CHAD",1507 WESTOVER TER STE C GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1447319454,HECKER OPHTHALMOLOGY PA,~,1507 WESTOVER TER STE C GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1265218481,"FRAZIER, CHAD",1507 WESTOVER TER STE C GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 16 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265251854,"NASSAR, ARIANNA, FAHMIEH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1265252704,"HILTON, COLTYN, TYLER",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336188184,MIDCAROLINA PEDIATRICS,MIDCAROLINA PEDIATRICS,2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265254338,"SARDO, MALENA, WENNING",2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1154453496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT MINERAL SPRINGS,4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265260707,"FIORE, EMMA, FAY",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265261515,"ROGERS, ABIGAIL, ANN",855 SAM NEWELL RD STE 204 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265272942,"CHANG, ASHLEY, LAUREN",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265273072,"WALKER, SARAH, LYNN",8800 N TRYON ST   CHARLOTTE NC,,Unknown,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265281224,"ADAMSON, TRENTON, JAMES",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,109 WNC SHOPPING CTR   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265281224,"ADAMSON, TRENTON, JAMES",328 NEW LEICESTER HWY STE 150 ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265286801,"DICKINSON, EMILY, ELIZABETH",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275968620,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINAS REHAB PINE,10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265286801,"DICKINSON, EMILY, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063472116,OCRACOKE HEALTH CENTER INC,ENGELHARD MEDICAL CENTER,33270 US 264   ENGELHARD NC,048,Hyde,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265286843,"SPENCER, GINGER, MCDERMOTT",33270 US HIGHWAY 264   ENGELHARD NC,048,Hyde,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 43 , 54 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1265297808,"ERDEDI, LIEL, JENNY",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 33 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1265297808,"ERDEDI, LIEL, JENNY",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1265297808,"ERDEDI, LIEL, JENNY",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265297808,"ERDEDI, LIEL, JENNY",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1912228347,INTERNATIONAL CLINIC OF THE CAROLIN,INTERNATIONAL CLINIC OF THE CAROLINAS PLLC,2406 BLUE RIDGE RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265400758,"LLIBRE, MARTA",2406 BLUE RIDGE RD STE 205 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 27 , 32 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1265400998,"JUNCADELLA, BEATRIZ, EUNICE",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 27 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1265400998,"JUNCADELLA, BEATRIZ, EUNICE",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 59 , 67 , 116 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1265400998,"JUNCADELLA, BEATRIZ, EUNICE",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265401343,"GOLDBERG, AMIT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 13 , 31 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265401343,"GOLDBERG, AMIT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265401343,"GOLDBERG, AMIT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265402184,"ENGLISH, BETSY, MAURICE",50 MILLER ST   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1245475342,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH WINSTON SALEM HEALTHCARE,250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265402184,"ENGLISH, BETSY, MAURICE",250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1265402291,"HODGES, JOSEPH, AL",40894 NC HWY 12   AVON NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083684898,ELKIN PEDIATRIC AND ADULT MEDICINE,ELKIN PEDIATRIC AND ADULT MEDICINE PA,124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1265402572,"WALKER, STEPHEN, THOMAS",124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 24 , 56 ,$#,,
MEDICAID DIRECT,1083684898,ELKIN PEDIATRIC AND ADULT MEDICINE,ELKIN PEDIATRIC AND ADULT MEDICINE PA,124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1265402572,"WALKER, STEPHEN, THOMAS",124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 93 , 139 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265403711,"WALKER, MCARTHUR",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 43 , 47 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265403711,"WALKER, MCARTHUR",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1437311933,CARTERET MEDICAL SPECIALISTS PLLC,CARTERET MEDICAL SPECIALISTS PLLC,147 NC HIGHWAY 24 STE 102 MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1265403760,"VETTICHIRA, SUSAN",147 NC HIGHWAY 24 STE 102 MOREHEAD CITY NC,016,Carteret,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 42 , 47 , 145 ,$#,,
MEDICAID DIRECT,1932353208,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAYETTEVILLE,1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265403950,"DHANDHA, MEDAHAVINI, HARKISAN",1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 17 , 62 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265405393,"CURULLA, RICHARD, MICHAEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265406037,"KASTNER, ROBERT, JOHN",603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 30 , 39 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1265406037,"KASTNER, ROBERT, JOHN",603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 131 , 191 , 264 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265406532,"HARE, CRAIG, JOHN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1265406789,"ALLISON, FERDINAND, VINCENT",6208 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 222 , 260 , 861 ," $29,616.05 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1265406789,"ALLISON, FERDINAND, VINCENT",6208 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 28 , 96 ,$#,,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1265406789,"ALLISON, FERDINAND, VINCENT",6208 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1265406789,"ALLISON, FERDINAND, VINCENT",6208 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 21 , 77 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265406789,"ALLISON, FERDINAND, VINCENT",6208 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1265406789,"ALLISON, FERDINAND, VINCENT",F VINCENT ALLISON III DDS,6208 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1265406789,"ALLISON, FERDINAND, VINCENT",6208 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 216 , 404 ," 1,014 "," $52,511.86 ",,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265407324,"MORIN, MICHAEL, CHARLES",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 90 , 104 , 123 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265407605,"COOK, LADONNA, WARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,114 N MAIN ST STE 200 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265407639,"REON, JULIA, FAYE",114 N MAIN ST STE 200 SUFFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265407639,"REON, JULIA, FAYE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265407639,"REON, JULIA, FAYE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1376564625,WILSON MEDICAL GROUP PLLC,WILSON MEDICAL GROUP,3302 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1265409254,"PARKS, PEGGIE, ROSE",3302 NASH ST N   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 79 , 149 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1265409254,"PARKS, PEGGIE, ROSE",3302 NASH ST N   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,3141 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265409320,"KNIGHT, MARY, CATHERINE",3141 CAPITAL BLVD STE 107 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,9201 LEESVILLE RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265409320,"KNIGHT, MARY, CATHERINE",9201 LEESVILLE RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,110 SHANNON VLG   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1265409320,"KNIGHT, MARY, CATHERINE",110 SHANNON VLG   LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265410674,"STEWART, JOSEPH, SHANE",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265410674,"STEWART, JOSEPH, SHANE",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 25 , 37 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265410674,"STEWART, JOSEPH, SHANE",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 59 , 93 ,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265411086,"CLONINGER, KENNETH, KYLE",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265411169,"WHEELER, PATTI, BEARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 32 , 35 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,209 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1265411169,"WHEELER, PATTI, BEARD",209 HOSPITAL DR   HIGHLANDS NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265411169,"WHEELER, PATTI, BEARD",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265411938,"GLENN, ROBERT, FREDERICK",24 2ND AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 151 , 282 ,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1265412985,"BALDI, RACHEL, AMY",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 85 , 85 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1265413660,"MAHAR, MATTHEW, ALAN",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1265413660,"MAHAR, MATTHEW, ALAN",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 37 , 62 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265414007,"DELAY, BRIAN, SCOTT",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265414007,"DELAY, BRIAN, SCOTT",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265414007,"DELAY, BRIAN, SCOTT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265414007,"DELAY, BRIAN, SCOTT",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 23 , 36 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265414007,"DELAY, BRIAN, SCOTT",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265414262,"COOKE, ROBERT, GLENN",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265414262,"COOKE, ROBERT, GLENN",700 ACADEMY ST S   AHOSKIE NC,046,Hertford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 107 , 143 , 182 ," $14,319.65 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265414262,"COOKE, ROBERT, GLENN",700A ACADEMY ST S   AHOSKIE NC,046,Hertford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1164470134,MOUNTAIN AREA PEDIATRICS ASSOCIATES,Mountain Area Pediatric Associates PA,500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265414619,"O DONNELL, BRIAN, PETER",500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 52 , 83 , 231 ," $11,083.29 ",,
MEDICAID DIRECT,1912995630,THE PURCELL CLINIC PA,THE PURCELL CLINIC PA,418 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1265415442,"HOWARD, THARON, CURRIN",418 S KING ST   LAURINBURG NC,083,Scotland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 132 , 204 , 472 ," $26,639.53 ",,
MEDICAID DIRECT,1639407737,STATESVILLE HMA MEDICAL GROUP LLC,STATESVILLE HMA MEDICAL GROUP LLC,1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265415681,"GETTER, MICHAEL, DENNIS",1414 FERN CREEK DR   STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1265415954,"LOOKABILL, PATRICIA, BERRIER",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 65 , 147 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1265415954,"LOOKABILL, PATRICIA, BERRIER",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265416788,"ROSENBAUM, DARYL, ALAN",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265416788,"ROSENBAUM, DARYL, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 62 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265416788,"ROSENBAUM, DARYL, ALAN",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891192019,CLEVELAND EYECARE OD PA,~,422 W WARREN ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1265417125,"HAMRICK, LEANDER, SHEPARD",422 W WARREN ST   SHELBY NC,023,Cleveland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1265417653,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDIN,5901 NORTHWOODS BUSINESS PKWY STE L CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1265417653,LABORATORY CORPORATION OF AMERICA H,5901 NORTHWOODS BUSINESS PKWY STE L CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 604 , 753 ," 1,073 "," $10,109.29 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265417877,"JILCOTT, RUPERT, WADSWORTH",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 173 , 402 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1265417877,"JILCOTT, RUPERT, WADSWORTH",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265418347,"REYNOLDS, PATRICK, SHAWN",624 QUAKER LN STE 201 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265418347,"REYNOLDS, PATRICK, SHAWN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 49 , 97 , 100 ,$#,,
MEDICAID DIRECT,1568763795,DESANTIS FAMILY PRACTICE,DESANTIS FAMILY PRACTICE,10 3RD AVE NE STE 500 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265418586,"KUNZE, JOEL, CARL",10 3RD AVE NE STE 500 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 35 ,$#,,
MEDICAID DIRECT,1891809893,MICHAEL CHRISTOPHER DESANTIS,MICHAEL CHRISTOPHER DESANTIS,608 46TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265418586,"KUNZE, JOEL, CARL",10 3RD AVE NE STE 500 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 474 , 474 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265419931,"CLINE, WILLIAM, TUCKER",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265419931,"CLINE, WILLIAM, TUCKER",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265419931,"CLINE, WILLIAM, TUCKER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265420335,HANGER PROSTHETICS & ORTHOTICS EAST,~,1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265420335,HANGER PROSTHETICS & ORTHOTICS EAST,1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 134 , 136 , 906 ," $194,094.88 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265422737,"SYLVESTER, FRANCISCO, AUGUSTO",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 30 , 41 , 41 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265422737,"SYLVESTER, FRANCISCO, AUGUSTO",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265422737,"SYLVESTER, FRANCISCO, AUGUSTO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 14 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265424246,"CASH, BILLY, KEITH",177 PARKWOOD DR   ELKIN NC,086,Surry,152W00000X,Eye and Vision Services Providers,Optometrist,, 20 , 23 , 28 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265424766,"GESSLER, WALTER, CURTIS",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265424766,"GESSLER, WALTER, CURTIS",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265424766,"GESSLER, WALTER, CURTIS",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265424766,"GESSLER, WALTER, CURTIS",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 72 , 124 , 360 ," $14,938.78 ",,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265425375,"ATREE, SUSHEEL, VAIDYA",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265425375,"ATREE, SUSHEEL, VAIDYA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265425375,"ATREE, SUSHEEL, VAIDYA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265425391,"MIAO, KAI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265425441,"NATTELL, DANIEL",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265426696,"ROMANO, CAROL, ANNE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265426696,"ROMANO, CAROL, ANNE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 61 , 67 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265427520,"KOCMOND, JONATHAN, HOWARD",1315 EAST BLVD STE 280 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 20 , 34 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265427710,"KIRLIN, DAVID, RUSSELL",251 WILMOT DR   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942841218,FOOT AND ANKLE SPECIALISTS OF THE M,,251 WILMOT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265427710,"KIRLIN, DAVID, RUSSELL",251 WILMOT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1356727341,DR REIMELS UNIVERSITY PLLC,,8401 UNIVERSITY EXEC PARK DR STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265427967,"REIMELS, MICHAEL, OWEN",16511 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 371 , 601 ," 2,859 "," $154,739.48 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265428544,"GHARAIBEH, NUMAN",1120 FAIRGROVE CHURCH RD STE 12 HICKORY NC,018,Catawba,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1265429351,"MCCALLION, JAMES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1023048279,GASTONIA MEDICAL SPECIALTY CLINIC,GASTONIA MEDICAL SPECIALTY CLINIC PA,1021 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265429864,"KELCHNER, JANET, WINSLOW",1021 X RAY DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 36 , 58 ,$#,,
MEDICAID DIRECT,1023048279,GASTONIA MEDICAL SPECIALTY CLINIC,GASTONIA MEDICAL SPECIALTY CLINIC PA,1021 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265429864,"KELCHNER, JANET, WINSLOW",1021 X RAY DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 168 , 195 ,$#,,
MEDICAID DIRECT,1730416801,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265431225,"KAPLAN, KRISTEN, DIANE",4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 39 , 64 ,$#,,
MEDICAID DIRECT,1720177140,COUNTY OF DAVIE OFFICE OF FINANCE A,DAVIE COUNTY HEALTH DEPARTMENT,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265432983,"SNIDER, ALISON, TOWNSEND",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1265435044,"CHIAVETTA, JOHN, BYRAN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 23 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265435044,"CHIAVETTA, JOHN, BYRAN",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 32 , 50 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265435044,"CHIAVETTA, JOHN, BYRAN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 31 , 62 ,$#,,
MEDICAID DIRECT,1952626384,BLUE RIDGE HEALTHCARE MEDICAL GROUP,TABLE ROCK FAMILY MEDICINE,301 LINVILLE ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265435689,"SPAHN, KREIG, ANTHONY",301 LINVILLE ST   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 228 , 431 ,$#,,
MEDICAID DIRECT,1972683126,BLUE RIDGE HEALTHCARE MEDICAL GROUP,FAMILY MEDICAL ASSOCIATES,2209 S STERLING ST STE 300 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265435689,"SPAHN, KREIG, ANTHONY",301 LINVILLE ST   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265436844,"WARWICK, JOYCE, CORBEIL",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265436844,"WARWICK, JOYCE, CORBEIL",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 61 , 105 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265436844,"WARWICK, JOYCE, CORBEIL",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265438253,"ABERNETHY, WILLIAM, BORDEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 19 , 22 , 49 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265438253,"ABERNETHY, WILLIAM, BORDEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 30 , 42 , 81 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265438253,"ABERNETHY, WILLIAM, BORDEN",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265440085,"BETTS, MADELENE, DANCEL",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265440192,"KUCHTJAK, GREGORY, JOHN",GREGORY KUCHTJAK,933 N CAROLINA AVE   STATESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1265440192,"KUCHTJAK, GREGORY, JOHN",933 N CAROLINA AVE   STATESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 363 , 631 ," 2,600 "," $101,014.23 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265441166,"GUIRKIN, THOMAS, CHARLES",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851691570,ALVI PRIME TIME CLINICS PLLC,NORTH RALEIGH MEDICAL CENTER,11009 INGLESIDE PL STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265441950,"SACHDEVA, ALKA, VAISHALI",11009 INGLESIDE PL STE 201 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265443683,"FELLMAN, RICHARD, ALLEN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265443683,"FELLMAN, RICHARD, ALLEN",380 COPPERFIELD BLVD NE STE A CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1265444020,"SPIVEY, JAMES, DAVID",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265444376,"THOMAS, DAVID, CARL",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 49 , 94 , 187 ," $20,269.07 ",,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265444376,"THOMAS, DAVID, CARL",161 WALKER ST   COLUMBUS NC,075,Polk,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 25 , 29 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 15 , 19 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 53 , 68 , 93 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265444384,"NAYLOR, IRVIN, HART",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265444392,"BELHORN, THOMAS, H",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 35 , 79 , 79 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265444954,"GABRIEL, ZIZETTE, MOHEB",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265444954,"GABRIEL, ZIZETTE, MOHEB",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 112 , 114 , 124 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265444954,"GABRIEL, ZIZETTE, MOHEB",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 46 , 52 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265444954,"GABRIEL, ZIZETTE, MOHEB",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265446942,"SHULSTAD, ANDREW, ROBERT",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265447742,"KOKLANARIS, NIKKI",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 22 , 31 , 39 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265447742,"KOKLANARIS, NIKKI",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 47 , 56 , 77 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265447742,"KOKLANARIS, NIKKI",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265447742,"KOKLANARIS, NIKKI",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265447742,"KOKLANARIS, NIKKI",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265447742,"KOKLANARIS, NIKKI",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 14 , 18 , 42 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265447742,"KOKLANARIS, NIKKI",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265448500,"FAGAN, SHAWN, PATRICK",~,3675 J DEWEY GRAY CIR STE 300 AUGUSTA GA,102,Out of State > 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1265448500,"FAGAN, SHAWN, PATRICK",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1215904909,JOSEPH M STILL BURN CENTERS INC,,3675 J DEWEY GRAY CIR STE 300 AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1265448500,"FAGAN, SHAWN, PATRICK",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265450068,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1950,2150 US HIGHWAY 13 S   AHOSKIE NC,046,Hertford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1265450068,WAL-MART STORES EAST LP,2150 US HIGHWAY 13 S   AHOSKIE NC,046,Hertford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265451702,"YEOMAN, JOHN, WESLEY",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265451918,"JOHNSON, MARC, ALEXANDER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265451918,"JOHNSON, MARC, ALEXANDER",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 139 , 218 , 256 ," $12,529.24 ",,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265451918,"JOHNSON, MARC, ALEXANDER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265451918,"JOHNSON, MARC, ALEXANDER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 36 , 41 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265452023,"BERGAMO, BETHANY, MICHELE",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 20 , 23 , 32 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265452023,"BERGAMO, BETHANY, MICHELE",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 46 , 68 , 109 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265452023,"BERGAMO, BETHANY, MICHELE",315 19TH ST SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 19 , 26 , 37 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,105 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1265452023,"BERGAMO, BETHANY, MICHELE",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1710191069,TRIANGLE NEUROPSYCHIATRY,~,3713 UNIVERSITY DR STE B DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1265452270,"CHANDLER, MARK, CHRISTOPHER",3713 UNIVERSITY DR STE B DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 17 , 42 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265454136,"VALDEZ, PURNIMA, THYAGARAJAN",3000 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 13 , 19 , 31 ,$#,,
MEDICAID DIRECT,1043319197,FAYETTEVILLE NEUROLOGY ASSOCIATES P,Fayetteville Neurology Associates PA,1308 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1265454185,"RAMACHANDRAN, RANGASAMY",1766 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1043319197,FAYETTEVILLE NEUROLOGY ASSOCIATES P,Fayetteville Neurology Associates PA,1308 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1265454185,"RAMACHANDRAN, RANGASAMY",1308 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 71 , 137 , 141 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265456289,"PATEL, SHREYANG, HEMONSUROY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265456289,"PATEL, SHREYANG, HEMONSUROY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265456289,"PATEL, SHREYANG, HEMONSUROY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265456289,"PATEL, SHREYANG, HEMONSUROY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1821240995,WESTGATE DERMATOLOGY AND LASER CENT,WESTGATE DERMATOLOGY AND LASER CENTER PA,2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265456420,"PLONK, ABIGAIL, SAGAR",2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 24 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265456495,"RICHTER, STEPHANIE, ROZIER",311 CODDLE MARKET DR NW STE 100 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265456495,"RICHTER, STEPHANIE, ROZIER",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 17 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265456750,"AQUINO, DANIEL, ANTHONY",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265456750,"AQUINO, DANIEL, ANTHONY",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1265456792,"PARKS, BOYD, LEE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265457410,"BLISS, SUSAN, ALICIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 160 , 166 , 168 ," $58,566.30 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265457410,"BLISS, SUSAN, ALICIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265457410,"BLISS, SUSAN, ALICIA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265457451,"BOHMER, MARY, KATHRYN WHITTEN",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366779928,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265457451,"BOHMER, MARY, KATHRYN WHITTEN",7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1932436490,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS ROCK HILL PEDIATRIC,704 GOLD HILL RD STE 207 FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265457915,"LINDSAY, NIKITA, WILLIAMS",704 GOLD HILL RD STE 207 FORT MILL SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265460448,"LONGEST, ROBIN, IPOCK",850 W H SMITH BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265460901,A PHARMACY AND SURGICAL SUPPLY LLC,A1 PHARMACY AND SURGICAL SUPPLY LLC,124 FOREST HILL RD   LEXINGTON NC,029,Davidson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265460901,A PHARMACY AND SURGICAL SUPPLY LLC,124 FOREST HILL RD   LEXINGTON NC,029,Davidson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 38 , 178 , 180 ," $16,440.27 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265462535,"WHITTEN, ANGELA, BRITT",521C MOYE BLVD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265462535,"WHITTEN, ANGELA, BRITT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1265462535,"WHITTEN, ANGELA, BRITT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265462535,"WHITTEN, ANGELA, BRITT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265463459,"MCCALLION, MEGAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265463459,"MCCALLION, MEGAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265463459,"MCCALLION, MEGAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265463459,"MCCALLION, MEGAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1265463541,"MOREA, TRACY, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265463541,"MOREA, TRACY, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1265463541,"MOREA, TRACY, MARIE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265463541,"MOREA, TRACY, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265464804,"KELLEY, MICHAEL, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265464804,"KELLEY, MICHAEL, EDWARD",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,10901 WORLD TRADE BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265464903,"MADDEN, REGINALD, LEVON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 35 , 35 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265464903,"MADDEN, REGINALD, LEVON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265464903,"MADDEN, REGINALD, LEVON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265465819,"VANG, MAI, KHOU",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 144 , 416 , 651 ," $17,368.19 ",,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265467898,"HEETDERKS, PETER, WILLIAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265467898,"HEETDERKS, PETER, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 56 , 98 , 110 ," $10,319.58 ",,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265467898,"HEETDERKS, PETER, WILLIAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265468060,"BELLAVIA, TANYA, LYNELLE",2400 PRATT ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265468060,"BELLAVIA, TANYA, LYNELLE",2400 PRATT ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265468227,"COTY, DANIEL, GUSTAVO",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 73 , 94 , 94 ," $33,742.87 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265468227,"COTY, DANIEL, GUSTAVO",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265470421,"CARROLL, KEVIN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265470421,"CARROLL, KEVIN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265470421,"CARROLL, KEVIN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265470421,"CARROLL, KEVIN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 420 , 440 , 508 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265470421,"CARROLL, KEVIN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 26 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1265470421,"CARROLL, KEVIN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265470421,"CARROLL, KEVIN, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265470975,"MELTON, CATHLEEN, MARIE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 166 , 419 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265471890,"FUTRELL, BRIAN, DENNEY",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265471890,"FUTRELL, BRIAN, DENNEY",1001 PEMBERTON HILL RD STE 102 APEX NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 12 , 19 , 33 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265471890,"FUTRELL, BRIAN, DENNEY",103 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 11 , 16 , 23 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265472278,"KARRAS, DEAN, HARRY",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265472278,"KARRAS, DEAN, HARRY",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265472278,"KARRAS, DEAN, HARRY",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 51 , 138 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265472278,"KARRAS, DEAN, HARRY",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265472278,"KARRAS, DEAN, HARRY",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 79 , 213 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265472666,"BURHANS, GEORGE, ANDREW",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265472773,"THORNTON, DAVID, CHRISTOPHER",1413 GREENWAY CT   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265472773,"THORNTON, DAVID, CHRISTOPHER",245 PAGE RD   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265472773,"THORNTON, DAVID, CHRISTOPHER",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 39 , 42 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265472773,"THORNTON, DAVID, CHRISTOPHER",205 PAGE RD   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 179 , 304 , 647 ," $10,801.86 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265472773,"THORNTON, DAVID, CHRISTOPHER",520 ALLEN ST   TROY NC,062,Montgomery,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 26 , 26 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265472773,"THORNTON, DAVID, CHRISTOPHER",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1831142553,CAROLINA CRANIOSPINAL NEUROSURGERY,CAROLINA CRANIOSPINAL NEUROSURGERY PLLC,2111 NEUSE BLVD STE A NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1265473516,"DALRYMPLE, STEPHEN, JOHN",2111 NEUSE BLVD STE A NEW BERN NC,025,Craven,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 31 , 35 , 41 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265474209,"THOMAS, KOITHARA, VARKEY GEORGE",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 143 , 323 , 464 ,$#,,
MEDICAID DIRECT,1265475560,LAYNES FAMILY PHARMACY INC,LAYNES FAMILY PHARMACY INC,509 S VAN BUREN RD   EDEN NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1265475560,LAYNES FAMILY PHARMACY INC,509 S VAN BUREN RD   EDEN NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 77 , 395 , 744 ," $70,777.08 ",,
MEDICAID DIRECT,1255070868,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2695 HENDERSONVILLE ROAD SUITE 200,2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265475636,"MERRELL, BETSY, SALSBURY",2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 36 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265475685,"SHELDON, SCOTT, ANDREW",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265475685,"SHELDON, SCOTT, ANDREW",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265475685,"SHELDON, SCOTT, ANDREW",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 74 , 75 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265475685,"SHELDON, SCOTT, ANDREW",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265475685,"SHELDON, SCOTT, ANDREW",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 51 , 51 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265476675,"GREENE, KEVIN, WAYNE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 30 , 35 ,$#,,
MEDICAID DIRECT,1548221856,CHAPEL HILL PEDIATRICS,CHAPEL HILL PEDIATRICS,205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265478796,"SILKSTONE, MARGARET, LYNN",205 SAGE RD   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 65 , 214 ," $10,759.83 ",,
MEDICAID DIRECT,1265479497,COUNTY OF CURRITUCK,CURRITUCK COUNTY EMS,2169 OCEAN PEARL RD   CURRITUCK NC,027,Currituck,3416L0300X,Transportation Services,Ambulance,Land Transport,1265479497,COUNTY OF CURRITUCK,2169 OCEAN PEARL RD   CURRITUCK NC,027,Currituck,3416L0300X,Transportation Services,Ambulance,Land Transport, 64 , 128 , 256 ,$#,,
MEDICAID DIRECT,1932661246,RALEIGH DURHAM MEDICAL GROUP PA,HEALTHPARK PEDIATRICS,8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265479869,"MCMILLAN, MICHELE, HALBY",8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 18 , 33 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265480149,"FLORES, ROBERT, ANDREW",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265480149,"FLORES, ROBERT, ANDREW",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 64 , 77 , 98 ,$#,,
MEDICAID DIRECT,1639470461,FAMILY EYE CARE OPTOMETRY PA,FAMILY EYE CARE OPTOMETRY PA,210 W IVEY ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265480271,"SMITH, LAURA, LYNN",210 W IVEY ST   LILLINGTON NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265482814,"JESSEN, ADRIAN, PARTON",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 12 , 80 , 227 ,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265482814,"JESSEN, ADRIAN, PARTON",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 26 , 43 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1265482814,"JESSEN, ADRIAN, PARTON",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 49 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265482889,"WRIGHT, PATRICK, EUGENE GLENN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 64 , 95 , 150 ,$#,,
MEDICAID DIRECT,1194877373,COASTAL VISION CENTER OD PA,,2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1265484737,"KIRBY, THOMAS, RANDALL",2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,152W00000X,Eye and Vision Services Providers,Optometrist,, 199 , 241 , 322 ," $22,827.38 ",,
MEDICAID DIRECT,1265484737,"KIRBY, THOMAS, RANDALL",~,2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,152W00000X,Eye and Vision Services Providers,Optometrist,,1265484737,"KIRBY, THOMAS, RANDALL",2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 32 , 68 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265485437,"EVERHART, DANIEL, ERIK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 16 , 16 , 72 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,920 COX RD STE 201 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",920 COX RD STE 201 GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 32 , 35 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",710 W HUDSON BLVD   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",710 W HUDSON BLVD   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",2544 COURT DR STE F GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 42 , 68 , 110 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",710 W HUDSON BLVD   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",10501 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 37 , 99 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 22 , 44 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",10501 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265486054,"CHEIFETZ, PAUL, ADAM",10501 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1265486799,"BALDWIN, DAVID, DANIEL",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265486799,"BALDWIN, DAVID, DANIEL",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265486799,"BALDWIN, DAVID, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 29 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265486799,"BALDWIN, DAVID, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 46 , 60 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265486799,"BALDWIN, DAVID, DANIEL",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265486799,"BALDWIN, DAVID, DANIEL",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265487763,"MINTZ SMITH, RASHONDA, LATISSA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 141 , 141 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265487763,"MINTZ SMITH, RASHONDA, LATISSA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265488662,"PELLETIER, KENNETH, JAMES",3404 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265488662,"PELLETIER, KENNETH, JAMES",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 43 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265489124,"SABA, PHILIP, ROBERT",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 243 , 258 , 323 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265489124,"SABA, PHILIP, ROBERT",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 100 , 107 , 157 ," $11,160.05 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265490494,"ALEXANDER, KAREN, PATTON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1265490494,"ALEXANDER, KAREN, PATTON",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1578867057,JACKSONVILLE VISION CENTER OD PLLC,JACKSONVILLE VISION CENTER OD PLLC,409 WESTERN BLVD STE 700 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1265490619,"TAYLOR, JARED",409 WESTERN BLVD STE 700 JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 35 , 49 ,$#,,
MEDICAID DIRECT,1265908479,MH MISSION HOSPITAL MCDOWELL LLLP,,1633 SUGAR HILL RD   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265491708,"ST BERNARD, EDWARD, LYLE",1633 SUGAR HILL RD   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265493027,"CHEEK, HERMAN, BARRETT",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265493027,"CHEEK, HERMAN, BARRETT",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 235 , 280 , 289 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265493027,"CHEEK, HERMAN, BARRETT",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265493027,"CHEEK, HERMAN, BARRETT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 56 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265493027,"CHEEK, HERMAN, BARRETT",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 104 , 114 , 125 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265493027,"CHEEK, HERMAN, BARRETT",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265493407,"CRIDER, STEVEN, SNOWDEN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1265493522,"MUSGROVE, HOLLY, CHRISTINE",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 47 , 98 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265494215,"VEREB, MARGARETE, JEANNE",98 DOCTORS DR STE 100 SYLVA NC,050,Jackson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 70 , 111 , 198 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1265494215,"VEREB, MARGARETE, JEANNE",98 DOCTORS DR STE 100 SYLVA NC,050,Jackson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 19 , 24 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265494413,"RUIZ, JIMMY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 67 , 75 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265494413,"RUIZ, JIMMY",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 14 , 21 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 38 , 38 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265494686,"AGOR, LONGINUS, OLEWUIKE",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265495071,"TRUAX, DOROTHY, KELLY",512 VILLAGE RD STE 101 SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265495659,"SULLIVAN, MICHAEL, STANLEY",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 40 , 81 , 146 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265496798,"DAWSON, WILLIAM, BOWKER",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 90 , 123 , 161 ,$#,,
MEDICAID DIRECT,1316791247,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MORGANTON INTERNAL MEDICINE,607 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265497366,"ABERNATHY, DAVID, SMITH",607 E PARKER RD   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 32 , 61 ,$#,,
MEDICAID DIRECT,1861449464,MORGANTON INTERNAL MEDICINE PA,MORGANTON INTERNAL MEDICINE,607 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1265497366,"ABERNATHY, DAVID, SMITH",607 E PARKER RD   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 50 , 72 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265499479,"ROTHBART, ROBERT, MITCHELL",50 HOSPITAL DR STE 3B-2 HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 49 , 56 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265499479,"ROTHBART, ROBERT, MITCHELL",50 HOSPITAL DR STE 3B-2 HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 21 , 32 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1265499479,"ROTHBART, ROBERT, MITCHELL",68 HOSPITAL RD STE 201 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 51 , 69 , 88 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265499479,"ROTHBART, ROBERT, MITCHELL",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265500250,"KIRCHMAYER, DEANNA",601 N ELM ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1265500839,"WEBBER III, SPURGEON, WILLARD",~,2120 DR WEBBER AVE   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1265500839,"WEBBER III, SPURGEON, WILLARD",2120 DR WEBBER AVE   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649289760,S W WEBBER JR DDS PA,S W WEBBER DDS PA,2120 DR WEBBER AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265500839,"WEBBER III, SPURGEON, WILLARD",2120 DR WEBBER AVE   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 797 ," 1,749 "," 6,419 "," $521,700.76 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265502090,"COOPER, ALICE, PINNELL",3116 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265502090,"COOPER, ALICE, PINNELL",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265503338,"MCCLUNG, AMANDA, B",109 BRIDGE ST APT 202 DANVILLE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1265504179,"SHEEHAN, THERESA, CIARDI",336 DEERFIELD RD   BOONE NC,095,Watauga,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265504179,"SHEEHAN, THERESA, CIARDI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265505093,"COHEN, MYRON, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265505309,"LEE, KAREN, HALL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265507149,"MIJALLI, MAMDOUH, NASIM",3617 CASEY ST STE D LORIS SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265507149,"MIJALLI, MAMDOUH, NASIM",3980 HIGHWAY 9 E STE 310 LITTLE RIVER SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265507230,"SCHMITT, TERRY, JAY",TERRY J SCHMITT DDS MS PA,568 RUIN CREEK RD STE 7 HENDERSON NC,091,Vance,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1265507230,"SCHMITT, TERRY, JAY",568 RUIN CREEK RD STE 7 HENDERSON NC,091,Vance,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 91 , 336 , 375 ," $54,988.46 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265507370,"HUDSON, CHRISTOPHER, JOHN",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265507370,"HUDSON, CHRISTOPHER, JOHN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 37 , 45 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265507370,"HUDSON, CHRISTOPHER, JOHN",1001 NEWMAN RD   NEW BERN NC,025,Craven,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 80 , 100 , 112 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265507370,"HUDSON, CHRISTOPHER, JOHN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 45 , 111 , 126 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265507370,"HUDSON, CHRISTOPHER, JOHN",4275 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265510416,"STINCHCOMBE, THOMAS, ELDRIDGE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265510416,"STINCHCOMBE, THOMAS, ELDRIDGE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265510416,"STINCHCOMBE, THOMAS, ELDRIDGE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 17 , 29 ,$#,,
MEDICAID DIRECT,1265510689,"HARDY, JAMES, GHIO",,122 JOLLY ST STE 103 LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice,1265510689,"HARDY, JAMES, GHIO",122 JOLLY ST STE 103 LOUISBURG NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice, 96 , 146 , 358 ," $17,498.49 ",,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265511554,"REYNOLDS, LESLIE, DENISE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265512263,"STEFFENS, REBECCA, ROWLAND",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 40 , 81 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265512263,"STEFFENS, REBECCA, ROWLAND",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 38 ,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265512636,"MCNEILL, WENDY, WATERS",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265512966,"LEDDY, MICHAEL, THOMAS",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265512966,"LEDDY, MICHAEL, THOMAS",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265512966,"LEDDY, MICHAEL, THOMAS",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 36 , 46 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1265512966,"LEDDY, MICHAEL, THOMAS",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265514061,"JEE, LORI, ESTELLE HOOTS",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265514061,"JEE, LORI, ESTELLE HOOTS",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265514061,"JEE, LORI, ESTELLE HOOTS",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1265514087,"BRADSHAW, SHANNA, POLLOCK",101 BALDWIN DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265514087,"BRADSHAW, SHANNA, POLLOCK",101 BALDWIN DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265514087,"BRADSHAW, SHANNA, POLLOCK",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1265514087,"BRADSHAW, SHANNA, POLLOCK",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1265514087,"BRADSHAW, SHANNA, POLLOCK",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 76 , 100 ,$#,,
MEDICAID DIRECT,1427176866,COUNTY OF PAMLICO,PAMLICO COUNTY HEALTH DEPT,203 NORTH ST   BAYBORO NC,069,Pamlico,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265514673,"MCMILLEN, PEGGY, DOLEEN",203 NORTH ST   BAYBORO NC,069,Pamlico,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861534950,STEVEN R PATTY DDS PA,~,1851 WELLNESS BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1265515399,"LYBRAND, KELLEY, SUZANNE",1851 WELLNESS BLVD   MONROE NC,090,Union,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 27 , 40 , 150 ," $13,043.61 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265515415,"ECK, JOHN, BRIGHT",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265515415,"ECK, JOHN, BRIGHT",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265515415,"ECK, JOHN, BRIGHT",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265515415,"ECK, JOHN, BRIGHT",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 63 , 70 ,$#,,
MEDICAID DIRECT,1265515969,CLEVELAND COUNTY SCHOOLS,Cleveland County Schools,400 W MARION ST   SHELBY NC,023,Cleveland,251300000X,Agencies,Local Education Agency (LEA),,1265515969,CLEVELAND COUNTY SCHOOLS,400 W MARION ST   SHELBY NC,023,Cleveland,251300000X,Agencies,Local Education Agency (LEA),, 923 ," 15,828 "," 16,223 "," $625,935.08 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265518732,"ADAMS, TIFFANY, BONITA",716 SIPES ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 68 , 68 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265518732,"ADAMS, TIFFANY, BONITA",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265518732,"ADAMS, TIFFANY, BONITA",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265518732,"ADAMS, TIFFANY, BONITA",716 SIPES ST   KINGS MOUNTAIN NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 24 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",250 18TH ST SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",250 18TH ST SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265519755,"AUSTIN, TAYLOR, GENTRY",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558360974,LONG LAXER & SAVAGE DDS PLLC,LAXER LONG AND SAVAGE,7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265520498,"LAXER, JUDY, ZUCKER",7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 40 , 41 , 136 ,$#,,
MEDICAID DIRECT,1558360974,LONG LAXER & SAVAGE DDS PLLC,LAXER LONG AND SAVAGE,7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265520498,"LAXER, JUDY, ZUCKER",7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 79 , 100 , 340 ,$#,,
MEDICAID DIRECT,1063941128,COMPREHENSIVE DENTAL CENTER OF SC,COMPREHENSIVE DENTAL CENTER OF SC,841 ENTERPRISE RD STE A DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265521454,"MATHIS, VERONICA, VARNETTA",841 ENTERPRISE RD STE A DILLON SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 560 ," 1,106 "," 3,351 "," $161,676.97 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265521728,"BAKER, JAY, ALAN",S TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265521728,"BAKER, JAY, ALAN",S TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265521728,"BAKER, JAY, ALAN",S TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 27 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265521728,"BAKER, JAY, ALAN",S TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1972024354,RDMG ASSOCIATES PA,,827 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1265523005,"CARLEY, JEFFREY, PETER",827 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 113 , 263 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265523377,"STRICKLER, JOHN, HOWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265523377,"STRICKLER, JOHN, HOWARD",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265525372,"GORDON, CHARLES, DAVID",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1679110621,NOVANT HEALTH MEDICAL GROUP LLC,NH NEUROLOGY & HEADACHE,6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265525372,"GORDON, CHARLES, DAVID",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265525372,"GORDON, CHARLES, DAVID",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265525372,"GORDON, CHARLES, DAVID",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 76 , 102 ,$#,,
MEDICAID DIRECT,1265528277,"WATSON III, MOSES",WATSON FAMILY DENTISTRY,4601 WESTERN BLVD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1265528277,"WATSON III, MOSES",4601 WESTERN BLVD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 48 , 93 , 363 ," $15,694.36 ",,
MEDICAID DIRECT,1265528277,"WATSON III, MOSES",WATSON FAMILY DENTISTRY,426 S KING ST   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice,1265528277,"WATSON III, MOSES",426 S KING ST   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice, 715 ," 1,834 "," 6,500 "," $390,817.76 ",,
MEDICAID DIRECT,1568691533,BHAT & ASSOCIATES DDS PA,GEETA BHAT DDS PA,3 REGIONAL CIR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1265528400,"PERKINS, KENNETH, TILLMAN",3 REGIONAL CIR STE A PINEHURST NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 45 , 64 , 197 ,$#,,
MEDICAID DIRECT,1265723597,UNC PHYSICIANS NETWORK LLC,~,1515 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265531339,"SIDDIQUE, SUFIA",1515 SW CARY PKWY STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 70 , 135 ,$#,,
MEDICAID DIRECT,1265723597,UNC PHYSICIANS NETWORK LLC,~,1515 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265531339,"SIDDIQUE, SUFIA",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 28 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265533871,"SHARAF, MOHAMED, WALAA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265533871,"SHARAF, MOHAMED, WALAA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 16 , 47 , 47 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 57 , 60 , 96 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 50 , 69 , 86 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265540298,"WINSLOW, TIMOTHY, MERRILL",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 44 , 81 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265540629,"NANDA, MONIKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 65 , 65 , 71 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265540629,"NANDA, MONIKA",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265540629,"NANDA, MONIKA",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265540629,"NANDA, MONIKA",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1265544704,"KARPINSKI, MARK, ALLAN",1206 BROWN ST   WASHINGTON NC,007,Beaufort,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 78 , 97 , 355 ," $14,116.33 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265546386,"WALLNER, JULIANN, SUE",205 PAGE RD   PINEHURST NC,063,Moore,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 30 , 41 , 68 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265546386,"WALLNER, JULIANN, SUE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265548259,"ZACKOWSKI, SCOTT, WILLIAM",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265548499,"EL MALLAH, MAI, KAMAL",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 81 , 129 , 312 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265548499,"EL MALLAH, MAI, KAMAL",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 23 , 48 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265548499,"EL MALLAH, MAI, KAMAL",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1184921843,DUNN MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-DUNN,803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265548671,"PAGE, CONSTANCE, DALE",803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1033461967,ESE ASSOCIATES INC,PRO DENTAL,5409 POTTER RD # 100 STALLINGS NC,090,Union,193200000X,Group,Multi-Specialty,,1265554828,"PARK, JAMES, JAEHYUN",5409 POTTER RD UNIT 100 STALLINGS NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 148 , 279 , 841 ," $44,031.50 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265557482,"MORETTI, ANTONIO, JOSE",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0300X,Dental Providers,Dentist,Periodontics, 20 , 21 , 37 ,$#,,
MEDICAID DIRECT,1992171060,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF BOLIVIA,4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265557706,"ZINK, LYNN, FRANCES",4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003218439,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SHALLOTTE,341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265557706,"ZINK, LYNN, FRANCES",341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891287520,DLP PERSON PHYSICIAN PRACTICES LLC,~,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265557953,"JAYATILAKA, SURESH, GEHAN",615 RIDGE RD   ROXBORO NC,073,Person,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 20 , 26 ,$#,,
MEDICAID DIRECT,1891287520,DLP PERSON PHYSICIAN PRACTICES LLC,~,503 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265557953,"JAYATILAKA, SURESH, GEHAN",503 RIDGE RD   ROXBORO NC,073,Person,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 26 , 35 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265559660,"TOTTEN, SUSAN, ELIZABETH",10207 CERNY ST   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265561187,HERITAGE CARE OF CONOVER,,3430 LESTER ST   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265561187,HERITAGE CARE OF CONOVER,3430 LESTER ST   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 33 ," 6,534 "," 6,534 "," $421,864.90 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265567762,"WEATHERS, RINSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 65 , 72 ,$#,,
MEDICAID DIRECT,1275863722,NAYLOR OF LINCOLNTON PPLC,COMFORT AND CARE DENTISTY OF LINCOLNTON,518 N GENERALS BLVD STE F LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1265569107,"NAYLOR, ADAM, EDWARD",518 N GENERALS BLVD STE F LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 31 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265570469,"KELSO, THOMAS, BENTON",902 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 24 , 38 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265570469,"KELSO, THOMAS, BENTON",902 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265570469,"KELSO, THOMAS, BENTON",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265570469,"KELSO, THOMAS, BENTON",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1265576847,"MILLER, NAZALY, ANN",1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1265576847,"MILLER, NAZALY, ANN",1100 NAVAHO DR   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265578074,"NAPENAS, JOEL, JUSTIN",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265578074,"NAPENAS, JOEL, JUSTIN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265578074,"NAPENAS, JOEL, JUSTIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 129 , 146 , 327 ," $16,442.76 ",,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265578074,"NAPENAS, JOEL, JUSTIN",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 88 , 88 ,$#,,
MEDICAID DIRECT,1871325308,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - CONOVER,130 1ST ST W   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265579833,"CLINE, KIMBERLY, HORST",130 1ST ST W   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 34 , 63 ,$#,,
MEDICAID DIRECT,1134311723,FAMILY HEALTHCARE PRACTICE PLLC,FAMILY HEALTHCARE PRACTICE PLLC,130 1ST ST W   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265579833,"CLINE, KIMBERLY, HORST",130 1ST ST W   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 81 , 96 ,$#,,
MEDICAID DIRECT,1861828022,MICHAEL O REIMELS DDS & CATHERINE S,THE SMILE ZONE,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265579866,"LASSITER, MARK, DAVID",816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265581276,"FRITZ, JULIE, TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265590426,"CALVILLO, KATHRYN, WOOD",600 NEW WAVERLY PL STE 310 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1265591317,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03120,301 US 70 E   VALDESE NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1265591317,NORTH CAROLINA CVS PHARMACY LLC,301 US 70 E   VALDESE NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1265591317,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03120,301 US 70 E   VALDESE NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265591317,NORTH CAROLINA CVS PHARMACY LLC,301 US 70 E   VALDESE NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1265591317,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03120,301 US 70 E   VALDESE NC,012,Burke,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1265591317,NORTH CAROLINA CVS PHARMACY LLC,301 US 70 E   VALDESE NC,012,Burke,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265591945,"HAUSCHILDT, AMY, BETH",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265591945,"HAUSCHILDT, AMY, BETH",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 108 , 108 , 769 ," $37,228.35 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265592430,"FOWLKES, WILLIAM, MORTIMER",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 44 , 60 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1265592430,"FOWLKES, WILLIAM, MORTIMER",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 56 , 68 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265592596,"LEJAWA, ROBERT, JOSEPH",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 75 , 159 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265592596,"LEJAWA, ROBERT, JOSEPH",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265592802,"PEIFER, JENNIFER, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265592802,"PEIFER, JENNIFER, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265592802,"PEIFER, JENNIFER, LYNN",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 33 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1265594980,"ESCOTT, SARAH, MARGARET",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 97 , 127 , 180 ," $19,086.79 ",,
MEDICAID DIRECT,1790799237,"SCOTT, STEPHEN, SHERROD",STEPHEN STEPHEN SCOTT,40 E MEDICAL CT   MARION NC,059,McDowell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1265594980,"ESCOTT, SARAH, MARGARET",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1265594980,"ESCOTT, SARAH, MARGARET",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 49 , 52 , 69 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265594980,"ESCOTT, SARAH, MARGARET",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 33 , 47 , 64 ,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265594980,"ESCOTT, SARAH, MARGARET",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 51 , 56 , 64 ,$#,,
MEDICAID DIRECT,1265597256,SOUTHERN ASSISTED LIVING INC,BROOKDALE MONROE SQUARE 1,918 FITZGERALD ST   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265597256,SOUTHERN ASSISTED LIVING INC,918 FITZGERALD ST   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 3,641 "," 3,641 "," $254,882.89 ",,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265599351,"DOBY, WANDA, CHERITA",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 31 ,$#,,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265599351,"DOBY, WANDA, CHERITA",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 541 , 600 ," 1,879 "," $79,769.58 ",,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265600621,"VAUGHAN, LOREN, LOUISE",1814 WESTCHESTER DR STE 400 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 105 , 213 , 257 ,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265600621,"VAUGHAN, LOREN, LOUISE",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265606966,"MEHMOOD, KHALID",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 35 , 36 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1265607907,"ANTHONY, NICHOLAS, EISENHOWER",1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265607907,"ANTHONY, NICHOLAS, EISENHOWER",15110 JOHN J DELANEY DR STE 120 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265607907,"ANTHONY, NICHOLAS, EISENHOWER",15110 JOHN J DELANEY DR STE 120 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265607907,"ANTHONY, NICHOLAS, EISENHOWER",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 15 , 18 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265607907,"ANTHONY, NICHOLAS, EISENHOWER",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265611289,"HUCKS, GEORGE, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1265613855,"WALLACE, SCOTT, ARTHUR",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265613855,"WALLACE, SCOTT, ARTHUR",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265613855,"WALLACE, SCOTT, ARTHUR",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265613855,"WALLACE, SCOTT, ARTHUR",10000 FALLS OF NEUSE ROAD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265613855,"WALLACE, SCOTT, ARTHUR",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1265613855,"WALLACE, SCOTT, ARTHUR",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1265613855,"WALLACE, SCOTT, ARTHUR",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265617088,"VISER, PAUL, EDWARD",PAUL EDWARD VISER,603 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1265617088,"VISER, PAUL, EDWARD",603 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 54 , 92 ,$#,,
MEDICAID DIRECT,1295904951,SAMPSON REGIONAL MEDICAL CENTER,~,607 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1265617088,"VISER, PAUL, EDWARD",603 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 428 , 625 , 670 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265619423,"CARR, COURTNEY, HUCKEL",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 30 ,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265619720,"SWARTZ, EDINA, CSEH",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 17 , 54 , 66 ,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265619720,"SWARTZ, EDINA, CSEH",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265619720,"SWARTZ, EDINA, CSEH",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265620025,"WATSON, LAKEISHA, SHALOUNDA",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265620025,"WATSON, LAKEISHA, SHALOUNDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265620504,"DANIEL, RENIE",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265620504,"DANIEL, RENIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1609515220,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-6503 BREVARD ROAD,6503 BREVARD RD   ETOWAH NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265627574,"SAFT, ELIZABETH, LYNNE",6503 BREVARD RD   ETOWAH NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 122 , 153 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 19 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 62 , 97 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 68 , 75 , 100 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 54 , 80 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 32 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 48 , 71 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 405 , 486 , 605 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 34 , 42 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 44 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265631675,"HARTLEY, KATHERINE, GRAY",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265631931,"SHARMA, ADITYA, MULTANMAL",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265631931,"SHARMA, ADITYA, MULTANMAL",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265631931,"SHARMA, ADITYA, MULTANMAL",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265631931,"SHARMA, ADITYA, MULTANMAL",10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265631931,"SHARMA, ADITYA, MULTANMAL",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265632731,"KNOWLES, MARTYN",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1265632731,"KNOWLES, MARTYN",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 32 , 51 , 74 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265632731,"KNOWLES, MARTYN",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 61 , 71 , 90 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265632731,"KNOWLES, MARTYN",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265632731,"KNOWLES, MARTYN",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265632731,"KNOWLES, MARTYN",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 37 , 49 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1265632731,"KNOWLES, MARTYN",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265632731,"KNOWLES, MARTYN",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265632996,"PISHARODY, MURALI, DHARA",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 124 , 291 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265632996,"PISHARODY, MURALI, DHARA",1411 GREENWAY CT   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265633648,"MENDOZA, MICHELLE, LYN",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1265633648,"MENDOZA, MICHELLE, LYN",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265633648,"MENDOZA, MICHELLE, LYN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1265633648,"MENDOZA, MICHELLE, LYN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265633648,"MENDOZA, MICHELLE, LYN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265633648,"MENDOZA, MICHELLE, LYN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265635858,"HAGAN, ROBERT, STEWART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 46 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265635858,"HAGAN, ROBERT, STEWART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265635858,"HAGAN, ROBERT, STEWART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 51 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265635858,"HAGAN, ROBERT, STEWART",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1265635940,"REGAN, CONOR, MATTHEW",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 20 , 37 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265635940,"REGAN, CONOR, MATTHEW",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265635940,"REGAN, CONOR, MATTHEW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265635940,"REGAN, CONOR, MATTHEW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 34 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265635940,"REGAN, CONOR, MATTHEW",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 16 , 19 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265635940,"REGAN, CONOR, MATTHEW",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 23 , 35 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265635940,"REGAN, CONOR, MATTHEW",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 23 , 35 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1265637839,"FLOYD, TOM, SLEDGE",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 48 , 67 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265637839,"FLOYD, TOM, SLEDGE",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265637839,"FLOYD, TOM, SLEDGE",101 E W T HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 63 , 107 , 175 ,$#,,
MEDICAID DIRECT,1134172604,WESTERN PIEDMONT ANESTHESIA,WESTERN PIEDMONT ANESTHESIA,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265638183,"HARLINE, CORBIN, DENNIS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 36 , 38 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265638183,"HARLINE, CORBIN, DENNIS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 45 , 48 ,$#,,
MEDICAID DIRECT,1184921843,DUNN MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-DUNN,803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265639207,"KHANDELWAL, CHRISTINE, MAZZOLA",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1184921843,DUNN MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-DUNN,803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265639207,"KHANDELWAL, CHRISTINE, MAZZOLA",800 TILGHMAN DR   DUNN NC,043,Harnett,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1871052597,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KILDAIRE FARM ROAD,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265639207,"KHANDELWAL, CHRISTINE, MAZZOLA",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265639306,"TUCKER, ELLIOT, MOORE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265639306,"TUCKER, ELLIOT, MOORE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265640858,"BARROSO, LUIS, FRANCIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 59 , 96 , 99 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265640858,"BARROSO, LUIS, FRANCIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1760719843,LINER WARD & SHOBE DDS PA,SOUTHERN DENTAL ASSOCIATES,6570 SHALLOWFORD RD   LEWISVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265642920,"RASHE, PETER, JAMES",6570 SHALLOWFORD RD   LEWISVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265643332,"BACCHUS, LEON, SHAFRAZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265646582,"DAVID, RACHAL, ALICE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1265646582,"DAVID, RACHAL, ALICE",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265646582,"DAVID, RACHAL, ALICE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265646582,"DAVID, RACHAL, ALICE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265646582,"DAVID, RACHAL, ALICE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 36 , 36 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265646582,"DAVID, RACHAL, ALICE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 25 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265647069,"PICKERING, NATHAN, ROGER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 18 , 24 ,$#,,
MEDICAID DIRECT,1669123584,FOOT AND ANKLE SPECIALISTS OF THE M,,1 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1265648109,"SHEEDY, MATTHEW, REGAN",1 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265648109,"SHEEDY, MATTHEW, REGAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 13 , 19 , 26 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265648109,"SHEEDY, MATTHEW, REGAN",1 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 12 , 17 , 27 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265648109,"SHEEDY, MATTHEW, REGAN",1 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 101 , 238 , 387 ,$#,,
MEDICAID DIRECT,1265651293,HEALTHCORE HOMECARE,~,2949 NEW BERN AVE STE 108A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1265651293,HEALTHCORE HOMECARE,2949 NEW BERN AVE STE 108A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 23 ," 5,941 "," 6,479 "," $878,471.14 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265656011,"MCALHANY, CHRISTOPHER, DUKES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265656011,"MCALHANY, CHRISTOPHER, DUKES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265656011,"MCALHANY, CHRISTOPHER, DUKES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265656011,"MCALHANY, CHRISTOPHER, DUKES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265656011,"MCALHANY, CHRISTOPHER, DUKES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 40 , 49 , 75 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 25 , 32 , 83 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",2001 VAIL AVE STE 340 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 35 , 39 , 63 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",111 W GROVER ST   SHELBY NC,023,Cleveland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265656094,"FANDETTI, GLEN, ANTHONY",600 HOSPITAL DR   MONROE NC,090,Union,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 11 , 26 ,$#,,
MEDICAID DIRECT,1265656458,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAP SERVICES,1706 CEDAR CREEK RD   FAYETTEVILLE NC,026,Cumberland,251B00000X,Agencies,Case Management,,1265656458,CUMBERLAND COUNTY HOSPITAL SYSTEM I,1706 CEDAR CREEK RD   FAYETTEVILLE NC,026,Cumberland,251B00000X,Agencies,Case Management,, 314 ," 2,958 "," 2,959 "," $1,155,268.90 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265657894,"GEORGE, RONALD, LEE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 40 , 65 , 116 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265657894,"GEORGE, RONALD, LEE",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 55 , 74 , 114 ,$#,,
MEDICAID DIRECT,1417383837,MOSES CONE MEDICAL SERVICES INC,BROWN SUMMIT FAMILY MEDICINE,4901 NC HIGHWAY 150 E   BROWNS SUMMIT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265659288,"PICKARD II, WARREN, THOMAS",4901 NC HIGHWAY 150 E   BROWNS SUMMIT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 138 , 170 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265660120,"EWALD, TIMOTHY, JAMES",130 PLANTATION RIDGE DR STE 100 MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 28 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265660120,"EWALD, TIMOTHY, JAMES",269 GILLMAN RD STE 200B DENVER NC,055,Lincoln,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 41 , 71 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265660120,"EWALD, TIMOTHY, JAMES",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265660120,"EWALD, TIMOTHY, JAMES",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265660120,"EWALD, TIMOTHY, JAMES",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1306539838,NEWHOPE MEDICAL GROUP PA,,8422 US HIGHWAY 158   STOKESDALE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265661391,"MICHAELS, CHASE, ANDERSON",8422 US HIGHWAY 158   STOKESDALE NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 51 , 79 ,$#,,
MEDICAID DIRECT,1265150494,COVENANT SPINE AND NEUROLOGY PLLC,~,280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265661391,"MICHAELS, CHASE, ANDERSON",7779 NC HIGHWAY 68 N STE 2A STOKESDALE NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306539838,NEWHOPE MEDICAL GROUP PA,,8422 US HIGHWAY 158   STOKESDALE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265661391,"MICHAELS, CHASE, ANDERSON",7779 NC HIGHWAY 68 N STE 2A STOKESDALE NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699784660,ONSITE NEONATAL PC,~,1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1265661649,"MATAM, RAMESH",1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265662688,"VENTRAPRAGADA, SANDHYA",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265662688,"VENTRAPRAGADA, SANDHYA",16525 HOLLY CREST LN STE 150 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 33 ,$#,,
MEDICAID DIRECT,1659343440,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD GENERAL SURGERY DILLON,705 N 8TH AVE STE 2B DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265662886,"BERBIGLIA, LINDSAY, BRIANA",705 N 8TH AVE STE 2B DILLON SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265663066,COMFORT OF HOME CARE AGENCY LLC,~,246 DABNEY DR   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1265663066,COMFORT OF HOME CARE AGENCY LLC,246 DABNEY DR   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,, 83 ," 20,835 "," 21,195 "," $1,734,305.15 ",,
MEDICAID DIRECT,1013784875,PIEDMONT PARTNERS FOR MENTAL HEALTH,,2723 HORSE PEN CREEK RD STE 105 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265663371,"HUGHES, JO, ANDREA",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013784875,PIEDMONT PARTNERS FOR MENTAL HEALTH,,2723 HORSE PEN CREEK RD STE 105 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265663371,"HUGHES, JO, ANDREA",2723 HORSE PEN CREEK RD STE 105 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 98 , 249 , 405 ," $15,072.41 ",,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1265665400,"FLOCK, KELLIE, ELIZABETH",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 49 , 166 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265665707,"WALLENTIN, CYNTHIA, LYNN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265667000,"CHANDLER, ASHLEY, HUNT",4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 2,471 "," 2,901 "," 11,605 "," $398,604.62 ",,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265667000,"CHANDLER, ASHLEY, HUNT",3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 53 , 225 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265667117,"BASNET, EKTA",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265667117,"BASNET, EKTA",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 22 ,$#,,
MEDICAID DIRECT,1366588212,PRIVATE DIAGNOSTIC CLINIC PLLC,GENERAL INTERNAL MEDICINE,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265669907,"SUMMERVILLE, SARAH, GUO",234 CROOKED CREEK PKWY STE 520 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265669907,"SUMMERVILLE, SARAH, GUO",234 CROOKED CREEK PKWY STE 520 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265669907,"SUMMERVILLE, SARAH, GUO",234 CROOKED CREEK PKWY STE 520 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 39 , 41 ,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265670160,"WILLIAMS, ANGELA, MICHELLE",2505 COURT DR   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1871931253,MONARCH,~,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1265670160,"WILLIAMS, ANGELA, MICHELLE",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265677132,"CHAPA-RODRIGUEZ, ALEJANDRO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 17 , 26 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1265677199,"BRIZZOLARA, ROBERT, ANTHONY",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265677199,"BRIZZOLARA, ROBERT, ANTHONY",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 76 , 77 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265679898,"MCNAUGHTON, ERIC, DAVID",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1538418967,LANDERS AND LANDERS PLLC,~,2711 RANDOLPH RD STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265686836,"LANDERS, TYRONE, ANTONIO",2711 RANDOLPH RD STE 202 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 267 , 507 ," 1,463 "," $102,857.76 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2300 OAK RIDGE RD CORNER OF HIGHWAY 150 AND HIGHWAY 68 OAK RIDGE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265687339,"SOLOMON, DANA, CAROLINE",2300 OAK RIDGE RD   OAK RIDGE NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1105 S MAIN ST   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265687339,"SOLOMON, DANA, CAROLINE",2300 OAK RIDGE RD   OAK RIDGE NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265687339,"SOLOMON, DANA, CAROLINE",2300 OAK RIDGE RD   OAK RIDGE NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2770 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265687339,"SOLOMON, DANA, CAROLINE",2300 OAK RIDGE RD   OAK RIDGE NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,309 E CORNWALLIS DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265687339,"SOLOMON, DANA, CAROLINE",2300 OAK RIDGE RD   OAK RIDGE NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265688493,"REEVES, BRANDI, NIKCOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 14 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265690242,"CHENG, JEFFREY",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 24 , 27 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265690242,"CHENG, JEFFREY",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 85 , 111 , 132 ," $10,380.34 ",,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265692008,"HENNINGS, JACOB, RYAN",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265692073,"ARDELJAN, JOHNY, DENIS",1124 GALLERY PARK LN STE 103 WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265692073,"ARDELJAN, JOHNY, DENIS",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 166 , 254 , 445 ," $14,875.77 ",,
MEDICAID DIRECT,1265692537,"SHENOUDA, IHAB, MOURIS BOTROS",,727 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1265692537,"SHENOUDA, IHAB, MOURIS BOTROS",727 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 32 , 47 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 18 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 108 , 188 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1265694194,"POPA, MATTHEW, ALLAN",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124115886,DILLON INTERNAL MEDICINE,DILLON INTERNAL MEDICINE ASSOCIATES,705 N 8TH AVE STE 1A DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265695126,"WALLACE, JAMES, NICHOLAS",705 N 8TH AVE STE 1A DILLON SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1720033988,MCLEOD MEDICAL CENTER DILLION,MCLEOD MEDICAL CENTER DILLON,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265695126,"WALLACE, JAMES, NICHOLAS",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1063179729,S VAKIL DDS MS V PA,GROWING SMILES PEDIATRIC DENTISTRY- MORRISVILLE,4181 DAVIS DR STE 100B MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1265695597,"TU, JENNY, TSU",4181 DAVIS DR STE 100B MORRISVILLE NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 735 ," 1,352 "," 5,858 "," $186,453.82 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265695639,"PARIC, POLINA, ALEKSANDROVNA",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 241 , 304 , 368 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265696140,"SOPKO, DAVID, RICHARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265696264,UNITED SEATING AND MOBILITY LLC,NUMOTION,7908 INDUSTRIAL VILLAGE RD STE B GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1265696264,UNITED SEATING AND MOBILITY LLC,7908 INDUSTRIAL VILLAGE RD STE B GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 29 , 34 , 50 ," $99,369.05 ",,
MEDICAID DIRECT,1265696264,UNITED SEATING AND MOBILITY LLC,NUMOTION,7908 INDUSTRIAL VILLAGE RD STE B GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265696264,UNITED SEATING AND MOBILITY LLC,7908 INDUSTRIAL VILLAGE RD STE B GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 664 ," 1,820 "," 4,298 "," $1,607,336.61 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265697080,"ELBEERY, JOSEPH, DODSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265697734,"GRIGGS, BRIAN, JOSEPH",5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265697734,"GRIGGS, BRIAN, JOSEPH",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780822098,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF RALEIGH,10880 DURANT RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265699243,"BAINS, SONIA, NOREEN",10880 DURANT RD STE 200 RALEIGH NC,092,Wake,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 26 , 50 , 69 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1265701577,"MURPHY, KATHRYN, CORINE",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265701577,"MURPHY, KATHRYN, CORINE",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 242 , 242 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6840 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265701577,"MURPHY, KATHRYN, CORINE",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265703581,"MCKINZIE, TRACEY",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 40 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265703581,"MCKINZIE, TRACEY",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265703607,MCPHERSON FAMILY EYE CARE,MCPHERSON FAMILY EYE CARE,3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1265703607,MCPHERSON FAMILY EYE CARE,3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,, 103 , 104 , 205 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265704290,"BLEIER, ERICA, ESSMAN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265707590,"ONI, ADELEKE, AYOKUNLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265707590,"ONI, ADELEKE, AYOKUNLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265707590,"ONI, ADELEKE, AYOKUNLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265708796,"CHO, YONGHEE, KRISTINA",3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265710065,"PATIBANDLA, GOPI, K",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1497084982,WAKE ENDOSCOPY CENTER LLC,~,2601 LAKE DR STE 201 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1265711444,"HUSSAIN, FARAH, SHERI BAHA A",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265711444,"HUSSAIN, FARAH, SHERI BAHA A",10540 LIGON MILL RD STE 109 WAKE FOREST NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265711444,"HUSSAIN, FARAH, SHERI BAHA A",10540 LIGON MILL RD STE 109 WAKE FOREST NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265717474,"SINGHAL, MAYANK",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 91 , 91 ,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265717474,"SINGHAL, MAYANK",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265717474,"SINGHAL, MAYANK",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265721872,"STEARNS, CORDELIA, RAYMOND",935 STATE FARM RD   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 22 , 28 ,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,160 DEN MAC DR   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265721872,"STEARNS, CORDELIA, RAYMOND",935 STATE FARM RD   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265723126,"WARING, JAMES, LAWRENCE",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",1545 ORCHARD VILLAS AVE   APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 22 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 ,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 22 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265725329,"PIDGEON, TYLER, STEVEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265726335,"PHILLIPS, RICHARD, BROCK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 51 , 86 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265726483,"DUENSING, SARAH, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 146 , 148 ," $11,226.02 ",,
MEDICAID DIRECT,1326394990,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1265726665,"GREER, ASHLEY, WINTER",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326394990,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1265726665,"GREER, ASHLEY, WINTER",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265726855,"MICHAEL, AMANDA, LEIGH",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265726855,"MICHAEL, AMANDA, LEIGH",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1265726855,"MICHAEL, AMANDA, LEIGH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265727192,"WILLIAMS, DAVETTE, WAGNER",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265727192,"WILLIAMS, DAVETTE, WAGNER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265728281,"PATEL, JITENDRA, KANUBHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265728281,"PATEL, JITENDRA, KANUBHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1265728281,"PATEL, JITENDRA, KANUBHAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265728281,"PATEL, JITENDRA, KANUBHAI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 80 , 80 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265728281,"PATEL, JITENDRA, KANUBHAI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 37 , 37 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265728489,"KALARIA, CHANDNI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 67 , 133 , 133 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265730220,"HARRIS, CHRISTOPHER, LEE TOTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265730220,"HARRIS, CHRISTOPHER, LEE TOTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265730220,"HARRIS, CHRISTOPHER, LEE TOTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265730220,"HARRIS, CHRISTOPHER, LEE TOTH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265738157,WEST BLADEN ASSISTED LIVING LLC,WEST BLADEN ASSISTED LIVING LLC,714 E BLADEN ST   BLADENBORO NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265738157,WEST BLADEN ASSISTED LIVING LLC,714 E BLADEN ST   BLADENBORO NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 44 ," 3,309 "," 3,310 "," $806,434.03 ",,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265738371,"POLYNICE, MARIE, JUDETTE",915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265738371,"POLYNICE, MARIE, JUDETTE",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265742852,LOFTIS HOME MEDICAL LLC,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1265742852,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1265742852,LOFTIS HOME MEDICAL LLC,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1265742852,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1265742852,LOFTIS HOME MEDICAL LLC,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265742852,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1265742852,LOFTIS HOME MEDICAL LLC,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1265742852,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 25 , 25 ," $10,285.66 ",,
MEDICAID DIRECT,1265742852,LOFTIS HOME MEDICAL LLC,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265742852,LOFTIS HOME MEDICAL LLC,940 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 362 ," 2,101 "," 2,867 "," $61,478.88 ",,
MEDICAID DIRECT,1265742951,CARING FOR YOU SERVICES LLC,~,2416 ROCK QUARRY RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1265742951,CARING FOR YOU SERVICES LLC,2416 ROCK QUARRY RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 105 , 105 ,$#,,
MEDICAID DIRECT,1407188600,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PULMONARY & SLEEP CENTER,2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265744429,"DAVIDSON, JAMES",2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265744429,"DAVIDSON, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 59 , 108 , 120 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265744429,"DAVIDSON, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 ,#, 12 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265745327,"ENGLAND, ELIZABETH, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 87 , 103 , 121 ," $20,874.63 ",,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265745327,"ENGLAND, ELIZABETH, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265745327,"ENGLAND, ELIZABETH, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 22 , 22 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265745327,"ENGLAND, ELIZABETH, ANN",24 FALCON CREST LN   CLYDE NC,044,Haywood,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265745384,"KOMABAYASHI, TAKASHI",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265745384,"KOMABAYASHI, TAKASHI",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265745384,"KOMABAYASHI, TAKASHI",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223E0200X,Dental Providers,Dentist,Endodontics, 285 , 316 , 581 ," $57,023.36 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,CB #7450 UNC SCHOOL OF DENTISTRY CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1265745384,"KOMABAYASHI, TAKASHI",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223E0200X,Dental Providers,Dentist,Endodontics,#,#, 11 ,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265746002,"LAMBERTUS, VIKI",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265746002,"LAMBERTUS, VIKI",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 40 , 42 ,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1265750194,"LOCKLEAR, GINGER, NICHOLE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1265750194,"LOCKLEAR, GINGER, NICHOLE",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 114 , 190 , 548 ," $26,452.61 ",,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1265750194,"LOCKLEAR, GINGER, NICHOLE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1265752273,"MOORE, DONNESHIA, GABRIELLE",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265752273,"MOORE, DONNESHIA, GABRIELLE",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265752794,"KASSOUF, BETHANY, HUNT",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1265752943,"FRANKLIN, JOHN, DAVID",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265752943,"FRANKLIN, JOHN, DAVID",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 28 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265752943,"FRANKLIN, JOHN, DAVID",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 30 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265752976,"BROWN, MALLORY, MCCLESTER",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 24 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265752976,"BROWN, MALLORY, MCCLESTER",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 78 , 151 ,$#,,
MEDICAID DIRECT,1265754170,UNITED HOME CARE AND HEALTH SOLUTIO,UNITED HOME CARE AND HEALTH SOLUTIONS INCORPORATE,3440 ST VARDELL LN STE B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1265754170,UNITED HOME CARE AND HEALTH SOLUTIO,3440 ST VARDELL LN STE B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 45 ," 10,454 "," 10,459 "," $764,691.68 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265756191,"DUGGAN, CRAIG, DENNIS",4515 PREMIER DR STE 307 HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265756944,"TURNBULL, MARGARET, ANN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265756944,"TURNBULL, MARGARET, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265757058,"MURPHY, SAVANNAH, RUTH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265757728,"SEEBURG, DANIEL, PHILIP",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 176 , 180 , 213 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265757728,"SEEBURG, DANIEL, PHILIP",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 206 , 218 , 252 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,293D00000X,Laboratories,Physiological Laboratory,,1265757728,"SEEBURG, DANIEL, PHILIP",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659759389,EASTERN RADIATION ONCOLOGY PLLC,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1265758205,"RUSTHOVEN, CHAD, GEORGE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 25 , 76 , 92 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265758544,"TRIFIRO, SETH, JAMES",1001 NEWMAN RD   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265758544,"TRIFIRO, SETH, JAMES",4275 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 73 , 108 , 164 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265759526,"BLUMBERG, JEFFREY, MARTIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 44 , 76 , 112 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265759526,"BLUMBERG, JEFFREY, MARTIN",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1154456986,COUNTY OF GUILFORD,~,1203 MAPLE ST   GREENSBORO NC,041,Guilford,251B00000X,Agencies,Case Management,,1265759666,"MCNEIL, CANDICE, JOY",1203 MAPLE ST   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 357 , 861 , 861 ," $324,372.59 ",,
MEDICAID DIRECT,1245272657,COUNTY OF GUILFORD,GUILFORD CO DEPT PUBLIC HEALTH,1203 MAPLE ST   GREENSBORO NC,041,Guilford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265759666,"MCNEIL, CANDICE, JOY",1203 MAPLE ST   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265759666,"MCNEIL, CANDICE, JOY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 32 , 57 , 57 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265760268,"SMITH, VIRGINIA, FOUST",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 34 , 34 , 38 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265760268,"SMITH, VIRGINIA, FOUST",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1265760920,180 MEDICAL INC,,717 ATANDO AVE STE J CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1265760920,180 MEDICAL INC,717 ATANDO AVE STE J CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265760920,180 MEDICAL INC,,717 ATANDO AVE STE J CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265760920,180 MEDICAL INC,717 ATANDO AVE STE J CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 259 ," 1,592 "," 3,809 "," $857,313.84 ",,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265761720,"JHA, SHALINEE",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265761720,"JHA, SHALINEE",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265761720,"JHA, SHALINEE",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265761720,"JHA, SHALINEE",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 27 ,$#,,
MEDICAID DIRECT,1902614464,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY UROLOGY,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265762173,"FUGALLI, BELINDA, KAYDIANNE",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265762173,"FUGALLI, BELINDA, KAYDIANNE",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 95 , 123 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265762173,"FUGALLI, BELINDA, KAYDIANNE",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1265763205,THERAPEUTIC ALTERNATIVES INC,CANDOR HOUSE,110 E BLAKE ST   CANDOR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265763205,THERAPEUTIC ALTERNATIVES INC,110 E BLAKE ST   CANDOR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 233 , 233 ," $14,864.24 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265764112,"HANNEMAN, MARIYA",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,168 NORMAN STATION BLVD STE Q MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265764112,"HANNEMAN, MARIYA",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2280 HWY 70 SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265764112,"HANNEMAN, MARIYA",2280 HWY 70 SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 75 , 174 ,$#,,
MEDICAID DIRECT,1689992851,ADVANCED BRACE LIMB,ADVANCED BRACE & LIMB,4140 FERNCREEK DR STE 803 FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265764120,"FREEDLANDER, AARON, ROSS",4140 FERNCREEK DR STE 803 FAYETTEVILLE NC,026,Cumberland,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1689992851,ADVANCED BRACE LIMB,ADVANCED BRACE & LIMB,4140 FERNCREEK DR STE 803 FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265764120,"FREEDLANDER, AARON, ROSS",4140 FERNCREEK DR STE 803 FAYETTEVILLE NC,026,Cumberland,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 23 , 23 , 30 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265766158,"MARA, BRUNILDA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265766158,"MARA, BRUNILDA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1265766158,"MARA, BRUNILDA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265766471,"MANESS, CARRIE, BRUNO",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1265766471,"MANESS, CARRIE, BRUNO",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1265766471,"MANESS, CARRIE, BRUNO",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265766471,"MANESS, CARRIE, BRUNO",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265766471,"MANESS, CARRIE, BRUNO",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265768485,"MAGEL, GEORGE, DIMITRI",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 42 , 66 , 137 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265768485,"MAGEL, GEORGE, DIMITRI",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 109 , 176 , 305 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1265768485,"MAGEL, GEORGE, DIMITRI",315 19TH ST SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 15 , 20 , 39 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265768485,"MAGEL, GEORGE, DIMITRI",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,315 19TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265768485,"MAGEL, GEORGE, DIMITRI",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265768873,"HARMON, DEREK",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265768873,"HARMON, DEREK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1265768873,"HARMON, DEREK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 48 , 59 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265768873,"HARMON, DEREK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 33 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265768873,"HARMON, DEREK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265768873,"HARMON, DEREK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265768873,"HARMON, DEREK",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265769392,"BERKOWITZ, SETH, ALOISI",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265769392,"BERKOWITZ, SETH, ALOISI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265770309,"RAMIREZ, OSCAR, ANTONIO",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265770309,"RAMIREZ, OSCAR, ANTONIO",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265770309,"RAMIREZ, OSCAR, ANTONIO",101 E W T HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265770309,"RAMIREZ, OSCAR, ANTONIO",101 E W T HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 29 , 29 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265770309,"RAMIREZ, OSCAR, ANTONIO",206 GAMBLE DR STE C LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265770309,"RAMIREZ, OSCAR, ANTONIO",206 GAMBLE DR STE C LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609386424,SPARTANBURG MEDICAL CENTER,MGC-ORTHOPAEDIC SURGERY- NORTH GROVE,1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265775217,"LANGLEY, KATHERINE, JANE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265775217,"LANGLEY, KATHERINE, JANE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265775928,"BURRITT, DANIEL, JAMES",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265776306,"ACHOR, ALEXA, GREGORY",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 155 , 243 , 433 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265776553,"WRIGHT, RHONDA, MICHELLE",600 HOSPITAL DR   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1265776553,"WRIGHT, RHONDA, MICHELLE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265776553,"WRIGHT, RHONDA, MICHELLE",520 ALLEN ST   TROY NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265776553,"WRIGHT, RHONDA, MICHELLE",520 ALLEN ST   TROY NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265776900,"SALVEMINI, SURAIYA, JANE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265777056,"DURHAM, KATIE, TRIANA",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 23 ,$#,,
MEDICAID DIRECT,1881648442,DDP PHARMACY INC,DDP PHARMACY INC,107 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1265779797,"JONES, WILLIE, MARK",107 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,773 RUSS AVE   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265781868,"KOVALIK, ADRIANA, KOOTZ",773 RUSS AVE   WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265785463,LILLINGTON OPERATIONS LLC,GREEN LEAF CARE CENTER,2041 NC 210 N   LILLINGTON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265785463,LILLINGTON OPERATIONS LLC,2041 NC 210 N   LILLINGTON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 41 ," 10,132 "," 10,132 "," $686,838.16 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1265786115,"TIWARI, MANISHA, KATHMANDU",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265786115,"TIWARI, MANISHA, KATHMANDU",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 225 , 551 ," 1,094 "," $18,200.02 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265788384,"WOLFF, BRADLEY, FOREMAN",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265792915,"ESKEW, ASHLEY, MARIE",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1265793145,"WIDELOCK, TALLA, MOTAKEF",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265793145,"WIDELOCK, TALLA, MOTAKEF",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 121 , 152 , 207 ," $19,211.66 ",,
MEDICAID DIRECT,1770610602,COUNTY OF EDGECOMBE OFFICE OF AUDI,EDGECOMBE COUNTY HEALTH DEPARTMENT,122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265794226,"BAKER, CHRISTOPHER, DAVID",122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,798 "," 3,455 "," 13,852 "," $601,182.79 ",,
MEDICAID DIRECT,1831174028,DRS JERNIGAN AND ASSOCIATES,DRS JERNIGAN AND ASSOCIATES,1427 N WESLEYAN BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1265794226,"BAKER, CHRISTOPHER, DAVID",122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,1223G0001X,Dental Providers,Dentist,General Practice, 68 , 73 , 292 ," $54,952.47 ",,
MEDICAID DIRECT,1891886222,MARSHALL C MURREY MD,MARSHALL CARY MURREY MD,950 STATE FARM RD STE 300 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1265794382,"WILLIAMS, KAREN, EDITH",950 STATE FARM RD STE 350 BOONE NC,095,Watauga,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1265798052,"TORRES, JOSEPH, DEREK",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 104 , 109 , 114 ,$#,,
MEDICAID DIRECT,1265798243,HENDERSON COUNTY RESCUE SQUAD,HENDERSON COUNTY RESCUE SQUAD,2529 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,3416L0300X,Transportation Services,Ambulance,Land Transport,1265798243,HENDERSON COUNTY RESCUE SQUAD,2529 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,3416L0300X,Transportation Services,Ambulance,Land Transport, 175 , 269 , 489 ," $15,418.70 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265798631,"MANTRI, SNEHA, ARUN",932 MORREENE RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265798631,"MANTRI, SNEHA, ARUN",932 MORREENE RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265798631,"MANTRI, SNEHA, ARUN",932 MORREENE RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1265799159,"GOLDEN, KALEE, MARIE",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 113 , 223 , 352 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265800346,"STEELMAN, LALAGAY, LAWSON",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#, 17 , 17 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265800346,"STEELMAN, LALAGAY, LAWSON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1265801815,"ETEO, NICOLE, MARIE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 41 , 51 , 128 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1265801815,"ETEO, NICOLE, MARIE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 12 ,#, 18 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1265801815,"ETEO, NICOLE, MARIE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 17 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265802227,"GOULD, ANGELA, LEIGH",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265807606,DOGWOOD PEDIATRIC THERAPY PLLC,,6428 CAPE CHARLES DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265807606,DOGWOOD PEDIATRIC THERAPY PLLC,6428 CAPE CHARLES DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#, 85 , 85 ,$#,,
MEDICAID DIRECT,1265807606,DOGWOOD PEDIATRIC THERAPY PLLC,,8390 SIX FORKS RD STE 104 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265807606,DOGWOOD PEDIATRIC THERAPY PLLC,8390 SIX FORKS RD STE 104 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 21 , 203 , 214 ," $10,648.02 ",,
MEDICAID DIRECT,1962097626,BREECHES BUOY ADDICTION MEDICINE,~,2550 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1265807648,"MARTIN, JOHANNAH, CECELIA",2550 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 S CAREY ST   LA GRANGE NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1265809990,"SHEARER, LAURA, WHITFIELD",101 S CAREY ST   LA GRANGE NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265809990,"SHEARER, LAURA, WHITFIELD",101 S CAREY ST   LA GRANGE NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 66 , 178 , 311 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265809990,"SHEARER, LAURA, WHITFIELD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265810808,"ARAFEH, MOHAMED-OMAR, SAMIR",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265810808,"ARAFEH, MOHAMED-OMAR, SAMIR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 83 , 86 ," $10,580.34 ",,
MEDICAID DIRECT,1245600931,RICCOBENE & ASSOCIATES XVI DDS PA,BRUSH AND FLOSS ORTHODONTICS,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1265811707,"MORGENSTERN, ASHLEY, DIANE",2250 NASH ST N   WILSON NC,098,Wilson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1841694254,LANE AND ASSOCIATES XXVIII DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1265814297,"SKOUSEN, JOEL, REUBEN",473 WOOD ST   TROY NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 720 , 994 ," 3,411 "," $140,220.96 ",,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1265814297,"SKOUSEN, JOEL, REUBEN",473 WOOD ST   TROY NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154954550,LANE AND ASSOCIATES XXXVII DDS PA,,473 WOOD ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1265814297,"SKOUSEN, JOEL, REUBEN",473 WOOD ST   TROY NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 182 , 319 , 948 ," $64,303.71 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265819353,"MVULA, MADELEINE, MALEMBE",13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265819353,"MVULA, MADELEINE, MALEMBE",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 48 , 57 ,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,4024 STIRRUP CREEK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265820260,"RONK, ASHLEY, MCDANIEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,10901 WORLD TRADE BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265820260,"RONK, ASHLEY, MCDANIEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1265821011,"HAN, BRIAN, S",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1265821995,"MCLEAN, RANDAL, NICOLE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 24 , 56 ,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1265821995,"MCLEAN, RANDAL, NICOLE",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 41 , 67 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265822126,"CONNER, WILLIAM, BLAKE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1265822126,"CONNER, WILLIAM, BLAKE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 45 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265822126,"CONNER, WILLIAM, BLAKE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265822407,"ELLINGTON, KELLY, ANN",507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 20 , 24 , 51 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265822407,"ELLINGTON, KELLY, ANN",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265822407,"ELLINGTON, KELLY, ANN",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265822407,"ELLINGTON, KELLY, ANN",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2076 VETERANS PKWY STE 250 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265822407,"ELLINGTON, KELLY, ANN",2076 VETERANS PKWY STE 250 CLAYTON NC,051,Johnston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1376899252,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF MCGEES CROSSROADS,70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265822407,"ELLINGTON, KELLY, ANN",550 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265822407,"ELLINGTON, KELLY, ANN",550 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1265822464,"FULTON, CHRISTINA",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265822464,"FULTON, CHRISTINA",3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1265826481,ALL AROUND THERAPY PLLC,,1800 FOUR SEASONS BLVD STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265826481,ALL AROUND THERAPY PLLC,1800 FOUR SEASONS BLVD STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,, 46 , 991 ," 1,004 "," $66,792.94 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265827638,"WILLIAMS, MICHAEL, TODD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265827638,"WILLIAMS, MICHAEL, TODD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265828487,"CARROLL, TREVOR, DUGAN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 31 , 56 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265828487,"CARROLL, TREVOR, DUGAN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 76 , 127 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265828487,"CARROLL, TREVOR, DUGAN",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 37 , 61 , 94 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1265828487,"CARROLL, TREVOR, DUGAN",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 45 , 69 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265828503,"EGWAKHE, ADEKUNBI, ETSEOGBOYA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265828503,"EGWAKHE, ADEKUNBI, ETSEOGBOYA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 102 , 102 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265828503,"EGWAKHE, ADEKUNBI, ETSEOGBOYA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 105 , 105 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265828503,"EGWAKHE, ADEKUNBI, ETSEOGBOYA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265828503,"EGWAKHE, ADEKUNBI, ETSEOGBOYA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265828503,"EGWAKHE, ADEKUNBI, ETSEOGBOYA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265828503,"EGWAKHE, ADEKUNBI, ETSEOGBOYA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265829360,"REHMAN, ZUBAIR, UR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 47 , 47 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265829360,"REHMAN, ZUBAIR, UR",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265829477,"ROTBERG, DAVID, ELIJAH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 93 , 93 , 98 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265829493,"FOUSHEE, MADISON, STEELE",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265829840,"HAMM, JACOB, BRADLEY",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,1265829840,"HAMM, JACOB, BRADLEY",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265830095,"PASQUINI, GINNY, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265832554,"HALL, CARRIE, VIRGINIA",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265832554,"HALL, CARRIE, VIRGINIA",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 74 , 77 ,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265832554,"HALL, CARRIE, VIRGINIA",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 26 ,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265832554,"HALL, CARRIE, VIRGINIA",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265832612,"HATCH, JACQUELINE, PARKER",604 W MAIN ST   JAMESTOWN NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265832612,"HATCH, JACQUELINE, PARKER",931 3RD ST   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265833479,"SIMPSON, JONATHAN, BROOKS",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 316 , 400 , 446 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",107B MICA AVE   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",107B MICA AVE   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265833727,"BECK, CHRISTOPHER, KEITH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265840003,"MISHRA, RAMESH, RAJ",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 177 , 585 ," 1,162 "," $19,154.51 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1265840003,"MISHRA, RAMESH, RAJ",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508190067,CROSSROADS SEXUAL ASSAULT RESPONSE,CROSSROADS SEXUAL ASSAULT RESPONSE & RESOURCE CENT,1206 VAUGHN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265841514,"MARTIN, MARGARET, MICHELE",317 CHEROKEE CAMP RD   REIDSVILLE NC,079,Rockingham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1265842181,"MAO, YUQI",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,106 LONG SHOALS RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265842181,"MAO, YUQI",106 LONG SHOALS RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265842181,"MAO, YUQI",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1265842181,"MAO, YUQI",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 27 , 47 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1265842181,"MAO, YUQI",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1265842181,"MAO, YUQI",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 25 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265842298,"LI, WINSTON, YUNQING",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1265842637,"JORDAN, KATHERINE, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1265842637,"JORDAN, KATHERINE, ANN",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 20 , 58 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265842892,"POWELL, STEPHEN, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 56 , 62 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265842892,"POWELL, STEPHEN, LEE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265842892,"POWELL, STEPHEN, LEE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1265842900,"PAGE, STEPHANIE, ORTIZ",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 19 , 43 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1265842900,"PAGE, STEPHANIE, ORTIZ",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 109 , 273 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265843866,"SCARRITT, THOMAS, VARNON",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1265843866,"SCARRITT, THOMAS, VARNON",7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265844880,"FERRANDINO, SUSAN, ELIZABETH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265845101,"MAPAKSHI, SWAPNA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 42 , 42 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265845176,"FIELDS, RYAN, MICHAEL",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265846331,"MUSSHORN, EMMA, L",2025 GLENN MITCHELL DR   VA BEACH VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265846729,"YOUNCE, DANICELA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265846729,"YOUNCE, DANICELA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 41 , 41 ,$#,,
MEDICAID DIRECT,1275685844,LANE AND ASSOCIATES V DDS PA,LANE AND ASSOCIATES,598 E JACKSON BLVD STE 100 ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265847388,"KINNO, MICHAEL, FAIK",15 RAWLS RD   ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1275685844,LANE AND ASSOCIATES V DDS PA,LANE AND ASSOCIATES,598 E JACKSON BLVD STE 100 ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265847388,"KINNO, MICHAEL, FAIK",6540 CLINTON RD   STEDMAN NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#, 12 , 27 ,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,6540 CLINTON RD   STEDMAN NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265847388,"KINNO, MICHAEL, FAIK",6540 CLINTON RD   STEDMAN NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 569 ," 1,334 "," 3,889 "," $178,207.44 ",,
MEDICAID DIRECT,1275685844,LANE AND ASSOCIATES V DDS PA,LANE AND ASSOCIATES,598 E JACKSON BLVD STE 100 ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1265847388,"KINNO, MICHAEL, FAIK",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265847420,"ROOKS, ABIGAIL, LISA",,,,Unknown,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1265847420,"ROOKS, ABIGAIL, LISA",601 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265847420,"ROOKS, ABIGAIL, LISA",,117 E KINGS HWY   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1265847420,"ROOKS, ABIGAIL, LISA",117 E KINGS HWY   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 75 , 127 ,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1265847420,"ROOKS, ABIGAIL, LISA",117 E KINGS HWY   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1265847420,"ROOKS, ABIGAIL, LISA",,607 S MAIN ST UNIT E KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1265847420,"ROOKS, ABIGAIL, LISA",607 S MAIN ST UNIT E KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 24 ,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265848238,"DIXON, MARI, NEWTON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265848238,"DIXON, MARI, NEWTON",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265851109,"GOLDSTEIN, AARON, LOUIS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 160 , 160 ," $10,983.13 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265851109,"GOLDSTEIN, AARON, LOUIS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 170 , 172 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265851364,"SIEKMAN, NEIL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 166 , 166 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265851364,"SIEKMAN, NEIL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265851562,"WELLINGTON, JENNIFER, LYNNE",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 87 , 111 , 131 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265851562,"WELLINGTON, JENNIFER, LYNNE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265851562,"WELLINGTON, JENNIFER, LYNNE",1225 HARDING PL STE 5200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265851562,"WELLINGTON, JENNIFER, LYNNE",808 N WASHINGTON ST   SHELBY NC,023,Cleveland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1265852156,"CARROLL, ALYSSA, LEAHEY",1514 GLENWOOD AVE   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265852685,"LOCKLEAR, AARON, MAURICE",412 S JONES ST   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 203 , 466 , 595 ," $22,088.16 ",,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265853048,"FULLER, TORICA, TODAI",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 60 ,$#,,
MEDICAID DIRECT,1265854855,GENETIC TECHNOLOGICAL INNOVATIONS,GTI LABORATORIES,13402 N NORTH SCOTTSDALE RD STE 190 SCOTTSDALE AZ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1265854855,GENETIC TECHNOLOGICAL INNOVATIONS,13402 N NORTH SCOTTSDALE RD STE 190 SCOTTSDALE AZ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#, 14 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13440 NC 210 HWY   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265856330,"SMITH, CHAD, JOSEPH",7201 US HIGHWAY 64 E   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265858047,"COWARD, SHANNON, HIATT",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265858047,"COWARD, SHANNON, HIATT",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 25 , 78 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265858195,"HILL, SUSAN, BLAIR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 57 , 57 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265858195,"HILL, SUSAN, BLAIR",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1265858195,"HILL, SUSAN, BLAIR",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 56 , 154 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 351 , 430 , 500 ," $11,168.48 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1265859193,"OLINGER, KRISTEN, LORRAINE CHECKS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265860829,"SCHOOLEY, SARAH, RUTH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 69 , 85 ,$#,,
MEDICAID DIRECT,1265863831,BRADLEY A WRUBLE OD PLLC,BELMONT EYE,111 S MAIN ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1265863831,BRADLEY A WRUBLE OD PLLC,111 S MAIN ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,, 401 , 421 , 798 ,$#,,
MEDICAID DIRECT,1265865489,EASTWAY FAMILY CARE,~,108 EASTWAY LN   GRAHAM NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265865489,EASTWAY FAMILY CARE,108 EASTWAY LN   GRAHAM NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 339 , 339 ," $22,980.27 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265865653,"IRELAND, KRISTIN, MARGARET",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265866990,"MIECZKOWSKI, JACLYN, MARYANNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265866990,"MIECZKOWSKI, JACLYN, MARYANNA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265866990,"MIECZKOWSKI, JACLYN, MARYANNA",1023 EDGEHILL RD S   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265869408,"ROSE, TIFFANY, HUMPHREYS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265870687,"MCCANN, DAWN, JEANETTE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 24 , 24 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265870687,"MCCANN, DAWN, JEANETTE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265873186,"HOUSER, SCOTT, ANDREW",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 40 ,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265873194,"DIPAOLO, ZACHARY, JEFFREY",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265875017,"MATRONE, ANDREW, KENNETH",2412 WINDSOR TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1437501863,MATRONE PRIMARY CARE,,2412 WINDSOR TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265875017,"MATRONE, ANDREW, KENNETH",2412 WINDSOR TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 76 , 449 , 477 ," $26,975.71 ",,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265876932,"OVERMILLER, ALEX, CARL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 60 , 63 , 91 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265876932,"OVERMILLER, ALEX, CARL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265878680,"SHAFFER, KRISTINA, MAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265878680,"SHAFFER, KRISTINA, MAY",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265878680,"SHAFFER, KRISTINA, MAY",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 31 , 34 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265880124,"SANTIAGO-WICKEY, JENNA, NICOLE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 40 , 40 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265880124,"SANTIAGO-WICKEY, JENNA, NICOLE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265880124,"SANTIAGO-WICKEY, JENNA, NICOLE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265880124,"SANTIAGO-WICKEY, JENNA, NICOLE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1265880124,"SANTIAGO-WICKEY, JENNA, NICOLE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",1530 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265881015,"MALLOY, FAITH, MARIE",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265881775,"BERNARD, JONATHAN, DAVID",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265881809,"MINKOWSKI, JONATHAN, SHREVE",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 68 , 108 , 145 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265881809,"MINKOWSKI, JONATHAN, SHREVE",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265881809,"MINKOWSKI, JONATHAN, SHREVE",10520 PARK RD   CHARLOTTE NC,060,Mecklenburg,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1265882021,"MOSHTAGHI, ALEXANDER, CYRUS",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1265882021,"MOSHTAGHI, ALEXANDER, CYRUS",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 78 , 103 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1265883466,"WALKER, SUSAN, RENEE",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1265883466,"WALKER, SUSAN, RENEE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265883466,"WALKER, SUSAN, RENEE",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 64 , 78 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1265883466,"WALKER, SUSAN, RENEE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 35 , 48 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265883516,"ALLEN, ASHLEY, NICOLE COBB",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 13 , 22 , 24 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265883516,"ALLEN, ASHLEY, NICOLE COBB",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265883516,"ALLEN, ASHLEY, NICOLE COBB",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265883516,"ALLEN, ASHLEY, NICOLE COBB",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265883516,"ALLEN, ASHLEY, NICOLE COBB",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265883516,"ALLEN, ASHLEY, NICOLE COBB",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1713 S CHURCH ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1265883557,"BAUER, JESSICA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 17 , 20 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265883557,"BAUER, JESSICA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 49 , 73 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265883557,"BAUER, JESSICA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 21 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265885461,"RIFKIN, RACHEL, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1265886626,"GOLDEN, ANDREW, JARROD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1265886626,"GOLDEN, ANDREW, JARROD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1265886626,"GOLDEN, ANDREW, JARROD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1265886626,"GOLDEN, ANDREW, JARROD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265886808,"WHITLEY, WYATT, STEWART",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265886808,"WHITLEY, WYATT, STEWART",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265886808,"WHITLEY, WYATT, STEWART",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265889224,"SCOTT, ELIZABETH, JOY",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265889224,"SCOTT, ELIZABETH, JOY",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265889224,"SCOTT, ELIZABETH, JOY",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265889224,"SCOTT, ELIZABETH, JOY",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265890560,"VETSCH, PAMELA, HOPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 40 , 43 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265890560,"VETSCH, PAMELA, HOPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 25 , 26 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265890560,"VETSCH, PAMELA, HOPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265890560,"VETSCH, PAMELA, HOPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265894133,"TATUM, BRITTANY, BRINKLEY",335 E PARKER RD   MORGANTON NC,012,Burke,152W00000X,Eye and Vision Services Providers,Optometrist,, 71 , 85 , 95 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265894414,"KITCHEN, ANDREW, DAMON",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265894414,"KITCHEN, ANDREW, DAMON",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 28 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265894414,"KITCHEN, ANDREW, DAMON",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1265894414,"KITCHEN, ANDREW, DAMON",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 89 , 90 , 141 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265894513,"MARTIN, MATTHEW, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 91 , 127 , 137 ,$#,,
MEDICAID DIRECT,1720177140,COUNTY OF DAVIE OFFICE OF FINANCE A,DAVIE COUNTY HEALTH DEPARTMENT,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1265894612,"DOWLEN, ELISABETH, JANTZEN",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 22 , 45 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1265895676,"ALMAGUER, ADAM, MICHAEL",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265895676,"ALMAGUER, ADAM, MICHAEL",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1265895676,"ALMAGUER, ADAM, MICHAEL",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1265895676,"ALMAGUER, ADAM, MICHAEL",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1265895676,"ALMAGUER, ADAM, MICHAEL",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265896278,"SEBASI, ADAM, MARCUS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649216631,PIEDMONT EAR NOSE AND THROAT PA,PIEDMONT EAR NOSE AND THROAT ASSOCIATES,110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1265896906,"CASALE, GARRETT, GARROD ARTHUR",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 61 , 90 , 197 ,$#,,
MEDICAID DIRECT,1578854147,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST UNIT 2 DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1265896989,"BUCKENHEIMER, ALYSSA, SHARON",105 N CRUTCHFIELD ST UNIT 2 DOBSON NC,086,Surry,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265897789,"COLE, JUSTIN, BROCK",1 HOSPITAL DR STE 4200   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265897789,"COLE, JUSTIN, BROCK",1 HOSPITAL DR STE 4200   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6901 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265897847,"SCHMIERER, PAMELA, LYNNE",6132 CAROLINA BEACH RD STE 8 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427389865,MASONBORO URGENT CARE PC,MASONBORO URGENT CARE PC,6132 CAROLINA BEACH RD STE 8 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1265897847,"SCHMIERER, PAMELA, LYNNE",6132 CAROLINA BEACH RD STE 8 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 40 , 119 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265900013,"ODOM, PATRICIA-MARIE, EDGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265900013,"ODOM, PATRICIA-MARIE, EDGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265900013,"ODOM, PATRICIA-MARIE, EDGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265901268,"BLAKEMORE, THOMAS",2301 ERWIN ROAD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265901268,"BLAKEMORE, THOMAS",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265901268,"BLAKEMORE, THOMAS",2301 ERWIN ROAD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265901425,"HOWELL, JOHN, WESLEY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1265902852,"FAIRLEY, CHELSEA",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1265904064,WHEELCHAIR CLINIC INC,,4307 WESTERN PARK PL STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265904064,WHEELCHAIR CLINIC INC,4307 WESTERN PARK PL STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265905780,"WHYTE HENRY, SHAKIERA, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1265905780,"WHYTE HENRY, SHAKIERA, MONIQUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659494292,TOTAL WOMAN CARE LLC,,942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1265906531,"FAIRCLOTH, BRITTAIN, CIERA",942 JOHNSON RIDGE RD   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 33 , 62 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265906531,"FAIRCLOTH, BRITTAIN, CIERA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265906762,"WILLIAMS, RACHAEL, MARIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265908602,"PARK, JENNIFER, ABBOTT",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265911176,"GRIMES, BRITTNEY, ELIZABETH",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 70 , 142 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265915201,"REDMOND, DANA, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 94 , 94 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,624 QUAKER LN STE 200D HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265915201,"REDMOND, DANA, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447255328,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOKE FAMILY MEDICAL CENTER,405 S MAIN ST   RAEFORD NC,047,Hoke,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265915763,"WALTERS, CAROL, EVANS",405 S MAIN ST   RAEFORD NC,047,Hoke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1265919443,PUBLIX NORTH CAROLINA LP,PUBLIX PHARMACY 1552,425 EMISSARY DR   CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1265919443,PUBLIX NORTH CAROLINA LP,425 EMISSARY DR   CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265920664,"WARD, ELIZABETH, BLAIR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265920664,"WARD, ELIZABETH, BLAIR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1265920664,"WARD, ELIZABETH, BLAIR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265922983,"STEPHENS, TIMOTHY, TRACEY",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1265922983,"STEPHENS, TIMOTHY, TRACEY",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1265922983,"STEPHENS, TIMOTHY, TRACEY",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265922983,"STEPHENS, TIMOTHY, TRACEY",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265923536,"ARTHUR, SHANELLE, RANAE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265923536,"ARTHUR, SHANELLE, RANAE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265923536,"ARTHUR, SHANELLE, RANAE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265923536,"ARTHUR, SHANELLE, RANAE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 39 , 117 , 117 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265923536,"ARTHUR, SHANELLE, RANAE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 45 , 114 , 114 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265925598,"FERNANDEZ, ERMAREFE, CASTILLO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 178 , 179 ," $10,558.22 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1265925598,"FERNANDEZ, ERMAREFE, CASTILLO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 195 , 195 ,$#,,
MEDICAID DIRECT,1861268245,CALDWELL MEMORIAL HOSPITAL,PLUS URGENT CARE HICKORY,36 14TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1265928964,"CROUCH, JESSICA, BERRY",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265928964,"CROUCH, JESSICA, BERRY",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265928964,"CROUCH, JESSICA, BERRY",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265928964,"CROUCH, JESSICA, BERRY",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1265928964,"CROUCH, JESSICA, BERRY",8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265930523,PEACE ZONE HOME CARE INC,,4925 W MARKET ST STE 1113 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1265930523,PEACE ZONE HOME CARE INC,4925 W MARKET ST STE 1113 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 14,807 "," 14,869 "," $1,316,039.52 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265931216,"JOHNSON, COURTNEY, GENAE",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,442 S HIGHWAY 27   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1265931216,"JOHNSON, COURTNEY, GENAE",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1265931679,"BAKER DUCKER, SARAH, CATHERINE",600 HOSPITAL DR STE 10B CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265936595,"MACZIS, MICHAEL, MARCONI",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1265936595,"MACZIS, MICHAEL, MARCONI",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265937304,R & S INDEPENDENT HEALTH SERVICES,,636 GUNN ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1265937304,R & S INDEPENDENT HEALTH SERVICES,636 GUNN ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 949 , 949 ," $59,028.40 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265938096,"MEBUGE, DANIELLE, LINDA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 24 , 74 , 79 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265938096,"MEBUGE, DANIELLE, LINDA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1265938757,"GONZALEZ, SARA, ISABEL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 21 , 24 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265938757,"GONZALEZ, SARA, ISABEL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 18 , 24 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1265938757,"GONZALEZ, SARA, ISABEL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1265942403,UBYLEE HEALTHCARE GROUP,,9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265942403,UBYLEE HEALTHCARE GROUP,9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265944763,"SNYDER, ANNA, GRACE",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265944763,"SNYDER, ANNA, GRACE",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265944763,"SNYDER, ANNA, GRACE",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1265944763,"SNYDER, ANNA, GRACE",10344 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265944763,"SNYDER, ANNA, GRACE",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265944763,"SNYDER, ANNA, GRACE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265947279,"BENNETT, KEATON, CHRISTOPHER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265947279,"BENNETT, KEATON, CHRISTOPHER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 33 , 34 ,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265949747,"BOONE, JAMIE, MILLICENT",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265949747,"BOONE, JAMIE, MILLICENT",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1265949747,"BOONE, JAMIE, MILLICENT",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265949747,"BOONE, JAMIE, MILLICENT",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1265949747,"BOONE, JAMIE, MILLICENT",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1265950364,"FARMER, AMANDA, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 52 , 60 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265951081,"WAGGONER, LAUREN, MICHELE",710 PARK CENTER DR STE 200 MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265951727,"CAVALLO, KERI, ANNE",1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1265954259,"SHENK, ELIZABETH, MARY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1265954259,"SHENK, ELIZABETH, MARY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265954804,"JAMIL, MARIUM",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1265956197,"EDOUARD, KEVIN, CLIFF",2040 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265960520,"PATEL, BIANCA, YOGESH",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265960520,"PATEL, BIANCA, YOGESH",2630 E 7TH ST STE 101 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265960520,"PATEL, BIANCA, YOGESH",269 GILLMAN RD STE 200A DENVER NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1265960520,"PATEL, BIANCA, YOGESH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265960520,"PATEL, BIANCA, YOGESH",311 CODDLE MARKET DR NW STE 100 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265960520,"PATEL, BIANCA, YOGESH",2525 COURT DR   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1265960983,"DAVIS, SHELLIAN, SIMONE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1265960983,"DAVIS, SHELLIAN, SIMONE",201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 107 , 107 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265962559,"OLCESE, MAURA, ELIZABETH ALLEGRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 42 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265963045,"HATFIELD, TIFFANY, SCHWAB",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 44 , 44 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,2101 OAKHEART RD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265963060,"LEGGETT, JONATHAN, HEATH",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265963060,"LEGGETT, JONATHAN, HEATH",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265963060,"LEGGETT, JONATHAN, HEATH",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1265964035,"FOLEY, SHAWNA, MARIE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265964274,"MCCANN, KELLI, LAUREN",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265965180,"FINCHER, KERRY, NOEL",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1265965180,"FINCHER, KERRY, NOEL",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063151678,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1409 ASHEVILLE HIGHWAY,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265965180,"FINCHER, KERRY, NOEL",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 67 , 102 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265965727,"COLE, BRITTNEY, CHANTEL",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265965727,"COLE, BRITTNEY, CHANTEL",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265965727,"COLE, BRITTNEY, CHANTEL",13460 PLAZA ROAD EXT STE 100 CHARLOTTE NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 39 , 79 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265965727,"COLE, BRITTNEY, CHANTEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730413949,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD VASCULAR ASSOCIATES,101 WILLIAM H JOHNSON ST STE 100 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265965958,"STEWART, LUKE, MITCHELL",3980 HIGHWAY 9 E STE 310 LITTLE RIVER SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730413949,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD VASCULAR ASSOCIATES,101 WILLIAM H JOHNSON ST STE 100 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265965958,"STEWART, LUKE, MITCHELL",101 WILLIAM H JOHNSON ST STE 100 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265966592,"MORGAN, KRYSTAL, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265966683,"KEANE, BARRY, JOSEPH",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 86 , 86 , 139 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265966683,"KEANE, BARRY, JOSEPH",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 212 , 223 , 261 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265967749,"KUMFER, ANN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 106 , 112 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1265969265,"FOKAKIS, TERRY, NICK",183 LEDFORD ST STE B MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 45 , 45 ," $17,820.00 ",,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1265969265,"FOKAKIS, TERRY, NICK",183 LEDFORD ST STE B MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1437520392,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST STE B MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265969265,"FOKAKIS, TERRY, NICK",183 LEDFORD ST STE B MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 176 , 178 ," $20,335.11 ",,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1265969265,"FOKAKIS, TERRY, NICK",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1265969265,"FOKAKIS, TERRY, NICK",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1265969265,"FOKAKIS, TERRY, NICK",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1265970149,"MARRKAND, JACLYN, CHRISTINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265972202,"DICKEY, HALEY, ELISE",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265972202,"DICKEY, HALEY, ELISE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265972202,"DICKEY, HALEY, ELISE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265972202,"DICKEY, HALEY, ELISE",3193 W HIGHWAY 74   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1265972202,"DICKEY, HALEY, ELISE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679868426,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS BEHAVIORAL MEDICINE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1265977763,"HARVEY, NATASHA, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 13 , 31 , 31 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1265978472,"WORGESS, HILARY, ANN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265980775,"ELDRIDGE, SERENA, YIN ON",40 DUKE MEDICINE CIR # 1E DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 58 , 66 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265982052,"MENIA, GINA, MARIE",2076 HWY 42 W STE 250 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265982052,"MENIA, GINA, MARIE",507 N BRIGHTLEAF BLVD STE 102 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2076 VETERANS PKWY STE 250 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265982052,"MENIA, GINA, MARIE",2076 VETERANS PKWY STE 250 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265982052,"MENIA, GINA, MARIE",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1265982052,"MENIA, GINA, MARIE",300 S 3RD ST STE C SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902447022,CHEROKEE MEDICAL CENTER,CMC - IMMEDIATE CARE CENTER - GAFFNEY,840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1265984678,"CROCKER, JODI, CAMERON",2995 REIDVILLE RD STE 100 SPARTANBURG SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1265986715,"NEIGH, DEANNA, MAE",1506 WAYNE MEMORIAL DR STE D GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 34 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1265986715,"NEIGH, DEANNA, MAE",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 50 , 85 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1265986715,"NEIGH, DEANNA, MAE",1506 WAYNE MEMORIAL DR STE D GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1265987101,"HENDEE, VAN AHN HUY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1265987101,"HENDEE, VAN AHN HUY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 25 , 30 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1265987101,"HENDEE, VAN AHN HUY",3100 WELLONS BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 29 , 47 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1265987101,"HENDEE, VAN AHN HUY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 31 , 50 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1265987101,"HENDEE, VAN AHN HUY",3100 WELLONS BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1265988059,"LAURENCE, JENNIFER, NICOLE",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 59 , 196 ,$#,,
MEDICAID DIRECT,1265991020,"SHEMESH, YANEVE",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1265991020,"SHEMESH, YANEVE",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1265991632,"DOCKTER, JANELL, LEE",3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 698 , 698 ," $24,665.17 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1265992333,"GREENE, NATTALY, ELIANETH",2001 VAIL AVE STE 200A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1265992820,"CHHETRI, SHANKAR",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265993430,"TRAN, MISHA, CATHIEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 286 , 292 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265994164,"CEPEDA MORA, DIEGO, FERNANDO",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 145 , 145 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265994164,"CEPEDA MORA, DIEGO, FERNANDO",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 63 , 64 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265994164,"CEPEDA MORA, DIEGO, FERNANDO",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265994594,"HOLMES, JEFFREY, SCOTT",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1265994594,"HOLMES, JEFFREY, SCOTT",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265994594,"HOLMES, JEFFREY, SCOTT",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265995245,"SHEN, JEFFREY, ZHAN",40 DUKE MEDICINE CIR # 1J DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 13 , 19 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265995245,"SHEN, JEFFREY, ZHAN",2351 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1265995245,"SHEN, JEFFREY, ZHAN",2351 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1265995245,"SHEN, JEFFREY, ZHAN",10207 CERNY ST STE 102 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 14 , 23 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1265997274,"CLINE, STEPHANIE, RUTH",738 NEWMAN RD   NEW BERN NC,025,Craven,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 22 , 56 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 65 , 65 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 186 , 187 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 290 , 291 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1265997605,"WAGNER, NICOLE, JONES",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1265999023,"DIEZ, KAREN, CASSIDY",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1265999023,"DIEZ, KAREN, CASSIDY",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 29 , 79 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1265999023,"DIEZ, KAREN, CASSIDY",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1265999023,"DIEZ, KAREN, CASSIDY",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1265999023,"DIEZ, KAREN, CASSIDY",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275002511,"FESTA, JUSTIN, JAMES",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275002511,"FESTA, JUSTIN, JAMES",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 22 , 39 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275002511,"FESTA, JUSTIN, JAMES",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518570761,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275002511,"FESTA, JUSTIN, JAMES",1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578176723,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275002511,"FESTA, JUSTIN, JAMES",134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275002511,"FESTA, JUSTIN, JAMES",1910 JAKE ALEXANDER BLVD W STE 202 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 64 , 97 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275002511,"FESTA, JUSTIN, JAMES",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790446672,LANE & ASSOCIATES XLIV DDS PA,~,7430 RICHLANDS HWY   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1275009367,"SARAF, PALLAVI",1932 S 16TH ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275009367,"SARAF, PALLAVI",1932 S 16TH ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275009938,"SHEAVES, JANET, CAROLYN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275011017,"FARISH, RACHAEL, PITTS",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1275011017,"FARISH, RACHAEL, PITTS",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 33 , 33 ,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1275011017,"FARISH, RACHAEL, PITTS",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 74 , 83 ,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1275011017,"FARISH, RACHAEL, PITTS",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275012742,"MYERS-CASSIDY, JENNIFER, ALICIA",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275012742,"MYERS-CASSIDY, JENNIFER, ALICIA",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275012999,"WHITE, LISA, TATARA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275012999,"WHITE, LISA, TATARA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275013583,"SHRESTHA, POOJAN",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 124 , 183 ," 1,146 "," $81,826.65 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275013583,"SHRESTHA, POOJAN",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 64 , 65 , 140 ,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275013583,"SHRESTHA, POOJAN",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 96 , 97 , 98 ,$#,,
MEDICAID DIRECT,1588080436,WAKE FAMILY EYE CARE OD PA,WAKE FAMILY EYE CARE,100 PARKWAY OFFICE CT STE 112 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1275013765,"HOPKINS, KELLER, KOSTERMAN",100 PARKWAY OFFICE CT STE 112 CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 25 , 48 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275015380,"SAULTERS, CARLY, ARMATO",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275015380,"SAULTERS, CARLY, ARMATO",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275015380,"SAULTERS, CARLY, ARMATO",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275015380,"SAULTERS, CARLY, ARMATO",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275015380,"SAULTERS, CARLY, ARMATO",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 45 , 46 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275015380,"SAULTERS, CARLY, ARMATO",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 50 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275015380,"SAULTERS, CARLY, ARMATO",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1275017394,"ATKINS, SAVANA, EDWARDS",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 38 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1275017394,"ATKINS, SAVANA, EDWARDS",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1275017394,"ATKINS, SAVANA, EDWARDS",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1275017394,"ATKINS, SAVANA, EDWARDS",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1275017394,"ATKINS, SAVANA, EDWARDS",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 86 , 136 ,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275017576,"CAPPAERT, GUSTAV, NEIL",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 149 , 190 ," $16,463.39 ",,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275020208,"ATKINSON, ASHLEY, DANIELLE",2100 STANTONSBURG RD GME GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275020208,"ATKINSON, ASHLEY, DANIELLE",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 38 , 40 , 51 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275020208,"ATKINSON, ASHLEY, DANIELLE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 48 , 49 , 67 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275020208,"ATKINSON, ASHLEY, DANIELLE",2100 STANTONSBURG RD GME GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 41 , 44 ," $13,195.46 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275020208,"ATKINSON, ASHLEY, DANIELLE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275020208,"ATKINSON, ASHLEY, DANIELLE",2100 STANTONSBURG RD GME GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1275021420,"RUDESEAL, BLAKE, ALLEN",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1275021420,"RUDESEAL, BLAKE, ALLEN",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275021974,"DARJI, DEEPALI",101 MANNING DR   CHAPEL HILL NC,068,Orange,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 32 , 74 , 113 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275023541,"BATES, LUKE, CHARLES",97 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 203 , 294 , 468 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275023541,"BATES, LUKE, CHARLES",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,171 NC HIGHWAY 125 STE A ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1275023541,"BATES, LUKE, CHARLES",97 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1275024440,"MYERS, CURTIS, ALLEN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1275024440,"MYERS, CURTIS, ALLEN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275025793,"MANNING, DAVID",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 104 , 614 , 735 ," $16,308.39 ",,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1275026072,"QUEEN, AMY, CYRILLA",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1275027294,TONYA CLARK FREEMAN,THE HOME PLACE,404 W RIVER ST   COLERAIN NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275027294,TONYA CLARK FREEMAN,404 W RIVER ST   COLERAIN NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 179 , 179 ," $26,370.54 ",,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275027963,"GANAPATHIRAJU, IASWARYA",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275028169,"MILLER, CHRISTINE, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275029720,"HOLT, MELISSA, BUTCHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST # 102 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1275030348,"KOTTURI, VINAY, KUMAR",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275030348,"KOTTURI, VINAY, KUMAR",515 THOMPSON ST STE D EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275030348,"KOTTURI, VINAY, KUMAR",4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1275030348,"KOTTURI, VINAY, KUMAR",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275030348,"KOTTURI, VINAY, KUMAR",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 25 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275030348,"KOTTURI, VINAY, KUMAR",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 16 , 18 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275034357,"O'DONNELL, MATTHEW",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275034357,"O'DONNELL, MATTHEW",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 63 , 128 ,$#,,
MEDICAID DIRECT,1003183120,MCLEOD PHYSICIAN ASSOCIATES II,SOUTHERN MEDICAL ASSOCIATES,3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275037145,"THACKER, BRIAN, JAMES",3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1275037541,"BALLARD, DANIELLE, MCKIE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 106 , 115 , 139 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275037541,"BALLARD, DANIELLE, MCKIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1275037541,"BALLARD, DANIELLE, MCKIE",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3821 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 228 , 247 , 299 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275037632,"NELSON, JACOB, DILLON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275046237,"COVERT, KELLI, MACK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275046237,"COVERT, KELLI, MACK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457828253,COASTAL COMPREHENSIVE CARE PA,,1067 13TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275047714,"JOYNER, LISA, DAVIS",1067 13TH ST SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457828253,COASTAL COMPREHENSIVE CARE PA,,710 SUNSET BLVD N STE A SUNSET BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1275047714,"JOYNER, LISA, DAVIS",1067 13TH ST SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 95 , 366 , 444 ,$#,,
MEDICAID DIRECT,1215596135,PAIN MANAGEMENT PLUS PLLC,,249 OAK ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1275047714,"JOYNER, LISA, DAVIS",1067 13TH ST SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457828253,COASTAL COMPREHENSIVE CARE PA,,1067 13TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275047714,"JOYNER, LISA, DAVIS",1067 13TH ST SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1275047714,"JOYNER, LISA, DAVIS",1067 13TH ST SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 79 , 234 , 234 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1275050718,"HADLEY, TEGAN, MARIE",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275050718,"HADLEY, TEGAN, MARIE",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275050718,"HADLEY, TEGAN, MARIE",206 N DYSON ST   HOLLY RIDGE NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265277172,ELITE COMPREHENSIVE CARE,ELITE COMPREHENSIVE CARE,13094 NC HWY   SURF CITY NC,071,Pender,193200000X,Group,Multi-Specialty,,1275050718,"HADLEY, TEGAN, MARIE",206 N DYSON ST   HOLLY RIDGE NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275050718,"HADLEY, TEGAN, MARIE",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1275050718,"HADLEY, TEGAN, MARIE",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275052565,"BUTLER, MARIA, KRISTINA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 36 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275052565,"BUTLER, MARIA, KRISTINA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 13 , 14 , 32 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275053167,"HARRIS, REGINALD, WINFRED",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 133 , 134 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275053167,"HARRIS, REGINALD, WINFRED",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275053167,"HARRIS, REGINALD, WINFRED",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 36 , 108 , 110 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",1016 N LAFAYETTE ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 158 , 158 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 122 , 163 , 252 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",201 E GROVER ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 56 , 56 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 206 , 206 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",1016 N LAFAYETTE ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 106 , 106 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",608 W KING ST STE A KINGS MOUNTAIN NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 84 , 100 , 178 ,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",141 LAUREL HILL DR STE 1 RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275053217,"MENA PASQUEL, JOSE, DANIEL",141 LAUREL HILL DR STE 1 RUTHERFORDTON NC,081,Rutherford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 24 , 41 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275053233,"BICE, ASHLEY, HOLT",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275053738,"STOKHUYZEN, CHELSE, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275053738,"STOKHUYZEN, CHELSE, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1275054462,"STRATTON, AMANDA, JANE",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1275054462,"STRATTON, AMANDA, JANE",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194707901,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275054991,"KODALI, ALIMITHA, MONALI",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275055600,"KHAN, MOHAMMAD, SHAHZEB",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275055600,"KHAN, MOHAMMAD, SHAHZEB",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275055600,"KHAN, MOHAMMAD, SHAHZEB",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275060105,"GRINSTEAD, RHETT, MARTIN",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1275060105,"GRINSTEAD, RHETT, MARTIN",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275063471,"SYED, IMRAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 180 , 181 ," $10,816.58 ",,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275063893,"ADEJUMO, ADEYINKA, CHARLES",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 36 , 46 , 52 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275064644,"ROBINS, JOSHUA, ELI",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275064644,"ROBINS, JOSHUA, ELI",1220 MAGNOLIA ST # 4A GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275064644,"ROBINS, JOSHUA, ELI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275064644,"ROBINS, JOSHUA, ELI",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 142 , 177 , 234 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275065823,"HALL, GEOFFREY, FRANKLIN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275065823,"HALL, GEOFFREY, FRANKLIN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1639316151,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL RHEUMATOLOGY,2146 BLOWING ROCK RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1275066508,"CIRINO, DANIEL, PATRICK",2146 BLOWING ROCK RD   BOONE NC,095,Watauga,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 51 , 92 , 161 ," $14,894.12 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275067407,"CARTER, ZACHARY, JOHN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275067407,"CARTER, ZACHARY, JOHN",3643 N ROXBORO ST   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 32 , 47 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275067407,"CARTER, ZACHARY, JOHN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 24 , 34 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1275067589,"DAVIS, BLAKE, THOMAS",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275067605,"ERICKSON, RACHEL, ANN",129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 49 , 119 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275069817,"HUANG, BEVERLY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1275069817,"HUANG, BEVERLY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1275069817,"HUANG, BEVERLY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275069817,"HUANG, BEVERLY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1275069817,"HUANG, BEVERLY",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 33 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275069817,"HUANG, BEVERLY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 49 , 106 ,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275071540,"SIMS, ARCHIE, ANDREW",6047 TYVOLA GLEN CIR # 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 107 , 163 , 169 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275074346,"CRITTENDEN, JORDAN, PAUL",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275079352,A WILSON CO INC,A WILSON TRANSPORTATION SERVICES,707 PROFESSIONAL DR   NEW BERN NC,025,Craven,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1275079352,A WILSON CO INC,707 PROFESSIONAL DR   NEW BERN NC,025,Craven,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 26 ," 1,324 "," 1,362 "," $120,774.60 ",,
MEDICAID DIRECT,1730817420,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH DIABETES & ENDOCRINE,803 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1275080731,"KATTAMANCHI, ADITHYA",803 TILGHMAN DR STE 400 DUNN NC,043,Harnett,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 174 , 352 , 531 ," $10,122.63 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275080806,"MARTINEZ-RIVERA, MARIELA, RAQUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275080806,"MARTINEZ-RIVERA, MARIELA, RAQUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275080806,"MARTINEZ-RIVERA, MARIELA, RAQUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275080806,"MARTINEZ-RIVERA, MARIELA, RAQUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 18 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275082703,"WHITE, SARAH, ROBERSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 19 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275082703,"WHITE, SARAH, ROBERSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275082703,"WHITE, SARAH, ROBERSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275082703,"WHITE, SARAH, ROBERSON",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1275083974,"MUNDY, KRISTEN, MICHELLE",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275083974,"MUNDY, KRISTEN, MICHELLE",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1275083974,"MUNDY, KRISTEN, MICHELLE",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1275083974,"MUNDY, KRISTEN, MICHELLE",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 22 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275083974,"MUNDY, KRISTEN, MICHELLE",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1275083974,"MUNDY, KRISTEN, MICHELLE",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275084261,"BOISSEAU, HAYLEY, MARIE",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275085854,"LONG, KATHERINE, NICOLE",2400 PRATT ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275085854,"LONG, KATHERINE, NICOLE",2400 PRATT ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275088684,THE VILLAS AT BENSON V INC,,606 E MORRIS AVE VILLAS III BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275088684,THE VILLAS AT BENSON V INC,606 E MORRIS AVE VILLAS III BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 2,496 "," 2,496 "," $166,122.93 ",,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275090383,"HYLAND, KATHERINE, GATEWOOD",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275092579,"MARCHAND, STEPHANIE, DEVANE",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275094096,"ADIKEY, ARCHANA RAO",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275094161,"BRANCAZIO, SOPHIA, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 31 , 35 , 40 ," $14,671.74 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275094161,"BRANCAZIO, SOPHIA, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275094161,"BRANCAZIO, SOPHIA, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 15 , 18 , 21 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275094161,"BRANCAZIO, SOPHIA, NICOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275094161,"BRANCAZIO, SOPHIA, NICOLE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275094161,"BRANCAZIO, SOPHIA, NICOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 31 , 31 , 32 ," $11,326.91 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275095499,"MORELLI, BRANDON, ANTHONY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1275095499,"MORELLI, BRANDON, ANTHONY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275095499,"MORELLI, BRANDON, ANTHONY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 52 , 131 ,$#,,
MEDICAID DIRECT,1255054409,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE SPECIALTY CLINICS,1551 WESTBROOK PLAZA DR STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275096067,"MALIK, ALI, SHAUKAT",1551 WESTBROOK PLAZA DR STE 200 WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 14 , 24 ,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275096158,"PENNINGTON, RICHELLE, PATRICIA",2544 COURT DR STE G GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,1212 SPRUCE ST STE 211 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275096158,"PENNINGTON, RICHELLE, PATRICIA",1212 SPRUCE ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,4235 S NEW HOPE RD STE I GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275096158,"PENNINGTON, RICHELLE, PATRICIA",4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275096836,"BECAK, DANIEL, PATRICK",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275096836,"BECAK, DANIEL, PATRICK",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 53 , 55 ,$#,,
MEDICAID DIRECT,1851555734,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RIVERWOOD FAMILY MEDICI,3715 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275099152,"WORCESTER, DAINA, MARIE",3715 UNION RD   GASTONIA NC,036,Gaston,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275100505,"RIDER, JESSICA, MARIE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 39 , 64 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275102352,"HILL, ASHLEY, CAROL",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275102352,"HILL, ASHLEY, CAROL",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275102352,"HILL, ASHLEY, CAROL",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275102352,"HILL, ASHLEY, CAROL",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,702 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275102352,"HILL, ASHLEY, CAROL",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 41 , 58 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275102972,"MOSS, JEFFREY, TAYLOR",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 25 , 35 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,16525 HOLLY CREST LN STE 150   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275102972,"MOSS, JEFFREY, TAYLOR",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275102972,"MOSS, JEFFREY, TAYLOR",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275106601,"KILBY, JILL, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1275106601,"KILBY, JILL, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1275106601,"KILBY, JILL, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275110975,"RUSZKIEWICZ, BRIANA, LYNN",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 66 , 83 , 231 ,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1275110975,"RUSZKIEWICZ, BRIANA, LYNN",104 SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 638 , 791 ," 2,501 "," $86,415.11 ",,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275113045,"KEYS, TRENIA, RENEE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 18 , 21 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275113045,"KEYS, TRENIA, RENEE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1275113045,"KEYS, TRENIA, RENEE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275113045,"KEYS, TRENIA, RENEE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275113789,B&B ASSISTED LIVING CARE LLC,B&B ASSISTED LIVING NO 3,9461 NC HIGHWAY 710 S   ROWLAND NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275113789,B&B ASSISTED LIVING CARE LLC,9461 NC HIGHWAY 710 S   ROWLAND NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 709 , 709 ," $44,477.88 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,275 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275114571,"SWITZER, CRISTEN, RENCSOK",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275114571,"SWITZER, CRISTEN, RENCSOK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 105 , 147 , 177 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275114571,"SWITZER, CRISTEN, RENCSOK",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275117913,"BRITTAIN, ASHLEY, MORSE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1275121733,"OLSEN, CHAD, JAMES",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 52 , 174 , 200 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275123432,"WILLIAMS, LINDSEY, ELLZEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275123432,"WILLIAMS, LINDSEY, ELLZEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 30 , 33 , 65 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275123432,"WILLIAMS, LINDSEY, ELLZEY",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275123432,"WILLIAMS, LINDSEY, ELLZEY",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275123432,"WILLIAMS, LINDSEY, ELLZEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275123432,"WILLIAMS, LINDSEY, ELLZEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1275124430,"WAGES, MARK, SHANE KRUEGER",965 STATE FARM RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 38 , 38 ,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275128183,"SHARPE, ALYSSA, JANAE",1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275128183,"SHARPE, ALYSSA, JANAE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1275128183,"SHARPE, ALYSSA, JANAE",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 17 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275128183,"SHARPE, ALYSSA, JANAE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 71 , 73 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275128183,"SHARPE, ALYSSA, JANAE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275132821,INFINITE FAVOR HOME CARE SERVICES,INFINITE FAVOR HOME CARE SERVICES LLC,4373 AUBURN HILLS DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1275132821,INFINITE FAVOR HOME CARE SERVICES,4373 AUBURN HILLS DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 356 , 356 ," $22,350.00 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275134777,"WILKINS, KAREN, DENICE",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275134777,"WILKINS, KAREN, DENICE",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275139966,ASHEVILLE GERIATRIC LLC,RICHMOND HILL ASSISTED LIVING 3,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275139966,ASHEVILLE GERIATRIC LLC,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,609 "," 1,609 "," $97,936.92 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275142408,"QUINN, MCLEAN, KEMPER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275150005,"TOOMEY, TERESA, ANN",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275150005,"TOOMEY, TERESA, ANN",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275153074,"BUTERBAUGH, BENJAMIN, THOMAS",601 N ELM ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 30 , 45 , 56 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1275154270,"LOWRIE, CHRISTIAN, CASTILLO HAYNES",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 150 , 190 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275154270,"LOWRIE, CHRISTIAN, CASTILLO HAYNES",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 38 , 44 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275155186,"MENDEZ, ISRAEL, MIGUAL",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 50 , 57 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275155681,"STEVENS, JOSEPH, TURNER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275156697,H&S THERAPEUTIC SERVICES LLC,,1150 CREWS RD STE F MATTHEWS NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1275156697,H&S THERAPEUTIC SERVICES LLC,1150 CREWS RD STE F MATTHEWS NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1275156697,H&S THERAPEUTIC SERVICES LLC,,1150 CREWS RD STE F MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1275156697,H&S THERAPEUTIC SERVICES LLC,1150 CREWS RD STE F MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 7,853 "," 8,181 "," $945,953.32 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275157059,"KIM, ROYCE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275157059,"KIM, ROYCE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275158206,"TUNGATE LOPEZ, ALEJANDRO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275158206,"TUNGATE LOPEZ, ALEJANDRO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154340149,CARRBORO FAMILY VISION LLC,CARRBORO FAMILY VISION OD PLLC,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,,1275159873,"MOSS, MADISON, MCKINNEY",200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1275160665,"GARTMAN, GRACE, HUGH",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275161580,LONDYN HOME CARE AGENCY LLC,LONDYN HOME CARE AGENCY LLC,1914 J N PEASE PL STE 155 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1275161580,LONDYN HOME CARE AGENCY LLC,1914 J N PEASE PL STE 155 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 975 , 975 ," $44,936.92 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275162224,"HOWE, BRYCE, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 153 , 153 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275162299,"SUTTON, ALEXANDRIA, JADE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 64 , 209 , 210 ,$#,,
MEDICAID DIRECT,1275163859,HANDS OF SERENITY HOME CARE LLC,,110 SCOTT AVE STE 10 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1275163859,HANDS OF SERENITY HOME CARE LLC,110 SCOTT AVE STE 10 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 3,827 "," 4,061 "," $396,685.68 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275165607,"OKUDA, MEGAN, TAKAYE",924 COX RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275165607,"OKUDA, MEGAN, TAKAYE",924 COX RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 27 , 42 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275167207,"LEWIS, MEGAN, STANLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275167207,"LEWIS, MEGAN, STANLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275167868,"CARTER, ALICIA, JANE",2810 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 68 , 81 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275167868,"CARTER, ALICIA, JANE",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275170284,"JOHNSON, HEATHER, SHEA",300 MEADOWMONT VILLAGE CIR STE 313 CHAPEL HILL NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1275171241,"PULLEY, KAYLA, BRETT",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1275171241,"PULLEY, KAYLA, BRETT",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 40 , 79 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1275171241,"PULLEY, KAYLA, BRETT",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275172744,"MILLER, GABRIELLE, KRISTINE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275172744,"MILLER, GABRIELLE, KRISTINE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 33 , 33 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275172744,"MILLER, GABRIELLE, KRISTINE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275172744,"MILLER, GABRIELLE, KRISTINE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275172744,"MILLER, GABRIELLE, KRISTINE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275172744,"MILLER, GABRIELLE, KRISTINE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275172744,"MILLER, GABRIELLE, KRISTINE",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275178816,COASTAL PROSTHETICS ORTHOTICS,,1134 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1275178816,COASTAL PROSTHETICS ORTHOTICS,1134 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 11 , 68 ," $25,733.14 ",,
MEDICAID DIRECT,1275179566,STAR CARE NETWORK INC,SHULER HEALTH CARE - CRANE VILLA,250 PITTS ST   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275179566,STAR CARE NETWORK INC,250 PITTS ST   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 482 , 482 ," $50,898.13 ",,
MEDICAID DIRECT,1578854147,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST UNIT 2 DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1275180945,"CREED, HANNAH, MERRITT",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851355424,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1275180945,"CREED, HANNAH, MERRITT",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1275183147,"CRISP, JODY, PUCKETT",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1275183147,"CRISP, JODY, PUCKETT",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1275183147,"CRISP, JODY, PUCKETT",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275183147,"CRISP, JODY, PUCKETT",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275186181,"DIMONT, RUTH, ANN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275186181,"DIMONT, RUTH, ANN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275186181,"DIMONT, RUTH, ANN",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1275186181,"DIMONT, RUTH, ANN",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588859466,WAKE FOREST HEALTH NETWORK LLC,AHWFB INTERNAL MEDICINE - ASHEBORO,327 ROCK CRUSHER RD   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1275187908,"GOINS, KAREN, CRAVEN",327 ROCK CRUSHER RD   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 90 , 130 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275188096,"PILGRIM, TAYLOR, ALEXANDER",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275188096,"PILGRIM, TAYLOR, ALEXANDER",2345 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 29 , 52 ,$#,,
MEDICAID DIRECT,1275189367,GREATER LOVE HOME CARE LLC,GREATER LOVE HOME CARE LLC,2347 CHASEWATER RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1275189367,GREATER LOVE HOME CARE LLC,2347 CHASEWATER RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 3,328 "," 3,644 "," $273,646.15 ",,
MEDICAID DIRECT,1376184499,CHEROKEE MEDICAL CENTER,CMC - CENTER FOR FAMILY MEDICINE - PEACHVIEW,722 HYATT ST STE C GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1275190738,"DESTEFANO, JOSEPH, ANTHONY",840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275193542,"BERGMAN, MEGHAN, DEANNE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 14 , 19 , 29 ,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1275194441,"RAKES, LINDA, MICHELLE",401 W DECATUR ST   MADISON NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 153 , 239 ,$#,,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1275195000,"LAGOD, CASSANDRA, JO",414 E MAIN ST   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275195026,"FAGAN, ELIZABETH, ASHLEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275195026,"FAGAN, ELIZABETH, ASHLEY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 183 , 183 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275195166,"BETHEA, KIERSTEN, DENISE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 115 , 192 , 437 ," $18,878.34 ",,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1275196362,"MARCUM, CHRISTIAN, TYLER",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275198038,"CLARK, ALEXANDRIA, MORGAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1275199119,"HAUERT, THOMAS, SPENCER",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275199341,"OSTWALT, JANNA, PAK",1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 41 , 65 ,$#,,
MEDICAID DIRECT,1083917249,ARMC PHYSICIANS CARE INC,BURLINGTON FAMILY PRACTICE,1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275199341,"OSTWALT, JANNA, PAK",1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 92 , 132 ,$#,,
MEDICAID DIRECT,1275199978,RAC SURGERY CENTER LLC,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1275199978,RAC SURGERY CENTER LLC,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 413 , 821 , 953 ," $275,323.92 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275205478,"MURPHY, MARGO, ELENA",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 50 , 50 ," $14,809.00 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275205759,"MARSHALL, MEREDITH, ANN",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275205759,"MARSHALL, MEREDITH, ANN",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 32 ,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1275205759,"MARSHALL, MEREDITH, ANN",181 DANIEL RD   FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275207441,"FONS, KRISTINA, LYNN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275209934,"SHIRLEY, JENNIFER, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 144 , 642 , 675 ," $11,114.32 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275209934,"SHIRLEY, JENNIFER, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275210635,"DAVENPORT, ALISHA, CHESTNUT",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275211070,"LAHOUD, MERIDETH, COURTNEY",1401 MATTHEWS TOWNSHIP PKWY STE 212 MATTHEWS NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 14 , 20 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275211070,"LAHOUD, MERIDETH, COURTNEY",1401 MATTHEWS TOWNSHIP PKWY STE 212 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 45 , 105 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275211070,"LAHOUD, MERIDETH, COURTNEY",1401 MATTHEWS TOWNSHIP PKWY STE 212 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275211070,"LAHOUD, MERIDETH, COURTNEY",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275211070,"LAHOUD, MERIDETH, COURTNEY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 28 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275214116,"YOUNG, ALEXIS, SIERRA",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275214124,"JAMES, NANCY, VIOLA",1480 WESLEY CHAPEL RD   INDIAN TRAIL NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 70 , 124 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275218075,"SORENSEN, GRACE, KATHERINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275218075,"SORENSEN, GRACE, KATHERINE",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275218075,"SORENSEN, GRACE, KATHERINE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275218075,"SORENSEN, GRACE, KATHERINE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275218075,"SORENSEN, GRACE, KATHERINE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679589212,CONCORD CHILDRENS CLINIC,CONCORD CHILDREN CLINIC,1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275220410,"LITTLE, ELLA, GRACE",1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 35 , 50 , 154 ,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275221558,"MUYONGA, DIANA, NGUMSINA",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1679675581,CAROLINA VISION CARE DR THOMAS C MC,CAROLINA VISION CARE,1804 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275223240,"FISHER, JOELLE, NICOLE",1804 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275226078,"DROLSHAGEN, TAYLOR, BLANCHE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275227654,"LEE, ALEXANDER, DOUGLAS",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275227654,"LEE, ALEXANDER, DOUGLAS",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275227654,"LEE, ALEXANDER, DOUGLAS",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1740628734,MONARCH,,103B MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1275227969,"LEPLEY-STARR, MARLA, PATRESE",2693 FOREST HILLS RD SW   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275229635,"COCKEY, WILLIAM, EDWIN",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 95 , 95 ," $27,400.28 ",,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275231227,"HARRIS, SHANIQUA, LANETTE",110 W GROVER ST   SHELBY NC,023,Cleveland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1275231227,"HARRIS, SHANIQUA, LANETTE",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1275231672,"KERLEY, JENNIFER, LYNN",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1902957954,COUNTY OF HENDERSON OFFICE OF ACCOU,HENDERSON CO DEPT PUBLIC HEALTH,1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1275240350,"PRICHARD, PAIGE, NEWTON",1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 99 , 376 ," $14,235.46 ",,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1275242224,"HELMS, BAILEY, ALEXIS",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1275242224,"HELMS, BAILEY, ALEXIS",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1275242224,"HELMS, BAILEY, ALEXIS",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1275242224,"HELMS, BAILEY, ALEXIS",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 34 , 49 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1275243651,"TORO, JONATHAN, MATTHEW",210 MAIN ST W   LOCUST NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1275243651,"TORO, JONATHAN, MATTHEW",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 35 , 124 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1275243651,"TORO, JONATHAN, MATTHEW",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1275243651,"TORO, JONATHAN, MATTHEW",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1275243651,"TORO, JONATHAN, MATTHEW",9040 NATIONS FORD RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 29 , 119 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275243735,"HARDWICK, JESSICA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1713 S CHURCH ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275244287,"WYNN, JENNIFER, MORRIS",1713 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 18 , 22 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275244287,"WYNN, JENNIFER, MORRIS",1713 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 48 , 69 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275244287,"WYNN, JENNIFER, MORRIS",1713 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 18 , 28 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,824 S VAN BUREN RD STE F EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1275244287,"WYNN, JENNIFER, MORRIS",1713 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1275245581,"FRINK, JILL, ANNE",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,2202 CAROLINA PL STE 200 KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275246019,"BROWN, MICHAELA, KENNEDY",2202 CAROLINA PL STE 200 KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 42 ,$#,,
MEDICAID DIRECT,1841929395,STEP UP CARE OF NORTH CAROLINA PC,,3250 HOMESTEAD CLUB DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275247462,"MILLER, TERRY, FORD",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health, 27 , 44 , 48 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275247462,"MILLER, TERRY, FORD",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275247462,"MILLER, TERRY, FORD",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1841929395,STEP UP CARE OF NORTH CAROLINA PC,,3250 HOMESTEAD CLUB DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275247462,"MILLER, TERRY, FORD",5623 US 221 S   MARION NC,059,McDowell,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275249187,"NUAMAH, NANA, AKUA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275249187,"NUAMAH, NANA, AKUA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 74 , 76 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275253726,"VANN, SHALANDA, CELESTE",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 30 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275253726,"VANN, SHALANDA, CELESTE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275253726,"VANN, SHALANDA, CELESTE",111 S CHURCH ST   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275253726,"VANN, SHALANDA, CELESTE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275253726,"VANN, SHALANDA, CELESTE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497918338,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - LOUISBURG,111 S CHURCH ST   LOUISBURG NC,035,Franklin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275253726,"VANN, SHALANDA, CELESTE",111 S CHURCH ST   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497918338,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - LOUISBURG,111 S CHURCH ST   LOUISBURG NC,035,Franklin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275253726,"VANN, SHALANDA, CELESTE",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 76 , 83 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275259541,"CAMPBELL, EMILY, ELAINE BELLFI",4610 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275259541,"CAMPBELL, EMILY, ELAINE BELLFI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 60 , 62 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1275260176,"PONGO, BENEDICTA, NYARKOA",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 62 , 105 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1275260176,"PONGO, BENEDICTA, NYARKOA",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 25 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275261786,"GILMORE, KATHERINE, ANN",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073914024,LITTLE OAKS PEDIATRICS PLLC,,13200 STRICKLAND RD STE 120 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275261786,"GILMORE, KATHERINE, ANN",1702 MEDICAL PARK DR W   WILSON NC,098,Wilson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275261786,"GILMORE, KATHERINE, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 42 , 44 ,$#,,
MEDICAID DIRECT,1568400174,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,281 E MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1275264533,"CRAIG, AMARON, MACKENZIE",281 E MAIN ST   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 79 , 131 ,$#,,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275269128,"TELLEZ-PACHECO, SANTIAGO",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 42 ,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275269128,"TELLEZ-PACHECO, SANTIAGO",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 15 , 66 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275269128,"TELLEZ-PACHECO, SANTIAGO",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 977 ," 1,423 "," 4,248 "," $262,717.60 ",,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275269128,"TELLEZ-PACHECO, SANTIAGO",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275270233,"REID, BLAKE, ANDREW",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 97 , 124 ,$#,,
MEDICAID DIRECT,1902677206,WESLEY SHAW DMD PLLC,VALLEY HILLS DENTISTRY,1624 TATE BLVD SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1275272213,"SHAW, WESLEY, MITCHELL",1624 TATE BLVD SE   HICKORY NC,018,Catawba,1223D0001X,Dental Providers,Dentist,Dental Public Health, 262 , 598 ," 2,014 "," $130,579.78 ",,
MEDICAID DIRECT,1407505266,VALLEY HILLS LLC,VALLEY HILLS DENTISTRY,1624 TATE BLVD SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1275272213,"SHAW, WESLEY, MITCHELL",1624 TATE BLVD SE   HICKORY NC,018,Catawba,1223D0001X,Dental Providers,Dentist,Dental Public Health,#, 11 , 45 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275273898,"TAIT, ZOE, SMITH",741A TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275273898,"TAIT, ZOE, SMITH",741A TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 125 , 230 , 518 ," $10,277.87 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275273898,"TAIT, ZOE, SMITH",741A TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1275273898,"TAIT, ZOE, SMITH",741A TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 30 , 58 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275273898,"TAIT, ZOE, SMITH",131 E MARKET ST   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1275277626,"SCOTT, LAUREN, PENDLETON",1010 LAKEVIEW DR   PINEVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 361 , 369 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1275277626,"SCOTT, LAUREN, PENDLETON",1010 LAKEVIEW DR   PINEVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 635 , 645 ," $26,466.36 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1010 LAKEVIEW DR   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275277626,"SCOTT, LAUREN, PENDLETON",1010 LAKEVIEW DR   PINEVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1275277626,"SCOTT, LAUREN, PENDLETON",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1275277626,"SCOTT, LAUREN, PENDLETON",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316375140,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-MEDICALINTENSIVISTS,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1275277717,"COOK, LAURA, JO",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275279820,"JOHNSON, RACHEL, CARLIE",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 44 , 45 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275284531,"LANGEFELD, STEPHANIE, MICHELLE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275284531,"LANGEFELD, STEPHANIE, MICHELLE",303 AIRPORT RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275285397,"HESTER, MARY, ABIGAIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275290231,"ADAMS, KIMBERLY, EWELL",101 HEART DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275290231,"ADAMS, KIMBERLY, EWELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 186 , 227 , 386 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275297194,"ROBINSON, JOHN, KESLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275300667,"BROWNLOW, BRIANA, NICOLE",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275304842,"STEPHENS, SARAH, LOUISE",510 CAROLINA BAY DR. STE 200 WILMINGTON NC,065,New Hanover,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 47 , 64 , 64 ,$#,,
MEDICAID DIRECT,1275305468,BILINGUAL-PASS PLLC,,6034 CREFT CIR   INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1275305468,BILINGUAL-PASS PLLC,6034 CREFT CIR   INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275309288,"GENTILE, KEVIN, MATTHEW",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275309288,"GENTILE, KEVIN, MATTHEW",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2411 LANDMARK DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275309288,"GENTILE, KEVIN, MATTHEW",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6840 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275309288,"GENTILE, KEVIN, MATTHEW",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,245 E ROOSEVELT AVE   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1275309288,"GENTILE, KEVIN, MATTHEW",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5311 N ROXBORO RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275309288,"GENTILE, KEVIN, MATTHEW",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11314 US 15 501 N   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1275309288,"GENTILE, KEVIN, MATTHEW",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275340796,"BERTOCCHI, JEREMY, PAUL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1275346686,"COLLINS, ANSLEY, HAMER",725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1275356891,"SOLIMAN, SALLY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275356891,"SOLIMAN, SALLY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275362287,DIVINE LOVING CARE LLC,,309 S 4TH ST   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1275362287,DIVINE LOVING CARE LLC,309 S 4TH ST   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,307 "," 1,307 "," $77,903.16 ",,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275365587,"DAVIS, STEPHANIE, LYNNE",3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275367237,"FULK, DIXIE, LYNN",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275370231,"CAKIR, YAVUZ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275370231,"CAKIR, YAVUZ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275370231,"CAKIR, YAVUZ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275370652,"SCHMUTZ, EMILY, ANNE",7210 VILLAGE MEDICAL CIR STE 310 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1275373409,"FARQUHARSON, PATRICE, ANDREA",835 ALBEMARLE RD   TROY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 26 , 44 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275373565,"GILBERT-VASS, REID, CHRISTIAN",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275373565,"GILBERT-VASS, REID, CHRISTIAN",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1275373565,"GILBERT-VASS, REID, CHRISTIAN",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275373565,"GILBERT-VASS, REID, CHRISTIAN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275373565,"GILBERT-VASS, REID, CHRISTIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1275374134,"HOPE, GABRIELLE, ANNE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1275374134,"HOPE, GABRIELLE, ANNE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 66 , 66 ,$#,,
MEDICAID DIRECT,1275374290,NASH HOSPITALS INC,UNC HEALTH NASH SPECIALTY CARE TRANSPORT,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,3416L0300X,Transportation Services,Ambulance,Land Transport,1275374290,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,3416L0300X,Transportation Services,Ambulance,Land Transport, 13 , 14 , 27 ,$#,,
MEDICAID DIRECT,1033565007,STAR MEDICAL CLINIC PLLC,,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1275377681,"WILLIAMS, ASHLEY, MONIQUE",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 13 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275381345,"WILLIAMS, KRISTINA, CELESTE",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275381345,"WILLIAMS, KRISTINA, CELESTE",1 MEDICAL DR   BENSON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 41 , 42 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275383796,"CHARPIE, BRIANNA, REBECCA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 65 , 69 ,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275385668,"ALLSBROOK, BOYD, LEWIS",490 HOSPITAL DR   CLYDE NC,044,Haywood,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1538561865,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM MEDICAL ONCOLOGY,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1275387060,"HIGHT, TRACEY, DUNCAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275387441,"SECREST, VIRGINIA, LEE",630 5TH AVE W   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275387441,"SECREST, VIRGINIA, LEE",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 34 , 62 ,$#,,
MEDICAID DIRECT,1275388381,"KHALIL, ALBARAA",,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1275388381,"KHALIL, ALBARAA",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1275388381,"KHALIL, ALBARAA",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275388381,"KHALIL, ALBARAA",,501 ESSEOLA DR   SALUDA NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1275388381,"KHALIL, ALBARAA",501 ESSEOLA DR   SALUDA NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1275388381,"KHALIL, ALBARAA",501 ESSEOLA DR   SALUDA NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 550 , 552 ," $16,445.25 ",,
MEDICAID DIRECT,1275390437,HUMBLE HOMECARE,,600 LIBERTY RD UNIT B HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1275390437,HUMBLE HOMECARE,600 LIBERTY RD UNIT B HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 3,556 "," 3,563 "," $349,699.30 ",,
MEDICAID DIRECT,1043336415,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER LAMBERTS,130 N CENTER ST   MOUNT OLIVE NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275395949,"GRADY, APRIL, RUTLEDGE",130 N CENTER ST   MOUNT OLIVE NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1194128991,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER ROSEWOOD,104 ADAIR DR   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275395949,"GRADY, APRIL, RUTLEDGE",104 ADAIR DR # A GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275395949,"GRADY, APRIL, RUTLEDGE",130 N CENTER ST   MOUNT OLIVE NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1114116944,CAROLINA PSYCHIATRY PC,~,548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275399263,"BARTLEY, CAMILLE, KAISHA",548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1275399925,A BRIGHTER HOME CARE LLC,,102 S DISCOVERY ST STE 4   ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1275399925,A BRIGHTER HOME CARE LLC,102 S DISCOVERY ST STE 4   ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 3,341 "," 3,341 "," $193,807.28 ",,
MEDICAID DIRECT,1275500084,OXYTECH,ROTECH,1115 S 3RD ST STE C WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1275500084,OXYTECH,1115 S 3RD ST STE C WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 172 , 492 , 853 ," $14,020.56 ",,
MEDICAID DIRECT,1275500084,OXYTECH,ROTECH,1115 S 3RD ST STE C WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1275500084,OXYTECH,1115 S 3RD ST STE C WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1275500084,OXYTECH,ROTECH,1115 S 3RD ST STE C WILMINGTON NC,065,New Hanover,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1275500084,OXYTECH,1115 S 3RD ST STE C WILMINGTON NC,065,New Hanover,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 100 , 254 , 409 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275500357,"STRAKA, MICHAEL, JOHN",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275500779,"BARRETT, KATHERINE, ELLIS",4414 LAKE BOONE TRL STE 308 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 308 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275500779,"BARRETT, KATHERINE, ELLIS",4414 LAKE BOONE TRL STE 308 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275501918,"CHAPMAN, JOSEPH, BENTON",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447373063,HUGH CHATHAM MEMORIAL HOSPITAL,CLINGMAN MEDICAL CENTER,3369 CLINGMAN RD   RONDA NC,097,Wilkes,193400000X,Group,Single Specialty,,1275502320,"SNYDER, ALEXANDER, BENJAMIN",3369 CLINGMAN RD   RONDA NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275503047,"SANDERS, JAMES, OLIVER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 30 ," $15,403.85 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275503047,"SANDERS, JAMES, OLIVER",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275503047,"SANDERS, JAMES, OLIVER",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 26 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275503047,"SANDERS, JAMES, OLIVER",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1275504029,"RAKOWSKI, DANIEL, ANTHONY",300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1275504144,"SMITH, JAMES, RONALD",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 ,#, 11 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1275504185,"BERES, MICHAEL, WAYNE",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 27 , 52 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1275504185,"BERES, MICHAEL, WAYNE",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 56 , 147 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1275504185,"BERES, MICHAEL, WAYNE",1908 CAUDLE DR STE 103 MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 14 , 33 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1275504243,"GILBERT, TONYA, T.",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1275504243,"GILBERT, TONYA, T.",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 44 , 44 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1275504243,"GILBERT, TONYA, T.",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1275504243,"GILBERT, TONYA, T.",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1275504243,"GILBERT, TONYA, T.",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275504243,"GILBERT, TONYA, T.",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275504243,"GILBERT, TONYA, T.",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275505257,"ZIEGELMANN, ROBERT, TOBYAS",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 80 , 154 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275505257,"ZIEGELMANN, ROBERT, TOBYAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275505794,"SMITH, GLENN, RAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275506123,"GRIFFIN, JUDI, DENNISE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275507030,"CALABRIA, WILLIAM, ANTHONY",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 168 , 168 ,$#,,
MEDICAID DIRECT,1760669709,R COHEN DDS AND ASSOCIATES PA,R COHEN DDS AND ASSOCIATES PA,2482 WONDER DR   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275507774,"MENDEZ, RAFAEL, ALBERTO",747 BRAWLEY SCHOOL RD   MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 52 , 59 , 200 ," $11,978.92 ",,
MEDICAID DIRECT,1760669709,R COHEN DDS AND ASSOCIATES PA,R COHEN DDS AND ASSOCIATES PA,2482 WONDER DR   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275507774,"MENDEZ, RAFAEL, ALBERTO",3380 E WILSON ST   FARMVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 1,044 "," 2,023 "," 7,286 "," $383,745.79 ",,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,78 LONG SHOALS RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1275508285,"CLARKE, JAY, LAWRENCE",78 LONG SHOALS RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275508285,"CLARKE, JAY, LAWRENCE",78 LONG SHOALS RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 63 , 107 ,$#,,
MEDICAID DIRECT,1346927423,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON NEW HOPE PRIMARY CARE RHC,2508 WARD BLVD   WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1275508830,"SIDAROS, MEDHAT, FAHMY",2508 WARD BLVD   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346927423,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON NEW HOPE PRIMARY CARE RHC,2508 WARD BLVD   WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1275508830,"SIDAROS, MEDHAT, FAHMY",1700 TARBORO ST W STE 100 WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 128 , 414 , 418 ," $18,789.42 ",,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2508 WARD BLVD   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1275508830,"SIDAROS, MEDHAT, FAHMY",2508 WARD BLVD   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1275509051,"JONES, MARY, MCKEEL",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 23 , 39 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275509051,"JONES, MARY, MCKEEL",4551 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275509051,"JONES, MARY, MCKEEL",520 N DEKALB ST STE B SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275509127,"IGLEHART, JAMES, NELSON",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 133 , 559 , 636 ,$#,,
MEDICAID DIRECT,1750735064,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS HEALTHCARE SYSTEM WOUND CARE PHYSICIANS-,101 E W T HARRIS BLVD STE 5203 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275509127,"IGLEHART, JAMES, NELSON",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 16 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275509390,"JAMES, MARK, JOSEPH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 41 , 43 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275509390,"JAMES, MARK, JOSEPH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 61 , 69 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275509390,"JAMES, MARK, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1275509705,"DESANTIS, DOUGLAS, HARDOL",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 52 , 95 ,$#,,
MEDICAID DIRECT,1871894626,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,532 WEBB BLVD   HAVELOCK NC,025,Craven,193200000X,Group,Multi-Specialty,,1275509705,"DESANTIS, DOUGLAS, HARDOL",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 61 , 95 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1275509705,"DESANTIS, DOUGLAS, HARDOL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1275509705,"DESANTIS, DOUGLAS, HARDOL",532 WEBB BLVD   HAVELOCK NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710165501,PREFERRED PAIN MANAGEMENT PA,PREFERRED PAIN MANAGEMENT PA,,,Unknown,193200000X,Group,Multi-Specialty,,1275510570,"SPIVEY, DAVID, LEE",1511 WESTOVER TER STE 107 GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275510588,"MILLER, DAVID, CHARLES",2906 N MAIN ST   TARBORO NC,033,Edgecombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 63 , 110 , 146 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275512469,"BARONE, BARBARA, KRYSTYNA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 102 , 102 ,$#,,
MEDICAID DIRECT,1871676296,JONES CENTER FOR WOMENS HEALTH PLLC,JONES CENTER FOR WOMENS HEALTH,1261 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275513020,"JONES, MICHAEL, RESSAL",1261 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 115 , 179 , 253 ," $20,422.32 ",,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275513020,"JONES, MICHAEL, RESSAL",1261 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1275513020,"JONES, MICHAEL, RESSAL",1261 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275514242,"WOFFORD, PAMELA",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 19 , 19 ,$#,,
MEDICAID DIRECT,1275514614,"NEEL, WILLIAM, TODD",~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1275514614,"NEEL, WILLIAM, TODD",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 59 , 96 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1275514614,"NEEL, WILLIAM, TODD",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 113 , 138 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275515249,"TYNDALL, KRISTY, ELLER",1 MEDICAL DR   BENSON NC,051,Johnston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275515249,"TYNDALL, KRISTY, ELLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1275515249,"TYNDALL, KRISTY, ELLER",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1275515249,"TYNDALL, KRISTY, ELLER",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275515272,CITY OF WASHINGTON EMS,CITY OF WASHINGTON EMS,410 N MARKET ST   WASHINGTON NC,007,Beaufort,3416L0300X,Transportation Services,Ambulance,Land Transport,1275515272,CITY OF WASHINGTON EMS,410 N MARKET ST   WASHINGTON NC,007,Beaufort,3416L0300X,Transportation Services,Ambulance,Land Transport, 227 , 366 , 683 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1275516221,"DELANCY JR, ROBERT, FREDERICK",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275516221,"DELANCY JR, ROBERT, FREDERICK",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1275516221,"DELANCY JR, ROBERT, FREDERICK",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275516221,"DELANCY JR, ROBERT, FREDERICK",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 33 , 40 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275516221,"DELANCY JR, ROBERT, FREDERICK",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1275516221,"DELANCY JR, ROBERT, FREDERICK",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275516437,"HOPE IV, WILLIAM, CAMERON",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275517682,"ALBERS, DUANE, WALTER",4601 PARK RD STE 250 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,640 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275517831,"CLARK, CHAD, MICHAEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275517831,"CLARK, CHAD, MICHAEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275517831,"CLARK, CHAD, MICHAEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275517831,"CLARK, CHAD, MICHAEL",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275517997,"GARDNER, ALISON, RACHEL",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 24 , 47 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275518300,"DEAN, LAURA, SALIZZONI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 72 , 71 , 79 ," $11,524.35 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275518334,"LEVINE, EDWARD, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 41 , 47 ,$#,,
MEDICAID DIRECT,1275518649,LABORATORY CORPORATION OF AMERICA H,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,,1275518649,LABORATORY CORPORATION OF AMERICA H,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275518789,"MALINOWSKI, MARSHALL, JOHN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275520702,"PATTI, MARYANNE, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275520702,"PATTI, MARYANNE, ELIZABETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 123 , 123 ,$#,,
MEDICAID DIRECT,1275520942,"AYCOCK, JOHN, DAVID",J DAVID AYCOCK,808 CIRCLE DR   MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,1275520942,"AYCOCK, JOHN, DAVID",808 CIRCLE DR   MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,, 192 , 200 , 365 ,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275521080,"FOSTER, KATHERINE, WALKER",5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275521080,"FOSTER, KATHERINE, WALKER",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275521080,"FOSTER, KATHERINE, WALKER",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275521080,"FOSTER, KATHERINE, WALKER",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275521080,"FOSTER, KATHERINE, WALKER",5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 47 , 84 ,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1275521809,"BRAY, KIRSTEN, NICOLE",500 ARCHDALE DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275522492,"RHYNE, DARRYL, BRUCE",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 20 , 28 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275522492,"RHYNE, DARRYL, BRUCE",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 52 , 53 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275522492,"RHYNE, DARRYL, BRUCE",167 MOORE RD STE 201 KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275523102,"MOORE, STEPHEN, CHARLES",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275523102,"MOORE, STEPHEN, CHARLES",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275523102,"MOORE, STEPHEN, CHARLES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275523193,"HAYNES, CHRISTOPHER, PAUL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1275523524,"MINA, ALFRED, JOSEPH ALBERT",40 BRETTWOOD TRCE   CLYDE NC,044,Haywood,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 66 , 81 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1275523524,"MINA, ALFRED, JOSEPH ALBERT",40 BRETTWOOD TRCE   CLYDE NC,044,Haywood,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 31 , 37 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275527160,"GLASER, KRISTA, LYNN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 40 , 40 ,$#,,
MEDICAID DIRECT,1275527863,WATAUGA MEDICS INC,~,921 W KING ST   BOONE NC,095,Watauga,3416L0300X,Transportation Services,Ambulance,Land Transport,1275527863,WATAUGA MEDICS INC,921 W KING ST   BOONE NC,095,Watauga,3416L0300X,Transportation Services,Ambulance,Land Transport, 108 , 188 , 384 ,$#,,
MEDICAID DIRECT,1801922901,ROBESON FAMILY PRACTICE ASSOCIATES,ROBESON FAMILY PRACTICE ASSOCIATES,,,Unknown,193400000X,Group,Single Specialty,,1275530594,"LOCKLEAR, KENNETH, EDWARD",1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1700552270,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-ROBESON FAMILY PRACTICE,1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1275530594,"LOCKLEAR, KENNETH, EDWARD",1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 211 , 953 ," 1,278 "," $29,174.96 ",,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1275531006,"SHERROD, WILLIAM, MAXWELL",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 129 , 144 , 166 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1275531006,"SHERROD, WILLIAM, MAXWELL",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1275531006,"SHERROD, WILLIAM, MAXWELL",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 86 , 94 , 103 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275532731,"PHERWANI, VARSHA, LAXMAN",201 E MATTHEWS ST   MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1275532798,"HENN, ADAM, RYAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 29 , 40 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 47 , 77 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 29 , 40 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 14 , 20 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",375 SUNSET AVE   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275532798,"HENN, ADAM, RYAN",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1275532855,CITY OF MYRTLE BEACH,,921B N OAK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,1275532855,CITY OF MYRTLE BEACH,921B N OAK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#, 15 ,$#,,
MEDICAID DIRECT,1275533960,"LAVELLE-SAMS, MIRIAM, JOSEPHINE",~,917 RIDGE RD   ROXBORO NC,073,Person,152W00000X,Eye and Vision Services Providers,Optometrist,,1275533960,"LAVELLE-SAMS, MIRIAM, JOSEPHINE",917 RIDGE RD   ROXBORO NC,073,Person,152W00000X,Eye and Vision Services Providers,Optometrist,, 24 , 24 , 37 ,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1275534968,"BELL, JOSEPH, TRYON",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 48 , 72 , 129 ,$#,,
MEDICAID DIRECT,1235195389,WILMINGTON PLASTIC SURGERY SPECIALI,WILMINGTON PLASTIC SURGERY SPECIALISTS,2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275535072,"MORGAN, MARK, WAYNE",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1700952637,COUNTY OF COLUMBUS OFFICE OF ACCOUN,COLUMBUS CO HEALTH DEPT,304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1275535767,"ANDREWS, FRAN, WILLOUGHBY",304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1649240698,PIEDMONT ACCESS TO HEALTH SERVICES,PIEDMONT ACCESS TO HEALTH SERVICES INC,705 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275536567,"MILAM, JAMES, THOMAS",705 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275536815,"ALLISON, DAVID, JAMES",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 244 , 337 , 398 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275536815,"ALLISON, DAVID, JAMES",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 68 , 77 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275538167,"LUBANSKI JR, ROBERT, EUGENE",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1275538167,"LUBANSKI JR, ROBERT, EUGENE",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275538167,"LUBANSKI JR, ROBERT, EUGENE",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275538167,"LUBANSKI JR, ROBERT, EUGENE",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 23 , 29 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275538167,"LUBANSKI JR, ROBERT, EUGENE",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 44 , 57 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275538449,"RALSTON, JEFFREY, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275538449,"RALSTON, JEFFREY, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275538449,"RALSTON, JEFFREY, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275538449,"RALSTON, JEFFREY, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 318 , 351 , 451 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275538449,"RALSTON, JEFFREY, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275538449,"RALSTON, JEFFREY, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275538449,"RALSTON, JEFFREY, JOHN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184673378,QUADRANGLE ENDOSCOPY CENTER,QUADRANGLE ENDOSCOPY CENTER,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1275538639,"BRILLANT, PATRICK, THIERRY",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275538639,"BRILLANT, PATRICK, THIERRY",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 74 , 100 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275539330,"CORRIGAN, FRANCIS, CHARLES",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 383 , 876 , 954 ," $12,597.45 ",,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275539330,"CORRIGAN, FRANCIS, CHARLES",7 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1275541096,"WRIGHT, LAURA, ELLEN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306855770,HALIFAX GASTROENTEROLOGY PC,~,1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1275542649,"YERRA, NAGARJUNA",1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 244 , 387 , 389 ," $12,844.23 ",,
MEDICAID DIRECT,1306855770,HALIFAX GASTROENTEROLOGY PC,~,1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1275542649,"YERRA, NAGARJUNA",1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1275544215,"HATA, LAURA, BROOKE LAWRENCE",3975 ROBINSON RD   NEWTON NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275544215,"HATA, LAURA, BROOKE LAWRENCE",3975 ROBINSON RD   NEWTON NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275544306,"HABER, ROBERT, HUGH",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 64 , 72 , 119 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275544306,"HABER, ROBERT, HUGH",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275544306,"HABER, ROBERT, HUGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1275544306,"HABER, ROBERT, HUGH",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 29 , 43 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1275544306,"HABER, ROBERT, HUGH",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1275546210,"BRANDON, MICHELE, MISE",1919 S 16TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275546210,"BRANDON, MICHELE, MISE",1919 S 16TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275546210,"BRANDON, MICHELE, MISE",1919 S 16TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275547465,"SCHUMAN, STEFANIE, GAIL",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 18 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275547465,"SCHUMAN, STEFANIE, GAIL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 17 , 26 ,$#,,
MEDICAID DIRECT,1427048172,ASHE MEMORIAL HOSPITAL INC,AMH MOUNTAIN FAMILY CARE CENTER,310 HOSPITAL AVENUE   JEFFERSON NC,005,Ashe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1275550113,"PASZKOWSKI, SUZANNE, MARIE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275551095,"HONEYCUTT, TRAVIS, CLARKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 58 , 66 ," $10,164.20 ",,
MEDICAID DIRECT,1821653288,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC MINOR PROCEDURES,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275551095,"HONEYCUTT, TRAVIS, CLARKE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275551228,"KLEPIN, HEIDI, DIANA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275551228,"KLEPIN, HEIDI, DIANA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1275552440,"KHOSROWPOUR, SAIED",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 21 , 28 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275552440,"KHOSROWPOUR, SAIED",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 63 , 65 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275553448,"HUDSON, TONYA, MARIE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 40 , 40 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275553448,"HUDSON, TONYA, MARIE",5737 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275553448,"HUDSON, TONYA, MARIE",16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275553448,"HUDSON, TONYA, MARIE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 24 , 32 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275553448,"HUDSON, TONYA, MARIE",5737 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275553448,"HUDSON, TONYA, MARIE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557126,"LEVINE, JOSHUA, DAVID",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 26 , 33 , 42 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557126,"LEVINE, JOSHUA, DAVID",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557126,"LEVINE, JOSHUA, DAVID",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 129 , 218 , 237 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 58 , 72 , 72 ,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 36 , 69 , 73 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 12 , 23 , 24 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 18 , 23 , 25 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1275557571,"SAXONHOUSE, SHERRY, JOUEI",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1194016055,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL ASSOCIATES,823 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1275557647,"MANRIQUE-KINIRY, MARITZA",823 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1306431796,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - WOMENS HEALTH,823 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1275557647,"MANRIQUE-KINIRY, MARITZA",823 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1194016055,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL ASSOCIATES,904 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1275557647,"MANRIQUE-KINIRY, MARITZA",823 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,635 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1275558124,"MAUPIN, ROBERT, STUART",635 MCCARTHY BLVD   NEW BERN NC,025,Craven,1223G0001X,Dental Providers,Dentist,General Practice, 280 , 322 ," 1,109 "," $51,615.79 ",,
MEDICAID DIRECT,1942633482,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1275558124,"MAUPIN, ROBERT, STUART",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 139 , 234 , 509 ," $28,865.51 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,635 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1275558124,"MAUPIN, ROBERT, STUART",600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 36 , 36 , 123 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275558520,"ALEMAN, MARCO, ANTONIO",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 103 , 182 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275558520,"ALEMAN, MARCO, ANTONIO",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 60 , 70 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275559163,"SPISAK, LORI, DIANE",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 27 , 34 ," $12,559.94 ",,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275559163,"SPISAK, LORI, DIANE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275559163,"SPISAK, LORI, DIANE",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 34 , 35 ,$#,,
MEDICAID DIRECT,1467972703,NORTH CAROLINA SPECIALTY HOSPITALS,,3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1275559536,"DORAN, LETTIE, MARIE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 28 , 28 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275559536,"DORAN, LETTIE, MARIE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1275559833,"MCELHINNEY, DOFF, BRYAN",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1275561144,"NGUYEN, YEN, THAI",YEN THAI NGUYEN,2375 BREWER RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1275561144,"NGUYEN, YEN, THAI",2375 BREWER RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 879 ," 2,212 "," 6,632 "," $322,555.86 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275561433,"PLEASANT, HENRY, NEWTON",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275561433,"PLEASANT, HENRY, NEWTON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275561433,"PLEASANT, HENRY, NEWTON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 37 , 41 , 55 ,$#,,
MEDICAID DIRECT,1730256017,COUNTY OF PERSON OFFICE OF COUNTY F,PERSON COUNTY HEALTH DEPARTMENT,355 S MADISON BLVD STE A ROXBORO NC,073,Person,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1275561433,"PLEASANT, HENRY, NEWTON",355 S MADISON BLVD STE A ROXBORO NC,073,Person,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 30 , 77 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275561912,"DAVIS, MARGARET, ANN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275561912,"DAVIS, MARGARET, ANN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275561912,"DAVIS, MARGARET, ANN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275561912,"DAVIS, MARGARET, ANN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275561912,"DAVIS, MARGARET, ANN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275561912,"DAVIS, MARGARET, ANN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275561912,"DAVIS, MARGARET, ANN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1275561912,"DAVIS, MARGARET, ANN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255045795,CENTERWELL SENIORPRIMARYCARENC JVPC,,1408 GARNER STATION BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275562035,"VADASSERY, REGI, JOSE",1408 GARNER STATION BLVD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275565152,"LAWRENCE, KATHRYN, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 79 , 125 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275565152,"LAWRENCE, KATHRYN, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275566689,"VESA, ALLIN, CORNELIUS",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 37 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275566689,"VESA, ALLIN, CORNELIUS",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 28 , 38 ,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275566689,"VESA, ALLIN, CORNELIUS",4220 APEX HWY STE 160 DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275566937,"POWERS, CHRISTOPHER, ROBIN",15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 21 , 33 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275568099,"DURAN, MICHAEL, RICHARD",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275568099,"DURAN, MICHAEL, RICHARD",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275569402,"CANNON, DANIEL, FREDERICK",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1003861212,EYECARECENTER OD PA,,4130 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1275571051,"DOOLEY, PATRICK, MICHAEL",4130 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1003861212,EYECARECENTER OD PA,,4130 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1275571051,"DOOLEY, PATRICK, MICHAEL",4130 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275571507,"FENNELL, PATRICK, STANLEY",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 20 , 46 ,$#,,
MEDICAID DIRECT,1275571630,SWAIN COUNTY HEALTH DEPARTMENT,Swain County EMS,,,Unknown,3416L0300X,Transportation Services,Ambulance,Land Transport,1275571630,SWAIN COUNTY HEALTH DEPARTMENT,155 SLOPE ST   BRYSON CITY NC,087,Swain,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275572208,"MAYO, PHILIP, DOUGLAS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 41 , 49 , 53 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275572208,"MAYO, PHILIP, DOUGLAS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275572208,"MAYO, PHILIP, DOUGLAS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 30 , 35 , 53 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275572208,"MAYO, PHILIP, DOUGLAS",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 138 , 253 , 268 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275572208,"MAYO, PHILIP, DOUGLAS",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 31 , 45 , 45 ,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1275573453,"WOOD, BRANDT, THOMAS",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275573453,"WOOD, BRANDT, THOMAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1275573453,"WOOD, BRANDT, THOMAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275573453,"WOOD, BRANDT, THOMAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275573453,"WOOD, BRANDT, THOMAS",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275573453,"WOOD, BRANDT, THOMAS",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 56 , 71 , 119 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275573537,"WRIGHT, NATHAN, BARRETT",2874 WARD BLVD   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 67 , 101 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,2874 WARD BLVD   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1275573537,"WRIGHT, NATHAN, BARRETT",2874 WARD BLVD   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275573651,"WEAVER, RICHARD, ALAN",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 21 , 33 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275573651,"WEAVER, RICHARD, ALAN",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 85 , 134 , 206 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275573651,"WEAVER, RICHARD, ALAN",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1275574162,LEXINGTON CITY SCHOOLS,LEXINGTON CITY SCHOOLS,1010 FAIR ST   LEXINGTON NC,029,Davidson,251300000X,Agencies,Local Education Agency (LEA),,1275574162,LEXINGTON CITY SCHOOLS,1010 FAIR ST   LEXINGTON NC,029,Davidson,251300000X,Agencies,Local Education Agency (LEA),, 161 ," 2,951 "," 3,013 "," $131,520.21 ",,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275574949,"COX, LAURA, ROBYN",100 GREENWAY CIR   ERWIN TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275574949,"COX, LAURA, ROBYN",100 GREENWAY CIR   ERWIN TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275575029,"VANDERSEA, BRIAN, ALAN",BRIAN ALAN VANDERSEA,501 EASTOWNE DR STE 110 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1275575029,"VANDERSEA, BRIAN, ALAN",501 EASTOWNE DR STE 110 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1275575029,"VANDERSEA, BRIAN, ALAN",BRIAN ALAN VANDERSEA,2823 N DUKE ST   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1275575029,"VANDERSEA, BRIAN, ALAN",2823 N DUKE ST   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1275575029,"VANDERSEA, BRIAN, ALAN",BRIAN ALAN VANDERSEA,109 DENNIS DR   SANFORD NC,053,Lee,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1275575029,"VANDERSEA, BRIAN, ALAN",109 DENNIS DR   SANFORD NC,053,Lee,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275575615,"KAMINENI, PADMA",514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1275575615,"KAMINENI, PADMA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1275576282,"BAUGHAN, MICHAEL, CAYCE",1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1902859952,EYECARECENTER OD PA,Eyecare Center OD PA,1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1275576282,"BAUGHAN, MICHAEL, CAYCE",1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1275576282,"BAUGHAN, MICHAEL, CAYCE",1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,152W00000X,Eye and Vision Services Providers,Optometrist,, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1144259961,ALLCARE CLINICAL ASSOCIATES PA,~,34 GRANBY ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1275578296,"HANKS, MICHAEL, DOUGLAS",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275579005,"DYER, MATTHEW, CHARLES",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275579229,"MARRA, SUSAN, LUANN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1275579229,"MARRA, SUSAN, LUANN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275579229,"MARRA, SUSAN, LUANN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326105016,INTERNATIONAL FAMILY CLINIC,INTERNATIONAL FAMILY CLINIC,2105 MAPLE AVE   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1275579609,"STEIN, ROSEMARY, FERNANDEZ",2105 MAPLE AVE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 61 , 146 ,$#,,
MEDICAID DIRECT,1992286009,FHPG LLC,FIRSTHEALTH CARDIO PULMONARY REHAB,2925 BEECHTREE DR STE 143 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1275580219,"SALVADOR, SAUL, ARTURO GOPINGCO",2925 BEECHTREE DR STE 143 SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275580219,"SALVADOR, SAUL, ARTURO GOPINGCO",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 253 , 254 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275580326,"VASIREDDY, SABITHA, KIRAN",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 92 , 93 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275580706,"LESSARIS, THOMAS, PETER",9615 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 68 , 98 ,$#,,
MEDICAID DIRECT,1932702107,FOOT AND ANKLE SPECIALISTS OF THE M,,3801 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275580862,"WOELFFER, KIRK, ELIEL",3801 WAKE FOREST RD   RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1932702107,FOOT AND ANKLE SPECIALISTS OF THE M,,3801 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275580862,"WOELFFER, KIRK, ELIEL",3801 WAKE FOREST RD   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1275580862,"WOELFFER, KIRK, ELIEL",3801 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1275580862,"WOELFFER, KIRK, ELIEL",3801 WAKE FOREST RD   RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 41 , 76 , 132 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1275581142,"DONAHUE, PATRICK, WAYNE",811 US 70 HWY W   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275581142,"DONAHUE, PATRICK, WAYNE",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 35 , 49 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1275581142,"DONAHUE, PATRICK, WAYNE",231 N JUDD PWKY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275581142,"DONAHUE, PATRICK, WAYNE",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275581183,"LE, TRI, HUU",1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275581183,"LE, TRI, HUU",1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1295850923,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST GASTROENTEROLOGY,1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275581183,"LE, TRI, HUU",601 N ELM ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 25 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275581183,"LE, TRI, HUU",601 N ELM ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,825 SPARTANBURG HWY STE 17 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1275582645,"BUDDENDECK, BRIAN, GERALD",825 SPARTANBURG HWY STE 17 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 72 , 145 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275582645,"BUDDENDECK, BRIAN, GERALD",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 37 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,511 SMOKY PARK HWY   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275582645,"BUDDENDECK, BRIAN, GERALD",511 SMOKY PARK HWY STE A2 CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275582793,"RIZWAN, SAIMA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1962926451,SOUTHEASTERN REGIONAL MEDICAL CENTE,SRMC-INTENSIVISTS,300 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1275583585,"ABBOY, CHANDAR, RAJA",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 35 , 37 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1275583585,"ABBOY, CHANDAR, RAJA",151 HAROLD FLEMING CT   SPARTANBURG SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275584088,"GRAZIANI, LENORA, PATTERSON",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275584088,"GRAZIANI, LENORA, PATTERSON",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275584252,"SINGER, JAMES, DANIEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 39 , 44 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275584252,"SINGER, JAMES, DANIEL",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275584252,"SINGER, JAMES, DANIEL",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275584252,"SINGER, JAMES, DANIEL",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 95 , 142 , 154 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 280 , 325 , 347 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 37 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275585796,"WASHINGTON, LACEY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 201 , 265 , 300 ,$#,,
MEDICAID DIRECT,1568544492,HUGH CHATHAM MEMORIAL HOSPITAL,YADKIN VALLEY ADULT MEDICINE,500 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1275585960,"GARRISON, PAUL, LESLIE",500 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 85 , 114 ,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275586331,"SCALABRIN, CRAIG, ALAN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275586331,"SCALABRIN, CRAIG, ALAN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275586471,"CARSTEN, CHRISTOPHER, GADSDEN",MD,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1275586471,"CARSTEN, CHRISTOPHER, GADSDEN",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275586612,"KHAN, KALSOOM, KAUSER",601 N ELM ST   HIGH POINT NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 102 , 234 , 234 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275589012,"GORDON, DANIEL, SOLOMON",3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 333 , 338 , 449 ," $19,670.02 ",,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275589012,"GORDON, DANIEL, SOLOMON",3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 321 , 332 , 436 ," $21,448.04 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275589053,"STANLEY, SARAH, ROXANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 65 , 97 ,$#,,
MEDICAID DIRECT,1275589244,BETH L WARREN OD,COMMUNITY EYE ASSOCIATES,306 KIRBY RD   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1275589244,BETH L WARREN OD,306 KIRBY RD   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1275589491,"PHILLIS, JASON, MICHAEL",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 28 , 59 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275589491,"PHILLIS, JASON, MICHAEL",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 145 , 281 ,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275589855,"FLEENOR, KRISTI, ELIZABETH",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 30 , 92 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275590416,"BROWN, WILLIAM, EDWARD",2251 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 23 , 45 ,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275590879,"KOKOLSKI, GEORGE, MAXIM",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1275592271,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,, 42 , 44 , 83 ,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1275592271,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,," 1,294 "," 1,335 "," 2,598 "," $35,706.20 ",,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275594764,"ADAMS, ROBIN, DENISE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275594772,"HENKE, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275595217,"BARTEE, SYLVIA, ANN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 25 , 51 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275595225,"TOOTHMAN, DONALD",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1275595407,"JONES, JASON, DANIEL",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 40 ,$#,,
MEDICAID DIRECT,1205247970,CLINTON SURGICAL PLLC,CLINTON SURGICAL PLLC,603 BEAMAN ST STE 200 CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1275596017,"VALENTI, MICHAEL, ARTHUR",603 BEAMAN ST STE 200 CLINTON NC,082,Sampson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 44 , 49 ,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275596124,"AMBATI, SARITHA",101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 30 , 79 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275596124,"AMBATI, SARITHA",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,901 DOW RD   CAROLINA BEACH NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275596199,"AYCOTH, SHIRLEY, LYNN",901 DOW RD   CAROLINA BCH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6901 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275596199,"AYCOTH, SHIRLEY, LYNN",6901 MARKET ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4600 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275596199,"AYCOTH, SHIRLEY, LYNN",4600 OLEANDER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275597965,"LAVALLEE, LISA, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 39 , 98 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275597965,"LAVALLEE, LISA, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 30 , 30 ,$#,,
MEDICAID DIRECT,1932170438,SAI UROLOGY PA,SAI UROLOGY PA,117 PROFESSIONAL DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1275598633,"RAJAN, NATARAJAN",117 PROFESSIONAL DR   ROANOKE RAPID NC,042,Halifax,208800000X,Allopathic & Osteopathic Physicians,Urology,, 144 , 282 , 361 ," $11,613.85 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275599490,"PALLOTTO, EUGENIA, JEAN KATHLYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 13 , 30 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275599490,"PALLOTTO, EUGENIA, JEAN KATHLYN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275599490,"PALLOTTO, EUGENIA, JEAN KATHLYN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1053074369,MCPC 22 LLC,FIRSTHEALTH-SANDHILLS NEUROLOGISTS,295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275601833,"CHINTALAPUDI, GIRIDHAR",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1053074369,MCPC 22 LLC,FIRSTHEALTH-SANDHILLS NEUROLOGISTS,295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275601833,"CHINTALAPUDI, GIRIDHAR",295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 107 , 169 , 224 ,$#,,
MEDICAID DIRECT,1053074369,MCPC 22 LLC,FIRSTHEALTH-SANDHILLS NEUROLOGISTS,295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275601833,"CHINTALAPUDI, GIRIDHAR",520 ALLEN ST   TROY NC,062,Montgomery,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275602708,"VAPNE, EKATERINA",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 17 , 27 ,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275602708,"VAPNE, EKATERINA",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1275602997,"WATKINS, JANA, HOLLAND",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275602997,"WATKINS, JANA, HOLLAND",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275602997,"WATKINS, JANA, HOLLAND",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275605701,"MCKAY, LYNSY, TUCKER",5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",4515 PREMIER DR STE 307B HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 195 , 204 , 253 ,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",375 SUNSET AVE   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275606022,"STEVENS, WILLIAM, ROSS",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245482793,CROSSROADS TREATMENT CENTER OF GREE,,2706 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275606030,"MERCADO, RAY, ANTHONY",1126 N CHURCH ST STE 202 GREENSBORO NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1275608044,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AMD ORTHOTICS EAST INC,2301 EXECUTIVE CIR STE C GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1275608044,HANGER PROSTHETICS & ORTHOTICS EAST,2301 EXECUTIVE CIR STE C GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 58 , 65 , 309 ," $48,438.78 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275608192,"DYER, GEORGE, DICKERSON",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,1601 ABBEY PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275608192,"DYER, GEORGE, DICKERSON",1601 ABBEY PL   CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1275610925,"BLAIR, ALENE, REEP",ALENE REEP BLAIR,,,Unknown,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1275610925,"BLAIR, ALENE, REEP",1205 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275611972,"CODY, MARGARET, SUSAN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1275611972,"CODY, MARGARET, SUSAN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,2000 HOSPITAL DR   MOUNT PLEASANT SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1275612335,"BECKNER, GLEN, ERIC",2000 HOSPITAL DR   MOUNT PLEASANT SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275613242,"PATT, JOSHUA, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275613242,"PATT, JOSHUA, CHARLES",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 24 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275614117,"WOOD, KAREN, SUZANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 42 , 43 ," $14,266.62 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275616419,"BRODER, JOSHUA, SETH",2100 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 61 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275616419,"BRODER, JOSHUA, SETH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275616419,"BRODER, JOSHUA, SETH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275616427,"DIEHL, LOUIS, FREDERIC",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 48 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275616427,"DIEHL, LOUIS, FREDERIC",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 67 , 68 ,$#,,
MEDICAID DIRECT,1275617284,CARE SOUTH INC,CARE SOUTH INC,512 N BRIDGE ST   ELKIN NC,086,Surry,253Z00000X,Agencies,In Home Supportive Care,,1275617284,CARE SOUTH INC,512 N BRIDGE ST   ELKIN NC,086,Surry,253Z00000X,Agencies,In Home Supportive Care,, 34 ," 5,997 "," 6,018 "," $778,129.80 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275627440,"HUNTER, MELISSA, PENCE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1154820934,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS NEONATAL FOLLOW-UP CLINIC,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275627812,"FENIKILE, TSEHAIWORK, TESFAYE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1942637319,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS OF THE CAROLIN,2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275627812,"FENIKILE, TSEHAIWORK, TESFAYE",2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 25 , 48 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1275629222,"MUTTON, PAULA, BADGETT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1275629222,"MUTTON, PAULA, BADGETT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275629222,"MUTTON, PAULA, BADGETT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275629222,"MUTTON, PAULA, BADGETT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619150992,ADVANCED CAROLINA FOOT AND ANKLE,~,516 VILLAGE CT   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1275630295,"UKATA, CHUKWUMA",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1619150992,ADVANCED CAROLINA FOOT AND ANKLE,~,516 VILLAGE CT   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1275630295,"UKATA, CHUKWUMA",516 VILLAGE CT   GARNER NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 131 , 222 , 412 ,$#,,
MEDICAID DIRECT,1275630295,"UKATA, CHUKWUMA",~,516 VILLAGE CT   GARNER NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1275630295,"UKATA, CHUKWUMA",516 VILLAGE CT   GARNER NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457531790,TRI CITY FAMILY MEDICINE URGENT C,TRICITY FAMILY MEDICINE AND URGENT CARE,107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1275632945,"PATEL, CHAITANY, R",107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 27 , 49 ,$#,,
MEDICAID DIRECT,1457531790,TRI CITY FAMILY MEDICINE URGENT C,TRICITY FAMILY MEDICINE AND URGENT CARE,1106 PARKSIDE MAIN ST   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275632945,"PATEL, CHAITANY, R",1106 PARKSIDE MAIN ST   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1457531790,TRI CITY FAMILY MEDICINE URGENT C,TRICITY FAMILY MEDICINE AND URGENT CARE,1106 PARKSIDE MAIN ST   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275632945,"PATEL, CHAITANY, R",107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457531790,TRI CITY FAMILY MEDICINE URGENT C,TRICITY FAMILY MEDICINE AND URGENT CARE,107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1275632945,"PATEL, CHAITANY, R",1106 PARKSIDE MAIN ST   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962578716,SOUTH CHARLOTTE CHIROPRACTIC PLLC,~,8179 ARDREY KELL RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275634545,"RANDAZZO, NATALIE, GEORGE",6823 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1346315710,MID SOUTH PAIN MANAGEMENT PC,MID SOUTH PAIN MANAGEMENT PC,,,Unknown,193400000X,Group,Single Specialty,,1275636623,"BERNSTEIN, DANIEL, JOSEPH",8914 COTTON PRESS RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1275636953,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07536,4307 WILGROVE MINT HILL RD   MINT HILL NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1275636953,NORTH CAROLINA CVS PHARMACY LLC,4307 WILGROVE MINT HILL RD   MINT HILL NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1275636953,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07536,4307 WILGROVE MINT HILL RD   MINT HILL NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1275636953,NORTH CAROLINA CVS PHARMACY LLC,4307 WILGROVE MINT HILL RD   MINT HILL NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275638595,"CLARK, SANDRA, CROVI",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 21 , 23 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275638595,"CLARK, SANDRA, CROVI",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1366611279,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275641979,"MCMILLAN, MILLICENT, LEIGH",247 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 3,403 "," 4,216 "," 18,111 "," $605,508.44 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275643686,"HALL, SANDRA, LILIANA",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275643686,"HALL, SANDRA, LILIANA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1578747077,COMPREHENSIVE REHAB AND PAIN SPECIA,COMPREHENSIVE REHAB AND PAIN SPECIALIST,135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1275647794,"GORR, JESSICA, HYANG",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 46 , 209 , 312 ,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275649618,"ANQUILO, LOUIE, ASTRERA",704 GOLD HILL RD STE 1200 FORT MILL SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275649618,"ANQUILO, LOUIE, ASTRERA",9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275649618,"ANQUILO, LOUIE, ASTRERA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275652067,"ROUCHARD PLASSER, ROBIN, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 35 , 40 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275652067,"ROUCHARD PLASSER, ROBIN, ANN",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275656506,"PATEL, ROSHNI, PARAG",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275656506,"PATEL, ROSHNI, PARAG",1995 WELLNESS BLVD STE 110 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 83 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275656506,"PATEL, ROSHNI, PARAG",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 47 , 143 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275656639,"BRINGARDNER, BENJAMIN, DAVID",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 58 , 77 , 133 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1275656639,"BRINGARDNER, BENJAMIN, DAVID",1237 HARDING PL STE 1300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275656639,"BRINGARDNER, BENJAMIN, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 24 , 35 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275656639,"BRINGARDNER, BENJAMIN, DAVID",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275661092,"ZVOLENSKY, HEIDI, LUDWIG",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 100 , 186 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275662421,"SMITH, DAVID, CONAN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275662421,"SMITH, DAVID, CONAN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",3610 PETERS CT   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 17 , 39 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 123 , 408 ," 1,441 "," $12,344.00 ",,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",3604 PETERS CT   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",3604 PETERS CT   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",3604 PETERS CT   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 53 , 221 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275663593,"SMITH, KARLA, RENE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 68 , 136 , 660 ,$#,,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1275667545,"LEMELIN, MARGARET, ANN",1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 185 , 197 , 294 ," $34,708.81 ",,
MEDICAID DIRECT,1275668170,JEFFREY L TAYLOR OD AND LYNN C TAYL,ANDREWS FAMILY EYE CARE,29 CHESTNUT ST   ANDREWS NC,020,Cherokee,193400000X,Group,Single Specialty,,1275668170,JEFFREY L TAYLOR OD AND LYNN C TAYL,29 CHESTNUT ST   ANDREWS NC,020,Cherokee,193400000X,Group,Single Specialty,, 648 , 658 ," 1,316 "," $18,067.76 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275669707,"TROST, MELANIE, EILEEN KIRK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275669707,"TROST, MELANIE, EILEEN KIRK",3116 N DUKE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275669848,"CHANDRAN, ANJANA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 17 ,$#,,
MEDICAID DIRECT,1104151109,EMERGENCY MEDICINE PHYSICIANS OF IR,~,,,Unknown,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 73 , 80 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 40 , 54 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275670010,"BENTLEY, KAREN, BLANKENBURG",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215476908,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE,1125 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1275671505,"SLUSHER, RICHARD, MICHAEL",1125 CARTHAGE ST   SANFORD NC,053,Lee,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 76 , 128 ,$#,,
MEDICAID DIRECT,1215476908,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE,1125 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1275671505,"SLUSHER, RICHARD, MICHAEL",540 NORTH ST   SMITHFIELD NC,051,Johnston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1275672099,"EZEIHUAKU, CHRISTOPHER, CHUKWUEMEKA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275672099,"EZEIHUAKU, CHRISTOPHER, CHUKWUEMEKA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275672099,"EZEIHUAKU, CHRISTOPHER, CHUKWUEMEKA",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275676561,WAYNE COUNTY REST VILLA NO,~,305 S VANCE ST   FREMONT NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275676561,WAYNE COUNTY REST VILLA NO,305 S VANCE ST   FREMONT NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,259 "," 2,259 "," $141,253.56 ",,
MEDICAID DIRECT,1275676827,THE WRIGHTS CENTER INC,THE WRIGHTS CENTER INC,513 W RALEIGH BLVD   ROCKY MOUNT NC,064,Nash,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,1275676827,THE WRIGHTS CENTER INC,513 W RALEIGH BLVD   ROCKY MOUNT NC,064,Nash,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,#, 710 , 710 ," $30,522.55 ",,
MEDICAID DIRECT,1134264195,JASPER L LEWIS JR DDS PA,~,1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275678112,"LEWIS, WILLIAM, LEE",1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 65 , 126 , 349 ," $24,853.92 ",,
MEDICAID DIRECT,1780026575,W LEE LEWIS DDS PLLC,~,1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275678112,"LEWIS, WILLIAM, LEE",1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 16 , 61 , 88 ," $14,599.86 ",,
MEDICAID DIRECT,1134264195,JASPER L LEWIS JR DDS PA,~,1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275678112,"LEWIS, WILLIAM, LEE",1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 31 , 77 , 77 ,$#,,
MEDICAID DIRECT,1275678567,WILKES DAY CARE ASSOCIATION INC,WILKES DAY CARE ASSOCIATION INC,1021 WELBORN AVE   WILKESBORO NC,097,Wilkes,251S00000X,Agencies,Community/Behavioral Health,,1275678567,WILKES DAY CARE ASSOCIATION INC,1021 WELBORN AVE   WILKESBORO NC,097,Wilkes,251S00000X,Agencies,Community/Behavioral Health,, 37 , 800 , 800 ," $49,977.00 ",,
MEDICAID DIRECT,1275681918,GENESIS HEALTH CARE,GENESIS HEALTH CARE INC,1937 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,,1275681918,GENESIS HEALTH CARE,1937 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 6,404 "," 7,406 "," $1,048,352.08 ",,
MEDICAID DIRECT,1275683542,"THORNE, DORIS, KNIGHT",~,3729 WESTRIDGE CIRCLE DR   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,1275683542,"THORNE, DORIS, KNIGHT",3729 WESTRIDGE CIRCLE DR   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 223 , 440 ," 1,476 "," $78,563.51 ",,
MEDICAID DIRECT,1215790803,DORIS K THORNE DDS PA,~,3729 WESTRIDGE CIRCLE DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1275683542,"THORNE, DORIS, KNIGHT",3729 WESTRIDGE CIRCLE DR   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 14 , 32 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1275685166,"AMPOMAH, JOHN, KWEKU",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1275685166,"AMPOMAH, JOHN, KWEKU",7101 JAHNKE RD   RICHMOND VA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1275685166,"AMPOMAH, JOHN, KWEKU",7101 JAHNKE RD   RICHMOND VA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275687691,"AYGARI, VISHALI",4220 CAROLINA EXCHANGE DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275688699,"CIBIRAS, THOMAS, ALAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1275688855,HERTFORD COUNTY PUBLIC SCHOOLS,HERTFORD COUNTY PUBLIC SCHOOLS,701 N MARTIN ST   WINTON NC,046,Hertford,251300000X,Agencies,Local Education Agency (LEA),,1275688855,HERTFORD COUNTY PUBLIC SCHOOLS,701 N MARTIN ST   WINTON NC,046,Hertford,251300000X,Agencies,Local Education Agency (LEA),, 39 , 524 , 525 ," $21,773.52 ",,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275689713,"WALKER, ELAINE, VIRGINIA",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275689713,"WALKER, ELAINE, VIRGINIA",209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1275689713,"WALKER, ELAINE, VIRGINIA",209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 34 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275689861,"LEE, MICHELLE, DIANNE",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1962727388,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",1900 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 18 , 21 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 100 , 122 , 203 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 125 , 164 , 272 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 16 , 27 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1275695918,"ANASTACIO, RAMON, MARTINEZ",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1275696254,TENDER CARE INC,TENDER CARE INC,3560 VEST MILL RD STE 7 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1275696254,TENDER CARE INC,3560 VEST MILL RD STE 7 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 23 ," 3,103 "," 3,103 "," $205,751.16 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275696650,"BHOWMICK, DEB, ASHISH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275696650,"BHOWMICK, DEB, ASHISH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1740869395,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE SPECIALTY CARE,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275696650,"BHOWMICK, DEB, ASHISH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275696650,"BHOWMICK, DEB, ASHISH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1275696650,"BHOWMICK, DEB, ASHISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275697021,"POWERS, CLARK, ALFRED",520 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275698359,"HIGGINSON, AMANDA, IRMEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,24 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275699365,"OLNEY, STACEY, CASSANDRA",24 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275700288,"JAY, COLLEEN, LOUISE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 65 , 79 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275705253,"GLANVILLE MIRANDA, CARLOS, JAVIER",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275705253,"GLANVILLE MIRANDA, CARLOS, JAVIER",2790 GODWIN BLVD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275705311,"SUNG, KRISTIN, ELIZABETH",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 53 , 95 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275705311,"SUNG, KRISTIN, ELIZABETH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275705311,"SUNG, KRISTIN, ELIZABETH",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285905059,NEW HOPE PSYCHIATRIC SERVICES OF TH,NEW HOPE PSYCHIATRIC SERVICES OF THE CAROLINAS,1558 UNION RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275705725,"NORMAN, TONJA, SIMMONS",1558 UNION RD STE A GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 99 , 599 , 602 ," $31,046.05 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275706756,"RUBIN, BECKY, SUZZANNE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275706756,"RUBIN, BECKY, SUZZANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275706756,"RUBIN, BECKY, SUZZANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275706756,"RUBIN, BECKY, SUZZANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275707325,"JOSEPH, ALLEN, MANUEL",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 386 , 449 , 612 ,$#,,
MEDICAID DIRECT,1437196318,FIRST IMAGING OF THE CAROLINAS,First Imaging of the Carolinas,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275707325,"JOSEPH, ALLEN, MANUEL",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1275707325,"JOSEPH, ALLEN, MANUEL",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",10650 PARK RD STE 320 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",10650 PARK RD STE 320 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 40 , 56 , 100 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",10650 PARK RD STE 320 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,325 HAWTHORNE LN STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",10650 PARK RD STE 320 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275708125,"FITZSIMONS, NICHOLAS, JOHN",325 HAWTHORNE LN STE 300 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 17 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275708463,"PAVLISKO, ELIZABETH, NUNNERY",1000 TRENT DR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275708463,"PAVLISKO, ELIZABETH, NUNNERY",1000 TRENT DR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275708463,"PAVLISKO, ELIZABETH, NUNNERY",1000 TRENT DR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275708646,"FISHER, TISHA, BRITTAIN",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1275708646,"FISHER, TISHA, BRITTAIN",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,109A AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275708687,"ESCABI MENDEZ, FERNANDO, ARMANDO",109A AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326892985,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,7868 US HIGHWAY 70 W   LA GRANGE NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275708687,"ESCABI MENDEZ, FERNANDO, ARMANDO",7868 US HIGHWAY 70 W   LA GRANGE NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801640461,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,109 AIRPORT RD STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275708687,"ESCABI MENDEZ, FERNANDO, ARMANDO",109A AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801640461,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,109 AIRPORT RD STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275708687,"ESCABI MENDEZ, FERNANDO, ARMANDO",107 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 137 , 301 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275709354,"PAVON, JULIESSA, MARTA",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275709354,"PAVON, JULIESSA, MARTA",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275709354,"PAVON, JULIESSA, MARTA",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275709354,"PAVON, JULIESSA, MARTA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275709495,"MESZAROS, PETRONELA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275709495,"MESZAROS, PETRONELA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275709495,"MESZAROS, PETRONELA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics, 888 ," 1,014 "," 1,040 "," $280,853.52 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275709495,"MESZAROS, PETRONELA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881289932,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR DIVISION OF PSYCHIATRY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275709842,"MCKINNEY, TARA ANNA, SZCZESNY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275717217,"BROWN, GRETCHEN, GODCHAUX",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 23 , 25 ,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1275718926,"DIYANAT, NURULLA",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 202 , 250 , 667 ," $35,288.01 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275723017,"SMITH, MARSHA, MAREK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275723017,"SMITH, MARSHA, MAREK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1275726838,"BELL GILES, JOY, HELENE",JOY HELENE BELL GILES DBA SPEECH SPAN,202 LITHIA INN RD   LINCOLNTON NC,055,Lincoln,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1275726838,"BELL GILES, JOY, HELENE",202 LITHIA INN RD   LINCOLNTON NC,055,Lincoln,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 150 , 153 ," $10,085.28 ",,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1275729642,"LUBKEMANN, MICHELLE, HUTT",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 41 , 80 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1275730178,"WOODCOCK, JESSICA, AMBER",201 WILLIAMSBURG PKWY   JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1275730178,"WOODCOCK, JESSICA, AMBER",738 NEWMAN RD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 53 , 76 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1275732067,"MIHALIK, JENNIFER, ERIN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275732927,"BRAYBOY, JACOB, RYAN",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 27 , 87 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275735805,"KAMATH, APARNA, SAMEER",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275735805,"KAMATH, APARNA, SAMEER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 66 , 66 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275736977,"SCRUGGS, KRISTINE, VISSAGE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1275736977,"SCRUGGS, KRISTINE, VISSAGE",117 E KINGS HWY   EDEN NC,079,Rockingham,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275736977,"SCRUGGS, KRISTINE, VISSAGE",800 TILGHMAN DR   DUNN NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275736977,"SCRUGGS, KRISTINE, VISSAGE",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275736977,"SCRUGGS, KRISTINE, VISSAGE",800 TILGHMAN DR   DUNN NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1275736977,"SCRUGGS, KRISTINE, VISSAGE",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275738270,ALEXANDER COUNTY,Alexander County Department of Social Services,,,Unknown,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1275738270,ALEXANDER COUNTY,604 7TH ST SW   TAYLORSVILLE NC,002,Alexander,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1275738270,ALEXANDER COUNTY,Alexander County Department of Social Services,,,Unknown,251B00000X,Agencies,Case Management,,1275738270,ALEXANDER COUNTY,604 7TH ST SW   TAYLORSVILLE NC,002,Alexander,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1275738775,"JONES, SHAYNA, DARIENE",105 MCALPINE LN   LAURINBURG NC,083,Scotland,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275741076,"COSPER, GRAHAM, HARVEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275741076,"COSPER, GRAHAM, HARVEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 47 , 58 ," $12,413.15 ",,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275741076,"COSPER, GRAHAM, HARVEY",1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275741076,"COSPER, GRAHAM, HARVEY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275741076,"COSPER, GRAHAM, HARVEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 15 , 23 ,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275741076,"COSPER, GRAHAM, HARVEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275742397,"BERRETH, MARGARET, ELISABETH",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275742397,"BERRETH, MARGARET, ELISABETH",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275742397,"BERRETH, MARGARET, ELISABETH",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275742397,"BERRETH, MARGARET, ELISABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275747891,"TADDESSE, ABAY, TASSEW",4001 COLISEUM DR STE 310 HAMPTON VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203A EARNHART DR   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1275748584,"HUEY, KAREN, PARRISH",203A EARNHART DR   EDENTON NC,021,Chowan,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275748584,"HUEY, KAREN, PARRISH",309 N BROAD ST   EDENTON NC,021,Chowan,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 41 , 43 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275751026,"O BRIANT, AMANDA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275751026,"O BRIANT, AMANDA, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1275752230,COLTRANE LIFE CENTER INC,Coltrane LIFE Center Inc,321 CORBAN AVE SE   CONCORD NC,013,Cabarrus,385H00000X,Respite Care Facility,Respite Care,,1275752230,COLTRANE LIFE CENTER INC,321 CORBAN AVE SE   CONCORD NC,013,Cabarrus,385H00000X,Respite Care Facility,Respite Care,,#," 1,618 "," 1,618 "," $69,671.08 ",,
MEDICAID DIRECT,1275755019,"DEMARTINI, SUSAN, MARIE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,1275755019,"DEMARTINI, SUSAN, MARIE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275757064,"HOWES, BRENDAN, LUKE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275757064,"HOWES, BRENDAN, LUKE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275757064,"HOWES, BRENDAN, LUKE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1275757569,"WESTON, REBECCA, GOODMAN",~,4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,1275757569,"WESTON, REBECCA, GOODMAN",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1275757569,"WESTON, REBECCA, GOODMAN",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1275757569,"WESTON, REBECCA, GOODMAN",~,4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1275757569,"WESTON, REBECCA, GOODMAN",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 31 , 45 ,$#,,
MEDICAID DIRECT,1750526257,OCEANSIDE PEDIATRICS PA,OCEANSIDE PEDIATRICS,3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1275757569,"WESTON, REBECCA, GOODMAN",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1275757569,"WESTON, REBECCA, GOODMAN",~,4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,1275757569,"WESTON, REBECCA, GOODMAN",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275759581,"THERTULIEN, RAYMOND",20 MEDICAL PARK DR STE B ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275759581,"THERTULIEN, RAYMOND",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 23 , 25 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275759581,"THERTULIEN, RAYMOND",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 22 , 25 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275759581,"THERTULIEN, RAYMOND",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275759581,"THERTULIEN, RAYMOND",63 S MEDICAL CT   MARION NC,059,McDowell,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 17 , 46 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275759730,"REEDER HAYES, KATHERINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 12 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275760092,"GARCIA SANTANA, SHEILA, MARIE",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1275760092,"GARCIA SANTANA, SHEILA, MARIE",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1275760092,"GARCIA SANTANA, SHEILA, MARIE",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 16 , 33 ,$#,,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1275760092,"GARCIA SANTANA, SHEILA, MARIE",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1275760092,"GARCIA SANTANA, SHEILA, MARIE",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 38 , 106 , 180 ," $20,110.13 ",,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275760092,"GARCIA SANTANA, SHEILA, MARIE",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275760621,"MARTIN, WILLIAM, EDWARD",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275760720,"HUTTMAN, DANIEL, THOMAS",4741 RANDOLPH RD STE 100&200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275760720,"HUTTMAN, DANIEL, THOMAS",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275761355,"ANDRIES, LILIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 67 , 203 , 204 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275763567,"SACHDEV, GAURAV",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 51 , 80 , 88 ," $14,730.32 ",,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275765968,"WOLSKI, JENNIFER, LACEY",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275765968,"WOLSKI, JENNIFER, LACEY",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 29 , 47 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275766305,"MARRINER, ANGELA, MARIE",7921 ACC BLVD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275766305,"MARRINER, ANGELA, MARIE",600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306323951,CAROLINA CHILDRENS EYE CARE PA,,3608 W FRIENDLY AVE STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275767766,"PATEL, MARTHA, GRACE GREEN",3608 W FRIENDLY AVE STE 101 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 119 , 147 , 205 ," $14,998.22 ",,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275768236,"LONG, JENNIFER, LYNN ROCHETTE",3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 26 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275768491,"HINES, ANDREW, URIAH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 139 , 155 , 201 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275768491,"HINES, ANDREW, URIAH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 210 , 229 , 292 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275768640,"ALEXANDER, THOMAS, BLICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 11 , 43 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275768731,"SIGLIN, JOSHUA, JAMES",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 11 , 23 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275768731,"SIGLIN, JOSHUA, JAMES",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 14 , 58 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275768731,"SIGLIN, JOSHUA, JAMES",20 MEDICINE CIRCLE   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 42 , 53 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",1710 KERNERSVILLE MEDICAL PKWY STE 202B KERNERSVILLE NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 28 , 39 , 82 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 15 , 40 , 40 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 37 , 41 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275775389,"ARAPIAN, MICHAEL, GRAHAM",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275777179,"THOMPSON, ASHLEIGH, ANNE OWEN",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275777179,"THOMPSON, ASHLEIGH, ANNE OWEN",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275777179,"THOMPSON, ASHLEIGH, ANNE OWEN",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 19 , 25 ,$#,,
MEDICAID DIRECT,1639370778,MAZDA BERENJIAN DDS,HENDERSON FAMILY DENTISTRY,560 DABNEY DR STE C HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1275777245,"BERENJIAN, MAZDA",560 DABNEY DR STE C HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice," 1,858 "," 4,519 "," 14,118 "," $840,023.51 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275779720,"LITTLE, KAREN, RICH",910 W WILLIAMS ST   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275783425,"ALI, HAMED, HUSSEIN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275786345,"ERICKSON, BRITTAIN, ADELLE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275786345,"ERICKSON, BRITTAIN, ADELLE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275786345,"ERICKSON, BRITTAIN, ADELLE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 129 , 272 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275786345,"ERICKSON, BRITTAIN, ADELLE",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 43 , 68 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 34 , 45 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 21 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 17 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE L KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275791899,"ROSE, JOEL, SIMON",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",919 S FIFTH ST   MEBANE NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 51 , 80 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4680 US HIGHWAY 117 N   PIKEVILLE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,2610 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 39 , 141 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 37 , 51 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275793143,"KURITZKY, JACK, JOSEPH",3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275793515,"FESTA, CARYN, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 33 , 33 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275794703,"PINEO, CALEB, EVANS",1821 HILLANDALE RD STE 24B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 116 , 289 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275794703,"PINEO, CALEB, EVANS",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 31 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275795544,"SALAMEH, NABIL, PETER",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275795544,"SALAMEH, NABIL, PETER",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275795544,"SALAMEH, NABIL, PETER",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1275796062,"HAUCK, STEVEN, JOSEPH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275798480,"RUSSELL, KEITH, EVERETTE",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 21 , 28 ,$#,,
MEDICAID DIRECT,1679875231,COMMUNITY FAMILY HEALTHCARE PLLC,~,219A AVERY AVE   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1275799967,"SNIPES, JUSTIN, WAYNE",219A AVERY AVE   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720503972,"HICKS, ALAN, MICHAEL",~,219A AVERY AVE   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1275799967,"SNIPES, JUSTIN, WAYNE",219A AVERY AVE   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275799967,"SNIPES, JUSTIN, WAYNE",~,219A AVERY AVE   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1275799967,"SNIPES, JUSTIN, WAYNE",219A AVERY AVE   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 106 , 376 , 434 ," $29,838.41 ",,
MEDICAID DIRECT,1881011120,FIRSTHEALTH OF THE CAROLINAS INC,~,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",35 MEMORIAL DR   PINEHURST NC,063,Moore,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 29 , 33 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 20 , 43 , 73 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1720612492,REX HOSPITAL INC,UNC REX MATERNAL FETAL MEDICINE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275800526,"STRINGER, ELIZABETH, MCPHILLIPS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275802142,"PATRICK, ERIN, DENISE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275802142,"PATRICK, ERIN, DENISE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1275802142,"PATRICK, ERIN, DENISE",195 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275802696,"KERNICKY, ASHLEY, BLACK",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275809451,"PATEL, SWETA, MAHESH",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 15 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275809451,"PATEL, SWETA, MAHESH",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275809451,"PATEL, SWETA, MAHESH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 17 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275809451,"PATEL, SWETA, MAHESH",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275809451,"PATEL, SWETA, MAHESH",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275809451,"PATEL, SWETA, MAHESH",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275811168,"GARG, PARVESH, MOHAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 14 , 93 , 93 ," $18,122.83 ",,
MEDICAID DIRECT,1205889185,CLAUDE LUVIS MD PA,,2682 COURT DR STE B GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275812851,"LUVIS, SHERRYL, DEVIKA",2682 COURT DR STE B GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 98 , 125 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275816787,"WARD, SUSAN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275816787,"WARD, SUSAN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1356852511,GRACE CLINIC OF YADKIN VALLEY,,948 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1275818817,"EDWARDS, SUSAN, TODD",948 JOHNSON RIDGE RD   ELKIN NC,086,Surry,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1275819617,"WILKINS, KELLY, GRAHAM",205 MEMORIAL DR   PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1275820987,"HELAK, CHRISTOPHER, JOSEPH",,1717 SHIPYARD BLVD STE 300 WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1275820987,"HELAK, CHRISTOPHER, JOSEPH",1717 SHIPYARD BLVD STE 300 WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235895137,BLUEWATER SURGICAL PLLC,,1717 SHIPYARD BLVD STE 300 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275820987,"HELAK, CHRISTOPHER, JOSEPH",1717 SHIPYARD BLVD STE 300 WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 71 , 80 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275821910,"TAILOR, BINITA, BHUPENDRA",3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 44 , 44 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2609 N DUKE ST STE 301 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275823569,"LIAO, GARY, YU-JEN",2609 N DUKE ST STE 301 DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 16 , 20 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275823569,"LIAO, GARY, YU-JEN",2609 N DUKE ST STE 301 DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275823569,"LIAO, GARY, YU-JEN",2609 N DUKE ST STE 301 DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275823569,"LIAO, GARY, YU-JEN",5107 SOUTHPARK DR STE 202 DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275823882,"SHAFIQ, SAIF, LUTFI",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275823882,"SHAFIQ, SAIF, LUTFI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 81 , 199 , 199 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275823882,"SHAFIQ, SAIF, LUTFI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1275825002,"BORMAN, DANIEL, JACOB",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,210 OVERLAND DR   GREENWOOD SC,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1275825002,"BORMAN, DANIEL, JACOB",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,210 OVERLAND DR   GREENWOOD SC,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1275825002,"BORMAN, DANIEL, JACOB",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1275825002,"BORMAN, DANIEL, JACOB",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1275826646,"RULE, LEE, JACOB",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",1795 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 33 , 54 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",3724 WIRELESS DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 136 , 163 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",323 BALDWIN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 113 , 114 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",323 BALDWIN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",72 CHATHAM ST   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",106 CAMERON ST   LAKE WACCAMAW NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",208 MERCER RD   ELIZABETH TOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",3031 TATE BLVD SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",849 WATERWORKS RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 76 , 87 ," $11,958.45 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",214 LANEFIELD RD   WARSAW NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 123 , 203 ," $11,789.92 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",7449 FAIR OAKS DR   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 48 , 49 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",115 WHITE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",311 S CAMPBELL ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",7166 JORDAN RD   RAMSEUR NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 53 , 55 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",1716 LEGION RD   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 122 , 124 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",1602 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 217 , 261 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",333 E LEE AVE   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 25 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275827834,"BLACK, BRENDAN, CHRISTIAN",903 W MAIN ST   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 38 , 40 ,$#,,
MEDICAID DIRECT,1487804670,WATERWAY EMERGENCY PHYSICIANS,,,,Unknown,193400000X,Group,Single Specialty,,1275829475,"GILLMAN, JESSICA, LYNN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1275829475,"GILLMAN, JESSICA, LYNN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275829475,"GILLMAN, JESSICA, LYNN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275829475,"GILLMAN, JESSICA, LYNN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275834830,"RUZEK, MICHAEL, ADEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1275835928,WALGREEN CO,WALGREENS 11765,1230 E MAIN ST   LINCOLNTON NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1275835928,WALGREEN CO,1230 E MAIN ST   LINCOLNTON NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275839532,"ROODE, RICHARD, JOHN",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 97 , 159 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275839532,"ROODE, RICHARD, JOHN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275839532,"ROODE, RICHARD, JOHN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 33 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275842361,"MUNDAY, KYLE, RANCLX",503 E PARKER RD   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275842361,"MUNDAY, KYLE, RANCLX",841 MALCOLM BLVD   RUTHERFORD COLLEGE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 136 , 260 , 543 ," $13,250.70 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1275842361,"MUNDAY, KYLE, RANCLX",503 E PARKER RD   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1275842361,"MUNDAY, KYLE, RANCLX",841 MALCOLM BLVD   RUTHERFORD COLLEGE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 71 , 158 ,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275844177,"MIKHAYLOV, YANA, ANATOLIEVNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548510969,CUMBERLAND COUNTY HOSPITAL SYSTEM I,FERNCREEK GENERAL SURGERY,4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275844177,"MIKHAYLOV, YANA, ANATOLIEVNA",4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 34 , 35 ,$#,,
MEDICAID DIRECT,1548510969,CUMBERLAND COUNTY HOSPITAL SYSTEM I,FERNCREEK GENERAL SURGERY,4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275844177,"MIKHAYLOV, YANA, ANATOLIEVNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 123 , 149 ," $15,166.60 ",,
MEDICAID DIRECT,1851723951,PIEDMONT HEALTH SERVICES INC,MONCURE CHC DENTAL,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275845505,"EILERTSON, NICHOLAS, JEFFREY",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 651 ," 1,110 "," 3,091 "," $138,155.03 ",,
MEDICAID DIRECT,1124450226,PIEDMONT HEALTH SERVICES INC,~,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275845505,"EILERTSON, NICHOLAS, JEFFREY",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275846065,"SCHELL, ELAINE, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275846065,"SCHELL, ELAINE, ANN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE L KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275849143,"BJURLIN, MARC, ANDREW",701 DOCTORS DR STE L KINSTON NC,054,Lenoir,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275849143,"BJURLIN, MARC, ANDREW",701 DOCTORS DR STE L KINSTON NC,054,Lenoir,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275849143,"BJURLIN, MARC, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 36 , 45 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1275849143,"BJURLIN, MARC, ANDREW",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275849143,"BJURLIN, MARC, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE L KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1275849143,"BJURLIN, MARC, ANDREW",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1598486565,BEACON DERMATOLOGY LLC,,76 PEACHTREE RD STE 120 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1275851032,"RAINS, MICHAEL, LEROY",76 PEACHTREE RD STE 120 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 22 , 37 , 78 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275853566,"MCCAMMACK, KEVIN, CHARLES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1275853566,"MCCAMMACK, KEVIN, CHARLES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275853566,"MCCAMMACK, KEVIN, CHARLES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 124 , 129 , 158 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275853566,"MCCAMMACK, KEVIN, CHARLES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 146 , 146 , 176 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275853640,"SELLERS, SUBHASHINI, APPULINGAM",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 27 , 64 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275853640,"SELLERS, SUBHASHINI, APPULINGAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 16 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275853640,"SELLERS, SUBHASHINI, APPULINGAM",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275853640,"SELLERS, SUBHASHINI, APPULINGAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 28 , 35 ,$#,,
MEDICAID DIRECT,1275855850,PERSONAL ASSIST HOMECARE OF NORTH C,PERSONAL ASSIST HOMECARE OF NORTH CAROLINA,2202 N PINE ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1275855850,PERSONAL ASSIST HOMECARE OF NORTH C,2202 N PINE ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 45 ," 10,305 "," 10,334 "," $1,160,855.40 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1275859498,"UNDERHILL, JAMES, GRAHAM",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 121 , 206 , 248 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1275859498,"UNDERHILL, JAMES, GRAHAM",2000 NEUSE BLVD   NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275860751,"JOHNSON, KELSEY, RUTH",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1275861577,CHOSEN HEALTH CARE SERVICES INC,~,8401 UNIVERSITY EXEC PARK DR STE 111 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1275861577,CHOSEN HEALTH CARE SERVICES INC,8401 UNIVERSITY EXEC PARK DR STE 111 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 2,647 "," 2,857 "," $304,312.91 ",,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1275872236,"HODGIN, ELIZABETH, MCNEILL",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 83 , 121 , 311 ," $14,028.85 ",,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1275872236,"HODGIN, ELIZABETH, MCNEILL",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1275874109,"HALE, KELLY, ANN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1275874109,"HALE, KELLY, ANN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275875007,"LADD, MITCHELL, RYAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 46 , 98 , 119 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1275875973,"HAUG, JAMES, CLARK",6057 GRIFFIN DR   COLORADO SPRINGS CO,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 78 , 87 , 110 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1275875973,"HAUG, JAMES, CLARK",6057 GRIFFIN DR   COLORADO SPRINGS CO,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275876393,"WALDROP, HEATHER, WETHERELL",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 54 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275876393,"WALDROP, HEATHER, WETHERELL",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275876393,"WALDROP, HEATHER, WETHERELL",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 18 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275876393,"WALDROP, HEATHER, WETHERELL",3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275876393,"WALDROP, HEATHER, WETHERELL",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275876393,"WALDROP, HEATHER, WETHERELL",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 27 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275876393,"WALDROP, HEATHER, WETHERELL",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437112612,WNC DERMATOLOGICAL ASSOCIATES PA,~,281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275876682,"SOTOMAYOR VALDIVIA, CLAUDIA, DEYANIRA",281 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275877052,"REULE III, WILLIAM, HOUSTON",703 COMFORT LN   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 83 , 142 ,$#,,
MEDICAID DIRECT,1275879926,WP-ROXBORO HEALTH HOLDINGS LLC,THE CANTERBURY HOUSE,1284 LEASBURG RD   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275879926,WP-ROXBORO HEALTH HOLDINGS LLC,1284 LEASBURG RD   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 44 ," 11,812 "," 11,812 "," $835,935.35 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275882367,"EVANS, PEGGY, EUBANKS",75A LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 31 , 63 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275882987,"DUNN, MARIE, JACKSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 30 , 30 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275883597,"FRAZIER, LATONYA, EVERETTE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275883597,"FRAZIER, LATONYA, EVERETTE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275888661,"HINDS, HANNAH, BEAUCHAMP",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275889479,"PERVEZ, SUNIA, AYEZA",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275889479,"PERVEZ, SUNIA, AYEZA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275889479,"PERVEZ, SUNIA, AYEZA",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 16 , 21 ,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275889479,"PERVEZ, SUNIA, AYEZA",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 28 , 39 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275890477,"SMILEY, MARK, ANTHONY",1028 LEE ANN DR NE STE 200 CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275890477,"SMILEY, MARK, ANTHONY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275890477,"SMILEY, MARK, ANTHONY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275890477,"SMILEY, MARK, ANTHONY",1028 LEE ANN DR NE STE 200 CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457309221,CABARRUS EMERGENCY MEDICINE ASSOCIA,CABARRUS EMERGENCY MEDICINE ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1275890477,"SMILEY, MARK, ANTHONY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1275891277,"NIU, XILIN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275891277,"NIU, XILIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 82 , 83 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1275893372,"CARPENTER, TERESA, JOHNSON",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275893372,"CARPENTER, TERESA, JOHNSON",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 76 , 76 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275893927,"NOWAK, NATALIE, LYNN",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 31 , 33 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275893927,"NOWAK, NATALIE, LYNN",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275893927,"NOWAK, NATALIE, LYNN",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275895666,"HEFFERNAN, LINDA, AUGUSTA",4711 S CROATAN HWY STE 6B NAGS HEAD NC,028,Dare,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275897027,"WILSON, KELLY, EDWARD",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275897035,"PADUCHOWSKI, BRITTNEY, LEIGHVANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275897035,"PADUCHOWSKI, BRITTNEY, LEIGHVANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275897035,"PADUCHOWSKI, BRITTNEY, LEIGHVANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275897035,"PADUCHOWSKI, BRITTNEY, LEIGHVANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467890301,LUZ A CHAVEZ DDS PC,ALL FAMILY DENTISTRY PC,9912 MONROE RD STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275897258,"RAMOS VERA, ANDY, WILLIAM",9912 MONROE RD STE 100 MATTHEWS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 377 , 708 ," 3,387 "," $102,714.06 ",,
MEDICAID DIRECT,1861961963,SPARTANBURG MEDICAL CENTER,MEDGRPOFTHECAROLINAS- DIVISION OF SURGERY - SKYLYN,1690 SKYLYN DR STE 350 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1275898652,"BUDREVICH, DZIANIS",1690 SKYLYN DR STE 350 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275898835,"MCCLELLAN, MARY, KATHRYN",68 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275899163,"ADAMS MORANCIE, NAILAH, SAFIYA",3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 42 , 109 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275899163,"ADAMS MORANCIE, NAILAH, SAFIYA",3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275899981,"CENGIA, MA, ELIZABETH DIONISO",5110 ROBINHOOD VILLAGE DR STE C-1 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 35 , 84 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275906778,"FRYE, AMANDA, KEESLER",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 68 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275912321,"EVANS, ADJOA, BOATENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 40 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275912321,"EVANS, ADJOA, BOATENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 20 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275912321,"EVANS, ADJOA, BOATENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 27 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275912321,"EVANS, ADJOA, BOATENG",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1275913006,"POLANSKY, MAXIM, ALEXANDROVICH",701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275913006,"POLANSKY, MAXIM, ALEXANDROVICH",701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1275914285,"JONES, CRYSTAL, EASTER",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 47 , 70 , 87 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1275914285,"JONES, CRYSTAL, EASTER",1909 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 59 , 95 , 100 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1275914285,"JONES, CRYSTAL, EASTER",108 S STATE ST   YADKINVILLE NC,099,Yadkin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 106 , 156 , 171 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1275914285,"JONES, CRYSTAL, EASTER",108 S STATE ST   YADKINVILLE NC,099,Yadkin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 86 , 136 , 153 ,$#,,
MEDICAID DIRECT,1104679448,PHILLIP MCIVER DDS PA,~,304 IONA ST   FAIRMONT NC,078,Robeson,193200000X,Group,Multi-Specialty,,1275914871,"NELSON, DERRICK, COURTNEY",304 IONA ST   FAIRMONT NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 34 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275915001,"GONZALEZ, LEONARD, STEVE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275915001,"GONZALEZ, LEONARD, STEVE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275915001,"GONZALEZ, LEONARD, STEVE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1275915001,"GONZALEZ, LEONARD, STEVE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275920357,"LEWIS, LINDSAY, GIBEAULT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 40 , 41 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275924755,"FRIESEMA, KIMBERLY, ANNE",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 25 , 30 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275924755,"FRIESEMA, KIMBERLY, ANNE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407150816,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275924755,"FRIESEMA, KIMBERLY, ANNE",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275924854,"WRIGHT, MICHELLE, CORINNE KOSCO",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275925216,"CEARLEY, WESLEY, THOMAS",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275925216,"CEARLEY, WESLEY, THOMAS",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275925547,"WILSON, ADAM, JERROD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 12 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275925547,"WILSON, ADAM, JERROD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 25 , 29 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275928384,"TRAPANI, KEVIN, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275928384,"TRAPANI, KEVIN, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275928848,"MAYBERRY, JORDAN, LEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275928848,"MAYBERRY, JORDAN, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275928848,"MAYBERRY, JORDAN, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275928848,"MAYBERRY, JORDAN, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 32 , 42 , 65 ,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275929036,"MANISCALCO, KENNETH, BLAISE",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275929101,"GIRGUIS, DAVID, NABIL",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 51 , 51 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275929101,"GIRGUIS, DAVID, NABIL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 36 , 36 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1275929101,"GIRGUIS, DAVID, NABIL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275929481,"ALEXANDER, ALLISON, KATHLEEN",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 128 , 276 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275929648,"HAM, ASHLEY, HERRMANN",5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275929648,"HAM, ASHLEY, HERRMANN",101 E W T HARRIS BLVD STE 121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1841526837,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATR,5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275929648,"HAM, ASHLEY, HERRMANN",5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 38 , 68 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1275932048,"NDIAYE, AMI, PAULINE",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1275932048,"NDIAYE, AMI, PAULINE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275932048,"NDIAYE, AMI, PAULINE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275935082,"EUBANK, LAUREN, RUSSELL",332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 15 ,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275935082,"EUBANK, LAUREN, RUSSELL",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275935082,"EUBANK, LAUREN, RUSSELL",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 18 ,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275935082,"EUBANK, LAUREN, RUSSELL",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 18 , 19 , 50 ,$#,,
MEDICAID DIRECT,1720457567,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DIGESTIVE HEALTH CENTER SEACOAST,3980 HIGHWAY 9 E STE 320 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1275935256,"CALDERA ALVARADO, GLORIMAR",3980 HIGHWAY 9 E STE 320 LITTLE RIVER SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275936502,"PATEL, SHIDDHI, PANKAJ",2525 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 65 , 65 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275939738,"BRIGGS, RAINA, VICTORIA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1275939738,"BRIGGS, RAINA, VICTORIA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1912085648,CHOICE PHYSICAL THERAPY WELLNESS,~,847 WESTLAKE DR   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1275942922,"SHELTON, OLIVIA, RATCLIFF",847 WESTLAKE DR 847 WESTLAKE DRIVE MOUNT AIRY NC,086,Surry,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1326849456,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PAIN SPECIALIST,720 MALCOLM BLVD STE 400 VALDESE NC,012,Burke,193400000X,Group,Single Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",720 MALCOLM BLVD   VALDESE NC,012,Burke,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,201 E GROVER ST FL 3 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",720 MALCOLM BLVD   VALDESE NC,012,Burke,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 26 , 30 , 38 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",720 MALCOLM BLVD   VALDESE NC,012,Burke,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 33 , 37 , 43 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326849456,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PAIN SPECIALIST,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275943011,"CUNNINGHAM, CAMERON, SCOTT",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 52 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275945297,"WILLHITE, JAY, PAUL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1275948655,"CARR, SARAH, ELIZABETH",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 68 , 172 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1275948655,"CARR, SARAH, ELIZABETH",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1275948655,"CARR, SARAH, ELIZABETH",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1083050389,ORANGE COUNTY,~,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1275948804,"STACK, RIVKAH, ZELDA KREVSKY",702 N MAIN ST   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 52 ,$#,,
MEDICAID DIRECT,1083050389,ORANGE COUNTY,~,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1275948804,"STACK, RIVKAH, ZELDA KREVSKY",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 400 , 497 ," 1,735 "," $56,359.71 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275951675,"LASHLEY, DEANA, KAY",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275951675,"LASHLEY, DEANA, KAY",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics, 34 , 33 , 77 ," $19,042.85 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275952525,"PAINENI, JAYAKRISHNA",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386960342,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275952525,"PAINENI, JAYAKRISHNA",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275952525,"PAINENI, JAYAKRISHNA",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275952525,"PAINENI, JAYAKRISHNA",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1114373404,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1275952590,"LO, JASON, YUNG",351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275953614,"PANZO, WILLIAM, JOHN",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 53 , 73 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275953614,"PANZO, WILLIAM, JOHN",601 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275953788,"BHOSAI, SATASUK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275960486,BILINGUAL THERAPY SERVICES,~,5945 CLIFFDALE RD STE 1111 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275960486,BILINGUAL THERAPY SERVICES,5945 CLIFFDALE RD STE 1111 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 151 , 850 ," 1,598 "," $110,232.43 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275960692,"WILLIAMS, KATHRYN, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275960692,"WILLIAMS, KATHRYN, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275960999,"COLTRAIN, CHRISTOPHER, TODD",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275960999,"COLTRAIN, CHRISTOPHER, TODD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 119 , 166 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275961682,"LAKE, MELISSA, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1275961682,"LAKE, MELISSA, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1275961708,"WOOTEN, LINDSEY, HILL",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 42 , 55 , 63 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275961708,"WOOTEN, LINDSEY, HILL",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275966939,"DESROSIERS, MICHELLE, REBECCA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 18 , 20 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1275968216,"STEVENS, REBECCA, SPRING",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 167 , 167 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275968216,"STEVENS, REBECCA, SPRING",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 173 , 173 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,25 REYNOLDS MOUNTAIN BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1275968216,"STEVENS, REBECCA, SPRING",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275968216,"STEVENS, REBECCA, SPRING",3205 RANDALL PKWY   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1275968216,"STEVENS, REBECCA, SPRING",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275968216,"STEVENS, REBECCA, SPRING",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1275968216,"STEVENS, REBECCA, SPRING",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 95 , 95 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",101 MANNING DR   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 34 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",101 MANNING DR   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 344 , 467 , 841 ," $44,059.27 ",,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 21 , 213 ," $17,321.97 ",,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",101 MANNING DR   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 43 , 412 ," $32,335.72 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275970345,"LIM, SI ON",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275970600,"MINGES, EILEEN, MCGREW",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275970600,"MINGES, EILEEN, MCGREW",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 39 , 39 ,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 40 , 46 , 85 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1992284327,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH BREAST IMAGING CENTER LANGTREE,106 LANGTREE VILLAGE DR STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275972309,"DEVALAPALLI, AMRITA, PRAKASH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 196 , 204 , 280 ,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1275973323,"HASOU, DONA, TAWFIG",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 47 , 47 ,$#,,
MEDICAID DIRECT,1275973661,"MULLAGURI, NARESH",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1275973661,"MULLAGURI, NARESH",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1275974685,"NARAYAN, AARTI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275975153,WP-BEULAVILLE HEALTH HOLDINGS LLC,AUTUMN VILLAGE,235 N NC 41 HWY   BEULAVILLE NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1275975153,WP-BEULAVILLE HEALTH HOLDINGS LLC,235 N NC 41 HWY   BEULAVILLE NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 9,182 "," 9,183 "," $617,090.36 ",,
MEDICAID DIRECT,1275975153,WP-BEULAVILLE HEALTH HOLDINGS LLC,AUTUMN VILLAGE,235 N NC 41 HWY   BEULAVILLE NC,031,Duplin,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1275975153,WP-BEULAVILLE HEALTH HOLDINGS LLC,235 N NC 41 HWY   BEULAVILLE NC,031,Duplin,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 23 , 123 , 123 ," $17,209.11 ",,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1275976581,"GUIDETTI, RICHARD, SAMUEL",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 112 , 122 , 133 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1275977837,"CLEMONS, ROBERT, STEPHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 45 , 46 , 48 ,$#,,
MEDICAID DIRECT,1386653830,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,4525 CAMERON VALLEY PKWY STE 1500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275979106,"CARDWELL, CASSANDRA, JEAN",4525 CAMERON VALLEY PKWY STE 1500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 38 , 48 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 55 , 72 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 27 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 57 , 60 , 89 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 34 , 44 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1275979437,"PATEL, ANAND",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 33 , 37 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275980021,"CHATHAM, ALEXANDER, HARRIS",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 45 , 67 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1275980021,"CHATHAM, ALEXANDER, HARRIS",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275980021,"CHATHAM, ALEXANDER, HARRIS",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1275980021,"CHATHAM, ALEXANDER, HARRIS",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 31 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275980021,"CHATHAM, ALEXANDER, HARRIS",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 28 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1275980021,"CHATHAM, ALEXANDER, HARRIS",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 25 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1275980021,"CHATHAM, ALEXANDER, HARRIS",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 22 , 38 ,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275981938,"PONG, DENISE, DI",3004 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 18 , 38 ,$#,,
MEDICAID DIRECT,1487940268,OUR FAMILY DOCTOR PLLC,OUR FAMILY DOCTOR PLLC,43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275982571,"IRVINE, CHRISTOPHER, JOHN",43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 24 , 30 ,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1275982860,"BATES, ZHANNA",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 149 , 150 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1275983744,"KALRA, SALIL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1013635176,HOLLIS LEE JONES DDS PA,AFFORDABLE DENTURES & IMPLANTS - GASTONIA,3860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1275984544,"WHYTE, JAIMIE, GRANTLEY",3860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 21 , 102 ," $15,639.83 ",,
MEDICAID DIRECT,1871295220,RFDEST DDS PLLC,MAGNOLIA DENTISTRY,910 DONTIA DR   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1275984544,"WHYTE, JAIMIE, GRANTLEY",3860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice," 1,248 "," 2,123 "," 6,424 "," $444,847.57 ",,
MEDICAID DIRECT,1871295220,RFDEST DDS PLLC,MAGNOLIA DENTISTRY,910 DONTIA DR   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1275984544,"WHYTE, JAIMIE, GRANTLEY",910 DONTIA DR   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 116 , 120 , 336 ," $22,564.74 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275986911,"AVERY, KELLY, ERIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275986911,"AVERY, KELLY, ERIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1275986911,"AVERY, KELLY, ERIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1275986911,"AVERY, KELLY, ERIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1302 WESLEY CHAPEL RD STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",1302 WESLEY CHAPEL RD STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 31 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1275988990,"MALLOY, DYLAN, MICHAEL ANDERS",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275989675,"HILDEBRAND, PETER, FRANCIS",1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,600A CENTREPARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275989675,"HILDEBRAND, PETER, FRANCIS",600A CENTREPARK DR   ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1275989774,"WEST, PORTIA, ELISE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265942403,UBYLEE HEALTHCARE GROUP,,9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1275993149,"DOUGAN, KRISTI, DIAHANN",9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 65 , 281 , 626 ," $11,201.09 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275993172,"SILVER, LANCE, CARROLL",430 RANKIN DR   MARION NC,059,McDowell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 12 , 14 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1275993172,"SILVER, LANCE, CARROLL",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275994113,BENEFIT THERAPY SERVICES,,1140 HOLLY SPRINGS RD STE 111 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1275994113,BENEFIT THERAPY SERVICES,1140 HOLLY SPRINGS RD STE 111 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,, 17 , 106 , 120 ,$#,,
MEDICAID DIRECT,1275994113,BENEFIT THERAPY SERVICES,,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1275994113,BENEFIT THERAPY SERVICES,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 318 , 385 ," $25,675.12 ",,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,145 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,2340 HEMBY LN STE 300 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,2340 HEMBY LN STE 300 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1101 DRESSER CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 44 , 68 , 131 ," $10,969.27 ",,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1101 DRESSER CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",2340 HEMBY LN STE 300 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 64 , 144 ," $12,769.56 ",,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1101 DRESSER CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",4037 CAPITAL DR   ROCKY MOUNT NC,064,Nash,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 28 , 68 , 126 ," $24,552.12 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",145 TILGHMAN DR   DUNN NC,043,Harnett,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1101 DRESSER CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",145 TILGHMAN DR   DUNN NC,043,Harnett,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 68 , 154 ," $16,600.79 ",,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,145 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",145 TILGHMAN DR   DUNN NC,043,Harnett,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 47 , 130 ,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1101 DRESSER CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1275995177,"SAMARA, WASIM, AYED SAED",3322 WELLONS BLVD   NEW BERN NC,025,Craven,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 28 , 67 ,$#,,
MEDICAID DIRECT,1275589244,BETH L WARREN OD,COMMUNITY EYE ASSOCIATES,306 KIRBY RD   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1275996795,"HOOGLAND, MATTHIEW, KERK",306 KIRBY RD   KING NC,085,Stokes,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275997702,"WILSON, SARAH, BRYAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 177 , 137 , 169 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1275997702,"WILSON, SARAH, BRYAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275997702,"WILSON, SARAH, BRYAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 200 , 213 , 253 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1275997702,"WILSON, SARAH, BRYAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,1401 MATTHEWS TOWNSHIP PKWY STE 310 MATTHEWS NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1275997702,"WILSON, SARAH, BRYAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1275997702,"WILSON, SARAH, BRYAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285002717,"MILTON, DARRINA, O'NEAL",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 42 , 42 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285002717,"MILTON, DARRINA, O'NEAL",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 39 , 140 , 140 ,$#,,
MEDICAID DIRECT,1285882928,PHYSICIAN ALLIANCE FOR MENTAL HEALT,~,3208 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285003285,"MORGAN, LEIGHTON, DANIELLE",3208 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285008268,"STOUT, SAMANTHA, LEANNE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1285010611,"KLOTH, TERRA, LYNN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 42 , 42 , 42 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285012625,"HUNSUCKER, MATTHEW, RYAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285012625,"HUNSUCKER, MATTHEW, RYAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 40 , 45 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285012625,"HUNSUCKER, MATTHEW, RYAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285012625,"HUNSUCKER, MATTHEW, RYAN",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 43 , 63 , 79 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285012625,"HUNSUCKER, MATTHEW, RYAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 31 , 32 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285013409,"PANGENI, PUSHPA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 111 , 111 ,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285014662,"KONICKI, WILLIAM, STANLEY",1711 S MAIN ST   WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 38 ,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285014662,"KONICKI, WILLIAM, STANLEY",1725 S MAIN ST   WAKE FOREST NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 32 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285015990,"SMITH, JEREMY, KEITH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 108 , 115 , 140 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285015990,"SMITH, JEREMY, KEITH",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285015990,"SMITH, JEREMY, KEITH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 28 , 29 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285016048,"PORTZ, BRENT, JAMES",511 PALADIN DR   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 236 , 441 , 949 ," $92,283.45 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285016048,"PORTZ, BRENT, JAMES",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,970 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1285016048,"PORTZ, BRENT, JAMES",511 PALADIN DR   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 23 ,$#,,
MEDICAID DIRECT,1285016048,"PORTZ, BRENT, JAMES",,511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,1285016048,"PORTZ, BRENT, JAMES",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285016048,"PORTZ, BRENT, JAMES",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 41 , 45 , 117 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285016048,"PORTZ, BRENT, JAMES",511 PALADIN DR   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 80 , 483 ," $26,797.00 ",,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 370 , 401 , 472 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1285016964,"ZHANG, JESSICA",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285017863,"STURKEY, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 22 , 48 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285017863,"STURKEY, DANIELLE",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285017863,"STURKEY, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285018879,"PEARCE, SARAH, ALEXANDER",135 PAGE RD N   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 48 , 78 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285018879,"PEARCE, SARAH, ALEXANDER",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1023048279,GASTONIA MEDICAL SPECIALTY CLINIC,GASTONIA MEDICAL SPECIALTY CLINIC PA,1021 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285019000,"RANDOLPH, AMY, LYNN",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 112 , 161 , 187 ,$#,,
MEDICAID DIRECT,1477589158,EASTRIDGE FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE EASTRIDGE FAMILY MEDICI,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285019000,"RANDOLPH, AMY, LYNN",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 46 , 69 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285020149,"HORTON, KRISTIE, MARIE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285020180,"MCKNIGHT, WESSLEY, RYAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 64 , 67 , 92 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1285020495,"CORBY, MARGEAUX, ROSE",400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 105 , 179 , 295 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285020495,"CORBY, MARGEAUX, ROSE",2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 17 , 26 , 50 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285020495,"CORBY, MARGEAUX, ROSE",400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 39 , 52 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 27 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285020834,"WILSON, REECE, ERIC",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1285024539,SUPREME FAMILY CARE HOME LLC,,1120 BENNING ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285024539,SUPREME FAMILY CARE HOME LLC,1120 BENNING ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 164 , 164 ," $59,967.34 ",,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285027136,"LOR, KAO, ASHLI",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 31 , 67 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285027623,"CLARK, CHRISTA, LEIGH",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 23 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1285027623,"CLARK, CHRISTA, LEIGH",1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285027938,"TAYLOR, JANICE, RODRIGUEZ",815 COX RD   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 41 , 47 , 47 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285028373,"HINES, CORY, MICHAEL",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285028373,"HINES, CORY, MICHAEL",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 18 , 25 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1285028373,"HINES, CORY, MICHAEL",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1285028373,"HINES, CORY, MICHAEL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 75 , 102 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285028522,"COONEY, HOLLY, MARIE",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 28 , 41 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285028522,"COONEY, HOLLY, MARIE",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285028522,"COONEY, HOLLY, MARIE",905 THUNDER RD STE 140 ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1285028605,"ZALESKI, MICHAEL, PHILLIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285028605,"ZALESKI, MICHAEL, PHILLIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 23 , 23 , 35 ,$#,,
MEDICAID DIRECT,1477704443,WAKE MEDICAL LABORATORY CONSULTANTS,WAKE MEDICAL LABORATORY CONSULTANTS INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285028605,"ZALESKI, MICHAEL, PHILLIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285029025,"JEAN-PIERRE, EVENS",14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285029025,"JEAN-PIERRE, EVENS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285031781,"MINER, WHITNEY, ERIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 35 , 42 ,$#,,
MEDICAID DIRECT,1720568660,CAPE FEAR HEALTH & WELLNESS PLLC,,3333 WRIGHTSVILLE AVE UNIT G WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285032979,"CARTE, NICHOLAS, STANLEY",3333 WRIGHTSVILLE AVE UNIT G WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 20 , 28 ,$#,,
MEDICAID DIRECT,1285033761,UNIVERSAL GROUP HOME LLC,,404 S CLAIBORNE ST   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285033761,UNIVERSAL GROUP HOME LLC,404 S CLAIBORNE ST   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 353 , 353 ," $96,037.73 ",,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285037077,"VAIL, ANNE, MERYL",101 E WT HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1285037697,"MAY, KATILYN, ELIZABETH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 78 , 155 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285038307,"DUGAN, JENNIFER, MARIE",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285038307,"DUGAN, JENNIFER, MARIE",3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285038307,"DUGAN, JENNIFER, MARIE",2728 W MALLARD CREEK CHURCH RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285038307,"DUGAN, JENNIFER, MARIE",2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285041053,"BROWN, CASEY, BAYLISS",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285044347,"KUHN, ELIZABETH, NAYLOR",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 25 , 34 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285044347,"KUHN, ELIZABETH, NAYLOR",152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 33 , 33 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 34 , 53 , 73 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 27 , 27 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285045500,"KOPPARTHY, PALLAVI",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285045963,"DANTULURI, KEERTI, LAXMI",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 16 , 22 , 24 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285045963,"DANTULURI, KEERTI, LAXMI",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285045963,"DANTULURI, KEERTI, LAXMI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285045963,"DANTULURI, KEERTI, LAXMI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 17 , 40 , 40 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285046193,"SEIPPEL, MCKENZIE, COX",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 52 , 104 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285047027,"AHMED, ADIL, HASSAN MOHAMMED",2301 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285047027,"AHMED, ADIL, HASSAN MOHAMMED",2301 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285047027,"AHMED, ADIL, HASSAN MOHAMMED",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 134 , 135 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285047027,"AHMED, ADIL, HASSAN MOHAMMED",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 94 , 94 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285047027,"AHMED, ADIL, HASSAN MOHAMMED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5000 GLENHOPE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285047027,"AHMED, ADIL, HASSAN MOHAMMED",5000 GLENHOPE CT   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285047266,"DONOHUE, MEGAN, HARLESS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 22 , 22 ,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1285048025,"HALL, JOHN, MARTIN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 99 , 153 , 330 ,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1285048025,"HALL, JOHN, MARTIN",1421 S GLENBURNIE RD # D NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 19 ,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1285048025,"HALL, JOHN, MARTIN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 40 , 41 , 98 ,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1285048025,"HALL, JOHN, MARTIN",800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285048181,"VEMIREDDY, KATIE GRACE, MELLINGTON",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285048181,"VEMIREDDY, KATIE GRACE, MELLINGTON",8201 HEALTHCARE LOOP STE 302 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 25 , 40 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285048694,"WYLIE, ALLEN, MOFFAT",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,302 STONE RIDGE BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1285048702,"LEE, DAVID, ALAN",388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1720521982,TIMOTHY O IMAFIDON JR DDS PA,GOLDSBORO PEDIATRIC DENTISTRY & ORTHODONTICS,300 S CENTER ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285049718,"BUTLER, MELODY",300 S CENTER ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 51 , 281 ," $11,159.10 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285052035,"MILLARD, MICHAEL, ALAN",205 PAGE RD   PINEHURST NC,063,Moore,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 44 , 57 , 80 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285052035,"MILLARD, MICHAEL, ALAN",205 PAGE RD   PINEHURST NC,063,Moore,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 105 , 155 , 269 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285052142,"WEN, JESSICA, JINGJING",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 189 , 201 , 246 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285052142,"WEN, JESSICA, JINGJING",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 179 , 179 , 211 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285052142,"WEN, JESSICA, JINGJING",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285052241,"YAPORT, MIGUEL, ANDRES",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285052241,"YAPORT, MIGUEL, ANDRES",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285052241,"YAPORT, MIGUEL, ANDRES",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285052241,"YAPORT, MIGUEL, ANDRES",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285052324,"REYNOLDS, JESSICA, HARDEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285052324,"REYNOLDS, JESSICA, HARDEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1285052324,"REYNOLDS, JESSICA, HARDEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285052639,"DAVE, DARSHAN, DINESH",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 32 , 83 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285052639,"DAVE, DARSHAN, DINESH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285052639,"DAVE, DARSHAN, DINESH",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285053082,"ESPOSITO, KELLY, ROSE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 50 , 81 , 147 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285053082,"ESPOSITO, KELLY, ROSE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 18 , 30 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285053082,"ESPOSITO, KELLY, ROSE",1168 E CUTLAR XING   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285053355,"MANDRY, HEIDI, ANN",4510 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 50 , 59 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1285053371,"MUJIB, NUSRAT, ANNY",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 26 , 26 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1285053371,"MUJIB, NUSRAT, ANNY",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1285053371,"MUJIB, NUSRAT, ANNY",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285053777,"MCCULLAGH, KASSIE, LYN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285053777,"MCCULLAGH, KASSIE, LYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285053777,"MCCULLAGH, KASSIE, LYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 285 , 317 , 436 ," $16,853.08 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1285053777,"MCCULLAGH, KASSIE, LYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285053777,"MCCULLAGH, KASSIE, LYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285053777,"MCCULLAGH, KASSIE, LYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285053777,"MCCULLAGH, KASSIE, LYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1285053967,"CREIGHTON, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285053967,"CREIGHTON, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285053967,"CREIGHTON, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285053967,"CREIGHTON, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",835 S NEW HOPE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 27 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",835 S NEW HOPE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 21 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",835 S NEW HOPE CHURCH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",301 S RALEIGH ST   ANGIER NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",301 S RALEIGH ST   ANGIER NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285054403,"BAILEY, ALEXIS, YU",301 S RALEIGH ST   ANGIER NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467093583,CHEROKEE MEDICAL CENTER,CMC - CENTER FOR FAMILY MEDICINE - GRASSY POND,517 CHESNEE HWY   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285059303,"CHILDERS, AMBER, JONES",517 CHESNEE HWY STE A GAFFNEY SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285061903,"HOOGAR, MAMATA, GIRISH",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 32 , 107 ,$#,,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1285061903,"HOOGAR, MAMATA, GIRISH",137 GRAND HILL PL   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1285061903,"HOOGAR, MAMATA, GIRISH",MAMATA HOOGAR DMD PA,137 GRAND HILL PL   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1285061903,"HOOGAR, MAMATA, GIRISH",137 GRAND HILL PL   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 92 , 121 , 605 ," $28,131.21 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1285061903,"HOOGAR, MAMATA, GIRISH",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1285061903,"HOOGAR, MAMATA, GIRISH",104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 224 , 234 , 848 ," $34,261.33 ",,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1285062760,"HANSON, LAUREN, RENEE",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 93 , 93 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1285062760,"HANSON, LAUREN, RENEE",188 MEDICAL PARK DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 25 , 25 ,$#,,
MEDICAID DIRECT,1396061347,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE CAROLINA LAKES INTERNAL,7666 CHARLOTTE HWY STE 200 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285068197,"VALAPARLA, GRACE, ANURADHA",7666 CHARLOTTE HWY STE 200 INDIAN LAND SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1285069955,"VENCES, SARAH, ANN",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 54 , 80 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1285069955,"VENCES, SARAH, ANN",631 CC CAMP RD   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1285069955,"VENCES, SARAH, ANN",911 E ATKINS ST   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1285069955,"VENCES, SARAH, ANN",157 HEALTH SERVICES RD   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285070359,"KNOBELOCH, LAUREN, CONRAD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285070359,"KNOBELOCH, LAUREN, CONRAD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285070359,"KNOBELOCH, LAUREN, CONRAD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285070359,"KNOBELOCH, LAUREN, CONRAD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",211 VIRGINIA RD   EDENTON NC,021,Chowan,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",211 VIRGINIA RD   EDENTON NC,021,Chowan,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 58 , 71 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285071902,"ROBINSON, STEFANIE, MITCHELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1285072660,"SCHLOESSER, JESSICA, NICOLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1285072660,"SCHLOESSER, JESSICA, NICOLE",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1285072660,"SCHLOESSER, JESSICA, NICOLE",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285072660,"SCHLOESSER, JESSICA, NICOLE",210 ASHVILLE AVE   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285072785,"PHILLIPS, COURTNEY, SANDERS",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 37 , 67 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1285073395,"OVERBY, ANNA, SULLIVAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 40 , 40 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1285073395,"OVERBY, ANNA, SULLIVAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 70 , 71 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1285073536,"ROMANO PERRY, ANISAA, WIDYAWATI",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 185 , 185 ," $72,963.00 ",,
MEDICAID DIRECT,1972123537,MURPHY MEDICAL CENTER INC,,2751 BUSINESS 19   ANDREWS NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285073536,"ROMANO PERRY, ANISAA, WIDYAWATI",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 115 , 318 , 327 ," $29,814.31 ",,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1285073536,"ROMANO PERRY, ANISAA, WIDYAWATI",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 24 , 26 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285077859,"LITTLE, PERRY, EVERETT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1952832941,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PHYSICAL MEDICINE AND REHAB,3246 6TH AVE SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285079004,"URZEN, JESSICA, MAE",3246 6TH AVE SE   HICKORY NC,018,Catawba,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 70 , 246 , 507 ," $64,040.55 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285080499,"LEE, BOWA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285080499,"LEE, BOWA",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 41 , 61 , 105 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285080499,"LEE, BOWA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 29 , 63 , 72 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285080499,"LEE, BOWA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285083915,"JESTER, RACHEL, LOIS-ANN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 134 , 144 , 256 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285084426,"IYEKEPOLO, ANDREA, EVBU",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285084426,"IYEKEPOLO, ANDREA, EVBU",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1255913182,FOOT AND ANKLE SPECIALISTS OF THE M,,534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285085357,"JACKSON, WESLEY, ALEXANDER",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1255913182,FOOT AND ANKLE SPECIALISTS OF THE M,,534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285085357,"JACKSON, WESLEY, ALEXANDER",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1285085357,"JACKSON, WESLEY, ALEXANDER",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285087031,"PENNELL, RACHAEL, VAUGHN",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285087031,"PENNELL, RACHAEL, VAUGHN",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285087064,"CASTO, KATHRYN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285087064,"CASTO, KATHRYN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285088070,"SHAH-ZAMORA, DEEPAL, PANKAJ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 49 , 88 , 120 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285088203,"HENDRICK, DANIELLE, NICOLE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285089524,"MONTESANO, PETER, VINCENT",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285091561,"ROWLAND, AMY, KATHERINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285091561,"ROWLAND, AMY, KATHERINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285091561,"ROWLAND, AMY, KATHERINE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285093260,"SEYMOUR, AMANDA, MARIE",711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 25 , 38 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285094045,"METZ, EVELYN, GABUYA",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 34 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285096156,"GHIATHI, CHRISTOPHER, DARIUS SALEH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 37 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285096156,"GHIATHI, CHRISTOPHER, DARIUS SALEH",601 N ELM ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285097972,"BAKSHI, SHUBHAM, MAULIK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 28 , 100 , 101 ," $25,196.13 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285097972,"BAKSHI, SHUBHAM, MAULIK",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285097972,"BAKSHI, SHUBHAM, MAULIK",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285097972,"BAKSHI, SHUBHAM, MAULIK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285098749,"AZER, FADI, SAMIR",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 204 , 226 , 289 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1285098749,"AZER, FADI, SAMIR",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285098749,"AZER, FADI, SAMIR",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 185 , 204 , 277 ,$#,,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1285100040,"NOE, CHARLES, ANTHONY",106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285100354,"ENGLAND, BRITTANY, SHUFFLER",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1285100354,"ENGLAND, BRITTANY, SHUFFLER",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 67 , 78 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285101303,"REID, ADAM, GABRIEL",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 44 , 47 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285101303,"REID, ADAM, GABRIEL",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1285101303,"REID, ADAM, GABRIEL",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 62 , 66 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1285101303,"REID, ADAM, GABRIEL",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285102053,"HEARD, COURTNEY, SIERRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285102640,"RUMBACK, KENDRA, LEE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 85 , 109 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1285102640,"RUMBACK, KENDRA, LEE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 25 , 25 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285102780,"OSTERGAARD, LINDSAY, BLAIR",101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1285104729,MOTHERS HELPER HOME HEALTH SOLUTION,,518 BEAUMONT RD STE 102 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1285104729,MOTHERS HELPER HOME HEALTH SOLUTION,518 BEAUMONT RD STE 102 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,073 "," 1,073 "," $99,462.44 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285108209,"DONALDSON, TYWANA, MYAVA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285108209,"DONALDSON, TYWANA, MYAVA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 36 , 122 ," $24,622.17 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285108209,"DONALDSON, TYWANA, MYAVA",10207 CERNY ST STE E200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 52 ," $14,305.92 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285108209,"DONALDSON, TYWANA, MYAVA",10207 CERNY ST STE E200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 24 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285108209,"DONALDSON, TYWANA, MYAVA",10207 CERNY ST STE E200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285108282,"TUELL, JASON, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285111005,"SHELL, HEIDI",5241 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285111005,"SHELL, HEIDI",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285113019,"DUNCAN, TAYLOR, GAZAWAY",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144271305,RICHARD FOWLER PT INC,GENTLE PAIN RELEASE,828 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1285114371,"GUTOWSKI, LINDA, OWENS",828 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 76 , 136 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285121855,"MORRIS, JOSHUA, MICHAEL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063196327,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD EAST FAMILY CARE RHC,605 NC 120 HWY   MOORESBORO NC,023,Cleveland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285123109,"MORALES, GENEVIEVE, ANGELINA",1001 BLYTHE BLVD STE 403 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 74 , 94 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1285123786,"HORSEY, MEGAN, LOUISE",2807 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1285124586,"BROWN, DYLAN, JAY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1285124586,"BROWN, DYLAN, JAY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598891665,HIGHLAND MEDICAL ASSOCIATES PA,~,165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285125526,"LOCKWOOD, TYLER, ALEXANDER",165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285125682,"KIM, SUNG, MIN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 42 , 47 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1285126250,"TOMMERAASEN, MILES, AUSTIN",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 27 , 32 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1285126425,"PARIKH, SOHAM, BIREN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285126805,"BIRK, ALEXANDER",225 CLEARFIELD AVE   VA BCH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285127266,"DEHAVEN, MARY, ELIZABETH",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285127266,"DEHAVEN, MARY, ELIZABETH",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 29 , 34 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285127266,"DEHAVEN, MARY, ELIZABETH",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285127274,"TATARSKI, DANIEL, JOSEPH",~,1818 RICHARDSON DR STE D REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1285127274,"TATARSKI, DANIEL, JOSEPH",1818 RICHARDSON DR STE D REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 235 , 410 ," 1,172 "," $50,473.85 ",,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285128348,"ANTONELLI, RAY, GALLAGHER",108 N MOSBY AVE   LITTLETON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 86 , 191 , 193 ,$#,,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285128348,"ANTONELLI, RAY, GALLAGHER",204 EVANS RD   HOLLISTER NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285129759,"GODINE, RICHARD, KOHLSTADT",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 32 , 60 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285129759,"GODINE, RICHARD, KOHLSTADT",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 34 , 55 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285129759,"GODINE, RICHARD, KOHLSTADT",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 58 , 97 ,$#,,
MEDICAID DIRECT,1265863831,BRADLEY A WRUBLE OD PLLC,BELMONT EYE,111 S MAIN ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1285129775,"CLAYTON, CALAH",111 S MAIN ST   BELMONT NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 34 , 34 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1285130039,"BOMBECK, ABRAHAM, SYVERSEN",1 HOSPITAL RD   CHEROKEE NC,087,Swain,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1285130039,"BOMBECK, ABRAHAM, SYVERSEN",1 HOSPITAL RD   CHEROKEE NC,087,Swain,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 20 , 22 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1285130039,"BOMBECK, ABRAHAM, SYVERSEN",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 64 , 325 , 325 ," $29,401.55 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285130815,"SMITH, RILEY, WHELCHEL",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 31 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285130815,"SMITH, RILEY, WHELCHEL",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 56 , 64 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285130815,"SMITH, RILEY, WHELCHEL",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285131912,"RHODES, JEREMY, ALLEN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285132654,"TRUHE, SHELLY, LENAY",185 KIMEL PARK DR STE 201 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 16 , 19 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285132654,"TRUHE, SHELLY, LENAY",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 26 , 34 ,$#,,
MEDICAID DIRECT,1275996571,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH BRAIN AND SPINE SURGERY,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285132654,"TRUHE, SHELLY, LENAY",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285132654,"TRUHE, SHELLY, LENAY",3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285136093,"GODWIN, KELLY, LEDOUX",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 121 , 303 ,$#,,
MEDICAID DIRECT,1285136762,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,1227 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193400000X,Group,Single Specialty,,1285136762,MYEYEDR OPTOMETRY OF NORTH CAROLINA,1227 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193400000X,Group,Single Specialty,, 134 , 102 , 204 ,$#,,
MEDICAID DIRECT,1013303080,ACCESS TELECARE PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1285138024,"GROHMAN, EMILY, IRENE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285139410,"DESROUILLERES, RONALD",4105 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 30 , 46 ,$#,,
MEDICAID DIRECT,1285140590,COASTAL SPEECH THERAPY SOLUTIONS P,,166 JOPPA RD   BELVIDERE NC,072,Perquimans,193400000X,Group,Single Specialty,,1285140590,COASTAL SPEECH THERAPY SOLUTIONS P,166 JOPPA RD   BELVIDERE NC,072,Perquimans,193400000X,Group,Single Specialty,,#, 74 , 74 ,$#,,
MEDICAID DIRECT,1285140863,INNOVATION HEALTH CENTER,,7915 EBENEZER CHURCH RD   RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1285140863,INNOVATION HEALTH CENTER,7915 EBENEZER CHURCH RD   RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 22 , 50 , 63 ," $67,027.16 ",,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 37 , 38 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 70 , 70 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,215 LASH DR   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",515 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 743 , 750 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",606 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",606 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",969 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",969 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,969 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285143891,"VANDERHAM, JESSICA, MARIE",969 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285145219,"COOK, EMILY, BLAKE",7010 NC HIGHWAY 751 STE 101 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 19 , 32 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,825 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1285145219,"COOK, EMILY, BLAKE",825 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 81 , 210 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285146217,"FUSSNER, KIANA, MORGAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285146217,"FUSSNER, KIANA, MORGAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285146639,RACHEL TOMPKINS MS OTRL PC,,103 EAST AVE   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1285146639,RACHEL TOMPKINS MS OTRL PC,103 EAST AVE   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,, 65 ," 1,389 "," 1,414 "," $130,966.37 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285147793,"MCCULLOUGH, KEVIN, MICHAEL",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285147793,"MCCULLOUGH, KEVIN, MICHAEL",601 SUTTON RD S STE 101 FORT MILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285148312,"BLUE, NICOLE, MISHONDA",4009 BARRETT DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 69 , 84 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285148312,"BLUE, NICOLE, MISHONDA",19 NOBLE ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285148312,"BLUE, NICOLE, MISHONDA",2151 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285148726,"DREIER, ELIZABETH, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285148726,"DREIER, ELIZABETH, ANNE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285148833,"THOMPSON, ANNIE, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285148833,"THOMPSON, ANNIE, MARIE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285149781,"ANDERSON, REBECCA, MARIE",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 99 , 135 , 181 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1285150441,"AMBS, ANNE, MICHELLE",120 DAVIS ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285150441,"AMBS, ANNE, MICHELLE",120 DAVIS ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 96 , 156 ,$#,,
MEDICAID DIRECT,1194707901,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285155010,"CHETRIT, DAVID, ALEXANDRE",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285155283,"SALISBURY, JAMES, DON",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1285155283,"SALISBURY, JAMES, DON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285155283,"SALISBURY, JAMES, DON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285155283,"SALISBURY, JAMES, DON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285155283,"SALISBURY, JAMES, DON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285155283,"SALISBURY, JAMES, DON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 62 , 85 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285155283,"SALISBURY, JAMES, DON",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285155283,"SALISBURY, JAMES, DON",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285157669,"TESORIERO, KALLIE, KEEGAN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285157727,"JONES, LATONYA, RENEE",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1326627399,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES- PLYMOUTH,115 ADAMS ST   PLYMOUTH NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285157727,"JONES, LATONYA, RENEE",115 ADAMS ST   PLYMOUTH NC,094,Washington,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285158576,"GONZALEZ, GEMA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285158576,"GONZALEZ, GEMA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285158709,"CHEESE, ASHLEY, NICOLE",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285158709,"CHEESE, ASHLEY, NICOLE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1982071114,ABRAMS BARROWS COHEN & ASSOCIATES P,,160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285159475,"EDELMANN, ALEXANDER, REUBEN",7215 LEBANON RD STE B MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 24 , 24 , 57 ,$#,,
MEDICAID DIRECT,1639746621,G ABRAMS AND R COHEN XXIII PC,STEELE CREEK ORTHODONTICS,13527 STEELECROFT PWKY STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285159475,"EDELMANN, ALEXANDER, REUBEN",7215 LEBANON RD STE B MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 259 ," 1,292 "," 1,476 "," $217,139.37 ",,
MEDICAID DIRECT,1891221107,G ABRAMS AND R COHEN XVIII PC,,8440 PIT STOP CT NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285159475,"EDELMANN, ALEXANDER, REUBEN",7215 LEBANON RD STE B MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 109 , 183 , 214 ," $31,950.06 ",,
MEDICAID DIRECT,1609206580,WESLEY L ROBINSON DMD PA,SMILES FOR LIFE ORTHODONTICS,7215 LEBANON RD STE B MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285159475,"EDELMANN, ALEXANDER, REUBEN",7215 LEBANON RD STE B MINT HILL NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285160598,"IACOCCA, ADAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285162008,"TAYLOR, MICHELLE, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285165530,"MOORE, SPENCER, HARDING",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 73 , 143 , 257 ," $10,549.92 ",,
MEDICAID DIRECT,1255868980,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV FOOT AND ANKLE CARE,300 MEDICAL PAVILION DR STE 320 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 20 , 28 , 34 ,$#,,
MEDICAID DIRECT,1255868980,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV FOOT AND ANKLE CARE,,,Unknown,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",300 E MCKAY ST STE E ELIZABETHTOWN NC,009,Bladen,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 24 , 23 , 23 ,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,300 MEDICAL PAVILION DR STE 320 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",300 MEDICAL PAVILION DR STE 320 RAEFORD NC,047,Hoke,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1255868980,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV FOOT AND ANKLE CARE,300 MEDICAL PAVILION DR STE 320 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",300 MEDICAL PAVILION DR STE 320 RAEFORD NC,047,Hoke,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 100 , 156 , 162 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",588 BAILEY RD STE E LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 70 , 85 , 86 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,,,Unknown,193200000X,Group,Multi-Specialty,,1285165829,"SAHLI-CARTER, HANNAH, JO",4850 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285166231,"DODD, ERIN, MARIE",275 N NC 16 BUSINESS HWY STE 202 DENVER NC,055,Lincoln,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285166819,"WILKES, SEAN, LOWELL",35 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285166884,"KHALIQDINA, SALMAN, ALI JEHANGIR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 75 , 95 , 98 ,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285166884,"KHALIQDINA, SALMAN, ALI JEHANGIR",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285167908,"AARON, ROBERT, JOSEPH",162 LEGACY OAKS DR STE 2102 KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285167981,"PATEL, MITAL, KAMLESH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 21 , 40 , 40 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1285168286,"PANDHI, NEELAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285168286,"PANDHI, NEELAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 25 , 165 , 167 ," $24,225.61 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285168302,"NATHANSON, JARED, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1285169763,"PORT, CHARLES, ROBERT",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,941 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1285169763,"PORT, CHARLES, ROBERT",702 NEWMAN RD   NEW BERN NC,025,Craven,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1285169763,"PORT, CHARLES, ROBERT",702 NEWMAN RD   NEW BERN NC,025,Craven,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 146 , 189 , 359 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285170274,"BOWES, SUE ELLEN",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 80 , 93 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1285171215,"JANKOSKY, FRANCESCA, FARIEL",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285172981,"MARKEY, MELANIE, REYER",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 66 , 84 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285172981,"MARKEY, MELANIE, REYER",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 24 , 30 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285179580,"BENEDICT, KAITLIN, SCARLETT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285182295,"LAROCCO, SARAH, CATHERINE",903 RANDOLPH ST   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285182295,"LAROCCO, SARAH, CATHERINE",1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 109 , 206 , 317 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285182295,"LAROCCO, SARAH, CATHERINE",1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 36 , 51 ,$#,,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285182931,"ANGLERO-CORRETJER, GABRIELA, CRISTINA",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1285184192,STARLIGHT HEALTHCARE SERVICES INC,,1121 OLD CONCORD RD STE 11 SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1285184192,STARLIGHT HEALTHCARE SERVICES INC,1121 OLD CONCORD RD STE 11 SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,, 65 ," 13,368 "," 13,368 "," $993,796.88 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285186072,"WETHERINGTON, KIMBERLY, PARKER",2465 EMERALD PL   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 186 , 254 , 328 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285186072,"WETHERINGTON, KIMBERLY, PARKER",701 DOCTORS DR   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1285186072,"WETHERINGTON, KIMBERLY, PARKER",701 DOCTORS DR   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1285186866,OPTION 1 NUTRITION SOLUTIONS LLC,AVEANNA HEALTHCARE MEDICAL SOLUTIONS,5950 FAIRVIEW RD STE 240 CHARLOTTE NC,060,Mecklenburg,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1285186866,OPTION 1 NUTRITION SOLUTIONS LLC,5950 FAIRVIEW RD STE 240 CHARLOTTE NC,060,Mecklenburg,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition," 1,639 "," 25,763 "," 33,622 "," $6,192,226.47 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285189969,"LAMBERT, TIMOTHY, HEATH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 35 , 35 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285190025,"FLORY, AMANDA, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285190157,"BUCK, SUMMER, LANGSTON",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285190157,"BUCK, SUMMER, LANGSTON",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285193102,"STUNTZ, GAGE, ALEXANDER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 29 , 71 , 78 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285193458,"BURGESS, BRAD, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285193458,"BURGESS, BRAD, MICHAEL",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285194076,"BEAMER, VICTORIA, PAIGE",1309 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659673838,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT SENIOR CARE,1309 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285194076,"BEAMER, VICTORIA, PAIGE",1309 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285194076,"BEAMER, VICTORIA, PAIGE",606 N ELM ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 97 , 246 , 293 ," $14,584.08 ",,
MEDICAID DIRECT,1972050979,TRIAD ADULT AND PEDIATRIC MEDICINE,,2039 BRENTWOOD ST STE B109 HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285194076,"BEAMER, VICTORIA, PAIGE",2039 BRENTWOOD ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285194662,"HYLARIDES, MARK, JUSTIN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 65 , 199 , 202 ,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285195354,"BLACK, KATHRYN, MERYL",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285195768,"WHITE, REBECCA, HILL",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285195768,"WHITE, REBECCA, HILL",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 59 , 64 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285200360,"CASEY, JORDAN, MARIE",3719 UNION RD   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 32 , 35 ,$#,,
MEDICAID DIRECT,1285201848,"WALKER, JESSICA, MARIKO",,1572 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1285201848,"WALKER, JESSICA, MARIKO",1572 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1427212562,EAST CAROLINA CENTER FOR SIGHT PA,EAST CAROLINA CENTER FOR SIGHT PA,1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285202317,"FISHER, THOMAS, JOHN",1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427212562,EAST CAROLINA CENTER FOR SIGHT PA,EAST CAROLINA CENTER FOR SIGHT PA,1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285202317,"FISHER, THOMAS, JOHN",1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1285203901,"MEINECKE, KEITH, ORVAL",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1285203901,"MEINECKE, KEITH, ORVAL",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1821403957,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1285203901,"MEINECKE, KEITH, ORVAL",434 HOSPITAL DR   LINVILLE NC,006,Avery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 40 , 40 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,217 W BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1285204388,"AVILA-GALEANA, MARQUILLA, LYNN",217 W BROAD ST   SAINT PAULS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 111 , 151 , 274 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285204388,"AVILA-GALEANA, MARQUILLA, LYNN",217 W BROAD ST   SAINT PAULS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 28 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1285211334,"BIGGS, YVONNE",5718 HIGHWAY 64 E STE 10 MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285211904,"MASSRI, THERESE, TIREZ",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1285211904,"MASSRI, THERESE, TIREZ",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 47 , 96 , 96 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285211904,"MASSRI, THERESE, TIREZ",700A PROGRESS PL   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447373063,HUGH CHATHAM MEMORIAL HOSPITAL,CLINGMAN MEDICAL CENTER,3369 CLINGMAN RD   RONDA NC,097,Wilkes,193400000X,Group,Single Specialty,,1285212985,"VERNON, NICHOLAS, TODD",3369 CLINGMAN RD   RONDA NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 97 , 224 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,68 CROSSROAD HILL RD   CANTON NC,044,Haywood,193200000X,Group,Multi-Specialty,,1285213371,"EDMONDS, JESSICA, DANIELLE",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285213371,"EDMONDS, JESSICA, DANIELLE",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1285216481,"HAVEMANN, CATHERINE, MARIA SUSE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285216481,"HAVEMANN, CATHERINE, MARIA SUSE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 33 , 37 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285217075,"MCALISTER, MAURICE, KYLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285218099,"ABUKAR, HAFSA, ASHIR",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 22 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,6824 HARRISBURG RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285219733,"OLIVER, ANTHONY",6824 HARRISBURG RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 70 , 93 , 131 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285219733,"OLIVER, ANTHONY",6824 HARRISBURG RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285220012,"DOUCETTE, BRIAN, ROLAND",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285220012,"DOUCETTE, BRIAN, ROLAND",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1285223875,"GERTH, EMMA, CHRISTINE",404 S SUTHERLAND AVE   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 37 , 135 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1285223875,"GERTH, EMMA, CHRISTINE",9040 NATIONS FORD RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 28 , 100 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1285223875,"GERTH, EMMA, CHRISTINE",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1285223875,"GERTH, EMMA, CHRISTINE",2450 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1669971826,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN GASTROENTEROLOGY,870 STATE FARM RD STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1285225706,"BRINKMAN, MORGAN, HEMPHILL",870 STATE FARM RD STE 102 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 80 , 80 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285226993,"SHAWKEY, CARRIE, ANNE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285226993,"SHAWKEY, CARRIE, ANNE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285227553,"FITZGERALD, KATHLEEN, PERRY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285228510,"YOUNG, ALYSSA, RAE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 26 , 41 , 46 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285228510,"YOUNG, ALYSSA, RAE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 65 , 93 , 112 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285228700,"CASEY, DESIREE, NICHOLE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 77 , 87 , 147 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285229583,"MILLER, JESSICA, LANE",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285229583,"MILLER, JESSICA, LANE",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285229583,"MILLER, JESSICA, LANE",3173 W HIGHWAY 74   MONROE NC,090,Union,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285230177,"KOEHLER, JORDYN, HUDGINS",5950 FAIRVIEW RD STE 808 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285232710,"PRICE, LINDSEY, KATHLEEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 23 , 43 ,$#,,
MEDICAID DIRECT,1003660663,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1285236612,"HAWKINS, JENNIFER, JACKSON",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 35 , 50 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1285236612,"HAWKINS, JENNIFER, JACKSON",107 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003660663,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1285236612,"HAWKINS, JENNIFER, JACKSON",107 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 144 , 256 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285236612,"HAWKINS, JENNIFER, JACKSON",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285241042,"RAMOS, THOMAS, LUIS",625 LEWIS ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285241042,"RAMOS, THOMAS, LUIS",1209 S BRIGGS AVE   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285241042,"RAMOS, THOMAS, LUIS",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 41 , 60 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285241083,"ELPHICK, ERIN, AMBER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285241083,"ELPHICK, ERIN, AMBER",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 91 , 110 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285244905,"ARNOLD, JORDAN, WOOLARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285244905,"ARNOLD, JORDAN, WOOLARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285244905,"ARNOLD, JORDAN, WOOLARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285245472,ITS A FAMILY AFFAIR HOMECARE LLC,,501 THIRD ST   AYDEN NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1285245472,ITS A FAMILY AFFAIR HOMECARE LLC,501 THIRD ST   AYDEN NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 9,279 "," 9,396 "," $748,107.44 ",,
MEDICAID DIRECT,1285245514,FAMILY FIRST HEALTHCARE LLC,,4921 ALBEMARLE RD STE 114 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1285245514,FAMILY FIRST HEALTHCARE LLC,4921 ALBEMARLE RD STE 114 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 880 ," 1,029 "," $93,320.93 ",,
MEDICAID DIRECT,1407471881,OYEGUNWA AND ASSOCIATES,O2 DENTAL GROUP OF SOUTHERN PINES,340 CAPITAL DR   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1285249656,"WRIGHT, CHRISTIE, ANNE",340 CAPITAL DR   CARTHAGE NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 36 , 77 ,$#,,
MEDICAID DIRECT,1841694254,LANE AND ASSOCIATES XXVIII DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1285249656,"WRIGHT, CHRISTIE, ANNE",340 CAPITAL DR   CARTHAGE NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 74 , 88 , 281 ," $13,186.07 ",,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1285249656,"WRIGHT, CHRISTIE, ANNE",340 CAPITAL DR   CARTHAGE NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 146 , 212 , 799 ," $41,095.17 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285251884,"DORSEY, ADRIANNE, DWANNA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285253567,"FREITAS, NICHOLE, RUTH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285256289,"JUNEAU, RYAN, PAUL",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 ,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285256289,"JUNEAU, RYAN, PAUL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 84 , 84 , 84 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285257600,"POPURI, SRIKANTH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 138 , 138 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285258962,"BORKAN, NOA, AVITA",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285261628,UNIQUE HOME CARE SERVICES INC,UNIQUE HOME CARE SERVICES INC,210 CLEMENT ST   CLEVELAND NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1285261628,UNIQUE HOME CARE SERVICES INC,210 CLEMENT ST   CLEVELAND NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,#," 1,557 "," 1,557 "," $96,745.81 ",,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285261982,"TRENT, ANIKA, JEANETTE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285261982,"TRENT, ANIKA, JEANETTE",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285262220,"RAINWATER, JOHN, HIERS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 14 , 31 , 34 ,$#,,
MEDICAID DIRECT,1285263582,PRECISE HOME CARE SERVICE LLC,,325 MCGILL AVE NW STE 510 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1285263582,PRECISE HOME CARE SERVICE LLC,325 MCGILL AVE NW STE 510 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,059 "," 3,059 "," $188,818.41 ",,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285265488,"BUTLER, ASHLEY, ELIZABETH",202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 33 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285265488,"BUTLER, ASHLEY, ELIZABETH",202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 65 , 105 ,$#,,
MEDICAID DIRECT,1588614168,ASHEVILLE NEUROLOGY SPECIALISTS PA,~,731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1285266635,"CARDONA, ALLYSSA, VICTORIA",731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 102 , 122 , 195 ,$#,,
MEDICAID DIRECT,1467947127,DLP MARIA PARHAM PHYSICIAN PRACTICE,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1285266833,"WAGNER, BRANDI, MARIE",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285267344,"TRIMBLE, ASHLEY, SELMA",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 24 , 51 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285268821,"KIM, CHEAHEE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285268821,"KIM, CHEAHEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285270561,PERSONAL CARE SOLUTIONS OF THE CARO,~,3450 JAMES B WHITE HWY S   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1285270561,PERSONAL CARE SOLUTIONS OF THE CARO,3450 JAMES B WHITE HWY S   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 40 ," 9,109 "," 9,606 "," $1,143,870.38 ",,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285271510,"GONZALEZ, MARTIN",11009 INGLESIDE PL STE 102 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285271841,"BURNS, JAMIE, NICOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1225372246,DUKE UNIVERSITY AFFILIATED PHYSICIA,DPC BLUE RIDGE,3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285272989,"TARABEK, ASHLEY, DIANE",3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285274357,"MUNTEANU, SORIN, MARIUS",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285274357,"MUNTEANU, SORIN, MARIUS",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285274498,"JUNG, JIUK, JAMES",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285274498,"JUNG, JIUK, JAMES",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285274498,"JUNG, JIUK, JAMES",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285274498,"JUNG, JIUK, JAMES",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285276048,"HARRIS, BRITTANY, COURTNEY",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285279521,"JOHNSTON, CATHERINE, BROOKE",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 19 , 50 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285280313,"SHORT, HOLLY, MARIE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497526719,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA MEDICAL PARK,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1285280313,"SHORT, HOLLY, MARIE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497526719,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA MEDICAL PARK,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1285280313,"SHORT, HOLLY, MARIE",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285280313,"SHORT, HOLLY, MARIE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285281451,"BURNEY, CASSANDRA, LYNETTA",548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285282244,"HILL, ANDREW, FELDIN",118 AVON AVE # 3 WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 43 , 44 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285282244,"HILL, ANDREW, FELDIN",511 PALADIN DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 103 , 170 , 283 ,$#,,
MEDICAID DIRECT,1821496753,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1285282947,"RINGLE, ALYSON, ANN",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,,,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285283762,"MUHAMMAD, SWIYYAH, OJINJI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285283762,"MUHAMMAD, SWIYYAH, OJINJI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 28 , 35 , 43 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285283762,"MUHAMMAD, SWIYYAH, OJINJI",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285283762,"MUHAMMAD, SWIYYAH, OJINJI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1376290239,IVX HEALTH OF NORTH CAROLINA PC,IVX HEALTH,9200 HARRIS CORNERS PKWY STE A CHARLOTTE NC,060,Mecklenburg,261QI0500X,Ambulatory Health Care Facilities,Clinic/Center,Infusion Therapy,1285284844,"SCHWARTZ, JAMIE, BOMBARDIER",9200 HARRIS CORNERS PKWY STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ," $11,283.62 ",,
MEDICAID DIRECT,1285285601,GAHC3 CLEMMONS NC TRS SUB LLC,CADENCE AT CLEMMONS,1165 S PEACE HAVEN RD   CLEMMONS NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285285601,GAHC3 CLEMMONS NC TRS SUB LLC,1165 S PEACE HAVEN RD   CLEMMONS NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 122 , 122 ,$#,,
MEDICAID DIRECT,1730362641,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285288738,"GAMBLE, JULIA, MARIE",16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 34 ,$#,,
MEDICAID DIRECT,1285290353,AFFINITY THERAPY SERVICES PLLC,,2130B HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285290353,AFFINITY THERAPY SERVICES PLLC,2130B HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,, 20 , 112 , 122 ,$#,,
MEDICAID DIRECT,1285290353,AFFINITY THERAPY SERVICES PLLC,,2130B HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285290353,AFFINITY THERAPY SERVICES PLLC,2130B HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#, 119 , 126 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1285291377,"TRYON, LAURA, KATHRYN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285292607,"ROSMAN, LINDSEY, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1194707901,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285296236,"PARTHASARATHY, SAHANA",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285297705,"SMITH, MELANIE, RENEE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285297705,"SMITH, MELANIE, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285297705,"SMITH, MELANIE, RENEE",1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285297937,"STINSON, SAMUEL, ANDREW",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285299016,"IQBAL, HAMZA",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 96 , 112 , 180 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1285299016,"IQBAL, HAMZA",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1285299016,"IQBAL, HAMZA",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1285300046,LINCOLNTON OPCO LLC,HEATH HOUSE,919 WILMA SIGMON RD   LINCOLNTON NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285300046,LINCOLNTON OPCO LLC,919 WILMA SIGMON RD   LINCOLNTON NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 43 ," 9,273 "," 9,273 "," $688,751.06 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285301028,"TOTH, EMILY, CAROLINE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285301028,"TOTH, EMILY, CAROLINE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285301630,"NEVILLE, MARIA, CATHERINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285301630,"NEVILLE, MARIA, CATHERINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 24 , 26 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285304568,"MULLIGAN, SARAH, BANKHEAD",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285304568,"MULLIGAN, SARAH, BANKHEAD",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285304568,"MULLIGAN, SARAH, BANKHEAD",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 35 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285304568,"MULLIGAN, SARAH, BANKHEAD",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 56 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285304568,"MULLIGAN, SARAH, BANKHEAD",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285306795,"BAGGETT, JENNIFER, RENEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285307447,"BEARD, TAYLOR, MICHELLE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285307447,"BEARD, TAYLOR, MICHELLE",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 48 , 65 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285307447,"BEARD, TAYLOR, MICHELLE",9929 REA RD STE 101 WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285309955,"THOMPSON, TODD, MARSHALL",16507 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,1344 N CENTER ST STE B HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285309955,"THOMPSON, TODD, MARSHALL",1344 N CENTER ST STE B HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1285311167,"HAMILTON, JESSE, ANNE",1403 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1578541660,EAST CAROLINA HEALTH BERTIE,Cashie Medical Center Windsor,1403 S KING ST   WINDSOR NC,008,Bertie,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285311167,"HAMILTON, JESSE, ANNE",1403 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 86 , 94 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285315739,"LEE, HAN, BIN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1285317370,BLOOMING EXPRESSIONS THERAPY PLLC,,711 MARCELLUS WAY   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1285317370,BLOOMING EXPRESSIONS THERAPY PLLC,711 MARCELLUS WAY   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,#, 18 , 22 ,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1285318485,"HARVEY, RENEE, LOUISE",105 MCALPINE LN   LAURINBURG NC,083,Scotland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285318535,"THOMAS, TAYLOR, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285318535,"THOMAS, TAYLOR, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285319053,"WATSON, CARA, SECREST",290 W WALL ST   RURAL HALL NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 65 , 150 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285319053,"WATSON, CARA, SECREST",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285329037,"WARDEN, EMILY, PAIGE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 26 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285329037,"WARDEN, EMILY, PAIGE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366779928,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285332155,"KEEN, TAYLOR, SLOAN",7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 20 , 35 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285332155,"KEEN, TAYLOR, SLOAN",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285332155,"KEEN, TAYLOR, SLOAN",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285334292,"REDMOND, SCOTT, ANTHONY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285334318,"PARKER, NAOMI, ELISE",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285334318,"PARKER, NAOMI, ELISE",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1285335836,"DATLA, MANASA DEVI",1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,624 "," 2,336 "," 9,235 "," $369,050.33 ",,
MEDICAID DIRECT,1225135601,"WESSINGER, LESLIE, ANN",LESLIE WESSINGER DDS PA,1 HOSPITAL DR STE 200 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1285335836,"DATLA, MANASA DEVI",1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,123 "," 1,465 "," 5,891 "," $245,946.38 ",,
MEDICAID DIRECT,1285340059,JOANNES HELPING HANDS HOME CARE,,3127 EASTWAY DR STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1285340059,JOANNES HELPING HANDS HOME CARE,3127 EASTWAY DR STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 98 , 98 ,$#,,
MEDICAID DIRECT,1285341529,WICKHAM HEALTH & WELLNESS LLC,FYZICAL THERAPY AND BALANCE CENTERS,1125 W NC HIGHWAY 54 STE 503 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285341529,WICKHAM HEALTH & WELLNESS LLC,1125 W NC HIGHWAY 54 STE 503 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 83 ," 1,376 "," 1,813 "," $141,784.05 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285342451,"HUPMAN, GREGORY, TRIPP",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 158 , 158 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285345967,"THORNTON, SUSAN, WILLIAMSON",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285345967,"THORNTON, SUSAN, WILLIAMSON",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 36 , 46 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285349498,"LLOYD, BEVERLY, ANN",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 211 , 335 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285350223,"KUNTZ, LEAH, GABRIELLE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619673258,THRIVE SAMPSON LLC,THRIVE SAMPSON PHYSICAL THERAPY & WELLNESS,1302 SUNSET AVE   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1285350850,"AYCOCK, LEAH, PALMER",1302 SUNSET AVE   CLINTON NC,082,Sampson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 19 , 50 ,$#,,
MEDICAID DIRECT,1285351064,UNION ORTHOTICS & PROSTHETICS LLC,,104 E FRANKLIN ST   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1285351064,UNION ORTHOTICS & PROSTHETICS LLC,104 E FRANKLIN ST   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285356147,"WHITMER, JAMIE, MICHELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285356147,"WHITMER, JAMIE, MICHELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285360818,"MUSSER, ALLISON, TAYLOR",981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 43 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285361121,"STONE, DALLEN, SHAWN",3444 S CONTENTNEA ST   FARMVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285361121,"STONE, DALLEN, SHAWN",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285361121,"STONE, DALLEN, SHAWN",300 BETHESDA DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1285362699,MOORE ANGELS CARE LLC,,2309 ASHE ST   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1285362699,MOORE ANGELS CARE LLC,2309 ASHE ST   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 51 ," 11,553 "," 11,616 "," $826,941.64 ",,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1285364406,"SMITH, MICHELE, LYNN",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1285364406,"SMITH, MICHELE, LYNN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1285364406,"SMITH, MICHELE, LYNN",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1285364406,"SMITH, MICHELE, LYNN",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 34 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1285364406,"SMITH, MICHELE, LYNN",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 46 , 77 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1285364703,"REEVES, LISA, DIANE",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285368423,"BLACK, CHRISTAN, SHADEEN",2001 TODAY'S WOMAN AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 27 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1285368423,"BLACK, CHRISTAN, SHADEEN",2041 WILLOW RD   GREENSBORO NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,934 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285370247,"FRYE, ELICIA, MELTON",934 COX RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285370247,"FRYE, ELICIA, MELTON",2525 COURT DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 27 , 27 ,$#,,
MEDICAID DIRECT,1285370510,HUMBLE HEARTS AND HANDS HOME CARE L,,129 HOLLEY GROVE RD   EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,,1285370510,HUMBLE HEARTS AND HANDS HOME CARE L,129 HOLLEY GROVE RD   EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,853 "," 1,853 "," $111,738.08 ",,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285371427,"MCMAHON, BRODIE, JOLYNN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285373464,DESTINYTOC LLC,DESTINYTOC HEALTHCARE SERVICES,1784 HERITAGE CENTER DR STE 204 WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1285373464,DESTINYTOC LLC,1784 HERITAGE CENTER DR STE 204 WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 850 , 850 ," $58,622.56 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285373555,"FIEBELKORN, TAYLOR, STEWART",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285373555,"FIEBELKORN, TAYLOR, STEWART",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1285373787,TOWN OF CHOCOWINITY,TOWN OF CHOCOWINITY EMS,512 NC HIGHWAY 33 E   CHOCOWINITY NC,007,Beaufort,3416L0300X,Transportation Services,Ambulance,Land Transport,1285373787,TOWN OF CHOCOWINITY,512 NC HIGHWAY 33 E   CHOCOWINITY NC,007,Beaufort,3416L0300X,Transportation Services,Ambulance,Land Transport, 29 , 41 , 70 ,$#,,
MEDICAID DIRECT,1841733714,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE COMMUNITY HOSPITAL OF STOKES,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193200000X,Group,Multi-Specialty,,1285375741,"SANFORD, JAMES, BAILEY",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285387639,"SANTOS, JENNIFER, NICOLE",4605 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 34 , 67 ,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285392431,"ULU, TIFFANY, JOYCE",1038 X RAY DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 28 , 49 ,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285392431,"ULU, TIFFANY, JOYCE",1909 BRAGG BLVD STE 94 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 22 , 67 ,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285392431,"ULU, TIFFANY, JOYCE",1560 UNION RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285392431,"ULU, TIFFANY, JOYCE",1309 E SUNSET DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1710012174,PSYCHIATRIC SERVICES OF CAROLINAS,PSYCHIATRIC SERVICES OF CAROLINAS PC,1530 UNION RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285392464,"GRAY, ROBERT, ELLIOTT",1530 UNION RD STE A GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 89 , 97 ,$#,,
MEDICAID DIRECT,1043963564,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - FALLSTON,5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285393397,"DELLINGER, ASHBY, KAYLIN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 127 , 149 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285393397,"DELLINGER, ASHBY, KAYLIN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 112 , 130 ,$#,,
MEDICAID DIRECT,1285393710,KULTURE CARE LLC,,104 HAZELWOOD CT   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1285393710,KULTURE CARE LLC,104 HAZELWOOD CT   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,#, 971 , 977 ," $151,427.52 ",,
MEDICAID DIRECT,1497158554,TIERNEY ORTHOTICS AND PROSTHETICS,~,1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1285394833,"ROWLAND, HEATHER, MICHELLE",1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1437860889,PINNACLE URGENT CARE PLLC,,1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1285396325,"ROBBINS, KIRBY, ALAN",1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285396325,"ROBBINS, KIRBY, ALAN",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 30 , 68 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1285396325,"ROBBINS, KIRBY, ALAN",10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 32 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1285404160,"BLACKSHEAR, ANNA, RENEE",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1285404160,"BLACKSHEAR, ANNA, RENEE",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285407809,"LEVINE, SARAH, REECE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 13 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285407809,"LEVINE, SARAH, REECE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285415448,"FEROLITO, MISHA, ALLEGRA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285419846,"GARACH, GRACE, REAGAN",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 50 , 60 ,$#,,
MEDICAID DIRECT,1285456988,HOPE HAVEN HOME CARE LLC,,131 S. MAIN STREET   RED SPRINGS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1285456988,HOPE HAVEN HOME CARE LLC,131 S. MAIN STREET   RED SPRINGS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,#, 122 , 122 ," $10,354.11 ",,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285457861,"SILAR, SAMANTHA, ISABEL",240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285464115,"MALINOWSKI, LAUREN, ELIZABETH",1135 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285464115,"MALINOWSKI, LAUREN, ELIZABETH",1135 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285464115,"MALINOWSKI, LAUREN, ELIZABETH",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285471458,"SIMMONS, SUSAN, ALLISON",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285471458,"SIMMONS, SUSAN, ALLISON",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1285475335,PRAISE HOMECARE INC,,112 N CIRCLE DR STE E ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1285475335,PRAISE HOMECARE INC,112 N CIRCLE DR STE E ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 189 , 189 ," $17,307.84 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285478917,"JOHNSON, BROOKE, SIERRA",5826 SAMET DR STE 101 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 32 , 34 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1285491670,"NEAL, ASHLEY",371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 16 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285493676,"WUNDER, RACHEL, MARGARET",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285493676,"WUNDER, RACHEL, MARGARET",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285493676,"WUNDER, RACHEL, MARGARET",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1679529051,KIDZCARE PEDIATRICS PC,~,3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285495499,"JIN, HONGLIAN, K",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 ,#, 16 ,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285600221,"O BRIEN, STEPHEN, JOSEPH",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 62 , 97 , 161 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285602227,"VAN NOY, JOANNA, WATSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285602227,"VAN NOY, JOANNA, WATSON",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 159 , 166 , 178 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1285602227,"VAN NOY, JOANNA, WATSON",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285602730,"ALLISON, DAVID, CAMPBELL",1420 E FRANKLIN ST   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 40 , 81 ,$#,,
MEDICAID DIRECT,1477743086,J STUART MCCRACKEN MD PA,J STUART MCCRACKEN MD PA,2609 N DUKE ST STE 620 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1285602995,"MCCRACKEN, JOSEPH, STUART",2609 N DUKE ST STE 620 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285604132,"BEARD, MICHELLE, ANN",11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 21 , 24 , 24 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285604132,"BEARD, MICHELLE, ANN",11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1285604702,"JENKINS, ENCHANTA, LACHELLE MURPHY",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366658833,CLAYTON INTERNAL MEDICINE PC,~,301 AMOS ST   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1285604934,"KHUSAYEM, MAZEN",301 AMOS ST   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 236 , 412 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285605121,"DAVIS, BRANDON, SCOTT",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 72 , 72 ,$#,,
MEDICAID DIRECT,1407951221,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - PALLIATIVE CARE,100 E WOOD ST STE 300A SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1285605295,"POWERS, CHRISTOPHER, RICHARD",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285605642,"HOLM, RICHARD, PHILLIP",171 NC HIGHWAY 125 STE A ROANOKE RAPIDS NC,042,Halifax,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 66 , 106 , 140 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285606210,"RHYNE, JOHNATHAN, DAVID",3746 VEST MILL RD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285606210,"RHYNE, JOHNATHAN, DAVID",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 48 , 89 , 212 ," $10,291.23 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285606400,"NEAL, CYNCERE",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285606400,"NEAL, CYNCERE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 75 , 100 ,$#,,
MEDICAID DIRECT,1306904917,COUNTY OF PITT OFFICE OF AUDITOR,PITT COUNTY HEALTH DEPT,201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1285606400,"NEAL, CYNCERE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 11 , 26 ,$#,,
MEDICAID DIRECT,1306904917,COUNTY OF PITT OFFICE OF AUDITOR,PITT COUNTY HEALTH DEPT,201 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1285606400,"NEAL, CYNCERE",101 HEART DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285609719,"SUMICH, ANDREW, IVAN",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285609719,"SUMICH, ANDREW, IVAN",1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285609719,"SUMICH, ANDREW, IVAN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 61 , 103 , 150 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285609719,"SUMICH, ANDREW, IVAN",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285609818,"SINGHEL, KENNETH, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 44 , 44 ,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285611053,"JOHNSON, TROY, E",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285612374,"EVIVIE, PATRICK, ENOROMOJA",~,3627 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1285612374,"EVIVIE, PATRICK, ENOROMOJA",3627 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 231 , 786 ," 1,322 "," $28,098.75 ",,
MEDICAID DIRECT,1013974864,BOMRAY MEDICAL CLINIC INC,PRIME CARE MEDICAL CENTER,3627 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285612374,"EVIVIE, PATRICK, ENOROMOJA",3627 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 157 , 309 , 726 ," $14,662.83 ",,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285612523,"AKINOLA, OLAYINKA, DANIEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285612523,"AKINOLA, OLAYINKA, DANIEL",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285612523,"AKINOLA, OLAYINKA, DANIEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285612754,"TSOMIDES, THEODORE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285612754,"TSOMIDES, THEODORE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487633780,SHELBY RADIOLOGICAL ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1285613570,"TUBBS, CHARLES, OTIS",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,27 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1285613976,"ARCARA, VICTORIA, MARIE",27 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1285614479,"HELLAMS, ROBERT",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285614578,"TINSLEY, ELLIS, ALLAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285614578,"TINSLEY, ELLIS, ALLAN",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 212 , 378 , 671 ," $30,128.18 ",,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285614578,"TINSLEY, ELLIS, ALLAN",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1285617241,"GOAD, BRADLEY, JACKSON",249 STONE BROOK DR   GALAX VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 41 , 41 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1285617241,"GOAD, BRADLEY, JACKSON",249 STONE BROOK DR   GALAX VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 64 , 80 ,$#,,
MEDICAID DIRECT,1740363621,NEW HOPE FAMILY MEDICINE,NEW HOPE FAMILY MEDICINE,2311 ABERDEEN BLVD STE C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285617399,"PARLIER, REGGIE, DAVID",2311 ABERDEEN BLVD STE C GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285617985,"KINCAID, EDWARD, HAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 37 , 42 ,$#,,
MEDICAID DIRECT,1578663290,THUANHANH T NGUYEN MD PA,THUANHANH T NGUYEN MD PA,1433 EMERYWOOD DR STE D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285622407,"NGUYEN, THUANHANH, THI",1433 EMERYWOOD DR STE D CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 287 , 485 ,$#,,
MEDICAID DIRECT,1972513679,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - WOUND HEALING SER,853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1285623694,"NEGRON, DAVID, ERIC",853 N CHURCH ST STE 701 SPARTANBURG SC,101,Out of State <= 40 miles,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1285626770,"CASLOWITZ, PAMELA, LOUISE",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104819754,SHELBY MEDICAL ASSOCIATES PA,~,711 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1285627612,"GANTT, EMILY, WHITE",711 N DEKALB ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 75 , 287 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285627786,"DEAL, MARTIN, TYLER",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 77 , 77 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1285627786,"DEAL, MARTIN, TYLER",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 174 , 176 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,517 B HWY 210 N   SPRING LAKE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285627869,"BERTRAND, SUSAN, TRUE",517 B HWY 210 N SPRING LAKE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285627869,"BERTRAND, SUSAN, TRUE",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285627869,"BERTRAND, SUSAN, TRUE",517 B HWY 210 N SPRING LAKE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 25 , 40 , 66 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285627869,"BERTRAND, SUSAN, TRUE",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285627869,"BERTRAND, SUSAN, TRUE",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1285628628,"ELLS, SANDRA, MELISSA",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285628628,"ELLS, SANDRA, MELISSA",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285628719,"DUKE, JOSIAH, WILLIAM",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 130 , 309 , 547 ,$#,,
MEDICAID DIRECT,1730519182,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1285629584,"PATEL, SANGNYA, RANCHHODBHAI",201 E GROVER ST   SHELBY NC,023,Cleveland,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,,,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285629584,"PATEL, SANGNYA, RANCHHODBHAI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 43 , 45 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285629790,"PATEL, SUJANKUMAR, KIRIT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 67 , 67 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285629832,"CRAWFORD, JOHN, THOMAS",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 77 , 173 ,$#,,
MEDICAID DIRECT,1174624498,EAST TENNESSEE ORAL MAXILLOFACIAL,EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY PC,1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1285631135,"WIDLOSKI, MARK, MATTHEW",3228 TAZEWELL PIKE   KNOXVILLE TN,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1174624498,EAST TENNESSEE ORAL MAXILLOFACIAL,EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY PC,1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1285631135,"WIDLOSKI, MARK, MATTHEW",1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 54 , 55 , 389 ," $39,527.49 ",,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1285633727,"LAVELLE, MICHAEL, TODD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1285633727,"LAVELLE, MICHAEL, TODD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1285633727,"LAVELLE, MICHAEL, TODD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285633727,"LAVELLE, MICHAEL, TODD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285633727,"LAVELLE, MICHAEL, TODD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 125 , 134 , 152 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285633727,"LAVELLE, MICHAEL, TODD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 164 , 171 , 194 ,$#,,
MEDICAID DIRECT,1902983828,ADVANCED SURGICAL ASSOCIATES PA,~,530 NEW WAVERLY PL STE 304 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285634600,"MALIK, SABAH, HAMAD",530 NEW WAVERLY PL STE 304 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 20 , 33 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285635300,"ALUISIO, FRANK, VICTOR",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285635300,"ALUISIO, FRANK, VICTOR",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 39 , 82 , 125 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,315 19TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1285636076,"JOHNSON, CHARLES, STEWART",315 19TH ST SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 22 , 25 , 43 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1285636076,"JOHNSON, CHARLES, STEWART",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 22 , 25 , 51 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285636076,"JOHNSON, CHARLES, STEWART",315 19TH ST SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 69 , 122 , 271 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285636076,"JOHNSON, CHARLES, STEWART",315 19TH ST SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285636076,"JOHNSON, CHARLES, STEWART",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 38 , 46 , 103 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1285636738,"CUNEO, PATRICIA, JEAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1285637108,"SARACINO, JOSEPH, ANTHONY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1285637397,"DANTZLER JR, LEON, ENTEA",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285637397,"DANTZLER JR, LEON, ENTEA",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1285637397,"DANTZLER JR, LEON, ENTEA",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285637397,"DANTZLER JR, LEON, ENTEA",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 827 , 827 ," $18,051.16 ",,
MEDICAID DIRECT,1285637413,"CHAPMAN, TRACY, DONALD",TRACY D CHAPMAN,219A AVERY AVE   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1285637413,"CHAPMAN, TRACY, DONALD",219A AVERY AVE   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 191 , 223 ,$#,,
MEDICAID DIRECT,1265740203,EYE CONSULTANTS OF GREENSBORO PA,EYE CONSULTANTS OF GREENSBORO PA,3810 N ELM ST STE 209 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285638866,"WHITAKER, ROY",3810 N ELM ST STE 209 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 15 , 20 ,$#,,
MEDICAID DIRECT,1265740203,EYE CONSULTANTS OF GREENSBORO PA,EYE CONSULTANTS OF GREENSBORO PA,3810 N ELM ST STE 209 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1285638866,"WHITAKER, ROY",3810 N ELM ST STE 209 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 35 , 51 , 63 ,$#,,
MEDICAID DIRECT,1295194751,SMITHFIELD FAMILY EYE CARE OD PA,~,1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285639526,"REYNOLDS, JAMES",1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 174 , 246 , 406 ," $12,635.91 ",,
MEDICAID DIRECT,1003148727,RS EYE CARE OD PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1285639526,"REYNOLDS, JAMES",5237 SUNSET LAKE RD   HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1285639690,"POMERANZ, STEPHEN, JORY",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 217 , 230 , 258 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285641928,"BRINSKO, MARTHA, MARY",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 87 , 162 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285641928,"BRINSKO, MARTHA, MARY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285644211,"BOWEN, JOSIE, BARNES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 107 , 109 , 157 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285644211,"BOWEN, JOSIE, BARNES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 14 , 22 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285648071,"HARPER, TIFFINEY",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 336 , 663 ," 1,383 "," $66,022.40 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285648352,"STAFFORD, HARRY, COZENE",3475 ERWIN RD PEPSICO FITNESS CENTER DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285648352,"STAFFORD, HARRY, COZENE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285648352,"STAFFORD, HARRY, COZENE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 119 , 272 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285650051,"COUGHLIN, PAUL, WILLIAM FITZHENRY",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 34 , 61 , 112 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285650051,"COUGHLIN, PAUL, WILLIAM FITZHENRY",601 N ELM ST   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285650051,"COUGHLIN, PAUL, WILLIAM FITZHENRY",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1750526257,OCEANSIDE PEDIATRICS PA,OCEANSIDE PEDIATRICS,3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1285650945,"KILUK, ANDREW, KENNETH",3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 184 , 275 ," $18,693.13 ",,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1285650945,"KILUK, ANDREW, KENNETH",3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1285650945,"KILUK, ANDREW, KENNETH",3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1285650945,"KILUK, ANDREW, KENNETH",~,3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1285650945,"KILUK, ANDREW, KENNETH",3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1285650945,"KILUK, ANDREW, KENNETH",3701 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285650978,"DONOGHUE, BRIAN, DAVID",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1285650978,"DONOGHUE, BRIAN, DAVID",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285650978,"DONOGHUE, BRIAN, DAVID",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 54 , 54 , 79 ,$#,,
MEDICAID DIRECT,1285651430,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1452,3209 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1285651430,WAL-MART STORES EAST LP,3209 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285652008,"MOORE, CARLTON, REID",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 25 , 72 , 79 ,$#,,
MEDICAID DIRECT,1285652081,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1191,501 HAMPTON PT   HILLSBOROUGH NC,068,Orange,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1285652081,WAL-MART STORES EAST LP,501 HAMPTON PT   HILLSBOROUGH NC,068,Orange,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346537180,ALAMANCE DERMATOLOGY PA,~,480 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285655266,"SANDRIDGE, BRENDA, KAY",945 GOLF HOUSE RD W STE A WHITSETT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346537180,ALAMANCE DERMATOLOGY PA,~,480 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285655266,"SANDRIDGE, BRENDA, KAY",480 W WEBB AVE   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285655290,"BARKENBUS, JOHN, EROL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285655290,"BARKENBUS, JOHN, EROL",330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285655290,"BARKENBUS, JOHN, EROL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285655290,"BARKENBUS, JOHN, EROL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 70 , 79 , 114 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,,,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 18 , 18 , 26 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285656595,"PRELI, ROBERT, BRUNO",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285658054,"HAYNES, MARYBETH",14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1285658195,"PARK IDLER, SUJI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285658195,"PARK IDLER, SUJI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285659938,"MANOUSOS, GEORGE, ANTHONY",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285659938,"MANOUSOS, GEORGE, ANTHONY",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285659938,"MANOUSOS, GEORGE, ANTHONY",332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285659938,"MANOUSOS, GEORGE, ANTHONY",332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 17 , 36 ,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285659938,"MANOUSOS, GEORGE, ANTHONY",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,915 PEE DEE RD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",915 PEE DEE RD   ABERDEEN NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",915 PEE DEE RD   ABERDEEN NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",2702 FARRELL RD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 192 , 192 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,310 COMMERCE DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",2702 FARRELL RD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,310 COMMERCE DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",2702 FARRELL RD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 56 , 56 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2702 FARRELL RD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",2702 FARRELL RD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 37 , 37 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",2702 FARRELL RD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 63 , 63 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",323 BALDWIN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 40 , 40 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 109 , 109 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,323 BALDWIN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",323 BALDWIN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 57 , 57 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",323 BALDWIN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 107 , 107 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285660753,"SIMPSON-TAROKH, LEANN, RAE",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922003136,MITCHELL EYE CENTER,Mitchell Eye Center,515 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285661728,"WAHL, SALLIE, MITCHELL",515 N SPENCE AVE   GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1285661785,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 330B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1285661785,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 330B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 33 ," 1,306 "," 1,306 "," $448,392.75 ",,
MEDICAID DIRECT,1285661785,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 330B CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1285661785,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 330B CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 47 ," 7,952 "," 9,370 "," $4,385,865.23 ",,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285661991,"MCDONALD, COLIN, TIMOTHY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 62 , 62 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,774 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285665703,"KATZ, JEFFREY, ALAN",1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1124402946,IREDELL PHYSICIAN NETWORK,FAMILY CARE CENTER,1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285665703,"KATZ, JEFFREY, ALAN",1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 31 , 32 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285665703,"KATZ, JEFFREY, ALAN",1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 71 , 122 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285665703,"KATZ, JEFFREY, ALAN",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871776039,JAMES P RUBEL,JAMES P RUBEL,1636 TATE BLVD SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1285666917,"RUBEL, JAMES, PEARSON",1636 TATE BLVD SE   HICKORY NC,018,Catawba,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1871776039,JAMES P RUBEL,JAMES P RUBEL,1636 TATE BLVD SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1285666917,"RUBEL, JAMES, PEARSON",1636 TATE BLVD SE   HICKORY NC,018,Catawba,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 25 ,$#,,
MEDICAID DIRECT,1316270838,JAMES P RUBEL,ABILITY ORTHOPEDICS,738 STATE FARM RD   BOONE NC,095,Watauga,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1285666917,"RUBEL, JAMES, PEARSON",738 STATE FARM RD   BOONE NC,095,Watauga,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1285667790,"HEY, DANIEL, SPURGEON",472 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285668244,"RICH, AMY, RENEE",202 PENNY LN   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1285668244,"RICH, AMY, RENEE",202 PENNY LN   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 441 , 444 ," $11,747.04 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1285668244,"RICH, AMY, RENEE",4007 M L KING JR BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 164 , 165 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1285668244,"RICH, AMY, RENEE",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285668244,"RICH, AMY, RENEE",4007 M L KING JR BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285668244,"RICH, AMY, RENEE",202 PENNY LN   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285668244,"RICH, AMY, RENEE",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 52 , 54 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285668426,"SOMMER, TODD, CLARK",134 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,134 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285668426,"SOMMER, TODD, CLARK",134 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 87 , 136 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285668426,"SOMMER, TODD, CLARK",117 DENNIS DR   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,117 DENNIS DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1285668426,"SOMMER, TODD, CLARK",117 DENNIS DR   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1285668772,"MOORE, MICHAEL, JAMES",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",1212 SPRUCE STREET   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285668798,"MANCHESTER, JULIE, ANNA",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285669002,"ARMISTEAD, DRURY, LACY",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 69 , 145 , 261 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285670885,"RASMUSSEN, BRETT, ANTHONY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285670885,"RASMUSSEN, BRETT, ANTHONY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 34 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285670885,"RASMUSSEN, BRETT, ANTHONY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285670885,"RASMUSSEN, BRETT, ANTHONY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1285670885,"RASMUSSEN, BRETT, ANTHONY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285670885,"RASMUSSEN, BRETT, ANTHONY",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285670885,"RASMUSSEN, BRETT, ANTHONY",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1285671032,"WESTMORELAND, AMANDA, KATHERINE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 79 , 85 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285671735,"KRESHON JR, MARTIN, JOHN",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285671735,"KRESHON JR, MARTIN, JOHN",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285671735,"KRESHON JR, MARTIN, JOHN",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 78 , 94 ,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285671883,"TODD, KAREN, GROSSMANN",3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 26 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285674150,"WESTERMAN, JAN, HENDRIK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285674150,"WESTERMAN, JAN, HENDRIK",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285674606,"FEDORIW, KELLY, BOSSENBROEK",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285674606,"FEDORIW, KELLY, BOSSENBROEK",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 50 , 102 ,$#,,
MEDICAID DIRECT,1184165607,EYECARECENTER OD PA,EYECARE CENTER,5121 REIDSVILLE RD   WALKERTOWN NC,034,Forsyth,193400000X,Group,Single Specialty,,1285676262,"ANDERSON, TERI, DAVIS",5121 REIDSVILLE RD   WALKERTOWN NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1184165607,EYECARECENTER OD PA,EYECARE CENTER,5121 REIDSVILLE RD   WALKERTOWN NC,034,Forsyth,193400000X,Group,Single Specialty,,1285676262,"ANDERSON, TERI, DAVIS",800 S STRATFORD RD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285676627,"BUCHHOLZ, JEFFREY, MICHAEL",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285678771,"BROWN, RHETT, MICHAEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285678771,"BROWN, RHETT, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285678847,"SAVAGE, ROBERT, MITCHELL",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285679316,"BOWLES, ANNE, ERSKINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285679316,"BOWLES, ANNE, ERSKINE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 124 , 207 , 207 ,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",203 POMONA DR   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 257 ," 1,048 "," 1,334 "," $36,588.03 ",,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,2609 N DUKE ST STE 303B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",203 POMONA DR   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 22 ,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",203 POMONA DR   GREENSBORO NC,041,Guilford,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#, 20 , 29 ,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,2609 N DUKE ST STE 303B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",2609 N DUKE ST STE 303B DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,2609 N DUKE ST STE 303B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",2609 N DUKE ST STE 303B DURHAM NC,032,Durham,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 41 , 215 , 326 ,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",2609 N DUKE ST STE 303B DURHAM NC,032,Durham,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174625248,THE HEAG PAIN MANAGEMENT CENTER PA,~,1305 W WENDOVER AVE STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285679845,"GYARTENG DAKWA, KWADWO",2609 N DUKE ST STE 303B DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 29 , 43 ,$#,,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1285680066,"BUENTING, JOHN, ERNST",38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 223 , 501 , 598 ," $41,263.14 ",,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285681106,"ROBERSON, JOHN, PORTER",555 CARTHAGE ST   SANFORD NC,053,Lee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285681106,"ROBERSON, JOHN, PORTER",555 CARTHAGE ST   SANFORD NC,053,Lee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285681106,"ROBERSON, JOHN, PORTER",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 37 , 40 ,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285681106,"ROBERSON, JOHN, PORTER",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 341 , 389 , 486 ,$#,,
MEDICAID DIRECT,1437196318,FIRST IMAGING OF THE CAROLINAS,First Imaging of the Carolinas,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285681106,"ROBERSON, JOHN, PORTER",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 45 , 75 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285681692,"NICHOLS, JEAN, ELLEN",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 45 , 54 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285682989,"SURLES, LARA, KESTER",2450 EMERALD PL   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 52 , 87 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285682989,"SURLES, LARA, KESTER",3681 N MAIN ST   FARMVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 70 , 89 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285685131,"LANDI, JAMES, LOUIS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285686691,"MATTHEWS, ROBERT, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 36 , 36 ,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285686766,"BROWN, CHARLES, WALTER",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285686766,"BROWN, CHARLES, WALTER",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417900903,EYECARECENTER OD PA,EYECARE CENTER,1300 EASTCHESTER DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285686857,"ADKINS, ALLAN, RAY",1300 EASTCHESTER DR   HIGH POINT NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285686865,"RIGGINS, JIMMIE, WAYNE",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 128 , 259 , 423 ,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285686865,"RIGGINS, JIMMIE, WAYNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285686865,"RIGGINS, JIMMIE, WAYNE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 29 , 45 , 47 ,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285686865,"RIGGINS, JIMMIE, WAYNE",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 29 , 37 ,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285686865,"RIGGINS, JIMMIE, WAYNE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285689398,"LEAVITT, KATHLEEN, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 60 , 65 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1285690222,"TAYLOR MILLER, BERTHA",211 BONNIE BROOK RD   ABERDEEN NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 154 , 323 ,$#,,
MEDICAID DIRECT,1285690222,"TAYLOR MILLER, BERTHA",~,211 BONNIE BROOK RD   ABERDEEN NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1285690222,"TAYLOR MILLER, BERTHA",211 BONNIE BROOK RD   ABERDEEN NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1285691568,"PITTARD, MICHELLE, HAMBRICK",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285691998,"SOUTHERN, BETSY, WHICKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 99 , 122 , 156 ," $14,022.03 ",,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285692764,"WARREN, JOHN, GREGORY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 43 , 53 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1285692764,"WARREN, JOHN, GREGORY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 44 , 63 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1285692764,"WARREN, JOHN, GREGORY",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285693242,"LEWIS, ANDREW, JON",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 38 , 67 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285693242,"LEWIS, ANDREW, JON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285693242,"LEWIS, ANDREW, JON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1134558752,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VALAROAS & LEWIS OBGYN,245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285693242,"LEWIS, ANDREW, JON",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285693242,"LEWIS, ANDREW, JON",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285694182,"MEADOR, MICHAEL, MOORE",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285695346,"GREEMON, MARK, DAVID",2345 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 106 , 232 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285695635,"HANDLER, KEITH, JARRETT",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 34 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285695635,"HANDLER, KEITH, JARRETT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1285695635,"HANDLER, KEITH, JARRETT",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1285695635,"HANDLER, KEITH, JARRETT",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285695635,"HANDLER, KEITH, JARRETT",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1285695825,"YORKE, BROOKE, HONEYCUTT",307 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285695825,"YORKE, BROOKE, HONEYCUTT",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285695825,"YORKE, BROOKE, HONEYCUTT",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477593960,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH RANKIN OBGYN,1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285696229,"BLAND, MARK, LEEKLEY",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285696229,"BLAND, MARK, LEEKLEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285696229,"BLAND, MARK, LEEKLEY",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 19 , 36 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285696229,"BLAND, MARK, LEEKLEY",14215 BALLANTYNE CORPORATE PL STE 110 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285696450,"HAWKINS, SETH, CHRIS COLLINGS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 28 , 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285696450,"HAWKINS, SETH, CHRIS COLLINGS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285698829,"LIAO, SHIXIONG",1800 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285698829,"LIAO, SHIXIONG",1800 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285699637,"WALSH, THOMAS, DECLAN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1285700625,"RESTREPO, GEORGE, IVAN",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1285700625,"RESTREPO, GEORGE, IVAN",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1285702597,"QUIST, MARK, ALAN",16419 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1346878410,FOOT AND ANKLE SPECIALISTS OF THE M,,16419 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285702597,"QUIST, MARK, ALAN",16419 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1285702597,"QUIST, MARK, ALAN",16419 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 66 , 156 , 391 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285703660,"VASANAWALA, SHREYAS, SHREENIVAS",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285703801,"DAVIS, WALTER, SHERWOOD",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 25 , 75 , 75 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285705525,"BOYCE, LESLIE, HELEN",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 49 , 68 , 70 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285707026,"COOK, JENNIFER, LYNN",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 55 , 60 , 79 ,$#,,
MEDICAID DIRECT,1174068837,RESTORATION MEDICAL CLINICS PC,,,,Unknown,193200000X,Group,Multi-Specialty,,1285709691,"PLUMMER, CHARLES, WAYNE",114 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285710152,"REISMAN, DAVID",220 PAGE RD   PINEHURST NC,063,Moore,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285710152,"REISMAN, DAVID",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 15 , 27 , 27 ,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285710350,"ALEXANDER, DONNA, DENISE",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 81 , 81 , 416 ," $14,938.64 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1285710350,"ALEXANDER, DONNA, DENISE",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 12 ,#, 109 ," $14,481.16 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285710350,"ALEXANDER, DONNA, DENISE",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 4,481 "," 5,277 "," 28,884 "," $848,621.79 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1285710566,"GRIFFETH, JAMES, KENNETH",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285710566,"GRIFFETH, JAMES, KENNETH",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1285710566,"GRIFFETH, JAMES, KENNETH",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285711754,"SCARLETT, YOLANDA, VALJEAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 37 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1285711754,"SCARLETT, YOLANDA, VALJEAN",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285711754,"SCARLETT, YOLANDA, VALJEAN",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285713149,"MORGAN, DIANA, CRAWFORD",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 28 , 92 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285713149,"MORGAN, DIANA, CRAWFORD",8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285713149,"MORGAN, DIANA, CRAWFORD",1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285713149,"MORGAN, DIANA, CRAWFORD",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 39 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285713149,"MORGAN, DIANA, CRAWFORD",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285713149,"MORGAN, DIANA, CRAWFORD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,, 538 , 543 , 543 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285714493,"KATZ, LAURENCE, MATTHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285715664,"AHMED, MAQSOOD",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 121 , 149 ,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,502 MCKNIGHT DR STE 200 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1285715664,"AHMED, MAQSOOD",502 MCKNIGHT DR STE 200 KNIGHTDALE NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285715664,"AHMED, MAQSOOD",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 79 , 310 , 394 ,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285715664,"AHMED, MAQSOOD",502 MCKNIGHT DR STE 200 KNIGHTDALE NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285715664,"AHMED, MAQSOOD",210 PENNY LN MEDICAL PARK NUMBER 3 MOREHEAD CITY NC,016,Carteret,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,210 PENNY LN MEDICAL PARK NUMBER 3 MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1285715664,"AHMED, MAQSOOD",210 PENNY LN MEDICAL PARK NUMBER 3 MOREHEAD CITY NC,016,Carteret,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 18 ,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285715664,"AHMED, MAQSOOD",210 PENNY LN MEDICAL PARK NUMBER 3 MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285716662,"PETRIN, MARSHA, LYNN",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1063151678,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1409 ASHEVILLE HIGHWAY,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285717231,"FOSTER, MARSHALL, SHANE",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 117 , 162 ,$#,,
MEDICAID DIRECT,1720546732,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,,,Unknown,251B00000X,Agencies,Case Management,,1285717231,"FOSTER, MARSHALL, SHANE",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285717439,"DI BERNARDO, LOUIS, ROBERT",ELECTRON MICROSCOPY DIAGNO   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 37 , 82 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285717439,"DI BERNARDO, LOUIS, ROBERT",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 42 , 58 , 145 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285718338,"HARRISON, JOHN, KEVIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 15 , 29 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1285718338,"HARRISON, JOHN, KEVIN",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285718338,"HARRISON, JOHN, KEVIN",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 17 , 26 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285718338,"HARRISON, JOHN, KEVIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285718346,"HENNIG, THERESE, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285718346,"HENNIG, THERESE, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285719096,"HOSKI, JAMES, JOSEPH",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1285719096,"HOSKI, JAMES, JOSEPH",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 27 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",45 SHOTWELL RD   CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285719716,"DIMITROVA-KOUTLEVA, DOBRINKA, VELIKOVA",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285720615,"SUTHERLAND, RICHARD, WOOD",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285720615,"SUTHERLAND, RICHARD, WOOD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 65 , 83 , 110 ," $11,281.51 ",,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1285720615,"SUTHERLAND, RICHARD, WOOD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1285720615,"SUTHERLAND, RICHARD, WOOD",1301 CENTRAL DR   SANFORD NC,053,Lee,208800000X,Allopathic & Osteopathic Physicians,Urology,, 28 , 32 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285722496,"CALIKOGLU, MUGE, GUCSAVAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 38 , 38 ,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,90 E MAIN ST STE 1 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1285723353,"SCHOMBERG, CARLYLE, ROGERS",90 E MAIN ST STE 1 SYLVA NC,050,Jackson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1285723353,"SCHOMBERG, CARLYLE, ROGERS",90 E MAIN ST STE 1 SYLVA NC,050,Jackson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 14 , 102 , 181 ,$#,,
MEDICAID DIRECT,1952678013,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE NORTH HICKORY,212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285724260,"BROOKS, GREGORY, TODD",212 29TH AVE NE STE 102 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 171 , 463 ,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1285728865,"OSEI-BOATENG, KWABENA",447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 66 , 100 , 100 ,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,441 MCALISTER RD STE 1200B LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1285728865,"OSEI-BOATENG, KWABENA",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366684771,CHARLOTTE SPORTS MEDICINE INSTITUTE,CHARLOTTE SPORTS MEDICINE INSTITUTE PA,10616 METROMONT PKWY STE 106 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285729061,"PAUL, JONATHAN, JAMES",10616 METROMONT PKWY STE 106 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285729657,"HILLEN, TRAVIS, JON",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659340636,IMAGING SPECIALISTS PLLC,,750 OLD HICKORY BLVD BLDG 1-260 BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1285729657,"HILLEN, TRAVIS, JON",750 OLD HICKORY BLVD STE 1-260 BRENTWOOD TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285729913,"BANDARENKO, NICHOLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,252 TURNERSBURG HWY STE E STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285731299,"FLOYD, SAMUEL, STEVEN",252 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 74 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285731299,"FLOYD, SAMUEL, STEVEN",2728 W MALLARD CREEK CHURCH RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285731299,"FLOYD, SAMUEL, STEVEN",2728 W MALLARD CREEK CHURCH RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285731299,"FLOYD, SAMUEL, STEVEN",2728 W MALLARD CREEK CHURCH RD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285732412,CANNON PHARMACY,,342 E PARKER RD   MORGANTON NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1285732412,CANNON PHARMACY,342 E PARKER RD   MORGANTON NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285732446,"SALZBERG, LENARD, DAVID",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 150 , 224 , 387 ,$#,,
MEDICAID DIRECT,1285732453,SHELBY EYE CENTERS PA,~,1170 WYKE RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1285732453,SHELBY EYE CENTERS PA,1170 WYKE RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,, 80 , 114 , 189 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1285734665,"MARSCHKE, MICHAEL, CHARLES",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275524621,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1285734665,"MARSCHKE, MICHAEL, CHARLES",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285735464,"CHILLURA, ANTHONY, BUDDY",600 HOSPITAL DR   MONROE NC,090,Union,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 40 , 43 ,$#,,
MEDICAID DIRECT,1922441773,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST BOWERS PLASTIC S,1002 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285736165,"BOWERS, DAVID, MCDONALD",1002 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285738955,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02356,790 TIMBER DR   GARNER NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1285738955,NORTH CAROLINA CVS PHARMACY LLC,790 TIMBER DR   GARNER NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285740662,"KLENA, JAMES, WILLIAM",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285741330,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 01752,930 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1285741330,NORTH CAROLINA CVS PHARMACY LLC,930 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1285745638,"TATE, KNOX, RANDOLPH",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 780 , 898 ," 1,120 "," $20,840.22 ",,
MEDICAID DIRECT,1700202066,DESIREE T PALMER DMD PA,~,105 NEWSOM ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285746966,"PALMER, DESIREE, TWITTY",105 NEWSOM ST STE 204 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 27 , 89 ,$#,,
MEDICAID DIRECT,1285749994,PARTNERS IN LEARNING CHILD DEVELOPM,~,1775 S MARTIN LUTHER KING JR AVE   SALISBURY NC,080,Rowan,251S00000X,Agencies,Community/Behavioral Health,,1285749994,PARTNERS IN LEARNING CHILD DEVELOPM,1775 S MARTIN LUTHER KING JR AVE   SALISBURY NC,080,Rowan,251S00000X,Agencies,Community/Behavioral Health,, 241 ," 4,265 "," 4,265 "," $273,513.20 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285752279,"KREINER, VIRGINIA, GARRIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285753913,"DAWSON, MARGARET, RUTH",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 214 , 414 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285753913,"DAWSON, MARGARET, RUTH",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285753913,"DAWSON, MARGARET, RUTH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285753939,CAROLINA SPEECH THERAPY INC,CAROLINA SPEECH & OCCUPATIONAL THERAPY,129 N TRADD ST   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285753939,CAROLINA SPEECH THERAPY INC,129 N TRADD ST   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,, 111 ," 2,673 "," 3,001 "," $232,560.12 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285754408,"SUN, ALBERT, YUAN-YEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1285754408,"SUN, ALBERT, YUAN-YEN",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 15 , 16 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285754408,"SUN, ALBERT, YUAN-YEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 14 , 18 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285754408,"SUN, ALBERT, YUAN-YEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1285754564,ONEALS DRUG STORE INC,ONEALS DRUG STORE INC,820 W MAIN ST   BELHAVEN NC,007,Beaufort,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1285754564,ONEALS DRUG STORE INC,820 W MAIN ST   BELHAVEN NC,007,Beaufort,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 13 , 48 , 49 ,$#,,
MEDICAID DIRECT,1285756296,SPEECH N PROGRESS INC,SPEECH N PROGRESS INC,202 E 3RD ST   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1285756296,SPEECH N PROGRESS INC,202 E 3RD ST   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,, 26 , 390 , 392 ," $27,273.88 ",,
MEDICAID DIRECT,1285758920,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE GROUP HOME 2,608 4TH ST SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285758920,THE MENTAL HEALTH FUND INC,608 4TH ST SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 841 , 841 ," $30,974.62 ",,
MEDICAID DIRECT,1285759068,"DASGUPTA-OBRIEN, SUDESHNA",Sudeshna Dasgupta-OBrien,1000 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1285759068,"DASGUPTA-OBRIEN, SUDESHNA",1000 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285763185,"COMBS, MICHELLE, WILLIAMS",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285763185,"COMBS, MICHELLE, WILLIAMS",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285763391,"LIVELY, JONATHAN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285764399,"PAIK, PETER, D L",1060 FIRST COLONIAL RD   VIRGINIA BCH VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285765263,"MAHALINGASHETTY, ARPANA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285765263,"MAHALINGASHETTY, ARPANA",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285765263,"MAHALINGASHETTY, ARPANA",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285765263,"MAHALINGASHETTY, ARPANA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1285769265,BAPTIST CHILDRENS HOME OF NC INC,DAVIS HOUSE AT BETHABARA,2020 CLYDE HAYES DR   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285769265,BAPTIST CHILDRENS HOME OF NC INC,2020 CLYDE HAYES DR   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1285770933,WILSON ASSISTED LIVING,~,3501 SENIOR VILLAGE LN NW   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285770933,WILSON ASSISTED LIVING,3501 SENIOR VILLAGE LN NW   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 44 ," 10,422 "," 10,422 "," $849,397.81 ",,
MEDICAID DIRECT,1801481965,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR WRIGHTSVILLE BEACH FAMILY MEDICINE,1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285771931,"KRAMER, PETER, GIBBS",1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 41 , 136 ,$#,,
MEDICAID DIRECT,1285772913,"YOUNG, JULIA, CLINE",REACH HIGH COMMUNICATIONS INC,359 CEDARBROOK LN   NEBO NC,059,McDowell,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1285772913,"YOUNG, JULIA, CLINE",359 CEDARBROOK LN   NEBO NC,059,McDowell,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285774166,"ELLIOTT, JOSEPH, GRADY",1014 N ELM ST   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 60 , 63 , 73 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285775296,"SETH, RAMAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 84 , 84 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1285775296,"SETH, RAMAN",1000 HEALING WAY   MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1285776260,"GRIGGS, JERI, DENISE",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1285776260,"GRIGGS, JERI, DENISE",715 US HIGHWAY 64   MANTEO NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1285776260,"GRIGGS, JERI, DENISE",715 US HIGHWAY 64   MANTEO NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1285776260,"GRIGGS, JERI, DENISE",715 US HIGHWAY 64   MANTEO NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1306031620,AR CLEMONS MD PC,AR CLEMONS MD PC,1601 ABBEY PL STE 105 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285779405,"CLEMONS, ALISON, RUWET",1601 ABBEY PL STE 105 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 47 , 54 ,$#,,
MEDICAID DIRECT,1285779405,"CLEMONS, ALISON, RUWET",ALISON RUWET CLEMONS,1601 ABBEY PL STE 105 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1285779405,"CLEMONS, ALISON, RUWET",1601 ABBEY PL STE 105 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 184 , 206 ,$#,,
MEDICAID DIRECT,1285780106,CANAAN CARE HOME LLC,KENYA,429 431 WALDO ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285780106,CANAAN CARE HOME LLC,429 431 WALDO ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 177 , 177 ," $11,053.14 ",,
MEDICAID DIRECT,1285780106,CANAAN CARE HOME LLC,KENYA,431 WALDO ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285780106,CANAAN CARE HOME LLC,431 WALDO ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 186 , 186 ," $11,639.88 ",,
MEDICAID DIRECT,1982833976,ABC PEDIATRICS OF GREENSBORO PA,ABC PEDIATRICS OF GREENSBORO PA,1002 N CHURCH ST STE 1 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285781674,"WARNER, PAMELA, GREY",1002 N CHURCH ST STE 1 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 13 , 39 ,$#,,
MEDICAID DIRECT,1982833976,ABC PEDIATRICS OF GREENSBORO PA,ABC PEDIATRICS OF GREENSBORO PA,1002 N CHURCH ST STE 1 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1285781674,"WARNER, PAMELA, GREY",1002 N CHURCH ST STE 1 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 28 , 74 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1285782532,"KELLEY, WILLIAM, JACKSON",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1285782532,"KELLEY, WILLIAM, JACKSON",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1285782912,INTERIM HEALTHCARE OF THE EASTERN C,INTERIM HEALTHCARE,615 E SOUTHERLAND ST   WALLACE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,1285782912,INTERIM HEALTHCARE OF THE EASTERN C,615 E SOUTHERLAND ST   WALLACE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 3,326 "," 3,326 "," $224,781.40 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285783209,"POPE, KIMBERLY, GEORGETTE",1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1285783209,"POPE, KIMBERLY, GEORGETTE",1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1285783209,"POPE, KIMBERLY, GEORGETTE",1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285783209,"POPE, KIMBERLY, GEORGETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 67 , 67 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1285783290,"COVINGTON, DIANE, MARIE BEAL",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",3031 TATE BLVD SE   HICKORY NC,018,Catawba,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 23 , 27 , 27 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 36 , 172 , 183 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 28 , 188 , 195 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 44 , 252 , 257 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 83 , 966 , 999 ," $15,184.49 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 30 , 31 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285783415,"MARTIN, MELISSA, ARLENE",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 11 , 29 , 32 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285786152,"JOHNSON, WENDY, LOUISE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285786152,"JOHNSON, WENDY, LOUISE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1285786178,"BEAVERS, MARK, EDWIN",BEAVERS FAMILY DENTISTRY,619 W CHATHAM ST   APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1285786178,"BEAVERS, MARK, EDWIN",619 W CHATHAM ST   APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#, 20 , 49 ,$#,,
MEDICAID DIRECT,1285786764,FAITHFUL NURSES HEALTH CARE INC,FAITHFUL NURSES HEALTH CARE INC,845 CHURCH ST N STE 210 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1285786764,FAITHFUL NURSES HEALTH CARE INC,845 CHURCH ST N STE 210 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,500 "," 1,688 "," $199,886.08 ",,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1285789610,"WATERS, CARRIE, LEE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285789610,"WATERS, CARRIE, LEE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 89 , 207 ,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,1914 MCKINNEY ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285791368,"KRZYSZTOFORSKA, ELIZABETH, MARIA",1914 MCKINNEY ST   BURLINGTON NC,001,Alamance,1223D0001X,Dental Providers,Dentist,Dental Public Health," 1,304 "," 1,663 "," 5,239 "," $180,401.46 ",,
MEDICAID DIRECT,1083050389,ORANGE COUNTY,~,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1285791368,"KRZYSZTOFORSKA, ELIZABETH, MARIA",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 235 , 268 , 976 ," $29,197.60 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285796615,"WHANG, YOUNG, EUI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 36 , 98 , 137 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285797068,"SEMMEL, DEBORAH, JANE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 46 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285797068,"SEMMEL, DEBORAH, JANE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285797068,"SEMMEL, DEBORAH, JANE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1285797100,"MASLOW, JASON, LEO",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1285797100,"MASLOW, JASON, LEO",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1285797100,"MASLOW, JASON, LEO",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285797100,"MASLOW, JASON, LEO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285797100,"MASLOW, JASON, LEO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285797100,"MASLOW, JASON, LEO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285797100,"MASLOW, JASON, LEO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 32 ,$#,,
MEDICAID DIRECT,1285801258,COMMUNITY HEALTH CARE INC,~,2902 HACKNEY WAY   JAMESTOWN NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1285801258,COMMUNITY HEALTH CARE INC,2902 HACKNEY WAY   JAMESTOWN NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,452 "," 2,452 "," $143,903.46 ",,
MEDICAID DIRECT,1285803189,J MARK SAUNDERS OD PA,,4637 MAIN ST   SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1285803189,J MARK SAUNDERS OD PA,4637 MAIN ST   SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,, 105 , 110 , 212 ,$#,,
MEDICAID DIRECT,1285804229,PHARMACY CORPORATION OF AMERICA,EXPRESS CARE PHARMACY,505 HACKNEY AVE   WASHINGTON NC,007,Beaufort,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1285804229,PHARMACY CORPORATION OF AMERICA,505 HACKNEY AVE   WASHINGTON NC,007,Beaufort,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#, 13 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285804419,"PYRTLE, JAY, MALONE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 25 , 33 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285804419,"PYRTLE, JAY, MALONE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1194744532,MOSES CONE MEDICAL SERVICES INC,LEBAUER ENDOSCOPY CENTER,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1285804419,"PYRTLE, JAY, MALONE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285804419,"PYRTLE, JAY, MALONE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285804419,"PYRTLE, JAY, MALONE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285804419,"PYRTLE, JAY, MALONE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285808048,"PALIWAL, HIMANSHU, HARIHAH",2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3808 W GATE CITY BLVD # A1 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285808048,"PALIWAL, HIMANSHU, HARIHAH",2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 80 , 145 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285808279,"HUENINK, LAURA, CARLISLE",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 28 , 36 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285808279,"HUENINK, LAURA, CARLISLE",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 56 , 64 , 64 ,$#,,
MEDICAID DIRECT,1639179393,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 86 , 108 , 149 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 96 , 107 , 107 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 93 , 117 , 215 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285808725,"MEADOWS, TELLY, ALI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 13 , 16 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285808741,"LEE, JUSTIN, ALLEN",3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 42 , 110 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285808741,"LEE, JUSTIN, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285808741,"LEE, JUSTIN, ALLEN",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 51 , 170 ,$#,,
MEDICAID DIRECT,1407235864,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD SURGERY CHERAW,721 S DOCTORS DR   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285809475,"DAVIS, JASON, EVAN",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285809939,"HAYNES, ERIN, HERRICK",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 27 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285809939,"HAYNES, ERIN, HERRICK",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285809939,"HAYNES, ERIN, HERRICK",10545 BLAIR RD STE 2100 MINT HILL NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285809939,"HAYNES, ERIN, HERRICK",10545 BLAIR RD STE 2100 MINT HILL NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285810515,"MITCHELL, BRADFORD, CHARLES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 183 , 208 , 286 ," $10,084.44 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285810515,"MITCHELL, BRADFORD, CHARLES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 139 , 149 , 187 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285814707,"SWINNEY, VERNETTA, MICHELE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285814707,"SWINNEY, VERNETTA, MICHELE",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 36 , 52 , 94 ,$#,,
MEDICAID DIRECT,1285814756,"SOMMA, CHRISTINE, ANNE",~,400 N BROOME ST STE 301 WAXHAW NC,090,Union,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1285814756,"SOMMA, CHRISTINE, ANNE",400 N BROOME ST STE 301 WAXHAW NC,090,Union,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 77 , 77 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 30 , 40 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 25 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 236 , 654 , 788 ," $15,150.28 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1285816157,"ORDAZ VERNET, ENRIQUE, JOSE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1285816322,"NTATIN, AMUSA, NDZENYUY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285818856,"PLONK, DREW, PATTERSON",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 42 , 56 , 85 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285818856,"PLONK, DREW, PATTERSON",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285820118,"FADEYI, EMMANUEL, ADEGOKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207ZC0006X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology, 61 , 76 , 76 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285821827,"HODSHON, CARY, TIERNEY",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285821827,"HODSHON, CARY, TIERNEY",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285821827,"HODSHON, CARY, TIERNEY",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285821827,"HODSHON, CARY, TIERNEY",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285822445,"KIM-TENSER, MAY, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1871081000,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT DRUGCO EXPRESS,1096 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285822940,"LYNCH JONES, SHARON, FAYE",1096 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 155 , 175 ,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285822940,"LYNCH JONES, SHARON, FAYE",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285822940,"LYNCH JONES, SHARON, FAYE",1096 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285824961,"CROSLEY, DEBBY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285824961,"CROSLEY, DEBBY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285824961,"CROSLEY, DEBBY",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285825208,"RYAN, BRANDON, KEITH",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1261 JULIAN ALLSBRK HWY   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1285825208,"RYAN, BRANDON, KEITH",202 VILLAGE RD NE   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285825208,"RYAN, BRANDON, KEITH",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,202 VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1285825208,"RYAN, BRANDON, KEITH",202 VILLAGE RD NE   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 44 , 139 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5214 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285825208,"RYAN, BRANDON, KEITH",5214 MARKET ST STE 101 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1669997144,WRIGHT AND ASSOCIATES VII DDS PA,,120 NE MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 20 ,$#,,
MEDICAID DIRECT,1740705219,WRIGHT AND ASSOCIATES VI,,12450 CLEVELAND RD STE 103 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 181 , 410 , 467 ," $88,801.88 ",,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 84 , 85 , 109 ," $13,103.55 ",,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 23 , 23 , 45 ,$#,,
MEDICAID DIRECT,1154475036,LANE & ASSOCIATES X DDS PA,~,407 TIFFANY DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1750737102,WRIGHT AND ASSOCIATES I DDS PA,NC ORAL SURGERY AND ORTHODONTICS,5925 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1194240671,WRIGHT AND ASSOCIATES IX DDS PA,,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 105 , 280 , 415 ," $65,984.80 ",,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 36 , 37 , 48 ," $10,999.46 ",,
MEDICAID DIRECT,1124556063,WRIGHT AND ASSOCIATES V DDS PA,,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 91 , 279 , 358 ," $65,043.89 ",,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",407 TIFFANY DR   SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 966 ," 2,215 "," 2,887 "," $410,446.37 ",,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 265 , 309 , 392 ," $58,208.52 ",,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 37 , 37 , 53 ,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 37 , 37 , 45 ,$#,,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 111 , 119 , 135 ," $35,330.12 ",,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1285825547,"CHEN, GRACE",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1285825547,"CHEN, GRACE",616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285827451,"SLAUGHTER, VAN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 152 , 152 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1285827451,"SLAUGHTER, VAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346279445,FHPG LLC,MONTGOMERY MEMORIAL HOSPITAL,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1285827451,"SLAUGHTER, VAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285827469,"TALANTOV, ANDREI",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285828186,"GHORBANI RODRIGUEZ, TAHEREH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 29 , 42 , 68 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285828186,"GHORBANI RODRIGUEZ, TAHEREH",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 65 , 91 , 148 ,$#,,
MEDICAID DIRECT,1285828756,"JAMMULA, ANJANI",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,1285828756,"JAMMULA, ANJANI",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1285829796,"WRIGHT, DONALD, JOHNSTON",DONALD J WRIGHT DDS PLLC,407 S VAN BUREN RD STE 1 EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1285829796,"WRIGHT, DONALD, JOHNSTON",407 S VAN BUREN RD STE 1 EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 440 , 775 ," 1,515 "," $82,520.71 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285830604,"STANG, MICHAEL, TRACEY",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285830604,"STANG, MICHAEL, TRACEY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285830604,"STANG, MICHAEL, TRACEY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285830604,"STANG, MICHAEL, TRACEY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285830604,"STANG, MICHAEL, TRACEY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285830604,"STANG, MICHAEL, TRACEY",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285830604,"STANG, MICHAEL, TRACEY",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1285831719,"ALBAUGH, CHAD, ALLEN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 76 , 84 , 107 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285832485,"JAMES, JEHANA, ASAIDRA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285832485,"JAMES, JEHANA, ASAIDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 160 , 160 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285832485,"JAMES, JEHANA, ASAIDRA",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285832485,"JAMES, JEHANA, ASAIDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 42 , 42 ,$#,,
MEDICAID DIRECT,1417610627,MOSES CONE AFFILIATED PHYSICIANS IN,GYNECOLOGY CENTER OF GREENSBORO,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285833939,"BOSWELL, ELIZABETH, KATHLEEN",719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 25 , 42 ,$#,,
MEDICAID DIRECT,1417610627,MOSES CONE AFFILIATED PHYSICIANS IN,GYNECOLOGY CENTER OF GREENSBORO,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285833939,"BOSWELL, ELIZABETH, KATHLEEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1417610627,MOSES CONE AFFILIATED PHYSICIANS IN,GYNECOLOGY CENTER OF GREENSBORO,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285833939,"BOSWELL, ELIZABETH, KATHLEEN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285833939,"BOSWELL, ELIZABETH, KATHLEEN",2251 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1285834622,"TAYLOR, LAURA, SUE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 77 , 108 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1285834622,"TAYLOR, LAURA, SUE",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285834622,"TAYLOR, LAURA, SUE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285834788,"HOWELL, ERIC, RICHARD",142 AVON AVE   WASHINGTON NC,007,Beaufort,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 103 , 202 , 313 ,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285834788,"HOWELL, ERIC, RICHARD",420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 65 , 131 , 223 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285835355,"JASKOLKA, MICHAEL, STEPHEN",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285835355,"JASKOLKA, MICHAEL, STEPHEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 37 , 55 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285835355,"JASKOLKA, MICHAEL, STEPHEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1285836288,"PORFILIO, WILLIAM, LOUIS",1016 KIRKPATRICK RD 1016 KIRKPATRICK ROAD BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285836288,"PORFILIO, WILLIAM, LOUIS",1016 KIRKPATRICK RD 1016 KIRKPATRICK ROAD BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 172 , 258 , 350 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1285838086,"COOK, CATHLEEN, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285838086,"COOK, CATHLEEN, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 13 , 41 , 41 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1285838086,"COOK, CATHLEEN, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285838086,"COOK, CATHLEEN, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 102 , 103 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285838086,"COOK, CATHLEEN, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1285839571,BORDERBELT AIDS RESOURCES TEAM,BORDERBELT AIDS RESOURCES TEAM,415 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,251B00000X,Agencies,Case Management,,1285839571,BORDERBELT AIDS RESOURCES TEAM,415 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,251B00000X,Agencies,Case Management,, 15 , 208 , 208 ," $21,384.00 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285839670,"SMITH, MACKENZIE, MARIE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 88 , 243 , 426 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 39 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,703 COMFORT LN   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 35 , 37 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 51 , 66 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1604 MEDICAL DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1285841130,"KENNEDY, ROBERT, MOFFATT",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1285841346,INTERIM HEALTHCARE OF THE TRIAD,~,330 BILLINGSLEY RD STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1285841346,INTERIM HEALTHCARE OF THE TRIAD,330 BILLINGSLEY RD STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 4,799 "," 5,074 "," $713,030.56 ",,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285841379,"LAI, HSIAO, LING",2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285841379,"LAI, HSIAO, LING",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 53 , 53 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285841379,"LAI, HSIAO, LING",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 51 , 150 , 174 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285841379,"LAI, HSIAO, LING",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285841379,"LAI, HSIAO, LING",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 25 , 27 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285841379,"LAI, HSIAO, LING",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 112 , 114 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285841528,"LIM, PEI, FENG",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 25 , 40 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 57 , 65 , 90 ,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 30 , 40 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1285841916,"ARMSTRONG, LINDA, KANG",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285842138,"JOSHI, SANGEETA, PRABHAKAR",2100 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285842138,"JOSHI, SANGEETA, PRABHAKAR",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 39 , 39 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285842138,"JOSHI, SANGEETA, PRABHAKAR",2100 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285844183,"MOODY, JOHN, SCOTT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285844183,"MOODY, JOHN, SCOTT",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 21 , 112 , 140 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1285844183,"MOODY, JOHN, SCOTT",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 116 , 153 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1285844183,"MOODY, JOHN, SCOTT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285844183,"MOODY, JOHN, SCOTT",373 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1134117393,EMERGENCY MEDICINE ASSOCIATES,EMERGENCY MEDICINE ASSOCIATES PA PC,12420 MILESTONE CENTER DR STE 200 GERMANTOWN MD,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1285845040,"DICKSON, JEFFREY, DOUGLAS",100 FAIRVIEW DR   FRANKLIN VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285845289,"DUBOSE, MELINDA, JENNIFER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 136 , 152 , 192 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285845289,"DUBOSE, MELINDA, JENNIFER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 179 , 202 , 282 ," $10,129.32 ",,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285845289,"DUBOSE, MELINDA, JENNIFER",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,509 OLDE WATERFORD WAY STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1285847939,"NORRIS, JOSEPH, BRYAN",509 OLDE WATERFORD WAY STE 102 LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 19 , 36 ,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1285847939,"NORRIS, JOSEPH, BRYAN",701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285848143,"LUGUE, CARMELITA, JASMINE",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285848143,"LUGUE, CARMELITA, JASMINE",620 SUMMIT CROSSING PL STE 108 GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 31 , 40 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285848143,"LUGUE, CARMELITA, JASMINE",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1285848143,"LUGUE, CARMELITA, JASMINE",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427106079,COASTAL FAMILY PRACTICE AND INTERNA,~,2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285849950,"HARTLEY, LORI, JEAN",235 N NC HWY 41   BEULAVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 358 , 358 ,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,2050 MERCANTILE DR   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1285849950,"HARTLEY, LORI, JEAN",2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 24 , 24 ,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,3200 WATERFIELD DR   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1285849950,"HARTLEY, LORI, JEAN",2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1285849950,"HARTLEY, LORI, JEAN",2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427106079,COASTAL FAMILY PRACTICE AND INTERNA,~,2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285849950,"HARTLEY, LORI, JEAN",2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 68 , 68 ,$#,,
MEDICAID DIRECT,1427106079,COASTAL FAMILY PRACTICE AND INTERNA,~,2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285849950,"HARTLEY, LORI, JEAN",300 W ASHE ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,2050 MERCANTILE DR   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1285849950,"HARTLEY, LORI, JEAN",300 W ASHE ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417397365,ALLISON C EGGLESTON DDS PC,DR EGG PEDIATRIC DENTISTRY DDS MS,6781 PARKER FARM DR STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285863266,"EGGLESTON, ALLISON, CAVENAUGH",6781 PARKER FARM DR STE 100 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 353 , 673 ," 2,504 "," $92,681.06 ",,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1285863852,"BROWN, MILLICENT, BRYANNE",2609 N DUKE ST STE 612 DURHAM NC,032,Durham,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3320 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285863852,"BROWN, MILLICENT, BRYANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285863852,"BROWN, MILLICENT, BRYANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 13 , 36 , 40 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285863852,"BROWN, MILLICENT, BRYANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 35 , 46 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285864868,"UZZLE, ELIZABETH, GRAY",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 21 , 23 , 37 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285864868,"UZZLE, ELIZABETH, GRAY",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285864868,"UZZLE, ELIZABETH, GRAY",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1831414150,ISLAND FAMILY MEDICINE,~,2540 NC HIGHWAY 210 E   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1285864991,"DAVANZO, MICHAEL, JAMES",2540 NC HIGHWAY 210 E   HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 41 , 55 ,$#,,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1285865576,"DAUGHERTY, DECEMBER, LYNN",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1285865576,"DAUGHERTY, DECEMBER, LYNN",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 32 , 49 ,$#,,
MEDICAID DIRECT,1285866319,ESLIKER SAMUELS INC,THE MANOR AT EDGEWATER,1038 STORMY LN   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285866319,ESLIKER SAMUELS INC,1038 STORMY LN   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,164 "," 1,164 "," $81,837.33 ",,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285866830,"SCHMIT, JODY, LEIGH",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285868117,"PARKER, AUGUSTUS, GARLAND",5815 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 53 , 117 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285876219,"MERZ, MICHAEL, KURT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 29 , 41 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285876219,"MERZ, MICHAEL, KURT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285876219,"MERZ, MICHAEL, KURT",100 PERKINS DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1285878090,RES-CARE INC,ALL WAYS CARING HOMECARE,1825 W CITY DR STE E ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1285878090,RES-CARE INC,1825 W CITY DR STE E ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2000 REGENCY PKWY   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285878124,"ALLINGHAM, MICHAEL, JOHN",2000 REGENCY PKWY STE 100 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 46 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285878124,"ALLINGHAM, MICHAEL, JOHN",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 31 , 89 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285878314,"HAMBY, MONICA, SIMONA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1285878314,"HAMBY, MONICA, SIMONA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285881276,"BAUER, SCOTT, ALLAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 26 , 30 ,$#,,
MEDICAID DIRECT,1902834658,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE HILLSBOROUGH,267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1285882829,"OWENS, LEANNE, WHALEY",267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 20 , 54 ,$#,,
MEDICAID DIRECT,1447604376,EASTWAY MEDICAL CLINIC AND URGENT C,~,1220 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285883884,"OKOYE, SYLVIA, IFEYINWA",1220 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 201 , 443 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285884262,"BLACKWELL, ASHLEY, LYNN",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285884262,"BLACKWELL, ASHLEY, LYNN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285886564,"COMBS, SHERI, RENEE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 73 , 73 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285889832,"VASU, SUJETHRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285889832,"VASU, SUJETHRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 297 , 358 , 390 ,$#,,
MEDICAID DIRECT,1285890145,CAROLINA FAMILY HOME CARE INC,Peaceful Living,5816 WILLOW POINT DR   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285890145,CAROLINA FAMILY HOME CARE INC,5816 WILLOW POINT DR   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 167 , 167 ," $21,108.58 ",,
MEDICAID DIRECT,1548445646,KENNETH R MARSH DDS PA,KENNETH R MARSH DDS PA,1582 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,193400000X,Group,Single Specialty,,1285892174,"MARSH, KENNETH, REID",1582 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 157 , 485 ," $16,844.00 ",,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1285892448,"MARRA, AUNDREA, LYNN",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285892448,"MARRA, AUNDREA, LYNN",4525 CAMERON VALLEY PKWY STE 2500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285892448,"MARRA, AUNDREA, LYNN",10320 MALLARD CREEK RD STE 260A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285892448,"MARRA, AUNDREA, LYNN",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 17 , 30 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285892448,"MARRA, AUNDREA, LYNN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285892448,"MARRA, AUNDREA, LYNN",6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285892448,"MARRA, AUNDREA, LYNN",6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1285893289,"HATCH, AMBER, GIPSON",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 26 , 39 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285893289,"HATCH, AMBER, GIPSON",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285893289,"HATCH, AMBER, GIPSON",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285893289,"HATCH, AMBER, GIPSON",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 43 , 55 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285893289,"HATCH, AMBER, GIPSON",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285894576,"BAGGETT, REBECCA, MILLER",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285894600,"SANTOS, ALBERTO, LUIZ MOURA DOS",110 KILDAIRE PARK DR   CARY NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285894600,"SANTOS, ALBERTO, LUIZ MOURA DOS",110 KILDAIRE PARK DR   CARY NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285894600,"SANTOS, ALBERTO, LUIZ MOURA DOS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285894774,"BAKER, MATTHEW, STEPHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285894774,"BAKER, MATTHEW, STEPHEN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285894774,"BAKER, MATTHEW, STEPHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 416 , 561 , 587 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285894774,"BAKER, MATTHEW, STEPHEN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285895169,"DZURIK, MATTHEW, JAMES",8114 MARKET ST   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285895169,"DZURIK, MATTHEW, JAMES",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 69 , 178 , 253 ,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285895292,"UPHAM, TREVOR, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 35 , 64 ," $13,438.40 ",,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285895292,"UPHAM, TREVOR, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285898833,"MURPHY, STEPHANIE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285898833,"MURPHY, STEPHANIE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285898833,"MURPHY, STEPHANIE, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598135188,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH TRANSITION CLINIC,1237 HARDING PL # 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285898833,"MURPHY, STEPHANIE, ELIZABETH",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1285898833,"MURPHY, STEPHANIE, ELIZABETH",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 32 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1285899658,"JACO, LEE ANN, HARTLEY",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 38 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285903609,"TOSHICH, MARKO",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285909416,"SHEPHERD, CALONDRA, YVETTE",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 67 ,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285910786,"FAULK, MARIA, ALEJANDRA",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1285910786,"FAULK, MARIA, ALEJANDRA",3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285910786,"FAULK, MARIA, ALEJANDRA",3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285911552,"EPSTEIN, ANJALI, PARTHASARATHI",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285911552,"EPSTEIN, ANJALI, PARTHASARATHI",700 HOWIE MINE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285911552,"EPSTEIN, ANJALI, PARTHASARATHI",700 HOWIE MINE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 417 , 417 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285913624,"GALVEZ GUERRA, EDUARDO, MANUEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 20 , 36 , 44 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285913624,"GALVEZ GUERRA, EDUARDO, MANUEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285916148,"MARRI, VIJAYA DURGA LAKSHMI, PRADEEPTHI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285916148,"MARRI, VIJAYA DURGA LAKSHMI, PRADEEPTHI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 81 , 81 ,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285916783,"BELL, JESSICA, BLAIR",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 44 , 56 , 64 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1285918516,"BUFFALOE, VALERIE, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1285918516,"BUFFALOE, VALERIE, MARIE",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1285918516,"BUFFALOE, VALERIE, MARIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1285918516,"BUFFALOE, VALERIE, MARIE",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801148457,KINGSLEY MOMODU DDS & ASSOCIATES P,BRITE CARE DENTAL,2901 BREEZEWOOD AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285919902,"MOMODU, KINGSLEY, OISE",2901 BREEZEWOOD AVE   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 43 , 133 ,$#,,
MEDICAID DIRECT,1801148457,KINGSLEY MOMODU DDS & ASSOCIATES P,BRITE CARE DENTAL,2901 BREEZEWOOD AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1285919902,"MOMODU, KINGSLEY, OISE",2901 BREEZEWOOD AVE   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 932 ," 1,591 "," 6,736 "," $582,017.39 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,3003 KENSINGTON PARK DR   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1285919910,"SCALONE, GINGER, DEE",3003 KENSINGTON PARK DR   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 284 , 284 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285920223,"MENTZER, CALEB, JAMES",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285920223,"MENTZER, CALEB, JAMES",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285920496,"GOODING, ZANE",414 E MAIN ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1285920496,"GOODING, ZANE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 103 , 238 , 245 ," $11,285.39 ",,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",3610 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 40 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",3604 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 26 , 47 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",1103 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285920512,"KUMAR, PANKAJ",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,1725 S MAIN ST STE 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1285920769,"ADDISON, SAMUEL, N",8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1285920769,"ADDISON, SAMUEL, N",8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 22 , 30 , 134 ," $12,225.09 ",,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285922690,"FAIZI, ADAM, SHAH",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 20 , 34 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285922690,"FAIZI, ADAM, SHAH",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285922849,"PARIS, MEGHAN, BELANGER",981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285923177,"RASMUSSEN, STEWART, FARR",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 387 , 458 , 572 ,$#,,
MEDICAID DIRECT,1437196318,FIRST IMAGING OF THE CAROLINAS,First Imaging of the Carolinas,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285923177,"RASMUSSEN, STEWART, FARR",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 41 , 61 ,$#,,
MEDICAID DIRECT,1073567244,PINEHURST RADIOLOGY ASSOCIATES,PINEHURST RADIOLOGY ASSOCIATES,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1285923177,"RASMUSSEN, STEWART, FARR",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 40 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285923888,"THOMPSON, TYLER, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 28 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285924563,"BEDOYA, ARMANDO, DIEGO",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 27 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285924563,"BEDOYA, ARMANDO, DIEGO",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285925008,"MCCUTHEON, JESSICA, LISA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285925008,"MCCUTHEON, JESSICA, LISA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 76 , 76 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285925131,"WILSON, LAUREN, PORTNOW",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1285925131,"WILSON, LAUREN, PORTNOW",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 110 , 110 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1285925289,"BOWERS, EDITH, VILLETTE",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 23 , 24 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285925289,"BOWERS, EDITH, VILLETTE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 16 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285925289,"BOWERS, EDITH, VILLETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 25 , 34 , 49 ,$#,,
MEDICAID DIRECT,1679687586,GASTROENTEROLOGY ASSOCIATES OF THE,SALEM ENDOSCOPY CENTER,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285926741,"CRISS, DENISE, GROH",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 26 , 34 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 26 , 80 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285929539,"YAMMINE, HALIM, YOUSSEF",1237 HARDING PL STE 1400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 63 , 70 , 97 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285932558,"SEARS, SARAH, CUMMINGS",2251 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285932558,"SEARS, SARAH, CUMMINGS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1285932558,"SEARS, SARAH, CUMMINGS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 23 , 23 , 41 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1285932558,"SEARS, SARAH, CUMMINGS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285938563,"ADAMS, CAROL, JOY",301 YADKIN ST   ALBEMARLE NC,084,Stanly,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285939843,"YAO, DAVID, HSIEN TA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285939843,"YAO, DAVID, HSIEN TA",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285939843,"YAO, DAVID, HSIEN TA",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285939843,"YAO, DAVID, HSIEN TA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285939843,"YAO, DAVID, HSIEN TA",1200 N ELM ST 1200 NORTH ELM STREET GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285939843,"YAO, DAVID, HSIEN TA",1200 N ELM ST 1200 NORTH ELM STREET GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 26 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285939843,"YAO, DAVID, HSIEN TA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 29 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285942987,"MAAMBO, NCHIMUNYA, MOOMBA",2015 RANDOLPH RD STE 101&208 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285942987,"MAAMBO, NCHIMUNYA, MOOMBA",2015 RANDOLPH RD STE 101&208 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 88 , 88 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285942987,"MAAMBO, NCHIMUNYA, MOOMBA",2015 RANDOLPH RD STE 101&208 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1285943035,"STANLEY, SARA, MILLER",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285943035,"STANLEY, SARA, MILLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285945600,REX HOSPITAL INC,REX CANCER SPECIALTY CENTER,2901 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285945600,REX HOSPITAL INC,2901 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 22 , 96 , 191 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285946988,"SHAH, PRIYANK, PANKAJKUMAR",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285946988,"SHAH, PRIYANK, PANKAJKUMAR",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 81 , 119 , 197 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285946988,"SHAH, PRIYANK, PANKAJKUMAR",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285946988,"SHAH, PRIYANK, PANKAJKUMAR",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285946988,"SHAH, PRIYANK, PANKAJKUMAR",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285946988,"SHAH, PRIYANK, PANKAJKUMAR",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285946988,"SHAH, PRIYANK, PANKAJKUMAR",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1285948299,SANDRA CARRIE LEMONDS,EARTH ANGELS NC,167 MACARTHUR ST   ASHEBORO NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1285948299,SANDRA CARRIE LEMONDS,167 MACARTHUR ST   ASHEBORO NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,914 "," 4,302 "," $517,553.80 ",,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285949032,"MESSENGER, SARA, ELIZABETH",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285949032,"MESSENGER, SARA, ELIZABETH",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285949032,"MESSENGER, SARA, ELIZABETH",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285949032,"MESSENGER, SARA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1285950402,"GREGG, DAVID, ANDREW",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 101 , 117 , 155 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1285950402,"GREGG, DAVID, ANDREW",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 32 , 45 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285950782,"RANKIN, MATTHEW, HALL",517 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 17 , 26 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1285952002,"CHONG, BENNY, YEE-CHUN",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 61 , 80 ,$#,,
MEDICAID DIRECT,1285952705,"MCNEELY, DAVID, EUGENE",~,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1285952705,"MCNEELY, DAVID, EUGENE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285953125,"ONWUCHURUBA, CHERYL, NNENNA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285953125,"ONWUCHURUBA, CHERYL, NNENNA",2711 RANDOLPH RD STE 512 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 35 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285953430,"ABI HACHEM, RALPH",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285953430,"ABI HACHEM, RALPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 25 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285953430,"ABI HACHEM, RALPH",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 17 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285953430,"ABI HACHEM, RALPH",120 E CARVER ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285953430,"ABI HACHEM, RALPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285954024,"HOLWERDA, SCOTT, LEWIS",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285954685,"NANAVATI, ANKIT, DIPTANSHU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285954685,"NANAVATI, ANKIT, DIPTANSHU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285954685,"NANAVATI, ANKIT, DIPTANSHU",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285954685,"NANAVATI, ANKIT, DIPTANSHU",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 26 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285954685,"NANAVATI, ANKIT, DIPTANSHU",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285954685,"NANAVATI, ANKIT, DIPTANSHU",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285954685,"NANAVATI, ANKIT, DIPTANSHU",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 17 , 19 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1285954958,"FAROOQUI, MOHAMMED, ATAULLAH",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1285954958,"FAROOQUI, MOHAMMED, ATAULLAH",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285954958,"FAROOQUI, MOHAMMED, ATAULLAH",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 95 , 209 , 258 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1285954958,"FAROOQUI, MOHAMMED, ATAULLAH",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 410 , 911 ," 1,168 "," $35,354.44 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285954958,"FAROOQUI, MOHAMMED, ATAULLAH",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 121 , 279 , 344 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285955229,"CONNOLLY, SARAH, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285955229,"CONNOLLY, SARAH, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285955435,"HAM, KENDRA, KAMERA",901 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285955435,"HAM, KENDRA, KAMERA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285955682,"CARDER, KELLYE, CHRISTIAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285955682,"CARDER, KELLYE, CHRISTIAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285955930,"SCHUTTE, KIRSTEN, MARIE",3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 32 , 124 , 159 ,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285955930,"SCHUTTE, KIRSTEN, MARIE",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285955930,"SCHUTTE, KIRSTEN, MARIE",3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1285955930,"SCHUTTE, KIRSTEN, MARIE",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 15 , 23 , 39 ,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1285957209,"RICHARDS, JAMIE, HARRELL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356472880,BLUE RIDGE MEDICAL MANAGEMENT CORPO,BHMA CRITICAL CARE JC,400 N STATE OF FRANKLIN RD STE 2746 JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1285958207,"HARDIN, ANGELA, MICHELLE",400 N STATE OF FRANKLIN RD RM 2746 JOHNSON CITY TN,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285965525,"SPACEK, MELISSA, BRENNEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 37 , 37 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285969154,"BASNET, PRAVESH, MAN SINGH",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285969154,"BASNET, PRAVESH, MAN SINGH",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1285970541,"SCHWEIZER, HEATHER, ROSE",1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285970541,"SCHWEIZER, HEATHER, ROSE",1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1285970913,WP-BURNSVILLE HEALTH HOLDINGS,YANCEY HOUSE,6 COOPER LN   BURNSVILLE NC,100,Yancey,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1285970913,WP-BURNSVILLE HEALTH HOLDINGS,6 COOPER LN   BURNSVILLE NC,100,Yancey,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 46 ," 8,025 "," 8,026 "," $740,681.57 ",,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285973396,"CARROLL, STACEY, PERKINS",1540 SUNDAY DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 72 , 81 , 114 ,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1285973677,"JOYCE, JULISSA, GRACE",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,409 OLIN WAY STE 2300 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1285973677,"JOYCE, JULISSA, GRACE",409 OLIN WAY STE 2300 DENVER NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 38 , 81 ,$#,,
MEDICAID DIRECT,1285974113,HELPING MANY LIVES LLC,~,2409 CHARLES BLVD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1285974113,HELPING MANY LIVES LLC,2409 CHARLES BLVD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 358 , 358 ," $22,504.96 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285975961,"SUTTON, MOLLY, MCDONALD",2797 NC 55 HWY   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 16 , 18 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 56 , 68 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1285976456,"DERKS, LUCIA, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 35 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285977751,"STROHM, TAMARA, APRIL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 61 , 81 ,$#,,
MEDICAID DIRECT,1720794944,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE PHYSICIANS WELLNESS,104 POMONA DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285980540,"MARTE, HEATHER, MARIE",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285981027,"ZERNEC, JENNIFER, LILLIAN",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1285981027,"ZERNEC, JENNIFER, LILLIAN",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285981522,"JONES, ANN MARIE, MICHELLE",3012 FALSTAFF RD   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285982124,"WATSON, MARLO, RAYLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285982173,"SCHULTZ-VILLARREAL, MARY ELIZABETH",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285982173,"SCHULTZ-VILLARREAL, MARY ELIZABETH",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 78 , 108 ,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285982173,"SCHULTZ-VILLARREAL, MARY ELIZABETH",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 73 , 109 ,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285982173,"SCHULTZ-VILLARREAL, MARY ELIZABETH",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1285982173,"SCHULTZ-VILLARREAL, MARY ELIZABETH",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285982587,"ADOLPHUS, JOHNELA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 241 , 241 ," $11,062.58 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285982900,"EADY, ARESE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285982900,"EADY, ARESE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1285982900,"EADY, ARESE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285982900,"EADY, ARESE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1285982900,"EADY, ARESE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285983817,"LANE, KATHERINE, CARLISLE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285983817,"LANE, KATHERINE, CARLISLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 59 , 147 , 156 ,$#,,
MEDICAID DIRECT,1285984500,CARESOURCE LLC,~,5611 NC HIGHWAY 55 STE 202 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1285984500,CARESOURCE LLC,5611 NC HIGHWAY 55 STE 202 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#," 1,008 "," 1,023 "," $64,749.44 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285985606,"MERCER, MAXWELL, OWEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285986745,"SCHOUTEN, STEPHANIE, HANNON",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 26 , 26 ,$#,,
MEDICAID DIRECT,1427599802,EYECARECENTER OD PA,EYECARE CENTER,2630 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1285986927,"TRAN, TRUC LY N",2630 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285987008,"PHILLIPS, KATLIN, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285987008,"PHILLIPS, KATLIN, MARIE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285987008,"PHILLIPS, KATLIN, MARIE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1285987248,"CARNEY, BRYAN, CHRISTOPHER",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 122 , 134 , 175 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1285987248,"CARNEY, BRYAN, CHRISTOPHER",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285987248,"CARNEY, BRYAN, CHRISTOPHER",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1285989210,"CORN, ADAM",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 27 , 42 ,$#,,
MEDICAID DIRECT,1255805065,CAREPARTNERS HHA LLLP,CAREPARTNERS PRIVATE DUTY SERVICES,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1285989210,"CORN, ADAM",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1285989210,"CORN, ADAM",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285992552,"DURRANI, RAISA, JIHAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285992552,"DURRANI, RAISA, JIHAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285992552,"DURRANI, RAISA, JIHAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285992552,"DURRANI, RAISA, JIHAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 63 , 68 , 122 ,$#,,
MEDICAID DIRECT,1043270671,CARRBORO PEDIATRICS AND INTERNAL ME,CARRBORO PEDIATRICS AND INTERNAL MEDICINE PA,127 FIDELITY ST   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1285992669,"ANDREWS, LAURA, NOVACK",127 FIDELITY ST   CARRBORO NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 17 , 41 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1285994202,"JENISON, MATTHEW, CLARK",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 37 , 37 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 29 , 33 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 17 , 29 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1285994426,"GOMADAM, PALLAVI, SHARMA",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 69 , 109 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285994798,"WAYMOUTH, VIRGINIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 72 , 87 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1285994798,"WAYMOUTH, VIRGINIA",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",10512 PARK RD STE 101 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1285995316,"HIRSCH-REILLY, CHRISTIE, MARIANNE",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1285995571,"LAMRISSI, MELISSA, JEAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285995571,"LAMRISSI, MELISSA, JEAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1285995571,"LAMRISSI, MELISSA, JEAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285995571,"LAMRISSI, MELISSA, JEAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285995571,"LAMRISSI, MELISSA, JEAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1285995571,"LAMRISSI, MELISSA, JEAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285995936,"CHANG, MEGAN, TIEN-LING",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285995936,"CHANG, MEGAN, TIEN-LING",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#, 18 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1285996140,"FRANKLIN, ANDREW, LAWRENCE",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 32 , 42 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285996447,"REYNOLDS, MONICA, LONA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1285996447,"REYNOLDS, MONICA, LONA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285996447,"REYNOLDS, MONICA, LONA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 43 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285996447,"REYNOLDS, MONICA, LONA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285996447,"REYNOLDS, MONICA, LONA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285996447,"REYNOLDS, MONICA, LONA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1285996447,"REYNOLDS, MONICA, LONA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 39 , 96 , 106 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285999482,"MEHDIRATTA, NITIN, LEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 46 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285999482,"MEHDIRATTA, NITIN, LEE",2301 ERWIN ROAD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1285999482,"MEHDIRATTA, NITIN, LEE",2301 ERWIN ROAD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 27 , 28 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295001618,"HEMBERG, KATHERINE, VAUGHAN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 41 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295001618,"HEMBERG, KATHERINE, VAUGHAN",1941 NEW GARDEN RD STE 216 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 88 , 169 ,$#,,
MEDICAID DIRECT,1376371880,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH FAMILY MEDICINE & BEHAVIORAL HEALTH C,1347 OZONE DR STE 2 SALUDA NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295001931,"REECE, LISA, MARIE",1347 OZONE DR STE 2 SALUDA NC,075,Polk,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649788662,ST LUKES HOSPITAL INC,SALUDA FAMILY MEDICINE,1347 OZONE DR STE 2 SALUDA NC,075,Polk,193200000X,Group,Multi-Specialty,,1295001931,"REECE, LISA, MARIE",1347 OZONE DR STE 2 SALUDA NC,075,Polk,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649788662,ST LUKES HOSPITAL INC,SALUDA FAMILY MEDICINE,1347 OZONE DR STE 2 SALUDA NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295001931,"REECE, LISA, MARIE",1347 OZONE DR STE 2 SALUDA NC,075,Polk,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 27 , 28 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295002012,"JAMAR, WALKER, JACKMAN",301 S CAMPBELL ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 22 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295002012,"JAMAR, WALKER, JACKMAN",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 53 , 66 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295002012,"JAMAR, WALKER, JACKMAN",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295002012,"JAMAR, WALKER, JACKMAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295002012,"JAMAR, WALKER, JACKMAN",7420 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295007292,"SHARPE, KAREN, HOBSON",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295007292,"SHARPE, KAREN, HOBSON",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295008324,"MATULAY, JUSTIN, THOMAS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 30 , 43 , 54 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295008324,"MATULAY, JUSTIN, THOMAS",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 23 , 28 , 40 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295008340,"LEONARD, KENDALL, BLAINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 72 , 72 , 83 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295008340,"LEONARD, KENDALL, BLAINE",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295008340,"LEONARD, KENDALL, BLAINE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295008381,"BORDERS, JOSHUA, RYAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 40 , 73 , 73 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295009827,"FINCH, KATHRYN, ROBBINS",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 36 , 58 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295009827,"FINCH, KATHRYN, ROBBINS",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 77 , 105 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295010551,"ROBINETTE, KATY, ROSE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295010551,"ROBINETTE, KATY, ROSE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295010551,"ROBINETTE, KATY, ROSE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295010551,"ROBINETTE, KATY, ROSE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295010551,"ROBINETTE, KATY, ROSE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1295010551,"ROBINETTE, KATY, ROSE",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295010551,"ROBINETTE, KATY, ROSE",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295010551,"ROBINETTE, KATY, ROSE",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295011716,"IRAGGI, ERIN, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295011716,"IRAGGI, ERIN, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1295012920,"BARNES, JUSTINE, RENEE",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 53 , 57 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295012920,"BARNES, JUSTINE, RENEE",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 22 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1295013795,"DESHAZER, MICHELLE, BEATRICE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1295013795,"DESHAZER, MICHELLE, BEATRICE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1295013795,"DESHAZER, MICHELLE, BEATRICE",145 W PLAZA DR STE K WEST END NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 47 , 64 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,145 W PLAZA DR STE K WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1295013795,"DESHAZER, MICHELLE, BEATRICE",145 W PLAZA DR STE K WEST END NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 28 , 46 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1295013795,"DESHAZER, MICHELLE, BEATRICE",145 W PLAZA DR STE K WEST END NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295015022,"MILLINER, DEBRA, ANN",101 CLINIC DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1295015022,"MILLINER, DEBRA, ANN",101 CLINIC DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295015022,"MILLINER, DEBRA, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 175 , 198 , 279 ,$#,,
MEDICAID DIRECT,1124451182,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROPSYCHOLOGY,1814 WESTCHESTER DR STE 402 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295015196,"STEWART, PETER, VANDERVOORT",1814 WESTCHESTER DR STE 402 HIGH POINT NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 32 ,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295016855,"BOWER, STEVEN, TIMOTHY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295016855,"BOWER, STEVEN, TIMOTHY",25 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295017465,"SCOFIELD, ERIC",1333 S DICKINSON DR   LELAND NC,010,Brunswick,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 28 , 54 , 54 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295017465,"SCOFIELD, ERIC",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 27 , 70 , 71 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295021749,"CONWAY, JENNIFER, ANN",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295021749,"CONWAY, JENNIFER, ANN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295021749,"CONWAY, JENNIFER, ANN",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 24 , 57 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295022838,"PROCHASKA, LINDSEY, HASTINGS",2131 S 17TH ST HOSPITALIST WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295022838,"PROCHASKA, LINDSEY, HASTINGS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 82 , 154 , 215 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295025906,"HENDERSON, ROBERT, ANDREW",3311 JESSIE VILLAGE DR   CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 26 , 34 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295025906,"HENDERSON, ROBERT, ANDREW",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 48 , 84 , 132 ,$#,,
MEDICAID DIRECT,1295026565,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02538,2351 US 70 HWY   SWANNANOA NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295026565,NORTH CAROLINA CVS PHARMACY LLC,2351 US 70 HWY   SWANNANOA NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295027845,"SEGEBARTH, KIRA, MOLLENKOPF",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295028710,GENESIS OF CAROLINAS HOME CARE LLC,~,5736 N TRYON ST STE 128 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1295028710,GENESIS OF CAROLINAS HOME CARE LLC,5736 N TRYON ST STE 128 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,954 "," 2,183 "," $374,621.76 ",,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295028744,"ETTEFAGH, KATE, SCOTT",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 43 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295029130,"COSTA, CRISTIANA, ABRANTES",2400 PRATT ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295029130,"COSTA, CRISTIANA, ABRANTES",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295029130,"COSTA, CRISTIANA, ABRANTES",2400 PRATT ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 11 , 16 , 20 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295030955,"LAVENBURG, ALEXANDRA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1295030989,OPTOMETRIC EYE CLINIC PA,OPTOMETRIC EYE CLINIC,622 N MAIN ST   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295030989,OPTOMETRIC EYE CLINIC PA,622 N MAIN ST   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1295033926,MEGA CARE HOME CARE,~,3019 ZEBULON RD   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1295033926,MEGA CARE HOME CARE,3019 ZEBULON RD   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#," 1,887 "," 2,000 "," $145,033.56 ",,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295034767,"KREINER, MELANIE, MARIE",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 39 , 93 ,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295037299,"WHITEHEAD, KAREN, NORRIS",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295037299,"WHITEHEAD, KAREN, NORRIS",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1295037299,"WHITEHEAD, KAREN, NORRIS",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1912493776,EYE POINT OPTOMETRY,,1105 N LINDSAY ST   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1295040111,"SELLERS, ANGELA, BETH",1105 N LINDSAY ST   HIGH POINT NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 51 , 54 , 64 ,$#,,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1295040194,"GLOVER, PATRICIA, KEITH",2359 HIGHWAY 105   BOONE NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 74 , 83 , 90 ,$#,,
MEDICAID DIRECT,1295040228,BILINGUAL CARING HEARTS INC,Bilingual Caring Hearts Inc,112 STARDALE RD   MORRISVILLE NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1295040228,BILINGUAL CARING HEARTS INC,112 STARDALE RD   MORRISVILLE NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,, 60 ," 1,246 "," 1,250 "," $80,611.20 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295042893,"WALKER, LUZ, ELENA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295042893,"WALKER, LUZ, ELENA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,7825 BALLANTYNE COMMONS PKWY STE 210   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295043412,"CASEY, PATRICK, RICHARD",7825 BALLANTYNE COMMONS PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5900 QUAIL HOLLOW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295043412,"CASEY, PATRICK, RICHARD",7825 BALLANTYNE COMMONS PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1740238435,ATLANTIC GASTROENTEROLOGY PA,~,2465 EMERALD PL   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295043461,"KRESS, CHRISTINE, MARIE BAZIK",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295043800,MYLES HOME HEALTH AGENCY,~,3102 NASH ST N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1295043800,MYLES HOME HEALTH AGENCY,3102 NASH ST N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 11,941 "," 11,941 "," $712,613.36 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295044261,"LINDAMAN, KRISTIN, JENNIFER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 88 , 89 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295046795,"MANLOVE, ASHLEY, ELIZABETH",140 DENTAL CIRL STE 143 CHAPEL HILL NC,019,Chatham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295046795,"MANLOVE, ASHLEY, ELIZABETH",140 DENTAL CIRL STE 143 CHAPEL HILL NC,019,Chatham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295046795,"MANLOVE, ASHLEY, ELIZABETH",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 112 , 131 , 303 ," $24,029.34 ",,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295046795,"MANLOVE, ASHLEY, ELIZABETH",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295046795,"MANLOVE, ASHLEY, ELIZABETH",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 14 , 14 , 35 ,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295046795,"MANLOVE, ASHLEY, ELIZABETH",101 MANNING DR GROUND FLOOR CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 27 , 30 , 69 ,$#,,
MEDICAID DIRECT,1295046878,PINK REGALIA LLC,~,452 HAZELWOOD AVE   WAYNESVILLE NC,044,Haywood,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295046878,PINK REGALIA LLC,452 HAZELWOOD AVE   WAYNESVILLE NC,044,Haywood,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1700888542,GREENE COUNTY HEALTH CARE INC,KATE B REYNOLDS MEDICAL CENTER,205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295047926,"HU, XINRAN",205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295048833,"XU, JINDONG",1200 N ELM ST STE 3360 GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 61 , 161 , 163 ," $10,274.38 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295048973,"STEPP, AMBER, LEE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295048973,"STEPP, AMBER, LEE",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598135188,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH TRANSITION CLINIC,1237 HARDING PL # 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295048973,"STEPP, AMBER, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 20 , 21 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295048973,"STEPP, AMBER, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295048973,"STEPP, AMBER, LEE",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 72 , 76 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295048973,"STEPP, AMBER, LEE",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 33 , 33 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295048973,"STEPP, AMBER, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295048981,"LE, YEN, THI HONG",~,4424 W WENDOVER AVE   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,1295048981,"LE, YEN, THI HONG",4424 W WENDOVER AVE   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295048981,"LE, YEN, THI HONG",~,6711 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,152W00000X,Eye and Vision Services Providers,Optometrist,,1295048981,"LE, YEN, THI HONG",6711 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295051340,"WINSTEAD, MICHAEL, VINCENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 12 , 22 , 25 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295052223,"BRANDON, DONNA, PEARL",4901 AUBURN RD   SUMMERFIELD NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 27 , 55 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295052223,"BRANDON, DONNA, PEARL",2205 OAK RIDGE RD STE BB OAK RIDGE NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295052314,"LOWDER II, RICHARD, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295052348,"ADAMS, LU, WANG",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295052348,"ADAMS, LU, WANG",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295052348,"ADAMS, LU, WANG",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 33 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295052348,"ADAMS, LU, WANG",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295052348,"ADAMS, LU, WANG",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 30 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295052843,"JOHNSON, NICHOLE, LYNETTE",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295052843,"JOHNSON, NICHOLE, LYNETTE",2610 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295052843,"JOHNSON, NICHOLE, LYNETTE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 42 , 78 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295052843,"JOHNSON, NICHOLE, LYNETTE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114780137,EDYN WELLNESS PLLC,,47 E FORK RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1295053510,"RICHARDS, TNESHIA, LEA",47 E FORK RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 43 , 64 ,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1295053510,"RICHARDS, TNESHIA, LEA",47 E FORK RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295053742,"AHERN, ANTONIA, BARYIAMES",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 42 , 54 , 83 ,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295055127,"IGLESIA, CAROL, ANN",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295056430,"PARCHMENT, NADIA, ROXANNE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295056430,"PARCHMENT, NADIA, ROXANNE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 58 , 58 ,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295058394,"WILLIAMS, MICHAEL, B",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1295058790,"NIGAM, NITIN",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295059434,"MORSE, CARYN, GEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 42 , 92 , 96 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295060234,"LIU, AMY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1831465442,MONARCH,,3200 NORTHLINE AVE STE 132 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295063790,"BUTLER, MICHELLE, RENEE",601 S MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295063790,"BUTLER, MICHELLE, RENEE",601 S MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831465442,MONARCH,,3200 NORTHLINE AVE STE 132 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295063790,"BUTLER, MICHELLE, RENEE",601 S MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528406519,MONARCH,~,2003 GODWIN AVE STE C LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1295063790,"BUTLER, MICHELLE, RENEE",601 S MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295067650,M SHERILL GLOVER OD,PRINCETON EYE CARE,110 E EDWARDS ST   PRINCETON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295067650,M SHERILL GLOVER OD,110 E EDWARDS ST   PRINCETON NC,051,Johnston,193200000X,Group,Multi-Specialty,, 33 , 33 , 70 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295071751,"GLECKLER, TRAVIS, NEAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295072478,"STEWART, ROSALIE, KATHLEEN",448 CRANBERRY ST   NEWLAND NC,006,Avery,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295072478,"STEWART, ROSALIE, KATHLEEN",935 STATE FARM RD   BOONE NC,095,Watauga,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295072478,"STEWART, ROSALIE, KATHLEEN",935 STATE FARM RD   BOONE NC,095,Watauga,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1447980883,TRIAD ADULT AND PEDIATRIC MEDICINE,,300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295072684,"WHITSON, MEAGHAN, CRYSTAL",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 17 , 82 , 82 ,$#,,
MEDICAID DIRECT,1598762940,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295072684,"WHITSON, MEAGHAN, CRYSTAL",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295072684,"WHITSON, MEAGHAN, CRYSTAL",606 N ELM ST   HIGH POINT NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 14 , 56 , 56 ," $11,433.20 ",,
MEDICAID DIRECT,1063712727,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1002 S EUGENE ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295072684,"WHITSON, MEAGHAN, CRYSTAL",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295072759,"HINES, COURTNEY, ELIZABETH",3485 US HIGHWAY 301 N   DUNN NC,043,Harnett,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 29 , 87 , 91 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295072759,"HINES, COURTNEY, ELIZABETH",565 BOYETTE RD   FOUR OAKS NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 43 , 109 , 121 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295072759,"HINES, COURTNEY, ELIZABETH",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 98 , 228 , 238 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295072759,"HINES, COURTNEY, ELIZABETH",217 JONESBORO RD   DUNN NC,043,Harnett,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 20 , 35 , 38 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295072759,"HINES, COURTNEY, ELIZABETH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 21 , 25 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295072759,"HINES, COURTNEY, ELIZABETH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295072759,"HINES, COURTNEY, ELIZABETH",403 CRESTVIEW AVE SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 42 , 78 , 88 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295077014,"CAPPELLO, ZACHARY, JOHN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 45 , 86 , 163 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295081123,"FOSTER, CHRISTOPHER, BARRETT",9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295081123,"FOSTER, CHRISTOPHER, BARRETT",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295081388,"MAY, DANIEL, ROY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1295083673,"OHREE, NATHLYN, BRYANT",~,1713 BEVERLY RD   ROCKY MOUNT NC,033,Edgecombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1295083673,"OHREE, NATHLYN, BRYANT",1713 BEVERLY RD   ROCKY MOUNT NC,033,Edgecombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295084358,"LINK, JILLIAN, EVE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 31 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295084358,"LINK, JILLIAN, EVE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295085652,"GLADSTONE, JORDAN, NICOLE",2000 PERIMETER PARK DR STE 200 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295085652,"GLADSTONE, JORDAN, NICOLE",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295085652,"GLADSTONE, JORDAN, NICOLE",114 BRADY CT   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295086346,"VARNES, MELISSA, NICOLE",10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 25 , 59 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295087088,"NAHAS, ARLEY, BYTRACE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295088748,"MANSFIELD, ZED, ALEX",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 53 , 53 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1295088748,"MANSFIELD, ZED, ALEX",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 40 , 40 ,$#,,
MEDICAID DIRECT,1295089225,SPEAK NOW LLC,CAROLINA SPEAK NOW,6405 DEERVIEW DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295089225,SPEAK NOW LLC,6405 DEERVIEW DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 619 ," 8,416 "," 8,471 "," $606,764.85 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295090694,"EPSTEIN, MELISSA, ANNA",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 34 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295090694,"EPSTEIN, MELISSA, ANNA",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295090801,"BEDDARD, CRYSTAL, PATRICE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295091064,"SANTEE, EDWARD, WESTON",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295091353,"BRANTLEY, AMANDA, BOLCH",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295091353,"BRANTLEY, AMANDA, BOLCH",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295091353,"BRANTLEY, AMANDA, BOLCH",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1295092187,"WEAVER, SETH, FULTON",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1295092187,"WEAVER, SETH, FULTON",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1295092187,"WEAVER, SETH, FULTON",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 81 , 82 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1295092187,"WEAVER, SETH, FULTON",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1295092187,"WEAVER, SETH, FULTON",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1295093144,DR ROLANDO ORTIZ OPTOMETRIST PLLC,BRIGHT VISION CENTER,836 E CHATHAM ST STE 106 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295093144,DR ROLANDO ORTIZ OPTOMETRIST PLLC,836 E CHATHAM ST STE 106 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,," 1,345 "," 1,360 "," 2,712 "," $37,804.94 ",,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1295095842,"MYERS, JON, CHRISTOPHER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1295095842,"MYERS, JON, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1295095842,"MYERS, JON, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295095842,"MYERS, JON, CHRISTOPHER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1295095842,"MYERS, JON, CHRISTOPHER",1705 TARBORO ST SW   WILSON NC,098,Wilson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1295095842,"MYERS, JON, CHRISTOPHER",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295096352,"CARTER, JESSICA, ELYSE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295096352,"CARTER, JESSICA, ELYSE",1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295096352,"CARTER, JESSICA, ELYSE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295096352,"CARTER, JESSICA, ELYSE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295096352,"CARTER, JESSICA, ELYSE",1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295096352,"CARTER, JESSICA, ELYSE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295096352,"CARTER, JESSICA, ELYSE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295096741,"HOLLIFIELD, RACHAEL, BEACH",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 28 , 59 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295097772,"HUKILL, STEPHANIE, ATLAS",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 200 , 205 , 788 ," $29,024.17 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295098952,"PATTERSON, MORGAN, URIAH AMANDA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295100964,CHOSEN HEALTH CARE SERVICES INC,CHOSEN HEALTH CARE SERVICES INC,122 W ELWOOD AVE STE 210 RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1295100964,CHOSEN HEALTH CARE SERVICES INC,122 W ELWOOD AVE STE 210 RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,#," 1,416 "," 1,416 "," $84,804.84 ",,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1295101616,"MCLOUGHLIN, ROBERT, JOHN BENTLEY",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1295101616,"MCLOUGHLIN, ROBERT, JOHN BENTLEY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1295101616,"MCLOUGHLIN, ROBERT, JOHN BENTLEY",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1295101616,"MCLOUGHLIN, ROBERT, JOHN BENTLEY",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 67 , 178 , 179 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1295101616,"MCLOUGHLIN, ROBERT, JOHN BENTLEY",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295107043,"TRAN, THANH, THANH",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 41 , 55 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295107043,"TRAN, THANH, THANH",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295107043,"TRAN, THANH, THANH",11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 19 , 25 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295107043,"TRAN, THANH, THANH",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295107126,"TOILOLO, TIFI, OTTO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 34 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295107126,"TOILOLO, TIFI, OTTO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295113579,"WARD, ANNE, STEPHANO",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295113579,"WARD, ANNE, STEPHANO",1411 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295113579,"WARD, ANNE, STEPHANO",3480 WAKE FOREST RD STE 520 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295113579,"WARD, ANNE, STEPHANO",3480 WAKE FOREST RD STE 520 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295113579,"WARD, ANNE, STEPHANO",3480 WAKE FOREST RD STE 520 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295115111,"COHEN, JENNIFER, LEIGH",2301 ERWIN ROAD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295115111,"COHEN, JENNIFER, LEIGH",3000 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295115111,"COHEN, JENNIFER, LEIGH",3000 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1184400954,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC AUDIOLOGY SERVICES,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295115152,"OVERTON, ANDREA, BUCKER",115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295115186,"FINDLAY, JILLIAN, MARIE",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821596115,GODEL AND ASSOCIATES II PLLC,CHARLOTTE FAMILY DENTAL CARE,5232 ALBEMARLE RD STE F CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295116481,"REYES, CAROLINA, DEVERS",5232 ALBEMARLE RD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1821596115,GODEL AND ASSOCIATES II PLLC,CHARLOTTE FAMILY DENTAL CARE,5232 ALBEMARLE RD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295116481,"REYES, CAROLINA, DEVERS",5232 ALBEMARLE RD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 806 ," 1,821 "," 6,532 "," $368,508.04 ",,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1295116770,"DEDMON, ALYSSA, NICOLE",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 28 , 55 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1295116770,"DEDMON, ALYSSA, NICOLE",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 71 , 133 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,4429 W HIGHWAY 27   VALE NC,055,Lincoln,193400000X,Group,Single Specialty,,1295116770,"DEDMON, ALYSSA, NICOLE",4429 W HIGHWAY 27   VALE NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,4429 W HIGHWAY 27   VALE NC,055,Lincoln,193400000X,Group,Single Specialty,,1295116770,"DEDMON, ALYSSA, NICOLE",4429 W HIGHWAY 27   VALE NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295117521,"TYSINGER, KATHRYN, KELLY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295117836,"HEATHCOTE, JOHN, DANIEL",2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295119014,"ANDERSON, BRETT, MATTHEW",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295119014,"ANDERSON, BRETT, MATTHEW",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 43 , 74 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295119014,"ANDERSON, BRETT, MATTHEW",510 EMERGENCY DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295120210,"CLARKE, CHRISTOPHER, KHALIL",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1295120210,"CLARKE, CHRISTOPHER, KHALIL",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295120442,"BAGLIA, CORRINA, BETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295120442,"BAGLIA, CORRINA, BETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295120442,"BAGLIA, CORRINA, BETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295120442,"BAGLIA, CORRINA, BETH",2704 HENRY ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295120442,"BAGLIA, CORRINA, BETH",2704 HENRY ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295121168,"KODALI, SILPA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 33 , 118 , 118 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295121671,"SISON, NATHAN, PETER",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 139 , 301 , 753 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295121671,"SISON, NATHAN, PETER",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 51 , 133 ,$#,,
MEDICAID DIRECT,1619904430,SOUTH CHARLOTTE PRIMARY CARE,ATRIUM HEALTH PRIMARY CARE SOUTH CHARLOTTE INTERNA,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295121754,"BUTLER, BETH, CHRISTINA",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 26 , 37 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295121754,"BUTLER, BETH, CHRISTINA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295121754,"BUTLER, BETH, CHRISTINA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295121754,"BUTLER, BETH, CHRISTINA",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295122109,"EANES, ALISA, KATHERINE",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295122109,"EANES, ALISA, KATHERINE",430 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295122109,"EANES, ALISA, KATHERINE",472 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 34 , 45 ," $10,029.34 ",,
MEDICAID DIRECT,1295124550,MINT HILL HEALTH HOLDINGS LLC,MINT HILL SENIOR LIVING,10830 LAWYERS GLEN DR   MINT HILL NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295124550,MINT HILL HEALTH HOLDINGS LLC,10830 LAWYERS GLEN DR   MINT HILL NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 58 ," 12,635 "," 12,636 "," $883,413.12 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295124774,"WORLEY, BARBARA, DELOIS-STONE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 715 ," 1,958 "," 2,874 "," $25,949.30 ",,
MEDICAID DIRECT,1326394990,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1295125656,"YORK, MAGHEN, KATHLEEN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326394990,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1295125656,"YORK, MAGHEN, KATHLEEN",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1467635128,COASTAL HEALTHCARE RESOURCES INC,COASTAL HEALTHCARE RESOURCES,1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1295126043,"FESEL, JOSHUA, DAVID",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295126043,"FESEL, JOSHUA, DAVID",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295126043,"FESEL, JOSHUA, DAVID",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295127504,"PATTERSON, WESLEY, GORDON",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1295128338,"KING, LESLIE, LEE",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 61 , 449 , 491 ," $11,618.07 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295128338,"KING, LESLIE, LEE",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 69 , 368 , 400 ," $11,548.10 ",,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1295129773,"HARRILL, SHARHONDA, BELL",1 HOSPITAL RD   CHEROKEE NC,087,Swain,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1295129773,"HARRILL, SHARHONDA, BELL",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1295130342,"WILSON, LAUREN, HAHN",7476 WATERSIDE LOOP RD   DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1295130342,"WILSON, LAUREN, HAHN",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1740339449,PATTY VISION CENTER OD PA,Patty Vision Center OD PA,2858 DURHAM RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295132520,"CHEN OD, JINGYA, JEANNE",415 SEMORA RD   ROXBORO NC,073,Person,152W00000X,Eye and Vision Services Providers,Optometrist,, 57 , 58 , 89 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1295132769,"YI, CRYSTAL, JUNE",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 46 , 55 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295132785,"WANG, LI",7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 47 , 115 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295134955,"ALLEN, JEFFREY, NORMAN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295134955,"ALLEN, JEFFREY, NORMAN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295134955,"ALLEN, JEFFREY, NORMAN",114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 35 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295134955,"ALLEN, JEFFREY, NORMAN",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295139798,"DOHERTY, LAURA, CHRISTINE",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 41 , 51 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295139798,"DOHERTY, LAURA, CHRISTINE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295139798,"DOHERTY, LAURA, CHRISTINE",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295141224,"DANNALS, CHRISTOPHER, PRATT",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295141224,"DANNALS, CHRISTOPHER, PRATT",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",7473C HIGHWAY 22   WHISPERING PINES NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 31 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",7473C HIGHWAY 22   WHISPERING PINES NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",7473C HIGHWAY 22   WHISPERING PINES NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 44 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",7473C HIGHWAY 22   WHISPERING PINES NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",7473C HIGHWAY 22   WHISPERING PINES NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295141661,"KOBAISSI, ZENA",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1295141661,"KOBAISSI, ZENA",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295141927,"BOURBIA, AMINE",11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295142545,"TASLEEM, SYED, TALHA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 52 , 52 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295142545,"TASLEEM, SYED, TALHA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 23 , 82 , 83 ,$#,,
MEDICAID DIRECT,1295145563,THERACARE HEALTH & WELLNESS LLC,~,101 S TRYON ST STE 2700 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1295145563,THERACARE HEALTH & WELLNESS LLC,101 S TRYON ST STE 2700 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295146108,"PATEL, VIRAL, MAHESH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,130 HARBOUR PLACE DR STE 180   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",130 HARBOUR PLACE DR STE 180 DAVIDSON NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 39 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 18 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 4,195 "," 5,677 "," 24,908 "," $919,202.40 ",,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 103 , 106 , 739 ," $62,117.56 ",,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 63 , 64 , 397 ," $35,297.52 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 74 , 80 , 221 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295148807,"KERNS, AMANDA, KILBURN",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 212 , 212 ," 3,622 "," $361,758.23 ",,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295149672,"GETMAN, BORIS, NIKOLAEVICH",10208 CERNY ST STE 210 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 99 , 176 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 47 , 110 ,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",420 PARK ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295150449,"TATE, THOMAS, CHADWICK",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295152601,"LI, CHUN, XIANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295153393,"DELONE, NOAH, FRIEDMAN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295153435,"WEGERMANN, ZACHARY, KIRK",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295153435,"WEGERMANN, ZACHARY, KIRK",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 22 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1295153435,"WEGERMANN, ZACHARY, KIRK",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295153435,"WEGERMANN, ZACHARY, KIRK",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295153500,"GILMORE, BRIAN, FREDERICKS",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295153500,"GILMORE, BRIAN, FREDERICKS",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295153500,"GILMORE, BRIAN, FREDERICKS",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295153500,"GILMORE, BRIAN, FREDERICKS",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295153633,"SEE, KHAING, ZAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 223 , 223 ," $12,277.93 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295154300,"LEE, MIN JI",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 321 , 771 , 806 ," $24,099.78 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295154318,"FRIEDLAND, ANNE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 40 , 116 , 124 ,$#,,
MEDICAID DIRECT,1023420973,KIDZCARE PEDIATRICS PC,,1406 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295154805,"RUSHTON, SAMANTHA, JOELLE",1406 S MAIN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 74 , 160 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1295155141,"FANNING, MATTHEW, MIDDLETON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295155562,"SMITH, MELISSA, ROBIN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295155562,"SMITH, MELISSA, ROBIN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295155562,"SMITH, MELISSA, ROBIN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 106 , 111 , 150 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1295155695,"JONES, FREDERICK, SCOTT",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295155703,"TONEY, DEREK, NELSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295156206,POPLAR SPRINGS ASSISTED LIVING INC,,601 DOVER RD   STAR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295156206,POPLAR SPRINGS ASSISTED LIVING INC,601 DOVER RD   STAR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,844 "," 1,844 "," $98,165.74 ",,
MEDICAID DIRECT,1417061011,ABC PEDIATRICS OF DUNN PA,~,104 TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1295156305,"HERRING, HANNAH, KINLAW",104 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 116 , 400 ," $16,223.06 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295156537,"HAYES, LISA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295157055,"MEUTH, BROOKE, ASHLYN MILLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295157055,"MEUTH, BROOKE, ASHLYN MILLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295159077,"DANDANEAU, CHRISTINA, MARIE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295163681,"SIMMONS, BRITTAINY, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 40 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295170009,"CATANZARO, JENNIFER, LEA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295170009,"CATANZARO, JENNIFER, LEA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295171940,"IFOKWE, JOSEPH, IKECHUKWU",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295172252,"PARIKH, SHAUNAK, SHARAD",350 PEE DEE AVE STE 101 ALBEMARLE NC,084,Stanly,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 76 , 354 , 366 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295172252,"PARIKH, SHAUNAK, SHARAD",568 FAIRWOODS DR   HUNTERSVILLE NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 16 , 52 , 53 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295172252,"PARIKH, SHAUNAK, SHARAD",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 71 , 287 , 310 ,$#,,
MEDICAID DIRECT,1386960342,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295172328,"KAMANZI, ODILE",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 53 , 72 ,$#,,
MEDICAID DIRECT,1386960342,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295172328,"KAMANZI, ODILE",200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295172328,"KAMANZI, ODILE",200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962728923,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295172328,"KAMANZI, ODILE",200 S COLLEGE ST STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295172328,"KAMANZI, ODILE",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 35 , 44 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295173524,"PRESBY, KIRSTEN, LINDA",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295173524,"PRESBY, KIRSTEN, LINDA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,611 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1295173524,"PRESBY, KIRSTEN, LINDA",611 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295173524,"PRESBY, KIRSTEN, LINDA",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295173706,"PERRY, JONATHAN, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1295173706,"PERRY, JONATHAN, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295173706,"PERRY, JONATHAN, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295173706,"PERRY, JONATHAN, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 159 , 165 , 197 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295173706,"PERRY, JONATHAN, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295173706,"PERRY, JONATHAN, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295173706,"PERRY, JONATHAN, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1295174928,"MICHALAK, JOHN, ROBERT",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208800000X,Allopathic & Osteopathic Physicians,Urology,, 138 , 370 , 921 ," $19,447.12 ",,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1295174928,"MICHALAK, JOHN, ROBERT",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295174977,"THEKKEKANDAM, MARIA, THERESA",100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295174977,"THEKKEKANDAM, MARIA, THERESA",120 HEALTHPLEX WAY   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295174977,"THEKKEKANDAM, MARIA, THERESA",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164599866,ASWAD SURGICAL GROUP PC,~,441 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1295177848,"SPAKE, STACI, KRISANN",441 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295178986,"ZOUMBEROS, MELISSA, SILVA",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295178986,"ZOUMBEROS, MELISSA, SILVA",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295178986,"ZOUMBEROS, MELISSA, SILVA",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295178986,"ZOUMBEROS, MELISSA, SILVA",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295180206,"MAYERS, CARI, SUSANN",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487116968,THE MOSES H CONE MEMORIAL HOSPITAL,PRIMARY CARE AT ELMSLEY SQUARE,3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295180206,"MAYERS, CARI, SUSANN",3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 70 , 101 ,$#,,
MEDICAID DIRECT,1487116968,THE MOSES H CONE MEMORIAL HOSPITAL,PRIMARY CARE AT ELMSLEY SQUARE,3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295180206,"MAYERS, CARI, SUSANN",2525 PHILLIPS AVE STE C GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295180206,"MAYERS, CARI, SUSANN",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295183614,"SHAY, GIL",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 78 , 78 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295184539,"BENNETT, ADAM, JACOB",3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 35 , 68 , 86 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295184539,"BENNETT, ADAM, JACOB",2406 BLUE RIDGE RD STE 280 RALEIGH NC,092,Wake,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 42 , 71 , 78 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295185213,"OGUNWO, NYARADZO",101 ROBESON ST STE 202 E FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 157 , 266 , 268 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1295185213,"OGUNWO, NYARADZO",101 ROBESON ST STE 202 E FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 30 , 43 , 43 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295185213,"OGUNWO, NYARADZO",1700 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 42 , 142 , 142 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295185445,"WRIGHT, KARI, JOY",800 TILGHMAN DR   DUNN NC,043,Harnett,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295185445,"WRIGHT, KARI, JOY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295185445,"WRIGHT, KARI, JOY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295185445,"WRIGHT, KARI, JOY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295185445,"WRIGHT, KARI, JOY",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295185635,"CONNER, KELLY, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 70 , 86 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295186633,"HORNE, BRADLEY, SCOTT",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295186633,"HORNE, BRADLEY, SCOTT",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1154042992,RDMG ASSOCIATES PA,,7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295188340,"SITTON, JACQUELINE, BLAINE",7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295191450,FOUNTAIN ADULT HOME CARE LLC,,303 WILLIAM WALSTON LN   TARBORO NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295191450,FOUNTAIN ADULT HOME CARE LLC,303 WILLIAM WALSTON LN   TARBORO NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 97 , 97 ," $20,979.21 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295194561,"ROSS, TYLER, LANG",209 PARK ST   BELMONT NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 20 , 40 ,$#,,
MEDICAID DIRECT,1295194751,SMITHFIELD FAMILY EYE CARE OD PA,~,1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295194751,SMITHFIELD FAMILY EYE CARE OD PA,1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,, 400 , 409 , 802 ," $10,850.34 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295196624,"HALLOCK, ESTHER, KIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 32 ,$#,,
MEDICAID DIRECT,1295196780,LLD LABORATORIES LLC,,249 E NC HIGHWAY 54 STE 310 DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,1295196780,LLD LABORATORIES LLC,249 E NC HIGHWAY 54 STE 310 DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,, 68 , 81 , 81 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295197069,"MARSHALL, SAMANTHA, MARIE PERSSON",2790 GODWIN BLVD STE 375 SUFFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295198679,"MELISH, GREGORY, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 49 , 72 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295198679,"MELISH, GREGORY, ALAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 27 , 33 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295198679,"MELISH, GREGORY, ALAN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295198679,"MELISH, GREGORY, ALAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 26 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295198679,"MELISH, GREGORY, ALAN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295198679,"MELISH, GREGORY, ALAN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295198679,"MELISH, GREGORY, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295198679,"MELISH, GREGORY, ALAN",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1295201010,"SEIGER, LEAH, LANA",186 MEDICAL PARK LOOP STE 503 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1295203321,LABORATORY CORPORATION OF AMERICA H,,300 MOORESVILLE RD RM 2111 KANNAPOLIS NC,013,Cabarrus,291U00000X,Laboratories,Clinical Medical Laboratory,,1295203321,LABORATORY CORPORATION OF AMERICA H,300 MOORESVILLE RD RM 2111 KANNAPOLIS NC,013,Cabarrus,291U00000X,Laboratories,Clinical Medical Laboratory,, 32 , 37 , 61 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295209260,"TURNER, DUSTIN, PRENTICE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295209260,"TURNER, DUSTIN, PRENTICE",115 HEART DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295209260,"TURNER, DUSTIN, PRENTICE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295210649,"BLANKENSHIP, SARAH, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal, 55 , 71 , 72 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295210649,"BLANKENSHIP, SARAH, ANNE",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295210649,"BLANKENSHIP, SARAH, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295214013,"ITO-LUCAS, SHELLALYN, RODALFO",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 263 , 263 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1295219863,"LAREW, DAVID, MICHAEL",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 59 , 61 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295219863,"LAREW, DAVID, MICHAEL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1295220168,"KIRBY, JAMES, WHITFIELD",434 HOSPITAL DR   LINVILLE NC,006,Avery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821403957,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1295220168,"KIRBY, JAMES, WHITFIELD",434 HOSPITAL DR   LINVILLE NC,006,Avery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1295220168,"KIRBY, JAMES, WHITFIELD",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1295220226,"MAZZOLA POLI DE FIGUEIREDO, SERGIO",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295220226,"MAZZOLA POLI DE FIGUEIREDO, SERGIO",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1295220226,"MAZZOLA POLI DE FIGUEIREDO, SERGIO",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1295220226,"MAZZOLA POLI DE FIGUEIREDO, SERGIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295220226,"MAZZOLA POLI DE FIGUEIREDO, SERGIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295220507,"STUTZMAN, TYLER, DAVID",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295220507,"STUTZMAN, TYLER, DAVID",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295220507,"STUTZMAN, TYLER, DAVID",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295220507,"STUTZMAN, TYLER, DAVID",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 104 , 116 , 140 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295220507,"STUTZMAN, TYLER, DAVID",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295220507,"STUTZMAN, TYLER, DAVID",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295220507,"STUTZMAN, TYLER, DAVID",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 28 ,$#,,
MEDICAID DIRECT,1780969667,"LOCEY, RACHEL, ANNE",~,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1295220895,"SMITH, MELANIE, DANIELLE",725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1700054574,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL OF FOUR OAKS,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295220895,"SMITH, MELANIE, DANIELLE",725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 27 , 98 ,$#,,
MEDICAID DIRECT,1780969667,"LOCEY, RACHEL, ANNE",~,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1295220895,"SMITH, MELANIE, DANIELLE",1525 OCEAN ISLE BEACH RD UNIT 2 OCEAN ISLE BEACH NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1700054574,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL OF FOUR OAKS,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295220895,"SMITH, MELANIE, DANIELLE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780969667,"LOCEY, RACHEL, ANNE",~,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1295220895,"SMITH, MELANIE, DANIELLE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1396388096,THOME & KANKASH DDS PLLC I,FUQUAY PEDIATRIC DENTISTRY,401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1295220895,"SMITH, MELANIE, DANIELLE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 114 , 118 , 479 ," $12,540.68 ",,
MEDICAID DIRECT,1912588476,DAVID E THOME XII,DUNN PEDIATRIC DENTISTRY,711 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295220895,"SMITH, MELANIE, DANIELLE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 100 , 100 , 442 ," $10,939.87 ",,
MEDICAID DIRECT,1467507640,COUNTY OF WILSON,WILSON COUNTY DEPARTMENT OF PUBLIC HEALTH,1801 GLENDALE DR SW   WILSON NC,098,Wilson,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1295220895,"SMITH, MELANIE, DANIELLE",1801 GLENDALE DR SW   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780969667,"LOCEY, RACHEL, ANNE",~,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1295220895,"SMITH, MELANIE, DANIELLE",1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice,#, 15 , 48 ,$#,,
MEDICAID DIRECT,1225584287,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH,1508 MAPLE GROVE CHURCH RD UNIT 1 DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295220895,"SMITH, MELANIE, DANIELLE",1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 24 , 162 ,$#,,
MEDICAID DIRECT,1720198369,ROANOKE VALLEY HEALTH SERVICES INC,ROANOKE CLINIC,1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295221232,"SABA MUSHTAQ, FNU",1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 108 , 249 , 263 ," $11,035.32 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295221851,"VALDIVIA, TRISTIN, RAE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295221851,"VALDIVIA, TRISTIN, RAE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 47 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295224095,"TALLA, SWATHI",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 33 , 75 ,$#,,
MEDICAID DIRECT,1205597721,LUMBERTON CARE CLINIC PLLC,,4307 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1295224525,"HERRING, MATTHEW, DANIEL",4307 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1295224525,"HERRING, MATTHEW, DANIEL",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 40 , 78 ,$#,,
MEDICAID DIRECT,1720120637,NORTH CAROLINA A T STATE UNIVERSITY,,112 N BENBOW RD   GREENSBORO NC,041,Guilford,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1295226199,"AFATSAWO, ABLA, DJIGBODI",112 N BENBOW ROAD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1194801852,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CLAYTON,31 OLEANDER DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295226744,"RUNYON, JUSTIN, MICHAEL",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 23 , 78 ,$#,,
MEDICAID DIRECT,1295226975,BYRAM HEALTHCARE CENTERS INC,,202 COMMERCE BLVD STE 101 KINGS MOUNTAIN NC,023,Cleveland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295226975,BYRAM HEALTHCARE CENTERS INC,202 COMMERCE BLVD STE 101 KINGS MOUNTAIN NC,023,Cleveland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 831 ," 2,820 "," 7,293 "," $240,426.28 ",,
MEDICAID DIRECT,1295226975,BYRAM HEALTHCARE CENTERS INC,,202 COMMERCE BLVD STE 101 KINGS MOUNTAIN NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1295226975,BYRAM HEALTHCARE CENTERS INC,202 COMMERCE BLVD STE 101 KINGS MOUNTAIN NC,023,Cleveland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 12 , 11 , 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295227619,"TURNER, RODRICK, MAURICE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295227817,"IONESCU, ADRIAN, GEORGE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295227817,"IONESCU, ADRIAN, GEORGE",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 30 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295227817,"IONESCU, ADRIAN, GEORGE",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295227817,"IONESCU, ADRIAN, GEORGE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295227957,"PERUZZINI, ERIN, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295227957,"PERUZZINI, ERIN, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1295227957,"PERUZZINI, ERIN, MARIE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295228948,"CHAN, NIM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 31 , 37 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295230928,"KALBAC, TYLER, DANIEL",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295230928,"KALBAC, TYLER, DANIEL",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295230993,"SUKUMAR, ROHIT",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 61 , 63 , 98 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295230993,"SUKUMAR, ROHIT",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 136 , 152 , 191 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1295231645,"HOPKINS, JARED",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295236438,"MCKINNEY, HELEN, JO",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1295237519,NOA HUMAN SERVICES LLC 4,,4328 STOKESDALE AVE   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295237519,NOA HUMAN SERVICES LLC 4,4328 STOKESDALE AVE   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 530 , 530 ," $37,028.51 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295238814,"ROSENSMITH, ANTHONY, RYAN",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 63 , 149 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295238814,"ROSENSMITH, ANTHONY, RYAN",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295239960,"KARNS, SAMUEL, LLOYD",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295239960,"KARNS, SAMUEL, LLOYD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295239960,"KARNS, SAMUEL, LLOYD",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295245447,"SHEPHERD, SARAH, ROSS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295245447,"SHEPHERD, SARAH, ROSS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295246874,"PICHETTE, ASHLEE, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295246874,"PICHETTE, ASHLEE, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295246874,"PICHETTE, ASHLEE, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1295246874,"PICHETTE, ASHLEE, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295246874,"PICHETTE, ASHLEE, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295248052,"FUREY, MOLLY, ALORA",2511 OLD CORNWALLIS RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154872315,RDMG ASSOCIATES PA,,10620 PARK RD STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295248052,"FUREY, MOLLY, ALORA",10620 PARK RD STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1295249209,"FERNANDEZ VAZQUEZ, RUBEN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 174 , 194 , 259 ," $13,079.36 ",,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1295252377,"THOMASON, MICHELLE, LOWRY",129 WOODSON ST   SALISBURY NC,080,Rowan,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 38 , 105 , 147 ,$#,,
MEDICAID DIRECT,1295253219,WALGREEN CO,WALGREENS 17372,3501 GROOMETOWN RD   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1295253219,WALGREEN CO,3501 GROOMETOWN RD   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295255289,"WOLDEMARIAM, RAHEL, HAILEMICHAEL",11300 CRESTHILL DR STE 100 MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 54 , 136 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295255289,"WOLDEMARIAM, RAHEL, HAILEMICHAEL",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295256824,"CARLSON, SUMMER, DAWN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295256824,"CARLSON, SUMMER, DAWN",4709 CREEKSTONE DR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295256824,"CARLSON, SUMMER, DAWN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295259117,"ZYDONIK, JOSEE, LEIGH",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295259117,"ZYDONIK, JOSEE, LEIGH",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295259117,"ZYDONIK, JOSEE, LEIGH",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295259612,AEROFLOW UROLOGY LLC,,65 BEALE RD STE 101 ARDEN NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1295259612,AEROFLOW UROLOGY LLC,65 BEALE RD STE 101 ARDEN NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 84 , 390 , 390 ," $35,755.20 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295263051,"BAER, TIMOTHY, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295263689,"LANE, LAUREN, BOYD",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295263689,"LANE, LAUREN, BOYD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205590510,SAL C ZAMMITTI DMD MMSC PLLC AND MA,HUNTERSVILLE SMILES,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295264232,"VIDALON, CHRISTIAN, ALEXANDER",8620 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1295258648,G ABRAMS & R COHEN XIX PC,,8620 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295264232,"VIDALON, CHRISTIAN, ALEXANDER",8620 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 655 ," 1,930 "," 2,147 "," $276,015.93 ",,
MEDICAID DIRECT,1659034411,MODLIN & LONDRY VIII DDS PLLC,ELKIN DENTAL,320 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1295264372,"FAW, JEREMIAH, JAMES",320 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 61 , 103 , 274 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1295264380,"WOO, MICHELLE",306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,2266 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295264380,"WOO, MICHELLE",2266 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295265098,"ST CLAIR, TERRI, JAELIN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295265098,"ST CLAIR, TERRI, JAELIN",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 30 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295265098,"ST CLAIR, TERRI, JAELIN",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 34 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295265098,"ST CLAIR, TERRI, JAELIN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295265098,"ST CLAIR, TERRI, JAELIN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295265098,"ST CLAIR, TERRI, JAELIN",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295265379,"BAKER, MICHAEL, TODD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 97 , 98 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295265551,"ROSENBERG, MICHELLE, DEBRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",1602 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 77 , 77 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",1602 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",1101 HARTWELL ST   GARNER NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",4000 WAKE FOREST RD STE 280 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 37 , 212 , 212 ," $18,415.16 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",1000 TANDAL PL   KNIGHTDALE NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",1000 TANDAL PL   KNIGHTDALE NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 14 , 97 , 97 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",1101 HARTWELL ST   GARNER NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",515 BARBOUR RD   SMITHFIELD NC,051,Johnston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 52 , 52 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",195 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 47 , 47 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295265841,"HAMILTON, JASMINE, IESHA",515 BARBOUR RD   SMITHFIELD NC,051,Johnston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295266153,"MOSTAGHIM, ANAHITA, SENWAN",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295266153,"MOSTAGHIM, ANAHITA, SENWAN",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295266153,"MOSTAGHIM, ANAHITA, SENWAN",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1124593470,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES BALLANTYNE,7825 BALLANTYNE COMMONS PKWY STE 110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295266633,"MORGAN, AFRAYEM, BENIAMEEN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295266633,"MORGAN, AFRAYEM, BENIAMEEN",447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295266633,"MORGAN, AFRAYEM, BENIAMEEN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295267458,"WERTALIK, LARISSA, ANN",1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1295267516,"POMERANZ, TAYLOR, KERE",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295267748,"STOEN, ERICSON, ISAAK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 50 , 93 , 116 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295268803,"COSTON, TUCKER, WADE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295268803,"COSTON, TUCKER, WADE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295268803,"COSTON, TUCKER, WADE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 78 , 134 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295268803,"COSTON, TUCKER, WADE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295270767,"RAMIREZ, NICHOLAS, DANIEL",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295275535,"ELLIS, HANNAH, KERR",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 170 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295281210,"PARSONS, EMILY, ELIZABETH",77 VILCOM CENTER DR STE 320 CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295281210,"PARSONS, EMILY, ELIZABETH",77 VILCOM CENTER DR STE 320 CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295282333,"SHAH, RISHMA",DENTAL FACULTY PRACTICE 143 BRAUER HALL CB 7450 CHAPEL HILL NC,019,Chatham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1295283182,"BRADSHAW, KELLY, TODD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295283182,"BRADSHAW, KELLY, TODD",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295283182,"BRADSHAW, KELLY, TODD",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 29 , 43 , 49 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1295283182,"BRADSHAW, KELLY, TODD",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295291755,"GALLOWAY, BRANDY, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1295291755,"GALLOWAY, BRANDY, NICOLE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1295293058,"IROHA, KALU, BEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295293058,"IROHA, KALU, BEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295293058,"IROHA, KALU, BEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295293280,"GARCIA RIVERA, MIRIAN, VANESA",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295293280,"GARCIA RIVERA, MIRIAN, VANESA",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225372246,DUKE UNIVERSITY AFFILIATED PHYSICIA,DPC BLUE RIDGE,3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295294072,"SIJAPATI, NIKITA",3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 63 , 142 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295295087,"POTTER, LEXIS, KAY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295295087,"POTTER, LEXIS, KAY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295295517,"ALEXANDER, MICHAEL, PRICE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 61 , 62 , 69 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295295517,"ALEXANDER, MICHAEL, PRICE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295295517,"ALEXANDER, MICHAEL, PRICE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1295296036,"MILES, JONATHAN, ALEXANDER",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1295296036,"MILES, JONATHAN, ALEXANDER",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295296358,"RYAN, DYLAN, THOMAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295296358,"RYAN, DYLAN, THOMAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295296358,"RYAN, DYLAN, THOMAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295297117,"SLAUER, RYAN, DANIEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295297117,"SLAUER, RYAN, DANIEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295297117,"SLAUER, RYAN, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295297117,"SLAUER, RYAN, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 52 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295297117,"SLAUER, RYAN, DANIEL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 16 , 56 , 56 ,$#,,
MEDICAID DIRECT,1891002374,BLUE RIDGE HEALTHCARE MEDICAL GROUP,LENOIR FAMILY MEDICINE,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1295298024,"POGORELEC, EVAN, JACOB",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 93 , 263 , 519 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295301182,"ADOM, JOYCELYN, ABOAGYE",825 FAIRFAX AVE STE 445 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295301620,"BEARD, ELISABETH, CAITLIN",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295301620,"BEARD, ELISABETH, CAITLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1295301620,"BEARD, ELISABETH, CAITLIN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 27 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295301620,"BEARD, ELISABETH, CAITLIN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295301620,"BEARD, ELISABETH, CAITLIN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1295301620,"BEARD, ELISABETH, CAITLIN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366068397,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BOILING SPRINGS,305 W COLLEGE AVE   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 28 , 38 ,$#,,
MEDICAID DIRECT,1043963564,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - FALLSTON,5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",133 1ST AVE SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",502 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962086793,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA PEDIATRIC MEDICINE - SHELBY,1019 N LAFAYETTE ST   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 19 , 25 ,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003935750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285485383,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",2721 X RAY DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417525999,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE MOCKSVILLE,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225445331,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - THOMASVILLE,611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295302024,"BROWNING, CHARLES, WILLIAM",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295302651,"LANE, CHRISTOPHER, BRENT",CHRISTOPHER B LANE DDS PA,2306 M L KING JR BLVD   NEW BERN NC,025,Craven,1223G0001X,Dental Providers,Dentist,General Practice,1295302651,"LANE, CHRISTOPHER, BRENT",2306 M L KING JR BLVD   NEW BERN NC,025,Craven,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 33 , 97 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295305795,"LAHR, CALEB, JAMES",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 28 , 52 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295305795,"LAHR, CALEB, JAMES",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1295305795,"LAHR, CALEB, JAMES",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 95 , 213 ,$#,,
MEDICAID DIRECT,1861566747,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS& ORTHOTICS,1840 OWEN DR STE 102 FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295306496,"METZ BROWN, STEVEN",1840 OWEN DR STE 102 FAYETTEVILLE NC,026,Cumberland,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1861566747,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS& ORTHOTICS,1840 OWEN DR STE 102 FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295306496,"METZ BROWN, STEVEN",1840 OWEN DR STE 102 FAYETTEVILLE NC,026,Cumberland,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 54 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295308591,"MOSS, BRIANNA, LYNN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 21 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295308591,"MOSS, BRIANNA, LYNN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1295308591,"MOSS, BRIANNA, LYNN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 29 , 32 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295309300,"WAUGH, JORDAN, PHILIP",2145 COUNTRY CLUB RD STE 200 JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 48 , 131 ,$#,,
MEDICAID DIRECT,1295312056,ROCKSTAR HOME CARE LLC,,211 W 14TH ST STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1295312056,ROCKSTAR HOME CARE LLC,211 W 14TH ST STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 127 , 127 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295312114,"FURR, ELAINA, KATHERINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 31 , 31 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295312114,"FURR, ELAINA, KATHERINE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1295312114,"FURR, ELAINA, KATHERINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 60 , 60 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295312114,"FURR, ELAINA, KATHERINE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295312130,"ALICEAACOSTA, CATHRYN, ROSE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295313385,"HARIGOVINDSINGH, DHANUSH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 37 , 39 , 39 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295313385,"HARIGOVINDSINGH, DHANUSH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295313583,"LEE, BRITTANY, MEANS",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295315687,"SHAH, ZEEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 62 , 62 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295321255,"ELLIOTT, KATIE, NICOLE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295321255,"ELLIOTT, KATIE, NICOLE",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295321255,"ELLIOTT, KATIE, NICOLE",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1578541660,EAST CAROLINA HEALTH BERTIE,Cashie Medical Center Windsor,1403 S KING ST   WINDSOR NC,008,Bertie,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295324861,"WILLIAMS, HEATHER, EVANS",1403 S KING ST   WINDSOR NC,008,Bertie,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 22 , 23 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295324861,"WILLIAMS, HEATHER, EVANS",211 VIRGINIA RD   EDENTON NC,021,Chowan,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 22 , 36 , 36 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295326536,"JAMES, TIFFANY, JENANN",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 103 , 144 ," $32,598.94 ",,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295326536,"JAMES, TIFFANY, JENANN",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295326585,"HOWERIN, BRIAN, SCOTT",600 GRESHAM DR FL 7 NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295326585,"HOWERIN, BRIAN, SCOTT",600 GRESHAM DR FL 7 NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1295330397,ASHEVILLE GERIATRIC LLC,RICHMOND HILL ASSISTED LIVING 1,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295330397,ASHEVILLE GERIATRIC LLC,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 14 ," 2,377 "," 2,377 "," $149,123.60 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295334647,"BRACEY, KENNITRISH, NICKOLA",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,,,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1131 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295334647,"BRACEY, KENNITRISH, NICKOLA",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295334647,"BRACEY, KENNITRISH, NICKOLA",230 E PRESNELL ST   ASHEBORO NC,076,Randolph,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1295334647,"BRACEY, KENNITRISH, NICKOLA",230 E PRESNELL ST   ASHEBORO NC,076,Randolph,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 11 , 30 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295335529,"CRAFT, MELANIE, HOPE",400 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 27 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295337525,"AVES, LAUREN, ELAINE",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 33 , 43 , 110 ,$#,,
MEDICAID DIRECT,1295341006,LABORATORY CORPORATION OF AMERICA H,,125 QUEENS RD STE 370 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1295341006,LABORATORY CORPORATION OF AMERICA H,125 QUEENS RD STE 370 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 15 , 27 , 49 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295341667,"MEALEY, NICOLE, ANNE",2909 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295341667,"MEALEY, NICOLE, ANNE",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295341667,"MEALEY, NICOLE, ANNE",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295342145,LOVINGCARE HOMECARE SERVICE INC,,2973 N CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1295342145,LOVINGCARE HOMECARE SERVICE INC,2973 N CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 71 ," 13,620 "," 14,258 "," $1,133,176.29 ",,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295342566,"BERTRAND, ARIANA, MARGARET ALIASSO",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 36 , 38 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295342566,"BERTRAND, ARIANA, MARGARET ALIASSO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295342566,"BERTRAND, ARIANA, MARGARET ALIASSO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295342566,"BERTRAND, ARIANA, MARGARET ALIASSO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295343515,"HUGHES, LAUREN, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1326028978,CHATUGE REGIONAL HOSPITAL INC,CHATUGE REGIONAL HOSPITAL,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295346161,"MARTIN, BRITTANY, LAUREN",120 RIVER ST STE B HIAWASSEE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 33 , 34 ,$#,,
MEDICAID DIRECT,1326028978,CHATUGE REGIONAL HOSPITAL INC,CHATUGE REGIONAL HOSPITAL,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295346161,"MARTIN, BRITTANY, LAUREN",103 CHURCH ST   HIAWASSEE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1659538908,"FOX, NOEL, FREDERICK",~,601 S YORK ST   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1295350023,"FOX, DANI, YANG",601 S YORK ST   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 101 , 135 , 738 ," $46,185.64 ",,
MEDICAID DIRECT,1568641165,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1200 VILLAGE HARBOR DR   LAKE WYLIE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295350494,"HELD, EDWARD, LAWSON",519 NAUTICAL DR STE 100A CLOVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295353126,"GURAM, NAVNEET, KAUR",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 164 , 334 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295354488,"ERBOWOR BECKSEN, ZITA, ANLUMUAH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1295354488,"ERBOWOR BECKSEN, ZITA, ANLUMUAH",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295354512,"BALDWIN, NICOLLETTE, ARIELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295354512,"BALDWIN, NICOLLETTE, ARIELLE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 60 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295354579,"NOLAN, RYAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295354579,"NOLAN, RYAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295354579,"NOLAN, RYAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295354579,"NOLAN, RYAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295354579,"NOLAN, RYAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1295354579,"NOLAN, RYAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1942251251,WESTERN WAKE PEDIATRICS PA,WESTERN WAKE PEDIATRICS PA,940 SE CARY PKWY STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1295354868,"STEWART, TIFFANY, ALEXIS",940 SE CARY PKWY STE 200 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 32 , 55 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1295355709,"REGNERY, MARY, KATHERINE",404 S SUTHERLAND AVE   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1295355709,"REGNERY, MARY, KATHERINE",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295357853,"HERRING, BRANDY",15 RAWLS RD STE 100 ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 12 , 34 ,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295357853,"HERRING, BRANDY",15 RAWLS RD STE 100 ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295358505,"MUSICK, STEFANIE, LAINE",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295358505,"MUSICK, STEFANIE, LAINE",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295358505,"MUSICK, STEFANIE, LAINE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295358505,"MUSICK, STEFANIE, LAINE",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295358505,"MUSICK, STEFANIE, LAINE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 78 , 83 ,$#,,
MEDICAID DIRECT,1770515272,INTRACOASTAL INTERNAL MEDICINE,~,2580 PICKARD RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295358547,"PERKINS, JENNY, LEE TREST",2580 PICKARD RD   WILMINGTON NC,065,New Hanover,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295359123,"ANDREWS, JENNA, LEE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295359123,"ANDREWS, JENNA, LEE",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 68 , 180 ,$#,,
MEDICAID DIRECT,1295360196,BEYOND MEASURE CARE INC,,1290 E ARLINGTON BLVD STE 108 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1295360196,BEYOND MEASURE CARE INC,1290 E ARLINGTON BLVD STE 108 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 4,305 "," 4,606 "," $393,613.00 ",,
MEDICAID DIRECT,1336188184,MIDCAROLINA PEDIATRICS,MIDCAROLINA PEDIATRICS,2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295361400,"AMIN, CHANDNI, KOTHADIA",2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 13 , 38 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295364867,"KLEMANN, KYLIE, HAYES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 36 ,$#,,
MEDICAID DIRECT,1295365013,CENTRAL TRANSPORT SERVICES OF CLEVE,,109 HEINZ RD   GROVER NC,023,Cleveland,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1295365013,CENTRAL TRANSPORT SERVICES OF CLEVE,109 HEINZ RD   GROVER NC,023,Cleveland,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 43 ," 1,672 "," 1,726 "," $89,304.40 ",,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295365377,"SHELTON, KAITLYN, MARIE",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295365377,"SHELTON, KAITLYN, MARIE",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 21 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295368553,"STITT, JANELLE, RASHAWN",845 CHURCH ST N STE 203 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 34 ,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295373181,"RABIN, AMANDA, MORCOM",4140 RAMSEY ST STE 110 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295374692,"WETZEL, MANDA, RAE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1295375426,"HIXSON, SHELBY, WOLFE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 21 , 23 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1295375426,"HIXSON, SHELBY, WOLFE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1295375426,"HIXSON, SHELBY, WOLFE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 46 , 55 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295375426,"HIXSON, SHELBY, WOLFE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295375426,"HIXSON, SHELBY, WOLFE",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295375426,"HIXSON, SHELBY, WOLFE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295376739,"GIBSON, EVA",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 38 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295379204,"RICHARDSON, TIMNECIA, ARRINGTON",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 275 ," 1,698 "," 1,702 "," $39,102.24 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295379204,"RICHARDSON, TIMNECIA, ARRINGTON",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295379204,"RICHARDSON, TIMNECIA, ARRINGTON",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1008 BIG OAK CT STE A KNIGHTDALE NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 40 , 40 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1008 BIG OAK CT STE A KNIGHTDALE NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1008 BIG OAK CT STE A KNIGHTDALE NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1008 BIG OAK CT STE A KNIGHTDALE NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 25 , 49 , 50 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 17 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1295381648,"STEVENSON, KRISTEN, ZANLUNGHI",1008 BIG OAK CT STE A KNIGHTDALE NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295382059,"WASHINGTON, KRISTINA, MARIE",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295382059,"WASHINGTON, KRISTINA, MARIE",1225 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295382059,"WASHINGTON, KRISTINA, MARIE",1021 MOREHEAD MEDICAL DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295382059,"WASHINGTON, KRISTINA, MARIE",1021 MOREHEAD MEDICAL DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295383644,"ELBERT, TRAVIS, GUSTAFSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1295385227,WH PHARMACY 1 LLC,DRUGCO DISCOUNT PHARMACY,1507 N MAIN ST   TARBORO NC,033,Edgecombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1295385227,WH PHARMACY 1 LLC,1507 N MAIN ST   TARBORO NC,033,Edgecombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 37 , 129 , 211 ," $13,278.38 ",,
MEDICAID DIRECT,1295385227,WH PHARMACY 1 LLC,DRUGCO DISCOUNT PHARMACY,1507 N MAIN ST   TARBORO NC,033,Edgecombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1295385227,WH PHARMACY 1 LLC,1507 N MAIN ST   TARBORO NC,033,Edgecombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1295385227,WH PHARMACY 1 LLC,DRUGCO DISCOUNT PHARMACY,1507 N MAIN ST   TARBORO NC,033,Edgecombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295385227,WH PHARMACY 1 LLC,1507 N MAIN ST   TARBORO NC,033,Edgecombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 13 , 34 , 76 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295386886,"WOODSON, AUBREY, MICHELLE",3000 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 35 , 36 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295386886,"WOODSON, AUBREY, MICHELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 27 , 30 ,$#,,
MEDICAID DIRECT,1295387637,EXCEL EYECARE OD PA,,13749 STEELE CREEK RD STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295387637,EXCEL EYECARE OD PA,13749 STEELE CREEK RD STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1295387637,EXCEL EYECARE OD PA,,14154 STEELE CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295387637,EXCEL EYECARE OD PA,14154 STEELE CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#,#, 12 ,$#,,
MEDICAID DIRECT,1245779123,ROTH POWELL & MANN DDS PA,~,301 GLENWOOD AVE STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295387835,"ATHERTON, TAYLOR, FULTON",301 GLENWOOD AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 138 , 188 , 710 ," $29,583.56 ",,
MEDICAID DIRECT,1407350465,ROTH & POWELL III DDS PA,~,3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295387835,"ATHERTON, TAYLOR, FULTON",3110 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1386928083,KYLE J ROTH III DDS PA,CAROLINA DENTAL OF GOLDSBORO,2720 GRAVES DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1295387835,"ATHERTON, TAYLOR, FULTON",2720 GRAVES DR   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 663 ," 1,192 "," 4,375 "," $212,392.97 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1295392512,"SHIPLEY, ADAM, TAYLOR",,22725 HIGHWAY 76 E   CLINTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1295392512,"SHIPLEY, ADAM, TAYLOR",22725 HIGHWAY 76 E   CLINTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295392512,"SHIPLEY, ADAM, TAYLOR",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1295392512,"SHIPLEY, ADAM, TAYLOR",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689944514,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES PINEHURST,7 REGIONAL CIR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1295392595,"CRADIC, AMY, ELIZABETH",7 REGIONAL CIR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 118 , 127 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295393098,"RITCHIE, CHRISTOPHER, WILLIAM",1450 MATTHEWS TOWNSHIP PKWY STE 350 MATTHEWS NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 20 , 39 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1295393098,"RITCHIE, CHRISTOPHER, WILLIAM",1450 MATTHEWS TOWNSHIP PKWY STE 350 MATTHEWS NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1942265301,WALTERS SURGICAL ASSOC PA,~,220 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1295396364,"LIN, ANDREW, CHIA HSUEH",220 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 121 , 124 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295398329,"ROEBKE, AUSTIN, JEROME",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295399871,"INGOLD, BRIAN, CHRISTOPHER",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295399871,"INGOLD, BRIAN, CHRISTOPHER",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 34 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295401545,"GRIFFIN, JAMES, FORREST",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295401545,"GRIFFIN, JAMES, FORREST",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 40 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295401545,"GRIFFIN, JAMES, FORREST",197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295403137,CCJ ADULT CARE II LLC,OPENVIEW RETIREMENT CENTER,112 PONY BARN RD   LAWNDALE NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295403137,CCJ ADULT CARE II LLC,112 PONY BARN RD   LAWNDALE NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 22 ," 4,765 "," 4,809 "," $329,609.39 ",,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295409035,"ROCKERS TYNI, MARY, MARGARET",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 14 , 37 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295409035,"ROCKERS TYNI, MARY, MARGARET",401 KEISLER DR STE 101 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 42 ,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295410520,"GARCIA SANCHEZ, CLAUDIA",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 155 , 155 , 178 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1295412765,"ROBINSON, ALEXANDRIA, FAITH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033710637,NOURISH ADOLESCENT WELLNESS PLLC,,307 S SALEM ST STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1295413458,"GANDSEY, HALEY, GRACE",307 S SALEM ST STE 100 APEX NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1295413458,"GANDSEY, HALEY, GRACE",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 14 , 35 ,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295414233,"DUTCH, ANNALESE, RAYEN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295414233,"DUTCH, ANNALESE, RAYEN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 13 , 25 , 25 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9628 REA RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295418010,"WLODARCZYK, MEGAN, LAURA",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2901 WESLEY CHAPEL STOUTS RD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1295418010,"WLODARCZYK, MEGAN, LAURA",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3310 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295418010,"WLODARCZYK, MEGAN, LAURA",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295418010,"WLODARCZYK, MEGAN, LAURA",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295418010,"WLODARCZYK, MEGAN, LAURA",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295424950,"WILLMAN, TAYLOR, NICOLE",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice," 3,186 "," 3,611 "," 18,270 "," $502,712.12 ",,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295424950,"WILLMAN, TAYLOR, NICOLE",2620 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 239 , 257 ," 1,804 "," $138,967.35 ",,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295427052,"BROADWELL, MADISON, CHRISTINE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 178 , 883 ," 1,969 "," $14,939.72 ",,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",2805 S MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 37 ,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295428779,"SCHLAPPI, KATHRYN, ELIZABETH",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 182 , 399 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1295429827,"BURNHAM, MEGAN, TERESE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1295429827,"BURNHAM, MEGAN, TERESE",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295429827,"BURNHAM, MEGAN, TERESE",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1295434298,"WOODARD, ANASTASIYA, VALERY",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1295434298,"WOODARD, ANASTASIYA, VALERY",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295434298,"WOODARD, ANASTASIYA, VALERY",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295434298,"WOODARD, ANASTASIYA, VALERY",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295438638,"CHAPLINSKIY, ALLITA, BRAGA",825 FAIRFAX AVE STE 445 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295439586,"STEELE, JASON, WAYNE",1995 BETHABARA RD   WINSTON-SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295440162,"RUSH, AMBREDAWN, TACARA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 13 ,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295441202,"AGBAI, VICTOR, UDE",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295441202,"AGBAI, VICTOR, UDE",1202 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 17 , 38 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295441202,"AGBAI, VICTOR, UDE",1202 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1295441202,"AGBAI, VICTOR, UDE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 25 , 73 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295448348,"SCHWARZ, KELSEY, MARIE",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 48 , 48 ,$#,,
MEDICAID DIRECT,1235527151,DOWN EAST DIABETOLOGY PA,DOWN EAST DIABETOLOGY PA,2609 W ARLINGTON BLVD STE 106 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295450351,"TUCCI, ERIN, THERESA",2609 W ARLINGTON BLVD STE 106 GREENVILLE NC,074,Pitt,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 24 , 28 , 28 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295450989,"KERN, RHONDA, MARIE",615 RIDGE RD   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 25 , 25 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295450989,"KERN, RHONDA, MARIE",615 RIDGE RD   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295451797,TRANSFORMATIVE HOME CARE LLC,,115 E MAIN ST STE 17 WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1295451797,TRANSFORMATIVE HOME CARE LLC,115 E MAIN ST STE 17 WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,#," 1,010 "," 1,010 "," $62,424.84 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295452795,"SENGUL, YILDIZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295452795,"SENGUL, YILDIZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295452795,"SENGUL, YILDIZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295452795,"SENGUL, YILDIZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295452795,"SENGUL, YILDIZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295452795,"SENGUL, YILDIZ",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 591 , 918 , 969 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295456572,"CROSS, CASSANDRA, LYNN",300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295456572,"CROSS, CASSANDRA, LYNN",300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295459709,"HUNGERFORD, BROOKE, ALEXANDRA",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184302655,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT ST STEPHENS ELEMENTARY,684 30TH ST NE   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295460012,"LOR, PANGKALAMA",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1851020457,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT ARNDT MIDDLE,3350 34TH STREET DR NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295460012,"LOR, PANGKALAMA",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295464493,"YIP, JOEY, POK SI",101 DELTA PARK DR   SHELBY NC,023,Cleveland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1295468221,"GULLEDGE, WANA, MICHELLE",480 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 51 , 127 ,$#,,
MEDICAID DIRECT,1962544197,CHARLES R DISDIER DDS PA,IMMEDIATE DENTAL CARE,1468 TARBORO ST W STE F WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1295468700,"SMITH, JACK, SHEA",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 672 , 802 ," 3,695 "," $197,691.56 ",,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295471159,"WOOLARD, JESSICA, RENEE",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 83 , 146 , 151 ," $13,050.48 ",,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295471159,"WOOLARD, JESSICA, RENEE",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295480952,"ACOSTA, MARY, ELIZABETH",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 36 , 104 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1295480952,"ACOSTA, MARY, ELIZABETH",2501 LINCOLNTON HWY   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295481356,"MATEO, MARIANA, CARMEN",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 149 , 326 ,$#,,
MEDICAID DIRECT,1205865979,EDGEWATER MEDICAL CENTER AND URGENT,EDGEWATER MEDICAL CENTER AND URGENT CARE,,,Unknown,193400000X,Group,Single Specialty,,1295481356,"MATEO, MARIANA, CARMEN",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 ,#, 12 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295481802,"LANCASTER, MADISON, GAGE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295483816,"ZILL, EMILY",2718 HENRY ST   GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1821419508,KIDZCARE PEDIATRICS PC,~,5244B N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295486223,"JAIN, AASHNA",5244B N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154179638,KIDZCARE PEDIATRICS PC,,904 MORVEN RD STE 100 WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1295486223,"JAIN, AASHNA",904 MORVEN RD STE 100 WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 49 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295486413,"SALAS, ERIN, BIRMINGHAM",1735 TODDVILLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1295486413,"SALAS, ERIN, BIRMINGHAM",1735 TODDVILLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 113 , 113 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295486413,"SALAS, ERIN, BIRMINGHAM",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 444 , 444 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1295486413,"SALAS, ERIN, BIRMINGHAM",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295486413,"SALAS, ERIN, BIRMINGHAM",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295486413,"SALAS, ERIN, BIRMINGHAM",215 LASH DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1295486413,"SALAS, ERIN, BIRMINGHAM",215 LASH DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457320756,THE PEDIATRIC CENTER,THE PEDIATRIC CENTER PLLC,1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295487585,"BRADSHAW, BRITTANY",1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 20 ,$#,,
MEDICAID DIRECT,1689445520,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY LEGACY PEDIATRICS,556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295488179,"BARRETT, SAMANTHA, THOMASON",556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 42 ,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295488179,"BARRETT, SAMANTHA, THOMASON",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 192 , 245 ,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1295491827,"SANE, ANNA, BAKER",181 DANIEL RD   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 52 , 70 , 90 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295495448,"DELAROSA, REBECCA, ANNE",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 21 , 50 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295498897,"MCMICHAEL, BAYLEY, WALSH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 66 , 94 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295498897,"MCMICHAEL, BAYLEY, WALSH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295500510,"HUDSON, CARALYN, REBEKAH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 21 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295500510,"HUDSON, CARALYN, REBEKAH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295500510,"HUDSON, CARALYN, REBEKAH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 26 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295510477,"DOLMAN, KELSEY, ELIZABETH",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295510477,"DOLMAN, KELSEY, ELIZABETH",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295510477,"DOLMAN, KELSEY, ELIZABETH",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295510477,"DOLMAN, KELSEY, ELIZABETH",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295511145,"JAMES, NOEMI, ALICEA",257 HOSPITAL DR NE STE 101 BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 43 , 98 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295515542,"GAYNES, HELEN, ELIZABETH",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 27 ,$#,,
MEDICAID DIRECT,1093883852,CAROLINA FAMILY HEALTH CENTERS INC,HARVEST FAMILY HEALTH CENTER,8250 NC 58 S   ELM CITY NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295515542,"GAYNES, HELEN, ELIZABETH",8250 NC 58 S   ELM CITY NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295515542,"GAYNES, HELEN, ELIZABETH",303 GREEN ST E # A WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 108 , 190 , 202 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295560597,"WOOD, WHITNEY, REBECCA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1295599439,"KIM, GRACE, MEEHYUN",197 RIVERVIEW STREET   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1295599439,"KIM, GRACE, MEEHYUN",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 35 , 35 ,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295700482,"SANTIAGO-RODRIQUEZ, TIRZA, SHANNY",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,1216 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295700573,"BOYD, LEE, ANN",1216 6TH AVE W   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 83 , 84 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295700573,"BOYD, LEE, ANN",1216 6TH AVE W   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 74 , 78 ,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1295701019,"FOX, DAVID, SCOTT",1717 SHIPYARD BLVD STE 350 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 44 , 74 ,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1295701019,"FOX, DAVID, SCOTT",701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 170 , 349 , 676 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295701498,"MORGAN, GARY, LON",5010 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 36 , 109 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1295703338,"SANGMUAH, EUGENE, BOWA",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1295703338,"SANGMUAH, EUGENE, BOWA",434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1528376712,MATTHEWS INTERNAL MEDICINE PLLC,MATTHEWS INTERNAL MEDICINE PLLC,434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295703338,"SANGMUAH, EUGENE, BOWA",101 E MATTHEWS ST STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 92 , 217 ,$#,,
MEDICAID DIRECT,1528376712,MATTHEWS INTERNAL MEDICINE PLLC,MATTHEWS INTERNAL MEDICINE PLLC,434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295703338,"SANGMUAH, EUGENE, BOWA",434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 66 , 109 ,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1295703338,"SANGMUAH, EUGENE, BOWA",434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295703338,"SANGMUAH, EUGENE, BOWA",~,434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1295703338,"SANGMUAH, EUGENE, BOWA",434 N TRADE ST STE 104 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295704716,"WILLIAMS, SCOTT, SETH",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1295705374,"MULLINAX, SHEENA, FREEMAN",TALK WITH ME INC,1040 GARDEN CLUB WAY   LELAND NC,010,Brunswick,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1295705374,"MULLINAX, SHEENA, FREEMAN",1040 GARDEN CLUB WAY   LELAND NC,010,Brunswick,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 60 , 60 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295707909,"SMITH, TERRI, SELLS",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 68 , 147 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295708592,"BALOCH, MOHAMMAD, HAROON",3126 BLUE RIDGE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 122 , 164 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295708592,"BALOCH, MOHAMMAD, HAROON",3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 160 , 258 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295709426,"SIEGFRIED, BRETT, HARRIS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295709426,"SIEGFRIED, BRETT, HARRIS",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295710275,"GANDHI, SANJAY, KUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295710275,"GANDHI, SANJAY, KUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 30 , 37 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295710648,"KRIBBS, SCOTT, BENDON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 68 , 71 , 94 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295710648,"KRIBBS, SCOTT, BENDON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 30 , 41 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295711398,"ROMBLAD, KATRINA, COLE",5010 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 38 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295711398,"ROMBLAD, KATRINA, COLE",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295712305,"PATEL, RAKESH, C",1809 BRENNER AVE STE 202 SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295712305,"PATEL, RAKESH, C",1809 BRENNER AVE STE 202 SALISBURY NC,080,Rowan,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 44 , 62 , 87 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295712305,"PATEL, RAKESH, C",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 65 , 120 , 174 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,1809 BRENNER AVE STE 202 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295712305,"PATEL, RAKESH, C",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295712990,"NOVACK, TRACY, LEAH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295712990,"NOVACK, TRACY, LEAH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295714327,"ANAGNOS, DAMON, PHILLIP",BLUE RIDGE PLASTIC SURGERY GROUP,141 DOCTORS DR   BOONE NC,095,Watauga,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,1295714327,"ANAGNOS, DAMON, PHILLIP",141 DOCTORS DR   BOONE NC,095,Watauga,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295714517,"REPASS, KAREN, ELAINE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295714517,"REPASS, KAREN, ELAINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 51 , 51 ,$#,,
MEDICAID DIRECT,1649216631,PIEDMONT EAR NOSE AND THROAT PA,PIEDMONT EAR NOSE AND THROAT ASSOCIATES,110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295715563,"MCGUIRT, WILLIAM, FREDERICK",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 169 , 306 , 472 ," $26,882.88 ",,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1295715704,"BERES, MARY EMMA, HOLLEMAN",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 164 , 295 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295715951,"PORCELLI, PETER, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 15 , 102 , 102 ," $17,303.34 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295717767,"SHUSTERMAN, DOUGLAS, JOSEPH",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 429 , 443 , 547 ," $13,167.16 ",,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295717767,"SHUSTERMAN, DOUGLAS, JOSEPH",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1295717767,"SHUSTERMAN, DOUGLAS, JOSEPH",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 459 , 511 , 623 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295718328,"KAMMIRE, LESLIE, DANESE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 63 , 75 , 86 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295718609,"TULLOCK, JULIE",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 91 , 96 , 134 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1295718609,"TULLOCK, JULIE",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295718609,"TULLOCK, JULIE",2311 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,152W00000X,Eye and Vision Services Providers,Optometrist,, 37 , 41 , 46 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1295718708,"GROVES, NICOLE, KRISTINE",50 HOSPITAL DR STE 5D HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 35 , 53 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295718997,"EPLING, EMILY, SARTAIN",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295718997,"EPLING, EMILY, SARTAIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295719557,"RATTINI, KAREN, HUGHES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295719557,"RATTINI, KAREN, HUGHES",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295719631,"WAGNER, ALAN, LEWIS",1855 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 20 , 55 ,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295719631,"WAGNER, ALAN, LEWIS",809 GREENBRIER PKWY STE 109 CHESAPEAKE VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 36 ,$#,,
MEDICAID DIRECT,1639252000,RETINA & VITREOUS CENTER PC,WAGNER MACULA AND RETINA CENTER,6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295719631,"WAGNER, ALAN, LEWIS",6160 KEMPSVILLE CIR STE 120B NORFOLK VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1295719920,"LOFTUS, HOS, CYRUS",202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 12 ,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1295720696,"SMIR, BASSAM, NUMAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1295720696,"SMIR, BASSAM, NUMAN",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1295721710,"DODGE, ROBERT, THOMAS",10 SUNNYBROOK RD CLINIC B RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 17 , 30 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295722767,"HECKEL, MARK, CAMPBELL",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 212 , 310 , 424 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295722767,"HECKEL, MARK, CAMPBELL",2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 26 , 36 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,4235 S NEW HOPE RD STE F GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295722767,"HECKEL, MARK, CAMPBELL",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295723062,"RHODES, CHARLES, WINSTON WOLFGANG",8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 35 , 49 ,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295723062,"RHODES, CHARLES, WINSTON WOLFGANG",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1295726032,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDINGS,1801 1ST AVE S   BIRMINGHAM AL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1295726032,LABORATORY CORPORATION OF AMERICA H,1801 1ST AVE S   BIRMINGHAM AL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 24 , 37 , 128 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295726131,"SANG JR, CHARLIE, JOSEPH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295726131,"SANG JR, CHARLIE, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295726131,"SANG JR, CHARLIE, JOSEPH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 73 , 84 , 191 ," $10,926.81 ",,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295726131,"SANG JR, CHARLIE, JOSEPH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 20 , 22 , 22 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295726131,"SANG JR, CHARLIE, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 42 , 47 , 47 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295726131,"SANG JR, CHARLIE, JOSEPH",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295726131,"SANG JR, CHARLIE, JOSEPH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295728020,"HAMMOND, JOB, LAMBETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1295728608,"FRIEDLAND, BETH, RENA",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 29 , 33 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1295728608,"FRIEDLAND, BETH, RENA",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295728608,"FRIEDLAND, BETH, RENA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 34 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6512 SIX FORKS RD STE 105 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295728608,"FRIEDLAND, BETH, RENA",6512 SIX FORKS RD STE 105 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 23 , 26 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1295728608,"FRIEDLAND, BETH, RENA",781 AVENT FERRY RD STE 202 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1295729135,"BOWMAN, JANE, EVERHART",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1295729697,"HOFFMAN, TIMOTHY, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295729697,"HOFFMAN, TIMOTHY, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 23 , 29 , 73 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295729697,"HOFFMAN, TIMOTHY, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 39 , 54 , 71 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295729697,"HOFFMAN, TIMOTHY, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 21 , 23 , 71 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1295730083,"MILLER, MAURICE, MONROE",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295730174,"APOLTAN, IOANA, MIHAELA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295730174,"APOLTAN, IOANA, MIHAELA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 118 , 118 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295730430,"FALTER JR, RICHARD, THOMAS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1295730430,"FALTER JR, RICHARD, THOMAS",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295730430,"FALTER JR, RICHARD, THOMAS",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295730430,"FALTER JR, RICHARD, THOMAS",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,,,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295731214,"SALOPEK, MARK, DAVID",1107 WALNUT ST STE 100 CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295731214,"SALOPEK, MARK, DAVID",1105 WALNUT ST STE 100 CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295731271,"GIRMAY, AREGAI, ABAY",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 83 , 159 , 182 ,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295731271,"GIRMAY, AREGAI, ABAY",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295731271,"GIRMAY, AREGAI, ABAY",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295731438,"BROOKS, HIRAM, BROWNLEE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295731438,"BROOKS, HIRAM, BROWNLEE",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295731438,"BROOKS, HIRAM, BROWNLEE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295731438,"BROOKS, HIRAM, BROWNLEE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295732691,"HALL, ANDREW, JUSTIN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 ,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295733251,"YOCUM, RANDY, EDWARD",7608 PURFOY RD   FUQUAY VARINA NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912955337,HANDSCHUMACHER ENTERPRISES OD PA,FAMILY EYECARE CENTER,7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295734739,"HANDSCHUMACHER, JEFFREY, DAVID",7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 14 , 30 ,$#,,
MEDICAID DIRECT,1912955337,HANDSCHUMACHER ENTERPRISES OD PA,FAMILY EYECARE CENTER,7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295734739,"HANDSCHUMACHER, JEFFREY, DAVID",7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 24 , 24 , 41 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1295736882,"LUGUS, THOMAS, REIN",207 LINDA VISTA DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 36 , 50 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295736882,"LUGUS, THOMAS, REIN",207 LINDA VISTA DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 29 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295737203,"BROSNAN, RHODA, BROOKER",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295737203,"BROSNAN, RHODA, BROOKER",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295737203,"BROSNAN, RHODA, BROOKER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 57 , 73 , 88 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1295737203,"BROSNAN, RHODA, BROOKER",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295737203,"BROSNAN, RHODA, BROOKER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295737203,"BROSNAN, RHODA, BROOKER",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295741726,"NEIGHBORS, JOSEPH, DONWELL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295741726,"NEIGHBORS, JOSEPH, DONWELL",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1295741726,"NEIGHBORS, JOSEPH, DONWELL",,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1295741726,"NEIGHBORS, JOSEPH, DONWELL",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 18 , 27 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295742054,"GAST, TIMOTHY, MICHAEL",220 FOUST ST STE C ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295742054,"GAST, TIMOTHY, MICHAEL",2905 N ELM ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295742054,"GAST, TIMOTHY, MICHAEL",101 MEDICAL CIR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295742054,"GAST, TIMOTHY, MICHAEL",923 N 2ND ST STE 201 ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1437860889,PINNACLE URGENT CARE PLLC,,1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1295742054,"GAST, TIMOTHY, MICHAEL",1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 44 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295742054,"GAST, TIMOTHY, MICHAEL",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1295742054,"GAST, TIMOTHY, MICHAEL",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 64 , 69 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295745073,"WEST, DARREN, RICHARD",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003827155,HARNETT COUNSELING SERVICES PC,~,1186 N MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295748432,"MCGEE, MELISSA, GRIFFIN",1186 N MAIN ST   LILLINGTON NC,043,Harnett,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295749612,"PERSAUD-KRAUT, ARLENE, NALINI",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1295749612,"PERSAUD-KRAUT, ARLENE, NALINI",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 38 , 46 ," $13,783.33 ",,
MEDICAID DIRECT,1295751345,MED-TRANS CORPORATION,~,300 AIRPORT RD   GREENEVILLE TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1295751345,MED-TRANS CORPORATION,300 AIRPORT RD   GREENEVILLE TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295752145,"KUO, ANTHONY",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295752145,"KUO, ANTHONY",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 30 , 36 , 42 ,$#,,
MEDICAID DIRECT,1295752442,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1242,250 HIGHLANDS SQUARE DR   HENDERSONVILLE NC,045,Henderson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1295752442,WAL-MART STORES EAST LP,250 HIGHLANDS SQUARE DR   HENDERSONVILLE NC,045,Henderson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 17 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295756724,"JACOBS, DAVID, GEORGE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295757169,"OBRIEN, UMA, NADIMINTI",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295757169,"OBRIEN, UMA, NADIMINTI",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295759330,"DINGELDEIN, STEVEN, ANDREW",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 127 , 151 , 183 ,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295759330,"DINGELDEIN, STEVEN, ANDREW",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295759538,"BENNER, ALISHA, BETH",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295759538,"BENNER, ALISHA, BETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295759538,"BENNER, ALISHA, BETH",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295759538,"BENNER, ALISHA, BETH",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295759538,"BENNER, ALISHA, BETH",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295759538,"BENNER, ALISHA, BETH",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295759983,"FICENEC, MICHAEL, CHRISTOPHER",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 19 , 32 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295761351,"LAPUENTE, MICHAEL, ANTHONY",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295761351,"LAPUENTE, MICHAEL, ANTHONY",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 13 , 24 , 29 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295761351,"LAPUENTE, MICHAEL, ANTHONY",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295761351,"LAPUENTE, MICHAEL, ANTHONY",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295761351,"LAPUENTE, MICHAEL, ANTHONY",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295761351,"LAPUENTE, MICHAEL, ANTHONY",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295761351,"LAPUENTE, MICHAEL, ANTHONY",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1295761443,"ABERCROMBIE, JOHN, FREDERICK",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1295761781,"NERNEY, MICHAEL, EDWARD",145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 32 , 45 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295763746,"COURTNEY, ARDITH, MARIE",1225 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 44 , 70 , 70 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295764165,"JOHN, KELLY, DEANNE",8936 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295765014,MAXIM HEALTHCARE SERVICES,Maxim Healthcare Services Inc,300 RIDGEFIELD CT STE 312 ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,1295765014,MAXIM HEALTHCARE SERVICES,300 RIDGEFIELD CT STE 312 ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1295765014,MAXIM HEALTHCARE SERVICES,Maxim Healthcare Services Inc,300 RIDGEFIELD CT STE 312 ASHEVILLE NC,011,Buncombe,251J00000X,Agencies,Nursing Care,,1295765014,MAXIM HEALTHCARE SERVICES,300 RIDGEFIELD CT STE 312 ASHEVILLE NC,011,Buncombe,251J00000X,Agencies,Nursing Care,, 28 ," 3,353 "," 3,552 "," $1,986,669.75 ",,
MEDICAID DIRECT,1295766111,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 305&330A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1295766111,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 305&330A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 113 ," 16,788 "," 17,163 "," $2,033,814.24 ",,
MEDICAID DIRECT,1295766111,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 305&330A CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1295766111,BAYADA HOME HEALTH CARE INC,8801 J M KEYNES DR STE 305&330A CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 43 ," 6,995 "," 7,717 "," $4,051,919.19 ",,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1295766756,"TU, SONG-YIH",155 MEMORIAL DR EMERGENCY DEPT PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 65 , 97 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1295766756,"TU, SONG-YIH",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1295766756,"TU, SONG-YIH",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1295766756,"TU, SONG-YIH",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1295766756,"TU, SONG-YIH",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 21 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1295766756,"TU, SONG-YIH",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 25 , 36 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1295766756,"TU, SONG-YIH",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 19 , 22 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295766897,"SWAN, CAROL, FARPOUR",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295766996,"DENNY, ROGER, ROSWELL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 28 , 30 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,934 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295767028,"PENO-GREEN, LAURA, ANN",934 COX RD   GASTONIA NC,036,Gaston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 93 , 197 , 294 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295767028,"PENO-GREEN, LAURA, ANN",2525 COURT DR   GASTONIA NC,036,Gaston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 48 , 66 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 50 , 60 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 CLAYTON BLVD STE 102 CLAYTON NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770182933,WAKE PET SERVICES LLC,,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 22 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770182933,WAKE PET SERVICES LLC,,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295768596,"BORTOFF, GREGORY, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295770618,"GILMER, BENJAMIN, PAUL",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295770618,"GILMER, BENJAMIN, PAUL",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 53 , 79 ,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295770618,"GILMER, BENJAMIN, PAUL",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 26 , 26 ,$#,,
MEDICAID DIRECT,1457541062,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT CANE CREEK,1542 CANE CREEK RD   FLETCHER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295770618,"GILMER, BENJAMIN, PAUL",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295771079,"STARNES, AMY, ELIZABETH",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295771079,"STARNES, AMY, ELIZABETH",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295771079,"STARNES, AMY, ELIZABETH",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 40 , 40 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295772341,"PRICE, KEVIN, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 51 , 124 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295772341,"PRICE, KEVIN, DAVID",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 123 , 326 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295772341,"PRICE, KEVIN, DAVID",512 VILLAGE RD STE 103 SHALLOTTE NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609528215,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH OCEANSIDE FAMILY MEDICINE,512 VILLAGE RD STE 103 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1295772341,"PRICE, KEVIN, DAVID",512 VILLAGE RD STE 103 SHALLOTTE NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295773646,"OTTERBERG, DUSTIN, JAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295773646,"OTTERBERG, DUSTIN, JAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 26 ,$#,,
MEDICAID DIRECT,1033622618,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CANCER INSTITUTE,,,Unknown,193200000X,Group,Multi-Specialty,,1295774164,"MOREB, JAN, SULIMAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295774164,"MOREB, JAN, SULIMAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295774164,"MOREB, JAN, SULIMAN",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295774164,"MOREB, JAN, SULIMAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 30 , 94 , 120 ,$#,,
MEDICAID DIRECT,1801989504,AMSOL PHYSICIANS OF ELKIN NC PLLC,AMSOL PHYSICIANS OF ELKIN NC PLLC,180 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1295774750,"DE VILMORIN, NINA, LISETTE",180 PARKWOOD DR   ELKIN NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295774925,"DAVIS, BARRY, RODGERS",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295778306,"CRAIG, MICHAEL, WILSON",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 48 , 84 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",1212 SPRUCE ST   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295779189,"BEAL, ELIZABETH, BOWMAN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083277735,FOREFRONT DERMATOLOGY SC,~,6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295780849,"FERRITTO, FRANK, JOSEPH",6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 59 , 82 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1295780948,"WEHRUNG, KRISTIN, MARY",720 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295780948,"WEHRUNG, KRISTIN, MARY",720 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1508269093,PEDIATRIC EYE CARE & STRABISMUS PC,,1674 CRANIUM DR STE 104 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295783223,"GOSHORN, ERIN, BOOHER",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1942478383,DUPLIN GENERAL HOSPITAL INC,DUPLIN GENERAL HOSPITAL INC,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1295785749,"HARTSELL, THERESA, LYNN",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295785749,"HARTSELL, THERESA, LYNN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295786143,"HAAS, KEVAN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295786481,"BEACHAM, HOPE, DUET",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 34 , 34 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295786713,"GOODMAN, BRENDA, FAYE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295786713,"GOODMAN, BRENDA, FAYE",16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295786713,"GOODMAN, BRENDA, FAYE",16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 44 , 44 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295786713,"GOODMAN, BRENDA, FAYE",16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295786713,"GOODMAN, BRENDA, FAYE",16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",300 N MAIN ST   RICH SQUARE NC,066,Northampton,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 89 , 170 ," $13,023.79 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",300 N MAIN ST   RICH SQUARE NC,066,Northampton,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 140 , 238 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",300 N MAIN ST   RICH SQUARE NC,066,Northampton,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",119 GATLING ST   WILLIAMSTON NC,058,Martin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",119 GATLING ST   WILLIAMSTON NC,058,Martin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 115 , 270 ," $33,370.63 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",1403 CONNER AVENUE   WINDSOR NC,008,Bertie,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 163 , 224 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",105 COMMERCE ST   POWELLSVILLE NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 28 , 47 ,$#,,
MEDICAID DIRECT,1962660472,EASTERN CAROLINA GERIATRICS ASSOCIA,COMPREHENSIVE MEDICAL CARE OF EASTERN CAROLINA,105 COMMERCE ST   POWELLSVILLE NC,008,Bertie,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295788628,"FERGUSON, STEVEN, WALLACE",105 COMMERCE ST   POWELLSVILLE NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 162 , 821 , 821 ," $29,608.34 ",,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1295788628,"FERGUSON, STEVEN, WALLACE",105 COMMERCE ST   POWELLSVILLE NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 35 , 35 ," $13,854.75 ",,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 167 , 267 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",2578 W 5TH ST   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",1300 DON JUAN RD   HERTFORD NC,072,Perquimans,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295788628,"FERGUSON, STEVEN, WALLACE",1084 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 113 , 212 ," $14,251.54 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295788990,"DEVESHWAR, SHAILI",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 63 , 82 , 149 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295788990,"DEVESHWAR, SHAILI",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 16 ,$#,,
MEDICAID DIRECT,1104925072,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,608 W ACADEMY ST   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,,1295789535,"KELLER, MARK, ROBERT",608 W ACADEMY ST   RANDLEMAN NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 231 , 451 , 857 ," $17,460.95 ",,
MEDICAID DIRECT,1922193622,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1295789535,"KELLER, MARK, ROBERT",197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 245 , 386 , 714 ," $13,603.45 ",,
MEDICAID DIRECT,1104925072,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,608 W ACADEMY ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1295789535,"KELLER, MARK, ROBERT",608 W ACADEMY ST   RANDLEMAN NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265457568,J DAVID FISHER JR DDS PA,,1808 DOCTORS DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1295792174,"FISHER JR, JOHN, DAVID",1808 DOCTORS DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 86 , 177 , 423 ," $18,374.31 ",,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295793016,"PIERCY, KENNETH, TODD",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 58 , 173 , 251 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,415 N CENTER ST STE 203 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1295793016,"PIERCY, KENNETH, TODD",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 74 , 100 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295793198,"CRUSAN, CHRIS, ANDREW",1225 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 32 , 61 ,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295793198,"CRUSAN, CHRIS, ANDREW",1225 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295793198,"CRUSAN, CHRIS, ANDREW",1225 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 42 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295793198,"CRUSAN, CHRIS, ANDREW",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 65 , 114 , 219 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 259 , 315 , 331 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295795201,"JONES, JOHN",2609 N DUKE ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 117 , 155 , 195 ,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1295797207,"OKELLEY, BRIAN, SCOTT",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 43 , 80 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295798668,"SIDANA, LALITA, VIJAY",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 323 ," 1,134 "," 1,212 "," $31,595.67 ",,
MEDICAID DIRECT,1578118089,LIBERTY HEALTHCARE GROUP LLC,LIBERTY COMMONS NSGANDREHAB CTR OF FRANKLIN CO LLC,202 SMOKETREE WAY   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295798668,"SIDANA, LALITA, VIJAY",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 240 , 242 ," $403,495.58 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295798668,"SIDANA, LALITA, VIJAY",101 CABARRUS AVE E STE 1001 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 31 , 140 , 140 ," $14,823.35 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",251 SHELTON ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",67 LOVING WAY   CLYDE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 14 , 37 , 38 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",75 FISHER LOOP   MAGGIE VALLEY NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 39 , 153 , 153 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 47 , 81 , 82 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 26 , 79 , 79 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295798957,"DORN, REBECCA, ELIZABETH",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295799278,"MCLEAN, JAMES, MARTIN",601 N ELM ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295799278,"MCLEAN, JAMES, MARTIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,," 1,085 "," 1,104 "," 2,111 "," $28,912.33 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1295805554,"HANNA, GEORGE, MICHAEL",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 24 , 45 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295806701,"SIMPSON, JILL, EILEEN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",2041 WILLOW RD   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",2041 WILLOW RD   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",1987 HILTON RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",1987 HILTON RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 22 , 22 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",1987 HILTON RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 50 , 50 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 31 , 31 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1295806750,"SCHWARTZMAN, NEIL, ROBERT",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366580441,FY EYE CARE ASSOCIATES OPTOME PA,FY EYE CARE ASSOCIATES OPTOMETRISTS PA,10210 PROSPERITY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295812865,"JONES, KAREN, ELIZABETH",10210 PROSPERITY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1366580441,FY EYE CARE ASSOCIATES OPTOME PA,FY EYE CARE ASSOCIATES OPTOMETRISTS PA,10210 PROSPERITY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295812865,"JONES, KAREN, ELIZABETH",10210 PROSPERITY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1033182571,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD OB GYN DILLON,706 N 8TH AVE   DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295814390,"GLOVER, GREGORY, LYLE",706 N 8TH AVE   DILLON SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1295814762,"TYSON, ELIZABETH, STREETT",ELIZABETH STREETT TYSON,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1295814762,"TYSON, ELIZABETH, STREETT",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295815751,"NOAH, TERRY, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 55 , 139 , 146 ," $12,208.69 ",,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295815751,"NOAH, TERRY, LEE",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1013014596,PIEDMONT HEALTH SERVICES INC,SCOTT COMMUNITY HEALTH CENTER,5270 UNION RIDGE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295816106,"TOBIN, PAUL, CHRISTOPHER",301 LLOYD ST   CARRBORO NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295816106,"TOBIN, PAUL, CHRISTOPHER",301 LLOYD ST   CARRBORO NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295816106,"TOBIN, PAUL, CHRISTOPHER",301 LLOYD ST   CARRBORO NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1295816676,FOCUS THERAPY SERVICES INC,,1319 S GLENBURNIE RD STE B NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1295816676,FOCUS THERAPY SERVICES INC,1319 S GLENBURNIE RD STE B NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1295816676,FOCUS THERAPY SERVICES INC,,5058 HWY 70 W STE S3 MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1295816676,FOCUS THERAPY SERVICES INC,5058 HWY 70 W STE S3 MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1295816676,FOCUS THERAPY SERVICES INC,,2805B TRENT RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1295816676,FOCUS THERAPY SERVICES INC,2805B TRENT RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1295817922,"PAVIC, DAG",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295818458,"GRANGER, CHRISTOPHER, BULL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 28 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295818458,"GRANGER, CHRISTOPHER, BULL",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1295818458,"GRANGER, CHRISTOPHER, BULL",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295818458,"GRANGER, CHRISTOPHER, BULL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 67 , 82 , 82 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",234 CROOKED CREEK PWKY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 361 , 432 , 432 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 225 , 288 , 288 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819167,"STIBER, JONATHAN, ANDREW",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819183,"NEWBY, LAURA, KRISTIN",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819183,"NEWBY, LAURA, KRISTIN",10 DUKE MEDICINE CIR 10 DUKE MEDICINE CIRCLE DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 60 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819183,"NEWBY, LAURA, KRISTIN",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819357,"KONG, DAVID, FRANKLIN",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819357,"KONG, DAVID, FRANKLIN",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 34 , 36 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295819357,"KONG, DAVID, FRANKLIN",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 25 , 28 , 42 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1295819993,"GOLI, VEERAINDAR",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295819993,"GOLI, VEERAINDAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295820561,"MARSTON, WILLIAM, ARNOLD",2214 NELSON HWY   CHAPEL HILL NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 104 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1295820561,"MARSTON, WILLIAM, ARNOLD",2214 NELSON HWY   CHAPEL HILL NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295820561,"MARSTON, WILLIAM, ARNOLD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 277 , 371 , 488 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295821361,"BORGES-NETO, SALVADOR",2301 ERWIN RD   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295821361,"BORGES-NETO, SALVADOR",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1295821361,"BORGES-NETO, SALVADOR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295821668,"JAFFE, TRACY, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 138 , 156 , 213 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295821668,"JAFFE, TRACY, ANNE",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295821668,"JAFFE, TRACY, ANNE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 58 , 65 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295821668,"JAFFE, TRACY, ANNE",20 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295821668,"JAFFE, TRACY, ANNE",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295821668,"JAFFE, TRACY, ANNE",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 131 , 154 , 217 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295823144,"HILBERT, KAREN, FRANCES",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 14 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295823144,"HILBERT, KAREN, FRANCES",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 23 , 33 , 33 ,$#,,
MEDICAID DIRECT,1295823540,AMERICAN HEALTH S LLC,AMERICAN HEALTH ASSOCIATES,15712 SW 41ST ST STE 16 DAVIE FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1295823540,AMERICAN HEALTH S LLC,15712 SW 41ST ST STE 16 DAVIE FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 187 , 834 ," 2,745 "," $28,346.20 ",,
MEDICAID DIRECT,1326036138,SOUTHEASTERN INTEGRATED CARE,~,3005 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1295824910,"CLARK, CYNTHIA, ANNE",3005 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 74 , 119 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1295824910,"CLARK, CYNTHIA, ANNE",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1295824910,"CLARK, CYNTHIA, ANNE",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 35 , 74 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1295824910,"CLARK, CYNTHIA, ANNE",105 LISBON AVE   GARLAND NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295824910,"CLARK, CYNTHIA, ANNE",105 LISBON AVE   GARLAND NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295827970,"WELLS, KENDRA",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295827970,"WELLS, KENDRA",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1831837095,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY PEDIATRICS,606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295830842,"MCGUIRE, MARIA, BERNADETTA",606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1619243300,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY PEDIATRICS,606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295830842,"MCGUIRE, MARIA, BERNADETTA",606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1295832301,"SHERLOCK, RANDY, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295832301,"SHERLOCK, RANDY, CHARLES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 32 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295833127,"HELTON, MARGARET, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295833127,"HELTON, MARGARET, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306397898,RDMG ASSOCIATES PA,,136 CHARLOTTE HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295835007,"BRADLEY, DIANA, FAISON",136 CHARLOTTE HWY   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295835825,"BAKER, DAVID, AARON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 67 , 84 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295835825,"BAKER, DAVID, AARON",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295835825,"BAKER, DAVID, AARON",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 65 , 79 ,$#,,
MEDICAID DIRECT,1003660663,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1295835924,"CRISP, LADDIE, MOORE",107 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 96 , 156 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1295835924,"CRISP, LADDIE, MOORE",107 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295836575,"BARRETT, WILLIAM, LAURENCE",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295836575,"BARRETT, WILLIAM, LAURENCE",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1295836575,"BARRETT, WILLIAM, LAURENCE",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1295836575,"BARRETT, WILLIAM, LAURENCE",4810 S CROATAN HWY STE 250 NAGS HEAD NC,028,Dare,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1295838738,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04284,1131 RANDOLPH ST   THOMASVILLE NC,029,Davidson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1295838738,NORTH CAROLINA CVS PHARMACY LLC,1131 RANDOLPH ST   THOMASVILLE NC,029,Davidson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1295838738,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04284,1131 RANDOLPH ST   THOMASVILLE NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1295838738,NORTH CAROLINA CVS PHARMACY LLC,1131 RANDOLPH ST   THOMASVILLE NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1295839918,"MCGRIFF, BUHILDA",~,1025 VINEHAVEN DR NE CAROLINA PED EYE SPEC CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1295839918,"MCGRIFF, BUHILDA",1025 VINEHAVEN DR NE CAROLINA PED EYE SPEC CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 259 , 263 , 518 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1295842029,"GARRIS, JEFFREY, BRUCE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1295842029,"GARRIS, JEFFREY, BRUCE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 28 , 51 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295842078,"IAMMARINO, CHRISTA, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1295842078,"IAMMARINO, CHRISTA, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1295842078,"IAMMARINO, CHRISTA, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295842193,APRIA HEALTHCARE LLC,~,2600 PERIMETER PARK DR STE 100 MORRISVILLE NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1295842193,APRIA HEALTHCARE LLC,2600 PERIMETER PARK DR STE 100 MORRISVILLE NC,092,Wake,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 562 ," 1,888 "," 3,622 "," $71,655.64 ",,
MEDICAID DIRECT,1295842193,APRIA HEALTHCARE LLC,~,2600 PERIMETER PARK DR STE 100 MORRISVILLE NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1295842193,APRIA HEALTHCARE LLC,2600 PERIMETER PARK DR STE 100 MORRISVILLE NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1912638917,S BASSIRI AND ASSOCIATES PA,KING FAMILY DENTISTRY,226 KIRBY RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1295842904,"BASSIRI, SASSAN",226 KIRBY RD   KING NC,085,Stokes,1223G0001X,Dental Providers,Dentist,General Practice," 1,454 "," 2,632 "," 12,397 "," $632,513.68 ",,
MEDICAID DIRECT,1124281084,GRANT AND JOYNER DDS PA,HORIZON FAMILY DENTISTRY,6250 ROGERS RD   ROLESVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1295843811,"JOYNER, BRANDY, THORTON",6250 ROGERS RD   ROLESVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 425 , 675 ," 2,853 "," $95,800.61 ",,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295843811,"JOYNER, BRANDY, THORTON",6250 ROGERS RD   ROLESVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 198 , 201 , 751 ," $32,272.01 ",,
MEDICAID DIRECT,1295844397,FAMILY MEDICAL SUPPLY LLC,~,1120 W BROAD ST   DUNN NC,043,Harnett,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1295844397,FAMILY MEDICAL SUPPLY LLC,1120 W BROAD ST   DUNN NC,043,Harnett,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 20 , 196 , 196 ," $22,981.05 ",,
MEDICAID DIRECT,1295844397,FAMILY MEDICAL SUPPLY LLC,~,1120 W BROAD ST   DUNN NC,043,Harnett,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295844397,FAMILY MEDICAL SUPPLY LLC,1120 W BROAD ST   DUNN NC,043,Harnett,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,246 "," 7,115 "," 11,740 "," $297,560.12 ",,
MEDICAID DIRECT,1295844397,FAMILY MEDICAL SUPPLY LLC,~,1120 W BROAD ST   DUNN NC,043,Harnett,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1295844397,FAMILY MEDICAL SUPPLY LLC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295845725,"BUZAN, ANDREW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 112 , 112 ,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295845725,"BUZAN, ANDREW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295845907,"THOMAS, NANCY, ELLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 15 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295845907,"THOMAS, NANCY, ELLEN",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1295847705,"MORTON, TERRENCE, DEWITT",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1295847705,"MORTON, TERRENCE, DEWITT",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295847705,"MORTON, TERRENCE, DEWITT",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295847705,"MORTON, TERRENCE, DEWITT",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1295847705,"MORTON, TERRENCE, DEWITT",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295847705,"MORTON, TERRENCE, DEWITT",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295847812,"LOCKLEAR-ZOLL, ROBBIE, RENEE",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,500 GATEWAY DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1295852341,"FOSTER, JENNIFER, NICOLE",500 GATEWAY DR   CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 41 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1295852341,"FOSTER, JENNIFER, NICOLE",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,116 E HORTON ST   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1295852341,"FOSTER, JENNIFER, NICOLE",116 E HORTON ST   ZEBULON NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295852606,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06518,11430 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1295852606,NORTH CAROLINA CVS PHARMACY LLC,11430 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1295853018,"ANDERSON, STEVEN, ROBERT",870 STATE FARM RD STE 100 BOONE NC,095,Watauga,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 39 , 44 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1295853018,"ANDERSON, STEVEN, ROBERT",232 BOONE HEIGHTS DR   BOONE NC,095,Watauga,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 79 , 92 , 221 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,,,Unknown,193200000X,Group,Multi-Specialty,,1295853018,"ANDERSON, STEVEN, ROBERT",870 STATE FARM RD STE 100 BOONE NC,095,Watauga,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1295857506,MYTREX INC,RESCUE ALERT,305 DUNHAMS CREEK LN   CARTHAGE NC,063,Moore,333300000X,Suppliers,Emergency Response System Companies,,1295857506,MYTREX INC,305 DUNHAMS CREEK LN   CARTHAGE NC,063,Moore,333300000X,Suppliers,Emergency Response System Companies,, 91 , 973 , 973 ," $28,898.10 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295858439,"LIN, JOEL, GI-TOU",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295858439,"LIN, JOEL, GI-TOU",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295858439,"LIN, JOEL, GI-TOU",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1295859700,CARING TOUCH HOME HEALTH CARE LLC,~,11705 DEEP BRANCH RD   MAXTON NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1295859700,CARING TOUCH HOME HEALTH CARE LLC,11705 DEEP BRANCH RD   MAXTON NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 4,010 "," 4,010 "," $260,589.08 ",,
MEDICAID DIRECT,1265703607,MCPHERSON FAMILY EYE CARE,MCPHERSON FAMILY EYE CARE,3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295861177,"MURPHY, JENNIFER, LEIGH HARRELSON",3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 18 , 18 , 40 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1295863249,"WOLPER, JESSICA, BRETT",1505 SW CARY PKWY STE 202 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295863249,"WOLPER, JESSICA, BRETT",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295863942,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,2024 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1295863942,LINCARE INC,2024 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 275 ," 1,766 "," 3,026 "," $121,503.53 ",,
MEDICAID DIRECT,1295863942,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,2024 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1295863942,LINCARE INC,2024 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1295863942,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,2024 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1295863942,LINCARE INC,2024 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 22 , 78 , 146 ," $49,716.42 ",,
MEDICAID DIRECT,1295865145,ADULT LIFE PROGRAMS INC,~,1265 21ST ST NE UNIT A HICKORY NC,018,Catawba,251B00000X,Agencies,Case Management,,1295865145,ADULT LIFE PROGRAMS INC,1265 21ST ST NE UNIT A HICKORY NC,018,Catawba,251B00000X,Agencies,Case Management,,#, 954 , 954 ," $41,079.24 ",,
MEDICAID DIRECT,1720292261,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1295874204,"BRODSKY, AARON, PHILIP",50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,2084P0805X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Geriatric Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295875581,"ALEXANDER, RICHARD, EDWIN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 18 , 27 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295875581,"ALEXANDER, RICHARD, EDWIN",410D S JONES ST   PEMBROKE NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 52 , 76 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295875581,"ALEXANDER, RICHARD, EDWIN",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 82 , 139 , 207 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295881951,"MEADVILLE, KAREN, ANN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295881951,"MEADVILLE, KAREN, ANN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295882009,"MOWERY, NATHAN, TEAGUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295882009,"MOWERY, NATHAN, TEAGUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 92 , 130 , 151 ," $20,261.27 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295886018,"LEVIEL, LINDA, HELENE",150 CHARLOIS BLVD STE 100 WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1295886471,"SALLING, BLAIR, CROWDER",,2002 EASTWOOD RD STE 105 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1295886471,"SALLING, BLAIR, CROWDER",2002 EASTWOOD RD STE 105 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 94 , 95 ,$#,,
MEDICAID DIRECT,1295887404,MARTIN COUNTY DSS,MARTIN COUNTY DSS,305 E MAIN ST   WILLIAMSTON NC,058,Martin,251B00000X,Agencies,Case Management,,1295887404,MARTIN COUNTY DSS,305 E MAIN ST   WILLIAMSTON NC,058,Martin,251B00000X,Agencies,Case Management,, 70 , 669 , 669 ," $264,924.00 ",,
MEDICAID DIRECT,1295887495,GOODMAN CARE INC,HOME INSTEAD,315 C ST   NORTH WILKESBORO NC,097,Wilkes,253Z00000X,Agencies,In Home Supportive Care,,1295887495,GOODMAN CARE INC,315 C ST   NORTH WILKESBORO NC,097,Wilkes,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 4,081 "," 4,129 "," $382,321.86 ",,
MEDICAID DIRECT,1295890077,J & D HEALTHCARE SERVICES LLC,J AND D HEALTHCARE SERVICES,464 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1295890077,J & D HEALTHCARE SERVICES LLC,464 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 3,491 "," 3,718 "," $267,574.89 ",,
MEDICAID DIRECT,1295890077,J & D HEALTHCARE SERVICES LLC,J AND D HEALTHCARE SERVICES,464 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1295890077,J & D HEALTHCARE SERVICES LLC,464 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 13 ," 2,232 "," 2,526 "," $1,444,659.88 ",,
MEDICAID DIRECT,1295890309,SOUTHERN ASSISTED LIVING INC,BROOKDALE PEACHTREE MC,2814 PEACHTREE RD   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295890309,SOUTHERN ASSISTED LIVING INC,2814 PEACHTREE RD   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 291 , 291 ," $18,235.53 ",,
MEDICAID DIRECT,1295892404,INTERIM HEALTHCARE OF THE EASTERN C,~,1424 S JK POWELL BLVD STE G WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1295892404,INTERIM HEALTHCARE OF THE EASTERN C,1424 S JK POWELL BLVD STE G WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,690 "," 1,690 "," $111,481.80 ",,
MEDICAID DIRECT,1831505346,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - 905 N HOWE,905 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1295893261,"MINOR, ANDRE, LEMEAC",905 N HOWE ST   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 35 , 55 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295896603,"CAMPBELL, TIMOTHY",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295896603,"CAMPBELL, TIMOTHY",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295900249,"AMRHEIN, TIMOTHY, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 68 , 72 , 110 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295900249,"AMRHEIN, TIMOTHY, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 33 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295900249,"AMRHEIN, TIMOTHY, JAMES",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295900249,"AMRHEIN, TIMOTHY, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295900249,"AMRHEIN, TIMOTHY, JAMES",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295900249,"AMRHEIN, TIMOTHY, JAMES",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295900249,"AMRHEIN, TIMOTHY, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295900629,"GONZALEZ, LUCIEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine, 22 , 41 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295900629,"GONZALEZ, LUCIEN",1101 WEAVER DAIRY RD STE 102 CHAPEL HILL NC,068,Orange,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205579059,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC SUBSTANCE TREATMENT AND RECOVERY,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295900629,"GONZALEZ, LUCIEN",1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295900959,"LEDFORD, PAUL, ALISTAIRE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 60 , 60 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295900959,"LEDFORD, PAUL, ALISTAIRE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295900959,"LEDFORD, PAUL, ALISTAIRE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 40 , 40 ,$#,,
MEDICAID DIRECT,1225479793,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295900959,"LEDFORD, PAUL, ALISTAIRE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1295900959,"LEDFORD, PAUL, ALISTAIRE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1295900959,"LEDFORD, PAUL, ALISTAIRE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1295900967,"BRENDLE, DAVID, CLAIR",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 37 , 60 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1295900967,"BRENDLE, DAVID, CLAIR",148 HIGHWAY 105 EXT STE 104 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1295904381,"QUINN, KRISTEN, HELANE",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295904381,"QUINN, KRISTEN, HELANE",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 105 , 136 , 178 ," $17,667.04 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295908499,"ROQUE, DANIEL, ALBERTO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 45 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295909034,"CLARKE, JEFFREY, MELSON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 14 , 31 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295909034,"CLARKE, JEFFREY, MELSON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295909034,"CLARKE, JEFFREY, MELSON",2100 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295909034,"CLARKE, JEFFREY, MELSON",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1104565407,LOTUS CARE PSYCHOLOGICAL SERVICES,,2521 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1295911543,"CONTINO, ALINA",2521 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295914687,"BRAMSON, BRIAN, THOMAS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295914687,"BRAMSON, BRIAN, THOMAS",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 23 , 26 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295914687,"BRAMSON, BRIAN, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 24 , 62 , 66 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295916104,"PLUNKETT, ANTHONY, ROBERT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1295916104,"PLUNKETT, ANTHONY, ROBERT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1295916104,"PLUNKETT, ANTHONY, ROBERT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295916104,"PLUNKETT, ANTHONY, ROBERT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295921450,"SWISHER, CHRISTA, BRITTANY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 93 , 104 ," $12,158.55 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295923639,"ROSE, DANIELLE, MATSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1295924033,"BARRAGREE, MATTHEW, WILLIAM",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 35 ,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295924033,"BARRAGREE, MATTHEW, WILLIAM",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1295924793,"LACIK, REBECCA, WOOD",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 27 , 39 , 44 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295924793,"LACIK, REBECCA, WOOD",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295924793,"LACIK, REBECCA, WOOD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295925089,"MCKENZIE, ILA, LEIGH",2501 DOWNING ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1295925089,"MCKENZIE, ILA, LEIGH",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 52 , 52 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1295925089,"MCKENZIE, ILA, LEIGH",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1174208813,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE RHC,1125 CARTHAGE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1295926251,"MCCONVILLE, PARKER, SARRIS",1125 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 136 , 145 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295928539,"HEMAL, ASHOK, KUMAR",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 81 , 117 , 174 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295928919,"NORMAN, MICHAEL, PADERICK",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295928919,"NORMAN, MICHAEL, PADERICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295928919,"NORMAN, MICHAEL, PADERICK",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1295930345,"BELLOFIORE PLONSKI, LISA",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 32 , 73 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1295930345,"BELLOFIORE PLONSKI, LISA",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1295930345,"BELLOFIORE PLONSKI, LISA",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1295930956,"SHRODE, CHARLES, WILLIARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 24 , 32 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1295930956,"SHRODE, CHARLES, WILLIARD",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 47 , 99 , 143 ,$#,,
MEDICAID DIRECT,1730343625,CHUANWEN SUN DMD PA,KITT CREEK FAMILY DENTISTRY,5322 NC HIGHWAY 55 STE 104 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295930998,"SUN, CHUANWEN",5322 NC HIGHWAY 55 STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#, 17 , 110 ," $10,860.16 ",,
MEDICAID DIRECT,1730343625,CHUANWEN SUN DMD PA,KITT CREEK FAMILY DENTISTRY,5322 NC HIGHWAY 55 STE 104 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1295930998,"SUN, CHUANWEN",5322 NC HIGHWAY 55 STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 391 ," 1,023 "," 7,177 "," $465,945.45 ",,
MEDICAID DIRECT,1295931574,NATIVE ANGELS TOTAL PROPERTY MANAGE,~,2609 RAEFORD RD STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1295931574,NATIVE ANGELS TOTAL PROPERTY MANAGE,2609 RAEFORD RD STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 30 ," 1,234 "," 1,234 "," $82,277.80 ",,
MEDICAID DIRECT,1295931574,NATIVE ANGELS TOTAL PROPERTY MANAGE,~,2112 SKIBO RD STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1295931574,NATIVE ANGELS TOTAL PROPERTY MANAGE,2112 SKIBO RD STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 5,743 "," 5,743 "," $387,572.84 ",,
MEDICAID DIRECT,1295931574,NATIVE ANGELS TOTAL PROPERTY MANAGE,~,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1295931574,NATIVE ANGELS TOTAL PROPERTY MANAGE,201 LIVERMORE DR   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 33 , 33 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,257 NC 125   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,257 NC 125   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",257 NC 125   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 156 , 765 , 772 ," $13,951.38 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",257 NC 125   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",257 NC 125   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 36 , 38 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",257 NC 125   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 79 , 79 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1295932457,"DANG, KIM, ANH THI",257 NC 125   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295933893,"THOMPSON, PATRICK, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 16 , 63 , 76 ,$#,,
MEDICAID DIRECT,1295934198,TRIANGLE LIFELINE INC,TRIANGLE LIFELINE,4220 NC-55 130A DURHAM NC,032,Durham,333300000X,Suppliers,Emergency Response System Companies,,1295934198,TRIANGLE LIFELINE INC,4220 NC-55 130A DURHAM NC,032,Durham,333300000X,Suppliers,Emergency Response System Companies,, 140 ," 1,360 "," 1,360 "," $42,592.48 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295936714,"ALLEMAN, MATTHEW, CLAYTON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1295936714,"ALLEMAN, MATTHEW, CLAYTON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295936714,"ALLEMAN, MATTHEW, CLAYTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 67 , 105 , 118 ," $20,867.27 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295936714,"ALLEMAN, MATTHEW, CLAYTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 36 , 37 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295936714,"ALLEMAN, MATTHEW, CLAYTON",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295936722,"TOLER, RICHARD, LEE",509 OLDE WATERFORD WAY STE 301 LELAND NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295936722,"TOLER, RICHARD, LEE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295936722,"TOLER, RICHARD, LEE",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 20 , 27 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295936722,"TOLER, RICHARD, LEE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295938611,"ESPONDA, OMAR, LAZARO",10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295939106,"RIDGE, STEPHEN, PAUL",920 CHURCH ST N STE 255B CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 194 , 195 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295939916,"RANKIN, CORWIN, JAWAYNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295939916,"RANKIN, CORWIN, JAWAYNE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295939916,"RANKIN, CORWIN, JAWAYNE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 212 , 212 ,$#,,
MEDICAID DIRECT,1124762877,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS - ROWAN,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1295939916,"RANKIN, CORWIN, JAWAYNE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295940815,"MELTON, KIM, RENEE",3205 ROGERS RD   WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 20 , 55 ,$#,,
MEDICAID DIRECT,1275685844,LANE AND ASSOCIATES V DDS PA,LANE AND ASSOCIATES,598 E JACKSON BLVD STE 100 ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295940815,"MELTON, KIM, RENEE",3205 ROGERS RD   WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1295940815,"MELTON, KIM, RENEE",3205 ROGERS RD   WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 123 , 162 , 571 ," $22,771.32 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295941649,"CORCORAN V, WILLIAM, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295943793,"FERTEL, DANIEL, HAROLD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295943793,"FERTEL, DANIEL, HAROLD",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295943793,"FERTEL, DANIEL, HAROLD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 37 , 38 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295943793,"FERTEL, DANIEL, HAROLD",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1295944114,"BAE JUMP, VICTORIA, LIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 26 , 33 , 37 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295945673,"SALVATORE, JAIME, KRISTIN",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 228 , 254 , 289 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295945673,"SALVATORE, JAIME, KRISTIN",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 153 , 189 , 216 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1295945673,"SALVATORE, JAIME, KRISTIN",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085U0001X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Ultrasound,#,#,#,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1295946671,"BAILEY, EMILY, GREENWOOD",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 50 , 50 , 69 ,$#,,
MEDICAID DIRECT,1295948339,WILMINGTON GASTROENTEROLOGY ENDOSCO,WILMINGTON GASTROENTEROLOGY ENDOSCOPY CENTER INC,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1295948339,WILMINGTON GASTROENTEROLOGY ENDOSCO,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 156 , 164 , 240 ," $10,282.61 ",,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1295949220,"AARON, HOUSTON, MICHAEL",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1295949220,"AARON, HOUSTON, MICHAEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 262 , 306 , 401 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",802 SEMART DR   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 64 , 64 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 12 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 57 , 57 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 73 , 73 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",802 SEMART DR   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",835 S NEW HOPE RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 47 , 77 , 118 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",802 SEMART DR   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1295951036,"JANG, SO, YOON",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295951903,"CRAWFORD, JAMILA, MICHELLE",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295951903,"CRAWFORD, JAMILA, MICHELLE",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295951903,"CRAWFORD, JAMILA, MICHELLE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1295951903,"CRAWFORD, JAMILA, MICHELLE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1295951903,"CRAWFORD, JAMILA, MICHELLE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295953446,"KING, ANJANETTE, THOMPSON",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295953446,"KING, ANJANETTE, THOMPSON",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295953446,"KING, ANJANETTE, THOMPSON",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295953446,"KING, ANJANETTE, THOMPSON",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295960367,J & S CARE INCORPORATED,MORNING STAR AL 3,941 GOINS RD   PEMBROKE NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295960367,J & S CARE INCORPORATED,941 GOINS RD   PEMBROKE NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,254 "," 1,254 "," $113,403.13 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295961662,"BOSTIC, SUSAN, DAVIES",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1295963361,"RAO, ARCHANA, CHANDRAKANT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 105 , 241 , 274 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1295963528,"THOMPSON, JAMES, ANDREW",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295963635,"ROOMIANY, PAHRESAH, LENORE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 135 , 135 ,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1295966109,CAROLINAS PHYSICIANS NETWORK INC,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295966554,"SCHWEPPE, ANN, BALLENGER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 16 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295968741,"SHAH, RICKIN, AVINASH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 129 , 135 , 167 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1295968741,"SHAH, RICKIN, AVINASH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 213 , 227 , 284 ," $10,010.53 ",,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1295970093,"BAKER, LYNN, CROW",58 PHYSICIANS DR NW   SUPPLY NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295974335,"OAT-JUDGE, JULIA, ELIZABETH",25 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295974335,"OAT-JUDGE, JULIA, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1295974335,"OAT-JUDGE, JULIA, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 22 , 22 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1295974335,"OAT-JUDGE, JULIA, ELIZABETH",68 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295974335,"OAT-JUDGE, JULIA, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1295974335,"OAT-JUDGE, JULIA, ELIZABETH",68 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1295975779,"BIRITWUM, MADONNA, ABENA POKUAA",35 MEMORIAL DR   PINEHURST NC,063,Moore,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1295975779,"BIRITWUM, MADONNA, ABENA POKUAA",35 MEMORIAL DR   PINEHURST NC,063,Moore,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 101 , 253 , 253 ,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,220 PAGE RD STE 300 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1295975779,"BIRITWUM, MADONNA, ABENA POKUAA",220 PAGE RD N STE 300 PINEHURST NC,063,Moore,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295977858,"WALCZYSZYN, MACIEJ, POITR",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 52 , 78 , 124 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295977858,"WALCZYSZYN, MACIEJ, POITR",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1295979284,"MITCHELL, NATHAN, PAUL",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1295983898,"KOTLAREVSKY, ALEXANDER, ANATOLIEVICH",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 277 , 278 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295985612,"MCKAY, CYNTHIA, BLAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1295988699,"RAY, TOMMY, LAMAR",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1295989135,"SMITH, ANN, LOUISE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 16 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1295995355,"JANG, DAVID, WOOJIN",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1295995462,"WALTZ, NICHOLE, ANN",416 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 81 , 170 ,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295995926,"MEISAMY, SINA",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295995926,"MEISAMY, SINA",340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295996213,"WOOTEN III, WILLIAM, ISLER",2150 HERBERT CT   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295996213,"WOOTEN III, WILLIAM, ISLER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295996213,"WOOTEN III, WILLIAM, ISLER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 49 , 63 , 68 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1295997211,"WONG MCKINSTRY, EDNA",303 E CARVER ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 56 , 56 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1295997211,"WONG MCKINSTRY, EDNA",303 E CARVER ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1295997211,"WONG MCKINSTRY, EDNA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295997260,"LOGANI, SACHIN",606 E 12TH ST   WASHINGTON NC,007,Beaufort,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295997260,"LOGANI, SACHIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 207 , 249 , 299 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295997260,"LOGANI, SACHIN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 20 , 31 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295997260,"LOGANI, SACHIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1295997260,"LOGANI, SACHIN",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 45 , 58 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 17 , 30 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,121 MEDICAL DR   ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 56 , 57 , 76 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1225 LEWISVILLE CLEMMONS RD   LEWISVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 61 , 76 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,50 MILLER ST STE G WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 17 , 21 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 32 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 77 , 86 , 115 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,144 FOREST HILL RD   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1295997682,"FORT BARRIE, LESLIE, FELICIA",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1295998029,ROBIN A WILLIAMS,FAYETTEVILLE STREET COMMUNITY HOME,111 N MAPLE ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1295998029,ROBIN A WILLIAMS,111 N MAPLE ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 40 , 40 ," $19,691.75 ",,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306000880,"YOUNG, DENISE, NICOLE",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 31 , 62 ,$#,,
MEDICAID DIRECT,1003900143,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - FAMILY MEDICINE -,120 HEYWOOD AVE STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306000948,"SLATER, VINCENT, CARL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1306004163,"BAER-SHALEV, TARYN, ZIPPORA",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 51 , 122 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306004577,"KELLY, MATTHEW, SCOTT",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1306005343,DIGESTIVE HEALTH SPECIALISTS PA,,2025 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1306005343,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 89 , 92 , 124 ," $12,479.03 ",,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1306005434,"DONOGHUE, KRISTIN, LYNN",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1518918259,RALEIGH DURHAM MEDICAL GROUP PA,NORTH RALEIGH PEDIATRIC GROUP,7205 STONEHENGE DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306005434,"DONOGHUE, KRISTIN, LYNN",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306006085,"THOMAS, KERRY, LYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 69 , 77 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306006242,"MIAN, FAWAD, AHMED",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306006242,"MIAN, FAWAD, AHMED",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 58 , 74 , 86 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306007885,"JOHNSON, NELL, BROCK POLLARD",111 HANESTOWN CT 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 VETERANS PKWY STE 214 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1306009774,"UHLIR, NICHOLAS, JASON",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 139 , 173 , 604 ," $24,843.06 ",,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306009774,"UHLIR, NICHOLAS, JASON",5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 220 , 257 , 857 ," $31,180.71 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306011515,"MEKERIAN, AREG, LEVON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 39 , 41 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2100 ERWIN RD   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2100 ERWIN RD   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 31 , 36 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",718 RIDGE RD   ROXBORO NC,073,Person,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 21 , 26 , 31 ,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 14 , 20 , 22 ,$#,,
MEDICAID DIRECT,1124694567,REX HOSPITAL INC,THE WOMENS HEALTH AND HEART CLINIC AT UNC REX,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1124694567,REX HOSPITAL INC,THE WOMENS HEALTH AND HEART CLINIC AT UNC REX,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306012091,"VOLZ, ELIZABETH, MICHELLE",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306012679,"BLAHA, STEPHEN, JOSEPH",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1306012679,"BLAHA, STEPHEN, JOSEPH",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1306012679,"BLAHA, STEPHEN, JOSEPH",6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 27 , 42 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306012679,"BLAHA, STEPHEN, JOSEPH",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306012679,"BLAHA, STEPHEN, JOSEPH",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1306012679,"BLAHA, STEPHEN, JOSEPH",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1578646865,CHARLOTTE SPEECH AND HEARING CENTER,~,817 E MOREHEAD ST STE 100 CHARLOTTE NC,060,Mecklenburg,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1306017686,"PALAZZOLO, JULIE, ANN",817 E MOREHEAD ST STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 29 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 110 , 134 , 192 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1306021407,"TIGHE, DEVIN, KENDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 34 , 38 ,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1126 N CHURCH ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 32 , 35 , 48 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 33 , 34 , 37 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",301 E WENDOVER AVE STE 100 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 20 , 22 , 26 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 14 , 15 , 24 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,6199 LAKE BRANDT RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 18 , 19 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306021704,"WAGNER, JAIME, STEPHAN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1306024005,"KATS, SVETLANA, SEMENOVNA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 25 , 93 , 110 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1306024005,"KATS, SVETLANA, SEMENOVNA",2000 NEUSE BLVD # B NEW BERN NC,025,Craven,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306024161,"SHAH, ANKOOR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306024161,"SHAH, ANKOOR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306026216,"STEVENSON, RACHEL, MARY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 139 , 139 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306028303,"RAVULA, RAJNIKANTH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 107 , 275 , 275 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306030739,"KRENZEL, BRIAN, ALLEN",214 18TH ST SE   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 46 , 53 , 65 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306030739,"KRENZEL, BRIAN, ALLEN",214 18TH ST SE   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306030960,"HOBBS, REBECCA, CHERYL",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306030960,"HOBBS, REBECCA, CHERYL",10320 MALLARD CREEK RD STE 260A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306030960,"HOBBS, REBECCA, CHERYL",150 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306030960,"HOBBS, REBECCA, CHERYL",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 22 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 2200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306030960,"HOBBS, REBECCA, CHERYL",409 OLIN WAY STE 2200 DENVER NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 17 , 21 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306030960,"HOBBS, REBECCA, CHERYL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306031935,"MACLELLAN, CAROLE",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306031935,"MACLELLAN, CAROLE",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 30 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306031935,"MACLELLAN, CAROLE",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306031935,"MACLELLAN, CAROLE",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306031935,"MACLELLAN, CAROLE",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306032388,"PATEL, SHIRLEY, HARISH",4796 OLD TAR RD   WINTERVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 68 , 153 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306032529,"BELL, TRACY, LYNETTE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1306033816,"PODBIELSKI, THERESA",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 42 , 43 , 111 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306035373,"LEONARD, PAUL, ANTHONY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 38 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306035373,"LEONARD, PAUL, ANTHONY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306035373,"LEONARD, PAUL, ANTHONY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306035373,"LEONARD, PAUL, ANTHONY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 125 , 254 ,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306040050,"NELSON, TODD, BRANDON",1840 HIGHWAY 24   NEWPORT NC,016,Carteret,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 11 , 30 ,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306040050,"NELSON, TODD, BRANDON",3311 TRENT RD   TRENT WOODS NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 99 , 153 , 263 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",3475 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",2301 ERWIN RD   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 12 , 12 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",3475 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",3475 ERWIN RD   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",3475 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",3475 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306042122,"FISHER, ELDA, LAMBERT",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306043971,"MORRISON, JEFFREY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306043971,"MORRISON, JEFFREY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 82 , 142 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306044953,"BRAHY, KELLY, MICHELE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306044953,"BRAHY, KELLY, MICHELE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306044953,"BRAHY, KELLY, MICHELE",303 AIRPORT RD   ARDEN NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306044953,"BRAHY, KELLY, MICHELE",303 AIRPORT RD   ARDEN NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 69 , 69 ," $17,483.91 ",,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306044953,"BRAHY, KELLY, MICHELE",264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306045570,"JENKINS, DONALD, DENISON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306045752,"HEINZERLING II, JOHN, HENRY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 24 , 105 , 145 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306045752,"HEINZERLING II, JOHN, HENRY",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306045752,"HEINZERLING II, JOHN, HENRY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306045752,"HEINZERLING II, JOHN, HENRY",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306046776,"ORTIZ-MELO, DAVID, ISAIAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 46 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306046776,"ORTIZ-MELO, DAVID, ISAIAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306046776,"ORTIZ-MELO, DAVID, ISAIAS",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306046776,"ORTIZ-MELO, DAVID, ISAIAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 60 , 141 , 160 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1703 NC HIGHWAY 39 N   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1306046776,"ORTIZ-MELO, DAVID, ISAIAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306046776,"ORTIZ-MELO, DAVID, ISAIAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306046776,"ORTIZ-MELO, DAVID, ISAIAS",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 49 , 50 ,$#,,
MEDICAID DIRECT,1831820927,LANE AND ASSOCIATES XLVI DDS PA,,2201 CANDUN DR STE 202 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1306047832,"HARALAMBAKIS, ELIAS, GEORGE",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 70 , 274 ,$#,,
MEDICAID DIRECT,1568999118,WRIGHT AND ASSOCIATES III DDS PA,,4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306047832,"HARALAMBAKIS, ELIAS, GEORGE",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 43 ,$#,,
MEDICAID DIRECT,1306048186,DARE COUNTY ADMINISTRATIVE OFFICES,DARE COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES,107 EXETER ST   MANTEO NC,028,Dare,251B00000X,Agencies,Case Management,,1306048186,DARE COUNTY ADMINISTRATIVE OFFICES,107 EXETER ST   MANTEO NC,028,Dare,251B00000X,Agencies,Case Management,,#, 99 , 99 ," $37,323.00 ",,
MEDICAID DIRECT,1306048186,DARE COUNTY ADMINISTRATIVE OFFICES,DARE COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES,107 EXETER ST   MANTEO NC,028,Dare,253Z00000X,Agencies,In Home Supportive Care,,1306048186,DARE COUNTY ADMINISTRATIVE OFFICES,107 EXETER ST   MANTEO NC,028,Dare,253Z00000X,Agencies,In Home Supportive Care,,#, 277 , 277 ," $23,700.05 ",,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306051750,"DOBZYNIAK, CHRISTOPHER, JOSEPH",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063179729,S VAKIL DDS MS V PA,GROWING SMILES PEDIATRIC DENTISTRY- MORRISVILLE,4181 DAVIS DR STE 100B MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1306052964,"WASSON, HARPREET, KAUR",4181 DAVIS DR STE 100B MORRISVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 173 , 227 ," 1,190 "," $37,098.89 ",,
MEDICAID DIRECT,1285343707,S VAKIL DDS MS VI PA,GROWING SMILES PEDIATRIC DENTISTRY- GARNER STATION,4446 FAYETTEVILLE RD STE B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306052964,"WASSON, HARPREET, KAUR",4446 FAYETTEVILLE RD STE B RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,190 "," 1,948 "," 10,020 "," $343,532.99 ",,
MEDICAID DIRECT,1063692812,GEETA BHAT DDS,,3434 KILDAIRE FARM RD STE 138 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1306052964,"WASSON, HARPREET, KAUR",9424 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1285343707,S VAKIL DDS MS VI PA,GROWING SMILES PEDIATRIC DENTISTRY- GARNER STATION,4446 FAYETTEVILLE RD STE B RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306052964,"WASSON, HARPREET, KAUR",9424 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 97 ," $10,812.71 ",,
MEDICAID DIRECT,1336671809,S VAKIL DDS I PA,VAYA DENTAL- GARNER STATION,4446 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306052964,"WASSON, HARPREET, KAUR",4446 FAYETTEVILLE RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 62 , 64 , 301 ," $10,496.91 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306053640,"ALMODOVAR SUAREZ, JORGE, LUIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 72 , 107 , 110 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306055249,"ALENCAR, CRISTINA, SAMPAIO DO VALE",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1306055249,"ALENCAR, CRISTINA, SAMPAIO DO VALE",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1051 LOFTIS BLVD STE 100 NEWPORT NEWS VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306055249,"ALENCAR, CRISTINA, SAMPAIO DO VALE",1051 LOFTIS BLVD STE 100 NEWPORT NEWS VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1306055249,"ALENCAR, CRISTINA, SAMPAIO DO VALE",744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306055249,"ALENCAR, CRISTINA, SAMPAIO DO VALE",744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 17 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306056809,"MAJOR, DAVID, ALBERT",2525 COURT DR   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306056809,"MAJOR, DAVID, ALBERT",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 275 , 383 , 489 ," $10,259.57 ",,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306056809,"MAJOR, DAVID, ALBERT",2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1306057047,"JOHNSON, ERIC, VON",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 817 , 965 ," 1,212 "," $23,218.25 ",,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1306057500,"VAN DER WESTHUIZEN, LIONEL",965 STATE FARM RD   BOONE NC,095,Watauga,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 48 , 67 ,$#,,
MEDICAID DIRECT,1306057500,"VAN DER WESTHUIZEN, LIONEL",~,965 STATE FARM RD   BOONE NC,095,Watauga,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1306057500,"VAN DER WESTHUIZEN, LIONEL",965 STATE FARM RD   BOONE NC,095,Watauga,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306058201,"DOBRATZ, ERIC, JOHN",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306058201,"DOBRATZ, ERIC, JOHN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306058201,"DOBRATZ, ERIC, JOHN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1306061320,"SKAGGS, JULIE, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306061320,"SKAGGS, JULIE, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1306061320,"SKAGGS, JULIE, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306063128,"KAPLAN, JOEL, ADAM",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306063128,"KAPLAN, JOEL, ADAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306063128,"KAPLAN, JOEL, ADAM",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 27 , 28 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306066576,"MEYER, GRETCHEN, LESLIE",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306066576,"MEYER, GRETCHEN, LESLIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306066576,"MEYER, GRETCHEN, LESLIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306066576,"MEYER, GRETCHEN, LESLIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306066576,"MEYER, GRETCHEN, LESLIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 23 , 33 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,2386 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306068234,"RUJUBALI, MOHAMMAD FAYEZ, BEN AZEL",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 25 , 26 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306068234,"RUJUBALI, MOHAMMAD FAYEZ, BEN AZEL",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 99 , 220 , 250 ," $11,471.29 ",,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306068234,"RUJUBALI, MOHAMMAD FAYEZ, BEN AZEL",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1306070347,GENTLE TOUCH HOME CARE LLC,GENTLE TOUCH HOME CARE,1248 E CASWELL ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,1306070347,GENTLE TOUCH HOME CARE LLC,1248 E CASWELL ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 5,188 "," 5,188 "," $566,200.00 ",,
MEDICAID DIRECT,1255731204,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DIGESTIVE HEALTH CENTER,401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306071725,"PANNU, DAVINDERBIR, SINGH",401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1740047455,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD DIGESTIVE HEALTH CENTER,401 EAST CHEVES STREET SUITE 301 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306071725,"PANNU, DAVINDERBIR, SINGH",401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306072475,"SLONE, TREVOR, LEE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306073440,"SMYRNIOUDIS, MARY, EVA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1306076450,"JOHNSON, SANDRA, JEAN",2800 KIDD RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 57 , 146 , 146 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1306076450,"JOHNSON, SANDRA, JEAN",2800 KIDD RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 34 , 48 , 49 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1306076450,"JOHNSON, SANDRA, JEAN",620 JOHNS RD   LAURINBURG NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1306076450,"JOHNSON, SANDRA, JEAN",620 JOHNS RD   LAURINBURG NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 11 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,620 JOHNS RD   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1306076450,"JOHNSON, SANDRA, JEAN",620 JOHNS RD   LAURINBURG NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1306077474,"KANSAGOR, ADAM, TROY",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306077474,"KANSAGOR, ADAM, TROY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1306077474,"KANSAGOR, ADAM, TROY",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306077474,"KANSAGOR, ADAM, TROY",210 ASHVILLE AVE   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306080403,"DANOI, LUMINITA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306080510,"GHANNAM, WASEEM",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861274169,AFTER HOURS URGENT CARE CENTER PLLC,,9101 PINEVILLE MATTHEWS RD STE R PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306080510,"GHANNAM, WASEEM",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 119 , 201 , 208 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306080973,"ROSSI, JEFFREY, ALLEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306080973,"ROSSI, JEFFREY, ALLEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 65 , 222 , 223 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306081468,"HEFNER, CASSAUNDRA, HOUSTON",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326589649,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - WELLNESS CENTER,3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306081468,"HEFNER, CASSAUNDRA, HOUSTON",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306081468,"HEFNER, CASSAUNDRA, HOUSTON",512 VILLAGE RD STE 103 SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306083639,"ARRU, ELIZABETH, HUSS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306083639,"ARRU, ELIZABETH, HUSS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306084280,"ALLMAN, ERIC, CHRISTIAN",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306085766,"WIDELITZ, JEFFREY, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306085766,"WIDELITZ, JEFFREY, SCOTT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 102 , 110 , 111 ," $10,382.45 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306087598,"BYRD, TEYWONIA, LASHALL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306087598,"BYRD, TEYWONIA, LASHALL",180 PARKWOOD DR   ELKIN NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306088380,"HILL, STACY, MENDENHALL",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306088380,"HILL, STACY, MENDENHALL",12208 HIGHWAY 150 N   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306088380,"HILL, STACY, MENDENHALL",12208 HIGHWAY 150 N   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 56 , 69 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 50 , 56 , 105 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 46 , 54 , 82 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306088737,"IYER, SUNIL",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306088737,"IYER, SUNIL",1126 N CHURCH ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306088737,"IYER, SUNIL",1126 N CHURCH ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 41 , 44 , 76 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306088828,"JNAH, AMY, JEANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306093646,"BEN DAVIES, MAUREEN, EYATUNDE",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 53 , 160 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306094131,"SEKULA, KONRAD, LUCASZ",703 COMFORT LN   MONROE NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,911 S HUGHES ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306094784,"SIGMON, EVARON, ROSE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5870 SAMET DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1600 HIGHWOODS BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",1600 HIGHWOODS BLVD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 21 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306095658,"JACKSON, MICHELLE, ANN",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306096938,"JEELANI, OWAIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 34 , 34 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306096938,"JEELANI, OWAIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 36 , 36 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306097936,"STECK, CASSIE, KAY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 35 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306097936,"STECK, CASSIE, KAY",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 143 , 582 , 710 ," $12,733.06 ",,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306102389,"HOLLIS, KEVIN, DESHAUN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 32 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306102389,"HOLLIS, KEVIN, DESHAUN",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306102389,"HOLLIS, KEVIN, DESHAUN",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306102389,"HOLLIS, KEVIN, DESHAUN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 57 , 59 , 71 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306103262,"LEVESQUE, SHARI, ANN",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306103262,"LEVESQUE, SHARI, ANN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306103403,"MACROSTY, CHRISTINA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306106190,"CROCKETT, ELIZABETH, LEE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306106828,"CHEN, JAMES, XIAO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 68 , 74 , 99 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306106828,"CHEN, JAMES, XIAO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 137 , 158 , 219 ,$#,,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306107727,"HAYES, BARBARA, JO",536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 41 , 71 ,$#,,
MEDICAID DIRECT,1578234506,ABOVE & BEYOND MEDICAL SERVICES LLC,,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1306107727,"HAYES, BARBARA, JO",521 BROOKDALE DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306107727,"HAYES, BARBARA, JO",31 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 45 , 73 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306107834,"TURK, STEPHEN, EDWARD",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306107834,"TURK, STEPHEN, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 86 , 87 , 103 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306107834,"TURK, STEPHEN, EDWARD",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306107834,"TURK, STEPHEN, EDWARD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 43 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306107883,"CAMARATO, JOSEPH, A",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306108899,"BRAND, TIMOTHY, MICHAEL",301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 17 , 25 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306108899,"BRAND, TIMOTHY, MICHAEL",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 23 , 24 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306108899,"BRAND, TIMOTHY, MICHAEL",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306109111,"MCCALLUM, MOLLY, ANN",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 30 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306109111,"MCCALLUM, MOLLY, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306109210,"BROWN, JENNA, LOUISE",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 220 , 220 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306109756,"SALINAS, CHRISTIAN, ALEXANDER",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 17 , 20 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306116421,"MAYNARD, JOHN, RYAN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 32 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306116421,"MAYNARD, JOHN, RYAN",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306117346,"BAILEY-WOODS, JENNIFER, ROSE",1001 BLYTHE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306117627,"STEGALL, CALLIE, GRIFFIN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 886 , 891 ," $13,388.21 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306117627,"STEGALL, CALLIE, GRIFFIN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 71 , 72 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306117718,"JENKINS, LINDSAY, YVONNE",1202 BROWN ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306117718,"JENKINS, LINDSAY, YVONNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 136 , 185 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1306119144,"BARR, PETER, WESLEY",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306119144,"BARR, PETER, WESLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1306119144,"BARR, PETER, WESLEY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306119144,"BARR, PETER, WESLEY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306119144,"BARR, PETER, WESLEY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1306119144,"BARR, PETER, WESLEY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306126917,"SYKES, AMBER, NOELLE",10616 METROMONT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 42 , 65 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,10616 METROMONT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306126917,"SYKES, AMBER, NOELLE",10616 METROMONT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1306127741,"ROSENSTEIN, AARON, ABRAHAM",~,2901 N DUKE ST   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,1306127741,"ROSENSTEIN, AARON, ABRAHAM",2901 N DUKE ST   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1972543825,AARON A ROSENSTEIN OD PA,~,2901 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306127741,"ROSENSTEIN, AARON, ABRAHAM",2901 N DUKE ST   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306128962,"HUNZEKER, ADAM, LEE",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306128962,"HUNZEKER, ADAM, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306131883,"STANCIL, STEWART, ALAN",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306132154,"BUNCH, PAUL, MICHAEL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306132154,"BUNCH, PAUL, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 213 , 217 , 343 ," $12,408.88 ",,
MEDICAID DIRECT,1841049913,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE BAPTIST IMAGING,3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306132154,"BUNCH, PAUL, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306136478,"MILLER, DEANA, HELEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306136478,"MILLER, DEANA, HELEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 78 , 92 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306137526,"SAUNDERS, JERRY, ALLEN",6010 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306137526,"SAUNDERS, JERRY, ALLEN",6010 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 49 , 61 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306137526,"SAUNDERS, JERRY, ALLEN",9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 40 , 43 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306137526,"SAUNDERS, JERRY, ALLEN",824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 86 , 124 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306139985,"MEYERS, ANNIE, BRIDGES",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1306139985,"MEYERS, ANNIE, BRIDGES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306140553,"MORRIS, ANNE, ROCHFORD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 77 , 80 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306142047,"FREESE, MEGAN, ANGELA",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 52 , 131 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306142047,"FREESE, MEGAN, ANGELA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 41 ,$#,,
MEDICAID DIRECT,1306142328,"COKER, WILLIAM, STEPHEN",~,3600 NW CARY PKWY STE 115 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1306142328,"COKER, WILLIAM, STEPHEN",3600 NW CARY PKWY STE 115 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 73 , 177 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306142336,"BASS, DIEDRE, MARIE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 38 , 69 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306142336,"BASS, DIEDRE, MARIE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306142336,"BASS, DIEDRE, MARIE",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306142336,"BASS, DIEDRE, MARIE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306143219,"GOSS, ALEXIS, PIERINO",6090 SIX FORKS RD STE A RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6090 SIX FORKS RD STE A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306143219,"GOSS, ALEXIS, PIERINO",6090 SIX FORKS RD STE A RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306143219,"GOSS, ALEXIS, PIERINO",4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760420186,PRIDE IN NORTH CAROLINA LLC,~,5710 OLEANDER DR STE 112 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306146618,"FURCHES, ALEXANDER, WEST",5710 OLEANDER DR STE 112 WILMINGTON NC,065,New Hanover,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306152350,"THOMAS, MELISSA, TITUS",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306152350,"THOMAS, MELISSA, TITUS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730646241,HAMMOCK DMD & LOTAKIS DDS IX PLLC,~,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 466 , 636 , 926 ," $149,465.75 ",,
MEDICAID DIRECT,1730646241,HAMMOCK DMD & LOTAKIS DDS IX PLLC,~,5970 FAIRVIEW RD STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,,,$#,,
MEDICAID DIRECT,1073070728,HAMMOCK DMD & LOTAKIS DDS IV PLLC,~,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1629257845,JOHN WALSH DDS PA,DENTISTRY OF THE CAROLINAS,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1730646241,HAMMOCK DMD & LOTAKIS DDS IX PLLC,~,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",5970 FAIRVIEW RD STE 120 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1801091640,JOHN WALSH DDS PA,DENTISTRY OF THE CAROLINAS,5970 FAIRVIEW RD STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",5970 FAIRVIEW RD STE 120 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1730646241,HAMMOCK DMD & LOTAKIS DDS IX PLLC,~,5970 FAIRVIEW RD STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",5970 FAIRVIEW RD STE 120 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,834 "," 10,475 "," 11,149 "," $1,593,710.43 ",,
MEDICAID DIRECT,1285761338,JOHN WALSH DDS PA,DENTISTRY OF THE CAROLINAS,2641 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306153796,"PRETTYMAN, CHASE, THOMAS",2641 COURT DR   GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306155155,"PENLAND, HEATHER, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 65 , 65 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306158035,"POUDEL, PUSHPA, RAJ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 70 , 73 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306159470,"NICOLAISEN DEGNAN, LYNN, MARGRET",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306159470,"NICOLAISEN DEGNAN, LYNN, MARGRET",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306159470,"NICOLAISEN DEGNAN, LYNN, MARGRET",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306159470,"NICOLAISEN DEGNAN, LYNN, MARGRET",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306159629,SKILL CREATIONS INC,Skill Creations Inc,600 W JOHN ST   MOUNT OLIVE NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306159629,SKILL CREATIONS INC,600 W JOHN ST   MOUNT OLIVE NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 352 , 352 ," $18,109.31 ",,
MEDICAID DIRECT,1306161013,GUIDING STAR HEALTH CARE ADULT GROU,GUIDING STAR HEALTH CARE ADULT GROUP HOME,2809 HUNTINGTON CT   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306161013,GUIDING STAR HEALTH CARE ADULT GROU,2809 HUNTINGTON CT   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 939 , 947 ," $43,490.07 ",,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306161971,"FISCHER, REBECCA, GASPERSON",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 49 , 85 ," $13,478.52 ",,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 39 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 58 , 74 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 18 , 25 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1306164389,"DAUGIRD, STEPHEN, ALLEN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306165600,"HOWARD, MATTHEW, CHARLES",950 STATE FARM RD STE 200 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 114 , 232 , 364 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306167226,"SMITH, TAMIKA, SHAYVONNE",1251 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306167440,"ROGERS, MARC, JOHN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306167440,"ROGERS, MARC, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306171541,"MILLER, RUSSELL, THOMAS",2024 OLDE REGENT WAY STE 130 LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 27 ,$#,,
MEDICAID DIRECT,1831465442,MONARCH,,3200 NORTHLINE AVE STE 132 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306172184,"VAN HORN, GAYLE, CAROLYN",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306172184,"VAN HORN, GAYLE, CAROLYN",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1306173844,TJS HOME CARE SERVICES INC,TJS HOME CARE SERVICES INC,3436 BEAMAN OLD CREEK RD   SNOW HILL NC,040,Greene,253Z00000X,Agencies,In Home Supportive Care,,1306173844,TJS HOME CARE SERVICES INC,3436 BEAMAN OLD CREEK RD   SNOW HILL NC,040,Greene,253Z00000X,Agencies,In Home Supportive Care,, 45 ," 11,582 "," 11,718 "," $1,049,924.64 ",,
MEDICAID DIRECT,1821454372,CAROLINA AMPUTEE & ORTHOTICS INC,,1921 TATE BLVD SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306175161,"RUFTY, JOHN, LUTHER",1921 TATE BLVD SE   HICKORY NC,018,Catawba,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 14 , 15 , 38 ,$#,,
MEDICAID DIRECT,1821454372,CAROLINA AMPUTEE & ORTHOTICS INC,,1921 TATE BLVD SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306175161,"RUFTY, JOHN, LUTHER",1921 TATE BLVD SE   HICKORY NC,018,Catawba,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,, 11 , 12 , 132 ,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306176433,"LIN, WIN, JIR",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306176433,"LIN, WIN, JIR",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306176433,"LIN, WIN, JIR",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 46 , 96 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1306176433,"LIN, WIN, JIR",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306178058,"BORASKI, MERYN, RITA",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306178058,"BORASKI, MERYN, RITA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306178058,"BORASKI, MERYN, RITA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306182936,"PARSONS, ARIELLE, ROSEMARIE",ARIELLE R PARSONS DBA SUNSHINE SPEECH,120 PRESTON EXECUTIVE DR STE 218 CARY NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1306182936,"PARSONS, ARIELLE, ROSEMARIE",120 PRESTON EXECUTIVE DR STE 218 CARY NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,61 BONNIE LN   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1306183058,"KRISPINSKY, ANDREW, JOHN",243 JONES COVE RD   CLYDE NC,044,Haywood,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 73 , 108 , 145 ,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,243 JONES COVE RD   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1306183058,"KRISPINSKY, ANDREW, JOHN",243 JONES COVE RD   CLYDE NC,044,Haywood,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,61 BONNIE LN   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1306183058,"KRISPINSKY, ANDREW, JOHN",61 BONNIE LN   SYLVA NC,050,Jackson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 54 , 84 , 134 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306183512,"JEPSEN, ERIN, STEPHANY",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 30 , 61 , 93 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306183512,"JEPSEN, ERIN, STEPHANY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306183512,"JEPSEN, ERIN, STEPHANY",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306183512,"JEPSEN, ERIN, STEPHANY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306183512,"JEPSEN, ERIN, STEPHANY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1306186218,"KUETEMEYER, JULIE, ANNA WILLENBERG",2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 92 , 98 , 250 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306186929,"VEDAR, POL, MARTIN DIMASUHID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1306187125,"MCKINNEY, BRITTANY, ALLEN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 29 , 38 ,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306187125,"MCKINNEY, BRITTANY, ALLEN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 57 , 65 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306189287,"DANFORD, CHRISTOPHER, PETER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 78 , 78 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306189287,"DANFORD, CHRISTOPHER, PETER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 39 , 39 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306189287,"DANFORD, CHRISTOPHER, PETER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306189832,"KRASNE, BENJAMIN, HOWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1306189832,"KRASNE, BENJAMIN, HOWARD",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306189923,"HAMDAN, AMEER, MOHAMMAD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 85 , 168 , 168 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306189923,"HAMDAN, AMEER, MOHAMMAD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306193172,SEASIDE EARLY CHILDHOOD AND INCLUSI,SEASIDE EARLY CHILDHOOD AND INCLUSION SERVICES,733 WINERY WAY   WILMINGTON NC,065,New Hanover,251S00000X,Agencies,Community/Behavioral Health,,1306193172,SEASIDE EARLY CHILDHOOD AND INCLUSI,733 WINERY WAY   WILMINGTON NC,065,New Hanover,251S00000X,Agencies,Community/Behavioral Health,, 30 , 615 , 615 ," $39,835.40 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1306194667,"QURESHI, FURHAN, RASHID",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306194667,"QURESHI, FURHAN, RASHID",628 E 12TH ST   WASHINGTON NC,007,Beaufort,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 32 , 32 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306195706,"MEADE, HANNAH, BREARLEY",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306196266,"DINGLE, ISAAC, FELDER",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 27 , 40 , 70 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306196266,"DINGLE, ISAAC, FELDER",10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306197975,"LAPICHE, FRANCINE, JAIME",10207 CERNEY STE STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306197975,"LAPICHE, FRANCINE, JAIME",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306197975,"LAPICHE, FRANCINE, JAIME",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306197975,"LAPICHE, FRANCINE, JAIME",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306198684,"GUNTHER, ELIZABETH, MAREE",3545 WHITEHALL PARK DR   CHARLOTTE NC,060,Mecklenburg,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306199542,"BAILEY, SHIBAHN, JOLENE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306199542,"BAILEY, SHIBAHN, JOLENE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306199542,"BAILEY, SHIBAHN, JOLENE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1306200175,"LEE, SUSAN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306200175,"LEE, SUSAN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306200175,"LEE, SUSAN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306200175,"LEE, SUSAN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306200175,"LEE, SUSAN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306200175,"LEE, SUSAN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 60 , 85 , 129 ," $14,490.79 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306200282,"MOTTA, CHRISTOPHER, SEAN",101 CLINIC DR   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 89 , 234 , 241 ," $13,335.33 ",,
MEDICAID DIRECT,1306200597,RIVERSIDE VILLAGE HOMES INC,,132 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306200597,RIVERSIDE VILLAGE HOMES INC,132 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 15 , 15 ," $26,748.48 ",,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306202130,"LU, HAIYAN",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 16 , 13 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306202130,"LU, HAIYAN",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306202130,"LU, HAIYAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1457090037,CENTERWELL SENIORPRIMARYCARENC JVPC,,901 N WENDOVER RD STE D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306202742,"KINDELL, MIESHA, KIA-JAYNE",901 N WENDOVER RD STE D CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1306202742,"KINDELL, MIESHA, KIA-JAYNE",901 N WENDOVER RD STE D CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306203443,"PRICE, ANNE, TEMPLE",150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 52 , 124 ,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1306203443,"PRICE, ANNE, TEMPLE",150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306203443,"PRICE, ANNE, TEMPLE",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",5080 KAHN DR STE 120 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 57 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 35 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306204870,"AKUOKO, NANA",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306208376,"POZAS-GUAJARDO, ALFONSO, GERARDO",104 SOUTHERN AVE   RAEFORD NC,047,Hoke,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 17 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306208376,"POZAS-GUAJARDO, ALFONSO, GERARDO",1031 WEISS AVE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 61 ,$#,,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1306208376,"POZAS-GUAJARDO, ALFONSO, GERARDO",3551 DUNN RD   EASTOVER NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306208376,"POZAS-GUAJARDO, ALFONSO, GERARDO",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,163 "," 1,767 "," 9,947 "," $749,572.24 ",,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1306208376,"POZAS-GUAJARDO, ALFONSO, GERARDO",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 502 , 616 ," 3,100 "," $187,986.10 ",,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1306208376,"POZAS-GUAJARDO, ALFONSO, GERARDO",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306208467,"BANSAL, RANI",4101 MACON POND RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306208467,"BANSAL, RANI",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306208467,"BANSAL, RANI",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306209325,"COPPOCK, JOSEPH, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 91 , 81 , 95 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306209325,"COPPOCK, JOSEPH, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306209937,"JAKHARIA, KUNAL, KISHOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 37 , 75 , 102 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306209937,"JAKHARIA, KUNAL, KISHOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 44 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306209937,"JAKHARIA, KUNAL, KISHOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306215975,"REICHMANN, GRETCHEN",1540 SUNDAY DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 58 , 118 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1306217450,"MCDOWELL, TERRI, PEARCE",1030 SIENA DR   WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 17 , 20 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306217450,"MCDOWELL, TERRI, PEARCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306217450,"MCDOWELL, TERRI, PEARCE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306217450,"MCDOWELL, TERRI, PEARCE",3324 SIX FORKS RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 44 , 50 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1306217450,"MCDOWELL, TERRI, PEARCE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306217450,"MCDOWELL, TERRI, PEARCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 21 , 25 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306217740,"BLACK, JASON, ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306223425,"CAPEK, DAPHNE, LOUISE",1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306223425,"CAPEK, DAPHNE, LOUISE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 16 , 26 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306223425,"CAPEK, DAPHNE, LOUISE",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306223425,"CAPEK, DAPHNE, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306225206,"DOAN, MATTHEW, TUAN",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1306226253,GATES HOUSE LLC,GATES HOUSE,11 COMMERCE DR   GATESVILLE NC,037,Gates,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306226253,GATES HOUSE LLC,11 COMMERCE DR   GATESVILLE NC,037,Gates,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 38 ," 4,586 "," 4,587 "," $801,073.62 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306226956,"CAMPBELL, KRISTIN, ELIZABETH",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306227160,"RUSH, BENJAMIN, WOODRESS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 79 , 142 , 177 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,7482 WATERSIDE CROSSING BLVD   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306228473,"BROOKS, RYAN, SCOTT",7482 WATERSIDE CROSSING BLVD   DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 38 , 56 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306228473,"BROOKS, RYAN, SCOTT",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306228473,"BROOKS, RYAN, SCOTT",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1306229174,"BORGET, GISELA, LILIAN",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,804 "," 3,444 "," 4,546 "," $832,357.63 ",,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1306229174,"BORGET, GISELA, LILIAN",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,994 "," 4,027 "," 5,320 "," $922,712.33 ",,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1306230347,"EWART, MARY, CATHERINE WILLIAMS",1000 HEALING WAY   MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 48 , 48 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306230347,"EWART, MARY, CATHERINE WILLIAMS",1000 HEALING WAY   MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 55 , 55 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306230347,"EWART, MARY, CATHERINE WILLIAMS",1000 HEALING WAY   MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306230347,"EWART, MARY, CATHERINE WILLIAMS",1000 HEALING WAY   MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306230347,"EWART, MARY, CATHERINE WILLIAMS",920 CHURCH ST N STE 225 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306230347,"EWART, MARY, CATHERINE WILLIAMS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306230941,"SHAH, KINCHIT, K",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306230941,"SHAH, KINCHIT, K",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306230941,"SHAH, KINCHIT, K",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306230941,"SHAH, KINCHIT, K",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 80 , 81 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306230941,"SHAH, KINCHIT, K",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306232004,"GREMILLION, SCOTT, DAVID",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306232004,"GREMILLION, SCOTT, DAVID",101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306232004,"GREMILLION, SCOTT, DAVID",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407277536,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306232004,"GREMILLION, SCOTT, DAVID",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306232715,"HILSMAN, MATTHEW, JAMES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 136 , 136 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306232715,"HILSMAN, MATTHEW, JAMES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 179 , 179 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306232731,"FONTENOT, PHILIP",30 AIRPORT PARK RD   FLETCHER NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306232731,"FONTENOT, PHILIP",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306232731,"FONTENOT, PHILIP",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 19 , 35 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306232731,"FONTENOT, PHILIP",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 42 , 84 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306232731,"FONTENOT, PHILIP",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306233457,"CHEN, LILING",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306233457,"CHEN, LILING",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306233457,"CHEN, LILING",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306233457,"CHEN, LILING",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306235429,"GALLUPPI, AMANDA, RENEE WELLS",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 33 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306235429,"GALLUPPI, AMANDA, RENEE WELLS",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 28 , 32 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306235429,"GALLUPPI, AMANDA, RENEE WELLS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306236930,"GUYTON, AMBER, NICOLE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306239686,"JUSTUS, AMANDA, GRINNELL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1306239686,"JUSTUS, AMANDA, GRINNELL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306245964,"BLESSING, MARY, ELIZABETH",4220 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306245964,"BLESSING, MARY, ELIZABETH",4220 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 48 ,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306246012,"HOEDT, CHRISTEN, WILHELM",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 164 , 446 , 807 ," $18,563.18 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1306251384,"PHIPPS, DEBORAH, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306251384,"PHIPPS, DEBORAH, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 24 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306251384,"PHIPPS, DEBORAH, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 19 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306251384,"PHIPPS, DEBORAH, ANNE",100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306251384,"PHIPPS, DEBORAH, ANNE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 18 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306253422,"HAUSBERGER, MICHAEL, DAVID",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306253422,"HAUSBERGER, MICHAEL, DAVID",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 25 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306253422,"HAUSBERGER, MICHAEL, DAVID",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1306254222,"KETNER, JESSICA, LEIGH",1135 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306254222,"KETNER, JESSICA, LEIGH",1135 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306254222,"KETNER, JESSICA, LEIGH",615 RIDGE RD   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306254222,"KETNER, JESSICA, LEIGH",615 RIDGE RD   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,3762 DURHAM RD STE A ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306254222,"KETNER, JESSICA, LEIGH",3762 DURHAM RD STE A ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1306254222,"KETNER, JESSICA, LEIGH",1705 TARBORO ST SW   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 34 , 37 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306254222,"KETNER, JESSICA, LEIGH",1705 TARBORO ST SW   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 26 , 28 ,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306255393,"WHARTON, COURTNEY, MARIE",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 28 , 54 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306256250,"KAVANAGH, LARISSA, ANNE",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306256250,"KAVANAGH, LARISSA, ANNE",301 S COLLEGE ST STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306256250,"KAVANAGH, LARISSA, ANNE",301 S COLLEGE ST STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1237 HARDING PL STE 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306256250,"KAVANAGH, LARISSA, ANNE",301 S COLLEGE ST STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306256250,"KAVANAGH, LARISSA, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306256250,"KAVANAGH, LARISSA, ANNE",301 S COLLEGE ST STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598135188,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH TRANSITION CLINIC,1237 HARDING PL # 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306256250,"KAVANAGH, LARISSA, ANNE",301 S COLLEGE ST STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306256599,"SOTELO, ALAN, ENRIQUE",5107 SOUTHPARK DR STE 202 DURHAM NC,032,Durham,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306256599,"SOTELO, ALAN, ENRIQUE",2609 N DUKE ST STE 301 DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306256599,"SOTELO, ALAN, ENRIQUE",5107 SOUTHPARK DR STE 202 DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2609 N DUKE ST STE 301 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306256599,"SOTELO, ALAN, ENRIQUE",2609 N DUKE ST STE 301 DURHAM NC,032,Durham,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#, 11 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306256706,"WILLIFORD, MICHAEL, LEE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306256706,"WILLIFORD, MICHAEL, LEE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306256706,"WILLIFORD, MICHAEL, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 40 , 43 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306256706,"WILLIFORD, MICHAEL, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 51 , 75 , 86 ," $14,428.64 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306257043,"GRAYSON, MARVYN, ANTHONY",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306257043,"GRAYSON, MARVYN, ANTHONY",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356366413,CRYSTAL COAST FAMILY PRACTICE,CRYSTAL COAST FAMILY PRACTICE,505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1306257902,"BELL, ELIZABETH, VIRGINIA",505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 19 , 33 , 38 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1306257902,"BELL, ELIZABETH, VIRGINIA",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1306257902,"BELL, ELIZABETH, VIRGINIA",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1306257902,"BELL, ELIZABETH, VIRGINIA",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 11 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306259015,"PATEL, JANUSKUMAR, SANMUKHBHAI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 81 , 186 , 290 ,$#,,
MEDICAID DIRECT,1063849487,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST RHEUMATOLOGY,,,Unknown,193400000X,Group,Single Specialty,,1306259700,"GN, CHARIS, SU-HSIEH",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,,,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306259700,"GN, CHARIS, SU-HSIEH",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 19 , 34 , 57 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,16645 BIRKDALE COMMONS PKWY STE 200F HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306259700,"GN, CHARIS, SU-HSIEH",16645 BIRKDALE COMMONS PKWY STE 200F HUNTERSVILLE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 22 , 28 ,$#,,
MEDICAID DIRECT,1891000493,EASTERN RADIOLOGIST INC,GREENVILLE MRI,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306259833,"WALLACE, JOSHUA, ADAM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1306259833,"WALLACE, JOSHUA, ADAM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 411 , 450 , 547 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306259833,"WALLACE, JOSHUA, ADAM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 481 , 512 , 644 ," $19,024.04 ",,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306260278,"TOBIN, DAVID, AARON",2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306260278,"TOBIN, DAVID, AARON",2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,7900 TRIAD CENTER DR STE 132 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,,1306263009,HEALTH & HOME SERVICES INC,3300 BATTLEGROUND AVE STE 406 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,, 40 ," 1,846 "," 1,872 "," $516,013.00 ",,
MEDICAID DIRECT,1306263009,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,3300 BATTLEGROUND AVE STE 406 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,,1306263009,HEALTH & HOME SERVICES INC,3300 BATTLEGROUND AVE STE 406 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,, 55 ," 9,351 "," 10,333 "," $4,674,239.74 ",,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1306263009,HEALTH & HOME SERVICES INC,3300 BATTLEGROUND AVE STE 406 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,,#,#,#,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1306263603,"JOHNSON, JEREMY, MICHAEL",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 86 , 91 , 96 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306264122,"SCHMITZ, DAVID, BRIAN",584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 29 , 85 ,$#,,
MEDICAID DIRECT,1265778278,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH OCEANSIDE FAMILY MEDICINE,584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1306264122,"SCHMITZ, DAVID, BRIAN",584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306264122,"SCHMITZ, DAVID, BRIAN",257 HOSPITAL DR NE STE 101 BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 50 , 122 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1306264122,"SCHMITZ, DAVID, BRIAN",584 HOSPITAL DR NE UNIT C BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306265228,"CHEVROLLIER, GUILLAUME, SYLVAIN",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306265228,"CHEVROLLIER, GUILLAUME, SYLVAIN",1718 E 4TH ST STE 307 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 21 , 48 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306265228,"CHEVROLLIER, GUILLAUME, SYLVAIN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306266804,"WANG, YI",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 12 ,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306266804,"WANG, YI",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306266804,"WANG, YI",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1306269477,"SPONSELLER, DENISE, WIBRAN",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 29 , 41 ,$#,,
MEDICAID DIRECT,1306269709,LAKEETA LADSON-ABROM,COMPLETE SPEECH THERAPY & WELLNESS,800 BRIAR CREEK RD STE AA206 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306269709,LAKEETA LADSON-ABROM,800 BRIAR CREEK RD STE AA206 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 17 , 256 , 324 ," $21,755.16 ",,
MEDICAID DIRECT,1306272828,WALGREEN CO,~,11 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1306272828,WALGREEN CO,11 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1306274238,"DRAKE, HOLLY, ANNE",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 18 , 19 , 20 ," $11,269.08 ",,
MEDICAID DIRECT,1518642255,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA WOMENS HEALTH CENTER RHC,1140 CARTHAGE ST STE A SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306274238,"DRAKE, HOLLY, ANNE",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306275177,"WENZEL, JULIE, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306276530,"BILLIAR, CHRISTOPHER, DAVID",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1306276803,"MOORE, ERIN, ALYCIA",87 MEDICAL PARK DR STE A BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1306276803,"MOORE, ERIN, ALYCIA",57 HOWARD GAP RD   FLETCHER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306276803,"MOORE, ERIN, ALYCIA",57 HOWARD GAP RD   FLETCHER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1306276803,"MOORE, ERIN, ALYCIA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306276803,"MOORE, ERIN, ALYCIA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 106 , 301 , 307 ,$#,,
MEDICAID DIRECT,1992703540,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306279336,"TUCKER, DAVID, CUSHING",11200 GOVERNOR MANLY WAY STE 305 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306279336,"TUCKER, DAVID, CUSHING",11200 GOVERNOR MANLY WAY STE 305 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306280128,"MILLIGAN, JUSTIN, MARC",600 GRESHAM DR STE 8620 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306280128,"MILLIGAN, JUSTIN, MARC",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306280128,"MILLIGAN, JUSTIN, MARC",397 LITTLE NECK RD STE 120 VIRGINIA BEACH VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1306282355,"HAWKINS, ABBEY, SPARKS",ABBY S HAWKINS,113 W ARBOR LN   EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1306282355,"HAWKINS, ABBEY, SPARKS",113 W ARBOR LN   EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 21 , 55 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306282520,"JONES, MONICA, GENE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306282520,"JONES, MONICA, GENE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306283122,"MOORE, GARRISON, HUNTER",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 16 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306283122,"MOORE, GARRISON, HUNTER",5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306283171,"SCHMITT, AARON, MISHAEL",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 62 , 68 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306283171,"SCHMITT, AARON, MISHAEL",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 28 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306284120,"NASSEF, CHRISTOPHER, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306284120,"NASSEF, CHRISTOPHER, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 66 , 66 ,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306284351,"TRIVEDI, VAIDEHI, MAHESH",2721 X RAY DR   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 37 , 57 ,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306284351,"TRIVEDI, VAIDEHI, MAHESH",2721 X RAY DR   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306284765,"LAROIA COON, SWATI",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306284765,"LAROIA COON, SWATI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306284773,"HALSEY, MICHAEL, GRAHAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 42 , 63 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306284773,"HALSEY, MICHAEL, GRAHAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 62 , 93 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306286141,"KAWAKITA, TETSUYA",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,,,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306288485,"THOMPSON, AMY, LYNN",912 2ND ST NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 69 , 83 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306288485,"THOMPSON, AMY, LYNN",912 2ND ST NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1306289996,PHI HEALTH LLC,PHI AIR MEDICAL,1500 INDUSTRIAL BLVD   MCKINNEY TX,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1306289996,PHI HEALTH LLC,1500 INDUSTRIAL BLVD   MCKINNEY TX,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306290564,"TAYLOR, KEVIN, ANDREW",503 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306290564,"TAYLOR, KEVIN, ANDREW",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 72 , 95 , 146 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306290572,"SIRA, ZAKERY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1306290572,"SIRA, ZAKERY",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1306290572,"SIRA, ZAKERY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 77 , 77 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306290572,"SIRA, ZAKERY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 43 , 43 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306290572,"SIRA, ZAKERY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306290572,"SIRA, ZAKERY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306291356,"SHANNON, SEAN, PATRICK",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306291356,"SHANNON, SEAN, PATRICK",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306291760,"MELVIN, ROMAN, GEBREMESKEL",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 39 , 97 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306292586,"PALMER, TONYA, LOUISE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 44 , 114 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306292586,"PALMER, TONYA, LOUISE",190 INDEPENDENCE AVE STE B NORTH WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306292669,"HOMISTEK, CODY, ELIZABETH",106 CORPORATE PARK DR STE 200&300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 21 , 40 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306292768,"DEAN, MICHAEL, EDWARD",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 25 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306292768,"DEAN, MICHAEL, EDWARD",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 34 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306295431,"MUTHIG, TRAVIS, MICHAEL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 22 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306295431,"MUTHIG, TRAVIS, MICHAEL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1306296181,"THAKARAR, RISHI, SHASHI",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1306296181,"THAKARAR, RISHI, SHASHI",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306296843,"TRAN, TAM, MINH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306296975,"COCHRANE, ANNA, CAROLINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 51 , 57 , 66 ," $15,711.67 ",,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1306297106,"YETZER, HANNAH, HARDWICK",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1306297106,"YETZER, HANNAH, HARDWICK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306297791,"HORNSBY, KRISTINA, HOWELL",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 72 , 144 ," $12,614.71 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306297841,"COUGHLIN, KEVIN, CHRISTOPHER",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 18 , 21 , 30 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306297841,"COUGHLIN, KEVIN, CHRISTOPHER",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306297841,"COUGHLIN, KEVIN, CHRISTOPHER",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 55 , 104 , 131 ,$#,,
MEDICAID DIRECT,1306299516,"LEE, CHUNG, HYUP",PRAUS DENTISTRY,679 MILLS PARK DR   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1306299516,"LEE, CHUNG, HYUP",679 MILLS PARK DR   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 88 , 173 , 577 ," $25,863.31 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306299532,"SCOTT, COURTNEY, SIMMONS",2265 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 40 , 54 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306300553,"WILLIAMS, JESSICA, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1306305859,THERAPY AND EDUCATION CONNECTIONS,,2106 CROSSWAY LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1306305859,THERAPY AND EDUCATION CONNECTIONS,2106 CROSSWAY LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,, 25 , 499 , 644 ," $47,189.97 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306306196,"WUNROW, ZACHARY, BLAZE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306307392,"CHITTA, PAWANKUMAR, ADITYA",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306307764,"MCLAWHORN, ROBIN, RHYNE",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 26 , 26 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1306309497,"RIZK, CHRISTINA, MARIE",201 WILLIAMSBURG PKWY   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306309497,"RIZK, CHRISTINA, MARIE",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306310735,"RIGBY, MORGAN, BASS",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306312327,"NTIBREY, DANIEL, KWAKU",606 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972050979,TRIAD ADULT AND PEDIATRIC MEDICINE,,2039 BRENTWOOD ST STE B109 HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306312327,"NTIBREY, DANIEL, KWAKU",2039 BRENTWOOD ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730636028,ELOHIM HOUSECALL DOCTORS PA,,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306312327,"NTIBREY, DANIEL, KWAKU",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 48 , 50 ,$#,,
MEDICAID DIRECT,1972050979,TRIAD ADULT AND PEDIATRIC MEDICINE,,2039 BRENTWOOD ST STE B109 HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306312327,"NTIBREY, DANIEL, KWAKU",2039 BRENTWOOD ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 21 ,$#,,
MEDICAID DIRECT,1730636028,ELOHIM HOUSECALL DOCTORS PA,,1320 N HAMILTON ST STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306312327,"NTIBREY, DANIEL, KWAKU",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1821359142,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306315270,"ROGERS, MICHELLE, TOLBERT",600 HOSPITAL DR   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 74 , 80 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306316179,"BURLESON, CARRIE, ELIZABETH AVERY",710 JULIAN RD   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306316179,"BURLESON, CARRIE, ELIZABETH AVERY",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 136 ," 1,136 "," 1,136 "," $35,724.19 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,707 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306316179,"BURLESON, CARRIE, ELIZABETH AVERY",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306318100,"OCHS, KENNETH, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306318209,"DARLING, CARA LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306318209,"DARLING, CARA LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306320593,"PERRIN, RACHAEL, HUPP",~,2521 ARBOR LN   HILLSBOROUGH NC,068,Orange,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1306320593,"PERRIN, RACHAEL, HUPP",2521 ARBOR LN   HILLSBOROUGH NC,068,Orange,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 23 , 186 , 186 ," $17,534.58 ",,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306321930,"OSLIE, EMILY, PAIGE",7021 HARPS MILL RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1306321930,"OSLIE, EMILY, PAIGE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306321930,"OSLIE, EMILY, PAIGE",10211 ALM ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306321930,"OSLIE, EMILY, PAIGE",1821 HILLANDALE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306321930,"OSLIE, EMILY, PAIGE",1821 HILLANDALE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 29 , 55 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1306321930,"OSLIE, EMILY, PAIGE",1901 HILLANDALE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306321930,"OSLIE, EMILY, PAIGE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306323845,NATIONAL MOBILE X-RAY,NATIONAL MOBILE X-RAY,251 DOMINION DR STE 112 MORRISVILLE NC,092,Wake,293D00000X,Laboratories,Physiological Laboratory,,1306323845,NATIONAL MOBILE X-RAY,251 DOMINION DR STE 112 MORRISVILLE NC,092,Wake,293D00000X,Laboratories,Physiological Laboratory,, 296 , 322 , 340 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306325030,"HOWELL, DAKAR, SCOTT",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 19 , 34 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4600 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306325030,"HOWELL, DAKAR, SCOTT",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 35 , 58 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,9101 OCEAN HWY E   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1306327515,"ANDERSON, NATASHA, RAY",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306327515,"ANDERSON, NATASHA, RAY",5130 SOUTHPORT SUPPLY RD SE STE 101 SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,202 VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1306327515,"ANDERSON, NATASHA, RAY",202 VILLAGE RD NE   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306327515,"ANDERSON, NATASHA, RAY",5130 SOUTHPORT SUPPLY RD SE STE 101 SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306327515,"ANDERSON, NATASHA, RAY",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 39 , 66 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5214 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306327515,"ANDERSON, NATASHA, RAY",5214 MARKET ST STE 101 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306327515,"ANDERSON, NATASHA, RAY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 20 , 24 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306328588,"CURRALL, TAYLOR, BLAIR",512 VILLAGE RD STE 205 SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 25 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306328588,"CURRALL, TAYLOR, BLAIR",512 VILLAGE RD STE 207 SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 27 , 36 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306330113,"CRANDALL, MARIA, SEEAR",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306330113,"CRANDALL, MARIA, SEEAR",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 24 , 36 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306330139,"OLAFSON, SAMANTHA, NEAL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306331236,"MORTIS, GABRIELLE, INEZ",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 12 , 14 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306331236,"MORTIS, GABRIELLE, INEZ",13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477834992,DEST REIMELS DDS PLLC,BELVEDERE DENTISTRY,2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306331707,"AKINYEMI, OLUFUNMILOLA, OLUBUKOLA",2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1306332077,"HAWES, ELIZABETH, HUNTER",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 140 , 414 ,$#,,
MEDICAID DIRECT,1114373404,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306332697,"ASUNCION, KRISTINE, JOYCE LANGCAUON",351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437580107,NORTH CAROLINA CENTRAL UNIVERSITY,~,1801 FAYETTEVILLE ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1306333943,"KAHN, EMILY, KATE",1801 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 13 ,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306336177,"PRITT, NICOLE, MAYLIN",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 73 , 133 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1306336995,"KING, ERIK, REID",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306336995,"KING, ERIK, REID",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 28 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306336995,"KING, ERIK, REID",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 69 , 87 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306336995,"KING, ERIK, REID",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1306337282,"SHI, LEI",LEI SHI DDS PLLC,8511 CANTILEVER WAY STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1306337282,"SHI, LEI",8511 CANTILEVER WAY STE 101 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 371 , 857 ," 3,462 "," $243,879.71 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306339676,"MOVERMAN, MICHAEL, ADAM",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306339676,"MOVERMAN, MICHAEL, ADAM",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306339676,"MOVERMAN, MICHAEL, ADAM",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306340203,"BYRNE, TERESA, JEAN",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 29 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306342381,"PAYNE, TIFFANY, MARIE",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306342381,"PAYNE, TIFFANY, MARIE",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 32 , 37 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306342381,"PAYNE, TIFFANY, MARIE",101 PLAZA RD   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 19 , 26 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306342597,"TAYLOR, HENRY, JOE",3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 153 , 222 , 408 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306342597,"TAYLOR, HENRY, JOE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306342597,"TAYLOR, HENRY, JOE",445 PINEVIEW DR STE 230 KERNERSVILLE NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 18 , 22 , 42 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306342597,"TAYLOR, HENRY, JOE",3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 39 , 39 , 74 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306342597,"TAYLOR, HENRY, JOE",445 PINEVIEW DR STE 230 KERNERSVILLE NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#, 16 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306342597,"TAYLOR, HENRY, JOE",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306345020,"WEEKS, JENNIFER, STEWART",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 50 , 116 ,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306345020,"WEEKS, JENNIFER, STEWART",714 S MAIN ST   LEXINGTON NC,029,Davidson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1306345020,"WEEKS, JENNIFER, STEWART",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 26 , 84 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306348081,"ALQARIAB, HANA",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1619904430,SOUTH CHARLOTTE PRIMARY CARE,ATRIUM HEALTH PRIMARY CARE SOUTH CHARLOTTE INTERNA,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306348081,"ALQARIAB, HANA",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 35 , 44 ,$#,,
MEDICAID DIRECT,1891013181,DEL BIANCO ENTERPRISES,DEL BIANCO PROSTHETICS & ORTHOTICS,1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306348354,"HITCHCOCK, JILLIAN, KAY",3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306348701,"BUSH, CHRISTY, POPE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982883583,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1895 HOFFMAN RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1306348701,"BUSH, CHRISTY, POPE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 31 , 41 ,$#,,
MEDICAID DIRECT,1982883583,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1895 HOFFMAN RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1306348701,"BUSH, CHRISTY, POPE",1895 HOFFMAN RD STE A GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 17 , 29 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,12000 RETAIL DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1306351564,"EDRALIN, PRINA, PATEL",3573 HILLSBOROUGH RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1306355060,"WOODLEY, ELIZABETH, UNIVA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1306355060,"WOODLEY, ELIZABETH, UNIVA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1306355060,"WOODLEY, ELIZABETH, UNIVA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 33 , 33 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1306355060,"WOODLEY, ELIZABETH, UNIVA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1306355060,"WOODLEY, ELIZABETH, UNIVA",1135 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1306355060,"WOODLEY, ELIZABETH, UNIVA",300 W 27TH ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306359120,"WILLINGER, MONICA, LEIGH",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1306361597,"TAIWO, ADEYEMI, ADEDAMOLA",220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306361597,"TAIWO, ADEYEMI, ADEDAMOLA",220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306361597,"TAIWO, ADEYEMI, ADEDAMOLA",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 462 , 787 , 982 ," $16,835.80 ",,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1306361829,"CABALONA, ABEGAIL, PENA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 97 , 97 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306361829,"CABALONA, ABEGAIL, PENA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 149 , 150 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306362884,"GUASCH, SARA, ALICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306363973,"FINNIGAN, MARY, KATHLEEN",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 45 , 47 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306363973,"FINNIGAN, MARY, KATHLEEN",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 30 , 32 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306364526,"WRIGHT, KELLY, KARELL",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 22 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306364526,"WRIGHT, KELLY, KARELL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306364526,"WRIGHT, KELLY, KARELL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 15 , 19 , 48 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2460 CURTIS ELLIS DR # 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306364526,"WRIGHT, KELLY, KARELL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 14 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306364526,"WRIGHT, KELLY, KARELL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1306364526,"WRIGHT, KELLY, KARELL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306364526,"WRIGHT, KELLY, KARELL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 38 , 44 , 90 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306365630,"RAFIDI, MELISSA, ANNE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306365630,"RAFIDI, MELISSA, ANNE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306365630,"RAFIDI, MELISSA, ANNE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 29 , 59 ,$#,,
MEDICAID DIRECT,1407325509,SPARTANBURG MEDICAL CENTER,MEDGRPOFTHECAROLINAS- GASTROENTEROLOGY-SKYLYN,11 DOCTORS PARK DR STE 240 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306366133,"BEATTIE, MICHAEL, JOSEPH",853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306368378,"PANEK, STACIE, MARIE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 41 , 91 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306370135,"DEMARCO, BENJAMIN, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 50 , 85 , 135 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 33 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 39 , 55 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 18 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 36 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 23 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306370804,"KOMMOR, MADISON, BENTLEY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1306371521,"NEAL, AMY, NICOLE",41 BAIN ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1102 B US 601   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1306371521,"NEAL, AMY, NICOLE",1102 B US 601   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 81 , 250 ," $11,836.72 ",,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1306372487,"SIDNEY, KATRINA, TRINETTE",101 ROBESON ST STE 202 E FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306372487,"SIDNEY, KATRINA, TRINETTE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306373808,"KAZE DJOU, ARNAUD",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306373808,"KAZE DJOU, ARNAUD",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306376405,"AGASHE, SHRUTI, HEMANT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306376405,"AGASHE, SHRUTI, HEMANT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology, 60 , 85 , 115 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306376405,"AGASHE, SHRUTI, HEMANT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology, 17 , 18 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306376405,"AGASHE, SHRUTI, HEMANT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology, 16 , 58 , 58 ,$#,,
MEDICAID DIRECT,1306376660,FOUNDATIONS EDUCATION ACADEMY,,929 E GARRISON BLVD STE 7 GASTONIA NC,036,Gaston,251S00000X,Agencies,Community/Behavioral Health,,1306376660,FOUNDATIONS EDUCATION ACADEMY,929 E GARRISON BLVD STE 7 GASTONIA NC,036,Gaston,251S00000X,Agencies,Community/Behavioral Health,, 45 ," 1,105 "," 1,105 "," $71,604.00 ",,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1306377999,"LUCAS, TAMMY, GAIL",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306377999,"LUCAS, TAMMY, GAIL",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306377999,"LUCAS, TAMMY, GAIL",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306378526,"DUKES, MARY, FRANCES",742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326364100,LOWCOUNTRY URGENT CARE,LOWCOUNTRY URGENT CARE,501 RADFORD BLVD   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306378856,"LANE, KRISTOPHER, OLEN",501 RADFORD BLVD   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306384235,"ROBERTS, LINDSAY, GORE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306388186,"CAIETTA, MICHELE, CATHERINE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306388202,"MCKINSEY, ALEXANDRA, RIEHM",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306388202,"MCKINSEY, ALEXANDRA, RIEHM",1718 E 4TH ST STE 604 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306388202,"MCKINSEY, ALEXANDRA, RIEHM",1718 E 4TH ST STE 604 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306388202,"MCKINSEY, ALEXANDRA, RIEHM",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1306388483,FAITHFUL SERVANTS CARE LLC,FAITHFUL SERVANTS CARE,304 GRIGGS ACRES DR   POINT HARBOR NC,027,Currituck,253Z00000X,Agencies,In Home Supportive Care,,1306388483,FAITHFUL SERVANTS CARE LLC,304 GRIGGS ACRES DR   POINT HARBOR NC,027,Currituck,253Z00000X,Agencies,In Home Supportive Care,,#, 69 , 75 ," $12,218.00 ",,
MEDICAID DIRECT,1194252874,WRIGHT AND ASSOCIATES IV DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1306391016,"COSTNER, RYAN",598 E JACKSON BLVD STE 200 ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 158 , 225 , 828 ," $83,408.86 ",,
MEDICAID DIRECT,1740636281,WRIGHT AND ASSOCIATES II DDS PA,,598 E JACKSON BLVD STE 200 ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1306391016,"COSTNER, RYAN",598 E JACKSON BLVD STE 200 ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 516 , 844 ," 3,319 "," $333,966.79 ",,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1306391016,"COSTNER, RYAN",598 E JACKSON BLVD STE 200 ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 33 ,$#,,
MEDICAID DIRECT,1841694254,LANE AND ASSOCIATES XXVIII DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1306391016,"COSTNER, RYAN",598 E JACKSON BLVD STE 200 ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 148 , 209 , 892 ," $94,010.59 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306391636,"JAYNES, JORDAN, BROOKS-GADDY",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306391636,"JAYNES, JORDAN, BROOKS-GADDY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 28 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306391776,"WELLS, COLLEEN, MARIE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306391776,"WELLS, COLLEEN, MARIE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306400809,"MORCOS, MARINA, WAFIK",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 159 , 271 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306400809,"MORCOS, MARINA, WAFIK",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306403308,"BURTON, KENYA, CHANTE",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306403308,"BURTON, KENYA, CHANTE",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306403308,"BURTON, KENYA, CHANTE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306403993,"BLACK, ALEXANDRIA, DIANE",722 HYATT ST STE C GAFFNEY SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306404611,"ALEXANDER, KRISTINE, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 52 , 52 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306405162,"OSBORNE, TIRRANY, TANIELLE",5710 W GATE CITY BLVD STE I GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 69 , 94 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,5710 W GATE CITY BLVD STE I GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306405162,"OSBORNE, TIRRANY, TANIELLE",5710 W GATE CITY BLVD STE I GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1306405527,"KWON, CAROLINE, SUN HYUNG",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306405527,"KWON, CAROLINE, SUN HYUNG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306406921,"ANDERSON, KITTY, RENE",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1306406921,"ANDERSON, KITTY, RENE",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1457604902,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES HOKE,6322 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1306406921,"ANDERSON, KITTY, RENE",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1306407648,"SMITH, AMY, LYNN",10 AVIEMORE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306408125,"BOYER, TRENT, MARVIN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306408125,"BOYER, TRENT, MARVIN",3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 172 , 328 , 495 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306408125,"BOYER, TRENT, MARVIN",445 PINEVIEW DR STE 230 KERNERSVILLE NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 31 , 61 , 90 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306409255,"NEWSOME, RACHEL, ALESSANDRA",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306409255,"NEWSOME, RACHEL, ALESSANDRA",8420 UNIVERSITY EXEC PARK DR STE 850 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 108 , 238 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306409255,"NEWSOME, RACHEL, ALESSANDRA",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306409883,"SAUNDERS, KATHERINE, EMILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 12 , 12 , 23 ,$#,,
MEDICAID DIRECT,1265908479,MH MISSION HOSPITAL MCDOWELL LLLP,,1633 SUGAR HILL RD   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306412713,"ALLISON, CHARISSE, CHRISTIANA",1633 SUGAR HILL RD   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 84 , 108 ," $19,127.83 ",,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306412846,"POKHAREL, SHATAKSHI",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 52 , 67 ,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306422373,"FADEL, ANNA, KATHRYN",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 33 , 75 ,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306422373,"FADEL, ANNA, KATHRYN",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851805022,STARMED URGENT & FAMILY CARE PA,,4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306422373,"FADEL, ANNA, KATHRYN",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306422373,"FADEL, ANNA, KATHRYN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306422373,"FADEL, ANNA, KATHRYN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306423306,LAKE GASTON OPCO HOLDINGS LLC,THE LANDINGS OF LAKE GASTON,206 N MOSBY AVE   LITTLETON NC,093,Warren,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306423306,LAKE GASTON OPCO HOLDINGS LLC,206 N MOSBY AVE   LITTLETON NC,093,Warren,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 28 ," 6,521 "," 6,521 "," $532,391.96 ",,
MEDICAID DIRECT,1427604149,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE - MORRISVILLE MEDICAL PARK,101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306426820,"JAMES, NEELAM, JASMINE",7560 CARPENTER FIRE STATION RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427604149,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE - MORRISVILLE MEDICAL PARK,101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306426820,"JAMES, NEELAM, JASMINE",101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730368952,SEASIDE FAMILY PRACTICE OF BEAUFORT,SEASIDE FAMILY PRACTICE OF BEAUFORT,407 LIVE OAK ST STE 1 BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1306427828,"LEONARD, EMILY, LOUISE",407 LIVE OAK ST STE 1 BEAUFORT NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 109 , 126 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306427877,"BEASLEY, TREVOR, COLE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306427877,"BEASLEY, TREVOR, COLE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1306427877,"BEASLEY, TREVOR, COLE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1306427877,"BEASLEY, TREVOR, COLE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306427877,"BEASLEY, TREVOR, COLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306428370,"FORD, KARLI, RACHEL",812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1306433164,CARING HEART HOME CARE LLC,,7633 KNIGHTDALE BLVD STE 103 KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1306433164,CARING HEART HOME CARE LLC,7633 KNIGHTDALE BLVD STE 103 KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 260 , 260 ," $22,670.25 ",,
MEDICAID DIRECT,1689944514,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES PINEHURST,7 REGIONAL CIR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1306434147,"KUHN, MATTHEW, CHUTE",7 REGIONAL CIR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 83 , 115 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306434808,"WILKERSON, KAYLA, THERESE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306434808,"WILKERSON, KAYLA, THERESE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 25 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306434808,"WILKERSON, KAYLA, THERESE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 26 , 61 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306434808,"WILKERSON, KAYLA, THERESE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114447083,THE MCINNIS CLINIC PLLC,,1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1306437074,"MARRS, CHERILYN, ARIEL",1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306437074,"MARRS, CHERILYN, ARIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 23 , 59 , 59 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306438304,"COCKERHAM, STACIE, SMITH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306438304,"COCKERHAM, STACIE, SMITH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306438304,"COCKERHAM, STACIE, SMITH",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972842086,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306438304,"COCKERHAM, STACIE, SMITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306438304,"COCKERHAM, STACIE, SMITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306438304,"COCKERHAM, STACIE, SMITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306438957,"RESPESS, ALESHA, LAMM",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 14 , 19 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306442363,"PARSONS, BRITTNEY, ELEASE",700 WALTER REED DR   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1306445648,GOOD HOPE MEDICAL SUPPLY LLC,,6120 SAINT GILES ST STE 210 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306445648,GOOD HOPE MEDICAL SUPPLY LLC,6120 SAINT GILES ST STE 210 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 87 , 403 ," 1,273 "," $111,034.74 ",,
MEDICAID DIRECT,1306445648,GOOD HOPE MEDICAL SUPPLY LLC,,6120 SAINT GILES ST STE 210 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1306445648,GOOD HOPE MEDICAL SUPPLY LLC,6120 SAINT GILES ST STE 210 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 88 , 478 , 843 ," $116,148.66 ",,
MEDICAID DIRECT,1306445648,GOOD HOPE MEDICAL SUPPLY LLC,,6120 SAINT GILES ST STE 210 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1306445648,GOOD HOPE MEDICAL SUPPLY LLC,6120 SAINT GILES ST STE 210 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306450119,"WILKINSON, KYLEE, MARIE",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 223 , 523 ," 1,012 "," $11,416.99 ",,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306450119,"WILKINSON, KYLEE, MARIE",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1306450895,ANGELS BY SURPRISE LLC,,4917 ALBEMARLE RD STE 205A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1306450895,ANGELS BY SURPRISE LLC,4917 ALBEMARLE RD STE 205A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,801 "," 2,801 "," $232,682.76 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306452073,"SIMS, CYNTHIA, LYNN",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 21 , 45 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306452073,"SIMS, CYNTHIA, LYNN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306452073,"SIMS, CYNTHIA, LYNN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306452073,"SIMS, CYNTHIA, LYNN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 61 , 139 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1306452073,"SIMS, CYNTHIA, LYNN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 78 , 158 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1261 JULIAN ALLSBRK HWY   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1306452073,"SIMS, CYNTHIA, LYNN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1306452073,"SIMS, CYNTHIA, LYNN",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306460340,"MARIN, FRANCIA, ELENA",301 LLOYD ST   CARRBORO NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306460340,"MARIN, FRANCIA, ELENA",301 LLOYD ST   CARRBORO NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 58 , 73 ," $17,216.92 ",,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306462569,"SONG, JENNY, HEE",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306462569,"SONG, JENNY, HEE",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306462692,"DEBREW, CARRIE, ANNE",9930 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1063948297,RDMG ASSOCIATES PA,SPINDALE FAMILY PRACTICE,144 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1306462692,"DEBREW, CARRIE, ANNE",144 RESERVATION DR   SPINDALE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306465653,"CARRILLO, ALESSANDRA, CLAIRE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306465885,"GENG, BERTIE",4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306466131,"PATRAS, ARIANA, FRANCES",4605 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306466198,"EFFIONG, ENO-OBONG, ANSON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306466198,"EFFIONG, ENO-OBONG, ANSON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306466198,"EFFIONG, ENO-OBONG, ANSON",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306466198,"EFFIONG, ENO-OBONG, ANSON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306466198,"EFFIONG, ENO-OBONG, ANSON",1420 E FRANKLIN ST   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 26 , 44 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306466727,"PATEL, POONAMKUMARI, JAYESHKUMAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306466859,"KONSTANT, KERI",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306466859,"KONSTANT, KERI",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306466859,"KONSTANT, KERI",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306466859,"KONSTANT, KERI",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306466859,"KONSTANT, KERI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306466859,"KONSTANT, KERI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306467261,"EKEH, LEROY, ONYEMAOBI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306467261,"EKEH, LEROY, ONYEMAOBI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306467261,"EKEH, LEROY, ONYEMAOBI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306467261,"EKEH, LEROY, ONYEMAOBI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205892916,PINEHURST NEUROLOGY PA,PINEHURST NEUROLOGY PA,10 PAGE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1306467709,"BISCHOF, GRANT",10 PAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 57 , 65 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306468608,"STILP, EMMALINE, KATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 35 , 60 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1306471024,"CRANFORD, REBECCA, HUDDLESTON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1306471024,"CRANFORD, REBECCA, HUDDLESTON",520 ALLEN ST   TROY NC,062,Montgomery,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1306471024,"CRANFORD, REBECCA, HUDDLESTON",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1306471024,"CRANFORD, REBECCA, HUDDLESTON",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1306471024,"CRANFORD, REBECCA, HUDDLESTON",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306472311,"GREEN, CRYSTAL, MEDLEY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306472311,"GREEN, CRYSTAL, MEDLEY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 116 , 154 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306472311,"GREEN, CRYSTAL, MEDLEY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 21 , 24 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306472311,"GREEN, CRYSTAL, MEDLEY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 45 , 112 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306472311,"GREEN, CRYSTAL, MEDLEY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306472311,"GREEN, CRYSTAL, MEDLEY",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 25 , 30 ,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306473012,"MOLITORIS, ANDREW, STEPHEN",803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306474168,"BAIG, AYSHA, ARFEEYA",309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 85 , 152 , 208 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306474374,"SCHLUSSEL, MAURA, ASHLEY",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306474374,"SCHLUSSEL, MAURA, ASHLEY",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306474374,"SCHLUSSEL, MAURA, ASHLEY",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306474655,"DURANT, BRANDON, ANTOINE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 52 , 52 , 52 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306474689,"COCO, MATTHEW, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 51 , 55 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306474689,"COCO, MATTHEW, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1225372246,DUKE UNIVERSITY AFFILIATED PHYSICIA,DPC BLUE RIDGE,3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306474770,"REDDY, PRIYANKA, PATEL",3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 14 , 28 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 24 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 35 , 79 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 41 , 148 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",705 GAITHER RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 134 , 281 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,118 KIRKMAN CT   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306476783,"GOSNELL, HALEY, NICOLE",118 KIRKMAN CT   TROUTMAN NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306478581,"WARPULA, GLENN, LYLE",490 HOSPITAL DR   CLYDE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306478581,"WARPULA, GLENN, LYLE",1207 EAST ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 34 , 73 , 73 ,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306478581,"WARPULA, GLENN, LYLE",29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 25 , 38 , 38 ,$#,,
MEDICAID DIRECT,1568131647,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN 65 N BROAD,65 N BROAD ST   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306478581,"WARPULA, GLENN, LYLE",65 N BROAD ST   BREVARD NC,088,Transylvania,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 35 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 31 ,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 31 , 61 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",901 DENIM DR   ERWIN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306479654,"PHUNG, OANH, NGOC",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306479662,PERQUIMANS OPCO HOLDINGS LLC,THE LANDINGS OF ALBEMARLE,603 S CHURCH ST   HERTFORD NC,072,Perquimans,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306479662,PERQUIMANS OPCO HOLDINGS LLC,603 S CHURCH ST   HERTFORD NC,072,Perquimans,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 43 , 43 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306480462,"CHAPMAN, DEREK, RYAN",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306480462,"CHAPMAN, DEREK, RYAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 44 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306481379,"SMOAK, GRACE, ELIZABETH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 78 , 117 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306481379,"SMOAK, GRACE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 23 , 35 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306481643,"LANIER, KELLI, DENISE",888 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306481643,"LANIER, KELLI, DENISE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 23 , 25 , 38 ,$#,,
MEDICAID DIRECT,1588178370,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH CABARRUS TRANSITION SERVICES,200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306481643,"LANIER, KELLI, DENISE",200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 26 , 33 , 33 ,$#,,
MEDICAID DIRECT,1588178370,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH CABARRUS TRANSITION SERVICES,,,Unknown,193400000X,Group,Single Specialty,,1306481643,"LANIER, KELLI, DENISE",888 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306481809,"NULL, JESSICA, NICOLE",935 STATE FARM RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306481809,"NULL, JESSICA, NICOLE",240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1124450572,CAROLINA CAPE FEAR MEDICAL GROUP PA,~,3637 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306482500,"LOCKLEAR, KIMALISA",4824 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 74 , 178 , 238 ," $12,072.92 ",,
MEDICAID DIRECT,1124450572,CAROLINA CAPE FEAR MEDICAL GROUP PA,~,3637 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306482500,"LOCKLEAR, KIMALISA",3637 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 96 , 175 , 197 ," $21,827.73 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306485008,"GRIMM, CRESENCIA, ANCHETA",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 65 , 435 , 439 ," $15,465.40 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306485008,"GRIMM, CRESENCIA, ANCHETA",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1306485206,"HUFF, MICHELLE, MARIE",2807 S HOMER BLVD   SANFORD NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306485206,"HUFF, MICHELLE, MARIE",801 TILGHMAN DR STE A DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780193557,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - DUNN,801 TILGHMAN DR   DUNN NC,043,Harnett,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306485206,"HUFF, MICHELLE, MARIE",801 TILGHMAN DR STE A DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1215366216,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER CAPE FEAR,3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306485206,"HUFF, MICHELLE, MARIE",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306485206,"HUFF, MICHELLE, MARIE",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306485206,"HUFF, MICHELLE, MARIE",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780193557,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - DUNN,801 TILGHMAN DR   DUNN NC,043,Harnett,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306485206,"HUFF, MICHELLE, MARIE",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306485206,"HUFF, MICHELLE, MARIE",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 95 , 97 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306485206,"HUFF, MICHELLE, MARIE",444 SW CENTER ST   FAISON NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1447993399,G ABRAMS AND R COHEN XXI PC,DYNAMIC DENTAL OF SOUTHEND,2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306486436,"GBARBEA, ESHERE, MANUELLA",2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306486949,"JACKOWICZ, SARA, ELIZABETH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306486949,"JACKOWICZ, SARA, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 72 , 72 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306486949,"JACKOWICZ, SARA, ELIZABETH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306487707,A PRIMARY CHOICE INC,,1617 W ROOSEVELT BLVD STE M MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1306487707,A PRIMARY CHOICE INC,1617 W ROOSEVELT BLVD STE M MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 4,381 "," 4,388 "," $285,388.64 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,5100 MACKAY RD   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 28 , 28 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 30 , 30 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,116 LANE DR   TRINITY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,323 BALDWIN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",323 BALDWIN RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 156 , 159 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,323 BALDWIN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",323 BALDWIN RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",323 BALDWIN RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 369 , 371 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",323 BALDWIN RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 46 , 46 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 203 , 206 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1201 CAROLINA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 403 , 407 ," $23,433.79 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1201 CAROLINA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306492426,"BROWN, AMBER, KALYNN",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306493663,"ROAK, ALEXANDRA, SIMONE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD STE M201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306493663,"ROAK, ALEXANDRA, SIMONE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1083189211,NEXT STEP PROSTHETICS LLC,,2826 RANDOLPH RD STE 201 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306496187,"BARLOW, TRAVIS, JOHN",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 60 ,$#,,
MEDICAID DIRECT,1477769784,FOOTHILLS PROSTHETICS LLC,~,1603 S STERLING ST   MORGANTON NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306496187,"BARLOW, TRAVIS, JOHN",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 46 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1306497904,"SCOTT, WILLIAM, JEFFREY",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1306507132,"POLLARD, CHRISTINA, NICOLE",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 32 , 32 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306507132,"POLLARD, CHRISTINA, NICOLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306507132,"POLLARD, CHRISTINA, NICOLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306507132,"POLLARD, CHRISTINA, NICOLE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306507132,"POLLARD, CHRISTINA, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306507132,"POLLARD, CHRISTINA, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306507132,"POLLARD, CHRISTINA, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205190600,"WARREN, ALEX, JORDAN",,3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1306507132,"POLLARD, CHRISTINA, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1306515820,"BEAUTI, AFNAN, MUHAMAD",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 58 , 59 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306517115,"FLORES, KEVIN CHRISTIAN, PINEDA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 60 , 60 , 60 ,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1306518014,"BOST, BROOKE, ANDERSON",270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184174542,CALDWELL MEMORIAL HOSPITAL,CALDWELL SLEEP MEDICINE,270 PINE MOUNTAIN RD STE 5 HUDSON NC,014,Caldwell,193400000X,Group,Single Specialty,,1306518014,"BOST, BROOKE, ANDERSON",270 PINE MOUNTAIN RD STE 5 HUDSON NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 98 , 98 ,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1306518014,"BOST, BROOKE, ANDERSON",8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205582624,GORDON AND SCHELLER DDS PLLC,DENTISTRY OF MOUNTAIN VIEW,2708 S NC 127 HWY   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306519137,"LYNCH, ALENA, LAVOCHINA",2953 N OXFORD ST   CLAREMONT NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice," 1,041 "," 2,155 "," 6,132 "," $411,253.36 ",,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306523618,"ROBINSON, STUART, WESLEY",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 55 , 99 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1306523618,"ROBINSON, STUART, WESLEY",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306523618,"ROBINSON, STUART, WESLEY",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1306523618,"ROBINSON, STUART, WESLEY",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306523618,"ROBINSON, STUART, WESLEY",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1306523618,"ROBINSON, STUART, WESLEY",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1306526272,"GAINES, RANDI, JANELLE",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#, 11 ,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,611 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306526272,"GAINES, RANDI, JANELLE",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1821604687,DR DURSHANAPALLI & ASSOCIATES PLLC,GENTLE CARE FAMILY DENTAL,2380 HICKSWOOD RD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306530415,"SASI PRAKASH, SRUTHI",2380 HICKSWOOD RD   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306536172,"WATSON, KENNA, RILEY",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144406539,PHYSICAL THERAPY FOR WOMEN,~,1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306538921,"TRINKER, BETH, LIANA",1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306544887,"BAUMGARTNER, DEVON, DIANE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306547179,"BOYD, PATRICIA, WEBB",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306547179,"BOYD, PATRICIA, WEBB",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 75 , 85 ,$#,,
MEDICAID DIRECT,1073572822,ONSLOW PEDIATRIC ASSOCIATES,~,51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1306547443,"MARMELO, MIKEALA, MARIE",51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 104 , 300 ," $11,282.21 ",,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306550926,"MOCILAN, ALYSSA, KAELIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306552658,"WESTBROOK, AUDRA, LYNN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1932652492,NHCS PHYSICIANS INC,UNC MEDICAL AND HEMATOLOGY ONCOLOGY AT NASH,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1306559117,"SINGH, RANJU JHA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 76 , 141 , 141 ,$#,,
MEDICAID DIRECT,1306562467,IMAGINATION STATION THERAPY PLLC,,91 LINDSAY LN   MARSHALL NC,057,Madison,193400000X,Group,Single Specialty,,1306562467,IMAGINATION STATION THERAPY PLLC,91 LINDSAY LN   MARSHALL NC,057,Madison,193400000X,Group,Single Specialty,, 29 , 157 , 161 ," $10,277.25 ",,
MEDICAID DIRECT,1306563523,BIRTH THROUGH LIFE INTERVENTIONS SU,,401 BECKER DR   ROANOKE RAPID NC,042,Halifax,252Y00000X,Agencies,Early Intervention Provider Agency,,1306563523,BIRTH THROUGH LIFE INTERVENTIONS SU,401 BECKER DR   ROANOKE RAPID NC,042,Halifax,252Y00000X,Agencies,Early Intervention Provider Agency,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1306573563,A&N CARE SOLUTIONS INC,HOME HELPERS HOME CARE OF NORTH GREENSBORO,5500 W FRIENDLY AVE STE 102J GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1306573563,A&N CARE SOLUTIONS INC,5500 W FRIENDLY AVE STE 102J GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 2,103 "," 2,103 "," $157,928.08 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306575378,"VENUTI, ANTHONY, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306575378,"VENUTI, ANTHONY, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 40 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306578000,"LONG, KELLI, ROS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306578000,"LONG, KELLI, ROS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1477894004,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS PEDIATRIC AUTISM CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306578000,"LONG, KELLI, ROS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306578042,"BLEDSOE, REBECCA, ANN",370 KNOLLWOOD ST STE 301 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 29 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306578620,"ALECCIA, KRISTEN, ANN",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306578620,"ALECCIA, KRISTEN, ANN",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306578620,"ALECCIA, KRISTEN, ANN",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 30 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306578620,"ALECCIA, KRISTEN, ANN",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306578620,"ALECCIA, KRISTEN, ANN",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1306578620,"ALECCIA, KRISTEN, ANN",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1306578620,"ALECCIA, KRISTEN, ANN",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1504 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306578919,"CONRAD, KADY, HURST",1504 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306579628,"PROCTOR, ALYSSA, TAYLOR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306579628,"PROCTOR, ALYSSA, TAYLOR",526 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 102 , 108 ,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1306580642,"SIDOTI, ANNA, KALEIGH",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306580642,"SIDOTI, ANNA, KALEIGH",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1306580642,"SIDOTI, ANNA, KALEIGH",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306584016,"BARNETT, MELISSA, BOWEN",8 REGIONAL CIR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 64 , 159 ,$#,,
MEDICAID DIRECT,1962881227,"HOLMAN, SHAINA, DEVI",~,1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,1306584594,"UNGARO, RACHEL, CHRISTINE",1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1932628401,SHAINA HOLMAN DDS PHD PA,HOLMAN FAMILY DENTAL CARE,1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1306584594,"UNGARO, RACHEL, CHRISTINE",1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 218 , 321 ," 1,085 "," $43,377.94 ",,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306586722,"ENGLERT, MELODY, ANN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 241 , 278 ,$#,,
MEDICAID DIRECT,1306590153,WINDFALL SPEECH & LANGUAGE SERVICES,,4005 SAWMILL TRACE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306590153,WINDFALL SPEECH & LANGUAGE SERVICES,4005 SAWMILL TRACE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#, 49 , 50 ,$#,,
MEDICAID DIRECT,1659591162,FAMILY BEHAVIORAL HEALTH,Family Behavioral Health,3000 BETHESDA PL STE 801 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306590948,"KILOLONG, JANE, PARANAE",3000 BETHESDA PL STE 801 WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,,,$#,,
MEDICAID DIRECT,1306592001,LIVING THROUGH MY DREAMS LLC,,7801 CALIBRE CROSSING DR APT 203 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306592001,LIVING THROUGH MY DREAMS LLC,7801 CALIBRE CROSSING DR APT 203 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 27 , 155 , 161 ," $15,369.43 ",,
MEDICAID DIRECT,1306592001,LIVING THROUGH MY DREAMS LLC,,7801 CALIBRE CROSSING DR APT 203 CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1306592001,LIVING THROUGH MY DREAMS LLC,7801 CALIBRE CROSSING DR APT 203 CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,, 53 , 912 , 912 ," $58,185.80 ",,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306592530,"LEDOUX, MARY, JOY-ANN",1141 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 38 , 67 ,$#,,
MEDICAID DIRECT,1851355424,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1306595335,"O'DELL, TRACI, CHEEK",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578854147,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST UNIT 2 DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1306595335,"O'DELL, TRACI, CHEEK",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1225445331,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - THOMASVILLE,611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306597794,"PUCKETT, MADELEINE, JUSTINE",611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306601216,"PEPE, ROWAN, ANNE",8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306603782,"SPRINGHETTI, NICHOLAS, MARSHALL",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1326589649,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - WELLNESS CENTER,3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306603832,"TABOR, JILLIAN, SARA",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326589649,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - WELLNESS CENTER,3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1306603832,"TABOR, JILLIAN, SARA",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306604020,"LASH, MICHELLE, ELAINE",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 18 , 30 ,$#,,
MEDICAID DIRECT,1902963937,WHITEVILLE MEDICAL ASSOCIATES PA,WHITEVILLE MEDICAL ASSOCIATES PA,823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1306610753,"DOWLESS, KATHERINE, NICOLE",823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 154 , 321 ," $12,353.39 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306612544,"PLUMB, ALEXANDRA, MARIE",5107 SOUTHPARK DR STE 104 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306612544,"PLUMB, ALEXANDRA, MARIE",5107 SOUTHPARK DR STE 104 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306615232,"TURNER, NUBIA, MARILIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306616420,"KING, JEREMY, ASHLEY",2800 ASHTON DR STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306624218,"MERRELL, GRACE, LIN GAMMON",300 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 34 , 50 ,$#,,
MEDICAID DIRECT,1306629068,ELDERCENTER,IREDELL ADULT DAY SERVICES,502 BREVARD ST   STATESVILLE NC,049,Iredell,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,1306629068,ELDERCENTER,502 BREVARD ST   STATESVILLE NC,049,Iredell,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,#, 301 , 301 ," $12,050.53 ",,
MEDICAID DIRECT,1306629803,JOY ETC INC,JOYFUL HOME FAMILY CARE,113 BEACON HL   ELLENBORO NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306629803,JOY ETC INC,113 BEACON HL   ELLENBORO NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 714 , 736 ," $85,582.63 ",,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306656327,"TURNER, MORGAN, WILLIFORD",1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306656327,"TURNER, MORGAN, WILLIFORD",1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306661442,"DAVIS, LATUNDRA",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164657532,KIDZCARE PEDIATRICS PC,~,5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306661442,"DAVIS, LATUNDRA",5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629394614,KIDZCARE PEDIATRICS PC,~,1022 N BRAGG BLVD   SPRING LAKE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306661442,"DAVIS, LATUNDRA",1022 N BRAGG BLVD   SPRING LAKE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 37 ,$#,,
MEDICAID DIRECT,1902859952,EYECARECENTER OD PA,Eyecare Center OD PA,1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1306665013,"MONCLA, JILL",1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 342 , 439 ," 1,365 "," $55,368.15 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 692 , 771 ," 4,009 "," $94,679.49 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 43 , 44 , 143 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 30 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 305 , 350 ," 1,143 "," $43,893.67 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306674114,"TAI, HELEN",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 72 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1306675079,"STEPHENSON, ANNA, GRACE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 47 ,$#,,
MEDICAID DIRECT,1700323557,GREENVILLE HEALTH CARE PA,,3121 MOSELEY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306678438,"FARMER, KIMBERLY, WARREN",3121 MOSELEY DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1700323557,GREENVILLE HEALTH CARE PA,,3121 MOSELEY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306678438,"FARMER, KIMBERLY, WARREN",3121 MOSELEY DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 17 , 31 ,$#,,
MEDICAID DIRECT,1427452341,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORWOOD FAMILY MEDICINE,269 S MAIN ST   NORWOOD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1306679329,"HUNT, JORDAN, SHEA",269 S MAIN ST   NORWOOD NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 86 , 113 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306680939,"MCLAUCHLIN, ANGELA",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306688809,"ROMODA, KIMBERLY, LAURETTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306688809,"ROMODA, KIMBERLY, LAURETTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306697735,"TALLEY, MARIAH, KENNEDY",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306801170,"ORTMANN, FRED, WILLIAM",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 69 , 185 , 277 ,$#,,
MEDICAID DIRECT,1245345776,LAKE NORMAN PULMONARY CRITICAL CA,LAKE NORMAN PULMONARY & SLEEP,123 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1306801998,"LEWANDOWSKI, LESA, ORLANDO",123 PROFESSIONAL PARK DR STE 200 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1184896540,LINDA SHAFIL DDS AND MAZIN AZIA DDS,ST MARYS FAMILY DENTISTRY,817 BROOKLYN ST STE A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306802145,"SHAFIK, LINDA, NAJEEB",817 BROOKLYN ST   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 267 , 659 ," 2,026 "," $80,762.22 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1306802434,"IANNACCONE, ALESSANDRO",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306802582,"MASLYK, PATRICIA, ANN",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306802822,"KNIGHT, TRACI, DAWN",1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 23 , 30 ,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306802822,"KNIGHT, TRACI, DAWN",420 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043894504,GENERATIONS FAMILY PRACTICE,TRIAD INTERNAL MEDICINE,300 MACK RD STE B ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1306802822,"KNIGHT, TRACI, DAWN",300 MACK RD STE B ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306803234,"HOLMES, ROBERT, JOHN",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 42 , 43 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306803234,"HOLMES, ROBERT, JOHN",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306803234,"HOLMES, ROBERT, JOHN",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306803234,"HOLMES, ROBERT, JOHN",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306803234,"HOLMES, ROBERT, JOHN",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306803234,"HOLMES, ROBERT, JOHN",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306804240,"PHARES, PASCAL, ALAIN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1306804240,"PHARES, PASCAL, ALAIN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1306804240,"PHARES, PASCAL, ALAIN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1306804240,"PHARES, PASCAL, ALAIN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 43 , 50 ,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1306804240,"PHARES, PASCAL, ALAIN",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1306804240,"PHARES, PASCAL, ALAIN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 38 , 45 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1306804240,"PHARES, PASCAL, ALAIN",180 PARKWOOD DR   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306804414,"MCLAWHORN, VICKI, CAUSA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 21 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306806179,"MEYERS III, SAMUEL, GRANT",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 40 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306806179,"MEYERS III, SAMUEL, GRANT",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 59 , 129 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306806211,"SCOTHORN, DOUGLAS, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306806211,"SCOTHORN, DOUGLAS, JAMES",21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306807151,"HARRISON, ALECIA, ANNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306807151,"HARRISON, ALECIA, ANNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 97 , 97 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 47 , 47 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 46 , 46 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 56 , 56 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 158 , 164 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 41 , 41 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 35 , 35 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,345 MANOR RD   MARS HILL NC,057,Madison,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 41 , 41 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 93 , 94 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",1264 AIRPORT RD   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1264 AIRPORT RD   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",1264 AIRPORT RD   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306807672,"KUTOB, RABI, DEAN",1264 AIRPORT RD   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 69 , 71 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306807680,"RAMOS, ROMMEL, NAVARRO",601 N ELM ST   HIGH POINT NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306807680,"RAMOS, ROMMEL, NAVARRO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 18 , 44 , 44 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306808084,"WALKER, GEORGE, KIRK",240 BROAD ST   KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 24 , 60 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306808233,"ENG, SHERRI",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306808233,"ENG, SHERRI",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 18 , 55 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1306808233,"ENG, SHERRI",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 113 , 119 , 253 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306808233,"ENG, SHERRI",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1306808233,"ENG, SHERRI",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1306809900,"HAGAN JR, ROBERT",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306809900,"HAGAN JR, ROBERT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306809900,"HAGAN JR, ROBERT",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1306809900,"HAGAN JR, ROBERT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1306809900,"HAGAN JR, ROBERT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1306809900,"HAGAN JR, ROBERT",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1306809900,"HAGAN JR, ROBERT",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306809900,"HAGAN JR, ROBERT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 27 ,$#,,
MEDICAID DIRECT,1699903542,LEGACY PEDIATRICS,~,,,Unknown,193200000X,Group,Multi-Specialty,,1306809926,"HODGES, ANA, CEIDE",556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1689445520,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY LEGACY PEDIATRICS,556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306809926,"HODGES, ANA, CEIDE",556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 46 , 77 ,$#,,
MEDICAID DIRECT,1487116968,THE MOSES H CONE MEMORIAL HOSPITAL,PRIMARY CARE AT ELMSLEY SQUARE,3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306810460,"WILSON, AMELIA, PUGH",3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 121 , 169 ,$#,,
MEDICAID DIRECT,1487116968,THE MOSES H CONE MEMORIAL HOSPITAL,PRIMARY CARE AT ELMSLEY SQUARE,3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306810460,"WILSON, AMELIA, PUGH",2525 PHILLIPS AVE STE C GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 23 , 29 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306810460,"WILSON, AMELIA, PUGH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1306810460,"WILSON, AMELIA, PUGH",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306810718,"SONFIELD, JOHN, WILLIAM",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1124161252,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIVISIONOFSURGEY-NORTHG,1330 BOILING SPRINGS RD STE 2300 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306811443,"WOOLLEN, CLAUDE, DANIEL",1330 BOILING SPRINGS RD STE 2300 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1306811856,"BOALS, JOSEPH, CALLOWAY",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 44 , 83 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1306811856,"BOALS, JOSEPH, CALLOWAY",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1306812235,"STEWART, JEANNE, MARIE",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1306812235,"STEWART, JEANNE, MARIE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306812797,"MADDEN, CHRISTOPHER, RONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 55 , 62 , 103 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1306812797,"MADDEN, CHRISTOPHER, RONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306812797,"MADDEN, CHRISTOPHER, RONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 50 , 60 , 94 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306812797,"MADDEN, CHRISTOPHER, RONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1942278411,PATHOLOGISTS DIAGNOSTIC SERVICES PL,,,,Unknown,193400000X,Group,Single Specialty,,1306812797,"MADDEN, CHRISTOPHER, RONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1306812797,"MADDEN, CHRISTOPHER, RONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1306813902,"ALEXANDER, ALEXANDER, F.",,4368 S NC HIGHWAY 62   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,1306813902,"ALEXANDER, ALEXANDER, F.",4368 S NC HIGHWAY 62   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 136 , 343 , 917 ," $82,182.23 ",,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306815287,"MCCOLLUM, MICHAEL, EDWARD",6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1306816194,"NUSE, PATRICIA, LYN",3173 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1053748426,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS ROCKY RIVER PEDIAT,5427 NC HIGHWAY 49 S STE 103 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306816194,"NUSE, PATRICIA, LYN",5427 HIGHWAY 49 S STE 103 HARRISBURG NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306816210,"CICCI, LEIGH, GOODWIN",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306816210,"CICCI, LEIGH, GOODWIN",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 30 , 32 ,$#,,
MEDICAID DIRECT,1457784191,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PRIMARY CARE ARDSLEY INTERNAL MEDICI,1085 NE GATEWAY CT NE STE 200A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306816210,"CICCI, LEIGH, GOODWIN",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306816244,"CARTER, BYRON, KEITH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306816244,"CARTER, BYRON, KEITH",1912 TRADD CT   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306816558,"DULIN, NANCY, LARSON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306816558,"DULIN, NANCY, LARSON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306816913,"HOPKINS, JUDITH, OWEN",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 37 , 57 , 57 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306816913,"HOPKINS, JUDITH, OWEN",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306816913,"HOPKINS, JUDITH, OWEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306817085,"LIU, BING",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 149 , 229 , 294 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306817333,"BASCH, ETHAN, MARTIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 19 , 25 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306817671,"GRAINGER, SUSAN, HUGGINS",240 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306817671,"GRAINGER, SUSAN, HUGGINS",1471 JAG BRANCH BLVD STE 101 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306817671,"GRAINGER, SUSAN, HUGGINS",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306818356,"KALATHOOR, SUNEETHA, REEDY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 91 , 91 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306818414,"BERNAL, STEVEN, DAVID",13557 STEELECROFT PKWY STE 2200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 34 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306818711,"BLANTON, CHARLES, MCANALLY",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 26 , 45 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306820105,"DAYAL, ASHRITO, KUMAR",4525 CAMERON VALLEY PKWY STE 410 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306820105,"DAYAL, ASHRITO, KUMAR",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 36 , 75 ," $23,349.24 ",,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306820105,"DAYAL, ASHRITO, KUMAR",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 40 , 47 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306820105,"DAYAL, ASHRITO, KUMAR",701 E ROOSEVELT BLVD STE 600 MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306820105,"DAYAL, ASHRITO, KUMAR",701 E ROOSEVELT BLVD STE 600 MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 36 , 134 ," $33,627.73 ",,
MEDICAID DIRECT,1750606174,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,704 GOLD HILL RD STE 203 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306820105,"DAYAL, ASHRITO, KUMAR",704 GOLD HILL RD STE 203 FORT MILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932189545,CAROLINA BONE AND JOINT,,10508 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306820113,"GOLDBERGER, NEAL, MICHAEL",10508 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 75 , 333 , 389 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306821269,"THIEBAUD JR, EUGENE, HENRY",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 44 , 81 ,$#,,
MEDICAID DIRECT,1407807092,THE NEUROLOGY INSTITUTE PA,THE NEUROLOGICAL INSTITUTE PA,2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306821582,"HARRIS, JANICE, TIMMONS",2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 27 ,$#,,
MEDICAID DIRECT,1407807092,THE NEUROLOGY INSTITUTE PA,THE NEUROLOGICAL INSTITUTE PA,2607 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306821582,"HARRIS, JANICE, TIMMONS",1501 E FRANKLIN ST   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073503470,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF FAYETTEVILLE,5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1306821749,"MACDOWELL, ANA LUIZA",5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 69 , 298 , 362 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306821814,"MILLER, ROBERT, WILLIAM",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306821814,"MILLER, ROBERT, WILLIAM",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 43 , 44 , 50 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306821814,"MILLER, ROBERT, WILLIAM",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 73 , 74 , 95 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306821848,"PRICE, JOHN, NAYLOR",485 VALLEY RD   MOCKSVILLE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 196 , 255 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 155 , 164 , 204 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822358,"BROWN, MICHAEL, HUNTER",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1689757007,COASTAL CAROLINA ENT DO PA,COASTAL CAROLINA ENT DO PA,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1306822424,"DIMUZIO, JAMES",2298 OCEAN HWY W   SUPPLY NC,010,Brunswick,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 24 , 27 ,$#,,
MEDICAID DIRECT,1689757007,COASTAL CAROLINA ENT DO PA,COASTAL CAROLINA ENT DO PA,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1306822424,"DIMUZIO, JAMES",2298 OCEAN HWY W # 17 SUPPLY NC,010,Brunswick,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 73 , 242 , 269 ,$#,,
MEDICAID DIRECT,1689757007,COASTAL CAROLINA ENT DO PA,COASTAL CAROLINA ENT DO PA,302 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1306822424,"DIMUZIO, JAMES",302 LIBERTY ST   WHITEVILLE NC,024,Columbus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 154 , 496 , 541 ," $11,130.10 ",,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1306822739,"WUNDER, RICHARD, JOHN",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306822804,"WEIN, ROBERT, MICHAEL",719 GREEN VALLEY RD STE 201 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306822903,"MILLER, PRESTON, ROY",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306822903,"MILLER, PRESTON, ROY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 80 , 105 , 114 ," $13,440.91 ",,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306823547,"RICE, WILLIAM, YATES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306824495,"KWONG, PETER, O",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1306824602,"MILLS, CHADWICK, MICHAEL",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306824602,"MILLS, CHADWICK, MICHAEL",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1306825005,CLOVER FAMILY CORPORATION,CLOVERS MASTECTOMY AND MEDICAL SUPPLY,1040 S CHURCH ST   BURLINGTON NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1306825005,CLOVER FAMILY CORPORATION,1040 S CHURCH ST   BURLINGTON NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 23 , 25 , 51 ,$#,,
MEDICAID DIRECT,1306825005,CLOVER FAMILY CORPORATION,CLOVERS MASTECTOMY AND MEDICAL SUPPLY,1040 S CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306825005,CLOVER FAMILY CORPORATION,1040 S CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 270 , 520 , 968 ," $87,700.15 ",,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306825070,"LEE, PAUL, GREGORY",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306825252,"SAYERS, RONALD, MERLE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306825575,"JACOBS, CAROLYN, YVETTE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306825575,"JACOBS, CAROLYN, YVETTE",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 23 , 61 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306825575,"JACOBS, CAROLYN, YVETTE",3727 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306826466,"CARD, JOHN, PATRICK",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 53 , 111 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306826466,"CARD, JOHN, PATRICK",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306826466,"CARD, JOHN, PATRICK",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306826870,"BOTTOM, KRYSTAL, DAWN SANCHEZ",21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306826870,"BOTTOM, KRYSTAL, DAWN SANCHEZ",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306827928,"MESSIER, AMY, EILEEN",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306827928,"MESSIER, AMY, EILEEN",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306828025,"CHOWDHARY, GEETA",4102 N ROXBORO ST   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306828025,"CHOWDHARY, GEETA",6910 FAYETTEVILLE RD STE 296 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306828025,"CHOWDHARY, GEETA",1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306828207,"SLOAN, TIMOTHY, COUNCIL",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 122 , 154 , 185 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1306828207,"SLOAN, TIMOTHY, COUNCIL",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 33 , 46 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1306828405,"JOHNSON, DENNIS, RAY",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 333 , 403 , 562 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306828405,"JOHNSON, DENNIS, RAY",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 187 , 212 , 266 ,$#,,
MEDICAID DIRECT,1558695288,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY SERVICES,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306828462,"HAGER, CHRISTOPHER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306828967,"SWAIM, IVETA, STRANAVOVA",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 114 , 223 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306828967,"SWAIM, IVETA, STRANAVOVA",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306829890,"WITTE, MARIE, LORETTA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 38 , 40 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306830187,"SCHELLENBERG, ROBERT, KARL",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 62 , 80 , 91 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1306830187,"SCHELLENBERG, ROBERT, KARL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1144317470,BOICE WILLIS CLINIC PA,~,901 N WINSTEAD AVE STE 310 ROCKY MOUNT NC,064,Nash,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1306830187,"SCHELLENBERG, ROBERT, KARL",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1306831136,"ARTHUR, BARTON, STEVENSON",201 WILLIAMSBURG PKWY   JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1306831136,"ARTHUR, BARTON, STEVENSON",738 NEWMAN RD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1306831136,"ARTHUR, BARTON, STEVENSON",738 NEWMAN RD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 51 , 94 , 157 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1306831854,"SANTIAGO, WAGNER, GILBERT",2525 COURT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1306831854,"SANTIAGO, WAGNER, GILBERT",251 WILMOT DR   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 175 , 480 ," 1,123 ",$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1306831854,"SANTIAGO, WAGNER, GILBERT",251 WILMOT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 40 , 53 , 118 ,$#,,
MEDICAID DIRECT,1942841218,FOOT AND ANKLE SPECIALISTS OF THE M,,251 WILMOT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1306831854,"SANTIAGO, WAGNER, GILBERT",251 WILMOT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306832001,"WESTBROOK, CHRISTIE, ISENHOUR",744 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 88 , 176 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1306836093,"MCCAULEY, JENNIFER, LYNN",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 34 , 56 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1306836093,"MCCAULEY, JENNIFER, LYNN",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1306836580,"SEASHORE, CARL, JOHN",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 22 , 85 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306836986,"MOON, JENNIFER, FRANCES",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306837687,"MARSHALL, JAMES, LEWIS",JAMES LEWIS MARSHALL,1003 N 1ST ST   ALBEMARLE NC,084,Stanly,152W00000X,Eye and Vision Services Providers,Optometrist,,1306837687,"MARSHALL, JAMES, LEWIS",1003 N 1ST ST   ALBEMARLE NC,084,Stanly,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 24 , 24 ,$#,,
MEDICAID DIRECT,1376854083,ADVANCE FAMILY AND SPORTS MEDICINE,ADVANCE FAMILY AND SPORTS MEDICINE CENTER PLLC,1000 SOUTHPARK BLVD STE A WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306839659,"EZEIGBO, WALTER, AZUBUIKE",1000 SOUTHPARK BLVD STE A WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 158 , 300 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306839832,"ABBOTT, LINDA, MARIE",201 VIRGINIA RD   EDENTON NC,021,Chowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 94 , 260 , 465 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,201 VIRGINIA RD   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1306839832,"ABBOTT, LINDA, MARIE",201 VIRGINIA RD   EDENTON NC,021,Chowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1306839832,"ABBOTT, LINDA, MARIE",201 VIRGINIA RD   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1306839832,"ABBOTT, LINDA, MARIE",201 VIRGINIA RD   EDENTON NC,021,Chowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 61 , 61 ," $24,146.85 ",,
MEDICAID DIRECT,1306840251,SPEECHCENTER INC,,185 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306840251,SPEECHCENTER INC,185 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,, 191 ," 1,988 "," 2,001 "," $136,563.45 ",,
MEDICAID DIRECT,1922434307,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306840962,"VALENTE II, LOUIS, ROCCO",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306840962,"VALENTE II, LOUIS, ROCCO",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306840962,"VALENTE II, LOUIS, ROCCO",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306840962,"VALENTE II, LOUIS, ROCCO",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 65 , 103 ,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306840962,"VALENTE II, LOUIS, ROCCO",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1306843107,COUNTY OF SURRY & SURRY COUNTY WELF,SURRY COUNTY EMERGENCY SERVICES,1218 STATE ST STE 500 MOUNT AIRY NC,086,Surry,3416L0300X,Transportation Services,Ambulance,Land Transport,1306843107,COUNTY OF SURRY & SURRY COUNTY WELF,1218 STATE ST STE 500 MOUNT AIRY NC,086,Surry,3416L0300X,Transportation Services,Ambulance,Land Transport, 680 ," 1,166 "," 2,178 "," $21,515.55 ",,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306843719,"BLUMENTHAL, AMY, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 38 , 35 , 37 ," $19,402.95 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306843719,"BLUMENTHAL, AMY, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 17 , 27 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306843719,"BLUMENTHAL, AMY, LEE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306843719,"BLUMENTHAL, AMY, LEE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 53 , 53 , 60 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306843719,"BLUMENTHAL, AMY, LEE",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 32 , 42 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306843719,"BLUMENTHAL, AMY, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1952569527,MILLENNIA CARDIOVASCULAR PA,MILLENNIA CARDIOVASCULAR PA,101 E MARKET ST STE 1H SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306844832,"WEFALD, FRANKLIN, CHARLES",101 E MARKET ST STE 1H SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952569527,MILLENNIA CARDIOVASCULAR PA,MILLENNIA CARDIOVASCULAR PA,101 E MARKET ST STE 1H SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1306844832,"WEFALD, FRANKLIN, CHARLES",101 E MARKET ST STE 1H SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 160 , 957 ," 2,774 "," $68,048.48 ",,
MEDICAID DIRECT,1487845020,AVANCE CARE PA,,1821 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1306845565,"GUSH, KIMBERLY, ANN",300 MARKET ST STE 112 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 26 , 49 ,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1306846191,"FOGARTY MERGY, KELLY, ANNE",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 69 , 77 , 328 ," $15,454.43 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306846563,"CLAY, THOMAS, HOWARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 20 , 22 , 22 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306846589,"DE JOYA, GERMAN, DY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 99 , 118 ," $11,944.64 ",,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1306847553,"MOORE, MARIA, GARCIA",201 E GROVER ST   SHELBY NC,023,Cleveland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1306847553,"MOORE, MARIA, GARCIA",201 E GROVER ST   SHELBY NC,023,Cleveland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306849047,"JENNINGS, WILLIAM, BRYAN",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 61 , 85 , 119 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306849047,"JENNINGS, WILLIAM, BRYAN",402 W KING ST   KING NC,085,Stokes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1306851928,HOMECHOICE PARTNERS LLC,BIOSCRIP INFUSION SERVICES,1738 OWEN DR STE 101 FAYETTEVILLE NC,026,Cumberland,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1306851928,HOMECHOICE PARTNERS LLC,1738 OWEN DR STE 101 FAYETTEVILLE NC,026,Cumberland,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 24 , 111 , 272 ," $38,289.18 ",,
MEDICAID DIRECT,1306851928,HOMECHOICE PARTNERS LLC,BIOSCRIP INFUSION SERVICES,1738 OWEN DR STE 101 FAYETTEVILLE NC,026,Cumberland,251F00000X,Agencies,Home Infusion,,1306851928,HOMECHOICE PARTNERS LLC,1738 OWEN DR STE 101 FAYETTEVILLE NC,026,Cumberland,251F00000X,Agencies,Home Infusion,, 18 , 346 , 774 ," $49,764.09 ",,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306852025,"FISHER, CHRISTEN, JULIA",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306854351,"LYNCH, PATRICK, GEORGE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306854351,"LYNCH, PATRICK, GEORGE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1306855002,"AUSBAND, STEPHEN, CLABURN",2041 WILLOW RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1306855002,"AUSBAND, STEPHEN, CLABURN",2041 WILLOW RD   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 43 , 46 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306855408,"OLDROYD, MATTHEW",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306855408,"OLDROYD, MATTHEW",35 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 50 , 54 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306855408,"OLDROYD, MATTHEW",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 52 , 59 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306855408,"OLDROYD, MATTHEW",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1306855770,HALIFAX GASTROENTEROLOGY PC,~,1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1306855770,HALIFAX GASTROENTEROLOGY PC,1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 74 , 84 , 84 ,$#,,
MEDICAID DIRECT,1922281385,CHANDA A GRIESSEL MD PLLC,TRIAD OPTHALMIC PHYSICIANS PLLC,150 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306856703,"GRIESSEL, CHANDA, ANNETTE",150 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1922281385,CHANDA A GRIESSEL MD PLLC,TRIAD OPTHALMIC PHYSICIANS PLLC,150 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306856703,"GRIESSEL, CHANDA, ANNETTE",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1306856844,1ST CHOICE IN-HOMECARE INC,FIRST CHOICE IN-HOMECARE,825 GREENBRIER CIR STE D CHESAPEAKE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1306856844,1ST CHOICE IN-HOMECARE INC,825 GREENBRIER CIR STE D CHESAPEAKE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1306857883,"RERKPATTANAPIPAT, PAIROJ",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 68 , 101 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306857883,"RERKPATTANAPIPAT, PAIROJ",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 16 , 28 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306857883,"RERKPATTANAPIPAT, PAIROJ",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 160 , 305 , 398 ,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1306860580,"CHEN, DOUGLAS, SOU",6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 135 , 197 ,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1306860614,"BALDWIN, ANGELA, LUNSFORD",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1346302783,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193400000X,Group,Single Specialty,,1306860614,"BALDWIN, ANGELA, LUNSFORD",434 HOSPITAL DR   LINVILLE NC,006,Avery,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1457309221,CABARRUS EMERGENCY MEDICINE ASSOCIA,CABARRUS EMERGENCY MEDICINE ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1306860879,"DRIVER, MELORA, TROTTER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306860879,"DRIVER, MELORA, TROTTER",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508987447,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - WE,1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306861133,"SOOD, VINEET",1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 15 , 16 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306861133,"SOOD, VINEET",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306861133,"SOOD, VINEET",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 28 , 28 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306861133,"SOOD, VINEET",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 25 , 29 , 32 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306861133,"SOOD, VINEET",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 31 , 32 ,$#,,
MEDICAID DIRECT,1003150798,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - PR,4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306861133,"SOOD, VINEET",4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1508987447,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - WE,1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306861133,"SOOD, VINEET",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1508987447,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - WE,1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1306861133,"SOOD, VINEET",601 N ELM ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003150798,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PULMONOLOGY - PR,4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306861133,"SOOD, VINEET",1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306861133,"SOOD, VINEET",1814 WESTCHESTER DR STE 202 HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861513,"MURDOCK, MONICA, PATE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861513,"MURDOCK, MONICA, PATE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861513,"MURDOCK, MONICA, PATE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861513,"MURDOCK, MONICA, PATE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861661,"DRAGO, DAVID, JUSTIN",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 12 , 22 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306861661,"DRAGO, DAVID, JUSTIN",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306861661,"DRAGO, DAVID, JUSTIN",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 35 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861661,"DRAGO, DAVID, JUSTIN",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1306861661,"DRAGO, DAVID, JUSTIN",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 62 , 143 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861679,"FAIRCLOTH, JACKIE, REX",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 69 , 106 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306861679,"FAIRCLOTH, JACKIE, REX",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 29 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306862081,"LHUILLIER, KIMBERLY, DAWN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306863741,"TISOVEC, RICHARD, WARREN",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1043556855,TRIAD CARE INC,,306 POMONA DR STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306863741,"TISOVEC, RICHARD, WARREN",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306864517,"JOSEPH, DAVID, BRIAN",1802 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306864517,"JOSEPH, DAVID, BRIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 64 , 65 , 82 ," $31,332.36 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306864517,"JOSEPH, DAVID, BRIAN",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306864517,"JOSEPH, DAVID, BRIAN",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 46 , 48 , 60 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,924 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1306866579,"OLEARY, GREGORY, JAMES",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306866579,"OLEARY, GREGORY, JAMES",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306866579,"OLEARY, GREGORY, JAMES",924 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 56 , 125 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306866967,"SINGH, HARMEET",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306866967,"SINGH, HARMEET",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 76 , 156 , 264 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1306866967,"SINGH, HARMEET",829 S MAIN ST   GRAHAM NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1306866967,"SINGH, HARMEET",2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1306866967,"SINGH, HARMEET",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 100 , 100 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306866967,"SINGH, HARMEET",829 S MAIN ST   GRAHAM NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 95 , 96 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306866967,"SINGH, HARMEET",2019 N CHURCH ST   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1306866967,"SINGH, HARMEET",2019 N CHURCH ST   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1306866967,"SINGH, HARMEET",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1306866967,"SINGH, HARMEET",1307 FREEWAY DR   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306866967,"SINGH, HARMEET",1307 FREEWAY DR   REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 47 , 47 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1306867411,"KADER, RONALD, WILLIAM",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 36 , 48 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306867411,"KADER, RONALD, WILLIAM",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 19 , 26 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306867411,"KADER, RONALD, WILLIAM",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 26 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306867411,"KADER, RONALD, WILLIAM",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 26 , 32 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306867411,"KADER, RONALD, WILLIAM",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306867411,"KADER, RONALD, WILLIAM",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1306867411,"KADER, RONALD, WILLIAM",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1952550154,VILLAGE EYE CARE OPTOMETRY PLLC,VILLAGE EYE CARE OPTOMETRY PLLC,1001 WADE AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1306868484,"BATEMAN, CHRISTOPHER, DEVERNE",1001 WADE AVE STE 110 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1952550154,VILLAGE EYE CARE OPTOMETRY PLLC,VILLAGE EYE CARE OPTOMETRY PLLC,1001 WADE AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306868484,"BATEMAN, CHRISTOPHER, DEVERNE",1001 WADE AVE STE 110 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1306869664,"DAVIS, LISA, FALETTE",~,1107 STATESVILLE BLVD   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,1306869664,"DAVIS, LISA, FALETTE",1107 STATESVILLE BLVD   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 962 ," 1,761 "," 6,803 "," $251,469.14 ",,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1306869870,"BROWER, ANNA, CHRISTINA",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1306870274,"LOWERY, SONDRA, GREENE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1306870274,"LOWERY, SONDRA, GREENE",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306870274,"LOWERY, SONDRA, GREENE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306872106,"KIRSCH, WINTER, NICHOLE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679521983,WILSON IMMEDIATE CARE PA,,1725 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1306872494,"FITCH, JAMES, MILTON",1725 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",149 FAIRHAVEN DR   BOSTIC NC,081,Rutherford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",86 OLD AIRPORT RD   FLETCHER NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",3331 TATE BLVD SE   HICKORY NC,015,Camden,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",380 BREVARD RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306872585,"BLOZE, ASTA, ELIZABETH",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1023124575,HAZELWOOD FAMILY MEDICINE PLLC,,1088 BROWN AVE   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1306874276,"BROWN, MICHAEL, ASHLEY",1088 BROWN AVE   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 304 , 386 ,$#,,
MEDICAID DIRECT,1396020202,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH HOSPICE AND PALLIATIVE CARE PROFESSION,251 CAMPGROUND RD   WEST END NC,063,Moore,193200000X,Group,Multi-Specialty,,1306875661,"CHRISTALDI, PAMELA, SANDUSKY",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 54 , 60 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3420 TEN TEN RD STE 318 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306878061,"ALBRECHT, RAMONA, PETEU",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306878061,"ALBRECHT, RAMONA, PETEU",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 18 , 33 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,4100 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306878061,"ALBRECHT, RAMONA, PETEU",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306878061,"ALBRECHT, RAMONA, PETEU",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 23 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1306878061,"ALBRECHT, RAMONA, PETEU",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878061,"ALBRECHT, RAMONA, PETEU",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 68 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 16 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 80 , 80 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306878673,"BLAZING, MICHAEL",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 47 , 151 , 159 ,$#,,
MEDICAID DIRECT,1194047340,WAKE EAR NOSE AND THROAT SPECIALIST,WAKE EAR NOSE AND THROAT SPECIALISTS PLLC,115 PARKWAY OFFICE CT STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1306880992,"GUPTA, PANKAJ",115 PARKWAY OFFICE CT STE 201 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 56 , 120 , 193 ,$#,,
MEDICAID DIRECT,1700888542,GREENE COUNTY HEALTH CARE INC,KATE B REYNOLDS MEDICAL CENTER,205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306882337,"MORENO, CARMEN, LUCIA",205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,2021 CONCERT DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306882543,"WARREN, MATTHEW, STENSON",2021 CONCERT DR SUITE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306882543,"WARREN, MATTHEW, STENSON",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306884002,NAKINA FIRE AND RESCUE SQUAD,Nakina Fire and Rescue Squad,214 RAMSEY FORD RD   NAKINA NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,1306884002,NAKINA FIRE AND RESCUE SQUAD,214 RAMSEY FORD RD   NAKINA NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport, 24 , 36 , 67 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1306885686,"ARNDT, PETER, MARTYN",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 42 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1306885819,"ROGERS, KIMBERLY, HILL",401 MOCKSVILLE AVE STE 200 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1306885819,"ROGERS, KIMBERLY, HILL",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306885876,"OWEN, WILLIAM, CONALLY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306886296,"SMITH III, MYRON, WALLACE",310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306886296,"SMITH III, MYRON, WALLACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 16 , 31 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306886296,"SMITH III, MYRON, WALLACE",111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1306886296,"SMITH III, MYRON, WALLACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306887617,"CRAFT-WHITLEY, JOCELYN, ANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306887617,"CRAFT-WHITLEY, JOCELYN, ANN",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306888235,"PEOPLES, CARL, EDWARD",DRS PEOPLES OGHALAI AND KRUTOY PA,1405 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1306888235,"PEOPLES, CARL, EDWARD",1405 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 28 , 52 , 177 ," $22,178.47 ",,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1306889134,"SCHAFER, GARY, ROBERT",181 DANIEL RD   FOREST CITY NC,081,Rutherford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 273 , 493 , 505 ," $14,924.42 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306891007,"COWARD, HOLLY, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 21 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306891007,"COWARD, HOLLY, JEAN",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1831386531,INSIGHT OPTOMETRIC SERVICES PA,Insight Optometric Services PA,300 CAMPEN RD STE A BEAUFORT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1306891015,"PATTERSON, PATRICK, AUSTIN",4252 ARENDELL ST STE G MOREHEAD CITY NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,, 17 , 22 , 25 ,$#,,
MEDICAID DIRECT,1831386531,INSIGHT OPTOMETRIC SERVICES PA,Insight Optometric Services PA,4252 ARENDELL ST STE G MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1306891015,"PATTERSON, PATRICK, AUSTIN",4252 ARENDELL ST STE G MOREHEAD CITY NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831386531,INSIGHT OPTOMETRIC SERVICES PA,Insight Optometric Services PA,300 CAMPEN RD STE A BEAUFORT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1306891015,"PATTERSON, PATRICK, AUSTIN",300 CAMPEN RD STE A BEAUFORT NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,, 67 , 79 , 111 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1306891254,"SHERROD, TRACEY, PARKER",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306891254,"SHERROD, TRACEY, PARKER",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 107 , 186 ,$#,,
MEDICAID DIRECT,1215348156,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES PRIMARY CARE APEX,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1306893540,"PARIKH-DESAI, AMRITA, SUNIL",212 ASHVILLE AVE   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215348156,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES PRIMARY CARE APEX,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1306893540,"PARIKH-DESAI, AMRITA, SUNIL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 28 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306894829,"KUO, TIMOTHY",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306894829,"KUO, TIMOTHY",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306894829,"KUO, TIMOTHY",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 20 , 31 , 54 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306895354,"WILNER, LANE, A.",501 ROBERTSON BLVD   WALTERBORO SC,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306895354,"WILNER, LANE, A.",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255731204,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DIGESTIVE HEALTH CENTER,401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306895636,"CHOWDHARY, DEEPAK",401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1740047455,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD DIGESTIVE HEALTH CENTER,401 EAST CHEVES STREET SUITE 301 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306895636,"CHOWDHARY, DEEPAK",401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609825710,SOUTHEASTERN PATHOLOGY,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1306895719,"JOHNSON, RICHARD, DEWITT",300 W 27TH ST   LUMBERTON NC,078,Robeson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1609825710,SOUTHEASTERN PATHOLOGY,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1306895719,"JOHNSON, RICHARD, DEWITT",300 W 27TH ST   LUMBERTON NC,078,Robeson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 263 , 320 , 437 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,924 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1306896147,"REED, DEREK, MICHAEL",2290 REMOUNT RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1932698156,PREMIER SLEEP AND NEUROLOGY,,10009 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306896592,"ASHKIN, KENNETH, TODD",1536 UNION RD STE C GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1932698156,PREMIER SLEEP AND NEUROLOGY,,111 COMMERCE CENTRE DR STE 304 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306896592,"ASHKIN, KENNETH, TODD",111 COMMERCE CENTRE DR STE 304 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 33 , 77 , 119 ,$#,,
MEDICAID DIRECT,1932698156,PREMIER SLEEP AND NEUROLOGY,,10009 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306896592,"ASHKIN, KENNETH, TODD",111 COMMERCE CENTRE DR STE 304 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 17 , 24 ,$#,,
MEDICAID DIRECT,1932698156,PREMIER SLEEP AND NEUROLOGY,,10009 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306896592,"ASHKIN, KENNETH, TODD",10009 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 47 , 77 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306897418,"SPOOLMAN, CYNTHIA, EPSTEIN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 11 , 21 , 23 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1306897418,"SPOOLMAN, CYNTHIA, EPSTEIN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1306900089,"TARABAN, LORA, ANNE",2872 S NC 127 HWY   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1306901541,SOUTHERN ASSISTED LIVING INC,BROOKDALE ASHEVILLE OVERLOOK,308 OVERLOOK RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306901541,SOUTHERN ASSISTED LIVING INC,308 OVERLOOK RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,022 "," 1,022 "," $81,875.18 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306901970,"NICOARA, ALINA",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306901970,"NICOARA, ALINA",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306901970,"NICOARA, ALINA",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 ,#, 18 ,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1306902382,"RIDDLE, BRUCE, CLAYTON",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 38 , 84 ,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1306904255,"KENNARD, TIMOTHY, PATRICK",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1306904255,"KENNARD, TIMOTHY, PATRICK",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 87 , 177 , 234 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306906086,"FENNELL, PAYTON, GREGORY",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 54 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306906086,"FENNELL, PAYTON, GREGORY",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 75 , 165 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306907043,"MAPP, ROSHNI, PATEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306907043,"MAPP, ROSHNI, PATEL",3404 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1306908116,"BURKE, STEPHANIE, ANN",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 98 , 179 , 411 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306908116,"BURKE, STEPHANIE, ANN",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 52 , 93 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1306908116,"BURKE, STEPHANIE, ANN",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",3643 N ROXBORO ST   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 105 , 140 , 217 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306909171,"CAMITTA, MICHAEL, GLEN WASCH",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306911177,"DETWILER, RANDAL, KENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 27 , 38 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306911177,"DETWILER, RANDAL, KENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306911177,"DETWILER, RANDAL, KENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306911177,"DETWILER, RANDAL, KENT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 66 , 138 , 139 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306914585,"WITT, CYNTHIA, JO",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285485383,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306914585,"WITT, CYNTHIA, JO",308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 114 , 138 ,$#,,
MEDICAID DIRECT,1003935750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1306914585,"WITT, CYNTHIA, JO",119 W PENNSYLVANIA AVE NA BESSEMER CITY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 98 , 115 ,$#,,
MEDICAID DIRECT,1306445648,GOOD HOPE MEDICAL SUPPLY LLC,,6120 SAINT GILES ST STE 210 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306918123,"UGOCHUKWU, KINGSLEY, CHUKS",441 LAKESTONE COMMONS AVE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104096015,ANGIER PEDIATRICS AND ADULT MEDICAL,~,441 LAKESTONE COMMONS AVE   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1306918123,"UGOCHUKWU, KINGSLEY, CHUKS",441 LAKESTONE COMMONS AVE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 232 ," 2,001 "," 4,434 "," $107,074.28 ",,
MEDICAID DIRECT,1104096015,ANGIER PEDIATRICS AND ADULT MEDICAL,~,441 LAKESTONE COMMONS AVE   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1306918123,"UGOCHUKWU, KINGSLEY, CHUKS",441 LAKESTONE COMMONS AVE   FUQUAY VARINA NC,092,Wake,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 23 , 38 , 81 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306919592,"WILKERSON, VALERIE, PARSONS",509 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1306919592,"WILKERSON, VALERIE, PARSONS",509 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306919592,"WILKERSON, VALERIE, PARSONS",509 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306919592,"WILKERSON, VALERIE, PARSONS",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306920210,"GRANT, STUART, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 75 , 75 , 78 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306920210,"GRANT, STUART, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306920269,"SKETCH, MICHAEL, HUGH",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1306920269,"SKETCH, MICHAEL, HUGH",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306920269,"SKETCH, MICHAEL, HUGH",718 RUTHERFORD ST   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2609 N DUKE ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306920285,"WRENN, BETH, THOMASON",2609 N DUKE ST STE 204 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306920459,"LEIGH-FLEMING, JAN, ANITA",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1306920459,"LEIGH-FLEMING, JAN, ANITA",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1306920459,"LEIGH-FLEMING, JAN, ANITA",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1720465354,MARTHA ANN KEELS DDS PHD PA,DUKE STREET PEDIATRIC DENTISTRY,2711 N DUKE ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1306920467,"KEELS, MARTHA, ANN",2711 N DUKE ST   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,573 "," 2,572 "," 9,075 "," $362,588.28 ",,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306922117,"AJAM, KAMAL, SAMI",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 173 , 258 , 309 ,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306922117,"AJAM, KAMAL, SAMI",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 34 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306922117,"AJAM, KAMAL, SAMI",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306922117,"AJAM, KAMAL, SAMI",330 BILLINGSLEY RD STE 210 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 28 , 35 , 45 ,$#,,
MEDICAID DIRECT,1982773206,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1510 NC HIGHWAY 68 N   OAK RIDGE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306926621,"THACKER, ROBERT, KELLER",5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 33 , 65 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306927132,"OZARKAR, PREETI, PRASAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 24 , 24 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306927132,"OZARKAR, PREETI, PRASAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1306927850,"COLEY, HARRILL, CHRISTOPHER",COLEY COSMETIC & HAND SURGERY CENTER PA,3625 N ELM ST STE 120 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1306927850,"COLEY, HARRILL, CHRISTOPHER",3625 N ELM ST STE 120 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1306927900,"KELLY, TODD, LAWRENCE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 23 , 72 , 73 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1306929674,"Myers, Charles, WESLEY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 119 , 575 , 587 ," $17,032.81 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306930631,"ABRAHA, SURAFEAL, GHEDAMU",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 104 , 104 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306930631,"ABRAHA, SURAFEAL, GHEDAMU",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1306930631,"ABRAHA, SURAFEAL, GHEDAMU",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 38 , 38 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306930649,"KOPICKI, BRIAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306930649,"KOPICKI, BRIAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1306930649,"KOPICKI, BRIAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306932918,"LININGER, RUTH, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 108 , 111 , 129 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306932918,"LININGER, RUTH, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306932918,"LININGER, RUTH, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1306933411,"GREELISH, JAMES, PATRICK",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 22 , 28 ,$#,,
MEDICAID DIRECT,1306937131,"MCKENZIE, ANDREW, STEPHENSON",ANDREW STEPHENSON MCKENZIE,689 BLYTHE STREET CT STE B HENDERSONVILLE NC,045,Henderson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1306937131,"MCKENZIE, ANDREW, STEPHENSON",689 BLYTHE STREET CT STE B HENDERSONVILLE NC,045,Henderson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 967 ," 2,633 "," 8,857 "," $332,436.10 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306937479,"MALONE, STEPHANIE, DIEHL",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 64 , 93 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1306937768,"LEONE, KATHLEEN, CANNING",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306938261,"SAVAGE, PAUL, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 35 , 40 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306942578,"GANJI, JAGADEESH, RUDRAPPA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 74 , 93 , 145 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306942578,"GANJI, JAGADEESH, RUDRAPPA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1982998159,PIEDMONT CARDIOVASCULAR PA,~,1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306942578,"GANJI, JAGADEESH, RUDRAPPA",1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 82 , 135 , 219 ,$#,,
MEDICAID DIRECT,1982998159,PIEDMONT CARDIOVASCULAR PA,~,1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306942578,"GANJI, JAGADEESH, RUDRAPPA",1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1306942578,"GANJI, JAGADEESH, RUDRAPPA",JAGADEESH RUDRAPPA GANJI,1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1306942578,"GANJI, JAGADEESH, RUDRAPPA",1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306942578,"GANJI, JAGADEESH, RUDRAPPA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306942578,"GANJI, JAGADEESH, RUDRAPPA",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1306942891,"ACKERMAN BHALLA, STACEY, ANN",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1306942891,"ACKERMAN BHALLA, STACEY, ANN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1659418515,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE TIMBERLYNE,77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306943295,"WEST, ANNE, JUNGRAN",77 VILCOM DRIVE   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 19 , 34 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1306945100,"ATKINSON, ANITA, LYNNETTE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306948492,"SIMMS, KRISTI, BARGER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1306948492,"SIMMS, KRISTI, BARGER",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 121 , 121 ,$#,,
MEDICAID DIRECT,1306949094,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07580,1180 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1306949094,NORTH CAROLINA CVS PHARMACY LLC,1180 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306949565,"FLEMING, RON, DELAYNE",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1306949565,"FLEMING, RON, DELAYNE",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1306957857,"SLICK, KEITH, AVERY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306957857,"SLICK, KEITH, AVERY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1306958335,"FABRIZIO, DAVID, MICHAEL",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1306958335,"FABRIZIO, DAVID, MICHAEL",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1306958335,"FABRIZIO, DAVID, MICHAEL",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679728216,FAMILY CENTERED HEALTHCARE PA,~,400 MILLSTONE DR STE 100 HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1306959614,"VINES, DAIN, EDSEL",400 MILLSTONE DR STE 100 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 29 , 36 ,$#,,
MEDICAID DIRECT,1548529878,CAROLINA FAMILY HEALTHCARE PA,,11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306959705,"KANELOS, DINO, PETER",11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1548529878,CAROLINA FAMILY HEALTHCARE PA,,11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306959705,"KANELOS, DINO, PETER",11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1306960232,"CHANG, SUSAN",3001B RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice," 1,660 "," 2,826 "," 10,141 "," $479,377.76 ",,
MEDICAID DIRECT,1306961826,NEW HORIZON HOME CARE OF NC INC,NEW HORIZON HOME CARE OF NC INC,195 S MAIN ST STE B MARION NC,059,McDowell,253Z00000X,Agencies,In Home Supportive Care,,1306961826,NEW HORIZON HOME CARE OF NC INC,195 S MAIN ST STE B MARION NC,059,McDowell,253Z00000X,Agencies,In Home Supportive Care,,#," 1,477 "," 1,606 "," $255,082.04 ",,
MEDICAID DIRECT,1306963186,NORTH BROOK REST HOME,NORTH BROOK REST HOME,1611 N BROOK 3 SCHOOL RD   VALE NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306963186,NORTH BROOK REST HOME,1611 N BROOK 3 SCHOOL RD   VALE NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 , 639 , 641 ," $267,852.89 ",,
MEDICAID DIRECT,1306964242,DEE & G ENRICHMENT CENTER,DEE & G ENRICHMENT CENTER 3,321 AUSTIN ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306964242,DEE & G ENRICHMENT CENTER,321 AUSTIN ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 132 , 135 ," $39,996.65 ",,
MEDICAID DIRECT,1306965140,"ELLIS JR, WILLARD, JACKSON",~,3136 SUNSET AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,1306965140,"ELLIS JR, WILLARD, JACKSON",3136 SUNSET AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 178 , 486 ," 1,132 "," $55,290.63 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306971387,"GILCHRIST, SUSAN, CLARK",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1306971387,"GILCHRIST, SUSAN, CLARK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 22 , 24 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306975156,"HAVLIK, HEATHER, SCHLESNER",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 15 , 35 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306975974,"PREVOST, MARY, ELLEN",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1306975974,"PREVOST, MARY, ELLEN",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306977160,"MORCIGLIO, APRIL, HARRELL",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1306978606,RIVERSTONE HEALTH MANAGEMENT INC,~,104 EFIRD BLVD   NEW BERN NC,025,Craven,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1306978606,RIVERSTONE HEALTH MANAGEMENT INC,104 EFIRD BLVD   NEW BERN NC,025,Craven,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 31 , 185 , 185 ,$#,,
MEDICAID DIRECT,1306978606,RIVERSTONE HEALTH MANAGEMENT INC,~,104 EFIRD BLVD   NEW BERN NC,025,Craven,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306978606,RIVERSTONE HEALTH MANAGEMENT INC,104 EFIRD BLVD   NEW BERN NC,025,Craven,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 29 ," 6,503 "," 6,503 "," $409,013.97 ",,
MEDICAID DIRECT,1306980362,"TUTTEROW, DOUGLAS",DOUGLAS A TUTTEROW DDS PA,4680 YADKINVILLE RD   PFAFFTOWN NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1306980362,"TUTTEROW, DOUGLAS",4680 YADKINVILLE RD   PFAFFTOWN NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1306981030,"CUTHRELL, JONATHAN, G",CUTHRELL DDS & MOCHNICK DMD PA,1341 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1306981030,"CUTHRELL, JONATHAN, G",1341 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1700921988,EDWARD F SCAMMON DMD PA,~,8159 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1306981550,"SCAMMON, EDWARD, FLOYD",8159 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 358 , 441 ," 1,695 "," $123,607.23 ",,
MEDICAID DIRECT,1598085227,EDWARD F SCAMMON DMD PA,EDWARD F SCAMMON DMD PA,327 TEAL DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306981550,"SCAMMON, EDWARD, FLOYD",8159 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114247822,EDWARD F SCAMMON DMD PA,~,115 SOUTHERN DUNES DR   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1306981550,"SCAMMON, EDWARD, FLOYD",115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 380 , 483 ," 1,709 "," $127,266.33 ",,
MEDICAID DIRECT,1598085227,EDWARD F SCAMMON DMD PA,EDWARD F SCAMMON DMD PA,327 TEAL DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306981550,"SCAMMON, EDWARD, FLOYD",115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1598085227,EDWARD F SCAMMON DMD PA,EDWARD F SCAMMON DMD PA,327 TEAL DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1306981550,"SCAMMON, EDWARD, FLOYD",327 TEAL DR   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 481 , 608 ," 2,192 "," $168,250.36 ",,
MEDICAID DIRECT,1639352032,NORTH WHITEVILLE URGENT CARE,NORTH WHITEVILLE URGENT CARE,614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1306983325,"OXENDINE, MICHELLE",614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 93 , 193 , 438 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306985189,"WHITLOCK, TOM, LEE",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306985189,"WHITLOCK, TOM, LEE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 61 , 97 , 132 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306985189,"WHITLOCK, TOM, LEE",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1306985189,"WHITLOCK, TOM, LEE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1306985379,"PACE, LAURA, SCOTT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306986658,TRIANGLE PHYSICAL THERAPY,Triangle Physical Therapy,519 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1306986658,TRIANGLE PHYSICAL THERAPY,519 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 24 , 47 ,$#,,
MEDICAID DIRECT,1942637319,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS OF THE CAROLIN,2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306987185,"SENTURIAS, YASMIN, SUZANNE NABLE",2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1942637319,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS OF THE CAROLIN,2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1306987185,"SENTURIAS, YASMIN, SUZANNE NABLE",2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 67 , 71 , 148 ," $28,275.87 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306987920,"WISEMAN, DAVID, MICHAEL",101 CLINIC DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1306987920,"WISEMAN, DAVID, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 146 , 248 , 271 ,$#,,
MEDICAID DIRECT,1306988753,ONSLOW COUNTY SCHOOLS,~,200 BROADHURST RD   JACKSONVILLE NC,067,Onslow,251300000X,Agencies,Local Education Agency (LEA),,1306988753,ONSLOW COUNTY SCHOOLS,200 BROADHURST RD   JACKSONVILLE NC,067,Onslow,251300000X,Agencies,Local Education Agency (LEA),, 924 ," 23,641 "," 24,591 "," $1,022,594.41 ",,
MEDICAID DIRECT,1306990197,PRONURSE,PRONURSE MEDICAL STAFFING INC,1125 E MOREHEAD ST STE 209 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1306990197,PRONURSE,1125 E MOREHEAD ST STE 209 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 41 ," 8,123 "," 8,123 "," $540,549.08 ",,
MEDICAID DIRECT,1336542067,DLP HAYWOOD REGIONAL MEDICAL CENTER,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1306991799,"DINWIDDIE JR, WILLIAM, COURTENAY",55 BUCKEYE COVE RD   CANTON NC,044,Haywood,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 25 , 28 , 29 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306992508,"PASSARETTI, CATHERINE, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1306992508,"PASSARETTI, CATHERINE, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 44 , 44 ,$#,,
MEDICAID DIRECT,1306992664,BREA CHARLOTTE LLC,BROOKDALE SOUTH PARK,5326 PARK RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1306992664,BREA CHARLOTTE LLC,5326 PARK RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,166 "," 1,166 "," $102,008.98 ",,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1306997218,"HACKNEY, TINA, ANN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 245 , 276 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1306998034,"MCCRORY, MICHAEL, CONOR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 35 , 53 , 69 ," $14,522.13 ",,
MEDICAID DIRECT,1982767778,DRS BELTON AND SCHRIMPER,DRS BELTON AND SCHRIMPER,1512 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1316000110,"SCHRIMPER, KEVIN, CHARLES",1512 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 44 , 135 ,$#,,
MEDICAID DIRECT,1649757568,PRIVATE DIAGNOSTIC CLINIC PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1316000185,"BONNER, MELANIE, JEAN",2100 ERWIN RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 51 , 68 , 152 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 13 , 23 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316000193,"MILLER, STEPHEN, GARY",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 17 , 20 , 64 ,$#,,
MEDICAID DIRECT,1316005358,"MARTIN, BARTOO, ELFRED",BART MARTIN DDS,18 CLAYTON ST   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1316005358,"MARTIN, BARTOO, ELFRED",18 CLAYTON ST   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 36 , 82 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316014400,"ANDERSON, SUSANNE, BICKLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316014509,"SHARPE, JENNIFER, MALOWAY",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,425 C MCARTHUR DR   ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,425 C MCARTHUR DR   ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,#, 69 , 69 ,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,129 W MAIN ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,903 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,903 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,903 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 32 , 606 , 606 ," $74,261.60 ",,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,2639 SUNSET AVE STE A   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 13 ,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,315 WILKESBORO BLVD NE STE 2B LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,315 WILKESBORO BLVD NE STE 2B LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,, 12 , 283 , 283 ," $28,798.72 ",,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,315 WILKESBORO BLVD NE STE 2B LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,117 N MARKET ST   WASHINGTON NC,007,Beaufort,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,117 N MARKET ST   WASHINGTON NC,007,Beaufort,253Z00000X,Agencies,In Home Supportive Care,, 35 , 583 , 583 ," $71,239.82 ",,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,224 MAIN ST W   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 15 ,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,129 W MAIN ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 75 ,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,903 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,104 SHORT ST   RICH SQUARE NC,066,Northampton,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 11 ,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,117 N MARKET ST   WASHINGTON NC,007,Beaufort,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 13 ,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,224 MAIN ST W   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,117 N MARKET ST   WASHINGTON NC,007,Beaufort,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,5040 NEW CENTRE DR STE F WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,809 GREEN VALLEY RD STE 103 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,228 US HIGHWAY 13 STE 1   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,224 MAIN ST W   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,2639 SUNSET AVE STE A   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,2639 SUNSET AVE STE A   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,2639 SUNSET AVE STE A   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 30 , 438 , 438 ," $71,615.06 ",,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,5040 NEW CENTRE DR STE F WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,5040 NEW CENTRE DR STE F WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,104 SHORT ST   RICH SQUARE NC,066,Northampton,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,104 SHORT ST   RICH SQUARE NC,066,Northampton,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 1,003 "," 1,003 "," $104,651.64 ",,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,129 W MAIN ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,129 W MAIN ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,, 526 ," 99,927 "," 103,422 "," $11,880,611.16 ",,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,129 W MAIN ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,224 MAIN ST W   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,224 MAIN ST W   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,224 MAIN ST W   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,, 30 , 515 , 515 ," $90,870.56 ",,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,809 GREEN VALLEY RD STE 103 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,129 W MAIN ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,117 N MARKET ST   WASHINGTON NC,007,Beaufort,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,129 W MAIN ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316015191,QUALITY HOME STAFFING INC,QUALITY HOME STAFFING INC,809 GREEN VALLEY RD STE 103 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1316015191,QUALITY HOME STAFFING INC,809 GREEN VALLEY RD STE 103 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 36 , 686 , 686 ," $70,908.96 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316015233,"LEVINE, ELISSA, ROSENFELD",8169 ARDREY KELL RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316016397,"YAMAGUCHI, DEAN, JARED",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 202 , 243 , 336 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316016397,"YAMAGUCHI, DEAN, JARED",115 HEART DR   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316016397,"YAMAGUCHI, DEAN, JARED",115 HEART DR   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316016397,"YAMAGUCHI, DEAN, JARED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316016397,"YAMAGUCHI, DEAN, JARED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 76 , 115 , 176 ," $17,086.24 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316016900,"GELBARD, ESTHER",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 34 , 68 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316016900,"GELBARD, ESTHER",2550 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316018658,"HINN, ALBERT, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 72 , 106 , 141 ," $13,793.16 ",,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1316018658,"HINN, ALBERT, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316018658,"HINN, ALBERT, RICHARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316021207,"MCNEILL, DIANA, BURES",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 43 , 45 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316021207,"MCNEILL, DIANA, BURES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 11 , 22 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1316021207,"MCNEILL, DIANA, BURES",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1316021207,"MCNEILL, DIANA, BURES",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316021280,"WHITE, HEIDI, KAY",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316021280,"WHITE, HEIDI, KAY",3300 EXECUTIVE DR   RALEIGH NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316022643,"MATHIAS, MATTHEW, DAVID",6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 68 , 158 ,$#,,
MEDICAID DIRECT,1942509534,HIGGINS MANI & WATSON VI DDS PA,THE DENTAL CARE CENTER,1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1316022676,"HIGGINS, STUART, SPENCE",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 31 , 160 ," $12,774.53 ",,
MEDICAID DIRECT,1316023443,HIGGINS MANI & WATSON IV DDS PA,THE DENTAL CARE CENTER,545 VENTURE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316022676,"HIGGINS, STUART, SPENCE",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 172 , 177 , 728 ," $44,193.40 ",,
MEDICAID DIRECT,1932283421,HIGGINS MANI & WATSON I DDS PA,THE DENTAL CARE CENTER,2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316022676,"HIGGINS, STUART, SPENCE",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 298 , 318 ," 1,287 "," $66,342.51 ",,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316022676,"HIGGINS, STUART, SPENCE",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 541 , 626 ," 2,223 "," $146,729.49 ",,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1316022676,"HIGGINS, STUART, SPENCE",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 812 , 888 ," 3,962 "," $216,210.42 ",,
MEDICAID DIRECT,1730263211,HIGGINS MANI & WATSON III DDS PA,THE DENTAL CARE CENTER,3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316022676,"HIGGINS, STUART, SPENCE",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 719 , 930 ," 3,421 "," $180,946.70 ",,
MEDICAID DIRECT,1306491444,HIGGINS MANI AND WATSON VIII DDS PA,THE DENTAL CARE CENTER,877 E GANNON AVE STE 401 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316022676,"HIGGINS, STUART, SPENCE",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 551 , 766 ," 2,986 "," $160,456.17 ",,
MEDICAID DIRECT,1316022700,"ACKERMAN JR, EMMETT, SMOAK",~,66 WHEATON AVE   YOUNGSVILLE NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice,1316022700,"ACKERMAN JR, EMMETT, SMOAK",66 WHEATON AVE   YOUNGSVILLE NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice, 362 , 928 ," 2,802 "," $129,868.35 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316023054,"FESEL, FREDERICK",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316023054,"FESEL, FREDERICK",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316023054,"FESEL, FREDERICK",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316023054,"FESEL, FREDERICK",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 ,#, 11 ,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316023336,"MOHANAN, SVETA",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 22 , 24 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316023336,"MOHANAN, SVETA",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316023336,"MOHANAN, SVETA",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316023435,"D'AVIGNON, AMY, REBECCA",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316023435,"D'AVIGNON, AMY, REBECCA",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1114365814,RICHARD C HOLMES DDS PA,RICHARD C HOLMES DDS PA,710 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,193400000X,Group,Single Specialty,,1316023534,"HOLMES, RICHARD, COE",710 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice, 182 , 474 ," 1,636 "," $78,811.02 ",,
MEDICAID DIRECT,1124235635,DYER & JONES PLLC,~,479 SOUTH DR   HIGHLANDS NC,056,Macon,193400000X,Group,Single Specialty,,1316025703,"DYER, CHRISTOPHER, TOWNSEND",479 SOUTH DR   HIGHLANDS NC,056,Macon,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 176 , 366 ," $19,000.39 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316026768,"SLUSS, KELLI, SUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 118 , 151 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316029606,"BUSUIOC, CORINA, ADELA",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 23 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316029606,"BUSUIOC, CORINA, ADELA",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316029929,"KHANDANI, AMIR, HOSSEIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0904X,Allopathic & Osteopathic Physicians,Radiology,Nuclear Radiology, 93 , 99 , 124 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316031487,"REDDY, JAYA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316031487,"REDDY, JAYA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 47 , 47 ,$#,,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1316033095,"CROSS, MICHAEL, TODD",14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 122 , 327 , 397 ," $15,765.22 ",,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1316033095,"CROSS, MICHAEL, TODD",700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 17 , 55 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316033616,"LINDSAY, BETH, HAYS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316033616,"LINDSAY, BETH, HAYS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1063890176,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM RADIATION ONCOLOGY,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1316033616,"LINDSAY, BETH, HAYS",566 RUIN CREEK RD   HENDERSON NC,091,Vance,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316035694,"STRAUSS, ROBERT, ALLEN",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 40 , 41 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316035694,"STRAUSS, ROBERT, ALLEN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1316035694,"STRAUSS, ROBERT, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316035694,"STRAUSS, ROBERT, ALLEN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316035694,"STRAUSS, ROBERT, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 12 , 15 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316035694,"STRAUSS, ROBERT, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 23 , 28 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316035694,"STRAUSS, ROBERT, ALLEN",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,90 E MAIN ST STE 1 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1316037476,"MCCRACKEN, MARY CURTIS, KIRKPATRICK",270 N HAYWOOD ST   WAYNESVILLE NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1316037476,"MCCRACKEN, MARY CURTIS, KIRKPATRICK",270 N HAYWOOD ST   WAYNESVILLE NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316037799,"WHITE, HALLEY, RHODES",109 MENDENHALL DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1316037799,"WHITE, HALLEY, RHODES",306 DOLPHIN DR   JACKSONVILLE NC,067,Onslow,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 707 , 823 ," 2,914 "," $93,136.17 ",,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316037799,"WHITE, HALLEY, RHODES",109 MENDENHALL DR   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 509 , 600 ," 3,813 "," $291,747.39 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316039431,"STAUFFACHER, KELLY, ANN",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316039431,"STAUFFACHER, KELLY, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1316040173,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03860,425 W STATE ST   BLACK MOUNTAIN NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1316040173,NORTH CAROLINA CVS PHARMACY LLC,425 W STATE ST   BLACK MOUNTAIN NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 48 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316041510,"ROGERS, STEPHEN, RUTHERFORD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316043532,"TRACY, ELEANOR, GAIL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 46 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316043763,"DENIZARD-THOMPSON, NANCY, MARIE",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316043763,"DENIZARD-THOMPSON, NANCY, MARIE",MEDICAL CENTE BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 204 , 314 , 382 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316048424,"ELLIS, MATTHEW, JAY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 48 , 82 , 110 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316048424,"ELLIS, MATTHEW, JAY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316048424,"ELLIS, MATTHEW, JAY",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1518696236,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-712 FLEMING STREET,712 FLEMING ST   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316049125,"LEE, KRISTEN, SPARROW",712 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 33 , 39 ,$#,,
MEDICAID DIRECT,1679571574,BECKFORD AVENUE MEDICAL CENTER PA,BECKFORD AVE MEDICAL CTR PA,816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972606820,BECKFORD AVENUE MEDICAL CENTER PA,~,816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,193400000X,Group,Single Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1679571574,BECKFORD AVENUE MEDICAL CENTER PA,BECKFORD AVE MEDICAL CTR PA,176 S BECKFORD DR   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972606820,BECKFORD AVENUE MEDICAL CENTER PA,~,816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 92 , 208 , 315 ,$#,,
MEDICAID DIRECT,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",FRANCIS CHUKWUNENYE ANIEKWENSI,816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679571574,BECKFORD AVENUE MEDICAL CENTER PA,BECKFORD AVE MEDICAL CTR PA,176 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",176 S BECKFORD DR   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 176 , 539 , 766 ," $11,566.54 ",,
MEDICAID DIRECT,1679571574,BECKFORD AVENUE MEDICAL CENTER PA,BECKFORD AVE MEDICAL CTR PA,176 S BECKFORD DR   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 90 , 90 ,$#,,
MEDICAID DIRECT,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",FRANCIS CHUKWUNENYE ANIEKWENSI,176 S BECKFORD DR   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",176 S BECKFORD DR   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679571574,BECKFORD AVENUE MEDICAL CENTER PA,BECKFORD AVE MEDICAL CTR PA,176 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 178 , 178 ,$#,,
MEDICAID DIRECT,1679571574,BECKFORD AVENUE MEDICAL CENTER PA,BECKFORD AVE MEDICAL CTR PA,176 S BECKFORD DR   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",176 S BECKFORD DR   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 47 , 59 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 30 , 30 ,$#,,
MEDICAID DIRECT,1972606820,BECKFORD AVENUE MEDICAL CENTER PA,~,816 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1316054364,"ANIEKWENSI, FRANCIS, CHUKWUNENYE",176 S BECKFORD DR   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 115 , 339 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 108 , 229 , 729 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316055700,"BULLA, DONALD, KING",3801 W MARKET ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316058134,"ROBERSON, ARTHUR",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316061534,TOM & JERRY MANAGEMENT LLC,HUNTER VILLAGE,111 S CHURCH ST   HUNTERSVILLE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316061534,TOM & JERRY MANAGEMENT LLC,111 S CHURCH ST   HUNTERSVILLE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 40 ," 11,339 "," 11,339 "," $735,987.06 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316061724,"NORTON, TARA, LUISA",2301 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316063944,"HERTEL, JOHANN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 21 , 21 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316063944,"HERTEL, JOHANN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 19 , 20 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316063944,"HERTEL, JOHANN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316063944,"HERTEL, JOHANN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 14 , 15 , 30 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316065204,"RUPERTO, CORNELIO",6620 SHALLOWFORD RD   LEWISVILLE NC,034,Forsyth,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,,,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1316065576,"HAWES, ANNEMARIE, MYERS",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,75 PAINT TOWN RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1316065576,"HAWES, ANNEMARIE, MYERS",75 PAINT TOWN RD   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1316065576,"HAWES, ANNEMARIE, MYERS",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1649890450,EQUITY HEALTH SERVICES PLLC,EQUITY HEALTH SERVICES PLLC,275 N NC 16 BUSINESS HWY STE 104 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1316066079,"OHARA, KELLIE, HARNEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 25 ,$#,,
MEDICAID DIRECT,1649890450,EQUITY HEALTH SERVICES PLLC,EQUITY HEALTH SERVICES PLLC,16 OAK BRANCH DR STE D GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316066079,"OHARA, KELLIE, HARNEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,2601 LAKE DR STE 201 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316067754,"VADLAMUDI, RAJA, SEKHAR",110 KILDAIRE PARK DR   CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316067754,"VADLAMUDI, RAJA, SEKHAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316067754,"VADLAMUDI, RAJA, SEKHAR",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316067754,"VADLAMUDI, RAJA, SEKHAR",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1902834658,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE HILLSBOROUGH,267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316068919,"HARPER, SEAN, SCOTT",267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 104 , 274 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316074693,"NARENDRAN, MAHENDRA",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 72 , 626 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1669 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316074693,"NARENDRAN, MAHENDRA",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 170 , 376 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1316074693,"NARENDRAN, MAHENDRA",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316074693,"NARENDRAN, MAHENDRA",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316074693,"NARENDRAN, MAHENDRA",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 32 , 52 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316074693,"NARENDRAN, MAHENDRA",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 40 , 63 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316074693,"NARENDRAN, MAHENDRA",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316075963,"MACOSKO, CECILIE",290 W WALL ST   RURAL HALL NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 22 , 44 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316075963,"MACOSKO, CECILIE",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316075963,"MACOSKO, CECILIE",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 52 , 73 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316075963,"MACOSKO, CECILIE",6371 JESSIE LN   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316075963,"MACOSKO, CECILIE",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316077134,"HAMID, NADY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 43 , 67 , 104 ,$#,,
MEDICAID DIRECT,1316077985,ESSENTIAL LIVING HOME CARE SERVICES,ESSENTIAL LIVING HOME CARE SERVICES LLC,107 E WADE ST STE D WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,1316077985,ESSENTIAL LIVING HOME CARE SERVICES,107 E WADE ST STE D WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,466 "," 2,466 "," $259,093.12 ",,
MEDICAID DIRECT,1366560443,LARRY J MORAY DDS MS PA,MYORTHODONTIST,2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,,,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 18 ,$#,,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 65 , 65 , 65 ," $12,150.41 ",,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 105 , 107 , 207 ," $19,857.32 ",,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",1919 BRAGG ST STE 7 SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 127 , 127 , 127 ," $14,200.19 ",,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 32 , 32 , 34 ,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1720014152,LARRY J MORAY DDS MS PA,MYORTHODONTIST,150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1316078272,"HERSHEY, BARBARA, THOMPSON",150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316079262,"CHERUKURI, SULOCHANA, DEVI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 30 , 45 ,$#,,
MEDICAID DIRECT,1174882344,CALDWELL MEMORIAL HOSPITAL,LAUREL PARK WOMENS HEALTH,906 COLLEGE AVE SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316079874,"ABOUZIED, AMY, MOHAMED",906 COLLEGE AVE SW STE A LENOIR NC,014,Caldwell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 51 , 57 ,$#,,
MEDICAID DIRECT,1174882344,CALDWELL MEMORIAL HOSPITAL,LAUREL PARK WOMENS HEALTH,4355 HICKORY BLVD STE 1 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316079874,"ABOUZIED, AMY, MOHAMED",906 COLLEGE AVE SW STE A LENOIR NC,014,Caldwell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1316080781,NEW HANOVER COUNTY SCHOOLS,New Hanover County Schools,6410 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,251300000X,Agencies,Local Education Agency (LEA),,1316080781,NEW HANOVER COUNTY SCHOOLS,6410 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,251300000X,Agencies,Local Education Agency (LEA),," 1,043 "," 27,501 "," 28,564 "," $1,179,157.74 ",,
MEDICAID DIRECT,1316082324,MARTIN COUNTY SCHOOLS,MARTIN COUNTY SCHOOLS,300 N WATTS ST   WILLIAMSTON NC,058,Martin,251300000X,Agencies,Local Education Agency (LEA),,1316082324,MARTIN COUNTY SCHOOLS,300 N WATTS ST   WILLIAMSTON NC,058,Martin,251300000X,Agencies,Local Education Agency (LEA),, 43 , 502 , 502 ," $26,487.66 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 470 , 475 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 102 , 102 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 49 , 50 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 91 , 92 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1402 PINCKNEY ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,180 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316083520,"SMITH, CHERYL, POMAVILLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316086325,"RONAN, DAVID, MICHAEL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316087463,"WALEWSKI, KELLY, JAN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316087463,"WALEWSKI, KELLY, JAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932130390,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE CAROLINA FAMILY ME,104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1316091325,"TAMEZ, ERNESTO, MARTE",104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 139 , 244 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316091424,"ATKINSON, CYNTHIA, LUANNE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316091424,"ATKINSON, CYNTHIA, LUANNE",11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1659759389,EASTERN RADIATION ONCOLOGY PLLC,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1316093081,"RUSTHOVEN, KYLE, EHRMAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 34 , 96 , 121 ,$#,,
MEDICAID DIRECT,1902957954,COUNTY OF HENDERSON OFFICE OF ACCOU,HENDERSON CO DEPT PUBLIC HEALTH,1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316094451,"CURRAN, DIANA, RENEE",1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 95 , 282 ," $12,180.94 ",,
MEDICAID DIRECT,1801184932,LIMBIONICS OF SANFORD INC,~,615 WICKER ST   SANFORD NC,053,Lee,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316098023,"TRUESDALE, STEPHEN, GREGORY",615 WICKER ST   SANFORD NC,053,Lee,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316099922,"FISK, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316099922,"FISK, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316099922,"FISK, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316100456,"JOYCE, AISHA, SOPHIA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080S0010X,Allopathic & Osteopathic Physicians,Pediatrics,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316102593,"DOAR, NORMANDIE, VREELAND",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316102676,"BELIGOTTI, SHANNON, VICTORIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 47 , 47 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316102676,"BELIGOTTI, SHANNON, VICTORIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 59 , 60 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316103708,"BOUTTE, DAWN, MICHELLE",2345 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316104425,"HINSON, ASHLEY, REBEKAH PRESAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 19 , 36 , 36 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316104425,"HINSON, ASHLEY, REBEKAH PRESAR",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 601 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,,,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316104425,"HINSON, ASHLEY, REBEKAH PRESAR",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316104425,"HINSON, ASHLEY, REBEKAH PRESAR",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316105489,"ALJISHI, WAEL, ZAKI",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316105489,"ALJISHI, WAEL, ZAKI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 32 , 38 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316105489,"ALJISHI, WAEL, ZAKI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316105489,"ALJISHI, WAEL, ZAKI",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1316105489,"ALJISHI, WAEL, ZAKI",420 N CENTER ST   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316105489,"ALJISHI, WAEL, ZAKI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316105547,"MAHADEVAPPA, MANJUNATH, CHIRAKANAHALLI",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316105547,"MAHADEVAPPA, MANJUNATH, CHIRAKANAHALLI",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316105547,"MAHADEVAPPA, MANJUNATH, CHIRAKANAHALLI",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 65 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316107295,"MORAN, TIMOTHY, PAUL",4414 LAKE BOONE TRL   RALEIGH NC,092,Wake,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology, 12 , 14 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316112105,"UDEOZO, CHIDEBE, ORAKWALU",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 80 , 170 , 171 ,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1316112105,"UDEOZO, CHIDEBE, ORAKWALU",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 181 , 184 ,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316113160,"CAVENDISH, AIMEE, LEE",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 176 , 288 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 32 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 42 , 56 , 80 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 25 , 31 , 46 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 34 , 36 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 64 , 200 , 340 ," $29,462.14 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 29 , 56 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 37 , 39 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316113897,"MANNAM, PRAVEEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316116643,"HROBAK, MANDY, LYNN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316116643,"HROBAK, MANDY, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 30 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316120017,"GEHI, ANIL, KISHIN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316120017,"GEHI, ANIL, KISHIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316120017,"GEHI, ANIL, KISHIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316120017,"GEHI, ANIL, KISHIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 91 , 174 , 190 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316122682,"FISHER, CEDRIC, MAURICE",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316122781,"DILLER, REBECCA, KAY",1550 FAULK ST   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 42 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316124415,"KALRA, GIRISH, LAKHMICHAND",540 NEW WAVERLY PL   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 15 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316124415,"KALRA, GIRISH, LAKHMICHAND",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316124415,"KALRA, GIRISH, LAKHMICHAND",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316124415,"KALRA, GIRISH, LAKHMICHAND",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 28 , 50 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1316124415,"KALRA, GIRISH, LAKHMICHAND",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316124415,"KALRA, GIRISH, LAKHMICHAND",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 45 , 52 ,$#,,
MEDICAID DIRECT,1861828022,MICHAEL O REIMELS DDS & CATHERINE S,THE SMILE ZONE,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316126881,"THOMPSON, KAREN, ANN",816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316127517,"WILLIAMS, JOSEPH, BENJAMIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 19 , 20 ,$#,,
MEDICAID DIRECT,1316131006,"KOVAL, YURIY",YURIY Z KOVAL DDS PLLC,1250 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1316131006,"KOVAL, YURIY",1250 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 105 , 186 , 544 ," $20,610.38 ",,
MEDICAID DIRECT,1316131337,THE SHAIRE CENTER,SHAIRE CENTER INC,1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316131337,THE SHAIRE CENTER,1450 SHAIRE CENTER DR   LENOIR NC,014,Caldwell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 16 ," 3,765 "," 4,090 "," $356,724.52 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316136575,"ADAMS, JOHN, MARK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1316136575,"ADAMS, JOHN, MARK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316136575,"ADAMS, JOHN, MARK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 30 , 84 , 84 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1316136575,"ADAMS, JOHN, MARK",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1316137912,"ROVIRA FIGUEROA, HELEN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 117 , 144 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1316137912,"ROVIRA FIGUEROA, HELEN",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316138548,"CHINO, JUNZO, PAUL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 13 , 59 , 109 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316138548,"CHINO, JUNZO, PAUL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 28 , 61 ,$#,,
MEDICAID DIRECT,1063890176,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM RADIATION ONCOLOGY,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1316138548,"CHINO, JUNZO, PAUL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316140932,"BARNETT, TED, MARCUS",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316140932,"BARNETT, TED, MARCUS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043328214,TRIAD ORTHOTICS AND PEDORTHICS INC,TRIAD O AND P,2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316142318,"MANSFIELD, PAUL, ANDREW",2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 69 ,$#,,
MEDICAID DIRECT,1659775948,CAROLINAS PROSTHETIC AND ORTHOTICS,CAROLINAS PROSTHETICS AND ORTHOTICS,118 W 3RD ST   PEMBROKE NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316142318,"MANSFIELD, PAUL, ANDREW",2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 45 ,$#,,
MEDICAID DIRECT,1659775948,CAROLINAS PROSTHETIC AND ORTHOTICS,CAROLINAS PROSTHETICS AND ORTHOTICS,118 W 3RD ST   PEMBROKE NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316142318,"MANSFIELD, PAUL, ANDREW",2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1043328214,TRIAD ORTHOTICS AND PEDORTHICS INC,TRIAD O AND P,2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316142318,"MANSFIELD, PAUL, ANDREW",2419 LEWISVILLE CLEMMONS RD STE 1 CLEMMONS NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316142656,"DHUNGEL, BIRAT",2525 COURT DR   GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316142656,"DHUNGEL, BIRAT",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1316142656,"DHUNGEL, BIRAT",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 57 , 105 , 108 ," $11,078.24 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316143670,"JACKSON, LERON, CELESTE",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 26 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316143670,"JACKSON, LERON, CELESTE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 51 , 74 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316147150,"AQUINO, KAREN, MARGHANITA",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 92 , 133 , 142 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316147150,"AQUINO, KAREN, MARGHANITA",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 19 , 21 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,301 E WENDOVER AVE STE 211 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316147150,"AQUINO, KAREN, MARGHANITA",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1316147507,"STEVENS, DARLA, STILLEY",420 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316147507,"STEVENS, DARLA, STILLEY",4355 HICKORY BLVD UPPR STE GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316147507,"STEVENS, DARLA, STILLEY",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1316147507,"STEVENS, DARLA, STILLEY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316147507,"STEVENS, DARLA, STILLEY",270 PINE MOUNTAIN RD STE 4 HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1316147507,"STEVENS, DARLA, STILLEY",420 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 76 , 81 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316147515,"WINCHESTER, JOHN, BRANDON BURL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316147812,"HOOKER, JAMES, BENJAMIN",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 52 , 124 ,$#,,
MEDICAID DIRECT,1073569679,LOVELL MEDICAL SUPPLY INC,~,186 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316148794,"DESAI, PRIYANK, KISHORKUMAR",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538264478,FAMILY MEDICAL SUPPLY LLC,~,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316148794,"DESAI, PRIYANK, KISHORKUMAR",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1316148794,"DESAI, PRIYANK, KISHORKUMAR",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 99 , 283 , 369 ," $26,203.83 ",,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1316148794,"DESAI, PRIYANK, KISHORKUMAR",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 250 , 442 , 922 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316149933,"SCHMITZ, COLLEEN, GILLIGAN",3009 NEW BERN AVE   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316152127,"PETERSON CARMICHAEL, STACEY, LEANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 68 , 148 , 226 ," $24,581.41 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316154685,"GWANZURA, RUDO",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 87 , 88 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1316154685,"GWANZURA, RUDO",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316155013,"WAHAB, HOLLY, TILLMAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356300248,SANFORD PEDIATRICS PA,SANFORD PEDIATRICS PA,1801 DOCTORS DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1316156359,"GUDDATI, RADHA, CHANDANA",1801 DOCTORS DR   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 23 , 46 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316157027,"GILMORE, JULIE, MICHELLE",9965 POPLAR TENT RD   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316157027,"GILMORE, JULIE, MICHELLE",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316157027,"GILMORE, JULIE, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316157076,"MEALING, TATUM, SHERRELL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1316158033,NORTH CENTRAL MEDICALTRANSPORT INC,,132 MARKET ST   HENDERSON NC,091,Vance,3416L0300X,Transportation Services,Ambulance,Land Transport,1316158033,NORTH CENTRAL MEDICALTRANSPORT INC,132 MARKET ST   HENDERSON NC,091,Vance,3416L0300X,Transportation Services,Ambulance,Land Transport, 90 , 230 , 418 ," $33,240.82 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316158819,"ERICKSON, CHRISTOPHER, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316158819,"ERICKSON, CHRISTOPHER, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316158819,"ERICKSON, CHRISTOPHER, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316159262,"JULIANO, JONATHAN, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 54 , 54 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316159429,"GOLDBAUM, ROSS, ALAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1316162712,"AYERS, RUFFIN, PHILLIPS",2359 HIGHWAY 105   BOONE NC,095,Watauga,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 49 , 130 , 132 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 27 , 31 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 88 , 102 , 170 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 14 , 20 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316162902,"GOLDEN, KEITH, MITCHELL",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 44 , 52 , 87 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1316163066,"HENDRICKER, RYAN, MATTHEW",304 10TH AVE NE   HICKORY NC,018,Catawba,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 145 , 308 , 488 ," $12,787.80 ",,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316163405,"ERICKSON, JOHN, MICHAEL",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316163405,"ERICKSON, JOHN, MICHAEL",3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 22 , 31 ,$#,,
MEDICAID DIRECT,1346486891,SEASIDE PEDIATRICS PA,SEASIDE PEDIATRICS PA,1606 WELLINGTON AVE STE E WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316164155,"JASKOLKA, JESSICA, BETH",1606 WELLINGTON AVE STE E WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 21 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316165251,"BLANCO, ROBERTO, ALEJANDRO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316165251,"BLANCO, ROBERTO, ALEJANDRO",77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1316166051,"SADLER, ERIC, JEROD",~,3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1316166051,"SADLER, ERIC, JEROD",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538271655,ERIC J SADLER DDS PA,ERIC J SADLER DDS PA,3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316166051,"SADLER, ERIC, JEROD",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 200 , 484 ," 1,287 "," $60,315.32 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316166473,"BATES, JAREN",1908 HILCO ST STE A ALBEMARLE NC,084,Stanly,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1316166903,"BITAR, RAGHID, SOBHI",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 13 , 23 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1316166903,"BITAR, RAGHID, SOBHI",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316168065,"WITT, MARILI, UNO",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316168065,"WITT, MARILI, UNO",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316168065,"WITT, MARILI, UNO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 176 , 184 , 199 ," $85,326.43 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316168065,"WITT, MARILI, UNO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1316170830,"CHAPPELEAR, ALEX, KNIGHT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 83 , 83 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1316170830,"CHAPPELEAR, ALEX, KNIGHT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 175 , 177 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1316170830,"CHAPPELEAR, ALEX, KNIGHT",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316178148,"KRAMER, JOHN, MARTIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316178148,"KRAMER, JOHN, MARTIN",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1316180425,"SOUZA, JEFFERSON, KRAWULSKI",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316181357,"PASCUAL, SANDI, GOUGHENOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 53 , 58 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316181357,"PASCUAL, SANDI, GOUGHENOUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316182652,"EDMONSTON, ASHLEY, KEITH",201 SAGE RD   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 30 ,$#,,
MEDICAID DIRECT,1881712842,NORTH CAROLINA STATE UNIVERSITY,,2815 CATES AVE   RALEIGH NC,092,Wake,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1316182991,"BRIM, ALISON, LYNN",2815 CATES AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316184146,"NEALE, ELIZABETH, LEIGH",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316184146,"NEALE, ELIZABETH, LEIGH",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316184146,"NEALE, ELIZABETH, LEIGH",200 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1316184146,"NEALE, ELIZABETH, LEIGH",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316184146,"NEALE, ELIZABETH, LEIGH",345 MANOR RD   MARS HILL NC,057,Madison,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316184146,"NEALE, ELIZABETH, LEIGH",1264 AIRPORT RD   MARION NC,059,McDowell,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316186273,"LEWIS, BRADLEY, WAYNE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316186273,"LEWIS, BRADLEY, WAYNE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316186273,"LEWIS, BRADLEY, WAYNE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316188238,"BROWN, DAVID, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316188238,"BROWN, DAVID, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316188238,"BROWN, DAVID, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316188238,"BROWN, DAVID, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1316188550,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 01246,612 N MAIN ST   CREEDMOOR NC,039,Granville,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316188550,NORTH CAROLINA CVS PHARMACY LLC,612 N MAIN ST   CREEDMOOR NC,039,Granville,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1316188659,"THOMPSON, WYATT, WHEELER",4450 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 173 , 567 ," 1,188 "," $14,169.96 ",,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1316195118,"PATE, JENNIFER",3311 BURNT MILL DR   WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 99 , 107 , 175 ," $33,193.48 ",,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316196298,"GOOLSBY, KIRSTEN, MCKOY",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 35 , 94 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 32 , 54 ,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 22 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1316198229,"NKYESIGA, PETER, KANKAKA",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1316201007,"YANAGIHARA, THEODORE, KATSUYUKI",516 S VAN BUREN RD   EDEN NC,079,Rockingham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1316201007,"YANAGIHARA, THEODORE, KATSUYUKI",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316201007,"YANAGIHARA, THEODORE, KATSUYUKI",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 45 , 106 , 148 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316201767,"ALFORD, TERRY, CURTIS",6030 W HIGHWAY 74 STE F INDIAN TRAIL NC,090,Union,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1316203151,"SHAH, CHRISTOPHER, TULIP",725 HIGHLAND OAKS DR STE 101 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 20 , 21 , 25 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1316203151,"SHAH, CHRISTOPHER, TULIP",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 207 , 332 , 468 ," $23,447.00 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1316203151,"SHAH, CHRISTOPHER, TULIP",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316203995,"STRICSEK, GEOFFREY, PAUL",2800 ASHTON DR STE 200 WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 41 , 58 , 67 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316205388,"BREMJIT, PRANEETA",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316205388,"BREMJIT, PRANEETA",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1316205388,"BREMJIT, PRANEETA",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1316205388,"BREMJIT, PRANEETA",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 68 , 96 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316205628,"CHEN, YIN, JIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316205628,"CHEN, YIN, JIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316205628,"CHEN, YIN, JIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316205628,"CHEN, YIN, JIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 348 , 368 , 439 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316205628,"CHEN, YIN, JIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316205628,"CHEN, YIN, JIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 13 , 19 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316205628,"CHEN, YIN, JIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316205768,"KIEBER-EMMONS, ANNMARIE, LOUISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 35 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316205768,"KIEBER-EMMONS, ANNMARIE, LOUISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316205768,"KIEBER-EMMONS, ANNMARIE, LOUISE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316205768,"KIEBER-EMMONS, ANNMARIE, LOUISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1316206220,INVITAE CORPORATION,~,1400 16TH ST   SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1316206220,INVITAE CORPORATION,1400 16TH ST   SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 22 , 22 , 52 ," $28,058.30 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316207319,"SOWA, NATHANIEL, ADAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316207905,"LILLETHUN, MARTHA, KATE MCKEMIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316207905,"LILLETHUN, MARTHA, KATE MCKEMIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 60 , 60 ," $16,377.91 ",,
MEDICAID DIRECT,1316213986,FOREVER YOUNG CARE SERVICES INC,~,2020 REMOUNT RD STE W113 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1316213986,FOREVER YOUNG CARE SERVICES INC,2020 REMOUNT RD STE W113 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#," 2,520 "," 2,520 "," $186,553.96 ",,
MEDICAID DIRECT,1316375140,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-MEDICALINTENSIVISTS,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1316215171,"REYNOLDS, STUART, FREDERICK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316217169,"LI, YING",830 KEMPSVILLE RD RM 2B223 NORFOLK VA,101,Out of State <= 40 miles,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1316217359,DEL BIANCO ENTERPRISES,Del Bianco Prosthetics and Orthotics,3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316217359,DEL BIANCO ENTERPRISES,3320 EXECUTIVE DR STE 210 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 18 , 18 , 88 ," $25,050.11 ",,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316221344,"DRIGGERS, LAURA, ANN DRESDOW",224 S 10TH AVE   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316221344,"DRIGGERS, LAURA, ANN DRESDOW",224 S 10TH AVE   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 26 , 33 ,$#,,
MEDICAID DIRECT,1316223464,FAMILY SOLUTIONS HOME CARE,~,301 S CHURCH ST STE 144 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1316223464,FAMILY SOLUTIONS HOME CARE,301 S CHURCH ST STE 144 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 8,878 "," 9,311 "," $769,656.52 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316224157,"MYERS, DOREEN, LYNN",2308 WESVILL CT   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1316228265,"JUBERG, LARISSA, ANN",295 W 27TH ST   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1316229065,HOPE UNITED HELPING OTHERS PROGRESS,~,700 N CANNON BLVD STE 113 KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1316229065,HOPE UNITED HELPING OTHERS PROGRESS,700 N CANNON BLVD STE 113 KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,071 "," 1,071 "," $63,299.96 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316233042,"DALYAI, CATHERINE, LAUREN",526 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316233042,"DALYAI, CATHERINE, LAUREN",526 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316233083,"AHMED, SYED, RIFAT",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316233083,"AHMED, SYED, RIFAT",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 98 , 167 ,$#,,
MEDICAID DIRECT,1336405471,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST AUDIOLOGY - GREE,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316234818,"LAING, BRITTANY, CARRIER",1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316236649,"YANG, MIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 16 , 34 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316236912,"SOUTHWELL, DEREK, GARDNER",200 TRENT DR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316236912,"SOUTHWELL, DEREK, GARDNER",200 TRENT DR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316236912,"SOUTHWELL, DEREK, GARDNER",200 TRENT DR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316236912,"SOUTHWELL, DEREK, GARDNER",200 TRENT DR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 20 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316236912,"SOUTHWELL, DEREK, GARDNER",200 TRENT DR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356688857,KERVIN MACK DMD MS PLLC,~,510 HAMPTON PT STE 200 HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1316237290,"MACK, KERVIN, BRANDON",1628 MEMORIAL DR STE C BURLINGTON NC,001,Alamance,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1356688857,KERVIN MACK DMD MS PLLC,~,1628 MEMORIAL DR STE C BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1316237290,"MACK, KERVIN, BRANDON",1628 MEMORIAL DR STE C BURLINGTON NC,001,Alamance,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 832 ," 2,713 "," 3,133 "," $451,867.31 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 308 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316237860,"SELLERS, CLAIRE, E.",4414 LAKE BOONE TRL STE 308 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1700104775,BURGAW MEDICAL CENTER PC,HAMPSTEAD FAMILY MEDICINE,25 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1316238173,"REZK, MOSTAFA, MOHAMED",25 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 174 , 233 ,$#,,
MEDICAID DIRECT,1700104775,BURGAW MEDICAL CENTER PC,HAMPSTEAD FAMILY MEDICINE,306 S CAMPBELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1316238173,"REZK, MOSTAFA, MOHAMED",25 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700104775,BURGAW MEDICAL CENTER PC,HAMPSTEAD FAMILY MEDICINE,306 S CAMPBELL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1316238173,"REZK, MOSTAFA, MOHAMED",306 S CAMPBELL ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 146 , 172 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1316238173,"REZK, MOSTAFA, MOHAMED",25 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316240435,JOSEFS PHARMACY,~,2100 NEW BERN AVE   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1316240435,JOSEFS PHARMACY,2100 NEW BERN AVE   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1316240435,JOSEFS PHARMACY,~,2100 NEW BERN AVE   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316240435,JOSEFS PHARMACY,2100 NEW BERN AVE   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316244106,"FOXX, JUWAIRIYAH, KHAFID",16525 HOLLY CREST LN STE 150 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 25 , 54 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316244106,"FOXX, JUWAIRIYAH, KHAFID",19830 ZION AVE   CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316246788,"KORN, JASON, MICHAEL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316246788,"KORN, JASON, MICHAEL",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316246788,"KORN, JASON, MICHAEL",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316246788,"KORN, JASON, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083041404,THE CHARLOTTE-MECKLENBURG HOSPITAL,~,200 MEDICAL PARK DR STE 320 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316246788,"KORN, JASON, MICHAEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083041404,THE CHARLOTTE-MECKLENBURG HOSPITAL,~,200 MEDICAL PARK DR STE 320 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316246788,"KORN, JASON, MICHAEL",200 MEDICAL PARK DR STE 320 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316248727,"QAMAR, ALI, RAZA",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316248727,"QAMAR, ALI, RAZA",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 21 , 43 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316248727,"QAMAR, ALI, RAZA",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316248727,"QAMAR, ALI, RAZA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316248727,"QAMAR, ALI, RAZA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316248727,"QAMAR, ALI, RAZA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 34 , 99 , 99 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1316250301,"ROBINSON, GAIL, MICHELLE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861592271,ASHE MEMORIAL HOSPITAL INC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1316250871,"SACHS, BRIAN, JAMES",1000 W HAMLET AVE   HAMLET NC,077,Richmond,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1316250871,"SACHS, BRIAN, JAMES",1135 CARTHAGE ST   SANFORD NC,053,Lee,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 31 , 31 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1316250871,"SACHS, BRIAN, JAMES",1135 CARTHAGE ST   SANFORD NC,053,Lee,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 31 , 31 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316250921,"BRUNMEIER, ERIN, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316250921,"BRUNMEIER, ERIN, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316251614,"CROWLEY, DAVID",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316252745,"BAXTER, CATHERINE, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1881640035,HARDEE FAMILY MEDICINE,HARDEE FAMILY MEDICINE,444 WILLIAMSON RD STE E MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1316257256,"SCHAEFER, ANDREW, JOSEPH",444 WILLIAMSON RD STE E MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1316258031,"MOORING, VICKY",3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 63 , 149 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1316258031,"MOORING, VICKY",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 106 , 251 , 621 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316258163,"DING, MING-CHIEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 30 , 115 , 117 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316258569,"CLARK, SHANNON, WANG",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316258569,"CLARK, SHANNON, WANG",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114143542,NC DHHS CHILD AND FAMILY WELL-BEING,MORGANTON HICKORY CDSA,145 W PARKER RD STE A MORGANTON NC,012,Burke,252Y00000X,Agencies,Early Intervention Provider Agency,,1316262900,"WHITTINGTON, GENA, CHURCH",145 W PARKER RD STE A MORGANTON NC,012,Burke,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 158 , 170 , 170 ," $11,014.14 ",,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",201 E GROVER ST   SHELBY NC,023,Cleveland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",720 MALCOLM BLVD   VALDESE NC,012,Burke,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 21 , 25 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 25 , 27 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 23 , 37 , 51 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",440 MCALISTER RD   LINCOLNTON NC,055,Lincoln,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 11 , 25 , 40 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",125 QUEENS RD STE 150 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,,,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 20 , 33 , 40 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",10030 GILEAD RD STE B120 HUNTERSVILLE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316263353,"HART, JUSTIN, PATRICK",600 HOSPITAL DR   MONROE NC,090,Union,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316264492,"BENSHOFF, MATTHEW, ALBERT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316264492,"BENSHOFF, MATTHEW, ALBERT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 41 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316265416,"JENNINGS, DAVID, EDWARD",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316267057,"JACKSON, JACQUELYN, CHRISANA",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407277536,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316267057,"JACKSON, JACQUELYN, CHRISANA",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316267057,"JACKSON, JACQUELYN, CHRISANA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700336955,ALEXANDRA BOUDREAU & KEVIN RICKER,CHATHAM PEDIATRIC DENTISTRY,79 FALLING SPRINGS DR STE 120 CHAPEL HILL NC,019,Chatham,193400000X,Group,Single Specialty,,1316267701,"BOUDREAU, ALEXANDRA, AC",79 FALLING SPRINGS DR STE 120 CHAPEL HILL NC,019,Chatham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 541 , 985 ," 3,732 "," $112,564.35 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1316267883,"FRIEDMAN, DANIEL, JOSEPH",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 23 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316267883,"FRIEDMAN, DANIEL, JOSEPH",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 32 , 41 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316267883,"FRIEDMAN, DANIEL, JOSEPH",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316267883,"FRIEDMAN, DANIEL, JOSEPH",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 13 , 15 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316267883,"FRIEDMAN, DANIEL, JOSEPH",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 18 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316267883,"FRIEDMAN, DANIEL, JOSEPH",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1316267974,"DAVIS, REBECCA, JO",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316267974,"DAVIS, REBECCA, JO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1316267974,"DAVIS, REBECCA, JO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1316268345,SOUTHLIGHT HEALTHCARE,~,2101 GARNER RD   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1316268345,SOUTHLIGHT HEALTHCARE,2101 GARNER RD   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1316276975,SUPREME INVESTMENTS LLC,SUPREME CHOICE HEALTH CARE,1100 HARDEE RD STE 115 KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1316276975,SUPREME INVESTMENTS LLC,1100 HARDEE RD STE 115 KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 129 ," 23,770 "," 23,829 "," $1,876,744.40 ",,
MEDICAID DIRECT,1598013781,TERESA G BIGGERSTAFF DDS MD PA,TERESA G BIGGERSTAFF DDS MD PA,122 E KINDERTON WAY   BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1316277676,"PARKER, DAVID, WESLEY",122 E KINDERTON WAY   BERMUDA RUN NC,030,Davie,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 94 , 135 , 517 ," $47,796.72 ",,
MEDICAID DIRECT,1598013781,TERESA G BIGGERSTAFF DDS MD PA,TERESA G BIGGERSTAFF DDS MD PA,900 OLD WINSTON RD STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1316277676,"PARKER, DAVID, WESLEY",122 E KINDERTON WAY   BERMUDA RUN NC,030,Davie,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 13 , 13 , 41 ,$#,,
MEDICAID DIRECT,1598013781,TERESA G BIGGERSTAFF DDS MD PA,TERESA G BIGGERSTAFF DDS MD PA,900 OLD WINSTON RD STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1316277676,"PARKER, DAVID, WESLEY",900 OLD WINSTON RD STE 204 KERNERSVILLE NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 265 , 436 ," 1,709 "," $142,652.53 ",,
MEDICAID DIRECT,1598013781,TERESA G BIGGERSTAFF DDS MD PA,TERESA G BIGGERSTAFF DDS MD PA,122 E KINDERTON WAY   BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1316277676,"PARKER, DAVID, WESLEY",900 OLD WINSTON RD STE 204 KERNERSVILLE NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316283567,"LINKE, ANDREA, WOLFGANG",7010 NC HIGHWAY 751 STE 101 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316283567,"LINKE, ANDREA, WOLFGANG",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1316285612,"KOWALSKI, MICHAEL, ALEXANDER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1316285612,"KOWALSKI, MICHAEL, ALEXANDER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316285612,"KOWALSKI, MICHAEL, ALEXANDER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558695288,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY SERVICES,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316286123,"PRENSHAW, KARYN, LEIGH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1902447022,CHEROKEE MEDICAL CENTER,CMC - IMMEDIATE CARE CENTER - GAFFNEY,840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1316286339,"WATTERS, JASON, LEE",840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1038 BETHANIA RURAL HALL RD   RURAL HALL NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316288228,"LABERGE, MEAGAN, BOLES",1038 BETHANIA RURAL HALL RD   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316288228,"LABERGE, MEAGAN, BOLES",290 W WALL ST   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 132 , 213 ,$#,,
MEDICAID DIRECT,1720433634,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH RURAL HALL FAMILY MEDICINE,290 W WALL ST   RURAL HALL NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316288228,"LABERGE, MEAGAN, BOLES",290 W WALL ST   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316288228,"LABERGE, MEAGAN, BOLES",1038 BETHANIA RURAL HALL RD   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316291057,"JOHNSON, DANA, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316291057,"JOHNSON, DANA, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316292071,"VRABLE, ALAXANDER, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 62 , 71 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316292071,"VRABLE, ALAXANDER, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 38 , 42 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316292071,"VRABLE, ALAXANDER, JOSEPH",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316292337,"SKROPETA, LILA, ESTELLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316294358,"SMITH, DANIEL, PATRICK",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316295173,"LONG, JOANNA, ELIZABETH",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316296585,"QUINN, HOLLY, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316296585,"QUINN, HOLLY, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316298094,"ALLEN, ERIN, KILELEE",1801 S 7TH ST   WILMINGTON NC,065,New Hanover,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 34 , 34 , 34 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316301260,"FALCONE, BIANCA, ANJELICA",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 24 , 35 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316301260,"FALCONE, BIANCA, ANJELICA",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316301260,"FALCONE, BIANCA, ANJELICA",16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316301468,"PATEL, ANOOJ, DEVENDRAKUMAR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316301468,"PATEL, ANOOJ, DEVENDRAKUMAR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1316301468,"PATEL, ANOOJ, DEVENDRAKUMAR",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316301468,"PATEL, ANOOJ, DEVENDRAKUMAR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1316301468,"PATEL, ANOOJ, DEVENDRAKUMAR",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1316301955,"SMITH, JENNIFER, LOUISE",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 63 , 134 ,$#,,
MEDICAID DIRECT,1316303209,JOEMAX HEALTHCARE SERVICES LLC,JOEMAX HEALTHCARE SERVICES LLC,3535 S WILMINGTON ST STE 208 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1316303209,JOEMAX HEALTHCARE SERVICES LLC,3535 S WILMINGTON ST STE 208 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,293 "," 1,401 "," $254,426.44 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316304694,"DERFLER, NICHOLAS, PATRICK",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1316304694,"DERFLER, NICHOLAS, PATRICK",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1316304694,"DERFLER, NICHOLAS, PATRICK",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 28 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316307572,"MAY, REBECCA, SALMAN",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316307572,"MAY, REBECCA, SALMAN",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 48 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316307572,"MAY, REBECCA, SALMAN",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316309388,"HARRISON, WADE, NICHOLSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 101 , 113 ," $10,558.58 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316309529,"VU, CINDY, HUYEN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316309529,"VU, CINDY, HUYEN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316309529,"VU, CINDY, HUYEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316309529,"VU, CINDY, HUYEN",2525 COURT DRIVE   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 56 , 63 , 63 ," $16,604.11 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316311178,"OBRATE, PHILIP, PATRICK",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 217 , 217 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316314628,"CARELS, WENDY, BALLARD",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316318660,"CUMMINS, JESSICA, RAE",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,325 HAWTHORNE LN STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316318660,"CUMMINS, JESSICA, RAE",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316318660,"CUMMINS, JESSICA, RAE",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 18 , 35 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316318660,"CUMMINS, JESSICA, RAE",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316319957,"BOON, HEIDI, ELISABETH",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316319957,"BOON, HEIDI, ELISABETH",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316319957,"BOON, HEIDI, ELISABETH",414 E MAIN ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316320344,"KELLER, SHANNON, STINSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316320344,"KELLER, SHANNON, STINSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316321284,"TRUMBLE, JENNIFER, MICHELLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 56 , 60 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316322076,"KAKOS, LYNN, SUZANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316322076,"KAKOS, LYNN, SUZANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316323124,"GOODMAN, ELIZABETH, ARPE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316323124,"GOODMAN, ELIZABETH, ARPE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316323124,"GOODMAN, ELIZABETH, ARPE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316324288,"TUSHAK, ZACKARY, J",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316324288,"TUSHAK, ZACKARY, J",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1316325376,"FLUEGEL, JASON, LAWRENCE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 86 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316326127,"KERBEL, MOLLY, LYNN",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 58 , 60 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316326895,"CAVALLINI MARTIN, MAXIMILIANO, MARIA",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,209 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316326895,"CAVALLINI MARTIN, MAXIMILIANO, MARIA",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316327000,"VEDAK, PRIYANKA, CHANDRAGUPTA",9735 KINCEY AVE STE 102 HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316327000,"VEDAK, PRIYANKA, CHANDRAGUPTA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 14 , 22 ,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1316327323,"BOULOS, MATTHEW, STEPHEN",11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1316327323,"BOULOS, MATTHEW, STEPHEN",1030 SIENA DR   WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316327752,"Gulley, Taylor, MICHELLE",1895 HOFFMAN RD STE C GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316328115,"MILLER, JACLYN, CHRISTINE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316328115,"MILLER, JACLYN, CHRISTINE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316328818,"JAFARI-LLOYD, SHIRIN",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316331622,"SASANNEJAD, CINA",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 32 , 105 , 119 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316331622,"SASANNEJAD, CINA",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 47 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316331622,"SASANNEJAD, CINA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1316332786,"HERRINGDINE, KELLY, RHEA",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1316332786,"HERRINGDINE, KELLY, RHEA",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 11 , 11 ,$#,,
MEDICAID DIRECT,1932137080,NORTHCROSS FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE NORTHCROSS FAMILY MEDIC,9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316333743,"SEWALISH, MARGARET, DUNLAP",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 46 , 68 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316333743,"SEWALISH, MARGARET, DUNLAP",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194302901,APPALACHIAN REGIONAL BEHAVIORAL HEA,ARBH PROVIDERS,432 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1316334709,"ELDER, KATHERINE, KRAGIEL",432 HOSPITAL DR   LINVILLE NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477785756,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - GRE,802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316334766,"GOLDEN, PAMELA, PEGGY",802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 45 , 96 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316337397,"WELLS, LAURA, ROSE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316337397,"WELLS, LAURA, ROSE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 104 , 137 , 143 ,$#,,
MEDICAID DIRECT,1376351833,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROLOGY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316337397,"WELLS, LAURA, ROSE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 34 , 34 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1316341738,"BROWN, JACQUELINE, SETFORD",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316342009,"MITCHELL, JASON, JAMES",5809 DEPARTURE DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 113 , 225 , 630 ," $30,920.74 ",,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316342009,"MITCHELL, JASON, JAMES",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 39 , 47 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316342009,"MITCHELL, JASON, JAMES",350 E HOLDING AVE   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1306592001,LIVING THROUGH MY DREAMS LLC,,7801 CALIBRE CROSSING DR APT 203 CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1316344245,"ROME-MARTIN, DONNIELLE, LAUREN",7801 CALIBRE CROSSING DR APT 203 CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1316345804,"WINSJANSEN, SHANNON, TAYLOR",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316346091,"GOLDEN, TAYLOR, ANNE",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 31 , 41 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316346158,"CALVERT, AMY, FOWLER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316346158,"CALVERT, AMY, FOWLER",125 QUEENS RD STE 540 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 31 , 51 ,$#,,
MEDICAID DIRECT,1316346976,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ENT,1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316346976,CUMBERLAND COUNTY HOSPITAL SYSTEM I,1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 37 , 37 , 74 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316350879,"BHATNAGAR, AMIT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 97 , 97 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316353907,"MANKALA, SYAMALA",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1316353907,"MANKALA, SYAMALA",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316353907,"MANKALA, SYAMALA",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316353907,"MANKALA, SYAMALA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316353907,"MANKALA, SYAMALA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316353907,"MANKALA, SYAMALA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316353907,"MANKALA, SYAMALA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316355407,"KANAMATHAREDDY, NARENDRA KUMAR REDDY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316355407,"KANAMATHAREDDY, NARENDRA KUMAR REDDY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316355407,"KANAMATHAREDDY, NARENDRA KUMAR REDDY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 101 , 357 , 357 ," $17,571.47 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316355407,"KANAMATHAREDDY, NARENDRA KUMAR REDDY",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1316355407,"KANAMATHAREDDY, NARENDRA KUMAR REDDY",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1013957414,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 36 , 38 , 41 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE L KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1013957414,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 106 , 218 , 386 ," $10,430.73 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 53 , 86 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1316357544,"SIMPSON, BRIAN, FRANCIS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316357551,"SMITH, COLIN, PAUL",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316357551,"SMITH, COLIN, PAUL",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316357940,"FORD, SAMUEL, EDMOND",209 PARK ST   BELMONT NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 17 , 30 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316357940,"FORD, SAMUEL, EDMOND",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 27 , 48 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1216 MOUNT JEFFERSON RD   WEST JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1316359003,"MORLEY, BETH",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1316359003,"MORLEY, BETH",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316359847,"PIAZZA, NICHOLAS, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 96 , 96 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316361843,"HUGHES, NASHAWN, AHMED",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,1860 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1316362817,"LOWERY, KRISTEN, ELIZABETH",1860 SUGAR HILL RD STE A MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 26 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1316362817,"LOWERY, KRISTEN, ELIZABETH",186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316362817,"LOWERY, KRISTEN, ELIZABETH",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1316362817,"LOWERY, KRISTEN, ELIZABETH",45 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1316363252,"GARCIA LEACH, GWENDOLYN, DENISE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 46 , 79 , 196 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1316363252,"GARCIA LEACH, GWENDOLYN, DENISE",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1316363252,"GARCIA LEACH, GWENDOLYN, DENISE",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 21 ,$#,,
MEDICAID DIRECT,1568887818,J ARTHUR DOSHER MEMORIAL HOSPITAL,~,4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1316364334,"BAXLEY, STEPHEN, TERRY",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568887818,J ARTHUR DOSHER MEMORIAL HOSPITAL,~,4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1316364334,"BAXLEY, STEPHEN, TERRY",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1316364334,"BAXLEY, STEPHEN, TERRY",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1316364334,"BAXLEY, STEPHEN, TERRY",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,6310 BEACH DR SW   OCEAN ISLE BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1316364334,"BAXLEY, STEPHEN, TERRY",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1316364334,"BAXLEY, STEPHEN, TERRY",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1316364334,"BAXLEY, STEPHEN, TERRY",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 25 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1316364334,"BAXLEY, STEPHEN, TERRY",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",1085 NE GATEWAY CT NE STE 280 CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",1085 NE GATEWAY CT NE STE 280 CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 55 , 77 , 95 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",101 E WT HARRIS BLVD STE 3215 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",8210 UNIVERSITY EXECUTIVE PARK DRIVE SUI   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",8210 UNIVERSITY EXECUTIVE PARK DRIVE SUI   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 16 , 17 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316365067,"ROTHWELL, VICTORIA, MALDONADO",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1316366016,"LEVESQUE, BRENDA, GRACE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316366727,"MEYER, JOHN, WILCOX",3735 GLENLAKE DR   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 59 , 64 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316366818,"COMMANDER, CLAYTON, WARREN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316366818,"COMMANDER, CLAYTON, WARREN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1316368178,"ROBINSON, ASHLEY, LAWSON",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316368178,"ROBINSON, ASHLEY, LAWSON",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316368640,"OLDRE, MARIA, GRACE",310 LONG SHOALS RD STE 310 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316368640,"OLDRE, MARIA, GRACE",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710166327,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,520 N DEKALB ST STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1316370471,"ALLEN, LAURA, HASTINGS",520 N DEKALB ST STE B SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 25 , 39 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316373475,"LEWIS, DARIA, DELORES",19 NOBLE ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 304 , 318 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316373475,"LEWIS, DARIA, DELORES",4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316374747,"WADE, JAMILA, AISHA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 45 , 67 , 90 ," $12,813.46 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316374747,"WADE, JAMILA, AISHA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316374747,"WADE, JAMILA, AISHA",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1316375694,"MELTON, DUSTIN, HARVEY",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316375694,"MELTON, DUSTIN, HARVEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1316375694,"MELTON, DUSTIN, HARVEY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 13 , 13 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1316375694,"MELTON, DUSTIN, HARVEY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316380207,"CIACCIA, DAVID, ANTHONY",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316380215,"CARAMORE, MARK, ANDREW",721 FAIRFAX AVE FL 3 NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316382187,"MITCHUAL, SERENA",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 942 , 981 ," 5,110 "," $194,291.63 ",,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316383243,"SCHENKEL, NASTASSIA, JENNAE",3044 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 32 , 76 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316385545,"MILLER, CASEY, GLENN",8108B MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 30 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1316385545,"MILLER, CASEY, GLENN",8108B MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316385545,"MILLER, CASEY, GLENN",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 27 , 42 ,$#,,
MEDICAID DIRECT,1538476973,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL DENTAL OF OCEAN ISLE,1525 OCEAN ISLE BEACH RD UNIT 2 OCEAN ISLE BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1316385610,"YODER, TERRON, EUGENE",1525 OCEAN ISLE BEACH RD UNIT 2 OCEAN ISLE BEACH NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538476973,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL DENTAL OF OCEAN ISLE,1525 OCEAN ISLE BEACH RD UNIT 2 OCEAN ISLE BEACH NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316385610,"YODER, TERRON, EUGENE",1525 OCEAN ISLE BEACH RD UNIT 2 OCEAN ISLE BEACH NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 558 ," 1,069 "," 3,296 "," $153,238.79 ",,
MEDICAID DIRECT,1932661246,RALEIGH DURHAM MEDICAL GROUP PA,HEALTHPARK PEDIATRICS,8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316385982,"EDRALIN, LORVEN, MICHAEL",8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 21 , 37 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1316390099,"WILLIAMS, DAVID, LEE",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 48 , 73 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316390099,"WILLIAMS, DAVID, LEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 46 , 66 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316390578,"VELEZ, JASMINE, MARISOL",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316390578,"VELEZ, JASMINE, MARISOL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316390578,"VELEZ, JASMINE, MARISOL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316391345,"WOLTERS, WILLIAM, CLAY",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316391345,"WOLTERS, WILLIAM, CLAY",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1316391378,"LEE, NICOLE, DENISE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 86 , 91 , 100 ,$#,,
MEDICAID DIRECT,1215990700,ADVANCED DERMATOLOGY AND SKIN SURGE,ADVANCED DERMATOLOGY AND SKIN SURGERY PA,16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1316391410,"DAVIS, JESSKIA, PINTO",16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1316391436,"LYLES, BENJAMIN, JAY",181 DANIEL RD   FOREST CITY NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 123 , 207 ,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1316391436,"LYLES, BENJAMIN, JAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 24 , 37 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316392434,"GOMEZ PAZ, SANDRA, ROSARIO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 65 , 87 , 89 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316392665,"BODZIOCK, GEORGE, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 28 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316392665,"BODZIOCK, GEORGE, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 17 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316392665,"BODZIOCK, GEORGE, MICHAEL",306 WESTWOOD AVE   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316396419,"WADE, SPENCER, DAVID",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,,,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316396419,"WADE, SPENCER, DAVID",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 231 , 233 ," 1,695 "," $115,931.55 ",,
MEDICAID DIRECT,1316396419,"WADE, SPENCER, DAVID",,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,1316396419,"WADE, SPENCER, DAVID",3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 23 , 23 , 146 ," $10,805.65 ",,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316396419,"WADE, SPENCER, DAVID",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316396419,"WADE, SPENCER, DAVID",2620 NEW BERN AVE   RALEIGH NC,092,Wake,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 113 , 113 , 355 ," $41,368.05 ",,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316396419,"WADE, SPENCER, DAVID",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 317 , 317 , 945 ," $116,520.80 ",,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316396419,"WADE, SPENCER, DAVID",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 49 , 49 , 362 ," $24,736.31 ",,
MEDICAID DIRECT,1316397987,CHEROKEE INDIAN HOSPITAL AUTHORITY,CIHA RESPIRATORY DEPT,1 HOSPITAL RD RM 2411 CHEROKEE NC,087,Swain,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1316397987,CHEROKEE INDIAN HOSPITAL AUTHORITY,1 HOSPITAL RD RM 2411 CHEROKEE NC,087,Swain,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 220 , 448 , 865 ," $61,823.35 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1316399082,"SHEPHERD, BRYSON, JAMES",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316399082,"SHEPHERD, BRYSON, JAMES",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 133 , 152 , 174 ," $14,273.09 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316399082,"SHEPHERD, BRYSON, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316399082,"SHEPHERD, BRYSON, JAMES",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1316399462,"KNIGHT, DARIUS",214 COCHRAN AVE   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 87 , 443 , 525 ,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1316399462,"KNIGHT, DARIUS",214 COCHRAN AVE   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316399462,"KNIGHT, DARIUS",214 COCHRAN AVE   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 333 , 375 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316400328,"GRIFFIN, SARAH, EVERITT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316400328,"GRIFFIN, SARAH, EVERITT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1316401862,SHINE THERAPY LLC,,1140 TURNBRIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316401862,SHINE THERAPY LLC,1140 TURNBRIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 115 ," 1,817 "," 1,838 "," $156,589.93 ",,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316405723,"DUNSTON, KAITLIN, OLIVIA",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1316405723,"DUNSTON, KAITLIN, OLIVIA",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316405723,"DUNSTON, KAITLIN, OLIVIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 26 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316405905,"MCCULLOCH, ANDREA, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1417019514,COUNTY OF YADKIN OFFICE OF TREASURE,YADKIN COUNTY HEALTH DEPT,320 W MAPLE ST   YADKINVILLE NC,099,Yadkin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316405954,"DOLLYHIGH-EASTER, JENNIFER, ALICE",320 W MAPLE STREET   YADKINVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 40 , 107 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316407570,"REEP, MICHAEL, JEFFREY",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 83 , 165 , 368 ," $18,835.58 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316407810,"ROZMUS, JOSEPH, WILLIAM",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 28 , 33 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1316407810,"ROZMUS, JOSEPH, WILLIAM",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 300 , 418 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316407810,"ROZMUS, JOSEPH, WILLIAM",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,451 RUIN CREEK RD STE 103 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1316407810,"ROZMUS, JOSEPH, WILLIAM",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316407810,"ROZMUS, JOSEPH, WILLIAM",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 46 , 66 ,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316409030,"RAJU, SNEHA, PENMETSHA",5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316409030,"RAJU, SNEHA, PENMETSHA",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 41 , 119 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316409303,"POLO, VICTORIA, ALEC",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316409303,"POLO, VICTORIA, ALEC",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316409303,"POLO, VICTORIA, ALEC",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 168 , 171 , 182 ," $44,186.50 ",,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316416555,"MCDANIEL, CHAKUN, TIFFANY",111 E 3RD AVE   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 102 , 102 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316416555,"MCDANIEL, CHAKUN, TIFFANY",111 E 3RD AVE   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 18 , 18 ,$#,,
MEDICAID DIRECT,1871854828,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316419542,"KRIEGER, YELIZAVETA, KRAVETS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 14 , 22 , 24 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1316420722,"WARWICK, KAREN, LYNN",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316420722,"WARWICK, KAREN, LYNN",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316420722,"WARWICK, KAREN, LYNN",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 35 , 170 ,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316420722,"WARWICK, KAREN, LYNN",3382 HENDERSON DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316422710,KARE 2 COMMUNICATE LLC,KARE 2 COMMUNICATE,5408 BEAUMONT DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316422710,KARE 2 COMMUNICATE LLC,5408 BEAUMONT DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 47 , 678 , 904 ," $49,493.33 ",,
MEDICAID DIRECT,1316422710,KARE 2 COMMUNICATE LLC,KARE 2 COMMUNICATE,5408 BEAUMONT DR   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,1316422710,KARE 2 COMMUNICATE LLC,5408 BEAUMONT DR   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,, 24 , 635 , 646 ," $40,986.00 ",,
MEDICAID DIRECT,1316422710,KARE 2 COMMUNICATE LLC,KARE 2 COMMUNICATE,5408 BEAUMONT DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316422710,KARE 2 COMMUNICATE LLC,5408 BEAUMONT DR   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,#,,,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1316423387,"LUSK, SANDY, AUBREY",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 28 , 48 ," $10,269.52 ",,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1316423387,"LUSK, SANDY, AUBREY",472 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316423957,"OLANG, KRISTINA, NICOLE",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316423957,"OLANG, KRISTINA, NICOLE",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316423957,"OLANG, KRISTINA, NICOLE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316425648,"ADAMS, VALERIE, JEAN",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316428618,"HOYLE, KELLY, ANN",3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316428618,"HOYLE, KELLY, ANN",1895 HOFFMAN RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316428618,"HOYLE, KELLY, ANN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316428618,"HOYLE, KELLY, ANN",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316428618,"HOYLE, KELLY, ANN",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1316429798,"STEELE, THOMAS, SCOTT",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 39 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316429798,"STEELE, THOMAS, SCOTT",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1730367467,HOSPICE & PALLIATIVE CARECENTER,TRELLIS SUPPORTIVE CARE,101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316430382,"BISS, KIMBERLY, MARIE",101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316432099,"BREEDLOVE, MICHELLE, LAURITA",401 N MORGAN ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 68 , 68 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316432099,"BREEDLOVE, MICHELLE, LAURITA",401 N MORGAN ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 95 , 712 , 718 ," $42,259.36 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316434970,"MCCONKEY, KEVIN, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 27 , 33 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316434970,"MCCONKEY, KEVIN, THOMAS",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316434970,"MCCONKEY, KEVIN, THOMAS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 30 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316434970,"MCCONKEY, KEVIN, THOMAS",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 19 , 25 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316435639,"DESAI, JINAL, BHARATKUMAR",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 44 , 124 , 130 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316438328,"YANG, KE",6840 GLENWOOD AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548620297,RHA BEHAVIORAL HEALTH NC LLC,,2732 ANN ELIZABETH DR   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316439375,"KEATING, ROSH, ANN",2732 ANN ELIZABETH DR   BURLINGTON NC,001,Alamance,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316440381,"WEAVER, KELLY, BROOK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316440381,"WEAVER, KELLY, BROOK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 49 , 71 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 60 , 77 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316441504,"WILLIS, JARED, KEITH",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316443641,"HIGGINS, MADELEINE, STREIT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316444243,"FORD, KRISTY, KESTER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316444243,"FORD, KRISTY, KESTER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 87 , 86 , 92 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316444367,"LUKEFAHR, LAUREN, MARTA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 37 , 37 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316444979,"WARTA, KAITLIN, ALIX",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316444979,"WARTA, KAITLIN, ALIX",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 29 , 41 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316444979,"WARTA, KAITLIN, ALIX",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 60 , 60 , 72 ," $28,029.69 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316445760,"MCLELLAN, THOMAS, MICHAEL",101 E WT HARRIS BLVD STE 5101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 88 , 142 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316445760,"MCLELLAN, THOMAS, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 42 , 66 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316445760,"MCLELLAN, THOMAS, MICHAEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316445760,"MCLELLAN, THOMAS, MICHAEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 53 , 55 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316446693,"CLAYTOR, JALEESA, RUTH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316446693,"CLAYTOR, JALEESA, RUTH",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 61 , 126 ,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316451032,"HARDEE, CHELSEA, GORE",3980 HIGHWAY 9 E STE 220 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316455280,"SUBRAMANIAM, DARCY, JO",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316460322,"HILTON, LAVENTRICE, MARSHALL",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#, 21 ,$#,,
MEDICAID DIRECT,1619452612,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1316464050,"GRAVES, MORGAN, NOEL",1007 W VERNON AVE   KINSTON NC,054,Lenoir,152W00000X,Eye and Vision Services Providers,Optometrist,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316464613,"CAMPO, BERNARD, CARL CALLIS",131 E MARKET ST   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316464613,"CAMPO, BERNARD, CARL CALLIS",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316464613,"CAMPO, BERNARD, CARL CALLIS",131 E MARKET ST   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750133781,WAKEMED SPECIALISTS GROUP LLC,WAKEMED SLEEP MEDICINE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316464613,"CAMPO, BERNARD, CARL CALLIS",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316464613,"CAMPO, BERNARD, CARL CALLIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750133781,WAKEMED SPECIALISTS GROUP LLC,WAKEMED SLEEP MEDICINE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316464613,"CAMPO, BERNARD, CARL CALLIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316464613,"CAMPO, BERNARD, CARL CALLIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316467350,"MALGIREDDY, KALYAN, REDDY",2100 STANTONSBURG RD 3RD FL NORTH TOWER GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 80 , 106 , 122 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316469497,"PEDERSEN, DANIEL, ALEXANDER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316471915,"HUNTER, LA MONICA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 16 , 63 , 93 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1316473424,"COPE, ROBERT, PAUL",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 40 , 71 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316473424,"COPE, ROBERT, PAUL",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 108 , 194 , 319 ," $10,699.08 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316474067,"LIU, CHI AN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316474067,"LIU, CHI AN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316474158,"WINSOR, KIARA, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316474414,"STEPHENSON, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 54 , 147 , 150 ," $14,609.90 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316475197,"MUGO, BRIAN, MWANGI",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 17 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316475197,"MUGO, BRIAN, MWANGI",3475 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316476906,"VANICEK, BAESHA, SUZANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316476989,"MATTA, REBEKAH, FERGUSON",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316476989,"MATTA, REBEKAH, FERGUSON",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316479090,"KATZMARK, RACHEL, SHELLEY",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316479090,"KATZMARK, RACHEL, SHELLEY",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1316479678,"HETHERINGTON, ANDREA, NICOLE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 430 , 435 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,306 DEER PARK RD   NEBO NC,059,McDowell,193200000X,Group,Multi-Specialty,,1316479678,"HETHERINGTON, ANDREA, NICOLE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 86 , 662 , 662 ," $11,779.26 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,109 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1316479678,"HETHERINGTON, ANDREA, NICOLE",109 FOOTHILLS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 375 , 384 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,100 SUNSET ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316479678,"HETHERINGTON, ANDREA, NICOLE",95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 23 , 24 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316483738,"KOZEL, JULIE, SHAUN",656 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 25 , 44 ,$#,,
MEDICAID DIRECT,1720344047,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF CHAPEL HILL,101 COSGROVE AVE STE 110 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1316484702,"CONOLOGUE, ERIC, EDWARD",101 COSGROVE AVE STE 110 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316486590,A PRIMARY CHOICE INC,,1922 S MARTIN LUTHER KING JR DR STE 27 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1316486590,A PRIMARY CHOICE INC,1922 S MARTIN LUTHER KING JR DR STE 13 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1316486590,A PRIMARY CHOICE INC,,1922 S MARTIN LUTHER KING JR DR STE 27 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1316486590,A PRIMARY CHOICE INC,1922 S MARTIN LUTHER KING JR DR STE 27 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 2,952 "," 2,952 "," $178,013.28 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316486830,"HAMILTON, KAITLIN, CELESTA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 36 , 114 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316489909,"MINDER, PATRICE, MARY",3903 N ELM ST   GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1316491582,"ROSE, MEGAN",2359 HIGHWAY 105   BOONE NC,095,Watauga,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 13 , 55 , 55 ,$#,,
MEDICAID DIRECT,1316495369,GUIDING STAR HEALTH CARE TWO INC,,1564 SPRINGBROOK DR   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316495369,GUIDING STAR HEALTH CARE TWO INC,1564 SPRINGBROOK DR   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 301 , 301 ," $11,690.84 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316496441,"STONE, LUCIE, DUNNINGTON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316496441,"STONE, LUCIE, DUNNINGTON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316496862,"LAGESSE, KATHLEEN, WILKIN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316496862,"LAGESSE, KATHLEEN, WILKIN",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316496862,"LAGESSE, KATHLEEN, WILKIN",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316501232,RIGHT AT HOME HOME HEALTHCARE,,200 S MASSEY ST   SELMA NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1316501232,RIGHT AT HOME HOME HEALTHCARE,200 S MASSEY ST   SELMA NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,#, 800 , 800 ," $58,306.68 ",,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316501919,"WEBSTER, LEAH, MEGHAN GRADY",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316501919,"WEBSTER, LEAH, MEGHAN GRADY",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 21 , 54 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316502677,"KNIGHT, ERICA, ANDRIA KYRA",410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 169 , 249 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316502677,"KNIGHT, ERICA, ANDRIA KYRA",410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 43 , 53 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316504764,"LIPHAM, AUSTEN, KENDEHL NELSON",109 BRIDGE ST APT 201 DANVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538626361,HAMMOCK DMD & LOTAKIS DDS III PLLC,DENTISTRY OF THE CAROLINAS - GASTONIA,2641 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316505837,"DENMEAD, ELLEN",2641 COURT DR   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 24 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316507163,"SCHULZ, ZACHARY, ROBERT",1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316507163,"SCHULZ, ZACHARY, ROBERT",1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316510381,"MORRIS, KATELYN, PARK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316511892,"KANSER, ROBERT, JOHN",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316511892,"KANSER, ROBERT, JOHN",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1316513328,HIS MISSION HOME CARE LLC,,310 N ROTARY DR   HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1316513328,HIS MISSION HOME CARE LLC,310 N ROTARY DR   HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,090 "," 2,090 "," $138,969.32 ",,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316513435,"GREEN, TIARA, TIKELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 90 , 118 , 188 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316513435,"GREEN, TIARA, TIKELL",101 HEART DR   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316514151,"CLOPP, REBECCA, ELIZABETH",4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316514920,"BLACK, MELISSA, WHITESELL",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316514920,"BLACK, MELISSA, WHITESELL",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316514920,"BLACK, MELISSA, WHITESELL",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1235198177,COUNTY OF DUPLIN,DUPLIN COUNTY HEALTH DEPARTMENT,340 SEMINARY ST   KENANSVILLE NC,031,Duplin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316514920,"BLACK, MELISSA, WHITESELL",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 24 , 28 , 45 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316514920,"BLACK, MELISSA, WHITESELL",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1285808469,JOHN L CLONINGER III DDS PLLC,~,904 DONTIA DR   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316516891,"HEAVNER, ERIN, REBECCA",904 DONTIA DR   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 102 , 189 , 464 ," $19,426.17 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316518889,"COOPER, ASHLEY, KEENE",211 VIRGINIA RD   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316518913,"BROWN, MEGAN, RUTH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316518913,"BROWN, MEGAN, RUTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316518913,"BROWN, MEGAN, RUTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316518913,"BROWN, MEGAN, RUTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316518913,"BROWN, MEGAN, RUTH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316519325,"HATLEVIG, CAMERON, RENEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316521032,"KELLY, KATHERINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316521032,"KELLY, KATHERINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316521032,"KELLY, KATHERINE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316521040,"N'GORAN, ANN, ELIZABETH",3521 HAWORTH DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316521040,"N'GORAN, ANN, ELIZABETH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316524242,"MAGHEN, PHILIP",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316524242,"MAGHEN, PHILIP",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 46 , 127 , 127 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316525181,"SLIEF, MATTHEW, LEE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316525199,"KOPPA, BRYAN, MATTHEW",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 49 , 131 , 132 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1316525348,"HATTER, KATE, ADRIENNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 61 , 89 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1316525348,"HATTER, KATE, ADRIENNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 26 , 37 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316526197,"DRAPER, JULIA, KATE",28 WEST RIDGE PLACE   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316526197,"DRAPER, JULIA, KATE",28 WEST RIDGE PLACE   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316526197,"DRAPER, JULIA, KATE",28 WEST RIDGE PLACE   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 16 , 28 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316526197,"DRAPER, JULIA, KATE",19 N ANN ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316526403,"CANTWELL, WILLIAM, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316526403,"CANTWELL, WILLIAM, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316526403,"CANTWELL, WILLIAM, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316526403,"CANTWELL, WILLIAM, JOSEPH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316526403,"CANTWELL, WILLIAM, JOSEPH",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316526403,"CANTWELL, WILLIAM, JOSEPH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316527104,"CAMPBELL, SAMANTHA, ALICE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 40 , 46 , 114 ,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316528235,"JUDD, JUSTIN, ROGER",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 37 , 69 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316528813,"LANCER, TANYA, MARIE",5211 COLLEGE RD S   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 60 , 108 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316528813,"LANCER, TANYA, MARIE",5211 COLLEGE RD S   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316537905,AJINNDA 13 GROUP LIVING FACILITY,AJINNDA 13 GROUP LIVING FACILITY,408 W MOREHEAD ST   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316537905,AJINNDA 13 GROUP LIVING FACILITY,408 W MOREHEAD ST   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 318 , 325 ," $18,951.80 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316539729,"VERNON, ELIJAH",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 96 , 111 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316539729,"VERNON, ELIJAH",1771 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316541493,"WEATHERSTONE, KENSIE, FRANCES",855 SAM NEWELL RD STE 204 MATTHEWS NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1316543218,TRUE HOME HEALTHCARE LLC,,725 W MAIN ST STE F JAMESTOWN NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1316543218,TRUE HOME HEALTHCARE LLC,725 W MAIN ST STE F JAMESTOWN NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#," 1,327 "," 1,388 "," $168,943.28 ",,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316543697,"THOMPSON, ANNA, PIEPER",1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316544505,"DONEY, ZOEY, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316544927,"DAVIS, CHRISTINE, MARIE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316544927,"DAVIS, CHRISTINE, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 97 , 97 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316548159,"LEIGHTON, THOMAS, MARTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316548159,"LEIGHTON, THOMAS, MARTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316549074,BRIGHTER FUTURE HOME HEALTHCARE,,7670 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1316549074,BRIGHTER FUTURE HOME HEALTHCARE,7670 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,713 "," 1,715 "," $166,522.40 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316551898,"MORGAN, KASEY, GRAGG",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316551898,"MORGAN, KASEY, GRAGG",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316552664,"ABSHER, RAYE LYNN",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 46 ,$#,,
MEDICAID DIRECT,1245734995,CALDWELL MEMORIAL HOSPITAL,CALDWELL ONCOLOGY ASSOCIATES,212 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1316552664,"ABSHER, RAYE LYNN",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 87 , 87 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316552664,"ABSHER, RAYE LYNN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 56 , 179 ,$#,,
MEDICAID DIRECT,1487116968,THE MOSES H CONE MEMORIAL HOSPITAL,PRIMARY CARE AT ELMSLEY SQUARE,3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316554231,"STEPHENS, AMY, JEANETTE BROWN",3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 79 , 110 ,$#,,
MEDICAID DIRECT,1487116968,THE MOSES H CONE MEMORIAL HOSPITAL,PRIMARY CARE AT ELMSLEY SQUARE,3711 ELMSLEY ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316554231,"STEPHENS, AMY, JEANETTE BROWN",2525 PHILLIPS AVE STE C GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1316554397,CAROLINA PHYSICAL THERAPY ASSOCIATE,CAROLINA PHYSICAL THERAPY ASSOCIATES-HARRISBURG,6604 ROBERTA RD   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316554397,CAROLINA PHYSICAL THERAPY ASSOCIATE,6604 ROBERTA RD   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316555675,"RIGOS, RACHELLE, MAUREEN",11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,773 RUSS AVE   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1316555675,"RIGOS, RACHELLE, MAUREEN",11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316555675,"RIGOS, RACHELLE, MAUREEN",11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316556319,"JANUSEK, CARLY, ELISE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 100 , 101 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316557192,"DAMIANI, JESSICA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316557333,PATS HOME HEALTH CARE LLC,PATS HOME HEALTH CARE LLC,5270 GERMANTON RD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1316557333,PATS HOME HEALTH CARE LLC,5270 GERMANTON RD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 128 , 128 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316558299,"ASTOLFI, ISABEL, CECILIA",2301 ERWIN RD   DURHAM NC,032,Durham,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316558588,"ZAMBOUROS, LEAH, ROSE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 38 , 44 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316558588,"ZAMBOUROS, LEAH, ROSE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316559800,"TRACZYK, CAROLINE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316559800,"TRACZYK, CAROLINE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770191421,AMY ANN KINLAW DMD PLLC,TAYLORSVILLE PEDIATRIC DENTISTRY,167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1316561103,"BROWN ABSHER, PEYTON, ELISE",167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,1223G0001X,Dental Providers,Dentist,General Practice, 167 , 174 , 761 ," $23,081.14 ",,
MEDICAID DIRECT,1629730130,STATESVILLE AMY KINLAW PLLC,IREDELL PEDIATRIC DENTISTRY,1316 DAVIE AVE STE C STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1316561103,"BROWN ABSHER, PEYTON, ELISE",167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 106 ,$#,,
MEDICAID DIRECT,1629730130,STATESVILLE AMY KINLAW PLLC,IREDELL PEDIATRIC DENTISTRY,1316 DAVIE AVE STE C STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1316561103,"BROWN ABSHER, PEYTON, ELISE",1316 DAVIE AVE STE C STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 151 , 164 , 708 ," $22,497.14 ",,
MEDICAID DIRECT,1518557354,KINLAW PLLC,MOUNT AIRY PEDIATRIC DENTISTRY,202 RAWLEY AVE STE 100 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1316561103,"BROWN ABSHER, PEYTON, ELISE",202 RAWLEY AVE STE 100 MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice," 1,587 "," 1,993 "," 7,844 "," $273,770.89 ",,
MEDICAID DIRECT,1801533120,WILKESBORO AMY KINLAW PLLC,KINLAW & ABSHER DENTISTRY FOR KIDS,200 W PARK CIR STE C N WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1316561103,"BROWN ABSHER, PEYTON, ELISE",200 W PARK CIR STE C NORTH WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice," 1,577 "," 3,156 "," 13,139 "," $581,078.26 ",,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316561178,"STOCKTON, MINTORIA, LYNETTE",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316561178,"STOCKTON, MINTORIA, LYNETTE",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1316561178,"STOCKTON, MINTORIA, LYNETTE",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316561178,"STOCKTON, MINTORIA, LYNETTE",6800 GLENWOOD AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1316561178,"STOCKTON, MINTORIA, LYNETTE",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 18 , 40 ,$#,,
MEDICAID DIRECT,1376123182,LOCAL START DENTAL INC,,370 JACKSON ST   DURHAM NC,032,Durham,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1316561640,"MCILWAIN, ANNA, KIHM",370 JACKSON ST   DURHAM NC,032,Durham,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1316562457,"STEPHENSON, EVANS, MICHAEL",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 23 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1316562457,"STEPHENSON, EVANS, MICHAEL",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316562457,"STEPHENSON, EVANS, MICHAEL",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316562457,"STEPHENSON, EVANS, MICHAEL",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1316562457,"STEPHENSON, EVANS, MICHAEL",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316562457,"STEPHENSON, EVANS, MICHAEL",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316562457,"STEPHENSON, EVANS, MICHAEL",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316564701,"NOBLITT, JESSICA, DAWN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 11 ,#, 19 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316566136,"GINSBERG, JOSHUA, SCOTT",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316567191,"MCNEILLY, COREY, DAVID",211 VIRGINIA RD   EDENTON NC,021,Chowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 32 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316567894,"BERNSTEIN, SARAH, NICOLE",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 53 , 131 ,$#,,
MEDICAID DIRECT,1619904430,SOUTH CHARLOTTE PRIMARY CARE,ATRIUM HEALTH PRIMARY CARE SOUTH CHARLOTTE INTERNA,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316567936,"SPRADLING, SEVERO, STEFAN",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 23 , 37 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316567936,"SPRADLING, SEVERO, STEFAN",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 22 , 29 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316567936,"SPRADLING, SEVERO, STEFAN",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316568025,"BLAKE, LAUREN, ASHLEY-MORGAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316568025,"BLAKE, LAUREN, ASHLEY-MORGAN",180 PARKWOOD DR   ELKIN NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1316568041,TARBORO OPCO LLC,THE BRIDGES OF HENDRICKS CREEK,3210 WESTERN BLVD   TARBORO NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316568041,TARBORO OPCO LLC,3210 WESTERN BLVD   TARBORO NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 29 ," 7,595 "," 7,595 "," $604,664.83 ",,
MEDICAID DIRECT,1316570252,FAITHFUL HANDS HOME CARE SERVICES I,,8025 N POINT BLVD STE 153 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1316570252,FAITHFUL HANDS HOME CARE SERVICES I,8025 N POINT BLVD STE 153 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 600 , 600 ," $58,282.84 ",,
MEDICAID DIRECT,1316570252,FAITHFUL HANDS HOME CARE SERVICES I,,543 COX RD STE C4 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1316570252,FAITHFUL HANDS HOME CARE SERVICES I,543 COX RD STE C4 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 39 ," 6,357 "," 6,517 "," $595,038.30 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316571557,"PIERSON, BETHANY, ERIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 14 , 30 , 51 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316572951,"GRIFFIN, SAMANTHA, MURRAY",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316572951,"GRIFFIN, SAMANTHA, MURRAY",620 SUMMIT CROSSING PL STE 202 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316572951,"GRIFFIN, SAMANTHA, MURRAY",855 SAM NEWELL RD STE 206 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316572951,"GRIFFIN, SAMANTHA, MURRAY",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316572951,"GRIFFIN, SAMANTHA, MURRAY",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316574494,"RILEY, MEG, MACKENZIE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,2101 OAKHEART RD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1316574494,"RILEY, MEG, MACKENZIE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821653205,MOSES CONE PHYSICIAN SERVICES INC,CHMG PLASTIC SURGERY SPECIALISTS,1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316574718,"GREEN, GARRETT, LEE",1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316576119,"MADER, LISA, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316576119,"MADER, LISA, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316576903,"BREAREY, PAMELA, RUTH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316576903,"BREAREY, PAMELA, RUTH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 36 , 57 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316576903,"BREAREY, PAMELA, RUTH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 48 , 77 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316576903,"BREAREY, PAMELA, RUTH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316580467,"LAM, LAURA, PLOTH",1207 EAST ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 79 , 190 , 190 ," $32,280.00 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1316581135,"HALL, MADISON, LEE",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 16 , 25 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316581135,"HALL, MADISON, LEE",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 23 , 29 , 29 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1316581135,"HALL, MADISON, LEE",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316581135,"HALL, MADISON, LEE",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316581135,"HALL, MADISON, LEE",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316581135,"HALL, MADISON, LEE",400 VISION DR   ASHEBORO NC,076,Randolph,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 32 , 328 , 331 ,$#,,
MEDICAID DIRECT,1316581200,IMPRESSIONS HOME CARE LLC,,10130 MALLARD CREEK RD STE 212 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1316581200,IMPRESSIONS HOME CARE LLC,10130 MALLARD CREEK RD STE 212 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 2,857 "," 2,889 "," $393,897.10 ",,
MEDICAID DIRECT,1316583982,EC OPCO NEWTON LP,TERRABELLA NEWTON,1088 RADIO STATION RD   NEWTON NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316583982,EC OPCO NEWTON LP,1088 RADIO STATION RD   NEWTON NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,199 "," 1,199 "," $89,881.06 ",,
MEDICAID DIRECT,1316584782,GA HC REIT II FAYETTEVILLE ALF TRS,THE ADDISON OF FAYETTEVILLE,1164 71ST SCHOOL RD   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316584782,GA HC REIT II FAYETTEVILLE ALF TRS,1164 71ST SCHOOL RD   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 ," 3,177 "," 3,217 "," $224,220.65 ",,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1316585417,"BEAM, ADAM, NORMAN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 33 , 41 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316585870,"COLVIN, LAWRENCE, ERWIN",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316585870,"COLVIN, LAWRENCE, ERWIN",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316588668,"AVEGNO, KOMLANVI, SEDO",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316593809,"MURPHY, TORRIE, KATHLEEN",1207 EAST ST   WAYNESVILLE NC,044,Haywood,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 44 , 44 ," $11,149.16 ",,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316593809,"MURPHY, TORRIE, KATHLEEN",44 BONNIE LN   SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316595671,"MCGOVERN, ANDREA, BROOKE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316595671,"MCGOVERN, ANDREA, BROOKE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316596240,"BENCHINA, AMY, ELIZABETH",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 17 , 25 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316596406,"BOOTH, KELSEY, COPELAND",105 MARK DR   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1316596406,"BOOTH, KELSEY, COPELAND",105 MARK DR   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 20 , 34 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1316596406,"BOOTH, KELSEY, COPELAND",1141 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1316597057,"HAYNES, LAUREN, MACLEOD",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 118 , 173 ,$#,,
MEDICAID DIRECT,1124460811,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY ORTHOPEDICS,199 HOSPITAL DR STE 2A GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316599038,"CROWDER, MEAGAN, UNDERWOOD",961 E STUART DR   GALAX VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316603889,"FREEMAN, SAMANTHA, LIN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316603889,"FREEMAN, SAMANTHA, LIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316607138,"SMITH, MARGERIE, CAVELL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 82 , 85 , 87 ,$#,,
MEDICAID DIRECT,1316607534,PEACE HAVEN ASSISTED LIVING LLC,,178 S PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316607534,PEACE HAVEN ASSISTED LIVING LLC,178 S PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 375 , 375 ," $41,457.35 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316608466,"SPAINHOUR, LINDSAY, BETH",216 MOORE RD   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 57 , 89 ,$#,,
MEDICAID DIRECT,1316613201,HEALTHY CARE HORIZONS LLC,,2530 MERIDIAN PKWY STE 300 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1316613201,HEALTHY CARE HORIZONS LLC,2530 MERIDIAN PKWY STE 300 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#," 1,583 "," 1,608 "," $184,110.16 ",,
MEDICAID DIRECT,1740225929,DUKE UNIVERSITY AFFILIATED PHYSICIA,,2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316623572,"JORDAN, BRETT, WINTERS",2609 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 17 , 35 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316626013,"WEERAPPERUMA DESILVA, DILINA, VIRAN",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1982339933,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE LOWES GRO,2216 E NC HIGHWAY 54   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316626690,"LAUGHON, RUTH, MARIE",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063096345,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE GLENWOOD,6800 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316626690,"LAUGHON, RUTH, MARIE",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316630981,"KEMLEIN, ZACHARY, HARRIS",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 5,667 "," 6,726 "," 34,424 "," $908,455.52 ",,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316630981,"KEMLEIN, ZACHARY, HARRIS",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316631237,"NICOL, SARAH, JANE BIEGLOW",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1316631237,"NICOL, SARAH, JANE BIEGLOW",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316631237,"NICOL, SARAH, JANE BIEGLOW",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 48 , 56 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316631237,"NICOL, SARAH, JANE BIEGLOW",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 31 , 36 , 48 ,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316639867,"WILKINSON, KRISTEN, JEAN",101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 35 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316639867,"WILKINSON, KRISTEN, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1902392418,CAROLINA PRIME PHYSICAL THERAPY,CAROLINA PRIME PHYSICAL THERAPY LLC,200 W PARK CIR STE A N WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1316644610,"HOLLAND, WILLIAM, FRANKLIN ALEXANDER",200 W PARK CIR STE A N WILKESBORO NC,097,Wilkes,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316644727,"ROUSSEAU, JULIETTE, HELENE",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316644727,"ROUSSEAU, JULIETTE, HELENE",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316644891,"MUELLER, ROBERT, BENJAMIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1316646110,CAROLINA PREMIER HOME CARE INC,,10931 E INDEPENDENCE BLVD STE L MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1316646110,CAROLINA PREMIER HOME CARE INC,10931 E INDEPENDENCE BLVD STE L MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,704 "," 1,802 "," $166,275.48 ",,
MEDICAID DIRECT,1023549094,GOSHEN MEDICAL CENTER INCORPORATED,~,106 JEFFERSON ST   HAMLET NC,077,Richmond,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316646557,"PATTERSON, JONATHAN, SAMUEL",106 JEFFERSON ST   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316646557,"PATTERSON, JONATHAN, SAMUEL",106 JEFFERSON ST   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316648249,CARE PROFESSIONALS OF NORTH CAROLIN,,9700 RESEARCH DR STE 135E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1316648249,CARE PROFESSIONALS OF NORTH CAROLIN,9700 RESEARCH DR STE 135E CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 673 , 673 ," $42,369.53 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316650005,"PALUTSIS, DANIELLE, ROSE",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 117 , 172 ,$#,,
MEDICAID DIRECT,1316650674,GOLD STAR PEDIATRIC SPEECH THERAPY,,283 ASHPOLE TRL   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1316650674,GOLD STAR PEDIATRIC SPEECH THERAPY,283 ASHPOLE TRL   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,, 28 , 659 , 659 ," $45,663.26 ",,
MEDICAID DIRECT,1720080070,CAPE FEAR NEUROSURGERY,CAPE FEAR NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1316653892,"DEISCH, LISA, ANN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316654072,"DIXON, ALEXANDRA, MICHELE",130 PLANTATION RIDGE DR STE 100 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316654072,"DIXON, ALEXANDRA, MICHELE",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316654072,"DIXON, ALEXANDRA, MICHELE",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316659220,"BUCK, ALLISON, LEE",300 BETHESDA DR   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 31 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316660152,"MCCARTHY, KYLE, JEFFREY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 81 , 81 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316661366,"KLINE, CHIANNE, CAI QI ST JULIAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1467449728,LEXINGTON FAMILY PHYSICIANS,LEXINGTON FAMILY PHYSICIANS PA,102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1316661366,"KLINE, CHIANNE, CAI QI ST JULIAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 41 , 77 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316661366,"KLINE, CHIANNE, CAI QI ST JULIAN",1236 GUILFORD COLLEGE RD STE 117 JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 43 , 90 ,$#,,
MEDICAID DIRECT,1265420335,HANGER PROSTHETICS & ORTHOTICS EAST,~,1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316661960,"STUART, MORGAN, RANDI",1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316663750,"GUSTAFSON, AMBER",3980 HIGHWAY 9 E STE 220 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316667595,"MENKE, JENNIFER, MICHELLE",200 W WENDOVER AVE   GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316668353,"CATANIA-THOMAS, GIANNA, MARIE",490 HOSPITAL DR   CLYDE NC,044,Haywood,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 41 , 41 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316674278,"BUCHWALD, PATRICK, ROBERT",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316674278,"BUCHWALD, PATRICK, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316674278,"BUCHWALD, PATRICK, ROBERT",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316674278,"BUCHWALD, PATRICK, ROBERT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316676802,"CHRISTY, BRANDI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1548510969,CUMBERLAND COUNTY HOSPITAL SYSTEM I,FERNCREEK GENERAL SURGERY,4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316676802,"CHRISTY, BRANDI",4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1316678584,SOLID GROUNDS HOME CARE,,7714 PONDEROSA PINE LN   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1316678584,SOLID GROUNDS HOME CARE,7714 PONDEROSA PINE LN   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 719 , 719 ," $77,748.20 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1316679343,"PRESSLEY, BETHANY",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316679343,"PRESSLEY, BETHANY",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 95 , 95 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1316679343,"PRESSLEY, BETHANY",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 28 , 28 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316679822,"BOROM, AKEEM, RASHAD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316683154,"PRINS, MARY, REBEKAH",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871232397,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CATAWBA SPRINGS ELEMENTARY,206 N LITTLE EGYPT RD   DENVER NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316683154,"PRINS, MARY, REBEKAH",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 38 , 38 ," $12,129.40 ",,
MEDICAID DIRECT,1912756602,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT SPRINGFIELD ELEMENTARY,900 S MAIN ST   STANLEY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316685811,"SPRINGFIELD, INDIA, MONE'T",4801 GLENWOOD AVENUE SUITE 200 PMB 533 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1497504286,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT KISER ELEMENTARY,311 E COLLEGE ST   STANLEY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316685811,"SPRINGFIELD, INDIA, MONE'T",4801 GLENWOOD AVENUE SUITE 200 PMB 533 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316687098,"THOMAS, LINDA, SUSAN",4220 CAROLINA EXCHANGE DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316687098,"THOMAS, LINDA, SUSAN",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 120 , 222 , 514 ," $21,734.21 ",,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316687098,"THOMAS, LINDA, SUSAN",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316689425,"NORMAN, SARAH, GUILBAULT",2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1316689425,"NORMAN, SARAH, GUILBAULT",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 22 , 58 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1316689425,"NORMAN, SARAH, GUILBAULT",1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 42 , 97 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316691876,"GROCE, CHRISTOPHER, FRASER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316691876,"GROCE, CHRISTOPHER, FRASER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316691876,"GROCE, CHRISTOPHER, FRASER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316691876,"GROCE, CHRISTOPHER, FRASER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316691876,"GROCE, CHRISTOPHER, FRASER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316691876,"GROCE, CHRISTOPHER, FRASER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316691876,"GROCE, CHRISTOPHER, FRASER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316694557,"KHALAF, MOHAMED, HASSAN GABER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 43 , 45 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316694557,"KHALAF, MOHAMED, HASSAN GABER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 24 , 37 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316696842,"MARSHALL, CHRISTIAN, PAIGE PENLAND",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 23 , 34 , 35 ,$#,,
MEDICAID DIRECT,1992464002,HNI MEDICAL SERVICES OF NORTH CAROL,,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316698244,"BURNS, BRANISHA",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 120 , 120 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316699838,"DEMEYERE, BENJAMIN, SCOTT",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316701394,"WATKINS, HEATHER, ELAINE",106 JEFFERSON ST   HAMLET NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1316722390,SIMPLY SPEECH THERAPY PLLC,,2 RIDGE RD   FOXFIRE VILLAGE NC,063,Moore,193400000X,Group,Single Specialty,,1316722390,SIMPLY SPEECH THERAPY PLLC,2 RIDGE RD   FOXFIRE VILLAGE NC,063,Moore,193400000X,Group,Single Specialty,, 11 , 177 , 179 ," $12,404.79 ",,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316722739,"LEE, CHELSEY, MAE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1467023747,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT DAVIE COUNTY EARLY COLLEGE,1211 SALISBURY RD   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316722739,"LEE, CHELSEY, MAE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184356305,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PINEBROOK ELEMENTARY,477 PINEBROOK SCHOOL RD   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316722739,"LEE, CHELSEY, MAE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 103 , 103 ," $32,965.23 ",,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316725815,"SCOTT, KIERSTEN, NICOLE",3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,100 W FREMONT ST STE B BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1316725815,"SCOTT, KIERSTEN, NICOLE",100 W FREMONT ST   BURGAW NC,071,Pender,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316727118,"DYE, CHRISTOPHER, DAVID",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316727118,"DYE, CHRISTOPHER, DAVID",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316771207,"BATAC, RODNELL STEPHEN, GONZALES",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316771207,"BATAC, RODNELL STEPHEN, GONZALES",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477302255,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT ASHEBORO HIGH,1221 S PARK ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316776453,"MCLAUGHLIN, KIMBERLY",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316776453,"MCLAUGHLIN, KIMBERLY",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316778384,"LEMUS-MARTINEZ, ISRAEL",214 18TH ST SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 95 , 141 ,$#,,
MEDICAID DIRECT,1659468130,ALBEMARLE REGIONAL HEALTH SERVICES,ALBEMARLE REGIONAL HEALTH SERVICES,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316781099,"GREEN, AMANDA, LYNN",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 18 , 38 ,$#,,
MEDICAID DIRECT,1427121144,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,413 MCCONNELL ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1316781644,"MOSER, VERNA, DENISE",126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427121144,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,413 MCCONNELL ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1316781644,"MOSER, VERNA, DENISE",413 MCCONNELL ST   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,110 DUTCHMAN CT   ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316784010,"LEUPOLD, CHRISTY, JONES",110 DUTCHMAN CT   ELKIN NC,086,Surry,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,110 DUTCHMAN CT   ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316784010,"LEUPOLD, CHRISTY, JONES",110 DUTCHMAN CT   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 29 , 47 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316785454,"SMITH, ANDREA",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316785454,"SMITH, ANDREA",1509 DOCTORS CIR BLDG C CAPE FEAR NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 25 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316788631,"BUCKLEY, STACY, ADAMS",1085 NE GATEWAY CT NE STE 100 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316788631,"BUCKLEY, STACY, ADAMS",1085 NE GATEWAY CT NE STE 100 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316789274,SPRINGDAILE ASSISTED LIVING INC,,4315 HOLDER RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1316789274,SPRINGDAILE ASSISTED LIVING INC,4315 HOLDER RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 577 , 577 ," $36,004.86 ",,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1316789977,"CARRIKER, LAUREN, ELIZABETH",145 APPLECROSS RD   PINEHURST NC,063,Moore,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316792708,"LINNENS, CIARA",3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 21 , 25 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316792708,"LINNENS, CIARA",1730 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 24 , 25 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316792708,"LINNENS, CIARA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316794845,"LYNCH, EMILY ROSE, MARSHALL",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 42 , 58 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316900947,"DAVIDSON, LISA, EVE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316900947,"DAVIDSON, LISA, EVE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1427156447,ROXBORO MEDICAL ASSOCIATES PA,ROXBORO MEDICAL ASSOCIATES,783 DOCTORS CT   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1316901093,"LONG, THOMAS, DRUMWRIGHT",783 DOCTORS CT STE B ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427156447,ROXBORO MEDICAL ASSOCIATES PA,ROXBORO MEDICAL ASSOCIATES,783 DOCTORS CT   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1316901093,"LONG, THOMAS, DRUMWRIGHT",783 DOCTORS CT   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 39 , 89 ,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1316901515,"KOSCHESKI, CAROLL, DEAN",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 65 , 93 , 116 ,$#,,
MEDICAID DIRECT,1154442630,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1316901515,"KOSCHESKI, CAROLL, DEAN",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1316901788,"HARDIN, JEFFREY, M",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 24 , 30 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1316901788,"HARDIN, JEFFREY, M",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1316901788,"HARDIN, JEFFREY, M",50 HOSPITAL DR STE 3B-2 HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 15 , 19 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1316901788,"HARDIN, JEFFREY, M",50 HOSPITAL DR STE 3B-2 HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 33 , 42 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316902794,"ROSE, NORALEA, ELIZABETH MEIKI",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316902794,"ROSE, NORALEA, ELIZABETH MEIKI",1144 NORTH ROAD STREET   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316902794,"ROSE, NORALEA, ELIZABETH MEIKI",1144 NORTH ROAD STREET   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1316902794,"ROSE, NORALEA, ELIZABETH MEIKI",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316902984,"LETVAK, RICHARD, IRA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 40 , 75 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316902984,"LETVAK, RICHARD, IRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316903289,"KIRKMAN, MARIAN, SUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316903289,"KIRKMAN, MARIAN, SUE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316903495,"LANDRIGAN, WENDY, MARIE",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 83 , 97 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316904675,"SOLIMAN, LORAN, ALFY MOUNIR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 52 , 59 ,$#,,
MEDICAID DIRECT,1033523709,MOSES CONE AFFILIATED PHYSICIANS IN,CHMG CARDIOVASCULAR DIVISION,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 70 , 92 , 120 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 18 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316904949,"ROSS, PAULA, VIRGINIA",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316905144,"STOUGHTON, THOMAS, LEROY",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 20 , 21 ,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316905144,"STOUGHTON, THOMAS, LEROY",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316905151,"NAGUIB, SHERIF, GEORGE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316905151,"NAGUIB, SHERIF, GEORGE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316905151,"NAGUIB, SHERIF, GEORGE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316905151,"NAGUIB, SHERIF, GEORGE",237 MULBERRY ST   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 70 , 70 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316905151,"NAGUIB, SHERIF, GEORGE",237 MULBERRY ST   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316905151,"NAGUIB, SHERIF, GEORGE",9600 NO 5 SCHOOL RD NW   ASH NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669809158,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS OBGYN HOSPITALISTS,920 CHURCH ST N STE 255E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1316905391,"WESLEY, CYNTHIA, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316905391,"WESLEY, CYNTHIA, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1316905391,"WESLEY, CYNTHIA, MARIE",1405 WILLOW LN   NORTH WILKESBORO NC,097,Wilkes,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",631 MOCKSVILLE AVE STE 1010 SALISBURY NC,080,Rowan,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 31 , 40 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",600 HOSPITAL DR   MONROE NC,090,Union,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 30 , 39 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 24 , 26 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",201 E GROVER ST   SHELBY NC,023,Cleveland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 22 , 31 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 16 , 23 , 26 ,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 15 , 34 , 38 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 12 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 13 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",10650 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710924162,RADIATION ONCOLOGY CENTERS OF THE C,MATTHEWS RADIATION ONCOLOGY CENTER,1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316906381,"MCCALL, BRADLEY, TODD",1400 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3573 HILLSBOROUGH RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316906431,"FOLAND, TRACY, LYNN",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316907041,"LEWIS, WILLIAM, LANCER",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316907041,"LEWIS, WILLIAM, LANCER",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 18 , 21 , 38 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316907041,"LEWIS, WILLIAM, LANCER",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 20 , 20 , 36 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316907041,"LEWIS, WILLIAM, LANCER",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316907041,"LEWIS, WILLIAM, LANCER",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1316907041,"LEWIS, WILLIAM, LANCER",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316907579,"PAYNE, THOMAS, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316908486,"ZIMMERMANN, MATTHIAS",2800 DARROW RD   WALKERTOWN NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 160 , 330 ,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316909138,"CLARK, WILLIAM, DOUGLAS",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 30 , 55 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316909302,"LECHNER, SHILEY, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316909302,"LECHNER, SHILEY, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 30 , 45 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1316909302,"LECHNER, SHILEY, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316909302,"LECHNER, SHILEY, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 82 , 108 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1316909583,"BURRELL, WILLIAM, JOSEPH",130 CARDINAL DR   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 23 , 33 ,$#,,
MEDICAID DIRECT,1013210517,KENT SEITZ MD PA,,1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1316911159,"HOWARD, CHAD, DANIEL",1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#, 18 , 37 ,$#,,
MEDICAID DIRECT,1598486565,BEACON DERMATOLOGY LLC,,76 PEACHTREE RD STE 120 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1316911308,"GIFFORD, LOLA, JILLIAN",76 PEACHTREE RD STE 120 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 30 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316913098,"SUN, YUN",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316913098,"SUN, YUN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316913098,"SUN, YUN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 99 , 564 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316913098,"SUN, YUN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316913098,"SUN, YUN",3605 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 114 , 314 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316913098,"SUN, YUN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 157 , 709 ," 1,780 "," $21,582.38 ",,
MEDICAID DIRECT,1588216253,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE CLAYTON,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316914401,"HAYNESWORTH, RENEE, PIGGEE",204 MEDSPRING DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316914401,"HAYNESWORTH, RENEE, PIGGEE",10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1578334892,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE FUQUAY VA,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1316914401,"HAYNESWORTH, RENEE, PIGGEE",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 13 , 31 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316914674,"SINACORI, JOHN, TODD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316914674,"SINACORI, JOHN, TODD",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316914674,"SINACORI, JOHN, TODD",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316914674,"SINACORI, JOHN, TODD",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 476 , 519 ," 2,675 "," $108,241.28 ",,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",2620 NEW BERN AVE   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 782 , 848 ," 6,639 "," $575,027.64 ",,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 11 , 50 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 119 , 124 , 462 ," $17,130.53 ",,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 28 , 18 , 91 ,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316915861,"JOHNSON, EUPHEMIA, LAREE",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 36 , 35 , 183 ,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,1212 SPRUCE ST STE 211 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316917214,"KHANDEKAR, SURESH",1212 SPRUCE ST   BELMONT NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316917214,"KHANDEKAR, SURESH",2544 COURT DR STE G GASTONIA NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 69 , 89 , 96 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316917230,"ROBINS, GREGORY, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316917230,"ROBINS, GREGORY, SCOTT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 54 , 61 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,6602 KNIGHTDALE BLVD STE 201 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1316917610,"LUTZ, RODNEY, SEAN",6602 KNIGHTDALE BLVD STE 110 KNIGHTDALE NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 40 , 113 , 193 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316917610,"LUTZ, RODNEY, SEAN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 64 , 90 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1316917610,"LUTZ, RODNEY, SEAN",3410 SIX FORKS RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316917610,"LUTZ, RODNEY, SEAN",3410 SIX FORKS RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 72 , 113 ,$#,,
MEDICAID DIRECT,1821496753,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1316918238,"CARR, JAMES, STEWART",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1316918238,"CARR, JAMES, STEWART",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316921828,"SHADDUCK, PHILLIP, PRICE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316922412,"CLARKSON, MARK, WILLIAM",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316922412,"CLARKSON, MARK, WILLIAM",10208 CERNY ST STE 300 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316922412,"CLARKSON, MARK, WILLIAM",2051 RALPH STEPHENS RD   HOLLY SPRINGS NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316922412,"CLARKSON, MARK, WILLIAM",781 AVENT FERRY RD STE 206 HOLLY SPRINGS NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316922412,"CLARKSON, MARK, WILLIAM",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 16 , 25 , 31 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316922412,"CLARKSON, MARK, WILLIAM",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316923360,"JORIZZO, JOSEPH, LUCIUS",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 179 , 257 , 289 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316923360,"JORIZZO, JOSEPH, LUCIUS",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316924624,"ORZECHOWSKI, NICOLE, MARIE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 48 , 59 , 91 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316924624,"ORZECHOWSKI, NICOLE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316924624,"ORZECHOWSKI, NICOLE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 19 , 28 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316924624,"ORZECHOWSKI, NICOLE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1316924624,"ORZECHOWSKI, NICOLE, MARIE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,,,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1316925787,"BARTHOLOMEW, SANTA, JOAN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 46 , 46 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1316925928,"KANERIYA, PERRY, PURSHOTTAM",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194858498,CASWELL COUNTY HEALTH DEPARTMENT,COUNTY OF CASWELL,189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316926348,"COBB, KELLY, LYNN",189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 55 , 85 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316928724,"MEANS, TIMOTHY, STEWART",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316929102,"SIGAL, BARRY, WILLAM",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1316930787,"EVERETT, ROY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316931488,"MAY, ANNE, SCHLAFKE",13300 STRICKLAND RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 27 , 52 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316931488,"MAY, ANNE, SCHLAFKE",13300 STRICKLAND RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 78 , 145 ,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316934847,"WATTS, ANN, TRIPPEL",4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 41 , 52 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316936156,"NICHOLS, GARY, GLENN",1404 WILLOW LN STE A N WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1316937352,"MAY, DAVID, THOMAS",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 23 , 24 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1316937352,"MAY, DAVID, THOMAS",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 62 , 76 , 99 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1316937352,"MAY, DAVID, THOMAS",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1831189992,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF COASTAL CAROLINA,1017 ASHES DR STE 206 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316937477,"YIP, ALEX, GARHOE",1017 ASHES DR STE 206 WILMINGTON NC,065,New Hanover,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 59 , 237 , 259 ,$#,,
MEDICAID DIRECT,1831189992,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF COASTAL CAROLINA,2321 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1316937477,"YIP, ALEX, GARHOE",2321 DELANEY AVE   WILMINGTON NC,065,New Hanover,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 25 , 28 ,$#,,
MEDICAID DIRECT,1316937980,HEALTHCARE EQUIPMENT INC,HEALTHCARE EQUIPMENT INC,4228 GARRETT RD   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316937980,HEALTHCARE EQUIPMENT INC,4228 GARRETT RD   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 217 , 469 ," 1,233 "," $716,338.09 ",,
MEDICAID DIRECT,1316937980,HEALTHCARE EQUIPMENT INC,HEALTHCARE EQUIPMENT INC,4228 GARRETT RD   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316937980,HEALTHCARE EQUIPMENT INC,4228 GARRETT RD   DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1316937980,HEALTHCARE EQUIPMENT INC,HEALTHCARE EQUIPMENT INC,4228 GARRETT RD   DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1316937980,HEALTHCARE EQUIPMENT INC,4228 GARRETT RD   DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 53 , 71 , 78 ," $163,943.64 ",,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316938681,"PFEIL, HEATHER, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 133 , 145 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316938681,"PFEIL, HEATHER, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 111 , 130 ,$#,,
MEDICAID DIRECT,1255054623,ASHE MULTISPECIALTY GROUP LLC,ASHE WOMEN AND CHILDRENS HEALTH,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1316939036,"KEPLEY, MICHAEL, AVERY",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1093790859,COUNTY OF IREDELL,IREDELL COUNTY HEALTH DEPARTMENT,318 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316939036,"KEPLEY, MICHAEL, AVERY",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1093790859,COUNTY OF IREDELL,IREDELL COUNTY HEALTH DEPARTMENT,318 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316939036,"KEPLEY, MICHAEL, AVERY",318 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 118 , 291 , 905 ," $45,342.50 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316939705,"BHOJWANI, NAVIN, CHANDRU",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316939705,"BHOJWANI, NAVIN, CHANDRU",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316939788,"PATTERSON, BRYAN, THOMAS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 11 , 37 , 37 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316939788,"PATTERSON, BRYAN, THOMAS",515 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316939788,"PATTERSON, BRYAN, THOMAS",1810 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316939788,"PATTERSON, BRYAN, THOMAS",430 BROOKWOOD AVE NE   CONCORD NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1316939788,"PATTERSON, BRYAN, THOMAS",916 S MARIETTA ST   GASTONIA NC,036,Gaston,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1316940133,"MIKLES, MARK, RAYMOND",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316940133,"MIKLES, MARK, RAYMOND",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 16 , 34 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1316940133,"MIKLES, MARK, RAYMOND",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 19 , 42 ,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316941065,"FLEISHMAN, SAMUEL, ALAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477595841,EASTERN CARDIOLOGY PA,EASTERN CARDIOLOGY PA,2090 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1316941206,"CARLSON, ERIC, BARNETT",2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316942022,"NASSR, KUSSAY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316942386,"CHESSER, KEITH, THOMAS",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316942386,"CHESSER, KEITH, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 122 , 132 , 159 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316942386,"CHESSER, KEITH, THOMAS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316942386,"CHESSER, KEITH, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1689114969,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN ORTHOPAEDICS,314 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1316942675,"WILLIAMSON, ROBERT, VAN",314 S SOUTH ST STE 100 MOUNT AIRY NC,086,Surry,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 45 , 75 , 133 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316944697,"BODNE, DAVID, J",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316944697,"BODNE, DAVID, J",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1316944697,"BODNE, DAVID, J",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1316944697,"BODNE, DAVID, J",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316944697,"BODNE, DAVID, J",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 26 , 41 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316944713,"BARD, MICHAEL, RICHARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 57 , 90 , 98 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316944713,"BARD, MICHAEL, RICHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316946205,"ROSS BLACKWOOD, RACHEL, SUZANNE",162 LEGACY OAKS DR STE 2102 KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 29 , 46 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316946205,"ROSS BLACKWOOD, RACHEL, SUZANNE",5920 SANDY FORKS RD STE 200 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1316946858,"GREENWOOD, GREGORY, TODD",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1316946858,"GREENWOOD, GREGORY, TODD",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 39 , 51 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316946858,"GREENWOOD, GREGORY, TODD",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316946858,"GREENWOOD, GREGORY, TODD",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 113 , 211 , 254 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1316946858,"GREENWOOD, GREGORY, TODD",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 56 , 245 , 264 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1316946858,"GREENWOOD, GREGORY, TODD",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1316947310,"COOLONG, KEVIN, JAMES",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1316947310,"COOLONG, KEVIN, JAMES",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053142265,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL RADIOLOGY,101 ROBESON ST STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316948094,"HUTCHISON, LISA, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1053142265,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL RADIOLOGY,101 ROBESON ST STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316948094,"HUTCHISON, LISA, MARIE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336131010,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOPE MILLS FAMILY CARE,5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1316948094,"HUTCHISON, LISA, MARIE",5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1336131010,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOPE MILLS FAMILY CARE,5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316948094,"HUTCHISON, LISA, MARIE",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1336131010,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOPE MILLS FAMILY CARE,5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316948094,"HUTCHISON, LISA, MARIE",5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 146 , 211 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316948532,"ALLORI, ALEXANDER, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 27 , 41 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316948532,"ALLORI, ALEXANDER, CHRISTOPHER",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316948672,"SHAH, BHAVNA, SAURIN",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1316948672,"SHAH, BHAVNA, SAURIN",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 46 ,$#,,
MEDICAID DIRECT,1962544197,CHARLES R DISDIER DDS PA,IMMEDIATE DENTAL CARE,1468 TARBORO ST W STE F WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1316948672,"SHAH, BHAVNA, SAURIN",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316948672,"SHAH, BHAVNA, SAURIN",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice," 1,157 "," 1,680 "," 5,358 "," $287,195.44 ",,
MEDICAID DIRECT,1962544197,CHARLES R DISDIER DDS PA,IMMEDIATE DENTAL CARE,1468 TARBORO ST W STE F WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1316948672,"SHAH, BHAVNA, SAURIN",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice," 1,532 "," 1,997 "," 8,167 "," $433,918.75 ",,
MEDICAID DIRECT,1538267224,H J BROWN AND ASSOCIATES DDS PA,H J BROWN AND ASSOCIATES DDS PA,410 W 14TH ST STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316948672,"SHAH, BHAVNA, SAURIN",410 W 14TH ST STE B GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 132 , 148 , 351 ," $28,004.02 ",,
MEDICAID DIRECT,1891756946,RANDOLPH SPECIALTY GROUP PRACTICE,RANDOLPH HEALTH INTERNAL MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1316951312,"UPPIN, NINA, BASAPPA",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1326623216,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH INTERNAL MEDICINE,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1316951312,"UPPIN, NINA, BASAPPA",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 134 , 212 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316951361,"THOMAS, JENNIFER, RENEE",148 POINTE SOUTH DR   RANDLEMAN NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 19 , 47 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316951429,"CAMERON, HAROLD, HARRINGTON",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 26 , 31 ,$#,,
MEDICAID DIRECT,1972807352,REX HOSPITAL INC,REX PALLIATIVE CARE SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316953235,"YEAGER, ANNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 31 , 83 , 84 ,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1316953474,"HUNTER, LAWRENCE, GILMORE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407960354,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1316953474,"HUNTER, LAWRENCE, GILMORE",335 E PARKER RD   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1316953474,"HUNTER, LAWRENCE, GILMORE",1622 E MARION ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1316953474,"HUNTER, LAWRENCE, GILMORE",335 E PARKER RD   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316953938,"MITCHELL, MATTHEW, THOMAS",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,310 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316953938,"MITCHELL, MATTHEW, THOMAS",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316953938,"MITCHELL, MATTHEW, THOMAS",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 28 , 34 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316953938,"MITCHELL, MATTHEW, THOMAS",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 28 , 34 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1316953938,"MITCHELL, MATTHEW, THOMAS",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316954522,"MILES, MATTHEW, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 130 , 179 , 273 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316954522,"MILES, MATTHEW, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1110 SE CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316956428,"GAUSMANN, PAIGE, LANGENBACH",1110 SE CARY PKWY   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316956774,"BASTEK, TARA, KOPP",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1316956774,"BASTEK, TARA, KOPP",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316956774,"BASTEK, TARA, KOPP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 12 , 92 , 94 ," $10,943.31 ",,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316956774,"BASTEK, TARA, KOPP",3024 NEW BERN AVE   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316956931,"FELDPAUSCH, DALE, ELDRED",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316956931,"FELDPAUSCH, DALE, ELDRED",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 44 , 132 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316956931,"FELDPAUSCH, DALE, ELDRED",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 61 ,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1316958580,"ALLISON, MATTHEW, CAMPBELL",2824 BENNETTS POND RD   WILLIAMSBURG VA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316958648,"SKINNER, BENNIE, ALAN",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316962632,"WILSON, MICHAEL, BRIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 25 , 45 , 59 ," $14,405.16 ",,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316963580,"NYMBERG, JANE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1316963580,"NYMBERG, JANE, ELIZABETH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 23 , 29 ,$#,,
MEDICAID DIRECT,1316964570,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1614,1525 GLENN SCHOOL RD   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1316964570,WAL-MART STORES EAST LP,1525 GLENN SCHOOL RD   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1316964570,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1614,1525 GLENN SCHOOL RD   DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1316964570,WAL-MART STORES EAST LP,1525 GLENN SCHOOL RD   DURHAM NC,032,Durham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1316964588,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-5118,10050 GLENWOOD AVE   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1316964588,WAL-MART STORES EAST LP,10050 GLENWOOD AVE   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316965726,"PORTWOOD, GLEN, LOY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316965726,"PORTWOOD, GLEN, LOY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 52 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316965726,"PORTWOOD, GLEN, LOY",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316965726,"PORTWOOD, GLEN, LOY",300 BILLINGSLEY RD STE 200-B CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316965726,"PORTWOOD, GLEN, LOY",8210 UNIVERSITY EXEC PARK DR STE 125 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316965726,"PORTWOOD, GLEN, LOY",101 E WT HARRIS BLVD STE 3215 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 21 , 35 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316965726,"PORTWOOD, GLEN, LOY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 53 , 71 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316965726,"PORTWOOD, GLEN, LOY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 40 , 51 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316965726,"PORTWOOD, GLEN, LOY",8210 UNIVERSITY EXEC PARK DR STE 125 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 50 , 50 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316965726,"PORTWOOD, GLEN, LOY",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316965726,"PORTWOOD, GLEN, LOY",101 E WT HARRIS BLVD STE 3215 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316965726,"PORTWOOD, GLEN, LOY",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1316965726,"PORTWOOD, GLEN, LOY",300 BILLINGSLEY RD STE 200-B CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316966989,"CURRIN, ANN, TEASS",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 36 , 36 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1316967425,"PARRIS, CHRISTOPHER, KEITH",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316969975,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 16370,2021 WALNUT ST   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1316969975,NORTH CAROLINA CVS PHARMACY LLC,2021 WALNUT ST   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316970817,"PIGNONE, MICHAEL, PATRICK",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316970817,"PIGNONE, MICHAEL, PATRICK",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 39 , 69 ,$#,,
MEDICAID DIRECT,1548465735,SMITHFIELD FAMILY PRACTICE PA,SMITHFIELD FAMILY PRACTICE PA,1551 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1316970908,"KATURU, RAGHU, RAMAIAH",1551 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 224 , 327 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316971526,"HAVRILESKY, LAURA, JEAN",DUKE HOSP SOUTH TRENT DR DUKE PRIVATE DIAG CL DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316971526,"HAVRILESKY, LAURA, JEAN",DUKE HOSP SOUTH TRENT DR DUKE PRIVATE DIAG CL DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 24 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316971526,"HAVRILESKY, LAURA, JEAN",DUKE HOSP SOUTH TRENT DR DUKE PRIVATE DIAG CL DURHAM NC,032,Durham,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316971526,"HAVRILESKY, LAURA, JEAN",4101 MACON POND RD   RALEIGH NC,092,Wake,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 12 , 22 , 38 ,$#,,
MEDICAID DIRECT,1316973787,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE 417 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1316973787,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE 417 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,, 41 ," 6,685 "," 7,864 "," $3,828,359.31 ",,
MEDICAID DIRECT,1316973787,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE 417 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1316973787,BAYADA HOME HEALTH CARE INC,1985 TATE BLVD SE STE 417 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 1,052 "," 1,119 "," $252,391.44 ",,
MEDICAID DIRECT,1205868080,DONALD R FORTNER JR DMD PA,DONALD R FORTNER JR DMD PA,1834 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1316974827,"FORTNER, DONALD, RICHARD",1834 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 33 , 92 ,$#,,
MEDICAID DIRECT,1104007996,DEBORA A BOLTON,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316975428,"BOLTON, DEBORA, ANN",3823 GUESS RD STE P DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice," 2,569 "," 4,643 "," 17,822 "," $790,465.47 ",,
MEDICAID DIRECT,1972507440,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERNAL MEDICINE,101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316976566,"KRISHNA, KALPANA, ANANTHA",1212 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972507440,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERNAL MEDICINE,101 ROBESON ST STE 300 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1316976566,"KRISHNA, KALPANA, ANANTHA",101 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 120 , 137 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316977119,"HESSION, MELISSA, ANN",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 52 , 89 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1316980725,"BARR, KAREN, ELIZABETH",50 HOSPITAL DR STE 1C HENDERSONVILLE NC,045,Henderson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1316982580,"MONDI, PHILIP, GERARD",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1316982580,"MONDI, PHILIP, GERARD",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 110 , 365 , 367 ," $12,617.85 ",,
MEDICAID DIRECT,1881127942,SOUTHLAND CHATUGE EMERGENCY MEDICAL,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316982911,"CONRAD, PAUL, CHRISTOPHER",3990 US HIGHWAY 64 EAST ALTERNATE   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316984503,"HOERR, GEORGE, RICHARD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316984503,"HOERR, GEORGE, RICHARD",2021 CONCERT DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316984610,"KUZMA, GARY, ROBERT",2718 HENRY ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1480 KELLY RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1316985872,"PROSPER, MAGALLY",1480 KELLY RD   APEX NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316986086,"REDDY, DEEPA",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1316986425,"BOYD, JASON",~,203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,1316986425,"BOYD, JASON",203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306828678,SOUTHEASTERN MEDICAL ONCOLOGY CENTE,SOUTHEASTERN MEDICAL ONCOLOGY CENTER,203 COX BLVD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1316986425,"BOYD, JASON",203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1881702595,"KASBARI, SAMER, SAMAAN",~,203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,1316986425,"BOYD, JASON",203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306828678,SOUTHEASTERN MEDICAL ONCOLOGY CENTE,SOUTHEASTERN MEDICAL ONCOLOGY CENTER,203 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1316986425,"BOYD, JASON",203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 396 ," 1,045 "," 4,255 "," $126,966.24 ",,
MEDICAID DIRECT,1306828678,SOUTHEASTERN MEDICAL ONCOLOGY CENTE,SOUTHEASTERN MEDICAL ONCOLOGY CENTER,211 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1316986425,"BOYD, JASON",211 BEAMAN ST   CLINTON NC,082,Sampson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780127431,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,301 E MEETING ST STE 101 MORGANTON NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1316987043,"JOHANSON, WILLIAM, THOMAS",301 E MEETING ST STE 101 MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 25 , 31 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316987100,"DANNALS, THOMAS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316987100,"DANNALS, THOMAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 39 , 176 , 181 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316987100,"DANNALS, THOMAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316987811,FREEDOM RESPIRATORY INC,,1155 PINEY FOREST RD STE A DANVILLE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1316987811,FREEDOM RESPIRATORY INC,1155 PINEY FOREST RD STE A DANVILLE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1316988058,"PLYLER, EDWARD, THURMAN",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1316988058,"PLYLER, EDWARD, THURMAN",2201 S STERLING ST   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1316988058,"PLYLER, EDWARD, THURMAN",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1316988082,"BRIDGMAN, JOHN, ALFRED",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1316988082,"BRIDGMAN, JOHN, ALFRED",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 38 , 46 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1316988082,"BRIDGMAN, JOHN, ALFRED",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1316988082,"BRIDGMAN, JOHN, ALFRED",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1316988082,"BRIDGMAN, JOHN, ALFRED",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316988140,"REZNIK, MARK",510 TIMBER DR E STE 105 GARNER NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316988140,"REZNIK, MARK",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 96 , 135 , 276 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1316988140,"REZNIK, MARK",10880 DURANT RD STE 324 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,4235 S NEW HOPE RD STE I GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316989288,"OH, CHANG, KYEONG",2544 COURT DR STE G GASTONIA NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,1212 SPRUCE ST STE 211 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316989288,"OH, CHANG, KYEONG",1212 SPRUCE ST STE 102 BELMONT NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1316989288,"OH, CHANG, KYEONG",2544 COURT DR STE G GASTONIA NC,036,Gaston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 175 , 246 , 278 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1316990179,"LOVINS, JONATHAN, SAMUEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 137 , 137 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1316990864,"SENU-OKE, EDWARD, OLUBANKOLE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1316990864,"SENU-OKE, EDWARD, OLUBANKOLE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1316991292,"KELL, JESSICA, JOY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316992092,"PFAHLERT, HEATHER, ELYSIA",201 VIRGINIA RD   EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 100 , 144 , 192 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1316992092,"PFAHLERT, HEATHER, ELYSIA",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1316992092,"PFAHLERT, HEATHER, ELYSIA",701 LUKE ST STE C EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1316992530,"DINEEN, TIMOTHY, EDWARD",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 23 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 54 , 65 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",10710 SIKES PL STE 100 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 36 , 36 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 17 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",5220 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 30 , 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",5220 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 47 , 47 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",5220 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316993736,"TIERNEY, DANIEL, JOSEPH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316994635,"DASNOIT, ROBERT, JOSEPH",2718 HENRY ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 58 , 99 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 28 , 28 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 33 , 45 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 129 , 251 , 324 ," $17,234.57 ",,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1316995400,"MCLEAN, DALTON, SINGLETARY",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1316995459,"MCCLURE, SHELLEY, ANN",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 34 , 36 , 38 ," $11,792.74 ",,
MEDICAID DIRECT,1548497209,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP MARION,2293 SUGAR HILL RD STE C MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1316995459,"MCCLURE, SHELLEY, ANN",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457309221,CABARRUS EMERGENCY MEDICINE ASSOCIA,CABARRUS EMERGENCY MEDICINE ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1316995673,"MOORE, CHRISTINA, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1316995673,"MOORE, CHRISTINA, LYNN",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1316995673,"MOORE, CHRISTINA, LYNN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 76 , 77 , 99 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316995988,"PU, MIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1154418754,COUNTY OF ANSON,ANSON COUNTY HEALTH DEPT,110 E ASHE ST   WADESBORO NC,004,Anson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316997497,"BRACEWELL, GREGORY",110 E ASHE ST   WADESBORO NC,004,Anson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 39 , 67 ,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1316997497,"BRACEWELL, GREGORY",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 55 , 65 , 65 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1316998495,"JOSLIN, DAVID, COKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1851567663,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM INPATIENT MEDICINE SPECIALISTS,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1316999196,"TAYLOR, JULIE, ANN",180 PARKWOOD DR   ELKIN NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 215 , 215 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316999857,"MANNING, MATTHEW, ALEXANDER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 98 , 135 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316999857,"MANNING, MATTHEW, ALEXANDER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 28 , 92 , 115 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316999857,"MANNING, MATTHEW, ALEXANDER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1316999857,"MANNING, MATTHEW, ALEXANDER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1316999857,"MANNING, MATTHEW, ALEXANDER",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326000704,"SVENDSEN, THOR, OWEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326000704,"SVENDSEN, THOR, OWEN",1918 RANDOLPH RD STE 6 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326001603,"PATEL, SANJAY, KUMAR",1771 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 85 , 156 , 212 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326001603,"PATEL, SANJAY, KUMAR",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 97 , 121 , 167 ,$#,,
MEDICAID DIRECT,1326001819,CENTER FOR DIGESTIVE DISEASES AND C,CENTER FOR DIGESTIVE DISEASES AND CARY ENDOSCOPY C,1120 SE CARY PKWY STE 204 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1326001819,CENTER FOR DIGESTIVE DISEASES AND C,1120 SE CARY PKWY STE 204 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1326002544,"BELL, ROBERT, BRADFORD",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 94 , 119 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1326002544,"BELL, ROBERT, BRADFORD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1326002544,"BELL, ROBERT, BRADFORD",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1326002544,"BELL, ROBERT, BRADFORD",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003028630,NHCS PHYSICIANS INC,NASH SPECIALTY SERVICES PA-C,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1326006214,"HEUTS, SHANNON, BRACKETT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 113 , 119 , 119 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326006347,"LANG, JASON, EDWARD",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 32 , 52 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326006347,"LANG, JASON, EDWARD",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326006974,"DAVIS, JAMES, MCDOWELL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326006974,"DAVIS, JAMES, MCDOWELL",4220 N ROXBORO ST 4220 NORTH ROXBORO STREET DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326006974,"DAVIS, JAMES, MCDOWELL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326010364,"JONES, ALLEN, GAFFORD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 52 , 187 , 187 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1326011339,"RAVE, MICHAEL",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 104 , 143 , 216 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1326011339,"RAVE, MICHAEL",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326011396,"DARKES, LEROY, SCOTT",400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 40 , 54 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1326011396,"DARKES, LEROY, SCOTT",400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 132 , 230 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326011974,"DIRING, ROSA, OBREGON",825 FAIRFAX AVE # 4 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1326013590,"GLOSE, SUSAN, MARIE",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326013590,"GLOSE, SUSAN, MARIE",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 23 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5915 FARRINGTON RD STE 103 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1326014127,"KANE, SHAWN, FRANCIS",5915 FARRINGTON RD STE 103 CHAPEL HILL NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326014127,"KANE, SHAWN, FRANCIS",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 89 , 176 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326014127,"KANE, SHAWN, FRANCIS",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326017278,"CATES, TERRI, BRIDGES",107 WEEKS DR   ROXBORO NC,073,Person,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 92 , 196 ,$#,,
MEDICAID DIRECT,1326017963,BLUE RIDGE HOME CARE,~,89 MEDICAL PARK DR STE B BREVARD NC,088,Transylvania,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1326017963,BLUE RIDGE HOME CARE,89 MEDICAL PARK DR STE B BREVARD NC,088,Transylvania,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1326017963,BLUE RIDGE HOME CARE,~,89 MEDICAL PARK DR STE B BREVARD NC,088,Transylvania,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1326017963,BLUE RIDGE HOME CARE,89 MEDICAL PARK DR STE B BREVARD NC,088,Transylvania,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 67 , 433 , 822 ," $13,962.61 ",,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1326018912,"LEON, ALBERTO, LUIS",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 36 , 69 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326018995,"DURLAND, WILLIAM, F",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326018995,"DURLAND, WILLIAM, F",10208 CERNY ST STE 300 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326018995,"DURLAND, WILLIAM, F",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326018995,"DURLAND, WILLIAM, F",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 17 , 37 ,$#,,
MEDICAID DIRECT,1760423503,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS GASTROENTEROLOGY,853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1326019316,"MONTAGNE, THOMAS, MARCEL",853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326019373,"NORWOOD, BRIAN, GILBERT",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 18 , 34 ,$#,,
MEDICAID DIRECT,1851344436,GREENVILLE PATHOLOGY PA,GREENVILLE PATHOLOGY PA,2515 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1326020793,"SMITH, NANCY, LANE",2515 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 92 , 97 , 139 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326021288,"ANDERSON, ROBERT, BENTLEY",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1002 N CHURCH ST STE 401 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 20 , 41 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1326021437,"LAWRENCE, THOMAS, EARL",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326023334,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDINGS,8040 VILLA PARK DR STE 200   RICHMOND VA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1326023334,LABORATORY CORPORATION OF AMERICA H,8040 VILLA PARK DR STE 200   RICHMOND VA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 27 , 29 , 69 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326023342,"MILLER, HENRY, SHELTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326024274,"WOOD, SCOTT, EDWARD",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326024498,"NACOUZI, MICHELE, DUVAL",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 56 , 139 ,$#,,
MEDICAID DIRECT,1972092054,HERITAGE FAMILY HEALTH AND WELLNESS,,190 CAROLINA DR   SNOW HILL NC,040,Greene,193400000X,Group,Single Specialty,,1326025610,"FELL, DEBRA, BEAMAN",190 CAROLINA DR   SNOW HILL NC,040,Greene,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 54 , 175 , 289 ,$#,,
MEDICAID DIRECT,1972092054,HERITAGE FAMILY HEALTH AND WELLNESS,,190 CAROLINA DR   SNOW HILL NC,040,Greene,193400000X,Group,Single Specialty,,1326025610,"FELL, DEBRA, BEAMAN",1108B KINGOLD BLVD   SNOW HILL NC,040,Greene,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326025966,"CASABLANCA, YOVANNI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326025966,"CASABLANCA, YOVANNI",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 25 , 38 , 44 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326025966,"CASABLANCA, YOVANNI",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326026337,"LUKENS, MARK, LEROY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 70 , 81 , 107 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 24 , 29 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",102 POMONA DR   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 240 , 295 , 358 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 54 , 60 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326026337,"LUKENS, MARK, LEROY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 38 , 43 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326026337,"LUKENS, MARK, LEROY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#, 13 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326028226,"SENNEWALD, KAREN",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326028226,"SENNEWALD, KAREN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326028226,"SENNEWALD, KAREN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326028226,"SENNEWALD, KAREN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326028226,"SENNEWALD, KAREN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326028226,"SENNEWALD, KAREN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 150 , 178 , 204 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326028382,"DEAKLE, TERRY, MICHAEL",6301 STADIUM DR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 30 , 59 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326028754,"ENGLAND, CHRISTINA, VALVANO",1517 N HOWE ST   SOUTHPORT NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326029695,"HO, JAMES, JUIMING",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326029695,"HO, JAMES, JUIMING",1010 LAKEVIEW DR   PINEVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326029695,"HO, JAMES, JUIMING",1420 E FRANKLIN ST   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1326029695,"HO, JAMES, JUIMING",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326029695,"HO, JAMES, JUIMING",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1131 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326029695,"HO, JAMES, JUIMING",1101 HARTWELL ST   GARNER NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326029695,"HO, JAMES, JUIMING",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1326030354,"ELLIS, THOMAS, JOSEPH",11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 88 , 195 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1326030354,"ELLIS, THOMAS, JOSEPH",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 35 , 76 ,$#,,
MEDICAID DIRECT,1356735336,SOUTHLAND BAINBRIDGE HOSPITALIST GR,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326031865,"TANNER, MARSHALL, GLYNN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295729747,THE CHILD HEALTH CENTER,THE CHILD HEALTH CENTER,1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1326032863,"SUMMER, KENNETH, VIRGIL",1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 40 , 48 , 159 ,$#,,
MEDICAID DIRECT,1154348597,WINSTON-SALEM PEDIATRICS HIGHROAD,~,2808 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326032947,"WILEY, TAMMIE, FRAIZER",2808 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 86 , 214 ," $10,124.68 ",,
MEDICAID DIRECT,1982129136,CAROLINA PAIN CARE PC,~,1112 YANCEY ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1326033879,"BROCKMAN, STEVEN, KENNETH",1112 YANCEY ST   SHELBY NC,023,Cleveland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 392 ," 2,498 "," 5,514 "," $39,731.16 ",,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326033937,"EVERHART, FRANKLIN, RAY",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326033937,"EVERHART, FRANKLIN, RAY",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225445331,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - THOMASVILLE,611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326033937,"EVERHART, FRANKLIN, RAY",611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 190 , 216 ," $10,815.91 ",,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326034406,"JONES, CONNIE, LOCKLEAR",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 53 , 64 ,$#,,
MEDICAID DIRECT,1346302429,WEST CALDWELL HEALTH COUNCIL INC,COLLETTSVILLE MEDICAL CENTER,4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326034406,"JONES, CONNIE, LOCKLEAR",4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326034406,"JONES, CONNIE, LOCKLEAR",104 RHODES AVE   WINDSOR NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326034406,"JONES, CONNIE, LOCKLEAR",307 S MAIN ST   LEWISTON NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 32 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326034513,"RUCKER, WILLIAM, LEE",130 GLENDALE DR W   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326034513,"RUCKER, WILLIAM, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326035049,"PETREE, CANDACE, CHURCHWELL",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 23 , 52 ,$#,,
MEDICAID DIRECT,1730225392,CHARLES W JONES MD PA,~,200 HOSPITAL AVE STE 5 JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1326035056,"JONES, CHARLES, WADE",200 HOSPITAL AVE STE 5 JEFFERSON NC,005,Ashe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 79 , 125 , 153 ," $10,326.59 ",,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1326035072,"LEWIS-CAREY, MARY, BETH",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 25 , 28 , 33 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326035841,"TAMBERELLA, MICHAEL, RAYMOND",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 225 , 287 , 430 ," $14,554.78 ",,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326035841,"TAMBERELLA, MICHAEL, RAYMOND",2525 COURT DR   GASTONIA NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326039223,"VUJICIC, RATKO",12610 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326039454,"ELLIOTT, JOHN, DANIEL",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 31 , 48 , 123 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326039454,"ELLIOTT, JOHN, DANIEL",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 43 , 83 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326039454,"ELLIOTT, JOHN, DANIEL",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326039454,"ELLIOTT, JOHN, DANIEL",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,,,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1326039751,"HARSHANY, MARK, LAWRENCE",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1326039751,"HARSHANY, MARK, LAWRENCE",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 79 , 82 , 104 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1326040643,"DICKSON, RICHARD, WARREN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 152 , 153 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326040775,"CHRISTIANO, ANTHONY, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326040924,"JOHNSON, CRAIG, CHARLES",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 21 , 46 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326040924,"JOHNSON, CRAIG, CHARLES",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 58 , 100 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326041104,"NELSON, LEONARD, DORSEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326041955,"BINDER, GEORGE, ARTHUR",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326041955,"BINDER, GEORGE, ARTHUR",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326042110,"PARSONS, GREGORY, STOKES",200 HERLONG AVE S STE A ROCK HILL SC,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326042268,"HILL, DAVID, ASHLEY",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 952 , 952 ," $16,898.96 ",,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326042284,"NARAYANASWAMY ADI, SANJAY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 147 , 147 ,$#,,
MEDICAID DIRECT,1760417570,WAYNESBORO FAMILY CLINIC PA,WAYNESBORO FAMILY CLINIC PA,1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326044082,"MCALLISTER III, JAMES, GRAY",1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#, 35 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,136 SPARKS DR   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326044165,"KRUSCH, MARGARET, CHESSER",136 SPARKS DR   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 82 , 154 , 154 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1326044165,"KRUSCH, MARGARET, CHESSER",136 SPARKS DR   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 36 , 36 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326044454,"WHARTON, WILLIAM, WYANT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 68 , 83 , 101 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326044454,"WHARTON, WILLIAM, WYANT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 28 , 36 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326044454,"WHARTON, WILLIAM, WYANT",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 20 , 23 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326044454,"WHARTON, WILLIAM, WYANT",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326044454,"WHARTON, WILLIAM, WYANT",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326044454,"WHARTON, WILLIAM, WYANT",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1033170113,HART FAMILY PRACTICE,HART FAMILY PRACTICE,221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1326044504,"HART, ROBERT, ERIC",221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1033170113,HART FAMILY PRACTICE,HART FAMILY PRACTICE,221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1326044504,"HART, ROBERT, ERIC",221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 22 , 24 ,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326045311,"WILLIAMS, WHEATON, JOHN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326045311,"WILLIAMS, WHEATON, JOHN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 17 , 37 , 74 ,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326045311,"WILLIAMS, WHEATON, JOHN",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326045311,"WILLIAMS, WHEATON, JOHN",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 18 , 83 , 94 ,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326045311,"WILLIAMS, WHEATON, JOHN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326045311,"WILLIAMS, WHEATON, JOHN",3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 18 , 29 ,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326045311,"WILLIAMS, WHEATON, JOHN",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326045972,"FREDERICK, MARY, GENA",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 48 , 80 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326045972,"FREDERICK, MARY, GENA",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326045972,"FREDERICK, MARY, GENA",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 37 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326045972,"FREDERICK, MARY, GENA",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,7021 HARPS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326046145,"BENTSEN, ISABELLA, DIMITROVA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 51 , 128 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326046145,"BENTSEN, ISABELLA, DIMITROVA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518995224,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP HARPS MILLINTERNAL MEDICINE,5920 SANDY FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326046145,"BENTSEN, ISABELLA, DIMITROVA",5920 SANDY FORKS RD STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 108 , 214 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326046186,"COWAN, MICHAEL",1401 MATTHEWS TOWNSHIP PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326046236,"ADAMSON, TIM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326046236,"ADAMSON, TIM",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326046236,"ADAMSON, TIM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1326046434,"YODER, LARRY, JOHN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326047242,"PLUMMER, CHRISTINE, ANN",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 51 , 72 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326047242,"PLUMMER, CHRISTINE, ANN",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326047242,"PLUMMER, CHRISTINE, ANN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326047242,"PLUMMER, CHRISTINE, ANN",2360 WILLIAMWOOD LN   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 51 , 51 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326047242,"PLUMMER, CHRISTINE, ANN",290 H M CAGLE DR   CAMERON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1386841195,DR JEFFREY R COLEMAN OPTOMETRIST PA,~,919 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326047689,"COLEMAN, JEFFREY",919 S 16TH ST   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 58 , 70 , 106 ,$#,,
MEDICAID DIRECT,1326048661,"AJLOUNY, MARTHA, JULIE",~,530 N ELAM AVE STE A GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,1326048661,"AJLOUNY, MARTHA, JULIE",530 N ELAM AVE STE A GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1326048661,"AJLOUNY, MARTHA, JULIE",530 N ELAM AVE STE A GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 31 , 38 , 71 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1326048661,"AJLOUNY, MARTHA, JULIE",367 S ANDY GRIFFITH PKWY STE 200 MOUNT AIRY NC,086,Surry,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,WESTERN CAROLINA EYE ASSOCIATES,610 STATE FARM RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1326048919,"KRONTZ, DANIEL, PAUL",610 STATE FARM RD STE A BOONE NC,095,Watauga,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 74 , 134 , 146 ,$#,,
MEDICAID DIRECT,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,WESTERN CAROLINA EYE ASSOCIATES,610 STATE FARM RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1326048919,"KRONTZ, DANIEL, PAUL",183 DOCTORS PARK DR   JEFFERSON NC,005,Ashe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1093776403,WESTERN CAROLINA EYE ASSOCIATES PA,WESTERN CAROLINA EYE ASSOCIATES,183 DOCTORS PARK DR   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1326048919,"KRONTZ, DANIEL, PAUL",183 DOCTORS PARK DR   JEFFERSON NC,005,Ashe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326049412,"SUPPLE, KEVIN, MARK",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 40 , 72 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1326049990,"HOLLIFIELD, MELISSA, LOVETTE",703 NEWMAN RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 69 , 185 ,$#,,
MEDICAID DIRECT,1952609687,QC KIDZ PEDIATRICS PLLC,~,6801 SOUTH BLVD STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326050725,"UTOH, JANCY, FREDERICK",6801 SOUTH BLVD STE D&E CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,816 GREENBRIER CIR STE G CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326050964,"GRAY, DERWIN, PEARSON",1101 MADISON PLZ STE 100&200 CHESAPEAKE VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1831103753,EYE ASSOCIATES OF ROWAN PA,EYE ASSOCIATES OF ROWAN PA,800 W CEMETARY ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1326052234,"BERGSMA, DONALD, ROY",800 W CEMETARY ST   SALISBURY NC,080,Rowan,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 57 , 103 , 181 ,$#,,
MEDICAID DIRECT,1952061517,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH,1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326053067,"CIEZA, OCTAVIO",1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1407039324,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SMITHFIELD,507 N BRIGHTLEAF BLVD STE 209 SMITHFIELD NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326053067,"CIEZA, OCTAVIO",507 N BRIGHTLEAF BLVD STE 209 SMITHFIELD NC,051,Johnston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1407039324,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SMITHFIELD,507 N BRIGHTLEAF BLVD STE 209 SMITHFIELD NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326053067,"CIEZA, OCTAVIO",507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326053067,"CIEZA, OCTAVIO",507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 25 , 34 , 37 ,$#,,
MEDICAID DIRECT,1326053067,"CIEZA, OCTAVIO",~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1326053067,"CIEZA, OCTAVIO",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 93 , 176 ,$#,,
MEDICAID DIRECT,1326053067,"CIEZA, OCTAVIO",~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,1326053067,"CIEZA, OCTAVIO",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326053067,"CIEZA, OCTAVIO",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 29 , 73 , 73 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326053067,"CIEZA, OCTAVIO",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 100 , 370 , 370 ," $22,435.32 ",,
MEDICAID DIRECT,1326054859,"JALKUT, MARK, WILLIAM",Mark William Jalkut,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1326054859,"JALKUT, MARK, WILLIAM",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 27 , 42 , 74 ,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326054859,"JALKUT, MARK, WILLIAM",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 16 , 37 ,$#,,
MEDICAID DIRECT,1578529962,"KIZER, WILLIAM, STEEL",ASSOCIATED UROLOGISTS OF NC PA,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1326054859,"JALKUT, MARK, WILLIAM",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326054941,"COLACCHIO, KATHRYN, EVANS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326054941,"COLACCHIO, KATHRYN, EVANS",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326057647,"HEINER, MARK, DAVID",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1326057647,"HEINER, MARK, DAVID",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 36 , 45 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326057928,"GIBSON, JOHN, HEYL",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326057928,"GIBSON, JOHN, HEYL",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 111 , 155 , 175 ,$#,,
MEDICAID DIRECT,1023349404,NOVANT HEALTH MEDICAL GROUP LLC,~,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326057928,"GIBSON, JOHN, HEYL",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326057928,"GIBSON, JOHN, HEYL",190 KIMEL PARK DR STE 121 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316298458,SAMPSON REGIONAL PROFESSIONAL SERVI,CAROLINA PAIN CENTER,518 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1326064619,"MORKOS, ESKANDER, GEORGE",518 BEAMAN ST   CLINTON NC,082,Sampson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 138 , 481 , 482 ,$#,,
MEDICAID DIRECT,1326065590,WAL-MART STORES EAST LP,WALMART PHARMACY 10-2836,1051 E BROAD ST   FUQUAY VARINA NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1326065590,WAL-MART STORES EAST LP,1051 E BROAD ST   FUQUAY VARINA NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1326065590,WAL-MART STORES EAST LP,WALMART PHARMACY 10-2836,1051 E BROAD ST   FUQUAY VARINA NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1326065590,WAL-MART STORES EAST LP,1051 E BROAD ST   FUQUAY VARINA NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#, 16 ,$#,,
MEDICAID DIRECT,1326066127,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1010,720 E US HIGHWAY 74   ROCKINGHAM NC,077,Richmond,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1326066127,WAL-MART STORES EAST LP,720 E US HIGHWAY 74   ROCKINGHAM NC,077,Richmond,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326066705,"FOWLER, FRED, CHARLES",1085 NE GATEWAY CT NE STE 280 CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 125 , 240 , 351 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326066705,"FOWLER, FRED, CHARLES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 48 , 58 , 84 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326066705,"FOWLER, FRED, CHARLES",1085 NE GATEWAY CT NE STE 280 CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326066705,"FOWLER, FRED, CHARLES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326066705,"FOWLER, FRED, CHARLES",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326066705,"FOWLER, FRED, CHARLES",101 E WT HARRIS BLVD STE 3215 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326066705,"FOWLER, FRED, CHARLES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326067224,"ALSTON, MICHAEL, CURTIS",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1326067224,"ALSTON, MICHAEL, CURTIS",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326067224,"ALSTON, MICHAEL, CURTIS",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326067224,"ALSTON, MICHAEL, CURTIS",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 94 , 117 ,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1326067224,"ALSTON, MICHAEL, CURTIS",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326067224,"ALSTON, MICHAEL, CURTIS",108 W MAIN ST   WOODLAND NC,066,Northampton,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326069063,"SIDDIQUI, MUSTAFA, SAAD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 21 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326071648,"BONSALL, DEAN, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 219 , 286 , 445 ," $14,901.53 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326071648,"BONSALL, DEAN, JOHN",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 17 , 30 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326072844,"STERLING, DAVID, MATTHEW",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326072844,"STERLING, DAVID, MATTHEW",607 BEAMAN ST   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 54 , 56 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326072844,"STERLING, DAVID, MATTHEW",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326073917,"VAN VOORHEES, ABBY, SUSAN",721 FAIRFAX AVE STE 200 NORFOLK VA,101,Out of State <= 40 miles,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1326074410,"KILLGORE, JOHN, EDWARD",1705 TARBORO ST SW   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 15 , 37 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326074410,"KILLGORE, JOHN, EDWARD",1403 S KING ST   WINDSOR NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2200 TREELIGHT WAY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1326074410,"KILLGORE, JOHN, EDWARD",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 47 , 47 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 59 , 59 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326074964,"KASIREDDY, UMA, RANI",615 RIDGE RD   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326075474,"MALLORY, MIA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 24 , 24 , 29 ,$#,,
MEDICAID DIRECT,1326078825,"TAYLOR-ANDEMICHAEL, MARSHA, RENEA",,205 W FRONT ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,1326078825,"TAYLOR-ANDEMICHAEL, MARSHA, RENEA",205 W FRONT ST   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 190 , 408 ," 1,270 "," $45,629.49 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326079500,"BARRETT, LISA, ANN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1326079500,"BARRETT, LISA, ANN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326079674,"GALAT, JOHN, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326079674,"GALAT, JOHN, ALAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326079674,"GALAT, JOHN, ALAN",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326079674,"GALAT, JOHN, ALAN",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518393560,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1326081753,"RUTTER, MARGARET, LYNN",151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1326082207,"ROSCOE JR, WILLIAM, DON",WILLIAM DON ROSCOE JR,150 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,152W00000X,Eye and Vision Services Providers,Optometrist,,1326082207,"ROSCOE JR, WILLIAM, DON",150 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,152W00000X,Eye and Vision Services Providers,Optometrist,, 289 , 292 , 560 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326085010,"DEMMER, LAURIE, ANN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326085010,"DEMMER, LAURIE, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 33 , 33 , 47 ,$#,,
MEDICAID DIRECT,1376914283,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326085622,"WHITE, CHERYL, DAY",3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1891002374,BLUE RIDGE HEALTHCARE MEDICAL GROUP,LENOIR FAMILY MEDICINE,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1326088261,"LEWIS, NEWMAN, MAXVILLE",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 89 , 123 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1326089624,"BERKOFF, MOLLY, CURTIN",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1326089624,"BERKOFF, MOLLY, CURTIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326090184,"PIKE, GINA, FIELDS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326090184,"PIKE, GINA, FIELDS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326090184,"PIKE, GINA, FIELDS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326090184,"PIKE, GINA, FIELDS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1326090184,"PIKE, GINA, FIELDS",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437623626,PRIME SURGICAL SUITES LLC,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1326092271,"KEVERLINE, JEFFREY, PAUL",160 RIVER BEND DR STE C GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326092271,"KEVERLINE, JEFFREY, PAUL",232 SHARON AVE NW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 60 , 136 , 245 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326092271,"KEVERLINE, JEFFREY, PAUL",232 SHARON AVE NW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 37 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326092271,"KEVERLINE, JEFFREY, PAUL",160 RIVER BEND DR STE C GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326092727,"COOKE, ELIZABETH, JEAN",10195 BEACH DR SW   CALABASH NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326092727,"COOKE, ELIZABETH, JEAN",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 52 , 63 , 84 ,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326092727,"COOKE, ELIZABETH, JEAN",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1306684642,KIDMED PLLC,,1165 CEDAR POINT BLVD STE F CEDAR POINT NC,016,Carteret,193400000X,Group,Single Specialty,,1326093956,"DURHAM, KELLY, RAE",1106 MAIN STREET EXT   SWANSBORO NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1326094624,"ANDERSON JR, JOHN, BROCKENBROUGH",101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 18 , 42 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1326094624,"ANDERSON JR, JOHN, BROCKENBROUGH",101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 91 , 227 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326094723,"BOUKMAN, IMHOTEP",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326096249,"MCCUTCHEN, PHYLLIS, LAMARR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1659156388,CAROLINA CHIROPRACTIC GROUP OF GAST,,528 UNION RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326096504,"DIBELLA, KEVIN",528 UNION RD   GASTONIA NC,036,Gaston,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326096819,"CAMPBELL, JOHN, FRANKLIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326097205,"YOUNG, RICHARD, MARTIN",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 45 , 77 ,$#,,
MEDICAID DIRECT,1679531560,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH FORSYTH NEUROLOGY,,,Unknown,193400000X,Group,Single Specialty,,1326097262,"KRAFT, HOWARD, ANDREW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1780063958,NOVANT HEALTH MEDICAL GROUP LLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1326097262,"KRAFT, HOWARD, ANDREW",2025 FRONTIS PLAZA BLVD STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1679531560,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH FORSYTH NEUROLOGY,,,Unknown,193400000X,Group,Single Specialty,,1326097262,"KRAFT, HOWARD, ANDREW",2025 FRONTIS PLAZA BLVD STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326098393,"BROWNING, DAVID, JUDSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 57 , 120 , 233 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326098393,"BROWNING, DAVID, JUDSON",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 34 , 65 ,$#,,
MEDICAID DIRECT,1932921137,MCPC-14 LLC,FIRSTHEALTH INTEGRATIVE ONCOLOGY AND SURVIVORSHIP,135 PAGE RD N STE 310 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1326099193,"BAILEY-DORTON, CHASSE, MARGOT",305 PAGE RD N STE 1 PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932921137,MCPC-14 LLC,FIRSTHEALTH INTEGRATIVE ONCOLOGY AND SURVIVORSHIP,135 PAGE RD N STE 310 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1326099193,"BAILEY-DORTON, CHASSE, MARGOT",135 PAGE RD N STE 310 PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326099458,"BENSON, KENNETH, JOHN",100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 531 , 589 ," 3,122 "," $386,608.67 ",,
MEDICAID DIRECT,1326099458,"BENSON, KENNETH, JOHN",KJ BENSON DDS PA,7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1326099458,"BENSON, KENNETH, JOHN",7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 48 , 48 , 205 ," $33,624.70 ",,
MEDICAID DIRECT,1932634029,SURGICAL CENTER FOR DENTAL PROFESSI,,2620 NEW BERN AVE   RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1326099458,"BENSON, KENNETH, JOHN",100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326100389,"SCHEER, JAMES, CHARLES",707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1366103574,DR ROBERT S POINT DDS PLLC,,1911 S 17TH ST STE 140 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326100397,"BRADLEY, LISE, KIM",1911 S 17TH ST STE 140 WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice," 1,225 "," 1,739 "," 7,780 "," $329,418.02 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326101106,"MARTIN, PAUL, LANGLIE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 27 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326101106,"MARTIN, PAUL, LANGLIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326101197,"AUTEN, RICHARD, LAMBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1326101825,"SUTHERLAND, CHRISTOPHER, DOUGLAS",~,73 APPLEWOOD LN   WEAVERVILLE NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1326101825,"SUTHERLAND, CHRISTOPHER, DOUGLAS",73 APPLEWOOD LN   WEAVERVILLE NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326102187,"LEVINE, FELICIA, LYNNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326102187,"LEVINE, FELICIA, LYNNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326102187,"LEVINE, FELICIA, LYNNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 ,#,#,$#,,
MEDICAID DIRECT,1083481824,MEDICAL PSYCHIATRIC PROVIDERS INC,,3200 WATERFIELD DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1326102187,"LEVINE, FELICIA, LYNNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457693335,CAROLINA PAIN CENTER PC,~,4251 ARENDELL ST STE B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1326107244,"SAVOIE, SHANEE, LYNN",4251 ARENDELL ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 262 , 345 ,$#,,
MEDICAID DIRECT,1881776771,LEXINGTON INTERNAL MEDICINE CLINIC,LEXINGTON INTERNAL MEDICINE CLINIC PA,901 E CENTER ST   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1326108887,"ARNOLD, TERRY, VINCENT",706 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 148 , 148 ,$#,,
MEDICAID DIRECT,1881776771,LEXINGTON INTERNAL MEDICINE CLINIC,LEXINGTON INTERNAL MEDICINE CLINIC PA,901 E CENTER ST   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1326108887,"ARNOLD, TERRY, VINCENT",901 E CENTER ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 136 , 592 , 596 ," $17,296.00 ",,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326115171,"LARSON, MICHELE, CHERRY",100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 34 , 76 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1326115650,"MISTRI, KAMLESH, KRISHNA",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 34 , 70 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326115650,"MISTRI, KAMLESH, KRISHNA",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 86 , 114 , 254 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326115650,"MISTRI, KAMLESH, KRISHNA",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 56 , 120 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326116047,"URBINATI, KRISTIN, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326116286,"KUMAR, ARCHANA",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326116286,"KUMAR, ARCHANA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326116286,"KUMAR, ARCHANA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326116286,"KUMAR, ARCHANA",700 WALTER REED DR   GREENSBORO NC,041,Guilford,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1326116617,ALPHABET SOUP INC,,310 LLOYD ST   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1326116617,ALPHABET SOUP INC,310 LLOYD ST   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326118068,"CHANG, PATRICIA, PAT-YUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 70 , 116 , 159 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1326118589,"CULLER, SHANNON, LEIGH",5718 W GATE CITY BLVD   GREENSBORO NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326118589,"CULLER, SHANNON, LEIGH",5718 W GATE CITY BLVD   GREENSBORO NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326118589,"CULLER, SHANNON, LEIGH",5718 W GATE CITY BLVD   GREENSBORO NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326118589,"CULLER, SHANNON, LEIGH",5718 W GATE CITY BLVD   GREENSBORO NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326118985,"CHARLES, CINDY, MCCOY",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326118985,"CHARLES, CINDY, MCCOY",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1316603301,DR CAMERON & ASSOCIATES OF DURHAM P,,5111 NC HIGHWAY 55 STE 102 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1326120239,"DAVIS, ERIC",5111 NC HIGHWAY 55 STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 42 , 132 ,$#,,
MEDICAID DIRECT,1578659801,ERIC DAVIS DDS PLLC,ERIC DAVIS DDS PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1326120239,"DAVIS, ERIC",5111 NC HIGHWAY 55 STE 102 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1225794217,DR CAMERON & ASSOCIATES OF HILLSBO,ERIC DAVIS LLC,510 HAMPTON PT STE 100 HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1326120239,"DAVIS, ERIC",510 HAMPTON PT STE 100 HILLSBOROUGH NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 613 ," 1,094 "," 3,591 "," $175,447.41 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326122219,"MCCALLUM, REX, MONROE",40 DUKE MEDICINE CIR # 1J DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 19 , 29 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326122219,"MCCALLUM, REX, MONROE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 18 , 21 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326122219,"MCCALLUM, REX, MONROE",718 RUTHERFORD ST   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 15 , 20 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326122219,"MCCALLUM, REX, MONROE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326122235,"DESJARDINS, ANNICK",ERWIN RD DUKE HOSPITAL   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326122235,"DESJARDINS, ANNICK",ERWIN RD DUKE HOSPITAL   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326122235,"DESJARDINS, ANNICK",ERWIN RD DUKE HOSPITAL   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,#,#,#,$#,,
MEDICAID DIRECT,1326123076,THE BRADFORD VILLAGE OF KERNERSVILL,THE BRADFORD VILLAGE OF KERNERSVILLE EAST LLC,413 N MAIN ST   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326123076,THE BRADFORD VILLAGE OF KERNERSVILL,413 N MAIN ST   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 9,110 "," 9,110 "," $806,519.85 ",,
MEDICAID DIRECT,1720292261,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1326129388,"DIMITROVA, GERGANA, DAMIANOVA",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 30 , 49 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326130113,"PIERCE, PATRICIA, ANN",138 DUBLIN SQUARE RD STE B ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1326130824,"GUNTHER, ROBERT, CARL",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 30 , 62 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326131053,"KREMPASKY, MICAH, HOOPER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326131053,"KREMPASKY, MICAH, HOOPER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326131509,"SEARS, JUDITH, DIROCCO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 33 , 42 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326131509,"SEARS, JUDITH, DIROCCO",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326131509,"SEARS, JUDITH, DIROCCO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1326131509,"SEARS, JUDITH, DIROCCO",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1578656773,COASTAL CAROLINA SURGICAL ASSOCIATE,~,1411 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326131525,"WEATHERFORD, DAVID, ALLEN",1411 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 207 , 496 , 726 ," $36,160.58 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326132671,"ADAMSON, WILLIAM, TALBOT",801 6TH ST S   ST PETERSBURG FL,102,Out of State > 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326135872,"SABOL, MICHAEL, EDWARD",1927 3RD. AVENUE LN SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 66 , 130 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326135872,"SABOL, MICHAEL, EDWARD",315 19TH ST SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 50 , 101 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326136904,"HENDERSON, SHAW, CARTIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 38 , 38 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326136904,"HENDERSON, SHAW, CARTIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 18 , 19 ,$#,,
MEDICAID DIRECT,1326137530,COUNTY OF NASH,,2420 PROFESSIONAL DR   ROCKY MOUNT NC,064,Nash,3416L0300X,Transportation Services,Ambulance,Land Transport,1326137530,COUNTY OF NASH,2420 PROFESSIONAL DR   ROCKY MOUNT NC,064,Nash,3416L0300X,Transportation Services,Ambulance,Land Transport, 232 , 442 , 881 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326137811,"BELT, THOMAS, JAMES",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 47 , 49 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1326137811,"BELT, THOMAS, JAMES",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 34 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326137811,"BELT, THOMAS, JAMES",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1326137811,"BELT, THOMAS, JAMES",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1427097823,GOLDSBORO FAMILY PHYSICIANS PA,~,1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326138496,"CLARKE, DONALD, KEITH",1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 63 , 122 ,$#,,
MEDICAID DIRECT,1427097823,GOLDSBORO FAMILY PHYSICIANS PA,~,1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1326138496,"CLARKE, DONALD, KEITH",1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326138553,"MARROQUIN, CARLOS, ERNESTO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1326140823,"MANGA, ROBERT, KEITH",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice, 274 , 532 ," 1,314 "," $81,219.86 ",,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1326140823,"MANGA, ROBERT, KEITH",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1326141011,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06408,102 ROCK BARN RD NE   CONOVER NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1326141011,NORTH CAROLINA CVS PHARMACY LLC,102 ROCK BARN RD NE   CONOVER NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1326141011,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06408,102 ROCK BARN RD NE   CONOVER NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1326141011,NORTH CAROLINA CVS PHARMACY LLC,102 ROCK BARN RD NE   CONOVER NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1326141011,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06408,102 ROCK BARN RD NE   CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326141011,NORTH CAROLINA CVS PHARMACY LLC,102 ROCK BARN RD NE   CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 15 , 33 ,$#,,
MEDICAID DIRECT,1326141029,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03987,10775 NC 55 HWY PAMLICO SQ GRANTSBORO NC,069,Pamlico,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1326141029,NORTH CAROLINA CVS PHARMACY LLC,10775 NC 55 HWY PAMLICO SQ GRANTSBORO NC,069,Pamlico,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1326141029,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03987,10775 NC 55 HWY PAMLICO SQ GRANTSBORO NC,069,Pamlico,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326141029,NORTH CAROLINA CVS PHARMACY LLC,10775 NC 55 HWY PAMLICO SQ GRANTSBORO NC,069,Pamlico,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1326141185,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04165,371 ASHEVILLE HWY   BREVARD NC,088,Transylvania,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1326141185,NORTH CAROLINA CVS PHARMACY LLC,371 ASHEVILLE HWY   BREVARD NC,088,Transylvania,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1326141185,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04165,371 ASHEVILLE HWY   BREVARD NC,088,Transylvania,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1326141185,NORTH CAROLINA CVS PHARMACY LLC,371 ASHEVILLE HWY   BREVARD NC,088,Transylvania,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326141656,"HAILE, SUSAN, LYNAM",1225 HARDING PL   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326141656,"HAILE, SUSAN, LYNAM",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326141656,"HAILE, SUSAN, LYNAM",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326142019,"ASHKIN, EVAN, ARTHUR",322 MAIN ST   PROSPECT HILL NC,017,Caswell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326142019,"ASHKIN, EVAN, ARTHUR",322 MAIN ST   PROSPECT HILL NC,017,Caswell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326142019,"ASHKIN, EVAN, ARTHUR",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 20 , 30 ,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326142019,"ASHKIN, EVAN, ARTHUR",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326142019,"ASHKIN, EVAN, ARTHUR",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326144080,"MOGABGAB, EDWARD, RODDY",447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1326146127,"TOLLEY, JODI, BELL",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1326146127,"TOLLEY, JODI, BELL",4810 S CROATAN HWY STE 100 NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1326146127,"TOLLEY, JODI, BELL",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 30 ,$#,,
MEDICAID DIRECT,1962833343,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,375 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1326149469,"JENNINGS, WILLIAM, THOMAS",375 SUNSET AVE   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326149469,"JENNINGS, WILLIAM, THOMAS",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326149469,"JENNINGS, WILLIAM, THOMAS",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265195523,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - LELAND,1215 W GATE DR STE 180 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326149485,"MCRANIE, CORIE",1215 W GATE DR STE 180 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326150301,"PATHAN, MUHAMMAD, HANIF",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1326150301,"PATHAN, MUHAMMAD, HANIF",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326150715,"BOYD, KATHLEEN, OCONNOR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326150962,"TOWNSEND, TAYLOR, FRANKLIN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 71 , 76 , 272 ," $15,495.72 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1326150962,"TOWNSEND, TAYLOR, FRANKLIN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326150962,"TOWNSEND, TAYLOR, FRANKLIN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 267 , 307 , 910 ," $49,426.38 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326150962,"TOWNSEND, TAYLOR, FRANKLIN",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1326150962,"TOWNSEND, TAYLOR, FRANKLIN",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 61 , 70 , 195 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326150962,"TOWNSEND, TAYLOR, FRANKLIN",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326151424,"SYMANSKI, JOHN, DAVID",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326154824,"HUMPHRIES, CHARLES, THOMAS",13557 STEELECROFT PKWY STE 2200 CHARLOTTE NC,060,Mecklenburg,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy,#, 51 , 51 ,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326154824,"HUMPHRIES, CHARLES, THOMAS",10310 MALLARD CREEK RD STE A CHARLOTTE NC,060,Mecklenburg,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy,#,#,#,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326154824,"HUMPHRIES, CHARLES, THOMAS",10310 MALLARD CREEK RD STE A CHARLOTTE NC,060,Mecklenburg,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 17 , 71 , 72 ,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326154824,"HUMPHRIES, CHARLES, THOMAS",8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 24 , 72 , 75 ,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326154824,"HUMPHRIES, CHARLES, THOMAS",8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 53 , 276 , 296 ,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326156944,"MCNEELY, RHONDA, ANNETTE",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326156944,"MCNEELY, RHONDA, ANNETTE",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 17 , 18 ,$#,,
MEDICAID DIRECT,1437189784,WESTERN NC COMMUNITY HEALTH SVCS,WESTERN NC COMMUNITY HEALTH SERVICES INC,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326156977,"BERKHEIMER, HEATHER, ANNE",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 214 , 312 , 897 ," $41,081.98 ",,
MEDICAID DIRECT,1124306675,LL BALLANCE DDS PLLC,CAROLINA WEST DENTAL,205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326156977,"BERKHEIMER, HEATHER, ANNE",205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice," 2,029 "," 2,582 "," 9,310 "," $389,726.19 ",,
MEDICAID DIRECT,1326157215,FAMILY EYE CARE OF CAROLINAS,~,1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,193400000X,Group,Single Specialty,,1326157215,FAMILY EYE CARE OF CAROLINAS,1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,193400000X,Group,Single Specialty,, 250 , 261 , 505 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326157991,"WARD, ROBERT, JEFFREY",757 BRYANT ST   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 80 , 129 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1326158361,"STEPHENS, ASHLEY, MEGAN LINDSAY",808 N WASHINGTON ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 90 , 105 , 105 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326158494,"KASHEFSKY, HOWARD, EVAN",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326158494,"KASHEFSKY, HOWARD, EVAN",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326158494,"KASHEFSKY, HOWARD, EVAN",1104 COLLEGE ST   OXFORD NC,039,Granville,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326158494,"KASHEFSKY, HOWARD, EVAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 68 , 116 , 177 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326159781,"HANSON, JILL, SHREVE",6329 UNITY ST STE A THOMASVILLE NC,076,Randolph,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326159856,"LOWERY, JAMES, A",1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 98 , 127 ,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326159856,"LOWERY, JAMES, A",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 19 , 33 ,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326159856,"LOWERY, JAMES, A",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326160649,"DURHAM, MEGAN, ELIZABETH",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 83 , 172 ,$#,,
MEDICAID DIRECT,1326162363,MARY MANOR,~,501 BUNN ST   ZEBULON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326162363,MARY MANOR,501 BUNN ST   ZEBULON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1326162363,MARY MANOR,~,228 GAIL RIDGE LN   WENDELL NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326162363,MARY MANOR,228 GAIL RIDGE LN   WENDELL NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 650 , 650 ," $40,894.68 ",,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1326164195,"THOMAS, SHERI, LYNN",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 14 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326165663,"BROWN, DORIS, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 49 , 153 , 211 ,$#,,
MEDICAID DIRECT,1265904064,WHEELCHAIR CLINIC INC,,4307 WESTERN PARK PL STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326166034,"BEAUVAIS, DANIELA, LISEL",6050 ROBERTA RD   HARRISBURG NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1326168204,"SHANK, RICHARD, ANTHONY",RICHARD A SHANK OPTOMETRY,3240 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,1326168204,"SHANK, RICHARD, ANTHONY",3240 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 514 , 519 , 995 ," $15,572.60 ",,
MEDICAID DIRECT,1326171893,PEN DU REST HOME,PEN DU REST HOME,685 NC HWY 50   WALLACE NC,071,Pender,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326171893,PEN DU REST HOME,685 NC HWY 50   WALLACE NC,071,Pender,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 526 , 526 ," $37,095.05 ",,
MEDICAID DIRECT,1720177140,COUNTY OF DAVIE OFFICE OF FINANCE A,DAVIE COUNTY HEALTH DEPARTMENT,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1326175738,"PIRKLE, STEPHANIE, SPAULDING",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 78 , 206 ," $10,683.56 ",,
MEDICAID DIRECT,1073148581,AMPUTATION PREVENTION CENTER OF NC,VASCULAR SOLUTIONS OF NORTH CAROLINA,1000 CRESCENT GRN STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1326178302,"NADOUR, ALAN, MUNZER",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 67 , 69 ,$#,,
MEDICAID DIRECT,1326178435,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,564 W MCLEAN ST STE A SAINT PAULS NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326178435,MEDICAL SERVICES OF AMERICA INC,564 W MCLEAN ST STE A SAINT PAULS NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1811412562,SNOW & SNOW DDS PLLC,~,5306 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326178518,"LOPEZ, MANUEL",5306 SOUTH BLVD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 2,780 "," 5,917 "," 27,570 "," $909,216.92 ",,
MEDICAID DIRECT,1326178625,BEVERLY RUCKER FAMILYCARE HOME,Beverly Rucker Familycare Home 8,6878 NC HIGHWAY 150   REIDSVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326178625,BEVERLY RUCKER FAMILYCARE HOME,6878 NC HIGHWAY 150   REIDSVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 328 , 328 ," $20,977.71 ",,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326184870,"LIN, CHRISTOPHER",1110 SE CARY PKWY STE 103 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 32 , 58 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1326184870,"LIN, CHRISTOPHER",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1326184870,"LIN, CHRISTOPHER",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326184870,"LIN, CHRISTOPHER",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1326184870,"LIN, CHRISTOPHER",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326187733,"KEEL, LISA, SELBY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326189663,"SCHRODER, DEREK, QUENTIN",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326189663,"SCHRODER, DEREK, QUENTIN",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013298926,MATTHEWS SURGERY CENTER LLC,MATTHEWS SURGERY CENTER LLC,710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1326190232,"FOSNAUGH, ADAM, WARREN",703 COMFORT LN   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326190232,"FOSNAUGH, ADAM, WARREN",703 COMFORT LN   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 138 , 225 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326190232,"FOSNAUGH, ADAM, WARREN",600 HOSPITAL DR   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326190232,"FOSNAUGH, ADAM, WARREN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326190364,"PHELPS, DANIEL, DEAN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326192642,"GUSTAFSON, KATHRYN, ELLEN",3000 ERWIN RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326192642,"GUSTAFSON, KATHRYN, ELLEN",2100 ERWIN RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1326195504,"SHIPLEY, JAMES, ROBERT",367 S ANDY GRIFFITH PKWY   MOUNT AIRY NC,086,Surry,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 56 , 76 , 146 ,$#,,
MEDICAID DIRECT,1326196031,INTERIM HEALTHCARE OF THE EASTERN C,~,210 MCKOY ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1326196031,INTERIM HEALTHCARE OF THE EASTERN C,210 MCKOY ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 1,934 "," 1,934 "," $121,813.44 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326198672,"UPP, JUSTIN, JOHN",752 HARTNESS RD   STATESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 72 , 72 , 81 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326198672,"UPP, JUSTIN, JOHN",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326198730,"LAYMON, ELIZABETH, EVANS",9104 MARKET ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326198730,"LAYMON, ELIZABETH, EVANS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1326198805,MITCHELL COUNTY SCHOOLS,~,72 LEDGER SCHOOL RD   BAKERSVILLE NC,061,Mitchell,251300000X,Agencies,Local Education Agency (LEA),,1326198805,MITCHELL COUNTY SCHOOLS,72 LEDGER SCHOOL RD   BAKERSVILLE NC,061,Mitchell,251300000X,Agencies,Local Education Agency (LEA),, 89 ," 2,160 "," 2,236 "," $89,711.81 ",,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1326200262,"HERNANDEZ, MARIE, MOLINA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1326200262,"HERNANDEZ, MARIE, MOLINA",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1326200262,"HERNANDEZ, MARIE, MOLINA",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1326200262,"HERNANDEZ, MARIE, MOLINA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 26 , 26 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326200262,"HERNANDEZ, MARIE, MOLINA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 106 , 106 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326200551,"OZKOK, DERYA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326200551,"OZKOK, DERYA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 61 , 61 ,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326200718,"LECHMAN, MICHELLE",1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326200825,"CHAUDHARY, DIPENDRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326200825,"CHAUDHARY, DIPENDRA",239 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 40 , 86 , 86 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1326201443,"BHAVSAR, HITESHRI, SURESH",401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326201443,"BHAVSAR, HITESHRI, SURESH",401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326201724,"ARIF, SANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326201724,"ARIF, SANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 18 , 46 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326201724,"ARIF, SANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,7825 BALLANTYNE COMMONS PKWY STE 210   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326205675,"OWENS, DENISE, IRENE",7825 BALLANTYNE COMMONS PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326208117,"HICKS, JACQUELINE, MICHELE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1326208752,"GRATTON, LAURA, DANIELLE",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 141 , 417 ," $10,366.91 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",1991 FORDHAM DR   FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 13 , 14 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 149 , 243 , 260 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 19 , 28 , 74 ,$#,,
MEDICAID DIRECT,1942532239,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Specialty of Greensboro,,,Unknown,193200000X,Group,Multi-Specialty,,1326208950,"SPECTOR, ZEBULON, ZACHARY",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326209776,"LIN, CHRISTINE, SHAN SHAN",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 40 , 36 , 49 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326209933,"SCHOPBACH, SARAH, JANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 22 , 26 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326209933,"SCHOPBACH, SARAH, JANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1033584917,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF ROWAN SALISBURY,20808 N MAIN ST   CORNELIUS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326212986,"WILLIAMS, AERIK, ANTHONY",20808 N MAIN ST STE 102 CORNELIUS NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1033584917,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF ROWAN SALISBURY,420 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1326212986,"WILLIAMS, AERIK, ANTHONY",420 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 54 , 181 , 233 ,$#,,
MEDICAID DIRECT,1639125271,VANN-VIRGINIA CENTER FOR ORTHOPAEDI,ATLANTIC ORTHOPAEDIC SPECIALISTS,1975 GLENN MITCHELL DR STE 200B VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326215518,"MOORE, BLAKE, ELLINGTON",1975 GLENN MITCHELL DR STE 200 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326218702,"VOCI, GINA, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1326220443,LUMBERTON RESCUE AND EMERGENCY MEDI,~,2391 N ROBERTS AVE   LUMBERTON NC,078,Robeson,3416L0300X,Transportation Services,Ambulance,Land Transport,1326220443,LUMBERTON RESCUE AND EMERGENCY MEDI,2391 N ROBERTS AVE   LUMBERTON NC,078,Robeson,3416L0300X,Transportation Services,Ambulance,Land Transport, 248 , 343 , 635 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326223728,"AMOO, FRANCIS, KOFI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326223728,"AMOO, FRANCIS, KOFI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 43 , 43 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326223728,"AMOO, FRANCIS, KOFI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326223728,"AMOO, FRANCIS, KOFI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 71 , 118 , 273 ," $17,662.38 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 47 , 67 , 163 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224387,"ULRICH, JAN, NIKLAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224908,"O BRIEN, CARA, LOUISE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224908,"O BRIEN, CARA, LOUISE",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 65 , 65 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326224908,"O BRIEN, CARA, LOUISE",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558776997,ONSLOW AMBULATORY SERVICES INC,ONSLOW SURGICAL CLINIC,255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326227448,"SAFLEY, TRAVIS, LAWSON",255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558776997,ONSLOW AMBULATORY SERVICES INC,ONSLOW SURGICAL CLINIC,255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326227448,"SAFLEY, TRAVIS, LAWSON",255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 58 , 89 , 111 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326228214,"DOROTAN-GUEVARA, MARIA MALAYA, CASANOVA",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 64 , 127 ," $11,649.56 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326228214,"DOROTAN-GUEVARA, MARIA MALAYA, CASANOVA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326228214,"DOROTAN-GUEVARA, MARIA MALAYA, CASANOVA",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 17 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326229931,"SINGER, MEREDITH, TIVONA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326229931,"SINGER, MEREDITH, TIVONA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326231481,"SURATWALA, DHARMESHKUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080S0012X,Allopathic & Osteopathic Physicians,Pediatrics,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326231481,"SURATWALA, DHARMESHKUMAR",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080S0012X,Allopathic & Osteopathic Physicians,Pediatrics,Sleep Medicine, 67 , 83 , 83 ," $12,755.37 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1326232570,"ROQUES-DAVIS, REBECCA, CLAIRE",600 HOSPITAL DR STE 10B CLYDE NC,044,Haywood,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 28 , 65 , 65 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1326232570,"ROQUES-DAVIS, REBECCA, CLAIRE",600 HOSPITAL DR STE 10B CLYDE NC,044,Haywood,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 37 , 37 ,$#,,
MEDICAID DIRECT,1902801244,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326233990,"MCDONALD, MICHAEL, JAMES",1677 WESTBROOK PLAZA DR STE 190 WINSTON SALEM NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1629788476,BIONIC PROSTHETICS AND ORTHOTICS GR,,1673 WESTBROOK PLAZA DR STE 230 WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326233990,"MCDONALD, MICHAEL, JAMES",1677 WESTBROOK PLAZA DR STE 190 WINSTON SALEM NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1912340944,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1326234600,"NAKKALA, KIRAN, REDDY",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326234600,"NAKKALA, KIRAN, REDDY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 17 , 18 ,$#,,
MEDICAID DIRECT,1912340944,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1326234600,"NAKKALA, KIRAN, REDDY",3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326234600,"NAKKALA, KIRAN, REDDY",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 50 , 58 , 61 ,$#,,
MEDICAID DIRECT,1700287869,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY GASTROENTEROLOGY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326234600,"NAKKALA, KIRAN, REDDY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 18 , 34 ,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326234600,"NAKKALA, KIRAN, REDDY",3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 14 , 24 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326235508,"AVILES, CESAR, GARCIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 17 , 48 , 68 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 22 , 30 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 14 , 27 , 28 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326235607,"ISHIZAWAR, DAVID, CHANG",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326239559,"REDD, MICHAEL, ALAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326240219,"POKHAREL, SAJAL, SHARMA",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 70 , 72 , 80 ,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326241126,"CRANE, ANDREW, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 34 , 63 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326241126,"CRANE, ANDREW, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326241126,"CRANE, ANDREW, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326241126,"CRANE, ANDREW, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 49 ,$#,,
MEDICAID DIRECT,1992284327,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH BREAST IMAGING CENTER LANGTREE,106 LANGTREE VILLAGE DR STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326241126,"CRANE, ANDREW, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326242173,"LODESERTO, FRANK, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 29 , 61 , 67 ,$#,,
MEDICAID DIRECT,1083002232,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PEDIATRIC INPATIENT SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326242173,"LODESERTO, FRANK, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1902124647,DOCTORS EXPRESS PLLC,~,101 MAYNARD CROSSING CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326242397,"PESANTE, MAISHA, LAILA",2813 WARREN ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245585009,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE WAXHAW FAMILY MEDICINE,2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1326242611,"VERRILL, MATTHEW, MILLIKAN",2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 107 , 172 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 46 , 46 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 26 , 73 , 73 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326244658,"GIZDARSKI, VESELIN, STOYANOV",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 28 , 28 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326244898,"GATTO, PAMELA, DIANE",121 COUNTRY LN   MOCKSVILLE NC,030,Davie,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1326245846,"HIGGINS, STEVEN, PATRICK",3008 PICKETT RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 53 , 74 , 111 ,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1326245846,"HIGGINS, STEVEN, PATRICK",203 E INDUSTRY DR STE A OXFORD NC,039,Granville,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1326246950,KIDS INTERACTIVE DEVELOPMENTAL SERV,KIDS INTERACTIVE DEVELOPMENTAL SERVICES,2010 STONEY CREEK DR NW   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1326246950,KIDS INTERACTIVE DEVELOPMENTAL SERV,2010 STONEY CREEK DR NW   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1326246950,KIDS INTERACTIVE DEVELOPMENTAL SERV,KIDS INTERACTIVE DEVELOPMENTAL SERVICES,2010 STONEY CREEK DR NW   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1326246950,KIDS INTERACTIVE DEVELOPMENTAL SERV,2010 STONEY CREEK DR NW   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,, 166 ," 3,322 "," 3,322 "," $211,005.00 ",,
MEDICAID DIRECT,1023050630,COURTVIEW OB GYN PA,COURTVIEW OB GYN PA,706 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326248345,"HARTWELL, ERIN, KATHLEEN",706 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 35 , 53 , 78 ,$#,,
MEDICAID DIRECT,1326248550,STALLS MEDICAL INC,STALLS MEDICAL INC,3604 MARINE DR   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326248550,STALLS MEDICAL INC,3604 MARINE DR   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 64 , 190 , 590 ," $40,798.77 ",,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1326249400,"SUTTER, JENNIFER, AUER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326249400,"SUTTER, JENNIFER, AUER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 35 , 45 , 64 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326249400,"SUTTER, JENNIFER, AUER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326249400,"SUTTER, JENNIFER, AUER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1326249400,"SUTTER, JENNIFER, AUER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326249400,"SUTTER, JENNIFER, AUER",2150 HERBERT CT   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1326250457,"HAWKINS, ERIC, RAY",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326250457,"HAWKINS, ERIC, RAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 77 , 77 , 124 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326253162,"WILDS, CAROLINE, LEE",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326253162,"WILDS, CAROLINE, LEE",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 42 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326253774,"EVERTS, SHELLEY, JANE",1401 MATTHEWS TOWNSHIP PKWY STE 320 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326253774,"EVERTS, SHELLEY, JANE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1326254053,"BARNETT, MICHAEL, DAVID",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275524621,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1326254053,"BARNETT, MICHAEL, DAVID",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1326254053,"BARNETT, MICHAEL, DAVID",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326257023,"MORTON, MICHAEL, ANTHONY",MIKE MORTON DDS PLLC,313 S MAIN ST STE 120 KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,1326257023,"MORTON, MICHAEL, ANTHONY",313 S MAIN ST STE 120 KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 278 , 654 ," 1,942 "," $87,888.20 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326259425,"CUMMINGS, KRIS, BAKER",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326259425,"CUMMINGS, KRIS, BAKER",2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326259425,"CUMMINGS, KRIS, BAKER",2460 EMERALD PL STE A GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326259433,"ALLAREDDY, VEERAJALANDHAR",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 11 , 13 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326259433,"ALLAREDDY, VEERAJALANDHAR",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326260951,"SCHERER, CHRISTINE, THERESA",1141 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 17 , 26 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326260951,"SCHERER, CHRISTINE, THERESA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326260951,"SCHERER, CHRISTINE, THERESA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326260951,"SCHERER, CHRISTINE, THERESA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 121 , 188 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326264425,"YIRENKYI, EMMANUEL, AWUKU",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 47 , 170 , 170 ,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,220 PAGE RD STE 300 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1326264839,"ARNOCZY, GRETCHEN, SHAUGHNESSY",220 PAGE RD N STE 300 PINEHURST NC,063,Moore,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1326264839,"ARNOCZY, GRETCHEN, SHAUGHNESSY",35 MEMORIAL DR   PINEHURST NC,063,Moore,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 41 , 56 , 63 ,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1326264839,"ARNOCZY, GRETCHEN, SHAUGHNESSY",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 45 , 103 , 108 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326266776,"FOX, MELISSA, DAWN",300 MARKET ST   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 17 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326267170,"TUCHMAN, SASCHA, ALEXANDER",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 14 , 16 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326267170,"TUCHMAN, SASCHA, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 16 , 56 , 58 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326269226,"GAILLARD, JOHN, PALMER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 87 , 114 ," $11,835.67 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326269671,"THAN, KHOI, DUC",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326270430,"WILLIAMSON, ERIN, DOUGLAS",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 114 , 226 , 251 ," $13,845.66 ",,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1326270430,"WILLIAMSON, ERIN, DOUGLAS",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326272139,"SURRATT, ANIKA, LATONYA",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1326272360,GENTLE TOUCH HOME CARE LLC,GENTLE TOUCH HOME CARE,515 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1326272360,GENTLE TOUCH HOME CARE LLC,515 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 5,480 "," 5,486 "," $434,597.24 ",,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326272592,"DOMFEH, AKOSUA, BENEFAH",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326272592,"DOMFEH, AKOSUA, BENEFAH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326272592,"DOMFEH, AKOSUA, BENEFAH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 32 , 34 , 54 ,$#,,
MEDICAID DIRECT,1528479185,BRIE FOLKNER MD PC,,1158 GREENWOOD RD   SPRUCE PINE NC,061,Mitchell,193400000X,Group,Single Specialty,,1326272824,"FOLKNER, BRIE, MICHELE",1158 GREENWOOD RD   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 52 , 68 ,$#,,
MEDICAID DIRECT,1326273111,PAULS LOVING CARE INC,,322 WALKER AVE   GRAHAM NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326273111,PAULS LOVING CARE INC,322 WALKER AVE   GRAHAM NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 74 , 74 ," $28,598.73 ",,
MEDICAID DIRECT,1326274929,"HENRY, JOSHUA, MICHAEL",~,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1326274929,"HENRY, JOSHUA, MICHAEL",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1326276437,"JEANMENNE, ANTHONY, RAOUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326276437,"JEANMENNE, ANTHONY, RAOUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 111 , 116 , 169 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326276437,"JEANMENNE, ANTHONY, RAOUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326276437,"JEANMENNE, ANTHONY, RAOUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326276437,"JEANMENNE, ANTHONY, RAOUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326276437,"JEANMENNE, ANTHONY, RAOUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912072315,PALMETTO RADIATION ONCOLOGY PA,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1326276551,"CLYBURN-IPOCK, VIRGINIA, LEE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326277369,"VAN, LYDIA, THUY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 54 , 54 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326277369,"VAN, LYDIA, THUY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326277443,"KADAKIA, KUNAL, CHAITANYA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1326277443,"KADAKIA, KUNAL, CHAITANYA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1326277443,"KADAKIA, KUNAL, CHAITANYA",10826 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326277443,"KADAKIA, KUNAL, CHAITANYA",10826 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326277443,"KADAKIA, KUNAL, CHAITANYA",1550 FAULK ST   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1326278029,"HINSON, HEATHER, YATES",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1326278466,"MITCHELL, HEATHER, MONTGOMERY",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 141 , 371 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326278532,"MCCALL, CHAD, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 204 , 264 , 446 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326278532,"MCCALL, CHAD, MICHAEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1326280207,"DEVLIN, JOSEPH, JOHN",JOSEPH JOHN DEVLIN,7016 HARPS MILL RD STE 101 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1326280207,"DEVLIN, JOSEPH, JOHN",7016 HARPS MILL RD STE 101 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 382 ," 2,517 "," 2,731 "," $318,585.11 ",,
MEDICAID DIRECT,1326281148,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,420 S BROADWAY ST STE 102 FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,,1326281148,CNC-ACCESS INC,420 S BROADWAY ST STE 102 FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,357 "," 1,357 "," $92,221.16 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326283334,"WILLIAMS, COURTNEY, HUDSON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326284795,"RESPESS, VICTORIA, MCINTOSH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326284795,"RESPESS, VICTORIA, MCINTOSH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326287780,"KROGEL, PHILENE, MICHELLE",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548497209,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP MARION,2293 SUGAR HILL RD STE C MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1326287780,"KROGEL, PHILENE, MICHELLE",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1467993931,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP-VALDESE,110 HILLTOP ST   CONNELLY SPG NC,012,Burke,193200000X,Group,Multi-Specialty,,1326287780,"KROGEL, PHILENE, MICHELLE",110 HILLTOP ST   CONNELLY SPRINGS NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326287780,"KROGEL, PHILENE, MICHELLE",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 25 , 32 ,$#,,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,1154A E CASWELL ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,1154A E CASWELL ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,#, 436 , 442 ," $63,867.36 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,565 HARPER AVE SW STE B LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,565 HARPER AVE SW STE B LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,#, 69 , 69 ," $11,592.20 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,2025 MORGANTON BLVD SW UNIT A2 LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,2025 MORGANTON BLVD SW UNIT A2 LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,#, 151 , 151 ," $20,836.16 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,4701 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,3217 FRIENDLY RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,2950 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,2950 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 5,527 "," 5,573 "," $648,780.91 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,505 S LAFAYETTE ST STE A SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,505 S LAFAYETTE ST STE A SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,166 "," 1,174 "," $141,234.12 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,100 MEMORY PLZ   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,100 MEMORY PLZ   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,124 "," 2,287 "," $334,415.60 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,809 N LAFAYETTE ST STE G SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,809 N LAFAYETTE ST STE G SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,473 "," 1,473 "," $176,958.36 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,1148 S CHURCH ST   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,1148 S CHURCH ST   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,#, 568 , 713 ," $98,363.84 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,3217 FRIENDLY RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,3217 FRIENDLY RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,372 "," 2,407 "," $351,780.50 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,302 N MAIN ST STE 2 KENANSVILLE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,302 N MAIN ST STE 2 KENANSVILLE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,#, 497 , 617 ," $88,839.76 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,302 N MAIN ST   KENANSVILLE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,302 N MAIN ST   KENANSVILLE NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,#," 1,645 "," 1,874 "," $276,046.88 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,101 N MAIN ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,101 N MAIN ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,#," 1,160 "," 1,194 "," $267,711.38 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,1922 S MARTIN LUTHER KING JR DR STE 27 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,1922 S MARTIN LUTHER KING JR DR STE 27 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 831 , 831 ," $127,025.48 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,20 W 5TH AVE UNIT 4 LEXINGTON NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,20 W 5TH AVE UNIT 4 LEXINGTON NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,857 "," 2,894 "," $378,966.60 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,110 VANDIVER DR   LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,110 VANDIVER DR   LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,, 11 , 951 , 951 ," $172,947.28 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,755 S MAIN ST   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,755 S MAIN ST   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,#," 1,512 "," 1,522 "," $221,258.77 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,2300 N HERRITAGE ST STE C KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,2300 N HERRITAGE ST STE C KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,#," 1,610 "," 1,612 "," $303,501.08 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,1518 S HORNER BLVD   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,1518 S HORNER BLVD   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,#," 2,313 "," 2,313 "," $353,256.84 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,1011 S POLLOCK ST   SELMA NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,1011 S POLLOCK ST   SELMA NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,#, 212 , 212 ," $31,689.32 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,2509 BATTLEGROUND AVE STE C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,2509 BATTLEGROUND AVE STE C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#," 1,396 "," 1,396 "," $197,959.12 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,509 W BROAD ST   DUNN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,509 W BROAD ST   DUNN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 3,219 "," 3,922 "," $532,274.77 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,102 ELIZABETH ST STE C JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,102 ELIZABETH ST STE C JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,#, 202 , 219 ," $44,136.45 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,3705 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,3705 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#," 2,383 "," 2,571 "," $430,959.74 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,621 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,621 E BROAD AVE   ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,#," 1,123 "," 1,491 "," $215,531.48 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,219 W BROAD ST   SAINT PAULS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,219 W BROAD ST   SAINT PAULS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 3,961 "," 4,178 "," $610,149.04 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,227 E 4TH AVE   RED SPRINGS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,227 E 4TH AVE   RED SPRINGS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 4,087 "," 4,168 "," $610,631.80 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,4701 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,4701 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 6,943 "," 6,970 "," $1,153,888.62 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,208 UNION CHAPEL RD STE D PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,208 UNION CHAPEL RD STE D PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,#," 1,634 "," 1,634 "," $246,833.40 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,817 S FAYETTEVILLE ST STE C ASHEBORO NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,817 S FAYETTEVILLE ST STE C ASHEBORO NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 4,341 "," 4,373 "," $692,521.63 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,407B COMMERCE ST   ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,407B COMMERCE ST   ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,801 S MAIN ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,801 S MAIN ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 47 ," 11,670 "," 12,834 "," $1,796,191.19 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,421 WARSAW RD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,421 WARSAW RD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,, 23 ," 5,773 "," 5,773 "," $924,713.59 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,1617 W ROOSEVELT BLVD STE M MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,1617 W ROOSEVELT BLVD STE M MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,732 "," 4,488 "," $777,389.88 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,214 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,214 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 719 , 949 ," $101,719.32 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,727 S BROADWAY ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,727 S BROADWAY ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,,#," 1,707 "," 1,707 "," $297,797.36 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,3358B AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,701 E ASH ST   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,701 E ASH ST   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,701 E ASH ST   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#," 1,438 "," 1,439 "," $260,245.84 ",,
MEDICAID DIRECT,1326288937,A PRIMARY CHOICE INC,~,3358B AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1326288937,A PRIMARY CHOICE INC,3358B AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 5,865 "," 6,783 "," $902,491.99 ",,
MEDICAID DIRECT,1801143805,WILSON COMMUNITY FAMILY PRACTICE,~,110 BRENTWOOD CENTER LN N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1326289034,"BROWN TAFT, JANELLE",110 BRENTWOOD CENTER LN N   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 147 , 794 ," 1,226 "," $24,533.90 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326289893,"OKANE, CHELSEA, HENDRICKS",2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326289893,"OKANE, CHELSEA, HENDRICKS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 37 , 37 ,$#,,
MEDICAID DIRECT,1326291246,WILLA DEAN MCNEILL,JOYFUL LIVING,1951 IRELAND DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326291246,WILLA DEAN MCNEILL,1951 IRELAND DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 395 , 395 ," $56,866.10 ",,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326295973,"FRAZIER, NATALIE, KNOTT",3000 MAPLEWOOD AVE STE 112 WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326295973,"FRAZIER, NATALIE, KNOTT",1704 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326297995,"RUMINJO, ANNE, WANJIRU",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326298365,"GITZINGER, KATHERINE, HUFFSTETLER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1326300617,"CHILDRESS, IRENE, MARIA",336 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 105 , 257 , 257 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1326300617,"CHILDRESS, IRENE, MARIA",211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1326300617,"CHILDRESS, IRENE, MARIA",310 PENSACOLA RD   BURNSVILLE NC,100,Yancey,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 78 , 373 , 373 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1326300617,"CHILDRESS, IRENE, MARIA",306 DEER PARK RD   NEBO NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 116 , 116 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1326300948,"YU, ZHOU",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326300948,"YU, ZHOU",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 141 , 369 , 370 ,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326303538,"LIM, BERNICE, FRANCESCA",3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326304353,"DUGAN, JAMES, PATRICK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326304353,"DUGAN, JAMES, PATRICK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1124773510,NOVANT HEALTH THOMASVILLE MEDICAL C,NOVANT HEALTH CANCER INSTITUTE - FORSYTH HEMATOLOG,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326304353,"DUGAN, JAMES, PATRICK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326304353,"DUGAN, JAMES, PATRICK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 32 , 88 , 130 ,$#,,
MEDICAID DIRECT,1326306259,ALLCARE MEDICAL SUPPLY LLC,~,112 COX AVE   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326306259,ALLCARE MEDICAL SUPPLY LLC,112 COX AVE   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 42 , 267 , 387 ," $61,828.23 ",,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326307828,"ALLAN, JENNIFER, DICKERSON",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326307828,"ALLAN, JENNIFER, DICKERSON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 32 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326307828,"ALLAN, JENNIFER, DICKERSON",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326307828,"ALLAN, JENNIFER, DICKERSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 59 , 60 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326308891,"VARKEY, DAX, THATTACUNNEL",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 54 , 134 , 258 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326308974,"SATA, SUCHITA, SHAH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 37 , 37 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326308974,"SATA, SUCHITA, SHAH",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326308974,"SATA, SUCHITA, SHAH",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 99 , 101 ,$#,,
MEDICAID DIRECT,1326310756,"HALL, EMILY, ALEXANDRA",~,101 RIVERSTONE VIS STE 215 BLUE RIDGE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1326310756,"HALL, EMILY, ALEXANDRA",101 RIVERSTONE VIS STE 215 BLUE RIDGE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376605394,SKIN CANCER AND COSMETIC DERMATOLOG,,136 BATTLEFIELD CROSSING CT   RINGGOLD GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326310756,"HALL, EMILY, ALEXANDRA",101 RIVERSTONE VIS STE 215 BLUE RIDGE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326312612,"WRIGHT, THOMAS, LEE",,571 COX RD   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1326312612,"WRIGHT, THOMAS, LEE",571 COX RD   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 27 ,$#,,
MEDICAID DIRECT,1326312612,"WRIGHT, THOMAS, LEE",,1610 E MARION ST STE 160 SHELBY NC,023,Cleveland,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1326312612,"WRIGHT, THOMAS, LEE",1610 E MARION ST STE 160 SHELBY NC,023,Cleveland,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 11 , 14 , 84 ,$#,,
MEDICAID DIRECT,1326313537,MOUNT EAGLE HEALTH CARE,Mount Eagle Health Care,4025 UNIVERSITY PKWY STE 100 WINSTON SALEM NC,034,Forsyth,251J00000X,Agencies,Nursing Care,,1326313537,MOUNT EAGLE HEALTH CARE,4025 UNIVERSITY PKWY STE 100 WINSTON SALEM NC,034,Forsyth,251J00000X,Agencies,Nursing Care,,#,#,#,$#,,
MEDICAID DIRECT,1326313537,MOUNT EAGLE HEALTH CARE,Mount Eagle Health Care,4025 UNIVERSITY PKWY STE 100 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1326313537,MOUNT EAGLE HEALTH CARE,4025 UNIVERSITY PKWY STE 100 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 127 ," 28,778 "," 29,188 "," $2,611,997.76 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,240 SMITH CHURCH RD STE A ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1326313719,"SMITH, HARRIS, JESSE",240 SMITH CHURCH RD STE A ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326313719,"SMITH, HARRIS, JESSE",240 SMITH CHURCH RD STE A ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326313719,"SMITH, HARRIS, JESSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 123 , 167 , 293 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1326314485,"TROMBLEY, LEAH, LOUISE",2818 NEUSE BLVD   NEW BERN NC,025,Craven,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326314717,"COLLINS, ALISSA, MICHELLE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326314717,"COLLINS, ALISSA, MICHELLE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 16 , 18 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326314717,"COLLINS, ALISSA, MICHELLE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 33 , 49 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326314717,"COLLINS, ALISSA, MICHELLE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326314717,"COLLINS, ALISSA, MICHELLE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326314717,"COLLINS, ALISSA, MICHELLE",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326314717,"COLLINS, ALISSA, MICHELLE",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 21 , 26 , 38 ,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326314808,"FERGUSON, ROBERT, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 17 , 28 ," $11,991.93 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326314808,"FERGUSON, ROBERT, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1326316308,"WATERS, DOUGLAS, LEE",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326316308,"WATERS, DOUGLAS, LEE",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326316308,"WATERS, DOUGLAS, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326316597,"FOX DUNCAN, AMANDA, DAWN",10030 GILEAD RD STE 3 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326317967,"EARLES, JENNIFER, JOHNS",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 30 , 54 , 75 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 96 , 148 , 207 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 13 , 38 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326319278,"RAU, NIKHIEL, BHASKER",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760909832,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,15235 JOHN J DELANEY DR STE H CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326323445,"MORRISON, SHERELLE, MCCOY",6300 E INDEPENDENCE BLVD STE A CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326323445,"MORRISON, SHERELLE, MCCOY",7808 S TRYON ST STE D CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326323445,"MORRISON, SHERELLE, MCCOY",6300 E INDEPENDENCE BLVD STE A CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1326326554,"HOLCOMB, ANNA, BROOKS CHURM",910 W WILLIAMS ST   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326326554,"HOLCOMB, ANNA, BROOKS CHURM",910 W WILLIAMS ST   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558320895,FAMILY MEDICINE ASSOCIATES,,1531 N ASPEN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1326327610,"SEXTON, JEREMY, WADE",1531 N ASPEN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326327610,"SEXTON, JEREMY, WADE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326329509,"WOODEN, TY, LOUIS",TY L WOODEN DMD PLLC,1106 S PARK DR   REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1326329509,"WOODEN, TY, LOUIS",1106 S PARK DR   REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 89 , 205 , 489 ," $25,393.17 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326329798,"FOWLER, MICHELLE, NICOLE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326329798,"FOWLER, MICHELLE, NICOLE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326331208,RICEVILLE VOLUNTEER FIRE DEPARTMENT,RICEVILLE VOLUNTEER FIRE DEPARTMENT INCORPORATED,2251 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport,1326331208,RICEVILLE VOLUNTEER FIRE DEPARTMENT,2251 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport, 49 , 69 , 128 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326331760,"ROEDIGER, LAURIAN, SPENCER",204 MEDSPRING DR   CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326331760,"ROEDIGER, LAURIAN, SPENCER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326331760,"ROEDIGER, LAURIAN, SPENCER",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 16 , 21 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326331760,"ROEDIGER, LAURIAN, SPENCER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326332024,"KIRBY, EDGAR, WILSON",1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 79 , 160 , 408 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326332362,"THOMPSON, JENNIFER, LYNNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RA0201X,Allopathic & Osteopathic Physicians,Internal Medicine,Allergy & Immunology, 51 , 98 , 111 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326333568,"BRINKLEY, GRANT, THOMAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 83 , 91 , 122 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326333568,"BRINKLEY, GRANT, THOMAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 47 , 62 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326333709,"SMITH, IAN, MICAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326333709,"SMITH, IAN, MICAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 39 , 57 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1326333709,"SMITH, IAN, MICAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 27 , 34 ,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326336850,"THAKER, SEEMA, RAHUL",3212 S WILMINGTON ST   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,943 "," 2,406 "," 7,443 "," $457,520.15 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326337064,"KATIRA, KRISTOPHER, MULRAJ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 39 , 47 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326337460,"CRAVANAS, ALEX, JACKSON",10207 CERNY ST STE 210 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326337460,"CRAVANAS, ALEX, JACKSON",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326337460,"CRAVANAS, ALEX, JACKSON",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1326337460,"CRAVANAS, ALEX, JACKSON",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 33 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3808 W GATE CITY BLVD # A1 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326338302,"BROWN, BEVERLY, ANN",3808 W GATE CITY BLVD STE A1 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 109 , 183 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326338302,"BROWN, BEVERLY, ANN",3808 W GATE CITY BLVD STE A1 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326338336,"OLATUNDE, SUNDAY, AYODEJI",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326339102,"HALBE, JEREMY, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326340217,"DAVIS, TRAVONIA, WYNEE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 66 , 66 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11314 US 15 501 N   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1326348160,"MACIAS, LOREN, THOMAS-CHEW",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6840 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326348160,"MACIAS, LOREN, THOMAS-CHEW",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326348418,CONTINUED CARE INC,CONTINUED CARE INC,1140 KILDAIRE FARM RD STE 107 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1326348418,CONTINUED CARE INC,1140 KILDAIRE FARM RD STE 107 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 417 , 417 ," $37,822.80 ",,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1326349325,"WEINGART, GREGORY, STEPHEN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 20 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 94 , 125 , 419 ," $14,611.90 ",,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",1031 WEISS AVE STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 17 ,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 125 , 125 ," 1,753 "," $187,924.26 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 739 , 931 ," 3,500 "," $104,745.87 ",,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 32 , 25 , 133 ,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",510 HICKORY DR STE 102 GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1326350547,"OLSEN, JORDAN, LANDON",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 32 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326351164,"ABID, SABEEN",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 37 , 51 , 67 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 50 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326354184,"LLOYD, ANDREW, VINCENT",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1326355587,BRIGHT HORIZONS HOME CARE LLC,~,325 PAGE RD N STE 12 PINEHURST NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,1326355587,BRIGHT HORIZONS HOME CARE LLC,325 PAGE RD N STE 12 PINEHURST NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,#, 233 , 233 ," $18,255.48 ",,
MEDICAID DIRECT,1326355587,BRIGHT HORIZONS HOME CARE LLC,~,325 PAGE RD N STE 12 PINEHURST NC,063,Moore,251J00000X,Agencies,Nursing Care,,1326355587,BRIGHT HORIZONS HOME CARE LLC,325 PAGE RD N STE 12 PINEHURST NC,063,Moore,251J00000X,Agencies,Nursing Care,, 12 ," 1,938 "," 2,196 "," $1,454,471.98 ",,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326355652,"HART, LORETTA, ANN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 49 , 101 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326355652,"HART, LORETTA, ANN",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326356015,"BARNES, ASHLEY, SMITH",208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 43 , 74 , 129 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326356015,"BARNES, ASHLEY, SMITH",208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 16 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326366048,"RUFFOLO, MICHAEL, ROBERT",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 20 , 40 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1326366048,"RUFFOLO, MICHAEL, ROBERT",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 36 , 60 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326366048,"RUFFOLO, MICHAEL, ROBERT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326366048,"RUFFOLO, MICHAEL, ROBERT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326366048,"RUFFOLO, MICHAEL, ROBERT",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326367574,"ZHANG, JIANDONG",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326367574,"ZHANG, JIANDONG",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326367574,"ZHANG, JIANDONG",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 93 , 119 , 150 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326367574,"ZHANG, JIANDONG",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326367574,"ZHANG, JIANDONG",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326367574,"ZHANG, JIANDONG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 43 , 49 , 69 ,$#,,
MEDICAID DIRECT,1114919206,SKYLAND PROSTHETICS AND ORTHOTICS I,SKYLAND PROSTHETICS AND ORTHOTICS INC,3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326367624,"SCHEPERS, BRADLEY, REGAN",3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 16 , 16 , 55 ,$#,,
MEDICAID DIRECT,1215463450,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PULMONARY MEDICINE,1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 47 , 62 , 88 ,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1215463450,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PULMONARY MEDICINE,1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 61 , 68 ,$#,,
MEDICAID DIRECT,1750197042,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY PULMONARY MEDICINE,1537 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1750197042,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY PULMONARY MEDICINE,1537 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1750197042,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY PULMONARY MEDICINE,1537 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1537 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1215463450,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PULMONARY MEDICINE,1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215463450,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PULMONARY MEDICINE,1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326370222,"SARWAR, HAFIZ, MUHAMMAD YASEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 28 , 35 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326371071,"DICE, MEGAN, HOWERTER",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 46 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326371071,"DICE, MEGAN, HOWERTER",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 44 , 93 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1326371071,"DICE, MEGAN, HOWERTER",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326371071,"DICE, MEGAN, HOWERTER",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1326371071,"DICE, MEGAN, HOWERTER",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326374208,"SULLIVAN, SARAH, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326375841,"PARKER, EMILY, GRACE",3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326375841,"PARKER, EMILY, GRACE",3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326375841,"PARKER, EMILY, GRACE",3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326376047,"MORGAN, GREGORY, TODD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326376047,"MORGAN, GREGORY, TODD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 24 ,$#,,
MEDICAID DIRECT,1326378332,WALGREEN CO,WALGREENS 11396,2200 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1326378332,WALGREEN CO,2200 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326380569,"BERASI, CARL, CHARLES",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 101 , 101 , 115 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326382185,"BELGUM, JENNIFER, SUSAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326382508,"BAKKESTUEN, REBECCA, OLSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 25 , 43 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5214 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326383118,"DELABASTIDE, DAYNE, HAYDEN",5214 MARKET ST STE 101 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 33 , 83 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326383118,"DELABASTIDE, DAYNE, HAYDEN",11491 US HIGHWAY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,202 VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326383118,"DELABASTIDE, DAYNE, HAYDEN",202 VILLAGE RD NE   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 30 , 55 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326383423,"REIBOLD, GRETCHEN",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 28 , 96 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,10 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1326383423,"REIBOLD, GRETCHEN",10 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 83 , 209 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1326383423,"REIBOLD, GRETCHEN",186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790739571,"WILLIAM D HUNTER MD PA, WILLIAM",~,2555 COURT DR STE 400 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326390311,"WILKINSON, MEGAN, HODGE",2555 COURT DR STE 400 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 81 , 99 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1326393018,"WILLIAMS, KATHERINE, AMES",1506 E FRANKLIN ST STE 104 CHAPEL HILL NC,068,Orange,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 83 , 229 , 447 ,$#,,
MEDICAID DIRECT,1033546403,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS,301 MEDICAL PARK DR STE 202B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1326393273,"MITTAL, SHRUTI",301 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 24 ,$#,,
MEDICAID DIRECT,1942637319,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS OF THE CAROLIN,2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326393273,"MITTAL, SHRUTI",2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 26 , 48 ,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326399809,"WOODCOCK, JACQUELINE, NICOLE",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1326400326,"WALLEN, ANDRIA, NANETTE",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1154196020,FD BILLING LLC,WAVERLY ORAL SURGERY,11840 SOUTHMORE DR STE 150 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326400789,"TAYLOR, COREY, ALAN",11840 SOUTHMORE DR STE 150 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 215 , 272 ," 1,597 "," $173,278.66 ",,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326400839,"ISENHOUR, JANIE, OGLE",2754 NC HIGHWAY 68 S STE 111 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326400839,"ISENHOUR, JANIE, OGLE",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 47 , 66 , 132 ,$#,,
MEDICAID DIRECT,1700446770,WEAVERVILLE PHYSICAL THERAPY AND WE,BIG IVY PHYSICAL THERAPY AND WELLNESS,3 GARRISON RD STE 101 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326401589,"POWER, CHRISTOPHER, MICHAEL",3 GARRISON RD ST 101 WEAVERVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 70 , 154 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326402082,"KHANNA, OMADITYA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 39 , 85 , 115 ," $16,517.65 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326402496,"NIEHUUS, RACHEL, MARIE",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 88 , 107 ,$#,,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1326405994,"DIGGS, EMILY, CAMILLE",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 89 , 99 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1326405994,"DIGGS, EMILY, CAMILLE",2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 29 , 30 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,730 MALCOLM BLVD STE 220 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1326405994,"DIGGS, EMILY, CAMILLE",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 90 , 95 ,$#,,
MEDICAID DIRECT,1902069693,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE DIGESTIVE HEALTH,2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326405994,"DIGGS, EMILY, CAMILLE",2209 S STERLING ST STE 200 MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 57 , 57 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1326405994,"DIGGS, EMILY, CAMILLE",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1326406083,"LORD, MATTHEW, STUART",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326406083,"LORD, MATTHEW, STUART",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326406083,"LORD, MATTHEW, STUART",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 34 , 35 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326406083,"LORD, MATTHEW, STUART",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,705 SUMMIT CROSSING PL STE 150B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326407404,"GREENE, DONALD, SCOTT",705 SUMMIT CROSSING PL STE 150B GASTONIA NC,036,Gaston,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1558638676,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PULMONARY & CRITICAL CARE SEACOAST,115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326408386,"LARA, SARA, MOYER",3980 HIGHWAY 9 E STE 340 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 27 ,$#,,
MEDICAID DIRECT,1326408386,"LARA, SARA, MOYER",,3980 HIGHWAY 9 E STE 340 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1326408386,"LARA, SARA, MOYER",3980 HIGHWAY 9 E STE 340 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326410770,"RASHID, LUCY, NEAL",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326410770,"RASHID, LUCY, NEAL",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 24 , 41 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326410770,"RASHID, LUCY, NEAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1598135188,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH TRANSITION CLINIC,1237 HARDING PL # 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326410770,"RASHID, LUCY, NEAL",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326410770,"RASHID, LUCY, NEAL",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326414137,"FAW-SEVEREIDE, TAMMY, MCCOY",10512 PARK RD STE 101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1326418559,"WILLIAMS, AMANDA, JOYNER",4923 S CROATAN HWY   NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1326418559,"WILLIAMS, AMANDA, JOYNER",4923 S CROATAN HWY   NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 37 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1326418559,"WILLIAMS, AMANDA, JOYNER",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1326418559,"WILLIAMS, AMANDA, JOYNER",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1326418559,"WILLIAMS, AMANDA, JOYNER",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1326418559,"WILLIAMS, AMANDA, JOYNER",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326420290,"MCFARLANE, SINEAD, MEGHAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 35 , 48 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326420928,"EDGERTON, MARKIESHA, WILLETTE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326420928,"EDGERTON, MARKIESHA, WILLETTE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326420928,"EDGERTON, MARKIESHA, WILLETTE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326420928,"EDGERTON, MARKIESHA, WILLETTE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326423229,"GARDNER, ELIZABETH, WILKES",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 15 , 26 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,110 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1326423229,"GARDNER, ELIZABETH, WILKES",110 PINE STATE ST   LILLINGTON NC,043,Harnett,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 86 , 96 , 149 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326428384,"NAGAVELLI, NIKHILA",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 46 , 50 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326429259,"MEHTA, ISHA, MANOHAR",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1326429259,"MEHTA, ISHA, MANOHAR",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 49 , 49 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326429259,"MEHTA, ISHA, MANOHAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326429317,"LIPPERT, JACQUELINE, DANIELLE",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326429317,"LIPPERT, JACQUELINE, DANIELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 60 , 150 , 150 ,$#,,
MEDICAID DIRECT,1326430935,OPEN HEARTS HOME CARE,,703 E FRANKLIN ST   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1326430935,OPEN HEARTS HOME CARE,703 E FRANKLIN ST   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,851 "," 3,851 "," $278,547.06 ",,
MEDICAID DIRECT,1023254497,PORT CITY URGENT CARE,~,706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1326431644,"GREEN, JUSTIN, TIMOTHY",706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023254497,PORT CITY URGENT CARE,~,706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326431644,"GREEN, JUSTIN, TIMOTHY",706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326431644,"GREEN, JUSTIN, TIMOTHY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023254497,PORT CITY URGENT CARE,~,706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326431644,"GREEN, JUSTIN, TIMOTHY",706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 36 , 100 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326431644,"GREEN, JUSTIN, TIMOTHY",5211 COLLEGE RD S   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326432733,"STEIN, JACOB, NEWTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 26 , 70 , 100 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326432899,"WILLIAMS, LINDSEY, BELK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 58 , 66 ,$#,,
MEDICAID DIRECT,1609475474,FHPG LLC,FIRSTHEALTH CONCIERGE SIGNATURE MEDICINE,1690 US HIGHWAY 1 S STE 300 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1326433046,"JOHNSTONE, WILLIAM, MILLER",1690 US HIGHWAY 1 S STE 300 SOUTHERN PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1326433392,"NORRIS, KERI, BUCHANAN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1326433392,"NORRIS, KERI, BUCHANAN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326433392,"NORRIS, KERI, BUCHANAN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 54 , 54 ,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326433392,"NORRIS, KERI, BUCHANAN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 48 , 51 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,612 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326433947,"BILLIOT, KATHARINE, MARY",121 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1033204540,MOUNTAIN SLEEP AND RESPIRATORY MEDI,MOUNTAIN SLEEP AND RESPIRATORY MEDICINE,1 RESORT DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326433947,"BILLIOT, KATHARINE, MARY",121 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1033204540,MOUNTAIN SLEEP AND RESPIRATORY MEDI,MOUNTAIN SLEEP AND RESPIRATORY MEDICINE,1 RESORT DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326433947,"BILLIOT, KATHARINE, MARY",1 RESORT DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 40 , 40 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326435561,"MCDOLE, MELISSA, MARQUES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326435561,"MCDOLE, MELISSA, MARQUES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 45 ,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326435561,"MCDOLE, MELISSA, MARQUES",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 52 , 53 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326435983,"AVERETT, NICOLE, GRIFFIN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 26 , 27 ,$#,,
MEDICAID DIRECT,1902957954,COUNTY OF HENDERSON OFFICE OF ACCOU,HENDERSON CO DEPT PUBLIC HEALTH,1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1326437914,"CHADWICK, MARIAN, CHOPELAS",1200 SPARTANBURG HWY STE 100 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 68 , 247 ," $10,808.61 ",,
MEDICAID DIRECT,1548740038,INDYCARE MEDICAL NORTH CAROLINA,~,1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326442062,"UPCHURCH, CHRISTOPHER, ARLIE",1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 27 , 50 ,$#,,
MEDICAID DIRECT,1548740038,INDYCARE MEDICAL NORTH CAROLINA,~,110 BOONE SQUARE ST STE 29A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1326442062,"UPCHURCH, CHRISTOPHER, ARLIE",1706 S CANNON BLVD STE 101 KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326451618,"BRAUN, ERICA, MARIE",2630 E 7TH ST STE 101 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 17 , 45 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326453739,"WAGGY, CATHERINE, MARIE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1326458506,"GRADY, BRITTANY, TAYLOR",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 27 , 59 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1326458506,"GRADY, BRITTANY, TAYLOR",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 59 , 102 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1326458506,"GRADY, BRITTANY, TAYLOR",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 25 , 111 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1326458506,"GRADY, BRITTANY, TAYLOR",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 53 , 144 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1326458506,"GRADY, BRITTANY, TAYLOR",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326458969,"MCKINNEY, ASHLEY, DAVIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326460650,"HOOVER-THOMPSON, ALYSIA, ANN",935 STATE FARM RD   BOONE NC,095,Watauga,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326466574,"COCHRAN, KENT, WILLIS",865 WESTLAKE DR STE 200 MOUNT AIRY NC,086,Surry,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326466574,"COCHRAN, KENT, WILLIS",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 74 , 123 , 262 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326466574,"COCHRAN, KENT, WILLIS",152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 64 , 110 , 220 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326466574,"COCHRAN, KENT, WILLIS",152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1497224760,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SPINE SPECIALISTS,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193200000X,Group,Multi-Specialty,,1326466574,"COCHRAN, KENT, WILLIS",152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326466731,"BARNETTE, DANIEL, CRAIG",719A GREENWAY RD STE 100 BOONE NC,095,Watauga,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326466731,"BARNETTE, DANIEL, CRAIG",719A GREENWAY RD STE 100 BOONE NC,095,Watauga,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 96 , 102 , 119 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326466780,"PEYTON, REID, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326466889,"SATTERFIELD, NICHELLE, ANGELINA",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,209 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326466889,"SATTERFIELD, NICHELLE, ANGELINA",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1225281876,PIEDMONT EYE SURGICAL AND LASER,~,1002 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326467515,"SUN, LISA, LIANGZI",1219 LEXINGTON AVE STE C THOMASVILLE NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 57 , 79 ,$#,,
MEDICAID DIRECT,1225281876,PIEDMONT EYE SURGICAL AND LASER,~,1002 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326467515,"SUN, LISA, LIANGZI",1002 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 56 , 89 , 135 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326467945,"BOGGESS, MARQUITA, WALLACE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326467945,"BOGGESS, MARQUITA, WALLACE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326467945,"BOGGESS, MARQUITA, WALLACE",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326467945,"BOGGESS, MARQUITA, WALLACE",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326467945,"BOGGESS, MARQUITA, WALLACE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326467945,"BOGGESS, MARQUITA, WALLACE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326467945,"BOGGESS, MARQUITA, WALLACE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326468299,"DALAL, PUJA, MAYANK",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 41 , 61 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326468356,"SMALLEY ADQUI, JENNIFER, LYNN",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326468695,"OGAKE, STELLA, BIYAKI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326468893,"KEEFE, NICOLE, ALEXIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 97 , 109 , 237 ," $12,083.60 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1326468893,"KEEFE, NICOLE, ALEXIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1326472085,"SPINOSI, STEPHANIE, A",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 49 , 52 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326472085,"SPINOSI, STEPHANIE, A",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 37 , 40 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326472085,"SPINOSI, STEPHANIE, A",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1326472085,"SPINOSI, STEPHANIE, A",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1326473190,"HAMMOND, ANN MARIE, GARDNER",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 26 , 79 , 115 ,$#,,
MEDICAID DIRECT,1689016628,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1010 E DIXON BLVD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1326475583,"READLING, ROCKY, BLUE",201 E GROVER ST   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 18 , 26 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326475583,"READLING, ROCKY, BLUE",201 E GROVER ST   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1326475583,"READLING, ROCKY, BLUE",201 E GROVER ST   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1689016628,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1010 E DIXON BLVD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1326475583,"READLING, ROCKY, BLUE",1010 E DIXON BLVD   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 126 , 165 , 200 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326476854,"FLANAGAN, COLIN, MICHAEL",1517 N HOWE ST STE 4 SOUTHPORT NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326483918,"PEELE, DEVON, KNIPPLE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1326483918,"PEELE, DEVON, KNIPPLE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1326484007,"ALEXANDER, NICHOLAS, HOWARD",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326484007,"ALEXANDER, NICHOLAS, HOWARD",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 28 , 30 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326484007,"ALEXANDER, NICHOLAS, HOWARD",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1326484007,"ALEXANDER, NICHOLAS, HOWARD",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 26 , 27 ,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1326484197,"CRABTREE, NATHAN, ROBERT",101 HOSPITAL DR   COLUMBUS NC,075,Polk,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1326484569,NXGEN MDX LLC,,801 BROADWAY AVE NW STE 203 GRAND RAPIDS MI,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1326484569,NXGEN MDX LLC,801 BROADWAY AVE NW STE 203 GRAND RAPIDS MI,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#, 35 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326485087,"BENSIMHON, ADAM, ROD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326486150,"PRATT, AMANDA, LEE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology, 15 , 16 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326486150,"PRATT, AMANDA, LEE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326486374,"GROLLER, RAYMOND, ROBERT",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 580 , 606 , 741 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326486374,"GROLLER, RAYMOND, ROBERT",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326486374,"GROLLER, RAYMOND, ROBERT",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 43 , 49 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326486465,"MISHRIKY, BASEM, MOURAD LABIB",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1326486465,"MISHRIKY, BASEM, MOURAD LABIB",7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326486465,"MISHRIKY, BASEM, MOURAD LABIB",7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326486465,"MISHRIKY, BASEM, MOURAD LABIB",7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 234 , 527 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326488560,"BERRY, DUNCAN, EAVES",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 33 , 85 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326488560,"BERRY, DUNCAN, EAVES",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 18 , 46 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326488560,"BERRY, DUNCAN, EAVES",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 71 , 172 , 426 ," $37,744.01 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326488560,"BERRY, DUNCAN, EAVES",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326488560,"BERRY, DUNCAN, EAVES",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 31 , 67 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326488818,"WOZNIAK, CHRISTOPHER, MICHAEL",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1326488818,"WOZNIAK, CHRISTOPHER, MICHAEL",724 S HORNER BLVD   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326488818,"WOZNIAK, CHRISTOPHER, MICHAEL",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 30 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326488818,"WOZNIAK, CHRISTOPHER, MICHAEL",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326488818,"WOZNIAK, CHRISTOPHER, MICHAEL",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326488818,"WOZNIAK, CHRISTOPHER, MICHAEL",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326489725,"CIRULLO, ELIZABETH, KATHLEEN CLAY",294 N NC 16 BUSINESS HWY STE A DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 21 , 33 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1326489725,"CIRULLO, ELIZABETH, KATHLEEN CLAY",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326489725,"CIRULLO, ELIZABETH, KATHLEEN CLAY",1896 REMOUNT RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 43 , 71 ,$#,,
MEDICAID DIRECT,1477589158,EASTRIDGE FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE EASTRIDGE FAMILY MEDICI,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1326489725,"CIRULLO, ELIZABETH, KATHLEEN CLAY",1896 REMOUNT RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 121 , 201 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326492216,"TALWAR, KATHERINE, ELIZABETH",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 97 , 97 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326492281,"GRETTE, KATHERINE, VIRGINIA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326492281,"GRETTE, KATHERINE, VIRGINIA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326492281,"GRETTE, KATHERINE, VIRGINIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 45 , 51 , 59 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1326492513,"MUELLER, MICHAEL, GERARD",6 REGIONAL DR STE B PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1265821342,ADVANCED MEDICAL GROUP,,6 REGIONAL DR STE B PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1326492513,"MUELLER, MICHAEL, GERARD",6 REGIONAL DR STE B PINEHURST NC,063,Moore,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1326492513,"MUELLER, MICHAEL, GERARD",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 67 , 132 , 194 ,$#,,
MEDICAID DIRECT,1730362641,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326493289,"FUNK, BLAIR, LINDSAY",16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326493669,"SNYDER, DEAN, CARLTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1326493669,"SNYDER, DEAN, CARLTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326493669,"SNYDER, DEAN, CARLTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326493669,"SNYDER, DEAN, CARLTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326493958,"PATIBANDLA, PRATEEK, V",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326494642,"DE CESAR NETTO, CESAR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326494642,"DE CESAR NETTO, CESAR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326494642,"DE CESAR NETTO, CESAR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326494642,"DE CESAR NETTO, CESAR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1326494642,"DE CESAR NETTO, CESAR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 21 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1326494642,"DE CESAR NETTO, CESAR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326496670,"PARRIS, SARAH, ANN",5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326497579,"AYRE, OLIVIA, JOY",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326497579,"AYRE, OLIVIA, JOY",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326499161,"SALMON ECHANIQUE, CRISTINA, DALINDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326499161,"SALMON ECHANIQUE, CRISTINA, DALINDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326499161,"SALMON ECHANIQUE, CRISTINA, DALINDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326499161,"SALMON ECHANIQUE, CRISTINA, DALINDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326499161,"SALMON ECHANIQUE, CRISTINA, DALINDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326499161,"SALMON ECHANIQUE, CRISTINA, DALINDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326499161,"SALMON ECHANIQUE, CRISTINA, DALINDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 28 , 53 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326499781,"EKENGREN, NEIL, TOBEY",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326499781,"EKENGREN, NEIL, TOBEY",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 127 , 128 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 193 , 193 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 43 , 45 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 24 , 24 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 69 , 69 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 104 , 106 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 29 , 30 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 128 , 130 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 161 , 165 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,95 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326507104,"THOMAS, ADALIE, MARIE",104 HOLCOMBE COVE RD   CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326507260,ALPHA MAGNOLIA GARDEN LLC,,930 US HIGHWAY 158 BUS E   WARRENTON NC,093,Warren,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326507260,ALPHA MAGNOLIA GARDEN LLC,930 US HIGHWAY 158 BUS E   WARRENTON NC,093,Warren,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 52 ," 8,477 "," 8,512 "," $745,857.09 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 107 , 124 , 216 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 134 , 145 , 193 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 67 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",3475 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326508037,"THOMAS, JOSEPH, CHARLES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326508649,"SMITH, JUSTIN, ALAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 20 , 47 ," $11,075.61 ",,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326508649,"SMITH, JUSTIN, ALAN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 59 , 82 ,$#,,
MEDICAID DIRECT,1497524524,INFINITY AND WELLNESS FAMILY PRACTI,INFINITY AND WELLNESS FAMILY PRACTICE,1007 WOODRIDGE DR STE A LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326509472,"LOCKLEAR, NATALIE, HUNT",3005 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326036138,SOUTHEASTERN INTEGRATED CARE,~,3005 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326509472,"LOCKLEAR, NATALIE, HUNT",3005 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497524524,INFINITY AND WELLNESS FAMILY PRACTI,INFINITY AND WELLNESS FAMILY PRACTICE,1007 WOODRIDGE DR STE A LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1326509472,"LOCKLEAR, NATALIE, HUNT",3005 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 44 , 57 ,$#,,
MEDICAID DIRECT,1497524524,INFINITY AND WELLNESS FAMILY PRACTI,INFINITY AND WELLNESS FAMILY PRACTICE,1007 WOODRIDGE DR STE A LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1326509472,"LOCKLEAR, NATALIE, HUNT",1007 WOODRIDGE DR   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 124 , 143 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1326509845,"MISHRA, KRITI",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326512534,"HEILMAN, LAUREN, MEADOWS",400 ATHLETIC CLUB BLVD   CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326512534,"HEILMAN, LAUREN, MEADOWS",4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 22 , 70 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1904 FRONT ST STE 530 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",4301 TURKOMAN WAY   GREENSBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",4301 TURKOMAN WAY   GREENSBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 57 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",4301 TURKOMAN WAY   GREENSBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1326514803,"HUSSAIN, HASEEB",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 268 , 473 ," 1,456 "," $93,041.49 ",,
MEDICAID DIRECT,1720177140,COUNTY OF DAVIE OFFICE OF FINANCE A,DAVIE COUNTY HEALTH DEPARTMENT,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1326514860,"CASSTEVENS, ELIZABETH, ANN",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1255950325,NORTHERN HOSPITAL DISTRICT OF SURRY,NORTHERN URGENT CARE,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1326514860,"CASSTEVENS, ELIZABETH, ANN",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 61 , 59 , 165 ,$#,,
MEDICAID DIRECT,1720839228,NORTHERN HOSPITAL DISTRICT OF SURRY,,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1326514860,"CASSTEVENS, ELIZABETH, ANN",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1326514860,"CASSTEVENS, ELIZABETH, ANN",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326515768,"HEDDLESON, HOLLY, HARVEY",1450 MATTHEWS TOWNSHIP PKWY STE 280 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 114 , 115 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326517723,"LABRANCHE, AMANDA, MORGAN",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326518945,"JOSEPH, SHARON, EMANCIA",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1326518945,"JOSEPH, SHARON, EMANCIA",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326518945,"JOSEPH, SHARON, EMANCIA",2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 30 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326520461,"COOMER, EDWARD, BRADLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326524182,"NALLURU, SWARNA SRI",401 E CHEVES ST STE 201 FLORENCE SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275128316,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH FAMILY PRACTICE - SEAGROVE,514 N BROAD ST   SEAGROVE NC,076,Randolph,193400000X,Group,Single Specialty,,1326526328,"POTTS, ANNA, SMITH",514 N BROAD ST   SEAGROVE NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 109 , 136 ,$#,,
MEDICAID DIRECT,1275128316,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH FAMILY PRACTICE - SEAGROVE,514 N BROAD ST   SEAGROVE NC,076,Randolph,193400000X,Group,Single Specialty,,1326526328,"POTTS, ANNA, SMITH",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 24 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326527466,"PATEL, MEGHNA, RAJESH",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326527466,"PATEL, MEGHNA, RAJESH",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 32 , 34 ,$#,,
MEDICAID DIRECT,1679916035,LIMBIONICS OF DURHAM INC,~,5007 SOUTHPARK DR STE 110 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326530809,"BUTLER, ZOE, DELAYNE",5007 SOUTHPARK DR STE 110 DURHAM NC,032,Durham,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1679916035,LIMBIONICS OF DURHAM INC,~,5007 SOUTHPARK DR STE 110 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326530809,"BUTLER, ZOE, DELAYNE",5007 SOUTHPARK DR STE 110 DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326531393,"BLAKE, DOROTHY, ALICE",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326531393,"BLAKE, DOROTHY, ALICE",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1326532102,"MCCLELLAN, CONNOR, BLANE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1326532102,"MCCLELLAN, CONNOR, BLANE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326532565,"MCGUIRT, JONATHAN, DAVID",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326532565,"MCGUIRT, JONATHAN, DAVID",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326532565,"MCGUIRT, JONATHAN, DAVID",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326533829,"SONI, RAJIV, LIM",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326533829,"SONI, RAJIV, LIM",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 20 , 23 , 23 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326533829,"SONI, RAJIV, LIM",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326534348,"BOWEN, KELLIE, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 23 , 24 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326534348,"BOWEN, KELLIE, MARIE",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326534348,"BOWEN, KELLIE, MARIE",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326534348,"BOWEN, KELLIE, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326534348,"BOWEN, KELLIE, MARIE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326534348,"BOWEN, KELLIE, MARIE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326536954,"GALLA, NAVEEN",2201 S STERLING ST   MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326538083,"WILLIAMS, SAMANTHA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 86 , 86 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326538083,"WILLIAMS, SAMANTHA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 116 , 116 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326538083,"WILLIAMS, SAMANTHA",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912942665,SOUTHEASTERN INTENSIVIST SERVICES P,,7101 JAHNKE RD   RICHMOND VA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326538083,"WILLIAMS, SAMANTHA",7101 JAHNKE RD   RICHMOND VA,102,Out of State > 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578144747,ELEVATION REHAB LLC,~,3420 HOLLOWAY ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1326538463,"BROWN, KIMBERLY, JEAN",5028 RAINMAKER DR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 24 , 263 , 282 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326539966,"SHOKES, WENDY, BENFIELD",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 72 , 289 , 295 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1326539966,"SHOKES, WENDY, BENFIELD",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 78 ," 1,007 "," 1,021 "," $17,868.21 ",,
MEDICAID DIRECT,1639757974,ASHE MEMORIAL HOSPITAL INC,FLEETWOOD FAMILY MEDICINE,13300 13290 HWY 221 S   FLEETWOOD NC,005,Ashe,193400000X,Group,Single Specialty,,1326540501,"BENNETT, KATELAND, ELAINE",301 MAIN ST   NEWTON GROVE NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1902411499,SOLARI MENTAL AND BEHAVIORAL HEALTH,,5500 EXECUTIVE CENTER DR STE 235 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326541574,"CAMERON-MATTHEWS, CAROL, ELIZABETH",5500 EXECUTIVE CENTER DR STE 235 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1841269305,INTERNAL MEDICINE ASSOCIATES,INTERNAL MEDICINE ASSOC,3850 ED DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326544289,"EUBANKS, HOLLY, LUCAS",3850 ED DR STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326544818,"BEARD, JONATHAN, ANDREWS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326544818,"BEARD, JONATHAN, ANDREWS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326544818,"BEARD, JONATHAN, ANDREWS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326545187,"PARA, KIRAN, SAI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 211 , 222 ," $16,509.30 ",,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326545591,"YANG, VINCENT, GUANG",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326547704,"GREENE, ANDREW, TODD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 43 , 47 ," $21,148.46 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326550484,"CURRENCE, ROBERT, ZACHARY",4515 PREMIER DR STE 307 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 112 , 188 ,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1273 MAIN ST   SWANQUARTER NC,048,Hyde,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",1273 MAIN ST   SWANQUARTER NC,048,Hyde,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1942633482,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 30 , 55 ,$#,,
MEDICAID DIRECT,1427452283,EAST CAROLINA UNIVERSITY,~,100 BRUNSWICK MEDICAL CENTER PKWY NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",100 BRUNSWICK MEDICAL CENTER PKWY NE   BOLIVIA NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538563473,EAST CAROLINA UNIVERSITY,~,600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 41 , 115 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 163 , 209 , 492 ," $26,938.84 ",,
MEDICAID DIRECT,1790212462,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326551656,"MACPHERSON, DAVID, GEORGE",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326554163,"EDWARDS, KATHRYN, LEONA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 72 , 77 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1326554163,"EDWARDS, KATHRYN, LEONA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 74 , 92 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1326554163,"EDWARDS, KATHRYN, LEONA",2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1326557596,MORSE CLINIC OF DUNN PC,,596 E JACKSON BLVD BLDG B ERWIN NC,043,Harnett,251S00000X,Agencies,Community/Behavioral Health,,1326557596,MORSE CLINIC OF DUNN PC,596 E JACKSON BLVD BLDG B ERWIN NC,043,Harnett,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326558545,"LAMONT, ELLYSE, LOPEZ",388 VENTURE DR STE I SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 69 , 165 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326568981,"GILL, KATHIA, ELIZABETH",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326568981,"GILL, KATHIA, ELIZABETH",1085 NE GATEWAY CT NE STE 200A CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326568981,"GILL, KATHIA, ELIZABETH",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 29 , 41 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326568981,"GILL, KATHIA, ELIZABETH",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326570870,"FERRERI, CHRISTOPHER, JAMES",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1326570870,"FERRERI, CHRISTOPHER, JAMES",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1326570870,"FERRERI, CHRISTOPHER, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1326570870,"FERRERI, CHRISTOPHER, JAMES",1550 FAULK ST   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326570904,"SHENOUDA, SANDRA, MARY",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 84 , 312 , 312 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326571258,"EVANS, CHRISTOPHER, SCOTT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326571381,"BARAKOTI, BINURAGI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 227 , 228 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326575002,"GEBREMARIAM, RIM, AMARE",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 55 , 86 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1326575002,"GEBREMARIAM, RIM, AMARE",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 34 , 64 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326576125,"ALYATEEM, GEORGE, ALEX",1771 TATE BLVD STE 201 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 36 , 43 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326576901,"DEVANATH, SUDIPTA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326577503,"COWART, SCOTT, MCTYER",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326577503,"COWART, SCOTT, MCTYER",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326577503,"COWART, SCOTT, MCTYER",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326579111,"SCHNAPP, KATHRYN, ROSALIE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326579111,"SCHNAPP, KATHRYN, ROSALIE",9929 REA RD STE 101 WAXHAW NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 21 , 32 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326579418,"DARJI, NATHAN, B",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326579418,"DARJI, NATHAN, B",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326579418,"DARJI, NATHAN, B",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 63 , 160 , 181 ," $10,706.07 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326579715,"KINZEL, ADAM, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 180 , 202 , 227 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326579715,"KINZEL, ADAM, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326579715,"KINZEL, ADAM, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 118 , 124 , 151 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1326579715,"KINZEL, ADAM, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1326579715,"KINZEL, ADAM, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326580150,CAROLINA PHYSICAL THERAPY ASSOCIATE,CAROLINA PHYSICAL THERAPY ASSOCIATES - GREENVILLE,2470 EMERALD PL STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326580150,CAROLINA PHYSICAL THERAPY ASSOCIATE,2470 EMERALD PL STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,#, 20 , 57 ,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326583071,"MANZANO, JENAH, WESLEY",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 40 , 65 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326583246,"CRABTREE, ELIZABETH, ANN",1902 ORA DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326583246,"CRABTREE, ELIZABETH, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 154 ," 1,615 "," 1,967 "," $41,196.33 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326583550,"MARUCUT, FELICA, LASTELLE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326584319,"STANLEY, KEVIN, JAMES",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1326584319,"STANLEY, KEVIN, JAMES",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326584319,"STANLEY, KEVIN, JAMES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326588153,"FUQUAY, MATTHEW, NEIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326588153,"FUQUAY, MATTHEW, NEIL",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 30 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326588153,"FUQUAY, MATTHEW, NEIL",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326588153,"FUQUAY, MATTHEW, NEIL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134713159,MIND AND BODY WELLNESS PLLC,,329 SILVER GROVE CHURCH RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1326588492,"TINDALL, LEISTEY, ELISE",329 SILVER GROVE CHURCH RD   ROCKINGHAM NC,077,Richmond,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 12 , 34 , 47 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326589599,"ILEY, ARIELLE, FRANCES",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326589599,"ILEY, ARIELLE, FRANCES",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326589599,"ILEY, ARIELLE, FRANCES",817 VOLVO PKWY   CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326589649,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - WELLNESS CENTER,3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1326589649,J ARTHUR DOSHER MEMORIAL HOSPITAL,3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health, 28 , 35 , 35 ,$#,,
MEDICAID DIRECT,1326590050,PUBLIX NORTH CAROLINA LP,PUBLIX PHARMACY 1546,165 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1326590050,PUBLIX NORTH CAROLINA LP,165 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 16 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326596511,"CARO, KATHERINE, VALENCIA",3901 N ROXBORO ST STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326596511,"CARO, KATHERINE, VALENCIA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326597246,"TRUSAL, NOEL, MARIE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1437181914,AULANDER MEDICAL PRACTICE PA,~,114 HOLLOWELL RD   AULANDER NC,008,Bertie,193400000X,Group,Single Specialty,,1326599523,"NILSEN, LAURIE, ANN",114 HOLLOWELL RD   AULANDER NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 174 , 283 , 590 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 34 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",82 WHITES CROSSING PLZ   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",41 BAIN ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 28 , 30 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1326600867,"SAMPSON, BILLY, JOE",1106 SUNSET AVE   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326601766,"DEPRIEST, NICHOLAS, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 22 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 170 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326601766,"DEPRIEST, NICHOLAS, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326603549,"GOODSON, KATHLEEN, BESS",1530 UNION RD STE A GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 40 , 40 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326603564,"STILLER, CANDICE, PROCTOR",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326603564,"STILLER, CANDICE, PROCTOR",1955 S US 29 HWY   CHINA GROVE NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 33 , 55 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326603564,"STILLER, CANDICE, PROCTOR",911 W HENDERSON ST STE 300 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326604174,"MARTIN-FERNANDEZ, KATY, WORMLEY",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1326605759,"WALDROP, KARA, MARIE",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 517 , 517 ,$#,,
MEDICAID DIRECT,1073380515,WOUNDSWIFT LLC,,5540 CENTERVIEW DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326605759,"WALDROP, KARA, MARIE",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1326605759,"WALDROP, KARA, MARIE",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 70 , 70 ,$#,,
MEDICAID DIRECT,1578747077,COMPREHENSIVE REHAB AND PAIN SPECIA,COMPREHENSIVE REHAB AND PAIN SPECIALIST,135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1326605759,"WALDROP, KARA, MARIE",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 32 , 50 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1326605759,"WALDROP, KARA, MARIE",135 E RICH BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 173 , 173 ,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,100 W FREMONT ST STE B BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1326608258,"HOGAN, RYAN, ALBERT",100 W FREMONT ST   BURGAW NC,071,Pender,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326608258,"HOGAN, RYAN, ALBERT",3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326610395,"NIEDERMANN, ABBY, CAITLIN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326610395,"NIEDERMANN, ABBY, CAITLIN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326610395,"NIEDERMANN, ABBY, CAITLIN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861170607,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WC FRIDAY MIDDLE,1221 RATCHFORD DR   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326610502,"DEEN, KEISHA, MICHELLE",201 HIGHWAY 321 S   DALLAS NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326610502,"DEEN, KEISHA, MICHELLE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1578312351,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT EAST GASTON HIGH,1744 LANE RD   MOUNT HOLLY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326610502,"DEEN, KEISHA, MICHELLE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 50 , 50 ," $16,016.50 ",,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326611849,"MCDANIEL, DEBORAH, ANN",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 24 , 26 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1326616368,"MARITATO, AVE, HELEN",11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1326616368,"MARITATO, AVE, HELEN",11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 26 , 37 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 124 , 208 , 233 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1326620790,"HITTO, AMER",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 54 , 97 , 120 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 40 , 66 , 79 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,300 E MCKAY ST STE E ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",300 E MCKAY ST STE E ELIZABETHTOWN NC,009,Bladen,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326620790,"HITTO, AMER",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1326621566,COMMITTED 2 CARING HOME CARE AGENCY,,2602 ERIC LN STE C7 BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1326621566,COMMITTED 2 CARING HOME CARE AGENCY,2602 ERIC LN STE C7 BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 1,266 "," 1,266 "," $77,608.70 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326622333,"WALLACE, ERIN, NICOLE",257 HOSPITAL DR NE STE 101 BOLIVIA NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 22 , 47 ,$#,,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326626029,"SARMENT, LEA, VICTORIA",5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326626029,"SARMENT, LEA, VICTORIA",5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 3,658 "," 11,198 "," 12,882 "," $1,960,478.39 ",,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326626029,"SARMENT, LEA, VICTORIA",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 13 , 19 , 20 ,$#,,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326626029,"SARMENT, LEA, VICTORIA",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 55 , 104 , 114 ," $20,696.28 ",,
MEDICAID DIRECT,1326627373,KIRSTEN T BERTSCHI MA CCC-SLP PLLC,HIGH POINT SPEECH THERAPY,1623 YORK AVE STE 103 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326627373,KIRSTEN T BERTSCHI MA CCC-SLP PLLC,1623 YORK AVE STE 103 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,, 11 , 97 , 103 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326627548,"BYOUK, JOSEPH, CHARLES",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326627548,"BYOUK, JOSEPH, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 43 , 45 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1326629460,"WENZEL, TYLER",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 30 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326629858,"ALLDAY, STEPHEN, ISAAC",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 114 , 176 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326630377,"THOMASSON, RACHELLE, GIOVANNA MCCAULEY",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326630377,"THOMASSON, RACHELLE, GIOVANNA MCCAULEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 26 , 26 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326631714,"FLECK, MICHELLE, RENEE",2605 HOSPITAL RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 64 , 89 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326632340,"GLYNN, LEAH, KATHRYN",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891884748,BLUE RIDGE HEALTHCARE MEDICAL GROUP,GRACE PSYCHIATRIC ASSOCIATES,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1326632340,"GLYNN, LEAH, KATHRYN",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 236 , 236 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326635996,"WILLIAMSON, EMILY, BARNES",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 48 , 49 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1326636754,"WORTHY, MYLINDA, TATIANA KISHAY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 40 , 40 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326636895,"WINTER, ERICA, AUDREY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 57 , 60 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326636895,"WINTER, ERICA, AUDREY",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326636895,"WINTER, ERICA, AUDREY",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 16 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1326636895,"WINTER, ERICA, AUDREY",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326636895,"WINTER, ERICA, AUDREY",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326637836,"ROBINSON, CECILIA, ELISE",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326637836,"ROBINSON, CECILIA, ELISE",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326637836,"ROBINSON, CECILIA, ELISE",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326638222,"MCCAIN, CHANDLER, BRAXTON",4101 MACON POND ROAD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1326645649,"BULLUCK, CHRISTINA, MCCARTNEY",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 24 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1326645649,"BULLUCK, CHRISTINA, MCCARTNEY",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 100 , 172 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1326645649,"BULLUCK, CHRISTINA, MCCARTNEY",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1326645649,"BULLUCK, CHRISTINA, MCCARTNEY",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326646597,"VAN GILS, HENRY, WILSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326646597,"VAN GILS, HENRY, WILSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326646597,"VAN GILS, HENRY, WILSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326646597,"VAN GILS, HENRY, WILSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326649518,"PARSONS, KENDALL, TAYLOR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1326651209,"BERNITSKY, LAURA, ANN",117 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1326651696,BURRIS FAMILY PAYINT IT FORWARD HOM,BURRIS FAMILY PAYING IT FORWARD HOMECARE LLC,143 GALILEE CHURCH RD   KINGS MOUNTAIN NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1326651696,BURRIS FAMILY PAYINT IT FORWARD HOM,143 GALILEE CHURCH RD   KINGS MOUNTAIN NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,#, 694 , 721 ," $57,492.87 ",,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326655424,"WALA, ASHLEY, MONIQUE",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 30 , 30 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1326657552,"TUCKER, EMILEE, VICTORIA",304 10TH AVE NE   HICKORY NC,018,Catawba,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1326657552,"TUCKER, EMILEE, VICTORIA",304 10TH AVE NE   HICKORY NC,018,Catawba,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1326657883,"GILLIAM, TODD, LAINE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 114 , 125 , 134 ," $11,568.41 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326657883,"GILLIAM, TODD, LAINE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 82 , 91 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326659327,"GALYEAN, BROOKLYN, MARIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336542067,DLP HAYWOOD REGIONAL MEDICAL CENTER,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1326659327,"GALYEAN, BROOKLYN, MARIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 134 , 141 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1326659327,"GALYEAN, BROOKLYN, MARIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326662883,"TAYLOR, LISA, SHIRAFUJI",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326662883,"TAYLOR, LISA, SHIRAFUJI",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326664814,"CARDELLINO, SHERRI, ANN",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326665142,"TODD, MARY, ANN",444 SW CENTER ST MOBILE UNIT FAISON NC,031,Duplin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326665142,"TODD, MARY, ANN",106 JEFFERSON ST   HAMLET NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1891789970,SCOTLAND MEMORIAL HOSPITAL INC,WAGRAM FAMILY PRACTICE,24420 MARLBORO ST   WAGRAM NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1326665142,"TODD, MARY, ANN",24420 MARLBORO ST   WAGRAM NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 67 , 105 , 135 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326667544,"POTOCNIK, BRIAN, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1326667544,"POTOCNIK, BRIAN, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1326667544,"POTOCNIK, BRIAN, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1326667742,"DEWESE, KIMBERLY, NICOLE",336 DEERFIELD RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 35 , 40 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1326667742,"DEWESE, KIMBERLY, NICOLE",434 HOSPITAL DR   LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326669201,"TEDDER, BRANDON, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1326671157,"COLEMAN, MEGAN, RENA",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326671173,"HELLER, ALYSON",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 13 , 15 , 25 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326671173,"HELLER, ALYSON",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 41 , 84 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1326671173,"HELLER, ALYSON",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1326673039,"JARRELL, ASHLEY, DENISE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326673039,"JARRELL, ASHLEY, DENISE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396166088,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB - MT,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326676453,"BANTIKASSEGN, AMLAK",275 BEATTY DR   BELMONT NC,036,Gaston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326676453,"BANTIKASSEGN, AMLAK",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1326676453,"BANTIKASSEGN, AMLAK",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1881033009,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB NORTH,487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326676453,"BANTIKASSEGN, AMLAK",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326676453,"BANTIKASSEGN, AMLAK",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1275968620,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINAS REHAB PINE,10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326676453,"BANTIKASSEGN, AMLAK",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326676453,"BANTIKASSEGN, AMLAK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326676453,"BANTIKASSEGN, AMLAK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 61 , 61 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1326676727,"DRISCOLL, HANNAH, CARROLL",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 30 , 63 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326677717,"GOTTLIEB, SAMANTHA, FARYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1326677717,"GOTTLIEB, SAMANTHA, FARYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1326677717,"GOTTLIEB, SAMANTHA, FARYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326678707,"FENYAK, LINDSAY, MARIE",3325 ROBINHOOD RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 30 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10100 S MAIN ST   ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1326678707,"FENYAK, LINDSAY, MARIE",3325 ROBINHOOD RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,309 E CORNWALLIS DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326678707,"FENYAK, LINDSAY, MARIE",3325 ROBINHOOD RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1326678889,"WHITLEY, SARAH",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326678889,"WHITLEY, SARAH",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326682634,"KLUESNER, MEGAN, ROSE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326684184,"CRUZ MALDONADO, JESAMIL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1326684598,"MOSS, PAMELA, CRAWFORD",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326684598,"MOSS, PAMELA, CRAWFORD",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 127 , 247 , 254 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1326685504,"DERBY, BRANDON, ANDREW",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1326688300,"LEISENRING, LORI, SUE",206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 29 , 32 ,$#,,
MEDICAID DIRECT,1225372246,DUKE UNIVERSITY AFFILIATED PHYSICIA,DPC BLUE RIDGE,3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326694944,"RODRIGUEZ, ALLEX, GRANGER",2406 BLUE RIDGE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,188 MEDICAL PARK DR STE 7B BREVARD NC,088,Transylvania,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1326696576,"JOSVAI, KIRK, LOUIS",188 MEDICAL PARK DR STE 7-B BREVARD NC,088,Transylvania,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1326696576,"JOSVAI, KIRK, LOUIS",20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1326696576,"JOSVAI, KIRK, LOUIS",2315 ASHEVILLE HWY STE 30 HENDERSONVILLE NC,045,Henderson,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326696782,"EAKER, BRITTANY, LUTZ",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326696824,"BOTTS, JAMES, HUNTER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326699687,"STEVENSON, JANEE, ALEXANDRIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 21 , 23 , 27 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326699745,"SOUTHERN, TYLER, ALEXANDER",152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326699745,"SOUTHERN, TYLER, ALEXANDER",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588614168,ASHEVILLE NEUROLOGY SPECIALISTS PA,~,731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1326699745,"SOUTHERN, TYLER, ALEXANDER",731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 57 , 69 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326703679,"HASDAN, LEAH, ELIZABETH",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326709460,"COLLINS, RYAN, DOUGLAS",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326709460,"COLLINS, RYAN, DOUGLAS",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 41 , 44 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326711912,"MARTINEZ, STEFANIE, VIANEY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326711912,"MARTINEZ, STEFANIE, VIANEY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326711912,"MARTINEZ, STEFANIE, VIANEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326711912,"MARTINEZ, STEFANIE, VIANEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 32 , 40 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2728 W MALLARD CREEK CHURCH RD STE 30 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326716879,"NELSON, EMILY, IONE",2728 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326716879,"NELSON, EMILY, IONE",2728 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4415 SCHOOL HOUSE CMNS   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326716879,"NELSON, EMILY, IONE",2728 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326716879,"NELSON, EMILY, IONE",2728 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326716879,"NELSON, EMILY, IONE",2728 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326717224,"HARTERT, ALEXIS, NICOLE",9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 26 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 114 , 137 , 282 ," $13,755.91 ",,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1326718313,"GRIER, ADRIENNE, NICOLE",910 E INNES ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 58 , 93 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326721903,"SCHMIDT, JOHN, PAUL",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 37 , 37 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326721903,"SCHMIDT, JOHN, PAUL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326721903,"SCHMIDT, JOHN, PAUL",1236 GUILFORD COLLEGE RD STE 117 JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 38 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326721903,"SCHMIDT, JOHN, PAUL",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326722760,"CAPAROSA, LAURA, HORAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 12 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326722760,"CAPAROSA, LAURA, HORAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 21 , 25 , 34 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326723172,"CAVE, JESSICA, FIONA",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326723628,"NAHOUM, TAYLOR, BROOKE",239 STATION ST   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326723628,"NAHOUM, TAYLOR, BROOKE",239 STATION ST   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 27 , 27 ,$#,,
MEDICAID DIRECT,1538850961,MODLIN & LONDRY XII DDS PLLC,MARS HILL DENTISTRY,831 S MAIN ST   MARS HILL NC,057,Madison,193400000X,Group,Single Specialty,,1326724253,"RENTZ, BRINSON, WAYNE",831 S MAIN ST   MARS HILL NC,057,Madison,1223G0001X,Dental Providers,Dentist,General Practice, 44 , 83 , 242 ," $11,148.25 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326725631,"ARELLANO NUNEZ, YAMILET",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 23 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1326725631,"ARELLANO NUNEZ, YAMILET",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 33 , 41 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326725631,"ARELLANO NUNEZ, YAMILET",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1326726191,"SULLIVAN, JASMINE, DANIELLE",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326726415,"EASLEY, BRANDI, PICKARD",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 48 , 93 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326728940,"GILLESPIE, ERIC, RICHARD",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 132 , 147 , 279 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326730854,"STEELE, ANNE, THOMAS",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 24 , 33 , 74 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,400 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326731233,"RWARA, KEDDY",400 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326739558,"VOIGT, DESIRAE, JO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 64 , 64 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326740697,"CREAMER, DONIELLE, TESHOWEL",13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 37 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326742024,"BROWN, OLIVIA, CHANTAL",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326742024,"BROWN, OLIVIA, CHANTAL",3282 WELLONS BLVD   NEW BERN NC,025,Craven,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1326742339,"BADALAMENTI, JESSICA, MASON",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326743535,HEALTHTRACKRX INDIANA INC,HEALTHTRACKRX OF LOUISVILLE,706 E LEWIS AND CLARK PKWY UNIT 11 CLARKSVILLE IN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1326743535,HEALTHTRACKRX INDIANA INC,706 E LEWIS AND CLARK PKWY UNIT 11 CLARKSVILLE IN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#, 11 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326744145,"TREACY, LINDSEY, ROSE",106 W MEDICAL PARK DR STE A LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 66 , 126 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326744145,"TREACY, LINDSEY, ROSE",584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1326744145,"TREACY, LINDSEY, ROSE",1219 LEXINGTON AVE STE D THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 65 , 135 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326749342,"FIGUEROA, AMARILIS",25 PROFESSIONAL PARK   ERWIN NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326749342,"FIGUEROA, AMARILIS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1326749342,"FIGUEROA, AMARILIS",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326749342,"FIGUEROA, AMARILIS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326749342,"FIGUEROA, AMARILIS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 36 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 260 ," 1,035 "," 2,623 "," $22,608.06 ",,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326750514,"FLEMING, SONYA, LEIGH",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 139 , 506 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326750811,"GITAU, CATHERINE, NYAMBURA",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 29 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1326750811,"GITAU, CATHERINE, NYAMBURA",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",910 E INNES ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326754508,"GOODWIN, ANNETTE, MICHELLE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326757063,AMARA HOME CARE AGENCY,,8396 SIX FORKS RD STE 201 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1326757063,AMARA HOME CARE AGENCY,8396 SIX FORKS RD STE 201 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 546 , 546 ," $34,645.44 ",,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326760364,"VELEZ TORO, NAOMI, ESTEFANIA",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003935750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326762352,"MISHOE, SARAH, CARRINGTON",119 W. PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326762352,"MISHOE, SARAH, CARRINGTON",308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285485383,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326762352,"MISHOE, SARAH, CARRINGTON",119 W. PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1285485383,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326762352,"MISHOE, SARAH, CARRINGTON",308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 81 , 96 ,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326764192,"VINCELLI, SARA, MARIE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326769068,"ROBERTS, RYAN, JOSEPH",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 44 , 54 ,$#,,
MEDICAID DIRECT,1326769514,RED WAGON CHILDRENS THERAPY,,516 WOODBERRY DR   MOORESVILLE NC,049,Iredell,251S00000X,Agencies,Community/Behavioral Health,,1326769514,RED WAGON CHILDRENS THERAPY,516 WOODBERRY DR   MOORESVILLE NC,049,Iredell,251S00000X,Agencies,Community/Behavioral Health,, 76 ," 1,243 "," 1,243 "," $81,243.00 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326770926,"GRAYDON, AUSTIN, JOSEPH",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1326772260,"GRIFFIN, MAGGIE, LYNN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 30 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326772559,"METZ, KIRSTEN, WESTBERG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326772740,"ZUBER, ANA, PAULA",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 37 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14221 BOREN ST   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 41 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 38 , 95 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,440 TYVOLA RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326774415,"MUCCI, TAYLOR, ELIZABETH",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326776956,"SNEED, JESSAMYN, VANIA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326776956,"SNEED, JESSAMYN, VANIA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326776956,"SNEED, JESSAMYN, VANIA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1326776956,"SNEED, JESSAMYN, VANIA",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326777665,"SHAIK, IZAZ",,137 GRAND HILL PL   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1326777665,"SHAIK, IZAZ",137 GRAND HILL PL   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 373 , 604 ," 3,722 "," $226,947.68 ",,
MEDICAID DIRECT,1821604687,DR DURSHANAPALLI & ASSOCIATES PLLC,GENTLE CARE FAMILY DENTAL,2380 HICKSWOOD RD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1326777665,"SHAIK, IZAZ",137 GRAND HILL PL   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 393 , 539 ," 1,886 "," $115,360.05 ",,
MEDICAID DIRECT,1326779737,SECURE DIRECTION NC LLC,,355 SPLICEWOOD DR SW   CONCORD NC,013,Cabarrus,171M00000X,Other Service Providers,Case Manager/Care Coordinator,,1326779737,SECURE DIRECTION NC LLC,355 SPLICEWOOD DR SW   CONCORD NC,013,Cabarrus,171M00000X,Other Service Providers,Case Manager/Care Coordinator,,#, 172 , 172 ," $22,987.72 ",,
MEDICAID DIRECT,1326779737,SECURE DIRECTION NC LLC,,355 SPLICEWOOD DR SW   CONCORD NC,013,Cabarrus,251B00000X,Agencies,Case Management,,1326779737,SECURE DIRECTION NC LLC,355 SPLICEWOOD DR SW   CONCORD NC,013,Cabarrus,251B00000X,Agencies,Case Management,, 53 ," 5,319 "," 5,748 "," $1,126,167.18 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1326780248,"PAROLI, ROSALEE, DANIELLE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1326780248,"PAROLI, ROSALEE, DANIELLE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 24 , 28 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326780248,"PAROLI, ROSALEE, DANIELLE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1326780248,"PAROLI, ROSALEE, DANIELLE",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1326780248,"PAROLI, ROSALEE, DANIELLE",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1326780248,"PAROLI, ROSALEE, DANIELLE",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1326780248,"PAROLI, ROSALEE, DANIELLE",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326780354,SPRING ARBOR KINSTON NC TENANT LLC,SPRING ARBOR OF KINSTON,3207 CAREY RD   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1326780354,SPRING ARBOR KINSTON NC TENANT LLC,3207 CAREY RD   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 4,203 "," 4,203 "," $277,932.68 ",,
MEDICAID DIRECT,1437200417,LANE AND ASSOCIATES IV DDS PA,~,315 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1326781907,"PURKS, TAYLOR, PAULINE",1310 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1659642395,LANE AND ASSOCIATES XXV DDS PA,,1117 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1326781907,"PURKS, TAYLOR, PAULINE",1310 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1326784786,"VOLLENWEIDER, AARON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1326785916,"MAYBERRY, FELICITY, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326787797,"MURPHY, KATHERINE, ANNE",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326787797,"MURPHY, KATHERINE, ANNE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1326787797,"MURPHY, KATHERINE, ANNE",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1326787797,"MURPHY, KATHERINE, ANNE",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326787797,"MURPHY, KATHERINE, ANNE",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326787847,"GUFFEY, CHARLENE, HARDIN",1403 E MAIN ST   BOGER CITY NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477510659,LINCOLN PEDIATRICS CLINIC PA,LINCOLN PEDIATRICS CLINIC PA,113 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1326787847,"GUFFEY, CHARLENE, HARDIN",1403 E MAIN ST   BOGER CITY NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 18 , 34 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1326790825,"SMITH, HAYLEY, DEANNA",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 171 , 344 , 499 ," $20,050.98 ",,
MEDICAID DIRECT,1326792516,CEG CARE HOME CARE,,301 N MAIN ST STE 2455 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1326792516,CEG CARE HOME CARE,301 N MAIN ST STE 2455 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 1,002 "," 1,022 "," $99,324.18 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1326795154,"WILLIS, BRITTNEY, TAYLOR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1326795154,"WILLIS, BRITTNEY, TAYLOR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 59 , 63 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1326795154,"WILLIS, BRITTNEY, TAYLOR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1326795154,"WILLIS, BRITTNEY, TAYLOR",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 77 , 87 , 103 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326795493,"BURKE, ERINN, NORA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1326798398,"PENDER, JULIE, FLOWERS",1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 33 , 44 ,$#,,
MEDICAID DIRECT,1073816997,ARMC PHYSICIANS CARE INC,CORNERSTONE MEDICAL CENTER,1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1326798398,"PENDER, JULIE, FLOWERS",1041 KIRKPATRICK RD STE 100 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 71 , 105 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326799529,"PARTON, DREW, MCKENZIE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326799529,"PARTON, DREW, MCKENZIE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326799529,"PARTON, DREW, MCKENZIE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326799529,"PARTON, DREW, MCKENZIE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1326801697,"HAMMACK, JONATHAN, DREW",220 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 132 , 216 , 247 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326807199,"WRIGHT, TIFFANY, NICOLE",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376605394,SKIN CANCER AND COSMETIC DERMATOLOG,,136 BATTLEFIELD CROSSING CT   RINGGOLD GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1326811258,"BOGGS, KAYLA, RENEE",101 RIVERSTONE VIS STE 215 BLUE RIDGE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326813338,"HOSSEINI, FARANAK",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1326813338,"HOSSEINI, FARANAK",2525 COURT DR   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1326815820,"COX, ADASSA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 156 , 158 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1326823170,"SEYMOUR, TYRA, MARIE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326865874,"EANES, ROBIN, TAYLOR",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 14 , 15 , 22 ,$#,,
MEDICAID DIRECT,1356069819,APPALACHIAN MOUNTAIN COMMUNITY HEAL,,419 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1326871013,"PETERSON, MADALYN, ANN",419 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871854828,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1326876475,"GAINES, NICHOLE, SHIONTAINE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396242046,OLU A OYEGUNWA DDS PLLC,O2 DENTAL GROUP,7150 MARKET ST STE 130 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1326880683,"HUGHES, EMMA, MAE",7150 MARKET ST STE 130 WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 355 , 744 ," 2,218 "," $121,831.88 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1326888546,"CASEY, JOHANNA, SUE",2301 ERWIN ROAD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336100064,"THOMPSON, AMY, LYNNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 68 , 110 ,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1336100619,"LIPKIN, ADAM, PAUL",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457514143,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336100619,"LIPKIN, ADAM, PAUL",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 58 , 63 ,$#,,
MEDICAID DIRECT,1912965989,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,455 S MAIN ST STE 100 DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336100742,"BEST, KENNETH, WHITTEN",455 S MAIN ST STE 100 DAVIDSON NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336100742,"BEST, KENNETH, WHITTEN",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336101294,"KETCHMAN, CHRISTOPHER, JOHN",131 W EDINBOROUGH AVE   RAEFORD NC,047,Hoke,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336101591,"KREITZ, KEITH, ALLAN",211 DUPLIN ST   KENANSVILLE NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 64 , 68 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336101757,"KAKRAKANDY, ARSHAD, NAYAMVITTIL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 62 , 62 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336101757,"KAKRAKANDY, ARSHAD, NAYAMVITTIL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336101757,"KAKRAKANDY, ARSHAD, NAYAMVITTIL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336101914,"LONG, MILLIE, DASCOMB",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 24 , 33 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1336101914,"LONG, MILLIE, DASCOMB",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",910 E INNES ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5870 SAMET DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",5870 SAMET DR   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 35 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 64 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1336102060,"PATRICK, FRANK, CHARLES",1122 RANDOLPH ST STE 100 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750718243,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE NORTHEA,1090 NE GATEWAY CT NE STE 201 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336102300,"MARCHANT, JEFFREY",1090 NE GATEWAY CT NE STE 201 CONCORD NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 56 , 86 , 159 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336102300,"MARCHANT, JEFFREY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 29 , 31 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336102466,"MISA, VOLTAIRE, SANTOS DE LOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1336102466,"MISA, VOLTAIRE, SANTOS DE LOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1336102466,"MISA, VOLTAIRE, SANTOS DE LOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 38 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336102466,"MISA, VOLTAIRE, SANTOS DE LOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336102466,"MISA, VOLTAIRE, SANTOS DE LOS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1336102466,"MISA, VOLTAIRE, SANTOS DE LOS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 53 , 60 ,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336103357,"LEWIS, WILLIAM, LLOYD",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336103357,"LEWIS, WILLIAM, LLOYD",720 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336103357,"LEWIS, WILLIAM, LLOYD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134185184,CAROLINA SPINE PAIN AND REHABILITA,CAROLINA SPINE PAIN AND REHABILITATION,900 COX RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336103365,"GORE, HERMAN, CLARK",900 COX RD STE A GASTONIA NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 317 ," 1,320 "," 3,004 "," $52,928.10 ",,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1336103498,"EVANS, JANET, ETCHISON",3812 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336103894,"BAUM, REBECCA, ANDERSON",101 RENEE LYNN CT   CARRBORO NC,068,Orange,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1336103894,"BAUM, REBECCA, ANDERSON",101 RENEE LYNN CT   CARRBORO NC,068,Orange,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336103894,"BAUM, REBECCA, ANDERSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 23 , 35 , 52 ,$#,,
MEDICAID DIRECT,1447214242,TRIANGLE PEDIATRIC CENTER,TRIANGLE PEDIATRIC CENTER,105 RIDGE VIEW DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1336104140,"LEE, SUSAN, CHUNG",105 RIDGE VIEW DR 105 RIDGE VIEW DR CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 18 , 43 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 37 , 44 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 44 , 48 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 36 , 48 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1336104181,"LEADER, DAVID, LINDSAY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1336104181,"LEADER, DAVID, LINDSAY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336104991,"MARREN, MICHELE, MARIE MCKAY",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1336105535,"TAREKEGNE, MULUGETA",,1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1336105535,"TAREKEGNE, MULUGETA",1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1851555734,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RIVERWOOD FAMILY MEDICI,3715 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336106038,"VAN METER, RICHARD, ANTHONY",3715 UNION RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 142 , 231 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336107333,"BEY, RICHARD, DOUD",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 28 , 28 , 54 ,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336107499,"DOWLING, MICHAEL, SCOTT",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 21 , 38 , 49 ,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336107499,"DOWLING, MICHAEL, SCOTT",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 73 , 104 , 142 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1336107499,"DOWLING, MICHAEL, SCOTT",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336107499,"DOWLING, MICHAEL, SCOTT",7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 128 , 246 , 297 ," $15,774.04 ",,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336107499,"DOWLING, MICHAEL, SCOTT",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336107499,"DOWLING, MICHAEL, SCOTT",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336107499,"DOWLING, MICHAEL, SCOTT",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962752881,HOKE HEALTHCARE LLC,HOKE PRIMARY CARE CLINIC,300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1336108109,"LETIZIA, RUTH, ELIZABETH",300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1336108109,"LETIZIA, RUTH, ELIZABETH",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 38 , 119 ,$#,,
MEDICAID DIRECT,1508275553,KIDZCARE PEDIATRICS PC,,216 E BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336108109,"LETIZIA, RUTH, ELIZABETH",216 E BROAD ST   SAINT PAULS NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336108455,"WEBSTER, HALA, JUBRAN",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336108455,"WEBSTER, HALA, JUBRAN",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336108455,"WEBSTER, HALA, JUBRAN",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336108455,"WEBSTER, HALA, JUBRAN",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407134323,BEACHCARE URGENT AND FAMILY MEDICAL,BEACHCARE URGENT AND FAMILY MEDICAL CENTERPLLC,5059 HWY 70 W   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1336109065,"RAPPAPORT, RICHARD, ALAN",5059 HWY 70 W   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942637319,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS OF THE CAROLIN,2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336109313,"BROWN, SARAH, WESTFALL",2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 55 , 68 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336109602,"LAWSON, AIMEE, MICHELLE",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336109602,"LAWSON, AIMEE, MICHELLE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336109602,"LAWSON, AIMEE, MICHELLE",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 61 , 61 ,$#,,
MEDICAID DIRECT,1336110113,"CHUNG, KI, YOUNG",Ki Young Chung,900 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,1336110113,"CHUNG, KI, YOUNG",900 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336110196,"CHAZLI, FIRAS",5102 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 70 , 168 ,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336110196,"CHAZLI, FIRAS",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 34 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336110386,"COLLURA, CHRISTINA, JANE",620 SUMMIT CROSSING PL STE 202 GASTONIA NC,036,Gaston,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336110386,"COLLURA, CHRISTINA, JANE",15940 NORTHCROSS DR STE C HUNTERSVILLE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336110386,"COLLURA, CHRISTINA, JANE",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336110386,"COLLURA, CHRISTINA, JANE",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336110386,"COLLURA, CHRISTINA, JANE",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336110386,"COLLURA, CHRISTINA, JANE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336110386,"COLLURA, CHRISTINA, JANE",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 17 , 151 , 209 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336110931,"HUEMAN, KEVIN, GEOFFREY",1010 TRYON VILLAGE DR   CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 40 , 52 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336110931,"HUEMAN, KEVIN, GEOFFREY",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336110931,"HUEMAN, KEVIN, GEOFFREY",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336111301,"KHAWAJA, USMAN, ANWAR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 14 , 14 , 33 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336111301,"KHAWAJA, USMAN, ANWAR",144 FOREST HILL RD STE 144&146 LEXINGTON NC,029,Davidson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336111301,"KHAWAJA, USMAN, ANWAR",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 25 , 32 , 40 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336111301,"KHAWAJA, USMAN, ANWAR",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 208 , 395 , 613 ," $12,384.32 ",,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1336111301,"KHAWAJA, USMAN, ANWAR",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 111 , 136 , 136 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336111301,"KHAWAJA, USMAN, ANWAR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336111301,"KHAWAJA, USMAN, ANWAR",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 12 , 14 , 18 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336112408,"COLLINS, JIMMIE, NELSON",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336112408,"COLLINS, JIMMIE, NELSON",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336114628,"MAGLAYA, FERNANDO, BELARO",816 INDEPENDENCE BLVD STE 2H VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336114628,"MAGLAYA, FERNANDO, BELARO",844 KEMPSVILLE RD STE 103A NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336115195,"CHATER, KAMAL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336115195,"CHATER, KAMAL",1000 HEALING WAY   MATTHEWS NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1336115195,"CHATER, KAMAL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336115195,"CHATER, KAMAL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 15 , 27 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336115682,"MORRISON, CHERYL, ANN",1038 BETHANIA RURAL HALL RD   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336115682,"MORRISON, CHERYL, ANN",1038 BETHANIA RURAL HALL RD   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 112 , 201 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336115682,"MORRISON, CHERYL, ANN",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336115682,"MORRISON, CHERYL, ANN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336115799,"OLD, WAYNE, D",612 KINGSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336115799,"OLD, WAYNE, D",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,600 GRESHAM DR STE 8620 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336115799,"OLD, WAYNE, D",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336118819,"COCHRAN, RONALD, GLENN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336118819,"COCHRAN, RONALD, GLENN",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336118819,"COCHRAN, RONALD, GLENN",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336118819,"COCHRAN, RONALD, GLENN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336120583,"COLLINS, ANN, SHARPE",4414 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1336120864,"STEVENS, KEISHA, CONSUELLA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336120864,"STEVENS, KEISHA, CONSUELLA",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336120864,"STEVENS, KEISHA, CONSUELLA",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336121797,"FARLEY, DAVID, JEFFERSON",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932189545,CAROLINA BONE AND JOINT,,1315 E SUNSET DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336123157,"HAYES, CHASON, SPENCER",1315 E SUNSET DR   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 41 ,$#,,
MEDICAID DIRECT,1932189545,CAROLINA BONE AND JOINT,,1315 E SUNSET DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336123157,"HAYES, CHASON, SPENCER",600 HOSPITAL DR   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1932189545,CAROLINA BONE AND JOINT,,10508 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336123157,"HAYES, CHASON, SPENCER",10508 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 61 , 134 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336123751,"BARHAM, ANN, HIOTT",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336123751,"BARHAM, ANN, HIOTT",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 48 , 62 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336123835,"DECKER, MELISSA, RUTH",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336124338,"FLOOD, ROY, DEVONNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336124338,"FLOOD, ROY, DEVONNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205925914,DR ALAN L BYRD AND ASSOCIATES,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336124833,"BYRD, ALAN, L",104 S MAIN ST   LILLINGTON NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,, 106 , 116 , 182 ,$#,,
MEDICAID DIRECT,1669561320,DR ALAN L BYRD ASSOCS OF ERWIN,~,2332 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336124833,"BYRD, ALAN, L",2332 W CUMBERLAND ST   DUNN NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,, 60 , 63 , 90 ,$#,,
MEDICAID DIRECT,1205925914,DR ALAN L BYRD AND ASSOCIATES,DR ALAN L BYRD AND ASSOCIATES,104 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336124833,"BYRD, ALAN, L",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720169220,DR ALAN L BYRD ASSOCIATES OF ANGIER,DR ALAN L BYRD & ASSOCIATES OF ANGIER,8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,193200000X,Group,Multi-Specialty,,1336124833,"BYRD, ALAN, L",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336124924,"MAYHEW, KAREN, SHAVER",656 CARPENTER AVE   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336124924,"MAYHEW, KAREN, SHAVER",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336125590,"WILHELMSON, JULIE, ANN BROTHERS",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,522 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1336125590,"WILHELMSON, JULIE, ANN BROTHERS",522 S VAN BUREN RD   EDEN NC,079,Rockingham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1285719997,ALPHA MEDICAL CENTER PA,~,1815 FORT BRAGG RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336125707,"OJO, BABATUNDE, ABIODUN",1815 FORT BRAGG RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 250 ," 1,225 "," 2,764 "," $43,313.66 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336126945,"BOZEMAN, WILLIAM, PYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 101 , 107 , 116 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336126945,"BOZEMAN, WILLIAM, PYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336127273,"CHEUNG, CATHERINE, WEI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336127273,"CHEUNG, CATHERINE, WEI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336127273,"CHEUNG, CATHERINE, WEI",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336127273,"CHEUNG, CATHERINE, WEI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336127273,"CHEUNG, CATHERINE, WEI",16455 STATESVILLE RD STE 100 HUNTERSVILLE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336127273,"CHEUNG, CATHERINE, WEI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1538217179,LEBAUER MEDICAL CENTER,~,3201 BRASSFIELD RD STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1336129410,"VAN WINKLE, ROBERT, CHRISTOPHER",3201 BRASSFIELD RD STE 400 GREENSBORO NC,041,Guilford,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 45 , 311 , 359 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336129535,"PETRUZZIELLO, MARK, JOHN",101 CLINIC DR   TARBORO NC,033,Edgecombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336129535,"PETRUZZIELLO, MARK, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 112 , 169 , 209 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336129915,"GLASSER, SCOTT, ANDREW",700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 40 , 44 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1336130418,"DEATON, BARBARA, JANE",304 S GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336132349,"LEWIS, DANIEL, ETHAN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336132430,"JONES, DAVID, SCOTT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 16 , 22 , 41 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336132430,"JONES, DAVID, SCOTT",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 48 , 89 , 114 ,$#,,
MEDICAID DIRECT,1811319171,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,5330B SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336134436,"WELLS, DAVID, MCLEAN",6300 E INDEPENDENCE BLVD STE A CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1629266820,AUSTIN VILLAGE EYECARE OD PA,UNION FAMILY EYE ASSOCIATES,1013 CHESTNUT LN STE 210 MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1336134485,"BHAT, KESHAV, SUBRAYA",1013 CHESTNUT LN STE 210 MATTHEWS NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1336134485,"BHAT, KESHAV, SUBRAYA",~,1013 CHESTNUT LN STE 210 MATTHEWS NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,1336134485,"BHAT, KESHAV, SUBRAYA",1013 CHESTNUT LN STE 210 MATTHEWS NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1336135052,"ROBERTS, MICHAEL, WILLIAM",139 DR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 108 , 214 , 513 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336135623,"STALLWORTH, ACQUAWON, JEAN",1904 JAKE ALEXANDER BLVD W STE 301 SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 203 , 443 , 837 ," $13,468.29 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336135623,"STALLWORTH, ACQUAWON, JEAN",1904 JAKE ALEXANDER BLVD W STE 303 SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336135623,"STALLWORTH, ACQUAWON, JEAN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336135623,"STALLWORTH, ACQUAWON, JEAN",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 16 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336135623,"STALLWORTH, ACQUAWON, JEAN",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 88 , 176 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336136837,"ELINE, EUGENE, ANTHONY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336136837,"ELINE, EUGENE, ANTHONY",1910 JAKE ALEXANDER BLVD W STE 202 SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 51 , 113 , 159 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336136837,"ELINE, EUGENE, ANTHONY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336136837,"ELINE, EUGENE, ANTHONY",810 MITCHELL AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336137124,"BROWN, SUZANNE, SPIVEY",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336137124,"BROWN, SUZANNE, SPIVEY",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336137652,"RUSSELL, AMY, HOWARD",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 23 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336137652,"RUSSELL, AMY, HOWARD",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336138809,"JOHNSON, KEVIN, EARL",290 W WALL ST   RURAL HALL NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336138809,"JOHNSON, KEVIN, EARL",3409 THOMASVILLE RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,803 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336140235,"CHRISTENSEN, TRACY, LEE",803 TILGHMAN DR STE 300 DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 441 , 583 ," $13,579.76 ",,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1336140235,"CHRISTENSEN, TRACY, LEE",803 TILGHMAN DR STE 300 DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 123 , 163 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336141258,"MOORE, RICHARD, SULTER",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 46 , 73 , 106 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336142488,"SUNDARARAMAN, SRINATH",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336142488,"SUNDARARAMAN, SRINATH",4927 S CROATAN HWY   NAGS HEAD NC,028,Dare,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609186790,THE STEDMAN WADE HEALTH SERVICES IN,~,2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336142959,"HENDERSON HINES, NANCY, LUCILLE",2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 118 , 120 ,$#,,
MEDICAID DIRECT,1609186790,THE STEDMAN WADE HEALTH SERVICES IN,~,2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336142959,"HENDERSON HINES, NANCY, LUCILLE",2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 122 , 126 , 162 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 587 , 878 ," 1,033 ",$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 81 , 106 ,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 17 ,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 82 , 86 , 108 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",609 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 39 , 45 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 55 , 66 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 58 , 60 , 73 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 72 , 81 , 103 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 130 , 163 , 215 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 40 , 57 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 76 , 82 , 113 ,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1336142975,"FAYKUS JR, MAX, HENRY",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1275596439,CAROLINA SPECIALTY CARE PA,CAROLINA SPECIALTY CARE PA,293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336144138,"WATSON, JEROME, THOMAS",293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 368 ," 2,575 "," 3,355 "," $40,991.26 ",,
MEDICAID DIRECT,1831809755,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV HOSPITAL SPECIALTY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336144823,"SLEHRIA, SANJEEV, KUMAR SUSHIL KUMAR",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1912340944,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1336144823,"SLEHRIA, SANJEEV, KUMAR SUSHIL KUMAR",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 22 , 30 ,$#,,
MEDICAID DIRECT,1831809755,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV HOSPITAL SPECIALTY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336144823,"SLEHRIA, SANJEEV, KUMAR SUSHIL KUMAR",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336144823,"SLEHRIA, SANJEEV, KUMAR SUSHIL KUMAR",1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 99 , 131 , 163 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336147768,"ZIMMERMAN, DONIELLE, MARIE",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336147768,"ZIMMERMAN, DONIELLE, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336148279,INNOVATIVE PHYSICAL THERAPY,~,503 CANVASBACK RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336148279,INNOVATIVE PHYSICAL THERAPY,503 CANVASBACK RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,, 11 , 132 , 137 ," $12,067.82 ",,
MEDICAID DIRECT,1336149426,COCHLEAR AMERICAS,COCHLEAR AMERICAS,10350 PARK MEADOWS DR   LONE TREE CO,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336149426,COCHLEAR AMERICAS,10350 PARK MEADOWS DR   LONE TREE CO,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 26 , 30 , 40 ," $37,412.24 ",,
MEDICAID DIRECT,1336150093,"PAYNE, DANNY, JOE",~,525 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,152W00000X,Eye and Vision Services Providers,Optometrist,,1336150093,"PAYNE, DANNY, JOE",525 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,152W00000X,Eye and Vision Services Providers,Optometrist,, 137 , 143 , 213 ,$#,,
MEDICAID DIRECT,1548620297,RHA BEHAVIORAL HEALTH NC LLC,,2732 ANN ELIZABETH DR   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336150150,"LITZ, MARIEL, MELISSA",2732 ANN ELIZABETH DR   BURLINGTON NC,001,Alamance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1336150192,"TUCK, WINNIE, BEVERLY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336150952,"YORK, SERENA, FAMATTA",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336150952,"YORK, SERENA, FAMATTA",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 78 , 83 , 84 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336150952,"YORK, SERENA, FAMATTA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336153881,"HICKEY, KATHLEEN, ANN",1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 30 , 30 ,$#,,
MEDICAID DIRECT,1023366242,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336153881,"HICKEY, KATHLEEN, ANN",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1023366242,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336153881,"HICKEY, KATHLEEN, ANN",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336153881,"HICKEY, KATHLEEN, ANN",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336153956,"LLOYD, RONNIE, DAVIS",RONNIE DAVIS LLOYD DDS,105 W CHURCH ST   NASHVILLE NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,1336153956,"LLOYD, RONNIE, DAVIS",105 W CHURCH ST   NASHVILLE NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 134 , 183 , 466 ," $24,395.11 ",,
MEDICAID DIRECT,1891884748,BLUE RIDGE HEALTHCARE MEDICAL GROUP,GRACE PSYCHIATRIC ASSOCIATES,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336155050,"ROBINSON, MARY, KATHLEEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 231 , 231 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336155050,"ROBINSON, MARY, KATHLEEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336155746,"ALEXANDER, MICHAEL, WARREN",1622 E MARION ST   SHELBY NC,023,Cleveland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336157122,"DESAI, NILAY, VIPINBHAI",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 306 , 474 , 820 ," $12,315.45 ",,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336158070,"CAPPOLA, JAMES, JOSEPH",133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 102 , 126 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336158070,"CAPPOLA, JAMES, JOSEPH",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336158070,"CAPPOLA, JAMES, JOSEPH",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 30 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336158070,"CAPPOLA, JAMES, JOSEPH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740047455,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD DIGESTIVE HEALTH CENTER,401 EAST CHEVES STREET SUITE 301 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336158658,"JAGGERS, TERRI, LYNN",401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336160670,"AJJAN, MAHDI",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 43 , 46 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336160670,"AJJAN, MAHDI",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 37 , 41 ,$#,,
MEDICAID DIRECT,1881792992,CHAPEL HILL CHILDREN & ADOLESCENTS,CHAPEL HILL CHILDREN & ADOLESCENTS,301 KILDAIRE RD STE 200 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1336162361,"DELGADO, KATHARINE, PHOEBE CIOFFI",301 KILDAIRE RD STE 200 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 24 , 73 ,$#,,
MEDICAID DIRECT,1649027111,CHATHAM PEDIATRICS PLLC,,10327 US 15 501 N   CHAPEL HILL NC,019,Chatham,193400000X,Group,Single Specialty,,1336162361,"DELGADO, KATHARINE, PHOEBE CIOFFI",301 KILDAIRE RD STE 200 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 21 ,$#,,
MEDICAID DIRECT,1295132009,ST LUKES PHYSICIAN NETWORK INC,CAROLINAS HOSPITALIST GROUP-ST LUKES,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336164078,"HOFFERBERT, PAUL, WESLEY",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336164615,"KEYSERLING, THOMAS, CHARLES",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 34 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336164615,"KEYSERLING, THOMAS, CHARLES",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336164615,"KEYSERLING, THOMAS, CHARLES",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 52 , 122 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336164680,"BUSE, JOHN, BERNARD",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336164680,"BUSE, JOHN, BERNARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 15 , 30 ,$#,,
MEDICAID DIRECT,1447383773,ASHEVILLE PEDIATRIC ASSOCIATES PA,ASHEVILLE PEDIATRIC ASSOCIATES PA,2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1336164706,"PAGE, DONNA, ANN",2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1336165166,"BROWN, KRISTI, LYNNE ENGLISH",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 17 , 30 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1336165166,"BROWN, KRISTI, LYNNE ENGLISH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336165695,"BAKER, DONYA, TODD",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336166347,SLEEP MANAGEMENT LLC,VIEMED,625 E KALISTE SALOOM RD   LAFAYETTE LA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336166347,SLEEP MANAGEMENT LLC,625 E KALISTE SALOOM RD   LAFAYETTE LA,102,Out of State > 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1336166347,SLEEP MANAGEMENT LLC,VIEMED,625 E KALISTE SALOOM RD   LAFAYETTE LA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336166347,SLEEP MANAGEMENT LLC,625 E KALISTE SALOOM RD   LAFAYETTE LA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 45 , 299 , 319 ," $68,984.82 ",,
MEDICAID DIRECT,1336166347,SLEEP MANAGEMENT LLC,VIEMED,625 E KALISTE SALOOM RD   LAFAYETTE LA,102,Out of State > 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1336166347,SLEEP MANAGEMENT LLC,625 E KALISTE SALOOM RD   LAFAYETTE LA,102,Out of State > 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1093793473,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1336167733,"CHAFIN, TIMOTHY, BRENT",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 139 , 153 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336168996,"BRUNING, KEVIN, FRANCIS",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 37 , 39 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336168996,"BRUNING, KEVIN, FRANCIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336168996,"BRUNING, KEVIN, FRANCIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336168996,"BRUNING, KEVIN, FRANCIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336171230,"SAMPSON, KELVIN, KEITH",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 45 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE C PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336171230,"SAMPSON, KELVIN, KEITH",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE B PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336171230,"SAMPSON, KELVIN, KEITH",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336171230,"SAMPSON, KELVIN, KEITH",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 22 , 55 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,102 N BOND ST   ROWLAND NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336171230,"SAMPSON, KELVIN, KEITH",102 N BOND ST   ROWLAND NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 118 , 501 , 894 ," $13,479.81 ",,
MEDICAID DIRECT,1902209877,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN MEDICAL CLINIC ROWLAND,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1336171230,"SAMPSON, KELVIN, KEITH",102 N BOND ST   ROWLAND NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1427282045,SOUTHEASTERN REGIONAL PHYSICIAN SER,~,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1336171230,"SAMPSON, KELVIN, KEITH",101 N WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336171230,"SAMPSON, KELVIN, KEITH",101 N WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 69 , 97 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336172543,"STONEKING, BRADLEY, JON",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336172543,"STONEKING, BRADLEY, JON",2630 WILLARD DAIRY RD STE 303 HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 31 , 70 , 100 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336172543,"STONEKING, BRADLEY, JON",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,2630 WILLARD DAIRY RD STE 303 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336172543,"STONEKING, BRADLEY, JON",2630 WILLARD DAIRY RD STE 303 HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336172543,"STONEKING, BRADLEY, JON",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1225500804,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,170 CHURCH ST   FRANKLIN NC,056,Macon,251B00000X,Agencies,Case Management,,1336173749,"HELM, KIT, CHRISTOPHER",161 IOTLA ST   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679689962,MOUNTAIN DOCS FAMILY MEDICINE PA,~,161 IOTLA ST   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1336173749,"HELM, KIT, CHRISTOPHER",161 IOTLA ST   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679689962,MOUNTAIN DOCS FAMILY MEDICINE PA,~,161 IOTLA ST   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1336173749,"HELM, KIT, CHRISTOPHER",161 IOTLA ST   FRANKLIN NC,056,Macon,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336174184,"SMITH, CATHERINE, MARY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 121 , 128 , 161 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336174184,"SMITH, CATHERINE, MARY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336174184,"SMITH, CATHERINE, MARY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336174184,"SMITH, CATHERINE, MARY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336176767,"INCANDELA, NICHOLAS, JOSEPH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336176767,"INCANDELA, NICHOLAS, JOSEPH",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 66 , 70 , 74 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336176767,"INCANDELA, NICHOLAS, JOSEPH",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1336177997,MTS SPEECH AND LANGUAGE SERVICES IN,Mts Speech and Language Services Inc,3609 TURQUOISE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336177997,MTS SPEECH AND LANGUAGE SERVICES IN,3609 TURQUOISE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#, 98 , 98 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336178011,"LEFEBVRE, CEDRIC, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 91 , 101 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336178136,"CAULWAY, KIMBERLY, ANN",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336178136,"CAULWAY, KIMBERLY, ANN",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336178136,"CAULWAY, KIMBERLY, ANN",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1336178136,"CAULWAY, KIMBERLY, ANN",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336178136,"CAULWAY, KIMBERLY, ANN",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1336178136,"CAULWAY, KIMBERLY, ANN",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 20 , 40 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR STE 101 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1336178136,"CAULWAY, KIMBERLY, ANN",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336178706,"MIRANDA, RAFAEL, ANGEL",610 W FISHER ST   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336178706,"MIRANDA, RAFAEL, ANGEL",610 W FISHER ST   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 38 , 38 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336178706,"MIRANDA, RAFAEL, ANGEL",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 22 , 22 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336178706,"MIRANDA, RAFAEL, ANGEL",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 129 , 366 , 366 ," $22,354.43 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336179142,"ARSHAD, MOHSIN, ALI",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 35 , 35 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336179142,"ARSHAD, MOHSIN, ALI",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 45 , 45 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336179142,"ARSHAD, MOHSIN, ALI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1336179142,"ARSHAD, MOHSIN, ALI",117 E KINGS HWY   EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1336179969,"SHOFFNER, JONATHAN, DANIEL",316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1336179969,"SHOFFNER, JONATHAN, DANIEL",316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 68 , 169 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336180389,"SCHLAPPICH, LESLIE, MCWHORTER",600 HOSPITAL DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336181015,"GELASHVILI, MARIKA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 205 , 233 , 298 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 57 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 98 , 105 , 123 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 28 , 31 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 29 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336181288,"ENDE, JOHN, FRANCIS",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1336181643,"LIEBERMAN, NATHAN, ALAN",~,1635A OWEN DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,1336181643,"LIEBERMAN, NATHAN, ALAN",1635A OWEN DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 69 , 78 , 143 ,$#,,
MEDICAID DIRECT,1558302067,LIEBERMAN AND LIEBERMAN OPTOMETRY,PROFESSIONAL OPTOMETRY,1635A OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336181643,"LIEBERMAN, NATHAN, ALAN",1635A OWEN DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 21 , 27 , 47 ,$#,,
MEDICAID DIRECT,1821139387,LIEBERMAN AND LIEBERMAN OPTOMETRY,~,327 S 5TH ST   SAINT PAULS NC,078,Robeson,193400000X,Group,Single Specialty,,1336181643,"LIEBERMAN, NATHAN, ALAN",327 S 5TH ST   SAINT PAULS NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,, 41 , 42 , 57 ,$#,,
MEDICAID DIRECT,1295194751,SMITHFIELD FAMILY EYE CARE OD PA,~,1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336182427,"STOCKBRIDGE, GREGORY, JAMES",1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 137 , 199 , 312 ," $10,087.76 ",,
MEDICAID DIRECT,1336182500,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 17215,12830 WALKER BRANCH RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1336182500,NORTH CAROLINA CVS PHARMACY LLC,12830 WALKER BRANCH RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336188457,"SPELLMAN, MICHAEL, JAMES",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336189174,"AGRAWAL, NEERAJ, RAMVISHAL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 35 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336189174,"AGRAWAL, NEERAJ, RAMVISHAL",3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 78 , 108 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336189505,"STRICKLAND, MYRON, SCOTT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336189505,"STRICKLAND, MYRON, SCOTT",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336189505,"STRICKLAND, MYRON, SCOTT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336189505,"STRICKLAND, MYRON, SCOTT",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 67 , 91 , 163 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336190446,"STEPPLING, MARY, E.",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992757827,PIEDMONT INTERNAL MEDICINE,~,3214 CHARLES B ROOT WYND STE 211 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336190578,"MASOOD, NASEEM, JEHEN",3214 CHARLES B ROOT WYND STE 211 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 52 , 121 , 279 ,$#,,
MEDICAID DIRECT,1336188184,MIDCAROLINA PEDIATRICS,MIDCAROLINA PEDIATRICS,2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336191048,"IGHADE, ANDREW, ELUONYE",2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 49 , 137 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1336194125,"ZDANSKI, CARLTON, JUDE",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 40 , 48 , 53 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336194125,"ZDANSKI, CARLTON, JUDE",4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336194125,"ZDANSKI, CARLTON, JUDE",4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336194125,"ZDANSKI, CARLTON, JUDE",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336194125,"ZDANSKI, CARLTON, JUDE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 61 , 113 , 157 ," $20,225.19 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336194521,"BOBBITT III, WILLIAM, HAYWOOD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1336194521,"BOBBITT III, WILLIAM, HAYWOOD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1336195551,"BELL, EDWIN, LILLINGTON",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336195783,"WEST, SUSAN, MCLENDON",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,300 ASHVILLE AVE STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336196203,"SAILER, SCOTT, LEE",300 ASHVILLE AVE STE 110 CARY NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336196203,"SAILER, SCOTT, LEE",3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336197219,"MULLINAX, EVANGELISTA, MARKUB",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336198126,"CHOCANO, JOSE, FRANCISCO",850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,2080S0012X,Allopathic & Osteopathic Physicians,Pediatrics,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336198126,"CHOCANO, JOSE, FRANCISCO",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080S0012X,Allopathic & Osteopathic Physicians,Pediatrics,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336198126,"CHOCANO, JOSE, FRANCISCO",500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336198126,"CHOCANO, JOSE, FRANCISCO",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 11 , 22 , 23 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336198423,"SAADAH, KHALID, MOHAMMAD",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336198787,"PENA, SANDRA, WILLIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336198787,"PENA, SANDRA, WILLIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336198787,"PENA, SANDRA, WILLIS",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336199249,"TROUTMAN, SOUNDRA, GAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1336199793,"KLEIN, KEVIN, MART",222 N LAFAYETTE ST STE 23 SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336202118,"MACINTYRE, NEIL, ROSS",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1336202118,"MACINTYRE, NEIL, ROSS",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1336202118,"MACINTYRE, NEIL, ROSS",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336202118,"MACINTYRE, NEIL, ROSS",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#, 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336202118,"MACINTYRE, NEIL, ROSS",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 51 , 52 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336202118,"MACINTYRE, NEIL, ROSS",2100 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 14 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336202118,"MACINTYRE, NEIL, ROSS",2100 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 68 , 68 , 146 ,$#,,
MEDICAID DIRECT,1336204429,SOUTHERN ASSISTED LIVING INC,BROOKDALE CONCORD PARKWAY,2452 ROCK HILL CHURCH RD NW   CONCORD NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1336204429,SOUTHERN ASSISTED LIVING INC,2452 ROCK HILL CHURCH RD NW   CONCORD NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 963 , 963 ," $79,306.01 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336205558,"VILLARROEL, SARAH, ASHLEY",3116 N DUKE ST   DURHAM NC,032,Durham,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics, 22 , 23 , 24 ," $11,949.24 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336205558,"VILLARROEL, SARAH, ASHLEY",3116 N DUKE ST   DURHAM NC,032,Durham,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336209915,"MOLL, STEPHAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336209915,"MOLL, STEPHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 44 , 49 , 51 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336213883,"DOUGLAS, THOMAS, HENRY",1698 HIGHWAY 160 W STE 220 FORT MILL SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336213883,"DOUGLAS, THOMAS, HENRY",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336217934,"RHYMER, COLLEEN, SULLIVAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1336218072,"GOLDIE, JASON, FRANKLIN",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 197 , 462 ,$#,,
MEDICAID DIRECT,1336219427,SECURING RESOURCES FOR CONSUMERS IN,~,3711 UNIVERSITY DR STE C DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1336219427,SECURING RESOURCES FOR CONSUMERS IN,3711 UNIVERSITY DR STE C DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1023174711,NORTHAMPTON COUNTY,NORTHAMPTON COUNTY HEALTH DEPARTMENT,9495 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1336222157,"TAYLOR, FRANCIS, MARVIN",111 E MAIN ST   CONWAY NC,066,Northampton,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 35 , 56 ,$#,,
MEDICAID DIRECT,1669687851,NORTHHAMPTON FAMILY PRACTICE PC,NORTHHAMPTON FAMILY PRACTICE PC,111 E MAIN ST   CONWAY NC,066,Northampton,193400000X,Group,Single Specialty,,1336222157,"TAYLOR, FRANCIS, MARVIN",111 E MAIN ST   CONWAY NC,066,Northampton,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 656 , 658 ," $14,150.09 ",,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1336222157,"TAYLOR, FRANCIS, MARVIN",111 E MAIN ST   CONWAY NC,066,Northampton,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1336222371,"LEWIS, STEVEN, CHARLES",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 32 , 70 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336222652,"MICK, JOSHUA, KEITH",4517 JESSUP GROVE RD FL 2 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336223015,"KADAU, MELISSA, WILLIAMSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336223015,"KADAU, MELISSA, WILLIAMSON",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336223049,"APPLEGATE, KATHERINE, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336223049,"APPLEGATE, KATHERINE, LYNN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1336223247,"AL KHATIB, SANA, MUSTAPHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 64 , 71 , 122 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336223247,"AL KHATIB, SANA, MUSTAPHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1336223247,"AL KHATIB, SANA, MUSTAPHA",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336223247,"AL KHATIB, SANA, MUSTAPHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 29 , 38 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336223247,"AL KHATIB, SANA, MUSTAPHA",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 13 , 16 , 18 ,$#,,
MEDICAID DIRECT,1790895126,BARRETT & COLLINS DDS PLLC,,313 HOSPITAL RD   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1336223718,"COLLINS, BRIAN, KEVIN",313 HOSPITAL RD   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 57 , 105 , 423 ," $10,553.14 ",,
MEDICAID DIRECT,1336224021,THE BRADFORD VILLAGE OF KERNERSVILL,,602 PINEY GROVE RD   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1336224021,THE BRADFORD VILLAGE OF KERNERSVILL,602 PINEY GROVE RD   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 45 ," 10,553 "," 10,553 "," $686,517.96 ",,
MEDICAID DIRECT,1336226034,MECKLENBURG EMS AGENCY,MEDIC,4425 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,3416L0300X,Transportation Services,Ambulance,Land Transport,1336226034,MECKLENBURG EMS AGENCY,4425 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,3416L0300X,Transportation Services,Ambulance,Land Transport," 1,331 "," 3,212 "," 6,399 ",$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336229061,"CAMPBELL, HEIDI, DIANE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336229061,"CAMPBELL, HEIDI, DIANE",250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 32 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336229061,"CAMPBELL, HEIDI, DIANE",2133 ROCKFORD ST STE 1400 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 87 , 213 ,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336230416,"CLOSSON, CAREY-WALTER, FRANKLIN",330 BILLINGSLEY RD STE 210 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 108 , 328 , 380 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336230747,"GILBERT, RICHARD, LESLIE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336230747,"GILBERT, RICHARD, LESLIE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 104 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336234012,"CZITO, BRIAN, GARY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 98 , 127 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336234012,"CZITO, BRIAN, GARY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,300 ASHVILLE AVE STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336234012,"CZITO, BRIAN, GARY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336234012,"CZITO, BRIAN, GARY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336234012,"CZITO, BRIAN, GARY",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336234012,"CZITO, BRIAN, GARY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 76 , 104 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336234012,"CZITO, BRIAN, GARY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336235969,"FORNAH, FATIMA, ALIMATU",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336235969,"FORNAH, FATIMA, ALIMATU",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336235969,"FORNAH, FATIMA, ALIMATU",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336235969,"FORNAH, FATIMA, ALIMATU",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336236090,"DRAUGHN, DAVID, GARDNER",~,860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1336236090,"DRAUGHN, DAVID, GARDNER",860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 72 , 100 ,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336236090,"DRAUGHN, DAVID, GARDNER",860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 29 , 40 ,$#,,
MEDICAID DIRECT,1346337094,VEIN SPECIALISTS OF THE CAROLINAS,,860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336236090,"DRAUGHN, DAVID, GARDNER",860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1336236090,"DRAUGHN, DAVID, GARDNER",~,860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1336236090,"DRAUGHN, DAVID, GARDNER",860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336236090,"DRAUGHN, DAVID, GARDNER",860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336236090,"DRAUGHN, DAVID, GARDNER",~,15825 BALLANTYNE MEDICAL PL STE 240 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1336236090,"DRAUGHN, DAVID, GARDNER",15825 BALLANTYNE MEDICAL PL STE 240 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194801852,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CLAYTON,31 OLEANDER DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336238690,"WILLIAMS, NICOLE, KELLEY",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 33 , 128 ,$#,,
MEDICAID DIRECT,1336242197,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03525,1320 W D ST STE 6 NORTH WILKESBORO NC,097,Wilkes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1336242197,NORTH CAROLINA CVS PHARMACY LLC,1320 W D ST STE 6 NORTH WILKESBORO NC,097,Wilkes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1336242973,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07681,10478 N NC HIGHWAY 109 STE 105 WINSTON SALEM NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1336242973,NORTH CAROLINA CVS PHARMACY LLC,10478 N NC HIGHWAY 109 STE 105 WINSTON SALEM NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1336246289,"JAGGERS, FREDENA, LUCAS",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 95 , 99 , 99 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336249382,"HUNT, KAREN, CHRISTINA",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336249382,"HUNT, KAREN, CHRISTINA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 24 , 32 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1336249382,"HUNT, KAREN, CHRISTINA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1336249382,"HUNT, KAREN, CHRISTINA",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1912952672,DREAM PROVIDER CARE SERVICES,DREAM PROVIDER CARE SERVICES INC,216 STEWART PKWY   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1336249846,"ANGELL, JANE",216 STEWART PKWY   WASHINGTON NC,007,Beaufort,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336250158,"BUCHHEIT, THOMAS, EDWARD",40 DUKE MEDICINE CIR CLINIC 2F2G DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336250158,"BUCHHEIT, THOMAS, EDWARD",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720420797,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS THOMASVIL,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1336250265,"KALEAB, BIRHANE, GEBREYESUS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336250265,"KALEAB, BIRHANE, GEBREYESUS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336250265,"KALEAB, BIRHANE, GEBREYESUS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 28 , 72 , 77 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336250265,"KALEAB, BIRHANE, GEBREYESUS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1336253236,"BLACKARD JR, WILLIAM, GRIFFITH",11 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336253236,"BLACKARD JR, WILLIAM, GRIFFITH",11 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 16 , 21 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1336253814,"PLATTS MILLS, TIMOTHY, FORTESCUE",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 29 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1336253814,"PLATTS MILLS, TIMOTHY, FORTESCUE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1336254515,"DERSE, THEODORE, SCOTT",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 36 , 46 ,$#,,
MEDICAID DIRECT,1972656262,ASHEVILLE ENDOCRINOLOGY CONSULTANTS,ASHEVILLE ENDOCRINOLOGY CONSULTANTS PA,750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1336254549,"BARTON, LINDA, BROWN",750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 220 , 333 ," 1,257 "," $11,291.72 ",,
MEDICAID DIRECT,1972656262,ASHEVILLE ENDOCRINOLOGY CONSULTANTS,ASHEVILLE ENDOCRINOLOGY CONSULTANTS PA,750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336254549,"BARTON, LINDA, BROWN",750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,, 12 , 57 , 169 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,#, 20 , 54 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 31 , 31 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",3605 PETERS CT   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 30 , 67 , 85 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",3610 PETERS CT   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 64 , 97 , 98 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 42 , 128 , 158 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 223 ," 1,114 "," 1,613 "," $11,407.19 ",,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336254697,"TANANIS JR, LEONARD, JOHN",3604 PETERS CT   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 27 , 75 , 104 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1336255223,"WHITFIELD, KATHERINE, OPPEDAHL",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1336255223,"WHITFIELD, KATHERINE, OPPEDAHL",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 85 , 92 , 152 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1336255223,"WHITFIELD, KATHERINE, OPPEDAHL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336255223,"WHITFIELD, KATHERINE, OPPEDAHL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336257724,"UPSTILL, SHARI, ANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336266329,"AL SOUDI, MAHDI, ABDEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 207 , 207 ," $10,751.29 ",,
MEDICAID DIRECT,1336273986,ACTION HEALTH STAFFING,ACTION HEALTH STAFFING INC,3606 EAGLE POINT LN   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1336273986,ACTION HEALTH STAFFING,3606 EAGLE POINT LN   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,#," 1,749 "," 1,898 "," $274,827.52 ",,
MEDICAID DIRECT,1558652784,WARREN-VANCE COMMUNITY HEALTH CENTE,~,120 CHARLES ROLLINS RD STE 205 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1336275403,"COLLINS-OGLE, MICHELLE, DENISE",120 CHARLES ROLLINS RD STE 205 HENDERSON NC,091,Vance,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 25 , 45 , 45 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336275965,"SMID, JOHN, ANDRE",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 97 , 183 , 330 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336275965,"SMID, JOHN, ANDRE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 17 , 21 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336275965,"SMID, JOHN, ANDRE",957 CHERAW ST   BENNETTSVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1336277607,"ARRU, JASON",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1336278886,"DANCEL, REX, DRAPETE",801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 20 , 46 ,$#,,
MEDICAID DIRECT,1336280544,C & S OPTOMETRIC SERVICES PLLC,NEW BERN FAMILY EYE CARE,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1336280544,C & S OPTOMETRIC SERVICES PLLC,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,, 223 , 235 , 441 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1336280742,"PARRETT, KIMBERLY, HUTTO",631 CC CAMP RD   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 121 , 146 , 234 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1336280742,"PARRETT, KIMBERLY, HUTTO",911 E ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 31 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1336280742,"PARRETT, KIMBERLY, HUTTO",911 E ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1336280742,"PARRETT, KIMBERLY, HUTTO",526 WINSTON RD   JONESVILLE NC,099,Yadkin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336281237,ANGELS HOME CARE INC,ANGELS HOME CARE INC,2061 MILLBORO RD   FRANKLINVILLE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1336281237,ANGELS HOME CARE INC,2061 MILLBORO RD   FRANKLINVILLE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 3,954 "," 3,982 "," $679,141.76 ",,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336282607,"DEAN, AMY, ELIZABETH",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336282607,"DEAN, AMY, ELIZABETH",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1336283290,HOKE COUNTY SCHOOLS,,116 W 5TH AVE   RAEFORD NC,047,Hoke,251300000X,Agencies,Local Education Agency (LEA),,1336283290,HOKE COUNTY SCHOOLS,116 W 5TH AVE   RAEFORD NC,047,Hoke,251300000X,Agencies,Local Education Agency (LEA),, 251 ," 4,163 "," 4,206 "," $170,657.42 ",,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336283795,"BROWN, ADAM, PULLAN",2800 ASHTON DR STE 200 WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 22 , 31 , 40 ,$#,,
MEDICAID DIRECT,1336285097,CHESTERFIELD ADULT CARE HOME INC,CHESTERFIELD ADULT CARE HOME INC,2630 PAX HILL RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1336285097,CHESTERFIELD ADULT CARE HOME INC,2630 PAX HILL RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 478 , 478 ," $37,429.33 ",,
MEDICAID DIRECT,1720033988,MCLEOD MEDICAL CENTER DILLION,MCLEOD MEDICAL CENTER DILLON,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336287523,"GOLDSTEIN, WILLIAM, MCCALL",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 38 , 38 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336288091,"BASS, JOHN, WATSON",2704 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 53 , 71 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1336288091,"BASS, JOHN, WATSON",2704 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 137 , 206 ,$#,,
MEDICAID DIRECT,1710008826,SMITHFIELD PULMONOLOGY PA,~,706 WILKINS ST STE A SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1336288539,"ALI, MIR, MUMTAZ",706 WILKINS ST STE A SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 24 , 100 ,$#,,
MEDICAID DIRECT,1760523260,WESTERN WAKE INTERNAL MEDICINE,Western Wake Internal Medicine,907 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1336289065,"POLAVARAM, RAJ",907 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1760523260,WESTERN WAKE INTERNAL MEDICINE,Western Wake Internal Medicine,907 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336289065,"POLAVARAM, RAJ",907 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 119 , 135 ,$#,,
MEDICAID DIRECT,1871064949,PARK URGENT CARE PLLC,PARK URGENT CARE PLLC,7560 CARPENTER FIRE STATION RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336289065,"POLAVARAM, RAJ",7560 CARPENTER FIRE STATION RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740480888,MONIQUE BROWN M D P C,~,154 SW MAIN ST   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336289636,"BROWN, MONIQUE, YOLANDA",154 SW MAIN ST   ROCKY MOUNT NC,064,Nash,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#," $21,446.04 ",,
MEDICAID DIRECT,1740480888,MONIQUE BROWN M D P C,~,154 SW MAIN ST   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336289636,"BROWN, MONIQUE, YOLANDA",154 SW MAIN ST   ROCKY MOUNT NC,064,Nash,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 127 , 314 , 361 ," $18,378.73 ",,
MEDICAID DIRECT,1619558103,DAVE E FOULKES DDS PLLC,PARADISE FAMILY DENTISTRY,895 S BECKFORD DR   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1336291772,"FOULKES, DAVE, ERSKINE",1308 CARIBOU XING   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice," 2,222 "," 4,382 "," 21,249 "," $1,309,840.58 ",,
MEDICAID DIRECT,1336293364,VANCE COUNTY SCHOOLS,~,1724 GRAHAM AVE   HENDERSON NC,091,Vance,251300000X,Agencies,Local Education Agency (LEA),,1336293364,VANCE COUNTY SCHOOLS,1724 GRAHAM AVE   HENDERSON NC,091,Vance,251300000X,Agencies,Local Education Agency (LEA),, 195 ," 2,820 "," 2,969 "," $127,129.49 ",,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336296151,"BOGER, MICHAEL, SEAN",200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336296151,"BOGER, MICHAEL, SEAN",200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336296151,"BOGER, MICHAEL, SEAN",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 18 , 22 , 26 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336296151,"BOGER, MICHAEL, SEAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 13 , 26 , 26 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336296151,"BOGER, MICHAEL, SEAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1336299684,BLADEN EYE CENTER,BLADEN EYE CENTER,409 E BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1336299684,BLADEN EYE CENTER,409 E BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,, 49 , 49 , 89 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 85 , 99 , 102 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 38 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336300342,"MCGARRAH, ROBERT, WALKER",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1538214713,CHILDRENS MEDICAL GROUP INC,TIDEWATER CHILDRENS ASSOCIATES,171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1336300391,"CRANDLEY, KATE, NOEL",171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1336301423,"OGBOLU, ONWELI, ERNEST",3009 CORPORATE LN STE 210 SUFFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336305473,"HOPPENFELD, JON DAVID",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336305473,"HOPPENFELD, JON DAVID",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336305473,"HOPPENFELD, JON DAVID",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336305473,"HOPPENFELD, JON DAVID",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336305473,"HOPPENFELD, JON DAVID",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,101 E W T HARRIS BLVD STE 4001 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336305473,"HOPPENFELD, JON DAVID",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine, 18 , 22 , 27 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336305473,"HOPPENFELD, JON DAVID",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336306349,"COLIN, BRIAN, JOSEPH",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336306349,"COLIN, BRIAN, JOSEPH",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336306349,"COLIN, BRIAN, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336306349,"COLIN, BRIAN, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336306349,"COLIN, BRIAN, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336306349,"COLIN, BRIAN, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1376868398,WIGGINS & GILES DDS PA,Main Street Family Dentistry,5050 KENTWORTH DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336308600,"GILES, JENINE, NICOLE",5050 KENTWORTH DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 586 ," 1,139 "," 4,322 "," $173,621.15 ",,
MEDICAID DIRECT,1336308600,"GILES, JENINE, NICOLE",~,5050 KENTWORTH DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1336308600,"GILES, JENINE, NICOLE",5050 KENTWORTH DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336309053,"PIETRYGA, JASON, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336309053,"PIETRYGA, JASON, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336309053,"PIETRYGA, JASON, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336309053,"PIETRYGA, JASON, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336309053,"PIETRYGA, JASON, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 498 , 543 , 930 ," $18,738.45 ",,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336309277,"WHITE, MATTHEW, STEDMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 106 , 179 , 218 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336309277,"WHITE, MATTHEW, STEDMAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336309277,"WHITE, MATTHEW, STEDMAN",505 OBERLIN RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 36 , 54 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336309277,"WHITE, MATTHEW, STEDMAN",166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336313410,"HAMILTON, SANDI, ELIZABETH",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336313410,"HAMILTON, SANDI, ELIZABETH",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336314053,"HERBST, JEFFREY, TODD",3009 NEW BERN AVE   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1053748426,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS ROCKY RIVER PEDIAT,5427 HIGHWAY 49 S STE 103 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336314566,"SHAREEF, AMIRAH, LACHAUNE",5427 NC HIGHWAY 49 S STE 103 HARRISBURG NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1053748426,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS ROCKY RIVER PEDIAT,5427 NC HIGHWAY 49 S STE 103 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336314566,"SHAREEF, AMIRAH, LACHAUNE",5427 NC HIGHWAY 49 S STE 103 HARRISBURG NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 49 , 91 , 190 ," $10,865.93 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336316454,"MCCLAIN, MICAH, THOMAS",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336316454,"MCCLAIN, MICAH, THOMAS",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336316454,"MCCLAIN, MICAH, THOMAS",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336316751,"GENTILE, LORI, FILICHIA",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336316751,"GENTILE, LORI, FILICHIA",125 QUEENS RD STE 560 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336316751,"GENTILE, LORI, FILICHIA",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 21 , 37 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336316751,"GENTILE, LORI, FILICHIA",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336316819,"TEBBIT, CHRISTOPHER, LEE",400 PARK ST   BELMONT NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 91 , 141 , 187 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,400 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336316819,"TEBBIT, CHRISTOPHER, LEE",400 PARK ST   BELMONT NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336316868,"MCCRANN, SHANNON, MARY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 53 , 64 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336316868,"MCCRANN, SHANNON, MARY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336316868,"MCCRANN, SHANNON, MARY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 75 , 76 , 112 ,$#,,
MEDICAID DIRECT,1568464386,GREENE COUNTY HEALTH CARE INC,GREENE DENTAL SERVICES,6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336318922,"ESTRADA, GLORIA, ENIBETTE",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice, 181 , 210 , 599 ," $21,336.35 ",,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336318922,"ESTRADA, GLORIA, ENIBETTE",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 49 , 50 , 140 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336319342,"GEISLER, JUSTIN, THOMAS",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1336319342,"GEISLER, JUSTIN, THOMAS",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 31 , 34 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1336319342,"GEISLER, JUSTIN, THOMAS",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053771717,RHA BEHAVIORAL HEALTH NC LLC,,24 HILL PLZ   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1336321926,"DOBSON, BURT, WILLIAM",106 4TH ST   BLADENBORO NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700318680,RHA BEHAVIORAL HEALTH NC LLC,,24 HILL PLZ   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1336321926,"DOBSON, BURT, WILLIAM",106 4TH ST   BLADENBORO NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144689837,RHA BEHAVIORAL HEALTH NC LLC,,2003 GODWIN AVE STE A LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336321926,"DOBSON, BURT, WILLIAM",106 4TH ST   BLADENBORO NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558721217,RHA BEHAVIORAL HEALTH NC LLC,,106 4TH ST   BLADENBORO NC,009,Bladen,193200000X,Group,Multi-Specialty,,1336321926,"DOBSON, BURT, WILLIAM",106 4TH ST   BLADENBORO NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336322205,"JOHNSON, KENYA, BOAZ",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 155 , 198 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336322205,"JOHNSON, KENYA, BOAZ",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 444 , 447 ," $16,298.94 ",,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336322205,"JOHNSON, KENYA, BOAZ",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336323740,"GARRETT, JEFFREY, PAUL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 69 , 107 , 158 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336323740,"GARRETT, JEFFREY, PAUL",503 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1336324193,"LAGUERRE, PATRICK, JACQUES",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 99 , 114 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1336324193,"LAGUERRE, PATRICK, JACQUES",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1336325117,"CVELIC, PATRICK, MILKO",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1336325117,"CVELIC, PATRICK, MILKO",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336325471,"MAXEY, THOMAS, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 16 , 19 ," $16,042.22 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336325471,"MAXEY, THOMAS, SCOTT",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336326131,"SHARMA, SONA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336326131,"SHARMA, SONA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336326131,"SHARMA, SONA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 15 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336326131,"SHARMA, SONA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336326131,"SHARMA, SONA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1336329614,MILESTONES TREATMENT AND LEARNING C,~,4401 CHERRY ST STE 50 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336329614,MILESTONES TREATMENT AND LEARNING C,4401 CHERRY ST STE 50 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,#, 72 , 72 ,$#,,
MEDICAID DIRECT,1336329614,MILESTONES TREATMENT AND LEARNING C,~,4401 CHERRY ST STE 50 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336329614,MILESTONES TREATMENT AND LEARNING C,4401 CHERRY ST STE 50 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,#, 67 , 68 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336330380,"CRANE, SCOTT, ANTHONY",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336330380,"CRANE, SCOTT, ANTHONY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336330380,"CRANE, SCOTT, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336330380,"CRANE, SCOTT, ANTHONY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 52 , 59 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336330380,"CRANE, SCOTT, ANTHONY",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1336330380,"CRANE, SCOTT, ANTHONY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336330380,"CRANE, SCOTT, ANTHONY",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629025283,CAROLINA HEALTHCARE PRODUCTS,Carolina Healthcare Products Inc,1635 N HOWE ST STE H SOUTHPORT NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336330703,"DE SANTO, RONALD, JOSEPH",1635 N HOWE ST STE H SOUTHPORT NC,010,Brunswick,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1750337044,CAROLINA HEALTHCARE PRODUCTS,~,20 MEDICAL CAMPUS DR NW STE 102 SUPPLY NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336330703,"DE SANTO, RONALD, JOSEPH",1635 N HOWE ST STE H SOUTHPORT NC,010,Brunswick,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 27 , 40 , 104 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336331875,"SAUNDERS, COURTNEY, BROOKE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 29 , 70 , 88 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336331875,"SAUNDERS, COURTNEY, BROOKE",850 W H SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336331875,"SAUNDERS, COURTNEY, BROOKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 51 , 118 , 129 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336331875,"SAUNDERS, COURTNEY, BROOKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336331875,"SAUNDERS, COURTNEY, BROOKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336333848,"DALAL, ARIHANT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336333897,"KEEN, CRYSTAL, RENEE",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336333897,"KEEN, CRYSTAL, RENEE",2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336333897,"KEEN, CRYSTAL, RENEE",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 68 , 93 , 112 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336333897,"KEEN, CRYSTAL, RENEE",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336333897,"KEEN, CRYSTAL, RENEE",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 14 , 17 , 20 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336333897,"KEEN, CRYSTAL, RENEE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 21 , 38 , 48 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336335108,"BANDLA, GEETHANJALI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 132 , 132 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1336335942,"FOERSCHLER, DEREK",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174204531,ASHE MULTISPECIALTY GROUP LLC,ASHE ORTHOPAEDIC & SPORTS MEDICINE,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1336337278,"CAPUTO, DANIEL",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952830804,RAPID CARE PLLC,,2609 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",4534 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164952446,CARDINAL HEART & VASCULAR PLLC,,4380 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",4155 FERNCREEK DR STE 102B FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 15 , 29 ,$#,,
MEDICAID DIRECT,1952830804,RAPID CARE PLLC,,4534 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",4155 FERNCREEK DR STE 102B FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1952830804,RAPID CARE PLLC,,4534 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",4534 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 41 , 65 ,$#,,
MEDICAID DIRECT,1164952446,CARDINAL HEART & VASCULAR PLLC,,4380 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",4534 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164952446,CARDINAL HEART & VASCULAR PLLC,,2609 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",4534 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1952830804,RAPID CARE PLLC,,2609 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",2609 S HORNER BLVD   SANFORD NC,053,Lee,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1164952446,CARDINAL HEART & VASCULAR PLLC,,2609 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",2609 S HORNER BLVD   SANFORD NC,053,Lee,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 27 , 85 , 140 ," $30,974.65 ",,
MEDICAID DIRECT,1952830804,RAPID CARE PLLC,,2609 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",2609 S HORNER BLVD   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 158 , 723 ," 1,049 "," $27,413.77 ",,
MEDICAID DIRECT,1952830804,RAPID CARE PLLC,,4534 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",2609 S HORNER BLVD   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 98 , 156 ,$#,,
MEDICAID DIRECT,1164952446,CARDINAL HEART & VASCULAR PLLC,,2609 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",2609 S HORNER BLVD   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 82 , 348 , 582 ," $76,495.02 ",,
MEDICAID DIRECT,1164952446,CARDINAL HEART & VASCULAR PLLC,,4380 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336338268,"JAYAWARDENA, SURIYA, BANDARA",2609 S HORNER BLVD   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336340454,"SMITH, MICHAEL, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336340579,"COHEN, BRIAN, LOUIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,187 MEDICAL PARK DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1336340579,"COHEN, BRIAN, LOUIS",187 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336340835,"FOX, CHRISTOPHER, DANIEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336340835,"FOX, CHRISTOPHER, DANIEL",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336340835,"FOX, CHRISTOPHER, DANIEL",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336340835,"FOX, CHRISTOPHER, DANIEL",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336340835,"FOX, CHRISTOPHER, DANIEL",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336342567,"SURYADEVARA, UMA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336342567,"SURYADEVARA, UMA",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336342997,"RAY KO, EMILY, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 83 , 83 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336344159,"MAYO, JULIA, JONES",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 23 , 28 ,$#,,
MEDICAID DIRECT,1336344282,"DESAI, DEVAL, INDRA",DEVAL I DESAI,261 COOPER CREEK DR   MOCKSVILLE NC,030,Davie,152W00000X,Eye and Vision Services Providers,Optometrist,,1336344282,"DESAI, DEVAL, INDRA",261 COOPER CREEK DR   MOCKSVILLE NC,030,Davie,152W00000X,Eye and Vision Services Providers,Optometrist,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1336344282,"DESAI, DEVAL, INDRA",DEVAL I DESAI,160 LOWES BLVD   LEXINGTON NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,,1336344282,"DESAI, DEVAL, INDRA",160 LOWES BLVD   LEXINGTON NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,, 24 , 24 , 30 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336344977,"GOLLOL-RAJU, NARASIMHA, SWAMY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 45 , 54 , 106 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336346840,"SMALLWOOD, TANYA, REAMS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336346840,"SMALLWOOD, TANYA, REAMS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336346840,"SMALLWOOD, TANYA, REAMS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 20 , 25 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336346840,"SMALLWOOD, TANYA, REAMS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1915 W PARK DR STE 103 NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1336347079,"HORNBUCKLE, CASSANDRA, MARIE",1405 WILLOW LN   NORTH WILKESBORO NC,097,Wilkes,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336347079,"HORNBUCKLE, CASSANDRA, MARIE",1405 WILLOW LN   NORTH WILKESBORO NC,097,Wilkes,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 27 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336347079,"HORNBUCKLE, CASSANDRA, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 46 , 72 , 82 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336347640,"QUARRIE, RICARDO, ORLANDO",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336347640,"QUARRIE, RICARDO, ORLANDO",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336347640,"QUARRIE, RICARDO, ORLANDO",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336348697,"GARCIA HRUBY, IDALINA",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336348697,"GARCIA HRUBY, IDALINA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 88 , 239 , 239 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336349315,"LAMPTEY, PHILIP, ODARTEI",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336349315,"LAMPTEY, PHILIP, ODARTEI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 29 , 41 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336349315,"LAMPTEY, PHILIP, ODARTEI",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336349315,"LAMPTEY, PHILIP, ODARTEI",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 33 , 45 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336349315,"LAMPTEY, PHILIP, ODARTEI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336349315,"LAMPTEY, PHILIP, ODARTEI",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457980401,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE RADIOLOGY HOLLY SPRINGS,401 IRVING PKWY STE 120 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336350883,"BASHIR, MUSTAFA, SHADI RIFAAT",2100 EWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 57 , 74 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336350883,"BASHIR, MUSTAFA, SHADI RIFAAT",2100 EWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336350883,"BASHIR, MUSTAFA, SHADI RIFAAT",2100 EWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336350883,"BASHIR, MUSTAFA, SHADI RIFAAT",2100 EWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 98 , 111 , 155 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336350883,"BASHIR, MUSTAFA, SHADI RIFAAT",2100 EWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336350883,"BASHIR, MUSTAFA, SHADI RIFAAT",2100 EWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336351535,"GLENN, MARIA, FRANCES",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 65 , 101 ,$#,,
MEDICAID DIRECT,1336353317,ALLEGHANY COUNTY BOARD OF COMMISSIO,ALLEGHANY COUNTY EMS,40 COX ST   SPARTA NC,003,Alleghany,3416L0300X,Transportation Services,Ambulance,Land Transport,1336353317,ALLEGHANY COUNTY BOARD OF COMMISSIO,40 COX ST   SPARTA NC,003,Alleghany,3416L0300X,Transportation Services,Ambulance,Land Transport, 48 , 86 , 156 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 45 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 65 , 95 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 247 , 264 , 318 ,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1336359199,"SANFORD, MELANIE, BERNADETTE",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 27 ,$#,,
MEDICAID DIRECT,1336363704,CARY VISION CARE OD PA,,1100 NW MAYNARD RD STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1336363704,CARY VISION CARE OD PA,1100 NW MAYNARD RD STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,, 29 , 29 , 58 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336365360,"ELREFAI, SARA, MOHAMED",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336365360,"ELREFAI, SARA, MOHAMED",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.),#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336365360,"ELREFAI, SARA, MOHAMED",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.),#,#,#,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336366210,"COGGIN, KRISTEN, BOSWELL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 20 , 68 , 69 ," $11,568.38 ",,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336367424,"LEE, JING",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 36 , 80 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336367424,"LEE, JING",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336367424,"LEE, JING",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 54 , 142 ,$#,,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336367424,"LEE, JING",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1336368737,"HELM, HUGHES, MONTGOMERY",606 MAIN ST   BAYBORO NC,069,Pamlico,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 40 , 69 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1336368737,"HELM, HUGHES, MONTGOMERY",3003 KENSINGTON PARK DR   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1336368737,"HELM, HUGHES, MONTGOMERY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 150 , 296 ,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1336368737,"HELM, HUGHES, MONTGOMERY",3003 KENSINGTON PARK DR   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336368737,"HELM, HUGHES, MONTGOMERY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 48 , 145 ,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336370295,CAROLINAS PHYSICIANS NETWORK INC,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336370295,CAROLINAS PHYSICIANS NETWORK INC,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336370808,"CHOKKALINGAM MANI, BHALAGHURU",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336370808,"CHOKKALINGAM MANI, BHALAGHURU",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336370808,"CHOKKALINGAM MANI, BHALAGHURU",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336370808,"CHOKKALINGAM MANI, BHALAGHURU",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336370808,"CHOKKALINGAM MANI, BHALAGHURU",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336370816,"NIAZ, FAIZA",311 W PHIFER ST   MARSHVILLE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336370816,"NIAZ, FAIZA",311 W PHIFER ST   MARSHVILLE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336370816,"NIAZ, FAIZA",13825 HUNTON LN   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336370816,"NIAZ, FAIZA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336370816,"NIAZ, FAIZA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 33 , 33 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336370816,"NIAZ, FAIZA",1770 OAK HOLLOW RD   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 72 , 72 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336370816,"NIAZ, FAIZA",1770 OAK HOLLOW RD   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336371277,"KHALID, BILAL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336371277,"KHALID, BILAL",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 44 , 45 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336371277,"KHALID, BILAL",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336371277,"KHALID, BILAL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336371277,"KHALID, BILAL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 24 , 24 ,$#,,
MEDICAID DIRECT,1720794944,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE PHYSICIANS WELLNESS,104 POMONA DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336371434,"MEMON, JEHANZEB",104 POMONA DR   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 62 , 144 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336372333,"PRICE, CHARLYNNE, FREEMAN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 118 , 130 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336372846,"TERRY, KRISTI, KELLY",201 E GROVER ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 59 , 212 , 213 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",25 REYNOLDS MOUNTAIN BLVD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 42 , 64 , 65 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 34 , 70 , 70 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 41 , 79 , 79 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",25 REYNOLDS MOUNTAIN BLVD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1255805065,CAREPARTNERS HHA LLLP,CAREPARTNERS PRIVATE DUTY SERVICES,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1336374081,"CRUM, KATHERINE, GRIMES",70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",203 MCCRACKEN ST   WAYNESVILLE NC,044,Haywood,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 23 , 23 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,516 WALL ST   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",203 MCCRACKEN ST   WAYNESVILLE NC,044,Haywood,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 12 , 24 , 24 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",203 MCCRACKEN ST   WAYNESVILLE NC,044,Haywood,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 53 , 210 , 210 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 16 , 35 , 35 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336374081,"CRUM, KATHERINE, GRIMES",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 60 , 197 , 197 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336374792,"TEKIN, UMMUHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336374792,"TEKIN, UMMUHAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 151 , 151 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336375047,"SPROUSE, TINA, EUN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 133 , 138 , 166 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336375047,"SPROUSE, TINA, EUN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 33 , 50 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336375179,"LEON GUERRERO, CHRISTOPHER, ROBERT",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 28 , 29 , 29 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336375179,"LEON GUERRERO, CHRISTOPHER, ROBERT",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 35 , 38 , 41 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336375179,"LEON GUERRERO, CHRISTOPHER, ROBERT",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 46 , 68 , 70 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1336375609,"HAYS, LAURA, MARTELLY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 39 , 56 ,$#,,
MEDICAID DIRECT,1336375609,"HAYS, LAURA, MARTELLY",~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1336375609,"HAYS, LAURA, MARTELLY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336375609,"HAYS, LAURA, MARTELLY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336375609,"HAYS, LAURA, MARTELLY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 24 , 38 ,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1336375955,"SARGENT, JULIA, MARIE",75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 87 , 197 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336376474,"AMIRICHETTY, SATYA, KUMAR",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336376649,"DOWNES, CYNTHIA, MARIE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1336376649,"DOWNES, CYNTHIA, MARIE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 34 , 43 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1336376649,"DOWNES, CYNTHIA, MARIE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 64 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336376755,"JOLLY, PUNEET, SINGH",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 13 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336376755,"JOLLY, PUNEET, SINGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 23 , 37 , 87 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336376755,"JOLLY, PUNEET, SINGH",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 15 , 22 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336376755,"JOLLY, PUNEET, SINGH",3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 33 , 42 , 76 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336377639,"SIDDIQI, NASAR, AHMAD",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 38 , 53 , 94 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336377639,"SIDDIQI, NASAR, AHMAD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 105 , 224 , 310 ," $15,626.42 ",,
MEDICAID DIRECT,1336377753,"FAULKNER, ANNA, RIPLEY",~,71 TRAILCREEK LN   BREVARD NC,088,Transylvania,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1336377753,"FAULKNER, ANNA, RIPLEY",71 TRAILCREEK LN   BREVARD NC,088,Transylvania,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 15 , 229 , 229 ," $20,956.30 ",,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1336382282,"CLARK, SOMMER, CORK",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 156 , 238 , 601 ," $18,035.02 ",,
MEDICAID DIRECT,1336382431,CLARKS HOME MEDICAL EQUIPMENT INC,~,505 W BOULEVARD   WILLIAMSTON NC,058,Martin,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336382431,CLARKS HOME MEDICAL EQUIPMENT INC,505 W BOULEVARD   WILLIAMSTON NC,058,Martin,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 98 , 333 , 439 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336384817,"BROYHILL, BRITNEY, SUMMER",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336385228,"FULLER, CHRISTINA, LAUREN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336385228,"FULLER, CHRISTINA, LAUREN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 21 , 25 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336385228,"FULLER, CHRISTINA, LAUREN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336385673,"DIERS, LINDSEY, ANN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336280544,C & S OPTOMETRIC SERVICES PLLC,NEW BERN FAMILY EYE CARE,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1336388396,"ONCAVAGE, KIMBERLY, LEWIS",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,, 25 , 30 , 41 ,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336388396,"ONCAVAGE, KIMBERLY, LEWIS",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1336388396,"ONCAVAGE, KIMBERLY, LEWIS",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336388396,"ONCAVAGE, KIMBERLY, LEWIS",2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1336388396,"ONCAVAGE, KIMBERLY, LEWIS",13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336389410,"BHALODIA, UCHIT, VALLABHDAS",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336389410,"BHALODIA, UCHIT, VALLABHDAS",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 162 , 164 ,$#,,
MEDICAID DIRECT,1336391630,"HASTINGS, MARY, LYNN",MARY LYNN HASTINGS,214 FORSYTH ST   THOMASVILLE NC,029,Davidson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1336391630,"HASTINGS, MARY, LYNN",214 FORSYTH ST   THOMASVILLE NC,029,Davidson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 22 , 187 , 187 ," $13,122.68 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1336393099,"ADAMS, THERESA, TORMEY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336393453,"SINGER, KRISTIE, NICOLE",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336393453,"SINGER, KRISTIE, NICOLE",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 2200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336393453,"SINGER, KRISTIE, NICOLE",409 OLIN WAY STE 2200 DENVER NC,055,Lincoln,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 11 , 14 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336393560,"DYE, JENNIFER, KRISTINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 83 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1336393560,"DYE, JENNIFER, KRISTINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336394014,"TURNER, MARY, CATHERINE BRAKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336394014,"TURNER, MARY, CATHERINE BRAKE",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336394014,"TURNER, MARY, CATHERINE BRAKE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 13 , 17 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336394014,"TURNER, MARY, CATHERINE BRAKE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 45 , 56 , 105 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1336395300,"LOVELY, JESSICA, LYN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336395300,"LOVELY, JESSICA, LYN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174280895,UC BEST MEDICAL CENTER,,1505 SKYWAY DR   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1336397306,"EDOSOMWAN EIGBE, EMMANUEL",1505 SKYWAY DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 122 , 545 ," 1,277 "," $32,771.41 ",,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336398387,"AKUNEME, MARCEL, IKWUOMA",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336398387,"AKUNEME, MARCEL, IKWUOMA",336 DEERFIELD RD   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336398387,"AKUNEME, MARCEL, IKWUOMA",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 67 , 75 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1336398387,"AKUNEME, MARCEL, IKWUOMA",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1336398387,"AKUNEME, MARCEL, IKWUOMA",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1083650881,COLLINS & SAMPSON DDS PA,COLLINS JEFF,312 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336400449,"COLLINS, BENJAMIN, KYLE",312 E WARDELL DR   PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 239 , 413 ," 1,358 "," $54,006.68 ",,
MEDICAID DIRECT,1881192631,COLLINS AND ASSOCIATES DDS PA,,714 E 4TH AVE   RED SPRINGS NC,078,Robeson,193400000X,Group,Single Specialty,,1336400449,"COLLINS, BENJAMIN, KYLE",714 E 4TH AVE   RED SPRINGS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 167 , 302 , 920 ," $49,519.62 ",,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1336400639,"MOORE, ANDREW, JOSEPH",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1336400639,"MOORE, ANDREW, JOSEPH",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336400639,"MOORE, ANDREW, JOSEPH",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 122 , 127 , 211 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1336401900,"BROWN, TALITHA",205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1932485943,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM SURGICAL ASSOCIATES,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1336401900,"BROWN, TALITHA",120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 61 , 68 ,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1336401900,"BROWN, TALITHA",1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1336401900,"BROWN, TALITHA",120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164171211,SOLANA REHAB LLC,,4469 VERANDA LAKE CT   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336402064,"THOMAS, THOMAS, ANTONY",4469 VERANDA LAKE CT   GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336402197,"PELLEGRIN, BENJAMIN, HUNTER",1135 MILITARY CUTOFF RD STE 103 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336402197,"PELLEGRIN, BENJAMIN, HUNTER",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336402197,"PELLEGRIN, BENJAMIN, HUNTER",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 40 , 69 ,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336402445,"CORTE, RYAN, CHRISTOPHER",8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,3 S TUNNEL RD # 187 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336402445,"CORTE, RYAN, CHRISTOPHER",3 S TUNNEL RD   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1336402940,"CALLAHAN, SEAN, JORGENSEN",75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336402940,"CALLAHAN, SEAN, JORGENSEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 48 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336402940,"CALLAHAN, SEAN, JORGENSEN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336402940,"CALLAHAN, SEAN, JORGENSEN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336402940,"CALLAHAN, SEAN, JORGENSEN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1447847975,CALLISTO PEDIATRICS LLC,,320 SEAGLE ST STE 10 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336403211,"MOON, TARA, DANIELLE",320 SEAGLE ST STE 10 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 13 , 26 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336403641,"MANANDHAR, SAMYAK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336403641,"MANANDHAR, SAMYAK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 84 , 240 , 245 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336404003,"NAKKALA, SANDHYA, PRASANNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 221 , 222 ,$#,,
MEDICAID DIRECT,1194821520,AMERICAN CHIROPRACTIC CARE INC,REVELS CHIROPRACTIC,5511 RAEFORD RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336404953,"REVELS, KOREY, LEE",5511 RAEFORD RD STE 100 FAYETTEVILLE NC,026,Cumberland,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1336405471,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST AUDIOLOGY - GREE,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336405471,WAKE FOREST HEALTH NETWORK LLC,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,#,#, 11 ,$#,,
MEDICAID DIRECT,1336405471,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST AUDIOLOGY - GREE,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1336405471,WAKE FOREST HEALTH NETWORK LLC,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,, 86 , 90 , 176 ,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336406180,"SMITH, GEARY, DANIEL",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 33 ,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336406180,"SMITH, GEARY, DANIEL",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336406180,"SMITH, GEARY, DANIEL",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 ,#, 19 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1336406180,"SMITH, GEARY, DANIEL",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 34 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336406503,"IVEY, STEPHANIE, ENZOR",2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336406503,"IVEY, STEPHANIE, ENZOR",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 14 , 16 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336406503,"IVEY, STEPHANIE, ENZOR",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 50 , 50 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336406503,"IVEY, STEPHANIE, ENZOR",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1336408681,"RAY, STEPHEN, CREIGHTON",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336409317,"JORDAN, ROBYN, ALEXIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1336412469,"CANTARUTTI, JESSICA, ROWENA",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1336413095,"STRATTON, SAMANTHA, RYAN",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1336413095,"STRATTON, SAMANTHA, RYAN",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1336413095,"STRATTON, SAMANTHA, RYAN",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 59 , 80 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1336413095,"STRATTON, SAMANTHA, RYAN",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 27 , 40 ,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336414168,"MARKOW, JUSTIN, MICHAEL",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 33 , 60 , 60 ,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336414168,"MARKOW, JUSTIN, MICHAEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,624 QUAKER LN STE 200D HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336415306,"ROBLES, CHRISTIAN, ANTONIO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114380102,NEUROVATIVE DIAGNOSTICS LLC,,2015 AYRSLEY TOWN BLVD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336415306,"ROBLES, CHRISTIAN, ANTONIO",3116 N DUKE ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 34 , 37 ," $24,371.12 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336415306,"ROBLES, CHRISTIAN, ANTONIO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 60 , 91 , 101 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336415306,"ROBLES, CHRISTIAN, ANTONIO",601 N ELM ST   HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 44 , 57 , 63 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336416965,"BASS, MICHELLE, LYNNE",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336416965,"BASS, MICHELLE, LYNNE",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336416965,"BASS, MICHELLE, LYNNE",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 55 , 55 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336416965,"BASS, MICHELLE, LYNNE",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336421015,"MILLER, LINDSEY, MICHELE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 29 , 36 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336421015,"MILLER, LINDSEY, MICHELE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1336425099,"GRISSETT, CHRISTINE, ELIZABETH",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336428580,"ACHEAMPONG, PETER, KWASI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336428580,"ACHEAMPONG, PETER, KWASI",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 73 , 73 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336428580,"ACHEAMPONG, PETER, KWASI",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 62 , 62 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336430800,"VINCENT, CHRISTINA, MICHELLE",2525 COURT DR   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336430800,"VINCENT, CHRISTINA, MICHELLE",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336430982,"MOORE, STEVEN, ANTHONY",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 26 , 46 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,11530 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336430982,"MOORE, STEVEN, ANTHONY",11530 PROVIDENCE RD STE 2300 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 45 , 53 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336430982,"MOORE, STEVEN, ANTHONY",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700918877,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - TRIA,145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336431451,"AUBUCHON, ADAM, CHRISTOPHER",145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 71 , 103 , 137 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336431774,"THORP, LINDSAY, CRANWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336431774,"THORP, LINDSAY, CRANWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336431774,"THORP, LINDSAY, CRANWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336431774,"THORP, LINDSAY, CRANWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336436591,"KENNEY-KALBUNEH, JAMIE, LILLIAN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1336437292,"BUCHANAN, HEATHER, DAWN",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 84 , 144 , 220 ," $20,242.45 ",,
MEDICAID DIRECT,1134454853,CAROLINA PAIN ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1336437367,"FAGAN, PAUL, EMANUEL",330 BILLINGSLEY RD STE 206 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1265942403,UBYLEE HEALTHCARE GROUP,,9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336437367,"FAGAN, PAUL, EMANUEL",9723 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 85 , 199 , 354 ," $12,798.66 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336437680,"KATURU, RAJASEKHAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336437680,"KATURU, RAJASEKHAR",329 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336437680,"KATURU, RAJASEKHAR",329 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 30 , 30 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336439074,"VIRGADAMO, SEBASTIANO, ANTONIO",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336439280,"CORBETT, WILLIAM, CHRISTOPHER",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336439280,"CORBETT, WILLIAM, CHRISTOPHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336439280,"CORBETT, WILLIAM, CHRISTOPHER",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336439280,"CORBETT, WILLIAM, CHRISTOPHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336439280,"CORBETT, WILLIAM, CHRISTOPHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336439280,"CORBETT, WILLIAM, CHRISTOPHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205579059,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC SUBSTANCE TREATMENT AND RECOVERY,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336440312,"FORD, AMY, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205579059,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC SUBSTANCE TREATMENT AND RECOVERY,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336440312,"FORD, AMY, LYNN",1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336444561,NEW INFINITI HOME CARE SERVICES LLC,~,325 MCGILL AVE NW STE 527 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1336444561,NEW INFINITI HOME CARE SERVICES LLC,325 MCGILL AVE NW STE 527 CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 52 ," 10,248 "," 10,399 "," $846,850.44 ",,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336446368,"FITCH, LEAH, GAYLORD",14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1326078072,PROVIDENCE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS PROVIDENCE PEDIATR,14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336446368,"FITCH, LEAH, GAYLORD",14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 14 ,$#,,
MEDICAID DIRECT,1699784660,ONSITE NEONATAL PC,~,1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1336448901,"BALAWI, FADEL",1872 ST LUKES BLVD   EASTON PA,102,Out of State > 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1336449099,INTEGRATED CARE SERVICES LLC,INTEGRATED CARE SERVICES LLC,5500 EXECUTIVE CENTER DR STE 238 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1336449099,INTEGRATED CARE SERVICES LLC,5500 EXECUTIVE CENTER DR STE 238 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,180 "," 3,180 "," $227,117.72 ",,
MEDICAID DIRECT,1730864547,KALEB C THOMPSON DMD PA IIII,DENTAL TRANSFORMATIONS-KIDS,103 TANGLEWOOD PKWY N STE K ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1336450816,"PETERSEN, LUKE, RUSSELL",212 AINSLEY AVE   HERTFORD NC,072,Perquimans,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 64 , 225 ,$#,,
MEDICAID DIRECT,1730864547,KALEB C THOMPSON DMD PA IIII,DENTAL TRANSFORMATIONS-KIDS,103 TANGLEWOOD PKWY N STE K ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1336450816,"PETERSEN, LUKE, RUSSELL",103 TANGLEWOOD PKWY N STE K ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 742 , 862 ," 3,176 "," $135,179.94 ",,
MEDICAID DIRECT,1710437322,"THOMPSON, KALEB, CONRAD",,153 WORTH GUARD RD   COINJOCK NC,027,Currituck,1223G0001X,Dental Providers,Dentist,General Practice,1336450816,"PETERSEN, LUKE, RUSSELL",212 AINSLEY AVE   HERTFORD NC,072,Perquimans,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1760247480,KALEB C THOMPSON DMD PA V,DENTAL TRANSFORMATIONS-HERTFORD,212 AINSLEY AVE   HERTFORD NC,072,Perquimans,193400000X,Group,Single Specialty,,1336450816,"PETERSEN, LUKE, RUSSELL",212 AINSLEY AVE   HERTFORD NC,072,Perquimans,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 16 , 68 ,$#,,
MEDICAID DIRECT,1760247480,KALEB C THOMPSON DMD PA V,DENTAL TRANSFORMATIONS-HERTFORD,212 AINSLEY AVE   HERTFORD NC,072,Perquimans,193400000X,Group,Single Specialty,,1336450816,"PETERSEN, LUKE, RUSSELL",103 TANGLEWOOD PKWY N STE K ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 21 , 74 ,$#,,
MEDICAID DIRECT,1710437322,"THOMPSON, KALEB, CONRAD",,153 WORTH GUARD RD   COINJOCK NC,027,Currituck,1223G0001X,Dental Providers,Dentist,General Practice,1336450816,"PETERSEN, LUKE, RUSSELL",103 TANGLEWOOD PKWY N STE K ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 41 ,$#,,
MEDICAID DIRECT,1861094542,KALEB C THOMPSON DMD PA III,DENTAL TRANSFORMATIONS,153 WORTH GUARD RD   COINJOCK NC,027,Currituck,193400000X,Group,Single Specialty,,1336450816,"PETERSEN, LUKE, RUSSELL",103 TANGLEWOOD PKWY N STE K ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1336454727,"SRIDARAN, RITA",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 56 , 81 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336455062,"GORDON, DIANA, WYN",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336455062,"GORDON, DIANA, WYN",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 34 , 36 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336455062,"GORDON, DIANA, WYN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336463009,"SATYAPRAKASH, REKHA, ARASARAJU",105 DELTA PARK DR   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 105 , 162 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336464338,"BURROWS, BRIAN, JOHN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 125 , 135 , 145 ,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336465988,"HADDAD, ARIEL, CATHERINE",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336465988,"HADDAD, ARIEL, CATHERINE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336465996,"WALKER, JEREMIE, ALLEN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336466846,"RASMUSSEN, BRIDGET, MAXINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 23 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336466846,"RASMUSSEN, BRIDGET, MAXINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3020 WEDDINGTON RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336467075,"LANE, SAMANTHA, JO",3020 WEDDINGTON RD   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 67 , 89 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336467075,"LANE, SAMANTHA, JO",3020 WEDDINGTON RD   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1336467760,"NAZARIAN, JOHN, PHILLIP",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336467760,"NAZARIAN, JOHN, PHILLIP",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 397 , 442 , 710 ," $17,553.65 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336467760,"NAZARIAN, JOHN, PHILLIP",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336467760,"NAZARIAN, JOHN, PHILLIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336467760,"NAZARIAN, JOHN, PHILLIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336467760,"NAZARIAN, JOHN, PHILLIP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 28 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336469600,"TRAN, BRYANT, WINSTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 65 , 73 ,$#,,
MEDICAID DIRECT,1295132009,ST LUKES PHYSICIAN NETWORK INC,CAROLINAS HOSPITALIST GROUP-ST LUKES,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1336469667,"NEWTON, STEVEN, JULIAN",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336469667,"NEWTON, STEVEN, JULIAN",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336469667,"NEWTON, STEVEN, JULIAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 71 , 71 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1336473479,"HOONHOUT, JANE, ELIZABETH",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1336473479,"HOONHOUT, JANE, ELIZABETH",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 93 , 224 , 224 ," $16,643.54 ",,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,210 SCHOOL RD   TRINITY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1336473479,"HOONHOUT, JANE, ELIZABETH",210 SCHOOL RD   TRINITY NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1417355629,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT SURGICAL ASSOCIATES,803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1336474535,"ABRAHAM, ANTHONY, MILARD",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417355629,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT SURGICAL ASSOCIATES,803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1336474535,"ABRAHAM, ANTHONY, MILARD",803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417355629,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT SURGICAL ASSOCIATES,803 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1336474535,"ABRAHAM, ANTHONY, MILARD",800 TILGHMAN DR   DUNN NC,043,Harnett,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1336476365,COUNTY OF LEE NORTH CAROLINA,LEE COUNTY DSS CAP PROGRAM,530 CARTHAGE ST   SANFORD NC,053,Lee,251B00000X,Agencies,Case Management,,1336476365,COUNTY OF LEE NORTH CAROLINA,530 CARTHAGE ST   SANFORD NC,053,Lee,251B00000X,Agencies,Case Management,, 70 , 659 , 659 ," $220,233.59 ",,
MEDICAID DIRECT,1336477470,ARRKKA HEALTHCARE AGENCY INC,ARRKKA HEALTHCARE AGENCY,201 W ASH ST STE 6 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1336477470,ARRKKA HEALTHCARE AGENCY INC,201 W ASH ST STE 6 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 7,658 "," 7,665 "," $556,842.80 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1336479815,"HARRIS-COLEMAN, JUDITH",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336479815,"HARRIS-COLEMAN, JUDITH",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 646 , 646 ," $13,807.62 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1336479815,"HARRIS-COLEMAN, JUDITH",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 754 , 754 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336479815,"HARRIS-COLEMAN, JUDITH",1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336481670,"KHAN, SARAH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1336482322,"REID, NICHOLAS, DAVID",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 38 , 49 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1336482322,"REID, NICHOLAS, DAVID",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336482322,"REID, NICHOLAS, DAVID",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 67 , 94 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1336482322,"REID, NICHOLAS, DAVID",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1336482322,"REID, NICHOLAS, DAVID",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336482322,"REID, NICHOLAS, DAVID",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1336482322,"REID, NICHOLAS, DAVID",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336482322,"REID, NICHOLAS, DAVID",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336482603,"ZACHRY, VERONICA, PATTERSON",250 NASH MEDICAL ARTS MALL STE A ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 37 , 43 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336482603,"ZACHRY, VERONICA, PATTERSON",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336482603,"ZACHRY, VERONICA, PATTERSON",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 86 , 96 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336482603,"ZACHRY, VERONICA, PATTERSON",250 NASH MEDICAL ARTS MALL STE A ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 27 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336482702,"HOQUE, MOHAMMED, MERAJUL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1336482702,"HOQUE, MOHAMMED, MERAJUL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 132 , 151 , 221 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336482835,"MCAFEE, MARY, KATHLEEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336482835,"MCAFEE, MARY, KATHLEEN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1851331359,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS CHARLOTTE,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336482835,"MCAFEE, MARY, KATHLEEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336482835,"MCAFEE, MARY, KATHLEEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 247 , 247 ," $12,430.39 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1336482850,"TREWICK, GARY, NEVILLE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 32 , 32 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1336482850,"TREWICK, GARY, NEVILLE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336487479,"BRICKELL, STACEY, LYNN",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336487479,"BRICKELL, STACEY, LYNN",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629504949,IMPERIAL HEALTH SERVICES,,707 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336491885,"DIXON, PAULA, LESHAE",707 S MAIN ST   KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 56 , 110 ,$#,,
MEDICAID DIRECT,1336492297,ELEVATE PHYSICAL THERAPY AND PAIN C,~,4 MARKET ST STE 4103 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1336492297,ELEVATE PHYSICAL THERAPY AND PAIN C,4 MARKET ST STE 4103 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,#, 23 , 57 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 55 , 65 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 29 , 33 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#, 13 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336495365,"RADPARVAR, ARASH",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 32 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336495365,"RADPARVAR, ARASH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336495365,"RADPARVAR, ARASH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 31 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336497437,"HALL, CHRISTINE, SARAH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 40 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336497700,"FAIGLE, SARAH, CASHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1336497700,"FAIGLE, SARAH, CASHEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336498401,"STEARNS, BRYANNA, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336498401,"STEARNS, BRYANNA, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336498732,"SMITH, COLTEDRA, SHNEE",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336499516,HEALTHLINK DIAGNOSTIC LABORATORIES,,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1336499516,HEALTHLINK DIAGNOSTIC LABORATORIES,13191 STARKEY RD STE 15 LARGO FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 320 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336501360,"BOYLE, KAITLIN, ALEXANDRA",77 VILCOM CENTER DR STE 320 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 170 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336501360,"BOYLE, KAITLIN, ALEXANDRA",77 VILCOM CENTER DR STE 320 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336501360,"BOYLE, KAITLIN, ALEXANDRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336501485,"MCLEOD, RENE, ANN",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336501485,"MCLEOD, RENE, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336501485,"MCLEOD, RENE, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336502475,"GAMBINO, CHRISTINA, MARIE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336502475,"GAMBINO, CHRISTINA, MARIE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336502475,"GAMBINO, CHRISTINA, MARIE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336502475,"GAMBINO, CHRISTINA, MARIE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336502475,"GAMBINO, CHRISTINA, MARIE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1336502475,"GAMBINO, CHRISTINA, MARIE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 24 , 53 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1336502475,"GAMBINO, CHRISTINA, MARIE",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 49 , 115 ,$#,,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336502525,"HIPKINS, BRITTANY, PIERCE",264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 58 , 67 ,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336502525,"HIPKINS, BRITTANY, PIERCE",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 88 , 100 ,$#,,
MEDICAID DIRECT,1447339767,CAROLINA DIGESTIVE DISEASES PA,CAROLINA DIGESTIVE DISEASES PA,704 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336502863,"MARCUARD, MAURICE, SHAWN",704 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 93 , 150 , 183 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336502897,"MCARTHUR-HERDER, JAYME, EMIL",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 46 , 53 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336502897,"MCARTHUR-HERDER, JAYME, EMIL",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 108 , 142 , 158 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336503036,"COSTELLA, VINCENT, JOSEPH",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 22 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336503036,"COSTELLA, VINCENT, JOSEPH",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336503036,"COSTELLA, VINCENT, JOSEPH",201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 57 , 58 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336503242,"KATZ, ERIC, CHARLES",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 28 , 32 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336503242,"KATZ, ERIC, CHARLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 71 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336506575,"NORRIS, JENNIFER, HOPPER",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336506575,"NORRIS, JENNIFER, HOPPER",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336506575,"NORRIS, JENNIFER, HOPPER",3480 WAKE FOREST RD STE 520 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 62 , 78 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1336507714,"SYNOWIEZ, TERESA, MONROE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 15 , 108 , 108 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336508969,"SCHWEITZER, SHANNON, DIEHL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336508969,"SCHWEITZER, SHANNON, DIEHL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1366631087,KING PODIATRY AND ASSOCIATES PLLC,,1121 N ROAD ST STE B ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1336513845,"PLESS, AMANDA, LEE",1121 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 155 , 364 , 498 ,$#,,
MEDICAID DIRECT,1366631087,KING PODIATRY AND ASSOCIATES PLLC,,1121 N ROAD ST STE B ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1336513845,"PLESS, AMANDA, LEE",1121 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 13 , 18 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336514595,"JENSEN, RACHEL, KATHRYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336520634,"HART, AMANDA, RAE",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 76 , 127 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336520634,"HART, AMANDA, RAE",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 27 ,$#,,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336525344,"AVIV, NAAMA",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336525344,"AVIV, NAAMA",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193400000X,Group,Single Specialty,,1336525344,"AVIV, NAAMA",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336525344,"AVIV, NAAMA",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 487 , 677 ," 3,478 "," $244,704.06 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336525625,"CLARK, DEBRA, SUE",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 26 , 75 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336525625,"CLARK, DEBRA, SUE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609851138,MOUNT AIRY EMERGENCY PHYSICIANS,MOUNT AIRY EMERGENCY PHYSICIANS,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1336526250,"LEIDLEIN HAMILTON, ERIN, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 63 , 94 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336526565,"WATERS, BRANDON, LEE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 58 , 82 , 124 ,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336526565,"WATERS, BRANDON, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1336526565,"WATERS, BRANDON, LEE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 272 , 798 , 798 ," $28,786.57 ",,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",620 SUMMIT CROSSING PL STE 202 GASTONIA NC,036,Gaston,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 61 , 70 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",15940 NORTHCROSS DR STE C HUNTERSVILLE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",19475 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336528322,"GILCHRIST, BAILEE, HILL",311 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 86 , 101 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336530534,"RICHARDSON, CHAD, ANDREW",3024 NEW BERN AVE   RALEIGH NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1336532548,"FEDEWA, SHAHEEN, AHMAD",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336532548,"FEDEWA, SHAHEEN, AHMAD",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,24 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336532902,"CARLTON, LAURA, JO",24 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 74 , 117 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336533868,"ZELLER, MARK, KENNETH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336534387,"GILMAN, ANDREW, JAMES",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336534387,"GILMAN, ANDREW, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 53 , 67 , 132 ," $11,555.10 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336534577,"BROWN, CARINA, MURPHY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336534577,"BROWN, CARINA, MURPHY",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336534577,"BROWN, CARINA, MURPHY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 147 , 216 , 313 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336534676,"TOMBERG, RYAN, JOHN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1336535822,"BHENSDADIA, PRASHANT, DHIRAJLAL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 218 , 218 ," $10,235.49 ",,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336535822,"BHENSDADIA, PRASHANT, DHIRAJLAL",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336535822,"BHENSDADIA, PRASHANT, DHIRAJLAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336535822,"BHENSDADIA, PRASHANT, DHIRAJLAL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336535822,"BHENSDADIA, PRASHANT, DHIRAJLAL",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 35 , 35 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336535822,"BHENSDADIA, PRASHANT, DHIRAJLAL",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336535822,"BHENSDADIA, PRASHANT, DHIRAJLAL",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1336535830,WATLINGTONS FAMILY HOME,WATLINGTONS FAMILY CARE HOMES 3,1401 SHERROD WATLINGTON CIR   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1336535830,WATLINGTONS FAMILY HOME,1401 SHERROD WATLINGTON CIR   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,455 "," 1,497 "," $105,190.41 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336535855,"CARRASQUILLO-GONZALEZ, OSWARD, YADIEL",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1336538040,"DEVORE, TOBY, RAE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 50 , 50 , 64 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336538040,"DEVORE, TOBY, RAE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336552983,"O CONNOR, SEAN, CHRISTIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336552983,"O CONNOR, SEAN, CHRISTIAN",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336552983,"O CONNOR, SEAN, CHRISTIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336553163,"BACHELER, CHRISTIAN, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 125 , 188 , 219 ," $12,147.08 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336553163,"BACHELER, CHRISTIAN, JOSEPH",1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1376351833,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROLOGY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336553163,"BACHELER, CHRISTIAN, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 20 , 24 ,$#,,
MEDICAID DIRECT,1467886978,G ABRAMS R COHEN VII PC,~,1605 GALLERIA BLVD STE 110 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336554013,"PATEL, JAY, SHAILESHKUMAR",1605 GALLERIA BLVD STE 110 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 365 , 576 ," 2,041 "," $108,056.74 ",,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1336556562,"DIXON, BRIDGETTE, NICOLE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 42 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336556562,"DIXON, BRIDGETTE, NICOLE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336556562,"DIXON, BRIDGETTE, NICOLE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336556562,"DIXON, BRIDGETTE, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1336559129,GRAHAMS SENIOR LIVING HOMES INC,,107 GRAHAM LN   BEAUFORT NC,016,Carteret,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1336559129,GRAHAMS SENIOR LIVING HOMES INC,107 GRAHAM LN   BEAUFORT NC,016,Carteret,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,527 "," 2,528 "," $160,122.33 ",,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1336563279,"TONKINSON, SANDRA, CAMPBELL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1336563279,"TONKINSON, SANDRA, CAMPBELL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336564202,"INGRAM, LESLIE, CAROLINE BARNES",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 40 , 41 , 42 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336567601,"CARVER, RYAN, ANDREW",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336567601,"CARVER, RYAN, ANDREW",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336567601,"CARVER, RYAN, ANDREW",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336568096,"STEM, JONATHAN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 64 , 79 ," $10,774.28 ",,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336568385,"INGERSOLL, KIMBERLY, FRANCES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 104 , 108 , 188 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336568757,"DIAZ, MONICA, MARIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336568757,"DIAZ, MONICA, MARIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 35 , 42 ,$#,,
MEDICAID DIRECT,1346501798,ARMC PHYSICIANS CARE INC,BURLINGTON UROLOGICAL ASSOCIATES,3940 ARROWHEAD BLVD STE 230 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336568807,"SNINSKY, BRIAN, CHARLES",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336568807,"SNINSKY, BRIAN, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 26 , 31 , 46 ,$#,,
MEDICAID DIRECT,1346501798,ARMC PHYSICIANS CARE INC,BURLINGTON UROLOGICAL ASSOCIATES,1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336568807,"SNINSKY, BRIAN, CHARLES",1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,208800000X,Allopathic & Osteopathic Physicians,Urology,, 67 , 93 , 131 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336569359,"STEVENS, KEVIN, GRANT",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336570332,"RAMEY, MIA, DECATO",GIFT OF GAB LLC,3608 W FRIENDLY AVE STE 108 GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1336570332,"RAMEY, MIA, DECATO",3608 W FRIENDLY AVE STE 108 GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1336572064,"BUMGARDNER, JOYCE, EVERSON",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 141 , 261 ,$#,,
MEDICAID DIRECT,1679732176,CAROLINAS PHYSICIANS NETWORK INC,WEST LINCOLN FAMILY MEDICINE,4429 W HIGHWAY 27   VALE NC,055,Lincoln,193400000X,Group,Single Specialty,,1336572064,"BUMGARDNER, JOYCE, EVERSON",4429 W HIGHWAY 27   VALE NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 39 , 72 ,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336573633,"KIVETTE, SUSANNA, SCOTT",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1336573856,"KORZELIUS, KAREN, SALEM",KAREN KORZELIUS,330 N 2ND ST STE B ALBEMARLE NC,084,Stanly,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1336573856,"KORZELIUS, KAREN, SALEM",330 N 2ND ST STE B ALBEMARLE NC,084,Stanly,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,7901 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336574318,"HUTCHERSON, KAREN, SYBYL",7901 T W ALEXANDER DR   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1336576776,"WEAVER, CHARLENE, SHANDELL",910 E INNES ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 52 , 58 , 104 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336576776,"WEAVER, CHARLENE, SHANDELL",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336576776,"WEAVER, CHARLENE, SHANDELL",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336577352,"BARISHNIKOV, MICHELLE, SRIJAYANTA",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 ,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336577352,"BARISHNIKOV, MICHELLE, SRIJAYANTA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336579796,"MENDOZA, CANDACE, CROWE",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 18 , 36 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1336579796,"MENDOZA, CANDACE, CROWE",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 101 , 213 , 223 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336579796,"MENDOZA, CANDACE, CROWE",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 60 , 61 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336582063,"ROCCHI, VANNA, JO",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1336582535,"GRAHAM, JONATHAN, DANIEL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336582543,"SENDON GUTIERREZ, CARLOS, SANTIAGO",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336582543,"SENDON GUTIERREZ, CARLOS, SANTIAGO",850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,2080S0012X,Allopathic & Osteopathic Physicians,Pediatrics,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336582543,"SENDON GUTIERREZ, CARLOS, SANTIAGO",500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,2080S0012X,Allopathic & Osteopathic Physicians,Pediatrics,Sleep Medicine,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336582543,"SENDON GUTIERREZ, CARLOS, SANTIAGO",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080S0012X,Allopathic & Osteopathic Physicians,Pediatrics,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 30 , 34 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 125 , 145 , 275 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 15 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 33 , 35 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",2321 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 65 , 65 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",9622 KINCEY AVE   HUNTERSVILLE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1942956123,METROLINA VASCULAR ACCESS CARE LLC,METROLINA SURGERY CENTER OF CHARLOTTE,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1336584572,"SADOLF, JOSHUA, SIMON",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",2321 W MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 49 , 49 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336584572,"SADOLF, JOSHUA, SIMON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336585041,"SIMMONS, BRIANA, RENEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 32 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1336585041,"SIMMONS, BRIANA, RENEE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336585041,"SIMMONS, BRIANA, RENEE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 49 , 53 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336585041,"SIMMONS, BRIANA, RENEE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336585041,"SIMMONS, BRIANA, RENEE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336585041,"SIMMONS, BRIANA, RENEE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 96 , 164 ,$#,,
MEDICAID DIRECT,1891013181,DEL BIANCO ENTERPRISES,DEL BIANCO PROSTHETICS & ORTHOTICS,1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336586080,"WOOLFE, CHARLES, STEVEN",1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 30 ,$#,,
MEDICAID DIRECT,1891013181,DEL BIANCO ENTERPRISES,DEL BIANCO PROSTHETICS & ORTHOTICS,1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1336586080,"WOOLFE, CHARLES, STEVEN",1031 W WILLIAMS ST STE 104 APEX NC,092,Wake,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 29 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336591106,"AGRAWAL, KAVITA, ANILKUMAR",1236 HUFFMAN MILL RD STE 120 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 91 , 91 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336591106,"AGRAWAL, KAVITA, ANILKUMAR",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073822029,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1336591320,"WATSON, MEGAN, ANN",711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 52 , 71 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,140 W MILLS ST STE A COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1336592708,"CAMPBELL, GARY, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592708,"CAMPBELL, GARY, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592708,"CAMPBELL, GARY, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592708,"CAMPBELL, GARY, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592708,"CAMPBELL, GARY, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592708,"CAMPBELL, GARY, EDWARD",63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592708,"CAMPBELL, GARY, EDWARD",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1336592708,"CAMPBELL, GARY, EDWARD",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1336592708,"CAMPBELL, GARY, EDWARD",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972079127,MH TRANSYLVANIA REGIONAL HOSPITAL L,,360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1336592708,"CAMPBELL, GARY, EDWARD",360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1336592708,"CAMPBELL, GARY, EDWARD",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1336592872,"MOZIAK, MICHAEL, ALLEN",90 HAYWOOD OFFICE PARK   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 62 , 85 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,,,Unknown,193200000X,Group,Multi-Specialty,,1336592872,"MOZIAK, MICHAEL, ALLEN",90 HAYWOOD OFFICE PARK   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1336592872,"MOZIAK, MICHAEL, ALLEN",262 LEROY GEORGE DR FL 1 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 71 , 96 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592872,"MOZIAK, MICHAEL, ALLEN",90 HAYWOOD OFFICE PARK   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 49 , 53 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1336592872,"MOZIAK, MICHAEL, ALLEN",81 MEDICAL PARK LOOP STE 202 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1336592872,"MOZIAK, MICHAEL, ALLEN",436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 133 , 191 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336592872,"MOZIAK, MICHAEL, ALLEN",436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 43 , 50 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,177 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1336593235,"BONDALAPATI, SAILAJA",177 PARKWOOD DR   ELKIN NC,086,Surry,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336593276,"NICOLAZZI, JOSEPH, THOMAS",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1134172604,WESTERN PIEDMONT ANESTHESIA,WESTERN PIEDMONT ANESTHESIA,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1336593839,"STOUT, DEREK, RUSSELL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 55 , 56 , 59 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336593839,"STOUT, DEREK, RUSSELL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 48 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336594241,"HARRINGTON, NIKITA, ANTOINETTE",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336594241,"HARRINGTON, NIKITA, ANTOINETTE",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336594423,"GABRA, MARTINA, GAD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336594845,"MONACO, ERIC, STAFFORD",709 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336594845,"MONACO, ERIC, STAFFORD",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 91 , 111 ,$#,,
MEDICAID DIRECT,1801261391,BLUE RIDGE COMMUNITY HEALTH SERVICE,SEVENTH AVENUE HEALTH CENTER,628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336594845,"MONACO, ERIC, STAFFORD",628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336594845,"MONACO, ERIC, STAFFORD",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1336595826,NORTH CAROLINA NEURODIAGNOSTICS LLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1336595826,NORTH CAROLINA NEURODIAGNOSTICS LLC,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,, 100 , 235 , 237 ," $283,120.40 ",,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336595909,"DENDY, COLBY, BOUCHARD",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336595909,"DENDY, COLBY, BOUCHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336595909,"DENDY, COLBY, BOUCHARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 41 , 41 ,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336595909,"DENDY, COLBY, BOUCHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336595909,"DENDY, COLBY, BOUCHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 53 , 86 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336595909,"DENDY, COLBY, BOUCHARD",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1336595909,"DENDY, COLBY, BOUCHARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336595933,"MURRAY, HALEY, DIANA",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336598952,"LUNSFORD, MELISSA, JENNINGS",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336598952,"LUNSFORD, MELISSA, JENNINGS",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336598952,"LUNSFORD, MELISSA, JENNINGS",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 21 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336599273,"FETT, JORDAN, DANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 113 , 216 , 302 ," $37,932.36 ",,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336600121,"AMEN, JEHON",157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336600121,"AMEN, JEHON",157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1336600170,"CLARK, BROCK, STEPHEN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 76 , 91 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336600964,"WEDZIK, ALLISON, GRACE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336601467,"WILLIAMS, KAYLA, MARIE",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336601467,"WILLIAMS, KAYLA, MARIE",590 MEDICAL PARK DR 590 MEDICAL PARK DRIVE MARSHALL NC,057,Madison,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 36 , 42 ,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336601467,"WILLIAMS, KAYLA, MARIE",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 33 , 41 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1336601467,"WILLIAMS, KAYLA, MARIE",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 66 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1336602325,"SCOTT, MATHEW, JONATHAN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336602325,"SCOTT, MATHEW, JONATHAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336602325,"SCOTT, MATHEW, JONATHAN",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336602325,"SCOTT, MATHEW, JONATHAN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336602424,"SUAREZ, MICHELLE, CAMILLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336602424,"SUAREZ, MICHELLE, CAMILLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 48 , 48 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336602424,"SUAREZ, MICHELLE, CAMILLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 48 , 48 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336602663,"SKEEN, LUCY, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336602960,"VANHEYST, PARISA, MARYAM",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336603075,"DICKERSON, BETSY, ANN",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336603075,"DICKERSON, BETSY, ANN",1821 HILLANDALE RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336603075,"DICKERSON, BETSY, ANN",1821 HILLANDALE RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1336606417,"HATCHER, JESSICA, LEE",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336606938,HIGH COUNTRY COMMUNITY HEALTH,1925 N BRIDGE ST STE 101 ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,110 DUTCHMAN CT   ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336606938,HIGH COUNTRY COMMUNITY HEALTH,110 DUTCHMAN CT   ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 30 , 70 , 70 ," $13,138.33 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336607464,"VANDERFORD, KATHERINE, WATERS",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336607464,"VANDERFORD, KATHERINE, WATERS",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336607464,"VANDERFORD, KATHERINE, WATERS",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336607464,"VANDERFORD, KATHERINE, WATERS",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1336607464,"VANDERFORD, KATHERINE, WATERS",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336608009,"JOHNSON, SHELBY, LEE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 27 , 27 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336608009,"JOHNSON, SHELBY, LEE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336608611,"WILKERSON, SARAH, MARRIOTT",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336609197,"ELFERING, JEANETTE, ELAINE",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336609197,"ELFERING, JEANETTE, ELAINE",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1336612225,"BILBROUGH, ERIN, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1336612225,"BILBROUGH, ERIN, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336612225,"BILBROUGH, ERIN, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336612225,"BILBROUGH, ERIN, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1336612225,"BILBROUGH, ERIN, ANN",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1336612225,"BILBROUGH, ERIN, ANN",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1336612225,"BILBROUGH, ERIN, ANN",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1336612225,"BILBROUGH, ERIN, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1336613603,"MINDEL, LANA, JO",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336614361,"WRAY, ILVANA, CAMPAGNA",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 35 , 35 ,$#,,
MEDICAID DIRECT,1841628518,MATTHEW W LINEBERGER DDS MS C SCHN,GASTON ORTHODONTICS,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336620350,"DAVE, SHIVANI, VINAYAK",816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,916 "," 7,661 "," 9,244 "," $1,437,335.62 ",,
MEDICAID DIRECT,1841628518,MATTHEW W LINEBERGER DDS MS C SCHN,GASTON ORTHODONTICS,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1336620350,"DAVE, SHIVANI, VINAYAK",816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1730519182,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336621127,"ALLEGO, EMILIE, LORRAINE",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1730519182,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1336621127,"ALLEGO, EMILIE, LORRAINE",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 84 , 94 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3325 ROBINHOOD RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336623248,"SHAW, DONNA, MARIE",605 COLLEGE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 23 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336627561,"SHAH, PUJA, PRATHMESH",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336627967,"PATEL, MITALI, DARSHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336627967,"PATEL, MITALI, DARSHAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821555020,SURGICAL CENTER FOR DENTAL PROFESSI,SCDP ANESTHESIA PROFESSIONALS,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336627967,"PATEL, MITALI, DARSHAN",2620 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336627967,"PATEL, MITALI, DARSHAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245637701,NEW DAWN PSYCHIATRIC SERVICES PLLC,,835 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336628957,"ISLER, SONYA, RENEE",111 AIRPORT RD   KINSTON NC,054,Lenoir,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336632207,"YOCUM, MAGGIE, ROSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336632207,"YOCUM, MAGGIE, ROSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336632207,"YOCUM, MAGGIE, ROSE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336632306,"VOLLMER, ALEXANDRA, KATHRYN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336633106,"PHILLIPS, MARK, STEPHEN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 67 , 151 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336633106,"PHILLIPS, MARK, STEPHEN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 40 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336633106,"PHILLIPS, MARK, STEPHEN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336633106,"PHILLIPS, MARK, STEPHEN",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336633106,"PHILLIPS, MARK, STEPHEN",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528554631,BETHANY MEDICAL CENTER,~,160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336633106,"PHILLIPS, MARK, STEPHEN",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336633106,"PHILLIPS, MARK, STEPHEN",MEDICAL CENTER BVLD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295729747,THE CHILD HEALTH CENTER,THE CHILD HEALTH CENTER,1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1336633270,"ADAMS, ANN, MARIE",1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 63 , 220 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1336633593,"BANFIELD, MOLLY, MAE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 40 , 73 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1336633593,"BANFIELD, MOLLY, MAE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1336633593,"BANFIELD, MOLLY, MAE",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1336634328,"JONES, BERNARD, KAY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 131 , 142 , 174 ," $11,520.06 ",,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336635481,"REED, MORGAN, HAILEY",111 W GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 57 , 90 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336635481,"REED, MORGAN, HAILEY",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 42 , 50 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336635481,"REED, MORGAN, HAILEY",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336637255,"CHUNDI, VAHINI",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336637255,"CHUNDI, VAHINI",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 104 , 257 , 277 ," $14,611.74 ",,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336637339,"STEELE, MARY, JEANETTE",250 HOSPICE CIR   RALEIGH NC,092,Wake,2080H0002X,Allopathic & Osteopathic Physicians,Pediatrics,Hospice and Palliative Medicine, 22 , 52 , 85 ," $13,408.05 ",,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1336639483,"SMITH, MORGAN, BRADFORD",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 21 , 34 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1336639483,"SMITH, MORGAN, BRADFORD",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336640333,"ZOHRA, MOBEEN",2101 N MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2101 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336640333,"ZOHRA, MOBEEN",2101 N MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336640333,"ZOHRA, MOBEEN",1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 36 ,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1336640333,"ZOHRA, MOBEEN",2101 N MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336640333,"ZOHRA, MOBEEN",1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1336640549,"KENDRICK, CAITLYN, SAMANTHA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336640788,"HERRING, DAVID, BRIAN",3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336640788,"HERRING, DAVID, BRIAN",3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336640788,"HERRING, DAVID, BRIAN",104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 25 , 47 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336642099,"CARDINALI, SERGE, ALEJANDRO",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 31 , 58 , 94 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336643535,"KOSTELIC, PHILLIP, MARTIN",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336643535,"KOSTELIC, PHILLIP, MARTIN",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336643535,"KOSTELIC, PHILLIP, MARTIN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336643535,"KOSTELIC, PHILLIP, MARTIN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336643535,"KOSTELIC, PHILLIP, MARTIN",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336643535,"KOSTELIC, PHILLIP, MARTIN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336643535,"KOSTELIC, PHILLIP, MARTIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 48 , 66 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1336644301,"LAHTI, ELIZABETH, ANN HOGAN",6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336644301,"LAHTI, ELIZABETH, ANN HOGAN",210 ASHVILLE AVE   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336644301,"LAHTI, ELIZABETH, ANN HOGAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,6102 GRACE PARK DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1336644301,"LAHTI, ELIZABETH, ANN HOGAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1336644301,"LAHTI, ELIZABETH, ANN HOGAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336644301,"LAHTI, ELIZABETH, ANN HOGAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1336644301,"LAHTI, ELIZABETH, ANN HOGAN",101 HOLLY CREEK RD   MORRISVILLE NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1336645191,"ANDERSON, TYLER, SCOTT",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336645431,"AJMERA, ARUN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336645431,"AJMERA, ARUN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 42 , 105 , 120 ," $10,618.62 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336645431,"AJMERA, ARUN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336645589,"HOFF, JOHN, AUGUST",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 98 , 105 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336645589,"HOFF, JOHN, AUGUST",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 41 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336645589,"HOFF, JOHN, AUGUST",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336646041,"HARSHBARGER, JADE, KELLAND",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 61 , 88 , 88 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336646041,"HARSHBARGER, JADE, KELLAND",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 29 , 47 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336646256,"LI, HUIHUA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336646256,"LI, HUIHUA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 27 , 29 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336646256,"LI, HUIHUA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 14 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336646538,"MASON, JAMES, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336646538,"MASON, JAMES, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336647247,"BLUDWORTH, JANELLE, NICOLE",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891402327,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WASHINGTON ELEMENTARY,1907 STONY POINT RD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336648203,"ROSS, TENISHA, LASHAES",216 W DIXON BLVD STE A-1 SHELBY NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 51 , 51 ," $16,336.83 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1336651678,"FUSSELL, PIERCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336651678,"FUSSELL, PIERCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1336651728,"COLLIER, GREGORY, ALEXANDER",169 BIRCH ST   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1336651728,"COLLIER, GREGORY, ALEXANDER",178 HIGHWAY 105 EXT STE 101 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1336651728,"COLLIER, GREGORY, ALEXANDER",169 BIRCH ST   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 85 , 195 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336652247,"PRICE, PHILIP, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336652247,"PRICE, PHILIP, ANDREW",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1336652247,"PRICE, PHILIP, ANDREW",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336652247,"PRICE, PHILIP, ANDREW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336652247,"PRICE, PHILIP, ANDREW",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1336652247,"PRICE, PHILIP, ANDREW",120 HEALTHPLEX WAY   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,340 COMMERCE AVE STE 5 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1336653567,"GASIOR, IWONA, ANNA",155 W MILLS ST   COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336653567,"GASIOR, IWONA, ANNA",155 W MILLS ST   COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 108 , 108 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1336653567,"GASIOR, IWONA, ANNA",155 W MILLS ST   COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 27 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336653567,"GASIOR, IWONA, ANNA",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1336653567,"GASIOR, IWONA, ANNA",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1336653567,"GASIOR, IWONA, ANNA",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336653567,"GASIOR, IWONA, ANNA",5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1336656529,"HEILMAN, TAYLOR, KATHERINE",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 28 , 28 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336656677,"MUQTASID, SAMANTHA, TURNER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336656677,"MUQTASID, SAMANTHA, TURNER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1851783385,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL INTERNAL MEDICINE SPECIALISTS,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1336658392,"OAKLEY, FAITH-MARIE",194 DOCTORS DR   BOONE NC,095,Watauga,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 19 , 39 , 78 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1336658459,"FRANCIS, TASHA, KELLY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1336658459,"FRANCIS, TASHA, KELLY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1336658459,"FRANCIS, TASHA, KELLY",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336660661,"MERZ, ZACHARY, CLIFFORD",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 20 , 57 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336662444,"SCHAFFNER, MICHAEL, DONOVAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336662444,"SCHAFFNER, MICHAEL, DONOVAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 32 , 37 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336662444,"SCHAFFNER, MICHAEL, DONOVAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336662444,"SCHAFFNER, MICHAEL, DONOVAN",13 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336662444,"SCHAFFNER, MICHAEL, DONOVAN",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336662444,"SCHAFFNER, MICHAEL, DONOVAN",1000 HEALING WAY   MATTHEWS NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336662444,"SCHAFFNER, MICHAEL, DONOVAN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1336662659,"DANIELSON, BRITTANY, NICOLE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336662659,"DANIELSON, BRITTANY, NICOLE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336662774,"LANGFORD, CAITLYN, MICHAEL MCKENZIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 101 , 102 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336667146,"WATSON, MARIE, ELIZABETH",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336667146,"WATSON, MARIE, ELIZABETH",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336667146,"WATSON, MARIE, ELIZABETH",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 11 , 24 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336667146,"WATSON, MARIE, ELIZABETH",2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336669845,"PRAY, MARGARET, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 137 , 210 , 266 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336670702,"LIECHTY, REVATHI, LAKKAKULA",1428 E MAIN ST STE B LINCOLNTON NC,055,Lincoln,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336670702,"LIECHTY, REVATHI, LAKKAKULA",3719 UNION RD   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336670702,"LIECHTY, REVATHI, LAKKAKULA",2675 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 39 , 90 , 155 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336671320,"PEELA, APPALA, SUMAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 70 , 121 , 121 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336671700,"WACKERLE, KELLY, RYAN",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336671700,"WACKERLE, KELLY, RYAN",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 31 , 40 , 57 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336672484,"LIN, JIMMY, YAO",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336672484,"LIN, JIMMY, YAO",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1336672484,"LIN, JIMMY, YAO",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 81 , 87 , 93 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 37 , 75 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 35 , 42 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 25 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811350887,PIEDMONT HEALTHCARE PA,,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 68 , 147 , 272 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336672534,"EASON, TRAVIS, BENJAMIN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336674357,"VARGHESE, SONIA, ANN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 29 , 32 , 33 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336674357,"VARGHESE, SONIA, ANN",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336674357,"VARGHESE, SONIA, ANN",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 31 , 49 , 75 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336674357,"VARGHESE, SONIA, ANN",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 128 , 202 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336674423,"BELLINA, CHRISTINA, MARIE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 19 , 36 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336674852,"PARKER, SETH, THOMAS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336674852,"PARKER, SETH, THOMAS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336674852,"PARKER, SETH, THOMAS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336674852,"PARKER, SETH, THOMAS",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336674852,"PARKER, SETH, THOMAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 24 , 27 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336674852,"PARKER, SETH, THOMAS",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336676618,"POLLY, SAMANTHA, ASHLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 19 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336676618,"POLLY, SAMANTHA, ASHLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 24 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336676618,"POLLY, SAMANTHA, ASHLEY",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336676618,"POLLY, SAMANTHA, ASHLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336677046,"BONVILLIAN, JOHN, PAUL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 173 , 305 , 388 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336677046,"BONVILLIAN, JOHN, PAUL",1814 WESTCHESTER DR STE 300 HIGH POINT NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1316692536,COASTAL FAMILY URGENT CARE,,310 LIBERTY ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1336677699,"CANADY, BRITTANY, BATTEN",310 LIBERTY ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 79 , 159 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336677954,"HURST, BENJAMIN, DAVID",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 51 , 51 ,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336677954,"HURST, BENJAMIN, DAVID",101 E WT HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336679794,"GAYED, MINA, SALAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 36 , 139 , 176 ," $31,838.26 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336679794,"GAYED, MINA, SALAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 76 , 95 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336682699,"MAPLES, KATIE, JO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#,#,$#,,
MEDICAID DIRECT,1336685551,WAYNE AL HOLDINGS LLC,EAGLES POINTE,901 W NEW HOPE RD   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1336685551,WAYNE AL HOLDINGS LLC,901 W NEW HOPE RD   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 26 ," 3,786 "," 3,786 "," $464,769.12 ",,
MEDICAID DIRECT,1336685551,WAYNE AL HOLDINGS LLC,EAGLES POINTE,901 W NEW HOPE RD   GOLDSBORO NC,096,Wayne,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1336685551,WAYNE AL HOLDINGS LLC,901 W NEW HOPE RD   GOLDSBORO NC,096,Wayne,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336685684,"WATERBURY, ELIZABETH, ANN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1336685684,"WATERBURY, ELIZABETH, ANN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336685684,"WATERBURY, ELIZABETH, ANN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336685684,"WATERBURY, ELIZABETH, ANN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 43 , 44 , 44 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336686831,"MAY, AUSTIN, BLENNER",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336689900,"JOHNSON, LEIGH, ELIZABETH",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336689900,"JOHNSON, LEIGH, ELIZABETH",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 24 , 55 , 103 ,$#,,
MEDICAID DIRECT,1336692060,"NELSON, BLAKE, PATRICK",BLAKE NELSON DDS,3066 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1336692060,"NELSON, BLAKE, PATRICK",3066 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 22 , 55 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336692524,"SOURBEER, AMBER, LYNN",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336692607,"ROYALL, MALLORY, MARIYA RAGAN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336692607,"ROYALL, MALLORY, MARIYA RAGAN",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336692607,"ROYALL, MALLORY, MARIYA RAGAN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 37 , 37 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336692607,"ROYALL, MALLORY, MARIYA RAGAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336692649,"BARBER, PHILIP, MARTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 37 , 40 , 72 ,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1336692649,"BARBER, PHILIP, MARTIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 55 , 55 , 114 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336693266,"GRAHAM, VANESSA, BRISTOW",5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336693266,"GRAHAM, VANESSA, BRISTOW",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1508293242,"BARNETTE, PHYLLIS, YVETTE",~,508 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),1336693852,ZENITH HOPE CENTER LLC,508 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1336694629,"WATSON, BRIAN, SCOTT",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1336694629,"WATSON, BRIAN, SCOTT",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1336694629,"WATSON, BRIAN, SCOTT",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1336694629,"WATSON, BRIAN, SCOTT",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1336694629,"WATSON, BRIAN, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336694629,"WATSON, BRIAN, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336694629,"WATSON, BRIAN, SCOTT",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1336697945,"KIM, MEGAN, MARIE",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 23 , 27 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1505 SW CARY PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336697945,"KIM, MEGAN, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336697945,"KIM, MEGAN, MARIE",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 23 , 33 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336697945,"KIM, MEGAN, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 26 , 35 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336697945,"KIM, MEGAN, MARIE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336700269,"SOLIMAN, DANIEL, ANGELO HALIM",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 35 ,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336700277,"LEWIS, AMANDA",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 191 ," 1,012 "," 1,384 "," $22,392.25 ",,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336701762,"PARKER, BONNIE, LAUREN HOWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",323 N BROOME ST   WAXHAW NC,090,Union,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 11 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",323 N BROOME ST   WAXHAW NC,090,Union,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 16 , 38 , 80 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 42 , 53 , 109 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 153 , 403 , 811 ,$#,,
MEDICAID DIRECT,1124600051,FOOT AND ANKLE SPECIALISTS OF THE M,,626 CLARK DR   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1124600051,FOOT AND ANKLE SPECIALISTS OF THE M,,626 CLARK DR   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 79 , 180 , 342 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1336705789,"ALBERS, BRIANNA, LYNN",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 23 , 23 , 38 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1336705938,"WATSON, ALEXIS, SWARINGER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336705938,"WATSON, ALEXIS, SWARINGER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336705938,"WATSON, ALEXIS, SWARINGER",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336705938,"WATSON, ALEXIS, SWARINGER",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336492008,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1336707348,"CODY, AMY, FREDRICK",447 MCALISTER RD STE 1600 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336707348,"CODY, AMY, FREDRICK",2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 73 , 97 ,$#,,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336707348,"CODY, AMY, FREDRICK",3715 UNION RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 28 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336709211,"SHEIKH, BATOOL, ZOHRA",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336709211,"SHEIKH, BATOOL, ZOHRA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336709211,"SHEIKH, BATOOL, ZOHRA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336711043,"KING, MITCHELL, NEWELL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1336712066,"MENDOZA RODRIGUEZ, KARLA, LIZETH",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 88 , 153 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1336712066,"MENDOZA RODRIGUEZ, KARLA, LIZETH",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1336712199,"ABATE, ELIAS, NEGASH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 73 , 73 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336712199,"ABATE, ELIAS, NEGASH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 82 , 82 ,$#,,
MEDICAID DIRECT,1215488481,RDMG ASSOCIATES PA,,3164 US HIGHWAY 70   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336713494,"BURKS, MORGAN, DURHAM",3164 US HIGHWAY 70   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 66 , 94 ,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336713833,"SCHWEITZER, CONNOR, JEFFERY",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336713833,"SCHWEITZER, CONNOR, JEFFERY",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336714542,"HOGAN, RACHEL, ELIZABETH",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336716729,"TRACY, DEBRA, KAY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336716729,"TRACY, DEBRA, KAY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 61 , 61 ," $17,876.22 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336719921,"ROMERO GARCIA, ALBERTO, NELSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1336719921,"ROMERO GARCIA, ALBERTO, NELSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 49 , 49 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336722107,"KOSTER, JENNA, KATE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1336722107,"KOSTER, JENNA, KATE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336722107,"KOSTER, JENNA, KATE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 40 , 41 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336722107,"KOSTER, JENNA, KATE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1336723410,"NGO, MICHAEL, XUAN KHANG",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336725050,"JORDAN, ROBERT, JAMES",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 16 , 18 ,$#,,
MEDICAID DIRECT,1275291361,LIVING THE BREAMEDICAL SALISBURY PL,BREAM MEDICAL SALISBURY,721 GROVE ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1336725050,"JORDAN, ROBERT, JAMES",109 W RIVER ST   COLERAIN NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 39 , 55 ,$#,,
MEDICAID DIRECT,1790851004,ROANOKE CHOWAN COMMUNITY HEALTH CEN,COLERAIN PRIMARY CARE,109 W RIVER ST   COLERAIN NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336725050,"JORDAN, ROBERT, JAMES",109 W RIVER ST   COLERAIN NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 93 , 103 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1336725597,"GRANDEZ, JESUS, ADOLFO",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336725795,"HUDDLESTUN, JENNIFER, ANN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 37 , 37 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336727320,"HULL, JAMES, ROBERT",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1861747479,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS INDIAN TRAIL PEDIA,6030 W HIGHWAY 74 STE F INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1336727593,"KULKARNI, VARSHA",6030 W HIGHWAY 74 STE F INDIAN TRAIL NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336728476,"UWENSUYI-EDOSOMWAN, UYIOGHOSA, FRANCIS",1995 WELLNESS BLVD   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 40 , 74 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336728476,"UWENSUYI-EDOSOMWAN, UYIOGHOSA, FRANCIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336728476,"UWENSUYI-EDOSOMWAN, UYIOGHOSA, FRANCIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336728476,"UWENSUYI-EDOSOMWAN, UYIOGHOSA, FRANCIS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336728476,"UWENSUYI-EDOSOMWAN, UYIOGHOSA, FRANCIS",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336728476,"UWENSUYI-EDOSOMWAN, UYIOGHOSA, FRANCIS",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336728492,ALWAYS AT HOME CARE LLC,,1101 TYVOLA RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1336728492,ALWAYS AT HOME CARE LLC,1101 TYVOLA RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,709 "," 4,713 "," $415,045.68 ",,
MEDICAID DIRECT,1336728682,SECOND WIND HOMECARE LLC,,2018 FORT BRAGG RD STE 114B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1336728682,SECOND WIND HOMECARE LLC,2018 FORT BRAGG RD STE 114B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 4,511 "," 4,640 "," $351,355.44 ",,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1336730381,"SASSER, KAYLA, GRACE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1336730381,"SASSER, KAYLA, GRACE",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 53 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1336731041,"MCKEON, ERIN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336731041,"MCKEON, ERIN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 102 , 102 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1336731041,"MCKEON, ERIN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336735935,"MORRISON, JUSTIN, CRAIG",5160 OCEAN HWY W   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 93 , 173 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1336735935,"MORRISON, JUSTIN, CRAIG",5160 OCEAN HWY W   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 21 , 52 ,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1336750454,"DYSON, CATHERINE, LINDSAY",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 26 ,$#,,
MEDICAID DIRECT,1033794300,LANE AND ASSOCIATES XLI DDS PA,,571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1336750454,"DYSON, CATHERINE, LINDSAY",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 113 , 149 , 439 ," $17,898.08 ",,
MEDICAID DIRECT,1336756964,ALL STAR HOME HEALTH CARE INC,,2609 ATLANTIC AVE   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1336756964,ALL STAR HOME HEALTH CARE INC,2609 ATLANTIC AVE   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,369 "," 2,369 "," $144,494.24 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336758655,"GRASSO, STEPHANIE, MORGAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336758655,"GRASSO, STEPHANIE, MORGAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336759109,"VEALE, JESSICA, CLEMMONS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336759109,"VEALE, JESSICA, CLEMMONS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336760628,"CLEVELAND, VICTORIA, SZILAGE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 25 ,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336760628,"CLEVELAND, VICTORIA, SZILAGE",200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336760701,"EGAN, EZEKIEL, DAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336761196,"BARRON, NATHAN, KOALI'I",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 77 , 233 , 237 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1336763176,"DIALLO, FATOUMATA",2525 COURT DR   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336763176,"DIALLO, FATOUMATA",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1336766369,"GRIMES, DUSTIN, ROSS",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1336766583,INREACH,,301 S STEWART ST   WINGATE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1336766583,INREACH,301 S STEWART ST   WINGATE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 373 , 373 ," $19,864.88 ",,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336767185,"CHAVIS, TEENA, RUBY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336767185,"CHAVIS, TEENA, RUBY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336767185,"CHAVIS, TEENA, RUBY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336767185,"CHAVIS, TEENA, RUBY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336767185,"CHAVIS, TEENA, RUBY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336768332,"DIGGS, ALEXANDRA, INES SOPHIA",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336773217,"HELLER, LAUREN, REAVIS",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 84 , 188 , 303 ,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336776152,"MCGOWAN, MELISSA, PAIGE",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336776152,"MCGOWAN, MELISSA, PAIGE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 20 , 36 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336776152,"MCGOWAN, MELISSA, PAIGE",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336776152,"MCGOWAN, MELISSA, PAIGE",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 35 , 64 ,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1336777176,"CUNINGHAM, JOHN, CARRINGTON",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 104 , 104 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336778455,"GROCH, REBECCA, ANNE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 30 , 30 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336778455,"GROCH, REBECCA, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1336780147,"CANADY, KRISTEN, LEEANN",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 57 , 58 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1336780147,"CANADY, KRISTEN, LEEANN",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 334 , 334 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1336780147,"CANADY, KRISTEN, LEEANN",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1336780147,"CANADY, KRISTEN, LEEANN",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 63 , 63 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336780410,"MAHMOUD, REBECCA, LAURA",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336782622,"GREESON, CHRISTINA, STUTTS",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 62 , 116 , 141 ," $11,631.69 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336782622,"GREESON, CHRISTINA, STUTTS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1306411228,SPARTANBURG MEDICAL CENTER,MEDICALGROPOFTHECAROLINAS-NEUROLOGY-SPARTANBURG,1650 SKYLYN DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1336782978,"SMITH, TINA, DIANNE",1650 SKYLYN DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336790278,"WALISIEWICZ, KAITLYN, ELIZABETH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336793694,"HAHN, ERIC, MYERS",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 88 , 88 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336793694,"HAHN, ERIC, MYERS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336793694,"HAHN, ERIC, MYERS",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336793694,"HAHN, ERIC, MYERS",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336797943,"COLLINS, RACHEL, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336797943,"COLLINS, RACHEL, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336797943,"COLLINS, RACHEL, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1336800325,"NARRON, JORDAN, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336802115,"RIVERA GONZALEZ, FLOR, ANDREA",915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 21 , 26 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336802248,"BERNACKI, SARAH, CROSBY",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336803857,"HARTMAN, LEIGH, ANNE",2400 PRATT ST STE 110 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336803857,"HARTMAN, LEIGH, ANNE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 24 ,$#,,
MEDICAID DIRECT,1356730741,DAVID E THOME DDS PLLC IV,STATESVILLE PEDIATRIC DENTISTRY,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336810027,"TAJIRI, CLAIRE, ELIZABETH",1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538407036,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WHITEVILLE,5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336813195,"SIMMONS, SELENA, PATRICK",5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336813195,"SIMMONS, SELENA, PATRICK",5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336813195,"SIMMONS, SELENA, PATRICK",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336818012,"BROOKS, TASHA, IVEY",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 41 , 111 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1336818012,"BROOKS, TASHA, IVEY",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 95 , 127 , 316 ," $12,907.94 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336818319,"HADDEN, STEPHEN, THOMAS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 260 ," 2,481 "," 2,665 "," $56,302.83 ",,
MEDICAID DIRECT,1841926169,COUNTY OF YANCEY,YANCEY COUNTY HEALTH DEPARTMENT,202 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1336820570,"ROBINSON, VICTORIA, DANIELLE",202 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 30 , 44 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336822998,"SELIG, JACOB, MAXIMILIAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336822998,"SELIG, JACOB, MAXIMILIAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 31 , 42 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336822998,"SELIG, JACOB, MAXIMILIAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1134376700,"ARNOLD, WILLIAM, BRANDON",,40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice,1336823285,"PHILIPS, KAMAIRA, HARTLEY",40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1538529474,WILLIAM BRANDON ARNOLD DMD PLLC,~,40 GRAYSON ST   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1336823285,"PHILIPS, KAMAIRA, HARTLEY",40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 51 , 134 ,$#,,
MEDICAID DIRECT,1568197523,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE TEN TEN,7750 TEN TEN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1336825686,"CONSIDINE, BRIANNA, MORGAN",7750 TEN TEN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336826411,TOUCHED BY GRACE HOMECARE LLC,,5375 SHATTALON DR   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1336826411,TOUCHED BY GRACE HOMECARE LLC,5375 SHATTALON DR   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 43 , 44 ,$#,,
MEDICAID DIRECT,1710661137,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT YADKINVILLE ELEMENTARY,305 N STATE ST   YADKINVILLE NC,099,Yadkin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336827369,"HINES, LAUREN, KYANN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1457086498,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PLEASANT RIDGE ELEMENTARY,1260 FLOYD LN   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336827369,"HINES, LAUREN, KYANN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336827369,"HINES, LAUREN, KYANN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1669221313,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CATAWBA HEIGHTS ELEMENTARY,101 IVEY ST   BELMONT NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336827369,"HINES, LAUREN, KYANN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1467201129,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PINEWOOD ELEMENTARY,1925 N MAIN ST   MOUNT HOLLY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336827369,"HINES, LAUREN, KYANN",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 64 , 64 ," $19,570.13 ",,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336829738,"KAUR, DILPREET",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 23 , 40 ,$#,,
MEDICAID DIRECT,1245086669,STEPHANIE KAYE HARDING DDS PA,AFFORDABLE DENTURES & IMPLANTS - GREENSBORO,1218 BRIDFORD PKWY UNIT S GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1336829738,"KAUR, DILPREET",1218 BRIDFORD PKWY UNIT S GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 36 , 171 ," $23,027.55 ",,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1336829811,"WOLFE, TRACIE, REBECCA",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 110 , 116 ,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1336829811,"WOLFE, TRACIE, REBECCA",322 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861268245,CALDWELL MEMORIAL HOSPITAL,PLUS URGENT CARE HICKORY,36 14TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336829811,"WOLFE, TRACIE, REBECCA",322 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1336829811,"WOLFE, TRACIE, REBECCA",270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336830702,PRISTINE HOME CARE INC,,5934 UNION PACIFIC AVE   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1336830702,PRISTINE HOME CARE INC,5934 UNION PACIFIC AVE   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 153 , 153 ," $14,561.67 ",,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336832914,"NESTOR, ROBERT, EARL",8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336833011,"HARRIS, SARAH, ADAMS",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1336837459,"WAGNER, EMMA, SUZANNE",15 JANE JACOBS RD STE 101 BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 22 , 36 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1336837459,"WAGNER, EMMA, SUZANNE",15 JANE JACOBS RD STE 101 BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 29 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336839968,"FARNSWORTH, JACOB, ANTHONY",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 94 , 166 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336842061,"CICCONE, ALEXIS, GRACE",4102 N ROXBORO ST   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336842061,"CICCONE, ALEXIS, GRACE",4102 N ROXBORO ST   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 40 , 43 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 49 , 174 , 174 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",2461 LEGION RD   FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 61 , 65 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",7348 N WEST ST   FALCON NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",121 RACINE DR   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",1170 LINKHAW RD   LUMBERTON NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 57 , 61 ,$#,,
MEDICAID DIRECT,1093315574,HEALING HANDS FAMILY PRACTICE PLLC,,1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1336845346,"EDDY, AMBER, LYNN",1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 15 , 20 , 26 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 21 , 26 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 57 , 139 , 143 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1336845346,"EDDY, AMBER, LYNN",310 E WARDELL DR   PEMBROKE NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336846070,"BUTTERFIELD, NATALIE, ELAINE",9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336846070,"BUTTERFIELD, NATALIE, ELAINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336846070,"BUTTERFIELD, NATALIE, ELAINE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336846070,"BUTTERFIELD, NATALIE, ELAINE",9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1336846104,"KYLE, VALERI, JOHANNA",8312 CREEDMOOR RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 66 , 150 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1336849702,"MUNDEN, ALEXANDRA, RAE",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 45 , 48 ,$#,,
MEDICAID DIRECT,1588115752,RDMG ASSOCIATES PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1336855006,"BISHOP, TAYLOR, MAREE",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1437553302,RALEIGH DURHAM MEDICAL GROUP PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1336855006,"BISHOP, TAYLOR, MAREE",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1336855428,"BROCKMILLER, COURTNEY, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 129 , 901 ," 1,070 "," $24,825.16 ",,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336855758,"MULLEN, JENNIFER, YOOJIN",500 PINEVIEW DR STE 101 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 114 , 214 ,$#,,
MEDICAID DIRECT,1417242439,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH TRIAD ENDOCRINE,500 PINEVIEW DR STE 101 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336855758,"MULLEN, JENNIFER, YOOJIN",500 PINEVIEW DR STE 101 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336860683,"MCCOY, BRANDON, TRAVIS",1941 NEW GARDEN RD STE 216 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 75 , 155 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336860949,"MCINTYRE, TRICIA, STRICKLAND",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336860949,"MCINTYRE, TRICIA, STRICKLAND",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336862150,"MAY, BRYCE, LAYNE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 141 , 242 , 243 ," $14,524.90 ",,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336862416,"STANDLEY, ALEXIA, MARIE",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336862416,"STANDLEY, ALEXIA, MARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1336862416,"STANDLEY, ALEXIA, MARIE",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1508681750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT GROVER ELEMENTARY,206 CAROLINA AVE   GROVER NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336865708,"CLARK, SAMANTHA, LEI",206 CAROLINA AVE   GROVER NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1336869353,CARING COMPANIONS LLC,,3508 BULLARD ST   HOPE MILLS NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1336869353,CARING COMPANIONS LLC,3508 BULLARD ST   HOPE MILLS NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 557 , 557 ," $66,623.14 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336870187,"HEFNER, CATHERINE, BYERS",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 42 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336870187,"HEFNER, CATHERINE, BYERS",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 74 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,142 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1336870187,"HEFNER, CATHERINE, BYERS",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 101 , 284 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336871011,"SMITH, BLAKE, LANDON",810 MITCHELL AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 177 , 304 ,$#,,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1336872357,"RACHA, DEEPTHI SREE",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 447 , 760 ," 2,822 "," $149,162.93 ",,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336872357,"RACHA, DEEPTHI SREE",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 121 , 166 , 520 ," $42,096.33 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336873827,"BORN, JESSICA, DIANE",865 W LAKE DR   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 90 , 167 , 282 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1336874486,"MCCONNAUGHEY, JOSEPH, KYLE",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1336874486,"MCCONNAUGHEY, JOSEPH, KYLE",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1336874486,"MCCONNAUGHEY, JOSEPH, KYLE",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 64 , 71 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336874486,"MCCONNAUGHEY, JOSEPH, KYLE",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 77 , 87 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336876457,"OXENDINE, DANIELLE, SMITH",4515 PREMIER DR STE 307 HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 22 , 31 ,$#,,
MEDICAID DIRECT,1336876788,EYECARECENTER OD PA,EYECARE CENTER,4140 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1336876788,EYECARECENTER OD PA,4140 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1336878859,"BROTHERTON, AMANDA, KAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336879642,"PEREIRA, VICTOR, MAURICIO",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336879642,"PEREIRA, VICTOR, MAURICIO",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336879642,"PEREIRA, VICTOR, MAURICIO",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 18 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1336879642,"PEREIRA, VICTOR, MAURICIO",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1336882349,"LEVI, JASON, DANIEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336882455,VITAL HOME CARE,,106 N DURHAM AVE STE B CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1336882455,VITAL HOME CARE,106 N DURHAM AVE STE B CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,#, 308 , 308 ," $28,162.95 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336883164,"CAIN, BRENDAN, MILLS",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 47 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336883164,"CAIN, BRENDAN, MILLS",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1336883412,ABUNDANCE LOVE HOME CARE,,2521 REBECCA AVE   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1336883412,ABUNDANCE LOVE HOME CARE,2521 REBECCA AVE   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,265 "," 1,265 "," $103,912.60 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336887033,"DRUM, CAITLIN, MARIE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1336887033,"DRUM, CAITLIN, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336887629,"BURRIS, METTA, NICOLE PITTMAN",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336887629,"BURRIS, METTA, NICOLE PITTMAN",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 40 , 57 , 62 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336888361,"ZAGE, TIMOTHY, SCOTT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 103 , 103 ,$#,,
MEDICAID DIRECT,1093013351,PROPTNC LLC,RESOLVE PHYSICAL THERAPY AND REHABILITATION,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1336889013,"LEWIS, JEWEL, ALESHA",10102 S MAIN ST STE S ARCHDALE NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336889583,"SHUTE, AMY, ELIZABETH",29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336889583,"SHUTE, AMY, ELIZABETH",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2344 S CHURCH ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1336890144,"MOORE, CHELSEA, DENITRA",2344 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#, 22 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1336894609,"GLASS, KATHLEEN, ANNE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1336894609,"GLASS, KATHLEEN, ANNE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 16 , 18 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1336894609,"GLASS, KATHLEEN, ANNE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1336894609,"GLASS, KATHLEEN, ANNE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730367467,HOSPICE & PALLIATIVE CARECENTER,TRELLIS SUPPORTIVE CARE,101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1336894948,"ZYLSTRA, TRICIA, CAUDLE",101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1093424723,DFENDER PHYSICAL THERAPY LLC,,310 ROANOKE AVE   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1336903616,"FERGUSON, KIMBERLY, SHEARIN",310 ROANOKE AVE   ROANOKE RAPIDS NC,042,Halifax,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336904630,"CARVER, JAMILA, MICHELLE HINTON",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 15 , 26 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336904630,"CARVER, JAMILA, MICHELLE HINTON",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336909191,"HEILEMANN, MEGAN, SWANSON",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336909191,"HEILEMANN, MEGAN, SWANSON",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1336914233,"LISOWSKI, ABIGAIL, CHRISTINE",9040 NATIONS FORD RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 23 , 80 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1336914233,"LISOWSKI, ABIGAIL, CHRISTINE",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 35 , 135 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1336914233,"LISOWSKI, ABIGAIL, CHRISTINE",2450 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 88 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1336914233,"LISOWSKI, ABIGAIL, CHRISTINE",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 80 , 282 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1336914233,"LISOWSKI, ABIGAIL, CHRISTINE",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 25 , 79 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1336923531,"CENTENO, KATHERINE, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1336923879,"TRAVERS, KATIE, MARIE",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 87 , 214 ,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336924190,"CAMERON, KENZIE, LYNN",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1336924232,"PALMER, ERICA, ALEXIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 27 , 51 ,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1336924919,"MCIVER, ANGELA, MIKI",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982339933,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE LOWES GRO,2216 E NC HIGHWAY 54   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336924919,"MCIVER, ANGELA, MIKI",7021 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336944628,SWEET PEA THERAPY GROUP PLLC,,14 S WILDWOOD LN   FLETCHER NC,045,Henderson,193400000X,Group,Single Specialty,,1336944628,SWEET PEA THERAPY GROUP PLLC,14 S WILDWOOD LN   FLETCHER NC,045,Henderson,193400000X,Group,Single Specialty,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336952027,"SNIPES, BRADLEY, PAUL",29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1770897142,LILLINGTON MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-LILLINGTON,7 E DUNCAN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1336958263,"LAWSON, ASHLEY, DARROCH",7 E DUNCAN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336962968,"ADAMS, RACHEL, FAITH",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1386379329,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CARR ELEMENTARY,307 S PINE ST   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336967199,"WHISENANT, MARY, GRACE",307 S PINE ST   DALLAS NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1336969708,"HUNT, BAILEY, DANIELLE",139 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1336970862,"WANG, KINGA, JOANNA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255688958,KIDZCARE PEDIATRICS PC,~,145 W MAIN ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1336976174,"AMELY-SHANNON, RYAN, PATRICK",145 W MAIN ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 26 , 65 ,$#,,
MEDICAID DIRECT,1336985753,MMJ HOMECARE SOLUTIONS INC,LUV N GRACE HOME CARE,2600 ELMIN ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1336985753,MMJ HOMECARE SOLUTIONS INC,2600 ELMIN ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 4,281 "," 4,281 "," $266,143.72 ",,
MEDICAID DIRECT,1194128991,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER ROSEWOOD,104 ADAIR DR   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336986892,"HAWLEY, ANNA",104 ADAIR DR # A GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1336986892,"HAWLEY, ANNA",104 ADAIR DR # A GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1336996297,EARLY STEPS THERAPY,EARLY STEPS THERAPY,851 SINCLAIR DR   MONROE NC,090,Union,251S00000X,Agencies,Community/Behavioral Health,,1336996297,EARLY STEPS THERAPY,851 SINCLAIR DR   MONROE NC,090,Union,251S00000X,Agencies,Community/Behavioral Health,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1093424723,DFENDER PHYSICAL THERAPY LLC,,310 ROANOKE AVE   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1346004629,"HURDLE, KAITLYN, NICOLE",310 ROANOKE AVE   ROANOKE RAPIDS NC,042,Halifax,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346004769,"MARTINDALE, CANDACE, ELVINA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346004769,"MARTINDALE, CANDACE, ELVINA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1346006897,"DOVER, BUFFY, KAY",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346008802,"MORKRID, KENNETH, THOMAS",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 37 , 57 ,$#,,
MEDICAID DIRECT,1336131010,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOPE MILLS FAMILY CARE,5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346008802,"MORKRID, KENNETH, THOMAS",5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 60 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346014685,"BERRY, MAKAYLA, TYSINGER",147 PEACHTREE LN   ADVANCE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 69 , 122 , 176 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346014685,"BERRY, MAKAYLA, TYSINGER",147 PEACHTREE LN   ADVANCE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346017183,"PREBOLA, ALEXA, ELIZABETH",9 HAYWOOD OFFICE PARK STE 102 WAYNESVILLE NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 44 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1346021748,"HALVORSEN, GRACE, CAROLINE",7353 LEWIS ST   OXFORD NC,039,Granville,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#, 32 ,$#,,
MEDICAID DIRECT,1255683157,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS PEDIATRICS,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346023454,"JONES, CHERYL, ANITA",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1346026903,"SESCILLA, LOGAN, BROOKS",101 WALMART SUPER CENTER   SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 36 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1346028230,"DREESSEN, JUSTIN, FREDERICK",101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346028461,"NOCITO, JOANN, LAUREN",2301 ERWIN RD   DURHAM NC,032,Durham,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346050705,"SANZONE, KATELIN, ROSE",2000 BRABHAM AVE STE 100 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346050705,"SANZONE, KATELIN, ROSE",2000 BRABHAM AVE STE 100 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1346062874,"BRELAND, ANISSA, SHEREE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346071032,"ROBERTS, ALEXIS, VICTORIA",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346071032,"ROBERTS, ALEXIS, VICTORIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346088655,"PATEL, KRUPA",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346088663,"IRIAS, LACEY, MARIE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215314778,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM WOMENS CENTER,150 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1346092871,"RAMEY, ADRIAN, NICOLE",150 PARKWOOD DR   ELKIN NC,086,Surry,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346098159,"FRAZIER, JENNIFER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346098159,"FRAZIER, JENNIFER, MARIE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346098159,"FRAZIER, JENNIFER, MARIE",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1437108461,NEPHROLOGY ASSOCIATES OF SPARTANBUR,SPARTANBURG NEPHROLOGY ASSOCIATES,322 N PINE ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346200961,"APPIAH, KOFI, ASANTE",322 N PINE ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1346201431,"CLARK, JASON, DREW",JASON D CLARK DDS PA DBA CLARK PEDIATRIC DENTISTRY,7810 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1346201431,"CLARK, JASON, DREW",7810 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 319 , 653 ," 2,209 "," $80,908.33 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1346201738,"MCCORD, LAURA, LYNN",4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1346201738,"MCCORD, LAURA, LYNN",4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1346201837,"TOMAN, LAURIE, KITTING",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 54 , 62 ,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1346201837,"TOMAN, LAURIE, KITTING",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1346201837,"TOMAN, LAURIE, KITTING",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1346201837,"TOMAN, LAURIE, KITTING",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1013971308,WOMENS WELLNESS CENTER PA,Womens Wellness Center PA,2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346202256,"JONES, WENDY, PILAR",2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1346203817,"WINANS, BRADFORD, ALAN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346203908,"CULLINGFORD, JO, ANN",3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 23 , 39 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346204013,"WILLIAMS, RANDAL, JAMES",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346204021,"MURTHY, ANITHA",828 HEALTHY WAY STE 270 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346204971,"HASSINGER, DENISE, CATHERINE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346204971,"HASSINGER, DENISE, CATHERINE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346206166,"SHUFORD, TRACY, ANNE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 29 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1346206927,"BUEHRIG, CHRISTOPHER, KEVIN",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346206927,"BUEHRIG, CHRISTOPHER, KEVIN",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346206927,"BUEHRIG, CHRISTOPHER, KEVIN",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1346206927,"BUEHRIG, CHRISTOPHER, KEVIN",6450 BANNINGTON RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346207040,"FOGLIA, LISA, MARIE",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346207040,"FOGLIA, LISA, MARIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346207040,"FOGLIA, LISA, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 18 , 24 , 30 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346207040,"FOGLIA, LISA, MARIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1346207875,GREENSBORO SPECIALTY SURGICAL CENTE,GREENSBORO SPECIALTY SURGERY LP,3812 N ELM ST   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1346207875,GREENSBORO SPECIALTY SURGICAL CENTE,3812 N ELM ST   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 96 , 108 , 109 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346208113,"HOWELL, TRAVIS, WORTH",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346208113,"HOWELL, TRAVIS, WORTH",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 128 , 233 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346209095,"WINTERING, ERIKA, LYNNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568934487,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP HICKORY,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346209293,"RICHARDSON, RYAN, NELSON",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548497209,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP MARION,2293 SUGAR HILL RD STE C MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1346209293,"RICHARDSON, RYAN, NELSON",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 20 , 21 ," $10,865.39 ",,
MEDICAID DIRECT,1467993931,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP-VALDESE,110 HILLTOP ST   CONNELLY SPG NC,012,Burke,193200000X,Group,Multi-Specialty,,1346209293,"RICHARDSON, RYAN, NELSON",110 HILLTOP ST   CONNELLY SPRINGS NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1346209293,"RICHARDSON, RYAN, NELSON",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1568934487,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP HICKORY,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346209293,"RICHARDSON, RYAN, NELSON",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 29 , 49 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209699,"KRASOWSKI, ROBERT, JERZY",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 17 , 23 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209699,"KRASOWSKI, ROBERT, JERZY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 29 , 50 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209699,"KRASOWSKI, ROBERT, JERZY",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209699,"KRASOWSKI, ROBERT, JERZY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 128 , 180 , 289 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209699,"KRASOWSKI, ROBERT, JERZY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 27 , 37 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209707,"OGBATA, SYLVESTER, IZUCHUKWU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 40 , 40 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209707,"OGBATA, SYLVESTER, IZUCHUKWU",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1851826499,CAROLINAS NEPHROLOGY AND HYPERTENSI,,1400 MEDFORD DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346209707,"OGBATA, SYLVESTER, IZUCHUKWU",1400 MEDFORD DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346209707,"OGBATA, SYLVESTER, IZUCHUKWU",1400 MEDFORD DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 38 , 38 ,$#,,
MEDICAID DIRECT,1851826499,CAROLINAS NEPHROLOGY AND HYPERTENSI,,1400 MEDFORD DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346209707,"OGBATA, SYLVESTER, IZUCHUKWU",1400 MEDFORD DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346209954,"PATWARDHAN, VRUSHALI, NITIN",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 38 , 83 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346210127,"SILVER, JEFFREY, ALAN",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356672505,RESPRACARE INC,~,641 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346210127,"SILVER, JEFFREY, ALAN",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1346210127,"SILVER, JEFFREY, ALAN",101 CLINIC DR   TARBORO NC,033,Edgecombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346210127,"SILVER, JEFFREY, ALAN",101 CLINIC DR   TARBORO NC,033,Edgecombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346210127,"SILVER, JEFFREY, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 185 , 339 , 520 ," $15,939.03 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346210838,"CONNER, GREGORY, ALLEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 162 , 167 ,$#,,
MEDICAID DIRECT,1346210937,"NURRE, LISA, DENISE",,80 PEACHTREE RD STE 106 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1346210937,"NURRE, LISA, DENISE",80 PEACHTREE RD STE 106 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1467582999,BILTMORE DERMATOLOGY ASSOCIATES PA,BILTMORE DERMATOLOGY ASSOCIATES PA,80 PEACHTREE RD STE 106 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346210937,"NURRE, LISA, DENISE",80 PEACHTREE RD STE 106 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346212321,"DOLAN, MELISSA, LYNN",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 17 , 32 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346213501,"LANIER, VICKI, MARIE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1346213501,"LANIER, VICKI, MARIE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346215456,"DINGES, MARIE, MOORE",105 HOSPITAL DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 62 , 95 , 107 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346215456,"DINGES, MARIE, MOORE",711 NATIONAL HWY STE 100 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346215464,"SULLIVAN, NEIL, MICHAEL",844 KEMPSVILLE RD STE 103B NORFOLK VA,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346216835,"MOENCH, CAROLYN, VIRGINIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578692703,PINEHURST FOOT SPECIALISTS PA,Pinehurst Foot Specialists PA,325 PAGE RD BLDG 3 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1346217031,"DUNLAP, GLENN",325 PAGE RD BLDG 3 PINEHURST NC,063,Moore,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 82 , 207 , 301 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1346217247,"CHERRY, STEPHEN, ROSS",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346218195,"NOVICK, CARA, DIANE",171 KEMPSVILLE RD BLDG A NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346218385,"SICKING, DANIEL, THOMAS",DANIEL SICKING MD,123 CAPCOM AVE STE 9 WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1346218385,"SICKING, DANIEL, THOMAS",123 CAPCOM AVE STE 9 WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346218534,"LAURENCE, WILLIAM, RICHARD",6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 102 , 233 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346219722,"SUMMER, GARRY, MICHAEL",165 LOWES FOODS DR   LEWISVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 29 , 70 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346219722,"SUMMER, GARRY, MICHAEL",1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 73 , 153 ,$#,,
MEDICAID DIRECT,1346220373,HIGH POINT SURGERY CENTER LLC,HIGH POINT SURGERY CENTER,600 N LINDSAY ST   HIGH POINT NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1346220373,HIGH POINT SURGERY CENTER LLC,600 N LINDSAY ST   HIGH POINT NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 193 , 213 , 252 ," $40,230.35 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346220621,"HAMILTON, RICHARD, SPOTSWOOD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346220902,"JARRETT, BECKIE, POE",1236 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346220902,"JARRETT, BECKIE, POE",1236 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346501798,ARMC PHYSICIANS CARE INC,BURLINGTON UROLOGICAL ASSOCIATES,1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346222775,"MACDIARMID, SCOTT, AVARD",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 24 , 31 , 36 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346222775,"MACDIARMID, SCOTT, AVARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 16 , 20 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1346222775,"MACDIARMID, SCOTT, AVARD",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 117 , 228 , 508 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1346222775,"MACDIARMID, SCOTT, AVARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346222775,"MACDIARMID, SCOTT, AVARD",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1346222775,"MACDIARMID, SCOTT, AVARD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1346223054,"ZUKOSKI, ROBERT, MICHAEL",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1346223484,"PASCUAL, RODOLFO, MARSHALL",233 DOCTORS ST   SPARTA NC,003,Alleghany,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346223484,"PASCUAL, RODOLFO, MARSHALL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 112 , 171 , 182 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 3400 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346224003,"LOGGINS, JAMIE, PAUL",1 HOSPITAL DR STE 3400 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 3400 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346224003,"LOGGINS, JAMIE, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346224003,"LOGGINS, JAMIE, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346224599,"BROOKS, DAHARI, DURWIN",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 70 , 142 , 262 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346224599,"BROOKS, DAHARI, DURWIN",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 30 ,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346224854,"LORD, RICHARD, WILLIAM",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346224854,"LORD, RICHARD, WILLIAM",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 75 , 124 ,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,1430 FELICITY LN   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346224854,"LORD, RICHARD, WILLIAM",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346224854,"LORD, RICHARD, WILLIAM",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 42 , 43 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346225232,"CURRAN, GARY, ALLAN",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 84 , 176 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346225778,"BLEYER, ANTHONY, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 63 , 180 , 197 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1346225943,"LEVY, PAUL, FREDRIC",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346225943,"LEVY, PAUL, FREDRIC",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346226016,"TARLETON, GREGORY, PAUL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 102 , 107 , 138 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346226016,"TARLETON, GREGORY, PAUL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 54 , 72 ,$#,,
MEDICAID DIRECT,1346226016,"TARLETON, GREGORY, PAUL",~,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1346226016,"TARLETON, GREGORY, PAUL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 31 , 31 , 78 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 22 , 24 , 48 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 60 , 65 , 138 ," $14,067.23 ",,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1346226354,"MEINE III, FREDERICK, JAMES",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346226453,"HASSAN, HOSSAN, A",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346226776,"TEMPLETON, LEAH, CAROL BUMGARNER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 80 , 82 , 87 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346226966,"STRATTA, ROBERT, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 83 , 86 ,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346227139,"BAKER, NANCY, HARRELL",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346227139,"BAKER, NANCY, HARRELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1538700745,GERIATRIC CARE OF THE CAROLINAS,,6001 GRABURNS FORD DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346228012,"MAHMOOD, SHAKEER",211 S CHESTNUT ST   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346228343,"RYTER BROWN, SHERRY, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346228343,"RYTER BROWN, SHERRY, MARIE",490 PINEVIEW DR STE A KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 24 , 43 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1346229564,"OGORMAN, NATASHA, FOLDA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346229564,"OGORMAN, NATASHA, FOLDA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1750482493,OPEN WATER MEDICAL PA,~,1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1346231388,"KRAUSE, ROBERT, ALLEN",1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 225 , 338 ," $11,138.87 ",,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1346232071,"GUM, HEIDI, RENEE",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346233277,SOLSTAS LAB PARTNERS GROUP LLC,~,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1346233277,SOLSTAS LAB PARTNERS GROUP LLC,4380 FEDERAL DR STE 100 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1134361272,DUKE UNIVERSITY AFFILIATED PHYSICIA,NORTH HILLS INTERNAL MEDICINE,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346234176,"THAKKAR, MADHVI, MAITREYA",3320 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 21 , 62 ,$#,,
MEDICAID DIRECT,1114373404,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346234176,"THAKKAR, MADHVI, MAITREYA",3320 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 22 , 56 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346234176,"THAKKAR, MADHVI, MAITREYA",3320 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346234226,"COLON II, FILIBERTO",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 79 , 88 ,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346234408,"TAYLOR, WILLIAM, MICHEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 45 , 48 , 71 ,$#,,
MEDICAID DIRECT,1609827393,BILTMORE MEDICAL ASSOCIATES,BILTMORE MEDICAL ASSOCIATES,147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346236809,"RENNARD, THOMAS, WILLIAM",147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1346237286,"FOGARTY, THERESA, CHRISTINE",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346237617,"TEJAN SIE, SHEIKH, AHMED",2905 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 166 , 623 , 646 ," $13,743.68 ",,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1346237617,"TEJAN SIE, SHEIKH, AHMED",2905 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 84 , 155 , 159 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,,,Unknown,193400000X,Group,Single Specialty,,1346237617,"TEJAN SIE, SHEIKH, AHMED",2905 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902862725,ALLIANCE MEDICAL ASSOCIATES,ALLIANCE MEDICAL ASSOCIATES,2905 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346237617,"TEJAN SIE, SHEIKH, AHMED",2905 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 107 , 492 , 661 ," $11,056.39 ",,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1346237617,"TEJAN SIE, SHEIKH, AHMED",2905 CROUSE LN   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1346237617,"TEJAN SIE, SHEIKH, AHMED",1701 WESTCHESTER DR STE 850 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346237617,"TEJAN SIE, SHEIKH, AHMED",1701 WESTCHESTER DR STE 850 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 132 , 133 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346237880,"MONKS, BRUCE, DWAYNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1346237880,"MONKS, BRUCE, DWAYNE",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1346237880,"MONKS, BRUCE, DWAYNE",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346237880,"MONKS, BRUCE, DWAYNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346238326,"CAMMOCK, LEONA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1346238326,"CAMMOCK, LEONA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346238326,"CAMMOCK, LEONA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 52 , 171 , 171 ,$#,,
MEDICAID DIRECT,1417542556,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH ORTHOPEDICS AND SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1346238755,"SISCO, LANCE, THAYER",503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 85 , 112 , 227 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1346241601,"BOWMAN, JENEE, LEE",1041 NOELL LN STE 105 ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1346241601,"BOWMAN, JENEE, LEE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346242112,"JACOBUS, KELLY, TODD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346242443,"DIAL, MICHAEL, LYNN",1051 NOELL LN   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 296 , 296 ,$#,,
MEDICAID DIRECT,1700970423,CAROLINA FAMILY EYE CARE OD PLLC,VISION SOURCE STUDIO 2020,2424 W MALLARD CREEK CHURCH RD STE D CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346242781,"KHOSHNEVIS, AMIR",2424 W MALLARD CREEK CHURCH RD STE D CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",430 RANKIN DR   MARION NC,059,McDowell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346243201,"SUTTON, FRANK, MORRISON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346243466,"KASOW WICHLAN, KIMBERLY, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1669654901,ELIZABETH D BRYAN MD PA,,227 BEAMAN ST   CLINTON NC,082,Sampson,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1346244977,"BRYAN, ELIZABETH, D",227 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 29 , 43 ,$#,,
MEDICAID DIRECT,1669654901,ELIZABETH D BRYAN MD PA,,227 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1346244977,"BRYAN, ELIZABETH, D",227 BEAMAN ST   CLINTON NC,082,Sampson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1346244977,"BRYAN, ELIZABETH, D",ELIZABETH D BRYAN,227 BEAMAN ST   CLINTON NC,082,Sampson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,1346244977,"BRYAN, ELIZABETH, D",227 BEAMAN ST   CLINTON NC,082,Sampson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1346244977,"BRYAN, ELIZABETH, D",ELIZABETH D BRYAN,227 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1346244977,"BRYAN, ELIZABETH, D",227 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 29 , 33 ,$#,,
MEDICAID DIRECT,1669654901,ELIZABETH D BRYAN MD PA,,227 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1346244977,"BRYAN, ELIZABETH, D",227 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1669654901,ELIZABETH D BRYAN MD PA,,227 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1346244977,"BRYAN, ELIZABETH, D",227 BEAMAN ST   CLINTON NC,082,Sampson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346245040,"RODDENBERRY, MYRON, GADSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1346245909,"SHANLEY, MARGARET, HILLMAN",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 118 , 264 , 659 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1346245909,"SHANLEY, MARGARET, HILLMAN",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 30 , 66 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1346245909,"SHANLEY, MARGARET, HILLMAN",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 44 , 44 ," $16,211.25 ",,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1346248002,"EISENHAUER, THOMAS, LYNN",288 S RIDGECREST AVE STE B116 RUTHERFORDTON NC,081,Rutherford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 40 , 57 , 59 ,$#,,
MEDICAID DIRECT,1346248994,"OSBORNE, COLIN, PORTER",COLIN PORTER OSBORNE III DDSPA,407 W 27TH ST   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,1346248994,"OSBORNE, COLIN, PORTER",407 W 27TH ST   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 25 , 79 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346251394,"PARKER, MICHAEL, YOUNG",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 41 , 48 , 69 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346251394,"PARKER, MICHAEL, YOUNG",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 51 , 58 , 85 ,$#,,
MEDICAID DIRECT,1144624206,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONARY ALBEMARLE,929 N 2ND ST STE 205 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1346251444,"POOR, CHRISTOPHER, SUTTON",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 25 , 74 , 82 ,$#,,
MEDICAID DIRECT,1144624206,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONARY ALBEMARLE,929 N 2ND ST STE 205 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1346251444,"POOR, CHRISTOPHER, SUTTON",929 N 2ND ST STE 205 ALBEMARLE NC,084,Stanly,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 155 , 236 , 261 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,224 SHARON AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1346252905,"SHEDD, OMER",224 SHARON AVE NW   LENOIR NC,014,Caldwell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2209 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1346252905,"SHEDD, OMER",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1346252905,"SHEDD, OMER",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 248 , 458 , 589 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346253093,"HANDE, RASHMI",6762 GREEN MILL WAY   COLUMBIA MD,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1346253093,"HANDE, RASHMI",6762 GREEN MILL WAY   COLUMBIA MD,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 31 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1346253093,"HANDE, RASHMI",6762 GREEN MILL WAY   COLUMBIA MD,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1346253978,"WALDROP, MY-LINH, THI",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346254174,"SNOWDEN, LAURA, ANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346254174,"SNOWDEN, LAURA, ANNE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346254679,"KERR, ELIZABETH, CAROLE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346256534,"HARRIS, ELIZABETH, HACKMAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346256534,"HARRIS, ELIZABETH, HACKMAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 37 , 60 , 86 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346256534,"HARRIS, ELIZABETH, HACKMAN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 52 , 63 , 99 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346256534,"HARRIS, ELIZABETH, HACKMAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 17 , 17 ,$#,,
MEDICAID DIRECT,1265821342,ADVANCED MEDICAL GROUP,,6 REGIONAL DR STE B PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1346257524,"PERROTTA, PHILIP, SAVERIO",6 REGIONAL DR STE B PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346260254,"PENISTON, KATHLEEN, KELLY",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346260254,"PENISTON, KATHLEEN, KELLY",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346260577,"DIXON, MICHAEL, JOHN",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346260577,"DIXON, MICHAEL, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346260577,"DIXON, MICHAEL, JOHN",1321 E SUNSET DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346260577,"DIXON, MICHAEL, JOHN",1321 E SUNSET DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346261773,"SHARP PRICHARD, SARAH, JANE",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1316965262,A C WILLIAMS DDS PA,~,601 W BROAD ST STE C DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1346262805,"WILLIAMS III, AUSTON, CULEIGH",601 W BROAD ST STE C DUNN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 50 , 147 ,$#,,
MEDICAID DIRECT,1346262904,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 17178,9870 REA RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1346262904,NORTH CAROLINA CVS PHARMACY LLC,9870 REA RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346263043,"WHITE, BECKY, LETITIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 23 , 84 , 85 ,$#,,
MEDICAID DIRECT,1598194284,PARK HILL MEDICINE PA,,510 PARK HILL CT   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346264900,"ABUMOUSSA, LATEEF, ISHAK",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1598194284,PARK HILL MEDICINE PA,,510 PARK HILL CT   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346264900,"ABUMOUSSA, LATEEF, ISHAK",510 PARK HILL CT   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 24 , 26 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1346264900,"ABUMOUSSA, LATEEF, ISHAK",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 62 , 64 ,$#,,
MEDICAID DIRECT,1346265287,CCHC ENDOSCOPY CENTER INC,CCHC ENDOSCOPY CENTER INC,975 NEWMAN RD   NEW BERN NC,025,Craven,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1346265287,CCHC ENDOSCOPY CENTER INC,975 NEWMAN RD   NEW BERN NC,025,Craven,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346265360,"NASRALLA, STACIE, RUTH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346268323,"FERREE, CHARLES, ELLIOT",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346268323,"FERREE, CHARLES, ELLIOT",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346268323,"FERREE, CHARLES, ELLIOT",10344 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346268745,"DUNHAM, CHARLES, KENDRICK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346270287,"SAMAAN, MAGED, GUIRGUIS",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 24 , 696 , 698 ," $16,362.65 ",,
MEDICAID DIRECT,1730154857,PEDIATRIC PARTNERS PA,~,5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346272721,"WALKER, MELANIE, PAUL",5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346273539,"KOURI, BRIAN, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 93 , 104 , 165 ,$#,,
MEDICAID DIRECT,1346274685,FAMILY MEDICAL SUPPLY LLC,~,301 WESTERN BLVD STE D JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1346274685,FAMILY MEDICAL SUPPLY LLC,301 WESTERN BLVD STE D JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1346274685,FAMILY MEDICAL SUPPLY LLC,~,301 WESTERN BLVD STE D JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346274685,FAMILY MEDICAL SUPPLY LLC,301 WESTERN BLVD STE D JACKSONVILLE NC,067,Onslow,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1346274685,FAMILY MEDICAL SUPPLY LLC,~,301 WESTERN BLVD STE D JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346274685,FAMILY MEDICAL SUPPLY LLC,301 WESTERN BLVD STE D JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 460 ," 2,759 "," 4,947 "," $174,473.84 ",,
MEDICAID DIRECT,1275857294,EASTERN PHYSICAL MEDICINE AND REHAB,~,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346275260,"SMITH, BILLY, RAY",2470 EMERALD PL STE D GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346275260,"SMITH, BILLY, RAY",2245 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 28 , 46 ,$#,,
MEDICAID DIRECT,1275857294,EASTERN PHYSICAL MEDICINE AND REHAB,~,2245 STANTONSBURG RD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346275260,"SMITH, BILLY, RAY",2245 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 62 , 168 , 174 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1346275633,"MATHEW, ROSHAN, KUZHIVELI",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1346275633,"MATHEW, ROSHAN, KUZHIVELI",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1346275633,"MATHEW, ROSHAN, KUZHIVELI",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346275955,"SAPPENFIELD, DANIEL, MARK",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346275955,"SAPPENFIELD, DANIEL, MARK",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1164453726,CARMEL FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE CARMEL FAMILY MEDICINE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346275955,"SAPPENFIELD, DANIEL, MARK",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 26 , 50 ,$#,,
MEDICAID DIRECT,1346278157,PEDIATRIC SERVICES OF AMERICA LLC,~,4530 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1346278157,PEDIATRIC SERVICES OF AMERICA LLC,4530 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 25 ," 3,040 "," 3,339 "," $1,842,295.00 ",,
MEDICAID DIRECT,1346279197,MAXIM HEALTHCARE SERVICES,MAXIM HEALTHCARE SERVICES INC,1300 BAXTER ST STE 450 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1346279197,MAXIM HEALTHCARE SERVICES,1300 BAXTER ST STE 450 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 40 ," 4,419 "," 4,824 "," $2,236,558.76 ",,
MEDICAID DIRECT,1649377359,PEDIATRIX MEDICAL GROUP OF TEXAS BI,PEDIATRIX MEDICAL GROUP OF TEXAS,2929 WOODLAND PARK DR   HOUSTON TX,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1346279460,"ABDUL-RAZAK, BASIMA, MUHAMMED",2929 WOODLAND PARK DR   HOUSTON TX,102,Out of State > 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1174049027,MOSES CONE PHYSICIAN SERVICES INC,CHMG MEDICAL WEIGHT MANAGEMENT CENTER,1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346279981,"MALDONADO, EDGARDO",1307 W WENDOVER AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 41 , 61 ,$#,,
MEDICAID DIRECT,1346280757,"TROCHA, STEVEN, DIETRICH",,890 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1346280757,"TROCHA, STEVEN, DIETRICH",890 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1346281466,"MERCER, NITA, TILLEY",200 STONEBRIDGE SQ   HAVELOCK NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 11 , 16 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1346281466,"MERCER, NITA, TILLEY",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 43 , 83 ,$#,,
MEDICAID DIRECT,1477839108,CALDWELL MEMORIAL HOSPITAL,UNC HEART & VASCULAR,401 MULBERRY ST SW STE 207 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1346282555,"DAWSON, EUGENE, SCOTT",401 MULBERRY ST SW STE 207 LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1346282555,"DAWSON, EUGENE, SCOTT",50 HOSPITAL DR STE 3B HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 23 , 28 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346282555,"DAWSON, EUGENE, SCOTT",50 HOSPITAL DR STE 3B HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 26 , 32 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346283801,"LAKE, JONATHAN, LAWRENCE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346283801,"LAKE, JONATHAN, LAWRENCE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346283801,"LAKE, JONATHAN, LAWRENCE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346283801,"LAKE, JONATHAN, LAWRENCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346283975,"MOORE, GAIL, ELIZABETH",3762 DURHAM RD STE A ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346284155,"ORDONEZ, BERNARDO, JOSE",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346284155,"ORDONEZ, BERNARDO, JOSE",300 MEDICAL PKWY STE 206 CHESAPEAKE VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 212   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346284155,"ORDONEZ, BERNARDO, JOSE",300 MEDICAL PKWY STE 206 CHESAPEAKE VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346284262,"DOVER, STANLEY, FRANK",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1346284262,"DOVER, STANLEY, FRANK",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1346284262,"DOVER, STANLEY, FRANK",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1346284403,"STONE, JOSEPH, E",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1346284403,"STONE, JOSEPH, E",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801360565,MOUNTAIN REGIONAL ANESTHESIA PLLC,,197 RIVERVIEW ST   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1346284700,"POLONY, JOHN, EDWARD",197 RIVERVIEW ST   FRANKLIN NC,056,Macon,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346338159,CAROLINA FAMILY AND URGENT CARE CEN,~,,,Unknown,193400000X,Group,Single Specialty,,1346286010,"JACKSON, ANITA",4315 LUDGATE ST   LUMBERTON NC,078,Robeson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1710166327,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,520 N DEKALB ST STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1346286366,"MARTIN, CHRISTIAN, EDUARDO",520 N DEKALB ST STE B SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 105 , 329 , 482 ,$#,,
MEDICAID DIRECT,1124207725,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,910 E CHURCH ST STE A CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1346286366,"MARTIN, CHRISTIAN, EDUARDO",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 84 , 216 , 324 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346287943,"WILSON, NANCY, ALYNE",25 REYNOLDS MOUNTAIN BLVD   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 26 , 26 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,25 REYNOLDS MOUNTAIN BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346287943,"WILSON, NANCY, ALYNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346287943,"WILSON, NANCY, ALYNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,341 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 54 , 101 , 125 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 55 , 67 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 28 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346289402,"CONRAD, RYAN, SCOTT",9735 KINCEY AVE STE 203 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 34 , 43 ,$#,,
MEDICAID DIRECT,1659343440,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD GENERAL SURGERY DILLON,705 N 8TH AVE STE 2B DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346289907,"THOMAS, CHADWICK, VAN",705 N 8TH AVE STE 2B DILLON SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346290277,"DENENNY, BRUCE, JOHN",600 GREEN VALLEY RD STE 304 GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346290277,"DENENNY, BRUCE, JOHN",600 GREEN VALLEY RD STE 304 GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 51 , 51 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1346292554,"BUNDY, DAVID, WILLIAM",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 89 , 136 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,908 EDEN WAY N STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346293099,"KNITTIG, SOMMER",908 EDEN WAY N STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346293784,"MOHAMED, MOHAMED, KAMEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 22 , 70 , 71 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346293784,"MOHAMED, MOHAMED, KAMEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 100 , 203 , 209 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1346294352,"MURRAY, WARREN, EDWARD",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1346294352,"MURRAY, WARREN, EDWARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 63 , 64 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,941 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1346294352,"MURRAY, WARREN, EDWARD",702 NEWMAN RD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1346294352,"MURRAY, WARREN, EDWARD",702 NEWMAN RD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 87 , 98 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346295417,"WOODS, JONATHAN, BRADLEY",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 246 , 638 , 830 ," $27,112.66 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346297306,"OBRIEN, RICHARD, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346297306,"OBRIEN, RICHARD, JOSEPH",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1427081611,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Neurology of Raleigh,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346297306,"OBRIEN, RICHARD, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346297306,"OBRIEN, RICHARD, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346297686,"FILIPPONE, EDWARD, C",435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1346298395,"ARCHIBALD, GORDON, RIDER",5015 ANDROS DR   NAPLES FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346298973,"PARKER, LISA, MICHELE LEE",104 RHODES AVE   WINDSOR NC,008,Bertie,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346299351,"STRINE, SCOTT, ALLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 29 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346299351,"STRINE, SCOTT, ALLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346299351,"STRINE, SCOTT, ALLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346301041,"FURIMSKY, MELANY",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346301249,"WISNOSKY, COLLEEN, LOUISE",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346301249,"WISNOSKY, COLLEEN, LOUISE",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346301249,"WISNOSKY, COLLEEN, LOUISE",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 25 , 25 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346301249,"WISNOSKY, COLLEEN, LOUISE",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1346303153,"HAIRE, SAMUEL, SCOTT",1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1346303153,"HAIRE, SAMUEL, SCOTT",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1346303153,"HAIRE, SAMUEL, SCOTT",1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346303344,"CHAN, KATE, WAI KI",1401 MATTHEWS TOWNSHIP PKWY STE 300 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346303344,"CHAN, KATE, WAI KI",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346304250,"VESTAL, TRACIE, LEIGH",DR TRACIE L VESTAL DDS,500 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice,1346304250,"VESTAL, TRACIE, LEIGH",500 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice, 221 , 510 ," 2,314 "," $72,287.39 ",,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1346305513,"FELTON, MAKEBA, BOOKER",480 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 24 , 75 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1346305513,"FELTON, MAKEBA, BOOKER",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 22 , 33 ,$#,,
MEDICAID DIRECT,1346305570,SOUTHERN ASSISTED LIVING INC,BROOKDALE NEW HOPE,1680 S NEW HOPE RD   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346305570,SOUTHERN ASSISTED LIVING INC,1680 S NEW HOPE RD   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 12 ," 2,792 "," 2,792 "," $182,191.64 ",,
MEDICAID DIRECT,1346308517,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1346308517,CABARRUS GASTROENTEROLOGY ASSOCIATE,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 58 , 59 , 92 ,$#,,
MEDICAID DIRECT,1346311644,LINCARE INC,~,2004 S ROAN ST STE 20 JOHNSON CITY TN,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1346311644,LINCARE INC,2004 S ROAN ST STE 20 JOHNSON CITY TN,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#, 18 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346314143,"THOMPSON, TERRI, LYNN",2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1346314143,"THOMPSON, TERRI, LYNN",2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346315843,"FINLEY, RACHAEL, PAGE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346315843,"FINLEY, RACHAEL, PAGE",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346315843,"FINLEY, RACHAEL, PAGE",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346315843,"FINLEY, RACHAEL, PAGE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346318375,"FRIEDMAN, SCOT, ALLEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203A EARNHART DR   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1346319209,"BOEHLING, PETER, FRANCIS",309 N BROAD ST   EDENTON NC,021,Chowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346319209,"BOEHLING, PETER, FRANCIS",309 N BROAD ST   EDENTON NC,021,Chowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 71 , 81 , 102 ," $18,142.55 ",,
MEDICAID DIRECT,1346319670,HENDERSON COUNTY PUBLIC SCHOOLS,HENDERSON COUNTY PUBLIC SCHOOLS,414 4TH AVE W   HENDERSONVILLE NC,045,Henderson,251300000X,Agencies,Local Education Agency (LEA),,1346319670,HENDERSON COUNTY PUBLIC SCHOOLS,414 4TH AVE W   HENDERSONVILLE NC,045,Henderson,251300000X,Agencies,Local Education Agency (LEA),, 566 ," 8,931 "," 9,374 "," $399,759.24 ",,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1346322559,"RISVOLD, MARY, BETH",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346323375,"PATE JR, CARL, DANIEL",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1639294309,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER BEULAVILLE,119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346323375,"PATE JR, CARL, DANIEL",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1346323375,"PATE JR, CARL, DANIEL",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 72 , 72 ," $26,719.86 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346323375,"PATE JR, CARL, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346323508,"FELKER, GARY, MICHAEL",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346323508,"FELKER, GARY, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 27 , 59 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346323508,"FELKER, GARY, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 11 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346323581,"BURLESON, JILL, KIMESIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346323581,"BURLESON, JILL, KIMESIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346323599,"CHILUKURI, VANI, RAO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 71 , 79 , 131 ,$#,,
MEDICAID DIRECT,1346323938,POWELL MEDICAL EQUIPMENT,POWELL MEDICAL EQUIPMENT,550 PYLON DR   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346323938,POWELL MEDICAL EQUIPMENT,550 PYLON DR   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1346323938,POWELL MEDICAL EQUIPMENT,POWELL MEDICAL EQUIPMENT,550 PYLON DR   RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1346323938,POWELL MEDICAL EQUIPMENT,550 PYLON DR   RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1346324118,"TYLER, MICHAEL, JOSEPH",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 43 , 43 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346324118,"TYLER, MICHAEL, JOSEPH",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 26 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346324118,"TYLER, MICHAEL, JOSEPH",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265669535,MOUNTAIN LAUREL FAMILY PRACTICE PLL,MOUNTAIN LAUREL FAMILY PRACTICE PLLC,222 LONGVUE DR   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1346324159,"YOUNG FRITCHIE, LEANNE",222 LONGVUE DR   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346329091,"BECKNER, ZACHARY, STUART",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346329091,"BECKNER, ZACHARY, STUART",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346329315,"WILLIAMS, VINCENT, GERARD",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1346329315,"WILLIAMS, VINCENT, GERARD",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346330636,"SOMMA, MITCHELL, MARTUCCI",1901 S HAWTHORNE RD STE 220 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 154 , 198 ,$#,,
MEDICAID DIRECT,1780127431,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,301 E MEETING ST STE 101 MORGANTON NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346331568,"GOLDEN-MYERS, SHARON",301 E MEETING ST STE 101 MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457320756,THE PEDIATRIC CENTER,THE PEDIATRIC CENTER PLLC,1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346336443,"JACKSON, ERIC, MICHAEL",1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 19 , 37 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1346336443,"JACKSON, ERIC, MICHAEL",1914 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1346339439,"PETERSON, GABRIEL, LAEL",80 SONGBIRD FOREST RD   BRYSON CITY NC,087,Swain,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 33 ,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,80 SONGBIRD FOREST RD   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1346339439,"PETERSON, GABRIEL, LAEL",80 SONGBIRD FOREST RD   BRYSON CITY NC,087,Swain,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346341633,"GORE, STEVEN, MARSHALL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 151 , 172 , 269 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1346341633,"GORE, STEVEN, MARSHALL",80 HEALTHCARE DR STE 101 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 78 , 112 , 168 ,$#,,
MEDICAID DIRECT,1235198177,COUNTY OF DUPLIN,DUPLIN COUNTY HEALTH DEPARTMENT,340 SEMINARY ST   KENANSVILLE NC,031,Duplin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1346341732,"GRIFFIN, ELIZABETH, JANE",340 SEMINARY ST   KENANSVILLE NC,031,Duplin,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1346343019,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07325,204 W MAIN ST   PILOT MOUNTAIN NC,086,Surry,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1346343019,NORTH CAROLINA CVS PHARMACY LLC,204 W MAIN ST   PILOT MOUNTAIN NC,086,Surry,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346343019,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07325,204 W MAIN ST   PILOT MOUNTAIN NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346343019,NORTH CAROLINA CVS PHARMACY LLC,204 W MAIN ST   PILOT MOUNTAIN NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1346343043,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05379,110 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1346343043,NORTH CAROLINA CVS PHARMACY LLC,110 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346343100,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03803,559 RIVER HWY   MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346343100,NORTH CAROLINA CVS PHARMACY LLC,559 RIVER HWY   MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1346343100,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03803,559 RIVER HWY   MOORESVILLE NC,049,Iredell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1346343100,NORTH CAROLINA CVS PHARMACY LLC,559 RIVER HWY   MOORESVILLE NC,049,Iredell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346343118,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03836,2302 S 17TH ST   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1346343118,NORTH CAROLINA CVS PHARMACY LLC,2302 S 17TH ST   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346343118,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03836,2302 S 17TH ST   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1346343118,NORTH CAROLINA CVS PHARMACY LLC,2302 S 17TH ST   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346343159,"BATTLE-WILLIAMS, LYDIA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 26 , 87 ,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346343159,"BATTLE-WILLIAMS, LYDIA, ANN",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 125 , 129 ,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346343159,"BATTLE-WILLIAMS, LYDIA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1346343340,"MATHER, NELSON, RAMON",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 46 , 45 , 45 ,$#,,
MEDICAID DIRECT,1346344017,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05445,5100 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1346344017,NORTH CAROLINA CVS PHARMACY LLC,5100 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1346344017,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05445,5100 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346344017,NORTH CAROLINA CVS PHARMACY LLC,5100 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1346344017,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05445,5100 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1346344017,NORTH CAROLINA CVS PHARMACY LLC,5100 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1053400853,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1346344439,"BALL, RAYMOND, CLYDE",17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1972940476,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,4358 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1346344439,"BALL, RAYMOND, CLYDE",98 STONEBRIDGE TRL   HAVELOCK NC,025,Craven,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346345394,"SILBERMAN, STEPHEN, CHARLES",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346345675,"WAREHAM, JOHN, ALLEN",300 W 27TH ST   LUMBERTON NC,078,Robeson,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1346345675,"WAREHAM, JOHN, ALLEN",300 W 27TH ST   LUMBERTON NC,078,Robeson,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1346346889,"OKOROAFOR, KINGSLEY, UZO",KINGSLEY OKOROAFOR,1315 AVON ST   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1346346889,"OKOROAFOR, KINGSLEY, UZO",1315 AVON ST   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 223 ," 1,079 "," 2,103 "," $35,536.97 ",,
MEDICAID DIRECT,1346347283,SPINDALE DRUG CO INC,~,109 W MAIN ST   SPINDALE NC,081,Rutherford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1346347283,SPINDALE DRUG CO INC,109 W MAIN ST   SPINDALE NC,081,Rutherford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1346347283,SPINDALE DRUG CO INC,~,109 W MAIN ST   SPINDALE NC,081,Rutherford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346347283,SPINDALE DRUG CO INC,109 W MAIN ST   SPINDALE NC,081,Rutherford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 88 , 560 ," 1,106 "," $106,190.59 ",,
MEDICAID DIRECT,1841792538,NORTH CAROLINA HYPERBARICS LLC,~,3035 BOONE TRAIL EXT STE A FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346350683,"MOO YOUNG, KARL, JAMES",3035 BOONE TRAIL EXT STE A FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 210 , 269 ,$#,,
MEDICAID DIRECT,1225808041,HYPERBARIC PHYSICIANS OF NC PLLC,,3035 BOONE TRAIL EXT STE A FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1346350683,"MOO YOUNG, KARL, JAMES",3035 BOONE TRAIL EXT STE A FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 45 , 49 ," $11,430.95 ",,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346351673,"RUDOLPH, CHARLES",10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346353315,"OUTLAW, WILLIAM, MARCUS",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346353315,"OUTLAW, WILLIAM, MARCUS",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 53 , 68 ,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346353315,"OUTLAW, WILLIAM, MARCUS",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 26 , 30 ,$#,,
MEDICAID DIRECT,1346361094,WESTDALE MANOR INCORPORATED,WESTDALE MANOR,303 WESTDALE PL   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346361094,WESTDALE MANOR INCORPORATED,303 WESTDALE PL   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,459 "," 1,459 "," $92,618.70 ",,
MEDICAID DIRECT,1346361102,EVERGREEN LIVING HOME INC,EVERGREEN LIVING HOME 1,101 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346361102,EVERGREEN LIVING HOME INC,101 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,131 "," 2,152 "," $201,587.23 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346368024,"CARON, JESSE, ANTHONY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033224274,UWHARRIE MEDICAL CENTER,UWHARRIE MEDICAL CENTER,207 BALFOUR DR STE 102 ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1346370996,"HASSAN, SAMI, ABDUS",207 BALFOUR DR STE 102 ARCHDALE NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 94 , 94 ,$#,,
MEDICAID DIRECT,1346372216,AUTUMN HOME CARE OF JOHNSTON CO INC,AUTUMN HOME CARE OF JOHNSTON CO INC III,474 JERRY RD   SELMA NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346372216,AUTUMN HOME CARE OF JOHNSTON CO INC,474 JERRY RD   SELMA NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 138 , 138 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346372331,"KROSHINSKY, DANIELA",5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346372331,"KROSHINSKY, DANIELA",5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346372331,"KROSHINSKY, DANIELA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 18 , 27 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346372331,"KROSHINSKY, DANIELA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346376423,"BAMBINI, DANIEL, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346376423,"BAMBINI, DANIEL, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 21 , 29 ,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346376423,"BAMBINI, DANIEL, ANDREW",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346376423,"BAMBINI, DANIEL, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 50 , 59 ,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346376423,"BAMBINI, DANIEL, ANDREW",1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346376423,"BAMBINI, DANIEL, ANDREW",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 23 , 26 ,$#,,
MEDICAID DIRECT,1790374999,FULLER & ASSOCIATES IX PLLC,SEASIDE FAMILY & COSMETIC DENTISTRY,2660 NC HIGHWAY 210 E STE 103 HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1346376860,"FRANCIS, LAUREN",2660 NC HIGHWAY 210 E STE 103 HAMPSTEAD NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 85 , 141 , 452 ," $16,817.18 ",,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346378882,"ARANGO, ANA",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 36 , 44 , 105 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346382884,"LENZE, MICHELE, MULLANEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346382884,"LENZE, MICHELE, MULLANEY",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 41 , 55 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346382884,"LENZE, MICHELE, MULLANEY",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346382884,"LENZE, MICHELE, MULLANEY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1346383593,"FRAZIER-MILLS, CAMILLE, GENISE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346383593,"FRAZIER-MILLS, CAMILLE, GENISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 75 , 102 , 174 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1346383593,"FRAZIER-MILLS, CAMILLE, GENISE",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346383593,"FRAZIER-MILLS, CAMILLE, GENISE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 24 , 35 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1346383593,"FRAZIER-MILLS, CAMILLE, GENISE",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 122 , 175 , 285 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346383593,"FRAZIER-MILLS, CAMILLE, GENISE",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346386190,"SIAGE, YOUSSEF",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 72 , 102 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346386190,"SIAGE, YOUSSEF",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 43 , 63 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346386190,"SIAGE, YOUSSEF",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 16 , 36 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346386190,"SIAGE, YOUSSEF",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1346389236,"FULBRIGHT, RENEE, ANNETTE",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 73 , 108 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1346389236,"FULBRIGHT, RENEE, ANNETTE",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427128651,COUNTY OF ROWAN,ROWAN COUNTY HEALTH DEPT,1811 E INNES ST   SALISBURY NC,080,Rowan,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1346391216,"WELTON, SAMANTHA, RENEE",1811 E INNES ST   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 732 ," 1,905 "," 5,559 "," $254,966.71 ",,
MEDICAID DIRECT,1427128651,COUNTY OF ROWAN,ROWAN COUNTY HEALTH DEPT,1811 E INNES ST   SALISBURY NC,080,Rowan,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1346391216,"WELTON, SAMANTHA, RENEE",1811 E INNES ST   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 26 , 69 ,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346391299,"WILLIAMS, JONATHAN, STEVEN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346393782,"MASSEY, CARMEN, BELINDA",1403 S KING ST   WINDSOR NC,008,Bertie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1346394012,RENU LIFE EXTENDED INC,~,201 WINDSOR CREEK PKWY   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346394012,RENU LIFE EXTENDED INC,201 WINDSOR CREEK PKWY   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 , 233 , 239 ," $293,728.23 ",,
MEDICAID DIRECT,1346395530,ADVANTAGE CARE IN HOME SERVICES,ADVANTAGE CARE IN HOME SERVICES INC,103 WORTHAM CT   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1346395530,ADVANTAGE CARE IN HOME SERVICES,103 WORTHAM CT   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,713 "," 1,944 "," $144,560.54 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",5156 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",8116 NC 711   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",1106 SUNSET AVE   CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 46 , 142 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1102 B US 601   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",1102B YADKINVILLE RD   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1346397676,"BATHEJA, NEHA",41 BAIN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346399367,"TELEN, MARILYN, JO",2100 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346402153,"KEITH, PHILIP, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 18 , 23 , 24 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346402153,"KEITH, PHILIP, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 42 , 84 , 131 ," $10,438.09 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,180 FOY DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346403870,"PASZEK, MATTHEW, ROBERT",180 FOY DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,, 162 , 327 , 687 ," $14,456.84 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346403870,"PASZEK, MATTHEW, ROBERT",180 FOY DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,, 49 , 114 , 209 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346405156,"CRAWFORD, KELLY, MARIE",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 58 , 146 , 210 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346405156,"CRAWFORD, KELLY, MARIE",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1346405867,"PACK, LISA, ELLEN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346405867,"PACK, LISA, ELLEN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346405867,"PACK, LISA, ELLEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346405867,"PACK, LISA, ELLEN",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346405867,"PACK, LISA, ELLEN",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346405867,"PACK, LISA, ELLEN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346405867,"PACK, LISA, ELLEN",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346405867,"PACK, LISA, ELLEN",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346405974,"REDDY, SESHA",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1346405974,"REDDY, SESHA",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346405974,"REDDY, SESHA",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 180 , 181 ," $10,324.27 ",,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346405974,"REDDY, SESHA",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346406113,"BURKE, ALLISON, MARIE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346406139,"TOLEDO, ALEXANDER, HORACIO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 53 , 81 , 91 ,$#,,
MEDICAID DIRECT,1447339767,CAROLINA DIGESTIVE DISEASES PA,CAROLINA DIGESTIVE DISEASES PA,704 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346406147,"GOLDSTEIN, PHILLIP, JOSHUA",704 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 102 , 165 , 217 ,$#,,
MEDICAID DIRECT,1588003032,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY,1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346408101,"BOOLS, LINDSAY, MARIE",1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 41 , 59 ,$#,,
MEDICAID DIRECT,1588003032,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346408101,"BOOLS, LINDSAY, MARIE",1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 152 , 230 , 321 ,$#,,
MEDICAID DIRECT,1588003032,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346408101,"BOOLS, LINDSAY, MARIE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 85 , 131 ,$#,,
MEDICAID DIRECT,1356185631,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY-HORIZON,125 HOSPITAL AVE NW STE 200-C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1346408101,"BOOLS, LINDSAY, MARIE",1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346408507,"LAD, SHIVANAND, PRAMOD",2100 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346408507,"LAD, SHIVANAND, PRAMOD",2100 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346408507,"LAD, SHIVANAND, PRAMOD",2100 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346408507,"LAD, SHIVANAND, PRAMOD",2100 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972566016,SANDHILLS ORTHOTICS LLC,SANDHILLS ORTHOTICS LLC,325 PAGE RD BLDG 3 PINEHURST NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346412160,"DECKER, TROY, CHRISTOPHER",325 PAGE RD N   PINEHURST NC,063,Moore,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 47 ,$#,,
MEDICAID DIRECT,1346413911,C AND B SUPPORT SERVICES INC,~,70 WOODFIN PL STE 22 ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1346413911,C AND B SUPPORT SERVICES INC,70 WOODFIN PL STE 22 ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,, 217 ," 2,154 "," 2,160 "," $872,225.85 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346418696,"STERLING, KRISTEN, LYNN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346418696,"STERLING, KRISTEN, LYNN",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790825206,COUNTY OF SURRY & SURRY COUNTY WELF,SURRY CO HEALTH & NUTRITION CTR,118 HAMBY RD   DOBSON NC,086,Surry,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1346421427,"VERNON, RICKY, JUNIOR",118 HAMBY RD   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 67 , 147 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1346422177,"FLEMING, CHRISTINE, EVE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346422177,"FLEMING, CHRISTINE, EVE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346422177,"FLEMING, CHRISTINE, EVE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346422177,"FLEMING, CHRISTINE, EVE",507 E FREMONT ST   BURGAW NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346422177,"FLEMING, CHRISTINE, EVE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346422177,"FLEMING, CHRISTINE, EVE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346422177,"FLEMING, CHRISTINE, EVE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 128 , 141 , 156 ," $11,363.81 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346422912,"JOSE, FOLASHADE, ADEBISI",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346422912,"JOSE, FOLASHADE, ADEBISI",100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 37 , 49 , 49 ,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346422912,"JOSE, FOLASHADE, ADEBISI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346425055,"BUTLER JR, JEROME, MACK",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 39 , 222 , 271 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346425055,"BUTLER JR, JEROME, MACK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 50 , 55 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346425055,"BUTLER JR, JEROME, MACK",440 MCALISTER RD   LINCOLNTON NC,055,Lincoln,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346429628,"HATCH, DAVID, MATTHEWS",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346429628,"HATCH, DAVID, MATTHEWS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346429628,"HATCH, DAVID, MATTHEWS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 45 , 51 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346429628,"HATCH, DAVID, MATTHEWS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346429628,"HATCH, DAVID, MATTHEWS",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346429628,"HATCH, DAVID, MATTHEWS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1346430543,"ROGERS, SELENA, JUSTICE",38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 14 , 16 , 31 ,$#,,
MEDICAID DIRECT,1346431715,L AND N FAMILY CARE HOME INC,~,142 GRASSY KNOB RD   ANDREWS NC,020,Cherokee,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346431715,L AND N FAMILY CARE HOME INC,142 GRASSY KNOB RD   ANDREWS NC,020,Cherokee,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,219 "," 1,219 "," $84,486.07 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346431806,"PENHALL, BRENT, DOUGLASS",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 63 , 107 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346431806,"PENHALL, BRENT, DOUGLASS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346436102,"WEATHERLY, JANICE, FRITCHMAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1881289932,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR DIVISION OF PSYCHIATRY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346440369,"HART PACALDO, LORA, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346442720,"BOWMAN, NATALIE, MCCARTER",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 18 , 27 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346442720,"BOWMAN, NATALIE, MCCARTER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 27 , 97 , 107 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346444064,"BELCHER, VERNEE, NICOLE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 165 , 165 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346444882,"MAGUIRE, JENNIFER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346444882,"MAGUIRE, JENNIFER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 45 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346444882,"MAGUIRE, JENNIFER, MARIE",100 EASTOWNE DR STE 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346444882,"MAGUIRE, JENNIFER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 54 , 70 ," $10,076.46 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346444973,"WEGH, WILLIAM, WALTER",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346445558,"BALFANZ, JAMES, GREGORY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346445558,"BALFANZ, JAMES, GREGORY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 57 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346446754,"CHIDGEY, BROOKE, ALISON",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 63 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346446754,"CHIDGEY, BROOKE, ALISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346446754,"CHIDGEY, BROOKE, ALISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 27 , 27 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1346446754,"CHIDGEY, BROOKE, ALISON",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1346446754,"CHIDGEY, BROOKE, ALISON",163 MEDICAL PARK DR   SILER CITY NC,019,Chatham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1346449196,INTERIM HEALTHCARE MORRIS GROUP INC,~,2526 WARD BLVD   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1346449196,INTERIM HEALTHCARE MORRIS GROUP INC,2526 WARD BLVD   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 14,833 "," 15,031 "," $2,176,222.00 ",,
MEDICAID DIRECT,1679278790,DANVILLE PEDIATRIC DRE PLLC,,4045 RIVERSIDE DR   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346449758,"MOSLEY, MONICA, SHERRELL",4045 RIVERSIDE DR   DANVILLE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 125 , 180 , 638 ," $22,495.18 ",,
MEDICAID DIRECT,1346449758,"MOSLEY, MONICA, SHERRELL",,4045 RIVERSIDE DR   DANVILLE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1346449758,"MOSLEY, MONICA, SHERRELL",4045 RIVERSIDE DR   DANVILLE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 24 , 24 , 70 ,$#,,
MEDICAID DIRECT,1780004556,MOSES CONE PHYSICIAN SERVICES INC,REIDSVILLE ENDOCRINOLOGY ASSOCIATES,1107 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346450657,"NIDA, GEBRESELASSIE, WOLDEBERHAN",1107 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 95 , 175 , 276 ,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1346451655,"HART, CATHERINE, KAY",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346454881,"BAKER, AMANDA, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 31 , 35 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346455235,"THOMAS, BROOKE, BURKART",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2609 N DUKE ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346457512,"JARVIS, AMBER, MARIE",2609 N DUKE ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346457512,"JARVIS, AMBER, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 23 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 340 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346457512,"JARVIS, AMBER, MARIE",234 CROOKED CREEK PKWY STE 340 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346458577,"SPARZAK, PAUL, BOYD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346458577,"SPARZAK, PAUL, BOYD",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1346458577,"SPARZAK, PAUL, BOYD",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346458577,"SPARZAK, PAUL, BOYD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346458577,"SPARZAK, PAUL, BOYD",100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346458908,"TRAN, KHOA, DANG",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346458908,"TRAN, KHOA, DANG",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346461183,"SLECHTA, RYAN, MATTHEW",80 HEALTHCARE DR STE 203 SYLVA NC,050,Jackson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 146 , 211 , 390 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1346461183,"SLECHTA, RYAN, MATTHEW",80 HEALTHCARE DR STE 203 SYLVA NC,050,Jackson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 35 , 47 , 90 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346461431,"NNAJI, NGOZI, EUNICE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1649545195,NEPHROPATHOLOGY ASSOCIATES PLC,ARKANA LABORATORIESNEPHROPATH,10810 EXECUTIVE CENTER DR STE 100 LITTLE ROCK AR,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1346462561,"BOURNE, THOMAS, DAVID",10810 EXECUTIVE CENTER DR STE 100 LITTLE ROCK AR,102,Out of State > 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1346464617,"ARCHER, TONYA, BRITTON",114 HOLLOWELL RD   AULANDER NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1346464617,"ARCHER, TONYA, BRITTON",114 HOLLOWELL RD   AULANDER NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437181914,AULANDER MEDICAL PRACTICE PA,~,114 HOLLOWELL RD   AULANDER NC,008,Bertie,193400000X,Group,Single Specialty,,1346464617,"ARCHER, TONYA, BRITTON",114 HOLLOWELL RD   AULANDER NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 248 , 715 ," 1,376 "," $15,053.80 ",,
MEDICAID DIRECT,1457514143,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1346465143,"SEVENSMA, ERIC, TAVIS",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 56 , 78 , 93 ,$#,,
MEDICAID DIRECT,1396017752,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC MARION,2293 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1346465143,"SEVENSMA, ERIC, TAVIS",2293 SUGAR HILL RD STE A MARION NC,059,McDowell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346471158,"CAMPBELL, MATTHEW, REED",,1841 WELLNESS BLVD   MONROE NC,090,Union,1223E0200X,Dental Providers,Dentist,Endodontics,1346471158,"CAMPBELL, MATTHEW, REED",1841 WELLNESS BLVD   MONROE NC,090,Union,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1346472123,RESTORATION HOME CARE SERVICES INC,RESTORATION HOME CARE SERVICES INC,410 1ST AVE S STE 3 CONOVER NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1346472123,RESTORATION HOME CARE SERVICES INC,410 1ST AVE S STE 3 CONOVER NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,273 "," 3,277 "," $417,217.88 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346475704,"FOREMAN, MATTHEW, ABBITT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346475704,"FOREMAN, MATTHEW, ABBITT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1346475837,"GRACE, JANE, ANN",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 23 ,$#,,
MEDICAID DIRECT,1346479169,MYRIAD WOMENS HEALTH INC,~,233 E GRAND AVE   SOUTH SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1346479169,MYRIAD WOMENS HEALTH INC,233 E GRAND AVE   SOUTH SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 96 , 95 , 227 ," $93,642.94 ",,
MEDICAID DIRECT,1346479169,MYRIAD WOMENS HEALTH INC,~,180 KIMBALL WAY   SOUTH SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1346479169,MYRIAD WOMENS HEALTH INC,180 KIMBALL WAY   SOUTH SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 162 , 159 , 312 ," $143,810.88 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1346482296,"LOBRACCO-SMITH, LISA, ANN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 45 , 45 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346482858,"MONTOYA, KELLEY, O'BRIEN",3333 SILAS CREEK PKWY 3333 SILAS CREEK PARKWAY WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 42 , 48 , 72 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346482858,"MONTOYA, KELLEY, O'BRIEN",3333 SILAS CREEK PKWY 3333 SILAS CREEK PARKWAY WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 13 , 27 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1346482858,"MONTOYA, KELLEY, O'BRIEN",3333 SILAS CREEK PKWY 3333 SILAS CREEK PARKWAY WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346482858,"MONTOYA, KELLEY, O'BRIEN",3333 SILAS CREEK PKWY 3333 SILAS CREEK PARKWAY WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 49 , 51 , 84 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346482858,"MONTOYA, KELLEY, O'BRIEN",3333 SILAS CREEK PKWY 3333 SILAS CREEK PARKWAY WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1346482858,"MONTOYA, KELLEY, O'BRIEN",3333 SILAS CREEK PKWY 3333 SILAS CREEK PARKWAY WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 13 , 21 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346484896,"KATRAGADDA, SREEDHAR",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 115 , 262 , 262 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346484896,"KATRAGADDA, SREEDHAR",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346484896,"KATRAGADDA, SREEDHAR",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 34 , 100 , 100 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346485687,"JONES, HEATHER, HARPER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 73 , 124 , 186 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346485687,"JONES, HEATHER, HARPER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 36 , 42 , 42 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346485687,"JONES, HEATHER, HARPER",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 35 , 114 , 164 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1346486446,"SRIVASTAVA, ADARSH, KUMAR",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4917 S CROATAN HWY STE 1A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1346487204,"TAFFERA-DEIHL, PAMELA, QUINN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1346487204,"TAFFERA-DEIHL, PAMELA, QUINN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 49 , 49 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346488525,"LIN, KAIWEN",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 125 , 164 , 231 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1346488525,"LIN, KAIWEN",1423 E FRANKLIN ST STE I MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346491578,"SAMATAM, SWAPNA",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 17 , 24 , 43 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346493053,"MEHTA STEINKE, SEEMA, ARUN",3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1912784406,REX HOSPITAL INC,NORTH CAROLINA INFECTIOUS DISEASES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346493053,"MEHTA STEINKE, SEEMA, ARUN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346493095,"MCHENRY, MARGARET, ANN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1194873901,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INFECTIOUS DISEASE SPECIALISTS,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346496700,"HEKMAN, ALIZA, LAUREN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346496700,"HEKMAN, ALIZA, LAUREN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346496734,"COLASACCO, COLBY, GODBOLD",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346496734,"COLASACCO, COLBY, GODBOLD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 93 , 93 ," $17,518.82 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346496734,"COLASACCO, COLBY, GODBOLD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346496767,"JOHNSON, TRISTIN, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346501400,"YUDT, SUSAN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346501400,"YUDT, SUSAN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346501400,"YUDT, SUSAN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346501939,"GANGOPADHYAY, PAULA",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 149 , 207 , 324 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346501939,"GANGOPADHYAY, PAULA",510 EMERGENCY DR   LEXINGTON NC,029,Davidson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346501939,"GANGOPADHYAY, PAULA",510 EMERGENCY DR   LEXINGTON NC,029,Davidson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346502325,"CAUSEY, ANH, KIM",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1346502325,"CAUSEY, ANH, KIM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346502325,"CAUSEY, ANH, KIM",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 55 , 74 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346502382,"WHITE, RACHEL, MARIE",211 VIRGINIA RD   EDENTON NC,021,Chowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346503125,"SULLIVAN, LAUREN, MARIE",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 42 ,$#,,
MEDICAID DIRECT,1386960177,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346503125,"SULLIVAN, LAUREN, MARIE",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 35 , 68 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346503125,"SULLIVAN, LAUREN, MARIE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 19 , 41 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346504297,"TILLMAN, ROBERT, HARRISON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 20 , 30 , 30 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346504297,"TILLMAN, ROBERT, HARRISON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346504297,"TILLMAN, ROBERT, HARRISON","1001 BLYTHE BLVD MEDICAL CENTER PLAZA, SUITE 200 CHARLOTTE NC",060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 103 , 200 , 211 ," $18,452.47 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346504297,"TILLMAN, ROBERT, HARRISON",1781 TATE BLVD SE   HICKORY NC,018,Catawba,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346505534,"KIM, IULIIA",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346505534,"KIM, IULIIA",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346505815,"GSCHNELL, HEATHER, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346505815,"GSCHNELL, HEATHER, MARIE",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346505815,"GSCHNELL, HEATHER, MARIE",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1346505815,"GSCHNELL, HEATHER, MARIE",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 37 , 50 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346508017,"MELVILLE, TONI, MARIE",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346508017,"MELVILLE, TONI, MARIE",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 26 , 42 ,$#,,
MEDICAID DIRECT,1346509155,WALKERS GROUP HOME,Walkers Home Care,12 PALASIDE DR NE   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1346509155,WALKERS GROUP HOME,12 PALASIDE DR NE   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1346509155,WALKERS GROUP HOME,Walkers Home Care,12 PALASIDE DR NE   CONCORD NC,013,Cabarrus,251J00000X,Agencies,Nursing Care,,1346509155,WALKERS GROUP HOME,12 PALASIDE DR NE   CONCORD NC,013,Cabarrus,251J00000X,Agencies,Nursing Care,, 17 ," 2,454 "," 2,469 "," $1,591,818.00 ",,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346509973,"NUCKLES, LINDSAY, BROEKER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346510682,"GHADIMI, KAMROUZ, NMI",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346510682,"GHADIMI, KAMROUZ, NMI",2400 A PAVILLION   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 20 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346510682,"GHADIMI, KAMROUZ, NMI",2400 A PAVILLION   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346511904,"HENSLEY, ANGELA, DIANE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1881877793,ANESTHESIA CONSULTANTS OF AUGUSTA,,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1346511961,"ABRAHAM, ALEXANDRA",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1346512951,"RODRIGUEZ, JESSICA, RHEA",11635 NORTHPARK DR STE 200 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 35 , 95 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346513223,"JONES, KATERINA, MARIA",710 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346513223,"JONES, KATERINA, MARIA",710 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346513223,"JONES, KATERINA, MARIA",2544 COURT DR STE F GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346513223,"JONES, KATERINA, MARIA",710 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346513223,"JONES, KATERINA, MARIA",710 W HUDSON BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346513223,"JONES, KATERINA, MARIA",2544 COURT DR STE F GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346513223,"JONES, KATERINA, MARIA",2544 COURT DR STE F GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1346515137,IMANI ENTERPRISE LLC,AL NURSING AGENCY,1348 WESTGATE CENTER DR STE 207 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1346515137,IMANI ENTERPRISE LLC,1348 WESTGATE CENTER DR STE 207 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 378 , 378 ," $45,116.96 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346515590,"BESS, JUANITA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 ,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346516283,"WHITE, BRITTANY, WALKER",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346516283,"WHITE, BRITTANY, WALKER",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 35 , 64 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346516994,"BRANTLEY, MARY, LISA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 53 , 105 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346517927,"CUNNINGHAM, LINDSEY, SHAY",150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 43 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346517927,"CUNNINGHAM, LINDSEY, SHAY",150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 67 , 179 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346519949,"SHILLING, BERNADETTE, ANN",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 32 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346519949,"SHILLING, BERNADETTE, ANN",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1346519949,"SHILLING, BERNADETTE, ANN",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1346519949,"SHILLING, BERNADETTE, ANN",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346520210,"BRANCH, SARA, LYNN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679582134,PEDIATRIC ENDOCRINOLOGY AND DIABETE,PEDIATRIC ENDOCRINOLOGY DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346521531,"CRUZ AVILES, LISA, MICHELLE",4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1679582134,PEDIATRIC ENDOCRINOLOGY AND DIABETE,PEDIATRIC ENDOCRINOLOGY DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346521531,"CRUZ AVILES, LISA, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1962218057,ATRIUM HEALTH CHILDRENS SPECIALTY,PEDIATRIC ENDOCRINOLOGY AND DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346521531,"CRUZ AVILES, LISA, MICHELLE",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1679582134,PEDIATRIC ENDOCRINOLOGY AND DIABETE,PEDIATRIC ENDOCRINOLOGY DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346521531,"CRUZ AVILES, LISA, MICHELLE",4501 CAMERON VALLEY PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 45 , 61 , 95 ,$#,,
MEDICAID DIRECT,1962218057,ATRIUM HEALTH CHILDRENS SPECIALTY,PEDIATRIC ENDOCRINOLOGY AND DIABETES SPECIALISTS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346521531,"CRUZ AVILES, LISA, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1962218057,ATRIUM HEALTH CHILDRENS SPECIALTY,PEDIATRIC ENDOCRINOLOGY AND DIABETES SPECIALISTS,1781 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346521531,"CRUZ AVILES, LISA, MICHELLE",1781 TATE BLVD SE   HICKORY NC,018,Catawba,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1003130493,PEDIATRIC ENDOCRINOLOGY AND DIABETE,Pediatric Endocrinology and Diabetes Specialists,1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346521531,"CRUZ AVILES, LISA, MICHELLE",1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346523826,"NOWICKI, DONNA, MEIWEN",105 NEWSOM ST STE 101 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346523826,"NOWICKI, DONNA, MEIWEN",1704 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346523826,"NOWICKI, DONNA, MEIWEN",1765 DOBBINS DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346523826,"NOWICKI, DONNA, MEIWEN",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346524766,"PLATANIA, JAMES, MATTHEW",600 MOYE BLVD   GREENVILLE NC,074,Pitt,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346525581,"AIRINEI-TEEL, ROXANA, MIHAELA",741A TILGHMAN DR   DUNN NC,043,Harnett,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 33 , 67 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1346525581,"AIRINEI-TEEL, ROXANA, MIHAELA",741A TILGHMAN DR   DUNN NC,043,Harnett,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1912952672,DREAM PROVIDER CARE SERVICES,DREAM PROVIDER CARE SERVICES INC,216 STEWART PKWY   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1346527314,"EDWARDS, CHARLENE",216 STEWART PKWY   WASHINGTON NC,007,Beaufort,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346528734,"HO, THUY, THI HUONG",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346528734,"HO, THUY, THI HUONG",502 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346528734,"HO, THUY, THI HUONG",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1366068397,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BOILING SPRINGS,305 W COLLEGE AVE   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346528734,"HO, THUY, THI HUONG",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346528734,"HO, THUY, THI HUONG",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548389125,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - 3RD AVE,111 E THIRD AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346528734,"HO, THUY, THI HUONG",111 E THIRD AVE   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 92 , 217 , 270 ," $14,090.74 ",,
MEDICAID DIRECT,1386094613,G ABRAMS & R COHEN XVII,,7128 LAWYERS RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346529807,"KUPPERI, VINUTHA",901 OAK FOREST DR   MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice," 3,257 "," 7,339 "," 26,587 "," $1,400,657.24 ",,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1346533304,"PHILLIPS, CHRISTY, LYNN",176 CLAYTON PAIT RD   BLADENBORO NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 25 , 29 ,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1346533304,"PHILLIPS, CHRISTY, LYNN",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 164 , 185 ,$#,,
MEDICAID DIRECT,1235478694,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-ORTHOPAEDICTRAUMASERVS,480 FLOYD RD   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346533742,"NORRIS, JAMES, PASCAL",480 FLOYD RD STE A SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1346534799,"ROSE, AMANDA, MARIE",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 14 , 53 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1346534799,"ROSE, AMANDA, MARIE",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 18 , 43 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1346534799,"ROSE, AMANDA, MARIE",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 68 , 87 , 195 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1346534799,"ROSE, AMANDA, MARIE",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 31 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346535929,"TRAVERSO, KATRINA, MARIE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346535929,"TRAVERSO, KATRINA, MARIE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1585 FORNEY CREEK PKWY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1346535929,"TRAVERSO, KATRINA, MARIE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346535929,"TRAVERSO, KATRINA, MARIE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346535929,"TRAVERSO, KATRINA, MARIE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,101 E W T HARRIS BLVD STE 4001 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346535929,"TRAVERSO, KATRINA, MARIE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346535929,"TRAVERSO, KATRINA, MARIE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1346537461,"GARG, SHWETA",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537461,"GARG, SHWETA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1346537461,"GARG, SHWETA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 91 , 96 , 118 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 42 , 56 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 58 , 61 , 83 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 40 , 51 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1346537891,"PRECHTER, SCOTT, ALLAN",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 40 , 41 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346541448,"FAKLER, ROBERT, WAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 32 , 38 ,$#,,
MEDICAID DIRECT,1568868297,EFFECTIVE INTERVENTIONS,~,375 SE BROAD ST STE A SOUTHERN PINES NC,063,Moore,251S00000X,Agencies,Community/Behavioral Health,,1346542537,"STRAIN, LEIGH, ANN",375 SE BROAD ST STE A SOUTHERN PINES NC,063,Moore,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346546835,"SALDANHA, KEVIN, GLEN",1901 MOONEY ST   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346549722,"BROWNSTEIN, MICHELLE, RICHARDSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 47 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346549722,"BROWNSTEIN, MICHELLE, RICHARDSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346549722,"BROWNSTEIN, MICHELLE, RICHARDSON",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346549722,"BROWNSTEIN, MICHELLE, RICHARDSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 77 , 82 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346549722,"BROWNSTEIN, MICHELLE, RICHARDSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346549722,"BROWNSTEIN, MICHELLE, RICHARDSON",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346549854,"DEESE, JENNIFER, PURSER",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346549854,"DEESE, JENNIFER, PURSER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346550993,"MOORE, PATRICIA, BROOKE",1206 BROWN ST   WASHINGTON NC,007,Beaufort,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 48 , 59 , 64 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346550993,"MOORE, PATRICIA, BROOKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346550993,"MOORE, PATRICIA, BROOKE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",338 DEERFIELD RD   BOONE NC,095,Watauga,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 18 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",201 E GROVER ST   SHELBY NC,023,Cleveland,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",125 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 17 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 18 , 28 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",125 QUEENS RD STE 640 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",125 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346552692,"OGBATA, OBIAGELI, UCHENNA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1346557576,"DULA, ANOMIS, SHAWN",120 HEALTHPLEX WAY   APEX NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1336154129,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE ELLERBE,112 E BALLARD ST   ELLERBE NC,077,Richmond,193400000X,Group,Single Specialty,,1346559911,"THOMPSON, BRIDGET, NICOLE",112 E BALLARD ST   ELLERBE NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 81 , 151 , 393 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346560505,"MAGNUSON, LAURA, KATHLEEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346560505,"MAGNUSON, LAURA, KATHLEEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 47 , 78 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346560505,"MAGNUSON, LAURA, KATHLEEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346561644,"EVERLY, REBECCA, BLANCHARD",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 80 , 108 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346561644,"EVERLY, REBECCA, BLANCHARD",900 OLD WINSTON RD STE 222 KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346561990,"GREENSPAN, HEATHER, NANCY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346561990,"GREENSPAN, HEATHER, NANCY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346561990,"GREENSPAN, HEATHER, NANCY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346561990,"GREENSPAN, HEATHER, NANCY",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346562147,"GORDON, KIMBERLY, RENEE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346562147,"GORDON, KIMBERLY, RENEE",9929 REA RD STE 201 WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1346563301,"ANDREWS, JASON, CHRISTIE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 28 , 29 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346565124,"SUN, NATALIE, ZHONGHUI",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 37 , 48 , 110 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346565124,"SUN, NATALIE, ZHONGHUI",525 CORPORATE CIR   SALISBURY NC,080,Rowan,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 22 , 27 , 58 ,$#,,
MEDICAID DIRECT,1346566080,VEDIC PHARMACY LLC,GURLEYS PHARMACY,114 W MAIN ST   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1346566080,VEDIC PHARMACY LLC,114 W MAIN ST   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1710237367,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA PEDIATRIC MEDICINE - STATESVILLE,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346566833,"HARKNETT, KATHLEEN, MARIE WRIGHT",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 22 , 31 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346566858,"PATEL, VIRAL, DINESH",15830 BALLANTYNE MEDICAL PL STE 175&150 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346566858,"PATEL, VIRAL, DINESH",15830 BALLANTYNE MEDICAL PL STE 175&150 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346566858,"PATEL, VIRAL, DINESH",2015 RANDOLPH RD STE 101&208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346566858,"PATEL, VIRAL, DINESH",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346566858,"PATEL, VIRAL, DINESH",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 37 , 40 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346566858,"PATEL, VIRAL, DINESH",2015 RANDOLPH RD STE 101&208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1346567203,"WILCOX, JOANNE, MARIE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 126 , 129 , 137 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346567468,"BAYLESS, TEAH, MARTIN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346567468,"BAYLESS, TEAH, MARTIN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346567468,"BAYLESS, TEAH, MARTIN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 85 , 122 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346567468,"BAYLESS, TEAH, MARTIN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 30 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1515 W PETTIGREW ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346567468,"BAYLESS, TEAH, MARTIN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346568029,"LEADER, ALEXANDRA, PFEIFER",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346568029,"LEADER, ALEXANDRA, PFEIFER",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104959055,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346569548,"EVANS, MICHAEL, WAYNE",1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 139 , 199 , 278 ," $11,958.74 ",,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1346574100,"HOLTON, RYAN, ALLEN",137 MOUNT CALVARY RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346574100,"HOLTON, RYAN, ALLEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346580453,"EAST, ADAM, LEE",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 44 , 64 , 122 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346580453,"EAST, ADAM, LEE",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346580453,"EAST, ADAM, LEE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346582624,"LEGER, ELISE",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346582624,"LEGER, ELISE",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1033523709,MOSES CONE AFFILIATED PHYSICIANS IN,CHMG CARDIOVASCULAR DIVISION,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 41 , 53 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 107 , 265 , 367 ,$#,,
MEDICAID DIRECT,1033523709,MOSES CONE AFFILIATED PHYSICIANS IN,CHMG CARDIOVASCULAR DIVISION,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346583747,"LAMBERT, CAMERON, THOMAS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346588944,"HARDING, MARGARET, HAMILTON",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346588944,"HARDING, MARGARET, HAMILTON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346589371,"PADGETT, JENNIFER, LYNN",152 SHERLOCK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,152 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346589371,"PADGETT, JENNIFER, LYNN",152 SHERLOCK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346589447,"GARCIA, KARI, ELIZABETH",3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 89 , 89 ,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346589447,"GARCIA, KARI, ELIZABETH",3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346593175,"LANCASTER, ASHLEY, RAE",1899 TATE BLVD SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346593175,"LANCASTER, ASHLEY, RAE",1870 N CENTER ST   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 66 , 94 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346593175,"LANCASTER, ASHLEY, RAE",725 HIGHLAND OAKS DR STE 106 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 18 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346594785,"LISK, LESLIE, BROOKE RICE",166 SPRINGBROOK AVE STE 201 CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346595238,"BUIE, BETHANY, LISI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1346595543,CENTER FOR ORTHOTIC AND PROSTHETIC,,166 SPRINGBROOK AVE STE 203 CLAYTON NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346595543,CENTER FOR ORTHOTIC AND PROSTHETIC,166 SPRINGBROOK AVE STE 203 CLAYTON NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 43 , 44 , 221 ," $36,121.20 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,773 RUSS AVE   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346597515,"TEACHNOR, LISA, MICHELLE",773 RUSS AVE   HAZELWOOD NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346598885,"MUHLEMAN, MITCHEL, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0904X,Allopathic & Osteopathic Physicians,Radiology,Nuclear Radiology,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346599768,"FERNANDO-ANTHONY, PREESHINI, MALINTHA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 35 , 35 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346599768,"FERNANDO-ANTHONY, PREESHINI, MALINTHA",2301 ERWINROAD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346599768,"FERNANDO-ANTHONY, PREESHINI, MALINTHA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 107 , 107 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346600780,"GREENE, AUSTRALIA, VANDYKE",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,10 E HOSPITAL ST   MANNING SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1346600780,"GREENE, AUSTRALIA, VANDYKE",10 E HOSPITAL ST   MANNING SC,102,Out of State > 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346603644,"ZIMMERMAN, CHRISTOPHER, RICHARD",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346603644,"ZIMMERMAN, CHRISTOPHER, RICHARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 13 , 31 , 34 ,$#,,
MEDICAID DIRECT,1396455267,NMG HEALTH SERVICES LLC,NHMG OBGYN URGENT CARE CLINICS,6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346603941,"WILSON, JACLYN, PLAICE",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 21 , 50 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346607827,"SANDBERG, LAUREN, TAYLOR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346607827,"SANDBERG, LAUREN, TAYLOR",2104 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1346610722,"ASSASA, OMAR",1010 COLLEGE ST   OXFORD NC,039,Granville,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346610722,"ASSASA, OMAR",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346610722,"ASSASA, OMAR",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346613742,"RALSTON, ELIZABETH, COCKERHAM",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1346614971,KBHR CONSULTING SERVICES LLC,,631 E GARRISON BLVD   GASTONIA NC,036,Gaston,251B00000X,Agencies,Case Management,,1346614971,KBHR CONSULTING SERVICES LLC,631 E GARRISON BLVD   GASTONIA NC,036,Gaston,251B00000X,Agencies,Case Management,, 45 , 387 , 387 ," $177,478.20 ",,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346620036,"CROOK, MEAGHAN, TERESE",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 53 , 87 ,$#,,
MEDICAID DIRECT,1346620150,BEYOND HEALTHCARE,,2617 CHAPEL HILL BLVD STE A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1346620150,BEYOND HEALTHCARE,2617 CHAPEL HILL BLVD STE A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 65 ," 11,989 "," 12,129 "," $1,174,660.58 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346620366,"HUNDAL, RAJBIR, SINGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 80 , 117 ,$#,,
MEDICAID DIRECT,1174197297,ROTH & POWELL IV DDS PA,CAROLINA DENTAL ARTS DURHAM,415 DUNSTAN AVE   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1346620648,"SPEIGHT, BIANCA, DENEE",415 DUNSTON AVE STE 2 DURHAM NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 60 ,$#,,
MEDICAID DIRECT,1407350465,ROTH & POWELL III DDS PA,~,3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346620648,"SPEIGHT, BIANCA, DENEE",3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 617 , 859 ," 3,680 "," $170,603.32 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346621703,"RIZK, KEROLOS, GEORGE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1033306279,ONSLOW AMBULATORY SERVICES INC,CENTRAL COAST DERMATOLOGY,215B STATION ST   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1346621885,"LICKTEIG, ERIK, JAMES",215B STATION ST   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 117 , 181 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346622453,"ADEFESO, OLADAPO",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346622453,"ADEFESO, OLADAPO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346622453,"ADEFESO, OLADAPO",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 67 , 67 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346622453,"ADEFESO, OLADAPO",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346622818,"PARKER, MEAGAN, MADIA",12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 69 , 79 , 224 ," $12,939.92 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346622891,"POTYNSKY, JACQUELYN, ELIZABETH",4208 MURDOCKSVILLE RD   WEST END NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 35 , 68 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1346624129,"MALDONADO TORRES, HENRRY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 43 , 47 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346624129,"MALDONADO TORRES, HENRRY",1550 FAULK ST STE 3100 MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710388772,SCHUSTER PHYSICAL THERAPY INC,,419 E MAIN ST UNIT 4 JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1346630829,"CAMERON, NICOLAS, ALEXANDER",419 E MAIN ST UNIT 4 JEFFERSON NC,005,Ashe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 30 , 64 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346632346,"FINCH, LINDSAY, NICOLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346632346,"FINCH, LINDSAY, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 36 , 37 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346634268,"WEIDNER, SERENA, LEE",10512 PARK RD STE 113 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 23 , 40 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,10512 PARK RD STE 113 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346634268,"WEIDNER, SERENA, LEE",10512 PARK RD STE 113 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,532 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1346634268,"WEIDNER, SERENA, LEE",10512 PARK RD STE 113 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346634532,"WOMPIERSKI, VICTORIA, ROOP",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346635109,"BELYSHEV, VITALIY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 103 , 101 , 143 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1346635539,"SINGH, VIKAS",309 NEW ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 270 , 680 , 754 ," $14,185.82 ",,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1346635737,"DURHAM, DANIELLE, JANINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1346637063,"VANDERJAGT, THOMAS, ANDREW",10393 SW RIDGEVIEW LN   PORTLAND OR,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346637063,"VANDERJAGT, THOMAS, ANDREW",10393 SW RIDGEVIEW LN   PORTLAND OR,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1346637964,"HERION, ANNE, MACK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346637964,"HERION, ANNE, MACK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 51 , 57 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346639168,"NEALEY, JOHN, PAUL",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1346639168,"NEALEY, JOHN, PAUL",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346639168,"NEALEY, JOHN, PAUL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1346639168,"NEALEY, JOHN, PAUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346639168,"NEALEY, JOHN, PAUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346639168,"NEALEY, JOHN, PAUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346639168,"NEALEY, JOHN, PAUL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,33 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346642147,"MOORE, SHEILA, GLASS",33 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 28 , 96 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346642147,"MOORE, SHEILA, GLASS",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 48 , 129 ,$#,,
MEDICAID DIRECT,1508349697,DRS REIMELS AND PCOLINSKY PLLC,,3693 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346643624,"PARMAR, JIGNESHKIMAR, ISHWARSINH",3693 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 854 ," 1,805 "," 6,196 "," $346,220.63 ",,
MEDICAID DIRECT,1346646882,GRACELAND MEDICAL SUPPLIES & HEALTH,,1708 TRAWICK RD STE 220 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346646882,GRACELAND MEDICAL SUPPLIES & HEALTH,1708 TRAWICK RD STE 220 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 67 , 410 ," 1,344 "," $105,028.83 ",,
MEDICAID DIRECT,1346648870,PRINCIPLE LABS LLC,,2550 BRODHEAD RD STE 105 BETHLEHEM PA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1346648870,PRINCIPLE LABS LLC,2550 BRODHEAD RD STE 105 BETHLEHEM PA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 34 , 175 , 367 ," $26,819.64 ",,
MEDICAID DIRECT,1346654134,TARBORO EYE ASSOCIATES OPTOMETRY PL,,2807 N MAIN ST   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1346654134,TARBORO EYE ASSOCIATES OPTOMETRY PL,2807 N MAIN ST   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,, 97 , 97 , 193 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346655578,"WASHINGTON, MONICA, MICHAELLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346655578,"WASHINGTON, MONICA, MICHAELLE",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 22 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346655586,"CHAND, GAURAV",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346655586,"CHAND, GAURAV",1450 MATTHEWS TOWNSHIP PKWY STE 460 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 36 , 38 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346655586,"CHAND, GAURAV",1663 CAMPUS PARK DR STE D MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 47 , 87 , 113 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346655586,"CHAND, GAURAV",1663 CAMPUS PARK DR STE A MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346655586,"CHAND, GAURAV",1663 CAMPUS PARK DR STE A MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346657715,"KENNEDY, TREYE, ALLEN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346658101,"DEMENT, JARED, KEITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1346658101,"DEMENT, JARED, KEITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,405 S GREEN ST   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1346658564,"ANTON-VALDEZ, LIZA, ANNA",2702 FARRELL RD   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 31 , 280 , 280 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,2702 FARRELL RD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1346658564,"ANTON-VALDEZ, LIZA, ANNA",2702 FARRELL RD   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 65 , 722 , 723 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1346659497,"BEATTY, YOLONDA, TIA",3205 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 102 , 120 , 178 ," $26,250.68 ",,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 30 , 51 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 19 , 28 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1346660305,"LUKOSIUS, ERIC, ZENON",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1346663572,"SCHELL, JEROD, ANDREW",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1346663572,"SCHELL, JEROD, ANDREW",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1346663572,"SCHELL, JEROD, ANDREW",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346663572,"SCHELL, JEROD, ANDREW",615 RIDGE RD   ROXBORO NC,073,Person,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346665684,"BORCHERDT, DANIEL, ROBERT",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346668092,"RAGLAND, CHELSEA, LINDLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 84 , 115 , 118 ," $14,698.86 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346669777,"GETTLER, ERIN, BROOKE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346669777,"GETTLER, ERIN, BROOKE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346669777,"GETTLER, ERIN, BROOKE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 20 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1346669777,"GETTLER, ERIN, BROOKE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,20 COLONIAL SQ   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1346671468,"TERRY, JENNIFER, ELLEN",20 COLONIAL SQ   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 19 , 55 ,$#,,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,20 COLONIAL SQ   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1346671468,"TERRY, JENNIFER, ELLEN",330 W MAIN ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1619619186,CHILD MEDICAL COLLABORATIVE INC,,20 COLONIAL SQ   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1346671468,"TERRY, JENNIFER, ELLEN",1159 N MAIN ST   WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346672912,GENESIS DEVELOPMENTAL SERVICES,~,123 HARRIS RD   SMITHFIELD NC,051,Johnston,251S00000X,Agencies,Community/Behavioral Health,,1346672912,GENESIS DEVELOPMENTAL SERVICES,123 HARRIS RD   SMITHFIELD NC,051,Johnston,251S00000X,Agencies,Community/Behavioral Health,, 41 , 975 , 975 ," $84,320.88 ",,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1346675501,"HARRIS, KELLY, DAVIS",2555 COURT DR   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346675907,"THOMAS, LISA, ANNE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346675907,"THOMAS, LISA, ANNE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346675907,"THOMAS, LISA, ANNE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1346675907,"THOMAS, LISA, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 14 , 17 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346675907,"THOMAS, LISA, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346675907,"THOMAS, LISA, ANNE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1346681392,"WILLIAMS, DAVID, ANTONIO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346681392,"WILLIAMS, DAVID, ANTONIO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346681426,CHANGING LIVES FAMILY CARE HOME LLC,~,207 AARONS WAY   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346681426,CHANGING LIVES FAMILY CARE HOME LLC,207 AARONS WAY   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 765 , 766 ," $43,732.24 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346682903,"CARVER, KRISTIN, BROOKS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 25 , 29 ,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1023366242,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346683174,"BARBAT, SELWAN, DAVID",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346683703,"LANCASTER, JOSHUA, MARK METZGER",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 91 , 176 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346683703,"LANCASTER, JOSHUA, MARK METZGER",412 LIBERTY ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 37 , 45 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346683703,"LANCASTER, JOSHUA, MARK METZGER",414 E MAIN ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346685831,"BALENTINE, BAILEY, SCHULTZ",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 61 , 128 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346685831,"BALENTINE, BAILEY, SCHULTZ",2161 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1346685831,"BALENTINE, BAILEY, SCHULTZ",2161 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619606316,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2775 HENDERSONVILLE ROAD,2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346685831,"BALENTINE, BAILEY, SCHULTZ",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1043283591,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD OB GYN ASSOCIATES,101 WILLIAM H JOHNSON ST STE 500 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346687290,"GREENAN, CANDICE, WHITAKER",101 WILLIAM H JOHNSON ST STE 500 FLORENCE SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346689031,"YANG, KATIE, SUEYUANE",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 33 , 41 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1346690666,"BEASLEY, KYLA, MARIE",703 NEWMAN RD   NEW BERN NC,025,Craven,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 81 , 116 , 296 ," $10,775.33 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346691458,"BECKERMAN, ZIV",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346692266,"ILAIWY, AMRO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 117 , 118 ,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1346693868,"CLARK, KERESSA, LEE",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 75 , 95 , 186 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346695665,"NICHOLAS, CHER, LYONS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346695665,"NICHOLAS, CHER, LYONS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 37 , 37 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346696028,"ROTHMAN, RICHARD, KYLE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 20 , 25 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1346696028,"ROTHMAN, RICHARD, KYLE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346697042,"SITLER, COLLIN, ANDREW",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1346697042,"SITLER, COLLIN, ANDREW",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1346700473,"CIMRING, JUSTIN, EDWARD",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 59 , 86 , 220 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1346700473,"CIMRING, JUSTIN, EDWARD",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346702453,"PLASENCIA, PABLO, CARLOS",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 15 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346702453,"PLASENCIA, PABLO, CARLOS",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10211 ALM ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346702453,"PLASENCIA, PABLO, CARLOS",10211 ALM ST STE 200 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 36 , 87 ,$#,,
MEDICAID DIRECT,1346704723,RESOURCEFUL CLINICAL LABORATORY LLC,~,8604 CLIFF CAMERON DR STE 116 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1346704723,RESOURCEFUL CLINICAL LABORATORY LLC,8604 CLIFF CAMERON DR STE 116 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,#, 14 , 27 ,$#,,
MEDICAID DIRECT,1346704723,RESOURCEFUL CLINICAL LABORATORY LLC,~,5412 CENTRAL AVE STE A CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1346704723,RESOURCEFUL CLINICAL LABORATORY LLC,5412 CENTRAL AVE STE A CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 14 , 50 , 100 ," $13,424.50 ",,
MEDICAID DIRECT,1578291084,OUR CHILD THERAPY NC LLC,,4801 GLENWOOD AVE STE 200 PMB 446 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346706116,"SCHULTZ, RACHEL, ANN",4801 GLENWOOD AVE STE 200 PMB 446 RALEIGH NC,092,Wake,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 100 , 124 ," $25,342.59 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346706371,"MARTIN, MELISSA, ANNE",2400 PRATT ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346706371,"MARTIN, MELISSA, ANNE",2400 PRATT ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346708989,"WOMER, LISA, LYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346708989,"WOMER, LISA, LYNN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 24 , 28 ,$#,,
MEDICAID DIRECT,1194302901,APPALACHIAN REGIONAL BEHAVIORAL HEA,ARBH PROVIDERS,432 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1346709623,"QUATTLEBAUM, TAYLOR, YOUNG",432 HOSPITAL DRIVE   LINVILLE NC,006,Avery,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1609236371,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT STOVALL,100 DURHAM   STOVALL NC,039,Granville,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346711009,"BRISTOW, ERIN, GILLIES",100 W PARKVIEW DR   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346711009,"BRISTOW, ERIN, GILLIES",100 W PARKVIEW DR   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 203 , 225 ," $10,030.53 ",,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1346715695,"MEADOWS, VIRGINIA, ELIZABETH",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 136 , 354 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1346715695,"MEADOWS, VIRGINIA, ELIZABETH",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1346715695,"MEADOWS, VIRGINIA, ELIZABETH",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346716909,"METZLER, LESLIE, MARIE",1994 WELLNESS BLVD STE 110 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 29 , 49 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346716909,"METZLER, LESLIE, MARIE",3614 PROVIDENCE RD S STE 101 WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 28 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346716909,"METZLER, LESLIE, MARIE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 46 , 67 , 93 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,,,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 35 , 69 , 101 ,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 15 , 17 , 21 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,300 E MCKAY ST STE E ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",300 E MCKAY ST STE E ELIZABETHTOWN NC,009,Bladen,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#, 13 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,145 TILGHMAN DR STE 400 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,,,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346717212,"EVANS, BENNETT, LAMONDE",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 175 , 310 , 432 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 62 , 68 , 98 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346717212,"EVANS, BENNETT, LAMONDE",588 BAILEY RD   LUMBERTON NC,078,Robeson,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346717436,"MILAM, CAITLYN, BYRD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 30 , 43 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346721750,"DYE, JOHN, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346721750,"DYE, JOHN, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346721750,"DYE, JOHN, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346721750,"DYE, JOHN, MICHAEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346721750,"DYE, JOHN, MICHAEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346725306,WALKER PHYSICAL THERAPY & WELLNESS,,4720 GREY MOSS DR   CLOVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346725306,WALKER PHYSICAL THERAPY & WELLNESS,4720 GREY MOSS DR   CLOVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,#, 49 , 51 ,$#,,
MEDICAID DIRECT,1346726411,NATIONAL MOBILE X-RAY,,38 ROSSCRAGGON RD STE M ASHEVILLE NC,011,Buncombe,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,,1346726411,NATIONAL MOBILE X-RAY,38 ROSSCRAGGON RD STE M ASHEVILLE NC,011,Buncombe,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,," 3,223 "," 6,540 "," 9,353 "," $82,120.72 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346726494,"EDWARDS, KRISANDRA, MARIE",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346726494,"EDWARDS, KRISANDRA, MARIE",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 16 , 27 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346726494,"EDWARDS, KRISANDRA, MARIE",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346726874,"EAKER, SAMANTHA, RUSSOMAGNO",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346726874,"EAKER, SAMANTHA, RUSSOMAGNO",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346726874,"EAKER, SAMANTHA, RUSSOMAGNO",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346726874,"EAKER, SAMANTHA, RUSSOMAGNO",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346729092,"WINEGAR, KATHERINE, MARIE",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346729092,"WINEGAR, KATHERINE, MARIE",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1164828471,TWO RIVERS PHYSICIAN PRACTICES LLC,,1499 MAIN ST   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1346729985,"ADAMS, ERICA",1499 MAIN ST   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 216 , 336 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1346730587,"BARNES, TONIA, CHERNAY",320 LILLINGTON AVE STE 101 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346730637,"MCCLOSKEY, HANNAH, MICHELLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346730637,"MCCLOSKEY, HANNAH, MICHELLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346730637,"MCCLOSKEY, HANNAH, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346730637,"MCCLOSKEY, HANNAH, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 20 , 43 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346730637,"MCCLOSKEY, HANNAH, MICHELLE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 14 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346730876,"VENEGAS, YADIRA",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346730876,"VENEGAS, YADIRA",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346730876,"VENEGAS, YADIRA",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346731155,"BEERS, MICHAEL, MILTON",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346731155,"BEERS, MICHAEL, MILTON",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346731155,"BEERS, MICHAEL, MILTON",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 165 , 193 , 277 ,$#,,
MEDICAID DIRECT,1639179393,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1346731155,"BEERS, MICHAEL, MILTON",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346731155,"BEERS, MICHAEL, MILTON",400 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851555734,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RIVERWOOD FAMILY MEDICI,3715 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1346733474,"WARREN, JENNIFER, LEAH",3715 UNION RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 118 , 199 ,$#,,
MEDICAID DIRECT,1346736113,CAROLINAS MEDICAL CENTER AT HOME LL,ATRIUM HEALTH AT HOME HME UNION,613 E ROOSEVELT BLVD STE 100 MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346736113,CAROLINAS MEDICAL CENTER AT HOME LL,613 E ROOSEVELT BLVD STE 100 MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 34 , 169 , 362 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346736667,"TEASDALL, GRACE, AUTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 52 , 63 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1346736808,"LUM, KEVIN, LEE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346736808,"LUM, KEVIN, LEE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1346736808,"LUM, KEVIN, LEE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1346736808,"LUM, KEVIN, LEE",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346736808,"LUM, KEVIN, LEE",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346736808,"LUM, KEVIN, LEE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1346736808,"LUM, KEVIN, LEE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,320 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1346739075,"WARD, COURTNEY, TERESSA",2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1346739075,"WARD, COURTNEY, TERESSA",2420 SUPERCENTER DR NE   KANNAPOLIS NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,, 20 , 20 , 38 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346739075,"WARD, COURTNEY, TERESSA",7735 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 29 , 29 , 55 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346739794,"ARMSTRONG, CHRISTOPHER, LUCAS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 46 , 49 , 50 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1346739927,"COLE, ASHLEY, ABENA APPIAGYEI",1000 HEALING WAY   MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346739927,"COLE, ASHLEY, ABENA APPIAGYEI",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 16 , 18 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1346739927,"COLE, ASHLEY, ABENA APPIAGYEI",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346739927,"COLE, ASHLEY, ABENA APPIAGYEI",1000 HEALING WAY   MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346739927,"COLE, ASHLEY, ABENA APPIAGYEI",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1346344934,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PEDIATRICS DILLON,705 N 8TH AVE STE 3A DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346741121,"RUSS, BRANDI, POWELL",705 N 8TH AVE STE 3A DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346744521,"ASHBURN, NICKLAUS, POWELL",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346744521,"ASHBURN, NICKLAUS, POWELL",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 39 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1346744737,"UNCANIN, NEDELJKO, JAKOV",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346744737,"UNCANIN, NEDELJKO, JAKOV",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 31 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346744737,"UNCANIN, NEDELJKO, JAKOV",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346744737,"UNCANIN, NEDELJKO, JAKOV",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346744737,"UNCANIN, NEDELJKO, JAKOV",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346744737,"UNCANIN, NEDELJKO, JAKOV",3475 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346746609,"KALANADHABHATTA, NALINI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 71 , 71 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",9600 NO 5 SCHOOL RD NW   ASH NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 127 , 127 ," $10,360.76 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 112 , 112 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",237 MULBERRY ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 48 , 48 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 67 , 67 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",200 FLOWERS PRIDGEN DR   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 102 , 102 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",9600 NO 5 SCHOOL RD NW   ASH NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",237 MULBERRY ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",101 CAROLINA AVE   WELDON NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 263 , 264 ," $14,436.79 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346749074,"DER GHAZARIAN, JOHN, FRANCIS-AUGUSTIN",1510 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 204 , 204 ," $11,216.48 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346751898,"MOORE, SHANNON, PATON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346752375,"AUDETTE, DIANNE, SINCLAIR",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 12 , 14 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346752375,"AUDETTE, DIANNE, SINCLAIR",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,1975 CAROLINA PLACE DR   FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346752375,"AUDETTE, DIANNE, SINCLAIR",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2728 W MALLARD CREEK CHURCH RD STE 30 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2101 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346753522,"MARTIN, MICHAEL, EDWARD",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1346754116,"GEORGE, ROBERT, EDWARD",1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346759990,"NIHART-COWAN, ELIZABETH, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346759990,"NIHART-COWAN, ELIZABETH, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346760246,"CROSBY, ASHTEN, KELLY",650 JULIAN RD   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 72 , 236 , 455 ,$#,,
MEDICAID DIRECT,1487940268,OUR FAMILY DOCTOR PLLC,OUR FAMILY DOCTOR PLLC,43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346760477,"IRVINE, ANNE",43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 18 , 30 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346760634,"BARBA-RUIZ, LAURA, CHRISTINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 25 , 25 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1346760634,"BARBA-RUIZ, LAURA, CHRISTINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 68 , 68 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346766029,"KROPP, STACY, MORETZ",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346766029,"KROPP, STACY, MORETZ",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346766029,"KROPP, STACY, MORETZ",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346767290,HEALING SYNERGY LLC,,1672 STATE HWY 96   FRANKLINTON NC,039,Granville,193200000X,Group,Multi-Specialty,,1346767290,HEALING SYNERGY LLC,1672 STATE HWY 96   FRANKLINTON NC,039,Granville,193200000X,Group,Multi-Specialty,, 21 , 120 , 396 ," $10,968.25 ",,
MEDICAID DIRECT,1346767290,HEALING SYNERGY LLC,,1672B NC HIGHWAY 96   FRANKLINTON NC,039,Granville,193200000X,Group,Multi-Specialty,,1346767290,HEALING SYNERGY LLC,1672B NC HIGHWAY 96   FRANKLINTON NC,039,Granville,193200000X,Group,Multi-Specialty,, 48 , 561 ," 1,381 "," $66,486.18 ",,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346768165,"STARNES, ASHLEY, WALLER",631 COX RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 25 , 85 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1346768165,"STARNES, ASHLEY, WALLER",631 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 26 , 56 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346768165,"STARNES, ASHLEY, WALLER",631 COX RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 55 , 151 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346768165,"STARNES, ASHLEY, WALLER",631 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 24 , 63 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,10 MEDICAL PARK DR STE 1 LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1346771474,"SHAIKH, WASSI, HAKIM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346771474,"SHAIKH, WASSI, HAKIM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346771870,"VEERAMACHANENI, RATNAKAR, PRASAD",2573 STANTONSBURG RD STE A GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 136 , 312 , 559 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346772175,"HILLENBRAND, MOLLY, JEAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 41 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346772175,"HILLENBRAND, MOLLY, JEAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 33 , 58 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346772175,"HILLENBRAND, MOLLY, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346772175,"HILLENBRAND, MOLLY, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 44 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346772175,"HILLENBRAND, MOLLY, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346774205,"HALISTA, MICHAEL, MITCHELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346774205,"HALISTA, MICHAEL, MITCHELL",518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 18 , 28 , 54 ,$#,,
MEDICAID DIRECT,1346775285,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL & URGENT CARE OF PINE HAL,3853 US 311 HWY N   PINE HALL NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1346775285,LIFEBRITE HOSPITAL GROUP OF STOKES,3853 US 311 HWY N   PINE HALL NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346775293,"ACKULA, HARITHA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 29 , 38 , 90 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,313 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1346775293,"ACKULA, HARITHA",313 AIRPORT RD   KINSTON NC,054,Lenoir,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346775293,"ACKULA, HARITHA",313 AIRPORT RD   KINSTON NC,054,Lenoir,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 86 , 210 , 484 ," $123,427.43 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346775293,"ACKULA, HARITHA",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346775509,"WEANT, JOEL, ANDREW",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 30 , 63 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346776044,"ST CLAIR, TIFFANY",104 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 19 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1346778834,"KHAN, TAHURIAH, GULNAZ",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 30 , 35 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 110 , 115 , 144 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346778834,"KHAN, TAHURIAH, GULNAZ",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346781523,"WILLIAMS, KEVIN, GEORGE",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 18 , 114 , 114 ," $29,078.21 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346781523,"WILLIAMS, KEVIN, GEORGE",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1346781721,EYECARECENTER OD PA,EYECARE CENTER,1575 NC HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1346781721,EYECARECENTER OD PA,1575 NC HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,, 77 , 77 , 154 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346784949,"SCRONCE, BRENDA, A",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 100 , 112 , 186 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346784949,"SCRONCE, BRENDA, A",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1346784949,"SCRONCE, BRENDA, A",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1346784949,"SCRONCE, BRENDA, A",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346784949,"SCRONCE, BRENDA, A",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 33 , 49 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1346784949,"SCRONCE, BRENDA, A",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346785243,"PEARSON, KATHRYN, REEVES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 32 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346785243,"PEARSON, KATHRYN, REEVES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346787322,"OLIVER, CASEY, RANDALL",742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1346788122,"MANNING, ROBERT, ANDREW",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346791019,"BENNETT, KASSANDRA, JEAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 52 , 52 ,$#,,
MEDICAID DIRECT,1679675581,CAROLINA VISION CARE DR THOMAS C MC,CAROLINA VISION CARE,1804 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1346795119,"MCINTOSH, SCOTT, JOSEPH",1804 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 14 , 23 ,$#,,
MEDICAID DIRECT,1447355755,SMOKY MOUNTAIN FOOT CLINIC PA,SMOKY MOUNTAIN FOOT CLINIC PA,289 ACCESS RD   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1346804689,"MAY, TYLER, JAMES",289 ACCESS RD   WAYNESVILLE NC,044,Haywood,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 127 , 233 , 316 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346804739,"BATTS, CHARNISSA, NICOLE",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1346804739,"BATTS, CHARNISSA, NICOLE",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1346806650,"CALCAGNO, SANDRA, CHRISTINE",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346806650,"CALCAGNO, SANDRA, CHRISTINE",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 25 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1346806650,"CALCAGNO, SANDRA, CHRISTINE",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 50 , 81 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346808235,"PATEL, RUSHAL, AKSHAY",885 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 60 , 133 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346808235,"PATEL, RUSHAL, AKSHAY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346810371,"MOLDOVAN, CHRISTIE, MICHELE",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 25 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346810371,"MOLDOVAN, CHRISTIE, MICHELE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346810371,"MOLDOVAN, CHRISTIE, MICHELE",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346810371,"MOLDOVAN, CHRISTIE, MICHELE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1346810371,"MOLDOVAN, CHRISTIE, MICHELE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346810512,"ARRINGTON, CHRYSTAL, DAWN",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 58 , 119 , 171 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346810512,"ARRINGTON, CHRYSTAL, DAWN",167 MOORE RD STE 206 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346810587,"KAATZ, ALEXANDRA, RUDOLPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346810587,"KAATZ, ALEXANDRA, RUDOLPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1346812559,"ROTH, MALEAH, RACHELLE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 54 , 56 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1346814175,"KNACK, JENNIFER, LYN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346817111,"DEFOOR, WILLIAM, MOORHEAD",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 88 , 424 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346817111,"DEFOOR, WILLIAM, MOORHEAD",1551 WESTBROOK PLAZA DR STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 90 ,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346819562,"DHARMASRI, KATHERINE, MYERS",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 17 , 24 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346819596,"COOKSEY, AMANDA, MORGAN",2827 LYNDHURST AVE STE 203 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 60 , 96 , 96 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",2700 ROYAL COMMONS LN   MATTHEWS NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 31 , 69 , 69 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346820388,"DAVIS, DENISE, LYNNE",5939 REDDMAN RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",10011 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",10011 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 32 , 54 , 54 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",2700 ROYAL COMMONS LN   MATTHEWS NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346820388,"DAVIS, DENISE, LYNNE",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346820388,"DAVIS, DENISE, LYNNE",9200 GLENWATER DR   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",204 E OLD HIGHWAY 74   MONROE NC,090,Union,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",796 NC 177 SOUTH   HAMLET NC,077,Richmond,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 34 , 91 , 91 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346820388,"DAVIS, DENISE, LYNNE",796 NC 177 SOUTH   HAMLET NC,077,Richmond,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346822251,"TUNISON, KELSEY, KAY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1346822251,"TUNISON, KELSEY, KAY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346822251,"TUNISON, KELSEY, KAY",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1346822251,"TUNISON, KELSEY, KAY",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346822251,"TUNISON, KELSEY, KAY",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 46 , 64 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1346822251,"TUNISON, KELSEY, KAY",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346822251,"TUNISON, KELSEY, KAY",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346823655,"LEE, CHRISTOPHER, JOSEPH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 27 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346823655,"LEE, CHRISTOPHER, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 29 , 34 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1346823911,"KREMER, AMIE, ELIZABETH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1346828621,HUEMAN KIND LLC,,521 BRIAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1346828621,HUEMAN KIND LLC,521 BRIAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 326 , 326 ," $20,023.16 ",,
MEDICAID DIRECT,1346828621,HUEMAN KIND LLC,,521 BRIAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1346828621,HUEMAN KIND LLC,521 BRIAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346831039,"GALLO, ALESSIA",3949 BROWNING PL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346831708,"SHANNON, SAMANTHA, NICOLE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1346831708,"SHANNON, SAMANTHA, NICOLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346835600,"CORRALES, KARINA, MARIA",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1346841467,"HOILMAN, MEREDITH, BURLESON",2359 HIGHWAY 105   BOONE NC,095,Watauga,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 29 , 132 , 133 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1346845708,"KANUPP, KIMBERLY, NICHOLE",41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,22 TRUST LN STE 101 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1346845708,"KANUPP, KIMBERLY, NICHOLE",22 TRUST LN STE 101 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346845708,"KANUPP, KIMBERLY, NICHOLE",1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 29 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346845708,"KANUPP, KIMBERLY, NICHOLE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 30 , 54 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346845708,"KANUPP, KIMBERLY, NICHOLE",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1346845708,"KANUPP, KIMBERLY, NICHOLE",120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346848215,"ZDENEK, ALEXANDRA, ELIZABETH",2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 48 , 72 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346848215,"ZDENEK, ALEXANDRA, ELIZABETH",2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 26 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346848306,"PLANTS, JESSICA, ELYSE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 67 , 68 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346851979,"KLEPZIG, KAREN, ACKISS",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 72 , 72 ," $19,265.93 ",,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346852522,"ADAMS, LINDSAY",6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 75 , 78 ,$#,,
MEDICAID DIRECT,1346854304,RAYNAS HOME CARE LLC,,126 E GRANVILLE ST   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,1346854304,RAYNAS HOME CARE LLC,126 E GRANVILLE ST   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,303 "," 2,323 "," $192,852.69 ",,
MEDICAID DIRECT,1164021051,ONESPOTMD PRIMARY AND URGENT CARE P,,2017 CENTRAL AVE STE 103 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346854544,"ANDERSON, BRIANA, CHERELLE",2017 CENTRAL AVE STE 103 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 18 , 48 ,$#,,
MEDICAID DIRECT,1750001749,ONESPOTMD PRIMARY AND URGENT CARE P,,2114 FREEMAN PARK DR STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346854544,"ANDERSON, BRIANA, CHERELLE",2114 FREEMAN PARK DR STE 105 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346855095,"BELAYA, MARIA, ANDREYEVNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 33 , 46 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1346859543,"PENTLIA, AMANDEEP, KAUR",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 88 , 90 , 381 ," $16,264.93 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1346859543,"PENTLIA, AMANDEEP, KAUR",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 93 , 95 , 384 ," $13,773.37 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346859543,"PENTLIA, AMANDEEP, KAUR",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 26 , 26 , 398 ," $27,420.67 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1346859543,"PENTLIA, AMANDEEP, KAUR",2700 COLTSGATE ROAD SUITE 204   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346859543,"PENTLIA, AMANDEEP, KAUR",2700 COLTSGATE ROAD SUITE 204   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,183 "," 1,262 "," 5,450 "," $216,899.64 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346859543,"PENTLIA, AMANDEEP, KAUR",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 15 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346860285,"FLICK, AUSTIN, COLLIN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1346860285,"FLICK, AUSTIN, COLLIN",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1346860285,"FLICK, AUSTIN, COLLIN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1346860285,"FLICK, AUSTIN, COLLIN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346860285,"FLICK, AUSTIN, COLLIN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 85 , 90 , 131 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1346860285,"FLICK, AUSTIN, COLLIN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST # 102 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346860848,"HAMILTON, MOLLY, CHRISTINE",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 45 , 72 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346860848,"HAMILTON, MOLLY, CHRISTINE",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1730926031,WALLYS CLINICAL SERVICES LLC,,933 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1346860848,"HAMILTON, MOLLY, CHRISTINE",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",707 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 228 , 228 ," $41,522.16 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 81 , 262 , 264 ," $34,901.48 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 246 , 247 ," $43,718.58 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",707 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 40 , 41 ," $10,222.53 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 76 , 76 ," $14,382.60 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 163 , 163 ," $25,139.48 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346862604,"MCGUIRE, DAWN, LEE",5680 WINDY HILL DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 42 , 42 ," $10,471.86 ",,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346863495,"KIANI, ALYSSA, MARIE",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346863495,"KIANI, ALYSSA, MARIE",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346863495,"KIANI, ALYSSA, MARIE",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346863537,"BROWN, SHEILA, LOVE",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1285337048,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - STAR,103 COTTON CREEK RD   STAR NC,062,Montgomery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346863537,"BROWN, SHEILA, LOVE",103 COTTON CREEK RD   STAR NC,062,Montgomery,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346863537,"BROWN, SHEILA, LOVE",103 COTTON CREEK RD   STAR NC,062,Montgomery,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1346864220,"CARTER, EMMA, LEIGH",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 144 , 144 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346864832,"MUNOZ, SEAVON",485 VALLEY RD   MOCKSVILLE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 160 , 282 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346864832,"MUNOZ, SEAVON",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346869674,"MAIN, RACHEL, HOLDER",1303 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639607153,SPINE & PAIN ASSOCIATES PLLC,,1303 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1346869674,"MAIN, RACHEL, HOLDER",1303 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972373751,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY INTERVENTIONAL PAIN SPECIALISTS,1205 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346869674,"MAIN, RACHEL, HOLDER",1303 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 50 , 51 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,6000 RAMSEY ST STE 108 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346869674,"MAIN, RACHEL, HOLDER",1303 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346869674,"MAIN, RACHEL, HOLDER",1303 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1346869898,"PRIETO, JULIET, MARIE",300 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1346869898,"PRIETO, JULIET, MARIE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346869898,"PRIETO, JULIET, MARIE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1861217846,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY OBGYN-HPN,6387 RAMSEY ST UNIT 240 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1346869898,"PRIETO, JULIET, MARIE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346870821,"KENNEY, ETHAN, RAYMOND",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346870821,"KENNEY, ETHAN, RAYMOND",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346870821,"KENNEY, ETHAN, RAYMOND",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346870821,"KENNEY, ETHAN, RAYMOND",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1346871639,"LUPA, CATHERINE, ANDREA",414 E MAIN ST   DURHAM NC,032,Durham,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 15 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1346872348,"BROWN, KAITLYN, MACKENZIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134558752,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VALAROAS & LEWIS OBGYN,245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346874039,"SZAMSKI, SHANNON, NICOLE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346874039,"SZAMSKI, SHANNON, NICOLE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 35 , 66 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346874302,"BREHUN, RAQUEL, EVE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1346874302,"BREHUN, RAQUEL, EVE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346874898,"DUFFY, LAUREN, TURNER",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346877032,"PATEL, GRACE, CAROLYN",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346877032,"PATEL, GRACE, CAROLYN",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1346877032,"PATEL, GRACE, CAROLYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346877032,"PATEL, GRACE, CAROLYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346879244,"MAURO, ZACHARY, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1346879244,"MAURO, ZACHARY, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407277536,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346882081,"RUGGIERO, LISA, MARIE",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346882305,"STEVENS, CELESTE, EDNA",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 29 , 40 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346882305,"STEVENS, CELESTE, EDNA",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346882305,"STEVENS, CELESTE, EDNA",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 , 154 , 205 ,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1346884533,"BULSARA, TUSHAR, PRADIP",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 18 , 39 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346886454,"MILLER, GREGORY, CHARLES",110 DENNIS DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629415914,NORTH CAROLINA GROUP SERVICES PLLC,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1346886454,"MILLER, GREGORY, CHARLES",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346886454,"MILLER, GREGORY, CHARLES",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1346886454,"MILLER, GREGORY, CHARLES",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 194 , 253 ,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1346886769,"PARMAR, POOJA, PANKAJ",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346886769,"PARMAR, POOJA, PANKAJ",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346886769,"PARMAR, POOJA, PANKAJ",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 48 , 87 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1346889649,"LIVOTI, REINALDO, ANTONIO",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1346889649,"LIVOTI, REINALDO, ANTONIO",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1346889649,"LIVOTI, REINALDO, ANTONIO",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346890779,"MOAJE, ELYNELLE JOY, HALLEGADO",102 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346890779,"MOAJE, ELYNELLE JOY, HALLEGADO",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 30 , 40 , 62 ,$#,,
MEDICAID DIRECT,1346893245,ALEGNA HOME CARE SERVICES LLC,,206 LAKE RD   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1346893245,ALEGNA HOME CARE SERVICES LLC,206 LAKE RD   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,688 "," 2,723 "," $208,993.35 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 705 , 706 ," $38,580.13 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 65 , 67 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1028 BLAIR ST STE 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",1028 BLAIR ST # 540N THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 299 , 304 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346893344,"LINDSAY, JOANNA, TERRY",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346893658,"NICHOLS, ZAKEYA, NEWTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346903648,"HOWELL, CHASSIDY, CAMPBELL",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,276 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346903648,"HOWELL, CHASSIDY, CAMPBELL",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 44 , 70 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346903648,"HOWELL, CHASSIDY, CAMPBELL",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 29 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346903648,"HOWELL, CHASSIDY, CAMPBELL",276 OLD MOCKSVILLE RD STE 105 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346904182,"JOHNSON, SHONTILLIOUS, DEVONIQUE",1814 WESTCHESTER DR STE 103 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 48 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346906286,"MERA, MARIA, FONT",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1346908498,"WALTERS, LINDSAY, JORDAN JAMES",6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 38 , 59 , 124 ,$#,,
MEDICAID DIRECT,1346917267,DONNIES COMPASSIONATE FAMILY CARE H,,3879 HODGES DAIRY RD   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1346917267,DONNIES COMPASSIONATE FAMILY CARE H,3879 HODGES DAIRY RD   YANCEYVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 672 , 672 ," $83,145.18 ",,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346918026,"STUTTS, BROOKE, TURNAMIAN",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346918026,"STUTTS, BROOKE, TURNAMIAN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1346918422,"AMMONS, SAMANTHA, CRAVEN",921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 34 , 46 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346921913,"ONTIVEROS, CAITLIN, MICHELLE",7210 VILLAGE MEDICAL CIR STE 310 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346932241,"SCHROEDER, BROOKE, NICOLE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346932241,"SCHROEDER, BROOKE, NICOLE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346932241,"SCHROEDER, BROOKE, NICOLE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 126 , 145 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346935905,"DEVANEY, CLAUDIA, SEABOLT",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346937430,"FURMAN, EMMA",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346937430,"FURMAN, EMMA",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 46 , 77 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346939212,"SIMPSON, KARA, MARIA",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346939212,"SIMPSON, KARA, MARIA",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1346940327,"DERMES, SARAH, SHAW",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 58 , 62 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1346940327,"DERMES, SARAH, SHAW",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 30 , 34 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346940707,"RISCH, SARAH, CHRISTINA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1346940707,"RISCH, SARAH, CHRISTINA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346945953,"OMEGA, JAIME JOAQUIN, ALIX",1540 SUNDAY DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 90 , 118 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346947843,"HILTON, SHEENA, BROOKE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1346948478,"HUNTER-ELDRIDGE, DIANA",2525 COURT DR   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346951209,"WILLIAMS, KAITLYN, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346953726,"SMITH, JAMES, DONTA",307 E WARDELL DR   PEMBROKE NC,078,Robeson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750348538,ROBESON HEALTH CARE CORPORATION,JULIAN T PIERCE HEALTH CENTER,307 E WARDELL DR   PEMBROKE NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346953726,"SMITH, JAMES, DONTA",307 E WARDELL DR   PEMBROKE NC,078,Robeson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346957099,"BUCHHOLZ, KELLY, MARIE",293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275596439,CAROLINA SPECIALTY CARE PA,CAROLINA SPECIALTY CARE PA,293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346957099,"BUCHHOLZ, KELLY, MARIE",293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 194 , 254 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346957099,"BUCHHOLZ, KELLY, MARIE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1346960671,"POZZUTO, MIRANDA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 11 , 11 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346960671,"POZZUTO, MIRANDA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1346960671,"POZZUTO, MIRANDA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1346961158,"PATE, OLIVIA, HERDER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346961158,"PATE, OLIVIA, HERDER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346961158,"PATE, OLIVIA, HERDER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346961158,"PATE, OLIVIA, HERDER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346961158,"PATE, OLIVIA, HERDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346961158,"PATE, OLIVIA, HERDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346961158,"PATE, OLIVIA, HERDER",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1346962180,"GAGNON, JESSICA, BARBARA",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346963097,"MARCIAL-HINCK, LESLIE ANN",1550 FAULK ST STE 3100 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 46 , 46 ,$#,,
MEDICAID DIRECT,1861274169,AFTER HOURS URGENT CARE CENTER PLLC,,9101 PINEVILLE MATTHEWS RD STE R PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346963097,"MARCIAL-HINCK, LESLIE ANN",1550 FAULK ST STE 3100 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 32 , 33 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1346963097,"MARCIAL-HINCK, LESLIE ANN",1550 FAULK ST STE 3100 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346963790,"BREWER, LESLIE, STEPHENS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1578219424,OPPORTUNITIES INDUSTRIALIZATION CEN,,2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346965324,"HASTY, TONYA, DENISE",2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346965324,"HASTY, TONYA, DENISE",2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1346967734,"HERNANDEZ, MARCELA",40 DUKE MEDICINE CIR # 1J DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 19 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346967734,"HERNANDEZ, MARCELA",40 DUKE MEDICINE CIR # 1J DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 31 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1346970142,"BUNTON, EMILY, SUZANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346970571,"LOEFFLER, GRACE, CATHERINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1346970571,"LOEFFLER, GRACE, CATHERINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 53 , 112 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,509 OLDE WATERFORD WAY STE 305 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1346971298,"SNOWTEN, ARRIAN, BAKER",509 OLDE WATERFORD WAY STE 305 BELVILLE NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1467763797,SOUTHMOUNTAIN CHILDREN AND FAMILY S,Southmountain Children and Family Services,81 W FORT ST   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1346971702,"JOLLY, CORRIE, ROSE",81 W FORT ST   MARION NC,059,McDowell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 14 , 13 , 40 ,$#,,
MEDICAID DIRECT,1467763797,SOUTHMOUNTAIN CHILDREN AND FAMILY S,Southmountain Children and Family Services,107 S JOHNSON ST   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1346971702,"JOLLY, CORRIE, ROSE",107 S JOHNSON ST   BREVARD NC,088,Transylvania,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 11 ,$#,,
MEDICAID DIRECT,1467763797,SOUTHMOUNTAIN CHILDREN AND FAMILY S,Southmountain Children and Family Services,49 ROCK WALL LN   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1346971702,"JOLLY, CORRIE, ROSE",49 ROCK WALL LN   BURNSVILLE NC,100,Yancey,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 33 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1346971843,"BUFF, SARAH, LIVSEY",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 168 , 189 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1346974037,"SHANER, AUBREY, GLENN",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538890793,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PIEDMONT MIDDLE,2970 S NEW HOPE RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346977188,"GIBSON, JASMINE, BROOKE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962097006,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR AFM,2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346977816,"WILLIAMS, LACEY, REBEKAH",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962097006,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR AFM,2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346977816,"WILLIAMS, LACEY, REBEKAH",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1962097006,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR AFM,2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1346977816,"WILLIAMS, LACEY, REBEKAH",136 S PARK ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346993664,LATITAS HELPING HANDS,~,2804 JASON DR   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1346993664,LATITAS HELPING HANDS,2804 JASON DR   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 766 , 766 ," $50,266.64 ",,
MEDICAID DIRECT,1871589762,ADVANCE COMMUNITY HEALTH INC,~,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1346994084,"NATHAN, JANE, LINDA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1346994084,"NATHAN, JANE, LINDA",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 41 , 117 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1346995206,"REED, SABRINA, STILES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 567 , 571 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346995206,"REED, SABRINA, STILES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 60 , 60 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1346995206,"REED, SABRINA, STILES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 339 , 341 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1346995206,"REED, SABRINA, STILES",78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 239 , 242 ,$#,,
MEDICAID DIRECT,1417914797,PARK AVENUE PEDIATRICS PA,PARK AVENUE PEDIATRICS PA,529 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1346996915,"VALLIANI, LAILA, GOWANI",529 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 21 , 86 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356000541,"HEINTZ, JULIE, LUCILLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356001937,"ECKERT, HANNAH, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1356002877,"DAVIS, CAROLINE, ANNE",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356002877,"DAVIS, CAROLINE, ANNE",1226 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 55 , 103 ,$#,,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356003693,"FREDERICK, DANIELA",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 17 , 29 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356004840,"HAMILTON, JENNIFER, LYNN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356004840,"HAMILTON, JENNIFER, LYNN",1035 LINCOLNTON RD STE E SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 116 , 252 ,$#,,
MEDICAID DIRECT,1407958226,EAGLE PHYSICIANS AND ASSOCIATES PA,~,301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356005979,"ORISCHAK, ALEXANDRA, JOSEPHINE",301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 28 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356008908,"CAMACHO STOKES, MIRIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356011373,"MCCURRY, BRAEDYN, ASHLEIGH",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356011373,"MCCURRY, BRAEDYN, ASHLEIGH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356012876,"CHRISTIE, BENJAMIN, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 39 , 55 , 60 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356015507,"BAYANAGARI, VISHNU, RAGHAVESG",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1356016497,"DICKSON, MACY, JOHNSON",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 112 , 165 ,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1356021679,"CHUKWU, ESTHER, OLUCHUKWU",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1356027890,"SAINIO, ERICA, MULLIS",181 DANIEL RD   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 135 , 204 , 288 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356030316,"LADUKE, CHANTAL, ALEIS",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1356030316,"LADUKE, CHANTAL, ALEIS",6030 W HIGHWAY 74 STE B INDIAN TRAIL NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356030316,"LADUKE, CHANTAL, ALEIS",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356030878,"MCGARITY, LINDSEY, ALLISON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1356030878,"MCGARITY, LINDSEY, ALLISON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356030878,"MCGARITY, LINDSEY, ALLISON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356031298,"BORREGO, KERRY, NYE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356031298,"BORREGO, KERRY, NYE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356031298,"BORREGO, KERRY, NYE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1356031298,"BORREGO, KERRY, NYE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 61 , 111 , 115 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356031298,"BORREGO, KERRY, NYE",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1356031298,"BORREGO, KERRY, NYE",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1356034441,"CRAWFORD, GABRIELLE, LEAH",8035 PROVIDENCE RD STE 320 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1356034441,"CRAWFORD, GABRIELLE, LEAH",1107 REYNOLDS ST   MONROE NC,090,Union,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1356040455,"DAVIS, NATALIE, DAWN",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356041420,"NWOSU, NKWACHIOMA, UGWUEZI",4720 TOMMANS TRL   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 59 , 470 , 477 ," $12,373.51 ",,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356058358,"WEAVIL, MIRANDA, JEAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356064638,ABUNDANT CARE HOMES LLC,,1009A E WEBB AVE   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356064638,ABUNDANT CARE HOMES LLC,1009A E WEBB AVE   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 231 , 231 ," $18,625.63 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356070031,"COBB, KATHERINE, VIRGINIA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 87 , 117 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356070031,"COBB, KATHERINE, VIRGINIA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1356072128,"WITTWER, LAUREN, HILLAM",1001 CRESCENT GRN   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 35 , 49 , 100 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1356072722,"CALLAHAN-COOLBAUGH, EILEEN, ANNE",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356073407,"COMEAU, NICHOLAS, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 44 , 63 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356073589,"SCOTT, TARENA, DANITRA",201 SAGE RD STE 200 CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1356075261,"LAYTON, GORDON, MITCHELL",15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 51 , 84 ,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1356075261,"LAYTON, GORDON, MITCHELL",15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356075352,"FOWLER, MALLI, KOTHAPALLI",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1356075352,"FOWLER, MALLI, KOTHAPALLI",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356075352,"FOWLER, MALLI, KOTHAPALLI",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 49 , 53 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356075352,"FOWLER, MALLI, KOTHAPALLI",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356075352,"FOWLER, MALLI, KOTHAPALLI",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356076749,"FRANTZ, HANNAH, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356079875,"THOMAS, MISTY, DANIELE",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 59 , 79 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356079875,"THOMAS, MISTY, DANIELE",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356079875,"THOMAS, MISTY, DANIELE",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 , 146 , 193 ,$#,,
MEDICAID DIRECT,1558308080,THE C W WILLIAMS COMMUNITY HEALTH C,~,5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356080055,"EBERHARDT, CAROLINE, MARIE",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356085906,"MULCAHY, SAMANTHA, JOAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356085906,"MULCAHY, SAMANTHA, JOAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356092316,"MICHAEL, ALEXANDRIA, DOMINICA",2280 HEMBY LN   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 44 , 50 ,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356092514,"CLARK, SARA, ANN LORI",935 STATE FARM RD   BOONE NC,095,Watauga,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,160 DEN MAC DR   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356092514,"CLARK, SARA, ANN LORI",935 STATE FARM RD   BOONE NC,095,Watauga,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356092514,"CLARK, SARA, ANN LORI",240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356092514,"CLARK, SARA, ANN LORI",448 CRANBERRY ST   NEWLAND NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1972842086,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356092829,"COGAR, BIANCA, CHRISTINE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356092829,"COGAR, BIANCA, CHRISTINE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 48 , 49 ,$#,,
MEDICAID DIRECT,1356097539,NANCYS HOME CARE OF THE CAROLINAS L,,1315 ASHLEYBROOK LN   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1356097539,NANCYS HOME CARE OF THE CAROLINAS L,1315 ASHLEYBROOK LN   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 62 ," 7,279 "," 7,286 "," $738,032.76 ",,
MEDICAID DIRECT,1356098818,GFC&S TRANSPORTATION LLC,,2500 REGENCY PKWY   CARY NC,092,Wake,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1356098818,GFC&S TRANSPORTATION LLC,2500 REGENCY PKWY   CARY NC,092,Wake,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 124 , 127 ,$#,,
MEDICAID DIRECT,1134293012,HANGER PROSTHETICS & ORTHOTICS EAST,,3031 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356103832,"GIANGRAVE, TYLER",3031 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356104038,"POMISH, JESSICA, LYNN",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356104038,"POMISH, JESSICA, LYNN",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1356106959,"FLYNN, CAROLINE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356107734,"ROCKEY, KEVIN, DANIEL",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1265703607,MCPHERSON FAMILY EYE CARE,MCPHERSON FAMILY EYE CARE,3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356108229,"RAHHAL, JEELAN, BASSAM",3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 24 , 54 ,$#,,
MEDICAID DIRECT,1356113799,HIGHLANDS SENIOR LIVING,,2270 OAKLAND RD   FOREST CITY NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356113799,HIGHLANDS SENIOR LIVING,2270 OAKLAND RD   FOREST CITY NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,452 "," 1,498 "," $112,753.63 ",,
MEDICAID DIRECT,1952359010,PRO PHYSICAL THERAPY INCORPORATED,PRO PHYSICAL THERAPY INCORPORATED,60 SHUFORD RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1356127005,"BROWDER, LANEY, KATHRYN-ANN",60 SHUFORD RD   COLUMBUS NC,075,Polk,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356129290,"ARCHER, CATHERINE, ANNE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356129290,"ARCHER, CATHERINE, ANNE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356129290,"ARCHER, CATHERINE, ANNE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 37 , 42 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1356129290,"ARCHER, CATHERINE, ANNE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1356129290,"ARCHER, CATHERINE, ANNE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356147318,HARMONY HOMES WITH PURPOSE LLC,,1806 KINGSTON RD   KINGSTOWN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356147318,HARMONY HOMES WITH PURPOSE LLC,1806 KINGSTON RD   KINGSTOWN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356160329,"JOHNSON, CLAUDETTE, ANTOINETTE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356160329,"JOHNSON, CLAUDETTE, ANTOINETTE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003687187,DLP WESTERN CAROLINA PHYSICIAN PRAC,HARRIS WOMENS CARE,70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356165831,"BARKER, ELIZABETH, ELLEN",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1356165831,"BARKER, ELIZABETH, ELLEN",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1457818262,HAMMOCK DMD & LOTAKIS DDS I PLLC,DENTISTRY OF THE CAROLINAS,6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356173967,"JEONG, ARIEL, HYEMIN",6708 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 397 , 464 ," 1,841 "," $93,118.72 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356176499,"GARCIA, JESSECA, MARIE",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356176499,"GARCIA, JESSECA, MARIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356176499,"GARCIA, JESSECA, MARIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356176499,"GARCIA, JESSECA, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356176499,"GARCIA, JESSECA, MARIE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356176499,"GARCIA, JESSECA, MARIE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356179329,"WOODSON, CASEY, DULIN",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 60 , 88 ,$#,,
MEDICAID DIRECT,1356180517,JACOBS BUSINESS VENTURES LLC,A LOYAL HOME CARE,925 S KERR AVE STE D3 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1356180517,JACOBS BUSINESS VENTURES LLC,925 S KERR AVE STE D3 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#, 307 , 307 ," $18,842.29 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356300057,"OMALLEY, GERALD, FRANCIS",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356300057,"OMALLEY, GERALD, FRANCIS",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356300057,"OMALLEY, GERALD, FRANCIS",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356300057,"OMALLEY, GERALD, FRANCIS",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881619740,COASTAL CAROLINA INTERNAL MED PA,~,2420 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1356301634,"ROS, JOSE IGNACIO, LARRABASTER",2420 HENDERSON DR   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 167 , 191 ,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356301691,"SPRATT, JOHN, ARTHUR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,, 96 , 121 , 280 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,188 MEDICAL PARK DR STE 7B BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,188 MEDICAL PARK DR STE 7B BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 38 , 146 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356304471,"CLAYTON, JANICE",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 63 , 133 ,$#,,
MEDICAID DIRECT,1689912792,METRO INTERNAL MEDICINE PA,~,3320 EXECUTIVE DR STE 222 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356304588,"HOLT, KENNETH, ALBERT",3320 EXECUTIVE DR STE 222 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1295012565,MED FIRST IMMEDIATE CARE AND FAMILY,Med First Immediate Care and Family Practice PA,325 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1356304810,"ULSTAD, RICHARD, DOUGLAS",2002 S GLENBURNIE RD STE 100 NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1356304810,"ULSTAD, RICHARD, DOUGLAS",2002 S GLENBURNIE RD STE 100 NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1356304810,"ULSTAD, RICHARD, DOUGLAS",2002 S GLENBURNIE RD STE 100 NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 189 , 378 , 831 ," $16,968.77 ",,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1356304968,"PARKER, SHERRI, LYNN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356304968,"PARKER, SHERRI, LYNN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356304968,"PARKER, SHERRI, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305676,"KIRBY, ALEX, RAY",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305676,"KIRBY, ALEX, RAY",2604 DR MARTIN LUTHER KING JR BLVD STE B NEW BERN NC,025,Craven,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305676,"KIRBY, ALEX, RAY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305676,"KIRBY, ALEX, RAY",1001 NEWMAN RD   NEW BERN NC,025,Craven,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305676,"KIRBY, ALEX, RAY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305833,"KIM, VICTOR, BANGSIK",960 NEWMAN RD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305833,"KIM, VICTOR, BANGSIK",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 21 , 36 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305833,"KIM, VICTOR, BANGSIK",2604 DR MARTIN LUTHER KING JR BLVD STE B NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305833,"KIM, VICTOR, BANGSIK",532 WEBB BLVD   HAVELOCK NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1356305833,"KIM, VICTOR, BANGSIK",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356305973,"CIRILLO, ROBERT, LOUIS",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356306922,"DAUBERT, HARLAN, BEAVER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356306922,"DAUBERT, HARLAN, BEAVER",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 26 , 35 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356306922,"DAUBERT, HARLAN, BEAVER",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 67 , 100 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356306922,"DAUBERT, HARLAN, BEAVER",445 PINEVIEW DR STE 220 KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1356308134,"BAKER JR, CHARLES, EDWIN",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 27 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356309710,"NICHOLS, KIMBERLEY, RENETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1356309884,"BRIGHT, DELLYSE, MAXINE",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356309884,"BRIGHT, DELLYSE, MAXINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356309884,"BRIGHT, DELLYSE, MAXINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 39 , 40 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356309884,"BRIGHT, DELLYSE, MAXINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356309884,"BRIGHT, DELLYSE, MAXINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 89 , 123 , 159 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356309884,"BRIGHT, DELLYSE, MAXINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356309884,"BRIGHT, DELLYSE, MAXINE",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083684898,ELKIN PEDIATRIC AND ADULT MEDICINE,ELKIN PEDIATRIC AND ADULT MEDICINE PA,124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1356311153,"CASTILLEJO, ALVARO, ANDRES",124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 79 , 166 ,$#,,
MEDICAID DIRECT,1356311534,SELECT HOME HEALTH CARE INC,ROTECH,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1356311534,SELECT HOME HEALTH CARE INC,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1356311534,SELECT HOME HEALTH CARE INC,ROTECH,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1356311534,SELECT HOME HEALTH CARE INC,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 140 , 698 ," 1,219 "," $21,966.47 ",,
MEDICAID DIRECT,1356311534,SELECT HOME HEALTH CARE INC,ROTECH,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356311534,SELECT HOME HEALTH CARE INC,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 111 , 279 , 489 ,$#,,
MEDICAID DIRECT,1356311534,SELECT HOME HEALTH CARE INC,ROTECH,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1356311534,SELECT HOME HEALTH CARE INC,1304 PATTON AVE STE C ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3125 SPRINGBANK LN STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356311575,"WARREN, DEBORAH, PARRY",3125 SPRINGBANK LN STE B CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356312664,"DOSHI, HIRENDRA, NAVINCHANDR",Hirendra Navinchandr Doshi,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1356312664,"DOSHI, HIRENDRA, NAVINCHANDR",2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356312664,"DOSHI, HIRENDRA, NAVINCHANDR",Hirendra Navinchandr Doshi,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,1356312664,"DOSHI, HIRENDRA, NAVINCHANDR",2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 50 , 55 ,$#,,
MEDICAID DIRECT,1417911322,TRIANGLE GASTROENTEROLOGY LLC,TRIANGLE GASTROENTEROLOGY LLC,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356312664,"DOSHI, HIRENDRA, NAVINCHANDR",2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 44 , 50 ,$#,,
MEDICAID DIRECT,1326028978,CHATUGE REGIONAL HOSPITAL INC,CHATUGE REGIONAL HOSPITAL,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356312847,"TURNER, SUZANNE, HENRY",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326028978,CHATUGE REGIONAL HOSPITAL INC,CHATUGE REGIONAL HOSPITAL,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356312847,"TURNER, SUZANNE, HENRY",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326028978,CHATUGE REGIONAL HOSPITAL INC,CHATUGE REGIONAL HOSPITAL,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356312847,"TURNER, SUZANNE, HENRY",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 24 , 32 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356314330,"GASIOR, KEVIN, BRIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356314330,"GASIOR, KEVIN, BRIAN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356314330,"GASIOR, KEVIN, BRIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356315113,"GIORDANO, KARIN, FRANCES",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356315113,"GIORDANO, KARIN, FRANCES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356315113,"GIORDANO, KARIN, FRANCES",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 33 , 94 , 94 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356315113,"GIORDANO, KARIN, FRANCES",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 28 , 28 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,14508 JAMES B WHITE HWY S   TABOR CITY NC,024,Columbus,193200000X,Group,Multi-Specialty,,1356315212,"MCCAULEY, CHRIS, STEPHEN",14508 JAMES B WHITE HWY S   TABOR CITY NC,024,Columbus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 47 , 68 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1356315212,"MCCAULEY, CHRIS, STEPHEN",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 16 , 19 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,14508 JAMES B WHITE HWY S   TABOR CITY NC,024,Columbus,193200000X,Group,Multi-Specialty,,1356315212,"MCCAULEY, CHRIS, STEPHEN",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 20 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356315279,"BARON, TODD, HUNTLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 43 , 53 , 101 ,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356315337,"NELSON, ROGER, FREDRICK",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356315337,"NELSON, ROGER, FREDRICK",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 212 , 234 , 234 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1356316335,"TAYLOR, RUTH, HELMS",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356316749,"HUMADI, SAHIRA ALI, AKBAR",825 FAIRFAX AVE STE 118 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356317325,"ELLIS, PAUL, TIMOTHY",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356317390,"FIORE, LOUIS, CHARLES",101 DELTA PARK DR   SHELBY NC,023,Cleveland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 148 , 249 , 390 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356317390,"FIORE, LOUIS, CHARLES",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1356318471,"HEMSTREET, JON, EMERSON",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356318471,"HEMSTREET, JON, EMERSON",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 110 , 110 ,$#,,
MEDICAID DIRECT,1356318562,CAROLINA HOME MEDICAL INC,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356318562,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1356318562,CAROLINA HOME MEDICAL INC,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1356318562,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 269 , 897 ," 1,515 "," $114,445.72 ",,
MEDICAID DIRECT,1356318562,CAROLINA HOME MEDICAL INC,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1356318562,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 187 ," 1,025 "," 1,207 "," $243,251.05 ",,
MEDICAID DIRECT,1356318562,CAROLINA HOME MEDICAL INC,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356318562,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 41 , 90 , 122 ,$#,,
MEDICAID DIRECT,1356318562,CAROLINA HOME MEDICAL INC,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,333300000X,Suppliers,Emergency Response System Companies,,1356318562,CAROLINA HOME MEDICAL INC,601 N 8TH ST STE C SMITHFIELD NC,051,Johnston,333300000X,Suppliers,Emergency Response System Companies,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356318828,"TALTON, ROBERT, KEVIN",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 28 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356318828,"TALTON, ROBERT, KEVIN",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 43 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356318828,"TALTON, ROBERT, KEVIN",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 31 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1356318828,"TALTON, ROBERT, KEVIN",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356318828,"TALTON, ROBERT, KEVIN",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 61 ,$#,,
MEDICAID DIRECT,1356319461,"MCLAUGHLIN, PATRICK",~,5056 HWY 70 W STE B MOREHEAD CITY NC,016,Carteret,111N00000X,Chiropractic Providers,Chiropractor,,1356319461,"MCLAUGHLIN, PATRICK",5056 HWY 70 W STE B MOREHEAD CITY NC,016,Carteret,111N00000X,Chiropractic Providers,Chiropractor,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356319933,"HOOVER, HUNTER, ASHLEY",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1356320535,"FINNEY, SEAN, DERRICK",3990 E US 64 ALT   MURPHY NC,020,Cherokee,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356320535,"FINNEY, SEAN, DERRICK",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356321095,"SHERRILL, THOMAS, MICHAEL",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356321095,"SHERRILL, THOMAS, MICHAEL",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 22 , 35 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356321350,"ROY, MICAH, JORDAN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,6237 CAROLINA COMMONS DR STE 110 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356323240,"MAJORS, ROY, ALAN",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356323257,"MASON, JOHN, BOHANNON",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356323406,"FLYE, CHRISTOPHER, WARREN",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 50 , 58 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356323406,"FLYE, CHRISTOPHER, WARREN",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 333 , 450 , 581 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356323406,"FLYE, CHRISTOPHER, WARREN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 58 , 65 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 41 , 100 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356323869,"RAMCHANDANI, GEETA, SUSHIL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1356324370,"GAGE, KELLY, DAVID",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 205 , 244 , 312 ,$#,,
MEDICAID DIRECT,1568407534,BROAD RIVER AREA MEDICAL AND AESTHE,~,245 OLD MAIN ST   CLIFFSIDE NC,081,Rutherford,193400000X,Group,Single Specialty,,1356324537,"GREEN, TIMOTHY, DARRELL",245 OLD MAIN ST   CLIFFSIDE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1649428194,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES,800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356324669,"PIENKOS, EDWARD, JOSEPH",800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1992284327,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH BREAST IMAGING CENTER LANGTREE,106 LANGTREE VILLAGE DR STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356324826,"ABINANTI, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356324826,"ABINANTI, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356324826,"ABINANTI, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356324826,"ABINANTI, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 148 , 158 , 219 ,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356324826,"ABINANTI, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356324826,"ABINANTI, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356324826,"ABINANTI, NICOLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356324982,"SLYMAN, JAMES, FRANCIS",2 HOSPITAL DR   LEXINGTON NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 84 , 105 , 121 ,$#,,
MEDICAID DIRECT,1669489225,DAVIDSON EYE ASSOCIATES PA,~,2 HOSPITAL DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1356324982,"SLYMAN, JAMES, FRANCIS",2 HOSPITAL DR   LEXINGTON NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 56 , 61 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356324982,"SLYMAN, JAMES, FRANCIS",2 HOSPITAL DR   LEXINGTON NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356325161,"LOSTETTER, STEPHEN, JOHN",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 162 , 171 , 201 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356325161,"LOSTETTER, STEPHEN, JOHN",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356325161,"LOSTETTER, STEPHEN, JOHN",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 129 , 138 , 172 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356325161,"LOSTETTER, STEPHEN, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 54 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356325351,"OSHEA, THOMAS, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1356325351,"OSHEA, THOMAS, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 33 , 42 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 47 , 60 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 37 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 27 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 174 , 194 , 261 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356325393,"CARSON, WILLIAM, FORREST",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 35 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1356325856,"KERR, JOHN, MCCLURE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 48 , 48 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356326177,"MILLER, SCOTT, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 46 , 50 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356326219,"WESTCOTT, CARL, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 55 , 60 ,$#,,
MEDICAID DIRECT,1356326607,"HEARN, PAUL, BRADFORD",Paul Bradford Hearn,16525 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,1356326607,"HEARN, PAUL, BRADFORD",16525 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 149 , 159 , 287 ,$#,,
MEDICAID DIRECT,1851566772,BRAD HEARN OD PA,~,16150 US HIGHWAY 17 STE A HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1356326607,"HEARN, PAUL, BRADFORD",16150 US HIGHWAY 17 STE A HAMPSTEAD NC,071,Pender,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356326607,"HEARN, PAUL, BRADFORD",Paul Bradford Hearn,16150 US HIGHWAY 17 STE A HAMPSTEAD NC,071,Pender,152W00000X,Eye and Vision Services Providers,Optometrist,,1356326607,"HEARN, PAUL, BRADFORD",16150 US HIGHWAY 17 STE A HAMPSTEAD NC,071,Pender,152W00000X,Eye and Vision Services Providers,Optometrist,, 116 , 127 , 230 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356326920,"CIACCIO, JOY, MARIE",116 3RD ST NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 109 , 323 , 336 ," $14,097.40 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1356326920,"CIACCIO, JOY, MARIE",116 3RD ST NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 474 , 480 ," $12,234.07 ",,
MEDICAID DIRECT,1013157171,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT WHITAKERS,105 SE RAILROAD ST   WHITAKERS NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356327233,"HUGHES, RONALD, EUGENE",105 NW RAILROAD ST   WHITAKERS NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356327944,"MARENICK, PAUL, NICKADEMUS",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1386723104,AARON MCKENNETH FRANCE MD,FRANCE MEDICAL CENTER,200 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1356329429,"FRANCE, AARON, MCKENNETH",200 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 70 , 89 ,$#,,
MEDICAID DIRECT,1356329841,"MCEACHERN, MONIQUE, DEON",MONIQUE DEON MCEACHERN,9916 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1356329841,"MCEACHERN, MONIQUE, DEON",9916 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 377 , 671 ," 2,937 "," $108,584.28 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356331409,"GOODRICH, STACEE, SHEETS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356331409,"GOODRICH, STACEE, SHEETS",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356331409,"GOODRICH, STACEE, SHEETS",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356331409,"GOODRICH, STACEE, SHEETS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,116 E HORTON ST   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1356332910,"RULE, CAROLEE, ANNE",116 E HORTON ST   ZEBULON NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356332910,"RULE, CAROLEE, ANNE",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 15 , 33 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356333827,"ALFORD, PETER, TYLER",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356333827,"ALFORD, PETER, TYLER",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356333827,"ALFORD, PETER, TYLER",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 15 , 21 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,2386 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356333827,"ALFORD, PETER, TYLER",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356334015,"MARCH, JUAN, ALBERTO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 89 , 95 , 101 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356335665,"HOBEN, MICHAEL, SKOW",1712 S STRATFORD RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356335665,"HOBEN, MICHAEL, SKOW",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356335665,"HOBEN, MICHAEL, SKOW",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427677624,NEW HOPE CLINIC INC,,201 W BOILING SPRING RD   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1356335939,"BOSTON, JAMES, EDWARD",201 W BOILING SPRING RD   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356335939,"BOSTON, JAMES, EDWARD",201 W BOILING SPRING RD   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356335988,"WANG, ERIC, ANTHONY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356335988,"WANG, ERIC, ANTHONY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 137 , 171 , 247 ," $10,810.75 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356335988,"WANG, ERIC, ANTHONY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 69 , 79 , 130 ,$#,,
MEDICAID DIRECT,1710051123,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH OCEANSIDE FAMILY MEDICINE AND CONVEN,5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1356336457,"THOMPSON, ANGELA, RENEE",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356336457,"THOMPSON, ANGELA, RENEE",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 242 , 566 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1356336457,"THOMPSON, ANGELA, RENEE",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#," $12,606.00 ",,
MEDICAID DIRECT,1154371763,WESTERN CAROLINA EAR NOSE THROAT SP,WESTERN CAROLINA EAR NOSE AND THROAT SPECIALISTS,63 HAYWOOD PARK DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1356336697,"WENZEL, CHRISTOPHER, TODD",63 HAYWOOD PARK DR   CLYDE NC,044,Haywood,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 53 , 71 , 96 ,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356337091,"FOLKS, JACQUELINE, DENISE",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 169 , 252 ,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356337166,"BRACK, LAURA, WILSON",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 27 , 42 , 65 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356337752,"TSAI, YIH-CHERNG, FRANKLIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 189 , 189 ,$#,,
MEDICAID DIRECT,1396431466,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY FAMILY CARE CENTER HILLSVILLE,702 PINE ST   HILLSVILLE VA,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356338016,"MENEZES, ROBERT, CHARLES",961 E STUART DR   GALAX VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356338131,"LIEBELT, ERICA, LYNN",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356339154,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER HEALTH SERVICES INC,4811 NC HWY 50   MAPLE HILL NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356339154,BLACK RIVER HEALTH SERVICES INC,4811 NC HWY 50   MAPLE HILL NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 12 , 42 , 42 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1356339618,"BYRD, RANDOLPH, COTTON",68 HOSPITAL RD STE 201 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 17 , 21 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1356339618,"BYRD, RANDOLPH, COTTON",68 HOSPITAL RD STE 201 SYLVA NC,050,Jackson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 25 , 29 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356339873,"JASZEWSKI, PAUL, KEVIN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356339873,"JASZEWSKI, PAUL, KEVIN",1585 FORNEY CREEK PKWY STE 110 DENVER NC,055,Lincoln,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356339873,"JASZEWSKI, PAUL, KEVIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356339873,"JASZEWSKI, PAUL, KEVIN",701 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1356340541,"ARNDER, LANCE, LEE",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1497755953,MID CAROLINA FAMILY MEDICINE PA,~,1038 ALBEMARLE RD   TROY NC,076,Randolph,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356341820,"BRITT, JANET, LEONE",1038 ALBEMARLE RD   TROY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 130 , 157 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356342893,"HIATT, PAUL, KEVIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1356342893,"HIATT, PAUL, KEVIN",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356342893,"HIATT, PAUL, KEVIN",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356342893,"HIATT, PAUL, KEVIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 673 , 804 ," 1,081 "," $15,050.30 ",,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356343016,"AROCHA, EMELINA, ACACIA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1356344030,"WYKER, ROBERT, TERLINCK",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356344030,"WYKER, ROBERT, TERLINCK",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 48 , 76 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356344030,"WYKER, ROBERT, TERLINCK",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 22 ,$#,,
MEDICAID DIRECT,1487684122,UNION COUNTY HOSPITAL AUTHORITY,UNION GENERAL HOSPITAL,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356344048,"CONNER, DANA, MCBRAYER",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 81 , 109 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356344105,"JARRETT, SAMUEL, DAVID",310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356344105,"JARRETT, SAMUEL, DAVID",34 GRANBY ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356344105,"JARRETT, SAMUEL, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356344105,"JARRETT, SAMUEL, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1821045071,STROUD CHIROPRACTIC PLLC,STROUD CHIROPRACTIC PLLC,3204 ARCHDALE RD   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1356344584,"STROUD JR, ROBERT, EUGENE",3204 ARCHDALE RD   ARCHDALE NC,076,Randolph,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356344642,"SCHRICKER, PAUL, OSKAR",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356344642,"SCHRICKER, PAUL, OSKAR",3701 WAKE FOREST RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 12 , 22 ,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1356344642,"SCHRICKER, PAUL, OSKAR",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356344964,"ROWELL, DIANE, LOUISE",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1356345615,"BRISLEY, JON, PHILIP",781 AVENT FERRY RD STE 202 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 17 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1356345615,"BRISLEY, JON, PHILIP",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356345615,"BRISLEY, JON, PHILIP",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 45 , 49 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1356345615,"BRISLEY, JON, PHILIP",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1356345615,"BRISLEY, JON, PHILIP",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 81 , 87 , 151 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356346688,"GRIFFIN, BETH, ALLISON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114919206,SKYLAND PROSTHETICS AND ORTHOTICS I,SKYLAND PROSTHETICS AND ORTHOTICS INC,3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356348742,"LAFOND, WILDER, KEITH",3845 HENDERSONVILLE RD   FLETCHER NC,045,Henderson,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356349435,"CHILDS, CARTER, JOHN HEARRING",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 28 , 55 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356349435,"CHILDS, CARTER, JOHN HEARRING",512 VILLAGE RD STE 101 SHALLOTTE NC,010,Brunswick,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 25 , 50 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356349435,"CHILDS, CARTER, JOHN HEARRING",1333 S DICKINSON DR   LELAND NC,010,Brunswick,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 45 , 66 , 129 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356349914,"BAKER, MATTHEW, GARRISON",101 E WT HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 28 , 33 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356349914,"BAKER, MATTHEW, GARRISON",101 E WT HARRIS BLVD STE 5201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 48 , 88 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356350227,"CHIEMPRABHA, ALAN, WAYNE",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356350227,"CHIEMPRABHA, ALAN, WAYNE",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 114 , 157 , 170 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356350490,"BISWAS, SUKANTO",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356350490,"BISWAS, SUKANTO",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356350490,"BISWAS, SUKANTO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 33 , 33 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356350490,"BISWAS, SUKANTO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 64 , 105 , 115 ," $16,431.65 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356350490,"BISWAS, SUKANTO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356350490,"BISWAS, SUKANTO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1356351399,"STOUT, ROBERT, WILLIAM",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 122 , 122 ,$#,,
MEDICAID DIRECT,1356351548,"PHAM, ALEX, HOA-DUC",~,414 S YORK ST LOWR LEVEL GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1356351548,"PHAM, ALEX, HOA-DUC",414 S YORK ST LOWR LEVEL GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 48 , 105 , 300 ," $29,800.18 ",,
MEDICAID DIRECT,1356351852,MORGANTON EYE PHYSICIANS PA,~,640 OAK ST   FOREST CITY NC,081,Rutherford,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1356351852,MORGANTON EYE PHYSICIANS PA,640 OAK ST   FOREST CITY NC,081,Rutherford,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 220 , 220 , 441 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356353379,"CEDARHOLM, JOHN, CARL",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356353379,"CEDARHOLM, JOHN, CARL",131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356353379,"CEDARHOLM, JOHN, CARL",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 21 , 27 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356355648,"VARANASI, JAYADEEP, SRINIVAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356355648,"VARANASI, JAYADEEP, SRINIVAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356355648,"VARANASI, JAYADEEP, SRINIVAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 30 , 38 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356355648,"VARANASI, JAYADEEP, SRINIVAS",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356355648,"VARANASI, JAYADEEP, SRINIVAS",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",1802 E MAIN ST LINCOLN LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",5717 ALBEMARLE RD 5717 ALBEMARLE ROAD CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",420 PARK ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356357073,"BRIDGES, ALLISON, GREENE",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356357156,"MENARD, MARY, KATHRYN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1356357156,"MENARD, MARY, KATHRYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356357156,"MENARD, MARY, KATHRYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 24 , 27 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356357156,"MENARD, MARY, KATHRYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1689427767,LONDRY MODLIN TUCKER IV DDS PLLC,CAROLINA KIDS DENTISTRY - BLAKENEY,9817 SUZANNE CT STE B WAXHAW NC,090,Union,193400000X,Group,Single Specialty,,1356359004,"MALLEY, BEVIN, KILEY",9817 SUZANNE CT STE B WAXHAW NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 15 , 15 , 59 ,$#,,
MEDICAID DIRECT,1689427767,LONDRY MODLIN TUCKER IV DDS PLLC,CAROLINA KIDS DENTISTRY - BLAKENEY,9817 SUZANNE CT STE B WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1356359004,"MALLEY, BEVIN, KILEY",9817 SUZANNE CT STE B WAXHAW NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 522 , 703 ," 2,653 "," $104,699.69 ",,
MEDICAID DIRECT,1164281275,LONDRY MODLIN TUCKER III DDS PLLC,CAROLINA KIDS DENTISTRY MINT HILL,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356359004,"MALLEY, BEVIN, KILEY",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 98 , 99 , 475 ," $27,985.65 ",,
MEDICAID DIRECT,1164281275,LONDRY MODLIN TUCKER III DDS PLLC,CAROLINA KIDS DENTISTRY MINT HILL,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356359004,"MALLEY, BEVIN, KILEY",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 36 ,$#,,
MEDICAID DIRECT,1023326287,BEVIN K MALLEY DDS PA,CAROLINA KIDS DENTISTRY,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356359004,"MALLEY, BEVIN, KILEY",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 268 , 289 ," 1,420 "," $75,038.49 ",,
MEDICAID DIRECT,1164281275,LONDRY MODLIN TUCKER III DDS PLLC,CAROLINA KIDS DENTISTRY MINT HILL,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356359004,"MALLEY, BEVIN, KILEY",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,455 "," 3,419 "," 15,584 "," $789,502.80 ",,
MEDICAID DIRECT,1023326287,BEVIN K MALLEY DDS PA,CAROLINA KIDS DENTISTRY,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356359004,"MALLEY, BEVIN, KILEY",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 32 ,$#,,
MEDICAID DIRECT,1164281275,LONDRY MODLIN TUCKER III DDS PLLC,CAROLINA KIDS DENTISTRY MINT HILL,5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356359004,"MALLEY, BEVIN, KILEY",5829 PHYLISS LN STE A MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 134 , 146 , 526 ," $23,665.75 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356360390,"WYATT, CHRISTINA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356360390,"WYATT, CHRISTINA, MARIE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 22 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356360390,"WYATT, CHRISTINA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356360457,"CLARK, SCOTT, KEVIN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356360457,"CLARK, SCOTT, KEVIN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1245585009,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE WAXHAW FAMILY MEDICINE,2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1356360739,"TOMCHO, PAIGE, EMILY",2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 48 , 87 ,$#,,
MEDICAID DIRECT,1356362305,SHARPCO INC,U SAVE IT PHARMACY FRANKLIN,20 FRANKLIN PLAZA DR   FRANKLIN NC,056,Macon,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356362305,SHARPCO INC,20 FRANKLIN PLAZA DR   FRANKLIN NC,056,Macon,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1356362446,DAVIDSON COUNTY PUBLIC SCHOOLS SUPE,DAVIDSON COUNTY SCHOOLS,250 COUNTY SCHOOL RD   LEXINGTON NC,029,Davidson,251300000X,Agencies,Local Education Agency (LEA),,1356362446,DAVIDSON COUNTY PUBLIC SCHOOLS SUPE,250 COUNTY SCHOOL RD   LEXINGTON NC,029,Davidson,251300000X,Agencies,Local Education Agency (LEA),, 857 ," 19,119 "," 19,436 "," $686,072.37 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356363089,"HARRIS, PEGGY, KISER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 20 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356363485,"GREGOLOFF, JANINE, LOUISE",124 WELTON WAY   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356364509,"WATKINS, FRANKLIN, SHIELDS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 15 , 50 , 54 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356364657,"MCIVER, JOHN, CHRISTENSEN",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 20 , 30 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356364657,"MCIVER, JOHN, CHRISTENSEN",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356364657,"MCIVER, JOHN, CHRISTENSEN",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356365480,"WYNN, RICHARD, THOMAS",9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 41 , 44 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356365480,"WYNN, RICHARD, THOMAS",2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356365480,"WYNN, RICHARD, THOMAS",6010 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 124 , 163 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356365480,"WYNN, RICHARD, THOMAS",6010 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356365480,"WYNN, RICHARD, THOMAS",10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 57 , 71 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356365480,"WYNN, RICHARD, THOMAS",6010 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 117 , 365 , 448 ," $17,870.87 ",,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356365480,"WYNN, RICHARD, THOMAS",10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 169 , 188 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356365480,"WYNN, RICHARD, THOMAS",10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356365480,"WYNN, RICHARD, THOMAS",824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356365878,"KNISH, EDWARD, JOHN",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356365878,"KNISH, EDWARD, JOHN",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 49 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356365878,"KNISH, EDWARD, JOHN",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1356365878,"KNISH, EDWARD, JOHN",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790809531,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - WEST,1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356367189,"FERARU, ELAINE, ROSE",1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 137 , 261 , 287 ," $18,127.66 ",,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367619,"PACICCO, THOMAS, JOHN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,,,Unknown,193200000X,Group,Multi-Specialty,,1356367619,"PACICCO, THOMAS, JOHN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367619,"PACICCO, THOMAS, JOHN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367619,"PACICCO, THOMAS, JOHN",1225 HARDING PL STE 5200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367619,"PACICCO, THOMAS, JOHN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367619,"PACICCO, THOMAS, JOHN",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367908,"BARRY, STUART, CHRISTOPHER",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367957,"CHERUVU, SRINIVAS",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356367957,"CHERUVU, SRINIVAS",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367957,"CHERUVU, SRINIVAS",2015 RANDOLPH RD STE 101&208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367957,"CHERUVU, SRINIVAS",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356367957,"CHERUVU, SRINIVAS",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 24 , 26 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356367957,"CHERUVU, SRINIVAS",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356367957,"CHERUVU, SRINIVAS",2015 RANDOLPH RD STE 101&208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356369151,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1767,4540 MAIN ST   SHALLOTTE NC,010,Brunswick,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1356369151,WAL-MART STORES EAST LP,4540 MAIN ST   SHALLOTTE NC,010,Brunswick,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356369979,"MILLER, JOEL, TODD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356370415,"SATTERFIELD, JAMISON, JEROME",3129 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 33 , 51 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356370894,"MASSEN, RICHARD, JODY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356370894,"MASSEN, RICHARD, JODY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356370894,"MASSEN, RICHARD, JODY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356370894,"MASSEN, RICHARD, JODY",1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356370894,"MASSEN, RICHARD, JODY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356371488,"BARRON, ANGELA, RENEE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 153 , 153 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356372072,"KLENOW, DAVID, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356372072,"KLENOW, DAVID, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356372833,"READE JR, ROBERT, ALEXANDER",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356372833,"READE JR, ROBERT, ALEXANDER",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356372833,"READE JR, ROBERT, ALEXANDER",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356374094,"MOHINDROO JR, KRISHAN, KUMAR",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356374219,"OBRIEN, PATRICK, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 145 , 501 ," 1,037 "," $283,836.22 ",,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356374219,"OBRIEN, PATRICK, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 132 , 540 , 804 ," $50,558.40 ",,
MEDICAID DIRECT,1356375273,SENTRY DRUG CENTER 11,SENTRY DRUG CENTER 11 INC,2622 E MAIN ST   LINCOLNTON NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356375273,SENTRY DRUG CENTER 11,2622 E MAIN ST   LINCOLNTON NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1356375273,SENTRY DRUG CENTER 11,SENTRY DRUG CENTER 11 INC,2622 E MAIN ST   LINCOLNTON NC,055,Lincoln,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1356375273,SENTRY DRUG CENTER 11,2622 E MAIN ST   LINCOLNTON NC,055,Lincoln,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1114116944,CAROLINA PSYCHIATRY PC,~,548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356376156,"RAHMAN, MIZANUR",548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356377840,"ASHE, ALLISON, RENEE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356377840,"ASHE, ALLISON, RENEE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356378152,"SUMMERS, AMY, ANN",4220 APEX HWY STE 160 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356378855,CASWELL COUNTY HEALTH DEPARTMENT,~,208 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,3416L0300X,Transportation Services,Ambulance,Land Transport,1356378855,CASWELL COUNTY HEALTH DEPARTMENT,208 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,3416L0300X,Transportation Services,Ambulance,Land Transport, 245 , 501 , 969 ," $12,203.85 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",935 N MAIN ST   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",1706 NC 39 HWY N   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",1706 NC 39 HWY N   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",1706 NC 39 HWY N   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",935 N MAIN ST   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",935 N MAIN ST   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",216 N BICKETT BLVD STE 5 LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356379358,"DAVID, EDELIZA, CALUB",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356380588,"MCHUGH, PETER, HOWARD",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 46 , 74 , 133 ,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356380588,"MCHUGH, PETER, HOWARD",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1356380778,OTWAY VOLUNTEER FIRE AND RESCUE DEP,~,509 HWY 70 E   BEAUFORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1356380778,OTWAY VOLUNTEER FIRE AND RESCUE DEP,509 HWY 70 E   BEAUFORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport, 11 , 14 , 26 ,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356382469,"KASSAM, NAHEED",927 BOSTON DR   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356382469,"KASSAM, NAHEED",302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356382469,"KASSAM, NAHEED",6910 FAYETTEVILLE RD STE 296 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356382469,"KASSAM, NAHEED",4351 THE CIRCLE AT NORTH HILLS ST STE 107 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356383947,"COBOS, FERNANDO, ANDRES",601 N ELM ST   HIGH POINT NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 27 , 53 , 53 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356386106,"WELBORN, REGGIE, NEIL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356386106,"WELBORN, REGGIE, NEIL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356386106,"WELBORN, REGGIE, NEIL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356386833,"SHELDON-MORRIS, TIFFINI, ANNE",190 KIMEL PARK DR STE 121 WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1487879177,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - KER,861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1356388540,"SMITH, LESLIE, RIERSON",861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 41 , 107 ,$#,,
MEDICAID DIRECT,1487879177,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - KER,861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356388540,"SMITH, LESLIE, RIERSON",861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356389340,"ALLEN, ANTOINETTE, ANN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356389340,"ALLEN, ANTOINETTE, ANN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356390314,"PYNES, SHELIA, JANE",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396702916,REHABILITATION MEDICINE SERVICES,REHABILITATION MEDICINE SERVICES,2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1356391940,"TAMADON, AFSHIN",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1396702916,REHABILITATION MEDICINE SERVICES,REHABILITATION MEDICINE SERVICES,1914 MEETING CT   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356391940,"TAMADON, AFSHIN",1914 MEETING CT   WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1891997334,EAST CAROLINA PSYCHIATRIC CONSULTAN,EAST CAROLINA PSYCHIATRIC CONSULTANTS PLLC,916 ELEVENTH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1356394050,"SABANAYAGAM, MUTHIAH, KRISHNASAMY",916 ELEVENTH ST   GOLDSBORO NC,096,Wayne,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 18 , 87 , 99 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1356395453,"CHAMBERLAIN, SCOTT, MITCHELL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 148 , 164 , 200 ," $13,882.78 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356395628,"HABASHI, NEVEEN, MAHER",201 E GROVER ST   SHELBY NC,023,Cleveland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356395628,"HABASHI, NEVEEN, MAHER",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 15 , 19 ,$#,,
MEDICAID DIRECT,1265486534,CAROLINA PULMONARY & CRITICAL CARE,~,501 N ASPEN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1356395628,"HABASHI, NEVEEN, MAHER",501 N ASPEN ST   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356395628,"HABASHI, NEVEEN, MAHER",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356395628,"HABASHI, NEVEEN, MAHER",~,501 N ASPEN ST   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1356395628,"HABASHI, NEVEEN, MAHER",501 N ASPEN ST   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 33 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356397624,"RUSSELL, JAMIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1356397624,"RUSSELL, JAMIE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 31 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1356397798,"HATCHER, WALTER, BENJAMIN",3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 78 , 80 , 113 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356397798,"HATCHER, WALTER, BENJAMIN",3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 305 , 317 , 435 ," $23,583.40 ",,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1356398432,"SHIDHAYE, NAMRATA, MADHAV",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356398432,"SHIDHAYE, NAMRATA, MADHAV",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356398432,"SHIDHAYE, NAMRATA, MADHAV",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962560284,BACK 2 BACK CHIROPRACTIC GROUP LLC,BACK 2 BACK CHIROPRACTIC,206 JOE KNOX AVE STE C MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1356400253,"UHRICH, CURTIS, JAY",206 JOE V KNOX AVE STE C MOORESVILLE NC,049,Iredell,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1356400402,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07054,4300 HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1356400402,NORTH CAROLINA CVS PHARMACY LLC,4300 HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1356400402,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07054,4300 HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1356400402,NORTH CAROLINA CVS PHARMACY LLC,4300 HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356401558,"DAVIS, GREGORY, BRANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356401558,"DAVIS, GREGORY, BRANT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356401558,"DAVIS, GREGORY, BRANT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356401558,"DAVIS, GREGORY, BRANT",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 36 , 44 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356401558,"DAVIS, GREGORY, BRANT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356401558,"DAVIS, GREGORY, BRANT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356401558,"DAVIS, GREGORY, BRANT",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356401558,"DAVIS, GREGORY, BRANT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 74 , 75 , 83 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1356401558,"DAVIS, GREGORY, BRANT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356401558,"DAVIS, GREGORY, BRANT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356401574,"GRAHAM, GREGG, TRAVIS",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 79 , 131 ,$#,,
MEDICAID DIRECT,1457836413,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - CLAREMONT,3114 W MAIN ST   CLAREMONT NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356401749,"GORDON, CECILIA, BERNADETTE",212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518439546,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - BETHLEHEM,174 BOLICK LN STE 202 TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1356401749,"GORDON, CECILIA, BERNADETTE",212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356401988,"PALMER, CARRIE, FARR",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356401988,"PALMER, CARRIE, FARR",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356401988,"PALMER, CARRIE, FARR",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356402135,"COFFEY, JAROD, MATTHEW",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356402135,"COFFEY, JAROD, MATTHEW",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 17 , 39 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356404123,"IZATT, SUSAN, DIANE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356404123,"IZATT, SUSAN, DIANE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356404131,"TURI, JENNIFER, LILLY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356404727,LINCARE INC,~,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356404727,LINCARE INC,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1356404727,LINCARE INC,~,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1356404727,LINCARE INC,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1356404727,LINCARE INC,~,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1356404727,LINCARE INC,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 342 ," 1,523 "," 2,530 "," $52,001.15 ",,
MEDICAID DIRECT,1356404727,LINCARE INC,~,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1356404727,LINCARE INC,1262 25TH STREET PL SE   HICKORY NC,018,Catawba,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356404768,"MILLER, HOWARD, EDWARD",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 57 , 102 , 228 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1356404768,"MILLER, HOWARD, EDWARD",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 19 , 57 ,$#,,
MEDICAID DIRECT,1356405005,PISGAH PHYSICAL THERAPY AND SPORTS,PISGAH PHYSICAL THERAPY AND SPORTS REHAB,1635 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1356405005,PISGAH PHYSICAL THERAPY AND SPORTS,1635 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,#,#, 22 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356405955,"PRINCE, MARY, WILLIAMS",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356405955,"PRINCE, MARY, WILLIAMS",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356405963,"MARGARIAN-NAMI, LILIT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 98 , 98 ,$#,,
MEDICAID DIRECT,1356407217,SOUTHERN ASSISTED LIVING INC,BROOKDALE REYNOLDA ROAD,2980 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356407217,SOUTHERN ASSISTED LIVING INC,2980 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 365 , 365 ," $16,647.28 ",,
MEDICAID DIRECT,1184797235,WILSON FAMILY PRACTICE CENTER,WILSON FAMILY PRACTICE CENTER,4008 NC HIGHWAY 42 W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1356408207,"SIGMON, JAMES, GREGG",4008 NC HIGHWAY 42 W   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 68 , 185 ,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356409858,"DEFRANK, CHERYL, HERNDON",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 30 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356411078,"CARSON, SHANNON, STEWART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356411078,"CARSON, SHANNON, STEWART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 44 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356411078,"CARSON, SHANNON, STEWART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 43 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356411078,"CARSON, SHANNON, STEWART",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356411300,"KNIGHT, MARVIN, EUGENE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356411300,"KNIGHT, MARVIN, EUGENE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356411300,"KNIGHT, MARVIN, EUGENE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356411300,"KNIGHT, MARVIN, EUGENE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1356411797,FAIRVIEW ASSISTED LIVING INC,FAIRVIEW ASSISTED LIVING INC,114 FAIRVIEW RD   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356411797,FAIRVIEW ASSISTED LIVING INC,114 FAIRVIEW RD   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,575 "," 1,575 "," $123,052.92 ",,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,524 S MAIN ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,524 S MAIN ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 78 , 286 , 349 ," $45,489.86 ",,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 91 , 294 , 347 ," $57,764.34 ",,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",524 S MAIN ST   KING NC,085,Stokes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,524 S MAIN ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1356420467,"CHERMAK, DAVID, STEPHEN",524 S MAIN ST   KING NC,085,Stokes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 86 , 313 , 423 ," $64,484.38 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356420954,"LEWIS, KRISTIE, MILLER",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,110 DENNIS DR   SANFORD NC,053,Lee,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1356421853,PINEHURST MEDICAL CLINIC INC,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,,,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1356421853,PINEHURST MEDICAL CLINIC INC,205 PAGE RD   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 21 ,,,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,,,Unknown,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1356421853,PINEHURST MEDICAL CLINIC INC,205 PAGE RD   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 39 ,,,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,110 DENNIS DR   SANFORD NC,053,Lee,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1356421853,PINEHURST MEDICAL CLINIC INC,205 PAGE RD   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,,,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1356421853,PINEHURST MEDICAL CLINIC INC,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 300 , 259 , 410 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356423768,"KOTORA, JOSEPH, GUY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1356425235,"RYAN, THOMAS, JOHN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356425235,"RYAN, THOMAS, JOHN",3475 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356425235,"RYAN, THOMAS, JOHN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356425235,"RYAN, THOMAS, JOHN",3475 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 19 , 32 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356425243,"PICKETT, LISA, CLARK",3116 N DUKE ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 22 , 24 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356425243,"PICKETT, LISA, CLARK",3116 N DUKE ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 27 , 34 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356425243,"PICKETT, LISA, CLARK",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1346422185,ADVANCED PAIN CONSULTANTS,~,3200 BLUE RIDGE RD STE 216 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356425268,"PASI, SONIA, NIYYAR",3200 BLUE RIDGE RD STE 216 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 20 , 112 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356425276,"ROGERS, LESCO, LLOYD",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356425417,"HODGINS, LEWIS, ROGER",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1356426548,"PALERMO, JAMES, ANTHONY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 31 , 39 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356426548,"PALERMO, JAMES, ANTHONY",373 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 39 , 45 ,$#,,
MEDICAID DIRECT,1699006858,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GENERAL SURGERY LINCOLN,441 MCALISTER RD STE 2100 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356429674,"JACKSON, LASANDRA, DENISE",441 MCALISTER RD STE 2100 LINCOLNTON NC,055,Lincoln,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356430607,"PHILIP, SHIBU",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356430813,"BAKER, CHERYL, ANN",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356430813,"BAKER, CHERYL, ANN",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356430813,"BAKER, CHERYL, ANN",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 67 , 110 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356431290,"REDDY, MICHAEL, JOSEPH",201 E GROVER ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 37 , 37 ,$#,,
MEDICAID DIRECT,1457169914,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1356432280,"BRAGG, PAUL, L",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720080070,CAPE FEAR NEUROSURGERY,CAPE FEAR NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1356432280,"BRAGG, PAUL, L",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 31 , 34 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1356432561,"COOK, ROBERT, MATTHEW",50 HOSPITAL DR STE 1C HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 34 , 37 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1356432561,"COOK, ROBERT, MATTHEW",50 HOSPITAL DR STE 1C HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 23 , 26 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1356435465,"STRINGFIELD, JOHN, WILLIAM",1272 EAST ST   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356435465,"STRINGFIELD, JOHN, WILLIAM",1272 EAST ST   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 63 , 63 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1356435465,"STRINGFIELD, JOHN, WILLIAM",1272 EAST ST   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356435465,"STRINGFIELD, JOHN, WILLIAM",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467149823,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH EMERGENCY PHYSICIANS,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1356436083,"OSBORNE, JODY, NEIL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 185 , 225 , 318 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356437651,"LEITHE, LINDA, GRAY",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356437651,"LEITHE, LINDA, GRAY",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356437651,"LEITHE, LINDA, GRAY",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356438998,"RUCH, DAVID, SIMMS",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 16 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1356438998,"RUCH, DAVID, SIMMS",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1356438998,"RUCH, DAVID, SIMMS",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356438998,"RUCH, DAVID, SIMMS",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356438998,"RUCH, DAVID, SIMMS",3116 N DUKE ST   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356439814,DELABY BRACE AND LIMB CO,Delaby Brace and Limb Co,218 LISBON ST   CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356439814,DELABY BRACE AND LIMB CO,218 LISBON ST   CLINTON NC,082,Sampson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 24 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356440028,"THIELEN, THOMAS, EDWARD",300 BETHESDA DR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 13 , 27 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356440028,"THIELEN, THOMAS, EDWARD",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 16 , 28 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356440028,"THIELEN, THOMAS, EDWARD",3444 S CONTENTNEA ST   FARMVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356440069,"MCKINNON, STUART, JAMES",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 43 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356440069,"MCKINNON, STUART, JAMES",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 89 , 141 , 249 ," $10,650.24 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 191 , 203 , 248 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 32 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 38 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356440481,"RUHLAND, JESSICA, MARIE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1356440853,"STAHLKUPPE, ROBERT, FRANK",56 HOSPITAL ST   HIAWASSEE GA,101,Out of State <= 40 miles,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1356440853,"STAHLKUPPE, ROBERT, FRANK",56 HOSPITAL ST   HIAWASSEE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1285706879,HIAWASSEE FAMILY PRACTICE,,56 HOSPITAL ST   HIAWASSEE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356440853,"STAHLKUPPE, ROBERT, FRANK",56 HOSPITAL ST   HIAWASSEE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 49 , 83 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356442198,"SHEA, GREGORY, FRANCIS",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356442198,"SHEA, GREGORY, FRANCIS",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 55 , 117 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356442198,"SHEA, GREGORY, FRANCIS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356442941,"VELAZQUEZ, LYZETTE, EILEEN",600 GRESHAM DR STE 8610 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1356444053,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03711,4700 PIEDMONT PKWY   JAMESTOWN NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1356444053,NORTH CAROLINA CVS PHARMACY LLC,4700 PIEDMONT PKWY   JAMESTOWN NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1356444129,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03853,2344 S CHURCH ST   BURLINGTON NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1356444129,NORTH CAROLINA CVS PHARMACY LLC,2344 S CHURCH ST   BURLINGTON NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1356445027,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02562,115 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356445027,NORTH CAROLINA CVS PHARMACY LLC,115 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1356445027,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02562,115 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1356445027,NORTH CAROLINA CVS PHARMACY LLC,115 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1356445761,"BEAVER, ANNE, CORINNE",965 STATE FARM RD   BOONE NC,095,Watauga,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 36 , 56 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1356447478,"INGOLD, LAURA, RAY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356448294,THOMAS DRUG STORE,THOMAS DRUG STORE,609 E CUMBERLAND ST   DUNN NC,043,Harnett,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1356448294,THOMAS DRUG STORE,609 E CUMBERLAND ST   DUNN NC,043,Harnett,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356449946,"REOTT, MICHAEL, ANDREW",525 N TRYON ST STE 1600 PMB 209 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 895 , 977 ," 5,223 "," $140,316.32 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356452577,"MEYERS, KAREN, VENERI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356452577,"MEYERS, KAREN, VENERI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356452767,"METCALF, SUSAN, WARMACK",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1356456974,"ROSE, MONICA, WYNETTE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356456974,"ROSE, MONICA, WYNETTE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356456974,"ROSE, MONICA, WYNETTE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356456974,"ROSE, MONICA, WYNETTE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447456587,CHRISTOPHER K ANENE DMD ASSOC,CHRISTOPHER K ANENE DMD & ASSOC,3607 WHITEHALL PARK DR STE 1000 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356457428,"ANENE, CHRISTOPHER, KANAYO",3607 WHITEHALL PARK DR STE 1000 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 79 , 165 , 391 ," $19,072.99 ",,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356458194,"FOLSOM, SCOTT, ALAN",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356458194,"FOLSOM, SCOTT, ALAN",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1700650371,LONDRY MODLIN TUCKER II DDS PLLC,DASH CITY PEDIATRIC AND ADULT DENTISTRY,705 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356458194,"FOLSOM, SCOTT, ALAN",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1356462071,TRANSYLVANIA COUNTY SCHOOLS,~,225 ROSENWALD LN   BREVARD NC,088,Transylvania,251300000X,Agencies,Local Education Agency (LEA),,1356462071,TRANSYLVANIA COUNTY SCHOOLS,225 ROSENWALD LN   BREVARD NC,088,Transylvania,251300000X,Agencies,Local Education Agency (LEA),, 232 ," 4,566 "," 4,727 "," $205,878.02 ",,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1356462287,"WILLIAMS, DANIEL, MARK",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 180 , 316 , 465 ," $21,415.76 ",,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,509 N ELAM AVE STE 300-D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356464846,"CANNON, JENNIFER",509 N ELAM AVE STE 300-D GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 72 , 343 , 590 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1356464846,"CANNON, JENNIFER",509 N ELAM AVE STE 300-D GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 136 , 277 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356465611,"KRASNOKUTSKY, MICHAEL, VLADIMIR",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 350 , 379 , 493 ," $14,353.56 ",,
MEDICAID DIRECT,1568643583,CAROMONT MEDICAL GROUP INC,INFECTIOUS DISEASE ASSOCIATES,2555 COURT DR STE 350 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1356469555,"NADKARNI, ABHIJEET, SHRIPAD",2555 COURT DR STE 350 GASTONIA NC,036,Gaston,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 61 , 174 , 174 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356469951,"RUDD, KAREN, JEAN",931 3RD ST   GREENSBORO NC,041,Guilford,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1356470173,KINGS MOUNTAIN CARE CENTER INC,,115 FERGUSON DR   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356470173,KINGS MOUNTAIN CARE CENTER INC,115 FERGUSON DR   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 17 ," 1,465 "," 1,465 "," $140,191.12 ",,
MEDICAID DIRECT,1871589762,ADVANCE COMMUNITY HEALTH INC,~,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356471007,"FEOLE, GLENN, LOUIS",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 37 , 40 ," $17,211.15 ",,
MEDICAID DIRECT,1518207216,ONSLOW AMBULATORY SERVICES INC,ONSLOW PULMONOLOGY ASSOCIATES,237 WHITE ST STE 1 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1356471767,"BARTHOLOMEW, ANN, REBECCA",237 OLD WHITE ST # 1 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 40 , 45 ,$#,,
MEDICAID DIRECT,1740562875,ONSLOW AMBULATORY SERVICES INC,ONSLOW EAR NOSE & THROAT,55 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1356471767,"BARTHOLOMEW, ANN, REBECCA",237 OLD WHITE ST # 1 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356473870,"FOX, SEAN, MARTIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 75 , 75 , 101 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356474274,"KOLLS, BRADLEY",40 DUKE MEDICINE CIRCLE CLINIC 2M DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 73 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356474274,"KOLLS, BRADLEY",2100 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 96 , 107 ," $10,342.61 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356474274,"KOLLS, BRADLEY",40 DUKE MEDICINE CIRCLE CLINIC 2M DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356474274,"KOLLS, BRADLEY",2100 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356474274,"KOLLS, BRADLEY",40 DUKE MEDICINE CIRCLE CLINIC 2M DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356476303,"STEPP, KEVIN, JAMES EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356476303,"STEPP, KEVIN, JAMES EDWARD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356476303,"STEPP, KEVIN, JAMES EDWARD",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356476303,"STEPP, KEVIN, JAMES EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356477525,"NARAYAN, ADITEE, ASHOK PRADHAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356477525,"NARAYAN, ADITEE, ASHOK PRADHAN",3116 N DUKE ST   DURHAM NC,032,Durham,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1114466802,DLP FRYE MEDICAL GROUP,FRYECARE GENERATIONS FAMILY MEDICINE,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356479828,"SMITH, AILISA, HIPP",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 191 , 254 ,$#,,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,," 1,679 "," 12,356 "," 13,373 "," $988,905.89 ",,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 986 ," 10,885 "," 11,683 "," $867,246.81 ",,
MEDICAID DIRECT,1679798029,NC DHHS CHILD AND FAMILY WELL-BEING,SHELBY CDSA,1429 E MARION ST STE 5 SHELBY NC,023,Cleveland,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 693 ," 6,409 "," 6,564 "," $473,797.38 ",,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 415 , 698 , 713 ," $40,867.92 ",,
MEDICAID DIRECT,1902020308,NC DHHS CHILD AND FAMILY WELL-BEING,DURHAM CDSA,115 MARKET ST STE 201 DURHAM NC,032,Durham,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,," 1,389 "," 7,772 "," 7,893 "," $410,937.56 ",,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,," 1,815 "," 11,622 "," 12,512 "," $750,791.43 ",,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,," 1,354 "," 8,677 "," 9,437 "," $628,517.03 ",,
MEDICAID DIRECT,1801011242,NC DHHS CHILD AND FAMILY WELL-BEING,SANDHILLS CHILDRENS DEVELOPMENTAL,95 TROTTER HILLS CIR   PINEHURST NC,063,Moore,252Y00000X,Agencies,Early Intervention Provider Agency,,1356482640,"MATTSON, GERRI, LYNN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 925 ," 9,741 "," 10,036 "," $550,110.05 ",,
MEDICAID DIRECT,1285808469,JOHN L CLONINGER III DDS PLLC,~,904 DONTIA DR   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356483739,"CLONINGER, JOHN, LESTER",904 DONTIA DR   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 59 , 105 , 247 ," $15,431.02 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356484232,"CASE, KIMBERLY, ANNE",125 QUEENS RD STE 510 CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 14 , 32 , 32 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356484232,"CASE, KIMBERLY, ANNE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356484232,"CASE, KIMBERLY, ANNE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356484232,"CASE, KIMBERLY, ANNE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356484232,"CASE, KIMBERLY, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 33 , 93 , 97 ,$#,,
MEDICAID DIRECT,1356484612,WAYNE COUNTY REST VILLA NO,WAYNE COUNTY REST VILLA NO 2,305 S VANCE ST   FREMONT NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356484612,WAYNE COUNTY REST VILLA NO,305 S VANCE ST   FREMONT NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,898 "," 2,898 "," $181,669.56 ",,
MEDICAID DIRECT,1356489496,SPRINGVIEW SENIOR LIVING INC,SPRINGVIEW ROSS BUILDING,1032B N MEBANE ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356489496,SPRINGVIEW SENIOR LIVING INC,1032B N MEBANE ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 13 ," 2,787 "," 2,793 "," $268,937.29 ",,
MEDICAID DIRECT,1356489835,"SPRUILL JR, JOSEPH, MILTON",~,107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1356489835,"SPRUILL JR, JOSEPH, MILTON",107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306986278,COMMUNITY FAMILY PRACTICE PHYSICIAN,COMMUNITY FAMILY PRACTICE PHYSICIANS PA,107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1356489835,"SPRUILL JR, JOSEPH, MILTON",107 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 145 , 204 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356493944,"SHI, CHANJUAN",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 65 , 70 , 95 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356493944,"SHI, CHANJUAN",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356493944,"SHI, CHANJUAN",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 18 , 26 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356495949,"GRUNWALD, MICHAEL, RICHARD",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356495949,"GRUNWALD, MICHAEL, RICHARD",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356497945,"FLETT, KELLY, BURKE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 37 , 60 ,$#,,
MEDICAID DIRECT,1356499065,INTERIM HEALTHCARE OF THE EASTERN C,INTERIM HEALTHCARE,140 CINEMA DR STE E WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1356499065,INTERIM HEALTHCARE OF THE EASTERN C,140 CINEMA DR STE E WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#, 655 , 655 ," $38,179.76 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356500516,"UDO, MFON, NSE",200 PERIMETER PARK DR STE C MORRISVILLE NC,092,Wake,207ZC0500X,Allopathic & Osteopathic Physicians,Pathology,Cytopathology,#,#,#,$#,,
MEDICAID DIRECT,1083779797,COUNTY OF BLADEN OFFICE OF AUDITOR,BLADEN CO HEALTH DEPT,300 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1356500763,"BUTLER, CAROL, RICH",300 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 33 , 86 ,$#,,
MEDICAID DIRECT,1356502041,"CALL, KASEY, LAWRENCE",K LAWRENCE CALL DMD PLLC,516 NEW MARKET BLVD STE 3 BOONE NC,095,Watauga,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1356502041,"CALL, KASEY, LAWRENCE",516 NEW MARKET BLVD STE 3 BOONE NC,095,Watauga,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 111 , 163 , 459 ," $64,462.72 ",,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1356504765,"ALBRIGHT, TRAVIS, PATRICK",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 82 , 87 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356505424,"HABASHY, CATHERINE, HANY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356505424,"HABASHY, CATHERINE, HANY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 40 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356505424,"HABASHY, CATHERINE, HANY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1487782942,PEACHTREE PEDIATRICS PLLC,PEACHTREE PEDIATRICS PLLC,125 MEDICAL PARK LN STE F MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1356505945,"SWAIN, PAMELA, GRAHAM",125 MEDICAL PARK LN STE F MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 , 136 , 354 ," $12,326.88 ",,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",111 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 21 , 32 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 129 , 156 , 232 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356507230,"BRIGGS, CHARLES, SAMUEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 40 , 49 , 134 ," $11,553.23 ",,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356507644,"NABIZADEH, REZA",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 54 , 68 , 72 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356507644,"NABIZADEH, REZA",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 15 , 18 , 20 ,$#,,
MEDICAID DIRECT,1245745587,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PRIMARY CARE - ERWIN,518 E H ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1356508360,"BROWN, CARLA, HAMILTON",518 E H ST   ERWIN NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 79 , 255 , 390 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356509038,"OTTO, TARA, MARIE",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1356509947,"PANKONIN, MARK, STEVEN",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1356509947,"PANKONIN, MARK, STEVEN",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 24 , 26 , 28 ,$#,,
MEDICAID DIRECT,1356510945,ABILITATIONS CHILDRENS THERAPY AND,~,801 CASCADE POINTE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356510945,ABILITATIONS CHILDRENS THERAPY AND,801 CASCADE POINTE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 24 , 315 , 415 ," $25,666.64 ",,
MEDICAID DIRECT,1356510945,ABILITATIONS CHILDRENS THERAPY AND,~,11030 RAVEN RIDGE RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356510945,ABILITATIONS CHILDRENS THERAPY AND,11030 RAVEN RIDGE RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 96 ," 1,411 "," 1,918 "," $115,114.97 ",,
MEDICAID DIRECT,1356510945,ABILITATIONS CHILDRENS THERAPY AND,~,6845 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356510945,ABILITATIONS CHILDRENS THERAPY AND,6845 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,, 75 ," 1,217 "," 1,690 "," $106,964.11 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 17 , 20 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",2225 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 20 , 31 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",1718 E 4TH ST STE 207 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",1718 E 4TH ST STE 207 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 23 , 23 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 54 , 97 ,$#,,
MEDICAID DIRECT,1962048512,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH DIABETES & NUTRITION,1400 WESTGATE CENTER DR STE 110 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",1400 WESTGATE CENTER DR STE 110 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356511216,"CROWDER, SAKEITHA, L TIA",1400 WESTGATE CENTER DR STE 110 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 13 , 14 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356513253,"MASON, PHILLIP, ROSS",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356513253,"MASON, PHILLIP, ROSS",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 104 , 157 , 319 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356513253,"MASON, PHILLIP, ROSS",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356515142,"MARYCZ, DAMIEN, MAXFIELD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 29 , 31 , 50 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356515142,"MARYCZ, DAMIEN, MAXFIELD",505 OBERLIN RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356515142,"MARYCZ, DAMIEN, MAXFIELD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 33 , 44 , 59 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356515142,"MARYCZ, DAMIEN, MAXFIELD",505 OBERLIN RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 12 , 18 , 27 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356515142,"MARYCZ, DAMIEN, MAXFIELD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356515142,"MARYCZ, DAMIEN, MAXFIELD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356515233,"PAPALAS III, JOHN, ANTHONY",420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 125 , 151 , 190 ,$#,,
MEDICAID DIRECT,1124733860,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH AUDIOLOGY,6324 FAIRVIEW RD STE 202 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1356516033,"BLACKWELL, STACI, GAYLE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1356516033,"BLACKWELL, STACI, GAYLE",6324 FAIRVIEW RD STE 202 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1356516033,"BLACKWELL, STACI, GAYLE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356516033,"BLACKWELL, STACI, GAYLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356517692,"MARTIN, JERMELIAH, MONIQUE TODD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 33 , 33 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356519706,"SMITH, ERNEST, TERRILL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356519706,"SMITH, ERNEST, TERRILL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 306 , 700 ," 1,275 "," $35,936.64 ",,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356519706,"SMITH, ERNEST, TERRILL",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356519706,"SMITH, ERNEST, TERRILL",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356519706,"SMITH, ERNEST, TERRILL",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356519706,"SMITH, ERNEST, TERRILL",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356519706,"SMITH, ERNEST, TERRILL",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356520837,"MILLER, TIMOTHY, ELLIS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356520837,"MILLER, TIMOTHY, ELLIS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356520837,"MILLER, TIMOTHY, ELLIS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356520837,"MILLER, TIMOTHY, ELLIS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356521439,"SHAHMEHDI, SEYED, AKHTAR",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356521439,"SHAHMEHDI, SEYED, AKHTAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356521439,"SHAHMEHDI, SEYED, AKHTAR",601 N ELM ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356521439,"SHAHMEHDI, SEYED, AKHTAR",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 55 , 55 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356522965,"PAWLAK, COLLEEN, MARIE",115 KILDAIRE PARK DR STE 205 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356522965,"PAWLAK, COLLEEN, MARIE",2115 S MAIN ST   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 244 , 267 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356525109,"SHIELDS, STACEY, LYNNE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356527196,"UDAYAKUMAR, MEERA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1356529960,PEC OPTOMETRY GROUP PA,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,, 337 , 337 , 674 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356530331,"PENKE, NICOLE, AMY",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356530331,"PENKE, NICOLE, AMY",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356530331,"PENKE, NICOLE, AMY",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356530331,"PENKE, NICOLE, AMY",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356530331,"PENKE, NICOLE, AMY",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356531255,"BANGA, CECILIA, WOREMA",510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356531255,"BANGA, CECILIA, WOREMA",510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356531255,"BANGA, CECILIA, WOREMA",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356531255,"BANGA, CECILIA, WOREMA",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1005 BIG OAK CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356532691,"MOUILLESSEAUX, CORTNEY, LYNN",1005 BIG OAK CT   KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356532691,"MOUILLESSEAUX, CORTNEY, LYNN",270 HORIZON DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 23 , 60 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356534358,"HEWITT, JANA, LANDER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 149 , 150 ,$#,,
MEDICAID DIRECT,1881289932,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR DIVISION OF PSYCHIATRY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356535991,"STELMACH, HANS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 351 , 424 , 476 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,5241 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 26 , 27 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 42 , 50 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 19 , 23 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 19 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1356537492,"MCBRIDE, ANDREW, DOMINIC",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356538813,"KAZAKEWICH, SHIRA, FRIEND",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356538813,"KAZAKEWICH, SHIRA, FRIEND",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 29 , 29 ,$#,,
MEDICAID DIRECT,1356539795,LIFE CHANGERS INTERVENTION SERVICES,LIFE CHANGERS INTERVENTION SERVICES,5039 MAIN ST STE 2 SHALLOTTE NC,010,Brunswick,251B00000X,Agencies,Case Management,,1356539795,LIFE CHANGERS INTERVENTION SERVICES,5039 MAIN ST STE 2 SHALLOTTE NC,010,Brunswick,251B00000X,Agencies,Case Management,, 19 , 603 , 603 ," $33,825.60 ",,
MEDICAID DIRECT,1356539795,LIFE CHANGERS INTERVENTION SERVICES,LIFE CHANGERS INTERVENTION SERVICES,5285 MAIN ST STE 19C SHALLOTTE NC,010,Brunswick,251B00000X,Agencies,Case Management,,1356539795,LIFE CHANGERS INTERVENTION SERVICES,5285 MAIN ST STE 19C SHALLOTTE NC,010,Brunswick,251B00000X,Agencies,Case Management,, 17 , 84 , 84 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356541320,"KUMAR, RAJAT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356541445,"SHAH, NILAY, ARVIND",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356541445,"SHAH, NILAY, ARVIND",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356541445,"SHAH, NILAY, ARVIND",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356543490,"BLAKE, KHASHANA, AMOIS",1315 GREENSBORO RD   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 41 , 41 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356543490,"BLAKE, KHASHANA, AMOIS",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356543490,"BLAKE, KHASHANA, AMOIS",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 103 , 318 , 318 ," $10,456.48 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356543490,"BLAKE, KHASHANA, AMOIS",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1356543805,MCDOWELL COUNTY RESCUE SQUAD AND AM,~,186 STATE ST   MARION NC,059,McDowell,3416L0300X,Transportation Services,Ambulance,Land Transport,1356543805,MCDOWELL COUNTY RESCUE SQUAD AND AM,186 STATE ST   MARION NC,059,McDowell,3416L0300X,Transportation Services,Ambulance,Land Transport,#, 38 , 67 ,$#,,
MEDICAID DIRECT,1356546857,"OLIVER, DAVID, PHILLIP",~,171 SLOAN RD   FRANKLIN NC,056,Macon,1223G0001X,Dental Providers,Dentist,General Practice,1356546857,"OLIVER, DAVID, PHILLIP",171 SLOAN RD   FRANKLIN NC,056,Macon,1223G0001X,Dental Providers,Dentist,General Practice, 380 , 656 ," 2,282 "," $115,816.65 ",,
MEDICAID DIRECT,1356548713,MCDOWELL COUNTY DSS,MCDOWELL COUNTY DSS,145 E COURT ST   MARION NC,059,McDowell,251B00000X,Agencies,Case Management,,1356548713,MCDOWELL COUNTY DSS,145 E COURT ST   MARION NC,059,McDowell,251B00000X,Agencies,Case Management,, 52 , 503 , 505 ," $209,345.00 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356549026,"FORBES, DIANNE, MARIE",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 108 , 164 , 282 ," $13,014.02 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356549851,"GILCHRIST, STEVEN, LEE",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 88 , 167 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356549851,"GILCHRIST, STEVEN, LEE",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 33 , 35 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 89 , 91 , 97 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",117 E KINGS HWY   EDEN NC,079,Rockingham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356549893,"MCGUIRE, ANTONIO, MARTRELL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356551949,"ANDERSON, DAVID, THOMAS",600 HOSPITAL DR   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 40 , 70 , 111 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356551949,"ANDERSON, DAVID, THOMAS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356551949,"ANDERSON, DAVID, THOMAS",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 46 , 62 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356555122,"GATES, TIMOTHY, ANDREW",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 51 , 91 , 110 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356557177,"DEMERS, NICHOLAS, GUY",2525 GASTONIA DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356560049,"BAERMAN, KATHRYN, MLINAR",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356561385,"HOBBS III, RICHARD, PRESTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356561385,"HOBBS III, RICHARD, PRESTON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 64 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356561583,"HAITHCOCK, BENJAMIN, EARL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 48 , 137 , 157 ," $10,428.07 ",,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1356563969,"BURDINE, STEVEN, ELLIOTT",250 W KINGS HWY   EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 185 , 378 , 668 ," $17,621.51 ",,
MEDICAID DIRECT,1356566756,SIMMONS EARLY INTERVENTION THERAPY,Simmons Early Intervention Therapy,611 S GEORGE ST   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,,1356566756,SIMMONS EARLY INTERVENTION THERAPY,611 S GEORGE ST   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,, 628 ," 33,405 "," 33,433 "," $6,790,900.22 ",,
MEDICAID DIRECT,1356566756,SIMMONS EARLY INTERVENTION THERAPY,Simmons Early Intervention Therapy,611 S GEORGE ST   GOLDSBORO NC,096,Wayne,252Y00000X,Agencies,Early Intervention Provider Agency,,1356566756,SIMMONS EARLY INTERVENTION THERAPY,611 S GEORGE ST   GOLDSBORO NC,096,Wayne,252Y00000X,Agencies,Early Intervention Provider Agency,, 31 , 227 , 230 ," $27,355.32 ",,
MEDICAID DIRECT,1356566756,SIMMONS EARLY INTERVENTION THERAPY,Simmons Early Intervention Therapy,611 S GEORGE ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1356566756,SIMMONS EARLY INTERVENTION THERAPY,611 S GEORGE ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1356567986,"BOYD, TIFFANY, KATEASE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1750585154,ALAN A GODEL DDS PA,BELMONT FAMILY DENTAL CARE,6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356568273,"HOWELL, EVERETT, LEON",6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 355 , 731 ," 1,710 "," $119,670.70 ",,
MEDICAID DIRECT,1750585154,ALAN A GODEL DDS PA,BELMONT FAMILY DENTAL CARE,6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1356568273,"HOWELL, EVERETT, LEON",6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1356568471,"GROSSE, JAY, WESTON",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 140 , 204 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1356568471,"GROSSE, JAY, WESTON",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 68 , 77 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356568570,"DOWNARD, MARTINA, GOMEZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 86 , 88 , 93 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356569420,"FORB, KELLY, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 23 , 24 ,$#,,
MEDICAID DIRECT,1437146800,COASTAL INTERNAL MEDICINE PA,~,2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356570188,"RICHARDSON, DAVID, WAYLON",2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 85 , 273 , 450 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1356570188,"RICHARDSON, DAVID, WAYLON",2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#," $15,255.50 ",,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356570493,"CRAWLEY, MARITZA, PARCHMENT",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356570493,"CRAWLEY, MARITZA, PARCHMENT",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356570493,"CRAWLEY, MARITZA, PARCHMENT",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 42 , 129 , 130 ,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356571392,"DAVIDSON, KEVIN, ROSS",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356571392,"DAVIDSON, KEVIN, ROSS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356571392,"DAVIDSON, KEVIN, ROSS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356571392,"DAVIDSON, KEVIN, ROSS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 21 , 60 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356571392,"DAVIDSON, KEVIN, ROSS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 32 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356571392,"DAVIDSON, KEVIN, ROSS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356571392,"DAVIDSON, KEVIN, ROSS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1356571459,"VALUSA, KODANDA, RAMULU SHALINI",300 W 27TH ST   LUMBERTON NC,078,Robeson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 119 , 119 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1356571459,"VALUSA, KODANDA, RAMULU SHALINI",300 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 176 , 179 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1356571459,"VALUSA, KODANDA, RAMULU SHALINI",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1356571459,"VALUSA, KODANDA, RAMULU SHALINI",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 103 , 123 , 224 ,$#,,
MEDICAID DIRECT,1356572382,THE SPEECH LANGUAGE CORNER PLLC,THE SPEECH & LANGUAGE CORNER PLLC,11947 STRATFIELD PLACE CIR   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356572382,THE SPEECH LANGUAGE CORNER PLLC,11947 STRATFIELD PLACE CIR   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356575005,"PEREZ, RAYMOND, ROSS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356575005,"PEREZ, RAYMOND, ROSS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356575005,"PEREZ, RAYMOND, ROSS",236 MARKET ST STE 110 LOCUST NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 32 , 89 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356575211,"ELLIS FARABEE, EBONI, MALKIA",652 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356575211,"ELLIS FARABEE, EBONI, MALKIA",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 56 , 119 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356575211,"ELLIS FARABEE, EBONI, MALKIA",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356575211,"ELLIS FARABEE, EBONI, MALKIA",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356576441,"INGLE, KRISTA, KAY",2301 ERWIN RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356576441,"INGLE, KRISTA, KAY",2301 ERWIN RD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356576649,"SUTSKO, RONALD, PHILLIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 54 , 54 ," $11,727.55 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356576649,"SUTSKO, RONALD, PHILLIP",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",214 19TH ST SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1356577464,"JOHNSON, MATTHEW, ROBERT",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1356578405,"BULLERS, CHRISTOPHER, TODD",232 BOONE HEIGHTS DR   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 39 , 91 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1356578405,"BULLERS, CHRISTOPHER, TODD",135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 36 , 92 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 35 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356578991,"GRATIAN, CHRISTOPHER, CAMPBELL",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1356580138,"SOSA, KENIA",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356583678,"MATTIS, CRISTINE, LINN",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356583678,"MATTIS, CRISTINE, LINN",10660 PARK RD STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 22 , 48 ,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1356585533,"GUIDRY, CHRISSY",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356587661,"SNAPP, MEREDITH, SPENCER",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356587661,"SNAPP, MEREDITH, SPENCER",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 46 , 57 , 83 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356587661,"SNAPP, MEREDITH, SPENCER",13815 PROFESSIONAL CENTER DR STE 300 HUNTERSVILLE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356587661,"SNAPP, MEREDITH, SPENCER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356587661,"SNAPP, MEREDITH, SPENCER",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356587661,"SNAPP, MEREDITH, SPENCER",1900 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,,,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356587661,"SNAPP, MEREDITH, SPENCER",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine, 48 , 49 , 59 ,$#,,
MEDICAID DIRECT,1811255219,A PLUS FAMILY CARE PLLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1356588073,"BATOULI, PHOUNG, HO",3521 HAWORTH DR FL 2 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1376809467,LLOYD CHIROPRACTIC PLLC,~,201 E MAIN ST   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1356589105,"LLOYD, KAREL, DAVIS GRAY",201 E MAIN ST   CLAYTON NC,051,Johnston,111N00000X,Chiropractic Providers,Chiropractor,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1356589105,"LLOYD, KAREL, DAVIS GRAY",~,201 E MAIN ST   CLAYTON NC,051,Johnston,111N00000X,Chiropractic Providers,Chiropractor,,1356589105,"LLOYD, KAREL, DAVIS GRAY",201 E MAIN ST   CLAYTON NC,051,Johnston,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356589576,"SWEETAPPLE, KATHERINE, MUENCH",3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 106 , 219 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356589576,"SWEETAPPLE, KATHERINE, MUENCH",3126 BLUE RIDGE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 40 , 75 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356590152,"TONKIN, KELLY, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356590152,"TONKIN, KELLY, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356590152,"TONKIN, KELLY, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356590152,"TONKIN, KELLY, ANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356591614,"PUNJABI, ASHWINI, MHATRE",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356591614,"PUNJABI, ASHWINI, MHATRE",15825 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 43 , 84 , 146 ,$#,,
MEDICAID DIRECT,1356865067,DLP FRYE MEDICAL GROUP,DLP FRYECARE NEONATOLOGY,415 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356594360,"COOPER, TERRY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1356596647,"CROUSE, ERICA, LYNN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1356596647,"CROUSE, ERICA, LYNN",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1356596647,"CROUSE, ERICA, LYNN",2508 WARD BLVD   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1356596647,"CROUSE, ERICA, LYNN",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1356596647,"CROUSE, ERICA, LYNN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 110 , 114 , 139 ," $10,282.48 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 127 , 139 , 220 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 144 , 152 , 220 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356597942,"KIANI, BAHRAM",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447355755,SMOKY MOUNTAIN FOOT CLINIC PA,SMOKY MOUNTAIN FOOT CLINIC PA,289 ACCESS RD   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1356599096,"DAVIS, MATTHEW, WARREN",289 ACCESS RD   WAYNESVILLE NC,044,Haywood,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 188 , 467 , 617 ," $10,977.96 ",,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1356600597,"JERNIGAN, EDWARD, WILLIAM",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356600597,"JERNIGAN, EDWARD, WILLIAM",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356600597,"JERNIGAN, EDWARD, WILLIAM",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 34 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356600662,"DESAI, NIKITA, SHWETAL",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 36 , 46 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356600662,"DESAI, NIKITA, SHWETAL",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 57 , 88 , 124 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356600852,"SHARMIN, SHAHNAZ",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1356600852,"SHARMIN, SHAHNAZ",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356600852,"SHARMIN, SHAHNAZ",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 160 , 243 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1356600852,"SHARMIN, SHAHNAZ",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601066,"RIGGINS, STEPHANIE, LEIGH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601066,"RIGGINS, STEPHANIE, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 79 , 159 , 169 ," $23,316.22 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601066,"RIGGINS, STEPHANIE, LEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 40 , 42 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601066,"RIGGINS, STEPHANIE, LEIGH",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601280,"CALLOWAY, NATHAN, HAMILTON",505 OBERLIN RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601280,"CALLOWAY, NATHAN, HAMILTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 29 , 32 , 46 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601280,"CALLOWAY, NATHAN, HAMILTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 18 , 22 , 33 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601280,"CALLOWAY, NATHAN, HAMILTON",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601280,"CALLOWAY, NATHAN, HAMILTON",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 32 , 41 , 48 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356601280,"CALLOWAY, NATHAN, HAMILTON",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1356601280,"CALLOWAY, NATHAN, HAMILTON",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356602932,"WILLIAMSON, EDWARD, VANVELSOR",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 30 , 45 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356602932,"WILLIAMSON, EDWARD, VANVELSOR",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 74 , 120 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356604128,"CHEN, LINGYE",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356604128,"CHEN, LINGYE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 27 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356604128,"CHEN, LINGYE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356604128,"CHEN, LINGYE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356604128,"CHEN, LINGYE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 78 , 97 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356604169,"SHAH, KENA",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356604169,"SHAH, KENA",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356606032,"BABAKOOHI, SHAHAB",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 18 , 23 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356606032,"BABAKOOHI, SHAHAB",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356607170,"VANNOY, JASON, THOMAS",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 31 , 31 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356609507,"MCCONVILLE, PATRICK, JOSEPH",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356609507,"MCCONVILLE, PATRICK, JOSEPH",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356609507,"MCCONVILLE, PATRICK, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 30 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356609507,"MCCONVILLE, PATRICK, JOSEPH",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356609507,"MCCONVILLE, PATRICK, JOSEPH",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356609507,"MCCONVILLE, PATRICK, JOSEPH",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356609507,"MCCONVILLE, PATRICK, JOSEPH",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356609606,"RYAN-SMITH, KAITLIN, MARIE",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356609606,"RYAN-SMITH, KAITLIN, MARIE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356609606,"RYAN-SMITH, KAITLIN, MARIE",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356609606,"RYAN-SMITH, KAITLIN, MARIE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356611065,TRIANGLE SPEECHWORKS PLLC,,725 WILLOW RUN SOUTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356611065,TRIANGLE SPEECHWORKS PLLC,725 WILLOW RUN SOUTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#, 63 , 63 ,$#,,
MEDICAID DIRECT,1912409210,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1356612535,"PARKER, COURTNEY, SWORD",601 GREENVILLE BLVD SE   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356612618,"WOLFE, STEPHANIE, JUSTICE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 50 , 103 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1356613855,"CUTHRELL, MATTHEW, DAVID",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 122 , 261 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356616692,"MOLLIGAN IV, HARRY, JOSEPH",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356616692,"MOLLIGAN IV, HARRY, JOSEPH",824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356616692,"MOLLIGAN IV, HARRY, JOSEPH",600 GRESHAM DR STE 204 NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356616692,"MOLLIGAN IV, HARRY, JOSEPH",824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356617559,"WARSCH, JESSICA, RENE LORING",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356617559,"WARSCH, JESSICA, RENE LORING",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356617559,"WARSCH, JESSICA, RENE LORING",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356617559,"WARSCH, JESSICA, RENE LORING",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356617559,"WARSCH, JESSICA, RENE LORING",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356617559,"WARSCH, JESSICA, RENE LORING",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356621155,EYECARECENTER OD PA,EYECARE CENTER,500 W 4TH ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356621155,EYECARECENTER OD PA,500 W 4TH ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356621916,"PURAM, AJITH, KUMAR",201 E GROVER ST   SHELBY NC,023,Cleveland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356621916,"PURAM, AJITH, KUMAR",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 44 , 264 , 264 ," $13,514.11 ",,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356621916,"PURAM, AJITH, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356621916,"PURAM, AJITH, KUMAR",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356622393,"ABUMOSTAFA, YOUSEF, SHOKRY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356624142,HEALTH TARGET HOMECARE INC,HEALTH TARGET HOMECARE INC,3201 YORKTOWN AVE STE 217A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1356624142,HEALTH TARGET HOMECARE INC,3201 YORKTOWN AVE STE 217A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 3,561 "," 3,805 "," $296,390.80 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356625164,"KUCK, BRITTNEY, RENAE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356625164,"KUCK, BRITTNEY, RENAE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356625164,"KUCK, BRITTNEY, RENAE",89 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1306957451,WILMINGTON MATERNAL-FETAL MEDICINE,WILMINGTON MATERNAL-FETAL MEDICINE PLLC,2212 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356625669,"MERK, JANE, ELIZABETH",2212 DELANEY AVE   WILMINGTON NC,065,New Hanover,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 29 , 33 , 33 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356631162,"HESS, CHRISTOPHER, AARON",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 14 , 38 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356631162,"HESS, CHRISTOPHER, AARON",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine, 15 , 30 , 81 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356631162,"HESS, CHRISTOPHER, AARON",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 95 , 227 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356632442,"SHIN, RICHARD, HEECHUN",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 16 , 23 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356632442,"SHIN, RICHARD, HEECHUN",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356632442,"SHIN, RICHARD, HEECHUN",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 48 , 71 , 117 ,$#,,
MEDICAID DIRECT,1275736795,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH UROLOGY,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356632442,"SHIN, RICHARD, HEECHUN",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356632517,"LAVIN, KYLE, NICHOLES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 24 , 60 , 60 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356632517,"LAVIN, KYLE, NICHOLES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356634166,"MARDAM-BEY, SAMI, WILLIAM",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 14 , 24 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1356634166,"MARDAM-BEY, SAMI, WILLIAM",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356634166,"MARDAM-BEY, SAMI, WILLIAM",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 19 , 37 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356634166,"MARDAM-BEY, SAMI, WILLIAM",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356634166,"MARDAM-BEY, SAMI, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 16 , 24 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356634166,"MARDAM-BEY, SAMI, WILLIAM",505 OBERLIN RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 27 , 52 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356634166,"MARDAM-BEY, SAMI, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356635528,"MCGILL, JACQUELYN, ANN",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 63 , 139 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356636872,"DENNY, JOSHUA, PAUL",318 S NORWOOD ST   WALLACE NC,031,Duplin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 26 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 14 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356636880,"VEERAPPAN, ANNAPOORANI",10207 CERNY ST   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1457169914,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1356637722,"STAMATES, MELISSA, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1720080070,CAPE FEAR NEUROSURGERY,CAPE FEAR NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1356637722,"STAMATES, MELISSA, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 80 , 93 , 104 ,$#,,
MEDICAID DIRECT,1356639801,FRIENDLY MEDICAL TRANSPORTATION LLC,~,3402 MANDY LN   MOREHEAD CITY NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1356639801,FRIENDLY MEDICAL TRANSPORTATION LLC,3402 MANDY LN   MOREHEAD CITY NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport, 422 ," 2,156 "," 3,484 "," $381,510.20 ",,
MEDICAID DIRECT,1154857662,PRESBYTERIAN SAMEDAY SURGERY CENTER,~,14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356640080,"ZENGER, AMANDA, PRISANT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356640080,"ZENGER, AMANDA, PRISANT",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,110 STOCKTON ST STE C STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,110 STOCKTON ST STE C STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,600 TIFFANY BLVD STE D ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,600 TIFFANY BLVD STE D ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,2302 ARENDELL ST STE D MOREHEAD CITY NC,016,Carteret,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,2302 ARENDELL ST STE D MOREHEAD CITY NC,016,Carteret,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,2302 ARENDELL ST STE D MOREHEAD CITY NC,016,Carteret,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,2248A N MAIN ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,2248A N MAIN ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,2248A N MAIN ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,130 N ARLINGTON ST STE H SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,130 N ARLINGTON ST STE H SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,2302 ARENDELL ST STE D MOREHEAD CITY NC,016,Carteret,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,323 CLIFTON ST STE 9 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,407 S GRIFFIN ST STE H ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,407 S GRIFFIN ST STE H ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,1400 W CHURCH ST   ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,1400 W CHURCH ST   ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,#, 104 , 104 ," $21,289.12 ",,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,1400 W CHURCH ST   ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,323 CLIFTON ST STE 9 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,407 S GRIFFIN ST STE H ELIZABETH CITY NC,070,Pasquotank,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,323 CLIFTON ST STE 9 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1356641377,EAST CAROLINA HOME CARE INCORPORATE,EAST CAROLINA HOME CARE,323 CLIFTON ST STE 9 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1356641377,EAST CAROLINA HOME CARE INCORPORATE,323 CLIFTON ST STE 9 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 11,886 "," 12,305 "," $1,740,427.28 ",,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356647929,"LE, PHUONG, DIEM",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356647929,"LE, PHUONG, DIEM",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356647929,"LE, PHUONG, DIEM",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1356647929,"LE, PHUONG, DIEM",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 45 , 46 ,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1356647929,"LE, PHUONG, DIEM",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356648190,"BRITT, ASHLEY, RENEE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356648190,"BRITT, ASHLEY, RENEE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770850067,TRIANGLE KIDNEY ASSOCIATES PLLC,TRIANGLE KIDNEY ASSOCIATES PLLC,301 KEISLER DR STE A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",301 KEISLER DR STE A CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",~,301 KEISLER DR STE A CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",301 KEISLER DR STE A CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1770850067,TRIANGLE KIDNEY ASSOCIATES PLLC,TRIANGLE KIDNEY ASSOCIATES PLLC,301 KEISLER DR STE A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 122 , 129 ,$#,,
MEDICAID DIRECT,1770850067,TRIANGLE KIDNEY ASSOCIATES PLLC,TRIANGLE KIDNEY ASSOCIATES PLLC,301 KEISLER DR STE A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 396 , 396 ," $12,677.19 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1770850067,TRIANGLE KIDNEY ASSOCIATES PLLC,TRIANGLE KIDNEY ASSOCIATES PLLC,301 KEISLER DR STE A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1770850067,TRIANGLE KIDNEY ASSOCIATES PLLC,TRIANGLE KIDNEY ASSOCIATES PLLC,301 KEISLER DR STE A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652416,"SHELIYA, RAKESH, RAGHAVBHAI",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 85 , 104 ,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652614,"STATILE, LINDSAY, ANDERSON",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356652614,"STATILE, LINDSAY, ANDERSON",1400 WALTER REED ROAD   FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 176 ," $17,512.31 ",,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356652614,"STATILE, LINDSAY, ANDERSON",3212 S WILMINGTON ST   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,947 "," 2,877 "," 17,538 "," $1,049,979.81 ",,
MEDICAID DIRECT,1205024007,CENTRAL CAROLINA ORTHOPAEDIC ASSOCI,~,1139 CARTHAGE ST STE 101 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1356657266,"ZIGLER, MICHAEL, ROBERT",1139 CARTHAGE ST STE 101 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417371154,AMARA PAIN & SPINE,,6429 BANNINGTON RD STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356658389,"AMARA, ASHVIN, KUMAR",6429 BANNINGTON RD STE B CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 210 ," 1,094 "," 1,469 "," $29,826.49 ",,
MEDICAID DIRECT,1225449168,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KNIGHTDALE,901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356659783,"BAILEY, ADIJA, DANIELLE",901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 18 , 41 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 57 , 62 , 128 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 48 , 48 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 37 , 37 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 27 , 36 , 48 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356661144,"SWAIN, KAWAN, ANTREY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356661185,"MUSTAFA, BILAL",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356661367,CURRITUCK COUNTY SCHOOLS,~,2958 CARATOKE HWY   CURRITUCK NC,027,Currituck,251300000X,Agencies,Local Education Agency (LEA),,1356661367,CURRITUCK COUNTY SCHOOLS,2958 CARATOKE HWY   CURRITUCK NC,027,Currituck,251300000X,Agencies,Local Education Agency (LEA),, 82 ," 1,446 "," 1,470 "," $62,330.66 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356661631,"CHANDRAMOHAN, VIDHYA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 39 , 152 , 156 ,$#,,
MEDICAID DIRECT,1013784875,PIEDMONT PARTNERS FOR MENTAL HEALTH,,2723 HORSE PEN CREEK RD STE 105 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356661847,"PARETTA-LEAHEY, DAWN, MARIE",719 GREEN VALLEY RD STE 306 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 67 , 76 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356662084,"KHANNA, ASHISH, KUMAR",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356662084,"KHANNA, ASHISH, KUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356662936,"OCONNELL, BRENDAN, POWERS",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 36 , 45 , 58 ,$#,,
MEDICAID DIRECT,1790825206,COUNTY OF SURRY & SURRY COUNTY WELF,SURRY CO HEALTH & NUTRITION CTR,118 HAMBY RD   DOBSON NC,086,Surry,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1356663587,"KELLER, MARY, LOUISE",118 HAMBY RD   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 29 , 52 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 41 , 55 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356667505,"WILMOT, KOBINA, ARHIN",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 58 , 88 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1356667752,"CEJAS, DIANA, MERCEDES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356667752,"CEJAS, DIANA, MERCEDES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 64 , 100 , 109 ,$#,,
MEDICAID DIRECT,1275178816,COASTAL PROSTHETICS ORTHOTICS,,1134 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356667877,"SIVERD, ROBERT, MEADE",1134 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356668495,"SHENVI, CHRISTINA, LORRAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 34 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1356668495,"SHENVI, CHRISTINA, LORRAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356668529,HOME CARE HELPERS LLC,HOME CARE HELPERS LLC,211 S CENTER ST STE 212 STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1356668529,HOME CARE HELPERS LLC,211 S CENTER ST STE 212 STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 2,642 "," 2,642 "," $178,156.32 ",,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1356669469,"PRATT, IAN, SCOTT",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 47 , 48 ,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1356669469,"PRATT, IAN, SCOTT",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1356669469,"PRATT, IAN, SCOTT",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356669469,"PRATT, IAN, SCOTT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356669469,"PRATT, IAN, SCOTT",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356670491,"EDWARDS, MIRANDA, BARE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1689628729,NURSE ANESTHESIA OF NC PLLC,~,180 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1356670491,"EDWARDS, MIRANDA, BARE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356672034,"BARCENAS, CRYSTAL, GAIL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1356672505,RESPRACARE INC,~,641 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1356672505,RESPRACARE INC,641 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1356672505,RESPRACARE INC,~,641 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356672505,RESPRACARE INC,641 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 636 ," 3,446 "," 5,592 "," $121,841.28 ",,
MEDICAID DIRECT,1356672505,RESPRACARE INC,~,641 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1356672505,RESPRACARE INC,641 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#, 15 ,$#,,
MEDICAID DIRECT,1356673008,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05556,7025 WINSTON HILL DR   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1356673008,NORTH CAROLINA CVS PHARMACY LLC,7025 WINSTON HILL DR   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1356675508,"HARDESTY, JENNIFER, KAREN",JENNIFER KAREN HARDESTY,153 BRADY STREET EXT   RAMSEUR NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,1356675508,"HARDESTY, JENNIFER, KAREN",153 BRADY STREET EXT   RAMSEUR NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 43 , 88 , 225 ," $11,907.14 ",,
MEDICAID DIRECT,1801481940,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PHYSICAL THERAPY & SPORTS MEDICINE,503 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1356676076,"REDDICK, KAREN, LYNN",148 POINTE SOUTH DR   RANDLEMAN NC,076,Randolph,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356676431,"RAMAS, CARLA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356676548,"MEHTA, RAVIN, JAYANT",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 70 , 159 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356676548,"MEHTA, RAVIN, JAYANT",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356677611,"DUQUETTE, PETER, JOSEPH",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356677611,"DUQUETTE, PETER, JOSEPH",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 14 , 15 , 33 ,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356677611,"DUQUETTE, PETER, JOSEPH",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 51 , 55 , 55 ,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1356677850,"SMOOT, HEIDI, ANGELA",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356677850,"SMOOT, HEIDI, ANGELA",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356682652,"ISHAK, MARK-MINA, MAHER",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 25 , 41 , 62 ,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356682652,"ISHAK, MARK-MINA, MAHER",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 44 , 64 , 70 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356682652,"ISHAK, MARK-MINA, MAHER",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1508215963,HIGHLAND PRIMARY CAREPLLC,,513 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1356683106,"NEWTON BUTLER, MARY, ANGELA",513 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356683445,HEAVENLY PLACE LLC,~,8600 NEUSE HUNTER DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356683445,HEAVENLY PLACE LLC,8600 NEUSE HUNTER DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 552 , 552 ," $53,318.76 ",,
MEDICAID DIRECT,1356683445,HEAVENLY PLACE LLC,~,3120 TUCKLAND DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356683445,HEAVENLY PLACE LLC,3120 TUCKLAND DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1356683445,HEAVENLY PLACE LLC,~,8600 NEUSE HUNTER DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356683445,HEAVENLY PLACE LLC,3120 TUCKLAND DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356683874,"TVERSKY, STEVEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356684021,"BHALLA, NITYA, MOOTHATHU",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356684021,"BHALLA, NITYA, MOOTHATHU",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356685135,"SHAW, HEATHER, RENEE",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1356685135,"SHAW, HEATHER, RENEE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1356685135,"SHAW, HEATHER, RENEE",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 130 , 144 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1356685739,"EARP, CRYSTAL, STRICKLAND",101 BALDWIN DR   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356685739,"EARP, CRYSTAL, STRICKLAND",101 BALDWIN DR   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356685739,"EARP, CRYSTAL, STRICKLAND",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1356685739,"EARP, CRYSTAL, STRICKLAND",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1356685739,"EARP, CRYSTAL, STRICKLAND",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356689319,"CHAND, SUDHAM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 37 , 90 , 110 ," $17,420.47 ",,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1356689319,"CHAND, SUDHAM",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356689319,"CHAND, SUDHAM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 31 , 63 , 76 ,$#,,
MEDICAID DIRECT,1356693766,GREATCARE SERVICES INC,~,7950 NATIONS FORD RD STE 31 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1356693766,GREATCARE SERVICES INC,7950 NATIONS FORD RD STE 31 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 3,747 "," 3,747 "," $259,400.44 ",,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356699151,"CHAMBERS, JAMES, STEPHEN",6715 MCCRIMMON PKWY STE 205 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356699151,"CHAMBERS, JAMES, STEPHEN",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 17 , 36 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356699151,"CHAMBERS, JAMES, STEPHEN",11200 GOVERNOR MANLY WAY   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356699904,"AZAD, MOHAMMAD, RAIHAN",1006 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 122 , 307 , 570 ," $11,980.80 ",,
MEDICAID DIRECT,1356703466,"FUERST, NICHOLAS, HARRISON",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1356703466,"FUERST, NICHOLAS, HARRISON",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356703706,"HYSON, JILL, SUSANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356703722,"MATUSZ-FISHER, ASHLEY, GRACE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1356704217,"MCKEON, ELIZABETH, CHERVENY",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 135 , 299 ,$#,,
MEDICAID DIRECT,1326669508,WESTERN CAROLINA SEDATION ASSOCIATE,,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356708945,"KANEY, TIMOTHY, KEITH",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356716534,SOLARA MEDICAL SUPPLIES LLC,,2084 OTAY LAKES RD STE 102 CHULA VISTA CA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356716534,SOLARA MEDICAL SUPPLIES LLC,2084 OTAY LAKES RD STE 102 CHULA VISTA CA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 160 , 201 , 206 ," $23,804.70 ",,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356718712,"ALLWARDT, ALYSSA, MICHELLE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356718712,"ALLWARDT, ALYSSA, MICHELLE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356718712,"ALLWARDT, ALYSSA, MICHELLE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356718712,"ALLWARDT, ALYSSA, MICHELLE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 27 , 61 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1356719868,"VUYOVICH, KRISTEN, MARIE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356720114,"NONATO, FREYLEN EVINA, LUSTRIA",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356720114,"NONATO, FREYLEN EVINA, LUSTRIA",530 W WEBB AVE   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 24 , 27 , 70 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356720114,"NONATO, FREYLEN EVINA, LUSTRIA",3940 ARROWHEAD BLVD STE 270 MEBANE NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 17 , 19 , 39 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356720163,"ADAMS, JONATHAN, MARK",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 23 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356720163,"ADAMS, JONATHAN, MARK",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356720163,"ADAMS, JONATHAN, MARK",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 44 , 89 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356720296,"BREWSTER, CAROLINE, THOMPSON",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356720296,"BREWSTER, CAROLINE, THOMPSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356720296,"BREWSTER, CAROLINE, THOMPSON",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356720296,"BREWSTER, CAROLINE, THOMPSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 78 , 78 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356720296,"BREWSTER, CAROLINE, THOMPSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356721831,"LEPORTE, ANDREW, DOUGLAS",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 114 , 188 , 251 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356721831,"LEPORTE, ANDREW, DOUGLAS",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356721831,"LEPORTE, ANDREW, DOUGLAS",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 42 , 61 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356722284,"GATES, SHAYAN",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356722698,"ZIPPER, RYAN, WILLIAM",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356722839,"CHRISTY, ELIZABETH, HALE",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356722839,"CHRISTY, ELIZABETH, HALE",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 27 ,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1356722839,"CHRISTY, ELIZABETH, HALE",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1356722946,"LOCKLEAR, AMY, LACREST",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 16 , 35 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1356722946,"LOCKLEAR, AMY, LACREST",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1356722946,"LOCKLEAR, AMY, LACREST",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1356722946,"LOCKLEAR, AMY, LACREST",8116 NC 711   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 83 , 101 , 306 ," $12,866.30 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1356723159,"PALMER, ASHLEY, MONIQUE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356723159,"PALMER, ASHLEY, MONIQUE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 286 , 286 ,$#,,
MEDICAID DIRECT,1497406979,"LEWIS, MICHELE, OLIVIA",,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1356723159,"PALMER, ASHLEY, MONIQUE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356723662,"SPELKE, MAE, BRIDGET",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 17 , 19 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1356727614,"TOWNSEND, WILLIAM, LUKE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1619523412,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356728364,"HUDSON, VICTORIA, ESTHER",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356728414,"WARE, ALISHA, DENISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZH0000X,Allopathic & Osteopathic Physicians,Pathology,Hematology, 29 , 42 , 132 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1356728497,"SHEETS, JULIA, WHITLEY",300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1356728851,"AHMED, TASRIF",1101 HARTWELL ST   GARNER NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1356728851,"AHMED, TASRIF",3724 WIRELESS DR   GREENSBORO NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1356728851,"AHMED, TASRIF",3724 WIRELESS DR   GREENSBORO NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 25 , 54 , 54 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1356728851,"AHMED, TASRIF",3724 WIRELESS DR   GREENSBORO NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 23 , 167 , 179 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1356728851,"AHMED, TASRIF",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1356728851,"AHMED, TASRIF",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356729677,"BUTLER, DANIELLE, LEIGH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356729677,"BUTLER, DANIELLE, LEIGH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356731897,"GEBREGIORGIS, TSEGAYE, DANIEL",100 SENTARA CIR RM 2C WILLIAMSBURG VA,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356733513,"OWEN, ELIZABETH, BEE",1168 E CUTLAR XING   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356733513,"OWEN, ELIZABETH, BEE",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1356733513,"OWEN, ELIZABETH, BEE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356733513,"OWEN, ELIZABETH, BEE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 42 , 74 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356735617,"PATEL, PAYAL, SHAH",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356735617,"PATEL, PAYAL, SHAH",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,1632 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1356735617,"PATEL, PAYAL, SHAH",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 20 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356735617,"PATEL, PAYAL, SHAH",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 105 , 138 , 179 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356735617,"PATEL, PAYAL, SHAH",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1356736417,"MAGNER, BRETT, ALEXANDER",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 29 , 45 ,$#,,
MEDICAID DIRECT,1487891933,APPALACHIAN REGIONAL MEDICAL ASSOCI,ELK RIVER MEDICAL ASSOCIATES,150 PARK AVE   BANNER ELK NC,006,Avery,193200000X,Group,Multi-Specialty,,1356736417,"MAGNER, BRETT, ALEXANDER",150 PARK AVE   BANNER ELK NC,006,Avery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356737803,"YELAMANCHILI, SREE TEJA",2525 COURT DR   GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356737803,"YELAMANCHILI, SREE TEJA",660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 52 , 139 , 156 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10208 CERNY ST STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356739015,"JOHNSON, KADDIJATOU, SANYANG",10208 CERNY ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 44 , 81 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356739015,"JOHNSON, KADDIJATOU, SANYANG",10208 CERNY ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356740120,"STOUT, KIMBERLY, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 28 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",4705 S HIGHWAY 150 STE B&C LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",4611 YADKINVILLE RD   PFAFFTOWN NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",2950 PINE PLANTATION PKWY   OAK ISLAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",1926 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",2133 ROCKFORD ST STE 1400 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356741102,"ROGERS, JAN, ELISA",167 MOORE RD STE 206 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356745319,"KING, LOUISE, RAMBO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 39 , 73 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356745319,"KING, LOUISE, RAMBO",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 83 , 148 , 334 ,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356745566,"SKALSKY, ELIZABETH, MARY",10030 EDISON SQUARE DR NW STE 100-A CONCORD NC,013,Cabarrus,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356745566,"SKALSKY, ELIZABETH, MARY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356745970,"ROMMEL, ASHLEY, SPROUSE",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 47 , 91 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356745970,"ROMMEL, ASHLEY, SPROUSE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356745970,"ROMMEL, ASHLEY, SPROUSE",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 12 , 24 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356745970,"ROMMEL, ASHLEY, SPROUSE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356747299,TRIPOINT DIAGNOSTICS PLLC,,627 DAVIS DR STE 600 MORRISVILLE NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1356747299,TRIPOINT DIAGNOSTICS PLLC,627 DAVIS DR STE 600 MORRISVILLE NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,, 105 , 113 , 164 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1356752042,"KNIGHT, SHALANDRIA, TAVISE",921 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 88 , 651 , 704 ," $14,477.93 ",,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1356752042,"KNIGHT, SHALANDRIA, TAVISE",617A E BROAD AVE   ROCKINGHAM NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1356752042,"KNIGHT, SHALANDRIA, TAVISE",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 96 , 103 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1356752042,"KNIGHT, SHALANDRIA, TAVISE",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1356752042,"KNIGHT, SHALANDRIA, TAVISE",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 38 , 76 , 120 ,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356752794,"TORREY, CARRIE, LISA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356752794,"TORREY, CARRIE, LISA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356752919,"PHILLIPS, ZACHARY, MCKEE",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,209 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1356752919,"PHILLIPS, ZACHARY, MCKEE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1356752919,"PHILLIPS, ZACHARY, MCKEE",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356752919,"PHILLIPS, ZACHARY, MCKEE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356754790,"MOBLEY, BETHANY, DAWN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356754790,"MOBLEY, BETHANY, DAWN",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356754790,"MOBLEY, BETHANY, DAWN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356754790,"MOBLEY, BETHANY, DAWN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 85 , 86 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356755391,"JEON, PETER, S",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356755391,"JEON, PETER, S",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356755391,"JEON, PETER, S",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295132009,ST LUKES PHYSICIAN NETWORK INC,CAROLINAS HOSPITALIST GROUP-ST LUKES,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1356755391,"JEON, PETER, S",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356755573,"VOLIN, SAMUEL, DOUGLAS",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging,1356755573,"VOLIN, SAMUEL, DOUGLAS",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356757348,"PRADHAN, CHRISTINA, SHRESTHA",157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1356757348,"PRADHAN, CHRISTINA, SHRESTHA",157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356757660,"SUTTON, DANIELLE, BASKIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 72 , 72 , 75 ,$#,,
MEDICAID DIRECT,1861451437,NEWTON FAMILY PHYSICIANS,~,767 W 1ST ST   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1356758890,"MORETZ, DANA MARIE, FRYE",767 W 1ST ST   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 49 , 103 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356760656,"KASS, STEVEN, JOSHUA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356760656,"KASS, STEVEN, JOSHUA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 42 , 46 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356760656,"KASS, STEVEN, JOSHUA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 47 , 116 , 118 ," $10,658.32 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356760656,"KASS, STEVEN, JOSHUA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1356761118,"TIMINS, AARON, MICHAEL",691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 23 , 28 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356761118,"TIMINS, AARON, MICHAEL",691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 25 , 31 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356761118,"TIMINS, AARON, MICHAEL",691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356761118,"TIMINS, AARON, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 106 , 139 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1356761118,"TIMINS, AARON, MICHAEL",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356761118,"TIMINS, AARON, MICHAEL",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 17 , 23 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356761183,"KOERNER, JAGGER, CRAWFORD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356761183,"KOERNER, JAGGER, CRAWFORD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 122 , 165 , 209 ," $14,221.97 ",,
MEDICAID DIRECT,1356469357,COUNTY OF MADISON OFFICE OF AUDITOR,MADISON COUNTY HEALTH DEPT,493 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1356761241,"ROBINSON, MELISSA, DUNAVANT",493 MEDICAL PARK DR   MARSHALL NC,057,Madison,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 27 , 47 ,$#,,
MEDICAID DIRECT,1376510875,HOT SPRINGS HEALTH PROGRAM,HOT SPRINGS MEDICAL AND DENTAL CENTER,66 NW US 25 70 HIGH   HOT SPRINGS NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356761241,"ROBINSON, MELISSA, DUNAVANT",66 NW US 25 70 HWY   HOT SPRINGS NC,057,Madison,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356761241,"ROBINSON, MELISSA, DUNAVANT",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356762306,COUNTY OF BERTIE,BERTIE COUNTY EMERGENCY SERVICES,106 DUNDEE ST STE 220 WINDSOR NC,008,Bertie,3416L0300X,Transportation Services,Ambulance,Land Transport,1356762306,COUNTY OF BERTIE,106 DUNDEE ST STE 220 WINDSOR NC,008,Bertie,3416L0300X,Transportation Services,Ambulance,Land Transport, 163 , 523 , 959 ," $54,213.66 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356762488,"PENNY, EMILY, ADAMS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 44 , 44 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1356763072,"TAYLOR, JESSICA, GRAY",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1356763072,"TAYLOR, JESSICA, GRAY",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1356763072,"TAYLOR, JESSICA, GRAY",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356763106,"FLESHER, JUSTIN, WILLIAM",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 20 , 26 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356763304,"GARTNER, MATTHEW, ALLYN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1356763304,"GARTNER, MATTHEW, ALLYN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356763833,"BEATTY, CELESTE, ALEXANDRA",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356763833,"BEATTY, CELESTE, ALEXANDRA",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356763833,"BEATTY, CELESTE, ALEXANDRA",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356763833,"BEATTY, CELESTE, ALEXANDRA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 32 , 36 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356763833,"BEATTY, CELESTE, ALEXANDRA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 42 , 46 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356764690,"TE, KALIYANN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356764690,"TE, KALIYANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 39 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356764690,"TE, KALIYANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356766810,"WALLS, SARAH, ELIZABETH",7210 VILLAGE MEDICAL CIR STE 310 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356766810,"WALLS, SARAH, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1356768196,"CLONINGER, ELIZABETH, ASHLEY",356 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 25 , 80 , 80 ,$#,,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1356768196,"CLONINGER, ELIZABETH, ASHLEY",18047 W CATAWBA AVE STE 203 CORNELIUS NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 28 , 138 , 138 ," $15,840.86 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",3645 TRUST DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",3645 TRUST DR   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1356768428,"RUSSELL, BRITNEY, WALKER",2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356769194,"KUMAR, AASHISH, JAY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 26 , 43 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356769194,"KUMAR, AASHISH, JAY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 40 , 74 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1356769194,"KUMAR, AASHISH, JAY",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356769772,"PEACH, MATTHEW, SEAN",524 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1821465642,VIDANT RADIATION ONCOLOGY LLC,~,524 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356769772,"PEACH, MATTHEW, SEAN",524 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 29 , 268 , 530 ," $23,264.55 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356769897,"CROWLEY, NIALL, DOLAN",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356769897,"CROWLEY, NIALL, DOLAN",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356769897,"CROWLEY, NIALL, DOLAN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1215629886,OCRACOKE HEALTH CENTER INC,MANTEO COMMUNITY HEALTH CENTER,402 BUDLEIGH ST   MANTEO NC,028,Dare,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356770697,"GAINES, LAUREN, SUZZANNE",402 BUDLEIGH ST   MANTEO NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 29 , 36 ,$#,,
MEDICAID DIRECT,1346059342,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CONCORD,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1356773691,"BOUCHER, SHELLI, ANN",205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 13 , 39 ,$#,,
MEDICAID DIRECT,1346059342,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CONCORD,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356773691,"BOUCHER, SHELLI, ANN",205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356776058,"RIEGER, ASHLEY, NOELE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 24 , 31 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1356776058,"RIEGER, ASHLEY, NOELE",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356778617,"OSMENT, ESTELLE, LORRAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2108 UMSTEAD DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356778617,"OSMENT, ESTELLE, LORRAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356780043,"KAZIBWE, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 106 , 127 , 127 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1356780092,"JOSHI, ABHYUDAYA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1356780092,"JOSHI, ABHYUDAYA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1356780092,"JOSHI, ABHYUDAYA",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1356780092,"JOSHI, ABHYUDAYA",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356780092,"JOSHI, ABHYUDAYA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 113 , 113 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356781629,"SHEKHAR, SHASHANK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356781629,"SHEKHAR, SHASHANK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 36 , 94 , 94 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356781629,"SHEKHAR, SHASHANK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 12 , 21 , 22 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1356784292,"KOSAKOWSKI, NICOLE, MARIE",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356784763,"SOMASUNDARAM, ASHWIN, SIVA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 26 , 50 , 79 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356785026,"WINE, SCOTT, GREGORY",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1356785257,"HAUSFELD, RYAN, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356785372,"KIRALY, DREW, DONOVAN",791 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356785372,"KIRALY, DREW, DONOVAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1972081800,SUNSHINE PROSTHETICS INC,,118 NASH ST SW STE E WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356786909,"CLARKE, JOHN, PHILIP",118 NASH ST SW STE E WILSON NC,098,Wilson,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1972081800,SUNSHINE PROSTHETICS INC,,118 NASH ST SW STE E WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356786909,"CLARKE, JOHN, PHILIP",118 NASH ST SW STE E WILSON NC,098,Wilson,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,, 12 , 13 , 49 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356789663,"PIETRZAK, KAITLYN, SLUKA",5920 SANDY FORKS RD STE 200 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356789663,"PIETRZAK, KAITLYN, SLUKA",4101 MACON POND RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356789705,"KREIDER, HARRY, KOEHLER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356789705,"KREIDER, HARRY, KOEHLER",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 53 , 68 , 115 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356791065,"BOMAR, JAMES, GRIER",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1356368708,CAMPUS HEALTH PHARMACY,CAMPUS HEALTH SERVICES,320 EMERGENCY ROOM DR JAMES A TAYLOR BLDG CB 7470 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356791339,"HEREDIA, CAITLIN, BLAZEK",320 EMERGENCY ROOM DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356791495,"PATZWAHL, AARON, MICHAEL",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 81 , 112 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356791644,"AGBOOLA, KOLADE, MUCHAILI",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 58 , 116 , 134 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356791644,"AGBOOLA, KOLADE, MUCHAILI",2525 COURT DR   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356791644,"AGBOOLA, KOLADE, MUCHAILI",2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356795082,"SPEARS, JAMES, REID",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 67 , 117 , 229 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356795512,"HOYLE, JOHN, DOUGLAS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 145 , 145 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356796288,"HESS, ALEXIS, BOYCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 54 , 60 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356796288,"HESS, ALEXIS, BOYCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 96 , 159 , 195 ," $29,718.23 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356796288,"HESS, ALEXIS, BOYCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356796288,"HESS, ALEXIS, BOYCE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356799852,"KERCHNER-CHIEVES, KATHY, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356799852,"KERCHNER-CHIEVES, KATHY, LYNN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1356799852,"KERCHNER-CHIEVES, KATHY, LYNN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1356799852,"KERCHNER-CHIEVES, KATHY, LYNN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1356799852,"KERCHNER-CHIEVES, KATHY, LYNN",800 TILGHMAN DR   DUNN NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356799852,"KERCHNER-CHIEVES, KATHY, LYNN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356800585,"SHAW, MEREDITH, KAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356800684,"LOWE, JOHNATHAN, SETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 38 , 52 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356800684,"LOWE, JOHNATHAN, SETH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356800684,"LOWE, JOHNATHAN, SETH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356800684,"LOWE, JOHNATHAN, SETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 50 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1356801286,"ARMSTRONG, ELIZABETH, ANN KING",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356801286,"ARMSTRONG, ELIZABETH, ANN KING",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356801286,"ARMSTRONG, ELIZABETH, ANN KING",100 W H ST   BUTNER NC,039,Granville,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356802441,"AMIRAULT, MARK, GERARD",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356802441,"AMIRAULT, MARK, GERARD",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356803001,"SEO, LAURA, JIYEON",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356804454,"LUCAS, JUSTIN, ROLAND",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 64 , 87 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356804454,"LUCAS, JUSTIN, ROLAND",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356807721,"CAMERON, JENNA, LEE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 42 , 42 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,10226 COULOAK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356807721,"CAMERON, JENNA, LEE",10226 COULOAK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356807721,"CAMERON, JENNA, LEE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356808729,"OLIO, TANSY, JANE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 15 , 26 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356808729,"OLIO, TANSY, JANE",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 99 , 162 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1356808729,"OLIO, TANSY, JANE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356808729,"OLIO, TANSY, JANE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356808729,"OLIO, TANSY, JANE",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1356808919,"HERNANDEZ PEREZ, JOSE, LISANDRO",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356808919,"HERNANDEZ PEREZ, JOSE, LISANDRO",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356808919,"HERNANDEZ PEREZ, JOSE, LISANDRO",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356808919,"HERNANDEZ PEREZ, JOSE, LISANDRO",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356808919,"HERNANDEZ PEREZ, JOSE, LISANDRO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356814040,"BRANTLEY, ELIZABETH, BARBARA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 56 , 56 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356814040,"BRANTLEY, ELIZABETH, BARBARA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356818330,"NUNES, BRIDGETTE, MARIE",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356818330,"NUNES, BRIDGETTE, MARIE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659943108,RISE UP ADDICTION MEDICINE & PAIN M,,204 W CHERRY ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1356819320,"ROYALL JR, MICHAEL, RAY",204 W CHERRY ST   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 384 , 597 ," $11,697.35 ",,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1356821003,"ANDREWS, JORDAN, RAE ATKINS",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1356821003,"ANDREWS, JORDAN, RAE ATKINS",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1356821086,"MCLAUGHLIN, MAGGIE, ELIZABETH",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1356821086,"MCLAUGHLIN, MAGGIE, ELIZABETH",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1356821086,"MCLAUGHLIN, MAGGIE, ELIZABETH",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1356821086,"MCLAUGHLIN, MAGGIE, ELIZABETH",2021 CREEKSIDE LANDING DR   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356821888,"DUGGAN, SEAN, WILLIAM",7540 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356821953,"RUUD, TAYLOR, ISAAC",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356823033,"KOERNER, TABITHA, WAITHIRA",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1356826481,"ROYSTER, JULIE, ELLIOTT",335A W COLLEGE AVE   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1356826481,"ROYSTER, JULIE, ELLIOTT",110 W GROVER ST   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 11 , 18 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1356826481,"ROYSTER, JULIE, ELLIOTT",201 E GROVER ST   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 21 , 20 , 27 ,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1356826481,"ROYSTER, JULIE, ELLIOTT",446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356826986,"LAVENDER, TAYLOR, ANNE",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 22 , 22 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356826986,"LAVENDER, TAYLOR, ANNE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356826986,"LAVENDER, TAYLOR, ANNE",14135 BALLANTYNE CORPORATE PL STE 200&160 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1356828982,"TIMMONS, LINDSEY, MICHELLE",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356829030,"WEST, ALLISON, RIVENBARK",2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,2739 IRON GATE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356829030,"WEST, ALLISON, RIVENBARK",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003821547,WILMINGTON SURGICAL ASSOCIATES PA,~,1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356829030,"WEST, ALLISON, RIVENBARK",1414 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1356832331,"BIDHAN, SOURABH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356832331,"BIDHAN, SOURABH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 27 , 27 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356833446,"GRANT, ERICKA, ELLEN",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1396020202,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH HOSPICE AND PALLIATIVE CARE PROFESSION,251 CAMPGROUND RD   WEST END NC,063,Moore,193200000X,Group,Multi-Specialty,,1356833958,"MCLEAN, MEAGAN, BRADHAM",251 CAMPGROUND RD   WEST END NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 83 , 86 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,340 COMMERCE AVE STE 5 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1356833958,"MCLEAN, MEAGAN, BRADHAM",340 COMMERCE AVE STE 5 SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 92 , 93 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,340 COMMERCE AVE STE 5 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1356833958,"MCLEAN, MEAGAN, BRADHAM",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 VETERANS PKWY STE 214 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1356834048,"EBN ALNASSIR, MOHAMMAD, ALI",105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1447892906,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SIX FORKS,3614 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356834048,"EBN ALNASSIR, MOHAMMAD, ALI",105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,1223G0001X,Dental Providers,Dentist,General Practice, 177 , 323 ," 1,160 "," $56,951.29 ",,
MEDICAID DIRECT,1447892906,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SIX FORKS,3614 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356834048,"EBN ALNASSIR, MOHAMMAD, ALI",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 17 , 43 ,$#,,
MEDICAID DIRECT,1447892906,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SIX FORKS,3614 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356834048,"EBN ALNASSIR, MOHAMMAD, ALI",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 13 , 20 ,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1356836019,"DEUTSCHER, ANNETTE, JAMIE",35 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1356837165,"GURAGAI, NIRMAL",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1356837165,"GURAGAI, NIRMAL",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 200 , 448 , 711 ," $19,849.49 ",,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356839393,"MELVIN, ALEXANDER, BRITT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 40 , 40 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356839518,"GERGOUDIS, LEWIS, RICHARD",3900 E 10TH ST   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 31 , 32 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356839518,"GERGOUDIS, LEWIS, RICHARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 187 , 223 , 376 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356839518,"GERGOUDIS, LEWIS, RICHARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 98 , 98 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356839518,"GERGOUDIS, LEWIS, RICHARD",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356839518,"GERGOUDIS, LEWIS, RICHARD",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1356840243,CORNERSTONE HEALTHCARE SERVICES INC,~,3201 YORKTOWN AVE STE 117B DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1356840243,CORNERSTONE HEALTHCARE SERVICES INC,3201 YORKTOWN AVE STE 117B DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,670 "," 2,900 "," $479,340.96 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356844468,"WELCH, VERONICA, VASSILEV",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356845069,"SAHLI, ZEYAD, TAMIM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356846653,"CHOW, BRYAN, HONG JER",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356846653,"CHOW, BRYAN, HONG JER",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356846653,"CHOW, BRYAN, HONG JER",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356847347,"RICHARDSON, CARESSA, DAMALIS",122 GATEWAY BLVD STE C MOORESVILLE NC,049,Iredell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356848006,"RATHBUN, SYLWIA",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356849111,"MYERS, JESSE, MICHAEL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 23 , 38 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356849111,"MYERS, JESSE, MICHAEL",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 32 , 48 ,$#,,
MEDICAID DIRECT,1720151525,COUNTY OF CLEVELAND NORTH CAROLINA,CLEVELAND COUNTY HEALTH DEPARTMENT,200 S POST RD   SHELBY NC,023,Cleveland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1356850796,"MILLWOOD, SHELBY, GREENE",200 S POST RD   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356852446,"THOMOPOULOS, MICHAEL, ANDRIANOS",2104 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1356852792,"TSCHOKE, MEREDITH, REGINA",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 80 , 129 , 246 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1356852933,"BOWMAN, JOANNA, BARLOW",2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 40 , 46 , 84 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1356852933,"BOWMAN, JOANNA, BARLOW",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 11 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2460 CURTIS ELLIS DR # 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1356852933,"BOWMAN, JOANNA, BARLOW",2460 CURTIS ELLIS DR # 100 ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 31 , 32 , 65 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1356852933,"BOWMAN, JOANNA, BARLOW",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 18 , 23 , 40 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1356852933,"BOWMAN, JOANNA, BARLOW",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 40 , 49 , 102 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356852933,"BOWMAN, JOANNA, BARLOW",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 34 , 42 , 89 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1356852933,"BOWMAN, JOANNA, BARLOW",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 14 ,$#,,
MEDICAID DIRECT,1053597856,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM HEALTH-UROLOGY,200 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1356854657,"FLECK, BREE, THARPE",200 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 134 , 277 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1356854657,"FLECK, BREE, THARPE",200 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356854657,"FLECK, BREE, THARPE",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356858344,KIDS IN STRIDE INC,,2810 W US HIGHWAY 64 STE 2 MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1356858344,KIDS IN STRIDE INC,2810 W US HIGHWAY 64 STE 2 MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,, 90 , 882 ," 1,306 "," $86,732.50 ",,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1356861694,"FINK, ANDREW, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1356861694,"FINK, ANDREW, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 26 ,$#,,
MEDICAID DIRECT,1336630862,S VAKIL DDS II PA,~,4558 CAPITAL BLVD STE B RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356865349,"MAHESHWARY, POOJA, A",4558 CAPITAL BLVD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 288 , 479 ," 2,274 "," $76,457.76 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1356866073,"CARUTHERS, CARMEN, ELISA",100 RENEE LYNN CT   CARRBORO NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1356866362,"CROFT, AMY, CHERKA",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 97 , 97 ,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356866362,"CROFT, AMY, CHERKA",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 33 , 33 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356866859,"MOODY, KAITLYN, MARIE",44 BONNIE LN   SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 24 , 99 , 99 ," $23,883.00 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356867162,"FAULKNER, MICHELLE, BETH",3903 N ELM ST STE 201 GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356867279,"BARROW, MEAGAN, ELIZABETH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356867279,"BARROW, MEAGAN, ELIZABETH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1356867576,"KARR, CHRISTIANNA, DAWN",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1356867576,"KARR, CHRISTIANNA, DAWN",11635 NORTHPARK DR STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 29 , 68 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356868418,"GREGUSKA, CHLOE, LYN",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356868418,"GREGUSKA, CHLOE, LYN",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 28 , 28 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356868863,"BENTLEY, JUSTIN, MARK",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1356868863,"BENTLEY, JUSTIN, MARK",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356868863,"BENTLEY, JUSTIN, MARK",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1356868863,"BENTLEY, JUSTIN, MARK",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356868863,"BENTLEY, JUSTIN, MARK",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356868863,"BENTLEY, JUSTIN, MARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356869465,"ELDER, CASSANDRA, KENDRICK",4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 47 , 65 , 115 ,$#,,
MEDICAID DIRECT,1538926183,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD PRIMARY CARE SEACOAST,3980 HWY. 9 EAST SUITE 100A LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356870299,"WHITLEY, ALLIE, GRACE",3980 HIGHWAY 9 E STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649547761,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PRIMARY CARE SEACOAST,3980 HIGHWAY 9 E STE 100A LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356870299,"WHITLEY, ALLIE, GRACE",3980 HIGHWAY 9 E STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356873616,"MACDONALD, ANDREA, LANE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356873616,"MACDONALD, ANDREA, LANE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356873616,"MACDONALD, ANDREA, LANE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356873616,"MACDONALD, ANDREA, LANE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 25 , 52 , 53 ,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356873616,"MACDONALD, ANDREA, LANE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356873616,"MACDONALD, ANDREA, LANE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356873616,"MACDONALD, ANDREA, LANE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356873657,"IVANOV, ALEXANDER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356874572,"HORAN, STEPHANIE, MEADOWS",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 54 , 138 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356874572,"HORAN, STEPHANIE, MEADOWS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356874572,"HORAN, STEPHANIE, MEADOWS",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356874572,"HORAN, STEPHANIE, MEADOWS",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 31 , 72 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356874572,"HORAN, STEPHANIE, MEADOWS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356874655,"MIRZOY, SILAI",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356874655,"MIRZOY, SILAI",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356875058,"GUILLOUD, CAROLYN, ROGERS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 157 , 248 , 368 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356876486,"DEMARI, JOSEPH, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 11 , 29 , 31 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356880009,"MOORHEAD, MARGARET, RAGN",15830 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1356880009,"MOORHEAD, MARGARET, RAGN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356880009,"MOORHEAD, MARGARET, RAGN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356880009,"MOORHEAD, MARGARET, RAGN",15830 BALLANTYNE MEDICAL PL STE 200 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1487969507,FOREFRONT DERMATOLOGY SC,,801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1356880868,"SCHULTZ, CHARLES, LEROY FREDERICK",801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356888168,"HOENER, CHRISTINE, MARIE",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,100 DODD ST   SPRING HOPE NC,064,Nash,193200000X,Group,Multi-Specialty,,1356889521,"THATCHER, ANGELA",100 DODD ST   SPRING HOPE NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1356890214,CAROLINAS HOMETOWN RESPIRATORY LLC,,371 CONCORD PKWY N   CONCORD NC,013,Cabarrus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1356890214,CAROLINAS HOMETOWN RESPIRATORY LLC,371 CONCORD PKWY N   CONCORD NC,013,Cabarrus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 559 ," 1,659 "," 3,671 "," $60,975.68 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356894778,"THAKKER, ZALAK, RAJIVKUMAR",1677 WESTBROOK PLAZA DR STE 100 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 27 , 60 ,$#,,
MEDICAID DIRECT,1407188600,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PULMONARY & SLEEP CENTER,2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1356895197,"PROHASKA, STEPHEN, PAUL",2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356895197,"PROHASKA, STEPHEN, PAUL",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 43 , 79 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356895197,"PROHASKA, STEPHEN, PAUL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,2386 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356895197,"PROHASKA, STEPHEN, PAUL",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356896153,"ENGLISH, TIFFANY, CLORICE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356896153,"ENGLISH, TIFFANY, CLORICE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356896153,"ENGLISH, TIFFANY, CLORICE",621 MICAVILLE LOOP STE 600 BURNSVILLE NC,100,Yancey,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 160 , 558 , 560 ," $20,567.86 ",,
MEDICAID DIRECT,1356896757,THE VILLAS AT BENSON I INC,~,606 E MORRIS AVE   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356896757,THE VILLAS AT BENSON I INC,606 E MORRIS AVE   BENSON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,100 "," 1,100 "," $68,037.54 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356897862,"LAMB, KATIE, AILEEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356901201,"ADHIKARI, SUSMITA",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1063096345,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE GLENWOOD,6800 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356901201,"ADHIKARI, SUSMITA",6800 GLENWOOD AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093104929,LIFELINK MEDICAL GROUP PLLC,~,901 DENIM DR   ERWIN NC,043,Harnett,193400000X,Group,Single Specialty,,1356901201,"ADHIKARI, SUSMITA",7851 ALEXANDER PROMENADE HILL PL STE 130 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356901201,"ADHIKARI, SUSMITA",7851 ALEXANDER PROMENADE HILL PL STE 130 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356902563,"PIPER, ROBIN, ELAINE",550 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1356905244,"ST ONGE, BRITTANY, ANNE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1356905244,"ST ONGE, BRITTANY, ANNE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356905244,"ST ONGE, BRITTANY, ANNE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356906184,"APICELLA, ANDREW, PAUL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 53 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1356906184,"APICELLA, ANDREW, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356906432,"SHAH, MILAN, JITENDRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 93 , 99 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356906432,"SHAH, MILAN, JITENDRA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356906697,"RIST, TYLER, MARK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1356906697,"RIST, TYLER, MARK",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356908701,"LIPHAM, BENJAMIN, TRAVIS",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174234538,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES MOCKSVILLE,562 VALLEY RD STE 102 MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1356910251,"HOMESLEY, MADISON, SHAYE",562 VALLEY RD STE 102 MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356911424,"MARTIN, TAMERA, BEATRICE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 82 , 95 , 95 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356911424,"MARTIN, TAMERA, BEATRICE",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356911879,"MUNOZ, JOSEFINA, AGUAYO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1356912430,"TAYLOR, ERICA, NICOLE",205 PAGE RD   PINEHURST NC,063,Moore,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 62 , 108 , 172 ,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356912497,"DEGOLYER, JACKI, SUE",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982883583,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1895 HOFFMAN RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1356912497,"DEGOLYER, JACKI, SUE",1895 HOFFMAN RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1356912497,"DEGOLYER, JACKI, SUE",600 W TRADE ST   DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578742177,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1356912497,"DEGOLYER, JACKI, SUE",4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1356912497,"DEGOLYER, JACKI, SUE",3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1356913214,"MCGUIRK, HOLLY, MARIE",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 90 , 120 ,$#,,
MEDICAID DIRECT,1265719512,PIRATE PEDIATRICS PA,~,118 OAKMONT DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356915151,"GROBER, ELISABETH, ROSE",118 OAKMONT DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 25 ,$#,,
MEDICAID DIRECT,1164500575,CHILDRENS HEALTH SERVICES PA,~,1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356915151,"GROBER, ELISABETH, ROSE",1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 34 , 61 ,$#,,
MEDICAID DIRECT,1265719512,PIRATE PEDIATRICS PA,~,118 OAKMONT DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356915151,"GROBER, ELISABETH, ROSE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356916480,BELLAMY HOME CARE SERVICES INC,,1100 HARDEE RD STE 103B KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1356916480,BELLAMY HOME CARE SERVICES INC,1100 HARDEE RD STE 103B KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,#, 429 , 429 ," $44,509.28 ",,
MEDICAID DIRECT,1356916480,BELLAMY HOME CARE SERVICES INC,,1100 HARDEE RD STE 97B KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1356916480,BELLAMY HOME CARE SERVICES INC,1100 HARDEE RD STE 97B KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 2,123 "," 2,127 "," $198,437.64 ",,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356918676,"BROUSSARD, NICHOLAS, RYAN",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 67 , 79 , 214 ," $10,654.79 ",,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1356918676,"BROUSSARD, NICHOLAS, RYAN",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 328 , 410 ," 1,264 "," $54,942.39 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356919542,"WOOTEN, MAGHAN, ELIZABETH",101 BETHESDA DR   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356920433,"WEHNER, ABIGAIL, SMITH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356920433,"WEHNER, ABIGAIL, SMITH",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1356923445,"TUCKER, REBEKAH, NICOLE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356929210,"OSORIO, REYNA, GUADALUPE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 48 , 48 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356932974,"WOOD, NACOLE, HIGGINS",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 207 , 210 ,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356932974,"WOOD, NACOLE, HIGGINS",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1134293012,HANGER PROSTHETICS & ORTHOTICS EAST,,3031 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1356940506,"CONTRERAS, JOSE MANUEL",3031 NEW BERN AVE   RALEIGH NC,092,Wake,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356943799,"SALMONSEN, MOLLY, LYNN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356943799,"SALMONSEN, MOLLY, LYNN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 199 ," 1,879 "," 2,105 "," $35,559.99 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 66 , 159 , 167 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1274 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 67 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356947824,"MURRAY, SUSAN, LOUISE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356956122,"CLEMENT, CAITLIN, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 17 , 17 ,$#,,
MEDICAID DIRECT,1356960231,MIZASAY HOME CARE,,110 E MAIN ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1356960231,MIZASAY HOME CARE,110 E MAIN ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,, 57 ," 13,354 "," 13,412 "," $880,882.04 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1356961163,"DORRIS, HUGH, DUNCAN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 88 , 279 , 282 ," $11,565.47 ",,
MEDICAID DIRECT,1356961718,MY PCA GREENVILLES HOME CARE LLC,,1914 W ARLINGTON BLVD STE 112 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1356961718,MY PCA GREENVILLES HOME CARE LLC,1914 W ARLINGTON BLVD STE 112 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,309 "," 2,340 "," $251,253.12 ",,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356963052,"COLMAN, ELI, CONSOVOY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 75 , 82 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356963052,"COLMAN, ELI, CONSOVOY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 98 , 106 , 124 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1356963052,"COLMAN, ELI, CONSOVOY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 34 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356963052,"COLMAN, ELI, CONSOVOY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 37 , 43 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1356963052,"COLMAN, ELI, CONSOVOY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1356963052,"COLMAN, ELI, CONSOVOY",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164695375,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER BOLTON,213 9TH ST   BOLTON NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356967368,"MCKENZIE, KATHY, LYNN",213 9TH ST   BOLTON NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1356967368,"MCKENZIE, KATHY, LYNN",213 9TH ST   BOLTON NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 40 , 40 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356967467,"ANDERSON, LEAH, NICOLE",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356969265,"HALL, SUSAN, MCCALL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356971048,"SAGE, JAKE, DWIGHT",2097 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356972483,"WISSBAUM, KRISTEN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1356972483,"WISSBAUM, KRISTEN, ELIZABETH",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 22 , 22 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1356972731,"BLEREAU, CLAUDE, ALEX BARRETT",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 32 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1356972731,"BLEREAU, CLAUDE, ALEX BARRETT",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1356972731,"BLEREAU, CLAUDE, ALEX BARRETT",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1356972731,"BLEREAU, CLAUDE, ALEX BARRETT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356974901,"FEAGAN, JENNIFER, MARIE",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356974901,"FEAGAN, JENNIFER, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 27 , 32 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356974901,"FEAGAN, JENNIFER, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1356976161,"HARRIS, CHELSEA, KENNEDY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1356976161,"HARRIS, CHELSEA, KENNEDY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1356979314,"WOODY, DANIELLE, MARINO",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1356979314,"WOODY, DANIELLE, MARINO",801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 23 , 42 ,$#,,
MEDICAID DIRECT,1679845846,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,436 HOSPITAL DR STE 200 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1356981021,"SPEARS, SHARON, MELINDA",436 HOSPITAL DR STE 200 LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1356981021,"SPEARS, SHARON, MELINDA",965 STATE FARM RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679845846,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,436 HOSPITAL DR STE 200 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1356981021,"SPEARS, SHARON, MELINDA",965 STATE FARM RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1356981377,"PRICE, TATUM, LEE",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 38 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356981377,"PRICE, TATUM, LEE",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356981377,"PRICE, TATUM, LEE",1101 N GREEN ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1356981377,"PRICE, TATUM, LEE",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 100 , 207 ,$#,,
MEDICAID DIRECT,1902183759,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD NEUROLOGY SEACOAST,3980 HIGHWAY 9 E STE 300 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1356984322,"TULEY, KATELYN, MARIE",3980 HIGHWAY 9 E STE 300 LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356986418,VISIONS OF LOVE LLC,VISIONS OF LOVE,1237 WESTMORELAND DR   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1356986418,VISIONS OF LOVE LLC,1237 WESTMORELAND DR   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,394 "," 1,404 "," $86,100.52 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356991251,"BAKER, RACHAEL, VICKIE",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1356991251,"BAKER, RACHAEL, VICKIE",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356991384,"NGUYEN, CHI, MINH",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1356991384,"NGUYEN, CHI, MINH",3213 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 33 , 79 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1356992754,"JANKOWSKI, OLIVIA, KRISTINA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1356997381,"GRIM, MELANIE, BUCHANAN",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 24 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1356998108,"FRISBIE, BROOKE, BORLIE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1356998108,"FRISBIE, BROOKE, BORLIE",1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1356998108,"FRISBIE, BROOKE, BORLIE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356999494,"HERMANNS, ASHLEE, PICKREL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356999494,"HERMANNS, ASHLEE, PICKREL",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 27 , 56 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356999494,"HERMANNS, ASHLEE, PICKREL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1356999494,"HERMANNS, ASHLEE, PICKREL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033794300,LANE AND ASSOCIATES XLI DDS PA,,571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1366000333,"SHIRLEY, DANIEL, CHARLES",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1427614510,DRS VELAZQUEZ DAVILA & ASSOC PLLC,SOUTHERN SMILES OF EASTERN NORTH CAROLINA,5076 US HIGHWAY 264 E   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366000739,"OKEEFE, ANDREW, JOSEPH",5076 US HIGHWAY 264 E   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 2,964 "," 5,754 "," 18,586 "," $1,176,749.31 ",,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1366001489,"WHITMAN, CATHERINE, SHUMAKER",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 21 , 51 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,14508 JAMES B WHITE HWY S   TABOR CITY NC,024,Columbus,193200000X,Group,Multi-Specialty,,1366001752,"FOWLER, TIFFANY, ANN",14508 JAMES B WHITE HWY S   TABOR CITY NC,024,Columbus,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1366001752,"FOWLER, TIFFANY, ANN",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 24 , 30 , 39 ,$#,,
MEDICAID DIRECT,1366001976,FOUNDATION OF HOPE INC,,119 GRIST RD   CHADBOURN NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1366001976,FOUNDATION OF HOPE INC,119 GRIST RD   CHADBOURN NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 108 ," 19,576 "," 19,576 "," $1,284,498.88 ",,
MEDICAID DIRECT,1366001976,FOUNDATION OF HOPE INC,,300 N BROWN ST   CHADBOURN NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1366001976,FOUNDATION OF HOPE INC,119 GRIST RD   CHADBOURN NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1366001976,FOUNDATION OF HOPE INC,,300 N BROWN ST   CHADBOURN NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1366001976,FOUNDATION OF HOPE INC,300 N BROWN ST   CHADBOURN NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 14 , 75 , 75 ,$#,,
MEDICAID DIRECT,1366001976,FOUNDATION OF HOPE INC,,4015 WOODLEAF RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1366001976,FOUNDATION OF HOPE INC,4015 WOODLEAF RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 88 ," 4,479 "," 4,479 "," $294,370.72 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366002628,"CAMPBELL, CURTIS, RAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 31 , 32 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366005142,"BOGUE, VALORIE, MAE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1083854897,DOCTORS MAKING HOUSECALLS INTERNAL,DOCTORS MAKING HOUSECALLS INTERNAL MEDICINE PA,,,Unknown,193200000X,Group,Multi-Specialty,,1366005142,"BOGUE, VALORIE, MAE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1366007627,"JONES, PETER, WOODWARD",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366007627,"JONES, PETER, WOODWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1366007627,"JONES, PETER, WOODWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1366007627,"JONES, PETER, WOODWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1366007643,"SHAW, LEAH, CATHERINE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366007643,"SHAW, LEAH, CATHERINE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366007643,"SHAW, LEAH, CATHERINE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366007643,"SHAW, LEAH, CATHERINE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366007643,"SHAW, LEAH, CATHERINE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366007643,"SHAW, LEAH, CATHERINE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366007643,"SHAW, LEAH, CATHERINE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366009458,"KHAN, SALMA, ZIA",109 BRIDGE ST APT 201 DANVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366012775,"FEATHERSTONE, ASHLEY, NICOLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366012775,"FEATHERSTONE, ASHLEY, NICOLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 30 ,$#,,
MEDICAID DIRECT,1063472116,OCRACOKE HEALTH CENTER INC,ENGELHARD MEDICAL CENTER,33270 US 264   ENGELHARD NC,048,Hyde,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366015448,"PHAM, THAO, KIM",33270 US HIGHWAY 264   ENGELHARD NC,048,Hyde,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 89 , 109 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1366017881,"SPENCER, AIRIEL, HEWITT",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 228 , 234 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1366017881,"SPENCER, AIRIEL, HEWITT",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 166 , 169 ,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1366019242,"KWAKYE-ACKAH, EMELDA, YAA",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 75 , 75 , 92 ," $14,183.15 ",,
MEDICAID DIRECT,1235340803,LARRY J MORAY DDS MS PA,MYORTHODONTIST,120 CLINTON CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1366019242,"KWAKYE-ACKAH, EMELDA, YAA",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 676 ," 1,617 "," 2,350 "," $299,343.73 ",,
MEDICAID DIRECT,1235340803,LARRY J MORAY DDS MS PA,MYORTHODONTIST,120 CLINTON CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1366019242,"KWAKYE-ACKAH, EMELDA, YAA",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 888 ," 2,202 "," 3,079 "," $381,332.50 ",,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1366019242,"KWAKYE-ACKAH, EMELDA, YAA",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1366019242,"KWAKYE-ACKAH, EMELDA, YAA",616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366022576,"BROWN, JEREMY, PRESTON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366022576,"BROWN, JEREMY, PRESTON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366022576,"BROWN, JEREMY, PRESTON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366022576,"BROWN, JEREMY, PRESTON",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1366022907,B&B ASSISTED LIVING CARE LLC,B&B ASSISTED LIVING NO 2,2610 NC HIGHWAY 130 W   ROWLAND NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366022907,B&B ASSISTED LIVING CARE LLC,2610 NC HIGHWAY 130 W   ROWLAND NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 355 , 355 ," $22,272.13 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366023137,"YATES, MARISSA, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1366023202,"LANTZ, DYLAN, JOHN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 18 , 19 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1366023202,"LANTZ, DYLAN, JOHN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1366024168,HOMECHOICE OF COASTAL CAROLINA LLC,,1000 N MAIN ST STE 102 FUQUAY VARINA NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1366024168,HOMECHOICE OF COASTAL CAROLINA LLC,1000 N MAIN ST STE 102 FUQUAY VARINA NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1255054623,ASHE MULTISPECIALTY GROUP LLC,ASHE WOMEN AND CHILDRENS HEALTH,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1366024903,"RUPARD, JESSICA, SHOEMAKE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366024903,"RUPARD, JESSICA, SHOEMAKE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366025017,"PATEL, VANEESHA, MANSHUKH",7110 LAWYERS RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 28 , 56 ,$#,,
MEDICAID DIRECT,1366025116,HERRING HOME CARE LLC,,2270 NASH ST N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1366025116,HERRING HOME CARE LLC,2270 NASH ST N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,286 "," 2,341 "," $161,544.74 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366040503,"SPARKS, WILLIAM, TOMMY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 77 , 116 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366040503,"SPARKS, WILLIAM, TOMMY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366045338,"WEISS, LAUREN, NICOLE",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366045338,"WEISS, LAUREN, NICOLE",600 HOSPITAL DR   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1366045338,"WEISS, LAUREN, NICOLE",1000 HEALING WAY   MATTHEWS NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1366051922,"O'REILLY, ERIC, AODH",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 72 , 130 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1366051922,"O'REILLY, ERIC, AODH",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1124552310,SCOTLAND MEMORIAL HOSPITAL INC,WOLONICK FAMILY PRACTICE CENTER,106 MCALPINE LN   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1366051922,"O'REILLY, ERIC, AODH",106 MCALPINE LN   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366053001,"RUPERT, HANNAH, GRACE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366053993,"MILLER-THUWIS, MELISSA, RAE",2810 SOUTH BLVD STE B CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366053993,"MILLER-THUWIS, MELISSA, RAE",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366053993,"MILLER-THUWIS, MELISSA, RAE",3333 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366054629,"FOSTER, MAGGIE, ELIZABETH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 64 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366054629,"FOSTER, MAGGIE, ELIZABETH",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366054629,"FOSTER, MAGGIE, ELIZABETH",3801 W MARKET ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366054629,"FOSTER, MAGGIE, ELIZABETH",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366055808,"VENKER, CHRISTA, ANNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 57 , 87 ," $20,625.73 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366055808,"VENKER, CHRISTA, ANNE",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1366056244,5 STONE THERAPY LLC,,2036 QUILL CT   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366056244,5 STONE THERAPY LLC,2036 QUILL CT   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 47 , 526 , 585 ," $48,862.34 ",,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366058695,"NELSON, NOURA, ZAHRA",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366058695,"NELSON, NOURA, ZAHRA",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366058695,"NELSON, NOURA, ZAHRA",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366058695,"NELSON, NOURA, ZAHRA",7825 BALLANTYNE COMMONS PKWY STE 150 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 41 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366058695,"NELSON, NOURA, ZAHRA",7825 BALLANTYNE COMMONS PKWY STE 150 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366059594,"CADDELL, HOPE, RABIL",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366061509,"WRIGHT, BRANDON, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1447892906,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SIX FORKS,3614 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366061657,"MA, JASON, LI",111 E INDUSTRY DR   OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 55 , 66 , 237 ," $11,445.80 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366062184,"MUNOZ DAYAA, RODRIGO, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 144 , 144 , 150 ," $62,062.05 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366062184,"MUNOZ DAYAA, RODRIGO, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366062184,"MUNOZ DAYAA, RODRIGO, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366062184,"MUNOZ DAYAA, RODRIGO, DANIEL",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366063323,"DALY, SHAOLEEN, KHALED",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366063323,"DALY, SHAOLEEN, KHALED",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366063323,"DALY, SHAOLEEN, KHALED",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366063323,"DALY, SHAOLEEN, KHALED",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366063323,"DALY, SHAOLEEN, KHALED",7752 GATEWAY LN NW STE 100 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 26 , 53 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366066177,"JANOFSKI, BRITTANY, LYNN",517 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 61 , 61 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366066177,"JANOFSKI, BRITTANY, LYNN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366070450,"SILINSKI, LAUREN, WESTERHOLD",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 44 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366070450,"SILINSKI, LAUREN, WESTERHOLD",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 38 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366070450,"SILINSKI, LAUREN, WESTERHOLD",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366070450,"SILINSKI, LAUREN, WESTERHOLD",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366072365,"JESSUP, JOY, LYNN",1635 NC HIGHWAY 66 S STE 210 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366072365,"JESSUP, JOY, LYNN",1635 NC HIGHWAY 66 S STE 210 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 25 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366073710,"DAVIS, GERRIT, WARREN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1366073710,"DAVIS, GERRIT, WARREN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 28 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1366076481,"CARLTON, ALEXANDRA, WHITNEY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1366076481,"CARLTON, ALEXANDRA, WHITNEY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1366076481,"CARLTON, ALEXANDRA, WHITNEY",1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1366076481,"CARLTON, ALEXANDRA, WHITNEY",1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1366076481,"CARLTON, ALEXANDRA, WHITNEY",1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1366076481,"CARLTON, ALEXANDRA, WHITNEY",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 30 , 32 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1366076481,"CARLTON, ALEXANDRA, WHITNEY",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1366081481,"GRIFFIN, NOELLE, ANNE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 47 , 61 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366081481,"GRIFFIN, NOELLE, ANNE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 32 , 38 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366083677,"MARLOW, CAITLIN, MEZEY",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366083677,"MARLOW, CAITLIN, MEZEY",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1366088650,STAR CARE NETWORK INC,SHULER HEALTH CARE - PIERCE VILLA,250 PITTS ST   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366088650,STAR CARE NETWORK INC,250 PITTS ST   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 434 , 434 ," $87,956.13 ",,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 75 , 87 , 163 ,$#,,
MEDICAID DIRECT,1396041075,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH CENTRA CARE,436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 23 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1902223076,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1366089112,"BOICOURT, DIANE, WATSON",181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1366089757,"MITZEL, KATHERINE, ELIZABETH",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 18 , 145 , 149 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366089757,"MITZEL, KATHERINE, ELIZABETH",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 138 , 138 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366089757,"MITZEL, KATHERINE, ELIZABETH",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 62 , 621 , 629 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366089757,"MITZEL, KATHERINE, ELIZABETH",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366091258,"RIYAMI, ZAINAB, AMUR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366091258,"RIYAMI, ZAINAB, AMUR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366091258,"RIYAMI, ZAINAB, AMUR",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366093080,TLC AGENCY INC,,584 EXECUTIVE PL   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1366093080,TLC AGENCY INC,584 EXECUTIVE PL   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 12 , 996 ," 1,004 "," $63,014.92 ",,
MEDICAID DIRECT,1366093080,TLC AGENCY INC,,241 W COLUMBUS ST STE 202 WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1366093080,TLC AGENCY INC,241 W COLUMBUS ST STE 202 WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 52 ," 10,870 "," 10,891 "," $700,643.98 ",,
MEDICAID DIRECT,1366093817,ZEBULON OPCO LLC,COVENTRY HOUSE OF ZEBULON,1205 W GANNON AVE   ZEBULON NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366093817,ZEBULON OPCO LLC,1205 W GANNON AVE   ZEBULON NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 26 ," 7,590 "," 7,596 "," $486,004.73 ",,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1366093957,"PRUITT, ALEXIS, HOLLAND REUTHER",446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1720151525,COUNTY OF CLEVELAND NORTH CAROLINA,CLEVELAND COUNTY HEALTH DEPARTMENT,200 S POST RD   SHELBY NC,023,Cleveland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366093957,"PRUITT, ALEXIS, HOLLAND REUTHER",335A W COLLEGE AVE   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 15 , 31 , 154 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1366093957,"PRUITT, ALEXIS, HOLLAND REUTHER",201 E GROVER ST   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1366093957,"PRUITT, ALEXIS, HOLLAND REUTHER",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1366093957,"PRUITT, ALEXIS, HOLLAND REUTHER",110 W GROVER ST   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 18 , 18 , 28 ,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1366094971,"YUSUF, OLABODE, HAKEEM",1135 CARTHAGE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1366094971,"YUSUF, OLABODE, HAKEEM",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1790568046,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA GYNECOLOGY AND AESTHETICS,127 N STEELE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1366094971,"YUSUF, OLABODE, HAKEEM",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518642255,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA WOMENS HEALTH CENTER RHC,1140 CARTHAGE ST STE A SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1366094971,"YUSUF, OLABODE, HAKEEM",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366097859,"BARBU, MARTHA, NELLY",1142 N BROOME ST   WAXHAW NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1142 N BROOME ST   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1366097859,"BARBU, MARTHA, NELLY",1142 N BROOME ST   WAXHAW NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1366098816,"STILLWELL, BRIANA, JAMISON",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 76 , 102 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1366098816,"STILLWELL, BRIANA, JAMISON",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1366098816,"STILLWELL, BRIANA, JAMISON",324 N QUEEN ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366100463,"SHULENBURGER, MISTY, DAWN",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366100463,"SHULENBURGER, MISTY, DAWN",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366100463,"SHULENBURGER, MISTY, DAWN",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366103012,"CHARLTON, ALEXANDRA, PEYTON",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1366107872,"ROSS, PEARL, MAE",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 22 , 45 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366107872,"ROSS, PEARL, MAE",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366109662,"MILLER, BRETT, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366109894,"BONEY, JENNIFER, TILLMAN",2416 BEDGOOD DR SW   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 82 , 496 , 505 ," $10,611.11 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366109894,"BONEY, JENNIFER, TILLMAN",208 MALLOY ST STE B GOLDSBORO NC,096,Wayne,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 93 , 686 , 755 ," $20,493.95 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366109894,"BONEY, JENNIFER, TILLMAN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 30 , 134 , 144 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366112369,"DONG, HUI, BING",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 27 , 36 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366112369,"DONG, HUI, BING",8401 UNIVERSITY EXEC PARK DR STE 130 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366112583,"LUTZ, KATHERINE, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 114 , 117 , 120 ,$#,,
MEDICAID DIRECT,1649221342,RALEIGH DURHAM MEDICAL GROUP PA,~,4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366114027,"HENDERSON, JADE, YEARBY",4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 16 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366114662,"SOMERA, CHERIE ANN, CUA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366114662,"SOMERA, CHERIE ANN, CUA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366114662,"SOMERA, CHERIE ANN, CUA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 67 , 67 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366117384,"BROWN, CHARLOTTE, ALEXANDRA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366117384,"BROWN, CHARLOTTE, ALEXANDRA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1366119331,"STEVENS, ANNA, WRIGHT",1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 29 , 253 , 253 ," $17,693.67 ",,
MEDICAID DIRECT,1366123192,AMERICANS FIRST SENIOR CARE LLC,,2731 HOFFMAN RD   FOXFIRE VILLAGE NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,1366123192,AMERICANS FIRST SENIOR CARE LLC,2731 HOFFMAN RD   FOXFIRE VILLAGE NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,#, 550 , 550 ," $50,929.01 ",,
MEDICAID DIRECT,1689849200,NORTH CAROLINA BAPTIST HOSPITAL,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1366128993,"DIEM, KAREE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366129637,"RIVERA, GABRIELLE, GRACE",227 MEMORIAL DR STE A JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 128 , 240 , 501 ,$#,,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1366129819,"FLOTRON, SOPHIE, BOYER",1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 338 , 774 ," 2,389 "," $127,857.96 ",,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,100 GOODMAN CIR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1366129819,"FLOTRON, SOPHIE, BOYER",1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1770136103,CHARLES STRAUGHAN DMD PLLC,~,2428 N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366129819,"FLOTRON, SOPHIE, BOYER",1303 PLAZA DR   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1992483465,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WEBB A MURRAY ELEMENTARY,3901 SECTION HOUSE RD   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366129827,"VANG, LINA, YER",1270 25TH STREET PL SE   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366130072,"PHARR, CAROLINE, ROBERTS",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366130072,"PHARR, CAROLINE, ROBERTS",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366130072,"PHARR, CAROLINE, ROBERTS",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366130072,"PHARR, CAROLINE, ROBERTS",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1366131542,A&M HOME CARE,,800 SALEM WOODS DR STE 205 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1366131542,A&M HOME CARE,800 SALEM WOODS DR STE 205 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,128 "," 2,128 "," $130,892.73 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366133415,"DORNER, ALEXANDRA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366133415,"DORNER, ALEXANDRA, MARIE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366133415,"DORNER, ALEXANDRA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366135311,"LIPPARD, ROSS, ALDEN",75 EMERSON BAY RD STE 102 CAROLINA SHORES NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 33 , 56 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366140303,"JONES, RACHEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366140303,"JONES, RACHEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1366151029,"JOHNSON, VALERIE, DIANE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1366151029,"JOHNSON, VALERIE, DIANE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1366151029,"JOHNSON, VALERIE, DIANE",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 47 , 54 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,517 B HWY 210 N   SPRING LAKE NC,026,Cumberland,193400000X,Group,Single Specialty,,1366151029,"JOHNSON, VALERIE, DIANE",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1366151029,"JOHNSON, VALERIE, DIANE",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 75 , 116 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366151029,"JOHNSON, VALERIE, DIANE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1366153975,"PAWELA, JOSHUA, MARK",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 95 , 113 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366153975,"PAWELA, JOSHUA, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1366153975,"PAWELA, JOSHUA, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366153975,"PAWELA, JOSHUA, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5402 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366153975,"PAWELA, JOSHUA, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366153975,"PAWELA, JOSHUA, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366155509,"ANDREWS, TAYLOR, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 87 , 150 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366155509,"ANDREWS, TAYLOR, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366155509,"ANDREWS, TAYLOR, ANNE",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366155509,"ANDREWS, TAYLOR, ANNE",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821059650,POLYCLINIC MEDICAL CENTER INC,POLYCLINIC MEDICAL CENTER INC,9705 NORTHEAST PKWY STE 400 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366157992,"RIVERA, ALEXA, ROE",9705 NORTHEAST PKWY STE 400 MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366157992,"RIVERA, ALEXA, ROE",13620 REESE BLVD E   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366162349,"SWANSON, MELISSA, MARIE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205005824,EYECARECENTER OD PA,,14 CONSULTANT PL   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1366165094,"KALLON, JEREDINE, M",14 CONSULTANT PL STE 100 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1366165490,"PRADHAN, TENISHA",303 E CARVER ST   DURHAM NC,032,Durham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 67 , 813 , 823 ," $14,976.06 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1366165490,"PRADHAN, TENISHA",303 E CARVER ST   DURHAM NC,032,Durham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 116 ," 1,747 "," 1,774 "," $41,599.61 ",,
MEDICAID DIRECT,1326775404,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,9310 STRAUSE DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366170953,"NUTTER, EMILY, ELIZABETH",9310 STRAUSE DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1366171019,"LANG, RACHEL, NICOLE",420 N CENTER ST   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366175820,"PASCARELLA, RAEJONNA, LIN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 30 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1366175820,"PASCARELLA, RAEJONNA, LIN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366175820,"PASCARELLA, RAEJONNA, LIN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 28 , 33 ,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1366179095,"BOLES, KAREEM, COLON",3000 HIGHWOODS BLVD STE 310 RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1629843933,OPTUM BEHAVIORAL CARE OF NORTH CARO,CAROLINA BEHAVIORAL CARE CENTERS,1101 MARCO DR STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366179095,"BOLES, KAREEM, COLON",3000 HIGHWOODS BLVD STE 310 RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366180929,"COX, CHANCE, JENNINGS",105 PROFESSIONAL PARK DR   BEAUFORT NC,016,Carteret,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 40 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1366195828,"WEST, KARMON, NICOLE",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 73 , 100 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1366195828,"WEST, KARMON, NICOLE",911 E ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366196602,"ALLEN, HEATHER, LEE",5241 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366196602,"ALLEN, HEATHER, LEE",5241 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366196602,"ALLEN, HEATHER, LEE",8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366196602,"ALLEN, HEATHER, LEE",5241 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 39 , 41 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366196602,"ALLEN, HEATHER, LEE",5241 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366196602,"ALLEN, HEATHER, LEE",8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 61 , 61 ,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366197402,"PETRIELLA, REBEKAH, PAIGE",1244 COMMERCE ST SW STE A CONOVER NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366198491,"MONACO, CAITLIN, DRENNAN",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366198491,"MONACO, CAITLIN, DRENNAN",102 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1366200404,"GABBARD, LE'ANDRA, TA'ZHAWNAY",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366200883,"WIGGINS, JENNY, MOORING",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366200883,"WIGGINS, JENNY, MOORING",623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1366200883,"WIGGINS, JENNY, MOORING",623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1366200883,"WIGGINS, JENNY, MOORING",623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366200883,"WIGGINS, JENNY, MOORING",623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 46 , 46 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1366200883,"WIGGINS, JENNY, MOORING",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 166 , 166 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366252165,"HOUSTON, DESIREE, FLORENCE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1366263709,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY EAR NOSE AND THROAT-LILLINGTON,225 BRIGHTWATER DR STE 210 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1366263709,CAPE FEAR VALLEY HEALTH MEDICAL GRO,225 BRIGHTWATER DR STE 210 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,, 17 , 19 , 38 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1366276495,"CRUZ, ISAI",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558371286,CAROLINA KIDS PEDIATRIC,CAROLINA KIDS PEDIATRIC ASSOCIATES PLLC,2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366280349,"MULLINS, JENNIFER, JERVEY",2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366282576,"GIBBS-MORRIS, LATOYA, DONEILL",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 30 , 38 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366283178,"PARNELL, KATHLEEN, ELIZABETH",3110 WELLONS BLVD   NEW BERN NC,025,Craven,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1366287526,"BALDWIN, EMILY, JORDAN",110 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1366287526,"BALDWIN, EMILY, JORDAN",446 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 21 , 34 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366287658,"HOLLAND, ALEXANDRA",1144 N ROAD STREET   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366294233,"MAYNARD, JORDAN, ALAN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366294233,"MAYNARD, JORDAN, ALAN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1366401036,"SHAH-KHAN, SARDAR, MAHMOOD",~,303 S COLLEGE ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1366401036,"SHAH-KHAN, SARDAR, MAHMOOD",303 S COLLEGE ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 179 , 385 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366401390,"PAPPAS, THEODORE, NICK",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366401390,"PAPPAS, THEODORE, NICK",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366402406,"MYERS, JOHN, JAY",111 HOSPITAL DR   LEGGETT NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366402406,"MYERS, JOHN, JAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 99 , 107 , 111 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366403065,"RHODES, HERMAN, KYLE",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366403065,"RHODES, HERMAN, KYLE",510 CAROLINA BAY DR STE 100 WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366405003,"WHITMORE III, ROBERT, BURTON",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366406340,"KLEIN, STEVEN, COCHRAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 104 , 367 , 595 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366406340,"KLEIN, STEVEN, COCHRAN",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 25 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366406340,"KLEIN, STEVEN, COCHRAN",3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366406340,"KLEIN, STEVEN, COCHRAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1568856870,R ROFF CHIROPRACTIC SERVICES,ROFF CHIROPRACTIC,785-2 W CORBETT AVE   SWANSBORO NC,067,Onslow,193400000X,Group,Single Specialty,,1366406845,"ROFF JR, ROGER, ROLAN",785-2 W CORBETT AVE   SWANSBORO NC,067,Onslow,111N00000X,Chiropractic Providers,Chiropractor,,#, 77 , 80 ,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1366407405,"COWAN, FREDA, CLARK",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 69 , 81 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 69 , 82 , 116 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 22 , 27 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 23 ,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1366407496,"JACOBSON, LESLIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356815138,INTEGRATIVE ARTHRITIS AND PAIN CONS,~,2719 GRAVES DR STE 14 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1366407686,"HOGARTY, SUNEYA, GUPTA",2719 GRAVES DR STE 14 GOLDSBORO NC,096,Wayne,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 83 , 222 , 348 ,$#,,
MEDICAID DIRECT,1366407686,"HOGARTY, SUNEYA, GUPTA",~,2719 GRAVES DR STE 14 GOLDSBORO NC,096,Wayne,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,1366407686,"HOGARTY, SUNEYA, GUPTA",2719 GRAVES DR STE 14 GOLDSBORO NC,096,Wayne,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1356815138,INTEGRATIVE ARTHRITIS AND PAIN CONS,~,2719 GRAVES DR STE 14 GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1366407686,"HOGARTY, SUNEYA, GUPTA",2719 GRAVES DR STE 14 GOLDSBORO NC,096,Wayne,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 17 , 19 , 28 ,$#,,
MEDICAID DIRECT,1649427089,TINA S MERHOFF DDS PA,,185 KIMEL PARK DR STE 202 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366408338,"MERHOFF, TINA, SCOTT",185 KIMEL PARK DR STE 202 WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#, 12 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366409575,"SUTTON, LINDA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649786567,JOHNSTON SPECIALTY PHYSICIAN SERVIC,JOHNSTON HEALTH HEMATOLOGY AND ONCOLOGY,514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366409575,"SUTTON, LINDA, MARIE",514 N BRIGHTLEAF BLVD STE 1100 SMITHFIELD NC,051,Johnston,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1366409575,"SUTTON, LINDA, MARIE",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 17 , 35 , 36 ,$#,,
MEDICAID DIRECT,1487940268,OUR FAMILY DOCTOR PLLC,OUR FAMILY DOCTOR PLLC,43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366409989,"WEIZMAN, MICHAEL, SHALOM",43 OAKLAND RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 69 , 117 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1366410821,"PINCUS, MARIA, DIANE",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1366410821,"PINCUS, MARIA, DIANE",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 21 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1366410821,"PINCUS, MARIA, DIANE",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 49 , 126 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366411159,"ZHAO, DAVID, XIAN MING",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 43 , 63 , 76 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366411209,"ONEAL, MELISSA, GOLD",1210 BROWN ST   WASHINGTON NC,007,Beaufort,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1210 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1366411209,"ONEAL, MELISSA, GOLD",1210 BROWN ST   WASHINGTON NC,007,Beaufort,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1366411209,"ONEAL, MELISSA, GOLD",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366411209,"ONEAL, MELISSA, GOLD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 49 , 61 , 80 ," $11,579.08 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1366411209,"ONEAL, MELISSA, GOLD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1366411407,"ZAWODNIAK, MARK, JOSEPH",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1043272784,GREENSBORO DERMATOLOGY ASSOCIATES P,GREENSBORO DERMATOLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1366411506,"JONES, DANIEL, BRIAN",2704 SAINT JUDE ST   GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366412207,"DY, MARC, KENNETH",10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366412207,"DY, MARC, KENNETH",10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 31 , 37 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366413130,"PATTISON, TIMOTHY, WILSON COUSAR",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366413130,"PATTISON, TIMOTHY, WILSON COUSAR",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 112 , 112 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366413353,"HALLIGAN, MICHAEL, EDWARD",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366413353,"HALLIGAN, MICHAEL, EDWARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366413353,"HALLIGAN, MICHAEL, EDWARD",960 NEWMAN RD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1659337046,COASTAL SURGICAL SPECIALIST,Coastal Surgical Specialist,2203 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1366413445,"BELL III, WILLIAM, HARRISON",2203 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 18 , 49 , 53 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 118 , 139 , 139 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 29 , 37 , 44 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366414344,"KOK, LAI, CHOW",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1366415259,AMERICAN HOMEPATIENT OF UNIFOUR LLC,AMERICAN HOMEPATIENT,1929 TATE BLVD SE   HICKORY NC,018,Catawba,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1366415259,AMERICAN HOMEPATIENT OF UNIFOUR LLC,1929 TATE BLVD SE   HICKORY NC,018,Catawba,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1366415259,AMERICAN HOMEPATIENT OF UNIFOUR LLC,AMERICAN HOMEPATIENT,1929 TATE BLVD SE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1366415259,AMERICAN HOMEPATIENT OF UNIFOUR LLC,1929 TATE BLVD SE   HICKORY NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1366415259,AMERICAN HOMEPATIENT OF UNIFOUR LLC,AMERICAN HOMEPATIENT,1929 TATE BLVD SE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1366415259,AMERICAN HOMEPATIENT OF UNIFOUR LLC,1929 TATE BLVD SE   HICKORY NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 225 ," 1,299 "," 2,433 "," $38,947.20 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366416877,"FEASTER, RAY",1942 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 30 , 60 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366416877,"FEASTER, RAY",1942 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 37 , 68 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366416877,"FEASTER, RAY",11300 CRESTHILL DR STE 100 MINT HILL NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366416877,"FEASTER, RAY",11300 CRESTHILL DR STE 100 MINT HILL NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366417321,"WILLIAMS, HARRY, T",2859 VIRGINIA BEACH BLVD   VIRGINIA BCH VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1366417354,"SESSIONS, RAYMOND, RENARD",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366418956,"MOODY ANTONIO, STEPHANIE, ANN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1366419624,"IKALOWYCH, SHERRY, ZILBERT",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366419624,"IKALOWYCH, SHERRY, ZILBERT",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 94 , 95 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1366419624,"IKALOWYCH, SHERRY, ZILBERT",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1366420507,"MILLER, JODI, LYNN",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 179 , 323 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366420507,"MILLER, JODI, LYNN",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 36 , 61 ,$#,,
MEDICAID DIRECT,1366423220,EBI LLC,~,1 GATEHALL DR STE 303 PARSIPPANY NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1366423220,EBI LLC,1 GATEHALL DR STE 303 PARSIPPANY NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 29 , 29 , 29 ," $31,634.75 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366424731,"STEED, ROBERT, DENNIS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366427411,"OWEN, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366427858,"WADDELL, HEATHER, SIMMONS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366427858,"WADDELL, HEATHER, SIMMONS",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1801850250,TRIANGLE PRIMARY CARE ASSOCIATES PL,TRIANGLE PRIMARY CARE ASSOCIATES PLLC,851 DURHAM RD STE D WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1366428393,"CAPP, MONICA, MIANZO",851 DURHAM RD STE D WAKE FOREST NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 18 , 39 , 46 ,$#,,
MEDICAID DIRECT,1366428393,"CAPP, MONICA, MIANZO",~,851 DURHAM RD STE D WAKE FOREST NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,1366428393,"CAPP, MONICA, MIANZO",851 DURHAM RD STE D WAKE FOREST NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366428443,"ODONOVAN, CORMAC, ALVIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 83 , 117 , 136 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366428443,"ODONOVAN, CORMAC, ALVIN",624 QUAKER LN   HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366428583,"FISCUS, SUZANNE, RENEE",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255390225,WILSON OB GYN,WILSON OB GYN,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1366428583,"FISCUS, SUZANNE, RENEE",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 35 , 41 , 47 ," $10,571.06 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1366428583,"FISCUS, SUZANNE, RENEE",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 31 , 39 , 56 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366428740,"CHASNIS, ALEXANDER, WALTER",150 FAIRVIEW RD STE 230 MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366428740,"CHASNIS, ALEXANDER, WALTER",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366428740,"CHASNIS, ALEXANDER, WALTER",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 44 , 59 , 97 ,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366430308,"TURNER JR, JOHN, FRANKLIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 115 , 119 , 252 ,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366430308,"TURNER JR, JOHN, FRANKLIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366430308,"TURNER JR, JOHN, FRANKLIN",1915 S 17TH ST STE 100 WILMINGTON NC,065,New Hanover,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,9735 KINCEY AVE STE 300 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366431165,"ZUHOSKY, JOSEPH, PATRICK",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 73 , 166 , 274 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366431165,"ZUHOSKY, JOSEPH, PATRICK",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 18 , 29 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366431165,"ZUHOSKY, JOSEPH, PATRICK",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366432007,"GUFFIN, SHAWN, THOMAS",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366432007,"GUFFIN, SHAWN, THOMAS",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366432007,"GUFFIN, SHAWN, THOMAS",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366432007,"GUFFIN, SHAWN, THOMAS",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366432007,"GUFFIN, SHAWN, THOMAS",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366432007,"GUFFIN, SHAWN, THOMAS",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366432007,"GUFFIN, SHAWN, THOMAS",1585 FORNEY CREEK PKWY STE 110 DENVER NC,055,Lincoln,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1366432148,"CARLINNIA, BRIAN, A",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 134 , 134 ,$#,,
MEDICAID DIRECT,1386682367,EAST ASHEVILLE FAMILY HEALTH CARE,~,997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1366432619,"PARKER, ANNE, JENNINGS",997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1215488481,RDMG ASSOCIATES PA,,3164 US HIGHWAY 70   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366432619,"PARKER, ANNE, JENNINGS",3164 US HIGHWAY 70   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 178 , 284 ,$#,,
MEDICAID DIRECT,1366557803,WHITE EYE ASSOCIATES PA,WHITE EYE ASSOCIATES PA,301 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366432924,"BAUER, ROBERT, MCHENRY",301 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 101 , 184 , 216 ," $12,902.26 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1366434557,"KINTER, MARK, EDWARD",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1780637850,MIDWAY MEDICAL CENTER CANTON,MIDWAY MEDICAL CENTER,6750 CAROLINA BLVD   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1366434557,"KINTER, MARK, EDWARD",6750 CAROLINA BLVD   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 52 , 106 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366434862,"GEORGESON, RAY, IRWIN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 40 , 48 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366434862,"GEORGESON, RAY, IRWIN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366434862,"GEORGESON, RAY, IRWIN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 341 , 615 , 767 ," $10,170.94 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366434862,"GEORGESON, RAY, IRWIN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 85 , 156 , 192 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366434862,"GEORGESON, RAY, IRWIN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366434862,"GEORGESON, RAY, IRWIN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1366435828,"SHEAFFER, LUANNE, GARDNER",319 WB MCLEAN DR   CAPE CARTERET NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1300 2 BRIDGE BARRIER RD   CAROLINA BEACH NC,065,New Hanover,193400000X,Group,Single Specialty,,1366436222,"MCGARRITY, MICHAEL, SCOTT",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366436222,"MCGARRITY, MICHAEL, SCOTT",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 40 , 65 , 104 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,6781 PARKER FARM DR STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366436222,"MCGARRITY, MICHAEL, SCOTT",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366436222,"MCGARRITY, MICHAEL, SCOTT",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 31 , 52 , 101 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366436628,"RAMASWAMY, KOLANDAIVELU",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366436628,"RAMASWAMY, KOLANDAIVELU",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366436628,"RAMASWAMY, KOLANDAIVELU",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 43 , 46 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1366437048,"MALLON, WILLIAM, JAMES",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1366438111,"PAXSON, ALICIA, MARIE",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 39 , 39 ,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366438194,"CHUNG, DAWN, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366438194,"CHUNG, DAWN, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 37 , 37 ,$#,,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366439093,"DAVIS, ELLEN, SATTERWHITE",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 17 ,$#,,
MEDICAID DIRECT,1265547483,RETINA INSTITUTE OF NORTH CAROLINA,RETINA INSTITUTE OF NORTH CAROLINA PC,1535 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1366440273,"MCKENNA, LISA, FOGEL",1535 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 18 , 35 ,$#,,
MEDICAID DIRECT,1265547483,RETINA INSTITUTE OF NORTH CAROLINA,RETINA INSTITUTE OF NORTH CAROLINA PC,2605 BLUE RIDGE RD STE 320 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366440273,"MCKENNA, LISA, FOGEL",1535 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 22 , 30 ,$#,,
MEDICAID DIRECT,1265547483,RETINA INSTITUTE OF NORTH CAROLINA,RETINA INSTITUTE OF NORTH CAROLINA PC,2605 BLUE RIDGE RD STE 320 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366440273,"MCKENNA, LISA, FOGEL",2605 BLUE RIDGE RD STE 320 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 82 , 213 ," $16,930.82 ",,
MEDICAID DIRECT,1265547483,RETINA INSTITUTE OF NORTH CAROLINA,RETINA INSTITUTE OF NORTH CAROLINA PC,152 CAPCOM AVE STE 102 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1366440273,"MCKENNA, LISA, FOGEL",152 CAPCOM AVE STE 102 WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 21 , 46 ,$#,,
MEDICAID DIRECT,1265547483,RETINA INSTITUTE OF NORTH CAROLINA,RETINA INSTITUTE OF NORTH CAROLINA PC,2605 BLUE RIDGE RD STE 320 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366440273,"MCKENNA, LISA, FOGEL",152 CAPCOM AVE STE 102 WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265547483,RETINA INSTITUTE OF NORTH CAROLINA,RETINA INSTITUTE OF NORTH CAROLINA PC,152 CAPCOM AVE STE 102 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1366440273,"MCKENNA, LISA, FOGEL",2605 BLUE RIDGE RD STE 320 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1265547483,RETINA INSTITUTE OF NORTH CAROLINA,RETINA INSTITUTE OF NORTH CAROLINA PC,2605 BLUE RIDGE RD STE 320 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366440273,"MCKENNA, LISA, FOGEL",2605 BLUE RIDGE RD STE 320 RALEIGH NC,092,Wake,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366441123,"REDMOND, BERNIECE, ELIZABETH",417 N MAIN ST   KENANSVILLE NC,031,Duplin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1114969706,COMPLETE EYE CARE OD PA,COMPLETE EYE CARE OD PA,1200 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366442220,"MARCUSSEN, BARBARA, LYNN",1200 SPRUCE ST   BELMONT NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 50 , 78 , 145 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366442733,"WERNER, HARRY, RUPERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366442733,"WERNER, HARRY, RUPERT",1995 WELLNESS BLVD STE 110 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 56 , 113 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366443392,"CARLSON, BETH, LYNN",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 31 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366443392,"CARLSON, BETH, LYNN",332 N TRADE ST STE 2000-A MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366443392,"CARLSON, BETH, LYNN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,332 N TRADE ST STE 2000A MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366443392,"CARLSON, BETH, LYNN",332 N TRADE ST STE 2000-A MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 78 , 111 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366443509,"EMERY, MARK, THOMAS",1213 LEXINGTON AVE STE A THOMASVILLE NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366443509,"EMERY, MARK, THOMAS",209 PARK ST STE 500 BELMONT NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 21 , 29 , 40 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366443509,"EMERY, MARK, THOMAS",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366443509,"EMERY, MARK, THOMAS",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 20 , 24 , 46 ,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366443509,"EMERY, MARK, THOMAS",1180 WYKE RD   SHELBY NC,023,Cleveland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366444218,"BALL, JOY, KENDRICK",1315 EAST BLVD STE 280 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1366444358,"RAMOS, RICHARD, DARREN",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 32 , 57 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366444358,"RAMOS, RICHARD, DARREN",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 144 , 280 , 404 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366444515,"RODRIGUEZ FALCON, WILFREDO, YADIRA",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366444515,"RODRIGUEZ FALCON, WILFREDO, YADIRA",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 50 , 78 , 135 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366444515,"RODRIGUEZ FALCON, WILFREDO, YADIRA",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457604902,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES HOKE,6322 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1366445975,"DELANEY, AGNES, BLANCHE",608 E 12TH ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457604902,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES HOKE,6322 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1366445975,"DELANEY, AGNES, BLANCHE",6322 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 110 , 178 , 179 ,$#,,
MEDICAID DIRECT,1457604902,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES HOKE,6322 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1366445975,"DELANEY, AGNES, BLANCHE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457604902,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES HOKE,6322 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1366445975,"DELANEY, AGNES, BLANCHE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1366445975,"DELANEY, AGNES, BLANCHE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366446148,"PHALEN, TIMOTHY, JOSEPH",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366446148,"PHALEN, TIMOTHY, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 63 , 64 , 74 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366446320,"MADDEN, CHRISTOPHER, ANDREW",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 23 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366446320,"MADDEN, CHRISTOPHER, ANDREW",6301 STADIUM DR   CLEMMONS NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 56 , 127 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366446320,"MADDEN, CHRISTOPHER, ANDREW",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366447344,"DIXON, CHRISTOPHER, ANDREW",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1366447344,"DIXON, CHRISTOPHER, ANDREW",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366447344,"DIXON, CHRISTOPHER, ANDREW",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 55 , 55 , 57 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366447344,"DIXON, CHRISTOPHER, ANDREW",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366447344,"DIXON, CHRISTOPHER, ANDREW",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1366447757,"SZWEJBKA, PAUL, ERIC",CUMBERLAND NEUROLOGY PA,4140 FERNCREEK DR STE 401 FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1366447757,"SZWEJBKA, PAUL, ERIC",4140 FERNCREEK DR STE 401 FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 69 , 174 , 275 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366448342,"OCLOO, SHIRLEY, DAIKIE",502 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366448342,"OCLOO, SHIRLEY, DAIKIE",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366448342,"OCLOO, SHIRLEY, DAIKIE",133 1ST AVE SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366448342,"OCLOO, SHIRLEY, DAIKIE",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366448342,"OCLOO, SHIRLEY, DAIKIE",2721 X RAY DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 98 , 100 ,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366448342,"OCLOO, SHIRLEY, DAIKIE",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366448342,"OCLOO, SHIRLEY, DAIKIE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1366450173,"INSCOE, KAREN, KRISTINE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366451882,"BELLAMY, JON, MICHAEL",8025 CORPORATE CENTER DR STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1366451882,"BELLAMY, JON, MICHAEL",J MICHAEL BELLAMY DDS PA,8025 CORPORATE CENTER DR STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1366451882,"BELLAMY, JON, MICHAEL",8025 CORPORATE CENTER DR STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 43 , 117 ,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1366452187,"GOODES, ANNE, FISHER",122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1366453185,"GARDNER, SPENCER, RODWELL",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1366453185,"GARDNER, SPENCER, RODWELL",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1366453185,"GARDNER, SPENCER, RODWELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366453201,"SLEASMAN, JOHN, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,CLINICAL IMMUNOLOGY LAB RM 108 RESEARCH PARK BLDG DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366453201,"SLEASMAN, JOHN, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 19 , 21 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366453201,"SLEASMAN, JOHN, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 23 , 24 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366456063,"JONES, WILLIAM, SCHUYLER",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366456063,"JONES, WILLIAM, SCHUYLER",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 25 , 25 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366456063,"JONES, WILLIAM, SCHUYLER",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 12 , 14 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1366456063,"JONES, WILLIAM, SCHUYLER",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 14 , 15 , 20 ,$#,,
MEDICAID DIRECT,1811274558,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM CARDIOLOGY,568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1366456063,"JONES, WILLIAM, SCHUYLER",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 59 , 97 , 110 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366458283,"CARDELIA, JAMES, MARC",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366459224,"SHIRLEN, ANDREW, MARK",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366460560,"WU, JENNIFER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366460560,"WU, JENNIFER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 430 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366461568,"KONTOS, JIMMY, LARRY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 510 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366461568,"KONTOS, JIMMY, LARRY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366462889,"FITCH, MICHAEL, JEROME",1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366462889,"FITCH, MICHAEL, JEROME",4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 111 , 148 ,$#,,
MEDICAID DIRECT,1366463200,"CLAY, KEITH, DOYLE",~,137 PEACHTREE ST   MURPHY NC,020,Cherokee,152W00000X,Eye and Vision Services Providers,Optometrist,,1366463200,"CLAY, KEITH, DOYLE",137 PEACHTREE ST   MURPHY NC,020,Cherokee,152W00000X,Eye and Vision Services Providers,Optometrist,, 124 , 126 , 218 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366464166,"FOSTER, KIMBERLY, LYNCH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366464166,"FOSTER, KIMBERLY, LYNCH",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366464166,"FOSTER, KIMBERLY, LYNCH",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366464307,"BHOJWANI, JENNIFER, TASSA",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366464307,"BHOJWANI, JENNIFER, TASSA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366467649,"SPENCE, JOHN, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1366468365,"MILLER, AMY, JOSEPHINE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1366468365,"MILLER, AMY, JOSEPHINE",4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366468365,"MILLER, AMY, JOSEPHINE",2035 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1366468365,"MILLER, AMY, JOSEPHINE",2035 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1366468365,"MILLER, AMY, JOSEPHINE",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 104 , 106 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366468621,"RENTZ, DAVID, EDWARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 67 , 96 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366468621,"RENTZ, DAVID, EDWARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366470163,"JONES, HELEN, ROBERTSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366471575,"SUN, JESSICA, MULLER",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366472102,"ANSCHER, MITCHELL, STEVEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 11 , 27 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366472565,"HUTCHENS, MICHELE, JOHNSON",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 82 , 114 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366473035,"CAKIR, BERIL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366473035,"CAKIR, BERIL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 59 , 59 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366473035,"CAKIR, BERIL",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 85 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366474082,"COHEN, SETH, MORRIS",1000 TRENT DR DUKE HOSPITAL DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 26 , 40 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366474082,"COHEN, SETH, MORRIS",1000 TRENT DR DUKE HOSPITAL DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366474082,"COHEN, SETH, MORRIS",1000 TRENT DR DUKE HOSPITAL DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 19 , 28 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366474082,"COHEN, SETH, MORRIS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366474082,"COHEN, SETH, MORRIS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366474082,"COHEN, SETH, MORRIS",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 19 , 33 , 54 ,$#,,
MEDICAID DIRECT,1275685844,LANE AND ASSOCIATES V DDS PA,LANE AND ASSOCIATES,598 E JACKSON BLVD STE 100 ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1366475477,"TURONIS, JAMES, WILLIAM",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223P0300X,Dental Providers,Dentist,Periodontics,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366477895,"HAMPTON, CYNTHIA, ANNE",451 RUIN CREEK RD STE 204 HENDERSON NC,091,Vance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 51 , 57 , 88 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366479370,"POWELL, JAMES, ROBERT",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366479370,"POWELL, JAMES, ROBERT",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 232 , 379 , 489 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366479370,"POWELL, JAMES, ROBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 75 , 75 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366479370,"POWELL, JAMES, ROBERT",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366479370,"POWELL, JAMES, ROBERT",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366480923,"BANKS, FAYE, THERESA",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 93 , 282 ,$#,,
MEDICAID DIRECT,1447980883,TRIAD ADULT AND PEDIATRIC MEDICINE,,300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366481053,"VARGHESE, MARY, REENA",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366486623,"LEWIS, TARA, LAVERN BURNETT",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 112 , 198 , 622 ," $16,351.69 ",,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366489288,"AUEL, GWENN, KELLER",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366493751,"PISANI, BARBARA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 23 , 102 , 157 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366493751,"PISANI, BARBARA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366494965,"HARRIS, SANDRA, LAMBERT",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366494965,"HARRIS, SANDRA, LAMBERT",1900 RANDOLPH RD STE 1010 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 28 , 29 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366495822,"NEIJSTROM, ERIC, SHERWOOD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1073971347,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP FAMILY AND WOMENS HEALTH,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366496804,"HENRY, WAYNE, ANDRADE",270 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073971347,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP FAMILY AND WOMENS HEALTH,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366496804,"HENRY, WAYNE, ANDRADE",1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 19 , 23 ,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366496804,"HENRY, WAYNE, ANDRADE",270 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1366498909,"PASCHALL, JEANIE, LASSITER",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1366498909,"PASCHALL, JEANIE, LASSITER",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1366498909,"PASCHALL, JEANIE, LASSITER",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366498958,"HOLLAND, KEVIN, LEE",139 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 56 , 114 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366501454,"RENTNER, TRACY, LAINE",5317 HIGHGATE DR STE 117 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366501454,"RENTNER, TRACY, LAINE",7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 25 , 42 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366502452,"PITTONI CONDON, ANN, ELIZABETH",269 GILLMAN RD STE 200A DENVER NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 26 , 71 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366503534,"EASTERWOOD, LEE, HUNTER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 52 , 79 , 91 ,$#,,
MEDICAID DIRECT,1245670298,FIRSTHEALTH OF THE CAROLINAS INC,~,2925 BEECHTREE DR STE 145 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1366508467,"LEAIRD, KIMBERLY, DAWN",2925 BEECHTREE DR STE 145 SANFORD NC,053,Lee,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1477573640,"WILLGING, JAY, PAUL",,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,1366509226,"RUTTER, MICHAEL, JOHN",3333 BURNET AVE ML 2018 CINCINNATI OH,102,Out of State > 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1366509226,"RUTTER, MICHAEL, JOHN",3333 BURNET AVE ML 2018 CINCINNATI OH,102,Out of State > 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366510216,"POWELL, EMILY, KILBURN",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366511131,"GRIFFIN, LAURIE, JANELL",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366511669,"COOPER, SHARON, PATRICE",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1366517120,"NUZUM, CLAUDE, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366517120,"NUZUM, CLAUDE, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1366517872,"HOPKINS, TERESA, BIBLE",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1366517872,"HOPKINS, TERESA, BIBLE",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366517872,"HOPKINS, TERESA, BIBLE",9600 NUMBER 5 SCHOOL RD NW   ASH NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366517872,"HOPKINS, TERESA, BIBLE",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366517872,"HOPKINS, TERESA, BIBLE",200 FLOWERS PRIDGEN DR   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1402 PINCKNEY ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1366517872,"HOPKINS, TERESA, BIBLE",200 FLOWERS PRIDGEN DR   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366517872,"HOPKINS, TERESA, BIBLE",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 38 , 38 ,$#,,
MEDICAID DIRECT,1407137938,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,216 N BICKETT BLVD STE 3 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1366519977,"JUDGE, REGINA, NASHON",216 N BICKETT BLVD   LOUISBURG NC,035,Franklin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 11 , 11 , 35 ,$#,,
MEDICAID DIRECT,1003902313,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,1417 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1366519977,"JUDGE, REGINA, NASHON",1417 COLLEGE ST   OXFORD NC,039,Granville,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 21 ,$#,,
MEDICAID DIRECT,1902991698,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1366519977,"JUDGE, REGINA, NASHON",451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 25 , 32 , 69 ,$#,,
MEDICAID DIRECT,1619058955,FRANKLIN COUNTY HEALTH DEPT,FRANKLIN CO HEALTH DEPT,107 INDUSTRIAL DR   LOUISBURG NC,035,Franklin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366521254,"ALLEN, LOUIS, DAVID",107 INDUSTRIAL DR STE C LOUISBURG NC,035,Franklin,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 24 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366524720,"MANUEL, CRYSTAL, APRIL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 17 , 42 , 42 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366524720,"MANUEL, CRYSTAL, APRIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366524720,"MANUEL, CRYSTAL, APRIL",330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366524910,ADVANTAGE VISION CENTER OD,Advantage Vision Center,1016 S CHURCH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366524910,ADVANTAGE VISION CENTER OD,1016 S CHURCH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,," 1,262 "," 1,265 "," 2,530 "," $34,677.01 ",,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1366528473,"BENTZLER, SARAH, RICHARDSON",3311 BURNT MILL DR   WILMINGTON NC,065,New Hanover,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1710299375,DANI STANSELL DDS PA,STANSELL DENTISTRY ASSOCIATES,1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1366529372,"POLK, BRANDON, LEWIS",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1366529372,"POLK, BRANDON, LEWIS",~,1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1366529372,"POLK, BRANDON, LEWIS",1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1710299375,DANI STANSELL DDS PA,STANSELL DENTISTRY ASSOCIATES,1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1366529372,"POLK, BRANDON, LEWIS",1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 231 , 320 ," 1,095 "," $61,681.32 ",,
MEDICAID DIRECT,1730347600,"STANSELL, DANI, ELIZABETH",~,1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1366529372,"POLK, BRANDON, LEWIS",1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 534 , 873 ," 2,826 "," $156,117.47 ",,
MEDICAID DIRECT,1861078974,DANI STANSELL DDS PA 3,STANSELL DENTISTRY ASSOCIATES,1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1366529372,"POLK, BRANDON, LEWIS",1101 GREAT FALLS CT STE 102 KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 486 , 738 ," 2,229 "," $113,611.39 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366529729,"SCHAEFFER, TAMMY, ROSS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366529729,"SCHAEFFER, TAMMY, ROSS",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1366531741,"TAYLOR, ALLIE, BARD",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 56 , 123 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366532053,"BAUER, STACEY, ANN",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 45 , 62 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366532053,"BAUER, STACEY, ANN",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 23 ,$#,,
MEDICAID DIRECT,1760573877,HINNANT FAMILY DENTISTRY,HINNANT FAMILY DENTISTRY,2603 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1366533549,"HINNANT, KEITH, FREDERICK",2603 HOSPITAL RD   GOLDSBORO NC,096,Wayne,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1760573877,HINNANT FAMILY DENTISTRY,HINNANT FAMILY DENTISTRY,2603 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1366533549,"HINNANT, KEITH, FREDERICK",2603 HOSPITAL RD   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 26 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366533804,"FAERBER, GARY, JOSEPH",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366533804,"FAERBER, GARY, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1366534026,PEDIATRIC POSSIBILITIES,PEDIATRIC POSSIBILITIES PA,7209 CREEDMOOR RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366534026,PEDIATRIC POSSIBILITIES,7209 CREEDMOOR RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 15 , 253 , 253 ," $19,722.68 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366534463,"ULLMARK, JAMIE, LYNN",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366534463,"ULLMARK, JAMIE, LYNN",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366534463,"ULLMARK, JAMIE, LYNN",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366537847,"HEDGE, KRISTIN, WARNER",738 NEWMAN RD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 16 , 28 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366537847,"HEDGE, KRISTIN, WARNER",201 WILLIAMSBURG PKWY   JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1366538720,"UMANA, OTTO, DAMASUS",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1366538720,"UMANA, OTTO, DAMASUS",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 78 , 96 ," $12,764.98 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366539496,"DUKE, NAOMI, NICHELE",3116 N DUKE ST   DURHAM NC,032,Durham,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1124167796,COUNTY OF STANLY,STANLY COUNTY HEALTH DEPT,1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366540635,"LEWIS, PATRICIA, MONTGOMERY",1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366540635,"LEWIS, PATRICIA, MONTGOMERY",1000 N 1ST ST STE 3 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366540650,"MELKONIAN, MICHAEL, GEORGE",1450 MATTHEWS TOWNSHIP PKWY STE 230 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366540650,"MELKONIAN, MICHAEL, GEORGE",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366540650,"MELKONIAN, MICHAEL, GEORGE",2104 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 27 , 29 ,$#,,
MEDICAID DIRECT,1598247843,N AHMAD DDS 1 PA,VAYA DENTAL,5117 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366542573,"CARTER, COLLEEN, WARE",5117 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 112 , 151 , 525 ," $25,954.96 ",,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1366544801,"SMITH, MARY, VEE",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 21 , 103 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1366544843,"DIVINA, DARIUS, JOSE AYALA",205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 59 , 128 , 237 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1366544843,"DIVINA, DARIUS, JOSE AYALA",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1558750893,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM ORTHOPAEDICS,120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1366544843,"DIVINA, DARIUS, JOSE AYALA",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 75 , 137 , 224 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1366544843,"DIVINA, DARIUS, JOSE AYALA",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,1501 N BICKETT BLVD STE E LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1366544843,"DIVINA, DARIUS, JOSE AYALA",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366546715,"ROBERTS, STEPHANIE, DEAL",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 63 , 103 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366547374,"TJALMA, JAMIE, LYNN",4020 WAKE FOREST RD STE 105 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366547697,"WILLIS, KRISTIE, LEE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366547697,"WILLIS, KRISTIE, LEE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366547697,"WILLIS, KRISTIE, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366547697,"WILLIS, KRISTIE, LEE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1689048423,CENTRAL TRIAD RETINA PA,,3333 BROOKVIEW HILLS BLVD STE 107 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366548174,"KOSOBUCKI, BRIAN, RICHARD",3333 BROOKVIEW HILLS BLVD STE 107 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 68 , 228 , 499 ," $18,608.15 ",,
MEDICAID DIRECT,1689048423,CENTRAL TRIAD RETINA PA,,3333 BROOKVIEW HILLS BLVD STE 107 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366548174,"KOSOBUCKI, BRIAN, RICHARD",3333 BROOKVIEW HILLS BLVD STE 107 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366550220,"LARSON, ERIC, JOHN",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366550220,"LARSON, ERIC, JOHN",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 20 , 22 ,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366550220,"LARSON, ERIC, JOHN",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366550493,"WINIGER, AMY",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366553968,"HERNDON, WILLIAM, MAUNEY",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366553968,"HERNDON, WILLIAM, MAUNEY",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 22 , 36 ,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1366554222,"HALLIDAY JR, ARTHUR, RICHARD",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1366554222,"HALLIDAY JR, ARTHUR, RICHARD",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1366554222,"HALLIDAY JR, ARTHUR, RICHARD",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1366554222,"HALLIDAY JR, ARTHUR, RICHARD",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1366554222,"HALLIDAY JR, ARTHUR, RICHARD",180 PARKWOOD DR   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 27 , 36 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1366554222,"HALLIDAY JR, ARTHUR, RICHARD",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366557134,"KRISHINGNER, DAVID, SCOTT",~,70 DEPOT ST   TRYON NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice,1366557134,"KRISHINGNER, DAVID, SCOTT",70 DEPOT ST   TRYON NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 23 , 57 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1366558801,"HANKENSON, PAUL, DAVID",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 56 , 97 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1366558801,"HANKENSON, PAUL, DAVID",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 220 , 527 ," 1,155 "," $16,239.94 ",,
MEDICAID DIRECT,1578118089,LIBERTY HEALTHCARE GROUP LLC,LIBERTY COMMONS NSGANDREHAB CTR OF FRANKLIN CO LLC,202 SMOKETREE WAY   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366558801,"HANKENSON, PAUL, DAVID",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",211 VIRGINIA RD   EDENTON NC,021,Chowan,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 31 , 32 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 51 , 55 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366558819,"FLOOD, CHRISTOPHER, DANIEL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1245207356,CLEVELAND PEDIATRICS PC,CLEVELAND PEDIATRICS PC,11709 STATESVILLE BLVD   CLEVELAND NC,080,Rowan,193400000X,Group,Single Specialty,,1366559106,"FRANKLIN, PAULA, DAWN",11709 STATESVILLE BLVD   CLEVELAND NC,080,Rowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 23 , 72 ,$#,,
MEDICAID DIRECT,1366575011,PREMIER HOMECARE LLC,,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,1366575011,PREMIER HOMECARE LLC,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 2,772 "," 2,772 "," $176,165.68 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366575417,"MORRISON, WILLIAM, ROHIMBOX",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366575417,"MORRISON, WILLIAM, ROHIMBOX",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1366576696,"FULLER, ALISON, SH'REE",1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 69 , 74 , 151 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366578007,"RINEER, CRAIG, ANDREW",1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366578007,"RINEER, CRAIG, ANDREW",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366578007,"RINEER, CRAIG, ANDREW",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 55 , 102 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366578007,"RINEER, CRAIG, ANDREW",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366579518,"DAVIDOW, PHILIPI, ANDREW",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 42 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366579518,"DAVIDOW, PHILIPI, ANDREW",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1366580441,FY EYE CARE ASSOCIATES OPTOME PA,FY EYE CARE ASSOCIATES OPTOMETRISTS PA,10210 PROSPERITY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366580441,FY EYE CARE ASSOCIATES OPTOME PA,10210 PROSPERITY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 21 , 24 , 46 ,$#,,
MEDICAID DIRECT,1366583130,HARRIS HOME CARE INC,,150 E MAIN ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,,1366583130,HARRIS HOME CARE INC,150 E MAIN ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,137 "," 2,137 "," $135,566.16 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366583213,"RAUSTOL, OLE, ANTON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 28 , 39 ," $16,353.83 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366583213,"RAUSTOL, OLE, ANTON",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 158 , 201 , 226 ," $14,259.92 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366583213,"RAUSTOL, OLE, ANTON",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366583213,"RAUSTOL, OLE, ANTON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366586349,HOMEBRIDGE HEALTH CARE,UNITY HOME CARE,605 W MLK RD   MAXTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1366586349,HOMEBRIDGE HEALTH CARE,605 W MLK RD   MAXTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 7,220 "," 7,220 "," $459,593.48 ",,
MEDICAID DIRECT,1366587578,INEZS HOUSE HC LLC,~,2811 INDEPENDENCE AVE   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366587578,INEZS HOUSE HC LLC,2811 INDEPENDENCE AVE   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 333 , 333 ," $84,031.94 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366592297,"KEMP, CLINTON, DUNKEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366594293,"KIM, IAN",521 CLANTON RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366594558,"PYE, JOSEPH, PATRICK",201 VIRGINIA RD   EDENTON NC,021,Chowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 65 , 96 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366594558,"PYE, JOSEPH, PATRICK",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366594558,"PYE, JOSEPH, PATRICK",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366594715,COLTRANES GROUP HOME INC,COLTRANES GROUP HOME INC,3811 REPON ST   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366594715,COLTRANES GROUP HOME INC,3811 REPON ST   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 167 , 167 ," $41,224.25 ",,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366599169,"PAYNE, JOSEPH, RINE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366599169,"PAYNE, JOSEPH, RINE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366599169,"PAYNE, JOSEPH, RINE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 57 , 58 , 72 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366599763,"ADKINS, GRETCHEN, LEA",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366599763,"ADKINS, GRETCHEN, LEA",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366600991,"SAAD, MICHAEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 103 , 113 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366600991,"SAAD, MICHAEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366600991,"SAAD, MICHAEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 40 , 48 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366601262,"AMBATI, RAJITHA",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 92 , 92 ,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,1751 GUNBARREL RD   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1366601288,"STEVENS, NANCY, G",1751 GUNBARREL RD   CHATTANOOGA TN,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1366601684,"BERNARD, THOMAS, NORTON",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 56 , 65 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 36 , 50 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366601684,"BERNARD, THOMAS, NORTON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1366601684,"BERNARD, THOMAS, NORTON",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1366601684,"BERNARD, THOMAS, NORTON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1366601684,"BERNARD, THOMAS, NORTON",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366601684,"BERNARD, THOMAS, NORTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1366601684,"BERNARD, THOMAS, NORTON",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1366601684,"BERNARD, THOMAS, NORTON",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215990700,ADVANCED DERMATOLOGY AND SKIN SURGE,ADVANCED DERMATOLOGY AND SKIN SURGERY PA,16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1366602583,"SWICK, JULIE, MILLER",12 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 19 , 22 , 28 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366604332,"HEIN, KYAW",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 67 , 67 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1366608390,"DOUGLASS, SAMUEL, JAMES",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 64 , 90 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366608630,"VIPRAKASIT, DAVIS, PAUL",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366608630,"VIPRAKASIT, DAVIS, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 54 , 80 , 147 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366608937,"FERGUSON, JENNIFER, COUSINS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366608937,"FERGUSON, JENNIFER, COUSINS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1831348317,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1366610578,"DOLL, REBECCA, DAWN",2301 ERWIN RD   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1831348317,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1366610578,"DOLL, REBECCA, DAWN",200 TRENT DR   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1831348317,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1366610578,"DOLL, REBECCA, DAWN",2301 ERWIN RD   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 23 , 25 , 29 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366611089,"PENLAND, MICHAEL, ROYCE",2305 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366616351,"HYATT, LESLIE, GILMORE",6001 WILORA LAKE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 135 , 135 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366616351,"HYATT, LESLIE, GILMORE",600 FULLWOOD RD   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 ,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366616351,"HYATT, LESLIE, GILMORE",2727 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 205 , 205 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366616351,"HYATT, LESLIE, GILMORE",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 146 , 146 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366616351,"HYATT, LESLIE, GILMORE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 47 , 47 ,$#,,
MEDICAID DIRECT,1164493615,COMMUNITY FAMILY PRACTICE PA,,260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1366617136,"MAYS, RHETT, CHURCHILL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 22 , 42 ,$#,,
MEDICAID DIRECT,1164493615,COMMUNITY FAMILY PRACTICE PA,,260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1366617136,"MAYS, RHETT, CHURCHILL",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366617524,"HRDINA, JASON, CONRAD",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366617524,"HRDINA, JASON, CONRAD",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366617524,"HRDINA, JASON, CONRAD",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2301 ERWIN RD FL 1 DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 116 , 122 , 159 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 40 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 78 , 85 , 140 ,$#,,
MEDICAID DIRECT,1780097618,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE IMAGING SERVICE,3700 NW CARY PKWY STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 28 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750701082,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3700 NW CARY PKWY STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366618704,"GUPTA, RAJAN, TILAK",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 40 , 94 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366621724,"HUBER, KENNETH, ROBERT",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366621724,"HUBER, KENNETH, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 85 , 86 , 86 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366621724,"HUBER, KENNETH, ROBERT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366623464,"LAWLEY, CHRISTINA, LYNN",770 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 151 , 174 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,774 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366623464,"LAWLEY, CHRISTINA, LYNN",770 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1356300248,SANFORD PEDIATRICS PA,SANFORD PEDIATRICS PA,1801 DOCTORS DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1366624181,"AGBADUDU, AJENADORO, UFUOMA",1801 DOCTORS DR   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 51 , 160 ,$#,,
MEDICAID DIRECT,1366628885,INTERCARE HOME HEALTH SERVICES LLC,~,311 W 24TH ST   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1366628885,INTERCARE HOME HEALTH SERVICES LLC,311 W 24TH ST   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#, 356 , 356 ," $296,192.00 ",,
MEDICAID DIRECT,1366628885,INTERCARE HOME HEALTH SERVICES LLC,~,311 W 24TH ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1366628885,INTERCARE HOME HEALTH SERVICES LLC,311 W 24TH ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 82 ," 21,773 "," 22,046 "," $1,547,506.08 ",,
MEDICAID DIRECT,1649890450,EQUITY HEALTH SERVICES PLLC,EQUITY HEALTH SERVICES PLLC,275 N NC 16 BUSINESS HWY STE 104 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1366629057,"SCHMERGE, MICHELLE, BENDER",275 N NC 16 BUS HWY STE 104 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 32 , 42 ,$#,,
MEDICAID DIRECT,1649890450,EQUITY HEALTH SERVICES PLLC,EQUITY HEALTH SERVICES PLLC,16 OAK BRANCH DR STE D GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366629057,"SCHMERGE, MICHELLE, BENDER",3407 W WENDOVER AVE STE D GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1649890450,EQUITY HEALTH SERVICES PLLC,EQUITY HEALTH SERVICES PLLC,16 OAK BRANCH DR STE D GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366629057,"SCHMERGE, MICHELLE, BENDER",3407 W WENDOVER AVE STE D GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649890450,EQUITY HEALTH SERVICES PLLC,EQUITY HEALTH SERVICES PLLC,3407 W WENDOVER AVE STE D GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366629057,"SCHMERGE, MICHELLE, BENDER",3407 W WENDOVER AVE STE D GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366632598,"YAECK, BRIAN",738 NEWMAN RD   NEW BERN NC,025,Craven,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 22 , 43 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1366634834,"LITTLE, ALLISON, KAE",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 64 , 134 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1366634834,"LITTLE, ALLISON, KAE",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1366634834,"LITTLE, ALLISON, KAE",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1366634834,"LITTLE, ALLISON, KAE",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1366634834,"LITTLE, ALLISON, KAE",8004 HIGHWAY 73 W MT GILEAD   MOUNT GILEAD NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1366634834,"LITTLE, ALLISON, KAE",8004 HIGHWAY 73 W MT GILEAD   MOUNT GILEAD NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1366640658,"ERICSSON, KRISTINA, RENEE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 25 , 26 , 31 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366640658,"ERICSSON, KRISTINA, RENEE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 57 , 65 , 66 ," $11,244.64 ",,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366640658,"ERICSSON, KRISTINA, RENEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366640807,"PICKETT, KATHERINE, STOKES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366640807,"PICKETT, KATHERINE, STOKES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 21 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 50 , 67 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1007 NC HIGHWAY 150 W STE G SUMMERFIELD NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 27 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 25 , 31 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,4030 OAKS PROFESSIONAL PKWY   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",4515 PREMIER DR   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003401142,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH,237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1366641243,"MCCULLOUGH, HEATH, KEAY",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 111 , 119 , 134 ," $11,582.54 ",,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366642720,"KARAKULA, SATHEESH, REDDY",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 210 , 210 ,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 31 , 54 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 90 , 148 , 220 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1962727388,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1962727388,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1366642928,"PATEL, SHOMEET, VIKRAM",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1083971485,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEPHROLOGY - PRE,4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366645848,"NWOBU, IKECHUKWU, ONYEKACHI",601 N ELM ST   HIGH POINT NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 41 , 256 , 259 ,$#,,
MEDICAID DIRECT,1083971485,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEPHROLOGY - PRE,4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366645848,"NWOBU, IKECHUKWU, ONYEKACHI",4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 114 , 354 , 382 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366646747,"TURNBULL, JENNIFER, RUTH",1591 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366646747,"TURNBULL, JENNIFER, RUTH",1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366646747,"TURNBULL, JENNIFER, RUTH",1525 APEX PEAKWAY   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366646747,"TURNBULL, JENNIFER, RUTH",1525 APEX PEAKWAY   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366647067,"SCHISLER, RANDALL, EUGENE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 14 , 54 , 79 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366647067,"SCHISLER, RANDALL, EUGENE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366647067,"SCHISLER, RANDALL, EUGENE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366647067,"SCHISLER, RANDALL, EUGENE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366647067,"SCHISLER, RANDALL, EUGENE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 35 , 72 , 74 ,$#,,
MEDICAID DIRECT,1598410565,SOUTH CHARLOTTE RHEUMATOLOGY PLLC,,8840 BLAKENEY PROFESSIONAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366649014,"KASSAB, FIRAS",8840 BLAKENEY PROFESSIONAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1366649345,"FRENCH, JOHN, WESLEY",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 118 , 193 , 261 ," $14,328.90 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1366649345,"FRENCH, JOHN, WESLEY",107 HUNT DR   DUNN NC,043,Harnett,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 20 , 29 , 30 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366651143,"BISHOP, CANDACE, MICHELLE",291 COMMERCIAL DR   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 107 , 141 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366651143,"BISHOP, CANDACE, MICHELLE",111 S CHURCH ST   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 403 , 506 ," $12,295.65 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366651143,"BISHOP, CANDACE, MICHELLE",301 CRAIG ST   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 327 , 380 ," $10,039.13 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366651143,"BISHOP, CANDACE, MICHELLE",3900 WEXFORD LN   DENVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 124 , 133 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366651143,"BISHOP, CANDACE, MICHELLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 114 , 711 , 808 ," $20,467.77 ",,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366651952,"LOKITZ, MICHELE, LYNN",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366651952,"LOKITZ, MICHELE, LYNN",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366651952,"LOKITZ, MICHELE, LYNN",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366651952,"LOKITZ, MICHELE, LYNN",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1508297003,ELITECARE OF FAYETTEVILLE PLLC,,3622 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366652125,"DELELLIS, STEPHEN, MICHAEL",3622 N MAIN ST   HOPE MILLS NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366654071,"DOWNING, WILLIAM, MILNOR",William Milnor Downing,2917 S CROATAN HWY   NAGS HEAD NC,028,Dare,1223G0001X,Dental Providers,Dentist,General Practice,1366654071,"DOWNING, WILLIAM, MILNOR",2917 S CROATAN HWY   NAGS HEAD NC,028,Dare,1223G0001X,Dental Providers,Dentist,General Practice, 400 , 805 ," 2,181 "," $79,246.05 ",,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1366654162,"HAYS, JOHNATHAN, CHARLES",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1366654162,"HAYS, JOHNATHAN, CHARLES",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366655631,"LEE, CHON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 62 , 97 , 98 ," $12,880.91 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366655631,"LEE, CHON",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 23 , 32 , 46 ,$#,,
MEDICAID DIRECT,1366656464,COUNTY OF HALIFAX,HALIFAX COUNTY DSS CAP,4421 US HIGHWAY 301   HALIFAX NC,042,Halifax,251B00000X,Agencies,Case Management,,1366656464,COUNTY OF HALIFAX,4421 US HIGHWAY 301   HALIFAX NC,042,Halifax,251B00000X,Agencies,Case Management,, 103 ," 1,014 "," 1,016 "," $237,431.20 ",,
MEDICAID DIRECT,1366656571,FAITH HOME CARE INC,~,406B HARRIS AVE   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1366656571,FAITH HOME CARE INC,406B HARRIS AVE   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 2,088 "," 2,090 "," $131,519.40 ",,
MEDICAID DIRECT,1366656571,FAITH HOME CARE INC,~,114 W BROAD ST   SAINT PAULS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1366656571,FAITH HOME CARE INC,114 W BROAD ST   SAINT PAULS NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 3,193 "," 3,193 "," $264,585.68 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366656761,"ANDERSON, STEPHANIE, TRUAN",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366657256,"FONG, PHILIP, AUSTIN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 54 , 83 , 89 ," $11,581.12 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366657256,"FONG, PHILIP, AUSTIN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 29 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366657256,"FONG, PHILIP, AUSTIN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366659310,"CAPAL, JAMIE, KORIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1366659310,"CAPAL, JAMIE, KORIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366670457,"PATEL, DARSHAN, BABUBHAI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 19 , 27 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366670457,"PATEL, DARSHAN, BABUBHAI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366670606,"JACKS, DEMETRIA, ILEANA STRAUCH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366670606,"JACKS, DEMETRIA, ILEANA STRAUCH",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366670606,"JACKS, DEMETRIA, ILEANA STRAUCH",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 41 , 85 , 91 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366670606,"JACKS, DEMETRIA, ILEANA STRAUCH",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366670606,"JACKS, DEMETRIA, ILEANA STRAUCH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1730636028,ELOHIM HOUSECALL DOCTORS PA,,1320 N HAMILTON ST STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366673048,"ASENSO, PHILIP",5009 BENNINGTON WAY   HIGH POINT NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 156 , 179 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1366673048,"ASENSO, PHILIP",5009 BENNINGTON WAY   HIGH POINT NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730636028,ELOHIM HOUSECALL DOCTORS PA,,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366673048,"ASENSO, PHILIP",5009 BENNINGTON WAY   HIGH POINT NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 164 , 188 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366673048,"ASENSO, PHILIP",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 27 , 27 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1366673048,"ASENSO, PHILIP",117 E KINGS HWY   EDEN NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366673436,"HAUTER, JOSEPH, WILLIAM",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508942848,ALBEMARLE REGIONAL HEALTH SERVICES,PASQUOTANK COUNTY HEALTH DEPARTMENT,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366674095,"PARVA, MOHAMAD MEHDI",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366674095,"PARVA, MOHAMAD MEHDI",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366674095,"PARVA, MOHAMAD MEHDI",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366674095,"PARVA, MOHAMAD MEHDI",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366676231,"MANOGUE, ERICA, PACOLI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 45 , 51 , 54 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366676231,"MANOGUE, ERICA, PACOLI",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366676231,"MANOGUE, ERICA, PACOLI",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366676454,"BATES, MICHAEL, DEVON",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 106 , 161 , 237 ,$#,,
MEDICAID DIRECT,1366677429,J & S CARE INCORPORATED,MORNING STAR ASSISTED LIVING,941 GOINS RD   PEMBROKE NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366677429,J & S CARE INCORPORATED,941 GOINS RD   PEMBROKE NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 13 ," 2,744 "," 2,744 "," $256,283.12 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366678252,"CATER, LYDIA, TURLYKINA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366678377,"PIERSON, DUSTIN, RYAN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 39 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366678450,"STONE, TAYLOR, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 153 , 158 , 200 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366678450,"STONE, TAYLOR, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366678450,"STONE, TAYLOR, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1366678450,"STONE, TAYLOR, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1366678450,"STONE, TAYLOR, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366678450,"STONE, TAYLOR, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 103 , 106 , 123 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366678450,"STONE, TAYLOR, JAMES",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1366678641,"MACNEAL, LUCINDA, ANN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 42 , 42 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366678641,"MACNEAL, LUCINDA, ANN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1154888642,KATHERINE PEPPERS DNP PLLC,,3812 ROCKING ROBYN RUN   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1366680373,"PEPPERS, KATHERINE, HOPE",3812 ROCKING ROBYN RUN   KNIGHTDALE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 65 , 92 ,$#,,
MEDICAID DIRECT,1154888642,KATHERINE PEPPERS DNP PLLC,,8358 SIX FORKS RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366680373,"PEPPERS, KATHERINE, HOPE",8358 SIX FORKS RD STE 204 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 93 , 189 , 234 ," $19,534.13 ",,
MEDICAID DIRECT,1366680373,"PEPPERS, KATHERINE, HOPE",~,8358 SIX FORKS RD STE 204 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,1366680373,"PEPPERS, KATHERINE, HOPE",8358 SIX FORKS RD STE 204 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366683419,"SHETH, ANUJA, MUKESH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1366683419,"SHETH, ANUJA, MUKESH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366683419,"SHETH, ANUJA, MUKESH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 62 , 236 , 236 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1366683419,"SHETH, ANUJA, MUKESH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366683419,"SHETH, ANUJA, MUKESH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1366684060,"STULL, MICHAEL, EUGENE",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366684318,"LESUER, HAYLEY, HASTY",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366684318,"LESUER, HAYLEY, HASTY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366684318,"LESUER, HAYLEY, HASTY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366684318,"LESUER, HAYLEY, HASTY",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366684318,"LESUER, HAYLEY, HASTY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366684318,"LESUER, HAYLEY, HASTY",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1366684615,"ACKERMAN, BRIAN, EVAN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366684854,"REMMOUCHE, ILHEM",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366684854,"REMMOUCHE, ILHEM",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1366684854,"REMMOUCHE, ILHEM",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366684854,"REMMOUCHE, ILHEM",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 51 , 80 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366684904,"SWINSON, BRADLEY, MORRIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 77 , 127 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366684904,"SWINSON, BRADLEY, MORRIS",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 51 , 51 , 66 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1366684904,"SWINSON, BRADLEY, MORRIS",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 45 , 47 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366685497,"TELHAN, GAURAV",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366685497,"TELHAN, GAURAV",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 36 , 46 , 52 ,$#,,
MEDICAID DIRECT,1366689291,CHRISTINE E LEMLEY OD PLLC,CHRISTINE E LEMLEY OD PLLC,18736 DEMBRIDGE DR   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366689291,CHRISTINE E LEMLEY OD PLLC,18736 DEMBRIDGE DR   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 240 , 215 , 412 ,$#,,
MEDICAID DIRECT,1902392418,CAROLINA PRIME PHYSICAL THERAPY,CAROLINA PRIME PHYSICAL THERAPY LLC,200 W PARK CIR STE A N WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1366689374,"FORREST, SCOTT, CHRISTOPHER",200 W PARK CIR STE A NORTH WILKESBORO NC,097,Wilkes,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366689945,"GARRETT, JAMES, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366689945,"GARRETT, JAMES, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1366690265,"MONTGOMERY, NATHAN, MICHAEL",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366690265,"MONTGOMERY, NATHAN, MICHAEL",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 34 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366690711,"ADAM, SOHEIR, SAEED",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366690711,"ADAM, SOHEIR, SAEED",2100 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366690711,"ADAM, SOHEIR, SAEED",2100 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 21 , 32 , 40 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366693335,"IRWIN, MATTHEW, SCOTT",2906 N MAIN ST   TARBORO NC,033,Edgecombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2906 N MAIN ST   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1366693335,"IRWIN, MATTHEW, SCOTT",2906 N MAIN ST   TARBORO NC,033,Edgecombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366693335,"IRWIN, MATTHEW, SCOTT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 77 , 160 , 279 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366694853,"PRATT, ASHLEY, JOYCE",112 MEDICAL VILLAGE DR STE G WALLACE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366694853,"PRATT, ASHLEY, JOYCE",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 43 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366694853,"PRATT, ASHLEY, JOYCE",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366694853,"PRATT, ASHLEY, JOYCE",8115 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 32 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366694853,"PRATT, ASHLEY, JOYCE",1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366694853,"PRATT, ASHLEY, JOYCE",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366695496,"MONTGOMERY, ALEXANDRIA, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366695660,"SPELLER, DESINTA",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 70 , 70 , 241 ," $12,286.47 ",,
MEDICAID DIRECT,1366682361,DR PL JEFFRIES AND ASSOCIATES PA,PERRY L JEFFRIES DDS PA,1307 DOVE ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366695660,"SPELLER, DESINTA",1307 DOVE ST   MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 618 , 745 ," 2,730 "," $129,641.62 ",,
MEDICAID DIRECT,1770940678,ADVANCED PROSTHETICS OF EASLEY INC,,2550 COURT DR STE 101 GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1366697294,"CLEVINGER, JAMES, KEVIN",2310 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1366682361,DR PL JEFFRIES AND ASSOCIATES PA,PERRY L JEFFRIES DDS PA,1307 DOVE ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366699738,"BOULOS, MARIEROSE, MALEK",1307 DOVE ST   MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice," 2,671 "," 5,525 "," 20,496 "," $833,501.68 ",,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366699738,"BOULOS, MARIEROSE, MALEK",1307 DOVE ST   MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366700833,"HADDIX, WHITNEY, IVY",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366700833,"HADDIX, WHITNEY, IVY",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 32 , 32 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1366700932,"HOWARD, TIMOTHY, SCOTT",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 132 , 280 , 517 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366701500,"POWELL, KEVIN, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 29 , 33 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1366702193,"JOHNSON, MICHAEL, GUNNAR",1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 84 , 159 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366702193,"JOHNSON, MICHAEL, GUNNAR",1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1366702193,"JOHNSON, MICHAEL, GUNNAR",1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366702359,"TATREAU, JASON, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366702359,"TATREAU, JASON, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366702359,"TATREAU, JASON, RYAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366702359,"TATREAU, JASON, RYAN",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366702649,"FLEURISMOND, BRANDY, JANAE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 59 , 59 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366702649,"FLEURISMOND, BRANDY, JANAE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366702672,"FOURNET, RACHAEL, RIDER",9224 ARDREY KELL RD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 20 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366702847,"PRIME, DANILLE, LEONA NAOMI",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 32 , 60 , 99 ,$#,,
MEDICAID DIRECT,1922547793,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1366703696,"BYRD, BRENDA, LEE",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1770219594,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - GRAYSTONE,3511 GRAYSTONE PL SE   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366703696,"BYRD, BRENDA, LEE",3511 GRAYSTONE PL SE   CONOVER NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366704983,"MOLER, EMILY, ANN",11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366704983,"MOLER, EMILY, ANN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366705329,"ENTER, DANIEL, HODGES",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366706111,"AYINDE, HAKEEM, OLUFEMI",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366706137,"CRESPO, MARIA, ELLEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 28 , 37 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366706137,"CRESPO, MARIA, ELLEN",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366706137,"CRESPO, MARIA, ELLEN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1366706137,"CRESPO, MARIA, ELLEN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1366706137,"CRESPO, MARIA, ELLEN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366706137,"CRESPO, MARIA, ELLEN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1366706137,"CRESPO, MARIA, ELLEN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1366706137,"CRESPO, MARIA, ELLEN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164934485,KIDZCARE PEDIATRICS PC,,132 SYLVA PLZ   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1366709545,"NEIHEISEL, PHILIP, ARLIS",132 SYLVA PLAZA   SYLVA NC,087,Swain,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 74 , 269 ," $11,671.53 ",,
MEDICAID DIRECT,1629327671,KIDZCARE PEDIATRICS PC,~,427 HARRISON AVE   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1366709545,"NEIHEISEL, PHILIP, ARLIS",427 HARRISON AVE   FRANKLIN NC,056,Macon,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 107 , 152 , 415 ," $19,896.92 ",,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1366709743,"CHAPMAN, WILL, STANTON",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 49 , 50 , 50 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366712044,"WILLIAMSON JR, ALFONZA, HILLS",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1366712044,"WILLIAMSON JR, ALFONZA, HILLS",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1366712044,"WILLIAMSON JR, ALFONZA, HILLS",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 1,267 "," 2,956 "," 9,264 "," $410,685.93 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1366712044,"WILLIAMSON JR, ALFONZA, HILLS",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1366712622,HANNAH FAMILY CARE HOMES INC,,,,Unknown,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1366712622,HANNAH FAMILY CARE HOMES INC,7109 HICKORY NUT DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 42 , 42 ,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,3500 OLEANDER DR STE 1048 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366713356,"WALENT, THOMAS, MATTHEW",3500 OLEANDER DR STE B10 WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366713356,"WALENT, THOMAS, MATTHEW",3500 OLEANDER DR STE B10 WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,11530 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366713463,"CURLEY, JACQUELINE, MARIE",11530 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366713463,"CURLEY, JACQUELINE, MARIE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366726622,SOUTHEAST OCCUPATIONAL THERAPY,~,1409 SPIVEY RD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1366726622,SOUTHEAST OCCUPATIONAL THERAPY,1409 SPIVEY RD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,, 22 , 113 , 116 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",11835 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",15419 HODGES CIR   HUNTERSVILLE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",1800 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 12 , 32 , 48 ," $16,050.81 ",,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",10834 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 81 , 180 , 461 ," $39,220.73 ",,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366732851,"RYDER, STEVEN, JOHN",10520 PARK ROARD   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#, 12 ,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366733305,"SELAK, MONICA, ANN",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 45 , 82 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366735433,"SATA, SIDDHARTH, DEVENDRA",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366735433,"SATA, SIDDHARTH, DEVENDRA",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366735433,"SATA, SIDDHARTH, DEVENDRA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 25 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366735433,"SATA, SIDDHARTH, DEVENDRA",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1366736159,"EDGERTON, JOSHUA, KENNETH",330 NC HWY 108   RUTHERFORDTON NC,081,Rutherford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 54 , 104 , 119 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366736878,"HAUCK, CHRISTOPHER, GALE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 64 , 159 , 179 ," $11,476.95 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366736878,"HAUCK, CHRISTOPHER, GALE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366737058,"KELLY, NOREEN, PATRICIA",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366737058,"KELLY, NOREEN, PATRICIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366737058,"KELLY, NOREEN, PATRICIA",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 37 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366737058,"KELLY, NOREEN, PATRICIA",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366737058,"KELLY, NOREEN, PATRICIA",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366737058,"KELLY, NOREEN, PATRICIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366738569,"RODRIGUEZ, ADAM, RAY",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366738569,"RODRIGUEZ, ADAM, RAY",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366738601,"FITZGERALD, ROBERT, EMMETT",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 20 , 24 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366738601,"FITZGERALD, ROBERT, EMMETT",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366738601,"FITZGERALD, ROBERT, EMMETT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 59 , 65 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1366738601,"FITZGERALD, ROBERT, EMMETT",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366739120,"PATEL, MILANI, RAMANBHAI",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 25 , 65 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366739120,"PATEL, MILANI, RAMANBHAI",3727 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366742090,"BEATTY, LATONYA, ROSHELLE",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 26 , 35 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366742090,"BEATTY, LATONYA, ROSHELLE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 28 , 28 ,$#,,
MEDICAID DIRECT,1366748428,RALEIGH BEST MEDICAL SUPPLY AND HOM,RALEIGH BEST MEDICAL SUPPLY AND HOME HEALTH CARE S,111 NORWOOD ST   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1366748428,RALEIGH BEST MEDICAL SUPPLY AND HOM,111 NORWOOD ST   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,, 68 ," 15,249 "," 15,654 "," $1,120,853.90 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366749988,"RIEDEL JR, JOHN, JOSEPH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 39 , 39 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1366750564,"OSBORNE, JENNIFER, WILLARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366754954,"ZAUSNER SKARBNIK, ALAN, PIERRE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366754954,"ZAUSNER SKARBNIK, ALAN, PIERRE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 22 , 61 , 73 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366754954,"ZAUSNER SKARBNIK, ALAN, PIERRE",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 30 , 48 , 63 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366754954,"ZAUSNER SKARBNIK, ALAN, PIERRE",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366754954,"ZAUSNER SKARBNIK, ALAN, PIERRE",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 18 , 20 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366760415,"BUTTS, MAUREEN, CAROL",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366760415,"BUTTS, MAUREEN, CAROL",40 DUKE MEDICINE CIR # 2D DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366760415,"BUTTS, MAUREEN, CAROL",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366761207,"LOWRY, JONATHAN, LEWIS",JONATHAN L LOWRY DDS,905 OAKLAND ST   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,1366761207,"LOWRY, JONATHAN, LEWIS",905 OAKLAND ST   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice, 59 , 127 , 463 ," $19,746.73 ",,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366761553,"FAULKENBERRY, LUCAS, HALL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366761553,"FAULKENBERRY, LUCAS, HALL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 52 , 199 , 199 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366762643,"KACHARE, SWAPNIL, DILIP",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 23 , 30 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366763096,"OGUNLEYE, ADEYEMI, ADEBANJI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366763096,"OGUNLEYE, ADEYEMI, ADEBANJI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366763096,"OGUNLEYE, ADEYEMI, ADEBANJI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366763096,"OGUNLEYE, ADEYEMI, ADEBANJI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366763096,"OGUNLEYE, ADEYEMI, ADEBANJI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366763096,"OGUNLEYE, ADEYEMI, ADEBANJI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 17 , 21 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366764847,"PITTENGER, SARA, LOUISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 35 , 46 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366766560,"BENECKE, DOUGLAS, NEAL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366766941,"GARCIA, NICOLE, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366766941,"GARCIA, NICOLE, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 65 , 77 , 83 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366767758,"KROCH, DANIEL, AARON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 54 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366768632,"RAMALINGAM, SUNDHAR, RAYMOND",216 ASHVILLE AVENNUE STE 20 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 23 , 50 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366768632,"RAMALINGAM, SUNDHAR, RAYMOND",216 ASHVILLE AVENNUE STE 20 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 40 , 89 , 150 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366768632,"RAMALINGAM, SUNDHAR, RAYMOND",216 ASHVILLE AVENNUE STE 20 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366769044,"DEANE-WYMAN, JESSICA, JAMISON",7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366769044,"DEANE-WYMAN, JESSICA, JAMISON",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366769044,"DEANE-WYMAN, JESSICA, JAMISON",2100 S TRYON ST STE 201 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366769705,"MENDOZA, MICHAEL, VINCENT",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1861525305,MANDELL RETINA CENTER,,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366769911,"LIPMAN, ADAM, T.",1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 18 , 41 ,$#,,
MEDICAID DIRECT,1861525305,MANDELL RETINA CENTER,,397 LITTLE NECK RD   VA BCH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366769911,"LIPMAN, ADAM, T.",1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 40 , 87 ," $15,108.68 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366775090,"FARAHI, NARGES",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 16 , 18 ,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366775090,"FARAHI, NARGES",322 MAIN ST   PROSPECT HILL NC,017,Caswell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366775298,"ARIGO, LAURA, JOAN",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366775298,"ARIGO, LAURA, JOAN",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366775298,"ARIGO, LAURA, JOAN",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366776833,"SAINE, COURTNEY, HUFFMAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366776833,"SAINE, COURTNEY, HUFFMAN",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 57 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366776833,"SAINE, COURTNEY, HUFFMAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366777807,POTTERS HOUSE HOME HEALTHCARE,POTTERS HOUSE HOME HEALTHCARE,10926 DAVID TAYLOR DR STE 119 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1366777807,POTTERS HOUSE HOME HEALTHCARE,10926 DAVID TAYLOR DR STE 119 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,703 "," 1,805 "," $119,123.56 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1366778144,"PHILLIPS, REBECCA, SUE",381 HILL ST   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 30 , 30 ," $11,880.00 ",,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1366778383,"LONG, KATHERINE, HILL",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1366779415,"LEE, SOO, SUN",1530 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,193200000X,Group,Multi-Specialty,,1366780033,"BORDEAUX, JUSTIN, WAYNE",700 US 1 HWY STE 100 YOUNGSVILLE NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 23 ,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 27 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1366780413,"SHIPMAN, VICKI, STARLENE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013489947,AGES & STAGES PEDIATRICS PLLC,,10340 PARK RD STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366780793,"GARRIDOGOICO, EDUARDO, JOSE",10340 PARK RD STE B CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366782039,"BELBASE, SASMRITA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1366782930,"WANG, ANDREW, WILSON",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366783680,"HENDERSON, KATHERINE, BEIER",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366783680,"HENDERSON, KATHERINE, BEIER",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1902366180,SOUNDSIDE ORTHOTICS & PROSTHETICS L,EVERGREEN PROSTHETICS & ORTHOTICS,4110 DR MARTIN LUTHER KING JR BLVD STE C NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1366783755,"OVERCASH, CHAD, MICHAEL",4110 DR MARTIN LUTHER KING JR BLVD STE C NEW BERN NC,025,Craven,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1184369761,SOUNDSIDE ORTHOTICS & PROSTHETICS L,EVERGREEN PROSTHETICS & ORTHOTICS,2501 WAYNE MEMORIAL DR STE A GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1366783755,"OVERCASH, CHAD, MICHAEL",2501 WAYNE MEMORIAL DR STE A GOLDSBORO NC,096,Wayne,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366785792,"MCCULLOCH, TYLER, DUNCAN",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 32 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366785792,"MCCULLOCH, TYLER, DUNCAN",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 26 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,12000 RETAIL DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1366786386,"TUCKER, REBECCA, SUE",7201 US HIGHWAY 64 E   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1366788341,"MANNINO, NATALIE, MARIE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366789711,"CURTIS, LINDA, ANN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366790834,"ARUOGU, KELECHI, KINGSLEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 83 , 180 , 180 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366793176,"MCKENDREE, MARY, ALYCE",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366793176,"MCKENDREE, MARY, ALYCE",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366793176,"MCKENDREE, MARY, ALYCE",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 25 , 55 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366793176,"MCKENDREE, MARY, ALYCE",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366793176,"MCKENDREE, MARY, ALYCE",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366796377,"CLATTERBUCK, KAYLI, MARIE POLLITTE",1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366796377,"CLATTERBUCK, KAYLI, MARIE POLLITTE",1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1366796377,"CLATTERBUCK, KAYLI, MARIE POLLITTE",1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821054339,NORTHEASTERN ORTHOPEDICS PA,~,602 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1366797128,"PERRY, MARY, KATHLEEN BOONE",602 ACADEMY ST S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 47 , 77 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366798001,"SCHAUB, TAMMY, SCHNOPLE",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366803298,"MCGOOGAN, LAUREN, SOUTHWELL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1083738645,COUNTY OF CARTERET COURTHOUSE SQUAR,~,3820 BRIDGES ST STE A MOREHEAD CITY NC,016,Carteret,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366803348,"DOBBS, NICOLE, AMBER",3820 BRIDGES ST STE A MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366805046,"FITZ, CHRISTINA, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366805830,"ANDREWS WOOD, KATHLEEN, PATRICIA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366806002,"FATEMI, PARASTOU",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366806002,"FATEMI, PARASTOU",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366806317,"DURBIN, COURTNEY, LYNNE",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366806317,"DURBIN, COURTNEY, LYNNE",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1366806317,"DURBIN, COURTNEY, LYNNE",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1366806317,"DURBIN, COURTNEY, LYNNE",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1366806317,"DURBIN, COURTNEY, LYNNE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1366806952,"FELIX, PABLO, ALEJANDRO",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 53 , 57 ,$#,,
MEDICAID DIRECT,1366807646,FAST TRACK EMS LLC,,,,Unknown,3416L0300X,Transportation Services,Ambulance,Land Transport,1366807646,FAST TRACK EMS LLC,1140 KEMPSVILLE RD   CHESAPEAKE VA,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1366808594,"CLEMMONS, BRITTANY, CORBIN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1366808594,"CLEMMONS, BRITTANY, CORBIN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1366808594,"CLEMMONS, BRITTANY, CORBIN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 22 , 57 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1366808594,"CLEMMONS, BRITTANY, CORBIN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 19 , 30 ,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1366809642,"RADFORD, ALLISON, ROSE",103 COX BLVD   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366811598,"FLINCHUM, MATTHEW, EDWARD",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366811598,"FLINCHUM, MATTHEW, EDWARD",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366811598,"FLINCHUM, MATTHEW, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366814410,"LUKE, LANE, HANKINSON",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366814410,"LUKE, LANE, HANKINSON",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366814410,"LUKE, LANE, HANKINSON",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366814410,"LUKE, LANE, HANKINSON",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 48 ,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366815052,"MORRIS, TERESA, LANIER",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1366815052,"MORRIS, TERESA, LANIER",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366815052,"MORRIS, TERESA, LANIER",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 87 , 165 , 181 ,$#,,
MEDICAID DIRECT,1598891665,HIGHLAND MEDICAL ASSOCIATES PA,~,165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1366817066,"SNYDER, GINA, MARIE",165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 109 , 730 , 755 ," $23,967.45 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366817314,"SALNIKOVA, EVGENIA, ALEXANDROVNA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366817314,"SALNIKOVA, EVGENIA, ALEXANDROVNA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366817314,"SALNIKOVA, EVGENIA, ALEXANDROVNA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1366817314,"SALNIKOVA, EVGENIA, ALEXANDROVNA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1366817314,"SALNIKOVA, EVGENIA, ALEXANDROVNA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366817314,"SALNIKOVA, EVGENIA, ALEXANDROVNA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366817314,"SALNIKOVA, EVGENIA, ALEXANDROVNA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366819807,"NICHOLS, TONYA, SMITH",509 N ELAM AVE STE 3E GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 56 , 82 ,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,509 N ELAM AVE FL 3 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366819807,"NICHOLS, TONYA, SMITH",509 N ELAM AVE STE 3E GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366819807,"NICHOLS, TONYA, SMITH",865 W LAKE DR   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 103 , 194 , 296 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366821100,"SAMUELSON, DAVID, BARROW",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1366821100,"SAMUELSON, DAVID, BARROW",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366821100,"SAMUELSON, DAVID, BARROW",2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366821100,"SAMUELSON, DAVID, BARROW",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 73 , 73 ," 1,333 "," $133,300.28 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366821100,"SAMUELSON, DAVID, BARROW",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 218 , 239 , 746 ," $34,596.32 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366821605,"PARKER, CALEB, MICHAEL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 24 , 49 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366821605,"PARKER, CALEB, MICHAEL",4443 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366821605,"PARKER, CALEB, MICHAEL",4443 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1366822488,"HA, KEVIN, HOAG YOUL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366822488,"HA, KEVIN, HOAG YOUL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366823726,"NEWSOME, ANDREW, RANDALL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366823726,"NEWSOME, ANDREW, RANDALL",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275030272,RDL THERAPEUTIC OUTPATIENT THERAPY,~,3591 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366823908,"COMISKEY, JESSICA, WALKER",3591 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 38 ,$#,,
MEDICAID DIRECT,1285240804,SAPNA THAKKAR DDS PLLC,NORTH POINT DENTAL ASSOCIATES,6425 OLD PLANK RD STE 102 HIGH POINT NC,029,Davidson,193400000X,Group,Single Specialty,,1366826539,"THAKKAR, SAPNA, RAMESH",6425 OLD PLANK RD STE 102 HIGH POINT NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1366826539,"THAKKAR, SAPNA, RAMESH",,6425 OLD PLANK RD STE 102 HIGH POINT NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,1366826539,"THAKKAR, SAPNA, RAMESH",6425 OLD PLANK RD STE 102 HIGH POINT NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 36 , 125 ,$#,,
MEDICAID DIRECT,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,~,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366827883,"DICKENS, LATANIS, WILLIAMSON",1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366829012,"PITTMAN, THOMAS, FARAN",6488 WEDDINGTON MONROE RD   MATTHEWS NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 31 , 65 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366829152,"FERREN, EDWIN, CLAYTON",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366829152,"FERREN, EDWIN, CLAYTON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 38 , 60 , 66 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366829152,"FERREN, EDWIN, CLAYTON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366829293,"DEWALD, JONATHAN, BARBOUR",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 60 , 96 , 127 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366829293,"DEWALD, JONATHAN, BARBOUR",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366829293,"DEWALD, JONATHAN, BARBOUR",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 59 , 76 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1366830036,"REYNOLDS, JONATHAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1366830036,"REYNOLDS, JONATHAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1366831067,"ANDREWS, JORDAN, MICHAEL",3830 N MAIN ST   HIGH POINT NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 184 , 193 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366831067,"ANDREWS, JORDAN, MICHAEL",3830 N MAIN ST   HIGH POINT NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 244 , 345 ,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1366831067,"ANDREWS, JORDAN, MICHAEL",3830 N MAIN ST   HIGH POINT NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 40 , 56 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366835605,"IRONS, GEOFFREY, CHASE",120 HEALTHPLEX WAY   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 29 , 42 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366835605,"IRONS, GEOFFREY, CHASE",120 HEALTHPLEX WAY   APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1366836124,"SNEAD, MATTHEW, RYAN",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 33 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1366836124,"SNEAD, MATTHEW, RYAN",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 59 , 81 ,$#,,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366836298,"GOERES, LINDSEY, WRIGHT",10208 CERNY ST STE 210 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 29 , 91 ,$#,,
MEDICAID DIRECT,1619463429,FHPG LLC,~,2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1366836942,"ZHANG, ADDISON, DI",2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366837098,"BOSTER, ALEXANDRA, HELEN",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366837098,"BOSTER, ALEXANDRA, HELEN",1450 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 17 , 32 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366837098,"BOSTER, ALEXANDRA, HELEN",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366837098,"BOSTER, ALEXANDRA, HELEN",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366838047,"OVERTON, LAURA, KOTAS",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366838047,"OVERTON, LAURA, KOTAS",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 31 , 59 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366840241,"PORE, ADAM, JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1366841330,"DENNISON, KENDRA, RAWLS",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780829697,CHILDRENS ADVOCACY CENTER OF CATAWB,Childrens Advocacy Center of Catawba County Inc,4360 COUNTY HOME RD   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1366843120,"WETMORE, JULIA, PEDEN",4360 COUNTY HOME RD   CONOVER NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1386960177,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366847915,"UMAIR, SANA",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 22 , 32 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366847915,"UMAIR, SANA",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 15 , 27 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366847915,"UMAIR, SANA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386960177,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366847915,"UMAIR, SANA",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366852303,"THOMPSON, ATALIE, CARINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 34 , 53 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366852303,"THOMPSON, ATALIE, CARINE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366852683,"MCCABE, RACHAEL, ELIZABETH",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 25 , 34 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366852683,"MCCABE, RACHAEL, ELIZABETH",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366852683,"MCCABE, RACHAEL, ELIZABETH",1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366852683,"MCCABE, RACHAEL, ELIZABETH",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 40 , 61 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,320 VETERANS PARKWAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",320 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,920 S LOMBARD ST STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 86 , 128 , 172 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 90 , 129 , 202 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366853145,"PHERSON, MICAH, JAMES",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1366853384,"BARNETT, PATRICK, MICHAEL",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1366854325,"RUSNAK, WILLIAM, JOSEPH",105 GABLE RD   PAOLI PA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1366854325,"RUSNAK, WILLIAM, JOSEPH",105 GABLE RD   PAOLI PA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1487633780,SHELBY RADIOLOGICAL ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1366854325,"RUSNAK, WILLIAM, JOSEPH",105 GABLE RD   PAOLI PA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1366855173,"TAYLOR, CYRITA, JAI",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366855173,"TAYLOR, CYRITA, JAI",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 64 , 87 , 102 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366855447,"CHEN, MINGWEI",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 123 , 124 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 11 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366857930,"BALLANTYNE, NANCY, CLARKE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366858086,"NIFONG, LESLIE, WILEY",115 HEART DR   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366858086,"NIFONG, LESLIE, WILEY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 34 , 37 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366858086,"NIFONG, LESLIE, WILEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1689217564,HAKUNA WELLNESS CENTER LLC,,304 S JIMMIES CREEK DR   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1366858755,"SLOAN, KOURTNEY, BROWN",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558773770,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN ORTHOPEDICS,,,Unknown,193200000X,Group,Multi-Specialty,,1366858946,"FREEMAN, JOSHUA, LEE",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1558773770,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN ORTHOPEDICS,,,Unknown,193200000X,Group,Multi-Specialty,,1366858946,"FREEMAN, JOSHUA, LEE",4901 DAWN DR STE 3400 LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366859613,"BURGESS, SARAH, RICHARDSON",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366859613,"BURGESS, SARAH, RICHARDSON",9611 SHERRILL ESTATES RD STE B HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366860397,"KANG, BARRY, KYU SIK GOLDENSON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 19 , 22 ,$#,,
MEDICAID DIRECT,1366860546,WAKE PEDIATRIC SPEECH THERAPY,WAKE PEDIATRIC SPEECH THERAPY,9933 US 70 BUS HWY W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1366860546,WAKE PEDIATRIC SPEECH THERAPY,9933 US 70 BUS HWY W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,#, 46 , 46 ,$#,,
MEDICAID DIRECT,1366860546,WAKE PEDIATRIC SPEECH THERAPY,WAKE PEDIATRIC SPEECH THERAPY,527 KEISLER DR STE 204 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1366860546,WAKE PEDIATRIC SPEECH THERAPY,527 KEISLER DR STE 204 CARY NC,092,Wake,193400000X,Group,Single Specialty,, 18 , 285 , 285 ," $13,778.43 ",,
MEDICAID DIRECT,1366860546,WAKE PEDIATRIC SPEECH THERAPY,WAKE PEDIATRIC SPEECH THERAPY,2000 BEAR CAT WAY STE 105 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1366860546,WAKE PEDIATRIC SPEECH THERAPY,2000 BEAR CAT WAY STE 105 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,#, 54 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366861148,"KLOEFKORN, CHAD, ALAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 18 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366861148,"KLOEFKORN, CHAD, ALAN",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1497771992,PRIVATE DIAGNOSTIC CLINIC PLLC,Raleigh Pulmonary and Allergy,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366861148,"KLOEFKORN, CHAD, ALAN",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366861148,"KLOEFKORN, CHAD, ALAN",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 32 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366861148,"KLOEFKORN, CHAD, ALAN",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 19 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366861148,"KLOEFKORN, CHAD, ALAN",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366861668,"PORTER, ASHLEY, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366861668,"PORTER, ASHLEY, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366861882,"LU, YOUNG",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 120 , 176 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366862518,"HICKS, MEGAN, HENLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 21 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366862666,"BREKKE, ADAM, CHARLES",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 45 , 100 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366862666,"BREKKE, ADAM, CHARLES",4709 CREEKSTONE DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366862666,"BREKKE, ADAM, CHARLES",4709 CREEKSTONE DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366862666,"BREKKE, ADAM, CHARLES",4709 CREEKSTONE DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 35 ,$#,,
MEDICAID DIRECT,1972266237,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SHALLOTTE,301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1366866600,"PEPPERS, KARIM, DASAN",6132 CAROLINA BEACH RD STE 6 WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 55 , 184 ,$#,,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1366866600,"PEPPERS, KARIM, DASAN",6132 CAROLINA BEACH RD STE 6 WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 117 , 119 , 330 ," $17,468.88 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1366866600,"PEPPERS, KARIM, DASAN",104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 179 , 193 , 639 ," $29,360.31 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 4 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366866857,"RUGGIERO, THERESA, ANN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366867269,"THOMAS, ELIZABETH, STERLING",1509 DOCTORS CIR BLDG C CAPE FEAR NC,065,New Hanover,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 11 , 14 , 42 ,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366867269,"THOMAS, ELIZABETH, STERLING",1509 DOCTORS CIR BLDG C CAPE FEAR NC,065,New Hanover,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 18 , 28 , 64 ,$#,,
MEDICAID DIRECT,1366868572,PREMIER SURGERY CENTER LLC,PREMIER SURGERY CENTER,4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1366868572,PREMIER SURGERY CENTER LLC,4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 134 , 222 , 253 ,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366872228,"DEBEVOISE, TAMMY, MARIE",505 OBERLIN RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1366873796,"VAN SICKLE, COURTNEY, MARIE",50 HOSPITAL DR STE 3B-2 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1366873796,"VAN SICKLE, COURTNEY, MARIE",50 HOSPITAL DR STE 3B-2 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1366873796,"VAN SICKLE, COURTNEY, MARIE",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1366873796,"VAN SICKLE, COURTNEY, MARIE",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366874042,"WIEGAND, REBECCA, SARAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366875668,"HORNE, LAURA, LYNN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366875668,"HORNE, LAURA, LYNN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750333126,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES,918 7TH AVE   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1366878878,"MARTIN, BARRETT, KEITH",918 7TH AVE   GARNER NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES PA,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1366878878,"MARTIN, BARRETT, KEITH",1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 29 , 31 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 33 , 87 , 87 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",1000 HEALING WAY   MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 45 , 45 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 33 , 33 ,$#,,
MEDICAID DIRECT,1457853079,HOSPITALIST SOLUTION PLLC,,338 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 41 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",201 E GROVER ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366880197,"PATEL, ANKUR, NALINBHAI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366880304,"PROCTOR, RANDALL, LEE",3311 TRENT RD   TRENT WOODS NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 20 , 26 , 48 ,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366880304,"PROCTOR, RANDALL, LEE",420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 58 , 87 , 182 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1366884769,"BRANN, ALEX, GRANT",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE G KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1366884769,"BRANN, ALEX, GRANT",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 172 , 345 , 876 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366884769,"BRANN, ALEX, GRANT",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 56 , 119 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366884926,"HIGGINBOTHAM, KARLA, D",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 58 , 122 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366885527,"ELLINGBOE, MARY, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366885840,"ROGERS, JASON, ERIK",101 EAST WOOD STYREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1366887283,"HOWARD, ALICIA, GERMAINE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 71 , 73 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366887317,"JUHAISH, JESSICA, BLAIR",16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366887325,"COLOMBO, JOSHUA, RICHARD",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366887325,"COLOMBO, JOSHUA, RICHARD",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366887325,"COLOMBO, JOSHUA, RICHARD",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1366887325,"COLOMBO, JOSHUA, RICHARD",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1366887325,"COLOMBO, JOSHUA, RICHARD",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 24 , 41 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1366887325,"COLOMBO, JOSHUA, RICHARD",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427309608,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1366887325,"COLOMBO, JOSHUA, RICHARD",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1366888596,"SEIFERT, MICHAEL, KENNETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366888596,"SEIFERT, MICHAEL, KENNETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 31 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366888596,"SEIFERT, MICHAEL, KENNETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366888596,"SEIFERT, MICHAEL, KENNETH",6715 MCCRIMMON PKWY STE 204A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 103 , 190 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1366888752,"FULLER, ADDISON, DEITRICH",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366888752,"FULLER, ADDISON, DEITRICH",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 113 , 188 , 198 ," $18,104.34 ",,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366888935,"TOLTON, GAIL, WILEY",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 22 , 58 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1366888935,"TOLTON, GAIL, WILEY",120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1366888935,"TOLTON, GAIL, WILEY",41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1366889552,"TAYLOR, ASHLEY, DICKSON",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1366889552,"TAYLOR, ASHLEY, DICKSON",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1366889925,"DEUTSCH, ERIC, ROBERT",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1366890436,"MCCARTER, NATALIE, VICTORIA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740238435,ATLANTIC GASTROENTEROLOGY PA,~,2465 EMERALD PL   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1366890436,"MCCARTER, NATALIE, VICTORIA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1366891640,"SUTTLE, CHRISTINA, HILTON",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619443827,MH MISSION HOSPITAL MCDOWELL LLLP,,387 US 70 W   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1366892333,"GARY, SAVANNA, YOUNT",184 ALLENDALE DR   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 31 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366892432,"MOOSE, WHITNEY, JOLLY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366892432,"MOOSE, WHITNEY, JOLLY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366892432,"MOOSE, WHITNEY, JOLLY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366892432,"MOOSE, WHITNEY, JOLLY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366892432,"MOOSE, WHITNEY, JOLLY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366892432,"MOOSE, WHITNEY, JOLLY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 39 , 47 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 31 , 39 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 70 , 102 , 121 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 53 , 68 , 108 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 85 , 148 , 233 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 20 , 26 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 32 , 35 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 79 , 95 , 112 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",160 DENTAL CIR # 7075 CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",160 DENTAL CIR # 7075 CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 114 , 198 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1366896235,"FRENCH, JOHN, MICHAEL",160 DENTAL CIR # 7075 CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366896458,"ENOS, CLINTON, WILLIAM",721 FAIRFAX AVE STE 200 NORFOLK VA,101,Out of State <= 40 miles,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366897522,"STRAUB, LIZA, RAY",100 VILLAGE CENTER DR STE 1002 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 41 , 73 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366897522,"STRAUB, LIZA, RAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366897522,"STRAUB, LIZA, RAY",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 20 , 32 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366897878,"RUIZ PATINO, JESUS, ALBERTO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 26 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366897878,"RUIZ PATINO, JESUS, ALBERTO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1366897878,"RUIZ PATINO, JESUS, ALBERTO",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 45 , 51 ," $19,186.61 ",,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366897878,"RUIZ PATINO, JESUS, ALBERTO",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 76 , 94 ," $23,556.30 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1366898041,"STARR, SARAH, ELIZABETH",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366898041,"STARR, SARAH, ELIZABETH",1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366898041,"STARR, SARAH, ELIZABETH",1525 APEX PEAKWAY   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 14 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366898041,"STARR, SARAH, ELIZABETH",1525 APEX PEAKWAY   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 44 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901118,"SCHEVING, WILLIAM, LAWRENCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 18 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366901332,"GRAY, SAMUEL, ALLEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 18 , 24 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366902314,"CARLSSON, CAITLIN, MAY",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366902314,"CARLSSON, CAITLIN, MAY",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 14 , 27 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366903049,"AL GHAZAWI, SAMIR, SADIK SHAREEF",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 82 , 126 , 126 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366903262,"EPPS, JAMES, CARTER",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1366903916,"FATIMA, ANAM",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1366904732,"JOHN, MINTU, MARY",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 81 , 148 , 192 ,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1366905176,"SANCHEZ, JOSUE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 98 , 98 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1366905705,"TATRO, KELLIE, DEANNE",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 118 , 126 , 156 ,$#,,
MEDICAID DIRECT,1366908469,BRUNSWICK SURGERY CENTER LLC,,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1366908469,BRUNSWICK SURGERY CENTER LLC,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1366909178,"PINERO, STEPHANIE, DIANNE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366909178,"PINERO, STEPHANIE, DIANNE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447975073,LOVE CHIROPRACTIC CENTER SALISBURY,LOVE CHIROPRACTIC CENTER SALISBURY,628 W INNES ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1366910267,"LEE, KOU",628 W INNES ST   SALISBURY NC,080,Rowan,111N00000X,Chiropractic Providers,Chiropractor,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1891869780,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS EAST INC,2219 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1366911828,"KERGER, COLLEEN, CASSIDY",2219 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366915688,"DEMENT, EMILY, MARGARET TINSLEY",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366915688,"DEMENT, EMILY, MARGARET TINSLEY",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366915688,"DEMENT, EMILY, MARGARET TINSLEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366915688,"DEMENT, EMILY, MARGARET TINSLEY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1366915985,"COLLINS, AMANDA, NICOLE",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1366915985,"COLLINS, AMANDA, NICOLE",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1366915985,"COLLINS, AMANDA, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 53 , 64 ,$#,,
MEDICAID DIRECT,1518397587,CAROLINA CARDIOLOGY SLEEP & OBESITY,,1136 HWY 258 N STE 102B KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1366917999,"PLACE, STEPHANIE",1136 HWY 258 N STE 105 KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 37 , 44 ,$#,,
MEDICAID DIRECT,1518397587,CAROLINA CARDIOLOGY SLEEP & OBESITY,,3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1366917999,"PLACE, STEPHANIE",3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366921173,"BYRD, LILA, KATHERINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,,,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366921173,"BYRD, LILA, KATHERINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366921769,"LEWIS, PATRICIA, MARIE",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 33 , 57 ,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366922338,"CAMPBELL, JESSICA, KATE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1366924789,"DEGREGORIO, SAMANTHA, MARIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 49 , 50 , 50 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1366925158,"GRAY, ELIZABETH, WALTERS",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366925158,"GRAY, ELIZABETH, WALTERS",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366925158,"GRAY, ELIZABETH, WALTERS",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366925158,"GRAY, ELIZABETH, WALTERS",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366925158,"GRAY, ELIZABETH, WALTERS",6060 PIEDMONT ROW DR S FL 10 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 21 , 26 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366930257,"KHAYR, KHALID, WALID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366930257,"KHAYR, KHALID, WALID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 86 , 236 , 236 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366930273,"MILLER, JONTE, AMERE",97 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366930943,"RILEY, SAMUEL, VIRGIL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 106 , 110 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366934366,"WOLL, ABBIGAIL, KATHLEEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366934366,"WOLL, ABBIGAIL, KATHLEEN",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366934556,"ABRAHAM, NITA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1174067813,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - MEBANE,1931 S NC HIGHWAY 119   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366935538,"TRENDOWSKI, ALEXIS, SIMS",1931 S NC HIGHWAY 119   MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 224 , 369 ," 1,074 "," $45,563.50 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366935728,"FERRUZZI, MORGAN, ELIZABETH MARIE",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366935728,"FERRUZZI, MORGAN, ELIZABETH MARIE",10816 BLACK DOG LN STE 160 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 22 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366937526,"WILLIAMS, BRYANT, MATTHEW",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366937526,"WILLIAMS, BRYANT, MATTHEW",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366938409,"WARD, KENDALL, WALLACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 107 , 110 ,$#,,
MEDICAID DIRECT,1215348156,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES PRIMARY CARE APEX,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366938631,"FORBES, SARA, JANE",120 HEALTHPLEX WAY   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366939472,"FRIEDLANDER, HILARY, SAMUELSON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366939514,"FIE, TAYLOR, ANN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366939514,"FIE, TAYLOR, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 37 , 37 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1366939514,"FIE, TAYLOR, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366939514,"FIE, TAYLOR, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366939514,"FIE, TAYLOR, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 40 , 73 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1366939514,"FIE, TAYLOR, ANN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1366941379,"FAWZE, MINA, AYMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1366941379,"FAWZE, MINA, AYMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1366941379,"FAWZE, MINA, AYMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1366941379,"FAWZE, MINA, AYMAN",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1366941379,"FAWZE, MINA, AYMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366941379,"FAWZE, MINA, AYMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1366941379,"FAWZE, MINA, AYMAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1366941379,"FAWZE, MINA, AYMAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366941379,"FAWZE, MINA, AYMAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366941379,"FAWZE, MINA, AYMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1366941379,"FAWZE, MINA, AYMAN",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366941866,"TAYLOR, CHELSEA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 20 , 21 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366941866,"TAYLOR, CHELSEA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 31 , 31 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366941866,"TAYLOR, CHELSEA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366941965,"FROCK, BRITTANY, WATSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366944027,"BROWN, MATTHEW, SCOTT",107 S QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 129 , 368 , 437 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366944027,"BROWN, MATTHEW, SCOTT",107 S QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366944027,"BROWN, MATTHEW, SCOTT",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639634819,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY BEHAVIORAL HEALTH,107 S QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1366944027,"BROWN, MATTHEW, SCOTT",107 S QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366944027,"BROWN, MATTHEW, SCOTT",2573 STANTONSBURG RD STE A GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366945446,"CAMPBELL, SYLVIA, CIERRAANN",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 39 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1366945446,"CAMPBELL, SYLVIA, CIERRAANN",600 W TRADE ST   DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366945990,"FINK, ERIKA, MARIE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1366945990,"FINK, ERIKA, MARIE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 20 , 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366946410,"HORN, AMANDA, NICOLE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366946410,"HORN, AMANDA, NICOLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 52 , 83 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1366946410,"HORN, AMANDA, NICOLE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366946410,"HORN, AMANDA, NICOLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 54 , 67 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366946410,"HORN, AMANDA, NICOLE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366946576,"BROCK, WILLIAM, MACKAY",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 39 , 85 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1366946576,"BROCK, WILLIAM, MACKAY",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366946576,"BROCK, WILLIAM, MACKAY",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 54 , 95 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1366948879,"KALLINS, MOLLY, GRANT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1366948879,"KALLINS, MOLLY, GRANT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 92 , 92 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1366948879,"KALLINS, MOLLY, GRANT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 47 , 47 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1366949174,"WEIDMAN RICE, ERIKA, LEIGH",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366949174,"WEIDMAN RICE, ERIKA, LEIGH",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1366949174,"WEIDMAN RICE, ERIKA, LEIGH",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 28 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366949174,"WEIDMAN RICE, ERIKA, LEIGH",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366949174,"WEIDMAN RICE, ERIKA, LEIGH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 47 , 85 ,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1366949737,"JORGE, JORGE, LUIS",35 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366952376,"PHILLIPS, KATHRYN, LYNN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 68 , 113 , 133 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366952376,"PHILLIPS, KATHRYN, LYNN",2390 HEMBY LN   GREENVILLE NC,074,Pitt,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366952376,"PHILLIPS, KATHRYN, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 25 , 27 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366952376,"PHILLIPS, KATHRYN, LYNN",2390 HEMBY LN   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1366953325,"ELKINS, TERRI, KLEINER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1366953325,"ELKINS, TERRI, KLEINER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 62 , 62 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366956229,"BOYLE, BRIAN, MATTHEW",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 24 , 58 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1366957128,"JONES, BRITTNEY, MARIE",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366958746,"MROCZKIEWICZ, ELENA, KATHRYN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366958746,"MROCZKIEWICZ, ELENA, KATHRYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1366958746,"MROCZKIEWICZ, ELENA, KATHRYN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1366958746,"MROCZKIEWICZ, ELENA, KATHRYN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366958746,"MROCZKIEWICZ, ELENA, KATHRYN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366958746,"MROCZKIEWICZ, ELENA, KATHRYN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366962656,"HANNA, JOHN, JOSEPH REZKALLAH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366962656,"HANNA, JOHN, JOSEPH REZKALLAH",2390 HEMBY LN   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1366963571,"BOYER, REBECCA, DAWN",145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1366963571,"BOYER, REBECCA, DAWN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366963589,"RASH, WENDY, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 39 , 66 ,$#,,
MEDICAID DIRECT,1124306675,LL BALLANCE DDS PLLC,CAROLINA WEST DENTAL,205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1366966129,"MORANTES-VILLALOBOS, ANDRES, FELIPE",205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice," 3,267 "," 4,169 "," 19,057 "," $587,386.56 ",,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1366966418,"HARDEE, ASHLEY, CARPENTER",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 337 , 647 , 814 ," $13,547.84 ",,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366969834,"BLANKENSHIP, MEGAN, KATHERINE",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366969834,"BLANKENSHIP, MEGAN, KATHERINE",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366969834,"BLANKENSHIP, MEGAN, KATHERINE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366969834,"BLANKENSHIP, MEGAN, KATHERINE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 124 , 124 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366973372,"HOLCOMB, MIRIAM, WILLIAMS",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 47 , 49 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2544 COURT DR STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1366973372,"HOLCOMB, MIRIAM, WILLIAMS",2544 COURT DR STE A GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366973489,"BOYD, WILLIAM, LAWRENCE",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366973489,"BOYD, WILLIAM, LAWRENCE",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366973588,"RAO, SHANTI, GUNDAVARAM",16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366973588,"RAO, SHANTI, GUNDAVARAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 15 , 19 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366973588,"RAO, SHANTI, GUNDAVARAM",101 E W T HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366973943,"BAKER, ELIZABETH, KAITLYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366973943,"BAKER, ELIZABETH, KAITLYN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366973943,"BAKER, ELIZABETH, KAITLYN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 29 , 32 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366973943,"BAKER, ELIZABETH, KAITLYN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902834658,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE HILLSBOROUGH,267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1366974180,"TON, CHRISTIE",267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 40 , 122 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1366974453,"RICCIO, ANGELA, CAROL",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 52 , 82 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1366974453,"RICCIO, ANGELA, CAROL",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 23 , 32 ,$#,,
MEDICAID DIRECT,1225500804,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,170 CHURCH ST   FRANKLIN NC,056,Macon,251B00000X,Agencies,Case Management,,1366974453,"RICCIO, ANGELA, CAROL",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1366974867,"RESSA, NICHOLAS, ANTHONY",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366975807,"COMMESSO, EMILY, ANN",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 20 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366975807,"COMMESSO, EMILY, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366975807,"COMMESSO, EMILY, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366975807,"COMMESSO, EMILY, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366975807,"COMMESSO, EMILY, ANN",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366975807,"COMMESSO, EMILY, ANN",120 E CARVER ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366975864,"SHIVALINGAPPA, HITESH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366975864,"SHIVALINGAPPA, HITESH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1366975864,"SHIVALINGAPPA, HITESH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 86 , 93 , 104 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1366976136,"HOFFMAN, ERIC, DAVID",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366976680,"MCGILLICK, BRIAN, EDWARD",705 NEWMAN RD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 60 , 86 , 133 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366976680,"MCGILLICK, BRIAN, EDWARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 19 , 24 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1366976680,"MCGILLICK, BRIAN, EDWARD",241 FREEDOM WAY   JACKSONVILLE NC,067,Onslow,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366977795,"BLOUNT, COURTLAND, RODERICK",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366977795,"BLOUNT, COURTLAND, RODERICK",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 35 , 45 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366977795,"BLOUNT, COURTLAND, RODERICK",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 24 , 26 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1366977795,"BLOUNT, COURTLAND, RODERICK",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366977795,"BLOUNT, COURTLAND, RODERICK",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1366977795,"BLOUNT, COURTLAND, RODERICK",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1366979213,"WICKER, JORDAN, BENNETT",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366979759,"MCCALL, BRITTANY, HORNE",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 24 , 31 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366979874,"REGAN, BRIAN, PATRICK",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1366979874,"REGAN, BRIAN, PATRICK",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1861592271,ASHE MEMORIAL HOSPITAL INC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1366979874,"REGAN, BRIAN, PATRICK",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 55 , 55 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1366979874,"REGAN, BRIAN, PATRICK",628 E 12TH ST   WASHINGTON NC,007,Beaufort,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1861592271,ASHE MEMORIAL HOSPITAL INC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1366979874,"REGAN, BRIAN, PATRICK",628 E 12TH ST   WASHINGTON NC,007,Beaufort,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1366979874,"REGAN, BRIAN, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1366981086,"HAMLIN, AMY, LAUREL",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902323561,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1366982944,"FRUTCHEY, CRYSTAL, ANN",835 ALBEMARLE RD   TROY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902323561,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1366982944,"FRUTCHEY, CRYSTAL, ANN",150 IVEY LN STE B PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 74 , 188 ,$#,,
MEDICAID DIRECT,1902323561,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1366982944,"FRUTCHEY, CRYSTAL, ANN",202 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 29 , 71 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366984734,"MYERS, KIMBERLY, DAWN",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 67 , 75 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366984734,"MYERS, KIMBERLY, DAWN",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1366984734,"MYERS, KIMBERLY, DAWN",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1366986374,"MANGIACAPRE, THOMAS, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 22 , 22 ,$#,,
MEDICAID DIRECT,1366986937,HOLLY SPRINGS FEEDING & SPEECH,,500 HOLLY SPRINGS RD STE 103 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1366986937,HOLLY SPRINGS FEEDING & SPEECH,500 HOLLY SPRINGS RD STE 103 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,, 16 , 83 , 83 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1366992273,"DEVITA, MICHELE, LISA",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 64 , 73 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366994550,"SUREY, TAMARA, KAYE ESTES",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,150 PROFESSIONAL PARK DR STE 400 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1366994550,"SUREY, TAMARA, KAYE ESTES",150 PROFESSIONAL PARK DR STE 400 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 38 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366995490,"HATTORI, KENAI",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366995490,"HATTORI, KENAI",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1366995490,"HATTORI, KENAI",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366996621,"CARRIGAN, TODD, LOUIS",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366996621,"CARRIGAN, TODD, LOUIS",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 69 , 106 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1366996621,"CARRIGAN, TODD, LOUIS",3311 JESSIE VILLAGE DR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1376002949,"HALL, SANDRA, MERLINI",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1376002949,"HALL, SANDRA, MERLINI",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376003392,"HELTON, COREY, MATTHEW",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376003392,"HELTON, COREY, MATTHEW",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376003566,"MBATA, OSINAKACHUKWU, CHINAZAEKPERE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376003566,"MBATA, OSINAKACHUKWU, CHINAZAEKPERE",2301 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 23 , 24 , 25 ," $11,948.10 ",,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376004465,"VERSULIEN, EVODIE",10208 CERNY ST STE 210 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 49 , 121 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376005116,"FORCINITO, CHRISTOPHER, CARMINE",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 50 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376005116,"FORCINITO, CHRISTOPHER, CARMINE",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 30 , 66 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376005116,"FORCINITO, CHRISTOPHER, CARMINE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 30 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376005207,"MALHOTRA, ARUN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376005942,"ROUCH, SELBY, GAGE",1400 WESTGATE CENTER DR STE 130 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 56 , 143 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376005942,"ROUCH, SELBY, GAGE",3080 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 25 , 66 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376005942,"ROUCH, SELBY, GAGE",114 W 30TH ST STE 800 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376005975,"USHER, ERIK, CALHOUN",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 29 , 34 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376005975,"USHER, ERIK, CALHOUN",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1376005975,"USHER, ERIK, CALHOUN",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376006148,"BEARD, SAMANTHA, NEWING",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376006148,"BEARD, SAMANTHA, NEWING",930 3RD ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 90 , 157 , 207 ," $16,988.57 ",,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376006239,"ZENG, JENNIFER, YAJING",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376006239,"ZENG, JENNIFER, YAJING",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 55 , 62 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376006239,"ZENG, JENNIFER, YAJING",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1376006254,"BROUSSARD, ELZIA, RENA",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 53 , 139 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376007328,"FOSTER, KAITLYN, BLANCHE MARIE",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 45 ,$#,,
MEDICAID DIRECT,1679056733,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRICS MINT HILL,8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376007328,"FOSTER, KAITLYN, BLANCHE MARIE",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376011403,"PUTNAM, ANDREA, UNZELMANN",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 34 , 35 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1376011460,"DOWNING, JULIE, DEVAUGHN",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376013706,"RAMSEY, ROBERT, MARSHALL",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 40 , 61 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376013706,"RAMSEY, ROBERT, MARSHALL",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376013706,"RAMSEY, ROBERT, MARSHALL",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376015040,"BEARD, AUSTIN, GREGORY",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 25 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376017418,"LINGER, MEREDITH, SCOTT",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 50 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1376018333,"BEST, KANDACE, BURROUGHS",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376018333,"BEST, KANDACE, BURROUGHS",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1376018333,"BEST, KANDACE, BURROUGHS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 63 , 64 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376018333,"BEST, KANDACE, BURROUGHS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 94 , 94 ,$#,,
MEDICAID DIRECT,1225690290,WEE CARE PEDIATRICS OF SANFORD PLLC,~,207 GORDON ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1376018630,"FISHER, MITCHELL, DAVID",207 GORDON ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376021485,"MIKAC, SARAH, ELIZABETH GRAY",329 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376021485,"MIKAC, SARAH, ELIZABETH GRAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 23 ,$#,,
MEDICAID DIRECT,1235709692,HARMONY 360 COUNSELING,,12339 WAKE UNION CHURCH RD STE 111 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1376021535,"MOHR, JESSICA, ANN",12339 WAKE UNION CHURCH RD STE 111 WAKE FOREST NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376023234,"ROMANELLI, RONALD, ROSS JAMES",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376023234,"ROMANELLI, RONALD, ROSS JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376023234,"ROMANELLI, RONALD, ROSS JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376023937,"FAIR, RACHEL, DENISE",2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 41 , 86 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376023937,"FAIR, RACHEL, DENISE",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376023937,"FAIR, RACHEL, DENISE",1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376023937,"FAIR, RACHEL, DENISE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376026294,"FADIA, RHYTHM, MANISH",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 41 ,$#,,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1376026294,"FADIA, RHYTHM, MANISH",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 1,412 "," 2,682 "," 7,912 "," $467,400.21 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376028464,"LAKOW, ALIXANDRA, MEGAN",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376028464,"LAKOW, ALIXANDRA, MEGAN",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 22 , 32 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376029926,"GUHA ROY, SHAMBO",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376029926,"GUHA ROY, SHAMBO",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376029926,"GUHA ROY, SHAMBO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376029926,"GUHA ROY, SHAMBO",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376029926,"GUHA ROY, SHAMBO",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376029926,"GUHA ROY, SHAMBO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 231 , 290 , 311 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376031724,"SPERLAZZA, JUSTIN, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376033464,"LOCHOCKI, DIANE, RITA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 114 , 115 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376035907,"MILLER, ANDREW, HARRIS FARBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 17 , 20 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1376037549,"MONTANA, BRANDON, LEE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1376037549,"MONTANA, BRANDON, LEE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1376037549,"MONTANA, BRANDON, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 39 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376038398,"LOWE, DANIELLE, WAULENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 18 , 27 , 31 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376040238,"BLOM, ZACHARY, TYLER",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 107 , 213 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1376041525,"FERRANTE, ERIN, ELIZABETH",1910 JAKE ALEXANDER BLVD W STE 202 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 62 , 86 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1376041525,"FERRANTE, ERIN, ELIZABETH",911 W HENDERSON ST STE 110 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 110 , 198 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1376041525,"FERRANTE, ERIN, ELIZABETH",584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376042499,"MALLIN, JULIE, CARTER",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376043661,"MILLS, STEPHEN, CHRISTOPHER",4709 CREEKSTONE DR   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1952030652,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-611B FIFTH AVENUE WEST,611 B FIFTH AVE W   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376046862,"ASENJO, JOHN, CASTILLO",611 5TH AVE W STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376047761,"SLEMP, WILLIAM, HUNTER",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 40 , 101 ,$#,,
MEDICAID DIRECT,1376049619,VIDANT MEDICAL GROUP LLC,,701 DOCTORS DR STE N KINSTON NC,054,Lenoir,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1376049619,VIDANT MEDICAL GROUP LLC,701 DOCTORS DR STE N KINSTON NC,054,Lenoir,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 34 , 34 , 42 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376052753,"ZALINOV, DANIEL, HENRY",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376052753,"ZALINOV, DANIEL, HENRY",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376052753,"ZALINOV, DANIEL, HENRY",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 22 , 36 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376052753,"ZALINOV, DANIEL, HENRY",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376054106,"MCKENZIE, TARA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376054106,"MCKENZIE, TARA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487879177,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - KER,861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1376055087,"RICKMAN, SHELLEY, YORK",861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 26 , 53 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376056788,"LOVE, LORI, VANLANDINGHAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 38 , 40 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376056788,"LOVE, LORI, VANLANDINGHAM",144 FOREST HILL RD STE 144&146 LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 112 , 119 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376056788,"LOVE, LORI, VANLANDINGHAM",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 120 , 131 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376058024,"JONES, KERRI, MICHELE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 24 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376058024,"JONES, KERRI, MICHELE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1376058412,"HILL, BRENDA",10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1376058412,"HILL, BRENDA",12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 53 , 123 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376058412,"HILL, BRENDA",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376062885,"MASK, CATHERINE, CIMA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 45 , 47 , 47 ,$#,,
MEDICAID DIRECT,1376123182,LOCAL START DENTAL INC,,370 JACKSON ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376065458,"CHEN, ANNIE, YU",370 JACKSON ST   DURHAM NC,032,Durham,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1194899542,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376065458,"CHEN, ANNIE, YU",370 JACKSON ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1376123182,LOCAL START DENTAL INC,,370 JACKSON ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376065458,"CHEN, ANNIE, YU",370 JACKSON ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 192 , 277 , 785 ," $69,424.11 ",,
MEDICAID DIRECT,1376123182,LOCAL START DENTAL INC,,370 JACKSON ST   DURHAM NC,032,Durham,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1376065458,"CHEN, ANNIE, YU",370 JACKSON ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 244 , 402 ," 1,104 "," $104,953.11 ",,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376066811,"LUDWIG, TAYLOR, WRAY",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 46 , 46 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376068320,"FLEMING, ZELDA, WIMBERLY",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376068320,"FLEMING, ZELDA, WIMBERLY",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 119 , 211 , 306 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376068320,"FLEMING, ZELDA, WIMBERLY",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376070029,"ROUNDY, PRESTON, ELLSWORTH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376070342,"ALAMI, FOUAD, HAZEM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376070342,"ALAMI, FOUAD, HAZEM",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376070342,"ALAMI, FOUAD, HAZEM",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003902313,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,1417 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1376070466,"PHILLIP, EUREKA, LLOWANNA",1417 COLLEGE ST   OXFORD NC,039,Granville,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1407137938,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,216 N BICKETT BLVD STE 3 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1376070466,"PHILLIP, EUREKA, LLOWANNA",216 N BICKETT BLVD   LOUISBURG NC,035,Franklin,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 21 , 42 ,$#,,
MEDICAID DIRECT,1902991698,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1376070466,"PHILLIP, EUREKA, LLOWANNA",451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 33 , 67 ,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376072496,"JOYNER-POWELL, NICOLE, BUNA",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073822029,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1376072538,"PHILLIPS, ALEXISS, LEE",711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376072538,"PHILLIPS, ALEXISS, LEE",2630 WILLARD DAIRY RD STE 200 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 22 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376073106,"SMITH, MEGAN, EILEEN",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 65 , 77 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1376073106,"SMITH, MEGAN, EILEEN",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376073478,"PESESKI, ANDREW, MICHAEL",40 DUKE MEDICINE CIR # 1E DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 21 , 30 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376073478,"PESESKI, ANDREW, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1376073957,CROSSROADS TREATMENT CENTER OF WEAV,,901 OLD MARS HILL HWY STE 3 WEAVERVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1376073957,CROSSROADS TREATMENT CENTER OF WEAV,901 OLD MARS HILL HWY STE 3 WEAVERVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376074468,"FORBES, BRANDI, LYNNE",791 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 16 , 18 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376075366,"GRISSOM, NICHOLAS, BRADLEY",725 HIGHLAND OAKS DR STE 101 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 20 , 25 , 45 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376075366,"GRISSOM, NICHOLAS, BRADLEY",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 99 , 193 , 313 ," $10,468.39 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376075366,"GRISSOM, NICHOLAS, BRADLEY",220 FOUST ST STE C ASHEBORO NC,076,Randolph,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 24 , 42 , 58 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376078154,"RAO-ZAWADZKI, AMI, RAJESWARI",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376078154,"RAO-ZAWADZKI, AMI, RAJESWARI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376078154,"RAO-ZAWADZKI, AMI, RAJESWARI",107 SUNNYBROOK RD   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376079483,"OSBORNE, JENNIFER, LEIGH",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1376079483,"OSBORNE, JENNIFER, LEIGH",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 19 , 28 , 36 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376079483,"OSBORNE, JENNIFER, LEIGH",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376079483,"OSBORNE, JENNIFER, LEIGH",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376079624,"MUFUKA, BOLANLE, METIKO",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 133 , 133 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376079624,"MUFUKA, BOLANLE, METIKO",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376079624,"MUFUKA, BOLANLE, METIKO",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376080549,"SINGLETON, FRANCES, LEACH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376082362,"RICE, ASHLEY, W",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376082362,"RICE, ASHLEY, W",2790 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376084947,"FOSTER, ABIGAIL, ELEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1376090415,"BOEKEL, SUSAN, ELAINE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245895697,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OUTPATIENT BEHAVIORAL HEALTH,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376092106,"DEANGELIS, STEPHANIE, MARIE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1376092106,"DEANGELIS, STEPHANIE, MARIE",120 HEALTHPLEX WAY   APEX NC,092,Wake,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376092106,"DEANGELIS, STEPHANIE, MARIE",104 MEDSPRING DR   CLAYTON NC,051,Johnston,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376093971,"LEE, LISA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1376093971,"LEE, LISA",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376093971,"LEE, LISA",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376096669,"BULLARO, ANDREW, NEUMANN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376101287,"PALMER, ROBERT, FOUNT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 21 , 21 , 30 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376102111,"ANDERSON, SARAH, ANNE",445 PINEVIEW DR STE 220 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 70 , 119 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376103010,"WEBB, JESSICA, WALKER",1501 TATE BLVD SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376103010,"WEBB, JESSICA, WALKER",1501 TATE BLVD SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1306138714,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1376104075,"PATERNO, TARA, TRIPLETT",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376104463,"SIKANDAR, ANUM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 103 , 103 ,$#,,
MEDICAID DIRECT,1376104877,MAY SEVEN HOME HEALTH,MAY SEVEN HOME HEALTH LLC,3551 N SHARON AMITY RD STE 101 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1376104877,MAY SEVEN HOME HEALTH,3551 N SHARON AMITY RD STE 101 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,626 "," 1,626 "," $102,319.60 ",,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376105585,"GUPTA, SHILPI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1376105585,"GUPTA, SHILPI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376106716,"RAINBOLT, BRIANNA, MAROTA",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376106716,"RAINBOLT, BRIANNA, MAROTA",391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1245870708,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2211 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376106716,"RAINBOLT, BRIANNA, MAROTA",2211 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376106716,"RAINBOLT, BRIANNA, MAROTA",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376106716,"RAINBOLT, BRIANNA, MAROTA",2242 W ROOSEVELT BLVD STE A MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376110262,"SCHMELZER, ANNE, COLLEEN",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 16 , 30 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376110262,"SCHMELZER, ANNE, COLLEEN",3000 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376110817,"BLANTON, LINDSEY, ALLSBROOK",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1295107779,COUNTY OF COLUMBUS OFFICE OF ACCOUN,,304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376112433,"BENBOW, BREANNA, MARJORIE",304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,1223D0001X,Dental Providers,Dentist,Dental Public Health, 171 , 171 , 577 ," $17,564.39 ",,
MEDICAID DIRECT,1376113068,ST JUDE MEDICAL SUPPLY,,3900 MERTON DR   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376113068,ST JUDE MEDICAL SUPPLY,3900 MERTON DR   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 12 , 65 , 161 ," $13,345.04 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376114462,"MANGUBAT, EMILY, ROBINSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376115865,"JOHNSON, TUCKER, LEE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376115865,"JOHNSON, TUCKER, LEE",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376115865,"JOHNSON, TUCKER, LEE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 40 , 51 ,$#,,
MEDICAID DIRECT,1326719055,FAMILY 1ST HEALTHCARE ASSOCIATES PL,~,602 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376115873,"KELLEY, KELLI, BROOKE",602 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 95 , 130 ,$#,,
MEDICAID DIRECT,1376117044,COLE COASTAL THERAPY LLC,COLE PEDIATRIC THERAPY,210 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376117044,COLE COASTAL THERAPY LLC,210 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,, 150 ," 1,185 "," 1,397 "," $82,554.55 ",,
MEDICAID DIRECT,1376118851,THE SENIOR ENRICHMENT CENTER,TIER ONE HOME CARE,409 W MAIN ST STE 201 WASHINGTON NC,007,Beaufort,253Z00000X,Agencies,In Home Supportive Care,,1376118851,THE SENIOR ENRICHMENT CENTER,409 W MAIN ST STE 201 WASHINGTON NC,007,Beaufort,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 3,461 "," 3,511 "," $368,108.33 ",,
MEDICAID DIRECT,1376118851,THE SENIOR ENRICHMENT CENTER,TIER ONE HOME CARE,2828 PICKETT RD STE 250A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1376118851,THE SENIOR ENRICHMENT CENTER,2828 PICKETT RD STE 250A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 104 , 104 ," $10,686.28 ",,
MEDICAID DIRECT,1376118851,THE SENIOR ENRICHMENT CENTER,TIER ONE HOME CARE,5322 HIGHGATE DR STE 142 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1376118851,THE SENIOR ENRICHMENT CENTER,5322 HIGHGATE DR STE 142 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 569 , 569 ," $74,845.58 ",,
MEDICAID DIRECT,1376119586,HEALTH 1ST PROS,,100 W MAIN ST STE F YOUNGSVILLE NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,,1376119586,HEALTH 1ST PROS,100 W MAIN ST STE F YOUNGSVILLE NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,,#, 333 , 333 ," $49,331.20 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376121053,"JOHNSON, COURTNEY, RAE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 75 , 84 , 164 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376121053,"JOHNSON, COURTNEY, RAE",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 251 , 305 , 804 ," $41,395.38 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1376121053,"JOHNSON, COURTNEY, RAE",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 62 , 127 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376121053,"JOHNSON, COURTNEY, RAE",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 37 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376121558,"MAROIS, BOONE, ELY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 25 , 38 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376121558,"MAROIS, BOONE, ELY",19 N ANN ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376121558,"MAROIS, BOONE, ELY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1972209336,AFFINITY WELLNESS AND HEALTH PLLC,AFFINITY WELLNESS AND HEALTH PLLC,799 JAMES LYNN DR   PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1376124883,"BRITT, FELICIA, ANN",799 JAMES LYNN DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376125542,"SLAUSON, JAMES, WALLACE",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376125542,"SLAUSON, JAMES, WALLACE",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376125542,"SLAUSON, JAMES, WALLACE",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376125542,"SLAUSON, JAMES, WALLACE",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376126276,"CLEM, MATTHEW, EDWARD",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376127852,CAREASSIST LLC,,1775 GRAHAM AVE STE 204 HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1376127852,CAREASSIST LLC,1775 GRAHAM AVE STE 204 HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,#," 1,750 "," 1,750 "," $116,227.64 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376129254,"MARINER, COURTNEY, RENEE",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376129254,"MARINER, COURTNEY, RENEE",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376129254,"MARINER, COURTNEY, RENEE",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,400 N ENGLEWOOD DR   KENLY NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376131128,"NARRON, LISA, CAROL",400 N ENGLEWOOD DR   KENLY NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 104 , 186 , 272 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376131557,"BRUMFIELD, JILL, MCALLISTER",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376131557,"BRUMFIELD, JILL, MCALLISTER",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376131557,"BRUMFIELD, JILL, MCALLISTER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376131557,"BRUMFIELD, JILL, MCALLISTER",349 PENNY LN   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,319 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376131557,"BRUMFIELD, JILL, MCALLISTER",319 PENNY LN   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376131557,"BRUMFIELD, JILL, MCALLISTER",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1376133520,"DELANCEY, KATHLEEN, GRACE",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376135111,"SMITH, WHITNEY, MARIA",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376140632,"FLORES-CHAVEZ, KARLA",155 PARKWAY OFFICE CT STE 204 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376140632,"FLORES-CHAVEZ, KARLA",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376140632,"FLORES-CHAVEZ, KARLA",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 17 , 28 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376140632,"FLORES-CHAVEZ, KARLA",155 PARKWAY OFFICE CT STE 204 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376140723,A LENDING HAND HOME CARE SERVICES,A LENDING HAND HOME CARE SERVICES,1922 S MLK JR DR STE 203 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1376140723,A LENDING HAND HOME CARE SERVICES,1922 S MLK JR DR STE 203 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,887 "," 2,887 "," $182,082.78 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376140855,"BRAIMA, ANDRE, NAZAR",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1376140855,"BRAIMA, ANDRE, NAZAR",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376140855,"BRAIMA, ANDRE, NAZAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376140855,"BRAIMA, ANDRE, NAZAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1376140855,"BRAIMA, ANDRE, NAZAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1376140855,"BRAIMA, ANDRE, NAZAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376142398,"BAILEY, ABIGAIL, JORDAN",1910 JAKE ALEXANDER BLVD W STE 202 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 171 , 374 , 656 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376142398,"BAILEY, ABIGAIL, JORDAN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558396622,HOME HEALTH AND HOSPICE CARE INC,HOME HEALTH AND HOSPICE CARE INC,107 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1376144121,"HILL, HEATHER, HARDY",2402 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376144683,EMINENT CARING HANDS,EMINENT CARING HANDS,1501 BROOKFORD RD   KERNERSVILLE NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1376144683,EMINENT CARING HANDS,1501 BROOKFORD RD   KERNERSVILLE NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 676 , 762 ," $116,666.88 ",,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1376152074,"SHAH, MEERA, UPENDRA",169 BIRCH ST   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 27 , 54 ,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1376152074,"SHAH, MEERA, UPENDRA",169 BIRCH ST   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 212   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376153163,"CAPILITAN, MARIA, ROWENA",300 MEDICAL PKWY STE 206 CHESAPEAKE VA,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376154591,"FLORES, LORI, SANSONE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 35 , 40 ,$#,,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376155507,"VALLEE, EVAN, MICHAEL",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1376155507,"VALLEE, EVAN, MICHAEL",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 122 , 123 , 693 ," $25,972.67 ",,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376155507,"VALLEE, EVAN, MICHAEL",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 3,817 "," 4,422 "," 25,233 "," $917,020.84 ",,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376158451,"MORALES, LUISA, FERNANDA",502 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376159400,"PATTERSON, RONALD, JEROME",2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376164442,"TARLTON, MELONIE, REBECCA",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376166371,"HUBBARD, JOHN, COWAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 43 , 43 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376166371,"HUBBARD, JOHN, COWAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376166371,"HUBBARD, JOHN, COWAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 54 , 54 ,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376168757,"MEHAFFEY, ERIN, CAITLIN",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376169698,"SCISCENTO, KATHERINE, MEYER",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 128 , 222 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1376169698,"SCISCENTO, KATHERINE, MEYER",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 34 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376171983,"SHOFF, CASSIDY, TAYLOR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 30 , 30 ,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1376174078,"SAIN, MICHELLE, LUMPKIN",415 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376174078,"SAIN, MICHELLE, LUMPKIN",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376174078,"SAIN, MICHELLE, LUMPKIN",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1376174078,"SAIN, MICHELLE, LUMPKIN",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 46 , 46 ,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376174078,"SAIN, MICHELLE, LUMPKIN",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376174078,"SAIN, MICHELLE, LUMPKIN",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1376177634,"PEARCE, TENNILLYA, DEWAN",2501 DOWNING ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 64 , 66 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1376177634,"PEARCE, TENNILLYA, DEWAN",2501 DOWNING ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 363 , 363 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1376177634,"PEARCE, TENNILLYA, DEWAN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 102 , 102 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1376177634,"PEARCE, TENNILLYA, DEWAN",2501 DOWNING ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 67 , 67 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1376177634,"PEARCE, TENNILLYA, DEWAN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 62 , 62 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1804 FOREST HILLS RD W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1376177634,"PEARCE, TENNILLYA, DEWAN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1376177634,"PEARCE, TENNILLYA, DEWAN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 165 , 165 ,$#,,
MEDICAID DIRECT,1376179770,REJOICE HOMECARE SERVICES LLP,,7401 THE PLZ STE C CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1376179770,REJOICE HOMECARE SERVICES LLP,7401 THE PLZ STE C CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,176 "," 1,282 "," $130,532.04 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376181487,"FAIRFAX, JESSICA, NICOLE",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 38 , 92 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376181487,"FAIRFAX, JESSICA, NICOLE",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 87 , 212 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376181487,"FAIRFAX, JESSICA, NICOLE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376182055,"DEVOE, HALEY, NOELLE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376182055,"DEVOE, HALEY, NOELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376182055,"DEVOE, HALEY, NOELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376182055,"DEVOE, HALEY, NOELLE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376182055,"DEVOE, HALEY, NOELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376182055,"DEVOE, HALEY, NOELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376182055,"DEVOE, HALEY, NOELLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376182741,PROVIDENCE TRANSPORTATION INC,,7385 RIDGE RD   LEXINGTON NC,029,Davidson,3416L0300X,Transportation Services,Ambulance,Land Transport,1376182741,PROVIDENCE TRANSPORTATION INC,7385 RIDGE RD   LEXINGTON NC,029,Davidson,3416L0300X,Transportation Services,Ambulance,Land Transport, 666 , 837 ," 1,544 "," $33,560.74 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1376183129,"CRAIG, STEPHEN, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 34 , 66 , 66 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376183129,"CRAIG, STEPHEN, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 40 , 97 , 97 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376186346,"MCINNIS, LINDSEY, NICOLE",4105 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376186346,"MCINNIS, LINDSEY, NICOLE",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376186346,"MCINNIS, LINDSEY, NICOLE",1450 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 32 , 36 ,$#,,
MEDICAID DIRECT,1376187955,LEONE FREIGHT SERVICES,LEONE TRANSPORTATION,2 CENTERVIEW DR STE 27 GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1376187955,LEONE FREIGHT SERVICES,2 CENTERVIEW DR STE 27 GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 161 ," 2,122 "," 2,185 "," $153,398.00 ",,
MEDICAID DIRECT,1942867510,GASTON FAMILY HEALTH SERVICES INC,~,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376190330,"LOPEZ, ELIZABETH, RENE",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376190330,"LOPEZ, ELIZABETH, RENE",2721 X RAY DR   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1376190751,"SEMBLY, TAYESHAWN, LARRAINE",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376190751,"SEMBLY, TAYESHAWN, LARRAINE",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1376190751,"SEMBLY, TAYESHAWN, LARRAINE",150 IVEY LN STE A PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1376190751,"SEMBLY, TAYESHAWN, LARRAINE",7473C HWY 22   CARTHAGE NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376192120,"PFUELB, PHILIP, AUGUSTINE",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376193904,"KINZER, EVA, MARIE",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1376194365,"DONOVAN, ASHLEY, ROSE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376194365,"DONOVAN, ASHLEY, ROSE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 35 , 48 ,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,713 "," 3,093 "," 13,257 "," $428,729.25 ",,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 57 , 33 , 127 ,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 850 , 927 ," 3,857 "," $121,918.46 ",,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 17 ,#, 34 ,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1376195636,"BARRY-BLOCKER, AISSATOU, CODEL",510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 38 , 20 , 70 ,$#,,
MEDICAID DIRECT,1023549094,GOSHEN MEDICAL CENTER INCORPORATED,~,106 JEFFERSON ST   HAMLET NC,077,Richmond,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376199125,"GALLOPS, DENISE, EVANS",106 JEFFERSON ST   HAMLET NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376199125,"GALLOPS, DENISE, EVANS",106 JEFFERSON ST   HAMLET NC,077,Richmond,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376199125,"GALLOPS, DENISE, EVANS",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 21 , 34 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376201996,"GURLEY, AJLA, BECIREVIC",16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1376205682,"SOWAH, EMMANUEL, NII ADJEI",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 37 , 39 ,$#,,
MEDICAID DIRECT,1376206706,HARRISONS CARING HANDS 3 LLC,,915 IRVING AVE   EDEN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376206706,HARRISONS CARING HANDS 3 LLC,915 IRVING AVE   EDEN NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 276 , 280 ," $30,290.65 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376207431,"TRAN, FATIMA, MORALES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 95 , 205 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376208777,"MIETHE, JADEN, MOORE",167 MOORE RD STE 201 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 53 , 127 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376208777,"MIETHE, JADEN, MOORE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376210054,"PIPPIN, CAMILLA, BAUCOM",208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,415 N CENTER ST STE 203 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376214338,"HONEYMAN, LORI, JOAN",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 68 , 104 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376214338,"HONEYMAN, LORI, JOAN",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 62 , 86 ,$#,,
MEDICAID DIRECT,1518696236,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-712 FLEMING STREET,712 FLEMING ST   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376215020,"CANNADAY, KIMBERLEY, ALYSE",712 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 70 , 91 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376216689,"LORICK, MORGAN, NICOLE",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376216689,"LORICK, MORGAN, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1376220798,"CLARK, KATHERINE, SUE",230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376221432,"BERNSTEIN, ALEXA, JULE",885 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 81 , 158 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376221887,"LIDE, KEISHA, LATRICE",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376227108,KINERA LLC,KINERA HOMECARE,701 GREEN VALLEY RD # 100-129 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1376227108,KINERA LLC,701 GREEN VALLEY RD # 100-129 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 13 , 628 , 628 ," $35,849.40 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1376227181,"METRIONE, OLIVIA, GRACE",41 BAIN ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 22 , 73 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1376227181,"METRIONE, OLIVIA, GRACE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 17 , 19 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1376227181,"METRIONE, OLIVIA, GRACE",1106 SUNSET AVE   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 19 , 49 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376227512,"OVERBY, KATELYN, ELIZABETH",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 53 , 79 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376227512,"OVERBY, KATELYN, ELIZABETH",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1376228635,"PRIEST, ALEXANDRA, RENEE",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376228635,"PRIEST, ALEXANDRA, RENEE",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1376228635,"PRIEST, ALEXANDRA, RENEE",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376228635,"PRIEST, ALEXANDRA, RENEE",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376228635,"PRIEST, ALEXANDRA, RENEE",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1487612628,KIDS CARE PEDIATRICS PA,KIDS CARE PEDIATRICS PA,101 KELLIE DR   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1376230185,"SOROS, ALEXANDRIA",101 KELLIE DR   SMITHFIELD NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 15 , 39 ,$#,,
MEDICAID DIRECT,1376232371,GRATEFUL HEARTS HOME CARE LLC,,179 S GRACE ST   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1376232371,GRATEFUL HEARTS HOME CARE LLC,179 S GRACE ST   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 499 , 499 ," $31,474.76 ",,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376238956,"FULTON, NATALIE, JUNE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 38 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376238956,"FULTON, NATALIE, JUNE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1376238964,"FRANKEN, SUNNY, ROSE",250 HUFF DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 215 , 231 ,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1376238964,"FRANKEN, SUNNY, ROSE",14057 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 35 , 35 ,$#,,
MEDICAID DIRECT,1912262593,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,2090 S US 29 HWY   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376239624,"CHILDERS, NAKISHA, LACHELLE",2090 S US 29 HWY   CHINA GROVE NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 48 , 73 ,$#,,
MEDICAID DIRECT,1912262593,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,2090 S US 29 HWY   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376239624,"CHILDERS, NAKISHA, LACHELLE",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376239624,"CHILDERS, NAKISHA, LACHELLE",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1376239624,"CHILDERS, NAKISHA, LACHELLE",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1376241463,"NUNN, HOLLY, ANN",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1376241463,"NUNN, HOLLY, ANN",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1376241463,"NUNN, HOLLY, ANN",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376249136,"FRASER, ALEXIS, H",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376249136,"FRASER, ALEXIS, H",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1376252098,"MARR-CARTER, TARA, LYNN",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 32 , 77 ,$#,,
MEDICAID DIRECT,1821076589,EAST CAROLINA HEALTH HERITAGE INC,Vidant Family Medicine Pinetops,1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1376256586,"BRASWELL, TAYLOR, ANDREW",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 62 , 96 ,$#,,
MEDICAID DIRECT,1821076589,EAST CAROLINA HEALTH HERITAGE INC,Vidant Family Medicine Pinetops,1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1376256586,"BRASWELL, TAYLOR, ANDREW",1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1679600969,LENOIR CO HEALTH DEPT,LENOIR COUNTY HEALTH DEPARTMENT,201 N MCLEWEAN ST   KINSTON NC,054,Lenoir,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376257063,"WILLIAMS, CANDACE, G",201 N MCLEWEAN ST   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 79 ,$#,,
MEDICAID DIRECT,1376257238,YOUNG AT HEART ELDERLY SITTING SERV,YOUNG AT HEART ESS,3108 BRIARCLIFF DR   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1376257238,YOUNG AT HEART ELDERLY SITTING SERV,3108 BRIARCLIFF DR   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#," 1,104 "," 1,143 "," $89,137.76 ",,
MEDICAID DIRECT,1962478362,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE,327 1ST AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376257808,"RICHARDS, MEGHAN, EILEEN",327 1ST AVE NW   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376258384,"TURNER, DEBRA, DENISE ARTHUR",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 28 , 29 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376258384,"TURNER, DEBRA, DENISE ARTHUR",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 247 , 263 ,$#,,
MEDICAID DIRECT,1376258806,GLORY TRAIN TRANSPORTATION LLC,,2271 CHANDLER MILL RD   PELHAM NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1376258806,GLORY TRAIN TRANSPORTATION LLC,2271 CHANDLER MILL RD   PELHAM NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 50 , 752 , 777 ," $92,580.00 ",,
MEDICAID DIRECT,1376258806,GLORY TRAIN TRANSPORTATION LLC,,5584 US 29 BUS   REIDSVILLE NC,079,Rockingham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1376258806,GLORY TRAIN TRANSPORTATION LLC,5584 US 29 BUS   REIDSVILLE NC,079,Rockingham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 15 , 49 , 49 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376262261,"FAWCETT, SUSAN, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 42 , 60 , 159 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376265959,"HAWKINS, GRACE, TALBERT",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 102 , 175 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376269175,"HUTTON, CHARLES, BUTCHER",903 RANDOLPH ST STE 1 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 128 , 232 , 328 ,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1376270793,"LEON, MADINA, RAVILYEVNA",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1376270793,"LEON, MADINA, RAVILYEVNA",75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376274738,"PAIR, VIRGIL, THOMAS",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 126 , 126 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376274738,"PAIR, VIRGIL, THOMAS",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 29 , 46 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,257 NC 125   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1376274738,"PAIR, VIRGIL, THOMAS",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,257 NC 125   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1376274738,"PAIR, VIRGIL, THOMAS",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 140 , 702 , 747 ," $18,743.53 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1376274738,"PAIR, VIRGIL, THOMAS",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376277186,"FLYE, ASHLEY, DIBBERT",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 28 ,$#,,
MEDICAID DIRECT,1659495133,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376277186,"FLYE, ASHLEY, DIBBERT",4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659495133,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376277186,"FLYE, ASHLEY, DIBBERT",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,16525 HOLLY CREST LN STE 150   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376277186,"FLYE, ASHLEY, DIBBERT",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376277186,"FLYE, ASHLEY, DIBBERT",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376280412,"FOOR, TYLER, GENE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376281741,"VALENTINI, FRANCESCA, LEIGH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1376283218,"CLARK, RYAN, RADWIN",10 AVIEMORE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 117 , 117 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376285379,"WHITLEY, JESSICA, MARIE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1376285379,"WHITLEY, JESSICA, MARIE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1376285379,"WHITLEY, JESSICA, MARIE",307 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 41 , 52 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376285379,"WHITLEY, JESSICA, MARIE",307 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 20 , 20 ,$#,,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1376292441,"PEEK, MAIZEY, DAWN",3311 BURNT MILL DR   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 99 , 152 , 152 ," $11,482.44 ",,
MEDICAID DIRECT,1083002232,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PEDIATRIC INPATIENT SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376295147,"KROUT, EMILY, ELAINE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376296061,TOOSDAYE FAMILY CARE LLC,SHINAH BEST,319 BRANCH ST   ENFIELD NC,042,Halifax,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376296061,TOOSDAYE FAMILY CARE LLC,319 BRANCH ST   ENFIELD NC,042,Halifax,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 337 , 340 ," $71,330.20 ",,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376297051,"COLE, ALEXANDRA, HIROKO",150 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1376297325,"BURKHALTER, TREVOR, ANDREW",,790 US HIGHWAY 70 SW   HICKORY NC,018,Catawba,111N00000X,Chiropractic Providers,Chiropractor,,1376297325,"BURKHALTER, TREVOR, ANDREW",790 US HIGHWAY 70 SW   HICKORY NC,018,Catawba,111N00000X,Chiropractic Providers,Chiropractor,, 19 , 101 , 101 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",1602 WESTOVER DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 29 , 48 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",150 IVEY LN STE A PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1376299248,"SUTTON, RENEE, ELIZABETH",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 22 ,$#,,
MEDICAID DIRECT,1376893057,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PRIMARY CARE CHARLOTTE INTERNAL MEDI,400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376299750,"REZABAKHSHPOUR, PADIDEH",400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 85 , 119 ,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1376299750,"REZABAKHSHPOUR, PADIDEH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376893057,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PRIMARY CARE CHARLOTTE INTERNAL MEDI,400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376299750,"REZABAKHSHPOUR, PADIDEH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376305730,"CHRIST, KELLY, ANN",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 72 , 80 ,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376305730,"CHRIST, KELLY, ANN",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376305730,"CHRIST, KELLY, ANN",1340 WALTER REED RD STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 85 , 105 ,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1376308924,"DAVIS, MEGHAN, ALEXANDRIA",381 DEERFIELD RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376312272,CAROLINA DIAGNOSTIC LABS LLC,,517 PYLON DR   RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1376312272,CAROLINA DIAGNOSTIC LABS LLC,517 PYLON DR   RALEIGH NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,, 28 , 62 , 71 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376313718,"DAGENHART, JAMIE, HILLIARY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376315242,"BREWIN, HAZEL, JANA",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 22 , 24 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376315242,"BREWIN, HAZEL, JANA",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1942637319,THE CHARLOTTE-MECKLENBURG HOSPITAL,DEVELOPMENT & BEHAVIORAL PEDIATRICS OF THE CAROLIN,2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376321166,"CUEVAS TORRES, CLAREXI",2608 E 7TH ST STE B CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376327098,"WIZA, TYLER, DAVID",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 100 , 202 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376328047,"MOREHOUSE, YARELI, GABRIELA",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1376371815,"MASSEY, ALEXI, CONTAXIS",3000 ROGERS ROAD   WAKE FOREST NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1376375642,"NGUYEN, JIM, VIETHUNG",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376383539,"LOCKLEY, JERYL, CHAVEZ",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376383539,"LOCKLEY, JERYL, CHAVEZ",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376383539,"LOCKLEY, JERYL, CHAVEZ",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376387415,"MAYLE, MADISON, LUCILLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376387415,"MAYLE, MADISON, LUCILLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376398404,A SUNNY DAY HOME HEALTHCARE INC,A SUNNY DAY HOME CARE,1244 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1376398404,A SUNNY DAY HOME HEALTHCARE INC,1244 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 39 ," 7,416 "," 7,416 "," $503,101.48 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376500264,"STEFANE, ALLEN, BENJAMIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376500264,"STEFANE, ALLEN, BENJAMIN",6911 SHANNON WILLOW RD STE 100 CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1720610983,MOFFITT AUDIOLOGY PLLC,,1915 W PARK DR STE 108 NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1376500413,"MOFFITT, BRIAN, DAVID",1915 W PARK DR STE 108 NORTH WILKESBORO NC,097,Wilkes,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 38 , 49 , 99 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376500660,"SIMMONS, JENNIFER, SNEAD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376501403,"STECK, AUDREY, ELAINE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376501650,"SERRANO, KAREN, DENISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 71 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1376501650,"SERRANO, KAREN, DENISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376501809,"HOSU, LIANA, GABRIELA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376501809,"HOSU, LIANA, GABRIELA",2021 CONCERT DR STE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376502278,"NYINAKU YEBOAH, PHYLLIS, KORANTEMA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 195 , 195 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376503458,"LEE, RICHARD, SOMMERVILLE",40 DUKE MEDICINE CIR CLINIC 2J DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376503458,"LEE, RICHARD, SOMMERVILLE",40 DUKE MEDICINE CIR CLINIC 2J DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1376503458,"LEE, RICHARD, SOMMERVILLE",120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376505305,"ELLIS, CLARENCE",2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 62 , 94 ,$#,,
MEDICAID DIRECT,1326000845,METROLINA INTERNAL MEDICINE PA,~,2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376505305,"ELLIS, CLARENCE",2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,7945 N TRYON ST STE 112 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376505305,"ELLIS, CLARENCE",2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376505305,"ELLIS, CLARENCE",2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 37 , 47 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376505305,"ELLIS, CLARENCE",2300 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 32 , 37 ,$#,,
MEDICAID DIRECT,1831306992,HOPSCOTCH PRIMARY CARE GROUP PA,HOPSCOTCH PRIMARY CARE,113 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1376505784,"LATESSA, ROBYN, ANN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376505784,"LATESSA, ROBYN, ANN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 29 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",1611 ANDREWS RD   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",1611 ANDREWS RD   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",102 COLLEGE STATION DR STE 10 BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376506030,"JUSTICE, PAUL, HOWELL",102 COLLEGE STATION DR STE 10 BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376507699,"BOULWARE, MARY, ALICE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 , 69 , 75 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376507855,"SCHIRMER, CHARLES, CARR",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 30 , 31 , 56 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,300 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1376507855,"SCHIRMER, CHARLES, CARR",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 22 , 22 , 33 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1376507855,"SCHIRMER, CHARLES, CARR",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 40 , 42 , 73 ,$#,,
MEDICAID DIRECT,1538189279,FAYETTEVILLE OTOLARYNGOLOGY,FAYETTEVILLE OTOLARYNGOLOGY HEAD AND NECK SURGERY,1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376509778,"WIGGS, WILLIAM, JAMES",1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 79 , 177 , 251 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1376510289,"LARTEY, KINGSLEY, ASAMOAH",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 86 , 93 , 96 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376510289,"LARTEY, KINGSLEY, ASAMOAH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376510289,"LARTEY, KINGSLEY, ASAMOAH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376510289,"LARTEY, KINGSLEY, ASAMOAH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376510289,"LARTEY, KINGSLEY, ASAMOAH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376510511,CAROLINA HOME MEDICAL INC,,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376510511,CAROLINA HOME MEDICAL INC,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 120 , 287 , 511 ," $12,629.14 ",,
MEDICAID DIRECT,1376510511,CAROLINA HOME MEDICAL INC,,5370 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376510511,CAROLINA HOME MEDICAL INC,5370 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1376510511,CAROLINA HOME MEDICAL INC,,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376510511,CAROLINA HOME MEDICAL INC,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1376510511,CAROLINA HOME MEDICAL INC,,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376510511,CAROLINA HOME MEDICAL INC,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 353 ," 1,653 "," 2,990 "," $151,661.48 ",,
MEDICAID DIRECT,1376510511,CAROLINA HOME MEDICAL INC,,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1376510511,CAROLINA HOME MEDICAL INC,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 82 , 646 , 669 ," $80,798.75 ",,
MEDICAID DIRECT,1376510511,CAROLINA HOME MEDICAL INC,,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1376510511,CAROLINA HOME MEDICAL INC,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1376510511,CAROLINA HOME MEDICAL INC,,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376510511,CAROLINA HOME MEDICAL INC,5209 HWY 70 W STE A MOREHEAD CITY NC,016,Carteret,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1053878868,NOVANT HEALTH MEDICAL GROUP LLC,~,106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376511394,"ROBINOWITZ-ELINS, HILLARY, ANN",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511394,"ROBINOWITZ-ELINS, HILLARY, ANN",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511394,"ROBINOWITZ-ELINS, HILLARY, ANN",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511394,"ROBINOWITZ-ELINS, HILLARY, ANN",269 GILLMAN RD STE 200A DENVER NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511659,"DELGADO, GABRIEL, ANGEL",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511659,"DELGADO, GABRIEL, ANGEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511659,"DELGADO, GABRIEL, ANGEL",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 47 , 56 , 87 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511659,"DELGADO, GABRIEL, ANGEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 24 , 37 , 73 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376511659,"DELGADO, GABRIEL, ANGEL",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1588216253,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE CLAYTON,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376512616,"WIRTH, LYNNE",204 MEDSPRING DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 61 , 130 ,$#,,
MEDICAID DIRECT,1568400174,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,281 E MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1376513523,"DICKSON, LORETTA, ANNE",281 E MAIN ST   FOREST CITY NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 108 , 195 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376513697,"MANNE, PURNA, PRASAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376513697,"MANNE, PURNA, PRASAD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437459021,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH UROLOGY LINCOLN,441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1376514067,"BURNO, DERRICK, KENNETH",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,208800000X,Allopathic & Osteopathic Physicians,Urology,, 70 , 145 , 222 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376515304,"OGLE JR, JOHN, MARSHALL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376515304,"OGLE JR, JOHN, MARSHALL",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 18 , 38 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376515304,"OGLE JR, JOHN, MARSHALL",3444 S CONTENTNEA ST   FARMVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376515304,"OGLE JR, JOHN, MARSHALL",300 BETHESDA DR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 19 , 46 ,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376515502,"JONES, RACHEL, WIESE",332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376515502,"JONES, RACHEL, WIESE",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376515502,"JONES, RACHEL, WIESE",332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 24 , 41 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376515502,"JONES, RACHEL, WIESE",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 26 , 53 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1376515593,"DARCEY, JACQUELINE, MARIE",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 113 , 190 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376515635,"JELESOFF, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376515635,"JELESOFF, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376515635,"JELESOFF, NICOLE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 27 , 36 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376515635,"JELESOFF, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376515635,"JELESOFF, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 15 , 20 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376516021,"DESAI, MUNEER, JANAK",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376516021,"DESAI, MUNEER, JANAK",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376516369,"NIEMEYER JR, CHARLES, JOHN",2345 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 107 , 227 ,$#,,
MEDICAID DIRECT,1255360459,SMITHFIELD RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT SMITHFIELD,514 N BRIGHTLEAF BLVD STE 1200 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1376516823,"LIM, MAY",514 N BRIGHTLEAF BLVD STE 1200 SMITHFIELD NC,051,Johnston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376516823,"LIM, MAY",11200 GOVERNOR MANLY WAY STE 120 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376516823,"LIM, MAY",2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376516823,"LIM, MAY",2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 70 , 94 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376517243,"JUBERG, BRETON, CHESTER",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376518134,"KEENE, MICHAEL, GRAHAM",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376518134,"KEENE, MICHAEL, GRAHAM",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376518134,"KEENE, MICHAEL, GRAHAM",530 NEW WAVERLY PL STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376518134,"KEENE, MICHAEL, GRAHAM",530 NEW WAVERLY PL STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1376518290,"STALFORD, MICHAEL, DEE",80 DOCTORS DR STE 2 HENDERSONVILLE NC,045,Henderson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 31 , 55 , 67 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1376518290,"STALFORD, MICHAEL, DEE",80 DOCTORS DR STE 2 HENDERSONVILLE NC,045,Henderson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 21 , 25 ,$#,,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376519280,"NANCE, KEITH, VAN ALLEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 18 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376520684,"GALISIN, THOMAS, JOHN",2906 N MAIN ST   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 158 , 389 , 675 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376521054,"PAULI, JON, WARREN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376521054,"PAULI, JON, WARREN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376521054,"PAULI, JON, WARREN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 66 , 80 , 83 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1376521161,"BULLARD, MARK, JEFFREY",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376521161,"BULLARD, MARK, JEFFREY",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376521161,"BULLARD, MARK, JEFFREY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 61 , 78 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376521161,"BULLARD, MARK, JEFFREY",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376521385,"FLOBERG, DANE, ROBERT",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376521385,"FLOBERG, DANE, ROBERT",5303 POPLAR TENT RD STE 90 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992215446,TAPESTRY TELEHEALTH PLLC,TAPESTRY TELEHEALTH PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1376521773,"CHESS, DAVID, MARK",555 S MANGUM ST STE 100 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1376521872,"CONTY, ORLANDO",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1376521872,"CONTY, ORLANDO",2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 49 , 103 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1376521872,"CONTY, ORLANDO",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376523043,HOME MEDICAL SYSTEMS INC,ROTECH,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376523043,HOME MEDICAL SYSTEMS INC,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1376523043,HOME MEDICAL SYSTEMS INC,ROTECH,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376523043,HOME MEDICAL SYSTEMS INC,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 419 ," 1,801 "," 3,091 "," $75,726.28 ",,
MEDICAID DIRECT,1376523043,HOME MEDICAL SYSTEMS INC,ROTECH,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376523043,HOME MEDICAL SYSTEMS INC,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 394 ," 1,203 "," 2,033 "," $45,503.27 ",,
MEDICAID DIRECT,1376523043,HOME MEDICAL SYSTEMS INC,ROTECH,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1376523043,HOME MEDICAL SYSTEMS INC,2956 OWEN DR STE 116 FAYETTEVILLE NC,026,Cumberland,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376523480,"KUEHN, ERIC, FORD",90 ASHELAND AVE STE D ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376523480,"KUEHN, ERIC, FORD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376523571,"CLIFFORD, BARBARA, ANN",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1376523712,"JONES, RICHARD, HUGHES",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376524686,"HARP, KAREN, MARIE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",13640 STEELECROFT PKWY STE 320 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 13 , 16 , 33 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 30 , 35 , 35 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,101 E W T HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 22 , 34 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376525816,"KASHYAP, SONA, SHRIKANT",4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376526400,"OHAR, JILL, MUSIKA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 51 , 62 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 24 , 31 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 33 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 54 , 62 , 65 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1126 N CHURCH ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",301 E WENDOVER AVE STE 100 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 27 , 28 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 19 , 22 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#, 18 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1376526434,"LIEBKEMANN, WALTER, DICKINSON",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376526624,"FLEISCHLI, JAMES, EDWARD",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 44 , 76 ,$#,,
MEDICAID DIRECT,1376527754,"GOLDMAN, NEAL, DAVID",~,717 GREENWAY RD STE A BOONE NC,095,Watauga,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,1376527754,"GOLDMAN, NEAL, DAVID",717 GREENWAY RD STE A BOONE NC,095,Watauga,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376528687,"WATSON, PETER, ROBINS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 13 ,$#,,
MEDICAID DIRECT,1376530725,COUNTY OF VANCE OFFICE OF TREASURER,VANCE CO AMBULANCE SERVICE,122 YOUNG ST STE B HENDERSON NC,091,Vance,3416L0300X,Transportation Services,Ambulance,Land Transport,1376530725,COUNTY OF VANCE OFFICE OF TREASURER,122 YOUNG ST STE B HENDERSON NC,091,Vance,3416L0300X,Transportation Services,Ambulance,Land Transport, 197 , 337 , 594 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1376530881,"AGRAWAL, MALAY",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 135 , 206 , 256 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376530881,"AGRAWAL, MALAY",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 43 , 78 , 110 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376532960,"MAHARAJH, GARNET, DAUDHARRY",1994 WELLNESS BLVD STE 110 MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 54 , 103 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,3551 N BROAD ST   PHILADELPHIA PA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1376534651,"ANUPINDI, SUDHA, AYYALA",3551 N BROAD ST   PHILADELPHIA PA,102,Out of State > 40 miles,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376535369,"YATES, JENNIFER, ELAINE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376535369,"YATES, JENNIFER, ELAINE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 33 , 33 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376535369,"YATES, JENNIFER, ELAINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 109 , 109 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376535450,"ENGELKE, STEPHEN, CARL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376535450,"ENGELKE, STEPHEN, CARL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1376536151,"ROWE, KRISTINA, DEZIELLE",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871894626,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,532 WEBB BLVD   HAVELOCK NC,025,Craven,193200000X,Group,Multi-Specialty,,1376536151,"ROWE, KRISTINA, DEZIELLE",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376536318,"ALEXANDER, GREGORY, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376536318,"ALEXANDER, GREGORY, EDWARD",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376536714,"HUTCHINS, KEITH, LEON",171 NC HIGHWAY 125 STE A ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 179 , 269 , 436 ," $13,976.89 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376536789,"POTH, ROBERT, ALEXANDER",601 N ELM ST   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376536789,"POTH, ROBERT, ALEXANDER",400 E COMMERCE AVE   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 29 , 60 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376537118,"CONLEY, MARTIN, JAMES",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376537712,"MASTRANGELO, MICHAEL, ROCCO",1520 PHYSICIANS DR STE A WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376537712,"MASTRANGELO, MICHAEL, ROCCO",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376537712,"MASTRANGELO, MICHAEL, ROCCO",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376537712,"MASTRANGELO, MICHAEL, ROCCO",1520 PHYSICIANS DR STE B WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376537712,"MASTRANGELO, MICHAEL, ROCCO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 34 , 44 , 60 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376537712,"MASTRANGELO, MICHAEL, ROCCO",1515 DOCTORS CIR BLDG A WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376537969,"ENGLISH, THADDEUS, DAVID",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376538439,"DEHORITY, DIXON, REMY",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 40 , 40 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376538686,"PRATO, CHRISTOPHER, ALLEN",2345 COURT DR   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 70 , 120 , 215 ,$#,,
MEDICAID DIRECT,1306845573,CLARK FAMILY MEDICINE PA,CLARK FAMILY MEDICINE,137 NOTALEE ST   NEWLAND NC,006,Avery,193400000X,Group,Single Specialty,,1376542597,"CLARK, ROBERT, DALE",137 NOTALEE ST   NEWLAND NC,006,Avery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043453004,CATINO EYE CARE CENTER OD PA,CATINO EYE CARE CENTER OD PA,8116 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376543579,"CATINO, GILBERT, SEAN",8116 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",145 W PLAZA DR STE K WEST END NC,063,Moore,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",145 W PLAZA DR STE K WEST END NC,063,Moore,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",1650 LIBERTY DR   THOMASVILLE NC,029,Davidson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",1007 N 6TH ST   ALBEMARLE NC,084,Stanly,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",1007 N 6TH ST   ALBEMARLE NC,084,Stanly,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",360 SUNSET AVE   ASHEBORO NC,076,Randolph,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 46 , 52 , 96 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",360 SUNSET AVE   ASHEBORO NC,076,Randolph,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 24 , 27 , 41 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",530 NEW WAVERLY PL STE 101 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376545301,"WILLIAMS, JAMES, TODD",530 NEW WAVERLY PL STE 101 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376545871,"COX JR, BRUCE, ARTHUR",201 E GROVER ST   SHELBY NC,023,Cleveland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376545871,"COX JR, BRUCE, ARTHUR",101 DELTA PARK DR   SHELBY NC,023,Cleveland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 84 , 134 , 203 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1376547356,"PARKER, DAVID, RAY",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376547356,"PARKER, DAVID, RAY",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 22 , 22 ,$#,,
MEDICAID DIRECT,1902474547,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER-FAYETTEVILLE,1248 FORT BRAGG RD   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376547356,"PARKER, DAVID, RAY",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1376547356,"PARKER, DAVID, RAY",1248 FORT BRAGG RD STE 200 FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376548222,"JOHNSON, JAMES, CLIFTON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376548222,"JOHNSON, JAMES, CLIFTON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376548222,"JOHNSON, JAMES, CLIFTON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376548222,"JOHNSON, JAMES, CLIFTON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376548222,"JOHNSON, JAMES, CLIFTON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376548222,"JOHNSON, JAMES, CLIFTON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 286 , 304 , 346 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376548222,"JOHNSON, JAMES, CLIFTON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376548420,"GERSTNER, LAURA, REED",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376549956,"PRASAD, ALKA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376549956,"PRASAD, ALKA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 30 , 109 , 109 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376551895,"SOTIR, CATHERINE, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376551895,"SOTIR, CATHERINE, LEE",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 108 , 160 , 228 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376553776,"VAN TASSEL, KAREN, M",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1376553776,"VAN TASSEL, KAREN, M",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 32 ,$#,,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1376554220,"MILLSAPS, DAVID, MCIVER",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 90 , 129 , 322 ," $10,108.28 ",,
MEDICAID DIRECT,1376556167,"BADGETT, DAVID, ADAM",~,211 TRADE ST   TARBORO NC,033,Edgecombe,1223G0001X,Dental Providers,Dentist,General Practice,1376556167,"BADGETT, DAVID, ADAM",211 TRADE ST   TARBORO NC,033,Edgecombe,1223G0001X,Dental Providers,Dentist,General Practice, 151 , 242 ," 1,420 "," $107,559.92 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376557504,"SAYLES, JOHN, MINOTT",6251 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376558007,"GIARRIZZI, MARK, ANTHONY",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1760417570,WAYNESBORO FAMILY CLINIC PA,WAYNESBORO FAMILY CLINIC PA,1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1376558825,"CHENGAPPA, KULIAKANDA, MANDAPPA",1706 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1881651347,GOLDSBORO COUNSELING CENTER PA,Goldsboro Counseling Center PA,208 MALLOY ST STE E GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1376558825,"CHENGAPPA, KULIAKANDA, MANDAPPA",208 MALLOY ST STE E GOLDSBORO NC,096,Wayne,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376561324,"PRICE, MARTIE, LEE",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376561324,"PRICE, MARTIE, LEE",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376561415,"WILSON, CAROL",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 18 , 31 ,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376561415,"WILSON, CAROL",1022 N BRAGG BLVD   SPRING LAKE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 33 , 74 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376561613,"STEPHENSON, STEPHEN",300 BILLINGSLEY RD STE 200B CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376561613,"STEPHENSON, STEPHEN",1663 CAMPUS PARK DR STE D MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 115 , 154 , 167 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376561613,"STEPHENSON, STEPHEN",1663 CAMPUS PARK DR STE D MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376561613,"STEPHENSON, STEPHEN",600 HOSPITAL DR   MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376561613,"STEPHENSON, STEPHEN",600 HOSPITAL DR   MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 60 , 68 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376561613,"STEPHENSON, STEPHEN",1663 CAMPUS PARK DR STE A MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 33 , 41 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376561613,"STEPHENSON, STEPHEN",1663 CAMPUS PARK DR STE A MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376561662,"LEINBACH, ROBERT, FREDERIC",624 QUAKER LN STE 208C HIGH POINT NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376561662,"LEINBACH, ROBERT, FREDERIC",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,624 QUAKER LN STE 200D HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376561662,"LEINBACH, ROBERT, FREDERIC",624 QUAKER LN STE 208C HIGH POINT NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376561662,"LEINBACH, ROBERT, FREDERIC",4515 PREMIER DR STE 404 HIGH POINT NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 135 , 169 , 237 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376561662,"LEINBACH, ROBERT, FREDERIC",601 N ELM ST   HIGH POINT NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376562223,"YEOMANS, JAY, ANTHONY",2001 VALE AVE   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1164453726,CARMEL FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE CARMEL FAMILY MEDICINE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376562710,"SHARMA, ISHA, PURI",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 42 , 68 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376562710,"SHARMA, ISHA, PURI",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376562710,"SHARMA, ISHA, PURI",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376562728,"COLE, ALICE, WIGHT",6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376562728,"COLE, ALICE, WIGHT",6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366597114,CHILDRENS MEDICAL GROUP INC,GENERAL BOOTH PEDS,2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376562926,"BARTIMOCCIA, MICHELLE, LEE",2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376562975,"HOGUE, LAURA, PENCE",10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 108 , 115 , 456 ," $10,598.44 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",9601 BROOKDALE DR STE 400 CHARLOTTE NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 12 ,$#,,
MEDICAID DIRECT,1962745992,KELLEY AND HOLT PLLC,~,9601 BROOKDALE DR STE 400 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",9601 BROOKDALE DR STE 400 CHARLOTTE NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",9601 BROOKDALE DR STE 400 CHARLOTTE NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 45 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",9601 BROOKDALE DR STE 400 CHARLOTTE NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 121 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 64 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 85 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 116 ," $12,168.56 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 51 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 971 ," 1,138 "," 4,242 "," $141,998.54 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 11 , 11 , 42 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 340 , 385 ," 1,428 "," $46,178.02 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1376563098,"HOLT, MICHAEL, TIMOTHY",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376563924,"BACON MENSHEW, JENISE, VICTORIA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376563924,"BACON MENSHEW, JENISE, VICTORIA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 27 ,$#,,
MEDICAID DIRECT,1801843925,ARTHRITIS AND OSTEOPOROSIS CONSULTA,ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CARO,1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376564104,"SICELOFF, ERIN, PARSONS",1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 37 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376568550,"SWAMINATHAN, VISWANATHAN",804 WASHINGTON ST   PLYMOUTH NC,094,Washington,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376570564,"MATHIS, LISA, KEY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457853079,HOSPITALIST SOLUTION PLLC,,338 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376570564,"MATHIS, LISA, KEY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376570564,"MATHIS, LISA, KEY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 73 , 76 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376570689,"VAN WALLENDAEL, SHAWN, EDMUND",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 52 , 52 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376571489,"O'CONNELL, JAMES, PATRICK",11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376573790,"LONG STOKES, SHARON, ANITA",DR SHARON LONG-STOKES DDS PA,106 S MURROW BLVD STE 100 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1376573790,"LONG STOKES, SHARON, ANITA",106 S MURROW BLVD STE 100 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 679 ," 2,458 "," 13,924 "," $578,836.60 ",,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376574988,"JOHNSON, JEFFREY, DAVID",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 31 , 31 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376574988,"JOHNSON, JEFFREY, DAVID",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1376574988,"JOHNSON, JEFFREY, DAVID",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 29 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376575746,"GALLAGHER, DAVID, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376575746,"GALLAGHER, DAVID, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1376576207,"POOLE, KENNETH, ALEXANDER",K ALEX POOLE II DMD PA,2835 HORSE PEN CREEK RD STE 106 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1376576207,"POOLE, KENNETH, ALEXANDER",2835 HORSE PEN CREEK RD STE 106 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1376576777,DEPARTMENT OF ADULT CORRECTION,~,2869 US HIGHWAY 64A   NASHVILLE NC,064,Nash,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1376576777,DEPARTMENT OF ADULT CORRECTION,2869 US HIGHWAY 64A   NASHVILLE NC,064,Nash,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician," 209,431 "," 209,690 "," 527,554 "," $6,079,480.08 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376577130,"WEISS, JARED, MARC",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 26 , 47 , 86 ,$#,,
MEDICAID DIRECT,1295824159,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - PSYCHIATRY,391 SERPENTINE DR STE 400 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376578252,"FULLER, HAROLD, JONES",391 SERPENTINE DR STE 400 SPARTANBURG SC,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,725 VOLVO PKWY STE 210 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376578922,"DIAZ, REX, GALAM",725 VOLVO PKWY STE 210 CHESAPEAKE VA,101,Out of State <= 40 miles,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376578922,"DIAZ, REX, GALAM",725 VOLVO PKWY STE 210 CHESAPEAKE VA,101,Out of State <= 40 miles,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 18 , 24 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376579110,"KNIGHT, LYDIA, MAY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376579110,"KNIGHT, LYDIA, MAY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376579110,"KNIGHT, LYDIA, MAY",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376579110,"KNIGHT, LYDIA, MAY",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376579110,"KNIGHT, LYDIA, MAY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376580811,CITY OF SOUTHPORT,CITY OF SOUTHPORT,1011 N HOWE ST   SOUTHPORT NC,010,Brunswick,3416L0300X,Transportation Services,Ambulance,Land Transport,1376580811,CITY OF SOUTHPORT,1011 N HOWE ST   SOUTHPORT NC,010,Brunswick,3416L0300X,Transportation Services,Ambulance,Land Transport, 36 , 52 , 96 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376581769,"CETRONE, TEODORA, MICHELLE",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376582205,"JAMIESON, KATARZYNA, JOANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 46 , 46 ,$#,,
MEDICAID DIRECT,1376582239,EYECARECENTER OD PA,EYECARE CENTER,3401 RALEIGH ROAD PKWY W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1376582239,EYECARECENTER OD PA,3401 RALEIGH ROAD PKWY W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,, 28 , 28 , 55 ,$#,,
MEDICAID DIRECT,1376582239,EYECARECENTER OD PA,EYECARE CENTER,3401 RALEIGH ROAD PKWY W STE B WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1376582239,EYECARECENTER OD PA,3401 RALEIGH ROAD PKWY W STE B WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376582353,"AGARWALA, RAVI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 12 , 26 , 28 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376582353,"AGARWALA, RAVI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 40 , 101 , 127 ," $16,328.19 ",,
MEDICAID DIRECT,1003558461,GENERATIONS FAMILY PRACTICE,KERNERSVILLE PRIMARY CARE,420 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376583245,"CHOW, ANDREW, ONSHING",1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1376583245,"CHOW, ANDREW, ONSHING",1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003558461,GENERATIONS FAMILY PRACTICE,KERNERSVILLE PRIMARY CARE,420 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376583245,"CHOW, ANDREW, ONSHING",420 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 104 , 106 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376584524,"COGGIN, SHARON, DELOIS",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 81 , 123 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1376584524,"COGGIN, SHARON, DELOIS",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 48 , 49 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376584524,"COGGIN, SHARON, DELOIS",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 109 , 566 , 631 ," $16,290.41 ",,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376584524,"COGGIN, SHARON, DELOIS",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376585612,"KNEISLY, DEBRA, JEAN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376585612,"KNEISLY, DEBRA, JEAN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376585612,"KNEISLY, DEBRA, JEAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376585612,"KNEISLY, DEBRA, JEAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376585612,"KNEISLY, DEBRA, JEAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780772715,BLUE RIDGE HEALTHCARE MEDICAL GROUP,RUTHERFORD COLLEGE FAMILY MEDICAL CARE CENTER,730 MALCOLM BLVD STE 230 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1376586909,"GENANT, JACKSON, ROSS",730 MALCOLM BLVD STE 230 RUTHERFORD COLLEGE NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 40 , 54 ,$#,,
MEDICAID DIRECT,1780772715,BLUE RIDGE HEALTHCARE MEDICAL GROUP,RUTHERFORD COLLEGE FAMILY MEDICAL CARE CENTER,730 MALCOLM BLVD STE 230 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1376586909,"GENANT, JACKSON, ROSS",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 143 , 191 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1376586909,"GENANT, JACKSON, ROSS",730 MALCOLM BLVD STE 230 RUTHERFORD COLLEGE NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1376587329,"SHERMAN, DEBBIE, ANN",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376587329,"SHERMAN, DEBBIE, ANN",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376587386,"LAWSON, STEVEN, JAMES",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 96 , 136 , 221 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1376589374,"THORP IV, ADAM, TREDWELL",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1457309221,CABARRUS EMERGENCY MEDICINE ASSOCIA,CABARRUS EMERGENCY MEDICINE ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1376591149,"KACZMAREK, MICHAEL, KITSON",1325 SPRING ST   GREENWOOD SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376591420,"SCOTT, MELISSA, STAKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 27 , 27 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376591420,"SCOTT, MELISSA, STAKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 30 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376591586,"OTOOLE, SARAH, CATHERINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1891789970,SCOTLAND MEMORIAL HOSPITAL INC,WAGRAM FAMILY PRACTICE,24420 MARLBORO ST   WAGRAM NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1376591636,"MANZO, MATTHEW, THOMAS",24420 MARLBORO ST   WAGRAM NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 112 , 252 , 358 ," $12,364.96 ",,
MEDICAID DIRECT,1972949949,MOSES CONE AFFILIATED PHYSICIANS IN,GLEN RAVEN MEDICAL CARE CENTER,1611 FLORA AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376592451,"MASOUD, JAVED",1611 FLORA AVE   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1376592451,"MASOUD, JAVED",,1611 FLORA AVE   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1376592451,"MASOUD, JAVED",1611 FLORA AVE   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 23 , 24 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376592899,"NEAGLE, PAUL, EVERETTE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376592899,"NEAGLE, PAUL, EVERETTE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,534 N 35TH ST STE A MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,534 N 35TH ST STE A MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1517 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,1517 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,232 SHARON AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,232 SHARON AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,75 LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,75 LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,, 86 , 518 ," 1,217 ",$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,825 W 25TH ST   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,825 W 25TH ST   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,139 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,139 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,, 16 , 59 , 112 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2647 S NC 127 HWY   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1376592964,EMERGEORTHO PA,2647 S NC 127 HWY   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,841 MALCOM BLVD   RUTHERFORD COLLEGE NC,012,Burke,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,841 MALCOM BLVD   RUTHERFORD COLLEGE NC,012,Burke,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,," 1,589 "," 9,732 "," 22,990 "," $209,261.49 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,, 112 , 460 ," 1,134 ",$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,, 56 , 198 , 450 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,, 49 , 225 , 574 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1427 FREEWAY DR   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,1427 FREEWAY DR   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,, 55 , 243 , 545 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,, 15 , 35 , 72 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,, 83 , 456 , 914 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 54 , 144 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,, 23 , 112 , 340 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 63 , 359 , 751 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376592964,EMERGEORTHO PA,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 36 , 167 , 460 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376593624,"CECCHINI, JOHN, MATTHEW",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1376593624,"CECCHINI, JOHN, MATTHEW",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376593624,"CECCHINI, JOHN, MATTHEW",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376593624,"CECCHINI, JOHN, MATTHEW",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376593624,"CECCHINI, JOHN, MATTHEW",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376593749,"JONES, THOMAS, LANIER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376593749,"JONES, THOMAS, LANIER",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 119 , 359 ,$#,,
MEDICAID DIRECT,1124207725,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,910 E CHURCH ST STE A CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376594424,"LOVE, REBECCA, JEAN",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 30 , 34 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376594861,"YOUNG, KAREN, JOANN",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376594978,"EISENBERG, DANNY",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 15 , 18 ,$#,,
MEDICAID DIRECT,1376595199,"ARIAS, ROQUE, MANUEL",ROQUE MANUEL ARIAS,112 E MAIN ST   EAST BEND NC,099,Yadkin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1376595199,"ARIAS, ROQUE, MANUEL",112 E MAIN ST   EAST BEND NC,099,Yadkin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 49 , 76 ,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376596197,"WOLFE, BETSY, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376596197,"WOLFE, BETSY, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376596197,"WOLFE, BETSY, ANNE",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376596197,"WOLFE, BETSY, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376596197,"WOLFE, BETSY, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1376596379,"HEINLY, CRAIG, STEPHEN",3008 PICKETT RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 29 , 39 , 68 ,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1376596379,"HEINLY, CRAIG, STEPHEN",176 FLAT RIVER CHURCH RD   ROXBORO NC,073,Person,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1376596882,"MEHROTRA, MONY, SURBHI",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1376596882,"MEHROTRA, MONY, SURBHI",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376596882,"MEHROTRA, MONY, SURBHI",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376596882,"MEHROTRA, MONY, SURBHI",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376596882,"MEHROTRA, MONY, SURBHI",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 63 , 67 , 130 ,$#,,
MEDICAID DIRECT,1528011137,VALLEY INTERNAL MEDICINE INC,VALLEY INTERNAL MEDICINE INC,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1376596965,"SALAHUDDIN, ABU, NASSER",2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 20 , 22 ,$#,,
MEDICAID DIRECT,1417906520,"HANNAN, MOHAMMED, ASHRAFUL",~,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1376596965,"SALAHUDDIN, ABU, NASSER",2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376596965,"SALAHUDDIN, ABU, NASSER",~,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1376596965,"SALAHUDDIN, ABU, NASSER",2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528011137,VALLEY INTERNAL MEDICINE INC,VALLEY INTERNAL MEDICINE INC,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376596965,"SALAHUDDIN, ABU, NASSER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528011137,VALLEY INTERNAL MEDICINE INC,VALLEY INTERNAL MEDICINE INC,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376596965,"SALAHUDDIN, ABU, NASSER",2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 128 , 470 , 637 ," $11,887.47 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376596973,"DELO, DOUGLAS, PERRY",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1609822287,EASTERN CAROLINA MEDICAL CENTER PC,EASTERN CAROLINA MEDICAL CENTER PC,1 MEDICAL DR   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1376599647,"VYAS, PANKAJ, KIRTIKANT",1 MEDICAL DR   BENSON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 274 ," 1,429 "," 8,637 "," $69,929.81 ",,
MEDICAID DIRECT,1881877793,ANESTHESIA CONSULTANTS OF AUGUSTA,,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1376603290,"RYAN, JESSE, LYNN",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376605063,"GADSDEN, JEFFREY, CHARLES FREDERICK",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 38 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376605063,"GADSDEN, JEFFREY, CHARLES FREDERICK",2400 A NORTH PAVILION   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376605063,"GADSDEN, JEFFREY, CHARLES FREDERICK",2400 A NORTH PAVILION   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376607614,"RAMIREZ, CLAUDIA",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376607614,"RAMIREZ, CLAUDIA",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558426007,EASTERN PSYCHIATRIC AND BEHAVIORAL,EASTERN PSYCHIATRIC & BEHAVIORAL SPECIAL,1704 E ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376608893,"ROBINSON, DONNA, LEE",1704 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1346387883,COUNTY OF MOORE,MOORE COUNTY HEALTH DEPARTMENT,705 PINEHURST AVE   CARTHAGE NC,063,Moore,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376610022,"BARRETT, DEBORAH, SHAMBERGER",705 PINEHURST AVE   CARTHAGE NC,063,Moore,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1376610139,"HORTON, TEAGUE, LON",403 FAIRVIEW ST   CLINTON NC,082,Sampson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 110 , 213 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1376610139,"HORTON, TEAGUE, LON",403 FAIRVIEW ST   CLINTON NC,082,Sampson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376611327,"SCHAAD, SHELLY, DOUB",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376613109,"ONKEN, JANE, ELIZABETH",10207 CERNY ST STE 300 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376613109,"ONKEN, JANE, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376613109,"ONKEN, JANE, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376613109,"ONKEN, JANE, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376613109,"ONKEN, JANE, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1376614313,"HAGERMAN, NANCY, MARIE SOKAL",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376614438,"KIM, EDWARD, HAN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376614438,"KIM, EDWARD, HAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 24 , 28 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376614438,"KIM, EDWARD, HAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376614438,"KIM, EDWARD, HAN",11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,300 HEALTH PARK DR STE 110 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1376614438,"KIM, EDWARD, HAN",300 HEALTH PARK DR STE 110 GARNER NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 25 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376614693,"VAUGHN, BRADLEY, VANCE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376614693,"VAUGHN, BRADLEY, VANCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 51 , 54 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,194 FINLEY GOLF COURSE RD STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376614693,"VAUGHN, BRADLEY, VANCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1376614693,"VAUGHN, BRADLEY, VANCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376616185,"DOOLEY, MARY, ANNE",507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376616185,"DOOLEY, MARY, ANNE",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 17 , 22 , 24 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376616185,"DOOLEY, MARY, ANNE",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,2076 HWY 42 W STE 330 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376616185,"DOOLEY, MARY, ANNE",34 HEALTHPARK WAY STE 100C CLAYTON NC,051,Johnston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 71 , 92 , 113 ,$#,,
MEDICAID DIRECT,1376619783,"BLAKELEY, DEAN, DEWAYNE",DEAN D BLAKELEY MD PA,323 HOSPITAL RD   ZEBULON NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1376619783,"BLAKELEY, DEAN, DEWAYNE",323 HOSPITAL RD   ZEBULON NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982915369,DEAN D BLAKELEY MD PA,EASTERN WAKE INTERNAL MEDICINE,323 HOSPITAL RD   ZEBULON NC,092,Wake,193400000X,Group,Single Specialty,,1376619783,"BLAKELEY, DEAN, DEWAYNE",323 HOSPITAL RD   ZEBULON NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 225 , 241 ,$#,,
MEDICAID DIRECT,1376621714,"BROWN, KEISHA, RENEE",SOMETHING TO SMILE ABOUT,6213 ROCK QUARRY RD STE 110 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1376621714,"BROWN, KEISHA, RENEE",6213 ROCK QUARRY RD STE 110 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 257 , 494 ," 1,685 "," $64,650.33 ",,
MEDICAID DIRECT,1376622472,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,2311 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376622472,LINCARE INC,2311 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1376622472,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,2311 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376622472,LINCARE INC,2311 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 224 ," 1,508 "," 2,713 "," $43,392.18 ",,
MEDICAID DIRECT,1376622472,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,2311 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1376622472,LINCARE INC,2311 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#, 12 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376622647,"CLEMENTS, DEBRA, SUE",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376622647,"CLEMENTS, DEBRA, SUE",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376622670,"COOK, ELISABETH, STANGER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 56 , 89 ,$#,,
MEDICAID DIRECT,1619443827,MH MISSION HOSPITAL MCDOWELL LLLP,,387 US 70 W   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1376623892,"PRINZHORN, JOANNE, NAZELROD",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 74 , 74 ," $19,017.52 ",,
MEDICAID DIRECT,1619443827,MH MISSION HOSPITAL MCDOWELL LLLP,,387 US 70 W   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1376623892,"PRINZHORN, JOANNE, NAZELROD",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 25 , 65 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376623892,"PRINZHORN, JOANNE, NAZELROD",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 20 , 47 ,$#,,
MEDICAID DIRECT,1619443827,MH MISSION HOSPITAL MCDOWELL LLLP,,387 US 70 W   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1376623892,"PRINZHORN, JOANNE, NAZELROD",387 US 70 W   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619443827,MH MISSION HOSPITAL MCDOWELL LLLP,,387 US 70 W   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1376623892,"PRINZHORN, JOANNE, NAZELROD",387 US 70 W   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 47 ,$#,,
MEDICAID DIRECT,1376624171,FIRST CHOICE AMBULANCE INC,,270 N RON MCNAIR BLVD   LAKE CITY SC,102,Out of State > 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,1376624171,FIRST CHOICE AMBULANCE INC,270 N RON MCNAIR BLVD   LAKE CITY SC,102,Out of State > 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#, 20 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1376624304,"DURBIN, NICOLE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376624304,"DURBIN, NICOLE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,500 GATEWAY DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376625145,"JACOBSON, LOUIS, ROBERT",500 GATEWAY DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 59 , 89 , 184 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1005 BIG OAK CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1376625145,"JACOBSON, LOUIS, ROBERT",1005 BIG OAK CT   KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376626515,"BORDLEY, WILLIAM, CLAYTON",MASON FARM RD   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 72 , 79 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376626515,"BORDLEY, WILLIAM, CLAYTON",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376627430,"HELMS, TANYA, ANN",2400 PRATT ST STE 110 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376627430,"HELMS, TANYA, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376627786,"HEWER, IAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376627869,"HEGLAND, DONALD, DALE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376627869,"HEGLAND, DONALD, DALE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 16 , 21 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376627869,"HEGLAND, DONALD, DALE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1376627869,"HEGLAND, DONALD, DALE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1376628370,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,230 SLOAN RD   FRANKLIN NC,056,Macon,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1376628370,LINCARE INC,230 SLOAN RD   FRANKLIN NC,056,Macon,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 18 , 27 ,$#,,
MEDICAID DIRECT,1376628370,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,230 SLOAN RD   FRANKLIN NC,056,Macon,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1376628370,LINCARE INC,230 SLOAN RD   FRANKLIN NC,056,Macon,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 117 , 511 , 953 ," $20,530.68 ",,
MEDICAID DIRECT,1376628578,GIBSON CARE CORPORATION,HOME INSTEAD SENIOR CARE,117 N CENTER ST   STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1376628578,GIBSON CARE CORPORATION,117 N CENTER ST   STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,#," 1,185 "," 1,185 "," $148,563.74 ",,
MEDICAID DIRECT,1376628735,CREEKSIDE MANOR OF FORSYTH LLC,Creekside Manor of Forsyth LLC,6206 REIDSVILLE RD   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376628735,CREEKSIDE MANOR OF FORSYTH LLC,6206 REIDSVILLE RD   KERNERSVILLE NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 37 ," 7,420 "," 7,420 "," $473,998.80 ",,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376628974,"SCHUENEMAN, AARON, JOEL",308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 42 , 75 , 78 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376629113,"VISSER, SCOTT, WILLIAM",4141 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 28 , 49 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1376629113,"VISSER, SCOTT, WILLIAM",4141 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376630384,"THOMAS, VICKIE, LYNN",702 N MAIN ST   ROXBORO NC,073,Person,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376630988,"GEORGE, NEOMA, SMITH",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760423503,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS GASTROENTEROLOGY,853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376631739,"TABER, ANDREW, DEAN",853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1346392248,EARL R CROUCH JR MD FACS PC,VIRGINIA PEDIATRIC EYE CENTER,4665 SOUTH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376632075,"CROUCH, EARL, RUSSELL",4665 SOUTH BLVD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1376632745,"RANSOM, AMY, DURHAM",9858 WR LATHAN DR   CLARKTON NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1376632745,"RANSOM, AMY, DURHAM",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 169 , 227 ,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,604 N MADISON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1376632745,"RANSOM, AMY, DURHAM",604 N MADISON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376633537,"HARRIGAN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 34 , 35 ,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376636548,"PHILLIPS, J, DUNCAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 32 , 50 ," $12,434.74 ",,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376636548,"PHILLIPS, J, DUNCAN",1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376636548,"PHILLIPS, J, DUNCAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1376636548,"PHILLIPS, J, DUNCAN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376636548,"PHILLIPS, J, DUNCAN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376636548,"PHILLIPS, J, DUNCAN",104 MEDSPRING DR   CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376637918,"COYLE RONCO, BONNIE, SUE",3205 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 149 , 184 , 470 ," $20,778.74 ",,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376638056,"MOTLEY, GREGORY, STEPHEN",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376638312,"BROWN, SHERBY",270 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 625 ," 1,031 "," 1,243 "," $194,112.18 ",,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 465 ," 1,321 "," 1,321 "," $132,348.54 ",,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 725 ," 1,754 "," 2,727 "," $426,212.91 ",,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 12 , 26 , 44 ,$#,,
MEDICAID DIRECT,1033989637,GODEL AND ASSOCIATES II PLLC,KANNAPOLIS FAMILY DENTAL CARE,2320 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1376641233,"CASE, JACK, CLIFFORD",2320 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 381 , 900 ," 1,385 "," $222,581.07 ",,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 252 , 769 , 769 ," $81,602.61 ",,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1376641233,"CASE, JACK, CLIFFORD",~,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1376641233,"CASE, JACK, CLIFFORD",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,,,$#,,
MEDICAID DIRECT,1730646241,HAMMOCK DMD & LOTAKIS DDS IX PLLC,~,2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 67 , 67 ,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1811412562,SNOW & SNOW DDS PLLC,~,5306 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376641233,"CASE, JACK, CLIFFORD",2258 W ROOSEVELT BLVD STE A MONROE NC,090,Union,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 97 , 176 , 200 ," $54,677.68 ",,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376641233,"CASE, JACK, CLIFFORD",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376643452,"PASSANNANTE, MARY, LOUISE",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1376643452,"PASSANNANTE, MARY, LOUISE",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1376643452,"PASSANNANTE, MARY, LOUISE",2000 PERIMETER PARK DR STE 200 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376643809,"COFFIN, ABIGAIL, STARBUCK",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376643809,"COFFIN, ABIGAIL, STARBUCK",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 22 , 38 , 50 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376643809,"COFFIN, ABIGAIL, STARBUCK",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376643809,"COFFIN, ABIGAIL, STARBUCK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376644757,"KUBIT, VICTOR, FRANCIS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376644757,"KUBIT, VICTOR, FRANCIS",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376644757,"KUBIT, VICTOR, FRANCIS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 33 , 39 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376644757,"KUBIT, VICTOR, FRANCIS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1376644757,"KUBIT, VICTOR, FRANCIS",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376644757,"KUBIT, VICTOR, FRANCIS",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1376644757,"KUBIT, VICTOR, FRANCIS",800 TILGHMAN DR   DUNN NC,043,Harnett,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 62 , 65 , 70 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376646166,"CARR, TIMOTHY, JOHN",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376646166,"CARR, TIMOTHY, JOHN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376646166,"CARR, TIMOTHY, JOHN",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255165619,COASTAL CARDIOVASCULAR ASSOCIATESPA,~,1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376647081,"WESTENDORFF, REBECCA, JONES",1717 SHIPYARD BLVD STE 220 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376650010,"KOYA, SRINIVAS",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 103 , 104 ,$#,,
MEDICAID DIRECT,1376650903,"ATKINSON, JOHN, ERIC",~,608 JACKSON PARK RD   KANNAPOLIS NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,1376650903,"ATKINSON, JOHN, ERIC",608 JACKSON PARK RD   KANNAPOLIS NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,, 673 , 677 ," 1,311 "," $19,472.36 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376652412,"GRIFFITH, JAMES, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 84 , 97 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376652412,"GRIFFITH, JAMES, ROBERT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376657726,"LIU, LYNN, CECILIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376657726,"LIU, LYNN, CECILIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376657726,"LIU, LYNN, CECILIA",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 49 , 69 , 97 ," $10,298.85 ",,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1376657726,"LIU, LYNN, CECILIA",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376658575,"LINGO, STEPHEN, TODD",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376658575,"LINGO, STEPHEN, TODD",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 28 , 43 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376658575,"LINGO, STEPHEN, TODD",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376661553,JOHNSTON COUNTY SCHOOLS,JOHNSTON COUNTY SCHOOLS,2320 US HWY 70 BUSINESS E   SMITHFIELD NC,051,Johnston,251300000X,Agencies,Local Education Agency (LEA),,1376661553,JOHNSTON COUNTY SCHOOLS,2320 US HWY 70 BUSINESS E   SMITHFIELD NC,051,Johnston,251300000X,Agencies,Local Education Agency (LEA),," 1,958 "," 43,191 "," 44,329 "," $2,003,018.27 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1376662205,"GUTOVITZ, SCOTT, BARRY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1376662205,"GUTOVITZ, SCOTT, BARRY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376662205,"GUTOVITZ, SCOTT, BARRY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376662205,"GUTOVITZ, SCOTT, BARRY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376662205,"GUTOVITZ, SCOTT, BARRY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 62 , 80 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 20 , 24 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376663344,"NICOLA, LAUREN, PARKS",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790736379,ORTHOTICS AND PROSTHETICS EAST INC,ORTHOTICS AND PROSTHETICS EAST INC,1025 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376663534,"DESSOFFY, TRAVIS, LANDON",1025 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1790736379,ORTHOTICS AND PROSTHETICS EAST INC,ORTHOTICS AND PROSTHETICS EAST INC,1025 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376663534,"DESSOFFY, TRAVIS, LANDON",1025 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376664524,"CHAMNIN, WILLIAM, RATAPHON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376664524,"CHAMNIN, WILLIAM, RATAPHON",1912 TRADD CT   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1376667519,"KARP, TRACEY, ANN",1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1376669101,BECKYS REST HOME,Beckys Rest Home Two,316 LOWER BRUSH CREEK RD   FLETCHER NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376669101,BECKYS REST HOME,316 LOWER BRUSH CREEK RD   FLETCHER NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,711 "," 1,748 "," $111,486.80 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376672832,"COPLAND, SPENCER, THOMAS",940 GOLF HOUSE CT E   WHITSETT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 21 , 49 ,$#,,
MEDICAID DIRECT,1376679001,"TRIDICO, TRINA, INSOOK",~,24 2ND AVE NE   HICKORY NC,018,Catawba,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,1376679001,"TRIDICO, TRINA, INSOOK",24 2ND AVE NE   HICKORY NC,018,Catawba,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376679001,"TRIDICO, TRINA, INSOOK",24 2ND AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 215 , 437 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,275 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376679571,"EDWARDS, BRIAN, EDWIN",275 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376679571,"EDWARDS, BRIAN, EDWIN",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 35 , 90 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376681593,"HASSELL, CHARLENA, DONNA",2609 OLD SALISBURY RD   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376682195,"ROSEBROCK, KELLEY, ANN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376682492,DEE & G ENRICHMENT CENTER,~,155 CARRIAGE LOOP   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376682492,DEE & G ENRICHMENT CENTER,155 CARRIAGE LOOP   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 253 , 253 ," $77,371.69 ",,
MEDICAID DIRECT,1376685313,UNIVERSAL MENTAL HEALTH SERVICES I,Universal Mental Health Services In,370 N LOUISIANA AVE STE F1 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1376685313,UNIVERSAL MENTAL HEALTH SERVICES I,370 N LOUISIANA AVE STE A2 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1376685313,UNIVERSAL MENTAL HEALTH SERVICES I,Universal Mental Health Services In,370 N LOUISIANA AVE STE F1 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1376685313,UNIVERSAL MENTAL HEALTH SERVICES I,370 N LOUISIANA AVE STE F1 ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,, 109 ," 1,669 "," 1,672 "," $99,868.80 ",,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1376688531,"GERACIMOS, RYAN, TYLER",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 146 , 180 , 269 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1376690172,"FLEMING, GREGORY, ALLAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1376690172,"FLEMING, GREGORY, ALLAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690172,"FLEMING, GREGORY, ALLAN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 28 , 40 , 82 ,$#,,
MEDICAID DIRECT,1942532239,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Specialty of Greensboro,,,Unknown,193200000X,Group,Multi-Specialty,,1376690172,"FLEMING, GREGORY, ALLAN",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690172,"FLEMING, GREGORY, ALLAN",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376690172,"FLEMING, GREGORY, ALLAN",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690172,"FLEMING, GREGORY, ALLAN",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 15 , 20 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",3643 N ROXBORO ST   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 86 , 130 , 227 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376690198,"CAMPBELL, MICHAEL, JAY",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376690248,"FILES, DANIEL, CLARK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 23 , 50 , 54 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376690362,"GROH, MARK, ALLEN",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 36 , 41 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376690362,"GROH, MARK, ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 18 , 27 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376692194,"BLUTE, MICHAEL, LAWRENCE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 27 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376692384,"STOUT, PENNY, LYNNETTE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376692384,"STOUT, PENNY, LYNNETTE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376692384,"STOUT, PENNY, LYNNETTE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376692640,"MISHKIN, JOSEPH, DAVID",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376692640,"MISHKIN, JOSEPH, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376692640,"MISHKIN, JOSEPH, DAVID",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1376692640,"MISHKIN, JOSEPH, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,,,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376692640,"MISHKIN, JOSEPH, DAVID",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1376693317,"GUINEY, BENJAMIN, FRANKLIN",68 HOSPITAL RD   SYLVA NC,050,Jackson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376693317,"GUINEY, BENJAMIN, FRANKLIN",68 HOSPITAL RD   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669808143,SYLVA EMERGENCY GROUP LLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376693317,"GUINEY, BENJAMIN, FRANKLIN",68 HOSPITAL RD   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 98 , 103 , 115 ,$#,,
MEDICAID DIRECT,1043752363,SWAIN INTEGRATED SERVICES PC,,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1376693317,"GUINEY, BENJAMIN, FRANKLIN",45 PLATEAU ST   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 72 , 87 , 89 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,45 PLATEAU ST   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1376693317,"GUINEY, BENJAMIN, FRANKLIN",45 PLATEAU ST   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,45 HENDERSONVILLE HWY STE B PISGAH FOREST NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1376694398,"TAYLOR, MARIAN, HAZELTON",45 HENDERSONVILLE HWY STE B PISGAH FOREST NC,088,Transylvania,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 16 , 30 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1376694398,"TAYLOR, MARIAN, HAZELTON",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 24 , 40 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1376694398,"TAYLOR, MARIAN, HAZELTON",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 40 , 56 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376694398,"TAYLOR, MARIAN, HAZELTON",2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376694398,"TAYLOR, MARIAN, HAZELTON",2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376694877,"POWELL-FAULKS, YURI, JANEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376700856,"SCHMITT, TERRA, LYNN",10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376702522,"MICHAEL, TESFALDET, TECLE",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376702522,"MICHAEL, TESFALDET, TECLE",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376702522,"MICHAEL, TESFALDET, TECLE",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376702522,"MICHAEL, TESFALDET, TECLE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 53 , 75 , 116 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,,,Unknown,193200000X,Group,Multi-Specialty,,1376702522,"MICHAEL, TESFALDET, TECLE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376702522,"MICHAEL, TESFALDET, TECLE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376702522,"MICHAEL, TESFALDET, TECLE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1376915256,MORRIS AND CARMICHAEL 1 DDS PLLC,SHALLOTTE FAMILY DENTISTRY,4704 MAIN ST   SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1376702563,"MORRIS, CAMMIE, THOMPSON",4704 MAIN ST   SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 355 , 675 ," 1,998 "," $79,596.62 ",,
MEDICAID DIRECT,1093187973,MORRIS AND CARMICHAEL 2 DDS PLLC,~,4742 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1376702563,"MORRIS, CAMMIE, THOMPSON",4704 MAIN ST   SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 95 , 196 , 561 ," $24,686.76 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376704213,"HE, JUN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1376704288,"BANDARUPALLI, HIMABINDU",Himabindu Bandarupalli MD,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1376704288,"BANDARUPALLI, HIMABINDU",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376704312,"SHARPE, ROSE, MAUREEN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376704767,"ALLEY, WILLIAM, DANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376704767,"ALLEY, WILLIAM, DANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 99 , 113 , 120 ,$#,,
MEDICAID DIRECT,1801011242,NC DHHS CHILD AND FAMILY WELL-BEING,SANDHILLS CHILDRENS DEVELOPMENTAL,95 TROTTER HILLS CIR   PINEHURST NC,063,Moore,252Y00000X,Agencies,Early Intervention Provider Agency,,1376704882,"LONG, VIRGINIA, BREWER",95 TROTTER HILLS CIR   PINEHURST NC,063,Moore,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 64 , 64 , 116 ," $19,813.65 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376705863,"COX, KRISTY, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1376706390,"WROBLEWSKA SHAH, JOANNA, MONIKA",9735 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 47 , 66 , 78 ,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1376706390,"WROBLEWSKA SHAH, JOANNA, MONIKA",9735 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1548625429,WESTMORELAND & OKANE PLLC,WNC DENTAL,3179 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376706788,"WESTMORELAND, ASHLEY, LEANN",3179 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 197 , 279 ," 1,083 "," $42,686.96 ",,
MEDICAID DIRECT,1356469357,COUNTY OF MADISON OFFICE OF AUDITOR,MADISON COUNTY HEALTH DEPT,493 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376707752,"LOVE, EMILY, ANNE RUDA",493 MEDICAL PARK DR   MARSHALL NC,057,Madison,1223D0001X,Dental Providers,Dentist,Dental Public Health, 470 ," 1,019 "," 2,522 "," $118,279.57 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376710269,"KIEFER, TODD, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 25 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1376710269,"KIEFER, TODD, LEE",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376710269,"KIEFER, TODD, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 24 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376710269,"KIEFER, TODD, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376711713,"KALISETTI, RADHIKA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376711713,"KALISETTI, RADHIKA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376711713,"KALISETTI, RADHIKA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376711713,"KALISETTI, RADHIKA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 146 , 541 ,$#,,
MEDICAID DIRECT,1376712067,LEGACY HUMAN SERVICES INC,,663 MOULTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376712067,LEGACY HUMAN SERVICES INC,663 MOULTON RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 185 , 185 ," $11,949.80 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376714634,"PORCIUNCULA, JON, CARLO",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376715128,"MOSER, LORAINE",214 18TH ST SE   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376715565,"BENNETT, DANIEL, KITTELLE",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 53 , 85 , 239 ," $34,844.02 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376715565,"BENNETT, DANIEL, KITTELLE",3113 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 36 , 85 , 208 ," $17,199.90 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376715565,"BENNETT, DANIEL, KITTELLE",5900 SIX FORKS RD STE 105 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 50 , 91 , 215 ," $19,321.42 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376715565,"BENNETT, DANIEL, KITTELLE",2613 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 62 , 115 , 296 ," $28,417.02 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376715656,"CARANASOS, THOMAS, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 43 , 55 ,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376717355,"FINE, KATIE, SNEAD",3193 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 24 , 48 ,$#,,
MEDICAID DIRECT,1376718742,"KNECHTEL, DANIEL, PAUL",DAN KNECHTEL DDS PA,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1376718742,"KNECHTEL, DANIEL, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1376718742,"KNECHTEL, DANIEL, PAUL",DAN KNECHTEL DDS PA,218 ELKWOOD AVE STE 101 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1376718742,"KNECHTEL, DANIEL, PAUL",218 ELKWOOD AVE STE 101 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 2,161 "," 4,530 "," 18,920 "," $708,630.76 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376720946,"YEHYA, AMIN, A",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376720946,"YEHYA, AMIN, A",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376727354,"WILSON, JONATHAN, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 25 , 34 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376727354,"WILSON, JONATHAN, LEE",2341 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376731190,"JONES, WALTER, GEORGE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376731190,"JONES, WALTER, GEORGE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376731729,"UZBELGER FELDMAN, DANIEL",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 226 , 301 , 781 ," $48,062.39 ",,
MEDICAID DIRECT,1578854147,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST UNIT 2 DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1376732560,"WAITE, KELLEY, CAMPBELL",2810 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578854147,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST UNIT 2 DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1376732560,"WAITE, KELLEY, CAMPBELL",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851355424,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1376732560,"WAITE, KELLEY, CAMPBELL",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376732727,"EZIRIM, CHINWE, UZOAMAKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376732727,"EZIRIM, CHINWE, UZOAMAKA",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376732727,"EZIRIM, CHINWE, UZOAMAKA",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",1505 SW CARY PKWY STE 210 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376733873,"KIM, JASON, KWANGYON",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 70 , 104 , 158 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",1505 SW CARY PKWY STE 210 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",1505 SW CARY PKWY STE 210 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 63 , 92 , 128 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376733873,"KIM, JASON, KWANGYON",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376733873,"KIM, JASON, KWANGYON",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376734970,"RAMIREZ PEREZ, BEATRIZ, EUGENIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 29 , 86 , 86 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376734970,"RAMIREZ PEREZ, BEATRIZ, EUGENIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376734970,"RAMIREZ PEREZ, BEATRIZ, EUGENIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 90 , 98 , 131 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 112 , 114 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 123 , 123 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 30 , 32 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 228 , 232 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 103 , 107 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1376735423,"NORRIS, LESLIE, WATKINS",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376736546,"SINGH, TARAN, KAUR",2019 N CHURCH ST   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1376736546,"SINGH, TARAN, KAUR",2019 N CHURCH ST   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1376736546,"SINGH, TARAN, KAUR",829 S MAIN ST   GRAHAM NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356582506,CENTRAL CAROLINA KIDNEY ASSOCIATES,CENTRAL CAROLINA KIDNEY ASSOCIATES PA,2903 PROFESSIONAL PARK DR STE D BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376736546,"SINGH, TARAN, KAUR",829 S MAIN ST   GRAHAM NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801843925,ARTHRITIS AND OSTEOPOROSIS CONSULTA,ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CARO,1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376736553,"TABRIZI, ELNAZ, NASSEHZADEH",1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 49 , 104 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1376740258,"FAUST, CECILIA, PATRICIA",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376741967,"LUGAR, PATRICIA, LYNNE",2100 ERWIN RD   DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376741967,"LUGAR, PATRICIA, LYNNE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376741967,"LUGAR, PATRICIA, LYNNE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 17 , 26 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376741967,"LUGAR, PATRICIA, LYNNE",2100 ERWIN RD   DURHAM NC,032,Durham,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376742015,"OJIE, JUDE, OGOCHUKWU",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1376742015,"OJIE, JUDE, OGOCHUKWU",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376742015,"OJIE, JUDE, OGOCHUKWU",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 217 , 217 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376742577,"CASTILLER, FRANCIS, ADAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 38 , 45 , 51 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376744805,"KISER, MICHELLE, MCCRAIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376744805,"KISER, MICHELLE, MCCRAIN",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376744813,"MCLEAN, RACHEL, LEE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376747105,"SCHROEDER, KRISTIN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 57 , 58 ,$#,,
MEDICAID DIRECT,1053603001,MOSES CONE AFFILIATED PHYSICIANS IN,REIDSVILLE FAMILY MEDICINE,520 MAPLE AVE STE B REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1376748004,"HOSKINS, CAROLYN, CHANEY",520 MAPLE AVE STE B REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 42 , 63 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376748244,"HOUSTON, CAROLINE, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 33 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376748244,"HOUSTON, CAROLINE, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 86 , 104 , 139 ,$#,,
MEDICAID DIRECT,1376749200,MORGANTON LTC SOUTHVIEW FACILITY,~,151 SOUTHVIEW ST   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376749200,MORGANTON LTC SOUTHVIEW FACILITY,151 SOUTHVIEW ST   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 467 , 467 ," $29,489.96 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376751131,"PHELPS, JAMES, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 123 , 221 , 373 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,4515 PREMIER DR STE 307B HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376751131,"PHELPS, JAMES, RICHARD",4515 PREMIER DR STE 307 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376751131,"PHELPS, JAMES, RICHARD",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 27 , 29 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",600 HOSPITAL DR STE 10 CLYDE NC,044,Haywood,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 24 , 236 , 453 ," $15,969.89 ",,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,63 S MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",63 S MEDICAL CT   MARION NC,059,McDowell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 49 , 91 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",600 HOSPITAL DR STE 10 CLYDE NC,044,Haywood,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,,,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",63 S MEDICAL CT   MARION NC,059,McDowell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 43 , 80 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,600 HOSPITAL DR STE 10 CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",600 HOSPITAL DR STE 10 CLYDE NC,044,Haywood,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",20 MEDICAL PARK DR STE A ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 24 , 44 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",1 HOSPITAL DR STE 102 ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 18 , 21 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",179 N BUNCOMBE SCHOOL RD   WEAVERVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 24 , 61 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376751354,"KELLEY, JOSEPH",171 DANIEL RD   FOREST CITY NC,081,Rutherford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1972656262,ASHEVILLE ENDOCRINOLOGY CONSULTANTS,ASHEVILLE ENDOCRINOLOGY CONSULTANTS PA,750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376751909,"MITCHELL, THOMAS, CREIGHTON",750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 144 , 312 ," 1,227 "," $11,986.94 ",,
MEDICAID DIRECT,1003244286,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN MEDICAL SPECIALISTS,,,Unknown,193200000X,Group,Multi-Specialty,,1376753046,"LANGLEY, DAWN, TRACY",725 OAKRIDGE BLVD STE A3 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003244286,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN MEDICAL SPECIALISTS,,,Unknown,193200000X,Group,Multi-Specialty,,1376753046,"LANGLEY, DAWN, TRACY",923 W 3RD ST   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1952819575,SAMPSON REGIONAL EMERGENCY PROFESSI,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",607 BEAMAN ST   CLINTON NC,082,Sampson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 63 , 77 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 39 , 54 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1376754648,"ONEAL, BRIAN, VAUGHAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 43 , 46 ,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1376759811,"PIENKOS, BRIAN, LEE",139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 143 , 318 , 656 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376762377,"OFFNER, MARIA, CLAUDIA",4100 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376762377,"OFFNER, MARIA, CLAUDIA",4100 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,4100 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376762377,"OFFNER, MARIA, CLAUDIA",4100 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1376762377,"OFFNER, MARIA, CLAUDIA",4100 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376762377,"OFFNER, MARIA, CLAUDIA",4100 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376762377,"OFFNER, MARIA, CLAUDIA",4100 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376762377,"OFFNER, MARIA, CLAUDIA",4100 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144583055,PIEDMONT HEALTH SERVICES INC,Sylvan Community Health Center,7718 SYLVAN RD   SNOW CAMP NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376762542,"WHITTEN, ROBIN, ANDREA",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376763276,"CANNON, TRINITIA, YEVETTE",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376763276,"CANNON, TRINITIA, YEVETTE",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376763276,"CANNON, TRINITIA, YEVETTE",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376763276,"CANNON, TRINITIA, YEVETTE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 16 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376763276,"CANNON, TRINITIA, YEVETTE",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376765784,"MEUSE, MEGAN, CLARE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376765966,"EIDEN, KRISTINA, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376765966,"EIDEN, KRISTINA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376765966,"EIDEN, KRISTINA, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376768887,"PAGLIEI, JENNIFER, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 145 , 150 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376768887,"PAGLIEI, JENNIFER, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3031 NEW BERN AVE STE 303 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",790 SE CARY PKWY STE 101 CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 17 , 29 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3645 TRUST DR   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3645 TRUST DR   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 51 , 51 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 35 , 36 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 73 , 79 , 142 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",790 SE CARY PKWY STE 101 CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3645 TRUST DR   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 87 , 87 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 61 , 61 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3031 NEW BERN AVE STE 303 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 13 , 33 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1376769893,"STERN, ADAM, BAKER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376770289,"SUTTLE, KATHERINE, WINSTEAD",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376770289,"SUTTLE, KATHERINE, WINSTEAD",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376770289,"SUTTLE, KATHERINE, WINSTEAD",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376770289,"SUTTLE, KATHERINE, WINSTEAD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376770289,"SUTTLE, KATHERINE, WINSTEAD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376770404,"MADRID, SARAH, MICHAL",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376771360,"REDDY, LEELA, MADHURI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 40 , 40 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376771360,"REDDY, LEELA, MADHURI",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376771360,"REDDY, LEELA, MADHURI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 22 , 47 , 47 ,$#,,
MEDICAID DIRECT,1538491642,A BRIGHTER FUTURE MEDICAL,A BRIGHTER FUTURE HEALTHCARE SERVICES,1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376771501,"GANT, APRIL",1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 53 , 53 ,$#,,
MEDICAID DIRECT,1376771501,"GANT, APRIL",~,1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,1376771501,"GANT, APRIL",1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1538491642,A BRIGHTER FUTURE MEDICAL,A BRIGHTER FUTURE HEALTHCARE SERVICES,1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376771501,"GANT, APRIL",1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1376771501,"GANT, APRIL",~,1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1376771501,"GANT, APRIL",1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 239 , 239 ," $14,791.93 ",,
MEDICAID DIRECT,1376771527,THE SHARPE ROAD ADULT HOME CARE,The Sharpe Road Adult Home Care,826 SHARPE RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376771527,THE SHARPE ROAD ADULT HOME CARE,826 SHARPE RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376775163,"PINTO, ALICIA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376778597,"VINCENT, BENJAMIN, GARRETT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1124451182,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROPSYCHOLOGY,1814 WESTCHESTER DR STE 402 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376779116,"MCDERMOTT, ADAM, THOMAS",1814 WESTCHESTER DR STE 402 HIGH POINT NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 17 , 17 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376780619,"ADAMS, DONNA, BOTZ",2400 PRATT ST NORTH PAVILION SUITE 1100 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1376781609,"BROWN, JESSICA, LILLEY",101 CLINIC DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376781609,"BROWN, JESSICA, LILLEY",101 CLINIC DR   TARBORO NC,033,Edgecombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376781609,"BROWN, JESSICA, LILLEY",2210 HEMBY LN STE 101 GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 138 , 171 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376784371,"RICHARDSON, JENNIFER, MARZOLF",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 166 , 350 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376785295,"CAPERNA, APRIL, SUNSHINE",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376786541,"ROBINSON, LAUREN, BRIGGS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376786541,"ROBINSON, LAUREN, BRIGGS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care", 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376786541,"ROBINSON, LAUREN, BRIGGS",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376787606,"BASRA, APRAM, APAR",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376787606,"BASRA, APRAM, APAR",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 31 , 42 ,$#,,
MEDICAID DIRECT,1376789248,PIONEER AMBULATORY SURGERY CENTER,PIONEER AMBULATORY SURGERY CENTER LLC,2905 CROUSE LN   BURLINGTON NC,001,Alamance,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1376789248,PIONEER AMBULATORY SURGERY CENTER,2905 CROUSE LN   BURLINGTON NC,001,Alamance,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#, 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2341 LEWISVILLE CLEMMONS RD FL 2   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376789792,"WREN, AMY, HOWELL",2341 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376789792,"WREN, AMY, HOWELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 38 , 38 ,$#,,
MEDICAID DIRECT,1376790899,"BOSTIC, LISA, MARILYN",,50 GROVE PT   PITTSBORO NC,019,Chatham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1376790899,"BOSTIC, LISA, MARILYN",50 GROVE PT   PITTSBORO NC,019,Chatham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376791202,"LOTZ, RUTH, JOHANNA",5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376791202,"LOTZ, RUTH, JOHANNA",301 KILDAIRE RD   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 19 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376791673,"GOODPASTURE, TINA, PARKS",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 91 , 186 , 228 ," $18,517.48 ",,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376791673,"GOODPASTURE, TINA, PARKS",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376791673,"GOODPASTURE, TINA, PARKS",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376792002,"PARODI, FEDERICO, EZEQUIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 59 , 63 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1376797472,"JERNIGAN, NICHOLAS, ALLEN",20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1063896132,KIDZCARE PEDIATRICS PC,,20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1376797472,"JERNIGAN, NICHOLAS, ALLEN",20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 76 , 151 , 344 ," $17,776.32 ",,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1376797472,"JERNIGAN, NICHOLAS, ALLEN",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1760865760,KIDZCARE PEDIATRICS PC,,1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376797472,"JERNIGAN, NICHOLAS, ALLEN",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376797647,A GREAT CHOICE FOR HOME CARE INC,~,1671 WELLONS DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1376797647,A GREAT CHOICE FOR HOME CARE INC,1671 WELLONS DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 4,612 "," 4,612 "," $287,786.99 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376800698,"STRICKLAND, KIMBERLY, SARA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376800698,"STRICKLAND, KIMBERLY, SARA",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 28 , 59 , 102 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376800698,"STRICKLAND, KIMBERLY, SARA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376800698,"STRICKLAND, KIMBERLY, SARA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376800698,"STRICKLAND, KIMBERLY, SARA",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376800698,"STRICKLAND, KIMBERLY, SARA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1376802231,"SUGGS, STEVEN, WAYNE",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376803692,"LEVY, AARON, ALPER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 31 , 32 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804047,"BEASLEY, LAUREN, MANSFIELD",781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376804047,"BEASLEY, LAUREN, MANSFIELD",4414 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,601 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804443,"GEORGOFF, PATRICK, EDWARD",601 ATTAIN ST   FUQUAY VARINA NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376804443,"GEORGOFF, PATRICK, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 48 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804443,"GEORGOFF, PATRICK, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376804443,"GEORGOFF, PATRICK, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 50 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376804443,"GEORGOFF, PATRICK, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 73 , 95 , 96 ," $10,978.22 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804443,"GEORGOFF, PATRICK, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804443,"GEORGOFF, PATRICK, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 47 , 52 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376804674,"CONTERATO, ANNA, JACLYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376805366,"STEPHENSON, BRIAN, WILLIAM",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 58 , 96 , 108 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376805366,"STEPHENSON, BRIAN, WILLIAM",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376805366,"STEPHENSON, BRIAN, WILLIAM",781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376805374,"SAINE, LAURA, ELIZABETH",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 96 , 106 ,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1376806976,"RUSSELL, LAKEYA, CHARRON",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 68 , 72 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376807131,"ALKHAWAM, LORA",3643 N ROXBORO ST DURHAM REGIONAL HOSPITAL DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 98 , 101 , 103 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376807214,"STEIN, RANDALL, NOAH",185 JOE KNOX AVE   MOORESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376807214,"STEIN, RANDALL, NOAH",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376807214,"STEIN, RANDALL, NOAH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376807214,"STEIN, RANDALL, NOAH",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 61 , 93 , 166 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376807214,"STEIN, RANDALL, NOAH",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376807214,"STEIN, RANDALL, NOAH",15419 HODGES CIR   HUNTERSVILLE NC,060,Mecklenburg,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376807669,"MILLER, EMILY, NORRIS",104 MEDSPRING DR   CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376807669,"MILLER, EMILY, NORRIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376807669,"MILLER, EMILY, NORRIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376807669,"MILLER, EMILY, NORRIS",2820 KIDD RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1376808329,"EHSAN, HAMID",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 27 ,$#,,
MEDICAID DIRECT,1629344940,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1376808329,"EHSAN, HAMID",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 58 , 86 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376809111,"MARIETTA, AMY, ELEANOR",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 58 , 58 ," $16,685.96 ",,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1376809608,"NEWMAN, MORKOR",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,2202 CAROLINA PL STE 200 KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1376809608,"NEWMAN, MORKOR",2202 CAROLINA PL STE 200 KINGS MOUNTAIN NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 83 , 114 , 294 ," $12,814.98 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376812180,"LEHMANN, AUSTIN, BENEDICT",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 136 , 154 , 254 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1376812479,"BELTZ, GABRIELLE, THERESA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1376812479,"BELTZ, GABRIELLE, THERESA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,115 KILDAIRE PARK DR STE 309 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813535,"WELDEN, ERIN, ELIZABETH",1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 38 , 79 ,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376813535,"WELDEN, ERIN, ELIZABETH",1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376813535,"WELDEN, ERIN, ELIZABETH",1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376813535,"WELDEN, ERIN, ELIZABETH",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 142 , 259 , 280 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813634,"BURNELL, JULIE, PAGE",121 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 79 , 103 , 190 ," $11,755.25 ",,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813634,"BURNELL, JULIE, PAGE",20 PARKER LN STE 2 PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 15 , 38 , 38 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813634,"BURNELL, JULIE, PAGE",1514 S HORNER BLVD   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 43 , 73 , 73 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813634,"BURNELL, JULIE, PAGE",1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 26 , 44 , 44 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813634,"BURNELL, JULIE, PAGE",1970C W ARLINGTON BLVD STE C GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 38 , 40 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813634,"BURNELL, JULIE, PAGE",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 54 , 138 , 138 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376813634,"BURNELL, JULIE, PAGE",600 FARRINGDOM ST STE AB LUMBERTON NC,078,Robeson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1376815365,SOZO FAMILY CARE HOME INC,~,2757 MEWBORN CHURCH RD   SNOW HILL NC,040,Greene,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376815365,SOZO FAMILY CARE HOME INC,2757 MEWBORN CHURCH RD   SNOW HILL NC,040,Greene,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 578 , 580 ," $112,952.58 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,140 CHARLOIS BLVD FL 2 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376816736,"ZHOU, RUIFENG",365 BROOKDALE DR   STATESVILLE NC,049,Iredell,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376816736,"ZHOU, RUIFENG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1639475593,SAFECHILD,SAFECHILD,2841 KIDD RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376819292,"WILLIAMS, HEATHER, NICOLE",2815 KIDD RD   RALEIGH NC,092,Wake,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics, 13 , 12 , 34 ,$#,,
MEDICAID DIRECT,1376819375,TERRY BELL,HOME CARE PROFESSIONALS,209B RAILROAD ST N   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1376819375,TERRY BELL,209B RAILROAD ST N   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 8,442 "," 8,442 "," $476,132.48 ",,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376821561,"BURKE, TAMMY, RENA",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1376821561,"BURKE, TAMMY, RENA",250 18TH ST SE # CL HICKORY NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1376830273,NORTH CAROLINA ORTHOTICS AND PROSTH,NORTH CAROLINA ORTHOTICS AND PROSTHETICS OF ROCKY,3721 SUNSET AVE   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376830273,NORTH CAROLINA ORTHOTICS AND PROSTH,3721 SUNSET AVE   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376830349,"MCCURRY, STEPHANIE, DAWN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#, 15 , 15 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376830349,"MCCURRY, STEPHANIE, DAWN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376831982,"VILLANUEVA, JOSEPH, BORROMEO",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 45 , 45 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376832709,"MC BETH, RYAN, KENT",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376832709,"MC BETH, RYAN, KENT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376832709,"MC BETH, RYAN, KENT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 35 , 48 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376832709,"MC BETH, RYAN, KENT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376832709,"MC BETH, RYAN, KENT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 32 , 35 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376832709,"MC BETH, RYAN, KENT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376832725,"MICHAEL, HEATHER, CHRISTINA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 36 , 199 , 203 ," $12,579.48 ",,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376832725,"MICHAEL, HEATHER, CHRISTINA",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 19 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376832824,"KELKAR, ANITA, AJIT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,,,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376833004,"OVERSTREET GALEANO, MAYRA, ALICIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 27 , 31 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376833004,"OVERSTREET GALEANO, MAYRA, ALICIA",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 200 , 296 , 356 ," $18,515.80 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376833004,"OVERSTREET GALEANO, MAYRA, ALICIA",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376833004,"OVERSTREET GALEANO, MAYRA, ALICIA",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1376833004,"OVERSTREET GALEANO, MAYRA, ALICIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 36 , 36 ," $13,572.00 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376833004,"OVERSTREET GALEANO, MAYRA, ALICIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376833293,"RAFF, EVAN, JEROME DONNELLY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376833723,"WALCZYSZYN, BARTOSZ, ADAM",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 25 , 63 , 65 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376833723,"WALCZYSZYN, BARTOSZ, ADAM",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376833723,"WALCZYSZYN, BARTOSZ, ADAM",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 16 , 43 , 45 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376834283,"PAINTER, THOMAS, JOHN",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376834317,"HARTZELL, MATTHEW, LEO",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376834416,"MYERS, WARD, JOSEPH",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376834416,"MYERS, WARD, JOSEPH",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1376834416,"MYERS, WARD, JOSEPH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1376834416,"MYERS, WARD, JOSEPH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376834416,"MYERS, WARD, JOSEPH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1376834416,"MYERS, WARD, JOSEPH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1376834416,"MYERS, WARD, JOSEPH",117 E KINGS HWY   EDEN NC,079,Rockingham,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376835033,"WILLIAMS, LANDON, TODD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376835033,"WILLIAMS, LANDON, TODD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376835033,"WILLIAMS, LANDON, TODD",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518642255,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA WOMENS HEALTH CENTER RHC,1140 CARTHAGE ST STE A SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1376835033,"WILLIAMS, LANDON, TODD",1140 CARTHAGE ST   SANFORD NC,053,Lee,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1376836254,"MITCHELL, WILLIAM, RYAN",1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 108 , 238 , 531 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1376836254,"MITCHELL, WILLIAM, RYAN",1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 63 , 153 ,$#,,
MEDICAID DIRECT,1639698533,RALEIGH SEDATION ASSOCIATES LLC,,2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376837567,"SMITH, SHANA, KORINNE",2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1376838011,"LEVY, JEFFREY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 61 , 60 , 60 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1376839118,"HILL, ANDREW, JUDSON",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 21 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1376839118,"HILL, ANDREW, JUDSON",2076 HIGHWAY 69 S   HAYESVILLE NC,022,Clay,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1376839118,"HILL, ANDREW, JUDSON",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1376839118,"HILL, ANDREW, JUDSON",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 37 , 47 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1376839118,"HILL, ANDREW, JUDSON",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376839266,"KAELKE MILLER, KRISTIN, ELIZA LEE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 83 ,$#,,
MEDICAID DIRECT,1770191421,AMY ANN KINLAW DMD PLLC,TAYLORSVILLE PEDIATRIC DENTISTRY,167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1376839266,"KAELKE MILLER, KRISTIN, ELIZA LEE",167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,1223G0001X,Dental Providers,Dentist,General Practice, 508 , 663 ," 2,807 "," $109,397.79 ",,
MEDICAID DIRECT,1114571981,DENNIS GARTH STODDARD DDS PLLC,EASTFIELD PEDIATRIC DENTISTRY & ORTHODONTICS,8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376839266,"KAELKE MILLER, KRISTIN, ELIZA LEE",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 84 ,$#,,
MEDICAID DIRECT,1629730130,STATESVILLE AMY KINLAW PLLC,IREDELL PEDIATRIC DENTISTRY,1316 DAVIE AVE STE C STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1376839266,"KAELKE MILLER, KRISTIN, ELIZA LEE",1209 DAVIE AVE   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 501 , 879 ," 3,668 "," $151,006.45 ",,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376839316,"WILSON, AYANA, MAIA",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 102 , 159 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1376839316,"WILSON, AYANA, MAIA",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1376839316,"WILSON, AYANA, MAIA",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1376841437,APPLE HOME HEALTH CARE AGENCY INCOR,APPLE HOME HEALTH CARE INC,3605 BASTION LN STE 108 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1376841437,APPLE HOME HEALTH CARE AGENCY INCOR,3605 BASTION LN STE 108 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,197 "," 1,264 "," $69,297.94 ",,
MEDICAID DIRECT,1376845396,COMPASSION HEALTH SERVICES INC,COMPASSION HEALTH SEVICES INC,4023 WAKE FOREST RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1376845396,COMPASSION HEALTH SERVICES INC,4023 WAKE FOREST RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,929 "," 1,929 "," $172,569.12 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376846535,"ZALEWSKI, MOLLY, HELEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376846535,"ZALEWSKI, MOLLY, HELEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1376847384,"MCGOWAN, SEAN, JOSEPH",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1376847384,"MCGOWAN, SEAN, JOSEPH",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376847384,"MCGOWAN, SEAN, JOSEPH",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1376847798,"TAYLOR, VANESSA, MARIE",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376849786,"DEWITT, TIFFANY, MOORE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376849950,"BARRETT, GARY, SETH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376849950,"BARRETT, GARY, SETH",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 47 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 33 , 42 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 38 , 41 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 61 , 69 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,144 FOREST HILL RD   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1376854281,"ONG, LEONARD, TSUNG-WEI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376854562,TDS HOME CARE SERVICES LLC,,5513 MONROE RD STE 206 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1376854562,TDS HOME CARE SERVICES LLC,5513 MONROE RD STE 206 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,588 "," 1,588 "," $116,386.88 ",,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1376855007,"LIWAN, HENNY",1140 CARTHAGE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376855007,"LIWAN, HENNY",115 PARKWAY OFFICE CT STE 104 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376855007,"LIWAN, HENNY",781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,10030 GREEN LEVEL CHURCH RD STE 808 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376855007,"LIWAN, HENNY",115 PARKWAY OFFICE CT STE 104 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376856799,"JONES, LAUREN, TURNER",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376856799,"JONES, LAUREN, TURNER",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376856799,"JONES, LAUREN, TURNER",2555 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376857151,"DOROODCHI, HAMIDREZA",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376857151,"DOROODCHI, HAMIDREZA",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376857540,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02233,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1376857540,NORTH CAROLINA CVS PHARMACY LLC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1376857540,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02233,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376857540,NORTH CAROLINA CVS PHARMACY LLC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1376858696,CROMARTIE SPRING VILLAGE REST HOME,CromartieSpring Village Rest Home,508 E WORTH ST   SAINT PAULS NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1376858696,CROMARTIE SPRING VILLAGE REST HOME,508 E WORTH ST   SAINT PAULS NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,650 "," 1,738 "," $110,987.72 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376858910,"KAPLAN, JASON, BAKER",600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821555020,SURGICAL CENTER FOR DENTAL PROFESSI,SCDP ANESTHESIA PROFESSIONALS,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376858910,"KAPLAN, JASON, BAKER",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376858910,"KAPLAN, JASON, BAKER",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376860593,"PATEL, NILESH, VINOD",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376860593,"PATEL, NILESH, VINOD",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376860593,"PATEL, NILESH, VINOD",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 42 , 42 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376860924,"LAMBETH, JENNA, WALTERS",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1585 FORNEY CREEK PKWY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1376860924,"LAMBETH, JENNA, WALTERS",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1376861203,"BERKOWITZ, JOSHUA, NORSTROM",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1376861203,"BERKOWITZ, JOSHUA, NORSTROM",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 13 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1376861203,"BERKOWITZ, JOSHUA, NORSTROM",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376861203,"BERKOWITZ, JOSHUA, NORSTROM",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376861732,"TAFRESHI SAHIBZADA, LEYLA, SADAT",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376861732,"TAFRESHI SAHIBZADA, LEYLA, SADAT",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863266,"IZZY, SAEF",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1376863456,"WHITAKER, JOHNATHAN, JACK",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 133 , 202 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1376863456,"WHITAKER, JOHNATHAN, JACK",1908 CAUDLE DR STE 301 MOUNT AIRY NC,086,Surry,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1740391283,AMERICAN NEUROMONITORING ASSOCIATES,,10275 LITTLE PATUXENT PKWY STE 300 COLUMBIA MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1376863720,"ROBLES, LILIANA",7 GALLETA CT   SPRING TX,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 28 , 46 , 58 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 16 , 22 , 28 ,$#,,
MEDICAID DIRECT,1053655647,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 24 , 30 , 30 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376863910,"KAMBUR, THOMAS, RYAN",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1376864033,"SPIVEY, DAVID, REID",ANCHOR DENTAL,3718 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1376864033,"SPIVEY, DAVID, REID",3718 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376864199,"RICKLEFS, LORI, ANN",~,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1376864199,"RICKLEFS, LORI, ANN",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1376864199,"RICKLEFS, LORI, ANN",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 113 , 197 , 250 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376864488,"MORRIS, JOHN, CHRISTOPHER",1730 KERNERSVILLE MEDICAL PKWY STE 203 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 117 , 185 , 216 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376864488,"MORRIS, JOHN, CHRISTOPHER",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1275911612,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH NEUROLOGY,1730 KERNERSVILLE MEDICAL PKWY STE 203 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376864488,"MORRIS, JOHN, CHRISTOPHER",1730 KERNERSVILLE MEDICAL PKWY STE 203 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1275911612,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH NEUROLOGY,1730 KERNERSVILLE MEDICAL PKWY STE 203 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376864488,"MORRIS, JOHN, CHRISTOPHER",445 PINEVIEW DR STE 240 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376864488,"MORRIS, JOHN, CHRISTOPHER",445 PINEVIEW DR STE 240 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 43 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376870337,"ARAGON, KATHERINE, NICOLE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376870337,"ARAGON, KATHERINE, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 18 , 39 , 46 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1376870998,"WELLS, JENNIFER, JONES",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1376870998,"WELLS, JENNIFER, JONES",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 28 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1376870998,"WELLS, JENNIFER, JONES",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1376870998,"WELLS, JENNIFER, JONES",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 80 , 177 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1376875732,"KELLAM, WYNETTE, JENELLE",3205 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 122 , 134 , 176 ," $31,041.15 ",,
MEDICAID DIRECT,1255355814,COASTAL EYE CLINIC PA,COASTAL EYE CLINIC PA,802 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1376876227,"KANJIYA, NIRVIGHNA, NAVINCHANDRA",802 MCCARTHY BLVD   NEW BERN NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1629514112,CARTERET VISION CENTER OD PA,,5053 EXECUTIVE DR STE A MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1376876631,"CHRISTENSEN, JOSEPH, RUDI",5053 EXECUTIVE DR STE A MOREHEAD CITY NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,, 64 , 70 , 84 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376877449,"EDWARDS, LYNNE, SINK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 41 , 45 , 45 ,$#,,
MEDICAID DIRECT,1053742056,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT KIPP,320 PLEASANT HILL RD   GASTON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376879726,"ENGLISH MANGUM, DANIELLE, GAIL",320 PLEASANT HILL RD   GASTON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice, 72 , 129 , 359 ,$#,,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376879726,"ENGLISH MANGUM, DANIELLE, GAIL",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1053742056,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT KIPP,320 PLEASANT HILL RD   GASTON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376879726,"ENGLISH MANGUM, DANIELLE, GAIL",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376879726,"ENGLISH MANGUM, DANIELLE, GAIL",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice, 306 , 338 ," 1,170 "," $36,696.25 ",,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376879726,"ENGLISH MANGUM, DANIELLE, GAIL",100 W PARKVIEW DR   HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376880179,"JACOBSON, CAITLIN, ANNE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740535657,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1376880922,"NETREBKO, TAISIYA",6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 122 , 315 , 446 ," $11,929.44 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376881904,"MALLET, THIERRY, MITCHEL",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 41 , 42 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376881904,"MALLET, THIERRY, MITCHEL",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1376885160,"PERTOT, ELYSE, MARIE",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 18 , 29 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376888313,"GANTT, JOHN, ARTHUR",506 PARK HILL CT   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376888313,"GANTT, JOHN, ARTHUR",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 77 , 131 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376888313,"GANTT, JOHN, ARTHUR",111 FOOTHILLS DR STE B MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 143 , 290 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,111 FOOTHILLS DR STE B MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1376888313,"GANTT, JOHN, ARTHUR",111 FOOTHILLS DR STE B MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,105 CHESTNUT ST   MARS HILL NC,057,Madison,193400000X,Group,Single Specialty,,1376890582,"VERLA, THOMAS, DANIEL",105 CHESTNUT ST   MARS HILL NC,057,Madison,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,105 CHESTNUT ST   MARS HILL NC,057,Madison,193400000X,Group,Single Specialty,,1376890582,"VERLA, THOMAS, DANIEL",105 CHESTNUT ST   MARS HILL NC,057,Madison,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,105 CHESTNUT ST   MARS HILL NC,057,Madison,193400000X,Group,Single Specialty,,1376890582,"VERLA, THOMAS, DANIEL",440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,193400000X,Group,Single Specialty,,1376890582,"VERLA, THOMAS, DANIEL",440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 12 , 20 , 23 ,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,193400000X,Group,Single Specialty,,1376890582,"VERLA, THOMAS, DANIEL",440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,2211 HIGHWAY 105   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1376890582,"VERLA, THOMAS, DANIEL",2211 HIGHWAY 105   BOONE NC,095,Watauga,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,2211 HIGHWAY 105   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1376890582,"VERLA, THOMAS, DANIEL",2211 HIGHWAY 105   BOONE NC,095,Watauga,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376890731,"ALJAAFAREH, ALMOTASEMBELLAH, MOHAMMAD",4000 COLISEUM DR STE 320 HAMPTON VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376894469,"BOYCE, TRINA, DANETTE",6824 HARRISBURG RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1013437755,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST COMPLEX CARE - W,1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376894469,"BOYCE, TRINA, DANETTE",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 22 , 27 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,6824 HARRISBURG RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376894469,"BOYCE, TRINA, DANETTE",6824 HARRISBURG RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 69 , 83 , 122 ,$#,,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 61 , 63 , 274 ," $30,673.21 ",,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 47 , 229 ," $26,446.18 ",,
MEDICAID DIRECT,1093497521,ALLES DDS HUNTERSVILLE PLLC,IDEAL DENTAL HUNTERSVILLE,14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 51 ,$#,,
MEDICAID DIRECT,1467152496,ALLES DDS KANNAPOLIS PLLC,IDEAL DENTAL KANNAPOLIS,582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 66 , 67 , 591 ," $67,531.26 ",,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376900795,"RAMSEY, DARREN, JEROME",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 29 , 166 ," $15,406.74 ",,
MEDICAID DIRECT,1205595998,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WILSON,3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 28 , 102 ," $10,392.22 ",,
MEDICAID DIRECT,1851050918,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF MORRISVILLE,9648 CHAPEL HILL RD STE 100 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1376900795,"RAMSEY, DARREN, JEROME",9648 CHAPEL HILL RD STE 100 MORRISVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 38 , 128 ," $14,348.10 ",,
MEDICAID DIRECT,1376901900,BLUE RIDGE HEALTHCARE MEDICAL GROUP,CAROLINA DIGESTIVE CARE,150 AUGUST ST STE 100 MORGANTON NC,012,Burke,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1376901900,BLUE RIDGE HEALTHCARE MEDICAL GROUP,150 AUGUST ST STE 100 MORGANTON NC,012,Burke,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 43 , 46 , 70 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1376902171,"JONES, NATALIE, CLAIRE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 59 , 66 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376902171,"JONES, NATALIE, CLAIRE",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376903385,"CLARK, KRISTEN, MCKINNEY",2337 WINTERHAVEN LN   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376903385,"CLARK, KRISTEN, MCKINNEY",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 148 , 348 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376903385,"CLARK, KRISTEN, MCKINNEY",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376904011,"WYATT, TONNA, KARENLYN",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376904011,"WYATT, TONNA, KARENLYN",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 34 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376904011,"WYATT, TONNA, KARENLYN",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 71 , 171 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376904011,"WYATT, TONNA, KARENLYN",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 38 , 73 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376906735,"CARTER, HUGHEY, COLTON",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 93 , 141 , 184 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1376906735,"CARTER, HUGHEY, COLTON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1376906735,"CARTER, HUGHEY, COLTON",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 17 , 28 , 36 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376906735,"CARTER, HUGHEY, COLTON",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 14 , 26 , 39 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376906735,"CARTER, HUGHEY, COLTON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376907287,"JEWELL, REBEKAH, QUINN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 81 , 88 , 95 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376907436,"WELBORN, SETH, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1376907782,"JOHNS, DANIEL, ALAN",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,,,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1376908194,"WILSON, BEVERLY, BELK",360 COUNTY COMPLEX RD STE 200 CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 32 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1376908194,"WILSON, BEVERLY, BELK",360 COUNTY COMPLEX RD STE 200 CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1376908830,"GARDNER, ARIEL, CAMILLE",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",5870 SAMET DR   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 28 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5701 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",11840 SOUTHMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 37 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1376909325,"DEVLIN, BRIAN, JOHN",3193 W HIGHWAY 74   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1376909481,"MCNEIL, SARAH, MOSS",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376909481,"MCNEIL, SARAH, MOSS",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1376909481,"MCNEIL, SARAH, MOSS",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1376909820,"JOHNSTON, JEFFERY, WARREN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1376910034,"BREWINGTON-WILLIAMS, TISHIRA, RANIESE",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1376910034,"BREWINGTON-WILLIAMS, TISHIRA, RANIESE",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1376910034,"BREWINGTON-WILLIAMS, TISHIRA, RANIESE",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 66 , 92 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376913970,"ROBINSON, KATHERINE, ELIZABETH",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 14 , 14 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376913970,"ROBINSON, KATHERINE, ELIZABETH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376913970,"ROBINSON, KATHERINE, ELIZABETH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376913970,"ROBINSON, KATHERINE, ELIZABETH",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 12 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376916296,"FINCH, MARIA, MASTORAS",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 101 , 141 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376916296,"FINCH, MARIA, MASTORAS",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 31 , 52 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1376918581,"ERKES, SUSAN, ANN",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 55 , 90 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1376921494,"JONES, EVAN, GREGORY",15 JANE JACOBS RD STE 101 BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 45 , 93 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1376921494,"JONES, EVAN, GREGORY",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1376921494,"JONES, EVAN, GREGORY",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1376921494,"JONES, EVAN, GREGORY",15 JANE JACOBS RD STE 101 BLACK MOUNTAIN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 35 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376923078,"KINLAW, KEVIN, ZACHARY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 80 , 80 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376923078,"KINLAW, KEVIN, ZACHARY",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376923540,"CARNAHAN, JOANA, ALEXANDRA",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 23 , 62 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376923540,"CARNAHAN, JOANA, ALEXANDRA",509 OLDE WATERFORD WAY STE 200 LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376923540,"CARNAHAN, JOANA, ALEXANDRA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912784406,REX HOSPITAL INC,NORTH CAROLINA INFECTIOUS DISEASES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376924365,"ZHONG, DIANA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376924605,"KABUGO MUSOKE, LORIE, DESMARAIS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376925214,"MINTZ, JOSEPH, WILLIAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376925214,"MINTZ, JOSEPH, WILLIAM",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376927913,"STONE, BRIANNA, LYNN",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 30 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376927913,"STONE, BRIANNA, LYNN",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376927913,"STONE, BRIANNA, LYNN",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1376927913,"STONE, BRIANNA, LYNN",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 38 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1376927913,"STONE, BRIANNA, LYNN",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 31 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376927996,"LIGGETT, LAURA, ELIZABETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 93 , 93 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376930818,"RANDELL, RACHEL, LEIGH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376930818,"RANDELL, RACHEL, LEIGH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1376932038,"LOUCKS, JUSTIN, PEARCE-JORDAN",3332 BRIDGES ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 22 , 53 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1376932038,"LOUCKS, JUSTIN, PEARCE-JORDAN",3332 BRIDGES ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1376932038,"LOUCKS, JUSTIN, PEARCE-JORDAN",3332 BRIDGES ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1376932038,"LOUCKS, JUSTIN, PEARCE-JORDAN",3332 BRIDGES ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 57 , 112 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1376932038,"LOUCKS, JUSTIN, PEARCE-JORDAN",2145 COUNTRY CLUB RD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376933531,"MARTIN, MARY, REBECCA",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1376933531,"MARTIN, MARY, REBECCA",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376935379,"SIGMON, FREDA, THOMPSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 81 , 132 , 134 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376935379,"SIGMON, FREDA, THOMPSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 137 , 142 ,$#,,
MEDICAID DIRECT,1649414517,TRI COUNTY COMMUNITY HEALTH COUNCIL,TRI-COUNTY COMMUNITY HEALTH COUNCIL INC,1508 MAPLE GROVE CHURCH RD STE B DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376936013,"AKPAKA, CYNTHIA, CHINENYE",1508 MAPLE GROVE CHURCH RD STE B DUNN NC,082,Sampson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376937839,"SEIBERT, JONATHAN, SCOTT",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376937839,"SEIBERT, JONATHAN, SCOTT",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 23 , 25 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376937839,"SEIBERT, JONATHAN, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 250 , 262 , 266 ," $88,386.34 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376937839,"SEIBERT, JONATHAN, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376938050,"BISSET, AMANDA, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 91 , 91 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1376938274,"CANNON, IAN, LATEEF",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 113 , 284 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376938357,"KURKIS, GREGORY, MATTHEW",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 41 , 75 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376938530,"OLDFIELD, EDWARD, CHARLES",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376938647,"ROSSI, ANTHONY, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376938647,"ROSSI, ANTHONY, MICHAEL",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376938647,"ROSSI, ANTHONY, MICHAEL",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376938647,"ROSSI, ANTHONY, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376938787,"TAVERNIER, JOSHUA, DEE",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 19 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376948489,"MORRIS, LINDSAY, ANNE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376948489,"MORRIS, LINDSAY, ANNE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1376951194,"SHASTRI, BHAGYASHREE",850 KEMPSVILLE RD STE 100F NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 95 , 126 , 199 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 46 , 59 , 59 ,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",2225 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376954776,"ZUBAIRU, JOSIAH, JEBO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 38 , 69 , 81 ,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376956417,"PIOR, JESSICA, SMITH",490 HOSPITAL DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 110 , 255 , 302 ," $20,795.91 ",,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376956417,"PIOR, JESSICA, SMITH",545 CENTER ST   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376957423,"LASHGARI, GOLNAR",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376957423,"LASHGARI, GOLNAR",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376957423,"LASHGARI, GOLNAR",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376957423,"LASHGARI, GOLNAR",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376957423,"LASHGARI, GOLNAR",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 41 , 66 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376957423,"LASHGARI, GOLNAR",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 18 , 59 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1376957423,"LASHGARI, GOLNAR",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376957464,"KROHN, KOURTNEY, LANE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 138 , 269 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376957480,"POWELL, PENNY, LYNN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 50 , 50 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376959189,"WESTERMAN, MARY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376959189,"WESTERMAN, MARY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 20 , 25 , 29 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376961342,"ISMAIL, HICHAM, SABIH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 142 , 154 , 194 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376962027,"IROHA, UKEGBU, BEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1376962027,"IROHA, UKEGBU, BEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 51 , 51 , 51 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376962027,"IROHA, UKEGBU, BEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376962027,"IROHA, UKEGBU, BEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376962365,"SHUKLA-UDAWATTA, MONICA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376962365,"SHUKLA-UDAWATTA, MONICA",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1376962431,"NEWELL, KATHERINE, ANN",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 24 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376962431,"NEWELL, KATHERINE, ANN",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376962431,"NEWELL, KATHERINE, ANN",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376962431,"NEWELL, KATHERINE, ANN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 60 , 89 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1376962431,"NEWELL, KATHERINE, ANN",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1376962431,"NEWELL, KATHERINE, ANN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 29 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1376962431,"NEWELL, KATHERINE, ANN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1376962712,"PETTUS, MICHAEL, LOGAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376962712,"PETTUS, MICHAEL, LOGAN",10826 MALLARD CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376962712,"PETTUS, MICHAEL, LOGAN",10826 MALLARD CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376962712,"PETTUS, MICHAEL, LOGAN",10826 MALLARD CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1376962712,"PETTUS, MICHAEL, LOGAN",10826 MALLARD CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1376962712,"PETTUS, MICHAEL, LOGAN",10826 MALLARD CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1376962712,"PETTUS, MICHAEL, LOGAN",640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376962761,"RICHARDSON, DANIEL, ROSS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 23 , 67 , 75 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1376965103,"BENEVILLE, CLAUDIA, DANIELLE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376965103,"BENEVILLE, CLAUDIA, DANIELLE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 29 , 64 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376965103,"BENEVILLE, CLAUDIA, DANIELLE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1538189279,FAYETTEVILLE OTOLARYNGOLOGY,FAYETTEVILLE OTOLARYNGOLOGY HEAD AND NECK SURGERY,1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376965988,"BROWN, THOMAS, RADFORD",1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 126 , 237 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1376966879,"HARRIS, ERICA, MESSANA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376966879,"HARRIS, ERICA, MESSANA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376966879,"HARRIS, ERICA, MESSANA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1376967752,"NORDAN, ASHLEY, GREEN",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376968487,"MAZUREK, MAGGIE, WHITT",2727 SHAMROCK DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376968487,"MAZUREK, MAGGIE, WHITT",1316 PATTERSON ST   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376968487,"MAZUREK, MAGGIE, WHITT",918 FITZGERALD ST   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376968487,"MAZUREK, MAGGIE, WHITT",33426 OLD SALISBURY RD   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1376970103,"CALLAWAY, LAURA, LIND",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1376970608,"PARLIER, MORGAN, CATHELIN",101 RENEE LYNN CT   CARRBORO NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376971259,"DODGE, CHRISTINA, MARIE",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 113 , 152 ,$#,,
MEDICAID DIRECT,1205590510,SAL C ZAMMITTI DMD MMSC PLLC AND MA,HUNTERSVILLE SMILES,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376971564,"GIDALY, MATTHEW, PHILIP",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 146 , 166 , 169 ," $29,271.44 ",,
MEDICAID DIRECT,1215664339,SAL C ZAMMITTI DMD MMSC AND MATTHEW,ZAMMITTI & GIDALY ORTHODONTICS,132 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1376971564,"GIDALY, MATTHEW, PHILIP",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 27 , 29 , 30 ,$#,,
MEDICAID DIRECT,1205590510,SAL C ZAMMITTI DMD MMSC PLLC AND MA,HUNTERSVILLE SMILES,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376971564,"GIDALY, MATTHEW, PHILIP",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376972869,"LAWSON, AMANDA, LEA",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 56 , 91 ," $11,145.48 ",,
MEDICAID DIRECT,1770858938,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1 TRADE ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1376972869,"LAWSON, AMANDA, LEA",1 TRADE ST   GRANITE FALLS NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 93 , 274 , 343 ," $53,974.16 ",,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,524 S MAIN ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 151 , 420 , 489 ," $91,824.79 ",,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,524 S MAIN ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,524 S MAIN ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",524 S KING MAIN ST   KING NC,085,Stokes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 94 , 318 , 372 ," $58,536.40 ",,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,3742 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",524 S KING MAIN ST   KING NC,085,Stokes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356036743,NICOLAS R BISIG DMD PLLC,,1564 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376973693,"BISIG, NICOLAS, RYAN",524 S KING MAIN ST   KING NC,085,Stokes,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1376974865,"RATHJE, VERA, N",101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 85 , 185 , 186 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376977058,"BROWNING, ROBERT, BRIAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376977058,"BROWNING, ROBERT, BRIAN",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376977058,"BROWNING, ROBERT, BRIAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376977058,"BROWNING, ROBERT, BRIAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376977058,"BROWNING, ROBERT, BRIAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376977058,"BROWNING, ROBERT, BRIAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376979369,"WATKINS, SHARMETRIS, KEIWYNNE",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 35 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376979369,"WATKINS, SHARMETRIS, KEIWYNNE",1918 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 21 , 44 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1376980482,"TUCKER, MALLORY, CONWAY",101 BETHESDA DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1376980789,WAL-MART STORES EAST LP,WALMART PHARMACY 10-2414,973 N HARRISON AVE   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1376980789,WAL-MART STORES EAST LP,973 N HARRISON AVE   CARY NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1841920600,DR KIM DMD PLLC,PITTSBORO SMILES FAMILY DENTISTRY,987 EAST ST STE H PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1376981258,"KIM, MIJUNG",987 EAST ST   PITTSBORO NC,019,Chatham,1223G0001X,Dental Providers,Dentist,General Practice, 361 , 845 ," 2,595 "," $127,757.17 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376981407,"LEE, JASON, EVAN",100 AIRPORT RD   KINSTON NC,054,Lenoir,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE G KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1376981407,"LEE, JASON, EVAN",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 37 , 78 , 128 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1376981407,"LEE, JASON, EVAN",204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376981407,"LEE, JASON, EVAN",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 96 , 100 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2503 N QUEEN ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1376981407,"LEE, JASON, EVAN",2503 N QUEEN ST   KINSTON NC,054,Lenoir,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 14 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1376981506,"PAGE, SUSAN, ELIZABETH",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1376981944,"FIESELMAN STROUD, KAREN, EMILY",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 22 , 42 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,3518 DRAWBRIDGE PKWY STE 310 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 18 , 25 , 28 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 32 , 52 , 72 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1376982876,"ELLISON, CHI JANE, TU",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376983700,"PEREZ, NANCY",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1376983700,"PEREZ, NANCY",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1376983700,"PEREZ, NANCY",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1376983700,"PEREZ, NANCY",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1376983700,"PEREZ, NANCY",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376983700,"PEREZ, NANCY",3009 WAUGHTOWN ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376983700,"PEREZ, NANCY",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376983700,"PEREZ, NANCY",1430 FELICITY LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,1430 FELICITY LN   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1376983700,"PEREZ, NANCY",1430 FELICITY LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1376983700,"PEREZ, NANCY",910 E INNES ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376983718,"KOLAPPA, SHRADDHA, PATEL",SHRADDHA P KOLAPPA,400 TEW CT STE 106 CLAYTON NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1376983718,"KOLAPPA, SHRADDHA, PATEL",400 TEW CT STE 106 CLAYTON NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,701 "," 5,596 "," 21,670 "," $839,413.03 ",,
MEDICAID DIRECT,1336641109,ISMAIL JOLAOSO DDS PC,AFFORDABLE DENTURES - SOUTH HILL,1165 E ATLANTIC ST   SOUTH HILL VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376983908,"JOLAOSO, ISMAIL, ADEYEMI",1165 E ATLANTIC ST   SOUTH HILL VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 38 , 167 ," $22,756.84 ",,
MEDICAID DIRECT,1376983908,"JOLAOSO, ISMAIL, ADEYEMI",,1165 E ATLANTIC ST   SOUTH HILL VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1376983908,"JOLAOSO, ISMAIL, ADEYEMI",1165 E ATLANTIC ST   SOUTH HILL VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 37 ,$#,,
MEDICAID DIRECT,1124568688,NORTHERN HOSPITAL OF SURRY COUNTY,~,100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1376984161,"SALIBA, JOYCE",100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 29 , 30 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,8 DEERLICK   BRISTOL TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1376986828,"LANGDON, NEAL, WESTON",2101 W ARLINGTON BLVD STE 210 GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 43 , 51 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376986828,"LANGDON, NEAL, WESTON",2101 W ARLINGTON BLVD STE 210 GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376988360,"FOX, SARAH, SCOTT",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376988360,"FOX, SARAH, SCOTT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 21 , 22 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1376988360,"FOX, SARAH, SCOTT",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 34 , 39 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1376988634,"KANWAR, RAJDEEP, SINGH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1376988634,"KANWAR, RAJDEEP, SINGH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376988634,"KANWAR, RAJDEEP, SINGH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 51 , 62 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376988634,"KANWAR, RAJDEEP, SINGH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1376988634,"KANWAR, RAJDEEP, SINGH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376988634,"KANWAR, RAJDEEP, SINGH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 36 , 41 ,$#,,
MEDICAID DIRECT,1063822765,"SACKMANN, ROBERT, KYLE",,2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1376988634,"KANWAR, RAJDEEP, SINGH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1376988634,"KANWAR, RAJDEEP, SINGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1376989285,"ONG, DAVID, YANG MING",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1376991257,"HALE, VIRGINIA, LEIGH",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376992123,"HARAN, PRASHANTH, HARI",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 378 , 424 , 558 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376992123,"HARAN, PRASHANTH, HARI",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 29 , 43 ,$#,,
MEDICAID DIRECT,1023084936,WATAUGA RADIOLOGICAL SERVICES PA,WATAUGA RADIOLOGICAL SERVICES PA,155 FURMAN RD STE 101A BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1376993485,"MAXWELL, ADAM, WALTER",336 DEERFIELD RD   BOONE NC,095,Watauga,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 107 , 155 , 221 ,$#,,
MEDICAID DIRECT,1023084936,WATAUGA RADIOLOGICAL SERVICES PA,WATAUGA RADIOLOGICAL SERVICES PA,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1376993485,"MAXWELL, ADAM, WALTER",155 FURMAN RD STE 101A BOONE NC,095,Watauga,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 102 , 161 ,$#,,
MEDICAID DIRECT,1023084936,WATAUGA RADIOLOGICAL SERVICES PA,WATAUGA RADIOLOGICAL SERVICES PA,155 FURMAN RD STE 101A BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1376993485,"MAXWELL, ADAM, WALTER",155 FURMAN RD STE 101A BOONE NC,095,Watauga,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 185 , 302 , 448 ,$#,,
MEDICAID DIRECT,1023084936,WATAUGA RADIOLOGICAL SERVICES PA,WATAUGA RADIOLOGICAL SERVICES PA,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1376993485,"MAXWELL, ADAM, WALTER",336 DEERFIELD RD   BOONE NC,095,Watauga,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 34 , 41 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376998260,"ROGERS, CORIANNE, DENISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376998260,"ROGERS, CORIANNE, DENISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376998260,"ROGERS, CORIANNE, DENISE",210 ASHVILLE AVE   CARY NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1376998260,"ROGERS, CORIANNE, DENISE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1376998260,"ROGERS, CORIANNE, DENISE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1376998351,"LIBOIRON, MIREILLE, ANDREE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 25 , 65 , 70 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1376999342,"BRISBIN, IVY, PAULINE",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 31 , 33 , 92 ,$#,,
MEDICAID DIRECT,1255196366,THOME & YOO DDS PLLC,MEBANE PEDIATRIC DENTISTRY,1107 S FIFTH ST STE 100 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1376999342,"BRISBIN, IVY, PAULINE",1107 S FIFTH ST STE 100 MEBANE NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 ,#,#,$#,,
MEDICAID DIRECT,1255196366,THOME & YOO DDS PLLC,MEBANE PEDIATRIC DENTISTRY,1107 S FIFTH ST STE 100 MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,1376999342,"BRISBIN, IVY, PAULINE",1107 S FIFTH ST STE 100 MEBANE NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,637 "," 2,951 "," 12,658 "," $393,373.23 ",,
MEDICAID DIRECT,1780072181,JINA K YOO DMD MS PC,MEBANE PEDIATRIC DENTISTRY,1107 S FIFTH ST STE 100 MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,1376999342,"BRISBIN, IVY, PAULINE",1107 S FIFTH ST STE 100 MEBANE NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 23 , 23 , 223 ," $15,364.27 ",,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1386001477,"CLIFF, STACY, WAGONER",306 COLLEGE ST   WILKESBORO NC,097,Wilkes,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386003135,"MCGEE, SHELBY, JO",1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386003135,"MCGEE, SHELBY, JO",1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 50 , 52 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386004513,"MOODY, CAITLIN, VOLCHANSKY",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386004513,"MOODY, CAITLIN, VOLCHANSKY",9735 KINCEY AVE STE 205 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1811350887,PIEDMONT HEALTHCARE PA,,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 64 , 128 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 55 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386004943,"HARRIS, RICHARD, ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386006203,"FRANCIS, OLIVIA, LAURENNE",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 11 , 15 , 22 ,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386006203,"FRANCIS, OLIVIA, LAURENNE",11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386006203,"FRANCIS, OLIVIA, LAURENNE",4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386006203,"FRANCIS, OLIVIA, LAURENNE",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,,,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386006203,"FRANCIS, OLIVIA, LAURENNE",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 29 , 48 , 65 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386006872,"WIGGINS, ROBERT, CASPER",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 47 , 56 , 94 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386006872,"WIGGINS, ROBERT, CASPER",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386006914,"DALAL, JUGAL, MAYANK",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 78 , 188 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386006914,"DALAL, JUGAL, MAYANK",865 W LAKE DR STE 200 MOUNT AIRY NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 33 , 51 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1386007698,"JARMAKANI, HADDY, MARWAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,15110 JOHN J DELANEY DR STE 130 CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1386007698,"JARMAKANI, HADDY, MARWAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386007698,"JARMAKANI, HADDY, MARWAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386007698,"JARMAKANI, HADDY, MARWAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 235 , 237 , 266 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386012094,"BRZYCKI, KRISTIN, MICHELLE",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386012094,"BRZYCKI, KRISTIN, MICHELLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",420 PARK ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902223076,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1386013480,"LISENBY, STEPHANIE, NICOLE",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386017630,"KREBS, AMY, LAUREN",801 W BARBEE   CHAPEL HIL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386017630,"KREBS, AMY, LAUREN",1205 S MAIN ST   GRAHAM NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1386020873,"DANCY, BENJAMIN, ERIC",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1386020873,"DANCY, BENJAMIN, ERIC",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1386020873,"DANCY, BENJAMIN, ERIC",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1366068397,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BOILING SPRINGS,305 W COLLEGE AVE   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386021418,"BARLOW, BROOKLYN, DOHERTY",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386021418,"BARLOW, BROOKLYN, DOHERTY",1019 N LAFAYETTE ST   SHELBY NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386021418,"BARLOW, BROOKLYN, DOHERTY",3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1669232328,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT JAMES LOVE ELEMENTARY,309 JAMES LOVE SCHOOL RD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386021418,"BARLOW, BROOKLYN, DOHERTY",3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 57 , 57 ," $15,475.39 ",,
MEDICAID DIRECT,1386383909,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-805 FAIRVIEW ROAD SUITE 200,805 FAIRVIEW RD STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386021541,"ROBERTS, MAYU, TONER",805 FAIRVIEW RD STE 200 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 21 , 30 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386021921,"LEE, REBECCA, DIANE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,666 W CORBETT AVE   SWANSBORO NC,067,Onslow,193200000X,Group,Multi-Specialty,,1386023281,"MARSH, JEANE, ASHLEY",666 W CORBETT AVE   SWANSBORO NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1386023281,"MARSH, JEANE, ASHLEY",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 30 , 53 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386023281,"MARSH, JEANE, ASHLEY",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386023281,"MARSH, JEANE, ASHLEY",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386024172,"PEGG, ERICA, ELIZABETH",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386024172,"PEGG, ERICA, ELIZABETH",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1659695781,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386024172,"PEGG, ERICA, ELIZABETH",16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1386025591,"ALKIRE, REECE, LINDEN TRAVIS",250 NASH MEDICAL ARTS MALL STE A ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 35 , 45 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1386025591,"ALKIRE, REECE, LINDEN TRAVIS",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 66 , 70 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386025591,"ALKIRE, REECE, LINDEN TRAVIS",250 NASH MEDICAL ARTS MALL STE A ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 78 , 90 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386026144,"PATEL, KHILEN, BHUPENDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 56 , 109 , 143 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1386026607,"HEATON, TANA",157 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 34 , 65 ,$#,,
MEDICAID DIRECT,1578958773,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CLEVELAND INTERNAL MEDI,807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1386026607,"HEATON, TANA",807 SCHENCK ST STE 2 SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 88 , 117 ,$#,,
MEDICAID DIRECT,1992932016,SUMMIT EYE CARE PA,SUMMIT EYE CARE PA,3073 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386027159,"BIGGS, PAUL, KEITH",1102C YADKINVILLE RD   MOCKSVILLE NC,030,Davie,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992932016,SUMMIT EYE CARE PA,SUMMIT EYE CARE PA,3073 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386027159,"BIGGS, PAUL, KEITH",3073 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 136 , 163 , 216 ,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386028124,"REHMAN, HASAN",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 170 , 257 , 307 ," $37,414.27 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386028728,"ZAHAR, NADINE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1811136476,UNITED HEALTH CENTERS,~,2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386029585,"MEADOWS, KELLICE, NICOLE",2101 PETERS CREEK PKWY STE 16-19 WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031177,"PATEL, SHITAL, HIMANSHU",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 47 , 74 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031177,"PATEL, SHITAL, HIMANSHU",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031177,"PATEL, SHITAL, HIMANSHU",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386031177,"PATEL, SHITAL, HIMANSHU",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031177,"PATEL, SHITAL, HIMANSHU",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 52 , 77 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031177,"PATEL, SHITAL, HIMANSHU",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 33 , 62 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031441,"DESAI, NINAD, DIPAK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386031441,"DESAI, NINAD, DIPAK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386031441,"DESAI, NINAD, DIPAK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031441,"DESAI, NINAD, DIPAK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031441,"DESAI, NINAD, DIPAK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386031441,"DESAI, NINAD, DIPAK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386031441,"DESAI, NINAD, DIPAK",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1790809531,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - WEST,1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386032399,"SCALES, HOPE, RENEE",1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 89 , 122 , 127 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386032647,"ALEXANDER, LEAH, MILES",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386032647,"ALEXANDER, LEAH, MILES",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386032696,"MCNUTT, ASHTON, ELIZABETH",3330 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 61 , 75 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386032696,"MCNUTT, ASHTON, ELIZABETH",1401 MATTHEWS TOWNSHIP PKWY STE 312 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386032696,"MCNUTT, ASHTON, ELIZABETH",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1386033314,"BALL, JON, ROBERT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386033314,"BALL, JON, ROBERT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386033314,"BALL, JON, ROBERT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386033314,"BALL, JON, ROBERT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386034379,"WILFLEY, LEIGH, ANNE",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1033130117,UWHARRIE REGIONAL PEDIATRICS P A,ALBEMARLE PEDIATRICS,1420 US 52 N STE A ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1386035343,"ALMOND, KRISTINA, ALLMON",1420 US 52 N STE A ALBEMARLE NC,084,Stanly,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 61 , 120 , 315 ," $11,373.08 ",,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386035509,"WHITWORTH, KATIE, MEZYNSKI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 145 , 145 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386035509,"WHITWORTH, KATIE, MEZYNSKI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 122 , 122 ,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1386036390,"SNYDER, ELLEN, MARGARET",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 93 , 247 , 314 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386036796,"TUCKER, MATTHEW, KYLE",760 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 69 , 109 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386036796,"TUCKER, MATTHEW, KYLE",3803 ROBERT PORCHER WAY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386036796,"TUCKER, MATTHEW, KYLE",3803 ROBERT PORCHER WAY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386037810,"MACKENZIE, SCOTT, ALAN",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386037810,"MACKENZIE, SCOTT, ALAN",800 TILGHMAN DR   DUNN NC,043,Harnett,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386037810,"MACKENZIE, SCOTT, ALAN",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386037810,"MACKENZIE, SCOTT, ALAN",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1386038099,"OWENS, MYOSHI",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386038099,"OWENS, MYOSHI",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386038099,"OWENS, MYOSHI",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386038099,"OWENS, MYOSHI",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386038099,"OWENS, MYOSHI",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1386038099,"OWENS, MYOSHI",910 E INNES ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386039022,"PATEL, KETU, DINESH",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386039303,"BODIE, WESLEY, WINFIELD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 252 , 257 ," $13,909.67 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",2359 SPRINGS RD NE   HICKORY NC,018,Catawba,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 21 , 226 , 242 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 49 , 344 , 378 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 41 , 205 , 213 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",322 NUWAY CIR   LENOIR NC,014,Caldwell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 19 , 68 , 68 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",322 NUWAY CIR   LENOIR NC,014,Caldwell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 25 , 84 , 89 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",2359 SPRINGS RD NE   HICKORY NC,018,Catawba,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 26 , 48 , 51 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 15 , 31 , 35 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",107 MAGNOLIA DR   MORGANTON NC,012,Burke,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386044501,"MOOSE, WENDY, BROWN",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386044527,"WRIGHT, COLLIN, DAVIS",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 33 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386044527,"WRIGHT, COLLIN, DAVIS",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386047157,"DESVAUX, ROBIN, SIKES",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1154352938,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE RIVERBEND FAMILY MEDICI,215 S MAIN ST   MT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386047157,"DESVAUX, ROBIN, SIKES",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386047157,"DESVAUX, ROBIN, SIKES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386047157,"DESVAUX, ROBIN, SIKES","5815 BLAKENEY PARK DRIVE, SUITE 200   CHARLOTTE NC",060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386047157,"DESVAUX, ROBIN, SIKES",13557 STEELECROFT PKWY STE 1200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386047157,"DESVAUX, ROBIN, SIKES",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1386054146,CAREOLINA HOME CARE SERVICES LLC,,8305 UNIVERSITY EXEC PARK DR STE 335B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1386054146,CAREOLINA HOME CARE SERVICES LLC,8305 UNIVERSITY EXEC PARK DR STE 335B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,818 "," 2,823 "," $254,254.18 ",,
MEDICAID DIRECT,1386054146,CAREOLINA HOME CARE SERVICES LLC,,1913 J N PEASE PL STE 103B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1386054146,CAREOLINA HOME CARE SERVICES LLC,1913 J N PEASE PL STE 103B CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,110 "," 1,180 "," $101,248.48 ",,
MEDICAID DIRECT,1386054146,CAREOLINA HOME CARE SERVICES LLC,,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1386054146,CAREOLINA HOME CARE SERVICES LLC,5736 N TRYON ST STE 220 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386054781,"BLACKMON, STEPHEN, CHARLES",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 96 , 97 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386054971,"CANNON, LAURA, ARMFIELD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386054971,"CANNON, LAURA, ARMFIELD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386054971,"CANNON, LAURA, ARMFIELD",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386054971,"CANNON, LAURA, ARMFIELD",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386054971,"CANNON, LAURA, ARMFIELD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386055200,"BERNERT, BRADFORD, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386055200,"BERNERT, BRADFORD, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386055549,"HOBSON, DAVID, RICHARD",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386055549,"HOBSON, DAVID, RICHARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386055549,"HOBSON, DAVID, RICHARD",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386056430,"SOUFFRANT, EDMIRE, FLORE",707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386056430,"SOUFFRANT, EDMIRE, FLORE",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 22 , 29 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386056430,"SOUFFRANT, EDMIRE, FLORE",7110 LAWYERS RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386056430,"SOUFFRANT, EDMIRE, FLORE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386056430,"SOUFFRANT, EDMIRE, FLORE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 43 , 43 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386056430,"SOUFFRANT, EDMIRE, FLORE",7110 LAWYERS RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386186120,JACKSON HM SERVICES PC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1386057248,"WHITFIELD, KATHARINE, MICHELLE",68 HOSPITAL RD   SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 185 , 185 ," $12,385.70 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386058089,"HOUSKAMP, DANIEL, JOHN",4218 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386059202,"ALEXANDER, SUSAN, CROSBY",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386059202,"ALEXANDER, SUSAN, CROSBY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 21 , 21 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386059202,"ALEXANDER, SUSAN, CROSBY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 32 , 32 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386059202,"ALEXANDER, SUSAN, CROSBY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386059202,"ALEXANDER, SUSAN, CROSBY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386059285,"YAKHMI, RUPALI",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 31 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386060887,"CHOI, EDWIN, YOUNJOON",155 MEMORIAL DR   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1386062446,"TANIMOTO, AKI, AGATHA",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386062495,"SIOSHANSI, PEDROM, CYRUS",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 41 , 53 , 96 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 123 , 127 , 160 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 41 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 129 , 137 , 173 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6602 KNIGHTDALE BLVD   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 70 , 130 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386063725,"TOBBEN, JOHN, PAUL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386064475,"HARDIN, JOSHUA, SPICER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386064475,"HARDIN, JOSHUA, SPICER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386067338,"GREENE, KELLEY, MAI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386067338,"GREENE, KELLEY, MAI",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386067338,"GREENE, KELLEY, MAI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205005824,EYECARECENTER OD PA,,14 CONSULTANT PL   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1386069599,"BARBER, SHARON, LUONG",14 CONSULTANT PL   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386070928,"SHALLEY, KENDALL, NICOLE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386074250,"VAUGHAN, ANDREW, WILLIAM",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 90 , 90 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386074250,"VAUGHAN, ANDREW, WILLIAM",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 71 , 72 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386074250,"VAUGHAN, ANDREW, WILLIAM",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,,,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",5151 SARDIS RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 29 , 38 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 34 , 42 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",5151 SARDIS RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",5151 SARDIS RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386076859,"HUSTON, ERIN, RACHELLE NICHOL",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386080208,"YOUSSEF, MAGI, ADEL",MAGI ADEL YOUSSEF DDS PLLC,101 SLEEPY DR STE 102 SPRING LAKE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1386080208,"YOUSSEF, MAGI, ADEL",101 SLEEPY DR STE 102 SPRING LAKE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 440 ," 1,014 "," 3,184 "," $166,875.65 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386081198,"STROTHER, BRADLEY, LORNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730367467,HOSPICE & PALLIATIVE CARECENTER,TRELLIS SUPPORTIVE CARE,101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386083210,"SMITH, KELSEY, ANNE",101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1386083210,"SMITH, KELSEY, ANNE",631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 50 , 50 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386087005,"COLLINS, HUNTER, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 54 , 63 , 67 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1386087005,"COLLINS, HUNTER, JOSEPH",202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 40 , 46 , 60 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386087112,"CARROLL, LISA, MARTIN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 16 , 25 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386087112,"CARROLL, LISA, MARTIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 24 , 25 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386087112,"CARROLL, LISA, MARTIN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386087112,"CARROLL, LISA, MARTIN",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1386088052,"LITTLE, KEVIN, DONALD",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386088607,"MCKIBBIN, CHRISTOPHER, ROWLAND",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386088607,"MCKIBBIN, CHRISTOPHER, ROWLAND",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1386089217,"ROWE, MELISSA, ANN",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 80 , 119 , 157 ," $13,314.58 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386089894,"CRUZ, CHRISTINA, MELISSA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386089902,"WANG, KATHLEEN, YIRU",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology, 12 , 15 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386089902,"WANG, KATHLEEN, YIRU",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386090579,"NIMMONS, SCOTT, JOSEPH BELLAMY",865 WESTLAKE DR STE 200 MOUNT AIRY NC,086,Surry,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 33 , 35 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386090579,"NIMMONS, SCOTT, JOSEPH BELLAMY",865 W LAKE DR STE 200 MOUNT AIRY NC,086,Surry,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386090579,"NIMMONS, SCOTT, JOSEPH BELLAMY",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 40 , 65 , 74 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386091551,"ALEXANDER, AMANDA, LYNN",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1386091551,"ALEXANDER, AMANDA, LYNN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 61 , 64 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386095958,"SUNDARAVEL, SWETHIKA, HARINI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 104 , 167 ,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1386096535,"LIU, YUZHOU",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1386096535,"LIU, YUZHOU",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386097038,"LINTZ, MADISON, WILLIAMS",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386097038,"LINTZ, MADISON, WILLIAMS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386097038,"LINTZ, MADISON, WILLIAMS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386097038,"LINTZ, MADISON, WILLIAMS",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386097723,"SWANSON, JAIME, STUART",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 71 , 100 ,$#,,
MEDICAID DIRECT,1386100873,LIBERTY HEALTHCARE AGENCY LLC,,2421 TIMBER DR STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1386100873,LIBERTY HEALTHCARE AGENCY LLC,2421 TIMBER DR STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,415 "," 1,415 "," $87,768.22 ",,
MEDICAID DIRECT,1194240671,WRIGHT AND ASSOCIATES IX DDS PA,,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386101541,"GILL, VICTORIA, ANNE",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 408 , 696 ," 3,034 "," $143,044.54 ",,
MEDICAID DIRECT,1669997144,WRIGHT AND ASSOCIATES VII DDS PA,,120 NE MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1386101541,"GILL, VICTORIA, ANNE",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 609 ," 1,099 "," 5,359 "," $291,301.07 ",,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386101541,"GILL, VICTORIA, ANNE",4106 WAKE FOREST RD STE 203 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 146 , 149 , 891 ," $63,373.81 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386102218,"WILSON, LAUREN, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386102218,"WILSON, LAUREN, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1386102218,"WILSON, LAUREN, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1386102218,"WILSON, LAUREN, ALLEN",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386102218,"WILSON, LAUREN, ALLEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386103463,"PACI, KARINA, MAUREEN",719 GREEN VALLEY RD STE 306 GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 40 , 73 , 135 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386103463,"PACI, KARINA, MAUREEN",3518 DRAWBRIDGE PKWY STE 320 GREENSBORO NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386104180,"CARTER, KUTRENI, LACHELLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386104180,"CARTER, KUTRENI, LACHELLE",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386104180,"CARTER, KUTRENI, LACHELLE",103 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386104271,"DUGDALE, EVAN, MICHAEL",2001 VAIL AVE STE 200A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386104602,"SCHERMERHORN, DEMETRA, VAPORIS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386104602,"SCHERMERHORN, DEMETRA, VAPORIS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386104602,"SCHERMERHORN, DEMETRA, VAPORIS",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 33 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386105096,"MIRZA, FARYAL, GOHAR",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386105096,"MIRZA, FARYAL, GOHAR",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386105104,"ANTONO, ANDREAS, DELANO",41 OAKLAND RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386105104,"ANTONO, ANDREAS, DELANO",41 OAKLAND RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386105930,"LONG, CLAYTON, VANCE",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386105930,"LONG, CLAYTON, VANCE",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1386105930,"LONG, CLAYTON, VANCE",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 24 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1386105930,"LONG, CLAYTON, VANCE",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386105930,"LONG, CLAYTON, VANCE",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1386106888,"INGALLS, KATELIND, ELIZABETH",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 116 , 167 ,$#,,
MEDICAID DIRECT,1336292556,TRIAD BEHAVIORAL RESOURCES PC,,12 N 5TH AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386110716,"KNOWLES, NICOLEE",12 N 5TH AVE   WILMINGTON NC,065,New Hanover,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,8990 HIGHWAY 17 S   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1386111722,"WRIGHT, LAKASHA, AKISHA",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386111722,"WRIGHT, LAKASHA, AKISHA",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,2600 OLD CHERRY POINT RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1386111722,"WRIGHT, LAKASHA, AKISHA",2600 OLD CHERRY POINT RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2600 OLD CHERRY POINT RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1386111722,"WRIGHT, LAKASHA, AKISHA",2600 OLD CHERRY POINT RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 60 , 60 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386111722,"WRIGHT, LAKASHA, AKISHA",2600 OLD CHERRY POINT RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 557 , 557 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1386111722,"WRIGHT, LAKASHA, AKISHA",2600 OLD CHERRY POINT RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 244 , 246 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386111722,"WRIGHT, LAKASHA, AKISHA",2910 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336645720,GRANVILLE HEALTH INC,~,103 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1386113124,"EDWARDS, ALEXIA, KEARNS",103 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1336645720,GRANVILLE HEALTH INC,~,103 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1386113124,"EDWARDS, ALEXIA, KEARNS",103 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 93 , 129 , 130 ,$#,,
MEDICAID DIRECT,1083604300,SUNMED MEDICAL SYSTEMS LLC,,36 ROUTE 70 W STE 214 MARLTON NJ,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386113868,"MEARES, MELISSA, ANN",414 CATAWBA ST   MORGANTON NC,012,Burke,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 21 , 23 , 53 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386115392,"BANKER, HIRAL, KANTILAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 361 , 482 , 587 ," $10,603.61 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386115392,"BANKER, HIRAL, KANTILAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386115392,"BANKER, HIRAL, KANTILAL",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386115392,"BANKER, HIRAL, KANTILAL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386115392,"BANKER, HIRAL, KANTILAL",3120 NORTHLINE AVE STE 101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386115392,"BANKER, HIRAL, KANTILAL",3120 NORTHLINE AVE STE 101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801843925,ARTHRITIS AND OSTEOPOROSIS CONSULTA,ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CARO,1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386118354,"HALL, MEREDYTH, BLAIR",1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386122083,"ZANKLE, SARAH, LYNNE",2350 BENTRIDGE LN APT 102 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 23 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386122117,"PIDANA, MUNESH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1083854897,DOCTORS MAKING HOUSECALLS INTERNAL,DOCTORS MAKING HOUSECALLS INTERNAL MEDICINE PA,,,Unknown,193200000X,Group,Multi-Specialty,,1386125391,"HOGG, STACEY, LYNN",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1386131639,"ENGWALL, ELIJAH, CHARLES",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386131639,"ENGWALL, ELIJAH, CHARLES",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 77 , 115 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 27 , 39 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 14 , 55 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 26 , 38 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1386131993,"MCNEIL, NYKIA, LATASHA",,308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,1386131993,"MCNEIL, NYKIA, LATASHA",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 24 , 57 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 574 ," 1,311 "," 2,991 "," $149,965.99 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386131993,"MCNEIL, NYKIA, LATASHA",2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386133502,"RUMBALL, ALISON, MITCHELL",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 151 , 224 , 339 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386133502,"RUMBALL, ALISON, MITCHELL",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 40 , 40 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1125 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386133502,"RUMBALL, ALISON, MITCHELL",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386133882,"LIBOVE, EILEEN, CHERYL",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386133882,"LIBOVE, EILEEN, CHERYL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 27 , 27 ,$#,,
MEDICAID DIRECT,1851331359,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS CHARLOTTE,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386133882,"LIBOVE, EILEEN, CHERYL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386135838,"HOBBS, FRANCIS, FAYE",605 TILGHMAN DR   DUNN NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386135838,"HOBBS, FRANCIS, FAYE",3943 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 38 , 38 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386135838,"HOBBS, FRANCIS, FAYE",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1386135838,"HOBBS, FRANCIS, FAYE",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386135838,"HOBBS, FRANCIS, FAYE",3943 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1386135838,"HOBBS, FRANCIS, FAYE",3943 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386136596,"ZANGRILLI, JULIAN, ANDREAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,7825 BALLANTYNE COMMONS PKWY STE 210   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386137511,"HALSTEAD, JUSTIN, MICHAEL",7825 BALLANTYNE COMMONS PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 37 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386140531,"MATRKA, ALEXIS, KING",2001 VAIL AVE STE 200A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720177140,COUNTY OF DAVIE OFFICE OF FINANCE A,DAVIE COUNTY HEALTH DEPARTMENT,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1386141323,"ANTONY, TEENA, JOSE",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386141638,"BROACH, ANSLEY, GARDNER",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386141638,"BROACH, ANSLEY, GARDNER",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386141828,"BAUGHMAN, ASHLEY, MARIE",304 10TH AVE NE   HICKORY NC,018,Catawba,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386144574,"MIHALOVICH, JOSEPH, ALLEN",1308 HIGHLAND DR   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386144574,"MIHALOVICH, JOSEPH, ALLEN",1471 JAG BRANCH BLVD UNIT 103 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 71 , 104 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386144764,"QURESHI, MEHVEEN, RASHID",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1346711322,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - SELMA,1111 S POLLOCK ST   SELMA NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386144764,"QURESHI, MEHVEEN, RASHID",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 50 , 50 , 194 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386144764,"QURESHI, MEHVEEN, RASHID",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 78 , 80 , 312 ,$#,,
MEDICAID DIRECT,1790242345,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS SPECIALTY- CLAYTON,31 OLEANDER DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386144764,"QURESHI, MEHVEEN, RASHID",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 45 , 55 , 215 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386144764,"QURESHI, MEHVEEN, RASHID",31 OLEANDER DR   CLAYTON NC,051,Johnston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 111 , 113 , 429 ," $13,680.76 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386148500,"MACINTYRE, CHARLES, WORTHINGTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 65 , 68 , 73 ," $10,263.30 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386148963,"NOLIN, ANGELA, CHARLENE",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386149458,"ROSSI, MATTHEW, JOHN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1619260031,G ABRAMS R COHEN II PC,G ABRAMS & R COHEN II PC,14135 STEELE CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386153971,"ALSAERY, AMANI, SALEH",591 RIVER HWY   MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 151 , 235 , 844 ," $44,534.43 ",,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386154409,"PETERS, JOANNA, BARRETT",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 33 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1386161768,"TINSBLOOM, BRANDI, NICOLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1386162766,ALPHA CONCORD OF GREENSBORO LLC,,3301 GAR PL   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386162766,ALPHA CONCORD OF GREENSBORO LLC,3301 GAR PL   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 37 ," 7,287 "," 7,288 "," $567,417.23 ",,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386162980,"RAINES, RITA, YOUNGERMAN",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386162980,"RAINES, RITA, YOUNGERMAN",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386162980,"RAINES, RITA, YOUNGERMAN",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386162980,"RAINES, RITA, YOUNGERMAN",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386162980,"RAINES, RITA, YOUNGERMAN",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386162980,"RAINES, RITA, YOUNGERMAN",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1386168219,"BRIGGS, STUART, FENTON",131 MONTGOMERY XING   BISCOE NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 698 ," 1,160 "," 3,669 "," $183,386.37 ",,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386168565,"OSER, JESSICA, MARIE",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821240995,WESTGATE DERMATOLOGY AND LASER CENT,WESTGATE DERMATOLOGY AND LASER CENTER PA,2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386169258,"ALLEN, LYNDSEY, SAUNDERS",2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 25 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386169266,"EE, LENA",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386169266,"EE, LENA",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386169266,"EE, LENA",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 61 , 72 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386173029,"ERBY, BRITTAINY, RENEE",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 89 , 135 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 107 , 175 , 272 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386175008,"MALLIPEDDI, VISHNU, PRIYA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 35 , 53 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386175727,"ROACHE, WILLIAM, KENNEDY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386177756,"GU, JESSIE, PING",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 33 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386177756,"GU, JESSIE, PING",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386177756,"GU, JESSIE, PING",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 19 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386177756,"GU, JESSIE, PING",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1013910330,ANESTHESIA SPECIALISTS,ANESTHESIA SPECIALISTS,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386178911,"MADSEN, GABRIELLE, ZOE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386178911,"MADSEN, GABRIELLE, ZOE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386179042,"HATCH, ERICA, SWANSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 18 , 30 , 33 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386179547,"HOFFMAN, JESSICA, RATLIFF",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 35 , 41 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386179547,"HOFFMAN, JESSICA, RATLIFF",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 261 , 303 ,$#,,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 42 , 42 , 169 ,$#,,
MEDICAID DIRECT,1588238463,DAVID E THOME DDS PLLC XI,HICKORY PEDIATRIC DENTISTRY,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 112 , 117 , 501 ," $18,557.48 ",,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 15 ,$#,,
MEDICAID DIRECT,1326746355,DAVID E THOME DDS PLLC L1,,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 20 , 20 , 389 ," $33,417.61 ",,
MEDICAID DIRECT,1588238463,DAVID E THOME DDS PLLC XI,HICKORY PEDIATRIC DENTISTRY,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1063110005,DAVID E THOME DDS PLLC L1,,140 MAHALEY AVE STE B EAST SPENCER NC,080,Rowan,193200000X,Group,Multi-Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 12 , 243 ," $21,221.24 ",,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 233 , 249 ," 1,101 "," $37,351.89 ",,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 3,312 "," 4,286 "," 17,852 "," $683,027.86 ",,
MEDICAID DIRECT,1639877665,DAVID E THOME DDS PLLC L1,,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 30 , 30 , 586 ," $50,222.69 ",,
MEDICAID DIRECT,1649016171,DAVID E THOME DDS PLLC L1,,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1386179604,"AL-MAHDI, SIRAJ, HAKIM",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 22 , 22 , 415 ," $34,683.41 ",,
MEDICAID DIRECT,1164828471,TWO RIVERS PHYSICIAN PRACTICES LLC,,1499 MAIN ST   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1386180230,"GILL, PUSHPINDER, KAUR",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386180230,"GILL, PUSHPINDER, KAUR",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 21 , 45 , 45 ," $10,699.55 ",,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386182756,"LOPEZ, JENNIFER",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386182756,"LOPEZ, JENNIFER",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 21 , 35 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386182756,"LOPEZ, JENNIFER",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386185569,"SOSSOU, CHRISTOPH, WENTEE",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1386190957,HOLLY SPRINGS SURGERY CENTER,,600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1386190957,HOLLY SPRINGS SURGERY CENTER,600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386193803,"SCHICHTEL, BARRATT, LEE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386193803,"SCHICHTEL, BARRATT, LEE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386193803,"SCHICHTEL, BARRATT, LEE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386193803,"SCHICHTEL, BARRATT, LEE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386195154,"WILKINS, RYAN, GABRIEL",1901 MOONEY ST   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386195295,"JOHNSON, HALEY, MAE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386195295,"JOHNSON, HALEY, MAE",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386195295,"JOHNSON, HALEY, MAE",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386195295,"JOHNSON, HALEY, MAE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 43 ,$#,,
MEDICAID DIRECT,1386196236,JOSS TRANSPORT SERVICES,,143 MIDDLE OAKS DR   WILMINGTON NC,065,New Hanover,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1386196236,JOSS TRANSPORT SERVICES,143 MIDDLE OAKS DR   WILMINGTON NC,065,New Hanover,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 160 ," 2,053 "," 2,098 "," $234,977.50 ",,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386198646,"CORDERO CASTRO, EDUARDO, MANUEL",582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386199396,"SOMMER, JENNIFER, ELISE",1340 MATTHEWS TOWNSHIP PKWY STE 102 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386199396,"SOMMER, JENNIFER, ELISE",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 93 , 185 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1386200301,"LAKEY, JODY, LEROY",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 32 , 39 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386200301,"LAKEY, JODY, LEROY",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 28 , 42 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1386200301,"LAKEY, JODY, LEROY",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 165 , 179 , 245 ," $14,760.94 ",,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386200962,"BLOOMFIELD, CARLEY, DRYE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386201374,"ROARK, JENNIFER, HOPE",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1386201374,"ROARK, JENNIFER, HOPE",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1386201374,"ROARK, JENNIFER, HOPE",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386203792,"GOODRICH, CALLIE, ELIZABETH",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 24 , 32 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386203792,"GOODRICH, CALLIE, ELIZABETH",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386203792,"GOODRICH, CALLIE, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386203842,"RUIZ, KIRSTIN, CAYCE",2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386203842,"RUIZ, KIRSTIN, CAYCE",2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 61 , 87 ,$#,,
MEDICAID DIRECT,1972566016,SANDHILLS ORTHOTICS LLC,SANDHILLS ORTHOTICS LLC,325 PAGE RD BLDG 3 PINEHURST NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386204923,"AYCOCK, BERRY, DEWAYNE",325 PAGE RD N STE 3 PINEHURST NC,063,Moore,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,519 NAUTICAL DR STE 100C CLOVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386207009,"LANE, REBECCA, SUSAN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386207009,"LANE, REBECCA, SUSAN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 23 , 32 ,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386207009,"LANE, REBECCA, SUSAN",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386207009,"LANE, REBECCA, SUSAN",1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386207009,"LANE, REBECCA, SUSAN",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1386207603,"EARLY, CAROLINE, ALEXANDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386207603,"EARLY, CAROLINE, ALEXANDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 16 , 17 , 22 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386207603,"EARLY, CAROLINE, ALEXANDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386207603,"EARLY, CAROLINE, ALEXANDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 26 , 28 , 44 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386207603,"EARLY, CAROLINE, ALEXANDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1386207603,"EARLY, CAROLINE, ALEXANDRA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386208577,"TUCK, ANDREW, NICHOLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386208577,"TUCK, ANDREW, NICHOLAS",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1932856333,CHARLOTTE LIMB PRESERVATION & DIABE,,10035 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386208874,"BERGEN, CHRISTOPHER, ANDREW",10035 PARK CEDAR DR STE 100 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 23 , 31 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386209146,"HOWARD, BENJAMIN, MCKINNLEY",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 17 , 20 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386209146,"HOWARD, BENJAMIN, MCKINNLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386209146,"HOWARD, BENJAMIN, MCKINNLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1386209146,"HOWARD, BENJAMIN, MCKINNLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386210482,"KALSBEEK, MELIA, JOHNSON",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386210482,"KALSBEEK, MELIA, JOHNSON",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386212652,"RUSSEAU, TEAL, MARIE",29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386212652,"RUSSEAU, TEAL, MARIE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1386212694,BRUNSWICK OPCO HOLDINGS LLC,THE LANDINGS OF OAK ISLAND,2910 PINE PLANTATION PKWY   OAK ISLAND NC,010,Brunswick,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386212694,BRUNSWICK OPCO HOLDINGS LLC,2910 PINE PLANTATION PKWY   OAK ISLAND NC,010,Brunswick,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 13 ," 2,443 "," 2,443 "," $250,245.60 ",,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386213023,"BURGOYNE, MARY, ELIZABETH",1333 S DICKINSON DR STE 140 BELVILLE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386213023,"BURGOYNE, MARY, ELIZABETH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386213825,"TALTON, JOHN, WESLEY",2308 WESVILL CT   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386217230,"DUNCAN, AUTUMN, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487799730,KINSTON COMMUNITY HEALTH CENTER,~,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386218329,"YIU, KATHERINE",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1487799730,KINSTON COMMUNITY HEALTH CENTER,~,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386218329,"YIU, KATHERINE",324 N QUEEN ST   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 209 , 296 , 748 ," $32,468.49 ",,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386222743,"OMAR, ADAM, WAEL",8035 PROVIDENCE RD STE 340 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386224723,"IDIAGBONYA, JULIET",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386224723,"IDIAGBONYA, JULIET",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386224723,"IDIAGBONYA, JULIET",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386224723,"IDIAGBONYA, JULIET",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386224723,"IDIAGBONYA, JULIET",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386224723,"IDIAGBONYA, JULIET",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 55 , 72 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386224996,"COLT, ALEXANDRA, ADARE",19830 ZION AVE   CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 26 , 40 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386235984,"THOMAS, JORDAN, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1386238210,"KALCZYNSKI, JEFFREY, MICHAEL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659777282,STEPHEN KNOWLTON MD,~,601 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1386238442,"CURLEE, VENESSA, THERESA",1704 N HAMILTON ST APT C HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386241727,"RUPARELIA, VISHAL, PIYUSH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386241727,"RUPARELIA, VISHAL, PIYUSH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386249241,"OBLER, VICTORIA, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 33 , 37 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386251981,"ABONZA, MARITZA",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 45 , 78 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386251981,"ABONZA, MARITZA",4208 MURDOCKSVILLE RD   WEST END NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386252914,"WHITFIELD, MELITA",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 25 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386252914,"WHITFIELD, MELITA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 35 , 36 ,$#,,
MEDICAID DIRECT,1548997893,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386254068,"FRADY, COURTNEY, ELISABETH",1212 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386254068,"FRADY, COURTNEY, ELISABETH",1212 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1386254068,"FRADY, COURTNEY, ELISABETH",1212 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386254068,"FRADY, COURTNEY, ELISABETH",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1386254068,"FRADY, COURTNEY, ELISABETH",600 W TRADE ST   DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386254068,"FRADY, COURTNEY, ELISABETH",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386254068,"FRADY, COURTNEY, ELISABETH",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1386258028,ELITE HOME CARE AGENCY LLC,,2329 THE PLZ STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1386258028,ELITE HOME CARE AGENCY LLC,2329 THE PLZ STE 105 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 7,669 "," 7,669 "," $468,968.56 ",,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386258432,"MILLER, VALERIE, REENE",2609 OLD SALISBURY RD   WINSTON SALEM NC,034,Forsyth,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 14 , 36 , 57 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386260347,"MAICHE, ELIZABETH, WARRINGTON",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386261097,"OKEREKE, KELECHI, ONONAUJU",,705 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1386261097,"OKEREKE, KELECHI, ONONAUJU",705 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1386261097,"OKEREKE, KELECHI, ONONAUJU",,30 S MAIN ST   CHATHAM VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1386261097,"OKEREKE, KELECHI, ONONAUJU",30 S MAIN ST   CHATHAM VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386262640,"GRANT, LAUREN, STEPHENSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1386262640,"GRANT, LAUREN, STEPHENSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386262640,"GRANT, LAUREN, STEPHENSON",5241 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386262913,"CARSON, SAMANTHA, DENISE",90 HAYWOOD OFFICE PARK   WAYNESVILLE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1386262913,"CARSON, SAMANTHA, DENISE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 57 , 63 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386262913,"CARSON, SAMANTHA, DENISE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386263119,"SIMMONS-ROBINSON, MAKIERA, LENAE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 39 , 51 ,$#,,
MEDICAID DIRECT,1083917249,ARMC PHYSICIANS CARE INC,BURLINGTON FAMILY PRACTICE,1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386263119,"SIMMONS-ROBINSON, MAKIERA, LENAE",1041 KIRKPATRICK RD STE 200 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 38 , 61 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1386263713,"HUGGINS, JAMES, ROSS",432 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,152W00000X,Eye and Vision Services Providers,Optometrist,, 36 , 41 , 43 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,432 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193400000X,Group,Single Specialty,,1386263713,"HUGGINS, JAMES, ROSS",432 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1386263713,"HUGGINS, JAMES, ROSS",124 E MAIN ST   CLINTON NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,, 43 , 48 , 51 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1386263713,"HUGGINS, JAMES, ROSS",305 W ROSEBORO ST   ROSEBORO NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,124 E MAIN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1386263713,"HUGGINS, JAMES, ROSS",124 E MAIN ST   CLINTON NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,, 41 , 46 , 64 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,305 W ROSEBORO ST   ROSEBORO NC,082,Sampson,193400000X,Group,Single Specialty,,1386263713,"HUGGINS, JAMES, ROSS",305 W ROSEBORO ST   ROSEBORO NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1386264141,"JAMISON, KIMBERLY, MYRICK MAY",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609833490,CARTERET CLINIC FOR ADOLESCENTS AND,CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN,312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1386264141,"JAMISON, KIMBERLY, MYRICK MAY",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 60 , 137 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,256 SHENSTONE LN   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386264216,"BARKER, AUBREY, ELIZABETH",256 SHENSTONE BLVD   GARNER NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 54 , 96 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386264380,"BARLOW, JENNIFER, LYN",270 COPPERFIELD BLVD NE STE 202 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1902837073,DAVIDSON CLINIC,ATRIUM HEALTH PRIMARY CARE DAVIDSON CLINIC,705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386264380,"BARLOW, JENNIFER, LYN",705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083738645,COUNTY OF CARTERET COURTHOUSE SQUAR,~,3820 BRIDGES ST STE A MOREHEAD CITY NC,016,Carteret,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1386264513,"BROWN, EMILY, MORGAN",3820 BRIDGES ST STE A MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 43 ,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386264513,"BROWN, EMILY, MORGAN",1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 37 , 40 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386265007,"COE, BENJAMIN, NICHOLAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 152 , 156 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386265486,"CULBRETH, CAYLA, LAUREN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386265486,"CULBRETH, CAYLA, LAUREN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386265486,"CULBRETH, CAYLA, LAUREN",2138 VETERANS PKWY   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386265486,"CULBRETH, CAYLA, LAUREN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 56 , 56 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386265486,"CULBRETH, CAYLA, LAUREN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 38 , 38 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386265486,"CULBRETH, CAYLA, LAUREN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2000 PERIMETER PARK DR STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1386265858,"REGAN, EMILY, FITZGERALD",4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386267136,"NELSON, CARA, LORRAINE",1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 113 , 182 , 189 ,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,115 KILDAIRE PARK DR STE 309 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1386267136,"NELSON, CARA, LORRAINE",1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 29 , 49 ,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386267136,"NELSON, CARA, LORRAINE",1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,824 S VAN BUREN RD STE F EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1386267243,"PROBST, JAKOB, DOUGLAS",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 27 , 33 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1386267243,"PROBST, JAKOB, DOUGLAS",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1386267243,"PROBST, JAKOB, DOUGLAS",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 34 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386267243,"PROBST, JAKOB, DOUGLAS",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 69 ,$#,,
MEDICAID DIRECT,1386268183,"LIMOGIANNIS, NICOLAS, ANTHONY",,830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1386268183,"LIMOGIANNIS, NICOLAS, ANTHONY",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386269470,"PARKER, MOLLY, KATHRYN",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386269470,"PARKER, MOLLY, KATHRYN",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1386270460,"POE, JACOB, KEITH",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 18 , 18 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386270460,"POE, JACOB, KEITH",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366779928,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386271898,"RAINES, ANNA, CATHERINE",7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386271898,"RAINES, ANNA, CATHERINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386271898,"RAINES, ANNA, CATHERINE",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386272458,"SPAULDING, JOI, CAMILLE",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386272458,"SPAULDING, JOI, CAMILLE",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 37 , 49 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386272458,"SPAULDING, JOI, CAMILLE",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386273191,"TANG, RACHEL, JIE",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386273191,"TANG, RACHEL, JIE",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386273191,"TANG, RACHEL, JIE",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780643999,CHADBOURN FAMILY PRACTICE CENTER PA,~,104 E 7TH AVE   CHADBOURN NC,024,Columbus,193400000X,Group,Single Specialty,,1386275006,"BARNHILL-BLACKWELL, ELIZABETH, PAIGE",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386275006,"BARNHILL-BLACKWELL, ELIZABETH, PAIGE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 19 , 20 ,$#,,
MEDICAID DIRECT,1780643999,CHADBOURN FAMILY PRACTICE CENTER PA,~,104 E 7TH AVE   CHADBOURN NC,024,Columbus,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1386275006,"BARNHILL-BLACKWELL, ELIZABETH, PAIGE",104 E 7TH AVE   CHADBOURN NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386275006,"BARNHILL-BLACKWELL, ELIZABETH, PAIGE",703 ELIZABETH ST   TABOR CITY NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 473 , 512 ," $13,105.01 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386275006,"BARNHILL-BLACKWELL, ELIZABETH, PAIGE",703 S WALNUT ST   FAIRMONT NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386275006,"BARNHILL-BLACKWELL, ELIZABETH, PAIGE",703 S WALNUT ST   FAIRMONT NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 505 , 584 ," $11,306.72 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386276046,"BUONTEMPO, GENNARO",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386276046,"BUONTEMPO, GENNARO",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1386276046,"BUONTEMPO, GENNARO",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1386281590,CIRCLE THERAPY,CIRCLE THERAPY,614 CARDINAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1386281590,CIRCLE THERAPY,614 CARDINAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,, 130 ," 2,881 "," 5,038 "," $340,769.17 ",,
MEDICAID DIRECT,1386281590,CIRCLE THERAPY,CIRCLE THERAPY,614 CARDINAL DR   LEXINGTON NC,029,Davidson,251S00000X,Agencies,Community/Behavioral Health,,1386281590,CIRCLE THERAPY,614 CARDINAL DR   LEXINGTON NC,029,Davidson,251S00000X,Agencies,Community/Behavioral Health,, 23 , 45 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386284305,"VENTER, MARGAUX",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 38 , 73 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386284925,"PIERCE, RACHEL, ELIZABETH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386284925,"PIERCE, RACHEL, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1386287084,"NORTHUP, COURTNEY, JEAN",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1386287084,"NORTHUP, COURTNEY, JEAN",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386287084,"NORTHUP, COURTNEY, JEAN",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386287084,"NORTHUP, COURTNEY, JEAN",1026 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386287084,"NORTHUP, COURTNEY, JEAN",1026 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386287084,"NORTHUP, COURTNEY, JEAN",1026 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 19 , 23 ,$#,,
MEDICAID DIRECT,1447314075,MORCOM MEDICAL CONSULTANTS PLLC,MORCOM MEDICAL CONSULTANTS PLLC,235 JENKINS RD   DOVER NC,052,Jones,193200000X,Group,Multi-Specialty,,1386287175,"CRISCO, GRETA, HATHCOCK",235 JENKINS RD   DOVER NC,052,Jones,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 398 ," 1,018 "," 1,018 "," $26,912.61 ",,
MEDICAID DIRECT,1841929395,STEP UP CARE OF NORTH CAROLINA PC,,3250 HOMESTEAD CLUB DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386288256,"HESTER, RIKKI, MARTIN",3250 HOMESTEAD CLUB DR   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386289874,"KOSTA, IRA",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386291888,"JOHNSON, KASSI, ROSE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386291888,"JOHNSON, KASSI, ROSE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386291888,"JOHNSON, KASSI, ROSE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386291888,"JOHNSON, KASSI, ROSE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386291888,"JOHNSON, KASSI, ROSE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386291888,"JOHNSON, KASSI, ROSE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386293843,"LUCCI, ARIEL, ELIZABETH",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386293843,"LUCCI, ARIEL, ELIZABETH",1025 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386293934,"KIBLER, HANNAH, GREENE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 92 , 120 ,$#,,
MEDICAID DIRECT,1922577048,MH HIGHLANDS-CASHIERS MEDICAL CENTE,,57 WHITE OWL LN   CASHIERS NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1386295467,"SHATTENKIRK, KATHLEEN, ANNE",57 WHITE OWL LN   CASHIERS NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386297299,JOHNSTON OPCO LLC,THE LANDINGS OF SMITHFIELD,200 KELLIE DR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386297299,JOHNSTON OPCO LLC,200 KELLIE DR   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 22 ," 4,240 "," 4,240 "," $377,231.91 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386299691,"KREIS, KATHRYN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 52 , 213 , 213 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386299691,"KREIS, KATHRYN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 100 , 207 , 207 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386299691,"KREIS, KATHRYN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 63 , 110 , 112 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386299691,"KREIS, KATHRYN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 26 , 69 , 69 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,934 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386301976,"GOLDING, WESLEY, DAVID",934 COX RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386301976,"GOLDING, WESLEY, DAVID",2525 COURT DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1386305878,"SANDLIN, AUSTIN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386306561,"JACOBS, BRANDIE, NICOLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 120 , 907 , 981 ," $24,369.80 ",,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386308211,"MCGEHEE, JONATHAN, MILES",1330 BOILING SPRINGS RD STE 1700 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386312601,"FRANZESE, KELLY, ANNE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386312601,"FRANZESE, KELLY, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 25 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386312601,"FRANZESE, KELLY, ANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 26 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386312601,"FRANZESE, KELLY, ANNE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386312601,"FRANZESE, KELLY, ANNE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386312601,"FRANZESE, KELLY, ANNE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386314102,"PADRON ESPINOSA, ANDERSSON",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1386314342,"ROBBINS, MORGAN, SISK",113 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1750068219,DLP RUTHERFORD PHYSICIAN PRACTICES,FOREST CITY FAMILY CARE RHC,212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1386314342,"ROBBINS, MORGAN, SISK",113 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 224 , 281 ," $11,449.91 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386315158,"BAKKEN, MADISON, MCKENZIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386315422,"DANAHEY, SAVANNAH, LYN",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 37 , 108 , 109 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386315422,"DANAHEY, SAVANNAH, LYN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386317642,"SPENCER, PHILIP, DONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386317642,"SPENCER, PHILIP, DONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386317642,"SPENCER, PHILIP, DONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386317808,"TIEU, SOPHIA, TRAN HOAI HUONG",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386317808,"TIEU, SOPHIA, TRAN HOAI HUONG",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295881712,PRIVATE DIAGNOSTIC CLINIC PLLC,GYN CLINIC,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1386317808,"TIEU, SOPHIA, TRAN HOAI HUONG",3000 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386318772,"ADDIS, CALLISTA, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679117048,EASTERN VIRGINIA ANESTHESIA LLC,,208 CARMICHAEL WAY   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386319598,"MENDOZA, DARRELL, NATHAN",208 CARMICHAEL WAY   CHESAPEAKE VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1386323715,"MESSAMER, SAMANTHA, BRYCE",1840 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1386323715,"MESSAMER, SAMANTHA, BRYCE",1840 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386323715,"MESSAMER, SAMANTHA, BRYCE",1840 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1386323715,"MESSAMER, SAMANTHA, BRYCE",1840 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386325116,"GILBERT, REBECCA, BANKS",110 EASTWOOD DR   WALLACE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821681271,SANDY SHORES MEDICAL CENTER AND URG,,13741 NC HIGHWAY 50 STE A HOLLY RIDGE NC,071,Pender,193200000X,Group,Multi-Specialty,,1386325116,"GILBERT, REBECCA, BANKS",110 EASTWOOD DR   WALLACE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386325124,QEH TRANSPORT LLC,STELLARMED MOBILE TRANSPORT,4355 GUM BRANCH RD STE A JACKSONVILLE NC,067,Onslow,3416L0300X,Transportation Services,Ambulance,Land Transport,1386325124,QEH TRANSPORT LLC,4355 GUM BRANCH RD STE A JACKSONVILLE NC,067,Onslow,3416L0300X,Transportation Services,Ambulance,Land Transport, 35 , 52 , 104 ,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386326007,"BRYSON, JENNA, RENEE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1437908209,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WEST LINCOLN HIGH,172 SHOAL RD   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386326007,"BRYSON, JENNA, RENEE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1194286328,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT NEWTON-CONOVER HIGH,338 W 15TH ST   NEWTON NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386326007,"BRYSON, JENNA, RENEE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,934 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386340511,"WESTMORELAND, BARRY, LEE",934 COX RD   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386340511,"WESTMORELAND, BARRY, LEE",2525 COURT DR   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1437459021,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH UROLOGY LINCOLN,441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1386340511,"WESTMORELAND, BARRY, LEE",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 75 , 132 , 177 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386341113,"LOLL, RYAN, FITZPATRICK",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 31 , 35 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386341113,"LOLL, RYAN, FITZPATRICK",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 30 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1386352698,"JONES, RAVEN, SHARIE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 23 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386352698,"JONES, RAVEN, SHARIE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386357440,"BRUFF-YOUNTS, OLIVIA, MARIE",444 SW CENTER ST   FAISON NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386359107,"NEIBERGER, ANGELINA, THERESA",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386359107,"NEIBERGER, ANGELINA, THERESA",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386360410,"VOSS, JENNIFER, LYNN",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386360410,"VOSS, JENNIFER, LYNN",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386360410,"VOSS, JENNIFER, LYNN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386362234,"SHELL, ASHLEY, ANNA",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 27 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386362234,"SHELL, ASHLEY, ANNA",1919 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 135 , 240 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386376887,"JANSEN, ZACHARY, PAUL",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 23 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386376887,"JANSEN, ZACHARY, PAUL",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,10030 GREEN LEVEL CHURCH RD STE 808 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1386377414,"GEDMINAS, SARAH, ELIZABETH",10030 GREEN LEVEL CHURCH RD STE 808 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1386377414,"GEDMINAS, SARAH, ELIZABETH",781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205566379,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES SALISBURY,480 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1386383404,"SMITH, HANNA, LYNN",480 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1174234538,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES MOCKSVILLE,562 VALLEY RD STE 102 MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1386383404,"SMITH, HANNA, LYNN",480 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1174234538,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES MOCKSVILLE,562 VALLEY RD STE 102 MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1386383404,"SMITH, HANNA, LYNN",275 N MAIN ST STE B TROUTMAN NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649750183,CARNAGGIO AND PIPER DMD MS PA,~,275 N MAIN ST STE B TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386383404,"SMITH, HANNA, LYNN",275 N MAIN ST STE B TROUTMAN NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 12 , 27 ,$#,,
MEDICAID DIRECT,1174234538,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES MOCKSVILLE,562 VALLEY RD STE 102 MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1386383404,"SMITH, HANNA, LYNN",562 VALLEY RD STE 102 MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice, 57 , 74 , 179 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386387934,"BRANNON, ELIZABETH, BLYE",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 16 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386390920,"WHITE, PATRICE, LASHAWN",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386390920,"WHITE, PATRICE, LASHAWN",700 WALTER REED DR   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1154954550,LANE AND ASSOCIATES XXXVII DDS PA,,473 WOOD ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1386392629,"BROCK, JEREMY, DUSTIN",131 MONTGOMERY XING   BISCOE NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 410 , 784 ," 2,347 "," $161,978.17 ",,
MEDICAID DIRECT,1841694254,LANE AND ASSOCIATES XXVIII DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1386392629,"BROCK, JEREMY, DUSTIN",131 MONTGOMERY XING   BISCOE NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 35 , 96 ,$#,,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1386392629,"BROCK, JEREMY, DUSTIN",131 MONTGOMERY XING   BISCOE NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 626 ," 1,028 "," 3,573 "," $195,474.08 ",,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386398337,"BURRELL, KRISTIANA, TWEED",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 192 , 235 ," $12,852.10 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386399152,"HARDISON, CONNOR, ROSE",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 142 , 251 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1386399152,"HARDISON, CONNOR, ROSE",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1386399343,"SWINDELL, HANNAH, ELIZABETH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 43 , 86 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386399343,"SWINDELL, HANNAH, ELIZABETH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,666 W CORBETT AVE   SWANSBORO NC,067,Onslow,193200000X,Group,Multi-Specialty,,1386399343,"SWINDELL, HANNAH, ELIZABETH",666 W CORBETT AVE   SWANSBORO NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1386409688,"HODGES, MERCEDES, SUZANNE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 27 , 60 ,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1386409688,"HODGES, MERCEDES, SUZANNE",440 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1437653359,SANDHILLS BEHAVIORAL CARE PLLC,SANDHILLS BEST CARE,523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1386411478,"MURPHY, ROSEMARIE, ELLEN",523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 25 , 40 , 44 ,$#,,
MEDICAID DIRECT,1063948297,RDMG ASSOCIATES PA,SPINDALE FAMILY PRACTICE,144 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1386415339,"ROBERTSON, TIFFANY, LEE",144 RESERVATION DR   SPINDALE NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 46 , 88 ,$#,,
MEDICAID DIRECT,1063948297,RDMG ASSOCIATES PA,SPINDALE FAMILY PRACTICE,144 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1386415339,"ROBERTSON, TIFFANY, LEE",31 CALIFORNIA AVE   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386415339,"ROBERTSON, TIFFANY, LEE",31 CALIFORNIA AVE   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386416527,"BRILEY, EMILY, AMES",503 COVIL AVE STE 100 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386416527,"BRILEY, EMILY, AMES",9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1457696361,BLACK MOUNTAIN PHYSICAL THERAPY LLC,PHOENIX REHABILITATION AND HEALTH SERVICES INC,10610 METROMONT PKWY STE 108 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386416972,"RICCIUTI, JOHN, C",10610 METROMONT PKWY STE 108 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 53 , 102 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386420610,"HUBBARD, DANIELLE, MARIE",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1585 FORNEY CREEK PKWY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386420610,"HUBBARD, DANIELLE, MARIE",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 13 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1386420610,"HUBBARD, DANIELLE, MARIE",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386420610,"HUBBARD, DANIELLE, MARIE",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,101 E W T HARRIS BLVD STE 4001 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386420610,"HUBBARD, DANIELLE, MARIE",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386420610,"HUBBARD, DANIELLE, MARIE",16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386420792,"LUCK, CAMIEKO, CHANTESE",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 36 , 53 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386423523,"HICKEY, KATIE, SWAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 59 , 59 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386423523,"HICKEY, KATIE, SWAN",15 REGIONAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386423523,"HICKEY, KATIE, SWAN",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 74 , 77 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386423523,"HICKEY, KATIE, SWAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386425353,"REDDINGER, SAMUEL, LARUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386425353,"REDDINGER, SAMUEL, LARUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386425353,"REDDINGER, SAMUEL, LARUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386425353,"REDDINGER, SAMUEL, LARUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386465045,SOUTHPORT SPEECH AND LANGUAGE PLLC,,1746 E CORONADO AVE SE   BOLIVIA NC,010,Brunswick,193400000X,Group,Single Specialty,,1386465045,SOUTHPORT SPEECH AND LANGUAGE PLLC,1746 E CORONADO AVE SE   BOLIVIA NC,010,Brunswick,193400000X,Group,Single Specialty,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386468239,"GILLIAM, JONATHAN, CALVIN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386468239,"GILLIAM, JONATHAN, CALVIN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386473064,JENNETTA SPEARS PT DPT LLC,,204 LYNN DR   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1386473064,JENNETTA SPEARS PT DPT LLC,204 LYNN DR   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1679824676,KIDZCARE PEDIATRICS PC,~,2501 S MEBANE ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386473767,"DICKSON, TERESA, ANN",2501 S MEBANE ST   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 30 , 72 ,$#,,
MEDICAID DIRECT,1700323557,GREENVILLE HEALTH CARE PA,,3121 MOSELEY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386478907,"WILLIAMSON, NOAH, LUKE",3121 MOSELEY DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386480192,"BRENNAN, KELEY, RADCLIFFE",333 E LEE AVE   YADKINVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 200 , 200 ,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386480192,"BRENNAN, KELEY, RADCLIFFE",10021 PARK CEDAR DR SUITE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 404 , 404 ," $13,619.78 ",,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1386481091,"MANCINO, MADISON, BROOKE",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1386481091,"MANCINO, MADISON, BROOKE",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1386481091,"MANCINO, MADISON, BROOKE",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 28 , 30 ,$#,,
MEDICAID DIRECT,1568464386,GREENE COUNTY HEALTH CARE INC,GREENE DENTAL SERVICES,6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386481489,"POPE, MIKAELA, YAZMEEN",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386481489,"POPE, MIKAELA, YAZMEEN",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 99 , 110 , 286 ," $13,221.95 ",,
MEDICAID DIRECT,1073386165,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT BESSEMER CITY HIGH,119 YELLOW JACKET LN   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386481745,"BOYD, SHANNON, SHANTEL",119 YELLOW JACKET LN   BESSEMER CITY NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386487544,"QUINTANILLA, JULISSA",444 SW CENTER ST   FAISON NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700901287,GOSHEN MEDICAL CENTER INCORPORATED,COMMUNITY HEALTH SERVICES,325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386487544,"QUINTANILLA, JULISSA",325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386490357,"BARNES, HALEY, ANN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386491199,"LEININGER, BRENNAN, ROBERT",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 26 , 56 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386491579,"LAMPRECHT, TESS",509 BILTMORE AVENUE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 11 , 13 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1386494490,"KLEPPER, LAUREN, MARIE",451 E CHARLOTTE AVE   MT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1386494490,"KLEPPER, LAUREN, MARIE",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1386494490,"KLEPPER, LAUREN, MARIE",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1578702775,FAYETTEVILLE VASCULAR AND VEIN CENT,SANDHILLS SURGICAL ASSOCIATES,3410 VILLAGE DR STE 200 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1386601045,"LEKE, MICHAEL, ACHANYI",3410 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 227 , 776 ," 1,360 "," $68,001.35 ",,
MEDICAID DIRECT,1386601045,"LEKE, MICHAEL, ACHANYI",MICHAEL ACHANYI LEKE MD,3410 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1386601045,"LEKE, MICHAEL, ACHANYI",3410 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386603710,"SHANMUGAM, CHAMUNDAMBIKA",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386604213,"RAINEY, DAVID, YOTHAM",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386604213,"RAINEY, DAVID, YOTHAM",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 85 , 155 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386605640,"CHRISTINE, CYBELE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386605996,"WOLFF, THOMAS, VINCENT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 62 , 259 , 260 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386606028,"ERVIN, SHANNON, RUTH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 25 , 28 ,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386606275,"KIKEL, STEPHEN, PHILLIP",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386606564,"BAILEY, CORTIS, WARD",4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386606564,"BAILEY, CORTIS, WARD",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386606564,"BAILEY, CORTIS, WARD",5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 63 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386606564,"BAILEY, CORTIS, WARD",8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,1442 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386606564,"BAILEY, CORTIS, WARD",1442 MILITARY CUT OFF RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386606564,"BAILEY, CORTIS, WARD",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386606564,"BAILEY, CORTIS, WARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386607653,"LYNCH, EDWARD, MICHAEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1386608115,"POINTON, CATHERINE, JEANNE",12611 N COMMUNITY HOUSE RD   CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386608404,"CARLUCCI, MELISSA, ANN",104 MEDSPRING DR   CLAYTON NC,051,Johnston,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 13 , 16 , 22 ,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386608404,"CARLUCCI, MELISSA, ANN",1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 19 , 28 , 43 ,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386608404,"CARLUCCI, MELISSA, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386608404,"CARLUCCI, MELISSA, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386608404,"CARLUCCI, MELISSA, ANN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386608495,"HARDY, STUART, MCDOWELL",8115 MARKET ST STE 200 WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 54 , 62 , 103 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386608495,"HARDY, STUART, MCDOWELL",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386608495,"HARDY, STUART, MCDOWELL",2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 142 , 205 , 295 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386608495,"HARDY, STUART, MCDOWELL",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386608784,"KULIK, ANN, MARIE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 83 , 176 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386608784,"KULIK, ANN, MARIE",4443 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1386609220,"POLLOCK, RICHARD, ALLISON",400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386610632,"GLANCE, GREGORY, LYNN",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 65 ,$#,,
MEDICAID DIRECT,1699878207,ASHEVILLE INTERNAL MEDICINE,ASHEVILLE INTERNAL MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1386610632,"GLANCE, GREGORY, LYNN",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386614089,"DILLON, AMY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 44 , 44 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386614162,"PETERS IV, ROBERT, BROOKES",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 98 , 98 ,$#,,
MEDICAID DIRECT,1588091904,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS PIEDMONT PEDIATRIC,1085 NE GATEWAY CT NE STE 290 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386615060,"BELDEN, LEONA, MATL",1085 NE GATEWAY CT NE STE 290 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 48 , 98 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1386616415,"DOUGHERTY, PATRICK, JEROLD",1004 DRESSER CT STE 102 RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 45 , 62 , 123 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1386616415,"DOUGHERTY, PATRICK, JEROLD",3801 WAKE FOREST RD   RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 138 , 264 , 623 ,$#,,
MEDICAID DIRECT,1932702107,FOOT AND ANKLE SPECIALISTS OF THE M,,3801 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386616415,"DOUGHERTY, PATRICK, JEROLD",3801 WAKE FOREST RD   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1386616415,"DOUGHERTY, PATRICK, JEROLD",451 RUIN CREEK RD STE 202 HENDERSON NC,091,Vance,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1063037950,FOOT AND ANKLE SPECIALISTS OF THE M,,451 RUIN CREEK RD STE 202 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1386616415,"DOUGHERTY, PATRICK, JEROLD",451 RUIN CREEK RD STE 202 HENDERSON NC,091,Vance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1386616415,"DOUGHERTY, PATRICK, JEROLD",451 RUIN CREEK RD STE 202 HENDERSON NC,091,Vance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 313 , 528 ," 1,343 "," $17,612.34 ",,
MEDICAID DIRECT,1063037950,FOOT AND ANKLE SPECIALISTS OF THE M,,451 RUIN CREEK RD STE 202 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1386616415,"DOUGHERTY, PATRICK, JEROLD",451 RUIN CREEK RD STE 202 HENDERSON NC,091,Vance,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386617090,"ERWIN, MACK, EARL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 63 , 63 ,$#,,
MEDICAID DIRECT,1962926451,SOUTHEASTERN REGIONAL MEDICAL CENTE,SRMC-INTENSIVISTS,300 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1386617389,"THOMAS, EDWARD, ARMISTEAD",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386617710,"CHRISTOFFERSEN, BRETT",11840 SOUTHMORE DR STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 36 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386617710,"CHRISTOFFERSEN, BRETT",11840 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386618379,"WHITAKER, ANN, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386618379,"WHITAKER, ANN, ELIZABETH",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1386619278,"BUTCHER, ELIZABETH, ANNE",133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 85 , 105 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1386619278,"BUTCHER, ELIZABETH, ANNE",803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386620136,"OTTER, OLGA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1386620136,"OTTER, OLGA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 25 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386620136,"OTTER, OLGA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386620318,"PAUL, AMY, LEIGH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386620318,"PAUL, AMY, LEIGH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 45 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386620318,"PAUL, AMY, LEIGH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 18 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386620318,"PAUL, AMY, LEIGH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386623312,"BULL, THOMAS, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 59 , 62 , 69 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1386624831,"KESSEL, SHELIA, DAWN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386626240,"FOWLER, REGINALD, JAYE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386626240,"FOWLER, REGINALD, JAYE",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,,,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386626240,"FOWLER, REGINALD, JAYE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 11 , 16 , 18 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386626240,"FOWLER, REGINALD, JAYE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 11 , 17 , 18 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386626240,"FOWLER, REGINALD, JAYE",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 127 , 151 , 392 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386626828,"FINICAL, ERIC, JAMES",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 127 , 184 , 210 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1386626828,"FINICAL, ERIC, JAMES",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 251 , 358 , 397 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,640 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386627115,"MEMOLO, MARK, WILLIAM",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085U0001X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Ultrasound,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,640 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386627115,"MEMOLO, MARK, WILLIAM",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386627115,"MEMOLO, MARK, WILLIAM",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 149 , 181 , 230 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386627115,"MEMOLO, MARK, WILLIAM",620 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 182 , 201 , 268 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386627602,"ROBSON, MICHAEL, GAVIN",1248 HUFFMAN MILL RD STE 104 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 32 , 43 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386627602,"ROBSON, MICHAEL, GAVIN",1248 HUFFMAN MILL RD STE 104 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,509 N ELAM AVE STE 300-D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386627602,"ROBSON, MICHAEL, GAVIN",509 N ELAM AVE STE 300-D GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 72 , 98 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386627602,"ROBSON, MICHAEL, GAVIN",509 N ELAM AVE STE 300-D GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 58 , 68 ,$#,,
MEDICAID DIRECT,1659673838,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT SENIOR CARE,1309 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386627602,"ROBSON, MICHAEL, GAVIN",1309 N ELM ST   GREENSBORO NC,041,Guilford,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386627610,"CASEY, VIRGINIA, FISHBURNE",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 57 , 74 , 153 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386627610,"CASEY, VIRGINIA, FISHBURNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386627610,"CASEY, VIRGINIA, FISHBURNE",710 PARK CENTER DR   MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 30 , 51 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386627610,"CASEY, VIRGINIA, FISHBURNE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386627610,"CASEY, VIRGINIA, FISHBURNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 19 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386627610,"CASEY, VIRGINIA, FISHBURNE",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,338 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1386627677,"SOBOL, ANNA, LUCY",336 DEERFIELD RD   BOONE NC,095,Watauga,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 16 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1386627677,"SOBOL, ANNA, LUCY",336 DEERFIELD RD   BOONE NC,095,Watauga,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1386627677,"SOBOL, ANNA, LUCY",336 DEERFIELD RD   BOONE NC,095,Watauga,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 36 , 72 , 127 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386628535,"STIEFEL, ERIC, BOND",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770615114,PROMED HEALTHCARE PLLC,~,7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386628923,"OWENSBY, CHARLTON, NORMAN",7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1386629988,"DZIWANOWSKI, JENNIFER, SCHWARTZ",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1386629988,"DZIWANOWSKI, JENNIFER, SCHWARTZ",702 NEWMAN RD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 140 , 263 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1386629988,"DZIWANOWSKI, JENNIFER, SCHWARTZ",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 32 , 119 ,$#,,
MEDICAID DIRECT,1700552270,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-ROBESON FAMILY PRACTICE,1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386630564,"CHAVIS, HERMAN",1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 229 ," 1,203 "," 1,546 "," $35,676.51 ",,
MEDICAID DIRECT,1801922901,ROBESON FAMILY PRACTICE ASSOCIATES,ROBESON FAMILY PRACTICE ASSOCIATES,,,Unknown,193400000X,Group,Single Specialty,,1386630564,"CHAVIS, HERMAN",1002C E 4TH AVE   RED SPRINGS NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386631075,"MILROY, GREGORY, TODD",3173 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962086793,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA PEDIATRIC MEDICINE - SHELBY,1019 N LAFAYETTE ST   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386631075,"MILROY, GREGORY, TODD",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386631075,"MILROY, GREGORY, TODD",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386631760,"THOMPSON, MARK, ALLEN",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 180 , 258 , 336 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386631760,"THOMPSON, MARK, ALLEN",2525 COURT DR   GASTONIA NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386632826,"CAMP, JOHN, FREDERICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1558351726,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE PIEDMONT,1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386634541,"HOFFMANN, INGRID, MARGARETE",1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 60 , 165 , 191 ,$#,,
MEDICAID DIRECT,1386635993,ASH-RAND RESCUE AND EMS,ASH RAND RESCUE AND EMS,805 S COX ST   ASHEBORO NC,076,Randolph,3416L0300X,Transportation Services,Ambulance,Land Transport,1386635993,ASH-RAND RESCUE AND EMS,805 S COX ST   ASHEBORO NC,076,Randolph,3416L0300X,Transportation Services,Ambulance,Land Transport, 154 , 203 , 389 ,$#,,
MEDICAID DIRECT,1386636462,"ROUPAS, ANASTASI, JOHN",~,5833 PHYLISS LN   MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1386636462,"ROUPAS, ANASTASI, JOHN",5833 PHYLISS LN   MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#, 17 , 47 ,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386636686,"EVANS, WILLIAM, ANDREW",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386636942,"GOUGH, JOHN, EDWARD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",300 W 27TH ST   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 20 , 36 ,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1386638260,"TURLINGTON IV, WILLIAM, TROY",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 61 , 84 , 116 ," $13,588.65 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",300 W 27TH ST   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",923 W 3RD ST   PEMBROKE NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1386638260,"TURLINGTON IV, WILLIAM, TROY",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1821083551,BLUE RIDGE DERMATOLOGY PA,BLUE RIDGE DERMATOLOGY PA,540 HOSPITAL DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1386639524,"MASTERS, MICHAEL, JASON",540 HOSPITAL DR   CLYDE NC,044,Haywood,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 38 ,$#,,
MEDICAID DIRECT,1124083753,CAROLINA SURGERY AND CANCER CENTER,CAROLINA SURGERY AND CANCER CENTER PLLC,1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1386640514,"MCCLUER, BRYAN, ANDREW",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 28 , 33 ,$#,,
MEDICAID DIRECT,1558126276,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY SURGERY & CANCER CENTER,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386640514,"MCCLUER, BRYAN, ANDREW",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 47 , 53 ,$#,,
MEDICAID DIRECT,1558126276,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY SURGERY & CANCER CENTER,1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386640514,"MCCLUER, BRYAN, ANDREW",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1386641850,"ERCOLINO, PETER, SALVATORE",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 54 , 141 ,$#,,
MEDICAID DIRECT,1619904430,SOUTH CHARLOTTE PRIMARY CARE,ATRIUM HEALTH PRIMARY CARE SOUTH CHARLOTTE INTERNA,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386642270,"HUNKELE, KIMBERLY, DAWN",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386643609,"NEWMAN, MARK, GLIDWELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 131 , 166 , 226 ," $20,423.19 ",,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1386643609,"NEWMAN, MARK, GLIDWELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1295030989,OPTOMETRIC EYE CLINIC PA,OPTOMETRIC EYE CLINIC,622 N MAIN ST   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386643757,"WIKE, PEGGY, LYNN",622 N MAIN ST   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386644474,"GOODMAN, SARAH, ELIZABETH",4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 25 , 42 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386644474,"GOODMAN, SARAH, ELIZABETH",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841269305,INTERNAL MEDICINE ASSOCIATES,INTERNAL MEDICINE ASSOC,3850 ED DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386646453,"LIEBOWITZ, STEVEN, MARC",3850 ED DR STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 45 , 45 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386646628,"BLAIR, RICHARD, DANIEL",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 74 , 93 , 200 ," $18,624.08 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386646628,"BLAIR, RICHARD, DANIEL",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 37 , 68 , 450 ," $23,267.88 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,970 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1386646628,"BLAIR, RICHARD, DANIEL",970 NEWMAN RD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 67 , 87 , 268 ," $49,813.92 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386646628,"BLAIR, RICHARD, DANIEL",970 NEWMAN RD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386646628,"BLAIR, RICHARD, DANIEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 35 , 64 , 64 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386647808,"SMITH, LEANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1386649598,"DHILLON, GURMEET",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1386651826,"CRUMPLER, LAURA, JEAN",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386651826,"CRUMPLER, LAURA, JEAN",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1386656916,"MITCHELL, BRIAN, PATRICK",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1386656916,"MITCHELL, BRIAN, PATRICK",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1386656932,"DANIELS, MARY, LEIGH ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386656932,"DANIELS, MARY, LEIGH ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 61 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386656932,"DANIELS, MARY, LEIGH ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 44 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386656932,"DANIELS, MARY, LEIGH ANNE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386656932,"DANIELS, MARY, LEIGH ANNE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 35 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386656932,"DANIELS, MARY, LEIGH ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386658383,"HUMES, ILONA, SPITSYNA",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386658383,"HUMES, ILONA, SPITSYNA",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386658383,"HUMES, ILONA, SPITSYNA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 50 , 99 , 106 ," $11,623.09 ",,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386658383,"HUMES, ILONA, SPITSYNA",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 80 , 114 , 124 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386658383,"HUMES, ILONA, SPITSYNA",441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386658391,"TROTTER, KATHRYN, JANE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386658391,"TROTTER, KATHRYN, JANE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386659464,WALGREEN CO,WALGREENS 02540,2184 BLOWING ROCK RD   BOONE NC,095,Watauga,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1386659464,WALGREEN CO,2184 BLOWING ROCK RD   BOONE NC,095,Watauga,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1386660066,"TONUZI, LIRM",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1790809531,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - WEST,1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386660066,"TONUZI, LIRM",1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 116 , 214 , 330 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386660173,"WADE, WILLIAM, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386661536,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1312,670 LILLINGTON HWY   SPRING LAKE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1386661536,WAL-MART STORES EAST LP,670 LILLINGTON HWY   SPRING LAKE NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1255672473,PRIVATE DIAGNOSTIC CLINIC PLLC,KERNODLE CLINIC - WEST,,,Unknown,193200000X,Group,Multi-Specialty,,1386662435,"CLINE, TODD, WILLIAM",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386662435,"CLINE, TODD, WILLIAM",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 164 , 271 , 385 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386662435,"CLINE, TODD, WILLIAM",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386662435,"CLINE, TODD, WILLIAM",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386662435,"CLINE, TODD, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 48 , 85 , 121 ,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1386662708,"ADKINS III, SAMUEL, BRENTON",149 W PARKER RD STE A MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 109 , 264 ,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1386662708,"ADKINS III, SAMUEL, BRENTON",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 68 , 201 ,$#,,
MEDICAID DIRECT,1386663698,"MOSESSON, JAY, FORREST",ACTIVE SPINE PHYSICAL THERAPY,1717 LEGION RD STE 102 CHAPEL HILL NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1386663698,"MOSESSON, JAY, FORREST",1717 LEGION RD STE 102 CHAPEL HILL NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1790809531,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - WEST,1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386664019,"MOSER, ERIC, TODD",1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 193 , 327 , 515 ," $46,767.14 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386664647,"JOHNSON WILLIAMS, TARA, CLARINDA",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386664647,"JOHNSON WILLIAMS, TARA, CLARINDA",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386664647,"JOHNSON WILLIAMS, TARA, CLARINDA",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386664670,"FRIEDLAND, MICHAEL, BRIAN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 31 , 65 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386664670,"FRIEDLAND, MICHAEL, BRIAN",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 40 , 59 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386664670,"FRIEDLAND, MICHAEL, BRIAN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 21 , 37 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386664670,"FRIEDLAND, MICHAEL, BRIAN",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1992126403,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM NEUROLOGY,101 ELDON PARKS DR STE B ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1386667343,"MEADOWS, ROBERT, STEVEN",100 CHATHAM DR   ELKIN NC,086,Surry,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1992126403,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM NEUROLOGY,101 ELDON PARKS DR STE B ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1386667343,"MEADOWS, ROBERT, STEVEN",100 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 125 , 179 , 225 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386668234,"HAIRE, RICHARD, EUGENE",75 EMERSON BAY RD STE 102 CAROLINA SHORES NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 28 , 44 ,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1386668879,"GORDIN, STEPHEN, JACOB",1000 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1386668879,"GORDIN, STEPHEN, JACOB",1000 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1386668879,"GORDIN, STEPHEN, JACOB",125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386672863,"OXENDINE, VICTORIA, FAYE",706 N THOMPSON ST   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386672863,"OXENDINE, VICTORIA, FAYE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 20 , 29 ,$#,,
MEDICAID DIRECT,1386672863,"OXENDINE, VICTORIA, FAYE",VICTORIA FAYE OXENDINE,1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1386672863,"OXENDINE, VICTORIA, FAYE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386672863,"OXENDINE, VICTORIA, FAYE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386673267,"GUPTA, OLGA, THERESA",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 18 , 29 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386673267,"GUPTA, OLGA, THERESA",3000 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386673267,"GUPTA, OLGA, THERESA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386673267,"GUPTA, OLGA, THERESA",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386673580,"SCHOTTHOEFER, ERIN, OMALLEY",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386673580,"SCHOTTHOEFER, ERIN, OMALLEY",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386673580,"SCHOTTHOEFER, ERIN, OMALLEY",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386673580,"SCHOTTHOEFER, ERIN, OMALLEY",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 100 , 116 , 130 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386673580,"SCHOTTHOEFER, ERIN, OMALLEY",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 43 , 50 , 59 ,$#,,
MEDICAID DIRECT,1053921874,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE OBERLIN,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386674083,"FOWLER, VICKIE, ANN",601 OBERLIN RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386677441,"GARMON, KELLY, HILL",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386677441,"GARMON, KELLY, HILL",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386677441,"GARMON, KELLY, HILL",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1407369440,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRICS SYMPHONY PARK,6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386677896,"VAN VOORHIS, KERRY, THOMAS",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386677896,"VAN VOORHIS, KERRY, THOMAS",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 48 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386678225,"AKDAMAR, MURAT, KEMAL",112 KINDERTON BLVD STE 100 ADVANCE NC,030,Davie,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 38 , 56 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386678225,"AKDAMAR, MURAT, KEMAL",195 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 61 , 77 , 107 ,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386678514,"PIEHL, MARK, DONALD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 18 , 35 , 39 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 29 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 20 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 38 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",104 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1386679546,"CLEMENS, DENNIS, MARK",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1386683209,"AMEZAGA, JESSE, REFUGIO",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1386683209,"AMEZAGA, JESSE, REFUGIO",1705 TARBORO ST SW   WILSON NC,098,Wilson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386683498,"MORRIS, MARK, DAVID",1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386683498,"MORRIS, MARK, DAVID",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 30 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386683498,"MORRIS, MARK, DAVID",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386683944,"BRIDGER, DEWEY, HERBERT",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386683944,"BRIDGER, DEWEY, HERBERT",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 109 , 317 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1386683944,"BRIDGER, DEWEY, HERBERT",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386683944,"BRIDGER, DEWEY, HERBERT",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386684330,"KIM, JAMES, YOUNGCHULL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 40 , 40 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386684330,"KIM, JAMES, YOUNGCHULL",1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063647394,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - FOR,2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386686319,"STEWART, WILLIAM, PASCHAL",2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 22 , 43 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386686343,"GUPTA, RUCHI",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1386688851,"BERGER, ROBERT",434 CONFEDERATE DR   CLAYTON GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1386688851,"BERGER, ROBERT",434 CONFEDERATE DR   CLAYTON GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1386688851,"BERGER, ROBERT",434 CONFEDERATE DR   CLAYTON GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 49 , 70 ,$#,,
MEDICAID DIRECT,1386691152,CHEROKEE COUNTY,CHEROKEE COUNTY EMS,59 HIWASSEE ST STE 105 MURPHY NC,020,Cherokee,3416L0300X,Transportation Services,Ambulance,Land Transport,1386691152,CHEROKEE COUNTY,59 HIWASSEE ST STE 105 MURPHY NC,020,Cherokee,3416L0300X,Transportation Services,Ambulance,Land Transport, 214 , 341 , 640 ," $11,059.44 ",,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386691350,"DENTON, ROBERT, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 21 , 30 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1386691350,"DENTON, ROBERT, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1386691707,"HANKLEY, DANIEL, WALTER",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 15 , 33 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386691707,"HANKLEY, DANIEL, WALTER",2585 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 54 , 76 , 133 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1386691855,"LOYNES, JAMES, THOMAS",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386692408,"SEBASTIANO, SONIA, LAU",1450 MATTHEWS TOWNSHIP PKWY STE 170 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386692408,"SEBASTIANO, SONIA, LAU",1450 MATTHEWS TOWNSHIP PKWY STE 355 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 61 , 82 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386692580,"BELT, HOLLIE, SUE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386693299,"VARNER JR, DONALD, RICHARD",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 58 , 88 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386693299,"VARNER JR, DONALD, RICHARD",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 30 , 48 , 77 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386693299,"VARNER JR, DONALD, RICHARD",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 18 , 24 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386693299,"VARNER JR, DONALD, RICHARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386694586,"KANSUPADA, KASHYAP, BHARAT",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386694586,"KANSUPADA, KASHYAP, BHARAT",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 16 , 23 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,400 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386694586,"KANSUPADA, KASHYAP, BHARAT",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386694586,"KANSUPADA, KASHYAP, BHARAT",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 51 , 84 , 126 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386694735,"GHANDI, MOHAMMAD, REZA",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1386696714,"TEWES, JODI, MEADOWS",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386698256,"DUNLOP, RICHARD, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386698256,"DUNLOP, RICHARD, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386698256,"DUNLOP, RICHARD, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 179 , 181 , 210 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386698256,"DUNLOP, RICHARD, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386698256,"DUNLOP, RICHARD, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386698256,"DUNLOP, RICHARD, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386698256,"DUNLOP, RICHARD, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932661246,RALEIGH DURHAM MEDICAL GROUP PA,HEALTHPARK PEDIATRICS,8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386699403,"DUBAL, NIRALI, MANISH",8300 HEALTH PARK STE 213 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1386700268,FOSTER DRUG OF MOCKSVILLE,~,495 VALLEY RD   MOCKSVILLE NC,030,Davie,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1386700268,FOSTER DRUG OF MOCKSVILLE,495 VALLEY RD   MOCKSVILLE NC,030,Davie,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1386700284,SOUTHERN ASSISTED LIVING INC,BROOKDALE WEDDINGTON PARK,2404 PLANTATION CENTER DR   MATTHEWS NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386700284,SOUTHERN ASSISTED LIVING INC,2404 PLANTATION CENTER DR   MATTHEWS NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 334 , 334 ," $20,978.53 ",,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386702066,"HANCOCK JR, JAMES, EVERETT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386702066,"HANCOCK JR, JAMES, EVERETT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 103 , 210 , 280 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386702066,"HANCOCK JR, JAMES, EVERETT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 30 ,$#,,
MEDICAID DIRECT,1275691115,CHAUVIN AND CHAUVIN DDS PA,CHAUVIN AND CHAUVIN DDS PA,816 LOWER DALLAS HWY   DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1386702223,"CHAUVIN, JEFFREY, MICHAEL",816 LOWER DALLAS HWY   DALLAS NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 231 , 564 ," 1,532 "," $66,058.46 ",,
MEDICAID DIRECT,1386702256,HOME LIFE CARE INC,~,990 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1386702256,HOME LIFE CARE INC,990 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 60 ," 10,069 "," 10,597 "," $947,704.37 ",,
MEDICAID DIRECT,1386702892,THE ARC OF HAYWOOD COUNTY INC,HAYWOOD COUNTY GROUP HOME,75 MAPLE ST   WAYNESVILLE NC,044,Haywood,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386702892,THE ARC OF HAYWOOD COUNTY INC,75 MAPLE ST   WAYNESVILLE NC,044,Haywood,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 268 , 268 ," $16,656.28 ",,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386707545,"BURNS, TRICIA, ANNE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386707545,"BURNS, TRICIA, ANNE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 26 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386708006,"EVANS, EDWARD, ANTHONY",3116 N DUKE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 61 , 109 ,$#,,
MEDICAID DIRECT,1083930671,PRIVATE DIAGNOSTIC CLINIC PLLC,DUKE MED PEDS AT ROXBORO ST,,,Unknown,193200000X,Group,Multi-Specialty,,1386708006,"EVANS, EDWARD, ANTHONY",4020 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386708006,"EVANS, EDWARD, ANTHONY",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386708816,APPLIED CLINICAL RESEARCH,SAN DIEGO REFERENCE LABORATORY,6565 NANCY RIDGE DR   SAN DIEGO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1386708816,APPLIED CLINICAL RESEARCH,6565 NANCY RIDGE DR   SAN DIEGO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1114466802,DLP FRYE MEDICAL GROUP,FRYECARE GENERATIONS FAMILY MEDICINE,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386709830,"GRIBBLE, ANITA, JAMES",1781 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 44 , 79 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386709830,"GRIBBLE, ANITA, JAMES",1781 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 35 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386709921,"RAMKUMAR, USHA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386709921,"RAMKUMAR, USHA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386713113,"HASAN, RABIYA, KHALID",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386713600,"BAALBAKI, ALI, HUSSEIN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386713923,"WILLIAMS, MARK, EDWARD",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386713923,"WILLIAMS, MARK, EDWARD",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386713923,"WILLIAMS, MARK, EDWARD",2006 S 16TH ST   WILMINGTON NC,065,New Hanover,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 42 , 189 , 189 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386713923,"WILLIAMS, MARK, EDWARD",2006 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 411 , 411 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386713923,"WILLIAMS, MARK, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386713923,"WILLIAMS, MARK, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 34 , 34 ,$#,,
MEDICAID DIRECT,1134118292,MOUNTAIN VIEW PEDIATRICS PA,~,100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1386714830,"BRADLEY, KELLEY, RENEE",100 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 62 , 144 , 384 ," $14,682.58 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386715639,"WARREN, THOMAS, BRENT",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 30 , 44 , 72 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386715639,"WARREN, THOMAS, BRENT",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386715639,"WARREN, THOMAS, BRENT",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386715639,"WARREN, THOMAS, BRENT",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386715639,"WARREN, THOMAS, BRENT",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386717320,"SATTERLY, ROBERT, ALAN",2801 WOOTEN BLVD SW STE A WILSON NC,098,Wilson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 17 , 32 , 51 ,$#,,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1386718690,"OBAID, SHAZIA",351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386719078,"CUMMINGS, DAVID, ALLEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285803189,J MARK SAUNDERS OD PA,,4637 MAIN ST   SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1386721314,"SAUNDERS, JAMES, MARK",4637 MAIN ST   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 21 , 36 , 42 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386721470,"PAK, CHIN HO",1104A S MAIN ST   LEXINGTON NC,029,Davidson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386723260,"FLYNN COOK, MARGARET, ANNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386723260,"FLYNN COOK, MARGARET, ANNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1629143391,TOWNSEND AND TOWNSEND DDS PA,TOWNSEND AND TOWNSEND DDS PA,212 N WILSON AVE   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1386727014,"TOWNSEND JR, GORDON",212 N WILSON AVE   DUNN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 59 , 91 , 244 ," $11,665.86 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386727535,"DATTO, MICHAEL, BRADLEY",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 20 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386727535,"DATTO, MICHAEL, BRADLEY",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 24 , 25 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1386728293,"LEHRICH, RUEDIGER, WILHELM",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386728293,"LEHRICH, RUEDIGER, WILHELM",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386728293,"LEHRICH, RUEDIGER, WILHELM",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386728293,"LEHRICH, RUEDIGER, WILHELM",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 56 , 265 , 272 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386728293,"LEHRICH, RUEDIGER, WILHELM",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 44 , 102 , 103 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,884 US HIGHWAY 158 BUS W   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1386728293,"LEHRICH, RUEDIGER, WILHELM",884 US HIGHWAY 158 BUSINESS W   WARRENTON NC,093,Warren,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477840791,ALLEGHANY EMERGENCY GROUP LLC,ALLEGHANY EMERGENCY GROUP LLC,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1386728731,"HARRIS, JOHN, ERIC",233 DOCTORS ST   SPARTA NC,003,Alleghany,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 22 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386728731,"HARRIS, JOHN, ERIC",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 55 , 63 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1386728731,"HARRIS, JOHN, ERIC",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1386728731,"HARRIS, JOHN, ERIC",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 94 , 108 , 121 ," $13,137.82 ",,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386728731,"HARRIS, JOHN, ERIC",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386730729,"WALLEN, ERIC, MARK",4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386730729,"WALLEN, ERIC, MARK",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386730729,"WALLEN, ERIC, MARK",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 15 , 22 ,$#,,
MEDICAID DIRECT,1033302401,PAMELA ANDERSON-LUKE OD PA,DR PAMELA ANDERSON,3000 W US HIGHWAY 64 STE 121 MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1386732717,"ANDERSON, PAMELA, MICHELLE",3000 W US HIGHWAY 64 STE 121 MURPHY NC,020,Cherokee,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 24 , 35 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386733558,"HARVIN, GLENN, KNOELL",521C MOYE BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386733558,"HARVIN, GLENN, KNOELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 93 , 122 , 125 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,521C MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386733558,"HARVIN, GLENN, KNOELL",521C MOYE BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386734564,"HARPOLE JR, DAVID, HAROLD",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386734564,"HARPOLE JR, DAVID, HAROLD",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386734564,"HARPOLE JR, DAVID, HAROLD",10 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386734564,"HARPOLE JR, DAVID, HAROLD",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053906115,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GYN ONC,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386735827,"NIEVES ARRIBA, LUCYBETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 43 , 153 , 161 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386736684,"MARTIN, MAIDA, HELEN",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386736684,"MARTIN, MAIDA, HELEN",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 46 , 85 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386737534,"STANLEY, RODNEY, JAY",124 WELTON WAY   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 54 , 92 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386737534,"STANLEY, RODNEY, JAY",124 WELTON WAY   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,402 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386738813,"PRICE JR, DONALD, LOWELL",402 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386742286,"HANNAPEL, ANDREW, CHRISTOPHER",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1386742286,"HANNAPEL, ANDREW, CHRISTOPHER",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 21 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386744167,"BACH, RICHARD, TAE",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 16 , 70 , 83 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386744167,"BACH, RICHARD, TAE",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1386745750,"WILLIAMS, MATTHEW, MICHAEL",8108B MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386745750,"WILLIAMS, MATTHEW, MICHAEL",8108B MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 41 , 79 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,8108B MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386745750,"WILLIAMS, MATTHEW, MICHAEL",8108B MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386745925,"ROSE, AUSTIN, SAMUEL",4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1417909409,ALAMANCE EAR NOSE AND THROAT LLP,~,4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1386745925,"ROSE, AUSTIN, SAMUEL",3940 ARROWHEAD BLVD STE 210 MEBANE NC,001,Alamance,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1417909409,ALAMANCE EAR NOSE AND THROAT LLP,~,4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1386745925,"ROSE, AUSTIN, SAMUEL",4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 19 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386745925,"ROSE, AUSTIN, SAMUEL",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386745925,"ROSE, AUSTIN, SAMUEL",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386745925,"ROSE, AUSTIN, SAMUEL",4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1386746576,"NEDEROSTEK, DOUGLAS, FRANK",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1386747814,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03847,505 SMOKEY PARK HWY   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1386747814,NORTH CAROLINA CVS PHARMACY LLC,505 SMOKEY PARK HWY   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386749133,"SHAWEN, SCOTT, BRINTON",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 53 , 80 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386751493,"MASON, MARK, THOMAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1538516877,HIGH POINT PHYSICAL THERAPY LLC,,1030 MALL LOOP RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386751766,"DISCHIAVI, TRACY, LEIGH",1030 MALL LOOP RD   HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1861828022,MICHAEL O REIMELS DDS & CATHERINE S,THE SMILE ZONE,816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386752046,"SCHNEIDER, CATHERINE, KIM",816 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice," 2,912 "," 4,872 "," 17,821 "," $786,849.35 ",,
MEDICAID DIRECT,1538935432,THOME & KENDRICK DDS PLLC,,9625 NORTHCROSS CENTER CT STE 101 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386752061,"KENDRICK, FRANK",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 390 , 439 ," 1,635 "," $50,097.29 ",,
MEDICAID DIRECT,1154673846,DR FRANK KENDRICK DMD - HUNTERSVILL,SOUTH LAKE PEDIATRIC DENTISTRY,9625 NORTHCROSS CENTER CT STE 101 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386752061,"KENDRICK, FRANK",8631 ARBOR CREEK DR STE D3 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 18 , 18 , 41 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1386752228,"SEBASTIAN, JACQUELINE, SUZANNE",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1386752228,"SEBASTIAN, JACQUELINE, SUZANNE",802 SEMART DR STE 108 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386752228,"SEBASTIAN, JACQUELINE, SUZANNE",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386752228,"SEBASTIAN, JACQUELINE, SUZANNE",802 SEMART DR STE 108 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386752228,"SEBASTIAN, JACQUELINE, SUZANNE",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386752228,"SEBASTIAN, JACQUELINE, SUZANNE",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386752228,"SEBASTIAN, JACQUELINE, SUZANNE",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386756062,"JANARDHANAM, RAM, PRABHU",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 64 , 68 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386756062,"JANARDHANAM, RAM, PRABHU",16455 STATESVILLE RD STE 100 HUNTERSVILLE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386757201,"COOLEY, ANTHONY, STEPHEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 47 , 74 , 75 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386758282,"AUSTIN, WILLIAM, ELLIOTT",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386758753,"ALMEIDA, MARIA, STAPHNEY",5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386758753,"ALMEIDA, MARIA, STAPHNEY",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386759066,"SWAMINATHAN, RAJESH, VISWANATHAN",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386759066,"SWAMINATHAN, RAJESH, VISWANATHAN",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386759066,"SWAMINATHAN, RAJESH, VISWANATHAN",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1508853698,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386759488,"BUMBALO, THOMAS, SAMUEL",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1386762326,"KOCHER, JULIE, LEE",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1386763894,CARTER GROUP HOME,,3101 E BESSEMER AVE   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386763894,CARTER GROUP HOME,3101 E BESSEMER AVE   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,459 "," 1,459 "," $91,545.24 ",,
MEDICAID DIRECT,1518439546,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - BETHLEHEM,174 BOLICK LN STE 202 TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1386764173,"FARUQUE, MARK, AHMED",174 BOLICK LN STE 202 TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 28 , 61 ,$#,,
MEDICAID DIRECT,1386771657,COTTAGE HEALTH CARE SERVICES INC,~,3826 BLAND RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1386771657,COTTAGE HEALTH CARE SERVICES INC,3826 BLAND RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,540 "," 1,540 "," $123,139.56 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386772127,"PATON, BEVERLY, LAUREN",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386772127,"PATON, BEVERLY, LAUREN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386772127,"PATON, BEVERLY, LAUREN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386772127,"PATON, BEVERLY, LAUREN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 20 , 25 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386777191,"IRWIN, TODD, ANDREW",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 54 , 99 , 154 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386777191,"IRWIN, TODD, ANDREW",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1386778363,"MURPHY, KATHLEEN",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 45 ,$#,,
MEDICAID DIRECT,1114028859,COLUMBUS FAMILY MEDICAL PA,~,712 VILLAGE RD STE 104 SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1386778363,"MURPHY, KATHLEEN",712 VILLAGE RD STE 104 SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386738516,HENDERSON AND HENDERSON LLC,HENDERSON AND HENDERSON LLC,516 W RIDGEWAY ST   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1386780328,"EVINS, KENNETH, EARL",304 HILLSBORO ST STE G OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 407 , 630 ," 2,148 "," $105,535.00 ",,
MEDICAID DIRECT,1386780328,"EVINS, KENNETH, EARL",KENNETH EVINS DENTAL HEALTH,304 HILLSBORO ST STE G OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,1386780328,"EVINS, KENNETH, EARL",304 HILLSBORO ST STE G OXFORD NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 82 , 187 , 385 ," $20,032.08 ",,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1386783397,"BURPEE, ELIZABETH, KIMBROUGH",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 11 , 15 , 19 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1386784585,"CRISP, ROSLYN, MOORE",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 98 , 96 ," 1,067 "," $97,126.89 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1386784585,"CRISP, ROSLYN, MOORE",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,573 "," 1,737 "," 6,970 "," $251,787.64 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,193400000X,Group,Single Specialty,,1386784585,"CRISP, ROSLYN, MOORE",3150 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1386784585,"CRISP, ROSLYN, MOORE",3154 S CHURCH ST   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 64 , 64 , 216 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1386784585,"CRISP, ROSLYN, MOORE",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1386784585,"CRISP, ROSLYN, MOORE",1203 VAUGHN RD   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 50 , 50 , 125 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386786978,"MAX, BRYAN, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386786978,"MAX, BRYAN, ANDREW",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386786978,"MAX, BRYAN, ANDREW",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386786978,"MAX, BRYAN, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 53 , 65 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386786978,"MAX, BRYAN, ANDREW",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386786978,"MAX, BRYAN, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386786978,"MAX, BRYAN, ANDREW",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386786978,"MAX, BRYAN, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1386786978,"MAX, BRYAN, ANDREW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386788776,"CARTER, YVONNE, LYNNETTE",200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 53 , 77 , 87 ,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386788776,"CARTER, YVONNE, LYNNETTE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 51 , 146 , 146 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386789295,"LUCAS, LINDA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386791184,"MILLER, RUSSELL, RAYMOND",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 48 , 49 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386791242,"BUSKIRK, ELIZABETH, JANE",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1386791242,"BUSKIRK, ELIZABETH, JANE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386791242,"BUSKIRK, ELIZABETH, JANE",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 74 , 154 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386791242,"BUSKIRK, ELIZABETH, JANE",4320 HENSON DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386791242,"BUSKIRK, ELIZABETH, JANE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1881059723,TRIAD ADULT AND PEDIATRIC MEDICINE,,1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386791879,"LOTT, TAMIKA, JO",1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063712727,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1002 S EUGENE ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386791879,"LOTT, TAMIKA, JO",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447980883,TRIAD ADULT AND PEDIATRIC MEDICINE,,300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1386791879,"LOTT, TAMIKA, JO",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1386792091,"LINDEN, MICHAEL, DAVID",14 DOCTORS CIR STE 2 SUPPLY NC,010,Brunswick,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1689673360,FOOTHILLS PODIATRY PA,Foothills Podiatry PA,707 N MORGAN ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1386797090,"LAWRENCE, GRETCHEN, ANN",707 N MORGAN ST   SHELBY NC,023,Cleveland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 45 , 95 , 178 ,$#,,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386797090,"LAWRENCE, GRETCHEN, ANN",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 102 , 147 , 159 ,$#,,
MEDICAID DIRECT,1477692606,COUNTY OF ONSLOW,ONSLOW COUNTY HEALTH DEPARTMENT,612 COLLEGE ST   JACKSONVILLE NC,067,Onslow,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1386800449,"CAMPBELLNUNEZ, SHIRLEY",612 COLLEGE ST   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 104 , 144 , 571 ," $21,696.44 ",,
MEDICAID DIRECT,1689031783,M THOMAS JONES DMD PA,ADAMS FARM FAMILY DENTAL,5710 W GATE CITY BLVD STE R GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386801397,"JONES, MICHAEL, THOMAS",5710 W GATE CITY BLVD STE R GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 496 ," 1,127 "," 3,361 "," $220,470.33 ",,
MEDICAID DIRECT,1386801397,"JONES, MICHAEL, THOMAS",MICHAEL T JONES,5613 DURALEIGH RD STE 131 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1386801397,"JONES, MICHAEL, THOMAS",5613 DURALEIGH RD STE 131 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 56 , 84 , 343 ," $23,026.55 ",,
MEDICAID DIRECT,1689031783,M THOMAS JONES DMD PA,ADAMS FARM FAMILY DENTAL,5710 W GATE CITY BLVD STE R GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386801397,"JONES, MICHAEL, THOMAS",914 NE MAYNARD RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386802205,"PATEL, MAYUR, KHANDU",1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 17 , 45 , 143 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386802205,"PATEL, MAYUR, KHANDU",1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386802205,"PATEL, MAYUR, KHANDU",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 80 , 277 , 723 ," $64,572.46 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386804227,"YAJNIK, AMIT, RAMESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 50 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386805109,"HARTNESS, CHRISTOPHER, BRINSON",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 39 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386806818,"HUNT, MEAGAN, RENN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386806818,"HUNT, MEAGAN, RENN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 115 , 135 , 142 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386808525,"DINANI, AMREEN, MOHSIN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 12 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386808525,"DINANI, AMREEN, MOHSIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 36 , 39 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386808525,"DINANI, AMREEN, MOHSIN",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 18 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386808525,"DINANI, AMREEN, MOHSIN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386808525,"DINANI, AMREEN, MOHSIN",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1083277735,FOREFRONT DERMATOLOGY SC,~,6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1386810588,"SODERBERG, JOHN, MILTON",6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386814218,"IRBY, PAMELA, ASHLYN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 15 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386814218,"IRBY, PAMELA, ASHLYN",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1649216631,PIEDMONT EAR NOSE AND THROAT PA,PIEDMONT EAR NOSE AND THROAT ASSOCIATES,110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1386815363,"SATTERWHITE, NICOLE, BARE",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1386817104,"KOONTZ, JASON, IAN",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 34 , 35 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386817104,"KOONTZ, JASON, IAN",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386817104,"KOONTZ, JASON, IAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 17 , 18 , 34 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386817203,"SHERRON, KATHERINE, NOLAND",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386817203,"SHERRON, KATHERINE, NOLAND",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518031665,HANGER PROSTHETICS A ORTHOTICS INC,HANGER PROSTHETICS AND ORTHOTICS,1717 SHIPYARD BLVD STE 150 WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386817336,"WHEATLEY, KERR, SCOTT",1717 SHIPYARD BLVD STE 150 WILMINGTON NC,065,New Hanover,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386819795,"CHUNG, RICHARD, JOONOH",3116 N DUKE ST   DURHAM NC,032,Durham,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386819795,"CHUNG, RICHARD, JOONOH",4020 N ROXBORO ST   DURHAM NC,032,Durham,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386819811,"JAMES, OLGA, GENNADYEVNA",2100 ERWIN RD   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386819811,"JAMES, OLGA, GENNADYEVNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 32 , 32 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386819811,"JAMES, OLGA, GENNADYEVNA",2301 ERWIN RD   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386819811,"JAMES, OLGA, GENNADYEVNA",2100 ERWIN RD   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386819811,"JAMES, OLGA, GENNADYEVNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 42 , 42 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386819811,"JAMES, OLGA, GENNADYEVNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386819969,"KARAKIS, IOANNIS",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386819969,"KARAKIS, IOANNIS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386819993,"PIPER, LAUREN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 33 , 77 , 99 ," $24,012.05 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386821635,"HUGHES, LOREN, SHRINER",58 WEAVER VILLAGE WAY UNIT 104 WEAVERVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386822484,"TENG, EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386822484,"TENG, EDWARD",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 18 , 22 , 26 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 76 , 379 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1818 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 163 , 291 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 31 , 48 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 32 , 48 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1386825131,"ACEVEDO, TANIA, MIMI",1818 DAVIE AVE   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 50 , 50 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 160 , 174 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 48 , 50 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 19 , 32 , 32 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 20 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386827210,"NELSON, VIRGINIA, PAULINE",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1386827582,INGLES MARKETS INC,INGLES PHARMACY 007,29 TUNNEL RD   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1386827582,INGLES MARKETS INC,29 TUNNEL RD   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1386827582,INGLES MARKETS INC,INGLES PHARMACY 007,29 TUNNEL RD   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1386827582,INGLES MARKETS INC,29 TUNNEL RD   ASHEVILLE NC,011,Buncombe,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386828754,"SHRIMANKER, NEVIN, MAHENDRA",2605 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1386828754,"SHRIMANKER, NEVIN, MAHENDRA",110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 14 , 23 , 34 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386828754,"SHRIMANKER, NEVIN, MAHENDRA",110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 27 , 64 , 116 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386828754,"SHRIMANKER, NEVIN, MAHENDRA",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386828754,"SHRIMANKER, NEVIN, MAHENDRA",110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386828754,"SHRIMANKER, NEVIN, MAHENDRA",110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 14 , 26 , 38 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386828754,"SHRIMANKER, NEVIN, MAHENDRA",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1598293714,DYNAMIC PHYSIATRY PLLC,,717 GREEN VALLEY RD STE 200-179 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1386829208,"OTEY, ASIM, SALIH",2041 WILLOW RD   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1598293714,DYNAMIC PHYSIATRY PLLC,,717 GREEN VALLEY RD STE 200-179 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1386829208,"OTEY, ASIM, SALIH",2401 S SIDE BLVD   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 44 , 294 , 294 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1386832194,"CLARK, ADAM, DEAN",1600 MEDICAL DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386833622,"BLAZAR, MELINDA, FRANCES",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386833622,"BLAZAR, MELINDA, FRANCES",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386834224,"WILSON, JOCELYN, DENISE",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 24 , 39 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386834224,"WILSON, JOCELYN, DENISE",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386834711,"SADIQ, TIMOTHY, SULEMAN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 35 , 38 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1386834711,"SADIQ, TIMOTHY, SULEMAN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386834711,"SADIQ, TIMOTHY, SULEMAN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 19 , 21 ,$#,,
MEDICAID DIRECT,1386835312,ALLIED HOME HEALTH CARE INC,~,1842 S MADISON ST   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1386835312,ALLIED HOME HEALTH CARE INC,1842 S MADISON ST   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 3,117 "," 3,341 "," $518,905.18 ",,
MEDICAID DIRECT,1386836708,COUNTY OF JONES,JONES COUNTY DEPARTMENT OF SOCIAL SERVICES,418 NC HIGHWAY 58 N   TRENTON NC,052,Jones,251B00000X,Agencies,Case Management,,1386836708,COUNTY OF JONES,418 NC HIGHWAY 58 N   TRENTON NC,052,Jones,251B00000X,Agencies,Case Management,, 26 , 216 , 216 ," $81,244.00 ",,
MEDICAID DIRECT,1386838357,HENDERSON CO COUNCIL ON AGING,,105 KING CREEK BLVD   HENDERSONVILLE NC,045,Henderson,332U00000X,Suppliers,Home Delivered Meals,,1386838357,HENDERSON CO COUNCIL ON AGING,105 KING CREEK BLVD   HENDERSONVILLE NC,045,Henderson,332U00000X,Suppliers,Home Delivered Meals,,#, 853 , 853 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 93 , 128 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 21 , 37 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 41 , 49 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 104 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386840890,"ROSE-JONES, LISA, JEANNETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1386841195,DR JEFFREY R COLEMAN OPTOMETRIST PA,~,919 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1386841195,DR JEFFREY R COLEMAN OPTOMETRIST PA,919 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 118 , 118 , 353 ,$#,,
MEDICAID DIRECT,1316416415,SPARTANBURG MEDICAL CENTER,MEDGRPOFTHECAROLINAS-ORTHOPEDICS - SKYLYN,1650 SKYLYN DR STE 120 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386841617,"COLBATH, GREGORY, PAUL",1552 N LIMESTONE ST STE B GAFFNEY SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1386842193,ALBEMARLE ORTHOTICS & PROSTHETICS I,COASTAL CAROLINA PROSTHETICS & ORTH,103 NC HIGHWAY 42 W   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386842193,ALBEMARLE ORTHOTICS & PROSTHETICS I,103 NC HIGHWAY 42 W   AHOSKIE NC,046,Hertford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 12 , 14 , 52 ," $11,610.78 ",,
MEDICAID DIRECT,1386843076,DAVIE COUNTY BOARD OF EDUCATION,DAVIE COUNTY SCHOOLS,1200 SALISBURY RD   MOCKSVILLE NC,030,Davie,251300000X,Agencies,Local Education Agency (LEA),,1386843076,DAVIE COUNTY BOARD OF EDUCATION,1200 SALISBURY RD   MOCKSVILLE NC,030,Davie,251300000X,Agencies,Local Education Agency (LEA),, 422 ," 8,093 "," 8,296 "," $325,793.27 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386844678,"CHO, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386845402,"JACKSON, JOSEPH, AUGUSTUS",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386847309,"TRICHE, JESSICA, LEE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386847309,"TRICHE, JESSICA, LEE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1386847309,"TRICHE, JESSICA, LEE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 98 , 125 , 188 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,645 AMALIA ST NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386848877,"STOWELL, NICHOLAS, GREGORY",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386848877,"STOWELL, NICHOLAS, GREGORY",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386848877,"STOWELL, NICHOLAS, GREGORY",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 65 , 90 , 116 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386851491,"WEAVER, DONALD, JOHN",1781 TATE BLVD SE   HICKORY NC,018,Catawba,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 12 , 14 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386851491,"WEAVER, DONALD, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 21 , 66 , 69 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386851491,"WEAVER, DONALD, JOHN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 25 , 49 , 49 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386852028,"DILLARD, CHARLES, MAURICE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,301 RIVERVIEW AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386852028,"DILLARD, CHARLES, MAURICE",301 RIVERVIEW AVE   NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1386855336,"KING, WESLEY, ERWIN",WESLEY E KING DDS PA,6200 FAYETTEVILLE RD   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1386855336,"KING, WESLEY, ERWIN",6200 FAYETTEVILLE RD   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 255 ," 1,261 "," 1,538 "," $173,455.59 ",,
MEDICAID DIRECT,1386856649,"KELL, VICTORIA, LYNN",KELL MEDICAL PA,200 DOCTORS DR STE F JACKSONVILLE NC,067,Onslow,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,1386856649,"KELL, VICTORIA, LYNN",200 DOCTORS DR STE F JACKSONVILLE NC,067,Onslow,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1508027046,KELL MEDICAL PA,KELL MEDICAL PA,200 DOCTORS DR STE F JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1386856649,"KELL, VICTORIA, LYNN",200 DOCTORS DR STE F JACKSONVILLE NC,067,Onslow,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386858165,"HATA, JONATHAN, ANDREW",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386858165,"HATA, JONATHAN, ANDREW",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 45 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386858165,"HATA, JONATHAN, ANDREW",420 N CENTER ST   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1356300248,SANFORD PEDIATRICS PA,SANFORD PEDIATRICS PA,1801 DOCTORS DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1386861219,"KEIFER, CARY, REBECCA",1801 DOCTORS DR   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 46 , 163 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386861268,"ALEXANDER, MARIA, PREMILLA",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 23 , 73 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386861268,"ALEXANDER, MARIA, PREMILLA",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 12 , 14 , 41 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 24 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 221 , 240 , 385 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 23 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 27 , 37 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1386862704,"BROWNE, JEFFREY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",839 DURHAM RD # A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 37 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 158 , 163 , 227 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1386865665,"VIOLA, RONALD, JAMES",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 26 ,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 45 , 59 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386865665,"VIOLA, RONALD, JAMES",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386865897,"HUBBARD, JOSHUA, MALCOLM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 19 , 44 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386865897,"HUBBARD, JOSHUA, MALCOLM",310 LONG SHOALS RD STE 203 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 22 , 24 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386865897,"HUBBARD, JOSHUA, MALCOLM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 187 , 215 , 323 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386865897,"HUBBARD, JOSHUA, MALCOLM",310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 39 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386865897,"HUBBARD, JOSHUA, MALCOLM",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386866747,GRAVES FAMILY CARE HOME,STONEY CREEK FAMILY CARE,2896 STONEY CREEK SCHOOL RD   REIDSVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386866747,GRAVES FAMILY CARE HOME,2896 STONEY CREEK SCHOOL RD   REIDSVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,326 "," 1,326 "," $82,902.49 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386868974,"ARNETTE, JENNIFER, DAWN KIRKPATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386871127,"SONI, AMY, CHANDRA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386871127,"SONI, AMY, CHANDRA",101 E W T HARRIS BLVD STE 1214 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 27 , 27 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386871127,"SONI, AMY, CHANDRA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386871127,"SONI, AMY, CHANDRA",101 E W T HARRIS BLVD STE 1214 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1881127298,S ROSS PENLAND DMDPA MORGANTON PLLC,,110 JUNIPER ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1386871697,"PENLAND, SAMUEL, ROSS",110 N CENTER ST STE 200 HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice," 1,117 "," 1,228 "," 6,178 "," $373,176.04 ",,
MEDICAID DIRECT,1013351824,S ROSS PENLAND DMD PA,~,110 N CENTER ST STE 200 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386871697,"PENLAND, SAMUEL, ROSS",110 N CENTER ST STE 200 HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 978 ," 1,201 "," 5,402 "," $316,269.41 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386871895,"GARRARD, JEREMY, ERWIN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386871895,"GARRARD, JEREMY, ERWIN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104369081,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE PEDIATRIC CLINIC OF DANBURY,1030 HOSPICE DR   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1386873198,"MABE, DANA, STEWART",1030 HOSPICE DR   DANBURY NC,085,Stokes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104369081,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE PEDIATRIC CLINIC OF DANBURY,1030 HOSPICE DR   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1386873198,"MABE, DANA, STEWART",1030 HOSPICE DR   DANBURY NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386873198,"MABE, DANA, STEWART",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 57 , 95 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386873677,"MCCLAIN, WADE, GLAZNER",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386873677,"MCCLAIN, WADE, GLAZNER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386873677,"MCCLAIN, WADE, GLAZNER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1386873677,"MCCLAIN, WADE, GLAZNER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386873677,"MCCLAIN, WADE, GLAZNER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 41 , 81 , 107 ," $12,620.25 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386873677,"MCCLAIN, WADE, GLAZNER",4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 38 , 41 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386873677,"MCCLAIN, WADE, GLAZNER",4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386873917,"JAMES, CHARLENE, LILLIAN",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 22 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1386873917,"JAMES, CHARLENE, LILLIAN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 63 , 67 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1386873917,"JAMES, CHARLENE, LILLIAN",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1386875714,KELLY MEDICAL INC,~,3727 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1386875714,KELLY MEDICAL INC,3727 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 117 , 945 ," 1,049 "," $100,457.98 ",,
MEDICAID DIRECT,1386875714,KELLY MEDICAL INC,~,3727 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386875714,KELLY MEDICAL INC,3727 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 244 ," 2,145 "," 4,665 "," $275,962.88 ",,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1386879062,"CLARK, KIMBERLY, ANN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 40 , 53 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1386879062,"CLARK, KIMBERLY, ANN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386879757,"SEWARD, SHATIMA, DAFONYAE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 52 , 52 ,$#,,
MEDICAID DIRECT,1396166088,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB - MT,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386879757,"SEWARD, SHATIMA, DAFONYAE",275 BEATTY DR   BELMONT NC,036,Gaston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1386880375,"EARLE, KRISTINA, ANSLEY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386881613,"BRYANT, ASHLEY, LOVEGROVE",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861592271,ASHE MEMORIAL HOSPITAL INC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1386883973,"ROBISON, MATTHEW, LEE",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1386883973,"ROBISON, MATTHEW, LEE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 104 , 104 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1386884252,"COSTELLO, NANETTE, BAUTISTA",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386885341,"SIGMON, JUSTIN, RAY",1700 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386885341,"SIGMON, JUSTIN, RAY",1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 162 , 235 , 394 ,$#,,
MEDICAID DIRECT,1386885341,"SIGMON, JUSTIN, RAY",~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1386885341,"SIGMON, JUSTIN, RAY",1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 24 , 34 ,$#,,
MEDICAID DIRECT,1386890440,BAPTIST CHILDRENS HOME OF NC INC,MERCER HOME,1434 CARTHAGE ST   SANFORD NC,053,Lee,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386890440,BAPTIST CHILDRENS HOME OF NC INC,1434 CARTHAGE ST   SANFORD NC,053,Lee,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 926 , 927 ," $59,792.02 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386891950,"GIBNEY, JESSICA, ANN",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386891950,"GIBNEY, JESSICA, ANN",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 30 , 33 , 63 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386893733,"WILLIAMSON, MEREDITH, NELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 33 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1386893733,"WILLIAMSON, MEREDITH, NELL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 41 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386893733,"WILLIAMSON, MEREDITH, NELL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 35 , 38 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1386894913,"GIBBONS, MARY, ELLEN",60 LIVINGSTON ST STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336914431,DEMETERS GARDEN,,60 LIVINGSTON ST STE 300 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1386894913,"GIBBONS, MARY, ELLEN",60 LIVINGSTON ST STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386899623,"MAGLENTE, HENRY, CASTRO",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 111 , 111 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386899623,"MAGLENTE, HENRY, CASTRO",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 164 , 166 ,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1386900660,"KANDIL, ALI, IBRAHIM",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1386901684,"GAGNON, AMY, LENFESTEY",110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1386901684,"GAGNON, AMY, LENFESTEY",110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1386901684,"GAGNON, AMY, LENFESTEY",110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1790436228,THE HEALTH AND WELLNESS CENTER OF L,THE HEALTH AND WELLNESS CENTER OF LUMBERTON PLLC,581 FARRINGDOM ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1386901866,"HUNT, ANN, MARIE",581 FARRINGDOM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 165 , 262 ,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386902104,"ANJUM, MALIK, ASAD",301 RIVERVIEW AVE STE 512 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386902104,"ANJUM, MALIK, ASAD",500 W 21ST ST STE 102 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1386905149,"BAITH, RAND, DEREK",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 59 , 109 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1386905149,"BAITH, RAND, DEREK",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 22 , 25 ,$#,,
MEDICAID DIRECT,1700336955,ALEXANDRA BOUDREAU & KEVIN RICKER,CHATHAM PEDIATRIC DENTISTRY,79 FALLING SPRINGS DR STE 120 CHAPEL HILL NC,019,Chatham,193400000X,Group,Single Specialty,,1386908242,"RICKER, KEVIN, SHAUN",79 FALLING SPRINGS DR STE 120 CHAPEL HILL NC,019,Chatham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 166 , 196 , 586 ," $27,432.80 ",,
MEDICAID DIRECT,1689852477,M TODD GROOMS DDS PA,ALAMANCE PEDIATRIC DENTISTRY,306 ALAMANCE RD STE C BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1386908242,"RICKER, KEVIN, SHAUN",79 FALLING SPRINGS DR STE 120 CHAPEL HILL NC,019,Chatham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,224 "," 1,800 "," 6,647 "," $194,911.33 ",,
MEDICAID DIRECT,1669573010,"GROOMS, MICHAEL, TODD",,306 ALAMANCE RD STE C BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1386908242,"RICKER, KEVIN, SHAUN",79 FALLING SPRINGS DR STE 120 CHAPEL HILL NC,019,Chatham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 18 , 20 , 64 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386909414,"HAMMOUDI, KELLY, BILELLO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 82 , 82 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386910693,"MORRIS, MEGAN, ANDERSON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386910693,"MORRIS, MEGAN, ANDERSON",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386910693,"MORRIS, MEGAN, ANDERSON",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386910693,"MORRIS, MEGAN, ANDERSON",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386913937,UNITED SEATING AND MOBILITY LLC,NUMOTION,1001 AMERICAN WAY   APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386913937,UNITED SEATING AND MOBILITY LLC,1001 AMERICAN WAY   APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 969 ," 2,806 "," 6,397 "," $2,996,762.17 ",,
MEDICAID DIRECT,1386913937,UNITED SEATING AND MOBILITY LLC,NUMOTION,1001 AMERICAN WAY   APEX NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386913937,UNITED SEATING AND MOBILITY LLC,1001 AMERICAN WAY   APEX NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1386913937,UNITED SEATING AND MOBILITY LLC,NUMOTION,1001 AMERICAN WAY   APEX NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1386913937,UNITED SEATING AND MOBILITY LLC,1001 AMERICAN WAY   APEX NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 89 , 111 , 135 ," $244,351.52 ",,
MEDICAID DIRECT,1386915700,LABTECH DIAGNOSTICS LLC,,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1386915700,LABTECH DIAGNOSTICS LLC,1502 E GREENVILLE ST   ANDERSON SC,101,Out of State <= 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386917060,"KRUSEN, CAITLIN, EMILY",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 59 , 110 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386919694,"YOZWIAK, DOUGLAS, JAMES",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 69 , 161 ,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1386919900,"MCMANUS, KENNETH, DANIEL",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386921476,"WILLIAMS, JASMINE, PIA",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386924702,"JOYNER, CHRISTY, JANEL",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386924702,"JOYNER, CHRISTY, JANEL",2719 GRAVES DR STE 5 GOLDSBORO NC,096,Wayne,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1386925337,"KING, JENNIFER, BYRD",180 PARKWOOD DR   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1386925337,"KING, JENNIFER, BYRD",180 PARKWOOD DR   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1386925337,"KING, JENNIFER, BYRD",631 CC CAMP RD   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 65 , 103 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1386926327,"THOMPSON, TIFFANY, YVETTE",1140 CARTHAGE ST   SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1386926327,"THOMPSON, TIFFANY, YVETTE",1140 CARTHAGE ST   SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1386926327,"THOMPSON, TIFFANY, YVETTE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 16 , 23 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1386931988,"DEAN, JONATHAN, PHILIP",98 DOCTORS DR STE 320 SYLVA NC,050,Jackson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 57 , 105 , 121 ," $11,369.69 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1386931988,"DEAN, JONATHAN, PHILIP",98 DOCTORS DR STE 320 SYLVA NC,050,Jackson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 44 , 52 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386932499,"THOMPSON, JAIME, LEIGH",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386932499,"THOMPSON, JAIME, LEIGH",2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356699599,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH CARMEL OB GYN,2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386932499,"THOMPSON, JAIME, LEIGH",2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386932838,"KHALIL, NARDIN, NABIL",8420 UNIVERSITY EXEC PARK DR STE 850 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 67 , 103 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386934164,"HERMAN, MELODY, GRACE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 55 , 56 , 60 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1386934347,"NGUYEN, DO, TU",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,111 FOOTHILLS DR STE B MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1386934933,"TURRENTINE, JAKE, EVERETT",111 FOOTHILLS DR STE A MORGANTON NC,012,Burke,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386934933,"TURRENTINE, JAKE, EVERETT",111 FOOTHILLS DR STE A MORGANTON NC,012,Burke,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386934933,"TURRENTINE, JAKE, EVERETT",1899 TATE BLVD SE STE 2110 HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 54 , 92 , 181 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386934933,"TURRENTINE, JAKE, EVERETT",1870 N CENTER ST   HICKORY NC,018,Catawba,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 35 , 39 , 40 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1386936342,"PATWA, LAURA",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 16 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1386936946,"STOCKTON DRUM, KELLY, JO",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 18 , 21 ,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1386936946,"STOCKTON DRUM, KELLY, JO",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386937217,"CHATTERJEE, ASHMITA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 40 , 111 , 115 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386939775,"BUDZYN, BRIAN, JAMES",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386939775,"BUDZYN, BRIAN, JAMES",218 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 102 , 182 , 367 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386939775,"BUDZYN, BRIAN, JAMES",601 N ELM ST   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 24 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386939775,"BUDZYN, BRIAN, JAMES",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386940864,"SCHMIDT, ERIN, KATHLEEN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386940864,"SCHMIDT, ERIN, KATHLEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386940864,"SCHMIDT, ERIN, KATHLEEN",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386940864,"SCHMIDT, ERIN, KATHLEEN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1386942985,"SMOLTER, PATRICIA, E",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1386948974,"FRENTZEL, ADRIENNE, KING",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1386948974,"FRENTZEL, ADRIENNE, KING",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386948974,"FRENTZEL, ADRIENNE, KING",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386948974,"FRENTZEL, ADRIENNE, KING",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386949196,"CARSON, TERESA, LOUISE",317 NORTH BLVD   CLINTON NC,082,Sampson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1386949907,JUST IN TIME FCH,~,226 KENDRICK CT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386949907,JUST IN TIME FCH,226 KENDRICK CT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 77 , 77 ," $28,550.70 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386950418,"REILLY, SEAN, MICHAEL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1386950418,"REILLY, SEAN, MICHAEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care", 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386950418,"REILLY, SEAN, MICHAEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1386954584,"RADTKE, INA",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386956571,"BENDLER, REGINA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1386960128,"SWART, ERIC, FRANCIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386960201,"GRIFFITH, BROOKE, DELILAH",175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1386962090,"SANDHU, MADHUPAL, KAUR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1386962090,"SANDHU, MADHUPAL, KAUR",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1386962249,"KELLY, MEREDITH, ELLIOTT",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1386962918,"KEITH, JARED, NATHANIEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 27 , 84 , 87 ,$#,,
MEDICAID DIRECT,1467672204,BLUE RIDGE NEPHROLOGY AND,BLUE RIDGE NEPHROLOGY PA,400 SHADOWLINE DR STE 203 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1386962918,"KEITH, JARED, NATHANIEL",400 SHADOWLINE DR STE 203 BOONE NC,095,Watauga,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 66 , 153 , 153 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1386963742,"FRANKHOUSER, CHARLES, WILLIAM",3975 ROBINSON RD   NEWTON NC,018,Catawba,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1386964302,"HINTON, AMY, ELIZABETH",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811344476,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE INFECTIOUS DISEASE,117 FOOTHILLS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1386964468,"SAMPATH, RAHUL",117 FOOTHILLS DR   MORGANTON NC,012,Burke,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 77 , 146 , 176 ,$#,,
MEDICAID DIRECT,1811344476,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE INFECTIOUS DISEASE,117 FOOTHILLS DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1386964468,"SAMPATH, RAHUL",2201 S STERLING ST   MORGANTON NC,012,Burke,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 41 , 84 , 94 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1386964674,"CHARLES, RONALD, ALLEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 59 , 174 , 174 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386969111,"MARSHALL, KEIR, DOUGLAS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 67 , 71 , 79 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386970325,"EVERETT, SHAUNA, MCCANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386970325,"EVERETT, SHAUNA, MCCANN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386970325,"EVERETT, SHAUNA, MCCANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386970325,"EVERETT, SHAUNA, MCCANN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386970325,"EVERETT, SHAUNA, MCCANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114351095,MCPC-16 LLC,FIRSTHEALTH PRIMARY CARE AND CARDIOLOGY,6322 FAYETTEVILLE RD OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1386970572,"DICKERHOFF, JAMIE, POLING",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 87 , 129 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1386972057,"MCDONALD, MARGARET, O'REILLY",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1386972057,"MCDONALD, MARGARET, O'REILLY",12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 35 , 102 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1386972057,"MCDONALD, MARGARET, O'REILLY",10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1386974152,"SMITH, NATALIE, BURNS",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1386976835,"MCCULLOUGH, LEIA, JUNE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 34 , 88 , 88 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1386976835,"MCCULLOUGH, LEIA, JUNE",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1386976835,"MCCULLOUGH, LEIA, JUNE",113A HOSPITAL RD   CHEROKEE NC,087,Swain,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1386976835,"MCCULLOUGH, LEIA, JUNE",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1386976975,PD OF WILMINGTON INC,CARE ALTERNATIVES,100B OLD EASTWOOD RD STE 25 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1386976975,PD OF WILMINGTON INC,100B OLD EASTWOOD RD STE 25 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 78 ," 17,615 "," 17,665 "," $1,760,050.40 ",,
MEDICAID DIRECT,1386980019,WP-GASTONIA HEALTH HOLDINGS LLC,WELLINGTON HOUSE,850 MAJESTIC CT   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1386980019,WP-GASTONIA HEALTH HOLDINGS LLC,850 MAJESTIC CT   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 36 ," 6,926 "," 6,929 "," $742,907.06 ",,
MEDICAID DIRECT,1306544333,DAVID E THOME DDS PLLC L1,,210 WILLOW ST NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",210 WILLOW ST NW   LENOIR NC,014,Caldwell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 14 ,$#,,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 70 , 70 , 328 ," $10,334.35 ",,
MEDICAID DIRECT,1649016171,DAVID E THOME DDS PLLC L1,,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",202 WILLIAMSON RD STE 202 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 98 , 98 ," 1,837 "," $150,553.78 ",,
MEDICAID DIRECT,1306544333,DAVID E THOME DDS PLLC L1,,210 WILLOW ST NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",202 WILLIAMSON RD STE 202 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 33 , 33 , 621 ," $49,418.89 ",,
MEDICAID DIRECT,1588238463,DAVID E THOME DDS PLLC XI,HICKORY PEDIATRIC DENTISTRY,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",202 WILLIAMSON RD STE 202 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",202 WILLIAMSON RD STE 202 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 221 , 237 ," 1,074 "," $36,188.38 ",,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",202 WILLIAMSON RD STE 202 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,288 "," 1,443 "," 5,810 "," $179,613.32 ",,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 18 ,$#,,
MEDICAID DIRECT,1649016171,DAVID E THOME DDS PLLC L1,,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 14 ,$#,,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1386984391,"CALLAWAY, CHIMERE, RASHAWN",236 MARKET ST STE 200 LOCUST NC,084,Stanly,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,508 "," 3,485 "," 15,090 "," $474,028.01 ",,
MEDICAID DIRECT,1386986552,BECAUSE EARLY EDUCATION MATTERS LL,~,693 DOCKSIDE TER   DENTON NC,029,Davidson,251S00000X,Agencies,Community/Behavioral Health,,1386986552,BECAUSE EARLY EDUCATION MATTERS LL,693 DOCKSIDE TER   DENTON NC,029,Davidson,251S00000X,Agencies,Community/Behavioral Health,, 171 ," 2,763 "," 2,763 "," $174,289.60 ",,
MEDICAID DIRECT,1104156108,MOORE ORTHOPEDICS AND SPORTS MEDICI,MOORE ORTHOPEDICS AND SPORTS MEDICINE PA,4218 ARENDELL ST STE M MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1386987204,"GOOD, CHRISTOPHER, SPENCER",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 69 , 127 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1386987204,"GOOD, CHRISTOPHER, SPENCER",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1386990844,"GURNEY, BRIAN, SCOTT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821053869,HANGER PROSTHETICS & ORTHOTICS EAST,,855 S BECKFORD DR STE C HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386993038,"DRUWE, JAMES, PAUL",855 S BECKFORD DR STE C HENDERSON NC,091,Vance,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1821053869,HANGER PROSTHETICS & ORTHOTICS EAST,,855 S BECKFORD DR STE C HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1386993038,"DRUWE, JAMES, PAUL",855 S BECKFORD DR STE C HENDERSON NC,091,Vance,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,100 W FREMONT ST STE B BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1386995108,"MELLIS, JENNIFER, RENEA",3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1386995256,"COSTE, JOSE, PEREZ",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 192 , 193 ," $12,432.67 ",,
MEDICAID DIRECT,1184029456,CAROLINA EYE CLINIC PLLC,,4037 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1386996916,"NAJI, MAY, YOUSEF",4037 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1386997054,"WILSON, DANA, HOPE",2525 COURT DR   GASTONIA NC,036,Gaston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1396000907,"ROBERSON, STEPHANIE, LYNNE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 81 , 112 ,$#,,
MEDICAID DIRECT,1396001897,"VAUGHT, MARCUS, OWEN",,1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1396001897,"VAUGHT, MARCUS, OWEN",1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,781 AVENT FERRY RD STE 200 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1396002325,"GANDHI, UJJAWAL, HITENDRA",150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396002325,"GANDHI, UJJAWAL, HITENDRA",150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396002325,"GANDHI, UJJAWAL, HITENDRA",150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 20 , 46 , 50 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396002580,"RICHBERG, CHRISTOPHER, ANDREW",5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396002580,"RICHBERG, CHRISTOPHER, ANDREW",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396002580,"RICHBERG, CHRISTOPHER, ANDREW",145 APPLECROSS RD   PINEHURST NC,063,Moore,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 31 , 41 , 63 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396003604,"GRIMSLEY, AIME, LAUREEN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396003604,"GRIMSLEY, AIME, LAUREEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1396005328,"BALDWIN, MATTHEW, FRANCIS",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396005369,"SINGER, BART, B",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396005369,"SINGER, BART, B",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396005369,"SINGER, BART, B",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396005369,"SINGER, BART, B",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 49 , 53 , 96 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396005773,"MAKADIA, MANTHAN, DIPAK",10512 PARK RD STE 101 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396005880,"RANGEL, MARIA, OCTAVIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396005880,"RANGEL, MARIA, OCTAVIA",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396005880,"RANGEL, MARIA, OCTAVIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 152 , 166 , 193 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396005880,"RANGEL, MARIA, OCTAVIA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396005880,"RANGEL, MARIA, OCTAVIA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396005948,"GARCIA, JOSHUA, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 34 , 96 , 98 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396005948,"GARCIA, JOSHUA, DAVID",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396005955,"JOHNSON, ADAM, PAUL",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396005955,"JOHNSON, ADAM, PAUL",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396005955,"JOHNSON, ADAM, PAUL",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396006029,"ALLEN, BRYANT, KENDALL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 106 , 108 , 148 ," $10,184.71 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396006276,"MILLER, APRIL, MILAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 69 , 79 , 96 ," $17,923.90 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396006797,"PAINTER, MATTHEW, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 64 , 103 , 117 ," $12,609.69 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396006797,"PAINTER, MATTHEW, DAVID",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 18 , 21 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396006896,"WHITE, BENJAMIN, JOSEPH",204 MEDSPRING DR   CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 17 , 21 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396006896,"WHITE, BENJAMIN, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396006896,"WHITE, BENJAMIN, JOSEPH",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396006896,"WHITE, BENJAMIN, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396006896,"WHITE, BENJAMIN, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396007704,"ROLLINS, VICTORIA, PAIGE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396007704,"ROLLINS, VICTORIA, PAIGE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 15 , 15 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396007704,"ROLLINS, VICTORIA, PAIGE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 16 , 19 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396007704,"ROLLINS, VICTORIA, PAIGE",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 18 , 24 , 45 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396007837,"RODRIGUEZ, GEORGE, ALBERT",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396008066,"DAVE, ANJALEE, KISHOR",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396008066,"DAVE, ANJALEE, KISHOR",416 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396008066,"DAVE, ANJALEE, KISHOR",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396008454,"RAMSEY, WAYNE, NORRIS",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 30 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396008983,"OVERBEY, DOUGLAS, MARVIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396008983,"OVERBEY, DOUGLAS, MARVIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396009791,"SMITH, RYAN, BOUGHTON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396010658,"HERNANDEZ-TELLEZ, LORENA",1771 TATE BLVD SE STE 103 HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 90 , 109 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396011730,"DEMASON, CHRISTINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 18 , 39 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1396011730,"DEMASON, CHRISTINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 33 , 51 , 68 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1396011730,"DEMASON, CHRISTINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1396011730,"DEMASON, CHRISTINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 29 , 45 , 66 ,$#,,
MEDICAID DIRECT,1396020202,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH HOSPICE AND PALLIATIVE CARE PROFESSION,251 CAMPGROUND RD   WEST END NC,063,Moore,193200000X,Group,Multi-Specialty,,1396013769,"BILINSKI, KRISTEN, MICHELE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396020202,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH HOSPICE AND PALLIATIVE CARE PROFESSION,251 CAMPGROUND RD   WEST END NC,063,Moore,193200000X,Group,Multi-Specialty,,1396013769,"BILINSKI, KRISTEN, MICHELE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 94 , 139 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396015772,"MOORE, VIRGINIA, JEANNE KEARNEY",604 AMANDA ST   MANTEO NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396015772,"MOORE, VIRGINIA, JEANNE KEARNEY",6488 WEDDINGTON-MONROE RD   WESLEY CHAPEL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 47 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396016804,"FUTRELL, SHERI, BRINKLEY",9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 15 , 261 , 442 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396016838,"SON, CHANG, O",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396016838,"SON, CHANG, O",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396023644,"LING, JAMES",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396023644,"LING, JAMES",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396023990,"JOUBERT, EMILY, GIOVANNINA",2301 ERWIN RD   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396023990,"JOUBERT, EMILY, GIOVANNINA",3643 N ROXBORO ST   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396024055,"KC, RAMESH",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396024055,"KC, RAMESH",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 190 , 190 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396029088,"KAHLON, ARUNDEEP, SINGH",441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 76 , 87 , 119 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396029088,"KAHLON, ARUNDEEP, SINGH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1585 FORNEY CREEK PKWY STE 2350 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396029088,"KAHLON, ARUNDEEP, SINGH",1585 FORNEY CREEK PKWY STE 2350 DENVER NC,055,Lincoln,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 16 , 18 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1396029187,"BLACKMAN, ANGELA, PAYNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1396030847,ALLIANCE HEALTH AND HOMECARE LLC,~,741 NC 24 27 BYP E   ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,,1396030847,ALLIANCE HEALTH AND HOMECARE LLC,741 NC 24 27 BYP E   ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,, 65 ," 9,704 "," 9,709 "," $620,316.80 ",,
MEDICAID DIRECT,1396030847,ALLIANCE HEALTH AND HOMECARE LLC,~,741 NC 24 27 BYP E   ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,,1396030847,ALLIANCE HEALTH AND HOMECARE LLC,741 HIGHWAY 27 E   ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396031514,"WATSON, PAUL, RANDALL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396031514,"WATSON, PAUL, RANDALL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396031514,"WATSON, PAUL, RANDALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396031852,"EARLEY, JOHN, WESLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396033437,"SHAH, RUCHIR, ASHWINBHAI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396033700,"BAJWA, RAVNEET",401 E CHEVES ST STE 201 FLORENCE SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396034310,"MCINNIS, SUSAN, NICOLE",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 64 , 81 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396034310,"MCINNIS, SUSAN, NICOLE",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 32 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396035168,"KEENAN, JEFFREY, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 42 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396035168,"KEENAN, JEFFREY, EDWARD",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 23 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396035168,"KEENAN, JEFFREY, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396037677,"KEMPER, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396037677,"KEMPER, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396037677,"KEMPER, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1396037883,"ONYEASO, ELIZABETH, EBERE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 104 , 513 , 627 ," $31,006.54 ",,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396037883,"ONYEASO, ELIZABETH, EBERE",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396037883,"ONYEASO, ELIZABETH, EBERE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1396037883,"ONYEASO, ELIZABETH, EBERE",1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 151 , 252 , 334 ," $14,325.59 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396037883,"ONYEASO, ELIZABETH, EBERE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 122 , 123 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396038220,"GAING, BYRON",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396039590,"GIORDANENGO, MATTHEW, STEPHEN",232 BOONE HEIGHTS DR   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 23 , 44 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396039590,"GIORDANENGO, MATTHEW, STEPHEN",135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558126276,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY SURGERY & CANCER CENTER,1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1396040739,"FRIDLEY, TODD, LEE",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558126276,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY SURGERY & CANCER CENTER,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1396040739,"FRIDLEY, TODD, LEE",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 63 , 66 ,$#,,
MEDICAID DIRECT,1124083753,CAROLINA SURGERY AND CANCER CENTER,CAROLINA SURGERY AND CANCER CENTER PLLC,1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1396040739,"FRIDLEY, TODD, LEE",1501 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 21 , 23 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396041463,"EVANS, MARA, GRONLI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396046595,"MCCAWLEY, GWYNETH, MARY",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 26 , 32 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396046595,"MCCAWLEY, GWYNETH, MARY",2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396046595,"MCCAWLEY, GWYNETH, MARY",709 N JUSTICE ST STE D HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 21 , 24 , 30 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396046595,"MCCAWLEY, GWYNETH, MARY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396046595,"MCCAWLEY, GWYNETH, MARY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396046595,"MCCAWLEY, GWYNETH, MARY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 51 , 82 , 98 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1396046595,"MCCAWLEY, GWYNETH, MARY",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396046785,"IUGA, ALINA, CORNELIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 21 , 21 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396046785,"IUGA, ALINA, CORNELIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396046785,"IUGA, ALINA, CORNELIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 21 , 21 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396046785,"IUGA, ALINA, CORNELIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 15 , 16 , 22 ,$#,,
MEDICAID DIRECT,1144863358,ENVISION PAIN MANAGEMENT PLLC,,107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1396047387,"SCARBOROUGH, MEGAN, ANN",107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 183 , 667 ," 1,294 "," $14,516.79 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396047387,"SCARBOROUGH, MEGAN, ANN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396048534,"DAVIS, ALICIA, BOLDT",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1801116405,MONARCH,~,820 GRIMES BLVD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1396048534,"DAVIS, ALICIA, BOLDT",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1629487236,MONARCH,~,4140 CHERRY ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396048534,"DAVIS, ALICIA, BOLDT",4140 CHERRY ST   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396049441,"FOX, GLENNA, PHILLIPS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1568641165,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1200 VILLAGE HARBOR DR   LAKE WYLIE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396055026,"BEYDER, BIANCA",1201 VILLAGE HARBOR DR STE 104 LAKE WYLIE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1396055638,"KWAN VERRUTO, SAMANTHA, KAYIN",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396055638,"KWAN VERRUTO, SAMANTHA, KAYIN",~,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1396055638,"KWAN VERRUTO, SAMANTHA, KAYIN",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396055638,"KWAN VERRUTO, SAMANTHA, KAYIN",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396055638,"KWAN VERRUTO, SAMANTHA, KAYIN",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396057006,"SPIVEY, JULIE, CUSTRED",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 27 , 27 , 584 ," $64,419.93 ",,
MEDICAID DIRECT,1922598275,JULIE C SPIVEY DMD PLLC,LAKE NORMAN PEDIATRIC DENTISTRY,407 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396057006,"SPIVEY, JULIE, CUSTRED",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 548 , 865 ," 4,281 "," $220,122.94 ",,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396057006,"SPIVEY, JULIE, CUSTRED",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 170 ," $17,767.70 ",,
MEDICAID DIRECT,1841583176,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,655 LENOIR RHYNE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1396057006,"SPIVEY, JULIE, CUSTRED",655 LENOIR RHYNE BLVD SE   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 185 ," $17,887.92 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396059747,"CRAVER, KATHLEEN, JOYCE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396062618,"GAINEY, MISTY, BENFIELD",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396062618,"GAINEY, MISTY, BENFIELD",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396062618,"GAINEY, MISTY, BENFIELD",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396064754,"WARD, MICHEAL, DAVID",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1396065827,"WILLIAMS, MATHEW, WADE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396065827,"WILLIAMS, MATHEW, WADE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 50 , 65 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1396065827,"WILLIAMS, MATHEW, WADE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 29 , 48 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396065827,"WILLIAMS, MATHEW, WADE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396066130,"MCKENZIE, CHRISTINE, PIASCIK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 71 , 71 , 77 ," $12,249.96 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1396066130,"MCKENZIE, CHRISTINE, PIASCIK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1396066288,"BARNAS, DOUGLAS, CHRISTOPHER",349 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 35 , 45 , 56 ," $12,776.68 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396070181,"BURNHAM, COLLEEN, ERIN",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396073250,PEDIATRIC PARTNERS OF NC INC,~,325 ALEXANDER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396073250,PEDIATRIC PARTNERS OF NC INC,325 ALEXANDER ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#, 128 , 137 ," $12,818.17 ",,
MEDICAID DIRECT,1912220690,ACTIVE LIVING CHIROPRACTIC INC,~,704 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396077087,"WIRTH, BRIAN, JAMES",704 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1114663424,WIRTH CHIROPRACTIC,,2100 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396077087,"WIRTH, BRIAN, JAMES",2100 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1699270256,IZZY HEALTH PLLC,,600 GREEN VALLEY RD STE 208 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1396078549,"IZEDIUNO, VINCENT, AMAECHI",600 GREEN VALLEY RD STE 208 GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1396089108,TRIANGLE ORTHOPAEDICS SURGERY CTR,~,7921 ACC BLVD   RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1396089108,TRIANGLE ORTHOPAEDICS SURGERY CTR,7921 ACC BLVD   RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 35 , 37 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396090189,"GLEESON, ELIZABETH, MORAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396091690,"CORRIGAN, ANTONIA, SCALIA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396091690,"CORRIGAN, ANTONIA, SCALIA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 55 , 59 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396095923,"LEVINSON, LINDSEY",13300 STRICKLAND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396095923,"LEVINSON, LINDSEY",13300 STRICKLAND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396098661,"PROVENZANO, ALICIA, PATRICIA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396098661,"PROVENZANO, ALICIA, PATRICIA",40 DUKE MEDICINE CIR CLINIC 1L DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 50 , 50 ,$#,,
MEDICAID DIRECT,1336416460,PRIVATE DIAGNOSTIC CLINIC PLLC,Cancer Center,,,Unknown,193200000X,Group,Multi-Specialty,,1396098661,"PROVENZANO, ALICIA, PATRICIA",40 DUKE MEDICINE CIR CLINIC 1L DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396101523,SUPREME HOME CARE INC,,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1396101523,SUPREME HOME CARE INC,148 E MORGAN ST STE B WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1396101523,SUPREME HOME CARE INC,,411 MCLAURIN ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,1396101523,SUPREME HOME CARE INC,411 MCLAURIN ST   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,, 48 ," 8,888 "," 8,888 "," $691,586.48 ",,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1396102869,"CABRAL, SUZAN, MARIE",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1396102869,"CABRAL, SUZAN, MARIE",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 13 , 23 , 23 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396103958,"SMITH, KRISTEN, MARIE",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1710609961,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN SPECIALTY CLINICS,6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396107009,"MALUS, MATTHEW, EARL",6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 85 , 143 , 206 ,$#,,
MEDICAID DIRECT,1538802301,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH RHEUMATOLOGY & ARTHRITIS,6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396107009,"MALUS, MATTHEW, EARL",6324 FAIRVIEW RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1275218737,CHARLES WILLIAMS DMD PLLC,,604 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1396108015,"MCQUINN, MICHAEL, WILLIAM",604 MCCARTHY BLVD   NEW BERN NC,025,Craven,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 81 , 125 , 564 ," $61,208.52 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396108411,"SHAH, JHEEL, VIJAY",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396108411,"SHAH, JHEEL, VIJAY",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396108411,"SHAH, JHEEL, VIJAY",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396108908,"STEVENS, TARSHONA, BERNICE",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 57 , 80 , 172 ,$#,,
MEDICAID DIRECT,1861485146,REGIONAL OBSTETRICAL CONSULTANTS PC,REGIONAL OBSTETRICAL CONSULTANTS PC,902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396109245,"SANJANWALA, AALOK, RAJEN",136 HOSPITAL DR   BLAIRSVILLE GA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1861485146,REGIONAL OBSTETRICAL CONSULTANTS PC,REGIONAL OBSTETRICAL CONSULTANTS PC,902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396109245,"SANJANWALA, AALOK, RAJEN",902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396109286,"AUSSPRUNG, MATTHEW, JAMES",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396109427,"SOLTIS, MARJORIE, ELLEN",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396109427,"SOLTIS, MARJORIE, ELLEN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396109427,"SOLTIS, MARJORIE, ELLEN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 21 , 29 , 30 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1396109427,"SOLTIS, MARJORIE, ELLEN",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396109427,"SOLTIS, MARJORIE, ELLEN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 18 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,400 ELF ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396109427,"SOLTIS, MARJORIE, ELLEN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396109526,"GREENE, EMILY, ELLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396111274,"MABRY, DANA, ALEXANDRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 35 , 97 , 104 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396113163,"CARL, MEGAN, MARY",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 46 , 67 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396113270,"MELIN, CECELIA, BROWN",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1659396893,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396113270,"MELIN, CECELIA, BROWN",7810 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396113270,"MELIN, CECELIA, BROWN",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396113270,"MELIN, CECELIA, BROWN",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396113270,"MELIN, CECELIA, BROWN",9908 COULOAK DR STE 201 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396113270,"MELIN, CECELIA, BROWN",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396113270,"MELIN, CECELIA, BROWN",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1396114096,RECOVERY HEALTHCARE AGENCY,,4528 HILLSBOROUGH RD STE 295 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1396114096,RECOVERY HEALTHCARE AGENCY,4528 HILLSBOROUGH RD STE 295 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,921 "," 2,921 "," $214,202.40 ",,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396117180,"WREN, KAYLIE, ELIZABETH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396124079,"POLLOCK, SUZANNA, SAVOR",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 15 , 43 , 70 ,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1396124467,"EDWARDS, KAYLAN, ELIZABETH",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1396124483,"GARCIA, KAYLA, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396124483,"GARCIA, KAYLA, LYNN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396124483,"GARCIA, KAYLA, LYNN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396124483,"GARCIA, KAYLA, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 64 , 72 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396124483,"GARCIA, KAYLA, LYNN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396124483,"GARCIA, KAYLA, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 53 , 79 ,$#,,
MEDICAID DIRECT,1396124590,PLAY EXPLORE AND LEARN LLC,PLAY EXPLORE AND LEARN LLC,655 SUSSEX ST   KINSTON NC,054,Lenoir,251S00000X,Agencies,Community/Behavioral Health,,1396124590,PLAY EXPLORE AND LEARN LLC,655 SUSSEX ST   KINSTON NC,054,Lenoir,251S00000X,Agencies,Community/Behavioral Health,, 34 , 621 , 621 ," $40,370.40 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396125183,"CHEUNG, NATHAN, LOLLINS",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 43 , 49 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396125183,"CHEUNG, NATHAN, LOLLINS",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396125183,"CHEUNG, NATHAN, LOLLINS",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 142 , 155 , 229 ," $11,231.64 ",,
MEDICAID DIRECT,1366598807,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,2100 ERWIN RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1396125183,"CHEUNG, NATHAN, LOLLINS",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396125878,"COOL, ADRIANNE, BETH",317 NORTH BLVD   CLINTON NC,082,Sampson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 77 , 167 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396126256,"MCGINNIS, HUDSON, TAYLOR",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396126256,"MCGINNIS, HUDSON, TAYLOR",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396126256,"MCGINNIS, HUDSON, TAYLOR",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396126256,"MCGINNIS, HUDSON, TAYLOR",434 HOSPITAL DR   LINVILLE NC,006,Avery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396127577,"GADDY, ALESHIA, JO",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1396127577,"GADDY, ALESHIA, JO",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1396128120,"DA ROCHA, MICHELLE, SOARES",3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,229 "," 1,407 "," 6,148 "," $248,746.70 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396128120,"DA ROCHA, MICHELLE, SOARES",2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 859 ," 1,000 "," 4,308 "," $181,215.37 ",,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396128120,"DA ROCHA, MICHELLE, SOARES",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 842 , 868 ," 4,989 "," $263,303.38 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396128120,"DA ROCHA, MICHELLE, SOARES",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 66 , 66 ," 1,402 "," $104,503.28 ",,
MEDICAID DIRECT,1578052635,MARCELA MUJICA DMD II PLLC,ALL KIDS PEDIATRIC DENTISTRY,3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1396128120,"DA ROCHA, MICHELLE, SOARES",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 57 , 57 ," 1,155 "," $87,827.57 ",,
MEDICAID DIRECT,1396128203,LLHAN LLC,CANNON PHARMACY SEDGEFIELD,2334 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396128203,LLHAN LLC,2334 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 95 , 427 , 481 ," $41,103.64 ",,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396128575,"HUMRICKHOUSE, JOHN, WILSON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 55 , 56 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396128575,"HUMRICKHOUSE, JOHN, WILSON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 46 , 150 , 150 ,$#,,
MEDICAID DIRECT,1396128757,MARICKEYO S HUSKEY,SERENITY LIVING 2,113 LESLIE DR   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396128757,MARICKEYO S HUSKEY,113 LESLIE DR   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,244 "," 2,323 "," $137,780.53 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396130332,"LLOYD, AARON, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 50 , 55 ,$#,,
MEDICAID DIRECT,1679576763,COUNTY OF BEAUFORT,BEAUFORT COUNTY HEALTH DEPT,1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1396134631,"NEWMAN, KELLEY, MARIE",1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 36 ,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396134631,"NEWMAN, KELLEY, MARIE",1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396136339,"KURTZ, ANDREA, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396136339,"KURTZ, ANDREA, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396138616,"BAHUNUTULA, UDAY, KUMAR",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,505 "," 3,667 "," 14,459 "," $511,782.85 ",,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1396138616,"BAHUNUTULA, UDAY, KUMAR",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 3,726 "," 5,275 "," 22,192 "," $856,037.86 ",,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1396138616,"BAHUNUTULA, UDAY, KUMAR",236 MARKET ST STE 200 LOCUST NC,084,Stanly,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396139119,"FLAHERTY, STACEY, MARIE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396139119,"FLAHERTY, STACEY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396139119,"FLAHERTY, STACEY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 23 , 27 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396139119,"FLAHERTY, STACEY, MARIE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1396139119,"FLAHERTY, STACEY, MARIE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396139119,"FLAHERTY, STACEY, MARIE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1396139119,"FLAHERTY, STACEY, MARIE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396139788,"DICKENS, BURKE, HAMILTON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396139788,"DICKENS, BURKE, HAMILTON",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396139788,"DICKENS, BURKE, HAMILTON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1447748819,INTEGRATED DERMATOLOGY OF NORTH RAL,,3809 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1396140695,"MACRI, ANGELA",3809 COMPUTER DR STE 200 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 22 , 55 , 83 ,$#,,
MEDICAID DIRECT,1396140737,ALLY MEDICAL SERVICES LLC,,127 N BROAD ST STE A BREVARD NC,088,Transylvania,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1396140737,ALLY MEDICAL SERVICES LLC,127 N BROAD ST STE A BREVARD NC,088,Transylvania,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396140737,ALLY MEDICAL SERVICES LLC,,127 N BROAD ST STE A BREVARD NC,088,Transylvania,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396140737,ALLY MEDICAL SERVICES LLC,127 N BROAD ST STE A BREVARD NC,088,Transylvania,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 48 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1396141974,"WILLIAMS, JOHN, RICHARD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396141974,"WILLIAMS, JOHN, RICHARD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1396147559,"MONTGOMERY, MARISA, MCGILL",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396150462,"THURMAN, TYLER, BRETT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396150462,"THURMAN, TYLER, BRETT",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 204 , 204 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396150462,"THURMAN, TYLER, BRETT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1396150462,"THURMAN, TYLER, BRETT",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1396150462,"THURMAN, TYLER, BRETT",420 N CENTER ST   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 30 , 30 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396152658,"DENSON, HANNAH, BROOKE",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 100 , 154 , 304 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396154209,"MORRISON, KAYLA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396155057,"BURKE, REBECCA, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 42 , 66 , 74 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1396156873,"KALLGREN, TIMOTHY, CARL",41 BAIN ST   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1396156873,"KALLGREN, TIMOTHY, CARL",1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396156873,"KALLGREN, TIMOTHY, CARL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1396156873,"KALLGREN, TIMOTHY, CARL",1106 SUNSET AVE   CLINTON NC,082,Sampson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1396161550,"HINSON, SHERRY, JOLYNN",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 28 , 58 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1396161550,"HINSON, SHERRY, JOLYNN",1908 CAUDLE DR STE 100 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 94 , 202 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1396161550,"HINSON, SHERRY, JOLYNN",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 79 , 155 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396161550,"HINSON, SHERRY, JOLYNN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1396161550,"HINSON, SHERRY, JOLYNN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 465 , 855 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 100&105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1396161550,"HINSON, SHERRY, JOLYNN",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 103 , 137 ,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1396161550,"HINSON, SHERRY, JOLYNN",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396163481,"EYADIEL, CYRIL, VARGHESE",1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 109 , 143 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396165585,"DORSEY, JOHN, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 74 , 125 , 125 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396165874,"SNYDER, ALEX, TAYLOR",1415 PHYSICIANS DR   CAPE FEAR NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396165874,"SNYDER, ALEX, TAYLOR",1415 PHYSICIANS DR   CAPE FEAR NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 51 , 66 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396165874,"SNYDER, ALEX, TAYLOR",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396165874,"SNYDER, ALEX, TAYLOR",1415 PHYSICIANS DR   CAPE FEAR NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396165874,"SNYDER, ALEX, TAYLOR",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396165874,"SNYDER, ALEX, TAYLOR",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 63 , 80 , 152 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1396166062,"CARD, ROBERT, LLOYD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396166336,"PARRISH, LAURA, ANN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396166336,"PARRISH, LAURA, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396166336,"PARRISH, LAURA, ANN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396166336,"PARRISH, LAURA, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1396167425,"DALLAS, MATTHEW, BRIAN",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1396167425,"DALLAS, MATTHEW, BRIAN",2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396167474,"WOODS, MICHAEL, CONNELY",MICHAEL C WOODS DMD MS,1601 DAVIE AVE   STATESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1396167474,"WOODS, MICHAEL, CONNELY",1601 DAVIE AVE   STATESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 363 ," 1,289 "," 1,715 "," $321,184.95 ",,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396173969,"HENDERSON, JOSHUA, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396173969,"HENDERSON, JOSHUA, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396173969,"HENDERSON, JOSHUA, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396173969,"HENDERSON, JOSHUA, MARK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 30 , 32 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396173969,"HENDERSON, JOSHUA, MARK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821147133,LAKE NORMAN OPHTHALMOLOGY PLLC,~,132 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1396177085,"INTIHAR, ERIC, LAWRENCE",132 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,, 59 , 88 , 125 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396177309,"SWAUGER, ASHLEY, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396178943,"RICHARDSON, OWEN, SCOTT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 64 , 98 , 107 ," $13,718.22 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396180717,"GRIDLEY, CHAD, MICHAEL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396180717,"GRIDLEY, CHAD, MICHAEL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396180717,"GRIDLEY, CHAD, MICHAEL",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 31 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396180717,"GRIDLEY, CHAD, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 15 , 33 ,$#,,
MEDICAID DIRECT,1255070868,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2695 HENDERSONVILLE ROAD SUITE 200,2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396181251,"DIAZ, TANIA, CLARICE",2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 43 , 59 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396181764,"ORTH, ERIN, ELIZABETH HAYES",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396181764,"ORTH, ERIN, ELIZABETH HAYES",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 11 , 31 , 32 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396184362,"MATTIOLI, TANIA, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1497080006,NOVANT HEALTH MEDICAL GROUP LLC,~,190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396184362,"MATTIOLI, TANIA, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568808855,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SPINE SPECIALISTS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396184362,"MATTIOLI, TANIA, MARIE",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396184362,"MATTIOLI, TANIA, MARIE",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396184610,"PATEL, JHARNA, RAKESH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 28 , 77 , 77 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396184610,"PATEL, JHARNA, RAKESH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 40 , 40 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 23 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396184628,"DE MACEDO RODRIGUES, KATYUCIA",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396185054,"WALKLEY, CARLA, FAVARO",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 58 , 61 , 94 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396185054,"WALKLEY, CARLA, FAVARO",1001 BLYTHE BLVD MEDICAL CENTER PLZ STE 200 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396185419,"PATEL, SAURABHKUMAR",100 SENTARA CIR RM 2C WILLIAMSBURG VA,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396185419,"PATEL, SAURABHKUMAR",100 SENTARA CIR RM 2C WILLIAMSBURG VA,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396189403,"MOODY, BRYCE, ALAIN",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396191714,"LUCKEY, ADAM, LAUREN",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396191714,"LUCKEY, ADAM, LAUREN",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396191714,"LUCKEY, ADAM, LAUREN",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396193181,"DIRKS, REBECCA, CRAVENS",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396193181,"DIRKS, REBECCA, CRAVENS",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396193637,"SANDEE, GINA, DIANE",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396193637,"SANDEE, GINA, DIANE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396193637,"SANDEE, GINA, DIANE",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396193637,"SANDEE, GINA, DIANE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 89 , 89 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396193637,"SANDEE, GINA, DIANE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184400954,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC AUDIOLOGY SERVICES,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396195111,"ROTH, NOELLE, ELIZABETH",115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1942359997,THOMAS W BELL JR DDS AND EDWARD G C,THOMAS W BELL JR DDS AND EDWARD G COVERT DDS PA,400 DOLPHIN DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1396195160,"SAUNDERS, ROBERT, NICHOLAS",400 DOLPHIN DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 155 , 205 , 633 ," $25,687.77 ",,
MEDICAID DIRECT,1912547415,GASTON FAMILY HEALTH SERVICES INC,IREDELL PSYCHIATRY,766 HARTNESS RD   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396195723,"TAYLOR, MARGARET, BRYAN",766 HARTNESS RD   STATESVILLE NC,049,Iredell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1700202066,DESIREE T PALMER DMD PA,~,105 NEWSOM ST STE 204 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396198727,"CALMORE, CANAI, FRANCES",105 NEWSOM ST STE 204 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 196 , 401 ," 1,382 "," $59,290.87 ",,
MEDICAID DIRECT,1396198727,"CALMORE, CANAI, FRANCES",~,410 W 14TH ST STE B GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,1396198727,"CALMORE, CANAI, FRANCES",410 W 14TH ST STE B GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538267224,H J BROWN AND ASSOCIATES DDS PA,H J BROWN AND ASSOCIATES DDS PA,410 W 14TH ST STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396198727,"CALMORE, CANAI, FRANCES",410 W 14TH ST STE B GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 165 , 201 , 453 ," $34,171.79 ",,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396199543,"GUO, ROSE",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.), 29 , 34 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396200473,"DOGARIU, LAUREN, KOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396201935,"WISE, BLAKELY, DAVID",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396201935,"WISE, BLAKELY, DAVID",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396202941,"SMOAK, PEYTON, PLAYER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396204210,"CHOI, EUN, YOUNG",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396206124,"REED, GABRIELA, ELIZABETH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 23 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396206124,"REED, GABRIELA, ELIZABETH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396206124,"REED, GABRIELA, ELIZABETH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396206124,"REED, GABRIELA, ELIZABETH",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396206124,"REED, GABRIELA, ELIZABETH",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396206900,"MCDOWELL, DONNA, SUE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 125 , 212 , 256 ," $13,786.31 ",,
MEDICAID DIRECT,1699322388,HOPE HEALTH FAMILY PRACTICE,,201 E MAIN ST   ROWLAND NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396206900,"MCDOWELL, DONNA, SUE",201 E MAIN ST   ROWLAND NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1699322388,HOPE HEALTH FAMILY PRACTICE,,201 E MAIN ST   ROWLAND NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396206900,"MCDOWELL, DONNA, SUE",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396206900,"MCDOWELL, DONNA, SUE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,600 W SALISBURY ST STE D ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1396206926,"SIKORA, REBECCA, ROSE",600 W SALISBURY ST STE D ASHEBORO NC,076,Randolph,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1635 NC HIGHWAY 66 S STE 155 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396206926,"SIKORA, REBECCA, ROSE",1635 NC HIGHWAY 66 S STE 155 KERNERSVILLE NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 28 , 58 , 65 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396206926,"SIKORA, REBECCA, ROSE",1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 25 , 40 , 50 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396206926,"SIKORA, REBECCA, ROSE",1200 N ELM ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,2001 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396206926,"SIKORA, REBECCA, ROSE",2001 N CHURCH ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 146 , 236 , 299 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,2001 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396206926,"SIKORA, REBECCA, ROSE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396207304,"WOLF, COREY, JAMES",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1396208773,"THOMALLA, TARA, ANN",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396208773,"THOMALLA, TARA, ANN",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396208773,"THOMALLA, TARA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396208773,"THOMALLA, TARA, ANN",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 46 , 90 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1396208898,"MESSERSMITH, SARAH, MARGARET",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 133 , 133 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396208898,"MESSERSMITH, SARAH, MARGARET",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 231 , 231 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396208922,"CULLEN, JASON, MICHAEL",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 29 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396208922,"CULLEN, JASON, MICHAEL",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",323 BALDWIN RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 25 , 88 , 88 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",485 VETERANS WAY   KERNERSVILLE NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 28 , 115 , 115 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 22 , 42 , 42 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",516 WALL ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 21 , 32 , 32 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 18 , 19 , 20 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",4412 S MAIN ST   SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 21 , 48 , 48 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",4412 S MAIN ST   SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",117 E KINGS HWY   EDEN NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 14 , 67 , 67 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396209250,"CLAYTON, HATTIE, DENICE",500 MOUNTAIN TOP DR   ASHEBORO NC,076,Randolph,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396211165,"SONEK, ALEXANDRA, VEZZETTI",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396211165,"SONEK, ALEXANDRA, VEZZETTI",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1396212080,"AHMED, FATIMA, SAYYEDA",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 114 , 150 , 377 ," $18,155.69 ",,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1396212981,"EDWARDS, LYNDSAY, JENSEN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1396212981,"EDWARDS, LYNDSAY, JENSEN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396212981,"EDWARDS, LYNDSAY, JENSEN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 140 , 152 ," $15,021.04 ",,
MEDICAID DIRECT,1396213500,COMPASS HEALTHCARE AND REHAB ROWAN,COMPASS ASSISTED LIVING ROWAN,1404 S SALISBURY AVE   SPENCER NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396213500,COMPASS HEALTHCARE AND REHAB ROWAN,1404 S SALISBURY AVE   SPENCER NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 20 ," 1,155 "," 1,184 "," $340,571.78 ",,
MEDICAID DIRECT,1396215448,INTEGRITY-OPEN ARMS LLC,OPEN ARMS RETIREMENT CENTER,612 HEALTH DR   RAEFORD NC,047,Hoke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396215448,INTEGRITY-OPEN ARMS LLC,612 HEALTH DR   RAEFORD NC,047,Hoke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 50 ," 13,111 "," 13,125 "," $1,032,356.13 ",,
MEDICAID DIRECT,1558812594,ST LUKES HOSPITAL INC,FOOTHILLS MEDICAL ASSOCIATES,130 FOREST GLEN RD STE B COLUMBUS NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1396216826,"ODELL, COLDEN, THOMAS",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 34 , 40 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396217139,"BACHMEYER, ASHTON, HARRINGTON",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396217139,"BACHMEYER, ASHTON, HARRINGTON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396217139,"BACHMEYER, ASHTON, HARRINGTON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396217139,"BACHMEYER, ASHTON, HARRINGTON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396217139,"BACHMEYER, ASHTON, HARRINGTON",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396217139,"BACHMEYER, ASHTON, HARRINGTON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396223772,HENDERSONVILLE AL HOLDINGS LLC,THE LANDINGS OF MILLS RIVER,4143 HAYWOOD RD   MILLS RIVER NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396223772,HENDERSONVILLE AL HOLDINGS LLC,4143 HAYWOOD RD   MILLS RIVER NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 16 ," 3,474 "," 3,475 "," $302,308.67 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396229688,"STAPLETON, AUBREE, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1790739571,"WILLIAM D HUNTER MD PA, WILLIAM",~,2555 COURT DR STE 400 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396229969,"PARTIN, MISTY, NICOLE",2555 COURT DR STE 400 GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 85 , 136 , 165 ,$#,,
MEDICAID DIRECT,1790739571,"WILLIAM D HUNTER MD PA, WILLIAM",~,2555 COURT DR STE 400 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396229969,"PARTIN, MISTY, NICOLE",2555 COURT DR STE 400 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396230843,"AKHAMA, REBECCA, ADHIAMBO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1396231569,"ROSARIO, JENNIFER",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396232658,"ROJAS, MELANIE, REZENDE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 67 , 249 , 249 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1396233425,"MANNING, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 116 , 116 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396233425,"MANNING, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 80 , 80 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1396238622,"MILLER, NATHANIEL, STEVEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1396238622,"MILLER, NATHANIEL, STEVEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396238622,"MILLER, NATHANIEL, STEVEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396238622,"MILLER, NATHANIEL, STEVEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 59 , 74 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1396238622,"MILLER, NATHANIEL, STEVEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 16 , 26 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1396238622,"MILLER, NATHANIEL, STEVEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396239455,"GYASI, NICOLE",202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396239455,"GYASI, NICOLE",202 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 51 , 76 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396241279,"WHITLOCK, KEITH, GARRETT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 21 , 31 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396241279,"WHITLOCK, KEITH, GARRETT",505 OBERLIN RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396241279,"WHITLOCK, KEITH, GARRETT",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 20 , 31 ,$#,,
MEDICAID DIRECT,1083277735,FOREFRONT DERMATOLOGY SC,~,6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1396242244,"FARMER, WILLIAM, STEADMAN",2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1083277735,FOREFRONT DERMATOLOGY SC,~,6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1396242244,"FARMER, WILLIAM, STEADMAN",6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396247763,"RATHBUN, MATTHEW, JOHN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396247763,"RATHBUN, MATTHEW, JOHN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396247763,"RATHBUN, MATTHEW, JOHN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396247995,"STRICKLAND, AMANDA, KATHLEEN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 138 , 148 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396249256,"GRIFFIE, DEANNA, ANDREWS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 22 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396249256,"GRIFFIE, DEANNA, ANDREWS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1245734995,CALDWELL MEMORIAL HOSPITAL,CALDWELL ONCOLOGY ASSOCIATES,212 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1396249314,"KEY, ASHLEY, POPE",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 84 , 108 , 108 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396249900,"HO-GOTSHALL, SANNA, MICHELLE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427699412,HARVEST FOCUSED & CONSULTING SCVS,,154 HUFFMAN MILL RD STE 203 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396250254,"HINES, DANA, LEE",154 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1568050573,THE ULTIMATE SACRIFICE LLC,,2290 PREMIER PARK LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396250254,"HINES, DANA, LEE",2290 PREMIER PARK LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 116 , 374 , 533 ," $52,061.17 ",,
MEDICAID DIRECT,1568050573,THE ULTIMATE SACRIFICE LLC,,2290 PREMIER PARK LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396250254,"HINES, DANA, LEE",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1164784948,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES REID HEART CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1396252722,"LAWRENCE, SARA, ANN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 27 , 45 , 52 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396253217,"KAZNOWSKI, ALEXANDRA, KILRAINE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 64 , 88 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396253217,"KAZNOWSKI, ALEXANDRA, KILRAINE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396258703,"AVERY, TERESA, SANCHEZ",3000 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396258703,"AVERY, TERESA, SANCHEZ",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396258703,"AVERY, TERESA, SANCHEZ",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396263950,"JOHNSON, ROBERT, ORMOND",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 44 , 69 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396263950,"JOHNSON, ROBERT, ORMOND",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396264396,"DAVIS, LINDSEY, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396264503,"FOLEY, LAUREN, DOROTHY",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396264503,"FOLEY, LAUREN, DOROTHY",3025 SPRINGBANK LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1154646578,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396264503,"FOLEY, LAUREN, DOROTHY",3025 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 27 , 36 ,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1396265237,"GUILFORD, PHILIP, MARK",730 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 20 , 41 ,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1396265237,"GUILFORD, PHILIP, MARK",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 37 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1396265237,"GUILFORD, PHILIP, MARK",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 33 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1396265526,"REILLY, BENJAMIN, THOMAS",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1396265526,"REILLY, BENJAMIN, THOMAS",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1396265526,"REILLY, BENJAMIN, THOMAS",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043264724,EASTERN CAROLINA CARDIOVASCULAR,EASTERN CAROLINA CARDIOVASCULAR PA,1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1396265526,"REILLY, BENJAMIN, THOMAS",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396265872,"GANT, DEMETRIO, ANQUAIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 13 , 18 ,$#,,
MEDICAID DIRECT,1396266235,"PASUPULETI, HEMANTH, GIRISH",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1396266235,"PASUPULETI, HEMANTH, GIRISH",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1144946138,NAYANKUMAR VYAS DDS PLLC,,8 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1396267266,"FERNANDES, ANUPRIYA",8 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,013 "," 1,752 "," 6,463 "," $275,868.88 ",,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396267787,"SONGMEN, SWACHCHHANDA",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104828342,ORTHOPEDIC APPLIANCE CO INC,ORTHOPEDIC APPLICANCE COMPANY INCORPORATED,75 VICTORIA RD   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396269130,"AYCOCK, BRYAN, REAGAN",75 VICTORIA RD   ASHEVILLE NC,011,Buncombe,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 27 ,$#,,
MEDICAID DIRECT,1104828342,ORTHOPEDIC APPLIANCE CO INC,ORTHOPEDIC APPLICANCE COMPANY INCORPORATED,75 VICTORIA RD   ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396269130,"AYCOCK, BRYAN, REAGAN",75 VICTORIA RD   ASHEVILLE NC,011,Buncombe,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1871017749,ORTHOPEDIC APPLIANCE CO INC,,235 ST JOHN RD STE 100 FLETCHER NC,045,Henderson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396269130,"AYCOCK, BRYAN, REAGAN",235 ST JOHN RD STE 100 FLETCHER NC,045,Henderson,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396269643,"THOMAS, CAITLIN, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396269643,"THOMAS, CAITLIN, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396269643,"THOMAS, CAITLIN, ELIZABETH",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 24 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396269643,"THOMAS, CAITLIN, ELIZABETH",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 25 , 29 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396269643,"THOMAS, CAITLIN, ELIZABETH",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396269643,"THOMAS, CAITLIN, ELIZABETH",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417615030,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,16645 BIRKDALE COMMONS PKWY STE 100A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396270740,"HENSON, PAUL, MELVIN",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417615030,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,16645 BIRKDALE COMMONS PKWY STE 100A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396270740,"HENSON, PAUL, MELVIN",16645 BIRKDALE COMMONS PKWY STE 100A HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 25 , 30 ,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396272696,"EDWARDS, GEORGE, EMORY",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396274619,"STRASMA, ANNA, KRISTINA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396274619,"STRASMA, ANNA, KRISTINA",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396274619,"STRASMA, ANNA, KRISTINA",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396274619,"STRASMA, ANNA, KRISTINA",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 45 , 45 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396275103,"KAYSERIAN, EDWARD, YEPREM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396275103,"KAYSERIAN, EDWARD, YEPREM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1720420797,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS THOMASVIL,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1396275103,"KAYSERIAN, EDWARD, YEPREM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396276150,"CONTI, MATTHEW, PHILLIP",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 169 , 169 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1396276150,"CONTI, MATTHEW, PHILLIP",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 156 , 156 ," $10,116.60 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1396276150,"CONTI, MATTHEW, PHILLIP",117 E KINGS HWY   EDEN NC,079,Rockingham,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396276952,"MEYER, ASHLEY, LAUREL",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 59 , 139 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396276952,"MEYER, ASHLEY, LAUREL",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396277067,"TAREEN, TAMOUR KHAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 50 , 108 , 108 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396277067,"TAREEN, TAMOUR KHAN",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396277067,"TAREEN, TAMOUR KHAN",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396277117,"BYSTROM, REBECCA, PAULINE",2400 PRATT ST   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396277307,"WILLIAMS, SARAH, CHERRY DUSENBURY",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396277307,"WILLIAMS, SARAH, CHERRY DUSENBURY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 123 , 124 ,$#,,
MEDICAID DIRECT,1396280350,JK2C LLC,BHG ELIZABETH CITY TREATMENT CENTER,105 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,251S00000X,Agencies,Community/Behavioral Health,,1396280350,JK2C LLC,105 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396284352,"MCDAVID, STIRLING, DOUGLAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396284352,"MCDAVID, STIRLING, DOUGLAS",1001 BLYTHE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1396291282,BREVARD ACADEMY,~,1110 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,251300000X,Agencies,Local Education Agency (LEA),,1396291282,BREVARD ACADEMY,1110 HENDERSONVILLE HWY   PISGAH FOREST NC,088,Transylvania,251300000X,Agencies,Local Education Agency (LEA),,#, 68 , 68 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1396293056,"MARZI, LELAH, RUTH",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 29 , 177 , 223 ," $11,269.55 ",,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396293056,"MARZI, LELAH, RUTH",836 RAY LEGGETT WAY   NEW BERN NC,025,Craven,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 60 , 484 , 661 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396293320,"WARD, JAIME, PILCHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 55 , 62 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396294393,"MORGAN, EMILY, MORGAN ALLISON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 ,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396294716,"PETTIGREW, ABIGAIL, CATHERINE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396294716,"PETTIGREW, ABIGAIL, CATHERINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396294716,"PETTIGREW, ABIGAIL, CATHERINE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396296232,"SCHMUTZ, KAITLYN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396296232,"SCHMUTZ, KAITLYN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1396296232,"SCHMUTZ, KAITLYN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396296976,"METIKO, OLASUNKANMI, BABATUNDE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 134 , 134 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396298014,"SANDERS, JIMMY, BRIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1457531790,TRI CITY FAMILY MEDICINE URGENT C,TRICITY FAMILY MEDICINE AND URGENT CARE,107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1396298501,"GEYER, KRISTEN, EVA",107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396300422,"OGLESBY, ALEXIS, BLAINE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396300422,"OGLESBY, ALEXIS, BLAINE",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1396300554,"SEARLE, BRANDON, THOMAS",2626 GLENWOOD AVE STE 550 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 28 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1396300554,"SEARLE, BRANDON, THOMAS",2626 GLENWOOD AVE STE 550 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 452 , 638 ," $16,811.99 ",,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396300554,"SEARLE, BRANDON, THOMAS",2626 GLENWOOD AVE STE 550 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 789 ," 1,323 "," $15,706.45 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396303202,"HOLLOWAY, VICTORIA, MARY KERRY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 24 , 23 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396303210,"DA SILVA, PRISCILA, PIVATTO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 53 , 57 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396305496,"BARTLETT, JENNIFER, MARIE",4709 CREEKSTONE DR   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396307534,"INGLE, MEREDITH, COLLINS",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 99 , 102 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1396308391,"LOBBAN, ALIDA, NIEMEYER",8841 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 11 , 23 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1396308391,"LOBBAN, ALIDA, NIEMEYER",2007 WALNUT ST   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1306583620,BRUCE MEDICAL PLLC,,160 MACGREGOR PINES DR STE 109 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1396308573,"MIJARES, CARLOS, ALFREDO",6602 KNIGHTDALE BLVD STE 310 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396309662,"BAHRAINI, ANOOSH",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396309662,"BAHRAINI, ANOOSH",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396309662,"BAHRAINI, ANOOSH",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396311445,ALWAYS THERE HOME CARE LLC,,104 MANNING ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1396311445,ALWAYS THERE HOME CARE LLC,104 MANNING ST   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,#," 1,282 "," 1,282 "," $74,553.64 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396313144,"HOOVEN, RACHEL, RENAE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396314068,"LATTER, PHILIP, JOSEPH",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 53 , 53 ," $12,596.91 ",,
MEDICAID DIRECT,1568131647,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN 65 N BROAD,65 N BROAD ST   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396314068,"LATTER, PHILIP, JOSEPH",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396314068,"LATTER, PHILIP, JOSEPH",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396315057,"TARN, MITCHELL, THOMAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396315271,"THOMAS, ALLISON, SUGG",702 NEWMAN RD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 41 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396318358,"RIDER, DAVID, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1396318358,"RIDER, DAVID, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1396318358,"RIDER, DAVID, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396319166,"HOLLOWELL, ALLISON, GRACE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1396319166,"HOLLOWELL, ALLISON, GRACE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396319166,"HOLLOWELL, ALLISON, GRACE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 18 , 20 ,$#,,
MEDICAID DIRECT,1396321022,SPECTRA LABORATORIES INC,,1280 STATELINE RD E   SOUTHAVEN MS,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1396321022,SPECTRA LABORATORIES INC,1280 STATELINE RD E   SOUTHAVEN MS,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 121 ," 1,010 "," 3,794 "," $76,384.04 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1396322376,"FAYYAZ, ANAAM",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1396322376,"FAYYAZ, ANAAM",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 43 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396322970,"KASCHAK, CHRISTIAN, NELSON",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396322970,"KASCHAK, CHRISTIAN, NELSON",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396323408,"PACE, RUSSELL, CLAYTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396323408,"PACE, RUSSELL, CLAYTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 41 , 42 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396323408,"PACE, RUSSELL, CLAYTON",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 23 , 31 ,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396323408,"PACE, RUSSELL, CLAYTON",161 WALKER ST   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 33 , 40 ,$#,,
MEDICAID DIRECT,1023568995,RED MILL PEDIATRIC DENTISTRY AND BE,,2033 FISHER ARC STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396324646,"HILLEL, OMER, RACHEL",2033 FISHER ARC   VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 47 , 50 , 233 ,$#,,
MEDICAID DIRECT,1023568995,RED MILL PEDIATRIC DENTISTRY AND BE,,2336 ELSON GREEN AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396324646,"HILLEL, OMER, RACHEL",2336 ELSON GREEN AVE STE 101 VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 26 , 29 , 138 ,$#,,
MEDICAID DIRECT,1023568995,RED MILL PEDIATRIC DENTISTRY AND BE,,2336 ELSON GREEN AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396324646,"HILLEL, OMER, RACHEL",2033 FISHER ARC   VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 49 , 52 , 226 ,$#,,
MEDICAID DIRECT,1346613528,HAMPTON ROADS PEDIATRIC DENTISTRY,HANBURY PEDIATRIC DENTISTRY & BEHL ORTHODONTICS,237 HANBURY RD E STE 30 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396324646,"HILLEL, OMER, RACHEL",237 HANBURY RD E STE 30 CHESAPEAKE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 263 , 285 ," 1,298 "," $47,952.74 ",,
MEDICAID DIRECT,1346613528,HAMPTON ROADS PEDIATRIC DENTISTRY,HANBURY PEDIATRIC DENTISTRY & BEHL ORTHODONTICS,1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396324646,"HILLEL, OMER, RACHEL",237 HANBURY RD E STE 30 CHESAPEAKE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 359 , 384 ," 1,940 "," $71,364.60 ",,
MEDICAID DIRECT,1396328100,PLAYTALK&GROW LLC,PLAYTALKGROW LLC,10 REGENT PARK BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1396328100,PLAYTALK&GROW LLC,10 REGENT PARK BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,, 17 , 82 , 83 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1396329801,"DUDNEY, NICOLE, MARGARET",8326 PINEVILLE MATTHEWS RD STE 404 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1396329801,"DUDNEY, NICOLE, MARGARET",8700 PINEVILLE MATTHEWS RD STE 540 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396333613,"GOLDMAN, JESSICA, LEIGH",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396333613,"GOLDMAN, JESSICA, LEIGH",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396336061,"PRICE, JIHAN, JOY",120 FRAZIER ST STE 6 WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396336061,"PRICE, JIHAN, JOY",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396336061,"PRICE, JIHAN, JOY",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396336061,"PRICE, JIHAN, JOY",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,140 W MILLS ST STE A COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1396336061,"PRICE, JIHAN, JOY",140 W MILLS ST STE A COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396337580,"SHELTON, MEGAN, MONTGOMERY",3333 BROOKVIEW HILLS BLVD STE 201 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 30 , 56 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396338182,"SONG, REBECCA",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396338182,"SONG, REBECCA",115 KILDAIRE PARK DR STE 108 CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 37 , 45 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396348546,"SMALL, NICOLE, RAE",510 TIMBER DR E STE 105 GARNER NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 77 , 310 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396351607,"BLACKWELL, MICHAEL, JAMES",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1396353835,"HOWARD, RACHEL, ELIZABETH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1396353835,"HOWARD, RACHEL, ELIZABETH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1396353835,"HOWARD, RACHEL, ELIZABETH",,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1396353835,"HOWARD, RACHEL, ELIZABETH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1396353835,"HOWARD, RACHEL, ELIZABETH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396354734,"CABLE, JAMES",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 22 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396354734,"CABLE, JAMES",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 88 , 281 ,$#,,
MEDICAID DIRECT,1225372246,DUKE UNIVERSITY AFFILIATED PHYSICIA,DPC BLUE RIDGE,3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396356085,"LEGGOTT, SANDRA, RENEE",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396358271,"DAHNOUN, ABID-ALHAMID",~,7800 FAYETTEVILLE RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,1396358271,"DAHNOUN, ABID-ALHAMID",7800 FAYETTEVILLE RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003687187,DLP WESTERN CAROLINA PHYSICIAN PRAC,HARRIS WOMENS CARE,70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1396359733,"PICHER, RACHEL, ELLEN",191 P AND J RD   ROBBINSVILLE NC,038,Graham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 13 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1396359733,"PICHER, RACHEL, ELLEN",191 P AND J RD   ROBBINSVILLE NC,038,Graham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 38 , 41 , 45 ," $10,906.42 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396360095,"COHEN, TAYLOR, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396362778,"SHOPE, CORI, JENSON",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1396364220,"NEUPANE, AZAD",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1396364220,"NEUPANE, AZAD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396364220,"NEUPANE, AZAD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 89 , 278 , 278 ,$#,,
MEDICAID DIRECT,1396366316,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC REHABILITATION,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396366316,NOVANT HEALTH MEDICAL GROUP LLC,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396366522,"ROTEN, WESLEY, TYLER",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 21 , 25 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1396366522,"ROTEN, WESLEY, TYLER",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 28 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1396366522,"ROTEN, WESLEY, TYLER",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396366522,"ROTEN, WESLEY, TYLER",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1396367603,AIMHIGH CARE SERVICES INC,,232 S LAFAYETTE ST STE F SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1396367603,AIMHIGH CARE SERVICES INC,232 S LAFAYETTE ST STE F SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 178 ," 37,828 "," 37,828 "," $2,637,557.12 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396368205,"HOLT, BRIANA, BRALLEY",1225 LEWISVILLE CLEMMONS RD   LEWISVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 24 , 44 ,$#,,
MEDICAID DIRECT,1518393560,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1396372504,"SHAPIRO, LINDSEY, ERIN",151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 118 , 169 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396372538,"ARONOFF, KELLY, O'MARA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396372892,"DARD, ZAKI, KRISHAN FARAZ",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 14 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1396372892,"DARD, ZAKI, KRISHAN FARAZ",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 131 , 216 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396375325,"GROSS, LISA, ANN",4401 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 34 , 62 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396375325,"GROSS, LISA, ANN",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396375325,"GROSS, LISA, ANN",4401 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 30 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,824 S VAN BUREN RD STE F EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1396375325,"GROSS, LISA, ANN",4401 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396375325,"GROSS, LISA, ANN",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1396375325,"GROSS, LISA, ANN",4401 RAMSEY ST STE 104 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396375325,"GROSS, LISA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952981391,COASTLINE FAMILY MEDICINE,,2145 COUNTRY CLUB RD STE 500 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1396375523,"YOST, REGINA, LEE",2145 COUNTRY CLUB RD STE 500 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 257 , 417 ,$#,,
MEDICAID DIRECT,1073503470,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF FAYETTEVILLE,5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1396376380,"CONWAY, KELLY, JEANNIE",5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 32 , 53 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1396380358,"HUFFMAN, MELANIE, FAYE CAREY",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 , 23 , 58 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1396380358,"HUFFMAN, MELANIE, FAYE CAREY",210 SCHOOL RD   TRINITY NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 17 , 18 , 33 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1396380358,"HUFFMAN, MELANIE, FAYE CAREY",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 17 , 22 , 67 ,$#,,
MEDICAID DIRECT,1396381950,EC OPCO HILLSBOROUGH LP,TERRABELLA HILLSBOROUGH,1911 ORANGE GROVE RD   HILLSBOROUGH NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396381950,EC OPCO HILLSBOROUGH LP,1911 ORANGE GROVE RD   HILLSBOROUGH NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 723 , 723 ," $45,316.12 ",,
MEDICAID DIRECT,1396384251,ANALYZE PATHOLOGY INC,,160 SW 12TH AVE STE 103 DEERFIELD BEACH FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1396384251,ANALYZE PATHOLOGY INC,160 SW 12TH AVE STE 103 DEERFIELD BEACH FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1558060178,APEX FUNCTIONAL NUTRITION LLC,APEX FUNCTIONAL NUTRITION,200 HAWKINS AVE STE 103D SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1396384343,"KOTLYAR, VERA",200 HAWKINS AVE STE 103D SANFORD NC,053,Lee,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396384517,"GRIFFIN, JORDAN, RAYE",2210 HEMBY LN   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 53 , 53 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396384517,"GRIFFIN, JORDAN, RAYE",2210 HEMBY LN   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396384517,"GRIFFIN, JORDAN, RAYE",1711 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396385779,FAVOR HOME CARE,,217 N MAIN ST STE 101 TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1396385779,FAVOR HOME CARE,217 N MAIN ST STE 101 TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 1,443 "," 1,443 "," $111,058.64 ",,
MEDICAID DIRECT,1396388468,HANNAHS CARE SERVICES,HANNAHS CARE SERVICES,300 W J ST   NEWTON NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1396388468,HANNAHS CARE SERVICES,300 W J ST   NEWTON NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,#, 521 , 521 ," $65,132.53 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396388914,"MAXWELL, KRISTEN, MARIE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396388914,"MAXWELL, KRISTEN, MARIE",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 18 , 21 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396388914,"MAXWELL, KRISTEN, MARIE",13425 HOOVER CREEK BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396390084,"KAPADIA, VRUNDA, MAYANKKUMAR",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396390514,"GINN, ALEXANDRA, ROSE",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396390514,"GINN, ALEXANDRA, ROSE",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 33 , 40 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396390514,"GINN, ALEXANDRA, ROSE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396390514,"GINN, ALEXANDRA, ROSE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396390563,"PUNZALAN, JANE, LINGAO",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,824 S VAN BUREN RD STE F EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1396390563,"PUNZALAN, JANE, LINGAO",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396390563,"PUNZALAN, JANE, LINGAO",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 38 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396392544,"NELSON, SALLY, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1396394144,"LACKEY, BRYCE, CLINTON",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396402715,"LOPEZ, ALESSANDRA, INEZ",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750342820,ARDMORE FAMILY PRACTICE,ARDMORE FAMILY PRACTICE PA,2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396402806,"EVANS, AMANDA",2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 33 , 57 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396403911,"MURPHY, JOHN, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396406146,"YATES, ALICIA, MARIE",744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396408829,NEOGENOMICS LABORATORIES INC,,9490 NEOGENOMICS WAY   FORT MYERS FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1396408829,NEOGENOMICS LABORATORIES INC,9490 NEOGENOMICS WAY   FORT MYERS FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 70 , 73 , 118 ,$#,,
MEDICAID DIRECT,1396410312,GUIDED PATH HOMECARE LLC,,3691 GLENN RD   PARKTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1396410312,GUIDED PATH HOMECARE LLC,3691 GLENN RD   PARKTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,045 "," 3,045 "," $182,769.36 ",,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1396410775,"KHAN, HAMZAH, MOHSIN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396410775,"KHAN, HAMZAH, MOHSIN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 133 , 134 ,$#,,
MEDICAID DIRECT,1396411161,WINSTON-SALEM OPCO LLC,SOUTHFORK,1345 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396411161,WINSTON-SALEM OPCO LLC,1345 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 60 ," 13,617 "," 13,618 "," $1,139,992.05 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396411377,"JOHNSON, MORGAN, BROOKE",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1396411898,"DOWNING, HANNAH, MARIE",1806 GLENDALE DR SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 211 , 393 , 479 ," $14,090.56 ",,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1396411898,"DOWNING, HANNAH, MARIE",3516 US HIGHWAY 301 S   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 92 , 121 ,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1396412532,"MURPHY, LAUREN, NICOLE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396412532,"MURPHY, LAUREN, NICOLE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396412532,"MURPHY, LAUREN, NICOLE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1396412532,"MURPHY, LAUREN, NICOLE",440 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 29 , 32 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1396413852,"NORTON, BRANDY, NICHOLE",1140 CARTHAGE ST   SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1396413852,"NORTON, BRANDY, NICHOLE",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396416483,"ORE, MICHELLE, LANE",2400 PRATT ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396416483,"ORE, MICHELLE, LANE",2400 PRATT ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396418851,"KUMARI, BARKHA",1918 RANDOLPH RD STE 350 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 63 , 159 ,$#,,
MEDICAID DIRECT,1871028340,DR MICHAEL J GORDON DDS PA,WESTERN CAROLINA FAMILY DENTISTRY,505 REALTY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1396419495,"BEAUCHEMIN, MATTHEW, ORESTE",505 REALTY ST SW   LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice, 835 ," 1,312 "," 3,715 "," $316,066.34 ",,
MEDICAID DIRECT,1477386548,MATTHEW BEAUCHEMIN DMD PA,WESTERN CAROLINA FAMILY DENTISTRY,505 REALTY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1396419495,"BEAUCHEMIN, MATTHEW, ORESTE",505 REALTY ST SW   LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice, 817 ," 1,166 "," 3,541 "," $284,932.93 ",,
MEDICAID DIRECT,1477386548,MATTHEW BEAUCHEMIN DMD PA,WESTERN CAROLINA FAMILY DENTISTRY,505 REALTY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1396419495,"BEAUCHEMIN, MATTHEW, ORESTE",505 REALTY ST SW   LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice, 74 , 77 , 230 ," $16,327.06 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396419909,"FRIENDT, TAYLOR, ALEXANDRA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396419909,"FRIENDT, TAYLOR, ALEXANDRA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396421855,"BURTON, SOLANGE, RAEJHON-DOLDRON",6324 FAIRVIEW RD STE 430 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629753231,DLP WILSON PHYSICIAN PRACTICES LLC,BAILEY PRIMARY CARE,6321 DEANS ST   BAILEY NC,064,Nash,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1396422978,"LYNCH, TYECHIA, SHENELL",6321 DEANS ST   BAILEY NC,064,Nash,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 62 , 148 , 156 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1396422978,"LYNCH, TYECHIA, SHENELL",6321 DEANS ST   BAILEY NC,064,Nash,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 22 , 26 , 32 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396425393,"STEAGALL, ASHLEY, MARIE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1396425591,BLESSING HANDS IN-HOME AIDE SERVICE,BLESSING HANDS IN-HOME AIDE SERVICES,723 W INNES ST   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1396425591,BLESSING HANDS IN-HOME AIDE SERVICE,723 W INNES ST   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,#, 692 , 692 ," $42,768.96 ",,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396428496,"MCCOMAS, MEGAN, ELIZABETH",1001 BLYTHE BLVD 1 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1396439188,"THOMES, CRYSTAL, MARY",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 40 , 90 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1396439188,"THOMES, CRYSTAL, MARY",2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1396441747,"CHRISTENSEN, STACEY, LYNN",4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396442513,"JONES, AMANDA, RAENAE",303 AIRPORT RD   ARDEN NC,011,Buncombe,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396442513,"JONES, AMANDA, RAENAE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396442513,"JONES, AMANDA, RAENAE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396443396,"RAFTE, MIKAYLA, JORDAN",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 60 , 94 ,$#,,
MEDICAID DIRECT,1881109452,ALIGNMED PARTNERS PC,GPS PHYSICIAN GROUP PC,877 HILL EVERHART RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1396445854,"DAILEY, CHERISE, MONET",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1881109452,ALIGNMED PARTNERS PC,GPS PHYSICIAN GROUP PC,710 JULIAN RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1396445854,"DAILEY, CHERISE, MONET",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396445854,"DAILEY, CHERISE, MONET",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 63 , 63 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396447678,"LOMBARDI, STEPHEN, JOSEPH",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 73 , 93 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396447678,"LOMBARDI, STEPHEN, JOSEPH",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1598762940,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396447710,"ROBINSON, SYDNEY, LATRICE",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 16 , 20 , 42 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396450748,"FAULKNER, KATHLEEN, STARLING",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396450748,"FAULKNER, KATHLEEN, STARLING",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396452801,"NORRIS, JESSICA, LOCKLEAR",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 61 , 71 , 241 ," $10,106.48 ",,
MEDICAID DIRECT,1679324412,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAIRMONT,202 LEESVILLE ST   FAIRMONT NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396452801,"NORRIS, JESSICA, LOCKLEAR",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396452801,"NORRIS, JESSICA, LOCKLEAR",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396454161,"MADDUX, ALICE, BARTRAM",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1396454161,"MADDUX, ALICE, BARTRAM",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396459665,"CARTER, SAVANNAH, MARGARET",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396459665,"CARTER, SAVANNAH, MARGARET",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396459665,"CARTER, SAVANNAH, MARGARET",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396459665,"CARTER, SAVANNAH, MARGARET",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396459665,"CARTER, SAVANNAH, MARGARET",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396459665,"CARTER, SAVANNAH, MARGARET",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1396463584,ANGELS OF MERCY HOME HEALTH SERVICE,,1144 EXECUTIVE CIR   CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1396463584,ANGELS OF MERCY HOME HEALTH SERVICE,1144 EXECUTIVE CIR   CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396469755,"BEADDLES, ELIZABETH, NICHOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 22 , 27 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396470696,"SCOTT, MORGAN, ELIZABETH",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 40 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396471991,"KULLA, BRIANNA, SARAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1396472908,TIERNEY ORTHOTICS AND PROSTHETICS,,41 BOONE TRL   N WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396472908,TIERNEY ORTHOTICS AND PROSTHETICS,41 BOONE TRL   N WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 11 , 14 , 63 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,555 KITCHINGS DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396473914,"DYE, KATHRYN, JEAN",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 126 , 141 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396473914,"DYE, KATHRYN, JEAN",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396473914,"DYE, KATHRYN, JEAN",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396473914,"DYE, KATHRYN, JEAN",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 27 , 71 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396473914,"DYE, KATHRYN, JEAN",555 KITCHINGS DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 39 , 45 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1396477840,"WALLACE, COLBY, RIP",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396480851,"HATT, WARREN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 122 , 553 , 576 ," $13,961.89 ",,
MEDICAID DIRECT,1992881254,VALERIE C POLLOCK DDS PA,VALERIE C POLLOCK DDS PA,302 S BENNETT ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1396482295,"SANTISTEBAN, RENZO, SILVA",460 SW CENTER ST   FAISON NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice, 204 , 272 , 865 ," $44,827.34 ",,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396482295,"SANTISTEBAN, RENZO, SILVA",460 SW CENTER ST   FAISON NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice, 373 , 747 ," 1,963 "," $86,075.87 ",,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396482295,"SANTISTEBAN, RENZO, SILVA",104 ADAIR DR   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396482634,"PAPPAS, GABRIELLE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1305 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396483483,"HOLST, CARLY, CHRISTINE",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1225372246,DUKE UNIVERSITY AFFILIATED PHYSICIA,DPC BLUE RIDGE,3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396492385,"ZELENYAK, ROSEMARY, CATHERINE",3633 HARDEN RD STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 31 ,$#,,
MEDICAID DIRECT,1396495735,REIDSVILLE HEALTH HOLDINGS LLC,THE LANDINGS OF ROCKINGHAM,2605 SWALLOW RD   REIDSVILLE NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396495735,REIDSVILLE HEALTH HOLDINGS LLC,2605 SWALLOW RD   REIDSVILLE NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 12 ," 1,657 "," 1,657 "," $129,968.70 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1396496600,"GARDNER, STEPHANIE, RENEE BIAS",201 E GROVER ST   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1396496642,"HUGHES, KRISTIN, GRIMSLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396496642,"HUGHES, KRISTIN, GRIMSLEY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396496642,"HUGHES, KRISTIN, GRIMSLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396496642,"HUGHES, KRISTIN, GRIMSLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740480888,MONIQUE BROWN M D P C,~,154 SW MAIN ST   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1396497715,"ARNOLD, CHRISTY, COLEY",154 SW MAIN ST   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1396497962,"SAYED, SOMMAYAH, SHAHER",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 46 , 50 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1396497962,"SAYED, SOMMAYAH, SHAHER",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396501391,"FAGAN, KAITLIN, MARIE",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396508842,"ROGERS, MERNETHA, DENISE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1558546184,JACKSONVILLE PHYSICAL THERAPY CENTE,~,2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1396509998,"JOERS, NICOLE, A",2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 30 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396511705,"HALEY, SHENG, LE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396511705,"HALEY, SHENG, LE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396523312,"O'LEARY-PECK, CHRISTINA, DAWN",12208 N NC HIGHWAY 150   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 30 , 37 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396523312,"O'LEARY-PECK, CHRISTINA, DAWN",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437653359,SANDHILLS BEHAVIORAL CARE PLLC,SANDHILLS BEST CARE,523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1396525168,"MERTA, AUBRIE, ANNE",523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1972910941,ROANOKE THERAPY SERVICES INC,,2756 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,193200000X,Group,Multi-Specialty,,1396528956,"STEWART, KRISTEN, HARRISON",2756 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 24 , 54 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396565057,"BURTON, ANNA, KATHRYN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396572376,"BROWN, SARAH, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1396574687,"HUNU, KAFUI, ADZENA",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 27 ,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396579033,"BAILEY, LACEY, ANDREA",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 77 , 96 , 296 ," $11,202.19 ",,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396579033,"BAILEY, LACEY, ANDREA",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 32 , 96 ,$#,,
MEDICAID DIRECT,1225216377,JESSE A GRIMM DDS PA,JESSE A GRIMM DDS PA,851 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1396580288,"CANNON, JASON, NICHOLAS",851 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1811925647,"GRIMM, JESSE, AARON",JESSE AARON GRIMM,851 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1396580288,"CANNON, JASON, NICHOLAS",851 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 82 , 119 , 378 ," $26,381.80 ",,
MEDICAID DIRECT,1396580288,"CANNON, JASON, NICHOLAS",,851 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1396580288,"CANNON, JASON, NICHOLAS",851 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396581450,"SMITH, ADRIAN, HERBERT",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396586582,"LIVINGSTON, JENNIFER, JANE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396586582,"LIVINGSTON, JENNIFER, JANE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1396588943,"COOK, BRIANNA, MULLINAX",108 CREEKSIDE DR   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598779803,NEPHROLOGY ASSOC OF THE CAROLINAS P,NEPHROLOGY ASSOCIATES OF THE CAROLINAS PA,1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1396588943,"COOK, BRIANNA, MULLINAX",1019 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 45 , 83 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396589032,"ZINGSHEIM, KAITLYN, MARY ROSE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396592168,"ALEXANDER, EMILY, ANNE ATKINSON",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1396599072,QUEENS HELPING HANDS HOME HEALTH,,3325 WASHBURN AVE STE 213 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1396599072,QUEENS HELPING HANDS HOME HEALTH,3325 WASHBURN AVE STE 213 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 779 , 779 ," $53,729.20 ",,
MEDICAID DIRECT,1396700555,"PATEL, KAMINI",~,701 EXPOSITION PL STE 202 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1396700555,"PATEL, KAMINI",701 EXPOSITION PL STE 202 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 80 , 99 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396700605,"LEAMY, GREGORY, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 39 , 39 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396700605,"LEAMY, GREGORY, JOSEPH",37 MEDICAL PARK LOOP STE 103 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 95 , 113 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396700605,"LEAMY, GREGORY, JOSEPH",37 MEDICAL PARK LOOP STE 103 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 15 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396700605,"LEAMY, GREGORY, JOSEPH",37 MEDICAL PARK LOOP STE 103 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 25 , 24 , 24 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396702767,"CONNOLLEY, CHRISTOPHER, DAVID",445 PINEVIEW DR STE 240 KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396706115,"BUCHELE, BARRY, KEVIN",5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 22 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396706115,"BUCHELE, BARRY, KEVIN",145 APPLECROSS RD   SOUTHERN PINES NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396706214,"ROBERT, KENNETH, MARK",1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 40 , 57 ,$#,,
MEDICAID DIRECT,1720198369,ROANOKE VALLEY HEALTH SERVICES INC,ROANOKE CLINIC,1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1396706214,"ROBERT, KENNETH, MARK",1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 87 , 244 , 251 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396706883,"SPENCER, JAMES, CRAIG",400 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 102 , 122 ,$#,,
MEDICAID DIRECT,1811254733,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PLASTIC AND RECONSTRUCTIVE SURGERY,401 E CHEVES ST STE 302 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396707253,"CONNER, GERALD, FOSTER",401 E CHEVES ST STE 302 FLORENCE SC,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1982700258,NEPHROLOGY AND HYPERTENSION,NEPHROLOGY AND HYPERTENSION CONSULTANTS PA,8401 UNIVERSITY EXEC PARK DR STE 123 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396708269,"DOMAN, KATHLEEN, ANNE",8401 UNIVERSITY EXEC PARK DR STE 123 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 199 , 199 ,$#,,
MEDICAID DIRECT,1982700258,NEPHROLOGY AND HYPERTENSION,NEPHROLOGY AND HYPERTENSION CONSULTANTS PA,8401 UNIVERSITY EXEC PARK DR STE 123 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396708269,"DOMAN, KATHLEEN, ANNE",8401 UNIVERSITY EXEC PARK DR STE 123 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 80 , 321 , 321 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396708285,"BARNABEI, ROBERT, ANTHONY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396708285,"BARNABEI, ROBERT, ANTHONY",8310 UNIVERSITY EXEC PARK DR STE 550 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 109 , 293 , 293 ,$#,,
MEDICAID DIRECT,1649995549,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SENIOR LIVING HEALTH SERVICES,108 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396708285,"BARNABEI, ROBERT, ANTHONY",8310 UNIVERSITY EXEC PARK DR STE 550 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396708285,"BARNABEI, ROBERT, ANTHONY",6300 ROBERTA RD   HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 65 , 65 ,$#,,
MEDICAID DIRECT,1912951252,MUNTHER S TABET MD PA,~,120 CHARLES ROLLINS RD STE 101 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1396708434,"TABET, MUNTHER, SALIM",120 CHARLES ROLLINS RD STE 101 HENDERSON NC,091,Vance,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 298 , 463 , 495 ," $12,175.57 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396708665,"SMITH-GRIFFIN, KIMBERLY, ANN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396708665,"SMITH-GRIFFIN, KIMBERLY, ANN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396708707,"MILLER, STUART, OTTO",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 26 , 75 ,$#,,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396709010,"MALICK, SAJJAD, AHMED",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 159 , 327 , 338 ,$#,,
MEDICAID DIRECT,1578949079,CALDWELL MEMORIAL HOSPITAL,BLOWING ROCK MEDICAL PARK,8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396709176,"DAVANT III, CHARLES",8439 VALLEY BLVD   BLOWING ROCK NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 101 , 102 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396709564,"LAMBERT, KORIE, DEWIRE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396709564,"LAMBERT, KORIE, DEWIRE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396709564,"LAMBERT, KORIE, DEWIRE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396709564,"LAMBERT, KORIE, DEWIRE",14330 OAKHILL PARK LN STE 200B HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 67 , 147 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1396710380,"CHEESBOROUGH, JOHN, DAVIDSON",100 S 10TH ST   LILLINGTON NC,043,Harnett,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1396710380,"CHEESBOROUGH, JOHN, DAVIDSON",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1396710380,"CHEESBOROUGH, JOHN, DAVIDSON",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 41 , 77 , 138 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,959 EAST ST STE B PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1396710380,"CHEESBOROUGH, JOHN, DAVIDSON",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1396710380,"CHEESBOROUGH, JOHN, DAVIDSON",100 S 10TH ST   LILLINGTON NC,043,Harnett,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 49 , 68 , 120 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,959 EAST ST STE B PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1396710380,"CHEESBOROUGH, JOHN, DAVIDSON",959 EAST ST STE B PITTSBORO NC,019,Chatham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 14 , 39 , 76 ,$#,,
MEDICAID DIRECT,1033185780,HIGH COUNTRY FAMILY MEDICINE PA,HIGH COUNTRY FAMILY MEDICINE PA,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1396711057,"KURTZ, KEVIN, JOHN",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 109 , 237 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396711230,"BRADLEY, TERESA, KELLER",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,15 SKYLAND INN DR   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396711230,"BRADLEY, TERESA, KELLER",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1396711230,"BRADLEY, TERESA, KELLER",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 18 , 35 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396713459,"EYO, UNWANA, AMAJAK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396713459,"EYO, UNWANA, AMAJAK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396713459,"EYO, UNWANA, AMAJAK",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396713459,"EYO, UNWANA, AMAJAK",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396713459,"EYO, UNWANA, AMAJAK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396713459,"EYO, UNWANA, AMAJAK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396714853,"VOGLER, AMY, CHEEK",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396714853,"VOGLER, AMY, CHEEK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396714853,"VOGLER, AMY, CHEEK",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265403042,NORTH CAROLINA NEUROPSYCHIATRY,NORTH CAROLINA NEUROPSYCHIATRY PA,1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396715033,"WHITE, COURTNEY, DALLAS",13251 FALLS OF NEUSE RD STE 121 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1396715496,"COWARD, KAREN, DENISE",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396715496,"COWARD, KAREN, DENISE",101 CLINIC DR   TARBORO NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 138 , 430 , 944 ," $14,476.24 ",,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1396716205,"KIM, HAN, YOUNG",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366589483,COUNTY OF DAVIDSON,~,915 N GREENSBORO ST   LEXINGTON NC,029,Davidson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1396716494,"GARRISON, MICHAEL, STEPHEN",915 N GREENSBORO ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396717708,"KELLING JR, DOUGLAS, GEORGE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396717708,"KELLING JR, DOUGLAS, GEORGE",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 103 , 290 , 367 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396717708,"KELLING JR, DOUGLAS, GEORGE",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396718219,AMERICAN HOMEPATIENT INC,AMERICAN HOME PATIENT,,,Unknown,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1396718219,AMERICAN HOMEPATIENT INC,4305 ENTERPRISE DR STE D   WINSTON SALEM NC,034,Forsyth,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1396718219,AMERICAN HOMEPATIENT INC,AMERICAN HOME PATIENT,,,Unknown,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1396718219,AMERICAN HOMEPATIENT INC,104 PROGRESS CT STE 20   WINSTON SALEM NC,034,Forsyth,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396718482,"HAGLER, RACHEL, HUNT",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396718482,"HAGLER, RACHEL, HUNT",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 33 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396718482,"HAGLER, RACHEL, HUNT",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 27 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396718482,"HAGLER, RACHEL, HUNT",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 45 , 159 ,$#,,
MEDICAID DIRECT,1790568046,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA GYNECOLOGY AND AESTHETICS,127 N STEELE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1396719266,"HEIMBECKER, PAUL, MARK",127 N STEELE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 33 , 35 ,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1396719266,"HEIMBECKER, PAUL, MARK",127 N STEELE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396720678,"KITZMAN, DALANE, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 51 , 52 , 66 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396721098,"DYER, SAMUEL, TAYLOR",100 PERKINS DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396721379,"PORTER, ALLISON, PAMELA",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396721379,"PORTER, ALLISON, PAMELA",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 31 , 31 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1396721718,"HEATER WILLIAMSON, YASMIN",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 32 , 45 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1396721858,"POLLOCK, HOKE, WARD",3505 CONVERSE RD STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 29 , 29 ," $10,839.00 ",,
MEDICAID DIRECT,1669907929,HANOVER PEDIATRICS,,3505 CONVERSE RD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396721858,"POLLOCK, HOKE, WARD",3505 CONVERSE RD STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 65 , 113 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1396722195,"HUNT, DENISE, ANNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 115 , 115 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1396722195,"HUNT, DENISE, ANNE",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 64 , 64 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1396722195,"HUNT, DENISE, ANNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1396722195,"HUNT, DENISE, ANNE",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1396722195,"HUNT, DENISE, ANNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 68 , 68 ,$#,,
MEDICAID DIRECT,1396722195,"HUNT, DENISE, ANNE",~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1396722195,"HUNT, DENISE, ANNE",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1396722195,"HUNT, DENISE, ANNE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1396722195,"HUNT, DENISE, ANNE",~,501 ESSEOLA DR   SALUDA NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1396722195,"HUNT, DENISE, ANNE",501 ESSEOLA DR   SALUDA NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 99 , 99 ,$#,,
MEDICAID DIRECT,1487809265,SOUND MEDICAL OF CAPE CATERET,~,3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1396722534,"RICKABAUGH, JOHN, CLYDE",3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 79 , 345 , 671 ," $10,693.66 ",,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396723250,"DALY JR, JOHN, JOSEPH",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 24 ,$#,,
MEDICAID DIRECT,1396724225,"RUSS LONG, NATASHA, SCARLETT",~,129 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,1396724225,"RUSS LONG, NATASHA, SCARLETT",129 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396725453,"HUFF, RICHARD, KEVIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396725453,"HUFF, RICHARD, KEVIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396725453,"HUFF, RICHARD, KEVIN",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1396725453,"HUFF, RICHARD, KEVIN",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396725453,"HUFF, RICHARD, KEVIN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1396725453,"HUFF, RICHARD, KEVIN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1396725453,"HUFF, RICHARD, KEVIN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",210 ASHVILLE AVE   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 22 , 37 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396726394,"LISSON, SCOTT, WALKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 23 , 55 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,401 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1396727954,"COCHRAN, WILLIAM, GERALD",401 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 11 , 24 , 41 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396727954,"COCHRAN, WILLIAM, GERALD",401 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396727996,"VELEZ, RAMON",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396728804,"LEWIS, ROY, SHELDON",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 40 , 69 , 96 ,$#,,
MEDICAID DIRECT,1518549393,IREDELL PHYSICIAN NETWORK,IREDELL SURGERY AT MOORESVILLE,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1396728804,"LEWIS, ROY, SHELDON",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396728804,"LEWIS, ROY, SHELDON",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396729018,"MARTIN, MATTHEW, BRUNSON",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396729018,"MARTIN, MATTHEW, BRUNSON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396729018,"MARTIN, MATTHEW, BRUNSON",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1396729265,"WARD, WILLIAM, GOODE",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396729265,"WARD, WILLIAM, GOODE",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396729265,"WARD, WILLIAM, GOODE",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 25 ,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1396729265,"WARD, WILLIAM, GOODE",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134172604,WESTERN PIEDMONT ANESTHESIA,WESTERN PIEDMONT ANESTHESIA,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1396729570,"MCKENNEY, TODD, WHITNEY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396729620,"FRITZ, JONATHAN, PAUL",1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396729620,"FRITZ, JONATHAN, PAUL",1998 HENDERSONVILLE RD STE 40 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1998 HENDERSONVILLE RD STE 40 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396729620,"FRITZ, JONATHAN, PAUL",1998 HENDERSONVILLE RD STE 40 ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,192 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1396729620,"FRITZ, JONATHAN, PAUL",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396729620,"FRITZ, JONATHAN, PAUL",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 57 , 96 , 130 ,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1 VANDERBILT PARK DR STE 150 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396729620,"FRITZ, JONATHAN, PAUL",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1316485410,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA GENERAL SURGERY,1139 CARTHAGE ST STE 110-B SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1396731485,"JURISICH, STEVEN, MICHAEL",1139 CARTHAGE ST STE 110 SANFORD NC,053,Lee,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 51 , 109 , 122 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396732145,"POPE, NECIA, MCREE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1417909409,ALAMANCE EAR NOSE AND THROAT LLP,~,4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1396732525,"MCQUEEN, CHAPMAN, TEAGUE",4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 52 , 124 , 194 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396733820,"CLYNE, BRITTANY, BERGIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 34 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396734190,"GIEDRAITIS, ROBERT, BASIL",7825 BALLANTYNE COMMONS PKWY STE 150 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 76 , 95 , 155 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396734190,"GIEDRAITIS, ROBERT, BASIL",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396734190,"GIEDRAITIS, ROBERT, BASIL",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1972593382,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF EASTERN CAROLINA,1150 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396735700,"TAHA, SHERIF, HOSNY MOHAMED",1150 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 75 , 377 , 443 ,$#,,
MEDICAID DIRECT,1306138714,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1396736542,"OLIVER, TONYA, VON",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396736542,"OLIVER, TONYA, VON",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1396736617,"MESSNER, DANIEL, KENT",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1396736617,"MESSNER, DANIEL, KENT",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 59 , 125 , 177 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1396736617,"MESSNER, DANIEL, KENT",514 S MAIN ST   LAURINBURG NC,083,Scotland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 53 , 93 , 127 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396736955,"RYAN, JEFFERY, CHARLES",3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396736955,"RYAN, JEFFERY, CHARLES",10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 39 , 75 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1396737318,"HARDY, ALVIN, EUGENE",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1396737318,"HARDY, ALVIN, EUGENE",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1396737318,"HARDY, ALVIN, EUGENE",2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1396737318,"HARDY, ALVIN, EUGENE",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396737318,"HARDY, ALVIN, EUGENE",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396737649,"KREEGER, RICHARD, WAYNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 35 , 45 , 45 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396737649,"KREEGER, RICHARD, WAYNE",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396737649,"KREEGER, RICHARD, WAYNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396737649,"KREEGER, RICHARD, WAYNE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 281 , 352 , 412 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1396738357,"CASANOVA, ROSEMARIE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396738357,"CASANOVA, ROSEMARIE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 31 , 36 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396738357,"CASANOVA, ROSEMARIE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,903 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1396738357,"CASANOVA, ROSEMARIE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396738357,"CASANOVA, ROSEMARIE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396738357,"CASANOVA, ROSEMARIE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396738365,"KANAAN, CAMILLE, MUNIR",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396738365,"KANAAN, CAMILLE, MUNIR",2075 GLENN MITCHELL DR STE 500 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1396739116,"BASSETT-SHAFTOE, LINDA, ANNE",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 161 , 538 ," 1,156 "," $14,423.37 ",,
MEDICAID DIRECT,1619903481,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1396739116,"BASSETT-SHAFTOE, LINDA, ANNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 53 , 54 ,$#,,
MEDICAID DIRECT,1619279247,MAIN STREET FAMILY PRACTICE OF CHIN,~,302 S MAIN ST   CHINA GROVE NC,080,Rowan,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1396739330,"REID, KIM, PURCELL",302 S MAIN ST   CHINA GROVE NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619279247,MAIN STREET FAMILY PRACTICE OF CHIN,~,302 S MAIN ST   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1396739330,"REID, KIM, PURCELL",302 S MAIN ST   CHINA GROVE NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1619279247,MAIN STREET FAMILY PRACTICE OF CHIN,~,302 S MAIN ST   CHINA GROVE NC,080,Rowan,193400000X,Group,Single Specialty,,1396739330,"REID, KIM, PURCELL",302 S MAIN ST   CHINA GROVE NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396740114,"POWELL, THOMAS, WILLIAM",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396740114,"POWELL, THOMAS, WILLIAM",~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1396740114,"POWELL, THOMAS, WILLIAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 32 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396740510,"RIELY, JACQUELINE, HERRFELDT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 15 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396740510,"RIELY, JACQUELINE, HERRFELDT",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396740510,"RIELY, JACQUELINE, HERRFELDT",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396740510,"RIELY, JACQUELINE, HERRFELDT",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1396740510,"RIELY, JACQUELINE, HERRFELDT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396740510,"RIELY, JACQUELINE, HERRFELDT",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396740510,"RIELY, JACQUELINE, HERRFELDT",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396743860,"NEWMAN, WILLIAM, NEAL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396743860,"NEWMAN, WILLIAM, NEAL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 21 , 27 , 49 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396744199,"CLAWSON, ELTON, SHEROD",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 31 , 43 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,4525 CAMERON VALLEY PKWY STE 1000A   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396745188,"SCHNEIDER, ANDREW, MARTIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1396745188,"SCHNEIDER, ANDREW, MARTIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396745188,"SCHNEIDER, ANDREW, MARTIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 148 , 154 , 189 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1396745188,"SCHNEIDER, ANDREW, MARTIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396745188,"SCHNEIDER, ANDREW, MARTIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 122 , 128 , 158 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396745535,"REED, JAMES, TODD",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396745535,"REED, JAMES, TODD",11300 CRESTHILL DR STE 100 MINT HILL NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 87 , 160 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396745881,"STANZIONE, MICHOL",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396745881,"STANZIONE, MICHOL",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 115 , 301 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396745881,"STANZIONE, MICHOL",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114028859,COLUMBUS FAMILY MEDICAL PA,~,712 VILLAGE RD STE 104 SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1396746871,"WALKER, KATHY, HINMAN",1601 2 SEASIDE RD SW   OCEAN ISLE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 111 , 129 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,212 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1396748729,"HOLLAND, ROGER, EVAN",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 28 , 189 , 226 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396748729,"HOLLAND, ROGER, EVAN",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 42 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396748729,"HOLLAND, ROGER, EVAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1851710388,FHPG LLC,FIRSTHEALTH PRIMARY CARE - WHISPERING PINES,7473 B HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1396749032,"NICHOLSON, TODD, RICHARD",7473 B HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 143 , 309 ,$#,,
MEDICAID DIRECT,1255868980,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV FOOT AND ANKLE CARE,300 MEDICAL PAVILION DR STE 320 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",300 MEDICAL PAVILION DR STE 320 RAEFORD NC,047,Hoke,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 33 , 36 , 41 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",300 E MCKAY ST ST E ELIZABETHTOWN NC,009,Bladen,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 32 , 50 , 60 ,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",300 E MCKAY ST ST E ELIZABETHTOWN NC,009,Bladen,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 100 , 172 , 206 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",300 E MCKAY ST ST E ELIZABETHTOWN NC,009,Bladen,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396749198,"WARD, PHILLIP, EVANS",588 BAILEY RD STE E LUMBERTON NC,078,Robeson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 112 , 139 , 156 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396749198,"WARD, PHILLIP, EVANS",588 BAILEY RD STE E LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396749867,"CAMBRON, KATHRYN, ANN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 47 , 48 , 61 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396749867,"CAMBRON, KATHRYN, ANN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1396749867,"CAMBRON, KATHRYN, ANN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396750246,INGLES MARKETS INC,INGLES PHARMACY 003,915 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1396750246,INGLES MARKETS INC,915 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1396750394,WALGREEN CO,WALGREENS 07646,2915 N CENTER ST   HICKORY NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1396750394,WALGREEN CO,2915 N CENTER ST   HICKORY NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396754446,"ALDOUS, MARK, DANIEL",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 103 , 124 , 138 ,$#,,
MEDICAID DIRECT,1689761546,GATEWAY AMBULATORY SURGERY CENTER,GATEWAY AMBULATORY SURGERY CENTER,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1396754446,"ALDOUS, MARK, DANIEL",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396754446,"ALDOUS, MARK, DANIEL",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 12 , 16 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396754446,"ALDOUS, MARK, DANIEL",510 CORPORATE CIR STE 1000 SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396754586,"MARSHBANKS, MARY, ALICE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 37 , 37 ,$#,,
MEDICAID DIRECT,1396755591,"LINEBERRY, KEITH, HARDEN",KEITH HARDEN LINEBERRY,901 S AYERSVILLE RD   MAYODAN NC,079,Rockingham,111N00000X,Chiropractic Providers,Chiropractor,,1396755591,"LINEBERRY, KEITH, HARDEN",901 S AYERSVILLE RD   MAYODAN NC,079,Rockingham,111N00000X,Chiropractic Providers,Chiropractor,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396756821,"WALSH, DANIELLE, SAUNDERS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396756995,"WYATT, STEPHEN, ARMSTRONG",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 18 , 27 , 27 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396756995,"WYATT, STEPHEN, ARMSTRONG",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396756995,"WYATT, STEPHEN, ARMSTRONG",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396756995,"WYATT, STEPHEN, ARMSTRONG",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 25 , 33 , 33 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,570 LOWER BRUSH CREEK RD   FLETCHER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396756995,"WYATT, STEPHEN, ARMSTRONG",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1396757423,"BRUNS, MICHAEL, LEE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1396757423,"BRUNS, MICHAEL, LEE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396757423,"BRUNS, MICHAEL, LEE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396757423,"BRUNS, MICHAEL, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396759205,"ALMQUIST, PERRY, FUTRAL",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 29 , 65 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396759205,"ALMQUIST, PERRY, FUTRAL",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 17 , 29 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396759262,"NONOY, NATHANIEL, PAUL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 51 , 52 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396759262,"NONOY, NATHANIEL, PAUL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396759262,"NONOY, NATHANIEL, PAUL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 25 , 28 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396759262,"NONOY, NATHANIEL, PAUL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396759262,"NONOY, NATHANIEL, PAUL",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396760666,"ALLEN, GAIL, ATKINS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396760666,"ALLEN, GAIL, ATKINS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1396760815,"KIM, PAMINA, SUEYON",203 E INDUSTRY DR   OXFORD NC,039,Granville,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1871547364,TRIANGLE DERMATOLOGY ASSOCIATES PA,TRIANGLE ASSOCIATES DERMATOLOGY PA,3008 PICKETT RD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1396760815,"KIM, PAMINA, SUEYON",3008 PICKETT RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 32 , 33 , 53 ,$#,,
MEDICAID DIRECT,1396762555,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1664,2500 FOREST HILLS RD W   WILSON NC,098,Wilson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1396762555,WAL-MART STORES EAST LP,2500 FOREST HILLS RD W   WILSON NC,098,Wilson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1396762837,"UMALI-JHANJI, SOFIA, JECIEL",70 OAK ST   TRYON NC,075,Polk,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1396762837,"UMALI-JHANJI, SOFIA, JECIEL",70 OAK ST   TRYON NC,075,Polk,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1396762837,"UMALI-JHANJI, SOFIA, JECIEL",606 WADE AVE STE 100 RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1396762837,"UMALI-JHANJI, SOFIA, JECIEL",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1396762837,"UMALI-JHANJI, SOFIA, JECIEL",830 BETHANY CHURCH RD   FOREST CITY NC,081,Rutherford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 17 , 67 , 67 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1396762837,"UMALI-JHANJI, SOFIA, JECIEL",830 BETHANY CHURCH RD   FOREST CITY NC,081,Rutherford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1396762837,"UMALI-JHANJI, SOFIA, JECIEL",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396763959,"JOHNSON IV, WILLIAM, EUGENE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 81 , 81 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396765301,"SWARTZ, ZACHARY, THEODORE",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 65 , 138 , 147 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1396765715,"REICHENBACH, DANIEL, JAMES",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1396765715,"REICHENBACH, DANIEL, JAMES",701 NEWMAN RD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 30 , 30 ,$#,,
MEDICAID DIRECT,1881278299,ARCHWELL HEALTH PROFESSIONAL SERVIC,,3022 EASTWAY DR STE 1-3 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396768578,"MCINTOSH, KENYA, PILAR",5740 N GRAHAM ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396769964,"WEBSTER, JULIE",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1396770384,"JOHNSON, JEFFREY, CRAIG",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 54 , 98 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396771291,"BREWER, BRENDA, KEYS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 11 , 12 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1396772117,"AKBAR, FAROOQ",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1396772703,"TAYLOR, KIMBERLY, ANN",8900 W UNIVERSITY ST UNIT 106 WICHITA KS,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 27 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1396772703,"TAYLOR, KIMBERLY, ANN",8900 W UNIVERSITY ST UNIT 106 WICHITA KS,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,1601 ABBEY PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396775862,"HART, VIRGINIA, SPARROW",1601 ABBEY PL   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1396776753,"NEWSOME, CURTIS, WAYNE",CURTIS W NEWSOME,4845 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1396776753,"NEWSOME, CURTIS, WAYNE",4845 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 68 , 244 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396777066,"BRANDON, SCOTT, CRAIG",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396777066,"BRANDON, SCOTT, CRAIG",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396777066,"BRANDON, SCOTT, CRAIG",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396777066,"BRANDON, SCOTT, CRAIG",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811350887,PIEDMONT HEALTHCARE PA,,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396777066,"BRANDON, SCOTT, CRAIG",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 23 , 46 ,$#,,
MEDICAID DIRECT,1104880723,WNC EYE SURGERY CENTER,,8B MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1396782116,"MACALUSO, DAMIEN, CHARLES",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 33 , 33 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396782116,"MACALUSO, DAMIEN, CHARLES",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 57 , 65 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1396782702,"POHLMEYER, ROBERT, AUSTIN",135 PAGE RD N   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 75 , 135 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396782702,"POHLMEYER, ROBERT, AUSTIN",205 PAGE RD   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1396782702,"POHLMEYER, ROBERT, AUSTIN",220 PAGE RD   PINEHURST NC,063,Moore,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 16 , 28 ,$#,,
MEDICAID DIRECT,1629262050,SHARON LAKES MEDICAL ASSOCIATES PC,~,7631 SHARON LAKES RD STE P CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396782983,"ALLEYNE, ERNEST, ALEXANDER",7631 SHARON LAKES RD STE P CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154857662,PRESBYTERIAN SAMEDAY SURGERY CENTER,~,14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396783429,"TIPTON, NAOMI, KURUSU",14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1396785994,"DETERDING, JAMES, LEROY",1301 CENTRAL DR   SANFORD NC,053,Lee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1396785994,"DETERDING, JAMES, LEROY",309 NEW ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396787057,"PEDERSON, DANA, BEEVERS",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396787057,"PEDERSON, DANA, BEEVERS",300 BILLINGSLEY RD STE 200B CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1396787057,"PEDERSON, DANA, BEEVERS",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396787057,"PEDERSON, DANA, BEEVERS",1550 UNION RD STE B GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003218439,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SHALLOTTE,341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396788287,"LYNCH, ANN, HARMON",341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992171060,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF BOLIVIA,4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396788287,"LYNCH, ANN, HARMON",4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 57 , 57 ," $18,009.14 ",,
MEDICAID DIRECT,1992728950,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SALEMBURG,500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396788287,"LYNCH, ANN, HARMON",500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3112 CASEY ST UNIT A LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396788733,"FERRARO, ROBERTO, FULVIO",3112 CASEY ST UNIT A LORIS SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396788733,"FERRARO, ROBERTO, FULVIO",3112 CASEY ST UNIT A LORIS SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 24 , 29 ,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,115 MCLEOD HEALTH BLVD STE 201 MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396788733,"FERRARO, ROBERTO, FULVIO",135 PROFESSIONAL PARK DR   CONWAY SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1801659164,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES SEACOAST,3600 SEA MOUNTAIN HWY STE B LITTLE RIVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1396788733,"FERRARO, ROBERTO, FULVIO",135 PROFESSIONAL PARK DR   CONWAY SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 20 , 23 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396789152,"HIPP, DAVID, ERIC",15 REGIONAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396789152,"HIPP, DAVID, ERIC",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396789152,"HIPP, DAVID, ERIC",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 67 , 112 ,$#,,
MEDICAID DIRECT,1396789715,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,251B00000X,Agencies,Case Management,,1396789715,LENOIR MEMORIAL HOSPITAL INC,100 AIRPORT RD   KINSTON NC,054,Lenoir,251B00000X,Agencies,Case Management,, 190 ," 1,902 "," 1,904 "," $778,639.75 ",,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396791745,"LEUCHTMANN, PETER, LAWRENCE",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 265 , 277 , 371 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396791745,"LEUCHTMANN, PETER, LAWRENCE",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 31 , 31 , 48 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396792321,"MUREA, MARIANA, ABDELRHMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 196 , 196 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396792321,"MUREA, MARIANA, ABDELRHMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396792693,"SULLIVAN, MELISSA, EVANS",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396792693,"SULLIVAN, MELISSA, EVANS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 22 , 51 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396793303,"CAMPBELL, SCOTTY, JOE",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396793303,"CAMPBELL, SCOTTY, JOE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 39 , 55 ,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 48 , 55 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 32 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",375 SUNSET AVE   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1396793386,"SHICK, MICHAEL, TREVOR",223 W WARD ST # B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1396793477,"RAYNOR, ROY, MAX",124 E MAIN ST COURTHOUSE SQUARE CLINTON NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,, 42 , 44 , 50 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,124 E MAIN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1396793477,"RAYNOR, ROY, MAX",124 E MAIN ST COURTHOUSE SQUARE CLINTON NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,, 34 , 37 , 52 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1396793477,"RAYNOR, ROY, MAX",432 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1396793477,"RAYNOR, ROY, MAX",113 W MAIN ST   BENSON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 30 , 30 , 31 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1396793519,"ASHBY, JEFFREY, WAYNE",1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396793519,"ASHBY, JEFFREY, WAYNE",1007 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1396793519,"ASHBY, JEFFREY, WAYNE",2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1396793949,"CLARK, DAVID, ALLAN",300 HEALTH PARK DR STE 210 GARNER NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 15 , 29 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1396793949,"CLARK, DAVID, ALLAN",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 14 , 28 ,$#,,
MEDICAID DIRECT,1588705776,RICHMOND COUNTY DSS,~,127 CAROLINE ST   ROCKINGHAM NC,077,Richmond,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1396795159,"KNOTTS, SHARON, MAXINE",804 S LONG DR   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 51 , 83 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1396795159,"KNOTTS, SHARON, MAXINE",2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 104 , 104 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1396795159,"KNOTTS, SHARON, MAXINE",2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1740213321,GOLDSBORO PHYSICAL THERAPY,GOLDSBORO PHYSICAL THERAPY,2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1396797981,"POPE, ELIZABETH, PHILLIPS",2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1396798401,"PHILLIPS, JASON, VANN",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396798666,"BRYAN, JAMES, ALEXANDER",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1396798864,EYECARECENTER OD PA,EYECARE CENTER,315A WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1396798864,EYECARECENTER OD PA,315A WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1396798864,EYECARECENTER OD PA,EYECARE CENTER,315A WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1396798864,EYECARECENTER OD PA,315A WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,, 24 , 24 , 48 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1396799334,"GRIGSBY SESSOMS, KIMBERLY, DENISE",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 53 , 53 ," $20,980.05 ",,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1396799334,"GRIGSBY SESSOMS, KIMBERLY, DENISE",102 SW RAILROAD ST   ROSE HILL NC,031,Duplin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1508123571,SESSOMS MEDICAL ASSOCIATES LLC,~,500 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1396799334,"GRIGSBY SESSOMS, KIMBERLY, DENISE",500 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1295824159,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - PSYCHIATRY,391 SERPENTINE DR STE 400 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396799631,"STEPHENS, CHARLOTTE, H",391 SERPENTINE DR STE 400 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396800355,"PARKER AUTRY, CANDACE, YVONNE",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396800355,"PARKER AUTRY, CANDACE, YVONNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396800355,"PARKER AUTRY, CANDACE, YVONNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 72 , 123 , 248 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396801668,"BLEVINS, MONICA, NICOLE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396801668,"BLEVINS, MONICA, NICOLE",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396802260,GLENFLORA,~,5701 N FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396802260,GLENFLORA,5701 N FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 613 , 613 ," $38,436.61 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396802534,"ANDERSON, DEVERICK, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396802534,"ANDERSON, DEVERICK, JOHN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396802534,"ANDERSON, DEVERICK, JOHN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 18 , 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396803912,"EDELSTEIN, ANDREW, ROBERT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396803912,"EDELSTEIN, ANDREW, ROBERT",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 106 , 172 , 172 ," $14,797.69 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1396805354,"SCHWARTZBERG, BRIAN, JEFFREY",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396807251,"SHOLLER, PETER, FREDERICK",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396807939,"WATSON, LISA, MCINTOSH",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 38 , 43 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396807939,"WATSON, LISA, MCINTOSH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396807939,"WATSON, LISA, MCINTOSH",584 HOSPITAL DR NE UNIT A BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396807988,"RYAN, JASON, WILLIAM",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396807988,"RYAN, JASON, WILLIAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1396807988,"RYAN, JASON, WILLIAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396807988,"RYAN, JASON, WILLIAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 57 , 57 , 68 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396807988,"RYAN, JASON, WILLIAM",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396807988,"RYAN, JASON, WILLIAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396807988,"RYAN, JASON, WILLIAM",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1396807988,"RYAN, JASON, WILLIAM",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396808168,"COX, GARY",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 20 , 56 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396808168,"COX, GARY",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 23 , 62 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396808168,"COX, GARY",DUKE HOSPITAL SOUTH TRENT   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396808168,"COX, GARY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 82 , 195 , 289 ,$#,,
MEDICAID DIRECT,1396811451,"SMITH, JACQUELINE, BROWN",JACQUELINE BROWN SMITH DDS PLLC,621 LYNNHAVEN PKWY STE 255 VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1396811451,"SMITH, JACQUELINE, BROWN",621 LYNNHAVEN PKWY STE 255 VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 29 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1396814331,MECKLENBURG COUNTY,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,," 2,350 "," 17,877 "," 19,056 "," $1,553,913.01 ",,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,171M00000X,Other Service Providers,Case Manager/Care Coordinator,,1396814331,MECKLENBURG COUNTY,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,#,,,$#,,
MEDICAID DIRECT,1396816104,CLAIBORNE PROSTHETICS AND ORTHOTIC,CLAIBORNE PROSTHETICS AND ORTHOTICS,1041 HAWTHORNE LN STE B CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396816104,CLAIBORNE PROSTHETICS AND ORTHOTIC,1041 HAWTHORNE LN STE B CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 24 ,$#,,
MEDICAID DIRECT,1396824884,XEON ENTERPRISES INC,XEON HOME HEALTHCARE SERVICES,100 W POLLOCK ST STE 2 MOUNT OLIVE NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1396824884,XEON ENTERPRISES INC,100 W POLLOCK ST STE 2 MOUNT OLIVE NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 45 ," 9,994 "," 10,065 "," $731,148.96 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396826640,"WILSON, JASON, PAUL",11803 JEFFERSON AVE STE 235 NEWPORT NEWS VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396827499,"DAVENPORT, ASHLEY, PARKER",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396829206,"KIM, RAYMOND, JIN-SUK",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396829206,"KIM, RAYMOND, JIN-SUK",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396829446,"LOBACH, DAVID, FRANKLIN",2100 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1396831723,"PEARSON, MARVIN, BRUCE",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396831723,"PEARSON, MARVIN, BRUCE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 20 , 24 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396831723,"PEARSON, MARVIN, BRUCE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396832853,"POON, ERIC, GON-CHEE",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1023046042,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE RIVERVIEW,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396832853,"POON, ERIC, GON-CHEE",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 43 , 42 , 657 ," $49,703.36 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 64 , 64 , 836 ," $64,683.37 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 57 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 99 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 33 , 33 , 604 ," $47,132.91 ",,
MEDICAID DIRECT,1396840781,"HWANG, SUN HEE",SUN HEE HWANG,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1396840781,"HWANG, SUN HEE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 38 , 36 , 553 ," $45,447.23 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 13 , 13 , 167 ," $10,336.77 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 17 , 17 , 298 ," $28,138.57 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 11 ,#, 151 ," $11,910.96 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 18 , 18 , 296 ," $31,338.36 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",8415 MEDICAL PLAZA DR   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 38 , 38 , 591 ," $50,886.51 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 76 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 25 , 25 , 489 ," $46,962.29 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 78 , 78 ," 1,524 "," $157,367.85 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396840781,"HWANG, SUN HEE",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 23 , 23 , 342 ," $23,873.76 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396840872,"CAPPELLUTI, ERIKA",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396840872,"CAPPELLUTI, ERIKA",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 32 , 62 , 67 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396840872,"CAPPELLUTI, ERIKA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396840872,"CAPPELLUTI, ERIKA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396841227,"YU, SUNNY, PYON",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 142 , 205 , 567 ," $23,591.53 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396841227,"YU, SUNNY, PYON",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 579 , 676 ," 1,952 "," $90,977.92 ",,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396841227,"YU, SUNNY, PYON",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396841227,"YU, SUNNY, PYON",1031 WEISS AVE STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1083850606,BOONE TRAIL OPTOMETRIC EYE CARE,,48 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1396841813,"SWARINGEN, SANDRA",48 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1396842357,BLOUNTS MUTUAL DRUGS INC,~,323 S BROAD ST   EDENTON NC,021,Chowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396842357,BLOUNTS MUTUAL DRUGS INC,323 S BROAD ST   EDENTON NC,021,Chowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1528704004,PITT COUNTY MEMORIAL HOSPITAL INC,ECU HEALTH BEAUFORT HOSPITAL,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1396842423,"COURNOYER, EDDIE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396845426,"CHATTERJEE, SROBONA, TUBLU",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396845426,"CHATTERJEE, SROBONA, TUBLU",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194714626,ATLANTIC PULMONARY ASSOCIATES PA,ATLANTIC PULMONARY ASSOCIATES PA,111 MEDICAL DR STE A ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1396845483,"MELKO, JUANITA, MEADS",111 MEDICAL DR STE A ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 32 , 32 ,$#,,
MEDICAID DIRECT,1396848081,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07024,300 MANGROVE DR   EMERALD ISLE NC,016,Carteret,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396848081,NORTH CAROLINA CVS PHARMACY LLC,300 MANGROVE DR   EMERALD ISLE NC,016,Carteret,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396851218,"FOTO, ANTHONY, ANGELO",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 100 , 256 , 269 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396851218,"FOTO, ANTHONY, ANGELO",2780 X RAY DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 130 , 138 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396851218,"FOTO, ANTHONY, ANGELO",7615 DALLAS CHERRYVILLE HWY   CHERRYVILLE NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 101 , 103 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396851218,"FOTO, ANTHONY, ANGELO",1212 E SUNSET DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396851218,"FOTO, ANTHONY, ANGELO",3510 W HIGHWAY 74   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 154 , 158 ,$#,,
MEDICAID DIRECT,1396852570,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1002 N CHURCH ST STE 2 GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1396852570,EAGLE PHYSICIANS AND ASSOCIATES PA,1002 N CHURCH ST STE 2 GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 28 , 20 , 31 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396853024,"IAMMARINO, JOHN, CHARLES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396853024,"IAMMARINO, JOHN, CHARLES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 26 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396856175,"CERNE, CONNIE, DIANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 104 , 121 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396856175,"CERNE, CONNIE, DIANN",2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396856225,"BUIE, STEPHEN, EUGENE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 24 , 31 , 31 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396856225,"BUIE, STEPHEN, EUGENE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396856225,"BUIE, STEPHEN, EUGENE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396858619,"OFORI MANTE, JULIANA, ATEI",13557 STEELECROFT PKWY STE 2200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 33 , 83 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396859104,"MULLINAX, ASHLEE, LYNNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396859815,"ELLIOTT, TAMMY, KAY",2196 HWY 42 W   CLAYTON NC,051,Johnston,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396859815,"ELLIOTT, TAMMY, KAY",910 W WILLIAMS ST   APEX NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1568610889,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,704 GOLD HILL RD STE 1200 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396867941,"PERNO, MICHELLE, MARIE",704 GOLD HILL RD STE 1200 FORT MILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396867941,"PERNO, MICHELLE, MARIE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396867941,"PERNO, MICHELLE, MARIE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396867941,"PERNO, MICHELLE, MARIE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396867941,"PERNO, MICHELLE, MARIE",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 32 , 77 ,$#,,
MEDICAID DIRECT,1396870457,BAPTIST CHILDRENS HOME OF NC INC,ALVERTA BOLICK HOME,80 BAKER AVE   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396870457,BAPTIST CHILDRENS HOME OF NC INC,80 BAKER AVE   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 80 , 80 ,$#,,
MEDICAID DIRECT,1396870838,TOUCHED BY ANGELS HOME HEALTH,TOUCHED BY ANGELS,4400 SILAS CREEK PKWY STE 100 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1396870838,TOUCHED BY ANGELS HOME HEALTH,4400 SILAS CREEK PKWY STE 100 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 5,240 "," 5,240 "," $330,011.16 ",,
MEDICAID DIRECT,1396871869,MOVE WITH ME PHYSICAL THERAPY PLLC,MOVE WITH ME PHYSICAL THERAPY LLC,7532 WILKINS DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396871869,MOVE WITH ME PHYSICAL THERAPY PLLC,7532 WILKINS DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 199 ," 3,113 "," 3,195 "," $271,185.17 ",,
MEDICAID DIRECT,1710908041,YADKIN RIVER RADIOLOGY PA,YADKIN RIVER RADIOLOGY PA,122 WYNDHAM WAY   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",1365 WESTGATE CENTER DR STE K1 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 24 , 32 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",1365 WESTGATE CENTER DR STE K1 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",180 PARKWOOD DR   ELKIN NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1710908041,YADKIN RIVER RADIOLOGY PA,YADKIN RIVER RADIOLOGY PA,122 WYNDHAM WAY   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1396872024,"WOLSKE, KRISTY, MARIE",180 PARKWOOD DR   ELKIN NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1396873667,"CARNEY, KELLY, ANNE",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1396879292,"LYNN, LARRY, WADE",98 DOCTORS DR   SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1396879292,"LYNN, LARRY, WADE",98 DOCTORS DR STE 300 SYLVA NC,050,Jackson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396880068,"MOORE, KRISTI, MICHELLE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396880068,"MOORE, KRISTI, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 67 , 67 ,$#,,
MEDICAID DIRECT,1134264195,JASPER L LEWIS JR DDS PA,~,1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1396880258,"LEWIS, JASPER, LEE",1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396881579,"KEET, CORINNE, ALLISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1396885968,COMPANION HOME HEALTH CARE,~,4820 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396885968,COMPANION HOME HEALTH CARE,4820 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 12 ,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 255 , 691 , 691 ," $82,614.22 ",,
MEDICAID DIRECT,1396887428,OASIS EYE CARE OPTOMETRY PA,~,701 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1396887428,OASIS EYE CARE OPTOMETRY PA,701 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,," 1,533 "," 1,534 "," 3,068 "," $42,142.35 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396887485,"BLODGETT, ANDREW, DEATON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396887485,"BLODGETT, ANDREW, DEATON",8401 MEDICAL PLAZA DR STE 250 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 60 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396887485,"BLODGETT, ANDREW, DEATON",19830 ZION AVE   CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 60 , 138 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396889333,"POLK, CHRISTOPHER, MICHAEL",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 27 , 29 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396889333,"POLK, CHRISTOPHER, MICHAEL",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1396891776,"JONES, DARRELL, EDWARD",155 MEMORIAL DR   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396891776,"JONES, DARRELL, EDWARD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1396891776,"JONES, DARRELL, EDWARD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 46 , 55 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396892329,"MARTINELLI, JOHN, FRANCIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 21 , 24 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396892329,"MARTINELLI, JOHN, FRANCIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1396895041,"GUPTA, TINA",~,700 EXPOSITION PL STE 111 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1396895041,"GUPTA, TINA",700 EXPOSITION PL STE 111 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#, 12 , 64 ,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396897187,"POST, MOIRA, SHORTELL",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1396897187,"POST, MOIRA, SHORTELL",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396897187,"POST, MOIRA, SHORTELL",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1396897187,"POST, MOIRA, SHORTELL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396897187,"POST, MOIRA, SHORTELL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396897575,"BAILEY JR, DONALD, LEE",4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 123 , 182 , 543 ," $26,497.22 ",,
MEDICAID DIRECT,1811041700,LANE AND ASSOCIATES XII DDS PA,LANE AND ASSOCIATES XII DDS PA,4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396897575,"BAILEY JR, DONALD, LEE",4106 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 34 , 70 , 216 ," $12,836.38 ",,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396898714,"HAWKS, LINDSEY, BROOKE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396898714,"HAWKS, LINDSEY, BROOKE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396898714,"HAWKS, LINDSEY, BROOKE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 41 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396900288,"LANEY, RONALD, BUREN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 79 , 131 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396900288,"LANEY, RONALD, BUREN",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1396900882,"CROSSBOURNE, ANEISHA, SELENE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 50 , 50 ,$#,,
MEDICAID DIRECT,1396901047,STRIVE MEDICAL,,5800 CAMPUS CIRCLE DR E STE 100B IRVING TX,102,Out of State > 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1396901047,STRIVE MEDICAL,5800 CAMPUS CIRCLE DR E STE 100B IRVING TX,102,Out of State > 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396901633,"HABERSHAW, BRITTANY, MYERS",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 54 , 54 ,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396901773,"TARR, MEGAN, ELIZABETH",10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396901773,"TARR, MEGAN, ELIZABETH",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1467790055,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVI,200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396901773,"TARR, MEGAN, ELIZABETH",200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396901773,"TARR, MEGAN, ELIZABETH",200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1396902391,"GEIGEL, CARLOS, OSCAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 166 , 190 , 249 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396902466,"SCHRODER, VANESSA, TEABERRY",10 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 20 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396902466,"SCHRODER, VANESSA, TEABERRY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396902466,"SCHRODER, VANESSA, TEABERRY",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396902466,"SCHRODER, VANESSA, TEABERRY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396902599,"SUNG, JULIA, ANNE MARSH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396902599,"SUNG, JULIA, ANNE MARSH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1174030225,ALLEN BUTLER OD PA,FAMILY EYE CARE,200 DOCTORS DR STE K JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1396904132,"BUTLER, LLOYD, ALLEN",200 DOCTORS DR   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,, 76 , 82 , 94 ,$#,,
MEDICAID DIRECT,1396904132,"BUTLER, LLOYD, ALLEN",~,200 DOCTORS DR   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,1396904132,"BUTLER, LLOYD, ALLEN",200 DOCTORS DR   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396904777,"SATTERLY, STEVEN, ANDREW",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396904777,"SATTERLY, STEVEN, ANDREW",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 42 , 55 ,$#,,
MEDICAID DIRECT,1851691570,ALVI PRIME TIME CLINICS PLLC,NORTH RALEIGH MEDICAL CENTER,11009 INGLESIDE PL STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396904967,"KUNDE, SACHIN, SHRIKAR",11009 INGLESIDE PL STE 201 RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396905121,"MISRA, SWARUP",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1396905469,"BAYLEY, RYAN, PATRICK",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1396905469,"BAYLEY, RYAN, PATRICK",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 35 , 44 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396906533,"LONGFORS, NANCY, SUE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396908299,"SAINI, ASHISH, PAL",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396910097,"RESTEL, BRADLEY, HARTWELL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 556 , 549 , 701 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396910097,"RESTEL, BRADLEY, HARTWELL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 47 , 62 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396910097,"RESTEL, BRADLEY, HARTWELL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 98 , 106 , 123 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396910279,"MARION, CHAD, RYAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 37 , 46 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396910543,"WOLFE, CAMERON, ROBERT",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 36 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396910543,"WOLFE, CAMERON, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 34 , 82 , 110 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396910543,"WOLFE, CAMERON, ROBERT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396910709,"ELLIOTT, REBECCA, LYNN",10826 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 40 , 78 , 125 ,$#,,
MEDICAID DIRECT,1932151305,CAROLINA EAR AND HEARING CLINIC PC,CAROLINA EAR AND HEARING CLINIC PC,5900 SIX FORKS RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1396911244,"RICHARDS, COURTNEY",5900 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396912051,"HWANG, JANICE, JIN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 29 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396912051,"HWANG, JANICE, JIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396912051,"HWANG, JANICE, JIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1396913794,SHELLEY WATERS MS CCC SLP,~,452 GATLIN HUNTING CLUB RD   HOBGOOD NC,042,Halifax,193200000X,Group,Multi-Specialty,,1396913794,SHELLEY WATERS MS CCC SLP,452 GATLIN HUNTING CLUB RD   HOBGOOD NC,042,Halifax,193200000X,Group,Multi-Specialty,, 18 , 306 , 306 ," $20,932.08 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396915104,"DEBELAK, JACOB, PATRICK",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 81 , 81 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396915104,"DEBELAK, JACOB, PATRICK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396921664,"JARRETT, CLAUDIUS, DAMIEN BABATUNDE",9101 OCEAN HWY E   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396921664,"JARRETT, CLAUDIUS, DAMIEN BABATUNDE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 59 , 92 , 134 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396921664,"JARRETT, CLAUDIUS, DAMIEN BABATUNDE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396922209,SERENITY FAMILY CARE LLC,~,2415 S CENTER ST APT B HICKORY NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396922209,SERENITY FAMILY CARE LLC,2415 S CENTER ST APT B HICKORY NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 525 , 525 ," $74,951.21 ",,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1396923322,"KENDALL, EMILY, BETH",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396923322,"KENDALL, EMILY, BETH",705 GRIFFITH ST STE 205 DAVIDSON NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396923322,"KENDALL, EMILY, BETH",8210 UNIVERSITY EXEC PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396923322,"KENDALL, EMILY, BETH",8210 UNIVERSITY EXEC PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 34 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396923793,"SWAMY, RAJIV, SETH",709 WICKER ST STE A SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1508305293,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA CARDIOLOGY,709 WICKER ST STE A SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1396923793,"SWAMY, RAJIV, SETH",709 WICKER ST STE A SANFORD NC,053,Lee,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 89 , 220 , 288 ,$#,,
MEDICAID DIRECT,1508305293,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA CARDIOLOGY,709 WICKER ST STE A SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1396923793,"SWAMY, RAJIV, SETH",709 WICKER ST STE A SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396923793,"SWAMY, RAJIV, SETH",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396925152,"COCHRANE, SHELLEY",600 HOSPITAL DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 39 , 39 ,$#,,
MEDICAID DIRECT,1396926184,THE WHEELCHAIR PLACE,~,920 TATE BLVD SE STE 104 HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396926184,THE WHEELCHAIR PLACE,920 TATE BLVD SE STE 104 HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 30 , 80 , 131 ,$#,,
MEDICAID DIRECT,1396926184,THE WHEELCHAIR PLACE,~,920 TATE BLVD SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396926184,THE WHEELCHAIR PLACE,920 TATE BLVD SE   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1396926986,AMERICAN MEDICAL EQUIPMENT SUPPLI,AMERICAN MEDICAL EQUIPMENT & SUPPLIES,4909 ALPINIS DR STE 101 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1396926986,AMERICAN MEDICAL EQUIPMENT SUPPLI,4909 ALPINIS DR STE 101 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 58 , 585 ," 2,140 "," $149,831.13 ",,
MEDICAID DIRECT,1396926986,AMERICAN MEDICAL EQUIPMENT SUPPLI,AMERICAN MEDICAL EQUIPMENT & SUPPLIES,4909 ALPINIS DR STE 101 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1396926986,AMERICAN MEDICAL EQUIPMENT SUPPLI,4909 ALPINIS DR STE 101 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1396926986,AMERICAN MEDICAL EQUIPMENT SUPPLI,AMERICAN MEDICAL EQUIPMENT & SUPPLIES,4909 ALPINIS DR STE 101 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1396926986,AMERICAN MEDICAL EQUIPMENT SUPPLI,4909 ALPINIS DR STE 101 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 4,308 "," 4,567 "," $458,389.00 ",,
MEDICAID DIRECT,1396928859,"SHELL, GREGORY, KENNETH",~,4558 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1396928859,"SHELL, GREGORY, KENNETH",4558 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 808 ," 4,117 "," 4,739 "," $592,782.13 ",,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396928966,"BLACKBURN, JEFFREY, ROBERT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 52 , 74 , 96 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396928966,"BLACKBURN, JEFFREY, ROBERT",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396928966,"BLACKBURN, JEFFREY, ROBERT",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396928966,"BLACKBURN, JEFFREY, ROBERT",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396928966,"BLACKBURN, JEFFREY, ROBERT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 64 , 90 , 100 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396928966,"BLACKBURN, JEFFREY, ROBERT",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 34 , 47 , 76 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1396928966,"BLACKBURN, JEFFREY, ROBERT",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 33 , 49 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396929964,"DAVIS, PAUL, LAWSON",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396929964,"DAVIS, PAUL, LAWSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396929964,"DAVIS, PAUL, LAWSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 4 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396929964,"DAVIS, PAUL, LAWSON",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,21 HOSPITAL DR FL 4 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396929964,"DAVIS, PAUL, LAWSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 17 , 21 , 28 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1396931481,"CONTENTO, RANDALL, JAMES",251 WILMOT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1396931481,"CONTENTO, RANDALL, JAMES",251 WILMOT DR   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 195 , 713 ," 1,237 "," $10,600.80 ",,
MEDICAID DIRECT,1942841218,FOOT AND ANKLE SPECIALISTS OF THE M,,251 WILMOT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396931481,"CONTENTO, RANDALL, JAMES",251 WILMOT DR   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396932869,"BODE, JOHN, HERMAN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396932869,"BODE, JOHN, HERMAN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 47 , 52 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396933065,"BYRAM, MARGARET, LILLIAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396933065,"BYRAM, MARGARET, LILLIAN",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 28 , 55 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396933065,"BYRAM, MARGARET, LILLIAN",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 24 , 43 ,$#,,
MEDICAID DIRECT,1265277172,ELITE COMPREHENSIVE CARE,ELITE COMPREHENSIVE CARE,13094 NC HWY   SURF CITY NC,071,Pender,193200000X,Group,Multi-Specialty,,1396933065,"BYRAM, MARGARET, LILLIAN",206 N DYSON ST   HOLLY RIDGE NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396933065,"BYRAM, MARGARET, LILLIAN",206 N DYSON ST   HOLLY RIDGE NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396934535,B & C CARE SYSTEM INC,B&C CARE SYSTEM INC,2917 GUESS RD STE 1 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1396934535,B & C CARE SYSTEM INC,2917 GUESS RD STE 1 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 69 ," 14,057 "," 14,401 "," $2,007,594.95 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396934618,"MCKAY, MELISSA, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 107 , 107 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1396934618,"MCKAY, MELISSA, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 55 , 55 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396935771,"LARBI SIAW, KWAME",2555 COURT DR STE 270 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1396935771,"LARBI SIAW, KWAME",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 237 , 237 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396935771,"LARBI SIAW, KWAME",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396937561,"CENDALES, LINDA, CARIME",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 21 , 30 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1396937561,"CENDALES, LINDA, CARIME",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1396937561,"CENDALES, LINDA, CARIME",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1396939443,"COLE, MICHELE, TIDWELL",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518393560,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1396939443,"COLE, MICHELE, TIDWELL",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1396939443,"COLE, MICHELE, TIDWELL",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 37 , 92 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1396939443,"COLE, MICHELE, TIDWELL",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518393560,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1396939443,"COLE, MICHELE, TIDWELL",151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 20 ,$#,,
MEDICAID DIRECT,1396939955,"SARKODIE, OLGA, LEONIDOVNA",~,325 N STATE OF FRANKLIN RD FL 1 JOHNSON CITY TN,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,1396939955,"SARKODIE, OLGA, LEONIDOVNA",325 N STATE OF FRANKLIN RD FL 1 JOHNSON CITY TN,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396940177,MIMS FAMILY CARE HOME,,6337 MIMS RD   HOLLY SPRINGS NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1396940177,MIMS FAMILY CARE HOME,6337 MIMS RD   HOLLY SPRINGS NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1396941589,"MCCLAIN, ARNOLD, TODD",ARNOLD TODD MCCLAIN DDS MS PA,5015 SOUTHPARK DR STE 130 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1396941589,"MCCLAIN, ARNOLD, TODD",5015 SOUTHPARK DR STE 130 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1396941589,"MCCLAIN, ARNOLD, TODD",ARNOLD TODD MCCLAIN DDS MS PA,5015 SOUTHPARK DR STE 130 DURHAM NC,032,Durham,1223P0300X,Dental Providers,Dentist,Periodontics,1396941589,"MCCLAIN, ARNOLD, TODD",5015 SOUTHPARK DR STE 130 DURHAM NC,032,Durham,1223P0300X,Dental Providers,Dentist,Periodontics, 85 , 87 , 440 ," $58,410.38 ",,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396942207,"VANN, JESSICA, UPCHURCH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 85 , 85 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396942207,"VANN, JESSICA, UPCHURCH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396942207,"VANN, JESSICA, UPCHURCH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396945028,"OLMEDO, MARIO",1901 HILLANDALE RD STE D DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 44 , 94 ,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1396945028,"OLMEDO, MARIO",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 124 , 254 ,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,1396945028,"OLMEDO, MARIO",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396953469,"PATEL, MANOJKUMAR, D",725 VOLVO PKWY STE 102 CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396953469,"PATEL, MANOJKUMAR, D",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 42 , 44 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396954103,"JONES, MALIAKA, KAI",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 63 , 124 , 125 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396954103,"JONES, MALIAKA, KAI",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 25 , 25 ,$#,,
MEDICAID DIRECT,1649216631,PIEDMONT EAR NOSE AND THROAT PA,PIEDMONT EAR NOSE AND THROAT ASSOCIATES,110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396955589,"WAGONER, GWENDOLYN, FIELD",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 33 , 53 , 86 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1396956371,"KHAN, FAISAL, MAHMOOD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1396956371,"KHAN, FAISAL, MAHMOOD",400 US 70 HWY E   GARNER NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 60 , 108 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396956371,"KHAN, FAISAL, MAHMOOD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 112 , 193 , 243 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396956371,"KHAN, FAISAL, MAHMOOD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1396956371,"KHAN, FAISAL, MAHMOOD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396956371,"KHAN, FAISAL, MAHMOOD",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396956371,"KHAN, FAISAL, MAHMOOD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1396956793,"HARRIS, MELANIE, BERLIN",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 115 , 126 , 325 ,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,306 DOLPHIN DR STE 2 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1396956991,"JOHNSON, ANDREW, MATHEW",306 DOLPHIN DR   JACKSONVILLE NC,067,Onslow,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 465 , 532 ," 1,987 "," $72,664.70 ",,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1396956991,"JOHNSON, ANDREW, MATHEW",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 571 , 650 ," 4,580 "," $367,514.83 ",,
MEDICAID DIRECT,1548510969,CUMBERLAND COUNTY HOSPITAL SYSTEM I,FERNCREEK GENERAL SURGERY,4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1396957429,"VAN FOSSEN, KELLY, MARIE",4140 FERNCREEK DR STE 601 FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 59 , 101 , 106 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396962510,"NECE, BONNIE, ANN",1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396962510,"NECE, BONNIE, ANN",1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 20 , 24 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396962510,"NECE, BONNIE, ANN",317 N KING ST STE B HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396962510,"NECE, BONNIE, ANN",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 39 ,$#,,
MEDICAID DIRECT,1457729634,APPALACHIAN REGIONAL MEDICAL ASSOCI,BOONE UROLOGY CENTER,870 STATE FARM RD STE 100 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1396966644,"ANCAYA, FRANCISCO, LUIS",870 STATE FARM RD STE 100 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 55 ,$#,,
MEDICAID DIRECT,1538561865,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM MEDICAL ONCOLOGY,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1396966818,"MACK, DAVID, ADAM",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1538561865,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM MEDICAL ONCOLOGY,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1396966818,"MACK, DAVID, ADAM",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 92 , 162 , 162 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396966917,"THOMAS, LISA, KAY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 52 , 52 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,3518 DRAWBRIDGE PKWY STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1396966917,"THOMAS, LISA, KAY",3518 DRAWBRIDGE PKWY STE 210 GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396969408,"MARROQUIN, BRIDGET, MURPHY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1083650881,COLLINS & SAMPSON DDS PA,COLLINS JEFF,312 E WARDELL DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1396969515,"COLLINS, JEFF",312 E WARDELL DR   PEMBROKE NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 274 , 451 ," 1,425 "," $56,832.57 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1396970760,"MORITA, HOKUTO",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 77 , 106 , 106 ,$#,,
MEDICAID DIRECT,1235680463,RDMG ASSOCIATES PA,,1 SAINT DUNSTANS RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396973905,"FERRIS, HOLLY, ELIZABETH",1 SAINT DUNSTANS RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 24 , 45 ,$#,,
MEDICAID DIRECT,1548625684,ALI LUNG CLINIC PC,,706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1396973996,"ALI, MIR, MUSTAFA",706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1548625684,ALI LUNG CLINIC PC,,706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1396973996,"ALI, MIR, MUSTAFA",706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1548625684,ALI LUNG CLINIC PC,,706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1396973996,"ALI, MIR, MUSTAFA",706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 338 , 991 ," 1,856 "," $74,014.88 ",,
MEDICAID DIRECT,1396973996,"ALI, MIR, MUSTAFA",~,706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,1396973996,"ALI, MIR, MUSTAFA",706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 45 , 72 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 111 , 144 , 175 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 40 , 60 , 100 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1396974309,"JARIWALA, NIKHIL, ARVIND",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 212   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396974473,"YEATTS, SHERI, LYNN MCLOUD",300 MEDICAL PKWY STE 206 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 28 , 28 ,$#,,
MEDICAID DIRECT,1396974770,CAROLINA CARE SOLUTIONS LLC,~,1001 VAN BUREN AVE STE A INDIAN TRAIL NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1396974770,CAROLINA CARE SOLUTIONS LLC,1001 VAN BUREN AVE STE A INDIAN TRAIL NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#, 325 , 325 ," $19,586.78 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396978797,"AHMED, FARHAN",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396978797,"AHMED, FARHAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 33 , 33 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396978797,"AHMED, FARHAN",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 88 , 100 , 253 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1396978797,"AHMED, FARHAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 13 , 27 , 28 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396978797,"AHMED, FARHAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 25 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1396979449,"SONGARA, VARSHABEN, MAGANSINH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1396979449,"SONGARA, VARSHABEN, MAGANSINH",800 TILGHMAN DR   DUNN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255775938,COATS MEDICAL SERVICES LLC,CFV PRIMARY CARE FAMILY MEDICINE CONT CLINIC-COATS,25 N JOHNSON ST   COATS NC,043,Harnett,193200000X,Group,Multi-Specialty,,1396979449,"SONGARA, VARSHABEN, MAGANSINH",25 N JOHNSON ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 35 , 50 ,$#,,
MEDICAID DIRECT,1255775938,COATS MEDICAL SERVICES LLC,CFV PRIMARY CARE FAMILY MEDICINE CONT CLINIC-COATS,25 N JOHNSON ST   COATS NC,043,Harnett,193400000X,Group,Single Specialty,,1396979449,"SONGARA, VARSHABEN, MAGANSINH",25 N JOHNSON ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 50 , 74 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1396979993,"FENDER, TRACE, ISAIAH",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396979993,"FENDER, TRACE, ISAIAH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396979993,"FENDER, TRACE, ISAIAH",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1396979993,"FENDER, TRACE, ISAIAH",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1396981221,"DURNING, APRIL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1396981221,"DURNING, APRIL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 137 , 304 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1396984043,"PATEL, SNEHAL, RAJENDRAKUMAR",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1396984043,"PATEL, SNEHAL, RAJENDRAKUMAR",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1396984043,"PATEL, SNEHAL, RAJENDRAKUMAR",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 80 , 129 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1396985644,"MADUAKO, NDI, JOHNNIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1396985644,"MADUAKO, NDI, JOHNNIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1396985644,"MADUAKO, NDI, JOHNNIE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1396985644,"MADUAKO, NDI, JOHNNIE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396986329,"SHAH, RAJIV, EDLAGAN",1014 N ELM ST   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396986329,"SHAH, RAJIV, EDLAGAN",750 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396986329,"SHAH, RAJIV, EDLAGAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 153 , 285 , 495 ," $42,501.52 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396986329,"SHAH, RAJIV, EDLAGAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1396987087,"WRIGHT, KRYSTAL, RICHARDSON",835 ALBEMARLE RD   TROY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 240 , 462 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396988598,"LAVIN, LINDSAY, ROOFE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 69 , 70 , 78 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1396988598,"LAVIN, LINDSAY, ROOFE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1396988598,"LAVIN, LINDSAY, ROOFE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1396988598,"LAVIN, LINDSAY, ROOFE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396988598,"LAVIN, LINDSAY, ROOFE",,3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,1396988598,"LAVIN, LINDSAY, ROOFE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1396988598,"LAVIN, LINDSAY, ROOFE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1396990438,"ESTES SHUTE, EMILY, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396993184,"BALAKRISHNAN, NIKHIL",131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396993184,"BALAKRISHNAN, NIKHIL",131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,,,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1396993184,"BALAKRISHNAN, NIKHIL",131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 21 , 30 , 35 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396994026,"ANDERSON, DANIEL, ROBERT",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396994026,"ANDERSON, DANIEL, ROBERT",1690 SKYLYN DR STE 350 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 17 , 25 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396994026,"ANDERSON, DANIEL, ROBERT",1690 SKYLYN DR STE 350 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 28 , 51 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1396994026,"ANDERSON, DANIEL, ROBERT",1690 SKYLYN DR STE 350 SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 58 , 73 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 34 , 54 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 2101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 68 , 142 , 434 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",6646 REGAL OAKS DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 16 , 27 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 72 , 125 , 300 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",6646 REGAL OAKS DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1396997649,"PHADKE, GAUTAM, MUKUND",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 13 , 34 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396998282,"FEDOROV, ASHLEY, LYNN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 62 , 306 , 308 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396998282,"FEDOROV, ASHLEY, LYNN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1396998282,"FEDOROV, ASHLEY, LYNN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1407000706,PATHFINDERS OF COASTAL CAROLINA INC,PATHFINDERS OF COASTAL CAROLINA INC,125A W WATER ST   PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,,1407000706,PATHFINDERS OF COASTAL CAROLINA INC,125A W WATER ST   PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,,#, 527 , 527 ," $72,640.48 ",,
MEDICAID DIRECT,1063880045,KOREN & ASSOCIATES DDS II PA,DENTAL SMILES OF NC,4112 PLEASANT VALLEY RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407001076,"HEWETT, AARON, SCOTT",4112 PLEASANT VALLEY RD STE 200 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 973 ," 2,180 "," 11,176 "," $810,329.41 ",,
MEDICAID DIRECT,1184255101,JOHN T WILL DDS PLLC,,4045 RIVERSIDE DR   DANVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407001811,"WILL, JOHN, TAYLOR",4045 RIVERSIDE DR   DANVILLE VA,101,Out of State <= 40 miles,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#, 27 ,$#,,
MEDICAID DIRECT,1407004989,THERAPLAY JUNCTION,~,2994 OLD AIRPORT RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1407004989,THERAPLAY JUNCTION,2994 OLD AIRPORT RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,, 120 ," 2,324 "," 2,896 "," $231,196.60 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407005119,"GUPTILL, CHANDA, NICOLE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407005119,"GUPTILL, CHANDA, NICOLE",332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 14 , 24 ,$#,,
MEDICAID DIRECT,1295093144,DR ROLANDO ORTIZ OPTOMETRIST PLLC,BRIGHT VISION CENTER,836 E CHATHAM ST STE 106 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407006141,"ORTIZ, ROLANDO",836 E CHATHAM ST STE 106 CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 46 , 60 , 157 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407007065,"MOSTAK, RICHARD, GRANT",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 54 , 97 , 160 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407011398,"HILL, ASHLEY, ROSE",648 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 27 , 56 ,$#,,
MEDICAID DIRECT,1154196020,FD BILLING LLC,WAVERLY ORAL SURGERY,11840 SOUTHMORE DR STE 150 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407011927,"NAIDU, KARTHIK, KANAKASUNDARAM",5700 UNIVERSITY POINTE BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 46 ,$#,,
MEDICAID DIRECT,1497189419,G ABRAMS R COHEN VI PC,~,5700 UNIVERSITY POINTE BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407011927,"NAIDU, KARTHIK, KANAKASUNDARAM",5700 UNIVERSITY POINTE BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery," 1,635 "," 2,416 "," 12,658 "," $1,397,886.48 ",,
MEDICAID DIRECT,1407011927,"NAIDU, KARTHIK, KANAKASUNDARAM",,5700 UNIVERSITY POINTE BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1407011927,"NAIDU, KARTHIK, KANAKASUNDARAM",5700 UNIVERSITY POINTE BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407013279,"PHILLIPS, BRETT, THOMAS",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407013279,"PHILLIPS, BRETT, THOMAS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407013279,"PHILLIPS, BRETT, THOMAS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407013279,"PHILLIPS, BRETT, THOMAS",3475 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003558461,GENERATIONS FAMILY PRACTICE,KERNERSVILLE PRIMARY CARE,420 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407015217,"COX, ERICA, AMBURGY",420 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1407015217,"COX, ERICA, AMBURGY",1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407017254,"LACHIEWICZ, ANNE, MONICA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 43 , 121 , 161 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1407018658,"PHILLIPS, BRANDON, NICKOLAS",2905 N ELM ST   LUMBERTON NC,078,Robeson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1407018658,"PHILLIPS, BRANDON, NICKOLAS",2047 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407019458,"KING, JODY, PAYNE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407019987,"KAHLE, CAROLINE, HOLLECK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407019987,"KAHLE, CAROLINE, HOLLECK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 13 , 14 , 31 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 13 , 27 , 38 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 24 , 45 , 84 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 17 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 29 , 29 , 71 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,,,Unknown,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407023989,"SMRTKA, MICHAEL, PATRICK-BOUSSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029044,"ZIA, SHAMS",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029044,"ZIA, SHAMS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029044,"ZIA, SHAMS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 119 , 119 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029044,"ZIA, SHAMS",505 OBERLIN RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029044,"ZIA, SHAMS",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029044,"ZIA, SHAMS",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029044,"ZIA, SHAMS",400 US 70 HWY E   GARNER NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029085,"SCHWARTZ, EMILY, LYNN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 124 , 124 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407029135,"GAGLIARDI, DAVID, MICHAEL",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407029135,"GAGLIARDI, DAVID, MICHAEL",8090 MARKET ST   WILMINGTON NC,065,New Hanover,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029218,"PEERY, CHARLES, ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029218,"PEERY, CHARLES, ANDREW",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029218,"PEERY, CHARLES, ANDREW",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029218,"PEERY, CHARLES, ANDREW",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029770,"STOECKER, MAGGIE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029770,"STOECKER, MAGGIE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029770,"STOECKER, MAGGIE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 29 , 29 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407029770,"STOECKER, MAGGIE, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 44 , 44 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407029770,"STOECKER, MAGGIE, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 40 , 41 , 77 ,$#,,
MEDICAID DIRECT,1205155801,CABRAL INTERNAL MEDICINE PLLC,CABRAL INTERNAL MEDICINE PLLC,711 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407031420,"CABRAL, DAVID, ISMAEL",711 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407032469,"HUO, JEFFREY, SEAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 25 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407032469,"HUO, JEFFREY, SEAN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407034192,"PAGE, NNEKA, ORJI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407034192,"PAGE, NNEKA, ORJI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407037195,"SELF, JULIA, MURDOCH",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407037195,"SELF, JULIA, MURDOCH",128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1407037732,CHILDRENS NEUROTHERAPY SERVICES LLC,CNS CLINIC,1087 13TH ST SE   HICKORY NC,018,Catawba,251S00000X,Agencies,Community/Behavioral Health,,1407037732,CHILDRENS NEUROTHERAPY SERVICES LLC,1087 13TH ST SE   HICKORY NC,018,Catawba,251S00000X,Agencies,Community/Behavioral Health,, 68 ," 1,329 "," 1,329 "," $86,154.00 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407038680,"KEMP, JENNIFER, ANN",201 E GROVER ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407038680,"KEMP, JENNIFER, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407040785,VICTORY HEALTHCARE SERVICES INC,,1421 PJ FARMS LN   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407040785,VICTORY HEALTHCARE SERVICES INC,1421 PJ FARMS LN   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 220 , 220 ," $15,543.68 ",,
MEDICAID DIRECT,1407040785,VICTORY HEALTHCARE SERVICES INC,,3716 SUMMER PL   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407040785,VICTORY HEALTHCARE SERVICES INC,3716 SUMMER PL   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 772 , 772 ," $52,422.98 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407043656,"QUAYE, ROLAND, ANETEY",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407049042,"TAYLOR-GANTTE, DEANNA, FAYE",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1407049042,"TAYLOR-GANTTE, DEANNA, FAYE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407049042,"TAYLOR-GANTTE, DEANNA, FAYE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477834992,DEST REIMELS DDS PLLC,BELVEDERE DENTISTRY,2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407052301,"BANSCH, JASON, PHILIP",2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 794 ," 1,479 "," 4,375 "," $205,049.89 ",,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1407052574,"SHULTZ, AMANDA, MCMILLAN",1211A IRELAND DR   FAYETTEVILLE NC,026,Cumberland,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 65 , 203 , 207 ," $16,741.05 ",,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407054760,"MELON, DAVID, ETHAN",304 10TH AVE NE   HICKORY NC,018,Catawba,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 162 , 332 , 440 ," $10,755.32 ",,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 66 , 72 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",17 CORNELIA ST   LEXINGTON NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 34 , 34 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 56 , 62 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 44 , 44 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",1101 HARTWELL ST   GARNER NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 31 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407054976,"CANTILLO, MANUEL, EDWARDO",1101 HARTWELL ST   GARNER NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174635882,GILLIAM AND GILLIAM PLLC,~,2 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1407056153,"GILLIAM, MAXWELL, LEE",2 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 357 , 603 ," 1,535 "," $68,257.76 ",,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1407057508,"FURIA, SAMANTHA",100 PLANK BRIDGE RD # B CAMDEN NC,015,Camden,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 14 , 29 , 61 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1805 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407057508,"FURIA, SAMANTHA",1805 W CITY DR STE H ELIZABETH CITY NC,070,Pasquotank,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 23 , 37 , 71 ,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407057920,"CHANG, WARREN, ANDREW",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 184 , 184 ,$#,,
MEDICAID DIRECT,1407058399,"MOZINGO, BRYAN, ANDREWS",~,434 N TRADE ST STE 103 MATTHEWS NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,1407058399,"MOZINGO, BRYAN, ANDREWS",434 N TRADE ST STE 103 MATTHEWS NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#, 49 , 52 ,$#,,
MEDICAID DIRECT,1538539655,ADIO ASSOCIATES INC,CHIROPRACTIC HEALTH OF MATTHEWS,434 N TRADE ST STE 103 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407058399,"MOZINGO, BRYAN, ANDREWS",434 N TRADE ST STE 103 MATTHEWS NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#, 42 , 43 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407058472,"HENSLEY, KYLE, ADAM",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407058498,"DOLAN, HILLARY, JANE",4102 N ROXBORO ST   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407058498,"DOLAN, HILLARY, JANE",1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407058498,"DOLAN, HILLARY, JANE",1010 TRYON VILLAGE DR   CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407062235,"VAN POPPEL, MARK, DANIEL",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407062235,"VAN POPPEL, MARK, DANIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 53 , 55 , 81 ," $18,690.11 ",,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407062235,"VAN POPPEL, MARK, DANIEL",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407062235,"VAN POPPEL, MARK, DANIEL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 101 , 125 , 186 ," $13,940.26 ",,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407062235,"VAN POPPEL, MARK, DANIEL",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821489188,ULTRA VIOLET MENTAL HEALTH,~,1930 JAKE ALEXANDER BLVD W STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1407063282,"CUPP, BRENDA, BELK",1930 JAKE ALEXANDER BLVD W STE 1020 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 35 , 69 ,$#,,
MEDICAID DIRECT,1407064470,"JENKINS, LILLIAN, MAE",LILLIAN M JENKINS,621 N CHURCH ST   ROCKY MOUNT NC,064,Nash,227900000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers","Respiratory Therapist, Registered",,1407064470,"JENKINS, LILLIAN, MAE",621 N CHURCH ST   ROCKY MOUNT NC,064,Nash,227900000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers","Respiratory Therapist, Registered",,#, 81 , 81 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1407065402,"DYER JR, BENJAMIN, FRANCIS",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 33 , 125 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1407065402,"DYER JR, BENJAMIN, FRANCIS",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1407065402,"DYER JR, BENJAMIN, FRANCIS",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,122300000X,Dental Providers,Dentist,,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,107 W NAOMI ST   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,,1407065402,"DYER JR, BENJAMIN, FRANCIS",107 W NAOMI ST   RANDLEMAN NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1407065402,"DYER JR, BENJAMIN, FRANCIS",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1407065402,"DYER JR, BENJAMIN, FRANCIS",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 178 , 251 , 828 ," $46,289.54 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1407065402,"DYER JR, BENJAMIN, FRANCIS",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 37 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407065477,"PARK, PAUL, BEOM-SOO",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407065477,"PARK, PAUL, BEOM-SOO",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 22 , 32 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407065477,"PARK, PAUL, BEOM-SOO",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 17 , 21 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407065477,"PARK, PAUL, BEOM-SOO",11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407067929,"KHAN, RAZA, ALI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 20 , 31 , 54 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407067929,"KHAN, RAZA, ALI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,929 N 2ND ST STE 101 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1407067929,"KHAN, RAZA, ALI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 31 , 36 , 62 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,101 E W T HARRIS BLVD STE 4001 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407067929,"KHAN, RAZA, ALI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1407067929,"KHAN, RAZA, ALI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1407070295,"DOYLE, MELISSA",ALPHA ONE ENDOCRINE,804 STAMPER RD STE 201 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1407070295,"DOYLE, MELISSA",804 STAMPER RD STE 201 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,61 BONNIE LN   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1407070824,"PATTERSON, CURRENT, CUSTER",243 JONES COVE RD   CLYDE NC,044,Haywood,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205456290,PATTERSON DERMATOLOGY PC,CURRENT DERMATOLOGY,61 BONNIE LN   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1407070824,"PATTERSON, CURRENT, CUSTER",61 BONNIE LN   SYLVA NC,050,Jackson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 57 , 91 , 170 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1407072069,"DANNER, JAMES, DAVID",3724 WIRELESS DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407072069,"DANNER, JAMES, DAVID",3724 WIRELESS DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 44 , 44 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1407072069,"DANNER, JAMES, DAVID",215 LASH DR   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 97 , 99 ,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407072069,"DANNER, JAMES, DAVID",215 LASH DR   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1407073125,IMPACT FAMILY CARE HOME INC,IMPACT FAMILY CARE HOME INC,211 RED HOLLY DR   SANFORD NC,053,Lee,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407073125,IMPACT FAMILY CARE HOME INC,211 RED HOLLY DR   SANFORD NC,053,Lee,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,075 "," 1,076 "," $83,541.18 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407074255,"PEREA, ELENA",430 RANKIN DR   MARION NC,059,McDowell,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407074255,"PEREA, ELENA",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407074255,"PEREA, ELENA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407074255,"PEREA, ELENA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407074255,"PEREA, ELENA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 19 , 23 , 23 ,$#,,
MEDICAID DIRECT,1407078165,D H D GROUP HOME,D H D GROUP HOME,1005 HORTON RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407078165,D H D GROUP HOME,1005 HORTON RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 543 , 544 ," $200,462.89 ",,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1407079817,"DRAKE, KRISTEN, MASSLOFSKY",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1407079817,"DRAKE, KRISTEN, MASSLOFSKY",2007 WALNUT ST   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407080641,"ALLEN, AMANDA, MARSHBURN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 33 , 72 , 72 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407081334,"SLECHTA, LINDSEY, RAE",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 83 , 182 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407081334,"SLECHTA, LINDSEY, RAE",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1518606136,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-156 CROSS ROAD DRIVE,156 CROSS ROAD DR   MILLS RIVER NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407082118,"JOHNSON, AMY, BROOK",156 CROSSROADS DR   MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 36 , 42 ,$#,,
MEDICAID DIRECT,1659152932,EDWARD L OLCESE DDS PLLC,ANSON FAMILY DENTISTRY,148 E MORGAN ST   WADESBORO NC,004,Anson,193400000X,Group,Single Specialty,,1407083108,"OLCESE, EDWARD, LUIS",148 E MORGAN ST STE A WADESBORO NC,004,Anson,1223G0001X,Dental Providers,Dentist,General Practice, 818 ," 1,527 "," 4,224 "," $167,598.08 ",,
MEDICAID DIRECT,1407083108,"OLCESE, EDWARD, LUIS",~,148 E MORGAN ST STE A WADESBORO NC,004,Anson,1223G0001X,Dental Providers,Dentist,General Practice,1407083108,"OLCESE, EDWARD, LUIS",148 E MORGAN ST STE A WADESBORO NC,004,Anson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1407083314,"SCHWARTZ, MICHELE, MILLER",3110 WELLONS BLVD   NEW BERN NC,025,Craven,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1407089949,"LAM, DUY, QUANG",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1841734209,EYECARECENTER OD PA,EYECARE CENTER,1225 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1407089949,"LAM, DUY, QUANG",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 29 , 39 , 43 ,$#,,
MEDICAID DIRECT,1841734209,EYECARECENTER OD PA,EYECARE CENTER,1225 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1407089949,"LAM, DUY, QUANG",1225 CARTHAGE ST   SANFORD NC,053,Lee,152W00000X,Eye and Vision Services Providers,Optometrist,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407090095,"ADENIYI, ADERONKE, OLUPONLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 20 , 26 ,$#,,
MEDICAID DIRECT,1407095037,HALIKIERRA COMMUNITY SERVICES,HALIKIERRA COMMUNITY SERVICES,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1407095037,HALIKIERRA COMMUNITY SERVICES,1304 WOODSIDE DR   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1801360565,MOUNTAIN REGIONAL ANESTHESIA PLLC,,197 RIVERVIEW ST   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1407096597,"RICH, CHRISTOPHER, DWIGHT",197 RIVERVIEW ST   FRANKLIN NC,056,Macon,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407097280,"HAVILL, JOHN, PAUL",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 238 , 485 , 618 ," $13,361.73 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407097520,"BUCHANAN, DALE, JAMES",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1407097520,"BUCHANAN, DALE, JAMES",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1407097520,"BUCHANAN, DALE, JAMES",430 RANKIN DR   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407097520,"BUCHANAN, DALE, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407097520,"BUCHANAN, DALE, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407097538,"SUMRALL, SARAH, WEBBER",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407097538,"SUMRALL, SARAH, WEBBER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,1100 HEALING WAY STE 21D MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1407097538,"SUMRALL, SARAH, WEBBER",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1407099229,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,414 N LAFAYETTE ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1407099229,CNC-ACCESS INC,414 N LAFAYETTE ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,655 "," 1,655 "," $115,099.52 ",,
MEDICAID DIRECT,1407099229,CNC-ACCESS INC,ALL WAYS CARING HOMECARE,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1407099229,CNC-ACCESS INC,1165 COUNTY HOME RD   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1467141721,LITTLE SPARROW PEDIATRICS PLLC,,31 E MEDICAL CT STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1407099369,"ALLEN HELMS, ANGELA, RENEE",31 E MEDICAL CT STE 2 MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 128 , 217 ," $11,334.90 ",,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1407103112,"ANDERSON, MEGAN, COWIN",1206 BROWN ST   WASHINGTON NC,007,Beaufort,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 28 , 73 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407103112,"ANDERSON, MEGAN, COWIN",101 HEART DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407103682,"GATTAN, MARAME, KHALED",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407103930,"RANDAZZO, SONYA, CRYSTAL DELWADIA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 97 , 96 , 109 ," $15,631.02 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407106628,"COLEMAN, TARA, BETH",114 BRADY CT   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 21 , 28 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407106628,"COLEMAN, TARA, BETH",114 BRADY CT   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407106628,"COLEMAN, TARA, BETH",114 BRADY CT   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 21 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407106628,"COLEMAN, TARA, BETH",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407106628,"COLEMAN, TARA, BETH",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407106628,"COLEMAN, TARA, BETH",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407107501,"LOZANO, STEPHANIE, LEE",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407107501,"LOZANO, STEPHANIE, LEE",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 85 , 103 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407107501,"LOZANO, STEPHANIE, LEE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1740558949,BLUE RIDGE HEALTHCARE MEDICAL GROUP,ALAN F JACKS MD PA,845 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1407109309,"PROFFITT, SHANA, COOK",730 MALCOLM BLVD STE 100 CONNELLY SPRINGS NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 126 , 398 , 430 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407109614,"GODFREY, ANDREW, WYATT",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407109614,"GODFREY, ANDREW, WYATT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407113103,"GONCHAROW, WILLIAM, GLEN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407113103,"GONCHAROW, WILLIAM, GLEN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1407113103,"GONCHAROW, WILLIAM, GLEN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1407113103,"GONCHAROW, WILLIAM, GLEN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 33 , 37 ,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407114168,"MILLS, KIMBERLY, ROBIN",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407114168,"MILLS, KIMBERLY, ROBIN",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 94 , 110 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407115371,"MOLINARI, LYNDSAY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407115371,"MOLINARI, LYNDSAY, MARIE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407115371,"MOLINARI, LYNDSAY, MARIE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407115470,"DOW, AMANDA, LYNNE",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 33 , 63 , 63 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407115470,"DOW, AMANDA, LYNNE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407115470,"DOW, AMANDA, LYNNE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407115892,"HILL, JONATHAN, CRISTIAN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407116296,"EL-AMRAOUI, AMINE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407117070,"PENWARDEN, AMY, AMANDA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407117070,"PENWARDEN, AMY, AMANDA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 69 , 71 ,$#,,
MEDICAID DIRECT,1275596439,CAROLINA SPECIALTY CARE PA,CAROLINA SPECIALTY CARE PA,293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407118615,"PAWLOWSKI, KRISTEN, LYNNE",293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407119266,"BRUEHL, MATTHEW, JAMES",104 MEDSPRING DR   CLAYTON NC,051,Johnston,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1407119266,"BRUEHL, MATTHEW, JAMES",120 HEALTHPLEX WAY   APEX NC,092,Wake,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1407409543,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC PULMONOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407119266,"BRUEHL, MATTHEW, JAMES",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 19 , 23 , 30 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407122153,"KOKAJKO, LAUREN, ELIZABETH",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407122153,"KOKAJKO, LAUREN, ELIZABETH",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 36 , 39 ,$#,,
MEDICAID DIRECT,1407124613,SUNRISE HOME CARE INC,~,1754 E 11TH ST STE D SILER CITY NC,019,Chatham,253Z00000X,Agencies,In Home Supportive Care,,1407124613,SUNRISE HOME CARE INC,1754 E 11TH ST STE D SILER CITY NC,019,Chatham,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 3,806 "," 4,022 "," $645,164.04 ",,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407125008,"WOODWARD, BRENT, HEALEY",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407125008,"WOODWARD, BRENT, HEALEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407131691,"SURIKE, LAURA, ROLLYSON",201 E GROVER ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1245585009,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE WAXHAW FAMILY MEDICINE,2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1407132178,"GONZALES, JENNIFER, LYNN",2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 32 , 42 ,$#,,
MEDICAID DIRECT,1245585009,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE WAXHAW FAMILY MEDICINE,2700 PROVIDENCE RD S STE 300 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1407132178,"GONZALES, JENNIFER, LYNN",3614 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 20 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407132228,"AKULA, VIJAYA, BHARGAVI",501 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 49 , 49 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407132228,"AKULA, VIJAYA, BHARGAVI",1200 N ELM ST STE 3360 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 92 , 92 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407132855,"CONG, DAN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407132855,"CONG, DAN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407133069,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE NORTHEAST HICKORY,2365 SPRINGS RD NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407133069,GASTON FAMILY HEALTH SERVICES INC,2365 SPRINGS RD NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 334 , 762 , 762 ," $16,362.04 ",,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407137573,"SWANGER, REBECCA, LYNN",1207 EAST ST   WAYNESVILLE NC,044,Haywood,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407137573,"SWANGER, REBECCA, LYNN",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407137573,"SWANGER, REBECCA, LYNN",44 BONNIE LN   SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407140973,"KLAENHAMMER, ELLEN, BETH",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407140973,"KLAENHAMMER, ELLEN, BETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 56 , 57 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407140973,"KLAENHAMMER, ELLEN, BETH",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407140973,"KLAENHAMMER, ELLEN, BETH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407140973,"KLAENHAMMER, ELLEN, BETH",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1407141435,"WARD, BRYANT, ALAN",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1407141435,"WARD, BRYANT, ALAN",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407142466,"NISSAO, ESTHER, ALICE",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 34 , 87 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407144405,"BROTHERS, TAMARA, KATHLEEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407144744,"OLSON, DAVID, CHARLES",10502 PARK RD STE 150 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407144744,"OLSON, DAVID, CHARLES",10502 PARK RD STE 150 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407144744,"OLSON, DAVID, CHARLES",15110 JOHN J DELANEY DR STE 120 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407144744,"OLSON, DAVID, CHARLES",15110 JOHN J DELANEY DR STE 120 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407146319,"GILLESPIE, JEREMY, THOMAS",280 BROAD ST STE G KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407146319,"GILLESPIE, JEREMY, THOMAS",195 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 35 , 47 , 52 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407146319,"GILLESPIE, JEREMY, THOMAS",195 KIMEL PARK DR STE 300 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407146319,"GILLESPIE, JEREMY, THOMAS",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147150,"KLATT-CROMWELL, CRISTINE, NICOLE",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 23 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407147150,"KLATT-CROMWELL, CRISTINE, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 16 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147275,"WILLIAMS, ZACHARY, FORREST",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147275,"WILLIAMS, ZACHARY, FORREST",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147275,"WILLIAMS, ZACHARY, FORREST",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407147283,"SHELDON, CANDICE, RAY",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 11 , 16 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147283,"SHELDON, CANDICE, RAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147283,"SHELDON, CANDICE, RAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147283,"SHELDON, CANDICE, RAY",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 11 , 14 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147283,"SHELDON, CANDICE, RAY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 14 , 41 , 42 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147804,"FEENEY, COLBY, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 53 , 53 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147804,"FEENEY, COLBY, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407147804,"FEENEY, COLBY, DANIELLE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407149768,"SWEENEY, ADAM, PATRICK",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407149768,"SWEENEY, ADAM, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 ,#, 16 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407150592,"BENTLEY, MONICA, ARTHURS",1867 REMOUNT RD STE H GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407150592,"BENTLEY, MONICA, ARTHURS",1867 REMOUNT RD STE H GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407150592,"BENTLEY, MONICA, ARTHURS",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407150592,"BENTLEY, MONICA, ARTHURS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407152218,"FERREIRA SUSIN, LISIANE",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223E0200X,Dental Providers,Dentist,Endodontics, 81 , 84 , 159 ," $17,039.36 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 50 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 49 , 70 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 131 , 146 , 203 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 97 , 112 , 157 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1407152283,"MARIN, DANIELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407153992,"DRIVER, CLAUDIA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1407153992,"DRIVER, CLAUDIA, MARIE",200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1093901696,CAROLINA CARING HEALTH PARTNERS,CAROLINA CARING HOUSE CALLS,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407159767,"MARCHMON, ANGELA, MICHELLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,,,$#,,
MEDICAID DIRECT,1710353479,ATLANTIC EYE OPTOMETRIC SERVICES PA,~,2803A CASHWELL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1407162043,"STATSICK, KENNETH, RICHARD",2803 CASHWELL DR STE A GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,, 41 , 44 , 54 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 109 , 112 , 138 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1407167687,"DALAL, RAVI, RAJENDRAKUMAR",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407168404,"DURANT, JAMES, MCDOWELL",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics, 36 , 38 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407170079,"SOLOSKO, STEPHANIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 26 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1407170079,"SOLOSKO, STEPHANIE",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407172455,"BULLOCK, WILLIAM, MICHAEL",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407172455,"BULLOCK, WILLIAM, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407172455,"BULLOCK, WILLIAM, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 17 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1407172455,"BULLOCK, WILLIAM, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407172455,"BULLOCK, WILLIAM, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 46 , 68 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407172786,"BALLARD, MARQUIEZ, DENISE",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407172836,"KINSINGER, LUKE, AARON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407172836,"KINSINGER, LUKE, AARON",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 50 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407172836,"KINSINGER, LUKE, AARON",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 42 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407172836,"KINSINGER, LUKE, AARON",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407173867,"BRANTLEY, JERRY, LENDO",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407173867,"BRANTLEY, JERRY, LENDO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 25 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407173867,"BRANTLEY, JERRY, LENDO",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1407174782,"NANNAPANENI, SRIKANT",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407174782,"NANNAPANENI, SRIKANT",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366687568,AMERICAN ACCESS CARE OF NC,TRIANGLE INTERVENTIONAL SERVICES LLC,2501 WESTON PKWY STE 201 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175110,"PECHTER, WILLIAM, HARRIS",511 PALADIN DR   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1366687568,AMERICAN ACCESS CARE OF NC,TRIANGLE INTERVENTIONAL SERVICES LLC,2501 WESTON PKWY STE 201 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175110,"PECHTER, WILLIAM, HARRIS",2501 WESTON PKWY STE 201 CARY NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 251 , 380 , 836 ," $86,737.13 ",,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407175839,"MILES, JEREMY, J",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 18 , 29 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407176282,"DAWS, SNOW, BRENNER",1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407176282,"DAWS, SNOW, BRENNER",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 96 , 148 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407176282,"DAWS, SNOW, BRENNER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407176282,"DAWS, SNOW, BRENNER",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 33 , 54 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407176811,"LAM, KENT, KWOK KIN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407176811,"LAM, KENT, KWOK KIN",600 GRESHAM DR STE 1100 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1952626384,BLUE RIDGE HEALTHCARE MEDICAL GROUP,TABLE ROCK FAMILY MEDICINE,301 LINVILLE ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1407177439,"HOVIS, JACOB, ROSS",301 LINVILLE ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 75 , 152 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407177652,"SHIVER, AUSTIN, LUKE",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407177652,"SHIVER, AUSTIN, LUKE",1915 RANDOLPH RD FL 2 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407177892,"ZAHEER, SARAH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 12 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407177892,"ZAHEER, SARAH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407177892,"ZAHEER, SARAH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407177892,"ZAHEER, SARAH",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407177892,"ZAHEER, SARAH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407177892,"ZAHEER, SARAH",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 15 , 16 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407177892,"ZAHEER, SARAH",10207 CERNY ST   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407181969,"DIAZ, DAWN, MARIE",5720 CREEDMOOR RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407181969,"DIAZ, DAWN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,51 MOSAIC BLVD STE 110 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1407181969,"DIAZ, DAWN, MARIE",51 MOSAIC BLVD STE 110 PITTSBORO NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1407181969,"DIAZ, DAWN, MARIE",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1407186422,"BODDAPATI, KALYANA C R",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 20 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407186422,"BODDAPATI, KALYANA C R",615 RIDGE RD   ROXBORO NC,073,Person,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407186422,"BODDAPATI, KALYANA C R",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407186422,"BODDAPATI, KALYANA C R",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407186422,"BODDAPATI, KALYANA C R",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 119 , 119 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407187578,"DUNN, MARY, WEINSTEIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 83 , 135 ,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407188071,GASTON FAMILY HEALTH SERVICES INC,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407188378,"ROCKWELL, NATALIE, ELAINE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407188451,JAI SIDDHI VINAYAK INC,M L K PHARMACY,1489 NEW WALKERTOWN RD   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1407188451,JAI SIDDHI VINAYAK INC,1489 NEW WALKERTOWN RD   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 20 , 52 , 52 ,$#,,
MEDICAID DIRECT,1407188451,JAI SIDDHI VINAYAK INC,M L K PHARMACY,1489 NEW WALKERTOWN RD   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1407188451,JAI SIDDHI VINAYAK INC,1489 NEW WALKERTOWN RD   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407190135,"GROSSMAN, JANELLE, MARIE",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 91 , 266 , 429 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407190135,"GROSSMAN, JANELLE, MARIE",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 22 , 47 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 230 , 245 , 341 ,$#,,
MEDICAID DIRECT,1992284327,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH BREAST IMAGING CENTER LANGTREE,106 LANGTREE VILLAGE DR STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 19 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1407198484,"SIMON, JOSEPH, JORDAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407200330,"DOSHI, SHREYANS, MAYUR",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 55 , 62 , 105 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407200330,"DOSHI, SHREYANS, MAYUR",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 19 , 20 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407200330,"DOSHI, SHREYANS, MAYUR",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407200330,"DOSHI, SHREYANS, MAYUR",101 E W T HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407200330,"DOSHI, SHREYANS, MAYUR",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407200330,"DOSHI, SHREYANS, MAYUR",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1407200330,"DOSHI, SHREYANS, MAYUR",1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1407203151,"HOLT, DEANNA, LEIGH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1407203151,"HOLT, DEANNA, LEIGH",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407203888,"TACKETT, JONATHAN, KENTON",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407203888,"TACKETT, JONATHAN, KENTON",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407203888,"TACKETT, JONATHAN, KENTON",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 359 ," 1,326 "," 1,381 "," $34,435.62 ",,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407207012,"HENNESSEE, PENNY, LINGERFELT",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407207012,"HENNESSEE, PENNY, LINGERFELT",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407207012,"HENNESSEE, PENNY, LINGERFELT",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 35 , 52 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407207657,"HOWARD, HEATHER, MCPHERSON",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 17 , 71 , 71 ,$#,,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407210057,"DEANS, JOHN, RANDOLPH",1899 N MARINE BLVD STE 400 JACKSONVILLE NC,067,Onslow,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 36 , 86 , 219 ," $32,090.64 ",,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407210057,"DEANS, JOHN, RANDOLPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407210057,"DEANS, JOHN, RANDOLPH",1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1899 N MARINE BLVD STE 400 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1407210057,"DEANS, JOHN, RANDOLPH",1899 N MARINE BLVD STE 400 JACKSONVILLE NC,067,Onslow,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 51 , 115 , 294 ," $27,226.80 ",,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407210057,"DEANS, JOHN, RANDOLPH",1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 39 , 54 , 98 ," $16,404.44 ",,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407210057,"DEANS, JOHN, RANDOLPH",5211 EASON ST STE 1 SOUTHPORT NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407210057,"DEANS, JOHN, RANDOLPH",14 DOCTORS CIR STE 4 SUPPLY NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407210388,"CHEN, FENGMING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 25 , 27 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407210388,"CHEN, FENGMING",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 68 , 69 , 92 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407210487,"PAGE, NATHAN, CHAD",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407210487,"PAGE, NATHAN, CHAD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 90 , 92 , 98 ,$#,,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,138 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,138 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 38 , 38 ," $68,754.56 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,12 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,12 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 20 , 226 , 226 ," $94,671.35 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,11 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,11 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 99 , 99 ," $26,937.67 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,236 COUNTRY TIME CIR   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,236 COUNTRY TIME CIR   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 244 , 244 ," $15,257.64 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,19 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,19 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 273 , 298 ," $69,228.71 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,8 ELLA LN   ALEXANDER NC,011,Buncombe,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1407210644,RIVERSIDE VILLAGE HOMES INC,8 ELLA LN   ALEXANDER NC,011,Buncombe,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 34 ," 1,359 "," 1,373 "," $174,520.45 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,8 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,8 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 21 , 307 , 336 ," $145,762.14 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,138 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1407210644,RIVERSIDE VILLAGE HOMES INC,138 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 67 ," 2,258 "," 2,289 "," $302,953.88 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,18 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,18 ELLA LN   ALEXANDER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 16 , 257 , 257 ," $76,625.91 ",,
MEDICAID DIRECT,1407210644,RIVERSIDE VILLAGE HOMES INC,,351 FAMILY RIDGE RD   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407210644,RIVERSIDE VILLAGE HOMES INC,351 FAMILY RIDGE RD   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 244 , 244 ," $15,257.64 ",,
MEDICAID DIRECT,1720198369,ROANOKE VALLEY HEALTH SERVICES INC,ROANOKE CLINIC,1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1407212699,"CARLISLE, BRANDON, COLBY",1385 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 118 , 354 , 371 ," $13,740.03 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407217300,"TAHA, MOHAMED, E",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407219025,"PUNG, JORDAN, STEVEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 19 , 45 , 51 ," $11,972.50 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407220684,"JONES, STACEY, LAWRENCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407220684,"JONES, STACEY, LAWRENCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407220684,"JONES, STACEY, LAWRENCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407220684,"JONES, STACEY, LAWRENCE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 21 , 37 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407220684,"JONES, STACEY, LAWRENCE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407223712,"DOBBINS, SHANNON, NICOLE",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407223712,"DOBBINS, SHANNON, NICOLE",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407223712,"DOBBINS, SHANNON, NICOLE",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407223712,"DOBBINS, SHANNON, NICOLE",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407226749,"PARK, EUNJIN, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407226749,"PARK, EUNJIN, LYNN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407226749,"PARK, EUNJIN, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407227028,"SCZUDLO, STEPHANIE, LYNN",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1407227226,SPEECH THERAPY EAST INC,,115 REGENCY BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407227226,SPEECH THERAPY EAST INC,115 REGENCY BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,, 20 , 268 , 269 ," $18,695.41 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407231723,"MEINERS, KATHRYN, ELIZABETH",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 54 , 98 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407232259,"CERASARO, MICHAEL, ANTHONY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407232259,"CERASARO, MICHAEL, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1407232259,"CERASARO, MICHAEL, ANTHONY",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407233034,"BURNS, ALEXA, RICHARDSON",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 174 , 175 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407233471,"STAY, EMMALIE, ELIZABETH",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407233901,"ZAKHAR, JOSEPH, ALLEN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 11 , 16 , 22 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407234818,"REGELSBERGER-ALVAREZ, CHRISTINA, MARIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 58 , 92 , 104 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407234818,"REGELSBERGER-ALVAREZ, CHRISTINA, MARIA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407234818,"REGELSBERGER-ALVAREZ, CHRISTINA, MARIA",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1861131328,REX HOSPITAL INC,NORTH CAROLINA UROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407235211,"OKORO, CHINONYEREM, UZOAMAKA",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1861131328,REX HOSPITAL INC,NORTH CAROLINA UROLOGY,781 AVENT FERRY RD STE 206 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1407235211,"OKORO, CHINONYEREM, UZOAMAKA",781 AVENT FERRY RD STE 206 HOLLY SPRINGS NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407235294,"TAGGART, MICHAEL, GLEN",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 42 , 54 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407235294,"TAGGART, MICHAEL, GLEN",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 35 , 42 , 62 ,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1407235294,"TAGGART, MICHAEL, GLEN",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 33 , 64 , 95 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1407235294,"TAGGART, MICHAEL, GLEN",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 32 , 38 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407236144,"MCCOLLUM MILLER, EMILY, KATHLEEN",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 85 , 148 , 376 ," $27,170.49 ",,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1407236144,"MCCOLLUM MILLER, EMILY, KATHLEEN",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407236144,"MCCOLLUM MILLER, EMILY, KATHLEEN",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1407236144,"MCCOLLUM MILLER, EMILY, KATHLEEN",11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,10 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1407236144,"MCCOLLUM MILLER, EMILY, KATHLEEN",10 ONE CENTER CT   FRANKLIN NC,056,Macon,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 51 , 170 ," $20,890.90 ",,
MEDICAID DIRECT,1043761513,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,225 COURT ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1407238876,"CHAPMAN, STEPHANIE, ANN",225 COURT ST   JEFFERSON NC,005,Ashe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 232 , 262 , 814 ," $40,104.95 ",,
MEDICAID DIRECT,1043307887,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - CARDIOTHORACIC &,225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407239361,"CARUSO, CYNTHIA, ANN",225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407241417,"COBB, MATTHEW, WILLIAM",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407242944,"SHAFFER, BRETT, KEVIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 33 , 35 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407242951,"WAITS, GEORGE, SIDNEY",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407242951,"WAITS, GEORGE, SIDNEY",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 29 , 35 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407242951,"WAITS, GEORGE, SIDNEY",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1730583600,THE BONE AND JOINT SURGERY CLINIC,,3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407243439,"HAMMONDS, SAMUEL, CHARLES",3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 69 , 124 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407243850,"ZUBER, MATTHEW, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 76 , 86 , 108 ," $17,088.12 ",,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1407243850,"ZUBER, MATTHEW, JAMES",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1407244007,"WALL, MICHAEL, ANDREW",718 W CORBETT AVE   SWANSBORO NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 111 , 459 , 953 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407248180,"KALUZNY, JOEL, VINCENT",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 34 , 43 , 76 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407248180,"KALUZNY, JOEL, VINCENT",11835 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407249006,"BAHO, SAMMY, MARK",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407249196,"SLAUGHTERBECK, EMILY, SUZANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407249196,"SLAUGHTERBECK, EMILY, SUZANN",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407249196,"SLAUGHTERBECK, EMILY, SUZANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407249196,"SLAUGHTERBECK, EMILY, SUZANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407249196,"SLAUGHTERBECK, EMILY, SUZANN",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1407249709,"AMAN, COURTNEY, RENEE",SOUTHERN SMILES ORTHODONTICS,1121 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1407249709,"AMAN, COURTNEY, RENEE",1121 GREGORY DR   ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 492 ," 2,103 "," 2,657 "," $393,269.54 ",,
MEDICAID DIRECT,1073971347,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP FAMILY AND WOMENS HEALTH,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407249733,"WETHERALD, JENNIFER, DIANE",1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 55 , 80 , 90 ,$#,,
MEDICAID DIRECT,1073971347,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP FAMILY AND WOMENS HEALTH,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407249733,"WETHERALD, JENNIFER, DIANE",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1407251440,"SORENSEN, JOHNNA, MARY",738 NEWMAN RD   NEW BERN NC,025,Craven,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407251721,"DUNN, MEGAN, LEE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407253792,"TAYLOR, JEFFREY, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407253792,"TAYLOR, JEFFREY, ROBERT",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407253875,ELITE GROUP SERVICES INC,~,2148 HWY 401 BUSINESS   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1407253875,ELITE GROUP SERVICES INC,2148 HWY 401 BUSINESS   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 9,158 "," 9,181 "," $924,359.86 ",,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 22 ,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 23 ,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033148622,REX HOSPITAL INC,UNC URGENT CARE AT CARY,,,Unknown,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",2609 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407254113,"DAVIS, BRITTANY, MARIE",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407257389,"JONES, KATHERINE, ANNE",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 27 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407257546,"SHAH, DEVAL, BHADRASHIL",600 HOSPITAL DR   MONROE NC,090,Union,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 43 , 122 , 123 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1407257546,"SHAH, DEVAL, BHADRASHIL",1000 HEALING WAY   MATTHEWS NC,090,Union,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407257546,"SHAH, DEVAL, BHADRASHIL",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1487727459,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1407257884,"SVITZER, TODD, ALAN",126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 47 ,$#,,
MEDICAID DIRECT,1407259179,GRACIOUS LIVING ADHCC CORPORATION,GRACIOUS LIVING ADULT DAY AND HEALTH CARE CENTER,9920 KINCEY AVE STE 110 HUNTERSVILLE NC,060,Mecklenburg,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,1407259179,GRACIOUS LIVING ADHCC CORPORATION,17220 NORTHCROSS DR   HUNTERSVILLE NC,060,Mecklenburg,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care, 11 , 916 , 916 ," $39,442.96 ",,
MEDICAID DIRECT,1407259179,GRACIOUS LIVING ADHCC CORPORATION,GRACIOUS LIVING ADULT DAY AND HEALTH CARE CENTER,17220 NORTHCROSS DR   HUNTERSVILLE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1407259179,GRACIOUS LIVING ADHCC CORPORATION,17220 NORTHCROSS DR   HUNTERSVILLE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 11 , 552 , 552 ," $23,729.06 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407264245,"CHAND, SANDEEP, KUMAR",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407264245,"CHAND, SANDEEP, KUMAR",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 137 , 138 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407265002,"DAVIS, HEATHER, O'NEAL",125 DAYS INN DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407265002,"DAVIS, HEATHER, O'NEAL",125 DAYS INN DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 24 , 30 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407265002,"DAVIS, HEATHER, O'NEAL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1407265002,"DAVIS, HEATHER, O'NEAL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407265002,"DAVIS, HEATHER, O'NEAL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",420 PARK ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 18 , 39 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1407265937,"GRIFFIN, NAOMI, BETH",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407266695,"WOODARD, PAUL, RICHARD",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 84 , 117 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407267545,"GAVIGAN, THOMAS, SANDERSON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407267545,"GAVIGAN, THOMAS, SANDERSON",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407267545,"GAVIGAN, THOMAS, SANDERSON",2104 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 39 , 40 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407267875,"CHINTALAPANI, PAVANI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 147 , 149 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407269426,"CONWAY, VICTORIA, BLAIR",102 PARKWOOD DR   SNOW HILL NC,040,Greene,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 77 , 90 , 106 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE B KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1407269426,"CONWAY, VICTORIA, BLAIR",701 DOCTORS DR STE B KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE D KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1407269426,"CONWAY, VICTORIA, BLAIR",701 DOCTORS DR STE B KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407271026,"SPOON, JEFFREY, JAMES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407271026,"SPOON, JEFFREY, JAMES",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 40 , 46 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407271026,"SPOON, JEFFREY, JAMES",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407271539,"REIMER, LORI, LOUISE",6333 CENTER DR BLDG 16 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407274335,"HAMANJIAN, ANNA, MARIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407274335,"HAMANJIAN, ANNA, MARIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 32 , 70 , 88 ," $17,737.66 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407275258,"PURAKAL, JOHN, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 30 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407275258,"PURAKAL, JOHN, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407275258,"PURAKAL, JOHN, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 81 , 88 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407276751,"JONES, RAYLEEN, CASSIDY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 31 , 235 , 241 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,280 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1407276751,"JONES, RAYLEEN, CASSIDY",280 S BECKFORD DR   HENDERSON NC,091,Vance,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 24 , 330 , 330 ," $23,835.79 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1407276751,"JONES, RAYLEEN, CASSIDY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407276751,"JONES, RAYLEEN, CASSIDY",280 S BECKFORD DR   HENDERSON NC,091,Vance,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 33 , 253 , 266 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1407276751,"JONES, RAYLEEN, CASSIDY",280 S BECKFORD DR   HENDERSON NC,091,Vance,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407276751,"JONES, RAYLEEN, CASSIDY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407278146,"BROTHERS, JENNA, NICOLE",10211 ALM ST STE 212 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407278146,"BROTHERS, JENNA, NICOLE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407278146,"BROTHERS, JENNA, NICOLE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407278146,"BROTHERS, JENNA, NICOLE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407278146,"BROTHERS, JENNA, NICOLE",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407279631,"BREEN, JULIE, ELIZABETH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407279631,"BREEN, JULIE, ELIZABETH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1407279631,"BREEN, JULIE, ELIZABETH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407279631,"BREEN, JULIE, ELIZABETH",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 116 , 133 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1407279631,"BREEN, JULIE, ELIZABETH",910 W WILLIAMS ST   APEX NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407279631,"BREEN, JULIE, ELIZABETH",100 PERKINS DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407280159,"LEONHARDT, PAYTON, THOMAS",55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407280159,"LEONHARDT, PAYTON, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407280159,"LEONHARDT, PAYTON, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1407280266,"JENNINGS, DONNA, YATES",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 77 , 114 , 218 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1407280266,"JENNINGS, DONNA, YATES",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 54 , 101 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407281348,"SCOTT, STACY, LEE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 53 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407281348,"SCOTT, STACY, LEE",5311 N ROXBORO RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 18 ,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407283476,"POLAND, ELLEN, CROWELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407283476,"POLAND, ELLEN, CROWELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1407285349,"WARD, CATHERINE, SWAIN",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 40 , 51 ,$#,,
MEDICAID DIRECT,1609833490,CARTERET CLINIC FOR ADOLESCENTS AND,CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN,312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1407286339,"GILLIKIN, ROBIN, LEIGH",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 52 , 72 , 179 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407287527,"KELLY, CATHERINE, JENNY",155 MEMORIAL DR   PINEHURST NC,063,Moore,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407287527,"KELLY, CATHERINE, JENNY",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 84 , 84 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1407287832,"ROBINSON, HEATHER, ANGOLIA",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407287832,"ROBINSON, HEATHER, ANGOLIA",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407287832,"ROBINSON, HEATHER, ANGOLIA",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407287832,"ROBINSON, HEATHER, ANGOLIA",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407287832,"ROBINSON, HEATHER, ANGOLIA",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 25 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407287832,"ROBINSON, HEATHER, ANGOLIA",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407288459,"COOK, CHARLES, DAVID",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,700 JOHNSON RIDGE RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1407288459,"COOK, CHARLES, DAVID",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 96 , 96 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407288459,"COOK, CHARLES, DAVID",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1101 MAPLE CARE LN   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407288459,"COOK, CHARLES, DAVID",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407291222,"MYERS, NORA, SUTTON",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 34 , 34 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1407291222,"MYERS, NORA, SUTTON",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407291222,"MYERS, NORA, SUTTON",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1407291222,"MYERS, NORA, SUTTON",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1407291370,ADVANCED SPEECH AND COMMUNICATION S,~,313 BAILEY RIDGE DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1407291370,ADVANCED SPEECH AND COMMUNICATION S,313 BAILEY RIDGE DR   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 289 , 289 ," $19,682.21 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407291941,"CHANDLER, MARK, WILLIAM",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407291941,"CHANDLER, MARK, WILLIAM",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 40 , 40 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407291941,"CHANDLER, MARK, WILLIAM",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 177 , 177 ," $14,258.39 ",,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407292915,"BLAKE, REBECCA, THOMSON",1402 PINCKNEY ST   WHITEVILLE NC,024,Columbus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407292915,"BLAKE, REBECCA, THOMSON",615 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407295132,"SHAMBURG, KEVIN, ARTHUR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407298714,"SETZER, MOLLY, KELLY",1501 TATE BLVD SE   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407298714,"SETZER, MOLLY, KELLY",1501 TATE BLVD SE   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407298714,"SETZER, MOLLY, KELLY",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407298714,"SETZER, MOLLY, KELLY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407298714,"SETZER, MOLLY, KELLY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407298714,"SETZER, MOLLY, KELLY",1501 TATE BLVD SE   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407299340,"SHETH, ANOOP, DIPAK",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 186 , 470 , 519 ," $11,435.86 ",,
MEDICAID DIRECT,1023481520,LIBERTY HEALTHCARE GROUP LLC,WOODLANDS NURSING & REHABILITATION CENTER,400 PELT DR   FAYETTEVILLE NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407299340,"SHETH, ANOOP, DIPAK",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407299340,"SHETH, ANOOP, DIPAK",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407299340,"SHETH, ANOOP, DIPAK",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558123398,HEALTHBLOOM PC & AESTHETICS,,9360 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299340,"SHETH, ANOOP, DIPAK",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299340,"SHETH, ANOOP, DIPAK",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558123398,HEALTHBLOOM PC & AESTHETICS,,9360 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299340,"SHETH, ANOOP, DIPAK",9360 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299357,"QUIST-NELSON, JOHANNA, RACHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 31 , 37 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407299357,"QUIST-NELSON, JOHANNA, RACHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 15 , 31 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407299357,"QUIST-NELSON, JOHANNA, RACHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1124694567,REX HOSPITAL INC,THE WOMENS HEALTH AND HEART CLINIC AT UNC REX,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299357,"QUIST-NELSON, JOHANNA, RACHEL",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299357,"QUIST-NELSON, JOHANNA, RACHEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1124694567,REX HOSPITAL INC,THE WOMENS HEALTH AND HEART CLINIC AT UNC REX,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299357,"QUIST-NELSON, JOHANNA, RACHEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1720612492,REX HOSPITAL INC,UNC REX MATERNAL FETAL MEDICINE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407299357,"QUIST-NELSON, JOHANNA, RACHEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407299415,"ALVAREZ, MITCHELL, DEAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407299415,"ALVAREZ, MITCHELL, DEAN",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 27 , 45 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1407303548,"RAINES, ASHLEY, JOHNSON",1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1407303548,"RAINES, ASHLEY, JOHNSON",1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 28 , 44 ,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1407305659,"MAYNARD, MATTHEW, JAMES",250 HUFF DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 107 , 436 , 493 ,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1407305659,"MAYNARD, MATTHEW, JAMES",750 MCCARTHY BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1770897142,LILLINGTON MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-LILLINGTON,7 E DUNCAN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407307598,"SMITH, MADILYN, GRAY",7 E DUNCAN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 30 , 38 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407308307,"WALSH, ELIZABETH, WHITNEY",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407308307,"WALSH, ELIZABETH, WHITNEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407308307,"WALSH, ELIZABETH, WHITNEY",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 109 , 130 , 156 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407308307,"WALSH, ELIZABETH, WHITNEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407309677,"PARCELL, PATRICK, JAMES",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407309677,"PARCELL, PATRICK, JAMES",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407309677,"PARCELL, PATRICK, JAMES",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1487726352,DALLAS FAMILY MEDICINE PA,DALLAS FAMILY MEDICINE PA,,,Unknown,193400000X,Group,Single Specialty,,1407309768,"ALSTON, BRITTANY, DANIELLE",824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407309768,"ALSTON, BRITTANY, DANIELLE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 87 , 193 ,$#,,
MEDICAID DIRECT,1093793473,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1407312382,"FAUCETTE, BRANDON, SCOTT",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 20 , 21 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407312424,"RAPP, KEVIN, AUSTIN",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 43 , 44 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1407312424,"RAPP, KEVIN, AUSTIN",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 48 , 50 ,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407313703,"MACKNET, NATALIE, ANN",1107 REYNOLDS ST   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407313703,"MACKNET, NATALIE, ANN",8035 PROVIDENCE RD STE 320 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407313729,"SMITH, KELLY, HANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407314768,"MINORE, DAVID, JONATHAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407314768,"MINORE, DAVID, JONATHAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407314818,"MORRISON, ERIN, MAEVE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407314818,"MORRISON, ERIN, MAEVE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 84 , 84 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407315286,"PARDUE, DAVID, RALPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 123 , 132 , 195 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407315286,"PARDUE, DAVID, RALPH",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407315286,"PARDUE, DAVID, RALPH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407315286,"PARDUE, DAVID, RALPH",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407316953,"PRESUTTO, ELIZABETH, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 68 , 69 , 73 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407318165,"XU, JIAQIAN",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407318165,"XU, JIAQIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 236 , 362 , 372 ," $10,583.84 ",,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407319064,"SHOUJAA, ADHAM, BASSAM",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 103 , 127 , 179 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1407319064,"SHOUJAA, ADHAM, BASSAM",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1407324254,"BAUNE, JEREMY, RICHARD",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 21 , 56 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1407324254,"BAUNE, JEREMY, RICHARD",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 50 , 104 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1407324254,"BAUNE, JEREMY, RICHARD",210 SCHOOL RD   TRINITY NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 42 , 98 ,$#,,
MEDICAID DIRECT,1407326010,HOME RULE LLC,,200 1ST AVE NW STE 501-503 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1407326010,HOME RULE LLC,200 1ST AVE NW STE 501-503 HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1407326010,HOME RULE LLC,,200 1ST AVE NW STE 501-503 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1407326010,HOME RULE LLC,200 1ST AVE NW STE 501-503 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,, 32 ," 4,938 "," 5,695 "," $2,539,596.68 ",,
MEDICAID DIRECT,1104369081,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE PEDIATRIC CLINIC OF DANBURY,1030 HOSPICE DR   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1407333768,"WILSON, ERICA, JOYCE",100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1124568688,NORTHERN HOSPITAL OF SURRY COUNTY,~,100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1407333768,"WILSON, ERICA, JOYCE",100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 22 , 37 , 51 ,$#,,
MEDICAID DIRECT,1386389922,CAROLINA FAMILY FOOT AND ANKLE PLLC,,1707 BERWICK DR STE B LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1407334220,"LIANG, SISI, L",1707 BERWICK DR STE B LAURINBURG NC,083,Scotland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 208 , 537 , 843 ," $13,864.84 ",,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407334220,"LIANG, SISI, L",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 23 , 46 , 84 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407343627,"MARTIN, ALEXA, KATHRYNE",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407343627,"MARTIN, ALEXA, KATHRYNE",325 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 29 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407344070,"BOGGIANO, VICTORIA, LYNN",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 50 , 72 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407344070,"BOGGIANO, VICTORIA, LYNN",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407344070,"BOGGIANO, VICTORIA, LYNN",1830 FORDHAM BLVD STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407344070,"BOGGIANO, VICTORIA, LYNN",1830 FORDHAM BLVD STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 52 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",410 COLLEGE RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",3604 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",410 COLLEGE RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",3604 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 48 , 133 ,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 92 , 299 , 777 ,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,,,Unknown,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 20 , 98 ,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",3610 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,410 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",975 HIGH WAY 66 S   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 60 , 307 ,$#,,
MEDICAID DIRECT,1972065282,BETHANY MEDICAL CENTER,,,,Unknown,193200000X,Group,Multi-Specialty,,1407344724,"VANDERBURG, LAURA, LEE",975 HIGH WAY 66 S   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1407344906,"FRUSH, DANIEL, JACK",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407344906,"FRUSH, DANIEL, JACK",3475 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407344906,"FRUSH, DANIEL, JACK",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407344906,"FRUSH, DANIEL, JACK",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 31 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407344906,"FRUSH, DANIEL, JACK",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407344906,"FRUSH, DANIEL, JACK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407344906,"FRUSH, DANIEL, JACK",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1780637850,MIDWAY MEDICAL CENTER CANTON,MIDWAY MEDICAL CENTER,6750 CAROLINA BLVD   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1407344989,"CAMPBELL, THANE, ROBERT",6750 CAROLINA BLVD   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 61 , 126 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407348659,"COOPER, CASEY, RENE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407350788,"DAHLBEN, BRIAN, ANDRE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407350788,"DAHLBEN, BRIAN, ANDRE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407350788,"DAHLBEN, BRIAN, ANDRE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407351240,"WILLIAMS, DOMINIC, MARC",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1407351240,"WILLIAMS, DOMINIC, MARC",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1407351240,"WILLIAMS, DOMINIC, MARC",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 130 , 141 , 168 ," $11,029.16 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407351414,"PALLANSCH, JENNIFER, CULLEN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407351414,"PALLANSCH, JENNIFER, CULLEN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407351414,"PALLANSCH, JENNIFER, CULLEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 38 , 48 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407351414,"PALLANSCH, JENNIFER, CULLEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 33 , 56 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407351414,"PALLANSCH, JENNIFER, CULLEN",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407351414,"PALLANSCH, JENNIFER, CULLEN",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 36 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 36 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407351851,"MIKHJIAN, GARY, PAUL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 20 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407351919,"EMMONS, ERICA, CHRISTINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 77 , 103 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407352024,"HAAG, JENNIFER, GOLDEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407352255,"ALBERT, JUDITH",653 BLUEFIELD RD STE F MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 83 , 140 ,$#,,
MEDICAID DIRECT,1407352677,"MOVASSAGHI, MIYAD",,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1407352677,"MOVASSAGHI, MIYAD",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407352677,"MOVASSAGHI, MIYAD",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407352677,"MOVASSAGHI, MIYAD",110 CAPCOM AVE STE 201 WAKE FOREST NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1083642169,COTSWOLD FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE COTSWOLD FAMILY MEDICIN,309 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407352727,"POPLIN, MATTHEW, JAMES",309 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407354491,"DAVE, NEEMA, NAILESH",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 117 , 465 , 759 ,$#,,
MEDICAID DIRECT,1013963982,UPSTATE LUNG AND CRITICAL CARE SPEC,UPSTATE LUNG AND CRITICAL CARE,151 HAROLD FLEMING CT   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407357478,"EVERETTE, ELIZABETH",1529 N LIMESTONE ST   GAFFNEY SC,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407364607,"AJUONUMA, NKECHI, PERPETUA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 85 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407366230,"LOVINS, LAURA, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407368228,"SWANN, JESSICA, LAUREN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 33 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407368228,"SWANN, JESSICA, LAUREN",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407371065,"WEST, JOSEPH, BENJAMIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407371065,"WEST, JOSEPH, BENJAMIN",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 25 , 66 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407372568,"VANCE, KRISTEN, ELIZABETH",300 S STRATFORD RD STE B WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407372568,"VANCE, KRISTEN, ELIZABETH",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407372568,"VANCE, KRISTEN, ELIZABETH",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407372568,"VANCE, KRISTEN, ELIZABETH",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407375348,"KESSLER HOURIGAN, HAILEY, JANE",3118 OXFORD DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407375348,"KESSLER HOURIGAN, HAILEY, JANE",3118 OXFORD DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407376551,"ROEBUCK GIBSON, LINDSAY, RAY",511 PALADIN DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 26 , 34 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407376551,"ROEBUCK GIBSON, LINDSAY, RAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447339767,CAROLINA DIGESTIVE DISEASES PA,CAROLINA DIGESTIVE DISEASES PA,704 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407376551,"ROEBUCK GIBSON, LINDSAY, RAY",704 W H SMITH BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 28 , 29 , 50 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 59 , 84 , 129 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",201 E GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 169 , 226 , 338 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 200 , 261 , 370 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1407376684,"GADDAM, SATHVIKA, REDDY",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2280 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407376890,"LAWAL, TEMITOPE, AYODEJI",9 MEDICAL DR   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407376890,"LAWAL, TEMITOPE, AYODEJI",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407376890,"LAWAL, TEMITOPE, AYODEJI",9 MEDICAL DR   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 86 , 125 , 158 ," $11,647.09 ",,
MEDICAID DIRECT,1063155562,DR OLER DDS & ASSOCIATES PLLC,KIND SMILES,1600 CROSS LINK RD STE 103-104 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407378524,"GATTUMEEDHI, SHASHANK REDDY",1600 CROSS LINK RD UNIT 103-104 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 735 ," 1,240 "," 5,478 "," $292,189.72 ",,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1407380504,"LEE, MARI, JO",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1407380504,"LEE, MARI, JO",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1407380504,"LEE, MARI, JO",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 27 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407380793,"JANUSZKIEWICZ, KAITLYN, ASHLEY",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 69 , 73 ,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407381148,"REGISTER-LAKE, SHELBY, LAUREN",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 28 , 60 , 63 ," $12,912.04 ",,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407381148,"REGISTER-LAKE, SHELBY, LAUREN",207 E MEADOW RD STE 6 EDEN NC,079,Rockingham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 17 , 29 , 32 ," $10,863.65 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407381742,"FRAUM, ALLISON, SHOSHANA",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 31 , 35 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407383649,"COWLES, SARA, RENEE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 31 , 75 , 155 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407385131,"AMADASUN, OWEN, EDOSA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 89 , 90 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407385131,"AMADASUN, OWEN, EDOSA",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407385131,"AMADASUN, OWEN, EDOSA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407385131,"AMADASUN, OWEN, EDOSA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407385131,"AMADASUN, OWEN, EDOSA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407385446,"SCHMIDT, GER, DANIEL",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 47 , 124 ,$#,,
MEDICAID DIRECT,1407385552,CAROLINA OCCUPATIONAL THERAPY SERVI,,619A E KING ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1407385552,CAROLINA OCCUPATIONAL THERAPY SERVI,619A E KING ST   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,, 124 ," 1,956 "," 2,315 "," $179,790.64 ",,
MEDICAID DIRECT,1407386030,SIMMS ASSISTED LIVING LLC,RIVER OAK ASSISTED LIVING,716 WALL ST   GRIFTON NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1407386030,SIMMS ASSISTED LIVING LLC,716 WALL ST   GRIFTON NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 8,156 "," 8,156 "," $602,084.61 ",,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407386865,"DIGERONIMO, KATE, ELIZABETH",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 49 , 314 , 319 ," $46,388.42 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",498 MADISON RD   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",4748 OLD SALISBURY RD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",707 N ELM ST   HIGH POINT NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 37 , 37 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",707 N ELM ST   HIGH POINT NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 21 , 202 , 205 ," $38,587.89 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",109 PENNY RD   HIGH POINT NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 31 , 31 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 17 , 18 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407386907,"HARDY, KENYETTA, OMEK",206 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1407387582,"NG, BEVERLY",509 OLDE WATERFORD WAY STE 305 BELVILLE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,509 OLDE WATERFORD WAY STE 305 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1407387582,"NG, BEVERLY",509 OLDE WATERFORD WAY STE 305 BELVILLE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,302 STONE RIDGE BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407388465,"STONEM, ELYSIA, LYNN",388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 15 , 24 , 27 ,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1407388465,"STONEM, ELYSIA, LYNN",388 S MAIN ST STE 3 WAYNESVILLE NC,044,Haywood,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407388630,"JIANG, NAN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407388630,"JIANG, NAN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 61 , 88 , 115 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407389646,"SALTZMAN, ELIANA, BRAILOVSKY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407389646,"SALTZMAN, ELIANA, BRAILOVSKY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 15 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407389646,"SALTZMAN, ELIANA, BRAILOVSKY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407389877,"LAU-JULIEN, CARISSA, ANNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407389877,"LAU-JULIEN, CARISSA, ANNE",600 BARRETT LN   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407389877,"LAU-JULIEN, CARISSA, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407389877,"LAU-JULIEN, CARISSA, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407391733,"HANSON, MELISSA, ANN",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407391733,"HANSON, MELISSA, ANN",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1407395742,PHOENIX HOME CARE OF THE TRIAD,,4929 W MARKET ST STE 2128 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1407395742,PHOENIX HOME CARE OF THE TRIAD,4929 W MARKET ST STE 2128 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 54 ," 3,394 "," 3,394 "," $326,405.36 ",,
MEDICAID DIRECT,1407395742,PHOENIX HOME CARE OF THE TRIAD,,400 PRESCOTT ST STE A GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1407395742,PHOENIX HOME CARE OF THE TRIAD,400 PRESCOTT ST STE A GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 63 ," 11,865 "," 11,884 "," $1,080,768.52 ",,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407396955,"PADGETT, LAUREN, ALYSE",8700 PINEVILLE MATTHEWS RD STE 540 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407396955,"PADGETT, LAUREN, ALYSE",8326 PINEVILLE MATTHEWS RD STE 404 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407397359,"HIGGS, TYLER, ANNE",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407398548,"FLANIGAN, JESSICA, LEE",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407398548,"FLANIGAN, JESSICA, LEE",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407398548,"FLANIGAN, JESSICA, LEE",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 75 , 110 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407399306,"KLEIN, STEPHANIE, GREGG",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 114 ," 1,078 "," 1,085 "," $19,719.07 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407399306,"KLEIN, STEPHANIE, GREGG",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 154 , 155 ," $10,412.42 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407408297,"ANDERSON, SELINA, MOYO",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407408297,"ANDERSON, SELINA, MOYO",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 53 , 58 ,$#,,
MEDICAID DIRECT,1154348597,WINSTON-SALEM PEDIATRICS HIGHROAD,~,2808 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407410004,"PARK, GRACE, MEEJUNG",2808 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 30 , 83 ,$#,,
MEDICAID DIRECT,1770858938,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1 TRADE ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1407410491,"JARRETT, APRIL, RIVER RUSSELL",1 TRADE ST   GRANITE FALLS NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 94 , 157 ,$#,,
MEDICAID DIRECT,1245992999,LANE AND ASSOCIATES XLII DDS PA,,2401 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407412562,"AJITH NAIR, ARCHANA",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1407412562,"AJITH NAIR, ARCHANA",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 178 , 252 , 762 ," $40,239.10 ",,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407412562,"AJITH NAIR, ARCHANA",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 54 ,$#,,
MEDICAID DIRECT,1154336642,LANE AND ASSOCIATES I DDS PA,LANE AND ASSOCIATES I DDS PA,1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1407412562,"AJITH NAIR, ARCHANA",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 206 , 352 ," 1,261 "," $70,950.42 ",,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407413040,"FIELDS, MARQUITA, MORRIS",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 26 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407413040,"FIELDS, MARQUITA, MORRIS",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407413040,"FIELDS, MARQUITA, MORRIS",9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 20 ,$#,,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407413040,"FIELDS, MARQUITA, MORRIS",9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 36 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407413305,"PUNEKY, GEORGE, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407413305,"PUNEKY, GEORGE, ANDREW",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3573 HILLSBOROUGH RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407414410,"EVANS, TARREN, DEONNA",3573 HILLSBOROUGH RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952405474,ROBERT B MILLER IV DDS PLLC,COMPLETE DENTAL CARE,1505 S GLENBURNIE RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1407415292,"TROXELL, AMY, THOMASON",1505 S GLENBURNIE RD UNIT IJ NEW BERN NC,025,Craven,1223G0001X,Dental Providers,Dentist,General Practice, 510 , 620 ," 2,455 "," $100,393.83 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407415789,"STANISLAWSKI, MELANIE, SMALLEY",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 37 , 71 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407416324,"WILLIAMS, GLORIA, BENOIT",4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,2000 BROOKSIDE DR   KINGSPORT TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407416423,"BRAUCHLA, CHARLES, LOGAN",2000 BROOKSIDE DR   KINGSPORT TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407416605,"STINOGEL, COLLIN, DAVID",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,971 GOLD HILL RD   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407416605,"STINOGEL, COLLIN, DAVID",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407416605,"STINOGEL, COLLIN, DAVID",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407418288,"ELLIS, JOSHUA, BRIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407419344,"IANDOLI, MATTHEW, ALBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1407419955,ALFA LABS INC,,101 WOODWINDS INDUSTRIAL CT STE L CARY NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1407419955,ALFA LABS INC,101 WOODWINDS INDUSTRIAL CT STE L CARY NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1407421779,"GASTON, JASMINE, ELIZABETH",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407421779,"GASTON, JASMINE, ELIZABETH",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407421779,"GASTON, JASMINE, ELIZABETH",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1407421779,"GASTON, JASMINE, ELIZABETH",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1407421779,"GASTON, JASMINE, ELIZABETH",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1407421779,"GASTON, JASMINE, ELIZABETH",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407426034,"JOHNSON, ANDREW, PHILLIP",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1407426893,"ROARK, MELISSA, REESE",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407427156,"AKBARZADEH, HANNAH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407427156,"AKBARZADEH, HANNAH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407427537,KRYSTALS HAVEN CARE INC,,1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1407427537,KRYSTALS HAVEN CARE INC,1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 60 ," 11,530 "," 12,210 "," $1,299,691.23 ",,
MEDICAID DIRECT,1407427941,HOME WITH HELP HEALTH CARE SERVICES,,4434 TIPPERARY PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1407427941,HOME WITH HELP HEALTH CARE SERVICES,4434 TIPPERARY PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 4,108 "," 4,108 "," $359,395.61 ",,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407429665,"HASBROUCK, ALLISON, CULLIPHER",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407430440,"MARX, ANNA, SHELBY",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407430572,BOUNTIFUL LIFE LLC,,1631 MIDTOWN PL STE 104-112 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1407430572,BOUNTIFUL LIFE LLC,1631 MIDTOWN PL STE 104-112 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 90 ," 18,866 "," 20,589 "," $2,123,919.58 ",,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407434194,"PIKUS, ANGELA, MARIE",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407434194,"PIKUS, ANGELA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 60 , 60 , 82 ,$#,,
MEDICAID DIRECT,1407437908,NEXT LEVEL ADVANCED THERAPY LLC,,303 PLATEAU DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407437908,NEXT LEVEL ADVANCED THERAPY LLC,303 PLATEAU DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,, 65 , 712 , 868 ," $54,976.43 ",,
MEDICAID DIRECT,1134264195,JASPER L LEWIS JR DDS PA,~,1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407439029,"OXENDINE, RUDOLPH",1025 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 468 , 683 ," 2,611 "," $114,016.45 ",,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1407440456,"GRINDLEY, JANNA, MARIE",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 102 , 113 , 254 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1407440456,"GRINDLEY, JANNA, MARIE",695 W FLEMING DR   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 31 ,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1407442957,"HARKINS, ANDREW, PATRICK",835 ALBEMARLE RD   TROY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 67 , 119 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407443401,"WHITE, CHESNEY, LEIGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 17 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407443997,"PENICK, ELIZABETH, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407443997,"PENICK, ELIZABETH, ANNE",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 34 , 55 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407443997,"PENICK, ELIZABETH, ANNE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 56 , 102 ,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1407447659,"KOPEL, ANDREW, LEE",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 31 , 41 ,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1407447659,"KOPEL, ANDREW, LEE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 47 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407453319,"WADDELL, KHYAN, CHRIONY MASHAY",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407455363,"DIMERY, NICKEY, LASHAE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 223 ," 1,621 "," 1,710 "," $37,786.02 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407455363,"DIMERY, NICKEY, LASHAE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407457211,"POOL, JENNIFER, LYNN",125 RIVER VINE PKWY   WALLACE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 98 , 129 ,$#,,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1407458359,"GARWOOD, SHELBY, ANN",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,~,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407460355,"FRAZIER, SHY'ANN, RENA",1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1407460843,"BENSON, ALEXANDRA, PAIGE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407460843,"BENSON, ALEXANDRA, PAIGE",2695 HENDERSONVILLE RD STE 132 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 25 , 29 ,$#,,
MEDICAID DIRECT,1902834658,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE HILLSBOROUGH,267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1407461601,"RAMJI, AMRITA, KETAN",267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 34 , 77 ,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1407465651,"ONORI, KENNEDY, UKORIYOBHE",480 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 59 , 112 ,$#,,
MEDICAID DIRECT,1124537246,IMPACT HEALTHCARE PA,IMPACT PRIMARY AND URGENT CARE,315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1407465651,"ONORI, KENNEDY, UKORIYOBHE",315 FRANKLIN PLZ   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 25 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407468317,"SEIFERT, MICAH, SHIZUE ALIKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407468317,"SEIFERT, MICAH, SHIZUE ALIKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1407469158,OACES COMMUNITY HEALTH CARE LLC,OACES COMMUNITY HOME CARE LLC,321 N FRONT ST   WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1407469158,OACES COMMUNITY HEALTH CARE LLC,321 N FRONT ST   WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 71 ," 15,107 "," 15,107 "," $962,718.80 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407469927,"RUMMAGE, LESLEY, FISHER",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 72 , 149 , 149 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1407472129,"MATHURIN, EVISENCIA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407472699,"OAKLEY, RACHAEL, MARIE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407472699,"OAKLEY, RACHAEL, MARIE",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407472699,"OAKLEY, RACHAEL, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407472699,"OAKLEY, RACHAEL, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407472699,"OAKLEY, RACHAEL, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407472699,"OAKLEY, RACHAEL, MARIE",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407472699,"OAKLEY, RACHAEL, MARIE",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841644531,APPALACHIAN MOUNTAIN COMMUNITY HEAL,SYLVA COMMUNITY HEALTH CENTER,154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407476336,"THOMAS, DESTIN, STONE",154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407479108,"ANDERSON, SARAH, COVINGTON",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 45 , 89 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407479108,"ANDERSON, SARAH, COVINGTON",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407480478,"DUBIEL, WILLIAM, STANISLAW",11081 FOREST PINES DR STE 112 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 26 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407484496,"STERN, SARAH, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407484496,"STERN, SARAH, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407484595,"JASTY, RAJESWARI",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407484801,"SCALES, RENYTA, NYASHA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407484801,"SCALES, RENYTA, NYASHA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407484835,"SCHEVERS, JUSTIN, JAMES",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 81 , 105 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407484835,"SCHEVERS, JUSTIN, JAMES",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 60 , 65 ,$#,,
MEDICAID DIRECT,1407486525,SOUTHERN COMFORT HOME HEALTHCARE LL,,1006 UNION RD STE H GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1407486525,SOUTHERN COMFORT HOME HEALTHCARE LL,1006 UNION RD STE H GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 75 ," 13,952 "," 14,011 "," $1,317,736.20 ",,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407488380,"RITGER, HOLLY, MURPHY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 26 , 32 , 32 ,$#,,
MEDICAID DIRECT,1467435040,WNC INTERNAL MEDICINE,WNC INTERNAL MEDICINE PLLC,98 COPE CREEK RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1407490600,"BALDERRAMA, JODI, FOSTER",98 COPE CREEK RD AB SYLVA NC,050,Jackson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 30 , 50 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407495385,"WEST, GARRETT, HUNTER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366962623,CAROLINA CHIROPRACTIC GROUP PLLC,,145 W DIXON BLVD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1407496565,"CRAWFORD, SIDNEY, DYLAN",145 W DIXON BLVD   SHELBY NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407504582,"WISE, TIFFANY, ANTOINETTE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1407507296,"JOHNSON, SHIRLENE, ANNETTE",1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 41 , 291 , 294 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1407507296,"JOHNSON, SHIRLENE, ANNETTE",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 31 , 67 , 67 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407508914,"HOLCOMB, CONNOR, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407508914,"HOLCOMB, CONNOR, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407508914,"HOLCOMB, CONNOR, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407508914,"HOLCOMB, CONNOR, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407508914,"HOLCOMB, CONNOR, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407510563,"LINTON, CHLOE, MICHELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407518475,"GREGORY, JODIE, BROCK",152 E KINDERTON WAY STE 101 ADVANCE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407518475,"GREGORY, JODIE, BROCK",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407518475,"GREGORY, JODIE, BROCK",152 E KINDERTON WAY STE 101 ADVANCE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 62 , 115 , 177 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407518574,"TRAN, TIFFANY, WOO",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407518574,"TRAN, TIFFANY, WOO",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 85 , 92 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407520174,"KAMZIK, JESSICA, SUSAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407520174,"KAMZIK, JESSICA, SUSAN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740213321,GOLDSBORO PHYSICAL THERAPY,GOLDSBORO PHYSICAL THERAPY,2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1407520976,"WOODALL, JACLYN, FARRIOR",2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407521636,"GREEN, TESS, LOUISE",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407521636,"GREEN, TESS, LOUISE",2344 S CHURCH ST   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407521636,"GREEN, TESS, LOUISE",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2344 S CHURCH ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407521636,"GREEN, TESS, LOUISE",2344 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407523772,"ELLINGTON, EMILY, NOELLE",1450 MATTHEWS TOWNSHIP PKWY STE 300 MATTHEWS NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1841269305,INTERNAL MEDICINE ASSOCIATES,INTERNAL MEDICINE ASSOC,3850 ED DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407526767,"HICKS, KWANMESHIA, TEONNE",3850 ED DR STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 41 , 41 ,$#,,
MEDICAID DIRECT,1083050389,ORANGE COUNTY,~,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1407527732,"NASH, WILLIAM, THURSTON",77 VILCOM CENTER DR STE 310 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 101 , 112 , 400 ," $14,044.61 ",,
MEDICAID DIRECT,1760695589,THERESA CLIFTON DDS PLLC,~,77 VILCOM CENTER DR STE 310 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1407527732,"NASH, WILLIAM, THURSTON",77 VILCOM CENTER DR STE 310 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 208 , 262 , 892 ," $33,308.50 ",,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407529696,WILCOX OPTOMETRY PLLC,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,, 774 , 777 ," 1,548 "," $24,435.66 ",,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407535107,"HEMBY, ELIZABETH, SCOTT",448 CRANBERRY ST   NEWLAND NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407536956,"MOTLEY-MANGRUM, JADEKA, ALEATHEA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407536956,"MOTLEY-MANGRUM, JADEKA, ALEATHEA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407536956,"MOTLEY-MANGRUM, JADEKA, ALEATHEA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1063196327,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD EAST FAMILY CARE RHC,605 NC 120 HWY   MOORESBORO NC,023,Cleveland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1407537020,"WHITAKER, AMANDA, WHITESIDE",444 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912684473,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD CHILDRENS CARE,162 COMMERCIAL DR STE B FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1407537020,"WHITAKER, AMANDA, WHITESIDE",444 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 31 , 62 ,$#,,
MEDICAID DIRECT,1912684473,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD CHILDRENS CARE,162 COMMERCIAL DR STE B FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1407537020,"WHITAKER, AMANDA, WHITESIDE",1269 US HIGHWAY 221A   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 26 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407537020,"WHITAKER, AMANDA, WHITESIDE",1269 US HIGHWAY 221A   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 45 , 112 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1407538424,"MERIDETH, KRYSTAL, LEIA",390 US HIGHWAY 70 W   HAVELOCK NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 21 , 92 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407545890,"HALLOCK, ANNA, LILLIAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1407545890,"HALLOCK, ANNA, LILLIAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1366962623,CAROLINA CHIROPRACTIC GROUP PLLC,,145 W DIXON BLVD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1407555485,"MILLER, SARA, JANE",145 W DIXON BLVD   SHELBY NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,#, 38 , 39 ,$#,,
MEDICAID DIRECT,1407557283,INNERLOGIC HOME CARE INC,,1701 SUNSET AVE STE 202 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1407557283,INNERLOGIC HOME CARE INC,1701 SUNSET AVE STE 202 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 221 , 221 ," $11,192.88 ",,
MEDICAID DIRECT,1871800177,DRAGONFLY HOUSE CHILDRENS ADVOCACY,~,387 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1407560550,"PROCTOR, AUDREY, DAWN",387 VALLEY RD   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407560790,PLAY WITH ME OT,,255 SUGAR PINE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1407560790,PLAY WITH ME OT,255 SUGAR PINE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,#, 106 , 106 ," $10,788.63 ",,
MEDICAID DIRECT,1407564669,A PRIMARY CHOICE INC,,110 VANDIVER DR   LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,1407564669,A PRIMARY CHOICE INC,110 VANDIVER DR   LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,#," 1,664 "," 1,664 "," $109,991.80 ",,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1407565856,"SMITH, ALYSSA, ANNAMARIE",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 36 , 42 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1407565856,"SMITH, ALYSSA, ANNAMARIE",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1407565856,"SMITH, ALYSSA, ANNAMARIE",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407567456,OLE CREEK HEALTH AND WELLNESS,OLE CREEK HEALTHCARE,555 S MANGUM ST STE 100 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1407567456,OLE CREEK HEALTH AND WELLNESS,555 S MANGUM ST STE 100 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 164 , 164 ," $12,474.28 ",,
MEDICAID DIRECT,1407570328,DGJ VENTURES LLC,BRIGHTSTAR CARE OF GREENVILLE,625 LYNNDALE CT STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1407570328,DGJ VENTURES LLC,625 LYNNDALE CT STE B GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 145 , 145 ," $10,424.04 ",,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407571284,"BAKER, CORI, ELIZABETH",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 94 , 109 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1407574056,"WATSON, MICHAEL, DALTON",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1407574056,"WATSON, MICHAEL, DALTON",5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1407574056,"WATSON, MICHAEL, DALTON",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1407574056,"WATSON, MICHAEL, DALTON",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 42 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1407574056,"WATSON, MICHAEL, DALTON",8116 NC 711   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1407575830,"SMITH, DEVIN, TALOR",1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1407575830,"SMITH, DEVIN, TALOR",1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1407575830,"SMITH, DEVIN, TALOR",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 15 , 25 ,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1407575830,"SMITH, DEVIN, TALOR",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 11 , 22 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1407575830,"SMITH, DEVIN, TALOR",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407577984,"COBB, MADISON, GRAY",1816 DOCTORS DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407577984,"COBB, MADISON, GRAY",1413 GREENWAY CT   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 112 , 222 ,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1407578834,"NELSON, SIMONE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 103 , 376 , 592 ," $13,168.28 ",,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1407578834,"NELSON, SIMONE",440 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 73 , 98 ,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1407579816,"HELIN, DANIEL, ROBERT",8111 CONCORD MILLS BLVD   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205579059,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC SUBSTANCE TREATMENT AND RECOVERY,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407580111,"PUCKETT, SAMANTHA, JO",1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407587496,"SCHLEUTKER, ALLISON, KAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 66 , 85 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1407611858,"BASS, SHELLY, CORINNE",604 STOKES ST E   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1407611858,"BASS, SHELLY, CORINNE",604 STOKES ST E   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1407611858,"BASS, SHELLY, CORINNE",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 853 , 862 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1407611858,"BASS, SHELLY, CORINNE",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 171 , 194 ," $10,455.50 ",,
MEDICAID DIRECT,1144726928,EVANS PHYSICAL THERAPY & SPORT PERF,,2585 W ROOSEVELT BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1407619406,"SMITH, CHASE, HUNTER",2585 W ROOSEVELT BLVD   MONROE NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407626120,"MOSER, DAWN, ELIZABETH",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13845 CONLAN CIR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407627037,"PAYNE, KELLY, SILVER",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407637242,"WILLEY, LAUREN, MARIE",2145 COUNTRY CLUB RD STE 800 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407637242,"WILLEY, LAUREN, MARIE",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407637242,"WILLEY, LAUREN, MARIE",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 106 , 146 , 248 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1407637242,"WILLEY, LAUREN, MARIE",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,559 RIVER HWY   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407637689,"TURNER, MARY, CAROLINE",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1407637689,"TURNER, MARY, CAROLINE",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407637689,"TURNER, MARY, CAROLINE",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407637689,"TURNER, MARY, CAROLINE",548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1407661382,"HOLZINGER, CHRISTINA, MARIE",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407671548,"KOMANDUR, ABHAY, KAUSHIK",3320 EXECUTIVE DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407677420,"RICHARDSON, LASHAWNDA, HOPE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1407685019,"SREDL, MEGAN, MARIE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407685019,"SREDL, MEGAN, MARIE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1407685019,"SREDL, MEGAN, MARIE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407685019,"SREDL, MEGAN, MARIE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1407685019,"SREDL, MEGAN, MARIE",3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689770133,CAROLINA CHIROPRACTIC PLUS,CAROLINA CHIROPRACTIC PLUS OF RUTHERFOR,152 W MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1407685365,"BLANTON, SEANN, GRANT",152 W MAIN ST   FOREST CITY NC,081,Rutherford,111N00000X,Chiropractic Providers,Chiropractor,,#, 45 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407686652,"SCOTT, ERIN, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1407689615,"BACCHUS, TASLIMA, ELISHA",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407694540,"GILL, BRIANNA, NICOLE",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 368 , 892 ," 1,968 "," $118,426.49 ",,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407694763,"WORKMAN, CHELSEA, RAE MARIE",4815 BEREWICK TOWN CENTER DR STE I& CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 122 , 156 , 600 ," $40,541.75 ",,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407694763,"WORKMAN, CHELSEA, RAE MARIE",515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 33 , 167 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1407697667,"SELEVANY, ZHIAN, ARIF",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205471430,WISE OPTOMETRY ASSOCIATES PA,WISE EYE CARE,15 JANE JACOBS RD STE 103 BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1407698889,"WISE, MARCUS, LAWRENCE",15 JANE JACOBS RD STE 103 BLACK MOUNTAIN NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1407800139,"TODD, MARTHA, JUSTUS",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1407800139,"TODD, MARTHA, JUSTUS",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,190 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 152 , 152 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 95 , 97 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",615 RIDGE RD   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1407801632,"HOLCOMB, DEBORAH, DEOSS",615 RIDGE RD   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1407802036,LOVELL MEDICAL SUPPLY INC,AEROCARE,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1407802036,LOVELL MEDICAL SUPPLY INC,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 18 , 62 , 62 ," $11,453.45 ",,
MEDICAID DIRECT,1407802036,LOVELL MEDICAL SUPPLY INC,AEROCARE,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1407802036,LOVELL MEDICAL SUPPLY INC,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 668 ," 3,853 "," 5,974 "," $116,402.57 ",,
MEDICAID DIRECT,1407802036,LOVELL MEDICAL SUPPLY INC,AEROCARE,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1407802036,LOVELL MEDICAL SUPPLY INC,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 79 , 343 , 660 ,$#,,
MEDICAID DIRECT,1407802036,LOVELL MEDICAL SUPPLY INC,AEROCARE,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1407802036,LOVELL MEDICAL SUPPLY INC,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1407802036,LOVELL MEDICAL SUPPLY INC,AEROCARE,46 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1407802036,LOVELL MEDICAL SUPPLY INC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1407802861,COUNTY OF BLADEN OFFICE OF AUDITOR,BLADEN COUNTY EMERGENCY MEDICAL SERVICES,292 BENGREEN IND PK RD   ELIZABETHTOWN NC,009,Bladen,3416L0300X,Transportation Services,Ambulance,Land Transport,1407802861,COUNTY OF BLADEN OFFICE OF AUDITOR,292 BENGREEN IND PK RD   ELIZABETHTOWN NC,009,Bladen,3416L0300X,Transportation Services,Ambulance,Land Transport, 167 , 773 ," 1,485 "," $69,797.00 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407803497,"PAUL, ROBERT, ALLEN",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407803497,"PAUL, ROBERT, ALLEN",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407803497,"PAUL, ROBERT, ALLEN",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 44 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407803497,"PAUL, ROBERT, ALLEN",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740214048,SHUBI SHAHIDA MD PC,SHUBI SHAHIDA MD PC,712 WILKINS ST STE A SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1407803562,"SHAHIDA, SHUBI",712 WILKINS ST STE A SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 236 , 357 ,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1407804388,"BREECH, LESLEY, LOUISE",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1407805328,"DOROCIAK, JEFFERY, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 26 , 62 , 66 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407805823,"BUZZEO, BRIAN, DEREK",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407805823,"BUZZEO, BRIAN, DEREK",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 21 , 26 , 54 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407805823,"BUZZEO, BRIAN, DEREK",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 26 , 42 , 110 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407805823,"BUZZEO, BRIAN, DEREK",2525 COURT DR   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407805823,"BUZZEO, BRIAN, DEREK",2525 COURT DR   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407805823,"BUZZEO, BRIAN, DEREK",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 69 , 90 , 183 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407805823,"BUZZEO, BRIAN, DEREK",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 45 , 51 , 89 ,$#,,
MEDICAID DIRECT,1407807191,ACCREDO HEALTH GROUP INC,~,422 GALLIMORE DAIRY RD STE A GREENSBORO NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1407807191,ACCREDO HEALTH GROUP INC,422 GALLIMORE DAIRY RD STE A GREENSBORO NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#, 47 , 61 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407807274,"RHOLL, VICKY, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1477519148,PATHOLOGISTS MEDICAL LABORATORY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1407807274,"RHOLL, VICKY, LEE",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407807274,"RHOLL, VICKY, LEE",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407807274,"RHOLL, VICKY, LEE",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235116724,R KELLY FAULK JR DDS PA,~,1806 DOCTORS DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1407807605,"FAULK JR, RANDOLPH, KELLY",1806 DOCTORS DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 67 , 150 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1407808264,"WRIGHT, EMILY, HURLEY",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 41 , 41 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1407808264,"WRIGHT, EMILY, HURLEY",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467695031,PATHWAYS TO LIFE INC,PATHWAYS TO LIFE INC,1015 CONFERENCE DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407808314,"EVANS, ERIC, EUGENE",1015 CONFERENCE DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 41 , 41 ,$#,,
MEDICAID DIRECT,1669809158,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS OBGYN HOSPITALISTS,920 CHURCH ST N STE 255E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1407808603,"MADZIVIRE, ESTHER, GAMUCHIRAI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 55 , 81 , 88 ," $20,084.39 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407809023,"HOGAN, ANGELA, DUFF",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407809296,"FEDALEI, ALBERT, GEORGE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407809809,"BLOODWORTH, DOROTHY, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407810435,"NISHAN, PETER, CHARLES",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407810435,"NISHAN, PETER, CHARLES",518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407810435,"NISHAN, PETER, CHARLES",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407810435,"NISHAN, PETER, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 25 , 28 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407810435,"NISHAN, PETER, CHARLES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407810435,"NISHAN, PETER, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 102 , 110 , 134 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407810435,"NISHAN, PETER, CHARLES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1669971826,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN GASTROENTEROLOGY,870 STATE FARM RD STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1407810609,"DIAMONTI, GREGORY",870 STATE FARM RD STE 102 BOONE NC,095,Watauga,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 56 , 77 , 111 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407812068,"BAHNER, RICHARD, SCOTT",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 67 , 113 , 202 ,$#,,
MEDICAID DIRECT,1992857841,COUNTY OF CATAWBA OFFICE OF ACCOUNT,CATAWBA COUNTY PUBLIC HEALTH,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1407812308,"PRICE, BILLY, LEE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 37 , 56 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407814536,"MILLER, DOUGLAS, PARKER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 32 , 33 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407814551,"REUTER, ERIC, HORST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407814999,"KOKENES, DENNIS, DEMOSTHENES",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407814999,"KOKENES, DENNIS, DEMOSTHENES",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407814999,"KOKENES, DENNIS, DEMOSTHENES",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407814999,"KOKENES, DENNIS, DEMOSTHENES",2015 RANDOLPH RD STE 101208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407814999,"KOKENES, DENNIS, DEMOSTHENES",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407814999,"KOKENES, DENNIS, DEMOSTHENES",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407815657,"GARWACKI, CHRISTOPHER, PAUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407815657,"GARWACKI, CHRISTOPHER, PAUL",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407815657,"GARWACKI, CHRISTOPHER, PAUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 84 , 87 , 151 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407815657,"GARWACKI, CHRISTOPHER, PAUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407815657,"GARWACKI, CHRISTOPHER, PAUL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,500 GATEWAY DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407815921,"RAMSDELL, KIMBERLY, GLASS",500 GATEWAY DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,260 HORIZON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407815921,"RAMSDELL, KIMBERLY, GLASS",260 HORIZON DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1649545195,NEPHROPATHOLOGY ASSOCIATES PLC,ARKANA LABORATORIESNEPHROPATH,10810 EXECUTIVE CENTER DR STE 100 LITTLE ROCK AR,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1407816218,"WILSON, JON, DANIEL",10810 EXECUTIVE CENTER DR STE 100 LITTLE ROCK AR,102,Out of State > 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407818164,"BAYER, CYNTHIA, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407818511,NOW WE RE TALKING PEDIATRIC THERAPY,NOW WERE TALKING PEDIATRIC THERAPY INC,1014 ADAMS POINT DR   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407818511,NOW WE RE TALKING PEDIATRIC THERAPY,1014 ADAMS POINT DR   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,, 162 ," 3,501 "," 3,850 "," $297,336.54 ",,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407819212,"KLUGH, TIMOTHY, RICHARD",1730 CAROLINA AVE   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,, 203 , 226 , 272 ," $12,414.17 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407819337,"KAMIL, ALICE, LORRAINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407819964,"MCCULLEY, JILL, ANN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 35 , 41 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407819964,"MCCULLEY, JILL, ANN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 108 , 302 , 397 ,$#,,
MEDICAID DIRECT,1730583600,THE BONE AND JOINT SURGERY CLINIC,,3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407819972,"CROWTHER, JAMES, DAVID",3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 16 , 36 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407821283,"KLAUSNER, TODD, STUART",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407821283,"KLAUSNER, TODD, STUART",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1407822091,"HANGER, CHRISTOPHER, CLAY",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407822091,"HANGER, CHRISTOPHER, CLAY",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407822091,"HANGER, CHRISTOPHER, CLAY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043446966,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407822273,"HAYES, KATHLEEN, ANNE",1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114259280,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,1314 PATTON AVE STE F ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407822273,"HAYES, KATHLEEN, ANNE",1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407822521,"EAST, JOAN",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407822539,"LARRABEE, LAURA, JEAN",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407822539,"LARRABEE, LAURA, JEAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407822539,"LARRABEE, LAURA, JEAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407823255,"ROBERTSON, SCOTT, ALAN",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407823255,"ROBERTSON, SCOTT, ALAN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407823255,"ROBERTSON, SCOTT, ALAN",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407823255,"ROBERTSON, SCOTT, ALAN",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356735336,SOUTHLAND BAINBRIDGE HOSPITALIST GR,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407823859,"JONES, JAY, JERRY",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407825466,"CLAIBORNE, CLAUDIA, VIOLA",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1407825466,"CLAIBORNE, CLAUDIA, VIOLA",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407825466,"CLAIBORNE, CLAUDIA, VIOLA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407825466,"CLAIBORNE, CLAUDIA, VIOLA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1407825466,"CLAIBORNE, CLAUDIA, VIOLA",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,190 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1407825565,"WORTHINGTON, JOHN, EVERETT",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407825565,"WORTHINGTON, JOHN, EVERETT",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1407826662,"HAYCOOK, BRIAN, EVERETT",581 LEROY GEORGE DR STE 380 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 73 , 96 , 99 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1407826662,"HAYCOOK, BRIAN, EVERETT",98 DOCTORS DR STE 310 SYLVA NC,050,Jackson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 18 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407826670,"MAVES, RYAN, CORY",404 WESTWOOD AVE STE 207 HIGH POINT NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407826670,"MAVES, RYAN, CORY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 59 , 119 , 125 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1407827645,"KENT, MICHAEL, LEWIS",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407827645,"KENT, MICHAEL, LEWIS",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 13 , 15 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1407827645,"KENT, MICHAEL, LEWIS",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407827645,"KENT, MICHAEL, LEWIS",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407827645,"KENT, MICHAEL, LEWIS",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 21 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407827645,"KENT, MICHAEL, LEWIS",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407829476,"SUTKER, BENJAMIN, DAVID",601 S SUTTON RD STE 101 FORT MILL SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962429589,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PEDIATRIC ORTHOPAEDICS,800 E CHEVES ST STE 480-A FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407829492,"GILPIN, ALBERT, THOMAS",800 E CHEVES ST STE 480-A FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407830516,"CRASS, JEFFREY, ROBERT",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407832090,"LECHNER, JONATHON, DAVID",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 53 , 102 ,$#,,
MEDICAID DIRECT,1154536076,DENNIS R CAMPBELL DDS PA,DENNIS R CAMPBELL DDS PA,430 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407832280,"CAMPBELL, DENNIS, RICHARD",430 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 410 , 788 ," 2,378 "," $89,950.65 ",,
MEDICAID DIRECT,1487726352,DALLAS FAMILY MEDICINE PA,DALLAS FAMILY MEDICINE PA,,,Unknown,193400000X,Group,Single Specialty,,1407833478,"KIRKPATRICK, RON, VAN",824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407833478,"KIRKPATRICK, RON, VAN",824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407833478,"KIRKPATRICK, RON, VAN",824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407833478,"KIRKPATRICK, RON, VAN",824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 125 , 165 ,$#,,
MEDICAID DIRECT,1407833783,"SMITH, JAMES",MCLAUGHLIN CHIROPRACTIC CENTER - NEW BERN PLLC,2113 S GLENBURNIE RD STE H NEW BERN NC,025,Craven,111N00000X,Chiropractic Providers,Chiropractor,,1407833783,"SMITH, JAMES",2113 S GLENBURNIE RD STE H NEW BERN NC,025,Craven,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1407834179,"AUMULLER, SCOTT, CHRISTOPHER",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 87 , 99 ,$#,,
MEDICAID DIRECT,1245275221,HOOKERTON FAMILY PRACTICE PA,~,516 S WILLIAM HOOKER DR   HOOKERTON NC,040,Greene,193400000X,Group,Single Specialty,,1407835010,"RIBEIRO, DONALD, ALAN",516 S WILLIAM HOOKER DR   HOOKERTON NC,040,Greene,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1407835010,"RIBEIRO, DONALD, ALAN",2601 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477717312,GREENVILLE EXPRESS CARE PA,GREENVILLE EXPRESS CARE PA,2601 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407835010,"RIBEIRO, DONALD, ALAN",2601 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1477717312,GREENVILLE EXPRESS CARE PA,GREENVILLE EXPRESS CARE PA,2601 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407835010,"RIBEIRO, DONALD, ALAN",613 S MEMORIAL DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477717312,GREENVILLE EXPRESS CARE PA,GREENVILLE EXPRESS CARE PA,2601 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407835010,"RIBEIRO, DONALD, ALAN",2601 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 143 , 427 ," 1,025 "," $16,893.95 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,214 18TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",250 18TH ST SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407836125,"LARISCY, CHRISTOPHER, LAVERNE",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1033344080,HUGH CHATHAM MEMORIAL HOSPITAL,YADKIN VALLEY GASTROENTEROLOGY,201 W MAIN ST   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1407838014,"KUNDU, SARBA",201 W MAIN ST   ELKIN NC,086,Surry,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 74 , 99 , 161 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407838899,"BURGESS, WILLIAM, CROMARTIE",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 31 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407838899,"BURGESS, WILLIAM, CROMARTIE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407839483,"GAINES, JEREMY, ALAN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407839491,"MCBRIDE JR, ROBERT, BENNIS",9848 N TRYON ST STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407839491,"MCBRIDE JR, ROBERT, BENNIS",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 70 , 103 , 160 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407839491,"MCBRIDE JR, ROBERT, BENNIS",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407839491,"MCBRIDE JR, ROBERT, BENNIS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407839491,"MCBRIDE JR, ROBERT, BENNIS",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407839491,"MCBRIDE JR, ROBERT, BENNIS",8840 BLAKENEY DR   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144652330,UNIVERSITY SURGERY CENTER LLC,MALLARD CREEK SURGERY CENTER,9848 N TRYON ST STE 200 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1407839491,"MCBRIDE JR, ROBERT, BENNIS",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407839889,"TRIMBLE, LINDA, HARWI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407839889,"TRIMBLE, LINDA, HARWI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407839889,"TRIMBLE, LINDA, HARWI",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 31 , 31 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1407840473,"GIBSON, TERESA, DELLINGER",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 22 , 37 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1407840473,"GIBSON, TERESA, DELLINGER",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 46 , 131 , 231 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1407840473,"GIBSON, TERESA, DELLINGER",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 11 ,$#,,
MEDICAID DIRECT,1174703946,JOINT AND MUSCLE MEDICAL CARE,JOINT AND MUSCLE MEDICAL CARE,332 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407841901,"BRENDESE, JOHN, JOSEPH",332 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 84 , 321 , 506 ," $10,101.74 ",,
MEDICAID DIRECT,1174703946,JOINT AND MUSCLE MEDICAL CARE,JOINT AND MUSCLE MEDICAL CARE,332 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407841901,"BRENDESE, JOHN, JOSEPH",332 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407843014,SOUTHEASTERN EYECARE PA,SOUTHEASTERN EYE CARE PA,106 FARM BROOK DR STE B LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1407843014,SOUTHEASTERN EYECARE PA,106 FARM BROOK DR STE B LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,, 11 , 15 , 33 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1407843238,"HA, VICTOR, LIN KHIAN",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 44 , 90 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407843238,"HA, VICTOR, LIN KHIAN",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1407843238,"HA, VICTOR, LIN KHIAN",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 60 , 102 ,$#,,
MEDICAID DIRECT,1811178833,CAROMONT MEDICAL GROUP INC,CAROMONT RHEUMATOLOGY,660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407843808,"DALESSANDRO, LOUIS, JOHN",660 SUMMIT CROSSING PL STE 302 GASTONIA NC,036,Gaston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,,,$#,,
MEDICAID DIRECT,1407844475,SOUTH ROBESON RESCUE UNIT INC,~,1001 S WALNUT ST   FAIRMONT NC,078,Robeson,3416L0300X,Transportation Services,Ambulance,Land Transport,1407844475,SOUTH ROBESON RESCUE UNIT INC,1001 S WALNUT ST   FAIRMONT NC,078,Robeson,3416L0300X,Transportation Services,Ambulance,Land Transport, 26 , 29 , 53 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407846777,"LOTT, CHARLES, EDMONDSON",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 40 , 66 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407846777,"LOTT, CHARLES, EDMONDSON",1272 EAST ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1407846777,"LOTT, CHARLES, EDMONDSON",1272 EAST ST   WAYNESVILLE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 36 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407848930,"GREWAL, MICHELLE, LYNETTE",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407848989,"IRONS, THOMAS, GRANT",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407849227,"RYAN, SARAH, DELORES",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 33 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1407851124,"KLEIMAN, SAMUEL, JOSEPH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407851124,"KLEIMAN, SAMUEL, JOSEPH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407851124,"KLEIMAN, SAMUEL, JOSEPH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,2790 GODWIN BLVD SUITE 101 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407851256,"GEORGE, EDWARD, RICHARD",2790 GODWIN BLVD SUITE 101 SUFFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407851256,"GEORGE, EDWARD, RICHARD",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 23 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407851256,"GEORGE, EDWARD, RICHARD",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 19 , 28 ," $12,135.37 ",,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407851256,"GEORGE, EDWARD, RICHARD",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1407851256,"GEORGE, EDWARD, RICHARD",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1619523412,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407852304,"HUBERTY, CHAD, ROGER",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063692515,CROSSROADS FAMILY MEDICAL CARE PA,,3121 PLATEAU RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1407854441,"PARKER, BILL, JACK",3121 PLATEAU RD   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 46 , 60 ,$#,,
MEDICAID DIRECT,1407854441,"PARKER, BILL, JACK",~,3121 PLATEAU RD   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1407854441,"PARKER, BILL, JACK",3121 PLATEAU RD   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407854540,"YOUNCE, LAURA, LEIGH",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 35 , 42 , 94 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407854540,"YOUNCE, LAURA, LEIGH",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407854540,"YOUNCE, LAURA, LEIGH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407854540,"YOUNCE, LAURA, LEIGH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 30 , 40 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407854540,"YOUNCE, LAURA, LEIGH",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407854540,"YOUNCE, LAURA, LEIGH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407854540,"YOUNCE, LAURA, LEIGH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,ROCKY MOUNTAIN HOLDINGS LLC,1207 NYS ROUTE 9N   TICONDEROGA NY,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,1207 NYS ROUTE 9N   TICONDEROGA NY,102,Out of State > 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,ROCKY MOUNTAIN HOLDINGS LLC,218 HOSPITAL CIR STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,218 HOSPITAL CIR STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#," $14,128.94 ",,
MEDICAID DIRECT,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,ROCKY MOUNTAIN HOLDINGS LLC,525 AIRPORT RD   MARTINSVILLE VA,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,525 AIRPORT RD   MARTINSVILLE VA,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#," $15,972.00 ",,
MEDICAID DIRECT,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,ROCKY MOUNTAIN HOLDINGS LLC,155 TECHNOLOGY PL   LIBERTY SC,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,155 TECHNOLOGY PL   LIBERTY SC,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,ROCKY MOUNTAIN HOLDINGS LLC,2550 N WALNUT ST   LUMBERTON NC,078,Robeson,3416A0800X,Transportation Services,Ambulance,Air Transport,1407855240,ROCKY MOUNTAIN HOLDINGS LLC,2550 N WALNUT ST   LUMBERTON NC,078,Robeson,3416A0800X,Transportation Services,Ambulance,Air Transport, 31 , 27 , 54 ," $29,712.39 ",,
MEDICAID DIRECT,1407855869,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,3616 MITCHELL AVE STE 10 NEWLAND NC,006,Avery,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1407855869,MEDICAL SERVICES OF AMERICA INC,3616 MITCHELL AVE STE 10 NEWLAND NC,006,Avery,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1407855869,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,3616 MITCHELL AVE STE 10 NEWLAND NC,006,Avery,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1407855869,MEDICAL SERVICES OF AMERICA INC,3616 MITCHELL AVE STE 10 NEWLAND NC,006,Avery,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 54 , 288 , 426 ,$#,,
MEDICAID DIRECT,1659307270,LINCOLN INTERNAL MEDICINE PA,LINCOLN INTERNAL MEDICINE PA,607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1407856461,"RADUT, TOMA",607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 195 , 237 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407857212,"NAVE, LESTER, DAVID",555 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407857212,"NAVE, LESTER, DAVID",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 42 , 114 ,$#,,
MEDICAID DIRECT,1245231364,HAYWOOD PEDIATRIC AND ADOLESCENT,HAYWOOD PEDIATRICS,15 FACILITY DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1407857691,"WEAVER, MORRILL, HARRINGTON",15 FACILITY DR   CLYDE NC,044,Haywood,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 33 , 47 , 118 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1407858301,"BARNHILL, PEGGY, SUE",630 S MADISON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1407858301,"BARNHILL, PEGGY, SUE",88 E GREEN ST   CLARKTON NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 32 , 32 ," $10,075.64 ",,
MEDICAID DIRECT,1821764390,BLADEN HEALTHCARE LLC,CFV PRIMARY CARE-VINELAND FAMILY MEDICINE,630 S MADISON ST   WHITEVILLE NC,024,Columbus,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1407858301,"BARNHILL, PEGGY, SUE",630 S MADISON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 166 , 169 ," $10,629.63 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407858343,"REYNOLDS, JOHN, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407858343,"REYNOLDS, JOHN, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 22 , 28 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407858467,"CORSO, STEVEN, WILLIAM",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1407858616,"LOEWEN, ANALISA, MIRANDA",1765 DOBBINS DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407858632,"KENDRICK, WILLIAM, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 32 , 53 , 53 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407858632,"KENDRICK, WILLIAM, THOMAS",510 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 61 , 377 , 377 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407858632,"KENDRICK, WILLIAM, THOMAS",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 95 , 187 , 500 ,$#,,
MEDICAID DIRECT,1407858632,"KENDRICK, WILLIAM, THOMAS",~,511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,1407858632,"KENDRICK, WILLIAM, THOMAS",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407858632,"KENDRICK, WILLIAM, THOMAS",511 PALADIN DR   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407859077,"FRANKLIN, JAMES, WILBERT",113 VIRGINIA RD   EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1407859077,"FRANKLIN, JAMES, WILBERT",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407859077,"FRANKLIN, JAMES, WILBERT",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 85 , 216 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407859077,"FRANKLIN, JAMES, WILBERT",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 31 , 85 ,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407859473,"CROAKE, TRICIA, KAY",165 TURNBERRY WAY   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 30 ,$#,,
MEDICAID DIRECT,1407859473,"CROAKE, TRICIA, KAY",,165 TURNBERRY WAY   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1407859473,"CROAKE, TRICIA, KAY",165 TURNBERRY WAY   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407860182,"SMITH, KRISTIE",544 BRAWLEY SCHOOL RD STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407860224,"MORAN, DANIEL, LAWRENCE",CAROLINA DEVELOPMENTAL PEDIATRICS,1001 W WILLIAMS ST STE 104 APEX NC,092,Wake,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,1407860224,"MORAN, DANIEL, LAWRENCE",1001 W WILLIAMS ST STE 104 APEX NC,092,Wake,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407861297,"SEEPE, CAROLYN, SUE",201 S MAIN ST STE 3200 DANVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407862089,"MURPHY, MICHAEL, JOSEPH",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407862089,"MURPHY, MICHAEL, JOSEPH",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1407862089,"MURPHY, MICHAEL, JOSEPH",8108 MARKET ST STE B WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407862089,"MURPHY, MICHAEL, JOSEPH",8108 MARKET ST STE B WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407862089,"MURPHY, MICHAEL, JOSEPH",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407866072,"CULBERTSON, DEBORAH, SEYFRIED",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407866072,"CULBERTSON, DEBORAH, SEYFRIED",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1104679448,PHILLIP MCIVER DDS PA,~,304 IONA ST   FAIRMONT NC,078,Robeson,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",304 IONA ST   FAIRMONT NC,078,Robeson,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 14 , 14 , 90 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,411 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 196 , 278 ," 1,157 "," $116,260.36 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,149 PLANTATION RIDGE DR STE 170 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,50A BOWMAN DR   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 42 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 20 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,160 TURNBERRY WAY   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407870470,"LOMBRANO, JENNIFER, LYNN",160 TURNBERRY WAY   PINEHURST NC,063,Moore,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 152 , 126 , 736 ," $75,121.32 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407870926,"CALLAHAN, CATHERINE, BRITTAIN",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1407870926,"CALLAHAN, CATHERINE, BRITTAIN",10344 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407870926,"CALLAHAN, CATHERINE, BRITTAIN",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 27 , 36 ,$#,,
MEDICAID DIRECT,1154820934,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHS NEONATAL FOLLOW-UP CLINIC,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407871767,"CHIU, MICHELLE, KAREN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407871767,"CHIU, MICHELLE, KAREN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 47 , 47 ," $10,392.21 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407872401,"HENDERSHOT, JON, PAUL",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407872401,"HENDERSHOT, JON, PAUL",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 76 , 119 ,$#,,
MEDICAID DIRECT,1407873664,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1558,304 E ARBOR LN   EDEN NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1407873664,WAL-MART STORES EAST LP,304 E ARBOR LN   EDEN NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1407873664,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1558,304 E ARBOR LN   EDEN NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1407873664,WAL-MART STORES EAST LP,304 E ARBOR LN   EDEN NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407875511,"SCHLOSSBERG, MATTHEW, LOUIS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1023254497,PORT CITY URGENT CARE,~,706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407875859,"OCHS, GARY, DORRELL",706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023254497,PORT CITY URGENT CARE,~,706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407875859,"OCHS, GARY, DORRELL",706 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 45 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407876675,"MCCUNE, SCOTT, ALAN",10030 GILEAD RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 27 , 38 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407877590,"KESTIN, SHARON",1155 MAIN ST   YOUNG HARRIS GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1407877590,"KESTIN, SHARON",1155 MAIN ST   YOUNG HARRIS GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407877590,"KESTIN, SHARON",1155 MAIN ST   YOUNG HARRIS GA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407879182,"GUDGER, JEFFREY, NEIL",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326077694,PHILLIPPI AND KWON DENTISTRY LLP,PHILLIPPI & KWON DENTISTRY LLP,2770 E WT HARRIS BLVD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407880875,"PHILLIPPI, PAUL, JEFFREY",2770 E WT HARRIS BLVD STE 102 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 25 , 68 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1407880917,"FRIEDMAN, ANGELA, ROGERS",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407880917,"FRIEDMAN, ANGELA, ROGERS",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 40 , 149 , 149 ," $21,289.44 ",,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",1918 RANDOLPH RD STE 700 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 36 , 45 , 112 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",1718 E 4TH ST STE 605 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 14 , 18 , 24 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",17810 STATESVILLE RD STE 311 CORNELIUS NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",1718 E 4TH ST STE 605 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407882368,"OHMSTEDE, DAVID, PICMAN",1806 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1635 NC HIGHWAY 66 S STE 210 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407882723,"METHENEY, CATHERINE, DENISE",1635 NC HIGHWAY 66 S STE 210 KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407882723,"METHENEY, CATHERINE, DENISE",1635 NC HIGHWAY 66 S STE 210 KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 40 , 65 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407882723,"METHENEY, CATHERINE, DENISE",1635 NC HIGHWAY 66 S STE 210 KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1407882871,"DUNCAN, ANNA, MARIE",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1407882871,"DUNCAN, ANNA, MARIE",2600 NC HIGHWAY 97   WENDELL NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1588256754,GENERATIONS FAMILY PRACTICE,WENDELL FAMILY MEDICINE,2839 WENDELL BLVD STE 100 WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1407882871,"DUNCAN, ANNA, MARIE",2600 NC HIGHWAY 97   WENDELL NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 84 , 248 , 318 ," $21,131.49 ",,
MEDICAID DIRECT,1588256754,GENERATIONS FAMILY PRACTICE,WENDELL FAMILY MEDICINE,2839 WENDELL BLVD STE 100 WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1407882871,"DUNCAN, ANNA, MARIE",2839 WENDELL BLVD STE 100 WENDELL NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 47 , 74 ,$#,,
MEDICAID DIRECT,1407882871,"DUNCAN, ANNA, MARIE",~,2839 WENDELL BLVD STE 100 WENDELL NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1407882871,"DUNCAN, ANNA, MARIE",2839 WENDELL BLVD STE 100 WENDELL NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1407884695,"THAXTON, ANTHONY, GRANT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 385 , 426 , 553 ,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407884695,"THAXTON, ANTHONY, GRANT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 21 , 21 , 28 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407884695,"THAXTON, ANTHONY, GRANT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 327 , 340 , 425 ," $14,582.95 ",,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,402 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407884695,"THAXTON, ANTHONY, GRANT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging,#,,,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1407885346,"KUTZ, SUSAN, LYNN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407887045,"LAWRENCE, JEREMY, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770004723,VITA FAMILY PRACTICE PLLC,,609 EXECUTIVE PL STE B FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1407887219,"STURCKEN, JENNIFER, IRENE",609 EXECUTIVE PL STE B FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 33 , 33 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407887573,"REVIS, SHELEY, RENE",8401 MEDICAL PLAZA DR STE 250 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 52 , 116 ,$#,,
MEDICAID DIRECT,1407887698,"WILLOUGHBY, WENDY, DEE",WENDY DEE WILLOUGHBY,192 E CHESTNUT ST STE B ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1407887698,"WILLOUGHBY, WENDY, DEE",192 E CHESTNUT ST STE B ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#, 22 , 49 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407887839,"LONGWATER, ADAM, BRIAN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407889371,"TARTER, DAVID, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 170 , 171 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407890080,"BARTON, GREGORY, ALLEN",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 68 , 90 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407890080,"BARTON, GREGORY, ALLEN",137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 25 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407890080,"BARTON, GREGORY, ALLEN",434 KIRBY RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 71 , 101 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407890999,"HOLT, JAMES, EMMETT",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1922140169,DIABETES & ENDOCRINOLOGY,~,623 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1407892441,"LUCAS, KATHRYN, JEAN",623 N 35TH ST   MOREHEAD CITY NC,016,Carteret,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 23 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",3000 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 27 , 27 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 66 , 114 , 198 ," $10,589.82 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",2400 PRATT ST NORTH PAVILION DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407892748,"WIENER, JOHN, SAMUEL",3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1407893738,"CICCARELLI, ANDREW, MICHAEL",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1407893738,"CICCARELLI, ANDREW, MICHAEL",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407893738,"CICCARELLI, ANDREW, MICHAEL",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407893738,"CICCARELLI, ANDREW, MICHAEL",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 12 , 41 , 71 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,1090 NE GATEWAY CT NE STE 204A CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,1090 NE GATEWAY CT NE STE 204A CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 67 , 445 , 854 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,2211 E FRANKLIN BLVD STE 100A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,2211 E FRANKLIN BLVD STE 100A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,#, 31 , 79 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 16 , 44 , 86 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,400 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,400 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 14 , 48 , 81 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,7825 BALLANTYNE COMMONS PKWY STE 210   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,7825 BALLANTYNE COMMONS PKWY STE 210   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 15 , 49 , 93 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,3030 RANDOLPH RD STE 105   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,3030 RANDOLPH RD STE 105   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 52 , 165 , 308 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5900 QUAIL HOLLOW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,5900 QUAIL HOLLOW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#, 18 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5727 PROSPERITY CROSSING DR STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,5727 PROSPERITY CROSSING DR STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 14 , 49 , 71 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,1401 MATTHEWS TOWNSHIP PKWY STE 225 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,1401 MATTHEWS TOWNSHIP PKWY STE 225 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 27 , 130 , 213 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,16455 STATESVILLE RD STE 300   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,16455 STATESVILLE RD STE 300   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 82 , 303 , 473 ," $10,889.46 ",,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,15940 BRIXHAM HILL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,15940 BRIXHAM HILL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#, 18 , 33 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1407893944,CAROLINAS REHABILITATION,6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,, 40 , 231 , 423 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407894835,"LINK, MAUREEN, HAGERTY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407894835,"LINK, MAUREEN, HAGERTY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1407894835,"LINK, MAUREEN, HAGERTY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 ,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407894835,"LINK, MAUREEN, HAGERTY",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407894835,"LINK, MAUREEN, HAGERTY",3500 MT HOLLY HUNTERSVILLE RD STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407894835,"LINK, MAUREEN, HAGERTY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1407896202,"GANEM, JACQUES, PAUL",325 HAWTHORNE LN STE 300 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1407896202,"GANEM, JACQUES, PAUL",325 HAWTHORNE LN STE 300 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 32 , 53 , 102 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407896244,"SPARGO, JOHN, MARK",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 199 , 216 , 271 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407896913,"GALLARDO, IGNACIO, LORENZO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1124450572,CAROLINA CAPE FEAR MEDICAL GROUP PA,~,3637 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407896913,"GALLARDO, IGNACIO, LORENZO",3637 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 65 , 72 , 118 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407896913,"GALLARDO, IGNACIO, LORENZO",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 23 , 35 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407897846,"DALEY, MICHAEL, BERNARD",15 REGIONAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407897846,"DALEY, MICHAEL, BERNARD",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 165 , 329 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1407897846,"DALEY, MICHAEL, BERNARD",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1407897846,"DALEY, MICHAEL, BERNARD",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407898554,"WERNER, ALICE, LAIBSTAIN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003915018,JAMES J CROSSWELL JR MD PA,~,97 CAMPEN RD   BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1407900673,"CROSSWELL, JAMES, JAQUEIN",97 CAMPEN RD   BEAUFORT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 512 , 524 ," $11,241.99 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407900749,"PARDEN, MARY, ALICIA",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407900749,"PARDEN, MARY, ALICIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407902596,"GLAND CERCONE, TAMMY, LYNN",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407902786,"MAYNARD, ARTHUR, STANLEY",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407902786,"MAYNARD, ARTHUR, STANLEY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407902786,"MAYNARD, ARTHUR, STANLEY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760717151,ANGIER MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE - ANGIER,185 RAWLS RD   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407903743,"RENN, AMBER, JAMES",185 RAWLS RD   ANGIER NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 42 , 71 ,$#,,
MEDICAID DIRECT,1760717151,ANGIER MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE - ANGIER,1535 N RALEIGH ST   ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407903743,"RENN, AMBER, JAMES",185 RAWLS RD   ANGIER NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 106 , 172 ,$#,,
MEDICAID DIRECT,1487902334,CAROLINA VISION ASSOCIATES OD PA,,5301B MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407906084,"JACKSON, JONATHAN, FLOYD",5301B MARKET ST   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407906084,"JACKSON, JONATHAN, FLOYD",5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1407906084,"JACKSON, JONATHAN, FLOYD",5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,561 YOPP RD   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1407906084,"JACKSON, JONATHAN, FLOYD",5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,561 YOPP RD   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1407906084,"JACKSON, JONATHAN, FLOYD",561 YOPP RD   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,1112 NEW POINTE BLVD   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1407906084,"JACKSON, JONATHAN, FLOYD",1112 NEW POINTE BLVD   LELAND NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407908528,"HSU, WESLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 41 , 55 , 73 ," $15,169.77 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407910219,"KING, BOOKER, TERRY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 50 , 88 , 195 ," $23,788.84 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407912967,"CARNEY, SUSAN, FOWLER",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1407912967,"CARNEY, SUSAN, FOWLER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1407915390,A & E HOME CARE,~,902 E EDGERTON ST   DUNN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,,1407915390,A & E HOME CARE,902 E EDGERTON ST   DUNN NC,043,Harnett,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 3,514 "," 3,514 "," $251,442.32 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1407916067,"WHITLEY, SUSAN, DEBORAH",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0802X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407916067,"WHITLEY, SUSAN, DEBORAH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0802X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Psychiatry, 20 , 24 , 24 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407916067,"WHITLEY, SUSAN, DEBORAH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0802X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1407917867,"TURBETT, TIMOTHY, JAMES",211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 120 , 432 , 432 ," $12,821.01 ",,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1407917867,"TURBETT, TIMOTHY, JAMES",310 PENSACOLA RD   BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 346 , 346 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407917875,"RUDOLPH, WILLIAM, GARTH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1508887076,COUNTY OF PENDER,PENDER COUNTY HEALTH DEPT,803 S WALKER ST   BURGAW NC,071,Pender,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1407918295,"TAYLOR, JOAN, JERNIGAN",803 S WALKER ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407919285,"MILAZZO, ANGELO, STEPHEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407919285,"MILAZZO, ANGELO, STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407919285,"MILAZZO, ANGELO, STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407919285,"MILAZZO, ANGELO, STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 29 , 33 , 88 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407919392,"LAURORA, ROSANNE, VIVIAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 14 , 20 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1407919392,"LAURORA, ROSANNE, VIVIAN",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 19 , 25 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407919392,"LAURORA, ROSANNE, VIVIAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1407920739,"EZZELL, STANTON, WALL",703 NEWMAN RD   NEW BERN NC,025,Craven,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 46 , 51 , 168 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1407920739,"EZZELL, STANTON, WALL",703 NEWMAN RD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407925142,"WILLIFORD, PEGGY, DEE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407925142,"WILLIFORD, PEGGY, DEE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407925142,"WILLIFORD, PEGGY, DEE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407925696,"HUSAIN, KARRAR",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 188 , 332 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407925696,"HUSAIN, KARRAR",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407927759,"MEETZE, KEITH",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 42 , 68 , 118 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407927759,"MEETZE, KEITH",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407927759,"MEETZE, KEITH",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407927759,"MEETZE, KEITH",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1407927759,"MEETZE, KEITH",140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407928526,"MONTELEONE, ANDREW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 27 , 29 ,$#,,
MEDICAID DIRECT,1649540030,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ACUTE CARE SURGEONS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1407928526,"MONTELEONE, ANDREW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407930308,"ROSS, ALLISON, KINDER",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 32 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407930308,"ROSS, ALLISON, KINDER",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407930308,"ROSS, ALLISON, KINDER",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1407932304,"KELTY, PATRICK, JAMES",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 40 , 63 , 68 ,$#,,
MEDICAID DIRECT,1881952810,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407932304,"KELTY, PATRICK, JAMES",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1407932304,"KELTY, PATRICK, JAMES",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 28 , 86 , 145 ," $12,159.57 ",,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1407932304,"KELTY, PATRICK, JAMES",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 25 , 59 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1407932304,"KELTY, PATRICK, JAMES",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 113 , 287 , 500 ," $58,597.15 ",,
MEDICAID DIRECT,1881952810,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2640 HIGHWAY 105 STE 102 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1407932304,"KELTY, PATRICK, JAMES",2640 HIGHWAY 105 STE 102 BOONE NC,095,Watauga,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1407932775,COMPREHAB INC,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,, 500 ," 4,295 "," 4,946 "," $356,661.00 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407935182,"BLOCKER, TIMOTHY, DWAYNE",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1407935182,"BLOCKER, TIMOTHY, DWAYNE",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1609236371,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT STOVALL,100 DURHAM   STOVALL NC,039,Granville,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407936800,"ALLIGOOD, RONALD, RAY",100 DURHAM   STOVALL NC,039,Granville,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1407938228,"LEHMAN, RACHEL, ELIZABETH",4201 LAKE BOONE TRL STE 5 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 33 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407939663,"GAGLIARDI, JANE, PATRICIA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407939663,"GAGLIARDI, JANE, PATRICIA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407940596,"PATEL, NIRAJ, CHANDRAKANT",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology, 16 , 23 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407940596,"PATEL, NIRAJ, CHANDRAKANT",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology, 14 , 20 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407940596,"PATEL, NIRAJ, CHANDRAKANT",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,920 S LOMBARD ST STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 40 ," $11,055.56 ",,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,320 VETERANS PARKWAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",320 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 29 , 41 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 28 , 36 ,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,320 VETERANS PKWY STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",320 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 19 , 24 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 68 , 97 , 132 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",11200 GOVERNOR MANLY WAY STE 305 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,320 VETERANS PARKWAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1407941784,"MENDES, ROBERT, RALPH",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477583102,TYRRELL COUNTY RURAL HEALTH ASSOCIA,COLUMBIA MEDICAL CENTER,208 N BROAD ST   COLUMBIA NC,089,Tyrrell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1407942196,"LEIBENSPERGER CAVALL, IRENE",208 N BROAD ST   COLUMBIA NC,089,Tyrrell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 386 , 449 ," $10,425.24 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1407944424,"BARNES, AMANDA, WESTBY",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1407944721,"WESTBROOK, BRENT, ASHLEY",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1407944721,"WESTBROOK, BRENT, ASHLEY",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1407944721,"WESTBROOK, BRENT, ASHLEY",2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1407950413,"GERALDELI, SAULO",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0300X,Dental Providers,Dentist,Periodontics, 70 , 72 , 114 ,$#,,
MEDICAID DIRECT,1982028759,EAST CAROLINA UNIVERSITY,~,316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1407950413,"GERALDELI, SAULO",316 COUNTY SERVICES PARK   SYLVA NC,050,Jackson,1223P0300X,Dental Providers,Dentist,Periodontics, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1437463130,RALEIGH DURHAM MEDICAL GROUP PA,DURHAM FAMILY MEDICINE,,,Unknown,193200000X,Group,Multi-Specialty,,1407951882,"CHILUKURI, MOHAN, MURALI",2400 BROAD ST STE 1 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487845020,AVANCE CARE PA,,1821 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1407951882,"CHILUKURI, MOHAN, MURALI",2400 BROAD ST STE 1 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407952195,"ROLLA, MELANIE, DAWN",111 W GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 40 , 52 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1407952195,"ROLLA, MELANIE, DAWN",111 W GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407952195,"ROLLA, MELANIE, DAWN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1407952195,"ROLLA, MELANIE, DAWN",130 JAMES AVE   LOCUST NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 57 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1407952963,"AHMED, IBRAHIM, MOHAMED",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1053340109,SPANGLER LAMBERT AND LIPP DDS PLLC,SPANGLER LAMBERT & LIPP DDS PLLC,1544 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407953359,"ROHLFING, GAIL, KAYE",1544 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1407955354,"BUSH, CHARLES, TOMMY",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1407955354,"BUSH, CHARLES, TOMMY",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1407955354,"BUSH, CHARLES, TOMMY",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1407955354,"BUSH, CHARLES, TOMMY",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1407958614,"JORDAN, SUE, ELLEN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1407958614,"JORDAN, SUE, ELLEN",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1407959265,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03574,3186 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1407959265,NORTH CAROLINA CVS PHARMACY LLC,3186 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1407959265,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03574,3186 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1407959265,NORTH CAROLINA CVS PHARMACY LLC,3186 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1407959265,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03574,3186 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1407959265,NORTH CAROLINA CVS PHARMACY LLC,3186 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1407960222,"LEE, NATHANIEL, JOHN",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366918476,LAM S CHU DDS PA,,129 N BRIDGE ST   JONESVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1407962343,"CHU, LAM, SUE",129 N BRIDGE ST   JONESVILLE NC,099,Yadkin,1223G0001X,Dental Providers,Dentist,General Practice, 123 , 235 , 521 ," $29,840.82 ",,
MEDICAID DIRECT,1558546184,JACKSONVILLE PHYSICAL THERAPY CENTE,~,2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1407962582,"MINER, MICHAEL, CHRISTOPHER",2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407962947,"BAKER, ZITA, KATRICE",~,4200 MORGANTON RD STE 304 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1407962947,"BAKER, ZITA, KATRICE",4200 MORGANTON RD STE 304 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 735 ," 1,454 "," 5,517 "," $246,385.10 ",,
MEDICAID DIRECT,1407964125,COUNTY OF MOORE,Moore County EMS,302 S MCNEILL ST   CARTHAGE NC,063,Moore,3416L0300X,Transportation Services,Ambulance,Land Transport,1407964125,COUNTY OF MOORE,302 S MCNEILL ST   CARTHAGE NC,063,Moore,3416L0300X,Transportation Services,Ambulance,Land Transport, 618 ," 1,184 "," 2,198 "," $20,685.78 ",,
MEDICAID DIRECT,1265533806,PARK PLASTIC SURGERY PA,~,4008 CAPITAL DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1407964547,"PARK, FREDERICK, KIM",4008 CAPITAL DR   ROCKY MOUNT NC,064,Nash,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407964851,"LEGRANDE, CATHY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 67 , 72 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407964851,"LEGRANDE, CATHY",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1407964851,"LEGRANDE, CATHY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 48 , 62 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1407964851,"LEGRANDE, CATHY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 33 ,$#,,
MEDICAID DIRECT,1518063064,FAYETTEVILLE HEART CENTER PC,FAYETTEVILLE HEART CENTER,2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1407968696,"BAHEKAR, AMOL, ASHOK",2301 ROBESON ST STE 301 FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 356 , 618 , 694 ," $33,167.63 ",,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407968696,"BAHEKAR, AMOL, ASHOK",805 TILGHMAN DR STE B DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 35 , 42 , 46 ,$#,,
MEDICAID DIRECT,1932814209,HARNETT HEALTH SYSTEM INC,~,805 TILGHMAN DR STE B DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407968696,"BAHEKAR, AMOL, ASHOK",100 S 10TH ST   LILLINGTON NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 21 , 27 , 43 ,$#,,
MEDICAID DIRECT,1275354615,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY HEART AND VASCULAR,225 BRIGHTWATER DR STE 220 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407968696,"BAHEKAR, AMOL, ASHOK",805 TILGHMAN DR STE B DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 12 , 14 , 15 ,$#,,
MEDICAID DIRECT,1275354615,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY HEART AND VASCULAR,225 BRIGHTWATER DR STE 220 LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1407968696,"BAHEKAR, AMOL, ASHOK",100 S 10TH ST   LILLINGTON NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 26 , 32 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 77 , 83 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 46 , 64 , 64 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 130 , 149 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",24 2ND AVE NE STE FR HICKORY NC,018,Catawba,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",498 MADISON RD   MOCKSVILLE NC,030,Davie,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 26 , 51 , 51 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",498 MADISON RD   MOCKSVILLE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 60 , 60 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,498 MADISON RD   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1407969694,"CAPOROSSI, LISA, MITCHELL",498 MADISON RD   MOCKSVILLE NC,030,Davie,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1407137938,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,216 N BICKETT BLVD STE 3 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1407970825,"BEAUFORT, NICOLE, SAINT SIMONE",216 N BICKETT BLVD   LOUISBURG NC,035,Franklin,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003902313,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,1417 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1407970825,"BEAUFORT, NICOLE, SAINT SIMONE",1417 COLLEGE ST   OXFORD NC,039,Granville,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1902991698,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1407970825,"BEAUFORT, NICOLE, SAINT SIMONE",451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 43 , 59 , 127 ,$#,,
MEDICAID DIRECT,1407971039,"MOORE, CECIL, BRIAN",CECIL B MOORE,363 N MAIN ST   RUTHERFORDTON NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice,1407971039,"MOORE, CECIL, BRIAN",363 N MAIN ST   RUTHERFORDTON NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 111 , 294 ," $10,785.25 ",,
MEDICAID DIRECT,1407975816,COUNTY OF GREENE,GREENE CO DEPT OF SOCIAL SERVICES,227 KINGOLD BLVD STE A SNOW HILL NC,040,Greene,251B00000X,Agencies,Case Management,,1407975816,COUNTY OF GREENE,227 KINGOLD BLVD STE A SNOW HILL NC,040,Greene,251B00000X,Agencies,Case Management,, 27 , 325 , 325 ," $128,361.00 ",,
MEDICAID DIRECT,1407975816,COUNTY OF GREENE,GREENE CO DEPT OF SOCIAL SERVICES,227 KINGOLD BLVD STE A SNOW HILL NC,040,Greene,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1407975816,COUNTY OF GREENE,227 KINGOLD BLVD STE A SNOW HILL NC,040,Greene,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1407978638,"SNYDER, AUDREY, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1407983836,"HWANG, DAVID, YI-GIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 156 , 164 ," $15,016.84 ",,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407984974,"HENSLEY, CHAD, THOMAS",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 54 , 55 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407984974,"HENSLEY, CHAD, THOMAS",720 MALCOLM BLVD   VALDESE NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1407984974,"HENSLEY, CHAD, THOMAS",720 MALCOLM BLVD   VALDESE NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1407984974,"HENSLEY, CHAD, THOMAS",2201 S STERLING ST   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1407984974,"HENSLEY, CHAD, THOMAS",2201 S STERLING ST   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1407984974,"HENSLEY, CHAD, THOMAS",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1407987357,LINCOLN COUNTY,DEPARTMENT OF SOCIAL SERVICES,1136 E MAIN ST   LINCOLNTON NC,055,Lincoln,251B00000X,Agencies,Case Management,,1407987357,LINCOLN COUNTY,1136 E MAIN ST   LINCOLNTON NC,055,Lincoln,251B00000X,Agencies,Case Management,, 109 ," 1,619 "," 1,635 "," $489,523.77 ",,
MEDICAID DIRECT,1407991425,METROCORP AFFILIATES LTD,TRINITY HOME CARE,401 E RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1407991425,METROCORP AFFILIATES LTD,401 E RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 61 ," 16,663 "," 17,467 "," $2,524,059.01 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1407993421,"ANDERSON, SPENCE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1407993421,"ANDERSON, SPENCE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1871714071,"VENET, LAWRENCE",~,100 HEALTH PARK DR STE 105 GARNER NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1407995590,"VAUGHAN, TRACIE, LYNNE",100 HEALTH PARK DR STE 105 GARNER NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 70 , 111 , 443 ," $14,827.42 ",,
MEDICAID DIRECT,1114134293,HOPE MILLS URGENT CARE AND MEDICAL,HOPE MILLS URGENT CARE AND MEDICAL CLINIC PLLC,3758 S MAIN ST   HOPE MILLS NC,026,Cumberland,193400000X,Group,Single Specialty,,1407998990,"OKONS, TOBY, BERTY",3758 S MAIN ST   HOPE MILLS NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 311 ," 2,314 "," 5,996 "," $82,379.86 ",,
MEDICAID DIRECT,1407998990,"OKONS, TOBY, BERTY",~,3758 S MAIN ST   HOPE MILLS NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1407998990,"OKONS, TOBY, BERTY",3758 S MAIN ST   HOPE MILLS NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1417000456,"KADUMPALLI, KAVITHA SRAVANTHI, REDDY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 11 , 24 , 25 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417000456,"KADUMPALLI, KAVITHA SRAVANTHI, REDDY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1417000456,"KADUMPALLI, KAVITHA SRAVANTHI, REDDY",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417000456,"KADUMPALLI, KAVITHA SRAVANTHI, REDDY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 20 , 28 , 33 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1417000456,"KADUMPALLI, KAVITHA SRAVANTHI, REDDY",781 AVENT FERRY RD STE 208 HOLLY SPRINGS NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 55 , 86 , 98 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417001736,"GUENTENSBERGER, DEBORAH, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417002098,"BHASKAR, SADASHIVAIAH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417002098,"BHASKAR, SADASHIVAIAH",3173 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1417003070,"TAYLOR, AMY, JEAN",2359 HIGHWAY 105   BOONE NC,095,Watauga,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 67 , 74 , 74 ,$#,,
MEDICAID DIRECT,1417003385,"HARSH, RENUKA, SHIV",RENUKA SHIV HARSH,218 FOUST ST STE B ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1417003385,"HARSH, RENUKA, SHIV",218 FOUST ST STE B ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 66 , 133 ,$#,,
MEDICAID DIRECT,1104060615,ASHLEY M COLLINS DDS PA,~,6135 HIGHWAY 16 S   DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1417004060,"COLLINS, ASHLEY, MICHELLE",6135 HIGHWAY 16 S   DENVER NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 238 , 547 ," 1,637 "," $77,440.93 ",,
MEDICAID DIRECT,1538217179,LEBAUER MEDICAL CENTER,~,3201 BRASSFIELD RD STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417005034,"SHARMA, RANJAN",3201 BRASSFIELD RD STE 400 GREENSBORO NC,041,Guilford,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 41 , 295 , 329 ,$#,,
MEDICAID DIRECT,1538217179,LEBAUER MEDICAL CENTER,~,3201 BRASSFIELD RD STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417005034,"SHARMA, RANJAN",519 BOONE STATION DR STE 112 BURLINGTON NC,001,Alamance,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 24 , 187 , 214 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417006115,"MOSER, MELISSA, RENEE",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417006115,"MOSER, MELISSA, RENEE",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,152 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417006115,"MOSER, MELISSA, RENEE",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417008210,"MEHR, PETER, JEROME",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 144 , 164 , 386 ," $21,005.71 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417008210,"MEHR, PETER, JEROME",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 55 , 115 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1417008210,"MEHR, PETER, JEROME",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 170 , 251 , 596 ," $29,800.27 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417008210,"MEHR, PETER, JEROME",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417008210,"MEHR, PETER, JEROME",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 36 , 84 ,$#,,
MEDICAID DIRECT,1992464002,HNI MEDICAL SERVICES OF NORTH CAROL,,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417009085,"DELGADO, JOSE, ANTONIO",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 96 , 96 ,$#,,
MEDICAID DIRECT,1689372187,SURRY MEDICAL MINISTRIES FOUNDATION,SURRY MEDICAL MINISTRIES FOUNDATION INC,951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1417009390,"POTTER, ANN, BARTZ",951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508903477,HANGER PROSTHETICS & ORTHOTICS EAST,~,401 WESTWOOD AVE STE 102 HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1417009614,"CLENDENIN, RANDALL, WAYNE",401 WESTWOOD AVE   HIGH POINT NC,041,Guilford,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1801036801,PERRY L JEFFRIES DDS PA,,1208 RIDDLE RD STE B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417009929,"BOYD, LOUKISHA, RENEE",1208 RIDDLE RD STE B DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 264 , 427 ," 1,514 "," $73,789.85 ",,
MEDICAID DIRECT,1538309539,PERRY L JEFFRIES DDS PA,Perry Jeffries DDS,4400 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417009929,"BOYD, LOUKISHA, RENEE",4400 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 2,021 "," 4,362 "," 17,008 "," $768,524.35 ",,
MEDICAID DIRECT,1538309539,PERRY L JEFFRIES DDS PA,Perry Jeffries DDS,4400 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417009929,"BOYD, LOUKISHA, RENEE",4400 FALLS OF NEUSE RD STE 200 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 56 , 197 ,$#,,
MEDICAID DIRECT,1417013822,SOUTHERN ASSISTED LIVING INC,BROOKDALE PEACHTREE AL,2806 PEACHTREE RD   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417013822,SOUTHERN ASSISTED LIVING INC,2806 PEACHTREE RD   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 837 , 837 ," $52,542.02 ",,
MEDICAID DIRECT,1417014952,MOUNTAIN ULTRASOUND IMAGING,MOUNTAIN ULTRASOUND IMAGING,1 VANDERBILT PARK DR STE 240 ASHEVILLE NC,011,Buncombe,293D00000X,Laboratories,Physiological Laboratory,,1417014952,MOUNTAIN ULTRASOUND IMAGING,1 VANDERBILT PARK DR STE 240 ASHEVILLE NC,011,Buncombe,293D00000X,Laboratories,Physiological Laboratory,, 42 , 43 , 43 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417016759,"COLELLA, FRANK, JOSEPH",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417016759,"COLELLA, FRANK, JOSEPH",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417016759,"COLELLA, FRANK, JOSEPH",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 27 , 42 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417016759,"COLELLA, FRANK, JOSEPH",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720292261,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1417020165,"ROBERTS, JOHN, MARTIN",50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1417020694,"WILKIE, KATHRYN, LOTHIAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417020694,"WILKIE, KATHRYN, LOTHIAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417020751,"MISHRA, ELLEN, MARGARET",700A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417020751,"MISHRA, ELLEN, MARGARET",700A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972217982,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1381 E GARRISON BLVD GASTONIA GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417021254,"SCHENK, GARY, SCOTT",1381 E GARRISON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 56 , 84 ,$#,,
MEDICAID DIRECT,1417021676,THOMAS E SMART & HARRY L WHITE JR P,MABRYS DRUG AND HOME CARE,41 W MAIN ST   HAMLET NC,077,Richmond,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1417021676,THOMAS E SMART & HARRY L WHITE JR P,41 W MAIN ST   HAMLET NC,077,Richmond,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 534 ," 2,630 "," 4,987 "," $109,416.58 ",,
MEDICAID DIRECT,1417021890,"SCHMITT, STACY, SUZANNE",STACY SUZANNE SCHMITT,10616 METROMONT PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1417021890,"SCHMITT, STACY, SUZANNE",10616 METROMONT PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 107 , 203 ," 1,058 "," $33,394.84 ",,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417027442,"BRIDGES, CHRISTY, MCINTYRE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 37 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417027442,"BRIDGES, CHRISTY, MCINTYRE",2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417029455,"DUELLMAN, GREGORY, JOHN",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 200 , 259 , 390 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417029455,"DUELLMAN, GREGORY, JOHN",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417029455,"DUELLMAN, GREGORY, JOHN",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 208 , 328 , 489 ,$#,,
MEDICAID DIRECT,1700111515,CAROLINAS PHYSICIANS NETWORK INC,CAROLINA NEUROLOGICAL CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417030230,"PATEL, ASHOK, VALJIBHAI",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 39 , 51 , 80 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 400 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417030669,"COOK, JONATHAN",5324 MCFARLAND RD STE 400 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417030669,"COOK, JONATHAN",5324 MCFARLAND RD STE 400 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417030669,"COOK, JONATHAN",DUKE PRIVATE DIAG CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417031246,"DEROUIN, ANNE, LYNN",1313 HALLEY ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417031303,"MCCALL, SHANNON",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 46 , 46 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417031303,"MCCALL, SHANNON",4425 BEN FRANKLIN BLVD RM 178 DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417031303,"MCCALL, SHANNON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417031329,"DEAR, GUY, DE LISLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417031329,"DEAR, GUY, DE LISLE",PRIVATE DIAGNOSTIC CLINIC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 56 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417031329,"DEAR, GUY, DE LISLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417031576,"JOLLIS, JAMES, GERARD",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 63 , 73 , 85 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417031576,"JOLLIS, JAMES, GERARD",DUKE HOSP SOUTH TRENT DR DUKE MEDICAL CTR DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 86 , 94 , 122 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417031576,"JOLLIS, JAMES, GERARD",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 23 , 27 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417031576,"JOLLIS, JAMES, GERARD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,10901 WORLD TRADE BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417032913,"BURGER, MARIANNE, PETROS",10901 WORLD TRADE BLVD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417032913,"BURGER, MARIANNE, PETROS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417032913,"BURGER, MARIANNE, PETROS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417033218,"BAKER, STEVEN, HOWARD",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 35 , 52 , 52 ," $12,862.20 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417033218,"BAKER, STEVEN, HOWARD",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1417035817,"VERHEY, PETER, TAYLOR",4355 CASTLEWOOD CT   RENO NV,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417037474,"LEVINE, AMY, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 25 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417037524,"MEHROTRA, ABHISHEK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1417037524,"MEHROTRA, ABHISHEK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417037987,"PEDEN, DAVID, BLAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417038738,"HOLLAR, LARRY, ARRAY",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 72 , 116 ,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1417043183,"BEASLEY, PAULA, ANNE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1417043183,"BEASLEY, PAULA, ANNE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548702186,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SKIN CENTER,1734 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417043647,"STEWART, TARA, LISA",1734 WESTBROOK AVE   BURLINGTON NC,001,Alamance,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 49 , 98 , 153 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417043738,"MARKS, LAWERENCE, BRUCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417043738,"MARKS, LAWERENCE, BRUCE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1255360459,SMITHFIELD RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT SMITHFIELD,514 N BRIGHTLEAF BLVD STE 1200 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1417043738,"MARKS, LAWERENCE, BRUCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1417043738,"MARKS, LAWERENCE, BRUCE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1164880571,REX RADIATION ONCOLOGY LLC,UNC REX CANCER CARE OF EAST RALEIGH,117 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417043738,"MARKS, LAWERENCE, BRUCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1578885406,JOHNSTON RADIATION ONCOLOGY LLC,UNC RADIATION ONCOLOGY AT CLAYTON,2076 NC HIGHWAY 42 W STE 120 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417043738,"MARKS, LAWERENCE, BRUCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417044025,"OLSON, STEVEN, ARTHUR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417044025,"OLSON, STEVEN, ARTHUR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1417044025,"OLSON, STEVEN, ARTHUR",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1932652492,NHCS PHYSICIANS INC,UNC MEDICAL AND HEMATOLOGY ONCOLOGY AT NASH,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1417044512,"CHUANG, ELLEN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 23 , 23 ,$#,,
MEDICAID DIRECT,1265711956,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MCALISTER PEDIATRI,447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1417044900,"SOLANKI, RAJESH, BALVANTSINH",447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 129 , 219 ," $14,184.43 ",,
MEDICAID DIRECT,1417046129,"ZARITSKY, MICHAEL, RICHARD",~,3933 WELCH ST   KITTY HAWK NC,028,Dare,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1417046129,"ZARITSKY, MICHAEL, RICHARD",3933 WELCH ST   KITTY HAWK NC,028,Dare,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery," 1,090 "," 1,168 "," 10,983 "," $1,147,735.15 ",,
MEDICAID DIRECT,1417046129,"ZARITSKY, MICHAEL, RICHARD",~,3933 WELCH ST   KITTY HAWK NC,028,Dare,1223P0106X,Dental Providers,Dentist,Oral and Maxillofacial Pathology,1417046129,"ZARITSKY, MICHAEL, RICHARD",3933 WELCH ST   KITTY HAWK NC,028,Dare,1223P0106X,Dental Providers,Dentist,Oral and Maxillofacial Pathology,#,#,#,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417046343,"DALLAS, JENNIFER, LAUREN",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 50 , 139 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417046343,"DALLAS, JENNIFER, LAUREN",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 15 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417046343,"DALLAS, JENNIFER, LAUREN",7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417046343,"DALLAS, JENNIFER, LAUREN",7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 73 , 223 ," $14,236.26 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417047259,"KEREKES, ALISON, PARSONS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417047259,"KEREKES, ALISON, PARSONS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417047259,"KEREKES, ALISON, PARSONS",10441 MONCREIFFE RD STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417047333,"HUIET, CHRISTOPHER, DEAN",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740628734,MONARCH,,103B MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1417049420,"WILLIAMSON, THERESA, HARROLD",103B MCALPINE LN   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528406519,MONARCH,~,2003 GODWIN AVE STE C LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417049420,"WILLIAMSON, THERESA, HARROLD",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 38 , 42 ,$#,,
MEDICAID DIRECT,1700175015,MONARCH,~,207 W 29TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417049420,"WILLIAMSON, THERESA, HARROLD",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1801116405,MONARCH,~,820 GRIMES BLVD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1417049420,"WILLIAMSON, THERESA, HARROLD",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1740628734,MONARCH,,103B MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1417049420,"WILLIAMSON, THERESA, HARROLD",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1417050105,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06401,200 N GREEN ST   MORGANTON NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1417050105,NORTH CAROLINA CVS PHARMACY LLC,200 N GREEN ST   MORGANTON NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1417050105,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 06401,200 N GREEN ST   MORGANTON NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1417050105,NORTH CAROLINA CVS PHARMACY LLC,200 N GREEN ST   MORGANTON NC,012,Burke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1417050113,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03985,215 WILLIAMSBORO ST   OXFORD NC,039,Granville,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1417050113,NORTH CAROLINA CVS PHARMACY LLC,215 WILLIAMSBORO ST   OXFORD NC,039,Granville,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1417050287,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04381,1607 WAY ST   REIDSVILLE NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1417050287,NORTH CAROLINA CVS PHARMACY LLC,1607 WAY ST   REIDSVILLE NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1417050287,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04381,1607 WAY ST   REIDSVILLE NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1417050287,NORTH CAROLINA CVS PHARMACY LLC,1607 WAY ST   REIDSVILLE NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417051681,"HEBDA, WILLIAM, BERNARD",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 39 , 84 ,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,100 CUNNINGHAM LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417051681,"HEBDA, WILLIAM, BERNARD",100 CUNNINGHAM LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568822104,ANDREW R OBLINGER DDS PA,OBLINGER FAMILY DENTISTRY,225 S HAWTHORNE ST   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1417052119,"OBLINGER, ANDREW, ROGERS",225 S HAWTHORNE ST   MOUNT HOLLY NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 42 , 102 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417052143,"HYATT, MAX, TODD",1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 40 , 62 , 112 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,2001 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417052143,"HYATT, MAX, TODD",2001 N CHURCH ST   GREENSBORO NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 55 , 77 , 134 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417055088,"COLES, ROBERT, EMMET",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 101 , 202 , 335 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1417055088,"COLES, ROBERT, EMMET",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 35 , 51 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417055716,"LOWE, CARL, JARRETT",2104 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 50 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417058934,"MOSES, ALAN, DAVID",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417058934,"MOSES, ALAN, DAVID",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1417058934,"MOSES, ALAN, DAVID",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417058934,"MOSES, ALAN, DAVID",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417058934,"MOSES, ALAN, DAVID",100 DUKE HEALTH CARY PL   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417059379,"DECKER, ROBYN, MARCUM",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1811254733,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PLASTIC AND RECONSTRUCTIVE SURGERY,401 E CHEVES ST STE 302 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417060013,"CAPLAN, JEFFREY, ERIC",401 E CHEVES ST STE 302 FLORENCE SC,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,2929 MONROE WAY STE 120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",2929 MONROE WAY STE 120 MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,8455 PIT STOP CT NW STE 125 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",8455 PIT STOP CT NW STE 125 CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,1480 CONCORD PKWY N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",1480 CONCORD PKWY N   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",2266 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,2266 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",2266 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,132 W CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",132 W CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,246 N NEW HOPE RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",246 N NEW HOPE RD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,223 N MYRTLE SCHOOL RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",223 N MYRTLE SCHOOL RD   GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,701 HAWLEY AVE   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",701 HAWLEY AVE   BELMONT NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 40 , 40 , 40 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3732 CREEKSHIRE CT   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",3732 CREEKSHIRE CT   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,1900 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",1900 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,11025 CAROLINA PLACE PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",11025 CAROLINA PLACE PKWY   PINEVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,598 RIVER HWY SPC 4-B MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,1830 GALLERIA BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",1830 GALLERIA BLVD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1417060070,"PAWLISH, KEITH, ALLAN",~,11025 CAROLINA PLACE PKWY   PINEVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,1417060070,"PAWLISH, KEITH, ALLAN",11025 CAROLINA PLACE PKWY   PINEVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,9820 CALLABRIDGE CT   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",9820 CALLABRIDGE CT   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,3916 E FRANKLIN BLVD STE 160 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",11025 CAROLINA PLACE PKWY   PINEVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,12830 WALKER BRANCH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",12830 WALKER BRANCH RD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,598 RIVER HWY SPC 4-B MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",598 RIVER HWY SPC 4-B MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,594 RIVER HWY   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",594 RIVER HWY   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1417060070,"PAWLISH, KEITH, ALLAN",306 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1417060641,MOUNTAINEER OXYGEN SERVICES INC,MOUNTAINEER OXYGEN SERVICES INC,42 BRANNER AVE   WAYNESVILLE NC,044,Haywood,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1417060641,MOUNTAINEER OXYGEN SERVICES INC,42 BRANNER AVE   WAYNESVILLE NC,044,Haywood,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 102 , 416 , 978 ," $15,832.75 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417063694,"KAMAL, ARIF, HOSSAIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417063694,"KAMAL, ARIF, HOSSAIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417064155,"COE, DOUGLAS, PAUL",2196 HWY 42 W   CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417064155,"COE, DOUGLAS, PAUL",2196 HWY 42 W   CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 33 ,$#,,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1417064379,"MILLER, ROBERT, BAILEY",104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 128 , 137 , 513 ," $31,724.19 ",,
MEDICAID DIRECT,1801232244,MILLER AND ASSOCIATES FOUR PLLC,MILLER AND ASSOCIATES,1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1417064379,"MILLER, ROBERT, BAILEY",1107 NEW POINTE BLVD   LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 135 , 153 , 581 ," $37,930.96 ",,
MEDICAID DIRECT,1952405474,ROBERT B MILLER IV DDS PLLC,COMPLETE DENTAL CARE,1505 S GLENBURNIE RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1417064379,"MILLER, ROBERT, BAILEY",1505 S GLENBURNIE RD STE J NEW BERN NC,025,Craven,1223G0001X,Dental Providers,Dentist,General Practice, 435 , 589 ," 1,888 "," $204,947.22 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1417064379,"MILLER, ROBERT, BAILEY",1505 S GLENBURNIE RD STE J NEW BERN NC,025,Craven,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 86 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1417064718,"EVANS, STEVEN, RAY",314 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 36 ,$#,,
MEDICAID DIRECT,1063505949,ONSLOW AMBULATORY SERVICES INC,ONSLOW INTERNAL MEDICINE & PRIMARY CARE,31 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1417065236,"ARCOT, NARENDER, DEIVASEKHAMANI",31 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 57 , 97 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417065467,"JOKL, RUDOLF, JAN",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 24 , 25 ,$#,,
MEDICAID DIRECT,1417071457,ENTERPRISE HEALTHCARE OF STATESVILL,ENTERPRISE HEALTHCARE OF STATESVILLE INC,1942 VAN HAVEN DR   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417071457,ENTERPRISE HEALTHCARE OF STATESVILL,1942 VAN HAVEN DR   STATESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 7,890 "," 8,062 "," $580,818.66 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417074139,"BOEHLKE, CHRISTOPHER, STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 20 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2000 REGENCY PKWY   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417074139,"BOEHLKE, CHRISTOPHER, STEPHEN",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417074139,"BOEHLKE, CHRISTOPHER, STEPHEN",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417074139,"BOEHLKE, CHRISTOPHER, STEPHEN",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 13 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417074139,"BOEHLKE, CHRISTOPHER, STEPHEN",3300 EXECUTIVE DR   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417074139,"BOEHLKE, CHRISTOPHER, STEPHEN",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417074204,"GRILLEY OLSON, JUNEKO, ELAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417074204,"GRILLEY OLSON, JUNEKO, ELAINE",20 DUKE MEDICINE CIR # 001 DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417074204,"GRILLEY OLSON, JUNEKO, ELAINE",20 DUKE MEDICINE CIR # 001 DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417074204,"GRILLEY OLSON, JUNEKO, ELAINE",20 DUKE MEDICINE CIR # 001 DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417076415,LANCASTER HEALTH CARE INC,ROSEWOOD REST HOME,3134 HARMONY HWY   HARMONY NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417076415,LANCASTER HEALTH CARE INC,3134 HARMONY HWY   HARMONY NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 41 ," 1,935 "," 1,935 "," $694,134.23 ",,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417077736,"WOODY, ANJA, BENFIELD",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417077736,"WOODY, ANJA, BENFIELD",25 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 64 , 135 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417077736,"WOODY, ANJA, BENFIELD",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 166 , 166 ," $34,324.78 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417079369,"WATTS, TAMMARA, L",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417079369,"WATTS, TAMMARA, L",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 19 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417079369,"WATTS, TAMMARA, L",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417079369,"WATTS, TAMMARA, L",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1417080227,SHIPMAN FAMILY HOME CARE INC,~,163 STRATFORD CT STE 115 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1417080227,SHIPMAN FAMILY HOME CARE INC,163 STRATFORD CT STE 115 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 58 ," 9,305 "," 9,335 "," $764,340.20 ",,
MEDICAID DIRECT,1417080342,MORGANTON EYE PHYSICIANS PA,MORGANTON EYE PHYSICIANS PA,1622 E MARION ST   SHELBY NC,023,Cleveland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1417080342,MORGANTON EYE PHYSICIANS PA,1622 E MARION ST   SHELBY NC,023,Cleveland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 159 , 244 , 244 ," $48,648.14 ",,
MEDICAID DIRECT,1417080607,THE ASPEN CENTER INC,THE ASPEN CENTER,8733 HOLLY SPRINGS RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1417080607,THE ASPEN CENTER INC,8733 HOLLY SPRINGS RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,, 22 , 204 , 242 ," $17,689.61 ",,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417081506,"COATH, GWENNAYE, CHERIE",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417081506,"COATH, GWENNAYE, CHERIE",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417081506,"COATH, GWENNAYE, CHERIE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 27 , 75 ,$#,,
MEDICAID DIRECT,1649788662,ST LUKES HOSPITAL INC,SALUDA FAMILY MEDICINE,1347 OZONE DR STE 2 SALUDA NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417081720,"BROYLES, LISA",801 W MILLS ST   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1417083874,"BROOKS, LINDA, PURVIS",5593 OLD HAYWOOD RD   MILLS RIVER NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 73 , 73 ,$#,,
MEDICAID DIRECT,1417083874,"BROOKS, LINDA, PURVIS",~,5593 OLD HAYWOOD RD   MILLS RIVER NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1417083874,"BROOKS, LINDA, PURVIS",5593 OLD HAYWOOD RD   MILLS RIVER NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1417083874,"BROOKS, LINDA, PURVIS",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417085325,"JONES II, JAMES, EARL",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417085325,"JONES II, JAMES, EARL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417086935,"FRIEDMAN, ROY, JOSEPH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 12 , 32 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1417086935,"FRIEDMAN, ROY, JOSEPH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417086935,"FRIEDMAN, ROY, JOSEPH",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 43 , 147 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417086935,"FRIEDMAN, ROY, JOSEPH",1450 MATTHEWS TOWNSHIP PKWY STE 450 MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 30 , 80 ,$#,,
MEDICAID DIRECT,1417087990,SOUTHERN MANOR RTR HOME INC,SOUTHERN MANOR REST HOME INC,390 HARDIN RD   FOREST CITY NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417087990,SOUTHERN MANOR RTR HOME INC,390 HARDIN RD   FOREST CITY NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 14 ," 2,601 "," 2,601 "," $174,919.93 ",,
MEDICAID DIRECT,1417090721,COUNTY OF STANLY,Stanly County DSS,1000 N 1ST ST STE 2 ALBEMARLE NC,084,Stanly,251B00000X,Agencies,Case Management,,1417090721,COUNTY OF STANLY,1000 N 1ST ST STE 2 ALBEMARLE NC,084,Stanly,251B00000X,Agencies,Case Management,, 60 , 566 , 566 ," $212,538.50 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417103417,"OBIEFUNA, NKECHINYERE, ANGELA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1417103417,"OBIEFUNA, NKECHINYERE, ANGELA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 41 , 41 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1417103417,"OBIEFUNA, NKECHINYERE, ANGELA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417103979,"ARGENTA, ANNE, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 45 , 134 , 196 ,$#,,
MEDICAID DIRECT,1295507739,AEGIS MEDICAL CENTER PLLC,,1000 CRESCENT GRN STE 102 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417104597,"RAO, JAYALALITHA",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 39 , 41 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1417105941,"ATRASH, SHEBLI",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417105941,"ATRASH, SHEBLI",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417105941,"ATRASH, SHEBLI",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 32 , 32 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,34 HEALTHPARK WAY STE 100C CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417106170,"FLEISCHHAUER, LEAH, CHRISTINE",34 HEALTHPARK WAY STE 100D CLAYTON NC,051,Johnston,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417107046,"PARAS, PIERRE, ANGELOUH OLALIA",2905 CROUSE LN   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417107046,"PARAS, PIERRE, ANGELOUH OLALIA",2905 CROUSE LN   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417110057,"NANDIGAM, KAVITHA, VEENA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 30 , 45 , 52 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417110057,"NANDIGAM, KAVITHA, VEENA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 23 , 28 ,$#,,
MEDICAID DIRECT,1194744532,MOSES CONE MEDICAL SERVICES INC,LEBAUER ENDOSCOPY CENTER,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1417110057,"NANDIGAM, KAVITHA, VEENA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417115155,"ZAFFINO, MARYSHELL, BROSCHE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 84 , 100 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417115155,"ZAFFINO, MARYSHELL, BROSCHE",29 W FRENCH BROAD ST STE B BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417116229,"KOEHLER, KEVIN, SCOTT",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417116229,"KOEHLER, KEVIN, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 88 , 106 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1417116229,"KOEHLER, KEVIN, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 127 , 142 , 175 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417117136,"GRIFFIN, LANCE, WAYLAND",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 28 , 28 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417117136,"GRIFFIN, LANCE, WAYLAND",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417118316,"HILL, KEITH, DANIEL",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417118316,"HILL, KEITH, DANIEL",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 64 , 69 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417118316,"HILL, KEITH, DANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356300248,SANFORD PEDIATRICS PA,SANFORD PEDIATRICS PA,1801 DOCTORS DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1417118878,"MARLOWE, MINDY, DEASON",1801 DOCTORS DR   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 62 , 209 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417118977,"SHAPIRO, MICHAEL, ADAM",401 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1629405212,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417119082,"CHAPMAN, BRITTANY, ANDRIOT",16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 45 , 54 , 62 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417119850,"JESSUP, ASHLEY, BASHIOUM",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 17 , 23 , 45 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417119850,"JESSUP, ASHLEY, BASHIOUM",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417121716,"WEIL, ANDREW, CAMPBELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 38 , 63 , 85 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,160 TURNBERRY WAY   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1417123456,"COOK, DANIEL, ROBERT",~,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 15 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,1041 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,411 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 49 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,149 PLANTATION RIDGE DR STE 170 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 152 , 153 , 815 ," $71,294.42 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417123456,"COOK, DANIEL, ROBERT",7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 207 , 295 ," 1,119 "," $97,792.41 ",,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417124314,"PORTMANN, JENNIFER, JO",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 48 , 50 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1417124314,"PORTMANN, JENNIFER, JO",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417124314,"PORTMANN, JENNIFER, JO",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 111 , 120 , 120 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417126566,"WILLIAMSON-LEON, TONYA, MAY",338 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,442 S HIGHWAY 27   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417126897,"NEWBY, L'ANITA, RENEE",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417126897,"NEWBY, L'ANITA, RENEE",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1417126897,"NEWBY, L'ANITA, RENEE",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417127549,"DICKERSON, FELICIA, LUCY LORENA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 14 , 15 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417127549,"DICKERSON, FELICIA, LUCY LORENA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417127549,"DICKERSON, FELICIA, LUCY LORENA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417131376,"GRUEBEL, TIMOTHY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 33 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417131376,"GRUEBEL, TIMOTHY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1417131483,"DELISIO, KESAH, LYNN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417131483,"DELISIO, KESAH, LYNN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1417131483,"DELISIO, KESAH, LYNN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417131483,"DELISIO, KESAH, LYNN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1417131483,"DELISIO, KESAH, LYNN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 46 , 49 ,$#,,
MEDICAID DIRECT,1417133638,"WILSON, JAMES, SPERLING",JAMES S WILSON,416 W WARREN ST   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice,1417133638,"WILSON, JAMES, SPERLING",416 W WARREN ST   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 39 , 106 ,$#,,
MEDICAID DIRECT,1679529051,KIDZCARE PEDIATRICS PC,~,3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417135401,"DANG, MYTRANG, THI",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 155 , 183 , 574 ," $20,784.84 ",,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417135401,"DANG, MYTRANG, THI",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679529051,KIDZCARE PEDIATRICS PC,~,3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417135401,"DANG, MYTRANG, THI",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417136078,"OSBORNE, JAMES, BAISDEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1922577048,MH HIGHLANDS-CASHIERS MEDICAL CENTE,,57 WHITE OWL LN   CASHIERS NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417136078,"OSBORNE, JAMES, BAISDEN",57 WHITE OWL LN   CASHIERS NC,050,Jackson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,187 MEDICAL PARK DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1417136078,"OSBORNE, JAMES, BAISDEN",187 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417136078,"OSBORNE, JAMES, BAISDEN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,187 MEDICAL PARK DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1417136078,"OSBORNE, JAMES, BAISDEN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417136185,"SQUIRE, SARAH, ELIZABETH",373 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417136185,"SQUIRE, SARAH, ELIZABETH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417136185,"SQUIRE, SARAH, ELIZABETH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 64 , 86 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417136185,"SQUIRE, SARAH, ELIZABETH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 14 , 62 , 80 ,$#,,
MEDICAID DIRECT,1609828698,GREENSBORO RADIATION ONCOLOGISTS PA,PIEDMONT RADIATION ONCOLOGISTS PA,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417136185,"SQUIRE, SARAH, ELIZABETH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417136508,"MCHUTCHISON, LYNDA, LEE BURT",1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1417136508,"MCHUTCHISON, LYNDA, LEE BURT",,165 TURNBERRY WAY   PINEHURST NC,063,Moore,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,1417136508,"MCHUTCHISON, LYNDA, LEE BURT",165 TURNBERRY WAY   PINEHURST NC,063,Moore,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#, 11 ,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1417136508,"MCHUTCHISON, LYNDA, LEE BURT",165 TURNBERRY WAY   PINEHURST NC,063,Moore,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#, 20 , 27 ,$#,,
MEDICAID DIRECT,1417136508,"MCHUTCHISON, LYNDA, LEE BURT",,5309 HIGHGATE DR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,1417136508,"MCHUTCHISON, LYNDA, LEE BURT",5309 HIGHGATE DR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 19 , 23 ,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1417136508,"MCHUTCHISON, LYNDA, LEE BURT",5309 HIGHGATE DR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417137035,"SAEED, MARYAM",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417137035,"SAEED, MARYAM",600 HOSPITAL DR   MONROE NC,090,Union,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 23 , 81 , 81 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1417141052,"MCLEAN, VIRGINIA, ANN",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 341 , 341 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,345 MANOR RD   MARS HILL NC,057,Madison,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 111 , 112 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,345 MANOR RD   MARS HILL NC,057,Madison,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 253 , 253 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417144635,"WILSON, ALEXIS, DAWN",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356366413,CRYSTAL COAST FAMILY PRACTICE,CRYSTAL COAST FAMILY PRACTICE,505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1417145293,"REED, RACHEL, ELIZABETH",505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1417147653,"NADKARNI, VAISHALI, RAHUL",555 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1417147653,"NADKARNI, VAISHALI, RAHUL",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 74 , 130 , 283 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417148974,"JOHNSON, DANIEL, ALLEN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 55 , 61 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1417148974,"JOHNSON, DANIEL, ALLEN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417148974,"JOHNSON, DANIEL, ALLEN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417148974,"JOHNSON, DANIEL, ALLEN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 39 , 44 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 91 , 106 , 211 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 24 , 38 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3031 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 70 , 70 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",2700 LEIGHTON RIDGE DR   WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",3604 BUSH ST   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",790 SE CARY PKWY   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",86 HEALTHPARK WAY   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 75 , 75 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",86 HEALTHPARK WAY   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417149717,"PATEL, SEJAN, BHUPENDRA",86 HEALTHPARK WAY   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417151168,"MIN, CHRISTOPHER, JUSTUS",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417151168,"MIN, CHRISTOPHER, JUSTUS",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 81 , 81 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417151234,"MESSER, HANNAH, IMWOLD",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 67 , 126 , 179 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417152885,"WERNER, JEFF, DAVID",3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1407134323,BEACHCARE URGENT AND FAMILY MEDICAL,BEACHCARE URGENT AND FAMILY MEDICAL CENTERPLLC,5059 HWY 70 W   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1417155441,"BEDARD, SARAH, EMILY",5059 HWY 70 W   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1417155441,"BEDARD, SARAH, EMILY",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417155441,"BEDARD, SARAH, EMILY",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 105 , 188 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1417155441,"BEDARD, SARAH, EMILY",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063436640,TAYLOR HEALTHCARE SERVICES PC,TAYLOR CHIROPRACTIC,211 TURNER DR   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1417155466,"TAYLOR, MATTHEW, RYAN",211 TURNER DR   REIDSVILLE NC,079,Rockingham,111N00000X,Chiropractic Providers,Chiropractor,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417157611,"HENRICKSON, STACY, RUSSELL",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417159518,"ALLU, HARSHA, VARDHAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 70 , 238 , 243 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417161043,"WHEATON, JENNIFER, CARTER",1925 GLENN MITCHELL DR STE 202 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 11 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417162108,"TAZI, KARIM",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 16 , 53 , 87 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417162108,"TAZI, KARIM",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417165630,"FLYTHE, JENNIFER, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417165630,"FLYTHE, JENNIFER, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 36 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417165630,"FLYTHE, JENNIFER, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417165903,"LYALL, JOHN, GREGORY",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 76 , 135 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417166067,"MOSALY, NILIMA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417166067,"MOSALY, NILIMA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 48 , 49 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417166067,"MOSALY, NILIMA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417166067,"MOSALY, NILIMA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417166299,"BECKMANN, BRAD, BRUCE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 170 , 188 , 221 ," $14,362.67 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1417166851,"GARRETT-ALBAUGH, SHELI, RUTH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 25 , 44 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417166851,"GARRETT-ALBAUGH, SHELI, RUTH",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,666 W CORBETT AVE   SWANSBORO NC,067,Onslow,193200000X,Group,Multi-Specialty,,1417166851,"GARRETT-ALBAUGH, SHELI, RUTH",666 W CORBETT AVE   SWANSBORO NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1700276318,DR CHAD J MILLER DDS,,3203 ARCHDALE RD   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1417166901,"MILLER, CHAD, JEFFREY",3203 ARCHDALE RD   ARCHDALE NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 88 , 171 , 373 ," $13,530.84 ",,
MEDICAID DIRECT,1053456954,NORTH FULTON EMERGENCY PHYSICIANS L,,3000 HOSPITAL BLVD   ROSWELL GA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1417169574,"SOOCH, YADAVINDER, SINGH",3000 HOSPITAL BLVD   ROSWELL GA,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417170143,"PARMAR, MEENAKSHI",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1417172529,"TREECE, AMY, ELAINE",AMY E TREECE MD,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,1417172529,"TREECE, AMY, ELAINE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417174616,"MCCOLLOUGH, BRIAN, ANTHONY",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 89 , 157 , 257 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417175167,"RIZNYK, MICHAEL, JOHN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 28 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417175167,"RIZNYK, MICHAEL, JOHN",10030 GILEAD RD STE 345 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417175167,"RIZNYK, MICHAEL, JOHN",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417175167,"RIZNYK, MICHAEL, JOHN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417175886,"WOOLF, DANIEL, JARED",12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 62 , 68 , 176 ,$#,,
MEDICAID DIRECT,1417176421,"CHAVEZ TART, VERONICA",,204 MUIRS CHAPEL RD STE 370 GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1417176421,"CHAVEZ TART, VERONICA",204 MUIRS CHAPEL RD STE 370 GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417176579,"KEARLEY, CORA, PAULETTE",703 ROSANNE DR UNIT D KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 80 , 80 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417176579,"KEARLEY, CORA, PAULETTE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 26 ,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1417176579,"KEARLEY, CORA, PAULETTE",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417176579,"KEARLEY, CORA, PAULETTE",1970 W ARLINGTON BLVD STE C GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 47 , 47 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3729 N ROXBORO ST STE B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417177486,"SANDER, MARGIE, CATHERINE",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417177486,"SANDER, MARGIE, CATHERINE",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4113 CAPITOL ST STE A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417177486,"SANDER, MARGIE, CATHERINE",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3729 N ROXBORO ST STE B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417177486,"SANDER, MARGIE, CATHERINE",3729 N ROXBORO ST STE B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417177486,"SANDER, MARGIE, CATHERINE",3729 N ROXBORO ST STE B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417177668,"FUTRELL, GEMEKIA, COLEMAN",147 PEACHTREE LN   ADVANCE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 113 , 138 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417177668,"FUTRELL, GEMEKIA, COLEMAN",147 PEACHTREE LN   ADVANCE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417178591,"ZHOU, RUIHAI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 131 , 188 , 223 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417178591,"ZHOU, RUIHAI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 65 , 82 , 100 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 32 , 56 , 73 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 47 , 51 , 140 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",1001 BLYTHE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",1001 BLYTHE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",603 COX RD STE C GASTONIA NC,036,Gaston,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417179078,"WALLIS, GONZALO, ALBERTO",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417183054,"MANOGUE, MICHAEL, RAYMOND",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 25 , 35 , 56 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417183054,"MANOGUE, MICHAEL, RAYMOND",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 52 , 188 , 310 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417183054,"MANOGUE, MICHAEL, RAYMOND",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417184235,"SHAH, RIDDHISHKUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417184235,"SHAH, RIDDHISHKUMAR",216 ASHVILLE AVE STE 20 CARY NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417184235,"SHAH, RIDDHISHKUMAR",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 23 , 42 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417185125,"CHHABRA, ANIL, KUMAR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842086,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417185455,"OSIAS, JULES, VARNEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417185455,"OSIAS, JULES, VARNEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 48 , 49 ,$#,,
MEDICAID DIRECT,1710073606,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3800 ROBERT PORCHER WAY STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417187790,"KOIRALA, DIBAS",3800 ROBERT PORCHER WAY STE 200 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 70 , 205 ,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417187790,"KOIRALA, DIBAS",3800 ROBERT PORCHER WAY STE 200 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417190455,"BURT, TREVOR, DEON",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 14 , 47 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417190455,"BURT, TREVOR, DEON",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 18 , 27 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 152 , 166 , 225 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 61 , 75 , 116 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417190729,"CROITOR, SHERRYL, KATHRYN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417190869,"WILSON, THADDEUS, DAVID",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598816480,BEAVERS & KEATING DDS PA,,2600 OAKCREST AVE STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417195298,"APPLEBAUM, ELIZABETH, ANN",2600 OAKCREST AVE STE B GREENSBORO NC,041,Guilford,1223E0200X,Dental Providers,Dentist,Endodontics,#, 15 , 44 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417196601,"ELI-PHILLIPS, JONATHAN, GABRIEL",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 40 , 41 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417196601,"ELI-PHILLIPS, JONATHAN, GABRIEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1417196601,"ELI-PHILLIPS, JONATHAN, GABRIEL",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417206350,"CHILDERS, ZESTA, SHIRELLE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417208653,"RENNIE, JULIE, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417208653,"RENNIE, JULIE, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417208653,"RENNIE, JULIE, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417209701,BEST HOME HEALTHCARE AGENCY LLC,~,3535 S WILMINGTON ST STE 106 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1417209701,BEST HOME HEALTHCARE AGENCY LLC,3535 S WILMINGTON ST STE 106 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 58 ," 13,045 "," 13,094 "," $1,107,536.96 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417209891,"BRUN, LINDSEY, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417210048,"IZZO, BRETT, ANTHONY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 84 , 103 , 122 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417210048,"IZZO, BRETT, ANTHONY",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417210048,"IZZO, BRETT, ANTHONY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 49 , 60 , 80 ,$#,,
MEDICAID DIRECT,1417211541,CARE 1 HOME CARE,CARE 1 HOME CARE,690 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1417211541,CARE 1 HOME CARE,690 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 6,567 "," 6,588 "," $1,182,392.24 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417211947,"MARQUEZ-LARA, ALEJANDRO, JOSE",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 60 , 74 , 106 ," $22,446.40 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417213042,"TURNER, JAMES, DAVID",313 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417213042,"TURNER, JAMES, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417213786,"SWARTZ, JONAS, JACOB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417213786,"SWARTZ, JONAS, JACOB",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417213786,"SWARTZ, JONAS, JACOB",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417214404,"KUMAR, RAKESH",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417214404,"KUMAR, RAKESH",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417215476,"BEAN, ALLISON, BELLE",9101 OCEAN HWY E   LELAND NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 57 , 124 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,9101 OCEAN HWY E   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1417215476,"BEAN, ALLISON, BELLE",9101 OCEAN HWY E   LELAND NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1417215476,"BEAN, ALLISON, BELLE",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 15 , 30 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417215476,"BEAN, ALLISON, BELLE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 27 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417219239,"CRUZ, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417219239,"CRUZ, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417219239,"CRUZ, JOSEPH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 86 , 140 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417219239,"CRUZ, JOSEPH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1417219239,"CRUZ, JOSEPH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 110 , 141 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417219551,"LINDSEY, BRANDEN, LEE",3521 HAWORTH DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417219551,"LINDSEY, BRANDEN, LEE",3521 HAWORTH DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417219551,"LINDSEY, BRANDEN, LEE",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417219841,"GARDNER, LAURA, MABE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417223249,"PRIVRATSKY, JAMIE, RAE",2301 ERWIN ROAD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417223249,"PRIVRATSKY, JAMIE, RAE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417223249,"PRIVRATSKY, JAMIE, RAE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1790941755,PRIVATE DIAGNOSTIC CLINIC PLLC,Durham Regional Hospital Intensivist,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417223249,"PRIVRATSKY, JAMIE, RAE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417223249,"PRIVRATSKY, JAMIE, RAE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417223272,"BAQUERO, KYLEE, BEVIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417223777,"WATKINS, AMANDA, JEAN",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 47 , 71 ,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1417225665,"JONES, JUDITH, DANIELS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",1250 LINKHAW RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 45 , 169 , 169 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 86 , 86 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",1327 HARRY WEST LN   PEMBROKE NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 55 , 55 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",101 DIALYSIS DR   ELIZABETHTOWN NC,009,Bladen,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",219 MARTIN LUTHER KING JR DR   BLADENBORO NC,009,Bladen,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 55 , 181 , 181 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 158 , 197 , 299 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417226721,"KETHINENI, RAMA, KRISHNA",2560 LEGION RD   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417227380,"ARAIZA, CAROLE, ANN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417229063,"PRUETER, KAREN",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 35 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417232018,"COX, KEVIN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 21 , 43 ,$#,,
MEDICAID DIRECT,1316622491,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS SPECIALTY SHALLOTTE,301 S WILLIS DR   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1417237876,"TEMPLE, WILLIAM, HARRY",301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417237884,"HOLT, HENRY, DOUGLAS",5211 EASON ST STE 1 SOUTHPORT NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417237884,"HOLT, HENRY, DOUGLAS",1899 N MARINE BLVD STE 400 JACKSONVILLE NC,067,Onslow,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 38 , 102 , 254 ," $43,031.25 ",,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1899 N MARINE BLVD STE 400 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1417237884,"HOLT, HENRY, DOUGLAS",1899 N MARINE BLVD STE 400 JACKSONVILLE NC,067,Onslow,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 52 , 99 , 237 ," $18,481.57 ",,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417237884,"HOLT, HENRY, DOUGLAS",1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 37 , 89 , 187 ," $17,324.83 ",,
MEDICAID DIRECT,1326089442,RETINA OF COASTAL CAROLINA PLLC,RETINA OF COASTAL CAROLINA PLLC,1801 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417237884,"HOLT, HENRY, DOUGLAS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1417239807,LINCARE INC,~,,,Unknown,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1417239807,LINCARE INC,5441 LUMLEY RD STE 102&103 DURHAM NC,032,Durham,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1417239807,LINCARE INC,~,,,Unknown,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1417239807,LINCARE INC,5441 LUMLEY RD STE 102&103 DURHAM NC,032,Durham,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417241373,"BOMAR, REBECCA, PAGE",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 26 , 34 , 73 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417241373,"BOMAR, REBECCA, PAGE",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 30 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417241373,"BOMAR, REBECCA, PAGE",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 33 , 62 , 89 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,16645 BIRKDALE COMMONS PKWY STE 200F HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417241373,"BOMAR, REBECCA, PAGE",16645 BIRKDALE COMMONS PKWY STE 200F HUNTERSVILLE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 17 , 22 , 29 ,$#,,
MEDICAID DIRECT,1417241928,BYRAMS HOMECARE LLC,~,5736 N TRYON ST STE 201F CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1417241928,BYRAMS HOMECARE LLC,5736 N TRYON ST STE 201F CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 23 ," 5,575 "," 5,641 "," $442,017.23 ",,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1417242017,"HOSSAIN, SHARMEEN, AKHTAR",1220 SPRUCE ST   BELMONT NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 109 , 193 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",2972 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",2972 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",2972 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",2972 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 187 , 187 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 101 , 101 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 27 , 36 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",2201 S STERLING ST   MORGANTON NC,012,Burke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 63 , 63 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",420 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",420 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417243502,"ANDERSON, ANGELA, LEIGH",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 101 , 104 ,$#,,
MEDICAID DIRECT,1780752394,"MILNER, WILLIAM, EDWIN",~,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,1417246000,"SHIM, JAE HEE",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023177151,ACCESS DENTAL CARE,ACCESS DENTAL CARE,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1417246000,"SHIM, JAE HEE",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 903 ," 1,083 "," 2,840 "," $171,020.86 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417246612,"PAFOS, EMMANUEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 90 , 127 , 172 ," $31,263.95 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1417246612,"PAFOS, EMMANUEL",417 N MAIN ST   KENANSVILLE NC,031,Duplin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417246612,"PAFOS, EMMANUEL",417 N MAIN ST   KENANSVILLE NC,031,Duplin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417248089,"CAVALCANTI, RAFAEL, TENORIO CHAMIXAES",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417248089,"CAVALCANTI, RAFAEL, TENORIO CHAMIXAES",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417248089,"CAVALCANTI, RAFAEL, TENORIO CHAMIXAES",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 12 , 19 , 24 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417248089,"CAVALCANTI, RAFAEL, TENORIO CHAMIXAES",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 35 , 36 , 37 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417248089,"CAVALCANTI, RAFAEL, TENORIO CHAMIXAES",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 49 , 76 , 111 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417248089,"CAVALCANTI, RAFAEL, TENORIO CHAMIXAES",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417248360,"HILDEBRAND, JESSICA, ANN REIFER",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 21 , 24 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417249087,"THURSTON, HEATHER, O'NEIL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 72 , 72 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1417249087,"THURSTON, HEATHER, O'NEIL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 54 , 54 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1417253204,"DAWSON, ROBIN, PEACOCK",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 131 , 244 , 596 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417253204,"DAWSON, ROBIN, PEACOCK",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 57 , 132 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417254673,"SOBCZYK, MAGDALENA, SYLWIA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1417254673,"SOBCZYK, MAGDALENA, SYLWIA",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417254673,"SOBCZYK, MAGDALENA, SYLWIA",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1417254673,"SOBCZYK, MAGDALENA, SYLWIA",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417254673,"SOBCZYK, MAGDALENA, SYLWIA",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417254673,"SOBCZYK, MAGDALENA, SYLWIA",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548389125,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - 3RD AVE,111 E THIRD AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417255746,"LE, BACH, TUYET THI",111 E 3RD AVE   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 185 , 216 ," $16,782.33 ",,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417255746,"LE, BACH, TUYET THI",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1417256223,"KALEVAS, KAREN, MCGINNIS",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 189 , 203 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1417256223,"KALEVAS, KAREN, MCGINNIS",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 39 , 64 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1417256223,"KALEVAS, KAREN, MCGINNIS",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417256462,"RINEHARDT, ERIC, ANTHONY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417256462,"RINEHARDT, ERIC, ANTHONY",10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,,,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1417258708,"STURM, KELLEY, BROOKE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417260373,"COPLEY, DONALD, KYLE",~,1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1417260373,"COPLEY, DONALD, KYLE",1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1053742205,MJ MAYHEW PA,,1922 W PARK DR   N WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1417260373,"COPLEY, DONALD, KYLE",1922 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 454 , 917 ," 3,739 "," $184,635.25 ",,
MEDICAID DIRECT,1902452139,BRADLEY ROBERTS & ASSOCIATES PLLC,,1135 N CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1417260712,"HOLLIS, KASHEENA, SHALLYON",1135 N CHURCH ST   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 27 , 439 ," $36,053.89 ",,
MEDICAID DIRECT,1801442033,BRADLEY ROBERTS & ASSOCIATES PLLC,~,401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1417260712,"HOLLIS, KASHEENA, SHALLYON",401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 203 , 206 ," 1,457 "," $74,985.32 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1417260712,"HOLLIS, KASHEENA, SHALLYON",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 87 , 87 , 960 ," $64,158.74 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417260712,"HOLLIS, KASHEENA, SHALLYON",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 604 , 616 ," 4,104 "," $178,211.25 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417260712,"HOLLIS, KASHEENA, SHALLYON",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 1,482 "," 1,604 "," 9,864 "," $331,203.15 ",,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417261793,"MISHRA, ISHA, DUA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417261793,"MISHRA, ISHA, DUA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417261793,"MISHRA, ISHA, DUA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 40 , 40 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 37 , 37 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417261793,"MISHRA, ISHA, DUA",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053022988,EMPIRICAL WELLNESS CENTER,,3729 S CHURCH ST STE 102 BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1417262023,"KING, CRYSTAL, MICHELLE",4309 MEDICAL PARK DR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417262023,"KING, CRYSTAL, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 27 , 47 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,3711 ELMSLEY ST STE 102 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417262023,"KING, CRYSTAL, MICHELLE",3711 ELMSLEY ST STE 102 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417262023,"KING, CRYSTAL, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417262080,"RONALD, JAMES, SPENCER CLAYTON",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 47 , 53 , 162 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417262080,"RONALD, JAMES, SPENCER CLAYTON",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417262080,"RONALD, JAMES, SPENCER CLAYTON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 22 , 25 , 56 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417262692,"NUNDKUMAR, NEELESH, CRUMSAN",3812 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417262692,"NUNDKUMAR, NEELESH, CRUMSAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 31 , 47 , 93 ," $18,900.04 ",,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417262692,"NUNDKUMAR, NEELESH, CRUMSAN",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 59 , 84 , 89 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417262692,"NUNDKUMAR, NEELESH, CRUMSAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124361100,ELITE FAMILY EYE CARE OD PLLC,ELITE FAMILY EYE CARE,2340 15TH AVE SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417265976,"LY, YUPHENG",2340 15TH AVE SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 39 , 42 ,$#,,
MEDICAID DIRECT,1801346895,PRECISION EYE CENTER OD PLLC,PRECISION EYE CENTER,,,Unknown,193400000X,Group,Single Specialty,,1417265976,"LY, YUPHENG",2340 15TH AVE SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1417268665,DAISY AND EDWARD HOME CARE AGENCY,DAISY AND EDWARD HOME CARE AGENCY,503 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,253Z00000X,Agencies,In Home Supportive Care,,1417268665,DAISY AND EDWARD HOME CARE AGENCY,503 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 1,950 "," 1,950 "," $175,086.92 ",,
MEDICAID DIRECT,1417268665,DAISY AND EDWARD HOME CARE AGENCY,DAISY AND EDWARD HOME CARE AGENCY,503 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1417268665,DAISY AND EDWARD HOME CARE AGENCY,503 N MAIN ST   MOUNT GILEAD NC,062,Montgomery,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 84 , 716 , 732 ," $114,113.94 ",,
MEDICAID DIRECT,1417268665,DAISY AND EDWARD HOME CARE AGENCY,DAISY AND EDWARD HOME CARE AGENCY,118 S MAIN ST   MOUNT GILEAD NC,062,Montgomery,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1417268665,DAISY AND EDWARD HOME CARE AGENCY,118 S MAIN ST   MOUNT GILEAD NC,062,Montgomery,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 97 , 965 , 989 ," $164,617.64 ",,
MEDICAID DIRECT,1417268665,DAISY AND EDWARD HOME CARE AGENCY,DAISY AND EDWARD HOME CARE AGENCY,118 S MAIN ST   MOUNT GILEAD NC,062,Montgomery,253Z00000X,Agencies,In Home Supportive Care,,1417268665,DAISY AND EDWARD HOME CARE AGENCY,118 S MAIN ST   MOUNT GILEAD NC,062,Montgomery,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 2,624 "," 2,624 "," $253,913.88 ",,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417270448,"JONES, KATHY, JO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 214 , 305 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417271198,"BURRIS, MICHAEL, BRIAN",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 63 , 91 , 149 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417271198,"BURRIS, MICHAEL, BRIAN",630 5TH AVE W   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417271198,"BURRIS, MICHAEL, BRIAN",95 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417272840,"MARROTTE, ERIC, JASON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 12 , 31 , 31 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1417272915,"BYRNE, JONATHAN, MATTHEW",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417273517,"COOMBS, CATHERINE, CALLAGHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 26 , 27 ,$#,,
MEDICAID DIRECT,1134997463,REX HOSPITAL INC,UNC REX PELVIC HEALTH THERAPY,1515 SW CARY PKWY STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1417273525,"NAGEL, GAIL, DEVRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1417273624,"FALES, CARRIE, ANN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 20 , 22 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417273624,"FALES, CARRIE, ANN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417273624,"FALES, CARRIE, ANN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 67 , 84 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417274010,"NELSON, CHRISTOPHER, MICHAEL",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 101 , 171 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417274911,"BIALOBRZESKI, LYNDA, BRIDGES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 74 , 79 , 82 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1417274911,"BIALOBRZESKI, LYNDA, BRIDGES",250 HOSPITAL DR LEXINGTON MEMORIAL HOSPITAL LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417274994,"MOYO, TAMARA, KAY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 41 , 42 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1417274994,"MOYO, TAMARA, KAY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417275090,"HOWARD, MARGARET, SEANE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417275090,"HOWARD, MARGARET, SEANE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 40 , 84 , 150 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1417276668,"MILLER, SETH, MATTHEW",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 36 , 115 , 134 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417281759,"TRUM, CHRISTOPHER, HUNTER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417283268,"AVILES-MORALES, JUAN, RAMON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 111 , 115 , 115 ,$#,,
MEDICAID DIRECT,1417283623,AMERICAN FORENSIC TOXICOLOGY SERVIC,~,789 PARK AVE   HUNTINGTON NY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1417283623,AMERICAN FORENSIC TOXICOLOGY SERVIC,789 PARK AVE   HUNTINGTON NY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1417284266,CARING COMPANIONS LLC,~,8001 RAINTREE LN STE 213 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1417284266,CARING COMPANIONS LLC,8001 RAINTREE LN STE 213 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,048 "," 1,084 "," $134,612.56 ",,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417287764,"CONSTANT, PEGGY",1925 TRADD CT   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417287764,"CONSTANT, PEGGY",801 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417287764,"CONSTANT, PEGGY",801 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 51 , 58 , 74 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1417290255,"EARLE, MARCUS, AARON",702 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 29 , 52 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1417290255,"EARLE, MARCUS, AARON",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417293986,"SPRATT, TAYVIA, RICHETTE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417293986,"SPRATT, TAYVIA, RICHETTE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417296120,"FREDA, FREDERICK, STERLING",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417296120,"FREDA, FREDERICK, STERLING",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417298134,COLUMBUS REGIONAL DIAGNOSTICS,~,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,293D00000X,Laboratories,Physiological Laboratory,,1417298134,COLUMBUS REGIONAL DIAGNOSTICS,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,293D00000X,Laboratories,Physiological Laboratory,, 42 , 43 , 45 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417298779,"BARBOUR, BENJAMIN, PATTON",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,1860 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1417298779,"BARBOUR, BENJAMIN, PATTON",1860 SUGAR HILL RD STE B MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1417298779,"BARBOUR, BENJAMIN, PATTON",186 MEDICAL PARK LOOP STE 501 SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417299348,"CHUNG, ANNISE, KIEU",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1417299348,"CHUNG, ANNISE, KIEU",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417299348,"CHUNG, ANNISE, KIEU",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417299561,"DAVIS, ROBERT, PATRICK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 12 ," $11,617.66 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417299561,"DAVIS, ROBERT, PATRICK",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1487879177,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - KER,861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1417299603,"JORDAN, BRANDI, FOSTER",861 OLD WINSTON RD STE 103 KERNERSVILLE NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 43 , 103 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417301169,"CHAU, DANIELLE, BELINDA",6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417302233,"SEBESTA, MEGYN, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 71 , 100 ," $11,584.95 ",,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417302233,"SEBESTA, MEGYN, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1659337046,COASTAL SURGICAL SPECIALIST,Coastal Surgical Specialist,2203 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1417302340,"HODGE, ANDREW, STEPHEN",2203 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 44 , 113 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1417303488,"JAMES, SARA, MELISSA",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 19 , 27 , 45 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417303488,"JAMES, SARA, MELISSA",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 14 , 21 , 28 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417303991,"SRIDHAR, SRUTHIPRIYA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417303991,"SRIDHAR, SRUTHIPRIYA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 45 , 99 , 99 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417304890,"MARTIN, KATIE, DENISE",44 BONNIE LN   SYLVA NC,050,Jackson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1417305780,"RAETTIG, LEAH, ROSSER",738 NEWMAN RD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1417307521,DIVINE HEALTH ACADEMY,D & C HOME CARE SERVICES,613 W ROOSEVELT BLVD   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1417307521,DIVINE HEALTH ACADEMY,613 W ROOSEVELT BLVD   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#," 1,889 "," 1,889 "," $144,485.60 ",,
MEDICAID DIRECT,1417307521,DIVINE HEALTH ACADEMY,D & C HOME CARE SERVICES,115 UNIONVILLE INDIAN TRAIL RD W STE E2 INDIAN TRAIL NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1417307521,DIVINE HEALTH ACADEMY,115 UNIONVILLE INDIAN TRAIL RD W STE E2 INDIAN TRAIL NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,029 "," 1,029 "," $75,030.44 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1417307935,"STEPHENS, ALLEN, DANIEL",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 42 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417307935,"STEPHENS, ALLEN, DANIEL",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417308040,"MCLENDON, HOPE, BROWN",401 E CHEVES ST STE 201 FLORENCE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1417310939,"POMERANZ, CORBIN, LURRIE",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 52 , 56 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417311036,"CHAMBERS, KACIE, DILLON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 26 , 157 , 157 ," $18,483.32 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417311085,"BELL, ANDREA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417311127,"GASKIN, SARAH, ELMORE",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417311127,"GASKIN, SARAH, ELMORE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417311127,"GASKIN, SARAH, ELMORE",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417311127,"GASKIN, SARAH, ELMORE",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417312588,"SAMUELSON, JONATHAN, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417314022,"YU, DAPHNE, DIHUEI",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,890 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417316696,"STAHL, HOLLIS, TAGGART",1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417316696,"STAHL, HOLLIS, TAGGART",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417317215,"SAMPSON, MAEGAN, KING",1517 N HOWE ST STE 4 SOUTHPORT NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417319146,"ZAK, ARTHUR",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 47 , 55 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417319146,"ZAK, ARTHUR",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417319229,"BHIMANI, JAY, BHARATKUMAR",380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417319229,"BHIMANI, JAY, BHARATKUMAR",380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417319229,"BHIMANI, JAY, BHARATKUMAR",380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417322256,"ZHANG, PING",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 64 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417324302,"FREEMAN, BRANDILYNN, ASHLEY",3116 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417324302,"FREEMAN, BRANDILYNN, ASHLEY",3116 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417324302,"FREEMAN, BRANDILYNN, ASHLEY",3116 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1417326349,"DESCHAINE, JOSHUA, MICHAEL",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1417326349,"DESCHAINE, JOSHUA, MICHAEL",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 47 , 60 ,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1417327446,"GOMES, MEREDITH, MILDRED",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417327446,"GOMES, MEREDITH, MILDRED",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417330036,"ZUPRUK, DAVID, CHRISTOPHER",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417330242,"TRASOLINI, NICHOLAS, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 74 , 112 ," $11,817.05 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417330242,"TRASOLINI, NICHOLAS, ANTHONY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417330242,"TRASOLINI, NICHOLAS, ANTHONY",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497752026,ECONOMED OF ABERDEEN,ORTHOTICS & PROSTHETICS OF PINEHURST,95 AVIEMORE DR STE A PINEHURST NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1417333014,"SPIVEY, RHONDA, SUE",95 AVIEMORE DR   PINEHURST NC,063,Moore,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 30 , 44 , 65 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1417333055,"HOLT, ANTHONY, WAYNE",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 26 , 28 ,$#,,
MEDICAID DIRECT,1700802600,THE PISGAH INSTITUTE OF PSYCHOTHERA,THE PISGAH INSTITUTE FOR PSYCHOTHERAPY AND EDUCATI,158 ZILLICOA ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417334442,"MORRISON, ERIN, KATHLEEN",158 ZILLICOA ST   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1417334509,"SERBANESCU, MARA, ALEXANDRA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417334509,"SERBANESCU, MARA, ALEXANDRA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417334509,"SERBANESCU, MARA, ALEXANDRA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417334509,"SERBANESCU, MARA, ALEXANDRA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417334509,"SERBANESCU, MARA, ALEXANDRA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417335332,"TAYLOR, SHAWN, RISER",225 PATTON AVE STE 200 ASHEVILLE NC,011,Buncombe,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417335332,"TAYLOR, SHAWN, RISER",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417336157,"SMITH, RYAN, MICHAEL",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417336876,"SOTO, ELIZABETH, JOAN",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 33 , 65 ,$#,,
MEDICAID DIRECT,1255054409,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE SPECIALTY CLINICS,1551 WESTBROOK PLAZA DR STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417336876,"SOTO, ELIZABETH, JOAN",1551 WESTBROOK PLAZA DR STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417338765,"BURKETT, JENNA, RENEE",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417339565,"THOMASON, YOLANDAS, RENEE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417340886,"GODFREY, STEPHANIE, A MADRZYKOWSKI",1718 E 4TH ST STE 907 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,825 SPARTANBURG HWY STE 17 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417341405,"KENYON, KYLE, JUDSON",825 SPARTANBURG HWY STE 17 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 66 , 135 ,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1417341405,"KENYON, KYLE, JUDSON",825 SPARTANBURG HWY STE 17 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417341405,"KENYON, KYLE, JUDSON",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 38 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417341405,"KENYON, KYLE, JUDSON",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,511 SMOKY PARK HWY   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417341405,"KENYON, KYLE, JUDSON",511 SMOKY PARK HWY STE A2 CANDLER NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417343427,"HOWE, JEFFREY, HAMILTON",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 354 , 397 , 502 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417343427,"HOWE, JEFFREY, HAMILTON",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 64 , 65 , 96 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1417343815,"SUMPTER, JA'PEL, K M",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1003687187,DLP WESTERN CAROLINA PHYSICIAN PRAC,HARRIS WOMENS CARE,70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417343815,"SUMPTER, JA'PEL, K M",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1417343815,"SUMPTER, JA'PEL, K M",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 46 , 54 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1188 YADKINVILLE RD   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1417345315,"COLLETTE, EMILY, DRAUGHN",1188 YADKINVILLE RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417345315,"COLLETTE, EMILY, DRAUGHN",7811 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 53 , 114 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417349317,"KOREN, HEATHER, LYNN",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 89 , 770 , 879 ," $21,396.13 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417349317,"KOREN, HEATHER, LYNN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 167 , 207 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417349937,"WELLS, BRITTANY, JAMES",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417349937,"WELLS, BRITTANY, JAMES",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 241 ," 1,310 "," 1,356 "," $24,649.07 ",,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417350026,"CISNEROS-GONZALEZ, LIGIA, ELENA",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417350935,"ORTON, KRISTINA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417350935,"ORTON, KRISTINA, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417351297,"HONEYCHUCK, AMANDA, MAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417351297,"HONEYCHUCK, AMANDA, MAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,154 S MAIN ST   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417351297,"HONEYCHUCK, AMANDA, MAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417351297,"HONEYCHUCK, AMANDA, MAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417351297,"HONEYCHUCK, AMANDA, MAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,707 BRYANT ST   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417351297,"HONEYCHUCK, AMANDA, MAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 107 , 138 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417352568,"KERSHNER, JOHN, WILLIAM",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 65 , 65 ,$#,,
MEDICAID DIRECT,1417354556,FREEDOM CARE SERVICES LLC,,3560 BUNNLEVEL ERWIN RD   ERWIN NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417354556,FREEDOM CARE SERVICES LLC,3560 BUNNLEVEL ERWIN RD   ERWIN NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 400 , 402 ," $24,470.62 ",,
MEDICAID DIRECT,1417354556,FREEDOM CARE SERVICES LLC,,34 SHALLOW FORD ST   CAMERON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417354556,FREEDOM CARE SERVICES LLC,34 SHALLOW FORD ST   CAMERON NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 699 , 702 ," $43,016.82 ",,
MEDICAID DIRECT,1417354556,FREEDOM CARE SERVICES LLC,,1335 LASSITER RD   FOUR OAKS NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417354556,FREEDOM CARE SERVICES LLC,1335 LASSITER RD   FOUR OAKS NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,136 "," 1,146 "," $69,425.39 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417354861,"SAMS, CHELSEA, RAE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417363581,"BARNES, STEPHANIE, GIRARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417363623,"DYER, KATHERINE, ELIZABETH",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417364878,"PITASSI, THERESA, MARIE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417364878,"PITASSI, THERESA, MARIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417364878,"PITASSI, THERESA, MARIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 50 , 75 ,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417365685,"HOPSON, KERRY, CATHERINE",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 21 , 23 ,$#,,
MEDICAID DIRECT,1265430854,GRANVILLE HEALTH SYSTEM,SOUTH GRANVILLE PRIMARY CARE,1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417365685,"HOPSON, KERRY, CATHERINE",1614 NC HIGHWAY 56   CREEDMOOR NC,039,Granville,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417366089,"ZDZIARSKI-HORODYSKI, LAURA, ANN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1417366188,"D'AGOSTINO, BECKY, LYNN",100 W PARKVIEW DR   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417366188,"D'AGOSTINO, BECKY, LYNN",100 W PARKVIEW DR   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417368689,"MOTZ, BENJAMIN, MITCHELL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417368689,"MOTZ, BENJAMIN, MITCHELL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 23 , 25 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417368689,"MOTZ, BENJAMIN, MITCHELL",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376564625,WILSON MEDICAL GROUP PLLC,WILSON MEDICAL GROUP,3302 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1417370644,"MARSHBURN, BRITTANY, YEAGER",3302 NASH ST N   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 92 , 203 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417370750,"ZECKSER, NICOLE, FRANCES",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417370750,"ZECKSER, NICOLE, FRANCES",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417373721,"NARIO, MYRA FLOR, ASINAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417373721,"NARIO, MYRA FLOR, ASINAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 52 , 52 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417374976,"CALANDRA, JENNIFER, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 108 , 108 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417374976,"CALANDRA, JENNIFER, ANN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417375155,"CASALE, MICHAEL, JOSEPH",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417375155,"CASALE, MICHAEL, JOSEPH",6715 MCCRIMMON PKWY STE 205 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417375155,"CASALE, MICHAEL, JOSEPH",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 25 , 41 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417375155,"CASALE, MICHAEL, JOSEPH",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1417375155,"CASALE, MICHAEL, JOSEPH",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1417375569,"TALIAFERRO, JOHN, PRESTON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 13 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417375569,"TALIAFERRO, JOHN, PRESTON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417375569,"TALIAFERRO, JOHN, PRESTON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417375569,"TALIAFERRO, JOHN, PRESTON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1417375569,"TALIAFERRO, JOHN, PRESTON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 85 , 151 , 288 ,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417376328,"VINIKOOR, CONNER, REID",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417376328,"VINIKOOR, CONNER, REID",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 203 , 206 ," 1,347 "," $54,280.34 ",,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417376328,"VINIKOOR, CONNER, REID",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417376328,"VINIKOOR, CONNER, REID",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,872 "," 3,286 "," 16,922 "," $640,825.69 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1417376716,"WATTY, LAUREN, MICHELLE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1417376716,"WATTY, LAUREN, MICHELLE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 28 , 30 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1417376716,"WATTY, LAUREN, MICHELLE",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1417376716,"WATTY, LAUREN, MICHELLE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",600 HOSPITAL DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 18 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 44 , 57 , 110 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",10710 SIKES PL STE 100 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 67 , 120 , 326 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 45 , 79 , 168 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417376906,"KOCHAR, GUNEET, SINGH",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417377102,"HAWKEN, THOMAS, NELSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 136 , 170 , 235 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417377102,"HAWKEN, THOMAS, NELSON",501 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417377102,"HAWKEN, THOMAS, NELSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417377102,"HAWKEN, THOMAS, NELSON",601 S MAIN ST   REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417377441,"CULLIGAN, SARA, SMITH",430 RANKIN DR   MARION NC,059,McDowell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417377441,"CULLIGAN, SARA, SMITH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1568248284,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417377573,"URBAN, MARINA",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 40 , 68 ,$#,,
MEDICAID DIRECT,1265043574,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE DENTAL,307 E THOM ST   CHINA GROVE NC,080,Rowan,193400000X,Group,Single Specialty,,1417377573,"URBAN, MARINA",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 63 , 132 ,$#,,
MEDICAID DIRECT,1417382631,ELITE CARE SERVICES INC,,723 AQUADALE RD   ALBEMARLE NC,084,Stanly,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1417382631,ELITE CARE SERVICES INC,723 AQUADALE RD   ALBEMARLE NC,084,Stanly,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1114193695,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES DUBLIN,16 3RD ST   DUBLIN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417387036,"ROGERS, CRYSTAL, MICHELLE",16 3RD ST   DUBLIN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 176 , 177 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417390873,"JAMISON, MEGAN, O'BRIEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417390873,"JAMISON, MEGAN, O'BRIEN",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417390873,"JAMISON, MEGAN, O'BRIEN",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417390873,"JAMISON, MEGAN, O'BRIEN",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 18 , 19 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417392234,"STYONS, JENNIFER, JUTSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417392234,"STYONS, JENNIFER, JUTSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417394172,"HOWARD, AUSTIN, ARCHIE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417394172,"HOWARD, AUSTIN, ARCHIE",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417394172,"HOWARD, AUSTIN, ARCHIE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417394172,"HOWARD, AUSTIN, ARCHIE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417395823,"SELVARAJ, SENTHIL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417395823,"SELVARAJ, SENTHIL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 24 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417395823,"SELVARAJ, SENTHIL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417396219,"TOLBERT, CHRISTINA, FRANCES",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417396722,"TYLER, AMMA, ANKRAH",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417396722,"TYLER, AMMA, ANKRAH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1396455267,NMG HEALTH SERVICES LLC,NHMG OBGYN URGENT CARE CLINICS,6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417396722,"TYLER, AMMA, ANKRAH",5370 RIDGE RD STE D-1 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1659673838,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT SENIOR CARE,1309 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417397100,"VELUDANDI, PRASHANTHI",1309 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 43 , 54 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417397100,"VELUDANDI, PRASHANTHI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1417400094,"FORNEY, FARRAH, LATRICE",2076 NC HIGHWAY 42 W STE 110 CLAYTON NC,051,Johnston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1417400094,"FORNEY, FARRAH, LATRICE",2076 VETERANS PKWY STE 110 CLAYTON NC,051,Johnston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1417400094,"FORNEY, FARRAH, LATRICE",520 NORTH ST   SMITHFIELD NC,051,Johnston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 39 , 54 , 71 ," $19,404.59 ",,
MEDICAID DIRECT,1326157215,FAMILY EYE CARE OF CAROLINAS,~,1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,193400000X,Group,Single Specialty,,1417400987,"WACKER, BENJAMIN, HALE",1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 165 , 176 , 214 ," $12,812.09 ",,
MEDICAID DIRECT,1417400987,"WACKER, BENJAMIN, HALE",,1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,1417400987,"WACKER, BENJAMIN, HALE",1902 N SANDHILLS BLVD STE E ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417406885,"CARAMANTE, KATHERINE, JO",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 17 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417413774,"THOMAS, ROSALINDA, BENNETT",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#, 15 , 15 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417415043,"FARLOW, SUMMER, NECOLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417415084,"DONALDSON, JACQUELINE, MCSALLY",2825 LYNDHURST AVE STE 101 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417415456,"BLODGETT, COURTNEY, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417415456,"BLODGETT, COURTNEY, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 54 , 68 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417417213,"BOUCHER, KATHERINE, MARIE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1902020308,NC DHHS CHILD AND FAMILY WELL-BEING,DURHAM CDSA,115 MARKET ST STE 201 DURHAM NC,032,Durham,252Y00000X,Agencies,Early Intervention Provider Agency,,1417417262,"SANCHEZ, CARMEN",1002 W FOREST HILLS BLVD   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 22 , 22 , 32 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1417417676,"BLAND, ALISTER, JOSEPH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417417874,"CAMPBELL, MEGAN, LEIGH",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417417874,"CAMPBELL, MEGAN, LEIGH",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417418849,"MADRIL, JESSICA, DANIELLE",1600 CROSSWAYS BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417419110,"DUNN, EMILY, RENAE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417419292,"WILLIAMS, LAURA, ALLYSON",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417423286,"WHITE, MORGAN, ELIZABETH",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417423286,"WHITE, MORGAN, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417425240,"CLARK, LUKE, SAMUEL",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 25 , 28 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417427188,"PICKENPACK-COUSAR, ATHENA, NICOLE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 113 , 113 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417427188,"PICKENPACK-COUSAR, ATHENA, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417427188,"PICKENPACK-COUSAR, ATHENA, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417428236,"HUPP, CHRISTINA, IANNELLO",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 16 , 36 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417428301,"POWELL, KATELYN, ANN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417428301,"POWELL, KATELYN, ANN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 23 , 25 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417429432,"ALTMAN, JUSTIN, BROWN",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417429457,"BOONE, DANELLE, KINZENBAW",16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#, 15 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417429457,"BOONE, DANELLE, KINZENBAW",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417434903,"HUNT, GLORIA, ANNETTE",412 S JONES ST   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 250 , 336 , 696 ," $25,989.25 ",,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417434903,"HUNT, GLORIA, ANNETTE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1255155172,COMBS CHIROPRACTIC CLINIC PC,,6549 MOREHEAD RD   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417435322,"COMBS, ROBERT, ARNOLD",6549 MOREHEAD RD   HARRISBURG NC,013,Cabarrus,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1396751640,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH NORTHLAKE DERMATOLOGY,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417438839,"WRIGLESWORTH, MELISSA, DIANE",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417438839,"WRIGLESWORTH, MELISSA, DIANE",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 44 , 54 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417439050,"PLYLER, SARAH, STEPHENS",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417439050,"PLYLER, SARAH, STEPHENS",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417440967,"SHAH, SHREENA, GAURANG",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 21 , 21 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417440967,"SHAH, SHREENA, GAURANG",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417441049,"HADDAD, DIMITRI, KHALIL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417441049,"HADDAD, DIMITRI, KHALIL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1417441049,"HADDAD, DIMITRI, KHALIL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417441049,"HADDAD, DIMITRI, KHALIL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1407325509,SPARTANBURG MEDICAL CENTER,MEDGRPOFTHECAROLINAS- GASTROENTEROLOGY-SKYLYN,11 DOCTORS PARK DR STE 240 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1417443805,"BULLMAN, JANINE, WRIGHT",11 DOCTORS PARK DR STE 240 SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417444928,"PENNINGER, LINDSAY, PAIGE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417444928,"PENNINGER, LINDSAY, PAIGE",3839 BURLINGTON RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417444928,"PENNINGER, LINDSAY, PAIGE",309 NEW ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417444928,"PENNINGER, LINDSAY, PAIGE",622 INDUSTRIAL AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417445693,"FOULKS, CARLA, ALEXANDRIA",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1417446097,SAMUEL D JOHNSON OD PLLC,,204 IONA ST   FAIRMONT NC,078,Robeson,193400000X,Group,Single Specialty,,1417446097,SAMUEL D JOHNSON OD PLLC,204 IONA ST   FAIRMONT NC,078,Robeson,193400000X,Group,Single Specialty,, 73 , 73 , 146 ,$#,,
MEDICAID DIRECT,1417446311,MAKING VISIONS COME TRUE PLLC,MAKING VISIONS,2150 N CHURCH ST STE B BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1417446311,MAKING VISIONS COME TRUE PLLC,2150 N CHURCH ST STE B BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,#," 1,105 "," 1,110 "," $166,558.16 ",,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417447665,"FREITAS, JENNA, GENTRY-DEYOUNG",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 89 , 97 ,$#,,
MEDICAID DIRECT,1417449893,"SMIGIEL, ADAM, CHRISTOPHER",,7940 WILLIAMS POND LN STE 200 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1417449893,"SMIGIEL, ADAM, CHRISTOPHER",7940 WILLIAMS POND LN STE 200 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1447993399,G ABRAMS AND R COHEN XXI PC,DYNAMIC DENTAL OF SOUTHEND,2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417449893,"SMIGIEL, ADAM, CHRISTOPHER",2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 68 , 112 , 417 ," $22,935.09 ",,
MEDICAID DIRECT,1447993399,G ABRAMS AND R COHEN XXI PC,DYNAMIC DENTAL OF SOUTHEND,2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417449893,"SMIGIEL, ADAM, CHRISTOPHER",7940 WILLIAMS POND LN STE 200 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 30 , 36 , 165 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417451063,"SAVILLA, MICHAEL, RICHARD CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417451063,"SAVILLA, MICHAEL, RICHARD CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417451063,"SAVILLA, MICHAEL, RICHARD CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417451063,"SAVILLA, MICHAEL, RICHARD CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1417451063,"SAVILLA, MICHAEL, RICHARD CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417451063,"SAVILLA, MICHAEL, RICHARD CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1417451063,"SAVILLA, MICHAEL, RICHARD CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1417451097,"KREMERS, ALEX, STUART",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417451097,"KREMERS, ALEX, STUART",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417451097,"KREMERS, ALEX, STUART",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417451097,"KREMERS, ALEX, STUART",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417451097,"KREMERS, ALEX, STUART",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417451097,"KREMERS, ALEX, STUART",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417451097,"KREMERS, ALEX, STUART",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417452426,"HASYN, MICHAL, JANUSZ",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417452426,"HASYN, MICHAL, JANUSZ",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 194 , 209 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417452426,"HASYN, MICHAL, JANUSZ",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417452426,"HASYN, MICHAL, JANUSZ",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1417452954,"BRASWELL, MATTHEW, JOEL",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 27 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417452954,"BRASWELL, MATTHEW, JOEL",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 43 , 76 , 142 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1417452954,"BRASWELL, MATTHEW, JOEL",1168 E CUTLAR XING   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417455718,"FOWLER, HEATHER, DILLARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417455718,"FOWLER, HEATHER, DILLARD",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417455718,"FOWLER, HEATHER, DILLARD",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 45 , 50 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417455718,"FOWLER, HEATHER, DILLARD",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417455718,"FOWLER, HEATHER, DILLARD",1969 WELLNESS BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1417455809,"WALLACE, ANDREA, NICOLE",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1417455809,"WALLACE, ANDREA, NICOLE",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417455809,"WALLACE, ANDREA, NICOLE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 37 ,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417455809,"WALLACE, ANDREA, NICOLE",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417455809,"WALLACE, ANDREA, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417455809,"WALLACE, ANDREA, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417455809,"WALLACE, ANDREA, NICOLE",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 12 , 25 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417458670,"WALKER, STEPHEN, BRIAN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417458670,"WALKER, STEPHEN, BRIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1053921874,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE OBERLIN,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417460742,"BALOGH, HANNAH, WILLIAMS",601 OBERLIN RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053921874,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE OBERLIN,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417460742,"BALOGH, HANNAH, WILLIAMS",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417464777,"MCENTIRE, MATTHEW, DAVIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1417465550,"LUTZ, MATTHEW, ANTHONY",965 STATE FARM RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 49 , 50 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417467408,"ATKINS, KANDIS, DANIELLE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932353208,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAYETTEVILLE,1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417467408,"ATKINS, KANDIS, DANIELLE",1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 139 , 419 ," $18,759.36 ",,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1417469867,"HOOSIER, PATRICIA, COE",911 E ATKINS ST   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 24 , 49 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1417469867,"HOOSIER, PATRICIA, COE",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 17 , 22 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1417469867,"HOOSIER, PATRICIA, COE",1908 CAUDLE DR STE 103 MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1417469867,"HOOSIER, PATRICIA, COE",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 32 ,$#,,
MEDICAID DIRECT,1417471384,CEMAC HEALTHCARE SERVICES LLC,,109 INDIAN TRL   WENDELL NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1417471384,CEMAC HEALTHCARE SERVICES LLC,109 INDIAN TRL   WENDELL NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 3,197 "," 3,201 "," $252,130.96 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417471590,"GOLD, CATHERINE, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 62 , 98 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417472457,"KENDRICK, EMILY, JACKSON",159 EXECUTIVE DR STE C DANVILLE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417474578,"BERGER, JOHN, DOUGLAS",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417474578,"BERGER, JOHN, DOUGLAS",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417474578,"BERGER, JOHN, DOUGLAS",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417474636,"WOODS, JACLYN, MARIE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417474636,"WOODS, JACLYN, MARIE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417474636,"WOODS, JACLYN, MARIE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417474636,"WOODS, JACLYN, MARIE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417474636,"WOODS, JACLYN, MARIE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417475633,"HUNTINGTON, JONATHAN, BUDINGER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 157 , 158 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417476490,"CASTRO, JORDAN, PAIGE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 163 , 191 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417476490,"CASTRO, JORDAN, PAIGE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 387 , 471 ,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1417476839,"OVERSTREET, KAYLA, NICOLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417476839,"OVERSTREET, KAYLA, NICOLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 ,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1417477423,"TISHERMAN, ROBERT, THEODORE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417477423,"TISHERMAN, ROBERT, THEODORE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417477423,"TISHERMAN, ROBERT, THEODORE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417477423,"TISHERMAN, ROBERT, THEODORE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417477423,"TISHERMAN, ROBERT, THEODORE",100 DUKE DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417477886,"ALBERTI, MATTHEW, RALPH",1550 FAULK ST   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417477886,"ALBERTI, MATTHEW, RALPH",600 HOSPITAL DR   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417477886,"ALBERTI, MATTHEW, RALPH",1550 FAULK ST   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 51 , 153 , 153 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417477886,"ALBERTI, MATTHEW, RALPH",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417477928,"HITTSON, AARON, MATTHEW",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417480302,"CENTNER, AMANDA, NICOLE",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417480302,"CENTNER, AMANDA, NICOLE",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417480526,"GERMAN, JASHALYNN, CHANELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417480526,"GERMAN, JASHALYNN, CHANELLE",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1417481870,"CURRAN, JENNIFER, KATHLEEN",311 HILL ST   MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 181 , 200 ,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1417481870,"CURRAN, JENNIFER, KATHLEEN",311 HILL ST   MURPHY NC,020,Cherokee,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1417481870,"CURRAN, JENNIFER, KATHLEEN",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1417481870,"CURRAN, JENNIFER, KATHLEEN",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417481896,"JETER, TEE, MARIE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1417483439,"WHEELER, LORI, DENISE",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417484890,"SAOJI, APOORVA, VIVEK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 93 , 93 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1417485079,"GHOBADI, TELKA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 33 , 33 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1417485079,"GHOBADI, TELKA",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1619205721,SHAUN OHEARN DDS PLLC,AFFORDABLE DENTURES - ASHEVILLE,1445 TUNNEL RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417486739,"DAVIS, RONALD, SCOTT",1445 TUNNEL RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1619205721,SHAUN OHEARN DDS PLLC,AFFORDABLE DENTURES - ASHEVILLE,1445 TUNNEL RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417486739,"DAVIS, RONALD, SCOTT",1445 TUNNEL RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 1,225 "," 1,662 "," 8,249 "," $1,216,261.27 ",,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417487026,"PANDYA, KARAN, PRASHANT",11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 14 , 25 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417487026,"PANDYA, KARAN, PRASHANT",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 27 , 45 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417487026,"PANDYA, KARAN, PRASHANT",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 29 , 47 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417487026,"PANDYA, KARAN, PRASHANT",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417487067,"SETHI, SHAWN, JAY",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 101 , 110 , 131 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417487067,"SETHI, SHAWN, JAY",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 55 , 57 , 74 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417488685,"EVANGELISTA, MEAGAN, ELIZABETH",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 53 , 55 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417488685,"EVANGELISTA, MEAGAN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 50 , 91 , 109 ,$#,,
MEDICAID DIRECT,1417779620,SOUTHEASTERN REGIONAL MEDICAL CENTE,SRMC IP ORTHO CARE,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417488750,"ENOS, COURTNEY, NICOLE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417779620,SOUTHEASTERN REGIONAL MEDICAL CENTE,SRMC IP ORTHO CARE,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417488750,"ENOS, COURTNEY, NICOLE",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417488750,"ENOS, COURTNEY, NICOLE",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417488750,"ENOS, COURTNEY, NICOLE",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 82 , 141 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417488750,"ENOS, COURTNEY, NICOLE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1417488768,"FRIEZ, KYLE, MATTHEW",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881127942,SOUTHLAND CHATUGE EMERGENCY MEDICAL,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417488925,"MANER, ROBERT, DANIEL",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417488925,"MANER, ROBERT, DANIEL",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417489873,"LYON, KAYLA, TRIVETTE",791 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417489873,"LYON, KAYLA, TRIVETTE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417489972,"ATIA, ANDREW, NAGY",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417489972,"ATIA, ANDREW, NAGY",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417490202,ANGELS AT HEART ASSISTED LIVING,ANGELS AT HEART ASSISTED LIVING,1114 S MAIN ST   CHINA GROVE NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417490202,ANGELS AT HEART ASSISTED LIVING,1114 S MAIN ST   CHINA GROVE NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 3,341 "," 3,414 "," $278,169.12 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,5593 OLD HAYWOOD RD   MILLS RIVER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417491960,"GAY, VICTORIA, LINDA",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417493867,"CLARKE, RYAN, KEITH",2340 SPRING FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417496183,"SHEVLINO, JESSICA, KATHLEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417496183,"SHEVLINO, JESSICA, KATHLEEN",310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417496407,"REUTTER, JESSICA, LEE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417496407,"REUTTER, JESSICA, LEE",40 DUKE MEDICINE CIR # 1K DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417496407,"REUTTER, JESSICA, LEE",40 DUKE MEDICINE CIR # 1K DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417497140,"LARICCIA, AIMEE, KATHERINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 53 , 81 , 90 ,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417497918,"PRICE, KRISTEN, RHEW",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1417499112,CAROLINA PHYSICAL THERAPY ASSOCIATE,CAROLINA PHYSICAL THERAPY ASSOCIATES - LOUISBURG,1501 N BICKETT BLVD STE F LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1417499112,CAROLINA PHYSICAL THERAPY ASSOCIATE,1501 N BICKETT BLVD STE F LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417500257,"YANKALUNAS, CASEY, RENAE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417500257,"YANKALUNAS, CASEY, RENAE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1417500539,"CALLISTE, CHRYSTEL, MARLENE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 50 , 50 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417500539,"CALLISTE, CHRYSTEL, MARLENE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 30 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417501537,"PATEL, RADHA, ATUL",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417501537,"PATEL, RADHA, ATUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417501537,"PATEL, RADHA, ATUL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 21 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417502279,"BURKE, SHANNON, JEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417502279,"BURKE, SHANNON, JEAN",600 NEW WAVERLY PL   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417502279,"BURKE, SHANNON, JEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265908479,MH MISSION HOSPITAL MCDOWELL LLLP,,1633 SUGAR HILL RD   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417503483,"BIGHAM, JAMES, ANDREW",1633 SUGAR HILL RD   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 67 , 77 ," $16,322.80 ",,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417510728,"FAIZ, FARDEEN, AHMED",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1417512690,WAKEMED SPECIALISTS GROUP LLC,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417512690,WAKEMED SPECIALISTS GROUP LLC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417512690,WAKEMED SPECIALISTS GROUP LLC,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417512690,WAKEMED SPECIALISTS GROUP LLC,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1417512690,WAKEMED SPECIALISTS GROUP LLC,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417512690,WAKEMED SPECIALISTS GROUP LLC,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417512690,WAKEMED SPECIALISTS GROUP LLC,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1417517665,"PALMER, LATROSHIA, MAREE",75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 19 , 29 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1417517665,"PALMER, LATROSHIA, MAREE",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 52 , 91 ,$#,,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,579 GREENWAY RD STE 200 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1417520115,"WATSON, HOLLY, HENSON",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 68 , 153 ,$#,,
MEDICAID DIRECT,1669533923,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL PULMONOLOGY,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1417520115,"WATSON, HOLLY, HENSON",194 DOCTORS DR   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114038163,BLUE RIDGE PEDIATRIC AND ADOLESCENT,BLUE RIDGE PEDIATRIC AND ADOLESCENT MEDICINE INC,200 HOSPITAL AVE STE 6 JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1417520115,"WATSON, HOLLY, HENSON",579 GREENWAY RD STE 200 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417521253,"PRIDGEN, MELISSA, ROSE",4140 CHERRY ST   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417521345,"SIVARAJ, KRISHAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 212 , 213 ,$#,,
MEDICAID DIRECT,1184174542,CALDWELL MEMORIAL HOSPITAL,CALDWELL SLEEP MEDICINE,270 PINE MOUNTAIN RD STE 5 HUDSON NC,014,Caldwell,193400000X,Group,Single Specialty,,1417524364,"VIERIU, ABIGAIL",270 PINE MOUNTAIN RD STE 5 HUDSON NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 114 , 118 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417525304,"BREEDLOVE, BRENT, CLAYTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982773206,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1510 NC HIGHWAY 68 N   OAK RIDGE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417525304,"BREEDLOVE, BRENT, CLAYTON",1510 NC HIGHWAY 68 N   OAK RIDGE NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1417525999,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE MOCKSVILLE,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417525999,GASTON FAMILY HEALTH SERVICES INC,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1417526898,"MONTGOMERY, MARISSA, LEIGH",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1417526898,"MONTGOMERY, MARISSA, LEIGH",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 118 , 239 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417529124,"SLAUGHTER, CHRISTOPHER, SHAWN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417529124,"SLAUGHTER, CHRISTOPHER, SHAWN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417529405,"HURLEY, ALEXANDRIA, DAWES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1417530775,"CUDAHY, KAITLIN, ELIZABETH",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417530775,"CUDAHY, KAITLIN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417530775,"CUDAHY, KAITLIN, ELIZABETH",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1417531351,"SANKAR, SAHANA, RAKSHANA",145 APPLECROSS RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1417532011,"KELLEHER, ALLISON, NICOLE",,275 N NC 16 BUSINESS HWY STE 101 DENVER NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1417532011,"KELLEHER, ALLISON, NICOLE",275 N NC 16 BUSINESS HWY STE 101 DENVER NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 31 , 335 ," $31,849.16 ",,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417532748,"ROSS, DANIELLE, MONIQUE",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417534041,"CURRIEO, ANDREW, DAVID",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 18 , 32 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417534041,"CURRIEO, ANDREW, DAVID",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1417536459,"MASTROPOLE, MICHAEL, THOMAS",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1417540337,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE IMAGING ARRINGDON,5601 ARRINGDON PARK DR STE 110 MORRISVILLE NC,032,Durham,293D00000X,Laboratories,Physiological Laboratory,,1417540337,DUKE UNIVERSITY HEALTH SYSTEM INC,5601 ARRINGDON PARK DR STE 110 MORRISVILLE NC,032,Durham,293D00000X,Laboratories,Physiological Laboratory,, 84 , 93 , 131 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417544297,"COATES, KELSEY",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 159 , 161 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1417544297,"COATES, KELSEY",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1417544297,"COATES, KELSEY",812 SHEPARD ST   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417544297,"COATES, KELSEY",110 MCCOTTER BLVD   HAVELOCK NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 104 , 104 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417550013,"SANDRELLA, ROCCO, DELANO",905 OLD WINSTON RD STE B KERNERSVILLE NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417553900,APPLIED BEHAVIORAL CARES PLLC,,2530 MERIDIAN PKWY   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,1417553900,APPLIED BEHAVIORAL CARES PLLC,2530 MERIDIAN PKWY   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1003407586,QUICK DOC PARTNERS LLC,,3734 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417553942,"VANDERBILT, EDWARD, ROY",3734 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 71 , 153 ,$#,,
MEDICAID DIRECT,1003407586,QUICK DOC PARTNERS LLC,,3734 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417553942,"VANDERBILT, EDWARD, ROY",3734 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417555848,AADAX HOME CARE INC,~,5624 EXECUTIVE CENTER DR STE 131 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1417555848,AADAX HOME CARE INC,5624 EXECUTIVE CENTER DR STE 131 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 4,662 "," 4,987 "," $422,790.48 ",,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417557018,"CIAPPONI, JASON, MATTHEW",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 44 , 76 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417557018,"CIAPPONI, JASON, MATTHEW",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1417558990,"WARD, MUNIRA, AMIRALI",7353 LEWIS ST   OXFORD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 26 , 99 ,$#,,
MEDICAID DIRECT,1417564063,WICKSHIRE CREEKS CROSSING OPCO LLC,,8398 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417564063,WICKSHIRE CREEKS CROSSING OPCO LLC,8398 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,737 "," 1,737 "," $144,476.36 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417575457,"MURPHY, ANNE, PATRICIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417575457,"MURPHY, ANNE, PATRICIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417575457,"MURPHY, ANNE, PATRICIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 56 , 56 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417575457,"MURPHY, ANNE, PATRICIA",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417575457,"MURPHY, ANNE, PATRICIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417575473,"DESAI, HEMAL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417575473,"DESAI, HEMAL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417577057,"IBARRA LOPEZ, JOSE, SEBASTIAN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417577057,"IBARRA LOPEZ, JOSE, SEBASTIAN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417577057,"IBARRA LOPEZ, JOSE, SEBASTIAN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417582214,"JORDAN, KAREN, MELISSA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417582214,"JORDAN, KAREN, MELISSA",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417582214,"JORDAN, KAREN, MELISSA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1144863358,ENVISION PAIN MANAGEMENT PLLC,,107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1417583717,"MARSHBURN, MICHELLE, STEPHENS",107 HAYWOOD PARK DR   CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 142 , 283 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417584731,"LEE, MIN, SOO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417585548,"BROGDEN, LUCAS, BENJAMIN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 169 , 169 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417585829,"FLYNN, KELLY, DELANY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417585829,"FLYNN, KELLY, DELANY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417585829,"FLYNN, KELLY, DELANY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417588245,"HINES, JACOB, LANEY",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,901 N WINSTEAD AVE STE 430 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417588245,"HINES, JACOB, LANEY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417588245,"HINES, JACOB, LANEY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417588245,"HINES, JACOB, LANEY",303 GREEN ST E   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 152 , 259 , 265 ," $11,722.31 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1417592080,"YARBER, LEE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417592080,"YARBER, LEE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 47 , 212 , 229 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417592189,"JERNIGAN, KRISTIN, POWNALL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 48 , 55 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417592288,"THIGPEN, JACQUELINE, RENEE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417592288,"THIGPEN, JACQUELINE, RENEE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417592288,"THIGPEN, JACQUELINE, RENEE",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 32 , 40 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417592288,"THIGPEN, JACQUELINE, RENEE",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417593005,EHOMECARE,,18 PALASIDE DR NE   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1417593005,EHOMECARE,18 PALASIDE DR NE   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,121 "," 1,121 "," $141,545.76 ",,
MEDICAID DIRECT,1417593476,A PRIMARY CHOICE INC,,102 ELIZABETH ST STE C JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1417593476,A PRIMARY CHOICE INC,102 ELIZABETH ST STE C JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,#, 210 , 210 ," $13,773.56 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417597618,"SCHAEFER, RYAN, WILLIAM",16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417597618,"SCHAEFER, RYAN, WILLIAM",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1417597618,"SCHAEFER, RYAN, WILLIAM",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417597618,"SCHAEFER, RYAN, WILLIAM",4505 FAIR MEADOWS LN STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417597618,"SCHAEFER, RYAN, WILLIAM",4505 FAIR MEADOWS LN STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,2050 MERCANTILE DR   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1417599580,"MACKEY, KERRY, KELDON KERNADO",3610 BUSH ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 31 , 31 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417599580,"MACKEY, KERRY, KELDON KERNADO",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417599580,"MACKEY, KERRY, KELDON KERNADO",3610 BUSH ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 34 ,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,3200 WATERFIELD DR   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1417599580,"MACKEY, KERRY, KELDON KERNADO",3610 BUSH ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 35 , 35 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417609603,"JOHNSON, KASEY, LEE",744 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 39 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417610379,"LAKEW, LIYA, BITSUAN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1417612581,"POWELL, SATYDRA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417613282,"DEBELLIS, OLIVIA, PATRICE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 25 , 37 ,$#,,
MEDICAID DIRECT,1134558752,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VALAROAS & LEWIS OBGYN,245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417613282,"DEBELLIS, OLIVIA, PATRICE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417613464,"GREWAL, DILKARANJOT, SINGH",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 111 , 121 , 401 ," $19,842.79 ",,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417613464,"GREWAL, DILKARANJOT, SINGH",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417614363,"JARRETT, DAVID, CHRIS",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 67 , 68 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417614785,"KHAN, MARIA, QASIM",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 178 , 255 , 982 ," $36,471.70 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1417614785,"KHAN, MARIA, QASIM",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 74 , 80 , 288 ," $10,338.16 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417614785,"KHAN, MARIA, QASIM",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 91 , 103 , 302 ," $10,482.63 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417614785,"KHAN, MARIA, QASIM",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,100 SUNSET ST   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1417616905,"D'ARCY, MARY, ELLEN",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 789 , 794 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,109 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1417616905,"D'ARCY, MARY, ELLEN",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,969 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417616905,"D'ARCY, MARY, ELLEN",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,95 LOCUST ST   CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1417616905,"D'ARCY, MARY, ELLEN",4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 49 , 49 ,$#,,
MEDICAID DIRECT,1700888542,GREENE COUNTY HEALTH CARE INC,KATE B REYNOLDS MEDICAL CENTER,205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417617168,"LETCHWORTH, FRANKIE, JONES",205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417617168,"LETCHWORTH, FRANKIE, JONES",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346537180,ALAMANCE DERMATOLOGY PA,~,480 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417618786,"BORG, REBECCA, PAIGE",945 GOLF HOUSE RD W STE A WHITSETT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346537180,ALAMANCE DERMATOLOGY PA,~,480 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417618786,"BORG, REBECCA, PAIGE",480 W WEBB AVE   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2200 TREELIGHT WAY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1417618786,"BORG, REBECCA, PAIGE",480 W WEBB AVE   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1417618786,"BORG, REBECCA, PAIGE",480 W WEBB AVE   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417620105,"DAY, REBECCA, CATHERINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 32 , 51 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417635210,"DENG, YANGMEI",201 SAGE RD   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 22 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417635210,"DENG, YANGMEI",201 SAGE RD   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1609475474,FHPG LLC,FIRSTHEALTH CONCIERGE SIGNATURE MEDICINE,1690 US HIGHWAY 1 S STE 300 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1417636630,"LIVRAGO, KATIE, ELIZABETH",1690 US HIGHWAY 1 S STE 300 SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1417638651,"PATEL, MITESH, J",3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1932283421,HIGGINS MANI & WATSON I DDS PA,THE DENTAL CARE CENTER,2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417638651,"PATEL, MITESH, J",3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1730263211,HIGGINS MANI & WATSON III DDS PA,THE DENTAL CARE CENTER,3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417638651,"PATEL, MITESH, J",3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice," 1,669 "," 2,682 "," 8,805 "," $402,709.82 ",,
MEDICAID DIRECT,1942509534,HIGGINS MANI & WATSON VI DDS PA,THE DENTAL CARE CENTER,1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1417638651,"PATEL, MITESH, J",3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 132 , 140 , 471 ," $21,585.95 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417640244,"PEIGAN, TASHELLE, TEIA",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417640632,"NAKAMA, KAYO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417640632,"NAKAMA, KAYO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417640632,"NAKAMA, KAYO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417647843,"SPENCER, ELLEN, OLIVIA",330 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417647843,"SPENCER, ELLEN, OLIVIA",330 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 81 , 85 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",1103 W D ST   NORTH WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 28 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528525839,BETHANY MEDICAL CENTER,,1908 CAUDLE DR STE 105 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 49 , 149 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 126 , 355 , 710 ," $17,901.85 ",,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 287 , 561 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 194 , 836 ," 1,670 "," $19,550.55 ",,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",3605 PETERS CT   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 68 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417652538,"PENNINGTON, VICKI, ROGERS",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,110 S PARK TER STE A EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1417653791,"PECK, ELIZABETH, MARY",110 S PARK TER STE A EDEN NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417653791,"PECK, ELIZABETH, MARY",110 S PARK TER STE A EDEN NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 132 , 229 , 305 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417653791,"PECK, ELIZABETH, MARY",110 S PARK TER STE A EDEN NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1740915552,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT HOLBROOK MIDDLE,418 S CHURCH ST   LOWELL NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417653973,"SANDERS, BRIHONA, JEANNETTE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417653973,"SANDERS, BRIHONA, JEANNETTE",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,205 RATTLESNAKE TRL   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1417654583,"MARTIN, SHAMEKIA, QUICK",915 PEE DEE RD   ABERDEEN NC,063,Moore,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1417654583,"MARTIN, SHAMEKIA, QUICK",915 PEE DEE RD   ABERDEEN NC,063,Moore,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 30 , 239 , 243 ," $12,270.95 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1417654583,"MARTIN, SHAMEKIA, QUICK",915 PEE DEE RD   ABERDEEN NC,063,Moore,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 61 , 974 ," 1,006 "," $17,236.84 ",,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1417655598,"KEEN, ERICA, PAIGE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 93 , 101 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417655895,"LIGUORI, KELLY, MARIE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417662032,"MCCABE, PEYTON, STRICKLAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417662032,"MCCABE, PEYTON, STRICKLAND",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 33 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417662032,"MCCABE, PEYTON, STRICKLAND",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417662032,"MCCABE, PEYTON, STRICKLAND",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417663634,"GINN, MCKENNA, CLAY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 115 , 115 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417665001,"WESTMAN, MEGHAN, ROSE",2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1326447913,NUTRITION HEALTHWORKS LLC,,9216 BAILEYWICK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417665977,"ASEGE, LYDIA, ELLEN",9216 BAILEYWICK RD   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326447913,NUTRITION HEALTHWORKS LLC,,1136 SAM NEWELL RD STE A2 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417665977,"ASEGE, LYDIA, ELLEN",9216 BAILEYWICK RD   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,257 NC 125   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1417668807,"GENTRY, EILEEN, PAULINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417668807,"GENTRY, EILEEN, PAULINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417668807,"GENTRY, EILEEN, PAULINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 118 , 159 , 159 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,257 NC 125   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1417668807,"GENTRY, EILEEN, PAULINE",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 39 , 39 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417669037,"GARCIA, STEPHANIE, MICHELLE",2133 ROCKFORD ST STE 1400 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417669037,"GARCIA, STEPHANIE, MICHELLE",865 WESTLAKE DR   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 75 , 125 , 197 ,$#,,
MEDICAID DIRECT,1417670860,"ROSALES SOSA, MARIA",,6034 CREFT CIR   INDIAN TRAIL NC,090,Union,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1417670860,"ROSALES SOSA, MARIA",6034 CREFT CIR   INDIAN TRAIL NC,090,Union,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 115 , 116 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417671116,"SCHUERMANN, AMANDA, LEIGH",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 29 , 29 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,3311 BEAM RD STE 300A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417671116,"SCHUERMANN, AMANDA, LEIGH",3311 BEAM RD STE 300A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1417673831,"HELTON, ASHLEY, KEPHART",75 MEDICAL PARK LN STE B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1417673831,"HELTON, ASHLEY, KEPHART",145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1417673831,"HELTON, ASHLEY, KEPHART",183 LEDFORD ST STE B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437520392,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST STE B MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417673831,"HELTON, ASHLEY, KEPHART",183 LEDFORD ST STE B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 74 , 74 ,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417674417,"DARKO, AKOSUA, ADDAI",8035 PROVIDENCE RD STE 320 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417674417,"DARKO, AKOSUA, ADDAI",1107 REYNOLDS ST   MONROE NC,090,Union,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1417678210,COMPASSION HOME CARE SERVICES LLC,,5306 SIX FORKS RD STE 107 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1417678210,COMPASSION HOME CARE SERVICES LLC,5306 SIX FORKS RD STE 107 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 3,212 "," 3,212 "," $202,423.44 ",,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1417679010,"MORGAN, LINSAY, ELLEN",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417680042,"WONG, MEI, CHU",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 39 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417680042,"WONG, MEI, CHU",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417680042,"WONG, MEI, CHU",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417680604,"SAMPOGNA, JORDAN, LYNN",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 18 , 20 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417680604,"SAMPOGNA, JORDAN, LYNN",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 33 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417683186,"REINHARD, GARRETT, AUSTIN",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417683186,"REINHARD, GARRETT, AUSTIN",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417688672,"LARRABEE, MARIAN, ADELE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417688672,"LARRABEE, MARIAN, ADELE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 51 , 54 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417688714,"GREENE, MATTHEW, CLAYTON",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417688714,"GREENE, MATTHEW, CLAYTON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417688714,"GREENE, MATTHEW, CLAYTON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417688714,"GREENE, MATTHEW, CLAYTON",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417688714,"GREENE, MATTHEW, CLAYTON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417688714,"GREENE, MATTHEW, CLAYTON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1417692245,"EVANS, KATHERINE, MCCALL",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417695263,"BATTAL, BILAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417695263,"BATTAL, BILAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3821 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417695263,"BATTAL, BILAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417695263,"BATTAL, BILAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417695263,"BATTAL, BILAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417695263,"BATTAL, BILAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging, 330 , 363 , 517 ," $19,923.73 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1417695263,"BATTAL, BILAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085D0003X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Neuroimaging,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417695768,"KOLB, CASEY, LEANNE",2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1417695768,"KOLB, CASEY, LEANNE",2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417699133,"BRINSON, BRITNEY, SHAMARE",2000 CAROMONT PKWY STE 400 BELMONT NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417699133,"BRINSON, BRITNEY, SHAMARE",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417705310,"DAMMERS, MEREDITH, GARDNER",7724 N KINGS HWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417705310,"DAMMERS, MEREDITH, GARDNER",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417705310,"DAMMERS, MEREDITH, GARDNER",3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184783284,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER,7724 N KINGS HWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417705310,"DAMMERS, MEREDITH, GARDNER",7724 N KINGS HWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417708231,"WEAVER, AMANDA, SHEPHERD",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 86 , 189 , 189 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1417708231,"WEAVER, AMANDA, SHEPHERD",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1417708231,"WEAVER, AMANDA, SHEPHERD",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 41 , 41 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417711409,"TURNER, STEPHANIE, SHEA",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 19 , 25 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417711409,"TURNER, STEPHANIE, SHEA",303 AIRPORT RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417711409,"TURNER, STEPHANIE, SHEA",264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1417718818,"BEATTY, SARABETH, LYN",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 21 , 74 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417721465,"BATTEN, LOGAN, DANIELLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417721465,"BATTEN, LOGAN, DANIELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417721465,"BATTEN, LOGAN, DANIELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417721465,"BATTEN, LOGAN, DANIELLE",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417725599,GUARDIAN CARE SOLUTIONS LLC,,4801 HARGROVE RD STE 10C RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1417725599,GUARDIAN CARE SOLUTIONS LLC,4801 HARGROVE RD STE 10C RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 5,041 "," 5,041 "," $313,311.24 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417726183,"BURNS, JAIMEE, SNELSON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1417727389,"ESTURBAN, ELIZABETH, ANN",670 CARDINAL RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1417727389,"ESTURBAN, ELIZABETH, ANN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1417727389,"ESTURBAN, ELIZABETH, ANN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417728627,"KELLER, JENNIFER, ELLEN",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 52 , 73 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417733478,"MARTELL, SHELBY, HELEN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417735044,"TONEY, NATALIE, MARIE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417735044,"TONEY, NATALIE, MARIE",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912082645,WAKE FOREST UNIVERSITY HEALTH SCIEN,WINSTON SALEM CDSA,3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,252Y00000X,Agencies,Early Intervention Provider Agency,,1417735770,"HALSEY, LISA, ANN",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 33 , 235 , 235 ," $20,070.26 ",,
MEDICAID DIRECT,1417780362,TEEMED CARE LLC,,305 MRYTLE ROAD   SELMA NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417780362,TEEMED CARE LLC,305 MRYTLE ROAD   SELMA NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 471 , 471 ," $73,239.32 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417780883,"TRNAVSKY, CAROL, LYNN",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417780883,"TRNAVSKY, CAROL, LYNN",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417780883,"TRNAVSKY, CAROL, LYNN",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982453767,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT HUDSON MIDDLE,291 PINE MOUNTAIN RD   HUDSON NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417783960,"CHESTER, SARAH, WISE",291 PINE MOUNTAIN RD   HUDSON NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 53 , 53 ," $16,977.49 ",,
MEDICAID DIRECT,1184400954,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC AUDIOLOGY SERVICES,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417787284,"SCHMELE, BARBARA, ELISE",115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417788431,"SEEBOLD, DANIEL, JACOB",SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417788431,"SEEBOLD, DANIEL, JACOB",1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,,,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417788431,"SEEBOLD, DANIEL, JACOB",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417788431,"SEEBOLD, DANIEL, JACOB",1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 100 , 101 , 101 ," $88,162.32 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417788431,"SEEBOLD, DANIEL, JACOB",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 52 , 52 , 53 ," $10,080.46 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417788431,"SEEBOLD, DANIEL, JACOB",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,431 "," 1,942 "," 2,073 "," $325,418.74 ",,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1417791260,"BARLOW, CASSANDRA, GREENE",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 137 , 152 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1417791856,"GRAY, SYLVIA, JANE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417791864,"WILLIAMS, LIAM, JOHN",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 34 ,$#,,
MEDICAID DIRECT,1417900903,EYECARECENTER OD PA,EYECARE CENTER,1300 EASTCHESTER DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417900903,EYECARECENTER OD PA,1300 EASTCHESTER DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417901810,"CROITORU, CLAUDIA, MIRELA",601 N ELM ST   HIGH POINT NC,041,Guilford,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 63 , 62 , 87 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417901810,"CROITORU, CLAUDIA, MIRELA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912934704,SPECTRUM FAMILY EYE CENTER OPTOMETE,SPECTRUM FAMILY EYE CENTERS,160 FOX HOLLOW CT   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1417902156,"ATHANS, WILLIAM, SCOTT",160 FOX HOLLOW CT   PINEHURST NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 37 , 47 , 62 ,$#,,
MEDICAID DIRECT,1417902156,"ATHANS, WILLIAM, SCOTT",WILLIAM SCOTT ATHANS,160 FOX HOLLOW CT   PINEHURST NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,1417902156,"ATHANS, WILLIAM, SCOTT",160 FOX HOLLOW CT   PINEHURST NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417903287,"CLARK, KENNETH, BRYAN",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417903287,"CLARK, KENNETH, BRYAN",810 MITCHELL AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 70 , 123 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417903584,"POROSNICU, MERCEDES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417903584,"POROSNICU, MERCEDES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 114 , 133 ,$#,,
MEDICAID DIRECT,1417904277,CERRO GORDO VOLUNTEER FIRE DEPARTME,~,75 EAST RAILROAD STREET   CERRO GORDO NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,1417904277,CERRO GORDO VOLUNTEER FIRE DEPARTME,75 EAST RAILROAD STREET   CERRO GORDO NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1528011137,VALLEY INTERNAL MEDICINE INC,VALLEY INTERNAL MEDICINE INC,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417906520,"HANNAN, MOHAMMED, ASHRAFUL",2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 147 , 484 , 587 ," $14,341.89 ",,
MEDICAID DIRECT,1417906520,"HANNAN, MOHAMMED, ASHRAFUL",~,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1417906520,"HANNAN, MOHAMMED, ASHRAFUL",2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528011137,VALLEY INTERNAL MEDICINE INC,VALLEY INTERNAL MEDICINE INC,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417906520,"HANNAN, MOHAMMED, ASHRAFUL",2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 20 , 24 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417908138,"IMAD, MELHEM, A",113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417908138,"IMAD, MELHEM, A",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1417911322,TRIANGLE GASTROENTEROLOGY LLC,TRIANGLE GASTROENTEROLOGY LLC,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1417911322,TRIANGLE GASTROENTEROLOGY LLC,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 28 , 34 , 34 ,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1417912007,"PROBST, JEFFREY, JAMISON",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 57 , 58 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417912361,"TRIVETTE, GEORGE, ALEXANDER",10030 GILEAD RD STE B120 HUNTERSVILLE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417912361,"TRIVETTE, GEORGE, ALEXANDER",1201 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417912361,"TRIVETTE, GEORGE, ALEXANDER",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1417912361,"TRIVETTE, GEORGE, ALEXANDER",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417912361,"TRIVETTE, GEORGE, ALEXANDER",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417912932,"AFULUKWE, IFEDIORA, FOSTER",222 HERLONG AVE STE 402 ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1417913682,"VASSER-SMITH, MONTUBUA, FRENNETTE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1417914896,"HARGROVE, RODERICK, NEIL",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 23 , 26 , 31 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417914896,"HARGROVE, RODERICK, NEIL",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 104 , 152 , 204 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417916883,"QUARLES, ROBERT, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417916883,"QUARLES, ROBERT, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 45 , 46 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417916883,"QUARLES, ROBERT, PAUL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417918558,"JONES, MICHAEL, CLAYTON",349 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417918558,"JONES, MICHAEL, CLAYTON",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417918558,"JONES, MICHAEL, CLAYTON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417918558,"JONES, MICHAEL, CLAYTON",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417918814,"MCDANIELS, CHRISTOPHER, NOLAN",10880 DURANT RD STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275965410,MCPC-14 LLC,FIRSTHEALTH TRANSITION CARE CLINIC,305 PAGE RD N STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1417921016,"BARNES, DANIEL, RAY",305 PAGE RD N STE 1 PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730451204,COLUMBUS FAMILY CHIROPRACTIC CENTER,COLUMBUS FAMILY CHIROPRACTIC CENTER PC,5754 CHADBOURN HWY   CHADBOURN NC,024,Columbus,193400000X,Group,Single Specialty,,1417922899,"PREASE, WILLIAM, ERNEST",5754 CHADBOURN HWY   CHADBOURN NC,024,Columbus,111N00000X,Chiropractic Providers,Chiropractor,,#, 68 , 68 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417924127,"GAMBINO, JOHN, PETER",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417924127,"GAMBINO, JOHN, PETER",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1417924465,"MATTHEWS, DANIEL, ALAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1417924465,"MATTHEWS, DANIEL, ALAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 33 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2807 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417924465,"MATTHEWS, DANIEL, ALAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1417924465,"MATTHEWS, DANIEL, ALAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 36 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417924465,"MATTHEWS, DANIEL, ALAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1467449728,LEXINGTON FAMILY PHYSICIANS,LEXINGTON FAMILY PHYSICIANS PA,102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1417924465,"MATTHEWS, DANIEL, ALAN",102 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 31 , 44 ,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417924952,"DEVRIES, ABIGAIL, GREINER",1831 N FAYETTEVILLE ST ASHEBORO ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 20 , 22 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417925504,"SILVER, JOHN, ROBERT",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 46 , 64 , 86 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417925504,"SILVER, JOHN, ROBERT",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417925504,"SILVER, JOHN, ROBERT",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1558459602,PIEDMONT ENDOCRINOLOGY PA,PIEDMONT ENDOCRINOLOGY PA,311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417926007,"BARBER, ANTHONY, RODMAN",311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 38 , 50 , 78 ,$#,,
MEDICAID DIRECT,1790728145,"BULLARD III, REMUS, BENNETT",~,311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1417926007,"BARBER, ANTHONY, RODMAN",311 9TH AVENUE DR NE   HICKORY NC,018,Catawba,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1417926221,"THOMAS, JULIAN, MANUEL",4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 41 , 47 , 74 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417926965,"BULLARD, GUINEVERE, JOHNSON",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417926965,"BULLARD, GUINEVERE, JOHNSON",101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417926965,"BULLARD, GUINEVERE, JOHNSON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417926965,"BULLARD, GUINEVERE, JOHNSON",16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 39 , 52 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417927542,"FRESH, LANE, ERIC",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1417928474,"FUSONIE, GLENN, EDWARD",809 S LONG DRIVE   ROCKINGHAM NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417929126,"ROYCROFT, ROBERT, DAVID",3020 WEDDINGTON RD   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3020 WEDDINGTON RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417929126,"ROYCROFT, ROBERT, DAVID",3020 WEDDINGTON RD   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 75 , 109 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417930074,"REARDON, KENNETH, GEORGE",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 49 , 90 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417930587,"WARD, WILLIAM, ALAN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417930587,"WARD, WILLIAM, ALAN",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346302783,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193400000X,Group,Single Specialty,,1417931437,"JONES, STUART, ALLEN",434 HOSPTIAL DR   LINVILLE NC,006,Avery,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1417931437,"JONES, STUART, ALLEN",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417931437,"JONES, STUART, ALLEN",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1417931437,"JONES, STUART, ALLEN",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417931502,"CONERY, JOHN, PATRICK",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417931502,"CONERY, JOHN, PATRICK",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1417932476,"POTTKER, TAMARA, I",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417932559,"RAYKOVICZ, LEE, JOSEPH",1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 75 , 80 , 91 ,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417932559,"RAYKOVICZ, LEE, JOSEPH",2015 RANDOLPH RD STE 108 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 180 , 205 , 230 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417932575,"SHEN, PERRY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 42 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417932575,"SHEN, PERRY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417932781,"GILSON, ALEXANDER",250 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417933052,"ROSENKE, DOROTHY, HARSHER",~,905 HALSTEAD BLVD STE 7&8 ELIZABETH CITY NC,070,Pasquotank,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,1417933052,"ROSENKE, DOROTHY, HARSHER",905 HALSTEAD BLVD STE 7&8 ELIZABETH CITY NC,070,Pasquotank,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1417933052,"ROSENKE, DOROTHY, HARSHER",~,1129 HORSESHOE RD   ELIZABETH CITY NC,070,Pasquotank,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,1417933052,"ROSENKE, DOROTHY, HARSHER",1129 HORSESHOE RD   ELIZABETH CITY NC,070,Pasquotank,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417934878,"MARTIN, ROBERT, CHARLES",110 PATRICK CT   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 67 , 105 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1417935024,"CRAIG, ANDREW, EMERSON",600 W TRADE ST STE B DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417935420,"LIN, WEI CHEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 41 , 44 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417935420,"LIN, WEI CHEN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 34 , 38 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 48 , 55 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417935420,"LIN, WEI CHEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1417935420,"LIN, WEI CHEN",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 45 ,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",375 SUNSET AVE   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1417935420,"LIN, WEI CHEN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417935461,"FRANCIS, SABINA, PETRA",507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 123 , 178 , 281 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1417936048,"POLSTER, SCOTT, DAVID",24 2ND AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730552399,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE-MEDICAL ARTS,24 2ND AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417936048,"POLSTER, SCOTT, DAVID",24 2ND AVE NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 73 , 221 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417936055,"PAITSEL, LISA, KOONTZ",211 VIRGINIA RD   EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417936055,"PAITSEL, LISA, KOONTZ",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417937095,"CARCHMAN, REBECCA, MAYA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 80 , 81 ," $16,104.32 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417937095,"CARCHMAN, REBECCA, MAYA",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417937095,"CARCHMAN, REBECCA, MAYA",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 15 , 16 ,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1417937590,"DAVIS, WILLIAM, BRADLEY",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 57 , 130 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1417940420,"HARRIS, KRISTIE, CHARLOTTE",124 ABASOLO CT   DRIPPING SPRINGS TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1417940420,"HARRIS, KRISTIE, CHARLOTTE",124 ABASOLO CT   DRIPPING SPRINGS TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 117 , 122 , 157 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1417940420,"HARRIS, KRISTIE, CHARLOTTE",124 ABASOLO CT   DRIPPING SPRINGS TX,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 37 ,$#,,
MEDICAID DIRECT,1487807616,YADKIN VISION CENTER OD PLLC,~,225 E LEE AVE   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1417940552,"GORDON, GAIL, COX",225 E LEE AVE   YADKINVILLE NC,099,Yadkin,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 18 , 26 ,$#,,
MEDICAID DIRECT,1487807616,YADKIN VISION CENTER OD PLLC,~,225 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1417940552,"GORDON, GAIL, COX",225 E LEE AVE   YADKINVILLE NC,099,Yadkin,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417940990,"CARNES, PAUL",1540 SUNDAY DR   RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 52 , 297 , 642 ,$#,,
MEDICAID DIRECT,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,MAXTON FAMILY PRACTICE CENTER,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417941402,"BECKHAM, MICHELLE, WILKINS",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 40 , 63 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,100 DODD ST   SPRING HOPE NC,064,Nash,193200000X,Group,Multi-Specialty,,1417941402,"BECKHAM, MICHELLE, WILKINS",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417941402,"BECKHAM, MICHELLE, WILKINS",100 DODD ST   SPRING HOPE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,100 DODD ST   SPRING HOPE NC,064,Nash,193200000X,Group,Multi-Specialty,,1417941402,"BECKHAM, MICHELLE, WILKINS",100 DODD ST   SPRING HOPE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 177 , 353 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417941402,"BECKHAM, MICHELLE, WILKINS",1022 EASTERN AVE   NASHVILLE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417941923,"PERDUE JR, PHILIP, SUTHERLAND",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 79 , 176 , 382 ,$#,,
MEDICAID DIRECT,1477510659,LINCOLN PEDIATRICS CLINIC PA,LINCOLN PEDIATRICS CLINIC PA,113 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1417941949,"HUSSAIN, GHULAM",113 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 154 , 304 , 541 ," $32,606.17 ",,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1417942137,"KILLIAN, BRIAN, LAMAR",626 CLARK DR   LINCOLNTON NC,055,Lincoln,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255913182,FOOT AND ANKLE SPECIALISTS OF THE M,,534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417942137,"KILLIAN, BRIAN, LAMAR",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1417942137,"KILLIAN, BRIAN, LAMAR",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 103 , 327 , 573 ,$#,,
MEDICAID DIRECT,1255913182,FOOT AND ANKLE SPECIALISTS OF THE M,,534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417942137,"KILLIAN, BRIAN, LAMAR",534 W JOHN ST STE 100 MATTHEWS NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1417942137,"KILLIAN, BRIAN, LAMAR",323 N BROOME ST   WAXHAW NC,090,Union,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 39 , 91 , 157 ,$#,,
MEDICAID DIRECT,1235711169,FOOT AND ANKLE SPECIALISTS OF THE M,,323 N BROOME ST   WAXHAW NC,090,Union,193400000X,Group,Single Specialty,,1417942137,"KILLIAN, BRIAN, LAMAR",323 N BROOME ST   WAXHAW NC,090,Union,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235711169,FOOT AND ANKLE SPECIALISTS OF THE M,,323 N BROOME ST   WAXHAW NC,090,Union,193400000X,Group,Single Specialty,,1417942137,"KILLIAN, BRIAN, LAMAR",323 N BROOME ST   WAXHAW NC,090,Union,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417943135,"BROWN, MALGORZATA, ANNA",5815 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 28 , 49 ,$#,,
MEDICAID DIRECT,1417943507,AHOSKIE HOUSE LLC,AHOSKIE HOUSE,407 LOFTIN LN S   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1417943507,AHOSKIE HOUSE LLC,407 LOFTIN LN S   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 63 ," 16,527 "," 16,532 "," $1,717,688.76 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,137 PROFESSIONAL PARK DR STE C MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417943986,"MASSEY, KURT, ASHLEY",137 PROFESSIONAL PARK DR STE C MOORESVILLE NC,049,Iredell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 31 , 40 , 57 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417943986,"MASSEY, KURT, ASHLEY",137 PROFESSIONAL PARK DR STE C MOORESVILLE NC,049,Iredell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 29 , 45 , 69 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1417943986,"MASSEY, KURT, ASHLEY",137 PROFESSIONAL PARK DR STE C MOORESVILLE NC,049,Iredell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417944869,"TOTO, KATHERINE, ELIZABETH",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609047059,HIREN R PATEL MD PC,HIREN R PATEL MD PC,3009 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1417944885,"PATEL, HIREN, RAMANLAL",3009 N ELM ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1417945775,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,, 61 , 60 , 119 ,$#,,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1417945775,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,," 2,191 "," 2,306 "," 4,523 "," $60,908.69 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417947334,"CANFIELD, MICHELLE, MERCER",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417947334,"CANFIELD, MICHELLE, MERCER",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417948019,"HOSS, ARTHUR, ARESH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417948563,"SMITH, JOSHUA, FRANKLYN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417948563,"SMITH, JOSHUA, FRANKLYN",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417948563,"SMITH, JOSHUA, FRANKLYN",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 34 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417948597,"HENNION, DUANE, RICHARD",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760202303,NOVANT HEALTH TRIANGLE MEDICAL GROU,CAROLINA FAMILY PRACTICE & SPORTS MEDICINE,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417948597,"HENNION, DUANE, RICHARD",3700 NW CARY PKWY   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 320 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1417948597,"HENNION, DUANE, RICHARD",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417949413,"PLIHCIK, SPRING",630 COMFORT LN STE E MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,, 53 , 64 , 96 ,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1417949413,"PLIHCIK, SPRING",4101 CAMPUS RIDGE RD   MATTHEWS NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 26 , 26 , 32 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417949751,"ABSHER, JOHN, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1417950825,"GRAHAM, ANGUS, WOODWARD",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 43 , 57 , 83 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417950825,"GRAHAM, ANGUS, WOODWARD",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1417950825,"GRAHAM, ANGUS, WOODWARD",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 16 , 18 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1417950825,"GRAHAM, ANGUS, WOODWARD",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1417950825,"GRAHAM, ANGUS, WOODWARD",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1417950825,"GRAHAM, ANGUS, WOODWARD",316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417951864,"EARLS, MARIAN, FRANCES",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417951864,"EARLS, MARIAN, FRANCES",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417951864,"EARLS, MARIAN, FRANCES",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1417953548,"BROOKS, LAURA, KNIGHT",187 W MAIN ST   SPINDALE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 155 , 168 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417953654,"NELSON, MARK, HARVEY",750 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417954405,"FRALEY, DENNIS, MICHAEL",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1417955931,"WALKER, MICHELLE, CORNWELL",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417956087,"BASHORE, CHRISTOPHER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 19 , 43 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417956087,"BASHORE, CHRISTOPHER",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 33 , 46 , 80 ,$#,,
MEDICAID DIRECT,1073906392,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,193200000X,Group,Multi-Specialty,,1417956087,"BASHORE, CHRISTOPHER",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417956087,"BASHORE, CHRISTOPHER",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417956087,"BASHORE, CHRISTOPHER",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417956087,"BASHORE, CHRISTOPHER",1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1437657103,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417956087,"BASHORE, CHRISTOPHER",1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356305841,CAROLINA ONCOLOGY SPECIALISTS PA,~,2406 CENTURY PL SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417957234,"PETERSON, JOHN, LINKER",2406 CENTURY PL SE   HICKORY NC,018,Catawba,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 53 , 67 , 167 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417959230,"LINDSEY, JULIE, EVELYN NIELSEN",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1417959230,"LINDSEY, JULIE, EVELYN NIELSEN",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 83 , 95 , 362 ," $12,212.05 ",,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1407499353,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SUNSET,3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538589577,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY APEX,966 US 64 HWY W   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1346784089,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - DURHAM,1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1417959438,"LAMURA, JEFFREY, BENNET",1000 CRESCENT GRN STE 202 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1417959651,"CRAWFORD, CHARLES, MARSTON",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 117 , 170 , 447 ," $20,012.51 ",,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1417959651,"CRAWFORD, CHARLES, MARSTON",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",1600 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 36 , 57 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",329 MERRIMON AVE   WEAVERVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 110 , 111 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",329 MERRIMON AVE   WEAVERVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 101 , 101 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 22 , 34 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",840 FLEMING ST STE 6 HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 22 , 36 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 45 , 46 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",575 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417959685,"ENGLAND, BRIAN, KENT",575 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417960428,"ROSEMAN, VIRGINIA, JEANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417962242,"GURCANLAR, NIHAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 104 , 104 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417962242,"GURCANLAR, NIHAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417963604,"MCCARTHY, REGINA",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1417965633,"LEE, WILLIAM, LUKE",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417966409,"BRENTJENS, MATHIJS, HENRI",800 N MCPHERSON XING   ELIZABETH CITY NC,070,Pasquotank,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 53 , 97 , 192 ,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1417966409,"BRENTJENS, MATHIJS, HENRI",204 EARNHART DR   EDENTON NC,021,Chowan,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 37 , 66 , 114 ,$#,,
MEDICAID DIRECT,1457784191,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PRIMARY CARE ARDSLEY INTERNAL MEDICI,1085 NE GATEWAY CT NE STE 200A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417966938,"FREELAND, JULIE, MICHELLE",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1417966938,"FREELAND, JULIE, MICHELLE",1085 NE GATEWAY CT NE STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 85 , 137 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417966938,"FREELAND, JULIE, MICHELLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1528704004,PITT COUNTY MEMORIAL HOSPITAL INC,ECU HEALTH BEAUFORT HOSPITAL,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1417966953,"ANNIS, JASON, PAUL",628 E 12TH ST   WASHINGTON NC,007,Beaufort,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1417968579,"ARMANI, SAM",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 30 , 60 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1417969064,"PEDERSEN, JOSEPH, TERRANCE",338 DEERFIELD RD   BOONE NC,095,Watauga,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417972886,"WEINRIB, DAVID, ALLAN",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417972886,"WEINRIB, DAVID, ALLAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417972886,"WEINRIB, DAVID, ALLAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 43 , 43 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417972886,"WEINRIB, DAVID, ALLAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417972886,"WEINRIB, DAVID, ALLAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 19 , 22 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417972886,"WEINRIB, DAVID, ALLAN",1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 39 , 47 , 54 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417972886,"WEINRIB, DAVID, ALLAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 18 , 51 , 51 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 110 , 114 , 163 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770182933,WAKE PET SERVICES LLC,,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1417973298,"ALLEY JR, JOHN, GRANVILLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417973983,"TOLEDO, TEODORO, KEITH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 19 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2905 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417973983,"TOLEDO, TEODORO, KEITH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417973983,"TOLEDO, TEODORO, KEITH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 36 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417973983,"TOLEDO, TEODORO, KEITH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 25 , 40 ,$#,,
MEDICAID DIRECT,1417975210,WAL-MART STORES EAST LP,WALMART PHARMACY 10-3612,530 S GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1417975210,WAL-MART STORES EAST LP,530 S GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1417975210,WAL-MART STORES EAST LP,WALMART PHARMACY 10-3612,530 S GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1417975210,WAL-MART STORES EAST LP,530 S GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#, 17 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417976291,"HATLEY, CARMEN, MCCALL",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1417976291,"HATLEY, CARMEN, MCCALL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417976291,"HATLEY, CARMEN, MCCALL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1417976515,"MCGRUDER, JON",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417976812,"ENGELMANN, DEBRA, LYNN",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417977513,"KLEIN, BERT, JACK",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417977513,"KLEIN, BERT, JACK",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 103 , 446 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1417977513,"KLEIN, BERT, JACK",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417979485,"COPSIS, PETER, NICHOLAS",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 44 , 86 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417979485,"COPSIS, PETER, NICHOLAS",630 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1417979501,"KILPATRICK, JEFFERSON, KIRBY",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 26 , 52 , 65 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417979675,"MOULTON, CHARLOTTE, ELISE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417979675,"MOULTON, CHARLOTTE, ELISE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1417979675,"MOULTON, CHARLOTTE, ELISE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417980913,"KENSHOCK, EDWARD",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 235 , 359 , 522 ," $10,021.43 ",,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1417980913,"KENSHOCK, EDWARD",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1417980913,"KENSHOCK, EDWARD",1629 OWEN DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417981010,"AMIN, KETAN, BIPINCHANDRA",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417981010,"AMIN, KETAN, BIPINCHANDRA",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417981010,"AMIN, KETAN, BIPINCHANDRA",11030 GOLF LINKS DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417981093,"WHITAKER, DIANE, BEASLEY",2100 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417981093,"WHITAKER, DIANE, BEASLEY",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 31 , 31 , 53 ,$#,,
MEDICAID DIRECT,1679576763,COUNTY OF BEAUFORT,BEAUFORT COUNTY HEALTH DEPT,1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417982927,"STRAUB, LINDA, ANN",1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1417982927,"STRAUB, LINDA, ANN",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1417982927,"STRAUB, LINDA, ANN",1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1679576763,COUNTY OF BEAUFORT,BEAUFORT COUNTY HEALTH DEPT,1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417982927,"STRAUB, LINDA, ANN",313 MAIN ST   BAYBORO NC,069,Pamlico,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417983420,"JOSEPH, SALLY, SHERMAN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417983420,"JOSEPH, SALLY, SHERMAN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1417983420,"JOSEPH, SALLY, SHERMAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417983420,"JOSEPH, SALLY, SHERMAN",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1417983420,"JOSEPH, SALLY, SHERMAN",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417985540,"FULLER, DONALD, MICHAEL",6419 CAROLINA BEACH RD UNIT CD WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1245507516,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY CARE,105 S MAIN AVE STE B NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417985698,"PATEL, SHITAL, SURYAKANT",105 S MAIN AVE STE B NEWTON NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 149 , 526 ,$#,,
MEDICAID DIRECT,1245507516,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY CARE,105 S MAIN AVE STE B NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417985698,"PATEL, SHITAL, SURYAKANT",105 S MAIN AVE STE B NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417986530,"DEWS, MARSHALL, ANDREW",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417987215,"DAIRI, MAYS, ANTOINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 16 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417987215,"DAIRI, MAYS, ANTOINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 155 , 198 , 382 ," $17,499.00 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1417987215,"DAIRI, MAYS, ANTOINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1417987827,"CARTWRIGHT, MICHAEL, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1417987827,"CARTWRIGHT, MICHAEL, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417987827,"CARTWRIGHT, MICHAEL, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 77 , 103 , 110 ,$#,,
MEDICAID DIRECT,1093230336,GASTONIA WELLNESS & LONG TERM CARE,,,,Unknown,193400000X,Group,Single Specialty,,1417988825,"NEEDELL, JAMES, EDWARD",116 W 3RD AVE STE 101 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417988825,"NEEDELL, JAMES, EDWARD",116 W 3RD AVE STE 101 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417988825,"NEEDELL, JAMES, EDWARD",8401 MEDICAL PLAZA DR STE 250 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 89 , 186 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417989252,"LAWLESS, PAUL",2001 VAIL AVE MERCY HOSP CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1417990094,"TAYLOR, JAMES, EDWARD",165 TURNBERRY WAY   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1417990094,"TAYLOR, JAMES, EDWARD",610 N FAYETTEVILLE ST STE 106 ASHEBORO NC,076,Randolph,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1417990094,"TAYLOR, JAMES, EDWARD",601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 31 , 31 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 293 ," 1,654 "," 3,889 "," $44,547.80 ",,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 19 , 44 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",3604 PETERS CT   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",3801 W MARKET ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 34 , 99 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",3604 PETERS CT   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 174 , 532 , 689 ," $22,371.67 ",,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1417991613,"FOSTER, ROBERT, MIDDLETON",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669537593,COUNTY OF BUNCOMBE OFFICE OF ACCOUN,BUNCOMBE COUNTY HEALTH DEPARTMENT,40 COXE AVE   ASHEVILLE NC,011,Buncombe,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1417991845,"MULLENDORE, JENNIFER, LEIGH",40 COXE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 155 , 219 , 498 ," $20,912.18 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1417993130,"WALSH, PATRICK, JAMES",705 NEWMAN RD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1417993130,"WALSH, PATRICK, JAMES",2604 DR MARTIN LUTHER KING JR BLVD STE B NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1740595644,CAROLINAEAST PHYSICIANS,CAROLINAEAST UROLOGY,705 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1417993130,"WALSH, PATRICK, JAMES",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 20 , 30 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1417993130,"WALSH, PATRICK, JAMES",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 22 , 39 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1417993700,"RAMSEY, KAREN, MARIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1972842086,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417994401,"KRAUS, JACQUELINE, JOY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1790736379,ORTHOTICS AND PROSTHETICS EAST INC,ORTHOTICS AND PROSTHETICS EAST INC,1025 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1417994500,"COLTRAIN, RICHARD, SHANE",1025 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#, 12 , 86 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 25 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 93 , 100 , 113 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 41 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 21 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417994757,"FLEEMAN, SHERI, WELLS",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 23 ,$#,,
MEDICAID DIRECT,1417995309,COUNTY OF HYDE,HYDE COUNTY RESCUE SQUAD,30 OYSTER CRK   SWANQUARTER NC,048,Hyde,3416L0300X,Transportation Services,Ambulance,Land Transport,1417995309,COUNTY OF HYDE,30 OYSTER CRK   SWANQUARTER NC,048,Hyde,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#, 15 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1417995689,"MCINNIS, ELIZABETH, CATHERINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1417996331,"MIDKIFF, PAUL, ANDREW",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 162 , 391 ,$#,,
MEDICAID DIRECT,1184174542,CALDWELL MEMORIAL HOSPITAL,CALDWELL SLEEP MEDICINE,270 PINE MOUNTAIN RD STE 5 HUDSON NC,014,Caldwell,193400000X,Group,Single Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",270 PINE MOUNTAIN RD STE 5 HUDSON NC,014,Caldwell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1407188600,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PULMONARY & SLEEP CENTER,2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 38 , 39 ,$#,,
MEDICAID DIRECT,1972842086,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 33 , 56 , 56 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 102 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1417996695,"YAPUNDICH, ROBERT, ANTHONY",1700 TARBORO ST W STE 102 WILSON NC,098,Wilson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1417996703,"WHERRY, THOMAS, MATTHEW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1417997172,"BLOCK, MATTHEW",Matthew Block,1601 MEDICAL DR   LAURINBURG NC,083,Scotland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1417997172,"BLOCK, MATTHEW",1601 MEDICAL DR   LAURINBURG NC,083,Scotland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 319 , 608 ," 1,621 "," $30,172.75 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417998089,"COLE, TOBY, CECIL",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 29 , 37 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417998089,"COLE, TOBY, CECIL",310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417998089,"COLE, TOBY, CECIL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 50 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417998089,"COLE, TOBY, CECIL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 116 , 130 , 223 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1417998089,"COLE, TOBY, CECIL",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1427000181,EYECARECENTER OD PA,EYECARE CENTER,4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427000181,EYECARECENTER OD PA,4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 42 , 42 , 47 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427002898,"KAY, JAMES, DAVID",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427002898,"KAY, JAMES, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 92 , 100 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427002898,"KAY, JAMES, DAVID",180 PARKWOOD DR   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 25 , 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427004159,"SMITH, LEAH, FOSTER",910 PARK CENTER DR   MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427004159,"SMITH, LEAH, FOSTER",910 PARK CENTER DR   MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427004209,"GREER, STEPHEN, EDWARD",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427004209,"GREER, STEPHEN, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790739571,"WILLIAM D HUNTER MD PA, WILLIAM",~,2555 COURT DR STE 400 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1427005420,"HUNTER, WILLIAM, DEAN",2555 COURT DR STE 400 GASTONIA NC,036,Gaston,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 105 , 185 , 316 ," $12,458.04 ",,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427006865,"MULLIS, GARRICK, BRENT",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457309221,CABARRUS EMERGENCY MEDICINE ASSOCIA,CABARRUS EMERGENCY MEDICINE ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1427006865,"MULLIS, GARRICK, BRENT",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427006865,"MULLIS, GARRICK, BRENT",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427006865,"MULLIS, GARRICK, BRENT",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 25 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427006865,"MULLIS, GARRICK, BRENT",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902462518,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,1401 HAYWOOD RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427008291,"POOLE, CRAIG, MICHAEL",1401 HAYWOOD RD   HENDERSONVILLE NC,045,Henderson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1801166459,CAROLINA HEART CENTER PA,CAROLINA HEART CENTER PA,3406 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427008366,"PARIKH, PANKAJ, NANALAL",3406 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 90 , 306 , 592 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427008820,"SISK, YVETTE, EASTER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 133 , 133 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427008903,"HART, CAROLYN, ELIZABETH",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427008903,"HART, CAROLYN, ELIZABETH",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427008903,"HART, CAROLYN, ELIZABETH",1718 E 4TH ST STE 801 CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,,,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1010 LAKEVIEW DR   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427009471,"ANDERSON, ELIZABETH, MARA",1331 N ELM ST STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 28 , 29 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,405 S GREEN ST   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1427009471,"ANDERSON, ELIZABETH, MARA",1331 N ELM ST STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427009760,"MOORHOUSE, RYAN, LOUIS",11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427009760,"MOORHOUSE, RYAN, LOUIS",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427009760,"MOORHOUSE, RYAN, LOUIS",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427009760,"MOORHOUSE, RYAN, LOUIS",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1427009760,"MOORHOUSE, RYAN, LOUIS",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427010248,"MILLER, ROBERT, CHRISTOPHER",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 49 , 71 , 120 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1427011311,"SAMPAT, SMITA, NARESH",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 35 , 56 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1427011311,"SAMPAT, SMITA, NARESH",1051 NOELL LN   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 74 , 74 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427011501,"CROLEY II, GRANVILLE, GILTZ",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427011501,"CROLEY II, GRANVILLE, GILTZ",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 19 , 28 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427011501,"CROLEY II, GRANVILLE, GILTZ",431 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427011501,"CROLEY II, GRANVILLE, GILTZ",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427011691,"CROOK, JENNIFER, LEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427011691,"CROOK, JENNIFER, LEE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 21 , 25 , 41 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427011691,"CROOK, JENNIFER, LEE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 23 , 43 , 62 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427011691,"CROOK, JENNIFER, LEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427011691,"CROOK, JENNIFER, LEE",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427011691,"CROOK, JENNIFER, LEE",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427013036,"STRUNC, MICHAEL, JOSEPH",500 DISCOVERY DR STE 301 CHESAPEAKE VA,101,Out of State <= 40 miles,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427013036,"STRUNC, MICHAEL, JOSEPH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427013036,"STRUNC, MICHAEL, JOSEPH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084S0012X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Sleep Medicine,#,,,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427013226,"KOTHADIA, JAMANADAS, MAHIDAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 28 , 65 , 66 ," $15,917.42 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427013226,"KOTHADIA, JAMANADAS, MAHIDAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427017011,"SAILER, VOYTA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 105 , 105 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427017482,"COHEN, ARTHUR, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427017482,"COHEN, ARTHUR, ROBERT",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427017482,"COHEN, ARTHUR, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427017482,"COHEN, ARTHUR, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427017482,"COHEN, ARTHUR, ROBERT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 84 , 91 , 136 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427018381,"SULLIVAN, WILLIAM, CHRISTOPHER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 17 , 54 , 54 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427019744,"WETZLER, KURT, HENRY",110 KINGSLEY LN STE 305 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427019744,"WETZLER, KURT, HENRY",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1427020163,"BALVICH, JAMES, CHRISTOPHER",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 73 , 88 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427020163,"BALVICH, JAMES, CHRISTOPHER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 33 , 40 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1427020163,"BALVICH, JAMES, CHRISTOPHER",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427020163,"BALVICH, JAMES, CHRISTOPHER",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427022169,"GRANT JR, THOMAS, RUSSELL",825 FAIRFAX AVE STE 118 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427023217,"TAN, BETHANY, BRAGDON",880 KEMPSVILLE RD STE 1000 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1427026202,"RIGGAN, CATHERINE, SNYDER",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 13 , 47 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1427026202,"RIGGAN, CATHERINE, SNYDER",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 80 , 191 ," $10,049.37 ",,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1427026202,"RIGGAN, CATHERINE, SNYDER",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427026210,"CLYNE, STEPHEN, BERNARD",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427026210,"CLYNE, STEPHEN, BERNARD",10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 18 , 29 , 44 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427026210,"CLYNE, STEPHEN, BERNARD",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1295792430,NORTH STATE PATHOLOGY ASSOCIATES PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1427026467,"STERLING, ROBERT, TODD",601 N ELM ST   HIGH POINT NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427026798,"MOFFATT, LAWRENCE, STRONG",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 75 , 78 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427026798,"MOFFATT, LAWRENCE, STRONG",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 22 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427026798,"MOFFATT, LAWRENCE, STRONG",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427027242,"WASAN, SUMAN, MADANLAL",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 45 , 54 , 65 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427027242,"WASAN, SUMAN, MADANLAL",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427027242,"WASAN, SUMAN, MADANLAL",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1427027242,"WASAN, SUMAN, MADANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 27 , 32 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1427027242,"WASAN, SUMAN, MADANLAL",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 14 , 21 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427027242,"WASAN, SUMAN, MADANLAL",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427027242,"WASAN, SUMAN, MADANLAL",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 26 , 29 ,$#,,
MEDICAID DIRECT,1124627146,KIDZCARE PEDIATRICS PC,,413 W MAIN ST   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",413 W MAIN ST   WILLIAMSTON NC,058,Martin,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 78 , 194 ,$#,,
MEDICAID DIRECT,1164657532,KIDZCARE PEDIATRICS PC,~,5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 13 , 46 ,$#,,
MEDICAID DIRECT,1548495914,KIDZCARE PEDIATRICS PC,~,3115 BORDEAUX PARK DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",3115 BORDEAUX PARK DR   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 25 , 75 ,$#,,
MEDICAID DIRECT,1629394614,KIDZCARE PEDIATRICS PC,~,1022 N BRAGG BLVD   SPRING LAKE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",1022 N BRAGG BLVD   SPRING LAKE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 18 , 44 ,$#,,
MEDICAID DIRECT,1083038806,KIDZCARE PEDIATRICS PC,,,,Unknown,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",1271 OLIVER ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 ,#, 18 ,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1679824676,KIDZCARE PEDIATRICS PC,~,2501 S MEBANE ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",2501 S MEBANE ST   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 55 , 148 ,$#,,
MEDICAID DIRECT,1285158824,KIDZCARE PEDIATRICS PC,,801 W 3RD ST   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",801 W 3RD ST   SILER CITY NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 11 , 23 ,$#,,
MEDICAID DIRECT,1679529051,KIDZCARE PEDIATRICS PC,~,3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427028398,"JAIN, ASHOKKUMAR, CHATARMALJI",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427029487,"HONEYCUTT, ASHLEY, COPPAGE",7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427029487,"HONEYCUTT, ASHLEY, COPPAGE",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 14 , 30 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1427030303,"DIFURIO, MEGAN, JUSTINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 92 , 103 , 176 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,300 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1427030303,"DIFURIO, MEGAN, JUSTINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,300 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1427030303,"DIFURIO, MEGAN, JUSTINE",300 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 22 , 23 , 42 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427031368,"MORAN, MARY, MELYSSA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427031368,"MORAN, MARY, MELYSSA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427031574,"CRUCIANI, KAREN, RUTH",MEDICAL PARK BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427031574,"CRUCIANI, KAREN, RUTH",MEDICAL PARK BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427031715,"EMERSON, BRIAN, ROBERT",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 66 , 67 , 72 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 24 , 33 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 149 , 159 , 176 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 34 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",301 E WENDOVER AVE STE 300 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427032606,"MANSELL, ERIC, ARTHUR",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1609421775,HEALTHWORX PARTNERS PC,,118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1427035146,"CZUCHRA, DENNIS, ANDRE",1201 CAROLINA AVE   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427035575,"FELDMAN, JEFFREY, BRUCE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427036078,"ROGERS, KARA, MARIE",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427036664,"FABRIZO, MICHAEL, DEAN",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427036664,"FABRIZO, MICHAEL, DEAN",229 CLEARFIELD AVE STE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427036938,"COOK, KENTON, ROLLIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 36 , 118 , 118 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427036938,"COOK, KENTON, ROLLIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427036953,"BELANGER, JULIE, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427037795,"BEATY, ROY, DAVID",512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 33 , 55 , 64 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427037795,"BEATY, ROY, DAVID",512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427037795,"BEATY, ROY, DAVID",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 30 , 31 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427037795,"BEATY, ROY, DAVID",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427038488,"DAY, JENNIFER, BETH",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 33 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427038512,"CHRISTAKOS, CHRIS, NICHOLAS",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 24 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427039155,"ABSHER, DARREN, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1023354156,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1427039155,"ABSHER, DARREN, THOMAS",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1811233075,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,111 COMER ST   DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1427039155,"ABSHER, DARREN, THOMAS",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023354156,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1427039155,"ABSHER, DARREN, THOMAS",4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 99 , 145 ,$#,,
MEDICAID DIRECT,1811233075,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,111 COMER ST   DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1427039155,"ABSHER, DARREN, THOMAS",111 COMER ST   DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 18 , 23 ,$#,,
MEDICAID DIRECT,1679600969,LENOIR CO HEALTH DEPT,LENOIR COUNTY HEALTH DEPARTMENT,201 N MCLEWEAN ST   KINSTON NC,054,Lenoir,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1427039502,"PHILLIPS, PAMELA",201 N MCLEWEAN ST   KINSTON NC,054,Lenoir,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 21 , 31 , 128 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427040104,"BESTE, TODD, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 132 , 151 , 163 ," $50,966.09 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427040104,"BESTE, TODD, MICHAEL",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 91 , 108 , 159 ,$#,,
MEDICAID DIRECT,1194590364,SPECIALTY FOOT & ANKLE PLLC,,2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427040153,"GAULAND, CHRISTOPHER, JOSEPH",2502 N HERRITAGE ST   KINSTON NC,054,Lenoir,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 50 , 70 ,$#,,
MEDICAID DIRECT,1194590364,SPECIALTY FOOT & ANKLE PLLC,,2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427040153,"GAULAND, CHRISTOPHER, JOSEPH",2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1194590364,SPECIALTY FOOT & ANKLE PLLC,,2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427040153,"GAULAND, CHRISTOPHER, JOSEPH",2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073688123,EASTERN CAROLINA FOOT AND ANKLE SPE,~,2140 W ARLINGTON BLVD STE D GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427040153,"GAULAND, CHRISTOPHER, JOSEPH",2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1194590364,SPECIALTY FOOT & ANKLE PLLC,,2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427040153,"GAULAND, CHRISTOPHER, JOSEPH",2090 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 40 , 211 , 368 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427040971,"KUHLMAN, JEFFREY, REME",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427040971,"KUHLMAN, JEFFREY, REME",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811350887,PIEDMONT HEALTHCARE PA,,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427040971,"KUHLMAN, JEFFREY, REME",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427040971,"KUHLMAN, JEFFREY, REME",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427041425,"ROBERTS, JOSEPH, EDWARD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1427041425,"ROBERTS, JOSEPH, EDWARD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427041474,"DAUGHERTY, LOUIS, EUGENE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 16 , 30 , 42 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427041474,"DAUGHERTY, LOUIS, EUGENE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427041474,"DAUGHERTY, LOUIS, EUGENE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427041532,"WINEBARGER, NANCY, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427041532,"WINEBARGER, NANCY, LYNN",63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 28 ,$#,,
MEDICAID DIRECT,1083277735,FOREFRONT DERMATOLOGY SC,~,6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1427043330,"BENIGAR, CHRISTINE, LYNN",6807 KNIGHTDALE BLVD STE C KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 38 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427043470,"SHOOK, PAUL, RAYMOND",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 26 ,$#,,
MEDICAID DIRECT,1043754344,1ST CHOICE CHIROPRACTIC PLLC,,936 CIRCLEWOOD DR   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1427045590,"STOGNER, LARRY, EUGENE",936 CIRCLEWOOD DR   HAMLET NC,077,Richmond,111N00000X,Chiropractic Providers,Chiropractor,,#, 69 , 69 ,$#,,
MEDICAID DIRECT,1154456143,JEFFREY L TAYLOR OD AND LYNN C TAYL,PEACHTREE FAMILY EYE CARE MURPHY,4295 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1427050210,"TAYLOR, JEFFREY, LANE",4295 E US 64 ALT   MURPHY NC,020,Cherokee,152W00000X,Eye and Vision Services Providers,Optometrist,, 49 , 54 , 61 ,$#,,
MEDICAID DIRECT,1275668170,JEFFREY L TAYLOR OD AND LYNN C TAYL,ANDREWS FAMILY EYE CARE,29 CHESTNUT ST   ANDREWS NC,020,Cherokee,193400000X,Group,Single Specialty,,1427050210,"TAYLOR, JEFFREY, LANE",29 CHESTNUT ST   ANDREWS NC,020,Cherokee,152W00000X,Eye and Vision Services Providers,Optometrist,, 88 , 94 , 104 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427050889,"BELLE, BEVERLY, ANN VENESSA",8201 HEALTHCARE LOOP STE 302 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427050889,"BELLE, BEVERLY, ANN VENESSA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427050889,"BELLE, BEVERLY, ANN VENESSA",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427050889,"BELLE, BEVERLY, ANN VENESSA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",430 RANKIN DR   MARION NC,059,McDowell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",80 WESTGATE PLZ   FRANKLIN NC,056,Macon,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",80 WESTGATE PLZ   FRANKLIN NC,056,Macon,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",11 PARK TERRACE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",1250 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",11 PARK TERRACE DR   CLYDE NC,044,Haywood,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 12 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",1611 ANDREWS RD   MURPHY NC,020,Cherokee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",329 MERRIMON AVE   WEAVERVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",1611 ANDREWS RD   MURPHY NC,020,Cherokee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 50 , 50 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",93 FAMILY CHURCH RD   MURPHY NC,020,Cherokee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 39 , 59 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 168 , 297 , 479 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",2621 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 89 , 89 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",1600 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 80 , 177 , 248 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",329 MERRIMON AVE   WEAVERVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 28 , 68 , 68 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427051804,"MANLEY, JOHN, ALAN",102 COLLEGE STATION DR STE 10 BREVARD NC,088,Transylvania,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427051853,"LARA-TORRE, EDUARDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 26 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427051853,"LARA-TORRE, EDUARDO",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427051853,"LARA-TORRE, EDUARDO",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427051853,"LARA-TORRE, EDUARDO",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 21 , 30 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427052232,"BURKE, CHERIE, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427052232,"BURKE, CHERIE, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,1431 FERN CREEK DRIVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1427052950,"NEUWIRTH, BRYAN, RICHARD",1431 FERN CREEK DRIVE   STATESVILLE NC,049,Iredell,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,110 JUNIPER ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1427052950,"NEUWIRTH, BRYAN, RICHARD",110 JUNIPER ST STE 400 MORGANTON NC,012,Burke,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 242 , 400 ," 1,345 "," $138,149.84 ",,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,261 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1427052950,"NEUWIRTH, BRYAN, RICHARD",110 JUNIPER ST STE 400 MORGANTON NC,012,Burke,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,1431 FERN CREEK DRIVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1427052950,"NEUWIRTH, BRYAN, RICHARD",261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 23 ,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,261 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1427052950,"NEUWIRTH, BRYAN, RICHARD",261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 256 , 441 ," 1,514 "," $163,811.53 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427053263,"VAN TRIGT, PETER",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356305841,CAROLINA ONCOLOGY SPECIALISTS PA,~,2406 CENTURY PL SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427053461,"ORLOWSKI, RICHARD",2406 CENTURY PL SE   HICKORY NC,018,Catawba,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 151 , 480 ," 1,017 "," $57,623.91 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427053594,"DREESEN, ELIZABETH, BARTHOLD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427053594,"DREESEN, ELIZABETH, BARTHOLD",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,4 JOSH CT   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1427054089,"HOLLOWAY, MICHAEL, LAWRENCE",4 JOSH CT   JACKSONVILLE NC,067,Onslow,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427054089,"HOLLOWAY, MICHAEL, LAWRENCE",4 JOSH CT   JACKSONVILLE NC,067,Onslow,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1427054089,"HOLLOWAY, MICHAEL, LAWRENCE",4 JOSH CT   JACKSONVILLE NC,067,Onslow,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427054089,"HOLLOWAY, MICHAEL, LAWRENCE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427054089,"HOLLOWAY, MICHAEL, LAWRENCE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427054089,"HOLLOWAY, MICHAEL, LAWRENCE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2541 N QUEEN ST   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1427054089,"HOLLOWAY, MICHAEL, LAWRENCE",2541 N QUEEN ST   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1427054626,"SMITH, LLOYD, HAMLIN",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 37 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1427054626,"SMITH, LLOYD, HAMLIN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1093070757,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM SURGICAL,101 ELDON PARKS DR STE A ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1427054683,"FRIEDMAN, DAVID, JONATHAN",180 PARKWOOD DR   ELKIN NC,086,Surry,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 22 , 28 ,$#,,
MEDICAID DIRECT,1093070757,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM SURGICAL,101 ELDON PARKS DR STE A ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1427054683,"FRIEDMAN, DAVID, JONATHAN",700 ACADEMY ST S   AHOSKIE NC,046,Hertford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1427054683,"FRIEDMAN, DAVID, JONATHAN",233 DOCTORS ST   SPARTA NC,003,Alleghany,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427055052,"MALANEY, TIMOTHY, MICHAEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 89 , 98 , 113 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427056530,"LEGERE, BRIAN, MICHAEL",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 82 , 97 , 188 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427056530,"LEGERE, BRIAN, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 33 , 33 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427056530,"LEGERE, BRIAN, MICHAEL",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427056530,"LEGERE, BRIAN, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427056530,"LEGERE, BRIAN, MICHAEL",512 VILLAGE RD STE 101 SHALLOTTE NC,010,Brunswick,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 24 , 28 , 62 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1427056571,"MAYES, MARK, MONROE",911 E ATKINS ST STE D DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 77 , 140 ,$#,,
MEDICAID DIRECT,1912934704,SPECTRUM FAMILY EYE CENTER OPTOMETE,SPECTRUM FAMILY EYE CENTERS,160 FOX HOLLOW CT   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427060201,"POINDEXTER, KEITH",160 FOX HOLLOW CT   PINEHURST NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 35 , 50 ,$#,,
MEDICAID DIRECT,1962153833,RYAN HINCKLEY DDS MS PLLC,,1813 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1427062025,"BERKY, ZOLTAN, TIBOR",1813 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427062447,"WILSON, REBECCA, LYNN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 56 , 133 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427062447,"WILSON, REBECCA, LYNN",11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 22 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427062447,"WILSON, REBECCA, LYNN",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427066901,"SOMERVILLE, TAMMY, JEAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427068568,"BASH, KAREN, LOUISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 36 , 36 ," $12,573.92 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427068568,"BASH, KAREN, LOUISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427072131,"PLAGE, ROBERT",PLAGE AND EGLINTON DDS PA,1802 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1427072131,"PLAGE, ROBERT",1802 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 35 , 82 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427074616,"KADIR, HUMAYUN, MOHAMMAD",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6090 SIX FORKS RD STE A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427074616,"KADIR, HUMAYUN, MOHAMMAD",6090 SIX FORKS RD STE A RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 36 , 48 ,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427074970,"OGUNJIMI-POPOOLA, MODUPE, ABIDAYO",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 54 , 104 ,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427074970,"OGUNJIMI-POPOOLA, MODUPE, ABIDAYO",11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568529303,ATLANTIC PAIN MANAGEMENT AND REHABI,ATLANTIC REHABILITATION MEDICINE SPECIAL,3210 N CROATAN HWY STE 3 KILL DEVIL HILLS NC,028,Dare,193200000X,Group,Multi-Specialty,,1427075506,"NICHOLAS, THEODORE, WILLIAM",3210 N CROATAN HWY STE 3 KILL DEVIL HILLS NC,028,Dare,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 52 , 162 , 201 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427077593,"MARUSHACK, MICHAEL, MARK",902 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 24 , 31 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427077593,"MARUSHACK, MICHAEL, MARK",902 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 40 , 53 , 91 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427077593,"MARUSHACK, MICHAEL, MARK",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427077593,"MARUSHACK, MICHAEL, MARK",1168 E CUTLAR XING   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427077593,"MARUSHACK, MICHAEL, MARK",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427077593,"MARUSHACK, MICHAEL, MARK",1168 E CUTLAR XING   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144406539,PHYSICAL THERAPY FOR WOMEN,~,1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427078518,"ALBERT, JENNIFER, GUARDINO",1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1427079524,GRANVILLE COUNTY SCHOOLS,~,101 DELACROIX ST   OXFORD NC,039,Granville,251300000X,Agencies,Local Education Agency (LEA),,1427079524,GRANVILLE COUNTY SCHOOLS,101 DELACROIX ST   OXFORD NC,039,Granville,251300000X,Agencies,Local Education Agency (LEA),, 241 ," 3,667 "," 3,742 "," $155,527.26 ",,
MEDICAID DIRECT,1760695589,THERESA CLIFTON DDS PLLC,~,77 VILCOM CENTER DR STE 310 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1427080050,"CLIFTON, THERESA, LENISE",77 VILCOM CENTER DR STE 310 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 48 , 245 , 249 ," $29,271.06 ",,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427080233,"SHEAFFER, TRACI, IRWIN",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 77 , 126 , 133 ," $14,046.11 ",,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427080308,"MOLL, MATTHEW, TODD",101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 42 , 60 ,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E W T HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427080308,"MOLL, MATTHEW, TODD",101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427080357,"HAYES, TINA, JEAN",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427080357,"HAYES, TINA, JEAN",2000 WELLNESS BLVD STE 120 MONROE NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427080720,"BRAUNSTEIN, SETH, NEAL",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 55 , 138 , 211 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427080720,"BRAUNSTEIN, SETH, NEAL",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 26 , 50 , 125 ,$#,,
MEDICAID DIRECT,1427081439,COORS PHARMACY INC,COORS PHARMACY INC,1103 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427081439,COORS PHARMACY INC,1103 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1427081934,SOUTHEAST MEDICAL INC,SOUTHEAST MEDICAL INC DBA ABC HOME MEDICAL SUPP,75 N MAIN ST STE 229 CLAYTON GA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427081934,SOUTHEAST MEDICAL INC,75 N MAIN ST STE 229 CLAYTON GA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 122 , 698 ," 1,789 "," $120,784.68 ",,
MEDICAID DIRECT,1427081934,SOUTHEAST MEDICAL INC,SOUTHEAST MEDICAL INC DBA ABC HOME MEDICAL SUPP,75 N MAIN ST STE 229 CLAYTON GA,101,Out of State <= 40 miles,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1427081934,SOUTHEAST MEDICAL INC,75 N MAIN ST STE 229 CLAYTON GA,101,Out of State <= 40 miles,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427082015,"ROTH, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1427082528,"WATERS, SHELLEY, BUTLER",~,452 GATLIN HUNTING CLUB RD   HOBGOOD NC,042,Halifax,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1427082528,"WATERS, SHELLEY, BUTLER",452 GATLIN HUNTING CLUB RD   HOBGOOD NC,042,Halifax,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 11 , 133 , 134 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427083286,"SCHNEIDER, PETER",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 41 , 93 , 105 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427083526,"PATIL, CHANDRASHEKHAR, YADAO",10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427083526,"PATIL, CHANDRASHEKHAR, YADAO",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 19 , 38 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427083526,"PATIL, CHANDRASHEKHAR, YADAO",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427083526,"PATIL, CHANDRASHEKHAR, YADAO",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 79 , 122 ,$#,,
MEDICAID DIRECT,1215977194,CALDWELL MEMORIAL HOSPITAL,WESTPOINTE MEDICAL PRACTICE,2651 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1427086743,"CARLTON, MELISSA, ANN",2651 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 154 , 194 ,$#,,
MEDICAID DIRECT,1427089051,"GLOVER, MARION, SHERILL",~,110 E EDWARDS ST   PRINCETON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,1427089051,"GLOVER, MARION, SHERILL",110 E EDWARDS ST   PRINCETON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1295067650,M SHERILL GLOVER OD,PRINCETON EYE CARE,110 E EDWARDS ST   PRINCETON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427089051,"GLOVER, MARION, SHERILL",110 E EDWARDS ST   PRINCETON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1164493615,COMMUNITY FAMILY PRACTICE PA,,260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427091222,"LIVINGSTON, LAUREN, SNYDER",260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 95 , 145 ,$#,,
MEDICAID DIRECT,1104959055,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427091263,"TEPEDINO, MICHAEL, EMILE",1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 56 , 70 , 105 ,$#,,
MEDICAID DIRECT,1104959055,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427091263,"TEPEDINO, MICHAEL, EMILE",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 24 , 32 , 51 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427092352,"SYED, SALMA, SULTANA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427092352,"SYED, SALMA, SULTANA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427092659,"YOUNG, JAMIE, STAPP",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 30 , 30 ,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427092659,"YOUNG, JAMIE, STAPP",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 75 , 77 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1427092659,"YOUNG, JAMIE, STAPP",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 47 , 47 ," $18,604.95 ",,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427092691,"BOSS, CHERYL, LYNN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427092691,"BOSS, CHERYL, LYNN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1427092691,"BOSS, CHERYL, LYNN",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1427092691,"BOSS, CHERYL, LYNN",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427092691,"BOSS, CHERYL, LYNN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427092691,"BOSS, CHERYL, LYNN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1427092691,"BOSS, CHERYL, LYNN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427092691,"BOSS, CHERYL, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427092691,"BOSS, CHERYL, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1427092691,"BOSS, CHERYL, LYNN",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497792469,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PSYCHIATRIC SERVICES,1120 FAIRGROVE CHURCH RD STE 12 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427092972,"MUNOZ, RIGARDY, PAGAYONAN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427097138,"DANIEL, CHRISTIAN, PAGE",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427098698,"PLEMMONS, JOHN, KENNETH",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1114420254,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,600 W TRADE ST STE A DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1427098987,"BOYD, LISA, ANDERSON",600 W TRADE ST STE A DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 39 , 53 ,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427099373,"BISCETTE, SHAN, MELISSA",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427099548,"TUCKER, NIKKI, GIOVONNE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,500 SEAN DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427099548,"TUCKER, NIKKI, GIOVONNE",500 SEAN DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427099548,"TUCKER, NIKKI, GIOVONNE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 32 , 32 , 552 ," $41,802.23 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427099548,"TUCKER, NIKKI, GIOVONNE",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 817 ," 1,013 "," 3,256 "," $113,213.72 ",,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427099548,"TUCKER, NIKKI, GIOVONNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 61 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1427099787,"AKBAROV, ALEC",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 27 , 29 ,$#,,
MEDICAID DIRECT,1922884709,HARVEY LANE HARRIS JR DDS PLLC,,1317 CENTRAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1427100593,"HARRIS JUNIOR, HARVEY, LANE",1317 CENTRAL DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 54 , 113 , 375 ," $13,468.75 ",,
MEDICAID DIRECT,1356368708,CAMPUS HEALTH PHARMACY,CAMPUS HEALTH SERVICES,320 EMERGENCY ROOM DR JAMES A TAYLOR BLDG CB 7470 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427102748,"CHAI, CHANHTHEVY, SOURISAK",320 EMERGENCY ROOM DR TAYLOR STUDENT HEALTH SERVICES CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427103480,"RECTOR, JONATHAN, WAYNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427103480,"RECTOR, JONATHAN, WAYNE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1427104140,"VOSSERS, JOHN, THEODORE",JOHN THEODORE VOSSERS III,1616 MEMORIAL DR   BURLINGTON NC,001,Alamance,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1427104140,"VOSSERS, JOHN, THEODORE",1616 MEMORIAL DR   BURLINGTON NC,001,Alamance,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 284 ," 1,679 "," 1,773 "," $218,770.28 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427105980,"WALLER, JOHN, LAWRENCE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1427109594,"LANE, DON, GILBERT",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154336642,LANE AND ASSOCIATES I DDS PA,LANE AND ASSOCIATES I DDS PA,1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1427109594,"LANE, DON, GILBERT",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1427110378,"DODD, RICHARD, CRAIG",750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 27 , 27 ,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1427110378,"DODD, RICHARD, CRAIG",1188 SKYLAND DR   SYLVA NC,050,Jackson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 54 , 113 , 143 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427111293,"LAWSON, JENNIFER, MAH",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 23 , 35 ,$#,,
MEDICAID DIRECT,1427114412,SOUTHERN ASSISTED LIVING INC,BROOKDALE LENOIR,1145 POWELL RD   LENOIR NC,014,Caldwell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427114412,SOUTHERN ASSISTED LIVING INC,1145 POWELL RD   LENOIR NC,014,Caldwell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 17 ," 4,593 "," 4,593 "," $281,785.47 ",,
MEDICAID DIRECT,1942775390,ROBERTS & ASSOCIATES-GREENSBORO PLL,TRIAD ORTHODONTICS,5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427115146,"HUNSAKER, STEPHEN, DELON",5085 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427115823,"BERMUDEZ, DUSTIN, MIGUEL",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 54 , 83 , 85 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427115823,"BERMUDEZ, DUSTIN, MIGUEL",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427116383,HOME LIFE CARE INC,~,2117 S GLENBURNIE RD STE 8 NEW BERN NC,025,Craven,253Z00000X,Agencies,In Home Supportive Care,,1427116383,HOME LIFE CARE INC,2117 S GLENBURNIE RD STE 8 NEW BERN NC,025,Craven,253Z00000X,Agencies,In Home Supportive Care,, 106 ," 20,547 "," 20,701 "," $2,158,634.52 ",,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427119189,"HOWARD JR, ROBERT, GEORGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 45 , 77 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427119189,"HOWARD JR, ROBERT, GEORGE",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 48 , 70 , 122 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427119189,"HOWARD JR, ROBERT, GEORGE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 33 , 38 , 59 ," $21,690.72 ",,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427119189,"HOWARD JR, ROBERT, GEORGE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427119189,"HOWARD JR, ROBERT, GEORGE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 20 , 33 ,$#,,
MEDICAID DIRECT,1427122415,UNITED HOME CARE INC,,313 S MADISON BLVD   ROXBORO NC,073,Person,253Z00000X,Agencies,In Home Supportive Care,,1427122415,UNITED HOME CARE INC,313 S MADISON BLVD   ROXBORO NC,073,Person,253Z00000X,Agencies,In Home Supportive Care,, 61 ," 11,758 "," 12,256 "," $1,184,177.32 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427125947,"KEEVER, DANIELLE, SURRELLS",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 24 , 52 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427125947,"KEEVER, DANIELLE, SURRELLS",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972274447,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH TWIN CITY PEDIATRICS,2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427125947,"KEEVER, DANIELLE, SURRELLS",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427125947,"KEEVER, DANIELLE, SURRELLS",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427127067,"SARTI, MARC",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427127653,"BARBER, AMANDA, CORINE",9021 BELLA VERDE CT ADMINISTRATION OFFICE MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427128768,"SEEMANN, TINA, MARIE",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427128768,"SEEMANN, TINA, MARIE",300 BETHESDA DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 408 , 487 , 564 ," $11,478.47 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427130152,"HYSLOP, WILLIAM, BRIAN",1225 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1427131424,TACTILE SYSTEMS TECHNOLOGY INC,TACTILE MEDICAL,3701 WAYZATA BLVD STE 300 MINNEAPOLIS MN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427131424,TACTILE SYSTEMS TECHNOLOGY INC,3701 WAYZATA BLVD STE 300 MINNEAPOLIS MN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 145 , 273 , 429 ," $79,367.31 ",,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1427131796,"GAWLAS, DOROTA",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1427131804,GUYS FAMILY PHARMACY,~,817 RANDOLPH ST   THOMASVILLE NC,029,Davidson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427131804,GUYS FAMILY PHARMACY,817 RANDOLPH ST   THOMASVILLE NC,029,Davidson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 11 , 65 , 79 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1427132166,"GORDON-ESCOBAR, KATHRYN, ROSE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427132166,"GORDON-ESCOBAR, KATHRYN, ROSE",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427132166,"GORDON-ESCOBAR, KATHRYN, ROSE",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427133974,"PETTIS, PAMELA, COBB",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 39 , 46 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427135219,"MEINHARDT, STEPHEN, MARK",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427135219,"MEINHARDT, STEPHEN, MARK",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427135391,"BIRCH, MICHELE, NOELE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427135391,"BIRCH, MICHELE, NOELE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427135391,"BIRCH, MICHELE, NOELE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427135391,"BIRCH, MICHELE, NOELE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427135938,"TROIANI, LUIGI",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427136845,NC ORTHOTICS AND PROSTHETICS,NC ORTHOTICS AND PROSTHETICS,451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427136845,NC ORTHOTICS AND PROSTHETICS,451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 46 , 49 , 262 ," $36,115.99 ",,
MEDICAID DIRECT,1427138288,"CATLETT JR, JOSEPH, NEWTON",JOSEPH N CATLETT JR DDS,2500 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1427138288,"CATLETT JR, JOSEPH, NEWTON",2500 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 54 , 104 , 341 ," $12,884.02 ",,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,002 BRAUER HL CB# 7450 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,002 BRAUER HL CB# 7450 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,, 42 , 39 , 40 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1427141142,"ROSADO, EDDIE, ALBERTO",2002 S GLENBURNIE RD STE 100 NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427142066,"EDMISTON, BRYAN",OM SPA CHIROPRACTIC AND WELLNESS,523 FENTON PL   CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,1427142066,"EDMISTON, BRYAN",523 FENTON PL   CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1427142561,CAROLINA REHABILITATION INC,CAROLINA REHABILITATION INC,20 MEDICAL CAMPUS DR NW STE 204 SUPPLY NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427142561,CAROLINA REHABILITATION INC,20 MEDICAL CAMPUS DR NW STE 204 SUPPLY NC,010,Brunswick,193200000X,Group,Multi-Specialty,, 19 , 190 , 370 ,$#,,
MEDICAID DIRECT,1427143395,"ROSE, REBECCA, JEAN BOLLING",Rebecca Jean Bolling Rose,55 IRELAND RD   BAYBORO NC,069,Pamlico,1223G0001X,Dental Providers,Dentist,General Practice,1427143395,"ROSE, REBECCA, JEAN BOLLING",55 IRELAND RD   BAYBORO NC,069,Pamlico,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538401161,ALAMANCE INTERNAL & NUCLEAR MEDICIN,~,2961 CROUSE LN STE A BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427144104,"JADALI, FAYEGH",2961 CROUSE LN STE A BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427144450,"BESHAH, LEALEM, TILAHUN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427144450,"BESHAH, LEALEM, TILAHUN",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 113 , 115 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427144450,"BESHAH, LEALEM, TILAHUN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 152 , 174 , 218 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 52 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 145 , 163 , 214 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427144500,"MILLER, CHAD, MICHAEL",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 57 , 66 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427146117,"GEBREMEDHIN, MULUGETA",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427146117,"GEBREMEDHIN, MULUGETA",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427146158,"MISRA, DIPIKA",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 17 , 25 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427146158,"MISRA, DIPIKA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427146158,"MISRA, DIPIKA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427146158,"MISRA, DIPIKA",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 31 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427146687,"BLATT, JULIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427146877,"MUNOZ, MARIA, CRISTINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 104 , 115 , 124 ," $30,323.43 ",,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1427147354,"JOH, HUNTER, CROOM",123 BRYAN ST   KENANSVILLE NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice, 41 , 41 , 840 ," $71,945.48 ",,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,123 BRYAN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1427147354,"JOH, HUNTER, CROOM",123 BRYAN ST   KENANSVILLE NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice," 4,463 "," 6,157 "," 26,024 "," $1,404,862.57 ",,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1427147354,"JOH, HUNTER, CROOM",401 N MAIN ST   KENANSVILLE NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 139 ,$#,,
MEDICAID DIRECT,1427151281,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03594,2607 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1427151281,NORTH CAROLINA CVS PHARMACY LLC,2607 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1427151281,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03594,2607 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1427151281,NORTH CAROLINA CVS PHARMACY LLC,2607 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1427151299,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03896,9308 KENDALL DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427151299,NORTH CAROLINA CVS PHARMACY LLC,9308 KENDALL DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 74 , 80 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",100 AIRPORT RD   KINSTON NC,054,Lenoir,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 37 , 38 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 26 , 36 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427151737,"MINIOR, DANIEL, CHRISTIAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427151851,"ROSENBERG, DANIEL, LARSON",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 30 , 35 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,309 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427151851,"ROSENBERG, DANIEL, LARSON",309 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 79 , 100 ,$#,,
MEDICAID DIRECT,1083642169,COTSWOLD FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE COTSWOLD FAMILY MEDICIN,309 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427151851,"ROSENBERG, DANIEL, LARSON",309 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 91 , 167 , 231 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427154962,"FISHER, MICHAEL, JOHN",4551 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083336564,G ABRAMS & R COHEN XXIV PC,FRANKLIN SQUARE ORTHODONTICS & PEDIATRIC DENTISTRY,2930 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1427156306,"HULL, JAMES, CARTER",415 E WOODLAWN RD   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 273 ," 1,403 "," 1,561 "," $227,523.20 ",,
MEDICAID DIRECT,1295258648,G ABRAMS & R COHEN XIX PC,,8620 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427156306,"HULL, JAMES, CARTER",415 E WOODLAWN RD   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427158104,"POLK, MARY, OLIVIA",415 N CENTER ST STE 102 HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427158104,"POLK, MARY, OLIVIA",915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 123 , 215 , 306 ,$#,,
MEDICAID DIRECT,1427159219,SELECT CARE INC,SELECT CARE INC,4750 COMMONS DR   DENVER NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427159219,SELECT CARE INC,4750 COMMONS DR   DENVER NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 264 , 337 , 597 ," $19,462.42 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1427160068,"SCHMOKE, RAYMOND, EDWARD FRANK",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 286 , 290 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1427160068,"SCHMOKE, RAYMOND, EDWARD FRANK",1839 ONSLOW DR   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 71 , 71 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1427160068,"SCHMOKE, RAYMOND, EDWARD FRANK",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1427160068,"SCHMOKE, RAYMOND, EDWARD FRANK",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 388 , 390 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1427160068,"SCHMOKE, RAYMOND, EDWARD FRANK",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 170 , 173 ,$#,,
MEDICAID DIRECT,1427161074,"PORTER, WADEANA, NICOLE",PROGRESSIVE SPEECH THERAPY,120 BEGONIA TRL   HOLLY SPRINGS NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1427161074,"PORTER, WADEANA, NICOLE",120 BEGONIA TRL   HOLLY SPRINGS NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 12 , 378 , 379 ," $26,141.06 ",,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427161538,"TOLAN, DANIEL, LEE",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 27 , 51 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,295 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",295 W 27TH ST   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 59 , 98 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1427161579,"WILLIAMS, TAWANDA, BOWDEN",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1427161579,"WILLIAMS, TAWANDA, BOWDEN",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 108 , 115 , 208 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427161876,"LOWMAN, CHERIE, ELLIOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427161876,"LOWMAN, CHERIE, ELLIOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427161876,"LOWMAN, CHERIE, ELLIOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1427162163,"RYAN, BRADLEY, CURTIS",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 247 , 272 , 920 ," $34,745.43 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427162163,"RYAN, BRADLEY, CURTIS",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427162163,"RYAN, BRADLEY, CURTIS",2029 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427162163,"RYAN, BRADLEY, CURTIS",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 20 , 66 ,$#,,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427162163,"RYAN, BRADLEY, CURTIS",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427162163,"RYAN, BRADLEY, CURTIS",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 193 , 230 , 710 ," $26,844.78 ",,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1427162163,"RYAN, BRADLEY, CURTIS",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427162270,"DISTEFANO, JENNIFER, ROCHELLE",420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 82 , 149 , 225 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427162320,"SWEENEY, JOHN, THOMAS",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427162320,"SWEENEY, JOHN, THOMAS",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427162320,"SWEENEY, JOHN, THOMAS",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 19 , 22 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427162320,"SWEENEY, JOHN, THOMAS",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427162320,"SWEENEY, JOHN, THOMAS",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 34 , 36 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427162320,"SWEENEY, JOHN, THOMAS",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427162320,"SWEENEY, JOHN, THOMAS",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1427162700,"WINKLER, THELMA, SUSAN",233 DOCTORS ST   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 135 , 165 ,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,110 DUTCHMAN CT   ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427162700,"WINKLER, THELMA, SUSAN",110 DUTCHMAN CT   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427164904,"BLACK II, HUGH, RATCHFORD",10310 MALLARD CREEK RD STE 101A CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 30 , 33 , 57 ,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427164904,"BLACK II, HUGH, RATCHFORD",10310 MALLARD CREEK RD STE 101A CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 22 , 27 , 37 ,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427164904,"BLACK II, HUGH, RATCHFORD",8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 22 , 31 , 40 ,$#,,
MEDICAID DIRECT,1013093038,ASTHMA AND ALLERGY SPECIALIST PA,ASTHMA & ALLERGY SPECIALISTS PA,8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427164904,"BLACK II, HUGH, RATCHFORD",8045 PROVIDENCE RD STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427167303,"UDEKWU, PASCAL, OSITA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 20 , 21 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427167303,"UDEKWU, PASCAL, OSITA",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427167303,"UDEKWU, PASCAL, OSITA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427167303,"UDEKWU, PASCAL, OSITA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 50 , 113 , 118 ," $14,285.98 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,,,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 17 , 17 , 17 ," $14,804.64 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 2,296 "," 3,756 "," 5,744 "," $612,210.21 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 21 , 76 , 97 ," $14,505.57 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",130 HARBOUR PLACE DR STE 180 DAVIDSON NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1104597350,BURROW WELCHEL CULP MOORE PLLC KANN,~,1843 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",1843 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 23 , 23 , 55 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427169101,"BURROW, SAMUEL, JACK",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 78 , 118 , 223 ," $22,476.89 ",,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427170554,"KALE, GAUTAM, KISHORE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 69 , 158 , 158 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427173186,"TRAKAS, ERIN, VANDALE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427173186,"TRAKAS, ERIN, VANDALE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 31 , 43 ,$#,,
MEDICAID DIRECT,1427174374,"CLARK, SONYA",DR SONYA M CLARK P C,1650 SKYLYN DR STE 380 SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,1427174374,"CLARK, SONYA",1650 SKYLYN DR STE 380 SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427178540,EVERGREEN LIVING HOME INC,EVERGREEN LIVING HOME 11,351 FAMILY RIDGE RD   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427178540,EVERGREEN LIVING HOME INC,351 FAMILY RIDGE RD   LEICESTER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 428 , 428 ," $40,642.27 ",,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427179084,"YOUNGINER, MARY, CAROL",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427179084,"YOUNGINER, MARY, CAROL",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427179084,"YOUNGINER, MARY, CAROL",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427179084,"YOUNGINER, MARY, CAROL",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1427179084,"YOUNGINER, MARY, CAROL",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1427179084,"YOUNGINER, MARY, CAROL",401 IRVING PKWY STE 130 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427179951,"HWANG, EDWARD, CHAUCER",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376983213,THANE C HISAW DMD PA,,504 E CORNWALLIS DR STE J GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427180801,"HISAW, THANE, CURTIS",504 E CORNWALLIS DR STE J GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,700 "," 3,464 "," 11,882 "," $427,242.78 ",,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,10211 ALM ST STE 1100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427181502,"BAE, MICHELLE, HOWARD",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427183979,TOUCHED BY ANGELS HOME HEALTH,TOUCHED BY ANGELS,16 OAK GROVE ST   MOUNT HOLLY NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1427183979,TOUCHED BY ANGELS HOME HEALTH,16 OAK GROVE ST   MOUNT HOLLY NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,125 "," 1,125 "," $77,170.08 ",,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1427185263,"BORTNICK, PATRICIA, COLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427185263,"BORTNICK, PATRICIA, COLE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427186022,"MANOS, HEATHER, MICHELLE",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427186022,"MANOS, HEATHER, MICHELLE",10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427186022,"MANOS, HEATHER, MICHELLE",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427186022,"MANOS, HEATHER, MICHELLE",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427186022,"MANOS, HEATHER, MICHELLE",10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,9835 MONROE RD STE B CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427186022,"MANOS, HEATHER, MICHELLE",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427186022,"MANOS, HEATHER, MICHELLE",6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1427187004,"MULL, COURTNEY, DAWN",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1427187004,"MULL, COURTNEY, DAWN",472 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 232 , 328 , 507 ," $19,987.89 ",,
MEDICAID DIRECT,1427187525,DUKE UNIVERSITY HEALTH SYSTEM INC,~,,,Unknown,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1427187525,DUKE UNIVERSITY HEALTH SYSTEM INC,4321 MEDICAL PARK DR STE 101 DURHAM NC,032,Durham,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 47 , 87 , 192 ," $37,643.97 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427191295,"MOUNSEY, ANNE, LEATHES",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 31 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427191295,"MOUNSEY, ANNE, LEATHES",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1427191295,"MOUNSEY, ANNE, LEATHES",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427191295,"MOUNSEY, ANNE, LEATHES",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 41 , 74 ,$#,,
MEDICAID DIRECT,1427193713,RHA HEALTH SERVICES NC LLC,,3738 HOWELL DAY CARE RD   LA GRANGE NC,054,Lenoir,251B00000X,Agencies,Case Management,,1427193713,RHA HEALTH SERVICES NC LLC,3738 HOWELL DAY CARE RD   LA GRANGE NC,054,Lenoir,251B00000X,Agencies,Case Management,," 1,832 "," 20,148 "," 20,179 "," $9,238,394.31 ",,
MEDICAID DIRECT,1427194323,HANDI CARE INC,~,304 SOUTH MAIN STREET   DREXEL NC,012,Burke,253Z00000X,Agencies,In Home Supportive Care,,1427194323,HANDI CARE INC,304 SOUTH MAIN STREET   DREXEL NC,012,Burke,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,126 "," 1,126 "," $186,262.04 ",,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427194349,"EGERTON, KATHRYN, POPE",1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,2001 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427194349,"EGERTON, KATHRYN, POPE",2001 N CHURCH ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 18 , 19 , 27 ,$#,,
MEDICAID DIRECT,1427194570,BRIDGE STREET PHARMACY INC,,817 N BRIDGE ST   ELKIN NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427194570,BRIDGE STREET PHARMACY INC,817 N BRIDGE ST   ELKIN NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,314 BLOWING ROCK BLVD STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1427195049,"MASSEY-MCMAHAN, JENNY, MARIE",157 PARAGON PKWY STE 800 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427195049,"MASSEY-MCMAHAN, JENNY, MARIE",157 PARAGON PKWY STE 800 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427195049,"MASSEY-MCMAHAN, JENNY, MARIE",157 PARAGON PKWY STE 800 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427195049,"MASSEY-MCMAHAN, JENNY, MARIE",157 PARAGON PKWY STE 800 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427195213,BARNES FAMILY CARE,~,1008 CORBETT AVE NE   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427195213,BARNES FAMILY CARE,1008 CORBETT AVE NE   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 179 , 179 ," $11,279.60 ",,
MEDICAID DIRECT,1427196906,PEDIATRIC PLAY THERAPY,PEDIATRIC PLAY THERAPY,1709 TOMMYS RD   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,,1427196906,PEDIATRIC PLAY THERAPY,1709 TOMMYS RD   GOLDSBORO NC,096,Wayne,251S00000X,Agencies,Community/Behavioral Health,, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1427196906,PEDIATRIC PLAY THERAPY,PEDIATRIC PLAY THERAPY,1709 TOMMYS RD   GOLDSBORO NC,096,Wayne,252Y00000X,Agencies,Early Intervention Provider Agency,,1427196906,PEDIATRIC PLAY THERAPY,1709 TOMMYS RD   GOLDSBORO NC,096,Wayne,252Y00000X,Agencies,Early Intervention Provider Agency,, 26 , 475 , 475 ," $30,590.88 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427198985,"CAPPS, TERRI, CAMERON",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427204114,"DUNN, AMY, LUDWICK",521C MOYE BLVD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1427205939,"ANAND-NICHOLS, SONIA",9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427208297,"LINKER, KRISTIN, HILL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 43 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427210392,"MOEHRING, REBEKAH, WHITE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427210392,"MOEHRING, REBEKAH, WHITE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 26 , 45 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427210392,"MOEHRING, REBEKAH, WHITE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 27 , 40 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427211762,"NAYAK, DEEPA",2205 OAK RIDGE RD STE AA-BB OAK RIDGE NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 42 , 103 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427211762,"NAYAK, DEEPA",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427212778,"BEACHKOFSKY, JOEL, DANIEL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427212778,"BEACHKOFSKY, JOEL, DANIEL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427213149,"PRASAD, APSARA, JOSHI",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 43 , 50 , 58 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427213149,"PRASAD, APSARA, JOSHI",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 43 , 52 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427215920,"BROUGH, DAVID, THOMAS",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427215920,"BROUGH, DAVID, THOMAS",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427215920,"BROUGH, DAVID, THOMAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427215920,"BROUGH, DAVID, THOMAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427217439,"HATARA, MARIA, CRISTINA",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427217439,"HATARA, MARIA, CRISTINA",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 34 , 35 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427217439,"HATARA, MARIA, CRISTINA",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427217439,"HATARA, MARIA, CRISTINA",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427217595,"BLACKER, MELANIE, JANE",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 42 , 42 ,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427217652,"MUELLER, AMANDA, ELIZABETH",500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 33 , 33 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 27 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 56 , 72 , 90 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 126 , 179 , 284 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 51 , 56 , 67 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",3604 PETERS CT   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 31 , 48 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427218122,"MENON, RADHA, VANKAWALA",3610 PETERS CT   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427219807,"PARK, HENRY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427219831,"WILLIS, ANNE, LINN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427219831,"WILLIS, ANNE, LINN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427222454,"LACK, CHRISTOPHER, MARCUS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427222454,"LACK, CHRISTOPHER, MARCUS",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427222454,"LACK, CHRISTOPHER, MARCUS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 229 , 251 , 394 ," $15,092.23 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427222454,"LACK, CHRISTOPHER, MARCUS",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427222454,"LACK, CHRISTOPHER, MARCUS",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427222454,"LACK, CHRISTOPHER, MARCUS",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427222819,"BARRY, DAVID",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427222819,"BARRY, DAVID",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427222819,"BARRY, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427222819,"BARRY, DAVID",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427222819,"BARRY, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427222819,"BARRY, DAVID",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427222819,"BARRY, DAVID",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 37 , 47 , 50 ,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225317,"THATIGOTLA, BALA GANGADHARA, REDDY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225317,"THATIGOTLA, BALA GANGADHARA, REDDY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225317,"THATIGOTLA, BALA GANGADHARA, REDDY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225317,"THATIGOTLA, BALA GANGADHARA, REDDY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1013571587,WAKEMED SPECIALISTS GROUP LLC,WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225317,"THATIGOTLA, BALA GANGADHARA, REDDY",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 19 , 19 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225648,"ECONOMEDES, DEMETRI, MANUEL",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225648,"ECONOMEDES, DEMETRI, MANUEL",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 36 , 52 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225648,"ECONOMEDES, DEMETRI, MANUEL",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 31 , 38 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225648,"ECONOMEDES, DEMETRI, MANUEL",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 14 , 20 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 300 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1427225648,"ECONOMEDES, DEMETRI, MANUEL",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427227602,"QUEZADA, GERARDO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 32 , 43 , 43 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427230291,"BRAQUET, RAY, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 18 , 24 ,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427233733,"CHENG, LAY HAR",100 MEDICAL PARK DRIVE SUITE 310E CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 60 , 82 ,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427233733,"CHENG, LAY HAR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427233733,"CHENG, LAY HAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1427238153,"RAYNOR, MATHEW, CAMERON",701 DOCTORS DR STE L KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1427238153,"RAYNOR, MATHEW, CAMERON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 17 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427238153,"RAYNOR, MATHEW, CAMERON",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427238153,"RAYNOR, MATHEW, CAMERON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 45 , 62 , 79 ,$#,,
MEDICAID DIRECT,1740225929,DUKE UNIVERSITY AFFILIATED PHYSICIA,,2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427238658,"MURPHY, KATHLEEN, TULLY",2609 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 32 , 92 ,$#,,
MEDICAID DIRECT,1689944514,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES PINEHURST,7 REGIONAL CIR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1427238831,"HARRIS, WILLIAM, LAWRENCE",6322 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1164784948,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES REID HEART CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1427238831,"HARRIS, WILLIAM, LAWRENCE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1629327895,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES LAURINGBURG,705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1427238831,"HARRIS, WILLIAM, LAWRENCE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1689944514,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES PINEHURST,7 REGIONAL CIR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1427238831,"HARRIS, WILLIAM, LAWRENCE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 73 , 83 , 128 ,$#,,
MEDICAID DIRECT,1689944514,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES PINEHURST,7 REGIONAL CIR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1427238831,"HARRIS, WILLIAM, LAWRENCE",7 REGIONAL CIR   PINEHURST NC,063,Moore,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 66 , 95 , 125 ,$#,,
MEDICAID DIRECT,1629327895,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES LAURINGBURG,705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1427238831,"HARRIS, WILLIAM, LAWRENCE",705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 13 , 17 , 29 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1427238831,"HARRIS, WILLIAM, LAWRENCE",705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427240290,"COOK, HEATHER, LYNN",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568425262,BLUE RIDGE PATHOLOGY ASSOCIATES,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1427240613,"BURESH, ROBERT, C.",2201 S STERLING ST   MORGANTON NC,012,Burke,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 84 , 84 , 104 ,$#,,
MEDICAID DIRECT,1568425262,BLUE RIDGE PATHOLOGY ASSOCIATES,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1427240613,"BURESH, ROBERT, C.",720 MALCOLM BLVD   VALDESE NC,012,Burke,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1427240753,BAPTIST CHILDRENS HOME OF NC INC,LINDSAY HOME,394 CAMP JOY RD   ZIONVILLE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427240753,BAPTIST CHILDRENS HOME OF NC INC,394 CAMP JOY RD   ZIONVILLE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 306 , 306 ," $19,529.35 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427241629,"YAVERBAUM, LINDA, BETH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 13 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427241629,"YAVERBAUM, LINDA, BETH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427243740,"BURNS, STACY, JO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427243740,"BURNS, STACY, JO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 98 , 226 ,$#,,
MEDICAID DIRECT,1710940887,DERMATOLOGY CENTER OF SHELBY,DERMATOLOGY CENTER OF SHELBY PA,935 WYKE RD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1427244862,"URASH, JOSEPH, JOHN",935 WYKE RD   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 144 , 247 , 399 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427246867,"DIVARIS, KIMON",101 MANNING DR UNC HOSPTIALS DENTAL CLINIC CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 25 , 25 , 291 ," $18,895.69 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427246867,"DIVARIS, KIMON",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 231 , 242 , 591 ," $20,320.02 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427246867,"DIVARIS, KIMON",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 51 , 61 , 501 ," $40,724.23 ",,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427249697,"HOPPER, KELLY, S.",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427249697,"HOPPER, KELLY, S.",12019 VERHOEFF DR   HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427251123,"ZAMORA, EZEQUIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427251123,"ZAMORA, EZEQUIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427251123,"ZAMORA, EZEQUIEL",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427251123,"ZAMORA, EZEQUIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1134172604,WESTERN PIEDMONT ANESTHESIA,WESTERN PIEDMONT ANESTHESIA,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1427251297,"TUNNELL, DAVID, JOSHUA",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 63 , 64 , 72 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427251297,"TUNNELL, DAVID, JOSHUA",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 46 , 49 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427251297,"TUNNELL, DAVID, JOSHUA",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427251826,"MANDGE, VISHAL, ARUNBHAI",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology, 24 , 39 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427251826,"MANDGE, VISHAL, ARUNBHAI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology, 60 , 85 , 121 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427251826,"MANDGE, VISHAL, ARUNBHAI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427251826,"MANDGE, VISHAL, ARUNBHAI",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1427254986,"MCMINN, KATIE, LAWSON",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427254986,"MCMINN, KATIE, LAWSON",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457836413,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - CLAREMONT,3114 W MAIN ST   CLAREMONT NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427254986,"MCMINN, KATIE, LAWSON",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1427254986,"MCMINN, KATIE, LAWSON",270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1427254986,"MCMINN, KATIE, LAWSON",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427256098,"NARAYANRAO, VIJAYARAJAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 127 , 130 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427257377,"ALLEN, HANNAH, ELIZABETH",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427257377,"ALLEN, HANNAH, ELIZABETH",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 40 , 46 , 95 ,$#,,
MEDICAID DIRECT,1336564863,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CENTER FOR CHILDREN,301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427258060,"BROWN, KIRSTEN, RUTH",301 E WENDOVER AVE STE 400 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 12 , 35 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427258060,"BROWN, KIRSTEN, RUTH",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427262112,"GEBREGIORGIS, YARED, ASSEFA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 156 , 157 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427262831,"NEUWIRTH, CHARLES, ALAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427262831,"NEUWIRTH, CHARLES, ALAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 238 , 337 , 450 ," $19,978.80 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427263235,"LOUGHLIN, CEILA, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 60 , 147 , 157 ," $13,769.44 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427265446,"GEORGE, ALEX",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 22 , 49 , 49 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 76 , 71 , 75 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 45 , 52 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 47 , 52 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427265537,"PATEL, HETAL, PRAVIN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427266501,"FORSTER, MEGHAN, REBECCA",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427266501,"FORSTER, MEGHAN, REBECCA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427266501,"FORSTER, MEGHAN, REBECCA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427267509,"PARKHURST, JULIA, WALPOLE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427267509,"PARKHURST, JULIA, WALPOLE",15940 NORTHCROSS DR STE C HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427267509,"PARKHURST, JULIA, WALPOLE",311 WILLIAMSON RD STE 100 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427267509,"PARKHURST, JULIA, WALPOLE",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1427269547,"GADDAM, SHRAVAN, KUMAR",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427270032,"PATEL, SEJAL, SHASHIN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1427271261,"HALE, KATHRYN, AZELIA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427272392,"STEWART, ELEE, ELIJAH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1427272392,"STEWART, ELEE, ELIJAH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427272392,"STEWART, ELEE, ELIJAH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427272392,"STEWART, ELEE, ELIJAH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427272392,"STEWART, ELEE, ELIJAH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427272392,"STEWART, ELEE, ELIJAH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427272392,"STEWART, ELEE, ELIJAH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1427273598,CDX DIAGNOSTICS INC,,2 EXECUTIVE BLVD STE 102 SUFFERN NY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1427273598,CDX DIAGNOSTICS INC,2 EXECUTIVE BLVD STE 102 SUFFERN NY,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 49 , 50 , 286 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427273952,"PATEL, SACHIN, BHUPENDRA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427275817,"JU, JUSTINA, YEEHUA",441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1427276385,"SITOUAH, MAHDI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427276385,"SITOUAH, MAHDI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 69 , 70 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427278696,"GADDE, SUMANA",845 CHURCH ST N STE 203 CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427278696,"GADDE, SUMANA",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,101 RIVERSTONE VIS STE 102 BLUE RIDGE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427278720,"JONES, JENNIFER, LEE",101 RIVERSTONE VIS STE 102 BLUE RIDGE GA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427281542,"SHAH, HAJRA, ZEHRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 43 , 79 , 130 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427281641,"MANSOUR, KHALED",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 18 , 28 , 40 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427281641,"MANSOUR, KHALED",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 33 , 46 , 83 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427281641,"MANSOUR, KHALED",131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 25 , 36 , 37 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427281641,"MANSOUR, KHALED",131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427282904,"SCOTT, LISA, CHOE",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 41 , 105 ,$#,,
MEDICAID DIRECT,1447599303,TAMMY I ARTIS DDS PA,~,706 SUMMIT AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427285840,"ARTIS, TAMMY, INGRAM",706 SUMMIT AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 64 , 132 , 341 ," $16,462.85 ",,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1427286293,"HOLLY, AARON, SCOTT",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 80 , 99 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427286293,"HOLLY, AARON, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1427286293,"HOLLY, AARON, SCOTT",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 27 , 33 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1427286293,"HOLLY, AARON, SCOTT",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427286574,"PERROTT, JAMES, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 35 , 39 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427286574,"PERROTT, JAMES, ROBERT",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 20 , 21 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427286574,"PERROTT, JAMES, ROBERT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427286574,"PERROTT, JAMES, ROBERT",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427286574,"PERROTT, JAMES, ROBERT",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427286574,"PERROTT, JAMES, ROBERT",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1427286749,"JOHNSTON, SARA, GAYNELL",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1427286749,"JOHNSTON, SARA, GAYNELL",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427286749,"JOHNSTON, SARA, GAYNELL",601 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1427287267,"GURRAM, ANANDA, REDDY",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1427287267,"GURRAM, ANANDA, REDDY",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 61 , 61 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1427287267,"GURRAM, ANANDA, REDDY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 46 , 147 , 147 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1427287267,"GURRAM, ANANDA, REDDY",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 53 , 53 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1427287267,"GURRAM, ANANDA, REDDY",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 172 , 219 , 332 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1427287267,"GURRAM, ANANDA, REDDY",526 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 68 , 450 , 450 ," $10,555.54 ",,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1427287267,"GURRAM, ANANDA, REDDY",290 H M CAGLE DR   CAMERON NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 147 , 147 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427287994,"OTALLAH, SCOTT, IRELAND",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry, 33 , 51 , 51 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1427288174,"IDEM, IFIOK, AKPAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 64 , 64 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427288174,"IDEM, IFIOK, AKPAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 48 , 48 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1427288174,"IDEM, IFIOK, AKPAN",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1427288174,"IDEM, IFIOK, AKPAN",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427290477,"WESTER, TRACY, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 67 , 73 ," $10,535.04 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1427291699,"THORP, BRIAN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 23 , 50 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427291699,"THORP, BRIAN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 21 , 35 , 68 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427298249,"MANALANG, NESSA",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427303254,"JOHNSON, ERIN, LYNN CRIST",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1427303254,"JOHNSON, ERIN, LYNN CRIST",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427303254,"JOHNSON, ERIN, LYNN CRIST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1427305325,"KELLEY, PAUL, EDWARD",110 PATRICK CT   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 152 , 264 , 478 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427307644,"COLAIANNI, CATHERINE, ALESSANDRA",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427307644,"COLAIANNI, CATHERINE, ALESSANDRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1427308196,"LANGFORD, JUDITH, RHODES",JUDITH LANGFORD,26 DRAKES MEADOW LN   ARDEN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1427308196,"LANGFORD, JUDITH, RHODES",26 DRAKES MEADOW LN   ARDEN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1427310234,"REICHARD, ELIZABETH, CHERRY",316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1790817963,CARY PEDIATRIC CENTER PA,~,1001 CRESCENT GRN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1427310234,"REICHARD, ELIZABETH, CHERRY",316 JUDD PLACE DR   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 45 , 125 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427310416,"MCKAY, JOHN, WESLEY",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427310416,"MCKAY, JOHN, WESLEY",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427310416,"MCKAY, JOHN, WESLEY",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427310416,"MCKAY, JOHN, WESLEY",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427310416,"MCKAY, JOHN, WESLEY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 55 , 92 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427310416,"MCKAY, JOHN, WESLEY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427310416,"MCKAY, JOHN, WESLEY",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 193 , 219 , 292 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427310416,"MCKAY, JOHN, WESLEY",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427310416,"MCKAY, JOHN, WESLEY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427310416,"MCKAY, JOHN, WESLEY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 52 , 64 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427311497,"DAVIDSON, ASHMA, SHALONDA",1711 DAVIE AVE   STATESVILLE NC,049,Iredell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 144 , 212 , 394 ," $10,618.25 ",,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427311794,"JORDANHAZY, RYAN, ALAN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 150 , 165 , 186 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427311794,"JORDANHAZY, RYAN, ALAN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 82 , 89 , 94 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427311794,"JORDANHAZY, RYAN, ALAN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427311794,"JORDANHAZY, RYAN, ALAN",FORSYTH EMERGENCY SERVICES 333 SILAS CRK WINSTON SALEM NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427311836,"VASHISHT, RISHIK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427313923,"KROFT, ALEX",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 29 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427313923,"KROFT, ALEX",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427313923,"KROFT, ALEX",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1427313923,"KROFT, ALEX",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427314384,HEAVEN SENT CAREGIVERS LLC,~,5741 N GRAHAM ST STE A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1427314384,HEAVEN SENT CAREGIVERS LLC,5741 N GRAHAM ST STE A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 6,179 "," 6,180 "," $420,603.16 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427315779,"GONZALEZ-SANZ, TRISTAN, EMIL",445 PINEVIEW DR STE 110 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427315779,"GONZALEZ-SANZ, TRISTAN, EMIL",3015 MAPLEWOOD AVE STE 205 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427315779,"GONZALEZ-SANZ, TRISTAN, EMIL",3015 MAPLEWOOD AVE STE 205 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427315779,"GONZALEZ-SANZ, TRISTAN, EMIL",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 18 , 22 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427315779,"GONZALEZ-SANZ, TRISTAN, EMIL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427316124,"COVIELLO, ELIZABETH, MICHELLE",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427316124,"COVIELLO, ELIZABETH, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1720612492,REX HOSPITAL INC,UNC REX MATERNAL FETAL MEDICINE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427316124,"COVIELLO, ELIZABETH, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427316124,"COVIELLO, ELIZABETH, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 17 , 20 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427316124,"COVIELLO, ELIZABETH, MICHELLE",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427316124,"COVIELLO, ELIZABETH, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427316900,"WOODS, RYAN, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 76 , 124 , 130 ,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427318146,"THROCKMORTON, ASHLEY, KRISTINE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 33 , 58 , 66 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427318476,"BOYCE, ROSS, MATHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427318476,"BOYCE, ROSS, MATHEW",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427318997,"MURPHY, SHANNON, LISA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 44 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427318997,"MURPHY, SHANNON, LISA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 39 , 100 , 103 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3325 GARDEN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427318997,"MURPHY, SHANNON, LISA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 30 , 48 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427318997,"MURPHY, SHANNON, LISA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 31 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427318997,"MURPHY, SHANNON, LISA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 74 , 85 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1427321918,"COWELL, JACQUELINE, MICHELE",1911 S 17TH ST STE 130A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 139 , 335 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427324961,"MCCRACKEN, EMILY, KATHRYN ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 40 , 63 , 77 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427331370,"MASSARO, MATTHEW, MICHAEL",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427331370,"MASSARO, MATTHEW, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427332311,"GRUNZ, RYAN, BARRETT",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 52 , 52 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427332311,"GRUNZ, RYAN, BARRETT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 85 , 85 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427332311,"GRUNZ, RYAN, BARRETT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427332675,"BARNHILL, KIOTTA, LATRISE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 96 , 139 , 141 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427335694,"BURROWS, EMILY, SUE",1998 HENDERSONVILLE RD STE 51 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 31 , 124 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427338607,"STERLING, CHARLESETTA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427340017,"RO, SARAH, JEAN",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427340017,"RO, SARAH, JEAN",2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 48 , 75 ,$#,,
MEDICAID DIRECT,1427342021,DEDICATED HOME SERVICES INC,INTERIM HEALTHCARE OF THE CAROLINAS,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,251J00000X,Agencies,Nursing Care,,1427342021,DEDICATED HOME SERVICES INC,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,385H00000X,Respite Care Facility,Respite Care,,#,,,$#,,
MEDICAID DIRECT,1427342021,DEDICATED HOME SERVICES INC,INTERIM HEALTHCARE OF THE CAROLINAS,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,385H00000X,Respite Care Facility,Respite Care,,1427342021,DEDICATED HOME SERVICES INC,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,385H00000X,Respite Care Facility,Respite Care,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1427342021,DEDICATED HOME SERVICES INC,INTERIM HEALTHCARE OF THE CAROLINAS,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,251J00000X,Agencies,Nursing Care,,1427342021,DEDICATED HOME SERVICES INC,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,251J00000X,Agencies,Nursing Care,, 12 , 953 , 968 ," $496,721.67 ",,
MEDICAID DIRECT,1427342021,DEDICATED HOME SERVICES INC,INTERIM HEALTHCARE OF THE CAROLINAS,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1427342021,DEDICATED HOME SERVICES INC,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,#, 766 , 766 ," $106,657.04 ",,
MEDICAID DIRECT,1427342021,DEDICATED HOME SERVICES INC,INTERIM HEALTHCARE OF THE CAROLINAS,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,251J00000X,Agencies,Nursing Care,,1427342021,DEDICATED HOME SERVICES INC,425 E STATESVILLE AVE STE 101 MOORESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427343524,"KUMAR, NIKHIL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427343524,"KUMAR, NIKHIL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427343524,"KUMAR, NIKHIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427343524,"KUMAR, NIKHIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 29 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427343524,"KUMAR, NIKHIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 29 , 45 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427343524,"KUMAR, NIKHIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427343524,"KUMAR, NIKHIL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427343730,"SHEATSLEY, JARROD, THOMAS",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427343730,"SHEATSLEY, JARROD, THOMAS",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 101 , 236 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1427344357,"MVULA, OSCAR, NZITA",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 21 , 21 , 72 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1427344977,"BOGART, ROSARIO, WALTER",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427345123,"CARR, MICHAELEENA, MARIE",129 N WASHINGTON ST   SUMTER SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1427345537,"BRITT, ROBERT, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 43 , 45 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427345537,"BRITT, ROBERT, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427345537,"BRITT, ROBERT, ALEXANDER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1427345537,"BRITT, ROBERT, ALEXANDER",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427345537,"BRITT, ROBERT, ALEXANDER",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1427345537,"BRITT, ROBERT, ALEXANDER",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 42 , 45 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1427345537,"BRITT, ROBERT, ALEXANDER",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427346667,"JONES, KRISTEN, LEE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427346667,"JONES, KRISTEN, LEE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427346667,"JONES, KRISTEN, LEE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 50 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427346667,"JONES, KRISTEN, LEE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2021 CREEKSIDE LANDING DR STE 110 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1427346667,"JONES, KRISTEN, LEE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932125564,GROAT EYECARE ASSOCS PA,GROAT EYECARE ASSOCIATES PA,1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427347228,"GROAT, CHRISTOPHER, LANIER",1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1932125564,GROAT EYECARE ASSOCS PA,GROAT EYECARE ASSOCIATES PA,1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427347228,"GROAT, CHRISTOPHER, LANIER",1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 238 , 382 , 626 ," $11,390.85 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427348101,"BRISSON, PAMELA, BOWDEN",162 LEGACY OAKS DR STE 2102 KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 20 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427349554,"AMIN, MANSI, D",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427349554,"AMIN, MANSI, D",2301 ERWIN RD   DURHAM NC,032,Durham,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology, 28 , 100 , 101 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427349984,"GALLAGHER, JOEL, LOUIS",104 E NORTHWOOD ST   GREENSBORO NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1427349984,"GALLAGHER, JOEL, LOUIS",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 11 , 50 , 59 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427349984,"GALLAGHER, JOEL, LOUIS",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 116 , 340 , 465 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427354075,"GHANI, SOFIA",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427354075,"GHANI, SOFIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,210 ASHVILLE AVE STE 440 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427354075,"GHANI, SOFIA",210 ASHVILLE AVE STE 440 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427354075,"GHANI, SOFIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1356305841,CAROLINA ONCOLOGY SPECIALISTS PA,~,2406 CENTURY PL SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427355452,"HANNA, LOUAY",2406 CENTURY PLACE SE   HICKORY NC,011,Buncombe,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 158 , 432 , 917 ," $11,986.64 ",,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427357805,"HOILAND, STACEY, NICOLE",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 23 , 32 ,$#,,
MEDICAID DIRECT,1427359256,LINCARE INC,~,25 UNION SCHOOL RD NW   SHALLOTTE NC,010,Brunswick,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1427359256,LINCARE INC,25 UNION SCHOOL RD NW   SHALLOTTE NC,010,Brunswick,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 128 , 671 ," 1,148 "," $34,995.10 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427360627,"KIELL, ELEANOR, PITZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427360627,"KIELL, ELEANOR, PITZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 120 , 225 , 261 ," $18,025.76 ",,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427360783,"ADAM, LINDSAY, ELISE",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 31 , 40 ,$#,,
MEDICAID DIRECT,1427361286,MEDISOLUTIONS INC,~,1146 N CHURCH ST   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1427361286,MEDISOLUTIONS INC,1146 N CHURCH ST   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 5,998 "," 6,134 "," $801,427.32 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427362367,"JOLLY, MELISSA, STEVENS",925 THOMAS ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,925 THOMAS ST STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427362367,"JOLLY, MELISSA, STEVENS",925 THOMAS ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427362367,"JOLLY, MELISSA, STEVENS",925 THOMAS ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427364967,"SALGUERO, DONALD, DAVID",23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427364967,"SALGUERO, DONALD, DAVID",23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 INGLESIDE PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",11001 INGLESIDE PL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 36 , 103 , 104 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,601 FAYETTEVILLE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427365501,"PUNJ, SHWETA",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427366848,"DE LA CRUZ, TANYA, LISETTE",170 MEDICAL PARK RD STE 103 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427366848,"DE LA CRUZ, TANYA, LISETTE",9930 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 23 , 49 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1427368232,"PARKER, CLAYTEN, LEE",615B S MEMORIAL DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ," $19,360.19 ",,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427368232,"PARKER, CLAYTEN, LEE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 116 , 122 , 148 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427369537,"DOSTER MCINTYRE, JAMIE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427369701,"ZEDOM, WANSI, BERNADETTE",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427369701,"ZEDOM, WANSI, BERNADETTE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 33 , 118 , 119 ,$#,,
MEDICAID DIRECT,1902869530,CARY SKIN CENTER PA,~,200 WELLESLEY TRADE LN   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1427370352,"INGRAFFEA, ADAM, ANTHONY",200 WELLESLEY TRADE LN   CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1427372499,"NEY, MARSHALL, JAMES",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427372499,"NEY, MARSHALL, JAMES",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427372499,"NEY, MARSHALL, JAMES",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 15 , 24 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427372499,"NEY, MARSHALL, JAMES",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 34 , 39 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427372499,"NEY, MARSHALL, JAMES",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427372499,"NEY, MARSHALL, JAMES",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1427372499,"NEY, MARSHALL, JAMES",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 21 , 27 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427372499,"NEY, MARSHALL, JAMES",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 26 , 44 , 53 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427372499,"NEY, MARSHALL, JAMES",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427372770,"OREGAN, JANATHEA, MARIE",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427372770,"OREGAN, JANATHEA, MARIE",10207 CERNY ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427372770,"OREGAN, JANATHEA, MARIE",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427372770,"OREGAN, JANATHEA, MARIE",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427373497,"RAYAMAJHI, UBHA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427374339,"PENDYAL, AKSHAY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 15 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427374339,"PENDYAL, AKSHAY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 28 , 63 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427374339,"PENDYAL, AKSHAY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427374339,"PENDYAL, AKSHAY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427374339,"PENDYAL, AKSHAY",1401 MATTHEWS TOWNSHIP PKWY STE 212 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427374339,"PENDYAL, AKSHAY",1401 MATTHEWS TOWNSHIP PKWY STE 212 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 30 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427374339,"PENDYAL, AKSHAY",1401 MATTHEWS TOWNSHIP PKWY STE 212 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427374396,"CAMPBELL, BRITTNEY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 26 , 26 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427375930,"WEBSTER, ALLISON, BESSON",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 94 , 95 , 97 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427377613,"RAY, HOLLIS, MOYE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 64 , 77 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427378827,"HESLEP, MALLORY, GWEN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427378827,"HESLEP, MALLORY, GWEN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427378876,"SOLANKI, ANJALI",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053400853,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1427378975,"WALKER, DAVID, GLENN",17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1972940476,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,4358 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1427378975,"WALKER, DAVID, GLENN",98 STONEBRIDGE TRL   HAVELOCK NC,025,Craven,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 23 , 78 , 99 ," $20,400.72 ",,
MEDICAID DIRECT,1972940476,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,4358 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1427378975,"WALKER, DAVID, GLENN",4358 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 46 , 48 ,$#,,
MEDICAID DIRECT,1972940476,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,98 STONEBRIDGE TRL   HAVELOCK NC,025,Craven,193400000X,Group,Single Specialty,,1427378975,"WALKER, DAVID, GLENN",98 STONEBRIDGE TRL   HAVELOCK NC,025,Craven,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",3532 DUNN RD   EASTOVER NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 40 , 144 , 144 ,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",2461 LEGION RD   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,,,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 82 , 212 , 216 ," $17,125.80 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",820 S MCNEILL ST   CARTHAGE NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 34 , 108 , 108 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",1206 N FULTON ST   RAEFORD NC,047,Hoke,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",1206 N FULTON ST   RAEFORD NC,047,Hoke,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 35 , 116 , 117 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",310 E WARDELL DR   PEMBROKE NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 43 , 174 , 174 ," $14,814.96 ",,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",310 E WARDELL DR   PEMBROKE NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427379247,"HUNT, SHEILA, LOCKLEAR",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1427379379,"WILLIAMS, DENNIS, RAY",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 858 ," 1,051 "," 1,323 "," $25,017.56 ",,
MEDICAID DIRECT,1164470134,MOUNTAIN AREA PEDIATRICS ASSOCIATES,Mountain Area Pediatric Associates PA,500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427390459,"DERBY, KIERSTEN",500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 71 , 125 , 343 ," $17,438.49 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427391812,"GREY, RICHARD, KYLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 49 , 49 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427391812,"GREY, RICHARD, KYLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427391812,"GREY, RICHARD, KYLE",511 PALADIN DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 53 , 145 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427392448,"STIKELEATHER, BRITTANY, NELSON",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427392448,"STIKELEATHER, BRITTANY, NELSON",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427393602,"TERRELL, CHRISTINA, REBECCA EVANS",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 45 , 48 ,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427396647,"MCKAY, DESIREE, MONIQUE",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 39 , 39 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427396886,"ODEN, KRISTIN, NICOLE",222 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427396886,"ODEN, KRISTIN, NICOLE",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427397967,SALTWATER SPEECH THERAPY PC,SALTWATER SPEECH THERAPY PC,624 US HIGHWAY 17 S UNIT 5 HOLLY RIDGE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1427397967,SALTWATER SPEECH THERAPY PC,624 US HIGHWAY 17 S UNIT 5 HOLLY RIDGE NC,067,Onslow,193200000X,Group,Multi-Specialty,,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427400209,"KALARIA, TILAK, SUNIL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 206 , 206 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427402080,"SULLIVAN, RICHALLE, VICTORIA SMITH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 34 , 35 , 42 ," $13,223.72 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427402080,"SULLIVAN, RICHALLE, VICTORIA SMITH",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427402080,"SULLIVAN, RICHALLE, VICTORIA SMITH",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427402080,"SULLIVAN, RICHALLE, VICTORIA SMITH",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427403013,"HASSAN, OMER, ABDELRAHIM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 39 , 39 , 56 ,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427403013,"HASSAN, OMER, ABDELRAHIM",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 43 , 47 , 83 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427403013,"HASSAN, OMER, ABDELRAHIM",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427404565,"QAVI, AHMED, HASSAAN",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 89 , 205 , 436 ," $46,695.33 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",5900 SIX FORKS RD STE 105 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",1006 PROCURE ST STE 300 FUQUAY VARINA NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 58 , 112 , 240 ," $28,635.08 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",100 PARKWAY OFFICE CT STE 104 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427408228,"SCAVELLI, KURT, THOMAS",3113 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 19 ,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",340 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629625785,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,11115 GOLF LINKS DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427408426,"LIBERTO, DAVID, JOSEPH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427408913,"MURRAY, ROBERT, JAMES",1404 N LAFAYETTE ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 614 , 618 ," $23,501.05 ",,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427408913,"MURRAY, ROBERT, JAMES",625 BETHANY RD   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 758 , 763 ," $22,047.98 ",,
MEDICAID DIRECT,1447679956,ANDREW C GEER DDS,,3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427409440,"SPEER, TIMOTHY, DAVID",3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 176 , 230 , 658 ," $30,348.20 ",,
MEDICAID DIRECT,1053431346,"GEER, ANDREW, CHRISTIAN",~,3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1427409440,"SPEER, TIMOTHY, DAVID",3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 33 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 29 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427409903,"STONE, MIRIAM, CORDEIRO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427410075,"GRZANKOWSKI, JULIE, MARIE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 39 , 104 , 109 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427410612,"RUSHING, ASHLEIGH, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 16 , 37 , 37 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427411024,"PLAKSIN, JOSEPH, RUTHERFORD",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427411230,PROSPEROUS LIVING HOME HEALTH SERVI,~,9625 DAVID TAYLOR DR STE 118 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1427411230,PROSPEROUS LIVING HOME HEALTH SERVI,9625 DAVID TAYLOR DR STE 118 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 61 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427412576,"SISTA, PRIYANKA, PRAKASH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 43 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427412576,"SISTA, PRIYANKA, PRAKASH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 89 , 97 , 101 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1427412782,"KITCHIN, BENJAMIN, EDGAR",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 16 , 30 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1427412782,"KITCHIN, BENJAMIN, EDGAR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1427412782,"KITCHIN, BENJAMIN, EDGAR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 25 , 33 , 34 ," $13,865.17 ",,
MEDICAID DIRECT,1235198177,COUNTY OF DUPLIN,DUPLIN COUNTY HEALTH DEPARTMENT,340 SEMINARY ST   KENANSVILLE NC,031,Duplin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1427412782,"KITCHIN, BENJAMIN, EDGAR",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 111 , 188 , 494 ," $24,386.16 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1427412782,"KITCHIN, BENJAMIN, EDGAR",102 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1427414226,THE PATTERSON HOUSE FCH,,3053 COUNTRY PINES ST   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427414226,THE PATTERSON HOUSE FCH,3053 COUNTRY PINES ST   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 641 , 642 ," $77,780.20 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427414267,"FLOWE, LAUREN, ELIZABETH",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427414267,"FLOWE, LAUREN, ELIZABETH",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 20 , 21 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427414267,"FLOWE, LAUREN, ELIZABETH",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427414267,"FLOWE, LAUREN, ELIZABETH",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427415595,"ACHU, NGEHBEHGNUI, NGWEMETA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427419514,"COCKFIELD, FLYNN, WALTON",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427419514,"COCKFIELD, FLYNN, WALTON",117 E KINGS HWY   EDEN NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427419514,"COCKFIELD, FLYNN, WALTON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427425297,"MITCHELL, SOPHIA, JOSEPHINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427425669,"MOTWANI, KOMAL",301 E WENDOVER AVE STE 211 GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#, 18 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427425669,"MOTWANI, KOMAL",301 E WENDOVER AVE STE 211 GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 52 , 122 , 232 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427425669,"MOTWANI, KOMAL",725 OAKRIDGE BLVD STE A3 LUMBERTON NC,078,Robeson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1427425669,"MOTWANI, KOMAL",4901 DAWN DR STE 3400 LUMBERTON NC,078,Robeson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1235511536,SEASHORE EYE ASSOCIATES OD PLLC,,1612 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427429323,"WARWICK, JENNY, HINES",1612 DOCTORS CIR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427430578,"BEATTY, GARRETT, W",109 BRIDGE ST STE 201 DANVILLE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427430958,"CAPPETTO, SAMANTHA, GRETL",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427430958,"CAPPETTO, SAMANTHA, GRETL",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 101 , 101 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427430958,"CAPPETTO, SAMANTHA, GRETL",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427430958,"CAPPETTO, SAMANTHA, GRETL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 39 , 44 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427430958,"CAPPETTO, SAMANTHA, GRETL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,319 E 2ND ST   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427431527,"ZIMMERMAN, HEATHER, ANN",319 E 2ND ST   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 285 , 586 ," 1,972 "," $71,893.99 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,903 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1427431527,"ZIMMERMAN, HEATHER, ANN",903 N ARENDELL AVE   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1427431527,"ZIMMERMAN, HEATHER, ANN",1008 BIG OAK CT   KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 44 , 140 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427432111,"COWEN, MARCIA, NICOLE",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427433671,"SHELL, TONJA, RENEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427433671,"SHELL, TONJA, RENEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 34 , 35 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427433671,"SHELL, TONJA, RENEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417088865,HIGH MOUNTAIN HEALTHCARE LLC,HIGH MOUNTAIN HEALTHCARE LLC,63 PLEASANT HILL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427433945,"FOWLER, ANDREA, PAPAI",63 PLEASANT HILL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427434745,"MIHAILOVICH, NICOLE, ELAINE",3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 36 , 55 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427434745,"MIHAILOVICH, NICOLE, ELAINE",3126 BLUE RIDGE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427434844,"KULLA, BAKRI",301 RIVERVIEW AVE STE 710 NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427435106,"JULIAN, BRITTANY, ANN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 84 , 90 ,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427435106,"JULIAN, BRITTANY, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427436203,"CARTER, LACEY, MARTIN",,48 CROSS PARK CT   GREENVILLE SC,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,1427436203,"CARTER, LACEY, MARTIN",48 CROSS PARK CT   GREENVILLE SC,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427439777,"GUIDICI, JESSICA, LEIGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427439777,"GUIDICI, JESSICA, LEIGH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 74 , 79 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427443290,"SKARET, MICHAEL, MATTHEW",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427444207,"DE CUBA, RAYMOND, JOSEPH",1635 NC HIGHWAY 66 S STE 210 KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 47 , 54 ,$#,,
MEDICAID DIRECT,1063648533,ANKLE AND FOOT SURGICAL AND PODIATR,~,200 WESTGATE DR STE A WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1427444215,"SCHMIDTKE, KEVIN, WILLIAM",200 WESTGATE DR STE A WEST END NC,063,Moore,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 117 , 288 , 388 ,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1427444397,"DAMIAN, COURTNEY, ALYN",381 DEERFIELD RD   BOONE NC,095,Watauga,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 25 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427444603,"SHEN, YAOYUN, SARAH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427444603,"SHEN, YAOYUN, SARAH",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 74 , 81 , 92 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427444603,"SHEN, YAOYUN, SARAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 273 , 303 , 342 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427444918,"LOWE, JARED, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427445527,"STRAIGHT, ERIN, ELIZABETH",5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1427446061,"HAMRICK, JONATHAN, DAVID",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 19 , 21 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,5200 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1427446061,"HAMRICK, JONATHAN, DAVID",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427448927,WAL-MART STORES EAST LP,~,349 KINSTON HWY   RICHLANDS NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1427448927,WAL-MART STORES EAST LP,349 KINSTON HWY   RICHLANDS NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427450519,"FLOYD, JENNI, CLARK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427452812,"SHAW, JANE, ANNE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 47 , 54 , 56 ,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1427458157,"CAVISTON, JENNIFER, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1427458157,"CAVISTON, JENNIFER, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 14 , 26 ,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1427458157,"CAVISTON, JENNIFER, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 26 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1427458157,"CAVISTON, JENNIFER, ANN",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427458157,"CAVISTON, JENNIFER, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1427458157,"CAVISTON, JENNIFER, ANN",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427458629,"CLONTZ, KRISTIE, REYNOLDS",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427460914,"GAMBELLA, AMERICO, NICOLA",,1608 BENJAMIN PKWY   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1427460914,"GAMBELLA, AMERICO, NICOLA",1608 BENJAMIN PKWY   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 88 , 202 ," $10,464.28 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427461185,"ANDERSON, MELISSA, ROBYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1912955337,HANDSCHUMACHER ENTERPRISES OD PA,FAMILY EYECARE CENTER,7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427462035,"FINN, CARA, ELLEN",5959 TRIANGLE TOWN BLVD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1912955337,HANDSCHUMACHER ENTERPRISES OD PA,FAMILY EYECARE CENTER,7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427462035,"FINN, CARA, ELLEN",4325 GLENWOOD AVE STE F RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1912955337,HANDSCHUMACHER ENTERPRISES OD PA,FAMILY EYECARE CENTER,7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427462035,"FINN, CARA, ELLEN",4325 GLENWOOD AVE STE F RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1912955337,HANDSCHUMACHER ENTERPRISES OD PA,FAMILY EYECARE CENTER,7500 RAMBLE WAY STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427462035,"FINN, CARA, ELLEN",5959 TRIANGLE TOWN BLVD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427462498,"HILL, LAUREN, MICHELLE",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 18 , 44 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427462498,"HILL, LAUREN, MICHELLE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427462498,"HILL, LAUREN, MICHELLE",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 92 , 132 , 176 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 20 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427462977,"TOBB, KARDIE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1427463280,"PAYNE, BRYAN, PAUL",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 67 , 114 , 120 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427464155,"MERRITT, CLAY, MICHAEL",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427464460,"CRAWFORD, EMERSON, GERMARION",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 18 , 18 , 32 ,$#,,
MEDICAID DIRECT,1881033009,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB NORTH,487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427464775,"TRABULCI, JANAINA",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 63 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427468784,"GUTTALU KRISHNAMURTHY RAO, KUMARASWAMY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427468784,"GUTTALU KRISHNAMURTHY RAO, KUMARASWAMY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427468784,"GUTTALU KRISHNAMURTHY RAO, KUMARASWAMY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427468784,"GUTTALU KRISHNAMURTHY RAO, KUMARASWAMY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427468784,"GUTTALU KRISHNAMURTHY RAO, KUMARASWAMY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427468784,"GUTTALU KRISHNAMURTHY RAO, KUMARASWAMY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427468958,"MOSKOWITZ, ADAM, JASON",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427468958,"MOSKOWITZ, ADAM, JASON",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427468958,"MOSKOWITZ, ADAM, JASON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 127 , 200 , 272 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427468958,"MOSKOWITZ, ADAM, JASON",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427468958,"MOSKOWITZ, ADAM, JASON",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427468958,"MOSKOWITZ, ADAM, JASON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1427469816,"BAUTISTA, VLADIMIR, SAMPILO",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1427469816,"BAUTISTA, VLADIMIR, SAMPILO",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1427469816,"BAUTISTA, VLADIMIR, SAMPILO",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 34 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427475839,"SHIELDS, JESSICA, ASHLEY KASIK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427475839,"SHIELDS, JESSICA, ASHLEY KASIK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427477348,"DAVIS, KELLY, MERYL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 19 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427477348,"DAVIS, KELLY, MERYL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427478262,"MARADEY, JOAN, ALBERTO",205 PAGE RD   PINEHURST NC,063,Moore,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 50 , 130 , 155 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427478262,"MARADEY, JOAN, ALBERTO",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 32 , 44 , 53 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427478262,"MARADEY, JOAN, ALBERTO",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427478262,"MARADEY, JOAN, ALBERTO",205 PAGE RD   PINEHURST NC,063,Moore,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 49 , 124 , 201 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427478684,"SCOTT, DAWN, ELIZABETH",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 46 , 112 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427478908,"BRAXTON, ELIZABETH, GREEN WILLIAMS",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427478908,"BRAXTON, ELIZABETH, GREEN WILLIAMS",770 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 62 , 136 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427482066,"DIAZ, AYLIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427482066,"DIAZ, AYLIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427483643,FIRST CHOICE HEALTH CARE LLC,BRENDA N BATTS,2500 NASH ST N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1427483643,FIRST CHOICE HEALTH CARE LLC,2500 NASH ST N   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 36 ," 7,285 "," 7,352 "," $582,318.17 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427485960,"PAGE, JESSICA, TRIPP",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 70 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427485960,"PAGE, JESSICA, TRIPP",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427485960,"PAGE, JESSICA, TRIPP",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 43 , 43 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457380313,ARBORETUM URGENT CARE CENTER,ATRIUM HEALTH URGENT CARE ARBORETUM,7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 24 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427489327,"GOLDSTEIN, MELISSA, ANN",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1427490150,"SHASTRI, SHRUTI",371 NC HIGHWAY 65   REIDSVILLE NC,079,Rockingham,1223D0001X,Dental Providers,Dentist,Dental Public Health, 636 ," 1,036 "," 2,778 "," $138,159.03 ",,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1427490150,"SHASTRI, SHRUTI",371 NC HIGHWAY 65   REIDSVILLE NC,079,Rockingham,1223D0001X,Dental Providers,Dentist,Dental Public Health, 336 , 387 ," 1,010 "," $52,429.87 ",,
MEDICAID DIRECT,1629122528,LANE & ASSOCIATES XIV DDS PA,LANE & ASSOCIATES XIV DDS PA,1200 BROAD ST STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1902950769,LANE & ASSOCIATES XV DDS PA,LANE & ASSOCIATES XV DDS PA,2617 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 14 , 36 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 31 ,$#,,
MEDICAID DIRECT,1154475036,LANE & ASSOCIATES X DDS PA,~,407 TIFFANY DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 35 ,$#,,
MEDICAID DIRECT,1679626832,LANE AND ASSOCIATES IX DDS PA,LANE & ASSOCIATES IX DDS PA,131 MONTGOMERY XING   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1639502727,LANE AND ASSOCIATES XXVII DDS PA,,4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 50 ,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1427490382,"PARSONS, DIANA, LYNN",407 TIFFANY DR   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 35 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",120 HEALTHPLEX WAY   APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 17 , 22 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 18 , 34 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427491257,"GENTRY, RYAN, DAVID",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427492230,"HAYWOOD, EDMUND, BURKE",8115 MARKET ST STE 200 WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 25 , 36 , 61 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427492230,"HAYWOOD, EDMUND, BURKE",2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 92 , 143 , 223 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427492230,"HAYWOOD, EDMUND, BURKE",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427492230,"HAYWOOD, EDMUND, BURKE",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427492503,"DAILY, BRIAN, CHRISTOPHER",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427492503,"DAILY, BRIAN, CHRISTOPHER",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 33 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1427492503,"DAILY, BRIAN, CHRISTOPHER",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215077201,HARNETT HEALTH SYSTEM INC,CAPE FEAR VALLEY PEDIATRIC CARE,716 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1427493071,"VURNAKES, ALISON, LEE",716 S 10TH ST   LILLINGTON NC,043,Harnett,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 43 , 91 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427493295,"CAMPBELL, HEATHER, EISENSON",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427493295,"CAMPBELL, HEATHER, EISENSON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 35 , 110 , 112 ," $25,292.50 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427493295,"CAMPBELL, HEATHER, EISENSON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",1220 MAGNOLIA ST   GREENSBORO NC,041,Guilford,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1982998159,PIEDMONT CARDIOVASCULAR PA,~,1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 45 , 62 , 112 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 71 , 77 , 128 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427493865,"TOLIA, SUNIT, YESHWANT",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427493980,"HAZY, MARIAN, VIRGINIA",50 MILLER ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 48 , 63 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1427494152,"MATTHEWS, SHANNON, MARIE",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427494152,"MATTHEWS, SHANNON, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1427494152,"MATTHEWS, SHANNON, MARIE",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427494152,"MATTHEWS, SHANNON, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 75 , 76 , 90 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1427494152,"MATTHEWS, SHANNON, MARIE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1427494152,"MATTHEWS, SHANNON, MARIE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427494152,"MATTHEWS, SHANNON, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 27 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427494467,"ROSENGREN-HOVEE, ANNA, LINA-KARIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427494640,"JONES, MICHELLE, BROOKS",1411 GREENWAY CT   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 36 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1427494640,"JONES, MICHELLE, BROOKS",1411 GREENWAY CT   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 53 , 113 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1800 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1427494640,"JONES, MICHELLE, BROOKS",1411 GREENWAY CT   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427496249,"BOUCHARD, MARY, REA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 644 , 705 ," $18,437.56 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427497320,"OGUNDIPE, FUNMILOLA, TITILAYO",400 SENTARA CIR STE 320 WILLIAMSBURG VA,102,Out of State > 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427498294,"ADAIR, CHRISTOPHER, RAY",1915 LENDEW ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 48 , 91 , 169 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427498575,"MEZEY, DYLAN, ALEXANDER",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427500354,"BUSH, TARA, LYNNE VENTURINI",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427500354,"BUSH, TARA, LYNNE VENTURINI",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 66 , 66 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427500982,"HOUGHTALEN, KATE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427500982,"HOUGHTALEN, KATE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#, 13 , 14 ,$#,,
MEDICAID DIRECT,1457836413,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - CLAREMONT,3114 W MAIN ST   CLAREMONT NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427501683,"LAWS, W LYNETTE",3114 W MAIN ST   CLAREMONT NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 21 , 28 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427504067,"O'BRIEN, JENNIFER, MICHELE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427506575,"TALWAR, SAHIL",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1427506625,"CASSIDY, ESTHER, NOELLE KURTZ",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427506625,"CASSIDY, ESTHER, NOELLE KURTZ",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427511906,"RAVULA, SHREYA, REDDY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427515055,"LONDON, AMELIA, ANNETTE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 29 , 29 ,$#,,
MEDICAID DIRECT,1225500804,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,170 CHURCH ST   FRANKLIN NC,056,Macon,251B00000X,Agencies,Case Management,,1427518570,"MAXWELL, REGAN, ARNOLD",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427518570,"MAXWELL, REGAN, ARNOLD",490 HOSPITAL DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 80 , 89 ,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427518570,"MAXWELL, REGAN, ARNOLD",161 WALKER ST   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427518570,"MAXWELL, REGAN, ARNOLD",146 NESBITT RDG   LAKE LURE NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427519057,"SABATINI, MATTHEW, MICAHEL",1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427519057,"SABATINI, MATTHEW, MICAHEL",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1427519149,"CHISENHALL, AUTUMN",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 16 , 32 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427519412,"PHILLIPS, MICHAEL, AANESS",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427519412,"PHILLIPS, MICHAEL, AANESS",3426 TORINGDON WAY STE 102 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427519412,"PHILLIPS, MICHAEL, AANESS",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427519412,"PHILLIPS, MICHAEL, AANESS",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427519412,"PHILLIPS, MICHAEL, AANESS",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427519792,"ALEXANDER, BAILIN, HARTE",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 80 , 95 , 141 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427519859,"AIKENS, ASHLEY, NICOLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 28 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427519859,"AIKENS, ASHLEY, NICOLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427519859,"AIKENS, ASHLEY, NICOLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427540780,"REYNOLDS, SEAN, PETER",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 77 , 128 , 212 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427541523,"COUCH, STUART, WILDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 64 , 66 , 91 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1427541523,"COUCH, STUART, WILDER",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427541523,"COUCH, STUART, WILDER",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1427541523,"COUCH, STUART, WILDER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",3100 DURALEIGH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",3100 DURALEIGH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",3100 DURALEIGH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 24 , 50 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",3100 DURALEIGH RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",7850 BRIER CREEK PKWY STE AND300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",7850 BRIER CREEK PKWY STE AND300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427541697,"EDWARDS, ALLISON, SHAE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 26 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427544121,"JEAN, SOLUNY",615 RIDGE RD   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184669053,SOUTHEASTERN MEDICAL GROUP PC,,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1427544121,"JEAN, SOLUNY",615 RIDGE RD   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1427452341,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORWOOD FAMILY MEDICINE,269 S MAIN ST   NORWOOD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427544477,"JARAMILLO, KAREN, ANABEL",269 S MAIN ST   NORWOOD NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558765313,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RICHFIELD FAMILY MEDICI,243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427544477,"JARAMILLO, KAREN, ANABEL",243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427544477,"JARAMILLO, KAREN, ANABEL",835 ALBEMARLE RD   TROY NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1427544477,"JARAMILLO, KAREN, ANABEL",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427544477,"JARAMILLO, KAREN, ANABEL",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427544477,"JARAMILLO, KAREN, ANABEL",3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548828965,TABOR CITY FAMILY MEDICAL CLINIC PC,TABOR CITY FAMILY MEDICAL CLINIC PC,706 E 5TH ST   TABOR CITY NC,024,Columbus,193400000X,Group,Single Specialty,,1427544915,"BEKING, FAITH",706 E 5TH ST UNIT B TABOR CITY NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 76 , 121 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427544931,"MARCERON, SHEILA, LOUISE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 31 , 48 ,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427545508,"SHILLINGFORD, KELISSA, STACY",6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 41 , 55 ,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427545508,"SHILLINGFORD, KELISSA, STACY",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427545508,"SHILLINGFORD, KELISSA, STACY",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427545755,"HALEY, ERIK, STEPHEN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427546274,"DEAVER, LAUREN, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427546340,"SILVERSTEIN, RACHEL, GINA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427546340,"SILVERSTEIN, RACHEL, GINA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427546860,"MOZGALA, JEFFREY, EMANUEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,825 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1427546860,"MOZGALA, JEFFREY, EMANUEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 91 , 255 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1427546860,"MOZGALA, JEFFREY, EMANUEL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427547140,"WILLIAMS, NATHANIEL, JOHN",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1427547140,"WILLIAMS, NATHANIEL, JOHN",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427547140,"WILLIAMS, NATHANIEL, JOHN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 135 , 245 , 343 ," $10,765.30 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,275 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427547140,"WILLIAMS, NATHANIEL, JOHN",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427547264,"LLAMAS, JEWEL, CARESSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427547264,"LLAMAS, JEWEL, CARESSE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427547264,"LLAMAS, JEWEL, CARESSE",322 MAIN ST   PROSPECT HILL NC,017,Caswell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 58 , 64 ,$#,,
MEDICAID DIRECT,1427548080,PUBLIX NORTH CAROLINA LP,PUBLIX PHARMACY 1586,635 GREENVILLE HWY   HENDERSONVILLE NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1427548080,PUBLIX NORTH CAROLINA LP,635 GREENVILLE HWY   HENDERSONVILLE NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427549476,"LAO, HAYES, YUEN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427549476,"LAO, HAYES, YUEN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1427549518,"HARFORD, JOSHUA, STEPHEN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 62 , 69 , 139 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427549518,"HARFORD, JOSHUA, STEPHEN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 36 , 41 , 65 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427552108,"CRAVANAS, TAYLOR, CHARISE",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427552926,"DAVIC, ALEXANDRA, LEIGH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 86 , 90 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427552926,"DAVIC, ALEXANDRA, LEIGH",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 12 , 14 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427553171,"MONTANO, EMIL, WOLDEN HJORTH",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427553171,"MONTANO, EMIL, WOLDEN HJORTH",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427553346,"VENUGOPAL, AISHA",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 11 , 14 , 18 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427553437,"KELLNER, MATTHEW, WYLAND",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 61 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427553486,"SHUFORD, REBECCA, ANNE",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427553486,"SHUFORD, REBECCA, ANNE",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1427558022,"URBAN, JENNIFER, CARROLL",3311 BURNT MILL DR SUITE A WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 92 , 96 , 145 ," $21,884.09 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427561877,"KOLOCURIS, NIKOLAS, DIMITRI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427563980,"PHILLIPS, WILLIAM, WALKER",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427563980,"PHILLIPS, WILLIAM, WALKER",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 38 , 71 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1427566330,"SAKTHIVEL, MUTHU, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427566330,"SAKTHIVEL, MUTHU, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427566330,"SAKTHIVEL, MUTHU, KUMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 483 , 720 , 781 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427568229,"HOLLINGSWORTH, BRIEN, OWINGS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427568229,"HOLLINGSWORTH, BRIEN, OWINGS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427568229,"HOLLINGSWORTH, BRIEN, OWINGS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427568229,"HOLLINGSWORTH, BRIEN, OWINGS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1427568229,"HOLLINGSWORTH, BRIEN, OWINGS",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427568229,"HOLLINGSWORTH, BRIEN, OWINGS",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427570639,"FOGLEMAN, CAROLINE, KALEEL",,1205 FLORAL PKWY   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1427570639,"FOGLEMAN, CAROLINE, KALEEL",1205 FLORAL PKWY   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 122 , 130 , 205 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427571017,"LANE, STEPHANIE, JEAN",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427574920,"LEWIS, CAROLINE, HALIE",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 23 , 33 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427575638,"CROCKER OSBORNE, JOSHUA, QUINTIN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427575638,"CROCKER OSBORNE, JOSHUA, QUINTIN",2544 COURT DR STE D GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427575638,"CROCKER OSBORNE, JOSHUA, QUINTIN",600 HOSPITAL DR   MONROE NC,090,Union,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 20 , 77 , 77 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427575992,"WHINNEN, KAITLYN, JANE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 19 , 24 , 28 ,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1427580505,"FLANAGAN SINGLETARY, ALISON, MICHELLE",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 43 ,$#,,
MEDICAID DIRECT,1275638512,GRANVILLE HEALTH SYSTEM,GRANVILLE HEALTH SYSTEM CRNA GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1427580687,"TARLEY, JOSEPH, ALLEN",1010 COLLEGE ST   OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1427580687,"TARLEY, JOSEPH, ALLEN",1010 COLLEGE ST   OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1427580802,"PAUL, JOSHUA, ARI",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427580935,"RYDBERG, MICHAEL, GUY",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427580935,"RYDBERG, MICHAEL, GUY",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427580935,"RYDBERG, MICHAEL, GUY",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427580935,"RYDBERG, MICHAEL, GUY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1427582378,"DRAKE, JAMES",472 RANKIN DR   MARION NC,059,McDowell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1427582378,"DRAKE, JAMES",430 RANKIN DR   MARION NC,059,McDowell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1427582378,"DRAKE, JAMES",430 RANKIN DR   MARION NC,059,McDowell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1427582378,"DRAKE, JAMES",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1427582378,"DRAKE, JAMES",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427583095,"HURLEY, CYNTHIA, LAUREN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 61 , 74 , 74 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427586155,"YUSUPOV, DENIS",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1871577197,KINSTON PEDIATRIC ASSOCIATES PA,Kinston Pediatric Associates PA,2509 N QUEEN ST   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1427587625,"REGISTER, AMANDA, JO",2509 N QUEEN ST   KINSTON NC,054,Lenoir,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 42 , 98 , 249 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1427587807,"BIERMANN, DAVID, ALAN GORDON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 288 , 344 , 417 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 61 , 66 , 67 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 27 , 27 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",117 E KINGS HWY   EDEN NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427589068,"CORDOVA, ALDO, LUIGI",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1427593037,"RODGERS, KAROLYN, ANN",381 DEERFIELD RD   BOONE NC,095,Watauga,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427595503,"LEWIS, ANGELA, KORLESKI",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427596329,"MIOC, CLAUDIU, SAMUEL",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427596329,"MIOC, CLAUDIU, SAMUEL",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 65 , 120 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427596329,"MIOC, CLAUDIU, SAMUEL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427596329,"MIOC, CLAUDIU, SAMUEL",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427596329,"MIOC, CLAUDIU, SAMUEL",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 29 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1427596550,"RICHARDSON, SHAWN, ROBERT",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1427596550,"RICHARDSON, SHAWN, ROBERT",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1427596550,"RICHARDSON, SHAWN, ROBERT",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1427596550,"RICHARDSON, SHAWN, ROBERT",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,511 SMOKY PARK HWY   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427596550,"RICHARDSON, SHAWN, ROBERT",511 SMOKY PARK HWY STE A2 CANDLER NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 24 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427596550,"RICHARDSON, SHAWN, ROBERT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 90 , 93 , 101 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427599653,"BALLINGER, JENNIFER, LYNN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208800000X,Allopathic & Osteopathic Physicians,Urology,, 109 , 296 , 614 ," $10,270.42 ",,
MEDICAID DIRECT,1427599802,EYECARECENTER OD PA,EYECARE CENTER,2630 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1427599802,EYECARECENTER OD PA,2630 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427602176,"HERNANDEZ GONZALEZ, DANIEL, ENRIQUE",50 MILLER ST   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 111 , 152 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427602374,"BROSNICK, BEVERLY, BUTLER",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1700918877,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - TRIA,145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427604883,"TORAIN, JEANETTE, RENEA",145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 62 , 115 , 253 ,$#,,
MEDICAID DIRECT,1427606110,HOME DELIVERY INCONTINENT SUPPLIES,,1029 OLD CREEK RD   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1427606110,HOME DELIVERY INCONTINENT SUPPLIES,1029 OLD CREEK RD   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 98 , 478 ," 1,084 "," $80,544.96 ",,
MEDICAID DIRECT,1427606110,HOME DELIVERY INCONTINENT SUPPLIES,,1029 OLD CREEK RD   GREENVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1427606110,HOME DELIVERY INCONTINENT SUPPLIES,1029 OLD CREEK RD   GREENVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1033666888,NEW VISION THERAPY PLLC,,810 WARREN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427607308,"BENTON, CAEDORA, MARYLOUISE",3580 NC HIGHWAY 14   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1427607530,"THOMASON, BRITTANY, FRYE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 14 , 33 , 33 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1427607530,"THOMASON, BRITTANY, FRYE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1427607530,"THOMASON, BRITTANY, FRYE",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427607811,"DREYER, GRACE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 220 , 225 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1427609718,"HULING, ALYSON, LEIGH",605 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427609718,"HULING, ALYSON, LEIGH",605 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427610047,"SESSOMS, LAUREN, REBECCA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427610583,"PAGANO, NOAH, ANGELO",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427611581,"FRIED, AARON, JACOB",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427611581,"FRIED, AARON, JACOB",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 74 , 86 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427611581,"FRIED, AARON, JACOB",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 17 , 33 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1427612753,"CHAKANYUKA, MOREBLESSINGS, RUVIMBO",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1427612753,"CHAKANYUKA, MOREBLESSINGS, RUVIMBO",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 112 , 177 , 527 ," $23,068.44 ",,
MEDICAID DIRECT,1649820093,OYEGUNWA AND ASSOCIATES II PLLC,O2 DENTAL GROUP OF DURHAM,3219 WATKINS RD STE 103 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1427614031,"HART, LASHAWN, JENAY",3219 WATKINS RD STE 103 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 111 , 425 ," $21,598.93 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427614759,"WILLIAMS, PATRICK, EVERTON",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427614759,"WILLIAMS, PATRICK, EVERTON",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1750823746,NAZIR AHMAD DDS 5 PA,,2500 BLUE RIDGE RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427615855,"MONAHAN JR, THOMAS, PATRICK",2500 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 170 , 214 , 995 ," $128,831.87 ",,
MEDICAID DIRECT,1528314689,NAZIR AHMAD DDS PA,NAZIR AHMAD DDS PA,5904 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427615855,"MONAHAN JR, THOMAS, PATRICK",2500 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1528314689,NAZIR AHMAD DDS PA,NAZIR AHMAD DDS PA,5904 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427615855,"MONAHAN JR, THOMAS, PATRICK",5904 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 374 , 552 ," 2,228 "," $272,546.10 ",,
MEDICAID DIRECT,1184059792,NAZIR AHMAD DDS 3 PA,,853 HEATHER RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1427615855,"MONAHAN JR, THOMAS, PATRICK",853 HEATHER RD   BURLINGTON NC,001,Alamance,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 52 , 76 , 291 ," $34,476.98 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427617539,"WOLTERING, STHEPHANIE, NICOLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427617539,"WOLTERING, STHEPHANIE, NICOLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427620509,BOSCH BILINGUAL SPEECH THERAPY PLLC,,4807 RED BRUSH DR   MC LEANSVILLE NC,041,Guilford,193400000X,Group,Single Specialty,,1427620509,BOSCH BILINGUAL SPEECH THERAPY PLLC,4807 RED BRUSH DR   MC LEANSVILLE NC,041,Guilford,193400000X,Group,Single Specialty,, 28 , 322 , 322 ," $23,301.24 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427624642,"MADDOX, KAROLYNE, NICHOLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427624642,"MADDOX, KAROLYNE, NICHOLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427628098,"WADDELL, DANIEL, PATRICK",3940 ARROWHEAD BLVD STE 225 MEBANE NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 28 ,$#,,
MEDICAID DIRECT,1093017154,ARMC PHYSICIANS CARE INC,MEBANE MEDICAL CLINIC,3940 ARROWHEAD BLVD STE 225 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427628098,"WADDELL, DANIEL, PATRICK",3940 ARROWHEAD BLVD STE 225 MEBANE NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 40 , 72 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1427629716,"BANDARU, MOULIKA, REDDY",101 CLINIC DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 84 , 163 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427637800,"ERNSTBERGER, GRACE, CATHERINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 39 , 39 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427637800,"ERNSTBERGER, GRACE, CATHERINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427637800,"ERNSTBERGER, GRACE, CATHERINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 109 , 109 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427637917,"BROOKS, KYLEE, NICOLE",16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1427637917,"BROOKS, KYLEE, NICOLE",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427637917,"BROOKS, KYLEE, NICOLE",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427637917,"BROOKS, KYLEE, NICOLE",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 59 ,$#,,
MEDICAID DIRECT,1427639335,CAROLINAS ALLIANCE FOR RESIDENTIAL,MONTGOMERY SENIOR LIVING,327 FREEMAN ST   STAR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427639335,CAROLINAS ALLIANCE FOR RESIDENTIAL,327 FREEMAN ST   STAR NC,062,Montgomery,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 35 ," 9,370 "," 9,380 "," $770,104.37 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427641745,"BRYAN, MARCY, CARPENTER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427641745,"BRYAN, MARCY, CARPENTER",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 84 , 97 ,$#,,
MEDICAID DIRECT,1427641893,A TRUE VISION HOME HEALTH CARE LLC,,129 N BEAUMONT AVE STE C BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1427641893,A TRUE VISION HOME HEALTH CARE LLC,129 N BEAUMONT AVE STE C BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 3,123 "," 3,123 "," $172,911.52 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427642263,"WISDO, TIA, ROSE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427642263,"WISDO, TIA, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 37 , 47 ,$#,,
MEDICAID DIRECT,1689870941,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427642958,"BREWER, KIDDY, PIERRE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 70 , 78 ,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427642958,"BREWER, KIDDY, PIERRE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427643386,"YOUNG, ROBERT, JOHN",4214 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427643386,"YOUNG, ROBERT, JOHN",121 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 99 , 148 , 266 ," $13,987.97 ",,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427643386,"YOUNG, ROBERT, JOHN",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427643386,"YOUNG, ROBERT, JOHN",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 153 , 153 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427643386,"YOUNG, ROBERT, JOHN",1970 W ARLINGTON BLVD STE C GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 45 , 45 ,$#,,
MEDICAID DIRECT,1427643667,HIGHER STANDARD ASSISTED LIVING LLC,,596 NEAL RD   REIDSVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427643667,HIGHER STANDARD ASSISTED LIVING LLC,596 NEAL RD   REIDSVILLE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,129 "," 1,130 "," $143,948.40 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427644814,"WILLIAMS, JASMINE, SHERRELL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1427644814,"WILLIAMS, JASMINE, SHERRELL",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427650233,"TOMASIELLO, LAUREN, ANNE ROGERS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427650233,"TOMASIELLO, LAUREN, ANNE ROGERS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427651447,GINGERLY HC INC,GINGERLY HOME CARE,4748 STANTONSBURG RD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1427651447,GINGERLY HC INC,4748 STANTONSBURG RD   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 342 , 342 ," $44,372.20 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1427656420,"BLAIR, SARAH, NICOLE",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 32 , 87 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427657964,"IANNARELLI, BRIANNA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427661321,"BLATZ, DAVID, NATHAN",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 37 , 74 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427661321,"BLATZ, DAVID, NATHAN",1231 EASTCHESTER DR STE 120 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1427661321,"BLATZ, DAVID, NATHAN",10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 30 , 71 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1427664564,"POCITOVII, YELENA",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 104 ," 1,426 "," 1,426 "," $30,295.65 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427668847,"VERNOLA, EMILY, KEEFER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427668847,"VERNOLA, EMILY, KEEFER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427671270,"BUFFUM, HOPE, ELIZABETH",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 22 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427671270,"BUFFUM, HOPE, ELIZABETH",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427671270,"BUFFUM, HOPE, ELIZABETH",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427671270,"BUFFUM, HOPE, ELIZABETH",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 37 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427672682,"GRAY, JOSEPH, MICHAEL",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 91 , 114 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3310 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427673607,"HASSPACHER, LAUREN, NICOLE",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427675057,"MITCHELL, ROBERT, BRINSON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427675057,"MITCHELL, ROBERT, BRINSON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437189784,WESTERN NC COMMUNITY HEALTH SVCS,WESTERN NC COMMUNITY HEALTH SERVICES INC,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427675677,"KUYK, CORY, SATTERFIELD",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 81 , 120 , 334 ," $16,304.57 ",,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1427677186,"PHILIPPIDES, DAVID, ELIAS",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427678515,BLESSED WITH GOODNESS,,1811 SARDIS RD N STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1427678515,BLESSED WITH GOODNESS,1811 SARDIS RD N STE 207 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 256 , 256 ," $28,492.10 ",,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427680602,"TURNER, REBECCA, ELAINE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 68 , 68 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427680768,MOSES CONE PHYSICIAN SERVICES INC,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427680917,"MCILWAINE, PETER",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1427680917,"MCILWAINE, PETER",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427680917,"MCILWAINE, PETER",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 68 , 155 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427680917,"MCILWAINE, PETER",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 43 , 64 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427682715,"BAWA, MARY JO-AN, CARRILLO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427685023,"WALDROUP, AMBER, NICHOLE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1427685023,"WALDROUP, AMBER, NICHOLE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427685023,"WALDROUP, AMBER, NICHOLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1427685023,"WALDROUP, AMBER, NICHOLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1427685023,"WALDROUP, AMBER, NICHOLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427685296,"LIU, ZHE",6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 94 , 221 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,893 EAST ST   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1427685387,"ALLEN, BAILEY, COY",893 EAST ST   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 50 , 97 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427685668,"PARROTT, KENDALL, MARONE",2100 S TRYON ST UNIT 201 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1386183028,WESTERN VIRGINIA REGIONAL EMERGENCY,,16000 JOHNSTON MEMORIAL DR   ABINGDON VA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1427686856,"BRIM, MEREDITH, LYNN",16000 JOHNSTON MEMORIAL DR   ABINGDON VA,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427687284,"AUVIL, BRYAN, JAMES",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 60 , 213 , 213 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427687532,"BROOKS EVARISTE, LEANNA",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427687532,"BROOKS EVARISTE, LEANNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427687532,"BROOKS EVARISTE, LEANNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457808271,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427687532,"BROOKS EVARISTE, LEANNA",447 MCALISTER RD STE 3400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1427687532,"BROOKS EVARISTE, LEANNA",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 18 , 26 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427691278,"SHEEHAN, COURTNEY, ELISE",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427691278,"SHEEHAN, COURTNEY, ELISE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427691278,"SHEEHAN, COURTNEY, ELISE",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427691278,"SHEEHAN, COURTNEY, ELISE",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 21 , 24 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427691278,"SHEEHAN, COURTNEY, ELISE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427691278,"SHEEHAN, COURTNEY, ELISE",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427691278,"SHEEHAN, COURTNEY, ELISE",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1427692227,"SPEICE, KARA, WILSON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1427692227,"SPEICE, KARA, WILSON",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427696434,"ELLIS, JAMIE, MARIE",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427696434,"ELLIS, JAMIE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427696434,"ELLIS, JAMIE, MARIE",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427697622,"DINSMORE, DAVID, DURANT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427697622,"DINSMORE, DAVID, DURANT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427697622,"DINSMORE, DAVID, DURANT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427699412,HARVEST FOCUSED & CONSULTING SCVS,,154 HUFFMAN MILL RD STE 203 BURLINGTON NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,,1427699412,HARVEST FOCUSED & CONSULTING SCVS,154 HUFFMAN MILL RD STE 203 BURLINGTON NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427702505,"GREENE, BRIA, MORNIQUE",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 24 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427702505,"GREENE, BRIA, MORNIQUE",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 4,368 "," 5,078 "," 27,091 "," $700,208.32 ",,
MEDICAID DIRECT,1386158616,CAROLINA ELITE WOMENS CARE,,901 US 70 HWY W STE 100 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1427702596,"AUTRY, KERRY, LYNN",901 US 70 HWY W STE 100 GARNER NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 35 , 55 , 78 ,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427702851,"LOR, GAOSHEN, CRISTI",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427702851,"LOR, GAOSHEN, CRISTI",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 41 , 142 , 143 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427702851,"LOR, GAOSHEN, CRISTI",260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427706597,"MORGAN, SHENIKA, LENETTE",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 412 , 439 ," $15,595.60 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1427706597,"MORGAN, SHENIKA, LENETTE",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 52 , 672 , 731 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1721 BALD HILL LOOP   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1427706597,"MORGAN, SHENIKA, LENETTE",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427706597,"MORGAN, SHENIKA, LENETTE",2920 FORESTVILLE RD STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,3201 EDWARDS MILL RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427706597,"MORGAN, SHENIKA, LENETTE",2920 FORESTVILLE RD STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427706746,WONDER OF WORDS SPEECH THERAPY PLLC,,5500 W FRIENDLY AVE STE 102F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1427706746,WONDER OF WORDS SPEECH THERAPY PLLC,5500 W FRIENDLY AVE STE 102F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,, 15 , 229 , 229 ," $16,107.56 ",,
MEDICAID DIRECT,1962941773,DLP FRYE MEDICAL GROUP,FRYECARE URGENT CARE,1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427708767,"ATTAWAY, CYNTHIA, MORTON",1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1427597111,DLP FRYE MEDICAL GROUP,FRYECARE HICKORY FAMILY PRACTICES ASSOCIATES,52 12TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427708767,"ATTAWAY, CYNTHIA, MORTON",52 12TH AVE NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427597111,DLP FRYE MEDICAL GROUP,FRYECARE HICKORY FAMILY PRACTICES ASSOCIATES,210 13TH AVENUE PL NW STE 120 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427708767,"ATTAWAY, CYNTHIA, MORTON",210 13TH AVENUE PL NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427597111,DLP FRYE MEDICAL GROUP,FRYECARE HICKORY FAMILY PRACTICES ASSOCIATES,210 13TH AVENUE PL NW STE 120 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427708767,"ATTAWAY, CYNTHIA, MORTON",210 13TH AVENUE PL NW STE 120 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 49 , 78 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427711191,"REILLY, MEAGHAN, FRANCIS",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,14135 BALLANTYNE CORPORATE PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427711191,"REILLY, MEAGHAN, FRANCIS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427712884,"BROOKS, ASHLEY, VALRIE",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427713387,"HENSLEY, KELSEY, PATRICIA",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427713387,"HENSLEY, KELSEY, PATRICIA",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427714872,"AKONCHONG, JOYCE, OBEN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 25 , 25 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427714922,"BREAULT, LUCY, HANORA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427714922,"BREAULT, LUCY, HANORA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 57 , 60 , 60 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1427717420,"HOPE, MADSION",2575 W 5TH ST   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1427717420,"HOPE, MADSION",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427717420,"HOPE, MADSION",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 30 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427719335,"ANDERSON, ANNE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427719590,"PETERSON, BENJAMIN, SCARBROUGH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427720655,"JOHNSON, KATHERINA, KAREN",2660 TATE BLVD SE   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 18 , 31 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1427720655,"JOHNSON, KATHERINA, KAREN",128 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 84 , 93 ,$#,,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,123 BRYAN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1427720739,"HOLMGREN, JORDAN, WALTER",123 BRYAN ST   KENANSVILLE NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice," 1,699 "," 1,935 "," 6,502 "," $295,219.92 ",,
MEDICAID DIRECT,1710307327,STEPHANIE MYLES PC,MYLES FAMILY DENTISTRY,404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427720739,"HOLMGREN, JORDAN, WALTER",404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 567 ," 1,001 "," 2,791 "," $165,693.44 ",,
MEDICAID DIRECT,1255484309,"MYLES, STEPHANIE, ANN",MYLES FAMILY DENTISTRY,404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1427720739,"HOLMGREN, JORDAN, WALTER",404 S COLLEGE RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1871507699,CUMBERLAND HOSPITAL,,9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1427721372,"BRIERLEY, HALEY, MARINO",9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 199 , 199 ," $11,641.88 ",,
MEDICAID DIRECT,1861160038,GALATIANS FOUNDATION,~,4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427726389,"ASARE, SARAH, OFFEIBEA",4551 NEW BERN AVE STE 160 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 76 , 101 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1427731520,"COLE, LAUREN, REED",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427731520,"COLE, LAUREN, REED",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427731520,"COLE, LAUREN, REED",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1427731520,"COLE, LAUREN, REED",25 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427731520,"COLE, LAUREN, REED",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427731520,"COLE, LAUREN, REED",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427731520,"COLE, LAUREN, REED",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 60 , 77 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427734359,"CAPERILLA, MARISSA, NICOLE",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 21 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427734359,"CAPERILLA, MARISSA, NICOLE",865 WESTLAKE DR STE 200 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427739507,"MCKEEN, SAMANTHA, KAY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427744150,"KIRUI, JOAN, CHEBET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1427744499,OAT GROUP,OPEN ARMS THERAPY,227 PINNACLE XING   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1427744499,OAT GROUP,227 PINNACLE XING   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,, 33 ," 1,009 "," 1,019 "," $68,975.56 ",,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1427753003,"CARPENTER, SARAH, GIBBS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 36 , 47 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427754761,"GRIFFITH, NATALIE, STERLING",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427754761,"GRIFFITH, NATALIE, STERLING",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 22 , 37 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1427754761,"GRIFFITH, NATALIE, STERLING",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427756139,"WEDDERBURN, NGOZI, NADIA",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1427756139,"WEDDERBURN, NGOZI, NADIA",5100 MACKAY RD   JAMESTOWN NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1427756139,"WEDDERBURN, NGOZI, NADIA",5100 MACKAY RD   JAMESTOWN NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1427757905,"KAISER, SYDNEY, I",304 10TH AVE NE   HICKORY NC,018,Catawba,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1427760727,"FITZGERALD, CIERA, CAYLIN",2544 COURT DR STE G GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,101 E WT HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427760727,"FITZGERALD, CIERA, CAYLIN",101 E W T HARRIS BLVD STE 3301 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427760727,"FITZGERALD, CIERA, CAYLIN",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 51 , 56 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427762780,"ALASTI, SHELLY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427763762,"HICKS, HANNAH, LINDSEY",4207 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427764380,"WEBSTER, KAITLYN, PAXTON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1427764380,"WEBSTER, KAITLYN, PAXTON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427767334,"CAYTON, HANA, MARIE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1427767334,"CAYTON, HANA, MARIE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,101 RIVERSTONE VIS STE 102 BLUE RIDGE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427771047,"ONEAL, LACY, OSHEA",101 RIVERSTONE VIS STE 102 BLUE RIDGE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609986488,KORDONOWY CHIROPRACTIC CENTER,KORDONOWY CHIROPRACTIC CENTER,473 HENDERSONVILLE RD STE C ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427772078,"KORDONOWY, RACHEL, AUSTIN",473 HENDERSONVILLE RD STE C ASHEVILLE NC,011,Buncombe,111N00000X,Chiropractic Providers,Chiropractor,, 11 , 50 , 52 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,127 S MAIN ST   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427772649,"RIMMER, MIKAYLA, ANN",559 RIVER HWY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427772649,"RIMMER, MIKAYLA, ANN",559 RIVER HWY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427774108,"STEPHENSON, ZACHERY, TAYLOR",1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427774108,"STEPHENSON, ZACHERY, TAYLOR",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 45 , 60 , 76 ,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427774108,"STEPHENSON, ZACHERY, TAYLOR",1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427774108,"STEPHENSON, ZACHERY, TAYLOR",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427774108,"STEPHENSON, ZACHERY, TAYLOR",10195 BEACH DR SW   CALABASH NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1427774108,"STEPHENSON, ZACHERY, TAYLOR",10195 BEACH DR SW   CALABASH NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427778299,"REID, JESSICA, MCNAIR",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427778299,"REID, JESSICA, MCNAIR",7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 66 , 87 ," $11,530.57 ",,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1427778299,"REID, JESSICA, MCNAIR",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427778844,ELDERHAUS INC,ELDERHAUS AT THE LAKE,1950 AMPHITHEATER DR   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1427778844,ELDERHAUS INC,1950 AMPHITHEATER DR   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,, 15 , 262 , 262 ," $11,278.51 ",,
MEDICAID DIRECT,1427778844,ELDERHAUS INC,ELDERHAUS AT THE LAKE,1950 AMPHITHEATER DR   WILMINGTON NC,065,New Hanover,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care,1427778844,ELDERHAUS INC,1950 AMPHITHEATER DR   WILMINGTON NC,065,New Hanover,261QA0600X,Ambulatory Health Care Facilities,Clinic/Center,Adult Day Care, 14 ," 2,099 "," 2,099 "," $80,887.86 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427779891,"WHITMAN, MICHAEL, EDWARD",1401 MATTHEWS TOWNSHIP PKWY STE 320 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 30 , 53 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427780691,"FLEMING, SUMMER, ELIZABETH",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 32 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1427780691,"FLEMING, SUMMER, ELIZABETH",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 31 , 64 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427780691,"FLEMING, SUMMER, ELIZABETH",404 S SUTHERLAND AVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1427780691,"FLEMING, SUMMER, ELIZABETH",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 62 , 127 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427781244,"FLEMING, CONNER, MATTHEW",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427781244,"FLEMING, CONNER, MATTHEW",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427781244,"FLEMING, CONNER, MATTHEW",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427781244,"FLEMING, CONNER, MATTHEW",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427781244,"FLEMING, CONNER, MATTHEW",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427781244,"FLEMING, CONNER, MATTHEW",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427781244,"FLEMING, CONNER, MATTHEW",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1427783208,"DEPUTY, JAYNIE, COLLEEN",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 53 , 113 ,$#,,
MEDICAID DIRECT,1679845846,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,436 HOSPITAL DR STE 200 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1427783208,"DEPUTY, JAYNIE, COLLEEN",436 HOSPITAL DR STE 200 LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1427784222,"HARRIS, KENNETH, RAY",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1427784222,"HARRIS, KENNETH, RAY",529 S VAN BUREN RD   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1427784222,"HARRIS, KENNETH, RAY",5156 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 42 ,$#,,
MEDICAID DIRECT,1427785294,BETTER HOME CARE SERVICES LLC,,3811 LARKHAVEN VILLAGE DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1427785294,BETTER HOME CARE SERVICES LLC,3811 LARKHAVEN VILLAGE DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427787134,"YOUSEFI, BABAK",1076 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1194899542,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427787134,"YOUSEFI, BABAK",1076 NC HIGHWAY 86 N   YANCEYVILLE NC,017,Caswell,1223G0001X,Dental Providers,Dentist,General Practice, 483 , 972 ," 2,154 "," $112,766.07 ",,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427788520,"BRATTON-BLANIAR, DEVON, DENAY",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1427788520,"BRATTON-BLANIAR, DEVON, DENAY",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1427788520,"BRATTON-BLANIAR, DEVON, DENAY",20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1427788520,"BRATTON-BLANIAR, DEVON, DENAY",20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 13 , 13 , 23 ,$#,,
MEDICAID DIRECT,1275167454,LATCH BREASTFEEDING AND POSTPARTUM,,154 BOW ST STE C FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427791532,"SMITH HACKLEY, BRIDGETT",154 BOW ST STE C E FAYETTEVILLE NC,026,Cumberland,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 31 , 33 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 46 , 75 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",190 KIMEL PARK DR STE 131 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",190 KIMEL PARK DR STE 131 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841848249,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH STROKE BRIDGE CLINIC,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427791979,"BUHAGIAR, JAMIE, ANNE",865 W LAKE DR STE 200 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 23 , 27 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4601 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427792092,"HICKSON, TIFFANY, BELL",309 E CORNWALLIS DR   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2300 OAK RIDGE RD CORNER OF HIGHWAY 150 AND HIGHWAY 68 OAK RIDGE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427792092,"HICKSON, TIFFANY, BELL",309 E CORNWALLIS DR   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1427792092,"HICKSON, TIFFANY, BELL",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1427792092,"HICKSON, TIFFANY, BELL",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1427792092,"HICKSON, TIFFANY, BELL",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1427792092,"HICKSON, TIFFANY, BELL",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 47 , 47 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1427792092,"HICKSON, TIFFANY, BELL",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1427792092,"HICKSON, TIFFANY, BELL",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1427793769,"GILDER, SIERRA, GAFFNEY",170 MANNING DR CB# 7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1427793769,"GILDER, SIERRA, GAFFNEY",170 MANNING DR CB# 7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427794775,"HEIGHT, BRITTANIE, ALMITRA",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 600 , 660 ," 2,202 "," $102,441.43 ",,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1427794775,"HEIGHT, BRITTANIE, ALMITRA",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 316 , 352 ," 1,230 "," $52,926.92 ",,
MEDICAID DIRECT,1427794775,"HEIGHT, BRITTANIE, ALMITRA",,5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1427794775,"HEIGHT, BRITTANIE, ALMITRA",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1902251275,CHARLOTTE COMMUNITY HEALTH CLINIC I,,5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1427794775,"HEIGHT, BRITTANIE, ALMITRA",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 16 , 36 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1427796218,"MACKLER, CAMILLE, DEFECHE",2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 38 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1427796218,"MACKLER, CAMILLE, DEFECHE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 21 , 58 ,$#,,
MEDICAID DIRECT,1427804350,GLOBAL HOMECARE LLC,,1631 MIDTOWN PL STE 104-138 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1427804350,GLOBAL HOMECARE LLC,1631 MIDTOWN PL STE 104-138 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 792 , 792 ," $47,477.52 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427807262,"CORROTHERS, MEGAN, ELIZABETH",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1427807262,"CORROTHERS, MEGAN, ELIZABETH",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1427807262,"CORROTHERS, MEGAN, ELIZABETH",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861947905,KIDZCARE PEDIATRICS PC,,1001 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1427807635,"BRENCE, MADELINE, GAUTREAUX",1001 W CUMBERLAND ST   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427807734,DIVINE CARE HOME,DIVINE CARE HOME,429 CROCKER RD   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1427807734,DIVINE CARE HOME,429 CROCKER RD   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 300 , 300 ," $71,913.89 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1427807817,"INGRAM, BRANDI, MORGAN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427813427,ALIFEROUS FEEDING AND SPEECH PLLC,,3220 MYRA ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1427813427,ALIFEROUS FEEDING AND SPEECH PLLC,3220 MYRA ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1427815711,GOLD STANDARD NURSING PLLC,,139 W WALNUT ST UNIT D GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1427815711,GOLD STANDARD NURSING PLLC,139 W WALNUT ST UNIT D GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#, 287 , 298 ," $36,302.36 ",,
MEDICAID DIRECT,1427822691,RIGHT TOUCH NC LLC,,6047 TYVOLA GLEN CIR STE 119A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1427822691,RIGHT TOUCH NC LLC,6047 TYVOLA GLEN CIR STE 119A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 2,296 "," 2,414 "," $309,988.65 ",,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1427828300,"CHRISTMANN-FISHMAN, TAYLOR, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1427828466,"DONOVAN, JENA, JO",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1427828466,"DONOVAN, JENA, JO",300 KEISLER DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,145 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1427828466,"DONOVAN, JENA, JO",145 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427833789,"DAVIS, GINGER, GABRIELLE",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427833789,"DAVIS, GINGER, GABRIELLE",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427835115,TOUCH OF GOLD LLC,TOUCH OF GOLD HOME HEALTH,2925 E INDEPENDENCE BLVD STE 203 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1427835115,TOUCH OF GOLD LLC,2925 E INDEPENDENCE BLVD STE 203 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,278 "," 2,279 "," $161,903.30 ",,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1427836584,"PEGGINS, APARECIO, DONNELL",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 268 , 307 , 799 ," $51,525.26 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1427836808,"NELSON, KRISTA, LEIGH",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 26 , 50 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1427836808,"NELSON, KRISTA, LEIGH",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,345 MANOR RD   MARS HILL NC,057,Madison,193200000X,Group,Multi-Specialty,,1427837210,"WILLIAMS, HANNAH, NICOLE",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 202 , 204 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,78 WEAVER BLVD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427837210,"WILLIAMS, HANNAH, NICOLE",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427863406,ROYALE SENIOR HOME CARE AGENCY,,6900 SIX FORKS RD STE 100C RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1427863406,ROYALE SENIOR HOME CARE AGENCY,6900 SIX FORKS RD STE 100C RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1427874544,"COLEY, DANA, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1427874544,"COLEY, DANA, NICOLE",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1427874544,"COLEY, DANA, NICOLE",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1841929395,STEP UP CARE OF NORTH CAROLINA PC,,3250 HOMESTEAD CLUB DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427878495,"MCMULLAN, DEBORAH",920 COPPERFIELD BLVD   CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 37 , 234 , 234 ,$#,,
MEDICAID DIRECT,1023354156,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1427879915,"RHONEY, COLIN, RAY",4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1023354156,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1427879915,"RHONEY, COLIN, RAY",4000 S SWAIM STREET EXT   JONESVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 18 , 29 ,$#,,
MEDICAID DIRECT,1811233075,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,111 COMER ST   DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1427879915,"RHONEY, COLIN, RAY",111 COMER ST   DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811233075,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,111 COMER ST   DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1427879915,"RHONEY, COLIN, RAY",111 COMER ST   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1427880509,"BUSH, ABIGAIL, MAY",8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427892173,"PFISTER, GINA, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1427892173,"PFISTER, GINA, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1427892173,"PFISTER, GINA, MARIE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427892173,"PFISTER, GINA, MARIE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1427892173,"PFISTER, GINA, MARIE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427893502,"LIBRIZZI, EMMA, GRACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 33 , 50 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427895978,"GOMEZ MIHALIK, MARIA, ALEJANDRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 90 , 91 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1427896703,"ROONEY, MADISON, LAUREL MEADOWS",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1427897032,"WARD, CHICQUITA, LEVY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 179 , 372 , 384 ," $10,595.40 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427899053,"BAUER, COLLIN, SAMUEL",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427899053,"BAUER, COLLIN, SAMUEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427899053,"BAUER, COLLIN, SAMUEL",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427899053,"BAUER, COLLIN, SAMUEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1427899053,"BAUER, COLLIN, SAMUEL",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427899053,"BAUER, COLLIN, SAMUEL",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1427899053,"BAUER, COLLIN, SAMUEL",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427899731,"CAMPBELL, VICTORIA, HOLLAND",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427899731,"CAMPBELL, VICTORIA, HOLLAND",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427899731,"CAMPBELL, VICTORIA, HOLLAND",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427899731,"CAMPBELL, VICTORIA, HOLLAND",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427899731,"CAMPBELL, VICTORIA, HOLLAND",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427899731,"CAMPBELL, VICTORIA, HOLLAND",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1427899731,"CAMPBELL, VICTORIA, HOLLAND",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437100245,"WEILKE, FLORIAN, WOLFGANG",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437100245,"WEILKE, FLORIAN, WOLFGANG",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1609386424,SPARTANBURG MEDICAL CENTER,MGC-ORTHOPAEDIC SURGERY- NORTH GROVE,1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437100781,"KANA, STEPHEN",1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518071315,PROVIDENCE IMAGING CENTER INC,~,53 S FRENCH BROAD AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437101045,"LIND, RICHARD, NORMAN",53 S FRENCH BROAD AVE STE 200 ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437101508,"THEISZ, GORDON, WALKER",825 FAIRFAX AVE STE 118 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427281070,VERDIN PEDIATRICS PLLC,VERDIN PEDIATRICS PLLC,9869 OCEAN HWY W STE 12 CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1437102720,"VERDIN III, THOMAS, MARION",9869 OCEAN HWY W STE 12 CALABASH NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 30 , 40 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1437102720,"VERDIN III, THOMAS, MARION",9869 OCEAN HWY W STE 12 CALABASH NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1487942314,EAGLE MEDICAL CENTER,EAGLE MEDICAL CENTER PC,6005 HICKORY GROVE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437102753,"ALUKO, GBENGA",1951 OLD STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 85 , 225 , 524 ," $11,229.46 ",,
MEDICAID DIRECT,1245563352,EAGLE MEDICAL CENTER,EAGLE MEDICAL CENTER,1951 OLD STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437102753,"ALUKO, GBENGA",1951 OLD STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245563352,EAGLE MEDICAL CENTER,EAGLE MEDICAL CENTER,1951 OLD STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437102753,"ALUKO, GBENGA",1951 OLD STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 105 , 327 , 721 ," $13,104.89 ",,
MEDICAID DIRECT,1487942314,EAGLE MEDICAL CENTER,EAGLE MEDICAL CENTER PC,6005 HICKORY GROVE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437102753,"ALUKO, GBENGA",1951 OLD STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437102878,"MCCARTY, CHRISTINE, HOLZER",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 50 , 90 , 90 ,$#,,
MEDICAID DIRECT,1437102902,HELPING HANDS ALTERNATIVE OF OXFORD,Helping Hands Alternative of Oxford Inc,308 HILLSBORO ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1437102902,HELPING HANDS ALTERNATIVE OF OXFORD,308 HILLSBORO ST   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 6,698 "," 6,698 "," $425,430.54 ",,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437103611,"ZBAN, WILLIAM, MATTHEW",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 34 , 47 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437103611,"ZBAN, WILLIAM, MATTHEW",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437103611,"ZBAN, WILLIAM, MATTHEW",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437103611,"ZBAN, WILLIAM, MATTHEW",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437103611,"ZBAN, WILLIAM, MATTHEW",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437105327,"KING, WILLIAM, WALTER",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 77 , 134 , 203 ," $15,280.91 ",,
MEDICAID DIRECT,1437106044,TOWN OF ATLANTIC BEACH,ATLANTIC BEACH FIRE DEPARTMENT,125 W FORT MACON RD   ATLANTIC BEACH NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1437106044,TOWN OF ATLANTIC BEACH,125 W FORT MACON RD   ATLANTIC BEACH NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437106515,"VAUGHN, JOHN, ANTHONY",401 N DRIVER ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437106515,"VAUGHN, JOHN, ANTHONY",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437106887,"BAKARE, MOBOLAJI, BABATOPE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437106887,"BAKARE, MOBOLAJI, BABATOPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1295265221,MOBOLAJI BABATOPE BAKARE MD PC,GATE CITY PRIMARY CARE CENTER,3411 W WENDOVER AVE STE D GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1437106887,"BAKARE, MOBOLAJI, BABATOPE",3411 W WENDOVER AVE STE D GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 89 , 176 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1437108123,"PERKINS, PHILLIP, KERRY",3722 BRIDGES ST STE 1A MOREHEAD CITY NC,016,Carteret,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 32 , 39 ,$#,,
MEDICAID DIRECT,1992482079,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON PRIMARY CARE RHC,1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437108123,"PERKINS, PHILLIP, KERRY",3722 BRIDGES ST STE 1A MOREHEAD CITY NC,016,Carteret,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 31 , 33 , 56 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1437108123,"PERKINS, PHILLIP, KERRY",3722 BRIDGES ST STE 1A MOREHEAD CITY NC,016,Carteret,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 32 , 34 ,$#,,
MEDICAID DIRECT,1992482079,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON PRIMARY CARE RHC,1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437108123,"PERKINS, PHILLIP, KERRY",1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1437108123,"PERKINS, PHILLIP, KERRY",1700 TARBORO ST W STE 200 WILSON NC,098,Wilson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437108206,"WEST IV, JESSE, LYLE",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 34 , 68 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437108610,"OMURA, AKIKO",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 42 , 61 , 63 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437108610,"OMURA, AKIKO",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437108610,"OMURA, AKIKO",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437108610,"OMURA, AKIKO",702 WILDWOOD RD   ABERDEEN NC,063,Moore,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437108610,"OMURA, AKIKO",702 WILDWOOD RD   ABERDEEN NC,063,Moore,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 65 , 125 , 128 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437108610,"OMURA, AKIKO",311 W PHIFER ST   MARSHVILLE NC,090,Union,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,516 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1437108628,"HOWERTON, SHAWN, MICHAEL",304 W NC HIGHWAY 24   ROSEBORO NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 43 , 48 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437108826,"WASHBURN, KURT, RICHARD",6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437108826,"WASHBURN, KURT, RICHARD",6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 20 , 31 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437108826,"WASHBURN, KURT, RICHARD",6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 68 , 83 ,$#,,
MEDICAID DIRECT,1437110905,CAPE FEAR ORTHOTICS AND PROSTHETICS,Cape Fear Orthotics and Prosthetics,435 W RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437110905,CAPE FEAR ORTHOTICS AND PROSTHETICS,435 W RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 14 , 20 , 46 ," $14,793.03 ",,
MEDICAID DIRECT,1437111523,"CONNER, LILLIAN, MICHELLE",~,4805 PARK RD STE 223 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1437111523,"CONNER, LILLIAN, MICHELLE",4805 PARK RD STE 223 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 50 , 140 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437112836,"HEARON, BRIAN, PAUL",128 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 78 , 100 , 121 ,$#,,
MEDICAID DIRECT,1467851626,COASTAL FAMILY PRACTICE PLLC,,820 W MAIN ST   BELHAVEN NC,007,Beaufort,193400000X,Group,Single Specialty,,1437116761,"ONEAL, HELENE, ROSE",820 W MAIN ST   BELHAVEN NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 65 , 164 , 319 ,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1437116761,"ONEAL, HELENE, ROSE",820 W MAIN ST   BELHAVEN NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,510 N ELAM AVE STE 303 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437119161,"POWELL, ELMIRA, JUANITA",510 N ELAM AVE STE 303 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1437119997,"BRUIN, MICHAEL, LEROY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 39 , 45 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437124021,"SAMOTOWKA, MICHAEL, ALEXANDER",8201 HEALTHCARE LOOP STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437124021,"SAMOTOWKA, MICHAEL, ALEXANDER",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437124021,"SAMOTOWKA, MICHAEL, ALEXANDER",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 82 , 83 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437124195,"INCORVAIA, JULIE, ANNE",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437124195,"INCORVAIA, JULIE, ANNE",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 23 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437124195,"INCORVAIA, JULIE, ANNE",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437124559,"LEE, ALBERT, H",844 KEMPSVILLE RD STE 103B NORFOLK VA,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 19 ,$#,,
MEDICAID DIRECT,1437125085,CHILD FAMILY DEVELOPMENT INC,CHILD & FAMILY DEVELOPMENT INC,4012 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437125085,CHILD FAMILY DEVELOPMENT INC,4012 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 70 ," 1,420 "," 2,005 "," $141,357.94 ",,
MEDICAID DIRECT,1437125085,CHILD FAMILY DEVELOPMENT INC,CHILD & FAMILY DEVELOPMENT INC,11940 CAROLINA PLACE PKWY STE 200 PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437125085,CHILD FAMILY DEVELOPMENT INC,11940 CAROLINA PLACE PKWY STE 200 PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 137 , 896 ," 1,089 "," $83,001.41 ",,
MEDICAID DIRECT,1982797072,FAYETTEVILLE PULMONOLOGY CRITICAL C,FAYETTEVILLE PULMONOLOGY CRITICAL CARE PC,1205 CAPE CT STE A FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437126224,"DEV, GAUTAM",1205 CAPE CT STE A FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 161 , 334 ," 1,032 "," $13,696.70 ",,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1437128600,"BURTON, CHRISTOPHER, EDWARD",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1437129087,"SCHLEINITZ, PAUL, FRITZ",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437129285,"DARTEY-HAYFORD, SAMUEL, KWAME",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 61 , 69 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437129285,"DARTEY-HAYFORD, SAMUEL, KWAME",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437129285,"DARTEY-HAYFORD, SAMUEL, KWAME",11840 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437129285,"DARTEY-HAYFORD, SAMUEL, KWAME",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 30 , 47 , 59 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437129285,"DARTEY-HAYFORD, SAMUEL, KWAME",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437129335,"PROVENZANO, JOHN, MARC",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033150875,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - DIABETES AND ENDO,853 N CHURCH ST STE 720C SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437129525,"SANDRIN, MAYTE",853 N CHURCH ST STE 720C SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,710 MILITARY CUTOFF RD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437130523,"VIEHMAN, GREG, EDWIN",710 MILITARY CUTOFF RD STE 200 WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437130523,"VIEHMAN, GREG, EDWIN",710 MILITARY CUTOFF RD STE 200 WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437130689,"SILVER, JULIE, KATHLEEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437130846,"BEARDSLEY, THOMAS, LEWIS",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437132511,"YEH, ANDOL, STEPHEN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 22 , 35 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1437132511,"YEH, ANDOL, STEPHEN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 28 , 39 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437133600,"WEARMOUTH II, WILLIAM, HARVEY",301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1437133626,"GILDERSLEEVE, RONALD, CLARK",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1437133626,"GILDERSLEEVE, RONALD, CLARK",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437133626,"GILDERSLEEVE, RONALD, CLARK",242 9TH AVENUE DR NE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1871577197,KINSTON PEDIATRIC ASSOCIATES PA,Kinston Pediatric Associates PA,2509 N QUEEN ST   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1437133634,"SICO DAVIS, CHRISANDRA, REY",2509 N QUEEN ST   KINSTON NC,054,Lenoir,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 35 , 91 ,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1437133717,"MARKS, CAROL, CONLEY",169 DOCTORS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1437133717,"MARKS, CAROL, CONLEY",169 BIRCH ST   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 23 , 43 ,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1437133717,"MARKS, CAROL, CONLEY",169 BIRCH ST   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1437133717,"MARKS, CAROL, CONLEY",169 DOCTORS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437133816,"POEHLING, GARY, GEORGE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 72 , 94 , 151 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437133832,"WEBB, LAWRENCE, XAVIER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134095,"SANDERS, JOHN, WALTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 74 , 127 , 135 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437134442,"CASEY, DAVID, JOSEPH",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 66 , 106 , 173 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,311 E PRESNELL ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1437134475,"FITZGERALD, DAVID, MICHAEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134475,"FITZGERALD, DAVID, MICHAEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134475,"FITZGERALD, DAVID, MICHAEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 199 , 328 , 422 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134525,"ROCCO, MICHAEL, VITO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 103 , 318 , 318 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134632,"KAHL, FREDERIC, ROSS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 699 , 875 , 879 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134632,"KAHL, FREDERIC, ROSS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134632,"KAHL, FREDERIC, ROSS",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 68 , 75 , 75 ,$#,,
MEDICAID DIRECT,1437134848,"MEBANE, THOMAS, ALLEN",~,444 JACKSON ST   ROANOKE RAPIDS NC,042,Halifax,152W00000X,Eye and Vision Services Providers,Optometrist,,1437134848,"MEBANE, THOMAS, ALLEN",444 JACKSON ST   ROANOKE RAPIDS NC,042,Halifax,152W00000X,Eye and Vision Services Providers,Optometrist,, 44 , 48 , 83 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134863,"BRUGGEN, JOEL, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 58 , 74 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134863,"BRUGGEN, JOEL, THOMAS",500 SHEPHERD ST   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134863,"BRUGGEN, JOEL, THOMAS",500 SHEPHERD ST   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437134863,"BRUGGEN, JOEL, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1437136678,"KEELEY, MICHAEL, MURRAY",110 W GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 32 , 43 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1437136678,"KEELEY, MICHAEL, MURRAY",201 E GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1437137080,"HOBSON, HARRY, DOUGLAS",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 62 , 64 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437137080,"HOBSON, HARRY, DOUGLAS",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437137080,"HOBSON, HARRY, DOUGLAS",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 23 , 29 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1437137080,"HOBSON, HARRY, DOUGLAS",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 23 , 36 ,$#,,
MEDICAID DIRECT,1134295850,COUNTY OF MONTGOMERY,MONTGOMERY COUNTY HEALTH DEPT,217 S MAIN ST STE B TROY NC,062,Montgomery,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1437137866,"SHEN, JOHN",815 N 3RD ST   ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1033207766,ALBERMARLE WOMENS CLINIC PA,~,815 N 3RD ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1437137866,"SHEN, JOHN",815 N 3RD ST   ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 65 , 131 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437139920,"KERCHNER, BRYAN, MICHAEL",10030 GILEAD RD STE 140 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437139920,"KERCHNER, BRYAN, MICHAEL",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 60 , 102 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437139920,"KERCHNER, BRYAN, MICHAEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1326669508,WESTERN CAROLINA SEDATION ASSOCIATE,,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437139995,"RICHARD, MICHAEL, ELMER",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1437139995,"RICHARD, MICHAEL, ELMER",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437140050,"LOIACONO, ANDREW, PATRICK",582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,180 FOY DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1437141009,"COWDER, ANDREW, JOHN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 23 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437141009,"COWDER, ANDREW, JOHN",180 FOY DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,, 35 , 81 , 210 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437141009,"COWDER, ANDREW, JOHN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,180 FOY DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1437141009,"COWDER, ANDREW, JOHN",180 FOY DR   ROCKY MOUNT NC,064,Nash,208800000X,Allopathic & Osteopathic Physicians,Urology,, 150 , 253 , 720 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437141264,"GALLAHER, ROBERT, THOMAS",706 ROSANNE DR   KINSTON NC,054,Lenoir,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,706 ROSANNE DR   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1437141264,"GALLAHER, ROBERT, THOMAS",706 ROSANNE DR   KINSTON NC,054,Lenoir,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 33 , 36 , 45 ,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437141314,"BOOTH, KELLY, ALEXANDER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437141314,"BOOTH, KELLY, ALEXANDER",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437141314,"BOOTH, KELLY, ALEXANDER",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437141314,"BOOTH, KELLY, ALEXANDER",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 25 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437141611,"HENWOOD-FINLEY, MARIA, JANAE",2150 HERBERT CT   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437141611,"HENWOOD-FINLEY, MARIA, JANAE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 31 , 44 , 51 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437141611,"HENWOOD-FINLEY, MARIA, JANAE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437141611,"HENWOOD-FINLEY, MARIA, JANAE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437141934,"KATWA, GEETA",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 62 , 86 , 136 ,$#,,
MEDICAID DIRECT,1437143419,"MEJIA, VICENTE, ALONSO",~,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1437143419,"MEJIA, VICENTE, ALONSO",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437144094,"POWELL, CHARLES, STEVEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 16 , 32 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437144094,"POWELL, CHARLES, STEVEN",115 HEART DR   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437144094,"POWELL, CHARLES, STEVEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437144094,"POWELL, CHARLES, STEVEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 110 , 133 , 191 ,$#,,
MEDICAID DIRECT,1679568992,GASTONIA PEDIATRIC ASSOCIATES PA,GASTONIA PEDIATRIC ASSOCIATES PA,1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437144748,"WATTS, JOHN, COMER",1839 E GARRISON BLVD   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 15 , 40 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,250 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1437145000,"OLEKSYK, MICHAEL, STEVEN",250 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437145000,"OLEKSYK, MICHAEL, STEVEN",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437145604,"ALLISON, TREVOR, ROBERT",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437145604,"ALLISON, TREVOR, ROBERT",307 E THOM ST   CHINA GROVE NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 33 , 56 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437145604,"ALLISON, TREVOR, ROBERT",1965 S US 29 HWY   CHINA GROVE NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 83 , 256 , 606 ,$#,,
MEDICAID DIRECT,1134172604,WESTERN PIEDMONT ANESTHESIA,WESTERN PIEDMONT ANESTHESIA,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1437146107,"RINALDO, FRANK, EDWARD",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437146842,"KAUFFMAN, SCOTT, EDWARD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1932599248,EAST CAROLINA UNIVERSITY,ECU PHYSICAL THERAPY SERVICES,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437148913,"GARRISON, MICHAEL, PAUL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 12 , 24 , 36 ,$#,,
MEDICAID DIRECT,1780686659,NEWTON OPTOMETRIC CENTER PLLC,NEWTON VISION CENTER,750 IRIS LN   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1437151321,"KULESIA, DAVID, JEROME",750 IRIS LN   NEWTON NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1578565305,MAIDEN OPTOMETRIC EYE CARE CENTER P,MAIDEN EYE CLINIC,503 ISLAND FORD RD   MAIDEN NC,018,Catawba,193400000X,Group,Single Specialty,,1437151321,"KULESIA, DAVID, JEROME",503 ISLAND FORD RD   MAIDEN NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1578565305,MAIDEN OPTOMETRIC EYE CARE CENTER P,MAIDEN EYE CLINIC,503 ISLAND FORD RD   MAIDEN NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437151321,"KULESIA, DAVID, JEROME",503 ISLAND FORD RD   MAIDEN NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1780686659,NEWTON OPTOMETRIC CENTER PLLC,NEWTON VISION CENTER,750 IRIS LN   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437151321,"KULESIA, DAVID, JEROME",750 IRIS LN   NEWTON NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 22 , 27 ,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437151784,"CHAVIS, LARHODA, FRANCINE",102 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437151784,"CHAVIS, LARHODA, FRANCINE",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 93 , 294 , 298 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1437151784,"CHAVIS, LARHODA, FRANCINE",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 74 , 74 ," $23,742.64 ",,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1437153954,"ENGSTROM, WILLIAM, GARY",169 DOCTORS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1437153954,"ENGSTROM, WILLIAM, GARY",169 BIRCH ST   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 19 , 35 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437154093,"HULL, JENNIFER, MARIE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1437154093,"HULL, JENNIFER, MARIE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1437154093,"HULL, JENNIFER, MARIE",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 31 , 35 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437154093,"HULL, JENNIFER, MARIE",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 422 , 554 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1437154093,"HULL, JENNIFER, MARIE",2001 VAN HAVEN DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 248 , 345 ,$#,,
MEDICAID DIRECT,1467763797,SOUTHMOUNTAIN CHILDREN AND FAMILY S,Southmountain Children and Family Services,116 N ENGLEWOOD DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1437156668,"CABINUM FOELLER, ELAINE, SHARON",116 N ENGLEWOOD DR   ROCKY MOUNT NC,064,Nash,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1467763797,SOUTHMOUNTAIN CHILDREN AND FAMILY S,Southmountain Children and Family Services,506 POLLOCK ST   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1437156668,"CABINUM FOELLER, ELAINE, SHARON",506 POLLOCK ST   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 23 ,$#,,
MEDICAID DIRECT,1467763797,SOUTHMOUNTAIN CHILDREN AND FAMILY S,Southmountain Children and Family Services,8076 NC HIGHWAY 105 S   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1437156668,"CABINUM FOELLER, ELAINE, SHARON",506 POLLOCK ST   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437157195,"KING, ERIKA, ROCHELLE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 26 , 26 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1437157963,"KAISER, BARBARA",10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1437157963,"KAISER, BARBARA",10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 13 , 30 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1437157963,"KAISER, BARBARA",717 S TORRENCE ST   CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1437158201,"PEACE, ROBIN, YOLANDA",725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 102 , 261 , 536 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437158201,"PEACE, ROBIN, YOLANDA",725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 29 , 46 ,$#,,
MEDICAID DIRECT,1427282045,SOUTHEASTERN REGIONAL PHYSICIAN SER,~,,,Unknown,193200000X,Group,Multi-Specialty,,1437158201,"PEACE, ROBIN, YOLANDA",725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437158201,"PEACE, ROBIN, YOLANDA",923 W 3RD ST   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 74 , 90 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 141 , 172 , 185 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 81 , 122 , 191 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 59 , 89 , 201 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 26 , 48 ,$#,,
MEDICAID DIRECT,1952334120,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Cardiology of Raleigh,,,Unknown,193400000X,Group,Single Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437158508,"PARSONS, WILLIAM, JONATHAN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437158870,"INFANTE, JORGE, LUIS",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730203506,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,10188 N MAIN ST   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1437159118,"WITTEN, BOBBY, DEWAYNE",10188 N MAIN ST   ARCHDALE NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 121 , 164 ,$#,,
MEDICAID DIRECT,1437159613,COUNTY OF DURHAM FINANCE DEPT,DURHAM COUNTY EMS,201 E MAIN ST STE 660 DURHAM NC,032,Durham,3416L0300X,Transportation Services,Ambulance,Land Transport,1437159613,COUNTY OF DURHAM FINANCE DEPT,201 E MAIN ST STE 660 DURHAM NC,032,Durham,3416L0300X,Transportation Services,Ambulance,Land Transport," 1,953 "," 3,811 "," 6,699 "," $105,366.58 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1437160249,"HENNINGER, LANCE, RAYMOND",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437160249,"HENNINGER, LANCE, RAYMOND",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 82 , 86 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437160462,"WELDNER, PAUL, WILLIAM",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437160462,"WELDNER, PAUL, WILLIAM",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 22 , 27 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437161213,"JOE, RANDALL, ROBERT",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 27 , 46 ,$#,,
MEDICAID DIRECT,1861161515,UNC PHYSICIANS GROUP PRACTICES II L,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437161395,"OXFORD, ROBERT, GLENN",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437161395,"OXFORD, ROBERT, GLENN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437161395,"OXFORD, ROBERT, GLENN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437161395,"OXFORD, ROBERT, GLENN",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1184669053,SOUTHEASTERN MEDICAL GROUP PC,,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1437162732,"FRANKS, DAVID, ALAN",250 HOSPITAL DR   HIGHLANDS NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437162732,"FRANKS, DAVID, ALAN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 116 , 116 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1437162732,"FRANKS, DAVID, ALAN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 40 , 41 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437162732,"FRANKS, DAVID, ALAN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043246556,SPORTS MEDICINE ORTHOPAEDIC CENTE,SPORTS MEDICINE & ORTHOPAEDIC CENTER INC,150 BURNETTS WAY STE 100 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437162815,"FOX, BRYAN, ALAN",150 BURNETTS WAY STE 100 SUFFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1437163268,"BRITT, AMY, SMITH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437163268,"BRITT, AMY, SMITH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437163268,"BRITT, AMY, SMITH",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437163722,"VINCENT, MICHELLE, SUE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1437163722,"VINCENT, MICHELLE, SUE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437163722,"VINCENT, MICHELLE, SUE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174188494,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PHYSICAL THERAPY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437163748,"GRAVATT, CHARLES, OTIS",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1437167319,"SMITH, ERIC, LAURENCE",ERIC LAURENCE SMITH,7 NOBLE ST   SMITHFIELD NC,051,Johnston,111N00000X,Chiropractic Providers,Chiropractor,,1437167319,"SMITH, ERIC, LAURENCE",7 NOBLE ST   SMITHFIELD NC,051,Johnston,111N00000X,Chiropractic Providers,Chiropractor,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437167350,"GIEGENGACK, MATTHEW",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 71 , 115 , 127 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437167350,"GIEGENGACK, MATTHEW",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 41 , 43 ,$#,,
MEDICAID DIRECT,1437167806,"SULLENS, CAROLYN, NICOLE",~,1998 HENDERSONVILLE RD STE 21 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1437167806,"SULLENS, CAROLYN, NICOLE",1998 HENDERSONVILLE RD STE 21 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 102 , 273 , 606 ," $31,658.30 ",,
MEDICAID DIRECT,1437170677,GUILFORD COUNTY SCHOOLS,GUILFORD COUNTY SCHOOLS,712 N EUGENE ST   GREENSBORO NC,041,Guilford,251300000X,Agencies,Local Education Agency (LEA),,1437170677,GUILFORD COUNTY SCHOOLS,712 N EUGENE ST   GREENSBORO NC,041,Guilford,251300000X,Agencies,Local Education Agency (LEA),," 3,088 "," 56,924 "," 58,268 "," $2,326,164.21 ",,
MEDICAID DIRECT,1437171097,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 17162,2901 W HIGHWAY 74   MONROE NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1437171097,NORTH CAROLINA CVS PHARMACY LLC,2901 W HIGHWAY 74   MONROE NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1437171949,SMITHS DRUGS OF FOREST CITY INC,~,139 E MAIN ST   FOREST CITY NC,081,Rutherford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437171949,SMITHS DRUGS OF FOREST CITY INC,139 E MAIN ST   FOREST CITY NC,081,Rutherford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 163 , 693 ," 1,113 "," $24,617.01 ",,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437172012,"KEARNEY, BOBBY, PAXTON",536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437172012,"KEARNEY, BOBBY, PAXTON",31 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1831393198,STEWART OPTOMETRY GROUP PA,STEWART OPTOMETRY GROUP PA,1299 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437172053,"STEWART III, FLOYD",1299 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 107 , 119 , 148 ,$#,,
MEDICAID DIRECT,1831393198,STEWART OPTOMETRY GROUP PA,STEWART OPTOMETRY GROUP PA,1299 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437172053,"STEWART III, FLOYD",5141 NC HIGHWAY 42 W   GARNER NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1538495767,CHARLOTTE PEDIATRIC CLINIC,CHARLOTTE PEDIATRIC CLINIC,6235 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437172640,"SPELL, ARTHUR, BENNETT",6235 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,6235 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437172640,"SPELL, ARTHUR, BENNETT",6235 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1538495767,CHARLOTTE PEDIATRIC CLINIC,CHARLOTTE PEDIATRIC CLINIC,6235 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437172640,"SPELL, ARTHUR, BENNETT",6235 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437172640,"SPELL, ARTHUR, BENNETT",4501 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437173846,"SPITTLE, AMY, CALL",1000 BLYTHE BLVD CAROLINAS MEDICAL CENTER CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437173846,"SPITTLE, AMY, CALL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 39 , 39 ,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437173937,"CAMPBELL, GRANT, LILES",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437173937,"CAMPBELL, GRANT, LILES",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437173937,"CAMPBELL, GRANT, LILES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366765893,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437173937,"CAMPBELL, GRANT, LILES",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437173937,"CAMPBELL, GRANT, LILES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437173937,"CAMPBELL, GRANT, LILES",349 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437173937,"CAMPBELL, GRANT, LILES",4315 PHYSICIANS BLVD STE 201 HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437174109,"YOON, SORA, CHRISTINA",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437174109,"YOON, SORA, CHRISTINA",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437174109,"YOON, SORA, CHRISTINA",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437174109,"YOON, SORA, CHRISTINA",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437174109,"YOON, SORA, CHRISTINA",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437174653,"SPROUSE, SCOTT",600 HOSPITAL DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 50 , 60 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437175239,"MORAN, ANDREW, GREGORY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437175239,"MORAN, ANDREW, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437175239,"MORAN, ANDREW, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1770182933,WAKE PET SERVICES LLC,,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437175239,"MORAN, ANDREW, GREGORY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 111 , 126 , 173 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 23 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 99 , 106 , 152 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437175429,"CHAPMAN, PHILIP, RANDALL",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437175650,"LASTER, KRISTIN, CLICKETT",180 PARKWOOD DR   ELKIN NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437175700,SISTERS OF MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,#,#, 11 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437175890,"SENFT, DANIEL, SCOTT",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 40 , 72 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437175890,"SENFT, DANIEL, SCOTT",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 72 , 179 , 278 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437176138,"MCNEAL TRICE, KENYA, ADJORA",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 86 , 91 ,$#,,
MEDICAID DIRECT,1437176674,WAL-MART STORES EAST LP,WALMART PHARMACY 10-3700,2101 YOUNTS RD   INDIAN TRAIL NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1437176674,WAL-MART STORES EAST LP,2101 YOUNTS RD   INDIAN TRAIL NC,090,Union,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437179108,"PEARSON, DAVID, ANDRES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 39 , 49 ,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437179447,"MIN, JOHN, KYUNG HWAN",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437179447,"MIN, JOHN, KYUNG HWAN",1838 MARTIN LUTHER KING JR BLVD STE 19B CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437179447,"MIN, JOHN, KYUNG HWAN",1838 MARTIN LUTHER KING JR BLVD STE 19B CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437179447,"MIN, JOHN, KYUNG HWAN",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 24 , 26 ,$#,,
MEDICAID DIRECT,1437179892,COMMUNITY PHARMACY OF LINCOLNTON,THE DRUG STORE,626 CENTER DR   LINCOLNTON NC,055,Lincoln,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1437179892,COMMUNITY PHARMACY OF LINCOLNTON,626 CENTER DR   LINCOLNTON NC,055,Lincoln,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1437180635,"BOWMAN, RYAN, SCOTT",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 42 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437180783,"MOODY, MICHAEL, ANTHONY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437180783,"MOODY, MICHAEL, ANTHONY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437180940,"POWERS, WILLIAM, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437180940,"POWERS, WILLIAM, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 16 , 33 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437180940,"POWERS, WILLIAM, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437180940,"POWERS, WILLIAM, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437181831,"STEPHENSON MARSHALL, COURTNEY, DANA",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1437182227,MAXIM HEALTHCARE SERVICES,~,5535 CURRITUCK DR AUTUMN HALL 3 SUITE 220 WILMINGTON NC,065,New Hanover,251J00000X,Agencies,Nursing Care,,1437182227,MAXIM HEALTHCARE SERVICES,5535 CURRITUCK DR AUTUMN HALL 3 SUITE 220 WILMINGTON NC,065,New Hanover,251J00000X,Agencies,Nursing Care,, 37 ," 4,866 "," 5,203 "," $2,335,372.00 ",,
MEDICAID DIRECT,1437182227,MAXIM HEALTHCARE SERVICES,~,5535 CURRITUCK DR AUTUMN HALL 3 SUITE 220 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1437182227,MAXIM HEALTHCARE SERVICES,5535 CURRITUCK DR AUTUMN HALL 3 SUITE 220 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437182730,"RIFFE, DUFFEY, ALAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437182730,"RIFFE, DUFFEY, ALAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437182730,"RIFFE, DUFFEY, ALAN",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437182730,"RIFFE, DUFFEY, ALAN",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 25 , 31 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437182730,"RIFFE, DUFFEY, ALAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437182730,"RIFFE, DUFFEY, ALAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437182730,"RIFFE, DUFFEY, ALAN",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437182920,"WOOSLEY, KIRK, LYLE",12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891726634,HARRISBURG FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE HARRISBURG FAMILY PHYSI,12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437182920,"WOOSLEY, KIRK, LYLE",12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 14 , 22 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437182920,"WOOSLEY, KIRK, LYLE",12170 UNIVERSITY CITY BLVD   HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437185204,"HOOKER, THOMAS, PARRY",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 66 , 117 , 199 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437185204,"HOOKER, THOMAS, PARRY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 17 , 30 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437185204,"HOOKER, THOMAS, PARRY",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 40 , 72 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437185204,"HOOKER, THOMAS, PARRY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437188737,"BUTLER, MARTIN, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437188737,"BUTLER, MARTIN, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437188737,"BUTLER, MARTIN, JOSEPH",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 126 , 199 , 260 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437188737,"BUTLER, MARTIN, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 87 , 272 , 272 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1437190048,"SMITH, ANNE, MARIA",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1437190048,"SMITH, ANNE, MARIA",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1437190048,"SMITH, ANNE, MARIA",5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,193200000X,Group,Multi-Specialty,,1437190048,"SMITH, ANNE, MARIA",5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1437190048,"SMITH, ANNE, MARIA",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437192127,"BOGGS, LINDA, RITA",444 SW CENTER ST   FAISON NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1437192630,"SHELTON, CHARLES, HENDRIX",4927 S CROATAN HWY   NAGS HEAD NC,028,Dare,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 57 , 76 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437193687,"RAYNER, JULIE, SWEET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437196714,"JONES, HEATHER",6251 E VIRGINIA BEACH BLVD STE 115 NORFOLK VA,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4309 MEDICAL PARK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437196839,"DIMON, CAIN, EDWARD",4309 MEDICAL PARK DR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 81 , 118 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437196839,"DIMON, CAIN, EDWARD",4309 MEDICAL PARK DR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437196839,"DIMON, CAIN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 58 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437196839,"DIMON, CAIN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 31 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437196839,"DIMON, CAIN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437196839,"DIMON, CAIN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437200219,"MARTIN, TIMOTHY, WALTER",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1437202595,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,200 E ARROWHEAD DR STE 0-1 CHARLOTTE NC,060,Mecklenburg,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1437202595,LINCARE INC,200 E ARROWHEAD DR STE 0-1 CHARLOTTE NC,060,Mecklenburg,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 366 ," 1,890 "," 3,213 "," $897,745.16 ",,
MEDICAID DIRECT,1437202595,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,200 E ARROWHEAD DR STE 0-1 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1437202595,LINCARE INC,200 E ARROWHEAD DR STE 0-1 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 281 ," 1,951 "," 3,979 "," $119,108.38 ",,
MEDICAID DIRECT,1437202595,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,200 E ARROWHEAD DR STE 0-1 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1437202595,LINCARE INC,200 E ARROWHEAD DR STE 0-1 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1437204245,"VO, MINH, OAI",~,469 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1437204245,"VO, MINH, OAI",469 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 815 ," 1,238 "," 8,756 "," $586,071.72 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437204419,"WEST, KATHLEEN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1437204419,"WEST, KATHLEEN, ELIZABETH",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437204419,"WEST, KATHLEEN, ELIZABETH",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437204609,FREEDOM CALLERS,~,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1437204609,FREEDOM CALLERS,1913 J N PEASE PL STE 101 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1437204609,FREEDOM CALLERS,~,2800 ZEBULON AVE # 201 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1437204609,FREEDOM CALLERS,2800 ZEBULON AVE # 201 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 54 ," 10,253 "," 10,427 "," $1,230,988.93 ",,
MEDICAID DIRECT,1659418515,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE TIMBERLYNE,77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437204872,"MESSICK, MARK, ANDREW",77 VILCOM CIR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 53 , 114 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1 MARITHE CT   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437205150,"SNOW, WHITNEY, LEA",1 MARITHE CT   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 297 , 298 ,$#,,
MEDICAID DIRECT,1609833490,CARTERET CLINIC FOR ADOLESCENTS AND,CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN,312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1437206356,"JOHNSTON, MELANIE, CANADY",312 COMMERCE AVE   MOREHEAD CITY NC,016,Carteret,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 51 , 89 , 187 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437206448,"COTTLE, MARGARET, MOORING",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 26 , 54 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1437206448,"COTTLE, MARGARET, MOORING",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 79 , 207 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437208451,"TAYLOR, ALLISON, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437208451,"TAYLOR, ALLISON, ELIZABETH",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437208451,"TAYLOR, ALLISON, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437208451,"TAYLOR, ALLISON, ELIZABETH",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1437210465,"TILLEY, STEPHEN, LLOYD",75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 56 , 83 , 98 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1437210465,"TILLEY, STEPHEN, LLOYD",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437210465,"TILLEY, STEPHEN, LLOYD",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437210465,"TILLEY, STEPHEN, LLOYD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1437211737,"NULTY, JOHN, M",520 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437212206,"KURTZBERG, JOANNE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437212206,"KURTZBERG, JOANNE",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437212651,"BEDNAR JR, ROBERT, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437212651,"BEDNAR JR, ROBERT, EDWARD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437212669,"PITTMAN, JANA, PEOPLES",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437212669,"PITTMAN, JANA, PEOPLES",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1437217288,SUPERIOR HOME MEDICAL INC,SUPERIOR HOME MEDICAL INC,108 S MAIN ST   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437217288,SUPERIOR HOME MEDICAL INC,108 S MAIN ST   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 43 , 290 , 386 ," $93,269.48 ",,
MEDICAID DIRECT,1437217288,SUPERIOR HOME MEDICAL INC,SUPERIOR HOME MEDICAL INC,108 S MAIN ST   MONROE NC,090,Union,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1437217288,SUPERIOR HOME MEDICAL INC,108 S MAIN ST   MONROE NC,090,Union,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 86 , 758 ," 2,447 "," $174,178.03 ",,
MEDICAID DIRECT,1437221660,ENDOSCOPY CENTER UNIVERSITY LLC,ENDOSCOPY CENTER UNIVERSITY LLC,101 E W T HARRIS BLVD STE 3215 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1437221660,ENDOSCOPY CENTER UNIVERSITY LLC,101 E W T HARRIS BLVD STE 3215 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 37 , 38 , 62 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437224201,"LEWALLEN, LINDA, LORRAINE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1437224201,"LEWALLEN, LINDA, LORRAINE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437224763,"STEMPEK, MICHAEL, DAVID",444 SW CENTER ST   FAISON NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386158475,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CLEMMONS,4168 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437225869,"GARRETSON, JOSEPH, KORY",1228 W ROOSEVELT BLVD STE B MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 37 , 104 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437231685,"BUSHNELL, CHERYL, DIANE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 37 , 61 , 65 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437231685,"BUSHNELL, CHERYL, DIANE",624 QUAKER LN   HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437233301,"VAWTER, HEATHER, ANNE",4116 CAPITOL ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437233301,"VAWTER, HEATHER, ANNE",4116 CAPITOL ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437233301,"VAWTER, HEATHER, ANNE",4116 CAPITOL ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437233301,"VAWTER, HEATHER, ANNE",4116 CAPITOL ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1063948297,RDMG ASSOCIATES PA,SPINDALE FAMILY PRACTICE,144 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437235173,"VOGEL, NICKI, PARTON",144 RESERVATION DR   SPINDALE NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 147 , 322 ,$#,,
MEDICAID DIRECT,1346248119,SURGICAL EYE CARE PA,SURGICAL EYE CARE PA,1717 SHIPYARD BLVD STE 140 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437236114,"HAWKINS, RICHARD, DAX",1717 SHIPYARD BLVD STE 140 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 48 , 89 , 134 ,$#,,
MEDICAID DIRECT,1437236221,UNITED HOME CARE INC,,137 S BICKETT BLVD   LOUISBURG NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,,1437236221,UNITED HOME CARE INC,137 S BICKETT BLVD   LOUISBURG NC,035,Franklin,253Z00000X,Agencies,In Home Supportive Care,, 55 ," 11,600 "," 11,655 "," $1,232,075.34 ",,
MEDICAID DIRECT,1437238284,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,1221 SALISBURY AVE   ALBEMARLE NC,084,Stanly,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1437238284,LINCARE INC,1221 SALISBURY AVE   ALBEMARLE NC,084,Stanly,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1437238284,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,1221 SALISBURY AVE   ALBEMARLE NC,084,Stanly,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1437238284,LINCARE INC,1221 SALISBURY AVE   ALBEMARLE NC,084,Stanly,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1437238284,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,1221 SALISBURY AVE   ALBEMARLE NC,084,Stanly,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1437238284,LINCARE INC,1221 SALISBURY AVE   ALBEMARLE NC,084,Stanly,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 180 ," 1,615 "," 2,457 "," $51,269.14 ",,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437239829,"ROBINSON, BLAIR, VERNON",1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1437239829,"ROBINSON, BLAIR, VERNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1437239829,"ROBINSON, BLAIR, VERNON",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1437239829,"ROBINSON, BLAIR, VERNON",120 HEALTHPLEX WAY   APEX NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437239829,"ROBINSON, BLAIR, VERNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 43 , 49 , 102 ,$#,,
MEDICAID DIRECT,1013571405,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC CARDIOLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437239829,"ROBINSON, BLAIR, VERNON",104 MEDSPRING DR   CLAYTON NC,051,Johnston,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437241007,"SMITH, SUSAN, ELAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,429 COMMONWEALTH BLVD E   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437243656,"HALUKURIKE, VISHWANATH, NARAYANASWAMY",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1619927100,DANVILLE UROLOGIC CLINIC INC,SOUTHSIDE UROLOGY & NEPHROLOGY,1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437243656,"HALUKURIKE, VISHWANATH, NARAYANASWAMY",1040 MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437243680,"AGGARWAL, PUNEET, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437243680,"AGGARWAL, PUNEET, KUMAR",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1386991297,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437243680,"AGGARWAL, PUNEET, KUMAR",14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 26 , 39 , 60 ,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437243680,"AGGARWAL, PUNEET, KUMAR",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 20 , 25 , 46 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437243680,"AGGARWAL, PUNEET, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1386991297,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437243680,"AGGARWAL, PUNEET, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437244985,"LYKINS, KIMBERLY, GLENN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 66 , 100 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437244985,"LYKINS, KIMBERLY, GLENN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437245115,"FICHTINGER, MARY, KATHRYN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437245115,"FICHTINGER, MARY, KATHRYN",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1437250131,"PEREZ-RIVERA, EFRAIN",520 NORTH ST   SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 67 , 101 , 128 ," $29,393.74 ",,
MEDICAID DIRECT,1437250347,COUNTY OF ROWAN,ROWAN COUNTY EMS,130 W INNES ST   SALISBURY NC,080,Rowan,3416L0300X,Transportation Services,Ambulance,Land Transport,1437250347,COUNTY OF ROWAN,130 W INNES ST   SALISBURY NC,080,Rowan,3416L0300X,Transportation Services,Ambulance,Land Transport, 849 ," 1,457 "," 2,661 "," $34,583.81 ",,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437250875,"BARBU, RICHARD, RAZVAN",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437251949,"MCSHEA, CHRISTINA, TAYLOR",3193 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,705 GRIFFITH ST   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437251949,"MCSHEA, CHRISTINA, TAYLOR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 29 ,$#,,
MEDICAID DIRECT,1902837073,DAVIDSON CLINIC,ATRIUM HEALTH PRIMARY CARE DAVIDSON CLINIC,705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437251949,"MCSHEA, CHRISTINA, TAYLOR",705 GRIFFITH ST   DAVIDSON NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1437252103,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05597,3311 MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1437252103,NORTH CAROLINA CVS PHARMACY LLC,3311 MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1437252137,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03319,9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1437252137,NORTH CAROLINA CVS PHARMACY LLC,9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1437252202,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03815,1156 E CASWELL ST   WADESBORO NC,004,Anson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437252202,NORTH CAROLINA CVS PHARMACY LLC,1156 E CASWELL ST   WADESBORO NC,004,Anson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1437252202,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03815,1156 E CASWELL ST   WADESBORO NC,004,Anson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1437252202,NORTH CAROLINA CVS PHARMACY LLC,1156 E CASWELL ST   WADESBORO NC,004,Anson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437252699,"MILLER, CARLTON, DAVID",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1437252699,"MILLER, CARLTON, DAVID",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 24 ,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437252699,"MILLER, CARLTON, DAVID",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437253879,"GRAEUB, CHARLES, MAX",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 54 , 57 ,$#,,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437255387,"HALL, GARY, LEE",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437255387,"HALL, GARY, LEE",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 77 ,$#,,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1437255387,"HALL, GARY, LEE",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 42 ,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1437255387,"HALL, GARY, LEE",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 28 , 100 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437256443,"KOONTS, HEATHER, LEIGH MCDANIEL",3431 WALKERTOWN COMMONS DR   WALKERTOWN NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 20 , 37 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437256443,"KOONTS, HEATHER, LEIGH MCDANIEL",240 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 19 , 33 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437256443,"KOONTS, HEATHER, LEIGH MCDANIEL",2205 OAK RIDGE RD STE AA-BB OAK RIDGE NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437256443,"KOONTS, HEATHER, LEIGH MCDANIEL",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437257029,"YACUZZO, ANGELA, SPILLMAN",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 25 , 42 ,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437257029,"YACUZZO, ANGELA, SPILLMAN",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,2101 SHILOH CHURCH RD   DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437257029,"YACUZZO, ANGELA, SPILLMAN",2101 SHILOH CHURCH RD   DAVIDSON NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1437257094,"HOUGH, JANA, WOLLER",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1437257094,"HOUGH, JANA, WOLLER",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1437257094,"HOUGH, JANA, WOLLER",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 VETERANS PKWY   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 25 , 66 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 37 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,910 N MADISON BLVD STE B ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",910 N MADISON BLVD STE B ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,903 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",903 S BECKFORD DR   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437257573,"MCMURTRAY, MARK, VINCENT",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730288895,EDEN INTERNAL MEDICINE ASSOCIATES,EDEN INTERNAL MEDICINE PLLC,405 THOMPSON ST   EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1437257706,"VYAS, DHRUV, BHUPENDRAPRASAD",405 THOMPSON ST   EDEN NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 159 , 596 ," 1,397 "," $15,283.75 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437260262,"SCARLETT, ELIZABETH, ERIN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 32 , 81 , 97 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437260262,"SCARLETT, ELIZABETH, ERIN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 51 , 179 , 343 ," $65,027.46 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437262383,"NORWOOD, KIRSTA, LYNNE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437263498,"GAMBLE, YVETTE, DENISE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437263498,"GAMBLE, YVETTE, DENISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437263498,"GAMBLE, YVETTE, DENISE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437263803,"STEELE, BRIAN, MCKAY",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437264736,"BRENNAN, KEVIN, JOSEPH",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 25 , 55 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437264736,"BRENNAN, KEVIN, JOSEPH",6781 PARKER FARM DR STE 200 WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 38 , 61 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1437264736,"BRENNAN, KEVIN, JOSEPH",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1437264736,"BRENNAN, KEVIN, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437268265,"SCAGNELLI, JOHN, RENSHAW",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437268265,"SCAGNELLI, JOHN, RENSHAW",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437268265,"SCAGNELLI, JOHN, RENSHAW",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 94 , 139 , 273 ,$#,,
MEDICAID DIRECT,1235347378,NORTHLAKE CHILDRENS ASSOCIATES,~,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1437269644,"JAMES, MARY, MARGARET",170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 28 , 48 ,$#,,
MEDICAID DIRECT,1437269800,IREDELL SURGICAL ASSOCIATES LLP,IREDELL SURGICAL ASSOCIATES LLP,1720 DAVIE AVE   STATESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1437269800,IREDELL SURGICAL ASSOCIATES LLP,1720 DAVIE AVE   STATESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1437272408,"BAKER, CARRIE, LILLIE",~,144 ANNARON CT   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,1437272408,"BAKER, CARRIE, LILLIE",144 ANNARON CT   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437273257,"BROWN, JIL, HUMBERGER",2704 N MAIN ST   TARBORO NC,033,Edgecombe,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 29 , 34 , 47 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437274396,"OURSLER, THERESA, NOEL",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700548377,WESTERN NC COMMUNITY HEALTH SVCS,,1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437274396,"OURSLER, THERESA, NOEL",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437274776,"BRADLEY, STACY, DENISE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1437283231,"EDWARDS, CHASTITY, TAKOMA",105 MCALPINE LN   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1437283231,"EDWARDS, CHASTITY, TAKOMA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1437286325,"HAYNES, MARJORIE, PRIM",~,207 FAIRWAY DR   ROCKINGHAM NC,077,Richmond,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1437286325,"HAYNES, MARJORIE, PRIM",207 FAIRWAY DR   ROCKINGHAM NC,077,Richmond,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 11 , 147 , 147 ," $14,049.64 ",,
MEDICAID DIRECT,1437288081,NU- EYES INC,VISIONMASTERS,2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1437288081,NU- EYES INC,2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 313 , 325 , 618 ,$#,,
MEDICAID DIRECT,1437288081,NU- EYES INC,VISIONMASTERS,2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1437288081,NU- EYES INC,2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,, 122 , 124 , 246 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437288404,"REYNOLDS, GREGORY, BRIAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437288404,"REYNOLDS, GREGORY, BRIAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437288404,"REYNOLDS, GREGORY, BRIAN",1450 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 39 , 67 ,$#,,
MEDICAID DIRECT,1437291317,GLEN ALPINE FAMILY CARE HOME,Glen Alpine Family Care,405 LINVILLE ST   GLEN ALPINE NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437291317,GLEN ALPINE FAMILY CARE HOME,405 LINVILLE ST   GLEN ALPINE NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 437 , 440 ," $132,039.68 ",,
MEDICAID DIRECT,1437293594,SUSAN DURHAM,GOLDEN YEARS FAMILY CARE HOME,410 MONTFORD DR   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437293594,SUSAN DURHAM,410 MONTFORD DR   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 276 , 276 ," $126,387.84 ",,
MEDICAID DIRECT,1437297413,BILINGUAL THERAPEUTIC RESOURCES INC,Bilingual Therapeutic Resources Inc,128 SALEM TOWNE CT   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1437297413,BILINGUAL THERAPEUTIC RESOURCES INC,128 SALEM TOWNE CT   APEX NC,092,Wake,193400000X,Group,Single Specialty,, 36 , 596 , 596 ," $41,418.77 ",,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437303666,"GARFINKEL, PAMELA, ELLYN",624 JONES FERRY RD   CARRBORO NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437303666,"GARFINKEL, PAMELA, ELLYN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437303666,"GARFINKEL, PAMELA, ELLYN",10130 PERIMETER PKWY   CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1700918125,RHA HEALTH SERVICES INC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1437305786,"RUSSO, FRANK, LOUIS",13 S MAIN ST   MARSHALL NC,057,Madison,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437307691,"BREWER, JULIE, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437307691,"BREWER, JULIE, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437308046,"ZUCCO, SARA, EMILIE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437309366,"BAKER, KATHRYN, METCALF",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437309366,"BAKER, KATHRYN, METCALF",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437310158,"LOWERY, SHELLY, STRICKLAND",412 S JONES ST   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 59 , 87 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,136 SPARKS DR   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437311958,"KALAPURAKAL, SINI, JOSEPH",136 SPARKS DR   FOREST CITY NC,081,Rutherford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 44 , 110 , 111 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,136 SPARKS DR   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437311958,"KALAPURAKAL, SINI, JOSEPH",181 DANIEL RD STE 100 FOREST CITY NC,081,Rutherford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437311958,"KALAPURAKAL, SINI, JOSEPH",136 SPARKS DR   FOREST CITY NC,081,Rutherford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437311958,"KALAPURAKAL, SINI, JOSEPH",181 DANIEL RD STE 100 FOREST CITY NC,081,Rutherford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437313194,"THOMAS, DENISE, CRYSTAL",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 44 , 53 , 65 ,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437313194,"THOMAS, DENISE, CRYSTAL",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 227 , 373 , 477 ,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437313194,"THOMAS, DENISE, CRYSTAL",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437313194,"THOMAS, DENISE, CRYSTAL",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437313194,"THOMAS, DENISE, CRYSTAL",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437316783,"BETZ, PAMELA",13 MEDICAL CAMPUS DR NW STE 101 SUPPLY NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1437316783,"BETZ, PAMELA",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,3541 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437318292,"KOLKER, JEANETTE, IRENE",3541 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437318441,"KARAMCHANDANI, RAHUL, RAMESH",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437318441,"KARAMCHANDANI, RAHUL, RAMESH",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 94 , 96 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437322047,"JORDAN, GRACE, ANNE",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437322047,"JORDAN, GRACE, ANNE",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437324415,"ORCIGA, LEE, SY",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",1423 E FRANKLIN ST STE I MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",1423 E FRANKLIN ST STE I MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",1225 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 28 , 30 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",1437 SCOTT AVE   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 52 , 56 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",202 E GROVER ST   SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",202 E GROVER ST   SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437324951,"DIMITRIU, DAN-ANDREI",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437326931,"PASCARELLA, LUIGI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 62 , 80 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 104 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437326931,"PASCARELLA, LUIGI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437326931,"PASCARELLA, LUIGI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1164726105,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,1600 MEDICAL DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1437327376,"PARKES, BRIAN, MICHAEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 38 , 41 ,$#,,
MEDICAID DIRECT,1164726105,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1437327376,"PARKES, BRIAN, MICHAEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 139 , 198 , 204 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437333135,"SCHUETZE, DAVID, PAUL",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 31 , 32 , 41 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437333135,"SCHUETZE, DAVID, PAUL",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437333135,"SCHUETZE, DAVID, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437333770,"WARNER, BENJAMIN, WELTON",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 44 , 90 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437333846,"MCALLISTER, BECK, DEAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 52 , 59 , 70 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437335247,"TRENT, NATALIE, DAWN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437337946,ANGEL HOUSE FCH LLC,ANGEL HOUSE FAMILY CARE HOMES LLC IV,60 HORNOT CIR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437337946,ANGEL HOUSE FCH LLC,60 HORNOT CIR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,081 "," 1,081 "," $69,501.81 ",,
MEDICAID DIRECT,1497752026,ECONOMED OF ABERDEEN,ORTHOTICS & PROSTHETICS OF PINEHURST,95 AVIEMORE DR STE A PINEHURST NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437340619,"ELLIS, DANNY, RALPH",95 AVIEMORE DR STE A PINEHURST NC,063,Moore,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 51 ,$#,,
MEDICAID DIRECT,1437341666,SPEECH TECHNIQUES PA,,3369 DEAL RD   MOORESVILLE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1437341666,SPEECH TECHNIQUES PA,3369 DEAL RD   MOORESVILLE NC,080,Rowan,193200000X,Group,Multi-Specialty,, 75 , 944 ," 1,020 "," $72,172.26 ",,
MEDICAID DIRECT,1437342151,"PLOSZAK, STEFAN, ANDREW",STEFAN A PLOSZAK DDS PA,6801 SOUTH BLVD STE F CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1437342151,"PLOSZAK, STEFAN, ANDREW",6801 SOUTH BLVD STE F CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 528 ," 1,037 "," 4,355 "," $154,916.43 ",,
MEDICAID DIRECT,1770515272,INTRACOASTAL INTERNAL MEDICINE,~,2580 PICKARD RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437343357,"DILLS, ERIN, CAUDLE",2580 PICKARD RD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 40 , 53 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437344058,"SMITH, MICHAEL, TYLER",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437344058,"SMITH, MICHAEL, TYLER",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437344058,"SMITH, MICHAEL, TYLER",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437345097,"CULLEY, JOHANNA, FENCL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437347747,NATIVE ANGELS TOTAL PROPERTY MANAGE,NATIVE ANGELS,2112 SKIBO RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1437347747,NATIVE ANGELS TOTAL PROPERTY MANAGE,2112 SKIBO RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,736 "," 2,736 "," $181,589.28 ",,
MEDICAID DIRECT,1437347747,NATIVE ANGELS TOTAL PROPERTY MANAGE,NATIVE ANGELS,2609 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1437347747,NATIVE ANGELS TOTAL PROPERTY MANAGE,2609 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 419 , 419 ," $26,653.12 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437349016,"CHADA, PRAVEEN, REDDY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 80 , 80 ,$#,,
MEDICAID DIRECT,1306957451,WILMINGTON MATERNAL-FETAL MEDICINE,WILMINGTON MATERNAL-FETAL MEDICINE PLLC,2212 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437350147,"CARVER, ALISSA, RENEE",2212 DELANEY AVE   WILMINGTON NC,065,New Hanover,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 68 , 109 , 248 ," $15,084.17 ",,
MEDICAID DIRECT,1306957451,WILMINGTON MATERNAL-FETAL MEDICINE,WILMINGTON MATERNAL-FETAL MEDICINE PLLC,2212 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437350147,"CARVER, ALISSA, RENEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437350154,"BEAMON, CARMEN, JE VONNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 27 ,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437350154,"BEAMON, CARMEN, JE VONNE",210 ASHVILLE AVE   CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 17 ,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,10880 DURANT RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437350154,"BEAMON, CARMEN, JE VONNE",10880 DURANT RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 26 , 28 , 51 ,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437350154,"BEAMON, CARMEN, JE VONNE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 73 , 89 , 155 ," $12,193.67 ",,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437350154,"BEAMON, CARMEN, JE VONNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437352895,"ZHOU, LI",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1437352895,"ZHOU, LI",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 32 , 55 ,$#,,
MEDICAID DIRECT,1063647394,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - FOR,2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437353364,"ERICKSON, CARRIE, JOY",2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 72 , 142 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437353612,"BEAR, BROOKE, COLIN",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 91 , 173 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437353612,"BEAR, BROOKE, COLIN",4796 OLD TAR RD   WINTERVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 189 , 261 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437354446,"MILLER, ANDREW, HARRY FRANK",844 KEMPSVILLE RD STE 103B NORFOLK VA,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437354446,"MILLER, ANDREW, HARRY FRANK",844 KEMPSVILLE RD STE 103B NORFOLK VA,101,Out of State <= 40 miles,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1437356557,PHOENIX ASSISTED CARE LLC,~,201 WESTHIGH ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437356557,PHOENIX ASSISTED CARE LLC,201 WESTHIGH ST   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 54 ," 16,425 "," 16,425 "," $1,395,907.38 ",,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437357423,"XIA, TIAN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427048172,ASHE MEMORIAL HOSPITAL INC,AMH MOUNTAIN FAMILY CARE CENTER,310 HOSPITAL AVENUE   JEFFERSON NC,005,Ashe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437359585,"KESSLER, AYLA, AHMED",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 45 , 102 , 102 ,$#,,
MEDICAID DIRECT,1881771046,DWIGHT S SMITH DDS PA,DWIGHT S SMTIH DDS PA,2300 WAYNE MEMORIAL DR STE F GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1437360609,"ADAMS, MEREDITH, MARIE SMITH",2300 WAYNE MEMORIAL DR STE F GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 715 ," 1,696 "," 5,616 "," $211,991.99 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437361391,"MCWILLIAMS, MICHAEL, JAY",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 37 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437361391,"MCWILLIAMS, MICHAEL, JAY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437366473,"ELGAVISH, ROTEM, LASZLO ABRAHAM",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437366473,"ELGAVISH, ROTEM, LASZLO ABRAHAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437366754,"ADAWADKAR, SATISH, PRAKASH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1437368586,CASWELL COUNTY SCHOOLS,~,319 MAIN ST E   YANCEYVILLE NC,017,Caswell,251300000X,Agencies,Local Education Agency (LEA),,1437368586,CASWELL COUNTY SCHOOLS,319 MAIN ST E   YANCEYVILLE NC,017,Caswell,251300000X,Agencies,Local Education Agency (LEA),, 103 ," 1,645 "," 1,667 "," $61,150.05 ",,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437369691,"KHETERPAL, EMIL, MITTER",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1437369691,"KHETERPAL, EMIL, MITTER",~,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1437369691,"KHETERPAL, EMIL, MITTER",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 26 , 53 , 93 ,$#,,
MEDICAID DIRECT,1437369691,"KHETERPAL, EMIL, MITTER",~,110 CAPCOM AVE STE 201 WAKE FOREST NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1437369691,"KHETERPAL, EMIL, MITTER",110 CAPCOM AVE STE 201 WAKE FOREST NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437372703,"RAYMO, CHARLES, EUGENE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437372703,"RAYMO, CHARLES, EUGENE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 36 , 36 ,$#,,
MEDICAID DIRECT,1437372737,DONALD BROWN SR,DONS ADULT CARE GROUP HOME,2015 ELLIS RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437372737,DONALD BROWN SR,2015 ELLIS RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 275 , 275 ," $75,151.97 ",,
MEDICAID DIRECT,1437372737,DONALD BROWN SR,DONS ADULT CARE GROUP HOME,,,Unknown,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437372737,DONALD BROWN SR,1925 NC HIGHWAY 55   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#," $17,399.52 ",,
MEDICAID DIRECT,1912121393,ADAM T DORSETT DDS AND JASON T MOOR,ADAM T DORSETT AND JASON T MOORE DDS PA,127 ROYAL TROON LN   ADVANCE NC,030,Davie,193200000X,Group,Multi-Specialty,,1437373883,"DORSETT, ADAM, THOMAS",127 ROYAL TROON LN   ADVANCE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice, 202 , 254 , 778 ," $25,614.19 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437374584,"VANMATER, DAVID, SINCLAIRE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 26 , 70 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437374584,"VANMATER, DAVID, SINCLAIRE",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 26 , 29 , 40 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 24 , 33 , 35 ,$#,,
MEDICAID DIRECT,1891764320,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",800 TILGHMAN DR   DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 50 , 67 , 67 ,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",800 TILGHMAN DR   DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1891764320,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",800 TILGHMAN DR   DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",800 TILGHMAN DR   DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437375854,"VIDWAN, PARAMPREET, SINGH",800 TILGHMAN DR   DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 31 , 38 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437378783,"LEE, YUEH, ZENAS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437378783,"LEE, YUEH, ZENAS",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437378783,"LEE, YUEH, ZENAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437378783,"LEE, YUEH, ZENAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 179 , 190 , 243 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437379476,"HAWFIELD, WESLEY, RAYMOND",175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 16 , 28 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437379476,"HAWFIELD, WESLEY, RAYMOND",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 57 , 89 , 114 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437379732,"DROPKIN, EVAN, KRISTEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437379732,"DROPKIN, EVAN, KRISTEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 20 , 34 ,$#,,
MEDICAID DIRECT,1437380854,"WOODARD, JESSE, DAVID",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,1437380854,"WOODARD, JESSE, DAVID",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437383189,"WALKER, DAVID, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437383189,"WALKER, DAVID, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437384781,"LYON, JACLYN, BRONSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437384781,"LYON, JACLYN, BRONSON",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1437385069,AJT DIABETIC INC,COUNTRYWIDE MEDICAL,8500 ALMEDA GENOA RD STE 112A HOUSTON TX,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437385069,AJT DIABETIC INC,8500 ALMEDA GENOA RD STE 112A HOUSTON TX,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 58 , 246 , 336 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437386919,"CHAO, JENNIFER, JENKINS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437387446,"HARTMAN, NICHOLAS, DWIGHT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 71 , 72 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437388675,"NORTON, MICHAEL, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 68 , 69 , 74 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437388949,"JOYCE, EMMA, FLIPPIN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1437390440,"MOISE, TROY, GARNER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 349 , 349 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,5114 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437390440,"MOISE, TROY, GARNER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437390440,"MOISE, TROY, GARNER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 367 , 367 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437390440,"MOISE, TROY, GARNER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 149 , 149 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437390440,"MOISE, TROY, GARNER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 34 , 34 ,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437392883,"ULMER, JOHN, OLIVER",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1437393261,"HANCOCK, NANCY, LUCILLE",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 54 , 75 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437393774,"JENKINS, JENNIFER, LYNN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 62 , 63 ,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437393774,"JENKINS, JENNIFER, LYNN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437394418,"GOTUR, RAGHAVENDER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 40 , 40 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437394418,"GOTUR, RAGHAVENDER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 41 , 41 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437394418,"GOTUR, RAGHAVENDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437396413,"JAGGI, APRIL, JEANNETTE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1437396454,WENDELL EYE CARE OPTOMETRIC PA,WENDELL EYE CARE OPTOMETRIC PA,18 S MAIN ST   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1437396454,WENDELL EYE CARE OPTOMETRIC PA,18 S MAIN ST   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,, 300 , 307 , 606 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437399201,"JOHNSON, MELISSA, ANN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437399201,"JOHNSON, MELISSA, ANN",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1871232397,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CATAWBA SPRINGS ELEMENTARY,206 N LITTLE EGYPT RD   DENVER NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437401023,"JONES, COURTNEY, SHEQUELLE",2040 RANDOLPH RD STE A CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871232397,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CATAWBA SPRINGS ELEMENTARY,206 N LITTLE EGYPT RD   DENVER NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437401023,"JONES, COURTNEY, SHEQUELLE",206 N LITTLE EGYPT RD   DENVER NC,055,Lincoln,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1740391283,AMERICAN NEUROMONITORING ASSOCIATES,,10275 LITTLE PATUXENT PKWY STE 300 COLUMBIA MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1437404563,"KRISH, SONIA, NAGESH",5429 HIDALGO ST UNIT B HOUSTON TX,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1437405941,"CHATTEN, CARMEN, LASHAY",~,110 N CORCORAN ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1437405941,"CHATTEN, CARMEN, LASHAY",110 N CORCORAN ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437405941,"CHATTEN, CARMEN, LASHAY",~,110 N CORCORAN ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1437405941,"CHATTEN, CARMEN, LASHAY",110 N CORCORAN ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437407129,"BELLIS, EMILY, MOTALEB",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437407129,"BELLIS, EMILY, MOTALEB",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 48 , 48 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437411188,"MANLOVE, EMILY, MARIE",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 74 , 87 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437411188,"MANLOVE, EMILY, MARIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 42 , 58 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437411188,"MANLOVE, EMILY, MARIE",16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437411188,"MANLOVE, EMILY, MARIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 20 , 22 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437411188,"MANLOVE, EMILY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437411188,"MANLOVE, EMILY, MARIE",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 28 , 29 ,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437411188,"MANLOVE, EMILY, MARIE",201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437411220,"DICKENSON, LORI, BIZZELL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1871640458,HOSPICE OF THE PIEDMONT INC,HOSPICE OF THE PIEDMONT INC,1801 WESTCHESTER DR   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1437411253,"FREEMAN, GENE, WAYNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437411436,"KEITH, NADIRAH, NAFEESAH",2400 SOUTH BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 31 , 60 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437411436,"KEITH, NADIRAH, NAFEESAH",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871507699,CUMBERLAND HOSPITAL,,9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1437411907,"SCHLUETER, OCTAVIA, SIEGEL-HAWLEY",9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437412566,"SADIQ, AWAIL, USMAN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437415072,"WALSH, RABINA, KOCHAR",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437415072,"WALSH, RABINA, KOCHAR",5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437415072,"WALSH, RABINA, KOCHAR",5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437416062,"YOUNUS, USMAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 121 , 152 ," $11,131.78 ",,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437416211,"MSCISZ, ABIGAIL, CAMAROTA",9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437416211,"MSCISZ, ABIGAIL, CAMAROTA",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1437417136,"LAMBETH, MEGAN, NICHOLE",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437417136,"LAMBETH, MEGAN, NICHOLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437417136,"LAMBETH, MEGAN, NICHOLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 59 , 60 , 71 ," $26,270.77 ",,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437417136,"LAMBETH, MEGAN, NICHOLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437417136,"LAMBETH, MEGAN, NICHOLE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437417136,"LAMBETH, MEGAN, NICHOLE",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1437417359,"BROWN, CHARLES, MILLER",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1437417359,"BROWN, CHARLES, MILLER",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437417870,"CHEN, ANDREW, TANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 17 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437417870,"CHEN, ANDREW, TANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 30 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437417870,"CHEN, ANDREW, TANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 45 , 61 , 91 ," $24,170.20 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437417870,"CHEN, ANDREW, TANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 30 , 45 ," $10,492.94 ",,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1437418613,"KIMBALL, MEGAN, PELLERIN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1437418613,"KIMBALL, MEGAN, PELLERIN",30 13TH AVE NW   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417661976,CALDWELL MEMORIAL HOSPITAL,UNC HEALTH HICKORY MEDICAL PARK,30 13TH AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437418613,"KIMBALL, MEGAN, PELLERIN",30 13TH AVE NW   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437420254,"ELMORE, KELLY, RENEE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437423258,SPEECH KIDZ INC,SPEECH 4 KIDZ INC,2543 RAVENHILL DR STE E FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437423258,SPEECH KIDZ INC,2543 RAVENHILL DR STE E FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1437423258,SPEECH KIDZ INC,SPEECH 4 KIDZ INC,1401 MORGANTON RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437423258,SPEECH KIDZ INC,1401 MORGANTON RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 15 , 137 , 137 ,$#,,
MEDICAID DIRECT,1508117185,CAMPBELL UNIVERSITY HEALTH CENTER,~,129 T T LANIER ST   BUIES CREEK NC,043,Harnett,193200000X,Group,Multi-Specialty,,1437424009,"BYRD, LEIGH, MATTHEWS",129 T T LANIER ST   BUIES CREEK NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 25 , 45 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437424660,"MUCO, AGETA",14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437424660,"MUCO, AGETA",14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437424660,"MUCO, AGETA",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 44 , 49 ,$#,,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,355 VENUS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437424660,"MUCO, AGETA",355 VENUS ST   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437426079,"GARREN, WHITNEY, GALLOWAY",2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437426079,"GARREN, WHITNEY, GALLOWAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 34 , 69 ,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1437426095,"CHANCE, JESSICA, MARIE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 13 , 21 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437429115,"DUFFIE, MATTHEW, JOHN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1275968620,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINAS REHAB PINE,10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437429115,"DUFFIE, MATTHEW, JOHN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437429115,"DUFFIE, MATTHEW, JOHN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437430493,"TRIPP, FAY, JOBE",2351 ERWIN RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437430493,"TRIPP, FAY, JOBE",2351 ERWIN RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1891163457,BACK TO BASICS HEALTHCARE PLLC,~,2942 CLEAR RIDGE DR   TRINITY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1437431418,"BARR, JULIE, ROSE",2942 CLEAR RIDGE DR   TRINITY NC,076,Randolph,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437436854,"RIMAWI, BASSAM, HUSAM",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 52 , 59 , 105 ,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,10880 DURANT RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437436854,"RIMAWI, BASSAM, HUSAM",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437436854,"RIMAWI, BASSAM, HUSAM",210 ASHVILLE AVE   CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 29 , 35 , 59 ,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437436854,"RIMAWI, BASSAM, HUSAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437436854,"RIMAWI, BASSAM, HUSAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639698533,RALEIGH SEDATION ASSOCIATES LLC,,2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437437993,"RAYMOND, MICHELLE, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437439585,"NELSON, SHARON, ELIZABETH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 754 , 790 ," $15,496.51 ",,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1437440724,"BUTLER, DAWN, LAIN",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1437441003,"SEMINARA-ZAMBRZYCKA, NICOLE, MARIE",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 17 , 20 , 36 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1437441003,"SEMINARA-ZAMBRZYCKA, NICOLE, MARIE",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 25 , 31 , 62 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1437441003,"SEMINARA-ZAMBRZYCKA, NICOLE, MARIE",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 41 , 48 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437441003,"SEMINARA-ZAMBRZYCKA, NICOLE, MARIE",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1437441003,"SEMINARA-ZAMBRZYCKA, NICOLE, MARIE",959 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437441052,"CARRARO, MATTHEW",6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 20 , 23 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437441052,"CARRARO, MATTHEW",6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437441052,"CARRARO, MATTHEW",6060 PIEDMONT ROW DR S STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 65 , 71 ,$#,,
MEDICAID DIRECT,1437442811,"PARIYADATH, ANAND",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,1437442811,"PARIYADATH, ANAND",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437442886,"RIEK, NATALYA, NIKOLAYEVNA MEDVEDEV",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 45 , 47 ,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437443090,"DAVIS, MELISSA, LA RUSSO",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437443090,"DAVIS, MELISSA, LA RUSSO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437443587,"DARRESS, LINDA, DOAN",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 23 , 23 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437443587,"DARRESS, LINDA, DOAN",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3015 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",485 VALLEY RD   MOCKSVILLE NC,030,Davie,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3015 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 65 , 83 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3015 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3015 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3015 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 53 , 85 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3015 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3015 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 66 , 90 , 107 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,121 MEDICAL DR   ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 22 , 25 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 33 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 35 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437443892,"ROSENBERG, MICHAEL, DAVID",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1437444221,"HAUSER, STEVEN, SAUL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437444221,"HAUSER, STEVEN, SAUL",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437444221,"HAUSER, STEVEN, SAUL",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1437444221,"HAUSER, STEVEN, SAUL",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 23 , 23 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437444221,"HAUSER, STEVEN, SAUL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1437444221,"HAUSER, STEVEN, SAUL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437444221,"HAUSER, STEVEN, SAUL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 42 , 42 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1437444221,"HAUSER, STEVEN, SAUL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 29 , 29 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437444346,"DONNELLY, MEGAN, TUDOR",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 19 , 23 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437444346,"DONNELLY, MEGAN, TUDOR",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437444346,"DONNELLY, MEGAN, TUDOR",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1437446986,"MCWHINNEY, SUNSHINE, JEANNE ANNE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1437446986,"MCWHINNEY, SUNSHINE, JEANNE ANNE",113 A HOSPITAL LOOP   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1437446986,"MCWHINNEY, SUNSHINE, JEANNE ANNE",113 A HOSPITAL LOOP   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1437446986,"MCWHINNEY, SUNSHINE, JEANNE ANNE",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 43 , 49 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437447158,"FONTANARES, ALAN, PAUL",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437447539,"WENDLANDT, BLAIR, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437447539,"WENDLANDT, BLAIR, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437447539,"WENDLANDT, BLAIR, NICOLE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437447539,"WENDLANDT, BLAIR, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437447539,"WENDLANDT, BLAIR, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437447539,"WENDLANDT, BLAIR, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437447844,"CHAUDHARY, PRIYANK",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437447844,"CHAUDHARY, PRIYANK",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 34 , 48 , 83 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437447844,"CHAUDHARY, PRIYANK",11009 INGLESIDE PL STE 303 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437447844,"CHAUDHARY, PRIYANK",11009 INGLESIDE PL STE 303 RALEIGH NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 121 , 171 , 212 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 63 , 101 , 161 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1505 SW CARY PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 24 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,500 REDWOOD LN   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1437449634,"KELLY, CHRISTOPHER, REHBECK",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417123993,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BMA BLADENBORO,1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437449733,"BROWN, SHELLEY, YVONNE",1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 179 , 192 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437451283,"LE, THU, ANH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 59 , 60 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1437451283,"LE, THU, ANH",2007 WALNUT ST   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437458890,"GULABANI, ADITI, GULAB",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 116 , 126 , 151 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437458890,"GULABANI, ADITI, GULAB",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437458890,"GULABANI, ADITI, GULAB",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1437459450,ALL ABOUT THERAPY PLLC,ALL ABOUT THERAPY PLLC,501 W WILLIAMS ST UNIT 346 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1437459450,ALL ABOUT THERAPY PLLC,501 W WILLIAMS ST UNIT 346 APEX NC,092,Wake,193400000X,Group,Single Specialty,, 339 ," 4,319 "," 4,352 "," $382,611.12 ",,
MEDICAID DIRECT,1437459617,UNION WEST SURGERY CENTER,ATRIUM HEALTH SURGERY CENTER INDIAN TRAIL,6068 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1437459617,UNION WEST SURGERY CENTER,6068 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 104 , 150 , 183 ," $11,072.68 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437460623,"PEACOCK, BRIAN, BARKLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437460656,"GREWAL, DILRAJ, SINGH",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 49 , 73 , 120 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437460656,"GREWAL, DILRAJ, SINGH",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437460656,"GREWAL, DILRAJ, SINGH",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 50 , 79 , 170 ,$#,,
MEDICAID DIRECT,1548584717,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center of Raleigh,,,Unknown,193200000X,Group,Multi-Specialty,,1437460656,"GREWAL, DILRAJ, SINGH",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437460656,"GREWAL, DILRAJ, SINGH",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437460656,"GREWAL, DILRAJ, SINGH",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 82 , 135 , 252 ," $10,914.65 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437461977,"WILLIAMS, RYAN, PATRICK",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1437465648,"IMAFIDON, TIMOTHY, OSAGIE",~,300 S CENTER ST   GOLDSBORO NC,096,Wayne,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1437465648,"IMAFIDON, TIMOTHY, OSAGIE",300 S CENTER ST   GOLDSBORO NC,096,Wayne,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,352 "," 2,664 "," 14,939 "," $587,285.05 ",,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437466786,"BRINKLEY, DANETTE, HARRELL",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 103 , 123 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437468873,"JONES, RACHEL, CATHERINE PAYNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437468873,"JONES, RACHEL, CATHERINE PAYNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437469749,"PILKENTON, KIMBERLY, NICOLE",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437469749,"PILKENTON, KIMBERLY, NICOLE",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 77 , 178 ,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437469749,"PILKENTON, KIMBERLY, NICOLE",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 19 ,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437469749,"PILKENTON, KIMBERLY, NICOLE",100 15TH ST NW   NORTON VA,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437470903,"WOLFE, RACHEL, MATHILDA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 56 , 96 , 159 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437472297,"DEAL, MELISSA, LACKEY",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 75 , 160 , 160 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437475100,"SADUN, REBECCA, ELI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437475100,"SADUN, REBECCA, ELI",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437475720,"JOHNSON, GABRIELLE, MONIQUE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437475720,"JOHNSON, GABRIELLE, MONIQUE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437475779,"WORMER, BLAIR, ANDREW",1901 BRUNSWICK AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437475779,"WORMER, BLAIR, ANDREW",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154765832,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH APPEL & WORMER PLASTIC SURGERY,1901 BRUNSWICK AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437475779,"WORMER, BLAIR, ANDREW",1901 BRUNSWICK AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437475779,"WORMER, BLAIR, ANDREW",1901 BRUNSWICK AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235148529,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS ROCK HILL PEDIATRIC,1656 RIVERCHASE BLVD STE 3400 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437475936,"WALLACE BERMAN, LESLEY, ANN",275 N NC 16 BUSINESS HWY STE 103 DENVER NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437479151,"ZAVITZ, JOSHUA, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437479151,"ZAVITZ, JOSHUA, MICHAEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437479151,"ZAVITZ, JOSHUA, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 66 , 88 , 107 ," $11,103.82 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437479151,"ZAVITZ, JOSHUA, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437479151,"ZAVITZ, JOSHUA, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1437483302,"YOAKUM, TANIS, APRIL",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 92 , 100 , 108 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1437483302,"YOAKUM, TANIS, APRIL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 36 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1437483567,"HARGETT BECK, MELISSA, QUEEN",101 RENEE LYNN CT   CARRBORO NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437483567,"HARGETT BECK, MELISSA, QUEEN",101 RENEE LYNN CT   CARRBORO NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1588673636,CAROLINAS PHYSICIANS NETWORK INC,EAST CHARLOTTE FAMILY PHYSICIANS,5801 EXECUTIVE CENTER DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437484581,"SACKIE, MATEE, AUSTINA",5801 EXECUTIVE CENTER DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 80 , 136 , 179 ,$#,,
MEDICAID DIRECT,1588673636,CAROLINAS PHYSICIANS NETWORK INC,EAST CHARLOTTE FAMILY PHYSICIANS,5801 EXECUTIVE CENTER DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437484581,"SACKIE, MATEE, AUSTINA",1805 MILTON RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 29 , 39 ,$#,,
MEDICAID DIRECT,1528428091,LAKE WYLIE PEDIATRIC DENTISTRY,,534 NAUTICAL DR   CLOVER SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437485430,"COLOSI, RYAN, PETER",534 NAUTICAL DR   CLOVER SC,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 21 , 50 , 169 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437486057,"CHALOT, KIMBERLY, JONES",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 104 , 121 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1437486057,"CHALOT, KIMBERLY, JONES",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 26 , 28 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1437486057,"CHALOT, KIMBERLY, JONES",1141 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 14 , 17 , 18 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1437486057,"CHALOT, KIMBERLY, JONES",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1427309608,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1437487725,"HUSE, JOHN, DAMON",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437491305,"CRUTCHER, CLIFFORD, LEMONT",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437491305,"CRUTCHER, CLIFFORD, LEMONT",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437491305,"CRUTCHER, CLIFFORD, LEMONT",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437491305,"CRUTCHER, CLIFFORD, LEMONT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437491628,"SHAHEEN, STEPHEN, PATRICK",3475 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 26 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437491628,"SHAHEEN, STEPHEN, PATRICK",2301 ERWIN RD STE 2600 DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 40 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437491628,"SHAHEEN, STEPHEN, PATRICK",2301 ERWIN RD STE 2600 DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 97 , 111 , 120 ,$#,,
MEDICAID DIRECT,1437492246,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 10156,1550 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437492246,NORTH CAROLINA CVS PHARMACY LLC,1550 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437493459,"BENT, JENNIFER, ANNE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 35 ,$#,,
MEDICAID DIRECT,1558695288,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY SERVICES,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437493566,"VORA, MOIZ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1417661976,CALDWELL MEMORIAL HOSPITAL,UNC HEALTH HICKORY MEDICAL PARK,30 13TH AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437493954,"LEE, MAY, KHANG",30 13TH AVE NW   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 21 , 31 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437496213,"BAKER, ZACHARY, HARLAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1437496213,"BAKER, ZACHARY, HARLAN",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437496213,"BAKER, ZACHARY, HARLAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437496213,"BAKER, ZACHARY, HARLAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437496213,"BAKER, ZACHARY, HARLAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1437496213,"BAKER, ZACHARY, HARLAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437496213,"BAKER, ZACHARY, HARLAN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437499506,"DILORENZO, MARY, ELIZABETH",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437499506,"DILORENZO, MARY, ELIZABETH",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437499506,"DILORENZO, MARY, ELIZABETH",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 20 , 20 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",8450 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437500329,"BOLDEN, CARLOS, RAMON",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437502754,"AITKEN, ANDREA, MICHELLE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437502754,"AITKEN, ANDREA, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437502754,"AITKEN, ANDREA, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437502754,"AITKEN, ANDREA, MICHELLE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437502754,"AITKEN, ANDREA, MICHELLE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 28 , 31 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437503612,"SHARMA, VIDHI, PATEL",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 28 , 41 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437504313,"TRAN, DALTON, QUAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1437504610,"LOWRY, CRAIG, ELLIOTT",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 53 , 53 , 54 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437504834,"DELLA VALLE, PAMELA, ELIZABETH",512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437504834,"DELLA VALLE, PAMELA, ELIZABETH",512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 39 , 46 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,512 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437504834,"DELLA VALLE, PAMELA, ELIZABETH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 34 , 35 ,$#,,
MEDICAID DIRECT,1437505203,"PUNZELL, STEVEN, ROBERT",,200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,1437505203,"PUNZELL, STEVEN, ROBERT",200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 20 , 230 , 233 ," $13,950.97 ",,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",262 LEROY GEORGE DR FL 1 CLYDE NC,044,Haywood,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",90 HAYWOOD OFFICE PARK   WAYNESVILLE NC,044,Haywood,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",57 HOWARD GAP RD   FLETCHER NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 110 , 112 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 186 , 186 ," $11,083.32 ",,
MEDICAID DIRECT,1437505203,"PUNZELL, STEVEN, ROBERT",,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,1437505203,"PUNZELL, STEVEN, ROBERT",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 72 , 72 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1437505203,"PUNZELL, STEVEN, ROBERT",,91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,1437505203,"PUNZELL, STEVEN, ROBERT",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 141 , 145 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",22 TRUST LN STE 2 BREVARD NC,088,Transylvania,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",45 PLATEAU ST   BRYSON CITY NC,087,Swain,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1437505203,"PUNZELL, STEVEN, ROBERT",188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 38 , 40 ,$#,,
MEDICAID DIRECT,1437505401,LINCOLN SPEECH SERVICES INC,~,106 MOCKINGBIRD LN   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437505401,LINCOLN SPEECH SERVICES INC,106 MOCKINGBIRD LN   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,#, 77 , 79 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437505583,"BRYANT, MICHAEL, WILLIAM",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437505583,"BRYANT, MICHAEL, WILLIAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437505583,"BRYANT, MICHAEL, WILLIAM",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1437505583,"BRYANT, MICHAEL, WILLIAM",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 34 , 35 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437505583,"BRYANT, MICHAEL, WILLIAM",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 33 , 37 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437505583,"BRYANT, MICHAEL, WILLIAM",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 47 , 51 ,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437506375,"LUCIEN, JANET, NIQUETTE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437506375,"LUCIEN, JANET, NIQUETTE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 20 , 34 ,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437506375,"LUCIEN, JANET, NIQUETTE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1437506375,"LUCIEN, JANET, NIQUETTE",120 HEALTHPLEX WAY   APEX NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437506375,"LUCIEN, JANET, NIQUETTE",104 MEDSPRING DR   CLAYTON NC,051,Johnston,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#, 18 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437506607,"RAY, JUSTIN, JOHN",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437506607,"RAY, JUSTIN, JOHN",6715 MCCRIMMON PKWY STE 205 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437506607,"RAY, JUSTIN, JOHN",3001 EDWARDS MILL RD # 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437506607,"RAY, JUSTIN, JOHN",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 27 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1437506607,"RAY, JUSTIN, JOHN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437506672,"KLIONSKY, YAEL, MIRIAM SHOSHANA",601 N ELM ST   HIGH POINT NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437506672,"KLIONSKY, YAEL, MIRIAM SHOSHANA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437506672,"KLIONSKY, YAEL, MIRIAM SHOSHANA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 37 , 52 , 70 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437507498,"WOODY, TIFFANY, WRENE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437507498,"WOODY, TIFFANY, WRENE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 65 , 85 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437510781,"MENTON, KEITH, CASEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437511722,"CHOKSHI, YERA, VIRAL",2630 E 7TH ST STE 101 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 39 , 99 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437511748,"HOGAN JR, DANIEL, EDWARD",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 58 , 113 , 177 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1437511748,"HOGAN JR, DANIEL, EDWARD",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437512217,"MCHENRY, MARY ANN, WRIGHT",9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437512217,"MCHENRY, MARY ANN, WRIGHT",9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437515335,"LYKINS, KONDIE, LEE",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 31 , 54 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205596962,ACCESS MEDICAL CLINIC NORTH CAROLIN,,18901 IDA MILL RD   LAUREL HILL NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437515335,"LYKINS, KONDIE, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437515335,"LYKINS, KONDIE, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",4565 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437515335,"LYKINS, KONDIE, LEE",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205596962,ACCESS MEDICAL CLINIC NORTH CAROLIN,,18901 IDA MILL RD   LAUREL HILL NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437515335,"LYKINS, KONDIE, LEE",18901 IDA MILL RD   LAUREL HILL NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 163 , 169 ,$#,,
MEDICAID DIRECT,1205596962,ACCESS MEDICAL CLINIC NORTH CAROLIN,,18901 IDA MILL RD   LAUREL HILL NC,083,Scotland,193400000X,Group,Single Specialty,,1437515335,"LYKINS, KONDIE, LEE",18901 IDA MILL RD   LAUREL HILL NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",70 OAK ST   TRYON NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 255 , 257 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",70 OAK ST   TRYON NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 48 , 48 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",70 OAK ST   TRYON NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 53 , 54 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,70 OAK ST   TRYON NC,075,Polk,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",70 OAK ST   TRYON NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 139 , 144 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 68 , 71 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",100 RICEVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1437516481,"RUPPE, KIMBERLY, GRACE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437517935,GATEWAY COMMUNICATIONS PLLC,~,351 WAGONER DR STE 341 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437517935,GATEWAY COMMUNICATIONS PLLC,351 WAGONER DR STE 341 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437518214,"SKEELS, PAMELA, ANN",181 DANIEL RD   FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 117 , 143 , 145 ,$#,,
MEDICAID DIRECT,1194302901,APPALACHIAN REGIONAL BEHAVIORAL HEA,ARBH PROVIDERS,432 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1437519501,"JOHNSON, DAVID, HALE",432 HOSPITAL DR   LINVILLE NC,006,Avery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 25 , 55 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437522729,"SNYDER, ALLISON, BROOKE",1311 E MILLBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437525219,"MORRIS, SHERRI, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 49 , 97 , 106 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437525219,"MORRIS, SHERRI, ANN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1437526175,"HOLLAR, BETHANY, CRAIG",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 19 , 32 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1437526175,"HOLLAR, BETHANY, CRAIG",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 94 , 113 , 231 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437526704,"HANLEY, JAMES, ROBERT",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437529211,"SYLVESTER, JESSICA, NALL",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1437529211,"SYLVESTER, JESSICA, NALL",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437529898,ROBINS NEST FAMILY CARE HOME LLC,~,1514 SUNSET TER   WHITEVILLE NC,024,Columbus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437529898,ROBINS NEST FAMILY CARE HOME LLC,1514 SUNSET TER   WHITEVILLE NC,024,Columbus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 376 , 376 ," $34,226.03 ",,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1437531845,"BURGER, JOHN, ALBERT",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 62 , 92 , 99 ,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437531845,"BURGER, JOHN, ALBERT",2525 COURT DR   GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437533254,OTTENDORF LABORATORIE LLC,,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1437533254,OTTENDORF LABORATORIE LLC,1095 INVESTMENT BLVD   APEX NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437535499,"WARD, MONICA, LEIGH",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 22 , 25 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437536489,"ROYER, MAY, DOAN",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437536489,"ROYER, MAY, DOAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 89 , 112 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437536489,"ROYER, MAY, DOAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437536489,"ROYER, MAY, DOAN",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437536489,"ROYER, MAY, DOAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 18 , 18 ," $10,014.98 ",,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437536489,"ROYER, MAY, DOAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 34 , 37 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437536489,"ROYER, MAY, DOAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437536489,"ROYER, MAY, DOAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437538139,"GORDON, KATHERINE, FRANCES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437538139,"GORDON, KATHERINE, FRANCES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,209 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437538303,"THOMAS, JACOB, ADAM",209 E CARVER ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 16 , 34 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437538378,"GREEN, ERICA, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437538386,"LONG, JOANN, WONG",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 23 , 53 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437538386,"LONG, JOANN, WONG",10905 PROVIDENCE RD W STE 260 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437538519,"HINES, JEREMY, TYLER",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 51 , 89 , 141 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437538519,"HINES, JEREMY, TYLER",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 15 , 26 ,$#,,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437538774,"ALBERTSON, ZACHARY, DAVID",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 75 , 170 ," $14,910.52 ",,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437538774,"ALBERTSON, ZACHARY, DAVID",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 669 ," 1,122 "," 2,756 "," $120,936.70 ",,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437539004,"SIMPSON, KERRY, LYNN",8700 PINEVILLE MATTHEWS RD STE 540 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437539004,"SIMPSON, KERRY, LYNN",7427 MATTHEWS MINT HILL RD STE 103 MINT HILL NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437539004,"SIMPSON, KERRY, LYNN",1800 MAIN ST W   LOCUST NC,084,Stanly,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 20 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437539764,"CERAULO, ANTHONY, SAMUEL",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437539764,"CERAULO, ANTHONY, SAMUEL",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437539764,"CERAULO, ANTHONY, SAMUEL",3475 ERWIN RD   DURHAM NC,032,Durham,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 33 , 42 , 62 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437540416,"HESS, ASHLEY, NICOLE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,332 N TRADE ST STE 2000A MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437540416,"HESS, ASHLEY, NICOLE",332 N TRADE ST STE 2000A MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 30 , 53 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1437543204,"CALDERON, BORIS, EDUARDO",300 W 27TH ST   LUMBERTON NC,078,Robeson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 72 , 77 , 82 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1437543204,"CALDERON, BORIS, EDUARDO",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 69 , 78 , 96 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437543691,"O'CONNELL, MICHAEL, JOHN",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 97 , 189 , 279 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437544152,"BANN, DARRIN, VINCENT",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 70 , 122 , 185 ," $18,913.43 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437544194,"GACAD, VINCENT, ELAZEGUI",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 61 , 89 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437544194,"GACAD, VINCENT, ELAZEGUI",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 46 , 55 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437544194,"GACAD, VINCENT, ELAZEGUI",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 41 , 52 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437544194,"GACAD, VINCENT, ELAZEGUI",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 18 , 21 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437544194,"GACAD, VINCENT, ELAZEGUI",2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437545233,"HINES, KELSEY, REBECCA",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437545233,"HINES, KELSEY, REBECCA",2360 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437545233,"HINES, KELSEY, REBECCA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437545233,"HINES, KELSEY, REBECCA",1542 CANE CREEK RD   FLETCHER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881877793,ANESTHESIA CONSULTANTS OF AUGUSTA,,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1437547072,"ELZEY, STACY, RENEE",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518312073,MCPC-17 LLC,FIRSTHEALTH PRIMARY CARE,293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437547189,"EVANS, BRIANNE, HENDRICK",507 N MAIN ST   TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1518312073,MCPC-17 LLC,FIRSTHEALTH PRIMARY CARE,293 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437547189,"EVANS, BRIANNE, HENDRICK",293 OLMSTEAD BLVE STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 123 , 192 ,$#,,
MEDICAID DIRECT,1437547627,BLUECROSS HOME CARE & HEALTH SERVIC,,3509 HAWORTH DR STE 303 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437547627,BLUECROSS HOME CARE & HEALTH SERVIC,3509 HAWORTH DR STE 303 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 15 , 64 ,$#,,
MEDICAID DIRECT,1437547627,BLUECROSS HOME CARE & HEALTH SERVIC,,3509 HAWORTH DR STE 303 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1437547627,BLUECROSS HOME CARE & HEALTH SERVIC,3509 HAWORTH DR STE 303 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,423 "," 1,432 "," $211,344.52 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437549763,"ECKSTAT, MATTHEW, MAURICE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 71 , 76 , 98 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437549763,"ECKSTAT, MATTHEW, MAURICE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831157833,KERNERSVILLE REHAB SPECIALISTS LLC,,1027 E MOUNTAIN ST #101   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437550654,"TEMPLETON, ANNA, CRADDOCK",1027 E MOUNTAIN ST #101   KERNERSVILLE NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1437554110,OPEN HANDS NURSING AGENCY LLC,,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1437554110,OPEN HANDS NURSING AGENCY LLC,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 52 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1437560463,"PEARLSTEIN, KEVIN, ALEXANDER",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 26 , 57 , 67 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437560463,"PEARLSTEIN, KEVIN, ALEXANDER",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 21 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437560463,"PEARLSTEIN, KEVIN, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1437560463,"PEARLSTEIN, KEVIN, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1437560547,"O NEILL, JESSICA, FAHRBACH",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 42 , 108 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437562444,"BLACKWOOD, BENJAMIN, DAVID",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437562444,"BLACKWOOD, BENJAMIN, DAVID",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437562469,"SHARPE, ROBERT, ALLAN",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 124 , 211 , 339 ," $11,180.04 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1437562469,"SHARPE, ROBERT, ALLAN",107 HUNT DR   DUNN NC,043,Harnett,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437562469,"SHARPE, ROBERT, ALLAN",107 HUNT DR   DUNN NC,043,Harnett,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 72 , 101 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437562469,"SHARPE, ROBERT, ALLAN",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 69 , 117 , 172 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437564374,"MCLEAN, WILLIAM, COPLEY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437564374,"MCLEAN, WILLIAM, COPLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 45 , 45 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437564374,"MCLEAN, WILLIAM, COPLEY",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437564788,"LIN, JUNZHI",201 SAGE RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437564788,"LIN, JUNZHI",201 SAGE RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437565256,"RIZZARDI, CHAD, JOSEPH",844 KEMPSVILLE RD STE 104 NORFOLK VA,101,Out of State <= 40 miles,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437566718,"FERNANDES, CECILIA, SUCCOUR",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437566718,"FERNANDES, CECILIA, SUCCOUR",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437566718,"FERNANDES, CECILIA, SUCCOUR",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 32 , 41 , 41 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437566718,"FERNANDES, CECILIA, SUCCOUR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 27 , 28 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437566718,"FERNANDES, CECILIA, SUCCOUR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1437567005,"DOGGETT, JESSICA, ERWIN",5838 HARBOUR VIEW BLVD STE 105 SUFFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437567260,"ACHARYA, YAM, PRASAD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 109 , 110 , 110 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437568532,"ADCOCK, JULIE, JONES",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1437568706,"WARD, LAMAR, MARQUIS",1010 COLLEGE ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 49 , 49 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437568706,"WARD, LAMAR, MARQUIS",615 RIDGE RD   ROXBORO NC,073,Person,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 94 , 94 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437569852,"MANSOUR, WISSAM, NAJIB",932 MORREENE RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437569852,"MANSOUR, WISSAM, NAJIB",932 MORREENE RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 21 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,400 ELF ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437569852,"MANSOUR, WISSAM, NAJIB",400 ELF ST   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437569852,"MANSOUR, WISSAM, NAJIB",932 MORREENE RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437570405,"HENDRICKS, KATHERINE, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 16 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437570470,"SANDERS, LISA, MARIE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437570470,"SANDERS, LISA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 33 , 35 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437570470,"SANDERS, LISA, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437570470,"SANDERS, LISA, MARIE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437570470,"SANDERS, LISA, MARIE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437570504,"KING, LEANNE, RUTLEDGE",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437570504,"KING, LEANNE, RUTLEDGE",2240 REMOUNT RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437570504,"KING, LEANNE, RUTLEDGE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437571312,"THOMPSON, MATTHEW, BRIAN",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437571312,"THOMPSON, MATTHEW, BRIAN",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 56 , 127 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437571312,"THOMPSON, MATTHEW, BRIAN",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1437571312,"THOMPSON, MATTHEW, BRIAN",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437573219,"BROWN, HALEY, MILLWOOD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437573656,"CURTIS, CAITLIN, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 37 , 52 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437574084,"WILLIS, JASON, ALEXANDER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 21 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437574399,"SONG, TAMMY, HARDISON",925D CONFERENCE DR   GREENVILLE NC,074,Pitt,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1639634819,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY BEHAVIORAL HEALTH,107 S QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437574399,"SONG, TAMMY, HARDISON",925D CONFERENCE DR   GREENVILLE NC,074,Pitt,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437575883,"SPARKMAN, JEREMY, WENDELL",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1578987848,UNC PHYSICIANS NETWORK LLC,~,7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437577814,"PARK, EUNEE, KATHLEEN",7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#, 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437577954,"KRALL, JENNIFER, THI WING",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 54 , 88 , 93 ,$#,,
MEDICAID DIRECT,1437578150,LHCG L LLC,~,1899 N MARINE BLVD STE 300 JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1437578150,LHCG L LLC,1899 N MARINE BLVD STE 300 JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 1,162 "," 1,168 "," $134,073.08 ",,
MEDICAID DIRECT,1437578150,LHCG L LLC,~,2457 GUM BRANCH RD STE 1000 JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1437578150,LHCG L LLC,2457 GUM BRANCH RD STE 1000 JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 2,730 "," 2,761 "," $308,376.36 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437578473,"BEVERS, KAITLIN, COLLEEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437578473,"BEVERS, KAITLIN, COLLEEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1437579083,"EDWARDS, MARY, DALE",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1437579083,"EDWARDS, MARY, DALE",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437579331,"NOE, SARAH, MICHELLE",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,117 DENNIS DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1437579885,"MARTINEZ, REBECCA, DIANA",117 DENNIS DR   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 29 , 262 , 348 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437579885,"MARTINEZ, REBECCA, DIANA",117 DENNIS DR   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 90 , 126 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437583275,"ARNEY, CATHY, COOK",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437583275,"ARNEY, CATHY, COOK",648 ALMONDRIDGE DR   RURAL HALL NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437585163,"ECKEL, STEPHEN, MYLES",,7148 LAWYERS RD   MINT HILL NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,1437585163,"ECKEL, STEPHEN, MYLES",7148 LAWYERS RD   MINT HILL NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 38 , 39 , 52 ,$#,,
MEDICAID DIRECT,1427121144,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,413 MCCONNELL ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1437589199,"CLARK, REBECCA, SCOGGIN",413 MCCONNELL ST   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 49 , 122 ,$#,,
MEDICAID DIRECT,1285081562,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,255 NORTHWEST LN   WARRENSVILLE NC,005,Ashe,193200000X,Group,Multi-Specialty,,1437589199,"CLARK, REBECCA, SCOGGIN",255 NORTHWEST LN   WARRENSVILLE NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1487727459,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1437589199,"CLARK, REBECCA, SCOGGIN",126 POPLAR GROVE CONNECTOR   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437589710,"STAKIAS, JENNIFER, ANNE",325 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 147 ," 1,314 "," 1,546 "," $37,398.39 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437589710,"STAKIAS, JENNIFER, ANNE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 310 , 351 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437590072,"HELMING-SAUTER, CATHERINE, JANE",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376351833,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROLOGY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437590320,"SAMAAN, MENA, MICHAEL DANIAL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437590825,"RAPALO, ROBERTO, MANUEL",234 CROOKED CREEK PKWY STE 310 DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 28 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437592672,"STANAZAI, KHALID, SHAFAQ",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437592672,"STANAZAI, KHALID, SHAFAQ",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437592672,"STANAZAI, KHALID, SHAFAQ",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437592672,"STANAZAI, KHALID, SHAFAQ",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437593068,"STEPHENS, LEAH, MICHELLE",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 35 , 38 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437594009,"SCHRANZ, ASHER, JACOB",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437594009,"SCHRANZ, ASHER, JACOB",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437594363,"WOLF, BRIAN, CHRISTOPHER",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 11 , 17 , 20 ,$#,,
MEDICAID DIRECT,1073148581,AMPUTATION PREVENTION CENTER OF NC,VASCULAR SOLUTIONS OF NORTH CAROLINA,1000 CRESCENT GRN STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1437594363,"WOLF, BRIAN, CHRISTOPHER",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 37 , 121 , 156 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,251 KEISLER DR STE 101 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1437594363,"WOLF, BRIAN, CHRISTOPHER",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1437594363,"WOLF, BRIAN, CHRISTOPHER",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 54 , 76 , 149 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437594363,"WOLF, BRIAN, CHRISTOPHER",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437595386,"STEINBRINK, JULIE, MARIE",40 DUKE MEDICINE CIR # 1K DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437595386,"STEINBRINK, JULIE, MARIE",40 DUKE MEDICINE CIR # 1K DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 13 , 41 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437595386,"STEINBRINK, JULIE, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437595444,"GILLIAM, MEREDITH, ASHLEY",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437595444,"GILLIAM, MEREDITH, ASHLEY",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437595444,"GILLIAM, MEREDITH, ASHLEY",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437595444,"GILLIAM, MEREDITH, ASHLEY",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437595444,"GILLIAM, MEREDITH, ASHLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 18 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1437595659,"LANE, CHARLEY, WORLEY",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437595659,"LANE, CHARLEY, WORLEY",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437595659,"LANE, CHARLEY, WORLEY",410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 98 , 170 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 16 , 19 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 65 , 79 , 108 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 35 , 44 , 61 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437596269,"O'NEAL, WESLEY, THOMAS",3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437597176,"BATES, TIFFANY, SIERRA",10905 PROVIDENCE RD W STE 260 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437597176,"BATES, TIFFANY, SIERRA",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 30 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437597176,"BATES, TIFFANY, SIERRA",1918 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1437598273,"LIPSCOMB, PETER, MICHAEL",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 36 , 36 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1437598273,"LIPSCOMB, PETER, MICHAEL",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 32 , 39 ,$#,,
MEDICAID DIRECT,1881952810,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1437598273,"LIPSCOMB, PETER, MICHAEL",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 66 , 72 , 95 ,$#,,
MEDICAID DIRECT,1881952810,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2640 HIGHWAY 105 STE 102 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1437598273,"LIPSCOMB, PETER, MICHAEL",2640 HIGHWAY 105 STE 102 BOONE NC,095,Watauga,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 109 , 118 , 160 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437603107,"BEDIAKO, JOY, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 122 , 209 , 222 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,605 COTTON ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437603107,"BEDIAKO, JOY, ELIZABETH",605 COTTON ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437603743,"MOSES, MELISSA, JOHNSON",3325 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1437605003,COASTAL PROSTHETICS ORTHOTICS,,1924 LANDSTOWN CENTRE WAY INSIDE CHKD HEALTH CENTER PRINCESS ANNE VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437605003,COASTAL PROSTHETICS ORTHOTICS,1924 LANDSTOWN CENTRE WAY INSIDE CHKD HEALTH CENTER PRINCESS ANNE VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1437605201,"MAJORS, ROBERT, ANTHONY",300 W 27TH ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437605201,"MAJORS, ROBERT, ANTHONY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437605201,"MAJORS, ROBERT, ANTHONY",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1437605201,"MAJORS, ROBERT, ANTHONY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1437606340,"QUINN, ANDREW, LEE",518 S VAN BUREN RD STE 3 EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 49 , 79 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437607215,"DEGRASSI, AMANDA, ROSE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437607215,"DEGRASSI, AMANDA, ROSE",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437607215,"DEGRASSI, AMANDA, ROSE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437607215,"DEGRASSI, AMANDA, ROSE",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437609179,EUGENE C DAVENPORT,,1327 ECHO LAKE LN   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437609179,EUGENE C DAVENPORT,1327 ECHO LAKE LN   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 80 , 80 ," $32,286.57 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437610508,"MCKEE, NEIL, ANDREW",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 28 , 30 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437610508,"MCKEE, NEIL, ANDREW",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437610540,"ZHAO, TINGRUI",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 139 , 141 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437610540,"ZHAO, TINGRUI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 42 , 42 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437610540,"ZHAO, TINGRUI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437610771,"MANSHADI, MATEEN, OLIVER",7110 LAWYERS RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 100 , 176 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437611241,"WELLS, KIMBERLY, ELIZABETH",530 W WEBB AVE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 56 , 92 , 196 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437611241,"WELLS, KIMBERLY, ELIZABETH",3940 ARROWHEAD BLVD   MEBANE NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437611241,"WELLS, KIMBERLY, ELIZABETH",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 15 , 36 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437611852,"BROADWAY-ROBERTSON, NATALIE, NICOLE",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 20 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437611852,"BROADWAY-ROBERTSON, NATALIE, NICOLE",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437612694,"JEFFRIES, ELIZABETH, MASON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437612694,"JEFFRIES, ELIZABETH, MASON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437612959,"GRAY, KYNDAL, ALANNA",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437614773,"LEVITT, ALEXANDRA, PRESSLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 58 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1437614815,"WILLIAMSON, SARAH, ANN WADDILL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437614815,"WILLIAMSON, SARAH, ANN WADDILL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1932151305,CAROLINA EAR AND HEARING CLINIC PC,CAROLINA EAR AND HEARING CLINIC PC,5900 SIX FORKS RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437617727,"VENABLE, KATHERINE, CAMILLE",5900 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932151305,CAROLINA EAR AND HEARING CLINIC PC,CAROLINA EAR AND HEARING CLINIC PC,5900 SIX FORKS RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437617727,"VENABLE, KATHERINE, CAMILLE",1311 E MILLBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437618972,"PRICE, STEPHANIE, CLEGG",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder), 12 , 26 , 26 ,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437618972,"PRICE, STEPHANIE, CLEGG",403 E NASH ST UNIT B LOUISBURG NC,035,Franklin,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437621679,"ALDRIDGE, HANNAH, NICOLE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1437621679,"ALDRIDGE, HANNAH, NICOLE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437622545,"GUTIERREZ, NIMSI, PADUA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437622875,"PARSONS, MELISSA, ANN",373 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437622875,"PARSONS, MELISSA, ANN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437623626,PRIME SURGICAL SUITES LLC,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1437623626,PRIME SURGICAL SUITES LLC,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 66 , 71 , 120 ,$#,,
MEDICAID DIRECT,1235987819,PETERSON HEALTH AND WELLNESS,,56 STARDUST RD UNIT 3 BURNSVILLE NC,100,Yancey,193400000X,Group,Single Specialty,,1437624459,"PETERSON, KAREN, BLEVINS",56 STARDUST RD UNIT 3 BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1285381103,FAITH FAMILY HEALTH PLLC,,14 ACADEMY ST   BURNSVILLE NC,100,Yancey,193400000X,Group,Single Specialty,,1437624459,"PETERSON, KAREN, BLEVINS",14 ACADEMY ST   BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437625191,"COOK, MICHAEL",7851 ALEXANDER PROMENADE HILL PL STE 120 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437625191,"COOK, MICHAEL",7851 ALEXANDER PROMENADE HILL PL STE 120 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,903 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1437625191,"COOK, MICHAEL",7851 ALEXANDER PROMENADE HILL PL STE 120 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 76 , 86 , 161 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,910 N MADISON BLVD STE B ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437625191,"COOK, MICHAEL",7851 ALEXANDER PROMENADE HILL PL STE 120 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1437625191,"COOK, MICHAEL",7851 ALEXANDER PROMENADE HILL PL STE 120 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437625191,"COOK, MICHAEL",7851 ALEXANDER PROMENADE HILL PL STE 120 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 24 , 53 ,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437627858,"SHAW, HANNAH, CAROLINE",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 44 , 46 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437627858,"SHAW, HANNAH, CAROLINE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437627858,"SHAW, HANNAH, CAROLINE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,15235 JOHN J DELANEY DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437627858,"SHAW, HANNAH, CAROLINE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437627858,"SHAW, HANNAH, CAROLINE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 23 ,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,117 "," 1,571 "," 6,165 "," $216,048.76 ",,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 12 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 22 ,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 189 , 188 ," 2,707 "," $298,644.92 ",,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 14 ,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1437636826,"CUNNINGHAM, MELINDA, ELIZABETH",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 12 ,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437642170,"COX, TIMOTHY, RICHARD",250 SMITH CHURCH RD STE RHG ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437642170,"COX, TIMOTHY, RICHARD",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437642170,"COX, TIMOTHY, RICHARD",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 121 , 214 , 262 ,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437642170,"COX, TIMOTHY, RICHARD",250 SMITH CHURCH RD STE RHG ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 35 , 39 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437642188,"TREFZ, LINDSEY, MEGOW",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 23 , 29 , 48 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437642188,"TREFZ, LINDSEY, MEGOW",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437642188,"TREFZ, LINDSEY, MEGOW",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 56 , 72 , 101 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,1632 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437642188,"TREFZ, LINDSEY, MEGOW",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437643228,"YODER, MICHELLE, MOONEY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437644770,"MANZANO, MARYGRACE",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,2402 S MIAMI BLVD STE 101 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437644796,"CAMPBELL, ASHLEY, KEYS",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437644796,"CAMPBELL, ASHLEY, KEYS",123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437647500,"MCCUDDY, MICHAELA, STYRCULA",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 49 , 55 ," $12,013.87 ",,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437647500,"MCCUDDY, MICHAELA, STYRCULA",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346335312,COUNTY OF CHATHAM,CHATHAM COUNTY HEALTH DEPARTMENT,1000 S 10TH AVE   SILER CITY NC,019,Chatham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1437647500,"MCCUDDY, MICHAELA, STYRCULA",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437647500,"MCCUDDY, MICHAELA, STYRCULA",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437647500,"MCCUDDY, MICHAELA, STYRCULA",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437647500,"MCCUDDY, MICHAELA, STYRCULA",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437648334,MOOSE PHARMACY OF MT HOLLY LLC,,125 W CENTRAL AVE   MOUNT HOLLY NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1437648334,MOOSE PHARMACY OF MT HOLLY LLC,125 W CENTRAL AVE   MOUNT HOLLY NC,036,Gaston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437648714,"GRAVES, RACHEL, LYNN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437649712,"STEIN, MATTHEW, KLUG",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437649712,"STEIN, MATTHEW, KLUG",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437649712,"STEIN, MATTHEW, KLUG",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1437649712,"STEIN, MATTHEW, KLUG",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437649811,"MACKOW, NATALIE, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437651676,"STODDARD, ALEXANDER, RAY",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 32 , 47 ,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437651676,"STODDARD, ALEXANDER, RAY",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 63 , 81 , 118 ,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 33 , 62 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",600 W TRADE ST STE B DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",420 PARK ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 30 ,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437651767,"STAMEY, JESSICA, WEATHERS",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437652237,"LAIRD, JONATHAN, ROSS",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 236 , 236 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1437652237,"LAIRD, JONATHAN, ROSS",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 78 , 78 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,4235 S NEW HOPE RD STE F GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437653409,"UFONDU, CHUKWUDUM, LOTANNA",4235 S NEW HOPE RD STE F GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437653409,"UFONDU, CHUKWUDUM, LOTANNA",2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 36 , 50 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437653409,"UFONDU, CHUKWUDUM, LOTANNA",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 74 , 88 , 114 ,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437658473,"GEORGE, KATRINA, AUBRIEANA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437658473,"GEORGE, KATRINA, AUBRIEANA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437658473,"GEORGE, KATRINA, AUBRIEANA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437658796,"GREEN, SARAH, JYOTI",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437658796,"GREEN, SARAH, JYOTI",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437658796,"GREEN, SARAH, JYOTI",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437659752,"LAMBERSON, ARYN, MARIE",150 FAIRVIEW RD STE 230 MOORESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1437666138,"MICHAELS, LINDSEY, MICHELLE",LINDSEY MICHELLE MICHAELS DBASILVER CREEK FAMILY P,302 PITTS ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1437666138,"MICHAELS, LINDSEY, MICHELLE",302 PITTS ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 14 , 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437666344,"SCHWAB, JILLIAN, AILEEN",741A TILGHMAN DR   DUNN NC,043,Harnett,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 63 , 110 ,$#,,
MEDICAID DIRECT,1437669249,MED-TRANS CORPORATION,,901 W HENDERSON ST   SALISBURY NC,080,Rowan,3416A0800X,Transportation Services,Ambulance,Air Transport,1437669249,MED-TRANS CORPORATION,901 W HENDERSON ST   SALISBURY NC,080,Rowan,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1437673522,"DIAMOND-PAULSEN, ERIN, LAURA",11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891798054,GREENE COUNTY HEALTH CARE INC,SNOW HILL INTEGRATED CARE SERVICES,1106 KINGOLD BLVD   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437673522,"DIAMOND-PAULSEN, ERIN, LAURA",302 N GREENE ST   SNOW HILL NC,040,Greene,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437678836,"LITTMAN, KINDRA, JANEE",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437678836,"LITTMAN, KINDRA, JANEE",6231 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437678836,"LITTMAN, KINDRA, JANEE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437680238,"GODFREY, SEAN, JEROME",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 31 , 41 , 65 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437680352,"COLE, JORDAN, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 167 , 167 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437680352,"COLE, JORDAN, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437680352,"COLE, JORDAN, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 116 , 116 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437680352,"COLE, JORDAN, PAUL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437680741,"SINGH, ANKUR, KUMAR",1333 S DICKINSON DR UNIT 200 LELAND NC,010,Brunswick,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 34 , 52 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437680741,"SINGH, ANKUR, KUMAR",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 47 , 81 , 114 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1437681954,"LEVINE, ALEXANDER, JORDAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437681954,"LEVINE, ALEXANDER, JORDAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437681954,"LEVINE, ALEXANDER, JORDAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437681954,"LEVINE, ALEXANDER, JORDAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437681954,"LEVINE, ALEXANDER, JORDAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1437681954,"LEVINE, ALEXANDER, JORDAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437683661,"YOUNIS, HIBA, MOHAMED",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 36 , 36 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,275 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437683703,"KEHEILA, MOHAMED, ESMAT ABDELHAMID ALI",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437683703,"KEHEILA, MOHAMED, ESMAT ABDELHAMID ALI",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437683703,"KEHEILA, MOHAMED, ESMAT ABDELHAMID ALI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 107 , 210 , 299 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437684271,"LANE, KRYSTAL, JOY",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,971 GOLD HILL RD   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437684271,"LANE, KRYSTAL, JOY",971 GOLD HILL RD   FORT MILL SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437684271,"LANE, KRYSTAL, JOY",1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437684271,"LANE, KRYSTAL, JOY",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 27 , 43 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437684362,"DAVIS, KIMBERLY, MICHELE FENDER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 96 , 99 , 107 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437684388,"LUCAS, JORDYN, PAIGE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437685997,"SAJU, LEYA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 20 , 25 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437686250,"BRIM HICKS, KATHRYN, ROSE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437687332,"NELSON, CHRISTAL, DE-ANNA",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 25 , 25 ," $12,538.45 ",,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1437687621,"MOTES, KATHY, MARIE",317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 69 , 185 ,$#,,
MEDICAID DIRECT,1710237367,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA PEDIATRIC MEDICINE - STATESVILLE,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437687993,"BROADHURST, LEAH, RUTH",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437687993,"BROADHURST, LEAH, RUTH",133 1ST AVE SE   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 141 , 155 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437687993,"BROADHURST, LEAH, RUTH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437688322,"CROISSY, MARLEE, GERRI",1302 HEALTH DR   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1437688322,"CROISSY, MARLEE, GERRI",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 30 , 29 , 29 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437688322,"CROISSY, MARLEE, GERRI",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437688322,"CROISSY, MARLEE, GERRI",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1437688363,"HAMILTON, PHILLIP, DAVID",PHILLIP D HAMILTON DDS MS PLLC,421 OLD HONEYCUTT RD   FUQUAY VARINA NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1437688363,"HAMILTON, PHILLIP, DAVID",421 OLD HONEYCUTT RD   FUQUAY VARINA NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 145 , 365 , 446 ," $96,670.36 ",,
MEDICAID DIRECT,1437688363,"HAMILTON, PHILLIP, DAVID",PHILLIP D HAMILTON DDS MS PLLC,7200 FALLS OF NEUSE RD STE 201 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1437688363,"HAMILTON, PHILLIP, DAVID",7200 FALLS OF NEUSE RD STE 201 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 99 , 243 , 287 ," $67,715.81 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437690237,"TENNY, BRADLEY, CURTIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437690237,"TENNY, BRADLEY, CURTIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437690237,"TENNY, BRADLEY, CURTIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437690237,"TENNY, BRADLEY, CURTIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 41 , 62 , 75 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437690757,"SWANSON, JAMES, RICHARD",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437690757,"SWANSON, JAMES, RICHARD",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437690757,"SWANSON, JAMES, RICHARD",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 29 , 31 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437690757,"SWANSON, JAMES, RICHARD",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437690757,"SWANSON, JAMES, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 258 , 274 , 436 ," $13,402.67 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437690757,"SWANSON, JAMES, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1437692035,"MONZA, KRISTIN, HAYES",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1437692035,"MONZA, KRISTIN, HAYES",111 W GROVER ST   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437692035,"MONZA, KRISTIN, HAYES",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437692035,"MONZA, KRISTIN, HAYES",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1366180374,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,1001 MONROE ST STE D CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1437696150,"PURVIS, LESLIE, COCKMAN",1001 MONROE ST STE D CARTHAGE NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 33 , 78 , 161 ,$#,,
MEDICAID DIRECT,1437854403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY FAYETTEVILLE ORTHOPEDICS AND SPOR,1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437696960,"CLEVELAND, JEB, STUART",1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 156 , 231 , 383 ,$#,,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1437704392,"COOPER, ASHLEY, MINTON",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 79 , 104 , 286 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437708310,"HEPBURN, KRYSTIN, BROOKE",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 25 , 25 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437708310,"HEPBURN, KRYSTIN, BROOKE",125 QUEENS RD STE 640 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437708310,"HEPBURN, KRYSTIN, BROOKE",125 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437708385,"CHILDERS, THOMAS, CLAY",1090 NE GATEWAY CT NE STE 204A CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,1090 NE GATEWAY CT NE STE 204A CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437708385,"CHILDERS, THOMAS, CLAY",1090 NE GATEWAY CT NE STE 204A CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437709565,"MILLER, MOLLY, BENSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437713575,"GOODRICH, ROBERT, CHARLES",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 32 , 39 , 41 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437717519,"ANDRESEN, RICHARD, PHILIP",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437717519,"ANDRESEN, RICHARD, PHILIP",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 99 , 99 , 104 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1437718145,"FRENTZEL, LUCAS, MICHAEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437718145,"FRENTZEL, LUCAS, MICHAEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1437718145,"FRENTZEL, LUCAS, MICHAEL",2000 CAROMONT PKWY STE 100 BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1437718145,"FRENTZEL, LUCAS, MICHAEL",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1437718145,"FRENTZEL, LUCAS, MICHAEL",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1437718145,"FRENTZEL, LUCAS, MICHAEL",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1437722717,"CRUM, DANIELLE, NICOLE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1437722717,"CRUM, DANIELLE, NICOLE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1437722717,"CRUM, DANIELLE, NICOLE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437723715,"SANTOS, ASHLEY, PASCUAL",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437727344,"VANDERMEY, JOEL, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437727344,"VANDERMEY, JOEL, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437727344,"VANDERMEY, JOEL, DAVID",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437727344,"VANDERMEY, JOEL, DAVID",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437727344,"VANDERMEY, JOEL, DAVID",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437728268,"TRAN, TRANG, NGOC DIEM",BRIAN DENNIS KARRIKER,1309 UNION RD   GASTONIA NC,036,Gaston,1223D0001X,Dental Providers,Dentist,Dental Public Health,1437728268,"TRAN, TRANG, NGOC DIEM",1309 UNION RD   GASTONIA NC,036,Gaston,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#, 13 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437728680,"ROSENBALM, BAILEY, ROSE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1821653205,MOSES CONE PHYSICIAN SERVICES INC,CHMG PLASTIC SURGERY SPECIALISTS,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437728912,"ELENTENY, CLAIRE, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821653205,MOSES CONE PHYSICIAN SERVICES INC,CHMG PLASTIC SURGERY SPECIALISTS,1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437728912,"ELENTENY, CLAIRE, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821653205,MOSES CONE PHYSICIAN SERVICES INC,CHMG PLASTIC SURGERY SPECIALISTS,1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437728912,"ELENTENY, CLAIRE, ELIZABETH",1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 28 , 28 ,$#,,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437731353,"ZACCARIA, KYLIE, LYNN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437731353,"ZACCARIA, KYLIE, LYNN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 23 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437731353,"ZACCARIA, KYLIE, LYNN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437733136,"WELLS, DAVID, TYLER",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 32 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437733136,"WELLS, DAVID, TYLER",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 48 , 61 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1437734449,"RENZE, MARY, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437734449,"RENZE, MARY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1184935553,TROYER MEDICAL INC,~,107 S CENTRAL AVE   LANDIS NC,080,Rowan,193400000X,Group,Single Specialty,,1437735586,"PRATT, PATRICIA, MARSH",107 S CENTRAL AVE   LANDIS NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 223 , 471 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437736055,"LEE, MEGAN, LARISSA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 48 , 55 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437736055,"LEE, MEGAN, LARISSA",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437736055,"LEE, MEGAN, LARISSA",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437736055,"LEE, MEGAN, LARISSA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437736261,"JONES, RICHARD, WILLIAM",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437736311,"POPE, ALEXA, MOOREFIELD",216 MOORE RD   KING NC,085,Stokes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 94 , 137 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437736337,"MURRAY, EVELYN, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 15 , 30 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1437736337,"MURRAY, EVELYN, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 55 , 55 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437736337,"MURRAY, EVELYN, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437736337,"MURRAY, EVELYN, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437737087,"HUGHES, BRIANNA, NICOLE",101 MANNING DR GROUND FLOOR CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 25 , 150 ," $11,494.98 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437737087,"HUGHES, BRIANNA, NICOLE",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 223 , 264 , 559 ," $28,565.42 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437737715,"MELO, JONATHAN, DAVID",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 84 , 133 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437737715,"MELO, JONATHAN, DAVID",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437737715,"MELO, JONATHAN, DAVID",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043264724,EASTERN CAROLINA CARDIOVASCULAR,EASTERN CAROLINA CARDIOVASCULAR PA,1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1437740842,"HAYES, LUSHELL",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 139 , 271 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437747037,"SMITH, KENDALL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 102 , 102 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1437748001,"SITZMAN, ASHLEY, ANN",1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437748001,"SITZMAN, ASHLEY, ANN",1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1437748001,"SITZMAN, ASHLEY, ANN",1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 27 , 58 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437751989,"BRANCH, SCOTT, FLEMING",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1437751989,"BRANCH, SCOTT, FLEMING",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 59 , 105 , 105 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1437751989,"BRANCH, SCOTT, FLEMING",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1437751989,"BRANCH, SCOTT, FLEMING",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 50 , 50 ,$#,,
MEDICAID DIRECT,1437760162,COMFORT CARING HOME HEALTH LLC,,511 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1437760162,COMFORT CARING HOME HEALTH LLC,511 S BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,#," 1,277 "," 1,277 "," $78,737.56 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1437760386,"LAMBIASE, SAMANTHA, PAIGE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437760386,"LAMBIASE, SAMANTHA, PAIGE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437760386,"LAMBIASE, SAMANTHA, PAIGE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1437760386,"LAMBIASE, SAMANTHA, PAIGE",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 93 , 140 ," $27,763.93 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437760386,"LAMBIASE, SAMANTHA, PAIGE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437760386,"LAMBIASE, SAMANTHA, PAIGE",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437760386,"LAMBIASE, SAMANTHA, PAIGE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437760386,"LAMBIASE, SAMANTHA, PAIGE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1730275090,BOILING SPRING LAKES FAMILY MEDICIN,BOILING SPRING LAKES FAMILY MEDICINE PC,3599 GEORGE II HWY   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1437764768,"CAREY, AMANDA, LOUISE",3599 GEORGE II HWY   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437766029,"MARCOPLOS, HAYLEY, SMITH",3116 N DUKE ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1598067449,AUTISM THERAPEUTIC SERVICES LLC,HEALTHPRO PEDIATRICS LLC - HEALTHPRO HERITAGE,3020 HENDERSON DR   JACKSONVILLE NC,067,Onslow,251S00000X,Agencies,Community/Behavioral Health,,1437767563,"GIGLIO, TAYLOR, RAE",3020 HENDERSON DR   JACKSONVILLE NC,067,Onslow,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437768256,"JACKSON, REBECCA, GRACE",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437770831,"HONEYCUTT, BENJAMIN, JAMES",1602 DOCTORS CIR   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 126 , 184 , 267 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437770831,"HONEYCUTT, BENJAMIN, JAMES",205 E MAIN ST   WALLACE NC,031,Duplin,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1437770831,"HONEYCUTT, BENJAMIN, JAMES",603 PECAN LN   WHITEVILLE NC,024,Columbus,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 43 , 49 , 78 ,$#,,
MEDICAID DIRECT,1124757836,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-3334 BOYLSTON HIGHWAY SUITE 20,3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437770971,"ORR, BRADLEY, JAMES",3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 31 , 51 ,$#,,
MEDICAID DIRECT,1578139499,LINER WARD & SHOBE DDS PA,SOUTHERN DENTAL ASSOCIATES,1370 PIEDMONT DR STE 200 LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1437771045,"CHADWICK, SIDNEY, MICHELLE",1370 PIEDMONT DR STE 200 LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 159 , 288 , 775 ," $28,090.35 ",,
MEDICAID DIRECT,1578139499,LINER WARD & SHOBE DDS PA,SOUTHERN DENTAL ASSOCIATES,1370 PIEDMONT DR STE 200 LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1437771045,"CHADWICK, SIDNEY, MICHELLE",1370 PIEDMONT DR STE 200 LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437771557,"ALTIERI, DANIELLE, MARGARET",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 22 , 21 , 21 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437771557,"ALTIERI, DANIELLE, MARGARET",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1437772381,ENERGIZE THERAPY SERVICES,ENERGIZE THERAPY SERVICES,1281 LURECLIFF PL   FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437772381,ENERGIZE THERAPY SERVICES,1281 LURECLIFF PL   FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,#, 124 , 135 ,$#,,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437774155,"DILLON, REBECCA, GREGORY",108 N MOSBY AVE   LITTLETON NC,093,Warren,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 69 , 113 , 125 ,$#,,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437774155,"DILLON, REBECCA, GREGORY",204 EVANS RD   HOLLISTER NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902043292,ROXBORO FAMILY DENTISTRY,~,347 S MADISON BLVD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437775806,"CAMPBELL, HALBERT, EUGENE",347 S MADISON BLVD   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice, 382 , 531 ," 1,437 "," $88,908.01 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1437776499,"WHALING, ERIN, AMIRA",15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760027874,COASTAL CAROLINA CARE PLLC,,15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,193400000X,Group,Single Specialty,,1437776499,"WHALING, ERIN, AMIRA",15441 US HIGHWAY 17 STE 501 HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 30 , 48 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437781127,"GHALLY, MARIA, WAGDI",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 20 , 21 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437781309,"LANE, ANGELA, ANNE",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 99 ," 2,383 "," 2,387 "," $37,723.78 ",,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1437781309,"LANE, ANGELA, ANNE",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 39 , 118 , 118 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437784667,"ABRAMS, MERCEDE, LEE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437784667,"ABRAMS, MERCEDE, LEE",1718 E 4TH ST STE 907 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1437786241,"RICHARDS, ALLEEN, DANEIELLE",109A AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437786241,"RICHARDS, ALLEEN, DANEIELLE",109A AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003660663,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,107 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1437786241,"RICHARDS, ALLEEN, DANEIELLE",109A AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 119 , 244 , 426 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437787090,"HASHIMI, HANNAH, ROSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437787090,"HASHIMI, HANNAH, ROSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437788114,"NANNEY, MEGAN, JOY",16525 HOLLY CREST LN STE 150 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437789682,"THOMAS, LISA, MICHELLE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 108 , 115 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1437789807,"LUCK, PAIGE, FULLER",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 35 , 74 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1437789807,"LUCK, PAIGE, FULLER",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 46 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437794781,"YACANO, JOHN, WILLIAM",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1437794781,"YACANO, JOHN, WILLIAM",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1437794781,"YACANO, JOHN, WILLIAM",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 23 , 23 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437795408,"HARTLEY, KRYSTA, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 50 , 50 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437795408,"HARTLEY, KRYSTA, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 143 , 143 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437795416,"BREAUX, JESSICA, DAWN",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 129 , 963 , 964 ," $28,212.94 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437795416,"BREAUX, JESSICA, DAWN",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437797354,"FULMER, MELISSA, JEAN",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 28 , 32 , 32 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437797354,"FULMER, MELISSA, JEAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 40 , 53 , 53 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437797354,"FULMER, MELISSA, JEAN",517 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437797354,"FULMER, MELISSA, JEAN",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1437797354,"FULMER, MELISSA, JEAN",517 MOYE BLVD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437797354,"FULMER, MELISSA, JEAN",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437653359,SANDHILLS BEHAVIORAL CARE PLLC,SANDHILLS BEST CARE,523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1437806775,"SALE, JAIME, MARIE",523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 28 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437814027,"LANCE, BRIANNA, HODGES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 67 , 183 , 183 ,$#,,
MEDICAID DIRECT,1437815008,2W TRANSPORTATION LLC,,160 LONGLEAF DR   MOORESVILLE NC,049,Iredell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1437815008,2W TRANSPORTATION LLC,160 LONGLEAF DR   MOORESVILLE NC,049,Iredell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 31 ," 1,997 "," 2,085 "," $335,425.05 ",,
MEDICAID DIRECT,1437816857,SPEECH AND LANGUAGE SERVICES PLLC,LEAPS AND BOUNDS THERAPY,273 MEADOW BEAUTY DR   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1437816857,SPEECH AND LANGUAGE SERVICES PLLC,273 MEADOW BEAUTY DR   APEX NC,092,Wake,193400000X,Group,Single Specialty,, 51 ," 1,130 "," 1,186 "," $80,647.34 ",,
MEDICAID DIRECT,1437819661,WRIGHT PEDIATRIC THERAPY PLLC,WRIGHT PEDIATRIC THERAPY,211 E SIX FORKS RD STE 221 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1437819661,WRIGHT PEDIATRIC THERAPY PLLC,211 E SIX FORKS RD STE 221 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 74 ," 2,020 "," 2,021 "," $139,903.28 ",,
MEDICAID DIRECT,1417684135,DEBBIE C SMITH,FAYETTEVILLE INTERNAL MEDICINE,1766 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437827490,"SMITH, DEBBIE, CRIBB",1766 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 137 , 213 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437828225,"LIPP, ARIANA, MICHELLE CAIRNS",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 15 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437833670,"SEIDENFELD, AMANDA, JAMES",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437833670,"SEIDENFELD, AMANDA, JAMES",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437833670,"SEIDENFELD, AMANDA, JAMES",3404 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780370122,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - RIVERWOOD,3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437838067,"HORN, MARY, GRACE",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 16 , 34 , 34 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1437847944,"MEITNER, MCKENNA, GRACE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1437848884,ASSISTIVE MEDICAL EQUIPMENT LLC,ASSISTIVE MEDICAL EQUIPMENT,2000 BRENTWOOD RD STE 5 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437848884,ASSISTIVE MEDICAL EQUIPMENT LLC,2000 BRENTWOOD RD STE 5 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 45 , 120 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437850898,"LYNCH, MAUREEN, FRANCES",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 48 , 231 , 279 ,$#,,
MEDICAID DIRECT,1437854403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY FAYETTEVILLE ORTHOPEDICS AND SPOR,1991 FORDHAM DR STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437854403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,1991 FORDHAM DR STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 139 , 637 ," 1,734 "," $10,709.46 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1437855475,"POWELL, RACHEL, ANNE",1925 GLENN MITCHELL DR STE 206 PRINCESS ANNE VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1437856077,ASPIRE HOMEHEALTH SERVICES LLC,ASPIRE HOMEHEALTH SERVICES,1731 TRAWICK RD STE 103 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1437856077,ASPIRE HOMEHEALTH SERVICES LLC,1731 TRAWICK RD STE 103 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 355 , 355 ," $37,100.80 ",,
MEDICAID DIRECT,1407326291,TINSLEY SURGICAL PA,,1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437856259,"BARBER, CANDACE, ANN",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437856622,"BETHEA, EBONEE, RASHEEDANA",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437856812,"THEODROS, AREGASH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437856812,"THEODROS, AREGASH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1437856812,"THEODROS, AREGASH",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437856812,"THEODROS, AREGASH",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437856812,"THEODROS, AREGASH",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 28 , 54 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 33 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1600 HIGHWOODS BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437857190,"SUTHERBURG, NIAMH, ELIZABETH",1600 HIGHWOODS BLVD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1437857414,"WILSON, TRISTIN, REANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1437858271,OAKLAND LIVING LLC,,704 POORS FORD RD   RUTHERFORDTON NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437858271,OAKLAND LIVING LLC,704 POORS FORD RD   RUTHERFORDTON NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 727 , 727 ," $66,551.94 ",,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437859923,"MCCANN II, MICHAEL, JOSEPH",5603 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164887873,SIMPLECLINIC PLLC,,1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1437859923,"MCCANN II, MICHAEL, JOSEPH",5603 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1437861101,"SERRA, REBECCA, MARIE",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1437862141,"ZYRA, CHRISTOPHER, DANIEL",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801893151,CAROLINA CARING INC,~,3975 ROBINSON RD   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1437865292,"KAYLOR, KELSEY, YANCEY",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 35 , 52 ,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1437865292,"KAYLOR, KELSEY, YANCEY",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 20 ,#,#,$#,,
MEDICAID DIRECT,1437871209,ARTIS HOME CARE LLC,,105 GREEN ST E B WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1437871209,ARTIS HOME CARE LLC,105 GREEN ST E B WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,158 "," 2,420 "," $230,748.40 ",,
MEDICAID DIRECT,1437871209,ARTIS HOME CARE LLC,,2000 NASH ST N STE A WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1437871209,ARTIS HOME CARE LLC,2000 NASH ST N STE A WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,#, 348 , 358 ," $33,954.12 ",,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1437872868,"WILLIAMS, NICHOLA, DIANE",1059 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 26 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1437872868,"WILLIAMS, NICHOLA, DIANE",1059 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1437873668,"GRIFFIN, JANEL, SMITH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 125 , 194 , 194 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1437877909,"ERWIN, CHRISTY, CAPPS",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1437877909,"ERWIN, CHRISTY, CAPPS",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 24 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1437877909,"ERWIN, CHRISTY, CAPPS",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 112 , 126 , 220 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1437878196,"VANDEVREDE, BREANNA, MARIE",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437878196,"VANDEVREDE, BREANNA, MARIE",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 32 , 45 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1437878196,"VANDEVREDE, BREANNA, MARIE",555 CARTHAGE ST   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1437878196,"VANDEVREDE, BREANNA, MARIE",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437881141,"HOSTETTER, SHEILA, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 27 , 49 ,$#,,
MEDICAID DIRECT,1104369081,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE PEDIATRIC CLINIC OF DANBURY,1030 HOSPICE DR   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1437881141,"HOSTETTER, SHEILA, LYNN",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 45 , 59 ,$#,,
MEDICAID DIRECT,1235591892,MCPC-6 LLC,FIRSTHEALTH BACK AND NECK PAIN CENTER-MONTGOMERY,522 ALLEN ST STE 103 TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1437883261,"DAVIS, SHERRY, RENEE",522 ALLEN ST STE 103 TROY NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 89 , 270 , 464 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 2200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1437884392,"DAVIS, CHELSEA, ANNETTE",409 OLIN WAY STE 2200 DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 22 , 26 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1437884392,"DAVIS, CHELSEA, ANNETTE",294 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437887015,"MORRIS, MORGAN, VOGT",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1891287520,DLP PERSON PHYSICIAN PRACTICES LLC,~,503 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1437890134,"RILEY, SCOTT, FREDERICK",503 RIDGE RD   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558750893,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM ORTHOPAEDICS,120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1437890134,"RILEY, SCOTT, FREDERICK",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 246 , 523 ,$#,,
MEDICAID DIRECT,1437893401,SPRING ARBOR APEX NC TENANT LLC,SPRING ARBOR OF APEX,901 SPRING ARBOR CT   APEX NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1437893401,SPRING ARBOR APEX NC TENANT LLC,901 SPRING ARBOR CT   APEX NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 726 , 726 ," $45,534.40 ",,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1437895232,"BANKSTON, ANNMARIE, FUSCO",507 N MAIN ST   TROY NC,062,Montgomery,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1801232244,MILLER AND ASSOCIATES FOUR PLLC,MILLER AND ASSOCIATES,1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1437898046,"MOHR, FELIPE, JUNGBLUT",1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 511 , 877 ," 3,145 "," $174,717.25 ",,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1437910361,"SMITH, ERIN, KELLY",2277 NC 24-87   CAMERON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1437912375,"HICKS, JOEL, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437913381,"COLE, LINDSEY, KATHRYN",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 81 , 184 ,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437913381,"COLE, LINDSEY, KATHRYN",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437913381,"COLE, LINDSEY, KATHRYN",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437913381,"COLE, LINDSEY, KATHRYN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 148 , 480 ," 1,122 "," $11,506.40 ",,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437913381,"COLE, LINDSEY, KATHRYN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1629327895,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES LAURINGBURG,705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1437916848,"JACOBS, AMANDA, COLLINS",705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1437916848,"JACOBS, AMANDA, COLLINS",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 94 , 96 ,$#,,
MEDICAID DIRECT,1629327895,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES LAURINGBURG,705B LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1437916848,"JACOBS, AMANDA, COLLINS",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 42 , 49 ," $10,992.22 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 36 , 42 , 91 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,781 AVENT FERRY RD   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",781 AVENT FERRY RD STE 202 HOLLY SPRINGS NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 19 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 75 , 94 , 218 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1437920329,"BONATTI, RODOLFO",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437926912,"HOUSTON, HANNAH, SHERRILL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437926912,"HOUSTON, HANNAH, SHERRILL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 33 , 171 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437926912,"HOUSTON, HANNAH, SHERRILL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1437926912,"HOUSTON, HANNAH, SHERRILL",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 110 , 185 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437927043,"ASHE, BIANCA, JANAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1437927613,ALL VOICES LLC,ALL VOICES,59 SUMMIT BLVD   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1437927613,ALL VOICES LLC,59 SUMMIT BLVD   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,, 16 , 280 , 280 ," $19,730.45 ",,
MEDICAID DIRECT,1306825005,CLOVER FAMILY CORPORATION,CLOVERS MASTECTOMY AND MEDICAL SUPPLY,1040 S CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1437932332,"ALEXANDER, JASON, RYAN",1040 S CHURCH ST   BURLINGTON NC,001,Alamance,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 60 , 75 , 176 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1437935012,"GASKILL, EDFRED, MCKEE",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730416801,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437935806,"JAMES, NATALIE, WILSON",4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 40 , 56 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437939816,"MONDEK, RACHEL, MARIAH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 23 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1437939816,"MONDEK, RACHEL, MARIAH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2005 SHANNON GRAY CT   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1437966496,"KYKER, ANGELA, CHERI",401 LAMBERT RD   BISCOE NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 34 , 34 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,401 LAMBERT RD   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1437966496,"KYKER, ANGELA, CHERI",401 LAMBERT RD   BISCOE NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1437966496,"KYKER, ANGELA, CHERI",401 LAMBERT RD   BISCOE NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1437966496,"KYKER, ANGELA, CHERI",401 LAMBERT RD   BISCOE NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 62 , 62 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1437968021,"PUDENZ, LAUREN, ELIZABETH",1801 S 17TH ST   CAPE FEAR NC,065,New Hanover,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1437978673,"WATKINS, SARAH, BROWN",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 53 , 66 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447002506,"PRESSER, CARLY, BARBARA",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447002506,"PRESSER, CARLY, BARBARA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 56 , 62 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447005780,"WISMER, COURTNEY, GABRIELLE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447005780,"WISMER, COURTNEY, GABRIELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447005780,"WISMER, COURTNEY, GABRIELLE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447005780,"WISMER, COURTNEY, GABRIELLE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447005780,"WISMER, COURTNEY, GABRIELLE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447005780,"WISMER, COURTNEY, GABRIELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447028444,"KLEMM, DAWN, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 45 , 47 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447031257,"KELLY, ELLEN, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447031257,"KELLY, ELLEN, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447031257,"KELLY, ELLEN, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447031257,"KELLY, ELLEN, ELIZABETH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447031257,"KELLY, ELLEN, ELIZABETH",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447032743,"PATTON, LEE, KENT",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447033923,"SIFFORD, BRENNA, AVONTE",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 24 , 55 ,$#,,
MEDICAID DIRECT,1841929395,STEP UP CARE OF NORTH CAROLINA PC,,3250 HOMESTEAD CLUB DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447034533,"PRYCE, SHANICE",3250 HOMESTEAD CLUB DR   WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 26 , 225 , 233 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447077698,"NIVEN, BRENT, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1447086228,"ADAMS, WHITNEY, MCFARLAND",460 COUNTRY CLUB RD LUMBERTON LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447087002,"COHEN, SAMANTHA",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447087002,"COHEN, SAMANTHA",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1164887873,SIMPLECLINIC PLLC,,1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447092440,"MCQUEEN, ERIN, PATRICIA",1074 SOUTHERN AVE   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 32 ,$#,,
MEDICAID DIRECT,1679263552,KASAJI MEDICAL PC,QUEEN CITY PRIMARY AND URGENT CARE,5820 E W T HARRIS BLVD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447092697,"CASTILLO NAVIA, LESLIE, ELISE",5820 E W T HARRIS BLVD STE B CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447092721,"DANIELS, SHIRONDA, FRANCETTA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1831875400,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT NORTH BROOK ELEMENTARY,642 HIGHWAY 274   VALE NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447099619,"CARPENTER, SHANNON, ELIZABETH",4875 REEPSVILLE RD   VALE NC,055,Lincoln,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1447200183,"GIHWALA, RAMESH",GIHWALA AND ASSOCIATES,825 MAJESTIC CT STE A GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,1447200183,"GIHWALA, RAMESH",825 MAJESTIC CT STE A GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1447201587,"STAUFFER, DAVID, MARK",233 DOCTORS ST   SPARTA NC,003,Alleghany,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 36 , 79 , 111 ,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1447201587,"STAUFFER, DAVID, MARK",150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 22 , 49 , 62 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1447201678,"CHAUDHRY, MADHU",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 80 , 152 , 152 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1447201694,"MORRISON, CRYSTAL, GETTYS",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447201975,"BENSKY, KASEY, PELTON",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447201975,"BENSKY, KASEY, PELTON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447201975,"BENSKY, KASEY, PELTON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447202262,"KELLEY JR, ROBERT, GRIFFIN",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164453726,CARMEL FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE CARMEL FAMILY MEDICINE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447202262,"KELLEY JR, ROBERT, GRIFFIN",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 25 , 43 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447202262,"KELLEY JR, ROBERT, GRIFFIN",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 18 , 30 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 27 , 31 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447202635,"STEINL, KEVIN, EDWARD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447203021,"CAFFREY, WILLIAM, DANIEL",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 103 , 180 , 351 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",300 BLAKE BLVD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 139 , 148 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,106 CAMERON ST   LAKE WACCAMAW NC,024,Columbus,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 32 , 33 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1402 PINCKNEY ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",200 FLOWERS PRIDGEN DR   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,200 FLOWERS PRIDGEN RD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",200 FLOWERS PRIDGEN DR   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",200 FLOWERS PRIDGEN DR   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 125 , 138 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 120 , 124 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 35 , 36 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 152 , 161 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1150 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",1150 PINE RUN DR   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 49 , 49 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,180 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 93 , 103 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 67 , 71 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1447203229,"AYERS, TRACY, ELIZABETH",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447203450,"LEWIS, TORRANCE, ROBEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 22 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447203450,"LEWIS, TORRANCE, ROBEL",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447203450,"LEWIS, TORRANCE, ROBEL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447203450,"LEWIS, TORRANCE, ROBEL",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447203450,"LEWIS, TORRANCE, ROBEL",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447203450,"LEWIS, TORRANCE, ROBEL",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 15 , 21 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447203682,"SOLDIN, JAMES, VINCENT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1447205778,"HOLTZMAN, ADRIAN, WEI",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 813 , 939 ," 1,196 "," $16,636.09 ",,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447206479,"REYNOLDS, SHERRI, LYNN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861445686,PINEHURST RADIOLOGICAL GROUP,PINEHURST RADIOLOGICAL GROUP,30 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1447207360,"HUDGINS, WILLIAM, BRADFORD",30 MEMORIAL DR   PINEHURST NC,063,Moore,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1447208376,"LUDLOW, DONALD, NILES",2828 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1265458251,SEASHORE PEDIATRICS PC,SEASHORE PEDIATRICS,2828 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447208376,"LUDLOW, DONALD, NILES",2828 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 117 , 263 , 597 ," $26,910.88 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447208681,"BACHMANN, STACY, GRIFFIN",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 51 , 53 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447208681,"BACHMANN, STACY, GRIFFIN",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447208681,"BACHMANN, STACY, GRIFFIN",1814 WESTCHESTER DR STE 201 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164470134,MOUNTAIN AREA PEDIATRICS ASSOCIATES,Mountain Area Pediatric Associates PA,500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447208871,"JACKSON, MARK, THOMAS",500 CENTREPARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 79 , 117 , 323 ," $16,432.19 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447209838,"CHAUDHRY, VINAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 26 , 34 , 67 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447209861,"ELTON, SCOTT, WENTWORTH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 89 , 124 , 141 ," $24,002.28 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447209861,"ELTON, SCOTT, WENTWORTH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447209861,"ELTON, SCOTT, WENTWORTH",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1447209994,"SCHMIDT, GILBERT, FRANCIS",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1139 CARTHAGE ST STE 110-A SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1447210182,"O DONNELL, GERARD, JOSEPH",1139 CARTHAGE ST STE 110-A SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 215 , 287 ,$#,,
MEDICAID DIRECT,1912965989,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,455 S MAIN ST STE 100 DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447210273,"METWALLI, MAGDA, MEKKY",455 S MAIN ST STE 100 DAVIDSON NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447210802,"FLEENOR, JONATHAN, TODD",500 DISCOVERY DR SUITE 300 CHESAPEAKE VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447210802,"FLEENOR, JONATHAN, TODD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 27 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1447210885,"MELVIN, FRANK, MICHAEL",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 16 , 27 , 38 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1447210885,"MELVIN, FRANK, MICHAEL",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 57 , 89 , 118 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447212378,"TATE, KELLY, HARTIGAN",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 78 , 88 , 146 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447212378,"TATE, KELLY, HARTIGAN",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1447212618,"KATSOUDAS, GEORGE, TRIANTAFILOS",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447212618,"KATSOUDAS, GEORGE, TRIANTAFILOS",1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 47 , 48 , 48 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447212667,"STUART JR, SAMUEL, PATRICK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 20 , 21 ,$#,,
MEDICAID DIRECT,1588626865,PREMIER PEDIATRICS PA,PREMIER PEDIATRICS PA,135 TURNER ST   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1447213053,"ROBERSON, JILL, RENAE",135 TURNER ST   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 35 , 72 ,$#,,
MEDICAID DIRECT,1326848730,KIDZCARE PEDIATRICS PC,,135 TURNER ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1447213053,"ROBERSON, JILL, RENAE",135 TURNER ST   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1447213665,"LESSARD, JAMES, ARTHUR",5130 SOUTHPORT SUPPLY RD SE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 43 , 96 ,$#,,
MEDICAID DIRECT,1295012565,MED FIRST IMMEDIATE CARE AND FAMILY,Med First Immediate Care and Family Practice PA,325 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1447213665,"LESSARD, JAMES, ARTHUR",5130 SOUTHPORT SUPPLY RD SE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 41 , 97 ,$#,,
MEDICAID DIRECT,1437854403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY FAYETTEVILLE ORTHOPEDICS AND SPOR,1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447213715,"DILELLO, MICHAEL, ERNEST",1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 208 , 328 , 615 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447213814,"EVANS, MOLLY, MCCOY",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 21 , 46 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447213814,"EVANS, MOLLY, MCCOY",910 N MADISON BLVD STE B ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,910 N MADISON BLVD STE B ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447213814,"EVANS, MOLLY, MCCOY",910 N MADISON BLVD STE B ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 116 , 139 , 316 ," $10,861.75 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,903 S BECKFORD DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1447213814,"EVANS, MOLLY, MCCOY",903 S BECKFORD DR   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447213905,"BOSWELL, ROBERT, BROOKS",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 67 , 101 , 197 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1447213921,"REHM, THOMAS, SCOTT",60 S MEDICAL CT   MARION NC,059,McDowell,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 51 , 116 , 165 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1447213921,"REHM, THOMAS, SCOTT",60 S MEDICAL CT   MARION NC,059,McDowell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1447213921,"REHM, THOMAS, SCOTT",1 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 15 , 17 , 19 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1447213921,"REHM, THOMAS, SCOTT",1 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 81 , 159 , 217 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447214028,"WALDEN JR, THOMAS, LORENZO",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447214028,"WALDEN JR, THOMAS, LORENZO",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 22 , 128 , 155 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1447214028,"WALDEN JR, THOMAS, LORENZO",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 38 , 67 , 78 ,$#,,
MEDICAID DIRECT,1992802607,PEDIATRIX MEDICAL GROUP OF SOUTH CA,~,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447214317,"COX, JESSE, THOMAS",805 PAMPLICO HWY   FLORENCE SC,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1447214762,"WILLIAMS, JOHN, ANTHONY",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1497792469,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PSYCHIATRIC SERVICES,1120 FAIRGROVE CHURCH RD STE 12 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1447215900,"MYLES, SIDNEY, LOPEZ",1120 FAIRGROVE CHURCH RD STE 12 HICKORY NC,018,Catawba,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1497792469,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PSYCHIATRIC SERVICES,1120 FAIRGROVE CHURCH RD STE 12 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1447215900,"MYLES, SIDNEY, LOPEZ",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447216023,"BOULTON, STACY, LYNN",4201 LAKE BOONE TRL STE 5 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447217666,"BRENNAN, JAMES, JOSEPH",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447217666,"BRENNAN, JAMES, JOSEPH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447220827,"MENENDEZ, CAROLYN, SUE",1918 RANDOLPH RD STE 130 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447220827,"MENENDEZ, CAROLYN, SUE",1918 RANDOLPH RD STE 130 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447221601,"DARBY, CYNTHIA, ANN",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,,,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447222369,"PETERSON, CECILY, KAREN",3044 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 24 , 52 ,$#,,
MEDICAID DIRECT,1760423503,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS GASTROENTEROLOGY,853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447222690,"KOBES, PETER, JEFFERY",853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447223870,"LEMASTER, KIMBERLY, PAIGE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447223870,"LEMASTER, KIMBERLY, PAIGE",11840 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1447223979,"STANCZAK, JEFFREY, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447223979,"STANCZAK, JEFFREY, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447223979,"STANCZAK, JEFFREY, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447223979,"STANCZAK, JEFFREY, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447223979,"STANCZAK, JEFFREY, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 315 , 327 , 377 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447223979,"STANCZAK, JEFFREY, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447223979,"STANCZAK, JEFFREY, DAVID",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1447224936,"STACKS, TIMOTHY, KYLE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447224936,"STACKS, TIMOTHY, KYLE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1447224936,"STACKS, TIMOTHY, KYLE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1447226519,"SMITH, ANTHONY, GEORGE",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 83 , 123 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447227764,"SHAVES, MARK, ELLIOTT",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447228283,"AZZI, ANTHONY, FRANCESCO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447228283,"AZZI, ANTHONY, FRANCESCO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447228283,"AZZI, ANTHONY, FRANCESCO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447228283,"AZZI, ANTHONY, FRANCESCO",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 27 , 27 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447229406,"WALKER, MARLA, MICHELE",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 25 , 48 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447230099,"USZENSKI, RONALD, THOMAS",131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 17 , 24 , 26 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447230099,"USZENSKI, RONALD, THOMAS",131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447230099,"USZENSKI, RONALD, THOMAS",137 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1750081378,FORSYTH MEDICAL GROUP LLC,PRIVIA MEDICAL GROUP-NORTH CAROLINA,27 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1447230404,"DAS, ANITA, KRISHNA",27 DOCTORS DR   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447233143,"OAKS, TIMOTHY, EUGENE",3940 ARROWHEAD BLVD STE 230 MEBANE NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447234570,"KITELEY, REX, ALLISON",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 17 , 42 , 66 ,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447234570,"KITELEY, REX, ALLISON",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 26 , 75 , 103 ,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447234588,"NANTAIS, ROBERT, PAUL",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427309608,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1447234588,"NANTAIS, ROBERT, PAUL",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 36 , 80 ,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447234588,"NANTAIS, ROBERT, PAUL",2700 S PROVIDENCE RD STE 180 WAXHAW NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447234588,"NANTAIS, ROBERT, PAUL",600 HOSPITAL DR   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447235262,"JOHNSON III, JAMES, CALVIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447235742,"SMITH JR, CLEO, HERBERT",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 31 , 44 , 54 ,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447235742,"SMITH JR, CLEO, HERBERT",1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447235742,"SMITH JR, CLEO, HERBERT",1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1447235882,"ROSCOE, WILLIAM, DOUGLAS",ROSCOE OPTOMETRIC CLINIC,420 W MAIN ST   SANFORD NC,053,Lee,152W00000X,Eye and Vision Services Providers,Optometrist,,1447235882,"ROSCOE, WILLIAM, DOUGLAS",420 W MAIN ST   SANFORD NC,053,Lee,152W00000X,Eye and Vision Services Providers,Optometrist,, 45 , 49 , 75 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1447236070,"GOSS, FREDERICK, UHL",611 MOCKSVILLE AVE ROWAN DIAGNOSTIC CLINIC SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447236781,"JAMES, SELINA, LAGUA",3200 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1053973354,UNC PHYSICIANS NETWORK GROUP PRACTI,,501 HEALTH PARK DR STE 180 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1447237102,"NIEMI, WILLARD, JOHN",501 HEALTH PARK DR STE 180 GARNER NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 21 , 25 , 35 ,$#,,
MEDICAID DIRECT,1053973354,UNC PHYSICIANS NETWORK GROUP PRACTI,,1505 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447237102,"NIEMI, WILLARD, JOHN",1505 SW CARY PKWY STE 200 CARY NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 17 , 23 , 39 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447237623,"BLAIR, MOTT, PARKS",125 RIVER VINE PKWY   WALLACE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447237672,"BALL, RANDALL, NEAL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 22 , 22 , 361 ," $28,578.98 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447237672,"BALL, RANDALL, NEAL",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447237672,"BALL, RANDALL, NEAL",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 809 , 997 ," 3,217 "," $109,544.94 ",,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,715 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1447237672,"BALL, RANDALL, NEAL",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447238068,"WILLIAMSON, WELDON, KENT",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 36 , 49 , 73 ," $11,250.80 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447238068,"WILLIAMSON, WELDON, KENT",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 55 , 71 , 90 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447238340,"HO, ALBERT, FENG",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 33 , 36 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447238340,"HO, ALBERT, FENG",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 31 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447238340,"HO, ALBERT, FENG",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447238340,"HO, ALBERT, FENG",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1447239017,"RINGWALT, ERIC, CHARLES",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1447240056,"BRADLEY, MICHAEL, EDGAR",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 49 ,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1447240056,"BRADLEY, MICHAEL, EDGAR",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1942633482,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1447240056,"BRADLEY, MICHAEL, EDGAR",80 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 167 , 297 , 652 ," $41,390.32 ",,
MEDICAID DIRECT,1538563473,EAST CAROLINA UNIVERSITY,~,600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1447240056,"BRADLEY, MICHAEL, EDGAR",600 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 33 , 70 ,$#,,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1447240056,"BRADLEY, MICHAEL, EDGAR",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 33 ,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447240072,"MITCHELL, SHARON, SONIA",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 69 , 106 ,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447240072,"MITCHELL, SHARON, SONIA",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1447243670,"FLOYD, NATHAN, SCOTT",107 W MEDICAL PARK DR STE 102 LEXINGTON NC,029,Davidson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 24 , 98 , 115 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447243670,"FLOYD, NATHAN, SCOTT",107 W MEDICAL PARK DR STE 102 LEXINGTON NC,029,Davidson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 34 , 40 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1447243670,"FLOYD, NATHAN, SCOTT",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447243704,"WATKINS, WILLIAM, LYLE",1916 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 79 , 108 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1447243712,"REARDON, MICHAEL, LANESE",906 WB MCLEAN BLVD   CAPE CARTERET NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1447243712,"REARDON, MICHAEL, LANESE",532 WEBB BLVD   HAVELOCK NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1447243712,"REARDON, MICHAEL, LANESE",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 45 , 84 ,$#,,
MEDICAID DIRECT,1043511785,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,906 WB MCLEAN BLVD   CAPE CARTERET NC,016,Carteret,193200000X,Group,Multi-Specialty,,1447243712,"REARDON, MICHAEL, LANESE",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 40 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1447244074,"FELIX, ROBERT, JOHN",135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,135 JACK BRANCH RD STE 331 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1447244074,"FELIX, ROBERT, JOHN",336 DEERFIELD RD   BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 25 , 65 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1447244074,"FELIX, ROBERT, JOHN",232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 50 , 115 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1447244322,"GHAUSSY, NAJEEB, OMAR",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 40 , 77 , 81 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1447244322,"GHAUSSY, NAJEEB, OMAR",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 111 , 286 , 458 ," $13,747.00 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447244876,"LAPLACE, LILLIA, THERESA",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 17 , 19 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447244876,"LAPLACE, LILLIA, THERESA",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447244876,"LAPLACE, LILLIA, THERESA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 40 , 41 , 46 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447244876,"LAPLACE, LILLIA, THERESA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 51 , 72 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 250 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447244876,"LAPLACE, LILLIA, THERESA",2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447244876,"LAPLACE, LILLIA, THERESA",2775 HENDERSONVILLE RD STE 210 ARDEN NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 20 , 37 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,45 HENDERSONVILLE HWY STE B PISGAH FOREST NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1447244876,"LAPLACE, LILLIA, THERESA",45 HENDERSONVILLE HWY STE B PISGAH FOREST NC,088,Transylvania,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 24 , 31 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447246004,"GIFTOS, PETER, MICHAEL",517 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 17 , 25 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447246228,"ADCOCK, GEORGE, EDWARD",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 28 , 28 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447246566,"REICH, PATIENCE, EKUATINNE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 37 , 84 , 93 ,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1447247481,"HILDEBRAND, STEPHEN, WARD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1447247671,"SANPEDRO, RICARDO, ALUAGUE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447247671,"SANPEDRO, RICARDO, ALUAGUE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 103 , 108 , 121 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 67 , 76 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 161 , 174 , 194 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 31 , 34 ,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1447249495,"GUPTA, ASHOK, KUMAR",839 DURHAM RD # A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447249735,"SPAHN, MITCHELL, WILLIAM",911 W HENDERSON ST STE 300 SALISBURY NC,080,Rowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447249735,"SPAHN, MITCHELL, WILLIAM",8201 HEALTHCARE LOOP STE 302 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447249735,"SPAHN, MITCHELL, WILLIAM",8201 HEALTHCARE LOOP STE 302 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1447250394,"LONG, MARSHA, NADINE",183 LEDFORD ST STE A MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447250394,"LONG, MARSHA, NADINE",183 LEDFORD ST STE A MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 80 , 68 , 69 ," $13,004.18 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447251269,"MASTERS, JAMES, EDWARD",201 E GROVER ST   SHELBY NC,023,Cleveland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 59 , 59 , 66 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447251871,"BEANE, JEFFREY, CARLTON",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447251871,"BEANE, JEFFREY, CARLTON",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 39 , 74 , 132 ,$#,,
MEDICAID DIRECT,1063500908,KNOX CLINIC PEDIATRICS PLLC,KNOX CLINIC,2304 DELANEY AVE KNOX CLINIC WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447252234,"STAUB, SVETLANA, ALEXANDRA",2304 DELANEY AVE   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 76 , 156 , 397 ," $21,410.82 ",,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1447252234,"STAUB, SVETLANA, ALEXANDRA",2304 DELANEY AVE   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1063500908,KNOX CLINIC PEDIATRICS PLLC,KNOX CLINIC,2304 DELANEY AVE KNOX CLINIC WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447252234,"STAUB, SVETLANA, ALEXANDRA",2304 DELANEY AVE   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 36 , 72 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 45 , 65 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 72 , 88 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 42 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 40 , 49 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 457 , 627 , 775 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 78 , 79 , 105 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 42 , 49 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1114684941,COLUMBUS REGIONAL DIAGNOSTICS,ADVANCED IMAGING,509 OLDE WATERFORD WAY STE 104 LELAND NC,010,Brunswick,293D00000X,Laboratories,Physiological Laboratory,,1447253075,"BASTUG, DEMIR, EROL",1301 MEDICAL DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 47 , 63 ,$#,,
MEDICAID DIRECT,1417298134,COLUMBUS REGIONAL DIAGNOSTICS,~,619 JEFFERSON ST   WHITEVILLE NC,024,Columbus,293D00000X,Laboratories,Physiological Laboratory,,1447253075,"BASTUG, DEMIR, EROL",609 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 59 , 65 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 75 , 90 , 109 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",609 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1447253075,"BASTUG, DEMIR, EROL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 50 , 57 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 26 , 26 ,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1447253075,"BASTUG, DEMIR, EROL",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376914283,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447254834,"BAUGHAN, THOMAS, GERALD",3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447255542,"MACK, GENEVIEVE, DANESE",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 22 , 51 ,$#,,
MEDICAID DIRECT,1750999405,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PRIMARY CARE LITTLE RIVER,4237 RIVER HILLS DR STE 170 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447256672,"BAENS, MARIA, GARCIA",4237 RIVER HILLS DR STE 170 LITTLE RIVER SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447256730,"BEARDEN III, JAMES, DEWITT",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265446132,INTERNAL MEDICINE AND PEDIATRICS AS,~,224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447256748,"WOMBLE, JAMES, CORNELIUS",224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447257084,"POINT, STUART, WATKINS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 ,#, 13 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447257084,"POINT, STUART, WATKINS",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447257092,"GANDHI, LAUREN, BROOKE",2025 FRONTIS PLAZA BLVD STE 120 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447257092,"GANDHI, LAUREN, BROOKE",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 31 , 42 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447257332,"IANNITTI, DAVID, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1447258306,"BURLESON, PAMELA",1325 TIMBER DR E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447258306,"BURLESON, PAMELA",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 29 ,$#,,
MEDICAID DIRECT,1932151305,CAROLINA EAR AND HEARING CLINIC PC,CAROLINA EAR AND HEARING CLINIC PC,5900 SIX FORKS RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447259858,"MCELVEEN JR, JOHN, THOMAS",5900 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 28 , 50 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447262886,"WHATLEY, NANCY, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447267281,"KORANG, VICTOR, EBED",4611 YADKINVILLE RD   PFAFFTOWN NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 41 , 53 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447267836,"ESCHBACH, JEFFREY, CHARLES",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 165 , 165 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1447267893,"MARQUEZ, MARK, RAYMOND",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447267893,"MARQUEZ, MARK, RAYMOND",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447268263,"MCCORMICK, DIANE, BOUCHER",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447271317,MACON COUNTY SCHOOLS,~,1202 OLD MURPHY RD   FRANKLIN NC,056,Macon,251300000X,Agencies,Local Education Agency (LEA),,1447271317,MACON COUNTY SCHOOLS,1202 OLD MURPHY RD   FRANKLIN NC,056,Macon,251300000X,Agencies,Local Education Agency (LEA),, 237 ," 3,818 "," 3,902 "," $146,254.48 ",,
MEDICAID DIRECT,1447271390,FRANKLIN COUNTY SCHOOLS,Franklin County Schools,53 W RIVER RD   LOUISBURG NC,035,Franklin,251300000X,Agencies,Local Education Agency (LEA),,1447271390,FRANKLIN COUNTY SCHOOLS,53 W RIVER RD   LOUISBURG NC,035,Franklin,251300000X,Agencies,Local Education Agency (LEA),, 271 ," 3,582 "," 3,653 "," $154,910.51 ",,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447272877,"MCCULLOUGH, DANIEL, GRANT",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 36 , 58 , 63 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1447276159,"THOMPSON, WILLIAM, DAVID",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 24 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447276159,"THOMPSON, WILLIAM, DAVID",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 39 , 47 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447276159,"THOMPSON, WILLIAM, DAVID",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447276381,"SHAIKEWITZ, SAMUEL, THEODORE",4016 FREEDOM LAKE DR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447276381,"SHAIKEWITZ, SAMUEL, THEODORE",4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 125 , 424 , 504 ," $13,583.68 ",,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447276381,"SHAIKEWITZ, SAMUEL, THEODORE",1209 S BRIGGS AVE   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 81 , 81 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447276381,"SHAIKEWITZ, SAMUEL, THEODORE",4917 OLD FARM RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 67 , 67 ,$#,,
MEDICAID DIRECT,1962583203,DURHAM NEPHROLOGY ASSOCIATES PA,DURHAM NEPHROLOGY ASSOCIATES PA,4419 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447276381,"SHAIKEWITZ, SAMUEL, THEODORE",1620 WILLIAMSBORO ST   OXFORD NC,039,Granville,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 131 , 131 ,$#,,
MEDICAID DIRECT,1447276506,THE MEDICINE BOX PHARMACY OF RUTHER,THE MEDICINE BOX PHARMACY OF RUTHERFORDTON INC,200 CHARLOTTE RD   RUTHERFORDTON NC,081,Rutherford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1447276506,THE MEDICINE BOX PHARMACY OF RUTHER,200 CHARLOTTE RD   RUTHERFORDTON NC,081,Rutherford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447276522,"LAKSHMINARAYANAN, SOWMYA",1219 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447276522,"LAKSHMINARAYANAN, SOWMYA",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447276522,"LAKSHMINARAYANAN, SOWMYA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447276522,"LAKSHMINARAYANAN, SOWMYA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447276522,"LAKSHMINARAYANAN, SOWMYA",1219 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447276779,"SANTIAGO, PEDRO, EDGARDO",2301 ERWIN RD   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447276779,"SANTIAGO, PEDRO, EDGARDO",3475 ERWIN RD   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 61 , 78 , 90 ," $19,279.55 ",,
MEDICAID DIRECT,1447278247,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1498,3738 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1447278247,WAL-MART STORES EAST LP,3738 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447278882,"TANTAWANICHPISAL, DUANGNED",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447279013,"BLAIR, WENDY, SANDERS",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447279542,"BUNDSCHUH, WILLIAM, PAUL",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447281217,"KANE, PETER, NEAL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 20 , 36 ," $11,241.68 ",,
MEDICAID DIRECT,1497340327,NOVANT HEALTH MEDICAL GROUP COASTAL,COASTAL THORACIC SURGICAL ASSOCIATES,1912 TRADD CT   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447281217,"KANE, PETER, NEAL",1912 TRADD CT   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1447281217,"KANE, PETER, NEAL",~,1912 TRADD CT   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1447281217,"KANE, PETER, NEAL",1912 TRADD CT   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447281217,"KANE, PETER, NEAL",2153 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447281928,"HARRIS IV, WILLIAM, RANDALL",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447281928,"HARRIS IV, WILLIAM, RANDALL",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 46 , 155 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447281928,"HARRIS IV, WILLIAM, RANDALL",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447281928,"HARRIS IV, WILLIAM, RANDALL",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447281928,"HARRIS IV, WILLIAM, RANDALL",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 16 , 43 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1447283098,"RAYNOR, CAROL, SUE",114A MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 15 , 33 ,$#,,
MEDICAID DIRECT,1821359142,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447284872,"MORRILL, GINA, MARIE",600 HOSPITAL DR   MONROE NC,090,Union,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 31 , 91 , 100 ,$#,,
MEDICAID DIRECT,1447286596,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1500 PINECROFT RD STE 204 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,,1447286596,BAYADA HOME HEALTH CARE INC,1500 PINECROFT RD STE 204 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,, 49 ," 9,858 "," 11,510 "," $5,893,490.32 ",,
MEDICAID DIRECT,1447286596,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1500 PINECROFT RD STE 204 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1447286596,BAYADA HOME HEALTH CARE INC,1500 PINECROFT RD STE 204 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 1,157 "," 1,161 "," $443,568.06 ",,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447286729,"JONES, KATHLEEN, ROSE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447286729,"JONES, KATHLEEN, ROSE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 27 , 52 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447286729,"JONES, KATHLEEN, ROSE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 33 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447286729,"JONES, KATHLEEN, ROSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447286943,"GLENNON, TIMOTHY, CHRISTOPHER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447286943,"GLENNON, TIMOTHY, CHRISTOPHER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 24 , 28 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447286943,"GLENNON, TIMOTHY, CHRISTOPHER",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447287552,"MOORE, MELODY",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,138 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447287552,"MOORE, MELODY",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 35 , 68 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447287552,"MOORE, MELODY",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447287552,"MOORE, MELODY",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 28 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1447287578,"WINGFIELD, MICHAEL, DARWIN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 34 , 34 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1447289699,"WANG, NADIA, SOPHIA",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 17 , 19 , 31 ,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447289822,"HANSEN, AARON, JOHN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 40 , 39 , 64 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 274 , 304 , 389 ," $14,553.17 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1447290002,"HUANG, BENJAMIN, YU BIN",2226 NELSON HWY   CHAPEL HILL NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447290242,"ROSARIO, RAYMOND, TORIO",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 169 , 294 , 519 ," $13,369.75 ",,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447290242,"ROSARIO, RAYMOND, TORIO",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447290242,"ROSARIO, RAYMOND, TORIO",3610 PETERS CT   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 34 , 67 ,$#,,
MEDICAID DIRECT,1447290846,STEINBAKES INC,DOLPHIN MEDICAL,746 BURLINGTON AVE   GIBSONVILLE NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447290846,STEINBAKES INC,746 BURLINGTON AVE   GIBSONVILLE NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 11 , 91 , 243 ," $53,452.06 ",,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447291661,"BARTKO, ALBERT, KENNETH",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447293568,"WAYCASTER, RONALD, LANCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447294350,"KRAFT, DAVID, CHRISTOPHER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",636 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",521 CLANTON RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",222 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",300 COPPERFIELD BLVD NE STE 105 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",401 S MARIETTA ST   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",401 S MARIETTA ST   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",549 COX RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",404 S SUTHERLAND AVE   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",404 S SUTHERLAND AVE   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",404 S SUTHERLAND AVE   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 34 , 56 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",404 S SUTHERLAND AVE   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 23 , 45 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447295159,"OKWARA, ADANMA, MBADINUJU",1462 CONSTITUTION BLVD   ROCK HILL SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447296272,QUEST DIAGNOSTICS NICHOLS INSTITUTE,QUEST DIAGNOSTICS NICHOLS INSTITUTE INC,14225 NEWBROOK DR   CHANTILLY VA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1447296272,QUEST DIAGNOSTICS NICHOLS INSTITUTE,14225 NEWBROOK DR   CHANTILLY VA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 293 , 325 , 491 ," $19,678.96 ",,
MEDICAID DIRECT,1649221342,RALEIGH DURHAM MEDICAL GROUP PA,~,4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447297049,"WENZLIK, ADAM, CLARK",4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 37 , 101 ,$#,,
MEDICAID DIRECT,1649221342,RALEIGH DURHAM MEDICAL GROUP PA,~,4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447297049,"WENZLIK, ADAM, CLARK",4003 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 29 , 61 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447297809,"DOVE, DALTON, EDWARD",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447297809,"DOVE, DALTON, EDWARD",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 41 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447297809,"DOVE, DALTON, EDWARD",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 19 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447297809,"DOVE, DALTON, EDWARD",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 89 , 249 , 286 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447297809,"DOVE, DALTON, EDWARD",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 52 , 110 , 128 ," $13,774.64 ",,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 36 , 39 , 48 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 65 , 154 , 179 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1114200771,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447297833,"RUBERY, BRYON, EVAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1447299045,"BLACKMAN, WILLIAM, MICHAEL",BLACKMAN FAMILY DENTISTRY,1220 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1447299045,"BLACKMAN, WILLIAM, MICHAEL",1220 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447299730,"BROWN, RACHEL, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1184915639,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MOUNTAIN VALLEY ACADEMIC HEALTH CENTER,117 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1447299813,"COLLETT, ELLEN, CALHOUN",117 FOOTHILLS DR   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 59 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447300116,"RAYNOR, CARLY, AKULIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1659468130,ALBEMARLE REGIONAL HEALTH SERVICES,ALBEMARLE REGIONAL HEALTH SERVICES,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1447301007,"MEADS, LORETTA, WOOTEN",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1659468130,ALBEMARLE REGIONAL HEALTH SERVICES,ALBEMARLE REGIONAL HEALTH SERVICES,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1447301007,"MEADS, LORETTA, WOOTEN",828 ACADEMY ST S   AHOSKIE NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1437200417,LANE AND ASSOCIATES IV DDS PA,~,315 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447302088,"STEWART, EDWARD, ALLEN",401 E NC HIGHWAY 24   ROSEBORO NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447302112,"SINGH, PAWANDIP, KAUR",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 38 , 126 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1447302294,"JENKINS, TANA, BLACK",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497986509,DUPLIN GENERAL HOSPITAL INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193400000X,Group,Single Specialty,,1447302294,"JENKINS, TANA, BLACK",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447302294,"JENKINS, TANA, BLACK",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447303318,"HWANG, SANG, DONG",1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 784 , 830 ," 4,525 "," $136,337.75 ",,
MEDICAID DIRECT,1033488994,GREGORY R ABRAMS DMD II PA,GREGORY R ABRAMS DMD II PA,1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447303318,"HWANG, SANG, DONG",1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 18 , 18 ,$#,,
MEDICAID DIRECT,1386089662,GREGORY R ABRAMS DMD III PA,~,1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447303318,"HWANG, SANG, DONG",1712 BRANDON RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1447305651,ULTIMATE HOME HEALTH CARE INC,ULTIMATE HOME HEALTHCARE INC,3011 S MEMORIAL DR STE 6 GREENVILLE NC,074,Pitt,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1447305651,ULTIMATE HOME HEALTH CARE INC,3011 S MEMORIAL DR STE 6 GREENVILLE NC,074,Pitt,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 125 ," 1,933 "," 2,038 "," $87,096.15 ",,
MEDICAID DIRECT,1447305651,ULTIMATE HOME HEALTH CARE INC,ULTIMATE HOME HEALTHCARE INC,3011 S MEMORIAL DR STE 6 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1447305651,ULTIMATE HOME HEALTH CARE INC,3011 S MEMORIAL DR STE 6 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 848 , 848 ," $60,619.16 ",,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447306394,"RAND, WILLIAM, BAXTER WADDILL",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1447306394,"RAND, WILLIAM, BAXTER WADDILL",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447307244,"MOSS, JONATHAN, RANDALL",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447307244,"MOSS, JONATHAN, RANDALL",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447307244,"MOSS, JONATHAN, RANDALL",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 68 , 84 , 118 ,$#,,
MEDICAID DIRECT,1760559926,EAST CAROLINA UNIVERSITY,~,1000 E 5TH ST STUDENT HEALTH MAIL STOP 408 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447307483,"ANEJA, BELA, LAROIA",1000 E 5TH ST STUDENT HEALTH MAIL STOP 408 GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1447309125,"MUNTZ, JON, ALAN",2201 S STERLING ST   MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447309125,"MUNTZ, JON, ALAN",,2201 S STERLING ST   MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,1447309125,"MUNTZ, JON, ALAN",2201 S STERLING ST   MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1447309125,"MUNTZ, JON, ALAN",2201 S STERLING ST   MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 150 , 171 , 210 ,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,201 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1447309125,"MUNTZ, JON, ALAN",2201 S STERLING ST   MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 120 , 128 , 138 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447309455,"FERRERO-CONOVER, DEBORAH, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447310958,PEDIATRIC THERAPY ASSOCIATES,PEDIATRIC THERAPY ASSOCIATES,4201 LAKE BOONE TRL STE 4 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447310958,PEDIATRIC THERAPY ASSOCIATES,4201 LAKE BOONE TRL STE 4 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 238 ," 3,333 "," 4,076 "," $256,070.39 ",,
MEDICAID DIRECT,1447310958,PEDIATRIC THERAPY ASSOCIATES,PEDIATRIC THERAPY ASSOCIATES,4201 LAKE BOONE TRL STE 4 RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1447310958,PEDIATRIC THERAPY ASSOCIATES,4201 LAKE BOONE TRL STE 4 RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,, 20 , 234 , 234 ," $15,163.20 ",,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1447312095,"SMITHERMAN, SHONDA, HOBSON",911 E ATKINS ST   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447312442,"COLLINS, DANA, CHINESE",1511 WESTOVER TER   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 39 , 55 ,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447312442,"COLLINS, DANA, CHINESE",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1336102078,GREENSBORO MEDICAL ASSOCIATES PA,GREENSBORO MEDICAL ASSOCIATES PA,1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447312442,"COLLINS, DANA, CHINESE",1511 WESTOVER TER STE 201 GREENSBORO NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447313218,"IDRISS, SALIM, FAROUK",1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1718 E 4TH ST STE 304 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447313218,"IDRISS, SALIM, FAROUK",1718 E 4TH ST STE 304 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447313218,"IDRISS, SALIM, FAROUK",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 38 , 66 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447313218,"IDRISS, SALIM, FAROUK",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 17 , 20 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447313218,"IDRISS, SALIM, FAROUK",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447313218,"IDRISS, SALIM, FAROUK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1447319595,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07354,600 S MAIN ST   KING NC,085,Stokes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447319595,NORTH CAROLINA CVS PHARMACY LLC,600 S MAIN ST   KING NC,085,Stokes,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1447319595,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07354,600 S MAIN ST   KING NC,085,Stokes,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1447319595,NORTH CAROLINA CVS PHARMACY LLC,600 S MAIN ST   KING NC,085,Stokes,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1588043103,PROWELLNESS FAMILY CHIROPRACTIC,,644 CLARK DR   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1447319694,"GREGORY, MEGHAN, ANN",644 CLARK DR   LINCOLNTON NC,055,Lincoln,111N00000X,Chiropractic Providers,Chiropractor,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1679118228,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT ST STEPHENS HIGH,3205 34TH STREET DR NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447320809,"MANN, BRENDON, DAVIS",3205 34TH STREET DR NE   HICKORY NC,018,Catawba,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 44 , 44 ," $14,065.76 ",,
MEDICAID DIRECT,1447321443,LINCARE INC,~,126 WOODSIDE DR STE C DANVILLE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1447321443,LINCARE INC,126 WOODSIDE DR STE C DANVILLE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#, 56 , 126 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1447323233,"BATES, JAMES, BRADLEY",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114073160,PRIVATE DIAGNOSTIC CLINIC PLLC,Private Diagnostic Clinic PLLC,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1447324603,"ABOUAMARA, MOUNA",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447332150,"SMITH, JEFFREY, KEITH",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447332150,"SMITH, JEFFREY, KEITH",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447332150,"SMITH, JEFFREY, KEITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447332150,"SMITH, JEFFREY, KEITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447332150,"SMITH, JEFFREY, KEITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447332150,"SMITH, JEFFREY, KEITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 250 , 286 , 375 ," $13,947.00 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1447332150,"SMITH, JEFFREY, KEITH",2226 NELSON HWY   CHAPEL HILL NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447334313,"UNDERWOOD, ASHLEY, MCDANIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 43 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447334313,"UNDERWOOD, ASHLEY, MCDANIEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 30 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447334362,"ROCKMAN, HOWARD, ALLAN",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1447334362,"ROCKMAN, HOWARD, ALLAN",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447334362,"ROCKMAN, HOWARD, ALLAN",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447334362,"ROCKMAN, HOWARD, ALLAN",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1447337126,"STAVENGER, CHRISTOPHER, PAUL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1447337126,"STAVENGER, CHRISTOPHER, PAUL",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 43 , 105 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1447337126,"STAVENGER, CHRISTOPHER, PAUL",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447344692,"HASTINGS-WOOD, LAURA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447344692,"HASTINGS-WOOD, LAURA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 13 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447344692,"HASTINGS-WOOD, LAURA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1447345137,"JONES, RICHARD, BRIAN",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 15 , 18 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447345137,"JONES, RICHARD, BRIAN",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 22 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447349691,"BLACKMAN, DOUGLAS, ALLAN",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447349691,"BLACKMAN, DOUGLAS, ALLAN",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447349691,"BLACKMAN, DOUGLAS, ALLAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 29 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1127 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447349691,"BLACKMAN, DOUGLAS, ALLAN",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447349691,"BLACKMAN, DOUGLAS, ALLAN",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447349691,"BLACKMAN, DOUGLAS, ALLAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1235680463,RDMG ASSOCIATES PA,,1 SAINT DUNSTANS RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447349741,"ANDERSON, JOSEPH, ROBERT",1 SAINT DUNSTANS RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 136 , 227 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447349907,"AREPALLY, GOWTHAMI, MOREY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447349907,"AREPALLY, GOWTHAMI, MOREY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 24 , 27 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447349907,"AREPALLY, GOWTHAMI, MOREY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 30 , 39 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447349907,"AREPALLY, GOWTHAMI, MOREY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1447350293,TT&T SERVICES INC,~,126 N MAIN ST   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1447350293,TT&T SERVICES INC,126 N MAIN ST   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 7,398 "," 7,402 "," $739,098.02 ",,
MEDICAID DIRECT,1447353115,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05594,2400 GUM BRANCH RD   JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1447353115,NORTH CAROLINA CVS PHARMACY LLC,2400 GUM BRANCH RD   JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1447353115,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05594,2400 GUM BRANCH RD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1447353115,NORTH CAROLINA CVS PHARMACY LLC,2400 GUM BRANCH RD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1447353214,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03856,44 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447353214,NORTH CAROLINA CVS PHARMACY LLC,44 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447355029,"KAPURAL, LEONARDO",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 194 , 576 , 747 ," $11,351.63 ",,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447355029,"KAPURAL, LEONARDO",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447355185,"FLEMING, HERBON, EILIEZER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 36 , 67 , 141 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447355185,"FLEMING, HERBON, EILIEZER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447355185,"FLEMING, HERBON, EILIEZER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 157 , 351 , 792 ,$#,,
MEDICAID DIRECT,1447355300,FAMILY MEDICAL SUPPLY LLC,~,3209 GRESHAM LAKE RD STE 144 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447355300,FAMILY MEDICAL SUPPLY LLC,3209 GRESHAM LAKE RD STE 144 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,380 "," 6,712 "," 11,340 "," $228,672.67 ",,
MEDICAID DIRECT,1447355300,FAMILY MEDICAL SUPPLY LLC,~,3209 GRESHAM LAKE RD STE 144 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1447355300,FAMILY MEDICAL SUPPLY LLC,3209 GRESHAM LAKE RD STE 144 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 11 , 66 , 66 ," $10,673.26 ",,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1447356381,"JAMES, ANUJ",1710 S 401 BYPASS HWY   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447356381,"JAMES, ANUJ",1031 WEISS AVE STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447356381,"JAMES, ANUJ",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 57 , 71 , 206 ," $19,712.41 ",,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447356381,"JAMES, ANUJ",2038 LITHO PL   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447356381,"JAMES, ANUJ",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 22 , 22 , 330 ," $38,646.14 ",,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447356381,"JAMES, ANUJ",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447359252,"FOSTER, VALERIE, BARRIOS",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1447360201,"HEAD, JAMES, RYAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447360201,"HEAD, JAMES, RYAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1447360201,"HEAD, JAMES, RYAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447360201,"HEAD, JAMES, RYAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447360201,"HEAD, JAMES, RYAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447360201,"HEAD, JAMES, RYAN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447360201,"HEAD, JAMES, RYAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447360201,"HEAD, JAMES, RYAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447360201,"HEAD, JAMES, RYAN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1447361480,"OLEGARIO, ARNOLD, CAMACHO",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 57 , 86 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1447361480,"OLEGARIO, ARNOLD, CAMACHO",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 94 , 122 , 398 ," $16,920.65 ",,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1447361480,"OLEGARIO, ARNOLD, CAMACHO",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#," $18,677.17 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447361548,"OGHALAI, AMY, WILLIAMS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447362827,"BURTON, JEFFREY, ALAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447362827,"BURTON, JEFFREY, ALAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 43 , 44 , 45 ,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447362884,"CALLAWAY, ROBIN, GIDDENS",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447362884,"CALLAWAY, ROBIN, GIDDENS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447362884,"CALLAWAY, ROBIN, GIDDENS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386681625,WILLIAM SUMMERVILLE DDS PLLC,DISTINCTIVE DENTISTRY OF CHARLOTTE,475 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447364674,"SUMMERVILLE, WILLIAM, DICKSON",475 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 210 , 251 , 730 ," $42,902.58 ",,
MEDICAID DIRECT,1386681625,WILLIAM SUMMERVILLE DDS PLLC,DISTINCTIVE DENTISTRY OF CHARLOTTE,475 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447364674,"SUMMERVILLE, WILLIAM, DICKSON",475 N WENDOVER RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 849 ," 1,554 "," 4,591 "," $244,866.72 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447366430,"WENTZ, ELLIOTT, LEE",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 50 , 90 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447367206,"HUNTSINGER, LISA, BEELER",812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447367727,"HARGETT III, CHARLES, WILLIAM",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447367727,"HARGETT III, CHARLES, WILLIAM",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 90 , 111 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447367727,"HARGETT III, CHARLES, WILLIAM",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 72 , 104 ," $10,694.10 ",,
MEDICAID DIRECT,1447368337,APRIA HEALTHCARE LLC,,508 CENTRAL DR STE 105 VIRGINIA BEACH VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1447368337,APRIA HEALTHCARE LLC,508 CENTRAL DR STE 105 VIRGINIA BEACH VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 31 , 31 , 34 ,$#,,
MEDICAID DIRECT,1447368618,OMNICARE PHARMACY OF NORTH CAROLINA,OMNICARE OF HICKORY 48292,1257 25TH STREET PL SE   HICKORY NC,018,Catawba,3336L0003X,Suppliers,Pharmacy,Long Term Care Pharmacy,1447368618,OMNICARE PHARMACY OF NORTH CAROLINA,1257 25TH STREET PL SE   HICKORY NC,018,Catawba,3336L0003X,Suppliers,Pharmacy,Long Term Care Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1447371158,GORDONS FAMILY CARE HOME,GORDONS FAMILY CARE HOME,3727 RUBE SPANGLER RD   LAWNDALE NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1447371158,GORDONS FAMILY CARE HOME,3727 RUBE SPANGLER RD   LAWNDALE NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 143 , 143 ," $45,575.02 ",,
MEDICAID DIRECT,1306894597,MACON COLLIE PRETZER KORNSTEIN AND,WAKE ORTHODONTICS AND PEDIATRIC DENTISTRY,7401 CREEDMOOR RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447374830,"KORNSTEIN, DAVID, JASON",7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 435 , 519 ," 1,577 "," $62,895.10 ",,
MEDICAID DIRECT,1447374830,"KORNSTEIN, DAVID, JASON",,7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1447374830,"KORNSTEIN, DAVID, JASON",7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1306894597,MACON COLLIE PRETZER KORNSTEIN AND,WAKE ORTHODONTICS AND PEDIATRIC DENTISTRY,100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1447374830,"KORNSTEIN, DAVID, JASON",100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 127 , 136 , 623 ," $38,406.26 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447375977,"ARCHAMBAULT, FRANCOIS, JACQUES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447379052,"BRITTON, MARCIA, PAIGE",MARCIA BRITTON,185 TOWN BRANCH RD   BARNARDSVILLE NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1447379052,"BRITTON, MARCIA, PAIGE",185 TOWN BRANCH RD   BARNARDSVILLE NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 23 , 427 , 427 ," $28,954.17 ",,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447382379,"LEFLER, RODGER, WENDELL",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447384714,"BELL, PHILIP, TERWILLIGER",~,925 S MAIN ST   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1447384714,"BELL, PHILIP, TERWILLIGER",925 S MAIN ST   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 56 , 59 , 100 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447384797,"KOTLYAREVSKA, KATERYNA, VLADIMIROVNA",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447384797,"KOTLYAREVSKA, KATERYNA, VLADIMIROVNA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 23 , 29 , 31 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447384797,"KOTLYAREVSKA, KATERYNA, VLADIMIROVNA",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 87 , 146 , 186 ," $12,997.67 ",,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447384797,"KOTLYAREVSKA, KATERYNA, VLADIMIROVNA",510 CAROLINA BAY DRIVE   WILMINGTON NC,065,New Hanover,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447389549,"OROURKE, BRENDAN, JAMES",7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447389663,"CLARKE, NOELLEE, TASHINA",150 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1447390695,HOME SWEETHOME CARE SERVICES LLC,HOME SWEETHOME CARE SERVICES LLC,5522 MCQUEEN RD   RAMSEUR NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1447390695,HOME SWEETHOME CARE SERVICES LLC,5522 MCQUEEN RD   RAMSEUR NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,584 "," 2,584 "," $173,340.64 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447392659,"HOWELL, SHAWN, MONIQUE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447395777,ADVOCATE MEDICAL SERVICES LLC,ACTIVSTYLE,470 ASHEVILLE HWY STE D BREVARD NC,088,Transylvania,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1447395777,ADVOCATE MEDICAL SERVICES LLC,470 ASHEVILLE HWY STE D BREVARD NC,088,Transylvania,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1447395777,ADVOCATE MEDICAL SERVICES LLC,ACTIVSTYLE,470 ASHEVILLE HWY STE D BREVARD NC,088,Transylvania,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447395777,ADVOCATE MEDICAL SERVICES LLC,470 ASHEVILLE HWY STE D BREVARD NC,088,Transylvania,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 2,448 "," 17,582 "," 34,126 "," $2,423,319.48 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447397039,"FISCHER, WILLIAM, ARTHUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447397039,"FISCHER, WILLIAM, ARTHUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 51 , 68 ," $12,921.12 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447397039,"FISCHER, WILLIAM, ARTHUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447397807,"HERCE, MICHAEL, EMMANUEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 19 , 92 , 99 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447401385,"KIM, JUNG YOUNG",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447401385,"KIM, JUNG YOUNG",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447404488,"GENTRY, APRIL, BOLTON",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447404488,"GENTRY, APRIL, BOLTON",2701 STATESVILLE AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 77 , 147 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447404488,"GENTRY, APRIL, BOLTON",6231 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447404488,"GENTRY, APRIL, BOLTON",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447404488,"GENTRY, APRIL, BOLTON",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447404488,"GENTRY, APRIL, BOLTON",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447404488,"GENTRY, APRIL, BOLTON",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 31 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447406079,"COLON, DAVID, MANUEL",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 43 , 82 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447406079,"COLON, DAVID, MANUEL",10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 125 , 268 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1447406079,"COLON, DAVID, MANUEL",10344 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447406111,STAR MEDICAL INC,ETHOS THERAPY SOLUTIONS,2210 LEAH DR STE 1 HILLSBOROUGH NC,068,Orange,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1447406111,STAR MEDICAL INC,2210 LEAH DR STE 1 HILLSBOROUGH NC,068,Orange,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1447406111,STAR MEDICAL INC,ETHOS THERAPY SOLUTIONS,2210 LEAH DR STE 1 HILLSBOROUGH NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447406111,STAR MEDICAL INC,2210 LEAH DR STE 1 HILLSBOROUGH NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 80 , 424 , 475 ," $240,356.48 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447407788,"PHILLIPS, WHITNEY, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447407788,"PHILLIPS, WHITNEY, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447410394,"CROCKER, JUSTIN, ADAMS",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447410394,"CROCKER, JUSTIN, ADAMS",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447410394,"CROCKER, JUSTIN, ADAMS",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447410394,"CROCKER, JUSTIN, ADAMS",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447410394,"CROCKER, JUSTIN, ADAMS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 18 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447410394,"CROCKER, JUSTIN, ADAMS",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447410394,"CROCKER, JUSTIN, ADAMS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447410741,"MARKWALTER, COURTNEY, SIMMONS",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 29 , 29 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447410915,"ELLENDER, RYAN, PHILIP",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 44 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447410915,"ELLENDER, RYAN, PHILIP",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447410915,"ELLENDER, RYAN, PHILIP",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447410915,"ELLENDER, RYAN, PHILIP",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447412473,"SATTERFIELD MERCER, SARA, KATHRYN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 27 , 32 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447412507,"JURAU, CRISTIAN, ALEXANDRU",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 372 , 422 , 591 ," $10,841.25 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447412713,"KUYKENDAL, ADAM, REA",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447412713,"KUYKENDAL, ADAM, REA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447412713,"KUYKENDAL, ADAM, REA",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 20 , 45 , 63 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447412713,"KUYKENDAL, ADAM, REA",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",340 COMMERCE AVE STE 5 SOUTHERN PINES NC,063,Moore,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 24 , 24 , 38 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,340 COMMERCE AVE STE 5 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",340 COMMERCE AVE STE 5 SOUTHERN PINES NC,063,Moore,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780352252,J ARTHUR DOSHER MEMORIAL HOSPITAL,,4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 202 , 382 , 502 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 70 , 83 , 105 ,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",300 REGENT PARK CT   GREENVILLE SC,101,Out of State <= 40 miles,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,2082 WOODRUFF RD UNIT A GREENVILLE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",2082 WOODRUFF RD UNIT A GREENVILLE SC,101,Out of State <= 40 miles,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447413190,"BAKSH, JAVID, MU AZ",155 W MILLS ST STE 204 COLUMBUS NC,075,Polk,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 48 , 61 , 80 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447415351,"BYRD, SARAH, ARNETTE",1106 PARKSIDE MAIN ST   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447415351,"BYRD, SARAH, ARNETTE",1106 PARKSIDE MAIN ST   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447415351,"BYRD, SARAH, ARNETTE",1106 PARKSIDE MAIN ST   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447415351,"BYRD, SARAH, ARNETTE",1106 PARKSIDE MAIN ST   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1457531790,TRI CITY FAMILY MEDICINE URGENT C,TRICITY FAMILY MEDICINE AND URGENT CARE,107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1447415351,"BYRD, SARAH, ARNETTE",107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447415351,"BYRD, SARAH, ARNETTE",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447416110,"SAYERS, BENJAMIN, PETER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447416110,"SAYERS, BENJAMIN, PETER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 53 , 71 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447416110,"SAYERS, BENJAMIN, PETER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 91 , 96 , 134 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447416110,"SAYERS, BENJAMIN, PETER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447416334,"MADADI, ANUSHA, REDDY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447416334,"MADADI, ANUSHA, REDDY",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 47 , 49 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447416334,"MADADI, ANUSHA, REDDY",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447416334,"MADADI, ANUSHA, REDDY",1550 FAULK ST   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447416797,"YODER, DANIEL, EUGENE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447416797,"YODER, DANIEL, EUGENE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447416797,"YODER, DANIEL, EUGENE",709 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 68 , 75 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447416797,"YODER, DANIEL, EUGENE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 23 , 23 ,$#,,
MEDICAID DIRECT,1801261391,BLUE RIDGE COMMUNITY HEALTH SERVICE,SEVENTH AVENUE HEALTH CENTER,628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447416797,"YODER, DANIEL, EUGENE",628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1447418579,"DUNCAN, TODD, HARRISON",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 140 , 168 , 251 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447418579,"DUNCAN, TODD, HARRISON",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 126 , 142 , 237 ,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447419569,"WALEH, MESHIA, QUINELLE",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447419825,"DOYAL, ALEXANDER, SPENCER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 38 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447419825,"DOYAL, ALEXANDER, SPENCER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447420203,"COFIELD, KATTRON, RHODES",920 CHURCH ST N STE 255B CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 211 , 214 ,$#,,
MEDICAID DIRECT,1134182207,MMI HOLDINGS LLC,MEDICAL MODALITIES,325 MCGILL AVE NW STE 195 CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447420385,"CARROW, RICKEY, DALE",9307 MONROE RD STE M CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1790747244,ORTHO PROS EXPRESS INC,ORTHO PROS EXPRESS,9307 MONROE RD STE M CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447420385,"CARROW, RICKEY, DALE",9307 MONROE RD STE M CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,," 1,752 "," 1,890 "," 2,025 "," $52,076.26 ",,
MEDICAID DIRECT,1821569294,ATLANTIC COAST ORTHOPEDIC MEDICAL S,SELECT REHAB,9006 PERIMETER WOODS DR STE B CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447420385,"CARROW, RICKEY, DALE",9307 MONROE RD STE M CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447421763,"HATCH, DEBORA, RUSSWURM",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447424510,"SHARPE, TRIVIA, GRIFFIN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447424510,"SHARPE, TRIVIA, GRIFFIN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 64 , 65 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447424510,"SHARPE, TRIVIA, GRIFFIN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851783385,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL INTERNAL MEDICINE SPECIALISTS,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1447425608,"ZIMMERMAN, LAURA, IDA",194 DOCTORS DR   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 39 , 80 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1447425608,"ZIMMERMAN, LAURA, IDA",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 25 , 65 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447425780,"WELLMAN, DANIELLE, LEMUTH",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 34 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447425780,"WELLMAN, DANIELLE, LEMUTH",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447427737,"METTU, NIHARIKA, BANSAL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447427737,"METTU, NIHARIKA, BANSAL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 19 , 31 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447427737,"METTU, NIHARIKA, BANSAL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1447428784,"SANTIAGO, SARAH, ANN",101 CLINIC DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447428784,"SANTIAGO, SARAH, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447428784,"SANTIAGO, SARAH, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 48 , 54 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 23 , 42 , 42 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 173 , 278 , 308 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1447430061,"BEATY, ELIJAH, H.",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 27 , 40 , 40 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447430061,"BEATY, ELIJAH, H.",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1255932828,LABORATORY MEDICINE PC,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447431275,"WATKINS, JEREMIAH, RAY",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 11 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1447432166,"KIDDER, JAMES, MICHAEL",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1447436514,MEDICAL NEUROGENETICS LLC,,5424 GLENRIDGE DR   ATLANTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1447436514,MEDICAL NEUROGENETICS LLC,5424 GLENRIDGE DR   ATLANTA GA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1447437355,NEOGENOMICS LABORATORIES INC,,31 COLUMBIA   ALISO VIEJO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1447437355,NEOGENOMICS LABORATORIES INC,31 COLUMBIA   ALISO VIEJO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 46 , 47 , 61 ,$#,,
MEDICAID DIRECT,1447438106,MCLEOD CENTERS FOR WELLBEING,,500 ARCHDALE DR   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1447438106,MCLEOD CENTERS FOR WELLBEING,500 ARCHDALE DR   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,, 12 , 34 , 34 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447438593,"ZMIEWSKY, KENDALL, REID",145 APPLECROSS ROAD SOUTHERN PINES WOMENS SOUTHERN PINES NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447438593,"ZMIEWSKY, KENDALL, REID",145 APPLECROSS ROAD SOUTHERN PINES WOMENS SOUTHERN PINES NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 64 , 89 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447439336,"EDINGER, AMY, BETH",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 21 , 21 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447439336,"EDINGER, AMY, BETH",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447439336,"EDINGER, AMY, BETH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447441928,"STONE, HOYT, EDAY",509 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,509 N ELAM AVE STE 300-D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447441928,"STONE, HOYT, EDAY",509 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 27 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447441928,"STONE, HOYT, EDAY",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 135 , 172 ,$#,,
MEDICAID DIRECT,1558666776,INTEGRATED WOUND SPECIALISTS OF NC,,1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447441928,"STONE, HOYT, EDAY",1248 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 285 , 374 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1447442983,"SAJEEVAN, SUJATHA",1135 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447442983,"SAJEEVAN, SUJATHA",1135 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1982131843,SPECTRUM FAMILY MEDICINE PLLC,,519 KEISLER DR STE 104 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1447442983,"SAJEEVAN, SUJATHA",519 KEISLER DR STE 104 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 45 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447447040,"SNODGRASS, JEREMY, WILLIAM",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447449764,"WISE, SUSANNE, COCHRAN",146 NESBITT RDG   LAKE LURE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 69 , 84 ,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447449764,"WISE, SUSANNE, COCHRAN",161 WALKER ST   COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447450143,"WEICKERT, THELSA, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 183 , 295 , 386 ," $17,370.48 ",,
MEDICAID DIRECT,1447452024,DUPLIN SAMPSON GROUP HOMES INC,DUPLIN SAMPSON GROUP HOMES INC,300 JACOBS ST   CLINTON NC,082,Sampson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1447452024,DUPLIN SAMPSON GROUP HOMES INC,300 JACOBS ST   CLINTON NC,082,Sampson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 375 , 375 ," $71,121.56 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447452776,"MANDIP, RAWLA",850 KEMPSVILLE RD STE 100E NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447452776,"MANDIP, RAWLA",850 KEMPSVILLE RD STE 100E NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 410 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447452990,"BELLET, JANE, SANDERS",5324 MCFARLAND RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 14 , 28 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447452990,"BELLET, JANE, SANDERS",1000 TRENT DR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447452990,"BELLET, JANE, SANDERS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1821545633,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD SPINE CENTER,800 E CHEVES ST STE 480-B FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447453097,"JOHNSON, BRUCE, GATLIN",800 E CHEVES ST STE 480-B FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1326627399,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES- PLYMOUTH,115 ADAMS ST   PLYMOUTH NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447453287,"SADLER, WALTER, LEE",115 ADAMS ST   PLYMOUTH NC,094,Washington,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1215990700,ADVANCED DERMATOLOGY AND SKIN SURGE,ADVANCED DERMATOLOGY AND SKIN SURGERY PA,12 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1447453402,"MYRACLE, STEPHANIE, DIAMANTIS",16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1215990700,ADVANCED DERMATOLOGY AND SKIN SURGE,ADVANCED DERMATOLOGY AND SKIN SURGERY PA,16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1447453402,"MYRACLE, STEPHANIE, DIAMANTIS",16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447453451,"HUDNALL, SHANE, ROBERT",1131 N CHURCH ST STE C GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447453451,"HUDNALL, SHANE, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 36 , 48 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447454210,"MURPHY, ERIN, HEATHER",10650 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 52 , 65 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",1301 CENTRAL DR   SANFORD NC,053,Lee,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 21 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3325 GARDEN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 18 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 62 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 31 , 71 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447456512,"CHANG, EMILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,908 EDEN WAY N STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447456959,"PATEL, SONAL",908 EDEN WAY N STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730367467,HOSPICE & PALLIATIVE CARECENTER,TRELLIS SUPPORTIVE CARE,101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447457437,"CORBETT, TIMOTHY, MARK",101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1447461116,"CREEL, WILLIAM, BRADLEY",BRADLEY WILLIAM CREEL,145 MEDICAL PARK LN STE K MURPHY NC,020,Cherokee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,1447461116,"CREEL, WILLIAM, BRADLEY",145 MEDICAL PARK LN STE K MURPHY NC,020,Cherokee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 67 , 85 , 105 ,$#,,
MEDICAID DIRECT,1447461116,"CREEL, WILLIAM, BRADLEY",BRADLEY WILLIAM CREEL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,1447461116,"CREEL, WILLIAM, BRADLEY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1447461116,"CREEL, WILLIAM, BRADLEY",BRADLEY WILLIAM CREEL,218 HOSPITAL RD STE C BLAIRSVILLE GA,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,1447461116,"CREEL, WILLIAM, BRADLEY",218 HOSPITAL RD STE C BLAIRSVILLE GA,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1700901287,GOSHEN MEDICAL CENTER INCORPORATED,COMMUNITY HEALTH SERVICES,325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447461314,"KIRWAN, SUSAN, MARY",325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447461314,"KIRWAN, SUSAN, MARY",906 N US HIGHWAY 421   CLINTON NC,082,Sampson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447461314,"KIRWAN, SUSAN, MARY",444 SW CENTER ST   FAISON NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447461314,"KIRWAN, SUSAN, MARY",603 E COLLEGE ST   WARSAW NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1346365822,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WARSAW,603 E COLLEGE ST   WARSAW NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447461314,"KIRWAN, SUSAN, MARY",603 E COLLEGE ST   WARSAW NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1447461314,"KIRWAN, SUSAN, MARY",102 N MAIN ST   KENANSVILLE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447462247,"CHERRY, JANETTE, KATHERINE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1447462247,"CHERRY, JANETTE, KATHERINE",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447462247,"CHERRY, JANETTE, KATHERINE",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 53 , 94 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1447462247,"CHERRY, JANETTE, KATHERINE",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,,1447463518,"ZEDEK, DANIEL, CLAYTON",205 PAGE RD   PINEHURST NC,063,Moore,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#, 11 ,$#,,
MEDICAID DIRECT,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,,1447463518,"ZEDEK, DANIEL, CLAYTON",30 PAGE ST   PINEHURST NC,063,Moore,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447463518,"ZEDEK, DANIEL, CLAYTON",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 21 , 21 , 26 ,$#,,
MEDICAID DIRECT,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,,1447463518,"ZEDEK, DANIEL, CLAYTON",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 28 , 32 , 37 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447463682,"MORETZ, CHRISTIAN, BRADFORD",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 69 , 107 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447463682,"MORETZ, CHRISTIAN, BRADFORD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447463682,"MORETZ, CHRISTIAN, BRADFORD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487844510,CONWAY HOSPITAL EPS,CONWAY HOSPITAL EMERGENCY PROFESSIONAL SERVICES,300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447465455,"ARMSTRONG, CURTIS, DIXON",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518344035,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES,181 W WILKES MEDICAL CENTER RD   FERGUSON NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1447467089,"PIPER, JAMES, MATSON",181 W WILKES MEDICAL CENTER RD   FERGUSON NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 24 ,$#,,
MEDICAID DIRECT,1518344035,CARNAGGIO AND PIPER DMD MS PA,PIEDMONT DENTAL ASSOCIATES,181 W WILKES MEDICAL CENTER RD   FERGUSON NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1447467089,"PIPER, JAMES, MATSON",181 W WILKES MEDICAL CENTER RD   FERGUSON NC,097,Wilkes,1223P0700X,Dental Providers,Dentist,Prosthodontics, 438 , 889 ," 2,543 "," $118,487.22 ",,
MEDICAID DIRECT,1619258837,THOMAS V CARNAGGIO DMD MS PA,MT VIEW FAMILY DENTISTRY,3055 S NC 127 HWY   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1447467089,"PIPER, JAMES, MATSON",3055 S NC 127 HWY   HICKORY NC,018,Catawba,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447467980,"FRENCH, MARSHALL, LEVON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1447470216,LENOIR COUNTY PUBLIC SCHOOLS,LENOIR COUNTY SCHOOLS,2017 W VERNON AVE   KINSTON NC,054,Lenoir,251300000X,Agencies,Local Education Agency (LEA),,1447470216,LENOIR COUNTY PUBLIC SCHOOLS,2017 W VERNON AVE   KINSTON NC,054,Lenoir,251300000X,Agencies,Local Education Agency (LEA),, 388 ," 3,300 "," 3,347 "," $134,912.63 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447472071,"BRABHAM, VANCE, WELLS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447472071,"BRABHAM, VANCE, WELLS",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447472071,"BRABHAM, VANCE, WELLS",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 139 , 188 , 292 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447472071,"BRABHAM, VANCE, WELLS",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447472592,"SNIDER, CYNTHIA, BRIGITTE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447472592,"SNIDER, CYNTHIA, BRIGITTE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 195 , 279 ,$#,,
MEDICAID DIRECT,1205070984,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH TOWNSHIP PEDIATRICS,201 E MATTHEWS ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447474721,"ROMANOWSKI, AMI, PATEL",201 E MATTHEWS ST   MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447474721,"ROMANOWSKI, AMI, PATEL",201 E MATTHEWS ST   MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1447475066,CARING TOUCH HOME HEALTH CARE LLC,CARING TOUCH HOME HEALTH CARE LLC,11705 DEEP BRANCH RD   MAXTON NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1447475066,CARING TOUCH HOME HEALTH CARE LLC,11705 DEEP BRANCH RD   MAXTON NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 42 ," 10,920 "," 11,327 "," $1,780,556.43 ",,
MEDICAID DIRECT,1447475850,GP YANCEY ENTERPRISES INC,~,1025 RIDGE RD   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1447475850,GP YANCEY ENTERPRISES INC,1025 RIDGE RD   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 724 , 754 ," $46,064.59 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447475900,"MCLAWHORN, KRISTEL, JERNIGAN",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 50 , 98 , 319 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447475900,"MCLAWHORN, KRISTEL, JERNIGAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 58 , 110 , 159 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447475900,"MCLAWHORN, KRISTEL, JERNIGAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 33 , 33 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447475900,"MCLAWHORN, KRISTEL, JERNIGAN",3793 LEE ST   AYDEN NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 51 , 51 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447479076,"BENNETT, STACY, KAIJA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 16 , 17 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447479076,"BENNETT, STACY, KAIJA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447479308,"GEE, JONATHAN, BENJAMIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 119 , 119 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447479308,"GEE, JONATHAN, BENJAMIN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 19 , 19 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447483169,"SINGH, SAURAV, BAHADUR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 201 , 201 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1447484134,"BARNES, BRAD, PATRICK",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 16 , 26 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1447484134,"BARNES, BRAD, PATRICK",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1447484134,"BARNES, BRAD, PATRICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447484555,"STOMBAUGH, JASON, THOMAS",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447484555,"STOMBAUGH, JASON, THOMAS",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 30 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447484688,"CHAVIOUS, ANAYA, ALSTON",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1598474801,MCLEOD PHYSICIAN ASSOCIATES II,FLORENCE NEUROSURGERY AND SPINE AT MCLEOD HEALTH,1204 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447484852,"SEIN, MICHAEL, TIN",1204 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447485495,"ROBINSON, TODD, WAYNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 120 , 243 , 277 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447485818,"HEATH, JONATHON, PORTER",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 65 , 158 , 192 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447485818,"HEATH, JONATHON, PORTER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447486212,"BRISCOE, KIM, KOUCH",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 40 , 93 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447486212,"BRISCOE, KIM, KOUCH",1236 GUILFORD COLLEGE RD STE 117 JAMESTOWN NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 99 , 228 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447487954,"MCGEHEE, MICHAEL, LEE",214 18TH ST SE   HICKORY NC,018,Catawba,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 51 , 107 , 157 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447487954,"MCGEHEE, MICHAEL, LEE",950 STATE FARM RD STE 200 BOONE NC,095,Watauga,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 20 , 25 , 39 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447489570,"KROH, STEPHEN, FREDERICK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 30 , 45 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447489570,"KROH, STEPHEN, FREDERICK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 24 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447489570,"KROH, STEPHEN, FREDERICK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 44 , 55 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447489570,"KROH, STEPHEN, FREDERICK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447489570,"KROH, STEPHEN, FREDERICK",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447489570,"KROH, STEPHEN, FREDERICK",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447489570,"KROH, STEPHEN, FREDERICK",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1447490719,"SWEENEY, CATHERINE, ANN",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447490719,"SWEENEY, CATHERINE, ANN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 30 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447490719,"SWEENEY, CATHERINE, ANN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 45 , 56 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447490719,"SWEENEY, CATHERINE, ANN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 25 , 34 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1447490719,"SWEENEY, CATHERINE, ANN",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447491055,"PERKINS, CARRIE, LEIGH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447493580,"TERPENNING, SILANATH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 372 , 475 , 516 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447493580,"TERPENNING, SILANATH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447493580,"TERPENNING, SILANATH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447493580,"TERPENNING, SILANATH",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447493580,"TERPENNING, SILANATH",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447493580,"TERPENNING, SILANATH",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447493580,"TERPENNING, SILANATH",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1447493952,"DOWD, CANDICE, RENEE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447493952,"DOWD, CANDICE, RENEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494281,"KELLEY, CARLY, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 13 , 17 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494281,"KELLEY, CARLY, ELIZABETH",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 16 , 33 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447494356,"CHAPPELL, DAVID",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447494356,"CHAPPELL, DAVID",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494760,"SCHENKMAN, LUCY, MARIE",2100 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494760,"SCHENKMAN, LUCY, MARIE",5324 MCFARLAND RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494760,"SCHENKMAN, LUCY, MARIE",2100 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494760,"SCHENKMAN, LUCY, MARIE",4116 CAPITOL ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494760,"SCHENKMAN, LUCY, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447494760,"SCHENKMAN, LUCY, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447495841,"SAVAGE, JENNIE, PATTERSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 74 , 129 , 129 ," $10,324.98 ",,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447495890,"BRATINA, TIFFANY, BROOK",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447495890,"BRATINA, TIFFANY, BROOK",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447495890,"BRATINA, TIFFANY, BROOK",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447500061,"MILLER, MICHAEL, JOSEPH",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 203 , 203 ,$#,,
MEDICAID DIRECT,1447500400,GUARDIAN PHARMACY OF VIRGINIA LLC,SOUTHERN PHARMACY SERVICES,860 STAFFORD UMBERGER DR   WYTHEVILLE VA,101,Out of State <= 40 miles,3336L0003X,Suppliers,Pharmacy,Long Term Care Pharmacy,1447500400,GUARDIAN PHARMACY OF VIRGINIA LLC,860 STAFFORD UMBERGER DR   WYTHEVILLE VA,101,Out of State <= 40 miles,3336L0003X,Suppliers,Pharmacy,Long Term Care Pharmacy,#, 26 , 37 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447502828,"LEFFLER, WESLYN, ANNA",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1447505052,"GRAY, MATTHEW, JEREMY",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 40 , 41 , 50 ,$#,,
MEDICAID DIRECT,1447507835,GASTON PIEDMONT HEALTH CARE INC,FAMILY FIRST HOME HEALTH CARE INC,1120 UNION RD STE C GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1447507835,GASTON PIEDMONT HEALTH CARE INC,1120 UNION RD STE C GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 68 ," 13,316 "," 13,354 "," $955,391.98 ",,
MEDICAID DIRECT,1447507835,GASTON PIEDMONT HEALTH CARE INC,FAMILY FIRST HOME HEALTH CARE INC,1120 UNION RD STE C GASTONIA NC,036,Gaston,385H00000X,Respite Care Facility,Respite Care,,1447507835,GASTON PIEDMONT HEALTH CARE INC,1120 UNION RD STE C GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1447507835,GASTON PIEDMONT HEALTH CARE INC,FAMILY FIRST HOME HEALTH CARE INC,1120 UNION RD STE C GASTONIA NC,036,Gaston,385H00000X,Respite Care Facility,Respite Care,,1447507835,GASTON PIEDMONT HEALTH CARE INC,1120 UNION RD STE C GASTONIA NC,036,Gaston,385H00000X,Respite Care Facility,Respite Care,,#, 453 , 453 ," $33,551.68 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447508080,"SENG, LEAP, SEAM",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447511555,"PARKER, MATTHEW, JAMES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205253853,EAST CAROLINA UNIVERSITY,ECU PHYSICAL MEDICINE AND REHABILITATION CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447511555,"PARKER, MATTHEW, JAMES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 50 , 226 , 226 ," $10,827.50 ",,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447512074,"EARNST, KELLER, DUNAWAY",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679183776,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447513270,"BURFEIND, VICTORIA, HART",200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 29 , 34 ,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447513353,"SOBOL, ILYA, J",7185 HARBOUR TOWNE PKWY S STE 200 SUFFOLK VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447514229,"DOYLE, TAYLOR, PATRICK",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447514229,"DOYLE, TAYLOR, PATRICK",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447516331,"MALIS, JULIA, IRENE",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 26 , 42 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447517271,"GLOVER, ANGELICA, VANESSA",1718 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447517271,"GLOVER, ANGELICA, VANESSA",1450 MATTHEWS TOWNSHIP PKWY STE 410 MATTHEWS NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 21 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447517271,"GLOVER, ANGELICA, VANESSA",1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 17 , 20 , 49 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447517271,"GLOVER, ANGELICA, VANESSA",1718 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1437338050,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447517271,"GLOVER, ANGELICA, VANESSA",620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447517628,"MARTIN, ERIC, WILLIAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 29 , 37 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447517628,"MARTIN, ERIC, WILLIAM",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447517628,"MARTIN, ERIC, WILLIAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,971 GOLD HILL RD   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447517628,"MARTIN, ERIC, WILLIAM",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1447517628,"MARTIN, ERIC, WILLIAM",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447518543,CONTINUUM SERVICES LLC,,6020 NW 4TH PL STE A GAINESVILLE FL,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1447518543,CONTINUUM SERVICES LLC,6020 NW 4TH PL STE A GAINESVILLE FL,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447520606,"CABLES, MARIA, IVANOVNA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447520606,"CABLES, MARIA, IVANOVNA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1447525845,"CASTLE, JAMIE, ELIZABETH",180 PARKWOOD DR   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1447525845,"CASTLE, JAMIE, ELIZABETH",180 PARKWOOD DR   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447526652,"BAJWA, SWACHETAN, SINGH",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1447526652,"BAJWA, SWACHETAN, SINGH",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1447526652,"BAJWA, SWACHETAN, SINGH",201 E GROVER ST   KINGSTOWN NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 251 , 259 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447526660,"TURAKHIA, RUCHI, RAJESH",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 21 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447528021,"MURPHY, MARGARET, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447528021,"MURPHY, MARGARET, ANNE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447531488,"IVANOVA, DANIELA, TODOROVA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 40 , 40 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447532874,"CLAYTON, LISA, BLITZ",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447535794,"SHEETS, BROOKE, LEIGH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447536164,"ALLEN, LAUREN, ENGSTROM",103 PARKWAY OFFICE CT STE 102 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1932599248,EAST CAROLINA UNIVERSITY,ECU PHYSICAL THERAPY SERVICES,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447538434,"DURLAND, ALEXANDER, NATHANIEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447538434,"DURLAND, ALEXANDER, NATHANIEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447538988,"AUSTRIA, ERIC, JOVAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447538988,"AUSTRIA, ERIC, JOVAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 117 , 117 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447539887,"IRUKU, NAGA VENKATA, KALIPRAVEENA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 92 , 151 , 151 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447540836,"YANIK, MEGAN, VICTORIA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 19 , 82 , 86 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447540836,"YANIK, MEGAN, VICTORIA",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 17 , 56 , 56 ,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447543038,"RICHEY, JOHN, STEVEN",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710382411,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CARDIOLOGY CLEMMONS,7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447543632,"KIM, UN JU",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447543632,"KIM, UN JU",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447543632,"KIM, UN JU",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 95 , 121 , 184 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447545603,"KNACKSTEDT, THOMAS",5 REGIONAL CIR STE BANDC PINEHURST NC,063,Moore,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 20 , 38 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447545645,"ROBINSON, KRISTEN, LYN",13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447545645,"ROBINSON, KRISTEN, LYN",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 31 , 31 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447546189,"MERRILL, AMELIA, YOUNKER",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447546189,"MERRILL, AMELIA, YOUNKER",2104 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447546189,"MERRILL, AMELIA, YOUNKER",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447546189,"MERRILL, AMELIA, YOUNKER",1450 MATTHEWS TOWNSHIP PKWY STE 320 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447546189,"MERRILL, AMELIA, YOUNKER",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1447547567,"BHIRUD, ABHIJEET, RAVINDRAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447547567,"BHIRUD, ABHIJEET, RAVINDRAN",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 18 , 23 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447547567,"BHIRUD, ABHIJEET, RAVINDRAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 75 , 114 ," $10,487.83 ",,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,225 BRIGHTWATER DR STE 100 LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1447547567,"BHIRUD, ABHIJEET, RAVINDRAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447547567,"BHIRUD, ABHIJEET, RAVINDRAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 84 , 246 , 335 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447547567,"BHIRUD, ABHIJEET, RAVINDRAN",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447549340,"SMITH, ANDREW, BRYANT",705 GREEN VALLEY RD 705 GREEN VALLEY ROAD GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 17 , 21 ,$#,,
MEDICAID DIRECT,1447551759,ULTIMATE HEALTHCARE SERVICES INC,~,943 W ANDREWS AVE STE K HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1447551759,ULTIMATE HEALTHCARE SERVICES INC,943 W ANDREWS AVE STE K HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,, 53 ," 11,620 "," 11,624 "," $928,729.27 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447556691,"FOCKLER, SUE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#, 13 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447556691,"FOCKLER, SUE, ANN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447557269,"BENTON, ELIZABETH, JANE",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447557269,"BENTON, ELIZABETH, JANE",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 22 , 35 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,152 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447557269,"BENTON, ELIZABETH, JANE",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 GATEWAY BLVD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447557269,"BENTON, ELIZABETH, JANE",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447558622,"MCDOWELL, ELIZABETH, KATHRYN",4141 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 75 , 156 ,$#,,
MEDICAID DIRECT,1386928083,KYLE J ROTH III DDS PA,CAROLINA DENTAL OF GOLDSBORO,2720 GRAVES DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447561147,"TAYLOR, KEVIN, DON",8282 NC 58 S   ELM CITY NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1447561154,MCMC INC,MCMC Inc,24 GWENDOLYN CIR   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,1447561154,MCMC INC,24 GWENDOLYN CIR   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,, 363 ," 8,498 "," 8,527 "," $547,921.20 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447561907,"MARSHALL, JESSICA, LYNNE",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447561907,"MARSHALL, JESSICA, LYNNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447561907,"MARSHALL, JESSICA, LYNNE",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447561907,"MARSHALL, JESSICA, LYNNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447561907,"MARSHALL, JESSICA, LYNNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447561907,"MARSHALL, JESSICA, LYNNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447561907,"MARSHALL, JESSICA, LYNNE",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447563630,"PEARSALL, KATHARINE, BOLES",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 33 , 34 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447563630,"PEARSALL, KATHARINE, BOLES",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447564059,"TENACE, LAUREN, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 122 , 123 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447564950,"SHARMA, AMIT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447564950,"SHARMA, AMIT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447564950,"SHARMA, AMIT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447564950,"SHARMA, AMIT",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447565635,"TURNER, MARJORIE, PRINGLE",77 WEAVER RD STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 32 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447566534,"CORNETT, MALISSA, RENEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 87 , 87 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447566534,"CORNETT, MALISSA, RENEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 34 , 34 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447566534,"CORNETT, MALISSA, RENEE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1447569181,"WILLIAMS, SARAH, JANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447569223,"RUSSELL, MARSHA, YOLANDA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 26 , 59 , 64 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1447569223,"RUSSELL, MARSHA, YOLANDA",1301 CENTRAL DR   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1447572623,A1-OMEGA HEALTHCARE SERVICES INC,OMEGA HEALTHCARE SERVICES LLC,5870 FARINGDON PL STE 2 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1447572623,A1-OMEGA HEALTHCARE SERVICES INC,5870 FARINGDON PL STE 2 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 1,663 "," 1,833 "," $150,763.12 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447575816,"DAVIS, OGECHI, ODUAH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447575816,"DAVIS, OGECHI, ODUAH",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 94 , 94 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447575816,"DAVIS, OGECHI, ODUAH",920 CHURCH ST N STE 255-D CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447578927,"BALAKRISHNAN, PREETHI",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 19 , 22 , 22 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1447578927,"BALAKRISHNAN, PREETHI",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447579933,"WANGERIEN, LISA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 41 , 42 , 44 ," $13,458.98 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447581335,"LAL, ESHWAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447581335,"LAL, ESHWAR",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 51 , 157 , 157 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447581335,"LAL, ESHWAR",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447581335,"LAL, ESHWAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447581699,"PACETTI, TRACY, KATHERINE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447581699,"PACETTI, TRACY, KATHERINE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447581699,"PACETTI, TRACY, KATHERINE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447585781,"KURRA, VAMSI, KRISHNA",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447587423,"FIACCO, LINDSEY, BOXXE",201 SAGE RD   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447590534,"PHARES, JESSICA, RADFORD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447590534,"PHARES, JESSICA, RADFORD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447590534,"PHARES, JESSICA, RADFORD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447590534,"PHARES, JESSICA, RADFORD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447590856,"ELKINS, DONNAY, HALL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447590856,"ELKINS, DONNAY, HALL",1471 JAG BRANCH BLVD STE 103 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 47 , 81 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447590856,"ELKINS, DONNAY, HALL",903 RANDOLPH ST STE 1 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447591516,"GABRIELSKI, ANGELIKA, AUGUSTA",200 TRENT DR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 22 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447591516,"GABRIELSKI, ANGELIKA, AUGUSTA",200 TRENT DR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 36 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447591516,"GABRIELSKI, ANGELIKA, AUGUSTA",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 18 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447591516,"GABRIELSKI, ANGELIKA, AUGUSTA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 19 , 41 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447591920,"CARATURE, RYAN, FRANCIS",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447591920,"CARATURE, RYAN, FRANCIS",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447591920,"CARATURE, RYAN, FRANCIS",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447592308,RADEAS LLC,~,907 GATEWAY COMMONS CIR STE 100 WAKE FOREST NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1447592308,RADEAS LLC,907 GATEWAY COMMONS CIR STE 100 WAKE FOREST NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,, 911 ," 1,640 "," 2,807 "," $333,149.18 ",,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447592522,"MANASCO, ANTON, TRAVIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 32 , 39 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447592522,"MANASCO, ANTON, TRAVIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 29 , 38 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1447592787,"PATEL, MILIN, MUKESH",1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447592787,"PATEL, MILIN, MUKESH",4525 CAMERON VALLEY PKWY STE 1600 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447592787,"PATEL, MILIN, MUKESH",4525 CAMERON VALLEY PKWY STE 1600 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447592787,"PATEL, MILIN, MUKESH",4525 CAMERON VALLEY PKWY STE 1600 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447592787,"PATEL, MILIN, MUKESH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447598750,"FOWLER, HYMAN, LOUIS",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 44 , 46 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1447601075,"POPE, AMY, TURLINGTON",781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447601075,"POPE, AMY, TURLINGTON",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447601075,"POPE, AMY, TURLINGTON",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1447601075,"POPE, AMY, TURLINGTON",6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447601075,"POPE, AMY, TURLINGTON",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447602057,"JOHNSON, DANIELLE, GROOMS",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1447602685,"PETTIFORD, JASMINE",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 63 , 120 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447602685,"PETTIFORD, JASMINE",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 30 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1447603774,"BONNER, BRANDY, NICOLE",8841 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1447603774,"BONNER, BRANDY, NICOLE",2007 WALNUT ST   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1447603774,"BONNER, BRANDY, NICOLE",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447606496,"MCLAUGHLIN, CHRISTOPHER, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 83 , 88 , 98 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447609391,"LITTON, CURT, ANDREW",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467149823,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH EMERGENCY PHYSICIANS,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1447609391,"LITTON, CURT, ANDREW",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447609607,"MEYERS, HARVEY, PENDELL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 104 , 103 , 133 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1447610597,"KINSEY, BRAXTON, THOMAS",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 49 , 139 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1447610597,"KINSEY, BRAXTON, THOMAS",101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 36 , 77 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1447610597,"KINSEY, BRAXTON, THOMAS",101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447612585,"BASULI, DEBARGHA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 69 , 105 , 168 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447612585,"BASULI, DEBARGHA",2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447612585,"BASULI, DEBARGHA",2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 53 , 54 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614029,"PAUL, MERYL, ANN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 33 , 35 ,$#,,
MEDICAID DIRECT,1194263087,DLP FRYE MEDICAL GROUP,FRYECARE WOMENS SERVICES,1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1447614607,"TUCK, JOHN",1781 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 16 , 19 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 52 , 72 , 120 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 52 , 66 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447614862,"AUCOIN, VICTORIA, JEANNE",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447616602,"TAYLOR, LINDSAY, SPEARS",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447616602,"TAYLOR, LINDSAY, SPEARS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447616602,"TAYLOR, LINDSAY, SPEARS",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447618848,"POLLY, ALISON, REES",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447618848,"POLLY, ALISON, REES",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447618848,"POLLY, ALISON, REES",3901 N ROXBORO ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1447620364,"MOORE, NICOLE, MARIE",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 36 , 81 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447622295,"MICHNOWICZ, ELISE, PATRICIA",1821 HILLANDALE RD STE 24B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 23 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447622295,"MICHNOWICZ, ELISE, PATRICIA",1821 HILLANDALE RD STE 24B DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 22 , 59 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447626296,"NEWKIRK-BOSHERS, KAYLA",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447626296,"NEWKIRK-BOSHERS, KAYLA",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447626445,"SINGH, GAGAN, DEEP",2025 GLENN MITCHELL DR   VA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447626445,"SINGH, GAGAN, DEEP",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447627054,"GENSIC, MONICA, ENGLISH",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 101 , 101 ,$#,,
MEDICAID DIRECT,1164724100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE MINT HILL COMMONS FAMIL,11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447628573,"SEMELSBERGER, KIRAN, DEEP",11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 50 , 64 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447628573,"SEMELSBERGER, KIRAN, DEEP",2400 SOUTH BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447628573,"SEMELSBERGER, KIRAN, DEEP",2400 SOUTH BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447628672,"BUSH, NICOLE, VANDERBOSCH",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 21 , 33 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447628672,"BUSH, NICOLE, VANDERBOSCH",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447631569,"REID, TONYA, DAWN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447632369,"ORABI, MOHAMAD, YSER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447633680,"GENTILE, NICOLE, ELIZABETH",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 80 , 130 ,$#,,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1447634753,"SWAIN, LORI, ELIZABETH",1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 37 , 127 , 130 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447635396,"BROWN, COURTNEY, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447635396,"BROWN, COURTNEY, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1376600718,INTEGRATED CARE OF GREATER HICKORY,~,741 5TH ST SW   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1447635438,"PATTERSON, SAMUEL, LOUIS",741 5TH ST SW   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 370 , 390 ,$#,,
MEDICAID DIRECT,1376600718,INTEGRATED CARE OF GREATER HICKORY,~,741 5TH ST SW   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1447635438,"PATTERSON, SAMUEL, LOUIS",1228 N FLINT ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447636972,"KERNS, SHERRIE, LYNN",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 21 , 26 ,$#,,
MEDICAID DIRECT,1811964729,HOT SPRINGS HEALTH PROGRAM,LAUREL MEDICAL CENTER,80 GUNTERTOWN RD   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447636972,"KERNS, SHERRIE, LYNN",80 GUNTERTOWN RD   MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1376510875,HOT SPRINGS HEALTH PROGRAM,HOT SPRINGS MEDICAL AND DENTAL CENTER,66 NW US 25 70 HIGH   HOT SPRINGS NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447636972,"KERNS, SHERRIE, LYNN",66 NW US 25 70 HWY   HOT SPRINGS NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 19 , 21 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447636972,"KERNS, SHERRIE, LYNN",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447636972,"KERNS, SHERRIE, LYNN",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 30 , 39 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637277,"NAVEAU, MORGANE, ELIZABETH",4515 PREMIER DR   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637277,"NAVEAU, MORGANE, ELIZABETH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637277,"NAVEAU, MORGANE, ELIZABETH",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 142 , 147 , 199 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637277,"NAVEAU, MORGANE, ELIZABETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637277,"NAVEAU, MORGANE, ELIZABETH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637277,"NAVEAU, MORGANE, ELIZABETH",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637814,"OPYD, TIMOTHY, SAMUEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637814,"OPYD, TIMOTHY, SAMUEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 38 , 38 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447637814,"OPYD, TIMOTHY, SAMUEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447638366,"PATERSON, JAMIE, RACHEL",1001 BLYTHE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447638366,"PATERSON, JAMIE, RACHEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 79 , 82 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447638366,"PATERSON, JAMIE, RACHEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1447638549,"MORGAN, BLAKE, ALLEN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447639422,"LAFLEUR, TORI, ANN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447639422,"LAFLEUR, TORI, ANN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447640115,"EMORY, CARRIE, ANNE",1124 GALLERY PARK LN STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 52 , 58 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447640115,"EMORY, CARRIE, ANNE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 25 , 52 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447640461,"SPROUSE, CHELSEA, DANAHEY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447640461,"SPROUSE, CHELSEA, DANAHEY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",1602 WESTOVER DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",150 IVEY LN STE A PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1447644125,"YOUNG, ALYSA, DENAE",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 27 , 49 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1447644125,"YOUNG, ALYSA, DENAE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1447644125,"YOUNG, ALYSA, DENAE",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1447644125,"YOUNG, ALYSA, DENAE",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447644430,"JAIN, JUHI",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",1401 MATTHEWS TOWNSHIP PKWY STE 212&312 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",1401 MATTHEWS TOWNSHIP PKWY STE 212&312 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",1401 MATTHEWS TOWNSHIP PKWY STE 212&312 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 24 , 34 , 39 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447644885,"GREIF, SHANA, ROSAL",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,300 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1447645189,"HECK, KARISSA, LEIGH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 35 , 36 , 67 ,$#,,
MEDICAID DIRECT,1548224009,PINEHURST PATHOLOGY CENTER,PINEHURST PATHOLOGY CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1447645189,"HECK, KARISSA, LEIGH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 86 , 90 , 147 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447645213,"LANDA, KARENIA",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 28 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447645213,"LANDA, KARENIA",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447645213,"LANDA, KARENIA",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447645858,"ROBINSON, MATTHEW, GERALD",703 COMFORT LN   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 65 , 113 , 172 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447646013,"PLATT, SUSIE, WANG",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447646013,"PLATT, SUSIE, WANG",1515 DOCTORS CIR BLDG A WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 39 , 59 , 119 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447646013,"PLATT, SUSIE, WANG",295 OLMSTED BLVD   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 24 , 44 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447646211,"LINDBORG, BROOKE, HARRIS",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447647250,"STEINBACH, ERIN, CATHLEEN",100 EASTOWNE DR STE 420 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447647250,"STEINBACH, ERIN, CATHLEEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447647250,"STEINBACH, ERIN, CATHLEEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447651542,"KING, ASHLEY, COVERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447653506,"SIMON, DANA, ELIZABETH",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1447653670,"SISCO, MILDRETH, ANGELICA",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447656277,"ALEXANDER, JULIA, NELL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447656277,"ALEXANDER, JULIA, NELL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1447656277,"ALEXANDER, JULIA, NELL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1447656277,"ALEXANDER, JULIA, NELL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447656277,"ALEXANDER, JULIA, NELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1831837095,DLP TWIN COUNTY PHYSICIAN PRACTICES,TWIN COUNTY PEDIATRICS,606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447657150,"ELYAS, SAMMY",606 E STUART DR   GALAX VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1447660840,"SPENCE, LINSEY, HUDSON",1100 HEALING WAY STE 21B MATTHEWS NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447660840,"SPENCE, LINSEY, HUDSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 38 , 51 , 56 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447660840,"SPENCE, LINSEY, HUDSON",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447660840,"SPENCE, LINSEY, HUDSON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447660840,"SPENCE, LINSEY, HUDSON",10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447660840,"SPENCE, LINSEY, HUDSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447660964,"HODGES, ERIN, LANDIS",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 15 , 31 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447660964,"HODGES, ERIN, LANDIS",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447661335,"MARACAJA, DANIELLE, LAMEIRINHAS VIEIRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZB0001X,Allopathic & Osteopathic Physicians,Pathology,Blood Banking & Transfusion Medicine, 137 , 207 , 263 ,$#,,
MEDICAID DIRECT,1558695288,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY,ECU PHYSICIANS DIAGNOSTIC PATHOLOGY SERVICES,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447661392,"LI, TIAN, WEI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,,,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447665302,"LUCHETTI, TIMOTHY, JOHN",3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 25 , 49 ,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447665302,"LUCHETTI, TIMOTHY, JOHN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1447673215,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-7218,2915 NEUSE BLVD   NEW BERN NC,025,Craven,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1447673215,WAL-MART STORES EAST LP,2915 NEUSE BLVD   NEW BERN NC,025,Craven,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447676788,"BOLES, BENJAMIN, KEITH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447676788,"BOLES, BENJAMIN, KEITH",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 37 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447676788,"BOLES, BENJAMIN, KEITH",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447676788,"BOLES, BENJAMIN, KEITH",167 MOORE RD STE 202 KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447677174,"AMADOR, JODI, NICOLE",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447677448,"NCHE, CHARLOTTE, LUM",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 39 , 85 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447677448,"NCHE, CHARLOTTE, LUM",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447677448,"NCHE, CHARLOTTE, LUM",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 20 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1447678784,"LARSEN, DARIN, HEMINGWAY",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447678966,"WEGERMANN, KARA, BRIGHTMAN JOHNSON",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447678966,"WEGERMANN, KARA, BRIGHTMAN JOHNSON",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447678966,"WEGERMANN, KARA, BRIGHTMAN JOHNSON",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 39 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447678966,"WEGERMANN, KARA, BRIGHTMAN JOHNSON",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447679113,"LAMBIRD, JONATHAN, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 27 , 37 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447679782,"MOHAN, SATHISH",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447679782,"MOHAN, SATHISH",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447679782,"MOHAN, SATHISH",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 28 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447679782,"MOHAN, SATHISH",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 47 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447679782,"MOHAN, SATHISH",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 303 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447679782,"MOHAN, SATHISH",3300 EXECUTIVE DR STE 304 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447681572,"ALURI, KRISHNA, PAUL REICHEL",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 72 , 166 ,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447682794,"TAYLOR, EMILY, KATHRYN",4144 MENDENHALL OAKS PKWY STE 101 HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447689021,"CARPENTER, STACEY, LYNNETTE",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447689021,"CARPENTER, STACEY, LYNNETTE",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447689021,"CARPENTER, STACEY, LYNNETTE",1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 30 , 42 , 46 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447689872,"DAVIS, ASHLEY, LAUREN",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 50 , 110 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447689872,"DAVIS, ASHLEY, LAUREN",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 47 , 85 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447689872,"DAVIS, ASHLEY, LAUREN",1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1447690151,"POOVEY, KELLY, RAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1447690417,SERENITY FCH LLC,SERENITY FAMILY CARE HOME 2,912 BUCKHORN RD   WILLARD NC,082,Sampson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1447690417,SERENITY FCH LLC,912 BUCKHORN RD   WILLARD NC,082,Sampson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 12 , 370 , 370 ," $143,158.04 ",,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447690565,"FUHRMAN, TANYA, A",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1447690615,"KWANKAM, LAUREN, STRASSER",2511 OLD CORNWALLIS RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 29 , 31 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447690615,"KWANKAM, LAUREN, STRASSER",2511 OLD CORNWALLIS RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 58 , 81 ,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447690615,"KWANKAM, LAUREN, STRASSER",2511 OLD CORNWALLIS RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 54 , 60 ,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1447690615,"KWANKAM, LAUREN, STRASSER",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447692942,"TROUTMAN, PAMELA, SIKHUMBUZO",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 38 , 53 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 50 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 34 , 38 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447693908,"HENNESSEY, ERIN, COLLEEN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447695317,"MACHEN, GRAHAM, LUKE",1200 N ELM ST   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447695317,"MACHEN, GRAHAM, LUKE",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 68 , 109 , 174 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1447695317,"MACHEN, GRAHAM, LUKE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447695994,"WIGLAMA, ERIK, CHRISTIAN",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 72 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447697198,"BASCO, DEBORAH, CARTER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447698089,"CICCONE, EMILY, JANE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 18 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447698089,"CICCONE, EMILY, JANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 13 , 33 , 33 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447698303,"HICKS, BRADLEY, JAMES",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 116 , 685 , 877 ," $14,217.56 ",,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447698485,"PATEL, PRATIK, ASHVIN",2525 COURT DR   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447698485,"PATEL, PRATIK, ASHVIN",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 101 , 142 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447698642,"PATEL, KUNAL, JATINKUMAR",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447698642,"PATEL, KUNAL, JATINKUMAR",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447698642,"PATEL, KUNAL, JATINKUMAR",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447698642,"PATEL, KUNAL, JATINKUMAR",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 104 , 181 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",3420 TEN TEN RD STE 318 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",3420 TEN TEN RD STE 318 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",3420 TEN TEN RD STE 318 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",3420 TEN TEN RD STE 318 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 23 , 34 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447698840,"NGO, TRANG, THANH",3420 TEN TEN RD STE 318 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447699392,"FEI, JEFFREY, ZHAOKE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 74 , 79 , 104 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447699392,"FEI, JEFFREY, ZHAOKE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 59 , 75 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447702345,"MARCINOW, JUSTYNA, NATALIA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447702345,"MARCINOW, JUSTYNA, NATALIA",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447702345,"MARCINOW, JUSTYNA, NATALIA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447702345,"MARCINOW, JUSTYNA, NATALIA",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447702345,"MARCINOW, JUSTYNA, NATALIA",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447702345,"MARCINOW, JUSTYNA, NATALIA",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1447703426,"BEASLEY, NICOLE, ELIZABETH",100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1223G0001X,Dental Providers,Dentist,General Practice, 688 ," 1,179 "," 3,471 "," $141,496.14 ",,
MEDICAID DIRECT,1497001127,EAST CAROLINA UNIVERSITY,~,1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1447703426,"BEASLEY, NICOLE, ELIZABETH",1161 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447710496,"JENNY, RUTH, ANN DUBBELMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447710496,"JENNY, RUTH, ANN DUBBELMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447710496,"JENNY, RUTH, ANN DUBBELMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1053456954,NORTH FULTON EMERGENCY PHYSICIANS L,,3000 HOSPITAL BLVD   ROSWELL GA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1447711064,"VAITHI, RAMUPRIYA",3000 HOSPITAL BLVD   ROSWELL GA,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447711395,"BALAGANI, AMULYA",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 18 , 34 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447711684,"MORGAN, ANDREW, PARKER",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 36 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447711684,"MORGAN, ANDREW, PARKER",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 106 , 107 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447712005,"ELLINGTON, MARIANA, ALYN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447712005,"ELLINGTON, MARIANA, ALYN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447712005,"ELLINGTON, MARIANA, ALYN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447712005,"ELLINGTON, MARIANA, ALYN",1446 FERN CREEK DR   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 35 , 49 , 63 ," $14,726.93 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447712096,"MEHTA, VISHAL, JAGDISH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 259 , 259 ," $13,005.08 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447713078,"TRUB, CATHERINE, JACHTHUBER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447714704,"BENEFIEL, ERIN, KATHLEEN",2544 COURT DR STE G GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 36 , 36 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447714704,"BENEFIEL, ERIN, KATHLEEN",2544 COURT DR STE G GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,4235 S NEW HOPE RD STE I GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447714704,"BENEFIEL, ERIN, KATHLEEN",2544 COURT DR STE G GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447715461,WE CARE FOR YOU HOME HEALTH LLC,,2609 ATLANTIC AVE STE 115 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1447715461,WE CARE FOR YOU HOME HEALTH LLC,2609 ATLANTIC AVE STE 115 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 3,407 "," 3,407 "," $232,474.50 ",,
MEDICAID DIRECT,1447715982,MORIARTY PHYSICAL THERAPY INC,,2310 BALE ST STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447715982,MORIARTY PHYSICAL THERAPY INC,2310 BALE ST STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447717640,"HARRIS, WHITNEY, DAVIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 13 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447717640,"HARRIS, WHITNEY, DAVIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447717640,"HARRIS, WHITNEY, DAVIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1447718739,"RICHARDSON, RAHSAAN, JERRETT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 44 , 44 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447719299,"ADAMS, LOGAN, DALE",2301 ERWIN RD   DURHAM NC,032,Durham,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447719299,"ADAMS, LOGAN, DALE",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447719299,"ADAMS, LOGAN, DALE",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447719844,"FELIX, JOSHUA, DANIEL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 57 , 64 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447719844,"FELIX, JOSHUA, DANIEL",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447720156,"MELVIN, KRISTIN, WODARCZYK",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1447724224,"GUARENTE, KELLY, COLLEEN",215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 21 , 31 ," $14,002.43 ",,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,8509 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1447724224,"GUARENTE, KELLY, COLLEEN",8509 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 140 , 172 ," $113,107.98 ",,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1447724430,"BRADFORD, COURTNEY, PAIGE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 133 , 147 , 192 ," $11,968.43 ",,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447724430,"BRADFORD, COURTNEY, PAIGE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447725379,"WEINHOLD, SAMANTHA, COCHRANE",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 12 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1447725379,"WEINHOLD, SAMANTHA, COCHRANE",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447725379,"WEINHOLD, SAMANTHA, COCHRANE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447728399,"MENDAY, ERIN, KATHLEEN",505 OBERLIN RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447728399,"MENDAY, ERIN, KATHLEEN",505 OBERLIN RD   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 23 , 30 ,$#,,
MEDICAID DIRECT,1871867325,PARAGON OUTPATIENT REHABILITATION S,SYNCHRONY REHAB,2605 SWALLOW RD C/O THE LANDINGS OF ROCKINGHAM REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1447730601,"SCARBOROUGH, NATALIE, FAYE",111 S RAILROAD AVE   DUNN NC,043,Harnett,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447744834,"RIVADENEIRA ALAVA, JIMMY, SANTIAGO",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447744834,"RIVADENEIRA ALAVA, JIMMY, SANTIAGO",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447747084,"MONREAL, ALBERTO, JUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447747084,"MONREAL, ALBERTO, JUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447747084,"MONREAL, ALBERTO, JUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447747084,"MONREAL, ALBERTO, JUAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1306202296,FLEXOGENIX NORTH CAROLINA PC,,400 ASHVILLE AVE STE 330 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447749288,"JANGAM, AMIT, PAUL",400 ASHVILLE AVE STE 330 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447749668,"GRINCHAK, JULIA, PETROVNA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447755145,"WHITT, BENJAMIN, TIMBERLAKE",1690 SKYLYN DR STE 300B SPARTANBURG SC,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447755335,"KULKARNI, KEDAR, PRAKASH",301 RIVERVIEW AVE STE 810 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447755731,"STUDEBAKER, NICOLE, RENEE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447755731,"STUDEBAKER, NICOLE, RENEE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447755731,"STUDEBAKER, NICOLE, RENEE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447756135,"BEIL, EMILY, FISHMAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447756135,"BEIL, EMILY, FISHMAN",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447756135,"BEIL, EMILY, FISHMAN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447757992,"ABOUTAYEH, MAROUN, ELI",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1447757992,"ABOUTAYEH, MAROUN, ELI",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447757992,"ABOUTAYEH, MAROUN, ELI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 106 , 106 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447757992,"ABOUTAYEH, MAROUN, ELI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 159 , 159 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1447761804,"NZEWUNWAH, RODALYN, GONZALEZ",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447761804,"NZEWUNWAH, RODALYN, GONZALEZ",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 27 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447761804,"NZEWUNWAH, RODALYN, GONZALEZ",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447763750,TOWN OF EMERALD ISLE,EMERALD ISLE FIRE DEPARTMENT,7500 EMERALD DR   EMERALD ISLE NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1447763750,TOWN OF EMERALD ISLE,7500 EMERALD DR   EMERALD ISLE NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2770 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447764469,"POPE, ASHLEY, TATUM",2770 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447766019,"MAYS, JASMINE, LARISE-REGINA",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 125 , 277 ,$#,,
MEDICAID DIRECT,1306828678,SOUTHEASTERN MEDICAL ONCOLOGY CENTE,SOUTHEASTERN MEDICAL ONCOLOGY CENTER,203 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1447768502,"MEISENHELDER, JESSICA, MCCULLEN",203 COX BLVD   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 25 ,$#,,
MEDICAID DIRECT,1982302915,DAVID E THOME DDS PLLC L1,,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 117 ,$#,,
MEDICAID DIRECT,1669920609,DAVID E THOME DDS PLLC VII,DENVER PEDIATRIC DENTISTRY,275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,007 "," 1,520 "," 6,418 "," $251,310.74 ",,
MEDICAID DIRECT,1114475159,DAVID E THOME DDS PLLC VI,LINCOLNTON PEDIATRIC DENTISTRY,701 S LAUREL ST STE 1 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 18 ,$#,,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 514 , 542 ," 2,127 "," $78,841.27 ",,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 110 , 110 , 400 ," $12,237.62 ",,
MEDICAID DIRECT,1922555689,DAVID E THOME DDS PLLC V,CABARRUS PEDIATRIC DENTISTRY,2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 32 , 31 , 106 ,$#,,
MEDICAID DIRECT,1154905313,DAVID E THOME DDS PLLC XIII,MINT HILL PEDIATRIC DENTISTRY,9055 CRESSWIND BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 860 ," 1,260 "," 5,218 "," $187,069.38 ",,
MEDICAID DIRECT,1588238463,DAVID E THOME DDS PLLC XI,HICKORY PEDIATRIC DENTISTRY,5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",5708 N SHARON AMITY RD STE 5708-A CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 995 ," 1,598 "," 6,781 "," $230,565.59 ",,
MEDICAID DIRECT,1982302915,DAVID E THOME DDS PLLC L1,,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 69 ,$#,,
MEDICAID DIRECT,1669920609,DAVID E THOME DDS PLLC VII,DENVER PEDIATRIC DENTISTRY,275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",275 N NC 16 BUSINESS HWY STE 204B DENVER NC,055,Lincoln,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1447770391,"ADAMSON, MORGAN, NICOLE",275 N NC 16 BUSINESS HWY STE 204B DENVER NC,055,Lincoln,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1447771530,"WALKER, MATTHEW, HARRISON",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447771530,"WALKER, MATTHEW, HARRISON",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 35 , 69 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447771530,"WALKER, MATTHEW, HARRISON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447771530,"WALKER, MATTHEW, HARRISON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1447771530,"WALKER, MATTHEW, HARRISON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447771845,"MILLER, JONAS, RANDALL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 26 , 28 ,$#,,
MEDICAID DIRECT,1447772066,METROPOLITAN MILESTONES THERAPY PL,METROPOLITAN MILESTONES THERAPY PLLC,1744 BETHLEHEM CHURCH RD   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1447772066,METROPOLITAN MILESTONES THERAPY PL,1744 BETHLEHEM CHURCH RD   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,, 18 , 482 , 487 ," $32,963.16 ",,
MEDICAID DIRECT,1447776430,DIVINE SUPPORTIVE HOMES,DIVINE SUPPORTIVE HOMES,604 SE MAYNARD RD   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1447776430,DIVINE SUPPORTIVE HOMES,604 SE MAYNARD RD   CARY NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 219 , 219 ," $76,335.41 ",,
MEDICAID DIRECT,1447776430,DIVINE SUPPORTIVE HOMES,DIVINE SUPPORTIVE HOMES,3905 MARSH CREEK RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1447776430,DIVINE SUPPORTIVE HOMES,3905 MARSH CREEK RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 209 , 209 ," $71,831.10 ",,
MEDICAID DIRECT,1447776430,DIVINE SUPPORTIVE HOMES,DIVINE SUPPORTIVE HOMES,1703 VAUGHN RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1447776430,DIVINE SUPPORTIVE HOMES,1703 VAUGHN RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 152 , 152 ," $62,745.89 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447781349,"WALTERS, ANDREW, MADISON",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 83 , 85 , 95 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447781471,"FOLLETTE, CRAIG, JOSHUA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 53 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447781471,"FOLLETTE, CRAIG, JOSHUA",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447782263,"WHITLEY, MELODI, JAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447782263,"WHITLEY, MELODI, JAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447782263,"WHITLEY, MELODI, JAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447782263,"WHITLEY, MELODI, JAVID",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 16 , 27 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11081 FOREST PINES DR STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447782263,"WHITLEY, MELODI, JAVID",11081 FOREST PINES DR STE 110 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 11 , 14 , 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447782289,"MARTIN, JENNIFER, ANN LAW",167 MOORE RD STE 201 KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 77 , 223 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447782289,"MARTIN, JENNIFER, ANN LAW",111 GATEWAY CENTER DR   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 37 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447782354,"GIBBLE, JORDAN, ELIZABETH",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 39 , 48 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1447782354,"GIBBLE, JORDAN, ELIZABETH",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447782776,"LOWERY, GAIL, COOPER",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 52 , 90 , 186 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1447782776,"LOWERY, GAIL, COOPER",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447783071,"SAPPAL, SAMAY",7185 HARBOUR TOWNE PKWY S STE 200 SUFFOLK VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1437725041,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-HIGHLANDS CASHIERS,209 HOSPITAL DR   HIGHLANDS NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447783360,"FINCHER, KRISTY, NICOLE",209 HOSPITAL DR   HIGHLANDS NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 46 , 52 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447784699,"KRUMHOLZ, MATTHEW, JOSEPH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1447784699,"KRUMHOLZ, MATTHEW, JOSEPH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 ,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447784699,"KRUMHOLZ, MATTHEW, JOSEPH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447785696,"REA, DUSTIN, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 212 , 231 , 265 ,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447785860,"STEHR, HALEY, BARRIER",306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 69 , 110 ," $11,658.62 ",,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447786421,"SALIM, MOHAMMAD, ALI HUMZA",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1447788492,COMMUNICATION MATTERS INC,,4829 CROWNVISTA DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447788492,COMMUNICATION MATTERS INC,4829 CROWNVISTA DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 11 , 141 , 147 ," $10,415.95 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447788716,"JORDAN, SAMUEL, HUSKE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 39 , 44 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447788716,"JORDAN, SAMUEL, HUSKE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 53 , 57 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447791629,"SYMONDS, ANN, ELIZABETH",201 SAGE RD   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447791629,"SYMONDS, ANN, ELIZABETH",201 SAGE RD   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 27 ,$#,,
MEDICAID DIRECT,1447792148,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,401 ATTAIN ST STE 121 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1447792148,CAROLINA PHYSICAL THERAPY ASSOCIATE,401 ATTAIN ST STE 121 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,4525 CAMERON VALLEY PKWY STE 2700 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447792890,"MURRAY, RACHEL, DEBORAH",4525 CAMERON VALLEY PKWY STE 2700 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1447793567,"MAHTANI, SHARIEN",218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447793567,"MAHTANI, SHARIEN",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 236 , 236 ,$#,,
MEDICAID DIRECT,1447794987,KEVIN S LOFLIN OD PLLC,NC EYE ASSOCIATES,817 E GANNON AVE STE 101 ZEBULON NC,051,Johnston,193400000X,Group,Single Specialty,,1447794987,KEVIN S LOFLIN OD PLLC,817 E GANNON AVE STE 101 ZEBULON NC,051,Johnston,193400000X,Group,Single Specialty,, 61 , 60 , 122 ,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1447796933,"LAW, MARK, FRANKLIN",129 WOODSON ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 94 , 272 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447798376,"BISHOP, MICHAEL, ALLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447798376,"BISHOP, MICHAEL, ALLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447798525,"CHUGHTAI, SHAHEERA, BAIG",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447798525,"CHUGHTAI, SHAHEERA, BAIG",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447798525,"CHUGHTAI, SHAHEERA, BAIG",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 86 , 86 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447798525,"CHUGHTAI, SHAHEERA, BAIG",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447798525,"CHUGHTAI, SHAHEERA, BAIG",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 100 , 100 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447798558,"JOHNS, KIARA, GILDERSLEEVE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447798558,"JOHNS, KIARA, GILDERSLEEVE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447798558,"JOHNS, KIARA, GILDERSLEEVE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1891789970,SCOTLAND MEMORIAL HOSPITAL INC,WAGRAM FAMILY PRACTICE,24420 MARLBORO ST   WAGRAM NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447798558,"JOHNS, KIARA, GILDERSLEEVE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1447802640,"MATO, BARBARA",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 25 , 28 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1447804752,"MOORE, DEANNA, MICHELLE",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1447804752,"MOORE, DEANNA, MICHELLE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1447804752,"MOORE, DEANNA, MICHELLE",104 RHODES AVE   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 89 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1447804752,"MOORE, DEANNA, MICHELLE",104 RHODES AVE   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447805254,"CARROLL, ROSS, HUNTER",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447806294,"PERRY, CAMERON, DAVID",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 20 , 43 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447806294,"PERRY, CAMERON, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447806294,"PERRY, CAMERON, DAVID",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447806294,"PERRY, CAMERON, DAVID",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,22 TRUST LN STE 101 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1447806294,"PERRY, CAMERON, DAVID",22 TRUST LN STE 101 BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1447806294,"PERRY, CAMERON, DAVID",41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447808795,"SMITH, SHANNON, MORRIS",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447808795,"SMITH, SHANNON, MORRIS",10650 PARK RD STE 120 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447810866,"JOAQUIN, MIGUEL, EDUARDO",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447810866,"JOAQUIN, MIGUEL, EDUARDO",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 68 , 87 ," $14,091.55 ",,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447810866,"JOAQUIN, MIGUEL, EDUARDO",224 S 10TH AVE   SILER CITY NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821240995,WESTGATE DERMATOLOGY AND LASER CENT,WESTGATE DERMATOLOGY AND LASER CENTER PA,2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447813837,"TODD, EMILY, RENEE",2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 25 ,$#,,
MEDICAID DIRECT,1821240995,WESTGATE DERMATOLOGY AND LASER CENT,WESTGATE DERMATOLOGY AND LASER CENTER PA,2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447813837,"TODD, EMILY, RENEE",280 BROAD ST   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447820493,"BOUTON, ANABEL, LEIGH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447820493,"BOUTON, ANABEL, LEIGH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447820493,"BOUTON, ANABEL, LEIGH",16000 JOHNSTON MEMORIAL DR   ABINGDON VA,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1447821145,"CORALLO, OLIVIA, MARIE",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1447821509,"DOUGLAS, SHANEIKA, LASHAY",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1447821509,"DOUGLAS, SHANEIKA, LASHAY",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 24 , 39 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447821509,"DOUGLAS, SHANEIKA, LASHAY",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 67 , 121 ,$#,,
MEDICAID DIRECT,1245992999,LANE AND ASSOCIATES XLII DDS PA,,2401 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447822671,"ROENING, COCO, JEONG EN",2401 CAPITAL BLVD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 295 , 373 ," 1,136 "," $56,506.66 ",,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447823414,"KITCHEN, VIRGINIA, MARTINEZ",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 70 , 75 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447824800,"LEVEQUE, ALYSSA, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447824800,"LEVEQUE, ALYSSA, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 53 , 55 ," $14,324.28 ",,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447825674,"PRATT, SANDRA, NORTHCOTT",111 CENTRAL ST   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 24 , 38 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447825674,"PRATT, SANDRA, NORTHCOTT",111 CENTRAL ST   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447828207,"HACKNEY, BRADFORD, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447828207,"HACKNEY, BRADFORD, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 26 , 49 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447828207,"HACKNEY, BRADFORD, AUSTIN",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447828207,"HACKNEY, BRADFORD, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 72 , 138 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447828207,"HACKNEY, BRADFORD, AUSTIN",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447828207,"HACKNEY, BRADFORD, AUSTIN",232 SHARON AVE NW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447829619,"CEPEDA-CHYR, CHRISTINA, UN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447829619,"CEPEDA-CHYR, CHRISTINA, UN",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 26 , 39 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447831342,"CHUBB, CASEY, CHRISTOPHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 52 , 58 ," $14,764.80 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447831342,"CHUBB, CASEY, CHRISTOPHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447831573,"LEE, TRACY, LYNN",3800 INDEPENDENCE BLVD   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 33 , 236 , 237 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447831573,"LEE, TRACY, LYNN",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1578334892,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE FUQUAY VA,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1447832126,"WARNER-MOXLEY, RUKIAYAH, ASHA",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447833702,"KERNER, DAVID, SAMUEL FRANKLIN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447834957,"WHITE, MARY, BAILEY",525 AMHERST ST   WINCHESTER VA,102,Out of State > 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447835632,"MILROY, RENEE, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447836010,"MCDONALD, LISA, JENNINGS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447837125,"BIDWELL, MATTHEW, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447837240,"YATES, JAMIE, SHARISE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 168 , 168 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447838347,"CHEN, JIABI",1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 25 , 48 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1447838347,"CHEN, JIABI",905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 28 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447838594,"PALANISAMY, NAGESHWARI",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447838594,"PALANISAMY, NAGESHWARI",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 33 , 34 ,$#,,
MEDICAID DIRECT,1902995145,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT TWIN COUNTY,204 EVANS RD   HOLLISTER NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447841739,"SEVIER, ELENA, BUTLER",204 EVANS RD   HOLLISTER NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4917 S CROATAN HWY STE 1A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1447841739,"SEVIER, ELENA, BUTLER",4917 S CROATAN HWY STE 1A NAGS HEAD NC,028,Dare,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447842000,"PARKEY, MALLORY, K",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447842000,"PARKEY, MALLORY, K",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447842927,"CRIMMINS, REBECCA, MCNEIL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 25 , 27 ,$#,,
MEDICAID DIRECT,1356867782,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1447843669,"WEBB, MEGAN, LEIGH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447843669,"WEBB, MEGAN, LEIGH",121 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 53 , 73 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447843669,"WEBB, MEGAN, LEIGH",1970 W ARLINGTON BLVD STE C GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 80 , 80 ,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",613 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",613 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 62 , 80 ,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,613 SHIPYARD BLVD STE 106 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",120 COASTAL HORIZONS DR   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598048175,COASTAL HORIZONS CENTER INC,,120 COASTAL HORIZONS DR   SHALLOTTE NC,010,Brunswick,193400000X,Group,Single Specialty,,1447850458,"BLACK, HEATHER, NICHOLE",120 COASTAL HORIZONS DR   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447850946,"DRAUGHN, AMANDA, BOLES",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447850946,"DRAUGHN, AMANDA, BOLES",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 78 , 136 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447850946,"DRAUGHN, AMANDA, BOLES",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447850946,"DRAUGHN, AMANDA, BOLES",167 MOORE RD STE 206 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447853338,"ARANAS, JESSICA, CRUZ",2241 TREELIGHT WAY STE 104 WENDELL NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447857529,"FRY, CHRISTOPHER, O'NEAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447857529,"FRY, CHRISTOPHER, O'NEAL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447857529,"FRY, CHRISTOPHER, O'NEAL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447857529,"FRY, CHRISTOPHER, O'NEAL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447857529,"FRY, CHRISTOPHER, O'NEAL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447857529,"FRY, CHRISTOPHER, O'NEAL",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447857560,"BORJA, SEIJI, RAE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 23 , 47 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447857560,"BORJA, SEIJI, RAE",4105 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 49 , 87 ,$#,,
MEDICAID DIRECT,1447858493,CONCEPT OF CARE INC,,8929 J M KEYNES DR STE 305 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1447858493,CONCEPT OF CARE INC,8929 J M KEYNES DR STE 305 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 1,492 "," 1,498 "," $117,320.88 ",,
MEDICAID DIRECT,1447858493,CONCEPT OF CARE INC,,537 W SUGAR CREEK RD STE 204 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1447858493,CONCEPT OF CARE INC,537 W SUGAR CREEK RD STE 204 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 3,363 "," 3,378 "," $261,522.40 ",,
MEDICAID DIRECT,1447858493,CONCEPT OF CARE INC,,8929 J M KEYNES DR STE 305 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1447858493,CONCEPT OF CARE INC,537 W SUGAR CREEK RD STE 204 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1447861190,UNIQUE IN HOME HEALTHCARE LLC,,1501 N CHARLOTTE AVE # B230 MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1447861190,UNIQUE IN HOME HEALTHCARE LLC,1501 N CHARLOTTE AVE # B230 MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 2,427 "," 2,428 "," $232,613.84 ",,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447861539,"SHELLABARGER, CAROLINE, CLAIRE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 52 , 64 ,$#,,
MEDICAID DIRECT,1730367467,HOSPICE & PALLIATIVE CARECENTER,TRELLIS SUPPORTIVE CARE,101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1447865290,"LAPRE, DENISE",101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447865357,"BURR, COREY, ELIZABETH",10195 BEACH DR SW   CALABASH NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447865357,"BURR, COREY, ELIZABETH",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,10195 BEACH DR SW   CALABASH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447865357,"BURR, COREY, ELIZABETH",10195 BEACH DR SW   CALABASH NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447865357,"BURR, COREY, ELIZABETH",10195 BEACH DR SW   CALABASH NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447865357,"BURR, COREY, ELIZABETH",208 SMITH AVE   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 31 , 35 , 50 ,$#,,
MEDICAID DIRECT,1093768012,DR CHRISTOPHER J MOSHOURES,Dr Christopher J Moshoures,208 SMITH AVE   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1447865357,"BURR, COREY, ELIZABETH",1620 N HOWE ST   SOUTHPORT NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447867148,"SIMPSON, CHERYL, HOLLAND",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447867700,"PLESHER, RYAN, RICHARD",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 33 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447867700,"PLESHER, RYAN, RICHARD",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447867718,"LEVE, ANGELINA, RITA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447867718,"LEVE, ANGELINA, RITA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316603301,DR CAMERON & ASSOCIATES OF DURHAM P,,5111 NC HIGHWAY 55 STE 102 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1447869375,"JOSEPH, LIJI, MARY",1600 CROSS LINK RD UNIT 103-104 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1447870282,"GOLKOWSKI BARRON, ANYA, LAVINIA",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1447870282,"GOLKOWSKI BARRON, ANYA, LAVINIA",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1447870282,"GOLKOWSKI BARRON, ANYA, LAVINIA",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447871496,"OCONNOR, KAITLYN, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447871496,"OCONNOR, KAITLYN, ELIZABETH",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447871496,"OCONNOR, KAITLYN, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447871496,"OCONNOR, KAITLYN, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 36 , 51 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1447871496,"OCONNOR, KAITLYN, ELIZABETH",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 25 , 22 , 25 ," $11,221.31 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447871710,"GIBSON, ZACHARY, JOHN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 44 , 64 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447871710,"GIBSON, ZACHARY, JOHN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447871710,"GIBSON, ZACHARY, JOHN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447875380,"SHACKLEFORD, TRISHONDA, BUTTS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 117 , 123 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447875380,"SHACKLEFORD, TRISHONDA, BUTTS",138 DUBLIN SQUARE RD STE B ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 290 ," 2,007 "," 2,071 "," $44,364.48 ",,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447878194,"LO, KA BLIA, NICKY",501 N MAIN ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 74 , 89 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447878194,"LO, KA BLIA, NICKY",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447880844,"BUONTEMPO, MADELINE, RILEY",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1447880844,"BUONTEMPO, MADELINE, RILEY",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447883418,"RODRIGUEZ, ALEXIS, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447883418,"RODRIGUEZ, ALEXIS, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1932366044,CARE FIRST PHYSICAL THERAPY AND REH,CARE FIRST PHYSICAL THERAPY AND REHAB LLC,100 CORNERSTONE DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447883905,"BROWN, NAKIA, CHANEL",100 CORNERSTONE DR   CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884101,"HARSHAW, EMILY, CAROLINE",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884101,"HARSHAW, EMILY, CAROLINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884101,"HARSHAW, EMILY, CAROLINE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884101,"HARSHAW, EMILY, CAROLINE",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884101,"HARSHAW, EMILY, CAROLINE",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884101,"HARSHAW, EMILY, CAROLINE",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884101,"HARSHAW, EMILY, CAROLINE",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750972626,RAYMOND J TSENG DDS PHD PA,HIGH HOUSE PEDIATRIC DENTISTRY,1705 HIGH HOUSE RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1447884861,"ELLENTHAL, ADAM, TAKEO",1705 HIGH HOUSE RD   CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,687 "," 2,698 "," 12,440 "," $394,769.22 ",,
MEDICAID DIRECT,1750972626,RAYMOND J TSENG DDS PHD PA,HIGH HOUSE PEDIATRIC DENTISTRY,1705 HIGH HOUSE RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1447884861,"ELLENTHAL, ADAM, TAKEO",1705 HIGH HOUSE RD   CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 13 , 13 , 46 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1447885629,"PORTER, SARAH, ELIZABETH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 59 , 62 , 62 ,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447889597,"MONTGOMERY, JAMES, HAMILTON",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1447889704,"FUNDERBURK, KYNDAL, LEIGH",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1447889704,"FUNDERBURK, KYNDAL, LEIGH",1550 FAULK ST STE 3100 MONROE NC,090,Union,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447890520,"RIVERO, MARIA, CHRISTINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447891163,"WILLIAMS, ROY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447891163,"WILLIAMS, ROY",700 WALTER REED DR   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447891163,"WILLIAMS, ROY",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447892054,"BROUWER, JAY, WINSOR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447892054,"BROUWER, JAY, WINSOR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1447892054,"BROUWER, JAY, WINSOR",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 38 , 46 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1447892054,"BROUWER, JAY, WINSOR",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 34 , 46 ,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447893045,"BURSEY, JESSICA, JORDAN",146 HWY 64 E   HAYESVILLE NC,022,Clay,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 99 , 131 , 134 ," $20,489.22 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1447893045,"BURSEY, JESSICA, JORDAN",146 HWY 64 E   HAYESVILLE NC,022,Clay,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 84 , 84 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447893045,"BURSEY, JESSICA, JORDAN",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,110 TURNER ST   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1447895891,"KISHBAUGH, ANDREA, JEAN",110 TURNER ST   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447895891,"KISHBAUGH, ANDREA, JEAN",110 TURNER ST   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447895891,"KISHBAUGH, ANDREA, JEAN",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 91 , 121 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,110 TURNER ST   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1447895891,"KISHBAUGH, ANDREA, JEAN",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447897665,"SIMONE, LINDSAY, MAUNEY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447897665,"SIMONE, LINDSAY, MAUNEY",1450 MATTHEWS TOWNSHIP PKWY STE 280 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972024354,RDMG ASSOCIATES PA,,827 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1447899000,"EHLERS DENTEL, SARA, BRIE",827 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 58 , 113 ,$#,,
MEDICAID DIRECT,1740213321,GOLDSBORO PHYSICAL THERAPY,GOLDSBORO PHYSICAL THERAPY,2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1447899299,"GREEN, ELIZABETH, WEST",2503 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447902614,"WEEKS, HEATHER, FULGHUM",104 ADAIR DR # A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 50 , 50 ,$#,,
MEDICAID DIRECT,1194128991,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER ROSEWOOD,104 ADAIR DR   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447902614,"WEEKS, HEATHER, FULGHUM",104 ADAIR DR # A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447902614,"WEEKS, HEATHER, FULGHUM",444 SW CENTER ST   FAISON NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 262 , 287 ," 1,134 "," $39,232.34 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 622 , 705 ," 2,723 "," $95,391.10 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 25 , 25 , 322 ," $24,195.14 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 24 , 23 , 194 ," $13,283.65 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 54 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 19 , 18 , 77 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 39 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 18 , 16 , 216 ," $19,596.70 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 138 ," $11,908.23 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 22 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",9224 ARDREY KELL RD STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 13 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447904537,"GOTSCHALK, KAITLIN, SHIELDS",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,085 "," 1,186 "," 4,920 "," $180,330.65 ",,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447906490,"WILZ, ANDREW, PHILIP",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 27 , 38 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447907753,"KLEIN, CHARIS, ELIZABETH",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447907753,"KLEIN, CHARIS, ELIZABETH",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447907753,"KLEIN, CHARIS, ELIZABETH",3330 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447907753,"KLEIN, CHARIS, ELIZABETH",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 70 , 97 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447907753,"KLEIN, CHARIS, ELIZABETH",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447908488,"POPULUS, MICHELE, MINTZ",8090 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 23 , 39 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447912290,"GERACE, BROOKE, NICOLE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 39 , 61 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1447912290,"GERACE, BROOKE, NICOLE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 22 , 37 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1447919147,"BEAM, HANNAH, BENNETT",330 NC HIGHWAY 108   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 69 , 70 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447920194,"COLE, AMANDA, KING",1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447920194,"COLE, AMANDA, KING",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 25 , 26 ,$#,,
MEDICAID DIRECT,1700888542,GREENE COUNTY HEALTH CARE INC,KATE B REYNOLDS MEDICAL CENTER,205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447920988,"ALEXANDER, SKYLAR, JOY",205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1679166821,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL FAMILY PRACTICE,20 S MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1447921275,"POTEAT, BENJAMIN, ANDREW",20 S MEDICAL CT   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 123 , 193 ,$#,,
MEDICAID DIRECT,1982883583,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,1895 HOFFMAN RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1447925714,"TORRES, CYNTHIA, JAZMIN",1895 HOFFMAN RD STE A GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 29 , 42 ,$#,,
MEDICAID DIRECT,1790003580,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OB,5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447927744,"O'CONNOR, LINDSEY, BAILEY",5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447927744,"O'CONNOR, LINDSEY, BAILEY",101 E WT HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 20 ,$#,,
MEDICAID DIRECT,1720161334,COUNTY OF MACON,MACON CO PUBLIC HEALTH CENTER,1830 LAKESIDE DR   FRANKLIN NC,056,Macon,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1447928866,"ROGERS, JULIE, BOLICK",1830 LAKESIDE DR   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 24 , 40 ,$#,,
MEDICAID DIRECT,1861094542,KALEB C THOMPSON DMD PA III,DENTAL TRANSFORMATIONS,153 WORTH GUARD RD   COINJOCK NC,027,Currituck,193400000X,Group,Single Specialty,,1447935903,"ASHBY, TYLER, WINFIELD",153 WORTH GUARD RD   COINJOCK NC,027,Currituck,1223G0001X,Dental Providers,Dentist,General Practice, 92 , 107 , 282 ," $23,188.10 ",,
MEDICAID DIRECT,1710437322,"THOMPSON, KALEB, CONRAD",,153 WORTH GUARD RD   COINJOCK NC,027,Currituck,1223G0001X,Dental Providers,Dentist,General Practice,1447935903,"ASHBY, TYLER, WINFIELD",153 WORTH GUARD RD   COINJOCK NC,027,Currituck,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1447942826,"MUGALA, BARBRA, NAMFUKWE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 72 , 76 ,$#,,
MEDICAID DIRECT,1245992999,LANE AND ASSOCIATES XLII DDS PA,,2401 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1447946090,"MCINTOSH, KEITH, ERIC",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1447946090,"MCINTOSH, KEITH, ERIC",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447946090,"MCINTOSH, KEITH, ERIC",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 61 , 208 ,$#,,
MEDICAID DIRECT,1831820927,LANE AND ASSOCIATES XLVI DDS PA,,2201 CANDUN DR STE 202 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1447946090,"MCINTOSH, KEITH, ERIC",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 111 , 147 , 430 ," $20,487.65 ",,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1447946090,"MCINTOSH, KEITH, ERIC",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 29 ,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1447946090,"MCINTOSH, KEITH, ERIC",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1639502727,LANE AND ASSOCIATES XXVII DDS PA,,4013 VILLAGE PARK DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1447946090,"MCINTOSH, KEITH, ERIC",12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 424 , 694 ," 2,172 "," $94,263.15 ",,
MEDICAID DIRECT,1447948492,TRAILFINDER KID THERAPIES PLLC,~,120 HARINGEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1447948492,TRAILFINDER KID THERAPIES PLLC,120 HARINGEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 26 , 645 , 647 ," $60,896.76 ",,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1447951728,"BURCH, MADISON, GRACE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1760911689,LANE AND ASSOCIATES XXXI DDS PA,,1242 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447954995,"RUIZ, RACHEL, ALLEN",1242 S FIFTH ST STE D MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 396 , 622 ," 2,427 "," $133,077.99 ",,
MEDICAID DIRECT,1760911689,LANE AND ASSOCIATES XXXI DDS PA,,1242 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1447954995,"RUIZ, RACHEL, ALLEN",1200 BROAD ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 194 , 258 , 865 ," $48,465.97 ",,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447955257,"SHEPHARD, HANNAH, ELIZABETH",10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386649374,CUMBERLAND COUNTY HOSPITAL SYSTEM I,WESTSIDE MEDICAL CARE,1463 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1447958707,"NEWSOME, DIVINE, HOPE",1463 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386649374,CUMBERLAND COUNTY HOSPITAL SYSTEM I,WESTSIDE MEDICAL CARE,1463 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1447958707,"NEWSOME, DIVINE, HOPE",1463 PAMALEE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 220 , 433 , 455 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1447960505,"DUMONT, CAITLIN, COLLEENA",100 KELLIE DR   SMITHFIELD NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447960505,"DUMONT, CAITLIN, COLLEENA",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447960778,"CHAPMAN, AMY, CATHERINE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 32 , 67 ,$#,,
MEDICAID DIRECT,1558308080,THE C W WILLIAMS COMMUNITY HEALTH C,~,5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447960778,"CHAPMAN, AMY, CATHERINE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447963202,"WILLIAMS, EVAN, NATHANIEL",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447963202,"WILLIAMS, EVAN, NATHANIEL",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 29 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447963202,"WILLIAMS, EVAN, NATHANIEL",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1447963202,"WILLIAMS, EVAN, NATHANIEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447965736,"COBB, ALYSSA, LEIGH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447965736,"COBB, ALYSSA, LEIGH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1447966411,"MCALVAIN, RUSSELL, CHAD",45 PLATEAU ST STE 250 BRYSON CITY NC,087,Swain,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215314778,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM WOMENS CENTER,150 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1447967419,"JAYNES, MEGAN",150 PARKWOOD DR   ELKIN NC,086,Surry,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1447968458,"STEVENS, KRISTYN, STEWART",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 97 , 173 , 408 ," $20,308.07 ",,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447968458,"STEVENS, KRISTYN, STEWART",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 71 , 99 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1447968458,"STEVENS, KRISTYN, STEWART",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1447970082,"STEELE, SHERYL, MARIE",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447970082,"STEELE, SHERYL, MARIE",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1447970082,"STEELE, SHERYL, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 104 , 230 , 230 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447970157,"TOWNSEND, KATHERINE, COLE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447970157,"TOWNSEND, KATHERINE, COLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 37 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447971494,"CLINE, DOUGLAS, RAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 84 , 162 , 252 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1447971494,"CLINE, DOUGLAS, RAY",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447973664,"CAMERON, JORDYN, LAFON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447973664,"CAMERON, JORDYN, LAFON",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447973664,"CAMERON, JORDYN, LAFON",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1447974035,"QUINCY, ABIGAIL, KALEY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1447974035,"QUINCY, ABIGAIL, KALEY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1447974035,"QUINCY, ABIGAIL, KALEY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 37 , 107 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1447974035,"QUINCY, ABIGAIL, KALEY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447974035,"QUINCY, ABIGAIL, KALEY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 48 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1447981212,"HENDRIXON-WARD, ASHLEY, REBECCA",116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447981212,"HENDRIXON-WARD, ASHLEY, REBECCA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760458657,HOSPICE OF YANCEY COUNTY INC,COMPASSIONATE CARE WESTERN NORTH CAROLINA,856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1447981212,"HENDRIXON-WARD, ASHLEY, REBECCA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 38 , 54 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1447981212,"HENDRIXON-WARD, ASHLEY, REBECCA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 53 , 60 ,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1447981212,"HENDRIXON-WARD, ASHLEY, REBECCA",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972123537,MURPHY MEDICAL CENTER INC,,2751 BUSINESS 19   ANDREWS NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447982913,"RICHARDS, VICTORIA, ROSE",183 LEDFORD ST STE A&B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1447982913,"RICHARDS, VICTORIA, ROSE",183 LEDFORD ST STE A&B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 118 , 84 , 86 ," $24,277.42 ",,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1447982913,"RICHARDS, VICTORIA, ROSE",183 LEDFORD ST STE A&B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1790825206,COUNTY OF SURRY & SURRY COUNTY WELF,SURRY CO HEALTH & NUTRITION CTR,118 HAMBY RD   DOBSON NC,086,Surry,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1447994157,"HARBOUR, CAROLINE, YATES",118 HAMBY RD   DOBSON NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 15 , 41 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447994157,"HARBOUR, CAROLINE, YATES",167 MOORE RD STE 201 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 18 , 37 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447996103,"SKUBON, BAILEY, ALICIA",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1447996103,"SKUBON, BAILEY, ALICIA",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 32 , 63 ,$#,,
MEDICAID DIRECT,1346784089,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - DURHAM,1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1447998786,"SAMA, SHELBY, JUSTIN",1125 W NC HIGHWAY 54 STE 807 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447999339,"BROOKS, WILSON, CARTER",125 QUEENS RD STE 150 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1447999339,"BROOKS, WILSON, CARTER",10030 GILEAD RD STE B120 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457000333,"BLANKINSHIP, JAMIE, LEE",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457000333,"BLANKINSHIP, JAMIE, LEE",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457000333,"BLANKINSHIP, JAMIE, LEE",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457002339,"MCEACHREN, COLLEEN, MARGARET",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457002339,"MCEACHREN, COLLEEN, MARGARET",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457002339,"MCEACHREN, COLLEEN, MARGARET",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679997944,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT SOUTHPOINT,7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457003436,"WHITWORTH, EMILY, SALO",7011 FAYETTEVILLE RD STE 200 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 38 , 62 ,$#,,
MEDICAID DIRECT,1891543864,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRICS WAKE FOREST MEDICAL,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1457003592,"QUINN, KATHERINE, DAVIS",1030 SIENA DR   WAKE FOREST NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457003592,"QUINN, KATHERINE, DAVIS",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1750965257,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE KILDAIRE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457003592,"QUINN, KATHERINE, DAVIS",110 KILDAIRE PARK DR   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1942685458,DURANT ROAD PEDIATRICS,,10940 RAVEN RIDGE RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457003592,"QUINN, KATHERINE, DAVIS",10940 RAVEN RIDGE RD STE 200 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457004624,"DELL, RACHEL, ELIZABETH",11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457004624,"DELL, RACHEL, ELIZABETH",11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457005159,"LEWIS, ABBY, TOMLINSON",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1457009771,"SUTTON, HALEY, CLINE",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 28 , 40 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457009839,"PELTOLA, SAMANTHA, DAWN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457009839,"PELTOLA, SAMANTHA, DAWN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2620 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457009938,"MILLER, PATRICIA, SUSANNE",2620 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457009938,"MILLER, PATRICIA, SUSANNE",2620 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1457015703,"WILLIS, KELCIE, RANAE",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1457015703,"WILLIS, KELCIE, RANAE",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 ,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457016206,"BEVERLY, NICOLE, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 39 , 54 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457018772,"HOGGE, SARAH, BILLINGS",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 25 , 81 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457024226,"MCFAIL, CANDACE, ASTRID",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457024226,"MCFAIL, CANDACE, ASTRID",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457024226,"MCFAIL, CANDACE, ASTRID",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457024226,"MCFAIL, CANDACE, ASTRID",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 37 , 121 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457024226,"MCFAIL, CANDACE, ASTRID",3604 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457512691,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER AT CALHOUN DRIVE,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457027484,"MCQUEEN, JARRELL, STEPHEN",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457027484,"MCQUEEN, JARRELL, STEPHEN",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 19 , 49 , 49 ," $12,188.83 ",,
MEDICAID DIRECT,1457512691,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER AT CALHOUN DRIVE,240 CALHOUN DR   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457027484,"MCQUEEN, JARRELL, STEPHEN",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457027930,"DAUGHTRIDGE, CANDACE, WYNONA",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457027930,"DAUGHTRIDGE, CANDACE, WYNONA",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457029571,"ZHU, JULIA",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1457029571,"ZHU, JULIA",1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 21 , 46 ,$#,,
MEDICAID DIRECT,1457030272,BOSTIC HEALTH HOLDINGS LLC,LANDINGS OF LAKE LURE,920 BUFFALO CREEK RD   LAKE LURE NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1457030272,BOSTIC HEALTH HOLDINGS LLC,920 BUFFALO CREEK RD   LAKE LURE NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457030371,"WEST, JANE, ANN",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 95 , 132 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457030371,"WEST, JANE, ANN",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 19 , 36 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1457030884,"GREENE, JAYME, BROOKE",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457030884,"GREENE, JAYME, BROOKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 173 , 201 , 201 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457030884,"GREENE, JAYME, BROOKE",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457032633,EMBRACE LIFE HOME CARE OF NC,,102 S WILLIAM ST STE C GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1457032633,EMBRACE LIFE HOME CARE OF NC,102 S WILLIAM ST STE C GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 1,817 "," 1,817 "," $132,586.16 ",,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1457035826,"LOVE, KATIE, LYNN",111 W GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 112 , 161 ,$#,,
MEDICAID DIRECT,1962833343,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,375 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1457040388,"PLISHKA, CASSANDRA, RENEE",375 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 86 , 134 ,$#,,
MEDICAID DIRECT,1003257437,ROANOKE CHOWAN COMMUNITY HEALTH CEN,HERTFORD COUNTY STUDENT WELLNESS CENTER,1850 NC HIGHWAY 11   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457042962,"MOORE, GWENDOLYN, SHEUNTA",216 STEWART PKWY   WASHINGTON NC,007,Beaufort,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457042962,"MOORE, GWENDOLYN, SHEUNTA",216 STEWART PKWY   WASHINGTON NC,007,Beaufort,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457042962,"MOORE, GWENDOLYN, SHEUNTA",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457043598,"MEREDITH, SAVANNAH, FERCH",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457044596,"LE, KEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457049322,JEFFREY L TAYLOR OD AND LYNN C TAYL,HAYESVILLE FAMILY EYE CARE,1091 HWY 64 W STE 2 HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,,1457049322,JEFFREY L TAYLOR OD AND LYNN C TAYL,1091 HWY 64 W STE 2 HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,, 16 , 16 , 32 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457049975,"PIERCE, KATIE, ARMOR",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457049975,"PIERCE, KATIE, ARMOR",7825 BALLANTYNE COMMONS PKWY STE 150 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 20 , 25 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457049975,"PIERCE, KATIE, ARMOR",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 25 , 28 ,$#,,
MEDICAID DIRECT,1952557241,BOICE WILLIS CLINIC PA,~,2413 PROFESSIONAL DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457055600,"JOYNER, DONALD, CHRISTOPHER",2413 PROFESSIONAL DR   ROCKY MOUNT NC,064,Nash,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 12 , 40 , 78 ,$#,,
MEDICAID DIRECT,1760220123,GREENE COUNTY HEALTH CARE INC,CONTENTNEA HEALTH JH ROSE CLINIC,600 W ARLINGTON BLVD FL 1 GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457055857,"CAMPBELL, GRACE, E",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1457059271,"ALLEN, ELLEN, ELIZABETH",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1457063133,"WRIGHT, DESIREE, BRIANNE",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1457063133,"WRIGHT, DESIREE, BRIANNE",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972123537,MURPHY MEDICAL CENTER INC,,2751 BUSINESS 19   ANDREWS NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457063133,"WRIGHT, DESIREE, BRIANNE",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 117 , 137 , 155 ," $19,940.16 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457065138,"SAUER, SOMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457065138,"SAUER, SOMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457065138,"SAUER, SOMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457065252,"KHANDJIAN, MISTY, LEIGH",1200 NAVAHO DRIVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457065252,"KHANDJIAN, MISTY, LEIGH",1200 NAVAHO DRIVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 33 , 84 ,$#,,
MEDICAID DIRECT,1457066235,ADVANCE ONE HOME CARE AGENCY,,3480 ASPEN RD   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1457066235,ADVANCE ONE HOME CARE AGENCY,3480 ASPEN RD   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 460 , 460 ," $60,330.44 ",,
MEDICAID DIRECT,1457066235,ADVANCE ONE HOME CARE AGENCY,,120 N FRANKLIN ST STE C ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1457066235,ADVANCE ONE HOME CARE AGENCY,120 N FRANKLIN ST STE C ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 1,344 "," 1,415 "," $177,799.40 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457066698,"BERRIDI-GARCIA, LILIAN",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#, 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457069916,"YOUNG, KIMBERLEY, COOK",3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457072464,"VUE, MAI, LEE",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457072464,"VUE, MAI, LEE",760 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457072464,"VUE, MAI, LEE",1730 KERNERSVILLE MEDICAL PKWY STE 101 KERNERSVILLE NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1366068397,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BOILING SPRINGS,305 W COLLEGE AVE   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457079741,"HARBISON, MONRIEL, JAMIKA",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457080418,"REDWINE, MADISON, ALEXANDER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457080418,"REDWINE, MADISON, ALEXANDER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457080418,"REDWINE, MADISON, ALEXANDER",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457080418,"REDWINE, MADISON, ALEXANDER",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 46 , 85 ,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457080418,"REDWINE, MADISON, ALEXANDER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13440 NC 210 HWY   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457084808,"KAFLE, ANITA, PODASAINI",1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1457084808,"KAFLE, ANITA, PODASAINI",1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7201 US HIGHWAY 64 E   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1457084808,"KAFLE, ANITA, PODASAINI",1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457084808,"KAFLE, ANITA, PODASAINI",1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457084808,"KAFLE, ANITA, PODASAINI",1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457086464,"SCHLACHTER, COURTNEY, CAROLINE",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457100489,"ORANGE, MEGAN, JOY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,314 BLOWING ROCK BLVD STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1457100489,"ORANGE, MEGAN, JOY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457100489,"ORANGE, MEGAN, JOY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457100489,"ORANGE, MEGAN, JOY",14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093901696,CAROLINA CARING HEALTH PARTNERS,CAROLINA CARING HOUSE CALLS,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457104226,"WHITE, KAILEE, DANIELE",3975 ROBINSON RD   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457113243,"RIPPY, KATELYN, BROOKE",2544 COURT DR STE G GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457114480,"DAVIS, CIERA, PILCHER",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457114480,"DAVIS, CIERA, PILCHER",2075 GLENN MITCHELL DR STE 400 VIRGINIA BEACH VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457115487,"SCOTT, JORDAN",1428 E MAIN ST STE B LINCOLNTON NC,055,Lincoln,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6330 QUADRANGLE DR STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1457117806,"MEBRAHTU, FREWEINI, GHEBRETINSAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 , 164 , 272 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457117806,"MEBRAHTU, FREWEINI, GHEBRETINSAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 32 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457117871,"HEINTSCHEL, MADELINE, BURKE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457117871,"HEINTSCHEL, MADELINE, BURKE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457117871,"HEINTSCHEL, MADELINE, BURKE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1457120149,"VENABLE, JONATHAN, WILLIAM",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1457120149,"VENABLE, JONATHAN, WILLIAM",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 30 , 34 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457120214,"RODRIGUEZ, ALLISON, AMANDA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457120487,"FIGUEROA, EMILIO, ENRIQUE",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457120487,"FIGUEROA, EMILIO, ENRIQUE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457124638,"SPERLE, MANDY, MARIE",1730 KERNERSVILLE MEDICAL PKWY STE 101 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 47 , 82 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457124638,"SPERLE, MANDY, MARIE",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 15 , 23 ,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1457137648,"WOLFCALE, CHRISTINE, LAURA",2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 83 , 173 , 174 ,$#,,
MEDICAID DIRECT,1407921802,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1457171621,"REECE, JENNA, BROOKE",434 HOSPITAL DR   LINVILLE NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1457181745,"BAKER, DANIEL, KENNETH",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457184616,"MINGER, ASHLYNN, PATTERSON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457191736,"MAGUIRE, MEGAN, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225794217,DR CAMERON & ASSOCIATES OF HILLSBO,ERIC DAVIS LLC,510 HAMPTON PT STE 100 HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1457193591,"MCINTOSH, NOEL, ELIZABETH",510 HAMPTON POINT BLVD. SUITE 100   HILLSBOROUGH NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 239 , 317 , 995 ," $48,819.21 ",,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457197444,"STALUN, TANNER, WILLIAM",16455 STATESVILLE RD STE 420 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,16455 STATESVILLE ROAD SUITE 520 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457197444,"STALUN, TANNER, WILLIAM",16455 STATESVILLE RD STE 420 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,16455 STATESVILLE ROAD SUITE 520 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457197444,"STALUN, TANNER, WILLIAM",16455 STATESVILLE RD STE 420 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457197444,"STALUN, TANNER, WILLIAM",16455 STATESVILLE RD STE 420 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457301269,"KRISHNAN, GOKUL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457301269,"KRISHNAN, GOKUL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 121 , 121 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457301269,"KRISHNAN, GOKUL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1457302572,"SIERRA, CARLOS, RENE",204 N PERSON ST   RALEIGH NC,092,Wake,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457302754,"TEJWANI, LOKESH, KUMAR",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457302754,"TEJWANI, LOKESH, KUMAR",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457302754,"TEJWANI, LOKESH, KUMAR",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 63 , 89 , 164 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457302754,"TEJWANI, LOKESH, KUMAR",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457302754,"TEJWANI, LOKESH, KUMAR",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457302754,"TEJWANI, LOKESH, KUMAR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538366372,WOUND CARE SPECIALIST PA,~,112 SPARKS DR   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1457302804,"LASSITER, LONNIE, WAYNE",112 SPARKS DR   FOREST CITY NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 51 , 56 ,$#,,
MEDICAID DIRECT,1457304461,PAL-MED LLC,~,454 BERRYHILL RD STE B COLUMBIA SC,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457304461,PAL-MED LLC,454 BERRYHILL RD STE B COLUMBIA SC,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 320 , 458 , 473 ," $83,292.67 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457304693,"LOPEZ, WILLIAM, MANUEL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457304883,"KEILITZ, JANE, MARIE",4515 PREMIER DR   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 82 , 179 , 312 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457304990,"TOYE, LEON, ROBERT",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659340636,IMAGING SPECIALISTS PLLC,,750 OLD HICKORY BLVD BLDG 1-260 BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457304990,"TOYE, LEON, ROBERT",750 OLD HICKORY BLVD STE 1-260 BRENTWOOD TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1457304990,"TOYE, LEON, ROBERT",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1457305104,"VAUGHAN, JOEL, FULLER",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1457305104,"VAUGHAN, JOEL, FULLER",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,10211 ALM ST STE 1100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457305104,"VAUGHAN, JOEL, FULLER",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 58 , 120 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1457305104,"VAUGHAN, JOEL, FULLER",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457305104,"VAUGHAN, JOEL, FULLER",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457305104,"VAUGHAN, JOEL, FULLER",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457305104,"VAUGHAN, JOEL, FULLER",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457306581,"MOORE, ROBERT, ALEXANDER",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 110 , 271 , 451 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457307274,"STANISLAW, JAMES, EDWARD",232 SHARON AVE NW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 52 , 81 , 118 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457307274,"STANISLAW, JAMES, EDWARD",232 SHARON AVE NW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 26 , 38 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457307274,"STANISLAW, JAMES, EDWARD",160 RIVER BEND DR STE C GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457307274,"STANISLAW, JAMES, EDWARD",160 RIVER BEND DR STE C GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457307357,"ENGEMANN, JOHN, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 20 , 32 , 41 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457307357,"ENGEMANN, JOHN, JOSEPH",2304 WESVILL CT STE 240 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457307357,"ENGEMANN, JOHN, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 34 , 61 , 62 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457307357,"ENGEMANN, JOHN, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457307357,"ENGEMANN, JOHN, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457307357,"ENGEMANN, JOHN, JOSEPH",2304 WESVILL CT STE 240 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457307357,"ENGEMANN, JOHN, JOSEPH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1457307662,"LEWIS, PATRICIA, GAIL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1457307662,"LEWIS, PATRICIA, GAIL",3100 WELLONS BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 52 , 83 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1457307662,"LEWIS, PATRICIA, GAIL",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 66 , 81 , 140 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1457307662,"LEWIS, PATRICIA, GAIL",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457307886,"NELSON, ROBERT, DARRELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 66 , 79 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457308595,"POSILLICO, LOUIS, FRANK",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457308918,"HATCHER, JEFFREY, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 54 , 107 , 122 ,$#,,
MEDICAID DIRECT,1457309353,"LOCKLEAR, JASON, LYNN",~,812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,111N00000X,Chiropractic Providers,Chiropractor,,1457309353,"LOCKLEAR, JASON, LYNN",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,111N00000X,Chiropractic Providers,Chiropractor,, 24 , 121 , 126 ,$#,,
MEDICAID DIRECT,1366635989,DEESE AND LOCKLEAR CHIROPRACTIC CEN,~,812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1457309353,"LOCKLEAR, JASON, LYNN",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,111N00000X,Chiropractic Providers,Chiropractor,, 11 , 38 , 39 ,$#,,
MEDICAID DIRECT,1457309932,KM PEDIATRIC THERAPY INC,~,8514 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457309932,KM PEDIATRIC THERAPY INC,8514 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 58 , 758 , 785 ," $50,020.83 ",,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457309981,"DAUGHTRY, ELIZABETH, BASS",103 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457309981,"DAUGHTRY, ELIZABETH, BASS",721 TILGHMAN DR STE 300 DUNN NC,043,Harnett,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 166 , 466 ," 1,117 ",$#,,
MEDICAID DIRECT,1386289841,FOOT AND ANKLE SPECIALISTS OF THE M,,721 TILGHMAN DR STE 300 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1457309981,"DAUGHTRY, ELIZABETH, BASS",721 TILGHMAN DR STE 300 DUNN NC,043,Harnett,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457309981,"DAUGHTRY, ELIZABETH, BASS",721 TILGHMAN DR STE 300 DUNN NC,043,Harnett,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 77 , 121 , 269 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457310682,"ANDERSON, RICHARD, SCOTT",1060 1ST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457310971,"NEWELL, HOWARD, WILSON",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457311003,"TOLBERT, FRANKLIN, LEE",147 PEACHTREE LN   ADVANCE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 179 , 225 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457311177,"JOHNSON, JODIE, HARTLEY",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 65 , 65 ,$#,,
MEDICAID DIRECT,1275043481,DLP PERSON URGENT CARE,MEDACCESS URGENT CARE,3762 DURHAM RD STE A ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457311177,"JOHNSON, JODIE, HARTLEY",3762 DURHAM RD STE A ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457311649,"KAPUSTIN, ANDREW, JAY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457311649,"KAPUSTIN, ANDREW, JAY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457311649,"KAPUSTIN, ANDREW, JAY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457311649,"KAPUSTIN, ANDREW, JAY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457311649,"KAPUSTIN, ANDREW, JAY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 202 , 211 , 267 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457311649,"KAPUSTIN, ANDREW, JAY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457311649,"KAPUSTIN, ANDREW, JAY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1457312639,"CURRY, BRENTON, SHEA",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1457312639,"CURRY, BRENTON, SHEA",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 53 , 59 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457312639,"CURRY, BRENTON, SHEA",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457312639,"CURRY, BRENTON, SHEA",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 39 ,$#,,
MEDICAID DIRECT,1760458657,HOSPICE OF YANCEY COUNTY INC,COMPASSIONATE CARE WESTERN NORTH CAROLINA,856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1457313058,"THOMAS, APRIL, GRIFFIN",856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760458657,HOSPICE OF YANCEY COUNTY INC,COMPASSIONATE CARE WESTERN NORTH CAROLINA,856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1457313058,"THOMAS, APRIL, GRIFFIN",856 GEORGES FORK RD   BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 42 , 56 ,$#,,
MEDICAID DIRECT,1922094895,MEDICAL EYE ASSOCIATES PA,MEDICAL EYE ASSOCIATES PA,1707 MEDICAL PARK DR W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1457313363,"GENGE, MILAN, RAMESH",1707 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 241 , 374 , 449 ," $26,476.05 ",,
MEDICAID DIRECT,1922094895,MEDICAL EYE ASSOCIATES PA,MEDICAL EYE ASSOCIATES PA,1707 MEDICAL PARK DR W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1457313363,"GENGE, MILAN, RAMESH",3044 SUNSET AVE   ROCKY MOUNT NC,064,Nash,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 53 , 79 , 87 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1457313413,"BRULL, JAMES",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1457313413,"BRULL, JAMES",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1457313413,"BRULL, JAMES",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 27 ,$#,,
MEDICAID DIRECT,1457314437,THE RALEIGH EYE CENTER PA,THE OPTICAL DISPENSARY,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1457314437,THE RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 72 , 73 , 146 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457315335,"MCDOWELL, SAMUEL, GRAINGER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457315335,"MCDOWELL, SAMUEL, GRAINGER",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457315335,"MCDOWELL, SAMUEL, GRAINGER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457315335,"MCDOWELL, SAMUEL, GRAINGER",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 79 , 106 , 153 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457315335,"MCDOWELL, SAMUEL, GRAINGER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 49 , 56 , 71 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457315335,"MCDOWELL, SAMUEL, GRAINGER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457315335,"MCDOWELL, SAMUEL, GRAINGER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457315558,"LETICA, MARK",441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 44 , 49 , 61 ,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,431 COPPERFIELD BLVD NE STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457315558,"LETICA, MARK",12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457315558,"LETICA, MARK",12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457315558,"LETICA, MARK",12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,431 COPPERFIELD BLVD NE STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457315558,"LETICA, MARK",431 COPPERFIELD BLVD NE STE 100 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 33 , 45 ,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457315947,"JORDAN, KIMBERLY, ELIZABETH",2525 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 24 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457315954,"HULKA, GREGORY, FABIAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 27 , 31 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457315954,"HULKA, GREGORY, FABIAN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1457315954,"HULKA, GREGORY, FABIAN",1010 TRYON VILLAGE DR   CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457315954,"HULKA, GREGORY, FABIAN",1010 TRYON VILLAGE DR   CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396166088,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB - MT,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457316168,"ETUMADU, AJIKE, OGUNSULIRE",275 BEATTY DR   BELMONT NC,036,Gaston,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457316168,"ETUMADU, AJIKE, OGUNSULIRE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 35 , 92 , 93 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1457316168,"ETUMADU, AJIKE, OGUNSULIRE",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457316168,"ETUMADU, AJIKE, OGUNSULIRE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457316978,"NGUYEN, CHRISTOPHE, LIEM",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457318255,"AVERY, SCOTT, ROBERT",101 BETHESDA DR   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 33 , 57 , 103 ,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1457319360,"FARASH, ANN, ELIZABETH",157 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 24 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457319493,"GARCIA, ANNA, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457319493,"GARCIA, ANNA, MARIE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457319493,"GARCIA, ANNA, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 30 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457319493,"GARCIA, ANNA, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457319493,"GARCIA, ANNA, MARIE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1457319493,"GARCIA, ANNA, MARIE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457320020,"BLOTNICK, CHARLES, ADAM",2015 RANDOLPH RD STE 108 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 56 , 80 , 144 ,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457320020,"BLOTNICK, CHARLES, ADAM",4101 CAMPUS RIDGE RD   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 17 , 37 ,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457320020,"BLOTNICK, CHARLES, ADAM",8816 UNIVERSITY EAST DR STE C CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 24 , 30 , 52 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457320368,"BAKER, ANNA, CHAMPION",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457320368,"BAKER, ANNA, CHAMPION",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457320368,"BAKER, ANNA, CHAMPION",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457320368,"BAKER, ANNA, CHAMPION",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457320442,"STADNICK, MICHAEL, EDWARD",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659340636,IMAGING SPECIALISTS PLLC,,750 OLD HICKORY BLVD BLDG 1-260 BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457320442,"STADNICK, MICHAEL, EDWARD",750 OLD HICKORY BLVD STE 1-260 BRENTWOOD TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457321366,"THROWER, DANIELLE, KATHLEEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457321366,"THROWER, DANIELLE, KATHLEEN",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457321978,"CONNELLY, CHRISTOPHER, SCOTT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457321978,"CONNELLY, CHRISTOPHER, SCOTT",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 118 , 176 , 191 ,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1457321978,"CONNELLY, CHRISTOPHER, SCOTT",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457322190,"ARTMAN, MICHAEL, SCOTT",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 26 , 76 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1457322646,"BRANCH, GLENDA, MARCIA",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 314 , 318 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457322646,"BRANCH, GLENDA, MARCIA",604 STOKES ST E   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 275 , 275 ," $11,452.56 ",,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1457322646,"BRANCH, GLENDA, MARCIA",604 STOKES ST E   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 506 , 506 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457322646,"BRANCH, GLENDA, MARCIA",38 CARTERS RD   GATESVILLE NC,037,Gates,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457324659,"HOWE, DAVID, JEFFERSON",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457324659,"HOWE, DAVID, JEFFERSON",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 62 , 86 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457325110,"BROUSSARD, BRADLEY, JAMES",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 76 , 106 , 248 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457325110,"BROUSSARD, BRADLEY, JAMES",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 40 , 57 , 125 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457325110,"BROUSSARD, BRADLEY, JAMES",142 PARACLETE DR STE 301 RAEFORD NC,047,Hoke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457325110,"BROUSSARD, BRADLEY, JAMES",142 PARACLETE DR STE 301 RAEFORD NC,047,Hoke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,40 AVIEMORE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1457325110,"BROUSSARD, BRADLEY, JAMES",40 AVIEMORE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457325110,"BROUSSARD, BRADLEY, JAMES",40 AVIEMORE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457325334,"VILLARROEL FERNANDEZ, OMAR, MIJAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457325466,"RODRIGUE, TINA, CHRISTIANE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1457326456,"MONDAY, JOSHUA, MICHAEL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 34 , 34 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1457327272,"MANGUN, JENNIE, CRAIG",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1235430976,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE PEDIATRICS,2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1457327272,"MANGUN, JENNIE, CRAIG",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 27 , 49 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1457327272,"MANGUN, JENNIE, CRAIG",2636 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 32 , 72 ,$#,,
MEDICAID DIRECT,1295801827,CRAVEN COUNTY,CRAVEN COUNTY HEALTH DEPARTMENT,2818 NEUSE BLVD STE 1 NEW BERN NC,025,Craven,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1457327272,"MANGUN, JENNIE, CRAIG",2818 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 16 , 65 ,$#,,
MEDICAID DIRECT,1902087927,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1457327322,"SPARGO, SHERRY, JOY",1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 43 , 69 ,$#,,
MEDICAID DIRECT,1679056733,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRICS MINT HILL,8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457327504,"MAH, HANS, SANGHOON",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457327504,"MAH, HANS, SANGHOON",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 25 , 57 ,$#,,
MEDICAID DIRECT,1992764351,PARAGON SURGICAL SPECIALISTS,PARAGON SURGICAL SPECIALISTS,200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457327595,"SCHMIDT, JEFFREY, SCOTT",200 MEDICAL PARK DR STE 400 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 83 , 105 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457328767,"HUNDLEY, WILLOUGHBY, SHELTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 37 , 41 ,$#,,
MEDICAID DIRECT,1457331100,"CONNELLY, ROBERT",,485 WEST ST   PITTSBORO NC,019,Chatham,152W00000X,Eye and Vision Services Providers,Optometrist,,1457331100,"CONNELLY, ROBERT",485 WEST ST   PITTSBORO NC,019,Chatham,152W00000X,Eye and Vision Services Providers,Optometrist,, 105 , 107 , 108 ,$#,,
MEDICAID DIRECT,1457332264,CAROLINA THERAPY SERVICES INC,~,111 S RAILROAD AVE   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457332264,CAROLINA THERAPY SERVICES INC,111 S RAILROAD AVE   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,, 375 ," 5,446 "," 6,954 "," $476,772.86 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457334815,"BULLARD, INGRID, SPRUILL",14215 BALLANTYNE CORPORATE PL STE 110 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457334815,"BULLARD, INGRID, SPRUILL",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457334815,"BULLARD, INGRID, SPRUILL",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457334815,"BULLARD, INGRID, SPRUILL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1831137330,NEONATOLOGY & PEDIATRIC ACUTE CARE,~,352 2ND ST NW STE 205 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457335028,"BERRY, DAVID, DON",352 2ND ST NW STE 205 HICKORY NC,018,Catawba,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 13 , 125 , 125 ," $16,515.16 ",,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457335051,"OLIVA, NAMIK",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457335051,"OLIVA, NAMIK",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1457335051,"OLIVA, NAMIK",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1801850250,TRIANGLE PRIMARY CARE ASSOCIATES PL,TRIANGLE PRIMARY CARE ASSOCIATES PLLC,851 DURHAM RD STE D WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1457335242,"BRUCE-MENSAH, KOFI",851 DURHAM RD STE D WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 138 , 158 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457335457,"KASA, KURIAN, DAVID SOLOMON RAJ",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457335457,"KASA, KURIAN, DAVID SOLOMON RAJ",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457335457,"KASA, KURIAN, DAVID SOLOMON RAJ",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457335457,"KASA, KURIAN, DAVID SOLOMON RAJ",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 81 , 104 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457335853,"SOKOLOSKY, MITCHELL, CHRISS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 33 , 36 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457335879,"PHIPPS, JEREMY, C",15825 BALLANTYNE MEDICAL PL STE 120 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1457335887,"LEVENGOOD, JULIE, VICTORIA",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 20 , 26 , 87 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457336240,"JOHNSON, MOLLIE, KATHLEEN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 58 , 64 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457336240,"JOHNSON, MOLLIE, KATHLEEN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457336299,"WHELAN, DEBORAH, MOSCAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457336513,"FERNANDEZ, ADOLFO, ZACARIAS",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 51 , 52 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457336588,"SPRUILL, STEVEN, CARL",2704 N MAIN ST   TARBORO NC,033,Edgecombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1770610602,COUNTY OF EDGECOMBE OFFICE OF AUDI,EDGECOMBE COUNTY HEALTH DEPARTMENT,122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1457336588,"SPRUILL, STEVEN, CARL",122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457336588,"SPRUILL, STEVEN, CARL",2251 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 58 , 81 , 96 ," $12,420.46 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1457336760,"JOHNSON, KENNETH, LEE",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457336760,"JOHNSON, KENNETH, LEE",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 110 , 346 , 707 ," $10,297.39 ",,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1457336760,"JOHNSON, KENNETH, LEE",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457336778,"THOMPSON, BURKE, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 55 , 232 , 248 ," $21,860.88 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457336778,"THOMPSON, BURKE, EDWARD",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457336778,"THOMPSON, BURKE, EDWARD",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457336778,"THOMPSON, BURKE, EDWARD",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 31 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457336778,"THOMPSON, BURKE, EDWARD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457337420,"NARAHARI, NAVEEN, VYMUTT",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457337420,"NARAHARI, NAVEEN, VYMUTT",11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457337420,"NARAHARI, NAVEEN, VYMUTT",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457337420,"NARAHARI, NAVEEN, VYMUTT",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457337420,"NARAHARI, NAVEEN, VYMUTT",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457337610,"SHAVES, SARAH, CARLSON",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457337941,"DERRICK, RUSSELL, LAMAR",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 26 , 28 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457338204,"RADKAR, GAURI, VIJAYKUMAR",5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1950 GLENN MITCHELL DR STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457338204,"RADKAR, GAURI, VIJAYKUMAR",1950 GLENN MITCHELL DR STE 102 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1950 GLENN MITCHELL DR STE 102 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457338204,"RADKAR, GAURI, VIJAYKUMAR",1950 GLENN MITCHELL DR STE 102 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457338915,"DRISCOLL, LAURIE, ANN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457338915,"DRISCOLL, LAURIE, ANN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 35 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1457339251,"TUMMILLO, DORIS, ELIZABETH",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1902238728,JAE S LEE DDS PA,CARY LEE FAMILY DENTISTRY,1500 PINEY PLAINS RD STE 101 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1457339855,"LEE, JAE, SEONG",1500 PINEY PLAINS RD STE 101 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,404 "," 3,336 "," 13,460 "," $758,027.23 ",,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457341836,"JAMES, MARC, DOUGLAS",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 74 , 75 , 116 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1457342263,"MORRISON, JOHN, ANDREW",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 14 , 16 , 20 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457342263,"MORRISON, JOHN, ANDREW",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 69 , 87 , 154 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457342263,"MORRISON, JOHN, ANDREW",415 N CENTER ST STE 204 HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 41 , 56 , 83 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457342263,"MORRISON, JOHN, ANDREW",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750999405,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PRIMARY CARE LITTLE RIVER,4237 RIVER HILLS DR STE 170 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457342370,"RIVES, THOMAS, SCOTT",4237 RIVER HILLS DR STE 170 LITTLE RIVER SC,101,Out of State <= 40 miles,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457342701,"DOVER, KEVIN, GLENN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457342701,"DOVER, KEVIN, GLENN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457342701,"DOVER, KEVIN, GLENN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1457342701,"DOVER, KEVIN, GLENN",223 W WARD ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457342701,"DOVER, KEVIN, GLENN",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457342701,"DOVER, KEVIN, GLENN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1457342701,"DOVER, KEVIN, GLENN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457342701,"DOVER, KEVIN, GLENN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1457342701,"DOVER, KEVIN, GLENN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,341 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 54 , 88 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 26 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 54 , 77 , 90 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 46 , 63 , 68 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457343337,"BRAUNSTEIN, ANDREW, JOSEPH",124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 62 , 76 , 83 ,$#,,
MEDICAID DIRECT,1508111329,S&S OPTOMETRIC SERVICES,EYECARE CONCEPTS,476 SHOTWELL RD STE 104 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1457344897,"BRIGGS, SHERRY, E",476 SHOTWELL RD   CLAYTON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1457344988,HALSEY DRUG LLC,WARRENSVILLE DRUG STORE,5121 NC HIGHWAY 88 W   WARRENSVILLE NC,005,Ashe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1457344988,HALSEY DRUG LLC,5121 NC HIGHWAY 88 W   WARRENSVILLE NC,005,Ashe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1457345910,"SMITH, BRADLEY, TODD",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 81 , 104 , 134 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457345910,"SMITH, BRADLEY, TODD",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457345910,"SMITH, BRADLEY, TODD",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457345910,"SMITH, BRADLEY, TODD",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457345928,"PARKER, JOHN, CHARLES",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 26 , 38 , 62 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457345928,"PARKER, JOHN, CHARLES",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 21 , 28 , 64 ,$#,,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457346439,"JARIWALA, ARVIND, NAGINDAS",3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 167 , 167 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 45 , 45 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",3015 ENTERPRISE DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 45 , 45 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,8990 HIGHWAY 17 S   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 68 , 69 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 168 , 170 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 73 , 74 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",8990 US HIGHWAY 17   POLLOCKSVILLE NC,052,Jones,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1478 RIVER RD SE   WINNABOW NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 45 , 45 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 119 , 119 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1478 RIVER RD SE   WINNABOW NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 43 , 43 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 187 , 187 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 97 , 98 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457347627,"GONZALEZ, JOSE, ENRIQUE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 68 , 326 , 327 ,$#,,
MEDICAID DIRECT,1457351918,"MOREIRA, ROY",ROY MOREIRA MD PA,411 PARKWAY ST STE F GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1457351918,"MOREIRA, ROY",411 PARKWAY ST STE F GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 40 , 66 ,$#,,
MEDICAID DIRECT,1417303629,WESTWOOD MEDICAL,,1201 W LEBANON ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1457352353,"MCDOWELL, EDWARD, LEON",1201 W LEBANON ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 52 , 82 ,$#,,
MEDICAID DIRECT,1417303629,WESTWOOD MEDICAL,,1201 W LEBANON ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1457352353,"MCDOWELL, EDWARD, LEON",505 SAMARITANS RIDGE CT STE 100 ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 99 , 705 , 826 ," $14,305.02 ",,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457352684,"BAUER, BRAD, LEE",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1457353989,"YEAGER, KENNETH, PAUL",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457353989,"YEAGER, KENNETH, PAUL",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1457353989,"YEAGER, KENNETH, PAUL",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457354284,"MCCULLEN, BOBBY, KENNETH",~,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1457354284,"MCCULLEN, BOBBY, KENNETH",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457354284,"MCCULLEN, BOBBY, KENNETH",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 58 , 94 , 127 ," $12,623.33 ",,
MEDICAID DIRECT,1417945775,GASTON EYE ASSOCIATES LLP,GASTON EYE ASSOCIATES LLP,2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1457354284,"MCCULLEN, BOBBY, KENNETH",2325 ABERDEEN BLVD STE A GASTONIA NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1457354862,"POPE III, ROBERT, HARRIS",38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 259 , 619 , 640 ," $23,254.63 ",,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1457355406,"MICHAEL, STEVEN, PAUL",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 96 , 254 , 254 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1457355406,"MICHAEL, STEVEN, PAUL",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457356636,"LJUNG, MARTHA, LEE",8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457356636,"LJUNG, MARTHA, LEE",2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457357204,"APPEL, JAMES, EDWARD",8064 MARKET ST   WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 38 , 59 , 127 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457358137,"MOLAN, KEVIN, S",10370 PARK RD   CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457358137,"MOLAN, KEVIN, S",10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 38 , 104 , 228 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457358137,"MOLAN, KEVIN, S",10370 PARK RD   CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1114569100,FOOT AND ANKLE SPECIALISTS OF THE M,,10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457358137,"MOLAN, KEVIN, S",10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457358921,"COPLAND, ALICIA, BLOMBERG",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457358921,"COPLAND, ALICIA, BLOMBERG",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 27 , 41 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1457365207,"CARSON, MILDRED, FRANCES",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1457365207,"CARSON, MILDRED, FRANCES",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457365207,"CARSON, MILDRED, FRANCES",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457368185,"MAZZOLA, JOSEPH, CARMEN",101 WILKESBORO ST STE B MOCKSVILLE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 16 , 24 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457369266,"GAROFALO, CAROLANNE, EVANS",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457370199,"GOODRICH, DANIEL, PAUL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 31 , 31 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457370199,"GOODRICH, DANIEL, PAUL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457370405,"BEACHKOFSKY, MICHELLE, LYNN",7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457370405,"BEACHKOFSKY, MICHELLE, LYNN",6237 CAROLINA COMMONS DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457370405,"BEACHKOFSKY, MICHELLE, LYNN",630 COMFORT LN STE E MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,, 32 , 38 , 39 ,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457370405,"BEACHKOFSKY, MICHELLE, LYNN",630 COMFORT LN STE E MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",109 W CHURCH ST   ATKINSON NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",301 S CAMPBELL ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",301 S CAMPBELL ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356339154,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER HEALTH SERVICES INC,4811 NC HWY 50   MAPLE HILL NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 24 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5641 S HWY 41   WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 22 , 45 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,2600 NEW VILLAGE WAY   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",5214 MARKET ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 31 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457370546,"PRESLEY, MELISSA, ANN",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457370876,"HYATT, BRENDA, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457370967,"CLINE, DAVID, MICHAEL",240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457371080,"GENTRY, LELIA, RENEE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457371080,"GENTRY, LELIA, RENEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457371403,"SCHERMERHORN, THOMAS, JANSE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457371403,"SCHERMERHORN, THOMAS, JANSE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457371403,"SCHERMERHORN, THOMAS, JANSE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 44 , 84 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1457371403,"SCHERMERHORN, THOMAS, JANSE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457371403,"SCHERMERHORN, THOMAS, JANSE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457373540,"BASEGODA, MARIO, BALDOMERO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 54 , 210 , 215 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457373540,"BASEGODA, MARIO, BALDOMERO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457373540,"BASEGODA, MARIO, BALDOMERO",507 E FREMONT ST   BURGAW NC,071,Pender,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1457373888,"KHAN, BASALAT, ALI",2201 S STERLING ST   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457376469,"HELLNER, MARIEALANE, BARBERA",10650 PARK RD STE 420 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 15 , 37 , 37 ,$#,,
MEDICAID DIRECT,1386288298,LIMBIONICS OF GOLDSBORO INC,,2103 WAYNE MEMORIAL DR STE B GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457376931,"CALCAGNO, MARCO, TUCK",2103 WAYNE MEMORIAL DR STE B GOLDSBORO NC,096,Wayne,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457377582,"MAGUIRE, PATRICK, DAVID",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 32 , 71 , 95 ,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457377582,"MAGUIRE, PATRICK, DAVID",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 17 , 66 , 89 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457381535,"STANISLAUS, BRYAN, EDMUND",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 76 , 181 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457381535,"STANISLAUS, BRYAN, EDMUND",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457381535,"STANISLAUS, BRYAN, EDMUND",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457381600,"LOIBISSIO, JOSEPH, CHARLES",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457381600,"LOIBISSIO, JOSEPH, CHARLES",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 12 , 18 , 39 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457381600,"LOIBISSIO, JOSEPH, CHARLES",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457381865,"HAIRSTON, KRISTEN, GILL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 34 , 44 , 44 ,$#,,
MEDICAID DIRECT,1457382483,AMISUB OF SOUTH CAROLINA INC,PIEDMONT MEDICAL CENTER,222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,1457382483,AMISUB OF SOUTH CAROLINA INC,222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1457382483,AMISUB OF SOUTH CAROLINA INC,PIEDMONT MEDICAL CENTER,1065 HECKLE BLVD   ROCK HILL SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,1457382483,AMISUB OF SOUTH CAROLINA INC,1065 HECKLE BLVD   ROCK HILL SC,101,Out of State <= 40 miles,3416L0300X,Transportation Services,Ambulance,Land Transport,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457383606,"JORDAN, JAY, DANIEL",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457383606,"JORDAN, JAY, DANIEL",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457383663,"FLEMING, MARK",3000 COLISEUM DR STE 104 HAMPTON VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1457383663,"FLEMING, MARK",~,6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,1457383663,"FLEMING, MARK",6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457383663,"FLEMING, MARK",6251 E VIRGINIA BEACH BLVD STE 200 NORFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1447383773,ASHEVILLE PEDIATRIC ASSOCIATES PA,ASHEVILLE PEDIATRIC ASSOCIATES PA,2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1457384133,"DODSON, LEIGH, MASTEN",2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 53 , 85 , 329 ," $12,806.42 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457386070,"WRINKLE, GEOFFREY, THOMAS",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457386070,"WRINKLE, GEOFFREY, THOMAS",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1164453726,CARMEL FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE CARMEL FAMILY MEDICINE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457386070,"WRINKLE, GEOFFREY, THOMAS",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 28 , 35 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457386971,"SINGH, PRASHANT, KUMAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 253 , 253 ,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457387383,"VELAZQUEZ, LOUIS, MANUEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 22 , 55 ,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457387383,"VELAZQUEZ, LOUIS, MANUEL",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457388316,"HEAVNER, STEVEN, BRETT",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457388316,"HEAVNER, STEVEN, BRETT",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 16 , 23 , 32 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457388316,"HEAVNER, STEVEN, BRETT",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 22 , 24 , 33 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457388316,"HEAVNER, STEVEN, BRETT",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1457389090,"KING, DAVID, LEE",~,312 E CENTERVIEW ST   CHINA GROVE NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,,1457389090,"KING, DAVID, LEE",312 E CENTERVIEW ST   CHINA GROVE NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 23 , 26 ,$#,,
MEDICAID DIRECT,1205043411,DAVID L KING OD,KING EYE CENTER OD PA,312 E CENTERVIEW ST   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1457389090,"KING, DAVID, LEE",312 E CENTERVIEW ST   CHINA GROVE NC,080,Rowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1457389322,"CLIFTON, THOMAS, SCOTT",THOMAS S CLIFTON DDS,5242 N ROXBORO RD STE A DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1457389322,"CLIFTON, THOMAS, SCOTT",5242 N ROXBORO RD STE A DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 61 , 137 ,$#,,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457389793,"BELL, ANDRE, ERWIN",10211 ALM ST STE 1100 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 43 , 71 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1457390296,"VON, KARLA, VIRGINIA",808 N WASHINGTON ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 70 , 72 ,$#,,
MEDICAID DIRECT,1033185780,HIGH COUNTRY FAMILY MEDICINE PA,HIGH COUNTRY FAMILY MEDICINE PA,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1457391401,"LEONARD, JAYNE, BUNTON",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 86 , 169 ,$#,,
MEDICAID DIRECT,1457395394,DUKE UNIVERSITY HEALTH SYSTEM INC,~,4321 MEDICAL PARK DR STE 101 DURHAM NC,032,Durham,251F00000X,Agencies,Home Infusion,,1457395394,DUKE UNIVERSITY HEALTH SYSTEM INC,4321 MEDICAL PARK DR STE 101 DURHAM NC,032,Durham,251F00000X,Agencies,Home Infusion,, 191 ," 2,231 "," 3,623 "," $967,403.65 ",,
MEDICAID DIRECT,1457396376,MRB ACQUISITION CORP,LINCARE POWERED MOBILITY,1898 S CLYDE MORRIS BLVD STE 410 DAYTONA BEACH FL,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457396376,MRB ACQUISITION CORP,1898 S CLYDE MORRIS BLVD STE 410 DAYTONA BEACH FL,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457396632,"REHMAN, ZIA, UR",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457396632,"REHMAN, ZIA, UR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457396632,"REHMAN, ZIA, UR",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 235 , 337 , 555 ," $16,302.86 ",,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1457399610,"RODY, RICHARD, BRENT",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 50 , 69 ,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1457399610,"RODY, RICHARD, BRENT",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 59 , 74 ,$#,,
MEDICAID DIRECT,1457400194,LIFESPAN INC,LIFE SPAN INC,919 STOKES ST   BURLINGTON NC,001,Alamance,251S00000X,Agencies,Community/Behavioral Health,,1457400194,LIFESPAN INC,919 STOKES ST   BURLINGTON NC,001,Alamance,251S00000X,Agencies,Community/Behavioral Health,, 87 ," 1,441 "," 1,441 "," $94,729.88 ",,
MEDICAID DIRECT,1457400194,LIFESPAN INC,LIFE SPAN INC,919 STOKES ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457400194,LIFESPAN INC,919 STOKES ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,, 63 , 898 , 947 ," $69,514.42 ",,
MEDICAID DIRECT,1457400202,CARING HANDS HOME HEALTH INC,~,4321 S ELM EUGENE ST   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1457400202,CARING HANDS HOME HEALTH INC,4321 S ELM EUGENE ST   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 111 ," 13,799 "," 13,814 "," $910,068.67 ",,
MEDICAID DIRECT,1457403818,"SOMMERVILLE, MARIANNE",,5309 HIGHGATE DR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,1457403818,"SOMMERVILLE, MARIANNE",5309 HIGHGATE DR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1457403818,"SOMMERVILLE, MARIANNE",5309 HIGHGATE DR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457405003,"KAGER, CYNTHIA, MAYER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457405003,"KAGER, CYNTHIA, MAYER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2304 WESVILL CT STE 360 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457405151,"BROWN, ANNE, OGILVIE",11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457405151,"BROWN, ANNE, OGILVIE",11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457405151,"BROWN, ANNE, OGILVIE",11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1457405417,"MORGAN, DEBORAH, BANTOS",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 39 , 49 , 234 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457405417,"MORGAN, DEBORAH, BANTOS",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 11 , 13 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1457405417,"MORGAN, DEBORAH, BANTOS",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1457405417,"MORGAN, DEBORAH, BANTOS",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457405482,"MURPHY, TONYA, LANELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 43 , 46 ,$#,,
MEDICAID DIRECT,1144652249,PIEDMONT HEALTH SERVICES INC,~,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 251 , 302 , 690 ," $27,228.70 ",,
MEDICAID DIRECT,1124450226,PIEDMONT HEALTH SERVICES INC,~,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",301 LLOYD ST   CARRBORO NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124405014,PIEDMONT HEALTH SERVICES INC,~,1315 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",1315 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1497187595,PIEDMONT HEALTH SERVICES INC,~,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",322 MAIN ST   PROSPECT HILL NC,017,Caswell,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 30 , 68 ,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 171 , 223 , 511 ," $26,210.37 ",,
MEDICAID DIRECT,1851723951,PIEDMONT HEALTH SERVICES INC,MONCURE CHC DENTAL,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,1223G0001X,Dental Providers,Dentist,General Practice, 195 , 234 , 496 ," $21,823.01 ",,
MEDICAID DIRECT,1124450226,PIEDMONT HEALTH SERVICES INC,~,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",224 S 10TH AVE   SILER CITY NC,019,Chatham,1223G0001X,Dental Providers,Dentist,General Practice, 81 , 93 , 241 ,$#,,
MEDICAID DIRECT,1376361204,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL CHC,105 CONNER DR STE 2100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457411167,"MATTISON, KATRINA, CHAUNDANI",224 S 10TH AVE   SILER CITY NC,019,Chatham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1457411522,"MOODY, JOHN, AUSTIN",JOHN A MOODY DDS,16511 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1457411522,"MOODY, JOHN, AUSTIN",16511 NORTHCROSS DR STE F HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 22 , 91 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457412454,"VOORHEES, PETER, MICHAEL",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457412454,"VOORHEES, PETER, MICHAEL",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457412454,"VOORHEES, PETER, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457412454,"VOORHEES, PETER, MICHAEL",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1457413791,"LE, HUNG, NGOC",~,3803 COMPUTER DR STE 201B RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1457413791,"LE, HUNG, NGOC",3803 COMPUTER DR STE 201B RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 208 , 255 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457414161,"STOLERMAN, ELLIOT, SETH",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.),#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457414237,"TANAKA, DAVID, TIMOTHY",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 72 , 72 ," $10,397.31 ",,
MEDICAID DIRECT,1457415788,"DUNN III, ATLAS, CLEVELAND",Atlas Cleveland Dunn III,310 W SALISBURY ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,1457415788,"DUNN III, ATLAS, CLEVELAND",310 W SALISBURY ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 72 , 108 , 275 ,$#,,
MEDICAID DIRECT,1457416083,"TAYLOR WILLIAMS, VERONICA, LATRELLE",VERONICA TAYLOR-WILLIAMS,47 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,1457416083,"TAYLOR WILLIAMS, VERONICA, LATRELLE",47 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice," 1,251 "," 2,453 "," 10,379 "," $354,504.60 ",,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457416778,"ROBINSON, GARY, JAMES",801 TILGHMAN DR STE A DUNN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780193557,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - DUNN,801 TILGHMAN DR   DUNN NC,043,Harnett,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457416778,"ROBINSON, GARY, JAMES",801 TILGHMAN DR STE A DUNN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457416778,"ROBINSON, GARY, JAMES",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457418246,"SCHULTZ, LAURA",925 N 4TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 15 , 26 ,$#,,
MEDICAID DIRECT,1457418311,COASTAL REHABILITATION INC,~,532C CARATOKE HWY   MOYOCK NC,027,Currituck,193400000X,Group,Single Specialty,,1457418311,COASTAL REHABILITATION INC,532C CARATOKE HWY   MOYOCK NC,027,Currituck,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1457418311,COASTAL REHABILITATION INC,~,503 CYPRESS LN STE A MANTEO NC,028,Dare,193400000X,Group,Single Specialty,,1457418311,COASTAL REHABILITATION INC,503 CYPRESS LN STE A MANTEO NC,028,Dare,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1457418311,COASTAL REHABILITATION INC,~,101 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1457418311,COASTAL REHABILITATION INC,101 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1093793473,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1457418907,"LAMBERT, CHARLES, LEWIS",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 19 , 20 ,$#,,
MEDICAID DIRECT,1396725743,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,195 CAMLELOT CT   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1457419277,"BUCKLAND, SUSAN, LEANNE",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1003364589,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,131 NC HIGHWAY 109 S   MOUNT GILEAD NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1457419277,"BUCKLAND, SUSAN, LEANNE",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1457419277,"BUCKLAND, SUSAN, LEANNE",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457420002,"JOHNSON, CHRISTINA, ELISABETH",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457420002,"JOHNSON, CHRISTINA, ELISABETH",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457423840,"LEWIS, CAROLYN, ZOOK",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 68 , 103 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457424764,"MOSS SR, JOHN, SIMPSON",171 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457424764,"MOSS SR, JOHN, SIMPSON",171 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1457430977,AVERY PHARMACY AND HEALTHCARE,AVERY PHARMACY AND HEALTHCARE,436 HOSPITAL DR   LINVILLE NC,006,Avery,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1457430977,AVERY PHARMACY AND HEALTHCARE,436 HOSPITAL DR   LINVILLE NC,006,Avery,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 12 , 30 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457432023,"BALOCH, HASAN, AHMAD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457432023,"BALOCH, HASAN, AHMAD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457432023,"BALOCH, HASAN, AHMAD",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457432023,"BALOCH, HASAN, AHMAD",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1457432577,FAMILY EYE CENTER OD PA,FAMILY EYE CENTER PA,216 N BICKETT BLVD STE 6 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1457432577,FAMILY EYE CENTER OD PA,216 N BICKETT BLVD STE 6 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,, 292 , 307 , 582 ,$#,,
MEDICAID DIRECT,1457432577,FAMILY EYE CENTER OD PA,FAMILY EYE CENTER PA,560 DABNEY DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1457432577,FAMILY EYE CENTER OD PA,560 DABNEY DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,," 2,296 "," 2,396 "," 4,577 "," $62,543.45 ",,
MEDICAID DIRECT,1457432577,FAMILY EYE CENTER OD PA,FAMILY EYE CENTER PA,134 N MAIN ST   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,,1457432577,FAMILY EYE CENTER OD PA,134 N MAIN ST   WARRENTON NC,093,Warren,193200000X,Group,Multi-Specialty,, 342 , 356 , 682 ,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457433138,"FLEISHMAN, KENNETH, EDWIN",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457433138,"FLEISHMAN, KENNETH, EDWIN",3425 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457433138,"FLEISHMAN, KENNETH, EDWIN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457433690,"STARKS, LAWANNA, MARIE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 33 , 69 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457433690,"STARKS, LAWANNA, MARIE",1821 HILLANDALE RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457433690,"STARKS, LAWANNA, MARIE",2315 W ARBORS DR STE 115 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1982873899,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,900 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457435158,"DOONQUAH, SANDRA, BARLOW",2509 RICHARDSON DR STE B REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice," 3,083 "," 3,442 "," 15,629 "," $396,767.11 ",,
MEDICAID DIRECT,1457435158,"DOONQUAH, SANDRA, BARLOW",ALL ABOUT SMILES,2509 RICHARDSON DR STE B REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1457435158,"DOONQUAH, SANDRA, BARLOW",2509 RICHARDSON DR STE B REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice," 1,250 "," 2,860 "," 10,539 "," $407,377.05 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457435992,"MANNING, REBECCA, ANNA",2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457435992,"MANNING, REBECCA, ANNA",3113 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 52 , 107 , 266 ," $34,954.81 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457435992,"MANNING, REBECCA, ANNA",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 79 , 235 ," $29,922.90 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457435992,"MANNING, REBECCA, ANNA",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457435992,"MANNING, REBECCA, ANNA",220 SPRINGBROOK AVE STE 100 CLAYTON NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 85 , 218 , 524 ," $70,501.33 ",,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1457436008,"GAMBILL, STACY, JOHNSON",158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 200 , 200 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1457436008,"GAMBILL, STACY, JOHNSON",158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 221 , 221 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1457436008,"GAMBILL, STACY, JOHNSON",158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679824676,KIDZCARE PEDIATRICS PC,~,2501 S MEBANE ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457438129,"JONES, VICKIE, DENESE",2501 S MEBANE ST   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 44 , 47 , 117 ,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457439036,"VICKERS, HELEN, BARR",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1457439036,"VICKERS, HELEN, BARR",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 106 , 106 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1457439036,"VICKERS, HELEN, BARR",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457439036,"VICKERS, HELEN, BARR",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 299 , 302 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1457439036,"VICKERS, HELEN, BARR",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 438 , 440 ," $23,879.09 ",,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457439622,"MERTZ, DAVID, KIMO",530 W WEBB AVE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 34 , 69 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457439622,"MERTZ, DAVID, KIMO",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 18 , 36 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457439622,"MERTZ, DAVID, KIMO",3940 ARROWHEAD BLVD STE 270 MEBANE NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457440463,"RICHES, MARCIE, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457440620,"BIBER, JOSEPH, MOORE",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 48 , 64 , 100 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457440620,"BIBER, JOSEPH, MOORE",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 17 , 25 , 25 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457440620,"BIBER, JOSEPH, MOORE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457440620,"BIBER, JOSEPH, MOORE",1800 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 21 , 22 ,$#,,
MEDICAID DIRECT,1457443210,"MCCUEN, CHRISTINE, LEE",~,8 N POINTE CT   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1457443210,"MCCUEN, CHRISTINE, LEE",8 N POINTE CT   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1689673279,PIEDMONT NEPHROLOGY AND HYPERTENSIO,~,1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457444853,"HARNED, KEVIN, CHRISTIAN",1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 112 , 371 , 393 ," $15,013.86 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457445769,"ADEM, MUKHTAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 48 , 140 , 143 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457446163,"WALLENIUS, STEVEN, TODD",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 243 , 344 , 380 ,$#,,
MEDICAID DIRECT,1700548377,WESTERN NC COMMUNITY HEALTH SVCS,,1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457446163,"WALLENIUS, STEVEN, TODD",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 21 , 24 ,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457446163,"WALLENIUS, STEVEN, TODD",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 16 , 20 ,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457446163,"WALLENIUS, STEVEN, TODD",136 CREEKVIEW CT   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457448219,"HWANG, RICHARD, FANGYUAN",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 18 , 20 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457448219,"HWANG, RICHARD, FANGYUAN",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES PA,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,, 83 , 84 , 166 ,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457448474,"BOST, MANDY, TARANTINO",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457448565,"YARBROUGH, WENDELL, GRAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457448565,"YARBROUGH, WENDELL, GRAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 19 , 34 , 57 ,$#,,
MEDICAID DIRECT,1619205721,SHAUN OHEARN DDS PLLC,AFFORDABLE DENTURES - ASHEVILLE,1445 TUNNEL RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1457448862,"OHEARN, SHAUN, PALMER",1445 TUNNEL RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1548762347,SHAUN P OHEARN DDS PA,AFFORDABLE DENTURES & IMPLANTS - HENDERSONVILLE,210 HIGHLANDS SQUARE DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1457448862,"OHEARN, SHAUN, PALMER",210 HIGHLANDS SQUARE DR   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice," 1,052 "," 1,656 "," 6,771 "," $918,765.89 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1457448961,"STANLEY, SAMUEL, DAVID",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 47 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457448961,"STANLEY, SAMUEL, DAVID",DUKE HOSP SOUTH TRENT DR D   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457448961,"STANLEY, SAMUEL, DAVID",DUKE HOSP SOUTH TRENT DR D   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457448961,"STANLEY, SAMUEL, DAVID",DUKE HOSP SOUTH TRENT DR D   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457448961,"STANLEY, SAMUEL, DAVID",3643 N ROXBORO ST   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 28 , 29 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457449126,"LYDERS, ERIC, MATTHEW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457449795,"CONO, REBECCA, DYAN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457449795,"CONO, REBECCA, DYAN",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 29 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457449795,"CONO, REBECCA, DYAN",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 43 , 84 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457449795,"CONO, REBECCA, DYAN",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 24 ,$#,,
MEDICAID DIRECT,1144655903,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE WILKES,156 BOOMER COMMUNITY CENTER RD   BOOMER NC,097,Wilkes,193400000X,Group,Single Specialty,,1457450249,"HUBBARD, LAURA, MILES",5229 ROCK CREEK RD   HAYS NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144655903,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE WILKES,5229 ROCK CREEK RD   HAYS NC,097,Wilkes,193400000X,Group,Single Specialty,,1457450249,"HUBBARD, LAURA, MILES",5229 ROCK CREEK RD   HAYS NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 115 , 465 , 689 ,$#,,
MEDICAID DIRECT,1982669339,ADVANCED INTERVENTIONAL PAIN MANAGE,ADVANCED INTERVENTIONAL PAIN MANAGEMENT PA,,,Unknown,193400000X,Group,Single Specialty,,1457451064,"HODGES, ERNEST, SIDNEY",160 KIMEL FOREST DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457451742,"HAUGAN, CHARUL, GUPTA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457452260,"CHAUHAN, AJIT, SINGH",CARDIOLOGY CLINIC INC,1045 MAIN ST STE 1 DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1457452260,"CHAUHAN, AJIT, SINGH",1045 MAIN ST STE 1 DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 58 , 125 ,$#,,
MEDICAID DIRECT,1457452260,"CHAUHAN, AJIT, SINGH",CARDIOLOGY CLINIC INC,1045 MAIN ST STE 1 DANVILLE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1457452260,"CHAUHAN, AJIT, SINGH",1045 MAIN ST STE 1 DANVILLE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457454076,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04298,6435 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1457454076,NORTH CAROLINA CVS PHARMACY LLC,6435 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1457454126,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05568,801 N BROAD ST   EDENTON NC,021,Chowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457454126,NORTH CAROLINA CVS PHARMACY LLC,801 N BROAD ST   EDENTON NC,021,Chowan,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1457454126,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05568,801 N BROAD ST   EDENTON NC,021,Chowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1457454126,NORTH CAROLINA CVS PHARMACY LLC,801 N BROAD ST   EDENTON NC,021,Chowan,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1457454134,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07529,7201 KNIGHTDALE BLVD   KNIGHTDALE NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457454134,NORTH CAROLINA CVS PHARMACY LLC,7201 KNIGHTDALE BLVD   KNIGHTDALE NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1457454944,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04253,1433 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1457454944,NORTH CAROLINA CVS PHARMACY LLC,1433 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1457455123,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02561,4100 CARMEL RD STE F2 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1457455123,NORTH CAROLINA CVS PHARMACY LLC,4100 CARMEL RD STE F2 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457457186,"BUSH, DANA, MICHELLE",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 22 , 34 ,$#,,
MEDICAID DIRECT,1144486333,CONCORD WOMENS SPECIALTY CARE,CONCORD WOMENS SPECIALITY CARE,,,Unknown,193200000X,Group,Multi-Specialty,,1457457186,"BUSH, DANA, MICHELLE",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457457186,"BUSH, DANA, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 23 , 31 ,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457457186,"BUSH, DANA, MICHELLE",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376914283,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457458523,"WILLIAMS, PEVIN, EDWARD",3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457458788,"HANLON, CHARIN, LEE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 89 , 108 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1457458788,"HANLON, CHARIN, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ," $23,317.00 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457458788,"HANLON, CHARIN, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 268 , 271 ," $10,177.39 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457462897,"FORD, RUSSELL, PHILLIP ANSON",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 79 , 89 , 100 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457462897,"FORD, RUSSELL, PHILLIP ANSON",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457463549,"KONIDENA, SNEHALATHA",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457463549,"KONIDENA, SNEHALATHA",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457463861,"WALLER, CARRIE, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1235527151,DOWN EAST DIABETOLOGY PA,DOWN EAST DIABETOLOGY PA,2609 W ARLINGTON BLVD STE 106 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457463861,"WALLER, CARRIE, ELIZABETH",2609 W ARLINGTON BLVD STE 106 GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 17 , 21 , 50 ,$#,,
MEDICAID DIRECT,1700081072,GREG J PERENTISDDS PLLC,,5310 NC HIGHWAY 55 STE 103 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457464414,"WEST PERENTIS, RACHEL, ANN",1002 N CHURCH ST STE 402 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 2,741 "," 4,199 "," 17,276 "," $725,958.49 ",,
MEDICAID DIRECT,1558566836,RACHEL PERENTISDDS PA,~,1002 N CHURCH ST STE 402 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457464414,"WEST PERENTIS, RACHEL, ANN",1002 N CHURCH ST STE 402 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 3,081 "," 4,965 "," 20,010 "," $821,841.39 ",,
MEDICAID DIRECT,1457465437,HALSEY DRUG LLC,HALSEY DRUG COMPANY,55 S MAIN ST   SPARTA NC,003,Alleghany,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1457465437,HALSEY DRUG LLC,55 S MAIN ST   SPARTA NC,003,Alleghany,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1457465742,"CRANE, STEVEN, DOUGLAS",~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1457465742,"CRANE, STEVEN, DOUGLAS",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 27 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1457465742,"CRANE, STEVEN, DOUGLAS",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 27 , 36 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457466799,"MOSHESH, MALANA, KEIKO",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1679798029,NC DHHS CHILD AND FAMILY WELL-BEING,SHELBY CDSA,1429 E MARION ST STE 5 SHELBY NC,023,Cleveland,252Y00000X,Agencies,Early Intervention Provider Agency,,1457470056,"KISTLER, ELAINE, DIANNE",1429 E MARION ST STE 5 SHELBY NC,023,Cleveland,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 65 , 65 , 109 ," $22,270.21 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457470064,"MARTIN, KATHY, FRANCES",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457470064,"MARTIN, KATHY, FRANCES",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 18 , 21 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457470064,"MARTIN, KATHY, FRANCES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457470064,"MARTIN, KATHY, FRANCES",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 601 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457470064,"MARTIN, KATHY, FRANCES",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 601 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457470064,"MARTIN, KATHY, FRANCES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457471138,"CAREY, ERIN, TEETER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1457471138,"CAREY, ERIN, TEETER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457473852,"RENTZ, LISA, WERKHEISER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457473852,"RENTZ, LISA, WERKHEISER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 47 , 63 ,$#,,
MEDICAID DIRECT,1467113332,LANE & ASSOCIATES XLIII DDS PA,~,3445 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1457475691,"MORGAN, THOMAS",3445 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 126 , 210 , 651 ," $22,302.82 ",,
MEDICAID DIRECT,1861753741,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457479099,"BURKE, HENRY, LAWRENCE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457479099,"BURKE, HENRY, LAWRENCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457479099,"BURKE, HENRY, LAWRENCE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 29 , 47 , 53 ,$#,,
MEDICAID DIRECT,1457480667,"MCCULLOUGH SIMPSON, ERIKA, LYNN",FORTITUDE PSYCHOLOGICAL SERVICES,1804 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,1457480667,"MCCULLOUGH SIMPSON, ERIKA, LYNN",1804 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780231878,FORTITUDE PSYCHOLOGICAL SERVICES,,1804 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457480667,"MCCULLOUGH SIMPSON, ERIKA, LYNN",1804 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,PHC HOME HEALTH,1515 MOCKINGBIRD LN STE 520 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,1515 MOCKINGBIRD LN STE 520 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 14 , 34 , 34 ," $12,818.00 ",,
MEDICAID DIRECT,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,PHC HOME HEALTH,1515 MOCKINGBIRD LN STE 520 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,1515 MOCKINGBIRD LN STE 520 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 190 ," 38,537 "," 43,798 "," $6,922,998.44 ",,
MEDICAID DIRECT,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,PHC HOME HEALTH,1446 E GASTON ST STE 103 LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,1515 MOCKINGBIRD LN STE 520 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,PHC HOME HEALTH,1515 MOCKINGBIRD LN STE 520 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,1446 E GASTON ST STE 103 LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,PHC HOME HEALTH,1446 E GASTON ST STE 103 LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,1446 E GASTON ST STE 103 LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,PHC HOME HEALTH,119 SW MAYNARD RD STE 170 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1457482317,PERSONAL HOME CARE OF NORTH CAROLIN,119 SW MAYNARD RD STE 170 CARY NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1457484859,"BAILEY, FRANCES, WILEY",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 42 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1457484859,"BAILEY, FRANCES, WILEY",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 19 , 35 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1457484859,"BAILEY, FRANCES, WILEY",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457485658,CAROLINAS HOME CARE SERVICES INC,~,1107 W BROAD ST UNIT E   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,,1457485658,CAROLINAS HOME CARE SERVICES INC,1107 W BROAD ST UNIT E   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,,#," 2,386 "," 2,389 "," $345,593.55 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457486151,"LEIS, ANITA, SCHELBLE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1457486854,"HARRIS, JOEY, LEE",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 73 , 83 , 108 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1457486854,"HARRIS, JOEY, LEE",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 39 , 45 , 59 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1457486854,"HARRIS, JOEY, LEE",101 MEDICAL CIR   ROCKINGHAM NC,077,Richmond,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 14 , 17 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1457486854,"HARRIS, JOEY, LEE",220 FOUST ST STE C ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,, 40 , 45 , 53 ,$#,,
MEDICAID DIRECT,1437102381,CENTER FOR PEDIATRIC AND ADOLESCENT,CENTER FOR PEDIATRIC AND ADOLESCENT MEDICINE PA,136 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1457489973,"ABBOTT, KRISTI, DESHANNON",136 GATEWAY BLVD STE A MOORESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 43 , 72 ,$#,,
MEDICAID DIRECT,1235372681,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 100 CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1457492175,"GREENE, QUINCY, JUSTIN",730 MALCOLM BLVD. SUITE 100 CONNELLY SPRINGS NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 55 , 156 , 163 ,$#,,
MEDICAID DIRECT,1235372681,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,722 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1457492175,"GREENE, QUINCY, JUSTIN",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457514143,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1457492175,"GREENE, QUINCY, JUSTIN",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235372681,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 100 CONNELLY SPRINGS NC,012,Burke,193200000X,Group,Multi-Specialty,,1457492175,"GREENE, QUINCY, JUSTIN",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 40 , 82 , 89 ,$#,,
MEDICAID DIRECT,1235372681,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1457492175,"GREENE, QUINCY, JUSTIN",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457494254,"BOETTCHER, REBECCA, ANN",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457494254,"BOETTCHER, REBECCA, ANN",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457494346,"BEVILACQUA, REBECCA, KENT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457494346,"BEVILACQUA, REBECCA, KENT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 27 , 44 , 51 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457494346,"BEVILACQUA, REBECCA, KENT",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457496853,"GERSTEIN, MARY, JANE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457496853,"GERSTEIN, MARY, JANE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 14 , 31 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457496853,"GERSTEIN, MARY, JANE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 17 , 41 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457496853,"GERSTEIN, MARY, JANE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 22 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457496853,"GERSTEIN, MARY, JANE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457496853,"GERSTEIN, MARY, JANE",631 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 48 , 107 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457496853,"GERSTEIN, MARY, JANE",631 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 40 , 89 ,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457498289,"RODRIGUEZ COSTE, MICHELLE, AIMEE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 24 , 48 , 48 ,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457498289,"RODRIGUEZ COSTE, MICHELLE, AIMEE",200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 54 , 79 , 81 ,$#,,
MEDICAID DIRECT,1740331164,AZALEA GYNECOLOGY,,736 MEDICAL CENTER DR STE 102 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457498529,"FISHER, JESSICA, FRANCISCO",736 MEDICAL CENTER DR STE 102 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",3701 NW CARY PKWY STE 101 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",3701 NW CARY PKWY STE 101 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",3701 NW CARY PKWY STE 101 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 24 , 30 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",3701 NW CARY PKWY STE 101 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 59 , 71 , 106 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",3701 NW CARY PKWY STE 101 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",3701 NW CARY PKWY STE 101 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 29 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,783 DOCTORS CT STE C ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457499089,"LI, FRANKLIN, TAKHUNG",783 DOCTORS CT STE C ROXBORO NC,073,Person,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1063854057,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE KINGS MOUNTAIN INTERNAL,2202 CAROLINA PL STE 100 KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1457500316,"NEWELL, CARLEIGH, WHITAKER",2202 CAROLINA PL STE 100 KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 154 , 254 ,$#,,
MEDICAID DIRECT,1063854057,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE KINGS MOUNTAIN INTERNAL,2202 CAROLINA PL STE 100 KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1457500316,"NEWELL, CARLEIGH, WHITAKER",502 W KING ST STE A KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 50 , 79 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457502809,"WIRSING, CALLI, KAGE",3129 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 48 , 100 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457504268,"BEFERA, NICHOLAS, THOMAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 27 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457504268,"BEFERA, NICHOLAS, THOMAS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 70 , 79 , 202 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457504268,"BEFERA, NICHOLAS, THOMAS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457504268,"BEFERA, NICHOLAS, THOMAS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1457504383,AMORE HOME CARE SERVICES INC,~,2400 CROWNPOINT EXECUTIVE DR STE 100 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1457504383,AMORE HOME CARE SERVICES INC,2400 CROWNPOINT EXECUTIVE DR STE 100 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 3,177 "," 3,177 "," $211,762.19 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457504664,"JAWA, PANKAJ",1559 E BOOKER DAIRY RD STE B SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457504664,"JAWA, PANKAJ",1559 E BOOKER DAIRY RD STE B SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1457504664,"JAWA, PANKAJ",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 52 , 149 , 154 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457504664,"JAWA, PANKAJ",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 29 , 29 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457504664,"JAWA, PANKAJ",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 66 , 208 , 221 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1457506909,"ST JOHN, TODD, HAROLD",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1457506909,"ST JOHN, TODD, HAROLD",180 PARKWOOD DR   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 36 , 54 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1457506909,"ST JOHN, TODD, HAROLD",180 PARKWOOD DR   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1184370389,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM URGENT CARE - ELKIN,631 CC CAMP RD   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1457506909,"ST JOHN, TODD, HAROLD",180 PARKWOOD DR   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457510976,"RAUCH, KIMBERLY, KARRAT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 60 , 137 , 174 ," $27,094.10 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457510976,"RAUCH, KIMBERLY, KARRAT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 26 , 47 , 56 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1457510976,"RAUCH, KIMBERLY, KARRAT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1457510976,"RAUCH, KIMBERLY, KARRAT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 36 , 101 ," $33,056.00 ",,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457511412,"THAWANI, ANJALI, RAM",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457511412,"THAWANI, ANJALI, RAM",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 23 , 33 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,300 ASHVILLE AVE STE 240 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457511412,"THAWANI, ANJALI, RAM",300 ASHVILLE AVE STE 240 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1457511685,"ZIMMARDI, SHEILA, FAYE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 62 , 70 ,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457511743,"GRINMAN, LEV",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457512220,"CORBLEY, LAUREN, ELIZABETH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457512220,"CORBLEY, LAUREN, ELIZABETH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457512220,"CORBLEY, LAUREN, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457512220,"CORBLEY, LAUREN, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457512220,"CORBLEY, LAUREN, ELIZABETH",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457512220,"CORBLEY, LAUREN, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457512220,"CORBLEY, LAUREN, ELIZABETH",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1457512493,"LOCKEMER, HILLARY, ELIZABETH",120 HEALTHPLEX WAY   APEX NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457512493,"LOCKEMER, HILLARY, ELIZABETH",1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#, 15 ,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457512493,"LOCKEMER, HILLARY, ELIZABETH",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457512493,"LOCKEMER, HILLARY, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1265097695,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC ENDOCRINOLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457512493,"LOCKEMER, HILLARY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1457512691,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER AT CALHOUN DRIVE,240 CALHOUN DR   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457512691,NEW HANOVER COMMUNITY HEALTH CENTER,240 CALHOUN DR   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457513137,"PABALAN, MELISSA, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 27 , 76 , 81 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1457513327,"ORDRONNEAU, ROGER, ALAIN",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 39 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457513327,"ORDRONNEAU, ROGER, ALAIN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457513327,"ORDRONNEAU, ROGER, ALAIN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1457513327,"ORDRONNEAU, ROGER, ALAIN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1457513517,"AIRD, ANTHONY, LORENZO",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 44 , 44 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457513517,"AIRD, ANTHONY, LORENZO",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 106 , 106 ,$#,,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1457513590,"VAZQUEZ, ADRIAN",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 14 , 16 , 53 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457514200,"MCWEY, RYAN, PATRICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 44 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457514200,"MCWEY, RYAN, PATRICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 342 , 306 , 373 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457514200,"MCWEY, RYAN, PATRICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 72 , 79 , 93 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457515173,"DATAR, SUDHIR, VISHWAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457518037,"SABET, LEILA, MARLEEN",1021 DARRINGTON DR STE 101 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1457518037,"SABET, LEILA, MARLEEN",2007 WALNUT ST   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1457518037,"SABET, LEILA, MARLEEN",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457518524,"SALAMI, SAKA, ADEMOLA",925 N 4TH ST   WILMINGTON NC,065,New Hanover,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1457518813,"MYERS, LACI, JAMISON",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457521932,"TUCKER, ERIC, DEWAYNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457522252,"SHORTRIDGE, AMY, PARR",2721 X RAY DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457522252,"SHORTRIDGE, AMY, PARR",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457522252,"SHORTRIDGE, AMY, PARR",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 30 , 38 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457524324,"BENTLEY, ALEXANDRA, DENISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457524324,"BENTLEY, ALEXANDRA, DENISE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457525123,"GAINOR, LAUREN, HARMON",2131 S 17TH ST 2131 S 17TH STREET WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 46 , 49 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1457525354,"FOLLMER, KRISTA, JO",5118 N CROATAN HWY   KITTY HAWK NC,028,Dare,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457526659,"REIN, LINDSAY, ANNE MAGURA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457526659,"REIN, LINDSAY, ANNE MAGURA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457526659,"REIN, LINDSAY, ANNE MAGURA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457526659,"REIN, LINDSAY, ANNE MAGURA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457526667,"SCHUTT, MELISSA, ANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 82 , 82 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457533473,"BURGESS, ROXANNE, LYNN",11030 S TRYON ST STE 308 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 86 , 110 , 158 ,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1457534208,"BROWN, JESSICA, WADE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457534596,"FITZGERALD, TAMARA, NOEL",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457534596,"FITZGERALD, TAMARA, NOEL",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 57 , 86 , 92 ," $10,365.89 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457534596,"FITZGERALD, TAMARA, NOEL",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457534596,"FITZGERALD, TAMARA, NOEL",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457534596,"FITZGERALD, TAMARA, NOEL",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1457534919,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07943,8101 KENSINGTON DR   WAXHAW NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457534919,NORTH CAROLINA CVS PHARMACY LLC,8101 KENSINGTON DR   WAXHAW NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1457534919,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07943,8101 KENSINGTON DR   WAXHAW NC,090,Union,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1457534919,NORTH CAROLINA CVS PHARMACY LLC,8101 KENSINGTON DR   WAXHAW NC,090,Union,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#, 20 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457535197,"LEWIS, ROCHUNDA, PELMORE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457538316,"JAN, SOLOMON, A",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1457541906,"TRZEBIATOWSKI, MARGARET, IRENE",123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 51 , 90 ,$#,,
MEDICAID DIRECT,1225268170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,123 PROFESSIONAL PARK DR STE A LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1457541906,"TRZEBIATOWSKI, MARGARET, IRENE",123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457542300,"KENNEDY, NIKITA, CHARLES",NIKITA CHARLES KENNEDY,10121 GLENBURN LN   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1457542300,"KENNEDY, NIKITA, CHARLES",10121 GLENBURN LN   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 27 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457544637,"THANANOPAVARN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457544637,"THANANOPAVARN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 40 , 87 , 101 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457544637,"THANANOPAVARN, PAUL",1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 29 , 71 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457544637,"THANANOPAVARN, PAUL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 23 , 39 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,911 S HUGHES ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1457544637,"THANANOPAVARN, PAUL",911 S HUGHES ST   APEX NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457545279,"HODGE, BRYAN, KENNETH",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 41 , 45 ,$#,,
MEDICAID DIRECT,1679932776,B NABA DDS PLLC,SIX SIGMA DENTAL,9709 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457545386,"NABA, BUTHAYNA",9709 NORTHEAST PKWY STE 100 MATTHEWS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 460 , 890 ," 4,210 "," $170,990.52 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457547853,"HARRISON, ROBERT, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 45 , 45 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1457547853,"HARRISON, ROBERT, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457547853,"HARRISON, ROBERT, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 54 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457547853,"HARRISON, ROBERT, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 30 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1457547853,"HARRISON, ROBERT, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 23 , 39 ,$#,,
MEDICAID DIRECT,1649298548,ONSLOW OPHTHALMOLOGY PA,OFFICE PARK EYE CENTER,6 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1457548455,"ERGAS, HEATH, BRIAN",6 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 100 , 179 , 353 ," $10,370.11 ",,
MEDICAID DIRECT,1831567445,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST RHEUMATOLOGY - W,1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457549180,"BELFI, BRIAN, CAREY",1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 108 , 185 , 200 ,$#,,
MEDICAID DIRECT,1467789313,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INFUSION - WEST,1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457549180,"BELFI, BRIAN, CAREY",1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 35 , 92 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1457549198,"CALVERT, JUSTIN, ALLEN",2076 HIGHWAY 69 S   HAYESVILLE NC,022,Clay,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1457549198,"CALVERT, JUSTIN, ALLEN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1457549198,"CALVERT, JUSTIN, ALLEN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1457549198,"CALVERT, JUSTIN, ALLEN",975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 24 , 31 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457549198,"CALVERT, JUSTIN, ALLEN",975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1457549875,"ZIRKLE, ADAM, TREVOR",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457549875,"ZIRKLE, ADAM, TREVOR",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457549875,"ZIRKLE, ADAM, TREVOR",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457549875,"ZIRKLE, ADAM, TREVOR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457549875,"ZIRKLE, ADAM, TREVOR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1457549875,"ZIRKLE, ADAM, TREVOR",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1457549875,"ZIRKLE, ADAM, TREVOR",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1457550386,"DUFFEY, ROBERT, THOMAS",157 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 16 , 38 ,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1457550386,"DUFFEY, ROBERT, THOMAS",600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 99 , 187 , 435 ," $22,329.23 ",,
MEDICAID DIRECT,1013303080,ACCESS TELECARE PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1457551517,"SYED, TANVIR, UDDIN",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1457554263,"MUNRO, BRIAN, ERIC",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 627 , 901 ," 1,238 "," $19,688.51 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457556078,"FLOYD, BETH, NICOLE IDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457556078,"FLOYD, BETH, NICOLE IDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 27 , 36 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457556078,"FLOYD, BETH, NICOLE IDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457556078,"FLOYD, BETH, NICOLE IDA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1114964491,PIEDMONT MEDICAL SUPPLY INC,~,752 4TH ST SW   HICKORY NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457556441,"WARMUTH, DONNA, SWANSON",752 4TH ST SW   HICKORY NC,018,Catawba,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 18 , 15 , 33 ," $14,652.73 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457557548,"MISSICK, BENJAMIN, JAMES",5815 BLAKENEY PARK DR STE 200B CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 16 , 51 ,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1457561987,"OREM, SHEILA, MARIE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457565806,"TOWNSEND, BRENT, ARCHIBALD",3949 BROWNING PL   RALEIGH NC,092,Wake,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 132 , 137 , 164 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457565806,"TOWNSEND, BRENT, ARCHIBALD",3949 BROWNING PL   RALEIGH NC,092,Wake,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 34 , 34 , 43 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457565822,"SWEENEY, MEGHAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457571432,"PICKENS, JENNIFER, CAROL",412 S JONES ST   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457571432,"PICKENS, JENNIFER, CAROL",412 S JONES ST   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 162 , 361 , 505 ," $18,363.38 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457575383,"JAMES, DOMINIKA, LIPOWSKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 28 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457575383,"JAMES, DOMINIKA, LIPOWSKA",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457575383,"JAMES, DOMINIKA, LIPOWSKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457575383,"JAMES, DOMINIKA, LIPOWSKA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457575383,"JAMES, DOMINIKA, LIPOWSKA",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 84 , 101 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457576043,"HARDING, DAVID, WAYNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457576043,"HARDING, DAVID, WAYNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457576043,"HARDING, DAVID, WAYNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457576043,"HARDING, DAVID, WAYNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457576043,"HARDING, DAVID, WAYNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457576043,"HARDING, DAVID, WAYNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 101 , 167 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457576043,"HARDING, DAVID, WAYNE",3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457576571,"HASSLER, HEATHER, CARSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 70 , 80 , 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457577355,"WEAVER, DEBRA, SUE",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457577355,"WEAVER, DEBRA, SUE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1194744532,MOSES CONE MEDICAL SERVICES INC,LEBAUER ENDOSCOPY CENTER,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1457578023,"MCGREAL, NANCY, MARIE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457578023,"MCGREAL, NANCY, MARIE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1457579815,"STEVENSON, MARINA, LYNCH",1012 RIVERSHORE RD   ELIZABETH CITY NC,070,Pasquotank,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 30 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457580094,"PETRUNEY, JENNIE, SUE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457580870,"SELLER, AARON, ROBERT",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457580870,"SELLER, AARON, ROBERT",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 41 , 47 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457580870,"SELLER, AARON, ROBERT",35 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 38 , 42 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457580870,"SELLER, AARON, ROBERT",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 19 , 22 ,$#,,
MEDICAID DIRECT,1457913006,CAROMONT MEDICAL GROUP INC,CAROMONT FOOT AND ANKLE,2391 COURT DR STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457583429,"LANIER, THURMOND, DWYANE",2391 COURT DR STE 100 GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 90 , 128 , 189 ,$#,,
MEDICAID DIRECT,1457913006,CAROMONT MEDICAL GROUP INC,CAROMONT FOOT AND ANKLE,2391 COURT DR STE 100 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1457583429,"LANIER, THURMOND, DWYANE",2391 COURT DR STE 100 GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457913006,CAROMONT MEDICAL GROUP INC,CAROMONT FOOT AND ANKLE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457583429,"LANIER, THURMOND, DWYANE",2525 COURT DR   GASTONIA NC,036,Gaston,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 21 , 54 , 68 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457584831,"HAAKE, DANA, LINDSAY",10211 ALM ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457584831,"HAAKE, DANA, LINDSAY",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1457584831,"HAAKE, DANA, LINDSAY",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1457584831,"HAAKE, DANA, LINDSAY",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457584831,"HAAKE, DANA, LINDSAY",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457585432,"MCCANN, SCOTT, DESMOND",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457586448,"GERRALD, QUINCY, DILLON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1659340636,IMAGING SPECIALISTS PLLC,,750 OLD HICKORY BLVD BLDG 1-260 BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1457586562,"DALE, JARROD, DONALD",750 OLD HICKORY BLVD STE 1-260 BRENTWOOD TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1457586851,"DAVIS, JOSEPH, THOMAS",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457588915,"ODUNUSI, OLUWOLE, ADEMOLA",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 77 , 86 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457588915,"ODUNUSI, OLUWOLE, ADEMOLA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 22 , 36 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457588915,"ODUNUSI, OLUWOLE, ADEMOLA",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 75 , 134 , 192 ," $13,044.38 ",,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1457589186,"SPRINGER, RACHAEL, TRICIA",1 MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1457589533,"ISAACS, KAREN, MELINDA",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 85 , 134 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457589939,"YARBROUGH, CHESTER, KOSSMAN",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457589939,"YARBROUGH, CHESTER, KOSSMAN",1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,,,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457589939,"YARBROUGH, CHESTER, KOSSMAN",1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457589939,"YARBROUGH, CHESTER, KOSSMAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,,,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457589939,"YARBROUGH, CHESTER, KOSSMAN",1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 49 , 71 , 77 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457589970,"MCKEE, ELLIOT, CAPERS",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 101 , 130 , 164 ," $10,583.48 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,400 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457589970,"MCKEE, ELLIOT, CAPERS",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457589970,"MCKEE, ELLIOT, CAPERS",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 104 , 134 , 182 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457590044,"PERALTA, NICOLE, RACAZA",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457590044,"PERALTA, NICOLE, RACAZA",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457590507,"BATES, CRYSTAL, AMMONS",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699779280,TOTAL REHAB ORTHOTICS AND PROSTHETI,Total Rehab Orthotics and Prosthetics Inc,234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457591414,"MARCHANT, HEATHER, FOUST",234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1699779280,TOTAL REHAB ORTHOTICS AND PROSTHETI,Total Rehab Orthotics and Prosthetics Inc,234 OWEN DR   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457591414,"MARCHANT, HEATHER, FOUST",2407 N ELM ST   LUMBERTON NC,078,Robeson,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#, 11 ,$#,,
MEDICAID DIRECT,1235133943,TOTAL REHAB ORTHOTICS AND PROSTHETI,Total Rehab Orthotics and Prosthetics Inc,2407 N ELM ST   LUMBERTON NC,078,Robeson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457591414,"MARCHANT, HEATHER, FOUST",2407 N ELM ST   LUMBERTON NC,078,Robeson,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457591646,"JONES, SHEENA, SHEVETTE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457591646,"JONES, SHEENA, SHEVETTE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457591646,"JONES, SHEENA, SHEVETTE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457591646,"JONES, SHEENA, SHEVETTE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 18 , 22 ,$#,,
MEDICAID DIRECT,1164500575,CHILDRENS HEALTH SERVICES PA,~,1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457591653,"SENATORE, AMANDA, LEE",1826 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 29 , 82 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457594301,"LAPPE, JASON, MICHAEL",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 21 , 41 , 68 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457594301,"LAPPE, JASON, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457594301,"LAPPE, JASON, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 52 , 152 , 237 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457594517,"JIANG, XIAOYIN",2100 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457594517,"JIANG, XIAOYIN",2100 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457594913,"POWELL, ALISON, SCHMIDT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 113 , 146 , 148 ,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457595456,"DECLAIRE, MELODY, JOY",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 27 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457598914,"MICHAIL, EYOB, ESTIFANOS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457598914,"MICHAIL, EYOB, ESTIFANOS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457598914,"MICHAIL, EYOB, ESTIFANOS",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1457598914,"MICHAIL, EYOB, ESTIFANOS",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457598914,"MICHAIL, EYOB, ESTIFANOS",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 300 , 310 ," $11,516.08 ",,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1457598914,"MICHAIL, EYOB, ESTIFANOS",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1457601106,"SHAH, NISHANT, PRASHANT",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457601106,"SHAH, NISHANT, PRASHANT",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 46 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457601106,"SHAH, NISHANT, PRASHANT",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457601106,"SHAH, NISHANT, PRASHANT",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 35 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457601106,"SHAH, NISHANT, PRASHANT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 63 , 114 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457601429,"POOLE, TIFFANY, FLETCHER",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 42 , 45 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1457603508,"HENKEL, AMY, JO",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1689209553,MURPHY MEDICAL CENTER INC,,125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457604092,"THOMPSON, SAMANTHA, KEPHART",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 136 , 140 ,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1457604092,"THOMPSON, SAMANTHA, KEPHART",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1457604092,"THOMPSON, SAMANTHA, KEPHART",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 44 , 44 ," $17,424.00 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457606675,"METZLER, JESSICA, LEIGH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1457608788,"BARRETT, NATHANIEL, MORGAN",401 N MAIN ST   KENANSVILLE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457608788,"BARRETT, NATHANIEL, MORGAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 60 , 65 ,$#,,
MEDICAID DIRECT,1861747479,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS INDIAN TRAIL PEDIA,6030 W HIGHWAY 74 STE F INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1457610891,"KAAGAZA, MILDRED",6030 W HIGHWAY 74 STE F INDIAN TRAIL NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 60 , 130 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457611337,"CHRISTIANTO, MARIO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457612160,"GRIER, CHERECE, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457612160,"GRIER, CHERECE, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 53 ,$#,,
MEDICAID DIRECT,1316346976,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ENT,1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457614703,"SCHRANK, TRAVIS, PARKE",1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 21 , 40 , 58 ,$#,,
MEDICAID DIRECT,1316346976,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ENT,1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457614703,"SCHRANK, TRAVIS, PARKE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457614703,"SCHRANK, TRAVIS, PARKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 30 , 58 , 100 ,$#,,
MEDICAID DIRECT,1194124362,IN-HOUSE DOC INC,,308 W MEADOWVIEW RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1457615569,"COADY, ANITA, COLLEEN",1721 BALD HILL LOOP   MADISON NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1194124362,IN-HOUSE DOC INC,,,,Unknown,193400000X,Group,Single Specialty,,1457615569,"COADY, ANITA, COLLEEN",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1194124362,IN-HOUSE DOC INC,,1721 BALD HILL LOOP   MADISON NC,079,Rockingham,193400000X,Group,Single Specialty,,1457615569,"COADY, ANITA, COLLEEN",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457615585,"HISADA, REINA",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1730407131,ARMC PHYSICIANS CARE INC,ALAMANCE REGIONAL PSYCHIATRIC ASSOCIATES,1225 HUFFMAN MILL RD STE 205 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457615585,"HISADA, REINA",1225 HUFFMAN MILL RD STE 202 BURLINGTON NC,001,Alamance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1730407131,ARMC PHYSICIANS CARE INC,ALAMANCE REGIONAL PSYCHIATRIC ASSOCIATES,,,Unknown,193200000X,Group,Multi-Specialty,,1457615585,"HISADA, REINA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,621 S MAIN ST STE 200   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1457615585,"HISADA, REINA",621 S MAIN ST STE 200 REIDSVILLE NC,079,Rockingham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457618084,"DEESE, SHAUN, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457618084,"DEESE, SHAUN, MICHAEL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 81 , 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457620718,"LAM, MARGARET",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457620718,"LAM, MARGARET",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457621112,"PIGGOTT, MARCIA, LORELEI",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",7010 NC 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",724 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6010 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457622862,"STEGALL, STACIE, LEDFORD",1311 E MILLBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457630915,"ADDEPALLI, SRIKALA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457630915,"ADDEPALLI, SRIKALA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457630915,"ADDEPALLI, SRIKALA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 39 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457630931,"JAMES, KRISTIN, DEBORD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 TECHNOLOGY DR STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457633752,"SULLIVAN, AMANDA, ALLIEN VIVIAN",100 TECHNOLOGY DR STE A ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1942624218,UNC PHYSICIANS NETWORK LLC,~,163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1457634248,"DOLLESCHEL, EMILY, KNIGHT",163 MEDICAL PARK DR STE 210 SILER CITY NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 115 , 196 ,$#,,
MEDICAID DIRECT,1457639031,THE 4C COMPANY OF NC,~,240 CHURCH ST NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1457639031,THE 4C COMPANY OF NC,240 CHURCH ST NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,, 12 , 104 , 106 ,$#,,
MEDICAID DIRECT,1457639031,THE 4C COMPANY OF NC,~,240 CHURCH ST NE   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1457639031,THE 4C COMPANY OF NC,240 CHURCH ST NE   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 61 ," 14,557 "," 14,678 "," $1,065,338.08 ",,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457639411,"MUPPAVARAPU, SANGEETHA",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 90 , 148 , 303 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1457641995,"MERRITT, MATTHEW, JUSTIN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 37 , 47 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457641995,"MERRITT, MATTHEW, JUSTIN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 63 , 63 , 68 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457641995,"MERRITT, MATTHEW, JUSTIN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457641995,"MERRITT, MATTHEW, JUSTIN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457641995,"MERRITT, MATTHEW, JUSTIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 91 , 98 , 116 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1457641995,"MERRITT, MATTHEW, JUSTIN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457642134,"BODENHEIMER, NICHOLAS",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457642134,"BODENHEIMER, NICHOLAS",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 21 , 22 ," $10,397.65 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457642134,"BODENHEIMER, NICHOLAS",1456 N HOWE ST STE 201 SOUTHPORT NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457642134,"BODENHEIMER, NICHOLAS",509 OLDE WATERFORD WAY STE 200 LELAND NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 22 , 36 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457642134,"BODENHEIMER, NICHOLAS",75 EMERSON BAY RD STE 104 CAROLINA SHORES NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457642134,"BODENHEIMER, NICHOLAS",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 64 , 77 , 102 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1457642605,"CARROLL, SARAH, BASS",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 54 , 129 , 133 ,$#,,
MEDICAID DIRECT,1457645046,"MOORE, DANIEL, GREGG",WESTERN WAKE FAMILY DENTISTRY,8755 HOLLY SPRINGS RD   APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1457645046,"MOORE, DANIEL, GREGG",8755 HOLLY SPRINGS RD   APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 36 , 100 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457645269,"DOWNS, JAIRON, DANIEL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457645269,"DOWNS, JAIRON, DANIEL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457645269,"DOWNS, JAIRON, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 73 , 89 , 89 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457645269,"DOWNS, JAIRON, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 65 , 78 , 78 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457645269,"DOWNS, JAIRON, DANIEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 62 , 62 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457645269,"DOWNS, JAIRON, DANIEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 27 , 107 , 107 ,$#,,
MEDICAID DIRECT,1164493615,COMMUNITY FAMILY PRACTICE PA,,260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1457646499,"YOUNG, MARY, ELIZABETH",260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 38 , 77 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457647380,"WISDA, MICHELLE, HARRELSON",430 RANKIN DR   MARION NC,059,McDowell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1457647604,"KELLAWAY, CAROLYN, GREEN",~,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1457647604,"KELLAWAY, CAROLYN, GREEN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 27 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1457647604,"KELLAWAY, CAROLYN, GREEN",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 187 , 384 , 871 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1457649501,"COOPER, KAREEM, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457649501,"COOPER, KAREEM, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1457649501,"COOPER, KAREEM, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1457649501,"COOPER, KAREEM, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 24 , 31 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 41 , 55 , 107 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457650566,"SHARMA, SUNITA",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 47 , 55 , 102 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457650699,"MARCOTTE, JEFFREY, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 44 , 69 ,$#,,
MEDICAID DIRECT,1831130798,BENSON AREA MEDICAL CENTER INC,BENSON HEALTH,3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457651077,"CARTER, CARMELLA, ROCHELLE",105 TRACY LN   DUNN NC,043,Harnett,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1831130798,BENSON AREA MEDICAL CENTER INC,BENSON HEALTH,3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457651077,"CARTER, CARMELLA, ROCHELLE",3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457652877,"LOMBARD, JEFFREY, CHARLES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1457653727,"GUMPERT, JULIA, ANNA LYN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1457653727,"GUMPERT, JULIA, ANNA LYN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 38 , 38 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2807 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457653727,"GUMPERT, JULIA, ANNA LYN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457654204,"FOWLER, SHANNON, MARTIN",845 CHURCH ST N STE 203 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457654204,"FOWLER, SHANNON, MARTIN",280 EXECUTIVE PARK DR   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 30 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1457655953,"ADAMO, ASHLEY, DAWN",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457656100,HUMPHREY PLUS ONE INC,HUMPHREY FAMILY CARE HOME,6245 BURTON CHAPEL RD   MEBANE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1457656100,HUMPHREY PLUS ONE INC,6245 BURTON CHAPEL RD   MEBANE NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 40 ," 8,736 "," 8,766 "," $546,013.96 ",,
MEDICAID DIRECT,1457656100,HUMPHREY PLUS ONE INC,HUMPHREY FAMILY CARE HOME,6245 BURTON CHAPEL RD   MEBANE NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1457656100,HUMPHREY PLUS ONE INC,6245 BURTON CHAPEL RD   MEBANE NC,017,Caswell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 59 ," 5,603 "," 5,715 "," $815,502.50 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457657348,"JOHNSON, ROBERT, WILLIAM",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457657348,"JOHNSON, ROBERT, WILLIAM",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1457657348,"JOHNSON, ROBERT, WILLIAM",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1800 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1457657348,"JOHNSON, ROBERT, WILLIAM",1800 N SANDHILLS BLVD STE B ABERDEEN NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 45 , 100 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457658593,"HAMRICK, CHELLYN, WILLIAMSON",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457658593,"HAMRICK, CHELLYN, WILLIAMSON",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 80 , 139 , 211 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457659336,"WINSTEAD, VICTORIA, LYNNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457662041,"WILLIAMS, EMILY, BEASLEY",215 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457662819,"BAKER, NEAL, JORDAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 68 , 73 ,$#,,
MEDICAID DIRECT,1457662843,MONARCH,~,5700 EXECUTIVE CENTER DR STE 110 CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1457662843,MONARCH,5700 EXECUTIVE CENTER DR STE 110 CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,#,,,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",121 N CHURCH ST   CONWAY NC,066,Northampton,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 32 , 60 , 60 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",129 HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 46 , 46 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",115 EXETER ST   MANTEO NC,028,Dare,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",211 VIRGINIA RD   EDENTON NC,021,Chowan,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 75 , 75 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",1840 W CITY DR   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 42 , 42 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",210 OCEAN HWY S   HERTFORD NC,072,Perquimans,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 38 , 38 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 34 , 95 , 99 ,$#,,
MEDICAID DIRECT,1861555799,ALBEMARLE NEPHROLOGY PLLC,ALBEMARLE NEPHROLOGY PLLC,206 HASTINGS LN   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457663155,"SHABBIR, QURATULAIN",101 DAVITA LN   ELIZABETH CITY NC,070,Pasquotank,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 39 , 39 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 52 , 88 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",3515 W MARKET ST STE 110 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 160 , 209 , 211 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",3515 W MARKET ST STE 110 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 59 , 104 , 199 ,$#,,
MEDICAID DIRECT,1568973360,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH CARDIOLOGY GREENSBORO,3515 W MARKET ST STE 110 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",3515 W MARKET ST STE 110 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",3515 W MARKET ST STE 110 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457664880,"BADAL, MADAN, KUMAR",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1457665093,"WADDINGTON, ERIC, PRESTON",155 MEMORIAL DR   PINEHURST NC,063,Moore,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 101 , 239 , 239 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457665150,"KING, NICOLE, LYNNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457665150,"KING, NICOLE, LYNNE",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1457665424,"VAN HORN, JOANNE, BEECHER",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457665424,"VAN HORN, JOANNE, BEECHER",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,666 W CORBETT AVE   SWANSBORO NC,067,Onslow,193200000X,Group,Multi-Specialty,,1457665424,"VAN HORN, JOANNE, BEECHER",666 W CORBETT AVE   SWANSBORO NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 30 , 61 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457665994,"BINGHAM, JOHN, WILLIAM",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457666141,A PLUS HOME HEALTH CARE SERVICES L,A PLUS HOME HEALTH CARE SERVICES LLC,2932 BREEZEWOOD AVE STE 211 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1457666141,A PLUS HOME HEALTH CARE SERVICES L,2932 BREEZEWOOD AVE STE 211 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 53 ," 10,897 "," 11,151 "," $1,051,544.85 ",,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457667446,"TYLER, LINDSEY, HUGHES",600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 141 , 260 , 260 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457667446,"TYLER, LINDSEY, HUGHES",2412 PROFESSIONAL DR   ROCKY MOUNT NC,064,Nash,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 20 , 37 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1457667446,"TYLER, LINDSEY, HUGHES",257 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457670606,"ELFERSY, ADRIAN, JAY",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,645 AMALIA ST NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457670606,"ELFERSY, ADRIAN, JAY",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457670606,"ELFERSY, ADRIAN, JAY",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 27 , 48 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457670606,"ELFERSY, ADRIAN, JAY",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 139 , 216 , 326 ," $11,048.64 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,530 CORPORATE CIR   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1457670606,"ELFERSY, ADRIAN, JAY",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457671489,"TODD, DANA, LYTRICE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 105 , 248 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457671489,"TODD, DANA, LYTRICE",1821 HILLANDALE RD STE 24B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 27 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457671711,"REDMON, BENJAMIN, FRANCIS",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457671711,"REDMON, BENJAMIN, FRANCIS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 51 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457671711,"REDMON, BENJAMIN, FRANCIS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 23 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2905 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457671711,"REDMON, BENJAMIN, FRANCIS",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457671711,"REDMON, BENJAMIN, FRANCIS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457671711,"REDMON, BENJAMIN, FRANCIS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205694072,CHAVALA M HARRIS DDS PA,OAK GROVE FAMILY & COSMETIC DENTISTRY,103 GANYARD FARM WAY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1457671786,"HARRIS, CHAVALA, MELITA",103 GANYARD FARM WAY   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 219 , 466 ," 1,861 "," $66,719.07 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457671901,"THOMAS, NEEL, GEORGE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457671901,"THOMAS, NEEL, GEORGE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 53 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457671901,"THOMAS, NEEL, GEORGE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457671901,"THOMAS, NEEL, GEORGE",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457671901,"THOMAS, NEEL, GEORGE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 28 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457671935,"REED, LISA, NIEDERGESES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 80 , 81 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457671935,"REED, LISA, NIEDERGESES",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 57 , 121 ,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457671935,"REED, LISA, NIEDERGESES",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457671935,"REED, LISA, NIEDERGESES",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457671935,"REED, LISA, NIEDERGESES",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 64 , 64 ," $10,091.70 ",,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457671935,"REED, LISA, NIEDERGESES",218 ELKWOOD AVE STE 102 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 39 ,$#,,
MEDICAID DIRECT,1174092449,SPARTANBURG MEDICAL CENTER,MEDGRPOFTHECAROLINAS-CAROLINAFAMILYPHYSICIAN,1690 SKYLYN DR STE 210 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457672289,"BURRELL, TIMOTHY, JOHN",2191 SOUTHPORT RD   SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790370997,SDC KL LLC,,284 TADPOLE LN   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1457672420,"KANLI, EROL, JOHN",22 DAYFLOWER DR   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 2,069 "," 6,057 "," 14,187 "," $851,485.80 ",,
MEDICAID DIRECT,1962131656,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2695 HENDERSONVILLE ROAD SUITE 202,2695 HENDERSONVILLE RD STE 202 ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457672917,"BEASLEY, EVAN, RUEBEN",2695 HENDERSONVILLE RD STE 202 ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457672917,"BEASLEY, EVAN, RUEBEN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952030652,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-611B FIFTH AVENUE WEST,611 B FIFTH AVE W   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457672917,"BEASLEY, EVAN, RUEBEN",611 5TH AVE W STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 32 ,$#,,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1457674855,"SPENCER, JEREMY, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1457676389,TARHEEL SPEECH AND LANGUAGE SERVICE,~,211 COLVARD PARK DR   DURHAM NC,019,Chatham,193400000X,Group,Single Specialty,,1457676389,TARHEEL SPEECH AND LANGUAGE SERVICE,211 COLVARD PARK DR   DURHAM NC,019,Chatham,193400000X,Group,Single Specialty,, 14 , 117 , 117 ,$#,,
MEDICAID DIRECT,1457679235,INFINITY HEALTHCARE SERVICES INC,INFINITY HEALTH CARE SERVICES INC,118 E ELIZABETH ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1457679235,INFINITY HEALTHCARE SERVICES INC,118 E ELIZABETH ST   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 3,958 "," 3,958 "," $259,575.88 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457679904,"ABANILLA, MARIA, ZENAIDA",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457680183,"JOHN, JISHA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457680183,"JOHN, JISHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 20 , 46 , 49 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457680183,"JOHN, JISHA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457680183,"JOHN, JISHA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457680183,"JOHN, JISHA",2304 WESVILL CT STE 240 RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,2304 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457680183,"JOHN, JISHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 20 , 46 , 46 ,$#,,
MEDICAID DIRECT,1497431837,WAKEMED SPECIALISTS GROUP LLC,WAKEMED INFECTIOUS DISEASE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457680183,"JOHN, JISHA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457681306,"PRATER, CHRISTOPHER, WILLIAM",3116 N DUKE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 78 , 135 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457681306,"PRATER, CHRISTOPHER, WILLIAM",3116 N DUKE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1457682064,PIEDMONT HEALTHCARE PA,Piedmont Healthcare PA,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1457682064,PIEDMONT HEALTHCARE PA,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 79 , 83 , 133 ,$#,,
MEDICAID DIRECT,1457693301,NURTURING NURSES HOMECARE INC,,10915 DOWNS RD   PINEVILLE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1457693301,NURTURING NURSES HOMECARE INC,10915 DOWNS RD   PINEVILLE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#, 47 , 250 ," $60,735.48 ",,
MEDICAID DIRECT,1457693301,NURTURING NURSES HOMECARE INC,,10915 DOWNS RD   PINEVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1457693301,NURTURING NURSES HOMECARE INC,10915 DOWNS RD   PINEVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 33 ," 6,578 "," 6,723 "," $587,142.56 ",,
MEDICAID DIRECT,1083930671,PRIVATE DIAGNOSTIC CLINIC PLLC,DUKE MED PEDS AT ROXBORO ST,,,Unknown,193200000X,Group,Multi-Specialty,,1457694143,"LEE, YU-LIN, AMY",4020 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457694143,"LEE, YU-LIN, AMY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 21 , 23 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457694143,"LEE, YU-LIN, AMY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 21 , 28 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457694143,"LEE, YU-LIN, AMY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457694143,"LEE, YU-LIN, AMY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457694143,"LEE, YU-LIN, AMY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457700999,"DONALDSON, BRITTANY, CHRISTINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457701955,"CLOSE, JEYLAN, SUZAN",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457701955,"CLOSE, JEYLAN, SUZAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457702193,"ROONEY, KEVIN, PATRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1457703837,"EAKER, ZACHARY, YATES",2555 COURT DR STE 460 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457703837,"EAKER, ZACHARY, YATES",,2555 COURT DR STE 460 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1457703837,"EAKER, ZACHARY, YATES",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1457703837,"EAKER, ZACHARY, YATES",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457703837,"EAKER, ZACHARY, YATES",2555 COURT DR STE 460 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457703837,"EAKER, ZACHARY, YATES",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,600 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457706442,"DILLEY, JOSHUA, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1457706442,"DILLEY, JOSHUA, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 68 , 80 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,10 MEDICAL PARK DR STE 1 LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1457706442,"DILLEY, JOSHUA, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457706442,"DILLEY, JOSHUA, RICHARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 78 , 467 , 671 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457709222,"SULLIVAN, CHRISTOPHER, BLAKE",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457709222,"SULLIVAN, CHRISTOPHER, BLAKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 46 , 69 , 109 ,$#,,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10111 DIVISION DR   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1457711574,HEALTH & HOME SERVICES INC,10111 DIVISION DR   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#, 77 , 77 ," $31,343.00 ",,
MEDICAID DIRECT,1457711574,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,10111 DIVISION DR   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1457711574,HEALTH & HOME SERVICES INC,10111 DIVISION DR   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,, 16 ," 1,329 "," 1,450 "," $672,868.75 ",,
MEDICAID DIRECT,1194893438,HEALTH & HOME SERVICES INC,THRIVE SKILLED PEDIATRIC CARE,1333 2ND ST NE STE 202 HICKORY NC,018,Catawba,251J00000X,Agencies,Nursing Care,,1457711574,HEALTH & HOME SERVICES INC,10111 DIVISION DR   RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#, 186 , 186 ," $73,437.00 ",,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457714446,"STYLES, CHANTEL, REEVES",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 18 , 30 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457714446,"STYLES, CHANTEL, REEVES",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326374307,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE MOUNTAIN ISLAND FAMILY,9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457714446,"STYLES, CHANTEL, REEVES",9908 COULOAK DR STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 40 , 65 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457714446,"STYLES, CHANTEL, REEVES",9908 COULOAK DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 21 , 27 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1457717472,"SCHAFFER, DAVID, WILLIAM",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 86 , 97 , 108 ,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1457719049,"HENDRICKSON, SARAH, FULTON",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 24 ,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457719049,"HENDRICKSON, SARAH, FULTON",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 27 ,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457719049,"HENDRICKSON, SARAH, FULTON",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457719049,"HENDRICKSON, SARAH, FULTON",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 18 , 27 ,$#,,
MEDICAID DIRECT,1184202830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457719049,"HENDRICKSON, SARAH, FULTON",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457729998,"SORIANO, CATHERINE",3793 MCDOWELL LN STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457729998,"SORIANO, CATHERINE",1204 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457730707,"GEESON, DEVINN, LYNN",,3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,1457730707,"GEESON, DEVINN, LYNN",3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 72 , 79 , 260 ," $14,052.44 ",,
MEDICAID DIRECT,1033794300,LANE AND ASSOCIATES XLI DDS PA,,571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1457730707,"GEESON, DEVINN, LYNN",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457732356,"DUKE, ANGELA, NICOLE",1220 MAGNOLIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457732356,"DUKE, ANGELA, NICOLE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 37 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457732356,"DUKE, ANGELA, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457732406,"BARKER, ROBERT, CHESTER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1457732406,"BARKER, ROBERT, CHESTER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457732406,"BARKER, ROBERT, CHESTER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457733750,"ISAACS, ERIKA, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457734659,"CHARILAOU, PARIS",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457734659,"CHARILAOU, PARIS",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457734659,"CHARILAOU, PARIS",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 32 , 44 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457738072,"NGO, LAWRENCE",1108 VALLEY ROSE WAY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346680543,MONARCH,~,809 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457741746,"ALEXANDER, SANDRA, TIFFANY",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1255769618,MONARCH,~,311 MCBEE ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457741746,"ALEXANDER, SANDRA, TIFFANY",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457741746,"ALEXANDER, SANDRA, TIFFANY",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1013549302,EYECARECENTER OD PA,,303 SALISBURY AVE   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1457745838,"HART, KEVIN",1007 SKYWAY DR STE A MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,, 16 , 25 , 32 ,$#,,
MEDICAID DIRECT,1013549302,EYECARECENTER OD PA,,303 SALISBURY AVE   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1457745838,"HART, KEVIN",303 SALISBURY AVE   ALBEMARLE NC,084,Stanly,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457747057,"STECHSCHULTE, PAUL, JEFFREY",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 ,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457747057,"STECHSCHULTE, PAUL, JEFFREY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457747057,"STECHSCHULTE, PAUL, JEFFREY",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457747057,"STECHSCHULTE, PAUL, JEFFREY",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 31 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457747057,"STECHSCHULTE, PAUL, JEFFREY",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 32 , 45 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457747057,"STECHSCHULTE, PAUL, JEFFREY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 27 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457747057,"STECHSCHULTE, PAUL, JEFFREY",509 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457747842,"HOOKER, NEEMA",4444 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 48 , 50 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457747842,"HOOKER, NEEMA",4444 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457747842,"HOOKER, NEEMA",101 PLAZA RD   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457748378,"NARANG, GOPAL, LAKHI",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 39 , 69 , 103 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE L KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1457748378,"NARANG, GOPAL, LAKHI",701 DOCTORS DR STE L KINSTON NC,054,Lenoir,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1457748378,"NARANG, GOPAL, LAKHI",75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457749483,"PATTAN, SETH, WILLIAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457749483,"PATTAN, SETH, WILLIAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457749483,"PATTAN, SETH, WILLIAM",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457749483,"PATTAN, SETH, WILLIAM",2183 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457749483,"PATTAN, SETH, WILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1457749483,"PATTAN, SETH, WILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003227893,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER NEW BERN,4007 M L KING JR BLVD   NEW BERN NC,025,Craven,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457750267,"HANCOCK, VIRGINIA, CHRISTEL",4007 M L KING JR BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457750267,"HANCOCK, VIRGINIA, CHRISTEL",4007 M L KING JR BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1457750267,"HANCOCK, VIRGINIA, CHRISTEL",4007 M L KING JR BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457750267,"HANCOCK, VIRGINIA, CHRISTEL",444 SW CENTER ST   FAISON NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457752248,"BELL, SARAH, HEATHER",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 48 , 52 , 66 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457752248,"BELL, SARAH, HEATHER",15419 HODGES CIR STE 100 HUNTERSVILLE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457754566,"FERRANDIZ, SONIA, CLAIRE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457754566,"FERRANDIZ, SONIA, CLAIRE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457754566,"FERRANDIZ, SONIA, CLAIRE",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457760589,"PULLEY, RUTH, ARMSTRONG",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457761181,"MISTROT, DANIEL, PAUL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457761181,"MISTROT, DANIEL, PAUL",7210 VILLAGE MEDICAL CIR STE 310 CLEMMONS NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 38 , 67 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457761181,"MISTROT, DANIEL, PAUL",770 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457761181,"MISTROT, DANIEL, PAUL",1471 JAG BRANCH BLVD UNIT 105 KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457761181,"MISTROT, DANIEL, PAUL",2825 LYNDHURST AVE STE 101 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457761181,"MISTROT, DANIEL, PAUL",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457761637,"VERLANGIERI, ANNE, MARIE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457761637,"VERLANGIERI, ANNE, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 65 , 99 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457761637,"VERLANGIERI, ANNE, MARIE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1457761637,"VERLANGIERI, ANNE, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 12 , 16 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457761637,"VERLANGIERI, ANNE, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1457761637,"VERLANGIERI, ANNE, MARIE",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457761736,"FRANCISCO, JULIE, GEORGEAN",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457761736,"FRANCISCO, JULIE, GEORGEAN",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 104 , 104 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457762171,"HANNIGAN, STEVEN, JOSEPH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457762171,"HANNIGAN, STEVEN, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 87 , 89 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457762171,"HANNIGAN, STEVEN, JOSEPH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 80 , 141 , 297 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 46 , 75 , 174 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457762502,"WILLETT, KEIRNAN, LOVEWELL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1457763245,"PASSARO, CANDACE, PARKS",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457763476,"ACHARYA, SUNEETA, KUMARI",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457763476,"ACHARYA, SUNEETA, KUMARI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 39 , 41 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457766123,"MANDELIA, CHETAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 44 , 49 , 52 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457766123,"MANDELIA, CHETAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457767550,"PFRIMMER, VIRGINIA, ARLINE",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457770380,"LOW, JUSTIN, THOMAS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457770380,"LOW, JUSTIN, THOMAS",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457770380,"LOW, JUSTIN, THOMAS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1669515953,COUNTY OF GRAHAM,GRAHAM COUNTY HEALTH DEPT,191 P AND J RD   ROBBINSVILLE NC,038,Graham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1457771826,"GANS, BENJAMIN, CODY",21 S MAIN ST   ROBBINSVILLE NC,038,Graham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 65 , 142 ,$#,,
MEDICAID DIRECT,1407428931,SMOKY MOUNTAIN URGENT CARE,,80 VETERANS BLVD   BRYSON CITY NC,087,Swain,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457771826,"GANS, BENJAMIN, CODY",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 51 , 51 ,$#,,
MEDICAID DIRECT,1952075335,SMOKY MOUNTAIN URGENT CARE,,120 VETERANS BLVD   BRYSON CITY NC,087,Swain,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457771826,"GANS, BENJAMIN, CODY",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356490973,SWAIN COUNTY HEALTH DEPARTMENT,SWAIN COUNTY HEALTH DEPT,545 CENTER ST   BRYSON CITY NC,087,Swain,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1457771826,"GANS, BENJAMIN, CODY",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1407295447,SMOKY MOUNTAIN URGENT CARE,~,80 VETERANS BLVD   BRYSON CITY NC,087,Swain,193400000X,Group,Single Specialty,,1457771826,"GANS, BENJAMIN, CODY",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 80 , 126 , 188 ,$#,,
MEDICAID DIRECT,1033953997,BEN GANS FAMILY MEDICINE,MERRITT MEDCARE,200 SLOPE ST   BRYSON CITY NC,087,Swain,193400000X,Group,Single Specialty,,1457771826,"GANS, BENJAMIN, CODY",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 86 , 93 , 125 ,$#,,
MEDICAID DIRECT,1407295447,SMOKY MOUNTAIN URGENT CARE,~,120 VETERANS BLVD   BRYSON CITY NC,087,Swain,193400000X,Group,Single Specialty,,1457771826,"GANS, BENJAMIN, CODY",80 VETERANS BLVD   BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457772733,"FLESHER, CARMEN, PARKER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1871577197,KINSTON PEDIATRIC ASSOCIATES PA,Kinston Pediatric Associates PA,2509 N QUEEN ST   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1457773020,"HEMMINGS, ABIGAIL, LYNN",2509 N QUEEN ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 44 , 119 ,$#,,
MEDICAID DIRECT,1750616108,CAPE FEAR VALLEY HEALTH SYSTEM SPEC,THREE RIVERS MEDICAL CENTER,580 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1457773814,"ADAMS, JUSTIN",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 82 , 176 ,$#,,
MEDICAID DIRECT,1750616108,CAPE FEAR VALLEY HEALTH SYSTEM SPEC,THREE RIVERS MEDICAL CENTER,580 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1457773814,"ADAMS, JUSTIN",580 W MCLEAN ST   SAINT PAULS NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 110 , 360 , 784 ,$#,,
MEDICAID DIRECT,1457775454,WALGREEN CO,WALGREENS 15475,1519 N MAIN ST   TARBORO NC,033,Edgecombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1457775454,WALGREEN CO,1519 N MAIN ST   TARBORO NC,033,Edgecombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457779084,"BOYD, JOSHUA, PURYEAR",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 136 , 142 , 147 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457779100,"MORGAN, TARA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457779100,"MORGAN, TARA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457779100,"MORGAN, TARA",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457779100,"MORGAN, TARA",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457779100,"MORGAN, TARA",3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 13 , 25 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457779944,"YESAULAVA, LIUDMILA, V",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457779944,"YESAULAVA, LIUDMILA, V",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457779944,"YESAULAVA, LIUDMILA, V",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 60 , 76 , 135 ,$#,,
MEDICAID DIRECT,1457332421,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457780256,"KAROL, ALENA",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1457332421,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457780256,"KAROL, ALENA",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,1223G0001X,Dental Providers,Dentist,General Practice, 347 , 443 ," 1,123 "," $50,436.69 ",,
MEDICAID DIRECT,1619468766,BLUE RIDGE COMMUNITY HEALTH SERVICE,~,158 WHITE DR   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457780256,"KAROL, ALENA",158 WHITE DR   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750621603,BLUE RIDGE COMMUNITY HEALTH SERVICE,~,29 W FRENCH BROAD ST STE 203 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457780256,"KAROL, ALENA",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 287 , 386 ," 1,022 "," $39,115.46 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457783177,"ORR, MOLLY, MORRELL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457783177,"ORR, MOLLY, MORRELL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457783334,"HARRIS, NICOLE, EVETTE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 33 , 35 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457783334,"HARRIS, NICOLE, EVETTE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1710926662,WILSON EYE ASSOCIATES,~,2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1457787012,"ALDRICH, MATTHEW, CHRISTOPHER",2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,152W00000X,Eye and Vision Services Providers,Optometrist,, 99 , 111 , 149 ,$#,,
MEDICAID DIRECT,1003361163,EDWARDS EYE CARE OD PLLC,,1488 MEMORIAL DR E   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1457787756,"EDWARDS, MATTHEW, SCOTT",1488 MEMORIAL DR E   AHOSKIE NC,046,Hertford,152W00000X,Eye and Vision Services Providers,Optometrist,, 114 , 139 , 232 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457790487,"MAKWANA, PINALKUMAR, VRUJLAL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 103 , 104 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457792806,"SLATER, KATHRYN, ANDRUKONIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1457792806,"SLATER, KATHRYN, ANDRUKONIS",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457792806,"SLATER, KATHRYN, ANDRUKONIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1457792806,"SLATER, KATHRYN, ANDRUKONIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457792806,"SLATER, KATHRYN, ANDRUKONIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457793853,"BARRETT, NANCY, JO",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144980327,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEMATOLOGY & MEDICAL ONCOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457793853,"BARRETT, NANCY, JO",23 SUNNYBROOK RD STE 220 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457794125,"JONES, LAUREN, SOUTHERN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 42 , 75 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457794893,"WATERS, CANDACE, MITCHELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 26 , 33 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457794893,"WATERS, CANDACE, MITCHELL",2341 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457794927,"MARCELLINO, AMANDA, JO",1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 89 , 121 , 166 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457795411,"HEDLEY, JEFFREY, STEPHEN",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457795411,"HEDLEY, JEFFREY, STEPHEN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457798415,"KIMEL-SCOTT, KAREN, ELIZABETH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 77 , 128 , 276 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457798415,"KIMEL-SCOTT, KAREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 49 , 90 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 39 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 25 , 60 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 INGLESIDE PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",11001 INGLESIDE PL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1457799595,"FRAZIER, REBECCA, SUZANNE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457800229,"SANCHEZ, CHRISTINA, ELISABETH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457800682,"STONE, RACHEL, ALLYSON",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1457800872,"PETERS, EMILY, JOHNSON",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457800898,"STROUD, ROXANNE, KATHLEEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 44 , 56 ,$#,,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,101 RIVERSTONE VIS STE 102 BLUE RIDGE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457806184,"NICHOLSON, JUSTIN",101 RIVERSTONE VIS STE 102 BLUE RIDGE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457811093,"DOLLAR, SCOTT, CLAYTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457811093,"DOLLAR, SCOTT, CLAYTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457811093,"DOLLAR, SCOTT, CLAYTON",1720 DAVIE AVE   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1457811093,"DOLLAR, SCOTT, CLAYTON",1720 DAVIE AVE   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457811150,"MEHTA, AMIT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457811440,"SIGIREDDI, ROHINI, RAO",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1275638512,GRANVILLE HEALTH SYSTEM,GRANVILLE HEALTH SYSTEM CRNA GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1457811606,"YOUNT, HEATHER, MARIE",1010 COLLEGE ST   OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 43 , 43 , 43 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457811606,"YOUNT, HEATHER, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457811606,"YOUNT, HEATHER, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457812034,"CLARK, JENIECE, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 64 , 64 , 66 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457814584,"HERRERA, LISA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457814972,"CONNINE, TYLER, ROSS",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457817173,"TODD, DARBY, WOODARD",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457817173,"TODD, DARBY, WOODARD",10514 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 86 , 172 ,$#,,
MEDICAID DIRECT,1457820201,"KREK, BETHANY, SUE",ANCHORED THERAPY SERVICES,5002 RANDALL PKWY STE 102 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1457820201,"KREK, BETHANY, SUE",5002 RANDALL PKWY STE 102 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 69 , 71 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,41 CHARLIE BROWN RD STE 8 BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",1272 TUNNEL RD STE 10 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",201 NC HIGHWAY 9   BLACK MOUNTAIN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 28 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457822363,"STEIGHNER, LAUREN, HEBB",349 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1457825820,"KEBASO, PHANICE, NANCY",1010 COLLEGE ST   OXFORD NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457825820,"KEBASO, PHANICE, NANCY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457825820,"KEBASO, PHANICE, NANCY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457825820,"KEBASO, PHANICE, NANCY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457827859,"AGARWAL, CHETAN",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457830150,"BOLTER, ALYSSA, MARIE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 35 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457830440,"SMITH, TRACY, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1457836413,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - CLAREMONT,3114 W MAIN ST   CLAREMONT NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457836413,GASTON FAMILY HEALTH SERVICES INC,3114 W MAIN ST   CLAREMONT NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 199 , 550 , 550 ," $22,597.38 ",,
MEDICAID DIRECT,1114143542,NC DHHS CHILD AND FAMILY WELL-BEING,MORGANTON HICKORY CDSA,145 W PARKER RD STE A MORGANTON NC,012,Burke,252Y00000X,Agencies,Early Intervention Provider Agency,,1457836793,"SCHRAND, LORRAINE, CONSTANCE",145 W PARKER RD   MORGANTON NC,012,Burke,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 132 , 133 , 134 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457836934,"RAKESTRAW, WENDY, NICOLE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1457837619,"FERNANDEZ, DANIEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 90 , 217 , 217 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457838880,"MATTHEWS, BRITTANY, ARNOLD",2400 PRATT ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457840449,"LINDSAY, BRITTANY, PRIEST",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 200 , 200 ," $10,148.84 ",,
MEDICAID DIRECT,1114193695,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES DUBLIN,16 3RD ST   DUBLIN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457840449,"LINDSAY, BRITTANY, PRIEST",16 3RD ST   DUBLIN NC,009,Bladen,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457841355,"SCRIBNER, MICHELLE, ANN",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1457841355,"SCRIBNER, MICHELLE, ANN",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 118 , 119 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457845497,"HEAD, MARIA, CAMPBELL",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457845497,"HEAD, MARIA, CAMPBELL",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 145 , 370 ," $15,152.75 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457845497,"HEAD, MARIA, CAMPBELL",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457845497,"HEAD, MARIA, CAMPBELL",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114690880,MARY MORGAN BITLER KEYSER DDS MS,BUCKTHAL KEYSER ORTHODONTICS,106 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457846644,"KEYSER, MARY, MORGAN BITLER",106 LAKE BOONE TRL   RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 55 , 252 , 287 ," $40,030.85 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457847444,"DEVAGIRI, SAILAJA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457847444,"DEVAGIRI, SAILAJA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457848301,"BARANELLO, ROBERT, JOSEPH",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 75 , 113 , 261 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457849861,"HANSEN, NOELLA, OLSEN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457849861,"HANSEN, NOELLA, OLSEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457849861,"HANSEN, NOELLA, OLSEN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457849861,"HANSEN, NOELLA, OLSEN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457849861,"HANSEN, NOELLA, OLSEN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457849861,"HANSEN, NOELLA, OLSEN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1457849895,"MENDAPARA, VIVEK, RAMNIKBHAI",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457849895,"MENDAPARA, VIVEK, RAMNIKBHAI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457851164,"SCHLEGELMILCH, ELIZABETH, CORTNEY",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457851164,"SCHLEGELMILCH, ELIZABETH, CORTNEY",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1457851164,"SCHLEGELMILCH, ELIZABETH, CORTNEY",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 33 , 62 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457854754,"BRIDWELL, RACHEL, ELISABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1457855249,"STEWART, MATTHEW, THOMAS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1962650762,CAH ACQUISITION COMPANY 1 LLC,PLYMOUTH PRIMARY CARE RURAL HEALTH CLINIC,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457855405,"GAY, AMANDA, TUCKER",958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1811502818,CENTENNIAL HOUSING & COMMUNITY SERV,PLYMOUTH PRIMARY CARE RURAL HEALTH CLINIC,795 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1457855405,"GAY, AMANDA, TUCKER",958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457855678,"ROBINSON, KATHERINE, SAMPLE",14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1326078072,PROVIDENCE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS PROVIDENCE PEDIATR,14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457855678,"ROBINSON, KATHERINE, SAMPLE",14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 41 ,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457856015,"SIEKMANN, TYLER, EDWARD",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1457856015,"SIEKMANN, TYLER, EDWARD",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457856015,"SIEKMANN, TYLER, EDWARD",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1457856015,"SIEKMANN, TYLER, EDWARD",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 20 , 27 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1457856015,"SIEKMANN, TYLER, EDWARD",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 32 , 46 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1457856015,"SIEKMANN, TYLER, EDWARD",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457858953,"GONULLU-ROTMAN, DAMLA, CELEN",5601 ARRINGDON PARK DRIVE   MORRISVILLE NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457858953,"GONULLU-ROTMAN, DAMLA, CELEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457859431,"MOSES-LEBRON, ALYSE, JENNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 51 , 51 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457864894,"ATKINS, BRIANNA, SHARYN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457864894,"ATKINS, BRIANNA, SHARYN",301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114447083,THE MCINNIS CLINIC PLLC,,1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1457866451,"MCCORKLE, TENIKA, CHIQUE",1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 120 , 185 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1457869240,"SKINNER, MITCHELL, SHANE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 91 , 105 ,$#,,
MEDICAID DIRECT,1457871501,"BARRETT, CODY, EVAN",DR CODY EVAN BARRETT DDS PLLC,510 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice,1457871501,"BARRETT, CODY, EVAN",510 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 107 , 251 , 623 ," $24,115.30 ",,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1457873093,"KOSHY, RESHMA, ANN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 103 , 259 , 259 ," $12,308.30 ",,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1457873770,"LEWIS, JESSICA, MARIA",106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457875312,"BRADY, MARY SCOTT",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457876534,"CONDIT, BRIDGET, FRANCES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 21 , 25 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457878563,"HARGETT, ELIZABETH, MARIE",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457882623,"BAUMGARDNER, LAUREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080H0002X,Allopathic & Osteopathic Physicians,Pediatrics,Hospice and Palliative Medicine, 67 , 110 , 141 ," $14,535.90 ",,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457882953,"CALKINS, DEREK, WILLIAM",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457882953,"CALKINS, DEREK, WILLIAM",615 RIDGE RD   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 100 , 102 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457882953,"CALKINS, DEREK, WILLIAM",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457882953,"CALKINS, DEREK, WILLIAM",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447496112,WESTERN CARTERET MEDICAL CENTER PLL,WESTERN CARTERET MEDICAL CENTER PLLC,718 CEDAR POINT BLVD   CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1457883191,"GLASGOW, DEANA, MARGUERITE",3004 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 25 , 45 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457883241,"NOUJAIM, MICHAEL, GEORGE",195 KIMEL PARK DR STE 200 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 34 , 45 , 58 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457883241,"NOUJAIM, MICHAEL, GEORGE",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457883241,"NOUJAIM, MICHAEL, GEORGE",280 BROAD ST STE G KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457883241,"NOUJAIM, MICHAEL, GEORGE",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1457883241,"NOUJAIM, MICHAEL, GEORGE",434 KIRBY RD   KING NC,085,Stokes,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 44 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457883324,"HAGEY, JILL, MELISSA",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457883324,"HAGEY, JILL, MELISSA",2400 PRATT ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457883324,"HAGEY, JILL, MELISSA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 27 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1457883324,"HAGEY, JILL, MELISSA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457883324,"HAGEY, JILL, MELISSA",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457883324,"HAGEY, JILL, MELISSA",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 30 , 41 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1457883613,"TARLEY, REBECCA, ANN",10 MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457884678,HOME CARE DELIVERED INC,,71 COMMERCE DR   CLARKSVILLE VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457884678,HOME CARE DELIVERED INC,71 COMMERCE DR   CLARKSVILLE VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 2,330 "," 8,988 "," 16,437 "," $1,050,322.28 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457885055,"MANAM, DHISHNA, CHAUDHARY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 96 , 156 , 170 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457885055,"MANAM, DHISHNA, CHAUDHARY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457885055,"MANAM, DHISHNA, CHAUDHARY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1457885964,"EMS, THOMAS, ISAAC",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 54 , 69 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 55 , 65 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 42 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457885964,"EMS, THOMAS, ISAAC",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 37 , 46 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457887374,"DIX, BRIANNA, RENEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457887374,"DIX, BRIANNA, RENEE",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457888422,"MUSTAFA, MONIQUE",101 CLINIC DR   TARBORO NC,033,Edgecombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457888612,"LAMBERT, KARISSA, ANGELENE DINNALL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 49 , 58 , 74 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1457889743,"JABEN, ISAAC, LOUIS",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 67 , 82 , 94 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1457889743,"JABEN, ISAAC, LOUIS",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 23 , 25 , 25 ,$#,,
MEDICAID DIRECT,1952475832,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS EAST INCORPORATED,314 CRUTCHFIELD ST   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457889834,"BEEN, CHRISTIAN, ROBERTS",314 CRUTCHFIELD ST   DURHAM NC,032,Durham,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1952475832,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS EAST INCORPORATED,314 CRUTCHFIELD ST   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1457889834,"BEEN, CHRISTIAN, ROBERTS",314 CRUTCHFIELD ST   DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457892531,"HATTON, BRIDGETTE, BLAIRE",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 23 , 24 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1457892531,"HATTON, BRIDGETTE, BLAIRE",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 76 , 79 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457892721,"FLORES ROSARIO, KAREN, PATRICIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 28 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457892721,"FLORES ROSARIO, KAREN, PATRICIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457892721,"FLORES ROSARIO, KAREN, PATRICIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 96 , 119 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457892721,"FLORES ROSARIO, KAREN, PATRICIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1457892721,"FLORES ROSARIO, KAREN, PATRICIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457892721,"FLORES ROSARIO, KAREN, PATRICIA",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457897175,"RAFEEK, JENNIFER, LAUREN MILLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1518397587,CAROLINA CARDIOLOGY SLEEP & OBESITY,,1136 HWY 258 N STE 102B KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1457897282,"GROWNEY, ANNE",1136 HWY 258 N STE 102B KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 58 , 76 ,$#,,
MEDICAID DIRECT,1518397587,CAROLINA CARDIOLOGY SLEEP & OBESITY,,3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1457897282,"GROWNEY, ANNE",3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457904575,"TUNGARE, MELISSA, ROHRER",13425 HOOVER CREEK BLVD STE 101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 17 , 21 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457904575,"TUNGARE, MELISSA, ROHRER",14035 GRANDIFLORA DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 46 , 81 , 107 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457906877,"GUTHRIE, JOHN, SCOTT",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457906877,"GUTHRIE, JOHN, SCOTT",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 21 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457907115,"NONATO, FREYLEN, ERNA L",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457907115,"NONATO, FREYLEN, ERNA L",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457907115,"NONATO, FREYLEN, ERNA L",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 31 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457907115,"NONATO, FREYLEN, ERNA L",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093703886,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER FAMILY PRACTICE,301 S CAMPBELL ST   BURGAW NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457911075,"SUTTON-MEYER, SARA, JEAN",4811 NC HIGHWAY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093703886,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER FAMILY PRACTICE,301 S CAMPBELL ST   BURGAW NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457911075,"SUTTON-MEYER, SARA, JEAN",301 S CAMPBELL ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 86 , 102 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457914020,"SKINNER, DYLAN, JAMES",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 32 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457915290,"VRANES, CHELSEY, INGERSOLL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1457915456,"BOS, ALEXANDER, JON",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 243 , 244 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1457915456,"BOS, ALEXANDER, JON",1705 TARBORO ST SW   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 88 , 88 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457916447,"DUNNEBACK, ERIN, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 104 , 104 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457916447,"DUNNEBACK, ERIN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457916447,"DUNNEBACK, ERIN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134361272,DUKE UNIVERSITY AFFILIATED PHYSICIA,NORTH HILLS INTERNAL MEDICINE,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457917635,"MASOUDI, ELHAM, ALSADAT",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 53 , 107 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457917635,"MASOUDI, ELHAM, ALSADAT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 28 , 58 ,$#,,
MEDICAID DIRECT,1457920944,CBW CARE LLC,~,315 EVANS ST STE 4 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1457920944,CBW CARE LLC,315 EVANS ST STE 4 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,933 "," 3,224 "," $299,251.60 ",,
MEDICAID DIRECT,1992171060,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF BOLIVIA,4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457921033,"EZA, KAYLA, ROSE",4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1457921272,"GUNDERSON, BRANT, MARK",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1457921272,"GUNDERSON, BRANT, MARK",232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457923849,"PROBST, KARA, EVELYN",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 69 , 86 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1457925489,"BAXLEY, KATE, LYNN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1457927758,"HOWELL, DANIELLE, PAULA",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1457927758,"HOWELL, DANIELLE, PAULA",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 76 , 144 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1457927758,"HOWELL, DANIELLE, PAULA",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1457927758,"HOWELL, DANIELLE, PAULA",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1457927758,"HOWELL, DANIELLE, PAULA",335A W COLLEGE AVE   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1457927758,"HOWELL, DANIELLE, PAULA",110 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 18 , 28 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457927998,"WILLIAMSON, JOANNA, ROSE",4446 US HIGHWAY 220 N STE A SUMMERFIELD NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 22 , 45 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1457927998,"WILLIAMSON, JOANNA, ROSE",4446 US HIGHWAY 220 N STE A SUMMERFIELD NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,7482 WATERSIDE CROSSING BLVD   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1457932162,"ACCOMAZZO, RYAN, MARK",7482 WATERSIDE CROSSING BLVD   DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457932162,"ACCOMAZZO, RYAN, MARK",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457932907,"DUCHAINE, CARRIE, NICOLE",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 100 , 166 ,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1457933822,"MARSH, SPENCER, JOHN",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457933871,"CORLE, ASHLEY, SIMONE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457933871,"CORLE, ASHLEY, SIMONE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457933871,"CORLE, ASHLEY, SIMONE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457933871,"CORLE, ASHLEY, SIMONE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457933871,"CORLE, ASHLEY, SIMONE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1457935579,"MORGAN, TIFFANY, MILAN",401 W DECATUR ST   MADISON NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 76 , 153 , 211 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457937401,"ALLARD, MELANIE, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 56 , 82 ,$#,,
MEDICAID DIRECT,1124235205,MICHAEL A IGNELSI JR DDS PHD PA,LAKE JEANETTE ORTHO PED DENT,3901 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1457937914,"TOULOUPAS, MICHAEL, JOHN",3901 N ELM ST   GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457940165,"CASTILLO, RAYMOND, G",10508 PARK RD STE 130 CHARLOTTE NC,060,Mecklenburg,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457941759,"MIALIK, LESIA",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 20 , 26 , 26 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457943144,"RATHOD, JAYSHREE, NITESH",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457943144,"RATHOD, JAYSHREE, NITESH",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4300 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457943144,"RATHOD, JAYSHREE, NITESH",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457943144,"RATHOD, JAYSHREE, NITESH",10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1457947640,"NIEMYER, KRISTIN, ELISE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 87 , 132 , 133 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457947897,"STRICKLIN, RACHEL, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,106H00000X,Behavioral Health & Social Service Providers,Marriage & Family Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1457948820,AA HOME HEALTH ASSISTANCE,,236 N MEBANE ST STE 120B BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1457948820,AA HOME HEALTH ASSISTANCE,236 N MEBANE ST STE 120B BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 38 ," 7,355 "," 7,355 "," $566,807.92 ",,
MEDICAID DIRECT,1346680543,MONARCH,~,809 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1457949828,"STRACKBEIN, ANNA, MARIE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528406519,MONARCH,~,2003 GODWIN AVE STE C LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1457949828,"STRACKBEIN, ANNA, MARIE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1457949869,"THUKU, WAMBUI, KARANU",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1457950818,"BLANTON, KASSIDY, SHEA",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 28 , 54 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457950818,"BLANTON, KASSIDY, SHEA",1001 N WASHINGTON ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457950818,"BLANTON, KASSIDY, SHEA",520 N DEKALB ST STE B SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457951485,"YEE, LIBBY, MONICA",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 22 , 39 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457951485,"YEE, LIBBY, MONICA",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 15 , 17 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457953051,"MONTES, CHRISTINA, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457961682,"BROWN, MEGAN, KATHLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457961682,"BROWN, MEGAN, KATHLEEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1457961682,"BROWN, MEGAN, KATHLEEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457961682,"BROWN, MEGAN, KATHLEEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457961682,"BROWN, MEGAN, KATHLEEN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457961682,"BROWN, MEGAN, KATHLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457961682,"BROWN, MEGAN, KATHLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457962201,"BONENBERGER, MOLLY, CHRISTINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1457962201,"BONENBERGER, MOLLY, CHRISTINE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457963548,"ARMSTRONG, ANN, HARRIS",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457969164,"PAVITRA BALASUBRAMANIAN, UNKNOWN",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1457969164,"PAVITRA BALASUBRAMANIAN, UNKNOWN",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457970147,"MOON, SOPHIE, JU HYUNG",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1457970147,"MOON, SOPHIE, JU HYUNG",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457970147,"MOON, SOPHIE, JU HYUNG",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 34 , 34 , 34 ,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457970147,"MOON, SOPHIE, JU HYUNG",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 125 , 125 , 125 ," $15,921.02 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 44 , 64 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 13 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457971038,"SHANDER, NINA, LIVIA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457972796,"O'BRIEN, LINDSEY, MARIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952626384,BLUE RIDGE HEALTHCARE MEDICAL GROUP,TABLE ROCK FAMILY MEDICINE,301 LINVILLE ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1457975831,"THOMAS, AMANDA, ELISE",301 LINVILLE ST   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 80 , 157 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457976912,"WHELESS, WILLIAM, HARPER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750088571,MANSI SHAH DMD PC DBA MYDENTALVILLE,MY DENTAVILLE,4423 S NC HIGHWAY 150 STE E LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1457976987,"PATEL, SHIVAM, DIPAKKUMAR",4423 S NC HIGHWAY 150 STE E LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 725 ," 1,468 "," 5,520 "," $349,602.68 ",,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1457977076,"ROBERTS, SHONNA, MARIE",35 MEMORIAL DR   PINEHURST NC,063,Moore,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1457980401,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE RADIOLOGY HOLLY SPRINGS,401 IRVING PKWY STE 120 HOLLY SPRINGS NC,092,Wake,293D00000X,Laboratories,Physiological Laboratory,,1457980401,DUKE UNIVERSITY HEALTH SYSTEM INC,401 IRVING PKWY STE 120 HOLLY SPRINGS NC,092,Wake,293D00000X,Laboratories,Physiological Laboratory,, 29 , 35 , 39 ,$#,,
MEDICAID DIRECT,1386186120,JACKSON HM SERVICES PC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1457981342,"BAIRD, LILLIAN, JOYCE",68 HOSPITAL RD   SYLVA NC,050,Jackson,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 39 , 125 , 125 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457981847,"LANE, BENJAMIN, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1457981847,"LANE, BENJAMIN, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1457981847,"LANE, BENJAMIN, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1457982159,"LEHTONEN, ROBERT, GENE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1457982852,"SIMANCAS-PALLARES, MIGUEL, ANGEL",414 E MAIN ST   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 13 , 29 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457982852,"SIMANCAS-PALLARES, MIGUEL, ANGEL",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 108 , 154 ," 1,137 "," $88,076.49 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1457982852,"SIMANCAS-PALLARES, MIGUEL, ANGEL",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 108 , 120 , 349 ," $10,395.71 ",,
MEDICAID DIRECT,1457983587,ALWAYS LOVE GROUP HOME,ALWAYS LOVE GROUP HOME LLC,809 WICKER ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1457983587,ALWAYS LOVE GROUP HOME,809 WICKER ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 851 , 851 ," $122,644.66 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457984676,"LANCASTER, JESSICA, PATRICK",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 86 , 147 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1457984676,"LANCASTER, JESSICA, PATRICK",1124 GALLERY PARK LN STE 103 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 27 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457984908,"LYDA, BRITTANY, AUTUMN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1790815611,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL DENTAL OF NEWTON GROVESPIVEYS CORNER,1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457985004,"DUBUISSON, JILLIAN",1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,1223D0001X,Dental Providers,Dentist,Dental Public Health, 34 , 59 , 189 ,$#,,
MEDICAID DIRECT,1790815611,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL DENTAL OF NEWTON GROVESPIVEYS CORNER,1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,193200000X,Group,Multi-Specialty,,1457985004,"DUBUISSON, JILLIAN",1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1790815611,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL DENTAL OF NEWTON GROVESPIVEYS CORNER,1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457985004,"DUBUISSON, JILLIAN",1508 MAPLE GROVE CHURCH RD STE A DUNN NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice, 408 , 739 ," 2,507 "," $91,473.43 ",,
MEDICAID DIRECT,1780969667,"LOCEY, RACHEL, ANNE",~,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1457985004,"DUBUISSON, JILLIAN",1508 MAPLE GROVE CHURCH RD UNIT 1 DUNN NC,082,Sampson,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457986234,"MEITZEN, ROSE, GOOD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 26 , 26 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1457986234,"MEITZEN, ROSE, GOOD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457988305,"CUSTAR, GRAHAM, TAYLOR",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 47 , 106 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1457988305,"CUSTAR, GRAHAM, TAYLOR",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1457988305,"CUSTAR, GRAHAM, TAYLOR",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 34 , 34 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1457989303,"LAWSON, CAMERON, TAFT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1457991341,"LAMB, TYLER, WADE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457991721,"MINTON, ASHLEY, PAPPAS",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 60 , 86 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457991721,"MINTON, ASHLEY, PAPPAS",755 S STATE ST   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 16 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1457994097,"MACK, JESSICA, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 34 , 39 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1457994097,"MACK, JESSICA, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1457996274,"LEE, TERRI, CHANG",766 HARTNESS RD STE C STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467000208,"CHATTERTON, ALEXANDRA, LEE",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 49 , 89 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1467000208,"CHATTERTON, ALEXANDRA, LEE",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467000208,"CHATTERTON, ALEXANDRA, LEE",187 MEDICAL PARK DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467001503,"PALMER, HANNAH, DIBBLE",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467001503,"PALMER, HANNAH, DIBBLE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 79 , 79 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467002493,"MCCLUNG, SARAH, YACOBI",1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043494784,ORTHOPAEDIC TRAUMA SPECIALISTS PC,ORTHOPAEDIC TRAUMA SPECIALISTS PC,1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467002493,"MCCLUNG, SARAH, YACOBI",1321 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1467004366,"RUPENDU, SHWETHA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 66 , 66 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467004366,"RUPENDU, SHWETHA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 147 , 147 ,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467006452,"NATHANI, AJAY, KUMAR",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467006452,"NATHANI, AJAY, KUMAR",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467006452,"NATHANI, AJAY, KUMAR",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467006452,"NATHANI, AJAY, KUMAR",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 750 ," 1,061 "," 2,900 "," $198,109.40 ",,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467006452,"NATHANI, AJAY, KUMAR",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1205595998,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WILSON,3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1467006452,"NATHANI, AJAY, KUMAR",3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467006999,"MUNGIN, RASHIDA, ALIYA",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467006999,"MUNGIN, RASHIDA, ALIYA",19830 ZION AVE   CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 20 , 37 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,202 VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1467007377,"WITKOWSKI, MARY, GRACE",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467007377,"WITKOWSKI, MARY, GRACE",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 77 , 208 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5214 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467007377,"WITKOWSKI, MARY, GRACE",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467007377,"WITKOWSKI, MARY, GRACE",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467007377,"WITKOWSKI, MARY, GRACE",3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467008342,"RUSSELL, BRIDGET, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 81 , 81 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,417 MOUNTAIN TRACE RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 181 , 181 ," $10,471.44 ",,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 44 , 44 ,$#,,
MEDICAID DIRECT,1134791676,SMOKY MOUNTAIN URGENT CARE,,195 FRANKLIN PLAZA DR   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1467011940,"HENDERSON, JENNIFER, LENORE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407295447,SMOKY MOUNTAIN URGENT CARE,~,195 FRANKLIN PLAZA DR   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,417 CLOVERDALE RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 82 , 82 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 208 , 208 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 76 , 76 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,551 KENT ST   ANDREWS NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,551 KENT ST   ANDREWS NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1467011940,"HENDERSON, JENNIFER, LENORE",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 55 , 55 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467012054,"TERRY, TYLER",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 67 , 124 , 233 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467012054,"TERRY, TYLER",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467012054,"TERRY, TYLER",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 150 , 867 ," 1,703 "," $19,086.01 ",,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467012054,"TERRY, TYLER",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467012054,"TERRY, TYLER",1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 131 , 276 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467012054,"TERRY, TYLER",3801 W MARKET ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467013250,"SEGAL, EMMA, REBECCA",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 25 , 55 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467014175,"JONES, REBECCA, CALDWELL",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 27 ,$#,,
MEDICAID DIRECT,1467014779,METZ MEDICAL TRANSPORT INC,,2551 N CHURCH ST BLDG C ROCKY MOUNT NC,064,Nash,3416L0300X,Transportation Services,Ambulance,Land Transport,1467014779,METZ MEDICAL TRANSPORT INC,2551 N CHURCH ST BLDG C ROCKY MOUNT NC,064,Nash,3416L0300X,Transportation Services,Ambulance,Land Transport, 252 , 837 ," 1,502 "," $47,393.31 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467015495,"THAHIR, SAHAL, ALBITH",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467016329,"MULLIN, ANDREW, SONICH",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1467018762,"EVANS, GARRETT, RICHARD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467018903,"BARNES, JASON, MARK",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467018903,"BARNES, JASON, MARK",150 ROBESON ST   E FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467019208,"CURTIS, ROBERT, TREVOR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467019455,"AZZAWI, ALI, M",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467019455,"AZZAWI, ALI, M",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467019455,"AZZAWI, ALI, M",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467020552,"HARRIS, TAYLOR, SMITH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 35 , 35 ,$#,,
MEDICAID DIRECT,1467021030,NEIGHBORHOOD HOME CARE,,120 JAMES ST OFC 1-B LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1467021030,NEIGHBORHOOD HOME CARE,120 JAMES ST OFC 1-B LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,#, 429 , 429 ," $26,007.54 ",,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467022236,"HEDRICK, TRAVIS, RICHARD",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 61 , 69 , 150 ," $22,678.09 ",,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467022236,"HEDRICK, TRAVIS, RICHARD",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 744 ," 1,295 "," 3,044 "," $155,449.75 ",,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467023580,"TOHME, MOHAMED",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467025494,"HOBBS, ADAM, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467025494,"HOBBS, ADAM, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467025494,"HOBBS, ADAM, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467025494,"HOBBS, ADAM, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467025494,"HOBBS, ADAM, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467025494,"HOBBS, ADAM, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467025494,"HOBBS, ADAM, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821045071,STROUD CHIROPRACTIC PLLC,STROUD CHIROPRACTIC PLLC,3204 ARCHDALE RD   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1467030460,"LASSITER, SYDNEY, STROUD",3204 ARCHDALE RD   ARCHDALE NC,076,Randolph,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467031336,"MEHTA, NATASHA, AJAY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467031336,"MEHTA, NATASHA, AJAY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467031336,"MEHTA, NATASHA, AJAY",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 36 , 37 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467033514,"MOHAMED, RANA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 25 , 38 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467033514,"MOHAMED, RANA",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 27 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467033944,"MCCAULEY, LARRY, BAUMAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467033944,"MCCAULEY, LARRY, BAUMAN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467033944,"MCCAULEY, LARRY, BAUMAN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467033944,"MCCAULEY, LARRY, BAUMAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467033944,"MCCAULEY, LARRY, BAUMAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467033944,"MCCAULEY, LARRY, BAUMAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467033944,"MCCAULEY, LARRY, BAUMAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629007398,HEALTH ZONE PLLC,HEALTH ZONE PLLC,707 LASSITER ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467034090,"SULLIVAN, ANNA, NICOLE POWELL",707 LASSITER ST   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 ,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1467034314,"STACEY, BLAKE, ALEXANDER",170 MANNING DR CB#7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 95 , 113 , 129 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467034314,"STACEY, BLAKE, ALEXANDER",170 MANNING DR CB#7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467034314,"STACEY, BLAKE, ALEXANDER",170 MANNING DR CB#7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467034314,"STACEY, BLAKE, ALEXANDER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 27 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467037820,"FLOYD, BETHANY, FOSTER",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467037820,"FLOYD, BETHANY, FOSTER",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 25 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467037820,"FLOYD, BETHANY, FOSTER",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1467038265,"MCGILL, ERIN, TAYLOR",14 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 83 , 107 , 129 ,$#,,
MEDICAID DIRECT,1205826559,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF WESTERN NORTH CAROLINA,700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1467038265,"MCGILL, ERIN, TAYLOR",700 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1801442033,BRADLEY ROBERTS & ASSOCIATES PLLC,~,401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1467039149,"GARBA, AMINA, LAWAL",401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 545 , 566 ," 2,705 "," $77,236.72 ",,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1467039149,"GARBA, AMINA, LAWAL",371 NC HIGHWAY 65   WENTWORTH NC,079,Rockingham,1223D0001X,Dental Providers,Dentist,Dental Public Health, 201 , 650 ," 2,494 "," $112,977.46 ",,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1467039149,"GARBA, AMINA, LAWAL",371 NC HIGHWAY 65   WENTWORTH NC,079,Rockingham,1223D0001X,Dental Providers,Dentist,Dental Public Health, 134 , 211 , 524 ," $22,358.85 ",,
MEDICAID DIRECT,1881877793,ANESTHESIA CONSULTANTS OF AUGUSTA,,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467040055,"STUDSTILL, STACIE, BROOKE",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467044784,PLEASANT HEALTH AGENCY LLC,PLEASANT HEALTH AGENCY LLC,201 BRIARHAVEN DR   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1467044784,PLEASANT HEALTH AGENCY LLC,201 BRIARHAVEN DR   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 472 , 472 ," $33,280.53 ",,
MEDICAID DIRECT,1467044784,PLEASANT HEALTH AGENCY LLC,PLEASANT HEALTH AGENCY LLC,5304 YARDLEY TER   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1467044784,PLEASANT HEALTH AGENCY LLC,5304 YARDLEY TER   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467050120,"VILLERT, EDWIN, FRANCOIS XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 46 , 47 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467050120,"VILLERT, EDWIN, FRANCOIS XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467050120,"VILLERT, EDWIN, FRANCOIS XAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467050120,"VILLERT, EDWIN, FRANCOIS XAVIER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467050120,"VILLERT, EDWIN, FRANCOIS XAVIER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467050443,SPEECH THERAPY & ALLIED RESOURCES,STAR,811 9TH ST STE 120 # 266 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1467050443,SPEECH THERAPY & ALLIED RESOURCES,811 9TH ST STE 120 # 266 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,, 58 ," 1,472 "," 1,578 "," $109,009.98 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467056416,"HANKS, ERIN, ELIZABETH",3129 SPRINGBANK LN STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467056416,"HANKS, ERIN, ELIZABETH",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467056705,"SIGANPORIA, ARNAZ",3604 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467056705,"SIGANPORIA, ARNAZ",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 30 , 53 ,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467056705,"SIGANPORIA, ARNAZ",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 118 , 175 , 384 ,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467056705,"SIGANPORIA, ARNAZ",3610 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467056705,"SIGANPORIA, ARNAZ",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 26 ,$#,,
MEDICAID DIRECT,1508459306,BETHANY MEDICAL CENTER,,819 N MAIN ST STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467056705,"SIGANPORIA, ARNAZ",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467062026,"PATEL, NIRALI, MUKESH",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467063107,"RAJPUT, SMIT",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 26 , 35 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467063107,"RAJPUT, SMIT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467063107,"RAJPUT, SMIT",2390 HEMBY LN   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1831306992,HOPSCOTCH PRIMARY CARE GROUP PA,HOPSCOTCH PRIMARY CARE,113 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1467066118,"FOX, TABITHA, SILVERS",88 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 55 , 127 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467066118,"FOX, TABITHA, SILVERS",88 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 24 , 63 ,$#,,
MEDICAID DIRECT,1467066910,DIVINE HANDS HOME HEALTH ASSISTANCE,,16501 NORTHCROSS DR STE D HUNTERSVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1467066910,DIVINE HANDS HOME HEALTH ASSISTANCE,16501 NORTHCROSS DR STE D HUNTERSVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 2,579 "," 2,582 "," $179,795.87 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467066985,"CAMPBELL, ROWANTY, JENKINS",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467066985,"CAMPBELL, ROWANTY, JENKINS",6316 OLD OAK RIDGE RD STE E GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 73 , 138 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1467066985,"CAMPBELL, ROWANTY, JENKINS",101 WALMART SUPER CTR   SILER CITY NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,1011 HIGH POINT ST   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1467066985,"CAMPBELL, ROWANTY, JENKINS",101 WALMART SUPER CTR   SILER CITY NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1467067488,"MELILLO, FALLON",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 147 , 152 , 188 ," $19,531.14 ",,
MEDICAID DIRECT,1467068833,SOUTHERN PINES DIAGNOSTIC IMAGING,FIRSTHEALTH IMAGING - SOUTHERN PINES,355 S BENNETT ST   SOUTHERN PINES NC,063,Moore,293D00000X,Laboratories,Physiological Laboratory,,1467068833,SOUTHERN PINES DIAGNOSTIC IMAGING,355 S BENNETT ST   SOUTHERN PINES NC,063,Moore,293D00000X,Laboratories,Physiological Laboratory,, 31 , 33 , 36 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1467071266,"NESSIM, NOA, SCHLOSSBERG",3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467071266,"NESSIM, NOA, SCHLOSSBERG",3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,5704 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467071266,"NESSIM, NOA, SCHLOSSBERG",3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 32 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467071423,"PATEL, SITEN, DINESH",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 55 , 140 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467071423,"PATEL, SITEN, DINESH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 32 ,$#,,
MEDICAID DIRECT,1467071548,"SCOTT, BRITTNEI",ALTRUI CHIROPRACTIC CENTER PLLC DBA SOUTHPARK CHIR,6853 FAIRVIEW RD STE 100C CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,1467071548,"SCOTT, BRITTNEI",6853 FAIRVIEW RD STE 100C CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467071662,"LANZ, JENNA, VICTORIA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 37 , 37 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467071662,"LANZ, JENNA, VICTORIA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467071662,"LANZ, JENNA, VICTORIA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 94 , 94 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467071738,"QUINN, PATRICK, JAMES",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467071738,"QUINN, PATRICK, JAMES",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467071738,"QUINN, PATRICK, JAMES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467072611,"BETURE, LUCIANA",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467072611,"BETURE, LUCIANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467072611,"BETURE, LUCIANA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1467075440,"TEAGUE, LYDIA, ANNE",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 28 , 45 , 67 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1467075440,"TEAGUE, LYDIA, ANNE",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1467075440,"TEAGUE, LYDIA, ANNE",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 14 , 21 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467076299,"MCFARLAND, MYOSHA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467076299,"MCFARLAND, MYOSHA",5324 MCFARLAND RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 302 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467076299,"MCFARLAND, MYOSHA",10207 CERNY ST STE 302 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467076794,"LITTLETON, JESSICA, REBA",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 30 , 34 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467076794,"LITTLETON, JESSICA, REBA",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467076794,"LITTLETON, JESSICA, REBA",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467078907,"SUTTON, MORGAN, DELANE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 96 , 188 ,$#,,
MEDICAID DIRECT,1750041497,BLOOMING MEDICAL GROUP PLLC,,964 HIGH HOUSE RD PMB 4037 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1467082743,"JORDAN, JOSEPH, VINCENT",964 HIGH HOUSE RD PMB 4037 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1467083881,"WICKSTRUM, ERIK, MATTHEWS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467083881,"WICKSTRUM, ERIK, MATTHEWS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467083881,"WICKSTRUM, ERIK, MATTHEWS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 26 ,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467085746,"WILSON, MERON",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467088260,"DYER, JENNIFER, SHUMATE",755 S STATE ST   YADKINVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 142 , 171 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467089219,"BAIG, MARIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 86 , 86 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467089219,"BAIG, MARIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,150 PROFESSIONAL PARK DR STE 400 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467089474,"HAINES, TAYLOR, NICOLE",150 PROFESSIONAL PARK DR STE 400 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 36 , 55 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467089474,"HAINES, TAYLOR, NICOLE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1467090787,"HICKS, WHITNEY, RAE",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467091272,"KARAGOUNIS, KELLY, ROCKHOLT",404 S SUTHERLAND AVE   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1467092791,AMAZING HOME CARE INC,AMAZING HOME CARE INC,1631 MIDTOWN PL STE 104 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1467092791,AMAZING HOME CARE INC,1631 MIDTOWN PL STE 104 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 53 ," 8,350 "," 8,592 "," $727,983.98 ",,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467094821,"MARMOLEJOS, DIANA, RAQUEL",809 JOHN D BARRY DR   WILMINGTON NC,065,New Hanover,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467094821,"MARMOLEJOS, DIANA, RAQUEL",809 JOHN D BARRY DR   WILMINGTON NC,065,New Hanover,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467094821,"MARMOLEJOS, DIANA, RAQUEL",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 21 , 30 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,9101 OCEAN HWY E   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1467094821,"MARMOLEJOS, DIANA, RAQUEL",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467096008,"MARTIN, DANA, LYNN ZIMERMAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 44 , 45 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467096008,"MARTIN, DANA, LYNN ZIMERMAN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467099341,TWINKLE-STAR HOME SERVICES LLC,,202 BAINBRIDGE CIR   GARNER NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467099341,TWINKLE-STAR HOME SERVICES LLC,202 BAINBRIDGE CIR   GARNER NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 977 , 977 ," $65,059.38 ",,
MEDICAID DIRECT,1467099341,TWINKLE-STAR HOME SERVICES LLC,,1921 WATERS DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467099341,TWINKLE-STAR HOME SERVICES LLC,1921 WATERS DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,196 "," 1,196 "," $82,390.95 ",,
MEDICAID DIRECT,1467099341,TWINKLE-STAR HOME SERVICES LLC,,212 PINE RIDGE RD   ROANOKE RAPID NC,042,Halifax,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467099341,TWINKLE-STAR HOME SERVICES LLC,212 PINE RIDGE RD   ROANOKE RAPID NC,042,Halifax,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 450 , 450 ," $28,488.62 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467103747,"PAICH, KAITLIN, TAYLOR",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 92 , 185 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467103747,"PAICH, KAITLIN, TAYLOR",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 31 , 48 ,$#,,
MEDICAID DIRECT,1467104448,ENDLESS POSSIBILITIES PHYSICAL THER,ENDLESS POSSIBILITIES PHYSICAL THERAPY LLC,204 WENDY CT   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1467104448,ENDLESS POSSIBILITIES PHYSICAL THER,204 WENDY CT   CARY NC,092,Wake,193400000X,Group,Single Specialty,, 13 , 162 , 263 ," $11,764.32 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467105197,"CAMPISE, SALVATORE, NICK",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467109389,LITTLE TALKERS BILINGUAL SPEECH THE,,5926 LAURENFIELD DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467109389,LITTLE TALKERS BILINGUAL SPEECH THE,5926 LAURENFIELD DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467111856,"LOVELACE-PEARCE, APRIL, CAROLINE",1550 FAULK ST STE 2100 MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 55 , 87 ,$#,,
MEDICAID DIRECT,1467113159,GOLDENCARE HOME SERVICES LLC,,1908 SPRING CREEK DR   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1467113159,GOLDENCARE HOME SERVICES LLC,1908 SPRING CREEK DR   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 49 , 49 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467113241,"WALLS, LAKIN, JULIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 115 , 115 ,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467117549,"FRANKLIN, EMILY, ANNE",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 25 , 49 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467118885,"MARKHAM, RACHEL, OLIVIA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 129 , 140 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467118885,"MARKHAM, RACHEL, OLIVIA",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1467118885,"MARKHAM, RACHEL, OLIVIA",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467118885,"MARKHAM, RACHEL, OLIVIA",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1467120832,"MISLEVY, ALEXIS, TAYLOR",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467120832,"MISLEVY, ALEXIS, TAYLOR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 66 , 68 ,$#,,
MEDICAID DIRECT,1710166327,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,520 N DEKALB ST STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467127886,"CAMMER, HEIDI, SUZANNE",520 N DEKALB ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710166327,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,520 N DEKALB ST STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467127886,"CAMMER, HEIDI, SUZANNE",2910 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578742177,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1467127886,"CAMMER, HEIDI, SUZANNE",2910 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073034625,CENTERWELL SENIOR PRIMARY CARE NC P,CENTERWELL SENIOR PRIMARY CARE NC PC,2910 E FRANKLIN BLVD # 1 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467127886,"CAMMER, HEIDI, SUZANNE",2910 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467127886,"CAMMER, HEIDI, SUZANNE",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467127886,"CAMMER, HEIDI, SUZANNE",3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124207725,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,910 E CHURCH ST STE A CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467127886,"CAMMER, HEIDI, SUZANNE",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 40 , 54 ,$#,,
MEDICAID DIRECT,1851783385,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL INTERNAL MEDICINE SPECIALISTS,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1467130831,"SHUMATE, MANDY, SUZANNE ELLER",194 DOCTORS DR   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 22 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467130831,"SHUMATE, MANDY, SUZANNE ELLER",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1841843703,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPFAMILY MEDICINE,148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1467130831,"SHUMATE, MANDY, SUZANNE ELLER",148 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 22 , 46 ,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467131029,"CUMMINGS, SHANNON, CELINE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467131029,"CUMMINGS, SHANNON, CELINE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417914722,ROBESON HEALTH CARE CORPORATION,SOUTH ROBESON MEDICAL CENTER,210 S WALNUT ST   FAIRMONT NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467131029,"CUMMINGS, SHANNON, CELINE",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467131029,"CUMMINGS, SHANNON, CELINE",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467131029,"CUMMINGS, SHANNON, CELINE",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 43 , 53 ,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467131029,"CUMMINGS, SHANNON, CELINE",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 177 , 221 ,$#,,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1467132662,"PEARLSTEIN, MOLLY, MARTIN",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467141044,"HARKINS, MADELINE, GRACE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 113 , 116 ,$#,,
MEDICAID DIRECT,1194358770,CABARRUS ROWAN COMMUNITY HEALTH CEN,LOGAN FAMILY DENTAL,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467141796,"SALEH, ROA, YACOUB",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 49 , 68 , 113 ,$#,,
MEDICAID DIRECT,1235846668,CABARRUS ROWAN COMMUNITY HEALTH CEN,MCGILL FAMILY DENTAL,202 MCGILL AVE NW STE D CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467141796,"SALEH, ROA, YACOUB",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1265043574,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE DENTAL,307 E THOM ST   CHINA GROVE NC,080,Rowan,193400000X,Group,Single Specialty,,1467141796,"SALEH, ROA, YACOUB",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 178 , 411 , 656 ," $35,657.41 ",,
MEDICAID DIRECT,1568248284,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467141796,"SALEH, ROA, YACOUB",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 24 , 39 ,$#,,
MEDICAID DIRECT,1235801812,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH DENTAL,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1467141796,"SALEH, ROA, YACOUB",721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467143875,"STEEDMAN, SARAH, CATHERINE ANNE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467143875,"STEEDMAN, SARAH, CATHERINE ANNE",25 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467145276,"NESS, SYDNEY, ELIZABETH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467145276,"NESS, SYDNEY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467145276,"NESS, SYDNEY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467145318,OPTIMUM HOME CARE SERVICES,,612B UNION CHAPEL RD   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1467145318,OPTIMUM HOME CARE SERVICES,612B UNION CHAPEL RD   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 60 ," 9,659 "," 9,659 "," $828,119.70 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467147025,"DOWLING, VICTORIA, ANN",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467150565,"KELLOGG, CHLOE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1528461670,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - SOUTH HICKORY,1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1467151035,"ANDERSON, MORGAN, PROPST",1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 37 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467153726,"BOWLBY, HUNTER, LEE",3116 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467156174,"BALZEN, TIMOTHY, MATTHEW",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376132571,FULLER & ASSOCIATES VII PLLC,CLINTON FAMILY & COSMETIC DENTISTRY,320 NORTHEAST BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1467156174,"BALZEN, TIMOTHY, MATTHEW",320 NORTHEAST BLVD   CLINTON NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice, 982 ," 1,373 "," 4,921 "," $222,470.50 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467159970,"COMPEAU, JOSEPHINE, ROSE BARRIER",2718 HENRY ST   GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1467164145,COUNTRY LIVING GUEST HOME INC,COUNTRY LIVING HICKORY HOUSE,3636 CHERRY RD   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1467164145,COUNTRY LIVING GUEST HOME INC,3636 CHERRY RD   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 98 , 98 ,$#,,
MEDICAID DIRECT,1467164145,COUNTRY LIVING GUEST HOME INC,COUNTRY LIVING HICKORY HOUSE,3636 CHERRY RD   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467164145,COUNTRY LIVING GUEST HOME INC,3636 CHERRY RD   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 303 , 303 ," $22,518.85 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467166116,"LLULL CERDA, RAMON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1407133069,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE NORTHEAST HICKORY,2365 SPRINGS RD NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467166983,"FAULKNER, MICHAEL, TODD",2365 SPRINGS RD NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467169177,"TANKOOS, ERIN, KYLIE",517 ALCOVE RD   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467169177,"TANKOOS, ERIN, KYLIE",517 ALCOVE RD   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467170316,"YEOMANS, CAROLINE, ELIZABETH",534 N 35TH ST STE D MOREHEAD CITY NC,016,Carteret,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 36 , 92 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467173443,"DOUGHERTY, RYAN, THOMAS",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 28 , 58 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467173443,"DOUGHERTY, RYAN, THOMAS",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 72 , 128 ,$#,,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1467174102,"TYNDALL, NANCY, MARIE WEST",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 48 , 86 ,$#,,
MEDICAID DIRECT,1992728950,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SALEMBURG,500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467174342,"LEWIS, CHRISTINA, TAYLOR",500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1952061517,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH,1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467174342,"LEWIS, CHRISTINA, TAYLOR",1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467178004,"FUTRELL, MARIE, ANGELINA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467179234,"OXENDINE, HEATHER, EPPS",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 121 , 148 ,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467179234,"OXENDINE, HEATHER, EPPS",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467179234,"OXENDINE, HEATHER, EPPS",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467179234,"OXENDINE, HEATHER, EPPS",1309 E 5TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467180406,"RIVERA ROSARIO, DELILAH",3193 W HIGHWAY 74   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467180406,"RIVERA ROSARIO, DELILAH",420 PARK ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467180406,"RIVERA ROSARIO, DELILAH",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 46 , 89 ,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467180406,"RIVERA ROSARIO, DELILAH",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467180406,"RIVERA ROSARIO, DELILAH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467184739,"PROSPERI, CHRISTIAN, HENRI",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467186239,"SCHUSTER, MEREDITH, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 34 , 35 ,$#,,
MEDICAID DIRECT,1295303139,SCHRYER AND ASSOCIATES,,1611 GREENFIELD ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467186304,"SCHWARK, AARON, MITCHELL",1611 GREENFIELD ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 67 , 70 , 104 ," $41,170.83 ",,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1467186304,"SCHWARK, AARON, MITCHELL",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 253 , 297 ," 1,034 "," $53,215.72 ",,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1467186429,"BATES, ALLYNA, ELIZABETH",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1467186429,"BATES, ALLYNA, ELIZABETH",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 69 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467188243,"BEAL, WHITNEY, MORGAN-DEITZ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1467188979,HARVEYS FAMILY CARE HOME,HARVEYS FAMILY CARE HOME LLC,667 BH HARVEY TRL LOT H BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467188979,HARVEYS FAMILY CARE HOME,667 BH HARVEY TRL LOT H BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 630 , 630 ," $50,669.36 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467189647,"SWIRI, DAMALICE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1467197301,"EDWARDS, PAMELA, AUTRY",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1467197301,"EDWARDS, PAMELA, AUTRY",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1467197301,"EDWARDS, PAMELA, AUTRY",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467198028,"CASTRO, GIOVANNI, STEFANO",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice, 94 , 121 , 375 ," $17,470.02 ",,
MEDICAID DIRECT,1093706111,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - SOUTHEAST RALEIGH DENTA,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467198028,"CASTRO, GIOVANNI, STEFANO",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 831 ," 1,177 "," 3,419 "," $148,800.09 ",,
MEDICAID DIRECT,1467205724,REIGN SUPREME HOMECARE AGENCY LLC,REIGN SUPREME HOMECARE AGENCY LLC,500 ANONA DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1467205724,REIGN SUPREME HOMECARE AGENCY LLC,500 ANONA DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,032 "," 2,033 "," $164,329.40 ",,
MEDICAID DIRECT,1467205773,EMERGE FAMILY CARE INC,,3511 SHANNON RD FL 3 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1467205773,EMERGE FAMILY CARE INC,3511 SHANNON RD FL 3 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 86 , 98 ," $17,284.00 ",,
MEDICAID DIRECT,1467205773,EMERGE FAMILY CARE INC,,315 E GORDON ST   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1467205773,EMERGE FAMILY CARE INC,315 E GORDON ST   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467209858,"JONES, KRISTEN, LYNN",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1467216440,"GRIFFIN, MARGARET, SPERETHOULA",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467217646,"CROSBY, ELIZABETH, ELLIOTT",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 19 , 21 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467221408,"EGGLESTON, AMANDA, KELLY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 169 , 226 , 228 ,$#,,
MEDICAID DIRECT,1902995145,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT TWIN COUNTY,204 EVANS RD   HOLLISTER NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467223297,"MORGAN, AUBURN, ANNE",204 EVANS RD   HOLLISTER NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1093767535,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT LAKE GASTON,108 MOSBY AVE   LITTLETON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467223297,"MORGAN, AUBURN, ANNE",108 N MOSBY AVE   LITTLETON NC,093,Warren,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4100 CARMEL RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467224246,"KNOTT, JAMIE, ANNE",9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467227090,HEALING TOUCH HOME CARE AGENCY LLC,,51 PLAZA DR STE D JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,,1467227090,HEALING TOUCH HOME CARE AGENCY LLC,51 PLAZA DR STE D JACKSONVILLE NC,067,Onslow,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 1,343 "," 1,421 "," $166,158.84 ",,
MEDICAID DIRECT,1467227744,DEEPLY DEVOTED HOME CARE LLC,,12900 OLD LAKE RD   RIEGELWOOD NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1467227744,DEEPLY DEVOTED HOME CARE LLC,12900 OLD LAKE RD   RIEGELWOOD NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 2,602 "," 2,602 "," $205,573.11 ",,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1467230136,"CHIA, YESMIRA, SUN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 60 , 64 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467232314,"RICHARDSON, SUMMER, STREET",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 30 , 37 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467237586,"FULLER, EMILY, WEST",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1689114969,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN ORTHOPAEDICS,314 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1467238360,"BASILE, GRIFFIN, KANE",314 S SOUTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 147 , 232 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467239541,"ELMER, SEVIL, MARIYA",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467239541,"ELMER, SEVIL, MARIYA",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 37 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467239541,"ELMER, SEVIL, MARIYA",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467239541,"ELMER, SEVIL, MARIYA",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1467249474,KENNEDYS PROMISE,,498 PUETT COVE RD   MARBLE NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1467249474,KENNEDYS PROMISE,498 PUETT COVE RD   MARBLE NC,020,Cherokee,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467260968,"DEXTER, ALYSSA, GREGORY",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1467279158,"ZEISSLER, KATIE, ANN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467284695,"HESS, STEPHANIE, MARIE",6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 139 , 171 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467285932,"JOHNSON, BRANDI, ALEXANDRIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467287060,"KIRSCH, BRADY, GERALD",8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467287060,"KIRSCH, BRADY, GERALD",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1467295907,SILVERS HOME CARE LLC,,910 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1467295907,SILVERS HOME CARE LLC,910 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 82 , 82 ,$#,,
MEDICAID DIRECT,1073503470,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF FAYETTEVILLE,5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1467299925,"CHAVIS, TIERRA, DANIELLE",5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193200000X,Group,Multi-Specialty,,1467400259,"PADGETT, CHRISTOPHER, LEE",1302 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1043268295,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193400000X,Group,Single Specialty,,1467400259,"PADGETT, CHRISTOPHER, LEE",1302 BROWN ST   WASHINGTON NC,007,Beaufort,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467400432,"WINKLEY, JAMES, VINCENT",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 20 , 23 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467400432,"WINKLEY, JAMES, VINCENT",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 50 , 55 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467400432,"WINKLEY, JAMES, VINCENT",35 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 28 , 29 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467400432,"WINKLEY, JAMES, VINCENT",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467400556,"MERRELL, GERALD, LEE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 32 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1467400556,"MERRELL, GERALD, LEE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467400556,"MERRELL, GERALD, LEE",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467400556,"MERRELL, GERALD, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 25 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467400556,"MERRELL, GERALD, LEE",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 30 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467400556,"MERRELL, GERALD, LEE",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 40 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1467400556,"MERRELL, GERALD, LEE",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467400580,"PATEL, NILESH, HARIBHAI",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467402024,"SHIPLEY, AMY, JORDAN",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 33 , 66 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467402024,"SHIPLEY, AMY, JORDAN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467402719,"HARLEY II, WILLIAM, BEN",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 17 , 26 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467402719,"HARLEY II, WILLIAM, BEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 28 , 144 , 146 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1467403832,"NOVAK, TIMOTHY, DAVID",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 86 , 109 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467404343,"JACKSON, CARSWELL, HOOTS",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467404343,"JACKSON, CARSWELL, HOOTS",600 GREEN VALLEY RD STE 304   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467404343,"JACKSON, CARSWELL, HOOTS",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 26 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467404343,"JACKSON, CARSWELL, HOOTS",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467404343,"JACKSON, CARSWELL, HOOTS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 57 , 64 ,$#,,
MEDICAID DIRECT,1467405381,"BENKUSKY, STEPHEN, PAUL",~,111 VIRGINIA RD   EDENTON NC,021,Chowan,152W00000X,Eye and Vision Services Providers,Optometrist,,1467405381,"BENKUSKY, STEPHEN, PAUL",111 VIRGINIA RD   EDENTON NC,021,Chowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 106 , 109 , 273 ,$#,,
MEDICAID DIRECT,1215156401,EYE CARE OF EDENTON,~,111 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1467405381,"BENKUSKY, STEPHEN, PAUL",111 VIRGINIA RD   EDENTON NC,021,Chowan,152W00000X,Eye and Vision Services Providers,Optometrist,, 39 , 49 , 119 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1467407429,"BARTON, JOHN, HOMER",4927 S CROATAN HWY   NAGS HEAD NC,028,Dare,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467407429,"BARTON, JOHN, HOMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467410142,"GROCE, AMY, ANN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,213 BARDEN ST   PRINCETON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467410217,"REESE, RONNIE, LEE",213 BARDEN ST   PRINCETON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 135 , 277 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467410423,"MYERHOLTZ, LINDA, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467410597,"DONAHUE, TIMOTHY, PATRICK",2609 N DUKE ST STE 700 DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 55 , 149 , 223 ,$#,,
MEDICAID DIRECT,1174823066,PRIVATE DIAGNOSTIC CLINIC PLLC,TRIANGLE HEART ASSOCIATES,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467410597,"DONAHUE, TIMOTHY, PATRICK",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467410597,"DONAHUE, TIMOTHY, PATRICK",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 23 , 22 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467410597,"DONAHUE, TIMOTHY, PATRICK",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 122 , 341 , 456 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467411108,"SATTERFIELD, ROBERT, NELSON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 28 , 78 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1467411108,"SATTERFIELD, ROBERT, NELSON",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 56 , 124 , 325 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467412171,"HENDLER, JAY, MARK",2525 COURT DR   GASTONIA NC,036,Gaston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 50 , 69 ,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,934 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467412171,"HENDLER, JAY, MARK",934 COX RD   GASTONIA NC,036,Gaston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 122 , 224 , 330 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467412205,"MCCALL, TERRY, WAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1467412205,"MCCALL, TERRY, WAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 92 , 92 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467412205,"MCCALL, TERRY, WAYNE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 77 , 77 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1467412205,"MCCALL, TERRY, WAYNE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 115 , 115 ,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1467413054,"SPIVEY, DAVID, EUGENE",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 22 , 76 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467413062,"VANNOY, SHARON, QUEEN",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 25 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467413062,"VANNOY, SHARON, QUEEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 27 , 33 ,$#,,
MEDICAID DIRECT,1073003752,GOODEN MOBILE POD NC PLLC,,311 MCFADYEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467413419,"RICHARDSON, MILTON, WALDO",311 MCFADYEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 93 , 157 , 212 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467413450,"DANISA, OLUMIDE, AYODELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467413450,"DANISA, OLUMIDE, AYODELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467413450,"DANISA, OLUMIDE, AYODELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1932273513,GREENSBORO PEDIATRICIANS,Greensboro Pediatricians,510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467414110,"TWISELTON, LOUISE, ANN",510 N ELAM AVE STE 202 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 39 , 70 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467414292,"POSTON JR, WILLIAM, KARNES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1467414292,"POSTON JR, WILLIAM, KARNES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467414292,"POSTON JR, WILLIAM, KARNES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467414292,"POSTON JR, WILLIAM, KARNES",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467414292,"POSTON JR, WILLIAM, KARNES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 60 , 62 , 92 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1467414672,"PIQUERAS, EDUARDO, ANTONIO",,3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 85 , 85 , 100 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467414672,"PIQUERAS, EDUARDO, ANTONIO",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467414995,"LESHER, KATRINA, MARIE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467414995,"LESHER, KATRINA, MARIE",500 DISCOVERY DR STE 301 CHESAPEAKE VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,301 RIVERVIEW AVE   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467414995,"LESHER, KATRINA, MARIE",301 RIVERVIEW AVE   NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467414995,"LESHER, KATRINA, MARIE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 25 , 51 , 81 ," $23,514.32 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467414995,"LESHER, KATRINA, MARIE",850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,2021 CONCERT DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467414995,"LESHER, KATRINA, MARIE",2021 CONCERT DR STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467415166,"HOCHREIN, JAMES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 16 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467415166,"HOCHREIN, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467415166,"HOCHREIN, JAMES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1033523709,MOSES CONE AFFILIATED PHYSICIANS IN,CHMG CARDIOVASCULAR DIVISION,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467415166,"HOCHREIN, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467415166,"HOCHREIN, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 109 , 142 , 209 ,$#,,
MEDICAID DIRECT,1669620183,SUNSET EYE CARE OD PLLC,SUNSET EYE CARE OD PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1467415885,"BINKLEY, DUANE, KEITH",106A EMILY DR   WINTERVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1558308080,THE C W WILLIAMS COMMUNITY HEALTH C,~,5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467417774,"JONES, JERRY, ANTHONY",991 W HUDSON BLVD   GASTONIA NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467418673,"VENDELAND, LISA, LYNN",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467418673,"VENDELAND, LISA, LYNN",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1588943278,CALDWELL MEMORIAL HOSPITAL,ROBBINS PULMONOLOGY,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467419358,"MCGUIRE, FRANKLIN, RILEY",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 91 , 185 , 187 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467419358,"MCGUIRE, FRANKLIN, RILEY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1588943278,CALDWELL MEMORIAL HOSPITAL,ROBBINS PULMONOLOGY,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467419358,"MCGUIRE, FRANKLIN, RILEY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 59 , 121 , 242 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467420133,"SHAH, NIRAV, PRAVIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 178 , 186 , 194 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467420133,"SHAH, NIRAV, PRAVIN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 196 , 206 , 236 ,$#,,
MEDICAID DIRECT,1518927318,SUNDAR INTERNAL MEDICINE ASSOCIATES,~,511 RUIN CREEK RD STE 203 HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1467420182,"SUNDAR, VALARMATHI",511 RUIN CREEK RD STE 203 HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 467 , 467 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467422303,"DUNATOV, CHRISTOPHER, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467422303,"DUNATOV, CHRISTOPHER, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 40 , 73 , 78 ,$#,,
MEDICAID DIRECT,1326325994,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE SHERRILLS FORD,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1467422501,"RESTINO, ELIZABETH, DIANE",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 241 , 566 ,$#,,
MEDICAID DIRECT,1326325994,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE SHERRILLS FORD,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1467422501,"RESTINO, ELIZABETH, DIANE",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 41 , 82 ,$#,,
MEDICAID DIRECT,1326325994,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE SHERRILLS FORD,,,Unknown,193200000X,Group,Multi-Specialty,,1467422501,"RESTINO, ELIZABETH, DIANE",6127 HIGHWAY 16 S   DENVER NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467424515,"HOLTHUSEN, BETH, LYTLE",201 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 42 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467424515,"HOLTHUSEN, BETH, LYTLE",250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467424630,"MAMMEL, JAMES, BRYANT",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467425066,"HARTLINE, STEVEN, MICHAEL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467425348,"KIBLER, JOSEPH, FRANCIS",14 DOCTORS CIR STE 2 SUPPLY NC,010,Brunswick,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 72 , 107 , 163 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467426627,"MANIAN, SWARNA",1925 GLENN MITCHELL DR STE 202 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467426981,"HOLLADAY, JEFFREY, G",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1467427757,"LOVELESS, HOWARD, WILLIAM",4725 COUNTRY CLUB RD   MOREHEAD CITY NC,016,Carteret,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1467427757,"LOVELESS, HOWARD, WILLIAM",3110 WELLONS BLVD   NEW BERN NC,025,Craven,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 44 , 66 , 83 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1467427757,"LOVELESS, HOWARD, WILLIAM",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 29 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467427831,"SAKAI, TETSURO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1871052597,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KILDAIRE FARM ROAD,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467427971,"CHANG, RHODA, YUEH",110 KILDAIRE PARK DR   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1467428060,"MASON, NORA, CATHERINE S",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 39 , 73 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1467428060,"MASON, NORA, CATHERINE S",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467428631,"MURPHY, MARTIN, JAMES",50 MILLER ST   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 33 , 48 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467429399,"MANFREDI, BRENDA, LAURIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 33 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467429399,"MANFREDI, BRENDA, LAURIE",6316 OLD OAK RIDGE RD STE E GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 80 , 168 ,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467431403,"LIU, JOHN, SHIE PING",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467432047,"WILSON, JOHN, ALLEN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 26 , 30 , 36 ,$#,,
MEDICAID DIRECT,1467432690,GRAEBER CORPORAION,DIABETIC SUPPLY OF GRACO,910 E GARRISON BLVD   GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1467432690,GRAEBER CORPORAION,910 E GARRISON BLVD   GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 162 , 736 ," 1,658 "," $134,142.59 ",,
MEDICAID DIRECT,1467432690,GRAEBER CORPORAION,DIABETIC SUPPLY OF GRACO,910 E GARRISON BLVD   GASTONIA NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1467432690,GRAEBER CORPORAION,910 E GARRISON BLVD   GASTONIA NC,036,Gaston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1467433292,INFORM DIAGNOSTICS INC,~,6655 N MACARTHUR BLVD   IRVING TX,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1467433292,INFORM DIAGNOSTICS INC,6655 N MACARTHUR BLVD   IRVING TX,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#, 18 ,$#,,
MEDICAID DIRECT,1467433680,THERAPY PLAYGROUND INC,,1555 CAIN RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467433680,THERAPY PLAYGROUND INC,1555 CAIN RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1467433680,THERAPY PLAYGROUND INC,,103 SLEEPY DR STE G SPRING LAKE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467433680,THERAPY PLAYGROUND INC,103 SLEEPY DR STE G SPRING LAKE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1467433680,THERAPY PLAYGROUND INC,,4602 CUMBERLAND RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467433680,THERAPY PLAYGROUND INC,4602 CUMBERLAND RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 326 ," 4,060 "," 4,596 "," $312,244.12 ",,
MEDICAID DIRECT,1467433680,THERAPY PLAYGROUND INC,,5948 FISHER RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467433680,THERAPY PLAYGROUND INC,5948 FISHER RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467433847,"COPPER JR, JOSEPH, BENJAMIN",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1508117185,CAMPBELL UNIVERSITY HEALTH CENTER,~,129 T T LANIER ST   BUIES CREEK NC,043,Harnett,193200000X,Group,Multi-Specialty,,1467434134,"AGNELLO, ROBERT, NICHOLAS",129 TT LANIER ST   BUIES CREEK NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 35 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467435503,"TOSCHLOG, ERIC, ANDREW",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467435503,"TOSCHLOG, ERIC, ANDREW",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 57 , 87 , 93 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467436428,"KIMBALL, JAMES, NORMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 15 , 29 , 29 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467436543,"THOMAS, WILLIAM, ARTHUR",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 41 , 66 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,5818 HARBOUR VIEW BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467436642,"MCKENZIE, SUSAN, ELIZABETH",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467436642,"MCKENZIE, SUSAN, ELIZABETH",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1518397587,CAROLINA CARDIOLOGY SLEEP & OBESITY,,3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1467437079,"MITRA, SHYAMAL, KISHORE",3280 HENDERSON DR STE C JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 34 , 52 , 60 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1467437079,"MITRA, SHYAMAL, KISHORE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 198 , 278 , 279 ,$#,,
MEDICAID DIRECT,1518397587,CAROLINA CARDIOLOGY SLEEP & OBESITY,,1136 HWY 258 N STE 102B KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467437079,"MITRA, SHYAMAL, KISHORE",1136 HWY 258 N STE 102B KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 68 , 116 , 155 ,$#,,
MEDICAID DIRECT,1346314515,VALLEY RADIOLOGY ASSOCIATES PA,~,1370 W D ST   N WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1467437525,"EVANS, GREGORY, FRANCIS FELIX",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 104 , 135 , 168 ,$#,,
MEDICAID DIRECT,1346314515,VALLEY RADIOLOGY ASSOCIATES PA,~,1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1467437525,"EVANS, GREGORY, FRANCIS FELIX",1900 W PARK DR   N WILKESBORO NC,097,Wilkes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 299 , 434 , 578 ," $15,706.92 ",,
MEDICAID DIRECT,1346314515,VALLEY RADIOLOGY ASSOCIATES PA,~,1370 W D ST   N WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1467437525,"EVANS, GREGORY, FRANCIS FELIX",1900 W PARK DR   N WILKESBORO NC,097,Wilkes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 213 , 433 , 695 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467438416,"HAMM, ANTHONY, WAYNE",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467438739,"ALEXANDER, MEGAN, MOYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 26 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467438739,"ALEXANDER, MEGAN, MOYLE",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467438739,"ALEXANDER, MEGAN, MOYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467438770,"CAMPBELL, BRUCE, EDGAR",742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467440255,"ROSENTHAL, NANCY, SMUKLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 33 , 39 , 134 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467440750,"MORRELL, TODD, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467444679,"KEY, CANDICE, PUCKETT",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 109 , 738 , 772 ," $19,676.74 ",,
MEDICAID DIRECT,1689016628,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1010 E DIXON BLVD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467444752,"SARODIA, BIPIN, D",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1689016628,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1010 E DIXON BLVD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467444752,"SARODIA, BIPIN, D",201 E GROVER ST   SHELBY NC,023,Cleveland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467444885,"MATTHEWS, JEFFERY, CARL",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467445031,"BARILE, ANTHONY, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 57 , 135 , 142 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467445031,"BARILE, ANTHONY, JOHN",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467445031,"BARILE, ANTHONY, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 64 , 157 , 158 ," $13,113.02 ",,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467445429,"HOLLER, MATTHEW, BRADY",155 MEMORIAL DR   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 82 , 225 , 225 ,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467446039,"COHEN, MAX, WILLIAM",2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 42 , 88 , 158 ,$#,,
MEDICAID DIRECT,1861485146,REGIONAL OBSTETRICAL CONSULTANTS PC,REGIONAL OBSTETRICAL CONSULTANTS PC,902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467448035,"TORRES, CARLOS",136 HOSPITAL DR STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1467448282,"BOND, CHARLES, DANA",139 DR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 129 , 219 , 385 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467449629,"HEH, CHEN-WEN, CHRIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1467449876,"THOMPSON, KELLY, STONE",1388 SAND HILL RD STE 1 CANDLER NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467451187,"RAMADOSS, EASWAR",624 QUAKER LN STE 200D HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 48 , 111 , 278 ," $12,542.07 ",,
MEDICAID DIRECT,1467451963,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,72 S MAIN ST   SPARTA NC,003,Alleghany,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1467451963,MEDICAL SERVICES OF AMERICA INC,72 S MAIN ST   SPARTA NC,003,Alleghany,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1467451963,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,72 S MAIN ST   SPARTA NC,003,Alleghany,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1467451963,MEDICAL SERVICES OF AMERICA INC,72 S MAIN ST   SPARTA NC,003,Alleghany,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 108 , 623 , 969 ," $34,626.12 ",,
MEDICAID DIRECT,1467451963,MEDICAL SERVICES OF AMERICA INC,MEDI HOME CARE,72 S MAIN ST   SPARTA NC,003,Alleghany,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1467451963,MEDICAL SERVICES OF AMERICA INC,72 S MAIN ST   SPARTA NC,003,Alleghany,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1457695264,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467452128,"SHARKEY, KEVIN, CRONIN",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467452128,"SHARKEY, KEVIN, CRONIN",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 37 , 54 , 74 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467452128,"SHARKEY, KEVIN, CRONIN",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 97 , 152 , 238 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467452128,"SHARKEY, KEVIN, CRONIN",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 29 , 29 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467452128,"SHARKEY, KEVIN, CRONIN",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1487809265,SOUND MEDICAL OF CAPE CATERET,~,3608 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1467453449,"DALY, CLAUDIA, HAUCK",3609 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 52 , 97 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1467453936,"THAKUR, ANAYET, UDDIN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1467453936,"THAKUR, ANAYET, UDDIN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 83 , 83 ,$#,,
MEDICAID DIRECT,1467455444,"DREW IV, THOMAS, CHAMPION",THOMAS CHAMPION DREW IV,117 GLENVIEW RD   ENFIELD NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice,1467455444,"DREW IV, THOMAS, CHAMPION",117 GLENVIEW RD   ENFIELD NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice, 221 , 496 ," 1,263 "," $79,696.48 ",,
MEDICAID DIRECT,1609299064,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN SURGICAL CENTER-2,,,Unknown,193200000X,Group,Multi-Specialty,,1467455493,"MEDLOCK, MELVIN, DUBOSE",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467455493,"MEDLOCK, MELVIN, DUBOSE",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 133 , 211 , 218 ," $16,588.42 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467455493,"MEDLOCK, MELVIN, DUBOSE",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 73 , 81 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467457283,"HENDRICKSON, STEVEN, CRAIG",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467457283,"HENDRICKSON, STEVEN, CRAIG",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467457283,"HENDRICKSON, STEVEN, CRAIG",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 28 , 33 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467458612,"BIZUB, BARBARA, JO",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467458612,"BIZUB, BARBARA, JO",3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 46 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1467458612,"BIZUB, BARBARA, JO",3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 43 , 102 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467458612,"BIZUB, BARBARA, JO",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467458802,"ASGHARIAN, BEHNAM",110 DENNIS DR   SANFORD NC,053,Lee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 25 , 46 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,,,Unknown,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467458802,"ASGHARIAN, BEHNAM",110 DENNIS DR   SANFORD NC,053,Lee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467458802,"ASGHARIAN, BEHNAM",110 DENNIS DR   SANFORD NC,053,Lee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467458802,"ASGHARIAN, BEHNAM",1135 CARTHAGE ST   SANFORD NC,053,Lee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 19 , 17 , 26 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,110 DENNIS DR   SANFORD NC,053,Lee,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467458802,"ASGHARIAN, BEHNAM",110 DENNIS DR   SANFORD NC,053,Lee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467458802,"ASGHARIAN, BEHNAM",205 PAGE RD   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 48 , 63 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467460097,"GROSS, STEVEN, CUMMINS",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 18 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467460097,"GROSS, STEVEN, CUMMINS",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467460097,"GROSS, STEVEN, CUMMINS",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467460097,"GROSS, STEVEN, CUMMINS",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467460097,"GROSS, STEVEN, CUMMINS",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 21 , 24 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1467460428,"KAVANAUGH, ALISON, SCOTT",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 17 , 42 ,$#,,
MEDICAID DIRECT,1578987848,UNC PHYSICIANS NETWORK LLC,~,7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467460428,"KAVANAUGH, ALISON, SCOTT",7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 19 , 40 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467461038,"LARSON, KINDRA, A.",2075 GLENN MITCHELL DR STE 500 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467461038,"LARSON, KINDRA, A.",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1467463760,"OMOJI, BASSEY, UJAH",PIEDMONT PEDIATRICS INC,140 PINEY FOREST RD STE B DANVILLE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1467463760,"OMOJI, BASSEY, UJAH",140 PINEY FOREST RD STE B DANVILLE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609191121,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1656 RIVERCHASE BLVD STE 2500 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467464305,"HAYNIE, JUSTIN, FLETCHER",1656 RIVERCHASE BLVD STE 2500 ROCK HILL SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467464305,"HAYNIE, JUSTIN, FLETCHER",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467466169,"DARNELL, JONES, BRIAN",180 PARKWOOD DR   ELKIN NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1689628729,NURSE ANESTHESIA OF NC PLLC,~,180 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1467466169,"DARNELL, JONES, BRIAN",180 PARKWOOD DR   ELKIN NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467466961,"GORETSKY, MICHAEL, JAY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1904 FRONT ST STE 530 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1467467183,"WALTER, RICARDO",1525 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 98 , 174 , 521 ," $21,270.37 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1467467183,"WALTER, RICARDO",1525 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 23 , 38 , 117 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1467467183,"WALTER, RICARDO",1525 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467468041,"DYER, ERIC, WAYNE",1168 E CUTLAR XING   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 28 , 60 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467468041,"DYER, ERIC, WAYNE",1168 E CUTLAR XING   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 157 , 263 ,$#,,
MEDICAID DIRECT,1013210517,KENT SEITZ MD PA,,1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1467469320,"SEITZ, KENT",1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#, 21 , 53 ,$#,,
MEDICAID DIRECT,1013210517,KENT SEITZ MD PA,,1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1467469320,"SEITZ, KENT",1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 24 , 147 , 235 ," $12,724.41 ",,
MEDICAID DIRECT,1467469320,"SEITZ, KENT",~,1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,1467469320,"SEITZ, KENT",1421 ORCHARD LAKE DR UNIT C CHARLOTTE NC,060,Mecklenburg,207RA0401X,Allopathic & Osteopathic Physicians,Internal Medicine,Addiction Medicine,#, 15 , 41 ,$#,,
MEDICAID DIRECT,1467469536,CHARLES AIESI CONSULTING INC,BROWARD MEDICAL LAB,181 W PROSPECT RD   OAKLAND PARK FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1467469536,CHARLES AIESI CONSULTING INC,181 W PROSPECT RD   OAKLAND PARK FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 43 , 45 , 90 ,$#,,
MEDICAID DIRECT,1467470260,WAL-MART STORES EAST LP,~,548 CC CAMP RD   ELKIN NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1467470260,WAL-MART STORES EAST LP,548 CC CAMP RD   ELKIN NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,624 QUAKER LN STE 200D HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467470773,"PATEL, KALPEN, NAVIN",624 QUAKER LN STE 100E HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467470773,"PATEL, KALPEN, NAVIN",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467470773,"PATEL, KALPEN, NAVIN",601 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 68 , 104 , 171 ," $13,187.47 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467471060,"VAN METER, PATRICK, MICHAEL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 26 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467471060,"VAN METER, PATRICK, MICHAEL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467471292,"FLEISHMAN, LAWRENCE, MARK",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619904430,SOUTH CHARLOTTE PRIMARY CARE,ATRIUM HEALTH PRIMARY CARE SOUTH CHARLOTTE INTERNA,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467471292,"FLEISHMAN, LAWRENCE, MARK",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467471292,"FLEISHMAN, LAWRENCE, MARK",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467471771,"MCCURDY, ELEANOR, MARK",1718 E 4TH ST STE 907 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467471771,"MCCURDY, ELEANOR, MARK",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467471771,"MCCURDY, ELEANOR, MARK",6324 FAIRVIEW RD STE 430 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467472100,"MCINNIS, DANIEL, ANGUS",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 179 , 188 , 715 ," $18,231.81 ",,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467472100,"MCINNIS, DANIEL, ANGUS",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467472100,"MCINNIS, DANIEL, ANGUS",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice," 1,048 "," 1,100 "," 4,004 "," $109,307.06 ",,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467472100,"MCINNIS, DANIEL, ANGUS",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 77 , 79 , 267 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467472100,"MCINNIS, DANIEL, ANGUS",1031 WEISS AVE STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467472100,"MCINNIS, DANIEL, ANGUS",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467472209,"UCHENDU, NNENNA, IHUOMA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467472209,"UCHENDU, NNENNA, IHUOMA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 257 , 259 ," $12,540.70 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467472621,"DONNELLY, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1467472621,"DONNELLY, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467472621,"DONNELLY, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 82 , 91 , 95 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467472621,"DONNELLY, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467472621,"DONNELLY, LANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1033877592,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DILLON FAMILY MEDICINE,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467473801,"FITZGIBBON, TIMOTHY, ANDREW",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 35 , 199 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467475061,"PERRY, ANGELA, DOSS",1226 EASTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 34 , 66 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467475061,"PERRY, ANGELA, DOSS",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 42 , 42 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467475061,"PERRY, ANGELA, DOSS",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467475061,"PERRY, ANGELA, DOSS",728 PINEY GROVE RD   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467475061,"PERRY, ANGELA, DOSS",728 PINEY GROVE RD   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 46 , 46 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467475061,"PERRY, ANGELA, DOSS",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467475061,"PERRY, ANGELA, DOSS",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467475061,"PERRY, ANGELA, DOSS",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 26 , 26 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467475285,"MILLER, MARY, SUZANNE",719 GREEN VALLEY RD STE 101 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 30 , 50 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467475285,"MILLER, MARY, SUZANNE",930 3RD ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467475772,"HUDSON, ALBERT, DENNING",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467475772,"HUDSON, ALBERT, DENNING",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 23 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467475772,"HUDSON, ALBERT, DENNING",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467475772,"HUDSON, ALBERT, DENNING",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467476259,"KELLY, JOHN, LINUS",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467476416,"BAKER, BRENDA, GIBBS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467476416,"BAKER, BRENDA, GIBBS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467476416,"BAKER, BRENDA, GIBBS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467477901,"MILLER, CHAD, MICHAEL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1467478230,"DWYER, DANIEL, PATRICK",4810 S CROATAN HWY STE 100 NAGS HEAD NC,028,Dare,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 22 , 35 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467478230,"DWYER, DANIEL, PATRICK",4810 S CROATAN HWY STE 100 NAGS HEAD NC,028,Dare,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396852570,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1002 N CHURCH ST STE 2 GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467479204,"SCHOOLER, VINCENT, CYRIL",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467479204,"SCHOOLER, VINCENT, CYRIL",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 52 , 81 , 112 ,$#,,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467479493,"EPPS, CONSTANCE, ARNETTRES",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 103 , 106 , 405 ," $17,461.64 ",,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467479493,"EPPS, CONSTANCE, ARNETTRES",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467479493,"EPPS, CONSTANCE, ARNETTRES",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 29 ,$#,,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467479493,"EPPS, CONSTANCE, ARNETTRES",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 3,031 "," 4,490 "," 16,885 "," $815,412.78 ",,
MEDICAID DIRECT,1467479618,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1372,4500 FAYETTEVILLE RD   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1467479618,WAL-MART STORES EAST LP,4500 FAYETTEVILLE RD   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1467479618,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1372,4500 FAYETTEVILLE RD   RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1467479618,WAL-MART STORES EAST LP,4500 FAYETTEVILLE RD   RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1700643335,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES MYRTLE BEACH,107 MCLEOD HEALTH BLVD. SUITE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457804080,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES MYRTLE BEACH,107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1902663529,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES LORIS,3485 MITCHELL STREET   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 16 , 17 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 20 , 21 ,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467479808,"KOWALSKI, BRUCE, JAY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467481945,"BASS, LAWRENCE, ADRIAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 64 , 72 , 92 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467483743,"HENSLEY, AMY, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 49 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467485326,"FULBRIGHT, VIRGINIA, ELIZABETH",5826 SAMET DR STE 101 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 75 , 89 ,$#,,
MEDICAID DIRECT,1467485367,SPEECH SOLUTIONS INCORPORATED,SPEECH SOLUTIONS INCORPORATED,127 VILLAGE RD UNIT B SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1467485367,SPEECH SOLUTIONS INCORPORATED,127 VILLAGE RD UNIT B SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,, 14 , 112 , 112 ,$#,,
MEDICAID DIRECT,1467485367,SPEECH SOLUTIONS INCORPORATED,SPEECH SOLUTIONS INCORPORATED,704 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1467485367,SPEECH SOLUTIONS INCORPORATED,704 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,, 24 , 183 , 197 ," $13,662.34 ",,
MEDICAID DIRECT,1467485367,SPEECH SOLUTIONS INCORPORATED,SPEECH SOLUTIONS INCORPORATED,123 E COLUMBUS ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1467485367,SPEECH SOLUTIONS INCORPORATED,123 E COLUMBUS ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,, 52 , 621 , 647 ," $44,783.06 ",,
MEDICAID DIRECT,1467485367,SPEECH SOLUTIONS INCORPORATED,SPEECH SOLUTIONS INCORPORATED,580 FARRINGDOM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467485367,SPEECH SOLUTIONS INCORPORATED,580 FARRINGDOM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,, 121 ," 1,630 "," 1,653 "," $113,543.70 ",,
MEDICAID DIRECT,1467485367,SPEECH SOLUTIONS INCORPORATED,SPEECH SOLUTIONS INCORPORATED,714 ATKINSON ST   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1467485367,SPEECH SOLUTIONS INCORPORATED,714 ATKINSON ST   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,, 38 , 429 , 433 ," $30,632.70 ",,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467486027,"EICHELBERGER, SCOTT, PRESTON",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467486621,"PELLOM, GARY, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 43 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467486621,"PELLOM, GARY, LEE",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467486621,"PELLOM, GARY, LEE",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 28 , 35 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",505 OBERLIN RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 13 , 20 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 23 , 48 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467487025,"DEOL, GURVINDER, SINGH",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1922434307,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467487322,"WALLACE, AMY, JO",861 OLD WINSTON RD STE 101 KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 51 , 104 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467487322,"WALLACE, AMY, JO",3746 VEST MILL RD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1467490854,"SWARUP, JITENDRA",3524 N CROATAN HWY   KITTY HAWK NC,028,Dare,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1467490854,"SWARUP, JITENDRA",1730 CAROLINA AVE   WASHINGTON NC,007,Beaufort,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 121 , 217 , 277 ," $24,049.37 ",,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1467490854,"SWARUP, JITENDRA",2511 N QUEEN ST   KINSTON NC,054,Lenoir,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 83 , 145 , 206 ," $13,120.52 ",,
MEDICAID DIRECT,1154986347,CENTER FOR VISUAL SURGICAL EXCELLEN,,208 CARMICHAEL WAY   CHESAPEAKE VA,101,Out of State <= 40 miles,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467490854,"SWARUP, JITENDRA",1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1467490854,"SWARUP, JITENDRA",1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 155 , 205 , 298 ," $12,097.24 ",,
MEDICAID DIRECT,1467491035,"JONES, EMMETT, MORTON",~,3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,1467491035,"JONES, EMMETT, MORTON",3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 294 , 436 ," 1,320 "," $76,163.35 ",,
MEDICAID DIRECT,1023633930,"KANOSKY, MARCIE, LYNNE",,3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,1467491035,"JONES, EMMETT, MORTON",3745 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1619013562,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH NORTHPARK,251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467491761,"SODOMA, LINDSAY, MARIE",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467491761,"SODOMA, LINDSAY, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467491795,"ARRIVIELLO, RICHARD, THOMAS",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 48 , 49 , 75 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1467492587,"HELMS, VAN, EDWARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 31 , 32 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467492587,"HELMS, VAN, EDWARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 21 , 31 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1467493304,"KEELER, TIMOTHY, DAVID",175 TRYON RD STE A RUTHERFORDTON NC,081,Rutherford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467493304,"KEELER, TIMOTHY, DAVID",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,,,Unknown,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467494021,"VARANASI, RAVIKANT, VEERABHADRA",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467494021,"VARANASI, RAVIKANT, VEERABHADRA",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467494021,"VARANASI, RAVIKANT, VEERABHADRA",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467494021,"VARANASI, RAVIKANT, VEERABHADRA",205 PAGE RD   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 44 , 63 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467494021,"VARANASI, RAVIKANT, VEERABHADRA",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 30 , 29 , 45 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467494021,"VARANASI, RAVIKANT, VEERABHADRA",110 DENNIS DR   SANFORD NC,053,Lee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 14 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,110 DENNIS DR   SANFORD NC,053,Lee,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467494021,"VARANASI, RAVIKANT, VEERABHADRA",110 DENNIS DR   SANFORD NC,053,Lee,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1467494500,"SPEED, SHARON, YVONNE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1467494500,"SPEED, SHARON, YVONNE",811 US 70 HWY W   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467494500,"SPEED, SHARON, YVONNE",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467495069,"OGHALAI, MARK, ALAN",~,1405 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1467495069,"OGHALAI, MARK, ALAN",1405 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 15 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467495176,"STALLINGS, WENDY, JOY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 91 , 108 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467495176,"STALLINGS, WENDY, JOY",115 HEART DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467495176,"STALLINGS, WENDY, JOY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467495457,PAMLICO COUNTY RESCUE SQUAD,Pamlico County Rescue Squad,911 GRACE DANIELS RD   BAYBORO NC,069,Pamlico,3416L0300X,Transportation Services,Ambulance,Land Transport,1467495457,PAMLICO COUNTY RESCUE SQUAD,911 GRACE DANIELS RD   BAYBORO NC,069,Pamlico,3416L0300X,Transportation Services,Ambulance,Land Transport, 105 , 157 , 299 ,$#,,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1467495903,"FLEURY, ROBERT, ANDRE",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467496331,"REED, ROB, ALLEN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 35 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467496422,"KELLY, JONATHAN, DAVID",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 39 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467496422,"KELLY, JONATHAN, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1467496760,"VAIDYA, PRABHAKAR, NARHARI",133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1467496760,"VAIDYA, PRABHAKAR, NARHARI",133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 54 , 61 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1467496760,"VAIDYA, PRABHAKAR, NARHARI",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1467496760,"VAIDYA, PRABHAKAR, NARHARI",133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1467496760,"VAIDYA, PRABHAKAR, NARHARI",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467496869,"MCDONALD, JOHN, MATTHEW",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467496869,"MCDONALD, JOHN, MATTHEW",125 QUEENS RD STE 540 CHARLOTTE NC,060,Mecklenburg,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 18 , 35 , 50 ,$#,,
MEDICAID DIRECT,1023413580,INTERNAL MEDICINE OF WAKEFIELD,,11081 FOREST PINES DR STE 124 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467498840,"REYES, LAVINIA, TE",11081 FOREST PINES DR STE 124 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 199 , 309 ,$#,,
MEDICAID DIRECT,1578118089,LIBERTY HEALTHCARE GROUP LLC,LIBERTY COMMONS NSGANDREHAB CTR OF FRANKLIN CO LLC,202 SMOKETREE WAY   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467498840,"REYES, LAVINIA, TE",11081 FOREST PINES DR STE 124 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 21 ," $38,084.40 ",,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1467498907,"MCCULLEN, GINGER, ELIZABETH",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 18 , 24 , 58 ,$#,,
MEDICAID DIRECT,1710073606,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3800 ROBERT PORCHER WAY STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467498980,"WOLTERS, SHARON",3800 ROBERT PORCHER WAY STE 200 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 80 , 277 ,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1467499061,"WILSON, BRETT, LAMOND",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467499087,"MCNULTY, BRENDAN, DAVID",300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1467499087,"MCNULTY, BRENDAN, DAVID",300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 32 , 66 , 66 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467499327,"BURNHAM, CATHERINE, LEIGH",251 KEISLER DR STE 101 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 250 ," 1,775 "," 1,865 "," $42,167.30 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467499327,"BURNHAM, CATHERINE, LEIGH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467499376,"FARPOUR, ALIREZA",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467499376,"FARPOUR, ALIREZA",113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,,,Unknown,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 35 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 22 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467499608,"DALESSIO, THOMAS, LOUIS",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1467500975,YOU SHARE WE CARE INC,~,8604 CLIFF CAMERON DR STE 165 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1467500975,YOU SHARE WE CARE INC,8604 CLIFF CAMERON DR STE 165 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 44 ," 10,099 "," 10,135 "," $680,734.84 ",,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467501007,"ROUSE, BETTY, CAROLYN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1306046875,VANCEBORO INTERNAL MEDICINE,,260 NC HIGHWAY 43   VANCEBORO NC,025,Craven,193400000X,Group,Single Specialty,,1467502211,"SANDHU, GURINDER, PAUL SINGH",260 NC HIGHWAY 43   VANCEBORO NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 153 , 255 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1467502211,"SANDHU, GURINDER, PAUL SINGH",260 NC HIGHWAY 43   VANCEBORO NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1467508044,"SWAIN, KATHERINE, LYNN",600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 86 , 160 , 393 ," $18,178.04 ",,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1467508044,"SWAIN, KATHERINE, LYNN",157 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 20 , 66 ,$#,,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 110 , 110 , 113 ," $10,809.48 ",,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 19 , 19 , 19 ," $13,056.17 ",,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 271 , 281 , 319 ," $51,114.75 ",,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 43 , 43 , 52 ,$#,,
MEDICAID DIRECT,1720014152,LARRY J MORAY DDS MS PA,MYORTHODONTIST,150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 151 , 154 , 185 ," $25,104.97 ",,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1366560443,LARRY J MORAY DDS MS PA,MYORTHODONTIST,2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 84 , 84 , 91 ," $10,184.24 ",,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",1919 BRAGG ST STE 7 SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 269 , 275 , 337 ," $70,862.83 ",,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 116 , 120 , 130 ," $15,162.72 ",,
MEDICAID DIRECT,1720014152,LARRY J MORAY DDS MS PA,MYORTHODONTIST,150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 52 , 52 , 58 ," $10,624.17 ",,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 228 , 228 , 283 ," $43,243.35 ",,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1467510461,"SOLTMANN, RENATE, ELIZABETH",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 185 , 187 , 222 ," $35,352.97 ",,
MEDICAID DIRECT,1467511014,ATLANTIC PROSTHETICS AND ORTHOTICS,Atlantic Prosthetics and Orthotics LLC,200 TIMBERHILL PL UNIT 203 CHAPEL HILL NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1467511014,ATLANTIC PROSTHETICS AND ORTHOTICS,200 TIMBERHILL PL UNIT 203 CHAPEL HILL NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 45 , 64 , 468 ," $72,495.42 ",,
MEDICAID DIRECT,1467512020,DONNA S YOUNTS AND ASSOCIATES INC,DONNA S YOUNTS AND ASSOCIATES INC,110 SCOTT AVE STE 11 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467512020,DONNA S YOUNTS AND ASSOCIATES INC,110 SCOTT AVE STE 11 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,#, 247 , 247 ," $16,733.65 ",,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467513143,WEST CALDWELL HEALTH COUNCIL INC,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467515247,"SCHWEITZER, MICHELLE, MARSH",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 17 , 22 ,$#,,
MEDICAID DIRECT,1083886345,SKIP TYSON DDS & STEPHANIE HEANEY D,SKIP TYSON DDS AND STEPHANIE HEANEY DDS PA,2606 IRON GATE DR STE 200 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467516997,"HEANEY, STEPHANIE, FRECCIA",2606 IRON GATE DR STE 200 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 176 , 299 , 987 ," $41,025.49 ",,
MEDICAID DIRECT,1205809589,WILMINGTON PATHOLOGY ASSOCIATES PA,WILMINGTON PATHOLOGY ASSOCIATES PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467517540,"WEISS, MARK, ALEXANDER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,,,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467517631,"SHAW, WILLIAM, FREDERICK",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467517631,"SHAW, WILLIAM, FREDERICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467517631,"SHAW, WILLIAM, FREDERICK",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467517631,"SHAW, WILLIAM, FREDERICK",144 FOREST HILL RD STE 144&146 LEXINGTON NC,029,Davidson,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467517631,"SHAW, WILLIAM, FREDERICK",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 93 , 116 , 116 ,$#,,
MEDICAID DIRECT,1467518225,JAREH HEALTHCARE INC,~,2116 S MIAMI BLVD   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1467518225,JAREH HEALTHCARE INC,2116 S MIAMI BLVD   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 837 , 837 ," $64,582.56 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467518928,"CARON, DAVID, JOSEPH",111 S SALISBURY GQ AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467518928,"CARON, DAVID, JOSEPH",115 BROWN ST   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699540203,GQ INTERNAL MEDICINE AND PEDIATRICS,,111 S SALISBURY GQ AVE   GRANITE QRY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1467518928,"CARON, DAVID, JOSEPH",111 S SALISBURY GQ AVE   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 120 , 271 , 536 ,$#,,
MEDICAID DIRECT,1699540203,GQ INTERNAL MEDICINE AND PEDIATRICS,,111 S SALISBURY GQ AVE   GRANITE QRY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1467518928,"CARON, DAVID, JOSEPH",115 BROWN ST   SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699540203,GQ INTERNAL MEDICINE AND PEDIATRICS,,111 S SALISBURY GQ AVE   GRANITE QRY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1467518928,"CARON, DAVID, JOSEPH",111 S SALISBURY GQ AVE   GRANITE QUARRY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 79 , 174 , 420 ,$#,,
MEDICAID DIRECT,1467519520,"NELSON SR, LIONEL, MATTHEW",~,3325 DURHAM CHAPEL HILL BLVD STE 303 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1467519520,"NELSON SR, LIONEL, MATTHEW",3325 DURHAM CHAPEL HILL BLVD STE 303 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265403042,NORTH CAROLINA NEUROPSYCHIATRY,NORTH CAROLINA NEUROPSYCHIATRY PA,1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467521054,"RIFFE, LEIGH, SHEPHERD",1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467521351,"BASSIRI, ARASH, THOMAS",PINE VALLEY FAMILY DENTISTRY,1661 OWEN DR   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,1467521351,"BASSIRI, ARASH, THOMAS",1661 OWEN DR   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 89 , 199 , 529 ," $20,347.78 ",,
MEDICAID DIRECT,1689799082,NEAL S TAUB MD PA,~,3535 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467521567,"TAUB, NEAL, STEPHEN",3535 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 206 , 925 ," 1,052 "," $20,338.69 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467521757,"SHAHEEN, NICHOLAS, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 50 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467522292,"MORETTI, EUGENE, WILLIAM",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 174 , 199 , 200 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467522292,"MORETTI, EUGENE, WILLIAM",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467522292,"MORETTI, EUGENE, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467522292,"MORETTI, EUGENE, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467524074,"LEE, LEE-THIERRY, TIEN",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1467524074,"LEE, LEE-THIERRY, TIEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316000243,CAPLINGER CHIROPRACTIC PC,CAPLINGER FAMILY PHYSICAL AND PAIN CARE,218 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1467529149,"CAPLINGER, JOHN, NEIL",218 ASHEVILLE HWY   SYLVA NC,050,Jackson,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467529222,"YEH, SIEGFRIED, CHANG RONG",104 COMMERCIAL DR   PRINCETON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467529222,"YEH, SIEGFRIED, CHANG RONG",327 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 ,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1467529222,"YEH, SIEGFRIED, CHANG RONG",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 29 , 29 ," $10,984.83 ",,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467529222,"YEH, SIEGFRIED, CHANG RONG",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 128 , 155 , 388 ," $16,624.23 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467529644,"CURL, DAVID, HEMINGWAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 955 ," 1,084 "," $29,076.66 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467529644,"CURL, DAVID, HEMINGWAY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 480 , 523 ," $14,266.33 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467529644,"CURL, DAVID, HEMINGWAY",3420 WAKE FOREST RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,10650 PARK RD STE 480 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467530758,"ZACKS, STEVEN, LAWRENCE",10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467530758,"ZACKS, STEVEN, LAWRENCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,10502 PARK RD STE 110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467530758,"ZACKS, STEVEN, LAWRENCE",10502 PARK RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology, 16 , 20 , 21 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467530758,"ZACKS, STEVEN, LAWRENCE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1427000181,EYECARECENTER OD PA,EYECARE CENTER,4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467531590,"WENZ, DAVID, MARTIN",4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467533745,"MAGOD, MARC, EMANUEL",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 24 , 41 , 51 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467533745,"MAGOD, MARC, EMANUEL",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467536334,"SWAMY, GEETA, KRISHNA",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 16 , 17 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467536334,"SWAMY, GEETA, KRISHNA",2301 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639340979,VAN G DELLINGER OD PA,~,201 W CHURCH ST   CHERRYVILLE NC,036,Gaston,193400000X,Group,Single Specialty,,1467536821,"DELLINGER, VAN",201 W CHURCH ST   CHERRYVILLE NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1467536821,"DELLINGER, VAN",VAN G DELLINGER OD PA,201 W CHURCH ST   CHERRYVILLE NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,1467536821,"DELLINGER, VAN",201 W CHURCH ST   CHERRYVILLE NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1639340979,VAN G DELLINGER OD PA,~,201 W CHURCH ST   CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467536821,"DELLINGER, VAN",201 W CHURCH ST   CHERRYVILLE NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,, 62 , 69 , 85 ,$#,,
MEDICAID DIRECT,1467537696,LINCARE INC,LINCARE INC,530 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1467537696,LINCARE INC,530 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 12 , 65 , 86 ,$#,,
MEDICAID DIRECT,1467537696,LINCARE INC,LINCARE INC,530 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1467537696,LINCARE INC,530 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1467537696,LINCARE INC,LINCARE INC,530 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1467537696,LINCARE INC,530 W PARK CIR   NORTH WILKESBORO NC,097,Wilkes,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 466 ," 2,416 "," 3,909 "," $105,506.24 ",,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1467537852,"KOINIS, THOMAS, FRANK",101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 43 , 98 ,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1467537852,"KOINIS, THOMAS, FRANK",101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1490 WILLIAMSBORO ST   OXFORD NC,091,Vance,193200000X,Group,Multi-Specialty,,1467537852,"KOINIS, THOMAS, FRANK",101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 83 , 125 , 279 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1467540534,"PERLMUTTER, MARK, NICHOLAS",110 PATRICK CT   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 176 , 329 , 560 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1467540534,"PERLMUTTER, MARK, NICHOLAS",2906 N MAIN ST   TARBORO NC,033,Edgecombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 16 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 35 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 49 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",3475 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 45 , 57 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467547182,"VINSON, EMILY, NICOLE",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467550814,"HARTLEY, TAMARA, ANNE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467552497,"GREENBERG, SETH, H",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1467556134,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02471,6840 GLENWOOD AVE   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1467556134,NORTH CAROLINA CVS PHARMACY LLC,6840 GLENWOOD AVE   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 25 , 57 ,$#,,
MEDICAID DIRECT,1376893057,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PRIMARY CARE CHARLOTTE INTERNAL MEDI,400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467556514,"CHENG, IRIS, SUGIE",400 E MOREHEAD ST STE 202 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467556514,"CHENG, IRIS, SUGIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 78 , 87 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467556514,"CHENG, IRIS, SUGIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467556514,"CHENG, IRIS, SUGIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467558577,"BADDIGAM, KRISHNAMOHAN, R.",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467558577,"BADDIGAM, KRISHNAMOHAN, R.",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467558577,"BADDIGAM, KRISHNAMOHAN, R.",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467558577,"BADDIGAM, KRISHNAMOHAN, R.",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1902233380,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC ENDOCRINOLOGY - HUNTERSVILLE,9625 NORTHCROSS CENTER CT STE 102C HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467558924,"LYNSHUE, KECHA, ANNMARIE",9625 NORTHCROSS CENTER COURT SUITE 102C HUNTERSVILLE NC,060,Mecklenburg,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1902233380,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC ENDOCRINOLOGY - HUNTERSVILLE,9625 NORTHCROSS CENTER CT STE 102C HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467558924,"LYNSHUE, KECHA, ANNMARIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1912334335,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC ENDOCRINOLOGY,100 MEDICAL PARK DR STE 310B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467558924,"LYNSHUE, KECHA, ANNMARIE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 44 , 62 , 106 ,$#,,
MEDICAID DIRECT,1467559393,ARCHDALE DRUG CO INC,~,11220 N MAIN ST   HIGH POINT NC,076,Randolph,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1467559393,ARCHDALE DRUG CO INC,11220 N MAIN ST   HIGH POINT NC,076,Randolph,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1467560185,"VANN, SHANNON, DUDLEY",~,110 E WALL ST   RURAL HALL NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1467560185,"VANN, SHANNON, DUDLEY",110 E WALL ST   RURAL HALL NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 57 , 173 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1467561589,"DEVRIES, DAVID, TODD",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 29 , 69 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,855 EAST ST   PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1467561589,"DEVRIES, DAVID, TODD",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",6000 RAMSEY ST STE 108 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 44 , 64 , 107 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 78 , 128 , 222 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 177 , 251 , 498 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",142 PARACLETE DR STE 301 RAEFORD NC,047,Hoke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",142 PARACLETE DR STE 301 RAEFORD NC,047,Hoke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467562173,"LACAP, ANTON, PETER",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467563593,"MATTHEWS, CATHERINE, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 55 , 101 ,$#,,
MEDICAID DIRECT,1265545925,DUPLIN OB GYN PA,DUPLIN OB GYN PA,149 LIMESTONE RD STE 2 KENANSVILLE NC,031,Duplin,193400000X,Group,Single Specialty,,1467565127,"COOPER, JOSEPH, LITTON",149 LIMESTONE RD STE 2 KENANSVILLE NC,031,Duplin,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 86 , 92 , 93 ,$#,,
MEDICAID DIRECT,1265545925,DUPLIN OB GYN PA,DUPLIN OB GYN PA,149 LIMESTONE RD STE 2 KENANSVILLE NC,031,Duplin,193400000X,Group,Single Specialty,,1467565127,"COOPER, JOSEPH, LITTON",3125 POPLARWOOD CT STE 119 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 69 , 76 , 84 ,$#,,
MEDICAID DIRECT,1932271103,WILSON FAMILY CHIROPRACTIC,WILSON FAMILY CHIROPRACTIC,73 W MAIN ST   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1467566034,"WILSON, KATHRYN, KAY SPEICHER",73 W MAIN ST   SYLVA NC,050,Jackson,111N00000X,Chiropractic Providers,Chiropractor,, 15 , 26 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467566075,"HLADIK, GERALD, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467566075,"HLADIK, GERALD, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 85 , 88 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467566075,"HLADIK, GERALD, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 30 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467566075,"HLADIK, GERALD, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 69 , 79 ,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467566133,"MONTGOMERY, RANEE, CHATTERJEE",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467567735,"BROWN, CHRISTOPHER, ROBERT",DUKE HOSPITAL 1000 TRENT DR DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 15 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467567735,"BROWN, CHRISTOPHER, ROBERT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467567735,"BROWN, CHRISTOPHER, ROBERT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467567735,"BROWN, CHRISTOPHER, ROBERT",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 35 , 43 , 50 ,$#,,
MEDICAID DIRECT,1467568014,"TRAINOR, KELLY, MARIE",KELLY TRAINOR OTRL,1204 WINDSONG DR   GREENVILLE NC,074,Pitt,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1467568014,"TRAINOR, KELLY, MARIE",1204 WINDSONG DR   GREENVILLE NC,074,Pitt,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1467569483,"GAFFNEY, MARY, ELIZABETH",,4935 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1467569483,"GAFFNEY, MARY, ELIZABETH",4935 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275778011,GAFFNEY HEALTH SERVICES INC,GAFFNEY HEALTH SERVICES,4935 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467569483,"GAFFNEY, MARY, ELIZABETH",4935 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 68 , 109 ,$#,,
MEDICAID DIRECT,1275778011,GAFFNEY HEALTH SERVICES INC,GAFFNEY HEALTH SERVICES,4935 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467569483,"GAFFNEY, MARY, ELIZABETH",4935 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 29 , 104 , 155 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467573659,"THUKKANI, ARUN, KANTH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467573659,"THUKKANI, ARUN, KANTH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,,,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467573659,"THUKKANI, ARUN, KANTH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 18 , 24 , 24 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467573659,"THUKKANI, ARUN, KANTH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 63 , 78 , 110 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467573659,"THUKKANI, ARUN, KANTH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467573659,"THUKKANI, ARUN, KANTH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1316512551,ACTIVE LIFE HEALTH OF CHARLOTTE PLL,ARTHRITIS KNEE PAIN CENTERS,8401 MEDICAL PLAZA DR STE 355 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467573980,"STOCK, ALEX, VICTOR",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 86 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467573980,"STOCK, ALEX, VICTOR",5325 VINNING ST NW STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467581348,"SHELTON, GARY, RYAN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467581348,"SHELTON, GARY, RYAN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 25 ,$#,,
MEDICAID DIRECT,1467582395,WHITEVILLE CITY SCHOOLS,WHITEVILLE CITY SCHOOLS,107 W WALTER ST   WHITEVILLE NC,024,Columbus,251300000X,Agencies,Local Education Agency (LEA),,1467582395,WHITEVILLE CITY SCHOOLS,107 W WALTER ST   WHITEVILLE NC,024,Columbus,251300000X,Agencies,Local Education Agency (LEA),, 130 ," 2,089 "," 2,258 "," $105,278.68 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467586917,"QUINONEZ, ROCIO, BEATRIZ",DENTAL FACULTY PRACTICE 143 BRAUER HALL CB 7450 CHAPEL HILL NC,019,Chatham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 25 , 25 , 332 ," $35,641.09 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467586917,"QUINONEZ, ROCIO, BEATRIZ",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 30 , 31 , 65 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467586917,"QUINONEZ, ROCIO, BEATRIZ",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 26 , 26 , 335 ," $26,230.48 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467586917,"QUINONEZ, ROCIO, BEATRIZ",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 30 , 55 , 173 ,$#,,
MEDICAID DIRECT,1467590596,TEAM THERAPY,TEAM THERAPY SERVICES,4702 NC HIGHWAY 48   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1467590596,TEAM THERAPY,4702 NC HIGHWAY 48   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,, 22 , 306 , 314 ," $29,144.59 ",,
MEDICAID DIRECT,1467590596,TEAM THERAPY,TEAM THERAPY SERVICES,802 E WASHINGTON ST STE B NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1467590596,TEAM THERAPY,802 E WASHINGTON ST STE B NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,, 35 , 408 , 427 ," $38,767.70 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467593590,"ADAMS, MEREDITH, CLAIRE BRANDT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467594218,"JOHNSON, DOUGLAS, WILLIAM",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053337048,WESTERN CAROLINA UNIVERSITY,WESTERN CAROLINA UNIVERSITY SPEECH AND HEARING CEN,3971 LITTLE SAVANNAH RD RM 132 CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1467599068,"DORNEY, KATHRYN, EILEEN",3971 LITTLE SAVANNAH RD RM 132 CULLOWHEE NC,050,Jackson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1003288093,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1656 RIVERCHASE BLVD STE 1800 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467601195,"MUNOZ, MELCHOR, HERNAN",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1467603290,"THOMAS, MELISSA, KAY",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1467603290,"THOMAS, MELISSA, KAY",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467603290,"THOMAS, MELISSA, KAY",320 LILLINGTON AVE STE 101 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1467603290,"THOMAS, MELISSA, KAY",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1467603290,"THOMAS, MELISSA, KAY",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1467603290,"THOMAS, MELISSA, KAY",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467603431,"CLARK, DENISE, RAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,11783 ROCK LANDING DR   NEWPORT NEWS VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467604926,"FOCSENEANU, MARIEL, AIDA",11783 ROCK LANDING DR   NEWPORT NEWS VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,6425 RICHMOND RD   WILLIAMSBURG VA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467604926,"FOCSENEANU, MARIEL, AIDA",6425 RICHMOND RD   WILLIAMSBURG VA,102,Out of State > 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467604926,"FOCSENEANU, MARIEL, AIDA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083835441,SOUTHEASTERN PHYSICIAN SERVICES,SOUTHEASTERN PHYSICIAN SERVICES,435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467609735,"RAYMER, MELISSA, JEAN",435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467611012,"GORALSKI, JENNIFER, LYNN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 36 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467611012,"GORALSKI, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467611012,"GORALSKI, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 25 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467611012,"GORALSKI, JENNIFER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467612218,"CHEN, YONGYUE",113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467612218,"CHEN, YONGYUE",113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467612945,"IGBA, EBI, PHILLIA",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1467612945,"IGBA, EBI, PHILLIA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467613422,"DOHERTY, TIMOTHY, JAMES",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467613422,"DOHERTY, TIMOTHY, JAMES",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467614826,"SHAH, KANT, PRADIP",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 128 , 135 , 137 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1467614826,"SHAH, KANT, PRADIP",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467617126,"NICHOLAS, JENNIFER, LYNN",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1467617688,"CASANOVA, JUDITH",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467620906,"DEAL, ANNIE, STORIE",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 31 , 32 ,$#,,
MEDICAID DIRECT,1891002374,BLUE RIDGE HEALTHCARE MEDICAL GROUP,LENOIR FAMILY MEDICINE,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467620906,"DEAL, ANNIE, STORIE",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 17 , 33 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467620906,"DEAL, ANNIE, STORIE",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1467620906,"DEAL, ANNIE, STORIE",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1467620906,"DEAL, ANNIE, STORIE",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 25 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467625509,"BAE, JONATHAN, GREGORY",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467625509,"BAE, JONATHAN, GREGORY",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467625509,"BAE, JONATHAN, GREGORY",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",214 LANEFIELD RD   WARSAW NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",214 LANEFIELD RD   WARSAW NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,214 LANEFIELD RD   WARSAW NC,031,Duplin,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",214 LANEFIELD RD   WARSAW NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",214 LANEFIELD RD   WARSAW NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 30 , 31 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",214 LANEFIELD RD   WARSAW NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 28 , 29 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1467626788,"PETERSON, GAJARAH, B B",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467626929,"PURCELL, CHRISTOPHER, WILLIAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467626929,"PURCELL, CHRISTOPHER, WILLIAM",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 13 ,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467628644,"NICHOLS, MICHAEL, ALLISON",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 21 , 133 , 176 ,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467628644,"NICHOLS, MICHAEL, ALLISON",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 49 , 64 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467631523,"LERNER, CATHERINE, LUDEN BENTON",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 429 , 471 , 545 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467631523,"LERNER, CATHERINE, LUDEN BENTON",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 103 , 103 , 123 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467632281,"GONZALES, KRISTIN, HARBAUGH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467633057,"SARDESAI, MAHESH, PRABHAKER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 42 , 43 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467633818,"VOSS, ASHLEY, WICKLIFFE",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467633818,"VOSS, ASHLEY, WICKLIFFE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467634030,"BHARADWAJ, RAMESH, ANAND",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467634204,"STANWICK, NICHOLAS, RYAN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 107 , 210 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467634204,"STANWICK, NICHOLAS, RYAN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 31 , 79 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467634758,"SIKES III, CHARLES, VAN",124 WELTON WAY   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 52 , 71 , 109 ,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1467638791,"GIMPELEVICH, AKIVA, DMITRY",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 37 , 41 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467643254,"PACHECO-COLE, AURA, PAGBILAO",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467643254,"PACHECO-COLE, AURA, PAGBILAO",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467644708,"GEE, BRIANNA, GRIFFIN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467644708,"GEE, BRIANNA, GRIFFIN",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467646471,"WILES, BENJAMIN, SCOTT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1467646471,"WILES, BENJAMIN, SCOTT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467646471,"WILES, BENJAMIN, SCOTT",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467646471,"WILES, BENJAMIN, SCOTT",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467646471,"WILES, BENJAMIN, SCOTT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 70 , 86 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467646471,"WILES, BENJAMIN, SCOTT",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467648204,"NELSEN, JESSICA",895 STATE FARM RD STE 303 BOONE NC,095,Watauga,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 72 , 74 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 23 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 190 , 197 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 46 , 46 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 81 , 81 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1467650366,"ABULATIFA, KHALIL, TAHA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467650663,"JARRELL, STUART, TAYLOR",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467650663,"JARRELL, STUART, TAYLOR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467650663,"JARRELL, STUART, TAYLOR",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467650663,"JARRELL, STUART, TAYLOR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467650663,"JARRELL, STUART, TAYLOR",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467653196,"SANFORD, RYAN, BOBBITT",309 NEW ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 149 , 356 , 406 ," $11,959.21 ",,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467653196,"SANFORD, RYAN, BOBBITT",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467655779,"MANCL, TARA, BETH",109 BRIDGE ST STE 202 DANVILLE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467657361,"KOLLI, VAMSHI, KRISHNA",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801247960,PINNACLE RETINA PLLC,,4900 KOGER BLVD STE 125 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467657866,"PATEL, NARENDRA, MAFABHAI",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1801247960,PINNACLE RETINA PLLC,,4900 KOGER BLVD STE 125 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467657866,"PATEL, NARENDRA, MAFABHAI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 33 , 84 ,$#,,
MEDICAID DIRECT,1801247960,PINNACLE RETINA PLLC,,4900 KOGER BLVD STE 125 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467657866,"PATEL, NARENDRA, MAFABHAI",4900 KOGER BLVD STE 125 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 44 , 165 , 260 ," $26,537.06 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467657999,"LEWIS, KRISTINA, HENDERSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RB0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Obesity Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1467659177,"LEEPER, LAUREN, KILPATRICK",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 56 , 66 , 70 ,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467659177,"LEEPER, LAUREN, KILPATRICK",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467659177,"LEEPER, LAUREN, KILPATRICK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 34 , 58 , 87 ," $12,458.36 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467659177,"LEEPER, LAUREN, KILPATRICK",4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467659177,"LEEPER, LAUREN, KILPATRICK",4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467660597,"RAIZADA, AMOL",850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467660597,"RAIZADA, AMOL",2790 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1467661330,ABLENET,,2625 PATTON RD   ROSEVILLE MN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1467661330,ABLENET,2625 PATTON RD   ROSEVILLE MN,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 82 , 82 , 84 ," $381,518.86 ",,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467666370,"PATEL, YOGIN, KIRON",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1467666370,"PATEL, YOGIN, KIRON",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1467666370,"PATEL, YOGIN, KIRON",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1467666370,"PATEL, YOGIN, KIRON",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467152496,ALLES DDS KANNAPOLIS PLLC,IDEAL DENTAL KANNAPOLIS,582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467670018,"SWAYDEN, CHRISTOPHER, GEORGE",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467670018,"SWAYDEN, CHRISTOPHER, GEORGE",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 42 , 200 ,$#,,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467670018,"SWAYDEN, CHRISTOPHER, GEORGE",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 20 , 92 ,$#,,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467670018,"SWAYDEN, CHRISTOPHER, GEORGE",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467670018,"SWAYDEN, CHRISTOPHER, GEORGE",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 41 ,$#,,
MEDICAID DIRECT,1093497521,ALLES DDS HUNTERSVILLE PLLC,IDEAL DENTAL HUNTERSVILLE,14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467670018,"SWAYDEN, CHRISTOPHER, GEORGE",14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 82 ,$#,,
MEDICAID DIRECT,1184219222,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PEDIATRICS,713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1467672238,"SANGER, EDWARD, MICHAEL",713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 27 , 30 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1467673269,"FORT, AMBER, ESTELLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467673723,"JERNIGAN, SARAH, CRISSEY",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 58 , 80 , 120 ," $20,496.78 ",,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1467674465,"YU, HONG",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 41 , 107 , 134 ,$#,,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1467674465,"YU, HONG",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1467674465,"YU, HONG",901 RIDGE RD   ROXBORO NC,073,Person,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1386186120,JACKSON HM SERVICES PC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1467676817,"RIVENBARK, DON, ALAN",68 HOSPITAL RD   SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 116 , 116 ,$#,,
MEDICAID DIRECT,1194873901,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH INFECTIOUS DISEASE SPECIALISTS,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467678979,"DARNELL, TIMOTHY, ALAN",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467678979,"DARNELL, TIMOTHY, ALAN",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 76 , 198 , 233 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 49 , 69 , 103 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467680918,"CHAUDHARI, SAMEER, SADASHIV",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 23 , 25 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467682658,"HALL, BROOKE, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1467682781,"SCHILLING, SAMANTHA, SNOW",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 20 , 51 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1467682781,"SCHILLING, SAMANTHA, SNOW",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467687376,"HELMS, JONATHAN, ROBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 111 , 177 , 302 ," $44,307.62 ",,
MEDICAID DIRECT,1598320830,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROGYNECOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467689752,"WILLIAMS, KATHRYN, SHAW",210 ASHVILLE AVE   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 19 , 36 ,$#,,
MEDICAID DIRECT,1124771985,WAKEMED SURGERY CENTER - CARY LLC,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467689752,"WILLIAMS, KATHRYN, SHAW",210 ASHVILLE AVE   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1467690578,FAMILY MEDICAL SUPPLY LLC,~,1202 S GLENBURNIE RD   NEW BERN NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1467690578,FAMILY MEDICAL SUPPLY LLC,1202 S GLENBURNIE RD   NEW BERN NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#," $11,452.97 ",,
MEDICAID DIRECT,1467690578,FAMILY MEDICAL SUPPLY LLC,~,1202 S GLENBURNIE RD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1467690578,FAMILY MEDICAL SUPPLY LLC,1202 S GLENBURNIE RD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 388 ," 2,297 "," 3,976 "," $217,837.53 ",,
MEDICAID DIRECT,1467690578,FAMILY MEDICAL SUPPLY LLC,~,1202 S GLENBURNIE RD   NEW BERN NC,025,Craven,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1467690578,FAMILY MEDICAL SUPPLY LLC,1202 S GLENBURNIE RD   NEW BERN NC,025,Craven,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467691659,"KREIDER, KATHRYN, EVANS",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467691659,"KREIDER, KATHRYN, EVANS",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467691659,"KREIDER, KATHRYN, EVANS",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1467691766,"SMITH, MICHAEL, BRENT",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 30 , 36 ,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1467691766,"SMITH, MICHAEL, BRENT",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 252 , 370 , 465 ," $10,967.37 ",,
MEDICAID DIRECT,1578842035,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE RADIOLOGY,201 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1467691766,"SMITH, MICHAEL, BRENT",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 71 , 70 , 76 ,$#,,
MEDICAID DIRECT,1013675669,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CAROLINA INTERNAL MEDIC,7666 CHARLOTTE HWY   INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467694125,"CHOWDARYMUPPURI, VINUTHA",7666 CHARLOTTE HWY STE 200 INDIAN LAND SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396061347,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE CAROLINA LAKES INTERNAL,7666 CHARLOTTE HWY STE 200 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467694125,"CHOWDARYMUPPURI, VINUTHA",7666 CHARLOTTE HWY STE 200 INDIAN LAND SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467695486,"AVERY, CAROLYN, SEARS",4020 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467695486,"AVERY, CAROLYN, SEARS",3116 N DUKE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 59 , 156 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467697375,"MARTINEZ, LEONARDO, ADRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 25 , 34 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467697870,"SAMOILOV, DMITRI, EVGENYEVICH",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,600 GRESHAM DR STE 700 NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467697870,"SAMOILOV, DMITRI, EVGENYEVICH",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467700179,"AMOO, AKUA ADWUBI, PANYIN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 97 , 97 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 347 , 756 ," 1,088 "," $29,796.73 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",701 DOCTORS DR STE H KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE D KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",701 DOCTORS DR STE B KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",701 DOCTORS DR STE B KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE B KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",701 DOCTORS DR STE H KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013957414,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 90 , 95 , 99 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",701 DOCTORS DR STE H KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1013957414,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",100 AIRPORT RD   KINSTON NC,054,Lenoir,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE B KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",701 DOCTORS DR STE B KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467700484,"MISHRA, ABHISHEK, KUMAR",701 DOCTORS DR STE B KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467701425,"WILEY, NICHOLAS, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1467701797,"GARMON, KAREN, DEANNA",611 MOCKSVILLE AVE ROWAN DIAGNOSTIC CLINIC SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 33 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1467702167,"HUNT, MICHELLE, ROSEMARY",135 PAGE RD N   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1467702167,"HUNT, MICHELLE, ROSEMARY",135 PAGE RD N   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 99 , 130 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467703157,"WILSON, BEVERLY, CECILE",3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467703157,"WILSON, BEVERLY, CECILE",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619100096,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467703157,"WILSON, BEVERLY, CECILE",3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023788510,PRIMARY CARE PROVIDERS & BEYOND,,4311 SCHOOL HOUSE CMNS   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467705467,"HEDRICK, REDELLA, BAXLEY",4311 SCHOOL HOUSE CMNS STE 171 HARRISBURG NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1467709675,"REEVES, REBECCA, ELLIOTT",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 81 , 82 , 310 ," $15,298.26 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1467710228,"NNEJI, JACKIE, OGECHI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467710228,"NNEJI, JACKIE, OGECHI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467710228,"NNEJI, JACKIE, OGECHI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467712448,"PEETHUMNONGSIN, ERICA, SOPAH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 29 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467712448,"PEETHUMNONGSIN, ERICA, SOPAH",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 70 , 72 , 76 ,$#,,
MEDICAID DIRECT,1467713917,HOME INSTEAD SENIOR CARE,~,348 N SOUTH ST   MOUNT AIRY NC,086,Surry,253Z00000X,Agencies,In Home Supportive Care,,1467713917,HOME INSTEAD SENIOR CARE,348 N SOUTH ST   MOUNT AIRY NC,086,Surry,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,402 "," 2,402 "," $291,922.76 ",,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467718346,"CRAIG, CHRISTOPHER, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 67 , 173 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467718346,"CRAIG, CHRISTOPHER, PATRICK",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 65 , 236 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1467718346,"CRAIG, CHRISTOPHER, PATRICK",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467718668,"ALEXANDER, JEFFREY, DAVID",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 56 , 58 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467718668,"ALEXANDER, JEFFREY, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 15 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467718668,"ALEXANDER, JEFFREY, DAVID",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467718668,"ALEXANDER, JEFFREY, DAVID",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 40 ,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467718668,"ALEXANDER, JEFFREY, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467719559,"PARMELE, JUSTINE, MAE",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 32 , 82 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1467722082,"RUEMMLER, MATTHEW, WILLIAM",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467725093,"THOMAS, JACKIE, HAYES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467729129,"HOYT, ANITA, OLGA",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467729129,"HOYT, ANITA, OLGA",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 57 , 60 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467729129,"HOYT, ANITA, OLGA",16455 STATESVILLE RD.   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467729129,"HOYT, ANITA, OLGA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467729129,"HOYT, ANITA, OLGA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467729129,"HOYT, ANITA, OLGA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467729129,"HOYT, ANITA, OLGA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1467729475,"BOONE, SHANA, LATESHA W",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467731695,"BROCK II, PAUL, TALMAGE",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467732958,"COCHRAN, NICOLE, BETH",~,419 BYWOOD DR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1467732958,"COCHRAN, NICOLE, BETH",419 BYWOOD DR   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467736553,"SCARANO, REBECCA, REEVE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467736553,"SCARANO, REBECCA, REEVE",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 20 , 23 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467736553,"SCARANO, REBECCA, REEVE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467740332,"DIFFENBAUGH, MEGAN, FONTANA",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#, 28 , 30 ,$#,,
MEDICAID DIRECT,1467741678,UNITY HOME HEALTHCARE INC,~,5715 WESTPARK DR STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1467741678,UNITY HOME HEALTHCARE INC,5715 WESTPARK DR STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,565 "," 1,611 "," $138,224.32 ",,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1467743310,"PAGE, ALEXANDER, TOWNSEND",293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 96 , 233 , 272 ,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1467743310,"PAGE, ALEXANDER, TOWNSEND",313 TEAL DR   RAEFORD NC,047,Hoke,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 34 , 56 , 56 ,$#,,
MEDICAID DIRECT,1700889557,PINEHURST NEPHROLOGY ASSOCIATES,~,293 OLMSTED BLVD STE 7 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1467743310,"PAGE, ALEXANDER, TOWNSEND",921 S LONG DR STE 102 ROCKINGHAM NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467744425,"SARKAR, ROHIN, ANAND",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 51 , 53 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1467745513,"JOHNSTON, TAMMY, JERNIGAN",45 PLATEAU ST STE 250 BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 109 , 166 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1467745513,"JOHNSTON, TAMMY, JERNIGAN",45 PLATEAU ST STE 250 BRYSON CITY NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467747287,"JUNIOUS, SHACONDA, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1457432577,FAMILY EYE CENTER OD PA,FAMILY EYE CENTER PA,560 DABNEY DR   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1467748228,"JOHNSON, ERIC, MINCEY",560 DABNEY DR STE A HENDERSON NC,091,Vance,152W00000X,Eye and Vision Services Providers,Optometrist,, 165 , 217 , 318 ,$#,,
MEDICAID DIRECT,1457432577,FAMILY EYE CENTER OD PA,FAMILY EYE CENTER PA,216 N BICKETT BLVD STE 6 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1467748228,"JOHNSON, ERIC, MINCEY",216 N BICKETT BLVD STE 6 LOUISBURG NC,035,Franklin,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467748426,"LAUGHRIDGE, HEATHER, ANNE",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467748426,"LAUGHRIDGE, HEATHER, ANNE",13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467748426,"LAUGHRIDGE, HEATHER, ANNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 33 , 77 , 77 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 65 , 65 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467748988,"PAPINENI, LALITHA, SRI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467751263,"RICH, BRITTANY, MOBLEY",401 N MAIN ST   KENANSVILLE NC,031,Duplin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467751685,"KAPLAN, JONATHAN, ROBERT MANNING",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 24 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1467751685,"KAPLAN, JONATHAN, ROBERT MANNING",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467751685,"KAPLAN, JONATHAN, ROBERT MANNING",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467751685,"KAPLAN, JONATHAN, ROBERT MANNING",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1467751685,"KAPLAN, JONATHAN, ROBERT MANNING",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1467751685,"KAPLAN, JONATHAN, ROBERT MANNING",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1467751925,"PYLES, BRANDON, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467751925,"PYLES, BRANDON, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 144 , 144 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467755298,"GOMBAR, KATHRYN, LEIGH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467761833,"SHELTON, JENNIFER, E",400 SENTARA CIR STE 320 WILLIAMSBURG VA,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1467762062,"RUNGE, MARILEE, FAIRCLOTH",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1467762062,"RUNGE, MARILEE, FAIRCLOTH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467762062,"RUNGE, MARILEE, FAIRCLOTH",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1467762401,"HAZLETT, HEATHER, CODY",101 RENEE LYNN CT   CARRBORO NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1467762401,"HAZLETT, HEATHER, CODY",101 RENEE LYNN CT   CARRBORO NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1467762971,GREENSBORO HEALTH HOLDINGS LLC,WELLINGTON OAKS,3004 DEXTER AVE   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467762971,GREENSBORO HEALTH HOLDINGS LLC,3004 DEXTER AVE   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 59 ," 12,219 "," 12,224 "," $1,209,821.18 ",,
MEDICAID DIRECT,1467762971,GREENSBORO HEALTH HOLDINGS LLC,WELLINGTON OAKS,3004 DEXTER AVE   GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1467762971,GREENSBORO HEALTH HOLDINGS LLC,3004 DEXTER AVE   GREENSBORO NC,041,Guilford,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1467763227,"STRODE, MATTHEW, ALLEN",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467763227,"STRODE, MATTHEW, ALLEN",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 38 , 46 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1467763227,"STRODE, MATTHEW, ALLEN",5 FIRSTVILLAGE DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467763227,"STRODE, MATTHEW, ALLEN",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1104918754,SCOTLAND MEMORIAL HOSPITAL INC,~,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1467763227,"STRODE, MATTHEW, ALLEN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467765917,"COLEMAN, MARGARET, CHENEY",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 55 , 55 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467765958,"BROWN, CRAIG, JONATHAN",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 236 , 345 , 564 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467765958,"BROWN, CRAIG, JONATHAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467765958,"BROWN, CRAIG, JONATHAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 30 , 31 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467766006,"SINDHU, PALLAVI",155 MEMORIAL DR   PINEHURST NC,063,Moore,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 80 , 122 , 122 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467766162,"KING, DERRICK, TYLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467766162,"KING, DERRICK, TYLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1710512314,MIDTOWN RALEIGH ANESTHESIA PLLC,,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467766162,"KING, DERRICK, TYLER",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467766162,"KING, DERRICK, TYLER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467766949,"MATHIS, CAROLINE, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 64 , 120 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4100 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467766949,"MATHIS, CAROLINE, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4100 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467766949,"MATHIS, CAROLINE, ANNE",1 HOSPITAL DR STE 4100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 22 , 45 ,$#,,
MEDICAID DIRECT,1750345286,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH PEMBROKE,812 CANDY PARK RD   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467767053,"OXENDINE, SUZETTE, RENEE",812 CANDY PARK RD   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 54 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467767731,"HILL, SYLVIE, KIAKU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467767731,"HILL, SYLVIE, KIAKU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467767731,"HILL, SYLVIE, KIAKU",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1467769166,ABSOLUTE HOME HEALTH,~,1631 MIDTOWN PL STE 104-111 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1467769166,ABSOLUTE HOME HEALTH,1631 MIDTOWN PL STE 104-111 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 3,520 "," 3,527 "," $349,376.88 ",,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1467769281,"DADA, NEHA",800 TIFFANY BLVD STE 101 ROCKY MOUNT NC,064,Nash,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467770974,"CLARK, NANCY, SUZANNE",1333 S DICKINSON DR UNIT 120 LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 55 ,$#,,
MEDICAID DIRECT,1467773390,"SCOTT, EDWARD, RAY",EDWARD RAY SCOTT II DDS PA,5439 LIBERTY RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1467773390,"SCOTT, EDWARD, RAY",5439 LIBERTY RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 107 , 167 , 665 ," $65,398.73 ",,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467773564,"MILLER, JARED, WESLEY",1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 20 , 30 , 59 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467773564,"MILLER, JARED, WESLEY",1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 81 , 159 , 319 ,$#,,
MEDICAID DIRECT,1467774018,MEDEX MEDICAL TRANSPORT SERVICE INC,~,902 MEMORIAL DR E   AHOSKIE NC,046,Hertford,3416L0300X,Transportation Services,Ambulance,Land Transport,1467774018,MEDEX MEDICAL TRANSPORT SERVICE INC,902 MEMORIAL DR E   AHOSKIE NC,046,Hertford,3416L0300X,Transportation Services,Ambulance,Land Transport," 1,533 "," 4,885 "," 8,803 "," $547,131.04 ",,
MEDICAID DIRECT,1467774018,MEDEX MEDICAL TRANSPORT SERVICE INC,~,902 MEMORIAL DR E   AHOSKIE NC,046,Hertford,3416A0800X,Transportation Services,Ambulance,Air Transport,1467774018,MEDEX MEDICAL TRANSPORT SERVICE INC,902 MEMORIAL DR E   AHOSKIE NC,046,Hertford,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467775692,"DELGROSSO, BRIAN, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6330 QUADRANGLE DR STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1467776369,"GOETZINGER, AMY, MICHELE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467776369,"GOETZINGER, AMY, MICHELE",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 15 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 54 , 109 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",3000 ROGERS RD STE 120 WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",4101 MACON POND RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 57 , 60 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778241,"SENTER, ANDREA, STALLSMITH",3320 WAKE FOREST RD STE 130 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467778258,"BURLISON, JARED, SADLER",975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467778258,"BURLISON, JARED, SADLER",162 LEGACY PT   CLAYTON GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1467778258,"BURLISON, JARED, SADLER",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 20 , 22 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467778258,"BURLISON, JARED, SADLER",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 27 , 34 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467778555,"RAWL, REBECCA, ELAINE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467778555,"RAWL, REBECCA, ELAINE",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467778555,"RAWL, REBECCA, ELAINE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467778555,"RAWL, REBECCA, ELAINE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 20 , 31 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467778555,"RAWL, REBECCA, ELAINE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467778555,"RAWL, REBECCA, ELAINE",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467778555,"RAWL, REBECCA, ELAINE",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,104 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1467778738,"HILL, SAMAREH, GHORBANI",104 MEDSPRING DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778738,"HILL, SAMAREH, GHORBANI",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1962067314,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT,1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467778738,"HILL, SAMAREH, GHORBANI",1911 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 22 , 22 ,$#,,
MEDICAID DIRECT,1467779090,"DECLAN, ARWEN, BEATRICE LONG",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1467779090,"DECLAN, ARWEN, BEATRICE LONG",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467779322,"RICHARD, JAMES, JOHN",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 30 , 44 ,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467779322,"RICHARD, JAMES, JOHN",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 40 , 70 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467780627,"BOLTON III, CLINTON, STAFFORD",4207 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1467781898,OMEGA HOME CARE AGENCY LLC,~,107 N RAILROAD ST   WARSAW NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,,1467781898,OMEGA HOME CARE AGENCY LLC,107 N RAILROAD ST   WARSAW NC,031,Duplin,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 3,822 "," 3,822 "," $360,994.68 ",,
MEDICAID DIRECT,1467782219,"CHAVIS, WILENA, REVELS",THE SPEECH TREE PLLC,3257 DEEP BRANCH RD   LUMBERTON NC,078,Robeson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1467782219,"CHAVIS, WILENA, REVELS",3257 DEEP BRANCH RD   LUMBERTON NC,078,Robeson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467785774,"BRILLANT, KELLY, ANN",606 E 12TH ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 56 , 56 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467785774,"BRILLANT, KELLY, ANN",608 E 12TH ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467787531,"PRENTICE, JONATHAN, ROBERT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1467787531,"PRENTICE, JONATHAN, ROBERT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467787531,"PRENTICE, JONATHAN, ROBERT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467787531,"PRENTICE, JONATHAN, ROBERT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1467787531,"PRENTICE, JONATHAN, ROBERT",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1467787531,"PRENTICE, JONATHAN, ROBERT",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467787531,"PRENTICE, JONATHAN, ROBERT",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467794388,"LOSI, PETER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467794701,"KELLEY, BRENDAN, PATRICK",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467794701,"KELLEY, BRENDAN, PATRICK",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 258 , 276 , 376 ," $15,680.26 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1467794701,"KELLEY, BRENDAN, PATRICK",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 372 , 406 , 596 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467795609,"LORING, ZAK",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467795609,"LORING, ZAK",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 24 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1467796375,"GOEHL, JUSTIN, MICHAEL",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1467798199,WP-ALBEMARLE HEALTH HOLDINGS LLC,WOODHAVEN COURT,1930 WOODHAVEN DR   ALBEMARLE NC,084,Stanly,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1467798199,WP-ALBEMARLE HEALTH HOLDINGS LLC,1930 WOODHAVEN DR   ALBEMARLE NC,084,Stanly,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 35 , 141 , 142 ,$#,,
MEDICAID DIRECT,1467798199,WP-ALBEMARLE HEALTH HOLDINGS LLC,WOODHAVEN COURT,1930 WOODHAVEN DR   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467798199,WP-ALBEMARLE HEALTH HOLDINGS LLC,1930 WOODHAVEN DR   ALBEMARLE NC,084,Stanly,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 60 ," 14,230 "," 14,230 "," $1,446,027.90 ",,
MEDICAID DIRECT,1942719950,PEAK WELLNESS CLINIC PLLC,,1 BUFFALO AVE NW STE 201 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467798520,"BENEL, SABINA, CHINDIA",1 BUFFALO AVE NW STE 201 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 27 , 42 ,$#,,
MEDICAID DIRECT,1467799585,KATIE L ARMSTRONG,SURE PROMISE FAMILY CARE HOME II,240 AHOSKIE COFIELD RD   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467799585,KATIE L ARMSTRONG,240 AHOSKIE COFIELD RD   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 39 , 39 ," $19,071.33 ",,
MEDICAID DIRECT,1467799585,KATIE L ARMSTRONG,SURE PROMISE FAMILY CARE HOME II,222 W SALUDA HALL RD   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1467799585,KATIE L ARMSTRONG,222 W SALUDA HALL RD   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 20 , 20 ," $38,144.00 ",,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1467800045,"MCCAIN, CHAD, STEVEN",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 26 , 35 ,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1467800045,"MCCAIN, CHAD, STEVEN",2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 68 , 117 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467800649,"KONZEM, ANN, GIELYN SILVA-ABUEG",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 154 , 249 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467800649,"KONZEM, ANN, GIELYN SILVA-ABUEG",2906 N MAIN ST   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467802843,"JUAREZ, THANIA",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1467802843,"JUAREZ, THANIA",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 55 , 89 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467802843,"JUAREZ, THANIA",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1467802843,"JUAREZ, THANIA",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467802843,"JUAREZ, THANIA",1122 RANDOLPH ST STE 110 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467802843,"JUAREZ, THANIA",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5870 SAMET DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467802843,"JUAREZ, THANIA",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467802983,"RICHTER, JOSHUA, DAVID",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467802983,"RICHTER, JOSHUA, DAVID",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467802983,"RICHTER, JOSHUA, DAVID",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467802983,"RICHTER, JOSHUA, DAVID",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467804237,"PALURI, NIKITHA",205 PAGE RD   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 31 , 76 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1467804237,"PALURI, NIKITHA",1411 GREENWAY CT   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467806646,BHG REFERENCE LAB LLC,,1734 MADISON AVE STE B MEMPHIS TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1467806646,BHG REFERENCE LAB LLC,1734 MADISON AVE STE B MEMPHIS TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 34 , 38 , 38 ,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467806885,"ZHANG, LIN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467806885,"ZHANG, LIN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467806885,"ZHANG, LIN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1619099256,FAMILY MEDICAL ASSOCS OF RALEIGH,,3500 BUSH ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467807271,"LANCASTER, ABIGAIL, JOSEPH",3500 BUSH ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467808964,"SMITH-MARTINEZ, LUCIA, ANGELA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467808964,"SMITH-MARTINEZ, LUCIA, ANGELA",180 PARKWOOD DR   ELKIN NC,086,Surry,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467808964,"SMITH-MARTINEZ, LUCIA, ANGELA",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467808964,"SMITH-MARTINEZ, LUCIA, ANGELA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467808964,"SMITH-MARTINEZ, LUCIA, ANGELA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1801881883,DERMATOLOGY ASSOCIATES PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1467810242,"ALSIP, BRADLEY, WILLIAM",6781 PARKER FARM DR STE 300 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467810531,"SAPEL, KRISTINA, HENDLEY",4304 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 26 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467810531,"SAPEL, KRISTINA, HENDLEY",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467811950,"MCGARRY, WHITNEY, FORD",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1467813311,"DUNCAN, HOLLY, PRUETT",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 108 , 144 , 314 ," $10,265.52 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1467816132,"SCHOLAND, KATHERINE, ELIZABETH",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467816132,"SCHOLAND, KATHERINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467816132,"SCHOLAND, KATHERINE, ELIZABETH",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467816132,"SCHOLAND, KATHERINE, ELIZABETH",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467816132,"SCHOLAND, KATHERINE, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 36 , 47 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467816132,"SCHOLAND, KATHERINE, ELIZABETH",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1316943145,CENTRAL CAROLINA DERMATOLOGY,CENTRAL CAROLINA DERMATOLOGY CLINICINC,4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467816462,"FLORES, KYLE, HAMPTON",4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 17 , 20 , 38 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467816561,"BEYENE, GIRMA, TESFAYE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 77 , 78 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467816652,"ALLRED, JONATHAN, JACOB",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 36 , 44 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467817627,"RAY, HEATHER, EUSTIS",501 DOUGLAS ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467817817,"GIBSON, SARAH, KERR",2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467817817,"GIBSON, SARAH, KERR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467819094,"KESSLER, SYLVIA, KELLI",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154340149,CARRBORO FAMILY VISION LLC,CARRBORO FAMILY VISION OD PLLC,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,,1467820704,"STIEGEMEIER, TYLER, ANDREW",200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1467820704,"STIEGEMEIER, TYLER, ANDREW",,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,1467820704,"STIEGEMEIER, TYLER, ANDREW",200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1467822288,PREMIER TREATMENT SPECIALISTS LLC,~,400 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,251S00000X,Agencies,Community/Behavioral Health,,1467822288,PREMIER TREATMENT SPECIALISTS LLC,400 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1780184093,JONATHAN W HAIRR DDS PA,JONATHAN W HAIRR DDS PA,402 STERLINGWORTH ST   WINDSOR NC,008,Bertie,193400000X,Group,Single Specialty,,1467822635,"HAIRR, JONATHAN, WILSON",3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1780184093,JONATHAN W HAIRR DDS PA,JONATHAN W HAIRR DDS PA,402 STERLINGWORTH ST   WINDSOR NC,008,Bertie,193400000X,Group,Single Specialty,,1467822635,"HAIRR, JONATHAN, WILSON",402 STERLINGWORTH ST   WINDSOR NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice, 382 , 689 ," 2,323 "," $181,292.69 ",,
MEDICAID DIRECT,1467823096,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-4432,1818 NORTHWEST BLVD   NEWTON NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1467823096,WAL-MART STORES EAST LP,1818 NORTHWEST BLVD   NEWTON NC,018,Catawba,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467823179,"MCKITHAN, STEPHANIE, BOURNE",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073034625,CENTERWELL SENIOR PRIMARY CARE NC P,CENTERWELL SENIOR PRIMARY CARE NC PC,2910 E FRANKLIN BLVD # 1 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467824672,"PRESTON, DANA, AUBREY",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255105250,CENTERWELL SENIORPRIMARYCARENC JVPC,,105 RIVER HILLS RD STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467824672,"PRESTON, DANA, AUBREY",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467825505,BRIDGING THE GAP DEVELOPMENTAL SERV,~,2917 SNAPSWELL ST   RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1467825505,BRIDGING THE GAP DEVELOPMENTAL SERV,2917 SNAPSWELL ST   RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,#,#,#,$#,,
MEDICAID DIRECT,1467825505,BRIDGING THE GAP DEVELOPMENTAL SERV,~,2917 SNAPSWELL ST   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1467825505,BRIDGING THE GAP DEVELOPMENTAL SERV,2917 SNAPSWELL ST   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,, 131 ," 1,944 "," 1,944 "," $141,684.80 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467828053,"BURCHETT, LISA, MICHELLE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467828053,"BURCHETT, LISA, MICHELLE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467828830,"MCCLAY, MEREDITH, CHRISTINE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 233 , 285 , 855 ," $35,545.33 ",,
MEDICAID DIRECT,1285791087,FOOTHILLS HEALTH DISTRICT,RUTHERFORD COUNTY HEALTH DEPT,221 CALLAHAN KOON RD   SPINDALE NC,081,Rutherford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1467829705,"LAIL, BRITTANY, LOVELACE",221 CALLAHAN KOON RD   SPINDALE NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 100 , 214 ," $10,840.12 ",,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467830414,"HISLOP, FAITH, RACHEL",187 W MAIN ST   SPINDALE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 65 , 79 ,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467830414,"HISLOP, FAITH, RACHEL",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467830687,"BLACK, SHELIA, MARIA",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 150 , 224 , 585 ,$#,,
MEDICAID DIRECT,1467830802,MED-TRANS CORPORATION,~,333 PLEASANT GROVE RD   SWEETWATER TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1467830802,MED-TRANS CORPORATION,333 PLEASANT GROVE RD   SWEETWATER TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467832105,"TORRES, JOSEPH, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467833731,"WALL, APRIL, HALLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 38 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467833731,"WALL, APRIL, HALLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467833731,"WALL, APRIL, HALLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 59 , 69 ,$#,,
MEDICAID DIRECT,1467838003,MOVE LEARN PLAY INC,~,1072 NC HIGHWAY 210 STE B SNEADS FERRY NC,067,Onslow,193400000X,Group,Single Specialty,,1467838003,MOVE LEARN PLAY INC,1072 NC HIGHWAY 210 STE B SNEADS FERRY NC,067,Onslow,193400000X,Group,Single Specialty,,#, 71 , 71 ,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467838193,"BRYAN, CYNTHIA, NEWMAN",250 HOSPICE CIR   RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 16 , 39 , 47 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1467839191,"GOODHEART, VICTORIA, GRACE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1467839191,"GOODHEART, VICTORIA, GRACE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1467839191,"GOODHEART, VICTORIA, GRACE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467839191,"GOODHEART, VICTORIA, GRACE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 24 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467839191,"GOODHEART, VICTORIA, GRACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 46 , 67 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1467839191,"GOODHEART, VICTORIA, GRACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 43 , 70 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467839530,"DRAKE, JUSTIN, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467839530,"DRAKE, JUSTIN, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467839670,"DOAN, THANH-TRUC, THUY",600 HOSPITAL DR   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467839670,"DOAN, THANH-TRUC, THUY",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467839670,"DOAN, THANH-TRUC, THUY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 64 , 188 , 190 ," $14,873.57 ",,
MEDICAID DIRECT,1235134958,STANLY COUNTY IMAGING PLLC,~,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1467839811,"PERRY, RICHARD, BRADFORD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 287 , 403 , 531 ,$#,,
MEDICAID DIRECT,1407150816,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467840702,"MALKA, MEGHAN, HOGAN",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467841858,"LIU, ABBY, YOUNG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467842542,"DAVE, PUJAN, BHAVIN",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist, 33 , 60 , 95 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467842542,"DAVE, PUJAN, BHAVIN",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,11835 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467842542,"DAVE, PUJAN, BHAVIN",11835 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467842542,"DAVE, PUJAN, BHAVIN",11835 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,410 HERLONG AVE S STE 103 ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467842542,"DAVE, PUJAN, BHAVIN",410 HERLONG AVE S STE 103 ROCK HILL SC,101,Out of State <= 40 miles,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467842542,"DAVE, PUJAN, BHAVIN",410 HERLONG AVE S STE 103 ROCK HILL SC,101,Out of State <= 40 miles,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467844613,"ALSPAUGH, BRANDON, BERNARD",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 47 , 78 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467845701,"URBAN, CLARISSA, ANNE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467845701,"URBAN, CLARISSA, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 23 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467846923,"DOM, AARON, MATTHEW",10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 14 , 27 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 14 , 32 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 67 , 84 , 169 ," $15,325.70 ",,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467846923,"DOM, AARON, MATTHEW",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467847160,"KIMMEL, STEPHEN, DAVID",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 105 , 137 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467847434,"JARAMILLO, JULIANA, MARIA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 69 , 71 , 73 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 42 , 49 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,101 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,703 COMFORT LN   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 76 , 84 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,9848 N TRYON ST STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1604 MEDICAL DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 71 , 71 , 95 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,121 MEDICAL DR   ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1467847566,"RAULLI, ANNE-OLIVIA, AURELIE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467848267,"TAGNE NOUEMSSI, ALAIN BRUNO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 127 , 131 , 131 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467849034,"SEYMORE, ANDREW, CLAYTON",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467849034,"SEYMORE, ANDREW, CLAYTON",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467849034,"SEYMORE, ANDREW, CLAYTON",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 82 , 86 , 90 ,$#,,
MEDICAID DIRECT,1801116405,MONARCH,~,820 GRIMES BLVD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1467850685,"HJORTH, NATASHA, SHARKETRA",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1467851881,WAL-MART STORES EAST LP,~,3801 S MEMORIAL DR   WINTERVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1467851881,WAL-MART STORES EAST LP,3801 S MEMORIAL DR   WINTERVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467854224,"SHUKLA, JETAL, DIVYANG",624 JONES FERRY RD   CARRBORO NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467854224,"SHUKLA, JETAL, DIVYANG",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467854224,"SHUKLA, JETAL, DIVYANG",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467854463,"THORNBURG, HEATHER, NORENE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 45 , 149 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467854463,"THORNBURG, HEATHER, NORENE",1919 W PARK DR   N WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 102 , 323 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467856682,"PARKER, ALICIA, COSTON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467856682,"PARKER, ALICIA, COSTON",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467856682,"PARKER, ALICIA, COSTON",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 58 , 61 ,$#,,
MEDICAID DIRECT,1467860940,NC DEPARTMENT OF PUBLIC INSTRUCTION,EARLY LEARNING SENSORY SUPPORT PROGRAM,6356 MAIL SERVICE CTR   RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1467860940,NC DEPARTMENT OF PUBLIC INSTRUCTION,6356 MAIL SERVICE CTR   RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,, 620 ," 6,340 "," 6,351 "," $356,530.60 ",,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467862581,"HODGES, JONATHON, COOPER",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 50 , 103 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1467863076,"SCHMIDT, JOHN, MICHAEL",100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467863076,"SCHMIDT, JOHN, MICHAEL",100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 32 , 43 , 58 ,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,630 TIMBER DR EAST STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1467863076,"SCHMIDT, JOHN, MICHAEL",630 TIMBER DR EAST STE 120 GARNER NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1467863076,"SCHMIDT, JOHN, MICHAEL",3001 EDWARDS MILL RD STE 2 RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1467863076,"SCHMIDT, JOHN, MICHAEL",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 20 , 26 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467863134,"LANGHENRY, JOHN, GODFRED",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 71 , 206 , 206 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1467863191,"DEPP, CALEB, ANDREW",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467863191,"DEPP, CALEB, ANDREW",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1467863191,"DEPP, CALEB, ANDREW",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1467863191,"DEPP, CALEB, ANDREW",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1467863191,"DEPP, CALEB, ANDREW",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467863936,"LOUNSBURY, CATHERINE, TSUFIS",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467866418,"DESAI, HELI, ASHISH",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467866418,"DESAI, HELI, ASHISH",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467866558,"GAROFOLI, ADRIAN, CARLOS MARTIN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467866558,"GAROFOLI, ADRIAN, CARLOS MARTIN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467866731,"PACICCO, THOMAS, ALFRED",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467867184,"KAMEL, NADA, FAYEZ",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 72 , 87 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467867184,"KAMEL, NADA, FAYEZ",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 44 , 54 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467871053,"WILLIAMSON, EMILY, CRAWFORD",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467871053,"WILLIAMSON, EMILY, CRAWFORD",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467871053,"WILLIAMSON, EMILY, CRAWFORD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467871053,"WILLIAMSON, EMILY, CRAWFORD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467871053,"WILLIAMSON, EMILY, CRAWFORD",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1467871053,"WILLIAMSON, EMILY, CRAWFORD",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1194230573,VALLEYGATE DENTAL SURGERY CENTERS O,~,510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467871053,"WILLIAMSON, EMILY, CRAWFORD",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology," 2,233 "," 2,268 "," 4,527 "," $958,397.40 ",,
MEDICAID DIRECT,1194230573,VALLEYGATE DENTAL SURGERY CENTERS O,~,510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1467871053,"WILLIAMSON, EMILY, CRAWFORD",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1467871715,"CRAWFORD, KEVIN, ALDRIDGE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467871715,"CRAWFORD, KEVIN, ALDRIDGE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 20 , 25 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1467871715,"CRAWFORD, KEVIN, ALDRIDGE",975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1467871715,"CRAWFORD, KEVIN, ALDRIDGE",975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 23 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467872291,"COLACO, MARC, ALBINO",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 105 , 164 , 216 ," $23,569.35 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467872291,"COLACO, MARC, ALBINO",601 N ELM ST   HIGH POINT NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467872929,"ANDONIAN, BRIAN, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467872929,"ANDONIAN, BRIAN, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 13 , 16 , 25 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467876466,"DOSHI, RUCHI, SRIVASTAVA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 45 , 45 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467876466,"DOSHI, RUCHI, SRIVASTAVA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 115 , 115 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467876466,"DOSHI, RUCHI, SRIVASTAVA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467879783,"CAMPBELL, JAN, RAE",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 50 , 77 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467880625,"CARDUCCI, AFTON, MARIE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 31 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467880625,"CARDUCCI, AFTON, MARIE",2501 ATRIUM DR STE 305 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467880625,"CARDUCCI, AFTON, MARIE",2501 ATRIUM DR STE 305 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1467881318,"TUNEEV, KAREN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 130 , 130 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467881318,"TUNEEV, KAREN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1467881318,"TUNEEV, KAREN",2201 S STERLING ST   MORGANTON NC,012,Burke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1467881318,"TUNEEV, KAREN",201 E GROVER ST   KINGSTOWN NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467881318,"TUNEEV, KAREN",201 E GROVER ST   KINGSTOWN NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467883231,"MARTINHO, SARA, ANDRASE",15015 LANCASTER HWY STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467883231,"MARTINHO, SARA, ANDRASE",1420 E FRANKLIN ST   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 30 , 66 ,$#,,
MEDICAID DIRECT,1467887679,HOME CARE SPECIALISTS IN THE MOUNTA,~,232 CUNNINGHAM RD STE 2 FRANKLIN NC,056,Macon,253Z00000X,Agencies,In Home Supportive Care,,1467887679,HOME CARE SPECIALISTS IN THE MOUNTA,232 CUNNINGHAM RD STE 2 FRANKLIN NC,056,Macon,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 4,994 "," 5,068 "," $826,049.68 ",,
MEDICAID DIRECT,1801849302,BARTLETT GRIGSBY BOAN & ASSOS PLLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1467889881,"PHEBUS, MARK, RANDALL",1060 LENOIR RHYNE BLVD SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 205 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1467890012,"GAL, CHRISTOPHER, MICHAEL",1700 TARBORO ST W STE 205 WILSON NC,098,Wilson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 99 , 150 , 184 ," $11,111.54 ",,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1467890012,"GAL, CHRISTOPHER, MICHAEL",1700 TARBORO ST W STE 205 WILSON NC,098,Wilson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 48 , 101 , 120 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1467890012,"GAL, CHRISTOPHER, MICHAEL",1700 TARBORO ST W STE 205 WILSON NC,098,Wilson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467890749,"LONTOS, KONSTANTINOS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1821240995,WESTGATE DERMATOLOGY AND LASER CENT,WESTGATE DERMATOLOGY AND LASER CENTER PA,2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467892216,"HINKEL, VICTORIA, SHEETS",2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467892687,"ANDLEEB, SUMERA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467892687,"ANDLEEB, SUMERA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 68 , 170 , 170 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467892687,"ANDLEEB, SUMERA",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467893255,"KAPOOR, SARGAM",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467893255,"KAPOOR, SARGAM",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467893255,"KAPOOR, SARGAM",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467893255,"KAPOOR, SARGAM",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,,,Unknown,193200000X,Group,Multi-Specialty,,1467893255,"KAPOOR, SARGAM",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467893255,"KAPOOR, SARGAM",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467893255,"KAPOOR, SARGAM",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467893404,"STREHLOW, ROBERT",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467893602,"HOLTERMAN, KRYSTA, COSENTINO",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 NC HIGHWAY 42 W STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",1820 NC HIGHWAY 42 W STE 102 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 VETERANS PKWY STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,400 HEALTH PARK DR STE 100 GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 22 , 42 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,,,Unknown,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 NC HIGHWAY 42 W STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467895748,"KORRAPATI, PRANEET",166 SPRINGBROOK AVE STE 105 CLAYTON NC,051,Johnston,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 24 , 35 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467899260,"MCGEE, MISTINA, RENEE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467899294,"ABBEY, NAA DEISA",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 204 , 214 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1467899294,"ABBEY, NAA DEISA",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467899948,"LUCAS, CHANCY, GULOTTA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467900308,"CHATMAN, MONIQUE, RENE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 80 , 88 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467904359,"PRINCE, MARIAH, SHAQUANDA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992464002,HNI MEDICAL SERVICES OF NORTH CAROL,,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467904359,"PRINCE, MARIAH, SHAQUANDA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467904359,"PRINCE, MARIAH, SHAQUANDA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467904359,"PRINCE, MARIAH, SHAQUANDA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1609827393,BILTMORE MEDICAL ASSOCIATES,BILTMORE MEDICAL ASSOCIATES,147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1467905117,"RIVAROLA, MARIA, GUADALUPE",147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447792148,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,401 ATTAIN ST STE 121 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1467905158,"AMES, JENNIFER, KEITH",401 ATTAIN ST STE 121 FUQUAY VARINA NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1629528104,OLIVER OPTOMETRIC EYE CARE,~,18 GRAYSON ST   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1467907063,"OLIVER, LOGAN, JOSEPH",18 GRAYSON ST   SPARTA NC,003,Alleghany,152W00000X,Eye and Vision Services Providers,Optometrist,, 94 , 114 , 314 ,$#,,
MEDICAID DIRECT,1467908368,LAKE NORMAN COMMUNICATION SERVICES,,484 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467908368,LAKE NORMAN COMMUNICATION SERVICES,484 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,, 69 , 745 , 973 ," $73,854.35 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1467910877,"LELLOCK, MARGARET, ELIZABETH",901 DOW RD   CAROLINA BEACH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6901 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467910877,"LELLOCK, MARGARET, ELIZABETH",901 DOW RD   CAROLINA BEACH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1467910877,"LELLOCK, MARGARET, ELIZABETH",901 DOW RD   CAROLINA BEACH NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 39 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467911339,"KINNEY, LOGAN, PETE",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467911339,"KINNEY, LOGAN, PETE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1073881850,MOSES CONE PHYSICIAN SERVICES INC,REIDSVILLE PEDIATRICS,1816 RICHARDSON DR   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1467912246,"MECCARIELLO, MATTHEW, DOMINIC",1816 RICHARDSON DR   REIDSVILLE NC,079,Rockingham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 38 , 110 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467912246,"MECCARIELLO, MATTHEW, DOMINIC",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467912584,"MOORE, DAVID, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467912584,"MOORE, DAVID, CHARLES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467912584,"MOORE, DAVID, CHARLES",601 N ELM ST   HIGH POINT NC,041,Guilford,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467913400,"CUNNINGHAM, HAYLEY, ELISABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467913400,"CUNNINGHAM, HAYLEY, ELISABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1467914069,"ANDREWS, PAUL, NIELSEN",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1467914069,"ANDREWS, PAUL, NIELSEN",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 20 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467914069,"ANDREWS, PAUL, NIELSEN",1110 SE CARY PKWY STE 103 CARY NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1467914069,"ANDREWS, PAUL, NIELSEN",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 14 ,$#,,
MEDICAID DIRECT,1811424849,MOSES CONE PHYSICIAN SERVICES INC,CHMG PRIMARY CARE AT FOREST OAKS,4620 WOODY MILL RD STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467914515,"OLSON, DANIEL, KEITH",1705 TARBORO ST SW   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811424849,MOSES CONE PHYSICIAN SERVICES INC,CHMG PRIMARY CARE AT FOREST OAKS,4620 WOODY MILL RD STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467914515,"OLSON, DANIEL, KEITH",4620 WOODY MILL RD STE G GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 54 , 69 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467914952,"OCEAN, SUSAN, ELIZABETH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1467915397,"NGUYEN, ALVIN, LOC",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 30 , 53 ,$#,,
MEDICAID DIRECT,1770515272,INTRACOASTAL INTERNAL MEDICINE,~,2580 PICKARD RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467917880,"HORNE, ASHLEY, ROSE",2580 PICKARD RD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 24 , 35 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1467918177,"BORGES, ALEXANDER, STEPHEN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 42 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467918623,"MCCLURE, PARNIAN, GHASSEMI",2065 LYON ST   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 214 , 227 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467918623,"MCCLURE, PARNIAN, GHASSEMI",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 400 , 409 ,$#,,
MEDICAID DIRECT,1962752881,HOKE HEALTHCARE LLC,HOKE PRIMARY CARE CLINIC,300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1467919613,"PATEL, ANKITA, KANTILAL",300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 44 , 131 ,$#,,
MEDICAID DIRECT,1962171041,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN WALNUT,131 WALNUT ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467920041,"WHITTEMORE, KATHRYNE, MICHELLE",131 WALNUT ST   WAYNESVILLE NC,044,Haywood,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,268 GILLMAN RD STE A DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1467924514,"MCLANE, KELLI, ANN",268 GILLMAN RD STE A DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467924514,"MCLANE, KELLI, ANN",10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 39 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467924514,"MCLANE, KELLI, ANN",9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467924514,"MCLANE, KELLI, ANN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467931915,"HOPPE, MADELON, WYGAND",11009 INGLESIDE PL STE 102 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467931915,"HOPPE, MADELON, WYGAND",1009 STADIUM DR STE 124 WAKE FOREST NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467932673,"WEBB, JESSICA, LEEANNE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1467933671,"STARKS, NICOLE, RENEA",101 N TRYON ST STE 112 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467939116,"STATON, LEKEISHA, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 25 , 50 , 108 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467939355,"GREEN, RUSTIN, DALE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467939355,"GREEN, RUSTIN, DALE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1467939355,"GREEN, RUSTIN, DALE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467939355,"GREEN, RUSTIN, DALE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467940734,"PATEL, PRIYA, PRADIPKUMAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 72 , 134 , 181 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1467940734,"PATEL, PRIYA, PRADIPKUMAR",400 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467940734,"PATEL, PRIYA, PRADIPKUMAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 42 , 55 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1467940734,"PATEL, PRIYA, PRADIPKUMAR",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 19 , 24 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467942607,"MURAWSKI, CHRISTOPHER, DAVID",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467942607,"MURAWSKI, CHRISTOPHER, DAVID",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467942607,"MURAWSKI, CHRISTOPHER, DAVID",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467942607,"MURAWSKI, CHRISTOPHER, DAVID",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467942607,"MURAWSKI, CHRISTOPHER, DAVID",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1467942607,"MURAWSKI, CHRISTOPHER, DAVID",2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467942672,"MISENHIMER, JENNIFER, JORDAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467942672,"MISENHIMER, JENNIFER, JORDAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467942672,"MISENHIMER, JENNIFER, JORDAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 22 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467942672,"MISENHIMER, JENNIFER, JORDAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467942672,"MISENHIMER, JENNIFER, JORDAN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467943027,"JANDREAU, SAMUEL, CHRISTIAN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467944116,"WEI, CLARICE, B",1550 FAULK ST STE 3100 MONROE NC,090,Union,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467944116,"WEI, CLARICE, B",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467944116,"WEI, CLARICE, B",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467944116,"WEI, CLARICE, B",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467944116,"WEI, CLARICE, B",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467944116,"WEI, CLARICE, B",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467944116,"WEI, CLARICE, B",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1225142011,HORIZON SURGICAL SPECIALISTS,HORIZON SURGICAL SPECIALISTS PA,125 HOSPITAL AVE NW STE D LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1467945063,"TRAPANI, YESSICA, ALEJANDRA",401 MULBERRY ST SW STE 101 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467945063,"TRAPANI, YESSICA, ALEJANDRA",401 MULBERRY ST SW STE 101 LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,185 NORWOOD HOLLOW RD   BANNER ELK NC,006,Avery,193200000X,Group,Multi-Specialty,,1467945063,"TRAPANI, YESSICA, ALEJANDRA",185 NORWOOD HOLLOW RD   BANNER ELK NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467945063,"TRAPANI, YESSICA, ALEJANDRA",185 NORWOOD HOLLOW RD   BANNER ELK NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 30 , 31 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467945063,"TRAPANI, YESSICA, ALEJANDRA",166 DOCTORS DR   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 60 , 70 ,$#,,
MEDICAID DIRECT,1225142011,HORIZON SURGICAL SPECIALISTS,HORIZON SURGICAL SPECIALISTS PA,166 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1467945063,"TRAPANI, YESSICA, ALEJANDRA",166 DOCTORS DR   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1467945204,"CARR, JOHN, CURTIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467945204,"CARR, JOHN, CURTIS",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467945204,"CARR, JOHN, CURTIS",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467945204,"CARR, JOHN, CURTIS",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467945204,"CARR, JOHN, CURTIS",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467945204,"CARR, JOHN, CURTIS",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1467945204,"CARR, JOHN, CURTIS",111 CENTRAL ST   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 136 , 139 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 377 , 377 ," $18,630.06 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",1264 AIRPORT RD   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 90 , 90 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",268 GILLMAN RD STE A DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 107 , 323 , 324 ," $23,197.42 ",,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,268 GILLMAN RD STE A DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1467946277,"FULK, JESSICA, SWINK",268 GILLMAN RD STE A DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467946277,"FULK, JESSICA, SWINK",10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",501 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 58 , 58 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1467946277,"FULK, JESSICA, SWINK",511 BUMGARNER INDUSTRIAL DR SW   CONOVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",969 COX RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 162 , 162 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",514 OLD MOUNT HOLLY RD   STANLEY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 116 , 116 ,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",969 COX RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946277,"FULK, JESSICA, SWINK",514 OLD MOUNT HOLLY RD   STANLEY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467946558,HARRIS TEETER LLC,HARRIS TEETER PHARMACY 493,5116 N ROXBORO ST   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1467946558,HARRIS TEETER LLC,5116 N ROXBORO ST   DURHAM NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1609236371,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT STOVALL,100 DURHAM   STOVALL NC,039,Granville,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1467946715,"HORNE, KENDRA, BRIANN",100 DURHAM   STOVALL NC,039,Granville,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1306411228,SPARTANBURG MEDICAL CENTER,MEDICALGROPOFTHECAROLINAS-NEUROLOGY-SPARTANBURG,1650 SKYLYN DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1467948927,"GIL GUEVARA, ANDREA, DEL VALLE",1650 SKYLYN DR STE 200 SPARTANBURG SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467949305,"VYAS, VRINDA",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1467949305,"VYAS, VRINDA",101 CLINIC DR   TARBORO NC,033,Edgecombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467949305,"VYAS, VRINDA",101 CLINIC DR   TARBORO NC,033,Edgecombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 220 , 312 , 354 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467949586,"DRUMMOND, MALEA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467950139,"SMITH, LEIGH, ANNE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1134558752,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH VALAROAS & LEWIS OBGYN,245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467950139,"SMITH, LEIGH, ANNE",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1922598275,JULIE C SPIVEY DMD PLLC,LAKE NORMAN PEDIATRIC DENTISTRY,407 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1467951806,"HARLAN, TAYLOR, ASHLEY",407 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 636 , 960 ," 3,692 "," $124,112.06 ",,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467951814,"SHAH, ZUBIN, ASHWIN",2015 RANDOLPH RD STE 108 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 86 , 117 , 220 ,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1467951814,"SHAH, ZUBIN, ASHWIN",8816 UNIVERSITY EAST DR STE C CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 22 , 39 ,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1467952564,"PINTO, MICHAEL, RICHARD",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 34 , 45 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467952812,"NELSON, TAYLOR",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467956631,"GUNNELL, ELIAS, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 64 , 71 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467957233,"SISTO ALESSI CESAR, SABRINA",77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 44 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467957233,"SISTO ALESSI CESAR, SABRINA",77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 45 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467957233,"SISTO ALESSI CESAR, SABRINA",77 VILCOM CENTER DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1346493582,THEODORE F MAYER DDS PA,THEODORE F MAYER DDS PA,525 N TRYON ST STE 1600 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467957506,"HAMILTON, OLGA",525 N TRYON ST STE 1600 PMB 209 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467957589,"SANDBERG, TAYLOR, WHITE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 49 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,150 PROFESSIONAL PARK DR STE 400 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467957589,"SANDBERG, TAYLOR, WHITE",150 PROFESSIONAL PARK DR STE 400 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 23 , 35 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467957753,"FARO, DAVID, JEFFREY",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467957753,"FARO, DAVID, JEFFREY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 25 , 24 , 24 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467957787,"YANAMADALA, VANDANA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467958736,"NIBLOCK, FRANKLIN, CHALMERS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 79 , 182 , 304 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467958736,"NIBLOCK, FRANKLIN, CHALMERS",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467958736,"NIBLOCK, FRANKLIN, CHALMERS",598 W OLD COUNTY RD   BELHAVEN NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467958736,"NIBLOCK, FRANKLIN, CHALMERS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 40 , 40 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1467958736,"NIBLOCK, FRANKLIN, CHALMERS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467958736,"NIBLOCK, FRANKLIN, CHALMERS",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1467959601,"WILKES, JEREMY, SAMUEL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 101 , 189 , 189 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1467959601,"WILKES, JEREMY, SAMUEL",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467959833,"WATERS, ALEXA, MICHELLE",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 ,#, 18 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1467959833,"WATERS, ALEXA, MICHELLE",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265092977,ERNEST A GARNER JR DMD PLLC,GENTLE DENTAL,125 W KERR ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1467960351,"GARNER, ERNEST, ANDERSON",125 W KERR ST   SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 120 , 231 , 663 ," $46,962.11 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467961029,"WILHOIT, RANDALL, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 17 , 20 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467961029,"WILHOIT, RANDALL, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 45 , 48 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467961581,"LAPHAM, STEPHEN, DOUGLAS",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467961581,"LAPHAM, STEPHEN, DOUGLAS",210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,295 WILLIAMSON RD STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1467961581,"LAPHAM, STEPHEN, DOUGLAS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1467961581,"LAPHAM, STEPHEN, DOUGLAS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467961581,"LAPHAM, STEPHEN, DOUGLAS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1467964189,CORA NORTH CAROLINA LLC,CORA PHYSICAL THERAPY WILMINGTON,1115 MILITARY CUTOFF RD STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467964189,CORA NORTH CAROLINA LLC,1115 MILITARY CUTOFF RD STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467964379,"HOPKINS, TIFFANY, ANN",77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467964379,"HOPKINS, TIFFANY, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1467969410,"DISHROON, BONNIE, LYNN",5112 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386182608,OUTER BANKS PROFESSIONAL SERVICES,,5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1467969410,"DISHROON, BONNIE, LYNN",5002 S CROATAN HWY STE A NAGS HEAD NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467970301,"BRUCK, KIRA, LEA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467970301,"BRUCK, KIRA, LEA",10 MEDICINE   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467971325,"MOON, TIFFANY, GRAY",203A EARNHART DR   EDENTON NC,021,Chowan,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203A EARNHART DR   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1467971325,"MOON, TIFFANY, GRAY",203A EARNHART DR   EDENTON NC,021,Chowan,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 27 , 27 , 36 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467971325,"MOON, TIFFANY, GRAY",309 N BROAD ST   EDENTON NC,021,Chowan,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467971325,"MOON, TIFFANY, GRAY",700A ACADEMY ST S   AHOSKIE NC,046,Hertford,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467971325,"MOON, TIFFANY, GRAY",198 NC HIGHWAY 45 N   PLYMOUTH NC,094,Washington,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 22 , 27 , 37 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467971713,"MCALISTER, MEGAN, RENEE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467971713,"MCALISTER, MEGAN, RENEE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467971713,"MCALISTER, MEGAN, RENEE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1467971713,"MCALISTER, MEGAN, RENEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467972141,"GOBLE, MICHELLE, ANN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467972141,"GOBLE, MICHELLE, ANN",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 106 , 253 ,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467972935,"MOORE, TANNER, MATTSON",6387 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1467972935,"MOORE, TANNER, MATTSON",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 33 , 34 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1467973131,"PARKES, CHAD, WILLIAM",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467973131,"PARKES, CHAD, WILLIAM",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1467973131,"PARKES, CHAD, WILLIAM",101 LATTNER CT STE 200 MORRISVILLE NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1467973131,"PARKES, CHAD, WILLIAM",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1467973131,"PARKES, CHAD, WILLIAM",1120 SE CARY PKWY STE 100 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 29 , 54 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1467973131,"PARKES, CHAD, WILLIAM",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 20 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1467978189,"MEYER, LETITIA, ELIZABETH",151 3RD ST   AURORA NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 130 , 162 , 250 ,$#,,
MEDICAID DIRECT,1073940433,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY INPATIENT CARE,600 HOSPITAL DR STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1467980045,"PATEL, HARSH, NARENDRABHAI",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1467980045,"PATEL, HARSH, NARENDRABHAI",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 52 , 94 , 95 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1467980045,"PATEL, HARSH, NARENDRABHAI",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1467980045,"PATEL, HARSH, NARENDRABHAI",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1073940433,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY INPATIENT CARE,600 HOSPITAL DR STE A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1467980045,"PATEL, HARSH, NARENDRABHAI",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467983254,"MORRIS, DWAYNE, ALBERT",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1467983759,"AMIN, YASHIKA",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 96 , 178 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1467984203,"GROSSEIBL, ERICA, ANN",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 37 , 75 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467988014,"WILLSON, ADAM, KENNETH",3521 HAWORTH DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467988014,"WILLSON, ADAM, KENNETH",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1467988014,"WILLSON, ADAM, KENNETH",3521 HAWORTH DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 29 ,$#,,
MEDICAID DIRECT,1285671602,TRIAD PSYCHIATRIC COUNSELING CENT,TRIAD PSYCHIATRIC & COUNSELING CENTER PA,603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1467990143,"PARVATHANENI, ANNAPURNA, SURAPANENI",603 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1467990473,"KAYLOR, COURTNEY, WESTBROOK",5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1467990473,"KAYLOR, COURTNEY, WESTBROOK",5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1467993170,"OKEEFFE, CHRISTOPHER, RYAN",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 30 , 42 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1467993329,"WETZEL, ANDREW, ERNST",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1467993329,"WETZEL, ANDREW, ERNST",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1467994889,"MCCLOSKEY, SUZANNE, PATRICIA",1140 CARTHAGE ST   SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,,,$#,,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1467997767,"MAUTZ, CHRISTINE",106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1467999565,"BRAMBLETT, MELANIE, SAMPLES",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477000198,"LANGHANS, ERIC, MATTHEW",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 70 , 145 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477000198,"LANGHANS, ERIC, MATTHEW",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 31 ,$#,,
MEDICAID DIRECT,1477001246,DOWN EAST FIRE DEPARTMENT,,647 US 70 E   SEALEVEL NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1477001246,DOWN EAST FIRE DEPARTMENT,647 US 70 E   SEALEVEL NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477004422,"BOIVIN, ANGELA, KELLEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477007896,"WALSH, RYAN, XAVIER",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2994 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477011302,"TABRON, RITA, MICHELLE",605 N MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477011542,"CLAPPER, EMILY, SLAUGHTER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477012433,"NGUYEN, DAVID, TOAN VU",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1477013530,"PEIFFER, SARAH, ASMAN",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477013530,"PEIFFER, SARAH, ASMAN",161 WALKER ST   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801261391,BLUE RIDGE COMMUNITY HEALTH SERVICE,SEVENTH AVENUE HEALTH CENTER,628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477013530,"PEIFFER, SARAH, ASMAN",628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477013530,"PEIFFER, SARAH, ASMAN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477013530,"PEIFFER, SARAH, ASMAN",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 70 , 108 , 117 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477013845,"ROSSER, ALISON, MARY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477014330,"SCHOFIELD, CINDY, LOUISE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477014330,"SCHOFIELD, CINDY, LOUISE",2429A 9TH AVE DR NE   HICKORY NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477014330,"SCHOFIELD, CINDY, LOUISE",2429A 9TH AVE DR NE   HICKORY NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1477014330,"SCHOFIELD, CINDY, LOUISE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477014355,"LATIF, WAFA, AZHAR",1425 PROMISE BEACON CIR STE 110 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 20 , 30 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1425 PROMISE BEACON CIR STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477014355,"LATIF, WAFA, AZHAR",1425 PROMISE BEACON CIR STE 110 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 47 , 75 , 112 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477025716,"SMITH, RACHEL, ELIZABETH",5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1477025716,"SMITH, RACHEL, ELIZABETH",5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1477026532,CANDLESTICKS FAMILY CARE HOME,~,1607 AMBERLY DR   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477026532,CANDLESTICKS FAMILY CARE HOME,1607 AMBERLY DR   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 462 , 462 ," $49,966.79 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1477027977,"VARNELL, DANA, MARIE",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 35 , 97 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477027977,"VARNELL, DANA, MARIE",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 127 , 152 , 414 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477028215,"OCONNOR, LAUREN, ELIZABETH",604 W MAIN ST   JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 106 , 139 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,604 W MAIN ST   JAMESTOWN NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477028215,"OCONNOR, LAUREN, ELIZABETH",604 W MAIN ST   JAMESTOWN NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477028264,"BARNEY, LINDSAY, NICOLE",10100 S MAIN ST   ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2770 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477028264,"BARNEY, LINDSAY, NICOLE",10100 S MAIN ST   ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477029486,"CARPENTER, DUSTIN, SCOTT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477029486,"CARPENTER, DUSTIN, SCOTT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 18 ,$#,,
MEDICAID DIRECT,1477030872,THERAPY TREE SERVICES PLLC,,109 FOUNTAIN BROOK CIR STE A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477030872,THERAPY TREE SERVICES PLLC,109 FOUNTAIN BROOK CIR STE A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 91 ," 1,030 "," 1,031 "," $70,454.00 ",,
MEDICAID DIRECT,1477030872,THERAPY TREE SERVICES PLLC,,600 PINNER WEALD WAY STE 201 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477030872,THERAPY TREE SERVICES PLLC,600 PINNER WEALD WAY STE 201 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 191 ," 3,661 "," 3,669 "," $250,800.35 ",,
MEDICAID DIRECT,1427097823,GOLDSBORO FAMILY PHYSICIANS PA,~,1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1477032498,"HOLLEY, JENNIFER, JOHNSON",1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1427097823,GOLDSBORO FAMILY PHYSICIANS PA,~,1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1477032498,"HOLLEY, JENNIFER, JOHNSON",1108 PARKWAY DR STE B GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1477032498,"HOLLEY, JENNIFER, JOHNSON",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 75 ,$#,,
MEDICAID DIRECT,1881059723,TRIAD ADULT AND PEDIATRIC MEDICINE,,1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477033637,"YAYA, IRENE, JEPTOLO",1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881059723,TRIAD ADULT AND PEDIATRIC MEDICINE,,1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477033637,"YAYA, IRENE, JEPTOLO",1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 72 , 121 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477033835,"HORGAN, EDMUND, CHRISTOPHER",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",2300 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710166327,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,520 N DEKALB ST STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",600 W TRADE ST   DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",1223 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",2300 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",1895 HOFFMAN RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",910 E CHURCH ST STE A CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710166327,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,520 N DEKALB ST STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",520 N DEKALB ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548997893,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477036556,"BRYANT, ALVINA, ELAINE",9310 STRAUSE DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477037679,PHOENIX RISING SL THERAPY SERVICES,~,313 GOLDEN ROD LN   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1477037679,PHOENIX RISING SL THERAPY SERVICES,313 GOLDEN ROD LN   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,#, 120 , 122 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477040277,"SYMES, MALCOLM, OMAR",396 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 52 , 72 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,417 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477040277,"SYMES, MALCOLM, OMAR",417 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 137 , 227 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477040350,"HANSEN, REBECCA, MANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 198 , 280 , 366 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1477040350,"HANSEN, REBECCA, MANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477040350,"HANSEN, REBECCA, MANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477040350,"HANSEN, REBECCA, MANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477040921,"SCOTT, KELLY, PEARSON",,830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1477040921,"SCOTT, KELLY, PEARSON",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477043560,"ASAMOAH, PHILIP, NANA K BAAFO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 44 , 55 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477043560,"ASAMOAH, PHILIP, NANA K BAAFO",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 37 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477044733,"ORANGE, CHRISTOPHER, BRIAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 102 , 102 , 105 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477046340,"PATTERSON, EMILY, FRANCES",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477046340,"PATTERSON, EMILY, FRANCES",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 28 , 45 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477046340,"PATTERSON, EMILY, FRANCES",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477046852,"COMMANDER, SARA, JANE",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477046886,"BROWN, BRIAN, ETHAN",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1477046886,"BROWN, BRIAN, ETHAN",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477046886,"BROWN, BRIAN, ETHAN",,298 MEMORIAL DR   SENECA SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1477046886,"BROWN, BRIAN, ETHAN",298 MEMORIAL DR   SENECA SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477047413,"FRANCO, VIVIAN, ISABEL",75A LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 40 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477050508,"ZURFLUH, CARLEY, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 89 , 89 ,$#,,
MEDICAID DIRECT,1316486640,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PALLIATIVE CARE,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477050508,"ZURFLUH, CARLEY, MARIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477050573,"ODOM, TRAVIS, LEE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962102830,MAKING WAVES MENTAL HEALTH,,2632 CAROLINA BEACH RD # 4 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477050607,"LAWRENCE, LINDSEY, MARIE",2632 CAROLINA BEACH RD # 4 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 80 , 80 ,$#,,
MEDICAID DIRECT,1497526719,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA MEDICAL PARK,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1477050771,"FRATER, APRIL, JANINE",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477050961,"DONATHAN, RHETT, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477051027,"HICKS, MICHELE, CATHELINE",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477052496,"BHUIYAN, IQBAL, HM",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 92 , 97 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477052496,"BHUIYAN, IQBAL, HM",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,180 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1477052496,"BHUIYAN, IQBAL, HM",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1477052496,"BHUIYAN, IQBAL, HM",1740 SOUTHEAST BLVD   CLINTON NC,082,Sampson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477052496,"BHUIYAN, IQBAL, HM",1740 SOUTHEAST BLVD   CLINTON NC,082,Sampson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1477052496,"BHUIYAN, IQBAL, HM",1740 SOUTHEAST BLVD   CLINTON NC,082,Sampson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477055218,"HAUSFELD, KATELYN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1477057214,"BUCK, JAMES, KYLE",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1477057214,"BUCK, JAMES, KYLE",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1477057214,"BUCK, JAMES, KYLE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1477057214,"BUCK, JAMES, KYLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 51 ,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477057503,"GARLING, KATHERINE, KAEPPLER",680 OYSTER POINT RD   NEWPORT NEWS VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477058873,"CHUKWUNEKE, JEFFREY, CHIAGOZIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477058873,"CHUKWUNEKE, JEFFREY, CHIAGOZIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477058873,"CHUKWUNEKE, JEFFREY, CHIAGOZIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477058873,"CHUKWUNEKE, JEFFREY, CHIAGOZIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477058873,"CHUKWUNEKE, JEFFREY, CHIAGOZIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477058873,"CHUKWUNEKE, JEFFREY, CHIAGOZIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 208 , 222 , 274 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477058873,"CHUKWUNEKE, JEFFREY, CHIAGOZIE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477059202,"HILBERT, DOUGLAS, RICHARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 150 , 151 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477059616,"MAYL, JONATHAN, JONAH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477059616,"MAYL, JONATHAN, JONAH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477060614,"WARD, JOSHUA, WILLIAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477060879,"CAMP, NOAH, MATTHEW",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 153 , 231 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1477062743,"NICKELSON, CHRISTOPHER, MICHAEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1477062743,"NICKELSON, CHRISTOPHER, MICHAEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477062966,"BOGDANOVA, ELENA, SERGEYENA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477062966,"BOGDANOVA, ELENA, SERGEYENA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477067312,"MEYRAN, KIMBERLY, HANNAH",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 41 , 70 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477068575,"BARBEE, LAURA, CARDIE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477068575,"BARBEE, LAURA, CARDIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477070522,"SULLIVAN, SCOTT",2675 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 20 , 79 , 114 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1477073781,"KRUGH, MARISSA, CHRISTINE",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477073781,"KRUGH, MARISSA, CHRISTINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477073781,"KRUGH, MARISSA, CHRISTINE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 28 , 39 , 39 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477073781,"KRUGH, MARISSA, CHRISTINE",800 TILGHMAN DR   DUNN NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 29 , 52 , 52 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477073781,"KRUGH, MARISSA, CHRISTINE",800 TILGHMAN DR   DUNN NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477073781,"KRUGH, MARISSA, CHRISTINE",800 TILGHMAN DR   DUNN NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477075273,"HAMMAD, SAHLA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1477075273,"HAMMAD, SAHLA",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 155 , 156 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1477075273,"HAMMAD, SAHLA",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1477075596,"KALTENECKER, BRIAN, MATTHEW",2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1477075596,"KALTENECKER, BRIAN, MATTHEW",2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477075596,"KALTENECKER, BRIAN, MATTHEW",2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1013971308,WOMENS WELLNESS CENTER PA,Womens Wellness Center PA,2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477075596,"KALTENECKER, BRIAN, MATTHEW",2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 48 , 63 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477079093,"BARNHOUSE, BRITTANY, LEANNE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477079093,"BARNHOUSE, BRITTANY, LEANNE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477082311,"MAY, JESSICA, PARKER",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 47 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477084879,"MYERS, JULIE, NICOLE",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477085686,"STEELE, THOMAS, NORMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 27 , 37 , 59 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477086387,"SMITH, WILLIAM, TYLER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 27 , 27 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477086445,"MCCANN, PATRICK, AARON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 116 , 117 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1477086619,"DE ANDRADE PEREIRA, RACHEL",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477086619,"DE ANDRADE PEREIRA, RACHEL",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578656773,COASTAL CAROLINA SURGICAL ASSOCIATE,~,1411 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477086767,"COFFEY, DALE, DAVID",2511 DELANEY AVE   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 77 , 108 ,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1477087112,"MCGOWAN, MICHAEL, JOSEPH",150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 36 , 53 , 63 ,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,800 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1477087112,"MCGOWAN, MICHAEL, JOSEPH",800 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1477087112,"MCGOWAN, MICHAEL, JOSEPH",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,800 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1477087112,"MCGOWAN, MICHAEL, JOSEPH",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1477087112,"MCGOWAN, MICHAEL, JOSEPH",150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1578969515,HUGH CHATHAM MEMORIAL HOSPITAL,,800 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1477087112,"MCGOWAN, MICHAEL, JOSEPH",150 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 13 , 18 , 25 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1477087112,"MCGOWAN, MICHAEL, JOSEPH",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1477087294,"VANDE LOO, JENNIFER, MARIE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 29 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,34 HEALTHPARK WAY STE 100C CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477089613,UNC PHYSICIANS NETWORK LLC,34 HEALTHPARK WAY STE 100C CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,, 25 , 26 , 53 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477096972,"CUMMINGS, NEIL, CHRISTOPHER",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477096972,"CUMMINGS, NEIL, CHRISTOPHER",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205466323,SPEECH INSPIRATIONS PLLC,,4909 WATERS EDGE DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477099984,"ORTLER, JESSICA, MARIE",4909 WATERS EDGE DR STE 100 RALEIGH NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477100832,"MEDLEY, CHAELY, JONES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477100832,"MEDLEY, CHAELY, JONES",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 23 , 39 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477101152,"DELPH, DEVERICK, DEON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477101301,BEACHSIDE HOME SERVICE LLC,,101 E MARKET ST STE 1A SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1477101301,BEACHSIDE HOME SERVICE LLC,101 E MARKET ST STE 1A SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 2,389 "," 2,389 "," $260,045.82 ",,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477102143,"VALENCIA, YVONNE, ANDREA",812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 94 , 190 , 217 ," $11,213.26 ",,
MEDICAID DIRECT,1477103901,HICKORY PUBLIC SCHOOLS,,432 4TH AVE SW   HICKORY NC,018,Catawba,251300000X,Agencies,Local Education Agency (LEA),,1477103901,HICKORY PUBLIC SCHOOLS,432 4TH AVE SW   HICKORY NC,018,Catawba,251300000X,Agencies,Local Education Agency (LEA),, 125 ," 1,381 "," 1,388 "," $64,387.61 ",,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,100 PLANK BRIDGE RD # B CAMDEN NC,015,Camden,193200000X,Group,Multi-Specialty,,1477104925,"HARDEN, SHIRLEY, NICOLE",100 PLANK BRIDGE RD UNIT B CAMDEN NC,015,Camden,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 21 , 39 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1477104925,"HARDEN, SHIRLEY, NICOLE",100 PLANK BRIDGE RD UNIT B CAMDEN NC,015,Camden,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477106169,"EVANS, SHAWNA, KRISTEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477109486,"ALTAK, ALI, ANMAR",1521 E FRANKLIN ST APT B202 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477111375,"KAYE, AARON, JOSHUA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477111375,"KAYE, AARON, JOSHUA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477111375,"KAYE, AARON, JOSHUA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477111375,"KAYE, AARON, JOSHUA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477111375,"KAYE, AARON, JOSHUA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477111375,"KAYE, AARON, JOSHUA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477111375,"KAYE, AARON, JOSHUA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 19 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477111375,"KAYE, AARON, JOSHUA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477111375,"KAYE, AARON, JOSHUA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467886978,G ABRAMS R COHEN VII PC,~,1605 GALLERIA BLVD STE 110 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477112449,"L'HUILLIER, LING, HUANG",8170 S TRYON ST STE C CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 285 , 422 ," 1,501 "," $75,943.62 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477112449,"L'HUILLIER, LING, HUANG",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 828 , 897 ," 3,722 "," $139,132.63 ",,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477113090,"PHILLIPS, MCKENZIE, BOLIN",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 79 , 81 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477113090,"PHILLIPS, MCKENZIE, BOLIN",900 DONTIA DR   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1477113090,"PHILLIPS, MCKENZIE, BOLIN",951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477113884,"MCGOUGH, HALEY, CATHRYN",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477113884,"MCGOUGH, HALEY, CATHRYN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1609191121,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1656 RIVERCHASE BLVD STE 3600 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477113884,"MCGOUGH, HALEY, CATHRYN",1656 RIVERCHASE BLVD STE 3600 ROCK HILL SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477113975,"GREEN, ALEX, COLBY",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477113975,"GREEN, ALEX, COLBY",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 19 , 22 , 62 ,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477113975,"GREEN, ALEX, COLBY",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477113975,"GREEN, ALEX, COLBY",7 MCDOWELL ST STE 200 ASHEVILLE NC,011,Buncombe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 93 , 124 , 257 ," $15,112.12 ",,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477113975,"GREEN, ALEX, COLBY",4226 E US 64 ALT   MURPHY NC,020,Cherokee,1223D0001X,Dental Providers,Dentist,Dental Public Health, 19 , 20 , 49 ,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1477114528,"ALLEN, AMY, LOLA",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477114528,"ALLEN, AMY, LOLA",50 HOSPITAL DR STE 4A HENDERSONVILLE NC,045,Henderson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477114528,"ALLEN, AMY, LOLA",100 S BOYLAN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 18 , 19 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477114585,"WELSH, LAURA, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 21 ,$#,,
MEDICAID DIRECT,1194302901,APPALACHIAN REGIONAL BEHAVIORAL HEA,ARBH PROVIDERS,432 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1477115517,"HARRIS, PAIGE, LEIGH",432 HOSPITAL DR   LINVILLE NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1245745587,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PRIMARY CARE - ERWIN,518 E H ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477115707,"ENNIS, AMY, LAMB",518 E H ST   ERWIN NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 118 , 399 , 496 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",3801 W MARKET ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",3604 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 221 ," 1,226 "," 3,436 "," $18,397.13 ",,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 28 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 49 , 115 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,,,Unknown,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 106 , 263 , 612 ," $13,925.86 ",,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477116424,"MCCOY, RACHEL, LEANN",3610 PETERS CT   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477117315,"HUNTER, JAMIE, LYNETTE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477117315,"HUNTER, JAMIE, LYNETTE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 108 , 123 , 212 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477117315,"HUNTER, JAMIE, LYNETTE",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 105 , 118 ,$#,,
MEDICAID DIRECT,1871589762,ADVANCE COMMUNITY HEALTH INC,~,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477117448,"HARRIS, DEANNA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275085144,ADVANCE COMMUNITY HEALTH INC,~,173 HIGH HOUSE RD   CARY NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477117448,"HARRIS, DEANNA",173 HIGH HOUSE RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275085144,ADVANCE COMMUNITY HEALTH INC,~,173 HIGH HOUSE RD   CARY NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477117448,"HARRIS, DEANNA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 43 , 50 ,$#,,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477117448,"HARRIS, DEANNA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114913092,ADVANCE COMMUNITY HEALTH INC,WAKE HEALTH SERVICES INC,130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477117448,"HARRIS, DEANNA",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477117448,"HARRIS, DEANNA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 135 , 271 , 296 ," $15,776.87 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477120293,"BARFIELD, AMY, CAROLINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 34 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477121671,"MANNING, CHARLES, DURIAN",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477121671,"MANNING, CHARLES, DURIAN",1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477121788,CABARRUS OPCO LLC,THE DRAKE,1195 DRAKE MILL LN SW   CONCORD NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477121788,CABARRUS OPCO LLC,1195 DRAKE MILL LN SW   CONCORD NC,013,Cabarrus,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 22 ," 5,457 "," 5,461 "," $481,785.85 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477127298,"SMITH, IAN, EVERETT",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1477128486,"ABERNATHY, NATALIE, SPEAGLE",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 86 , 166 , 220 ,$#,,
MEDICAID DIRECT,1477128809,EAST CAROLINA COMPASS,ECCOMPASS,319 BARNES ST S   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1477128809,EAST CAROLINA COMPASS,319 BARNES ST S   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 5,917 "," 6,433 "," $814,347.76 ",,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477131704,"MILLER, EMILY, ANNETTE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 20 , 44 , 44 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1477133643,"BARNHART, CHAD, CHRISTIAN",317 WESTERN BOULEVARD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1477133908,B&B ASSISTED LIVING CARE LLC,B&B ASSISTED LIVING NO 1,2610 NC HIGHWAY 130 W   ROWLAND NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477133908,B&B ASSISTED LIVING CARE LLC,2610 NC HIGHWAY 130 W   ROWLAND NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,480 "," 1,480 "," $92,543.68 ",,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1477135531,"COVINGTON, DIONA, PATRICE",1211 IRELAND DR # A FAYETTEVILLE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477136935,"EASON, HANNAH, ELIZABETH",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477137743,BUTLER HOME CARE AGENCY LLC,,1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1477137743,BUTLER HOME CARE AGENCY LLC,1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,864 "," 2,871 "," $195,432.67 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477137768,"DIAMOND, JEFFREY, HARRIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477137768,"DIAMOND, JEFFREY, HARRIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1477137768,"DIAMOND, JEFFREY, HARRIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477138832,"SIMON, JENNA, DEAN",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1477141562,"TUCKER, ANNA, INGRAM",103 COX BLVD   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 109 , 153 , 235 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477144970,"RAMSEY, MONIQUE, LASHAWN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477144970,"RAMSEY, MONIQUE, LASHAWN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 56 , 90 , 114 ," $16,385.90 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477146009,"RIDDLE, SUZANN, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 34 , 47 , 74 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477146009,"RIDDLE, SUZANN, ELIZABETH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 13 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1477146090,"COWELL, LAUREN, HOLTON",2115 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 21 , 27 , 47 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1477146090,"COWELL, LAUREN, HOLTON",2115 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 39 , 41 , 71 ,$#,,
MEDICAID DIRECT,1477146934,DONISEWA NICOLE JOHNSON,TOUCHED BY ANGELS HOMECARE LLC,2801 CRISMAN ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1477146934,DONISEWA NICOLE JOHNSON,2801 CRISMAN ST   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,467 "," 1,467 "," $87,671.12 ",,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477149730,"LANE, AMY, VONGVILATH",1038 X RAY DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 48 , 87 ,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477149730,"LANE, AMY, VONGVILATH",1309 E SUNSET DR   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 40 ,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1309 E SUNSET DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477149730,"LANE, AMY, VONGVILATH",1309 E SUNSET DR   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477151769,"BENDER, ROBERT, LANDON",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477151769,"BENDER, ROBERT, LANDON",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477151769,"BENDER, ROBERT, LANDON",336 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477151769,"BENDER, ROBERT, LANDON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 30 , 42 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477154607,"BRICKERS, JESSICA, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1477154607,"BRICKERS, JESSICA, NICOLE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477157089,"REID, JAMAICA, NIKKIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 151 , 151 ,$#,,
MEDICAID DIRECT,1477161115,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT HICKORY CAREER & ARTS MAGNET,409 8TH AVE NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477161115,GASTON FAMILY HEALTH SERVICES INC,409 8TH AVE NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477162725,"SULLIVAN, AIDAN, MILLS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 13 , 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477162725,"SULLIVAN, AIDAN, MILLS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 40 , 41 ,$#,,
MEDICAID DIRECT,1508158940,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER MEBANE,1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice," 1,447 "," 1,925 "," 6,579 "," $734,975.10 ",,
MEDICAID DIRECT,1669892725,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER WILSON,1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1508158940,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER MEBANE,1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice," 1,543 "," 1,850 "," 6,637 "," $751,663.48 ",,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669892725,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER WILSON,1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1669892725,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER WILSON,1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1508158940,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER MEBANE,1107 S FIFTH ST STE 250 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669892725,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER WILSON,1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",1706 MEDICAL PARK DR W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 680 , 891 ," 2,817 "," $331,903.05 ",,
MEDICAID DIRECT,1639450869,REEBYE PARK & RICHMAN DDS PLC,TRIANGLE IMPLANT CENTER DURHAM,5318 NC HIGHWAY 55 STE 106 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",2300 WAYNE MEMORIAL DR STE G GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1649761602,REEBYE PARK & RICHMAN DDS PLC,~,431 KEISLER DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477163376,"MAY, MICHAEL, CLAYTON",431 KEISLER DR   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477163525,"ENCLADE, MELISA, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477163525,"ENCLADE, MELISA, ANN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 12 , 34 , 34 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477168565,"LAWSON, CODY, WAYNE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477168565,"LAWSON, CODY, WAYNE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477171338,"KLEVAN, LAUREN, RAIA",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477171403,INREACH,,2021 CAMDEN RD   WINGATE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477171403,INREACH,2021 CAMDEN RD   WINGATE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 356 , 356 ," $19,689.28 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477171494,"VICKERY, LARSON, THOMAS",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 19 , 25 ,$#,,
MEDICAID DIRECT,1639730880,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH TELEPSYCHIATRY,3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477171494,"VICKERY, LARSON, THOMAS",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477171627,"SEAL, AMY",1130 GODWIN DR   WILLIAMSTON NC,058,Martin,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477171627,"SEAL, AMY",120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 46 , 90 , 91 ," $13,702.32 ",,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477175248,"TAMAYO, CARLOS, JULIO",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 32 , 53 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477175248,"TAMAYO, CARLOS, JULIO",189 HICKORY TREE RD STE 112 WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 12 , 26 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477175248,"TAMAYO, CARLOS, JULIO",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477175248,"TAMAYO, CARLOS, JULIO",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 28 ,$#,,
MEDICAID DIRECT,1477177111,C&S ADULT CARE LLC,DEAL CARE INN,1075 DEAL RD   MOORESVILLE NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477177111,C&S ADULT CARE LLC,1075 DEAL RD   MOORESVILLE NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 4,388 "," 4,479 "," $354,006.22 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477179398,"RITCHIE, OLIVIA, MENDEN",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 34 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477179398,"RITCHIE, OLIVIA, MENDEN",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 56 , 94 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477180123,"ABERMAN, CAROLINE, CHEEK",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477180123,"ABERMAN, CAROLINE, CHEEK",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477180123,"ABERMAN, CAROLINE, CHEEK",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477180123,"ABERMAN, CAROLINE, CHEEK",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477180123,"ABERMAN, CAROLINE, CHEEK",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477180123,"ABERMAN, CAROLINE, CHEEK",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477180206,"MANGEL, BENISON, PAP",919 S FIFTH ST   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 67 , 109 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477180669,"WANG, JESSIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477180669,"WANG, JESSIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477180669,"WANG, JESSIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477181386,"PAPIER, ARIANA, PAULINE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477181386,"PAPIER, ARIANA, PAULINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 73 , 97 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1477181386,"PAPIER, ARIANA, PAULINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 29 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1477181386,"PAPIER, ARIANA, PAULINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477181386,"PAPIER, ARIANA, PAULINE",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1477181386,"PAPIER, ARIANA, PAULINE",520 ALLEN ST   TROY NC,062,Montgomery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1477181386,"PAPIER, ARIANA, PAULINE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477182707,"DRAKE, MATTHEW, THOMAS",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 24 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477182707,"DRAKE, MATTHEW, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 301 , 399 , 628 ," $12,307.45 ",,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477182707,"DRAKE, MATTHEW, THOMAS",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477183853,"BAZELOW, TERRESA, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 111 , 164 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477183853,"BAZELOW, TERRESA, MARIE",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477183853,"BAZELOW, TERRESA, MARIE",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477184653,ROSE VISTA ASSISTED LIVING LLC,,2130 ROSE VISTA RD   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477184653,ROSE VISTA ASSISTED LIVING LLC,2130 ROSE VISTA RD   KINSTON NC,054,Lenoir,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 48 ," 9,378 "," 9,378 "," $683,134.69 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477188019,"LOVE, LAURA, JO",555 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477188019,"LOVE, LAURA, JO",101 CHURCH ST   BROADWAY NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477188019,"LOVE, LAURA, JO",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 27 , 27 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477188019,"LOVE, LAURA, JO",15 REGIONAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 48 , 51 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477188019,"LOVE, LAURA, JO",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 56 , 68 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477188019,"LOVE, LAURA, JO",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477188019,"LOVE, LAURA, JO",15 REGIONAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477191211,"HAIRE, CARA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477191211,"HAIRE, CARA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477191211,"HAIRE, CARA, MARIE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477191211,"HAIRE, CARA, MARIE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477191211,"HAIRE, CARA, MARIE",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477191500,"WEBB, ERIN, REDMOND",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 49 , 98 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1477194629,"OLIVER, MARY, MELINDA",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477196665,"MEASE, QADIRAH, FRANCINE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 399 ," 2,222 "," 2,449 "," $47,887.74 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477196665,"MEASE, QADIRAH, FRANCINE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477196665,"MEASE, QADIRAH, FRANCINE",1000 JOHNS RD   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 89 , 98 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477197085,"FLEMING, MEREDITH, KATHRYN",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1477197556,"CROWDER, ASHLEY, NICHOLE",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 47 , 47 ," $18,612.00 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1477197556,"CROWDER, ASHLEY, NICHOLE",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477197556,"CROWDER, ASHLEY, NICHOLE",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477197556,"CROWDER, ASHLEY, NICHOLE",4226 E US 64 ALT   MURPHY NC,020,Cherokee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 69 , 112 , 131 ," $10,207.20 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1477197556,"CROWDER, ASHLEY, NICHOLE",154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477198091,"CANNICI, RYAN, THOMAS",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 54 , 97 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477198091,"CANNICI, RYAN, THOMAS",200 MEDICAL PARK DR   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 34 , 57 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477198091,"CANNICI, RYAN, THOMAS",1904 JAKE ALEXANDER BLVD W STE 301 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 114 , 211 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477204659,"GIBSON, KELSEY, MAE MAFFETT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477204659,"GIBSON, KELSEY, MAE MAFFETT",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 98 , 140 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477204725,"ANDERSON, SEAN, ROBERT",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 116 , 211 , 242 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477205631,"LARSON, CARLY, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 42 , 74 ,$#,,
MEDICAID DIRECT,1326208398,PREMIERE PEDIATRICS PLLC,PREMIERE PEDIATRICS PLLC,530 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1477207926,"TOPER, MELISSA, WILLIAMS",530 GREENSBORO ST   ASHEBORO NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 55 , 72 , 164 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477211530,"PARKER, SARAH, YATES",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",10 LAURA LN   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",190 INTERSTATE DR   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",500 W HANES MILL RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 26 , 26 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",500 W HANES MILL RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",140 MOORE RD   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477213932,"TURNER, LAJOYIOUS, FANTASHIA",225 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1477215978,"PALUMBO, SAMANTHA, JO",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1124207725,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,910 E CHURCH ST STE A CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477215978,"PALUMBO, SAMANTHA, JO",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578742177,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,214 CLEVELAND AVE   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1477215978,"PALUMBO, SAMANTHA, JO",6911 SHANNON WILLOW RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477215978,"PALUMBO, SAMANTHA, JO",6911 SHANNON WILLOW RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477217636,"DICK, ERNEST, HENRY",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477217636,"DICK, ERNEST, HENRY",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477217636,"DICK, ERNEST, HENRY",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 81 , 96 , 126 ,$#,,
MEDICAID DIRECT,1477220564,LUX HOME CARE LLC,~,6047 TYVOLA GLEN CIR STE 208 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1477220564,LUX HOME CARE LLC,6047 TYVOLA GLEN CIR STE 208 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 6,622 "," 6,746 "," $938,532.92 ",,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477224012,"MARTIN, KIMBERLY, BINK",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477225100,"MURRY, EMMA, CAROLINE",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477225100,"MURRY, EMMA, CAROLINE",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477225100,"MURRY, EMMA, CAROLINE",2025 FRONTIS PLAZA BLVD STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477229003,APRIA HEALTHCARE LLC,ABC AN APRIA COMPANY,818 PROFESSIONAL PL W   CHESAPEAKE VA,101,Out of State <= 40 miles,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1477229003,APRIA HEALTHCARE LLC,818 PROFESSIONAL PL W   CHESAPEAKE VA,101,Out of State <= 40 miles,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1477229003,APRIA HEALTHCARE LLC,ABC AN APRIA COMPANY,818 PROFESSIONAL PL W   CHESAPEAKE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1477229003,APRIA HEALTHCARE LLC,818 PROFESSIONAL PL W   CHESAPEAKE VA,101,Out of State <= 40 miles,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 56 , 193 , 349 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1477230951,"CROSS, DAVINA, SATTERFIELD",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1477230951,"CROSS, DAVINA, SATTERFIELD",2695 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1477230951,"CROSS, DAVINA, SATTERFIELD",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1477230951,"CROSS, DAVINA, SATTERFIELD",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 80 , 86 , 185 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477233310,"UXA, LAUREN, MARION",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477236073,"SCOTT, ASHLEY, JORDAN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477236073,"SCOTT, ASHLEY, JORDAN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477239234,"WILLIAMS, KIMBERLY, ANTHONY",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 81 , 126 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1477239234,"WILLIAMS, KIMBERLY, ANTHONY",4937 OLD COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477239234,"WILLIAMS, KIMBERLY, ANTHONY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477244549,"ATKINS, ASHLEY, NICOLE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477244549,"ATKINS, ASHLEY, NICOLE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952981391,COASTLINE FAMILY MEDICINE,,2145 COUNTRY CLUB RD STE 500 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1477248409,"BARTS, MICHELE, ANN",2145 COUNTRY CLUB RD STE 500 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477248409,"BARTS, MICHELE, ANN",4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1477248409,"BARTS, MICHELE, ANN",4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 65 , 95 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477248409,"BARTS, MICHELE, ANN",4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477248441,"CHAMBERS, BAILEY, STEHLER",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477248482,"HOLROYD, KENDALL, ADAIR",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 98 , 161 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1477250546,"JONES, ESTHER, ITUNU",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477250967,"BLIESE, LAURA, RACHEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477250967,"BLIESE, LAURA, RACHEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 32 ,$#,,
MEDICAID DIRECT,1881109452,ALIGNMED PARTNERS PC,GPS PHYSICIAN GROUP PC,710 JULIAN RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1477255057,"MIRAFUENTE, BERNA JEAN, BESANA",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 17 , 24 , 24 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1477258119,"PICKARTS, SAMANTHA, MICHELLE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1477258119,"PICKARTS, SAMANTHA, MICHELLE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1477258119,"PICKARTS, SAMANTHA, MICHELLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477260354,"LORICK, SARAH, ASHLEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1477264075,"IRVINE, HALLE, RAE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 30 , 32 ,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477265320,"ABIMBOLA, TOYIN, ADESEYE",2617 S HORNER BLVD   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 18 , 58 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477265320,"ABIMBOLA, TOYIN, ADESEYE",2617 S HORNER BLVD   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477265320,"ABIMBOLA, TOYIN, ADESEYE",2617 S HORNER BLVD   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 24 ,$#,,
MEDICAID DIRECT,1831820927,LANE AND ASSOCIATES XLVI DDS PA,,2201 CANDUN DR STE 202 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477265320,"ABIMBOLA, TOYIN, ADESEYE",2617 S HORNER BLVD   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 244 , 335 ," 1,099 "," $58,514.12 ",,
MEDICAID DIRECT,1902950769,LANE & ASSOCIATES XV DDS PA,LANE & ASSOCIATES XV DDS PA,2617 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1477265320,"ABIMBOLA, TOYIN, ADESEYE",2617 S HORNER BLVD   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice, 418 , 713 ," 2,189 "," $125,771.36 ",,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1477267912,"CORBETT, FLOR, DE MARIA",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477267912,"CORBETT, FLOR, DE MARIA",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477267912,"CORBETT, FLOR, DE MARIA",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477267912,"CORBETT, FLOR, DE MARIA",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1477267912,"CORBETT, FLOR, DE MARIA",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477267912,"CORBETT, FLOR, DE MARIA",68 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477269090,"BROWSKE, NATALIE, SARAH",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477270841,"ORDINARIO, MELODY, LEGASPI",,114 WRIGHT HILL DR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1477270841,"ORDINARIO, MELODY, LEGASPI",114 WRIGHT HILL DR   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477274264,"PAGE, EMILY, VIRGINIA",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477274264,"PAGE, EMILY, VIRGINIA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477274264,"PAGE, EMILY, VIRGINIA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477274264,"PAGE, EMILY, VIRGINIA",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477274264,"PAGE, EMILY, VIRGINIA",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 21 , 23 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",600 W TRADE ST STE B DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",910 E CHURCH ST   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 36 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417483728,CALDWELL MEMORIAL HOSPITAL,RIVERCREST MEDICAL PARK,160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",160 RIVER BEND DR STE A GRANITE FALLS NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 81 , 95 , 97 ,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1477275782,"ISENHOUR, LAUREN, WINKLER",270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477281871,"HESS, SAMANTHA, HELEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477283414,"PUHL, SAMANTHA, LYNNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477284958,PATHWAY HOMECARE AGENCY LLC,,1700 PARHAM STREET SUITE 1757   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1477284958,PATHWAY HOMECARE AGENCY LLC,1700 PARHAM STREET SUITE 1757   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,#, 42 , 42 ,$#,,
MEDICAID DIRECT,1750648077,ROBESON HEALTH CARE CORPORATION,SCOTLAND HEALTH CENTER,507 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477287563,"HICKS, CYLEE, RAE-LIN",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750648077,ROBESON HEALTH CARE CORPORATION,SCOTLAND HEALTH CENTER,507 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477287563,"HICKS, CYLEE, RAE-LIN",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 105 , 283 , 331 ," $19,556.30 ",,
MEDICAID DIRECT,1093772410,ROBESON HEALTH CARE CORPORATION,MAXTON MEDICAL CENTER,610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477287563,"HICKS, CYLEE, RAE-LIN",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477287563,"HICKS, CYLEE, RAE-LIN",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477287563,"HICKS, CYLEE, RAE-LIN",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477287563,"HICKS, CYLEE, RAE-LIN",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1962251850,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CHERRYVILLE ELEMENTARY,700 E ACADEMY ST   CHERRYVILLE NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477287761,"WEBSTER, KAHANIYAH",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477288611,"FRESCO, CHARLES, PATRICK",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 29 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477288611,"FRESCO, CHARLES, PATRICK",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,934 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477292209,"GURKIN, MARANDA, DEARING",934 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083069017,CAROMONT MEDICAL GROUP INC,CAROMONT PULMONARY MEDICINE,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477292209,"GURKIN, MARANDA, DEARING",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477300861,TRINITY HOME CARE SERVICES INC,,1206 EVANS ST STE 21 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1477300861,TRINITY HOME CARE SERVICES INC,1206 EVANS ST STE 21 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,865 "," 3,046 "," $222,558.10 ",,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477306835,"ELIAS, PAULA, SHEARIN",250 SMITH CHURCH RD STE RHG ROANOKE RAPID NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9915 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477310332,"STONE, ABIGAIL, ERIN",625 E ROOSEVELT BLVD   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477311157,COZZIE HOME CARE SERVICES LLC,,1906 WATERS TRAIL DRIVE   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1477311157,COZZIE HOME CARE SERVICES LLC,1906 WATERS TRAIL DRIVE   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 118 , 118 ,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477318715,"WASHINGTON, BRYELLE, YAHNA",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477318715,"WASHINGTON, BRYELLE, YAHNA",1550 FAULK ST STE 2100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1477319804,"LANGSETH, ZOE, MARIE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477319804,"LANGSETH, ZOE, MARIE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477319804,"LANGSETH, ZOE, MARIE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1477319804,"LANGSETH, ZOE, MARIE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 41 , 47 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477319804,"LANGSETH, ZOE, MARIE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477321909,"BOTTORFF, SYDNIE, CHRISTMAS",605 COTTON ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 74 , 134 , 206 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477322139,"PERKINS, KINA, KYSONIA",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 101 , 316 , 317 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477326643,"CURRIER, SARA, NICHOLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477326643,"CURRIER, SARA, NICHOLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1477333763,"AGALSOFF, KELLIE, MARIE",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 79 , 85 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477337954,"RIVERA VAZQUEZ, JORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477339224,"ALLEN, KEATON, KRISTOPHER",214 18TH ST SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 143 , 210 ,$#,,
MEDICAID DIRECT,1780193557,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - DUNN,801 TILGHMAN DR   DUNN NC,043,Harnett,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477339703,"NORRIS, MADELYN, SHEL",801 TILGHMAN DR STE A DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477339703,"NORRIS, MADELYN, SHEL",801 TILGHMAN DR STE A DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 93 , 97 ,$#,,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477366334,"HIGGS, LILLIAN, LOUISE SKINNER",9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1477371656,"PARKER, MCKENZIE, ROSE",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477371656,"PARKER, MCKENZIE, ROSE",600 HOSPITAL DRIVE   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1477378586,"PARRIS, KAYLA, ELAINE SLOAN",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1477382489,"REYNOLDS, JAIME, LEIGH",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 88 , 131 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477387553,"KERN, ANNA, GRACE",1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 19 , 50 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477387553,"KERN, ANNA, GRACE",1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477387553,"KERN, ANNA, GRACE",1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1477388825,"COLES, RENITA, MCCARTER",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 28 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1477389732,"CAMPBELL, KENZIE, ELIZABETH",910 E INNES ST   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5870 SAMET DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477389732,"CAMPBELL, KENZIE, ELIZABETH",5870 SAMET DR   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477395572,"HAROLD, CHRISTINA, RENEE",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1477500056,"MAZIN, ABDUL, HUSSEIN ALI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477500056,"MAZIN, ABDUL, HUSSEIN ALI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477500239,"LEFAIVRE, JEAN FRANCOIS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477500239,"LEFAIVRE, JEAN FRANCOIS",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154525293,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH PLASTIC & RECONSTRUCTIVE SURGERY CHA,1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477500239,"LEFAIVRE, JEAN FRANCOIS",1025 MOREHEAD MEDICAL DR STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1477501997,"NICHOLS, GREGORY, SCOTT",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1477501997,"NICHOLS, GREGORY, SCOTT",2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 56 , 54 , 65 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477501997,"NICHOLS, GREGORY, SCOTT",2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1477501997,"NICHOLS, GREGORY, SCOTT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477501997,"NICHOLS, GREGORY, SCOTT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477502136,"JESSUP, DAVID, BLACKWELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 14 , 17 , 23 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1477502136,"JESSUP, DAVID, BLACKWELL",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 18 , 28 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1477502136,"JESSUP, DAVID, BLACKWELL",906 WB MCLEAN BLVD   CAPE CARTERET NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 29 , 41 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1477502136,"JESSUP, DAVID, BLACKWELL",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1477502136,"JESSUP, DAVID, BLACKWELL",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1477502136,"JESSUP, DAVID, BLACKWELL",1001 NEWMAN RD   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1477502276,"KRULL, RONALD, DAVID",811 US HWY 70 W   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 42 , 59 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477502276,"KRULL, RONALD, DAVID",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477502276,"KRULL, RONALD, DAVID",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1477502276,"KRULL, RONALD, DAVID",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902953045,WHITE OAK PEDIATRIC ASSOCIATES PA,~,4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477504272,"DAUMEN, JUDITH, REBECCA",4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1932125564,GROAT EYECARE ASSOCS PA,GROAT EYECARE ASSOCIATES PA,1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1477505113,"COHEN, SANDYA, THIMMAPPA",1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477505907,"GREEN, GLEN, ALVIN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477505907,"GREEN, GLEN, ALVIN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477506558,"OBRIEN, JAMES, PATRICK",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477506558,"OBRIEN, JAMES, PATRICK",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477506558,"OBRIEN, JAMES, PATRICK",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477506558,"OBRIEN, JAMES, PATRICK",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 277 , 285 , 347 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477506558,"OBRIEN, JAMES, PATRICK",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477506558,"OBRIEN, JAMES, PATRICK",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477506558,"OBRIEN, JAMES, PATRICK",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174092449,SPARTANBURG MEDICAL CENTER,MEDGRPOFTHECAROLINAS-CAROLINAFAMILYPHYSICIAN,1690 SKYLYN DR STE 210 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477506673,"CUPSTID, HENRY, GRIFFIN",1690 SKYLYN DR STE 210 SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477507713,"ANSARI, AMIR, ZIA",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1477507713,"ANSARI, AMIR, ZIA",180 PARKWOOD DR   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1477507713,"ANSARI, AMIR, ZIA",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1477508679,"MCQUADE, JOHN, FRANCIS",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1477508679,"MCQUADE, JOHN, FRANCIS",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1477508679,"MCQUADE, JOHN, FRANCIS",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1316718497,DLP WESTERN CAROLINA PHYSICIAN PRAC,HARRIS PEDIATRIC CARE RHC,98 DOCTORS DR STE 300 SYLVA NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1477510592,"WHITE, MARGARET, AVERY",40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 22 , 42 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1477510592,"WHITE, MARGARET, AVERY",40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 23 , 45 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477515351,"PHILLIPS, SHARI, SCHNEIDER",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 16 , 27 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477515351,"PHILLIPS, SHARI, SCHNEIDER",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477515351,"PHILLIPS, SHARI, SCHNEIDER",101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1477515633,"COFFEY, JASON",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 73 , 78 , 106 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1477515773,"CREGAN, KEVIN, MICHAEL",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 150 , 151 , 208 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,5849 HARBOUR VIEW BLVD STE 250   SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477516748,"RAMSTAD, DAVID, SCOTT",5849 HARBOUR VIEW BLVD STE 250 SUFFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1477516920,"SAIT, SADIA, FAROOK",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477516920,"SAIT, SADIA, FAROOK",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477516920,"SAIT, SADIA, FAROOK",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 74 , 74 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477516920,"SAIT, SADIA, FAROOK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477517936,"SPARKS, CLAYTON, EUGENE",~,3220 HENDERSON DR   JACKSONVILLE NC,067,Onslow,111N00000X,Chiropractic Providers,Chiropractor,,1477517936,"SPARKS, CLAYTON, EUGENE",3220 HENDERSON DR   JACKSONVILLE NC,067,Onslow,111N00000X,Chiropractic Providers,Chiropractor,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477517977,"BOSTICK, ANTHONY, LAWRENCE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477517977,"BOSTICK, ANTHONY, LAWRENCE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477517977,"BOSTICK, ANTHONY, LAWRENCE",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477517977,"BOSTICK, ANTHONY, LAWRENCE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477519148,PATHOLOGISTS MEDICAL LABORATORY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1477519148,PATHOLOGISTS MEDICAL LABORATORY PA,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,, 555 , 642 ," 1,264 "," $42,003.77 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477520070,"HAIGHT, WILLIAM, CARY",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1770505653,TIMOTHY LYNN JOHNSTON DO PA,TUCKASEEGEE FAMILY PRACTICE,315 WIKE CEMETERY RD   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1477521102,"JOHNSTON, TIMOTHY, LYNN",315 WIKE CEMETERY RD   CULLOWHEE NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 158 , 286 ,$#,,
MEDICAID DIRECT,1477522910,COHEN DERMATOPATHOLOGY PC,INFORM DIAGNOSTICS,15 CRAWFORD ST STE 100 NEEDHAM HEIGHTS MA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1477522910,COHEN DERMATOPATHOLOGY PC,15 CRAWFORD ST STE 100 NEEDHAM HEIGHTS MA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 13 , 17 , 24 ,$#,,
MEDICAID DIRECT,1528187770,HEY CLINIC PA,~,3320 WAKE FOREST RD STE 450 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477523876,"HEY, LLOYD, ALBERT",3320 WAKE FOREST RD STE 450 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 36 , 76 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,137 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477524148,"KUNESH, BENJAMIN, PAUL",137 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 49 , 80 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477524148,"KUNESH, BENJAMIN, PAUL",137 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 21 , 27 ,$#,,
MEDICAID DIRECT,1417911322,TRIANGLE GASTROENTEROLOGY LLC,TRIANGLE GASTROENTEROLOGY LLC,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477524783,"HOLT, JOHN, PLUMMER",2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477524999,"HELTON, MARY BETH, OGLE",100 DUKE HEALTH CARY PL STE 210 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 21 , 65 ,$#,,
MEDICAID DIRECT,1396966412,NC KIDNEY CARE PA,NC KIDNEY CARE,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477525111,"BYNUM IV, ROBERT, WILLIAM",2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 42 , 130 , 130 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477525541,"HOYLE, MARGARETE, JOSEPHINE",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 41 , 96 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477525541,"HOYLE, MARGARETE, JOSEPHINE",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 18 , 37 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477527562,"SANT'ANNA, SUSIE, NELY",205 E MAIN ST   WALLACE NC,031,Duplin,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 85 , 123 , 153 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477527562,"SANT'ANNA, SUSIE, NELY",123 POMPANO PL STE 500 JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477527562,"SANT'ANNA, SUSIE, NELY",1602 DOCTORS CIR   WILMINGTON NC,065,New Hanover,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477527562,"SANT'ANNA, SUSIE, NELY",1602 DOCTORS CIR   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 156 , 210 , 257 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477527638,"SKAHEN III, JAMES, RAYMOND",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477528164,"ROGERS, TODD, ALLEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 113 , 114 , 121 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477529006,"BRUNELLE, KERMIT, BRION",3643 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1871780254,ASHEVILLE MEDICINE AND PEDIATRICS L,ASHEVILLE MEDICINE AND PEDIATRICS LTD,600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1477529725,"NICOLINI, JENNIFER, CROUTCHER",600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 24 , 39 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477529907,"BIANCONI, MICHAEL, JOSEPH",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 74 , 124 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477529907,"BIANCONI, MICHAEL, JOSEPH",7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 24 , 42 ,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1477530608,"LAMPLEY, CHARLES, GORDON",110 W GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1477530608,"LAMPLEY, CHARLES, GORDON",110 W GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 59 , 92 ,$#,,
MEDICAID DIRECT,1649611823,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,335A W COLLEGE AVE   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1477530608,"LAMPLEY, CHARLES, GORDON",335A W COLLEGE AVE   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 17 , 22 ,$#,,
MEDICAID DIRECT,1487096426,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1477530608,"LAMPLEY, CHARLES, GORDON",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1477530608,"LAMPLEY, CHARLES, GORDON",201 E GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477530863,"AKHTAR, WAHEED",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 133 , 251 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477530863,"AKHTAR, WAHEED",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1477530863,"AKHTAR, WAHEED",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 314 , 598 , 793 ," $27,870.11 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477530863,"AKHTAR, WAHEED",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 151 , 418 , 580 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477530863,"AKHTAR, WAHEED",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477530863,"AKHTAR, WAHEED",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1669971826,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN GASTROENTEROLOGY,870 STATE FARM RD STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1477531242,"TRATE, DOUGLAS, MICHAEL",870 STATE FARM RD STE 102 BOONE NC,095,Watauga,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 50 , 62 , 99 ,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1477531564,"ZUEHLKE, PETER, DAVID",1367 STEIN WAY   CORONA CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073796991,BRIAN J LANKFORD OD PA,~,807 WESTERN BLVD   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1477531796,"LANKFORD, BRIAN, JAY",807 WESTERN BLVD   TARBORO NC,033,Edgecombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477532117,"EFROS, JAMES, HOWARD",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477532356,"COOK, DAVID, MARTIN",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,1141 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1477533065,"MONCLA, PAUL, RICHARD",1141 N ROAD ST STE I ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 46 , 89 ,$#,,
MEDICAID DIRECT,1912577628,MERTZ MFM CENTER,,3815 FORRESTGATE DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477533115,"MERTZ, HEATHER, LEE",3815 FORRESTGATE DR   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1699863068,CAROLINA EYE CARE OF LINCOLN COUNTY,CAROLINA EYE CARE OF LINCOLN COUNTY,623 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477534253,"NISHEK, BRIAN, SCOTT",623 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 21 , 47 ,$#,,
MEDICAID DIRECT,1699863068,CAROLINA EYE CARE OF LINCOLN COUNTY,CAROLINA EYE CARE OF LINCOLN COUNTY,231 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477534253,"NISHEK, BRIAN, SCOTT",231 N GENERALS BLVD   LINCOLNTON NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1477534543,"COATS, ELAINE, MYERS",105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477535292,"MAITRA, RANJAN, SIMON",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477535292,"MAITRA, RANJAN, SIMON",2525 COURT DR   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 35 , 41 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477535292,"MAITRA, RANJAN, SIMON",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 71 , 90 , 139 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477535292,"MAITRA, RANJAN, SIMON",209 PARK ST   BELMONT NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 32 , 43 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477535292,"MAITRA, RANJAN, SIMON",2525 COURT DR   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477535292,"MAITRA, RANJAN, SIMON",101 DELTA PARK DR   SHELBY NC,023,Cleveland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477535581,"SNOW, TIMOTHY, MATTHEW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1477535680,"SOMVANSHI, RAHUL, ARVIND",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1598941122,TRIANGLE ALLERGY & ASTHMA PA,~,135 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1477536035,"GAYAM, PADMAJA, REDDY",135 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1346624590,KIDZCARE PEDIATRICS PC,,1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1477536167,"ROWLAND, JOHN, CHRISTOPHER",1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1477536811,"KASSAHUN, ZELEKE, DESSE",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1477536811,"KASSAHUN, ZELEKE, DESSE",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477536811,"KASSAHUN, ZELEKE, DESSE",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1477536811,"KASSAHUN, ZELEKE, DESSE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477536811,"KASSAHUN, ZELEKE, DESSE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 45 , 48 ,$#,,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477536951,"DARLINGTON, KIMBERLY, ANNETTE",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 55 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477537256,"MORALES, XIMENA",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477537256,"MORALES, XIMENA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477537256,"MORALES, XIMENA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477538098,"MATTHEWS, HEATHER, GRADY",701 DOCTORS DR STE H KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1477538098,"MATTHEWS, HEATHER, GRADY",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477538098,"MATTHEWS, HEATHER, GRADY",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 242 , 471 ,$#,,
MEDICAID DIRECT,1477538254,PORT HEALTH SERVICES,~,2602 COURTIER DR   GREENVILLE NC,074,Pitt,291U00000X,Laboratories,Clinical Medical Laboratory,,1477538254,PORT HEALTH SERVICES,2602 COURTIER DR   GREENVILLE NC,074,Pitt,291U00000X,Laboratories,Clinical Medical Laboratory,, 102 , 152 , 152 ," $10,478.55 ",,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477539724,"TER POORTEN, MARYANNA, COGGINS",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477539781,"HEPPERT, STACEY, STOWERS",37 PINEVILLE BLVD STE 101 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 107 , 176 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477540466,"SMITH, JOHN, JOSEPH",770 HIGHLAND OAKS DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 41 , 75 , 144 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477540466,"SMITH, JOHN, JOSEPH",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477540466,"SMITH, JOHN, JOSEPH",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477540466,"SMITH, JOHN, JOSEPH",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 17 , 44 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477540466,"SMITH, JOHN, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477540466,"SMITH, JOHN, JOSEPH",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 17 , 23 , 31 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477540466,"SMITH, JOHN, JOSEPH",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477541399,"KELLY, MICHAEL, GREG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 57 , 104 , 109 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477541399,"KELLY, MICHAEL, GREG",404 WESTWOOD AVE STE 205 HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477541399,"KELLY, MICHAEL, GREG",601 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477541480,"TAGG, NATHAN, TROY",2351 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477541480,"TAGG, NATHAN, TROY",40 DUKE MEDICINE CIR # 1L DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477541480,"TAGG, NATHAN, TROY",2351 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477541480,"TAGG, NATHAN, TROY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477541480,"TAGG, NATHAN, TROY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology, 17 , 22 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477541480,"TAGG, NATHAN, TROY",2351 ERWIN RD   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology, 44 , 59 , 141 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477543304,"GODSEY, RALEIGH, KIRBY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477543304,"GODSEY, RALEIGH, KIRBY",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477543304,"GODSEY, RALEIGH, KIRBY",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477543304,"GODSEY, RALEIGH, KIRBY",1450 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912995630,THE PURCELL CLINIC PA,THE PURCELL CLINIC PA,418 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1477545036,"RINKACS, THOMAS, JOSEPH",418 S KING ST   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 91 , 118 , 285 ," $13,528.77 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545358,"BARKER, TIMOTHY, ANDREW",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 40 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545358,"BARKER, TIMOTHY, ANDREW",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545358,"BARKER, TIMOTHY, ANDREW",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545358,"BARKER, TIMOTHY, ANDREW",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545358,"BARKER, TIMOTHY, ANDREW",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545358,"BARKER, TIMOTHY, ANDREW",357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 45 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545986,"HATHARASINGHE, ROGER, ROSHAN",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545986,"HATHARASINGHE, ROGER, ROSHAN",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 28 , 143 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545986,"HATHARASINGHE, ROGER, ROSHAN",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545986,"HATHARASINGHE, ROGER, ROSHAN",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,138 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477545986,"HATHARASINGHE, ROGER, ROSHAN",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 49 , 86 ,$#,,
MEDICAID DIRECT,1093793473,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1477546828,"CHRISTY, RODGER, SCATTERGOOD",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1477546828,"CHRISTY, RODGER, SCATTERGOOD",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477546828,"CHRISTY, RODGER, SCATTERGOOD",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477548345,"MCCALL, DUNCAN, ALEXANDER",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477548345,"MCCALL, DUNCAN, ALEXANDER",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477548345,"MCCALL, DUNCAN, ALEXANDER",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477548345,"MCCALL, DUNCAN, ALEXANDER",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477548345,"MCCALL, DUNCAN, ALEXANDER",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1477548378,"ROBERTS, JEFFREY, SCOTT",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477548378,"ROBERTS, JEFFREY, SCOTT",171 DANIEL RD   FOREST CITY NC,081,Rutherford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 34 , 66 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477548584,"WATTERSON, MICHAEL, KENNETH",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 199 , 431 , 787 ," $24,584.81 ",,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477548600,"BAILEY, TANYA",2122 ENTERPRISE RD   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477549376,"COLE, JACK, CECIL",2210 HEMBY LN   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 14 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477549707,"EVANS, ROBERT, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 99 , 161 , 257 ," $12,140.91 ",,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477549707,"EVANS, ROBERT, JAMES",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1477549707,"EVANS, ROBERT, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2303 EXECUTIVE CIR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477549848,"WRIGHT, JOHN, ESPER",2303 EXECUTIVE CIR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 18 , 37 ," $10,987.84 ",,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477549848,"WRIGHT, JOHN, ESPER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 25 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477549848,"WRIGHT, JOHN, ESPER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902862725,ALLIANCE MEDICAL ASSOCIATES,ALLIANCE MEDICAL ASSOCIATES,2905 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477549871,"KHAN, SHAUKAT, ALI",2905 CROUSE LN   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 156 , 471 , 586 ," $10,032.50 ",,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1477550440,"GERIG, JOHN, STEPHEN",1030 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1477551026,"EVANS, S",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 24 , 35 ,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1477551026,"EVANS, S",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1477551364,"YU, I-LING",3001 EDWARDS MILL RD # 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477551364,"YU, I-LING",1545 ORCHARD VILLAS AVE   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477551364,"YU, I-LING",3001 EDWARDS MILL RD # 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1477551364,"YU, I-LING",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 32 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477551760,"MANUS, KAREN, GRIFFIN",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 49 , 92 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477551760,"MANUS, KAREN, GRIFFIN",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 21 , 43 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477551844,"KOLLMAN, NICOLE, PRAY",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 27 , 47 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477551844,"KOLLMAN, NICOLE, PRAY",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 35 , 50 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477551844,"KOLLMAN, NICOLE, PRAY",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1477552198,"READ, JOANNA, PRICE",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477552198,"READ, JOANNA, PRICE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477552461,"COPELAND, CHANEL, LEAA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477553048,"ALLENSPACH, DEBRA, ANN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811350887,PIEDMONT HEALTHCARE PA,,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 63 , 130 , 247 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 19 , 36 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 27 , 38 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 19 , 29 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477553691,"SELDOMRIDGE, JOHN, ALDUS ALEXANDER",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477554830,"BEASLEY, MICHAEL, ANTHONY",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 29 , 30 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1477555654,"KAFER, LISA, MICHELE",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 65 , 95 , 224 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1477555654,"KAFER, LISA, MICHELE",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477555688,"NEWMAN, WALTER, JOSEPH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477555688,"NEWMAN, WALTER, JOSEPH",970 NEWMAN RD   NEW BERN NC,025,Craven,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 75 , 213 , 356 ,$#,,
MEDICAID DIRECT,1013971308,WOMENS WELLNESS CENTER PA,Womens Wellness Center PA,2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477556611,"LEWIS, ANESSA",2950 VILLAGE DR STE 100 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 28 , 44 ,$#,,
MEDICAID DIRECT,1477556876,MERIDIAN LABORATORY CORPORATION,MERIDIAN LABORATORY CORPORATION,2401 WHITEHALL PARK DR STE 700 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1477556876,MERIDIAN LABORATORY CORPORATION,2401 WHITEHALL PARK DR STE 700 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 446 ," 2,219 "," 6,427 "," $57,700.23 ",,
MEDICAID DIRECT,1992932016,SUMMIT EYE CARE PA,SUMMIT EYE CARE PA,3073 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477557023,"KHEMSARA, VICKAS",3073 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 140 , 187 , 307 ,$#,,
MEDICAID DIRECT,1477558542,"KEITH, RANDALL, SCOTT",HOLLY SPRINGS FAMILY PRACTICE,104 ARARAT LONGHILL RD   PILOT MOUNTAIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1477558542,"KEITH, RANDALL, SCOTT",104 ARARAT LONGHILL RD   PILOT MOUNTAIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 30 , 40 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477559219,"HOPP, LINDA, LOUELLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477559219,"HOPP, LINDA, LOUELLEN",100 RIDGEFIELD CT STE A ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477559730,"COLLINS III, JAMES, BERNARD",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 52 , 75 , 90 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477559730,"COLLINS III, JAMES, BERNARD",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477559730,"COLLINS III, JAMES, BERNARD",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 22 , 29 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477559730,"COLLINS III, JAMES, BERNARD",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 VETERANS PARKWAY STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477559730,"COLLINS III, JAMES, BERNARD",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477559730,"COLLINS III, JAMES, BERNARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477559730,"COLLINS III, JAMES, BERNARD",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1477561785,"TISDALE, ELIZABETH, HART",1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 128 , 201 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477566149,"STEPHENS, JOHN, RUAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 82 , 85 ,$#,,
MEDICAID DIRECT,1477568566,WALGREEN CO,WALGREENS 09558,2795 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1477568566,WALGREEN CO,2795 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1477568996,"SASHIDHAR, SREELEKHA",2035 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 84 , 205 ," $10,138.94 ",,
MEDICAID DIRECT,1477570620,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1290,1801 US HIGHWAY 421   WILKESBORO NC,097,Wilkes,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1477570620,WAL-MART STORES EAST LP,1801 US HIGHWAY 421   WILKESBORO NC,097,Wilkes,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477574721,"NEWMAN, KIMBERLY, ANNE",10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1477574721,"NEWMAN, KIMBERLY, ANNE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477575546,"SHAH, NAVEED, HUSSAIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477575652,"GRAHAM, DAVID, LEE",9606 CALDWELL COMMONS CIR STE B CORNELIUS NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 62 , 122 , 122 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477578847,"SECHLER, JOSEPH, WILLIAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 32 , 32 ,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477578847,"SECHLER, JOSEPH, WILLIAM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 138 , 138 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477578847,"SECHLER, JOSEPH, WILLIAM",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 32 , 32 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477579035,"CAMERON, CARA, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477579035,"CAMERON, CARA, LYNN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477579035,"CAMERON, CARA, LYNN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477579035,"CAMERON, CARA, LYNN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477579035,"CAMERON, CARA, LYNN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477579514,"MELO LIZARDO, ISAIAS, EMILIO",1001 ROCK QUARRY RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1477579514,"MELO LIZARDO, ISAIAS, EMILIO",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 43 , 57 ,$#,,
MEDICAID DIRECT,1457512691,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER AT CALHOUN DRIVE,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477579514,"MELO LIZARDO, ISAIAS, EMILIO",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477579761,"RICOTTA, PATRICK, JOSEPH",300 E MCKAY ST STE E ELIZABETHTOWN NC,009,Bladen,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1306695630,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY FOOT & ANKLE SPEC-RESIDENT CLINIC,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477579761,"RICOTTA, PATRICK, JOSEPH",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477579761,"RICOTTA, PATRICK, JOSEPH",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477579761,"RICOTTA, PATRICK, JOSEPH",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 54 , 130 , 165 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1477579761,"RICOTTA, PATRICK, JOSEPH",588 BAILEY RD STE E LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 140 , 179 , 203 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1477579761,"RICOTTA, PATRICK, JOSEPH",588 BAILEY RD STE E LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,588 BAILEY RD STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1477579761,"RICOTTA, PATRICK, JOSEPH",588 BAILEY RD STE E LUMBERTON NC,078,Robeson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 278 , 587 , 728 ,$#,,
MEDICAID DIRECT,1932380953,CAROMONT MEDICAL GROUP INC,CAROMONT CRITICAL CARE SPECIALIST,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477580199,"CARSON II, JOHN, RALPH",2240 REMOUNT RD STE 100 GASTONIA NC,036,Gaston,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 40 , 60 , 65 ,$#,,
MEDICAID DIRECT,1932380953,CAROMONT MEDICAL GROUP INC,CAROMONT CRITICAL CARE SPECIALIST,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477580199,"CARSON II, JOHN, RALPH",2525 COURT DR   GASTONIA NC,036,Gaston,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 46 , 77 , 86 ," $14,930.19 ",,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477581049,"COUSINS, JAYSUN, KIZIUK",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477581049,"COUSINS, JAYSUN, KIZIUK",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477581049,"COUSINS, JAYSUN, KIZIUK",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477581635,"LI, XIAOHUA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477581635,"LI, XIAOHUA",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 17 , 27 , 32 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477581775,"NAZARIAN, EMILY, BRAUNSTEIN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 12 , 26 , 35 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477582807,"HARRISON, XAVIER, ALRED",9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 40 , 124 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477582807,"HARRISON, XAVIER, ALRED",10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 24 , 57 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477582807,"HARRISON, XAVIER, ALRED",10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477582807,"HARRISON, XAVIER, ALRED",738 BRYANT ST   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,268 GILLMAN RD STE A DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1477582807,"HARRISON, XAVIER, ALRED",268 GILLMAN RD STE A DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,235 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477585107,"ADAMS, TODD, JERRY",235 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477585107,"ADAMS, TODD, JERRY",235 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1477586394,"SEXTON, RANDY, CARL",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1477586394,"SEXTON, RANDY, CARL",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477587947,"DENAMUR, DARIN, LEE",DARIN LEE DENAMUR,414 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,111N00000X,Chiropractic Providers,Chiropractor,,1477587947,"DENAMUR, DARIN, LEE",414 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,111N00000X,Chiropractic Providers,Chiropractor,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477588465,"TAYLOR, MELINDA, CATHERINE",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 41 , 105 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477589042,"BARBOR, MELISSA, ANN",818B PINE GROVE DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 25 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477589042,"BARBOR, MELISSA, ANN",1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 65 , 90 , 154 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477589299,"APPLE, BRYAN, STANLEY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477589851,"DINOME, MAGGIE, LEE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477589851,"DINOME, MAGGIE, LEE",4101 MACON POND RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477589851,"DINOME, MAGGIE, LEE",4101 MACON POND RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477589851,"DINOME, MAGGIE, LEE",4101 MACON POND RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1477590677,"LENSER, NOELLE, LIANE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 38 , 38 ,$#,,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477592327,"ARORA, SONAL",1991 FORDHAM DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 39 , 77 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477592327,"ARORA, SONAL",1991 FORDHAM DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 29 , 45 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477592327,"ARORA, SONAL",205 PAGE RD   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 364 , 786 ," 1,235 "," $31,438.95 ",,
MEDICAID DIRECT,1710707609,TEAMWORK HEALTH PLLC,,115 KILDAIRE PARK DR STE 309 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477592327,"ARORA, SONAL",1413 GREENWAY CT   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 39 , 48 , 85 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477592327,"ARORA, SONAL",1413 GREENWAY CT   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477592327,"ARORA, SONAL",1411 GREENWAY CT   SANFORD NC,053,Lee,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1477593705,"REAMES, KIMBERLY, VICTORIA BARNES",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477593705,"REAMES, KIMBERLY, VICTORIA BARNES",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 79 , 172 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477594182,"SAIR, FARRUKH, IQBAL",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 47 , 52 ,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1477594216,"ROBINSON, TIMOTHY, MICHAEL",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 103 , 332 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477594554,"WASHINGTON, GREGORY, DAVID",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477594844,"LE, TIFFANY",~,4540 MAIN ST   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,,1477594844,"LE, TIFFANY",4540 MAIN ST   SHALLOTTE NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 474 , 481 , 909 ," $13,398.05 ",,
MEDICAID DIRECT,1811145014,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GASTONIA CHILDRENS,2544 COURT DR STE C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1477595262,"FISHER, ANGELA, BETH",2544 COURT DR STE C GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 72 , 119 , 276 ," $10,685.92 ",,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1477597029,"BURNS, ERIC, MATTHEW",1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,152W00000X,Eye and Vision Services Providers,Optometrist,, 366 , 414 , 489 ," $19,505.96 ",,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477597169,"HERDMAN, JENNIFER, LYNNE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 152 , 233 , 389 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477597169,"HERDMAN, JENNIFER, LYNNE",101 HEART DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1477597938,"TATUM, GREGORY, HOWARD",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477598456,"STEVENS, KAREN, MAE",3207 CAREY RD   KINSTON NC,054,Lenoir,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 136 , 263 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477600260,"ENKER, MARK, H",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477600260,"ENKER, MARK, H",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477600260,"ENKER, MARK, H",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1477600260,"ENKER, MARK, H",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477600286,"BOYD, JENNY, MELISSA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477600286,"BOYD, JENNY, MELISSA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#, 15 ,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1477601573,"BERENDZEN, SUSAN, MARGARET",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477601573,"BERENDZEN, SUSAN, MARGARET",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 43 , 86 ,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1477601573,"BERENDZEN, SUSAN, MARGARET",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477602399,"HARRIS, CHANTELLE, NICOLE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,105 YADKIN ST STE 303 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1477602399,"HARRIS, CHANTELLE, NICOLE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477602837,"MITCHELL, SHANNON, HOWELL",264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1245907302,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN MACON,674 HIGHLANDS RD   FRANKLIN NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477602837,"MITCHELL, SHANNON, HOWELL",674 HIGHLANDS RD   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 51 , 51 ," $10,431.62 ",,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477602837,"MITCHELL, SHANNON, HOWELL",44 BONNIE LN   SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 113 , 113 ," $21,453.66 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477603785,"HALL, BRENDA, BENJAMIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1477603785,"HALL, BRENDA, BENJAMIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477603785,"HALL, BRENDA, BENJAMIN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477609063,"ZANDER, KIMBERLY, DAWN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics, 60 , 69 , 75 ,$#,,
MEDICAID DIRECT,1477610509,"SINGLETON, NAIDA, LIANA",MARLBORO FAMILY DENTISTRY,500 E MAIN ST   BENNETTSVILLE SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1477610509,"SINGLETON, NAIDA, LIANA",500 E MAIN ST   BENNETTSVILLE SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 44 , 118 ,$#,,
MEDICAID DIRECT,1477610657,COUNTRY LIVING GUEST HOME INC,COUNTRY LIVING GUEST HOME 5,204 STEWART DR   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477610657,COUNTRY LIVING GUEST HOME INC,204 STEWART DR   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 592 , 592 ," $45,455.45 ",,
MEDICAID DIRECT,1477610657,COUNTRY LIVING GUEST HOME INC,COUNTRY LIVING GUEST HOME 5,204 STEWART DR   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1477610657,COUNTRY LIVING GUEST HOME INC,204 STEWART DR   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 734 , 734 ,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1477611598,"HAIGLER, LORI, ANNETTE",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 198 , 244 , 687 ," $23,072.30 ",,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477620052,"MACDONALD, KERI, WOLFE",100 E DOGWOOD DR   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477620052,"MACDONALD, KERI, WOLFE",919 S FIFTH ST   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 89 , 174 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477620813,"GARRISON, HEATHER, MICHELLE",624 QUAKER LN STE 100E HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477624096,"CROWDER, ELIZABETH, SHONDA",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477624096,"CROWDER, ELIZABETH, SHONDA",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477624096,"CROWDER, ELIZABETH, SHONDA",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477624096,"CROWDER, ELIZABETH, SHONDA",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice," 1,242 "," 2,074 "," 6,626 "," $227,605.74 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477624096,"CROWDER, ELIZABETH, SHONDA",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477624096,"CROWDER, ELIZABETH, SHONDA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 51 , 234 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477628261,"DURR, AMY, LOUISE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 22 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477628261,"DURR, AMY, LOUISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477628501,"JONES, PENNY, TYNDALL",5710 W GATE CITY BLVD STE I GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 57 , 153 , 229 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477630911,"WIENER, DONNA, MARIE",321 E CARVER ST   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477630911,"WIENER, DONNA, MARIE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477630911,"WIENER, DONNA, MARIE",6885 CLIFFDALE RD STE 202 FAYETTEVILLE NC,026,Cumberland,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477633477,"AVERY, KIRSTEN, HILL",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 88 , 216 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477633477,"AVERY, KIRSTEN, HILL",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1477634335,"COUSINEAU, MARK, DANIEL",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 23 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1477634335,"COUSINEAU, MARK, DANIEL",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 31 , 32 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1477634335,"COUSINEAU, MARK, DANIEL",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1477634335,"COUSINEAU, MARK, DANIEL",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 35 , 35 ,$#,,
MEDICAID DIRECT,1265723597,UNC PHYSICIANS NETWORK LLC,~,1515 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477636629,"GRIFFIN, DAVIDA, JANE",1515 SW CARY PKWY STE 200 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265723597,UNC PHYSICIANS NETWORK LLC,~,1515 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477636629,"GRIFFIN, DAVIDA, JANE",1515 SW CARY PKWY STE 220 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477636637,"GUY, CYNTHIA, DIANNE",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 48 , 51 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477636637,"GUY, CYNTHIA, DIANNE",CLINICAL MICROBIOLOGY LAB RM 110 CARL DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 21 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477636637,"GUY, CYNTHIA, DIANNE",4425 BEN FRANKLIN BLVD RM 178 DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1902087927,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1477637080,"SINGLETON, SHAUNESE, DERAE",1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 36 , 67 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477637189,"KRAWIEC, MARZENA, EUGENIA",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477637189,"KRAWIEC, MARZENA, EUGENIA",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 44 , 85 , 122 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477637189,"KRAWIEC, MARZENA, EUGENIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477637189,"KRAWIEC, MARZENA, EUGENIA",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 13 , 22 , 31 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477637189,"KRAWIEC, MARZENA, EUGENIA",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1669809463,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,801 W BARBEE CHAPEL RD STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1477637361,"ODONNELL, TIMOTHY",1901 HILLANDALE RD STE B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,3643 N ROXBORO ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1477637528,"HALL, WILLIAM, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 346 , 420 , 588 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1477637528,"HALL, WILLIAM, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477637528,"HALL, WILLIAM, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1821046004,DURHAM DIAGNOSTIC IMAGING LLC,INDEPENDENCE PARK,4323 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1477637528,"HALL, WILLIAM, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750339933,DURHAM DIAGNOSTIC IMAGING LLC,TRIANGLE MEDICAL PARK,5107 SOUTHPARK DR STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1477637528,"HALL, WILLIAM, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1477637528,"HALL, WILLIAM, LEE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 47 , 72 ,$#,,
MEDICAID DIRECT,1104683341,GRANVILLE HEALTH SYSTEM,,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1477637528,"HALL, WILLIAM, LEE",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 41 , 65 ,$#,,
MEDICAID DIRECT,1063438513,DURHAM RADIOLOGY ASSOCIATES INC,DURHAM RADIOLOGY ASSOCIATES INC,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1477637528,"HALL, WILLIAM, LEE",1010 COLLEGE ST   OXFORD NC,039,Granville,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,, 86 , 87 , 174 ,$#,,
MEDICAID DIRECT,1518109388,BLUE RIDGE HEALTHCARE MEDICAL GROUP,JAYENDRAKUMAR I PATEL,,,Unknown,193200000X,Group,Multi-Specialty,,1477641462,"PATEL, JAYENDRAKUMAR",2201 S STERLING ST   MORGANTON NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1154571081,BLUE RIDGE HEALTHCARE MEDICAL GROUP,JAYENDRAKUMAR I PATEL MD,722 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1477641462,"PATEL, JAYENDRAKUMAR",722 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 21 , 23 ,$#,,
MEDICAID DIRECT,1609967884,HOOPER-THURSTON ELITE CHIROPRACTIC,~,806 HINES ST W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1477644672,"HOOPER, MARK, GORDON",806 HINES ST W   WILSON NC,098,Wilson,111N00000X,Chiropractic Providers,Chiropractor,,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477648475,"PRESSLEY, BRADFORD, ROY",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 990 ," 1,688 "," 3,448 "," $210,065.31 ",,
MEDICAID DIRECT,1902229420,RDEST DDS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1477648475,"PRESSLEY, BRADFORD, ROY",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477648731,VIDANT MEDICAL GROUP LLC,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,#,#, 15 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477648780,"TUCCI HERRON, KAREN, LOUISE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477649432,"EATON, DEREK, JAMES",SHENAN BRADSHAW DDS MD PA DBA CAROLINA OMS,660 SUMMIT CROSSING PL STE 303 GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1477649432,"EATON, DEREK, JAMES",660 SUMMIT CROSSING PL STE 303 GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 44 , 65 , 187 ," $20,861.57 ",,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477649721,"KERR, JEFFREY, SCOTT",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 64 , 143 , 319 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 131 , 137 , 189 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 21 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 21 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477649796,"EASTWOOD, JAMES, DAVID",302 TRENT DR 302 TRENT DR DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 73 , 79 , 109 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1477651206,"HEFNER, KATHERINE, CARPENTER",32 PHYSICIAN DR   CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 111 , 147 , 206 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1477651206,"HEFNER, KATHERINE, CARPENTER",81 MEDICAL PARK LOOP STE 202 SYLVA NC,050,Jackson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 57 , 79 ,$#,,
MEDICAID DIRECT,1477652402,"MANCINI, KEVIN, JOHN",MANCINI ORTHODONTICS,61 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1477652402,"MANCINI, KEVIN, JOHN",61 N HAMPSTEAD VILLAGE DR   HAMPSTEAD NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477653137,"HOSSAIN, MOHAMMAD, DELBAHAR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 176 , 179 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477654044,"DARVILLE, LEE, ANTOINETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477654051,"DRAKE, AMELIA, FISCHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477654051,"DRAKE, AMELIA, FISCHER",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477654051,"DRAKE, AMELIA, FISCHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 25 , 26 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477654051,"DRAKE, AMELIA, FISCHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1477654051,"DRAKE, AMELIA, FISCHER",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1477654051,"DRAKE, AMELIA, FISCHER",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1477654069,"SENIOR, BRENT, ANTHONY",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 20 , 31 , 59 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477654069,"SENIOR, BRENT, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477654069,"SENIOR, BRENT, ANTHONY",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477654374,"SCOTT, BURTON, LASATER",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477654374,"SCOTT, BURTON, LASATER",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 13 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477655876,"CAUSEY, PERCY, THOMAS",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 33 , 46 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477655876,"CAUSEY, PERCY, THOMAS",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477655876,"CAUSEY, PERCY, THOMAS",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 66 , 127 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477655876,"CAUSEY, PERCY, THOMAS",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477656155,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07323,36 NORTHWEST BLVD   NEWTON NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1477656155,NORTH CAROLINA CVS PHARMACY LLC,36 NORTHWEST BLVD   NEWTON NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1477656155,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07323,36 NORTHWEST BLVD   NEWTON NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1477656155,NORTH CAROLINA CVS PHARMACY LLC,36 NORTHWEST BLVD   NEWTON NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477657344,"RAGHUNATHAN, KARTHIK",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 23 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477657344,"RAGHUNATHAN, KARTHIK",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 22 , 32 ,$#,,
MEDICAID DIRECT,1891787222,VALLEY INFECTIOUS DISEASE CARE,VALLEY INFECTIOUS DISEASE CARE,101 ROBESON ST STE 300A FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1477658250,"TEHSIN, ATHAR, HUSSAIN",101 ROBESON ST STE 300A FAYETTEVILLE NC,026,Cumberland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 48 , 67 , 70 ,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477658250,"TEHSIN, ATHAR, HUSSAIN",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1891787222,VALLEY INFECTIOUS DISEASE CARE,VALLEY INFECTIOUS DISEASE CARE,101 ROBESON ST STE 300A FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1477658250,"TEHSIN, ATHAR, HUSSAIN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 75 , 244 , 244 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477659506,"LONG, SCOTT, DAVID",1309 LEES CHAPEL RD TRIAD PRIMARY CARE GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 32 , 69 ,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1477659506,"LONG, SCOTT, DAVID",1309 LEES CHAPEL RD TRIAD PRIMARY CARE GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,1003 OLDE WATERFORD WAY STE 1A LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1477662666,"WEINBERG, ADAM, WHITSON",3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1477662666,"WEINBERG, ADAM, WHITSON",~,3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1477662666,"WEINBERG, ADAM, WHITSON",3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477662666,"WEINBERG, ADAM, WHITSON",3505 CONVERSE RD STE 175 WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 251 , 339 ," 1,306 "," $68,818.09 ",,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,1165 E CUTLAR CROSSING STE 110 LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1477662666,"WEINBERG, ADAM, WHITSON",1165 E CUTLAR CROSSING STE 110 LELAND NC,010,Brunswick,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 63 , 63 , 206 ,$#,,
MEDICAID DIRECT,1073532248,DIMOCK WEINBERG & CHERRY DDS PLLC,DIMOCK WEINBERG & CHERRY DDS,1003 OLDE WATERFORD WAY STE 1A LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1477662666,"WEINBERG, ADAM, WHITSON",1003 OLDE WATERFORD WAY STE 1A LELAND NC,010,Brunswick,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 95 , 101 , 318 ,$#,,
MEDICAID DIRECT,1063637411,NC DHHS CHILD AND FAMILY WELL-BEING,CDSA OF THE CAPE FEAR,3311 BURNT MILL DR STE A WILMINGTON NC,065,New Hanover,252Y00000X,Agencies,Early Intervention Provider Agency,,1477663185,"SNOW, CELIA, LIPPITT",3311 BURNT MILL DR   WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477668176,"HAYES, SAMUEL, LINTON",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 42 , 55 , 246 ," $20,549.98 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477668176,"HAYES, SAMUEL, LINTON",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 11 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477668176,"HAYES, SAMUEL, LINTON",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 VANDERBILT PARK DR STE 210 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477668176,"HAYES, SAMUEL, LINTON",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477668176,"HAYES, SAMUEL, LINTON",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 VANDERBILT PARK DR STE 210 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477668176,"HAYES, SAMUEL, LINTON",4 VANDERBILT PARK DR STE 210 ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 61 , 77 , 251 ," $20,731.50 ",,
MEDICAID DIRECT,1699197012,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,720 MALCOLM BLVD STE 200 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1477668523,"SALVADOR, WENIMAR, DULDULAO",2201 S STERLING ST   MORGANTON NC,012,Burke,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1699197012,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,720 MALCOLM BLVD STE 200 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1477668523,"SALVADOR, WENIMAR, DULDULAO",720 MALCOLM BLVD   CONNELLY SPRINGS NC,012,Burke,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 39 , 68 , 68 ,$#,,
MEDICAID DIRECT,1538836655,PEDRAM MALEK DDS PA,ELAN DENTAL,310A S MAIN ST   ROLESVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1477671295,"KLEIN, PETER, JOSEPH",310 S MAIN ST STE A ROLESVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 207 , 495 ," 1,549 "," $75,537.34 ",,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477672145,"HUNGNESS, SUSAN, IRENE",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 14 , 53 , 80 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477672145,"HUNGNESS, SUSAN, IRENE",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 53 , 58 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477672145,"HUNGNESS, SUSAN, IRENE",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477675072,"GELLER, ELIZABETH, JOANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477675072,"GELLER, ELIZABETH, JOANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477675072,"GELLER, ELIZABETH, JOANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 32 , 62 ,$#,,
MEDICAID DIRECT,1861465205,CAROLINA EYE PROSTHETICS INC,CAROLINA EYE PROSTHETICS INC,420 MAPLE AVE   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1477675676,"JEFFERSON, ANNA, BOYD",420 MAPLE AVE   BURLINGTON NC,001,Alamance,156FX1700X,Eye and Vision Services Providers,Technician/Technologist,Ocularist, 13 , 15 , 44 ," $10,689.19 ",,
MEDICAID DIRECT,1477677169,EASTERN CAROLINA HOME HEALTHCARE,EASTERN CAROLINA HOME HEALTHCARE,13548 NC 55 STE B ALLIANCE NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,,1477677169,EASTERN CAROLINA HOME HEALTHCARE,13548 NC 55 STE B ALLIANCE NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,, 36 ," 8,685 "," 8,711 "," $859,873.02 ",,
MEDICAID DIRECT,1477678134,"GOODRICH, ANNA, FIELDS",,125 MURRAY HILL RD STE G SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,1477678134,"GOODRICH, ANNA, FIELDS",125 MURRAY HILL RD STE G SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 459 , 882 ," 3,057 "," $154,600.95 ",,
MEDICAID DIRECT,1477682243,NEIGHBORHOOD NURSES HEALTHCARE,,1821 N ROCKY RIVER RD   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1477682243,NEIGHBORHOOD NURSES HEALTHCARE,1821 N ROCKY RIVER RD   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 3,440 "," 3,440 "," $217,706.88 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477685360,"OBI, OGUGUA, NDILI",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477685360,"OBI, OGUGUA, NDILI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 50 , 63 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477685360,"OBI, OGUGUA, NDILI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 82 , 157 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477685360,"OBI, OGUGUA, NDILI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477685360,"OBI, OGUGUA, NDILI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477685360,"OBI, OGUGUA, NDILI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 34 ,$#,,
MEDICAID DIRECT,1477685964,ARO COMMUNITY SERVICES INC,ARO COMMUNITY SERVICES INC,1515 W CORNWALLIS DR STE G107 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1477685964,ARO COMMUNITY SERVICES INC,1515 W CORNWALLIS DR STE G107 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 123 ," 29,053 "," 30,116 "," $2,994,026.44 ",,
MEDICAID DIRECT,1225200843,AVNI C RAMPERSAUD DDS PA,CHAPEL HILL PEDIATRIC DENTISTRY,205 SAGE RD STE 202 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1477689339,"RAMPERSAUD, AVNI, CHHABRA",205 SAGE RD STE 202 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 257 , 373 ," 1,362 "," $43,194.20 ",,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1477691715,"CRAMP, DIANA, LYN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477692952,"BUIE, JENNIFER, LANKFORD",75A LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 18 , 34 ,$#,,
MEDICAID DIRECT,1477693810,AT HOME PERSONAL CARE SERVICES INC,AT HOME PERSONAL CARE SERVICES INC,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1477693810,AT HOME PERSONAL CARE SERVICES INC,204 E ARLINGTON BLVD STE M GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1477693810,AT HOME PERSONAL CARE SERVICES INC,AT HOME PERSONAL CARE SERVICES INC,1700 E ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1477693810,AT HOME PERSONAL CARE SERVICES INC,1700 E ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 88 ," 20,029 "," 20,928 "," $1,824,863.79 ",,
MEDICAID DIRECT,1477693810,AT HOME PERSONAL CARE SERVICES INC,AT HOME PERSONAL CARE SERVICES INC,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1477693810,AT HOME PERSONAL CARE SERVICES INC,204 E ARLINGTON BOULEVA STE M   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1477694313,MECKLENBURG COUNTY,,3205 FREEDOM DR STE 8500 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1477694313,MECKLENBURG COUNTY,3205 FREEDOM DR STE 8500 CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,, 25 , 295 , 295 ," $10,225.44 ",,
MEDICAID DIRECT,1609308113,RANGE URGENT CARE PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1477695237,"VELEZ, JULIETA",674 MERRIMON AVE STE 101 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477696102,COUNTY OF VANCE OFFICE OF TREASURER,VANCE COUNTY DSS,500 N BECKFORD DR STE C HENDERSON NC,091,Vance,251B00000X,Agencies,Case Management,,1477696102,COUNTY OF VANCE OFFICE OF TREASURER,500 N BECKFORD DR STE C HENDERSON NC,091,Vance,251B00000X,Agencies,Case Management,, 38 , 457 , 457 ," $180,972.00 ",,
MEDICAID DIRECT,1477696102,COUNTY OF VANCE OFFICE OF TREASURER,VANCE COUNTY DSS,,,Unknown,251B00000X,Agencies,Case Management,,1477696102,COUNTY OF VANCE OFFICE OF TREASURER,350 RUIN CREEK RD   HENDERSON NC,091,Vance,251B00000X,Agencies,Case Management,,#,#,#,$#,,
MEDICAID DIRECT,1477696656,"KISER, MELANIE, SUZANNE",,1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,1477696656,"KISER, MELANIE, SUZANNE",1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 26 , 27 , 29 ,$#,,
MEDICAID DIRECT,1417397027,DR MELANIE S KISER PC,KISER EYE CARE,1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1477696656,"KISER, MELANIE, SUZANNE",1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,, 40 , 42 , 71 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477697068,"GOWER, WILLIAM, ADAM",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477697068,"GOWER, WILLIAM, ADAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 38 , 98 , 109 ,$#,,
MEDICAID DIRECT,1477699700,ATLANTIC SPEECH THERAPY PC,~,3205 RANDALL PKWY STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477699700,ATLANTIC SPEECH THERAPY PC,3205 RANDALL PKWY STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,, 18 , 342 , 343 ," $23,310.82 ",,
MEDICAID DIRECT,1477705077,SPEECH THERAPY SOLUTIONS PLLC,~,616 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1477705077,SPEECH THERAPY SOLUTIONS PLLC,616 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,, 85 ," 1,250 "," 1,280 "," $86,142.83 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477705135,"RUSSO, COLLEEN, EARLEY",1424B FERN CREEK DR   STATESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1424B FERN CREEK DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1477705135,"RUSSO, COLLEEN, EARLEY",1424B FERN CREEK DR   STATESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1477705135,"RUSSO, COLLEEN, EARLEY",556 KITCHINGS DR   STATESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477708576,"DILANCHIAN, PAULA",16525 HOLLY CREST LN STE 220 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 49 , 50 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477708576,"DILANCHIAN, PAULA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477708576,"DILANCHIAN, PAULA",2460 CURTIS ELLIS DR STE 100 ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1477708576,"DILANCHIAN, PAULA",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477708576,"DILANCHIAN, PAULA",911 W HENDERSON ST STE 120 SALISBURY NC,080,Rowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 145 , 147 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477710044,"HAWKINS, ASHLEY, DAVIS",1126 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 23 ,$#,,
MEDICAID DIRECT,1396020202,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH HOSPICE AND PALLIATIVE CARE PROFESSION,251 CAMPGROUND RD   WEST END NC,063,Moore,193200000X,Group,Multi-Specialty,,1477710630,"WILLIAMSON, SONDRA, NEWHOUSE",251 CAMPGROUND RD   WEST END NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1396020202,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH HOSPICE AND PALLIATIVE CARE PROFESSION,251 CAMPGROUND RD   WEST END NC,063,Moore,193200000X,Group,Multi-Specialty,,1477710630,"WILLIAMSON, SONDRA, NEWHOUSE",102 GOSSMAN RD   SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1639634819,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY BEHAVIORAL HEALTH,107 S QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477711067,"MCGILL, MONICA, ANNE",324 N QUEEN ST   KINSTON NC,054,Lenoir,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477711109,"SHAW, EVA, NICOLENE PROESCHOLDT",102 POMONA DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1790725299,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRICS SOUTH BALLANTYNE,16139 LANCASTER HWY STE 110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477711323,"DAVIS, CRAIG, CARLTON",16139 LANCASTER HWY STE 110 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477711323,"DAVIS, CRAIG, CARLTON",16139 LANCASTER HWY STE 110 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 18 , 29 ,$#,,
MEDICAID DIRECT,1902259377,ANTUAN L HERRIOTT DMD PA,,821 E SYCAMORE ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477711539,"HERRIOTT, ANTUAN, LATRELL",821 E SYCAMORE ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 402 , 838 ," 2,609 "," $93,357.06 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477712339,"MCCORMICK, EMILY, SNYDER",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477712339,"MCCORMICK, EMILY, SNYDER",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 68 , 227 ," $10,177.28 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477712958,"POPLAWSKI, RAFAL",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477712958,"POPLAWSKI, RAFAL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477712958,"POPLAWSKI, RAFAL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477714194,"SILVA, PAULO, SOUZA",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477714335,"GONZALEZ, JOSE, LUIS",,1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1477714335,"GONZALEZ, JOSE, LUIS",1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1477714814,"ONAODOWAN, ONAJITE",80 DOCTORS DR STE 4 HENDERSONVILLE NC,045,Henderson,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 27 , 34 , 48 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1477714814,"ONAODOWAN, ONAJITE",80 DOCTORS DR STE 4 HENDERSONVILLE NC,045,Henderson,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 16 , 22 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477714947,"DRAEGER, REID, WILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 47 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477714947,"DRAEGER, REID, WILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 28 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477714947,"DRAEGER, REID, WILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 25 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477714947,"DRAEGER, REID, WILSON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1477716280,"LABOCCETTA, LYDIA, TOON",75 EMERSON BAY RD STE 104 CAROLINA SHORES NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1477716280,"LABOCCETTA, LYDIA, TOON",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1477716280,"LABOCCETTA, LYDIA, TOON",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1477716280,"LABOCCETTA, LYDIA, TOON",584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,, 36 , 51 , 102 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477717445,"KONDURU, RAMESH, BABU",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427487099,TRIANGLE GERIATRIC AND MEMORY CLINI,TRIANGLE GERIATRIC AND MEMORY CLINIC PLLC,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477717445,"KONDURU, RAMESH, BABU",907 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 161 , 647 , 666 ," $15,388.80 ",,
MEDICAID DIRECT,1477717445,"KONDURU, RAMESH, BABU",~,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1477717445,"KONDURU, RAMESH, BABU",10640 DURANT RD STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699558742,CAPITAL PRIMARY CARE,CAPITAL PRIMARY CARE,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477717445,"KONDURU, RAMESH, BABU",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 136 , 204 ,$#,,
MEDICAID DIRECT,1699558742,CAPITAL PRIMARY CARE,CAPITAL PRIMARY CARE,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477717445,"KONDURU, RAMESH, BABU",10640 DURANT RD STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 84 , 126 ,$#,,
MEDICAID DIRECT,1427487099,TRIANGLE GERIATRIC AND MEMORY CLINI,TRIANGLE GERIATRIC AND MEMORY CLINIC PLLC,907 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477717445,"KONDURU, RAMESH, BABU",500 HOLLY SPRINGS RD STE 100 HOLLY SPRINGS NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427487099,TRIANGLE GERIATRIC AND MEMORY CLINI,TRIANGLE GERIATRIC AND MEMORY CLINIC PLLC,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477717445,"KONDURU, RAMESH, BABU",500 HOLLY SPRINGS RD STE 100 HOLLY SPRINGS NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 161 , 465 , 489 ," $17,935.64 ",,
MEDICAID DIRECT,1427487099,TRIANGLE GERIATRIC AND MEMORY CLINI,TRIANGLE GERIATRIC AND MEMORY CLINIC PLLC,907 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477717445,"KONDURU, RAMESH, BABU",907 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 190 , 859 , 869 ," $27,845.74 ",,
MEDICAID DIRECT,1477717445,"KONDURU, RAMESH, BABU",~,907 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,1477717445,"KONDURU, RAMESH, BABU",907 KILDAIRE FARM RD   CARY NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427487099,TRIANGLE GERIATRIC AND MEMORY CLINI,TRIANGLE GERIATRIC AND MEMORY CLINIC PLLC,10640 DURANT RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477717445,"KONDURU, RAMESH, BABU",10640 DURANT RD STE 101 RALEIGH NC,092,Wake,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1477720183,SPRINGVIEW SENIOR LIVING INC,SPRINGVIEW ASSISTED LIVING PHILLIPS BUILDING,414 CHAPEL HILL RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477720183,SPRINGVIEW SENIOR LIVING INC,414 CHAPEL HILL RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 82 , 82 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477721892,"GEER, CAROL, PARKS",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 153 , 152 , 254 ," $10,464.12 ",,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477721892,"GEER, CAROL, PARKS",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477721892,"GEER, CAROL, PARKS",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477721892,"GEER, CAROL, PARKS",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477721892,"GEER, CAROL, PARKS",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1477723765,"TJIATTAS-SALESKI, LINDSAY, REED",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1477725109,"SAMAAN, MUHANNAD, MICHAEL",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1477725109,"SAMAAN, MUHANNAD, MICHAEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 71 , 71 ,$#,,
MEDICAID DIRECT,1477725380,HEAR ME SPEAK LLC,Hear Me Speak LLC,2994 OLD AIRPORT RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1477725380,HEAR ME SPEAK LLC,2994 OLD AIRPORT RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,, 59 , 796 ," 1,044 "," $68,783.80 ",,
MEDICAID DIRECT,1477725380,HEAR ME SPEAK LLC,Hear Me Speak LLC,824 GUM BRANCH RD STE W JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1477725380,HEAR ME SPEAK LLC,824 GUM BRANCH RD STE W JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1477725729,"OTT, JOSEPH, LEE",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 55 , 102 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1477725729,"OTT, JOSEPH, LEE",2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 12 , 24 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477726958,"DAVIS, PAIGE, PARRIS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1477727337,"ROYLE TABAK, SANDRA, KAY",4218 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477729440,"ARORA, SHIFALI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 40 , 53 , 62 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477729440,"ARORA, SHIFALI",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1477729440,"ARORA, SHIFALI",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477729556,"CHAUDOIN, LINDSEY, TILT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 58 , 59 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477729663,"ZIMMERMAN, KANECIA, OBIE",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477729663,"ZIMMERMAN, KANECIA, OBIE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 48 , 144 , 147 ," $27,500.57 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477730117,"WESTMORELAND, NEVA, JO",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477730117,"WESTMORELAND, NEVA, JO",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1477731248,"BOKU, ABINET",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1194259432,REX HOSPITAL INC,REX HEART FAILURE,2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477732535,"CHIEN, CHRISTOPHER, VERNIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477734846,HEART TO HEART,~,2102 N MAIN ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1477734846,HEART TO HEART,2102 N MAIN ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 5,556 "," 5,556 "," $416,872.20 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477735017,"LICON, JAVIER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477735017,"LICON, JAVIER",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 35 , 63 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1477735017,"LICON, JAVIER",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790179505,PACS,,10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477737567,"MYERS, DEBORAH, JO",10021 PARK CEDAR DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 120 , 120 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477737740,"NWAFOR, PETER, OKECHUKWU",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1477737740,"NWAFOR, PETER, OKECHUKWU",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477737740,"NWAFOR, PETER, OKECHUKWU",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477737740,"NWAFOR, PETER, OKECHUKWU",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477738383,"TRAPP, BENJAMIN, ALLEN",131 PROVIDENCE RD STE 201 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 43 , 44 ,$#,,
MEDICAID DIRECT,1477743151,MOORE HEALTH CARE,SENOIR CITIZENS VILLAGE,504 CANAL DR   DUNN NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477743151,MOORE HEALTH CARE,504 CANAL DR   DUNN NC,043,Harnett,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 39 ," 9,077 "," 9,104 "," $748,553.92 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477743490,"STANSBERRY, BRAD, STEVEN",11 RIVER RIDGE DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477744951,"MANGUM, CRAIG, ALAN",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477744951,"MANGUM, CRAIG, ALAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477744951,"MANGUM, CRAIG, ALAN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1477744951,"MANGUM, CRAIG, ALAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1477744951,"MANGUM, CRAIG, ALAN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1477744951,"MANGUM, CRAIG, ALAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477744951,"MANGUM, CRAIG, ALAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 22 , 29 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477744951,"MANGUM, CRAIG, ALAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477744951,"MANGUM, CRAIG, ALAN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1477744951,"MANGUM, CRAIG, ALAN",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1477744951,"MANGUM, CRAIG, ALAN",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477744951,"MANGUM, CRAIG, ALAN",~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1477744951,"MANGUM, CRAIG, ALAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477744951,"MANGUM, CRAIG, ALAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 71 , 82 ,$#,,
MEDICAID DIRECT,1083971485,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEPHROLOGY - PRE,4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477747756,"SADIQ, SAMEEA",601 N ELM ST   HIGH POINT NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 29 , 75 , 86 ,$#,,
MEDICAID DIRECT,1083971485,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEPHROLOGY - PRE,4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477747756,"SADIQ, SAMEEA",4515 PREMIER DR STE 403 HIGH POINT NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 60 , 106 , 121 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1477748564,"GRIMM, ELISSA, KATHLEEN",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1477748564,"GRIMM, ELISSA, KATHLEEN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1477748564,"GRIMM, ELISSA, KATHLEEN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1477748564,"GRIMM, ELISSA, KATHLEEN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477748911,ALSTON FAMILY CARE HOME,,476 LEONARD RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1477748911,ALSTON FAMILY CARE HOME,476 LEONARD RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 347 , 347 ," $22,389.86 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477750149,"KRISHNAMOORTHY, VIJAY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477750149,"KRISHNAMOORTHY, VIJAY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 62 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477750149,"KRISHNAMOORTHY, VIJAY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477750149,"KRISHNAMOORTHY, VIJAY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477751584,"RITTENHOUSE, RICHARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477751584,"RITTENHOUSE, RICHARD",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477755056,"GROVE II, ROBERT, EUGENE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 53 , 53 ,$#,,
MEDICAID DIRECT,1225449168,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KNIGHTDALE,901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1477755841,"PHIFER, JENNIFER, BENJAMINA",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1225449168,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KNIGHTDALE,901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1477755841,"PHIFER, JENNIFER, BENJAMINA",901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 27 , 45 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477757227,"ZERI, MANIKA, KUMAR",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 12 , 37 , 161 ," $47,436.27 ",,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477757227,"ZERI, MANIKA, KUMAR",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 40 , 82 , 154 ,$#,,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477757227,"ZERI, MANIKA, KUMAR",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 47 , 58 , 60 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477757953,"BARRIER, ANGELA, KIMBRELL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477757953,"BARRIER, ANGELA, KIMBRELL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538270814,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,157 HEALTH SERVICES RD   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1477758142,"AMBLER, RICHARD, BRIAN",157 HEALTH SERVICES RD   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 51 , 137 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477758522,"SOLIMAN, LAYLA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1477758829,"DILLEY, ERIN, LEIGH",3205 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 144 , 160 , 265 ," $41,567.89 ",,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477759686,"MORALES, AMELIA, ELENA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 51 , 55 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477760718,"PRIMICH, JAMES, FRANCIS",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477761534,"BEHL, ASHISH",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891004362,NETRA OPTOMETRIC ASSOCIATES,~,4203 W WENDOVER AVE STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1477766129,"POUDYAL, RITESH",4203 W WENDOVER AVE STE F GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1477767655,"MORRIS, THOMAS",,,,Unknown,1223G0001X,Dental Providers,Dentist,General Practice,1477767655,"MORRIS, THOMAS",2515 W FRONT ST   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477768182,"BERTHOLD, GINA, MARIE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 50 , 106 , 114 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477768323,"MAYNARD, JEFFREY, JOHN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871295220,RFDEST DDS PLLC,MAGNOLIA DENTISTRY,910 DONTIA DR   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477768745,"DEST, RICHARD",8511 COLONNADE CENTER DR STE 160 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 38 , 122 ,$#,,
MEDICAID DIRECT,1477769545,INTERIM HEALTHCARE MORRIS GROUP INC,,103 COMMERCE ST STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1477769545,INTERIM HEALTHCARE MORRIS GROUP INC,103 COMMERCE ST STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,444 "," 2,444 "," $158,089.00 ",,
MEDICAID DIRECT,1477769784,FOOTHILLS PROSTHETICS LLC,~,1603 S STERLING ST   MORGANTON NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1477769784,FOOTHILLS PROSTHETICS LLC,1603 S STERLING ST   MORGANTON NC,012,Burke,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 34 , 43 , 277 ," $36,712.33 ",,
MEDICAID DIRECT,1114293818,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST EAR NOSE & THRO,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477781193,"VANDEGRIEND, ZACHARY, PETER",1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 45 , 59 , 76 ,$#,,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1477781805,"FOTUCHANG, CHARLES, ANUJU",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477782407,"WATSON, KAREN, THURSTON",~,116 S MAIN ST STE 106 MOORESVILLE NC,049,Iredell,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),1477782407,"WATSON, KAREN, THURSTON",116 S MAIN ST STE 106 MOORESVILLE NC,049,Iredell,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,,,$#,,
MEDICAID DIRECT,1942478383,DUPLIN GENERAL HOSPITAL INC,DUPLIN GENERAL HOSPITAL INC,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1477783371,"PRUDEN, YOUNG-MI",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1740391283,AMERICAN NEUROMONITORING ASSOCIATES,,10275 LITTLE PATUXENT PKWY STE 300 COLUMBIA MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1477783926,"LAKSHMINARAYAN, GOWRI",825 LORRAINE CV   ROUND ROCK TX,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477786887,"WATKINS, MAI, TUYET",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477786887,"WATKINS, MAI, TUYET",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477786887,"WATKINS, MAI, TUYET",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477786887,"WATKINS, MAI, TUYET",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 34 , 35 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477786887,"WATKINS, MAI, TUYET",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477787331,GENTLE TOUCH HOME CARE LLC,GENTLE TOUCH HOME CARE LLC,1677 WESTCHESTER DR STE 142 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1477787331,GENTLE TOUCH HOME CARE LLC,1677 WESTCHESTER DR STE 142 HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 8,811 "," 8,811 "," $733,848.84 ",,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477788263,"SHEETS, NATHAN, CHRISTOPHER",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477789113,"KEYSER, KIMBERLY, ANN",3475 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,1705 BERWICK DR STE B LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,, 58 , 59 , 110 ,$#,,
MEDICAID DIRECT,1326099201,PRESBYTERIAN BREAST CENTER LLC,NOVANT HEALTH BREAST CENTER,315 LILLINGTON AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477792182,"KANEDA, HEATHER, JANE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477792182,"KANEDA, HEATHER, JANE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 44 , 77 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 27 , 31 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 33 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1477797199,"LEACH, DANIEL, ASHBY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477797850,"KRUTOY, JEFFREY, BRYAN",,1405 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1477797850,"KRUTOY, JEFFREY, BRYAN",1405 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 118 , 200 , 709 ," $88,819.87 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477798973,"NAUGHTON, LINDSAY, BURKE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477798973,"NAUGHTON, LINDSAY, BURKE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083834972,DENTAL ACCESS CAROLINA LLC,DENTAL ACCESS CAROLINA LLC,454 ANDERSON RD S STE 23 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477802585,"HICKS, JAMES, EDMUND",454 ANDERSON RD S STE 23 ROCK HILL SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 171 , 240 ," 1,272 "," $49,907.20 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477806156,"PARSEK, LARISSA, RODRIGUES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 130 , 131 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1477806651,"DIETRICH, JAMIE, ARTON",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477806651,"DIETRICH, JAMIE, ARTON",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 34 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477806651,"DIETRICH, JAMIE, ARTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477807089,"CARATOZZOLO, KATE, LYNN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477807089,"CARATOZZOLO, KATE, LYNN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477808301,"PATEL, MILAPKUMA, RAMESHBHAI",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477808301,"PATEL, MILAPKUMA, RAMESHBHAI",5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477808301,"PATEL, MILAPKUMA, RAMESHBHAI",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477808301,"PATEL, MILAPKUMA, RAMESHBHAI",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477809051,CONNECT AMERICA COM LLC,~,1507 PERRY PARK DR   KINSTON NC,054,Lenoir,333300000X,Suppliers,Emergency Response System Companies,,1477809051,CONNECT AMERICA COM LLC,1507 PERRY PARK DR   KINSTON NC,054,Lenoir,333300000X,Suppliers,Emergency Response System Companies,," 1,683 "," 16,938 "," 16,938 "," $502,774.70 ",,
MEDICAID DIRECT,1023107281,LIFELINE SYSTEMS COMPANY,~,5540 CENTERVIEW DR STE 200 RALEIGH NC,092,Wake,333300000X,Suppliers,Emergency Response System Companies,,1477809051,CONNECT AMERICA COM LLC,1507 PERRY PARK DR   KINSTON NC,054,Lenoir,333300000X,Suppliers,Emergency Response System Companies,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477810489,"BHOWMIK, NIRJHOR, MONDRIL",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477810489,"BHOWMIK, NIRJHOR, MONDRIL",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1477810489,"BHOWMIK, NIRJHOR, MONDRIL",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1477810885,"CRIDER, NATHANIEL, JAMES",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477811834,"BERNAL, CHRISTIANA, JAHNAE",120 HEALTHPLEX WAY   APEX NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477811834,"BERNAL, CHRISTIANA, JAHNAE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336704766,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC GASTROENTEROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477811834,"BERNAL, CHRISTIANA, JAHNAE",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 17 , 34 , 34 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477815447,"WILLIAMS, MEGHAN, BRIDGET",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477815447,"WILLIAMS, MEGHAN, BRIDGET",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 31 , 44 , 46 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477817013,"BOLIVAR, BREANNA, KEENAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics, 54 , 63 , 81 ," $14,661.67 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477817179,"BOWMAN, JOSHUA, DANIEL",9101 OCEAN HWY E   LELAND NC,010,Brunswick,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 17 , 25 , 38 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477817179,"BOWMAN, JOSHUA, DANIEL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 24 , 55 , 97 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477817179,"BOWMAN, JOSHUA, DANIEL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 56 , 127 , 204 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477817179,"BOWMAN, JOSHUA, DANIEL",8114 MARKET ST   WILMINGTON NC,065,New Hanover,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477819399,"AIKMAN, INGA, SARLI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 65 , 65 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477819399,"AIKMAN, INGA, SARLI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477819522,"DOZIER, CASSIE, MICHELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477819522,"DOZIER, CASSIE, MICHELLE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1477827772,"ALMASI, GAYE, MORGAN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477827772,"ALMASI, GAYE, MORGAN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477828200,"BLAKE, NANCY, CAMILLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477828200,"BLAKE, NANCY, CAMILLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1477828200,"BLAKE, NANCY, CAMILLE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477842144,"GROVER, JOSEPH, MARCUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477842144,"GROVER, JOSEPH, MARCUS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1477842144,"GROVER, JOSEPH, MARCUS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346315710,MID SOUTH PAIN MANAGEMENT PC,MID SOUTH PAIN MANAGEMENT PC,,,Unknown,193400000X,Group,Single Specialty,,1477842987,"SEGREST, JUSTIN, FLETCHER",1101 S MAIN ST   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1477843977,"ROGERS, JASON, PATRICK",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477843977,"ROGERS, JASON, PATRICK",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 52 , 90 , 143 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477845501,"PAGE, HEATHER, SHEARIN",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 51 , 101 ,$#,,
MEDICAID DIRECT,1477846251,FINCH HOME CARE AGENCY,~,600 N GRACE ST STE B ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1477846251,FINCH HOME CARE AGENCY,600 N GRACE ST STE B ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 6,580 "," 6,791 "," $591,744.56 ",,
MEDICAID DIRECT,1407499353,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SUNSET,3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1477848430,"LEE, JONGHOON",3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1407499353,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- SUNSET,3769 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1477848430,"LEE, JONGHOON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 604 , 911 ," 2,885 "," $140,513.46 ",,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1477848430,"LEE, JONGHOON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477849446,"KNOLL, GREGORY, MICHAEL",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 18 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477849446,"KNOLL, GREGORY, MICHAEL",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 18 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477849446,"KNOLL, GREGORY, MICHAEL",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 44 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477849446,"KNOLL, GREGORY, MICHAEL",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477849446,"KNOLL, GREGORY, MICHAEL",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 15 , 19 ,$#,,
MEDICAID DIRECT,1477849578,"BROOKS, TIMOTHY, MICHAEL",,1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1477849578,"BROOKS, TIMOTHY, MICHAEL",1330 TAYLOR AT MARION ST   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477850303,EULA HOME CARE AGENCY LLC,~,8430 UNIVERSITY EXEC PARK DR STE 606 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1477850303,EULA HOME CARE AGENCY LLC,8430 UNIVERSITY EXEC PARK DR STE 606 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 14,212 "," 14,341 "," $1,075,570.05 ",,
MEDICAID DIRECT,1477850774,CARING GROUP OF AMERICA PLLC,~,903 N LINDSAY ST   HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1477850774,CARING GROUP OF AMERICA PLLC,903 N LINDSAY ST   HIGH POINT NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,626 "," 1,626 "," $150,114.52 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477850915,"COLLIER, AMANDA, RUTH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 68 , 102 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477852234,"DODDS, TYLER, JOHN",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 26 , 27 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477852234,"DODDS, TYLER, JOHN",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477852242,"ROBERSON, JAMES, ROLAND GRANT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477854263,"JONES, CARRIE, YVONNE",5011 WEDDINGTON RD STE 50 CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 18 , 45 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477854263,"JONES, CARRIE, YVONNE",5011 WEDDINGTON RD STE 50 CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 22 , 45 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,16455 STATESVILLE RD STE 300   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477854263,"JONES, CARRIE, YVONNE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1477854263,"JONES, CARRIE, YVONNE",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 48 ,$#,,
MEDICAID DIRECT,1326394990,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FUQUAY VARINA,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1477855906,"WOODS, LATOYA, NICOLE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 31 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477857746,"SALINAS, PEDRINA",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477857746,"SALINAS, PEDRINA",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 22 , 57 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477857746,"SALINAS, PEDRINA",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477860070,"MUMIN, ZAKKIYYA, NASREEN",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477860070,"MUMIN, ZAKKIYYA, NASREEN",10545 BLAIR RD STE 1300 MINT HILL NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 20 , 21 ,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1477860526,"WALLACE, CAYCE, LAWAYNE",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 180 , 183 , 964 ," $33,961.70 ",,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477860526,"WALLACE, CAYCE, LAWAYNE",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 96 , 96 , 618 ," $27,144.74 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477861771,"GOODEVE, SANDRA, ROSE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477861771,"GOODEVE, SANDRA, ROSE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477862472,"MCDONALD, BRITTANY, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 28 , 28 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477862472,"MCDONALD, BRITTANY, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477862472,"MCDONALD, BRITTANY, LYNN",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477862969,"GARDNER, LARS, BENJAMIN",5838 SIX FORKS RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 29 , 39 , 55 ,$#,,
MEDICAID DIRECT,1477863934,B & B HOMECARE & ASSOCIATES LLC,B AND B HOMECARE AND ASSOCIATES LLC,3325 WASHBURN AVE STE 113 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1477863934,B & B HOMECARE & ASSOCIATES LLC,3325 WASHBURN AVE STE 113 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 51 ," 13,659 "," 13,659 "," $886,558.38 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1477864197,"GUSTINES, DIANE",3100 DURALEIGH RD STE 200 RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477864643,"RAVINDRAN, VEJAY, KUMAR",VEJAY K RAVINDRAN III DDS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1477864643,"RAVINDRAN, VEJAY, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1477864643,"RAVINDRAN, VEJAY, KUMAR",VEJAY K RAVINDRAN III DDS,3643 N ROXBORO ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1477864643,"RAVINDRAN, VEJAY, KUMAR",3643 N ROXBORO ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 35 , 423 ," $51,044.42 ",,
MEDICAID DIRECT,1497752026,ECONOMED OF ABERDEEN,ORTHOTICS & PROSTHETICS OF PINEHURST,95 AVIEMORE DR STE A PINEHURST NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1477867117,"PERRY, BRADLEY, CARSON",95 AVIEMORE DR STE A PINEHURST NC,063,Moore,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 17 , 17 , 58 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477871663,"JALANDHARA, VINITKUMAR, RAGHAVBHAI",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477873842,"BRONSHTEYN, YURIY, SEMENOVICH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 24 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477873842,"BRONSHTEYN, YURIY, SEMENOVICH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477873842,"BRONSHTEYN, YURIY, SEMENOVICH",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477874618,"DANISON, JESSICA, LYNN",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 53 , 73 , 73 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477874618,"DANISON, JESSICA, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 67 , 118 , 118 ," $10,804.93 ",,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1477874618,"DANISON, JESSICA, LYNN",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477874618,"DANISON, JESSICA, LYNN",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477874972,"GROTZKE, STEPHANIE, ANN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 68 , 209 , 213 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1477874972,"GROTZKE, STEPHANIE, ANN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477874972,"GROTZKE, STEPHANIE, ANN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477874972,"GROTZKE, STEPHANIE, ANN",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1477874972,"GROTZKE, STEPHANIE, ANN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245907302,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN MACON,674 HIGHLANDS RD   FRANKLIN NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477875623,"GREEN, LORI, SUSAN",674 HIGHLANDS RD   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 114 , 116 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1477876852,"WRIGHT, RANDY, SCOTT",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477878759,"PITT, KELLI, CHEREE",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 62 , 92 ,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477878759,"PITT, KELLI, CHEREE",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 29 , 43 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477878858,"KOPKE, BRYAN, JOHN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477878858,"KOPKE, BRYAN, JOHN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477878858,"KOPKE, BRYAN, JOHN",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477878858,"KOPKE, BRYAN, JOHN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 47 , 51 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477878858,"KOPKE, BRYAN, JOHN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 34 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477878858,"KOPKE, BRYAN, JOHN",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477878858,"KOPKE, BRYAN, JOHN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477882009,"CHEN, QING",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 91 , 213 , 214 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477882009,"CHEN, QING",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477882009,"CHEN, QING",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477882637,"BROWN, DANIELLE, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477884393,"ARCHAMBO, COURTNEY, LYNNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477884393,"ARCHAMBO, COURTNEY, LYNNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1477884393,"ARCHAMBO, COURTNEY, LYNNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497986509,DUPLIN GENERAL HOSPITAL INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193400000X,Group,Single Specialty,,1477889442,"WILLIAMS, ANGELA, PRICE",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477889723,"STANLEY, CATHERINE, LEIGH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1033130117,UWHARRIE REGIONAL PEDIATRICS P A,ALBEMARLE PEDIATRICS,1420 US 52 N STE A ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1477893899,"HONEYCUTT, ASHLEY, MARIE",1420 US 52 N STE A ALBEMARLE NC,084,Stanly,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 54 , 91 , 261 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477893923,"MORGAN, TAMARA, JOY",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 110 , 178 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477894467,"FEROLITO, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 85 , 90 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477894467,"FEROLITO, MICHELLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1477896827,"SARMIENTO, DIANA, MERYIT",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1477896827,"SARMIENTO, DIANA, MERYIT",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1477896827,"SARMIENTO, DIANA, MERYIT",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1477896827,"SARMIENTO, DIANA, MERYIT",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1477896827,"SARMIENTO, DIANA, MERYIT",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 53 , 68 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1477896827,"SARMIENTO, DIANA, MERYIT",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1528187770,HEY CLINIC PA,~,3320 WAKE FOREST RD STE 450 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477900462,"STANSON, KRISTINA, MARIELLE",3220 WAKE FOREST RD STE 450 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477900827,"CHRIST, JOHN, HAMILTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477900827,"CHRIST, JOHN, HAMILTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1477900827,"CHRIST, JOHN, HAMILTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1477900827,"CHRIST, JOHN, HAMILTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457482051,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF PENDERLEA DENTAL,5531 ELEANOR ROOSEVELT LN   WILLARD NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477902153,"PLAGE, NATALEIGH, HITT",5531 ELEANOR ROOSEVELT LN   WILLARD NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 293 , 499 ," 1,414 "," $60,501.12 ",,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477902203,"PERUSKI, LAUREN, ANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 26 , 45 , 45 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1477902229,"LEAL BAILEY, HUMBERTO",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 38 , 47 , 49 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477903177,"ANSARI, AHMER, MOHAMMAD",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1023455987,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,945 N 5TH ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1477903177,"ANSARI, AHMER, MOHAMMAD",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1023455987,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,945 N 5TH ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1477903177,"ANSARI, AHMER, MOHAMMAD",945 N 5TH ST   ALBEMARLE NC,084,Stanly,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 48 , 112 , 112 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,1041 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 153 , 170 , 797 ," $92,626.30 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 VANDERBILT PARK DR STE 210 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 12 , 13 , 37 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,130 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,411 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 258 , 365 ," 1,342 "," $146,681.56 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,135 MCBRAYER DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,160 TURNBERRY WAY   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477903441,"SADLER, JACKSON, LEWIS EZEKIEL",1041 X RAY DR   GASTONIA NC,036,Gaston,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477907889,"MCLAIN, COLIN, ANDREW",2301 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477907889,"MCLAIN, COLIN, ANDREW",2301 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1902614464,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY UROLOGY,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477907889,"MCLAIN, COLIN, ANDREW",2301 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,1212 SPRUCE ST STE 305E BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477908341,"NALLU, RAVALI",1212 SPRUCE ST STE 305E BELMONT NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 36 , 61 , 63 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2544 COURT DR STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477908341,"NALLU, RAVALI",2544 COURT DR STE A GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477908341,"NALLU, RAVALI",1212 SPRUCE ST STE 305E BELMONT NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477908341,"NALLU, RAVALI",2525 COURT DR   GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 15 , 25 , 26 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1477908341,"NALLU, RAVALI",2544 COURT DR STE A GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1578692703,PINEHURST FOOT SPECIALISTS PA,Pinehurst Foot Specialists PA,325 PAGE RD BLDG 3 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1477908846,"SMITH, JAMES, KEITH",325 PAGE RD BLDG 3 PINEHURST NC,063,Moore,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 161 , 450 , 749 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477909356,"UNRUH, BRADLEY, THOMS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477911295,"KEHOE, KRISTI, LYN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 42 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477911295,"KEHOE, KRISTI, LYN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477911675,"DOVE, KRYSTLE, HORNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477911675,"DOVE, KRYSTLE, HORNE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 43 , 43 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1477911675,"DOVE, KRYSTLE, HORNE",117 E KINGS HWY   EDEN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1477912632,"HAM, JAMIE, RYAN",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477912632,"HAM, JAMIE, RYAN",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477914000,"DOBBINS, JACLYN, HORNE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477914000,"DOBBINS, JACLYN, HORNE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 39 , 61 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477914141,"ULERY, DAVID, JOSEPH",6 DOCTORS CIR STE 5 SUPPLY NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477914935,"WILSON, TRACI, LEIGH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477914935,"WILSON, TRACI, LEIGH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477914935,"WILSON, TRACI, LEIGH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477915577,"DEUTSCH-LINK, SASHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477915791,"SUPPLES, SARAH, PATTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 20 , 43 , 45 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477915882,"RUSSELL, JAMES, TRUESDALE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477915882,"RUSSELL, JAMES, TRUESDALE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 43 , 50 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477915882,"RUSSELL, JAMES, TRUESDALE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477915882,"RUSSELL, JAMES, TRUESDALE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477915882,"RUSSELL, JAMES, TRUESDALE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1477915882,"RUSSELL, JAMES, TRUESDALE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 27 , 44 ,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477916583,"SHELTON, ANDREW, PAUL",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477916583,"SHELTON, ANDREW, PAUL",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 161 , 461 , 492 ," $18,826.28 ",,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477916583,"SHELTON, ANDREW, PAUL",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 26 , 26 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1477917888,"BURNER, JORDAN, MAE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1477917888,"BURNER, JORDAN, MAE",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 45 , 64 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477917888,"BURNER, JORDAN, MAE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 28 , 39 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477917888,"BURNER, JORDAN, MAE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477917888,"BURNER, JORDAN, MAE",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1477917888,"BURNER, JORDAN, MAE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 29 , 41 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477917888,"BURNER, JORDAN, MAE",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1477918498,"QIN, MIAO",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2702 FARRELL RD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1477918498,"QIN, MIAO",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 70 , 70 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1477918498,"QIN, MIAO",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 161 , 161 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,915 PEE DEE RD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1477918498,"QIN, MIAO",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477918498,"QIN, MIAO",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 146 , 146 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1477919256,"FLEMING, CHRISTA, MARTINA",1800 E FRANKLIN ST STE 11A CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 49 , 97 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477919256,"FLEMING, CHRISTA, MARTINA",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1477919256,"FLEMING, CHRISTA, MARTINA",107 HYANNIS DR   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477920247,"WHITE, JACLYN, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1477920684,"QUEEN, BLAKE, LANDRY",594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 40 ,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1477923019,"BOONE, CHEYENNE, ALLEN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1477923019,"BOONE, CHEYENNE, ALLEN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 206 , 247 , 329 ," $21,530.64 ",,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1477923316,"BOTTS, LINDA, KATHRYN",10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477928711,"CAMPBELL, ELIZABETH, BROWN",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1477929651,"HELSETH, OLIVIA, CHASSE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477929651,"HELSETH, OLIVIA, CHASSE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477929651,"HELSETH, OLIVIA, CHASSE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1477929651,"HELSETH, OLIVIA, CHASSE",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477931020,"MEDDA, ASHLEIGH, WELLS",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 36 , 50 , 65 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477931020,"MEDDA, ASHLEIGH, WELLS",2150 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 34 , 43 , 56 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477931020,"MEDDA, ASHLEIGH, WELLS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 59 , 77 , 94 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477931194,"MAYEUX, JESSICA, MALLORY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 28 , 30 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477932820,"GRAVITT, ASHLEY, WHITLOW",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477932820,"GRAVITT, ASHLEY, WHITLOW",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477932820,"GRAVITT, ASHLEY, WHITLOW",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1477932911,"KNORR, THOMAS, LOUIS",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 87 , 94 , 118 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1477932911,"KNORR, THOMAS, LOUIS",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1477932911,"KNORR, THOMAS, LOUIS",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477933612,"BROST, MELANIE, AYDT",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 29 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477933612,"BROST, MELANIE, AYDT",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477935468,"GREENE, ELIZABETH, BOOZER",1690 SKYLYN DR STE 300A SPARTANBURG SC,101,Out of State <= 40 miles,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477937787,"MCINTOSH, ALEXANDRIA",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 17 , 17 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477939437,"GORDON, CHRISTINE, LUTRELL",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477941367,"BUSBIN, SARAH, MARIA ANNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 119 , 120 ,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 50 , 24 , 128 ,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",510 GLENWOOD AVE   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 803 , 863 ," 3,658 "," $124,984.00 ",,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",510 GLENWOOD AVE   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,122 "," 2,447 "," 14,382 "," $903,267.76 ",,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",510 GLENWOOD AVE   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1477320802,DR CAMERON & ASSOCIATES OF RALEIGH,CAROLINA PEDIATRIC DENTISTRY,510 GLENWOOD AVE STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",510 GLENWOOD AVE   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,,,Unknown,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",510 GLENWOOD AVE   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 15 ,#,#,$#,,
MEDICAID DIRECT,1699743013,JOHNSON & MORRIS PLLC,CAROLINA PEDIATRIC DENTISTRY,2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477943231,"NGUYEN, TRANG, THI QUYNH",2800 WAKEFIELD PINES DR STE 110 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 97 , 74 , 292 ," $18,107.36 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477945707,"LEMMON, JENNIFER, LYNNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1477945707,"LEMMON, JENNIFER, LYNNE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 47 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1477945939,"KEPLEY, JOHN, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 179 , 191 , 208 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477945939,"KEPLEY, JOHN, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 72 , 77 , 82 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477945939,"KEPLEY, JOHN, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477946440,"GIESELMAN, LINDSEY, NELSON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1992459515,MONTERA HEALTH TEXAS LLC,,3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477947638,"HOSTETTER, JAMIE, LYNN",3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 86 , 90 ," $29,025.22 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477948180,"AVERY, KAYLA, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477949394,"JUDKINS, KYLE, MATTHEW",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 111 , 156 , 373 ,$#,,
MEDICAID DIRECT,1245759166,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CABARRUS PEDIATRICS,66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1477949915,"STATON, HOPE, MORGAN",66 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 55 , 86 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477954121,"LORBACHER, LESLIE, DONNELLY",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477954121,"LORBACHER, LESLIE, DONNELLY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 63 , 74 , 118 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477955607,"IANNITTO, ANN, ELIZABETH",2221 S. 17TH ST   CAPE FEAR NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1477959690,"BENELIYAHU, JASON, MICHAEL",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477959690,"BENELIYAHU, JASON, MICHAEL",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477959690,"BENELIYAHU, JASON, MICHAEL",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720283476,RANKIN & FIUME ORTHODONTICS LLP,,608 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1477961654,"FIUME, LEONARD, BRANDON",608 MCCARTHY BLVD   NEW BERN NC,025,Craven,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 163 , 514 , 586 ," $114,879.26 ",,
MEDICAID DIRECT,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,MAXTON FAMILY PRACTICE CENTER,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1477961795,"COX, JAMES, MICHAEL",4901 DAWN DR STE 3300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1407281082,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN SPINE & PAIN CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1477961795,"COX, JAMES, MICHAEL",4901 DAWN DR STE 3300 LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,MAXTON FAMILY PRACTICE CENTER,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1477961795,"COX, JAMES, MICHAEL",1001 W DR MARTIN LUTHER KING JR DR   MAXTON NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477963080,"WHEELER, ALAN, SCOTT",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477963080,"WHEELER, ALAN, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477963080,"WHEELER, ALAN, SCOTT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1477963163,"CAMPBELL, TIFFANY, ANN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 73 , 74 , 93 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1477963163,"CAMPBELL, TIFFANY, ANN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 26 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477963163,"CAMPBELL, TIFFANY, ANN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1477963627,"WYNNE, KARRI, BRITTON",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1477963627,"WYNNE, KARRI, BRITTON",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1477963627,"WYNNE, KARRI, BRITTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477963627,"WYNNE, KARRI, BRITTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477963676,"DOMINICK, ANTHONY, MICHAEL",1333 S DICKINSON DR UNIT 200 LELAND NC,010,Brunswick,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1477963676,"DOMINICK, ANTHONY, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1477963833,"JONES, NICOLA, SUNITA",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417088865,HIGH MOUNTAIN HEALTHCARE LLC,HIGH MOUNTAIN HEALTHCARE LLC,63 PLEASANT HILL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477964450,"DRESSLER, SUSAN, ALYCE",63 PLEASANT HILL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1013313857,PRIVIA MEDICAL GROUP OF GEORGIA LLC,,63 PLEASANT HILL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477964450,"DRESSLER, SUSAN, ALYCE",63 PLEASANT HILL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 20 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1477964450,"DRESSLER, SUSAN, ALYCE",63 PLEASANT HILL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1477964930,"TESFAYE, HANNA",2001 S MAIN ST   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1477964930,"TESFAYE, HANNA",480 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 124 , 248 , 583 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477965994,"JAYNES HONEYCUTT, EMILY, CAROLINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 23 , 50 , 51 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1477967917,"GHUMAN, TANEET",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 76 , 79 , 144 ,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1477969442,"VALENCIA, CATALINA, MARIA",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477969616,"OLIVAS, JEREMIAH, JACOB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477969616,"OLIVAS, JEREMIAH, JACOB",6301 HERNDON RD SOUTHPOINT MEDICAL PLAZA DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477969616,"OLIVAS, JEREMIAH, JACOB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1477971968,"PERKINS, AIMEE, ELAINE",304 10TH AVE NE   HICKORY NC,018,Catawba,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477972149,"LOYD, JOSHUA, WAYNE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477972149,"LOYD, JOSHUA, WAYNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 50 , 70 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477972149,"LOYD, JOSHUA, WAYNE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477972149,"LOYD, JOSHUA, WAYNE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477972149,"LOYD, JOSHUA, WAYNE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477972149,"LOYD, JOSHUA, WAYNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477972842,"MAZZELLA, ANTHONY, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 144 , 220 , 236 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477972842,"MAZZELLA, ANTHONY, JAMES",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477972842,"MAZZELLA, ANTHONY, JAMES",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1477972842,"MAZZELLA, ANTHONY, JAMES",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 21 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,316 CHESTNUT ST STE 2 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 19 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1477972958,"STEVENS, JESSICA, DANIELLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477973394,"GAGNON, ERIKA, BEALS",101 MANNING DR   CHAPEL HILL NC,068,Orange,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1245272657,COUNTY OF GUILFORD,GUILFORD CO DEPT PUBLIC HEALTH,1203 MAPLE ST   GREENSBORO NC,041,Guilford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1477973444,"HALL, KASHIF, RU-SHON JU-JUAN",501 E GREEN DR   HIGH POINT NC,041,Guilford,1223D0001X,Dental Providers,Dentist,Dental Public Health, 465 , 677 ," 2,491 "," $83,779.34 ",,
MEDICAID DIRECT,1245272657,COUNTY OF GUILFORD,GUILFORD CO DEPT PUBLIC HEALTH,1203 MAPLE ST   GREENSBORO NC,041,Guilford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1477973444,"HALL, KASHIF, RU-SHON JU-JUAN",1103 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223D0001X,Dental Providers,Dentist,Dental Public Health, 390 , 562 ," 2,138 "," $76,907.20 ",,
MEDICAID DIRECT,1245272657,COUNTY OF GUILFORD,GUILFORD CO DEPT PUBLIC HEALTH,501 E GREEN DR   HIGH POINT NC,041,Guilford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1477973444,"HALL, KASHIF, RU-SHON JU-JUAN",501 E GREEN DR   HIGH POINT NC,041,Guilford,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#, 22 ,$#,,
MEDICAID DIRECT,1245272657,COUNTY OF GUILFORD,GUILFORD CO DEPT PUBLIC HEALTH,1100 E WENDOVER AVE   GREENSBORO NC,041,Guilford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1477973444,"HALL, KASHIF, RU-SHON JU-JUAN",1103 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223D0001X,Dental Providers,Dentist,Dental Public Health,#,#,#,$#,,
MEDICAID DIRECT,1326078072,PROVIDENCE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS PROVIDENCE PEDIATR,14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477976819,"BALES, NATHANIEL, DAVID",14214 BALLANTYNE LAKE RD STE 300 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 27 ,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477976819,"BALES, NATHANIEL, DAVID",14214 BALLANTYNE LAKE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1477977312,"MCGANN, JAMES, JOSEPH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 62 , 66 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,,,Unknown,193400000X,Group,Single Specialty,,1477980449,"BACHRODT, TYLER, ELIZABETH",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1477980449,"BACHRODT, TYLER, ELIZABETH",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 VETERANS PKWY STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1477980449,"BACHRODT, TYLER, ELIZABETH",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,,,Unknown,193400000X,Group,Single Specialty,,1477980449,"BACHRODT, TYLER, ELIZABETH",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,1820 NC HIGHWAY 42 W STE 102 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1477980449,"BACHRODT, TYLER, ELIZABETH",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 48 , 49 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477980449,"BACHRODT, TYLER, ELIZABETH",507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 69 , 69 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1477980449,"BACHRODT, TYLER, ELIZABETH",801 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 79 , 95 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1477984631,"UDEVBULU, EHIZODE, MARTIN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477987030,"DE LA PAZ, ANDREW, RAMON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 40 , 51 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477987030,"DE LA PAZ, ANDREW, RAMON",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1480 KELLY RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477987030,"DE LA PAZ, ANDREW, RAMON",1480 KELLY RD   APEX NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477987030,"DE LA PAZ, ANDREW, RAMON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1477987030,"DE LA PAZ, ANDREW, RAMON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477987030,"DE LA PAZ, ANDREW, RAMON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477987030,"DE LA PAZ, ANDREW, RAMON",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477987238,"HERLIHY, LAUREN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1477988251,"NCOGO ALENE, INMACULADA, ANDEME",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1477988251,"NCOGO ALENE, INMACULADA, ANDEME",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1477988251,"NCOGO ALENE, INMACULADA, ANDEME",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 135 , 135 ,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477989101,"CARDINO, STEPHANIE-LYNN, AMANDA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477989101,"CARDINO, STEPHANIE-LYNN, AMANDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396061347,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE CAROLINA LAKES INTERNAL,7666 CHARLOTTE HWY STE 200 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477991479,"VINING, SETH, PATRICK",7666 CHARLOTTE HWY STE 200 INDIAN LAND SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013675669,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CAROLINA INTERNAL MEDIC,7666 CHARLOTTE HWY   INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477991479,"VINING, SETH, PATRICK",7666 CHARLOTTE HWY   INDIAN LAND SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1477991529,"OLIVA, LEONARDO, MARTIN",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477992063,"PATEL, NEIL, GHANSHYAM",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 25 , 40 , 56 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477992063,"PATEL, NEIL, GHANSHYAM",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 48 , 78 , 88 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477992063,"PATEL, NEIL, GHANSHYAM",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477992063,"PATEL, NEIL, GHANSHYAM",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 78 , 96 , 143 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477992063,"PATEL, NEIL, GHANSHYAM",3330 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477992063,"PATEL, NEIL, GHANSHYAM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477992352,"ROBERTS, NEAL, OMARI",480 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1477992352,"ROBERTS, NEAL, OMARI",11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 93 , 213 , 470 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1477992352,"ROBERTS, NEAL, OMARI",11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1477992402,"DASOUKI ABU-ALNADI, NOOR, MAJED",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1477992402,"DASOUKI ABU-ALNADI, NOOR, MAJED",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477992857,"NGENO, GEDION, TITUS KIPKOECH",40 DUKE MEDICINE CIR # 2K DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 34 , 49 , 70 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477992857,"NGENO, GEDION, TITUS KIPKOECH",40 DUKE MEDICINE CIR # 2K DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1477992857,"NGENO, GEDION, TITUS KIPKOECH",40 DUKE MEDICINE CIR # 2K DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477992857,"NGENO, GEDION, TITUS KIPKOECH",40 DUKE MEDICINE CIR # 2K DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 25 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477992857,"NGENO, GEDION, TITUS KIPKOECH",6301 HERNDON RD RM 181 DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477992857,"NGENO, GEDION, TITUS KIPKOECH",40 DUKE MEDICINE CIR # 2K DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 63 , 77 , 142 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477992857,"NGENO, GEDION, TITUS KIPKOECH",40 DUKE MEDICINE CIR # 2K DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477994507,"HAYNES, RENEE, CHILDRESS",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 49 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477994507,"HAYNES, RENEE, CHILDRESS",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477994507,"HAYNES, RENEE, CHILDRESS",207 MEDICAL ST   PILOT MOUNTAIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1477994507,"HAYNES, RENEE, CHILDRESS",167 MOORE RD STE 201 KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 77 , 198 ,$#,,
MEDICAID DIRECT,1669920609,DAVID E THOME DDS PLLC VII,DENVER PEDIATRIC DENTISTRY,275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1467150490,DAVID E THOME DDS PLLC L1,,401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 57 , 59 ," 1,065 "," $86,641.66 ",,
MEDICAID DIRECT,1740988773,DAVID E THOME DDS PLLC L1,,711 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 117 , 117 ," 2,278 "," $190,447.43 ",,
MEDICAID DIRECT,1467150490,DAVID E THOME DDS PLLC L1,,401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 85 ,$#,,
MEDICAID DIRECT,1396388096,THOME & KANKASH DDS PLLC I,FUQUAY PEDIATRIC DENTISTRY,401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",401 ATTAIN ST STE 111 FUQUAY VARINA NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,265 "," 1,889 "," 7,107 "," $225,083.61 ",,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",236 MARKET ST STE 200 LOCUST NC,084,Stanly,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1740988773,DAVID E THOME DDS PLLC L1,,711 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",711 TILGHMAN DR   DUNN NC,043,Harnett,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 17 ,$#,,
MEDICAID DIRECT,1912588476,DAVID E THOME XII,DUNN PEDIATRIC DENTISTRY,711 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1477994598,"KANKASH, SERENA, JOY",711 TILGHMAN DR   DUNN NC,043,Harnett,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,654 "," 2,692 "," 10,430 "," $336,372.01 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477995892,"ROYSTER, CHADWICK, BRYCE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 16 , 18 , 18 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477995983,"CABALUNA, MARLOU, BETH MATEO",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477995983,"CABALUNA, MARLOU, BETH MATEO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1477995983,"CABALUNA, MARLOU, BETH MATEO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 49 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477996007,"KIM, YOUNG",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 36 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477996007,"KIM, YOUNG",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 47 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477996007,"KIM, YOUNG",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 28 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477996007,"KIM, YOUNG",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477996007,"KIM, YOUNG",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1477996650,"CLARKE, WILLIAM, THOMAS",249 E NC HIGHWAY 54 STE 210 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 19 , 19 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1477996650,"CLARKE, WILLIAM, THOMAS",249 E NC HIGHWAY 54 STE 210 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477997849,"CONNOLLY, GILLIAN, WILLIAMS",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1477997849,"CONNOLLY, GILLIAN, WILLIAMS",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 21 , 25 ,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1477998664,"PEMBERTON, WILLIAM, BLAKE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1477998979,"TRUE, NICHOLAS, ALAN",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1477998979,"TRUE, NICHOLAS, ALAN",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 32 , 40 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1477998979,"TRUE, NICHOLAS, ALAN",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1477998979,"TRUE, NICHOLAS, ALAN",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 100 , 115 , 148 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477999274,"PERRY, BRIAN, ALAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1477999274,"PERRY, BRIAN, ALAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477999274,"PERRY, BRIAN, ALAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 266 , 279 , 319 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1477999274,"PERRY, BRIAN, ALAN",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 323 , 341 , 407 ," $11,783.13 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487000477,"HOLLIDGE, MELANIE, GAY",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487000477,"HOLLIDGE, MELANIE, GAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396041075,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH CENTRA CARE,436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487001210,"MESSIER, DEBORAH, LYNN",436 AIRPORT RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487002267,"RHEA, LOGAN, PATRICK-CARPENTER",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487002267,"RHEA, LOGAN, PATRICK-CARPENTER",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487002267,"RHEA, LOGAN, PATRICK-CARPENTER",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487002267,"RHEA, LOGAN, PATRICK-CARPENTER",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 15 , 54 , 95 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487002267,"RHEA, LOGAN, PATRICK-CARPENTER",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487002267,"RHEA, LOGAN, PATRICK-CARPENTER",125 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1487002770,"YANIK, JOHN, MICHAEL",,129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,1487002770,"YANIK, JOHN, MICHAEL",30 AIRPORT PARK RD   FLETCHER NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487002770,"YANIK, JOHN, MICHAEL",30 AIRPORT PARK RD   FLETCHER NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1487002770,"YANIK, JOHN, MICHAEL",129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 23 , 41 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487002770,"YANIK, JOHN, MICHAEL",129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 43 , 87 , 146 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487002770,"YANIK, JOHN, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 23 , 37 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1487002770,"YANIK, JOHN, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760423503,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS GASTROENTEROLOGY,853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487003943,"DOUGLASS, KEVIN, MICHAEL",853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1487004099,"HUNT, JOHN, STEWART",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487004677,"GANCAR, JESSICA, LAUREN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 35 , 36 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487004677,"GANCAR, JESSICA, LAUREN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487004677,"GANCAR, JESSICA, LAUREN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487005203,"BENSON, MARIANNA, CRISTINE",1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1487005203,"BENSON, MARIANNA, CRISTINE",1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 32 , 57 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487006821,"LEAO, SARAH, RUTH",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487006821,"LEAO, SARAH, RUTH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487006821,"LEAO, SARAH, RUTH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487006821,"LEAO, SARAH, RUTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487006821,"LEAO, SARAH, RUTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487006821,"LEAO, SARAH, RUTH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487006987,"SCHWEIGER, MAKULAH, EDITH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487007993,"CHILDS, LAUREN, MICHELLE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487008439,"WEBB, CHRISTOPHER, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 37 , 48 , 50 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487008827,"BINFORD, MEREDITH, ANN CAMP",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 99 , 104 , 134 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487009247,"KNIGHT, JOSHUA, KIRK",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 17 , 22 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487009379,"OELSEN, JAMES, MARSHALL",1085 NE GATEWAY CT NE STE 180 CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 27 , 54 , 123 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487009379,"OELSEN, JAMES, MARSHALL",1085 NE GATEWAY CT NE STE 180 CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 70 , 150 , 384 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487009759,"BROWN, JONATHAN, DAVIS",125 QUEENS RD STE 330 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487009759,"BROWN, JONATHAN, DAVIS",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487009759,"BROWN, JONATHAN, DAVIS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 105 , 144 , 155 ,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487010401,"CARTER, CHIARA, LYNN",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 154 , 480 ," $16,949.08 ",,
MEDICAID DIRECT,1730519182,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1487015616,"THAO, TSIMMENG, JUSTIN",201 E GROVER ST   SHELBY NC,023,Cleveland,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 33 , 53 , 78 ,$#,,
MEDICAID DIRECT,1730519182,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1487015616,"THAO, TSIMMENG, JUSTIN",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487018586,"SHIVAJI, SHANTI, MN",510 N ELAM AVE   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487018586,"SHIVAJI, SHANTI, MN",510 N ELAM AVE   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487021358,"LARSEN, HEATHER, ATKINS",2210 HEMBY LN   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 237 , 338 , 338 ,$#,,
MEDICAID DIRECT,1639757974,ASHE MEMORIAL HOSPITAL INC,FLEETWOOD FAMILY MEDICINE,13300 13290 HWY 221 S   FLEETWOOD NC,005,Ashe,193400000X,Group,Single Specialty,,1487022372,"MILLER, KATHLEEN, GAMMONS",13300 13290 U S HIGHWAY 221 S   FLEETWOOD NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 91 , 140 ,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1487024329,"HUFFMAN, ERIK, TAYLOR",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1487024329,"HUFFMAN, ERIK, TAYLOR",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1487024329,"HUFFMAN, ERIK, TAYLOR",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 33 , 59 ,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487030011,"PAYNE, ESTHER, COON",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487030011,"PAYNE, ESTHER, COON",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 15 , 15 , 34 ,$#,,
MEDICAID DIRECT,1487031449,A FRESH START ORG INC,A CHILDS HOPE FAMILY CARE HOME,329 PARK AVE   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1487031449,A FRESH START ORG INC,329 PARK AVE   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 241 , 244 ," $59,965.47 ",,
MEDICAID DIRECT,1487031449,A FRESH START ORG INC,A CHILDS HOPE FAMILY CARE HOME,301 S CHURCH ST STE 153 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1487031449,A FRESH START ORG INC,301 S CHURCH ST STE 153 ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,#, 59 , 59 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1487031597,"LOMBARDO, MARISSA, ANNE",1001 NEWMAN RD   NEW BERN NC,025,Craven,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487033999,"LANGE, ANDREW, PETERSON",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 23 , 37 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487033999,"LANGE, ANDREW, PETERSON",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487033999,"LANGE, ANDREW, PETERSON",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487034245,"ALLEN, JUSTIN, DERRICK",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 34 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487034245,"ALLEN, JUSTIN, DERRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487035945,"SINGH, JASKEERAT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 44 , 44 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487035945,"SINGH, JASKEERAT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487035945,"SINGH, JASKEERAT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 56 , 56 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487035945,"SINGH, JASKEERAT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 85 , 85 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487035945,"SINGH, JASKEERAT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487035945,"SINGH, JASKEERAT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487035945,"SINGH, JASKEERAT",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487035945,"SINGH, JASKEERAT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1487036695,"OSMAN, SAHAR, PATRICIA",5402 W MARKET ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1487036695,"OSMAN, SAHAR, PATRICIA",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487036695,"OSMAN, SAHAR, PATRICIA",1024 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487037453,"COOMBS, SPENCER, CROXTON",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487037818,"MAYO, WILLIAM, JOSEPH",110 PATRICK CT   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 302 ," 1,129 "," 1,847 "," $20,369.91 ",,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487046280,"CARDUCCI, DARYL, BRYANNA",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487046280,"CARDUCCI, DARYL, BRYANNA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487046850,"PELLIGRA, KYLE, GILMORE",801 TILGHMAN DR STE A DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487046850,"PELLIGRA, KYLE, GILMORE",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 59 , 59 ,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1487046983,"ABDULHAFID, GWEN, MESSER",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487048500,"BRANTLEY, COURTNEY, WEBBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 122 , 122 ," $12,512.11 ",,
MEDICAID DIRECT,1407134323,BEACHCARE URGENT AND FAMILY MEDICAL,BEACHCARE URGENT AND FAMILY MEDICAL CENTERPLLC,5059 HWY 70 W   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1487048971,"NORRIS, KELSEY, LYNN",5059 HWY 70 W   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487049342,"BURIC, CAROLINE, ANNE DEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 73 , 73 , 80 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487049342,"BURIC, CAROLINE, ANNE DEAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487049342,"BURIC, CAROLINE, ANNE DEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487049342,"BURIC, CAROLINE, ANNE DEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,315 19TH ST SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1487049656,"NAPOLITANO, LARRY, ANTHONY",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1487049656,"NAPOLITANO, LARRY, ANTHONY",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 281 , 409 , 861 ," $11,888.65 ",,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1487049656,"NAPOLITANO, LARRY, ANTHONY",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1487049656,"NAPOLITANO, LARRY, ANTHONY",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,105 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1487049656,"NAPOLITANO, LARRY, ANTHONY",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 45 , 57 , 100 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,651 WITHROW RD   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1487049656,"NAPOLITANO, LARRY, ANTHONY",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 81 , 95 , 173 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1487049656,"NAPOLITANO, LARRY, ANTHONY",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1487052445,"STARNES, MICHELLE, BLAIR",1205 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 41 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487055265,"BAKER, BARBARA, ANN",417 N MAIN ST   KENANSVILLE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 46 , 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487060232,"EL BITAR, SANDY",40 DUKE MEDICINE CIR # 1E DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 37 , 44 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487060232,"EL BITAR, SANDY",40 DUKE MEDICINE CIR # 1E DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1487062311,CARRIE DOUGLAS,DOUGLAS FAMILY CARE HOME,1439 US HIGHWAY 13 S   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1487062311,CARRIE DOUGLAS,1439 US HIGHWAY 13 S   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 992 , 992 ," $68,670.55 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487063525,"BARI, SHAHLA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487063525,"BARI, SHAHLA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487063525,"BARI, SHAHLA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487064663,"WANG, JACOB",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487064663,"WANG, JACOB",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 67 , 88 , 118 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487064663,"WANG, JACOB",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 15 , 22 , 32 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487064663,"WANG, JACOB",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 58 , 83 , 119 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487065066,"STEPP, JAMIE, MACKENZIE",6324 FAIRVIEW RD STE 310 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 25 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487065066,"STEPP, JAMIE, MACKENZIE",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487065066,"STEPP, JAMIE, MACKENZIE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487065066,"STEPP, JAMIE, MACKENZIE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487065066,"STEPP, JAMIE, MACKENZIE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487065066,"STEPP, JAMIE, MACKENZIE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1487065413,"FREI, ANDREW, SCHULDEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487065413,"FREI, ANDREW, SCHULDEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1487065413,"FREI, ANDREW, SCHULDEN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 50 , 53 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487065603,"MITCHELL, STUART, LEIGHTON",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 38 , 49 , 67 ," $15,089.00 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487065603,"MITCHELL, STUART, LEIGHTON",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487065603,"MITCHELL, STUART, LEIGHTON",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 20 , 30 ," $10,858.34 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487065603,"MITCHELL, STUART, LEIGHTON",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 29 , 34 ,$#,,
MEDICAID DIRECT,1487067062,HOKE HEALTHCARE LLC,CFV MOBILE INTEGRATED HEALTHCARE HOKE EMS,375 TEAL DR   RAEFORD NC,047,Hoke,3416L0300X,Transportation Services,Ambulance,Land Transport,1487067062,HOKE HEALTHCARE LLC,375 TEAL DR   RAEFORD NC,047,Hoke,3416L0300X,Transportation Services,Ambulance,Land Transport, 247 , 389 , 601 ," $20,400.02 ",,
MEDICAID DIRECT,1821240995,WESTGATE DERMATOLOGY AND LASER CENT,WESTGATE DERMATOLOGY AND LASER CENTER PA,2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487068540,"EDWARDS, ANNE, TYSON",2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1053431346,"GEER, ANDREW, CHRISTIAN",~,3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1487069589,"BOYTE, MEREDITH, GREESON",3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 13 , 40 ,$#,,
MEDICAID DIRECT,1447679956,ANDREW C GEER DDS,,3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487069589,"BOYTE, MEREDITH, GREESON",3244 REYNOLDA RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 212 , 288 , 853 ," $39,203.25 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487069852,"MORELEN, ASHLEY, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1487069852,"MORELEN, ASHLEY, MARIE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487072799,"FEYZEAU, KEAN, O'HARA",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902183759,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD NEUROLOGY SEACOAST,3980 HIGHWAY 9 E STE 300 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487072823,"SPENCER, OLINDA, PINEDA",3980 HIGHWAY 9 E STE 300 LITTLE RIVER SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487073623,"PENN, CICELY, EVETTE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487073623,"PENN, CICELY, EVETTE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487073755,"DORRY, MICHAEL, WILLIAM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487073755,"DORRY, MICHAEL, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487073755,"DORRY, MICHAEL, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 18 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487073755,"DORRY, MICHAEL, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487073755,"DORRY, MICHAEL, WILLIAM",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487073755,"DORRY, MICHAEL, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1487074118,CHRISTY HEALTH CARE SERVICES PLLC,CHRISTY HEALTH CARE SERVICES PLLC,10923 N MAIN ST STE B   ARCHDALE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1487074118,CHRISTY HEALTH CARE SERVICES PLLC,10923 N MAIN ST STE B   ARCHDALE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,#, 777 , 777 ," $57,182.04 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487074530,"LE, KHAHN, KHIEM PHAN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487074530,"LE, KHAHN, KHIEM PHAN",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487076287,"VERGA, JARED, MICHAEL",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487080859,"KENNEDY, KATHERINE, ELIZABETH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487080859,"KENNEDY, KATHERINE, ELIZABETH",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 60 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487083192,"DOUGHERTY, JENNIFER, POTHAVEN",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487083192,"DOUGHERTY, JENNIFER, POTHAVEN",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487083192,"DOUGHERTY, JENNIFER, POTHAVEN",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487088696,"SIPE, AMBER, SHERICE",815 COX RD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487088696,"SIPE, AMBER, SHERICE",815 COX RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487089223,"SHAFER, STACI, BETH",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 129 , 148 ,$#,,
MEDICAID DIRECT,1487090452,DIGESTIVE HEALTH SPECIALISTS PA,,137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1487090452,DIGESTIVE HEALTH SPECIALISTS PA,137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 50 , 53 , 77 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1487092193,"SANZA, DANIEL, JOHN",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487092193,"SANZA, DANIEL, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 143 , 178 , 178 ," $14,080.83 ",,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487092193,"SANZA, DANIEL, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487092193,"SANZA, DANIEL, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487093134,"CREWS, NICHOLAS, RAY",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487093134,"CREWS, NICHOLAS, RAY",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487093134,"CREWS, NICHOLAS, RAY",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487093134,"CREWS, NICHOLAS, RAY",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 38 , 49 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487093134,"CREWS, NICHOLAS, RAY",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487093134,"CREWS, NICHOLAS, RAY",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1487095709,NOA HUMAN SERVICES LLC 2,~,730 BLACKWOOD AVE   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1487095709,NOA HUMAN SERVICES LLC 2,730 BLACKWOOD AVE   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 685 , 685 ," $48,347.52 ",,
MEDICAID DIRECT,1487095709,NOA HUMAN SERVICES LLC 2,~,1507 BOLTON ST   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1487095709,NOA HUMAN SERVICES LLC 2,1507 BOLTON ST   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 94 , 94 ,$#,,
MEDICAID DIRECT,1881289932,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR DIVISION OF PSYCHIATRY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487096160,"CARTER, CLAUDINE, NIKIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1487098901,"PRICE, SARAH, KATHERINE",1705 TARBORO ST SW   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 164 , 164 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1487098901,"PRICE, SARAH, KATHERINE",1705 TARBORO ST SW   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 55 , 55 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487099701,"LUSK, RYAN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487100491,"LYDAY, JONATHAN, DOUGLAS",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 37 , 60 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487100491,"LYDAY, JONATHAN, DOUGLAS",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 124 , 199 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487100491,"LYDAY, JONATHAN, DOUGLAS",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487108445,"TAYLOR, JOUEL, ELISHEBA",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 27 , 37 , 92 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487113890,"GARRETSON, MATTHEW, PAUL",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 35 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487113890,"GARRETSON, MATTHEW, PAUL",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 20 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487114526,"LAGRANGE, RYAN, REX",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 81 , 81 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1487114724,"TREEN, JON, ROBERT",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1487114724,"TREEN, JON, ROBERT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 47 , 54 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1487114724,"TREEN, JON, ROBERT",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487115515,"METZ, KALLIE, RAE SCOTT",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487115515,"METZ, KALLIE, RAE SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1659695781,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487115515,"METZ, KALLIE, RAE SCOTT",16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 23 , 36 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487115515,"METZ, KALLIE, RAE SCOTT",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487115515,"METZ, KALLIE, RAE SCOTT",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487115515,"METZ, KALLIE, RAE SCOTT",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518556711,FULLER & ASSOCIATES X PLLC,WATERFORD FAMILY & COSMETIC DENTISTRY,509 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1487116299,"HEINSHEIMER, JOSHUA, WIDNEY",509 OLDE WATERFORD WAY STE 300 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 83 , 88 , 302 ," $10,734.17 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1487117115,"MULLEN, PATRICK, SWEENEY",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 34 , 67 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487117115,"MULLEN, PATRICK, SWEENEY",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487117354,"TARIQ, FEHAM",320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487117461,"VANDERBURG, JEFFREY, LYNN",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 111 , 153 ,$#,,
MEDICAID DIRECT,1730301037,JAIME E TRUJILLO MD PA,JAIME E TRUJILLO MD PA JAIME E TRUJILLO MD PA,3080 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487120465,"ROGERS, JENNIFER, LEIGH BECK",3080 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487127932,"VAN AUSDALL, STEPHEN, LUKE",201 E WENDOVER AVE   GREENSBORO NC,041,Guilford,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1427452341,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORWOOD FAMILY MEDICINE,269 S MAIN ST   NORWOOD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1487131496,"CRUMP, LUCY, EDWARDS",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 47 , 65 ,$#,,
MEDICAID DIRECT,1427452341,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORWOOD FAMILY MEDICINE,269 S MAIN ST   NORWOOD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1487131496,"CRUMP, LUCY, EDWARDS",269 S MAIN ST   NORWOOD NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 177 , 248 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1487131702,"WEAVER, EMILY, DENISE",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487131918,"LANGA, BLAIRE, JENKINS",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487131918,"LANGA, BLAIRE, JENKINS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487137055,"MITCHELL, LEENA, JEMBA",8420 UNIVERSITY EXEC PARK DR STE 850 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 41 , 94 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487137527,"SANDERS, KATIE, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487137667,RIVERSIDE MEDICAL SUPPLY LLC,,293 LAUREL RIDGE RD   COLUMBUS NC,075,Polk,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487137667,RIVERSIDE MEDICAL SUPPLY LLC,293 LAUREL RIDGE RD   COLUMBUS NC,075,Polk,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#," $15,705.73 ",,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487137931,"PENNINGTON, REBEKAH, MARIANNE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 123 , 123 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1487141073,"LIVINGSTON, BROOKE, ELIZABETH",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 26 , 83 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1487141073,"LIVINGSTON, BROOKE, ELIZABETH",3252 WELLONS BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073911822,COASTAL CAROLINA HEALTH CARE PA,CCHC CREEKSIDE PRIMARY CARE,1010 LATHAN LN   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1487141073,"LIVINGSTON, BROOKE, ELIZABETH",1010 LATHAN LN   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 39 , 62 ,$#,,
MEDICAID DIRECT,1073911822,COASTAL CAROLINA HEALTH CARE PA,CCHC CREEKSIDE PRIMARY CARE,1010 LATHAN LN   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1487141073,"LIVINGSTON, BROOKE, ELIZABETH",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 70 , 160 ,$#,,
MEDICAID DIRECT,1073911822,COASTAL CAROLINA HEALTH CARE PA,CCHC CREEKSIDE PRIMARY CARE,1010 LATHAN LN   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1487141073,"LIVINGSTON, BROOKE, ELIZABETH",3252 WELLONS BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487141131,"MCNULTY, LUKE, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487141131,"MCNULTY, LUKE, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487141131,"MCNULTY, LUKE, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487141131,"MCNULTY, LUKE, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487141131,"MCNULTY, LUKE, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 59 , 62 ,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1487141545,"SAHU, KIRTI, PULAK",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487143384,"CABALLES, SHANA-ANN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487143632,"HANCHER, JONATHAN, AARON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 56 , 86 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1487143632,"HANCHER, JONATHAN, AARON",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487143632,"HANCHER, JONATHAN, AARON",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487143632,"HANCHER, JONATHAN, AARON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1487143632,"HANCHER, JONATHAN, AARON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1487147799,"FERREIRA, ADRIANA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 34 , 40 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487147799,"FERREIRA, ADRIANA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 53 , 63 , 86 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487148367,"APPLEGATE, KEVIN, ARTHUR",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 38 , 92 , 92 ,$#,,
MEDICAID DIRECT,1558551671,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS BRUNSWICK,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1487148367,"APPLEGATE, KEVIN, ARTHUR",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487149688,"GARTMAN, MARGARET, GRACE",3475 ERWIN RD   DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184163883,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA UROLOGY,1139 CARTHAGE ST STE 110-B SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1487150074,"HAMILTON, PAIGE, ELAINE",1139 CARTHAGE ST STE 110B SANFORD NC,053,Lee,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1487150074,"HAMILTON, PAIGE, ELAINE",,95 SPRINGBROOK AVE STE 109 CLAYTON NC,051,Johnston,208800000X,Allopathic & Osteopathic Physicians,Urology,,1487150074,"HAMILTON, PAIGE, ELAINE",95 SPRINGBROOK AVE STE 109 CLAYTON NC,051,Johnston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 15 , 19 ,$#,,
MEDICAID DIRECT,1487150074,"HAMILTON, PAIGE, ELAINE",,110 KILDAIRE PARK DR   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1487150074,"HAMILTON, PAIGE, ELAINE",110 KILDAIRE PARK DR   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 13 , 19 ,$#,,
MEDICAID DIRECT,1487150074,"HAMILTON, PAIGE, ELAINE",,95 SPRINGBROOK AVE STE 109 CLAYTON NC,051,Johnston,208800000X,Allopathic & Osteopathic Physicians,Urology,,1487150074,"HAMILTON, PAIGE, ELAINE",110 KILDAIRE PARK DR   CARY NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487151338,"STEWART, BIANCA, LATIA",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 72 , 86 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487151338,"STEWART, BIANCA, LATIA",14135 BALLANTYNE CORPORATE PL STE 160 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487151338,"STEWART, BIANCA, LATIA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487152666,"GERALD, FORRESENA, DANIELLE",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 24 , 59 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,138 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487153912,"NUR, MICHELLE, DENIZ",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487153912,"NUR, MICHELLE, DENIZ",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487153912,"NUR, MICHELLE, DENIZ",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487153912,"NUR, MICHELLE, DENIZ",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487153912,"NUR, MICHELLE, DENIZ",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1487158960,"CARAGEA, MARC, ADRIAN",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 34 , 69 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487158960,"CARAGEA, MARC, ADRIAN",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 29 , 66 , 91 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 32 , 36 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,2874 WARD BLVD   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1487159596,"KIM, KATELYN, MARIKO",2874 WARD BLVD   WILSON NC,098,Wilson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",1301 CASTLEPOINTE DR   FUQUAY VARINA NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 18 , 22 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,1301 CASTLEPOINTE DR   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",1301 CASTLEPOINTE DR   FUQUAY VARINA NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,2874 WARD BLVD   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1487159596,"KIM, KATELYN, MARIKO",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487159596,"KIM, KATELYN, MARIKO",2874 WARD BLVD   WILSON NC,098,Wilson,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487163143,"FALLIN, DEA, ANN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487168662,"HUNT, KATLIN, ELIZABETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487173050,"AGYEMANG-MENSAH, NANA SARPONG",2025 GLENN MITCHELL DR GLENN MITCHELL DR VA BEACH VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487176368,"WATTS, JESSICA, VELISSA",2901 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2901 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1487176368,"WATTS, JESSICA, VELISSA",2901 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 69 , 98 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1626 N MAIN ST   SUMMERVILLE SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1487177895,"OSEAN, JUSTIN",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487177895,"OSEAN, JUSTIN",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487178737,"ALI, FATIMA",1550 FAULK ST   MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 38 , 38 ,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487181210,"MADDEN, EVAN, JEFFREY",1325 SPRING ST   GREENWOOD SC,102,Out of State > 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 31 , 76 ,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487181210,"MADDEN, EVAN, JEFFREY",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1609822287,EASTERN CAROLINA MEDICAL CENTER PC,EASTERN CAROLINA MEDICAL CENTER PC,1 MEDICAL DR   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1487181665,"HENDERSHOT, RAQUEL, LEIGH",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 143 , 786 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487184594,"KINNEY, KELSEY, LAINE",710 PARK CENTER DR STE 200 MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1366597114,CHILDRENS MEDICAL GROUP INC,GENERAL BOOTH PEDS,2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487185187,"WHITESIDE, AILA, CO",2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487185534,"SINGH, MUKUNDA",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 84 , 181 , 344 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487185534,"SINGH, MUKUNDA",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 29 ,$#,,
MEDICAID DIRECT,1326472812,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PRIMARY CARE CONCORD INTERNAL MEDICI,200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487185534,"SINGH, MUKUNDA",200 MEDICAL PARK DR STE 550 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487185542,"COSTA, AUSTIN, THOMAS",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487185542,"COSTA, AUSTIN, THOMAS",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 97 , 121 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487185542,"COSTA, AUSTIN, THOMAS",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487185799,"ZHANG, GARY, KANBO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 54 , 84 , 92 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487186458,"NAGARAJ, SAVITHA, VIJAY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487187134,"KINNY, SARA, REGINA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 114 , 177 , 178 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487187134,"KINNY, SARA, REGINA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,110 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487188850,"KENNEDY, LIANNE, RACTLIFFE",110 PINE STATE ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 25 , 52 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487188850,"KENNEDY, LIANNE, RACTLIFFE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487188850,"KENNEDY, LIANNE, RACTLIFFE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 32 , 76 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487188850,"KENNEDY, LIANNE, RACTLIFFE",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 54 , 65 , 138 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1487188850,"KENNEDY, LIANNE, RACTLIFFE",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487191888,"MOREB, KAI, SADIM",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487191888,"MOREB, KAI, SADIM",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487191888,"MOREB, KAI, SADIM",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487192951,"NEDEROSTEK, LAUREN, AMANDA",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 23 , 127 , 358 ,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1487193322,"KAGEN, AMBER, DEAN",1220 SPRUCE ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 29 , 44 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487193868,"QUINN, SARAH, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487194189,"BYRD, ANGELA, MICHELE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487195764,"IVORY, JOANNIE, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487200283,"PIPPIN, AUSTIN, ROBERT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 19 , 20 ,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487200283,"PIPPIN, AUSTIN, ROBERT",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 63 , 63 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487202784,"DREYER, THOMAS, COLIN",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487202784,"DREYER, THOMAS, COLIN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 43 , 43 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487203014,"PATEL, SAWAN, SATISHCHANDRA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 109 , 110 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487203014,"PATEL, SAWAN, SATISHCHANDRA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 50 , 50 ,$#,,
MEDICAID DIRECT,1487203592,COMMUNICATION POWERHOUSE PLLC,,345 CROWN PT   SANFORD NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487203592,COMMUNICATION POWERHOUSE PLLC,345 CROWN PT   SANFORD NC,043,Harnett,193200000X,Group,Multi-Specialty,, 78 ," 1,329 "," 1,374 "," $81,305.93 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487204293,"BARHAM, JORDAN, PAINTER",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487204293,"BARHAM, JORDAN, PAINTER",2301 ERWIN RD DUKE CENTRAL TOWER 10 B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1487204368,"BENTON, SAMUEL, EDISON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 32 , 32 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487209086,"GUNTER, CHASE",5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487209086,"GUNTER, CHASE",5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1487209458,"CRITCHER, SHAUNA, STADELMAIER",232 BOONE HEIGHTS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 72 , 126 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1487209458,"CRITCHER, SHAUNA, STADELMAIER",194 DOCTORS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,,2200 GATEWAY CENTRE BLVD STE 209 MORRISVILLE NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,2200 GATEWAY CENTRE BLVD STE 209 MORRISVILLE NC,092,Wake,291U00000X,Laboratories,Clinical Medical Laboratory,, 67 , 196 , 469 ,$#,,
MEDICAID DIRECT,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,,1918 RANDOLPH RD STE 140 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,1918 RANDOLPH RD STE 140 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,,4901 E NC HIGHWAY 150   BROWNS SUMMIT NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,4901 E NC HIGHWAY 150   BROWNS SUMMIT NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,719 GREEN VALLEY RD STE 305 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,,4380 FEDERAL DR STE 100 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,1487212551,QUEST DIAGNOSTICS CLINICAL LABORATO,4380 FEDERAL DR STE 100 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,," 4,622 "," 6,420 "," 25,817 "," $338,843.02 ",,
MEDICAID DIRECT,1205997053,DRS KRISHINGNER ROOT & ASSOCIATE PL,~,123 E MAIN ST STE 300 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1487212759,"VALDES, MEGHAN, RAQUEL",123 E MAIN ST STE 300 BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 113 , 168 , 480 ," $23,860.20 ",,
MEDICAID DIRECT,1205997053,DRS KRISHINGNER ROOT & ASSOCIATE PL,~,344 GALLIMORE RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1487212759,"VALDES, MEGHAN, RAQUEL",344 GALLIMORE RD   BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 142 , 219 , 609 ," $26,098.59 ",,
MEDICAID DIRECT,1104303668,GEORGE & DEST DDS PLLC,~,107 E MOUNTAIN ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487212817,"KNIER, KATHRYN, TAYLOR",107 E MOUNTAIN ST   KINGS MOUNTAIN NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 540 , 735 ," 2,458 "," $105,960.61 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487213047,"MUNOZ ALI, DIANA, ISABEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 79 , 93 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487213716,"INGRAM, DAMARCUS, ANTHONY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1487214185,"BAKER, MEREDITH-SCOTT",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 105 , 140 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487214185,"BAKER, MEREDITH-SCOTT",34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 40 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487215380,"BLECHER, NATHANIEL, AIDAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487215380,"BLECHER, NATHANIEL, AIDAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487215380,"BLECHER, NATHANIEL, AIDAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487215380,"BLECHER, NATHANIEL, AIDAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487216578,"RUDDIMAN, KATHLEEN, ROSE",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487216578,"RUDDIMAN, KATHLEEN, ROSE",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 19 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487218152,"IFTIKHAR, MUSTAFA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487218152,"IFTIKHAR, MUSTAFA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487218764,"BLACK, CHELSEA, GEBS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 119 , 121 , 149 ," $10,280.31 ",,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487218764,"BLACK, CHELSEA, GEBS",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487218764,"BLACK, CHELSEA, GEBS",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487219879,"MATTHEWS, MARY, ELIZABETH",702 N MAIN ST   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487220059,"CARVALHO, ANDREI, FELIPE SILVA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 54 , 54 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1487220059,"CARVALHO, ANDREI, FELIPE SILVA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 93 , 93 ,$#,,
MEDICAID DIRECT,1487223814,ORTHONC ASC LLC,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1487223814,ORTHONC ASC LLC,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487225256,"YOON, MELANIE, EUNHYE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1487225397,MANAGEMENT CONSULTANTS PRO LLC,MANAGEMENT CARE SERVICES,1100 LOGGER CT STE E102 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1487225397,MANAGEMENT CONSULTANTS PRO LLC,1100 LOGGER CT STE E102 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,, 24 , 198 , 198 ," $12,669.20 ",,
MEDICAID DIRECT,1487225397,MANAGEMENT CONSULTANTS PRO LLC,MANAGEMENT CARE SERVICES,1100 LOGGER CT STE E102 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1487225397,MANAGEMENT CONSULTANTS PRO LLC,1100 LOGGER CT STE E102 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,281 "," 1,281 "," $100,876.36 ",,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487225686,"PORTER, JAMAL, TYRONE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 25 , 67 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1487225686,"PORTER, JAMAL, TYRONE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1487228649,"PYAKURYAL, ARUN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1487228649,"PYAKURYAL, ARUN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 132 , 132 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487233029,"KIRKSEY, AUSTIN, AGONCILLO",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1487233755,"MACBEAN, DAYNA, KATHERINE",6845 KNIGHTDALE BLVD STE 100 KNIGHTDALE NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 26 , 36 , 85 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1487233755,"MACBEAN, DAYNA, KATHERINE",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1356730741,DAVID E THOME DDS PLLC IV,STATESVILLE PEDIATRIC DENTISTRY,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487233961,"PARKER, JAMES, RUDOLPH",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 24 , 130 ,$#,,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1487233961,"PARKER, JAMES, RUDOLPH",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 129 , 137 , 542 ," $18,970.69 ",,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487233961,"PARKER, JAMES, RUDOLPH",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 325 , 347 ," 1,220 "," $43,678.27 ",,
MEDICAID DIRECT,1174280176,MARCELA MUJICA DMD III PLLC,ALL KIDS PEDIATRIC DENTISTRY,2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487233961,"PARKER, JAMES, RUDOLPH",2501 THE PLZ STE 4 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,282 "," 1,519 "," 5,268 "," $190,513.65 ",,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487233961,"PARKER, JAMES, RUDOLPH",2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,955 "," 3,543 "," 12,165 "," $410,657.17 ",,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487236279,"WHIPPEN, JENNA, MARIE",101 HEART DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487236279,"WHIPPEN, JENNA, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 168 , 270 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487236279,"WHIPPEN, JENNA, MARIE",101 HEART DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1487239497,"NOVAK, STEPHANIE",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 42 , 60 , 131 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487243978,"HAMILTON, SARAH, ELIZABETH",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 188 , 198 , 201 ,$#,,
MEDICAID DIRECT,1083039176,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MED-W MTN VIEW,1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1487245361,"CROMBIE, ANNETTE, SWINSON",1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083039176,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MED-W MTN VIEW,1940 BRIARWOOD DR STE A HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1487245361,"CROMBIE, ANNETTE, SWINSON",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487245361,"CROMBIE, ANNETTE, SWINSON",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487245791,"PARKER, WESLEY, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine, 17 , 18 , 26 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487249454,"YE, SHIJIN",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1487255311,HEALTHY SPEECH SOLUTIONS PLLC,,115 S 3RD ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1487255311,HEALTHY SPEECH SOLUTIONS PLLC,115 S 3RD ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,#, 23 , 25 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,11635 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1487256087,"PATEL, NILABEN",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 58 , 106 ,$#,,
MEDICAID DIRECT,1275561847,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1487256087,"PATEL, NILABEN",205 SANDALWOOD AVE   LOUISBURG NC,035,Franklin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 36 , 76 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487260451,"INMAN-PUCKETT, JO, ELLEN",109 FOOTHILLS DR   MORGANTON NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 182 , 186 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1487260451,"INMAN-PUCKETT, JO, ELLEN",109 FOOTHILLS DR   MORGANTON NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,109 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1487260451,"INMAN-PUCKETT, JO, ELLEN",109 FOOTHILLS DR   MORGANTON NC,012,Burke,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487260451,"INMAN-PUCKETT, JO, ELLEN",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487260451,"INMAN-PUCKETT, JO, ELLEN",1100 N RALEIGH BLVD STE 130 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 26 , 28 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,185 NORWOOD HOLLOW RD   BANNER ELK NC,006,Avery,193200000X,Group,Multi-Specialty,,1487260451,"INMAN-PUCKETT, JO, ELLEN",1100 N RALEIGH BLVD STE 130 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1487260451,"INMAN-PUCKETT, JO, ELLEN",1100 N RALEIGH BLVD STE 130 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1487261327,"WATT, NICOLE, KATHARINE",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1487261327,"WATT, NICOLE, KATHARINE",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 50 , 90 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487261509,"KILPATRICK, REILLY, BRIELLE",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154352938,RIVERBEND FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE RIVERBEND FAMILY MEDICI,215 S MAIN ST   MT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487261509,"KILPATRICK, REILLY, BRIELLE",215 S MAIN ST   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 54 , 85 ,$#,,
MEDICAID DIRECT,1033584917,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF ROWAN SALISBURY,20808 N MAIN ST   CORNELIUS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487262762,"DISHMOND, CHRISTINA, DIANE",20808 N MAIN ST STE 102 CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558351726,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE PIEDMONT,1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487262762,"DISHMOND, CHRISTINA, DIANE",1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 115 , 166 ,$#,,
MEDICAID DIRECT,1033584917,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF ROWAN SALISBURY,420 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1487262762,"DISHMOND, CHRISTINA, DIANE",420 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487263422,"JOHNSON, AMANDA, NICOLE",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487263422,"JOHNSON, AMANDA, NICOLE",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528011137,VALLEY INTERNAL MEDICINE INC,VALLEY INTERNAL MEDICINE INC,2149 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487264370,"YATES, HELEN, YOUNG",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1487264370,"YATES, HELEN, YOUNG",2149 VALLEYGATE DR STE 102 # 102 FAYETTEVILLE NC,026,Cumberland,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1487264370,"YATES, HELEN, YOUNG",2149 VALLEYGATE DR STE 102 # 102 FAYETTEVILLE NC,026,Cumberland,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1891060398,FAYETTEVILLE URGENT CARE AND FAMILY,FAYETTEVILLE URGENT CARE AND FAMILY MEDICINE PA,4155 FERNCREEK DR STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487264370,"YATES, HELEN, YOUNG",4155 FERNCREEK DR STE 102 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 33 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487267878,"MOLENGRAFT, ANNA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 54 , 54 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487267878,"MOLENGRAFT, ANNA, MARIE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487268512,"ABDULAZIZ M ALENEZI, FAWAZ",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 14 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487268512,"ABDULAZIZ M ALENEZI, FAWAZ",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 61 , 65 , 92 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487268512,"ABDULAZIZ M ALENEZI, FAWAZ",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 94 , 96 , 202 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1487268512,"ABDULAZIZ M ALENEZI, FAWAZ",6301 HERNDON RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 23 ,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487269973,"THOMPSON, BENJAMIN, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 36 , 39 ,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487269973,"THOMPSON, BENJAMIN, JOSEPH",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 24 , 27 ,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487269973,"THOMPSON, BENJAMIN, JOSEPH",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801232244,MILLER AND ASSOCIATES FOUR PLLC,MILLER AND ASSOCIATES,1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1487271094,"MCLAUGHLIN, PATRICK, JAMES",8066 MARKET ST STE A WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 157 , 180 , 567 ," $27,636.36 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1487271094,"MCLAUGHLIN, PATRICK, JAMES",1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 570 , 663 ," 2,111 "," $100,202.01 ",,
MEDICAID DIRECT,1790446672,LANE & ASSOCIATES XLIV DDS PA,~,7430 RICHLANDS HWY   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1487271094,"MCLAUGHLIN, PATRICK, JAMES",1112 NC HIGHWAY 210   SNEADS FERRY NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 139 , 179 , 516 ," $20,049.19 ",,
MEDICAID DIRECT,1952405474,ROBERT B MILLER IV DDS PLLC,COMPLETE DENTAL CARE,1505 S GLENBURNIE RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1487271094,"MCLAUGHLIN, PATRICK, JAMES",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 100 , 105 , 350 ," $15,131.11 ",,
MEDICAID DIRECT,1790446672,LANE & ASSOCIATES XLIV DDS PA,~,7430 RICHLANDS HWY   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1487271094,"MCLAUGHLIN, PATRICK, JAMES",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1679930408,STEVEN W SMITH DDS PLLC,SMITH FAMILY AND COSMETIC DENTISTRY,3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1487271094,"MCLAUGHLIN, PATRICK, JAMES",3847 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 175 , 199 , 595 ," $33,974.88 ",,
MEDICAID DIRECT,1982339933,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE LOWES GRO,2216 E NC HIGHWAY 54   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487274528,"KIMBELL, YUVAL, ZEV",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487274635,GOODHOPE HOME HEALTHCARE INC,HOME MEDICAL SUPPLY,5029 FALLS OF NEUSE RD STE 222 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487274635,GOODHOPE HOME HEALTHCARE INC,5029 FALLS OF NEUSE RD STE 222 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 13 ,$#,,
MEDICAID DIRECT,1487274635,GOODHOPE HOME HEALTHCARE INC,HOME MEDICAL SUPPLY,5029 FALLS OF NEUSE RD STE 222 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1487274635,GOODHOPE HOME HEALTHCARE INC,5029 FALLS OF NEUSE RD STE 222 RALEIGH NC,092,Wake,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1487274635,GOODHOPE HOME HEALTHCARE INC,HOME MEDICAL SUPPLY,5029 FALLS OF NEUSE RD STE 222 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1487274635,GOODHOPE HOME HEALTHCARE INC,5029 FALLS OF NEUSE RD STE 222 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 59 , 59 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487275145,"STEEN, JAMES, JEFFREY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 26 , 34 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487275145,"STEEN, JAMES, JEFFREY",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487276242,ECHO PARK INTEGRATED INC,ECHO PARK HEALTH,3116 MILTON RD STE D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1487276242,ECHO PARK INTEGRATED INC,3116 MILTON RD STE D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 399 , 399 ," $89,163.59 ",,
MEDICAID DIRECT,1669971826,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN GASTROENTEROLOGY,870 STATE FARM RD STE 102 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1487278230,"WILKINS, OLIVIA, WILLIAMS",870 STATE FARM RD STE 102 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 82 , 82 ,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487280640,"RUSSELL-LADD, KATHERINE, LYNN",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 50 ,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487280640,"RUSSELL-LADD, KATHERINE, LYNN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 72 , 114 ,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487280640,"RUSSELL-LADD, KATHERINE, LYNN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 34 , 52 ,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487280640,"RUSSELL-LADD, KATHERINE, LYNN",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487280640,"RUSSELL-LADD, KATHERINE, LYNN",1509 DOCTORS CIR BLDG C CAPE FEAR NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487280640,"RUSSELL-LADD, KATHERINE, LYNN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 18 ,$#,,
MEDICAID DIRECT,1730774894,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR RHEUMATOLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487280640,"RUSSELL-LADD, KATHERINE, LYNN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1487280939,"MERINO, RUBI, BALTAZAR",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1487280939,"MERINO, RUBI, BALTAZAR",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487282166,"LARDO, OLIVIA, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 49 , 66 ,$#,,
MEDICAID DIRECT,1750068219,DLP RUTHERFORD PHYSICIAN PRACTICES,FOREST CITY FAMILY CARE RHC,212 ALLENDALE DR   FOREST CITY NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1487283248,"ESMAEIL POUR, MOHAMMAD, ALI",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 22 , 24 ,$#,,
MEDICAID DIRECT,1487289518,IT-S ABOUT YOU,~,5425 MURCHISON RD STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1487289518,IT-S ABOUT YOU,5425 MURCHISON RD STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 36 ," 6,910 "," 7,090 "," $520,790.76 ",,
MEDICAID DIRECT,1487295150,EVERYBODY SWIM,FOUNDATIONS 4 FUNCTION,800 SHIPYARD BLVD STE 10 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487295150,EVERYBODY SWIM,800 SHIPYARD BLVD STE 10 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 16 , 380 , 381 ," $34,482.69 ",,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487296869,"THOMSON, KATHERINE, MAY STITSINGER",9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487304119,"PEARL-GADDY, EMILY, RENEE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 149 , 149 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487304119,"PEARL-GADDY, EMILY, RENEE",180 PARKWOOD DR   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 381 , 381 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1487305678,"MARSHALL, MAUREEN, BRIGID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1487309415,"MEYER, TIFFANY, MARIE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487309415,"MEYER, TIFFANY, MARIE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487309845,"JOHNSON, KASEY, DALE",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487309845,"JOHNSON, KASEY, DALE",3404 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154475424,FORSYTH COUNTY,FORSYTH COUNTY,799 HIGHLAND AVE   WINSTON SALEM NC,034,Forsyth,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487311783,"MITCHELL, ANGELA, YEVETTE",799 HIGHLAND AVE   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 25 , 41 ,$#,,
MEDICAID DIRECT,1508942848,ALBEMARLE REGIONAL HEALTH SERVICES,PASQUOTANK COUNTY HEALTH DEPARTMENT,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487312013,"SUTTON, ALIVIA, ANNIE",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1659468130,ALBEMARLE REGIONAL HEALTH SERVICES,ALBEMARLE REGIONAL HEALTH SERVICES,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487312013,"SUTTON, ALIVIA, ANNIE",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 28 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487318259,"ROBERTS, ANDREA",3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,1914 MCKINNEY ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487319588,"ATAIDE PITHAN, SILVIA",1914 MCKINNEY ST   BURLINGTON NC,001,Alamance,1223D0001X,Dental Providers,Dentist,Dental Public Health, 656 , 713 ," 2,244 "," $83,701.96 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487322384,"GALLAGHER, KATHERINE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487322384,"GALLAGHER, KATHERINE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487322384,"GALLAGHER, KATHERINE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487322574,"LIPSKE, CHRISTINE, ELIZABETH",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 11 , 16 , 40 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487327102,"ROBBINS, HANNAH, MARIE",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1801261391,BLUE RIDGE COMMUNITY HEALTH SERVICE,SEVENTH AVENUE HEALTH CENTER,628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487327102,"ROBBINS, HANNAH, MARIE",628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 13 , 38 , 38 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487327532,"MAHARJAN, SUMAN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 71 , 91 , 91 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1487329298,"FISK, HOLLY, ANN",338 DEERFIELD RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 21 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,338 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1487329298,"FISK, HOLLY, ANN",338 DEERFIELD RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487339974,"GOOTS, JAMES, THADDEUS",,3002 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,1487339974,"GOOTS, JAMES, THADDEUS",3002 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice, 158 , 376 , 982 ," $45,649.33 ",,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487346334,"PARKINSON, JORDAN, TAYLOR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487356978,"PATEL, SEEMABEN, K",3801 W MARKET ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487356978,"PATEL, SEEMABEN, K",3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 21 , 60 ,$#,,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487356978,"PATEL, SEEMABEN, K",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 166 , 624 ," 1,353 "," $12,387.97 ",,
MEDICAID DIRECT,1003382839,BETHANY MEDICAL CENTER,,3801 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487356978,"PATEL, SEEMABEN, K",3801 W MARKET ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 152 , 340 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487365151,"ACHEW, KONGIT",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 102 , 889 , 915 ," $36,737.09 ",,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487366175,"KRITES, DANIELLE, LILLIAN",3010 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487366175,"KRITES, DANIELLE, LILLIAN",2909 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487379038,"CLAY, CASSANDRA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487379038,"CLAY, CASSANDRA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487379376,RISE THERAPY LLC,,3077 KELLY PLANTATION RD   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1487379376,RISE THERAPY LLC,3077 KELLY PLANTATION RD   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,, 13 , 188 , 188 ," $17,849.52 ",,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1487380606,"PETTINE, NICOLE, MARIE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1487380606,"PETTINE, NICOLE, MARIE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780399428,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC AUDIOLOGY,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1487380606,"PETTINE, NICOLE, MARIE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1780399428,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC AUDIOLOGY,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1487380606,"PETTINE, NICOLE, MARIE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1124733860,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH AUDIOLOGY,6324 FAIRVIEW RD STE 202 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1487380606,"PETTINE, NICOLE, MARIE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1710609979,NOVANT HEALTH MEDICAL GROUP LLC,NHMG REHABILITATION CLINICS,2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1487380606,"PETTINE, NICOLE, MARIE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487380713,"FELLOWS, JEFFREY, GRAYSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 27 , 27 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1487380713,"FELLOWS, JEFFREY, GRAYSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 140 , 140 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,6000 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487380713,"FELLOWS, JEFFREY, GRAYSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1487380713,"FELLOWS, JEFFREY, GRAYSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 60 , 60 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487380713,"FELLOWS, JEFFREY, GRAYSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 112 , 112 ,$#,,
MEDICAID DIRECT,1487381489,POWER UP THERAPY PC,,6622 GORDON RD STE L WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487381489,POWER UP THERAPY PC,6622 GORDON RD STE L WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,#, 41 , 41 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1487383998,"BURRIS, JACQUELYN, KATHLEEN",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1487383998,"BURRIS, JACQUELYN, KATHLEEN",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386379329,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CARR ELEMENTARY,307 S PINE ST   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487386611,"BIZZARO, DEANNA",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1669221420,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT COMMUNITY PUBLIC CHARTER,185 MARIPOSA RD   STANLEY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487386611,"BIZZARO, DEANNA",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 36 , 36 ," $11,531.88 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487388815,"SZCZEPKOWSKI, KATHERINE, KIM",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 11 , 11 , 24 ,$#,,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 115 ,$#,,
MEDICAID DIRECT,1902631575,MUNAF GASTONIA DMD PLLC,TOOTHTOWN DENTISTRY FOR KIDS,2641 COURT DR STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 238 , 317 ," 2,003 "," $88,838.52 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 22 , 22 , 431 ," $36,232.64 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 24 , 24 , 410 ," $36,244.43 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 13 ,#, 144 ," $11,067.30 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 43 , 43 , 758 ," $61,507.18 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,420 PARK ST STE 101 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",420 PARK ST STE 101 BELMONT NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 12 , 214 ," $13,664.63 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,2700 COLTSGATE RD STE 204 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 92 ,$#,,
MEDICAID DIRECT,1659961399,ZOHAIB MUNAF DMD MBS PLLC,TOOTHTOWN DENTISTRY FOR KIDS,4514 OLD MONROE RD STE CD INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1487391397,"AKINTONDE, CECILIA, FUNMILAYO",4514 OLD MONROE RD STE CD INDIAN TRAIL NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 23 , 23 , 205 ," $13,592.60 ",,
MEDICAID DIRECT,1508942848,ALBEMARLE REGIONAL HEALTH SERVICES,PASQUOTANK COUNTY HEALTH DEPARTMENT,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487396784,"BROWN, CAITLIN, SAWYER",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1841387263,ALBEMARLE REGIONAL HEALTH SERVICES,BERTIE COUNTY HEALTH DEPARTMENT,102 RHODES AVE   WINDSOR NC,008,Bertie,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487396784,"BROWN, CAITLIN, SAWYER",102 RHODES AVE   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1235226630,ALBEMARLE REGIONAL HEALTH SERVICES,CHOWAN COUNTY HEALTH DEPARTMENT,202 W HICKS ST   EDENTON NC,021,Chowan,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487396784,"BROWN, CAITLIN, SAWYER",202 W HICKS ST   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 36 ,$#,,
MEDICAID DIRECT,1659468130,ALBEMARLE REGIONAL HEALTH SERVICES,ALBEMARLE REGIONAL HEALTH SERVICES,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487396784,"BROWN, CAITLIN, SAWYER",202 W HICKS ST   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659468130,ALBEMARLE REGIONAL HEALTH SERVICES,ALBEMARLE REGIONAL HEALTH SERVICES,828 ACADEMY ST S   AHOSKIE NC,046,Hertford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487396784,"BROWN, CAITLIN, SAWYER",828 ACADEMY ST S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487398368,"CHAVIS, LEANNE, KING",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487400834,"KO, JOSEPH, ERIC",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1487400834,"KO, JOSEPH, ERIC",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487400867,INNOVATIVE TRIANGLE THERAPIES,,2918 CEDARWOOD DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487400867,INNOVATIVE TRIANGLE THERAPIES,2918 CEDARWOOD DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 14 , 106 , 145 ,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487402848,"BRIDGES, ROBERT, JOSEPH",303 N 35TH ST   MOREHEAD CITY NC,016,Carteret,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487410957,"LYEW, CALLIE, RUMFELT",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487411559,"FEDUREK, DIANA, LUISA SOJDA",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487411559,"FEDUREK, DIANA, LUISA SOJDA",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 18 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487411559,"FEDUREK, DIANA, LUISA SOJDA",2100 ERWIN RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780090324,NORTH CAROLINA INSTITUTE OF SPORTS,BYOUNG PHYSICAL THERAPY,2121 E WILLIAMS ST STE 108 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1487418851,"CARROLL, TYLER, ALEXANDER",2121 E WILLIAMS ST STE 108 APEX NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487419636,"HEFFELFINGER, JEANI, EDMONDSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487420808,"CORT, NICOLE, TAYLOR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487420808,"CORT, NICOLE, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487421574,"FRITZ, LAURA, BETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 42 , 42 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487424040,"FOGLE, ELIZABETH, JANE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487424040,"FOGLE, ELIZABETH, JANE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487424040,"FOGLE, ELIZABETH, JANE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 42 , 83 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487424040,"FOGLE, ELIZABETH, JANE",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 38 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487429148,"LAMM, RENEE, NICHOLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 196 ," 1,364 "," 1,406 "," $26,512.84 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487429486,"SMITH, AVA, RAE",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487430542,"FRASER, JORDYNN, MICHELLE",1900 RANDOLPH RD STE 1010 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487439162,"SAIEED, KASSIANE, SALIBA",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487439162,"SAIEED, KASSIANE, SALIBA",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487480984,JADA OPTICAL HOLDINGS INC,JABI OPTICS,152 BAKER RD   HIGH POINT NC,076,Randolph,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1487480984,JADA OPTICAL HOLDINGS INC,152 BAKER RD   HIGH POINT NC,076,Randolph,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1407117948,REGIONAL MEDICAL ONCOLOGY CENTER PA,~,2624 ORTHO DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1487492617,"RODRIGUEZ, CHRISTINE, AMANDA",2624 ORTHO DR W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 61 , 140 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487492682,"KDEISS, BIANCA, RAE",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 23 ,$#,,
MEDICAID DIRECT,1821240995,WESTGATE DERMATOLOGY AND LASER CENT,WESTGATE DERMATOLOGY AND LASER CENTER PA,2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487493912,"MCLEROY, KRISTEN, BLANCHE TALTY",2020 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487498754,"OZODIGWE, SOMGOLIE, ONYINYE",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1033420153,COASTAL HORIZONS CENTER INC,COASTAL HORIZONS CENTER INC,120 COASTAL HORIZONS DR   SHALLOTTE NC,010,Brunswick,251S00000X,Agencies,Community/Behavioral Health,,1487600631,"JAZAYERI, ANNA MARGARET, CHAUNCEY",120 COASTAL HORIZONS DR   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1487600821,"MERRICK III, HOMER, CURTISS",458 HIGHWAY 70 E   SEA LEVEL NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 72 , 87 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1487600821,"MERRICK III, HOMER, CURTISS",458 HIGHWAY 70 E   SEA LEVEL NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 80 , 107 ,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487600862,"ROOKER, SARA",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487602561,"WOOD, RICHARD, KEVIN",10207 CERNY ST   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487602561,"WOOD, RICHARD, KEVIN",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487602561,"WOOD, RICHARD, KEVIN",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487602561,"WOOD, RICHARD, KEVIN",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487602561,"WOOD, RICHARD, KEVIN",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 35 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487602561,"WOOD, RICHARD, KEVIN",2100 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487602934,"FLYNN, JOSEPH, PATRICK",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1487602934,"FLYNN, JOSEPH, PATRICK",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487602934,"FLYNN, JOSEPH, PATRICK",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487602934,"FLYNN, JOSEPH, PATRICK",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1487602934,"FLYNN, JOSEPH, PATRICK",2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 51 , 62 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487602934,"FLYNN, JOSEPH, PATRICK",2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871640458,HOSPICE OF THE PIEDMONT INC,HOSPICE OF THE PIEDMONT INC,1801 WESTCHESTER DR   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1487603502,"SHEVLIN, PATRICIA, ANN",416 VISION DR HOSPICE OF RANDOLPH COUNTY INC ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487603700,"BROWN, MARK, STEVEN",300 HEALTH PARK DR STE 210 GARNER NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487603700,"BROWN, MARK, STEVEN",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 15 , 24 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487603700,"BROWN, MARK, STEVEN",835 WAKE FOREST BUSINESS PARK STE B WAKE FOREST NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487604088,"GLASSMAN, STEVEN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 34 , 43 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1487605077,"PINNIX BAILEY, LAROSA, P",291 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 336 , 340 ," 1,192 "," $32,027.71 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1487605077,"PINNIX BAILEY, LAROSA, P",291 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1487606943,"JACKSON JR, KENNETH, WADE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics, 13 , 21 , 25 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487606943,"JACKSON JR, KENNETH, WADE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487606943,"JACKSON JR, KENNETH, WADE",50 HOSPITAL DR STE 4A HENDERSONVILLE NC,045,Henderson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1487606943,"JACKSON JR, KENNETH, WADE",50 HOSPITAL DR STE 4A HENDERSONVILLE NC,045,Henderson,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics,#,#,#,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487608105,"MAMEDI, VIJAYALAKSHMI",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487608105,"MAMEDI, VIJAYALAKSHMI",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 224 , 488 , 511 ," $19,848.27 ",,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487608105,"MAMEDI, VIJAYALAKSHMI",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487608154,"SINGH, HARMOHAN",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1962926451,SOUTHEASTERN REGIONAL MEDICAL CENTE,SRMC-INTENSIVISTS,300 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1487608154,"SINGH, HARMOHAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447462643,WAKE OPTHALMOLOGY ASSOCIATES PA,WAKE OPTHALMOLOGY ASSOCIATES PA,105 SW CARY PKWY STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1487608469,"RUSINEK, CHRISTOPHER, STANLEY",105 SW CARY PKWY STE 200 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 36 , 47 , 70 ,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487608725,"KETHEESWARAN, MARKANDU",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 50 , 133 , 133 ,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487608725,"KETHEESWARAN, MARKANDU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 12 , 21 , 21 ,$#,,
MEDICAID DIRECT,1215933239,TRINITY HEMATOLOGY AND ONCOLOGY CEN,TRINITY HEMATOLOGY AND ONCOLOGY CENTER PA,1209 CAPE CT   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487608725,"KETHEESWARAN, MARKANDU",1209 CAPE CT   FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 50 , 59 ,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1487608725,"KETHEESWARAN, MARKANDU",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 20 , 36 , 36 ,$#,,
MEDICAID DIRECT,1386121929,HARNETT HEALTH SYSTEM INC,CANCER CENTER AT CENTRAL HARNETT HOSPITAL,215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487608725,"KETHEESWARAN, MARKANDU",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487609145,"ROURK, ROBERT, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 49 , 64 , 64 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487609145,"ROURK, ROBERT, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487609145,"ROURK, ROBERT, MICHAEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 44 , 44 , 63 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487609145,"ROURK, ROBERT, MICHAEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 13 , 15 , 20 ,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487609319,"MCGRATH, JAMES, GERARD",2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 81 , 158 , 208 ,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487609319,"MCGRATH, JAMES, GERARD",2525 COURT DR   GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 23 , 72 , 76 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487609566,"SLADICKA, STEPHEN, JOSEPH",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720247570,CAROLINA THERAPEUTIC SERVICES INC,~,1528 UNION RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487609863,"SMITH-HARTNESS, JUNE, DURRELL",1528 UNION RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 32 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,2001 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487610259,"GALAWAY, JENNIFER, LEE",2001 N CHURCH ST   GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 183 , 330 , 413 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487610259,"GALAWAY, JENNIFER, LEE",1680 WESTBROOK AVE   BURLINGTON NC,001,Alamance,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 192 , 398 , 497 ,$#,,
MEDICAID DIRECT,1952614620,MOSES CONE AFFILIATED PHYSICIANS IN,TRIAD FOOT AND ANKLE CENTER,600 W SALISBURY ST STE D ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1487610259,"GALAWAY, JENNIFER, LEE",600 W SALISBURY ST STE D ASHEBORO NC,076,Randolph,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487610713,"WHEELER, ANTHONY, HALLOCK",3604 PETERS CT   HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487610713,"WHEELER, ANTHONY, HALLOCK",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487610713,"WHEELER, ANTHONY, HALLOCK",3610 PETERS CT   HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487610713,"WHEELER, ANTHONY, HALLOCK",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 211 ," 1,587 "," 2,417 "," $29,332.93 ",,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1487613840,"OKWARA, BENEDICT, ONWUKWE",9040 NATIONS FORD RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 107 , 343 ,$#,,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1487613840,"OKWARA, BENEDICT, ONWUKWE",2938 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 102 , 264 , 730 ," $10,532.13 ",,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1487613840,"OKWARA, BENEDICT, ONWUKWE",404 S SUTHERLAND AVE   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 381 ," 2,034 "," 4,024 "," $58,695.58 ",,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1487613840,"OKWARA, BENEDICT, ONWUKWE",1426 E MAIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 271 , 834 ," $12,370.24 ",,
MEDICAID DIRECT,1689635237,FIRST CARE MEDICAL CLINIC,~,404 S SUTHERLAND AVE   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1487613840,"OKWARA, BENEDICT, ONWUKWE",1462 CONSTITUTION BLVD   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992085971,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SOUTH CHARLOTTE ENDOCRINOLOGY,15825 BALLANTYNE MEDICAL PL STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487614772,"NARASIMHAN, KANAKASABAI, LAKSHMI",15825 JOHN J DELANEY DR STE 220B CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487614772,"NARASIMHAN, KANAKASABAI, LAKSHMI",15825 JOHN J DELANEY DR STE 220B CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 35 , 63 , 162 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487617510,"SIMPSON, JOSEPH, PAUL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487617510,"SIMPSON, JOSEPH, PAUL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487617510,"SIMPSON, JOSEPH, PAUL",431 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 25 , 29 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487617510,"SIMPSON, JOSEPH, PAUL",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487617510,"SIMPSON, JOSEPH, PAUL",431 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 21 , 25 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487617619,"RUSSELL, DOUGLAS, BLANE",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 43 , 45 ,$#,,
MEDICAID DIRECT,1689779720,ASHEBORO EMERGENCY PHYSICIANS PA,RANDOLPH HOSPITAL,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1487617619,"RUSSELL, DOUGLAS, BLANE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1487617619,"RUSSELL, DOUGLAS, BLANE",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801095641,GASTROENTEROLOGY AND HEPATOLOGY CON,~,10540 LIGON MILL RD STE 109 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1487617858,"AL SABBAGH, GHASSAN",10540 LIGON MILL RD   WAKE FOREST NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 106 , 215 , 228 ,$#,,
MEDICAID DIRECT,1801095641,GASTROENTEROLOGY AND HEPATOLOGY CON,~,10540 LIGON MILL RD STE 109 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1487617858,"AL SABBAGH, GHASSAN",2301 REXWOODS DR STE 100 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487620654,"BYRUM, ROBERT, STUART",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487620654,"BYRUM, ROBERT, STUART",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 72 , 100 , 111 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487620654,"BYRUM, ROBERT, STUART",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 57 , 143 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487620654,"BYRUM, ROBERT, STUART",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 21 , 33 , 55 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487620654,"BYRUM, ROBERT, STUART",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255054623,ASHE MULTISPECIALTY GROUP LLC,ASHE WOMEN AND CHILDRENS HEALTH,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1487620951,"LANG, GREGORY, TODD",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487621249,"WEISER, MARK, ROBERT",4705 S HIGHWAY 150 STE B&C LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487621249,"WEISER, MARK, ROBERT",110 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 160 , 269 ,$#,,
MEDICAID DIRECT,1295496495,LAURENCE R MESTER JR DDS & ASS III,FAYETTEVILLE FAMILY DENTAL,3218 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1487623138,"MESTER, LAURENCE, ROBERT",3218 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice," 2,705 "," 4,834 "," 15,428 "," $726,693.79 ",,
MEDICAID DIRECT,1316294762,LAURENCE R MESTER JR DDS AND ASSOCI,BAYWOOD FAMILY DENTAL,124 BAYWOOD RD STE 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487623138,"MESTER, LAURENCE, ROBERT",3218 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1316294762,LAURENCE R MESTER JR DDS AND ASSOCI,BAYWOOD FAMILY DENTAL,124 BAYWOOD RD STE 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487623138,"MESTER, LAURENCE, ROBERT",124 BAYWOOD RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice," 2,009 "," 3,843 "," 12,194 "," $613,458.31 ",,
MEDICAID DIRECT,1295496495,LAURENCE R MESTER JR DDS & ASS III,FAYETTEVILLE FAMILY DENTAL,3218 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487623138,"MESTER, LAURENCE, ROBERT",3218 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 277 , 493 ," 1,373 "," $66,768.39 ",,
MEDICAID DIRECT,1295496495,LAURENCE R MESTER JR DDS & ASS III,FAYETTEVILLE FAMILY DENTAL,3218 BRAGG BLVD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487623138,"MESTER, LAURENCE, ROBERT",124 BAYWOOD RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 40 ,$#,,
MEDICAID DIRECT,1912225996,LAURENCE R MESTER JR DDS AND ASSOCI,CAROLINA LAKES FAMILY DENTAL,468 NC 24-87   CAMERON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487623138,"MESTER, LAURENCE, ROBERT",468 NC 24-87   CAMERON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice," 1,388 "," 2,584 "," 6,733 "," $355,462.73 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487624326,"MAURO, PATRICIA, MARCHASE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487624326,"MAURO, PATRICIA, MARCHASE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1740265644,NEW HORIZONS SURGICAL EYE CENTERS P,,810 ELM ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1487624441,"GEIGER, JAMES, MICHAEL",810 ELM ST   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 41 , 68 ,$#,,
MEDICAID DIRECT,1740265644,NEW HORIZONS SURGICAL EYE CENTERS P,,810 ELM ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1487624441,"GEIGER, JAMES, MICHAEL",2183 JAMES B WHITE HWY N STE B WHITEVILLE NC,024,Columbus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 27 , 38 ,$#,,
MEDICAID DIRECT,1760423503,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS GASTROENTEROLOGY,853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487625471,"LIJEWSKI, MARK, ALLEN",853 N CHURCH ST STE 620 SPARTANBURG SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1811024961,PROFESSIONAL EYE CARE OPTOMETRY PA,PROFESSIONAL EYE CARE OPTOMETRY PA,3701 S MAIN ST   HOPE MILLS NC,026,Cumberland,193400000X,Group,Single Specialty,,1487626263,"MASTERS, MARY, ANN",3701 S MAIN ST   HOPE MILLS NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1811024961,PROFESSIONAL EYE CARE OPTOMETRY PA,PROFESSIONAL EYE CARE OPTOMETRY PA,3701 S MAIN ST   HOPE MILLS NC,026,Cumberland,193400000X,Group,Single Specialty,,1487626263,"MASTERS, MARY, ANN",432 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,152W00000X,Eye and Vision Services Providers,Optometrist,, 36 , 40 , 57 ,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487626560,"HUFFMON III, GEORGE, VANBUREN",2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 26 , 34 , 41 ,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487626602,"MORACE, ARMOND, WINDELL",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 104 , 178 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487626784,"PARK, TED, ANTHONY",920 CHURCH ST N STE 255B CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 89 , 307 , 307 ," $13,470.48 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487626784,"PARK, TED, ANTHONY",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487628285,"BERLINER, STEVEN, HARVEY",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487628285,"BERLINER, STEVEN, HARVEY",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487628285,"BERLINER, STEVEN, HARVEY",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487628285,"BERLINER, STEVEN, HARVEY",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 49 , 67 , 89 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487628285,"BERLINER, STEVEN, HARVEY",324 N QUEEN ST   KINSTON NC,054,Lenoir,207VX0000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Obstetrics, 19 , 28 , 43 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487628285,"BERLINER, STEVEN, HARVEY",1140 CARTHAGE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487628285,"BERLINER, STEVEN, HARVEY",1140 CARTHAGE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 41 , 45 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487628285,"BERLINER, STEVEN, HARVEY",1140 CARTHAGE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 24 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1261 JULIAN ALLSBRK HWY   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",1261 JULIAN ALLSBRK HWY   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 33 , 58 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 20 , 50 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 34 , 64 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 49 , 116 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1487628376,"SIMS, TOMMY, LEE",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487628657,"KANNAN, TAMILARASI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 22 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487628657,"KANNAN, TAMILARASI",8420 UNIVERSITY EXEC PARK DR STE 850 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 160 , 429 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487628723,"WEBER, THOMAS, NELSON",3213 ROGERS RD   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 26 , 51 ,$#,,
MEDICAID DIRECT,1487629044,RALEIGH NC ENDOSCOPY ASC LLC,RALEIGH ENDOSCOPY CENTER,2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1487629044,RALEIGH NC ENDOSCOPY ASC LLC,2417 ATRIUM DR STE 101 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 12 , 13 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487629929,"RIESZ, DAVID, ALAN",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487629929,"RIESZ, DAVID, ALAN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487629929,"RIESZ, DAVID, ALAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 178 , 243 , 431 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487630125,"SELLERS, TRAVELLA, A",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 13 , 15 , 28 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487630125,"SELLERS, TRAVELLA, A",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2130 FOREST HILLS RD W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487630125,"SELLERS, TRAVELLA, A",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 20 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 52 , 74 , 115 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 74 , 84 , 139 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487630125,"SELLERS, TRAVELLA, A",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487630125,"SELLERS, TRAVELLA, A",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487630125,"SELLERS, TRAVELLA, A",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 36 , 48 , 80 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 90 , 119 , 231 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2701 NEW BERN AVE   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 66 , 75 , 143 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2701 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2701 NEW BERN AVE   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 17 , 18 , 47 ,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2130 FOREST HILLS RD W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2701 NEW BERN AVE   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487630125,"SELLERS, TRAVELLA, A",2701 NEW BERN AVE   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,740 SUTTERS CREEK BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2701 NEW BERN AVE   RALEIGH NC,092,Wake,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1790873503,FOOT AND ANKLE ASSOCIATES OF NC,FOOT AND ANKLE ASSOCIATES OF NC,2130 FOREST HILLS RD W   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1487630125,"SELLERS, TRAVELLA, A",2130 FOREST HILLS RD W   WILSON NC,098,Wilson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1609461748,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH INTERNAL MEDICINE - DR DOUGLAS SCH,237 N FAYETTEVILLE ST STE D ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1487631859,"SCHULTZ, DOUGLAS, ERNST",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 46 ,$#,,
MEDICAID DIRECT,1326623216,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH INTERNAL MEDICINE,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1487631859,"SCHULTZ, DOUGLAS, ERNST",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275128316,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH FAMILY PRACTICE - SEAGROVE,514 N BROAD ST   SEAGROVE NC,076,Randolph,193400000X,Group,Single Specialty,,1487631859,"SCHULTZ, DOUGLAS, ERNST",237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609461748,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH INTERNAL MEDICINE - DR DOUGLAS SCH,237 N FAYETTEVILLE ST STE D ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1487631859,"SCHULTZ, DOUGLAS, ERNST",237 N FAYETTEVILLE ST STE D ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 170 , 284 ,$#,,
MEDICAID DIRECT,1346279445,FHPG LLC,MONTGOMERY MEMORIAL HOSPITAL,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1487632063,"BURGOON, KAREN, SUE",615 RIDGE RD   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487632063,"BURGOON, KAREN, SUE",615 RIDGE RD   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 102 , 102 ,$#,,
MEDICAID DIRECT,1346279445,FHPG LLC,MONTGOMERY MEMORIAL HOSPITAL,520 ALLEN ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1487632063,"BURGOON, KAREN, SUE",520 ALLEN ST   TROY NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487632360,"RISINGER, APRIL, MYERS",4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487632360,"RISINGER, APRIL, MYERS",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 30 , 69 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487632360,"RISINGER, APRIL, MYERS",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487632733,"PALMQUIST, FREDERICK, VICTOR",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 109 , 115 , 126 ,$#,,
MEDICAID DIRECT,1598743981,REHABILITATION MEDICINE AND PAIN CE,REHABILITATION MEDICINE AND PAIN CENTER PC,114 WELTON WAY STE A MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1487632881,"GOODSON, MARK, ALLEN",114 WELTON WAY STE A MOORESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 18 , 67 , 80 ,$#,,
MEDICAID DIRECT,1487632998,GENEDX LLC,~,207 PERRY PKWY   GAITHERSBURG MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1487632998,GENEDX LLC,207 PERRY PKWY   GAITHERSBURG MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 378 , 397 , 578 ," $2,259,637.47 ",,
MEDICAID DIRECT,1487632998,GENEDX LLC,~,205 AND 207 PERRY PKWY   GAITHERSBURG MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1487632998,GENEDX LLC,205 AND 207 PERRY PKWY   GAITHERSBURG MD,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487633590,"RHEINECKER, SCOT, BRADLEY",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 45 , 92 ,$#,,
MEDICAID DIRECT,1770878399,CRAIG S CARTER MD FACS PA,CRAIG S CARTER MD FACS PA,2076 NC HIGHWAY 42 W STE 240 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1487636106,"CARTER, CRAIG, STEVEN",2076 NC HIGHWAY 42 W STE 240 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 98 , 196 , 278 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487636916,"DUNCAN, MELISSA, BRULEY",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 32 , 31 , 37 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1487636916,"DUNCAN, MELISSA, BRULEY",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 58 , 66 , 88 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487637047,"HOLLIFIELD, THOMAS, RYAN",101 DELTA PARK DR   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 110 , 179 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487637534,"ZERI, RICHARD, STEPHEN",517 MOYE BLVD FL 3 GREENVILLE NC,074,Pitt,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487637534,"ZERI, RICHARD, STEPHEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 48 , 59 , 84 ," $13,733.90 ",,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487638045,"SCOTT-LOWE, JANINE, ANITA",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487639381,MEDTOX LABORATORIES INC,~,402 COUNTY ROAD D W   SAINT PAUL MN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1487639381,MEDTOX LABORATORIES INC,402 COUNTY ROAD D W   SAINT PAUL MN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 506 , 644 , 961 ," $57,229.04 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487639464,"ALLEN, ELIZABETH, COBEY",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 23 , 37 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1487639472,"FISCHER, VIVIAN, GAIL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487639472,"FISCHER, VIVIAN, GAIL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 25 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1487639472,"FISCHER, VIVIAN, GAIL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 27 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487639472,"FISCHER, VIVIAN, GAIL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 55 , 152 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487639472,"FISCHER, VIVIAN, GAIL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487639472,"FISCHER, VIVIAN, GAIL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 24B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487639472,"FISCHER, VIVIAN, GAIL",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487641007,"PRITCHETT, PAMELA, JEAN",1223 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609467760,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1201 VILLAGE HARBOR DR STE 104 CLOVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487641007,"PRITCHETT, PAMELA, JEAN",1201 VILLAGE HARBOR DR STE 104 LAKE WYLIE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487643581,"MUEKSCH, JOSEF, NILE",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 63 , 68 ,$#,,
MEDICAID DIRECT,1235189739,ATLANTIC GASTROENTEROLOGY ENDOSCOPY,ATLANTIC GASTROENDOSCOPY CENTER,2465 EMERALD PL   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1487643854,"FOUNTAIN, RAETTA, BEVAN",2465 EMERALD PL   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 31 , 39 ,$#,,
MEDICAID DIRECT,1740238435,ATLANTIC GASTROENTEROLOGY PA,~,2465 EMERALD PL   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487643854,"FOUNTAIN, RAETTA, BEVAN",2465 EMERALD PL   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 47 , 91 , 101 ,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1487645719,"CASSELL, IAN, LESLIE S.",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1689209553,MURPHY MEDICAL CENTER INC,,125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1487645743,"STROUP, DANIEL, FOSTER",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 37 , 37 ,$#,,
MEDICAID DIRECT,1538131800,CABARRUS PATHOLOGY ASSOCIATES,CABARRUS PATHOLOGY ASSOCIATES PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487646774,"PILLER, CHRISTINE, FRANCES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 38 , 37 , 84 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487647046,"CLEMENTS, DAVID, ALDAY",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 58 , 185 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1487647632,"TEEL, ALFONZA",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487647632,"TEEL, ALFONZA",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487647780,"SOBEL, AMY, HERBSTMAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 55 ,$#,,
MEDICAID DIRECT,1962522359,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193400000X,Group,Single Specialty,,1487647848,"LEE, BENJAMIN, FRANKLIN",7020 SIX FORKS RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962522359,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193400000X,Group,Single Specialty,,1487647848,"LEE, BENJAMIN, FRANKLIN",1904 GRAHAM AVE   HENDERSON NC,091,Vance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487649091,"BOUDREAUX, STACI, SIMON",63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1487649091,"BOUDREAUX, STACI, SIMON",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487649091,"BOUDREAUX, STACI, SIMON",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487649091,"BOUDREAUX, STACI, SIMON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 22 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487649513,"MONROE, RICKIE, KELVIN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487649513,"MONROE, RICKIE, KELVIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 91 , 96 , 99 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487650289,"THOMPSON, ANGELA, JEAN",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 32 , 32 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487650289,"THOMPSON, ANGELA, JEAN",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487650289,"THOMPSON, ANGELA, JEAN",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487650289,"THOMPSON, ANGELA, JEAN",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1487651535,"VASEY, CHARLES, GIBBS",125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1487651535,"VASEY, CHARLES, GIBBS",127 WAMSUTTA MILL RD STE D MORGANTON NC,012,Burke,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1487651535,"VASEY, CHARLES, GIBBS",127 WAMSUTTA MILL RD STE D MORGANTON NC,012,Burke,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1487652178,"ROSE, GREGORY, CHARLES",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1487652178,"ROSE, GREGORY, CHARLES",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487652178,"ROSE, GREGORY, CHARLES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 19 , 22 , 32 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1487652178,"ROSE, GREGORY, CHARLES",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,110 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487652178,"ROSE, GREGORY, CHARLES",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487652178,"ROSE, GREGORY, CHARLES",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 , 13 , 21 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,5200 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1487652558,"COMEAU, WILLIAM, RAYMOND",1144 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487652558,"COMEAU, WILLIAM, RAYMOND",1144 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487653416,"SMITH, ELTON, TRAVIS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#, 11 , 32 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487653416,"SMITH, ELTON, TRAVIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 28 , 30 , 81 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1487653911,"HWANG, JIMMY, JOHN",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487653911,"HWANG, JIMMY, JOHN",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 16 , 38 , 38 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1487654240,"GROSS, ROBERT, ALLEN",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 29 ,$#,,
MEDICAID DIRECT,1205113248,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS PRIMARY CARE,3109 CASEY ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487655106,"WILSON, ASHLEY, SMITH",3109 CASEY ST   LORIS SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689673279,PIEDMONT NEPHROLOGY AND HYPERTENSIO,~,1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1487655452,"HIGERD, MICHELE, LYNN",352 E PARKER RD STE B MORGANTON NC,012,Burke,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 40 , 42 ,$#,,
MEDICAID DIRECT,1689673279,PIEDMONT NEPHROLOGY AND HYPERTENSIO,~,1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1487655452,"HIGERD, MICHELE, LYNN",1899 TATE BLVD SE STE 2101 HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 77 , 308 , 331 ," $10,337.89 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487658415,"EVANS, SUSAN, LYNNE",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487658415,"EVANS, SUSAN, LYNNE",9 MEDICAL DR   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 104 , 139 , 158 ," $11,890.31 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3708 MAYFAIR ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 661 ," 1,064 "," 1,130 "," $11,489.00 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,34 HEALTHPARK WAY STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,37 PINEVILLE BLVD STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1487660171,"HAZELTON, TODD, RICHARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487662003,"GUPTA, SUMIT, KUMAR",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 190 , 260 , 362 ," $12,562.55 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487662003,"GUPTA, SUMIT, KUMAR",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1487664033,MORGANTON EYE PHYSICIANS PA,~,1622 E MARION ST   SHELBY NC,023,Cleveland,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician,1487664033,MORGANTON EYE PHYSICIANS PA,1622 E MARION ST   SHELBY NC,023,Cleveland,156FX1800X,Eye and Vision Services Providers,Technician/Technologist,Optician, 182 , 183 , 366 ,$#,,
MEDICAID DIRECT,1720292261,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,50 HOSPITAL DR STE 5A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1487667150,"TRAVIS, GERALD, WAYNE",3 CARSON CREEK DR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#, 14 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487667218,"SAUTER, PATRICIA, KAL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487667218,"SAUTER, PATRICIA, KAL",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",201 E GROVER ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",1100 N LAFAYETTE ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",1001 N WASHINGTON ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 77 , 114 , 298 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",201 E GROVER ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",1001 N WASHINGTON ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 28 , 35 , 83 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 25 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 21 , 40 , 116 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487667424,"BRAME, MICHAEL, EUGENE",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 15 , 43 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487667663,"SEEN, NELSON, DER",111 W GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1225500804,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,170 CHURCH ST   FRANKLIN NC,056,Macon,251B00000X,Agencies,Case Management,,1487667788,"ARUWANI, VERSI, MAL",55 MEDICAL PARK DR STE 116 FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003014770,KRISHNA INTERNAL MEDICINE PC,WAYAH INTERNAL MEDICINE,55 MEDICAL PARK DR STE 116 FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1487667788,"ARUWANI, VERSI, MAL",55 MEDICAL PARK DR STE 116 FRANKLIN NC,056,Macon,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 183 , 250 ,$#,,
MEDICAID DIRECT,1487669339,INGLES MARKETS INC,INGLES PHARMACY 177,220 N HIGHLAND LAKE RD   FLAT ROCK NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1487669339,INGLES MARKETS INC,220 N HIGHLAND LAKE RD   FLAT ROCK NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1801126479,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST UROLOGY,320 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1487669966,"GLINSKI, RONALD, PETER",720 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 20 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1403 S KING ST   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1487670683,"MARLOWE, ASHLEY, LANG",1403 S KING ST   WINDSOR NC,008,Bertie,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487670683,"MARLOWE, ASHLEY, LANG",203 EARNHART DR STE B EDENTON NC,021,Chowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 62 , 77 , 88 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,220 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1487670683,"MARLOWE, ASHLEY, LANG",211 VIRGINIA RD   EDENTON NC,021,Chowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203 EARNHART DR STE A EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1487670683,"MARLOWE, ASHLEY, LANG",203 EARNHART DR STE B EDENTON NC,021,Chowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487672598,"BRITT, JOAN, DAVIN",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487673240,"MELUCH, ANTHONY, MATTHEW",752 HARTNESS RD   STATESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 90 , 96 , 97 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487673869,"WHITE, DAVID, CLOID",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 56 , 56 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487673869,"WHITE, DAVID, CLOID",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 24 , 29 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487673869,"WHITE, DAVID, CLOID",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 57 , 71 ," $10,011.69 ",,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487674347,"PETERSON, CATHERINE, CANT",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD STE M201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487674347,"PETERSON, CATHERINE, CANT",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 44 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487674420,"VORHIS, ELIZABETH, BRAY",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487674578,"BREWER, MINDY, SHERYL",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1265513329,ALBEMARLE REGIONAL HEALTH SERVICES,CAMDEN COUNTY HEALTH DEPARTMENT,160 US HIGHWAY 158 E BLDG B CAMDEN NC,015,Camden,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487675138,"STEVENSON, PAUL, LINDSAY",160 US HIGHWAY 158 E BLDG B CAMDEN NC,015,Camden,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1235226630,ALBEMARLE REGIONAL HEALTH SERVICES,CHOWAN COUNTY HEALTH DEPARTMENT,202 W HICKS ST   EDENTON NC,021,Chowan,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487675138,"STEVENSON, PAUL, LINDSAY",202 W HICKS ST   EDENTON NC,021,Chowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487675138,"STEVENSON, PAUL, LINDSAY",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 47 , 58 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487675138,"STEVENSON, PAUL, LINDSAY",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1508942848,ALBEMARLE REGIONAL HEALTH SERVICES,PASQUOTANK COUNTY HEALTH DEPARTMENT,711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487675138,"STEVENSON, PAUL, LINDSAY",711 ROANOKE AVE   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 37 , 62 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487675138,"STEVENSON, PAUL, LINDSAY",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487675534,"WEISNER, JENNIFER, HUDSON",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 37 ,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,927 BOSTON DR # D3 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487677225,"BESHARAT, MOJGAN",927 BOSTON DR # D3 BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487677225,"BESHARAT, MOJGAN",302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487677225,"BESHARAT, MOJGAN",927 BOSTON DR # D3 BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487677225,"BESHARAT, MOJGAN",6910 FAYETTEVILLE RD STE 296 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487677407,"WALL, BENJAMIN, EVANS",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 41 , 122 , 129 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487677407,"WALL, BENJAMIN, EVANS",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487677407,"WALL, BENJAMIN, EVANS",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 44 , 44 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487677407,"WALL, BENJAMIN, EVANS",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487678439,"SING, RONALD, FONG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 51 , 134 , 138 ," $11,569.08 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487680799,"TOLBERT, ANTONINETTE, RACINE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE D HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487681003,"PARSONS, CHRISTOPHER, HAMILTON",705 6TH AVE W STE D HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 29 , 29 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487681003,"PARSONS, CHRISTOPHER, HAMILTON",705 6TH AVE W STE D HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE D HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487681003,"PARSONS, CHRISTOPHER, HAMILTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487681003,"PARSONS, CHRISTOPHER, HAMILTON",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 37 , 40 ,$#,,
MEDICAID DIRECT,1992881254,VALERIE C POLLOCK DDS PA,VALERIE C POLLOCK DDS PA,302 S BENNETT ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1487681128,"BRADDY, CLAUDE, JEFFREY",302 S BENNETT ST   BURGAW NC,071,Pender,1223G0001X,Dental Providers,Dentist,General Practice, 709 ," 1,427 "," 4,755 "," $214,809.42 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487681276,"DUFFEY, JANE, SHROPSHIRE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 79 , 99 , 110 ,$#,,
MEDICAID DIRECT,1023349404,NOVANT HEALTH MEDICAL GROUP LLC,~,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487681276,"DUFFEY, JANE, SHROPSHIRE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487683009,"BENNETT, MICHAEL, BRUCE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487683009,"BENNETT, MICHAEL, BRUCE",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508894239,SANFORD SANDHILLS EMERGENCY PHYSICI,~,628 EAST ST STE B PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1487685616,"POWELL, RONALD, JONES",628 EAST ST STE B PITTSBORO NC,019,Chatham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1508894239,SANFORD SANDHILLS EMERGENCY PHYSICI,~,3072 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1487685616,"POWELL, RONALD, JONES",3072 S HORNER BLVD   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1508894239,SANFORD SANDHILLS EMERGENCY PHYSICI,~,628 EAST ST STE B PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1487685616,"POWELL, RONALD, JONES",3072 S HORNER BLVD   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487686176,"JAIN, ASTRID, GENDA",7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487686176,"JAIN, ASTRID, GENDA",7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487686176,"JAIN, ASTRID, GENDA",1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,7810 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487686176,"JAIN, ASTRID, GENDA",7810 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366779928,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487686176,"JAIN, ASTRID, GENDA",7810 PROVIDENCE RD STE 105 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487686564,"EVANOFF, ALLISON, MARIE",2290 REMOUNT RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487686564,"EVANOFF, ALLISON, MARIE",885 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1487690723,"HILL, ALLEN, CHRISTIAN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1043080732,ACCESS CARE ANESTHESIA OF NORTH CAR,,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487690723,"HILL, ALLEN, CHRISTIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 121 , 141 , 143 ,$#,,
MEDICAID DIRECT,1043080732,ACCESS CARE ANESTHESIA OF NORTH CAR,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487690723,"HILL, ALLEN, CHRISTIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487690723,"HILL, ALLEN, CHRISTIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 12 , 12 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487691010,"BOWLING, CYNTHIA, LINSZ",736 BATTLEFIELD BLVD N FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1487691390,YADKIN PHYSICAL THERAPY LLC,~,102 WOODLYN DR   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1487691390,YADKIN PHYSICAL THERAPY LLC,102 WOODLYN DR   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1487692851,DYMOND SPEECH AND REHAB PA,DYMOND SPEECH AND REHAB PA,113 HILLCREST DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1487692851,DYMOND SPEECH AND REHAB PA,113 HILLCREST DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,, 63 , 697 , 814 ," $54,394.62 ",,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1487693305,"MIMS KIRKMAN, MISSY, ELAINE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 31 ,$#,,
MEDICAID DIRECT,1538214713,CHILDRENS MEDICAL GROUP INC,TIDEWATER CHILDRENS ASSOCIATES,171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487693727,"SEUSY, LATRICIA, BAKER",171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487694360,"MCLAURIN, ROBERT, LOVE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 16 , 53 , 54 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,666 W CORBETT AVE   SWANSBORO NC,067,Onslow,193200000X,Group,Multi-Specialty,,1487695367,"VAN DYKE, LESLIE, IPOCK",666 W CORBETT AVE   SWANSBORO NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487695367,"VAN DYKE, LESLIE, IPOCK",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1487695367,"VAN DYKE, LESLIE, IPOCK",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 22 , 38 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487696100,"PELLETIER, ELIZABETH, ANN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487696365,"PATEL, MANESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487696365,"PATEL, MANESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1487696365,"PATEL, MANESH",5601 ARRINGDON PARK DR # 240 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487696365,"PATEL, MANESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1215990700,ADVANCED DERMATOLOGY AND SKIN SURGE,ADVANCED DERMATOLOGY AND SKIN SURGERY PA,16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487696605,"RACKOFF, ELISE, MARIE JACKSON",16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1487696936,"KLENZAK, SCOTT, MICHAEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487697074,"WILLIAMS, GRANT, DAVID",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487697074,"WILLIAMS, GRANT, DAVID",434 HOSPITAL DR   NEWLAND NC,006,Avery,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 28 , 29 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487697553,"VARGAS, MARCEL, MOSES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 157 , 159 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487697553,"VARGAS, MARCEL, MOSES",507 E FREMONT ST   BURGAW NC,071,Pender,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487697801,"ROACH, MICHAEL, JUDSON",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487697801,"ROACH, MICHAEL, JUDSON",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487697801,"ROACH, MICHAEL, JUDSON",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487697801,"ROACH, MICHAEL, JUDSON",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 23 , 23 ,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487697801,"ROACH, MICHAEL, JUDSON",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487699096,"MANCHIKALAPUDI, PARTHA",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487699096,"MANCHIKALAPUDI, PARTHA",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487699096,"MANCHIKALAPUDI, PARTHA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,37 PINEVILLE BLVD STE 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1487700449,"HARRIS, TASHA, JEAN",37 PINEVILLE BLVD STE 101 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 117 , 190 ,$#,,
MEDICAID DIRECT,1487700597,GOLDEN YEARS OF MURPHY INCORPORATED,~,518 W US HIGHWAY 64   MURPHY NC,020,Cherokee,253Z00000X,Agencies,In Home Supportive Care,,1487700597,GOLDEN YEARS OF MURPHY INCORPORATED,518 W US HIGHWAY 64   MURPHY NC,020,Cherokee,253Z00000X,Agencies,In Home Supportive Care,, 49 ," 8,061 "," 8,061 "," $1,427,998.12 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1487703492,"CAMPAGNA, LARA, KAHLIL",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 148 , 156 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1487703492,"CAMPAGNA, LARA, KAHLIL",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487704763,GENTLE TOUCH HOME CARE LLC,GENTLE TOUCH HOME CARE LLC,4475 US 15 501 HWY   CARTHAGE NC,063,Moore,251B00000X,Agencies,Case Management,,1487704763,GENTLE TOUCH HOME CARE LLC,4475 US 15 501 HWY   CARTHAGE NC,063,Moore,251B00000X,Agencies,Case Management,, 106 ," 1,032 "," 1,032 "," $406,494.00 ",,
MEDICAID DIRECT,1487704763,GENTLE TOUCH HOME CARE LLC,GENTLE TOUCH HOME CARE LLC,4475 US 15 501 HWY   CARTHAGE NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,,1487704763,GENTLE TOUCH HOME CARE LLC,4475 US 15 501 HWY   CARTHAGE NC,063,Moore,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 3,904 "," 4,119 "," $586,076.60 ",,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487704912,"CLELAND ROBERTS, ELIZABETH, BRADLEY",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 23 , 23 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487708137,"KIMBERLEY, LOIS, JEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1487712352,HOME LIFE CARE INC,~,810 W VERNON AVE   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1487712352,HOME LIFE CARE INC,810 W VERNON AVE   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 9,925 "," 9,928 "," $733,400.86 ",,
MEDICAID DIRECT,1962478362,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE,327 1ST AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1487715082,"BAILEY DAY, KAY, LYNN",327 1ST AVE NW   HICKORY NC,018,Catawba,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487715512,"SANDLER, ROBERT, SAMUEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 24 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1487715512,"SANDLER, ROBERT, SAMUEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1487715553,PERSONAL HOMECARE SOLUTIONS INC,PERSONAL HOMECARE SOLUTIONS INC-PHS,1708 WAYNE MEMORIAL DR STE B GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1487715553,PERSONAL HOMECARE SOLUTIONS INC,1708 WAYNE MEMORIAL DR STE B GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 77 ," 16,920 "," 16,922 "," $1,126,507.64 ",,
MEDICAID DIRECT,1487715686,NH MED SERVICES LLC,NH MED SERVICES LLC,17563 S NC HIGHWAY 109   DENTON NC,029,Davidson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487715686,NH MED SERVICES LLC,17563 S NC HIGHWAY 109   DENTON NC,029,Davidson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1487715686,NH MED SERVICES LLC,NH MED SERVICES LLC,17563 S NC HIGHWAY 109   DENTON NC,029,Davidson,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1487715686,NH MED SERVICES LLC,17563 S NC HIGHWAY 109   DENTON NC,029,Davidson,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 24 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487717260,"PERFECT, JOHN, ROBERT",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487717260,"PERFECT, JOHN, ROBERT",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487718938,"BASNETT, BETHANY, RACHEL",121 COUNTRY LN   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 130 , 334 ," $16,870.73 ",,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487718938,"BASNETT, BETHANY, RACHEL",121 COUNTRY LN   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 46 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487718938,"BASNETT, BETHANY, RACHEL",400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 49 , 110 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487718938,"BASNETT, BETHANY, RACHEL",400 E STATESVILLE AVE STE 200 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 26 , 58 ,$#,,
MEDICAID DIRECT,1881144590,SOUTHERN FAMILY MEDICINE INC,~,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487718938,"BASNETT, BETHANY, RACHEL",160 BAKER RD   HIGH POINT NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487723102,"EDWARDS, JAY, FRANK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1487723102,"EDWARDS, JAY, FRANK",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487724142,"JINNAH, RIYAZ, HASSANALI",755 HIGHLAND OAKS DR STE 102 WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 123 , 188 , 259 ,$#,,
MEDICAID DIRECT,1699266742,SOUTHEASTERN REGIONAL PHYSICIAN SER,~,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1487725578,"CHRISTY, WINDY, DOTSON",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487726816,"HO, VICKI, CATHY",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487726816,"HO, VICKI, CATHY",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487726816,"HO, VICKI, CATHY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487726816,"HO, VICKI, CATHY",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487726816,"HO, VICKI, CATHY",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 51 , 51 ,$#,,
MEDICAID DIRECT,1982773206,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1510 NC HIGHWAY 68 N   OAK RIDGE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487727202,"MASNERI, SHANNON, MARIE",1510 NC HIGHWAY 68 N   OAK RIDGE NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487728739,"KONDRU, JAISHEELA",800 TILGHMAN DR   DUNN NC,043,Harnett,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487728739,"KONDRU, JAISHEELA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487729075,IMPACT HOME CARE SERVICES,IMPACT HOME CARE SERVICES,1219 ROCKINGHAM RD STE 9 ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1487729075,IMPACT HOME CARE SERVICES,1219 ROCKINGHAM RD STE 9 ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 3,143 "," 3,143 "," $188,854.52 ",,
MEDICAID DIRECT,1487729075,IMPACT HOME CARE SERVICES,IMPACT HOME CARE SERVICES,213 W CRONLY ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1487729075,IMPACT HOME CARE SERVICES,1219 ROCKINGHAM RD STE 9 ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,, 11 , 495 , 505 ," $46,064.84 ",,
MEDICAID DIRECT,1487729075,IMPACT HOME CARE SERVICES,IMPACT HOME CARE SERVICES,213 W CRONLY ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,,1487729075,IMPACT HOME CARE SERVICES,213 W CRONLY ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 5,406 "," 6,029 "," $581,028.48 ",,
MEDICAID DIRECT,1487729075,IMPACT HOME CARE SERVICES,IMPACT HOME CARE SERVICES,1219 ROCKINGHAM RD STE 9 ROCKINGHAM NC,077,Richmond,253Z00000X,Agencies,In Home Supportive Care,,1487729075,IMPACT HOME CARE SERVICES,213 W CRONLY ST   LAURINBURG NC,083,Scotland,253Z00000X,Agencies,In Home Supportive Care,, 15 , 499 , 499 ," $31,039.68 ",,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487731758,"BOYARSKY, BETH, KRATOCHVIL",447 BILLINGSLEY RD COTTAGE A CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487731949,"CHANG, CATHERINE, LEE",2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1164880571,REX RADIATION ONCOLOGY LLC,UNC REX CANCER CARE OF EAST RALEIGH,117 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487731949,"CHANG, CATHERINE, LEE",117 SUNNYBROOK RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487732632,"LYONS, KATERINA, RUTH",4414 LAKE BOONE TRL STE 205 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487735734,"GERKIN, JONATHAN, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487735866,"ALLEN, DEBRA, COVINGTON",371 NC HIGHWAY 65 STE 204 WENTWORTH NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487736070,"LEE, YEONHEE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 145 , 152 , 170 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487736070,"LEE, YEONHEE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 188 , 198 , 262 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487736708,"NELSON, RICHARD, SCOTT",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487736708,"NELSON, RICHARD, SCOTT",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 59 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487737649,"GOVERT, JOSEPH, ALAN",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 47 , 60 , 114 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487737649,"GOVERT, JOSEPH, ALAN",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487737649,"GOVERT, JOSEPH, ALAN",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487737649,"GOVERT, JOSEPH, ALAN",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 16 , 80 , 81 ,$#,,
MEDICAID DIRECT,1316335128,RAPHA HEALTHCARE SERVICES LLC,,4411 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487739579,"PAVELOCK, RICHARD, MICHAEL",4411 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316335128,RAPHA HEALTHCARE SERVICES LLC,,207 S BROAD ST   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487739579,"PAVELOCK, RICHARD, MICHAEL",207 S BROAD ST   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1487739579,"PAVELOCK, RICHARD, MICHAEL",~,2632 FINES CREEK DR   STATESVILLE NC,049,Iredell,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,1487739579,"PAVELOCK, RICHARD, MICHAEL",2632 FINES CREEK DR   STATESVILLE NC,049,Iredell,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1316335128,RAPHA HEALTHCARE SERVICES LLC,,4701 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1487739579,"PAVELOCK, RICHARD, MICHAEL",300 CORPORATE DR   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487739686,"SEH ACHU, EDWIN",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 217 , 217 ,$#,,
MEDICAID DIRECT,1124115886,DILLON INTERNAL MEDICINE,DILLON INTERNAL MEDICINE ASSOCIATES,705 N 8TH AVE STE 1A DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1487741146,"WALLACE, JAMES, PHILLIP",705 N 8TH AVE STE 1A DILLON SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 110 , 289 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487741591,"THOMPSON, ANNEMARIE",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487741591,"THOMPSON, ANNEMARIE",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487741591,"THOMPSON, ANNEMARIE",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1487743191,A BRIGHTER FUTURE HEALTHCARE SERVIC,,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1487743191,A BRIGHTER FUTURE HEALTHCARE SERVIC,4140 FERNCREEK DR STE 300 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1487743191,A BRIGHTER FUTURE HEALTHCARE SERVIC,,1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1487743191,A BRIGHTER FUTURE HEALTHCARE SERVIC,1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,255 "," 2,255 "," $171,063.92 ",,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1487743571,"ROBERTS, ALICE, JUNE",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1487744306,"MALDONADO, JOSE, LOPEZ",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 48 , 87 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487748448,"ESCALERA, ROBERT",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1487752036,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 00681,2103 TW ALEXANDER DR   MORRISVILLE NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1487752036,NORTH CAROLINA CVS PHARMACY LLC,2103 TW ALEXANDER DR   MORRISVILLE NC,032,Durham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1487752036,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 00681,2103 TW ALEXANDER DR   MORRISVILLE NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487752036,NORTH CAROLINA CVS PHARMACY LLC,2103 TW ALEXANDER DR   MORRISVILLE NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1487752234,"JONES, CYBIL, DYSON",129 WOODSON ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 64 , 204 ,$#,,
MEDICAID DIRECT,1487752416,THORNE DRUG,THORNES DRUG CENTER INC,2900 N MAIN ST   TARBORO NC,033,Edgecombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487752416,THORNE DRUG,2900 N MAIN ST   TARBORO NC,033,Edgecombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 11 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487752762,"TURK, PETER, SMITH",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487752762,"TURK, PETER, SMITH",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487752762,"TURK, PETER, SMITH",2104 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487754024,"SPARKS, MATTHEW, AARON",2100 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487754024,"SPARKS, MATTHEW, AARON",40 DUKE MEDICINE CIR # 2B2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 30 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487754024,"SPARKS, MATTHEW, AARON",40 DUKE MEDICINE CIR # 2B2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 18 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487754024,"SPARKS, MATTHEW, AARON",40 DUKE MEDICINE CIR # 2B2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487754552,"WANG, CATHAY, CHACHY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487755047,"NOLTE, KIMBERLY, CLARK",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487755047,"NOLTE, KIMBERLY, CLARK",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 22 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487755047,"NOLTE, KIMBERLY, CLARK",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487755195,"PHILLIPS, CHRISTOPHER, JAMES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 26 , 198 , 198 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1487757035,"PETERS, BRANDON",201 VIRGINIA RD   EDENTON NC,021,Chowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487757035,"PETERS, BRANDON",201 VIRGINIA RD   EDENTON NC,021,Chowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 142 , 188 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487757035,"PETERS, BRANDON",1124 HARVEY POINT RD   HERTFORD NC,072,Perquimans,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1124 HARVEY POINT RD   HERTFORD NC,072,Perquimans,193200000X,Group,Multi-Specialty,,1487757035,"PETERS, BRANDON",1124 HARVEY POINT RD   HERTFORD NC,072,Perquimans,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487757035,"PETERS, BRANDON",206 S ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1487757167,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07350,5712 CASTLE HAYNE RD   CASTLE HAYNE NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1487757167,NORTH CAROLINA CVS PHARMACY LLC,5712 CASTLE HAYNE RD   CASTLE HAYNE NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1487757167,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07350,5712 CASTLE HAYNE RD   CASTLE HAYNE NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1487757167,NORTH CAROLINA CVS PHARMACY LLC,5712 CASTLE HAYNE RD   CASTLE HAYNE NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1487757175,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07051,245 E ROOSEVELT AVE   WAKE FOREST NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1487757175,NORTH CAROLINA CVS PHARMACY LLC,245 E ROOSEVELT AVE   WAKE FOREST NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1487759544,"HUNT, JAMES, CRAIG",~,1701 WESTCHESTER DR STE 350 HIGH POINT NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,1487759544,"HUNT, JAMES, CRAIG",1701 WESTCHESTER DR STE 350 HIGH POINT NC,041,Guilford,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 27 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1487760419,"GARNER, JOHN, TIMOTHY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487760419,"GARNER, JOHN, TIMOTHY",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487760419,"GARNER, JOHN, TIMOTHY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487760419,"GARNER, JOHN, TIMOTHY",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487760419,"GARNER, JOHN, TIMOTHY",2305 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 174 , 174 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 29 , 44 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 28 , 38 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1487762464,"BARBER, CHRISTOPHER, COLLINS",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 38 , 83 ,$#,,
MEDICAID DIRECT,1487762985,"STIGALL, LARRY, EVERETT",LARRY STIGALL,240 DOCTORS DR   BOONE NC,095,Watauga,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1487762985,"STIGALL, LARRY, EVERETT",240 DOCTORS DR   BOONE NC,095,Watauga,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 90 , 125 , 544 ," $55,422.27 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487763017,"DUKE, STEPHANIE, JONES",1821 HILLANDALE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1487763454,"YATES, CHRISTOPHER, JOHN",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 32 , 32 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1487763454,"YATES, CHRISTOPHER, JOHN",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487765335,"HUGGINS, CLARENCE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 33 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487766267,"HILTY, KENNETH, CHANDLER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487766267,"HILTY, KENNETH, CHANDLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 25 , 32 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487766267,"HILTY, KENNETH, CHANDLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 23 , 23 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487766267,"HILTY, KENNETH, CHANDLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 94 , 109 , 156 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487766267,"HILTY, KENNETH, CHANDLER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487766267,"HILTY, KENNETH, CHANDLER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1750718243,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE NORTHEA,1090 NE GATEWAY CT NE STE 201 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487767406,"MERRILL, DIANE, ROCKWELL",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 31 , 40 ,$#,,
MEDICAID DIRECT,1750718243,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE NORTHEA,1090 NE GATEWAY CT NE STE 201 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487767406,"MERRILL, DIANE, ROCKWELL",1090 NE GATEWAY CT NE STE 201 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 106 , 155 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487767406,"MERRILL, DIANE, ROCKWELL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1487767547,"BENN, DWIGHT, RANDY",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 190 , 191 ," $10,034.13 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487768818,"KIM, LAWRENCE, THOMAS",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 33 , 63 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487768818,"KIM, LAWRENCE, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487768818,"KIM, LAWRENCE, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487768818,"KIM, LAWRENCE, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 32 , 34 ,$#,,
MEDICAID DIRECT,1336243997,HOSPICE OF IREDELL COUNTY INC,HOSPICE OF IREDELL COUNTY INC,2347 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1487769501,"LEWIS, WENDY, PAYNE",2347 SIMONTON RD   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 37 , 70 , 76 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487774949,"TRUMLER-SEBRING, ANYA, ANN",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 34 , 47 ,$#,,
MEDICAID DIRECT,1518549393,IREDELL PHYSICIAN NETWORK,IREDELL SURGERY AT MOORESVILLE,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1487774949,"TRUMLER-SEBRING, ANYA, ANN",646 HARTNESS RD   STATESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487774949,"TRUMLER-SEBRING, ANYA, ANN",646 HARTNESS RD   STATESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 115 , 134 , 165 ," $11,309.68 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487779807,"BAUER, SAMUEL, THOMAS",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 26 , 26 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487779807,"BAUER, SAMUEL, THOMAS",2301 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487779807,"BAUER, SAMUEL, THOMAS",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487779807,"BAUER, SAMUEL, THOMAS",11001 DURANT RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487779807,"BAUER, SAMUEL, THOMAS",600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1487780383,"WILSON, LILLY, RANDALL",82 WHITES CROSSING PLZ   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487780383,"WILSON, LILLY, RANDALL",41 BAIN ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1487780383,"WILSON, LILLY, RANDALL",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1487780383,"WILSON, LILLY, RANDALL",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 57 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487780383,"WILSON, LILLY, RANDALL",1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487781886,A AND S HOME HEALTHCARE,A AND S HOME HEALTHCARE,7925 N TRYON ST STE 109 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1487781886,A AND S HOME HEALTHCARE,7925 N TRYON ST STE 109 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,478 "," 3,478 "," $342,223.20 ",,
MEDICAID DIRECT,1487786315,OUR HOUSE HOME CARE SERVICES INC,OUR HOUSE HOME CARE SERVICES INC,323 E ARLINGTON BOULEVA   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1487786315,OUR HOUSE HOME CARE SERVICES INC,323 E ARLINGTON BOULEVA   GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,786 "," 2,786 "," $163,119.24 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487792198,"FERNANDEZ, JAIME",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 23 , 92 , 92 ," $20,432.48 ",,
MEDICAID DIRECT,1487792685,CHILDREN AROUND THE WORLD SERVICES,CHILDREN AROUND THE WORLD SERVICES INC,3828 NC HIGHWAY 130 W   ROWLAND NC,078,Robeson,251S00000X,Agencies,Community/Behavioral Health,,1487792685,CHILDREN AROUND THE WORLD SERVICES,3828 NC HIGHWAY 130 W   ROWLAND NC,078,Robeson,251S00000X,Agencies,Community/Behavioral Health,, 49 ," 1,009 "," 1,010 "," $65,253.60 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487794715,"JOHNSON, KRISTINE, ERICA",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487794715,"JOHNSON, KRISTINE, ERICA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 54 , 104 , 107 ," $13,140.00 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487794715,"JOHNSON, KRISTINE, ERICA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 46 , 108 , 124 ,$#,,
MEDICAID DIRECT,1275965410,MCPC-14 LLC,FIRSTHEALTH TRANSITION CARE CLINIC,305 PAGE RD N STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1487797114,"ELLER, CHRYSTAL, FAYE",305 PAGE RD N STE 1 PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487800314,"FAIRCLOTH, CRISTIE, WELLS",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1326785551,HEALTHY KIDZ,,10410 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487800611,"BADDI, POORNIMA",10410 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 25 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487800611,"BADDI, POORNIMA",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#, 13 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,106 ALEXANDER BANK DR STE 300 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487801957,"FISCINA, CREIGHTON, DAVID",106 ALEXANDER BANK DR STE 300 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487801957,"FISCINA, CREIGHTON, DAVID",106 ALEXANDER BANK DR STE 300 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487802377,"DOULTANI, VINOD, KUMAR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 38 , 154 , 154 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487802377,"DOULTANI, VINOD, KUMAR",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487803490,"DOMINGUEZ, JENNIFER, ESTRELLA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487803490,"DOMINGUEZ, JENNIFER, ESTRELLA",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487803490,"DOMINGUEZ, JENNIFER, ESTRELLA",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487804076,"BARRETT, ERIN, RENAE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851567663,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM INPATIENT MEDICINE SPECIALISTS,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1487804613,"NADAKAV, SUNIL, JACOB",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 45 , 45 ,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487804613,"NADAKAV, SUNIL, JACOB",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 102 , 102 ,$#,,
MEDICAID DIRECT,1487806758,KELMIRA LATHAM READY SET GO SPEECH,KELMIRA LATHAM READY SET GO SPEECH INC,3906 SOUTHAMPTON CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487806758,KELMIRA LATHAM READY SET GO SPEECH,3906 SOUTHAMPTON CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,, 17 , 225 , 225 ," $15,752.25 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487807467,"YU, HYEON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487807467,"YU, HYEON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 81 , 88 , 188 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487807467,"YU, HYEON",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 12 , 12 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1487807467,"YU, HYEON",2214 NELSON HWY   CHAPEL HILL NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487807467,"YU, HYEON",300 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1487807616,YADKIN VISION CENTER OD PLLC,~,225 E LEE AVE   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1487807616,YADKIN VISION CENTER OD PLLC,225 E LEE AVE   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,, 119 , 120 , 240 ,$#,,
MEDICAID DIRECT,1790298024,CHALLIE MINTON MD,,,,Unknown,193400000X,Group,Single Specialty,,1487807772,"SCHNERING, JENNIFER, LYNN",113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 47 ,$#,,
MEDICAID DIRECT,1790298024,CHALLIE MINTON MD,,113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1487807772,"SCHNERING, JENNIFER, LYNN",113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 135 , 200 , 448 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487808523,"BOZYLINSKY, KATHERINE, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 40 , 42 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487808523,"BOZYLINSKY, KATHERINE, ANN",500 SHEPHERD ST STE 500 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487811279,"PATELLA, MELANIE, JOHNSON",175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1487811907,"BENSCOTER, DAN, TAYLOR",3333 BURNET AVE ML 2021 CINCINNATI OH,102,Out of State > 40 miles,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487812749,"MOUSALLEM, TALAL, IMAD",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487812749,"MOUSALLEM, TALAL, IMAD",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487812749,"MOUSALLEM, TALAL, IMAD",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0201X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Allergy/Immunology,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1033149315,NORTH BUNCOMBE FAMILY MEDICINE,NORTH BUNCOMBE FAMILY MEDICINE,201 FLAT CREEK VILLAGE DR   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487814091,"SWIFT, TAMI, WESSELS",201 FLAT CREEK VILLAGE DR   WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 55 , 133 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487815056,"PHILLIPS, KELLY, ROBINSON",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",201 E GROVER ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487815387,"ITALIA, HIRENKUMAR, DAMJIBHAI",1000 HEALING WAY   MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1487815684,"SIMMONS, ERIC, GUPTILL",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1487815684,"SIMMONS, ERIC, GUPTILL",1325 TIMBER DR E   GARNER NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487815684,"SIMMONS, ERIC, GUPTILL",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 50 , 86 , 114 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487815684,"SIMMONS, ERIC, GUPTILL",1325 TIMBER DR E   GARNER NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1487815684,"SIMMONS, ERIC, GUPTILL",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 11 , 13 , 19 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487816617,"BROWN, DANIEL, CATES",310 LONG SHOALS RD STE 203 ARDEN NC,011,Buncombe,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 48 , 33 , 44 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487816617,"BROWN, DANIEL, CATES",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 91 , 98 , 139 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487816617,"BROWN, DANIEL, CATES",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 69 , 46 , 82 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487816617,"BROWN, DANIEL, CATES",310 LONG SHOALS RD STE 201 ARDEN NC,011,Buncombe,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487818597,"KOVTOUN, TATIANA",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487818597,"KOVTOUN, TATIANA",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700650371,LONDRY MODLIN TUCKER II DDS PLLC,DASH CITY PEDIATRIC AND ADULT DENTISTRY,705 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487819090,"MAYNOR, SONYA, LORRAINE",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1700650371,LONDRY MODLIN TUCKER II DDS PLLC,DASH CITY PEDIATRIC AND ADULT DENTISTRY,705 COLISEUM DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487819090,"MAYNOR, SONYA, LORRAINE",8711 GREAT BEAR CT   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 858 ," 1,163 "," 6,130 "," $257,944.21 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487820635,"MCMURRAY, ROGER, JACOB",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487820783,"SHARMA, POONAM",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 138 , 138 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487820833,"LEMM, JOHN, THOMAS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD STE M201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487821419,"STEELE, AMII, CORBISIERO",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD STE M201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487821419,"STEELE, AMII, CORBISIERO",1001 BLYTHE BLVD MEDICAL CENTER PLAZA STE 601 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,,,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487821419,"STEELE, AMII, CORBISIERO",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1821653205,MOSES CONE PHYSICIAN SERVICES INC,CHMG PLASTIC SURGERY SPECIALISTS,1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487821559,"TAYLOR, JACKSON, B",1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 59 , 87 , 90 ,$#,,
MEDICAID DIRECT,1821653205,MOSES CONE PHYSICIAN SERVICES INC,CHMG PLASTIC SURGERY SPECIALISTS,1002 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487821559,"TAYLOR, JACKSON, B",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1740535657,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1487822664,"ALEXANDER, TAMARA, LYNN",2211 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1740535657,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1487822664,"ALEXANDER, TAMARA, LYNN",6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 34 , 45 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1487823266,"BELL, AMY, MARIE",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 119 , 755 , 883 ," $17,721.52 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487824199,"RAO, SANTOSH, RAVI",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487824199,"RAO, SANTOSH, RAVI",1900 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1487824199,"RAO, SANTOSH, RAVI",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 197 , 220 , 293 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1487824199,"RAO, SANTOSH, RAVI",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1487824405,MILESTONE THERAPY INC,MILESTONE THERAPY INC,2300 GALLBERRY LN   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1487824405,MILESTONE THERAPY INC,2300 GALLBERRY LN   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,, 963 ," 18,315 "," 19,629 "," $1,438,778.04 ",,
MEDICAID DIRECT,1487824405,MILESTONE THERAPY INC,MILESTONE THERAPY INC,2300 GALLBERRY LN   WAXHAW NC,090,Union,251S00000X,Agencies,Community/Behavioral Health,,1487824405,MILESTONE THERAPY INC,2300 GALLBERRY LN   WAXHAW NC,090,Union,251S00000X,Agencies,Community/Behavioral Health,, 59 ," 1,720 "," 1,721 "," $111,601.80 ",,
MEDICAID DIRECT,1487824405,MILESTONE THERAPY INC,MILESTONE THERAPY INC,,,Unknown,193200000X,Group,Multi-Specialty,,1487824405,MILESTONE THERAPY INC,1229 TOTEROS DR   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,#, 24 , 25 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487825253,"PEREZ, CORYELL, JADE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 163 , 168 , 176 ," $74,144.02 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487825253,"PEREZ, CORYELL, JADE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487825253,"PEREZ, CORYELL, JADE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487825253,"PEREZ, CORYELL, JADE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487825311,"ORNELAS, MONIQUE, CHRISTINE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487825311,"ORNELAS, MONIQUE, CHRISTINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487825311,"ORNELAS, MONIQUE, CHRISTINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1649377359,PEDIATRIX MEDICAL GROUP OF TEXAS BI,PEDIATRIX MEDICAL GROUP OF TEXAS,2929 WOODLAND PARK DR   HOUSTON TX,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1487828745,"SALINAS, EZEQUIEL, DAVID",2929 WOODLAND PARK DR   HOUSTON TX,102,Out of State > 40 miles,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 21 , 22 ,$#,,
MEDICAID DIRECT,1487830733,CELLIGENT DIAGNOSTICS LLC,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1487830733,CELLIGENT DIAGNOSTICS LLC,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 40 , 41 , 50 ,$#,,
MEDICAID DIRECT,1487830733,CELLIGENT DIAGNOSTICS LLC,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1487830733,CELLIGENT DIAGNOSTICS LLC,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,, 27 , 30 , 32 ,$#,,
MEDICAID DIRECT,1487830733,CELLIGENT DIAGNOSTICS LLC,~,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1487830733,CELLIGENT DIAGNOSTICS LLC,101 E WT HARRIS BLVD STE 1212 CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1487830733,CELLIGENT DIAGNOSTICS LLC,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,1487830733,CELLIGENT DIAGNOSTICS LLC,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 38 , 38 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 21 , 23 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 17 , 19 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",2051 COUNTRY CLUB RD   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 42 , 44 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 61 , 64 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1487837027,"BOOKER, TIMBERLY, ESTHER",111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487838496,"DAVIS, ERICA, NICOLE",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487838496,"DAVIS, ERICA, NICOLE",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487838496,"DAVIS, ERICA, NICOLE",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 40 , 47 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487838496,"DAVIS, ERICA, NICOLE",465 STRATFORD DR   ZEBULON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1487838496,"DAVIS, ERICA, NICOLE",465 STRATFORD DR   ZEBULON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1487838496,"DAVIS, ERICA, NICOLE",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487838496,"DAVIS, ERICA, NICOLE",465 STRATFORD DR   ZEBULON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1487842407,FULL CIRCLE PEDIATRIC THERAPY,FULL CIRCLE PEDIATRIC THERAPY,1002 UNITY CT   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1487842407,FULL CIRCLE PEDIATRIC THERAPY,1002 UNITY CT   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,, 155 ," 2,934 "," 3,078 "," $255,385.73 ",,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487843843,"COVINGTON, SUZANNE, STEELE",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 27 , 64 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487846168,"CIARROCCA, KATHARINE, NEWMAN",2301 ERWIN RD   DURHAM NC,032,Durham,125Q00000X,Dental Providers,Dentist,Oral Medicine, 19 , 20 , 217 ," $24,734.63 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487846168,"CIARROCCA, KATHARINE, NEWMAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 57 , 72 , 220 ," $18,593.39 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487846168,"CIARROCCA, KATHARINE, NEWMAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,125Q00000X,Dental Providers,Dentist,Oral Medicine, 38 , 44 , 76 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487847273,"UGOJI, AMANZE",1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487847273,"UGOJI, AMANZE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487847273,"UGOJI, AMANZE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 62 , 68 , 68 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487847273,"UGOJI, AMANZE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 61 , 61 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487848917,"ANANTHULA, DEEPTI",1308 COWELL FARM RD   WASHINGTON NC,007,Beaufort,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 98 , 190 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487853065,"TYSON, LILIANE, ZIHERAMBERE",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 167 , 167 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487855664,"PALTA, MANISHA",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487855664,"PALTA, MANISHA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 44 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487855664,"PALTA, MANISHA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1063890176,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM RADIATION ONCOLOGY,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1487855664,"PALTA, MANISHA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043811128,FOOTHILLS FAMILY DERMATOLOGY,,109 E FLEMING DR STE 106 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1487855680,"EDHEGARD, KIM, DAVID",109 E FLEMING DR STE 106 MORGANTON NC,012,Burke,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487857025,"PATEL, SUNDIP, SOMABHAI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 26 , 43 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1487859351,"POORE, SUSAN, ASHLEY",317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 59 , 161 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487860524,"RIVERA, ANTHONY",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 20 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1487860524,"RIVERA, ANTHONY",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 39 , 80 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487860524,"RIVERA, ANTHONY",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487865770,"CHAUHAN, GAGNEET, SHERGILL",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 50 , 71 , 124 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487865838,"JACKSON, JENNIFER, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 66 , 66 ,$#,,
MEDICAID DIRECT,1538529474,WILLIAM BRANDON ARNOLD DMD PLLC,~,40 GRAYSON ST   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1487868378,"LOGAN, RONALD, WILLIAM",40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice, 71 , 93 , 274 ," $12,982.34 ",,
MEDICAID DIRECT,1134376700,"ARNOLD, WILLIAM, BRANDON",,40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice,1487868378,"LOGAN, RONALD, WILLIAM",40 GRAYSON ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 16 , 53 ,$#,,
MEDICAID DIRECT,1194706671,MARTIN TYRRELL WASHINGTON DISTRICT,MARTIN-TYRRELL-WASHINGTON DISTRICT HEALTH DEPT,198 NC HIGHWAY 45 N   PLYMOUTH NC,094,Washington,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1487869707,"CHARLES, ANNE, ELIZABETH",198 NC HIGHWAY 45 N   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 54 , 153 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487870259,"JONES, CHRISTOPHER, ALLEN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 20 , 28 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1487870259,"JONES, CHRISTOPHER, ALLEN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487870259,"JONES, CHRISTOPHER, ALLEN",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487870259,"JONES, CHRISTOPHER, ALLEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487870259,"JONES, CHRISTOPHER, ALLEN",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487870259,"JONES, CHRISTOPHER, ALLEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 12 , 31 , 52 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487870259,"JONES, CHRISTOPHER, ALLEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 19 , 36 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1487872602,"LEAHY, NICOLE, JEANNETTE",17039 KENTON DR STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 430 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487873485,"PEPE, ANTONIO, PAUL",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 210 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487873485,"PEPE, ANTONIO, PAUL",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487875373,"HUBBARD, JOHN, BEHRENS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 37 , 63 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487875373,"HUBBARD, JOHN, BEHRENS",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 21 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1487876223,"CULTON, DONNA, ALINE",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 36 , 46 , 68 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487876223,"CULTON, DONNA, ALINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 28 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487876223,"CULTON, DONNA, ALINE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 39 , 69 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1487879086,"MARTINELLI, SUSAN, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 51 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487880621,"MCCLUNG, RACHEL, LEANNE",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 44 , 89 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487881785,"DINGER, SHAWNA, MAE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487881785,"DINGER, SHAWNA, MAE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 30 , 33 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 22 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 34 , 43 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 67 , 119 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 27 , 36 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 34 , 45 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",6701 B NC 135   MAYODAN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 199 , 226 , 312 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 15 , 21 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487882528,"WATTS, JONATHAN, MICHAEL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487883062,"MULCRONE, DANIEL, PATRICK",1144 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 27 , 84 , 108 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487883062,"MULCRONE, DANIEL, PATRICK",1144 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1487883062,"MULCRONE, DANIEL, PATRICK",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487883062,"MULCRONE, DANIEL, PATRICK",1144 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487883062,"MULCRONE, DANIEL, PATRICK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 18 , 24 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487884979,"ARISTIZABAL, LAWRENCE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1306138714,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1487885307,"RANDALL, SUSAN, POAG",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487886776,"WELLS, ELIZABETH, LANUM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487886776,"WELLS, ELIZABETH, LANUM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 38 , 38 ,$#,,
MEDICAID DIRECT,1487887949,ADDICTION RECOVERY MEDICAL SERVICE,~,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,251S00000X,Agencies,Community/Behavioral Health,,1487887949,ADDICTION RECOVERY MEDICAL SERVICE,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487888152,"LONDON, KARLA, DUNCAN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1487892139,"RAY, SEAN, SAMUEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487892287,"LO, DONNA, KAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487892287,"LO, DONNA, KAY",2909 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487897310,"PUDUKADAN, CYNTHIA, FRANCIS",1900 RANDOLPH RD STE 1010 CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 41 , 65 , 75 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487897310,"PUDUKADAN, CYNTHIA, FRANCIS",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487897393,"MORELLI, SCOTT, ANTHONY",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1487897393,"MORELLI, SCOTT, ANTHONY",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 104 , 125 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1487897393,"MORELLI, SCOTT, ANTHONY",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487897997,"CLARK, NORMAN, RAY",188 MEDICAL PARK DR STE A BREVARD NC,088,Transylvania,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 15 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487897997,"CLARK, NORMAN, RAY",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 31 , 83 , 140 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487897997,"CLARK, NORMAN, RAY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 25 , 34 , 47 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1487897997,"CLARK, NORMAN, RAY",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 13 , 19 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487898458,"COLLIER, ANN, MARIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487898458,"COLLIER, ANN, MARIE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487898821,"NEWCOMB, MARY, THOMPSON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487898821,"NEWCOMB, MARY, THOMPSON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1487898821,"NEWCOMB, MARY, THOMPSON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487899274,"TANNER, JEANNE, BRYK",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487899373,"WILKES, CHARLOTTE, SALINAS",3333 SILAS CREEK PWKY   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1487902144,THE SPEECH LADY PLLC,~,3796 VEST MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487902144,THE SPEECH LADY PLLC,3796 VEST MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,, 64 , 451 , 451 ," $31,830.21 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487903019,"REVADIGAR, NEELAMBIKA, SHARANABASAPPA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487903019,"REVADIGAR, NEELAMBIKA, SHARANABASAPPA",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1114373404,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1487904520,"SHAH, NIKIT, YOGESH",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487909388,"INTINI, JANET, ELIZABETH",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487910832,"MARCEL, JOHN, JOSEPH",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 100 , 175 , 324 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487910832,"MARCEL, JOHN, JOSEPH",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 40 , 74 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487916318,"WELLER, EDWARD, BROOKS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 65 , 76 , 83 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1487919148,"BROWN, TYRONE, MARTINEZ",800 TILGHMAN DR   DUNN NC,043,Harnett,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1487919148,"BROWN, TYRONE, MARTINEZ",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1487919148,"BROWN, TYRONE, MARTINEZ",1705 TARBORO ST SW   WILSON NC,098,Wilson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1487919148,"BROWN, TYRONE, MARTINEZ",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467635128,COASTAL HEALTHCARE RESOURCES INC,COASTAL HEALTHCARE RESOURCES,1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1487919148,"BROWN, TYRONE, MARTINEZ",2308 WESVILL CT   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487920906,"MCCRARY, ANDREW, WALKER",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1487920906,"MCCRARY, ANDREW, WALKER",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487920906,"MCCRARY, ANDREW, WALKER",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487920906,"MCCRARY, ANDREW, WALKER",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 76 , 134 , 208 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487920906,"MCCRARY, ANDREW, WALKER",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487931671,"PHILLIPS, TROY, RALPH",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1487931903,"JONES, JANET, NOVAS",680 S STRATFORD RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487931903,"JONES, JANET, NOVAS",730 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1487931903,"JONES, JANET, NOVAS",324 N QUEEN ST   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881979011,NATURAL BEGINNINGS BIRTH AND WELLNE,NATURAL BEGINNINGS BIRTH AND WELLNESS CENTER,1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487932505,"WINECOFF, NICOLE, WEISNER",1420 FERN CREEK DR   STATESVILLE NC,049,Iredell,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487934162,"BROOKS, JENNIFER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487934162,"BROOKS, JENNIFER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 32 , 95 , 231 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487934162,"BROOKS, JENNIFER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487934162,"BROOKS, JENNIFER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 39 , 204 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487934162,"BROOKS, JENNIFER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1487934162,"BROOKS, JENNIFER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1487934865,"ANDERSON, JEFFREY, DREW",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 27 , 27 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487934865,"ANDERSON, JEFFREY, DREW",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609838283,"WIATER, JOSEPH, GERARD",~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1487934865,"ANDERSON, JEFFREY, DREW",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1487934865,"ANDERSON, JEFFREY, DREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1487934865,"ANDERSON, JEFFREY, DREW",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073922159,CHIROPRACTIC PHYSICIANS OF THE CARO,~,513 S DEKALB ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1487935094,"ELLISON, HEATHER, BROOKE",513 S DEKALB ST   SHELBY NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,, 16 , 123 , 126 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1487938320,"OPALACZ, COURTNEY, HILLYER",808 N WASHINGTON ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 74 , 74 ,$#,,
MEDICAID DIRECT,1487939161,CLARKE COMMUNITY CARE LLC,CLARKE COMMUNITY CARE LLC,6529 HUDSPETH RD   HARRISBURG NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1487939161,CLARKE COMMUNITY CARE LLC,6529 HUDSPETH RD   HARRISBURG NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,517 "," 2,517 "," $197,264.08 ",,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487939765,"ROSS, SHARON",435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487940292,"AALTO, MEAGHAN, MARGARET",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 52 , 86 , 122 ," $10,098.82 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487940292,"AALTO, MEAGHAN, MARGARET",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 68 , 112 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487940292,"AALTO, MEAGHAN, MARGARET",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487940300,"MORALES, JENNIFER, IRENE",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487940300,"MORALES, JENNIFER, IRENE",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 31 , 80 , 192 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487940300,"MORALES, JENNIFER, IRENE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 34 , 83 , 163 ,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487940375,"TROVILLION, ERIN, MURPHY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487940375,"TROVILLION, ERIN, MURPHY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487940375,"TROVILLION, ERIN, MURPHY",1001 BLYTHE BLVD STE 601 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487941001,"SABBAGH, SALAH",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 56 , 113 , 114 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487941001,"SABBAGH, SALAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487941001,"SABBAGH, SALAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487943403,"DIETRICH, KATIE, LYNN",910 W WILLIAMS ST   APEX NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1487943718,"CHIDESTER, ANDREW, DAVID",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487943718,"CHIDESTER, ANDREW, DAVID",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1487943718,"CHIDESTER, ANDREW, DAVID",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1487943718,"CHIDESTER, ANDREW, DAVID",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 35 , 42 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1487943718,"CHIDESTER, ANDREW, DAVID",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 39 , 55 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,,,Unknown,193400000X,Group,Single Specialty,,1487945333,"MEDARIS, LEIGH, ANN",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1861485146,REGIONAL OBSTETRICAL CONSULTANTS PC,REGIONAL OBSTETRICAL CONSULTANTS PC,902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487947305,"GONZALES, STEPHEN, KYLE",902 MCCALLIE AVE   CHATTANOOGA TN,102,Out of State > 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1487948055,COUNTY OF GRAHAM,GRAHAM COUNTY HEALTH DEPT,21 S MAIN ST   ROBBINSVILLE NC,038,Graham,251B00000X,Agencies,Case Management,,1487948055,COUNTY OF GRAHAM,21 S MAIN ST   ROBBINSVILLE NC,038,Graham,251B00000X,Agencies,Case Management,, 55 , 530 , 530 ," $199,693.00 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487948220,"CLIFFORD, KELLY, MARIE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 91 , 94 , 148 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487948220,"CLIFFORD, KELLY, MARIE",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 37 , 45 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487952800,"WOOLEY, LINDA, MEZZA",512 VILLAGE RD STE 207 S BRUNSWICK NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 51 , 75 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1487954962,"SMITH, JANE, SMITH",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1487954962,"SMITH, JANE, SMITH",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 69 , 136 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,55 MEDICAL PARK DR STE 114 FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1487956843,"WILLIAMSON, MICHELLE, WEN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1487956843,"WILLIAMSON, MICHELLE, WEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 45 , 46 ,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1487959318,"KIEFT, HOPE, MEREDITH",606 N ELM ST   HIGH POINT NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 53 , 113 , 281 ," $33,603.15 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487960597,"SCHEIB, TIFFANY, LEWIS",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 66 , 151 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487960597,"SCHEIB, TIFFANY, LEWIS",5145 SELLERS RD STE A SHALLOTTE NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 40 ,$#,,
MEDICAID DIRECT,1811424849,MOSES CONE PHYSICIAN SERVICES INC,CHMG PRIMARY CARE AT FOREST OAKS,4620 WOODY MILL RD STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487967386,"BOSCIA, HEATHER, HILES",4620 WOODY MILL RD STE G GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487967386,"BOSCIA, HEATHER, HILES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 30 , 30 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487967485,"GACUGA, ROSE, NYAMBURA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487967485,"GACUGA, ROSE, NYAMBURA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1487970265,"CARR, JEWELL, PAULINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487970265,"CARR, JEWELL, PAULINE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 42 , 55 ,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487971370,"VARGHESE, LIJU",309 PINEYWOOD RD   THOMASVILLE NC,029,Davidson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487974176,"HARPER, NATHAN, RUSSELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 25 , 27 , 34 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487974176,"HARPER, NATHAN, RUSSELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487974176,"HARPER, NATHAN, RUSSELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487974176,"HARPER, NATHAN, RUSSELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487974176,"HARPER, NATHAN, RUSSELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1487974176,"HARPER, NATHAN, RUSSELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 52 , 59 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1487974226,"MOORE, ROBIN, MICHELLE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487974226,"MOORE, ROBIN, MICHELLE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487974226,"MOORE, ROBIN, MICHELLE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487975504,"HOLLENBAUGH, NONA, MARIE",752 HARTNESS RD   STATESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 72 , 78 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1487976098,"KISTNER, ROBERT, MICHAEL",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487978789,CENTER OF MOREHEAD CITY LLC,THE SURGICAL CENTER OF MOREHEAD CITY,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1487978789,CENTER OF MOREHEAD CITY LLC,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 58 , 63 , 70 ,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487979712,"STROLLO, STEPHANIE, LAUREN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 60 , 183 , 183 ,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487979712,"STROLLO, STEPHANIE, LAUREN",200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 21 , 31 , 34 ,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487979712,"STROLLO, STEPHANIE, LAUREN",200 GAMBLE DR   LINCOLNTON NC,055,Lincoln,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1487979712,"STROLLO, STEPHANIE, LAUREN",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 28 , 60 , 60 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487979845,"NOEL, GILLIAN, ONIKA",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487979845,"NOEL, GILLIAN, ONIKA",2301 ERWIN RD   DURHAM NC,032,Durham,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology, 29 , 101 , 108 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1487979845,"NOEL, GILLIAN, ONIKA",2301 ERWIN RD   DURHAM NC,032,Durham,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487979852,"HOYLER, KIMBER, LEE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487987293,UNLIMITED ACCESS INC,UNLIMITED ACCESS INC,6674 PLAIN VIEW HWY   DUNN NC,082,Sampson,251B00000X,Agencies,Case Management,,1487987293,UNLIMITED ACCESS INC,6674 PLAIN VIEW HWY   DUNN NC,082,Sampson,251B00000X,Agencies,Case Management,, 22 , 481 , 481 ," $34,254.95 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1487987376,"DILLON, LEAH, BYERLY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1487992012,"HAPPACH, VINCENZO, COSMO",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487992012,"HAPPACH, VINCENZO, COSMO",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,971 GOLD HILL RD   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487992012,"HAPPACH, VINCENZO, COSMO",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1487992012,"HAPPACH, VINCENZO, COSMO",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487994653,"HOOKER, MELANIE, BROOKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1487994653,"HOOKER, MELANIE, BROOKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1487996344,"CARVER, ALISON, LEIGH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1487996344,"CARVER, ALISON, LEIGH",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1508215963,HIGHLAND PRIMARY CAREPLLC,,513 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1487997565,"GIBSON, DONNA, EDGE",513 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508215963,HIGHLAND PRIMARY CAREPLLC,,513 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1487997565,"GIBSON, DONNA, EDGE",513 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 46 , 80 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497005540,"SHANGULA, DEEPIKA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1083666887,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH NEUROLOGY AND SLEEP,1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497005540,"SHANGULA, DEEPIKA",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497005540,"SHANGULA, DEEPIKA",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 57 , 67 , 82 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497005540,"SHANGULA, DEEPIKA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 14 , 15 , 20 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1497006183,"QUINN, CLAYTON, LEE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497009039,HARRIS HOME CARE INC,HARRIS HOME CARE INC,150 E MAIN ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,,1497009039,HARRIS HOME CARE INC,150 E MAIN ST   FOREST CITY NC,081,Rutherford,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,520 "," 2,520 "," $371,385.48 ",,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1497009781,"ALLIN-HALL, SHERRI, LYNN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 42 , 45 , 58 ,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497010219,"SINGLETARY, FREDA, LEVETTE",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 50 , 99 ,$#,,
MEDICAID DIRECT,1932125564,GROAT EYECARE ASSOCS PA,GROAT EYECARE ASSOCIATES PA,1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1497011274,"GROAT, RICHARD, SCOTT",1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 255 , 381 , 595 ," $11,958.25 ",,
MEDICAID DIRECT,1932125564,GROAT EYECARE ASSOCS PA,GROAT EYECARE ASSOCIATES PA,1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497011274,"GROAT, RICHARD, SCOTT",1317 N ELM ST STE 4 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497012488,"PHELAN, KEVIN, MICHAEL ASHMAN",10030 GILEAD RD STE 245 HUNTERSVILLE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 28 , 36 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 31 , 38 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 57 , 61 , 72 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497012686,"RAHMAN, AKEF, SAMSHI",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497012686,"RAHMAN, AKEF, SAMSHI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 37 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497012751,"HARRIS, MICHAEL, JONATHAN",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497012751,"HARRIS, MICHAEL, JONATHAN",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1497013379,"COX, ROBERT, DALTON",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497013379,"COX, ROBERT, DALTON",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 91 , 94 , 126 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1497013734,"BINFORD, JOHN, CHRISTOPHER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1497013734,"BINFORD, JOHN, CHRISTOPHER",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497015648,"HESS, DEBORAH, SPERLING",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 14 , 25 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497015648,"HESS, DEBORAH, SPERLING",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1952918948,MARY ELIZABETH STARNES HUFFMAN DDS,SOUTHERN FAMILY DENTISTRY,206 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1497019640,"POWELL, JOSEPH, CHANCE",206 S STERLING ST   MORGANTON NC,012,Burke,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 163 , 170 , 653 ," $29,777.94 ",,
MEDICAID DIRECT,1295294122,J CHANCE POWELL DDS PA,,373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1497019640,"POWELL, JOSEPH, CHANCE",373 BOONE HEIGHTS DR   BOONE NC,095,Watauga,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,294 "," 1,974 "," 7,377 "," $307,465.00 ",,
MEDICAID DIRECT,1306397898,RDMG ASSOCIATES PA,,136 CHARLOTTE HWY   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497022305,"ORMAND, MAGGI, CASTELLOE",136 CHARLOTTE HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 32 , 51 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497023659,"CHRISTY, JUSTIN, LUKE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497023659,"CHRISTY, JUSTIN, LUKE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497023659,"CHRISTY, JUSTIN, LUKE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 58 , 60 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497023659,"CHRISTY, JUSTIN, LUKE",2465 EMERALD PL   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497029953,"PENNINGTON, RAND, RILEY",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 36 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497029953,"PENNINGTON, RAND, RILEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497029953,"PENNINGTON, RAND, RILEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497029953,"PENNINGTON, RAND, RILEY",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497029953,"PENNINGTON, RAND, RILEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497029953,"PENNINGTON, RAND, RILEY",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497029953,"PENNINGTON, RAND, RILEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497029953,"PENNINGTON, RAND, RILEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 21 , 44 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497029953,"PENNINGTON, RAND, RILEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497029953,"PENNINGTON, RAND, RILEY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497031553,"ABAYA, ALOYSIUS, ECLIPSE",13300 STRICKLAND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 25 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497031553,"ABAYA, ALOYSIUS, ECLIPSE",13300 STRICKLAND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 28 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497033724,"PAUL, LEENA, MARIA",1201 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497036388,"FORREST, CERISA, DANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497036388,"FORREST, CERISA, DANN",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497036388,"FORREST, CERISA, DANN",210 ASHVILLE AVE   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497036388,"FORREST, CERISA, DANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497036388,"FORREST, CERISA, DANN",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497037147,"MOODY, JENNIFER, POPE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497037147,"MOODY, JENNIFER, POPE",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497037147,"MOODY, JENNIFER, POPE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497037147,"MOODY, JENNIFER, POPE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497037147,"MOODY, JENNIFER, POPE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1497039911,"DIXON, CHRISTINA, KIRKLEY",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992938823,CAROLINA SPINE CENTER PA,CAROLINA SPINE CENTER PA,100 PARKWAY OFFICE CT STE 108 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497039911,"DIXON, CHRISTINA, KIRKLEY",120 COUNTY HOME RD   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497040679,"RAVINDRAN, SENTHURAN",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1497040679,"RAVINDRAN, SENTHURAN",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497042998,"VIDRI ALONSO-ROCHI, ROBERTO, JAVIER",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497042998,"VIDRI ALONSO-ROCHI, ROBERTO, JAVIER",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497042998,"VIDRI ALONSO-ROCHI, ROBERTO, JAVIER",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 30 , 33 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1497044705,"MUKONJE, TERENCE, NOAH",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497045413,"KOHLER, JOHN, AARON",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962404384,THE REGIONAL DIABETES AND ENDOCRINE,THE REGIONAL DIABETES AND ENDOCRINE CENTER,101 ROBESON ST STE 405 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497045496,"ONYEASO, NDUCHE, CHIKA",101 ROBESON ST STE 405 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 335 , 695 ," 1,215 "," $14,282.82 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,401 NORTH LIVE OAK DR. HWY 17A   MONCKS CORNER SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497046411,"KRAEMER, KARI, ELIZABETH",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497046874,"LIM, KIMBERLY, OPRASEUTH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 58 , 58 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497047278,"HANLEY, ALLISON, BRIGHT",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497047278,"HANLEY, ALLISON, BRIGHT",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,138 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497047278,"HANLEY, ALLISON, BRIGHT",140 LEANING OAK DR STE 101 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497047633,"CYRILLE-SUPERVILLE, NICOLE, BIANCA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497047633,"CYRILLE-SUPERVILLE, NICOLE, BIANCA",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497047633,"CYRILLE-SUPERVILLE, NICOLE, BIANCA",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497047633,"CYRILLE-SUPERVILLE, NICOLE, BIANCA",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 18 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497048102,"TRAN, BOWIE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497048417,TABONO CARE SERVICES,TABONO CARE SERVICES,3701 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1497048417,TABONO CARE SERVICES,3701 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497048714,"WRIGHT, DEBRA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497049639,"LAMBERT, JENNIFER, KOLOS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 29 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497049639,"LAMBERT, JENNIFER, KOLOS",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497050140,JUST IN TIME FCH,~,254 KENDRICK CT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497050140,JUST IN TIME FCH,254 KENDRICK CT   FLAT ROCK NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 256 , 256 ," $71,374.98 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497052377,"DUMRA, NATASHA",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497052377,"DUMRA, NATASHA",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497052377,"DUMRA, NATASHA",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912252263,NASH STREET HEALTHCARE,~,3725 NASH ST NW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1497057046,"MITCHELL, SHARON, JEANETTE",3725 NASH ST NW   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 23 , 24 ,$#,,
MEDICAID DIRECT,1912252263,NASH STREET HEALTHCARE,~,3725 NASH ST NW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1497057046,"MITCHELL, SHARON, JEANETTE",3725 NASH ST NW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 39 , 50 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497065338,"DALAL, KUNAL, SANJAY",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 77 , 117 , 166 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497066997,"NUNEZ GONZALEZ, JOEL, RADHAMES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497066997,"NUNEZ GONZALEZ, JOEL, RADHAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497066997,"NUNEZ GONZALEZ, JOEL, RADHAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497066997,"NUNEZ GONZALEZ, JOEL, RADHAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497066997,"NUNEZ GONZALEZ, JOEL, RADHAMES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497069546,"DEGNER, BENJAMIN, CHRISTIAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 12 , 30 ," $10,725.28 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497069546,"DEGNER, BENJAMIN, CHRISTIAN",115 HEART DR   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497069546,"DEGNER, BENJAMIN, CHRISTIAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 40 , 46 , 58 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,12000 RETAIL DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1497071153,"TYSON, TIFFANY, DESHELIA",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497071153,"TYSON, TIFFANY, DESHELIA",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497071153,"TYSON, TIFFANY, DESHELIA",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 188 , 552 , 553 ," $23,171.93 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497071153,"TYSON, TIFFANY, DESHELIA",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497071898,"RATTAN, HOLLIE, CHRISTINA",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497072169,"SMITH, HEATHER, HECEI",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497072169,"SMITH, HEATHER, HECEI",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497072169,"SMITH, HEATHER, HECEI",4101 MACON POND RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497072177,"WORMER, KELLY, COMERFORD",2400 SOUTH BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497072177,"WORMER, KELLY, COMERFORD",2100 S TRYON ST STE 201 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 14 , 27 ,$#,,
MEDICAID DIRECT,1376598268,CAROLINAS PAIN INSTITUTE PA,,145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497072300,"JOHNSON, CARRIE, ELIZABETH",145 KIMEL PARK DR STE 330 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 21 , 27 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 56 ,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 30 , 53 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1002 N CHURCH ST STE 401 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497072813,"COLLINS, MICHELLE, SUZANNE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497074041,"MOORE, EDGAR, CHARLES",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 46 , 46 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497074041,"MOORE, EDGAR, CHARLES",100 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497074041,"MOORE, EDGAR, CHARLES",100 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 36 , 40 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497074041,"MOORE, EDGAR, CHARLES",100 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 24 , 25 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497074041,"MOORE, EDGAR, CHARLES",701 DOCTORS DR STE A KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1497075105,"CHERRY, ANIKA, SHANNEL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497075105,"CHERRY, ANIKA, SHANNEL",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 29 , 43 , 64 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497075105,"CHERRY, ANIKA, SHANNEL",1248 HUFFMAN MILL RD STE 101 BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497075915,"BEJARANO OVIEDO, GIOVANNI",GIOVANNI O BEJARANO,6537 CLARKSDALE LN   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1497075915,"BEJARANO OVIEDO, GIOVANNI",6537 CLARKSDALE LN   DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1497076152,"BELLAMY, MICHAEL, ALLEN",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497079016,"SCHREIBER, JOSEPH, JOHN",115 KILDAIRE PARK DR STE 102 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497079016,"SCHREIBER, JOSEPH, JOHN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 27 , 62 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497079016,"SCHREIBER, JOSEPH, JOHN",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1497079016,"SCHREIBER, JOSEPH, JOHN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497082820,"KASPER, JUDY, LEE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497082820,"KASPER, JUDY, LEE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1497084982,WAKE ENDOSCOPY CENTER LLC,~,2601 LAKE DR STE 201 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1497084982,WAKE ENDOSCOPY CENTER LLC,2601 LAKE DR STE 201 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 57 , 64 , 64 ,$#,,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1497085955,"WIENER, HEATHER, LEANNE",1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1497086151,"CURRAN, MONA, F",338 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1669912333,ALEXANDER COUNTY,~,338 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1497086151,"CURRAN, MONA, F",338 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,1223D0001X,Dental Providers,Dentist,Dental Public Health, 979 ," 2,686 "," 9,342 "," $399,528.11 ",,
MEDICAID DIRECT,1497089692,"NORWOOD, CAROLINE, POWELL",~,242 CRAVEN ST   NEW BERN NC,025,Craven,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1497089692,"NORWOOD, CAROLINE, POWELL",242 CRAVEN ST   NEW BERN NC,025,Craven,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 18 , 376 , 382 ," $28,590.45 ",,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497091904,"AMICO, FRANK, JOSEPH",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1497091904,"AMICO, FRANK, JOSEPH",300 MEDICAL PKWY STE 120 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497091904,"AMICO, FRANK, JOSEPH",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1497091904,"AMICO, FRANK, JOSEPH",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497092191,"NIST, CHELSEA, NICOLE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1497093009,"BREWER, ANGELICA, JOSELYNN",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 22 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,110 PRESTON EXECUTIVE DR STE 108 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1497093009,"BREWER, ANGELICA, JOSELYNN",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1497093009,"BREWER, ANGELICA, JOSELYNN",110 PRESTON EXECUTIVE DR STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497094825,"MCKINZIE, PAULA, VEASEY",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 58 , 130 , 173 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497100911,"MAKA, LYNNE, MARIE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497100911,"MAKA, LYNNE, MARIE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497100911,"MAKA, LYNNE, MARIE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497101745,"LANE, DANIEL, PHILIP",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497102818,"LOCKHART, JENNIFER, LYNN",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 21 , 48 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1497102818,"LOCKHART, JENNIFER, LYNN",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 40 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497102818,"LOCKHART, JENNIFER, LYNN",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1497102818,"LOCKHART, JENNIFER, LYNN",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 117 , 123 , 268 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497102818,"LOCKHART, JENNIFER, LYNN",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 21 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497102958,"PANG, KIM, CHUNG",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497102958,"PANG, KIM, CHUNG",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497102958,"PANG, KIM, CHUNG",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1497102958,"PANG, KIM, CHUNG",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497102958,"PANG, KIM, CHUNG",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1497102958,"PANG, KIM, CHUNG",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 123 , 123 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497102958,"PANG, KIM, CHUNG",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497105704,"UZO OKEREKE, ADAKU, MENNWA",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497105993,"RATCHFORD, ADAM, TODD",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497107387,"JONES, AARON, MICHAEL",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 262 , 303 , 420 ," $14,252.22 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497107387,"JONES, AARON, MICHAEL",700 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 234 , 260 , 333 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497107536,"COLEMAN, KELLY, JACKSON",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 42 , 45 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497107650,"WILLAFORD, CASEY, DASHIELL",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497107650,"WILLAFORD, CASEY, DASHIELL",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1497108633,"SHUBICK, DEBORAH, MICHELLE",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 22 , 28 , 46 ,$#,,
MEDICAID DIRECT,1356366413,CRYSTAL COAST FAMILY PRACTICE,CRYSTAL COAST FAMILY PRACTICE,505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1497108633,"SHUBICK, DEBORAH, MICHELLE",505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 20 , 26 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1497108633,"SHUBICK, DEBORAH, MICHELLE",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 11 , 22 , 31 ,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497110498,"ZURL, CHELSEA, ANN",3821 ED DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 27 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497113690,"NAVARRO, BARBARA, LEE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497113690,"NAVARRO, BARBARA, LEE",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497113690,"NAVARRO, BARBARA, LEE",13557 STEELECROFT PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497113690,"NAVARRO, BARBARA, LEE",1718 E 4TH ST STE 907 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497114839,"SIDDIQUI, WAJIHA, TARIQ",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 136 , 233 , 399 ," $17,137.62 ",,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497115117,"WILSON, ERIN, RILEY",2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497115117,"WILSON, ERIN, RILEY",1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 22 ,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497115117,"WILSON, ERIN, RILEY",1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 615 , 723 ," 3,238 "," $155,361.80 ",,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497115117,"WILSON, ERIN, RILEY",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1053177923,KNOWLES SMITH & ASSOCIATES LLP,,1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497115117,"WILSON, ERIN, RILEY",1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 240 , 316 ," 1,461 "," $64,937.89 ",,
MEDICAID DIRECT,1053177923,KNOWLES SMITH & ASSOCIATES LLP,,1008 HUTTON LN STE 112 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497115117,"WILSON, ERIN, RILEY",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497115117,"WILSON, ERIN, RILEY",510 HICKORY RIDGE DR   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 792 , 942 ," 3,785 "," $155,258.24 ",,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1497115869,"MCCARTY, SAMANTHA, JO",1134 N ROAD ST STE 3 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 30 , 60 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,1134 N ROAD ST STE 3 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1497115869,"MCCARTY, SAMANTHA, JO",1134 N ROAD ST STE 3 ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 29 ,$#,,
MEDICAID DIRECT,1497117949,RIVERSIDE VILLAGE HOMES INC,,134 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497117949,RIVERSIDE VILLAGE HOMES INC,134 CENTER AVE   BLACK MOUNTAIN NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 13 , 54 , 54 ," $96,718.88 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497118335,"WALLACE, CATHERINE, LAUREN",801 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 74 , 132 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497118335,"WALLACE, CATHERINE, LAUREN",801 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1497118335,"WALLACE, CATHERINE, LAUREN",306 COLLEGE ST   WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 180 , 385 , 833 ," $20,784.42 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497118335,"WALLACE, CATHERINE, LAUREN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 35 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497118335,"WALLACE, CATHERINE, LAUREN",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497118418,"KUAN-CELARIER, ANNA, MEI-CHING",601 N ELM ST   HIGH POINT NC,041,Guilford,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497118418,"KUAN-CELARIER, ANNA, MEI-CHING",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 13 , 26 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497118418,"KUAN-CELARIER, ANNA, MEI-CHING",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497119234,"RETTENMAIER, CHRISTOPHER, RAPHAEL",2075 GLENN MITCHELL DR STE 512 VIRGINIA BEACH VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497119879,"LEMBERSKY, OLGA",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 54 , 65 , 91 ,$#,,
MEDICAID DIRECT,1629412184,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497120307,"SANGROULA, DINESH",16740 DAVIDSON CONCORD RD STE 200 DAVIDSON NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497125330,"LYM-MURPHY, LAURA, GALE",631 JUNCTION CREEK DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497125330,"LYM-MURPHY, LAURA, GALE",20062 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 141 , 183 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497125330,"LYM-MURPHY, LAURA, GALE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 36 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497130306,"HARRELL, FELICIA, LYNELLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497130306,"HARRELL, FELICIA, LYNELLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497130306,"HARRELL, FELICIA, LYNELLE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 35 , 85 ,$#,,
MEDICAID DIRECT,1497130652,CONFIDENTIAL HOME CARE INC,~,709 E MARKET ST STE 106 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1497130652,CONFIDENTIAL HOME CARE INC,709 E MARKET ST STE 106 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 7,579 "," 7,735 "," $598,968.08 ",,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497131031,"CLYBURN, KANITRA, SHAVON",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497131031,"CLYBURN, KANITRA, SHAVON",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497131031,"CLYBURN, KANITRA, SHAVON",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 23 , 50 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497131031,"CLYBURN, KANITRA, SHAVON",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497131031,"CLYBURN, KANITRA, SHAVON",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497131353,"CHANDRA SERHARAN, MALINI, FONSEKA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 38 , 38 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497131353,"CHANDRA SERHARAN, MALINI, FONSEKA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 52 , 52 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497131353,"CHANDRA SERHARAN, MALINI, FONSEKA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497131353,"CHANDRA SERHARAN, MALINI, FONSEKA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932230828,AXIS PROSTHETICS AND ORTHOTICS INC,ATLANTIC PROSTHETIC SERVICES,1142 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497131619,"POLOMIK, MICHAEL, RICHARD",1142 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1932230828,AXIS PROSTHETICS AND ORTHOTICS INC,ATLANTIC PROSTHETIC SERVICES,1142 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497131619,"POLOMIK, MICHAEL, RICHARD",1142 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497132898,"CONTE, TESSA, NICOLE",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497132898,"CONTE, TESSA, NICOLE",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 83 , 108 ,$#,,
MEDICAID DIRECT,1578987848,UNC PHYSICIANS NETWORK LLC,~,7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497132922,"WASSERMAN, STEVEN, TODD",7011 FAYETTEVILLE RD STE 210 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497132922,"WASSERMAN, STEVEN, TODD",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1932523206,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 210 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497132922,"WASSERMAN, STEVEN, TODD",1181 WEAVER DAIRY RD STE 210 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 41 , 83 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497133417,"VELDHUYZEN, MARIE, LOUISE",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497133417,"VELDHUYZEN, MARIE, LOUISE",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497133417,"VELDHUYZEN, MARIE, LOUISE",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,7535 CARPENTER FIRE STATION RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497134241,"ARRIAGADA, JORGE, EDUARDO",7535 CARPENTER FIRE STATION RD STE 201A CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 37 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,1460 KELLY RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1497134241,"ARRIAGADA, JORGE, EDUARDO",7535 CARPENTER FIRE STATION RD STE 201A CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 34 , 37 , 137 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,1625 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1497134241,"ARRIAGADA, JORGE, EDUARDO",7535 CARPENTER FIRE STATION RD STE 201A CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 12 , 12 , 38 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,101 REDFORD PLACE DR STE 100   ROLESVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1497134241,"ARRIAGADA, JORGE, EDUARDO",7535 CARPENTER FIRE STATION RD STE 201A CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,7860 BRIER CREEK PKWY STE 100A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497134241,"ARRIAGADA, JORGE, EDUARDO",7535 CARPENTER FIRE STATION RD STE 201A CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 41 , 49 , 162 ,$#,,
MEDICAID DIRECT,1902289648,SINDHURA CITINENI DDS PA,SMILE FIRST DENTAL,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497134241,"ARRIAGADA, JORGE, EDUARDO",3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497134407,"JHANG, JOYCE, MEE KYUNG",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497134407,"JHANG, JOYCE, MEE KYUNG",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 , 45 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497134464,"KELLY, CECILIA, RICE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497134464,"KELLY, CECILIA, RICE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497134464,"KELLY, CECILIA, RICE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497134464,"KELLY, CECILIA, RICE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 14 ,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",201 E GROVER ST   SHELBY NC,023,Cleveland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013232438,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013232438,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 20 , 30 , 57 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 23 , 43 , 50 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497136063,"SCHWARTZ, ANDREW, LOGAN DAILEY",9625 NORTHCROSS CENTER CT STE 102 HUNTERSVILLE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497137251,"THUMMALURU, JAHNAVI",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497137681,"TYSINGER, ELIZABETH, LENFESTEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1497139455,"GRIFFIN, JILL, FESPERMAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1497139455,"GRIFFIN, JILL, FESPERMAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497139455,"GRIFFIN, JILL, FESPERMAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497139620,"BURRUS-SANDERS, TESSA, N",855 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497139620,"BURRUS-SANDERS, TESSA, N",855 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497139620,"BURRUS-SANDERS, TESSA, N",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497139901,"RETTENMAIER, NICHOLAS, BATTISTA",6251 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497140016,"MURTER, CHRISTOPHER, DOUGLAS",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 16 , 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497140016,"MURTER, CHRISTOPHER, DOUGLAS",600 GRESHAM DR STE 8620 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1497140495,"WALKER, TAJA, ERICA ASHLEY NICOLE",1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 24 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497140628,"CHAN, ALICE, YUE XI",115 HEART DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497140628,"CHAN, ALICE, YUE XI",500 SEAN DR   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497140628,"CHAN, ALICE, YUE XI",1806 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 33 , 41 , 112 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497140628,"CHAN, ALICE, YUE XI",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497140925,"LUKAS, STEPHANIE, ANNE MASUCK",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497140925,"LUKAS, STEPHANIE, ANNE MASUCK",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073832812,MILLENNIUM PHYSICIAN GROUP OF NC PL,~,4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497140925,"LUKAS, STEPHANIE, ANNE MASUCK",4205 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497141022,"MURPHY, NANCY, BROOKE",4414 LAKE BOONE TRL STE 405 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497142962,"KANG, CAROLINE, MINGHWEI",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497142962,"KANG, CAROLINE, MINGHWEI",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1437459021,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH UROLOGY LINCOLN,441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1497142962,"KANG, CAROLINE, MINGHWEI",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497149520,"MATHEW, PATRICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 16 , 53 , 53 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497150114,"CHINNASAMY, KRISHNAMANI",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497150114,"CHINNASAMY, KRISHNAMANI",3604 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 41 , 141 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497150114,"CHINNASAMY, KRISHNAMANI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497150114,"CHINNASAMY, KRISHNAMANI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 35 , 143 ,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497150114,"CHINNASAMY, KRISHNAMANI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 81 , 208 , 613 ,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497150114,"CHINNASAMY, KRISHNAMANI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497150114,"CHINNASAMY, KRISHNAMANI",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831465442,MONARCH,,3200 NORTHLINE AVE STE 132 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497150155,"MENGISTU, ALEMU, TAFESSE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 152 , 155 ,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1497150155,"MENGISTU, ALEMU, TAFESSE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497150155,"MENGISTU, ALEMU, TAFESSE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346680543,MONARCH,~,809 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1497150155,"MENGISTU, ALEMU, TAFESSE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528406519,MONARCH,~,2003 GODWIN AVE STE C LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497150155,"MENGISTU, ALEMU, TAFESSE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1497150155,"MENGISTU, ALEMU, TAFESSE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992143242,MONARCH,~,1001 NAVAHO DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497150155,"MENGISTU, ALEMU, TAFESSE",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1730325473,APEX VISION CENTER OD PA,CLARITY VISION OF APEX,1049 BEAVER CREEK COMMONS DR CLARITY VISION APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1497150700,"POWELL, ASHLEY, HOLT",1049 BEAVER CREEK COMMONS DR   APEX NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1891886222,MARSHALL C MURREY MD,MARSHALL CARY MURREY MD,950 STATE FARM RD STE 300 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1497151500,"SHREVE, TIFFANY, LYNN",950 STATE FARM RD STE 300 BOONE NC,095,Watauga,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497152722,"CLEMENT, DONNA, GAINES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497152904,"ALIU, ERMAL",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.),#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497152904,"ALIU, ERMAL",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.),#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497152904,"ALIU, ERMAL",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.),#,#,#,$#,,
MEDICAID DIRECT,1770987125,MYEYEDR OPTOMETRY OF NORTH CAROLINA,~,,,Unknown,193400000X,Group,Single Specialty,,1497158018,"ALLARD, TAYLOR",2346 WALNUT ST   CARY NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1497158331,"RACHH, BEENAL, KISHOR",1800 MAIN ST W   LOCUST NC,084,Stanly,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1497158331,"RACHH, BEENAL, KISHOR",1899 TATE BLVD SE STE 2106 HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1497158331,"RACHH, BEENAL, KISHOR",7427 MATTHEWS MINT HILL RD STE 103 MINT HILL NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 67 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1497158331,"RACHH, BEENAL, KISHOR",8700 PINEVILLE MATTHEWS RD STE 540 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1497158554,TIERNEY ORTHOTICS AND PROSTHETICS,~,1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497158554,TIERNEY ORTHOTICS AND PROSTHETICS,1345 WESTGATE CENTER DR STE B WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 481 , 849 ," 3,661 "," $404,822.60 ",,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1497160899,"KENDALL, AIMEE, DAVIS",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1497160899,"KENDALL, AIMEE, DAVIS",2525 COURT DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497161384,"SALEEM, NAFISA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 131 , 131 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497163539,"CLAUSEN, JADE, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497165328,"HUTCHENS, JACQUELYN, DENISE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 41 , 192 , 193 ," $23,936.10 ",,
MEDICAID DIRECT,1932923950,OPPORTUNITIES INDUSTRIALIZATION CEN,,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497165328,"HUTCHENS, JACQUELYN, DENISE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497169130,"FIELDING, OANH, NGUYEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497169130,"FIELDING, OANH, NGUYEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497169130,"FIELDING, OANH, NGUYEN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497169130,"FIELDING, OANH, NGUYEN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588084032,LEGACY HEALTHCARE SERVICES INC,LEGACY HEALTHCARE,105 CONVENTION DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497169536,"PEARCE, TONI, MARIE",3501 SENIOR VILLAGE LN NW   WILSON NC,098,Wilson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1588084032,LEGACY HEALTHCARE SERVICES INC,LEGACY HEALTHCARE,2800 KIDD RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497169536,"PEARCE, TONI, MARIE",3501 SENIOR VILLAGE LN NW   WILSON NC,098,Wilson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1588084032,LEGACY HEALTHCARE SERVICES INC,LEGACY HEALTHCARE,3501 SENIOR VILLAGE LN NW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1497169536,"PEARCE, TONI, MARIE",3501 SENIOR VILLAGE LN NW   WILSON NC,098,Wilson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497170203,"TAN, KRISTEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497173033,"BURY, CATHLEEN, MARIE DASCENZO",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497173033,"BURY, CATHLEEN, MARIE DASCENZO",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 77 , 76 , 76 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497174114,"BOIWKA, ALEXANDER, VONDRA",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 72 , 96 , 160 ,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497174353,"SHEIKH, ATIF",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1497174353,"SHEIKH, ATIF",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497174353,"SHEIKH, ATIF",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 88 , 135 , 183 ," $12,637.20 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497174627,"LYLES, JOHN, LYNCH",10207 CERNY ST STE 110 RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497174627,"LYLES, JOHN, LYNCH",10207 CERNY ST STE 110 RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497174627,"LYLES, JOHN, LYNCH",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 47 , 73 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497174627,"LYLES, JOHN, LYNCH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 60 , 123 , 137 ," $12,001.24 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497174817,"THOMAS, BRETT, ALEXANDER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 50 , 77 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497175434,"TATEM, ANDRIA, EVETTE",401 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497175566,"FERGUSON, CHRISTEN, B",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497175939,"EMOKPAE, EJIROGHENE, ELOHOR",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 49 , 49 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497179584,"BAIRD, CHRISTOPHER, JAMES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497179584,"BAIRD, CHRISTOPHER, JAMES",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154857662,PRESBYTERIAN SAMEDAY SURGERY CENTER,~,14215 BALLANTYNE CORPORATE PL STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497179584,"BAIRD, CHRISTOPHER, JAMES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1497179733,"BLACKWELL, VICTORIA, GWENDOLYN",3205 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 133 , 151 , 239 ," $49,464.00 ",,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497180046,"MCCABE, CALVIN MAXWELL, JAMES",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 90 , 128 , 263 ,$#,,
MEDICAID DIRECT,1548661606,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497180046,"MCCABE, CALVIN MAXWELL, JAMES",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548661606,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497180046,"MCCABE, CALVIN MAXWELL, JAMES",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497180046,"MCCABE, CALVIN MAXWELL, JAMES",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 33 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497183156,"MAZZARELLI, SARA, SAWKA",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497183156,"MAZZARELLI, SARA, SAWKA",2100 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 48 , 74 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497188189,"AKPAN, UDUAK, STELLA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497188189,"AKPAN, UDUAK, STELLA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497188189,"AKPAN, UDUAK, STELLA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497190268,"STURKIE, EMILY, KAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 66 , 73 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 30 , 34 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 24 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 323 , 353 , 577 ," $12,020.06 ",,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 34 , 43 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 49 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 26 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1497191548,"ALTENBURG, MICHAEL, KELLY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 24 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497191803,"FISHER, ERIK, STEVEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 120 , 126 , 162 ," $10,305.21 ",,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497192876,"FARLAND, TAYLOR, GEAR",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497192876,"FARLAND, TAYLOR, GEAR",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 2,129 "," 2,347 "," 14,927 "," $837,958.14 ",,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497193080,"VASLOW, ZACHARY, KOEHN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 32 , 61 , 73 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497193569,"RUST, LAUREN, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 53 , 67 ,$#,,
MEDICAID DIRECT,1104959055,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497194666,"ONG, SALLY, SHIN YEE",1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 39 , 101 , 214 ," $15,047.31 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497194666,"ONG, SALLY, SHIN YEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 62 , 171 , 343 ," $54,291.49 ",,
MEDICAID DIRECT,1568113132,ELDRIDGE PODIATRY PA,CAROLINA FOOT & ANKLE ASSOCIATES,1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497195341,"ELDRIDGE, RANDALL, THOMAS",303 S GREEN ST STE 102 MORGANTON NC,012,Burke,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1568113132,ELDRIDGE PODIATRY PA,CAROLINA FOOT & ANKLE ASSOCIATES,1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497195341,"ELDRIDGE, RANDALL, THOMAS",303 S GREEN ST STE 102 MORGANTON NC,012,Burke,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1568113132,ELDRIDGE PODIATRY PA,CAROLINA FOOT & ANKLE ASSOCIATES,303 S GREEN ST # 102 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1497195341,"ELDRIDGE, RANDALL, THOMAS",303 S GREEN ST STE 102 MORGANTON NC,012,Burke,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1568113132,ELDRIDGE PODIATRY PA,CAROLINA FOOT & ANKLE ASSOCIATES,1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497195341,"ELDRIDGE, RANDALL, THOMAS",1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 89 , 128 , 228 ,$#,,
MEDICAID DIRECT,1568113132,ELDRIDGE PODIATRY PA,CAROLINA FOOT & ANKLE ASSOCIATES,1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497195341,"ELDRIDGE, RANDALL, THOMAS",1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1568113132,ELDRIDGE PODIATRY PA,CAROLINA FOOT & ANKLE ASSOCIATES,303 S GREEN ST # 102 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1497195341,"ELDRIDGE, RANDALL, THOMAS",1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1730529470,"ELDRIDGE, STEPHANIE, WAI LING",,1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,1497195341,"ELDRIDGE, RANDALL, THOMAS",1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1568113132,ELDRIDGE PODIATRY PA,CAROLINA FOOT & ANKLE ASSOCIATES,1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497195341,"ELDRIDGE, RANDALL, THOMAS",1501 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 31 , 36 , 80 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497195390,"KOTHARI, RAVISH, ASHOKKUMAR",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1124568688,NORTHERN HOSPITAL OF SURRY COUNTY,~,100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1497198170,"MINOR, JORDAN, JULIANNA",100 N POINTE BLVD   MOUNT AIRY NC,086,Surry,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 39 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497198287,"SIEWNY, LAUREN, ELIZABETH",2301 ERWIN RD STE 2600 DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497198287,"SIEWNY, LAUREN, ELIZABETH",2301 ERWIN RD STE 2600 DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 44 , 49 ,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497198634,"JOHNSON, JACOB, KEITH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 14 , 42 , 43 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497199335,"SILVER, ETHAN, H.",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497199335,"SILVER, ETHAN, H.",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497199335,"SILVER, ETHAN, H.",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1497199806,"RHOADES, STEPHANIE, CARISA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 61 , 74 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497200117,"WOMBLE, WALKER, SCHOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497200117,"WOMBLE, WALKER, SCHOTT",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497200117,"WOMBLE, WALKER, SCHOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497200117,"WOMBLE, WALKER, SCHOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 34 , 34 ,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497207641,"MARCHAL, JESSICA, LYNN",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1497213557,"GREENWOOD, BROOKE, STONER",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497213862,"LAW, LAURA, CATHERINE",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 25 , 26 ,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497213862,"LAW, LAURA, CATHERINE",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1497213862,"LAW, LAURA, CATHERINE",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497215248,"KELLY, JARED, ROBERT",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 45 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497216428,"AGGARWAL, SAHIL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497216428,"AGGARWAL, SAHIL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497216428,"AGGARWAL, SAHIL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497216428,"AGGARWAL, SAHIL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497217038,"KIMBRELL, CONNOR, WILLIAM",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 29 , 38 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497217160,"JOHNSON, DAKOTA, COLTON",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497218788,"BERNARD, ABIGAIL, LYNN",3031 OLD CLINIC BUILDING CB 7570   CHAPEL HILL NC,019,Chatham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497221097,"ELLER, LANA, ENSLEY",5003 HOSPICE LN   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,610 W FISHER ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1497221097,"ELLER, LANA, ENSLEY",5003 HOSPICE LN   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,1206 FULTON ST   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1497221097,"ELLER, LANA, ENSLEY",5003 HOSPICE LN   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1497221097,"ELLER, LANA, ENSLEY",5003 HOSPICE LN   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 103 ," 1,052 "," 1,240 "," $48,789.54 ",,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1497221097,"ELLER, LANA, ENSLEY",600 HOSPITAL DR   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 24 , 26 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497222087,"FLETCHER, ANDREA, SADLER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497223861,"BAKER, EMILY, KURZON",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 114 , 135 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497223952,"PICKENS, ALLYSON, SELF",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 46 , 87 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497223952,"PICKENS, ALLYSON, SELF",63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 25 , 38 ,$#,,
MEDICAID DIRECT,1255805065,CAREPARTNERS HHA LLLP,CAREPARTNERS PRIVATE DUTY SERVICES,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1497223952,"PICKENS, ALLYSON, SELF",63 MONTICELLO RD   WEAVERVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093219370,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PRIMARY CARE - A,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1497225767,"FOX, ALYSSA, MARIE",223 W WARD ST STE B ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1093219370,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PRIMARY CARE - A,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1497225767,"FOX, ALYSSA, MARIE",223 W WARD ST STE B ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 75 , 103 ,$#,,
MEDICAID DIRECT,1093219370,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PRIMARY CARE - A,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1497225767,"FOX, ALYSSA, MARIE",138 DUBLIN SQUARE RD STE C ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1497226252,"STANCIL, KACIE, BARBEE",1007 N 6TH ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 34 , 51 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,1007 N 6TH ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1497226252,"STANCIL, KACIE, BARBEE",1007 N 6TH ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1497226252,"STANCIL, KACIE, BARBEE",1007 N 6TH ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 76 , 125 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497226468,"MACKEY, AMY, LYNN",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1497227821,"LOPEZ, DENISE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 42 , 119 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2200 TREELIGHT WAY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1497227821,"LOPEZ, DENISE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2000 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1497227821,"LOPEZ, DENISE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 25 , 69 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497232425,"KERN, RYAN, ERIC",9 MEDICAL DR   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497233530,"WILLIAMS, ISAAC, ADISON",2140 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 1,006 "," 1,785 "," 5,781 "," $286,377.36 ",,
MEDICAID DIRECT,1932283421,HIGGINS MANI & WATSON I DDS PA,THE DENTAL CARE CENTER,2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497233530,"WILLIAMS, ISAAC, ADISON",2140 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 175 , 180 , 658 ," $29,010.24 ",,
MEDICAID DIRECT,1932283421,HIGGINS MANI & WATSON I DDS PA,THE DENTAL CARE CENTER,2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497233530,"WILLIAMS, ISAAC, ADISON",2470 EMERALD PL   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497233530,"WILLIAMS, ISAAC, ADISON",2470 EMERALD PL   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 418 , 565 ," 1,485 "," $144,899.18 ",,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497233530,"WILLIAMS, ISAAC, ADISON",3001B RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497241491,"MUKUNO, KAELA, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497241491,"MUKUNO, KAELA, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366181943,CENTERWELL SENIORPRIMARYCARENC JVPC,,8727 JW CLAY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497242630,"CONGRESS, JAICIE, NADINE",8727 JW CLAY BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497242812,"HESS, ARIANA, LANAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497242812,"HESS, ARIANA, LANAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497242812,"HESS, ARIANA, LANAE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497242812,"HESS, ARIANA, LANAE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497242812,"HESS, ARIANA, LANAE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497243497,"FIDDLER, GAVIN, LAWRENCE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 81 , 111 , 122 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497247852,"LAPPS, REBECCA, JEAN",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 52 , 73 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497247852,"LAPPS, REBECCA, JEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 17 , 17 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497247852,"LAPPS, REBECCA, JEAN",1515 DOCTORS CIR BLDG A CAPE FEAR NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 20 , 38 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497249973,"FREELS, PARKER, DOUGLAS",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1497249973,"FREELS, PARKER, DOUGLAS",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497249973,"FREELS, PARKER, DOUGLAS",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497250021,"RICKETTS, PETA-GAY, AMIKA",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 11 , 32 ," $11,569.05 ",,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497250021,"RICKETTS, PETA-GAY, AMIKA",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 41 , 76 , 107 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497250021,"RICKETTS, PETA-GAY, AMIKA",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 35 , 69 , 135 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497250146,"DRIVER, PAIGE, ELIZABETH",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 62 , 99 ,$#,,
MEDICAID DIRECT,1043441918,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1497250146,"DRIVER, PAIGE, ELIZABETH",270 COPPERFIELD BLVD NE STE 202 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497250146,"DRIVER, PAIGE, ELIZABETH",270 COPPERFIELD BLVD NE STE 202 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 72 , 72 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1497250146,"DRIVER, PAIGE, ELIZABETH",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497251946,"FITZGERALD, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 176 , 186 , 194 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497252365,"ABDEL AZIZ, RAMI, SADEK AWAD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,1401 MATTHEWS TOWNSHIP PKWY STE 225 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497259410,"ADKINS, TAMARA, LYNN",1401 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497259659,"FORD, LUCIE, REGINA",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497259667,"BRITT-VILLANUEVA, JEREMY",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497260608,PROVIDENCE HEALTHCARE OF THE CAROLI,PROVIDENCE ASSISTED LIVING,4302 NC HIGHWAY 210   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497260608,PROVIDENCE HEALTHCARE OF THE CAROLI,4302 NC HIGHWAY 210   SMITHFIELD NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 12 ," 3,143 "," 3,146 "," $268,012.67 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497261283,"LEE, HEEYOUNG",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497261283,"LEE, HEEYOUNG",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497264600,"LUCAS, MACIE, NICHOLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497264600,"LUCAS, MACIE, NICHOLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497265029,"ECKSTEIN, ANDREW, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497267645,"SWANSON, MARTHA",200 FLOWERS PRIDGEN DR   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 41 , 49 ,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497268320,"SQUIRES, KELLY, MAINES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 33 , 33 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497268320,"SQUIRES, KELLY, MAINES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1497269500,"KANG, ANGELA, HAERIN",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1366560443,LARRY J MORAY DDS MS PA,MYORTHODONTIST,2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497269500,"KANG, ANGELA, HAERIN",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,458 "," 3,594 "," 4,422 "," $668,187.32 ",,
MEDICAID DIRECT,1366560443,LARRY J MORAY DDS MS PA,MYORTHODONTIST,2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497269500,"KANG, ANGELA, HAERIN",2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 88 , 131 , 185 ," $26,602.72 ",,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1497269500,"KANG, ANGELA, HAERIN",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 148 , 165 , 262 ," $38,662.05 ",,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1497269500,"KANG, ANGELA, HAERIN",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1366560443,LARRY J MORAY DDS MS PA,MYORTHODONTIST,2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497269500,"KANG, ANGELA, HAERIN",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,402 "," 3,274 "," 4,100 "," $596,680.46 ",,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1497269500,"KANG, ANGELA, HAERIN",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 160 , 207 , 338 ," $48,724.01 ",,
MEDICAID DIRECT,1235340803,LARRY J MORAY DDS MS PA,MYORTHODONTIST,120 CLINTON CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1497269500,"KANG, ANGELA, HAERIN",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1497269500,"KANG, ANGELA, HAERIN",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497269534,"FLORES, CATHERINE, ANNE",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 43 , 88 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497269534,"FLORES, CATHERINE, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497271365,"GIBBS, THERESA, TUCKMANTEL",935 STATE FARM RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336606938,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PEDIATRICS,110 DUTCHMAN CT   ELKIN NC,086,Surry,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497271365,"GIBBS, THERESA, TUCKMANTEL",935 STATE FARM RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 45 , 76 ,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497271365,"GIBBS, THERESA, TUCKMANTEL",935 STATE FARM RD   BOONE NC,095,Watauga,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",1765 DOBBINS DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",100 S BOYLAN AVE   RALEIGH NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",3010 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 11 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",105 NEWSOM ST STE 101 DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 14 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",4551 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",68 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",700 S TORRENCE ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",1704 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497271902,"POULTON, WINONA, ELIZABETH",1925 TRADD CT   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497273023,"MORENO, EDUARDO, FABIAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497273023,"MORENO, EDUARDO, FABIAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health, 12 , 52 , 52 ," $12,862.20 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497274823,"HA, JENNIFER, THI",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 44 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497274823,"HA, JENNIFER, THI",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497274823,"HA, JENNIFER, THI",10207 CERNY ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497276646,"RASOOL, ZOAIB, SAFDAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497276646,"RASOOL, ZOAIB, SAFDAR",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497276646,"RASOOL, ZOAIB, SAFDAR",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497276646,"RASOOL, ZOAIB, SAFDAR",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 129 , 129 ,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497276968,"AGOSTINI, MEGHAN, KURZEL",1207 EAST ST   WAYNESVILLE NC,044,Haywood,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder), 26 , 161 , 161 ," $40,613.87 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1497281059,"MURRELL, CAROLINE, JONES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497281059,"MURRELL, CAROLINE, JONES",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497282214,"JUEL, LAURA, ELLEN",3000 ERWIN RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1497283899,BLADEN EAST HEALTH AND REHAB LLC,,804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497283899,BLADEN EAST HEALTH AND REHAB LLC,804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 20 ," 2,075 "," 2,076 "," $407,243.04 ",,
MEDICAID DIRECT,1124775655,DAYENA LEE DDS AND KANDICE LEE DDS,MEBANE OAKS FAMILY DENTISTRY,975 CAMERON LN   MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,1497284913,"LEE, DAYENA",975 CAMERON LN   MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 199 , 362 ," 1,179 "," $47,469.11 ",,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497285696,"MOORE, SHALANE, BETH",925 N 4TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 92 , 111 ," $10,542.99 ",,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497286108,"EBBING, BRITTANY, GABRIELLE",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497289367,"MARIS, ALEXANDER, SPYROS",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1497291645,"COLE, HOPE, MCKEE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1497291645,"COLE, HOPE, MCKEE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 11 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497291645,"COLE, HOPE, MCKEE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1497291645,"COLE, HOPE, MCKEE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497291645,"COLE, HOPE, MCKEE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1497291645,"COLE, HOPE, MCKEE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 28 , 31 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497291645,"COLE, HOPE, MCKEE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497294581,"MEYER, KATHLEEN, LAUREN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497294581,"MEYER, KATHLEEN, LAUREN",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497297014,"COSENTINO, ALLISON, ROSE",2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497297014,"COSENTINO, ALLISON, ROSE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1669 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497303309,"DAYWALT, DEBORAH, KIMBERLY",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 85 , 200 , 485 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497303309,"DAYWALT, DEBORAH, KIMBERLY",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497303309,"DAYWALT, DEBORAH, KIMBERLY",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 68 , 545 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497303309,"DAYWALT, DEBORAH, KIMBERLY",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 33 , 77 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497303309,"DAYWALT, DEBORAH, KIMBERLY",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 39 , 58 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1497306575,"MORRIS, CAROLINE, ELIZABETH",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 55 , 68 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1497306575,"MORRIS, CAROLINE, ELIZABETH",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 156 , 234 ,$#,,
MEDICAID DIRECT,1225500804,CAREPARTNERS HHA LLLP,CAREPARTNERS HOME CARE & HOSPICE,170 CHURCH ST   FRANKLIN NC,056,Macon,251B00000X,Agencies,Case Management,,1497306575,"MORRIS, CAROLINE, ELIZABETH",55 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497307474,"GILLISPIE, ALISON, MARGARET",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497310148,"GOLDSTON, JONATHAN, BRITT",150 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1497310148,"GOLDSTON, JONATHAN, BRITT",150 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1497310148,"GOLDSTON, JONATHAN, BRITT",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497310148,"GOLDSTON, JONATHAN, BRITT",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1497311740,"ROPER, WILLIAM, LEE",170 MANNING DR CB# 7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 26 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497311740,"ROPER, WILLIAM, LEE",170 MANNING DR CB# 7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 108 , 121 , 140 ," $10,742.54 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497314785,"KAISER, CHRISTOPHER, ROBERT",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497314785,"KAISER, CHRISTOPHER, ROBERT",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 37 , 78 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497314785,"KAISER, CHRISTOPHER, ROBERT",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 105 , 200 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497317176,"LAFFERTY, JOSEPH, WILLIAM",100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497317176,"LAFFERTY, JOSEPH, WILLIAM",401 IRVING PKWY STE 310 HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497317176,"LAFFERTY, JOSEPH, WILLIAM",401 IRVING PKWY STE 310 HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1245587534,FRENCH BROAD PEDIATRIC ASSOCIATES P,FRENCH BROAD PEDICATRIC ASSOCIATES PLLC,40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1497318687,"MIFFLIN, RACHEL, RONGSTAD",40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 58 , 73 , 175 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12016 LEMMOND FARM DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497318877,"HAMLETT, JASMIN, ALDRIDGE",12016 LEMMOND FARM DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 47 , 67 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497318877,"HAMLETT, JASMIN, ALDRIDGE",798 OAK RIDGE FARM HWY STE A MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 28 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,798 OAK RIDGE FARM HWY STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497318877,"HAMLETT, JASMIN, ALDRIDGE",798 OAK RIDGE FARM HWY STE A MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497320956,"SHOOK, MICAH, BURWELL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497320956,"SHOOK, MICAH, BURWELL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1659656916,CENTER FOR ORTHOTIC AND PROSTHETIC,HANGER CLINIC,4601 CREEKSTONE DR STE 112 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497322416,"NELSON, MIKAELA, ANN",4702 CREEKSTONE DR   DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1821604687,DR DURSHANAPALLI & ASSOCIATES PLLC,GENTLE CARE FAMILY DENTAL,2380 HICKSWOOD RD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1497322564,"BHADANI, NILU",2380 HICKSWOOD RD   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 2,080 "," 4,325 "," 12,426 "," $752,361.62 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497322895,"KING, KAYCE, LEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 29 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1497324776,"INGRAM, JORDAN, SCOTT",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1497325054,"HESS, KAYLA, MARIE",2145 COUNTRY CLUB RD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 27 , 45 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1497325054,"HESS, KAYLA, MARIE",3332 BRIDGES ST STE B MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497325815,"CRISAN, MARIUS, CLAUDIU",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497327209,"LEE, MATTHEW, HYUN YONG",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice," 1,397 "," 1,862 "," 5,614 "," $303,466.25 ",,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497327209,"LEE, MATTHEW, HYUN YONG",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497328140,"FUTRELL, MICHAEL, TODD",214 DUPLIN ST   KENANSVILLE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 28 , 28 ,$#,,
MEDICAID DIRECT,1093203473,GOSHEN MEDICAL CENTER INCORPORATED,~,102 N MAIN ST STE 1&2 KENANSVILLE NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497328140,"FUTRELL, MICHAEL, TODD",214 DUPLIN ST   KENANSVILLE NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497328140,"FUTRELL, MICHAEL, TODD",102 N MAIN ST STE 1&2 FAISON NC,031,Duplin,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1497328561,3 HEARTS THAT CARE,,704C PLAZA BLVD STE 109-111 KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1497328561,3 HEARTS THAT CARE,704C PLAZA BLVD STE 109-111 KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 1,942 "," 1,942 "," $173,269.12 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497329536,"DONG, CHRISTOPHER",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,516 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1497332258,"MATTE, ALLISON, ELISE",516 BEAMAN ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 141 , 237 , 277 ,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1497333066,"GANTA, ANUPA",10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 16 , 46 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497333439,"SPENCER, BAILEY, JEAN",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194408534,COASTAL CAROLINA HEALTH CARE PA,CCHC PSYCHIATRY,3252 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1497333603,"WALDROP, KOEHLER, ELIZABETH",3252 WELLONS BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 124 , 188 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,945 GOLF HOUSE RD W   WHITSETT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497333702,"KUMAR, AGNIJITA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497333702,"KUMAR, AGNIJITA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 62 , 66 ," $18,426.16 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5002 HIGH POINT RD STE A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1497334163,"JOHNSON, MALIK, LAMAR",5002 HIGH POINT RD STE A GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 250 , 393 ," 1,538 "," $64,946.39 ",,
MEDICAID DIRECT,1346626587,FORSYTH COUNTY,~,501 N CLEVELAND AVE STE 1 WINSTON SALEM NC,034,Forsyth,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1497334163,"JOHNSON, MALIK, LAMAR",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 91 , 124 , 301 ," $17,498.95 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1497334163,"JOHNSON, MALIK, LAMAR",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 50 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5002 HIGH POINT RD STE A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1497334163,"JOHNSON, MALIK, LAMAR",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1497334163,"JOHNSON, MALIK, LAMAR",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1497334163,"JOHNSON, MALIK, LAMAR",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1497334163,"JOHNSON, MALIK, LAMAR",3801 INDIANA AVE   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1043446966,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497336747,"BLEKICKI, ASHLEY, SUZANNE",1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1952537615,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,120 CHADWICK SQUARE CT STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1497336747,"BLEKICKI, ASHLEY, SUZANNE",1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1740611060,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,120 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1497336747,"BLEKICKI, ASHLEY, SUZANNE",1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1679181317,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT HICKORY HIGH,1234 3RD ST NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497339907,"SPRINGS, MARCUS, LEE",1234 3RD ST NE   HICKORY NC,018,Catawba,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1497345243,INFINITY 7EVEN HOMECARE LLC,,2530 MERIDIAN PKWY STE 3067 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1497345243,INFINITY 7EVEN HOMECARE LLC,2530 MERIDIAN PKWY STE 3067 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 874 , 874 ," $74,792.04 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497347314,"ROY, JASON, DOUGLAS",319 VILLAGE RD NE   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497347314,"ROY, JASON, DOUGLAS",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 60 , 134 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497347314,"ROY, JASON, DOUGLAS",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497347314,"ROY, JASON, DOUGLAS",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1497347314,"ROY, JASON, DOUGLAS",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1497347314,"ROY, JASON, DOUGLAS",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497348056,"EVANS, JORDAN, E.",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,1103 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1497359707,"PRIM, COURTNEY, MARIE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497359707,"PRIM, COURTNEY, MARIE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 189 ," 1,166 "," 2,048 "," $17,977.55 ",,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497359707,"PRIM, COURTNEY, MARIE",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 72 , 182 ,$#,,
MEDICAID DIRECT,1508341736,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497359707,"PRIM, COURTNEY, MARIE",975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 100 , 282 ,$#,,
MEDICAID DIRECT,1083484968,VENVISOR HEALTH OF NC,,106 LANGTREE VILLAGE DR STE 301 # 221 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497361067,"LLOYD, KARA",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 165 , 165 , 165 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497361216,"GALANTIS, JAMES, NICHOLAS",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497361216,"GALANTIS, JAMES, NICHOLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497361216,"GALANTIS, JAMES, NICHOLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 61 , 79 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497370308,"POSTON, WILLIAM, ZACHARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 44 , 62 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497371298,"MCILVEEN, COURTNEY, RENEE",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497371298,"MCILVEEN, COURTNEY, RENEE",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497371298,"MCILVEEN, COURTNEY, RENEE",1656 RIVERCHASE BLVD STE 3600 ROCK HILL SC,101,Out of State <= 40 miles,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1497371710,VISION FIRST OPTOMETRY PLLC,BETHLEHEM EYECARE,3398 HICKORY BLVD   HUDSON NC,014,Caldwell,193400000X,Group,Single Specialty,,1497371710,VISION FIRST OPTOMETRY PLLC,3398 HICKORY BLVD   HUDSON NC,014,Caldwell,193400000X,Group,Single Specialty,, 481 , 503 , 990 ," $13,014.45 ",,
MEDICAID DIRECT,1497371710,VISION FIRST OPTOMETRY PLLC,BETHLEHEM EYECARE,174 BOLICK LN STE 201 TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1497371710,VISION FIRST OPTOMETRY PLLC,174 BOLICK LN STE 201 TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,, 435 , 450 , 873 ," $11,917.44 ",,
MEDICAID DIRECT,1497371710,VISION FIRST OPTOMETRY PLLC,BETHLEHEM EYECARE,2063 15TH AVENUE PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497371710,VISION FIRST OPTOMETRY PLLC,2063 15TH AVENUE PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,, 663 , 696 ," 1,350 "," $18,048.40 ",,
MEDICAID DIRECT,1497373344,"PATEL, DHRUVAL, NIRUBHAI",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1497373344,"PATEL, DHRUVAL, NIRUBHAI",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1497373435,"TRETHEWEY, BRITTANY, NICOLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 42 , 65 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497374961,"LEONARD, GABRIELLE, GIOIA",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497375315,"MIRALOGLU, YUSUF",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497375315,"MIRALOGLU, YUSUF",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 24 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497375315,"MIRALOGLU, YUSUF",3000 ROGERS RD STE 200 WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497378996,"KIEHL, ROBIN, RAINEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497380646,"BERUMEN, CRYSTAL, BARNES",3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497380646,"BERUMEN, CRYSTAL, BARNES",3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 41 , 43 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497380646,"BERUMEN, CRYSTAL, BARNES",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 82 , 119 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497380646,"BERUMEN, CRYSTAL, BARNES",1 MEDICAL DR   BENSON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 61 , 61 ,$#,,
MEDICAID DIRECT,1689673360,FOOTHILLS PODIATRY PA,Foothills Podiatry PA,707 N MORGAN ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1497382964,"KARWA, SRUTI, M.",707 N MORGAN ST   SHELBY NC,023,Cleveland,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 21 , 45 , 69 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497383459,"FARRELL, JOHN, JOSEPH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 22 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497383822,"LOGAN, KRISTEN, ADAMS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497383822,"LOGAN, KRISTEN, ADAMS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497383822,"LOGAN, KRISTEN, ADAMS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1477582120,ROWAN DIAGNOSTIC CLINIC,ROWAN DIAGNOSTIC CLINIC,611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1497384200,"YOUNG, EMERY, LLEWELLYN",611 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 71 , 103 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1497384366,"AZAM, MONAZZA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497384366,"AZAM, MONAZZA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497385249,"PHILLIPS, REBECCA, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 24 , 47 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497387500,"SCIBELLI, KATHLEEN, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497387500,"SCIBELLI, KATHLEEN, MARIE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497388144,"MUSE, CAITLIN, SHEPHERD",10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 25 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497388219,"BLACKBURN, HAILEY, NICOLE",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 30 , 72 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497388219,"BLACKBURN, HAILEY, NICOLE",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1497388581,"FULLER, BILLY, CARL",BILLY CARL FULLER DBA JUST SPEAK BABY ADULT & PED,1007 MEADOW OAK DR   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1497388581,"FULLER, BILLY, CARL",1007 MEADOW OAK DR   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 43 ," 1,142 "," 1,142 "," $79,108.74 ",,
MEDICAID DIRECT,1497388755,ONSLOW OPCO HOLDINGS LLC,THE LANDINGS OF SWANSBORO,280 SWANSBORO LOOP RD   SWANSBORO NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497388755,ONSLOW OPCO HOLDINGS LLC,280 SWANSBORO LOOP RD   SWANSBORO NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 17 ," 3,107 "," 3,108 "," $313,693.81 ",,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1497391809,"REARY, DEANNA, RENEE",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 88 , 204 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1497392260,"NIGHTINGALE, JOANNA, LYNN",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 82 , 96 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497392260,"NIGHTINGALE, JOANNA, LYNN",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 46 , 62 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497394126,"AYER, SARAH, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497394373,"MENON, GAYATRI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 129 , 129 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497394373,"MENON, GAYATRI",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 149 , 149 ,$#,,
MEDICAID DIRECT,1497395156,HEALTHCARE OPTIONS ELITE INC,,705 N BROAD ST   EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,,1497395156,HEALTHCARE OPTIONS ELITE INC,705 N BROAD ST   EDENTON NC,021,Chowan,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 6,983 "," 7,718 "," $811,150.04 ",,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497395198,"BINKLEY, ANDREA, MILLER",31 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 24 , 41 ,$#,,
MEDICAID DIRECT,1669663175,ADDICTION RECOVERY MEDICAL SERVICES,ADDICTION RECOVERY MEDICAL SERVICES-PROVIDERS PLLC,536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497395198,"BINKLEY, ANDREA, MILLER",536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 114 , 171 ," $20,392.29 ",,
MEDICAID DIRECT,1497399422,VITAL HEALTH SERVICES LLC,,7048 KNIGHTDALE BLVD STE 101 KNIGHTDALE NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497399422,VITAL HEALTH SERVICES LLC,7048 KNIGHTDALE BLVD STE 101 KNIGHTDALE NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 32 , 67 ,$#,,
MEDICAID DIRECT,1497399422,VITAL HEALTH SERVICES LLC,,7048 KNIGHTDALE BLVD STE 101 KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1497399422,VITAL HEALTH SERVICES LLC,7048 KNIGHTDALE BLVD STE 101 KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,933 "," 1,933 "," $181,023.05 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497406979,"LEWIS, MICHELE, OLIVIA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 204 , 205 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497406979,"LEWIS, MICHELE, OLIVIA",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 79 , 79 ,$#,,
MEDICAID DIRECT,1497406979,"LEWIS, MICHELE, OLIVIA",,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1497406979,"LEWIS, MICHELE, OLIVIA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497406979,"LEWIS, MICHELE, OLIVIA",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 92 , 105 , 390 ," $15,546.20 ",,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 138 , 149 , 449 ," $18,242.58 ",,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 241 , 296 ," 1,228 "," $53,812.52 ",,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 212 , 238 ," 1,064 "," $41,761.11 ",,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 898 ," 1,325 "," 6,204 "," $274,870.53 ",,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497408512,"AZZAM, WISSAM, JAMAL",1000 CRESCENT GRN STE 200 CARY NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 302 , 367 ," 1,565 "," $63,989.09 ",,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497409304,"LUNDBERG, EKATERINA, SERGEYEVNA",615 RIDGE RD   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497409304,"LUNDBERG, EKATERINA, SERGEYEVNA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497411029,"FERGUSON, CHELSEA, FELTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497411029,"FERGUSON, CHELSEA, FELTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497412803,"CRUMPTON, CHARLOTTE, ROLLINSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1497412803,"CRUMPTON, CHARLOTTE, ROLLINSON",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1497412803,"CRUMPTON, CHARLOTTE, ROLLINSON",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497412803,"CRUMPTON, CHARLOTTE, ROLLINSON",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497412803,"CRUMPTON, CHARLOTTE, ROLLINSON",110 KILDAIRE PARK DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497412803,"CRUMPTON, CHARLOTTE, ROLLINSON",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497414361,"HARVELL, AMY, LOVE",416 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497417521,"NADEAU, RACHEL, TERESA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 353 ," 2,250 "," 2,301 "," $50,751.01 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497417521,"NADEAU, RACHEL, TERESA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497417745,"SEWELSON, SARA, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497417745,"SEWELSON, SARA, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497419220,"BLALOCK, JESSICA, LYNNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 61 , 69 ,$#,,
MEDICAID DIRECT,1497424493,WITH LOVE AND CARE SERVICES LLC,WITH LOVE AND CARE SERVICES LLC,105 BLUEGRASS DR   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1497424493,WITH LOVE AND CARE SERVICES LLC,105 BLUEGRASS DR   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 42 ," 10,420 "," 10,974 "," $1,505,706.88 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497424683,"OTT, CHANDLER, MACKENZIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497424683,"OTT, CHANDLER, MACKENZIE",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497424683,"OTT, CHANDLER, MACKENZIE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497424683,"OTT, CHANDLER, MACKENZIE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497424683,"OTT, CHANDLER, MACKENZIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497424683,"OTT, CHANDLER, MACKENZIE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497424683,"OTT, CHANDLER, MACKENZIE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1497425102,"KUBE, REBEKAH, LYNN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 55 , 55 ,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1497425102,"KUBE, REBEKAH, LYNN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1497425102,"KUBE, REBEKAH, LYNN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063962074,COASTAL CAROLINA HEALTH CARE PA,CCHC PAMLICO MEDICAL CENTER,606 MAIN ST   BAYBORO NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1497425102,"KUBE, REBEKAH, LYNN",1209 E ASH ST   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1528623790,COASTAL CAROLINA HEALTH CARE PA,CCHC EXTENDED CARE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1497425102,"KUBE, REBEKAH, LYNN",1209 E ASH ST   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1497429021,A SISTERLY CARE,,409 4TH ST SW UNIT B HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1497429021,A SISTERLY CARE,409 4TH ST SW UNIT B HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,645 "," 2,645 "," $406,495.84 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497429823,"LEIMBERGER, DAVID, NEIL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 80 , 85 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497432462,"FRANCIS, JUSTIN, JOSEPH JOHN",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497433825,"NASH, CORNELIA, SALLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497434393,"KERR, ERICA, CHRISTINE",404 WESTWOOD AVE STE 303 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497434526,"BROWN, SAVANNAH, LAUREN",930 3RD ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497434526,"BROWN, SAVANNAH, LAUREN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 29 , 52 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497434708,"VAN SCHOONEVELD, DARLA, MAE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497435663,"RICHARDSON, JUSTIN, KYLE",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497435663,"RICHARDSON, JUSTIN, KYLE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1497436828,"SULLIVAN, CIERRA, MOODY",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 59 , 173 ,$#,,
MEDICAID DIRECT,1497439780,EXPRESS MED LLC,,2016 MILLERTON AVE   CHARLOTTE NC,060,Mecklenburg,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1497439780,EXPRESS MED LLC,2016 MILLERTON AVE   CHARLOTTE NC,060,Mecklenburg,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#,#,#,$#,,
MEDICAID DIRECT,1457436982,EAGLE PHYSICIANS AND ASSOCIATES PA,~,1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497441307,"TOCCI, NICHOLAS, DAVID",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 22 ,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497441307,"TOCCI, NICHOLAS, DAVID",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497441307,"TOCCI, NICHOLAS, DAVID",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497441307,"TOCCI, NICHOLAS, DAVID",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497444236,"BROWN, OLIVIA, CHRISTIANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 46 , 83 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497444236,"BROWN, OLIVIA, CHRISTIANA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 20 , 27 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1497450746,"NDUKA, OGBEYIALU, INYANG",1202 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1497450746,"NDUKA, OGBEYIALU, INYANG",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 44 , 181 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497451777,"HILL, AVERY, SUZANNE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 41 , 58 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497451777,"HILL, AVERY, SUZANNE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497457287,"HULSMAN, MATTHEW, JOHN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 32 , 33 , 40 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497457287,"HULSMAN, MATTHEW, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1497461289,"CARIM, CHARLES, ALAIN",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 53 , 113 ,$#,,
MEDICAID DIRECT,1447980883,TRIAD ADULT AND PEDIATRIC MEDICINE,,300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497461420,"DARROW, MORGAN, LEE",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 85 , 112 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497462071,"CASS, BRIANA, CHRISTEN",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497462071,"CASS, BRIANA, CHRISTEN",4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497462071,"CASS, BRIANA, CHRISTEN",4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1700851045,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,6300 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497462600,"LEWIS, HANNAH, ELIZABETH",6300 E INDEPENDENCE BLVD STE A CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 39 , 39 , 39 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497463137,"KPAKOSSOU, AFI, NONO",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 17 , 27 , 27 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497463137,"KPAKOSSOU, AFI, NONO",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497463137,"KPAKOSSOU, AFI, NONO",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 149 , 149 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497463137,"KPAKOSSOU, AFI, NONO",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497463137,"KPAKOSSOU, AFI, NONO",1007 HOWARD ST   MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497463137,"KPAKOSSOU, AFI, NONO",1007 HOWARD ST   MOCKSVILLE NC,030,Davie,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 20 , 33 , 33 ,$#,,
MEDICAID DIRECT,1497463442,GRACE HOME CARE SERVICES INC,,600 PARK OFFICES DR STE 300 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1497463442,GRACE HOME CARE SERVICES INC,600 PARK OFFICES DR STE 300 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 266 , 266 ," $26,486.24 ",,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1497463475,"OTT, WILLIAM, ANDREW",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1497463475,"OTT, WILLIAM, ANDREW",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497466064,OHANAS CONNECTIONS LLC,OHANAS CONNECTION LLC,334 SONOMA RD   JACKSONVILLE NC,067,Onslow,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1497466064,OHANAS CONNECTIONS LLC,334 SONOMA RD   JACKSONVILLE NC,067,Onslow,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 43 , 538 , 644 ," $60,126.63 ",,
MEDICAID DIRECT,1497467211,SPLENDOUR HOME CARE SERVICES INC,,203 MANNINGTON DR   MORRISVILLE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1497467211,SPLENDOUR HOME CARE SERVICES INC,203 MANNINGTON DR   MORRISVILLE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 280 , 280 ," $18,452.16 ",,
MEDICAID DIRECT,1497467682,CHARISMATIC HEARTS HOME CARE AGENCY,,930 VINTAGE JONES WAY STE 3 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1497467682,CHARISMATIC HEARTS HOME CARE AGENCY,930 VINTAGE JONES WAY STE 3 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 161 , 161 ," $25,645.88 ",,
MEDICAID DIRECT,1811424849,MOSES CONE PHYSICIAN SERVICES INC,CHMG PRIMARY CARE AT FOREST OAKS,4620 WOODY MILL RD STE G GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497468524,"EDSTROM, MORGAN, ALEXIS",4620 WOODY MILL RD STE G GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 60 , 108 ,$#,,
MEDICAID DIRECT,1497469340,FIVE POINTS SPEECH THERAPY PLLC,,4900 SKIDMORE ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497469340,FIVE POINTS SPEECH THERAPY PLLC,4900 SKIDMORE ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 13 , 261 , 261 ," $18,343.90 ",,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497471494,"THAMES, MICHELLE, RENE",6329 UNITY ST STE A THOMASVILLE NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 36 , 41 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1497471494,"THAMES, MICHELLE, RENE",1713 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1497471494,"THAMES, MICHELLE, RENE",1713 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1497471494,"THAMES, MICHELLE, RENE",1713 S CHURCH ST   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497471494,"THAMES, MICHELLE, RENE",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1497471916,SENSATIONAL HEARTS HOME CARE AGENCY,,2307 W CONE BLVD STE 110C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1497471916,SENSATIONAL HEARTS HOME CARE AGENCY,2307 W CONE BLVD STE 110C GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 352 , 352 ," $24,501.56 ",,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497474449,"NEAL, DANIEL, ALYCE",420 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 , 78 , 89 ,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1497474449,"NEAL, DANIEL, ALYCE",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1497474449,"NEAL, DANIEL, ALYCE",270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497480024,"GLOCKZIN, VIRGINIA, ELIZABETH",1006 WH SMITH BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 177 , 358 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205597721,LUMBERTON CARE CLINIC PLLC,,4307 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",4307 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 25 , 58 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6701B NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 106 , 112 , 288 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2901 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",2901 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE E LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497481824,"CARLISLE, KAREN, ELIZABETH",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 46 , 95 ,$#,,
MEDICAID DIRECT,1023177151,ACCESS DENTAL CARE,ACCESS DENTAL CARE,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1497484968,"BLAZZIO BOWERS, ROBERTA",1124 GALLERY PARK LN STE 101 WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 17 , 33 ,$#,,
MEDICAID DIRECT,1497488514,MOUNTAIN ISLAND CHARTER SCHOOL,,13440 LUCIA RIVERBEND HWY   MOUNT HOLLY NC,036,Gaston,251300000X,Agencies,Local Education Agency (LEA),,1497488514,MOUNTAIN ISLAND CHARTER SCHOOL,13440 LUCIA RIVERBEND HWY   MOUNT HOLLY NC,036,Gaston,251300000X,Agencies,Local Education Agency (LEA),,#, 113 , 136 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,3030 RANDOLPH RD STE 105   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497491880,"WOLFE, DANIELLE, M",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497492615,"PRUITT, CHASE, THOMAS",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 45 , 96 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497492615,"PRUITT, CHASE, THOMAS",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1841644531,APPALACHIAN MOUNTAIN COMMUNITY HEAL,SYLVA COMMUNITY HEALTH CENTER,154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497493944,"TIGER, MALGORZATA, MARIA",154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 207 , 246 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1497493944,"TIGER, MALGORZATA, MARIA",154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 56 , 56 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1497493944,"TIGER, MALGORZATA, MARIA",154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1407133069,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE NORTHEAST HICKORY,2365 SPRINGS RD NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497494553,"GOTTRY, KRISTIN, MARIE",2365 SPRINGS RD NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 73 , 80 ,$#,,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1497495139,"DALI, SAFAA",15 RAWLS RD STE 200 ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 844 ," 1,288 "," 3,993 "," $173,785.73 ",,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1497495139,"DALI, SAFAA",15 RAWLS RD STE 200 ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1497495139,"DALI, SAFAA",15 RAWLS RD STE 200 ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 26 , 26 , 85 ,$#,,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1497497069,"SHEN, JESSICA, HUIYING",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1033878194,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HIGH POINT,1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497497069,"SHEN, JESSICA, HUIYING",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 949 ," 1,650 "," 5,663 "," $316,229.74 ",,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497497150,"ZAFUTO, DEVON, JAMES",209 W VIRGIL ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497497150,"ZAFUTO, DEVON, JAMES",4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 73 , 135 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497501647,"WOODS, JUSTIN, WILLIAM",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497508196,"PETERSON, CHELSEA, MILLER",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497513469,"FOSTER, DIANA, MARIE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 108 , 112 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497513873,"RIVENBURGH, KELSEY, EAVES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497515571,COASTAL COMPANION CARE,,5101 SOUTHPORT SUPPLY RD SE STE 4 SOUTHPORT NC,010,Brunswick,253Z00000X,Agencies,In Home Supportive Care,,1497515571,COASTAL COMPANION CARE,5101 SOUTHPORT SUPPLY RD SE STE 4 SOUTHPORT NC,010,Brunswick,253Z00000X,Agencies,In Home Supportive Care,,#, 511 , 517 ," $84,503.10 ",,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1497519375,"BLACKWELL, LINDSEY, STONE",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 61 , 74 ,$#,,
MEDICAID DIRECT,1457913857,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT NORTH BELMONT ELEMENTARY,210 SCHOOL ST   BELMONT NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497521165,"LAIL, MORGAN, AMBER",210 SCHOOL ST   BELMONT NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497523740,"MEBANE, COLTON, GLENN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497523971,"DONNELLY, JORDAN, BEY",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497523971,"DONNELLY, JORDAN, BEY",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497523971,"DONNELLY, JORDAN, BEY",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 26 , 31 ,$#,,
MEDICAID DIRECT,1497525554,YOUR FAMILY MATTER HOME CARE AGENCY,,1802 MARTIN LUTHER KING PKWY STE 207 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1497525554,YOUR FAMILY MATTER HOME CARE AGENCY,1802 MARTIN LUTHER KING PKWY STE 207 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 177 , 182 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1497525810,"SEGO, KATHERINE, MARY",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1497525810,"SEGO, KATHERINE, MARY",1106 SUNSET AVE   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 24 ,$#,,
MEDICAID DIRECT,1750333126,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES,918 7TH AVE   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1497531446,"JHALA, RACHEL, HARESH",918 7TH AVE   GARNER NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES PA,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1497531446,"JHALA, RACHEL, HARESH",1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962717025,ADVANTAGE OT INC,~,160 N NC 241 HWY   BEULAVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1497536379,"MORTON, ABIGAIL, JACY TOWNSEND",103 N PLAIN RD   JACKSONVILLE NC,067,Onslow,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1497576714,"MANQUEN, MALANA, ELISE",3000 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497579536,GRACEFUL LIVING ASSISTED LIVING LLC,,624 JONES FERRY RD   CARRBORO NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497579536,GRACEFUL LIVING ASSISTED LIVING LLC,624 JONES FERRY RD   CARRBORO NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497582654,"WILLIAMS, MATTHEW, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497589386,"FUZY, ESZTER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497589386,"FUZY, ESZTER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497593867,"IDOL, JANET, LENORA",319 N GRAHAM HOPEDALE RD FL B BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1497597306,"WILLIAMS, MARIAH, AMBER",130 JAMES AVE   LOCUST NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 54 ,$#,,
MEDICAID DIRECT,1760202303,NOVANT HEALTH TRIANGLE MEDICAL GROU,CAROLINA FAMILY PRACTICE & SPORTS MEDICINE,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497700264,"FOREMAN, BRETT, HUGH",8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497700264,"FOREMAN, BRETT, HUGH",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497700264,"FOREMAN, BRETT, HUGH",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1497700595,"WEBB, LAURA, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497700595,"WEBB, LAURA, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1437553302,RALEIGH DURHAM MEDICAL GROUP PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1497701239,"NORTON, ELIZABETH, IRENE",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588115752,RDMG ASSOCIATES PA,,620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1497701239,"NORTON, ELIZABETH, IRENE",620 DR CALVIN JONES HWY STE 212 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497702047,"NAWABI, KRISTEN, PFEIFFER",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497702773,"RUTHERFORD, EDMUND, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 65 , 157 , 159 ," $20,584.46 ",,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497702773,"RUTHERFORD, EDMUND, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497702773,"RUTHERFORD, EDMUND, JAMES",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497703672,"ANDERSON, APRIL, WOOD",3681 N MAIN ST   FARMVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 56 , 90 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,214 18TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497704217,ORTHOCAROLINA,214 18TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497704217,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 772 ," 3,832 "," 7,455 "," $78,426.08 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497704217,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 56 , 154 , 154 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",2560 LEGION RD   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 86 , 86 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 182 , 211 , 322 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",6959 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",2360 WILLIAMWOOD LN   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 40 , 249 , 249 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",130 LONGVIEW DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 76 , 76 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",1250 LINKHAW RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497707640,"ABOAGYE KUMI, MOSES, YAW",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 15 , 40 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497708697,"GARRIS, ERIN, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 47 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497708697,"GARRIS, ERIN, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346387883,COUNTY OF MOORE,MOORE COUNTY HEALTH DEPARTMENT,705 PINEHURST AVE   CARTHAGE NC,063,Moore,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1497709745,"PATRICK, WILLIAM, WARD",300 BLAKE BLVD   PINEHURST NC,063,Moore,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#, 15 ,$#,,
MEDICAID DIRECT,1033306279,ONSLOW AMBULATORY SERVICES INC,CENTRAL COAST DERMATOLOGY,215B STATION ST   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1497709778,"ABRAHAM, DANIEL, JOSEPH",215B STATION ST   JACKSONVILLE NC,067,Onslow,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 116 , 230 , 351 ,$#,,
MEDICAID DIRECT,1114420254,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,600 W TRADE ST STE A DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1497712277,"SCANLAN, BARRY, ANTHONY",600 W TRADE ST STE A DALLAS NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 103 , 351 , 466 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1497712780,"BOYD, LINDA, RENEE",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497713093,"YANNI, ALLYSON, JEAN",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497713093,"YANNI, ALLYSON, JEAN",131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497713093,"YANNI, ALLYSON, JEAN",131 MEDICAL PARK RD STE 308 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 63 , 68 ,$#,,
MEDICAID DIRECT,1497713473,SPEECH PLAY INC,,2024 JOELENE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1497713473,SPEECH PLAY INC,2024 JOELENE DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,, 23 , 326 , 326 ," $22,474.35 ",,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497713911,"REID, RICHARD, HAROLD",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1497713911,"REID, RICHARD, HAROLD",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497713911,"REID, RICHARD, HAROLD",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1497713911,"REID, RICHARD, HAROLD",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497713911,"REID, RICHARD, HAROLD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497713911,"REID, RICHARD, HAROLD",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497714810,"LONCAR, DRAGUTIN",601 N ELM ST   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1720364649,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1497714810,"LONCAR, DRAGUTIN",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497715213,"BERGER, WILLIAM, SCOTT",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497715213,"BERGER, WILLIAM, SCOTT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497715213,"BERGER, WILLIAM, SCOTT",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497715213,"BERGER, WILLIAM, SCOTT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497715213,"BERGER, WILLIAM, SCOTT",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 36 , 42 , 55 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497715213,"BERGER, WILLIAM, SCOTT",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1497715304,"VANMIDDLESWORTH, FRANK, L",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",257 HOSPITAL DR NE STE 201 BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 28 , 43 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 67 , 84 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 62 , 67 , 95 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497715692,"MURPHY, MARK, TIMOTHY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497715825,"BADALAMENTI, VITO, JOHN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 128 , 128 ,$#,,
MEDICAID DIRECT,1346302429,WEST CALDWELL HEALTH COUNCIL INC,COLLETTSVILLE MEDICAL CENTER,4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497715833,"ANDERSON, JEFFREY, STUART",4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497715833,"ANDERSON, JEFFREY, STUART",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 95 , 103 ,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497715833,"ANDERSON, JEFFREY, STUART",958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497715858,"ROHRBECK, STEVEN, CRAIG",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497715858,"ROHRBECK, STEVEN, CRAIG",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497715858,"ROHRBECK, STEVEN, CRAIG",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 171 , 221 , 337 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497715858,"ROHRBECK, STEVEN, CRAIG",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 133 , 156 , 178 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497715858,"ROHRBECK, STEVEN, CRAIG",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497715858,"ROHRBECK, STEVEN, CRAIG",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1497716211,"FASOLAK, WALTER, STEWART",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 34 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497716211,"FASOLAK, WALTER, STEWART",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 49 , 95 ,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,108 ENDO LN STE 1 HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1497716211,"FASOLAK, WALTER, STEWART",108 ENDO LN STE 1 HAMLET NC,077,Richmond,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1497716708,"PHILLIPS, LAURA, ZUGER",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497717987,"COOK, DAVID, OWEN",140 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1538276100,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1497717987,"COOK, DAVID, OWEN",401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 79 , 137 , 159 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497717987,"COOK, DAVID, OWEN",401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497718910,"CHALLY, MARGARET, KRISTIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497718910,"CHALLY, MARGARET, KRISTIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1497721153,"LANDFRIED, MATTHEW, JOHN",,1513 N HOWE ST STE 4 SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,1497721153,"LANDFRIED, MATTHEW, JOHN",1513 N HOWE ST STE 4 SOUTHPORT NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497722177,"WILLIAMS-CORBIN, LISA, MICHELLE",520 MULBERRY ST   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 137 ," 1,147 "," 1,161 "," $27,582.44 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497722177,"WILLIAMS-CORBIN, LISA, MICHELLE",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013680503,EVENTUS VALUE CARE LLC,,101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497722177,"WILLIAMS-CORBIN, LISA, MICHELLE",520 MULBERRY ST   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497722466,"WARSOF, STEVEN, LESTER",2075 GLENN MITCHELL DR STE 500 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497722466,"WARSOF, STEVEN, LESTER",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1497722672,"BACHMAN, KEVIN, GREGORY",603 PECAN LN   WHITEVILLE NC,024,Columbus,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1497722672,"BACHMAN, KEVIN, GREGORY",205 E MAIN ST   WALLACE NC,031,Duplin,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1497722672,"BACHMAN, KEVIN, GREGORY",205 E MAIN ST   WALLACE NC,031,Duplin,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 118 , 179 , 288 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1497722672,"BACHMAN, KEVIN, GREGORY",1602 DOCTORS CIR   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 97 , 139 , 199 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497722672,"BACHMAN, KEVIN, GREGORY",925 N 4TH ST   WILMINGTON NC,065,New Hanover,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 26 , 32 , 32 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497723795,"NICHOLSON, JOHN, CHRISTIE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497723795,"NICHOLSON, JOHN, CHRISTIE",728 HARTNESS RD   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 216 , 325 ,$#,,
MEDICAID DIRECT,1942252341,CAROLINA EAST FMLY MED,~,3282 CHARLES BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497723811,"JAHRSDORFER, CHARLES, EDWARD",3282 CHARLES BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497724660,ADVANCE PHYSICAL THERAPY,ADVANCE PHYSICAL THERAPY,1709 LEGION RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1497724660,ADVANCE PHYSICAL THERAPY,1709 LEGION RD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1497724660,ADVANCE PHYSICAL THERAPY,ADVANCE PHYSICAL THERAPY,77 S ELLIOTT RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497724660,ADVANCE PHYSICAL THERAPY,77 S ELLIOTT RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1497724991,COASTAL CAROLINA PATHOLOGY,~,2606 IRON GATE DR STE 201 WILMINGTON NC,065,New Hanover,291U00000X,Laboratories,Clinical Medical Laboratory,,1497724991,COASTAL CAROLINA PATHOLOGY,2606 IRON GATE DR STE 201 WILMINGTON NC,065,New Hanover,291U00000X,Laboratories,Clinical Medical Laboratory,, 98 , 119 , 171 ,$#,,
MEDICAID DIRECT,1669808143,SYLVA EMERGENCY GROUP LLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1497726145,"DURAN, MARY, KATHERINE",68 HOSPITAL RD   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 42 , 46 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",9104 MARKET ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 23 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",1919 S 16TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",9104 MARKET ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",507 E FREMONT ST   BURGAW NC,071,Pender,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497726996,"ARCE, LUIS ALBERTO, ISAAC",507 E FREMONT ST   BURGAW NC,071,Pender,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497727283,"PLAYFORD, SCOTT, ALAN",2000 BRABHAM AVE STE 100 JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 87 , 187 ,$#,,
MEDICAID DIRECT,1861558827,SURAJIT CHAUDHURI,SURAJIT CHAUDHURI MDPA,1205 CAPE CT STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497727879,"CHAUDHURI, SURAJIT",1205 CAPE CT STE B FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 56 , 241 , 256 ," $18,371.07 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497731095,"PETTY, JOHN, KENNETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 73 , 151 , 168 ," $17,192.43 ",,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497731822,"TEW, JOSHUA, BRIAN",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497734156,"JONES, CARROLL, PAYNE",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 62 , 90 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1497735831,"FREDERICK, LAURENCE, DAVIS",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 133 , 226 , 545 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497735831,"FREDERICK, LAURENCE, DAVIS",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 39 , 74 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497736664,"MOODY, WILLIS, ELVIS",191 DEEP SOUTH FARM RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497736664,"MOODY, WILLIS, ELVIS",191 DEEP SOUTH FARM RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497736698,"PATEL, AMRISH, CHIMANLAL",154 S MAIN ST   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 25 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497736698,"PATEL, AMRISH, CHIMANLAL",154 S MAIN ST   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 49 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497736698,"PATEL, AMRISH, CHIMANLAL",154 S MAIN ST   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497736698,"PATEL, AMRISH, CHIMANLAL",154 S MAIN ST   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497736698,"PATEL, AMRISH, CHIMANLAL",154 S MAIN ST   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497736698,"PATEL, AMRISH, CHIMANLAL",154 S MAIN ST   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,154 S MAIN ST   TROUTMAN NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497736698,"PATEL, AMRISH, CHIMANLAL",154 S MAIN ST   TROUTMAN NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 34 , 64 ,$#,,
MEDICAID DIRECT,1740626605,CAROLINA BREAST IMAGING SPECIALISTS,~,990 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497737365,"SCHROEDER, BRUCE, FREDERICK",990 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 122 , 129 , 247 ,$#,,
MEDICAID DIRECT,1669533923,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL PULMONOLOGY,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1497737621,"GRAHAM, DONALD, DEAN",194 DOCTORS DR   BOONE NC,095,Watauga,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 106 , 147 , 269 ,$#,,
MEDICAID DIRECT,1669533923,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL PULMONOLOGY,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1497737621,"GRAHAM, DONALD, DEAN",148 HIGHWAY 105 EXT STE 104 BOONE NC,095,Watauga,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 35 , 60 ,$#,,
MEDICAID DIRECT,1043273881,WOMENS HEALTHCARE ASSOCIATES PA,WOMENS HEALTHCARE ASSOCIATES PA,245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1497738744,"MCCARSON, JERI, ALLISON",245 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497739619,"OGRADY, MARTIN, GABRIEL",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1598257750,BALSAM HEALTH OF THE CAROLINAS,,607 W GROVER ST STE 101 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1497740682,"IBRAHIM, RADWAN, ABDELFATTAH",607 W GROVER ST STE 101 SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 444 , 444 ," $33,242.62 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497740799,"MORGAN, MARIA, MONIQUE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1134326176,VIEWMONT INTERNAL MEDICINE,,1375 4TH STREET DR NW   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497741987,"CRESSY, ELIZABETH, DELPIT",1375 4TH STREET DR NW   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 12 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497742373,"READE, ERIN, PARRISH",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497742373,"READE, ERIN, PARRISH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 53 , 142 , 182 ," $38,422.22 ",,
MEDICAID DIRECT,1275872905,UNC PHYSICIANS NETWORK GROUP PRACTI,BOYLAN HEALTHCARE,3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497743678,"NOBLE, RICHARD, CLAIRBORNE",3900 BROWNING PL STE 101 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 31 , 86 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,2610 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497745418,"ROYAL, STEPHEN, HAROLD",2610 N ELM ST   LUMBERTON NC,078,Robeson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 235 , 480 , 733 ," $14,668.17 ",,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497745822,"KIRBY, JESS, MCKARNS",130 PLANTATION RIDGE DR STE 100 MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497745822,"KIRBY, JESS, MCKARNS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497745822,"KIRBY, JESS, MCKARNS",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 37 , 61 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1497746093,"HOUGH, CHARLOTTE, LEE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1497746093,"HOUGH, CHARLOTTE, LEE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497746093,"HOUGH, CHARLOTTE, LEE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1497746093,"HOUGH, CHARLOTTE, LEE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497746093,"HOUGH, CHARLOTTE, LEE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1497746093,"HOUGH, CHARLOTTE, LEE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497746580,"HOUGH, JENNIFER, GUSLER",3050 DURALEIGH RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497746580,"HOUGH, JENNIFER, GUSLER",3050 DURALEIGH RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 36 , 43 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497746580,"HOUGH, JENNIFER, GUSLER",3050 DURALEIGH RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 30 , 33 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",3005 N ELM ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 29 , 74 ,$#,,
MEDICAID DIRECT,1326036138,SOUTHEASTERN INTEGRATED CARE,~,3005 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",3005 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1800 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 24 , 68 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 36 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 23 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,150 FRANCAM DR STE 120 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497746697,"HART, JOEL, MARVIN",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093779951,EYE SURGERY AND LASER CLINIC INC,EYE SURGERY AND LASER CLINIC INC,500 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1497748396,"LARK, KURT, KARL",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497748396,"LARK, KURT, KARL",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 76 , 153 , 235 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497748412,"LORD, JOHN, ANTHONY",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 15 , 23 , 28 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497748412,"LORD, JOHN, ANTHONY",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1497748412,"LORD, JOHN, ANTHONY",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 26 , 45 , 54 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1497748412,"LORD, JOHN, ANTHONY",910 W WILLIAMS ST   APEX NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497748412,"LORD, JOHN, ANTHONY",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 23 , 37 , 42 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497748693,"POOL, HENRY, ANDRAE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 53 , 120 , 144 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497748693,"POOL, HENRY, ANDRAE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 12 , 13 , 30 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497748693,"POOL, HENRY, ANDRAE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497748693,"POOL, HENRY, ANDRAE",3812 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497749352,YANCEY CENTER FOR PHYSICAL THERAPY,~,1720 W US HIGHWAY 19E   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1497749352,YANCEY CENTER FOR PHYSICAL THERAPY,1720 W US HIGHWAY 19E   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497749683,"MOVAHED, ASSADOLLAH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 133 , 167 , 196 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497749683,"MOVAHED, ASSADOLLAH",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497749683,"MOVAHED, ASSADOLLAH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497749683,"MOVAHED, ASSADOLLAH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 579 , 664 , 978 ," $23,641.55 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497749683,"MOVAHED, ASSADOLLAH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 60 , 60 , 62 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497750178,"ADAMS, JAMES, WELLINGTON",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497750178,"ADAMS, JAMES, WELLINGTON",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497750178,"ADAMS, JAMES, WELLINGTON",1003 OLDE WATERFORD WAY STE 1C LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497750178,"ADAMS, JAMES, WELLINGTON",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 35 ,$#,,
MEDICAID DIRECT,1215990700,ADVANCED DERMATOLOGY AND SKIN SURGE,ADVANCED DERMATOLOGY AND SKIN SURGERY PA,16 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1497751085,"ZIVONY, DANIEL, ISRAEL",12 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 57 , 80 , 131 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497751481,"STITT, VAN, JUNIUS",502 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497751481,"STITT, VAN, JUNIUS",111 E THIRD AVE   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 16 , 19 ,$#,,
MEDICAID DIRECT,1477079283,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR,2721 X RAY DR   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497751481,"STITT, VAN, JUNIUS",2721 X RAY DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497751481,"STITT, VAN, JUNIUS",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497751671,"SUMMERS, SHANE, ORNDOFF",50 MACEDONIA CHURCH RD STE A TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 39 , 101 ,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497751671,"SUMMERS, SHANE, ORNDOFF",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 37 , 62 ,$#,,
MEDICAID DIRECT,1215214879,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE VIEWMONT,1205 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497751671,"SUMMERS, SHANE, ORNDOFF",1205 N CENTER ST   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 80 , 240 , 561 ," $10,407.54 ",,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497751861,"PIPPIN, RICHARD, LEE",3681 N MAIN ST   FARMVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 151 , 251 ,$#,,
MEDICAID DIRECT,1497752026,ECONOMED OF ABERDEEN,ORTHOTICS & PROSTHETICS OF PINEHURST,95 AVIEMORE DR STE A PINEHURST NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497752026,ECONOMED OF ABERDEEN,95 AVIEMORE DR STE A PINEHURST NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497752968,"TACKMAN, LORI, ANNE",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 48 , 97 ,$#,,
MEDICAID DIRECT,1780015842,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780015842,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 104 , 172 , 203 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",3610 PETERS CT   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780015842,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",3610 PETERS CT   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 52 , 72 , 84 ,$#,,
MEDICAID DIRECT,1780015842,BETHANY MEDICAL CENTER,,3605 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",3605 PETERS CT   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 17 , 28 , 32 ,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",3605 PETERS CT   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 15 , 20 , 21 ,$#,,
MEDICAID DIRECT,1861049231,BETHANY MEDICAL CENTER,,975 HIGHWAY 66 S   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497754600,"SZABO, JAMES, JOSEPH",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497754659,"HAMRICK, GEORGE, LEE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497754659,"HAMRICK, GEORGE, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 21 , 26 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497754659,"HAMRICK, GEORGE, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 36 , 38 ,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497754659,"HAMRICK, GEORGE, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 47 , 137 , 233 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497754659,"HAMRICK, GEORGE, LEE",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497754659,"HAMRICK, GEORGE, LEE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497754659,"HAMRICK, GEORGE, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1497756084,"BAILEY III, GEORGE, TILLMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 157 , 206 , 304 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497756084,"BAILEY III, GEORGE, TILLMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 99 , 108 , 127 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497756688,"PERRY, DWIGHT",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 25 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497756688,"PERRY, DWIGHT",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 66 , 94 , 125 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497756688,"PERRY, DWIGHT",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497756688,"PERRY, DWIGHT",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1326001819,CENTER FOR DIGESTIVE DISEASES AND C,CENTER FOR DIGESTIVE DISEASES AND CARY ENDOSCOPY C,1120 SE CARY PKWY STE 204 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1497757256,"SINGH, HARMINDER, PAUL",1120 SE CARY PKWY STE 204 CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 24 , 35 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497764682,"KIRK, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497764682,"KIRK, DAVID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497767966,CORAM ALTERNATE SITE SERVICE,CORAM CVS SPECIALTY INFUSION SERVICES,30 GARFIELD ST STE B ASHEVILLE NC,011,Buncombe,251F00000X,Agencies,Home Infusion,,1497767966,CORAM ALTERNATE SITE SERVICE,30 GARFIELD ST STE B ASHEVILLE NC,011,Buncombe,251F00000X,Agencies,Home Infusion,, 16 , 81 , 180 ," $38,640.41 ",,
MEDICAID DIRECT,1497767966,CORAM ALTERNATE SITE SERVICE,CORAM CVS SPECIALTY INFUSION SERVICES,30 GARFIELD ST STE B ASHEVILLE NC,011,Buncombe,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1497767966,CORAM ALTERNATE SITE SERVICE,30 GARFIELD ST STE B ASHEVILLE NC,011,Buncombe,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 111 ," 1,048 "," 1,246 "," $161,399.61 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497770671,"JOHNSTON, REBECCA, ANN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 63 , 63 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497770671,"JOHNSTON, REBECCA, ANN",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 100 , 150 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497770671,"JOHNSTON, REBECCA, ANN",15 REGIONAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770182933,WAKE PET SERVICES LLC,,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497771216,"WATSON, JERRY, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1497771216,"WATSON, JERRY, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770182933,WAKE PET SERVICES LLC,,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 67 , 68 , 86 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1497771216,"WATSON, JERRY, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497771760,"SMITH, JAMES, ANDERSON",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 38 , 75 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497771760,"SMITH, JAMES, ANDERSON",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1497772362,"GRINTON, PATRICIA, WIEGAND",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 54 , 88 , 196 ," $10,664.41 ",,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497772362,"GRINTON, PATRICIA, WIEGAND",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1497772651,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1694,2875 SUGAR HILL RD   MARION NC,059,McDowell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1497772651,WAL-MART STORES EAST LP,2875 SUGAR HILL RD   MARION NC,059,McDowell,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1497772651,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1694,2875 SUGAR HILL RD   MARION NC,059,McDowell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1497772651,WAL-MART STORES EAST LP,2875 SUGAR HILL RD   MARION NC,059,McDowell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497773634,"SWEARINGEN, JENNIFER, WARREN",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497773634,"SWEARINGEN, JENNIFER, WARREN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497773634,"SWEARINGEN, JENNIFER, WARREN",1450 MATTHEWS TOWNSHIP PKWY STE 460 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497773634,"SWEARINGEN, JENNIFER, WARREN",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 27 , 27 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497774004,"LEE, THOMAS",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497774004,"LEE, THOMAS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497774004,"LEE, THOMAS",1960 S. 16TH STREET   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497774004,"LEE, THOMAS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 30 , 61 ,$#,,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497774178,"PATERSON, DANIEL, GEORGE",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 26 ,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497774236,"TERZIS, DEBORAH, KAY",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 35 , 50 ,$#,,
MEDICAID DIRECT,1467790055,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVI,200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497774236,"TERZIS, DEBORAH, KAY",200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497775464,"MEDDOWS, MICHAEL, JOHN",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497775464,"MEDDOWS, MICHAEL, JOHN",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033877592,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DILLON FAMILY MEDICINE,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497775670,"BROWN, MICHAEL, NATHANIEL",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 154 , 542 ,$#,,
MEDICAID DIRECT,1497775670,"BROWN, MICHAEL, NATHANIEL",~,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1497775670,"BROWN, MICHAEL, NATHANIEL",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1154442630,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1497776777,"ZINS, BRADLEY",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497776777,"ZINS, BRADLEY",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 79 , 105 , 146 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497776876,"BEGOVICH, JOHN, EMIL",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 83 , 144 , 311 ,$#,,
MEDICAID DIRECT,1396935193,COMMUNITY MEDICAL PA,COMMUNITY MEDICAL PA,520 W MAIN ST   MARSHVILLE NC,090,Union,193400000X,Group,Single Specialty,,1497778567,"HENRY, GARY",520 W MAIN ST   MARSHVILLE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497779003,"CLEVELAND, JEFFREY, ALLEN",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1710914171,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,332 N TRADE ST STE 1500 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497779003,"CLEVELAND, JEFFREY, ALLEN",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 22 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497780134,"WASKIN, RANDOLPH, BENJAMIN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497780589,"WOYAHN, LAURA, ELIZABETH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 13 , 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497780589,"WOYAHN, LAURA, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 29 , 29 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",11001 INGLESIDE PL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 51 , 51 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",2700 LEIGHTON RIDGE DR   WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",2700 LEIGHTON RIDGE DR   WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",835 S NEW HOPE RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",11001 INGLESIDE PL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 25 , 35 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",835 S NEW HOPE RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 42 , 42 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",2700 LEIGHTON RIDGE DR   WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 47 , 47 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",835 S NEW HOPE RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497781314,"OLIVERIO, MICHAEL, IGNATIUS",11001 INGLESIDE PL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1497782023,"LO, ERIC, LUP SING",1614 WILLIAMSBORO ST   OXFORD NC,039,Granville,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1497782023,"LO, ERIC, LUP SING",710 ERWIN RD   DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1497782965,"KADAU, DAVID, JOHN",1622 E MARION ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1497782965,"KADAU, DAVID, JOHN",335 E PARKER RD   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407960354,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1497782965,"KADAU, DAVID, JOHN",335 E PARKER RD   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 62 , 70 , 70 ,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1497782965,"KADAU, DAVID, JOHN",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497782965,"KADAU, DAVID, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407960354,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1497782965,"KADAU, DAVID, JOHN",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699118620,ANTHONY N HOANG DMD PLLC,ANTHONY N HOANG DMD PLLC,672 RADIO DR STE A LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1497783724,"HOANG, ANTHONY, NAM",672 RADIO DR STE A LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 717 ," 1,376 "," 5,123 "," $230,438.06 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497783856,"GODWIN, JAMES, EDWARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 44 , 44 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497783856,"GODWIN, JAMES, EDWARD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497783856,"GODWIN, JAMES, EDWARD",916 S MAIN ST STE 240 FUQUAY VARINA NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497783856,"GODWIN, JAMES, EDWARD",916 S MAIN ST STE 240 FUQUAY VARINA NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 20 , 20 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497783856,"GODWIN, JAMES, EDWARD",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497784680,"GIARRIZZI, DANA, PATETE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497784680,"GIARRIZZI, DANA, PATETE",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548529878,CAROLINA FAMILY HEALTHCARE PA,,11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497785430,"KANELOS, SHARON, KAY",11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 12 ,$#,,
MEDICAID DIRECT,1215223862,INTEGRA REHABILITATION PHYSICIANS,~,,,Unknown,193200000X,Group,Multi-Specialty,,1497785430,"KANELOS, SHARON, KAY",11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1215223862,INTEGRA REHABILITATION PHYSICIANS,~,11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497785430,"KANELOS, SHARON, KAY",11220 ELM LN STE 102 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 30 , 40 ,$#,,
MEDICAID DIRECT,1023048279,GASTONIA MEDICAL SPECIALTY CLINIC,GASTONIA MEDICAL SPECIALTY CLINIC PA,1021 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1497785604,"JARRATT, MIKELL, JENKINS",1021 X RAY DR   GASTONIA NC,036,Gaston,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 165 , 452 , 554 ," $11,976.54 ",,
MEDICAID DIRECT,1497785745,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1605 WESTBROOK PLAZA DR STE 102&402 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1497785745,BAYADA HOME HEALTH CARE INC,1605 WESTBROOK PLAZA DR STE 102&402 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 131 ," 19,612 "," 19,932 "," $2,600,852.19 ",,
MEDICAID DIRECT,1497785745,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1605 WESTBROOK PLAZA DR STE 102&402 WINSTON SALEM NC,034,Forsyth,251J00000X,Agencies,Nursing Care,,1497785745,BAYADA HOME HEALTH CARE INC,1605 WESTBROOK PLAZA DR STE 102&402 WINSTON SALEM NC,034,Forsyth,251J00000X,Agencies,Nursing Care,, 45 ," 6,511 "," 7,841 "," $3,877,467.31 ",,
MEDICAID DIRECT,1497786982,THERAPEUTIC ALTERNATIVES INC,FOREST PARK HOUSE,2910 FOREST PARK DR   RANDLEMAN NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497786982,THERAPEUTIC ALTERNATIVES INC,2910 FOREST PARK DR   RANDLEMAN NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 144 , 144 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 25 , 64 , 64 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 30 , 70 , 70 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 33 , 33 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1497789150,"DANIELI, SEMBUA, SAMUEL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497793269,"TAYLOR, GREGORY, GERARD",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497793269,"TAYLOR, GREGORY, GERARD",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497795553,"MEZZULLO, JOHN, JOSEPH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 32 , 32 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497795553,"MEZZULLO, JOHN, JOSEPH",7369 HUNTER HILL RD   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497795553,"MEZZULLO, JOHN, JOSEPH",2420 LAKE WHEELER RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497796916,"WESTROL, ROBERT",1330 BOILING SPRINGS RD STE 2100 SPARTANBURG SC,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1497798011,ALERT RESPONSE LLC,,2015 AYRSLEY TOWN BLVD STE 202 CHARLOTTE NC,060,Mecklenburg,333300000X,Suppliers,Emergency Response System Companies,,1497798011,ALERT RESPONSE LLC,2015 AYRSLEY TOWN BLVD STE 202 CHARLOTTE NC,060,Mecklenburg,333300000X,Suppliers,Emergency Response System Companies,, 31 , 114 , 114 ,$#,,
MEDICAID DIRECT,1497798177,PATTY VISION CENTER OD PA,PATTY VISION CENTER,495 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1497798177,PATTY VISION CENTER OD PA,495 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,, 637 , 653 ," 1,261 "," $17,361.78 ",,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1497799977,"BAUER, MICHAEL, BRIAN",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1720318009,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HEALTHCARE UROLOGY,730 MALCOLM BLVD STE 100 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1497799977,"BAUER, MICHAEL, BRIAN",730 MALCOLM BLVD STE 100 CONNELLY SPRINGS NC,012,Burke,208800000X,Allopathic & Osteopathic Physicians,Urology,, 108 , 205 , 281 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497799977,"BAUER, MICHAEL, BRIAN",730 MALCOLM BLVD STE 100 CONNELLY SPRINGS NC,012,Burke,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1588705776,RICHMOND COUNTY DSS,~,127 CAROLINE ST   ROCKINGHAM NC,077,Richmond,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1497801492,"WEBB, PATSY, CROUCH",127 CAROLINE ST   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 54 , 247 ," $10,153.28 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497802409,"MAHONY, REBECCA, DOBSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497804017,"BUCKLEY, JOHN, DAVID",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497804017,"BUCKLEY, JOHN, DAVID",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497804116,"BATTS, KELLY, SUZANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497804116,"BATTS, KELLY, SUZANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497804116,"BATTS, KELLY, SUZANNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497804116,"BATTS, KELLY, SUZANNE",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497804116,"BATTS, KELLY, SUZANNE",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497804421,"KAPOOR, SUSHMA, SURRINDER",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 43 , 78 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1497804603,"MILLER, THOMAS, DAVIS",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1497804603,"MILLER, THOMAS, DAVIS",8841 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1497805287,"THOMASSON, GLENN, POSEY",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801086558,SAMPSON REG MED SERVICES ANESTHESIA,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1497805287,"THOMASSON, GLENN, POSEY",607 BEAMAN ST   CLINTON NC,082,Sampson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497805287,"THOMASSON, GLENN, POSEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497806160,"CARTER, HOLLY, JONES",Holly Jones Carter,4316 HENSON DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,1497806160,"CARTER, HOLLY, JONES",4316 HENSON DR   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 33 ,$#,,
MEDICAID DIRECT,1558848093,DERMATOLOGY CONSULTANTS OF ASHEVILL,~,218 ELKWOOD AVE STE 104 WOODFIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1497807309,"BARTON, MICHELLE, LAINE",218 ELKWOOD AVE STE 104 ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 55 , 97 , 162 ,$#,,
MEDICAID DIRECT,1497807309,"BARTON, MICHELLE, LAINE",,218 ELKWOOD AVE STE 104 ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1497807309,"BARTON, MICHELLE, LAINE",218 ELKWOOD AVE STE 104 ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497807986,"WHEATLEY, MARIE, MCMILLAN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497807986,"WHEATLEY, MARIE, MCMILLAN",512 VILLAGE RD STE 103 SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 34 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497807986,"WHEATLEY, MARIE, MCMILLAN",302 LIBERTY ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497807986,"WHEATLEY, MARIE, MCMILLAN",512 VILLAGE RD STE 103 SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 92 , 174 ,$#,,
MEDICAID DIRECT,1497809172,GERICARE AND HEALTH SERVICES,GERICARE AND HEALTH SERVICES INC,3600 N DUKE ST STE 107 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1497809172,GERICARE AND HEALTH SERVICES,3600 N DUKE ST STE 107 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,828 "," 2,828 "," $188,778.62 ",,
MEDICAID DIRECT,1558829796,"HARVEY, ALEXANDRA, DAVIS",,1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1497810212,"JONES, SUSAN, KIMBERLY",1204 N CENTER ST   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497810212,"JONES, SUSAN, KIMBERLY",SUSAN KIMBERLY JONES,1204 N CENTER ST   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,1497810212,"JONES, SUSAN, KIMBERLY",1204 N CENTER ST   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497810212,"JONES, SUSAN, KIMBERLY",SUSAN KIMBERLY JONES,1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1497810212,"JONES, SUSAN, KIMBERLY",1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,706 "," 2,569 "," 8,796 "," $325,178.44 ",,
MEDICAID DIRECT,1558829796,"HARVEY, ALEXANDRA, DAVIS",,1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1497810212,"JONES, SUSAN, KIMBERLY",1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 273 , 308 ," 1,151 "," $53,993.24 ",,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1497814560,"REYHER, STACY, BOONE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1326101262,NORTH CAROLINA CENTER FOR DERMATOLO,NORTH CAROLINA CENTER FOR DERMATOLOGY,6216 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1497818397,"SCALES, JEFFREY, WELLINGTON",6216 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 94 , 168 , 254 ,$#,,
MEDICAID DIRECT,1497822704,"NASH, CHARLES, FREDERICK",CHARLES NASH DDS,338 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice,1497822704,"NASH, CHARLES, FREDERICK",338 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 54 , 123 , 212 ," $13,352.58 ",,
MEDICAID DIRECT,1497824973,"ALLEN, MARC, EDWARD",MARC ALLEN ORTHODONTICS,223 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1497824973,"ALLEN, MARC, EDWARD",223 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 122 ," 1,004 "," 1,146 "," $153,372.60 ",,
MEDICAID DIRECT,1801617881,KRISKA HEALTH PLLC,BLUE RIDGE SLEEP MEDICINE,708 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1497825657,"SEAL, VIVIAN, HOLDER",708 S SOUTH ST STE 400 MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801617881,KRISKA HEALTH PLLC,BLUE RIDGE SLEEP MEDICINE,1814 N BRIDGE ST   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1497825657,"SEAL, VIVIAN, HOLDER",1814 N BRIDGE ST   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1497825657,"SEAL, VIVIAN, HOLDER",737 PENN ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1497825657,"SEAL, VIVIAN, HOLDER",640 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1497825657,"SEAL, VIVIAN, HOLDER",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 46 , 46 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1497825657,"SEAL, VIVIAN, HOLDER",905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1003099409,SOUTHSIDE MEDICAL CENTER,SOUTHSIDE MEDICAL CENTER PA,1925A OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1497828511,"PIXTON, JAN, MAREE",1925A OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 162 , 310 , 651 ,$#,,
MEDICAID DIRECT,1639352032,NORTH WHITEVILLE URGENT CARE,NORTH WHITEVILLE URGENT CARE,614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1497828511,"PIXTON, JAN, MAREE",614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 11 , 25 ,$#,,
MEDICAID DIRECT,1699116111,SIMONCIC DDS PLLC,TRIAD ORAL SURGERY,511 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1497829311,"CROSS, DARREN, RICHARD",2017 EASTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1699116111,SIMONCIC DDS PLLC,TRIAD ORAL SURGERY,2017 EASTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1497829311,"CROSS, DARREN, RICHARD",2017 EASTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 864 , 957 ," 6,784 "," $662,260.20 ",,
MEDICAID DIRECT,1174208813,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE RHC,1125 CARTHAGE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1497830822,"HENSLEY, MICHELE, IMOGENE",1125 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 70 , 83 , 90 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497835482,"WARNER, DIANE, DUVALL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 39 , 160 , 160 ," $29,381.70 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497836076,"FENG, WUWEI",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1497836076,"FENG, WUWEI",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497836076,"FENG, WUWEI",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497837116,"KUZMIAK, CHERIE, MARIE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497837116,"KUZMIAK, CHERIE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 57 , 60 , 108 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497837116,"KUZMIAK, CHERIE, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 45 , 60 , 177 ," $16,564.72 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 15 , 18 , 32 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",40 DUKE MEDICINE CIR CLINIC 1L DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",932 MORREENE RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,400 ELF ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497837595,"HUSAIN, AATIF, MAIRAJ",40 DUKE MEDICINE CIR CLINIC 1L DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 135 , 207 , 288 ," $12,105.56 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497838650,"GENTILE, JUDITH, WALKER",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 95 , 127 , 127 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 363 , 498 , 498 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 625 , 792 , 795 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811274558,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM CARDIOLOGY,568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839302,"GRANT, AUGUSTUS, OLIVER",568 RUIN CREEK RD STE 128 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839351,"SKEEN, MARK, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839351,"SKEEN, MARK, BRIAN",DUKE SURGICAL PDC DUKE HOSP SOUTH TRENT DR DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 39 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839351,"SKEEN, MARK, BRIAN",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839369,"BENNETT, STACEY, NICOLE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497839369,"BENNETT, STACEY, NICOLE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 63 , 219 , 224 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1497839542,"LEGET, GAIL, ANN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497841019,"OBITA, TONYA, KRISTIN",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497841019,"OBITA, TONYA, KRISTIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 28 , 28 ,$#,,
MEDICAID DIRECT,1497841704,CAPE MEDICAL INC,CAPE MEDICAL INC,2732 OLD WRIGHTSBORO RD   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1497841704,CAPE MEDICAL INC,2732 OLD WRIGHTSBORO RD   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 687 ," 5,010 "," 5,699 "," $477,962.43 ",,
MEDICAID DIRECT,1497841704,CAPE MEDICAL INC,CAPE MEDICAL INC,2732 OLD WRIGHTSBORO RD   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497841704,CAPE MEDICAL INC,2732 OLD WRIGHTSBORO RD   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 2,826 "," 19,813 "," 43,472 "," $3,375,600.40 ",,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497842058,"GREGORY, SUSAN, FLOYD",201 MCCULLOUGH DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 50 , 116 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497842520,"ALLRED, JOHN, WINFIELD",2076 HIGHWAY 69 S   HAYESVILLE NC,022,Clay,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1497842520,"ALLRED, JOHN, WINFIELD",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 23 , 27 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1497842520,"ALLRED, JOHN, WINFIELD",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1497842520,"ALLRED, JOHN, WINFIELD",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 86 , 94 , 123 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497843247,"JESSE, NATHAN, MARC",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497843247,"JESSE, NATHAN, MARC",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 33 , 103 , 104 ," $24,173.64 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497843247,"JESSE, NATHAN, MARC",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497845895,"PENN, MELINDA, MARIE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1497849087,"SAVELL, RANDALL, LESTER",3520 AIRPORT BLVD NW STE F WILSON NC,098,Wilson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1497849087,"SAVELL, RANDALL, LESTER",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 19 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1497849087,"SAVELL, RANDALL, LESTER",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1497849087,"SAVELL, RANDALL, LESTER",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1497849087,"SAVELL, RANDALL, LESTER",98 DOCTORS DR STE 310 SYLVA NC,050,Jackson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1497849087,"SAVELL, RANDALL, LESTER",1 HOSPITAL RD CALLER BOX C-268 SYLVA NC,050,Jackson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497849939,"COSSEY, JASON, LEE",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194260919,COMPASS PHYSICAL THERAPY LLC,,2170 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1497850465,"KEVERN, MARK, ALAN",2170 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 14 , 41 ,$#,,
MEDICAID DIRECT,1972940476,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,98 STONEBRIDGE TRL   HAVELOCK NC,025,Craven,193400000X,Group,Single Specialty,,1497850861,"RICHARDS, BENJAMIN, JOHN",98 STONEBRIDGE TRL   HAVELOCK NC,025,Craven,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1972940476,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,4358 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1497850861,"RICHARDS, BENJAMIN, JOHN",98 STONEBRIDGE TRL   HAVELOCK NC,025,Craven,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1972940476,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,4358 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1497850861,"RICHARDS, BENJAMIN, JOHN",17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1053400853,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1497850861,"RICHARDS, BENJAMIN, JOHN",17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 26 , 52 , 69 ," $11,283.92 ",,
MEDICAID DIRECT,1497851091,"COVINGTON, FRANK, EDWARD",~,1620 LIVE OAK ST STE A BEAUFORT NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,,1497851091,"COVINGTON, FRANK, EDWARD",1620 LIVE OAK ST STE A BEAUFORT NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,, 20 , 23 , 32 ,$#,,
MEDICAID DIRECT,1083038806,KIDZCARE PEDIATRICS PC,,,,Unknown,193200000X,Group,Multi-Specialty,,1497852552,"ERVIN, ANDREW, EPHRAIM",216 E BROAD ST   SAINT PAULS NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508275553,KIDZCARE PEDIATRICS PC,,216 E BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497852552,"ERVIN, ANDREW, EPHRAIM",216 E BROAD ST   SAINT PAULS NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1497854285,"MARSON, DEAN, RANDALL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 42 , 46 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1497854285,"MARSON, DEAN, RANDALL",2007 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497854319,"GLICK, DAVID",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 34 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497854319,"GLICK, DAVID",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497854319,"GLICK, DAVID",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497854319,"GLICK, DAVID",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497854319,"GLICK, DAVID",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1497854319,"GLICK, DAVID",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1497854368,"CREIGHTON, ROBERT, ALEXANDER",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497854368,"CREIGHTON, ROBERT, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1497854368,"CREIGHTON, ROBERT, ALEXANDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1497854368,"CREIGHTON, ROBERT, ALEXANDER",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1497854368,"CREIGHTON, ROBERT, ALEXANDER",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1497854368,"CREIGHTON, ROBERT, ALEXANDER",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1497854368,"CREIGHTON, ROBERT, ALEXANDER",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 15 , 21 ,$#,,
MEDICAID DIRECT,1184804320,BOONE NEUROLOGICAL SERVICE PA,~,895 STATE FARM RD STE 501 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1497854889,"MCADAMS, SUZANNE, ELAINE",336 DEERFIELD RD   BOONE NC,095,Watauga,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184804320,BOONE NEUROLOGICAL SERVICE PA,~,895 STATE FARM RD STE 501 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1497854889,"MCADAMS, SUZANNE, ELAINE",895 STATE FARM RD STE 501 BOONE NC,095,Watauga,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 56 , 125 , 138 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497856843,"SQUIRES, STUART, MORRIS",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497856843,"SQUIRES, STUART, MORRIS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 35 , 42 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497856843,"SQUIRES, STUART, MORRIS",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 19 , 22 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497856843,"SQUIRES, STUART, MORRIS",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1497856843,"SQUIRES, STUART, MORRIS",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497856843,"SQUIRES, STUART, MORRIS",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1497856843,"SQUIRES, STUART, MORRIS",800 TILGHMAN DR   DUNN NC,043,Harnett,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 67 , 69 , 75 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1497857205,"DECKER, JAMES, CLARENCE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497857973,"ISAACS, GEORGE, COUPLAND",130 GLENDALE DR W   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 79 , 90 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,130 GLENDALE DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1497857973,"ISAACS, GEORGE, COUPLAND",130 GLENDALE DR W   WILSON NC,098,Wilson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 75 , 118 , 149 ,$#,,
MEDICAID DIRECT,1497858245,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03593,2501 W ROOSEVELT BLVD   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1497858245,NORTH CAROLINA CVS PHARMACY LLC,2501 W ROOSEVELT BLVD   MONROE NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1497858245,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03593,2501 W ROOSEVELT BLVD   MONROE NC,090,Union,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1497858245,NORTH CAROLINA CVS PHARMACY LLC,2501 W ROOSEVELT BLVD   MONROE NC,090,Union,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1497859714,"MANN, STEPHANIE, ELISE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497859714,"MANN, STEPHANIE, ELISE",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497860944,"LANGSTON, STEPHEN, JOSEPH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497860944,"LANGSTON, STEPHEN, JOSEPH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225331903,FASTMED URGENT CARE PC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1497862155,"CABANISS, WILLIAM",825 BLOWING ROCK BLVD STE B LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497863476,"DAUM, CATHERINE, ANNE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497863476,"DAUM, CATHERINE, ANNE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 23 , 33 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1497863476,"DAUM, CATHERINE, ANNE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497866040,"WYNN, VANDER, MARK",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1497866040,"WYNN, VANDER, MARK",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1497866040,"WYNN, VANDER, MARK",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1497866040,"WYNN, VANDER, MARK",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497867808,"EISENSON, HOWARD, JOSEPH",401 N DRIVER ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 108 , 173 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497867808,"EISENSON, HOWARD, JOSEPH",815 BROAD ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 89 , 137 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497867808,"EISENSON, HOWARD, JOSEPH",412 LIBERTY ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497867808,"EISENSON, HOWARD, JOSEPH",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 126 , 284 , 463 ," $14,621.35 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497867808,"EISENSON, HOWARD, JOSEPH",1313 HALLEY ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 28 , 48 ,$#,,
MEDICAID DIRECT,1497868954,"CHARLESWORTH, AMY, SUE",~,135 SOUNDVIEW DR   NEWPORT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1497868954,"CHARLESWORTH, AMY, SUE",135 SOUNDVIEW DR   NEWPORT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 59 , 66 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 48 , 53 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497871750,"LEWIS, HEATHER, KATHERINE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 16 , 17 ,$#,,
MEDICAID DIRECT,1497872287,MOUNTAIN AREA ENTERPRISES INC,WINDWOOD REST HOME,6 WINDWOOD DR PO BOX910 CANDLER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497872287,MOUNTAIN AREA ENTERPRISES INC,6 WINDWOOD DR PO BOX910 CANDLER NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 345 , 345 ," $21,130.38 ",,
MEDICAID DIRECT,1497874002,NELLIES FAMILY CARE HOME INC,NELLIES FAMILY CARE HOME,1608 FALLSTON RD   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497874002,NELLIES FAMILY CARE HOME INC,1608 FALLSTON RD   SHELBY NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 72 , 72 ," $24,790.07 ",,
MEDICAID DIRECT,1497874390,"HAGER, DONNA, KAY",DONNA KAY HAGER,3108A PROSPERITY CHURCH RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1497874390,"HAGER, DONNA, KAY",3108A PROSPERITY CHURCH RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 54 , 142 , 490 ," $18,235.70 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,155 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497877872,"CASTLE, DAVID, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,54 RED MULBERRY WAY   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1497877872,"CASTLE, DAVID, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1016 FLETCHER ST   WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1497877872,"CASTLE, DAVID, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497877872,"CASTLE, DAVID, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 116 , 117 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497877872,"CASTLE, DAVID, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 169 , 169 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1497877872,"CASTLE, DAVID, ANTHONY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 37 , 37 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1497882369,"SALEM, MOHAMED, ELSAYED AHEMD",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,,,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1497882369,"SALEM, MOHAMED, ELSAYED AHEMD",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497882369,"SALEM, MOHAMED, ELSAYED AHEMD",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 22 , 82 , 82 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1497885354,"GRUMET, SURAH",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 68 , 107 , 108 ,$#,,
MEDICAID DIRECT,1497891147,RED OAK ASSISTED LIVING,,2920 WILLIAMS RD   GREENVILLE NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497891147,RED OAK ASSISTED LIVING,2920 WILLIAMS RD   GREENVILLE NC,074,Pitt,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 41 ," 9,380 "," 9,380 "," $675,910.24 ",,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497893614,"PATEL, KUMAR, RAVJIBHAI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497893614,"PATEL, KUMAR, RAVJIBHAI",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1497894562,"DEAN, BRIAN, SCOTT",117 E KINGS HWY   EDEN NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1497894562,"DEAN, BRIAN, SCOTT",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467149823,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH EMERGENCY PHYSICIANS,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1497894562,"DEAN, BRIAN, SCOTT",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1497894562,"DEAN, BRIAN, SCOTT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,2601 LAKE DR STE 201 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497894927,"BATTAGLINO, MICHAEL, PAUL",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497894927,"BATTAGLINO, MICHAEL, PAUL",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497894927,"BATTAGLINO, MICHAEL, PAUL",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1497895684,DUCKWORTH ACQUISITIONS LLC,~,3341 OLD HWY 10 E   NEBO NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497895684,DUCKWORTH ACQUISITIONS LLC,3341 OLD HWY 10 E   NEBO NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 616 , 617 ," $82,891.07 ",,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497896690,"ROLLINS, JEANNE, ANNETTE",5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1497896690,"ROLLINS, JEANNE, ANNETTE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497896690,"ROLLINS, JEANNE, ANNETTE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1790003580,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OB,5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497896690,"ROLLINS, JEANNE, ANNETTE",5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497897300,"WARREN, BIRCHIE, ST. CLAIR",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497898092,"RAO-PATEL, ANURADHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 41 , 41 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1497898092,"RAO-PATEL, ANURADHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 32 , 118 , 118 ,$#,,
MEDICAID DIRECT,1558319251,SELF CARE THERAPY INC,~,6626 GORDON RD STE H WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497899256,"PISANI, ANGELA, RENEE",6626 GORDON RD STE H WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 60 , 109 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497903447,"GAJJAR, BHAVESH, ARVINDBHAI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 299 , 305 ,$#,,
MEDICAID DIRECT,1659337046,COASTAL SURGICAL SPECIALIST,Coastal Surgical Specialist,2203 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1497903884,"SIMMONS, KECIA, RENEE",2203 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 48 , 98 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497906424,"HOOPER, HAL, BROOKS",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 54 , 88 , 168 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497906424,"HOOPER, HAL, BROOKS",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1366067233,ST LUKES PHYSICIAN NETWORK INC,ST LUKES UROLOGY ASSOCIATES,54 HOSPITAL DR STE 3B COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1497906424,"HOOPER, HAL, BROOKS",54 HOSPITAL DR STE 3B COLUMBUS NC,075,Polk,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1497906432,"BETANCOURT-ALBRECHT, MARION, ELIETTE",617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1447999057,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-643 FIFTH AVENUE WEST,643 5TH AVE W   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497906432,"BETANCOURT-ALBRECHT, MARION, ELIETTE",643 5TH AVE W   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 22 , 26 , 59 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497910236,"ROSENBERRY, CLARK, MICHAEL",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 20 , 27 , 44 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 40 , 64 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,702 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497912018,"PATEL, KUSH, SHASHIKANT",702 HARTNESS RD   STATESVILLE NC,049,Iredell,208800000X,Allopathic & Osteopathic Physicians,Urology,, 45 , 79 , 135 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497915698,"WILSON, JOSEPH, BRIAN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497915698,"WILSON, JOSEPH, BRIAN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 60 , 103 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1497915698,"WILSON, JOSEPH, BRIAN",910 W WILLIAMS ST   APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497915698,"WILSON, JOSEPH, BRIAN",910 W WILLIAMS ST   APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 24 , 37 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497915698,"WILSON, JOSEPH, BRIAN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 18 , 37 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1497915698,"WILSON, JOSEPH, BRIAN",910 W WILLIAMS ST   APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1497915698,"WILSON, JOSEPH, BRIAN",910 W WILLIAMS ST   APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497915771,"CHAMBERS, KARINN, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 107 , 175 , 199 ,$#,,
MEDICAID DIRECT,1265703607,MCPHERSON FAMILY EYE CARE,MCPHERSON FAMILY EYE CARE,3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497916068,"WARD, SAMANTHA, KOTO",3150 ROGERS RD STE 110 WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497916415,"AVAIYA, HITESH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497916415,"AVAIYA, HITESH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497916613,"TORREZ, JASNA, MARKO",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1871589762,ADVANCE COMMUNITY HEALTH INC,~,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497916613,"TORREZ, JASNA, MARKO",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 16 , 38 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497916738,"POULIN, NATHANIEL, ROBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1417941352,SCOTLAND MEMORIAL HOSPITAL INC,MAXTON FAMILY PRACTICE CENTER,1001 W MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1497917298,"FREEMAN, ASHLEIGH, JOHNSON",1001 W DR MARTIN LUTHER KING JR DR   MAXTON NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 96 , 261 , 381 ," $16,095.24 ",,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1497917298,"FREEMAN, ASHLEIGH, JOHNSON",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497917389,GREENLIGHT OCCUPATIONAL THERAPY PC,~,413 BRADFORD RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497917389,GREENLIGHT OCCUPATIONAL THERAPY PC,413 BRADFORD RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,#, 81 , 81 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497918296,"THURSTON, BRIAN, CALDWELL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497918379,"STEWART, MICHAEL, JAMES",582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497918734,"MILLER, PETER, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 33 , 55 , 58 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5915 FARRINGTON RD STE 103 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1497918775,"COLE, WESLEY, REECE",5915 FARRINGTON RD STE 103 CHAPEL HILL NC,019,Chatham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1497919682,"TAYLOR HEWITT, EMI, DENISE",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 40 , 42 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497921175,"SCALES, CHARLES, DOUGLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497921175,"SCALES, CHARLES, DOUGLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 27 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497921175,"SCALES, CHARLES, DOUGLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1497921498,THERAPY CONNECTIONS INC,~,1625 COUNTRY CLUB RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497921498,THERAPY CONNECTIONS INC,1625 COUNTRY CLUB RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,#, 94 , 94 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497924625,"ATAY, ORHAN, KAHRAMAN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497926604,"SHARP, HADLEY, JEAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 16 , 73 , 87 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497926604,"SHARP, HADLEY, JEAN",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 13 , 79 , 105 ,$#,,
MEDICAID DIRECT,1952611543,FAMILY FOOT AND ANKLE PHYSICIANS,FAMILY FOOT AND ANKLE PHYSICIANS,1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1497927339,"PITZER, AMY, MEEKER",1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 223 , 655 , 944 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 34 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 89 , 92 , 137 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497929178,"ROTH, CHRISTOPHER, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497930101,"SHILT, JOHN, ANDREW",313 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 69 , 76 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497930499,"SWARTZ, JUSTIN, STEPHEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 27 , 47 , 55 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497930499,"SWARTZ, JUSTIN, STEPHEN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497930499,"SWARTZ, JUSTIN, STEPHEN",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 49 , 86 , 150 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1497931141,"VASSAUR, KATHLEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 253 , 253 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497931240,"RAVISH, MATTHEW, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 53 , 87 , 110 ,$#,,
MEDICAID DIRECT,1497933162,MILLENNIUM HEALTH LLC,MILLENNIUM HEALTH LLC,16981 VIA TAZON   SAN DIEGO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1497933162,MILLENNIUM HEALTH LLC,16981 VIA TAZON   SAN DIEGO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 307 , 864 ," 1,445 "," $175,479.08 ",,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497933899,"STANTON, MEREDITH, MURPHY",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1497933899,"STANTON, MEREDITH, MURPHY",35 MEMORIAL DR   PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 34 , 47 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497933956,"MORGAN, STEPHANIE, ESCHENBACH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497933956,"MORGAN, STEPHANIE, ESCHENBACH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 36 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497934343,"PETERS, LAURA, JOHNSON",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497934343,"PETERS, LAURA, JOHNSON",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1497934483,KAY FAMILY CARE HOME LLC,KAY FCH LLC,337 N OVERLOOK TER   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497934483,KAY FAMILY CARE HOME LLC,337 N OVERLOOK TER   HENDERSONVILLE NC,045,Henderson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,374 "," 1,374 "," $101,545.32 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497935183,"FRANCIS-ROGERS, SANDRA, MARIA",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326235821,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - STATESVILLE,1022 SHELTON AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497936009,"ROGERS, ASHLEY, CARD",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 186 , 204 ," $10,846.26 ",,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497936009,"ROGERS, ASHLEY, CARD",1022 SHELTON AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1497936009,"ROGERS, ASHLEY, CARD",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679117048,EASTERN VIRGINIA ANESTHESIA LLC,,208 CARMICHAEL WAY   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1497937395,"CAPRA, LEANN, RENE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 46 , 66 , 138 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 87 , 129 , 231 ,$#,,
MEDICAID DIRECT,1205170800,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",1401 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1720590185,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1063910404,NOVANT HEALTH MINT HILL MEDICAL CEN,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497941025,"KALRA, SUMIT",8201 HEALTHCARE LOOP STE 201 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497941074,"HARTLEY, TASHINA, ROBERTS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 40 , 40 ,$#,,
MEDICAID DIRECT,1497942460,ORTHOPAEDIC SURGERY CENTER ASHEVILL,OUTPATIENT SURGERY CENTER OF ASHEVILLE,29 NETTLEWOOD DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1497942460,ORTHOPAEDIC SURGERY CENTER ASHEVILL,29 NETTLEWOOD DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 189 , 231 , 318 ," $47,390.94 ",,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1497943286,"AHLUWALIA, SHAMSHER, SINGH",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497945554,"ALEXANDRU, DIANA, MIHAI",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497945554,"ALEXANDRU, DIANA, MIHAI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 191 , 263 , 290 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497945554,"ALEXANDRU, DIANA, MIHAI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497945554,"ALEXANDRU, DIANA, MIHAI",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497948160,PROGRESSIVE CARE OF PRINCETON LLC,PROGRESSIVE CARE,160 HAVEN LN   PRINCETON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497948160,PROGRESSIVE CARE OF PRINCETON LLC,160 HAVEN LN   PRINCETON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 13 ," 2,369 "," 2,392 "," $160,440.82 ",,
MEDICAID DIRECT,1497948160,PROGRESSIVE CARE OF PRINCETON LLC,PROGRESSIVE CARE,154 HAVEN LN   PRINCETON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1497948160,PROGRESSIVE CARE OF PRINCETON LLC,154 HAVEN LN   PRINCETON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,313 "," 1,313 "," $85,342.01 ",,
MEDICAID DIRECT,1497950158,MEALS ON WHEELS OF WAKE COUNTY INC,~,1001 BLAIR DR STE 100 RALEIGH NC,092,Wake,332U00000X,Suppliers,Home Delivered Meals,,1497950158,MEALS ON WHEELS OF WAKE COUNTY INC,1001 BLAIR DR STE 100 RALEIGH NC,092,Wake,332U00000X,Suppliers,Home Delivered Meals,, 18 ," 2,457 "," 2,457 "," $18,911.20 ",,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497950927,"BIRD, COLIN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497950927,"BIRD, COLIN, PATRICK",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497950927,"BIRD, COLIN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497950927,"BIRD, COLIN, PATRICK",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 30 , 58 ,$#,,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497950927,"BIRD, COLIN, PATRICK",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710089164,GRANVILLE HEALTH SYSTEM,BEHAVIORAL HEALTH SERVICES,102 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1497951404,"WELBORN, APRIL, EVE",1010 COLLEGE ST   OXFORD NC,039,Granville,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 15 , 26 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 43 , 60 , 105 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 46 , 53 , 71 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497953848,"CUMMINGS, MATTHEW, SHEA",189 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497954200,"BADWAN, WAFA, RAWHI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497954200,"BADWAN, WAFA, RAWHI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497954200,"BADWAN, WAFA, RAWHI",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497954200,"BADWAN, WAFA, RAWHI",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 42 , 42 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497954200,"BADWAN, WAFA, RAWHI",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1497954200,"BADWAN, WAFA, RAWHI",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 50 , 50 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 5 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1497954200,"BADWAN, WAFA, RAWHI",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497954564,"MUZAFFAR, JAMEEL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 13 , 27 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497954564,"MUZAFFAR, JAMEEL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497954564,"MUZAFFAR, JAMEEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497955074,"MICHEL, CHAD, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 28 , 32 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1497955074,"MICHEL, CHAD, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 22 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1497955215,"CARTER, ERICKA, ELIZABETH",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 42 , 82 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1497955215,"CARTER, ERICKA, ELIZABETH",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497955470,"VANDERGRIFT, PATTY, SUSAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,300 ASHVILLE AVE STE 240 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1497955728,"DULL, BARBARA, ZAREBCZAN",300 ASHVILLE AVE STE 240 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497955728,"DULL, BARBARA, ZAREBCZAN",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497955728,"DULL, BARBARA, ZAREBCZAN",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 21 , 31 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497957112,"KROPF, PATRICIA, LAMONT",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 26 , 51 , 66 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497957112,"KROPF, PATRICIA, LAMONT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 13 , 51 , 51 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497957112,"KROPF, PATRICIA, LAMONT",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 26 , 42 , 72 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497957336,"SALEMI, MEHDI",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497957336,"SALEMI, MEHDI",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497957336,"SALEMI, MEHDI",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1851050918,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF MORRISVILLE,9648 CHAPEL HILL RD STE 100 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1497959712,"GRAHAM, ERIKA, MICHELLE",9648 CHAPEL HILL RD STE 100 MORRISVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 296 , 613 ," 1,980 "," $103,071.65 ",,
MEDICAID DIRECT,1184325102,ALLES DDS WAKE FOREST PLLC,IDEAL DENTAL WAKE FOREST,515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1497959712,"GRAHAM, ERIKA, MICHELLE",515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1184325102,ALLES DDS WAKE FOREST PLLC,IDEAL DENTAL WAKE FOREST,515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1497959712,"GRAHAM, ERIKA, MICHELLE",515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 41 , 42 , 173 ,$#,,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1497959712,"GRAHAM, ERIKA, MICHELLE",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 55 , 56 , 211 ,$#,,
MEDICAID DIRECT,1851050918,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF MORRISVILLE,9648 CHAPEL HILL RD STE 100 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1497959712,"GRAHAM, ERIKA, MICHELLE",4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497962542,INTERIM HEALTHCARE OF THE TRIAD,,1566 UNION RD STE G GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1497962542,INTERIM HEALTHCARE OF THE TRIAD,1566 UNION RD STE G GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1497963011,"SHAH, DISHANT, GIRISH",12301 ELLABERRY LN   GLEN ALLEN VA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497964969,"CLINGER, JOHN, DANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 42 , 59 , 87 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497964969,"CLINGER, JOHN, DANIEL",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497966782,"BOULTON, BRYON, JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497966782,"BOULTON, BRYON, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 44 , 63 ," $13,182.90 ",,
MEDICAID DIRECT,1720643174,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR STRUCTURAL HEART,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497966782,"BOULTON, BRYON, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497967376,"HAZAN, TAL, BEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1497968606,"WALTERS, RUTH, ANDERSON FULGHUM",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1497968606,"WALTERS, RUTH, ANDERSON FULGHUM",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 56 , 70 , 84 ,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497970735,"KING, PETER, BRENT",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1174187637,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PEDIATRIC INTENSIVISTS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497972350,"PATE, ANN, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 94 , 95 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1497972350,"PATE, ANN, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1497972996,"MCCLENDON, EDWARD, BAILEY",TRIP MCCLENDON DDS,501 HICKMAN RD   TABOR CITY NC,024,Columbus,1223G0001X,Dental Providers,Dentist,General Practice,1497972996,"MCCLENDON, EDWARD, BAILEY",501 HICKMAN RD   TABOR CITY NC,024,Columbus,1223G0001X,Dental Providers,Dentist,General Practice, 537 , 767 ," 2,068 "," $114,223.55 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497974273,"SMETKA, VLASTIMIL",420 N CENTER ST   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 129 , 489 , 489 ," $13,359.76 ",,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497974273,"SMETKA, VLASTIMIL",420 N CENTER ST   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 36 , 36 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1497974273,"SMETKA, VLASTIMIL",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497974273,"SMETKA, VLASTIMIL",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 66 , 66 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497975593,"BUTTRISS, GRACE, OCONNOR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497979611,"MALECKI, ROBERT",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497979611,"MALECKI, ROBERT",3614 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 38 , 84 ,$#,,
MEDICAID DIRECT,1952918948,MARY ELIZABETH STARNES HUFFMAN DDS,SOUTHERN FAMILY DENTISTRY,206 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1497981344,"HUFFMAN, MARY, ELIZABETH STARNES",342 HARPER AVE NW STE A LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1386183408,MARY ELIZABETH STARNES HUFFMAN DDS,LENOIR FAMILY DENTISTRY,342 HARPER AVE NW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1497981344,"HUFFMAN, MARY, ELIZABETH STARNES",342 HARPER AVE NW STE A LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice, 174 , 231 , 970 ," $29,717.90 ",,
MEDICAID DIRECT,1629631239,MARY ELIZABETH STARNES HUFFMAN DDS,APPLE VALLEY FAMILY DENTISTRY,167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,193400000X,Group,Single Specialty,,1497981344,"HUFFMAN, MARY, ELIZABETH STARNES",167 1ST AVE SW   TAYLORSVILLE NC,002,Alexander,1223G0001X,Dental Providers,Dentist,General Practice, 122 , 328 ," 1,067 "," $60,478.66 ",,
MEDICAID DIRECT,1952918948,MARY ELIZABETH STARNES HUFFMAN DDS,SOUTHERN FAMILY DENTISTRY,206 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1497981344,"HUFFMAN, MARY, ELIZABETH STARNES",206 S STERLING ST   MORGANTON NC,012,Burke,1223G0001X,Dental Providers,Dentist,General Practice," 1,308 "," 1,408 "," 5,015 "," $137,221.24 ",,
MEDICAID DIRECT,1356794606,MARY ELIZABETH STARNES HUFFMAN DDS,~,505 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1497981344,"HUFFMAN, MARY, ELIZABETH STARNES",918 BURKEMONT AVE   MORGANTON NC,012,Burke,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 48 , 167 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497981583,"BROWNLEE, KATHRYN, WILLOUGHBY",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 12 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497981583,"BROWNLEE, KATHRYN, WILLOUGHBY",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497981583,"BROWNLEE, KATHRYN, WILLOUGHBY",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497981583,"BROWNLEE, KATHRYN, WILLOUGHBY",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 21 , 38 , 60 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497982540,"WHITFIELD, ANDREA, RUTH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 17 , 57 , 59 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1497982540,"WHITFIELD, ANDREA, RUTH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 69 , 69 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497983589,"POWERS, WILLIAM, FARLEY",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1497983589,"POWERS, WILLIAM, FARLEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 68 , 127 , 141 ," $11,455.92 ",,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1497987440,"BAUCOM, HARRISON, BIERMAN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 131 , 155 , 236 ,$#,,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497987861,"LISSADE, PATRICE",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 33 ,$#,,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497987861,"LISSADE, PATRICE",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 2,073 "," 2,671 "," 9,527 "," $460,023.92 ",,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497987861,"LISSADE, PATRICE",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 2,228 "," 3,314 "," 11,713 "," $516,531.59 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497988802,"HUBBARD, DANA, COATS",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1497988802,"HUBBARD, DANA, COATS",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1497988802,"HUBBARD, DANA, COATS",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1497988802,"HUBBARD, DANA, COATS",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1497991913,"THOMAS, ROBERT, LEE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497991913,"THOMAS, ROBERT, LEE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 141 , 393 , 428 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497991913,"THOMAS, ROBERT, LEE",522 ALLEN ST   TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1497991913,"THOMAS, ROBERT, LEE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1497994214,"HOLLEY, CHRISTINA, LEE",1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1497994552,PRIMARY HEALTH CHOICE INC,,219 W BROAD ST   SAINT PAULS NC,078,Robeson,251B00000X,Agencies,Case Management,,1497994552,PRIMARY HEALTH CHOICE INC,219 W BROAD ST   SAINT PAULS NC,078,Robeson,251B00000X,Agencies,Case Management,, 13 , 47 , 47 ," $17,719.00 ",,
MEDICAID DIRECT,1790825206,COUNTY OF SURRY & SURRY COUNTY WELF,SURRY CO HEALTH & NUTRITION CTR,118 HAMBY RD   DOBSON NC,086,Surry,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1497994768,"GONSALVES, RYAN, EMMANUEL",118 HAMBY RD   DOBSON NC,086,Surry,1223D0001X,Dental Providers,Dentist,Dental Public Health," 1,848 "," 3,174 "," 10,381 "," $397,256.31 ",,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1497994784,"RUSSELL, HYDE, MCKINNEY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1497994784,"RUSSELL, HYDE, MCKINNEY",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1497994966,"CLARKE, HANNAH, GRACE",110 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 26 , 33 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1497997712,"DISANDRO, GIOVANNI",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497997803,"XU, NAIPING, MICHAEL",640 S VAN BUREN RD UNIT B EDEN NC,079,Rockingham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497997803,"XU, NAIPING, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 16 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1127 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497997803,"XU, NAIPING, MICHAEL",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1497997803,"XU, NAIPING, MICHAEL",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 165 , 229 , 409 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508000621,"BELLE, JOHN, STEPHEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 56 , 88 , 122 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508000621,"BELLE, JOHN, STEPHEN",509 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 28 , 67 , 93 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508001876,"HUANG, WEI",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 118 , 186 , 263 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508001876,"HUANG, WEI",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508001876,"HUANG, WEI",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508006644,"CARAHER, PHILIP, ANDREW",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508006776,"PATEL, DONIKA, KANTILAL",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 60 , 72 , 106 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508006776,"PATEL, DONIKA, KANTILAL",301 E WENDOVER AVE STE 310 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508007485,"RANDLE, REESE, WOODSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 43 , 49 ,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508008277,"PALLICK, RONALD, JOHN",1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#, 88 , 88 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508008657,"SISK, GEOFFROY, COURCELLE",10 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508008657,"SISK, GEOFFROY, COURCELLE",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508008657,"SISK, GEOFFROY, COURCELLE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508010984,"HURT, LEIGH ANN, HAYDEN",10650 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508010984,"HURT, LEIGH ANN, HAYDEN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508012634,"BHAVSAR, ANIL, SHASHIKANT",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508014531,"WILLIAMS, AMANDA, LEIGH",1101 N GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 138 , 193 , 343 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1508014531,"WILLIAMS, AMANDA, LEIGH",1101 N GREEN ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 27 , 46 ,$#,,
MEDICAID DIRECT,1215048145,VIBRANCE MED SPA & WELLNESS CTR,,1025 W H SMITH BLVD STE 106 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508016908,"TERRY, JEVITA, DENISE",1025 WH SMITH BLVD STE 106 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508016908,"TERRY, JEVITA, DENISE",1025 WH SMITH BLVD STE 106 GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1508018573,"LOBB, ROBIN, ANN",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508020280,"BERRY, ANNE, MARIA",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508020280,"BERRY, ANNE, MARIA",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508020280,"BERRY, ANNE, MARIA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508021791,"AHMAD, NABIL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508021791,"AHMAD, NABIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1235566811,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508021791,"AHMAD, NABIL",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1700111515,CAROLINAS PHYSICIANS NETWORK INC,CAROLINA NEUROLOGICAL CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508021791,"AHMAD, NABIL",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 61 , 85 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508021791,"AHMAD, NABIL",10660 PARK RD STE 4400 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508021791,"AHMAD, NABIL",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508022286,"PUNJABI, OMAR, SURESH",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508022286,"PUNJABI, OMAR, SURESH",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 82 , 172 , 417 ," $11,926.43 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508022286,"PUNJABI, OMAR, SURESH",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 61 , 136 , 330 ," $21,943.55 ",,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1508022641,"FAIRBETTER, AMBER, JOY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 45 , 45 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508023284,"METTU, PRIYATHAM, SAI",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 55 , 103 , 161 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508023284,"METTU, PRIYATHAM, SAI",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 84 , 199 ,$#,,
MEDICAID DIRECT,1700119534,PRIVATE DIAGNOSTIC CLINIC PLLC,Duke Eye Center,,,Unknown,193400000X,Group,Single Specialty,,1508023284,"METTU, PRIYATHAM, SAI",2000 REGENCY PKWY   CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1255757167,MATTHEW J OLMSTED DDS MS PLLC,~,2205 OAK RIDGE RD STE CC OAK RIDGE NC,041,Guilford,193400000X,Group,Single Specialty,,1508023946,"OLMSTED, MATTHEW, JOHN",2205 OAK RIDGE RD STE CC OAK RIDGE NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 136 , 514 , 643 ," $101,572.30 ",,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1508024225,"BONN, JILL, ANDREA",1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508024290,"WINN, DANA, RENEE",216 MOORE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 67 , 96 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508026410,"BOARDMAN, CYNTHIA, JANE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508026410,"BOARDMAN, CYNTHIA, JANE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1508027178,"HARLOW, KATHERINE, LYNN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1508028093,"VANOURNY, JAIME, JANE",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 45 , 54 , 97 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1508028093,"VANOURNY, JAIME, JANE",959 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 46 , 55 , 78 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,974 S POINT RD UNIT D BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1508028093,"VANOURNY, JAIME, JANE",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,651 WITHROW RD   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1508028093,"VANOURNY, JAIME, JANE",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1508028093,"VANOURNY, JAIME, JANE",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 58 , 75 , 160 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,974 S POINT RD UNIT D BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1508028093,"VANOURNY, JAIME, JANE",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508028143,"TSYNMAN, DONALD, NAUM",2210 HEMBY LN   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508028143,"TSYNMAN, DONALD, NAUM",2210 HEMBY LN   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 227 , 307 , 424 ," $12,054.78 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508028325,"RATNER, SHANA, PATRICE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 17 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508028325,"RATNER, SHANA, PATRICE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 57 , 126 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508028515,"AGUIAR LAPSIA, CASSYANNE, LETITCIA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1801843925,ARTHRITIS AND OSTEOPOROSIS CONSULTA,ARTHRITIS AND OSTEOPOROSIS CONSULTANTS OF THE CARO,1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508028713,"ORLOWSKY, ERIC, WILLIAM",1918 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 22 , 54 , 104 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508028978,"ASGHAR, MAMMONA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 92 , 303 , 303 ," $16,347.77 ",,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508028978,"ASGHAR, MAMMONA",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508028978,"ASGHAR, MAMMONA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508028978,"ASGHAR, MAMMONA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508030313,"PATTON, JOHN, WILLIAM",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508030313,"PATTON, JOHN, WILLIAM",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",237 N FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 40 , 40 , 58 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 43 , 57 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 50 , 64 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 62 , 63 , 118 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 23 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",301 E WENDOVER AVE STE 100 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508031253,"GRADY, ALLEN, THOMAS",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1508032087,PATHWAYS FOR THE FUTURE,PATHWAYS FOR THE FUTURE INC,525 MINERAL SPRINGS DR   SYLVA NC,050,Jackson,253Z00000X,Agencies,In Home Supportive Care,,1508032087,PATHWAYS FOR THE FUTURE,525 MINERAL SPRINGS DR   SYLVA NC,050,Jackson,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 2,505 "," 2,512 "," $369,222.00 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508032194,"BLACK, COLLEEN, ROCHELLE",6555 KEE LN STE 200 HARRISBURG NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 27 , 54 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508036328,"MACDONALD, GIGI, MILOU",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 32 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508036328,"MACDONALD, GIGI, MILOU",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 47 , 116 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508036328,"MACDONALD, GIGI, MILOU",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508039496,"DAVIS, BRADLEY, SCOTT",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 28 , 38 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508039496,"DAVIS, BRADLEY, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508039496,"DAVIS, BRADLEY, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508039496,"DAVIS, BRADLEY, SCOTT",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 30 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508040684,"MORSE, JESSICA, ELIZABETH",1765 DOBBINS DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1508040684,"MORSE, JESSICA, ELIZABETH",100 S BOYLAN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 14 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508040684,"MORSE, JESSICA, ELIZABETH",100 S BOYLAN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1508041666,MOYE MEDICAL ENDOSCOPY CENTER,Moye Medical Endoscopy Center LLC,521C MOYE BLVD   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1508041666,MOYE MEDICAL ENDOSCOPY CENTER,521C MOYE BLVD   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 19 , 18 , 21 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508044140,"CLAY, ANDRA, TAYLOR",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 65 , 70 ," $12,444.94 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508048372,"MINC, SAMANTHA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508048372,"MINC, SAMANTHA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508048372,"MINC, SAMANTHA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508048372,"MINC, SAMANTHA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508048372,"MINC, SAMANTHA, DANIELLE",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508049388,"DAS, SAMRAT, UMASANKAR",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 45 , 45 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508050550,"SHOMAKER, KYRIE, LAUREN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1255632683,ANMED HEALTH,ANMED PULMONARY & SLEEP MEDICINE,2000 E GREENVILLE ST STE 1100 ANDERSON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508052275,"RAVAL, ABHIJIT, AJITKUMAR",800 N FANT ST   ANDERSON SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1508052457,"MILLER, DYLAN, KIERAN",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508054222,"FOREMAN ABERNETHY, LOVINIA, PAGE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1508055872,"BRANTLEY, AMY, GEORGE EDMUNDSON",114 E RAILROAD ST   LA GRANGE NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1508055872,"BRANTLEY, AMY, GEORGE EDMUNDSON",327 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1508055872,"BRANTLEY, AMY, GEORGE EDMUNDSON",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 104 , 252 ,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508056680,"YAN, YIJUN",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 147 , 217 , 373 ," $16,818.95 ",,
MEDICAID DIRECT,1275608044,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AMD ORTHOTICS EAST INC,2301 EXECUTIVE CIR STE C GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508057845,"KELLY, DAVID",2301 EXECUTIVE CIR STE C GREENVILLE NC,074,Pitt,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1275608044,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AMD ORTHOTICS EAST INC,2301 EXECUTIVE CIR STE C GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508057845,"KELLY, DAVID",2301 EXECUTIVE CIR STE C GREENVILLE NC,074,Pitt,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508061730,"SMITH, KAREN, EARLE",174 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508061730,"SMITH, KAREN, EARLE",224 S 10TH AVE   SILER CITY NC,019,Chatham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1508062399,"LYLES, GRAHAM, WARNER",~,8 N POINTE CT   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1508062399,"LYLES, GRAHAM, WARNER",8 N POINTE CT   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 859 , 913 ," 1,696 "," $28,324.09 ",,
MEDICAID DIRECT,1508062498,"HENRY, MICHAEL, THOMAS",MICHAEL T HENRY DDS MS PA,105 TURNBERRY WAY   PINEHURST NC,063,Moore,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1508062498,"HENRY, MICHAEL, THOMAS",105 TURNBERRY WAY   PINEHURST NC,063,Moore,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 467 ," 3,461 "," 3,730 "," $427,517.83 ",,
MEDICAID DIRECT,1508062498,"HENRY, MICHAEL, THOMAS",MICHAEL T HENRY DDS MS PA,503 WESTWOOD WAY   LAURINBURG NC,083,Scotland,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1508062498,"HENRY, MICHAEL, THOMAS",503 WESTWOOD WAY   LAURINBURG NC,083,Scotland,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 196 , 429 , 569 ," $73,396.88 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508064502,"EDANG, MARK ANCEL, GUERRERO",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508064502,"EDANG, MARK ANCEL, GUERRERO",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508068776,"SMITHERMAN, ANDREW, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508068776,"SMITHERMAN, ANDREW, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 11 , 31 , 35 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508068818,"WHITHAM, JOSHUA, WESLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 102 , 102 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508068818,"WHITHAM, JOSHUA, WESLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 26 , 64 , 64 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508069303,"LOVE, WILLIAM, ELLIOT",525 CORPORATE CIR   SALISBURY NC,080,Rowan,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508069303,"LOVE, WILLIAM, ELLIOT",9735 KINCEY AVE STE 102 HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508069303,"LOVE, WILLIAM, ELLIOT",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 18 , 17 , 43 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1508072620,"WOODWARD, JOHN, WILLIAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1508072620,"WOODWARD, JOHN, WILLIAM",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508076548,"VATCA, MIHAELA, ALINA",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 83 , 226 , 310 ,$#,,
MEDICAID DIRECT,1689750663,ADVANTAGE BEHAVIORAL HEALTHCARE INC,~,732 DAVIS AVE   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1508079476,"LOWERY, NATASHA, JACOBS",732 DAVIS AVE   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508080102,"KRUSE, SHAWN, RICHARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 32 , 34 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508081183,"MARTIN, STEPHANIE, FALK",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 63 , 96 , 148 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508081183,"MARTIN, STEPHANIE, FALK",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 70 , 81 , 82 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,901 N WINSTEAD AVE STE 430 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508081183,"MARTIN, STEPHANIE, FALK",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 169 , 245 , 454 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508086182,"GENAO, LIZA, ISABEL",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508086182,"GENAO, LIZA, ISABEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508086182,"GENAO, LIZA, ISABEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1508088873,PATHWAYS FOR THE FUTURE,PATHWAYS FOR THE FUTURE,525 MINERAL SPRINGS DR   SYLVA NC,050,Jackson,253Z00000X,Agencies,In Home Supportive Care,,1508088873,PATHWAYS FOR THE FUTURE,525 MINERAL SPRINGS DR   SYLVA NC,050,Jackson,253Z00000X,Agencies,In Home Supportive Care,,#, 117 , 117 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508090275,"HEALY, ZACHARY, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 39 , 40 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1508090275,"HEALY, ZACHARY, RYAN",200 TRENT DR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508090275,"HEALY, ZACHARY, RYAN",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 26 , 27 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508090275,"HEALY, ZACHARY, RYAN",200 TRENT DR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 27 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1508090929,"TIWARI, ANKUR",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508090929,"TIWARI, ANKUR",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 237 , 447 , 594 ,$#,,
MEDICAID DIRECT,1902837073,DAVIDSON CLINIC,ATRIUM HEALTH PRIMARY CARE DAVIDSON CLINIC,705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508090978,"JOHNSON, EMILY, SETLIFF",705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 22 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,705 GRIFFITH ST   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508090978,"JOHNSON, EMILY, SETLIFF",705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 35 , 52 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508090978,"JOHNSON, EMILY, SETLIFF",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154693455,G ABRAMS R COHEN III PC,G ABRAMS & R COHEN III PC,401 COX RD STE 188 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508091018,"PENG, CHUN, WEI",9115 SAMLEN LN APT 105 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,179 "," 2,492 "," 8,653 "," $456,154.36 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508091323,"CORDERO, VINCENT, ANDREI",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 26 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508091323,"CORDERO, VINCENT, ANDREI",600 HOSPITAL DR   MONROE NC,090,Union,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508091323,"CORDERO, VINCENT, ANDREI",6068 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1437643988,MOSES CONE AFFILIATED PHYSICIANS IN,COX FAMILY PRACTICE,350 N COX ST STE 28 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1508091489,"SIRIVOL, MAMATHA",350 N COX ST STE 28 ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 64 , 75 ,$#,,
MEDICAID DIRECT,1689019945,SHANEAN MICHELLE ANDERSON DDS PA,~,900 S FRANKLIN ST STE 101 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1508092826,"ANDERSON, SHANEAN, MICHELLE",900 S FRANKLIN ST STE 101 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 216 , 432 ," 1,585 "," $55,344.48 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1962727388,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 35 , 42 ,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 35 , 41 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1962727388,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 81 , 111 , 162 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1508093915,"VENKATESH, KIRAN",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1508093915,"VENKATESH, KIRAN",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1508093915,"VENKATESH, KIRAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508093915,"VENKATESH, KIRAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 42 , 61 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",8001 TW ALEXANDER DRIVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 12 , 14 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508093949,"ALKADHI, YOUSIF, ZAID",8001 TW ALEXANDER DRIVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508094004,"QUARRIE, RENEE, PETA-GAE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 26 , 26 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508094343,"IHDE, SCOTT, JASON",1540 SUNDAY DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 61 , 77 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508094681,"KUREMSKY, JEFFREY, GRIFFIN",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 62 , 69 ,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1508094681,"KUREMSKY, JEFFREY, GRIFFIN",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508094681,"KUREMSKY, JEFFREY, GRIFFIN",440 MCALISTER RD   LINCOLNTON NC,055,Lincoln,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508094681,"KUREMSKY, JEFFREY, GRIFFIN",2525 COURT DR   GASTONIA NC,036,Gaston,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 73 , 258 , 361 ," $13,404.94 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508095431,"ROBINSON, DAVID, WAYNE",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508095431,"ROBINSON, DAVID, WAYNE",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508095431,"ROBINSON, DAVID, WAYNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 408 , 449 , 675 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508095431,"ROBINSON, DAVID, WAYNE",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 38 , 40 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508095431,"ROBINSON, DAVID, WAYNE",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508095431,"ROBINSON, DAVID, WAYNE",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841049913,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE BAPTIST IMAGING,3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508095431,"ROBINSON, DAVID, WAYNE",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1154860146,TRI-CITIES OBSERVATION SERVICES PC,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508096900,"BELL, KIMBERLEY, ANN",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508097734,"STEVENS, KIMBERLY, ROBERSON",~,201 E WOODLAWN DR   WILLIAMSTON NC,058,Martin,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1508097734,"STEVENS, KIMBERLY, ROBERSON",201 E WOODLAWN DR   WILLIAMSTON NC,058,Martin,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,306 WESTWOOD AVE STE 401 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508097940,"STUTSRIM, ASHLEY, ELIZABETH",306 WESTWOOD AVE   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508097940,"STUTSRIM, ASHLEY, ELIZABETH",306 WESTWOOD AVE   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508097940,"STUTSRIM, ASHLEY, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 192 , 223 , 249 ," $13,381.15 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508098609,"ASIJA, AAKANKSHA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508098609,"ASIJA, AAKANKSHA",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 26 , 62 , 101 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508098609,"ASIJA, AAKANKSHA",170 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 19 , 33 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508098609,"ASIJA, AAKANKSHA",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508098609,"ASIJA, AAKANKSHA",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508098609,"ASIJA, AAKANKSHA",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508099839,"BROOKS, WHITNEY, HAMMER",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508099839,"BROOKS, WHITNEY, HAMMER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508103110,"RINELL, KATELYN, ASBILL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508103110,"RINELL, KATELYN, ASBILL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508103110,"RINELL, KATELYN, ASBILL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508103110,"RINELL, KATELYN, ASBILL",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 85 , 99 , 183 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1508105305,"STEVENS, BRADLEY, ELLIOTT",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508105305,"STEVENS, BRADLEY, ELLIOTT",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508107707,"DAVIS, JENNIFER, DOBY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508108739,"THOMAS, DANIEL, JAMES",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 131 , 140 , 141 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508109364,"COFFMAN, ZACHARY, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508109364,"COFFMAN, ZACHARY, JOSEPH",501 6TH AVE S   ST PETERSBURG FL,102,Out of State > 40 miles,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1932485943,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM SURGICAL ASSOCIATES,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1508110198,"ANEWENAH, LESLIE, STANISLAUS",120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 68 , 76 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1508110198,"ANEWENAH, LESLIE, STANISLAUS",205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1508111329,S&S OPTOMETRIC SERVICES,EYECARE CONCEPTS,476 SHOTWELL ROAD STE 104 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1508111329,S&S OPTOMETRIC SERVICES,476 SHOTWELL ROAD STE 104 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1508111329,S&S OPTOMETRIC SERVICES,EYECARE CONCEPTS,476 SHOTWELL RD STE 104 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1508111329,S&S OPTOMETRIC SERVICES,476 SHOTWELL RD STE 104 CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,, 545 , 561 ," 1,093 "," $15,058.76 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508111345,"LONDON, CHRISTIANE, HARTMAN",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508111345,"LONDON, CHRISTIANE, HARTMAN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 42 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508111345,"LONDON, CHRISTIANE, HARTMAN",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508111345,"LONDON, CHRISTIANE, HARTMAN",101 MEDICAL PARK DR   MEBANE NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508111527,"MANIKKAM UMAKANTHAN, JAYADEV",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508111527,"MANIKKAM UMAKANTHAN, JAYADEV",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508111527,"MANIKKAM UMAKANTHAN, JAYADEV",11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 30 , 46 , 46 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508114612,"MANANDHAR, UREENA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 180 , 180 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508115296,"CHURCH, ANTHONY, LEE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508115296,"CHURCH, ANTHONY, LEE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1801261391,BLUE RIDGE COMMUNITY HEALTH SERVICE,SEVENTH AVENUE HEALTH CENTER,628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508115296,"CHURCH, ANTHONY, LEE",628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1801261391,BLUE RIDGE COMMUNITY HEALTH SERVICE,SEVENTH AVENUE HEALTH CENTER,628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508115296,"CHURCH, ANTHONY, LEE",628 7TH AVE E   HENDERSONVILLE NC,045,Henderson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508115296,"CHURCH, ANTHONY, LEE",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1922734375,MCPC-24 LLC,FIRSTHEALTH TELEMEDICINE,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1508117573,"WHITESCARVER, ANNA, KATE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1508117763,"DALTON, MARLEE, COLLIGAN",80 DOCTORS DR STE 2 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 34 , 46 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1508117763,"DALTON, MARLEE, COLLIGAN",80 DOCTORS DR STE 2 HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 21 , 24 ,$#,,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508120072,"SHAH, JAY, ASHOKKUMAR",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1619463429,FHPG LLC,~,2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1508120734,"ROEHRS, JENNIFER, ELAINE",2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 54 , 105 ,$#,,
MEDICAID DIRECT,1619463429,FHPG LLC,~,2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1508120734,"ROEHRS, JENNIFER, ELAINE",1135 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508121187,"GIBSON, ROBIN, BRINKLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508121187,"GIBSON, ROBIN, BRINKLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 136 , 279 , 283 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508121666,"HUANG, ANTHONY, HSI TIEN",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508121666,"HUANG, ANTHONY, HSI TIEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 26 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508123795,"PASTIS, IRENE, SAVVAS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508123860,"ADAMS, SHARON, MICHELLE",650 JULIAN RD   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 74 , 224 ,$#,,
MEDICAID DIRECT,1508124298,PREMIER HOME HEALTH CARE SERVICES I,PREMIER HOME HEALTH CARE SERVICES INC,1550 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,1508124298,PREMIER HOME HEALTH CARE SERVICES I,1550 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 2,193 "," 2,202 "," $318,724.36 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1508126079,"REED, CRAIG, CONOVER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508126079,"REED, CRAIG, CONOVER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508126079,"REED, CRAIG, CONOVER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 50 , 61 , 71 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508126269,"GARY, CHARI, RENEE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 159 , 161 ," $11,757.06 ",,
MEDICAID DIRECT,1114946332,CRABTREE CHIROPRACTIC CENTER PA,CRABTREE CHIROPRACTIC CENTER PA,4517 LEAD MINE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508126376,"SCOTT, ZACHARY, DANE",4517 LEAD MINE RD   RALEIGH NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,, 16 , 77 , 81 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",201 E GROVER ST   SHELBY NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 86 , 93 , 126 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 32 , 39 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508126418,"TROHA, DANIEL, RICHARD",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508128075,"MARWELL, JULIANNA, GEORGE",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508128075,"MARWELL, JULIANNA, GEORGE",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 86 , 123 , 164 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 342 , 539 , 705 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 41 , 43 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508137977,"ZACHARIAH, JIPS, JOHN",633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1508139213,OPEN HEARTS,~,3038 STALLINGS RD   MACCLESFIELD NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1508139213,OPEN HEARTS,3038 STALLINGS RD   MACCLESFIELD NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 985 , 989 ," $94,430.92 ",,
MEDICAID DIRECT,1629405212,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508139403,"SCHULTZ, KATHERINE, MARSHALL",16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 31 , 42 ,$#,,
MEDICAID DIRECT,1629405212,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508139403,"SCHULTZ, KATHERINE, MARSHALL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508140179,"DENNIS, CHRISTINA, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508140179,"DENNIS, CHRISTINA, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1871800177,DRAGONFLY HOUSE CHILDRENS ADVOCACY,~,387 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1508141375,"SKRABACZ, SHARON, ANNETTE",218 FOUST ST STE B ASHEBORO NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 13 , 27 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508145459,"DONAHUE, ARINA, ALEKSANDROYNA",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508149162,"COMER, STACY-ANN, SHEMAINE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508149162,"COMER, STACY-ANN, SHEMAINE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568899136,THE CHARLOTTE-MECKLENBURG HOSPITAL,KANNAPOLIS INTERNAL MEDICINE,201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508149162,"COMER, STACY-ANN, SHEMAINE",201 DALE EARNHARDT BLVD STE 200 KANNAPOLIS NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 26 , 26 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508149162,"COMER, STACY-ANN, SHEMAINE",4414 WILKINSON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508149162,"COMER, STACY-ANN, SHEMAINE",1930 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508149162,"COMER, STACY-ANN, SHEMAINE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790283844,NAOMI LANE DDS PA,,2600 OAKCREST AVE STE A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1508150038,"LANE, NAOMI, LORENE",2600 OAKCREST AVE STE A GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 3,671 "," 6,546 "," 25,271 "," $1,003,835.20 ",,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508150558,"SIDDIQI, MOHAMMAD, FAISAL",16645 BIRKDALE COMMONS PKWY STE 200E HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 15 , 32 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,16645 BIRKDALE COMMONS PKWY STE 200E HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508150558,"SIDDIQI, MOHAMMAD, FAISAL",16645 BIRKDALE COMMONS PKWY STE 200E HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 37 , 54 , 108 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508150558,"SIDDIQI, MOHAMMAD, FAISAL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 21 , 22 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508152182,"KLEINBERG, ANDREW, BRIAN",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 40 , 99 ,$#,,
MEDICAID DIRECT,1295729747,THE CHILD HEALTH CENTER,THE CHILD HEALTH CENTER,1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1508152687,"NIEHUES, DENISE, ELLEN",1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 49 , 123 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1508154592,"MAZZELLA, DANIEL, CHRISTOPHER",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 39 , 39 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1508154592,"MAZZELLA, DANIEL, CHRISTOPHER",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063647394,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - FOR,2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508155169,"MAHLE, CASEY, KENYON",2933 MAPLEWOOD AVE STE 1 WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1124265236,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - BER,114 KINDERTON BLVD   BERMUDA RUN NC,030,Davie,193200000X,Group,Multi-Specialty,,1508155169,"MAHLE, CASEY, KENYON",114 KINDERTON BLVD   BERMUDA RUN NC,030,Davie,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 17 , 36 , 66 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508156928,"TYRELL, RICHARD, OLIVER",600 GRESHAM DR STE 204 NORFOLK VA,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",7862 IDLEWILD RD   INDIAN TRAIL NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",7862 IDLEWILD RD   INDIAN TRAIL NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",3033 EASTWAY DR STE 201 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 20 , 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",3211 BISHOPS WAY LN STE 2000 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",3211 BISHOPS WAY LN STE 2000 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 47 , 124 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 28 , 50 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 28 , 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 37 , 56 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508157629,"SINGLA, ANJALI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508157736,"DHAROD, AJAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 67 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508158528,"NICHOLS, ELIZABETH, ANN",120 E CARVER ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508158528,"NICHOLS, ELIZABETH, ANN",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508158528,"NICHOLS, ELIZABETH, ANN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 28 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508158528,"NICHOLS, ELIZABETH, ANN",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 24 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508158528,"NICHOLS, ELIZABETH, ANN",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508161274,"LOOPER, KARIN, DENISE",404 S SUTHERLAND AVE   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 ,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508161605,"BURKE, MATTHEW, PATRICK",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508161605,"BURKE, MATTHEW, PATRICK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508161605,"BURKE, MATTHEW, PATRICK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508161605,"BURKE, MATTHEW, PATRICK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1508164260,"FREY, MARIE, MCCREA",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 67 , 111 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508164260,"FREY, MARIE, MCCREA",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1508164260,"FREY, MARIE, MCCREA",3511 JOHN PLATT DR   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508164641,"SCHLEMMER, CHRISTINE, MARIE",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1508164641,"SCHLEMMER, CHRISTINE, MARIE",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1508170861,"CAMP, RICHARD, WAYNE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 86 , 114 ,$#,,
MEDICAID DIRECT,1508171216,CAROLINA OUTREACH LLC,~,2670 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,1508171216,CAROLINA OUTREACH LLC,2670 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1154042992,RDMG ASSOCIATES PA,,7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508171372,"RISEDEN, DEREK, LANCE",7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 30 , 51 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1508176348,"TAYLOR, SHARON, ELIZABETH",2041 VALLEYGATE DRIVE   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1508176348,"TAYLOR, SHARON, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,,,Unknown,193400000X,Group,Single Specialty,,1508176348,"TAYLOR, SHARON, ELIZABETH",518 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508177262,"SIEBER, MARTHA, ANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 71 , 100 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508177262,"SIEBER, MARTHA, ANN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508177262,"SIEBER, MARTHA, ANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 76 , 79 , 112 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508179656,"SELWANE, PIERRE, SAMI",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 87 , 228 , 229 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508180175,"DALLAPIAZZA, ROBERT, FRANCIS",5838 SIX FORKS RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 45 , 55 , 71 ,$#,,
MEDICAID DIRECT,1588216253,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE CLAYTON,204 MEDSPRING DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508180274,"ALAVIAN, SHEREEN, AZAM",204 MEDSPRING DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 33 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508183286,"URBAN, CHRISTOPHER, RYAN",78 LONG SHOALS RD   ARDEN NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 31 , 45 , 107 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,78 LONG SHOALS RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1508183286,"URBAN, CHRISTOPHER, RYAN",78 LONG SHOALS RD   ARDEN NC,011,Buncombe,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1265014849,REHAB MEDICINE OF THE CAROLINAS,,2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508183658,"HILL, ADRIENNE, ROBBINS",2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 14 , 38 , 50 ,$#,,
MEDICAID DIRECT,1508183658,"HILL, ADRIENNE, ROBBINS",~,2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,1508183658,"HILL, ADRIENNE, ROBBINS",2554 LEWISVILLE CLEMMONS RD STE 201 CLEMMONS NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 19 , 25 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508185075,"UDOFF, ROSS, ADAM",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,1632 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508185075,"UDOFF, ROSS, ADAM",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508185075,"UDOFF, ROSS, ADAM",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 88 , 174 , 225 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508185372,"CHANDEL, AMIT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508185604,"VON, STEPHEN, JONATHAN",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 49 , 67 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508185604,"VON, STEPHEN, JONATHAN",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 23 , 43 , 47 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508185604,"VON, STEPHEN, JONATHAN",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 35 , 40 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508185604,"VON, STEPHEN, JONATHAN",200 W GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 21 , 23 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508185703,"WATSON, JOSHUA, RAY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 133 , 133 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508187931,"DAVIS, CHERYL, RENEE",2525 COURT DR   GASTONIA NC,036,Gaston,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1508188194,TRUE CARE HOME CARE SERVICE,~,223 PERSON ST STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1508188194,TRUE CARE HOME CARE SERVICE,223 PERSON ST STE A FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 5,607 "," 5,607 "," $355,113.56 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508191545,"TIRO, AILEEN, VERONICA",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508195710,"NGUYEN, BRIGETTE, GENEVIEVE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 54 , 58 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508196924,"WELDEN, MELISSA, ELAINE",435 2ND ST   NEWPORT TN,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508199860,"CHAMBLEE, NELLIE, SUE",160 MINE LAKE CT # 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 177 ," 1,926 "," 2,051 "," $53,396.11 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508199860,"CHAMBLEE, NELLIE, SUE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1508201393,"JU, TOM, WENTAO",251 KEISLER DR STE 101 CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508201609,"YOU, GEOFFREY",2210 HEMBY LN   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 295 , 371 , 549 ," $15,363.05 ",,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508201948,"SWORDS, DOUGLAS, SAUNDERS",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508202508,"PAYE, LAURA, STAMM",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 24 , 53 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508203175,"SHTRIDELMAN, YURI",10035 PARK CEDAR DR STE 300 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 53 , 53 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508203175,"SHTRIDELMAN, YURI",1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508203175,"SHTRIDELMAN, YURI",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 47 , 143 , 148 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1508206285,"BLACK, JUSTIN, CLINT",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1508206889,"CHIAPPONE, MICHAEL, JOEL",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 24 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1508209073,"MESSMER, MARK, LOUIS",205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 23 , 40 ,$#,,
MEDICAID DIRECT,1578256749,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1508209073,"MESSMER, MARK, LOUIS",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558750893,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM ORTHOPAEDICS,120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1508209073,"MESSMER, MARK, LOUIS",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 107 , 220 , 459 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1508209073,"MESSMER, MARK, LOUIS",120 CHARLES ROLLINS RD STE 102 HENDERSON NC,091,Vance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1508209305,"PIERCE, MATTHEW, ARDEN",705 NEWMAN RD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 80 , 124 , 204 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1508209305,"PIERCE, MATTHEW, ARDEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 16 , 24 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1508209305,"PIERCE, MATTHEW, ARDEN",4275 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1326364100,LOWCOUNTRY URGENT CARE,LOWCOUNTRY URGENT CARE,501 RADFORD BLVD   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508210501,"MCKOY, ALEXIA, WANDELL",103 N KEMPER ST   LAKE VIEW SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508210923,"THOMPSON, NICHOLAS, JAMES",115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508210923,"THOMPSON, NICHOLAS, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4325 LAKE BOONE TRL STE 315 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508210923,"THOMPSON, NICHOLAS, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508210923,"THOMPSON, NICHOLAS, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 26 , 35 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1508210923,"THOMPSON, NICHOLAS, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508210923,"THOMPSON, NICHOLAS, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 28 , 40 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1508210923,"THOMPSON, NICHOLAS, JAMES",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508213745,"OSTLING, PETER, STEVEN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 51 , 53 ,$#,,
MEDICAID DIRECT,1508214784,COMMUNICATION BUILDERS INC,COMMUNICATION BUILDERS,1350 OBRIAN DR   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508214784,COMMUNICATION BUILDERS INC,1350 OBRIAN DR   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,, 30 , 717 , 772 ," $56,338.79 ",,
MEDICAID DIRECT,1508215054,ALPHA CONCORD PLANTATION LLC,,2809 OLD CONCORD RD   SALISBURY NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1508215054,ALPHA CONCORD PLANTATION LLC,2809 OLD CONCORD RD   SALISBURY NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 18 ," 3,978 "," 3,978 "," $306,375.05 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508215112,"WARRILOW, JAMES, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 46 , 97 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508215195,"FU, TOMMY, GUANYING",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508215195,"FU, TOMMY, GUANYING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 13 , 30 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508216102,"CAPITO, KRISTEN, CAROLINE",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 40 , 47 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508216961,"JONES, KAREN, SPORL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1952803827,JONATHAN C AUSTIN DMD PA,~,640 S MAGNOLIA ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1508217597,"AUSTIN, JONATHAN, CHARLES",640 S MAGNOLIA ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 67 , 153 , 439 ," $20,817.07 ",,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508221763,"LEE, AMY, WHITT",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508221763,"LEE, AMY, WHITT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508221763,"LEE, AMY, WHITT",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508221763,"LEE, AMY, WHITT",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508221763,"LEE, AMY, WHITT",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508221763,"LEE, AMY, WHITT",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508221763,"LEE, AMY, WHITT",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508221763,"LEE, AMY, WHITT",1321 E SUNSET DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508227851,"RODMAN -AGBEJULE, STEPHANIE, RENEE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508227851,"RODMAN -AGBEJULE, STEPHANIE, RENEE",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508228255,"MEIER, NATHANIEL, MARSH",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508228255,"MEIER, NATHANIEL, MARSH",ONE MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508228255,"MEIER, NATHANIEL, MARSH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508228255,"MEIER, NATHANIEL, MARSH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508228255,"MEIER, NATHANIEL, MARSH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508228255,"MEIER, NATHANIEL, MARSH",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 42 , 71 , 106 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508228255,"MEIER, NATHANIEL, MARSH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 15 , 20 ,$#,,
MEDICAID DIRECT,1508238403,LIFE 360 THERAPY SERVICES INC,,105 MCRAE ST   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1508238403,LIFE 360 THERAPY SERVICES INC,105 MCRAE ST   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,, 11 , 194 , 194 ," $12,999.77 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508239054,"SIMS, GWEN, ELIZABETH",401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,401 E WHITAKER MILL RD STE 2100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508239054,"SIMS, GWEN, ELIZABETH",401 E WHITAKER MILL RD   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508239054,"SIMS, GWEN, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508239112,"ESSEX, BRENNAN, WILLIAM",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508240797,"BRANSON, NATHAN, JAMES",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1508241431,"RODRIGUEZ MEJIA, RICARDO, ANTONIO",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1508241431,"RODRIGUEZ MEJIA, RICARDO, ANTONIO",100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508241431,"RODRIGUEZ MEJIA, RICARDO, ANTONIO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 157 , 157 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508241902,"WOOD, MONICA, LYNN",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1508244344,"SALDANA, DANIELLE, BOYCE",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1508244344,"SALDANA, DANIELLE, BOYCE",80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 15 , 16 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508244773,"HORTON, CHRISTINE, PRICE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508244773,"HORTON, CHRISTINE, PRICE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508244963,"HERNANDEZ NINO, JACKELINE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 165 , 165 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508245119,"MCKAY, LAUREN, ELIZABETH-KRAICS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508245762,"KAUFFMAN, LEVI, DAVID",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 69 , 95 , 119 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508245762,"KAUFFMAN, LEVI, DAVID",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 33 , 42 , 44 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508245762,"KAUFFMAN, LEVI, DAVID",1015 WORTH ST   MOUNT AIRY NC,086,Surry,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1467972703,NORTH CAROLINA SPECIALTY HOSPITALS,,3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1508245838,"ATKINS, ROD, LANCE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508246935,"FARWELL, MICHAEL, WAYNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 44 , 75 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508246935,"FARWELL, MICHAEL, WAYNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,6060 PIEDMONT ROW DR S   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508246935,"FARWELL, MICHAEL, WAYNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1508246935,"FARWELL, MICHAEL, WAYNE",6060 PIEDMONT ROW DR S FL 7 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508247610,PRIORITY CARE AMBULANCE INC,,5116 BUR OAK CIR   RALEIGH NC,092,Wake,3416L0300X,Transportation Services,Ambulance,Land Transport,1508247610,PRIORITY CARE AMBULANCE INC,5116 BUR OAK CIR   RALEIGH NC,092,Wake,3416L0300X,Transportation Services,Ambulance,Land Transport, 704 , 885 ," 1,767 "," $70,369.42 ",,
MEDICAID DIRECT,1619638970,CHRISTOPHER CLARK DDS II PLLC,HOMELAND AVENUE DENTISTRY,1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1508248717,"HUGGINS-CHALLENGER, HEREWARD, RUSSELL",1037 HOMELAND AVE   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 39 , 170 ," $18,022.48 ",,
MEDICAID DIRECT,1902328701,CHALLENGER AND ASSOCIATES PLLC,CHALLENGER FAMILY DENTAL,9096 CLEVELAND RD STE 1 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508248717,"HUGGINS-CHALLENGER, HEREWARD, RUSSELL",9096 CLEVELAND RD STE 1 CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 698 ," 1,490 "," 5,962 "," $324,562.82 ",,
MEDICAID DIRECT,1578152773,FULLER & ASSOCIATES VI PLLC,BLADENBORO FAMILY DENTISTRY,104 4TH ST   BLADENBORO NC,009,Bladen,193200000X,Group,Multi-Specialty,,1508248717,"HUGGINS-CHALLENGER, HEREWARD, RUSSELL",104 4TH ST   BLADENBORO NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 82 , 327 ," $31,106.54 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1508249327,"HALL, SHERRY, ANN",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1508249327,"HALL, SHERRY, ANN",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 80 , 94 , 143 ,$#,,
MEDICAID DIRECT,1073891719,CAROMONT MEDICAL GROUP INC,CAROMONT PATHOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508249392,"BANKS, MARA, ELEANOR",2525 COURT DR   GASTONIA NC,036,Gaston,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 96 , 99 , 146 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508250523,"BURNETTE, JENNIFER, MICHELLE",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 59 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508251844,"SLOAN, CAROLINE, ELLEN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508251844,"SLOAN, CAROLINE, ELLEN",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 67 , 107 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1508253162,"SCHRODER, DANIEL, JOSEPH",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 172 , 185 , 278 ," $12,331.60 ",,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",90 SOUTHSIDE AVE STE 300 ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",200 TABERNACLE RD   BLACK MOUNTAIN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 11 , 141 , 141 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 15 , 213 , 213 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508253360,"LAMM, JEANETTE, EVELYN",62 LAKE EDEN RD   BLACK MOUNTAIN NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 346 , 346 ,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E W T HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508254723,"MCCACHERN, ERIKA, KIRSTEN",101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508254723,"MCCACHERN, ERIKA, KIRSTEN",101 E W T HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 58 , 90 , 145 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1508256074,"TIMMONS, ASHLEY, WAHLFELDT",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 69 , 70 , 70 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508258583,"MCFARLAND, HEATHER, JEAN",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508260183,"ROSU, RAFAEL, FLORIN",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508260183,"ROSU, RAFAEL, FLORIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 24 , 29 ,$#,,
MEDICAID DIRECT,1265458251,SEASHORE PEDIATRICS PC,SEASHORE PEDIATRICS,2828 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508262486,"KRESSLER, LEIGH, MICHELLE",2828 BAYBORO ST   LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508267030,"GIVENS, CARMEN, MCNEIL",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1508269150,"SALYER, TRACIE, JEAN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 19 , 21 , 31 ,$#,,
MEDICAID DIRECT,1811761349,CAROMONT MEDICAL GROUP INC,CAROMONT HEALTH MATERNITY CLINIC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508269150,"SALYER, TRACIE, JEAN",991 W HUDSON BLVD SUITE 70B GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508269150,"SALYER, TRACIE, JEAN",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508269150,"SALYER, TRACIE, JEAN",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1508270570,"KONITZER, HOLLIS, CAMILLE",201 E GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1508270570,"KONITZER, HOLLIS, CAMILLE",110 W GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1508270570,"KONITZER, HOLLIS, CAMILLE",821 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508271560,"ACEVEDO MARTINEZ, STEPHANNY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 125 , 134 , 137 ,$#,,
MEDICAID DIRECT,1588613756,NEPHROLOGY ASSOCIATES PA,NEPHROLOGY ASSOCIATES PA,1436 RIVERCHASE BLVD   ROCK HILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508275587,"KODALI, RAVI, TEJA",1436 RIVERCHASE BLVD   ROCK HILL SC,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508279043,"TRULL, KELSEY, NORKETT",9965 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508279043,"TRULL, KELSEY, NORKETT",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#,#,$#,,
MEDICAID DIRECT,1972266237,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SHALLOTTE,301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1508279506,"BARRETT, RYAN, MICHAEL",301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508280082,"ADAMS, AMANDA, LYNN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508280082,"ADAMS, AMANDA, LYNN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508285065,"PATEL, KALPESH, GIRISH",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508285065,"PATEL, KALPESH, GIRISH",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 63 , 81 , 94 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508285065,"PATEL, KALPESH, GIRISH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508285065,"PATEL, KALPESH, GIRISH",510 CORPORATE CIR STE 1000 SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 69 , 95 , 95 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508285065,"PATEL, KALPESH, GIRISH",522 CORPORATE CIR   SALISBURY NC,080,Rowan,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508286394,"HORSTMAN, GABRIELLE, MARIE",MEDICAL CENTER VLVD   WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 24 , 57 , 61 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508286550,"ESTEPHAN, DAVID, ISMAEL",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508288168,"MENG, HAO",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 58 , 85 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508288168,"MENG, HAO",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508288168,"MENG, HAO",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,522 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1508288259,"HOLSOPPLE, AMANDA, LEE",522 S VAN BUREN RD   EDEN NC,079,Rockingham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508289398,"SHEIKH, SHABINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 69 , 97 , 107 ,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508292178,"KOOISTRA, REBECCA, ANN",301 LLOYD ST   CARRBORO NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 45 , 53 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508292483,"TOHID, USMAN, AMASH",701 CASHUA FERRY RD   DARLINGTON SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1508293242,"BARNETTE, PHYLLIS, YVETTE",~,508 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),1508293242,"BARNETTE, PHYLLIS, YVETTE",508 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 25 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508299777,"CLARK, SHANNON, JOAN",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508301185,VICTORY HOME HEALTH CARE LLC,,1519 W GARRISON BLVD   GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1508301185,VICTORY HOME HEALTH CARE LLC,1519 W GARRISON BLVD   GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 41 ," 10,339 "," 10,947 "," $872,223.36 ",,
MEDICAID DIRECT,1265949788,MARGARET BOWEN MD PLLC,,1449 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1508313628,"GRAVES, KWANDA, LEE",1449 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508315292,"BENTON, KRISTEN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508315292,"BENTON, KRISTEN",101 E WT HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1396986451,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508315292,"BENTON, KRISTEN",101 E WT HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508315623,"LI-BARBER, TROY, ALLEN",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508315623,"LI-BARBER, TROY, ALLEN",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1316603301,DR CAMERON & ASSOCIATES OF DURHAM P,,5111 NC HIGHWAY 55 STE 102 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1508315904,"SINGH, SMRITI, MARCHELLE",5111 NC 55 STE 102 DURHAM NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 34 , 37 , 112 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508315904,"SINGH, SMRITI, MARCHELLE",5111 NC 55 STE 102 DURHAM NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508315987,"SING, CINDY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 65 , 65 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 16 , 16 , 30 ,$#,,
MEDICAID DIRECT,1508318957,"WRIGHT, NIARA, ELIZABETH",,3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 81 , 90 , 205 ,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 31 , 23 , 42 ,$#,,
MEDICAID DIRECT,1144839515,WRIGHT PODIATRY PLLC,,3607 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,1380 EASTCHESTER DR STE 105 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 229 , 247 , 449 ,$#,,
MEDICAID DIRECT,1144839515,WRIGHT PODIATRY PLLC,,3607 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 503 ," 1,042 "," 2,289 "," $19,036.44 ",,
MEDICAID DIRECT,1144839515,WRIGHT PODIATRY PLLC,,3607 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1033353941,HORIZON INTERNAL MEDICINE PLLC,HORIZON INTERNAL MEDICINE PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1508318957,"WRIGHT, NIARA, ELIZABETH",3607 N ELM ST STE G GREENSBORO NC,041,Guilford,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508321043,"HITE, MARISSA, GAITHER",1471 JAG BRANCH BLVD UNIT 103 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 53 , 82 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508322504,"MACKUSICK, CAROL, ISAAC",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508322504,"MACKUSICK, CAROL, ISAAC",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 30 , 91 , 196 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508325515,"TOUS, ANNAMARIE, NATASHA",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1508326521,"CRYDER, SYDNEY, CHRISTINE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 81 , 92 , 118 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1508326521,"CRYDER, SYDNEY, CHRISTINE",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508327420,"YOON, STEPHEN, PAUL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508327420,"YOON, STEPHEN, PAUL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508328659,"HAMMONDS, RACQUEL, MARIE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508328659,"HAMMONDS, RACQUEL, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508329541,"MONTGOMERY, AKUA, ROSIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 170 , 170 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508331455,"WOOTEN, ANNA, GRACE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508331455,"WOOTEN, ANNA, GRACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508331455,"WOOTEN, ANNA, GRACE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508331455,"WOOTEN, ANNA, GRACE",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508331455,"WOOTEN, ANNA, GRACE",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508331455,"WOOTEN, ANNA, GRACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508332727,"MALONE, DAWN, ANTOINETTE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 69 , 410 , 626 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508333790,"WEST, DYLAN, HUNTER",211 VIRGINIA RD   EDENTON NC,021,Chowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508334939,"PIERPOINT, APRIL, NICOLE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508334939,"PIERPOINT, APRIL, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508334939,"PIERPOINT, APRIL, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508334939,"PIERPOINT, APRIL, NICOLE",916 S MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508334939,"PIERPOINT, APRIL, NICOLE",916 S MAIN ST   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508337379,NEUSE RIVER SPEECH AND LANGUAGE THE,NEUSE RIVER SPEECH AND LANGUAGE THERAPY PLLC,205 MAGNOLIA CIR   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1508337379,NEUSE RIVER SPEECH AND LANGUAGE THE,205 MAGNOLIA CIR   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,, 11 , 197 , 198 ," $13,331.97 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508338542,"DRIVER, KIMBERLY, LEIGH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 106 , 109 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508338542,"DRIVER, KIMBERLY, LEIGH",250 BISHOP LN   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 501 , 541 ," $11,389.31 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508338542,"DRIVER, KIMBERLY, LEIGH",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508339250,"SWARTZ, SAMUEL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 137 , 137 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508344805,"DRIEDGER, MICHAEL, ROSS",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508344805,"DRIEDGER, MICHAEL, ROSS",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508344805,"DRIEDGER, MICHAEL, ROSS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508345703,"LYERLY, CHRISTOPHER, FISHER",6341 COOK AVE STE D CLEMMONS NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 22 , 31 , 69 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508345703,"LYERLY, CHRISTOPHER, FISHER",147 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 28 , 32 , 71 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508345703,"LYERLY, CHRISTOPHER, FISHER",367 S ANDY GRIFFITH PKWY STE 200 MOUNT AIRY NC,086,Surry,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508348665,"SHANAHAN, BRIAN, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 29 , 36 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508348814,"LEVA, JUSTIN, DAVID",13024 EASTFIELD RD STE A600 HUNTERSVILLE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 44 , 102 ,$#,,
MEDICAID DIRECT,1609386424,SPARTANBURG MEDICAL CENTER,MGC-ORTHOPAEDIC SURGERY- NORTH GROVE,1330 BOILING SPRINGS RD STE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508350646,"PARKER, WESLEY",1330 BOILING SPRINGS ROAD SUITE 1540 SPARTANBURG SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508350919,"GHASEM, PARSA, RAIS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 63 , 64 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508350919,"GHASEM, PARSA, RAIS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508350919,"GHASEM, PARSA, RAIS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 121 , 123 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1508355058,"NEVOLO, ZACHARY, ANTON",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1508355058,"NEVOLO, ZACHARY, ANTON",133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 92 , 144 , 156 ,$#,,
MEDICAID DIRECT,1205538550,HARNETT HEALTH SYSTEM INC,CFV INTERNAL MEDICINE CONTINUITY CLINIC-ERWIN,133 PROFESSIONAL PARK   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1508355058,"NEVOLO, ZACHARY, ANTON",803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 25 , 26 ,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,197 PLAZA DR   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1508355165,"MOKHOR, NATALYA, LEONIDOVNA",150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,5825 THUNDER RD   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508355165,"MOKHOR, NATALYA, LEONIDOVNA",5825 THUNDER RD   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1992055966,RYAN LEBLANC OD PLLC,,150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508355165,"MOKHOR, NATALYA, LEONIDOVNA",150 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508355991,"RAWITZ, HALEY, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508355991,"RAWITZ, HALEY, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",465 STRATFORD DR   ZEBULON NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",465 STRATFORD DR   ZEBULON NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 78 , 78 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 33 , 48 , 71 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",465 STRATFORD DR   ZEBULON NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 100 , 100 ," $11,318.86 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 44 , 44 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 41 , 41 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508360215,"RUBERWA, JOSEPH",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508360603,"RIBAUDO, DANA, MICHELLE",10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508360603,"RIBAUDO, DANA, MICHELLE",3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 37 , 95 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508360876,"STUBENRAUCH, ANDREW, CHARLES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508361296,"LELEGREN, MATTHEW, JON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508361932,"SCRIMA, ANDREW, THOMAS",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508362468,"MEADOWCROFT, MARY, KATHERINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 29 , 29 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1508362468,"MEADOWCROFT, MARY, KATHERINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ," $17,808.43 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508362468,"MEADOWCROFT, MARY, KATHERINE",2523 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 102 , 156 , 246 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508363235,"MORAVEC, KATHERINE, ANN",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 43 , 43 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508363235,"MORAVEC, KATHERINE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922061092,SUMMIT COSMETIC SURGERY CENTER,SUMMIT COSMETIC SURGERY CENTER,1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508367186,"SHEDLOFSKY, LYDIA, BETH",1717 SHIPYARD BLVD STE 100 WILMINGTON NC,065,New Hanover,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 34 , 64 , 111 ,$#,,
MEDICAID DIRECT,1184051757,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508368150,"EUDY, ANDREA, EUDY",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 60 , 96 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508369620,"MCKNIGHT, RHEANNA, MICHELLE",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 45 , 56 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508371386,"BLACK, ELIZABETH, ANN",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508371386,"BLACK, ELIZABETH, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568400174,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,281 E MAIN ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1508372137,"SPURLIN, RYAN, MICHAEL",6503 BREVARD RD   ETOWAH NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 76 , 146 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508372830,"INMAN, ELYN, CHANCE",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508372830,"INMAN, ELYN, CHANCE",4101 MACON POND RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1508374232,"POETKER, HOPE, ANNA MARIE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1508374232,"POETKER, HOPE, ANNA MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508374273,"DIMINO, CHRISTINE, MARIE",2340 SPRING FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508376484,"MAUNEY, LORENA, GUADALPE DUNBAR",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548711963,GOSHEN MEDICAL CENTER INCORPORATED,~,4654 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508376484,"MAUNEY, LORENA, GUADALPE DUNBAR",4654 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508376484,"MAUNEY, LORENA, GUADALPE DUNBAR",4654 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508379611,"OLSON, YULIYA, RUDNITSKY",205 WAYNESVILLE PLZ   WAYNESVILLE NC,044,Haywood,1223G0001X,Dental Providers,Dentist,General Practice, 528 , 756 ," 1,592 "," $96,839.57 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508382953,"TURNER, SARA, EDWARDS",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 61 , 112 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508382953,"TURNER, SARA, EDWARDS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 32 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,,,Unknown,193200000X,Group,Multi-Specialty,,1508382953,"TURNER, SARA, EDWARDS",410 MARKET ST STE 400 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508382953,"TURNER, SARA, EDWARDS",3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 41 , 58 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1508382961,"BABBITT, SARA, FITZHENRY",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508382961,"BABBITT, SARA, FITZHENRY",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508382961,"BABBITT, SARA, FITZHENRY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508382961,"BABBITT, SARA, FITZHENRY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508382961,"BABBITT, SARA, FITZHENRY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508383506,"SHENK, KOREN, REBECCA WAGNER",10211 ALM ST STE 2400 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1750001749,ONESPOTMD PRIMARY AND URGENT CARE P,,2114 FREEMAN PARK DR STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508384934,"MAI, PHUONG",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164021051,ONESPOTMD PRIMARY AND URGENT CARE P,,2017 CENTRAL AVE STE 103 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508384934,"MAI, PHUONG",9628 REA RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508386012,"PHILLIPS, HANNAH, LEIGH",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1508386889,"MANUEL, KELLEY, OSBORNE",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 93 , 211 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1508386889,"MANUEL, KELLEY, OSBORNE",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255950325,NORTHERN HOSPITAL DISTRICT OF SURRY,NORTHERN URGENT CARE,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1508386889,"MANUEL, KELLEY, OSBORNE",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255950325,NORTHERN HOSPITAL DISTRICT OF SURRY,NORTHERN URGENT CARE,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1508386889,"MANUEL, KELLEY, OSBORNE",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1508386889,"MANUEL, KELLEY, OSBORNE",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 34 , 55 ,$#,,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508388620,"HEIMBROOK, EMILY, WILES",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,662 "," 2,025 "," 7,732 "," $420,826.50 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 24 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 93 , 114 , 151 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 162 , 182 , 235 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1508391210,"MINKEMEYER, VIVIAN, MARIE",3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508392325,"VANOVER, DAWN, MICHELLE",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508394495,"GLADZISZEWSKI, JULIE, LYNNE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508394495,"GLADZISZEWSKI, JULIE, LYNNE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 100 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508395260,"LOPEZ VASQUEZ, DASHA, VALERIA",507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,2076 HWY 42 W STE 330 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508395260,"LOPEZ VASQUEZ, DASHA, VALERIA",34 HEALTHPARK WAY STE 100C CLAYTON NC,051,Johnston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 24 , 31 , 59 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,507 N BRIGHTLEAF BLVD STE 202 SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508395260,"LOPEZ VASQUEZ, DASHA, VALERIA",507 N BRIGHTLEAF BLVD STE 201 SMITHFIELD NC,051,Johnston,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 23 , 33 , 57 ,$#,,
MEDICAID DIRECT,1699213843,CHANG AND RAMOS DDS PA,,3901 N ROXBORO ST STE 111 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1508395328,"FINGER, REBEKAH",3901 N ROXBORO ST STE 111 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1528495108,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - CONCORD,1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508395740,"REDMON, ANGELA, CHRISTINE",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 112 , 178 , 306 ,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508398058,"WOLFE, KENNEDY, COOK",3004 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 49 , 110 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508399346,"PROVENZA, JOHN, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 59 , 71 , 80 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508399346,"PROVENZA, JOHN, MICHAEL",500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508399437,"NANNEPAGA, SOWGANDHI",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508399718,"SHUMAN, THOMAS, PAUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 79 , 236 , 244 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1508403460,"BURDETTE, JAMES, MICHAEL LOWELL",325 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 24 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508404898,"COLE, CONNOR, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508405630,"MAHMOUD, KARIM, ABDEL",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508405630,"MAHMOUD, KARIM, ABDEL",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508405630,"MAHMOUD, KARIM, ABDEL",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104388263,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - TAYLORSVILLE,50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508410754,"PHARES, APRIL, HELTON",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 17 , 20 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508412511,"HEYSE, JESSICA, RAKES",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 21 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508412511,"HEYSE, JESSICA, RAKES",7473 C HWY 22   WHISPERING PINES NC,063,Moore,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1447715982,MORIARTY PHYSICAL THERAPY INC,,2310 BALE ST STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508414434,"VIRGIN, KATHERINE, IRENE",2310 BALE ST   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508417114,"WALKER, JONATHAN, WALTON",216 MOORE RD   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 71 , 124 , 174 ,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,652 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1508417403,"PARDI, VANESSA",652 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice, 98 , 140 , 605 ," $14,293.14 ",,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,716 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1508417403,"PARDI, VANESSA",716 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice, 44 , 97 , 308 ,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,3734 GOVERNORS RD   KELFORD NC,008,Bertie,193200000X,Group,Multi-Specialty,,1508417403,"PARDI, VANESSA",3734 GOVERNORS RD   KELFORD NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice, 85 , 116 , 463 ,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,202 N ACADEMY ST   COLERAIN NC,008,Bertie,193200000X,Group,Multi-Specialty,,1508417403,"PARDI, VANESSA",202 N ACADEMY ST   COLERAIN NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice, 87 , 121 , 508 ," $10,959.14 ",,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,2515 NC HIGHWAY 305   AULANDER NC,008,Bertie,193200000X,Group,Multi-Specialty,,1508417403,"PARDI, VANESSA",2515 NC HIGHWAY 305   AULANDER NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,104 COOPER HILL RD   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1508417403,"PARDI, VANESSA",104 COOPER HILL RD   WINDSOR NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice, 136 , 219 , 762 ," $17,003.13 ",,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,715 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1508417403,"PARDI, VANESSA",715 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,1223G0001X,Dental Providers,Dentist,General Practice,#, 16 , 59 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508418757,"LEE, KRISTIN, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1902953045,WHITE OAK PEDIATRIC ASSOCIATES PA,~,4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508421512,"HE, MASON",4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 21 , 53 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508421744,"LINGARD, CONOR, EDWARD",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649428194,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES,800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508429317,"HANNA, CHARLOTTE, HELEN",800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508431107,"NYABERA, KEVIN, OTUNDO",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 73 , 105 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508431107,"NYABERA, KEVIN, OTUNDO",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508431776,"FERREE, ANTHONY, WAYNE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508435322,"BRODAR, STEVEN, CANON",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 23 , 32 ,$#,,
MEDICAID DIRECT,1033420153,COASTAL HORIZONS CENTER INC,COASTAL HORIZONS CENTER INC,615 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508435744,"SIMMONS, JEFFREY, LEE",615 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1508436247,"KHANI, ARASH",ARASH KHANI DDS PA,110 BANKS DR   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,1508436247,"KHANI, ARASH",110 BANKS DR   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 82 , 159 , 426 ," $16,131.68 ",,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508439019,"SHARMA, EKTA",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 453 , 584 ," 1,936 "," $65,267.80 ",,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508439019,"SHARMA, EKTA",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 47 , 153 ," $10,843.13 ",,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1508443243,"STERLING, SHANE, BYRON",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 57 ,$#,,
MEDICAID DIRECT,1508445305,SAFE HANDS HOME CARE,,105 EAST GREEN STREET UNIT C WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1508445305,SAFE HANDS HOME CARE,105 EAST GREEN STREET UNIT C WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,#," 1,407 "," 1,407 "," $85,013.44 ",,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508445792,"DE LA CRUZ, ALEXIS, LUCILLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 72 , 72 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 3400 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508446337,"ROTHWELL, REBECCA, LYNN MCMAHEN",1 HOSPITAL DR STE 3400 ASHEVILLE NC,011,Buncombe,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508448150,"SOROKIN, ALEXANDER, IVANOVICH",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 43 , 43 ,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1508448275,"PORTER, CAITLIN, SILVER",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 19 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508448325,"HAMPE, MARY, ELIZABETH",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508448325,"HAMPE, MARY, ELIZABETH",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1508448325,"HAMPE, MARY, ELIZABETH",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508450743,"WHITE, KATILYNN, VICTORIA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 23 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508455072,"CLAY, TAYLOR",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508455072,"CLAY, TAYLOR",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508455635,"SAMBURSKY, ALI, ADELA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366882391,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH INFECTIOUS DISEASES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1508459736,"DI-MAJO, AMANDA, LEANNA",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 34 , 34 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508471806,"HARTMAN, EMILY",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508471806,"HARTMAN, EMILY",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508475260,"O'CONNOR, JODI, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1508477738,"IJAOLA, ONYEJE, MAURA",401 W DECATUR ST   MADISON NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508479270,"PATEL, DHRUTHI",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508479270,"PATEL, DHRUTHI",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508479270,"PATEL, DHRUTHI",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508479270,"PATEL, DHRUTHI",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 34 , 36 , 38 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508479270,"PATEL, DHRUTHI",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1508480385,"MULLEN, CHRYSTEN, SHERIDAN",738 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508480823,"BARKLEY, LAUREN, ELIZABETH",40 DUKE MEDICINE CIR CLINIC 2J DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508480823,"BARKLEY, LAUREN, ELIZABETH",40 DUKE MEDICINE CIR CLINIC 2J DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508480823,"BARKLEY, LAUREN, ELIZABETH",40 DUKE MEDICINE CIR CLINIC 2J DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508480823,"BARKLEY, LAUREN, ELIZABETH",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508481052,"WILK, ALEXANDER, GERASIMOS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 39 , 40 ,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508483595,"EL TANNIR, ZIAD, CHAHINE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 105 , 105 ,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508483595,"EL TANNIR, ZIAD, CHAHINE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 105 , 189 , 227 ," $18,529.16 ",,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508483595,"EL TANNIR, ZIAD, CHAHINE",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508483595,"EL TANNIR, ZIAD, CHAHINE",212 S SALEM ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598751463,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - APEX,212 S SALEM ST   APEX NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508483595,"EL TANNIR, ZIAD, CHAHINE",212 S SALEM ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508484932,"WILKINSON, FARREN, SHUMAKE",1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295824159,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - PSYCHIATRY,391 SERPENTINE DR STE 400 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508486507,"WRZESINSKI, PETER, CALVIN",391 SERPENTINE DR STE 400 SPARTANBURG SC,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508487091,"BENEDICT, XAVERIE, LENE",100 DODD ST   SPRING HOPE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 37 , 53 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,100 DODD ST   SPRING HOPE NC,064,Nash,193200000X,Group,Multi-Specialty,,1508487091,"BENEDICT, XAVERIE, LENE",100 DODD ST   SPRING HOPE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 159 , 303 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508490848,"JUDD, SANDRA, SUZANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 40 , 42 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508492539,"VALCEUS, JESSICA",14215 BALLANTYNE CORPORATE PL STE 130 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508493503,"WOOD, ANNA, CHRISTINE",11840 SOUTHMORE DR STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1508493529,"MCDONOUGH, MARGARET, EILEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508493529,"MCDONOUGH, MARGARET, EILEEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 89 , 89 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1508494162,"ZIMMERMAN, MICHAEL, DAVID",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 27 , 46 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508494162,"ZIMMERMAN, MICHAEL, DAVID",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508494675,"COOKSON, TIMOTHY, DAVID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 46 , 48 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508494675,"COOKSON, TIMOTHY, DAVID",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1649428194,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD UROLOGY ASSOCIATES,800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508496845,"WU, JEREMY, KENT",800 E CHEVES ST STE 350 FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1508500125,"COLVIN, EVAN, DOLAN",120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 54 , 70 , 70 ,$#,,
MEDICAID DIRECT,1174166359,THOME & ZIMMER DDS PLLC I,SHELBY PEDIATRIC DENTISTRY,221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508507138,"BAER, STEPHEN, WILLIAM",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 3,390 "," 4,997 "," 21,006 "," $772,513.39 ",,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508507138,"BAER, STEPHEN, WILLIAM",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508507138,"BAER, STEPHEN, WILLIAM",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 30 , 30 , 147 ,$#,,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508507138,"BAER, STEPHEN, WILLIAM",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 206 , 232 ," 1,072 "," $40,072.10 ",,
MEDICAID DIRECT,1538935432,THOME & KENDRICK DDS PLLC,,9625 NORTHCROSS CENTER CT STE 101 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508507138,"BAER, STEPHEN, WILLIAM",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1174166359,THOME & ZIMMER DDS PLLC I,SHELBY PEDIATRIC DENTISTRY,221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508507138,"BAER, STEPHEN, WILLIAM",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice, 446 , 457 ," 2,037 "," $76,402.54 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508507674,"OKRENT SMOLAR, AVITAL, LILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1508507674,"OKRENT SMOLAR, AVITAL, LILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508507674,"OKRENT SMOLAR, AVITAL, LILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508507674,"OKRENT SMOLAR, AVITAL, LILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508507674,"OKRENT SMOLAR, AVITAL, LILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology, 19 , 25 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508507674,"OKRENT SMOLAR, AVITAL, LILY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508511064,"FURNER, SHELEENA, RENEE",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508511064,"FURNER, SHELEENA, RENEE",216 MOORE RD   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 34 , 61 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,529 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1508511924,"FOLEY, LACINDA, ANN",529 S VAN BUREN RD   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 31 , 73 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5150 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1508511924,"FOLEY, LACINDA, ANN",5156 US 29 BUSINESS   REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1508511924,"FOLEY, LACINDA, ANN",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508514274,"BUCHAN, ZACHARY, TAYLOR",7851 ALEXANDER PROMENADE HILL PL STE 130 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 25 ,$#,,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1508519240,"BOZAI, SAMEEN",790 TIMBER DR   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1508521949,"WEEKS, MAEGAN, COLEEN",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1508521949,"WEEKS, MAEGAN, COLEEN",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 76 , 159 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1508527482,"TAYLOR, MICHAEL, BRIAN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508527482,"TAYLOR, MICHAEL, BRIAN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508527482,"TAYLOR, MICHAEL, BRIAN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1508527482,"TAYLOR, MICHAEL, BRIAN",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508528704,"ZANETTE, MURILO, SANTA HELENA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508528704,"ZANETTE, MURILO, SANTA HELENA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 27 , 64 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508528704,"ZANETTE, MURILO, SANTA HELENA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508528704,"ZANETTE, MURILO, SANTA HELENA",1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,711 NATIONAL HWY STE 100 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1508530528,"MYERS, ASHLEY, NICOLE",711 NATIONAL HWY STE 100 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508530528,"MYERS, ASHLEY, NICOLE",711 NATIONAL HWY STE 100 THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508530528,"MYERS, ASHLEY, NICOLE",4023 GUILFORD COLLEGE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 35 , 68 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508530528,"MYERS, ASHLEY, NICOLE",4023 GUILFORD COLLEGE RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508532219,"ALLEN, KATHRYN, LYNN",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508533308,"PISARSKI, ALYSSA",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508533308,"PISARSKI, ALYSSA",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295067650,M SHERILL GLOVER OD,PRINCETON EYE CARE,110 E EDWARDS ST   PRINCETON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508533639,"GLOVER, MOLLY",110 E EDWARDS ST   PRINCETON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508539792,"BELLISSIMO, MICHELLE, SUTTON",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1508541079,"ORR CARVER, REBECCA, A",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1508541079,"ORR CARVER, REBECCA, A",183 LEDFORD ST STE A MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1508541079,"ORR CARVER, REBECCA, A",183 LEDFORD ST STE A MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 77 , 77 ," $12,525.50 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1508541079,"ORR CARVER, REBECCA, A",183 LEDFORD ST STE A MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 35 ,$#,,
MEDICAID DIRECT,1528461670,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - SOUTH HICKORY,1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508542796,"ECKARD, ABIGAIL, ADAMS",174 BOLICK LN STE 202 TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 36 , 81 ,$#,,
MEDICAID DIRECT,1528461670,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - SOUTH HICKORY,1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508542796,"ECKARD, ABIGAIL, ADAMS",1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 47 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508546516,"HAUGH, CHARLES, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508546516,"HAUGH, CHARLES, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1508547480,"MATTHEWS, JOSHUA, WAYNE",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508548900,"BUSALACCHI, RYAN, PETER",775 W CORBETT AVE STE 2 SWANSBORO NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE G KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1508549627,"ALMOND, LEVI, ANDREW",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 142 , 282 , 684 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508549627,"ALMOND, LEVI, ANDREW",701 DOCTORS DR STE G KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 52 , 116 ,$#,,
MEDICAID DIRECT,1942325105,"CARLYLE, RICHARD, TODD",RICHARD TODD CARLYLE,206 AIRPORT RD   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,1508549866,"PATEL, ALEXIS, KARISHMA",206 AIRPORT RD   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 410 , 573 ," 1,870 "," $111,454.86 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508557299,"MARTIN, TAYLOR, GABRIELLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508558149,"MORRIS, JENNIFER, TUCKER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508558149,"MORRIS, JENNIFER, TUCKER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363LC0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508575713,"CHILDERS, JENNIFER, ANN",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 25 , 32 , 57 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1508575713,"CHILDERS, JENNIFER, ANN",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 30 , 44 ,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508575713,"CHILDERS, JENNIFER, ANN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1508575713,"CHILDERS, JENNIFER, ANN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 12 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508576901,"STONE, CLARE, MARIE",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508576901,"STONE, CLARE, MARIE",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508581992,PHOENIX RISING HOME CARE,PHOENIX RISING HOME CARE,2220 RAVEN RD UNIT 104 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1508581992,PHOENIX RISING HOME CARE,2220 RAVEN RD UNIT 104 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 531 , 531 ," $47,285.82 ",,
MEDICAID DIRECT,1487224283,DAWSON MED PC,,608 DAWSON ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508584582,"JACOBS, CAITLIN, MEGAN",608 DAWSON ST STE 103 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 98 , 104 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508585894,"EASLEY, AMY, ALYSSA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508590316,"PICONE, KAITLIN, MARY",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 33 , 60 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508590316,"PICONE, KAITLIN, MARY",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508590316,"PICONE, KAITLIN, MARY",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,910 W WILLIAMS ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508590316,"PICONE, KAITLIN, MARY",910 W WILLIAMS ST   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7850 BRIER CREEK PKWY   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508590316,"PICONE, KAITLIN, MARY",7850 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508590316,"PICONE, KAITLIN, MARY",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 24 , 45 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1508590316,"PICONE, KAITLIN, MARY",799 DOCTORS CT   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508590597,"CAMPO, GABRIELLE, NICOLE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508592601,"DE LA TORRE, CORTNEY, ELIZABETH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508592601,"DE LA TORRE, CORTNEY, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508595117,"BARNETT, LAUREL, IDOL",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508595117,"BARNETT, LAUREL, IDOL",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508595117,"BARNETT, LAUREL, IDOL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508595117,"BARNETT, LAUREL, IDOL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 22 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1508598962,"KASTLE, JUSTINE, CLAIRE",98 DOCTORS DR STE 300 SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 54 , 96 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508608076,"CLIFT, JOSEPH, SCOTT",201 E GROVER ST   SHELBY NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 37 , 39 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508609587,"JOHNSON, MARISSA, CAMPANELLI",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508609587,"JOHNSON, MARISSA, CAMPANELLI",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 22 , 51 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1508609587,"JOHNSON, MARISSA, CAMPANELLI",7420 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 19 , 36 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1508611146,"WALLER, CHASE, CHRISTIAN",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1508611146,"WALLER, CHASE, CHRISTIAN",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 369 , 375 ," 2,169 "," $53,640.74 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1508611146,"WALLER, CHASE, CHRISTIAN",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice," 3,657 "," 4,195 "," 22,905 "," $643,392.42 ",,
MEDICAID DIRECT,1528392289,RANDOLPH PRIMARY CARE PA,RANDOLPH PRIMARY CARE PA,350 N COX ST STE 6 ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508611351,"LEAK, BRANDI, LAWRENCE",350 N COX ST STE 6 ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528392289,RANDOLPH PRIMARY CARE PA,RANDOLPH PRIMARY CARE PA,350 N COX ST STE 6 ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508611351,"LEAK, BRANDI, LAWRENCE",350 N COX ST STE 6 ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508616137,"OTSUKA, YUMI",3325 SILAS CREEK PARKWAY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 20 , 38 ," $12,041.83 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508620584,"GALBREATH, JARED, DEVOY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508620584,"GALBREATH, JARED, DEVOY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508620584,"GALBREATH, JARED, DEVOY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508623646,"ABARE, GILBERT, R",113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508630476,NC WELLNESS & RECOVERY,,4006 PEACHTREE TOWN LN   KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1508630476,NC WELLNESS & RECOVERY,4006 PEACHTREE TOWN LN   KNIGHTDALE NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,172 "," 1,177 "," $61,798.24 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508633256,"GARDELA, KARINA, ZOFIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508638552,"ENDARA, CARRIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 21 , 37 ,$#,,
MEDICAID DIRECT,1922730142,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT PIEDMONT ELEMENTARY,119 E 2ND AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508640202,"SHEPHARD, ERIKA, WALKER",3050 RIVERWOOD PKWY STE B GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1669 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508641440,"GRIFFIN, BRITTANY, NICOLE",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 273 , 651 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,705 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508641440,"GRIFFIN, BRITTANY, NICOLE",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508641440,"GRIFFIN, BRITTANY, NICOLE",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508641440,"GRIFFIN, BRITTANY, NICOLE",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 103 , 805 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508641440,"GRIFFIN, BRITTANY, NICOLE",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 38 , 56 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508641440,"GRIFFIN, BRITTANY, NICOLE",1669 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 32 , 78 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508641622,"HOBBS, JESSICA, KIMSEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508642786,"RIERSON, CAITLIN, SWAYZE",207 E MEADOW RD STE 1 EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 32 , 38 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1508644873,"BENITEZ, BRENDAN, LY",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1508644873,"BENITEZ, BRENDAN, LY",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508644873,"BENITEZ, BRENDAN, LY",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508644873,"BENITEZ, BRENDAN, LY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508644873,"BENITEZ, BRENDAN, LY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508644873,"BENITEZ, BRENDAN, LY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508644873,"BENITEZ, BRENDAN, LY",601 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",3193 W HIGHWAY 74   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477891810,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",119 MARKET PLACE AVE STE D MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 41 ,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",420 PARK ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508646738,"WHITE, RACHEL, JANE",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508677105,"GOMEZ-REYES, MARIA, RAMONA",902 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508677105,"GOMEZ-REYES, MARIA, RAMONA",902 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508677105,"GOMEZ-REYES, MARIA, RAMONA",200 BELLAROSE LAKE WAY   GARNER NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508677105,"GOMEZ-REYES, MARIA, RAMONA",968 WAIT AVE   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508677105,"GOMEZ-REYES, MARIA, RAMONA",200 BELLAROSE LAKE WAY   GARNER NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1508679481,"SUDHOFF, KYLER, BRIDGEMAN",232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750646741,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,935 STATE FARM RD   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508681586,"YARBER, JACOB, EDWARD",935 STATE FARM RD   BOONE NC,095,Watauga,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1508681693,"BIELLO, JILLIAN, LEE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508683210,"BELLICH, NICOLE, MARIE",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508684127,"HAMILTON, VIRGINIA, ROEHM",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427128651,COUNTY OF ROWAN,ROWAN COUNTY HEALTH DEPT,1811 E INNES ST   SALISBURY NC,080,Rowan,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1508685777,"GILYARD, CHRISTINA, ODOM",1811 E INNES ST   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508800178,"AYUSO, RICHARD, DENNIS",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 120 , 137 , 197 ,$#,,
MEDICAID DIRECT,1477363760,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PODIATRY FOOT & ANKLE SPECIALISTS,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508800988,"BOWEN, STEVEN, KEITH",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 63 , 67 , 73 ,$#,,
MEDICAID DIRECT,1821557547,CAROLINA FOOTCARE PLLC,,,,Unknown,193400000X,Group,Single Specialty,,1508800988,"BOWEN, STEVEN, KEITH",1645 OWEN DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,,,$#,,
MEDICAID DIRECT,1104327709,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PODIATRY,1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508800988,"BOWEN, STEVEN, KEITH",1738 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 163 , 298 , 343 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508801374,"BOTELHO, RICHARD, JAMES",707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 68 , 99 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508801374,"BOTELHO, RICHARD, JAMES",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508803313,HAVELOCK FIRE RESCUE TOWN OF HAVELO,,2 GOVERNMENTAL DR   HAVELOCK NC,025,Craven,3416L0300X,Transportation Services,Ambulance,Land Transport,1508803313,HAVELOCK FIRE RESCUE TOWN OF HAVELO,2 GOVERNMENTAL DR   HAVELOCK NC,025,Craven,3416L0300X,Transportation Services,Ambulance,Land Transport, 111 , 184 , 360 ,$#,,
MEDICAID DIRECT,1508804568,COUNTY OF LENOIR,,200 RHODES AVE   KINSTON NC,054,Lenoir,3416L0300X,Transportation Services,Ambulance,Land Transport,1508804568,COUNTY OF LENOIR,200 RHODES AVE   KINSTON NC,054,Lenoir,3416L0300X,Transportation Services,Ambulance,Land Transport, 810 ," 1,501 "," 2,739 "," $26,845.12 ",,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508805847,"CHRISTIAN, STEPHEN, RICHARD",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1508806340,"KOZESKY, THOMAS, JAMES",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1508806340,"KOZESKY, THOMAS, JAMES",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1508806340,"KOZESKY, THOMAS, JAMES",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 62 , 108 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508806407,"HUDAK, NICHOLAS, MARK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508807728,"PEARCE, SHARON, PHILLIPS",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1508807728,"PEARCE, SHARON, PHILLIPS",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1508807728,"PEARCE, SHARON, PHILLIPS",1004 PROCURE ST STE 200 FUQUAY VARINA NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,1004 PROCURE ST   FUQUAY VARINA NC,092,Wake,193400000X,Group,Single Specialty,,1508807728,"PEARCE, SHARON, PHILLIPS",1004 PROCURE ST STE 200 FUQUAY VARINA NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1508807728,"PEARCE, SHARON, PHILLIPS",1120 SE CARY PKWY   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508809682,"LEVI, MARC, LAWRENCE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508809682,"LEVI, MARC, LAWRENCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1508809682,"LEVI, MARC, LAWRENCE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1508809682,"LEVI, MARC, LAWRENCE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508809682,"LEVI, MARC, LAWRENCE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1508809682,"LEVI, MARC, LAWRENCE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003687187,DLP WESTERN CAROLINA PHYSICIAN PRAC,HARRIS WOMENS CARE,70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1508810250,"BLATTNER, JENNIFER, MILSPAW",70 THE VILLAGE OUTLOOK   SYLVA NC,050,Jackson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 62 , 91 , 107 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1508810250,"BLATTNER, JENNIFER, MILSPAW",70 THE VILLAGE OUTLOOK   SYLVA NC,050,Jackson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 68 , 72 , 88 ," $16,750.50 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1508810250,"BLATTNER, JENNIFER, MILSPAW",70 THE VILLAGE OUTLOOK   SYLVA NC,050,Jackson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508812702,"RESTAINO, IRENE, GERALYNN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508812710,"PITRE, CHRISTOPHER, PAUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 167 , 173 , 174 ,$#,,
MEDICAID DIRECT,1831158245,DURHAM EMERGENCY PHYSICIANS PA,~,,,Unknown,193400000X,Group,Single Specialty,,1508812710,"PITRE, CHRISTOPHER, PAUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508813155,"KRITZ, ALAN, DANIEL",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 32 , 33 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508813155,"KRITZ, ALAN, DANIEL",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 29 , 59 , 59 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508813767,"FERDINANDS, LILLIAN, SHALINI",16525 HOLLY CREST LN STE 150 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508814039,"MILLER, DOUGLAS",1028 LEE ANN DR NE STE 200 CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508814039,"MILLER, DOUGLAS",1028 LEE ANN DR NE STE 200 CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508814633,"ARNE, THOMAS, JASON",3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 157 , 355 , 546 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508814633,"ARNE, THOMAS, JASON",445 PINEVIEW DR STE 230 KERNERSVILLE NC,034,Forsyth,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 23 , 42 , 73 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508814633,"ARNE, THOMAS, JASON",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 12 , 14 , 18 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508814633,"ARNE, THOMAS, JASON",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508815143,"AHMED, SHAHZAD",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508815143,"AHMED, SHAHZAD",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508815143,"AHMED, SHAHZAD",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508815457,"CAPIZZI, MICHELLE, CHRISTINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104229343,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1508816489,"MIDDLETON, GLENN, CHARLES",11088 N US HWY 15 501   ABERDEEN NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508817214,"WONG, ALLEN",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508818873,"SCHAEFFER, JILL, ANNETTE",1525 APEX PEAKWAY   APEX NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508818873,"SCHAEFFER, JILL, ANNETTE",1525 APEX PEAKWAY   APEX NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508818873,"SCHAEFFER, JILL, ANNETTE",1480 KELLY RD   APEX NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1508818873,"SCHAEFFER, JILL, ANNETTE",1525 APEX PEAKWAY STE 200 APEX NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508819301,"ROUSE II, STRUTHA, CHARLES",10834 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508819301,"ROUSE II, STRUTHA, CHARLES",15419 HODGES CIR STE 100 HUNTERSVILLE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 11 , 41 , 76 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508819301,"ROUSE II, STRUTHA, CHARLES",1800 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508819301,"ROUSE II, STRUTHA, CHARLES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508819301,"ROUSE II, STRUTHA, CHARLES",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508819301,"ROUSE II, STRUTHA, CHARLES",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#, 26 , 37 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508819301,"ROUSE II, STRUTHA, CHARLES",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 88 , 211 , 497 ," $30,344.63 ",,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1508819970,"MOESCH, DEAN, VINCENT",125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1184020547,IMAGING PARTNERS PLLC,,125 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1508819970,"MOESCH, DEAN, VINCENT",123 WAMSUTTA MILL RD STE C MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1508820887,ORTHOPEDIC SERVICES COMPANY OF RALE,~,2521 NOBLIN RD   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508820887,ORTHOPEDIC SERVICES COMPANY OF RALE,2521 NOBLIN RD   RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 13 , 26 , 65 ,$#,,
MEDICAID DIRECT,1508820887,ORTHOPEDIC SERVICES COMPANY OF RALE,~,2521 NOBLIN RD   RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1508820887,ORTHOPEDIC SERVICES COMPANY OF RALE,2521 NOBLIN RD   RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#, 15 ," $38,131.69 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508821315,"BROUS-DISTEFANO, NANCY",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 64 , 86 , 171 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508821315,"BROUS-DISTEFANO, NANCY",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700952637,COUNTY OF COLUMBUS OFFICE OF ACCOUN,COLUMBUS CO HEALTH DEPT,304 JEFFERSON ST   WHITEVILLE NC,024,Columbus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1508821992,"BERRY, RICHARD, GARTH",15 HILL PLZ STE A WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 48 , 100 ,$#,,
MEDICAID DIRECT,1346327707,SIGNET HEALTHCARE PC,~,15 HILL PLZ STE A WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1508821992,"BERRY, RICHARD, GARTH",15 HILL PLZ STE A WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 94 , 727 ," 1,711 "," $18,648.47 ",,
MEDICAID DIRECT,1447999057,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-643 FIFTH AVENUE WEST,643 5TH AVE W   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508822420,"FREETH FOUNTAIN, AMY, ELIZABETH",643 5TH AVE W   HENDERSONVILLE NC,045,Henderson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 14 , 25 ,$#,,
MEDICAID DIRECT,1598474801,MCLEOD PHYSICIAN ASSOCIATES II,FLORENCE NEUROSURGERY AND SPINE AT MCLEOD HEALTH,1204 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508823386,"RHEA, ANDREW, HILL",1204 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508823972,"DRIGGERS, JASON, NOEL",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508823972,"DRIGGERS, JASON, NOEL",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508824491,"CRAVEN, CHARLES, EDWARD",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508824491,"CRAVEN, CHARLES, EDWARD",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 89 , 141 , 248 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508824491,"CRAVEN, CHARLES, EDWARD",167 MOORE RD STE 202 KING NC,085,Stokes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 42 , 63 , 108 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508824947,"SHACKLEFORD, THOMAS, MICHAEL",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1508825431,"HUTTON, CARL, ANTHONY",1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1508825431,"HUTTON, CARL, ANTHONY",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 109 , 304 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1508825431,"HUTTON, CARL, ANTHONY",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508825506,"BURRI, STUART, HEINRICH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508825506,"BURRI, STUART, HEINRICH",1310 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 12 , 27 , 48 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508825506,"BURRI, STUART, HEINRICH",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 24 , 41 , 65 ,$#,,
MEDICAID DIRECT,1023055365,RADIATION ONCOLOGY CENTERS OF THE C,LAKE NORMAN RADIATION ONCOLOGY CENTER,170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1508825506,"BURRI, STUART, HEINRICH",170 MEDICAL PARK RD STE 100 MOORESVILLE NC,049,Iredell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1508826975,"KUTCHERA, KAREN, LYNN",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508826975,"KUTCHERA, KAREN, LYNN",1380 COWELL FARM RD   WASHINGTON NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 35 , 43 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508827239,"BECHTOL, BRIAN, MARSHALL",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1508827239,"BECHTOL, BRIAN, MARSHALL",60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 32 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508827239,"BECHTOL, BRIAN, MARSHALL",1101 N GREEN ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 94 , 179 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508827239,"BECHTOL, BRIAN, MARSHALL",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 63 , 127 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508827239,"BECHTOL, BRIAN, MARSHALL",1366 NC HIGHWAY 16 S CRESCENT SHOPPING PLAZA NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508827577,"MARIANO, ROBERT, THOMAS",110 KINGSLEY LN STE 305 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1508827874,"LENDERMAN, MARK, DAY",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 117 , 267 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508828054,"JAECKEL, KERRITH, LYN",14215 BALLANTYNE CORPORATE PL STE 130 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1508828955,VMS HOME OXYGEN INC,VMS HOME OXYGEN INC,1004 W CUMBERLAND ST STE B DUNN NC,043,Harnett,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1508828955,VMS HOME OXYGEN INC,1004 W CUMBERLAND ST STE B DUNN NC,043,Harnett,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 29 , 182 , 504 ," $47,147.48 ",,
MEDICAID DIRECT,1548234651,ROBERT L HAY PA,HAY CLINIC OF CHIROPRACTIC,927 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1508829060,"COLE, JOY, ELIZABETH",927 COX RD   GASTONIA NC,036,Gaston,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508829631,"WALTON, STEVEN, MICHAEL",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508831546,"SCHINDLER, JOHN, THOMAS",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 67 , 96 , 149 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508831652,"TILDON, TONI, OLA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 66 , 227 , 228 ," $18,670.94 ",,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508831728,"MUNOZ, MARC, EDWARD",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508831892,"LEWIS, DAVID, DU BRUTZ",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 130 , 204 , 313 ," $10,396.59 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,501 W 15TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1508831892,"LEWIS, DAVID, DU BRUTZ",501 W 15TH ST   WASHINGTON NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316375140,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-MEDICALINTENSIVISTS,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508833278,"RIORDAN, MICHAEL, PATRICK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1053547976,HOLDEN BEACH MEDICAL CENTER PA,HOLDEN BEACH MEDICAL CENTER PA,2930 HOLDEN BEACH RD SW   HOLDEN BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1508834045,"MERROW, HEATHER, MARIE",2930 HOLDEN BEACH RD SW   SUPPLY NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 37 ,$#,,
MEDICAID DIRECT,1053547976,HOLDEN BEACH MEDICAL CENTER PA,HOLDEN BEACH MEDICAL CENTER PA,2930 HOLDEN BEACH RD SW   SUPPLY NC,010,Brunswick,193400000X,Group,Single Specialty,,1508834045,"MERROW, HEATHER, MARIE",2930 HOLDEN BEACH RD SW   SUPPLY NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 52 , 130 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508834847,"SICARD, MICHAEL, WILLIAM",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 52 , 63 , 85 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508834847,"SICARD, MICHAEL, WILLIAM",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508834847,"SICARD, MICHAEL, WILLIAM",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508835091,"JOHNSON, LYNN, ROY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508835091,"JOHNSON, LYNN, ROY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 216 , 226 , 227 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508835091,"JOHNSON, LYNN, ROY",2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 81 , 85 , 87 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508835091,"JOHNSON, LYNN, ROY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508835091,"JOHNSON, LYNN, ROY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508835091,"JOHNSON, LYNN, ROY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447214242,TRIANGLE PEDIATRIC CENTER,TRIANGLE PEDIATRIC CENTER,105 RIDGE VIEW DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1508835844,"CHAO, IRENE, SHUN WO TSANG",105 RIDGE VIEW DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 37 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508836297,"RICKELTON, ANGELA, DRAUGHON",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508836297,"RICKELTON, ANGELA, DRAUGHON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1073572822,ONSLOW PEDIATRIC ASSOCIATES,~,51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1508837303,"GANT, JAMES, CURTIS",51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 68 , 135 , 225 ," $12,422.99 ",,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1508837303,"GANT, JAMES, CURTIS",51 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508838772,"RODGERS, CHRISTOPHER, PAUL",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508838772,"RODGERS, CHRISTOPHER, PAUL",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,601 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508838772,"RODGERS, CHRISTOPHER, PAUL",601 OBERLIN RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 22 , 29 ,$#,,
MEDICAID DIRECT,1508839630,"RIDLEY, STEPHEN, FITZGERALD",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1508839630,"RIDLEY, STEPHEN, FITZGERALD",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1508841479,"ANTONIO, BENJAMIN, LEANDRO",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 20 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508841479,"ANTONIO, BENJAMIN, LEANDRO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1508841479,"ANTONIO, BENJAMIN, LEANDRO",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1588003032,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY,1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508841966,"TAYLOR, STEPHENS, DAVIS",1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508842477,"TAYLOR, STUART, BARNES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508842725,"JONES, WILLIAM, DENNIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1508842972,"ROCHE, JOSEPH, JAMES",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 16 , 27 , 62 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508843210,"NGUYEN, QUYNH ANH, THI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508843210,"NGUYEN, QUYNH ANH, THI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508843442,"LEWIS, DANTE, NEISONE",3940 ARROWHEAD BLVD STE 270 MEBANE NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 44 , 75 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508843442,"LEWIS, DANTE, NEISONE",530 W WEBB AVE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 35 , 48 , 120 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1508843442,"LEWIS, DANTE, NEISONE",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,902 FLEMING ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1508843913,"LOGAN III, WILLIAM, HENRY",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508843913,"LOGAN III, WILLIAM, HENRY",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 66 , 103 , 339 ," $35,575.73 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508843913,"LOGAN III, WILLIAM, HENRY",4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 27 , 32 , 144 ," $10,409.38 ",,
MEDICAID DIRECT,1689804718,RANDOLPH SPECIALTY GROUP PRACTICE,RANDOLPH HEALTH PEDIATRICS,,,Unknown,193200000X,Group,Multi-Specialty,,1508843921,"VINOCUR, PATRICIA, ANA",713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1184219222,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH PEDIATRICS,713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1508843921,"VINOCUR, PATRICIA, ANA",713 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 44 , 81 , 157 ,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1508844358,"DAVIS COOLEY, DELINA, JOSET",114 HOLLOWELL RD   AULANDER NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437181914,AULANDER MEDICAL PRACTICE PA,~,114 HOLLOWELL RD   AULANDER NC,008,Bertie,193400000X,Group,Single Specialty,,1508844358,"DAVIS COOLEY, DELINA, JOSET",114 HOLLOWELL RD   AULANDER NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 205 , 730 ," 1,884 "," $17,634.21 ",,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1508844358,"DAVIS COOLEY, DELINA, JOSET",114 HOLLOWELL RD   AULANDER NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508844408,"TALBOT, JOHN, CYRIL",16455 STATESVILLE RD STE 100 HUNTERSVILLE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1508845587,DUPLIN EYE ASSOCIATES OD PA,~,402 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1508845587,DUPLIN EYE ASSOCIATES OD PA,402 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,," 1,368 "," 1,381 "," 2,752 "," $37,637.56 ",,
MEDICAID DIRECT,1508846130,SELECT HOME HEALTH CARE INC,KELLEYS HOME HEALTH SERVICES,4332 E US 64 ALTERNATE   MURPHY NC,020,Cherokee,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508846130,SELECT HOME HEALTH CARE INC,4332 E US 64 ALTERNATE   MURPHY NC,020,Cherokee,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 129 , 351 , 661 ," $10,514.67 ",,
MEDICAID DIRECT,1508846130,SELECT HOME HEALTH CARE INC,KELLEYS HOME HEALTH SERVICES,4332 E US 64 ALTERNATE   MURPHY NC,020,Cherokee,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1508846130,SELECT HOME HEALTH CARE INC,4332 E US 64 ALTERNATE   MURPHY NC,020,Cherokee,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 167 , 858 ," 1,433 "," $25,999.96 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1508846312,"STAHLE, SCOTT, DOUGLAS",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1508846312,"STAHLE, SCOTT, DOUGLAS",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1508846312,"STAHLE, SCOTT, DOUGLAS",2608 HOSPITAL RD   GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508846403,"VARMA, RAJAT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508846403,"VARMA, RAJAT",410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508846403,"VARMA, RAJAT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508846833,"MULLINS HODGIN, RITA, JOYCE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508846833,"MULLINS HODGIN, RITA, JOYCE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1821496753,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1508846932,"LAURY, DANIEL, HENRI",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508846999,"WEISENHORN, PHILIP, JOHN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1508846999,"WEISENHORN, PHILIP, JOHN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508846999,"WEISENHORN, PHILIP, JOHN",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508847781,"WELSHOFER, JOHN, ARTHUR",1401 MATTHEWS TOWNSHIP PKWY STE 300 MATTHEWS NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 63 , 91 , 129 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508847781,"WELSHOFER, JOHN, ARTHUR",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 30 , 59 , 75 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508847781,"WELSHOFER, JOHN, ARTHUR",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508848037,"KUSZYK, BRIAN, SCOTT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 356 , 378 , 465 ," $15,166.34 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1508848037,"KUSZYK, BRIAN, SCOTT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 398 , 441 , 510 ,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508848037,"KUSZYK, BRIAN, SCOTT",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 16 , 16 , 25 ,$#,,
MEDICAID DIRECT,1548290265,FHPG LLC,FIRST HEALTH FAMILY MEDICINE SEVEN LAKES,1035C 7 LAKES DR   WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1508850892,"ADAMS, LISA, ANN",1035C 7 LAKES DR   WEST END NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 75 , 165 ,$#,,
MEDICAID DIRECT,1548290265,FHPG LLC,FIRST HEALTH FAMILY MEDICINE SEVEN LAKES,1035C 7 LAKES DR   WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1508850892,"ADAMS, LISA, ANN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 28 ,$#,,
MEDICAID DIRECT,1619463429,FHPG LLC,~,2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1508850892,"ADAMS, LISA, ANN",2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1447314075,MORCOM MEDICAL CONSULTANTS PLLC,MORCOM MEDICAL CONSULTANTS PLLC,235 JENKINS RD   DOVER NC,052,Jones,193200000X,Group,Multi-Specialty,,1508850983,"MOORE, JOHN, THOMAS",235 JENKINS RD   DOVER NC,052,Jones,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 173 , 794 , 794 ," $16,705.72 ",,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1508851502,"HIGHSMITH-TYLER, AQUILLA, LYNETTE",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548997893,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 39 , 72 ,$#,,
MEDICAID DIRECT,1902677610,LEVEL TWO SERVICES PLLC,,205 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",205 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174868368,DOCTORS PLUS PLLC,~,205 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",205 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 26 ,$#,,
MEDICAID DIRECT,1902677610,LEVEL TWO SERVICES PLLC,,205 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",205 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 35 , 73 ,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",1895 HOFFMAN RD   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 126 , 189 , 412 ,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 127 , 203 , 455 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",600 W TRADE ST   DALLAS NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 203 , 318 , 657 ,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",600 W TRADE ST   DALLAS NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",1223 SPRUCE ST   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 63 , 90 , 219 ,$#,,
MEDICAID DIRECT,1609467760,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1201 VILLAGE HARBOR DR STE 104 CLOVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508854407,"SKEETE, LARRY, JOHANN WILLIAM",1201 VILLAGE HARBOR DR STE 104 CLOVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 23 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508856436,"PEKAL, WIESLAWA",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 153 , 261 , 685 ," $30,203.78 ",,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1508856634,"CHAMBERS, PETER, RALPH",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 131 , 150 , 167 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1508856634,"CHAMBERS, PETER, RALPH",3817 MAIN ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1508857137,"KUBICKI, STEVEN, PAUL",6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 52 , 95 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508857749,"ELSNER, HENRY, JOSEPH",3812 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508857749,"ELSNER, HENRY, JOSEPH",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 20 , 39 , 45 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508857749,"ELSNER, HENRY, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 17 , 27 ,$#,,
MEDICAID DIRECT,1295385748,MCPC-20 LLC,FIRSTHEALTH GYNECOLOGIC ONCOLOGY,220 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1508857962,"SUNDBORG, MICHAEL, JOHN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1295385748,MCPC-20 LLC,FIRSTHEALTH GYNECOLOGIC ONCOLOGY,220 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1508857962,"SUNDBORG, MICHAEL, JOHN",220 PAGE RD   PINEHURST NC,063,Moore,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 27 , 57 , 89 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1508860271,"CARPENTER, LALISA, ANN",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 29 , 57 ,$#,,
MEDICAID DIRECT,1063948297,RDMG ASSOCIATES PA,SPINDALE FAMILY PRACTICE,144 RESERVATION DR   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1508860271,"CARPENTER, LALISA, ANN",144 RESERVATION DR   SPINDALE NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 40 , 79 ,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508861238,"DONDERO, EILEEN, MARIE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508862681,"HYMAN JR, PETER, DEWITT",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1508862772,"SUMMER, JENNIFER, GAIL",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508862772,"SUMMER, JENNIFER, GAIL",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 18 , 44 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",111 DORSETT DR   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",611 MOCKSVILLE AVE STE 202 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",611 MOCKSVILLE AVE STE 202 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",111 DORSETT DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",111 DORSETT DR   SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 23 , 23 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",611 MOCKSVILLE AVE STE 202 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",611 MOCKSVILLE AVE STE 202 SALISBURY NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508863465,"MORTON, REBECCA, ODOM",1607 N MAIN ST   KANNAPOLIS NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508865247,"BRUMFIELD, CHRISTOPHER, SCOTT",1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508865247,"BRUMFIELD, CHRISTOPHER, SCOTT",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508865247,"BRUMFIELD, CHRISTOPHER, SCOTT",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 17 , 28 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508865247,"BRUMFIELD, CHRISTOPHER, SCOTT",1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 75 , 122 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508865247,"BRUMFIELD, CHRISTOPHER, SCOTT",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 21 , 38 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1508867516,"ALKOUTAMI, GHASSAN, SOULTAN",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 40 , 54 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508867516,"ALKOUTAMI, GHASSAN, SOULTAN",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508867516,"ALKOUTAMI, GHASSAN, SOULTAN",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 176 , 247 , 316 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508868282,"SUTTON, WILLIAM, ROGER",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508868282,"SUTTON, WILLIAM, ROGER",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508868282,"SUTTON, WILLIAM, ROGER",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 81 , 145 , 328 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508868647,"MILLER, PETER, DANIEL",766 HARTNESS RD STE C STATESVILLE NC,049,Iredell,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508868647,"MILLER, PETER, DANIEL",701 BRYANT ST   STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841269305,INTERNAL MEDICINE ASSOCIATES,INTERNAL MEDICINE ASSOC,3850 ED DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508868688,"LUE, JOHN, FRANCIS",3850 ED DR STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 36 , 36 ,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1508868738,"GUNSTEN, GREGORY, GARRETT",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 77 , 99 , 233 ,$#,,
MEDICAID DIRECT,1154872315,RDMG ASSOCIATES PA,,10620 PARK RD STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508869835,"BERMAN, LARRY, F",10620 PARK RD STE 128 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 21 , 32 ,$#,,
MEDICAID DIRECT,1508869918,TRI-COUNTY MEDICAL & OSTOMY SUPPLIE,~,198 MARKETPLACE BLVD STE B110 JOHNSON CITY TN,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508869918,TRI-COUNTY MEDICAL & OSTOMY SUPPLIE,198 MARKETPLACE BLVD STE B110 JOHNSON CITY TN,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 166 ," 1,112 "," 2,313 "," $168,251.84 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508870668,"BASS, ANDORA, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 35 , 58 , 74 ," $15,325.97 ",,
MEDICAID DIRECT,1508871807,"HARRELL, GAVIN, GIBBS",,834 CLAREMONT CENTER DR   ELKIN NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,1508871807,"HARRELL, GAVIN, GIBBS",834 CLAREMONT CENTER DR   ELKIN NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 184 , 354 , 743 ," $35,391.52 ",,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508872797,"WOJCIK, LOUIS, JOSEPH",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508872995,"FISHER, JONATHAN, ELIOT ESTE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508872995,"FISHER, JONATHAN, ELIOT ESTE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508872995,"FISHER, JONATHAN, ELIOT ESTE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 27 , 32 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1508873993,"NOWAK, SUSAN, ELIZABETH",6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1508874835,ASHE HOME CARE INC,~,1646 MOUNT JEFFERSON RD   WEST JEFFERSON NC,005,Ashe,253Z00000X,Agencies,In Home Supportive Care,,1508874835,ASHE HOME CARE INC,1646 MOUNT JEFFERSON RD   WEST JEFFERSON NC,005,Ashe,253Z00000X,Agencies,In Home Supportive Care,, 48 ," 4,251 "," 4,251 "," $470,474.08 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508875972,"VU, DAVIS, DINH",1930 N PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 105 , 116 , 212 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508875972,"VU, DAVIS, DINH",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1508877952,"WECKEL, BRYAN, MONTY",310 S BENNETT ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194736561,BRYAN WECKEL MD FAMILY MEDICINE,,310 S BENNETT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1508877952,"WECKEL, BRYAN, MONTY",310 S BENNETT ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 192 , 420 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508879370,"PANNILL II, MALCOLM, HART",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508879370,"PANNILL II, MALCOLM, HART",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 44 , 45 ,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1508880873,"MCMATH, JONATHAN, CHRISTOPHER",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 63 , 102 , 124 ,$#,,
MEDICAID DIRECT,1952678013,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE NORTH HICKORY,212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508881681,"SANDERSON, STEVEN, LEE",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 41 , 89 ,$#,,
MEDICAID DIRECT,1952678013,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE NORTH HICKORY,212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508881681,"SANDERSON, STEVEN, LEE",212 29TH AVE NE STE 1 HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 113 , 214 ,$#,,
MEDICAID DIRECT,1043507130,ACME MEDICAL SPECIALTIES PLLC,ACME MEDICAL SPECIALISTS PLLC,4348 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1508882192,"AGYEI-GYAMFI, FRANCES, THERESA",4348 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 50 , 124 , 206 ,$#,,
MEDICAID DIRECT,1962869446,FAYETTEVILLE GASTROENTEROLOGY ENDOS,,2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1508882325,"KUMAR, ARVIND",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 32 , 33 , 44 ,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1508882325,"KUMAR, ARVIND",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 288 , 478 , 535 ," $16,107.35 ",,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508883414,"ILOKA, UCHECHI, NWABUGO",2525 COURT DR   GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 31 , 47 , 51 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2544 COURT DR STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508883414,"ILOKA, UCHECHI, NWABUGO",2544 COURT DR STE A GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 154 , 249 , 274 ,$#,,
MEDICAID DIRECT,1215029608,KURTZ CHIROPRACTIC INC,KURTZ CHIROPRACTIC INC,3011 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1508884214,"KURTZ, COLIN",3011 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,111N00000X,Chiropractic Providers,Chiropractor,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1508884305,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-5489,930 HIGHWAY 711 E   PEMBROKE NC,078,Robeson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1508884305,WAL-MART STORES EAST LP,930 HIGHWAY 711 E   PEMBROKE NC,078,Robeson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1508885211,"AGUILAR, CELIA, MAE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508885211,"AGUILAR, CELIA, MAE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023643384,ZEN PSYCHIATRIC SERVICES PLLC,,126 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1508885443,"FRASCA, ANTHONY, ADOLPH",126 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 151 , 229 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508886516,"ERDMANN, DETLEV",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 13 , 19 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508886516,"ERDMANN, DETLEV",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508886516,"ERDMANN, DETLEV",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,415 N CENTER ST STE 203 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508886540,"KUMAR, UDAY",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 27 , 55 , 55 ,$#,,
MEDICAID DIRECT,1588103220,DLP FRYE MEDICAL GROUP,FRYECARE SPECIALTY CENTER,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1508886540,"KUMAR, UDAY",415 N CENTER ST STE 203 HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3713 BENSON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",3713 BENSON DR   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 32 , 40 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 50 , 77 , 109 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3713 BENSON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1326786138,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WOUND CARE CENTER,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508887068,"CHARLES, KIRK, LESLEY",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1508887456,HAYWOOD COUNTY CONSOLIDATED SCHOOLS,HAYWOOD COUNTY CONSOLIDATED SCHOOLS,1233 N MAIN ST   WAYNESVILLE NC,044,Haywood,251300000X,Agencies,Local Education Agency (LEA),,1508887456,HAYWOOD COUNTY CONSOLIDATED SCHOOLS,1233 N MAIN ST   WAYNESVILLE NC,044,Haywood,251300000X,Agencies,Local Education Agency (LEA),, 563 ," 8,911 "," 9,303 "," $345,893.78 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508887688,"EHLY, NELSON, RICHARD",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508887688,"EHLY, NELSON, RICHARD",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 56 , 94 ," $10,958.52 ",,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508887688,"EHLY, NELSON, RICHARD",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508890807,"DAHM, CHRISTOPHER, JOHN",1120 SE CARY PKWY STE 101 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 21 , 33 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508890807,"DAHM, CHRISTOPHER, JOHN",110 KILDAIRE PARK DR   CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508890807,"DAHM, CHRISTOPHER, JOHN",1120 SE CARY PKWY STE 101 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1124135603,OUR CHILDRENS CLINIC,Our Childrens Clinic,4024A OLD TAR RD   WINTERVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1508894551,"STEWART, ANGELA, GRACE",4024A OLD TAR RD   WINTERVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 55 , 80 , 166 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508896341,"DRIGGERS, JENNIFER, FAYE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 104 , 204 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,1007 N 6TH ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1508896341,"DRIGGERS, JENNIFER, FAYE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508896341,"DRIGGERS, JENNIFER, FAYE",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 27 , 45 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508896341,"DRIGGERS, JENNIFER, FAYE",510 PINEVIEW DR   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508896341,"DRIGGERS, JENNIFER, FAYE",1650 LIBERTY DR STE 100 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 43 , 74 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508896341,"DRIGGERS, JENNIFER, FAYE",1650 LIBERTY DR STE 100 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 79 , 149 ,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508896481,"OHAJU, VINCENT, UGOCHUKWU",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1508898669,"SORIANO, JASON, AGLIBUT",,1960 REGENTS WAY   MARIETTA GA,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1508898669,"SORIANO, JASON, AGLIBUT",1960 REGENTS WAY   MARIETTA GA,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1508900457,SIXTH STREET DDA GROUP HOME,~,313 E 6TH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1508900457,SIXTH STREET DDA GROUP HOME,313 E 6TH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,102 "," 1,102 "," $59,784.03 ",,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1508902867,"COX, MICHELLE, RISING",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1508902867,"COX, MICHELLE, RISING",105 MCALPINE LN   LAURINBURG NC,083,Scotland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 32 , 47 , 50 ,$#,,
MEDICAID DIRECT,1508903477,HANGER PROSTHETICS & ORTHOTICS EAST,~,401 WESTWOOD AVE STE 102 HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508903477,HANGER PROSTHETICS & ORTHOTICS EAST,401 WESTWOOD AVE STE 102 HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 123 , 136 , 668 ," $81,519.43 ",,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508905043,"SCHWARZ, RONALD, PAUL",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1508905043,"SCHWARZ, RONALD, PAUL",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1467706705,FHPG LLC,FIRSTHEALTH FAMILIY MEDICINE CANDOR,210 E MAIN ST   CANDOR NC,062,Montgomery,193400000X,Group,Single Specialty,,1508905480,"SAUNDERS, SHARON, LYNNE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 23 ,$#,,
MEDICAID DIRECT,1467706705,FHPG LLC,FIRSTHEALTH FAMILIY MEDICINE CANDOR,210 E MAIN ST   CANDOR NC,062,Montgomery,193400000X,Group,Single Specialty,,1508905480,"SAUNDERS, SHARON, LYNNE",210 E MAIN ST   CANDOR NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 62 , 167 , 345 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508906959,"SKOROPOWSKI, GARTH, CHRISTIAN",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508906959,"SKOROPOWSKI, GARTH, CHRISTIAN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1508906959,"SKOROPOWSKI, GARTH, CHRISTIAN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1437506946,THOMPSON DDS PA,THOMPSON DDS PA,114 CAMPUS AVE   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1508907627,"THOMPSON, MARK, STEPHEN",114 CAMPUS AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 913 ," 1,573 "," 5,441 "," $325,905.31 ",,
MEDICAID DIRECT,1508907627,"THOMPSON, MARK, STEPHEN",THOMPSON DDS PA,114 CAMPUS AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice,1508907627,"THOMPSON, MARK, STEPHEN",114 CAMPUS AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 14 , 48 ,$#,,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1508910399,"STEINBICKER, JASON, MATTHEW",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 185 , 288 , 674 ," $29,408.93 ",,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508910399,"STEINBICKER, JASON, MATTHEW",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 113 , 165 , 385 ," $19,629.20 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508913476,"SEGEBARTH, PAUL, BRADLEY",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 64 , 98 , 147 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508915307,"REVANKAR, RAJAN, RAMESH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508915307,"REVANKAR, RAJAN, RAMESH",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 126 , 149 , 273 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1508915307,"REVANKAR, RAJAN, RAMESH",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,542 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1508915307,"REVANKAR, RAJAN, RAMESH",2630 WILLARD DAIRY RD STE 301 HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",3643 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 141 , 196 , 220 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 102 , 150 , 163 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 225 , 277 , 313 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508915521,"KOWEEK, LYNNE, HURWITZ",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 28 , 41 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508916842,"HEADLEE, CRAIG",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1508916842,"HEADLEE, CRAIG",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508919069,COUNTY OF DUPLIN,Duplin County Emergency Medical Services,209 SEMINARY ST   KENANSVILLE NC,031,Duplin,3416L0300X,Transportation Services,Ambulance,Land Transport,1508919069,COUNTY OF DUPLIN,209 SEMINARY ST   KENANSVILLE NC,031,Duplin,3416L0300X,Transportation Services,Ambulance,Land Transport, 362 , 714 ," 1,281 "," $19,033.00 ",,
MEDICAID DIRECT,1588145395,HAMILTON AND WHITECOTTON ORTHODONTI,,7482 WATERSIDE CROSSING BLVD STE 201 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1508922287,"HAMILTON, TODD, LELAND",7482 WATERSIDE CROSSING BLVD STE 201 DENVER NC,055,Lincoln,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 234 , 406 , 519 ," $90,549.50 ",,
MEDICAID DIRECT,1245587534,FRENCH BROAD PEDIATRIC ASSOCIATES P,FRENCH BROAD PEDICATRIC ASSOCIATES PLLC,40 N MERRIMON AVE STE 117 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1508923368,"BOWDEN, CARYN, ANN",8108B MARKET ST   WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 34 , 41 , 77 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508923368,"BOWDEN, CARYN, ANN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 20 , 28 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,9101 OCEAN HWY E   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1508923368,"BOWDEN, CARYN, ANN",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508923368,"BOWDEN, CARYN, ANN",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 62 , 157 ,$#,,
MEDICAID DIRECT,1962883678,BLUE RIDGE MEDICAL MANAGEMENT CORPO,BHMA PEDIATRIC ENDOCRINOLOGY,408 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508929373,"ARTZ, EVELYN, MEYERS",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508933045,"CRAIG, DEBORAH, JONES",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 56 , 87 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508935800,"GANGAROSA, LISA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 39 , 43 , 60 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",1021 W HAMLET AVE   HAMLET NC,077,Richmond,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 35 , 39 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",1035C 7 LAKES DR   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",1035C 7 LAKES DR   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1952830432,FHPG LLC,FIRSTHEALTH TROY CARE CLINIC,522 ALLEN ST STE 203 TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",1035C 7 LAKES DR   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",1035C 7 LAKES DR   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",1035C 7 LAKES DR   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1508937970,"LIFFRIG, JAMES, RICHARD",1035C 7 LAKES DR   WEST END NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 26 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508939364,"COAKLEY, RAYMOND, DERMOT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 52 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508939364,"COAKLEY, RAYMOND, DERMOT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508939364,"COAKLEY, RAYMOND, DERMOT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508939364,"COAKLEY, RAYMOND, DERMOT",100 EASTOWNE DR STE 420 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508940412,"DASH, RAJESH, CHANDRA",2301 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508940412,"DASH, RAJESH, CHANDRA",CLINICAL MICROBIOLOGY LAB RM 110 CARL DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 20 , 20 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508940412,"DASH, RAJESH, CHANDRA",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 53 , 54 , 95 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508940495,"MCALLISTER, AMY, BURKHARDT",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508940495,"MCALLISTER, AMY, BURKHARDT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508941444,BLADEN COUNTY SCHOOLS,Bladen County Schools,1489 US HIGHWAY 701 S   ELIZABETHTOWN NC,009,Bladen,251300000X,Agencies,Local Education Agency (LEA),,1508941444,BLADEN COUNTY SCHOOLS,1489 US HIGHWAY 701 S   ELIZABETHTOWN NC,009,Bladen,251300000X,Agencies,Local Education Agency (LEA),, 186 ," 5,299 "," 5,563 "," $298,501.01 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508942277,"SIGMAN, KENA, BLACKWELDER",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1508942319,"CHALLA, HARIGOVINDA, REDDY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 24 , 38 ,$#,,
MEDICAID DIRECT,1043632433,TENNESSEE INTERVENTIONAL AND IMAGIN,,975 E 3RD ST   CHATTANOOGA TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1508942319,"CHALLA, HARIGOVINDA, REDDY",975 E 3RD ST   CHATTANOOGA TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 50 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508942566,"ERBA, HARRY, PAUL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508942566,"ERBA, HARRY, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508942566,"ERBA, HARRY, PAUL",2400 PRATT ST STE 110 DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508945510,"FRANCO, ELIZABETH, CAROL",806 HAY ST   FAYETTEVILLE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508945510,"FRANCO, ELIZABETH, CAROL",131 W EDINBOROUGH AVE   RAEFORD NC,047,Hoke,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1508945866,"MUSE, ROCHELLE, DONNAE",371 NC HIGHWAY 65   WENTWORTH NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 34 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1508945866,"MUSE, ROCHELLE, DONNAE",371 NC HIGHWAY 65   WENTWORTH NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508946013,"LONG, PATRICIA, KRAMER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1508946104,"MCANINLEY, MARC, ANTHONY",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1508946104,"MCANINLEY, MARC, ANTHONY",615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508946104,"MCANINLEY, MARC, ANTHONY",5565 N CROATAN HWY   SOUTHERN SHORES NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508946633,"MILANO, CARMELO, ALESSIO",DUKE HOSP SOUTH TRENT DR DUKE PDC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508946633,"MILANO, CARMELO, ALESSIO",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 20 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508946633,"MILANO, CARMELO, ALESSIO",DUKE HOSP SOUTH TRENT DR DUKE PDC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1508946757,"GRIFFIN, BRIAN, CHRISTOPHER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 134 , 184 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 108 , 114 , 152 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 69 , 69 , 102 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 13 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1508952896,"LASCOLA, CHRISTOPHER, DAVID",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 46 , 90 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",110 KILDAIRE PARK DR   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508955121,"HANSON, CURTIS, ASHLEY",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 48 , 90 ,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508955980,"ZELTNER, HAROLD, THEODORE",8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1508955980,"ZELTNER, HAROLD, THEODORE",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 ,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508960048,"TYREY, SCOTT, JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 64 , 76 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508960048,"TYREY, SCOTT, JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2308 WESVILL CT   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508960048,"TYREY, SCOTT, JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508962887,"SCHOFIELD, DEBORAH, ELAINE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207ZP0213X,Allopathic & Osteopathic Physicians,Pathology,Pediatric Pathology, 12 , 15 , 17 ,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1508963539,"DAVIDSON, JEREMY, SCOTT",1700 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 44 , 73 ,$#,,
MEDICAID DIRECT,1508963539,"DAVIDSON, JEREMY, SCOTT",~,1119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1508963539,"DAVIDSON, JEREMY, SCOTT",1119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1508963539,"DAVIDSON, JEREMY, SCOTT",1119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 112 , 187 , 306 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508964297,"SMITH, LESLIE, ANN",178 HIGHWAY 105 EXT STE 102 BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,701 HAWLEY AVE   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1508965161,"CLONINGER, FRED, SAMUEL",701 HAWLEY AVE   BELMONT NC,036,Gaston,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1508965526,"ENOHMBI, EMMANUEL, TAMBI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508965526,"ENOHMBI, EMMANUEL, TAMBI",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1508965526,"ENOHMBI, EMMANUEL, TAMBI",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1508965526,"ENOHMBI, EMMANUEL, TAMBI",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 57 , 57 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1508966573,"BOWERS, LEO, CLAYTON",4000 COLISEUM DR STE 445 HAMPTON VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508969205,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03387,1124 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508969205,NORTH CAROLINA CVS PHARMACY LLC,1124 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1508969296,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07053,904 S FIFTH ST   MEBANE NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1508969296,NORTH CAROLINA CVS PHARMACY LLC,904 S FIFTH ST   MEBANE NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1508969296,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07053,904 S FIFTH ST   MEBANE NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1508969296,NORTH CAROLINA CVS PHARMACY LLC,904 S FIFTH ST   MEBANE NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 26 , 40 ,$#,,
MEDICAID DIRECT,1508969361,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04126,1020 JOHN SMALL AVE   WASHINGTON NC,007,Beaufort,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1508969361,NORTH CAROLINA CVS PHARMACY LLC,1020 JOHN SMALL AVE   WASHINGTON NC,007,Beaufort,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1508969361,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04126,1020 JOHN SMALL AVE   WASHINGTON NC,007,Beaufort,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1508969361,NORTH CAROLINA CVS PHARMACY LLC,1020 JOHN SMALL AVE   WASHINGTON NC,007,Beaufort,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1659487502,WILKES PEDIATRIC CLINIC,,1925 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1508970831,"VAN NOY, TIMOTHY, QUINN",1925 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 95 , 185 , 481 ," $19,426.91 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1508972969,"BERKOFF, DAVID, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1508972969,"BERKOFF, DAVID, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1508972969,"BERKOFF, DAVID, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 13 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1508972969,"BERKOFF, DAVID, JOSEPH",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1508977463,APRIA HEALTHCARE LLC,~,300 W 27TH ST   WINSTON SALEM NC,034,Forsyth,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1508977463,APRIA HEALTHCARE LLC,300 W 27TH ST   WINSTON SALEM NC,034,Forsyth,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 517 ," 2,525 "," 4,913 "," $58,787.75 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1508977588,"GARRISON, SCOTT, KEENAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 60 , 64 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1804 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508977927,"TORRES, MARY, ELLEN",1804 DAVIE AVE   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508977927,"TORRES, MARY, ELLEN",1804 DAVIE AVE   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 16 , 29 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508977927,"TORRES, MARY, ELLEN",1804 DAVIE AVE   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508977927,"TORRES, MARY, ELLEN",1804 DAVIE AVE   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1518549393,IREDELL PHYSICIAN NETWORK,IREDELL SURGERY AT MOORESVILLE,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1508977927,"TORRES, MARY, ELLEN",1804 DAVIE AVE   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1669 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1508977927,"TORRES, MARY, ELLEN",1804 DAVIE AVE   STATESVILLE NC,049,Iredell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 59 , 82 , 127 ,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1508978743,"PEPPARD, DENISE, LYNN",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 29 , 36 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508979568,"WATTS, LARRY, THOMAS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508979568,"WATTS, LARRY, THOMAS",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1508979568,"WATTS, LARRY, THOMAS",1001 BLYTHE BLVD STE 200D CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1508979576,"THOMPSON, ROBERTA, WHITE",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1508979576,"THOMPSON, ROBERTA, WHITE",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1508979576,"THOMPSON, ROBERTA, WHITE",566 RUIN CREEK RD PO DRAWER 59 HENDERSON NC,091,Vance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508982232,MEDSCOPE AMERICA LLC,MEDSCOPE AMERICA LLC,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1508982232,MEDSCOPE AMERICA LLC,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1508984212,"ROBERTSON, DAVID, PRINCE",DAVID P ROBERTSON DDS PA,3002 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,1508984212,"ROBERTSON, DAVID, PRINCE",3002 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1508985144,"THOMPSON TUCKER, KIMBERLY, LEA",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 30 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1508985144,"THOMPSON TUCKER, KIMBERLY, LEA",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 21 , 42 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1508985144,"THOMPSON TUCKER, KIMBERLY, LEA",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1508985144,"THOMPSON TUCKER, KIMBERLY, LEA",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1508985144,"THOMPSON TUCKER, KIMBERLY, LEA",212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 13 , 31 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508985144,"THOMPSON TUCKER, KIMBERLY, LEA",315 GREENVILLE BLVD SE STE 100 GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 25 , 62 ,$#,,
MEDICAID DIRECT,1508985441,INREACH,INREACH,6312 WILLIAMS RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1508985441,INREACH,6312 WILLIAMS RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 610 , 610 ," $32,667.68 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508988742,"DEFAZIO, JENNIFER, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1508988742,"DEFAZIO, JENNIFER, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 22 , 36 ,$#,,
MEDICAID DIRECT,1508990268,"DOWDY, HUGH, TWIFORD",HUGH T DOWDY DDS,253 W KINGS HWY   EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1508990268,"DOWDY, HUGH, TWIFORD",253 W KINGS HWY   EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 146 , 338 , 946 ," $44,683.41 ",,
MEDICAID DIRECT,1508998295,EMERITUS CORPORATION,BROOKDALE COUNTRY DAY ROAD,380 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1508998295,EMERITUS CORPORATION,380 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 708 , 708 ," $44,453.18 ",,
MEDICAID DIRECT,1518003854,HIGH COUNTRY HOME CARE INC,HIGH COUNTRY HOME CARE,430 PINEOLA ST   NEWLAND NC,006,Avery,253Z00000X,Agencies,In Home Supportive Care,,1518003854,HIGH COUNTRY HOME CARE INC,430 PINEOLA ST   NEWLAND NC,006,Avery,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,274 "," 2,274 "," $319,146.08 ",,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518004373,"TANSAVATDI, KATHARINE, RATANA",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518004373,"TANSAVATDI, KATHARINE, RATANA",150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598959934,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS WF,839 DURHAM RD STE A WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1518004373,"TANSAVATDI, KATHARINE, RATANA",839 DURHAM RD STE A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518004373,"TANSAVATDI, KATHARINE, RATANA",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518004373,"TANSAVATDI, KATHARINE, RATANA",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 39 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3901 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",3901 N ROXBORO ST   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,601 FAYETTEVILLE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",601 FAYETTEVILLE ST   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 63 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 39 , 116 , 121 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3901 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518011832,"BUTTERLY, DAVID, WILLIAM",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1518012145,"BROWN, ALLEN",683 E PALMER ST   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 269 , 303 , 898 ," $14,343.74 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518012350,"SHARPE, DAPHNE, KAYE",1471 JAG BRANCH BLVD UNIT 103 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518012905,PROGRESSIVE SPEECH SERVICES INC,~,5023 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518012905,PROGRESSIVE SPEECH SERVICES INC,5023 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,, 23 , 234 , 234 ," $14,937.33 ",,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518015247,"HENNESSEE, PHEDRA, ELIZABETH",5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518015247,"HENNESSEE, PHEDRA, ELIZABETH",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518015247,"HENNESSEE, PHEDRA, ELIZABETH",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 29 ,$#,,
MEDICAID DIRECT,1548290265,FHPG LLC,FIRST HEALTH FAMILY MEDICINE SEVEN LAKES,1035C 7 LAKES DR   WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1518018688,"ALLRED, JOLENA, BETH",1035C 7 LAKES DR   WEST END NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 97 , 186 ,$#,,
MEDICAID DIRECT,1548290265,FHPG LLC,FIRST HEALTH FAMILY MEDICINE SEVEN LAKES,1035C 7 LAKES DR   WEST END NC,063,Moore,193400000X,Group,Single Specialty,,1518018688,"ALLRED, JOLENA, BETH",400 EASTOWNE DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 24 , 54 ,$#,,
MEDICAID DIRECT,1750482493,OPEN WATER MEDICAL PA,~,1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,193400000X,Group,Single Specialty,,1518019413,"ORTON, WILLIAM, JACK",1620C LIVE OAK ST   BEAUFORT NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 173 , 458 ," $12,781.29 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518020387,"LABELLE, VIRGINIA, SULLIVAN",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518020387,"LABELLE, VIRGINIA, SULLIVAN",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1598804916,FF & NF PA,FF&NF,,,Unknown,193400000X,Group,Single Specialty,,1518023001,"RAPALJE, JAMES, JOHN",6201 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518023183,SOUTHERN ASSISTED LIVING INC,BROOKDALE HIGH POINT,201 HARTLEY DR   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518023183,SOUTHERN ASSISTED LIVING INC,201 HARTLEY DR   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 365 , 365 ," $22,884.33 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1904 FRONT ST STE 530 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1518030360,"BARRERO, CARLOS, H",1525 E FRANKLIN ST STE 530 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,1525 E FRANKLIN ST STE 2 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1518030360,"BARRERO, CARLOS, H",1525 E FRANKLIN ST STE 530 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 22 , 60 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518031657,"FRAZIER, ANNIE, LAURA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518031657,"FRAZIER, ANNIE, LAURA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518031657,"FRAZIER, ANNIE, LAURA",250 HOSPITAL DR LEXINGTON MEMORIAL HOSPITAL LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1518031657,"FRAZIER, ANNIE, LAURA",250 HOSPITAL DR LEXINGTON MEMORIAL HOSPITAL LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518031665,HANGER PROSTHETICS A ORTHOTICS INC,HANGER PROSTHETICS AND ORTHOTICS,1717 SHIPYARD BLVD STE 150 WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518031665,HANGER PROSTHETICS A ORTHOTICS INC,1717 SHIPYARD BLVD STE 150 WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 35 , 42 , 249 ," $28,064.87 ",,
MEDICAID DIRECT,1518031780,"MITCHELL, JILL, ELAINE",~,2056 OAKTON DR   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1518031780,"MITCHELL, JILL, ELAINE",2056 OAKTON DR   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 42 , 42 ,$#,,
MEDICAID DIRECT,1720014152,LARRY J MORAY DDS MS PA,MYORTHODONTIST,150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",150 PRESTON EXECUTIVE DR STE 102 CARY NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 173 , 180 , 217 ," $28,360.75 ",,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",1919 BRAGG ST STE 7 SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 12 , 11 , 20 ,$#,,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 113 , 114 , 241 ," $24,109.95 ",,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 12 ,$#,,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 33 , 33 , 75 ," $13,451.36 ",,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 16 , 15 , 24 ,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1518035567,"MORAY, LAWRENCE, JOEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518036243,"EASLEY, DONALD, GRAHAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518036243,"EASLEY, DONALD, GRAHAM",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518036508,"BEYER, JOHN, LESLIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1558546184,JACKSONVILLE PHYSICAL THERAPY CENTE,~,2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518038322,"FISHER, FRANKLIN, S",2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518038827,"STRUICK, CYNTHIA, HALBROOK",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518038827,"STRUICK, CYNTHIA, HALBROOK",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1518038827,"STRUICK, CYNTHIA, HALBROOK",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518038827,"STRUICK, CYNTHIA, HALBROOK",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518038827,"STRUICK, CYNTHIA, HALBROOK",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518040286,"GARD, ALLISON, KAY",1901 HILLANDALE RD STE B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 31 , 62 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518040286,"GARD, ALLISON, KAY",1901 HILLANDALE RD STE B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518041417,"RHEE, ELEANOR, HOON JOO",2301 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518041417,"RHEE, ELEANOR, HOON JOO",2406 BLUE RIDGE RD STE 200 RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518041417,"RHEE, ELEANOR, HOON JOO",11001 DURANT RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518041417,"RHEE, ELEANOR, HOON JOO",600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518041482,"MIKUL, HELEN, MARGARET",224 S 10TH AVE   SILER CITY NC,019,Chatham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 72 , 122 , 169 ," $38,047.50 ",,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518041730,"HAAS, ANDREA, LEE",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1518041730,"HAAS, ANDREA, LEE",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518041730,"HAAS, ANDREA, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1518041730,"HAAS, ANDREA, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093013351,PROPTNC LLC,RESOLVE PHYSICAL THERAPY AND REHABILITATION,112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193400000X,Group,Single Specialty,,1518041755,"SKULAVIK, DANIEL, PAUL",112 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 29 , 62 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518043439,"CLARK, TALAYA, BLAKEY",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 177 , 274 , 341 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518043439,"CLARK, TALAYA, BLAKEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 26 ,$#,,
MEDICAID DIRECT,1518045079,"TURIK, SCOTT, ALAN",SCOTT A TURIK DDS PA,105 N CORBETT AVE   KENLY NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1518045079,"TURIK, SCOTT, ALAN",105 N CORBETT AVE   KENLY NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 122 , 126 , 134 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1518046085,"PULVER, LAURIE, SELF",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1710021811,ABC PEDIATRICS OF ASHEVILLE PA,ABC PEDIATRICS OF ASHEVILLE PA,64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1518046085,"PULVER, LAURIE, SELF",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 22 , 66 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518048586,"DEMARIA, ERIC, JOEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518048586,"DEMARIA, ERIC, JOEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518049378,"VISKOVICH, CORLEA, WHELAN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518049378,"VISKOVICH, CORLEA, WHELAN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518049378,"VISKOVICH, CORLEA, WHELAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518049683,"ERICKSON, KAREN, LYN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1273 MAIN ST   SWANQUARTER NC,048,Hyde,193200000X,Group,Multi-Specialty,,1518050111,"BODEN, DANIEL, KARL",1273 MAIN ST   SWANQUARTER NC,048,Hyde,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518050111,"BODEN, DANIEL, KARL",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 68 , 70 , 127 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1518051986,"SERVICE, VERSTON, KIRK",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1518051986,"SERVICE, VERSTON, KIRK",100 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 93 , 104 , 123 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518052471,"LARSON, SEAN, MARK",102 LEONARD AVE   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 198 , 198 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518052471,"LARSON, SEAN, MARK",102 LEONARD AVE   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 84 , 84 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518052471,"LARSON, SEAN, MARK",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518052471,"LARSON, SEAN, MARK",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518052497,"ACCARDO, TERRI, LEIGH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518053230,"TOOMES, SHANE, AARON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518053255,"HATEFI, AKEMI, ANGELA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518053255,"HATEFI, AKEMI, ANGELA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1518055466,"SINGH, SUNILJIT",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518057090,"PINEDA-ROMAN, MAURICIO",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 57 , 84 , 84 ,$#,,
MEDICAID DIRECT,1255449534,RUSSELL J BARONE DPM PA,RUSSELL J BARONE DPM PA,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1518057454,"STOVER, BRIAN, SCOTT",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1134367394,"STOVER, PAMELA, BARONE",~,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1518057454,"STOVER, BRIAN, SCOTT",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255449534,RUSSELL J BARONE DPM PA,RUSSELL J BARONE DPM PA,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1518057454,"STOVER, BRIAN, SCOTT",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 93 , 150 , 199 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518057868,"SHIPLEY, MELISSA, FAITH GAME",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 158 , 204 , 246 ," $18,009.35 ",,
MEDICAID DIRECT,1518057868,"SHIPLEY, MELISSA, FAITH GAME",~,9020 SENCA DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1518057868,"SHIPLEY, MELISSA, FAITH GAME",9020 SENCA DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1518057868,"SHIPLEY, MELISSA, FAITH GAME",~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1518057868,"SHIPLEY, MELISSA, FAITH GAME",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 25 , 47 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518057868,"SHIPLEY, MELISSA, FAITH GAME",9020 SENCA DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 39 , 55 , 69 ,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1518058304,"CHAMBERS, WILLIAM, LEROY",50 BOWMAN DR   WAYNESVILLE NC,044,Haywood,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 98 , 101 , 433 ," $33,380.54 ",,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1518058304,"CHAMBERS, WILLIAM, LEROY",10 YORKSHIRE ST # B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 668 , 957 ," 3,894 "," $280,716.73 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518058502,"MARTE, MICHAEL, CHARLES",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1518058577,"OGLE, ADRIAN, MAHENDRA",205 SANDALWOOD AVE STE B LOUISBURG NC,035,Franklin,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 22 , 43 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1518058577,"OGLE, ADRIAN, MAHENDRA",120 CHARLES ROLLINS RD STE 105 HENDERSON NC,091,Vance,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1518058577,"OGLE, ADRIAN, MAHENDRA",120 CHARLES ROLLINS RD STE 105 HENDERSON NC,091,Vance,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1366969966,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 105 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1518058577,"OGLE, ADRIAN, MAHENDRA",120 CHARLES ROLLINS RD STE 105 HENDERSON NC,091,Vance,208800000X,Allopathic & Osteopathic Physicians,Urology,, 217 , 389 , 786 ," $10,501.15 ",,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518058577,"OGLE, ADRIAN, MAHENDRA",120 CHARLES ROLLINS RD STE 105 HENDERSON NC,091,Vance,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912245663,SIEGEL CHIROPRACTIC INC,~,2712 HENDERSONVILLE RD STE 230 ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1518059294,"SIEGEL, CLAYTON, DREW",2712 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1518060383,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04398,921 S STATE ST   YADKINVILLE NC,099,Yadkin,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1518060383,NORTH CAROLINA CVS PHARMACY LLC,921 S STATE ST   YADKINVILLE NC,099,Yadkin,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1518060383,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04398,921 S STATE ST   YADKINVILLE NC,099,Yadkin,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1518060383,NORTH CAROLINA CVS PHARMACY LLC,921 S STATE ST   YADKINVILLE NC,099,Yadkin,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1053400853,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1518061605,"WILLIS, WESTON, ALEXANDER",17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 70 , 351 , 357 ," $40,655.43 ",,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518062041,"AVILA, ELENA, MARIE",5 REGIONAL CIR STE BANDC PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 53 , 115 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518062041,"AVILA, ELENA, MARIE",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 30 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,78 LONG SHOALS RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1518062041,"AVILA, ELENA, MARIE",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518062272,"AKKALADEVI, SHAILAJA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1518062272,"AKKALADEVI, SHAILAJA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 29 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518062272,"AKKALADEVI, SHAILAJA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 48 , 48 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518062272,"AKKALADEVI, SHAILAJA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 136 , 136 ,$#,,
MEDICAID DIRECT,1699870584,CAROLINA RADIOLOGY CONSULTANTS PA,CAROLINA RADIOLOGY CONSULTANTS,,,Unknown,193200000X,Group,Multi-Specialty,,1518062413,"JONES, JEFFREY, EMERSON",2138 NC HIGHWAY 42 W STE 400 CLAYTON NC,051,Johnston,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1518063718,"CASTRO, FERNANDO, XAVIER",705 6TH AVE W STE B HENDERSONVILLE NC,045,Henderson,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1518063718,"CASTRO, FERNANDO, XAVIER",705 6TH AVE W STE B HENDERSONVILLE NC,045,Henderson,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1518064583,"BRADSHAW, BASCOM, KYLE",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1801188941,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2550 COURT DR STE 202 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518065614,"LIM, ROBERT, BENTLEY",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518065614,"LIM, ROBERT, BENTLEY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518065614,"LIM, ROBERT, BENTLEY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 16 , 22 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518065614,"LIM, ROBERT, BENTLEY",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518065614,"LIM, ROBERT, BENTLEY",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518065614,"LIM, ROBERT, BENTLEY",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801188941,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2550 COURT DR STE 202 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518065614,"LIM, ROBERT, BENTLEY",2550 COURT DR STE 202 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1518066976,"WALKER, EARL, WILLIAM",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 61 , 86 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518066976,"WALKER, EARL, WILLIAM",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 113 , 169 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518072156,"NOVOSEL, TIMOTHY, JAMES",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518072156,"NOVOSEL, TIMOTHY, JAMES",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518072156,"NOVOSEL, TIMOTHY, JAMES",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518072156,"NOVOSEL, TIMOTHY, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 60 , 143 , 153 ," $15,122.48 ",,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518073261,"WARD, MARC, EDWARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518073261,"WARD, MARC, EDWARD",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518073261,"WARD, MARC, EDWARD",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 22 , 49 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518073261,"WARD, MARC, EDWARD",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 36 , 66 ,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518073261,"WARD, MARC, EDWARD",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518076603,"BLITZ, JEANNA, DIANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1518076660,"WILLIAMS, RANDALL, PAUL",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 24 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518077221,"MORRELL, DEAN, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518077221,"MORRELL, DEAN, SCOTT",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 48 , 62 , 71 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518077221,"MORRELL, DEAN, SCOTT",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518078070,"COMER, ANGIE, BLALOCK",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518078070,"COMER, ANGIE, BLALOCK",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518078195,"LASSITER, JENNIFER, WHORLEY",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 16 , 39 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518078195,"LASSITER, JENNIFER, WHORLEY",1994 WELLNESS BLVD STE 110 MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518080274,"WANG, YI-ZHE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 11 , 29 , 29 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518080274,"WANG, YI-ZHE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1609265610,J Z WANG PSYCHIATIC SERVICES PC,,3019 FALSTAFF RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518080274,"WANG, YI-ZHE",3019 FALSTAFF RD   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518080274,"WANG, YI-ZHE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 13 , 78 , 78 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518081520,"DISANTO, RACHEL",310 DAVIE AVE   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 77 , 132 ,$#,,
MEDICAID DIRECT,1518086453,CHESHIRE SPEECH AND VOICE CENTER,CHESHIRE SPEECH AND VOICE CENTER INC,2500 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518086453,CHESHIRE SPEECH AND VOICE CENTER,2500 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,, 338 ," 5,224 "," 5,307 "," $349,796.44 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518089291,"TABORI, KATHERINE, ELIZABETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518089291,"TABORI, KATHERINE, ELIZABETH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 29 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518089291,"TABORI, KATHERINE, ELIZABETH",4810 W WENDOVER AVE   JAMESTOWN NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1437854403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY FAYETTEVILLE ORTHOPEDICS AND SPOR,1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518089465,"MCBRAYER, DANIEL, ENOCH",1991 FORDHAM DR STE 100 FAYETTEVILLE NC,026,Cumberland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 101 , 202 , 308 ," $10,728.70 ",,
MEDICAID DIRECT,1518090935,CASWELL COUNTY HEALTH DEPARTMENT,COUNTY OF CASWELL,189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,251B00000X,Agencies,Case Management,,1518090935,CASWELL COUNTY HEALTH DEPARTMENT,189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,251B00000X,Agencies,Case Management,, 58 , 592 , 592 ," $263,127.14 ",,
MEDICAID DIRECT,1518091644,"ALDRIDGE, JULIUS, RAYNDOL",JULIUS ALDRIDGE,342 OAK AVE   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice,1518091644,"ALDRIDGE, JULIUS, RAYNDOL",342 OAK AVE   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice,#, 17 , 35 ,$#,,
MEDICAID DIRECT,1518092063,J & S CARE INCORPORATED,MORNING STAR AL 2,941 GOINS RD   PEMBROKE NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518092063,J & S CARE INCORPORATED,941 GOINS RD   PEMBROKE NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,652 "," 1,659 "," $132,231.20 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518093038,"RICE, HENRY, ELLIOT",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518093038,"RICE, HENRY, ELLIOT",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 61 , 80 , 90 ," $15,936.15 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518093038,"RICE, HENRY, ELLIOT",2400 PRATT ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518094093,"AMERSON, THERESA, CAMBRE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 40 , 40 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1518095033,"COPELAND, CARRIE, ALENE",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518095033,"COPELAND, CARRIE, ALENE",1225 E GARRISON BLVD   GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518095033,"COPELAND, CARRIE, ALENE",1212 SPRUCE ST STE 307 BELMONT NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144510207,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518095033,"COPELAND, CARRIE, ALENE",620 SUMMIT CROSSING PL STE 108A GASTONIA NC,036,Gaston,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1518099522,ALLYN HEALTHCARE PROFESSIONALS LLC,ALLYN HEALTHCARE PROFESSIONALS LLC,4265 BROWNSBORO RD STE 107 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1518099522,ALLYN HEALTHCARE PROFESSIONALS LLC,4265 BROWNSBORO RD STE 107 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 4,052 "," 4,282 "," $480,768.76 ",,
MEDICAID DIRECT,1134176506,CHARLES D GODWIN,EASTERN CAROLINA PSYCHIATRIC SERVICES,2800 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1518102573,"CLAYSON, BARBARA, ANN",2800 VILLAGE WAY   TRENT WOODS NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 65 , 65 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518103001,"GODDARD, MATTHEW, ARTHUR",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518103001,"GODDARD, MATTHEW, ARTHUR",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518107481,"NAZARIO ALBINO, GRISELLE, MARIE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1101 DRESSER CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518107671,"PATE, JAMES, CAREY",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 126 , 302 , 654 ," $79,875.29 ",,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,515 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1518107671,"PATE, JAMES, CAREY",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,145 TILGHMAN DR STE 200 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1518107671,"PATE, JAMES, CAREY",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 35 , 61 , 171 ," $21,542.33 ",,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,3322 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1518107671,"PATE, JAMES, CAREY",1101 DRESSER CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1679119499,MCPC-5 LLC,FIRSTHEALTH HEART FAILURE CLINIC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1518108158,"KINSMAN, AUBREY, LYNN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 144 , 251 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518112267,"TATKA, KEITH, DOMINIC",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 104 , 107 , 108 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518113604,"CAUDILL, PERRY, SCRUGGS",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518113604,"CAUDILL, PERRY, SCRUGGS",2075 GLENN MITCHELL DR STE 500 VIRGINIA BEACH VA,101,Out of State <= 40 miles,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1518120575,"ROWE, ANTHONY, JERROD",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1518120575,"ROWE, ANTHONY, JERROD",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518120575,"ROWE, ANTHONY, JERROD",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1346540101,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518122068,"LAMANNO, APRIL, ARTHUR",4315 PHYSICIANS BLVD STE 101 HARRISBURG NC,013,Cabarrus,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518123389,"LOZOVATSKY, MARGARET",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1801126479,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST UROLOGY,320 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1518123447,"MOREE, PARRISH, FRY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 28 , 28 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518124007,"LEONARD, SARAH, ELIZABETH BRIER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1518124007,"LEONARD, SARAH, ELIZABETH BRIER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518124007,"LEONARD, SARAH, ELIZABETH BRIER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518124007,"LEONARD, SARAH, ELIZABETH BRIER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518124007,"LEONARD, SARAH, ELIZABETH BRIER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518125509,"JARDELEZA, MARIA STEPHANIE, RAVADILLA",2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 60 , 107 , 236 ," $18,448.27 ",,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518125509,"JARDELEZA, MARIA STEPHANIE, RAVADILLA",2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518125509,"JARDELEZA, MARIA STEPHANIE, RAVADILLA",120 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 35 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,2613 W ARLINGTON BLVD STE 102 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518125509,"JARDELEZA, MARIA STEPHANIE, RAVADILLA",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518125509,"JARDELEZA, MARIA STEPHANIE, RAVADILLA",106 RIDGE VIEW DR STE 100 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 15 , 27 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518125509,"JARDELEZA, MARIA STEPHANIE, RAVADILLA",11200 GOVERNOR MANLY WAY   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518125509,"JARDELEZA, MARIA STEPHANIE, RAVADILLA",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 53 , 108 ,$#,,
MEDICAID DIRECT,1518126127,"BRACKEN, AMY, KATHLEEN",AMY BRACKEN PLLC,212 S HILLANDALE DR   EAST FLAT ROCK NC,045,Henderson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1518126127,"BRACKEN, AMY, KATHLEEN",212 S HILLANDALE DR   EAST FLAT ROCK NC,045,Henderson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 58 , 858 , 864 ," $81,226.75 ",,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1518126267,"KISSI, HARRY, AMOAKO",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1518126267,"KISSI, HARRY, AMOAKO",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518126267,"KISSI, HARRY, AMOAKO",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 62 , 157 , 158 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518126267,"KISSI, HARRY, AMOAKO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1518126267,"KISSI, HARRY, AMOAKO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518126267,"KISSI, HARRY, AMOAKO",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1518126267,"KISSI, HARRY, AMOAKO",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 104 , 104 ,$#,,
MEDICAID DIRECT,1518127315,STACY VEE DAVENPORT-BAIRD,WELCOME HOME GROUP HOME II,1522 GLEN EAGLES CT   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518127315,STACY VEE DAVENPORT-BAIRD,1522 GLEN EAGLES CT   NASHVILLE NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,353 "," 1,356 "," $175,164.10 ",,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1518128180,"PARRISH, TRACY, LYNN",306 DEER PARK RD   NEBO NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 97 , 318 , 318 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1518128180,"PARRISH, TRACY, LYNN",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1518128180,"PARRISH, TRACY, LYNN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 176 , 267 , 267 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1518128180,"PARRISH, TRACY, LYNN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1518128180,"PARRISH, TRACY, LYNN",211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 152 , 152 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1518128180,"PARRISH, TRACY, LYNN",310 PENSACOLA RD   BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 72 , 272 , 272 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518128511,"POISSON, JESSICA, LYNNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518128511,"POISSON, JESSICA, LYNNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 16 , 16 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1518128610,"MABRY, JENNIFER, MARIE",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1518128610,"MABRY, JENNIFER, MARIE",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 ,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1518128610,"MABRY, JENNIFER, MARIE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 58 , 140 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518128909,"PENNELL, KRISTEN, N",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518129139,"JEANES, SARAH, COOPER",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 50 , 75 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518129139,"JEANES, SARAH, COOPER",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598869075,"DEDMOND, RONALD, KEITH",~,1435 N ASPEN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1518130400,"DEDMOND, BRIAN, RICHARD",1435 N ASPEN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 58 , 95 , 251 ," $11,161.96 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1518130418,"SPANG, JEFFREY, TWEED",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518131812,"SWEIGARD, JENNY, LYNN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 17 , 44 , 44 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518131812,"SWEIGARD, JENNY, LYNN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 35 , 36 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1518133800,"BARKER, JOSEPH, UHALT",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518133800,"BARKER, JOSEPH, UHALT",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518133800,"BARKER, JOSEPH, UHALT",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 18 ,$#,,
MEDICAID DIRECT,1447241435,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF PINEHURST,14 REGIONAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1518135748,"FRASER, AMANDA, JEAN",14 REGIONAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 89 , 170 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1518136365,"GILBERT, MELINDA, HATCHEL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518136365,"GILBERT, MELINDA, HATCHEL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518136365,"GILBERT, MELINDA, HATCHEL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,500 SHEPHERD ST STE 500 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518137819,"PAWA, RISHI",500 SHEPHERD ST   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518137819,"PAWA, RISHI",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518137819,"PAWA, RISHI",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518137819,"PAWA, RISHI",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 49 , 58 , 127 ," $12,051.54 ",,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,201 DALE EARNHARDT BLVD STE 201 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518139732,"WATSON, LISA, LYNNE",201 DALE EARNHARDT BLVD STE 201 KANNAPOLIS NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518141225,"WEBER, SARAH, LOUISE",1941 NEW GARDEN RD STE 216 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 47 , 105 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518141472,"CONE, CHRISTINA, KITCHIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518141472,"CONE, CHRISTINA, KITCHIN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1518145242,"PEREZ, MARCIA",MARCIA M PEREZ DBA KIDS IN MOTION PHYSICAL THERAPY,1178 RIVER HWY STE B MOORESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1518145242,"PEREZ, MARCIA",1178 RIVER HWY STE B MOORESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 18 , 363 , 370 ," $27,940.22 ",,
MEDICAID DIRECT,1902370968,MISSION FOOT AND ANKLE PLLC,,4140 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1518147339,"BREWINGTON, SHELLI, LYNN",4140 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 313 , 776 ," 1,517 "," $24,832.26 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518147537,"MILLER, CAROL, DENISE",1060 FIRST COLONIAL RD FL 1 VIRGINIA BCH VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902991698,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1518148519,"HAYHURST, ALLISON, ANNE",451 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407137938,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,216 N BICKETT BLVD STE 3 LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1518148519,"HAYHURST, ALLISON, ANNE",216 N BICKETT BLVD   LOUISBURG NC,035,Franklin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 63 , 121 ,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518148642,"WEGMANN, JESSICA, TOMLINSON",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518149228,"MCBRIDE, JACK, MARVIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518149277,"HALL, GEORGE, DANIEL",250 BISHOP LN   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518149277,"HALL, GEORGE, DANIEL",413 WINECOFF SCHOOL RD   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 98 , 104 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518149277,"HALL, GEORGE, DANIEL",515 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518149277,"HALL, GEORGE, DANIEL",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518149277,"HALL, GEORGE, DANIEL",1810 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 35 , 36 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518149368,"MCAVOY, ELIZABETH, COLLEEN",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 90 , 161 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518151349,"TAXMAN, STEVEN, MARK",932 MORREENE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518151349,"TAXMAN, STEVEN, MARK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518151349,"TAXMAN, STEVEN, MARK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1518151620,"ELSANJAK, ABDELAZIZ, ALI",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1518151620,"ELSANJAK, ABDELAZIZ, ALI",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1518151620,"ELSANJAK, ABDELAZIZ, ALI",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518153022,"JOU, JASON, PETER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1518153683,MICHAELS PLACE INC,~,2815 CASCADILLA ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518153683,MICHAELS PLACE INC,2815 CASCADILLA ST   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1326365081,HUGH CHATHAM MEMORIAL HOSPITAL,~,201A ELDON PARKS DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1518154889,"LEE, ANDREW, DONGJUN",201A ELDON PARKS DR   ELKIN NC,086,Surry,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 25 , 32 , 51 ,$#,,
MEDICAID DIRECT,1326365081,HUGH CHATHAM MEMORIAL HOSPITAL,~,690 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1518154889,"LEE, ANDREW, DONGJUN",201A ELDON PARKS DR   ELKIN NC,086,Surry,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 120 , 182 , 253 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1518156181,"LY, NICK, MINH",2201 S STERLING ST   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1518156181,"LY, NICK, MINH",720 MALCOLM BLVD   VALDESE NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1518156181,"LY, NICK, MINH",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1518156181,"LY, NICK, MINH",100 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518156181,"LY, NICK, MINH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1518157064,HARRIS TEETER LLC,~,5920 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1518157064,HARRIS TEETER LLC,5920 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518157247,"ROBINSON, ELLEN, RENAE",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518157247,"ROBINSON, ELLEN, RENAE",648 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 31 , 78 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518157932,"LUPER, ALLISON, HINSHAW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1518158005,"GRATTON, JOANNA, ELIZABETH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518158005,"GRATTON, JOANNA, ELIZABETH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1518158351,WALGREEN CO,~,6028 S NC 16 HWY   MAIDEN NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1518158351,WALGREEN CO,6028 S NC 16 HWY   MAIDEN NC,018,Catawba,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518158559,"HEDGECOCK, SUZANN, BRYANT",4510 PREMIER DR   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 51 , 62 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518158633,"BOYKIN, ROBERT, ERNEST",75B LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 55 , 78 , 179 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518158633,"BOYKIN, ROBERT, ERNEST",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518158633,"BOYKIN, ROBERT, ERNEST",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518158724,"WATERMAN, BRIAN, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 53 , 73 , 112 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518158724,"WATERMAN, BRIAN, ROBERT",1901 MOONEY ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518158724,"WATERMAN, BRIAN, ROBERT",1901 MOONEY ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518158724,"WATERMAN, BRIAN, ROBERT",329 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518158971,"SILVERMAN, STEVEN, TODD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518158971,"SILVERMAN, STEVEN, TODD",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518160019,"LINN, JOANNA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518165182,"REINKE, CAROLINE, EDWARDS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 24 , 25 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518165182,"REINKE, CAROLINE, EDWARDS",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518165182,"REINKE, CAROLINE, EDWARDS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 18 , 19 ,$#,,
MEDICAID DIRECT,1518165646,VISION OF THERAPEUTIC DEVELOPMENT I,Vision of Therapeutic Development,35 SOUTHERN VILLAGE DR   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518165646,VISION OF THERAPEUTIC DEVELOPMENT I,35 SOUTHERN VILLAGE DR   ROXBORO NC,073,Person,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 376 , 376 ," $83,172.19 ",,
MEDICAID DIRECT,1518167113,GUARDIAN ANGELS ALTERNATIVE CARE IN,~,624 PARSLEY DR   HUBERT NC,067,Onslow,333300000X,Suppliers,Emergency Response System Companies,,1518167113,GUARDIAN ANGELS ALTERNATIVE CARE IN,624 PARSLEY DR   HUBERT NC,067,Onslow,333300000X,Suppliers,Emergency Response System Companies,, 54 , 489 , 489 ," $17,160.16 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518167725,"COSTANTINO, DAVID, ALAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518170620,"GREENE, KEVIN, GARY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1518171800,LIBERTY MEDICAL SPECIALTIES INC,LIBERTY MEDICAL SPECIALTIES INC,2224 S 17TH ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518171800,LIBERTY MEDICAL SPECIALTIES INC,2224 S 17TH ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 72 , 225 , 310 ," $14,591.01 ",,
MEDICAID DIRECT,1457386815,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS MAGNOLINA PLASTIC,391 SERPENTINE DR STE 250 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518172972,"BIRCHENOUGH, SHAWN, ARTHUR",391 SERPENTINE DR STE 250 SPARTANBURG SC,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518173681,INTERIM HEALTHCARE MORRIS GROUP INC,,704 PLAZA BLVD STE M KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1518173681,INTERIM HEALTHCARE MORRIS GROUP INC,704 PLAZA BLVD STE M KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 3,329 "," 3,329 "," $209,684.72 ",,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 25 , 38 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",120 HEALTHPLEX WAY   APEX NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 40 , 66 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 37 , 42 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 37 , 40 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518174747,"SOLOMON, HEMANT",210 ASHVILLE AVE   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 24 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518175058,"SIEGEL, JUDITH, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 61 , 83 , 125 ," $28,433.15 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518175058,"SIEGEL, JUDITH, ANN",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518175058,"SIEGEL, JUDITH, ANN",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518175058,"SIEGEL, JUDITH, ANN",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518176510,"MARGARON, FRANKLIN, CHARLES",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518178003,"GALLOWAY, GRACE, LIEM",~,4380 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1518178003,"GALLOWAY, GRACE, LIEM",4380 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518178003,"GALLOWAY, GRACE, LIEM",~,1781B S MAIN ST   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1518178003,"GALLOWAY, GRACE, LIEM",1781B S MAIN ST   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518178003,"GALLOWAY, GRACE, LIEM",~,1781B S MAIN ST   LAURINBURG NC,083,Scotland,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,1518178003,"GALLOWAY, GRACE, LIEM",1781B S MAIN ST   LAURINBURG NC,083,Scotland,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 33 , 90 , 218 ," $10,855.11 ",,
MEDICAID DIRECT,1346338159,CAROLINA FAMILY AND URGENT CARE CEN,~,,,Unknown,193400000X,Group,Single Specialty,,1518178003,"GALLOWAY, GRACE, LIEM",1781B S MAIN ST   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1518178003,"GALLOWAY, GRACE, LIEM",~,1781B S MAIN ST   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1518178003,"GALLOWAY, GRACE, LIEM",1781B S MAIN ST   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518178318,"BARR, JOHN, CARLO",3116 N DUKE ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518178318,"BARR, JOHN, CARLO",3643 N ROXBORO ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 17 , 22 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1518178318,"BARR, JOHN, CARLO",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1164799979,PRIVATE DIAGNOSTIC CLINIC PLLC,REGIONAL NEUROSUGERY,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518178318,"BARR, JOHN, CARLO",3643 N ROXBORO ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518178318,"BARR, JOHN, CARLO",10 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518178755,"YOUNG, TAMMY, LOUISE",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1518182005,T&C ROBINSON,ANGELS HOME HEALTH CARE,814 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,1518182005,T&C ROBINSON,814 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,#, 23 , 23 ," $14,352.00 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1518182138,"WITTSTEIN, JOCELYN, ROSS",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518182138,"WITTSTEIN, JOCELYN, ROSS",100 DUKE HEALTH   CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1518182138,"WITTSTEIN, JOCELYN, ROSS",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518182138,"WITTSTEIN, JOCELYN, ROSS",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1518182138,"WITTSTEIN, JOCELYN, ROSS",1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518183037,"STYNER, MAYA, SHALEV",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 11 , 15 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518183037,"STYNER, MAYA, SHALEV",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518183037,"STYNER, MAYA, SHALEV",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 16 , 17 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518183037,"STYNER, MAYA, SHALEV",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518184415,"CROUCHLEY, JILLIAN, LEIGH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 11 , 47 , 48 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518185552,"KALLIO, JENNIFER, KAY",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 32 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518188523,"WILLIAMS, CHRISTINE, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 91 , 92 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518191204,"BORUTA, MARY, KATHLEEN ROGERS",23 SUNNYBROOK RD STE 200 RALEIGH NC,092,Wake,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518191204,"BORUTA, MARY, KATHLEEN ROGERS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 27 , 45 , 55 ,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518191204,"BORUTA, MARY, KATHLEEN ROGERS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518191204,"BORUTA, MARY, KATHLEEN ROGERS",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518191204,"BORUTA, MARY, KATHLEEN ROGERS",9625 NORTHCROSS CENTER CT STE 102 HUNTERSVILLE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518191204,"BORUTA, MARY, KATHLEEN ROGERS",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 28 , 38 , 45 ,$#,,
MEDICAID DIRECT,1952611543,FAMILY FOOT AND ANKLE PHYSICIANS,FAMILY FOOT AND ANKLE PHYSICIANS,1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518191782,"CHEN, RICK, CHIEN AN",1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 71 , 202 , 294 ,$#,,
MEDICAID DIRECT,1952611543,FAMILY FOOT AND ANKLE PHYSICIANS,FAMILY FOOT AND ANKLE PHYSICIANS,1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518191782,"CHEN, RICK, CHIEN AN",1432 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 253 , 646 , 873 ," $15,482.87 ",,
MEDICAID DIRECT,1780637850,MIDWAY MEDICAL CENTER CANTON,MIDWAY MEDICAL CENTER,6750 CAROLINA BLVD   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1518192814,"RITTER, RHIANNA, KIRKPATRICK",6750 CAROLINA BLVD   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 34 , 71 ,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1518192897,"KALLMAN, THERESA, ANN",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,540 NEW WAVERLY PL   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518193838,"DOSS, LAURA, NASRALLAH",540 NEW WAVERLY PL   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518193838,"DOSS, LAURA, NASRALLAH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 76 , 103 , 185 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518193838,"DOSS, LAURA, NASRALLAH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 126 , 182 , 231 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518193838,"DOSS, LAURA, NASRALLAH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1518193838,"DOSS, LAURA, NASRALLAH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518193838,"DOSS, LAURA, NASRALLAH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518193838,"DOSS, LAURA, NASRALLAH",1821 HILLANDALE RD STE 25C DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 256 , 318 , 344 ,$#,,
MEDICAID DIRECT,1093790859,COUNTY OF IREDELL,IREDELL COUNTY HEALTH DEPARTMENT,318 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1518196849,"STRICKLAND, ROBIN, SUZANNE",318 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 347 , 440 ," 1,335 "," $74,278.86 ",,
MEDICAID DIRECT,1861826562,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518197086,"RAFIQUE, AMINA",101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518197086,"RAFIQUE, AMINA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518197086,"RAFIQUE, AMINA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518197086,"RAFIQUE, AMINA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518197458,CAROLINAS PHYSICIANS NETWORK INC,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,#,,,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518197458,CAROLINAS PHYSICIANS NETWORK INC,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518198969,"CATO, NADINE, CLAIRE",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 83 , 149 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518202068,"MCCULLOUGH, KATHLEEN, ROSE",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 19 , 46 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518202068,"MCCULLOUGH, KATHLEEN, ROSE",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 60 , 163 ,$#,,
MEDICAID DIRECT,1518202209,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 10157,1025 NC 24-87   CAMERON NC,043,Harnett,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1518202209,NORTH CAROLINA CVS PHARMACY LLC,1025 NC 24-87   CAMERON NC,043,Harnett,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1134714298,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PEDS SURGERY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518203017,"LINDHOLM, MOLLIE, JAIN OMARA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 28 , 39 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518203017,"LINDHOLM, MOLLIE, JAIN OMARA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 23 , 26 ,$#,,
MEDICAID DIRECT,1518203595,EHC CARES LLC,EXCELLENT HOME CARE,1135 FOUR LAKES DR STE H MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1518203595,EHC CARES LLC,1135 FOUR LAKES DR STE H MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 481 , 481 ," $32,722.33 ",,
MEDICAID DIRECT,1518203595,EHC CARES LLC,EXCELLENT HOME CARE,2008 MOORE RD STE B MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1518203595,EHC CARES LLC,2008 MOORE RD STE B MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 58 , 58 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518204478,"CAPOZZI, STEPHANIE, WEAST",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518204478,"CAPOZZI, STEPHANIE, WEAST",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518204478,"CAPOZZI, STEPHANIE, WEAST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518204478,"CAPOZZI, STEPHANIE, WEAST",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518206291,"DIAZ DE ARCE, MATTHEW, RYAN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518206291,"DIAZ DE ARCE, MATTHEW, RYAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518206291,"DIAZ DE ARCE, MATTHEW, RYAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518208958,"KEARNEY, VANESSA, LYNN",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 57 , 74 ,$#,,
MEDICAID DIRECT,1497713234,FORSYTH MEMORIAL HOSPITAL INC,Novant Health Mountainview Medical,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1518208958,"KEARNEY, VANESSA, LYNN",216 MOORE RD   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518209303,"PATEL, NISHITH, RAJESHBHAI",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518209303,"PATEL, NISHITH, RAJESHBHAI",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518209865,"SITLINGER, ANDREA, PHILLIPS",2301 ERWIN RD   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518209865,"SITLINGER, ANDREA, PHILLIPS",2400 PRATT ST NORTH PAVILION STE 1100 DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518209865,"SITLINGER, ANDREA, PHILLIPS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 18 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518209865,"SITLINGER, ANDREA, PHILLIPS",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518211481,"HUGHES, KATHLEEN, ANN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1518211481,"HUGHES, KATHLEEN, ANN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1518211481,"HUGHES, KATHLEEN, ANN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518211481,"HUGHES, KATHLEEN, ANN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518211481,"HUGHES, KATHLEEN, ANN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1518211481,"HUGHES, KATHLEEN, ANN",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518212679,"BACHABI, MALICK, VALERY",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 69 , 70 , 131 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518212679,"BACHABI, MALICK, VALERY",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518214071,"DODDAPANENI, SATYAJIT",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518214071,"DODDAPANENI, SATYAJIT",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 78 , 78 , 78 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518217199,"BUFFINGTON, CHRISTINA, KIMMEL",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518218684,"SAINE, TAMI, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 53 , 56 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518218684,"SAINE, TAMI, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 84 , 85 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518218684,"SAINE, TAMI, LYNN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518221472,"PANGLAO RAJAN, MARIA, GRACIA",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518221472,"PANGLAO RAJAN, MARIA, GRACIA",101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 20 , 47 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518223221,"HAMM, BRANDI, PAGE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional, 22 , 242 , 242 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518224617,"MYERS, DANIEL, LEWIS",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518224617,"MYERS, DANIEL, LEWIS",10479 N NC HIGHWAY 109 STE 107A WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 71 , 109 ,$#,,
MEDICAID DIRECT,1225475023,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH WALLBURG FAMILY MEDICINE,10479 N NC HIGHWAY 109 STE 107A WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1518224617,"MYERS, DANIEL, LEWIS",10479 N NC HIGHWAY 109 STE 107A WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518226786,"LAM, YEE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 112 , 205 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518226786,"LAM, YEE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 38 , 53 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1518226877,"WOOD, SALLY, DOWD",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 53 , 110 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518227255,"DISALVO, LINDA, ANNETTE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518227396,"MEDIKAYALA, SUSHMA",2809 MCLAMB PL   GOLDSBORO NC,096,Wayne,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 173 , 496 , 676 ," $19,542.56 ",,
MEDICAID DIRECT,1629415914,NORTH CAROLINA GROUP SERVICES PLLC,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1518227396,"MEDIKAYALA, SUSHMA",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114247822,EDWARD F SCAMMON DMD PA,~,115 SOUTHERN DUNES DR   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1518228311,"DENNISON, BERNARD, JAY",115 SOUTHERN DUNES DR   VASS NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 310 , 337 ," 1,270 "," $49,714.36 ",,
MEDICAID DIRECT,1427677624,NEW HOPE CLINIC INC,,201 W BOILING SPRING RD   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1518228451,"STANWICK, JULIE, ANN",201 W BOILING SPRING RD   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518229145,"MARTIN, CAMERON, MEADOW",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518229145,"MARTIN, CAMERON, MEADOW",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154563385,ST LUKES PHYSICIAN NETWORK INC,ST LUKES ORTHOPEDICS AND SPORTS MEDICINE,89 W MILLS ST   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1518229145,"MARTIN, CAMERON, MEADOW",89 W MILLS ST STE A COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 23 ,$#,,
MEDICAID DIRECT,1154563385,ST LUKES PHYSICIAN NETWORK INC,ST LUKES ORTHOPEDICS AND SPORTS MEDICINE,89 W MILLS ST   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1518229145,"MARTIN, CAMERON, MEADOW",101 HOSPITAL DR   COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518231547,UNITED SEATING AND MOBILITY LLC,NUMOTION,4347 STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518231547,UNITED SEATING AND MOBILITY LLC,4347 STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1518231547,UNITED SEATING AND MOBILITY LLC,NUMOTION,4347 STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518231547,UNITED SEATING AND MOBILITY LLC,4347 STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,040 "," 3,730 "," 8,741 "," $1,996,371.14 ",,
MEDICAID DIRECT,1518231547,UNITED SEATING AND MOBILITY LLC,NUMOTION,4347 STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1518231547,UNITED SEATING AND MOBILITY LLC,4347 STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 33 , 45 , 59 ," $67,513.70 ",,
MEDICAID DIRECT,1982270567,HOPE MEDICAL CLINIC PA,,3609 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1518235431,"GHEBREGZIABIHER, SOLOMON, TEWOLDE",3609 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 40 ,$#,,
MEDICAID DIRECT,1518238849,ALPHA HOME CARE SERVICES INC,Alpha Home Care Services Inc VI,105 OAKWOOD DR   WAKE FOREST NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518238849,ALPHA HOME CARE SERVICES INC,105 OAKWOOD DR   WAKE FOREST NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 781 , 781 ," $65,298.82 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518238989,"FELTS, DANA, SHUMATE",276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518238989,"FELTS, DANA, SHUMATE",276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518238989,"FELTS, DANA, SHUMATE",276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518238989,"FELTS, DANA, SHUMATE",276 OLD MOCKSVILLE RD STE 400 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821076589,EAST CAROLINA HEALTH HERITAGE INC,Vidant Family Medicine Pinetops,1473 NC HIGHWAY 42 43 W   PINETOPS NC,033,Edgecombe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1518239854,"EAVES, AUDREY, DENISE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518239854,"EAVES, AUDREY, DENISE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1518240423,"DENOYER, MICHAEL, THOMAS",6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1518240936,"MORSE, MELISSA, SUE",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 76 , 273 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518243328,"OSBOURN, KAITLIN, CLARK",10660 PARK RD STE 3400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 26 , 46 ,$#,,
MEDICAID DIRECT,1518244177,AVANT GARDE HOME CARE SERVICES,AVANT GARDE HOME CARE SERVICES,9700 RESEARCH DR STE 109 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1518244177,AVANT GARDE HOME CARE SERVICES,9700 RESEARCH DR STE 109 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 57 ," 11,239 "," 11,239 "," $816,311.40 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518245729,"HARTLEY, MEGAN, RENEE",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1518245729,"HARTLEY, MEGAN, RENEE",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 99 , 151 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518247733,"SHAH, SEJAL, S.",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518248004,"BUNN, KELLIE, ANN",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518248004,"BUNN, KELLIE, ANN",11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 24 , 24 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518248004,"BUNN, KELLIE, ANN",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518249689,"WOOD, JUSTIN, DAVID",10207 CERNY ST STE 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518249689,"WOOD, JUSTIN, DAVID",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518249689,"WOOD, JUSTIN, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518249689,"WOOD, JUSTIN, DAVID",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255627915,ANTONIO S BRAITHWAITE DDS MPH PA,SANFORD PEDIATRIC DENTISTRY,1013 SPRING LN   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1518251693,"KNOCKUM, BRANDON, MICHAEL",1013 SPRING LN   SANFORD NC,053,Lee,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 5,873 "," 7,837 "," 33,627 "," $1,153,136.79 ",,
MEDICAID DIRECT,1114406923,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH ORTHOPEDICS AND SPORTS MEDICINE,700 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1518252105,"PETTY, BENJAMIN, MARTIN",700 TILGHMAN DR   DUNN NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 54 , 90 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518253327,"ANDERSEN, WILLIAM, DONALD",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 28 , 29 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518253327,"ANDERSEN, WILLIAM, DONALD",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518253327,"ANDERSEN, WILLIAM, DONALD",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518253327,"ANDERSEN, WILLIAM, DONALD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 35 , 36 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518253327,"ANDERSEN, WILLIAM, DONALD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518253384,"DELUCCHI, JOHN, MICHAEL",150 FAIRVIEW RD STE 250 MOORESVILLE NC,049,Iredell,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1518254341,"BORING, TIFFANY, E",183 LEDFORD ST A AND B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1518254341,"BORING, TIFFANY, E",183 LEDFORD ST A AND B MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 13 , 13 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518255488,"COLLINS, MICHAEL, MERRITT",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 54 , 150 , 150 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518257849,"ROTHWELL, STEPHAN, MICHAEL",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 29 , 41 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518257849,"ROTHWELL, STEPHAN, MICHAEL",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518259092,"RAMESH, ATUL, KRISHNAN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518259977,"CHAUDHRY, HINA",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518259977,"CHAUDHRY, HINA",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518261155,"DONG, FAN",5826 SAMET DR STE 101 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 58 , 107 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1518261429,"MCCALL, TANYA, SUSANN",155 MEMORIAL DR EMERGENCY DEPT PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518261429,"MCCALL, TANYA, SUSANN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518261429,"MCCALL, TANYA, SUSANN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1518261429,"MCCALL, TANYA, SUSANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518261429,"MCCALL, TANYA, SUSANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518261429,"MCCALL, TANYA, SUSANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518265420,"MOELLER, BENJAMIN, JAMES",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 42 , 92 , 112 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518265420,"MOELLER, BENJAMIN, JAMES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518265420,"MOELLER, BENJAMIN, JAMES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518270867,"HALL, PHILIP, SCORZA",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518270867,"HALL, PHILIP, SCORZA",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 65 , 88 , 134 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518270867,"HALL, PHILIP, SCORZA",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1518270867,"HALL, PHILIP, SCORZA",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 62 , 87 , 137 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518270867,"HALL, PHILIP, SCORZA",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518270867,"HALL, PHILIP, SCORZA",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1518270867,"HALL, PHILIP, SCORZA",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518271279,"PRIESTLEY, YOS, MARIAM",2351 ERWIN RD   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1518272632,"BLACKMON, KATHERINE, THRUSH",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598101974,CAROLINA PAIN AND WEIGHT LOSS,~,131 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1518272707,"JOHNSON, KIMBERLY, LOUISE",131 WELTON WAY   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 379 , 565 ," $12,540.46 ",,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518279694,"HARRISON, MELODIE, CORNIQUE",7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518279694,"HARRISON, MELODIE, CORNIQUE",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 19 , 45 ,$#,,
MEDICAID DIRECT,1871052597,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KILDAIRE FARM ROAD,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518281187,"MANNAN, SINTHIA",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518282466,"LANGA, ALBERT, JOSEPH",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518282466,"LANGA, ALBERT, JOSEPH",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518282656,"YANG, MIN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518283373,"VIGELAND, CHRISTINE, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 16 , 36 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518283373,"VIGELAND, CHRISTINE, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 41 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518283373,"VIGELAND, CHRISTINE, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518283373,"VIGELAND, CHRISTINE, LEE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 27 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518284009,"BARTHEL, SHELBY, LAWRENCE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518284009,"BARTHEL, SHELBY, LAWRENCE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518284009,"BARTHEL, SHELBY, LAWRENCE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518284397,"DOSCHER, ASHLEY, KUKLENTZ",2720 SUNSET BLVD   WEST COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518285493,GRANVILLE HEALTH SYSTEM,GRANVILLE EMS,1040 COLLEGE ST   OXFORD NC,039,Granville,3416L0300X,Transportation Services,Ambulance,Land Transport,1518285493,GRANVILLE HEALTH SYSTEM,1040 COLLEGE ST   OXFORD NC,039,Granville,3416L0300X,Transportation Services,Ambulance,Land Transport, 537 , 931 ," 1,756 "," $23,939.50 ",,
MEDICAID DIRECT,1386206951,REX HOSPITAL INC,UNC REX GYNECOLOGIC ONCOLOGY,2901 BLUE RIDGE RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518286061,"CLARK, LESLIE, HORN",2901 BLUE RIDGE RD STE 200 RALEIGH NC,092,Wake,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 19 , 24 , 24 ,$#,,
MEDICAID DIRECT,1386206951,REX HOSPITAL INC,UNC REX GYNECOLOGIC ONCOLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518286061,"CLARK, LESLIE, HORN",2901 BLUE RIDGE RD STE 200 RALEIGH NC,092,Wake,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518286061,"CLARK, LESLIE, HORN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 34 , 63 , 68 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518286244,"KNIGHT, THOMAS, GREGORY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518286244,"KNIGHT, THOMAS, GREGORY",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518286244,"KNIGHT, THOMAS, GREGORY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518287291,"GALANG, ENRIQUE",4515 PREMIER DR   HIGH POINT NC,041,Guilford,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518287291,"GALANG, ENRIQUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 98 , 225 , 472 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518287580,"BROOKS, PATRICK, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 37 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,201 E GROVER ST FL 3 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1518288828,"CLOVER, CHARLES, ROUSE",1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518288828,"CLOVER, CHARLES, ROUSE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1518288828,"CLOVER, CHARLES, ROUSE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine, 83 , 132 , 171 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,201 E GROVER ST FL 3 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1518288828,"CLOVER, CHARLES, ROUSE",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208VP0014X,Allopathic & Osteopathic Physicians,Pain Medicine,Interventional Pain Medicine, 27 , 34 , 41 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518290378,"QUINTER, KIMBERLY, ANNE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1518290378,"QUINTER, KIMBERLY, ANNE",2760 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518290378,"QUINTER, KIMBERLY, ANNE",2760 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922003136,MITCHELL EYE CENTER,Mitchell Eye Center,515 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1518290659,"WOOLET, ANTHONY, JOEL",515 N SPENCE AVE   GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,, 31 , 33 , 38 ,$#,,
MEDICAID DIRECT,1790830487,CHILDRENS MEDICAL GROUP INC,SUFFOLK PEDIATRICS,1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518292127,"HERNANDEZ, DAPHNE, M.",1009 HILLPOINT BLVD N   SUFFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 17 ,$#,,
MEDICAID DIRECT,1245419845,CAROMONT MEDICAL GROUP INC,~,700 N MAIN ST   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1518292952,"BROWN, KYLE, DANIEL",700 N MAIN ST   STANLEY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 32 , 52 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518295559,"CULLY, JENNIFER, LYNN",712 VILLAGE RD STE 106 SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 40 , 78 ,$#,,
MEDICAID DIRECT,1710051123,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH OCEANSIDE FAMILY MEDICINE AND CONVEN,5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1518295559,"CULLY, JENNIFER, LYNN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518295559,"CULLY, JENNIFER, LYNN",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 96 , 203 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518300474,"HALL, CAROLE, NGANKEU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 71 , 71 ,$#,,
MEDICAID DIRECT,1235167800,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE BRIER CREEK,10208 CERNY ST STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518301571,"IRIZARRY, LAUREN, DELIA",10211 ALM ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 27 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",1030 SIENA DR   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518302769,"SWANEY, PAUL, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518303569,"MEREDITH, RICHARD, DANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518303981,"COCKBURN, STEPHEN, HARRISON",1730 KERNERSVILLE MEDICAL PKWY STE 203 KERNERSVILLE NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 98 , 147 , 222 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518303981,"COCKBURN, STEPHEN, HARRISON",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518304625,"MANOCHA, KEVIN, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 79 , 124 ,$#,,
MEDICAID DIRECT,1063077436,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR COMPLEX ARRHYTHMIA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518304625,"MANOCHA, KEVIN, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 19 , 44 , 66 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518304625,"MANOCHA, KEVIN, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 21 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518304625,"MANOCHA, KEVIN, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518304625,"MANOCHA, KEVIN, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518304625,"MANOCHA, KEVIN, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306828678,SOUTHEASTERN MEDICAL ONCOLOGY CENTE,SOUTHEASTERN MEDICAL ONCOLOGY CENTER,203 COX BLVD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1518304849,"SOCHAT, MATTHEW, MICHAEL",203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306828678,SOUTHEASTERN MEDICAL ONCOLOGY CENTE,SOUTHEASTERN MEDICAL ONCOLOGY CENTER,203 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1518304849,"SOCHAT, MATTHEW, MICHAEL",203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 468 ," 1,246 "," 4,820 "," $148,160.44 ",,
MEDICAID DIRECT,1518304849,"SOCHAT, MATTHEW, MICHAEL",,203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,1518304849,"SOCHAT, MATTHEW, MICHAEL",203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1881702595,"KASBARI, SAMER, SAMAAN",~,203 COX BLVD   GOLDSBORO NC,096,Wayne,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,1518304849,"SOCHAT, MATTHEW, MICHAEL",211 BEAMAN ST   CLINTON NC,082,Sampson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1518304898,"OANCEA, LYNDSAY, ALEXANDRA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518304898,"OANCEA, LYNDSAY, ALEXANDRA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1518304898,"OANCEA, LYNDSAY, ALEXANDRA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1518304898,"OANCEA, LYNDSAY, ALEXANDRA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1518307081,"COGGIN, ANDREW, DAVID",300 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 30 , 51 , 80 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518307255,"KUNEFF, RENEE, ANTOINETTE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 35 , 89 ,$#,,
MEDICAID DIRECT,1194842245,ALAMANCE FAMILY PRACTICE PLLC,ALAMANCE FAMILY PRACTICE PA,,,Unknown,193400000X,Group,Single Specialty,,1518308188,"LINDLEY, CHERYL, PAULETTE",3128 COMMERCE PL   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1700329497,PREFERRED PRIMARY CARE PLLC,,3128 COMMERCE PL   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1518308188,"LINDLEY, CHERYL, PAULETTE",3128 COMMERCE PL   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 86 , 330 , 754 ," $15,242.88 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 111 , 115 , 188 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 80 , 109 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518311844,"VERDE, AUDREY, ROSE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 210 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518312461,"O'FIELD, HEATHER, ASHLEY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 30 , 36 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 430 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518312461,"O'FIELD, HEATHER, ASHLEY",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518313824,"BLACK, MATTHEW, WILLIAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 59 , 87 , 91 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518315589,"HAUSLADEN, JORDAN, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518315589,"HAUSLADEN, JORDAN, LYNN",40 DUKE MEDICINE CIR CLINIC 2F 2G DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518317056,"YOHA, JOSEPH, AUGUST",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 113 , 186 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518317668,"HURST, KAITLYN, MARIE",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 41 , 60 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518317668,"HURST, KAITLYN, MARIE",12611 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518317668,"HURST, KAITLYN, MARIE",1450 MATTHEWS TOWNSHIP PKWY STE 170 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1770033763,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518317668,"HURST, KAITLYN, MARIE",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518320720,"MCMANIGLE, JOHN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518320720,"MCMANIGLE, JOHN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518320720,"MCMANIGLE, JOHN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 61 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518320720,"MCMANIGLE, JOHN, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518320761,"MORRIS, MICHAEL, DOUGLAS",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 34 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518320761,"MORRIS, MICHAEL, DOUGLAS",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 21 , 112 , 114 ," $14,929.50 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518322338,"SCOTT, JENNIFER, GRAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 18 , 18 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518323633,"WANG, XUEYANG, SARAH",10834 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518323633,"WANG, XUEYANG, SARAH",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#, 11 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518323633,"WANG, XUEYANG, SARAH",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 86 , 129 , 183 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518323633,"WANG, XUEYANG, SARAH",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518323633,"WANG, XUEYANG, SARAH",10834 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1518326743,"GIBSON, LARRY, RYAN",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 115 , 138 , 339 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518327022,"BAHERI, ALLEN, JUSTIN",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518327022,"BAHERI, ALLEN, JUSTIN",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 27 , 40 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518327022,"BAHERI, ALLEN, JUSTIN",134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578176723,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518327022,"BAHERI, ALLEN, JUSTIN",134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518328533,"MCKINNEY, AMY, ELIZABETH",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518328533,"MCKINNEY, AMY, ELIZABETH",83 CAVALIER DR STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518328533,"MCKINNEY, AMY, ELIZABETH",2305 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 424 , 424 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518328558,"STAMEY, MAELIA, MOLINA",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1114293818,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST EAR NOSE & THRO,1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518329341,"HOSHAL, STEVEN, GREGORY",1132 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 77 , 110 , 151 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 22 , 35 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518334994,"HAMMOND, LINDSAY, NICOLE",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1225 HARDING PL # 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518337203,"LAMBERT, ELEANOR, WEATHERSBEE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518337203,"LAMBERT, ELEANOR, WEATHERSBEE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518338631,"HARRIS, JULIENNE, SEWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518339696,PINK REGALIA LLC,,485 HENDERSONVILLE RD STE 3 ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518339696,PINK REGALIA LLC,485 HENDERSONVILLE RD STE 3 ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1518339902,"HUERTA, DUSTIN, RODOLFO",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518340314,"PATEL, SARAV",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 21 , 29 , 115 ," $12,138.07 ",,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518340314,"PATEL, SARAV",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 17 , 16 , 59 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518340314,"PATEL, SARAV",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,160 TURNBERRY WAY   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1518340314,"PATEL, SARAV",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518341866,"HALLETT, SARAH, ELLEN",7130 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 74 , 115 ,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",10 AVIEMORE DR   PINEHURST NC,063,Moore,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 14 , 33 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518344373,"HIGGINS, DOMINIQUE, MARIO OMAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 12 , 22 , 30 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518346105,"ABERNATHY, CHRISTOPHER, RYAN",8840 BLAKENEY PROFESSIONAL DR STE 102 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 14 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518346105,"ABERNATHY, CHRISTOPHER, RYAN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 18 , 23 , 72 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,1208 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518346105,"ABERNATHY, CHRISTOPHER, RYAN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,1208 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518346105,"ABERNATHY, CHRISTOPHER, RYAN",1208 MANN DR STE 100 MATTHEWS NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 35 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518346105,"ABERNATHY, CHRISTOPHER, RYAN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518346105,"ABERNATHY, CHRISTOPHER, RYAN",8840 BLAKENEY PROFESSIONAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 18 , 19 , 95 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1518347939,"DOAN, JOHN, MARK",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518348051,"ABDELMOUMEN, IMANE",1103 N ELM ST STE 300 GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518348051,"ABDELMOUMEN, IMANE",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 34 , 44 , 48 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518348051,"ABDELMOUMEN, IMANE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518348655,"DIBBLE, CHRISTOPHER, FRANCIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 32 , 46 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518348655,"DIBBLE, CHRISTOPHER, FRANCIS",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 14 , 16 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518349463,"YEAZELL, SHAWN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 132 , 235 , 445 ," $11,334.40 ",,
MEDICAID DIRECT,1124285515,SURGICENTER OF EASTERN CAROLINA,ECU HEALTH SURGICENTER,102 BETHESDA DR   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1518349463,"YEAZELL, SHAWN",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518349463,"YEAZELL, SHAWN",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518349463,"YEAZELL, SHAWN",503 BOWMAN GRAY DR   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518350271,"GANCHENKO, NATALIE, AVSYANIK",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518350271,"GANCHENKO, NATALIE, AVSYANIK",710 PARK CENTER DR STE 100 MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518350271,"GANCHENKO, NATALIE, AVSYANIK",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1518351105,"WELCH, ALLISON, STITSINGER",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518351493,"WILEY, LEE, ANGELO",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518351493,"WILEY, LEE, ANGELO",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 34 , 50 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518351493,"WILEY, LEE, ANGELO",13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 15 , 22 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,13532 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518351493,"WILEY, LEE, ANGELO",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518351493,"WILEY, LEE, ANGELO",10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518351493,"WILEY, LEE, ANGELO",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 19 , 25 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1518352020,"VENTO, FRANCIS, GEORGE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 55 , 86 ,$#,,
MEDICAID DIRECT,1164462586,EMERGENCY MEDICINE PHYSICIANS OF CR,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1518352756,"GRAY, ADAM, CLARKE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518353077,"NANDKEOLYAR, SHUKTIKA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 13 , 14 , 22 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518353077,"NANDKEOLYAR, SHUKTIKA",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518353077,"NANDKEOLYAR, SHUKTIKA",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 30 , 32 , 51 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518353077,"NANDKEOLYAR, SHUKTIKA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518353077,"NANDKEOLYAR, SHUKTIKA",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518353689,"SCHOENBACHLER, NICHOLAS, ROTH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518353689,"SCHOENBACHLER, NICHOLAS, ROTH",ONE MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518353689,"SCHOENBACHLER, NICHOLAS, ROTH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518353689,"SCHOENBACHLER, NICHOLAS, ROTH",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 33 , 31 , 38 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1518353689,"SCHOENBACHLER, NICHOLAS, ROTH",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 24 , 26 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1518353838,"WINDSOR, JENNIFER, LYNN",1340 PATTON AVE STE J ASHEVILLE NC,011,Buncombe,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1518353838,"WINDSOR, JENNIFER, LYNN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 18 , 30 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1518353838,"WINDSOR, JENNIFER, LYNN",31 CALIFORNIA AVE   MARION NC,059,McDowell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 25 , 35 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518354604,"DECOSTE, JENNIFER, MICHELLE",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518354604,"DECOSTE, JENNIFER, MICHELLE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 20 , 92 ,$#,,
MEDICAID DIRECT,1841635455,MCPC-11 LLC,FIRSTHEALTH BEHAVIORAL SERVICES,35 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1518354737,"SCRIBBEN, AMY, MARIE",35 MEMORIAL DR   PINEHURST NC,063,Moore,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518357383,"SCHECHNER, JOANNA",4207 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 16 , 18 , 18 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518357383,"SCHECHNER, JOANNA",4207 LAKE BOONE TRL   RALEIGH NC,092,Wake,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1518364827,WALGREEN CO,WALGREENS 15273,403 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1518364827,WALGREEN CO,403 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1518366293,"ALENTYEV, SERGEY, ANATOLIEVICH",315 MEDICAL PARK DR STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 37 , 37 ,$#,,
MEDICAID DIRECT,1194152777,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1518366293,"ALENTYEV, SERGEY, ANATOLIEVICH",441 MCALISTER RD STE 2200 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 78 , 85 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518370105,"LESHIKAR, AARON, JOHN",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 164 , 396 , 630 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518370105,"LESHIKAR, AARON, JOHN",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518370105,"LESHIKAR, AARON, JOHN",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518370899,"CARPENTER, JOSHUA, TRENT",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518373737,"MASSARWEH, KAMEL, MUNTHER",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1518374537,"ZANGHI, WILA",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518377589,"ROMINE, MARGARET, MONETTE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 42 , 44 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518377670,"TRISLER, DAVID, NATHAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518377670,"TRISLER, DAVID, NATHAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 86 , 127 , 135 ," $10,274.71 ",,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518377860,"WOMACK, JENNIFER, DOWNS",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 22 , 43 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518377860,"WOMACK, JENNIFER, DOWNS",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518378454,"ROSENKRANS, DANIEL, JAMES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 46 , 63 ,$#,,
MEDICAID DIRECT,1417615030,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,16645 BIRKDALE COMMONS PKWY STE 100A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518378496,"LEE, ERIC, KAI",16645 BIRKDALE COMMONS PKWY   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417615030,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,16645 BIRKDALE COMMONS PKWY STE 100A HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518378496,"LEE, ERIC, KAI",16645 BIRKDALE COMMONS PKWY STE 100A HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 19 , 20 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518378496,"LEE, ERIC, KAI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518378496,"LEE, ERIC, KAI",16645 BIRKDALE COMMONS PKWY   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 43 , 56 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518378710,"MARR, JOSHUA, ROBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 75 , 77 , 83 ,$#,,
MEDICAID DIRECT,1104388263,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - TAYLORSVILLE,50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518380344,"DUCKWORTH, JOY, MULLIS",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1932486503,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE TAYLORSVILLE,,,Unknown,193200000X,Group,Multi-Specialty,,1518380344,"DUCKWORTH, JOY, MULLIS",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518380500,"BLANCHARD, LAURA, DAIL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033150875,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - DIABETES AND ENDO,853 N CHURCH ST STE 720C SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518381482,"KELLAM, ELIZABETH, HUETHER",853 N CHURCH ST STE 720C SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1518382332,"MCMILLAN, KRISTEN, KRAUSE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1518382332,"MCMILLAN, KRISTEN, KRAUSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518382332,"MCMILLAN, KRISTEN, KRAUSE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 84 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518382332,"MCMILLAN, KRISTEN, KRAUSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518382332,"MCMILLAN, KRISTEN, KRAUSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518382332,"MCMILLAN, KRISTEN, KRAUSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518382332,"MCMILLAN, KRISTEN, KRAUSE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 52 , 52 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518384551,"HUTCHINS, ROBERT, PRESTON",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518385053,"LOVIN, DYLAN, COKER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#, 26 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518385053,"LOVIN, DYLAN, COKER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 48 , 97 , 128 ," $12,603.89 ",,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518385053,"LOVIN, DYLAN, COKER",1237 HARDING PL   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 39 , 70 , 121 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518385053,"LOVIN, DYLAN, COKER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518386457,"YALAMANCHILI, SILPA",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1518386457,"YALAMANCHILI, SILPA",6715 MCCRIMMON PKWY STE 201 CARY NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518386457,"YALAMANCHILI, SILPA",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 20 , 22 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1518386457,"YALAMANCHILI, SILPA",781 AVENT FERRY RD STE 204 HOLLY SPRINGS NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518387885,"NUSSBAUM, CHRISTINA, LYNNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 59 , 59 , 60 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518387885,"NUSSBAUM, CHRISTINA, LYNNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518387885,"NUSSBAUM, CHRISTINA, LYNNE",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518387992,"JOHNSTON, KENZIE, JANE BROWN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518387992,"JOHNSTON, KENZIE, JANE BROWN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 33 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518387992,"JOHNSTON, KENZIE, JANE BROWN",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720793094,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY ORTHOPEDICS AND SPORTS MEDICINE,1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518388370,"GRADY BROWN, AVERI, JORDAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 25 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518390632,"HICKS, SAMANTHA, BLAKE",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1588178370,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH CABARRUS TRANSITION SERVICES,200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518390632,"HICKS, SAMANTHA, BLAKE",200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 18 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518390632,"HICKS, SAMANTHA, BLAKE",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518390632,"HICKS, SAMANTHA, BLAKE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 44 , 48 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518390632,"HICKS, SAMANTHA, BLAKE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518390632,"HICKS, SAMANTHA, BLAKE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1518390632,"HICKS, SAMANTHA, BLAKE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518391184,"MURPHY, KATE, MARIE",1311 E MILLBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1518391184,"MURPHY, KATE, MARIE",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518391184,"MURPHY, KATE, MARIE",1500 GARNER RD STE A RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518391184,"MURPHY, KATE, MARIE",1500 GARNER RD STE A RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518391184,"MURPHY, KATE, MARIE",1500 GARNER RD STE A RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1518393768,"ALVIN, MATTHEW, DAVID",2134 14TH AVENUE CIR NW STE D HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 14 , 16 ,$#,,
MEDICAID DIRECT,1962042416,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PEDIATRIC VIRTUAL VISIT,2709 WATER RIDGE PKWY STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518394527,"LYNCH, JESSICA, ANDREA",2709 WATER RIDGE PKWY STE 500 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1285995415,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518394527,"LYNCH, JESSICA, ANDREA",6025 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518394527,"LYNCH, JESSICA, ANDREA",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 72 , 83 , 140 ,$#,,
MEDICAID DIRECT,1841611530,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS URGENT CARE,3193 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518394527,"LYNCH, JESSICA, ANDREA",3193 W HIGHWAY 74   MONROE NC,090,Union,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1043446966,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,1316 PATTON AVE STE D ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518396084,"CARTER, ALISHA, SHANELL",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114259280,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,1314 PATTON AVE STE F ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518396084,"CARTER, ALISHA, SHANELL",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669803078,FAMILY PRESERVATION SERVICES OF NC,CLARVIDA,1340 PATTON AVE STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518396084,"CARTER, ALISHA, SHANELL",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518397470,"FERRELL, RACHEL, ELIZABETH",211 VIRGINIA RD   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518397470,"FERRELL, RACHEL, ELIZABETH",211 VIRGINIA RD   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 37 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518398981,"DAVIS, MELISSA, COOK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518398981,"DAVIS, MELISSA, COOK",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 ,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518398981,"DAVIS, MELISSA, COOK",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 78 , 79 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518405844,"KRAPFEL, TIFFANY, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518406198,"TURNER, MEGAN, AMANDA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1518406354,"SANDERS, JENNIFER, DIANE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861456691,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518407402,"WATTS, KAYLA, LOUSIE",1901 BRUNSWICK AVE STE 240 CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1922048313,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518407402,"WATTS, KAYLA, LOUSIE",1901 BRUNSWICK AVE STE 240 CHARLOTTE NC,060,Mecklenburg,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 26 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518410786,"LLOYD ROTHROCK, JESSICA, HOPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518410786,"LLOYD ROTHROCK, JESSICA, HOPE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518410786,"LLOYD ROTHROCK, JESSICA, HOPE",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518410786,"LLOYD ROTHROCK, JESSICA, HOPE",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518411982,"EVANGELISTA, COURTNEY, MANION",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 24 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518412865,"WARREN, SARAH, NICOLE",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518413830,"TAYLOR, ARTHUR, CANNING",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518413830,"TAYLOR, ARTHUR, CANNING",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 31 , 31 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518413830,"TAYLOR, ARTHUR, CANNING",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518415173,"HARDY, MARGARET, ELLEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518420710,"CAI, ANGELA, RUOHONG",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 11 , 39 , 39 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518420710,"CAI, ANGELA, RUOHONG",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518420710,"CAI, ANGELA, RUOHONG",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518420710,"CAI, ANGELA, RUOHONG",330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1821045071,STROUD CHIROPRACTIC PLLC,STROUD CHIROPRACTIC PLLC,3204 ARCHDALE RD   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1518422419,"MARTIN, BROOKE, STROUD",3204 ARCHDALE RD   ARCHDALE NC,076,Randolph,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518425016,"JORDAN, MOLLY, ELLEN RUSH",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 37 , 37 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 43 , 43 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,2533 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 29 , 29 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",218 LAUREL CREEK CT   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 33 , 33 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,3864 SWEETEN CREEK RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,417 CLOVERDALE RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",811 SNOWBIRD RD   ROBBINSVILLE NC,038,Graham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,417 CLOVERDALE RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",417 CLOVERDALE RD   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 88 , 88 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518425149,"WITTY, DAVID, WAYNE",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 35 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518425867,"CAUSEY, MICHAEL, WILLIAM",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518425867,"CAUSEY, MICHAEL, WILLIAM",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518425867,"CAUSEY, MICHAEL, WILLIAM",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518425867,"CAUSEY, MICHAEL, WILLIAM",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1518427426,"HOWELL, NATHAN, ANDREW",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518427657,"BANDARAGE, DINETH, MARLON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518428200,"BLUE, OMOYEMEN, OSIWI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518428200,"BLUE, OMOYEMEN, OSIWI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518428200,"BLUE, OMOYEMEN, OSIWI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518428200,"BLUE, OMOYEMEN, OSIWI",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518428200,"BLUE, OMOYEMEN, OSIWI",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518428200,"BLUE, OMOYEMEN, OSIWI",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518428242,"RABINOVICH, ALFRED, GABRIAL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518428242,"RABINOVICH, ALFRED, GABRIAL",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 47 , 86 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518428242,"RABINOVICH, ALFRED, GABRIAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 17 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518428242,"RABINOVICH, ALFRED, GABRIAL",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518428242,"RABINOVICH, ALFRED, GABRIAL",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 24 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518428457,"PACKER, WILLIAM, LEWIS",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518428457,"PACKER, WILLIAM, LEWIS",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518428457,"PACKER, WILLIAM, LEWIS",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 45 , 107 , 107 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518428457,"PACKER, WILLIAM, LEWIS",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 42 , 100 , 100 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518428457,"PACKER, WILLIAM, LEWIS",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518428457,"PACKER, WILLIAM, LEWIS",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518429372,"HOLTEL, MASON, SCOTT",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 21 , 47 , 87 ,$#,,
MEDICAID DIRECT,1134226301,CAPE FEAR PHYSICAL MEDICINE AND REH,CAPE FEAR PHYSICAL MEDICINE AND REHAB ASSOCIATES P,1540 PURDUE DR STE 200 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1518430974,"SKINNER, HEATHER, LYN",1540 PURDUE DR STE 200 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 35 , 35 ,$#,,
MEDICAID DIRECT,1073503470,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF FAYETTEVILLE,5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1518430974,"SKINNER, HEATHER, LYN",5085 MORGANTON RD STE 100 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 21 ,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518433796,"WALTERS, KELCI, BETH",7808 S TRYON ST STE D CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518435858,"MENDAY, DANIEL, SCOTT",110 KILDAIRE PARK DR   CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518435858,"MENDAY, DANIEL, SCOTT",110 KILDAIRE PARK DR   CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1467947127,DLP MARIA PARHAM PHYSICIAN PRACTICE,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1518438969,"HUFFMAN-HALL, JIMMENA, KAMIL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1467947127,DLP MARIA PARHAM PHYSICIAN PRACTICE,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1518438969,"HUFFMAN-HALL, JIMMENA, KAMIL",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518448190,"HUGGINS, DIANA, JOHNSON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1518448190,"HUGGINS, DIANA, JOHNSON",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518448190,"HUGGINS, DIANA, JOHNSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518450402,"SCOMA, SAMUEL, LOUIS",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790003580,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OB,5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518452101,"INAN, KATHRYN, GARREN",5727 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518452101,"INAN, KATHRYN, GARREN",5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518452101,"INAN, KATHRYN, GARREN",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 14 , 18 , 22 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1518453661,"WALTERS, ELIZABETH, ONERVA MILLER",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518454073,"MILLER, ANDREW, KIPLING",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 30 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518454073,"MILLER, ANDREW, KIPLING",5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518457373,"SINNWELL, JOSEPH, GLENN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 39 , 65 , 80 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518457506,"HALABY, NICHOLAS",1333 S DICKINSON DR 140 A & B & C LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 43 , 120 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518457506,"HALABY, NICHOLAS",1333 S DICKINSON DR   LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 62 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518457506,"HALABY, NICHOLAS",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 23 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518457886,"BRANNON, LAUREN, MILBYDANIEL",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932137080,NORTHCROSS FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE NORTHCROSS FAMILY MEDIC,9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518457886,"BRANNON, LAUREN, MILBYDANIEL",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 18 , 30 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518457886,"BRANNON, LAUREN, MILBYDANIEL",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518457886,"BRANNON, LAUREN, MILBYDANIEL",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518457886,"BRANNON, LAUREN, MILBYDANIEL",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518459312,"RIBEIRO CAMARGO, CARLOS, HENRIQUE",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 126 , 138 , 237 ," $28,131.70 ",,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518459312,"RIBEIRO CAMARGO, CARLOS, HENRIQUE",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,CB #7450 UNC SCHOOL OF DENTISTRY CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1518459312,"RIBEIRO CAMARGO, CARLOS, HENRIQUE",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518460922,"BOSS, LAUREN, CHAZNEY",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1407133069,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE NORTHEAST HICKORY,2365 SPRINGS RD NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518461151,"HATHARASINGHE, REBECCA, HILARY-LAURINE",2365 SPRINGS RD NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518461151,"HATHARASINGHE, REBECCA, HILARY-LAURINE",2365 SPRINGS RD NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518461284,"OLMSTED, RICHARD, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518461284,"OLMSTED, RICHARD, EDWARD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518461284,"OLMSTED, RICHARD, EDWARD",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518461284,"OLMSTED, RICHARD, EDWARD",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 22 , 34 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518461540,"ROACH, CHRISANNE, GENNILLE",1140 CARTHAGE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,10030 GREEN LEVEL CHURCH RD STE 808 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518461540,"ROACH, CHRISANNE, GENNILLE",1140 CARTHAGE ST   SANFORD NC,053,Lee,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1518461540,"ROACH, CHRISANNE, GENNILLE",781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518461557,"WATTERSON, SHANNON, ASHLEY",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518461557,"WATTERSON, SHANNON, ASHLEY",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518461557,"WATTERSON, SHANNON, ASHLEY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518461557,"WATTERSON, SHANNON, ASHLEY",10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518461615,"GALLION, LAUREN, MILEY",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518461656,"LANDON, JONDAVID, DIMMIG",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1518461805,"HANNAFORD, STEPHEN, ROBERT",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1518461805,"HANNAFORD, STEPHEN, ROBERT",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 65 , 66 , 71 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1518461805,"HANNAFORD, STEPHEN, ROBERT",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 38 , 38 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1518463991,"FLAMING, ZACHARY, ENNS",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1518463991,"FLAMING, ZACHARY, ENNS",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1518463991,"FLAMING, ZACHARY, ENNS",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1518463991,"FLAMING, ZACHARY, ENNS",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1518463991,"FLAMING, ZACHARY, ENNS",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1518463991,"FLAMING, ZACHARY, ENNS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 82 , 89 , 103 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518463991,"FLAMING, ZACHARY, ENNS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 62 , 73 ,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,10901 WORLD TRADE BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518464098,"LE, THANH TAM",3019 FALSTAFF RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 146 , 204 , 206 ," $20,730.30 ",,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,4024 STIRRUP CREEK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518464098,"LE, THANH TAM",3019 FALSTAFF RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 68 , 103 , 103 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518468784,"LANIER, VALERIE, ROBERTSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518468784,"LANIER, VALERIE, ROBERTSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518472976,"VAN HOOSE, JONATHAN, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518474543,CARE INNOVATIONS OF NORTH CAROLINA,,2409 HORTON RD   KNIGHTDALE NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518474543,CARE INNOVATIONS OF NORTH CAROLINA,2409 HORTON RD   KNIGHTDALE NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,293 "," 1,345 "," $109,044.60 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518475763,"NOWAK, SARAH, MICHELE",104 POMONA DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 42 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518475763,"NOWAK, SARAH, MICHELE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 20 , 20 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1518477694,"CANCHARI AMES, RAUL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518477694,"CANCHARI AMES, RAUL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 21 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518477694,"CANCHARI AMES, RAUL",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730367467,HOSPICE & PALLIATIVE CARECENTER,TRELLIS SUPPORTIVE CARE,101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518479351,"PRICE, JENNIFER, C.",101 HOSPICE LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518481605,"SEGER, BRADLEY, JOSEPH",4515 PREMIER DR   HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1528363868,CHARLOTTE COMMUNITY HEALTH CLINIC I,CHARLOTTE COMMUNITY HEALTH CLINIC INC,8401 MEDICAL PLAZA DR STE 300 CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518482710,"TAH, RAYMOND, TANWANI",5301 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518483783,"BRASWELL, TROY, SCOT",161 WALKER ST   COLUMBUS NC,075,Polk,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health, 15 , 59 , 59 ," $13,988.20 ",,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518483783,"BRASWELL, TROY, SCOT",146 NESBITT RDG   LAKE LURE NC,081,Rutherford,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1922661750,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA INTEGRATED MEDICINE - STATESVILLE,1703 DAVIE AVE   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518483890,"EDWARDS, AMANDA, ELIZABETH",1703 DAVIE AVE   STATESVILLE NC,049,Iredell,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1619438942,GASTON FAMILY HEALTH SERVICES INC,~,810 HUNSUCKER DR NE   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518483890,"EDWARDS, AMANDA, ELIZABETH",409 S OAKLAND ST   GASTONIA NC,036,Gaston,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1619438942,GASTON FAMILY HEALTH SERVICES INC,~,810 HUNSUCKER DR NE   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518483890,"EDWARDS, AMANDA, ELIZABETH",810 HUNSUCKER DR NE   CONOVER NC,018,Catawba,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1518484138,"BARTON, SAMANTHA, BONHAM",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518484138,"BARTON, SAMANTHA, BONHAM",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 34 ,$#,,
MEDICAID DIRECT,1518484617,"RONEY, JENNA, LYNN",,2603 HOLLY HILL ST   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1518484617,"RONEY, JENNA, LYNN",2603 HOLLY HILL ST   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 16 , 32 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1518484617,"RONEY, JENNA, LYNN",2603 HOLLY HILL ST   BURLINGTON NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1518484617,"RONEY, JENNA, LYNN",220 FOUST ST STE C ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093219370,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PRIMARY CARE - A,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1518485333,"KRUPPENBACH, KATHERINE, HALL",223 W WARD ST STE B ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518487198,"HOSHAL, GILLIAN, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 40 , 41 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518487198,"HOSHAL, GILLIAN, LEIGH",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1518487701,"ZABEL, ANDREW, DAVID LAWRENCE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1518487701,"ZABEL, ANDREW, DAVID LAWRENCE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518487776,"BLOCKER, ANDREW, WILTON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518487776,"BLOCKER, ANDREW, WILTON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518487776,"BLOCKER, ANDREW, WILTON",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518490523,"LAMBERT, ALLISON, MAE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518490911,"MAHARREY, PHILLIP, BRANDON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 17 , 32 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1518490911,"MAHARREY, PHILLIP, BRANDON",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1700317096,MOSES CONE PHYSICIAN SERVICES INC,ROCKINGHAM SURGICAL ASSOCIATES,1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518491810,"PAPPAYLIOU, CATHERINE, ANNE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 16 , 22 ,$#,,
MEDICAID DIRECT,1700317096,MOSES CONE PHYSICIAN SERVICES INC,ROCKINGHAM SURGICAL ASSOCIATES,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518491810,"PAPPAYLIOU, CATHERINE, ANNE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700317096,MOSES CONE PHYSICIAN SERVICES INC,ROCKINGHAM SURGICAL ASSOCIATES,1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518491810,"PAPPAYLIOU, CATHERINE, ANNE",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 22 , 23 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518491927,"ATKINSON, WENDY, LAURA",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 32 , 97 , 97 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1518493980,"MENDOZA, JOSE, LUIS",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,105 N CRUTCHFIELD ST   DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1518493980,"MENDOZA, JOSE, LUIS",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1518493980,"MENDOZA, JOSE, LUIS",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 66 , 145 , 442 ,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1518494236,"LADERIAN, BEHNAM",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 71 , 112 , 137 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518498005,"LANEAVE, DARIAN, MAURICE",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 56 , 70 , 98 ," $11,439.29 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518498005,"LANEAVE, DARIAN, MAURICE",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1518498153,"DAFFRON, SARA, BEVERLY",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 67 , 133 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518498153,"DAFFRON, SARA, BEVERLY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518498872,"CALLESE, OLIVIA, HOSTETTER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518498872,"CALLESE, OLIVIA, HOSTETTER",1233 THE PLZ   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518498872,"CALLESE, OLIVIA, HOSTETTER",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518498872,"CALLESE, OLIVIA, HOSTETTER",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518498872,"CALLESE, OLIVIA, HOSTETTER",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518499490,"SHERZOY, SHEILA, SHERZAI",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518499490,"SHERZOY, SHEILA, SHERZAI",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518499490,"SHERZOY, SHEILA, SHERZAI",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518500461,"SWINTOSKY, ERIKA, ANDREJA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 132 , 144 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518500461,"SWINTOSKY, ERIKA, ANDREJA",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518502103,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,560 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518502103,HIGH COUNTRY COMMUNITY HEALTH,560 MALCOLM BLVD   CONNELLY SPG NC,012,Burke,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 153 , 544 , 554 ," $61,905.93 ",,
MEDICAID DIRECT,1366047748,TIGHT LINES FAMILY MEDICINE PA,,1902 MEETING CT   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518503168,"KLEISCH, KIMBERLY, ANNE",1902 MEETING CT   WILMINGTON NC,065,New Hanover,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518506187,"HOLIEN, DYLAN, STEVEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518508910,"SMITH, CARISSA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518508910,"SMITH, CARISSA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518511625,"CLAPP, AMBER, DAWN",604 W MAIN ST   JAMESTOWN NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518512821,"FOSTER, ASHLEY, BARRETT",3311 BEAM RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1518514025,"MONTE-PARKER, ANNE, MARIE",501 MAIN ST   GATESVILLE NC,037,Gates,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1437181914,AULANDER MEDICAL PRACTICE PA,~,114 HOLLOWELL RD   AULANDER NC,008,Bertie,193400000X,Group,Single Specialty,,1518514025,"MONTE-PARKER, ANNE, MARIE",501 MAIN ST   GATESVILLE NC,037,Gates,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 30 , 69 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1518514025,"MONTE-PARKER, ANNE, MARIE",915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 88 , 319 , 496 ,$#,,
MEDICAID DIRECT,1962941773,DLP FRYE MEDICAL GROUP,FRYECARE URGENT CARE,1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1518514025,"MONTE-PARKER, ANNE, MARIE",1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518516244,"TASTAD, LAURA, KATHRYN",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518516244,"TASTAD, LAURA, KATHRYN",306 WESTWOOD AVE STE 401 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 55 , 55 ,$#,,
MEDICAID DIRECT,1518517747,MS ENHANCEMENT LLC,,702 N PERSON ST   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1518517747,MS ENHANCEMENT LLC,702 N PERSON ST   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,506 "," 2,506 "," $212,918.19 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518519388,"MAYO, CARRIE, STEPHENS",815 BROAD ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518519388,"MAYO, CARRIE, STEPHENS",401 N DRIVER ST STE 1106 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518519388,"MAYO, CARRIE, STEPHENS",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1518519719,"MERCER, LAURA, YVETTE",1915 W PARK DR STE 104 N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 90 , 93 , 253 ," $10,642.29 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518520238,"JOHNSON, MALLORY, BROOKE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518522010,"HUMMEL, BRIAN, ROBERT",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518522010,"HUMMEL, BRIAN, ROBERT",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518522010,"HUMMEL, BRIAN, ROBERT",5815 BLAKENEY PARK DR STE 200B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 35 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518522127,"KAHNG, ANDREW, SUGKYUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1518522986,"THOMAS, SETH, LOWELL",403 FAIRVIEW ST   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 210 , 502 ,$#,,
MEDICAID DIRECT,1821553637,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1518525013,"DAVIS, ELIZABETH",235 HARVEY ST   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821553637,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1518525401,"VU, NICOLAS",235 HARVEY ST   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518525484,"HENDREN, KALEAH, LOWE",101 WILKESBORO ST STE B MOCKSVILLE NC,030,Davie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1497139398,IREDELL PHYSICIAN NETWORK,HARMONY MEDICAL CARE,3210 HARMONY HWY   HARMONY NC,049,Iredell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1518525484,"HENDREN, KALEAH, LOWE",510 N MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1124402946,IREDELL PHYSICIAN NETWORK,FAMILY CARE CENTER,1668 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1518525484,"HENDREN, KALEAH, LOWE",510 N MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518525484,"HENDREN, KALEAH, LOWE",510 N MAIN ST   TROUTMAN NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 67 , 94 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518527266,"PODOLAK, JESSICA, MARIE",1420 E FRANKLIN ST   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 48 , 98 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518527654,"SELVAGGIO, JESSICA, LOUISE",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 19 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518527654,"SELVAGGIO, JESSICA, LOUISE",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518531730,"EDICK, CORRINE, ELIZABETH",4654 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518531912,"DESIN, BAILEY, GRACE",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 170 , 170 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518531912,"DESIN, BAILEY, GRACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518531912,"DESIN, BAILEY, GRACE",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518531912,"DESIN, BAILEY, GRACE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1518532837,"LEEVY-JOHNSON, BROOKE, ANYA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518534288,"LY, KAYTLYN, ALYSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 68 , 69 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518535566,"JHA, PANAV, ARJUN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 26 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518535566,"JHA, PANAV, ARJUN",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1518537240,"GODFREY, ASHLEY, NOEL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518537240,"GODFREY, ASHLEY, NOEL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1518537240,"GODFREY, ASHLEY, NOEL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1518537240,"GODFREY, ASHLEY, NOEL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518537240,"GODFREY, ASHLEY, NOEL",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518539675,"ZORIN, ANDREY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518539675,"ZORIN, ANDREY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518539675,"ZORIN, ANDREY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518539691,"BEAL, NICOLE, METCALF",1560 UNION RD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 53 ,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518543305,"GLORIA, BROOKE, ANN",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 22 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518546423,"SERAFIN MOLINA, KAROL, LILI",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1518546423,"SERAFIN MOLINA, KAROL, LILI",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 29 ,$#,,
MEDICAID DIRECT,1518548494,A TRUE VISION HOME HEALTH CARE LLC,,129 N BEAUMONT AVE   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1518548494,A TRUE VISION HOME HEALTH CARE LLC,129 N BEAUMONT AVE   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,#, 543 , 543 ," $67,753.28 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1518548528,"HENDERSON, KELLY, STEVENS",1 SAINT DUNSTANS RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1518548528,"HENDERSON, KELLY, STEVENS",35 FACILITY DR   CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 43 , 56 ,$#,,
MEDICAID DIRECT,1518549393,IREDELL PHYSICIAN NETWORK,IREDELL SURGERY AT MOORESVILLE,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1518549393,IREDELL PHYSICIAN NETWORK,653 BLUEFIELD RD STE D MOORESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518549500,"WILLIAMS, HANNAH, WIKOFF",1920 W 1ST ST   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 46 , 70 ,$#,,
MEDICAID DIRECT,1568082212,KIDZCARE PEDIATRICS PC,,416 MCCULLOUGH DR STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518550326,"COGGINS, BRITTANY, CAMILLE",416 MCCULLOUGH DR STE 140 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 91 , 226 ,$#,,
MEDICAID DIRECT,1821419508,KIDZCARE PEDIATRICS PC,~,5244B N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518550326,"COGGINS, BRITTANY, CAMILLE",5244B N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518551357,MIRACLES OF LOVE HOME CARE LL,,714A 1/2 W VERNON AVE   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1518551357,MIRACLES OF LOVE HOME CARE LL,714A 1/2 W VERNON AVE   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,687 "," 2,687 "," $167,896.32 ",,
MEDICAID DIRECT,1780004556,MOSES CONE PHYSICIAN SERVICES INC,REIDSVILLE ENDOCRINOLOGY ASSOCIATES,1107 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518552090,"REARDON, WHITNEY, JONES",1107 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 112 , 205 , 389 ,$#,,
MEDICAID DIRECT,1780004556,MOSES CONE PHYSICIAN SERVICES INC,REIDSVILLE ENDOCRINOLOGY ASSOCIATES,1107 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518552090,"REARDON, WHITNEY, JONES",1107 S MAIN ST   REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 60 , 63 , 103 ,$#,,
MEDICAID DIRECT,1184921843,DUNN MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-DUNN,803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1518554617,"FUBARA, TAIWO, ADEBOLA",803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 156 , 258 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518554617,"FUBARA, TAIWO, ADEBOLA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518556240,"PERRIN, KERRY, ANNE",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518556240,"PERRIN, KERRY, ANNE",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518561703,"CAVANAUGH, BAILEY, JANEAN",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 44 , 85 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518561703,"CAVANAUGH, BAILEY, JANEAN",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 27 ,$#,,
MEDICAID DIRECT,1477589158,EASTRIDGE FAMILY MEDICINE,ATRIUM HEALTH PRIMARY CARE EASTRIDGE FAMILY MEDICI,1896 REMOUNT RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1518561703,"CAVANAUGH, BAILEY, JANEAN",1896 REMOUNT RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 81 , 104 , 194 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518564012,"PEYTON, LAUREN, BRIANNE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 19 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518564012,"PEYTON, LAUREN, BRIANNE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518564012,"PEYTON, LAUREN, BRIANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 70 , 74 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518564012,"PEYTON, LAUREN, BRIANNE",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518564012,"PEYTON, LAUREN, BRIANNE",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518564012,"PEYTON, LAUREN, BRIANNE",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1518564012,"PEYTON, LAUREN, BRIANNE",507 E FREMONT ST   BURGAW NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1518568013,"GWYN, ASHLEY, NICOLE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 34 , 34 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518568013,"GWYN, ASHLEY, NICOLE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184669053,SOUTHEASTERN MEDICAL GROUP PC,,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1518568013,"GWYN, ASHLEY, NICOLE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1518568013,"GWYN, ASHLEY, NICOLE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 63 , 63 ,$#,,
MEDICAID DIRECT,1518570514,ORICH HOME CARE LLC,,2609 ATLANTIC AVE STE 201B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1518570514,ORICH HOME CARE LLC,2609 ATLANTIC AVE STE 201B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 461 , 461 ," $43,089.85 ",,
MEDICAID DIRECT,1932745197,UNIVERSITY OF NORTH CAROLINA HOSPIT,UNC TRANSPLANT SERVICES,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518577782,"FREEMAN, JOHN, TAYLOR",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518577832,"MCCAIN, LEAH, MARIE",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518577832,"MCCAIN, LEAH, MARIE",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1518581974,"BRIDGES, ERIN, MICHELLE",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 89 , 89 ,$#,,
MEDICAID DIRECT,1366088957,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT NORTH DAVIE MIDDLE,497 FARMINGTON RD   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518582659,"HUMPHREY, LAURA, SUSAN",497 FARMINGTON RD   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1194343335,ERIC SEDERS DDS PLLC,SOUND DENTAL ASSOCIATES,306 PENNY LN   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1518582709,"SEDERS, ERIC, FRANKLIN",3110 ARENDELL ST STE 3 MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice," 2,065 "," 4,061 "," 17,106 "," $934,318.00 ",,
MEDICAID DIRECT,1518582709,"SEDERS, ERIC, FRANKLIN",,3110 ARENDELL ST STE 3 MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice,1518582709,"SEDERS, ERIC, FRANKLIN",3110 ARENDELL ST STE 3 MOREHEAD CITY NC,016,Carteret,1223G0001X,Dental Providers,Dentist,General Practice, 75 , 89 , 276 ," $11,178.57 ",,
MEDICAID DIRECT,1518584283,EVERGREEN CHOICE CARE SERVICES INC,~,8470 GARVEY DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1518584283,EVERGREEN CHOICE CARE SERVICES INC,8470 GARVEY DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 472 , 472 ," $33,908.56 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518584408,"AHMED, SARAH",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 64 , 65 ,$#,,
MEDICAID DIRECT,1326447913,NUTRITION HEALTHWORKS LLC,,172 WILLIAMSON RD UNIT 5205 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1518585645,"CREECH, MARY, FRANCES",1603 HILLSBOROUGH ST   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518587336,"GIL, NATALIA",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518588409,"DANIEL, KRISTIN, LEIGH",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 50 , 59 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1518591031,"EDGE, BRADY, ALAN",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1530 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1518593219,"BETHUNE, JOHN, MARVIN",1530 PROVIDENCE RD S   WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 27 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518593219,"BETHUNE, JOHN, MARVIN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518593219,"BETHUNE, JOHN, MARVIN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518594886,"MICHEL, MONIQUE, RENEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 70 , 72 , 96 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518594886,"MICHEL, MONIQUE, RENEE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 49 , 72 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1518596071,"AWODIYA, OYINKANSOLA, CHELSEA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 45 , 45 ,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518596402,"HUNTER, MARY, ELIZABETH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518596402,"HUNTER, MARY, ELIZABETH",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,2101 SHILOH CHURCH RD   DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518596402,"HUNTER, MARY, ELIZABETH",2101 SHILOH CHURCH RD   DAVIDSON NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730516196,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518596402,"HUNTER, MARY, ELIZABETH",1054 BURRAGE RD NE   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518596402,"HUNTER, MARY, ELIZABETH",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518599554,"JESTER, ROBERT, WESLEY",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 245 , 953 , 994 ," $26,783.03 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518599554,"JESTER, ROBERT, WESLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 23 , 25 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518600220,"MURRAY, MAX, LOGAN",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518601228,"RUNYON, MEGHANN, KIMBERLY",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 39 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1518601228,"RUNYON, MEGHANN, KIMBERLY",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1518603752,"KIM, CHRISTINE, SOMYEONG",1200 BROAD ST STE 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 47 ,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1518603752,"KIM, CHRISTINE, SOMYEONG",1200 BROAD ST STE 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 43 ,$#,,
MEDICAID DIRECT,1629122528,LANE & ASSOCIATES XIV DDS PA,LANE & ASSOCIATES XIV DDS PA,1200 BROAD ST STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518603752,"KIM, CHRISTINE, SOMYEONG",1200 BROAD ST STE 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 68 , 80 , 237 ," $13,968.95 ",,
MEDICAID DIRECT,1851931257,LANE AND ASSOCIATES XXXV DDS PA,,11180 E FINCH AVE   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1518603752,"KIM, CHRISTINE, SOMYEONG",1200 BROAD ST STE 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518603752,"KIM, CHRISTINE, SOMYEONG",1200 BROAD ST STE 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1518603752,"KIM, CHRISTINE, SOMYEONG",1200 BROAD ST STE 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518603752,"KIM, CHRISTINE, SOMYEONG",1200 BROAD ST STE 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1518604289,"DAO, JASON, VAN",1008 BIG OAK CT STE C KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 124 , 140 , 481 ," $17,640.45 ",,
MEDICAID DIRECT,1376188532,DRS MALEK KNIGHT & ASSOCIATES PLLC,AXIOM DENTISTRY,903 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1518604289,"DAO, JASON, VAN",903 N ARENDELL AVE   ZEBULON NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 738 ," 1,242 "," 4,370 "," $173,450.80 ",,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518604578,"EISENBERG, CASEY, GAYLE",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518610757,"WALTERS, CHRISTINA, MARIE",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 50 , 59 ,$#,,
MEDICAID DIRECT,1972092054,HERITAGE FAMILY HEALTH AND WELLNESS,,190 CAROLINA DR   SNOW HILL NC,040,Greene,193400000X,Group,Single Specialty,,1518610831,"HEAD, JORDAN, PERI DAIL",1108B KINGOLD BLVD   SNOW HILL NC,040,Greene,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 151 , 204 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518610997,"BRYANT, ANGELA, MARIA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518610997,"BRYANT, ANGELA, MARIA",123 SUNNYBROOK RD STE 120 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 160 , 672 , 711 ," $21,897.70 ",,
MEDICAID DIRECT,1518613330,MGA HOME HEALTHCARE FAYETTEVILLELLC,~,3400 WALSH PKWY STE 248 FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,1518613330,MGA HOME HEALTHCARE FAYETTEVILLELLC,3400 WALSH PKWY STE 248 FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,, 32 ," 4,495 "," 4,722 "," $2,745,499.48 ",,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1518618776,"PATEL, MINESH, JAGDISH",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518618776,"PATEL, MINESH, JAGDISH",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518620665,HIGH COUNTRY COMMUNITY HEALTH,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 184 , 626 , 639 ," $69,644.43 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518623941,"WOODLEY, KAITLIN, NICOLE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518623941,"WOODLEY, KAITLIN, NICOLE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 30 , 43 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518623941,"WOODLEY, KAITLIN, NICOLE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1518627496,CLASSY SENIOR HOME CARE LLC,,128 BAKER RD   HIGH POINT NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1518627496,CLASSY SENIOR HOME CARE LLC,128 BAKER RD   HIGH POINT NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,, 53 ," 7,714 "," 7,924 "," $763,464.08 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518628932,"RILEY, SARAH, KATHERINE",214 18TH ST SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 89 , 179 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518630581,"POPE, AUSTIN, CLAY",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 96 , 129 , 153 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518631415,"MARTIN, ASHLEY",5080 KAHN DRIVE STE 120 LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 ,#, 27 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518631415,"MARTIN, ASHLEY",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 17 , 45 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3007 TOWN CENTER DR STE 100-101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518631415,"MARTIN, ASHLEY",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518631415,"MARTIN, ASHLEY",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 24 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518631415,"MARTIN, ASHLEY",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 46 , 122 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518631415,"MARTIN, ASHLEY",4320 FAYETTEVILLE RD STE A LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518634617,RESIDENCE CARE SERVICES,BETHAMY RETIREMENT CENTER,909 N SALISBURY AVE   SPENCER NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1518634617,RESIDENCE CARE SERVICES,909 N SALISBURY AVE   SPENCER NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 21 ," 1,020 "," 1,020 "," $319,560.55 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518636810,"SHERMAN, AYLA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1518637859,MISS IRENES SPEECH THERAPY,,1207 CREEKSIDE DR   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1518637859,MISS IRENES SPEECH THERAPY,1207 CREEKSIDE DR   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518638428,"GORDON, SIMONE, ANTOINETTE",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518638428,"GORDON, SIMONE, ANTOINETTE",9101 PINEVILLE MATTHEWS RD STE C4 PINEVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518642289,"LARSEN, DEIRDRE, HELEN SUZANNE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1518643766,"SHAFFER, KACEY, NICOLLE",3110 WELLONS BLVD   NEW BERN NC,025,Craven,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518643980,"PATETTA, JENNIFER",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 27 , 51 ,$#,,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518644046,"LIN, LING",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 524 , 688 ," 2,140 "," $87,151.93 ",,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1518644046,"LIN, LING",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1518644046,"LIN, LING",104 SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice, 329 , 384 ," 1,189 "," $43,515.24 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518645183,"TATHAM, OLEN, THOMAS",1196 SKYLAND DR   SYLVA NC,050,Jackson,152W00000X,Eye and Vision Services Providers,Optometrist,, 196 , 216 , 256 ," $16,151.07 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518645183,"TATHAM, OLEN, THOMAS",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518645183,"TATHAM, OLEN, THOMAS",2001 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518646306,"HALSEY, MORGAN, ELLESE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1467152496,ALLES DDS KANNAPOLIS PLLC,IDEAL DENTAL KANNAPOLIS,582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1518646728,"ARMSTRONG, JOSEPH, SCOTT",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1467152496,ALLES DDS KANNAPOLIS PLLC,IDEAL DENTAL KANNAPOLIS,582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518646728,"ARMSTRONG, JOSEPH, SCOTT",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 337 , 497 ," 1,806 "," $107,625.42 ",,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518646728,"ARMSTRONG, JOSEPH, SCOTT",4815 BEREWICK TOWN CENTER DR STE I CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 55 , 249 ," $15,530.59 ",,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 21 , 37 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",7420 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",7420 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",7420 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1478 RIVER RD SE   WINNABOW NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",1478 RIVER RD SE   WINNABOW NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 25 , 37 ,$#,,
MEDICAID DIRECT,1457946519,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PENDER PRIMARY CARE,7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,193200000X,Group,Multi-Specialty,,1518648633,"HARTLEY, DANIEL, JESSON",7910 US HWY 117 S UNIT 120 ROCKY POINT NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518650654,"MORROW, KAYLA, NICHOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518651363,"GEIGER, CATHERINE, NANCY",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 28 , 56 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518651363,"GEIGER, CATHERINE, NANCY",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518651363,"GEIGER, CATHERINE, NANCY",1222 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 52 , 95 , 152 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518653666,"MACOPSON, PATRICIA, HOYLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518653666,"MACOPSON, PATRICIA, HOYLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518659713,"BORODULINA, MARYNA",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 39 , 39 ,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1518664317,"LINEBERRY, BRITTANY, DAVIS",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 115 , 115 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1518665025,"ELLIOTT, ASHLEY, ADEOLA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 26 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518666155,"PALMS, ERIN, LANG",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518666809,THE GROVE SPEECH CENTER PLLC,THE GROVE SPEECH CENTER,6712 RIVER HILLS DR   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1518666809,THE GROVE SPEECH CENTER PLLC,6712 RIVER HILLS DR   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1518668623,"MAHAFFEY, MORGAN, MACKENZIE",600 W TRADE ST STE B DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 48 , 99 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1518668623,"MAHAFFEY, MORGAN, MACKENZIE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 22 , 41 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1518672799,"REVELS, SYDNEE, MICAE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1518672799,"REVELS, SYDNEE, MICAE",1106 SUNSET AVE   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518674290,"CHMELIK, KASEY, ELLIS",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 19 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518674290,"CHMELIK, KASEY, ELLIS",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518674290,"CHMELIK, KASEY, ELLIS",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518674290,"CHMELIK, KASEY, ELLIS",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518674290,"CHMELIK, KASEY, ELLIS",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457169914,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1518675750,"DAHER, JOEY, JACK",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1518677368,BIONIC PROSTHETICS AND ORTHOTICS GR,,715 FAIRGROVE CHURCH RD SE STE 203 CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518677368,BIONIC PROSTHETICS AND ORTHOTICS GR,715 FAIRGROVE CHURCH RD SE STE 203 CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 20 , 19 , 74 ," $17,359.05 ",,
MEDICAID DIRECT,1518682582,ALMAREADA HOME CARE AGENCY,ALMAREADA HOME CARE AGENCY,403 ROYALL AVE   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1518682582,ALMAREADA HOME CARE AGENCY,403 ROYALL AVE   GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 1,608 "," 1,608 "," $128,206.49 ",,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518685106,"KOROMA, FATMATA, JULDEH",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1518685445,CLB HOMECARE AGENCY LLC,,5511 MONROE RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1518685445,CLB HOMECARE AGENCY LLC,5511 MONROE RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 2,471 "," 2,477 "," $164,692.67 ",,
MEDICAID DIRECT,1336280544,C & S OPTOMETRIC SERVICES PLLC,NEW BERN FAMILY EYE CARE,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1518685528,"MATHEWS, COURTNEY, DAVIS",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 31 , 32 ,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1518685528,"MATHEWS, COURTNEY, DAVIS",2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1518685528,"MATHEWS, COURTNEY, DAVIS",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1518685528,"MATHEWS, COURTNEY, DAVIS",13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093096141,SUNSHINE PEDIATRICS PA,,1519 E BOOKER DAIRY RD STE A SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1518686542,"BRENNAN, SIOBHAN, CLAIRE",1519 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 15 ,$#,,
MEDICAID DIRECT,1740562875,ONSLOW AMBULATORY SERVICES INC,ONSLOW EAR NOSE & THROAT,55 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1518686567,"YANCEY, CALLI",55 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 23 , 25 , 51 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518686906,"HALL, CHRISTINA, JEAN",511 PALADIN DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 18 , 32 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1518686948,"MONTOYA, ALICIA, HELEN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 69 , 97 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518687169,"MORRIS, JEVON, ANDRES",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518687169,"MORRIS, JEVON, ANDRES",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1881776771,LEXINGTON INTERNAL MEDICINE CLINIC,LEXINGTON INTERNAL MEDICINE CLINIC PA,901 E CENTER ST   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1518688092,"YOUNG, CHRISTA, MICHELLE",901 E CENTER ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 221 , 228 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518689694,"PRINCE, PAUL, MATTHEW",1995 WELLNESS BLVD   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 51 , 76 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518690395,"ROWE, CASSIDY, LEE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 81 , 94 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1518690395,"ROWE, CASSIDY, LEE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1518690395,"ROWE, CASSIDY, LEE",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 72 , 76 ,$#,,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,1203 VAUGHN RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1518690668,"RANSOM, REINA, ELIZABETH",215 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice, 838 , 924 ," 2,999 "," $106,838.21 ",,
MEDICAID DIRECT,1881985398,ROSLYN M CRISP DDS MS PA,~,3154 S CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1518690668,"RANSOM, REINA, ELIZABETH",215 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 26 , 71 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518691021,"BORGER, JUDITH, ANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 35 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518691021,"BORGER, JUDITH, ANNE",203A EARNHART DR   EDENTON NC,021,Chowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518692375,"KAPPERT, DAVIS, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 69 , 69 ,$#,,
MEDICAID DIRECT,1912995630,THE PURCELL CLINIC PA,THE PURCELL CLINIC PA,418 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1518692425,"LOCKLEAR, KIMBERLY, MICHELLE",418 S KING ST   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 93 , 136 , 344 ," $14,815.31 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518695840,"NICHOLLS, STEPHANIE, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518695840,"NICHOLLS, STEPHANIE, LYNN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 29 , 49 ,$#,,
MEDICAID DIRECT,1518697341,UNITED PROVIDERS OF HEALTH,~,108 W ANDREWS ST   BETHEL NC,074,Pitt,291U00000X,Laboratories,Clinical Medical Laboratory,,1518697341,UNITED PROVIDERS OF HEALTH,108 W ANDREWS ST   BETHEL NC,074,Pitt,291U00000X,Laboratories,Clinical Medical Laboratory,, 97 , 106 , 416 ," $28,218.85 ",,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518701085,"HENSLEY, SAVANNAH, ELMORE",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 54 , 81 ,$#,,
MEDICAID DIRECT,1518713072,LABCORP GENETICS INC,,1400 16TH ST   SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1518713072,LABCORP GENETICS INC,1400 16TH ST   SAN FRANCISCO CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 46 , 47 , 109 ," $55,118.24 ",,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1518721331,"OGBONNA, OBIAKU, ELSIE",190 LEXIE LN   CAMERON NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 24 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518724822,"TYNDALL, SKYLER, MARGARET",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1518724822,"TYNDALL, SKYLER, MARGARET",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1518724822,"TYNDALL, SKYLER, MARGARET",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1518724822,"TYNDALL, SKYLER, MARGARET",210 TOWNE VILLAGE DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1245780303,TARHEEL FOOT & SPECIALTY CARE PA,,300 BIRCH ST STE B RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1518738178,"BAUMIS, COREY, JOEL",300 BIRCH ST   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 631 ," 1,016 "," 3,062 "," $44,763.34 ",,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,106 ALEXANDER BANK DR STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518741149,"AUCI, KIMBERLY, ANN",106 ALEXANDER BANK DR STE 200 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518741149,"AUCI, KIMBERLY, ANN",106 ALEXANDER BANK DR STE 200 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518743244,"COBB, SANDRA, JONES",932 MORREENE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518743244,"COBB, SANDRA, JONES",932 MORREENE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1518745264,"OLSEN, SARA, KATE",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1518745264,"OLSEN, SARA, KATE",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518784982,"GALE, AMBER, NICOLE",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518799196,"KESLER, CALLIE, ANN MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518901420,"CLEVELAND, BRETT, STANDARD",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 59 , 59 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518901602,"THOMAS, TRACEY, SHANNON",1875 REMOUNT RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518902675,"IZZO, ANTOINETTE",1333 S DICKINSON DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518902675,"IZZO, ANTOINETTE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 36 , 42 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518902675,"IZZO, ANTOINETTE",1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518902824,"STOIA, JOEL, GREER",2301 ERWIN RD 2301 ERWIN ROAD DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 29 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518902824,"STOIA, JOEL, GREER",2301 ERWIN RD 2301 ERWIN ROAD DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518902824,"STOIA, JOEL, GREER",2301 ERWIN RD 2301 ERWIN ROAD DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1518903350,QUEST DIAGNOSTICS CLINICAL LABORATO,,10200 COMMERCE PKWY   MIRAMAR FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1518903350,QUEST DIAGNOSTICS CLINICAL LABORATO,10200 COMMERCE PKWY   MIRAMAR FL,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 310 , 374 , 560 ," $22,891.24 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518903988,"PETE, KARL, LYNDELL",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518903988,"PETE, KARL, LYNDELL",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 57 , 119 , 126 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518903988,"PETE, KARL, LYNDELL",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 157 , 226 , 260 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518903988,"PETE, KARL, LYNDELL",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 17 , 19 , 26 ,$#,,
MEDICAID DIRECT,1902614464,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY UROLOGY,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518903988,"PETE, KARL, LYNDELL",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 64 , 82 , 87 ,$#,,
MEDICAID DIRECT,1902614464,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY UROLOGY,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518903988,"PETE, KARL, LYNDELL",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518904127,"SMALLWOOD, BRANDON",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518904127,"SMALLWOOD, BRANDON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 54 , 70 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518904127,"SMALLWOOD, BRANDON",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 14 , 15 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518904127,"SMALLWOOD, BRANDON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1518904127,"SMALLWOOD, BRANDON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1518904127,"SMALLWOOD, BRANDON",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1518905041,"MCKINLEY, DOMINIC, WAYNE",1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 100 , 201 ,$#,,
MEDICAID DIRECT,1831567445,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST RHEUMATOLOGY - W,1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518905223,"ZIOLKOWSKA, ALDONA",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 130 , 224 , 257 ,$#,,
MEDICAID DIRECT,1467789313,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INFUSION - WEST,1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518905223,"ZIOLKOWSKA, ALDONA",1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1467789313,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INFUSION - WEST,1814 WESTCHESTER DR STE 302 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518905223,"ZIOLKOWSKA, ALDONA",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 32 , 67 , 152 ," $15,829.09 ",,
MEDICAID DIRECT,1851336465,SMITHFIELD EYE ASSOCIATES OPTOMETRY,HAINES VISION CARE,1319 N BRIGHTLEAF BLVD STE E SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1518906346,"HAINES, MICHAEL, JOSEPH",1319 N BRIGHTLEAF BLVD STE E SMITHFIELD NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 124 , 144 , 238 ," $12,907.69 ",,
MEDICAID DIRECT,1518910033,EYECARECENTER OD PA,EYECARE CENTER,7510 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518910033,EYECARECENTER OD PA,7510 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 60 , 60 , 120 ,$#,,
MEDICAID DIRECT,1518910041,EYECARECENTER OD PA,EYECARE CENTER,819 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1518910041,EYECARECENTER OD PA,819 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,, 77 , 78 , 146 ,$#,,
MEDICAID DIRECT,1518910041,EYECARECENTER OD PA,EYECARE CENTER,819 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1518910041,EYECARECENTER OD PA,819 TIFFANY BLVD   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1518911734,"BOYD, JAMES, FRANCIS",1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",1338 E SUNSET DR   MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",2544 COURT DR STE F GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",2544 COURT DR STE F GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",2544 COURT DR STE F GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",2544 COURT DR STE F GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518913276,"PASOUR, ANNA, GRIBBLE",348 BURTONWOOD DR   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",~,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223X0008X,Dental Providers,Dentist,Oral and Maxillofacial Radiology,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",~,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 188 , 213 , 677 ," $70,729.86 ",,
MEDICAID DIRECT,1043773427,"CANNON, DARRIEL, JOSEPH",,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 34 ,$#,,
MEDICAID DIRECT,1992754311,MEADOWS LUTCACAGE SMITH VINTON FIDL,Meadows Schaberg Lutcacage DBA Drs Lutcavage & Fi,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1518917657,"LUTCAVAGE, GREGORY, JOSEPH",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 291 , 340 ," 1,024 "," $110,564.12 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518917970,"MENDEZ, KEVIN, R",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518917970,"MENDEZ, KEVIN, R",4515 PREMIER DR   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518917970,"MENDEZ, KEVIN, R",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518917970,"MENDEZ, KEVIN, R",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,411 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518919059,"FARRELL, BARTHOLOMEW, CHARLES",411 BILLINGSLEY RD STE 105 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,411 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518919059,"FARRELL, BARTHOLOMEW, CHARLES",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518919059,"FARRELL, BARTHOLOMEW, CHARLES",8738 UNIVERSITY CITY BLVD   CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 16 ,$#,,
MEDICAID DIRECT,1326450743,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY & INTERNAL MEDICINE,2293 SUGAR HILL RD STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1518920271,"ISSERMAN, STEVEN, MICHAEL",2293 SUGAR HILL RD STE A MARION NC,059,McDowell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1518920271,"ISSERMAN, STEVEN, MICHAEL",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1962635540,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY MORGANTON,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1518920271,"ISSERMAN, STEVEN, MICHAEL",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1518920271,"ISSERMAN, STEVEN, MICHAEL",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1962635540,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY MORGANTON,2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1518920271,"ISSERMAN, STEVEN, MICHAEL",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 569 , 868 ," 1,080 "," $11,228.00 ",,
MEDICAID DIRECT,1326450743,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE CARDIOLOGY & INTERNAL MEDICINE,2293 SUGAR HILL RD STE A MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1518920271,"ISSERMAN, STEVEN, MICHAEL",2209 S STERLING ST STE 530 MORGANTON NC,012,Burke,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1518920305,"BLACKLEY, DONALD, WAYNE",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 29 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1518920305,"BLACKLEY, DONALD, WAYNE",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 83 , 133 , 189 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",3000 NEW BERN AVE STE 1130 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",3324 SIX FORKS RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 54 , 93 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",3000 NEW BERN AVE STE 1130 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518920545,"HARI, PADMA, BALA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 89 , 126 , 150 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1518920610,"BALDWIN JR, BOYCE, DAVID",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1518920966,"THOMPSON, RICKY, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518920966,"THOMPSON, RICKY, ALAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518920966,"THOMPSON, RICKY, ALAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518920966,"THOMPSON, RICKY, ALAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 66 , 71 , 124 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518920966,"THOMPSON, RICKY, ALAN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1275774432,BMI NEPHROLOGY SYSTEMS,BMI NEPHROLOGY SYSTEMS INC,635 N MAIN ST   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1518921188,"IGWEMEZIE, BENJAMIN, MADUAKONAM",635 N MAIN ST   HIGH POINT NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 146 , 831 , 921 ," $14,242.36 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518921642,"GRAHAM, MARLON, ANTHONY",512 VILLAGE RD STE 104 SHALLOTTE NC,010,Brunswick,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518923069,"WEYMANN, CATHERINE, ANN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518923069,"WEYMANN, CATHERINE, ANN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 21 , 30 , 38 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1518923069,"WEYMANN, CATHERINE, ANN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 36 , 49 , 53 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,340 SIGNAL HILL DR STE A STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518923069,"WEYMANN, CATHERINE, ANN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518923069,"WEYMANN, CATHERINE, ANN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518923069,"WEYMANN, CATHERINE, ANN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1518925221,"GRIDLEY, GREGORY, CHARLES",,907 ROUNTREE AVE   KINSTON NC,054,Lenoir,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,1518925221,"GRIDLEY, GREGORY, CHARLES",907 ROUNTREE AVE   KINSTON NC,054,Lenoir,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1447214242,TRIANGLE PEDIATRIC CENTER,TRIANGLE PEDIATRIC CENTER,105 RIDGE VIEW DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1518926294,"CAPPS, MARY",105 RIDGE VIEW DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 20 , 37 ,$#,,
MEDICAID DIRECT,1518928639,KILROY COMPANY,BLUEDOT NATIONAL RESPIRATORY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1518928639,KILROY COMPANY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1518928639,KILROY COMPANY,BLUEDOT NATIONAL RESPIRATORY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1518928639,KILROY COMPANY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1518928639,KILROY COMPANY,BLUEDOT NATIONAL RESPIRATORY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1518928639,KILROY COMPANY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1518928639,KILROY COMPANY,BLUEDOT NATIONAL RESPIRATORY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1518928639,KILROY COMPANY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 761 ," 3,231 "," 5,455 "," $431,867.64 ",,
MEDICAID DIRECT,1518928639,KILROY COMPANY,BLUEDOT NATIONAL RESPIRATORY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1518928639,KILROY COMPANY,2915 WHITEHALL PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 595 ," 1,761 "," 2,970 "," $136,547.19 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518928795,"YU, JULIA, JUYUN",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 108 , 155 ,$#,,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1518929942,"HUDSON, THERESA, ANN",1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 57 , 187 , 211 ," $22,037.76 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518930528,"GINGRICH, JEFFREY, RAE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518930528,"GINGRICH, JEFFREY, RAE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518930528,"GINGRICH, JEFFREY, RAE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518930528,"GINGRICH, JEFFREY, RAE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518930528,"GINGRICH, JEFFREY, RAE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1518930783,"RAMBEAU, CRYSTAL, BAKER",~,124 E STEWART ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1518930783,"RAMBEAU, CRYSTAL, BAKER",124 E STEWART ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164042412,HOMETOWN DIRECT PRIMARY CARE PLLC,,332 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1518930783,"RAMBEAU, CRYSTAL, BAKER",124 E STEWART ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518930783,"RAMBEAU, CRYSTAL, BAKER",~,332 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1518930783,"RAMBEAU, CRYSTAL, BAKER",332 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1164042412,HOMETOWN DIRECT PRIMARY CARE PLLC,,332 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1518930783,"RAMBEAU, CRYSTAL, BAKER",332 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 38 , 40 ,$#,,
MEDICAID DIRECT,1518930783,"RAMBEAU, CRYSTAL, BAKER",~,124 E STEWART ST   COATS NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1518930783,"RAMBEAU, CRYSTAL, BAKER",332 N BRIGHTLEAF BLVD STE C SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518932599,"PIERSON, CINDY, LEE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184669053,SOUTHEASTERN MEDICAL GROUP PC,,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1518932599,"PIERSON, CINDY, LEE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1518932599,"PIERSON, CINDY, LEE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1518932599,"PIERSON, CINDY, LEE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,190 HOSPITAL DR   HIGHLANDS NC,056,Macon,193200000X,Group,Multi-Specialty,,1518932599,"PIERSON, CINDY, LEE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518932763,"STAFFORD, CHARLES, WILLIAM",3004 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 46 , 69 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518932763,"STAFFORD, CHARLES, WILLIAM",3004 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518932763,"STAFFORD, CHARLES, WILLIAM",338 HOWARD BLVD   NEWPORT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,148 COX AVE   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",214 COCHRAN AVE   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,1304 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",1304 SE 2ND ST   SNOW HILL NC,040,Greene,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 474 , 584 ,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,323 CLIFTON ST STE 13   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",1304 SE 2ND ST   SNOW HILL NC,040,Greene,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 95 , 105 ,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,1304 SE SECOND ST   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",1304 SE 2ND ST   SNOW HILL NC,040,Greene,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,148 COX AVE   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 96 , 126 ,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,323 CLIFTON ST STE 13   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,323 CLIFTON ST STE 13   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",302 N GREENE ST   SNOW HILL NC,040,Greene,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,907 CUNNINGHAM RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",148 COX AVE   RICHLANDS NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,323 CLIFTON ST STE 13   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",148 COX AVE   RICHLANDS NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 26 , 34 ,$#,,
MEDICAID DIRECT,1013153121,HOPE MEDICAL CARE PC,HOME MEDICAL CARE,148 COX AVE   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1518933415,"LAWRENCE, MICHAEL, AVANDALE",148 COX AVE   RICHLANDS NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 121 , 202 ,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1518934082,"DRAUGHON, THOMAS, SCOTT",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 208 , 293 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518934686,"OTTAVIANI, ROBERT, AUGUSTUS",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 45 , 84 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1518934686,"OTTAVIANI, ROBERT, AUGUSTUS",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 131 , 256 , 465 ," $13,541.21 ",,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518934728,"SPIEGEL, DAVID, RICHARD",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1518936020,"BROOKS, DALTON, PETER",DALTON PETER BROOKS JR DMD PLLC,727 WESLEY PINES RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice,1518936020,"BROOKS, DALTON, PETER",727 WESLEY PINES RD   LUMBERTON NC,078,Robeson,1223G0001X,Dental Providers,Dentist,General Practice, 276 , 477 ," 1,410 "," $49,591.25 ",,
MEDICAID DIRECT,1033182571,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD OB GYN DILLON,706 N 8TH AVE   DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518936392,"KEETON, JANIS, ELIZABETH",706 N 8TH AVE   DILLON SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST # 102 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518936426,"GLAESNER, EDWARD",618 S PIERCE ST # 102 EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 53 , 82 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST # 102 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1518936426,"GLAESNER, EDWARD",218 ASHVILLE AVE STE 20 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 15 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518936426,"GLAESNER, EDWARD",218 ASHVILLE AVE STE 20 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 15 , 24 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1518936426,"GLAESNER, EDWARD",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 25 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518937416,"LITTLE, SARA, LEE",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518937416,"LITTLE, SARA, LEE",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518937416,"LITTLE, SARA, LEE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518937416,"LITTLE, SARA, LEE",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023142122,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518937424,"HILTON, SUZANNE, ELIZABETH",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023142122,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518937424,"HILTON, SUZANNE, ELIZABETH",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 57 , 75 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518937812,"HEARD, WILLIAM, UPTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518938257,"JOYCE, JOSEPH, ANTHONY",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 ,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518938323,"WILLIAMS, TOMIKA, MICHELE",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518938323,"WILLIAMS, TOMIKA, MICHELE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 19 , 20 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518938380,"GULLICKSON, MATTHEW, ALAN",15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518938380,"GULLICKSON, MATTHEW, ALAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518938380,"GULLICKSON, MATTHEW, ALAN",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 46 , 82 , 129 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518938380,"GULLICKSON, MATTHEW, ALAN",703 COMFORT LN   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417911322,TRIANGLE GASTROENTEROLOGY LLC,TRIANGLE GASTROENTEROLOGY LLC,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518938521,"TUMBAPURA, ANIL, PRAKASH",2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 44 , 52 ,$#,,
MEDICAID DIRECT,1518938521,"TUMBAPURA, ANIL, PRAKASH",~,2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1518938521,"TUMBAPURA, ANIL, PRAKASH",2600 ATLANTIC AVE STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 74 , 80 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1518938737,"MAUR, ERIC, EVAN",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1518938737,"MAUR, ERIC, EVAN",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 77 , 85 , 101 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518940220,"WALTER, KEITH, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518940220,"WALTER, KEITH, ANDREW",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 24 , 35 , 51 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518940584,"BRANUM, STEPHEN, COLSON",4601 PARK RD STE 250 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1518942119,"VARNADORE, DIANE, STEGALL",120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 109 , 150 , 150 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518942648,"FARNEY, ALAN, CHRISTOPHER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 32 , 50 , 56 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1518942861,"ROSSIN, RICHARD, DAVID",10654 BRECKENRIDGE DR   SAN DIEGO CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 19 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1518942861,"ROSSIN, RICHARD, DAVID",10654 BRECKENRIDGE DR   SAN DIEGO CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518942895,"WILKIN, AIMEE, MAREE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 112 , 197 , 242 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518942978,"MCPHERSON, EDGAR, LEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 29 , 35 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518942978,"MCPHERSON, EDGAR, LEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 57 , 70 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518942978,"MCPHERSON, EDGAR, LEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518943166,"WAGNER, KRISTIN, ELIZABETH",10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518943166,"WAGNER, KRISTIN, ELIZABETH",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518943166,"WAGNER, KRISTIN, ELIZABETH",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 26 , 41 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518944420,"ALLBERT, JOHN, RAYMOND",1450 MATTHEWS TOWNSHIP PKWY STE 410 MATTHEWS NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518944420,"ALLBERT, JOHN, RAYMOND",1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518944420,"ALLBERT, JOHN, RAYMOND",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1437338050,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518944420,"ALLBERT, JOHN, RAYMOND",620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518944909,"PAAT, JOHN, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518944909,"PAAT, JOHN, JOSEPH",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 33 , 57 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518945385,"NAVARRO, GILBERTO, PABALAN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518945385,"NAVARRO, GILBERTO, PABALAN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518945385,"NAVARRO, GILBERTO, PABALAN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 37 , 37 ,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518945385,"NAVARRO, GILBERTO, PABALAN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790851004,ROANOKE CHOWAN COMMUNITY HEALTH CEN,COLERAIN PRIMARY CARE,109 W RIVER ST   COLERAIN NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518945385,"NAVARRO, GILBERTO, PABALAN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1518945385,"NAVARRO, GILBERTO, PABALAN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 43 , 43 ," $16,922.58 ",,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1518945385,"NAVARRO, GILBERTO, PABALAN",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518945385,"NAVARRO, GILBERTO, PABALAN",108 W MAIN ST   WOODLAND NC,066,Northampton,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 153 , 436 , 484 ," $13,867.11 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518945583,"WATTERS, CHRISTOPHER, ROY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518945583,"WATTERS, CHRISTOPHER, ROY",1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518945583,"WATTERS, CHRISTOPHER, ROY",1212 CEDARHURST DR STE 102 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 30 , 30 ,$#,,
MEDICAID DIRECT,1588614168,ASHEVILLE NEUROLOGY SPECIALISTS PA,~,731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1518945617,"ARMSTRONG, ROBERT, FAIRBURN",731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 323 , 581 , 925 ," $23,863.83 ",,
MEDICAID DIRECT,1588614168,ASHEVILLE NEUROLOGY SPECIALISTS PA,~,731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1518945690,"PATTON, JAMES, MATTHEW",731 DOGWOOD RD   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 164 , 327 , 713 ," $41,794.89 ",,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1518945872,"NAMEN, ANDREW, MICHAEL",233 DOCTORS ST   SPARTA NC,003,Alleghany,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518945872,"NAMEN, ANDREW, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 220 , 314 , 350 ," $28,894.44 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518945872,"NAMEN, ANDREW, MICHAEL",601 N ELM ST   HIGH POINT NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518945880,"COWEN, JONATHAN, DAVID",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 118 , 118 ,$#,,
MEDICAID DIRECT,1851783385,APPALACHIAN REGIONAL MEDICAL ASSOCI,APPALACHIAN REGIONAL INTERNAL MEDICINE SPECIALISTS,194 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1518946078,"HARTER, MARK, RICHARD",194 DOCTORS DR   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518946458,"BUNDY, ROBERT, FRANCIS",106 CORPORATE PARK DR STE 200&300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 22 , 52 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518946458,"BUNDY, ROBERT, FRANCIS",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518946540,"DEVINE, BRIAN, DAVID",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 29 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518946540,"DEVINE, BRIAN, DAVID",4815 JOHNSTON OEHLER RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 128 , 224 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518947290,"MAGGITTI, MICHAEL, JOHN",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 110 , 226 , 428 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518947290,"MAGGITTI, MICHAEL, JOHN",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 30 , 49 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1518947365,"STOKES, JASON, RICHARD",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 18 , 21 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518947365,"STOKES, JASON, RICHARD",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 22 , 37 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518947951,"GREGORY, DIXON, ELIJAH",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 36 , 84 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518947951,"GREGORY, DIXON, ELIJAH",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1518947951,"GREGORY, DIXON, ELIJAH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 32 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518948561,"BROADWELL, SCOTT, RUSSELL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 65 , 76 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518948561,"BROADWELL, SCOTT, RUSSELL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 122 , 142 , 188 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1518949924,"WALTERS, BOBBY, CLIFTON",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 366 , 405 , 508 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1518949924,"WALTERS, BOBBY, CLIFTON",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 608 , 779 ," 1,063 ",$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1518950369,"BLACK, LEAH, AUTRY",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 70 , 155 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518951110,"NORRIS, STEVEN, ROLAND",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 65 , 118 , 230 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518951821,"O ROURKE, KATHERINE, DOERR",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518951821,"O ROURKE, KATHERINE, DOERR",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518952589,"KLOTZ, DARRELL, ALEXANDER",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 80 , 115 , 186 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518953447,"HANES, TRACI, PAGE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518953447,"HANES, TRACI, PAGE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 19 ,$#,,
MEDICAID DIRECT,1518953504,"HERON, KERRIE, ANNE",KERRIE ANNE HERON,3302 NASH ST N   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1518953504,"HERON, KERRIE, ANNE",3302 NASH ST N   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376564625,WILSON MEDICAL GROUP PLLC,WILSON MEDICAL GROUP,3302 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1518953504,"HERON, KERRIE, ANNE",3302 NASH ST N   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 397 ," 1,112 "," 2,542 "," $36,559.31 ",,
MEDICAID DIRECT,1598066730,MIDWEST NEUROMONITORING ASSOCIATES,,10275 LITTLE PATUXENT PKWY STE 300 COLUMBIA MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1518954080,"MAGGIO, VIJAY",3 BRETWOOD DR N   COLTS NECK NJ,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518954460,"SMITH, SHARON, ANNETTE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518954460,"SMITH, SHARON, ANNETTE",885 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 49 , 102 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518954460,"SMITH, SHARON, ANNETTE",2290 REMOUNT RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518954767,"PATRONE, NICHOLAS, ANGELO",303 GREEN ST E   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 98 , 98 ,$#,,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1518955269,"ROBERTS, JOSEPH, EARL",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 18 , 28 ,$#,,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1518955269,"ROBERTS, JOSEPH, EARL",3005 N ELM ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 52 , 104 ,$#,,
MEDICAID DIRECT,1326036138,SOUTHEASTERN INTEGRATED CARE,~,3005 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518955269,"ROBERTS, JOSEPH, EARL",3005 N ELM ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 137 , 298 ,$#,,
MEDICAID DIRECT,1740564376,SOUTHEASTERN REGIONAL MEDICAL CENTE,SOUTHEASTERN WOUND HEALING CENTER,103 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518955269,"ROBERTS, JOSEPH, EARL",3005 N ELM ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1518955269,"ROBERTS, JOSEPH, EARL",3005 N ELM ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1518956119,"HIDAJI, FARAMARZ, FRED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 32 , 34 ,$#,,
MEDICAID DIRECT,1962898296,OPPORTUNITIES INDUSTRIALIZATION CEN,~,300 N GRACE ST STE 200 ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518956978,"BLUNT, TRINA, MARIE",300 N GRACE ST STE 200 ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice, 384 , 552 ," 2,383 "," $92,049.40 ",,
MEDICAID DIRECT,1962898296,OPPORTUNITIES INDUSTRIALIZATION CEN,~,300 N GRACE ST STE 200 ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518956978,"BLUNT, TRINA, MARIE",300 N GRACE ST STE 200 ROCKY MOUNT NC,064,Nash,1223D0001X,Dental Providers,Dentist,Dental Public Health, 294 , 388 ," 1,726 "," $63,481.83 ",,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518958826,"ZBINDEN III, LOUIS, HENDERSON",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518958826,"ZBINDEN III, LOUIS, HENDERSON",10512 PARK RD STE 101 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518959055,"TOMBLIN, JAMES, EDWARD",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518959055,"TOMBLIN, JAMES, EDWARD",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518959055,"TOMBLIN, JAMES, EDWARD",802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518959063,"KIMBALL, ROBERT, ROY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 218 , 291 , 432 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518959063,"KIMBALL, ROBERT, ROY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518959063,"KIMBALL, ROBERT, ROY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518959063,"KIMBALL, ROBERT, ROY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518959063,"KIMBALL, ROBERT, ROY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 24 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1518959063,"KIMBALL, ROBERT, ROY",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1518960350,"ISBELL, WILLIAM, MARTIN",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518960350,"ISBELL, WILLIAM, MARTIN",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 21 , 38 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1518961853,"BAILEY, ROYCE, KADAN",50 HOSPITAL DR STE 1D HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 41 , 80 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1518961853,"BAILEY, ROYCE, KADAN",50 HOSPITAL DR STE 1D HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1427282045,SOUTHEASTERN REGIONAL PHYSICIAN SER,~,,,Unknown,193200000X,Group,Multi-Specialty,,1518962521,"STUART, DENNIS, O''GAREY",725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1518962521,"STUART, DENNIS, O''GAREY",725 OAKRIDGE BLVD STE B2 LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 105 , 270 , 558 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518962521,"STUART, DENNIS, O''GAREY",2934 N ELM ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 50 , 93 ,$#,,
MEDICAID DIRECT,1285485383,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - BESSEMER CITY,308 E VIRGINIA AVE   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518963594,"REYNOLDS, EUGENE",119 W PENNSYLVANIA AVE   BESSEMER CITY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1518963594,"REYNOLDS, EUGENE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 164 , 390 , 433 ," $19,735.17 ",,
MEDICAID DIRECT,1013287952,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DIALYSIS ACCESS,3112 CASEY ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1518964626,"BJERKEN, DAVID, SCOTT",3112 CASEY ST   LORIS SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 19 , 32 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1518965607,"AMIN, ASIM",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518965607,"AMIN, ASIM",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518966118,"DIER, GARY, LAWRENCE",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518966258,"LENNON, KENNETH, CHARLES",601 N ELM ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 22 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518966258,"LENNON, KENNETH, CHARLES",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518966258,"LENNON, KENNETH, CHARLES",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 155 , 271 , 609 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518966258,"LENNON, KENNETH, CHARLES",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1902983828,ADVANCED SURGICAL ASSOCIATES PA,~,530 NEW WAVERLY PL STE 304 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1518966886,"MALIK, MICHAEL",530 NEW WAVERLY PL STE 304 CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518968023,"MCDERMOTT, JAMES, EMMETT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518968957,"MUELLER, JOSEPH, COLE",200 GREENWICH RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 54 , 159 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518968957,"MUELLER, JOSEPH, COLE",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518971852,"AGBEMABIESE, CHARLES, KOFI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518971852,"AGBEMABIESE, CHARLES, KOFI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518971852,"AGBEMABIESE, CHARLES, KOFI",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 58 , 70 , 70 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518971852,"AGBEMABIESE, CHARLES, KOFI",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 100 , 181 , 181 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518972355,"KRONENBERG, ANDREW, CLARK",500 REDWOOD LN   LOUISBURG NC,035,Franklin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 71 , 101 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518972355,"KRONENBERG, ANDREW, CLARK",500 REDWOOD LN   LOUISBURG NC,035,Franklin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 55 , 80 , 117 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,500 REDWOOD LN   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1518972355,"KRONENBERG, ANDREW, CLARK",500 REDWOOD LN   LOUISBURG NC,035,Franklin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 147 , 224 , 301 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1518972355,"KRONENBERG, ANDREW, CLARK",500 REDWOOD LN   LOUISBURG NC,035,Franklin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518972355,"KRONENBERG, ANDREW, CLARK",500 REDWOOD LN   LOUISBURG NC,035,Franklin,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 108 , 181 , 242 ,$#,,
MEDICAID DIRECT,1427096528,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518974062,"NASH, ERIN, CAUDILL",133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518974260,"HOLMES, LAILA, WANG",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1518974757,"CHAMBERLAIN, ROBERT, JOSEPH",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1518974757,"CHAMBERLAIN, ROBERT, JOSEPH",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1518974757,"CHAMBERLAIN, ROBERT, JOSEPH",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,208800000X,Allopathic & Osteopathic Physicians,Urology,, 102 , 182 , 303 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518976026,"ANDERSON, RUTH, KAY",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 39 , 82 , 132 ,$#,,
MEDICAID DIRECT,1518976729,"DEOCHAND, MOHAN, CHARRAN",MOHAN C DEOCHAND MD,114 S GULF ST   SANFORD NC,053,Lee,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1518976729,"DEOCHAND, MOHAN, CHARRAN",114 S GULF ST   SANFORD NC,053,Lee,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 128 , 263 , 269 ,$#,,
MEDICAID DIRECT,1497239024,ADVANCE DIAGNOSTIC LLC,,2850 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1518976729,"DEOCHAND, MOHAN, CHARRAN",114 S GULF ST   SANFORD NC,053,Lee,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1518976794,"COLVIN, LARRY, GREGG",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 120 , 120 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518980119,"JOHNSRUDE, CURTIS, BRENT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 53 , 68 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1518980119,"JOHNSRUDE, CURTIS, BRENT",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 17 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518980374,"BOCK, CHERYL, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 39 , 90 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518980374,"BOCK, CHERYL, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518980374,"BOCK, CHERYL, LYNN",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1518980374,"BOCK, CHERYL, LYNN",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518982586,"BELGRAVE, ENRICO, ORLANDO",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 27 , 50 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518982586,"BELGRAVE, ENRICO, ORLANDO",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518982800,"KIRBY, LEMUEL, BROOME",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 30 ,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1518982800,"KIRBY, LEMUEL, BROOME",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 29 , 45 ,$#,,
MEDICAID DIRECT,1396166088,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB - MT,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1518985514,"RACHARLA, SUSHMA",275 BEATTY DR   BELMONT NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275968620,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINAS REHAB PINE,10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518985514,"RACHARLA, SUSHMA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518985811,"PIERCE, CAROLINE, CASE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518985811,"PIERCE, CAROLINE, CASE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518986272,"DENNIS, WILLIAM, RICHARD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 50 , 50 , 50 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1518986611,"HOLROYD, TIMOTHY",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033664933,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PULMONARY MEDICINE SOUTH,2000 WELLNESS BLVD STE 130 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1518986652,"SMART, CARL, ANDRE",2000 WELLNESS BLVD STE 130 MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518986652,"SMART, CARL, ANDRE",2000 WELLNESS BLVD STE 130 MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 44 , 82 , 144 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518986652,"SMART, CARL, ANDRE",10320 FELD FARM LN STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 33 , 63 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518986652,"SMART, CARL, ANDRE",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518986652,"SMART, CARL, ANDRE",1450 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 41 , 57 , 97 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518986652,"SMART, CARL, ANDRE",9550 ROCKY RIVER RD STE 100 CHARLOTTE NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 51 , 105 , 172 ,$#,,
MEDICAID DIRECT,1952601700,SNYDER PROFESSIONAL SERVICES CORPOR,SOUTHEAST CHIROPRACTIC THE MOTION CENTERS,71 MCADENVILLE RD   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1518987635,"SNYDER, RICHARD, DALE",71 MCADENVILLE RD   BELMONT NC,036,Gaston,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518987965,"HUANG, JIAOTI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 16 , 15 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518987965,"HUANG, JIAOTI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1518989623,CHATHAM COUNTY SCHOOLS,CHATHAM COUNTY SCHOOLS,468 RENAISSANCE DR   PITTSBORO NC,019,Chatham,251300000X,Agencies,Local Education Agency (LEA),,1518989623,CHATHAM COUNTY SCHOOLS,468 RENAISSANCE DR   PITTSBORO NC,019,Chatham,251300000X,Agencies,Local Education Agency (LEA),, 108 , 138 , 171 ," $25,403.82 ",,
MEDICAID DIRECT,1730548413,RHA BEHAVIORAL HEALTH NC LLC,,219 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1518991298,"GURNEY, INGRID, ANNA",2732 ANN ELIZABETH DR   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1518992072,"BROOKS, REBECCA, MATER",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1568401156,COASTAL CAROLINA HEALTH CARE PA,CCHC COASTAL PRIMARY CARE,670 CARDINAL RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1518992072,"BROOKS, REBECCA, MATER",670 CARDINAL RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 25 , 58 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1518992072,"BROOKS, REBECCA, MATER",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518992239,"YACOUB, WESAM, GABER",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518992239,"YACOUB, WESAM, GABER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518992239,"YACOUB, WESAM, GABER",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518992239,"YACOUB, WESAM, GABER",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 19 , 44 , 44 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518992239,"YACOUB, WESAM, GABER",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 14 , 19 , 25 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518992239,"YACOUB, WESAM, GABER",3515 W MARKET ST STE 210 GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 11 , 18 , 37 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518992684,"STANTON, ALLYSON, GENTRY",400 KEISLER DR   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1518992684,"STANTON, ALLYSON, GENTRY",400 KEISLER DR   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518992684,"STANTON, ALLYSON, GENTRY",400 KEISLER DR   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1518992684,"STANTON, ALLYSON, GENTRY",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1518992684,"STANTON, ALLYSON, GENTRY",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 44 , 76 ,$#,,
MEDICAID DIRECT,1518993252,"MAUGANS, TODD, ALLEN",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,1518993252,"MAUGANS, TODD, ALLEN",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1518993674,"NOVICK, THOMAS, LEONARD",1918 RANDOLPH RD STE 500 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649759341,EYECARECENTER OD PA,,275 E KING ST STE A BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1518994060,"JOHNSON, MARIA",2100 W CORNWALLIS DR STE J GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1649759341,EYECARECENTER OD PA,,275 E KING ST STE A BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1518994060,"JOHNSON, MARIA",275 E KING ST STE 1 BOONE NC,095,Watauga,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518994516,"GADDY, MICHAEL, SHAWN",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518995315,"MITCHELL, TIMOTHY, EUGENE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 21 , 80 , 80 ," $16,109.25 ",,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1518996024,"YOUNG, RICKEY, DALE",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 74 , 149 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1518996024,"YOUNG, RICKEY, DALE",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 33 ,$#,,
MEDICAID DIRECT,1518996404,KIND HEARTS HOME HEALTH CARE INC,KIND HEARTS HOME HEALTH CARE INC,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1518996404,KIND HEARTS HOME HEALTH CARE INC,104 SHORT ST   RICH SQUARE NC,066,Northampton,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1518997188,"MCCALLUM, JEFFREY, BORDEN",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1518997188,"MCCALLUM, JEFFREY, BORDEN",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1518997188,"MCCALLUM, JEFFREY, BORDEN",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 91 , 181 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1518997188,"MCCALLUM, JEFFREY, BORDEN",302 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 84 , 124 ,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1518997717,"RHUE, JENNIFER, ISENHOUR",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 63 , 68 , 106 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1518997923,"CONWAY, JASON, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518997923,"CONWAY, JASON, DAVID",500 SHEPHERD ST   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1518997923,"CONWAY, JASON, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 81 , 105 , 117 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1518997931,"PATEL, ARCHITA, AJITBHAI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 188 , 189 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518998368,"GALA, GARY, JEK",77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518998368,"GALA, GARY, JEK",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518998525,"CRUZ, NESTOR",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 208 , 374 , 586 ," $21,217.81 ",,
MEDICAID DIRECT,1639179393,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1518998525,"CRUZ, NESTOR",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518998525,"CRUZ, NESTOR",1640 E ROOSEVELT BLVD   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1518998525,"CRUZ, NESTOR",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1518998889,"MCCASKILL, CLEMENT, LEON",625 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 25 , 42 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1518998889,"MCCASKILL, CLEMENT, LEON",210 N HERMAN ST   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 33 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528000148,"HERAVI-HIGGINS, MITRA",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528000148,"HERAVI-HIGGINS, MITRA",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528000148,"HERAVI-HIGGINS, MITRA",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528000148,"HERAVI-HIGGINS, MITRA",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528000684,"SPEERS, KARL, RICHARD",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528000684,"SPEERS, KARL, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528000775,"DESMOND, TIMOTHY, PATRICK",720 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 209 , 230 , 284 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528001393,"LEDINGTON, JANE, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528001393,"LEDINGTON, JANE, ELIZABETH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1528001898,"DRESSEL, LAURA, ERIN",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 140 , 302 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528001914,"GILBERT, LYNN, STYERS",214 18TH ST SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528002177,"COWHERD, DAVID, MCLELLAN",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 33 , 58 , 85 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528002177,"COWHERD, DAVID, MCLELLAN",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 55 , 111 , 180 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528002177,"COWHERD, DAVID, MCLELLAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528002656,"HANRAHAN, JENNIFER, ANNE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1356368708,CAMPUS HEALTH PHARMACY,CAMPUS HEALTH SERVICES,320 EMERGENCY ROOM DR JAMES A TAYLOR BLDG CB 7470 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528003225,"CEFALU, JOSEPH, ANTHONY",320 EMERGENCY ROOM DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528004983,"NOVAK, LARA, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 54 , 63 ,$#,,
MEDICAID DIRECT,1154340149,CARRBORO FAMILY VISION LLC,CARRBORO FAMILY VISION OD PLLC,200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,,1528005147,"CHOW, JASON",200 W WEAVER ST STE 1 CARRBORO NC,068,Orange,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1649614777,TITAN NEUROPHYSIOLOGY PA,,9005 OVERLOOK BLVD   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1528005485,"VEGA-BERMUDEZ, FRANCISCO",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1497100721,GREENSBORO RHEUMATOLOGY PA,,2835 HORSE PEN CREEK RD STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528007259,"LALAMA, DEANNA, MICHELLE GIDEONS",2835 HORSE PEN CREEK RD 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 66 , 103 ,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1730 CAROLINA AVE   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1528007507,ALBEMARLE EYE CENTER PLLC,1730 CAROLINA AVE   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1528007507,ALBEMARLE EYE CENTER PLLC,ALBEMARLE EYE CENTER,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1528007507,ALBEMARLE EYE CENTER PLLC,1503 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,, 560 , 564 ," 1,120 "," $15,097.58 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528008232,"ROBINSON, JOHN, BRADEN",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 32 , 32 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528008265,"DAVIS, ALAN, SHAY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528008265,"DAVIS, ALAN, SHAY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528008265,"DAVIS, ALAN, SHAY",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528008265,"DAVIS, ALAN, SHAY",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 61 , 100 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528009875,"LAWAL, ADEYEMI, ADEKUNLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528009875,"LAWAL, ADEYEMI, ADEKUNLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 69 , 73 , 84 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528009875,"LAWAL, ADEYEMI, ADEKUNLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 37 , 45 , 52 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528009875,"LAWAL, ADEYEMI, ADEKUNLE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528009875,"LAWAL, ADEYEMI, ADEKUNLE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528009875,"LAWAL, ADEYEMI, ADEKUNLE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528009875,"LAWAL, ADEYEMI, ADEKUNLE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528010881,"JENKINS, PATRICK",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528012234,"WOOLLETT, IAN, FRANCIS",1933 EDWIN DR STE 208A CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 28 , 53 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528012234,"WOOLLETT, IAN, FRANCIS",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528012234,"WOOLLETT, IAN, FRANCIS",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528012234,"WOOLLETT, IAN, FRANCIS",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1174657951,CAROLINA VISIONCARE,CAROLINA VISIONCARE,703 ROSANNE DR   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1528012994,"HARVEY, JEFFREY",703 ROSANNE DR   KINSTON NC,054,Lenoir,152W00000X,Eye and Vision Services Providers,Optometrist,, 70 , 86 , 107 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528013885,"MARCU, CONSTANTIN, BOGDAN",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528013885,"MARCU, CONSTANTIN, BOGDAN",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528013885,"MARCU, CONSTANTIN, BOGDAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 753 , 882 ," 1,517 "," $42,014.89 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528013885,"MARCU, CONSTANTIN, BOGDAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 89 , 94 , 97 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528013885,"MARCU, CONSTANTIN, BOGDAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 277 , 304 , 368 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528013885,"MARCU, CONSTANTIN, BOGDAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014081,"SPEER, KEVIN, PAUL",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 27 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014081,"SPEER, KEVIN, PAUL",3404 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528014081,"SPEER, KEVIN, PAUL",3404 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528014339,"FOLTZ, JASON, ANDREW",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528014339,"FOLTZ, JASON, ANDREW",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528014339,"FOLTZ, JASON, ANDREW",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 32 , 65 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 15 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 125 , 128 , 169 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1528014891,"MITCHELL, JOSHUA, BRANNON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1528016078,"LAGVANKAR, SEEMA, ASHOK",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1528016078,"LAGVANKAR, SEEMA, ASHOK",50 HOSPITAL DR STE 2D HENDERSONVILLE NC,045,Henderson,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528016797,"QUARLESS, RYAN, MATTHEW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528018074,"DARROW, DAVID, HOWARD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 14 , 16 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528018298,"HATCHETT, JOHN, FRANKLIN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528018298,"HATCHETT, JOHN, FRANKLIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 26 ,$#,,
MEDICAID DIRECT,1225135361,GATE CITY ANESTHESIA INC,Gate City Anesthesia Inc,705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528018298,"HATCHETT, JOHN, FRANKLIN",600 GREEN VALLEY RD STE 304 GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528018298,"HATCHETT, JOHN, FRANKLIN",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528018298,"HATCHETT, JOHN, FRANKLIN",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1548276389,FIRSTHEALTH OF THE CAROLINAS INC,~,522 ALLEN ST STE 101 TROY NC,062,Montgomery,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528018314,"WALL, THOMAS, CRAVEN",522 ALLEN ST STE 101 TROY NC,062,Montgomery,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 96 , 143 , 143 ,$#,,
MEDICAID DIRECT,1750333126,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES,918 7TH AVE   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1528019486,"JOHNSON, ROBERT, LLOYD",918 7TH AVE   GARNER NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1457448300,JOHNSON OPTOMETRIC ASSOCIATES,JOHNSON OPTOMETRIC ASSOCIATES PA,1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1528019486,"JOHNSON, ROBERT, LLOYD",1340 N MAIN ST   FUQUAY VARINA NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528020682,"BUSH, KENNETH, WAYNE",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 51 , 73 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1528020799,"CICIN, JERFI, DAVID",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1528020799,"CICIN, JERFI, DAVID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 13 , 16 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1528020799,"CICIN, JERFI, DAVID",2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528020799,"CICIN, JERFI, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 46 , 59 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1528020799,"CICIN, JERFI, DAVID",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528020799,"CICIN, JERFI, DAVID",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1528020799,"CICIN, JERFI, DAVID",2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528020799,"CICIN, JERFI, DAVID",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528020799,"CICIN, JERFI, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1528020799,"CICIN, JERFI, DAVID",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528020948,"QUEEN, DEBORAH, FRYER",3614 PROVIDENCE RD S STE 101 WAXHAW NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 38 , 97 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528020948,"QUEEN, DEBORAH, FRYER",1994 WELLNESS BLVE STE 110 RANDOLPH PEDIATRICS MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528021086,"PECORARO, FRANCIS, SALVATORE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 105 , 206 , 354 ," $14,518.88 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528021086,"PECORARO, FRANCIS, SALVATORE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 29 , 61 , 92 ,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528021177,"DANIEL, JANICE, DEBELL",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 23 , 23 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",301 E WENDOVER AVE STE 100 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528021581,"REGISTER, THOMAS, EUGENE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1578975462,CROSS RIVER CARDIOLOGY PLLC,,224 SHARON AVE NW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1528021664,"DY, JOHNNY, REYES",224 SHARON AVE NW   LENOIR NC,014,Caldwell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 244 ," 1,201 "," 1,723 "," $33,190.15 ",,
MEDICAID DIRECT,1578975462,CROSS RIVER CARDIOLOGY PLLC,,224 SHARON AVE NW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1528021664,"DY, JOHNNY, REYES",224 SHARON AVE NW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528023298,"D AMORE, KRISTEN, GROSS",640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 244 , 768 , 792 ,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528023298,"D AMORE, KRISTEN, GROSS",1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 56 , 85 , 87 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528024692,"WERNER, KELLY, JO",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 25 , 34 , 79 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,120 CONNER DR STE 101 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528024759,"JOEL, LEIGH, ANN",120 CONNER DR STE 101 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,7780 BRIER CREEK PKWY STE 330 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528024759,"JOEL, LEIGH, ANN",209 E CARVER ST   DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528025723,"SRAN, SARBJEET, KAUR",912 2ND ST NE STE 3 HICKORY NC,018,Catawba,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528025723,"SRAN, SARBJEET, KAUR",912 2ND ST NE STE 3 HICKORY NC,018,Catawba,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528025889,"PANDE, AMIT, VYANKATESH",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1700643335,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES MYRTLE BEACH,107 MCLEOD HEALTH BLVD. SUITE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528025889,"PANDE, AMIT, VYANKATESH",107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1902663529,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES LORIS,3485 MITCHELL STREET   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528025889,"PANDE, AMIT, VYANKATESH",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 24 , 35 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528025889,"PANDE, AMIT, VYANKATESH",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 30 , 42 ,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528025889,"PANDE, AMIT, VYANKATESH",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 33 , 41 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528025889,"PANDE, AMIT, VYANKATESH",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 14 , 24 ,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528026077,"SILVERBERG, MARC, LINDSAY",830 KEMPSVILLE RD PATHOLOGY DEPT NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528026077,"SILVERBERG, MARC, LINDSAY",1975 GLENN MITCHELL DRIVE PATHOLOGY DEPT VIRGINIA BEACH VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528026077,"SILVERBERG, MARC, LINDSAY",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528026077,"SILVERBERG, MARC, LINDSAY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528027547,"ROOF, KEVIN, SCOTT",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 13 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528027547,"ROOF, KEVIN, SCOTT",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 85 , 121 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528027547,"ROOF, KEVIN, SCOTT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1861451437,NEWTON FAMILY PHYSICIANS,~,767 W 1ST ST   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1528027760,"LOPINA, BARTHOLOMEW, JOSEPH",767 W 1ST ST   NEWTON NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 66 , 162 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1528028602,"KOELE, DANIEL, SCOT",7473-C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 39 , 57 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1528028602,"KOELE, DANIEL, SCOT",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 171 , 207 , 301 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528029410,"MASON, STEPHANIE, VANCE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 44 , 44 , 44 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528029493,"KANTOROWSKI, PAMELA, GEERTGENS",145 APPLECROSS RD   SOUTHERN PINES NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 39 , 48 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528029493,"KANTOROWSKI, PAMELA, GEERTGENS",155 MEMORIAL DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003860917,SURGERY CENTER OF PINEHURST LLC,SURGERY CENTER OF PINEHURST LLC,10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1528029493,"KANTOROWSKI, PAMELA, GEERTGENS",5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528029493,"KANTOROWSKI, PAMELA, GEERTGENS",5 FIRST VILLAGE DR STE 100 PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 21 , 33 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528029972,"SMITH, GINGER, ELIZABETH",5603 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174996359,HAMPTON ROADS PEDIATRIC DENTISTRY,FRIENDLY FACES PEDIATRIC DENTISTRY,446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528030608,"GAROFALIS, HARALAMBOS",446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 173 , 306 ," 1,393 "," $50,393.08 ",,
MEDICAID DIRECT,1023568995,RED MILL PEDIATRIC DENTISTRY AND BE,,2336 ELSON GREEN AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528030608,"GAROFALIS, HARALAMBOS",2033 FISHER ARC STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 28 ,$#,,
MEDICAID DIRECT,1346613528,HAMPTON ROADS PEDIATRIC DENTISTRY,HANBURY PEDIATRIC DENTISTRY & BEHL ORTHODONTICS,237 HANBURY RD E STE 30 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528030608,"GAROFALIS, HARALAMBOS",237 HANBURY RD E STE 30 CHESAPEAKE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 337 , 350 ," 1,514 "," $51,788.64 ",,
MEDICAID DIRECT,1346613528,HAMPTON ROADS PEDIATRIC DENTISTRY,HANBURY PEDIATRIC DENTISTRY & BEHL ORTHODONTICS,1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528030608,"GAROFALIS, HARALAMBOS",237 HANBURY RD E STE 30 CHESAPEAKE VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 674 , 801 ," 3,379 "," $110,683.76 ",,
MEDICAID DIRECT,1023568995,RED MILL PEDIATRIC DENTISTRY AND BE,,2033 FISHER ARC STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528030608,"GAROFALIS, HARALAMBOS",2033 FISHER ARC STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 12 ,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528032257,"WONG, NANCY, N",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528032604,"CONLEY, DIANE, HUNTINGTON",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 151 , 155 , 210 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528032604,"CONLEY, DIANE, HUNTINGTON",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 118 , 132 , 181 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,905 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1528032687,"QUALHEIM, ROBERT, EVERETT",300 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1467672204,BLUE RIDGE NEPHROLOGY AND,BLUE RIDGE NEPHROLOGY PA,400 SHADOWLINE DR STE 203 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1528032687,"QUALHEIM, ROBERT, EVERETT",300 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1851363311,BLUE RIDGE CARDIOLOGY AND INTERNAL,BLUE RIDGE CARDIOLOGY AND INTERNAL MEDICINE PA,108 S STATE ST   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1528032687,"QUALHEIM, ROBERT, EVERETT",300 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1215697602,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM NEPHROLOGY,300 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1528032687,"QUALHEIM, ROBERT, EVERETT",300 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3163 GAMMON LN   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",3163 GAMMON LN   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,5870 SAMET DR   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528033172,"LAYMON, BRADLEY, LYNN",5870 SAMET DR   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1528034642,"GUERRIERO, GREGORY, PATRICK",3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 57 , 76 ,$#,,
MEDICAID DIRECT,1639697790,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,193400000X,Group,Single Specialty,,1528034642,"GUERRIERO, GREGORY, PATRICK",2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528034881,SCOTTY WAYNE HINSON,~,125 W THIRD ST   OAKBORO NC,084,Stanly,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528034881,SCOTTY WAYNE HINSON,125 W THIRD ST   OAKBORO NC,084,Stanly,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 15 , 22 , 81 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,2668 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528035268,"KINDLE SUERSIN, KESI, TABIA",2668 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 19 , 28 , 34 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528035268,"KINDLE SUERSIN, KESI, TABIA",2668 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528035425,"MACDONALD, ROBERT, GLEN",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 17 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528035854,"ZARZAR, NICHOLAS, SALEH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528037785,"LEVI, ALLISON",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528037785,"LEVI, ALLISON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528037785,"LEVI, ALLISON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 34 , 44 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1528037785,"LEVI, ALLISON",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 16 , 17 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1528037785,"LEVI, ALLISON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528037785,"LEVI, ALLISON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1528037785,"LEVI, ALLISON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528038205,"MCMANAMAN, JOANNE, FRANCES",301 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 12 , 39 , 74 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528038288,"GERBER, MATTHEW, JOSEPH",10208 CERNY ST STE 301 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528038288,"GERBER, MATTHEW, JOSEPH",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528038288,"GERBER, MATTHEW, JOSEPH",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528038288,"GERBER, MATTHEW, JOSEPH",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 17 , 27 , 39 ,$#,,
MEDICAID DIRECT,1417397027,DR MELANIE S KISER PC,KISER EYE CARE,1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1528038510,"MILAM, RONALD, WALDEN",1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1477696656,"KISER, MELANIE, SUZANNE",,1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,1528038510,"MILAM, RONALD, WALDEN",1960 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1528038817,"ASHBY, CHARLES, CHANDLER",612 KINGSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528038817,"ASHBY, CHARLES, CHANDLER",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528038817,"ASHBY, CHARLES, CHANDLER",111 MEDICAL PKWY FL 2 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1528038817,"ASHBY, CHARLES, CHANDLER",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,441 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528039252,"WOMACK, LAVONIA, CARTER",441 MCALISTER RD STE 2100 LINCOLNTON NC,055,Lincoln,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 86 , 113 , 113 ,$#,,
MEDICAID DIRECT,1104880723,WNC EYE SURGERY CENTER,,8B MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1528040128,"HAYNES, WILLIAM, LEE",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 19 , 21 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528040128,"HAYNES, WILLIAM, LEE",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 98 , 144 , 223 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1528040581,"FRIZZELL, BART, ALAN",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528040581,"FRIZZELL, BART, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 44 , 127 , 141 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528040961,"HADEN, ALLISON, OLEY",210 E TRADE ST STE D230 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528040961,"HADEN, ALLISON, OLEY",1942 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528041225,"BURDEN, SUSAN, KATHARINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528041225,"BURDEN, SUSAN, KATHARINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 112 , 152 , 237 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528041225,"BURDEN, SUSAN, KATHARINE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528042058,"MELIN, SUSAN, ANITRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1871577197,KINSTON PEDIATRIC ASSOCIATES PA,Kinston Pediatric Associates PA,2509 N QUEEN ST   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1528042728,"PERRY, JOAN, TEMPLETON",2509 N QUEEN ST   KINSTON NC,054,Lenoir,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 22 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528042926,"FERGUSON, CRISTIN, MARTHA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 32 , 69 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528043148,"ALSTON, NIMIA, JUDITH",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 32 , 47 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1528043148,"ALSTON, NIMIA, JUDITH",2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 58 , 111 , 193 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528043346,"TRIBBLE, BRENDAN, THOMAS",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528043346,"TRIBBLE, BRENDAN, THOMAS",1800 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528043346,"TRIBBLE, BRENDAN, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528043346,"TRIBBLE, BRENDAN, THOMAS",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528043940,"BURDETTE, JONATHAN, HILL",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528043940,"BURDETTE, JONATHAN, HILL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 196 , 208 , 338 ," $10,766.70 ",,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528043940,"BURDETTE, JONATHAN, HILL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528043940,"BURDETTE, JONATHAN, HILL",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447715982,MORIARTY PHYSICAL THERAPY INC,,2310 BALE ST STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528044013,"QUINN, JOHN, PAUL",2310 BALE ST STE 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 16 , 339 , 343 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528044187,"SMITH, STEVEN, WAYNE",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528044609,"BELL, WILLIAM, LYNN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528044609,"BELL, WILLIAM, LYNN",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1689019259,EAST CAROLINA UNIVERSITY,ECU MEDICINE NEUROLOGY SERVICES,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528044609,"BELL, WILLIAM, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528044609,"BELL, WILLIAM, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 125 , 145 , 162 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528045234,"MAHIQUEZ, JOSE, FELIPE",388 VENTURE DR STE I SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 142 , 183 , 268 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528045507,"CHAMBERS JR, CARROLL, LABRON",1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528045507,"CHAMBERS JR, CARROLL, LABRON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 32 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528045507,"CHAMBERS JR, CARROLL, LABRON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528045507,"CHAMBERS JR, CARROLL, LABRON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528046562,"GEOROFF, MARY, ELLEN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 21 , 18 , 21 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,3201 EDWARDS MILL RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",3201 EDWARDS MILL RD STE 140 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",621 CHESTNUT RIDGE PKWY   BLOWING ROCK NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",514 OLD MOUNT HOLLY RD   STANLEY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 44 , 45 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",514 OLD MOUNT HOLLY RD   STANLEY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 296 , 312 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,485 VETERANS WAY   KERNERSVILLE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",514 OLD MOUNT HOLLY RD   STANLEY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,3201 EDWARDS MILL RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,109 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",100 SUNSET ST   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 734 , 839 ," $15,201.76 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 80 , 80 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",56 N HIGHLAND AVE   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 54 , 54 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 65 , 72 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",100 SUNSET ST   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 100 , 110 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",2030 HARPER AVE NW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 195 , 237 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 100 , 291 , 302 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 63 , 90 , 94 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",3647 MILLER BRIDGE RD   CONNELLY SPRINGS NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 70 , 72 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",3031 TATE BLVD SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",2140 MEDICAL PARK DR   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",3031 TATE BLVD SE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 130 , 138 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1528047248,"NELSON, JOHN, DOUGLAS",931 N ASPEN ST   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,548 WILLIAMSON RD STE 6 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528047404,"WOLFE, STEVEN, FREDERICK",114 GATEWAY BLVD STE D MOORESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528047404,"WOLFE, STEVEN, FREDERICK",114 GATEWAY BLVD STE D MOORESVILLE NC,049,Iredell,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528047503,"CLARK, WILLIAM, GILMER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528047503,"CLARK, WILLIAM, GILMER",10500 LIGON MILL RD STE 113 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1528047701,"LUPKAS, RAYMOND, ROBERT",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1528047701,"LUPKAS, RAYMOND, ROBERT",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528047701,"LUPKAS, RAYMOND, ROBERT",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942478383,DUPLIN GENERAL HOSPITAL INC,DUPLIN GENERAL HOSPITAL INC,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1528047701,"LUPKAS, RAYMOND, ROBERT",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528048550,"SUMNER, BRIAN, ANDREW",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 30 , 46 , 118 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528048949,"CAMPBELL, GREGORY, HUGH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528048949,"CAMPBELL, GREGORY, HUGH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 83 , 104 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528049517,"GOLI, DEVAINDER",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528049517,"GOLI, DEVAINDER",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528049517,"GOLI, DEVAINDER",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 108 , 111 , 117 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528050614,"PRISCO, MELINDA, NOBLES",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528051729,"LILES, DARLA, KAYE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528051729,"LILES, DARLA, KAYE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 82 , 132 , 134 ,$#,,
MEDICAID DIRECT,1528051935,PIGEON VALLEY REST HOME LLC,,55 LAKE DR   CANTON NC,044,Haywood,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1528051935,PIGEON VALLEY REST HOME LLC,55 LAKE DR   CANTON NC,044,Haywood,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 17 , 17 ," $31,684.80 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528053931,"HALLA, BRIAN, LOUIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 72 , 73 ,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1528054152,"GARDNER, BRAD, VANCE",1220 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 510 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528054244,"KARAVAN, MARK, PHILLIP",920 DOUG WHITE DR STE 510 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1902087927,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1528054277,"HIGH, JAMES, RICHARD",1212 SPRUCE ST STE 201 BELMONT NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 31 , 69 ,$#,,
MEDICAID DIRECT,1194904706,CAROMONT MEDICAL GROUP INC,CAROMONT PEDIATRIC PARTNERS,705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528054277,"HIGH, JAMES, RICHARD",705 SUMMIT CROSSING PL STE 150 GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528054673,"DAVIS, RONALD, LEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 64 , 84 , 132 ,$#,,
MEDICAID DIRECT,1841516960,PREMIER IMAGING LLC,~,4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,293D00000X,Laboratories,Physiological Laboratory,,1528054673,"DAVIS, RONALD, LEE",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528057056,"BORSTAD, GREGORY, CLARK",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1528057056,"BORSTAD, GREGORY, CLARK",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,1101 DRESSER CT   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528057890,"CLARK, WILLIAM, LLOYD",3322 WELLONS BLVD   NEW BERN NC,025,Craven,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 28 , 67 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,3322 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1528057890,"CLARK, WILLIAM, LLOYD",3322 WELLONS BLVD   NEW BERN NC,025,Craven,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215100318,TAYLOR RETINA CENTER PLLC,~,3322 WELLONS BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1528057890,"CLARK, WILLIAM, LLOYD",3322 WELLONS BLVD   NEW BERN NC,025,Craven,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528058047,"RATHINASAMY, PALANI",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528058047,"RATHINASAMY, PALANI",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528058047,"RATHINASAMY, PALANI",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 58 , 58 , 72 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528058047,"RATHINASAMY, PALANI",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528058047,"RATHINASAMY, PALANI",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528058047,"RATHINASAMY, PALANI",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528058047,"RATHINASAMY, PALANI",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528058096,"COLEMAN, CLARENCE, COOLIDGE",810 DELANY DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528059292,"SKINNER, STEVEN, ALBERT",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207SG0201X,Allopathic & Osteopathic Physicians,Medical Genetics,Clinical Genetics (M.D.),#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1528059771,"PAPE, GREGORY, SCOTT",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528059771,"PAPE, GREGORY, SCOTT",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528059771,"PAPE, GREGORY, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528059771,"PAPE, GREGORY, SCOTT",201 E GROVER ST   SHELBY NC,023,Cleveland,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528059862,"GENTLESK, PHILIP, JOHN",300 MEDICAL PKWY STE 120 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528059862,"GENTLESK, PHILIP, JOHN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1366433773,GASTON MEDICAL ASSOCIATES,GASTON MEDICAL ASSOCIATES,2664 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528059920,"AJAO, OLUFOLARIN, AKANFE",2664 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 221 ," 1,082 "," 1,771 "," $25,051.65 ",,
MEDICAID DIRECT,1528059920,"AJAO, OLUFOLARIN, AKANFE",~,2664 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1528059920,"AJAO, OLUFOLARIN, AKANFE",2664 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528060209,"ANDERSON, ARNE, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528060209,"ANDERSON, ARNE, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1689114969,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN ORTHOPAEDICS,314 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1528062940,"FERRIS, JASON, LINDSEY",314 S SOUTH ST STE 100 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 218 , 304 ,$#,,
MEDICAID DIRECT,1245361484,HICKORY ADULT MEDICINE AND KIDNEY S,HICKORY ADULT MEDICINE AND KIDNEY SPECIALISTS PA,1344 N CENTER ST STE A HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1528065604,"PISEL, GREGORY, ALLEN",1899 TATE BLVD SE   HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1245361484,HICKORY ADULT MEDICINE AND KIDNEY S,HICKORY ADULT MEDICINE AND KIDNEY SPECIALISTS PA,1344 N CENTER ST STE A HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1528065604,"PISEL, GREGORY, ALLEN",301 10TH ST NW   CONOVER NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528065604,"PISEL, GREGORY, ALLEN",1344 N CENTER ST STE A HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 21 , 98 , 107 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528065604,"PISEL, GREGORY, ALLEN",1899 TATE BLVD SE   HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 115 , 225 , 228 ,$#,,
MEDICAID DIRECT,1245361484,HICKORY ADULT MEDICINE AND KIDNEY S,HICKORY ADULT MEDICINE AND KIDNEY SPECIALISTS PA,1344 N CENTER ST STE A HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1528065604,"PISEL, GREGORY, ALLEN",1344 N CENTER ST STE A HICKORY NC,018,Catawba,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528066354,"WILLIAMS, LINDA, GAIL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528066354,"WILLIAMS, LINDA, GAIL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528067204,"BEHLING, KAREN, JUTTA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 34 ,$#,,
MEDICAID DIRECT,1750536157,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE MEBANE,1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528067204,"BEHLING, KAREN, JUTTA",1352 MEBANE OAKS RD   MEBANE NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 136 , 305 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528067238,"KELLY, AMY, HENDERSON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1932534914,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH LIVER CARE AND TRANSPLANT,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528067238,"KELLY, AMY, HENDERSON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1528067519,"RICCI, DANIEL",112 MEDICAL VILLAGE DR STE G WALLACE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528068004,"HANDE, VISHWANATH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 117 , 342 ," 1,424 ",$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528068004,"HANDE, VISHWANATH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 47 , 159 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528068004,"HANDE, VISHWANATH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528068004,"HANDE, VISHWANATH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528068293,"LOMBARDOZZI, KRISTINE, ANNE KOLEWE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1013903830,RUTHERFORD ORTHOPAEDICS,Rutherford Orthopeadics,,,Unknown,193400000X,Group,Single Specialty,,1528069051,"FREELS, DOUGLAS, BOYD",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1013903830,RUTHERFORD ORTHOPAEDICS,Rutherford Orthopeadics,,,Unknown,193400000X,Group,Single Specialty,,1528069051,"FREELS, DOUGLAS, BOYD",901 E CHEVES ST STE 100   FLORENCE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1548884984,EYECARECENTER OD PA,EYECARE CENTER,215 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1528069234,"WALKER, KEVIN",215 MOORE RD   KING NC,085,Stokes,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 24 , 27 ,$#,,
MEDICAID DIRECT,1164688032,NORTHWOOD MEDICAL CENTER,,116 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528069762,"ARAGHI, SASAN, SAEDI",116 COUNTRY CLUB DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 84 , 349 , 400 ," $14,031.78 ",,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528071610,"CLAPACS, JOHN, TERRY",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528071610,"CLAPACS, JOHN, TERRY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528072394,"LENSCH, DAVID, PAUL",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 66 , 72 , 77 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528072394,"LENSCH, DAVID, PAUL",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,825 FAIRFAX AVE STE 118 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528073343,"FELIBERTI, ERIC, CHARLES",825 FAIRFAX AVE   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528076551,"DAVIS, STEVEN, HOWARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528077708,"ADAM, AMER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 75 , 221 , 221 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",600 HOSPITAL DR   MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 56 , 63 , 76 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528079324,"KOLASA, MARK, WAYNE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528080389,"O MALLEY, ROBERT, BRIAN",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 30 , 48 , 77 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528080389,"O MALLEY, ROBERT, BRIAN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528080389,"O MALLEY, ROBERT, BRIAN",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528080389,"O MALLEY, ROBERT, BRIAN",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 18 , 26 , 45 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 79 , 85 , 110 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 76 , 96 , 148 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 141 , 164 , 232 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1528083011,"MOORE, DAVID, ELDEN",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 828 ," 1,331 "," 1,942 "," $30,798.31 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528083011,"MOORE, DAVID, ELDEN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 42 , 44 , 56 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528084357,"WHITE, ELIZABETH, ANNE",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528084357,"WHITE, ELIZABETH, ANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 66 , 142 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528084357,"WHITE, ELIZABETH, ANNE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528084357,"WHITE, ELIZABETH, ANNE",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528084357,"WHITE, ELIZABETH, ANNE",1814 WESTCHESTER DR STE 101 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790851004,ROANOKE CHOWAN COMMUNITY HEALTH CEN,COLERAIN PRIMARY CARE,109 W RIVER ST   COLERAIN NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528085552,"MCGRATH, TIMOTHY, JOHN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528085552,"MCGRATH, TIMOTHY, JOHN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 118 , 307 , 347 ," $11,556.38 ",,
MEDICAID DIRECT,1528085768,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3305,6711 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1528085768,WAL-MART STORES EAST LP,6711 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1528085768,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3305,6711 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1528085768,WAL-MART STORES EAST LP,6711 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1689016628,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1010 E DIXON BLVD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528086295,"RAMACHANDRAN, PRADEEP",201 E GROVER ST   SHELBY NC,023,Cleveland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528086386,"CINOMAN, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 32 , 34 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528086980,"CYZNER, RONNIE",1450 MATTHEWS TOWNSHIP PKWY STE 460 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528086980,"CYZNER, RONNIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528086980,"CYZNER, RONNIE",1450 MATTHEWS TOWNSHIP PKWY STE 460 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528086980,"CYZNER, RONNIE",10520 PARK RD STE 105 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 16 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528086980,"CYZNER, RONNIE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528086980,"CYZNER, RONNIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528086980,"CYZNER, RONNIE",10620 PARK RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528086980,"CYZNER, RONNIE",300 BILLINGSLEY RD STE 200B CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528086980,"CYZNER, RONNIE",10620 PARK RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 40 , 89 , 120 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528086980,"CYZNER, RONNIE",600 HOSPITAL DR   MONROE NC,090,Union,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528087772,"MAUGHAN, ROBERT, EMMETT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 28 , 38 ," $12,897.86 ",,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528087772,"MAUGHAN, ROBERT, EMMETT",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1386084671,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY CARDIOVASCULAR,2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528087772,"MAUGHAN, ROBERT, EMMETT",2153 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 27 , 27 ,$#,,
MEDICAID DIRECT,1528091345,NURSE AID LLC,ANGEL HANDS HOME CARE,2711 PINEDALE RD STE D GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1528091345,NURSE AID LLC,2711 PINEDALE RD STE D GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 3,910 "," 3,913 "," $427,088.84 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528091758,"MOLAI, ASHTON, VISHNU",200 W PARK CIR STE B NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 148 , 221 ,$#,,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528092103,"CHERRY, ALKA, PATEL",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528092277,"POPLI, GUATAM, SIDHARATH SINGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 100 , 166 , 211 ," $18,781.23 ",,
MEDICAID DIRECT,1447383773,ASHEVILLE PEDIATRIC ASSOCIATES PA,ASHEVILLE PEDIATRIC ASSOCIATES PA,2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1528092830,"COHEN, SUSAN, RAY",2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 59 , 97 , 329 ," $13,987.26 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528094844,"VELAZQUEZ, GRETCHEN, YAZMINE",4515 PREMIER DR   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 64 , 85 ,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528096591,"ANDERSON, ROGER, FABIAN",2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528096591,"ANDERSON, ROGER, FABIAN",2901 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528096591,"ANDERSON, ROGER, FABIAN",11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 11 , 30 , 49 ,$#,,
MEDICAID DIRECT,1528096724,"LASSITER, JOHN, LAWRENCE",JOHN LAWRENCE LASSITER DDS,323 W MAIN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1528096724,"LASSITER, JOHN, LAWRENCE",323 W MAIN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 180 , 389 ," 1,079 "," $48,812.67 ",,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",420 PARK ST   BELMONT NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528098134,"SHAH, KETAN, DHAN",613 E ROOSEVELT BLVD   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 26 , 52 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528098936,"FRINO, JOHN",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528098936,"FRINO, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1093703886,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER FAMILY PRACTICE,301 S CAMPBELL ST   BURGAW NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528099462,"GREENSPAN, LINDA, I",301 S CAMPBELL ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 45 , 57 ,$#,,
MEDICAID DIRECT,1174511976,BLACK RIVER HEALTH SERVICES INC,Black River Health Services,109 W CHURCH ST   ATKINSON NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528099462,"GREENSPAN, LINDA, I",109 W CHURCH ST   ATKINSON NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1356339154,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER HEALTH SERVICES INC,4811 NC HWY 50   MAPLE HILL NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528099462,"GREENSPAN, LINDA, I",4811 NC HIGHWAY 50   MAPLE HILL NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1528099462,"GREENSPAN, LINDA, I",301 S CAMPBELL ST   BURGAW NC,071,Pender,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 29 , 29 ," $10,786.91 ",,
MEDICAID DIRECT,1124290218,RICHARD W WIEDEMAN DDS PA,~,15 JANE JACOBS RD STE 201 BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528102027,"WIEDEMAN, RICHARD, WILLIAM",15 JANE JACOBS RD STE 201 BLACK MOUNTAIN NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 244 , 483 ," 2,257 "," $149,041.48 ",,
MEDICAID DIRECT,1528102779,CARTERET COUNTY SCHOOLS,Careret County Schools 160,107 SAFRIT DR   BEAUFORT NC,016,Carteret,251300000X,Agencies,Local Education Agency (LEA),,1528102779,CARTERET COUNTY SCHOOLS,107 SAFRIT DR   BEAUFORT NC,016,Carteret,251300000X,Agencies,Local Education Agency (LEA),, 281 ," 7,110 "," 7,385 "," $341,749.63 ",,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528110996,"WINSTEAD, CRYSTAL, ALLEN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 39 , 39 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528110996,"WINSTEAD, CRYSTAL, ALLEN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1528112364,AVA MOORE DANIELS,MOORES FAMILY CARE HOME,154 HWY NC 42   POWELLSVILLE NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1528112364,AVA MOORE DANIELS,154 HWY NC 42   POWELLSVILLE NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 11 , 193 , 193 ," $128,078.40 ",,
MEDICAID DIRECT,1215348156,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES PRIMARY CARE APEX,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1528115961,"MADAN, RAGINI, TANDON",120 HEALTHPLEX WAY   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 32 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528117538,"GERSH, SCOTT, WARREN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 22 , 32 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528117538,"GERSH, SCOTT, WARREN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 178 , 184 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3320 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528117538,"GERSH, SCOTT, WARREN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 66 , 82 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528117546,"CHESSON, MELANIE, ANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 98 , 101 ,$#,,
MEDICAID DIRECT,1114273158,SHANA XAVIERA CRAWFORD-HAWKINS DDS,SHANA X CRAWFORD DDS,101 DALLAS TOWNE PLZ   DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1528117967,"CRAWFORD, SHANA, XAVIERA",101 DALLAS TOWNE PLZ   DALLAS NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 474 ," 1,147 "," 3,600 "," $200,962.66 ",,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528121191,"COOPER, TRELLA, SHEVONNE",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 ,#, 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2901 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1528121456,"CUMMINGS, EARL",2901 N ELM ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 225 , 307 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528121456,"CUMMINGS, EARL",395 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528121563,"HUNG, JERRY, BAULOONG",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 38 , 73 , 79 ," $10,734.47 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528121654,"KOONTS, ALISON, PERDUE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 32 ,$#,,
MEDICAID DIRECT,1528122678,SELECT LABORATORIES-SC LLC,SELECT LABORATORIES SC,1051 BILL BUYCK BLVD   MANNING SC,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1528122678,SELECT LABORATORIES-SC LLC,1051 BILL BUYCK BLVD   MANNING SC,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 57 , 69 , 166 ,$#,,
MEDICAID DIRECT,1285882928,PHYSICIAN ALLIANCE FOR MENTAL HEALT,~,3208 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528126166,"HOLLAND, GEOFFREY, DEVRIES",3208 OLEANDER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 275 , 275 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528128717,"SCHWARTZ, JOSHUA, DAVID",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528128717,"SCHWARTZ, JOSHUA, DAVID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 103 , 105 , 116 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528128717,"SCHWARTZ, JOSHUA, DAVID",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528128717,"SCHWARTZ, JOSHUA, DAVID",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 45 , 48 , 61 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528128717,"SCHWARTZ, JOSHUA, DAVID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528128717,"SCHWARTZ, JOSHUA, DAVID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528129491,"ZOLOTOR, ADAM, JASON",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528129491,"ZOLOTOR, ADAM, JASON",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 40 , 60 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528131356,"DOWNS, JOHN, PRESTON",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 45 , 45 ,$#,,
MEDICAID DIRECT,1265908479,MH MISSION HOSPITAL MCDOWELL LLLP,,1633 SUGAR HILL RD   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528131448,"DUNCAN, JACQUELINE, FRANCES",339 NEBO SCHOOL RD   NEBO NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265908479,MH MISSION HOSPITAL MCDOWELL LLLP,,1633 SUGAR HILL RD   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528131448,"DUNCAN, JACQUELINE, FRANCES",1633 SUGAR HILL RD   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 27 ,$#,,
MEDICAID DIRECT,1942389838,BLUE RIDGE PEDIATRICS LLP,BLUE RIDGE PEDIATRICS LLP,3124 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528132461,"PAREKH, KOMAL, HASMUKH",3124 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 29 , 89 ,$#,,
MEDICAID DIRECT,1528135035,VENTURE REHABILITATION GROUP,VENTURE REHABILITATION GROUP,1425 E FIRE TOWER RD UNIT 104 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528135035,VENTURE REHABILITATION GROUP,1425 E FIRE TOWER RD UNIT 104 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,, 136 ," 2,559 "," 2,601 "," $181,356.17 ",,
MEDICAID DIRECT,1124353198,CORNERSTONE INTERNAL MEDICINE PLLC,~,2703 JONES FRANKLIN RD STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528137254,"LIU, YU",2703 JONES FRANKLIN RD STE 101 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 42 , 52 ,$#,,
MEDICAID DIRECT,1528137494,BOONE DRUG AT NEW MARKET LLC,BOONE DRUG AT NEW MARKET,245 NEW MARKET CTR   BOONE NC,095,Watauga,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1528137494,BOONE DRUG AT NEW MARKET LLC,245 NEW MARKET CTR   BOONE NC,095,Watauga,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528138740,"LURIE, BRIAN, MATTHEW",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",4709 CREEKSTONE DR   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",2301 ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 37 , 37 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",10 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",2301 ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology, 194 , 356 , 436 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",2301 ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1528141777,"CARRICO, CAROLINE, WAY THOMPSON",ERWIN RD   DURHAM NC,032,Durham,2085P0229X,Allopathic & Osteopathic Physicians,Radiology,Pediatric Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141785,"FEILER, MICHAEL, JUSTIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,249 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528141785,"FEILER, MICHAEL, JUSTIN",249 E NC HIGHWAY 54 STE 200 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1073003752,GOODEN MOBILE POD NC PLLC,,311 MCFADYEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528141850,"HALL, JENNY, LIND",207 LEE ST   GOLDSBORO NC,096,Wayne,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 68 , 76 , 108 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528142130,"HASSAN, RAHMA, AHMED",2525 COURT DR   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 111 , 111 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528142411,"POSTEL, ERIC, ATTILA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528142494,"VASLEF, STEVEN, NICHOLAS",10 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528142494,"VASLEF, STEVEN, NICHOLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1528142601,"NORTH, CHERIE, NOELLE",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528143070,"JEFFCOAT, VALENCIA, HUDSON",901 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528143989,CAROLINA REST HOME OF HALIFAX,Carolina Rest Home of Halifax,1361 CAROLINA REST HOME RD   ROANOKE RAPIDS NC,042,Halifax,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1528143989,CAROLINA REST HOME OF HALIFAX,1361 CAROLINA REST HOME RD   ROANOKE RAPIDS NC,042,Halifax,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 29 ," 7,298 "," 7,298 "," $450,795.23 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528144359,"BUCHANAN, FAITH, BRIANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",1995 WELLNESS BLVD STE 200 MONROE NC,090,Union,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,,,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",14135 BALLANTYNE CORPORATE PL STE 225 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 66 , 69 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 85 , 85 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",11840 SOUTHMORE DR STE 175 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 22 , 33 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528145224,"PATEL, ROOPEN, RAJENDRA",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 35 , 226 , 305 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528148657,"GLOWER, DONALD, DUANE",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1952458325,CHRISTOPHER L DURHAM DDS PA,THE ORAL SURGERY INSTITUTE OF THE CAROLINAS,6 N POINTE CT STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528149358,"TSEGGA, TIBEBU, MEKONNEN",6 N POINTE CT STE 101 GREENSBORO NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 42 ,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1528149762,"JORDAN, HEATHER, WAGNER",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 15 ,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528149762,"JORDAN, HEATHER, WAGNER",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,261 LONGVUE DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528149762,"JORDAN, HEATHER, WAGNER",261 LONGVUE DR   BOONE NC,095,Watauga,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1316184807,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,381 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528149762,"JORDAN, HEATHER, WAGNER",381 DEERFIELD RD   BOONE NC,095,Watauga,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 19 , 26 , 55 ,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528155058,"ACEVEDO, ANGELA, PATRICIA",180 PARKWOOD DR 180 PARKWOOD DRIVE ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528155058,"ACEVEDO, ANGELA, PATRICIA",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528155058,"ACEVEDO, ANGELA, PATRICIA",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 40 , 57 ,$#,,
MEDICAID DIRECT,1952819575,SAMPSON REGIONAL EMERGENCY PROFESSI,,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1528155272,"EVANS, MICHAEL, ALLEN",607 BEAMAN ST   CLINTON NC,082,Sampson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 170 , 228 , 237 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528156957,"KULLER, JEFFREY",11001 DURANT RD STE 114 RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 22 , 42 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528156957,"KULLER, JEFFREY",2406 BLUE RIDGE RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528156957,"KULLER, JEFFREY",1200 NAVAHO DR   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528156957,"KULLER, JEFFREY",600 NEW WAVERLY PL   CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1720104540,VALDESE FAMILY PRACTICE,VALDESE FAMILY PRACTICE,99 GRIFFIN ST   RUTHERFORD COLLEGE NC,012,Burke,193400000X,Group,Single Specialty,,1528157690,"ARENSMAN, TODD, ALLEN",99 GRIFFIN ST   RUTHERFORD COLLEGE NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 27 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528160199,"ARMSTRONG, ANDREW, JOHN",20 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528160199,"ARMSTRONG, ANDREW, JOHN",20 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1821555020,SURGICAL CENTER FOR DENTAL PROFESSI,SCDP ANESTHESIA PROFESSIONALS,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528160827,"PAPADAKOS, GINA, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1821555020,SURGICAL CENTER FOR DENTAL PROFESSI,SCDP ANESTHESIA PROFESSIONALS,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528160827,"PAPADAKOS, GINA, MARIE",2620 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629472568,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1235 DCCC RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1528160959,"LANIER, KAREN",1235 DCCC RD   THOMASVILLE NC,029,Davidson,1223P0300X,Dental Providers,Dentist,Periodontics,#,#, 11 ,$#,,
MEDICAID DIRECT,1528161155,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07321,11314 US 15 501 N   CHAPEL HILL NC,019,Chatham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1528161155,NORTH CAROLINA CVS PHARMACY LLC,11314 US 15 501 N   CHAPEL HILL NC,019,Chatham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1528161221,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04655,401 S MAIN ST   GRAHAM NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528161221,NORTH CAROLINA CVS PHARMACY LLC,401 S MAIN ST   GRAHAM NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1528162294,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05341,1142 N BROOME ST   WAXHAW NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528162294,NORTH CAROLINA CVS PHARMACY LLC,1142 N BROOME ST   WAXHAW NC,090,Union,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1528162294,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05341,1142 N BROOME ST   WAXHAW NC,090,Union,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1528162294,NORTH CAROLINA CVS PHARMACY LLC,1142 N BROOME ST   WAXHAW NC,090,Union,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528164423,"EWING, WHITNEY, MERRILL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528167749,"WOOD JR, WILLIAM, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 32 , 36 ,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1528168275,"HUDSON, JENNIFER, GARRATY",129 WOODSON ST   SALISBURY NC,080,Rowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 61 , 120 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528168549,"MILLER, CHARLES, GRIFFITH",935 STATE FARM RD   BOONE NC,095,Watauga,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1457729634,APPALACHIAN REGIONAL MEDICAL ASSOCI,BOONE UROLOGY CENTER,870 STATE FARM RD STE 100 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528168549,"MILLER, CHARLES, GRIFFITH",935 STATE FARM RD   BOONE NC,095,Watauga,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1457729634,APPALACHIAN REGIONAL MEDICAL ASSOCI,BOONE UROLOGY CENTER,870 STATE FARM RD STE 100 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528168549,"MILLER, CHARLES, GRIFFITH",870 STATE FARM RD STE 100 BOONE NC,095,Watauga,208800000X,Allopathic & Osteopathic Physicians,Urology,, 31 , 50 , 100 ,$#,,
MEDICAID DIRECT,1457729634,APPALACHIAN REGIONAL MEDICAL ASSOCI,BOONE UROLOGY CENTER,870 STATE FARM RD STE 100 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528168549,"MILLER, CHARLES, GRIFFITH",968 HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1457729634,APPALACHIAN REGIONAL MEDICAL ASSOCI,BOONE UROLOGY CENTER,,,Unknown,193200000X,Group,Multi-Specialty,,1528168549,"MILLER, CHARLES, GRIFFITH",968 HWY 221 BUSINESS   WEST JEFFERSON NC,005,Ashe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1528169307,"MARZBANI, SIAMAK",2076 VETERANS PKWY   CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1528169307,"MARZBANI, SIAMAK",520 NORTH ST   SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 84 , 135 , 193 ," $22,406.29 ",,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1528169307,"MARZBANI, SIAMAK",2076 NC HIGHWAY 42 W STE 110 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 14 , 21 ,$#,,
MEDICAID DIRECT,1821590126,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1528169711,"NGUYEN, YEN, HOANG",499 GREENVILLE BLVD SE   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528169711,"NGUYEN, YEN, HOANG",9 MEDICAL DR   GREENVILLE NC,074,Pitt,152W00000X,Eye and Vision Services Providers,Optometrist,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528171139,"DEW, DORINDA, LEWIS",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528171139,"DEW, DORINDA, LEWIS",1630 MILITARY CUTOFF RD STE 108 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528171139,"DEW, DORINDA, LEWIS",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528171139,"DEW, DORINDA, LEWIS",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528171626,"DECKER, JACLYNN, JOAN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528171626,"DECKER, JACLYNN, JOAN",4009 CRAIG AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528171626,"DECKER, JACLYNN, JOAN",4009 CRAIG AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 82 , 82 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528172020,"CALLAHAN, KATHLEEN, MARIE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528174521,"CRUZ, THOMAS, MICHAEL",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528174521,"CRUZ, THOMAS, MICHAEL",3333 SILAS CREEK PKWY 3333 SILAS CREEK PKWAY WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 40 , 48 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528174521,"CRUZ, THOMAS, MICHAEL",3333 SILAS CREEK PKWY 3333 SILAS CREEK PKWAY WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 71 , 72 , 93 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528175858,"HACKLER, DEBBIE, JUNE",920 COX RD STE 201 GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,204 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1528177383,"WORSHAM, LEANNA, JO",8712 LINDHOLM DR STE 302 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 563 , 564 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1101 MAPLE CARE LN   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528177383,"WORSHAM, LEANNA, JO",8712 LINDHOLM DR STE 302 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 948 , 948 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1101 MAPLE CARE LN   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528177383,"WORSHAM, LEANNA, JO",1101 MAPLE CARE LN   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 67 ," 1,271 "," 1,271 "," $12,845.17 ",,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1101 MAPLE CARE LN   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528177383,"WORSHAM, LEANNA, JO",8712 LINDHOLM DR STE 302 HUNTERSVILLE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,204 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1528177383,"WORSHAM, LEANNA, JO",204 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 382 , 382 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528178233,"DIAZ, LUIS, ALBERTO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528178233,"DIAZ, LUIS, ALBERTO",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 19 , 21 , 25 ,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,4016 BATTLEGROUND AVE STE G&H GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528181732,"JORDAN, JENE, FRANKLIN",209 BALFOUR DR   ARCHDALE NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,209 BALFOUR DR   ARCHDALE NC,076,Randolph,193400000X,Group,Single Specialty,,1528181732,"JORDAN, JENE, FRANKLIN",209 BALFOUR DR   ARCHDALE NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 272 ," 1,083 "," 1,319 "," $203,208.84 ",,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,513 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1528181732,"JORDAN, JENE, FRANKLIN",513 WHITE OAK ST   ASHEBORO NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,513 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1528181732,"JORDAN, JENE, FRANKLIN",209 BALFOUR DR   ARCHDALE NC,076,Randolph,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 14 , 19 , 23 ,$#,,
MEDICAID DIRECT,1659031912,GOGGANS ASSOCIATES OF NORTH CAROLIN,SMILE DOCTORS OF NORTH CAROLINA,4016 BATTLEGROUND AVE STE G&H GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528181732,"JORDAN, JENE, FRANKLIN",4016 BATTLEGROUND AVE STE G&H GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528187069,"FOX, JANELLE, ANN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1528187770,HEY CLINIC PA,~,3320 WAKE FOREST RD STE 450 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528187770,HEY CLINIC PA,3320 WAKE FOREST RD STE 450 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1528189040,"LOPEZ, ALVARO, XAVIER",,117 N BROAD ST   BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice,1528189040,"LOPEZ, ALVARO, XAVIER",117 N BROAD ST   BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 238 , 496 ," 1,444 "," $46,119.78 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528190923,"SCHNOOR, ZACHARY, PAUL",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223E0200X,Dental Providers,Dentist,Endodontics, 190 , 208 , 412 ," $31,098.61 ",,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1528193547,"CRAWLEY, ELIZABETH, JARMAN",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528193554,"ELLINGTON, LAURA, BUDD",161 WALKER ST   COLUMBUS NC,075,Polk,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 20 , 119 , 119 ,$#,,
MEDICAID DIRECT,1932486503,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE TAYLORSVILLE,,,Unknown,193200000X,Group,Multi-Specialty,,1528196227,"OKUBOYE, DEJI, OLUREMI",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104388263,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - TAYLORSVILLE,50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528196227,"OKUBOYE, DEJI, OLUREMI",50 MACEDONIA CHURCH RD   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 23 , 35 ,$#,,
MEDICAID DIRECT,1528197829,BUNCOMBE COUNTY SCHOOLS,Buncombe County Schools,175 BINGHAM RD   ASHEVILLE NC,011,Buncombe,251300000X,Agencies,Local Education Agency (LEA),,1528197829,BUNCOMBE COUNTY SCHOOLS,175 BINGHAM RD   ASHEVILLE NC,011,Buncombe,251300000X,Agencies,Local Education Agency (LEA),, 904 ," 11,798 "," 12,138 "," $495,546.44 ",,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1528199056,"MANN, CHRISTOPHER, HAYES",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 33 , 55 , 109 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528199734,"MACIVER, NANCIE, JO",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 23 , 39 , 39 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528200094,"PATEL, ZEAL, RASIKLAL",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,2000 HOSPITAL DR   MOUNT PLEASANT SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1528200128,"MOORE, JOEL, RICHARD",2000 HOSPITAL DR   MOUNT PLEASANT SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528200276,"FLEISHMAN, MARGARET, VIRGINIA",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 26 , 30 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528200276,"FLEISHMAN, MARGARET, VIRGINIA",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528200276,"FLEISHMAN, MARGARET, VIRGINIA",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528202041,"HUGHLEY, BRIAN, BISHOP",3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528202041,"HUGHLEY, BRIAN, BISHOP",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528202041,"HUGHLEY, BRIAN, BISHOP",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528202041,"HUGHLEY, BRIAN, BISHOP",3404 WAKE FOREST RD STE 202 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528202074,"LANGFITT, MAXWELL, KENNETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 22 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528202074,"LANGFITT, MAXWELL, KENNETH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 58 , 76 , 85 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528202504,"HAYWARD, LISA, KAY",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528202504,"HAYWARD, LISA, KAY",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,,,Unknown,193200000X,Group,Multi-Specialty,,1528206018,"LINTON, ALLISON, AMELIA",702 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1528206018,"LINTON, ALLISON, AMELIA",702 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1528206018,"LINTON, ALLISON, AMELIA",702 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 94 , 223 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1528206018,"LINTON, ALLISON, AMELIA",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 27 , 92 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528208550,"DSOUZA, CAROLINE, CURRY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 21 , 22 ,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528208824,"STOREY, CASSANDRA, DEE",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932696267,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX COMMUNITY COLLEGE,100 COLLEGE DR BLDG 700 WELDON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528208824,"STOREY, CASSANDRA, DEE",100 COLLEGE DR BLDG 700 WELDON NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528210853,"GEORGE, BENOY, KANNIKATTEL",,8328 PINEVILLE MATTHEWS RD STE 302 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,1528210853,"GEORGE, BENOY, KANNIKATTEL",8328 PINEVILLE MATTHEWS RD STE 302 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 56 ,$#,,
MEDICAID DIRECT,1609421775,HEALTHWORX PARTNERS PC,,118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1528211075,"HAYWOOD, ANTONIA, HORSLEY",118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 ," 1,118 "," 1,118 "," $95,757.90 ",,
MEDICAID DIRECT,1366488280,METROPOLITAN COMMUNITY HEALTH,AGAPE HEALTH SERVICES,120 W MARTIN LUTHER KING JR DR   WASHINGTON NC,007,Beaufort,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528211075,"HAYWOOD, ANTONIA, HORSLEY",118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821866112,DREAM PRIMARY CARE SERVICES PC,,118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1528211075,"HAYWOOD, ANTONIA, HORSLEY",118 AVON AVE STE 103 WASHINGTON NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528212982,"OHAR, ANDREW, JOSEPH",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528212982,"OHAR, ANDREW, JOSEPH",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528212982,"OHAR, ANDREW, JOSEPH",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407188600,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PULMONARY & SLEEP CENTER,2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1528214442,"WAGHCHOURE, SIMON, STEPHEN",2209 S STERLING ST STE 600 MORGANTON NC,012,Burke,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 40 , 96 , 118 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528214780,"REDDY, UHA, PRABHAKAR",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 28 , 61 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528214780,"REDDY, UHA, PRABHAKAR",6060 PIEDMONT ROW DR S FL 6 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 14 , 30 ,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528215282,"WINSLOW, SHERRI, JENNINGS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528215407,"HONEYCUTT, CYNTHIA, KUPSICK",320 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 83 , 441 , 459 ," $15,149.69 ",,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528215407,"HONEYCUTT, CYNTHIA, KUPSICK",320 YADKIN ST   ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 64 , 72 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528215407,"HONEYCUTT, CYNTHIA, KUPSICK",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528215910,"ISBELL, AMANDA, PHYLIS",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 66 , 160 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528215910,"ISBELL, AMANDA, PHYLIS",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 44 ,$#,,
MEDICAID DIRECT,1982030466,CAROMONT MEDICAL GROUP INC,CAROMONT DERMATOLOGY,2391 COURT DR STE 120C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528221272,"WALKER, ASHLEY, MARIE",2391 COURT DR STE 120C GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 35 , 55 , 92 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528224821,"MCGRAW, JESSICA, LEE",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1528225471,"DELMONTE, DEREK, WILLS",725 HIGHLAND OAKS DR STE 101 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1528225471,"DELMONTE, DEREK, WILLS",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 48 , 73 , 89 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528226164,"XU, FANG",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528226164,"XU, FANG",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528226164,"XU, FANG",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528226164,"XU, FANG",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1528229143,"JONES, GWENDOLYN, ROSE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1659340636,IMAGING SPECIALISTS PLLC,,750 OLD HICKORY BLVD BLDG 1-260 BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1528229366,"CARPENTER, ELIZABETH, LEE",750 OLD HICKORY BLVD STE 1-260 BRENTWOOD TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528229366,"CARPENTER, ELIZABETH, LEE",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659340636,IMAGING SPECIALISTS PLLC,,750 OLD HICKORY BLVD BLDG 1-260 BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1528229366,"CARPENTER, ELIZABETH, LEE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1528231149,"FORSYTH, REGINA, RUMLEY",6066 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 64 , 79 ,$#,,
MEDICAID DIRECT,1568717478,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE LAKE PARK FAMILY MEDICI,6208 CREFT CIR STE 222 INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1528231149,"FORSYTH, REGINA, RUMLEY",6208 CREFT CIR STE 222 INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528231297,"WILD, PATRICIA, ANNE",4102 N ROXBORO ST   DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528231974,"HORNIK, CHRISTOPH, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528233665,"COHEN WOLKOWIEZ, MICHAEL",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528234804,"KIM, CHARLES, YOON",2301 ERWIN RD FL 1 DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 56 , 58 , 122 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528234804,"KIM, CHARLES, YOON",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 24 , 27 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528234804,"KIM, CHARLES, YOON",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528234804,"KIM, CHARLES, YOON",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528234804,"KIM, CHARLES, YOON",2301 ERWIN RD FL 1 DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528245297,"INCIONG, JESUS, GIL BELEN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1528247327,"PARKER, HALEY, SOUTHERN",PARKER FAMILY EYE CARE OD PLLC,1299 PARKWAY DR STE F GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,,1528247327,"PARKER, HALEY, SOUTHERN",1299 PARKWAY DR STE F GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1982974614,PARKER FAMILY EYE CARE OD PLLC,PARKER FAMILY EYE CARE OD PLLC,1299 PARKWAY DR STE F GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1528247327,"PARKER, HALEY, SOUTHERN",1299 PARKWAY DR STE F GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,, 35 , 35 , 45 ,$#,,
MEDICAID DIRECT,1982974614,PARKER FAMILY EYE CARE OD PLLC,PARKER FAMILY EYE CARE OD PLLC,402 N BERKELEY BLVD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1528247327,"PARKER, HALEY, SOUTHERN",402 N BERKELEY BLVD   GOLDSBORO NC,096,Wayne,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528247335,"BENJAMIN, KRISTI, CHANTEL",2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 64 , 76 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 101 , 144 , 185 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2607 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2410 MONTGOMERY DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 23 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 35 , 82 , 132 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528247806,"CARTER, AARON, MICHAEL",2010 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447715941,ASCEND HEALTH LLC,ASCEND HEALTH PLLC,10831 PINEVILLE RD   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528249257,"KALINSKI, MARTA, MARIA",10831 PINEVILLE RD   PINEVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 73 , 183 ,$#,,
MEDICAID DIRECT,1447715941,ASCEND HEALTH LLC,ASCEND HEALTH PLLC,750 HARTNESS RD STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528249257,"KALINSKI, MARTA, MARIA",750 HARTNESS RD STE C STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447715941,ASCEND HEALTH LLC,ASCEND HEALTH PLLC,10831 PINEVILLE RD   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528249257,"KALINSKI, MARTA, MARIA",750 HARTNESS RD STE C STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528250396,"ANDERSON, PAUL, SIDNEY",2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1528250396,"ANDERSON, PAUL, SIDNEY",128 PEACHTREE LN STE B ADVANCE NC,030,Davie,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1528250396,"ANDERSON, PAUL, SIDNEY",2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1528254919,"RAMGER, ROBIN, MOORE",1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528254950,"ASHIQ, JAVED",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1992720932,CHILDRENS UROLOGY OF THE CAROLINAS,~,230 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528255098,"OWUMI, WINIFRED",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1992720932,CHILDRENS UROLOGY OF THE CAROLINAS,~,230 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528255098,"OWUMI, WINIFRED",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1992720932,CHILDRENS UROLOGY OF THE CAROLINAS,~,230 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528255098,"OWUMI, WINIFRED",230 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 64 , 76 , 133 ," $10,548.52 ",,
MEDICAID DIRECT,1992720932,CHILDRENS UROLOGY OF THE CAROLINAS,~,230 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528255098,"OWUMI, WINIFRED",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1992720932,CHILDRENS UROLOGY OF THE CAROLINAS,~,230 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528255098,"OWUMI, WINIFRED",1918 RANDOLPH RD STE 740 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1477538254,PORT HEALTH SERVICES,~,2602 COURTIER DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528256716,"SHELTON, DONNA, LEIGH",3715 GUARDIAN AVE   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1528257987,PERSONAL HOME CARE OF NORTH CAROLIN,PHC HOME HEALTH,1446 E GASTON ST STE 103 LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,1528257987,PERSONAL HOME CARE OF NORTH CAROLIN,1446 E GASTON ST STE 103 LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,, 12 , 731 , 731 ," $48,168.72 ",,
MEDICAID DIRECT,1538698303,ELIZABETH E MILLER DDS MS PA,MILLER PEDIATRIC DENTISTRY,73 SUCCESS CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1528258290,"MILLER, ELIZABETH, EASLEY KELLY",73 SUCCESS CT   ROCKY MOUNT NC,064,Nash,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,917 "," 3,976 "," 13,684 "," $472,760.15 ",,
MEDICAID DIRECT,1528258290,"MILLER, ELIZABETH, EASLEY KELLY",~,73 SUCCESS CT   ROCKY MOUNT NC,064,Nash,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1528258290,"MILLER, ELIZABETH, EASLEY KELLY",73 SUCCESS CT   ROCKY MOUNT NC,064,Nash,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1588003032,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY,1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528258357,"GRIGGS, CHRISTOPHER, ALLEN",1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1588003032,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY VASCULAR SURGERY,1771 TATE BLVD SE STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528258357,"GRIGGS, CHRISTOPHER, ALLEN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1528258852,"BRINKER, CELIA, SAYERS",480 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 29 , 81 ,$#,,
MEDICAID DIRECT,1548221856,CHAPEL HILL PEDIATRICS,CHAPEL HILL PEDIATRICS,205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528259991,"STABLEIN, GEORGE, JOHN",205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 40 , 105 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528261252,"DODSON, JENNIFER, TATLONGHARI",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528261930,"TOU, KEVIN, MU",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 56 , 57 , 61 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1528267861,"HILL, DAVID, ANTHONY",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1528271848,"SMITH, GARY, ANTHONY",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1528271848,"SMITH, GARY, ANTHONY",100 HOSPITAL DR   LOUISBURG NC,035,Franklin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578256749,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528271848,"SMITH, GARY, ANTHONY",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 100 , 103 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1528271848,"SMITH, GARY, ANTHONY",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720364649,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1528271848,"SMITH, GARY, ANTHONY",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1578256749,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM PRIMARY CARE,511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528271848,"SMITH, GARY, ANTHONY",511 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 87 , 181 , 184 ,$#,,
MEDICAID DIRECT,1265420335,HANGER PROSTHETICS & ORTHOTICS EAST,~,1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528272002,"WENSLEY, ROBERT, EDWARD",1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528272754,"IZOTOVA, OLGA, VLADIMIROVNA",205 PAGE RD   PINEHURST NC,063,Moore,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 96 , 178 , 382 ," $14,016.29 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528272754,"IZOTOVA, OLGA, VLADIMIROVNA",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 11 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528274925,"PUWANANT, ARAYA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528275195,"WEBER, JEFFREY, ALAN",520 E 15TH ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 56 , 56 ,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528275195,"WEBER, JEFFREY, ALAN",121 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528275195,"WEBER, JEFFREY, ALAN",2508 N QUEEN ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 211 , 442 , 637 ," $30,196.46 ",,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528275195,"WEBER, JEFFREY, ALAN",600 FARRINGDOM ST STE AB LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 27 , 35 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,5501 FORTUNES RIDGE DR STE A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",115 KILDAIRE PARK DR STE 308 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 20 , 25 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1528277092,"BROWN, KEVIN, DAVID",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528278462,"KELLY, CYNTHIA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 64 , 72 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528278587,"GANDHI, SAFAL, YOGESH",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528279783,"REUTER, ROBERT, MARTIN",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528279783,"REUTER, ROBERT, MARTIN",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528279783,"REUTER, ROBERT, MARTIN",582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528280898,"THOMAS, ALICIA, CHRISTINE",509 N ELAM AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1127 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528280898,"THOMAS, ALICIA, CHRISTINE",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528280898,"THOMAS, ALICIA, CHRISTINE",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 30 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528280898,"THOMAS, ALICIA, CHRISTINE",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528280898,"THOMAS, ALICIA, CHRISTINE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528280898,"THOMAS, ALICIA, CHRISTINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1871295220,RFDEST DDS PLLC,MAGNOLIA DENTISTRY,910 DONTIA DR   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528287067,"LORIGAN, BRIDGETTE, LYNNE",912 DONTIA DR   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 97 , 100 , 366 ," $37,011.64 ",,
MEDICAID DIRECT,1447993399,G ABRAMS AND R COHEN XXI PC,DYNAMIC DENTAL OF SOUTHEND,2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528287067,"LORIGAN, BRIDGETTE, LYNNE",912 DONTIA DR   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 101 , 327 ," $20,964.25 ",,
MEDICAID DIRECT,1447993399,G ABRAMS AND R COHEN XXI PC,DYNAMIC DENTAL OF SOUTHEND,2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528287067,"LORIGAN, BRIDGETTE, LYNNE",2041 SOUTH BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 65 , 98 , 371 ," $21,456.60 ",,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1528287141,"COTONI, DAVID, ANDREW",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 49 , 79 , 117 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528287141,"COTONI, DAVID, ANDREW",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 35 , 40 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1528287141,"COTONI, DAVID, ANDREW",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 180 , 259 , 319 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528290574,"NOBLE, GINA, NICOLE",128 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 23 , 36 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528290574,"NOBLE, GINA, NICOLE",128 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528290574,"NOBLE, GINA, NICOLE",128 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528291671,ADVANCED ORTHOPEDIC PRODUCTS & SERV,A O P INC,835 JOHNS HOPKINS DR STE B GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528291671,ADVANCED ORTHOPEDIC PRODUCTS & SERV,835 JOHNS HOPKINS DR STE B GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 91 , 114 , 480 ," $30,447.76 ",,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1528292539,"CASTILE, JESSICA, ROSE",1100 NAVAHO DRIVE ST 100 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1528292679,"MATERIN, MIGUEL, ANGEL",2301 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1528292679,"MATERIN, MIGUEL, ANGEL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 23 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528292679,"MATERIN, MIGUEL, ANGEL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 15 , 38 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528292679,"MATERIN, MIGUEL, ANGEL",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1528293610,"GUSLER, CHRISTIN, ZANONI",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1528293610,"GUSLER, CHRISTIN, ZANONI",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 37 , 225 , 225 ,$#,,
MEDICAID DIRECT,1093774614,AUTHORACARE COLLECTIVE,~,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528293610,"GUSLER, CHRISTIN, ZANONI",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 19 , 27 , 27 ,$#,,
MEDICAID DIRECT,1194459461,AUTHORACARE COLLECTIVE,,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528293610,"GUSLER, CHRISTIN, ZANONI",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 38 , 146 , 146 ,$#,,
MEDICAID DIRECT,1720794944,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE PHYSICIANS WELLNESS,104 POMONA DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528293883,"WALLACE, ERICA, RENEE",104 POMONA DR   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720794944,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE PHYSICIANS WELLNESS,104 POMONA DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528293883,"WALLACE, ERICA, RENEE",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 35 , 56 ,$#,,
MEDICAID DIRECT,1528296647,GILDA S ROBERTSON,STEPHENSON FAMILY CARE HOME,316 RICHARD ST E   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1528296647,GILDA S ROBERTSON,316 RICHARD ST E   AHOSKIE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 141 , 141 ," $45,711.46 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528297546,"LIDHOO, POOJA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528297546,"LIDHOO, POOJA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528297546,"LIDHOO, POOJA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 62 , 62 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528297546,"LIDHOO, POOJA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 19 , 52 , 52 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528299278,"KULWA, EMA, WAKURU",3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 16 , 25 ,$#,,
MEDICAID DIRECT,1528299633,"HERRING, ROBYNE, CAUGHRON",~,133 VIRGINIA JOHNSON RD   MOUNT OLIVE NC,031,Duplin,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1528299633,"HERRING, ROBYNE, CAUGHRON",133 VIRGINIA JOHNSON RD   MOUNT OLIVE NC,031,Duplin,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 14 , 210 , 210 ," $15,275.40 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,256 SHENSTONE LN   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528300464,"OTTLEY, ADAM, CARL",256 SHENSTONE LN   GARNER NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 40 , 82 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1515 SW CARY PKWY STE 220 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528300464,"OTTLEY, ADAM, CARL",1515 SW CARY PKWY STE 200 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1585 FORNEY CREEK PKWY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,929 N 2ND ST STE 101 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1025 MOREHEAD MEDICAL DR STE 225 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,101 E W T HARRIS BLVD STE 4001 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,201 E GROVER ST FL 3 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,201 E GROVER ST FL 3 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528301371,"MCKINNELY, DANA, LAKISHA",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659351724,CLECO PRIMARY CARE NETWORK,UPPER CLEVELAND MEDICAL CENTER,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528303559,"MCDOWELL JR, DAVID, RICKY",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1043963564,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - FALLSTON,5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528303559,"MCDOWELL JR, DAVID, RICKY",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 115 , 259 , 280 ," $13,509.61 ",,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528303559,"MCDOWELL JR, DAVID, RICKY",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528303559,"MCDOWELL JR, DAVID, RICKY",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528307097,"EASTRIDGE, LAUREN, HARBER",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 57 , 71 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528309911,"GRAY, SHAKETHA, ACQUINETTA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RA0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Adolescent Medicine, 11 , 27 , 30 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528311826,"JOHNSON, JUSTIN, MICHAEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528313244,"KOTHARI, KAVITA",380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528313244,"KOTHARI, KAVITA",923 N 2ND ST STE 105 ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528313244,"KOTHARI, KAVITA",923 N 2ND ST STE 105 ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528313822,"HOLDER, DARA, D",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1528316239,EASTPOINT PROSTHEICS AND ORTHOTICS,~,11030 RAVEN RIDGE RD STE 109 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528316239,EASTPOINT PROSTHEICS AND ORTHOTICS,11030 RAVEN RIDGE RD STE 109 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 247 , 373 ," 2,690 "," $404,860.65 ",,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528316635,"BERRYHILL III, GROVER, CLEO",518 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528316635,"BERRYHILL III, GROVER, CLEO",1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528316635,"BERRYHILL III, GROVER, CLEO",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528316635,"BERRYHILL III, GROVER, CLEO",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 36 , 36 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528316635,"BERRYHILL III, GROVER, CLEO",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 65 , 100 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528317369,"WILLOUGHBY, ERIN, JESSICA",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 41 , 96 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1528317484,"SIMS, MATTHEW, WYATT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 33 , 33 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1528318813,"BECK, STACY, KAY",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1528318813,"BECK, STACY, KAY",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 40 , 40 ,$#,,
MEDICAID DIRECT,1184669053,SOUTHEASTERN MEDICAL GROUP PC,,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1528318813,"BECK, STACY, KAY",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528319654,"SHEMWELL, JENNA, AUTUMN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 12 , 59 , 60 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528319654,"SHEMWELL, JENNA, AUTUMN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 82 , 82 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528319654,"SHEMWELL, JENNA, AUTUMN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528322948,"KEHAYA, JANE, BEEBE",510 CAROLINA BAY DR STE 100 WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528322948,"KEHAYA, JANE, BEEBE",400 N ELM ST   HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1528324068,"KADALI, RENUKA, ANANTH KALYAN",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 84 , 84 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1528324068,"KADALI, RENUKA, ANANTH KALYAN",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 48 , 49 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528324068,"KADALI, RENUKA, ANANTH KALYAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528324068,"KADALI, RENUKA, ANANTH KALYAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528324902,"MCNEAL, MARISA, ELAINE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,1528324902,"MCNEAL, MARISA, ELAINE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528324985,"CALL, ERIKA, BORGERDING",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 60 , 65 ,$#,,
MEDICAID DIRECT,1821403957,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1528325354,"MEADOWS, MICHAEL, CHRISTOPHER",434 HOSPITAL DR   LINVILLE NC,006,Avery,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528325354,"MEADOWS, MICHAEL, CHRISTOPHER",336 DEERFIELD RD   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 116 , 116 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1528327533,"GAHLOT, MANASI",204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1528327533,"GAHLOT, MANASI",2503 N QUEEN ST   KINSTON NC,054,Lenoir,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528327533,"GAHLOT, MANASI",701 DOCTORS DR STE E2 KINSTON NC,054,Lenoir,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2503 N QUEEN ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1528327533,"GAHLOT, MANASI",2503 N QUEEN ST   KINSTON NC,054,Lenoir,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 88 , 95 , 104 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528327533,"GAHLOT, MANASI",2503 N QUEEN ST   KINSTON NC,054,Lenoir,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 33 , 39 , 39 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528327889,"UPTON, ELIZABETH, CHANDLER HENSHAW",309 NEW ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 77 , 139 , 198 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528327889,"UPTON, ELIZABETH, CHANDLER HENSHAW",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 32 , 34 ,$#,,
MEDICAID DIRECT,1700831799,CAROLINA KIDNEY ASSOCIATES PA,~,309 NEW ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1528327889,"UPTON, ELIZABETH, CHANDLER HENSHAW",622 INDUSTRIAL AVE   GREENSBORO NC,041,Guilford,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 95 , 328 , 328 ,$#,,
MEDICAID DIRECT,1063953602,RDMG ASSOCIATES PA,,6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528328572,"TOPPIN, GARY, MCCOY",6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1417525999,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE MOCKSVILLE,154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528332053,"FRYER, BRITTANY, JORDAN",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356802300,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - MOCKSVILLE,172 S CLEMENT ST   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528332053,"FRYER, BRITTANY, JORDAN",154 GOVERNMENT CENTER DR   MOCKSVILLE NC,030,Davie,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528339660,"SAVALIYA, VIPUL, ARVINDBHAI",1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 276 ," 2,843 "," 3,270 "," $93,379.67 ",,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528339660,"SAVALIYA, VIPUL, ARVINDBHAI",821 S HORNER BLVD STE C SANFORD NC,053,Lee,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 57 , 59 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528339702,"STOCKS, JAMES, ADAM",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528339702,"STOCKS, JAMES, ADAM",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1528339702,"STOCKS, JAMES, ADAM",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1992830483,UNC ROCKINGHAM HEALTH CARE INC,REIDSVILLE HIGH SCHOOL STUDENT HEALTH CENTER,1901 S PARK DR   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1528340163,"WEBSTER, LISA, KNIPPENBURG",1901 S PARK DR   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 25 ,$#,,
MEDICAID DIRECT,1912032095,UNC ROCKINGHAM HEALTH CARE INC,MCMICHAEL HIGH SCHOOL STUDENT HEALTH CENTER,6845 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1528340163,"WEBSTER, LISA, KNIPPENBURG",6845 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528340676,"SHAH, KHYATI, DHAVAL",13557 STEELECROFT PKWY STE 2200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 25 ,$#,,
MEDICAID DIRECT,1770615114,PROMED HEALTHCARE PLLC,~,7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528341864,"BEYDER, ROSTISLAV, MARKOVICH",7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,6010 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528341864,"BEYDER, ROSTISLAV, MARKOVICH",1560 UNION RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043849896,PAVANA TREATMENT GROUP PC,,1560 UNION RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528341864,"BEYDER, ROSTISLAV, MARKOVICH",1560 UNION RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 54 ,$#,,
MEDICAID DIRECT,1003301300,AMITY MEDICAL GROUP INC,,824 LOWER DALLAS HWY   DALLAS NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528341864,"BEYDER, ROSTISLAV, MARKOVICH",1560 UNION RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 61 , 79 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1528343480,"HAUSER, VIRGINIA, MARIA",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1528343480,"HAUSER, VIRGINIA, MARIA",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1528343480,"HAUSER, VIRGINIA, MARIA",333 GASHES CREEK RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1528343480,"HAUSER, VIRGINIA, MARIA",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,,,Unknown,193200000X,Group,Multi-Specialty,,1528344496,"TEMPLETON, AMY, BRYANT",1915 BOULEVARD ST   GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528344496,"TEMPLETON, AMY, BRYANT",1915 BOULEVARD ST   GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 23 , 222 , 350 ,$#,,
MEDICAID DIRECT,1528349941,"SKELTON, LAURA, COCKRELL",~,7309B SUMMERFIELD RD   SUMMERFIELD NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,1528349941,"SKELTON, LAURA, COCKRELL",7309B SUMMERFIELD RD   SUMMERFIELD NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1528351368,AVUTOX LLC,AVUTOX LLC,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1528351368,AVUTOX LLC,121 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,291U00000X,Laboratories,Clinical Medical Laboratory,,#,,,$#,,
MEDICAID DIRECT,1588050215,BLUE RIDGE HEALTHCARE MEDICAL GROUP,CAJAHS MOUNTAIN MEDICAL ASSOCIATES,1766 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1528352580,"KONKOL, JILL, NICOLE",1766 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 94 , 275 , 720 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1528353638,"PANTIEL, DEREK, TYLER",603 PECAN LN   WHITEVILLE NC,024,Columbus,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 101 , 153 , 218 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1528353638,"PANTIEL, DEREK, TYLER",123 POMPANO PL STE 500 JACKSONVILLE NC,067,Onslow,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 56 , 74 , 135 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1528353638,"PANTIEL, DEREK, TYLER",1602 DOCTORS CIR   WILMINGTON NC,065,New Hanover,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 145 , 235 , 311 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1528353851,"CARSON, REBECCA, ANN",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1528353851,"CARSON, REBECCA, ANN",2007 WALNUT ST   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528354511,"MEEKINS, TAMARA, MICHELLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 62 , 74 ," $11,978.39 ",,
MEDICAID DIRECT,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,,1528354883,"CHEN, YONGXIN",30 PAGE ST   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528355179,"POPPER, JOSEPH, EDWARD",214 18TH ST SE   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 87 , 150 , 210 ,$#,,
MEDICAID DIRECT,1598739799,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD PEDIATRIC SUBSPECIALTIES,101 WILLIAM H JOHNSON ST STE 400 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528355724,"STEFLIK, DAVID, JOSEPH",101 WILLIAM H JOHNSON ST STE 400 FLORENCE SC,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 15 , 16 , 27 ,$#,,
MEDICAID DIRECT,1295258648,G ABRAMS & R COHEN XIX PC,,8620 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528356128,"FORREST, MALLARY, CAMPBELL",13527 STEELECROFT PKWY STE C CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 344 , 758 , 773 ," $98,507.36 ",,
MEDICAID DIRECT,1982071114,ABRAMS BARROWS COHEN & ASSOCIATES P,,160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528356128,"FORREST, MALLARY, CAMPBELL",13527 STEELECROFT PKWY STE C CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1639746621,G ABRAMS AND R COHEN XXIII PC,STEELE CREEK ORTHODONTICS,13527 STEELECROFT PWKY STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528356128,"FORREST, MALLARY, CAMPBELL",13527 STEELECROFT PKWY STE C CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1205590510,SAL C ZAMMITTI DMD MMSC PLLC AND MA,HUNTERSVILLE SMILES,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528356128,"FORREST, MALLARY, CAMPBELL",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 166 , 197 , 197 ," $28,073.22 ",,
MEDICAID DIRECT,1215664339,SAL C ZAMMITTI DMD MMSC AND MATTHEW,ZAMMITTI & GIDALY ORTHODONTICS,132 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1528356128,"FORREST, MALLARY, CAMPBELL",132 WELTON WAY   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 43 , 53 , 53 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1528356847,"KITCHENS, JESSICA, LYNN SHOOK",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528357456,"WITHERS, PAUL, ALAN",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528357456,"WITHERS, PAUL, ALAN",10660 PARK RD STE 3200 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 27 , 58 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528357456,"WITHERS, PAUL, ALAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528357456,"WITHERS, PAUL, ALAN",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1528360930,MED1 SERVICES LLC,MED SERVICES LLC,,,Unknown,3416L0300X,Transportation Services,Ambulance,Land Transport,1528360930,MED1 SERVICES LLC,3999 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,3416L0300X,Transportation Services,Ambulance,Land Transport,#,,,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528363264,"CORBIN, HEATHER, HOLLEY",974 S POINT RD UNIT D BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528363264,"CORBIN, HEATHER, HOLLEY",959 COX RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528364809,"PIE, CYNTHIA, PALENCIA",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528364809,"PIE, CYNTHIA, PALENCIA",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528364957,"YUEN, BENNY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1528364957,"YUEN, BENNY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528367281,"NAGAN, MARGOT, ROSE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528367281,"NAGAN, MARGOT, ROSE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528367281,"NAGAN, MARGOT, ROSE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3416 POOLE RD STE 120 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528367406,"BUTLER ROBINSON, MARIANNE, CECELIA",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 47 , 73 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528367406,"BUTLER ROBINSON, MARIANNE, CECELIA",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 70 , 105 , 165 ,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 26 , 26 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528369543,"DHUNGANA, RAJAT",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528370244,"MCCOY, SHADERIKA, WILLIS",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 11 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1457853079,HOSPITALIST SOLUTION PLLC,,338 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528370897,"HUBERT, ANA, MARIA",336 DEERFIELD RD   BOONE NC,095,Watauga,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 134 , 134 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",601 N ELM ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528370897,"HUBERT, ANA, MARIA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881033009,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB NORTH,487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528370897,"HUBERT, ANA, MARIA",201 E GROVER ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528371341,"MYERS, KAREN, ELIZABETH",5325 VINNING ST NW STE 101 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 42 , 72 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528371341,"MYERS, KAREN, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528371341,"MYERS, KAREN, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528373529,"ELGERGAWY, DAWOOD, SOLIMAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 127 , 128 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528373529,"ELGERGAWY, DAWOOD, SOLIMAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1528373529,"ELGERGAWY, DAWOOD, SOLIMAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528374147,"LYONS, JENNINGS, DEWAYNE",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 36 , 53 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528374147,"LYONS, JENNINGS, DEWAYNE",1300 BRIDGE BARRIER RD STE 2 CAROLINA BEACH NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 33 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528376738,"SMITH, HEATHER, RENAE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528376738,"SMITH, HEATHER, RENAE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,3200 WATERFIELD DR   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1528377165,"PEARSON, JEFFREY, ARON",2050 MERCANTILE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,2050 MERCANTILE DR   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1528377165,"PEARSON, JEFFREY, ARON",2050 MERCANTILE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 107 , 239 , 240 ," $13,785.80 ",,
MEDICAID DIRECT,1184711301,CALDWELL HOSPICE AND PALLIATIVE CAR,AMOREM,902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1528378122,"CIRINO, CASEY, JO",902 KIRKWOOD AVE NW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528379609,"BROWNLEE, ROBERT, CALVIN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528379609,"BROWNLEE, ROBERT, CALVIN",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528383122,"KWON, SUN DUCK",721 FAIRFAX AVE FL 3 NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528383122,"KWON, SUN DUCK",721 FAIRFAX AVE FL 3 NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528383163,"DARBY, JANELLE, PAKISH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 40 , 69 , 80 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528385218,"CARDELLA, COLLEEN, WALSH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528385218,"CARDELLA, COLLEEN, WALSH",2711 RANDOLPH RD STE 512 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 29 , 43 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528385481,"LAWING, CHERYL, REESE",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 21 , 32 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1528387719,"LATEEF, SOHAIL, KHALIQ",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 41 , 41 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528387719,"LATEEF, SOHAIL, KHALIQ",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 84 , 84 ,$#,,
MEDICAID DIRECT,1528025137,FOOTHILLS NEPHROLOGY,FOOTHILLS NEPHROLOGY,126 DILLON DR   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528388030,"TANG, TANYA, TOCHAROEN",126 DILLON DR   SPARTANBURG SC,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1255688958,KIDZCARE PEDIATRICS PC,~,145 W MAIN ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1528388121,"JANAGAMA, RAVALI",145 W MAIN ST   SANFORD NC,053,Lee,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 46 , 146 ,$#,,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1528388543,"ANGRISH, KRISHAN, SUMIT",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 34 , 73 ,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528388667,"LOWERY, LEE, RYAN",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 43 , 59 , 90 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528389996,"MAO, TANYING",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528389996,"MAO, TANYING",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 32 , 34 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528389996,"MAO, TANYING",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528389996,"MAO, TANYING",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528389996,"MAO, TANYING",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528389996,"MAO, TANYING",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1528396777,CAROLINA HOME CARE SOLUTIONS INC,CAROLINA HOME CARE SOLUTIONS INC,3553 N SHARON AMITY RD STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1528396777,CAROLINA HOME CARE SOLUTIONS INC,3553 N SHARON AMITY RD STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 476 , 476 ," $30,435.46 ",,
MEDICAID DIRECT,1699755686,FIRSTHEALTH OF THE CAROLINAS INC,FIRST HEALTH DENTAL CARE,105 PERRY DR   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1528397619,"SYKES, REBECCA, STANCIL",105 PERRY DR   SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 27 , 104 ,$#,,
MEDICAID DIRECT,1396725743,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH DENTAL CARE,195 CAMLELOT CT   BISCOE NC,062,Montgomery,193400000X,Group,Single Specialty,,1528397619,"SYKES, REBECCA, STANCIL",195 CAMLELOT CT   BISCOE NC,062,Montgomery,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 36 , 129 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528397619,"SYKES, REBECCA, STANCIL",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,754 "," 3,081 "," 11,005 "," $360,562.96 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528400272,"EVANS, CHRISTOPHER, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528400272,"EVANS, CHRISTOPHER, ALLEN",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 45 , 71 , 104 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528400736,"DELLEDONNE, KRISTIN, SARA",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528400736,"DELLEDONNE, KRISTIN, SARA",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528400736,"DELLEDONNE, KRISTIN, SARA",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528400777,"STRAUSS, HEATHER, LINDSEY",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336292556,TRIAD BEHAVIORAL RESOURCES PC,,12 N 5TH AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528400777,"STRAUSS, HEATHER, LINDSEY",12 N 5TH AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700264058,APPALACHIAN COUNSELING AND PSYCHOLO,,1 OAK PLZ STE 208 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528400777,"STRAUSS, HEATHER, LINDSEY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1871507699,CUMBERLAND HOSPITAL,,9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1528400918,"YOUNG, REBECCA ANN",9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 231 , 231 ," $13,144.83 ",,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12016 LEMMOND FARM DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528403433,"TEAL, SANDRA, CARPENTER",12016 LEMMOND FARM DR STE 200 CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 25 , 36 , 64 ,$#,,
MEDICAID DIRECT,1639366214,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528403433,"TEAL, SANDRA, CARPENTER",12016 LEMMOND FARM DR STE 100 CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528403433,"TEAL, SANDRA, CARPENTER",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 24 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,500 SHEPHERD ST STE 300 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528403441,"ARNOLD, ERIN, FRANCIS",500 SHEPHERD ST STE 500 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528403441,"ARNOLD, ERIN, FRANCIS",500 SHEPHERD ST STE 500 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1528404480,"MEHTA, SAMIR, D",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 16 , 19 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528404480,"MEHTA, SAMIR, D",1705 TARBORO ST SW   WILSON NC,098,Wilson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 32 , 46 ,$#,,
MEDICAID DIRECT,1538601257,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE REGIONAL PAIN CLINIC,1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528404670,"LATEEF, BILAL, DANISH",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 47 , 50 ,$#,,
MEDICAID DIRECT,1538601257,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE REGIONAL PAIN CLINIC,1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528404670,"LATEEF, BILAL, DANISH",1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 78 , 214 , 219 ,$#,,
MEDICAID DIRECT,1497986509,DUPLIN GENERAL HOSPITAL INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193400000X,Group,Single Specialty,,1528404704,"RUSSELL, BRENNAN, VICTOR",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528404704,"RUSSELL, BRENNAN, VICTOR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528404704,"RUSSELL, BRENNAN, VICTOR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528404845,"AKTAN, IDIL",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1528404845,"AKTAN, IDIL",6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 26 , 42 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,10208 CERNY ST STE 106 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528404845,"AKTAN, IDIL",10208 CERNY ST STE 106 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528404845,"AKTAN, IDIL",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528404845,"AKTAN, IDIL",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 42 , 58 , 73 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1528404845,"AKTAN, IDIL",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528404845,"AKTAN, IDIL",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528405552,"SHARROCK, MATTHEW, FIELD SHONTELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 37 , 91 , 104 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 149 , 180 , 238 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 226 , 260 , 332 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406543,"KALISZ, KEVIN, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 84 , 111 , 132 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528406576,"THOMSON, DENISE, JOY",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1528406576,"THOMSON, DENISE, JOY",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528406576,"THOMSON, DENISE, JOY",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528406873,"OLESON, NICHOLAS, EDWIN",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 32 , 61 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 CLAYTON BLVD   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528406873,"OLESON, NICHOLAS, EDWIN",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528406873,"OLESON, NICHOLAS, EDWIN",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1528407442,"CUNNINGHAM, KELLY, ADKINS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528407442,"CUNNINGHAM, KELLY, ADKINS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528407442,"CUNNINGHAM, KELLY, ADKINS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528408275,"KING, EMILY, SECREST",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528408341,"LAUER, ASHLEY, HARWELL",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 83 , 155 , 217 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528408929,"TALLENT, SARAH, LAMAR",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528410255,"PANNEERSELVAN, RAJARAJAN",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 56 , 85 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528410255,"PANNEERSELVAN, RAJARAJAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 116 , 131 , 183 ,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528410255,"PANNEERSELVAN, RAJARAJAN",521 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,193200000X,Group,Multi-Specialty,,1528410388,"POWERS, NICHOLAS, SCOTT",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528410388,"POWERS, NICHOLAS, SCOTT",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 60 , 139 , 162 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528410388,"POWERS, NICHOLAS, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 209 , 346 , 439 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2150 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528410388,"POWERS, NICHOLAS, SCOTT",2150 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528410388,"POWERS, NICHOLAS, SCOTT",2150 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528410735,"WILSON, SUSAN, BERRY",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528410735,"WILSON, SUSAN, BERRY",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 31 ,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528411766,"WORDSWORTH, RYAN, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528412111,"HODGES, EDWARD, MURRAY",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528412111,"HODGES, EDWARD, MURRAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 83 , 120 , 144 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528412111,"HODGES, EDWARD, MURRAY",166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 32 , 51 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1528412111,"HODGES, EDWARD, MURRAY",166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528412483,"GONFA, TAYE, TOLCHA",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 62 , 63 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528412483,"GONFA, TAYE, TOLCHA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 152 , 152 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528412483,"GONFA, TAYE, TOLCHA",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528412483,"GONFA, TAYE, TOLCHA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528412483,"GONFA, TAYE, TOLCHA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528412764,"ILYAS, OMAR, AHMAD",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528412905,"RAULKAR, KRUTIKA, PARASAR",1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 21 , 76 , 79 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528412905,"RAULKAR, KRUTIKA, PARASAR",1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 61 , 193 , 202 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528413408,"DOCTOR, DANA, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366418816,COASTAL CHILDRENS CLINIC INC,COASTAL CHILDRENS CLINIC INC,703 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1528414091,"FOWLER, CHELSEA, ELIZABETH",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1528414091,"FOWLER, CHELSEA, ELIZABETH",703 NEWMAN RD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528414265,"KNOX, GILLIAM, JORDAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528414612,"WAYNE, MELISSA, BUCKNER",902 N HOWE ST   SOUTHPORT NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 18 , 37 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528414612,"WAYNE, MELISSA, BUCKNER",902 N HOWE ST   SOUTHPORT NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528414943,"ANDERSON, KIMBERLY, RAPLEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528414984,"ELLISON, JOHN, EVAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 28 , 39 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528414984,"ELLISON, JOHN, EVAN",2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033182571,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD OB GYN DILLON,706 N 8TH AVE   DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528415676,"HUGHES, CHELSEA, FOONG",706 N 8TH AVE   DILLON SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528416773,"PEAN, CHRISTIAN, ALEXANDER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 45 , 54 , 62 ," $17,813.18 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528416773,"PEAN, CHRISTIAN, ALEXANDER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 34 , 42 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528416773,"PEAN, CHRISTIAN, ALEXANDER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528417847,"RODRIGUEZ, SANTIAGO",844 KEMPSVILLE RD STE 104 NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528419058,"SHEVAVESH, TANYA, MONVILAI",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1528419058,"SHEVAVESH, TANYA, MONVILAI",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528419579,"CAPELLE, JOHN, MARTIN",6 DOCTORS CIR STE 5 SUPPLY NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 57 , 139 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528419579,"CAPELLE, JOHN, MARTIN",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 27 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528419579,"CAPELLE, JOHN, MARTIN",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528419777,"PARKER, JORDYN, LEIGH",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 55 , 73 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528419777,"PARKER, JORDYN, LEIGH",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 86 , 105 , 118 ,$#,,
MEDICAID DIRECT,1528422086,DCI LABORATORY LLC,,2917 FOSTER CREIGHTON DR   NASHVILLE TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1528422086,DCI LABORATORY LLC,2917 FOSTER CREIGHTON DR   NASHVILLE TN,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#, 20 , 68 ,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528422268,"WANN, ROBERT, CHARLES O'CONNOR",10 DOCTORS CIR STE 1 SUPPLY NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 29 , 66 ," $10,470.04 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528422268,"WANN, ROBERT, CHARLES O'CONNOR",6 DOCTORS CIR STE 2 SUPPLY NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528422268,"WANN, ROBERT, CHARLES O'CONNOR",1098 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 51 , 116 ,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528422268,"WANN, ROBERT, CHARLES O'CONNOR",1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 47 , 81 , 183 ," $14,330.55 ",,
MEDICAID DIRECT,1598007445,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE - VASS,3349 US HIGHWAY 1   VASS NC,063,Moore,193200000X,Group,Multi-Specialty,,1528424082,"HEPLER, JANINE, BARNHILL",3349 US 1 HWY   VASS NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 77 , 178 , 359 ,$#,,
MEDICAID DIRECT,1457836413,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - CLAREMONT,3114 W MAIN ST   CLAREMONT NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528425105,"LEE, PA, LEE",3114 W MAIN ST   CLAREMONT NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 25 , 40 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,401 LAMBERT RD   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1528426855,"LEE, THERESA, CRANFORD",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1528426855,"LEE, THERESA, CRANFORD",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1528426855,"LEE, THERESA, CRANFORD",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528426855,"LEE, THERESA, CRANFORD",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528426855,"LEE, THERESA, CRANFORD",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 23 , 53 , 55 ,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,80 SONGBIRD FOREST RD   BRYSON CITY NC,087,Swain,193200000X,Group,Multi-Specialty,,1528428919,"WATKINS, ERIK, MICHAEL",80 SONGBIRD FOREST RD   BRYSON CITY NC,087,Swain,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 18 ,$#,,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1528428919,"WATKINS, ERIK, MICHAEL",80 SONGBIRD FOREST RD   BRYSON CITY NC,087,Swain,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 94 , 206 ,$#,,
MEDICAID DIRECT,1124367347,INNOVATIVE BEHAVIORAL HEALTH SERVIC,,78 WHEATON AVE   YOUNGSVILLE NC,035,Franklin,193200000X,Group,Multi-Specialty,,1528430469,"YOUMANS, JONATHAN, DAVID",78 WHEATON AVE   YOUNGSVILLE NC,035,Franklin,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528431939,"RICHARDSON, CANDY, ANN",4709 CREEKSTONE DR STE 280 DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528432408,PRESTIGE HOME HEALTH CARE,,608 W JOHNSON ST STE 19 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1528432408,PRESTIGE HOME HEALTH CARE,608 W JOHNSON ST STE 19 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 4,446 "," 4,446 "," $271,478.00 ",,
MEDICAID DIRECT,1528435112,HELMS HOME CARE LLC,,300 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,251J00000X,Agencies,Nursing Care,,1528435112,HELMS HOME CARE LLC,300 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,251J00000X,Agencies,Nursing Care,,#, 378 , 378 ," $209,885.00 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528435310,"REO, JULIE, ANNE",3116 N DUKE ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 21 , 37 ,$#,,
MEDICAID DIRECT,1528437373,ORTHOFIT INC,ORTHOFIT BRACE & LIMB,3581 CENTRE CIR STE 104 FORT MILL SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528437373,ORTHOFIT INC,3581 CENTRE CIR STE 104 FORT MILL SC,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 34 , 53 , 390 ," $174,400.26 ",,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1528441706,"JOHNSON, SUSANNE, MARIE",106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1528442894,"BADOUR, JOSHUA, SCOTT",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598762940,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528443231,"MARSHALL, YING, WEN",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1447980883,TRIAD ADULT AND PEDIATRIC MEDICINE,,300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528443231,"MARSHALL, YING, WEN",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528443231,"MARSHALL, YING, WEN",1046 E WENDOVER AVE   GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1528444080,"CROCKER, JACY, KILLIAN",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1528444080,"CROCKER, JACY, KILLIAN",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1528444080,"CROCKER, JACY, KILLIAN",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1528444643,COUNTY OF GATES,GATES COUNTY EMS,16 US HIGHWAY 158 E   GATESVILLE NC,037,Gates,3416L0300X,Transportation Services,Ambulance,Land Transport,1528444643,COUNTY OF GATES,16 US HIGHWAY 158 E   GATESVILLE NC,037,Gates,3416L0300X,Transportation Services,Ambulance,Land Transport, 61 , 285 , 575 ," $22,959.53 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528445426,"YOUNT, NATALIE, BOONE",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528445426,"YOUNT, NATALIE, BOONE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528445426,"YOUNT, NATALIE, BOONE",75 EMERSON BAY RD STE 102 CAROLINA SHORES NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 47 , 82 ,$#,,
MEDICAID DIRECT,1598358707,REX HOSPITAL INC,UNC REX OUTPATIENT PSYCHIATRY,2901 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528447091,"BROOKS, ERIN, NICKEL",2901 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528447091,"BROOKS, ERIN, NICKEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1598358707,REX HOSPITAL INC,UNC REX OUTPATIENT PSYCHIATRY,2901 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528447091,"BROOKS, ERIN, NICKEL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528449113,"MACHEN, JULIE, HARDING LUCAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 173 , 283 , 475 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528449766,"UTZ, GREGORY, WILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528449766,"UTZ, GREGORY, WILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528449790,"DUNCAN, THOMAS, JONATHAN JACKSON",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528449790,"DUNCAN, THOMAS, JONATHAN JACKSON",2790 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528449956,"DUNLAP, DANIEL, JONATHAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 56 , 56 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528452745,"DUFFIN, MATTHEW, JOSEPH",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 51 , 69 , 87 ,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528452745,"DUFFIN, MATTHEW, JOSEPH",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1518570761,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528452745,"DUFFIN, MATTHEW, JOSEPH",1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528453388,"BROWN, LANDON, CARTER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528453388,"BROWN, LANDON, CARTER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 22 , 57 , 59 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528453388,"BROWN, LANDON, CARTER",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528455235,"PETERS, ANTHONY, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528455425,"MARCHANTE, MICHAEL, JOSEPH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528455516,"LUNDY, DEBORAH, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 51 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528455680,"SUMISLAWSKI, JOSHUA, JOSEPH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 35 , 40 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528455888,"FLEMING, NICHOLAS, JAMES",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528455888,"FLEMING, NICHOLAS, JAMES",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 59 , 89 , 96 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528455888,"FLEMING, NICHOLAS, JAMES",1010 EDGEHILL RD N   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1175 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1528461019,"SEAVER, LINDSEY, KENZ",1175 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 124 , 221 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528461019,"SEAVER, LINDSEY, KENZ",2021 CREEKSIDE LANDING DR   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 29 , 46 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528464344,"FANETTI, ANGEL",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528464344,"FANETTI, ANGEL",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528468394,"DUKE, ELLEN, ASHLEY DICKENS",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528468394,"DUKE, ELLEN, ASHLEY DICKENS",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 55 , 232 , 251 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528469749,"KOLIS, JULIE, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528469749,"KOLIS, JULIE, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 36 , 41 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528471737,"YEE, MICHAEL, ALEXANDER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1528473923,"CHADWICK, RICHARD, HUNTER",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,210 PENNY LN MEDICAL PARK NUMBER 3 MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1528473923,"CHADWICK, RICHARD, HUNTER",210 PENNY LN MEDICAL PARK NUMBER 3 MOREHEAD CITY NC,016,Carteret,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528475688,"BHINDER, VIKRAM, SINGH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 17 , 69 , 76 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528475985,"SCHLESINGER, JEANNE, ELOISE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528475985,"SCHLESINGER, JEANNE, ELOISE",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528475985,"SCHLESINGER, JEANNE, ELOISE",472 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1972079127,MH TRANSYLVANIA REGIONAL HOSPITAL L,,360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528475985,"SCHLESINGER, JEANNE, ELOISE",360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1528476058,"HARTMAN, CHRISTOPHER, BO",440 INGRAM DR   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1528476058,"HARTMAN, CHRISTOPHER, BO",440 INGRAM DR   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 31 , 33 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528476058,"HARTMAN, CHRISTOPHER, BO",440 INGRAM DR   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 123 ," 1,100 "," 1,494 "," $13,881.05 ",,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1528476058,"HARTMAN, CHRISTOPHER, BO",440 INGRAM DR   KING NC,085,Stokes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 326 , 396 ," $11,918.54 ",,
MEDICAID DIRECT,1528477585,CAROLINAS MEDICAL CENTER AT HOME LL,~,3395 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528477585,CAROLINAS MEDICAL CENTER AT HOME LL,3395 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 65 , 339 , 701 ," $11,160.47 ",,
MEDICAID DIRECT,1528477585,CAROLINAS MEDICAL CENTER AT HOME LL,~,3395 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1528477585,CAROLINAS MEDICAL CENTER AT HOME LL,3395 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#, 26 , 31 ,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528478468,"KOWALCZYK-KIM, ANNA",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2213 ELBA ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528478823,"MAZGAJ, ROBERT, LEONARD",2213 ELBA ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528478823,"MAZGAJ, ROBERT, LEONARD",2213 ELBA ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528478823,"MAZGAJ, ROBERT, LEONARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,2100 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1528480860,"WEIMANN, ELIZABETH, MICHELLE",2100 W CUMBERLAND ST   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1528480860,"WEIMANN, ELIZABETH, MICHELLE",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1528480860,"WEIMANN, ELIZABETH, MICHELLE",101 WALMART SUPER CTR   SILER CITY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 38 , 75 ,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1528480860,"WEIMANN, ELIZABETH, MICHELLE",1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1700397304,CDT HEALTHCARE,~,101 WALMART SUPERCENTER   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1528480860,"WEIMANN, ELIZABETH, MICHELLE",101 WALMART SUPER CTR   SILER CITY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528481181,"HYATT, CATHERINE, ELIZABETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528485638,"VITSHTEYN, ALEX, JOSHUAH",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043080732,ACCESS CARE ANESTHESIA OF NORTH CAR,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528485638,"VITSHTEYN, ALEX, JOSHUAH",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 32 , 32 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528485638,"VITSHTEYN, ALEX, JOSHUAH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1568180495,EMPOWERED ARTHRITIS AND RHEUMATOLOG,EMPOWERED ARTHRITIS AND RHEUMATOLOG,300 ASHVILLE AVE STE 301 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528485729,"GUPTA, SANDEEPKUMAR, JAGDISHBHAI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528485729,"GUPTA, SANDEEPKUMAR, JAGDISHBHAI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528485729,"GUPTA, SANDEEPKUMAR, JAGDISHBHAI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1528485968,"TECLE, BINIAM, TESSALDET",~,1001 VISION DR   APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1528485968,"TECLE, BINIAM, TESSALDET",1001 VISION DR   APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 52 , 97 , 419 ," $21,734.73 ",,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528485968,"TECLE, BINIAM, TESSALDET",3212 S WILMINGTON ST   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 4,781 "," 6,466 "," 25,069 "," $878,529.26 ",,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528485968,"TECLE, BINIAM, TESSALDET",1400 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1841583176,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,655 LENOIR RHYNE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528485968,"TECLE, BINIAM, TESSALDET",655 LENOIR RHYNE BLVD SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528485968,"TECLE, BINIAM, TESSALDET",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528486081,"VAN KIRK, JENNY, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 22 , 22 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528486081,"VAN KIRK, JENNY, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528486081,"VAN KIRK, JENNY, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 79 , 79 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528486081,"VAN KIRK, JENNY, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 27 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528486198,"SINCLAIR, MATTHEW, ROBERT",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528486198,"SINCLAIR, MATTHEW, ROBERT",40 DUKE MEDICINE CIR # 2B2C DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528486198,"SINCLAIR, MATTHEW, ROBERT",2301 ERWIN RD   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528486511,"TESH, PAIGE, KOONTS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1518263268,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED PRIMARY CARE,221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1528486990,"LABENNE, AMANDA, ROSE MARIE",221 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528486990,"LABENNE, AMANDA, ROSE MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528486990,"LABENNE, AMANDA, ROSE MARIE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528486990,"LABENNE, AMANDA, ROSE MARIE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528487022,"PATEL, SHEYLAN, DILIPKUMAR",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 15 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528487022,"PATEL, SHEYLAN, DILIPKUMAR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 28 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528487022,"PATEL, SHEYLAN, DILIPKUMAR",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1528487238,"HENSLEY, JUNE, MELIA",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 11 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1528487238,"HENSLEY, JUNE, MELIA",1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 14 , 33 , 42 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1528487238,"HENSLEY, JUNE, MELIA",328 OLD AIRPORT RD   MURPHY NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528487279,"COVAS, TIFFANY, LYNN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528487279,"COVAS, TIFFANY, LYNN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528487279,"COVAS, TIFFANY, LYNN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528487279,"COVAS, TIFFANY, LYNN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528487600,"PATE, JARED, SHOJI",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 117 , 170 , 286 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528487600,"PATE, JARED, SHOJI",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1033677240,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - MAIDEN,137 ISLAND FORD RD   MAIDEN NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528487832,"GREEMANN, RYAN, HALL",137 ISLAND FORD RD   MAIDEN NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528489895,RURAL HEALTH GROUP INC,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 63 , 100 , 101 ," $13,639.19 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528491073,"GARRETT, DEBRA, EVERHART",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 33 , 34 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528492733,"MULLIS, JESSICA, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528493400,"CARSON, ROCHELLE, LORRAINE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 162 , 162 ,$#,,
MEDICAID DIRECT,1528497732,"LE, MY, HONG",MY HONG LE,121 W ELMSLEY ST   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,,1528497732,"LE, MY, HONG",121 W ELMSLEY ST   GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 706 , 806 ," 1,298 "," $93,052.04 ",,
MEDICAID DIRECT,1588851687,RANDALL R MERCIER PA,,630 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1528500444,"DYER, HEATHER, MICHELLE",630 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 36 , 61 , 88 ,$#,,
MEDICAID DIRECT,1194975854,LEVEL FOUR ORTHOTICS & PROSTHETICS,RESTORE POC,415 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528500915,"DOLLYHITE, MATTHEW, RYAN",415 BLOWING ROCK BLVD   LENOIR NC,014,Caldwell,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528502358,"BASS, DERRICK, ANDREW",166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 69 , 104 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528502358,"BASS, DERRICK, ANDREW",166 SPRINGBROOK AVE STE 101 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 45 , 67 ,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528502663,"NALLS, SUSAN, THAGGARD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528504552,"STEVENS, KRISTINE, CARLYLE",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528504552,"STEVENS, KRISTINE, CARLYLE",2605 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 24 , 44 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528507266,"UNGER, REBECCA, DIANE",11009 INGLESIDE PL STE 303 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528507266,"UNGER, REBECCA, DIANE",11009 INGLESIDE PL STE 303 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 21 , 31 ,$#,,
MEDICAID DIRECT,1023256518,CAROLINA HEADACHE INSTITUTE PA,CAROLINA HEADACHE INSTITUTE PA,6114 FAYETTEVILLE RD STE 109 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528507704,"ROTHMAN, NICOLE, IRENE",6114 FAYETTEVILLE RD STE 109 DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 47 , 51 ,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1528508793,"PATTERSON, MALLORY, HONEYCUTT",129 WOODSON ST   SALISBURY NC,080,Rowan,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 11 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1528509395,"PABOM, MANUEL, ANDRES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1528509395,"PABOM, MANUEL, ANDRES",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528509395,"PABOM, MANUEL, ANDRES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528509395,"PABOM, MANUEL, ANDRES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1528509395,"PABOM, MANUEL, ANDRES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528509395,"PABOM, MANUEL, ANDRES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1528509395,"PABOM, MANUEL, ANDRES",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528509395,"PABOM, MANUEL, ANDRES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528509395,"PABOM, MANUEL, ANDRES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528513223,"KOENIGSEKER, SARAH, BETH",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 59 , 91 , 316 ," $13,276.35 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528513223,"KOENIGSEKER, SARAH, BETH",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 24 , 23 , 33 ,$#,,
MEDICAID DIRECT,1205884970,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH BRUNSWICK OBGYN MIDWIFERY,584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1528513223,"KOENIGSEKER, SARAH, BETH",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1528514528,"YANCEY, STACY, SIDERS",137 MOUNT CALVARY RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 25 , 31 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528514528,"YANCEY, STACY, SIDERS",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528516382,INGLES MARKETS INC,INGLES PHARMACY 023,259 BARBER BLVD   WAYNESVILLE NC,044,Haywood,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1528516382,INGLES MARKETS INC,259 BARBER BLVD   WAYNESVILLE NC,044,Haywood,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,10 E HOSPITAL ST   MANNING SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1528518388,"SMITH, MONIQUE, LYNNETTE",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528518388,"SMITH, MONIQUE, LYNNETTE",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528518388,"SMITH, MONIQUE, LYNNETTE",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528518388,"SMITH, MONIQUE, LYNNETTE",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528518388,"SMITH, MONIQUE, LYNNETTE",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871697599,PIEDMONT HEALTH SERVICES INC,Moncure Community Health Center,7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528519261,"ANGLE, LUCY, MELINDA",7228 MONCURE PITTSBORO RD   MONCURE NC,019,Chatham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528520368,"EATON, BETHANY, HUNTER",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528520368,"EATON, BETHANY, HUNTER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528520368,"EATON, BETHANY, HUNTER",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1528521887,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1528521887,NOVANT HEALTH CLEMMONS OUTPATIENT S,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 73 , 82 , 140 ," $13,230.49 ",,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528523834,"HALLORAN, MATTHEW, ANDREW",3444 S CONTENTNEA ST   FARMVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528523834,"HALLORAN, MATTHEW, ANDREW",623 OLD TAR VILLAGE RD   WINTERVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528523834,"HALLORAN, MATTHEW, ANDREW",300 BETHESDA DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 24 ,$#,,
MEDICAID DIRECT,1114564416,THE CHARLOTTE-MECKLENBURG HOSPITAL,CHILDRENS ADVOCACY CENTER TREEHOUSE,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528524329,"JEAN, ELIZABETH, ASHLEY",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1528526118,"ASHLEY, NICOLE, LINDSAY",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1528526118,"ASHLEY, NICOLE, LINDSAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528526118,"ASHLEY, NICOLE, LINDSAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528526118,"ASHLEY, NICOLE, LINDSAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528526118,"ASHLEY, NICOLE, LINDSAY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528526175,"URBAITIS, IAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528527082,"HUMPHREY, LINDSAY, DAVIS",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 60 , 60 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528527082,"HUMPHREY, LINDSAY, DAVIS",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 96 , 140 , 191 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528527082,"HUMPHREY, LINDSAY, DAVIS",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1528527082,"HUMPHREY, LINDSAY, DAVIS",704 S WALNUT ST   FAIRMONT NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 27 , 28 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,7200 CREEDMOOR RD STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528527389,"REZZONICO, CHRISTOPHER, JAMES",13300 STRICKLAND RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 36 ,$#,,
MEDICAID DIRECT,1407024110,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CREEDMOOR ROAD,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528527389,"REZZONICO, CHRISTOPHER, JAMES",13300 STRICKLAND RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 49 , 107 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528527389,"REZZONICO, CHRISTOPHER, JAMES",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1528527389,"REZZONICO, CHRISTOPHER, JAMES",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528527579,"VADLAMUDI, CHARITHA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 18 , 51 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528527926,"MCCARGO, SARA, SWANSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528527926,"MCCARGO, SARA, SWANSON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528528601,"HRUBY, CARTER, WILLIAM",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 89 , 368 , 370 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528528858,"ZELONIS, SANDRA, DEE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528529658,"ANDREW, BENJAMIN, YATES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 53 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528529658,"ANDREW, BENJAMIN, YATES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528529658,"ANDREW, BENJAMIN, YATES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528529658,"ANDREW, BENJAMIN, YATES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528529781,"MENTREDDY, RAMYA, SINGIREDDY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 54 , 65 , 76 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528529781,"MENTREDDY, RAMYA, SINGIREDDY",177 PARKWOOD DR   ELKIN NC,086,Surry,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528529963,"DARU, NAMRATA, SANJEEV",2790 GODWIN BLVD STE 355 SUFFOLK VA,101,Out of State <= 40 miles,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 13 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528529963,"DARU, NAMRATA, SANJEEV",2790 GODWIN BLVD STE 355 SUFFOLK VA,101,Out of State <= 40 miles,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,2021 CONCERT DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528530912,"HUMPHREY, KIMBERLY, ANNE",2021 CONCERT DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,2021 CONCERT DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528530912,"HUMPHREY, KIMBERLY, ANNE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528530912,"HUMPHREY, KIMBERLY, ANNE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,401 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528530912,"HUMPHREY, KIMBERLY, ANNE",401 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528531258,"HILDEBRAND, RACHEL",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528532397,"GENERELLI, JILL, MARIE",1333 S DICKINSON DR UNIT 2320 LELAND NC,010,Brunswick,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1811582877,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR COASTAL PULMONARY,1090 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528532397,"GENERELLI, JILL, MARIE",1333 S DICKINSON DR UNIT 2320 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 34 , 45 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528532587,"PILGRIM, CATHERINE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1740537653,APPALACHIAN REGIONAL MEDICAL ASSOCI,CHARLES E BAKER JR MD CENTER FOR PRIMARY CARE,436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,193200000X,Group,Multi-Specialty,,1528537552,"GOODWIN, JENNIE, LYNN",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1831928803,AVERY WELLNESS PLLC,,137 NOTALEE ST   NEWLAND NC,006,Avery,193400000X,Group,Single Specialty,,1528537552,"GOODWIN, JENNIE, LYNN",436 HOSPITAL DR STE 230 LINVILLE NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528540556,"SORACCO, ERIN, KATHRYN",9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1629405212,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528541026,"SISKO, CHELSEY, BRENNAN",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629405212,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH NEUROLOGY,16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528541026,"SISKO, CHELSEY, BRENNAN",16645 BIRKDALE COMMONS PKWY STE 200D HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 23 , 28 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",401 N MORGAN ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",401 N MORGAN ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 37 , 37 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 280 , 282 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 81 , 81 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",1404 S SALISBURY AVE   SPENCER NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",1404 S SALISBURY AVE   SPENCER NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 67 , 67 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",311 W PHIFER ST   MARSHVILLE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 169 , 169 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528542917,"MCGEE, KRYSTLE, LYNETTE",311 W PHIFER ST   MARSHVILLE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1780392274,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CANCER CLINICS,1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528547833,"WONG, ESTHER, AROOM",1718 E 4TH ST STE 707 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528547965,"SCHILKE, LAUREN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 27 , 37 ,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528550225,"SKOWRONSKI, MEGAN, MARIE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 57 , 138 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1528550225,"SKOWRONSKI, MEGAN, MARIE",600 W TRADE ST STE B DALLAS NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1528550290,"SCHULTZ, ABBY, LAUREN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528550290,"SCHULTZ, ABBY, LAUREN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528550290,"SCHULTZ, ABBY, LAUREN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528550415,"RAYFIELD, EMILY, BAUCOM",640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 41 , 41 ,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528550415,"RAYFIELD, EMILY, BAUCOM",1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 54 , 54 ,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528550415,"RAYFIELD, EMILY, BAUCOM",640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528550936,"ALVAREZ, IVETTE, GISELL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528550936,"ALVAREZ, IVETTE, GISELL",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528550936,"ALVAREZ, IVETTE, GISELL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568523371,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1528554219,"BOWMAN, STONEY, LEE",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1629843933,OPTUM BEHAVIORAL CARE OF NORTH CARO,CAROLINA BEHAVIORAL CARE CENTERS,1101 MARCO DR STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1528554219,"BOWMAN, STONEY, LEE",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1528554219,"BOWMAN, STONEY, LEE",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 11 , 18 , 35 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528554532,"MCLAMB, LESLIE, FAHY",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 32 , 34 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528555604,"SCOTT, SELENA, ERIN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1528555794,"WAGAN, SAMIULLAH",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 140 , 141 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1528555794,"WAGAN, SAMIULLAH",1135 CARTHAGE ST   SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528555927,"PENMETCHA, AKHIL",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 43 , 56 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528557162,"KLUTTZ, SUSAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 27 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528558384,"HART, ALEXANDRIA, SIMS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 34 , 47 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528558384,"HART, ALEXANDRIA, SIMS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528558384,"HART, ALEXANDRIA, SIMS",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 27 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528558384,"HART, ALEXANDRIA, SIMS",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1528558384,"HART, ALEXANDRIA, SIMS",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528558467,"WINGO, ASHLEIGH, ALANA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528562154,"JACOBS, KATE, LOUISE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528562154,"JACOBS, KATE, LOUISE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912072315,PALMETTO RADIATION ONCOLOGY PA,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528562592,"GAINEY, JORDAN, CHRISTOPHER",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528563251,"POHL, EVAN, CHRISTOPHER",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528563251,"POHL, EVAN, CHRISTOPHER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528563251,"POHL, EVAN, CHRISTOPHER",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528564101,"WILSON, TENISHA, DENISE",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528564101,"WILSON, TENISHA, DENISE",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1528564101,"WILSON, TENISHA, DENISE",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528564283,"BURT, MICHAEL, MOHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528564283,"BURT, MICHAEL, MOHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528564283,"BURT, MICHAEL, MOHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 166 , 166 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528564580,"HUNTER, ALEXANDER, HAYDEN",201 E GROVER ST   SHELBY NC,023,Cleveland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 78 , 81 , 84 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528565736,"MUENYI, CLARISSE, SORNSAY",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 65 , 78 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1528565736,"MUENYI, CLARISSE, SORNSAY",220 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 75 , 113 , 173 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528570553,"CLAYTON, JUSTIN, GRAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528571742,"ROBERTSON, DANIEL, OLIVER",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528571742,"ROBERTSON, DANIEL, OLIVER",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528573797,ART HOME CARE,,803 HERMITAGE RD   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1528573797,ART HOME CARE,803 HERMITAGE RD   BURLINGTON NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,, 43 ," 9,477 "," 10,336 "," $1,184,913.56 ",,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528575487,"POWELL, JONATHAN, JAY SCOTT",4251 LEGION RD STE 107 HOPE MILLS NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528575487,"POWELL, JONATHAN, JAY SCOTT",2350 BENTRIDGE LN APT 102 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528576790,"MONACO, MATTHEW, JOHN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1528576790,"MONACO, MATTHEW, JOHN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528576790,"MONACO, MATTHEW, JOHN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1528576790,"MONACO, MATTHEW, JOHN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1528576790,"MONACO, MATTHEW, JOHN",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1528576790,"MONACO, MATTHEW, JOHN",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1528576790,"MONACO, MATTHEW, JOHN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 20 , 22 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1528576790,"MONACO, MATTHEW, JOHN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215343421,MARCELA MUJICA DMD PLLC,ALL KIDS PEDIATRIC DENTISTRY,2630 W ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528578481,"OBOITE, STEPHANIE",3007 WESLEY CHAPEL STOUTS RD STE A MONROE NC,090,Union,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,799 "," 1,972 "," 7,331 "," $238,728.27 ",,
MEDICAID DIRECT,1609191121,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1656 RIVERCHASE BLVD STE 3600 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528578929,"FAULKENBERRY, HANNAH, FAILE",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528580917,"ZIMMER, NATALIE, JOY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528582103,"WEISS, AUTUMN, RAIN",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 51 , 58 ,$#,,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1528582434,"GROSSMAN, KIMBERLY",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528583671,"WEEKS, JONATHAN, WILLIAM",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528589991,"HOUSTON, KRISTIN, STRICKLAND",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1528590924,"MILLER, NICHOLAS, KAISER",717 S TORRENCE ST   CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 13 , 24 , 39 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1528590924,"MILLER, NICHOLAS, KAISER",10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 101 , 215 , 515 ,$#,,
MEDICAID DIRECT,1114569100,FOOT AND ANKLE SPECIALISTS OF THE M,,10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528590924,"MILLER, NICHOLAS, KAISER",10370 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528591328,"DEAN, SOPHIE, YIRU",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528591328,"DEAN, SOPHIE, YIRU",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528591328,"DEAN, SOPHIE, YIRU",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 43 , 56 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528591328,"DEAN, SOPHIE, YIRU",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528591484,"HERMAN, DAVID, GEORGE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528591484,"HERMAN, DAVID, GEORGE",2390 HEMBY LN   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528591484,"HERMAN, DAVID, GEORGE",2460 EMERALD PL   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528591484,"HERMAN, DAVID, GEORGE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 35 , 44 , 63 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528591484,"HERMAN, DAVID, GEORGE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528594413,"HARWANI, NEHA, MELANIE",1000 BLYTHE BLVD FL 1 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528594413,"HARWANI, NEHA, MELANIE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 64 , 64 ,$#,,
MEDICAID DIRECT,1912008459,"WARREN ULANCH, JULIA, GLADYS",CREEDMOOR CENTRE ENDOCRINOLOGY,8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",1528595675,"HIESTER, JENNIPHER, SHARON",8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841627692,CREEDMOOR CENTRE ENDOCRINOLOGY,~,8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528595675,"HIESTER, JENNIPHER, SHARON",8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1528596426,"WINFIELD, JENNA, MARIE",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548497209,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP MARION,2293 SUGAR HILL RD STE C MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1528596426,"WINFIELD, JENNA, MARIE",2293 SUGAR HILL RD STE C MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 22 , 31 ,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1528596426,"WINFIELD, JENNA, MARIE",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 67 , 86 , 99 ," $23,641.42 ",,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1528597739,"MOWERY, JOSHUA, LEE",2525 COURT DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1528597739,"MOWERY, JOSHUA, LEE",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528597739,"MOWERY, JOSHUA, LEE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528597739,"MOWERY, JOSHUA, LEE",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528597739,"MOWERY, JOSHUA, LEE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528597739,"MOWERY, JOSHUA, LEE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528597739,"MOWERY, JOSHUA, LEE",3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528597739,"MOWERY, JOSHUA, LEE",3250 WILKINSON BLVD UNIT I CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528599172,"BROWN, KELLY, ELIZABETH",2001 VAIL AVE STE 400 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902837073,DAVIDSON CLINIC,ATRIUM HEALTH PRIMARY CARE DAVIDSON CLINIC,705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528599172,"BROWN, KELLY, ELIZABETH",705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 24 , 54 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,705 GRIFFITH ST   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528599172,"BROWN, KELLY, ELIZABETH",705 GRIFFITH ST STE 100 DAVIDSON NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 23 , 33 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528599826,"HOGLUND, JESSICA, ROSE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 108 , 109 , 130 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528602786,"MESSER, CARMEN, MCGILL",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 18 , 31 , 32 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,400 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528607348,"NEUMANN, ALEXANDRA, MARIE",400 PARK ST   BELMONT NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528607348,"NEUMANN, ALEXANDRA, MARIE",400 PARK ST   BELMONT NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 112 , 147 ,$#,,
MEDICAID DIRECT,1528611936,HOPE STONE HOME CARE SERVICES LLC,,300 MCGILL AVE NW   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1528611936,HOPE STONE HOME CARE SERVICES LLC,300 MCGILL AVE NW   CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,160 "," 1,160 "," $156,780.72 ",,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528614013,"WALKER, ABIGAIL, DALTON",1207 EAST ST   WAYNESVILLE NC,044,Haywood,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528614013,"WALKER, ABIGAIL, DALTON",44 BONNIE LN   SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1568131647,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN 65 N BROAD,65 N BROAD ST   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528614013,"WALKER, ABIGAIL, DALTON",65 N BROAD ST   BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1750144119,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528614013,"WALKER, ABIGAIL, DALTON",29 W FRENCH BROAD ST STE 210 BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 31 , 31 ,$#,,
MEDICAID DIRECT,1316375140,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-MEDICALINTENSIVISTS,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1528616257,"TILLMAN, JONATHAN, PATRICK",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528616737,PS SENIOR LIVING LLC,,904 RALEIGH ST   OXFORD NC,039,Granville,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1528616737,PS SENIOR LIVING LLC,904 RALEIGH ST   OXFORD NC,039,Granville,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 31 ," 6,906 "," 7,175 "," $574,658.62 ",,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528619327,"APPLETON, LINDSAY, MARIE",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 49 , 49 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528619517,"MCCLUNG, KEVAN, DOUGLAS",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528619517,"MCCLUNG, KEVAN, DOUGLAS",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 50 , 91 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1528621471,"STEELE, NATALIA, SOPIARZ",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 38 , 50 , 59 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528621471,"STEELE, NATALIA, SOPIARZ",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 37 , 34 , 40 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528621828,"ZHU, BRIAN, YI",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528621828,"ZHU, BRIAN, YI",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 43 , 61 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528622040,"STEGALL, CASSANDRA, LOYCE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528623840,"SALTER, DAVID, JAMES",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 109 , 119 , 242 ,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528623840,"SALTER, DAVID, JAMES",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 41 ,$#,,
MEDICAID DIRECT,1528625399,ROWAN ENDOSCOPY CENTER,,1809 BRENNER AVE   SALISBURY NC,080,Rowan,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1528625399,ROWAN ENDOSCOPY CENTER,1809 BRENNER AVE   SALISBURY NC,080,Rowan,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 57 , 53 , 76 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528625456,"DEEN, NICOLE, LAUREN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528625886,"HARRIS, LISA, GAYLE",601 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 , 90 , 239 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528626520,"HANCE, JASON, THOMAS",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528626777,"CASEY, ERIN, MCCLURE",1450 MATTHEWS TOWNSHIP PKWY STE 300 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 26 , 44 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528626777,"CASEY, ERIN, MCCLURE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528626777,"CASEY, ERIN, MCCLURE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528628542,"RYAN, CANDICE, STARR",100 W H ST   BUTNER NC,039,Granville,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1528628542,"RYAN, CANDICE, STARR",615 RIDGE RD   ROXBORO NC,073,Person,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528628567,"SIMPSON, BRANDEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1528628823,HAPPY KIDS THERAPY,,11012 KNIGHT CASTLE DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528628823,HAPPY KIDS THERAPY,11012 KNIGHT CASTLE DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 16 , 338 , 349 ," $24,978.46 ",,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528628989,"CAMPBELL, COURTNEY, LYNN",10390 MARTINSVILLE HWY   DANVILLE VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 20 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528629490,"TAVAREZ ANGELES, ROCIO, CLARIBEL",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 28 , 48 ,$#,,
MEDICAID DIRECT,1528634250,BETTER DAYS HOME CARE LLC,BETTER DAYS HOME CARE LLC,1456 MIDDLESBROUGH DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1528634250,BETTER DAYS HOME CARE LLC,1456 MIDDLESBROUGH DR   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#," 1,322 "," 1,322 "," $96,324.39 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528634300,"PATTERSON, KAREN, DENISE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528634300,"PATTERSON, KAREN, DENISE",205 PAGE RD   PINEHURST NC,063,Moore,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 24 , 58 , 125 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1528636180,"HOENIG, HANNAH, JOY",2604 DR MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1528636180,"HOENIG, HANNAH, JOY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 29 , 29 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528637097,"ROEGGE, JOHN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 683 , 797 ," $20,583.01 ",,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1528638194,"SMITH, ZACHARY, JUSTIN",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528638764,"DOWD, SAMANTHA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528638764,"DOWD, SAMANTHA, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528638798,HARMONY PERSONAL CARE INC,,8025 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1528638798,HARMONY PERSONAL CARE INC,8025 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 5,145 "," 5,267 "," $609,194.99 ",,
MEDICAID DIRECT,1902289648,SINDHURA CITINENI DDS PA,SMILE FIRST DENTAL,3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528642683,"HRTYANSKI, EMILEE",3616 DURHAM CHAPEL HILL BLVD   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,107 "," 2,990 "," 12,647 "," $542,946.74 ",,
MEDICAID DIRECT,1528643285,SUMMIT HEALTH PARTNERS LLC,WESTERN CAROLINA SURGERY CENTER,30 AIRPORT PARK RD   FLETCHER NC,045,Henderson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1528643285,SUMMIT HEALTH PARTNERS LLC,30 AIRPORT PARK RD   FLETCHER NC,045,Henderson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 94 , 109 , 124 ," $34,977.09 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528645249,"SITTON, ZACHARY, EDWARD",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528645249,"SITTON, ZACHARY, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528646932,"KALADA, JOHN, MASON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 85 , 88 , 88 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528647146,"MEYERS, FAITH, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 39 , 46 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528647484,"REEVES, MATTHEW, TOWNSEND",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 49 , 80 ,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1528651528,"ENTREKIN, SETH, MICHAEL",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528654423,"MALOY, CAITLIN, ANN",6329 UNITY ST STE A THOMASVILLE NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528654423,"MALOY, CAITLIN, ANN",2810 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528654423,"MALOY, CAITLIN, ANN",6371 JESSIE LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528655214,"COOPER, JOSSELINE, PAULINO",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528655214,"COOPER, JOSSELINE, PAULINO",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 74 , 78 ,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528655214,"COOPER, JOSSELINE, PAULINO",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528659893,"ALEXANDER, VICTORIA, LYNN",1550 FAULK ST STE 2100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1528659893,"ALEXANDER, VICTORIA, LYNN",1550 FAULK ST STE 2100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 43 ,$#,,
MEDICAID DIRECT,1508395468,PRESTON DERMATOLOGY & SKIN SURGERY,,1010 HIGH HOUSE RD STE 202 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1528659893,"ALEXANDER, VICTORIA, LYNN",1550 FAULK ST STE 2100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 24 ,$#,,
MEDICAID DIRECT,1114116944,CAROLINA PSYCHIATRY PC,~,548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528661402,"MELONE, ALYSSA, JOY",548 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 22 , 24 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4402 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528666328,"DUNN, DUSTIN, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528666328,"DUNN, DUSTIN, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528666328,"DUNN, DUSTIN, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1528667870,"WHITE, DELICIA, MARIA",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528667870,"WHITE, DELICIA, MARIA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 19 , 21 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528667912,"HEFFELFINGER, KRISTINE, AUGUSTA",905 KENILWORTH AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528667912,"HEFFELFINGER, KRISTINE, AUGUSTA",905 KENILWORTH AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 21 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528673423,"YATES, MEREDITH, ABERNETHY",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 39 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528673423,"YATES, MEREDITH, ABERNETHY",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275736795,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH UROLOGY,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528673423,"YATES, MEREDITH, ABERNETHY",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1235629890,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH UROLOGY,140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528673423,"YATES, MEREDITH, ABERNETHY",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1598891665,HIGHLAND MEDICAL ASSOCIATES PA,~,165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528673688,"AVERY, JOHN, PATRICK",165 COOLRIDGE ST   HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528676392,"HENNING, LISA, EVE",3116 N DUKE ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 20 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528680808,"BROWNING, HARRISON, SMITH",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528680808,"BROWNING, HARRISON, SMITH",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528680808,"BROWNING, HARRISON, SMITH",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1528680808,"BROWNING, HARRISON, SMITH",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1528683620,"FRIEND, STACIA, LYNN",101 BETHESDA DR   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1528687472,EDUTHERAPY CONNECTION LLC,EDUTHERAPY CONNECTION LLC,5511 RAEFORD RD STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528687472,EDUTHERAPY CONNECTION LLC,5511 RAEFORD RD STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528688314,"STEMPNIAK, RYAN, JASON",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 44 , 131 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528688652,"FLETCHER, LUON, MARIE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,332 N TRADE ST STE 2000A MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528689759,"MITCHELL, COLEE, MICHELLE",332 N TRADE ST STE 2000-A MATTHEWS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528689759,"MITCHELL, COLEE, MICHELLE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528690492,PALMETTO OXYGEN LLC,,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1528690492,PALMETTO OXYGEN LLC,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1528690492,PALMETTO OXYGEN LLC,,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528690492,PALMETTO OXYGEN LLC,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,380 "," 6,762 "," 10,416 "," $236,096.22 ",,
MEDICAID DIRECT,1528690492,PALMETTO OXYGEN LLC,,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1528690492,PALMETTO OXYGEN LLC,2520 WHITEHALL PARK DR STE 950 CHARLOTTE NC,060,Mecklenburg,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1417914797,PARK AVENUE PEDIATRICS PA,PARK AVENUE PEDIATRICS PA,529 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1528691300,"KEETER, MORGAN, LYNN",529 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 39 , 102 ,$#,,
MEDICAID DIRECT,1265403042,NORTH CAROLINA NEUROPSYCHIATRY,NORTH CAROLINA NEUROPSYCHIATRY PA,1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528692100,"REAVES, CAMERON, JAMES",1829 E FRANKLIN ST STE 400 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528692670,HIGH 5 EARLY INTERVENTION SERVICES,,156 RYE LN   RAEFORD NC,047,Hoke,251S00000X,Agencies,Community/Behavioral Health,,1528692670,HIGH 5 EARLY INTERVENTION SERVICES,156 RYE LN   RAEFORD NC,047,Hoke,251S00000X,Agencies,Community/Behavioral Health,, 12 , 233 , 233 ," $15,098.40 ",,
MEDICAID DIRECT,1174208664,DOVE HOUSE CHILDRENS ADVOCACY CENTE,,2407 SIMONTON RD   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1528694346,"WALESKI, HEATHER, LYNN",2407 SIMONTON RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 37 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528694346,"WALESKI, HEATHER, LYNN",901 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528696499,"DAVIS, JEFFREY, DEAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 40 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528696770,"HOFFMAN, KARA, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528696770,"HOFFMAN, KARA, LEE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528697919,"JAEGER, JOSHUA, NELSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528697919,"JAEGER, JOSHUA, NELSON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528698784,"CLOSE, BETHANY",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 35 , 42 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528699915,"LYTLE, MEGGAN, ELISE",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528699915,"LYTLE, MEGGAN, ELISE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1528699915,"LYTLE, MEGGAN, ELISE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528699915,"LYTLE, MEGGAN, ELISE",472 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 70 , 82 , 120 ," $28,301.34 ",,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528699915,"LYTLE, MEGGAN, ELISE",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1528702214,"LOVETT, THOMAS, GRAHAM",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528710407,"BRANT, SARAH, BURNHAM",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 195 ," 1,179 "," 1,248 "," $22,099.43 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528710407,"BRANT, SARAH, BURNHAM",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528713757,"SPRATLEY, STACY",1090 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528713757,"SPRATLEY, STACY",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1861671463,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WEIGHT MANAGEMENT,2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528713757,"SPRATLEY, STACY",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528715281,"HARDEE, KERRI, BARBEE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",133 1ST AVE SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 24 , 46 ,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528719747,"MCCAIN, JESSICA, MARGIE LEE",133 1ST AVE SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",695 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 90 , 97 , 218 ,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",420 PARK ST   BELMONT NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902223076,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 23 ,$#,,
MEDICAID DIRECT,1902223076,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1528719747,"MCCAIN, JESSICA, MARGIE LEE",181 DANIEL RD STE A FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 28 , 61 ,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528720729,"ROSE CERVANTES, NICOLE, AMBER",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#, 11 , 44 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528720729,"ROSE CERVANTES, NICOLE, AMBER",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528723491,"RASMUSSEN, LAURENCE, JOSEPH",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,442 S HIGHWAY 27   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528723491,"RASMUSSEN, LAURENCE, JOSEPH",9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1528725546,"DEBOARD, EVAN, BLAKE",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 37 , 71 , 131 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528725835,"JONES, ISAIAH, RAKARL",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1528728979,STEP 4 PEDIATRIC THERAPY PLLC,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1528728979,STEP 4 PEDIATRIC THERAPY PLLC,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1528728979,STEP 4 PEDIATRIC THERAPY PLLC,,119 SASSAFRAS RD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1528728979,STEP 4 PEDIATRIC THERAPY PLLC,119 SASSAFRAS RD   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,, 24 , 245 , 278 ," $18,679.32 ",,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528730264,"OROURKE, COURTNEY, HESTER",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528730264,"OROURKE, COURTNEY, HESTER",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528730264,"OROURKE, COURTNEY, HESTER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 19 , 25 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528730264,"OROURKE, COURTNEY, HESTER",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528730264,"OROURKE, COURTNEY, HESTER",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528730264,"OROURKE, COURTNEY, HESTER",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528733474,"HODGES, NOAH, MICHAEL",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1528737855,FAITHFUL 2 HOME CARE LLC,,231 OMEGA RD   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1528737855,FAITHFUL 2 HOME CARE LLC,231 OMEGA RD   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#," 1,010 "," 1,017 "," $60,398.64 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528740123,"NYE, ALEXIS, MARIE",234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528741121,"GARRETT, MORGAN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 106 , 248 , 256 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1528742582,"GRECO, TIFFANY, MICHELLE",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 77 , 113 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528743036,"HOPPER, JESSICA",970 NEWMAN RD   NEW BERN NC,025,Craven,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 81 , 130 ,$#,,
MEDICAID DIRECT,1114322922,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - GASTONIA,409 S OAKLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528744117,"BAKER, MEGAN, ELIZABETH KENT",215 SHADY GROVE RD   LAWNDALE NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1700593233,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT BURNS MIDDLE,215 SHADY GROVE RD   LAWNDALE NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528744117,"BAKER, MEGAN, ELIZABETH KENT",215 SHADY GROVE RD   LAWNDALE NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 100 , 100 ," $30,612.29 ",,
MEDICAID DIRECT,1912220690,ACTIVE LIVING CHIROPRACTIC INC,~,704 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1528745155,"REAMES, MARK, KEVIN",704 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528747763,"KUDRNA, KARI, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 23 , 48 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528754314,"BENNETT, CHRISTAL, HAYES",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1528754314,"BENNETT, CHRISTAL, HAYES",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528758000,"ANDERSON, SUSANNA, MARIE",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1194459461,AUTHORACARE COLLECTIVE,,2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528759503,"SUMMERS, ANDREA, FELICIA",2500 SUMMIT AVE   GREENSBORO NC,041,Guilford,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1528759909,ANGELAS HELPING HANDZ INC,,10926 DAVID TAYLOR DR STE 120 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1528759909,ANGELAS HELPING HANDZ INC,10926 DAVID TAYLOR DR STE 120 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,697 "," 1,697 "," $107,220.40 ",,
MEDICAID DIRECT,1528762978,ANGELIC HOME CARE LLC,,54 BEGONIA LN   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1528762978,ANGELIC HOME CARE LLC,54 BEGONIA LN   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,#, 726 , 791 ," $137,949.71 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1528765021,"HAMAD, ALEXANDER, SMITH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1528765658,ABLE HANDS HEALTH CARE INC,,104 S WHITE ST STE 205B WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1528765658,ABLE HANDS HEALTH CARE INC,104 S WHITE ST STE 205B WAKE FOREST NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 504 , 504 ," $34,335.56 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528767126,"CAMPBELL, CLAIRE, LOUISE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 89 , 100 , 106 ,$#,,
MEDICAID DIRECT,1417019514,COUNTY OF YADKIN OFFICE OF TREASURE,YADKIN COUNTY HEALTH DEPT,320 W MAPLE ST   YADKINVILLE NC,099,Yadkin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1528769056,"CAUDLE, CONNIE, IRELAND",320 W MAPLE ST STE B YADKINVILLE NC,099,Yadkin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 25 , 89 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1528771383,"BOYD, BIANCA, ALEXANDRA",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,3680 ROBINWOOD RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528771383,"BOYD, BIANCA, ALEXANDRA",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1528771383,"BOYD, BIANCA, ALEXANDRA",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 30 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528771383,"BOYD, BIANCA, ALEXANDRA",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 11 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528773181,"FULK, WHITNEY, ROBERTS",730 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 26 , 32 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528773181,"FULK, WHITNEY, ROBERTS",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417061011,ABC PEDIATRICS OF DUNN PA,~,104 TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1528775962,"WHITE, CHARLES, SAWYER",104 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 121 , 418 ," $12,822.60 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528776671,"KELLER, EMILY, PAIGE",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 39 , 60 ,$#,,
MEDICAID DIRECT,1770561193,CAROLINA PSYCHOLOGICAL HEALTH SERVI,CAROLINA PSYCHOLOGICAL HEALTH SERVICES,1703 COUNTRY CLUB RD STE 204 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528777133,"CROSS, COURTNEY, RENEE",1703 COUNTRY CLUB RD STE 204 JACKSONVILLE NC,067,Onslow,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1326346602,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT PEDIATRICS,719 GREEN VALLEY RD STE 209 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528781168,"ROTHSTEIN, CHLOE, ELISABETH",719 GREEN VALLEY RD STE 209 GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 28 , 43 , 117 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528783537,"KRONE, CHRISTINE, BRENNEMAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1528783537,"KRONE, CHRISTINE, BRENNEMAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1982945242,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH RANDOLPH OBGYN,2711 RANDOLPH RD STE 512 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528783552,"LENEAVE, CARLIN, RENEE",2711 RANDOLPH RD STE 512 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528783552,"LENEAVE, CARLIN, RENEE",2711 RANDOLPH RD STE 512 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 21 , 38 ,$#,,
MEDICAID DIRECT,1033116389,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER CLINIC,470 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1528785003,"RANDOLPH, AMANDA, NICOLE",470 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1457345548,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND URGENT CARE CENTER,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1528787322,"HONEYCUTT, TRUDY, STEEN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 210 , 236 , 432 ," $17,887.31 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528788817,"PIERSON, ETHAN, DANIEL",710 PARK CENTER DR STE 200 MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528790425,"MORTON, LESLIE, GIBBS",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 36 , 40 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528792900,"BOYD, ASHTON, LEE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1528793965,"ZBIKOWSKI, DAWN, MARIE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 77 , 91 , 149 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528793965,"ZBIKOWSKI, DAWN, MARIE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1528795887,"HUYNH, MAI-LINH, THI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1528795887,"HUYNH, MAI-LINH, THI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 24 , 36 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528795887,"HUYNH, MAI-LINH, THI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1528797305,"NORRIS, MEGHAN, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1528797305,"NORRIS, MEGHAN, NICOLE",431 MEADOWMONT VILLAGE CIR   CHAPEL HILL NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 24 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1528797917,"HUTTON, PAMELA, LYN",1188 YADKINVILLE RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 86 , 145 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528799541,"ROGERS, LINDSEY, NICHOLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528799905,"ARANDA, PAOLA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134868300,APOGEE BEHAVIORAL MEDICINE PC,APOGEE BEHAVIORAL MEDICINE PC,445 DOLLEY MADISON RD STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528808763,"CAVANAUGH, MEGAN, ELIZABETH",370 KNOLLWOOD ST STE 301 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528813102,"SMITH, SARAH, JEAN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1376841874,UNC PHYSICIANS NETWORK LLC,UNC FAMILY MEDICINE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528816485,"BRENNER, AMELIA, LYN",11200 GOVERNOR MANLY WAY STE 205 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528816758,"REYNOLDS, VICTORIA, CAMILLE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033794300,LANE AND ASSOCIATES XLI DDS PA,,571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1528817509,"ALMALLA, MOHAMAD",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 196 , 362 ," 1,082 "," $52,265.40 ",,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1528817509,"ALMALLA, MOHAMAD",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 846 ," 1,312 "," 5,607 "," $277,385.42 ",,
MEDICAID DIRECT,1083144992,LANE AND ASSOCIATES XXXII DDS PA,,411 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1528817509,"ALMALLA, MOHAMAD",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1528817509,"ALMALLA, MOHAMAD",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 24 ,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193400000X,Group,Single Specialty,,1528817509,"ALMALLA, MOHAMAD",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1528818713,NEW AGE HOME CARE SERVICES,,2011 SUGAR HILL DR N   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1528818713,NEW AGE HOME CARE SERVICES,2011 SUGAR HILL DR N   CREEDMOOR NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,#, 681 , 695 ," $53,989.02 ",,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528822251,"WATSON, HALEY, CHEYENNE",1041 MORGANTON BLVD SW STE 100 LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 59 , 95 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528822699,"GREENE, CHAD, ROBERT",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528822699,"GREENE, CHAD, ROBERT",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528824422,"ROWELL, DESIRAE, NICOLE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1689870941,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,298 LINCOLN ST SW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528824422,"ROWELL, DESIRAE, NICOLE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 22 , 25 ,$#,,
MEDICAID DIRECT,1336780576,CABARRUS ROWAN COMMUNITY HEALTH CEN,SALISBURY HEALTH CENTER,330 JAKE ALEXANDER BLVD W STE 103 SALISBURY NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528824422,"ROWELL, DESIRAE, NICOLE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528824422,"ROWELL, DESIRAE, NICOLE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528824422,"ROWELL, DESIRAE, NICOLE",202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528835667,THE BEST HOME CARE,BEST HOME CARE,5046 WEBBS CHAPEL RD   MACCLESFIELD NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1528835667,THE BEST HOME CARE,5046 WEBBS CHAPEL RD   MACCLESFIELD NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 37 ," 4,538 "," 4,638 "," $511,228.02 ",,
MEDICAID DIRECT,1528837853,OASIS II HOME CARE SERVICES INC,,314 ROSE ST   ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1528837853,OASIS II HOME CARE SERVICES INC,314 ROSE ST   ROCKY MOUNT NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,, 57 ," 11,569 "," 12,967 "," $1,176,660.44 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528838984,"THOMAS, COURTNEY, MURR",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1548997893,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1528840840,"BOWMAN, TANZZA, MARIE",9310 STRAUSE DR STE B CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275209926,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528840840,"BOWMAN, TANZZA, MARIE",910 E CHURCH ST STE B CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700213956,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528840840,"BOWMAN, TANZZA, MARIE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1952936767,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,1223 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1528840840,"BOWMAN, TANZZA, MARIE",1223 SPRUCE ST   BELMONT NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1528840840,"BOWMAN, TANZZA, MARIE",600 W TRADE ST STE B DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 80 , 182 ,$#,,
MEDICAID DIRECT,1023511169,CAROMONT MEDICAL GROUP INC,CAROMONT URGENT CARE,600 W TRADE ST STE B DALLAS NC,036,Gaston,193400000X,Group,Single Specialty,,1528840840,"BOWMAN, TANZZA, MARIE",1895 HOFFMAN RD STE B GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 26 ,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1528849882,"TENJERLA, SRISAI, SARATDYUTI",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053084202,SHAE MEDICAL PLLC,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528849882,"TENJERLA, SRISAI, SARATDYUTI",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 35 , 38 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528849882,"TENJERLA, SRISAI, SARATDYUTI",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1528849882,"TENJERLA, SRISAI, SARATDYUTI",2635 LAWNDALE DR   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1871325308,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - CONOVER,130 1ST ST W   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528880192,"MOOSE, REECE, BUMGARNER",130 1ST ST W   CONOVER NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 26 ,$#,,
MEDICAID DIRECT,1578002341,DLP FRYE MEDICAL GROUP,~,915 TATE BLVD SE STE 182 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1528882610,"WARD, LAUREN, K HIPSHEAR",415 N CENTER ST STE 204 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1528886793,"ZOLDAK, WIOLETTA, ANNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1952150732,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT WHITNEL ELEMENTARY,1425 BERKLEY ST SW   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528889334,"RIDGES, ALAYSIA, CELENE",1425 BERKLEY ST SW   LENOIR NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1528892338,"DHANOTA, ASHLEEN, RANI",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1528893724,"ELHAJ OMAR, HANAN, AHMAD",6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1528894854,"KAUTZ, SARAH, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679868426,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS BEHAVIORAL MEDICINE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528899838,"PALIN, JENNIFER, LEAH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528899838,"PALIN, JENNIFER, LEAH",136 CREEKVIEW CT   MARION NC,059,McDowell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1437189784,WESTERN NC COMMUNITY HEALTH SVCS,WESTERN NC COMMUNITY HEALTH SERVICES INC,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1528899838,"PALIN, JENNIFER, LEAH",136 CREEKVIEW CT   MARION NC,059,McDowell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538101498,"HUGHES, LUCINDA, ANN",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538101498,"HUGHES, LUCINDA, ANN",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538101498,"HUGHES, LUCINDA, ANN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538102496,"ALFORD, KIMBERLY, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 35 , 36 ,$#,,
MEDICAID DIRECT,1811061013,EMPORIA MEDICAL ASSOCIATES PC,EMPORIA MEDICAL ASSOCIATES,6 DOCTORS DR   EMPORIA VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1538102819,"ANDERSON, MICHAEL",6 DOCTORS DR   EMPORIA VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1538102819,"ANDERSON, MICHAEL",,6 DOCTORS DR   EMPORIA VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1538102819,"ANDERSON, MICHAEL",6 DOCTORS DR   EMPORIA VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 27 ,$#,,
MEDICAID DIRECT,1669022570,JACKSON MEDICAL ASSOCIATES PLLC,,1188 SKYLAND DR   SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1538103080,"ROBERTS, SANDRA, JOSEPHINE",1188 SKYLAND DR   SYLVA NC,050,Jackson,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 18 , 30 , 35 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538103346,"BRENNER, JOEL, STEPHEN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080S0010X,Allopathic & Osteopathic Physicians,Pediatrics,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538105598,CHILDRENS NEUROTHERAPY SERVICES LLC,~,4012 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1538105598,CHILDRENS NEUROTHERAPY SERVICES LLC,4012 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,, 110 ," 1,500 "," 1,791 "," $146,464.25 ",,
MEDICAID DIRECT,1538105598,CHILDRENS NEUROTHERAPY SERVICES LLC,~,1087 13TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538105598,CHILDRENS NEUROTHERAPY SERVICES LLC,1087 13TH ST SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,, 146 ," 2,194 "," 2,703 "," $218,420.77 ",,
MEDICAID DIRECT,1649221342,RALEIGH DURHAM MEDICAL GROUP PA,~,4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538106133,"SHAH, POORVI",4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 48 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538106729,"HUDSON, MARY ALLISON, SCOTT",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 46 , 82 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538106950,"HENINGER, RONALD, DAMIAN",310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 301 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538106950,"HENINGER, RONALD, DAMIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1538106950,"HENINGER, RONALD, DAMIAN",111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538108907,"GAMBLE, JULIA, CRAWFORD",4220 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 21 , 22 ,$#,,
MEDICAID DIRECT,1366588212,PRIVATE DIAGNOSTIC CLINIC PLLC,GENERAL INTERNAL MEDICINE,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538108907,"GAMBLE, JULIA, CRAWFORD",4220 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538108907,"GAMBLE, JULIA, CRAWFORD",4220 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 104 , 104 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538108907,"GAMBLE, JULIA, CRAWFORD",4220 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366588212,PRIVATE DIAGNOSTIC CLINIC PLLC,GENERAL INTERNAL MEDICINE,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538108907,"GAMBLE, JULIA, CRAWFORD",4220 N ROXBORO ST   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538109798,"HERRING, CHARLES, BARRY",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 61 , 228 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1538111323,"SHAPIRO, DANIEL, ALLEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 49 , 52 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1538111323,"SHAPIRO, DANIEL, ALLEN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1538111851,"WARDELL, WALTER, JOHN",906 WB MCLEAN BLVD   CAPE CARTERET NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1538111851,"WARDELL, WALTER, JOHN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1538111851,"WARDELL, WALTER, JOHN",532 WEBB BLVD   HAVELOCK NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 62 , 95 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1538111851,"WARDELL, WALTER, JOHN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 44 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538111984,"LOWERY, JULIE, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538112529,"NOEL, TIFFANY, SPEAS",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538112529,"NOEL, TIFFANY, SPEAS",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538112529,"NOEL, TIFFANY, SPEAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538112529,"NOEL, TIFFANY, SPEAS",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538112875,"SCROGGS, MARK, WADE",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538113261,"GOPICHAND, ISHWAR, HAKUMAL",107 S WILMINGTON ST   RICHLANDS NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1538113261,"GOPICHAND, ISHWAR, HAKUMAL",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538113261,"GOPICHAND, ISHWAR, HAKUMAL",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 56 , 68 , 247 ," $11,905.24 ",,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538113261,"GOPICHAND, ISHWAR, HAKUMAL",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 23 , 36 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1538113758,"KRUEGER, HEATHER, GLENN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538114061,"GRIGGS, MARY, JANE",2001 VAIL AVE MERCY HOSP CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1538114244,CAROLINA EAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,, 174 , 970 , 971 ," $362,871.00 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538114863,"HEDLUND, JOEL, AXEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 135 , 138 , 157 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538114863,"HEDLUND, JOEL, AXEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 144 , 150 , 182 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,1401 MATTHEWS TOWNSHIP PKWY STE 310 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538114863,"HEDLUND, JOEL, AXEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1538116967,"WENDEL, JOHN, DAVID",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538116967,"WENDEL, JOHN, DAVID",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 198 , 221 , 290 ,$#,,
MEDICAID DIRECT,1538117031,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,714 HIGHWAY ST   MADISON NC,079,Rockingham,193400000X,Group,Single Specialty,,1538117031,MYEYEDR OPTOMETRY OF NORTH CAROLINA,714 HIGHWAY ST   MADISON NC,079,Rockingham,193400000X,Group,Single Specialty,, 115 , 81 , 163 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538117767,"VANDERHAVE, KENNETH, RONALD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 152 , 156 , 194 ," $13,881.74 ",,
MEDICAID DIRECT,1538117924,"RAUNIKAR, ROBERT, AUSTIN",Robert Austin Raunikar,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1538117924,"RAUNIKAR, ROBERT, AUSTIN",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538117924,"RAUNIKAR, ROBERT, AUSTIN",Robert Austin Raunikar,729 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,1538117924,"RAUNIKAR, ROBERT, AUSTIN",729 SE MAIN ST   SIMPSONVILLE SC,101,Out of State <= 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538118096,"SIGMON, CHRISTINE, ANN",214 18TH ST SE   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1538118450,"LECAMU, LEE, ADAM",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538118450,"LECAMU, LEE, ADAM",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1538118450,"LECAMU, LEE, ADAM",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538118450,"LECAMU, LEE, ADAM",2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1538118450,"LECAMU, LEE, ADAM",2465 HANESTOWN LN   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1538118450,"LECAMU, LEE, ADAM",128 PEACHTREE LN STE B ADVANCE NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 35 , 35 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538118898,"REYNOLDS, CHRISTOPHER, ROBERT",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538118898,"REYNOLDS, CHRISTOPHER, ROBERT",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538118898,"REYNOLDS, CHRISTOPHER, ROBERT",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 23 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538119094,"YOUNG, CLINTON, DRIVER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538119094,"YOUNG, CLINTON, DRIVER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538119094,"YOUNG, CLINTON, DRIVER",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 67 , 88 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538119094,"YOUNG, CLINTON, DRIVER",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700052289,BLADEN HEALTHCARE LLC,CFV BLADEN SURGICAL SPECIALISTS,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,193400000X,Group,Single Specialty,,1538119482,"WILLIAMSON, BARRY, EUGENE",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 29 , 32 ,$#,,
MEDICAID DIRECT,1114958576,BLADEN URGENT CARE,CAPE FEAR VALLEY - BLADEN SURGICAL SPECIALISTS,,,Unknown,193400000X,Group,Single Specialty,,1538119482,"WILLIAMSON, BARRY, EUGENE",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700052289,BLADEN HEALTHCARE LLC,CFV BLADEN SURGICAL SPECIALISTS,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,193400000X,Group,Single Specialty,,1538119482,"WILLIAMSON, BARRY, EUGENE",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 68 , 73 ,$#,,
MEDICAID DIRECT,1700052289,BLADEN HEALTHCARE LLC,CFV BLADEN SURGICAL SPECIALISTS,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,193400000X,Group,Single Specialty,,1538119482,"WILLIAMSON, BARRY, EUGENE",588 BAILEY RD STE K LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1538120886,"PICKETT, ANTHONY, J",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598729147,HAWTHORNE EYE ASSOCIATES PA,HAWTHORNE EYE ASSOCIATES PA,1364 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538123161,"NAGY, STEPHEN, STANLEY",1364 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 41 , 100 ,$#,,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538123989,"SMITH, ELLISON, LEON",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 32 , 40 , 114 ,$#,,
MEDICAID DIRECT,1770219594,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - GRAYSTONE,3511 GRAYSTONE PL SE   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538126081,"GOLD, STEVEN, ALLEN",3511 GRAYSTONE PL SE   CONOVER NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538126610,"SEGAL, BARRY, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 70 , 69 , 73 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538126792,"HADDOCK, MARCIA, HARRIS",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538126792,"HADDOCK, MARCIA, HARRIS",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538126792,"HADDOCK, MARCIA, HARRIS",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538127303,"POLLOCK JR, FRANK, EDWARD",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 77 , 169 , 274 ,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1538127303,"POLLOCK JR, FRANK, EDWARD",233 DOCTORS ST   SPARTA NC,003,Alleghany,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538127303,"POLLOCK JR, FRANK, EDWARD",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 28 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1538127303,"POLLOCK JR, FRANK, EDWARD",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538127337,"WAGNER, SHAWN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 58 , 59 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538127337,"WAGNER, SHAWN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1225 LEWISVILLE CLEMMONS RD   LEWISVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 34 , 50 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1538127568,"GABAEFF, DINA, ROBIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1467595959,CAROLINA PEDIATRIC GROUP PA,~,538 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1538127600,"ROBBINS, SANDRA, BARFIELD",538 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 26 , 64 , 134 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538128020,"GOECKER, ROBERT, MICHAEL",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538128020,"GOECKER, ROBERT, MICHAEL",445 PINEVIEW DR STE 230 KERNERSVILLE NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 19 , 21 , 32 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538128020,"GOECKER, ROBERT, MICHAEL",3057 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 140 , 244 , 342 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538128020,"GOECKER, ROBERT, MICHAEL",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1427194497,HARVEY KOHN MD PLLC,HARVEY KOHN MD PLLC,505 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1538128749,"KOHN, HARVEY, DAVID",505 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 20 , 29 ,$#,,
MEDICAID DIRECT,1770815722,KERNERSVILLE EYE ASSOCIATES OD,~,204 INGRAM DR   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1538129291,"SUBRAMANIAN, ARUN, THOPPE",204 INGRAM DR   KING NC,085,Stokes,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1770815722,KERNERSVILLE EYE ASSOCIATES OD,~,3475 PARKWAY VILLAGE CIR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538129291,"SUBRAMANIAN, ARUN, THOPPE",3475 PARKWAY VILLAGE CIR   WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 27 , 27 , 28 ,$#,,
MEDICAID DIRECT,1770815722,KERNERSVILLE EYE ASSOCIATES OD,~,1635 NC HIGHWAY 66 S STE 155 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1538129291,"SUBRAMANIAN, ARUN, THOPPE",1635 NC HIGHWAY 66 S STE 155 KERNERSVILLE NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538130026,"MANN, LARRY, DOUGLAS",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 21 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538130026,"MANN, LARRY, DOUGLAS",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 12 , 11 , 23 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538130034,"BERNSTEIN, ROBERT, CHARLES",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538131255,"GALLAGHER, THOMAS, QUINN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538131255,"GALLAGHER, THOMAS, QUINN",500 DISCOVERY DR   CHESAPEAKE VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538131651,"NAGABHIRAVA, SOWJANYA",744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 21 ," $20,521.46 ",,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1538131651,"NAGABHIRAVA, SOWJANYA",744 BATTLEFIELD BLVD N STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1912334335,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC ENDOCRINOLOGY,100 MEDICAL PARK DR STE 310B CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538131776,"PFEIFER, THEA, LOUISE",100 MEDICAL PARK DR STE 310B CONCORD NC,013,Cabarrus,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538131818,"ARROYO, MATTHEW, LUIS",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 28 , 31 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538131818,"ARROYO, MATTHEW, LUIS",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538131818,"ARROYO, MATTHEW, LUIS",6324 FAIRVIEW RD STE 310 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 127 , 134 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,2100 RIDGEFIELD BLVD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538133186,"HOWDEN, NANCY, LENHARDT SCHAFSTEDDE",2100 RIDGEFIELD BLVD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 38 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538133186,"HOWDEN, NANCY, LENHARDT SCHAFSTEDDE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538133186,"HOWDEN, NANCY, LENHARDT SCHAFSTEDDE",2100 RIDGEFIELD BLVD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 34 ,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1538133301,"MUNUGOTI, SRINIVAS",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 192 , 357 , 587 ," $12,821.42 ",,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1538133301,"MUNUGOTI, SRINIVAS",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1538134085,"PAYNE JR, FREDERICK, BOWEN",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 35 , 49 ,$#,,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538134341,"JOHNSON, ERIK, CHARLES",2345 COURT DR   GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 126 , 269 , 497 ," $12,205.39 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203A EARNHART DR   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1538135355,"SCHUELLEIN, PAUL, ROBERT",203A EARNHART DR   EDENTON NC,021,Chowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1609162023,ALBEMARLE PHYSICIAN SERVICES,~,112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1538135355,"SCHUELLEIN, PAUL, ROBERT",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538136247,"FELDMAN, KRISTEN, CONE",249 E NC HIGHWAY 54 STE 330 DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538137526,"DESHPANDE, ANITA, TIRUMALRAO",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,,,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538137971,"PURI, SAJEEV, KUMAR",5933 BLAKENEY PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 28 , 34 , 52 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538141551,"DUNAWAY III, HOWARD, YATES",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 17 , 27 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538141551,"DUNAWAY III, HOWARD, YATES",703 COMFORT LN   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538141767,"HINSON, THOMAS, RILEY",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 229 , 273 , 721 ,$#,,
MEDICAID DIRECT,1831306992,HOPSCOTCH PRIMARY CARE GROUP PA,HOPSCOTCH PRIMARY CARE,113 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1538141866,"STELLA, M. MERIKATON, FEAVER",116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538141866,"STELLA, M. MERIKATON, FEAVER",116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538141940,"DERBER, CATHERINE, JANE FORBES",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538141999,"MILLER, DAVID, PHILIP",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 62 , 63 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538141999,"MILLER, DAVID, PHILIP",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1538143375,MED EMPORIUM LLC,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 147 ," 1,426 "," 1,650 "," $172,476.56 ",,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1538143375,MED EMPORIUM LLC,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 48 ,,,$#,,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1538143375,MED EMPORIUM LLC,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 350 ," 1,673 "," 2,568 "," $283,885.40 ",,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1538143375,MED EMPORIUM LLC,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 12 ,,,$#,,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1538143375,MED EMPORIUM LLC,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 369 ," 2,568 "," 4,705 "," $548,055.23 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538143904,"SULLIVAN, CHRISTOPHER, ALBERT",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538143904,"SULLIVAN, CHRISTOPHER, ALBERT",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 64 , 122 , 151 ,$#,,
MEDICAID DIRECT,1043270671,CARRBORO PEDIATRICS AND INTERNAL ME,CARRBORO PEDIATRICS AND INTERNAL MEDICINE PA,127 FIDELITY ST   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1538144274,"LAWRENCE, KERITH, DAVIDSON",127 FIDELITY ST   CARRBORO NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 15 , 30 ,$#,,
MEDICAID DIRECT,1538144910,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDIN,1447 YORK CT   BURLINGTON NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,,1538144910,LABORATORY CORPORATION OF AMERICA H,1447 YORK CT   BURLINGTON NC,001,Alamance,291U00000X,Laboratories,Clinical Medical Laboratory,," 21,184 "," 29,017 "," 128,626 "," $2,153,211.48 ",,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538145800,"PRIEST, DAVID, HARDING",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 24 , 31 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538145800,"PRIEST, DAVID, HARDING",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538146147,"WIESLER, ETHAN, RON",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538146147,"WIESLER, ETHAN, RON",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538146147,"WIESLER, ETHAN, RON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 51 , 70 , 85 ,$#,,
MEDICAID DIRECT,1922398080,CAROMONT MEDICAL GROUP INC,THE HAND CENTER OF THE CAROLINAS,2391 COURT DR STE 120A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538146550,"CAULFIELD, KATHRYN, ANN",2391 COURT DR STE 120A GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 62 , 109 ,$#,,
MEDICAID DIRECT,1922398080,CAROMONT MEDICAL GROUP INC,THE HAND CENTER OF THE CAROLINAS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538146550,"CAULFIELD, KATHRYN, ANN",2391 COURT DR STE 120A GASTONIA NC,036,Gaston,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 41 , 67 , 114 ,$#,,
MEDICAID DIRECT,1538147061,"BRANCH, JAMES, DAVID",JAMES D BRANCH MD,224 TOWN RUN LN   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1538147061,"BRANCH, JAMES, DAVID",224 TOWN RUN LN   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 254 , 307 , 435 ," $13,840.58 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538147244,"WOLF, BRIAN, EDWARD",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 47 , 52 , 88 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538147244,"WOLF, BRIAN, EDWARD",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538147434,"GOGLIN, WILLIAM, KARL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538147434,"GOGLIN, WILLIAM, KARL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538147434,"GOGLIN, WILLIAM, KARL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 90 , 94 , 101 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1538149968,"ROCKWELL, DAVID, ALLEN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538149968,"ROCKWELL, DAVID, ALLEN",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538151881,"KYPSON, ALAN, PATRICK",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1871878470,REX HOSPITAL INC,REX CARDIAC SURGICAL SPECIALISTS,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538151881,"KYPSON, ALAN, PATRICK",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538151881,"KYPSON, ALAN, PATRICK",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710411160,REX HOSPITAL INC,REX STRUCTURAL HEART,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538151881,"KYPSON, ALAN, PATRICK",2800 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538152525,"GUILLORY JOHNSON, LORIN, ELAINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 164 , 164 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1538152525,"GUILLORY JOHNSON, LORIN, ELAINE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1548221856,CHAPEL HILL PEDIATRICS,CHAPEL HILL PEDIATRICS,205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538155346,"MORTON, CHRISTOPHER, WILLIAM",205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 61 , 134 ,$#,,
MEDICAID DIRECT,1538155643,COUNTRY TIME INN,COUNTRY TIME INN,602 BREVARD ST   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538155643,COUNTRY TIME INN,602 BREVARD ST   KINGS MOUNTAIN NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 46 ," 10,942 "," 10,942 "," $1,016,385.36 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538156070,"SHOFER, SCOTT, LEIGH",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538156070,"SHOFER, SCOTT, LEIGH",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538156070,"SHOFER, SCOTT, LEIGH",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538157789,"MULLINS, CHRISTOPHER, EDWARD",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 49 , 52 ,$#,,
MEDICAID DIRECT,1811516446,CALDWELL MEMORIAL HOSPITAL,UNC ORTHO,401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1538158670,"DUGGAN, ROBERT, JAMES",401 MULBERRY ST SW STE 102 LENOIR NC,014,Caldwell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 43 , 53 , 53 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 22 , 43 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1002 N CHURCH ST STE 401 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 45 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,,,Unknown,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538159686,"ARCEO, DINA, LUCILLE",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1831189992,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF COASTAL CAROLINA,2321 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538159777,"MYERS, KENNETH, WILLIAM",2321 DELANEY AVE   WILMINGTON NC,065,New Hanover,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 14 , 100 , 107 ,$#,,
MEDICAID DIRECT,1831189992,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF COASTAL CAROLINA,1017 ASHES DR STE 206 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538159777,"MYERS, KENNETH, WILLIAM",1017 ASHES DR STE 206 WILMINGTON NC,065,New Hanover,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 69 , 323 , 361 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538159967,"ANDERSON, LYNN, BIVINS",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538159967,"ANDERSON, LYNN, BIVINS",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538159967,"ANDERSON, LYNN, BIVINS",201 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 55 , 80 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538159967,"ANDERSON, LYNN, BIVINS",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538159967,"ANDERSON, LYNN, BIVINS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538159967,"ANDERSON, LYNN, BIVINS",135 MOCKSVILLE AVE STE 1 SALISBURY NC,080,Rowan,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538160031,"LIPFORD III, EDWARD, HOLDMAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 229 , 434 , 588 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538160031,"LIPFORD III, EDWARD, HOLDMAN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538160049,"STEM, THEODORE, BOURLS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 63 , 123 , 123 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538160262,"OLALERE, ADEWALE, ADEMOLA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538160262,"OLALERE, ADEWALE, ADEMOLA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 82 , 118 , 134 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538160262,"OLALERE, ADEWALE, ADEMOLA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 27 , 51 , 58 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538160262,"OLALERE, ADEWALE, ADEMOLA",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538160262,"OLALERE, ADEWALE, ADEMOLA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538160262,"OLALERE, ADEWALE, ADEMOLA",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538160833,"HA, CATHERINE, ANH",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 55 ,$#,,
MEDICAID DIRECT,1992172134,G ABRAMS AND R COHEN XI PC,,6807 FAYETTEVILLE RD STE 119 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538160833,"HA, CATHERINE, ANH",6807 FAYETTEVILLE RD STE 119 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 403 , 727 ," 3,297 "," $229,272.76 ",,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538160858,"SPRINGS, CLARK, LEON",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 39 , 75 , 113 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538160858,"SPRINGS, CLARK, LEON",106 E SATCHWELL ST   BURGAW NC,071,Pender,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538161245,"STROUSE, JOHN, JOSEPH",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538161245,"STROUSE, JOHN, JOSEPH",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538161245,"STROUSE, JOHN, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538161245,"STROUSE, JOHN, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 48 , 84 , 102 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1538161401,"WILLIAMS, ELLIOTT, FENNELL",4515 PREMIER DR STE 102 HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1538161401,"WILLIAMS, ELLIOTT, FENNELL",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 71 , 72 , 86 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1538161401,"WILLIAMS, ELLIOTT, FENNELL",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 28 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,4610 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538161542,"ANDREWS, ELIZABETH, JENKINS",1272 EAST ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538161542,"ANDREWS, ELIZABETH, JENKINS",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 61 , 81 , 81 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,14 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1538161542,"ANDREWS, ELIZABETH, JENKINS",14 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841269305,INTERNAL MEDICINE ASSOCIATES,INTERNAL MEDICINE ASSOC,3850 ED DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538161609,"JAMES, MICHAEL",3850 ED DR STE 100 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 72 , 72 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1538164298,"PHILLIPS, CHARLES, TAYLOR",400 SHADOWLINE DR STE 201 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1538164298,"PHILLIPS, CHARLES, TAYLOR",870 STATE FARM RD STE 101 BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 215 , 270 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1538164298,"PHILLIPS, CHARLES, TAYLOR",436 HOSPITAL DR STE 240 LINVILLE NC,006,Avery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 41 , 51 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1538164298,"PHILLIPS, CHARLES, TAYLOR",200 HOSPITAL AVE FL 3 JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 180 , 192 ,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1538164934,"LOBODA, MICHAEL, STEVEN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 60 , 60 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1538164934,"LOBODA, MICHAEL, STEVEN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538164934,"LOBODA, MICHAEL, STEVEN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1538164934,"LOBODA, MICHAEL, STEVEN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 42 , 44 ,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1538164934,"LOBODA, MICHAEL, STEVEN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538164934,"LOBODA, MICHAEL, STEVEN",11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538165287,"CROCKETT, JAY, ANTON",Jay Anton Crockett,48 CENTENNIAL WAY   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1538165287,"CROCKETT, JAY, ANTON",48 CENTENNIAL WAY   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538165287,"CROCKETT, JAY, ANTON",Jay Anton Crockett,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,1538165287,"CROCKETT, JAY, ANTON",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265446132,INTERNAL MEDICINE AND PEDIATRICS AS,~,224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538165733,"SARNO, ERSILIA",224 HIGH HOUSE RD STE 100 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538165774,"HARTLEY, WILLIAM, STUART",3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1538166327,"WALTER, CHERYL, DIANE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538166459,"LARK, JARRATT, DAVID",806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 93 , 272 , 458 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 170 , 489 , 855 ," $10,403.00 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,110 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 18 , 24 , 38 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 15 , 24 , 30 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 15 , 23 , 34 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538167994,"COOPER, RANDOLPH, AREND STRATTON",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538169982,ACTION HEALTH STAFFING,ACTION HEALTH STAFFING INC,3606 EAGLE POINT LN   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1538169982,ACTION HEALTH STAFFING,3606 EAGLE POINT LN   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,#," 1,281 "," 1,281 "," $76,884.00 ",,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1538171061,"CHESNUTT, DAVID, ALSTON",103 COX BLVD   GOLDSBORO NC,096,Wayne,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 176 , 259 , 381 ," $10,392.89 ",,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1538171061,"CHESNUTT, DAVID, ALSTON",103 COX BLVD   GOLDSBORO NC,096,Wayne,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1538171061,"CHESNUTT, DAVID, ALSTON",1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1538171061,"CHESNUTT, DAVID, ALSTON",1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1538171871,CORNERSTONE EAR NOSE AND THROAT,~,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538171871,CORNERSTONE EAR NOSE AND THROAT,1107 REYNOLDS ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538175278,"GETCHELL, WENDY, SUE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538175278,"GETCHELL, WENDY, SUE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538175278,"GETCHELL, WENDY, SUE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538175278,"GETCHELL, WENDY, SUE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 21 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538175393,"GORSUCH, NI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 55 , 202 , 203 ,$#,,
MEDICAID DIRECT,1265821342,ADVANCED MEDICAL GROUP,,6 REGIONAL DR STE B PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538176342,"BURNS, ANDREA, LYNN",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538176342,"BURNS, ANDREA, LYNN",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 95 , 586 , 739 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1538177100,"OREGAN, SIMON, PETER",532 WEBB BLVD   HAVELOCK NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 72 , 176 , 330 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1538177100,"OREGAN, SIMON, PETER",532 WEBB BLVD   HAVELOCK NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 40 , 40 ," $15,080.00 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538179098,"BOWEN, LAURA, MADELINE",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1538179098,"BOWEN, LAURA, MADELINE",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 33 , 70 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538179734,"MCNELIS, JOSEPH",201 E GROVER ST   SHELBY NC,023,Cleveland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 24 , 32 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538179734,"MCNELIS, JOSEPH",808 N WASHINGTON ST   SHELBY NC,023,Cleveland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 75 , 85 , 103 ,$#,,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,808 N WASHINGTON ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538179734,"MCNELIS, JOSEPH",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1770091290,EVERGREEN HEALTH CARE,EVERGREEN HEALTH CARE PLLC,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1538180690,"EMEZIE, ANTHONIA, OGECHI",10806 MONROE RD STE A MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 19 , 19 ," $15,678.00 ",,
MEDICAID DIRECT,1932521630,COVENANT PEDIATRICS,,10806 MONROE RD STE A MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538180690,"EMEZIE, ANTHONIA, OGECHI",10806 MONROE RD STE A MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 77 , 141 , 360 ," $15,851.25 ",,
MEDICAID DIRECT,1538181854,"LEE III, FOLDEN, WILFORD",FOLDEN W LEE III DDS PA,5400 BARBER MILL RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1538181854,"LEE III, FOLDEN, WILFORD",5400 BARBER MILL RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538182043,"SOBEL, BARRY, ADAM",600 HOSPITAL DR   MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528314994,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OB GYN,2700 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,193400000X,Group,Single Specialty,,1538182043,"SOBEL, BARRY, ADAM",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528314994,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OB GYN,2700 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,193400000X,Group,Single Specialty,,1538182043,"SOBEL, BARRY, ADAM",2700 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538182043,"SOBEL, BARRY, ADAM",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 35 , 53 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538182043,"SOBEL, BARRY, ADAM",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538183736,"MOTTL, AMY, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538183736,"MOTTL, AMY, KATHERINE",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 21 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538183736,"MOTTL, AMY, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538183736,"MOTTL, AMY, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538183736,"MOTTL, AMY, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 27 , 41 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3325 GARDEN RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538183736,"MOTTL, AMY, KATHERINE",3325 GARDEN RD   BURLINGTON NC,001,Alamance,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1245637701,NEW DAWN PSYCHIATRIC SERVICES PLLC,,835 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538183942,"LEONHARDT, GARY, GENE",2602 COURTIER DR   GREENVILLE NC,074,Pitt,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538185574,"PERINI, MARK, ANDREW",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 43 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1538186317,"MARITATO, CHRISTOPHER, JOHN",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1538186317,"MARITATO, CHRISTOPHER, JOHN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1538186317,"MARITATO, CHRISTOPHER, JOHN",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1538188636,"BOUCHER, RONALD, ROBERT",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538189279,FAYETTEVILLE OTOLARYNGOLOGY,FAYETTEVILLE OTOLARYNGOLOGY HEAD AND NECK SURGERY,1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538189279,FAYETTEVILLE OTOLARYNGOLOGY,1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#,#, 13 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 76 , 76 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538189360,"TANTA, FERAS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1538189360,"TANTA, FERAS",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538191341,"GLENN, SUSAN, ANNETTE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 12 , 21 , 22 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538191341,"GLENN, SUSAN, ANNETTE",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 34 , 35 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538191341,"GLENN, SUSAN, ANNETTE",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 31 , 49 , 53 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1538191879,"MCKENNA, MATTHEW, JOHN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 55 , 116 ,$#,,
MEDICAID DIRECT,1679589212,CONCORD CHILDRENS CLINIC,CONCORD CHILDREN CLINIC,1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538192604,"PRAKASH, HEMANT",1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 39 , 122 ,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1538192844,"ZUKE, JOHN, ERNEST",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1538193016,"HARBIN, JAMES, DOUGLAS",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,1210 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1538193016,"HARBIN, JAMES, DOUGLAS",1210 BROWN ST   WASHINGTON NC,007,Beaufort,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538193016,"HARBIN, JAMES, DOUGLAS",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538193016,"HARBIN, JAMES, DOUGLAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 48 , 65 , 87 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,628 E 12TH ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1538193016,"HARBIN, JAMES, DOUGLAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538193149,"CAICEDO, RICARDO, ANDRES",2550 COURT DRIVE   GASTONIA NC,036,Gaston,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538193149,"CAICEDO, RICARDO, ANDRES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538193149,"CAICEDO, RICARDO, ANDRES",4501 CAMERON VALLEY PKWY STE 300 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538193149,"CAICEDO, RICARDO, ANDRES",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538193149,"CAICEDO, RICARDO, ANDRES",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 53 , 80 , 95 ,$#,,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538193339,"HERSCHELMAN, MARC, AARON",3100 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1679589212,CONCORD CHILDRENS CLINIC,CONCORD CHILDREN CLINIC,1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538194956,"RICHARDS, JULIA, BLEVINS",1040 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 41 , 75 , 223 ," $10,054.51 ",,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538195243,"WHITAKER, MILES, WARREN",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 99 , 164 , 342 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538195243,"WHITAKER, MILES, WARREN",2919 BEECHTREE DR   SANFORD NC,053,Lee,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538195243,"WHITAKER, MILES, WARREN",1135 CARTHAGE ST   SANFORD NC,053,Lee,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 30 , 30 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538195243,"WHITAKER, MILES, WARREN",1818 DOCTORS DR   SANFORD NC,053,Lee,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538195276,"CURCIO, KRISTIN, RAINELLE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538195276,"CURCIO, KRISTIN, RAINELLE",3515 W MARKET ST STE 300 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 20 , 21 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538195276,"CURCIO, KRISTIN, RAINELLE",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538195276,"CURCIO, KRISTIN, RAINELLE",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1538195847,"YARLAGADDA, VAMSI, VEMANA",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1659052017,RETINA AND DIABETIC EYE CENTER PA,,1204 MAPLE ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1538196209,"RANKIN, GARY, ALAN",1204 MAPLE ST   GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 25 , 66 , 161 ,$#,,
MEDICAID DIRECT,1760729644,MOSES CONE AFFILIATED PHYSICIANS IN,RETINA AND DIABETIC EYE CENTER,1204 MAPLE ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538196209,"RANKIN, GARY, ALAN",1204 MAPLE ST   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1659052017,RETINA AND DIABETIC EYE CENTER PA,,1204 MAPLE ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1538196209,"RANKIN, GARY, ALAN",1204 MAPLE ST   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 30 , 118 , 271 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538196514,"BATTS, JENNAH, ELIZABETH DILDY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538196514,"BATTS, JENNAH, ELIZABETH DILDY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538196514,"BATTS, JENNAH, ELIZABETH DILDY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538196514,"BATTS, JENNAH, ELIZABETH DILDY",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538197827,"NORTON, SUJATHA, V",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1538197934,"BOYD JR, DALE, WOODS",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538197934,"BOYD JR, DALE, WOODS",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 20 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538201629,"GILLIAM, RYAN, DWAIN",216 MOORE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 48 , 62 ,$#,,
MEDICAID DIRECT,1538203708,"SHEPARD, ROBIN, LINNETTE",~,3108 LAKE ADGER RD   MILL SPRING NC,075,Polk,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,1538203708,"SHEPARD, ROBIN, LINNETTE",3108 LAKE ADGER RD   MILL SPRING NC,075,Polk,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 81 ," 1,369 "," 2,650 "," $115,162.15 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538205687,"VALLABHANENI, SATISH, CHANDRA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538206537,"LISSADE, MARCELLE, DESRONVIL",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1346711322,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - SELMA,1111 S POLLOCK ST   SELMA NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538206537,"LISSADE, MARCELLE, DESRONVIL",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice," 2,229 "," 4,223 "," 17,793 "," $604,619.12 ",,
MEDICAID DIRECT,1801318944,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GOLDSBORO,2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538207725,"MITCHELL, FRANK, BRADLEY",2702 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 38 ,$#,,
MEDICAID DIRECT,1376914283,DIGESTIVE HEALTH ENDOSOPY CENTER,~,3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538208269,"MORALES, NANCY",3202 BOONE TRL   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1538208335,"MITCHELL BARNES, DONNA, JEAN",2109 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 132 , 275 , 305 ," $12,362.88 ",,
MEDICAID DIRECT,1093778110,RPK CENTER FOR REHAB SPINE,RPK CENTER FOR REHAB SPINE,2109 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1538208335,"MITCHELL BARNES, DONNA, JEAN",2109 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538208517,"STONE, KATHERINE, LENAE",2025 FRONTIS PLAZA BLVD STE 100 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538208517,"STONE, KATHERINE, LENAE",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1538210737,"WELDON, JOHN, SWETNAM",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 57 , 58 ,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538211883,"SCACHERI, JOHN, FRANCIS",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1538211883,"SCACHERI, JOHN, FRANCIS",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 77 , 78 , 78 ,$#,,
MEDICAID DIRECT,1073807376,SURGERY CENTER ANESTHESIA PROVIDERS,~,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538211883,"SCACHERI, JOHN, FRANCIS",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538213590,"SABIN, DAVID, CHARLES",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538213590,"SABIN, DAVID, CHARLES",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538213590,"SABIN, DAVID, CHARLES",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1992390033,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH GASTROENTEROLOGY,700 SUNSET AVE   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1538214721,"BUTLER, ROBERT, HOYT",700 SUNSET AVE   ASHEBORO NC,076,Randolph,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 31 , 34 ,$#,,
MEDICAID DIRECT,1023396033,RANDOLPH SPECIALTY GROUP PRACTICE,RANDOLPH HEALTH GASTROENTEROLOGY,,,Unknown,193200000X,Group,Multi-Specialty,,1538214721,"BUTLER, ROBERT, HOYT",700 SUNSET AVE   ASHEBORO NC,076,Randolph,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538214754,"LOCKWOOD, MARIA, LISA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538215496,"COLLINS, MANDY, LEIGH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538215496,"COLLINS, MANDY, LEIGH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538215496,"COLLINS, MANDY, LEIGH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598043077,JOINT TECHNOLOGY INC,JOINT TECHNOLOGY INC,10440 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1538218979,"BARR, JOHN, FINDLEY",10440 PARK RD STE 200C CHARLOTTE NC,060,Mecklenburg,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,, 21 , 29 , 70 ,$#,,
MEDICAID DIRECT,1346473279,KNOWLES SMITH & ASSOCIATES LLP,SOUTHEASTERN DENTAL SPECIALISTS,2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538220223,"MAIORANA, ANTHONY",2038 LITHO PL   FAYETTEVILLE NC,026,Cumberland,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1538220223,"MAIORANA, ANTHONY",~,2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1538220223,"MAIORANA, ANTHONY",2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1346473279,KNOWLES SMITH & ASSOCIATES LLP,SOUTHEASTERN DENTAL SPECIALISTS,2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538220223,"MAIORANA, ANTHONY",2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 639 , 969 ," 4,623 "," $524,108.63 ",,
MEDICAID DIRECT,1538220355,"BROWDER, MICHAEL, HUGH",,404 8TH ST   NORTH WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,1538220355,"BROWDER, MICHAEL, HUGH",404 8TH ST   NORTH WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice, 54 , 152 , 372 ," $14,125.34 ",,
MEDICAID DIRECT,1538222153,MCDOWELLS PHARMACY INC,MCDOWELLS PHARMACY,1004 MAIN ST   SCOTLAND NECK NC,042,Halifax,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1538222153,MCDOWELLS PHARMACY INC,1004 MAIN ST   SCOTLAND NECK NC,042,Halifax,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538223292,"MASON, MARY ANN, BENDELOW",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538223292,"MASON, MARY ANN, BENDELOW",40 DUKE MEDICINE CIR # 2D DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538223441,"LEWIS, CHARMAINE, ANNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 192 , 196 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538223441,"LEWIS, CHARMAINE, ANNE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1538224845,B-MED INC,B-MED INC,2545 JETPORT RD   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1538224845,B-MED INC,2545 JETPORT RD   KINSTON NC,054,Lenoir,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 81 , 409 , 606 ,$#,,
MEDICAID DIRECT,1538224845,B-MED INC,B-MED INC,2545 JETPORT RD   KINSTON NC,054,Lenoir,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1538224845,B-MED INC,2545 JETPORT RD   KINSTON NC,054,Lenoir,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 72 , 539 ," 1,089 "," $70,578.86 ",,
MEDICAID DIRECT,1538228689,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07328,310 VERNON AVE   DENTON NC,029,Davidson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1538228689,NORTH CAROLINA CVS PHARMACY LLC,310 VERNON AVE   DENTON NC,029,Davidson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538229679,"DAMIS, YVES-LAURE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538230842,"LYEMANCE, ROBYN, LORRAINE",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538230842,"LYEMANCE, ROBYN, LORRAINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538230883,"MUREEBE, LEILA",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538230883,"MUREEBE, LEILA",10207 CERNY ST   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073914024,LITTLE OAKS PEDIATRICS PLLC,,13200 STRICKLAND RD STE 120 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538233192,"GUERRA, MARIA, MERCEDES",13200 STRICKLAND RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 17 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538237672,"KOZLOWSKI, MATTHEW, SCOTT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 29 ,$#,,
MEDICAID DIRECT,1538238696,"MOTAMED, MASSOUD",MT OLIVE CHIROPRACTIC CLINIC PC,515 W MAIN ST   MOUNT OLIVE NC,096,Wayne,111N00000X,Chiropractic Providers,Chiropractor,,1538238696,"MOTAMED, MASSOUD",515 W MAIN ST   MOUNT OLIVE NC,096,Wayne,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1801966395,KINSTON HEAD AND NECK PHYSICIANS AN,KINSTON HEAD & NECK PHYSICIANS AND SURGEONS PA,701 DOCTORS DR STE K KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1538239041,"GOHEEN, BARBARA, LYNN",701 DOCTORS DR STE K KINSTON NC,054,Lenoir,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1801966395,KINSTON HEAD AND NECK PHYSICIANS AN,KINSTON HEAD & NECK PHYSICIANS AND SURGEONS PA,701 DOCTORS DR STE K KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1538239041,"GOHEEN, BARBARA, LYNN",701 DOCTORS DR STE K KINSTON NC,054,Lenoir,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 110 , 222 , 287 ,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538239355,"SPADA, DEBORAH, A",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538239355,"SPADA, DEBORAH, A",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 32 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538239363,"BLUE, LAURA, JANE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538239587,"SNOW, NICHOLE, LYNN",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538240072,"JEONG, SEONG-JOO",4000 COLISEUM DR STE 320 HAMPTON VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538240072,"JEONG, SEONG-JOO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538240072,"JEONG, SEONG-JOO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538240072,"JEONG, SEONG-JOO",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538241369,"SHEHADEH, NASFAT, JAMEEL",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 45 , 112 , 320 ," $14,559.98 ",,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538241369,"SHEHADEH, NASFAT, JAMEEL",7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 23 , 57 , 126 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538241369,"SHEHADEH, NASFAT, JAMEEL",200 HAWTHORNE LN FL 3 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538241369,"SHEHADEH, NASFAT, JAMEEL",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 16 ,$#,,
MEDICAID DIRECT,1467406736,ONCOLOGY SPECIALISTS OF CHARLOTTE P,ONCOLOGY SPECIALISTS OF CHARLOTTE PA,7108 PINEVILLE MATTHEWS RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538241369,"SHEHADEH, NASFAT, JAMEEL",10635 PARK RD STE F CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1699483586,EYECARE SPECIALTIES OF NORTH CAROLI,,504 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1538241377,"NAIK, NIMA, AMULRAI",504 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1215994371,FOX EYE CARE GROUP,FOX EYE CARE GROUP,4325 GLENWOOD AVE STE F RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538241377,"NAIK, NIMA, AMULRAI",4325 GLENWOOD AVE   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1538241518,APPALACHIAN EYE ASSOCIATES OD PA,~,54 HILL ST   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1538241518,APPALACHIAN EYE ASSOCIATES OD PA,54 HILL ST   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,, 146 , 146 , 287 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538243415,"RUCH, JULIE, TIMMONS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1538243415,"RUCH, JULIE, TIMMONS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 32 , 32 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1538243415,"RUCH, JULIE, TIMMONS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538243415,"RUCH, JULIE, TIMMONS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538243423,"PEYSER, BRUCE, THEODORE",3044 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 44 , 109 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538243456,"WAHL, KERRI, MARGRET",DUKE HOSP SOUTH TRENT DR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1528463213,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY URGENT CARE - PIEDMONT,,,Unknown,193200000X,Group,Multi-Specialty,,1538243696,"HINCEMAN, MARCUS",2972 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538244454,"WADA, AMY, HATSUMI",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 37 , 37 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538244926,"LANG, DANIEL, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538244926,"LANG, DANIEL, JAMES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538245378,"HOLDSWORTH, JEREMY, PAUL",4141 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 13 , 31 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1538245394,"HARRIS, GLENN, RAY",101 PLAZA RD   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 62 , 84 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1538245394,"HARRIS, GLENN, RAY",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 81 , 165 , 193 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1538245394,"HARRIS, GLENN, RAY",700A PROGRESS PL   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1538246574,"HERFARTH, HANS, HEINRICH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538246574,"HERFARTH, HANS, HEINRICH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 60 , 79 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538246988,"BODNER, GAYLE, BETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851694160,ELITE HANDS WOUND CARE & SURGICAL A,~,7930 SKYLAND RIDGE PKWY STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538248125,"KURTZ, HARRY, DAVID",7930 SKYLAND RIDGE PKWY STE 203 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 99 , 186 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538249537,"LYNCH, SUSAN, KAYE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 16 , 54 , 57 ," $13,591.94 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538250303,"ADAMS, LARRY, LEE",640 MCCARTHY BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538250303,"ADAMS, LARRY, LEE",722 NEWMAN RD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 33 , 37 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538250303,"ADAMS, LARRY, LEE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538250303,"ADAMS, LARRY, LEE",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1538251053,"COLLINS, WENDY, CHANDLER",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1538251053,"COLLINS, WENDY, CHANDLER",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538253307,WESLEYAN ARMS RETIREMENT CENTER,WESTCHESTER HARBOUR,630 WHITTIER AVE   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538253307,WESLEYAN ARMS RETIREMENT CENTER,630 WHITTIER AVE   HIGH POINT NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 17 ," 1,632 "," 1,632 "," $143,278.40 ",,
MEDICAID DIRECT,1336492297,ELEVATE PHYSICAL THERAPY AND PAIN C,~,4 MARKET ST STE 4103 BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1538253562,"MCALISTER, KEVIN, ODELL",4 MARKET ST STE 4103 BREVARD NC,088,Transylvania,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 30 , 78 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538257902,"WEIL, AMY, BRETT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538257902,"WEIL, AMY, BRETT",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 64 , 139 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538258090,"ALLUSHUSKI, PATRICIA, GEESEN",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538258090,"ALLUSHUSKI, PATRICIA, GEESEN",2351 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1114152337,DABIRUDDIN M HUMAYUN MD PLLC,~,3830 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538260211,"HUMAYUN, DABIRUDDIN, MUHAMMAD",3830 BLUE RIDGE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 57 , 57 ,$#,,
MEDICAID DIRECT,1538262209,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07315,2 CRESCENT DR   WEST JEFFERSON NC,005,Ashe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1538262209,NORTH CAROLINA CVS PHARMACY LLC,2 CRESCENT DR   WEST JEFFERSON NC,005,Ashe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538262589,"MARTINDALE, JOSEPH, LEON",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1538263207,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02563,9931 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1538263207,NORTH CAROLINA CVS PHARMACY LLC,9931 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1538263207,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02563,9931 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1538263207,NORTH CAROLINA CVS PHARMACY LLC,9931 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1538264478,FAMILY MEDICAL SUPPLY LLC,~,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1538264478,FAMILY MEDICAL SUPPLY LLC,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 81 , 851 , 862 ," $105,758.49 ",,
MEDICAID DIRECT,1538264478,FAMILY MEDICAL SUPPLY LLC,~,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1538264478,FAMILY MEDICAL SUPPLY LLC,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment," 1,137 "," 7,247 "," 12,136 "," $387,551.29 ",,
MEDICAID DIRECT,1538264478,FAMILY MEDICAL SUPPLY LLC,~,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1538264478,FAMILY MEDICAL SUPPLY LLC,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1538264478,FAMILY MEDICAL SUPPLY LLC,~,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1538264478,FAMILY MEDICAL SUPPLY LLC,1800 PARKWOOD BLVD W STE A WILSON NC,098,Wilson,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1538265749,"KEMP, OLAN, BAXTER",4275 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 73 , 127 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1538265749,"KEMP, OLAN, BAXTER",4275 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538267646,"HOUCK, VICKI, MARIE",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223E0200X,Dental Providers,Dentist,Endodontics, 245 , 269 , 537 ," $65,684.15 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,CB #7450 UNC SCHOOL OF DENTISTRY CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1538267646,"HOUCK, VICKI, MARIE",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538267679,"VIDAL, MELVIN, THEODORE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 42 , 148 , 148 ,$#,,
MEDICAID DIRECT,1811635857,AMERICAN HEALTHCARE SYSTEMS LLC,ASHEBORO DIGESTIVE DISEASE AT RANDOLPH HEALTH,548 GREENSBORO ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1538268461,"MISENHEIMER, TIMOTHY, JOE",548 GREENSBORO ST   ASHEBORO NC,076,Randolph,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 141 , 239 , 255 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538272679,"SMITH, MECHELL, SPADIE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1538273859,"BAKER, SHANE, ARTHUR",340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1538273859,"BAKER, SHANE, ARTHUR",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1538273859,"BAKER, SHANE, ARTHUR",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538276670,"RANDALL, STEPHEN, MARTIN",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 44 , 53 , 89 ,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538277835,"IZAJ, JULIE, MELKERSON",306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 48 ,$#,,
MEDICAID DIRECT,1184951634,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,306 WESTWOOD AVE STE 501 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538277835,"IZAJ, JULIE, MELKERSON",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1538279120,"QUINN, ROBERT, PATEL",DR QUINN EAR NOSE AND THROAT,25 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,1538279120,"QUINN, ROBERT, PATEL",25 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 77 , 113 , 149 ,$#,,
MEDICAID DIRECT,1538279120,"QUINN, ROBERT, PATEL",DR QUINN EAR NOSE AND THROAT,25 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,1538279120,"QUINN, ROBERT, PATEL",1933 JAKE ALEXANDER BLVD W   SALISBURY NC,080,Rowan,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538281134,"MORRISON, CYNTHIA, KAY",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538281134,"MORRISON, CYNTHIA, KAY",230 COUNTRY TIME LN   LEICESTER NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538281134,"MORRISON, CYNTHIA, KAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538281134,"MORRISON, CYNTHIA, KAY",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538281134,"MORRISON, CYNTHIA, KAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538281928,"LEE, CARRIE, BETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 25 , 49 , 72 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538282645,"LUTHER, VERA, PARKHURST",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 16 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538282645,"LUTHER, VERA, PARKHURST",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 103 , 111 ,$#,,
MEDICAID DIRECT,1598007601,DRS DAVIS & LEE DDS PA,BLUE WATER PEDIATRIC DENTISTRY,345 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1538283924,"DAVIS, OLEN, BEN",345 EARNIE LN   HOLLY SPRINGS NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 882 ," 1,230 "," 4,485 "," $123,840.26 ",,
MEDICAID DIRECT,1598007601,DRS DAVIS & LEE DDS PA,BLUE WATER PEDIATRIC DENTISTRY,345 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1538283924,"DAVIS, OLEN, BEN",2106 WERRINGTON DR   HOLLY SPRINGS NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1538285069,"MIRIAN, MIRFATTAH",RICHMOND FOOT CLINIC P A,721 S LONG DR   ROCKINGHAM NC,077,Richmond,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1538285069,"MIRIAN, MIRFATTAH",721 S LONG DR   ROCKINGHAM NC,077,Richmond,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 275 , 824 ," 1,220 "," $15,801.33 ",,
MEDICAID DIRECT,1538289053,GLADYS POTEAT,~,1143 YARBOROUGHS MILL RD   MILTON NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538289053,GLADYS POTEAT,1143 YARBOROUGHS MILL RD   MILTON NC,017,Caswell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,115 "," 1,157 "," $63,172.73 ",,
MEDICAID DIRECT,1538291646,COMSERV INC,~,410 N POPLAR ST   LINCOLNTON NC,055,Lincoln,251S00000X,Agencies,Community/Behavioral Health,,1538291646,COMSERV INC,410 N POPLAR ST   LINCOLNTON NC,055,Lincoln,251S00000X,Agencies,Community/Behavioral Health,,#, 143 , 143 ,$#,,
MEDICAID DIRECT,1538291760,COUNTY OF BURKE,~,200 AVERY AVE   MORGANTON NC,012,Burke,3416L0300X,Transportation Services,Ambulance,Land Transport,1538291760,COUNTY OF BURKE,200 AVERY AVE   MORGANTON NC,012,Burke,3416L0300X,Transportation Services,Ambulance,Land Transport, 370 , 671 ," 1,258 "," $10,160.15 ",,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538293279,"HANDLER, JASON, PAUL",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 45 , 84 , 99 ,$#,,
MEDICAID DIRECT,1093779951,EYE SURGERY AND LASER CLINIC INC,EYE SURGERY AND LASER CLINIC INC,500 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1538293279,"HANDLER, JASON, PAUL",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 37 , 37 ,$#,,
MEDICAID DIRECT,1346425691,ROBERT L HOLLOWELL III DDS,,2824 ROGERS RD STE 201 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1538295472,"HOLLOWELL, ROBERT, LOUIS",2824 ROGERS RD STE 201 WAKE FOREST NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 140 , 145 , 579 ," $23,840.53 ",,
MEDICAID DIRECT,1124895354,DR CAMERON & ASSOCIATES OF WAKE FOR,TRIANGLE PEDIATRIC DENTISTRY,2824 ROGERS RD STE 201 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1538295472,"HOLLOWELL, ROBERT, LOUIS",2824 ROGERS RD STE 201 WAKE FOREST NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 607 ," 1,051 "," 3,790 "," $130,815.03 ",,
MEDICAID DIRECT,1538295597,ALLIED HOME HEALTH CARE INC,~,1842 S MADISON ST   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1538295597,ALLIED HOME HEALTH CARE INC,1842 S MADISON ST   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 41 ," 7,473 "," 7,473 "," $461,385.12 ",,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538296561,"HUNTER, DENISE, NICOLE",439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 50 , 65 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538296561,"HUNTER, DENISE, NICOLE",1000 TANDALL PALACE   KNIGHDALE NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1538298153,EAGLE HEALTHCARE SERVICES INC,Eagle Healthcare Services Inc,1500 GARNER RD STE A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1538298153,EAGLE HEALTHCARE SERVICES INC,1500 GARNER RD STE A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 310 , 310 ," $29,192.08 ",,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538299334,"LEE, BENJAMIN, CHUNG",401 SIGNAL RD   NEWPORT BEACH CA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538300025,"LEVINE, ETHAN, ROY",3420 HOLLOWAY ST   DURHAM NC,032,Durham,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,,,$#,,
MEDICAID DIRECT,1992171060,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF BOLIVIA,4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538300900,"PRESSLEY, DARLENE, HILL",4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417071283,G & G HEALTHCARE PC,G AND G HEALTHCARE PC,,,Unknown,193400000X,Group,Single Specialty,,1538300900,"PRESSLEY, DARLENE, HILL",341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538303235,"GOODWIN, COURTNEY, RORY",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538303235,"GOODWIN, COURTNEY, RORY",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538303235,"GOODWIN, COURTNEY, RORY",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538303235,"GOODWIN, COURTNEY, RORY",407 CRUTCHFIELD ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538304183,"RICHARDSON, VICKI, TERRY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 108 , 261 , 342 ,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538304266,"WHITE, KELLI, RENEE",500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1235515446,CLEVELAND FAMILY HEALTH CLINIC PLLC,,22 SHIPWASH DR   GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1538304837,"KEEN, MARIAN, JEANETTE",22 SHIPWASH DR   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 20 , 28 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538305073,"FAGGART, JONATHAN, LEE",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1538307020,"BRANT-DEITCH, DEBORAH, HELEN",1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538308291,HARMONY HOME CARE,HARMONY HOME CARE,230 MORGANTON BLVD SW STE D LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,1538308291,HARMONY HOME CARE,230 MORGANTON BLVD SW STE D LENOIR NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 4,315 "," 4,462 "," $670,304.28 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538314208,"LIN, QI",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1437286291,ALLCARE CLINICAL ASSOCIATES PA,ASHEVILLE ANESTHESIA ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1538314349,"COLEMAN, CHERI, LYNN",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1790123081,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE MATERNAL FETAL MEDICINE,200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 32 , 46 , 118 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790123081,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE MATERNAL FETAL MEDICINE,200 MEDICAL PARK DR STE 500 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790123081,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE MATERNAL FETAL MEDICINE,200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 11 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16455 STATESVILLE RD STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 11 , 24 , 41 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538315833,"BROWN, KELECIA, RUTHANN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1437396454,WENDELL EYE CARE OPTOMETRIC PA,WENDELL EYE CARE OPTOMETRIC PA,18 S MAIN ST   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1538316112,"LUTZ, JONATHAN, MICHAEL",18 S MAIN ST   WENDELL NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 51 , 58 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538317227,"MCNEILL, ELENA, BELYAEVA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1023053493,EAST CAROLINA GASTROENTEROLOGY PA,~,4 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1538317227,"MCNEILL, ELENA, BELYAEVA",4 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 35 , 54 , 100 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538317227,"MCNEILL, ELENA, BELYAEVA",4 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 27 , 28 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538317565,"VATSAAS, CORY, JOSEPH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 ,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538317565,"VATSAAS, CORY, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538317565,"VATSAAS, CORY, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 42 , 50 , 54 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538317698,"TYSINGER, DAVID, SHANE",1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538317698,"TYSINGER, DAVID, SHANE",1581 YANCEYVILLE ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 65 , 120 ,$#,,
MEDICAID DIRECT,1538319942,SAMUEL SERVICES CORPORATION,SENIOR HELPERS,9101 PINEVILLE MATTHEWS RD STE M PINEVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1538319942,SAMUEL SERVICES CORPORATION,9101 PINEVILLE MATTHEWS RD STE M PINEVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 3,544 "," 3,551 "," $282,504.00 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538319991,"SHEARIN, KIMBERLY, MOSELEY",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 48 , 101 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1261 JULIAN ALLSBRK HWY   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1538319991,"SHEARIN, KIMBERLY, MOSELEY",1261 JULIAN ALLSBRK HWY   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 167 , 207 , 423 ," $10,791.71 ",,
MEDICAID DIRECT,1548625429,WESTMORELAND & OKANE PLLC,WNC DENTAL,3179 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538320452,"WARE, JOHN, CONNOR",3179 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 45 , 72 , 254 ," $12,770.94 ",,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538322672,"VERMA, SOURABH",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1275572794,COASTAL CAROLINA HEALTH CARE PA,CCHC SOUTHERN GASTROENTEROLOGY ASSOCIATES,3100 WELLONS BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1538323563,"HU, HUANKAI",3100 WELLONS BLVD   NEW BERN NC,025,Craven,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538323563,"HU, HUANKAI",30 PAGE ST   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,,1538323563,"HU, HUANKAI",30 PAGE ST   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 42 , 46 , 94 ,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1538323563,"HU, HUANKAI",30 PAGE ST   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538323563,"HU, HUANKAI",205 PAGE RD   PINEHURST NC,063,Moore,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 115 , 117 , 182 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538324215,"MENA-GUTIERREZ, ALEJANDRA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 60 , 154 , 161 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538325634,"MALHOTRA, KAAYA",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538325642,"LAL, PARSHOTAM",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 96 , 224 , 226 ,$#,,
MEDICAID DIRECT,1437542206,SOUTHEASTERN REGIONAL PHYSICIAN SER,LUMBERTON MEDICAL CLINIC,395 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1538325642,"LAL, PARSHOTAM",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437542206,SOUTHEASTERN REGIONAL PHYSICIAN SER,LUMBERTON MEDICAL CLINIC,395 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1538325642,"LAL, PARSHOTAM",395 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 81 , 102 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538325642,"LAL, PARSHOTAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699760702,ENT CAROLINA PA,ENT CAROLINA PA,2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1538326095,"THOMPSON, CAROLYN",2520 ABERDEEN BLVD   GASTONIA NC,036,Gaston,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538327069,"THOMMEN, DOUGLAS, MICHAEL",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 32 , 89 , 122 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538327069,"THOMMEN, DOUGLAS, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538327069,"THOMMEN, DOUGLAS, MICHAEL",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538327911,"BENNETT, JEREMY, MICHAEL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 25 , 31 ,$#,,
MEDICAID DIRECT,1932716412,JANIER PATRICE BARTON,SMILES BY JB,1822 E NC HIGHWAY 54 STE 100 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1538331244,"BARTON, JANIER, PATRICE",1822 E NC HIGHWAY 54 STE 100 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 273 , 476 ," 1,948 "," $97,411.34 ",,
MEDICAID DIRECT,1184197063,LUZ A CHAVEZ DDS II PC,,816 E ARROWOOD RD STE C CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538331368,"CHAVEZ, LUZ, ANGELICA",816 E ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 255 , 558 ," 1,871 "," $80,438.08 ",,
MEDICAID DIRECT,1467890301,LUZ A CHAVEZ DDS PC,ALL FAMILY DENTISTRY PC,9912 MONROE RD STE 100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538331368,"CHAVEZ, LUZ, ANGELICA",9912 MONROE RD STE 100 MATTHEWS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1386094613,G ABRAMS & R COHEN XVII,,7128 LAWYERS RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",7128 LAWYERS RD   MINT HILL NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 30 , 33 , 55 ,$#,,
MEDICAID DIRECT,1891221107,G ABRAMS AND R COHEN XVIII PC,,8440 PIT STOP CT NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",5700 UNIVERSITY POINTE BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1679905350,ABRAMS BARROWS COHEN & ASSOCIATES I,~,3326 SISKEY PKWY STE 310 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",3326 SISKEY PKWY STE 310 MATTHEWS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 35 , 109 ,$#,,
MEDICAID DIRECT,1205193141,G ABRAMS AND R COHEN V PC,G ABRAMS AND R COHEN V PC,5700 UNIVERSITY POINTE BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",5700 UNIVERSITY POINTE BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1891221107,G ABRAMS AND R COHEN XVIII PC,,8440 PIT STOP CT NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",8170 S TRYON ST STE C CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1467886978,G ABRAMS R COHEN VII PC,~,1605 GALLERIA BLVD STE 110 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",1605 GALLERIA BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 750 ," 1,419 "," 5,237 "," $282,707.78 ",,
MEDICAID DIRECT,1891221107,G ABRAMS AND R COHEN XVIII PC,,8440 PIT STOP CT NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",401 COX RD STE 188 GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154693455,G ABRAMS R COHEN III PC,G ABRAMS & R COHEN III PC,401 COX RD STE 188 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",401 COX RD STE 188 GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 49 , 61 , 142 ," $19,175.94 ",,
MEDICAID DIRECT,1891221107,G ABRAMS AND R COHEN XVIII PC,,8440 PIT STOP CT NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1982071114,ABRAMS BARROWS COHEN & ASSOCIATES P,,160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",160 CONCORD COMMONS PL SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1912136664,R BARROWS AND ASSOCIATES PA,R BARROWS AND ASSOCIATES PA,323 UNIONVILLE INDIAN TRAIL RD W STE G INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",323 UNIONVILLE INDIAN TRAIL RD W   INDIAN TRAIL NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 66 , 191 ," $11,994.60 ",,
MEDICAID DIRECT,1720479876,G ABRAMS & R COHEN XIII PC,,901 OAK FOREST DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538332143,"COHEN, RON",901 OAK FOREST DR   MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 22 , 22 , 125 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538332903,"BUCKLEY, ANNE, FRANCES",2301 ERWIN RD   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538332903,"BUCKLEY, ANNE, FRANCES",2301 ERWIN RD   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538332903,"BUCKLEY, ANNE, FRANCES",2301 ERWIN RD   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 20 ,$#,,
MEDICAID DIRECT,1588705776,RICHMOND COUNTY DSS,~,127 CAROLINE ST   ROCKINGHAM NC,077,Richmond,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1538337407,"SANFORD, JANET, LYNN",127 CAROLINE ST   ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 21 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538339056,"PEARCE-SHEW, HEATHER, SAVON",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538339056,"PEARCE-SHEW, HEATHER, SAVON",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 19 , 19 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538340641,"HENDERSON, KIMBERLY, ANN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538340641,"HENDERSON, KIMBERLY, ANN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538340641,"HENDERSON, KIMBERLY, ANN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538340641,"HENDERSON, KIMBERLY, ANN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538340641,"HENDERSON, KIMBERLY, ANN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538343983,FLETCHER HOSPITAL INCORPORATED,COMMUNITY ALTERNATIVE PROGRAM,895 HOWARD GAP RD   FLETCHER NC,045,Henderson,251B00000X,Agencies,Case Management,,1538343983,FLETCHER HOSPITAL INCORPORATED,895 HOWARD GAP RD   FLETCHER NC,045,Henderson,251B00000X,Agencies,Case Management,, 81 , 928 , 928 ," $348,159.50 ",,
MEDICAID DIRECT,1710419619,SMOKY MOUNTAIN SPORTS MEDICINE & PT,,594 CENTENNIAL DR   CULLOWHEE NC,050,Jackson,193200000X,Group,Multi-Specialty,,1538346754,"DUNCAN, ROBYN, ROBERTS",80 SONGBIRD FOREST RD   BRYSON CITY NC,087,Swain,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538350327,"RAVULAPATI, JANAKIRAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 46 , 51 ,$#,,
MEDICAID DIRECT,1023647773,"JAMISON, ALICE, ROSE",,11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1538350640,"PAYNICH, JOSHUA, DAIN",11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 65 ,$#,,
MEDICAID DIRECT,1538350640,"PAYNICH, JOSHUA, DAIN",~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1538350640,"PAYNICH, JOSHUA, DAIN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 100 , 100 ," 1,661 "," $151,964.88 ",,
MEDICAID DIRECT,1538350640,"PAYNICH, JOSHUA, DAIN",~,11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1538350640,"PAYNICH, JOSHUA, DAIN",11 YORKSHIRE ST STE C ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice," 3,189 "," 4,603 "," 18,472 "," $672,943.06 ",,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1538352711,"VARNER, DWAN, QUENNEL",2201 S STERLING ST   MORGANTON NC,012,Burke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538352711,"VARNER, DWAN, QUENNEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 97 , 169 , 170 ," $10,773.78 ",,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1538352968,"DIETER, BENJAMIN, SCOTT",381 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1538352968,"DIETER, BENJAMIN, SCOTT",381 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 112 , 269 , 282 ," $12,998.81 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538353958,"AKULIAN, JASON, ATTICUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538353958,"AKULIAN, JASON, ATTICUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 38 , 49 , 77 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538353958,"AKULIAN, JASON, ATTICUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 36 , 45 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538357025,"TSAN, GLORIA, LILIAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538357025,"TSAN, GLORIA, LILIAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 65 , 92 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538357025,"TSAN, GLORIA, LILIAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538357025,"TSAN, GLORIA, LILIAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538357025,"TSAN, GLORIA, LILIAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538358551,"MERKER, JASON, DEREK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0007X,Allopathic & Osteopathic Physicians,Pathology,Molecular Genetic Pathology, 30 , 35 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538358551,"MERKER, JASON, DEREK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0007X,Allopathic & Osteopathic Physicians,Pathology,Molecular Genetic Pathology, 22 , 24 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538358551,"MERKER, JASON, DEREK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0007X,Allopathic & Osteopathic Physicians,Pathology,Molecular Genetic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538358551,"MERKER, JASON, DEREK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0007X,Allopathic & Osteopathic Physicians,Pathology,Molecular Genetic Pathology, 23 , 31 , 31 ,$#,,
MEDICAID DIRECT,1568197523,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE TEN TEN,7750 TEN TEN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538358619,"LORE, DIANNE, MARY",218 FOUST ST STE B ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538359492,"HAPANGAMA, NEIL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 170 , 170 ," $10,073.92 ",,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538359492,"HAPANGAMA, NEIL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538359492,"HAPANGAMA, NEIL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427309608,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",2700 S PROVIDENCE RD STE 225 WAXHAW NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",600 HOSPITAL DR   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1437607686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",600 HOSPITAL DR   MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427309608,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538361076,"KROPF, ERIC, JON",6050 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538363460,"EPPERLY, JAMES, JOSEPH",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1538363460,"EPPERLY, JAMES, JOSEPH",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538363460,"EPPERLY, JAMES, JOSEPH",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538363460,"EPPERLY, JAMES, JOSEPH",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538363460,"EPPERLY, JAMES, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 94 , 95 , 122 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538363460,"EPPERLY, JAMES, JOSEPH",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538363460,"EPPERLY, JAMES, JOSEPH",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538364203,"COOK, JASON, THOMAS",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538364948,"RUTHERFORD, ALTHEA, SHAWANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538364948,"RUTHERFORD, ALTHEA, SHAWANI",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 16 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538366257,"MONTALVO, BEVERLY, ANNE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538366364,"GRISWOLD, JENNIFER, LYNN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 77 , 104 , 124 ," $11,703.67 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538366711,"DECKER, OLGA, V.",10905 PROVIDENCE RD W STE G200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538366711,"DECKER, OLGA, V.",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538366711,"DECKER, OLGA, V.",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538366711,"DECKER, OLGA, V.",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538366711,"DECKER, OLGA, V.",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,101 E W T HARRIS BLVD STE 4001 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538368923,"SULLIVAN, ROBERT, JOSEPH",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538369871,"GREENGARD, EMILY, GUSTAVA",101 MANNING DRIVE   CHAPEL HILL NC,068,Orange,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 41 , 45 ,$#,,
MEDICAID DIRECT,1538373824,LIBERTY MEDICAL SPECIALTIES INC,LIBERTY MEDICAL SPECIALTIES INC,612-10 JEFFERSON ST   WHITEVILLE NC,024,Columbus,251F00000X,Agencies,Home Infusion,,1538373824,LIBERTY MEDICAL SPECIALTIES INC,612-10 JEFFERSON ST   WHITEVILLE NC,024,Columbus,251F00000X,Agencies,Home Infusion,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538374319,"VOLODKA, KARINA, MARIA",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538375597,"PIERSON, ERIC, DAVID",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 202 , 495 , 625 ," $19,157.01 ",,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538379284,"CHICHETTI, STEVEN, MICHAEL",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 36 , 81 ,$#,,
MEDICAID DIRECT,1538379839,DIAMONDS COMMUNITY BASED SERVICES,DIAMONDS COMMUNITY BASED SERVICES INC,228 GOFF ST   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538379839,DIAMONDS COMMUNITY BASED SERVICES,228 GOFF ST   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 390 , 390 ," $25,365.92 ",,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538383658,"BRIEN, JAMES, COOPER",630 5TH AVE W   HENDERSONVILLE NC,045,Henderson,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538383658,"BRIEN, JAMES, COOPER",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 55 , 92 , 131 ,$#,,
MEDICAID DIRECT,1366067233,ST LUKES PHYSICIAN NETWORK INC,ST LUKES UROLOGY ASSOCIATES,54 HOSPITAL DR STE 3B COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1538383658,"BRIEN, JAMES, COOPER",54 HOSPITAL DR STE 3B COLUMBUS NC,075,Polk,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1538384102,"ADAMS, JOHN, ROBERT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538384102,"ADAMS, JOHN, ROBERT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538384102,"ADAMS, JOHN, ROBERT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538384102,"ADAMS, JOHN, ROBERT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538384102,"ADAMS, JOHN, ROBERT",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538384102,"ADAMS, JOHN, ROBERT",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245600931,RICCOBENE & ASSOCIATES XVI DDS PA,BRUSH AND FLOSS ORTHODONTICS,1111 S POLLOCK ST   SELMA NC,051,Johnston,193400000X,Group,Single Specialty,,1538385281,"ALSTON, RICHARD, DAVID",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 188 , 365 , 376 ," $51,928.31 ",,
MEDICAID DIRECT,1245600931,RICCOBENE & ASSOCIATES XVI DDS PA,BRUSH AND FLOSS ORTHODONTICS,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1538385281,"ALSTON, RICHARD, DAVID",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 100 , 227 , 235 ," $77,359.04 ",,
MEDICAID DIRECT,1245600931,RICCOBENE & ASSOCIATES XVI DDS PA,BRUSH AND FLOSS ORTHODONTICS,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1538385281,"ALSTON, RICHARD, DAVID",5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1245600931,RICCOBENE & ASSOCIATES XVI DDS PA,BRUSH AND FLOSS ORTHODONTICS,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1538385281,"ALSTON, RICHARD, DAVID",120 CLINTON CT   ROCKY MOUNT NC,064,Nash,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538387378,"LEE, CATHERINE, SEE-NING",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538393517,"MADDEN, JESSE, LEE",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538393517,"MADDEN, JESSE, LEE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 25 , 30 ,$#,,
MEDICAID DIRECT,1376690412,ASHEVILLE HEART PA,~,257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538393517,"MADDEN, JESSE, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 24 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1538393517,"MADDEN, JESSE, LEE",257 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538393517,"MADDEN, JESSE, LEE",4622 COUNTRY CLUB RD STE 180 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1538393640,"KENJALE, HIMANSHU, RAMESH",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538393640,"KENJALE, HIMANSHU, RAMESH",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 26 , 28 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1538393640,"KENJALE, HIMANSHU, RAMESH",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538395546,"WEBER, SOMMANY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 116 , 117 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538395546,"WEBER, SOMMANY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538395546,"WEBER, SOMMANY",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538395629,"PHILLIPS, MICHAEL, RYAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 53 , 107 , 121 ," $25,473.47 ",,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1538397112,"MCPHERSON, JESSICA, ANNE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538397112,"MCPHERSON, JESSICA, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 89 , 99 , 127 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1538397302,"DURANT, CHRISTOPHER, D",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538401104,"HELSETH, ASHLEY, REYNOLDS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538401104,"HELSETH, ASHLEY, REYNOLDS",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538401104,"HELSETH, ASHLEY, REYNOLDS",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538401104,"HELSETH, ASHLEY, REYNOLDS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538401104,"HELSETH, ASHLEY, REYNOLDS",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 19 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538401104,"HELSETH, ASHLEY, REYNOLDS",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 94 , 135 , 204 ," $29,093.12 ",,
MEDICAID DIRECT,1952992729,STERLING CHIROPRACTIC PLLC,,8320 LITCHFORD RD STE 152 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538402094,"STERLING, MITCHELL, ANDREW",8320 LITCHFORD RD STE 152 RALEIGH NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#, 84 , 84 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538402839,"DUNN, KATHLEEN, TUREK",802 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1538411145,DIGESTIVE HEALTH SPECIALISTS PA,~,112 KINDERTON BLVD SUITE 100 ADVANCE NC,030,Davie,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1538411145,DIGESTIVE HEALTH SPECIALISTS PA,112 KINDERTON BLVD SUITE 100 ADVANCE NC,030,Davie,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 25 , 26 , 44 ,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538412242,"RASMUSSEN, KIRSTEN, HOLLY",7118 MAIN ST   WADE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1609186790,THE STEDMAN WADE HEALTH SERVICES IN,~,2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538412242,"RASMUSSEN, KIRSTEN, HOLLY",2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1538415120,"ATLAS, JENNIFER, LYNN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538415120,"ATLAS, JENNIFER, LYNN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 66 , 69 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538415914,"PERRY, KERRI",955 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 28 , 49 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538415914,"PERRY, KERRI",955 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538415914,"PERRY, KERRI",955 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538415914,"PERRY, KERRI",955 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,440 TYVOLA RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538415914,"PERRY, KERRI",955 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538415914,"PERRY, KERRI",955 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538415914,"PERRY, KERRI",955 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 75 , 143 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,3680 ROBINWOOD RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,3680 ROBINWOOD RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",2391 COURT DR STE 120A KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",2391 COURT DR STE 120A KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 60 , 118 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",2391 COURT DR STE 120A KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",2391 COURT DR STE 120A KINGS MOUNTAIN NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 34 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,3680 ROBINWOOD RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",120 S MOUNTAIN ST   CHERRYVILLE NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",120 S MOUNTAIN ST   CHERRYVILLE NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1713 S CHURCH ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538418983,"THIELBAR, SCOTT, DAVID",120 S MOUNTAIN ST   CHERRYVILLE NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538423249,"CHOP, YVETTE, BEUBENG",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 15 , 101 , 101 ," $20,408.68 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538428859,"WEGNER, ADAM, MICHAEL",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1538429592,"VANCE, JEFFREY, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538429592,"VANCE, JEFFREY, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1538429592,"VANCE, JEFFREY, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538430707,"KUHLMANN, SARAH, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538430707,"KUHLMANN, SARAH, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538430707,"KUHLMANN, SARAH, ELIZABETH",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538430707,"KUHLMANN, SARAH, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538430707,"KUHLMANN, SARAH, ELIZABETH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538430798,"BARRACLOUGH, SCHUYLER, MARIE",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 25 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538430798,"BARRACLOUGH, SCHUYLER, MARIE",10207 CERNY ST STE 312 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538431200,"OCKERS, SANDRA, BLAIR",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1538431622,"SHEETS, LESLIE, MARTIN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 33 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538431994,"BLACK, GEORGE, EDWARD",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538431994,"BLACK, GEORGE, EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538431994,"BLACK, GEORGE, EDWARD",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 19 , 22 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538431994,"BLACK, GEORGE, EDWARD",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,201 SAGE RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538432018,"SALLY, ELLIOTT, JOHN",201 SAGE RD   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 27 , 63 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538435300,"RUBINOS, CLIO, ARACELLI",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 46 , 123 , 140 ," $14,224.56 ",,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538435300,"RUBINOS, CLIO, ARACELLI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1700287695,REGENT PLLC,,4469 VERANDA LAKE CT   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538438163,"BELEVITCH, VITALY, YURIEVITCH",4469 VERANDA LAKE CT   GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 51 , 989 ," 1,862 "," $14,806.57 ",,
MEDICAID DIRECT,1700287695,REGENT PLLC,,906 BURCH AVE   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538438163,"BELEVITCH, VITALY, YURIEVITCH",906 BURCH AVE   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,10616 METROMONT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538444336,"SARVIS, ASHLEY, TAYLOR",10616 METROMONT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1538444336,"SARVIS, ASHLEY, TAYLOR",10616 METROMONT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 32 , 49 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538444393,"MCCLOY, SARAH, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 34 , 34 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538444393,"MCCLOY, SARAH, ELIZABETH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538444393,"MCCLOY, SARAH, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1538444807,"PATRINO, JESSICA, DAWN",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1538444807,"PATRINO, JESSICA, DAWN",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1538444807,"PATRINO, JESSICA, DAWN",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1811244726,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE URGENT CARE,695 W FLEMING DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1538444807,"PATRINO, JESSICA, DAWN",695 W FLEMING DR   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1538444807,"PATRINO, JESSICA, DAWN",184 ALLENDALE DR   FOREST CITY NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538445556,"IBRAHIM, SADOU",1515 COUNTRY LN   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1134526015,BEST CLINIC PLLC,,10320 LAFOY DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538445556,"IBRAHIM, SADOU",10320 LAFOY DR   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 812 , 812 ," $31,544.06 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538446356,"DEIMLER, RITA, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538446356,"DEIMLER, RITA, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 22 , 25 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538447081,"LIBBY, ALICIA, SIRMANS",135 PAGE RD N   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 35 , 60 ,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,220 PAGE RD   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538447081,"LIBBY, ALICIA, SIRMANS",135 PAGE RD N   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538447081,"LIBBY, ALICIA, SIRMANS",135 PAGE RD N   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 115 , 214 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538449848,"WINKLER, MARCUS, ROGER",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1538449848,"WINKLER, MARCUS, ROGER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538449848,"WINKLER, MARCUS, ROGER",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 204 , 215 , 271 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538449848,"WINKLER, MARCUS, ROGER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538449848,"WINKLER, MARCUS, ROGER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 25 , 35 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 28 , 35 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1609191121,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1656 RIVERCHASE BLVD STE 2500 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538450176,"BREMJIT, PRASHEEDA",1656 RIVERCHASE BLVD STE 2500 ROCK HILL SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538450242,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HOMECARE SPECIALISTS PHARMACY INFUSION THERAP,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,251F00000X,Agencies,Home Infusion,,1538450242,UNIVERSITY OF NC HOSPITALS AT CHAPE,4400 EMPEROR BLVD STE 100 DURHAM NC,032,Durham,251F00000X,Agencies,Home Infusion,, 31 , 262 , 625 ," $181,588.85 ",,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538450499,"VAN DER VAART, ROBERT, ALAN",75 EMERSON BAY RD STE 106 CAROLINA SHORES NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538450499,"VAN DER VAART, ROBERT, ALAN",9020 SENCA DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538450499,"VAN DER VAART, ROBERT, ALAN",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 21 , 28 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538450499,"VAN DER VAART, ROBERT, ALAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538450499,"VAN DER VAART, ROBERT, ALAN",1120 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 73 , 117 , 190 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538450499,"VAN DER VAART, ROBERT, ALAN",507 E FREMONT ST   BURGAW NC,071,Pender,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 48 , 51 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538450499,"VAN DER VAART, ROBERT, ALAN",205 US HIGHWAY 117 S   BURGAW NC,071,Pender,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1619548062,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT CATAWBA VALLEY COMMUNITY COLLEGE,2550 US HIGHWAY 70 SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538450804,"DRUM, JENNIFER, SAMANTHA CRISP",3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1538451406,"WOMBLE, MARY, HAMLIN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538451406,"WOMBLE, MARY, HAMLIN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538452610,"COX, TAMERA, BEAM",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 51 , 53 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538452610,"COX, TAMERA, BEAM",200 W GROVER ST   KINGSTOWN NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538452610,"COX, TAMERA, BEAM",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 35 , 44 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,200 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538452610,"COX, TAMERA, BEAM",200 W GROVER ST   KINGSTOWN NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 46 , 74 , 80 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538456611,"UNGER, ERIC, B",600 GRESHAM DR STE 8600 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538456611,"UNGER, ERIC, B",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538457577,"PATEL, PRANAV, MANGUBHAI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 47 , 47 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538457577,"PATEL, PRANAV, MANGUBHAI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 94 , 94 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538459128,"RICHMAN, SETH, HAYDEN",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 28 , 46 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538459128,"RICHMAN, SETH, HAYDEN",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538459474,"SHAH, ERIKA, ROSE",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538459987,"HENDERSON, ARTHUR, WILLIAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538459987,"HENDERSON, ARTHUR, WILLIAM",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538459987,"HENDERSON, ARTHUR, WILLIAM",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538459987,"HENDERSON, ARTHUR, WILLIAM",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 25 , 43 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538459987,"HENDERSON, ARTHUR, WILLIAM",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1538459987,"HENDERSON, ARTHUR, WILLIAM",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 25 , 37 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538460688,"WHISNANT, HEATHER, MARIE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 123 , 146 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538464649,"FLORES, TOBEY, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1932869013,SHELBY CHIROPRACTIC PLLC,RENO CHIROPRACTIC CENTER,210 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1538465414,"SMITH, JENNIFER, DAWN",210 E GROVER ST   SHELBY NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,#, 86 , 87 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538465943,"FOX, BRIANNE, ALLIS",706 N THOMPSON ST   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 26 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538465943,"FOX, BRIANNE, ALLIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538465943,"FOX, BRIANNE, ALLIS",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 104 , 163 ,$#,,
MEDICAID DIRECT,1194277186,PIEDMONT PHYSICIAN NETWORK LLC,,222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538466040,"WATSON, CARRIE, DAWN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1538466321,"JOHNSON, WALTER, ERIN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1538466321,"JOHNSON, WALTER, ERIN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538479407,"JENKINS, MELISSA, LEIGH",201 E GROVER ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2620 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538483078,"PAVIOL, SCOTT, MAURICE",2620 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1538483078,"PAVIOL, SCOTT, MAURICE",2620 E 7TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538485032,"SECHRIST, CATHERINE, WILLIFORD",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1619599198,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC CARDIOLOGY,1806 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538485032,"SECHRIST, CATHERINE, WILLIFORD",1806 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538485032,"SECHRIST, CATHERINE, WILLIFORD",1806 S HAWTHORNE RD STE 100 WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 76 , 83 , 155 ," $11,113.82 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538485065,"ERICKSON, ELIZABETH, STRACHAN",3024 PICKETT RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538485065,"ERICKSON, ELIZABETH, STRACHAN",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 14 , 37 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538485321,"FRANCILIN, ROBERT, RAJESH",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538486196,"GANDOLFI, MICHELE, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 63 , 85 , 113 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538487517,"EGBERG, MATTHEW, DAVID",6013 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538487517,"EGBERG, MATTHEW, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538488713,"ROGERS, LISA, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1538488838,"ELKINS-WILLIAMS, RETURI, PRITI RAO",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538488978,"BURRELL, TANYA, YVETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080C0008X,Allopathic & Osteopathic Physicians,Pediatrics,Child Abuse Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1538489281,"DOUNA, LAURA, ONEILL",LAURA D DOUNA DDS PA,5950 BEACH DR SW   SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,1538489281,"DOUNA, LAURA, ONEILL",5950 BEACH DR SW   SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 105 , 321 ," $14,698.71 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538489679,"LONG, JOSHUA, STEWART",216 MOORE RD   KING NC,085,Stokes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 99 , 133 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1538501978,"JOHNSON, CAROL, CHRISTINE",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538503941,"BYNUM, INDIA, GREEN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 18 , 18 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538503941,"BYNUM, INDIA, GREEN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538503941,"BYNUM, INDIA, GREEN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538503941,"BYNUM, INDIA, GREEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538504030,"BERNSTEIN, DEREK, THOMAS",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538504030,"BERNSTEIN, DEREK, THOMAS",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 130 , 180 , 291 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538504030,"BERNSTEIN, DEREK, THOMAS",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 41 , 51 , 62 ,$#,,
MEDICAID DIRECT,1023048279,GASTONIA MEDICAL SPECIALTY CLINIC,GASTONIA MEDICAL SPECIALTY CLINIC PA,1021 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538504451,"MAHRLE-HENSON, APRIL, MARIE",1021 X RAY DR 1021 X RAY DRIVE GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 182 , 232 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538504766,"GILES, SARAH, ADELAIDE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1538506043,SANEG HOME CARE INC,~,5601 EXECUTIVE CENTER DR STE 201D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1538506043,SANEG HOME CARE INC,5601 EXECUTIVE CENTER DR STE 201D CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 4,845 "," 4,860 "," $645,694.48 ",,
MEDICAID DIRECT,1538507819,RCA LABORATORY SERVICE LLC,GENETWORX,,,Unknown,291U00000X,Laboratories,Clinical Medical Laboratory,,1538507819,RCA LABORATORY SERVICE LLC,4060 INNSLAKE DR   GLEN ALLEN VA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538508544,"JAVIER, JIMZON, TRIA",1110 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,824 S VAN BUREN RD STE F EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1538508544,"JAVIER, JIMZON, TRIA",4012B BATTLEGROUND AVE STE 1020 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538508544,"JAVIER, JIMZON, TRIA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 29 , 52 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538508544,"JAVIER, JIMZON, TRIA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 22 , 40 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,824 S VAN BUREN RD STE F EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1538508544,"JAVIER, JIMZON, TRIA",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 21 , 24 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538508734,"PUNCH, NICHOLAS, RAPHEAL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 30 , 56 , 62 ,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538508734,"PUNCH, NICHOLAS, RAPHEAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538508734,"PUNCH, NICHOLAS, RAPHEAL",600 HOSPITAL DR   MONROE NC,090,Union,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538508734,"PUNCH, NICHOLAS, RAPHEAL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1962478362,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE,327 1ST AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538511225,"PENLAND, FRANCIS, STERLING",327 1ST AVE NW   HICKORY NC,018,Catawba,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 24 , 36 , 37 ,$#,,
MEDICAID DIRECT,1962478362,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE,327 1ST AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538511225,"PENLAND, FRANCIS, STERLING",301 E MEETING ST   MORGANTON NC,012,Burke,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1538511753,"HARDY, TATIANA, NAKITA GRANT",11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1538511753,"HARDY, TATIANA, NAKITA GRANT",11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1538511753,"HARDY, TATIANA, NAKITA GRANT",11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1538511753,"HARDY, TATIANA, NAKITA GRANT",2930 FORESTVILLE RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538514278,FAMILY FIRST PERSONAL CARE LLC,,110 E MAIN ST STE 105 CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1538514278,FAMILY FIRST PERSONAL CARE LLC,110 E MAIN ST STE 105 CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,, 75 ," 15,596 "," 15,869 "," $1,273,920.20 ",,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538514740,"XIONG, CHUE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 52 , 52 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1538514740,"XIONG, CHUE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538515044,"ALLMAN, ROBERT, DAVID",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538515044,"ALLMAN, ROBERT, DAVID",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538515200,"KANNA, ANILA",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1538515978,"ROJAS, ANDRES, FELIPE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538515978,"ROJAS, ANDRES, FELIPE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538515978,"ROJAS, ANDRES, FELIPE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 27 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538515978,"ROJAS, ANDRES, FELIPE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912059627,"NELSON, CHAUNCY, FITCH",CHAUNCY FITCH NELSON,2135 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1538516422,"BROWN, TANEISHA, LIVINGSTON",125 PUTTERS CT   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1912059627,"NELSON, CHAUNCY, FITCH",CHAUNCY FITCH NELSON,10940 RAVEN RIDGE RD STE 204 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1538516422,"BROWN, TANEISHA, LIVINGSTON",125 PUTTERS CT   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 51 , 53 , 53 ,$#,,
MEDICAID DIRECT,1538516877,HIGH POINT PHYSICAL THERAPY LLC,,1030 MALL LOOP RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538516877,HIGH POINT PHYSICAL THERAPY LLC,1030 MALL LOOP RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,, 16 , 87 , 159 ,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538517164,"CAPPUZZO, JUSTIN, MARK",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 34 , 61 , 98 ," $17,508.44 ",,
MEDICAID DIRECT,1538518238,"ARMSTRONG, MICHAEL, CHRISTOPHER",,200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1538518238,"ARMSTRONG, MICHAEL, CHRISTOPHER",200 FLEETWOOD DR   EASLEY SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538518238,"ARMSTRONG, MICHAEL, CHRISTOPHER",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1538518238,"ARMSTRONG, MICHAEL, CHRISTOPHER",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538520887,"EL KARA, ROSE, CURRY",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538520887,"EL KARA, ROSE, CURRY",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538521059,"MONGE, JOHN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 17 ,$#,,
MEDICAID DIRECT,1538521141,WESERVE HEALTH CARE INC,~,4030 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1538521141,WESERVE HEALTH CARE INC,4030 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 841 , 841 ," $49,189.08 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538521950,"LAPE, SAVANNAH, SILLYMAN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538521950,"LAPE, SAVANNAH, SILLYMAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538522479,"STEELE, TEMPLE, BARKATE",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538523204,"REBOLLAR, JESSICA, MARIE",400 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 78 , 89 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538523519,"RAWLINSON, DEMETRIA, RENEE WATFORD",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 21 , 36 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538523519,"RAWLINSON, DEMETRIA, RENEE WATFORD",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538524988,"FRANK, CHRISTOPHER, JEFFREY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538525159,"HINSHELWOOD, JESSICA, MCRAE",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1538526058,"MOORE, KENDRA, LARISSA",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1538526058,"MOORE, KENDRA, LARISSA",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538526058,"MOORE, KENDRA, LARISSA",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538526553,"DOBRIN, FLORENTINA, CRISTINA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538526553,"DOBRIN, FLORENTINA, CRISTINA",2760 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1538530340,"LOPES, LETICIA, DECARVALHO",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 153 , 153 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538530365,"QUARLES, MELISSA, SUZANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538530365,"QUARLES, MELISSA, SUZANNE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538530365,"QUARLES, MELISSA, SUZANNE",1001 BLYTHE BLVD MEDICAL CENTER PLAZA CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 32 , 84 , 85 ,$#,,
MEDICAID DIRECT,1538532064,GRANTSBORO OPCO HOLDINGS LLC,GARDENS OF PAMLICO,22 MAGNOLIA WAY   GRANTSBORO NC,069,Pamlico,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538532064,GRANTSBORO OPCO HOLDINGS LLC,22 MAGNOLIA WAY   GRANTSBORO NC,069,Pamlico,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 15 ," 3,419 "," 3,419 "," $236,410.59 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538536214,"CALONE, GREGORY, DONATO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 67 , 97 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,301 E WENDOVER AVE STE 111   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538536214,"CALONE, GREGORY, DONATO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003218439,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SHALLOTTE,341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538537048,"BAXLEY, LAURA, ANN",341A WHITEVILLE RD NW   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992728950,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF SALEMBURG,500 S FAYETTEVILLE ST   SALEMBURG NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538537048,"BAXLEY, LAURA, ANN",4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992171060,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF BOLIVIA,4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538537048,"BAXLEY, LAURA, ANN",4311 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 18 , 22 ,$#,,
MEDICAID DIRECT,1902834658,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE HILLSBOROUGH,267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1538537774,"CLARK, MICHAEL, LEE",267 S CHURTON ST STE 100 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 36 , 62 ,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538538723,"GREGORY, CHARLOTTE, WOOD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538538723,"GREGORY, CHARLOTTE, WOOD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538538723,"GREGORY, CHARLOTTE, WOOD",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538538723,"GREGORY, CHARLOTTE, WOOD",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538538723,"GREGORY, CHARLOTTE, WOOD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538538723,"GREGORY, CHARLOTTE, WOOD",501 BILLINGSLEY RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538538723,"GREGORY, CHARLOTTE, WOOD",501 BILLINGSLEY RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427096528,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1538540745,"THOMPSON, MINDY, DAWN",133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 31 ,$#,,
MEDICAID DIRECT,1538543665,JFC MERIDIAN OPCO GOLDSBORO LLC,SOMERSET COURT OF GOLDSBORO,603 LOCKHAVEN CT   GOLDSBORO NC,096,Wayne,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1538543665,JFC MERIDIAN OPCO GOLDSBORO LLC,603 LOCKHAVEN CT   GOLDSBORO NC,096,Wayne,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 46 , 47 ,$#,,
MEDICAID DIRECT,1538543665,JFC MERIDIAN OPCO GOLDSBORO LLC,SOMERSET COURT OF GOLDSBORO,603 LOCKHAVEN CT   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538543665,JFC MERIDIAN OPCO GOLDSBORO LLC,603 LOCKHAVEN CT   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 8,063 "," 8,063 "," $609,071.99 ",,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538544341,"RYAN, JEREMY, DOUGLAS",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 119 , 141 , 209 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538546361,"REILLY, DAVID, PATRICK",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 56 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1538546361,"REILLY, DAVID, PATRICK",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063964708,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY NEONATAL PRACTITIONERS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538546585,"TERRELL, MARY, JEANNE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 21 , 62 , 66 ," $13,470.47 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538547385,"KAPLON, RITA, PARKER",41 OAKLAND RD STE 200 ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,51 MOSAIC BLVD STE 110 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1538548268,"GAZDA, CASEY, LYNN",51 MOSAIC BLVD STE 110 PITTSBORO NC,019,Chatham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538548268,"GAZDA, CASEY, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 141 , 170 , 220 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538548268,"GAZDA, CASEY, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538548268,"GAZDA, CASEY, LYNN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1447319454,HECKER OPHTHALMOLOGY PA,~,1507 WESTOVER TER STE C GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1538548342,"VAN, CHAUNHI, THI",1507 WESTOVER TER STE C GREENSBORO NC,041,Guilford,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist, 14 , 21 , 39 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538549548,"EHLERS, ROBERT, WESTON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 241 , 267 ," 1,020 "," $32,117.50 ",,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1538549548,"EHLERS, ROBERT, WESTON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 109 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1538549548,"EHLERS, ROBERT, WESTON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1164894937,RICCOBENE & ASSOCIATES XIII DDS PA,BRUSH AND FLOSS PEDIATRIC DENTISTRY - GARNER,5638 VETERANS PKWY STE 109 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538549548,"EHLERS, ROBERT, WESTON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 125 , 132 , 470 ," $14,270.19 ",,
MEDICAID DIRECT,1538549548,"EHLERS, ROBERT, WESTON",,1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,1538549548,"EHLERS, ROBERT, WESTON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538549548,"EHLERS, ROBERT, WESTON",1111 S POLLOCK ST   SELMA NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1538549704,"RIVERA, DIANA, CAROLINA",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 489 , 495 ," $13,348.63 ",,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1538549704,"RIVERA, DIANA, CAROLINA",135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 123 , 124 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538551338,"WHITE, KELLI, NICHOLE",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 17 , 18 ,$#,,
MEDICAID DIRECT,1598135188,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH TRANSITION CLINIC,1237 HARDING PL # 3300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538551338,"WHITE, KELLI, NICHOLE",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538551338,"WHITE, KELLI, NICHOLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588178370,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH CABARRUS TRANSITION SERVICES,200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538551338,"WHITE, KELLI, NICHOLE",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588178370,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH CABARRUS TRANSITION SERVICES,200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538551338,"WHITE, KELLI, NICHOLE",200 MEDICAL PARK DR STE 550B CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1538551395,"VANDEVENTER, MATTHEW, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538551395,"VANDEVENTER, MATTHEW, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538551395,"VANDEVENTER, MATTHEW, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538551395,"VANDEVENTER, MATTHEW, THOMAS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538553177,"PATEL, JAY, KANTILAL",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 95 , 101 , 101 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538554431,"HAMMOND, AARYN, REESE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 111 , 122 , 137 ," $10,447.12 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538555099,"YOUNUS, ZILFAH",9 MEDICAL DR   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 89 , 137 , 170 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538555099,"YOUNUS, ZILFAH",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538555321,"SHARPE, CASEY, TRAVIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538555487,"DART, SCOTT, EVERETT",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 54 , 113 , 151 ," $10,599.69 ",,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538555750,"RION, DAVID, BUTTS",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 82 , 129 , 240 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538556055,"PATEL, RONAK, R",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538556055,"PATEL, RONAK, R",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538557921,"ZHYTKOVA, IRYNA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538558960,"SLEPCHENKO, OLGA, ALEXSANDROVNA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 18 , 20 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538558960,"SLEPCHENKO, OLGA, ALEXSANDROVNA",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538558960,"SLEPCHENKO, OLGA, ALEXSANDROVNA",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538558960,"SLEPCHENKO, OLGA, ALEXSANDROVNA",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538558960,"SLEPCHENKO, OLGA, ALEXSANDROVNA",624 JONES FERRY RD   CARRBORO NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",850 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 237 , 273 , 328 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1538561006,"MANJINI SENGODAN, PRASANNA",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538570130,"MARKO, ANGELA, MARIE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538573894,"DIXON, JORDAN, ELIZABETH",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538573894,"DIXON, JORDAN, ELIZABETH",101 EAST WOOD STREET   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1538573894,"DIXON, JORDAN, ELIZABETH",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538573894,"DIXON, JORDAN, ELIZABETH",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 26 , 33 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1538573894,"DIXON, JORDAN, ELIZABETH",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538575931,"BOLES, ASHLEY, HARDY",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 49 , 130 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538575931,"BOLES, ASHLEY, HARDY",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538576681,"SARODE, DARSHAN, PUNDAREEKA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538576681,"SARODE, DARSHAN, PUNDAREEKA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538576681,"SARODE, DARSHAN, PUNDAREEKA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 41 , 41 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538576681,"SARODE, DARSHAN, PUNDAREEKA",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 62 , 64 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538577242,"SMITH, ANUSHA, KUMAR",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 123 , 123 ,$#,,
MEDICAID DIRECT,1851830541,DLP FRYE MEDICAL GROUP,FRYECARE HEART LUNG AND VASCULAR,415 N CENTER ST STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538579701,"STARR, BRETT, TIMOTHY",415 N CENTER ST STE 204 HICKORY NC,018,Catawba,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 14 ,$#,,
MEDICAID DIRECT,1851830541,DLP FRYE MEDICAL GROUP,FRYECARE HEART LUNG AND VASCULAR,415 N CENTER ST STE 204 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538579701,"STARR, BRETT, TIMOTHY",2100 STANTONSBURG RD GME OFFICE GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 72 , 85 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1538579719,"SITTERSON, LISA, VOGEL",2905 N ELM ST   LUMBERTON NC,078,Robeson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 46 , 54 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1538579719,"SITTERSON, LISA, VOGEL",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 21 , 23 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1538579719,"SITTERSON, LISA, VOGEL",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1538579719,"SITTERSON, LISA, VOGEL",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1538579719,"SITTERSON, LISA, VOGEL",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 131 , 216 , 281 ," $16,141.81 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1538579719,"SITTERSON, LISA, VOGEL",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207WX0120X,Allopathic & Osteopathic Physicians,Ophthalmology,Cornea and External Diseases Specialist,#,#,#,$#,,
MEDICAID DIRECT,1124235205,MICHAEL A IGNELSI JR DDS PHD PA,LAKE JEANETTE ORTHO PED DENT,3901 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1538582036,"ANDREWS, REBECCA, GLOVER",3901 N ELM ST   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 144 , 163 , 553 ," $15,307.03 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538585575,"BERMUDEZ PACHECO, MARIA, FERNANDA",530 CORPORATE CIR STE 200 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932745197,UNIVERSITY OF NORTH CAROLINA HOSPIT,UNC TRANSPLANT SERVICES,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538587308,"CZEPIGA, ASHLEY, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538587761,"BRAYMAN, GRETCHEN, ELDER",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538587936,"BARNES, ALEXANDER, CHRISTOPHER",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 36 , 68 , 151 ," $11,678.46 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538587936,"BARNES, ALEXANDER, CHRISTOPHER",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#, 15 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,530 CORPORATE CIR   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1538587936,"BARNES, ALEXANDER, CHRISTOPHER",530 CORPORATE CIR   SALISBURY NC,080,Rowan,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538587936,"BARNES, ALEXANDER, CHRISTOPHER",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538587936,"BARNES, ALEXANDER, CHRISTOPHER",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 58 , 133 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538587936,"BARNES, ALEXANDER, CHRISTOPHER",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 23 , 47 , 99 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538587936,"BARNES, ALEXANDER, CHRISTOPHER",645 AMALIA ST NE   CONCORD NC,013,Cabarrus,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538588181,"MOORE, LAURA, PIPPITT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538588181,"MOORE, LAURA, PIPPITT",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538588181,"MOORE, LAURA, PIPPITT",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538588181,"MOORE, LAURA, PIPPITT",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538588181,"MOORE, LAURA, PIPPITT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538588181,"MOORE, LAURA, PIPPITT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538588181,"MOORE, LAURA, PIPPITT",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1740920362,QUADRANT PA VIRTUAL CARE PC,,5000 CENTRE GREEN WAY STE 500 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1538588595,"LEVINE, SELENA, RAE",5000 CENTRE GREEN WAY STE 500 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1538591722,HARRIS TEETER LLC,HARRIS TEETER PHARMACY 0229,67 FLOWERS CROSSROADS WAY   CLAYTON NC,051,Johnston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1538591722,HARRIS TEETER LLC,67 FLOWERS CROSSROADS WAY   CLAYTON NC,051,Johnston,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1538592605,VPS PARTNERS LLP,VILLAGE PEDIATRIC SPEECH ASSOC,1357 WALTER REED RD STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538592605,VPS PARTNERS LLP,1357 WALTER REED RD STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,#, 128 , 128 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538594189,"FIELD, BRAD, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1538594189,"FIELD, BRAD, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1538594189,"FIELD, BRAD, EDWARD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538596622,"CAGGIANO, KIMBERLY, HALL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 29 , 47 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538599931,"SPECTOR, DENISE, PERILLO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538602792,"SIMMONS, KAYLA, JADE",2000 BRABHAM AVE STE 100 JACKSONVILLE NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 53 , 123 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4600 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538608666,"BRUFF, PATRICK, GREGORY",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538608666,"BRUFF, PATRICK, GREGORY",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225449168,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE KNIGHTDALE,901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1538608666,"BRUFF, PATRICK, GREGORY",901 OLD KNIGHT RD   KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1538609565,"BERNARDI, GREGORY, JOHN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538609565,"BERNARDI, GREGORY, JOHN",218 ELKWOOD AVE STE 102 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538609565,"BERNARDI, GREGORY, JOHN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538609565,"BERNARDI, GREGORY, JOHN",218 ELKWOOD AVE STE 102 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 25 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538609565,"BERNARDI, GREGORY, JOHN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 74 , 74 ," $15,442.67 ",,
MEDICAID DIRECT,1356405005,PISGAH PHYSICAL THERAPY AND SPORTS,PISGAH PHYSICAL THERAPY AND SPORTS REHAB,1635 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1538609573,"GABRYNOWICZ, JENNIFER, BARBER",1635 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 41 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538610589,"SMITH, CHADWICK, BRYAN",101 E WT HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 31 , 61 , 63 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538614151,"ANTIS, CARSON, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538614151,"ANTIS, CARSON, LEE",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2301 MEDPARK DR STE B ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1538615265,"WEBB, STEPHANIE, PAYNE",2301 MEDPARK DR STE B ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1538615265,"WEBB, STEPHANIE, PAYNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1538615265,"WEBB, STEPHANIE, PAYNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538615265,"WEBB, STEPHANIE, PAYNE",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538615265,"WEBB, STEPHANIE, PAYNE",303 GREEN ST E   WILSON NC,098,Wilson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538616263,"LEWIS, TANIKA, NIKO",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538616263,"LEWIS, TANIKA, NIKO",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1881059723,TRIAD ADULT AND PEDIATRIC MEDICINE,,1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538616263,"LEWIS, TANIKA, NIKO",1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063712727,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1002 S EUGENE ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538616263,"LEWIS, TANIKA, NIKO",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 30 , 30 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,455 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",611 OLD US HWY 70 E   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 57 , 57 ,$#,,
MEDICAID DIRECT,1184669053,SOUTHEASTERN MEDICAL GROUP PC,,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1538617394,"LAFONTAINE, ALISHA, LEA",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538620174,"GREGSTON, ALDEN, PAIGE",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1538620224,"STROBEL, SPENCER, DIRK",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538620232,"KAUR, DEEPAKTA",410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 29 , 58 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538620232,"KAUR, DEEPAKTA",410 CANTERBURY RD   SMITHFIELD NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1548242365,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,3361 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538620711,"PAVLIQOTI, EMANUELA",3361 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538620737,"YDE, ANDREW, CARLISLE",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 29 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1538620737,"YDE, ANDREW, CARLISLE",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1538620737,"YDE, ANDREW, CARLISLE",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 43 , 59 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538620737,"YDE, ANDREW, CARLISLE",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538620737,"YDE, ANDREW, CARLISLE",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1538620919,"WALTON, MATTHEW, BRYAN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1538621172,"REDDY-MILLER, MICHAEL, PRASAD",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 19 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538621404,"BENN, RUBY, ATTAH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538621404,"BENN, RUBY, ATTAH",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538621404,"BENN, RUBY, ATTAH",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 20 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538622816,"GAUTHIER, SOPHIA, JEANNETTE",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 121 , 121 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538622873,"PHAN, DANIEL, DUONG",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538623426,"MOSS, KASIE, KING",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 34 , 52 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538624267,"SASSER, HOLLY, STRICKLAND",2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538624267,"SASSER, HOLLY, STRICKLAND",2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 34 , 58 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538624267,"SASSER, HOLLY, STRICKLAND",2600 US HIGHWAY 70 W   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 104 , 243 ,$#,,
MEDICAID DIRECT,1023048279,GASTONIA MEDICAL SPECIALTY CLINIC,GASTONIA MEDICAL SPECIALTY CLINIC PA,1021 X RAY DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1538624317,"SELF, MEGAN, WRAY",1021 X RAY DR 1021 X-RAY DRIVE GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 81 , 149 , 169 ,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538625751,"ROUX, KATIE, ELIZABETH",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538625876,"HOTALING, ASHLEIGH, AMMONS",3617 CASEY ST STE D LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538626015,MORGANTON OPCO HOLDINGS LLC,THE BERKELEY,330 JUNIPER ST   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538626015,MORGANTON OPCO HOLDINGS LLC,330 JUNIPER ST   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,674 "," 1,674 "," $143,663.64 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538626742,"BRUCE, BRITTANY, ASHLEE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 58 , 58 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538627658,"GOLOB, JAMIE, CAMBARERI",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538627658,"GOLOB, JAMIE, CAMBARERI",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538628110,"EASTERGARD, KELLY, TAYLOR",536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326364100,LOWCOUNTRY URGENT CARE,LOWCOUNTRY URGENT CARE,222 S VAN LINGLE MUNGO BLVD   PAGELAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538628110,"EASTERGARD, KELLY, TAYLOR",536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538628110,"EASTERGARD, KELLY, TAYLOR",536 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538628110,"EASTERGARD, KELLY, TAYLOR",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538628516,"DAVIS, GRACEN, CONWAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538628516,"DAVIS, GRACEN, CONWAY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538628516,"DAVIS, GRACEN, CONWAY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1043894504,GENERATIONS FAMILY PRACTICE,TRIAD INTERNAL MEDICINE,300 MACK RD STE B ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1538628656,"POE, CHELSEA, RICE",300 MACK RD   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 58 , 108 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538628680,"MONROE, BRYAN, STARRETT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 89 , 91 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538629126,"WELLES, MATTHEW, FREDERICK",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538629191,"TRAUNERO, KELSEY, KENDALL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538629191,"TRAUNERO, KELSEY, KENDALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538629191,"TRAUNERO, KELSEY, KENDALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538629191,"TRAUNERO, KELSEY, KENDALL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538629829,"CHILDS, MEGAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538629829,"CHILDS, MEGAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538629845,"OLIVER, TESIA, LACHELL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 52 , 53 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538629845,"OLIVER, TESIA, LACHELL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538630660,"JACKSON, AMBER, LYNN",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 104 , 104 ,$#,,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1538632187,"NICKSON, LAUREN, ALEXANDRA",1206 BROWN ST   WASHINGTON NC,007,Beaufort,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 123 , 384 ," $15,638.92 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538635081,"LEONARD, SHEENA, RENEE COOPER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 34 , 34 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538637863,"DILAO, KRISTIAN, ALEJANDRO",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538637863,"DILAO, KRISTIAN, ALEJANDRO",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538638812,"SOTO, JOHANA, GUADALUPE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538638812,"SOTO, JOHANA, GUADALUPE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1356735336,SOUTHLAND BAINBRIDGE HOSPITALIST GR,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538639851,"WARD, MARY, KATHRYN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538645361,"FRANCISCO, JACQUELINE, O'MEARA",250 HOSPICE CIR   RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 27 , 40 , 43 ,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538651716,"ARRINGTON, MORGAN, WINSLOW",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 109 , 235 , 272 ," $10,923.50 ",,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538651716,"ARRINGTON, MORGAN, WINSLOW",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1538651716,"ARRINGTON, MORGAN, WINSLOW",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538651716,"ARRINGTON, MORGAN, WINSLOW",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538651898,"MCCANN, ALISON, MENZIES",3515 W MARKET ST STE 110 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538651898,"MCCANN, ALISON, MENZIES",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538651898,"MCCANN, ALISON, MENZIES",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538651898,"MCCANN, ALISON, MENZIES",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538651898,"MCCANN, ALISON, MENZIES",1213 LEXINGTON AVE STE B THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1538651898,"MCCANN, ALISON, MENZIES",631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538655048,"PATTERSON, TANGELA, DENE",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,440 INGRAM DR   KING NC,085,Stokes,193200000X,Group,Multi-Specialty,,1538655048,"PATTERSON, TANGELA, DENE",440 INGRAM DR   KING NC,085,Stokes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538655048,"PATTERSON, TANGELA, DENE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 77 , 79 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538655048,"PATTERSON, TANGELA, DENE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,309 E CORNWALLIS DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538655048,"PATTERSON, TANGELA, DENE",1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538655048,"PATTERSON, TANGELA, DENE",1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 127 , 194 , 195 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538655048,"PATTERSON, TANGELA, DENE",1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 51 , 52 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538656343,"ZYCHOWSKI, DIANA, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538656343,"ZYCHOWSKI, DIANA, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1538656343,"ZYCHOWSKI, DIANA, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538656806,"SAUNDERS, ELEANOR, FARLEY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 21 , 22 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1538657424,"STUDLEY, WILLIAM, KEITH",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 116 , 116 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538658323,"NELSON, CHRISTOFFER, GREGORY LLOYD",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538658323,"NELSON, CHRISTOFFER, GREGORY LLOYD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538658323,"NELSON, CHRISTOFFER, GREGORY LLOYD",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538658323,"NELSON, CHRISTOFFER, GREGORY LLOYD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538659271,"ALKHALDI, RANA, AOUS",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 42 , 74 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1538659271,"ALKHALDI, RANA, AOUS",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538659271,"ALKHALDI, RANA, AOUS",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538659271,"ALKHALDI, RANA, AOUS",1830 FORDHAM BLVD STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 19 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538659271,"ALKHALDI, RANA, AOUS",1830 FORDHAM BLVD STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538659420,"JOHNSON, KYLE, THOMAS",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538659420,"JOHNSON, KYLE, THOMAS",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 23 , 38 , 59 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538659420,"JOHNSON, KYLE, THOMAS",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538659420,"JOHNSON, KYLE, THOMAS",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538659420,"JOHNSON, KYLE, THOMAS",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1538660121,PINEWOOD MANOR OF NC INC,,205 BUNN RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538660121,PINEWOOD MANOR OF NC INC,205 BUNN RD   LOUISBURG NC,035,Franklin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 69 , 69 ," $63,459.18 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538662374,"JACKSON, KEVIN, JEVON",1340 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 22 , 36 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538662374,"JACKSON, KEVIN, JEVON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 27 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1538662374,"JACKSON, KEVIN, JEVON",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538662374,"JACKSON, KEVIN, JEVON",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 16 , 25 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538663554,"OBI, JENNIFER, IFEOMA",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 23 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538663554,"OBI, JENNIFER, IFEOMA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538663554,"OBI, JENNIFER, IFEOMA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538663554,"OBI, JENNIFER, IFEOMA",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 45 , 101 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538663620,"WALKER, KADEEM, AUNDRE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1538663620,"WALKER, KADEEM, AUNDRE",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538663620,"WALKER, KADEEM, AUNDRE",3475 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538663620,"WALKER, KADEEM, AUNDRE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 38 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538663620,"WALKER, KADEEM, AUNDRE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538663620,"WALKER, KADEEM, AUNDRE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538663620,"WALKER, KADEEM, AUNDRE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 43 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538664008,"MENTREDDY, AKSHAY, RAO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 59 , 78 , 136 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538664172,"GRIMES, CHRISTOPHER, ALVIN",MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 93 , 143 , 330 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538664172,"GRIMES, CHRISTOPHER, ALVIN",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538665138,"JECK, LAUREN, ALEXIS",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 40 , 69 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538665252,"FUNICIELLO, LANDON, JAMES",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1538668009,"MCDONALD, MIA, ADAIR",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538668009,"MCDONALD, MIA, ADAIR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538668009,"MCDONALD, MIA, ADAIR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538668009,"MCDONALD, MIA, ADAIR",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538668496,INGLES MARKETS INC,INGLES PHARMACY 025,2060 HIGHWAY 19   MURPHY NC,020,Cherokee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1538668496,INGLES MARKETS INC,2060 HIGHWAY 19   MURPHY NC,020,Cherokee,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538669254,"MABE, CASEY, VAUGHN",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538672852,"KROHL, NATALIE, NEIL",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1538672852,"KROHL, NATALIE, NEIL",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538672852,"KROHL, NATALIE, NEIL",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538672852,"KROHL, NATALIE, NEIL",6011 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 26 , 26 , 39 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 RENEE LYNN CT   CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1538672852,"KROHL, NATALIE, NEIL",101 RENEE LYNN CT   CARRBORO NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,245 E ROOSEVELT AVE   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1538673470,"ABDULAHI, SUDE",1210 EASTERN AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1538673470,"ABDULAHI, SUDE",1210 EASTERN AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 52 , 415 , 557 ," $16,569.03 ",,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1538673470,"ABDULAHI, SUDE",1210 EASTERN AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1538673470,"ABDULAHI, SUDE",1210 EASTERN AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 481 , 642 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1538678248,"BLACK, IAN, CHARLES",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538678248,"BLACK, IAN, CHARLES",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1538678248,"BLACK, IAN, CHARLES",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1538678248,"BLACK, IAN, CHARLES",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1538678248,"BLACK, IAN, CHARLES",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538678248,"BLACK, IAN, CHARLES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1538678248,"BLACK, IAN, CHARLES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538678248,"BLACK, IAN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538678248,"BLACK, IAN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1538678248,"BLACK, IAN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1538678248,"BLACK, IAN, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1538678248,"BLACK, IAN, CHARLES",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538678248,"BLACK, IAN, CHARLES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700901436,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1538679907,"ROGERS, ZACKARY, DANIEL",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 53 , 80 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538680194,"BAZEMORE, KAITLYN, EMILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538680194,"BAZEMORE, KAITLYN, EMILY",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1538680657,"SHARDA, ALOK, KUMAR",BUTNER-CREEDMOOR FAMILY DENTISTRY,2552 CAPITOL DR STE 101 CREEDMOOR NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,1538680657,"SHARDA, ALOK, KUMAR",2552 CAPITOL DR STE 101 CREEDMOOR NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice, 74 , 133 , 419 ," $24,353.35 ",,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538682885,"HORGAN, REBECCA",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1538352760,BRIER CREEK INTEGRATED PAIN AND SPI,BRIER CREEK INTEGRATED PAIN & SPINE,7780 BRIER CREEK PKWY STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538685896,"BECKER, JANELL, K",1840 OWEN DR STE 103 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 170 , 463 , 662 ," $24,034.79 ",,
MEDICAID DIRECT,1538689625,INTEGRITY-MCDOWELL HOUSE LLC,~,1687 DAIRY DR   NEBO NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538689625,INTEGRITY-MCDOWELL HOUSE LLC,1687 DAIRY DR   NEBO NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 24 ," 4,824 "," 4,847 "," $447,985.52 ",,
MEDICAID DIRECT,1184921843,DUNN MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-DUNN,803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1538690557,"NAZARE, SHAINA, ELIZABETH",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1538690557,"NAZARE, SHAINA, ELIZABETH",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 44 , 44 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1538690557,"NAZARE, SHAINA, ELIZABETH",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184921843,DUNN MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-DUNN,803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1538690557,"NAZARE, SHAINA, ELIZABETH",803 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 84 , 129 ,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,1219 SMOKY PARK HWY   CANDLER NC,011,Buncombe,193400000X,Group,Single Specialty,,1538690862,"COX, CHINA, GRAYSON",1219 SMOKEY PARK HWY   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,2161 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1538690862,"COX, CHINA, GRAYSON",2161 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417906942,THE FAMILY HEALTH CENTERS PA,,206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1538690862,"COX, CHINA, GRAYSON",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 37 , 75 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538691258,"LIEBMAN, ZACHARY",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 43 , 86 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538691258,"LIEBMAN, ZACHARY",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356712921,PIEDMONT HEALTH SERVICES INC,CHAPEL HILL COMMUNITY HEALTH CENTER,107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538691696,"DICKENS, HALLUM, KIRKWOOD",107 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1538692868,"MALLORY, WILLIAM, SEVILLE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538693155,"TEJWANI, ROHIT, VIKRAM",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538693155,"TEJWANI, ROHIT, VIKRAM",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538693155,"TEJWANI, ROHIT, VIKRAM",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538693155,"TEJWANI, ROHIT, VIKRAM",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 37 , 49 , 78 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1538693494,"POGGI, JENNA, ELIZABETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538693494,"POGGI, JENNA, ELIZABETH",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1538696158,"REDDY, SUSHMA, KOMATI",617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 18 , 19 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1538696158,"REDDY, SUSHMA, KOMATI",617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538698758,"WANG, EDINA, CINDY",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 25 , 29 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538698972,"NEUMAN, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538699715,"MACDONALD, ASHTON, COFFEY",200 W PARK CIR STE C N WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 148 , 249 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538700620,"STEWART, ASHLEY, GEM",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 30 , 35 , 55 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538700620,"STEWART, ASHLEY, GEM",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538705074,"STOWE, SHANNA, DAWNE",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 52 , 109 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538705074,"STOWE, SHANNA, DAWNE",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1538706841,"MCGEE, AMANDA, ONEY",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 273 , 581 , 801 ," $15,238.07 ",,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538712534,"NETHERCUTT, ALANA, GOLDBERG",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1538712534,"NETHERCUTT, ALANA, GOLDBERG",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 63 , 68 , 160 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538715578,"ANTZOULATOS, MICAELA, DIONYSIOS",8115 MARKET ST STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538715578,"ANTZOULATOS, MICAELA, DIONYSIOS",2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 23 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538715982,"OLLAR, PEARCE, ROBERT",4220 CAROLINA EXCHANGE DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538715982,"OLLAR, PEARCE, ROBERT",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538717962,"MCLEAN, MEKAYLA, JONAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1538717962,"MCLEAN, MEKAYLA, JONAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538717962,"MCLEAN, MEKAYLA, JONAY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1538717962,"MCLEAN, MEKAYLA, JONAY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538719315,"HENDRICKSON, KELLY, MCPHERSON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1538719315,"HENDRICKSON, KELLY, MCPHERSON",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1538719315,"HENDRICKSON, KELLY, MCPHERSON",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538720255,"KING, CHRISTOPHER, JAMES",~,501 RISON ST STE 110 DANVILLE VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1538720255,"KING, CHRISTOPHER, JAMES",501 RISON ST STE 110 DANVILLE VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538721923,"GOUGH, JOSHUA, PAUL",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 71 , 121 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538721923,"GOUGH, JOSHUA, PAUL",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 23 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538726047,"GUEST, MEGAN, ELIZABETH",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 117 , 120 ,$#,,
MEDICAID DIRECT,1437833043,HARNETT HEALTH SYSTEM INC,HARNETT HEALTH NEUROLOGY,803 TILGHMAN DR STE 500 DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1538726195,"CAIN-AKBAR, ZAHRA, VIRGINIA",803 TILGHMAN DR STE 500 DUNN NC,043,Harnett,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 70 , 104 , 176 ,$#,,
MEDICAID DIRECT,1437970878,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROLOGY-LILLINGTON,225 BRIGHTWATER DR STE 230 LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1538726195,"CAIN-AKBAR, ZAHRA, VIRGINIA",803 TILGHMAN DR STE 500 DUNN NC,043,Harnett,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1437970878,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY NEUROLOGY-LILLINGTON,225 BRIGHTWATER DR STE 230 LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1538726195,"CAIN-AKBAR, ZAHRA, VIRGINIA",225 BRIGHTWATER DR STE 230 LILLINGTON NC,043,Harnett,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 35 , 42 , 70 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538730163,"HEALD, SHILPA",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538730163,"HEALD, SHILPA",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538735618,"OVENS, LEONARD, ROBERT",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 39 , 49 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538739321,"RAYMOND, MAEGAN, MARISSA",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 50 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538739321,"RAYMOND, MAEGAN, MARISSA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851805022,STARMED URGENT & FAMILY CARE PA,,4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538739321,"RAYMOND, MAEGAN, MARISSA",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1538740642,"ROCHE, KYLE, CARLSEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538740642,"ROCHE, KYLE, CARLSEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 38 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538742523,"JUST, KELSEA, JO",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 26 , 36 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538746714,"ALLENGER, DAVID, SAMUEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1538746714,"ALLENGER, DAVID, SAMUEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 57 , 57 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",7348 N WEST ST   FALCON NC,026,Cumberland,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",804 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 21 , 28 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",106 CAMERON ST   LAKE WACCAMAW NC,024,Columbus,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",3331 TATE BLVD SE   HICKORY NC,018,Catawba,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",2461 LEGION RD   FAYETTEVILLE NC,026,Cumberland,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 72 , 107 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",214 LANEFIELD RD   WARSAW NC,031,Duplin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 64 , 95 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",209 BEASLEY ST   KENANSVILLE NC,031,Duplin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",214 LANEFIELD RD   WARSAW NC,031,Duplin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",717 GREEN VALLEY RD STE 200 GREENSBORO NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 18 , 27 , 30 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",310 E WARDELL DR   PEMBROKE NC,078,Robeson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 15 , 57 , 68 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 15 , 90 , 119 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",1170 LINKHAW RD   LUMBERTON NC,078,Robeson,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 15 , 67 , 86 ,$#,,
MEDICAID DIRECT,1447527320,VOHRA WOUND PHYSICIANS OF NY PLLC,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538748132,"SULLIVAN, KATHERINE, ANNE",311 S CAMPBELL ST   BURGAW NC,071,Pender,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1730154857,PEDIATRIC PARTNERS PA,~,5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538749528,"OPHAUG, ALEXIS, MORGAN",5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1275030272,RDL THERAPEUTIC OUTPATIENT THERAPY,~,3591 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538752464,"ANDERSON, BRANDON, MARCUS",3591 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 71 ,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538754189,"WELSHEIMER, HEATHER, SUE",150 E DAVIE ST   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538754189,"WELSHEIMER, HEATHER, SUE",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538755376,ASAP LABS AND CARE,,2002 NEW GARDEN RD UNIT 205 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,1538755376,ASAP LABS AND CARE,2002 NEW GARDEN RD UNIT 205 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,, 229 ," 1,154 "," 1,483 "," $211,402.39 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538755905,"BIANCO, LAUREN, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1700851045,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,6300 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538762992,"SUGGS, JASMINE, MONIQUE",7808 S TRYON ST STE D CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1245304575,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,7808 S TRYON ST STE D&E CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538762992,"SUGGS, JASMINE, MONIQUE",7808 S TRYON ST STE D CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558765313,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RICHFIELD FAMILY MEDICI,243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427452341,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORWOOD FAMILY MEDICINE,269 S MAIN ST   NORWOOD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861896789,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE OAKBORO FAMILY MEDICINE,112 E 1ST ST   OAKBORO NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861896789,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE OAKBORO FAMILY MEDICINE,112 E 1ST ST   OAKBORO NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",112 E 1ST ST   OAKBORO NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558765313,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RICHFIELD FAMILY MEDICI,243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",243 N HIGHWAY 49   RICHFIELD NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427452341,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORWOOD FAMILY MEDICINE,269 S MAIN ST   NORWOOD NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",269 S MAIN ST   NORWOOD NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 68 , 84 ,$#,,
MEDICAID DIRECT,1255735312,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ALBEMARLE FAMILY MEDICI,105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",105 YADKIN ST STE 301 ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548664303,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE TROY FAMILY MEDICINE,835 ALBEMARLE RD   TROY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1538765524,"KRONZ, LILLIAN, MICHAELA",835 ALBEMARLE RD   TROY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538767173,"CORBETT, TEABLEE, ANGELL",101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 203 , 354 , 454 ,$#,,
MEDICAID DIRECT,1841293149,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SENIOR HEALTH SERVICES,101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1538767173,"CORBETT, TEABLEE, ANGELL",101 ROBESON ST STE 202 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 35 , 36 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538771795,"MUHAMMAD, MICHELLE, RENEE",4901 DAWN DR STE 3300 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538771795,"MUHAMMAD, MICHELLE, RENEE",4901 DAWN DR STE 2400 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 87 , 90 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2400 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538771795,"MUHAMMAD, MICHELLE, RENEE",4901 DAWN DR STE 2400 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 118 , 594 , 676 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538771795,"MUHAMMAD, MICHELLE, RENEE",4901 DAWN DR STE 2300 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538772058,"GOFF, LINDSAY, SUTTON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538772058,"GOFF, LINDSAY, SUTTON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1538772132,"SNEAD, LAURA, GRANT",809 S LONG DR STE H ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 112 , 164 , 436 ,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,222 W MAIN ST   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1538772132,"SNEAD, LAURA, GRANT",222 W MAIN ST   HAMLET NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 59 , 149 ,$#,,
MEDICAID DIRECT,1922193622,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1538772132,"SNEAD, LAURA, GRANT",197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538781893,"EGGLESTON, ROBERT, CHRISTOPHER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 25 , 30 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538781893,"EGGLESTON, ROBERT, CHRISTOPHER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 14 , 17 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1538785118,"MORGAN, AMANDA, STEPHANIE",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1538785118,"MORGAN, AMANDA, STEPHANIE",600 HOSPITAL DR STE 9 CLYDE NC,044,Haywood,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#, 11 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1538785134,"INSCOE, ELIZABETH, LITTLE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538785134,"INSCOE, ELIZABETH, LITTLE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538785134,"INSCOE, ELIZABETH, LITTLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 95 , 164 , 164 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538789383,"WIGGINS, DEREK, ALEXANDER",742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538790571,"WEINBRECHT, CHELSEY, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538790571,"WEINBRECHT, CHELSEY, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538792320,"BROCK, MARKESHIA, JENESE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1538792320,"BROCK, MARKESHIA, JENESE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538796685,"ORIHOOD, STEPHANIE, VOSHELL",4505 FAIR MEADOWS LN STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538796685,"ORIHOOD, STEPHANIE, VOSHELL",5156 NC HIGHWAY 42 W   GARNER NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 61 , 61 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1538797444,"HENDLEY, CORNELIA, WINTHER",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538797915,"BUCK, EMORY, SHANNON",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1538797915,"BUCK, EMORY, SHANNON",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1538798673,YRAM HOME CARE LLC,,801 SUMMIT AVE STE 3 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1538798673,YRAM HOME CARE LLC,801 SUMMIT AVE STE 3 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 456 , 456 ," $55,803.37 ",,
MEDICAID DIRECT,1538799127,PROMISE TO CARE HOME CARE,,7 DUNDAS CIR STE G GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1538799127,PROMISE TO CARE HOME CARE,7 DUNDAS CIR STE G GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 3,040 "," 3,167 "," $334,138.87 ",,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",202 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1356730741,DAVID E THOME DDS PLLC IV,STATESVILLE PEDIATRIC DENTISTRY,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 62 , 256 ," $10,151.26 ",,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,554 "," 1,923 "," 7,445 "," $253,928.88 ",,
MEDICAID DIRECT,1922555689,DAVID E THOME DDS PLLC V,CABARRUS PEDIATRIC DENTISTRY,2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 309 , 333 ," 1,074 "," $36,619.24 ",,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",140 MAHALEY AVE STE A SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice," 3,156 "," 4,180 "," 16,755 "," $630,367.10 ",,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 73 ,$#,,
MEDICAID DIRECT,1619418076,DAVID E THOME DDS PLLC VIII,LOCUST PEDIATRIC DENTISTRY,236 MARKET ST STE 200 LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1538799200,"BLISCHAK, NICOLE-MARIE, VILLANOS",236 MARKET ST STE 200 LOCUST NC,084,Stanly,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538799572,"WROBLESKI, ABIGAIL, JUNE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 28 , 28 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,11200 GOVERNOR MANLY WAY STE 208 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538799572,"WROBLESKI, ABIGAIL, JUNE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538799572,"WROBLESKI, ABIGAIL, JUNE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538799861,"RHODES, BRANDY, YOUNGINER",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538799861,"RHODES, BRANDY, YOUNGINER",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 51 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538805387,"KRAM, LEA, FIXLER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1538805536,"BEKAMPIS, ASHLEY, ROLLINS",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538805536,"BEKAMPIS, ASHLEY, ROLLINS",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 25 , 63 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1538805536,"BEKAMPIS, ASHLEY, ROLLINS",104 COMMERCIAL DR   PRINCETON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1538805536,"BEKAMPIS, ASHLEY, ROLLINS",104 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 34 , 31 , 74 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1538808381,"TAYLOR, MELINDA, LEE",701 DOCTORS DR STE D KINSTON NC,054,Lenoir,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 65 , 143 , 198 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1538808381,"TAYLOR, MELINDA, LEE",701 DOCTORS DR STE D KINSTON NC,054,Lenoir,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538811377,"RANDALL, MATTHEW, EVAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1124668868,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-SWAIN,264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538812805,"ROSS, BROOK, LYNN",264 HIGHWAY 19 S STE 4 BRYSON CITY NC,087,Swain,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 56 , 64 ,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538812805,"ROSS, BROOK, LYNN",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538814314,"MVULA-KAKU, MASEVO, FIFI",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538814686,"LANDMANN, KATHERINE, ROSE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1538815006,RSS WALNUT COVE OPERATIONS LLC,WALNUT RIDGE ASSISTED LIVING,411 WINDMILL ST   WALNUT COVE NC,085,Stokes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1538815006,RSS WALNUT COVE OPERATIONS LLC,411 WINDMILL ST   WALNUT COVE NC,085,Stokes,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 36 , 36 ," $36,219.28 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538819768,"HICKMAN, JENNIFER, FERN",2701 STATESVILLE AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1093901696,CAROLINA CARING HEALTH PARTNERS,CAROLINA CARING HOUSE CALLS,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1538819768,"HICKMAN, JENNIFER, FERN",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538820915,"FERNANDEZ, SARAH, LOLLI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538820915,"FERNANDEZ, SARAH, LOLLI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538820915,"FERNANDEZ, SARAH, LOLLI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538820915,"FERNANDEZ, SARAH, LOLLI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1538821301,"CASBOHM, MARISSA, DAYLE",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538822911,"ANDRADE, AMANDA, LINA DIAS",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538822911,"ANDRADE, AMANDA, LINA DIAS",2400 SOUTH BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 31 , 66 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538829833,"ALLEN, ERIN, BARNHARDT",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 87 , 306 ," $12,132.02 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538831383,"MCGOWAN, JOHN, BARTLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1881278299,ARCHWELL HEALTH PROFESSIONAL SERVIC,,3022 EASTWAY DR STE 1-3 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538832803,"SALAMI, NDIDI, JOY",5740 N GRAHAM ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1538836366,"DESMOND, SHANNON",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538836366,"DESMOND, SHANNON",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538836630,"MALLORY, SAMANTHA, SKYE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 84 , 84 ,$#,,
MEDICAID DIRECT,1538839220,OASIS HORIZONS LLC,VIP HOME CARE-NC,121 E PHIFER ST   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1538839220,OASIS HORIZONS LLC,121 E PHIFER ST   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#, 69 , 69 ,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1538843057,"HERRAN, LISA, BORRELLI",3396 CLOVERLEAF PKWY   KANNAPOLIS NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 25 , 34 , 66 ,$#,,
MEDICAID DIRECT,1033565007,STAR MEDICAL CLINIC PLLC,,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1538843115,"RHODES, AMANDA, JOLENE",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 99 , 125 , 228 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538843503,"SAMPSON, BRITTANY, DANIELLE",8116 NC 711   PEMBROKE NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1027 FLEMING STREET,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538848346,HENDERSON COUNTY HOSPITAL CORPORATI,1027 FLEMING ST STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1538407036,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WHITEVILLE,5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538858246,"BLACKWELL, VIOLA, ELIZABETH",5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538858246,"BLACKWELL, VIOLA, ELIZABETH",5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 34 , 34 ,$#,,
MEDICAID DIRECT,1538858527,STARMED URGENT AND FAMILY CARE,STELLARMED MOBILE TRANSPORT,4355B GUM BRANCH RD   JACKSONVILLE NC,067,Onslow,3416L0300X,Transportation Services,Ambulance,Land Transport,1538858527,STARMED URGENT AND FAMILY CARE,4355B GUM BRANCH RD   JACKSONVILLE NC,067,Onslow,3416L0300X,Transportation Services,Ambulance,Land Transport, 78 , 114 , 224 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538859772,"KUNTZ, SHERRI, LATRICE",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538866678,"JOHNSON, JOANNA, SCHOBER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 82 , 126 ,$#,,
MEDICAID DIRECT,1538867353,BALANCED BEGINNINGS PEDIATRIC THERA,,629 CONNINGTON WAY   ROLESVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1538867353,BALANCED BEGINNINGS PEDIATRIC THERA,629 CONNINGTON WAY   ROLESVILLE NC,092,Wake,193400000X,Group,Single Specialty,,#, 143 , 182 ," $12,626.29 ",,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1538872247,"STUCK, MICHAEL, BRIAN",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639634819,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY BEHAVIORAL HEALTH,107 S QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538873229,"ROUSE, DANA, LO DON",107 S QUEEN ST   KINSTON NC,054,Lenoir,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1538873419,OPTIMUM SPEECH LANGUAGE SERVICES PL,,9219 STONE ABBEY PL   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1538873419,OPTIMUM SPEECH LANGUAGE SERVICES PL,9219 STONE ABBEY PL   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 31 , 495 , 495 ," $28,677.13 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538873799,"NGUYEN, CHRISTINA, PHAN",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538873799,"NGUYEN, CHRISTINA, PHAN",100 S 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 187 , 425 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538873799,"NGUYEN, CHRISTINA, PHAN",707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538874284,"POPPENFUSE, SAMANTHA, ELAINE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538874284,"POPPENFUSE, SAMANTHA, ELAINE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1538874284,"POPPENFUSE, SAMANTHA, ELAINE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1106 SUNSET AVE   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1538878509,"SHEPHERD, AMY, SUZANNE",1106 SUNSET AVE   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1538878509,"SHEPHERD, AMY, SUZANNE",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1538878509,"SHEPHERD, AMY, SUZANNE",41 BAIN ST   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,8116 NC 711   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1538878509,"SHEPHERD, AMY, SUZANNE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 19 , 52 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1538878509,"SHEPHERD, AMY, SUZANNE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 34 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2807 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1538878509,"SHEPHERD, AMY, SUZANNE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 20 , 59 ,$#,,
MEDICAID DIRECT,1679868426,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS BEHAVIORAL MEDICINE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538879572,"HETTICH, CAITLIN, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 36 , 65 , 65 ," $16,885.82 ",,
MEDICAID DIRECT,1679868426,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS BEHAVIORAL MEDICINE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1538879572,"HETTICH, CAITLIN, ELIZABETH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538883657,"MEYERS, ALANA, CAHOON",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538883657,"MEYERS, ALANA, CAHOON",270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 19 , 49 , 49 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1120 SE CARY PKWY STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1538893656,"OWENS, WILLIAM, ROSS",1120 SE CARY PKWY STE 101 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1538893656,"OWENS, WILLIAM, ROSS",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1538893656,"OWENS, WILLIAM, ROSS",1120 SE CARY PKWY STE 101 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1538894068,"MCDONALD, LAUREN, BURRIS",809 S LONG DR STE G ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 55 , 87 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1538894068,"MCDONALD, LAUREN, BURRIS",921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 130 , 342 , 610 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538894290,"DUNCAN, MARA, LEE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538894290,"DUNCAN, MARA, LEE",611 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 55 , 116 ,$#,,
MEDICAID DIRECT,1154475424,FORSYTH COUNTY,FORSYTH COUNTY,799 HIGHLAND AVE   WINSTON SALEM NC,034,Forsyth,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1538897434,"BALDWIN, MAME, BINETA",799 HIGHLAND AVE   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 25 , 116 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538899570,"WASZCZENIUK, COURTNEY, WHITE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1538899570,"WASZCZENIUK, COURTNEY, WHITE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 30 , 31 ,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1538899810,"ROBINSON, SONIA, LYSETTE",19 NOBLE ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538906466,"HARRIS, ANNE, CATHERINE",67 JR RD STE 1200 SELMA NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 17 , 17 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1538906466,"HARRIS, ANNE, CATHERINE",67 JR RD STE 1200 SELMA NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1538906466,"HARRIS, ANNE, CATHERINE",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538906466,"HARRIS, ANNE, CATHERINE",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1538906466,"HARRIS, ANNE, CATHERINE",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538911847,CHANGING GRACE HOME CARE LLC,,622 LINCOLN DR   KENLY NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1538911847,CHANGING GRACE HOME CARE LLC,622 LINCOLN DR   KENLY NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,#, 175 , 175 ," $10,936.60 ",,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538913421,"YODER, DOUGLAS, MONTELL",2025 FRONTIS PLAZA BLVD STE 100 WINSTON SALEM NC,034,Forsyth,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538913421,"YODER, DOUGLAS, MONTELL",725 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1538914882,RIGHT TOUCH OF CARE LLC,,1050 NATIONAL HWY   THOMASVILLE NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,,1538914882,RIGHT TOUCH OF CARE LLC,1050 NATIONAL HWY   THOMASVILLE NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,,#, 119 , 119 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538915541,"PIPER, ALYSHA, MARY HALL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 36 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538920442,"JENSEN, CAMILLA, MARIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538922547,"GROVE, BENJAMIN, DALE",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 40 , 41 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538922547,"GROVE, BENJAMIN, DALE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538922547,"GROVE, BENJAMIN, DALE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1538922547,"GROVE, BENJAMIN, DALE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1720011729,COUNTY OF RANDOLPH,RANDOLPH COUNTY HEALTH DEPARTMENT,2222 S FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1538922596,"COOPER, HOLLY, BERRY",2222 S FAYETTEVILLE ST STE B ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 46 , 170 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538924691,"HARALSON, JOSPEH, MALCOM",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 104 , 104 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,300 BLAKE BLVD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1538924691,"HARALSON, JOSPEH, MALCOM",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1538924691,"HARALSON, JOSPEH, MALCOM",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 27 , 136 , 138 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1538924691,"HARALSON, JOSPEH, MALCOM",300 BLAKE BLVD   PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 47 , 47 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538937644,"MOSES, REBECCA, MGBENKONYE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 86 , 267 , 269 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1538937644,"MOSES, REBECCA, MGBENKONYE",2122 RIVERGRASS CT   RALEIGH NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1538948674,"CROWE, TRUDY, ELLA",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 24 , 42 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,75 PAINT TOWN RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1538948674,"CROWE, TRUDY, ELLA",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538948682,"BUTTERFIELD, NENA, ADAMS",161 WALKER ST   COLUMBUS NC,075,Polk,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 14 , 26 , 26 ,$#,,
MEDICAID DIRECT,1669803276,BLUE RIDGE COMMUNITY HEALTH SERVICE,RUTHERFORD HEALTH CENTER,187 W MAIN ST   SPINDALE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538948682,"BUTTERFIELD, NENA, ADAMS",187 W MAIN ST   SPINDALE NC,081,Rutherford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538948682,"BUTTERFIELD, NENA, ADAMS",110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 22 , 48 , 48 ," $11,456.30 ",,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1538948682,"BUTTERFIELD, NENA, ADAMS",1207 EAST ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1538949862,"SOBY, NATHANAEL, HAMPTON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 95 , 95 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1538949896,"D'AMICO, NICHOLAS, LOUIS",155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 30 , 52 , 102 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1538949896,"D'AMICO, NICHOLAS, LOUIS",155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 13 , 29 ,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1538949896,"D'AMICO, NICHOLAS, LOUIS",155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 70 , 99 , 112 ,$#,,
MEDICAID DIRECT,1538975115,SWEET SOUNDS SPEECH AND LANGUAGE SE,,803 MOUNTAIN SCENERY RD   ROARING RIVER NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1538975115,SWEET SOUNDS SPEECH AND LANGUAGE SE,803 MOUNTAIN SCENERY RD   ROARING RIVER NC,097,Wilkes,193200000X,Group,Multi-Specialty,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1538975115,SWEET SOUNDS SPEECH AND LANGUAGE SE,,803 MOUNTAIN SCENERY RD   ROARING RIVER NC,097,Wilkes,193400000X,Group,Single Specialty,,1538975115,SWEET SOUNDS SPEECH AND LANGUAGE SE,803 MOUNTAIN SCENERY RD   ROARING RIVER NC,097,Wilkes,193400000X,Group,Single Specialty,,#, 65 , 65 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538995162,"HUFF, EMILY, ANN",114C MEMORIAL DR.   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 27 , 49 ,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1538995162,"HUFF, EMILY, ANN",114C MEMORIAL DR.   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548001381,"COUGHLIN, CATHERINE, TERESE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548003320,"BURNETT, JORDAN, MCKENZIE",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548005739,"LOWMAN, MARIAH, CHRISTINE",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548007149,LINDA KAYE SNIPES,THE LKS HOME CARE AGENCY,120 S MAIN ST STE 240 GRAHAM NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,1548007149,LINDA KAYE SNIPES,120 S MAIN ST STE 240 GRAHAM NC,001,Alamance,253Z00000X,Agencies,In Home Supportive Care,,#, 704 , 704 ," $37,154.64 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548009848,"FICHERA, JENNIFER, LEA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 26 , 34 ,$#,,
MEDICAID DIRECT,1033128822,UNIFOUR FAMILY PRACTICE PLLC,UNIFOUR FAMILY PRACTICE,2874 S NC 127 HWY   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1548014301,"WILSON, LAURA, GROGAN",2874 S NC 127 HWY   HICKORY NC,018,Catawba,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1821059650,POLYCLINIC MEDICAL CENTER INC,POLYCLINIC MEDICAL CENTER INC,9705 NORTHEAST PKWY STE 400 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548014384,"KHAND THAKURI, SANAM",9705 NORTHEAST PKWY STE 400 MATTHEWS NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1801442033,BRADLEY ROBERTS & ASSOCIATES PLLC,~,401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1548016413,"HYACINTHE, ALEXIS, CHERISE",401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice," 3,004 "," 3,522 "," 19,062 "," $505,548.35 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548020274,"LEWIS, AMANDA, BLAINE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1659828291,RESERVE HEALTH PC,,135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548022429,"WINTON, AMBER, KATHLEEN",135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 74 , 74 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548022437,"BLOWE, WILLIAM, TRAVIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 22 , 22 , 24 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548026131,"BRADLEY, MEGAN, GENEVEA",7607 NC HIGHWAY 68 N STE B OAK RIDGE NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 70 , 139 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548030471,"NORMAN, EMMA, PAIGE",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548030471,"NORMAN, EMMA, PAIGE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548032683,"HARRIS, ERIN, ELIZABETH",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548032683,"HARRIS, ERIN, ELIZABETH",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1548032683,"HARRIS, ERIN, ELIZABETH",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 36 , 49 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548032683,"HARRIS, ERIN, ELIZABETH",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215366216,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER CAPE FEAR,3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548035595,"KLOKOW, MORGAN, MARIE",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548038375,"PATEL, SEEMA, HASMUKH",2020 CHAPEL HILL RD STE 28 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 17 ,$#,,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548046519,"NUNEZ, VICTORIA, MARIA",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568197523,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE TEN TEN,7750 TEN TEN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548046519,"NUNEZ, VICTORIA, MARIA",7750 TEN TEN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548047913,"HARRISON, ISABELLE, MARIE",703 COMFORT LN   MONROE NC,090,Union,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,138 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548071749,"GRANT, BRANDI, MICHELE",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548071749,"GRANT, BRANDI, MICHELE",138 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073693347,EASTERN CAROLINA PEDIATRICS,EASTERN CAROLINA PEDIATRICS,1702 MEDICAL PARK DR W STE 1 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548074081,"ELLIS, ASHLEY, ROSE",1702 MEDICAL PARK DR W   WILSON NC,098,Wilson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1548098601,"LAMBDIN, MOLLY, JEANNE",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1548098601,"LAMBDIN, MOLLY, JEANNE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548098601,"LAMBDIN, MOLLY, JEANNE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548098601,"LAMBDIN, MOLLY, JEANNE",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548099666,"BIBEY, BETHANY, FRYE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 31 , 41 ,$#,,
MEDICAID DIRECT,1548200173,ACME-DELCO-RIEGELWOOD FIRE-RESCUE I,ADR FIRE RESCUE,100 JOHN RIEGEL RD   RIEGELWOOD NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport,1548200173,ACME-DELCO-RIEGELWOOD FIRE-RESCUE I,100 JOHN RIEGEL RD   RIEGELWOOD NC,024,Columbus,3416L0300X,Transportation Services,Ambulance,Land Transport, 11 , 22 , 43 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1548201890,"WISNIEWSKI, MARY, LOUISE",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#," $18,834.83 ",,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1548201890,"WISNIEWSKI, MARY, LOUISE",108 LAKESIDE DR   SNEADS FERRY NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 32 , 63 ,$#,,
MEDICAID DIRECT,1366597114,CHILDRENS MEDICAL GROUP INC,GENERAL BOOTH PEDS,2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548201973,"BAZIL, MEGAN, KYNE",2088 PRINCESS ANNE RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548204928,"BARBER, MATTHEW, DON",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548204928,"BARBER, MATTHEW, DON",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548204928,"BARBER, MATTHEW, DON",5324 MCFARLAND RD STE 310 DURHAM NC,032,Durham,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548204969,"WILLIAMS, DAVID, JEFFREY",1200 N ELM ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 39 , 42 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548205016,"GRANDA, KAITLYN, ALGER",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 23 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548205016,"GRANDA, KAITLYN, ALGER",815 BROAD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 18 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548206030,"CRUMB, SHEILA, HAIRE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548207095,RELIABLE HEALTHCARE SERVICES,~,117 RAILROAD ST N   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,,1548207095,RELIABLE HEALTHCARE SERVICES,117 RAILROAD ST N   AHOSKIE NC,046,Hertford,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 2,760 "," 2,766 "," $228,393.16 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 500 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548208481,"FRANCIS, HOWARD, WAYNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548208481,"FRANCIS, HOWARD, WAYNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548208481,"FRANCIS, HOWARD, WAYNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548209257,"FULTON, STEPHEN, PARKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548209257,"FULTON, STEPHEN, PARKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548209562,"YBANEZ, JANE, KAREN",711 NATIONAL HWY STE 100 THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548209562,"YBANEZ, JANE, KAREN",919 S FIFTH ST   MEBANE NC,001,Alamance,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 57 , 111 , 176 ,$#,,
MEDICAID DIRECT,1548210826,"BROWN, TIMOTHY, ROSS",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,1548210826,"BROWN, TIMOTHY, ROSS",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1033565007,STAR MEDICAL CLINIC PLLC,,461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1548211444,"LOVATO, FRANK, JAMES",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 142 , 259 ,$#,,
MEDICAID DIRECT,1710926662,WILSON EYE ASSOCIATES,~,2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548212376,"PERRY, RALPH, BARNES",2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,152W00000X,Eye and Vision Services Providers,Optometrist,, 43 , 49 , 57 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548213481,"DUFFY, PETER, LOUIS",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1548213481,"DUFFY, PETER, LOUIS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1548213481,"DUFFY, PETER, LOUIS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 13 , 22 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548216757,"FUTCH JR, WILLIAM, STEWART",13 MEDICAL CAMPUS DR NW STE 102 SUPPLY NC,010,Brunswick,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 20 , 22 , 30 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548216757,"FUTCH JR, WILLIAM, STEWART",208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 30 , 36 , 53 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548217078,"ECKERT, LYNN, BENNETT",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548217078,"ECKERT, LYNN, BENNETT",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548217078,"ECKERT, LYNN, BENNETT",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1548217078,"ECKERT, LYNN, BENNETT",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548217490,"EISENBEIS, CHARLES, FREDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,781 AVENT FERRY RD STE 200 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1548217490,"EISENBEIS, CHARLES, FREDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548217490,"EISENBEIS, CHARLES, FREDRICK",150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 34 , 34 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548217490,"EISENBEIS, CHARLES, FREDRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1548217755,PATTY VISION CENTER OD PA,Patty Vision Center,2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548217755,PATTY VISION CENTER OD PA,2326 S CHURCH ST STE A BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,, 198 , 213 , 397 ,$#,,
MEDICAID DIRECT,1548217755,PATTY VISION CENTER OD PA,Patty Vision Center,1107 S FIFTH ST STE 300 MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,1548217755,PATTY VISION CENTER OD PA,1107 S FIFTH ST STE 300 MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548218118,"FULP, SAM, RUSSELL",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548218183,"SCHMITZ, ROBERT, JOSEPH",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548218183,"SCHMITZ, ROBERT, JOSEPH",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548218183,"SCHMITZ, ROBERT, JOSEPH",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 16 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548218183,"SCHMITZ, ROBERT, JOSEPH",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548218183,"SCHMITZ, ROBERT, JOSEPH",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548218183,"SCHMITZ, ROBERT, JOSEPH",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548218183,"SCHMITZ, ROBERT, JOSEPH",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 16 , 20 ,$#,,
MEDICAID DIRECT,1548220056,"SCHERTZINGER, GEORGE, EDWARD",~,107 PARKWOOD DR   SNOW HILL NC,040,Greene,152W00000X,Eye and Vision Services Providers,Optometrist,,1548220056,"SCHERTZINGER, GEORGE, EDWARD",107 PARKWOOD DR   SNOW HILL NC,040,Greene,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1649358052,EASTERN EYE ASSOCIATES OF PITT-GREE,EASTERN EYE CARE,107 PARKWOOD DR   SNOW HILL NC,040,Greene,193200000X,Group,Multi-Specialty,,1548220056,"SCHERTZINGER, GEORGE, EDWARD",107 PARKWOOD DR   SNOW HILL NC,040,Greene,152W00000X,Eye and Vision Services Providers,Optometrist,, 175 , 210 , 310 ," $10,640.20 ",,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,15825 BALLANTYNE MEDICAL PL STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548220619,"PUTTERMAN, PAUL, STUART",15825 BALLANTYNE MEDICAL PL STE 240 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,1130 NEW GARDEN RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548220619,"PUTTERMAN, PAUL, STUART",860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083363881,CENTER FOR VEIN RESTORATION NC PLLC,,860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548220619,"PUTTERMAN, PAUL, STUART",860 SUMMIT CROSSING PL STE 120 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548220726,"PERRY, JOSEPH, TODD",600 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 237 , 288 , 547 ," $13,279.67 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1900 W PARK DR STE C NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1548220726,"PERRY, JOSEPH, TODD",1900 W PARK DR STE B NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578638078,PITT FAMILY PHYSICIANS PA,PITT FAMILY PHYSICIANS PA,137 THIRD ST   AYDEN NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548221039,"BOWEN, TRACEY, WALSTON",137 THIRD ST   AYDEN NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 54 , 117 ,$#,,
MEDICAID DIRECT,1962737452,MCPC-2 LLC,FIRSTHEALTH RICHMOND MEDICAL GROUP INTERNAL MEDICI,809 S LONG DR STE H ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",809 S LONG DR STE H ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932130390,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE CAROLINA FAMILY ME,104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 48 , 56 ,$#,,
MEDICAID DIRECT,1710586581,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 200 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",1690 US HIGHWAY 1 S   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1720034895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RICHMOND FAMILY MEDI,921 S LONG DR STE 101 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245335066,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RAEFORD,313 TEAL DR OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932130390,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE CAROLINA FAMILY ME,104 PHYSICIANS PARK DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881968709,MCPC-7 LLC,SANDHILLS REGIONAL PHYSICIAN GROUP,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 36 ,$#,,
MEDICAID DIRECT,1619463429,FHPG LLC,~,2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710586581,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 200 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740904895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE HORNER,3110 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",7473C HWY 22   CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548276389,FIRSTHEALTH OF THE CAROLINAS INC,~,522 ALLEN ST STE 101 TROY NC,062,Montgomery,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1548221484,"SHILKITUS, WILLIAM, FRANCIS",522 ALLEN ST STE 101 TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114351095,MCPC-16 LLC,FIRSTHEALTH PRIMARY CARE AND CARDIOLOGY,6322 FAYETTEVILLE RD OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245335066,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE RAEFORD,313 TEAL DR OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",313 TEAL DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 37 , 70 ,$#,,
MEDICAID DIRECT,1740904895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE HORNER,3110 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",3110 S HORNER BLVD   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619463429,FHPG LLC,~,2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1548221484,"SHILKITUS, WILLIAM, FRANCIS",2919 BEECHTREE DR STE 1120 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548221690,"VON BIBERSTEIN, SARAH, ELIZABETH",2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 72 , 93 , 163 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548221690,"VON BIBERSTEIN, SARAH, ELIZABETH",8115 MARKET ST STE 200 WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 16 , 30 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548221690,"VON BIBERSTEIN, SARAH, ELIZABETH",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1710932629,WILMINGTON EAR NOSE AND THROAT ASSO,WILMINGTON EAR NOSE & THROAT,2311 DELANEY AVE   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548221690,"VON BIBERSTEIN, SARAH, ELIZABETH",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1548222755,"LANCASTER, REBECCA, LYNNE",1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1548222755,"LANCASTER, REBECCA, LYNNE",1317 N BRIGHTLEAF BLVD STE D SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1124083167,WAYNESBOROUGH OPHTHALMOLOGY PA,WAYNESBOROUGH OPHTHALMOLOGY PA,103 COX BLVD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1548222755,"LANCASTER, REBECCA, LYNNE",103 COX BLVD   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 110 , 158 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548223027,"DIEDRICH, ANDREA, LYNN",1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 39 , 50 , 50 ,$#,,
MEDICAID DIRECT,1396928230,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY KENILWORTH,1225 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548223027,"DIEDRICH, ANDREA, LYNN",3541 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 36 , 36 ,$#,,
MEDICAID DIRECT,1548224090,"FEREZ, NICHOLAS, JAMES",NICHOLAS J FEREZ DC FASA,501 GATEWAY DR STE 103 CLAYTON NC,051,Johnston,111N00000X,Chiropractic Providers,Chiropractor,,1548224090,"FEREZ, NICHOLAS, JAMES",501 GATEWAY DR STE 103 CLAYTON NC,051,Johnston,111N00000X,Chiropractic Providers,Chiropractor,,#, 59 , 59 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548227804,"LEASK, GAVIN, MARK",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548227804,"LEASK, GAVIN, MARK",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 24 , 38 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548227804,"LEASK, GAVIN, MARK",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548227804,"LEASK, GAVIN, MARK",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 27 , 36 ,$#,,
MEDICAID DIRECT,1902663529,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES LORIS,3485 MITCHELL STREET   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548227804,"LEASK, GAVIN, MARK",3485 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 33 , 49 ,$#,,
MEDICAID DIRECT,1457804080,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES MYRTLE BEACH,107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548227804,"LEASK, GAVIN, MARK",107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1700643335,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES MYRTLE BEACH,107 MCLEOD HEALTH BLVD. SUITE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548227804,"LEASK, GAVIN, MARK",107 MCLEOD HEALTH BLVD STE 202 MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1548227978,"BOINAPALLY, VAIDEHI",3024 PICKETT RD ROAD DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548227978,"BOINAPALLY, VAIDEHI",3044 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 45 , 105 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548228026,"BROWN, JUSTIN, CHAMBERLIN",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 31 , 81 , 219 ," $57,298.60 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548228026,"BROWN, JUSTIN, CHAMBERLIN",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548228026,"BROWN, JUSTIN, CHAMBERLIN",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 24 , 54 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548228026,"BROWN, JUSTIN, CHAMBERLIN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 90 , 221 , 589 ," $56,978.63 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548228026,"BROWN, JUSTIN, CHAMBERLIN",1632 E ROOSEVELT BLVD   MONROE NC,090,Union,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 45 , 92 , 203 ," $41,050.11 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548229107,"SOLDATO COUTURE, CATHY, MARIE",240 BROAD ST   KERNERSVILLE NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 38 , 97 ,$#,,
MEDICAID DIRECT,1164694683,CENTRAL EMERGENCY PHYSICIANS LLC,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1548230873,"ZUROWSKY, PHILIP, ADAM",1135 CARTHAGE ST   SANFORD NC,053,Lee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1386960342,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548231319,"BARZOLA, KERRY, JEAN",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 32 , 56 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548231319,"BARZOLA, KERRY, JEAN",332 N TRADE ST   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 14 , 20 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548231319,"BARZOLA, KERRY, JEAN",332 N TRADE ST STE 2000 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245475342,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH WINSTON SALEM HEALTHCARE,250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548231772,"STURGILL, WILLIAM, HUGH",175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,,,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548231772,"STURGILL, WILLIAM, HUGH",175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 35 , 49 , 80 ,$#,,
MEDICAID DIRECT,1033394267,DR RALPH W MAYNARD III OD PA,~,124 CEDAR VALLEY RD   HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1548232218,"MAYNARD, RALPH, W",124 CEDAR VALLEY RD   HUDSON NC,014,Caldwell,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548232366,"THOMAS, WALTER, EARL",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 28 , 44 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1336102243,SCOTLAND MEDICAL CENTER PA,SCOTLAND MEDICAL CENTER,422 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",202 E DR MLK JR DR   MAXTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1336102243,SCOTLAND MEDICAL CENTER PA,SCOTLAND MEDICAL CENTER,422 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",771 CHERAW RD   HAMLET NC,077,Richmond,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1336102243,SCOTLAND MEDICAL CENTER PA,SCOTLAND MEDICAL CENTER,422 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",422 S KING ST   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 136 , 213 ,$#,,
MEDICAID DIRECT,1336102243,SCOTLAND MEDICAL CENTER PA,SCOTLAND MEDICAL CENTER,422 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1336102243,SCOTLAND MEDICAL CENTER PA,SCOTLAND MEDICAL CENTER,422 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",422 S KING ST   LAURINBURG NC,083,Scotland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1336102243,SCOTLAND MEDICAL CENTER PA,SCOTLAND MEDICAL CENTER,422 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 108 , 123 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1548233323,"IQBAL, MUHAMMAD, JAWAD",422 S KING ST   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1548233430,"MORISY, LEE, RICHARD",327 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548233430,"MORISY, LEE, RICHARD",327 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 30 , 37 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1548233430,"MORISY, LEE, RICHARD",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548233430,"MORISY, LEE, RICHARD",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1548233430,"MORISY, LEE, RICHARD",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548233471,SPEAKABILITY INC,~,510 CARPENTER AVE   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1548233471,SPEAKABILITY INC,510 CARPENTER AVE   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,, 50 , 541 , 542 ," $37,558.22 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548234347,"MICCHIA, GINA, LOUISE",10500 LIGON MILL RD STE 113 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 23 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548234529,"RASMUSSEN, HOLLY, MARGREE",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548234529,"RASMUSSEN, HOLLY, MARGREE",1110 SE CARY PKWY STE 100 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548234529,"RASMUSSEN, HOLLY, MARGREE",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548234529,"RASMUSSEN, HOLLY, MARGREE",3225 BLUE RIDGE RD STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548234818,"YARNAL, JAMES, RODGERS",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437320892,HAYMOUNT INSTITUTE FOR PSYCHOLOGICA,HAYMOUNT INSTITUTE FOR PSYCHOLOGICAL SERVICES PLLC,806 HAY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548235054,"MILLER, RAMONA, MONIQUE",131 W EDINBOROUGH AVE   RAEFORD NC,047,Hoke,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,799 HICKORY TREE RD STE A WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1548235641,"PANNELL, CHRISTA, RANEE IDA",799 HICKORY TREE RD STE A WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 123 , 150 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548236680,"LODS, STEPHEN, CHRISTOPHER",311 CODDLE MARKET DR NW STE 100 CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 27 , 55 ,$#,,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548237894,"SHAW, MARY, CASSIE",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 19 , 43 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548238561,"GIBSON, FLOYD, BRIAN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 47 , 70 , 92 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548240229,"ITZKOWITZ, SCOTT, LOUIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548240963,"SEXTON, MICHAEL, JOHN",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 14 , 15 , 21 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548240963,"SEXTON, MICHAEL, JOHN",14330 OAKHILL PARK LN   HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548240963,"SEXTON, MICHAEL, JOHN",269 GILLMAN RD STE 200A DENVER NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548240963,"SEXTON, MICHAEL, JOHN",9955 POPLAR TENT RD   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 13 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548242258,"HAMILTON, BRIANNE, LESLIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1548242258,"HAMILTON, BRIANNE, LESLIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740391283,AMERICAN NEUROMONITORING ASSOCIATES,,10275 LITTLE PATUXENT PKWY STE 300 COLUMBIA MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548242647,"NAHM, FREDERICK, KI-IN",24 HOME PL   GREENWICH CT,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548244064,"OTIS, SCOTT, MICHAEL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 91 , 154 , 276 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1548245160,"DABNEY, LISA, GENE",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 37 , 77 ,$#,,
MEDICAID DIRECT,1700164464,CARTERET MEDICAL GROUP LLC,CARTERET MEDICAL GROUP LLC,1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1548245160,"DABNEY, LISA, GENE",1165 CEDAR POINT BLVD STE H CEDAR POINT NC,016,Carteret,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 28 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1548245806,"SUE, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 23 , 30 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548245806,"SUE, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1548245855,"DUMAS, MARK, NEAL",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1548246499,"ELLIOTT, DAVID, HORACE",DAVID HORACE ELLIOTT II,233 ALLEN ST   BELHAVEN NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice,1548246499,"ELLIOTT, DAVID, HORACE",233 ALLEN ST   BELHAVEN NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice, 210 , 377 ," 1,351 "," $81,381.89 ",,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1548247166,"WUEST, JOHN, HENRY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548247562,"GORSUCH, LISA, ANN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548247562,"GORSUCH, LISA, ANN",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548247562,"GORSUCH, LISA, ANN",1550 FAULK ST STE 2100 MONROE NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548253693,"LEVINE, GARY, IRA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 206 , 258 , 414 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548253693,"LEVINE, GARY, IRA",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548253693,"LEVINE, GARY, IRA",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548253693,"LEVINE, GARY, IRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 68 , 68 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548254527,"STEFFEE, CRAIG, HAROLD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 57 , 54 , 90 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548254576,"LOHRMAN, JULIE, ANN",304 10TH AVE NE   HICKORY NC,018,Catawba,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 11 , 11 , 22 ,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548254956,"KNUTSON, HEATHER, STOUT",101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548254956,"KNUTSON, HEATHER, STOUT",5727 PROSPERITY CROSSING DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1841526837,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATR,5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548254956,"KNUTSON, HEATHER, STOUT",5727 PROSPERITY CROSSING DR STE 1500 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 45 , 75 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548255680,"SINGER, RODY, BEN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548255680,"SINGER, RODY, BEN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548255680,"SINGER, RODY, BEN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548255680,"SINGER, RODY, BEN",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",920 CHURCH ST N SUIE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",2555 COURT DR STE 270 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548255680,"SINGER, RODY, BEN",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265462659,PALMETTO INFUSION SERVICES LLC,,1551 WESTBROOK PLAZA DR STE 100 WINSTON SALEM NC,034,Forsyth,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1548256266,"WADE, EUGENE, HENRY PETER",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#," $27,801.55 ",,
MEDICAID DIRECT,1265462659,PALMETTO INFUSION SERVICES LLC,,1551 WESTBROOK PLAZA DR STE 100 WINSTON SALEM NC,034,Forsyth,261QI0500X,Ambulatory Health Care Facilities,Clinic/Center,Infusion Therapy,1548256266,"WADE, EUGENE, HENRY PETER",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 137 , 480 ," 1,068 "," $1,045,841.38 ",,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548256332,"BAJWA, AJAY, PARTAP SINGH",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 306 , 429 , 567 ," $11,229.15 ",,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2000 CAROMONT PKWY STE 200 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548256332,"BAJWA, AJAY, PARTAP SINGH",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548258874,"HORN, ERICA, NICOLE",1302 LEXINGTON AVE   THOMASVILLE NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 28 , 31 , 41 ," $15,892.57 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548258874,"HORN, ERICA, NICOLE",108 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 31 , 47 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548258874,"HORN, ERICA, NICOLE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548259369,"LEFF, VICKY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 196 , 196 ," $11,515.46 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548259369,"LEFF, VICKY",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 67 , 668 , 668 ," $43,285.54 ",,
MEDICAID DIRECT,1124422704,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,923 N 2ND ST STE 204 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1548260250,"GODINO, JOHN",923 N 2ND ST STE 204 ALBEMARLE NC,084,Stanly,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 120 , 136 , 188 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548260417,"KOHLER, PATRICIA, LYNN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548260417,"KOHLER, PATRICIA, LYNN",315 TRENT DR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 78 , 78 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548260417,"KOHLER, PATRICIA, LYNN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548261142,"JOHNSON, ALLEN, MCKENZIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 172 , 201 , 264 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1548261142,"JOHNSON, ALLEN, MCKENZIE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 261 , 352 , 506 ,$#,,
MEDICAID DIRECT,1760579106,EAR NOSE AND THROAT LTD,EAR NOSE AND THROAT LTD,885 KEMPSVILLE RD STE 221 NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548261928,"DOROFI, DAVID, BRYANT",885 KEMPSVILLE RD STE 221 NORFOLK VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548265366,"STARLING, PAUL, BRITT",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1548267958,"SHETTY, AMITA, SADASHIV",3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548267958,"SHETTY, AMITA, SADASHIV",3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 66 , 85 , 85 ,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548267958,"SHETTY, AMITA, SADASHIV",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 27 , 35 , 35 ,$#,,
MEDICAID DIRECT,1609196633,CAPE FEAR VALLEY HEALTH SYSTEM SPEC,BLADEN SLEEP DISORDERS CLINIC,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1548267958,"SHETTY, AMITA, SADASHIV",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548267958,"SHETTY, AMITA, SADASHIV",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RS0012X,Allopathic & Osteopathic Physicians,Internal Medicine,Sleep Medicine, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548268378,"KRAVATH, PETER, EDWARD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 156 , 170 , 203 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548268378,"KRAVATH, PETER, EDWARD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 190 , 215 , 294 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548268949,"WORTH, MICHAEL, PAUL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 39 , 44 ,$#,,
MEDICAID DIRECT,1548268964,"ROSE, SHANNON, ELIZABETH",SHANNON ROSE MA CCC-SLP,51 MCDADE ST   ASHEVILLE NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1548268964,"ROSE, SHANNON, ELIZABETH",51 MCDADE ST   ASHEVILLE NC,011,Buncombe,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548269962,"ROBLES, EDWARD, CONRAD",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548269962,"ROBLES, EDWARD, CONRAD",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 49 , 61 , 74 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548269962,"ROBLES, EDWARD, CONRAD",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1548270358,"TANAKA, JEFFREY, JAY",2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558371286,CAROLINA KIDS PEDIATRIC,CAROLINA KIDS PEDIATRIC ASSOCIATES PLLC,2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548270358,"TANAKA, JEFFREY, JAY",2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1548274095,"WALTON, WILLIAM, HAROLD",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 44 , 74 , 115 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1548274095,"WALTON, WILLIAM, HAROLD",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1548274095,"WALTON, WILLIAM, HAROLD",40 E MEDICAL CT   MARION NC,059,McDowell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 27 , 41 ,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1548274095,"WALTON, WILLIAM, HAROLD",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 50 , 88 , 128 ,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548274095,"WALTON, WILLIAM, HAROLD",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 33 , 57 , 96 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548276132,"BABB, TRICIA, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548276132,"BABB, TRICIA, LYNN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,,,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548278252,"AHRENS, WILLIAM, ALBERT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 193 , 194 , 252 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548279292,"HOLMER, SHELLEY, ANNE",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548279292,"HOLMER, SHELLEY, ANNE",1000 TRENT DR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548280159,"BABCOCK, KAREN, RUTH",600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 53 , 70 , 188 ,$#,,
MEDICAID DIRECT,1912966656,HENDERSONVILLE PEDIATRICS PA,HENDERSONVILLE PEDIATRICS PA,600 BEVERLY HANKS CTR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548280159,"BABCOCK, KAREN, RUTH",157 MEDICAL PARK DR   BREVARD NC,088,Transylvania,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1548282916,"COLAVITO, STEFANIE, ANN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1710908041,YADKIN RIVER RADIOLOGY PA,YADKIN RIVER RADIOLOGY PA,122 WYNDHAM WAY   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1548283831,"BEERMAN, PAUL, JAY",180 PARKWOOD DR   ELKIN NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548284334,"LEE, JESSICA, YUNA",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548284334,"LEE, JESSICA, YUNA",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548284334,"LEE, JESSICA, YUNA",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 17 , 17 , 218 ," $15,692.78 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548284334,"LEE, JESSICA, YUNA",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 40 , 43 , 372 ," $35,344.28 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548284334,"LEE, JESSICA, YUNA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 382 , 463 ," 1,283 "," $43,086.27 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548284334,"LEE, JESSICA, YUNA",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548284482,"STANLEY, DAVID, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 43 , 43 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548286925,"TRAN, RAYMOND",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 47 , 66 ,$#,,
MEDICAID DIRECT,1215967377,LINCOLN FAMILY PRACTICE,LINCOLN FAMILY PRACTICE,,,Unknown,193400000X,Group,Single Specialty,,1548286925,"TRAN, RAYMOND",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548286925,"TRAN, RAYMOND",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 126 , 217 , 267 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548288921,"GASPARI, MICHAEL, MARION",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 38 , 42 , 52 ,$#,,
MEDICAID DIRECT,1659495133,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548288947,"FURR, SARA, MARCELLA",4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 77 , 99 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548289804,"HOPE, WILLIAM, WITHERSPOON",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548289804,"HOPE, WILLIAM, WITHERSPOON",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 75 , 84 ,$#,,
MEDICAID DIRECT,1194447805,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PSYCHIATRIC CLINICS,175 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548292295,"GARDNER COLE, STEPHANIE, RUTH",120 PENMARC DR STE 118 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548293541,"ZONA, SHANNON, ELIZABETH",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1831809755,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV HOSPITAL SPECIALTY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548293855,"VORDER BRUEGGE, WILLIAM, FRANCIS",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1548293855,"VORDER BRUEGGE, WILLIAM, FRANCIS",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 206 , 338 , 387 ," $10,884.45 ",,
MEDICAID DIRECT,1962869446,FAYETTEVILLE GASTROENTEROLOGY ENDOS,,2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1548293855,"VORDER BRUEGGE, WILLIAM, FRANCIS",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 23 , 24 , 33 ,$#,,
MEDICAID DIRECT,1104145390,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH WOUND CARE AND HYPERBARIC MEDICINE,300 BILLINGSLEY RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548295934,"WASSEL, JOHN, JOSEPH",300 BILLINGSLEY RD STE 105 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 49 , 115 , 116 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548296791,"NELSON SCHMALZ, JANELLE, MARIE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548296791,"NELSON SCHMALZ, JANELLE, MARIE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548297054,MAXIM HEALTHCARE SERVICES,MAXIM HEALTHCARE SERVICES INC,200 CENTREPORT DR STE 300 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,,1548297054,MAXIM HEALTHCARE SERVICES,200 CENTREPORT DR STE 300 GREENSBORO NC,041,Guilford,251J00000X,Agencies,Nursing Care,, 29 ," 4,437 "," 4,918 "," $2,256,584.08 ",,
MEDICAID DIRECT,1548297054,MAXIM HEALTHCARE SERVICES,MAXIM HEALTHCARE SERVICES INC,200 CENTREPORT DR STE 300 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1548297054,MAXIM HEALTHCARE SERVICES,200 CENTREPORT DR STE 300 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548298128,"DEANE, SANDRA, ANN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548298128,"DEANE, SANDRA, ANN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548298128,"DEANE, SANDRA, ANN",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548298334,"WILSON, JON, JAY",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 37 , 70 , 152 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548298334,"WILSON, JON, JAY",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1538601257,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE REGIONAL PAIN CLINIC,1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548299126,"NAVIERA, FRANCISCO, AUTURO",1236 HUFFMAN MILL RD STE 2000 BURLINGTON NC,001,Alamance,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 68 , 307 , 357 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548306640,"WILLIS, SCOTT, LESLE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548306640,"WILLIS, SCOTT, LESLE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548306640,"WILLIS, SCOTT, LESLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 12 , 17 , 25 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548306640,"WILLIS, SCOTT, LESLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 18 , 18 , 37 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548307259,"GRIFFIN, KATHLEEN, WETHERELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 103 , 135 , 142 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548307259,"GRIFFIN, KATHLEEN, WETHERELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548310162,"MCQUEEN, LAURA, FISHER",9104 MARKET ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1548310162,"MCQUEEN, LAURA, FISHER",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 14 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548310162,"MCQUEEN, LAURA, FISHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548310386,"CORCINO, VERONICA, MARIE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548310386,"CORCINO, VERONICA, MARIE",3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548310386,"CORCINO, VERONICA, MARIE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1306899950,CATAWBA VALLEY MEDICAL CENTER,FAIRGROVE PRIMARY HEALTH,3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548310386,"CORCINO, VERONICA, MARIE",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,3412 GRAYSTONE PL SE STE B CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548310386,"CORCINO, VERONICA, MARIE",3412 GRAYSTONE PL SE STE A CONOVER NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 26 , 78 , 93 ,$#,,
MEDICAID DIRECT,1952546756,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY INFECTIOUS DISEASE CONSULTANTS,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548310386,"CORCINO, VERONICA, MARIE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1538267224,H J BROWN AND ASSOCIATES DDS PA,H J BROWN AND ASSOCIATES DDS PA,410 W 14TH ST STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548310501,"ALVES, LOREN, DOUGLAS",410 W 14TH ST STE B GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 55 , 59 , 170 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548310816,"LEIDECKER, SHERYL, LOUISE",4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 25 , 56 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1548310816,"LEIDECKER, SHERYL, LOUISE",23 SUNNYBROOK RD STE 116 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548310816,"LEIDECKER, SHERYL, LOUISE",400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 22 , 60 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1548310816,"LEIDECKER, SHERYL, LOUISE",400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548310816,"LEIDECKER, SHERYL, LOUISE",400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1548315062,"ROGERS, JOHN, BUSH",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1548315062,"ROGERS, JOHN, BUSH",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1548315062,"ROGERS, JOHN, BUSH",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548316136,"BRINCKMAN, MARK, ALAN",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 49 , 59 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548317233,"KEEL, CYNTHIA, POWELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548322134,"TEWARI, ANAND",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 55 , 56 , 66 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1548322134,"TEWARI, ANAND",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548322134,"TEWARI, ANAND",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548322134,"TEWARI, ANAND",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 33 , 33 , 45 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548322134,"TEWARI, ANAND",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548322134,"TEWARI, ANAND",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1548323322,"STOUT, JASON, ERIC",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 42 , 58 , 170 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548323322,"STOUT, JASON, ERIC",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548323322,"STOUT, JASON, ERIC",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548323322,"STOUT, JASON, ERIC",DUKE HOSP SOUTH TRENT DR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 23 , 60 , 60 ,$#,,
MEDICAID DIRECT,1548326945,SOUTHERN ASSISTED LIVING INC,BROOKDALE ROBINWOOD,1750 ROBINWOOD RD   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548326945,SOUTHERN ASSISTED LIVING INC,1750 ROBINWOOD RD   GASTONIA NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 872 , 872 ," $67,553.53 ",,
MEDICAID DIRECT,1053459685,SALISBURY AUDIOLOGY AND HEARING AID,SALISBURY AUDIOLOGY AND HEARING AID SERVCS,310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1548327042,"PITTMAN, APRIL",310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,,,$#,,
MEDICAID DIRECT,1053459685,SALISBURY AUDIOLOGY AND HEARING AID,SALISBURY AUDIOLOGY AND HEARING AID SERVCS,310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,1548327042,"PITTMAN, APRIL",310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1053459685,SALISBURY AUDIOLOGY AND HEARING AID,SALISBURY AUDIOLOGY AND HEARING AID SERVCS,310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1548327042,"PITTMAN, APRIL",310 STATESVILLE BLVD STE 3 SALISBURY NC,080,Rowan,237600000X,"Speech, Language and Hearing Service Providers",Audiologist-Hearing Aid Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1548327489,UNION COUNTY PUBLIC SCHOOLS,~,400 N CHURCH ST   MONROE NC,090,Union,251300000X,Agencies,Local Education Agency (LEA),,1548327489,UNION COUNTY PUBLIC SCHOOLS,400 N CHURCH ST   MONROE NC,090,Union,251300000X,Agencies,Local Education Agency (LEA),, 804 ," 18,362 "," 18,972 "," $815,484.50 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548332406,"WILLIAMS, MARIE, LOUISE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 20 , 23 , 30 ,$#,,
MEDICAID DIRECT,1558360974,LONG LAXER & SAVAGE DDS PLLC,LAXER LONG AND SAVAGE,7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548333818,"LONG, LINWOOD, M",7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 93 , 147 , 244 ," $15,537.94 ",,
MEDICAID DIRECT,1558360974,LONG LAXER & SAVAGE DDS PLLC,LAXER LONG AND SAVAGE,7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548333818,"LONG, LINWOOD, M",7820 BALLANTYNE COMMONS PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 149 , 564 , 740 ," $77,738.20 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548335573,"MCKELLAR, MAHRI, SADRI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548335573,"MCKELLAR, MAHRI, SADRI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 19 , 29 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548335573,"MCKELLAR, MAHRI, SADRI",2100 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 20 , 20 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1548339930,"MARGOPULOS-KELENSKE, JENNIFER, NICOLE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548339930,"MARGOPULOS-KELENSKE, JENNIFER, NICOLE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 93 , 105 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548339930,"MARGOPULOS-KELENSKE, JENNIFER, NICOLE",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 25 , 25 ,$#,,
MEDICAID DIRECT,1932485943,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM SURGICAL ASSOCIATES,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1548343320,"NOEL JR, ROBERT, FREDERICK",120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 83 , 151 , 158 ,$#,,
MEDICAID DIRECT,1548343833,ENDOSCOPY CENTER OF LAKE NORMAN LLC,ENDOSCOPY CENTER OF LAKE NORMAN LLC,16525 HOLLY CREST LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1548343833,ENDOSCOPY CENTER OF LAKE NORMAN LLC,16525 HOLLY CREST LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548344211,"CARUSO, JOSHUA, ANTHONY",4590 PREMIER DR   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548344211,"CARUSO, JOSHUA, ANTHONY",2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548344419,"THRALL, GRACE, CODDINGTON",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1730416801,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548344450,"WILSON, FRED, HENRY",4431 US HIGHWAY 220 N   SUMMERFIELD NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 19 , 23 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548345572,"SALLEAN, ANDREW, JOHN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 178 , 184 , 188 ,$#,,
MEDICAID DIRECT,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,DRS JOHNSON & JOHNSON EYEWORKS,304 E MAIN ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,304 E MAIN ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,, 349 , 364 , 725 ,$#,,
MEDICAID DIRECT,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,DRS JOHNSON & JOHNSON EYEWORKS,2800 N ELM ST STE 1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,2800 N ELM ST STE 1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,," 2,350 "," 2,408 "," 4,816 "," $66,127.54 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548347040,"TODD, MORGAN, ARVIDSON",8108B MARKET ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548347040,"TODD, MORGAN, ARVIDSON",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548348543,"BYNUM, DEBRA, LYNN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548348543,"BYNUM, DEBRA, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548348543,"BYNUM, DEBRA, LYNN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548348543,"BYNUM, DEBRA, LYNN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417499112,CAROLINA PHYSICAL THERAPY ASSOCIATE,CAROLINA PHYSICAL THERAPY ASSOCIATES - LOUISBURG,1501 N BICKETT BLVD STE F LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1548350234,"HARRIS, KRISTIN, DAVIS",1501 N BICKETT BLVD STE F LOUISBURG NC,035,Franklin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1548350382,"CIVILETTI, KRISTA",75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 27 , 49 ,$#,,
MEDICAID DIRECT,1962565788,COUNTY OF WILKES,WILKES COUNTY HEALTH DEPARTMENT,306 COLLEGE ST   WILKESBORO NC,097,Wilkes,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1548350796,"KOSTYACK, GAYLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 191 , 233 , 613 ," $31,324.88 ",,
MEDICAID DIRECT,1811283518,HUNTER C JOH DDS PA,HUNTER C JOH DDS PA,123 BRYAN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1548351356,"BAECHTOLD, ANGELA, PAINTER",10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 39 , 40 , 124 ,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548351356,"BAECHTOLD, ANGELA, PAINTER",10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1114598612,HARRINGTON & WILHARM DDS PA,COASTAL PEDIATRIC DENTISTRY,3067 SOUTHPORT SUPPLY RD SE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1548351356,"BAECHTOLD, ANGELA, PAINTER",10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,699 "," 2,165 "," 10,238 "," $336,849.75 ",,
MEDICAID DIRECT,1730270448,FAYETTEVILLE CHILDRENS CLINIC,~,1606 MORGANTON RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1548351372,"KELLY, WILLIAM, HUSKE",1606 MORGANTON RD   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548351687,"LIESMAN, ROBERT, MITCHELL",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 286 , 345 , 401 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548352321,"SCHULTZ, HEATHER, MARIE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 21 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548352321,"SCHULTZ, HEATHER, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548352321,"SCHULTZ, HEATHER, MARIE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548354459,"OBERER, DANIEL, MICHIEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548354459,"OBERER, DANIEL, MICHIEL",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548354459,"OBERER, DANIEL, MICHIEL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 28 , 38 , 53 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1548354699,"LOPEZ STRATTON, ANNA, ELISA",56 MEDICAL PARK DR STE 203 FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972079127,MH TRANSYLVANIA REGIONAL HOSPITAL L,,360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1548354699,"LOPEZ STRATTON, ANNA, ELISA",360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548356603,"RAYALA, BRIAN, ZAGUIRRE",1512 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 35 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548356603,"RAYALA, BRIAN, ZAGUIRRE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 78 , 124 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1548357908,"ZIOMEK, PAUL, HENRY",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 19 , 21 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1548357908,"ZIOMEK, PAUL, HENRY",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 57 , 63 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1548357908,"ZIOMEK, PAUL, HENRY",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1548357908,"ZIOMEK, PAUL, HENRY",958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134201387,COMPASSION HEALTH CARE INC,CASWELL FAMILY MEDICAL CENTER INC,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548357908,"ZIOMEK, PAUL, HENRY",3616 CAPE CENTER DR STE A FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1548357908,"ZIOMEK, PAUL, HENRY",3616 CAPE CENTER DR STE A FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1548357908,"ZIOMEK, PAUL, HENRY",3616 CAPE CENTER DR STE A FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528237435,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548358088,"SENIOR, EDWARD, CLARENCE",3053 FREEDOM DR STE B CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 515 , 533 ," 1,692 "," $127,291.88 ",,
MEDICAID DIRECT,1194994004,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548358088,"SENIOR, EDWARD, CLARENCE",4901 N. TRYON STREET   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780358176,DLP FRYE MEDICAL GROUP,FRYECARE ORTHOPEDIC AND NEUROSURGERY,1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548358385,"KAPLAN, BARRY, JON",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 45 , 77 , 102 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548358385,"KAPLAN, BARRY, JON",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 510 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548359094,"GOEBEL, JASON, ANDREW",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1578529632,GASTROINTESTINAL ASSOCIATES OF NORT,GASTROINTESTINAL ASSOCIATES OF NORTHEAST,310 N STATE OF FRANKLIN RD STE 202 JOHNSON CITY TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548360332,"REDDY, CHAKRADHAR, MADHAVAREDDIGARI",310 N STATE OF FRANKLIN RD STE 202 JOHNSON CITY TN,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548361975,"PENG, YEN, LIN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548361975,"PENG, YEN, LIN",8108B MARKET ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1548363039,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07039,2994 KILDAIRE FARM RD   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1548363039,NORTH CAROLINA CVS PHARMACY LLC,2994 KILDAIRE FARM RD   CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1548363211,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05559,625 S VAN BUREN RD   EDEN NC,079,Rockingham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1548363211,NORTH CAROLINA CVS PHARMACY LLC,625 S VAN BUREN RD   EDEN NC,079,Rockingham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1548363211,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05559,625 S VAN BUREN RD   EDEN NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1548363211,NORTH CAROLINA CVS PHARMACY LLC,625 S VAN BUREN RD   EDEN NC,079,Rockingham,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1053400853,FISCHER RICHARDS & WALKER PA,COASTAL CAROLINA ORTHODONTICS,17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1548364631,"FISCHER, TODD, ALAN",17 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 32 , 47 , 64 ," $13,234.98 ",,
MEDICAID DIRECT,1548367063,PRISM MEDICAL PRODUCTS,PRISM MEDICAL PRODUCTS,112 CHURCH ST STE 101 ELKIN NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1548367063,PRISM MEDICAL PRODUCTS,112 CHURCH ST STE 101 ELKIN NC,086,Surry,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 44 , 63 , 80 ,$#,,
MEDICAID DIRECT,1548367063,PRISM MEDICAL PRODUCTS,PRISM MEDICAL PRODUCTS,112 CHURCH ST STE 101 ELKIN NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1548367063,PRISM MEDICAL PRODUCTS,112 CHURCH ST STE 101 ELKIN NC,086,Surry,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 579 ," 1,140 "," 2,014 "," $20,311.20 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548368905,"JONES, QUINNETTE, BROOKE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548369929,"JOHNSON, EDDIE, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548369929,"JOHNSON, EDDIE, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 27 , 31 ,$#,,
MEDICAID DIRECT,1538128194,ASHEVILLE CHILDRENS MEDICALCENT,ASHEVILLE CHILDRENS MEDICAL CENTER PA,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548372600,"KOHN, SAMUEL, MAURICE",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 64 , 103 , 249 ," $13,815.71 ",,
MEDICAID DIRECT,1205579059,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC SUBSTANCE TREATMENT AND RECOVERY,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548372915,"GARRISON, CECIL, LYNN",1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1568624344,PEDIATRIC DENTISTRY OF STEELE CREEK,STEELE CREEK PEDIATRIC DENTISTRY,13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548373319,"LOCHARY, MARGARET, ELIZABETH",13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 95 , 127 , 453 ," $17,015.19 ",,
MEDICAID DIRECT,1104845270,PEDIATRIC DENTISTRY OF MATTHEWS,~,1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548373319,"LOCHARY, MARGARET, ELIZABETH",1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 21 ,$#,,
MEDICAID DIRECT,1104845270,PEDIATRIC DENTISTRY OF MATTHEWS,~,1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548373319,"LOCHARY, MARGARET, ELIZABETH",1340 MATTHEWS TOWNSHIP PKWY STE 201 MATTHEWS NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 200 , 307 ," 1,235 "," $64,653.62 ",,
MEDICAID DIRECT,1568624344,PEDIATRIC DENTISTRY OF STEELE CREEK,STEELE CREEK PEDIATRIC DENTISTRY,13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548373319,"LOCHARY, MARGARET, ELIZABETH",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 39 ,$#,,
MEDICAID DIRECT,1568624344,PEDIATRIC DENTISTRY OF STEELE CREEK,STEELE CREEK PEDIATRIC DENTISTRY,13521 STEELECROFT PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548373319,"LOCHARY, MARGARET, ELIZABETH",1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548375918,"NECESSARY, BEVERLY, CAROL",11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548375918,"NECESSARY, BEVERLY, CAROL",11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 42 , 42 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548379662,"MORAN, ALICE, FRANCES",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548379662,"MORAN, ALICE, FRANCES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548379662,"MORAN, ALICE, FRANCES",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1457977852,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD INTERNAL MEDICINE ASSOCIATES,800 E CHEVES ST STE 400 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548380181,"YOUNG, DIERDRE, TANECIA",800 E CHEVES ST STE 400 FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 44 , 121 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548380231,"SONNEKALB, SARA",275 BEATTY DR   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 67 , 69 ,$#,,
MEDICAID DIRECT,1548380942,ALTERNATIVES HOME CARE SOLUTIONS IN,~,6985 NEXUS CT STE 101 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1548380942,ALTERNATIVES HOME CARE SOLUTIONS IN,6985 NEXUS CT STE 101 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 193 , 193 ," $24,544.57 ",,
MEDICAID DIRECT,1992286009,FHPG LLC,FIRSTHEALTH CARDIO PULMONARY REHAB,2925 BEECHTREE DR STE 143 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1548381924,"AINSLEY JR, THELLIE, RUPERT",2925 BEECHTREE DR STE 143 SANFORD NC,053,Lee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548386337,"LOZEVSKI, JONATHAN, LEONID",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1548386337,"LOZEVSKI, JONATHAN, LEONID",2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 569 , 816 ," 1,102 "," $16,120.18 ",,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1548386337,"LOZEVSKI, JONATHAN, LEONID",500 LAUCHWOOD DRIVE   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 38 , 58 ,$#,,
MEDICAID DIRECT,1548389026,"MALONEY, JASON, PAUL",~,2376 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1548389026,"MALONEY, JASON, PAUL",2376 BOONE TRL   NORTH WILKESBORO NC,097,Wilkes,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 60 , 60 ,$#,,
MEDICAID DIRECT,1548389778,SENIOR CHOICES UNLIMITED LLC,~,5710 OLEANDER DR STE 102 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1548389778,SENIOR CHOICES UNLIMITED LLC,5710 OLEANDER DR STE 102 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 66 ," 9,406 "," 9,977 "," $1,407,832.08 ",,
MEDICAID DIRECT,1548389778,SENIOR CHOICES UNLIMITED LLC,~,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1548389778,SENIOR CHOICES UNLIMITED LLC,1201 S 16TH ST STE C WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1548390065,ROANOKE RAPIDS GRADED SCHOOL,ROANOKE RAPIDS GRADED SCHOOL DISTRICT,536 HAMILTON ST   ROANOKE RAPIDS NC,042,Halifax,251300000X,Agencies,Local Education Agency (LEA),,1548390065,ROANOKE RAPIDS GRADED SCHOOL,536 HAMILTON ST   ROANOKE RAPIDS NC,042,Halifax,251300000X,Agencies,Local Education Agency (LEA),, 200 ," 4,311 "," 4,469 "," $167,722.54 ",,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548393564,"SCHUETTE, NORA, DOHM",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548393564,"SCHUETTE, NORA, DOHM",1918 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 25 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548394356,"TAYLOR, DANIEL, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548394356,"TAYLOR, DANIEL, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1548394356,"TAYLOR, DANIEL, NOEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1548394356,"TAYLOR, DANIEL, NOEL",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548394356,"TAYLOR, DANIEL, NOEL",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548400013,"AKINTOMIDE, OLADOTUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,210 ASHVILLE AVE STE 505 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548400013,"AKINTOMIDE, OLADOTUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548400013,"AKINTOMIDE, OLADOTUN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548400013,"AKINTOMIDE, OLADOTUN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548400773,"BOYLSTON, YUN, LEE",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548400773,"BOYLSTON, YUN, LEE",530 W WEBB AVE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 19 , 46 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548400773,"BOYLSTON, YUN, LEE",3940 ARROWHEAD BLVD STE 270 MEBANE NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 40 , 64 ,$#,,
MEDICAID DIRECT,1073971347,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP FAMILY AND WOMENS HEALTH,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548403603,"PIERCE, STEPHANIE, RENEE",1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 67 , 91 , 100 ,$#,,
MEDICAID DIRECT,1073971347,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP FAMILY AND WOMENS HEALTH,1381 MEDICAL CENTER DR   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548403603,"PIERCE, STEPHANIE, RENEE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548404775,"CHIAPPELLI, LYNN, ANN",170 MEDICAL PARK RD   MOORESVILLE NC,049,Iredell,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548404775,"CHIAPPELLI, LYNN, ANN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548404775,"CHIAPPELLI, LYNN, ANN",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1548405962,"GILLIS, CRYSTAL, STRICKLAND",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 76 , 206 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548406275,"SHORTRIDGE, MATTHEW, NATHANIEL",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548406275,"SHORTRIDGE, MATTHEW, NATHANIEL",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548406275,"SHORTRIDGE, MATTHEW, NATHANIEL",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548409576,VISION CARE ASSOCIATES OD PA,VISION CARE ASSOCIATES OD PA,3419 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548409576,VISION CARE ASSOCIATES OD PA,3419 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,, 18 , 18 , 36 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,90 SOUTHSIDE AVE STE 225 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,90 SOUTHSIDE AVE STE 225 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#,#, 18 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,317 NORTH BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,317 NORTH BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,6905 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,6905 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,3708 FORESTVIEW RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,3708 FORESTVIEW RD STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,7880 ALEXANDER PROMENADE PL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,7880 ALEXANDER PROMENADE PL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#, 14 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,109 W GANNON AVE   ZEBULON NC,092,Wake,193400000X,Group,Single Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,109 W GANNON AVE   ZEBULON NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,11009 INGLESIDE PL STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,11009 INGLESIDE PL STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,8410 LOUISBURG RD STE 130 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,8410 LOUISBURG RD STE 130 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,1009 STADIUM DR STE 124 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,1009 STADIUM DR STE 124 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,#,#, 23 ,$#,,
MEDICAID DIRECT,1962926451,SOUTHEASTERN REGIONAL MEDICAL CENTE,SRMC-INTENSIVISTS,300 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1548410095,"VAIDYA, SATYANARAYANA, RAO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 45 , 55 ,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548410095,"VAIDYA, SATYANARAYANA, RAO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 58 , 147 , 161 ," $10,854.17 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548410863,"WALLACE, ASHLEY, SMITH",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548412042,"ARNOLD-ROBICHAUX, KRISHA, LAMONICA",320 BOULEVARD ST   HIGH POINT NC,041,Guilford,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548419203,"JONES, COURTNEY, CRAWFORD",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548422595,"SARAIYA, NEHALI, VIRA",724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548422595,"SARAIYA, NEHALI, VIRA",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 63 , 84 , 111 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548422595,"SARAIYA, NEHALI, VIRA",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548422595,"SARAIYA, NEHALI, VIRA",10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548424666,"ARORI, CHRISTOPHER, NYAKUNDI",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548424666,"ARORI, CHRISTOPHER, NYAKUNDI",2717 NEUSE BLVD   NEW BERN NC,025,Craven,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 20 , 152 , 152 ," $11,778.55 ",,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548425309,"RUIZ, JOSE, ANTHONY",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 49 , 64 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548427651,"LULEY, TOMAS",1450 MATTHEWS TOWNSHIP PKWY STE 300 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 30 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548427651,"LULEY, TOMAS",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548428964,"JACKSON, STEPHEN, DANIEL",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548428964,"JACKSON, STEPHEN, DANIEL",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548428964,"JACKSON, STEPHEN, DANIEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548428964,"JACKSON, STEPHEN, DANIEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548429343,"NEWLIN, ENOBONG",201 E WENDOVER AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 158 , 286 , 440 ,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548429871,"SAULLO, THOMAS, ROBERT",2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 60 , 114 , 251 ,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548429871,"SAULLO, THOMAS, ROBERT",4590 PREMIER DR   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 20 , 28 , 35 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548429897,"SROKA, JOSEPH, MICHAEL",2620 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1548432131,"NJAPA, JACQUELINE, MASALE",507 E FREMONT ST   BURGAW NC,071,Pender,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548432131,"NJAPA, JACQUELINE, MASALE",507 E FREMONT ST   BURGAW NC,071,Pender,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548432131,"NJAPA, JACQUELINE, MASALE",9104 MARKET ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548432131,"NJAPA, JACQUELINE, MASALE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548432131,"NJAPA, JACQUELINE, MASALE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 49 , 54 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548432131,"NJAPA, JACQUELINE, MASALE",9104 MARKET ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548432131,"NJAPA, JACQUELINE, MASALE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 29 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548434921,"VAJZOVIC, LEJLA",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548434921,"VAJZOVIC, LEJLA",2100 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 29 , 59 , 150 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548434921,"VAJZOVIC, LEJLA",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 69 , 122 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548434921,"VAJZOVIC, LEJLA",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 26 , 53 ,$#,,
MEDICAID DIRECT,1295016038,UNC PHYSICIANS NETWORK LLC,CAROLINA ADVANCED HEALTH,6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1548435456,"NOORANI, SEZMIN, SHAMSHERALI",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548435456,"NOORANI, SEZMIN, SHAMSHERALI",1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1679996292,UNC PHYSICIANS NETWORK LLC,~,1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548435456,"NOORANI, SEZMIN, SHAMSHERALI",1181 WEAVER DAIRY RD STE 250 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548435795,"STORY, DAVID, JAMES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 141 , 157 , 171 ," $11,952.95 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548435977,"GRAVES, BENJAMIN, RAY",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548435977,"GRAVES, BENJAMIN, RAY",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548435977,"GRAVES, BENJAMIN, RAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 62 , 82 , 103 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548435977,"GRAVES, BENJAMIN, RAY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 19 , 21 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548436199,"CARIM, MARIANNE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548436199,"CARIM, MARIANNE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548436264,"JEFFERY, CHELLE, STINSON",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548436264,"JEFFERY, CHELLE, STINSON",1941 NEW GARDEN RD STE 216 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 50 , 151 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548437247,"NEAL, KATHERINE, NICOLE",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548437247,"NEAL, KATHERINE, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548437247,"NEAL, KATHERINE, NICOLE",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588043103,PROWELLNESS FAMILY CHIROPRACTIC,,644 CLARK DR   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1548439102,"OWINGS, JENNIFER, ROBIN",644 CLARK DR   LINCOLNTON NC,055,Lincoln,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1548439839,INVISION FAMILY EYECARE,Invision Family Eyecare,6167 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548439839,INVISION FAMILY EYECARE,6167 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 459 , 464 , 926 ," $12,701.44 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548440696,"MCDOWELL, JOHN, NEWTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 43 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548441702,"CALDWELL, JASON, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1548442379,MADISON COUNTY SCHOOLS,,5738 US 25/70 HWY   MARSHALL NC,057,Madison,251300000X,Agencies,Local Education Agency (LEA),,1548442379,MADISON COUNTY SCHOOLS,5738 US 25/70 HWY   MARSHALL NC,057,Madison,251300000X,Agencies,Local Education Agency (LEA),, 127 ," 1,280 "," 1,295 "," $56,818.23 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548443518,"JACUMIN, ERIKA, LEIGH",932 MORREENE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548443518,"JACUMIN, ERIKA, LEIGH",932 MORREENE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 24 , 44 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548444003,"LILLEY, JOHN, DAVID",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 58 , 80 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1548444003,"LILLEY, JOHN, DAVID",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1548444003,"LILLEY, JOHN, DAVID",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548444003,"LILLEY, JOHN, DAVID",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548450638,"KLAUSNER, BRIAN, THOMAS",150 E DAVIE ST   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548450638,"KLAUSNER, BRIAN, THOMAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699186619,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE DOWNTOWN RALEIGH,150 E DAVIE ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548450638,"KLAUSNER, BRIAN, THOMAS",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528704418,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CENTER FOR COMMUNITY HEALTH,2600 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548450638,"KLAUSNER, BRIAN, THOMAS",2600 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 57 , 64 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548450778,"MILLER, BRIAN, DOUGLAS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 39 , 50 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548450778,"MILLER, BRIAN, DOUGLAS",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 55 , 81 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548450778,"MILLER, BRIAN, DOUGLAS",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548450778,"MILLER, BRIAN, DOUGLAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 19 , 29 ,$#,,
MEDICAID DIRECT,1194964379,WAKE FOREST UNIVERSITY HEALTH SCIEN,Wake Forest University Health Sciences,,,Unknown,193400000X,Group,Single Specialty,,1548450778,"MILLER, BRIAN, DOUGLAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548450778,"MILLER, BRIAN, DOUGLAS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548450778,"MILLER, BRIAN, DOUGLAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548451669,"CAPP, ROBERTA",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548451669,"CAPP, ROBERTA",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1548452238,"FLETCHER, PATRICIA, PORTEOUS",ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548452238,"FLETCHER, PATRICIA, PORTEOUS",ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548452238,"FLETCHER, PATRICIA, PORTEOUS",ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548452238,"FLETCHER, PATRICIA, PORTEOUS",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548458367,"POMEROY, WILLIAM, LOOMIS",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548458367,"POMEROY, WILLIAM, LOOMIS",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548458367,"POMEROY, WILLIAM, LOOMIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 42 , 51 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548458367,"POMEROY, WILLIAM, LOOMIS",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548458367,"POMEROY, WILLIAM, LOOMIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 107 , 145 , 188 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1548458367,"POMEROY, WILLIAM, LOOMIS",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548458375,"GOINS, CARL, DOUGLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174635882,GILLIAM AND GILLIAM PLLC,~,2 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1548460298,"GILLIAM, CONNIE, BRUCE",2 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,445 "," 2,702 "," 10,999 "," $501,624.79 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,178 HIGHWAY 105 EXT STE 101 BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1548462161,"POOLE, RICHARD, WILLIAM",2280 HWY 70 SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2280 HWY 70 SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548462161,"POOLE, RICHARD, WILLIAM",2280 HWY 70 SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 79 , 162 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548462161,"POOLE, RICHARD, WILLIAM",2280 HWY 70 SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1548463086,BOBBY ABBOTT,SARAHS HOUSE,21 COLLEGE ROAD EXT   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548463086,BOBBY ABBOTT,21 COLLEGE ROAD EXT   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 595 , 595 ," $62,223.98 ",,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548463433,"SALTZMANN, ROBERT, MICHAEL",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 43 , 68 , 120 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,400 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548463433,"SALTZMANN, ROBERT, MICHAEL",400 PARK ST   BELMONT NC,036,Gaston,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548463433,"SALTZMANN, ROBERT, MICHAEL",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 98 , 147 , 259 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548465792,"SHAH, KESHA, DESAI",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 396 , 479 , 580 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548465792,"SHAH, KESHA, DESAI",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 25 ,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1548465792,"SHAH, KESHA, DESAI",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548465792,"SHAH, KESHA, DESAI",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 43 , 48 , 62 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548465792,"SHAH, KESHA, DESAI",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 234 , 244 , 309 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1548465792,"SHAH, KESHA, DESAI",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548466030,"KINER, JASON, LAWRENCE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548467152,"SELANDER, CRAIG, LEE",3617 CASEY ST STE D LORIS SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548467152,"SELANDER, CRAIG, LEE",3980 HIGHWAY 9 E STE 220 LITTLE RIVER SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1548467335,"WHITE, ANNA, VARLEY",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1548467335,"WHITE, ANNA, VARLEY",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 100 , 204 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548467392,"DREYER, SAMANTHA, CLARE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 123 , 123 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548467855,"DONAHUE, TIMOTHY, JOSHUA",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",336 DEERFIELD RD   BOONE NC,095,Watauga,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 42 , 42 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 38 , 38 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",117 E KINGS HWY   EDEN NC,079,Rockingham,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 30 , 109 , 115 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 77 , 77 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,100 AIRPORT RD FL 4 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1548468754,"BAVEJA, PUNIT",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548469224,"CICHON, MARTIN, PETER",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548469224,"CICHON, MARTIN, PETER",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568610889,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,704 GOLD HILL RD STE 1200 FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548469224,"CICHON, MARTIN, PETER",231 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548469224,"CICHON, MARTIN, PETER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1649545195,NEPHROPATHOLOGY ASSOCIATES PLC,ARKANA LABORATORIESNEPHROPATH,10810 EXECUTIVE CENTER DR STE 100 LITTLE ROCK AR,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548469745,"BOILS, CHRISTIE, LYNN",10810 EXECUTIVE CENTER DR STE 100 LITTLE ROCK AR,102,Out of State > 40 miles,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 17 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1548470503,"SCARBROUGH, MARY, WHITEN",1 HOSPITAL RD   CHEROKEE NC,087,Swain,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548471964,"RAMIREZ, BRYANT",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548473804,"SHAH, SMIRESH, SURESH",5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 32 , 36 , 66 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548473804,"SHAH, SMIRESH, SURESH",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 26 , 27 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548473804,"SHAH, SMIRESH, SURESH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548473804,"SHAH, SMIRESH, SURESH",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548473804,"SHAH, SMIRESH, SURESH",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 49 , 54 , 100 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1548474463,"RESPESS, TRACEY, BLACK",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548474463,"RESPESS, TRACEY, BLACK",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 33 , 88 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548474505,"STONER, KRISTEN, RENEE",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548474505,"STONER, KRISTEN, RENEE",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548474505,"STONER, KRISTEN, RENEE",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 78 , 253 ,$#,,
MEDICAID DIRECT,1356730741,DAVID E THOME DDS PLLC IV,STATESVILLE PEDIATRIC DENTISTRY,1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548474950,"KENDRICK, TONYA, MEALOR",1454 FERN CREEK DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 540 , 597 ," 2,208 "," $73,820.42 ",,
MEDICAID DIRECT,1669920609,DAVID E THOME DDS PLLC VII,DENVER PEDIATRIC DENTISTRY,275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548474950,"KENDRICK, TONYA, MEALOR",275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1548474950,"KENDRICK, TONYA, MEALOR",8631 ARBOR CREEK DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538935432,THOME & KENDRICK DDS PLLC,,9625 NORTHCROSS CENTER CT STE 101 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548474950,"KENDRICK, TONYA, MEALOR",9625 NORTHCROSS CENTER CT   HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548474950,"KENDRICK, TONYA, MEALOR",7856 VILLAGE CTR N STE 200 SHERRILLS FORD NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 17 , 79 ,$#,,
MEDICAID DIRECT,1437338050,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548478019,"AUSBECK, ELIZABETH, BATES",620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 29 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548478019,"AUSBECK, ELIZABETH, BATES",1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 22 , 25 , 63 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548478019,"AUSBECK, ELIZABETH, BATES",19475 OLD JETTON RD STE 101 CORNELIUS NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 28 ,$#,,
MEDICAID DIRECT,1548480718,LISA ANN ROGERS,BETHANY TENDER LOVE AND CARE,532 GREENWOOD DR   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548480718,LISA ANN ROGERS,532 GREENWOOD DR   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,087 "," 1,087 "," $71,869.99 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548485113,"DEHMER, ELIZABETH, WEAVER",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 150 , 272 , 325 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548490717,"SANIKOMMU, SRINIVASA, REDDY",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548490717,"SANIKOMMU, SRINIVASA, REDDY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 22 , 22 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548490717,"SANIKOMMU, SRINIVASA, REDDY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548490717,"SANIKOMMU, SRINIVASA, REDDY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 18 , 29 , 29 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548490717,"SANIKOMMU, SRINIVASA, REDDY",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548490717,"SANIKOMMU, SRINIVASA, REDDY",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1548491004,"MEKA, NAGA, PURNACHAND",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 48 , 101 , 101 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548491004,"MEKA, NAGA, PURNACHAND",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 196 , 204 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548491004,"MEKA, NAGA, PURNACHAND",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548491699,"SEARLES, ALISHA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548491699,"SEARLES, ALISHA, MARIE",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 23 ,$#,,
MEDICAID DIRECT,1548492002,AMAZING HOME CARE AGENCY LLC,~,1909 BRAGG BLVD STE 102B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1548492002,AMAZING HOME CARE AGENCY LLC,1909 BRAGG BLVD STE 102B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 5,579 "," 6,104 "," $680,635.68 ",,
MEDICAID DIRECT,1548492937,JAY HOME CARE AGENCY LLC,JAY HOME CARE AGENCY LLC,4705 SILVERTOWN RD   ENFIELD NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,,1548492937,JAY HOME CARE AGENCY LLC,4705 SILVERTOWN RD   ENFIELD NC,042,Halifax,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,995 "," 3,188 "," $481,666.28 ",,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548493620,"WARREN, JENNIFER, MARIE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548493620,"WARREN, JENNIFER, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548494404,DIVINE HOME CARE INC,~,2928 HWY 401 BUS   RAEFORD NC,047,Hoke,251B00000X,Agencies,Case Management,,1548494404,DIVINE HOME CARE INC,2928 HWY 401 BUS   RAEFORD NC,047,Hoke,251B00000X,Agencies,Case Management,, 104 , 943 , 943 ," $325,690.01 ",,
MEDICAID DIRECT,1548494404,DIVINE HOME CARE INC,~,2928 HWY 401 BUS   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1548494404,DIVINE HOME CARE INC,2928 HWY 401 BUS   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,, 20 ," 3,550 "," 3,560 "," $513,315.64 ",,
MEDICAID DIRECT,1548494404,DIVINE HOME CARE INC,~,2928 HWY 401 BUS   RAEFORD NC,047,Hoke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1548494404,DIVINE HOME CARE INC,2928 HWY 401 BUS   RAEFORD NC,047,Hoke,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 59 , 99 , 99 ," $120,354.49 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548494792,"DE LEON, LAURA, AUTUMN",133 WELTON WAY STE C MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 20 , 42 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548494792,"DE LEON, LAURA, AUTUMN",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548494792,"DE LEON, LAURA, AUTUMN",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427683044,NH DIGITAL HEALTH SERVICES LLC,NOVANT HEALTH DIGITAL CARE GROUP,2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548494792,"DE LEON, LAURA, AUTUMN",2085 FRONTIS PLAZA BVLD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548495823,"LAUGHON, SARAH, LIESL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 21 , 28 , 36 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548496490,"PATEL, MIT, BAKULESH",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 167 , 170 , 453 ," $20,376.06 ",,
MEDICAID DIRECT,1346473279,KNOWLES SMITH & ASSOCIATES LLP,SOUTHEASTERN DENTAL SPECIALISTS,2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548496490,"PATEL, MIT, BAKULESH",2028 LITHO PL STE 200 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548496490,"PATEL, MIT, BAKULESH",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548496490,"PATEL, MIT, BAKULESH",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 52 , 135 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548496490,"PATEL, MIT, BAKULESH",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 96 , 127 , 340 ," $19,717.02 ",,
MEDICAID DIRECT,1497059877,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,104 SOUTHERN AVE   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1548496490,"PATEL, MIT, BAKULESH",104 W SOUTHERN AVE   RAEFORD NC,047,Hoke,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548496813,"HELGESON, ASHLEY, PROCOPIO ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 48 , 68 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548496813,"HELGESON, ASHLEY, PROCOPIO ALLEN",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548496813,"HELGESON, ASHLEY, PROCOPIO ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 80 , 94 , 127 ,$#,,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548497050,"ASHE, TANYA, ELIZABETH",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1538267224,H J BROWN AND ASSOCIATES DDS PA,H J BROWN AND ASSOCIATES DDS PA,410 W 14TH ST STE B GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548497050,"ASHE, TANYA, ELIZABETH",410 W 14TH ST STE B GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 607 , 836 ," 2,603 "," $192,275.06 ",,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548497050,"ASHE, TANYA, ELIZABETH",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1962544197,CHARLES R DISDIER DDS PA,IMMEDIATE DENTAL CARE,1468 TARBORO ST W STE F WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548497050,"ASHE, TANYA, ELIZABETH",1468 TARBORO ST W STE F WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 682 , 781 ," 3,641 "," $202,055.34 ",,
MEDICAID DIRECT,1669514576,DISDIER & ASSOCIATES,IMMEDIATE DENTAL CARE,1208 E ASH ST   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548497050,"ASHE, TANYA, ELIZABETH",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice, 275 , 399 ," 1,180 "," $81,069.04 ",,
MEDICAID DIRECT,1962544197,CHARLES R DISDIER DDS PA,IMMEDIATE DENTAL CARE,1468 TARBORO ST W STE F WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548497050,"ASHE, TANYA, ELIZABETH",1208 E ASH ST   GOLDSBORO NC,096,Wayne,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548497381,"SIMMONS, BENJAMIN, FRANKLYN",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548497381,"SIMMONS, BENJAMIN, FRANKLYN",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548497381,"SIMMONS, BENJAMIN, FRANKLYN",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 103 , 175 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548497381,"SIMMONS, BENJAMIN, FRANKLYN",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548497381,"SIMMONS, BENJAMIN, FRANKLYN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548497381,"SIMMONS, BENJAMIN, FRANKLYN",10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 26 , 32 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548497381,"SIMMONS, BENJAMIN, FRANKLYN",10545 BLAIR RD STE 1200 MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1548498835,"CUNNINGHAM, SAMANTHA, LYNNE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1548498835,"CUNNINGHAM, SAMANTHA, LYNNE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 54 , 54 ,$#,,
MEDICAID DIRECT,1952372500,GRANVILLE HEALTH INC,GRANVILLE SURGICAL ASSOCIATES,101 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1548498975,"HODGE, SHANE, MICHAEL",101 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1952372500,GRANVILLE HEALTH INC,GRANVILLE SURGICAL ASSOCIATES,102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1548498975,"HODGE, SHANE, MICHAEL",101 PROFESSIONAL PARK STE B OXFORD NC,039,Granville,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1952372500,GRANVILLE HEALTH INC,GRANVILLE SURGICAL ASSOCIATES,102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1548498975,"HODGE, SHANE, MICHAEL",102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 48 , 56 ,$#,,
MEDICAID DIRECT,1689222689,ALYSSA SPROWL DDS MS PLLC,A LIST SMILES ORTHODONTICS,2510 VISTA DR STE 103 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548499346,"SPROWL, ALYSSA, ELAINIA",5306 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1689222689,ALYSSA SPROWL DDS MS PLLC,A LIST SMILES ORTHODONTICS,2510 VISTA DR STE 103 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548499346,"SPROWL, ALYSSA, ELAINIA",2510 VISTA DR STE 103 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,618 "," 5,967 "," 7,180 "," $882,613.42 ",,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548500085,"HIMES, KRISTIN, ANN",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548500085,"HIMES, KRISTIN, ANN",3900 TERRELL PARK DR STE 100 SHERRILLS FORD NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548500085,"HIMES, KRISTIN, ANN",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 80 , 146 ,$#,,
MEDICAID DIRECT,1780094771,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY PULMONARY AND SLEEP MEDICINE,2386 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548500085,"HIMES, KRISTIN, ANN",2386 SPRINGS RD NE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 24 ,$#,,
MEDICAID DIRECT,1174533624,HAMPTON ROADS RADIOLOGY ASSOC,HAMPTON ROADS RADIOLOGY ASSOC,582 LYNNHAVEN PKWY STE 301 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548502628,"TRACE, ANTHONY, PAUL",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548503311,"GRAMMATICO, ROBERT, JOHN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1548503311,"GRAMMATICO, ROBERT, JOHN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 21 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548503311,"GRAMMATICO, ROBERT, JOHN",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548503543,"DESAI, LEKHA, KOPPOLU",1212 CENTRAL DR STE 102 SANFORD NC,053,Lee,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548503543,"DESAI, LEKHA, KOPPOLU",120 CONNER DR STE 100 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548503543,"DESAI, LEKHA, KOPPOLU",2308 WESVILL CT   RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548503543,"DESAI, LEKHA, KOPPOLU",106 RIDGE VIEW DR STE 100 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1760408397,RETINA ASSOCIATES PLLC,~,4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548503543,"DESAI, LEKHA, KOPPOLU",4414 LAKE BOONE TRL STE 302 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 25 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548505563,"EREZO, KATHLEEN, BUSTAMANTE VIADO",885 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548508310,"HUFFMAN, RUTH, HINKLE",130 GLENDALE DR W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 83 , 116 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,130 GLENDALE DR W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548508310,"HUFFMAN, RUTH, HINKLE",130 GLENDALE DR W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 268 , 341 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548510191,"HIGHLAND, WHITNIE",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548511132,"GLEASON, LAURA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548511132,"GLEASON, LAURA, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548511132,"GLEASON, LAURA, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548511132,"GLEASON, LAURA, RENEE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447478771,MOHAMED & ASSOCIATES UROLOGY CTR PA,~,507 N BRIGHTLEAF BLVD STE 205 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1548511207,"HOOVER, RYAN, LLOYD",507 N BRIGHTLEAF BLVD STE 205 SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 115 , 202 ,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548511207,"HOOVER, RYAN, LLOYD",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 45 , 83 ,$#,,
MEDICAID DIRECT,1548512122,WALGREEN CO,WALGREENS 15251,700 CATHERINE CREEK RD S   AHOSKIE NC,046,Hertford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1548512122,WALGREEN CO,700 CATHERINE CREEK RD S   AHOSKIE NC,046,Hertford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548512767,"GOODWIN, MATTHEW, TROY",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 24 , 42 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548512767,"GOODWIN, MATTHEW, TROY",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 26 , 29 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548512767,"GOODWIN, MATTHEW, TROY",451 E CHARLOTTE AVE   MT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,615 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1548512767,"GOODWIN, MATTHEW, TROY",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548512767,"GOODWIN, MATTHEW, TROY",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 61 , 135 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548512767,"GOODWIN, MATTHEW, TROY",451 E CHARLOTTE AVE   MT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548516925,"CHAPMAN, LEAH, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,, 23 , 29 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,,,Unknown,193200000X,Group,Multi-Specialty,,1548516925,"CHAPMAN, LEAH, ANNE",4505 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548517055,"BEDDINGFIELD, CASEY, BAUGHMAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548517055,"BEDDINGFIELD, CASEY, BAUGHMAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1548519077,"HUGHES, LINDA, COX",115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 108 , 503 ," $21,799.08 ",,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1548519077,"HUGHES, LINDA, COX",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1124154216,GRANVILLE HEALTH SYSTEM,~,1010 COLLEGE ST   OXFORD NC,039,Granville,251B00000X,Agencies,Case Management,,1548519077,"HUGHES, LINDA, COX",1032 COLLEGE ST   OXFORD NC,039,Granville,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,1032 COLLEGE ST   OXFORD NC,039,Granville,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1548519077,"HUGHES, LINDA, COX",1032 COLLEGE ST   OXFORD NC,039,Granville,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 68 , 114 , 466 ," $19,346.50 ",,
MEDICAID DIRECT,1548521115,MITCHELL HOUSE ONE LLC,MITCHELL HOUSE,13681 S HIGHWAY 226   SPRUCE PINE NC,061,Mitchell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1548521115,MITCHELL HOUSE ONE LLC,13681 S HIGHWAY 226   SPRUCE PINE NC,061,Mitchell,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 28 , 94 , 94 ,$#,,
MEDICAID DIRECT,1548521115,MITCHELL HOUSE ONE LLC,MITCHELL HOUSE,13681 S HIGHWAY 226   SPRUCE PINE NC,061,Mitchell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548521115,MITCHELL HOUSE ONE LLC,13681 S HIGHWAY 226   SPRUCE PINE NC,061,Mitchell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 48 ," 7,945 "," 7,946 "," $787,266.55 ",,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548521966,"COLLINS, BRIAN, ADAM",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548521966,"COLLINS, BRIAN, ADAM",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548521966,"COLLINS, BRIAN, ADAM",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 76 , 80 , 123 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548521966,"COLLINS, BRIAN, ADAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1548521966,"COLLINS, BRIAN, ADAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 22 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548521966,"COLLINS, BRIAN, ADAM",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841757507,HAMMOCK DMD & LOTAKIS DDS V PLLC,DENTISTRY OF THE CAROLINAS - STATESVILLE,730 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548521982,"HAMASAGAR, ANAND, MOHAN",730 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 51 ," $13,376.05 ",,
MEDICAID DIRECT,1699585554,HAMASAGAR DDS PLLC,,730 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1548521982,"HAMASAGAR, ANAND, MOHAN",730 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 136 , 197 , 769 ," $47,471.22 ",,
MEDICAID DIRECT,1841757507,HAMMOCK DMD & LOTAKIS DDS V PLLC,DENTISTRY OF THE CAROLINAS - STATESVILLE,730 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548521982,"HAMASAGAR, ANAND, MOHAN",40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1346059342,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CONCORD,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548521982,"HAMASAGAR, ANAND, MOHAN",40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1932729688,OBRIEN AND WEST DMD IX PLLC,NIGHT AND DAY DENTAL,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548521982,"HAMASAGAR, ANAND, MOHAN",40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 294 , 436 ," 1,243 "," $77,333.90 ",,
MEDICAID DIRECT,1346059342,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CONCORD,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548521982,"HAMASAGAR, ANAND, MOHAN",40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,618 S PIERCE ST STE 203 EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1548522329,"STRAUGHAN, MEGAN, KATHLEEN",618 S PIERCE ST STE 203 EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 53 , 85 , 104 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548522329,"STRAUGHAN, MEGAN, KATHLEEN",117 E KINGS HWY   EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 30 , 48 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1548522329,"STRAUGHAN, MEGAN, KATHLEEN",117 E KINGS HWY   EDEN NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548523012,"NORMAN, JOHN, MICHAEL",5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548523012,"NORMAN, JOHN, MICHAEL",5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548523012,"NORMAN, JOHN, MICHAEL",5050 HIGHWAY 17 BYP S   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548523210,"VERRASTRO, GENEVIEVE, DOLLARD",218 ELKWOOD AVE STE 102 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548523210,"VERRASTRO, GENEVIEVE, DOLLARD",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1265774590,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548523210,"VERRASTRO, GENEVIEVE, DOLLARD",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 40 , 40 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548523210,"VERRASTRO, GENEVIEVE, DOLLARD",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 12 , 26 ,$#,,
MEDICAID DIRECT,1255805065,CAREPARTNERS HHA LLLP,CAREPARTNERS PRIVATE DUTY SERVICES,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1548523210,"VERRASTRO, GENEVIEVE, DOLLARD",257 BILTMORE AVE STE 100 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548523210,"VERRASTRO, GENEVIEVE, DOLLARD",218 ELKWOOD AVE STE 102 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548526312,"KAZAURE, HADIZA, SHUAIB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548526312,"KAZAURE, HADIZA, SHUAIB",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548526312,"KAZAURE, HADIZA, SHUAIB",2301 ERWIN ROAD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548526312,"KAZAURE, HADIZA, SHUAIB",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548526395,"STROCK, STEPHEN, BLAINE",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1548526395,"STROCK, STEPHEN, BLAINE",30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548526395,"STROCK, STEPHEN, BLAINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 38 , 53 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548526395,"STROCK, STEPHEN, BLAINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 23 , 22 , 26 ," $10,243.88 ",,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1548526411,"BONNER, EARIC, RAMON",105 MARK DR   EDENTON NC,021,Chowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548526411,"BONNER, EARIC, RAMON",105 MARK DR   EDENTON NC,021,Chowan,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639661796,OPPORTUNITIES INDUSTRIALIZATION CEN,~,260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548526411,"BONNER, EARIC, RAMON",260 ALBEMARLE AVE   ROCKY MOUNT NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922020908,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER,111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548526411,"BONNER, EARIC, RAMON",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548526411,"BONNER, EARIC, RAMON",111 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528478237,OPPORTUNITIES INDUSTRIALIZATION CEN,OIC FAMILY MEDICAL CENTER AT HAPPY HILL,300 N GRACE ST   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548526411,"BONNER, EARIC, RAMON",2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548526411,"BONNER, EARIC, RAMON",2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1578219424,OPPORTUNITIES INDUSTRIALIZATION CEN,,2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548526411,"BONNER, EARIC, RAMON",2309 SUNSET AVE   ROCKY MOUNT NC,064,Nash,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548526411,"BONNER, EARIC, RAMON",300 N GRACE ST   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548526411,"BONNER, EARIC, RAMON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 173 , 293 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1548526411,"BONNER, EARIC, RAMON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 50 , 50 ," $19,792.50 ",,
MEDICAID DIRECT,1548526569,"WARNER, SHIRLEY, ANNE",~,1006 S JEFFERSON AVE   WEST JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1548526569,"WARNER, SHIRLEY, ANNE",1006 S JEFFERSON AVE   WEST JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 339 , 411 ," $11,690.03 ",,
MEDICAID DIRECT,1073965760,HIGH COUNTRY HOUSE CALL,,1006 S JEFFERSON AVE   W JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1548526569,"WARNER, SHIRLEY, ANNE",1006 S JEFFERSON AVE   WEST JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 440 , 640 ,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548526825,"OSHO, AYOKUNLE, TOLULOPE",653 BLUEFIELD RD   MOORESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1548526825,"OSHO, AYOKUNLE, TOLULOPE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 357 , 512 , 647 ,$#,,
MEDICAID DIRECT,1235197179,IREDELL RADIOLOGY ASSOCIATES PA,IREDELL RADIOLOGY ASSOCIATES PA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548526825,"OSHO, AYOKUNLE, TOLULOPE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 23 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548527880,"VORIS, ANDREW, CHARLES",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548527880,"VORIS, ANDREW, CHARLES",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 21 , 26 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548527880,"VORIS, ANDREW, CHARLES",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548527880,"VORIS, ANDREW, CHARLES",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548527880,"VORIS, ANDREW, CHARLES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 41 , 59 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548527880,"VORIS, ANDREW, CHARLES",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548528375,"BROWN, RYAN, KEITH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 78 , 78 , 78 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548529001,"BROOKS, KARA",10512 PARK RD STE 113 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 20 , 29 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,193400000X,Group,Single Specialty,,1548529001,"BROOKS, KARA",701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548529001,"BROOKS, KARA",1423 E FRANKLIN ST STE E MONROE NC,090,Union,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 30 , 53 , 111 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548529001,"BROOKS, KARA",701 E ROOSEVELT BLVD STE 200A MONROE NC,090,Union,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 21 , 46 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548529050,"KINNEY, TINA, LOUISE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 130 , 148 , 315 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548531254,"ANDERSON, CHERYL, HUANG",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 29 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548531254,"ANDERSON, CHERYL, HUANG",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548538341,"STRITCH, MEGAN, LYNN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 25 , 25 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548538341,"STRITCH, MEGAN, LYNN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548538341,"STRITCH, MEGAN, LYNN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548546534,CAREONE HOMES NC,~,926 EDISON RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548546534,CAREONE HOMES NC,926 EDISON RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1790298024,CHALLIE MINTON MD,,113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1548547359,"SANDUSKY, JOSEPH, EDWARD",113 SCENIC OUTLET LN STE 2 MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 125 , 194 , 445 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548548514,"BARLOW, TRACY, KIDD",2605 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 87 , 91 ,$#,,
MEDICAID DIRECT,1861777468,REX HOSPITAL INC,REX PULMONARY SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548548514,"BARLOW, TRACY, KIDD",6000 FAYETTEVILLE RD   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 25 , 27 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548550494,"HU, BEI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548550494,"HU, BEI",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 23 , 24 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548550494,"HU, BEI",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 40 , 40 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548550544,"HILLER, DAVID, JOHNSON",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548550544,"HILLER, DAVID, JOHNSON",2825 LYNDHURST AVE STE 101 WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 35 , 42 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548550544,"HILLER, DAVID, JOHNSON",7210 VILLAGE MEDICAL CIR STE 310 CLEMMONS NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 52 , 82 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1548553837,"FREDLUND, KATHERINE, LEA",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1548553837,"FREDLUND, KATHERINE, LEA",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548553837,"FREDLUND, KATHERINE, LEA",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548553837,"FREDLUND, KATHERINE, LEA",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1548553837,"FREDLUND, KATHERINE, LEA",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 84 , 84 , 134 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548554587,"ROY, PINAKPANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 14 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548554587,"ROY, PINAKPANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548554587,"ROY, PINAKPANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548554587,"ROY, PINAKPANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 181 , 187 , 223 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548554587,"ROY, PINAKPANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548554587,"ROY, PINAKPANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548554587,"ROY, PINAKPANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073881850,MOSES CONE PHYSICIAN SERVICES INC,REIDSVILLE PEDIATRICS,1816 RICHARDSON DR   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1548556228,"BYFIELD, CELECIA, ROSE-MARIE",1816 RICHARDSON DR   REIDSVILLE NC,079,Rockingham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 20 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548556533,"PEREZ, ARIELLE, JACLYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1548556533,"PEREZ, ARIELLE, JACLYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 29 , 32 , 42 ,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548556749,"KANG-OH, LEAH, ELIZABETH",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 34 , 51 , 92 ,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548556749,"KANG-OH, LEAH, ELIZABETH",903 RANDOLPH ST   THOMASVILLE NC,029,Davidson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 79 , 148 , 255 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548558281,"CAVINESS, JAMES, WILLIAM",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548558281,"CAVINESS, JAMES, WILLIAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 23 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548558281,"CAVINESS, JAMES, WILLIAM",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1427528595,TRIAD SEDATION ASSOCIATES LLC,,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548558349,"RODRIGUEZ, MARITESS, LAURENTE",137 MOUNT CALVARY RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548558349,"RODRIGUEZ, MARITESS, LAURENTE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548558349,"RODRIGUEZ, MARITESS, LAURENTE",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548558562,"ROBERTSON, JESSICA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548558562,"ROBERTSON, JESSICA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 66 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548558562,"ROBERTSON, JESSICA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548558562,"ROBERTSON, JESSICA, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1548559032,"DAHYA, ZARNA, JITENDRA",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548559099,"SHACKLEFORD, JARREL, LYNNE",1099 MEDICAL CENTER DR STE 101 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548559099,"SHACKLEFORD, JARREL, LYNNE",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 68 , 143 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548559404,"HAINES, NATHAN, RONALD",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 14 , 28 , 74 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548559404,"HAINES, NATHAN, RONALD",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 25 , 55 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548559404,"HAINES, NATHAN, RONALD",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548559404,"HAINES, NATHAN, RONALD",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 37 , 79 , 127 ," $18,268.35 ",,
MEDICAID DIRECT,1548559404,"HAINES, NATHAN, RONALD",,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,1548559404,"HAINES, NATHAN, RONALD",195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548559404,"HAINES, NATHAN, RONALD",195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 14 , 11 , 17 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548559404,"HAINES, NATHAN, RONALD",195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548559404,"HAINES, NATHAN, RONALD",195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 29 , 61 , 93 ," $12,429.65 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548559628,"BURKHART, BRIAN, WESLEY",1704 GLENDALE DR SW STE C WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548560600,REX SURGERY CENTER OF CARY LLC,~,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1548560600,REX SURGERY CENTER OF CARY LLC,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548562598,"SOCHA, LAUREL, KAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548563976,"WARD, KATHERINE, ROSE",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548565591,SUPERIOR HOME CARE INC,SUPERIOR HOME CARE INC,1709 N LONG ST   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1548565591,SUPERIOR HOME CARE INC,1709 N LONG ST   SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,#, 829 , 829 ," $81,640.08 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548569791,"RAJA, SHRUTI, MUKUND",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548570682,"SUMNEY, LILI, TELEKI",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548570948,"RAHMAN, FARZANA",RAHMAN & ASSOCIATES,6208 FAYETTEVILLE RD STE 105 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1548570948,"RAHMAN, FARZANA",6208 FAYETTEVILLE RD STE 105 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 550 ," 2,066 "," 5,178 "," $451,304.23 ",,
MEDICAID DIRECT,1548570948,"RAHMAN, FARZANA",RAHMAN & ASSOCIATES,6208 FAYETTEVILLE RD STE 105 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1548570948,"RAHMAN, FARZANA",6208 FAYETTEVILLE RD STE 105 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548570948,"RAHMAN, FARZANA",RAHMAN & ASSOCIATES,6208 FAYETTEVILLE RD STE 105 DURHAM NC,032,Durham,1223P0700X,Dental Providers,Dentist,Prosthodontics,1548570948,"RAHMAN, FARZANA",6208 FAYETTEVILLE RD STE 105 DURHAM NC,032,Durham,1223P0700X,Dental Providers,Dentist,Prosthodontics, 18 , 20 , 50 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548571987,"WALDEN, JEFFREY, HOWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548571987,"WALDEN, JEFFREY, HOWARD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548572423,"HALL, JULIE, NEMERGUT",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548573231,"PATTON, DAVID, BALIS",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548577232,"LOU, GIN, WEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548577232,"LOU, GIN, WEN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548577232,"LOU, GIN, WEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 41 , 74 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548577232,"LOU, GIN, WEN",3614 PROVIDENCE RD S STE 100 WAXHAW NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 43 , 79 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548580632,"HAUSMAN, JENNIFER, DIANE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 55 , 117 , 118 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548580632,"HAUSMAN, JENNIFER, DIANE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548581119,"JOINES, JUSTIN, BOYETTE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 28 , 31 ,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1548581119,"JOINES, JUSTIN, BOYETTE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548581119,"JOINES, JUSTIN, BOYETTE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 37 , 39 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548581119,"JOINES, JUSTIN, BOYETTE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548581804,"MORRISON, HEATHER, RIEGEL",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548581804,"MORRISON, HEATHER, RIEGEL",400 PARK ST   BELMONT NC,036,Gaston,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 13 , 13 , 26 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548583503,"BADEN, SCOTT, JAMES",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 43 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 34 , 38 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 137 , 144 , 171 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 22 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548585482,"BHAKTA, MEHUL, KANTILAL",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548586977,"OLORUNTOBA, OMOBONIKE, OYINDASOLA",3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548586977,"OLORUNTOBA, OMOBONIKE, OYINDASOLA",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 18 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548586977,"OLORUNTOBA, OMOBONIKE, OYINDASOLA",4220 N ROXBORO ST FL 2 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548586977,"OLORUNTOBA, OMOBONIKE, OYINDASOLA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 52 , 89 , 112 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1548586977,"OLORUNTOBA, OMOBONIKE, OYINDASOLA",4220 N ROXBORO ST FL 2 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548587983,"MCKINNON, REBECCA, KEENER",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 17 , 33 ,$#,,
MEDICAID DIRECT,1902953045,WHITE OAK PEDIATRIC ASSOCIATES PA,~,4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548589609,"JOYNER, KASEY, ALDORIS",4414 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1174800577,NUTRITION IN MOTION,NUTRITION IN MOTION,2517 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548592892,"KENNEDY, SONIA, VIEREGGE",2517 DELANEY AVE   WILMINGTON NC,065,New Hanover,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 32 , 56 , 56 ,$#,,
MEDICAID DIRECT,1356628283,LANE OPTOMETRY PLLC,,1345 WESTERN BLVD STE 120B JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1548596356,"KELLEY, GAIL, JOSLIN",1345 WESTERN BLVD STE 120B JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548596356,"KELLEY, GAIL, JOSLIN",6740 ROCK SPRING RD STE 100 WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548596356,"KELLEY, GAIL, JOSLIN",1345 WESTERN BLVD STE 120B JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,, 25 , 26 , 42 ,$#,,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,1236 HUFFMAN MILL RD STE 2100 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548598899,"PACE, BRIEN, RAYMOND",1236 HUFFMAN MILL RD STE 2100 BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 16 , 16 ,$#,,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548598899,"PACE, BRIEN, RAYMOND",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295134948,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE VEIN AND VASCULAR SURGERY,2977 CROUSE LN   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548598899,"PACE, BRIEN, RAYMOND",2977 CROUSE LN   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1548599244,"BOYKIN, WILLIAM, NEIL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548599244,"BOYKIN, WILLIAM, NEIL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1548599244,"BOYKIN, WILLIAM, NEIL",400 US 70 HWY E   GARNER NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548599244,"BOYKIN, WILLIAM, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548599244,"BOYKIN, WILLIAM, NEIL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548600281,"WOLDEMICHAEL, JOBIRA, ANBESSIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548600281,"WOLDEMICHAEL, JOBIRA, ANBESSIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 124 , 383 , 384 ,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548601396,"COOK, VICTORIA, L.",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548601396,"COOK, VICTORIA, L.",4048 E U S HIGHWAY 64 ALTERNATE STE 1 MURPHY NC,020,Cherokee,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1841644531,APPALACHIAN MOUNTAIN COMMUNITY HEAL,SYLVA COMMUNITY HEALTH CENTER,154 MEDICAL PARK LOOP STE A SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548601396,"COOK, VICTORIA, L.",154 MEDICAL PARK LOOP STE 210 SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1548602121,LOTT MED LLC,~,9700 RESEARCH DR STE 151 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1548602121,LOTT MED LLC,9700 RESEARCH DR STE 151 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 15 , 44 ,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1548603046,"TANZIE, CHRISTOPHER, PARTICK",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1477640415,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,~,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1548603046,"TANZIE, CHRISTOPHER, PARTICK",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 34 , 38 , 44 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1548603046,"TANZIE, CHRISTOPHER, PARTICK",2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2311 E MAIN ST   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1548603046,"TANZIE, CHRISTOPHER, PARTICK",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 49 , 58 , 70 ,$#,,
MEDICAID DIRECT,1205923240,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1548603046,"TANZIE, CHRISTOPHER, PARTICK",2060 HICKORY BLVD SW   LENOIR NC,014,Caldwell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 21 , 24 ,$#,,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1548603046,"TANZIE, CHRISTOPHER, PARTICK",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 190 , 265 , 314 ," $16,896.61 ",,
MEDICAID DIRECT,1093960395,GRAYSTONE EYE SURGERY CENTER LLC,GRAYSTONE EYE SURGERY CENTER LLC,2424 CENTURY PL SE   HICKORY NC,018,Catawba,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1548603046,"TANZIE, CHRISTOPHER, PARTICK",2424 CENTURY PL SE   HICKORY NC,018,Catawba,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 62 , 62 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548604317,"TIBOLLA, NECOLE, ANTOINETTE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548604317,"TIBOLLA, NECOLE, ANTOINETTE",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548604317,"TIBOLLA, NECOLE, ANTOINETTE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1548605694,"FREEMAN, PAUL, TREVOR",720 MALCOLM BLVD   VALDESE NC,012,Burke,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1548605694,"FREEMAN, PAUL, TREVOR",2201 S STERLING ST   MORGANTON NC,012,Burke,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548605694,"FREEMAN, PAUL, TREVOR",720 MALCOLM BLVD   VALDESE NC,012,Burke,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548605694,"FREEMAN, PAUL, TREVOR",2201 S STERLING ST   MORGANTON NC,012,Burke,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 24 , 25 , 27 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1548606536,"THACKER, GREGORY, CHRISTOPHER",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548606791,"GRAY, STEPHANIE, LAUREN",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 58 , 60 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548606791,"GRAY, STEPHANIE, LAUREN",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548606791,"GRAY, STEPHANIE, LAUREN",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 42 , 43 ,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548607591,"STARNES, THOMAS, ALAN",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 41 , 57 , 130 ,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548607591,"STARNES, THOMAS, ALAN",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 31 , 75 ,$#,,
MEDICAID DIRECT,1861977522,MH MISSION IMAGING LLLP,~,149 W PARKER RD STE B MORGANTON NC,012,Burke,293D00000X,Laboratories,Physiological Laboratory,,1548607591,"STARNES, THOMAS, ALAN",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689778300,CAROLINA HAND AND SPORTS MEDICINE,CAROLINA HAND AND SPORTS MEDICINE PA,18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548607591,"STARNES, THOMAS, ALAN",18 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1295766079,SOUTH LAKE PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS SOUTH LAKE PEDIATRI,9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548608292,"HAYES, STEVEN, CHAD",9625 NORTHCROSS CENTER CT STE 201 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548609134,"ANDERSON, EMILY, AIKEN",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548609134,"ANDERSON, EMILY, AIKEN",445 PINEVIEW DR STE 220 KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548609134,"ANDERSON, EMILY, AIKEN",245 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548609936,"MELKUMOV, ALEXEY, BORISOVICH",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 87 , 223 , 223 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1548610967,"GREENLEE, JASON, RICHARD",1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 21 , 48 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1548610967,"GREENLEE, JASON, RICHARD",584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1538276100,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1548610967,"GREENLEE, JASON, RICHARD",401 MULBERRY ST SW STE 210 LENOIR NC,014,Caldwell,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1548610967,"GREENLEE, JASON, RICHARD",911 W HENDERSON ST STE 110 SALISBURY NC,080,Rowan,208800000X,Allopathic & Osteopathic Physicians,Urology,, 72 , 143 , 289 ,$#,,
MEDICAID DIRECT,1336630862,S VAKIL DDS II PA,~,4558 CAPITAL BLVD STE B RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548612500,"METWALLY, AHMED, USAMA EBRAHEM",6301 FALLS OF NEUSE RD STE C RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 78 , 114 , 461 ," $17,825.22 ",,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548614571,"RIGBY, GRAHAM, HOELSCHER",13521 STEELECROFT PKWY STE B CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1255449534,RUSSELL J BARONE DPM PA,RUSSELL J BARONE DPM PA,600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548614571,"RIGBY, GRAHAM, HOELSCHER",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548614571,"RIGBY, GRAHAM, HOELSCHER",600 5TH AVE W   HENDERSONVILLE NC,045,Henderson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548615412,"BOYD, MICHAEL, OWENS",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 92 , 142 , 318 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548615412,"BOYD, MICHAEL, OWENS",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 34 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548615412,"BOYD, MICHAEL, OWENS",3609 SW DURHAM DR   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1548615651,CHANGING LIVES GROUP HOME II LLC,~,5788 BETHEL CHURCH RD   MC LEANSVILLE NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548615651,CHANGING LIVES GROUP HOME II LLC,5788 BETHEL CHURCH RD   MC LEANSVILLE NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 637 , 638 ," $34,885.11 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548616139,"KNIGHT, ANNIE, KATHLEEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548616139,"KNIGHT, ANNIE, KATHLEEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 19 , 28 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548616139,"KNIGHT, ANNIE, KATHLEEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 ,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548616139,"KNIGHT, ANNIE, KATHLEEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 27 , 24 , 28 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548616139,"KNIGHT, ANNIE, KATHLEEN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 37 , 36 , 45 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548616139,"KNIGHT, ANNIE, KATHLEEN",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548616139,"KNIGHT, ANNIE, KATHLEEN",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 40 , 44 , 57 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548616329,"WEINBERG, STEVEN, HERBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 91 , 91 ,$#,,
MEDICAID DIRECT,1669400313,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP TRIANGLE FAMILY PRACTICE,6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548617020,"EGWIEKHOR, AMINA, JOYCE",6020 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 71 , 138 ,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1548618614,"LANAO, ANDREA, ELENA",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 64 , 128 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548619562,"WRIGHT, JAMES, LEWIS",101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548619562,"WRIGHT, JAMES, LEWIS",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 118 , 157 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548620719,"SPAINHOUR, KEVIN, LEON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114250354,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH SALEM SURGICAL ASSOCIATES,2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548620719,"SPAINHOUR, KEVIN, LEON",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548620719,"SPAINHOUR, KEVIN, LEON",2915 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548621436,"MARSZAL, LINDSAY, NICOLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080H0002X,Allopathic & Osteopathic Physicians,Pediatrics,Hospice and Palliative Medicine, 40 , 75 , 114 ," $15,905.69 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548621873,"STEINBACH, ASHLEY, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023486602,RAISE THE BAR THERAPY SERVICES LLC,,18676 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1548622111,"BASKEYFIELD, ALISON, PHILLIPS",18676 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1487969507,FOREFRONT DERMATOLOGY SC,,801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1548622533,"LECKEY, BRUCE, DANIEL",801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 18 , 21 ,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548622657,"PAYNE, BRENDAN, THOMAS",925 N 4TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 117 , 152 ," $10,837.00 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548622822,"WILLIAMS, SARAH, THOMAS",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548622822,"WILLIAMS, SARAH, THOMAS",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 65 , 145 ,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1548624059,"DAO, BENJAMIN, BAO",1614 WILLIAMSBORO ST   OXFORD NC,039,Granville,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 56 , 77 , 104 ,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1548624059,"DAO, BENJAMIN, BAO",710 ERWIN RD   DUNN NC,043,Harnett,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 302 , 582 , 831 ," $27,776.07 ",,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1548624059,"DAO, BENJAMIN, BAO",710 ERWIN RD   DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1548624059,"DAO, BENJAMIN, BAO",710 ERWIN RD   DUNN NC,043,Harnett,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1831575190,CHAMPION VASCULAR CARE PA,,710 ERWIN RD   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1548624059,"DAO, BENJAMIN, BAO",511 RUIN CREEK RD STE 106 HENDERSON NC,091,Vance,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 104 , 146 , 185 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548625353,"ROBINSON, KEITH, ARLEDGE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 36 , 36 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548625353,"ROBINSON, KEITH, ARLEDGE",205 PAGE RD   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 74 , 98 , 101 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548625353,"ROBINSON, KEITH, ARLEDGE",15 REGIONAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548626252,ADVANCED ORTHOPEDIC PRODUCTS & SERV,AOP INC,2708 WOOTEN BLVD SW   WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1548626252,ADVANCED ORTHOPEDIC PRODUCTS & SERV,2708 WOOTEN BLVD SW   WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 50 , 59 , 256 ," $13,459.60 ",,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1548628456,"SHIPPY, STEPHANIE, DANIELLE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1548628456,"SHIPPY, STEPHANIE, DANIELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 24 , 26 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1548628456,"SHIPPY, STEPHANIE, DANIELLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1548628456,"SHIPPY, STEPHANIE, DANIELLE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 29 , 32 ,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548628613,"NELSON, CHRISTIN, ALECIA",2350 BENTRIDGE LN APT 102 FAYETTEVILLE NC,026,Cumberland,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548629777,"KHATTAB, NASIM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548629777,"KHATTAB, NASIM",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 42 , 60 , 76 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548629777,"KHATTAB, NASIM",2150 HERBERT CT   GREENVILLE NC,074,Pitt,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548629967,"HAWKINS, LEAH, CHRISTINE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700045820,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT NORLINA,110 DIVISION ST   NORLINA NC,093,Warren,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548631575,"CLARK, AMY, ELIZABETH",110 DIVISION ST   NORLINA NC,093,Warren,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 89 , 201 , 241 ,$#,,
MEDICAID DIRECT,1346501673,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE GARNER,400 US 70 HWY E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1548634066,"OWEN, BROOKE, CHRISTINE",400 US HWY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548637895,"AGYEMANG, MATILDA, GRAHAM",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 26 , 33 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548637895,"AGYEMANG, MATILDA, GRAHAM",13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548639602,"CURRY, SARAH, LOUANNE",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 24 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1548639602,"CURRY, SARAH, LOUANNE",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 66 , 104 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548641780,"COHAGAN, BRIAN, JAMES",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548641780,"COHAGAN, BRIAN, JAMES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922555739,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPAEDICS - FLORENCE,1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548642325,"JORDAN, ARTHUR, BUIST",1005 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548643984,"WRENN, MEGAN, MCDONALD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548643984,"WRENN, MEGAN, MCDONALD",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548643984,"WRENN, MEGAN, MCDONALD",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548643984,"WRENN, MEGAN, MCDONALD",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548643984,"WRENN, MEGAN, MCDONALD",111 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043761513,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,225 COURT ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1548644040,"STROUD, AMANDA, DAWN GREENE",225 COURT ST   JEFFERSON NC,005,Ashe,1223D0001X,Dental Providers,Dentist,Dental Public Health," 1,235 "," 2,095 "," 7,612 "," $294,997.64 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548644826,"WILLIAMS, MILDRED, MORRIS",8919 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548644826,"WILLIAMS, MILDRED, MORRIS",3614 PROVIDENCE RD S STE 200 WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 23 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548647613,"SLATER, NATHANIEL, ALLEN",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 79 , 91 , 134 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548648595,"OSMAN, NAHLA, ABDELMONEM MOSTAFA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 33 , 32 , 32 ,$#,,
MEDICAID DIRECT,1275912974,MCLEOD HEALTH CHERAW,,711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548649627,"SNYDER, BRIAN, EDWARD",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1548649627,"SNYDER, BRIAN, EDWARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1548649627,"SNYDER, BRIAN, EDWARD",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548649627,"SNYDER, BRIAN, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1548649627,"SNYDER, BRIAN, EDWARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548649858,"BOULAND, ANDREW, JAMES",628 E 12TH ST   WASHINGTON NC,007,Beaufort,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548649858,"BOULAND, ANDREW, JAMES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 83 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548650906,"VANNOY LANKFORD, VICKI",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 48 , 48 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548650906,"VANNOY LANKFORD, VICKI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548651151,"MULLIN, ALLISON, KATHLEEN",3324 SIX FORKS RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548651151,"MULLIN, ALLISON, KATHLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548651151,"MULLIN, ALLISON, KATHLEEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548651763,"GRIFFITH, KOTAYA, LATREVA",5151 SARDIS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548651763,"GRIFFITH, KOTAYA, LATREVA",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 62 , 168 , 168 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548652928,"BAUTISTA, AMY, E.",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548653272,"WEIS, ALLISON, CAROLINE",3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 31 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548653272,"WEIS, ALLISON, CAROLINE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 35 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548653272,"WEIS, ALLISON, CAROLINE",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548653272,"WEIS, ALLISON, CAROLINE",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 18 , 29 ,$#,,
MEDICAID DIRECT,1427000181,EYECARECENTER OD PA,EYECARE CENTER,4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548654551,"COX, MATTHEW, RYAN",4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1427000181,EYECARECENTER OD PA,EYECARE CENTER,4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548654551,"COX, MATTHEW, RYAN",4107 OLEANDER DR STE B WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 24 , 26 ,$#,,
MEDICAID DIRECT,1275596439,CAROLINA SPECIALTY CARE PA,CAROLINA SPECIALTY CARE PA,293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548655616,"BURCHELL, MICHAEL, HABIB JARBARIE",293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656036,"STEPHENS, SARAH, JO",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 24 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656036,"STEPHENS, SARAH, JO",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548656036,"STEPHENS, SARAH, JO",4101 MACON POND RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656150,"RHODES, JESSE, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 171 , 172 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656150,"RHODES, JESSE, DAVID",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656150,"RHODES, JESSE, DAVID",40 MEDICINE CIRCLE   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656226,"JOHNSTON, ASHLEY, WIETSMA",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1126 N CHURCH ST STE 203 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548656226,"JOHNSTON, ASHLEY, WIETSMA",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656226,"JOHNSTON, ASHLEY, WIETSMA",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656226,"JOHNSTON, ASHLEY, WIETSMA",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656226,"JOHNSTON, ASHLEY, WIETSMA",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548656226,"JOHNSTON, ASHLEY, WIETSMA",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,, 29 , 41 , 43 ,$#,,
MEDICAID DIRECT,1275638512,GRANVILLE HEALTH SYSTEM,GRANVILLE HEALTH SYSTEM CRNA GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1548656564,"MCCANNA, MICAH, ANDREW",1010 COLLEGE ST   OXFORD NC,039,Granville,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548656564,"MCCANNA, MICAH, ANDREW",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548656564,"MCCANNA, MICAH, ANDREW",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407277536,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548656572,"MARTIN, ADDIE, PRICE",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 16 , 19 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548656572,"MARTIN, ADDIE, PRICE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1548656838,"NANDYALA, ANISHA",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639697790,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548657414,"GRIMES, AKILAH, ONI",2101 SHILOH CHURCH RD STE 101 DAVIDSON NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 50 , 93 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548657422,"CANASTAR, MEHTAP, DOGAN",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 47 , 72 , 130 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548658552,"BURGESS, CANDACE, HOPE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548658552,"BURGESS, CANDACE, HOPE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346654134,TARBORO EYE ASSOCIATES OPTOMETRY PL,,2807 N MAIN ST   TARBORO NC,033,Edgecombe,193400000X,Group,Single Specialty,,1548662323,"TYSON, SARAH",2807 N MAIN ST   TARBORO NC,033,Edgecombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 133 , 152 , 196 ,$#,,
MEDICAID DIRECT,1548662323,"TYSON, SARAH",,2807 N MAIN ST   TARBORO NC,033,Edgecombe,152W00000X,Eye and Vision Services Providers,Optometrist,,1548662323,"TYSON, SARAH",2807 N MAIN ST   TARBORO NC,033,Edgecombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548662349,"GAGLANI, BHAVITA, JAYESH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548662349,"GAGLANI, BHAVITA, JAYESH",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548662349,"GAGLANI, BHAVITA, JAYESH",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 14 , 17 , 26 ,$#,,
MEDICAID DIRECT,1376582239,EYECARECENTER OD PA,EYECARE CENTER,3401 RALEIGH ROAD PKWY W STE B WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1548663958,"LOUDON, ANDREW, JOSEPH",3401B RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1669905634,EYECARECENTER OD PA,EYECARE CENTER,119 E HARGETT ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548663958,"LOUDON, ANDREW, JOSEPH",3401B RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1376582239,EYECARECENTER OD PA,EYECARE CENTER,3401 RALEIGH ROAD PKWY W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548663958,"LOUDON, ANDREW, JOSEPH",3401B RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1669905634,EYECARECENTER OD PA,EYECARE CENTER,119 E HARGETT ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548663958,"LOUDON, ANDREW, JOSEPH",119 E HARGETT ST   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1548664766,"CLARK, JERRY, KENT",4611 OTTER CT   BURLINGTON NC,001,Alamance,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,, 25 , 26 , 65 ,$#,,
MEDICAID DIRECT,1902020308,NC DHHS CHILD AND FAMILY WELL-BEING,DURHAM CDSA,115 MARKET ST STE 201 DURHAM NC,032,Durham,252Y00000X,Agencies,Early Intervention Provider Agency,,1548664766,"CLARK, JERRY, KENT",4611 OTTER CT   BURLINGTON NC,001,Alamance,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1801 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1548666159,"CAMPBELL, KATHRYN, ELIZABETH",1801 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548666159,"CAMPBELL, KATHRYN, ELIZABETH",2800 ASHTON DR STE 100 WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548669757,"LEE, LATOYA, DOREEN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548669757,"LEE, LATOYA, DOREEN",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548669757,"LEE, LATOYA, DOREEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548669757,"LEE, LATOYA, DOREEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1619468766,BLUE RIDGE COMMUNITY HEALTH SERVICE,~,158 WHITE DR   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548671175,"TAUNTON, SUSAN, ELIZABETH",158 WHITE DR   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1487050738,BLUE RIDGE COMMUNITY HEALTH SERVICE,~,187 W MAIN ST   SPINDALE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1548671175,"TAUNTON, SUSAN, ELIZABETH",187 W MAIN ST   SPINDALE NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice, 405 , 811 ," 1,655 "," $95,758.24 ",,
MEDICAID DIRECT,1457332421,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548671175,"TAUNTON, SUSAN, ELIZABETH",187 W MAIN ST   SPINDALE NC,081,Rutherford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 39 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548671902,"GAVIGAN, HAILEY, WOOLLEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 12 , 59 , 66 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548671902,"GAVIGAN, HAILEY, WOOLLEN",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 21 , 29 , 29 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548672793,"CZUPRYNSKI, ROBERT, JAMES",1718 E 4TH ST STE 307 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548672793,"CZUPRYNSKI, ROBERT, JAMES",9930 KINCEY AVE STE 210 HUNTERSVILLE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 19 , 28 ,$#,,
MEDICAID DIRECT,1295196418,DR LI QIAN DDS PLLC,SOUTHPOINT DENTISTRY,,,Unknown,193200000X,Group,Multi-Specialty,,1548673809,"QIAN, LI",6104 FAYETTEVILLE RD STE 106 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1548675911,"DEMEUSY, ANDREW, PAUL",330 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 112 , 235 , 266 ,$#,,
MEDICAID DIRECT,1093063398,CAROMONT MEDICAL GROUP INC,CAROMONT BREAST SURGICAL SPECIALISTS,2391 COURT DR STE 105 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548676620,"SINNER, HEATHER, FROHMAN",2391 COURT DR STE 105 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 54 , 65 ,$#,,
MEDICAID DIRECT,1093063398,CAROMONT MEDICAL GROUP INC,CAROMONT BREAST SURGICAL SPECIALISTS,2000 CAROMONT PKWY STE 202 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548676620,"SINNER, HEATHER, FROHMAN",2391 COURT DR STE 105 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740459650,RAFAEL RIVERA JR DDS PLLC,,2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548677081,"TAYLOR, LAURA, OLSEN",2041 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 339 , 366 ," 1,060 "," $72,693.23 ",,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,1060 S MAIN ST STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 172 , 188 , 238 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 19 , 25 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680366,"PENDERGRAST, THOMAS, ELLIOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680994,"ROSENBAUM, ALAN, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548680994,"ROSENBAUM, ALAN, JOSEPH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548681828,"BLAKE, NATHAN, ALLEN",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1548682297,"ROUTZAHN, SARA, LYNN",724 S HORNER BLVD   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548682826,"PARSON, MARLENA, MARIE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 50 , 94 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548682826,"PARSON, MARLENA, MARIE",2213 ELBA ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 29 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548682826,"PARSON, MARLENA, MARIE",3480 WAKE FOREST RD STE 414 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1144571381,NSH CANCER INST PROF SERVICES G LLC,NSH CIPS G,308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548686272,"KEATON, TINA, SHELLEEN",308 DEEP SOUTH FARM RD STE 200 BLAIRSVILLE GA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 54 , 55 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548687577,"CILVIK, SARAH, NICOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 15 , 68 , 68 ," $11,422.35 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 51 , 57 , 81 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",21 S MAIN ST   ROBBINSVILLE NC,038,Graham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548687973,"MYRICK, PERRY, BLAKE",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 100 , 104 , 132 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 42 , 52 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548687973,"MYRICK, PERRY, BLAKE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 60 , 62 , 91 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1548687973,"MYRICK, PERRY, BLAKE",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548687973,"MYRICK, PERRY, BLAKE",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 28 , 37 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548687973,"MYRICK, PERRY, BLAKE",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548687973,"MYRICK, PERRY, BLAKE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548689771,"ZHANG, JINYU",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1548689771,"ZHANG, JINYU",2607 MEDICAL OFFICE PL STE B GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548689771,"ZHANG, JINYU",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548689771,"ZHANG, JINYU",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548689771,"ZHANG, JINYU",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548689771,"ZHANG, JINYU",2609 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548689771,"ZHANG, JINYU",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548689789,"HIATT, KEVIN, DAVID",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548689789,"HIATT, KEVIN, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548689789,"HIATT, KEVIN, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 328 , 352 , 653 ," $22,843.53 ",,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548689789,"HIATT, KEVIN, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548689789,"HIATT, KEVIN, DAVID",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 36 , 44 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548689789,"HIATT, KEVIN, DAVID",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1548689920,"RAFFA, BRITTANY, JANET",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 14 , 19 , 32 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,893 EAST ST   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1548689920,"RAFFA, BRITTANY, JANET",893 EAST ST   PITTSBORO NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548690308,"MOHAMMED, SARAH, STOUDEMIRE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 20 , 52 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,41 OAKLAND RD STE 100 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548690308,"MOHAMMED, SARAH, STOUDEMIRE",41 OAKLAND RD STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 20 , 37 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,41 OAKLAND RD STE 100 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548690308,"MOHAMMED, SARAH, STOUDEMIRE",41 OAKLAND RD STE 300 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548694284,"HUTCHERSON, TASHA, OSBORNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3573 HILLSBOROUGH RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548694714,"KIZER, CARMAN, BALLENGER",2994 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548697238,"MORGAN, KOREEN, DIANNE",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548701444,"HENSON, JENNIFER, WALKER",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 198 , 218 , 289 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",6301 HERNDON RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",40 DUKE MEDICINE CIR # 1B1C DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 38 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 64 , 89 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",4220 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",40 DUKE MEDICINE CIR # 1B1C DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 180 , 212 , 300 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",4220 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548701741,"KRUSE, DANIELLE, ELIZABETH",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548701782,"BROOKS, PETER, CHRISTIAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 33 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548705049,"VALASEK, SARA, ANNE DAVIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1144624206,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONARY ALBEMARLE,929 N 2ND ST STE 205 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1548705460,"CHAVIS, BRITTANY, MCDUFFIE",929 N 2ND ST STE 205 ALBEMARLE NC,084,Stanly,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1548711385,"CRANE, TYLER, WADE",375 HOSPITAL ST STE 200 MOCKSVILLE NC,030,Davie,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548711385,"CRANE, TYLER, WADE",375 HOSPITAL ST STE 200 MOCKSVILLE NC,030,Davie,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548711385,"CRANE, TYLER, WADE",375 HOSPITAL ST STE 200 MOCKSVILLE NC,030,Davie,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 23 , 33 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1548711385,"CRANE, TYLER, WADE",375 HOSPITAL ST STE 200 MOCKSVILLE NC,030,Davie,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 47 , 117 , 271 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548711385,"CRANE, TYLER, WADE",375 HOSPITAL ST STE 200 MOCKSVILLE NC,030,Davie,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 26 , 53 , 190 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548711385,"CRANE, TYLER, WADE",375 HOSPITAL ST STE 200 MOCKSVILLE NC,030,Davie,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1598194284,PARK HILL MEDICINE PA,,510 PARK HILL CT   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1548714223,"BENTLEY, SARAH, ELIZABETH",510 PARK HILL CT   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 58 , 67 ,$#,,
MEDICAID DIRECT,1770545550,BLUE RIDGE DERMATOLOGY ASSOCIATES P,~,4225 MACON POND RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548720345,"OSBORN, LINDSAY, PAIGE",4225 MACON POND RD   RALEIGH NC,092,Wake,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548720493,"SULLIVAN, BILLY, LEE",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548720923,"LU, AMY, QI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 17 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548720923,"LU, AMY, QI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548720923,"LU, AMY, QI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 29 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548720956,"FAHEY, CATHERINE, CLARE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 14 , 33 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1548721582,"LIM, STEPHANIE, LUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548721582,"LIM, STEPHANIE, LUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548721582,"LIM, STEPHANIE, LUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548721582,"LIM, STEPHANIE, LUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548721582,"LIM, STEPHANIE, LUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548721582,"LIM, STEPHANIE, LUY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548721723,"NIX, CATHERINE, ALICIA",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548721723,"NIX, CATHERINE, ALICIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548721723,"NIX, CATHERINE, ALICIA",32 APEX CIR   ASHEVILLE NC,011,Buncombe,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548722275,"ROHM-ENSING, DREW, MICHAEL",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548722275,"ROHM-ENSING, DREW, MICHAEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548722275,"ROHM-ENSING, DREW, MICHAEL",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548722275,"ROHM-ENSING, DREW, MICHAEL",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548722275,"ROHM-ENSING, DREW, MICHAEL",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 19 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",211 VIRGINIA RD   EDENTON NC,021,Chowan,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",211 VIRGINIA RD   EDENTON NC,021,Chowan,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 49 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 47 , 68 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548723018,"MATTHEWS, DYLAN, PATRICK",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548728249,"SHATLOCK, MALLORY, RICH",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1548729189,"DOUGLAS, URSULA, HILLIAN",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548729239,"NUNEZ, AMANDA, RENEE",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548729239,"NUNEZ, AMANDA, RENEE",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 68 , 108 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548740160,"KASKO, OKSANA, STEPANOVNA",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548740160,"KASKO, OKSANA, STEPANOVNA",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548740160,"KASKO, OKSANA, STEPANOVNA",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1548742638,"ACCETTA, JOSEPH, ANTHONY",1033 RANDOLPH ST STE 32 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 32 , 74 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548744758,"HAUPT, CAITLIN, BUMGARNER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 53 , 74 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548744808,"HERRON, ZACHARY, SCOTT",4709 CREEKSTONE DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1548744808,"HERRON, ZACHARY, SCOTT",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 29 , 36 ,$#,,
MEDICAID DIRECT,1821681271,SANDY SHORES MEDICAL CENTER AND URG,,13741 NC HIGHWAY 50 STE A HOLLY RIDGE NC,071,Pender,193200000X,Group,Multi-Specialty,,1548745359,"WALKER, KAYLA, SHOLAR",13741 NC HIGHWAY 50 STE A SURF CITY NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033710637,NOURISH ADOLESCENT WELLNESS PLLC,,307 S SALEM ST STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1548746365,"BRINO, KASSONDRA, AMADA SHOEMAKER",307 S SALEM ST STE 100 APEX NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 W H ST   BUTNER NC,039,Granville,193200000X,Group,Multi-Specialty,,1548746365,"BRINO, KASSONDRA, AMADA SHOEMAKER",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1922369883,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,433 MCALISTER RD FL 1 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548749021,"CLEMMER, KARA, HAWK",433 MCALISTER RD FL 1 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 62 , 87 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548750383,"SHAH, RUSHABH, HASMUKH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1548750516,ALPHA RESIDENTIAL SERVICES LLC,,105 MEAGAN LN   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548750516,ALPHA RESIDENTIAL SERVICES LLC,2103 OAKLAND AVE   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1548750516,ALPHA RESIDENTIAL SERVICES LLC,,105 MEAGAN LN   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548750516,ALPHA RESIDENTIAL SERVICES LLC,105 MEAGAN LN   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 940 , 942 ," $71,654.30 ",,
MEDICAID DIRECT,1548750516,ALPHA RESIDENTIAL SERVICES LLC,,2103 OAKLAND AVE   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548750516,ALPHA RESIDENTIAL SERVICES LLC,2103 OAKLAND AVE   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 121 , 121 ," $10,478.40 ",,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1548751571,"SMITH, CURTISS, JACOB",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548751720,"HINES, KRISTINA, ASHLEY",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 101 , 200 , 414 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548751720,"HINES, KRISTINA, ASHLEY",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 33 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",5601 ARRINGDON PARK DR STE 300 MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",4220 N ROXBORO ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 29 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",3475 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548752231,"NEVILLE, STEPHEN, JAMES",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1548754435,"PACLEB, ANYA-FAYE, ROA",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1548755432,"LACKEY, DANIEL, JAMES",1287 CREEKSHIRE WAY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 17 , 24 ,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1548755432,"LACKEY, DANIEL, JAMES",120 S GROVE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 38 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548756588,"REDDY, ARAVIND, BIZWAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1255627915,ANTONIO S BRAITHWAITE DDS MPH PA,SANFORD PEDIATRIC DENTISTRY,1013 SPRING LN   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1548758394,"HAWKINS, KEYACHTTA, CHAKEERRAH",1013 SPRING LN   SANFORD NC,053,Lee,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1730519182,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1548761752,"DAVIS, KAITLYN, RENEE",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 55 , 69 ,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1548762727,"HENDERSON, LINDSAY, MICHELLE",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 31 , 103 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548763428,"LEWIS, LOGAN, MONROE",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 35 , 56 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548763428,"LEWIS, LOGAN, MONROE",205 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 92 , 97 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548764137,"SKAF, MICHEL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 24 , 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548764137,"SKAF, MICHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 70 , 87 , 97 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1548764137,"SKAF, MICHEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1548764137,"SKAF, MICHEL",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 16 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,439 US HIGHWAY 158 W   YANCEYVILLE NC,017,Caswell,193200000X,Group,Multi-Specialty,,1548764137,"SKAF, MICHEL",305 CREST DR   CHAPEL HILL NC,068,Orange,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1033489216,TESFAYE D FANTA MD PLLC,TESFAYE D FANTA MD PLLC,910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1548765167,"SOLOMON, DEMISSIE",910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,,,$#,,
MEDICAID DIRECT,1033489216,TESFAYE D FANTA MD PLLC,TESFAYE D FANTA MD PLLC,910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1548765167,"SOLOMON, DEMISSIE",910 W HARRISON ST   REIDSVILLE NC,079,Rockingham,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 96 , 142 , 160 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548765290,"BUSH, AUSTIN, JAMES",270 COPPERFIELD BLVD NE STE 202 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548765290,"BUSH, AUSTIN, JAMES",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 100 , 182 , 331 ," $10,377.10 ",,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1548765365,"TANSEY, ALEX, HARRIS",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 30 , 42 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548765365,"TANSEY, ALEX, HARRIS",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932366044,CARE FIRST PHYSICAL THERAPY AND REH,CARE FIRST PHYSICAL THERAPY AND REHAB LLC,100 CORNERSTONE DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548765605,"CHAUHAN, SHIVANI",100 CORNERSTONE DR   CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 71 , 167 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548766470,"BIANCO, KRISTINA, MARGARET LINDEFJELD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548766470,"BIANCO, KRISTINA, MARGARET LINDEFJELD",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548766744,"JONES, ARCH, WOOTEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#, 30 , 44 ,$#,,
MEDICAID DIRECT,1841876307,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR GLEN MEADE,1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548766991,"BEEBE, SARAH, ELIZABETH",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548767809,"SANDHU, SHAIBA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,125Q00000X,Dental Providers,Dentist,Oral Medicine,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1548767809,"SANDHU, SHAIBA",511 GREENSBORO ST   ASHEBORO NC,076,Randolph,1223X2210X,Dental Providers,Dentist,Orofacial Pain, 26 , 29 , 111 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548769110,"FAULKNER, ASHLEY, JONES",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 27 , 31 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1548769110,"FAULKNER, ASHLEY, JONES",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1548769110,"FAULKNER, ASHLEY, JONES",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 85 , 102 , 110 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1548769110,"FAULKNER, ASHLEY, JONES",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 35 , 37 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548769110,"FAULKNER, ASHLEY, JONES",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 26 , 27 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548773054,"DOOLEY, BRIDGET",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1336382563,SPARTANBURG MEDICAL CENTER,MEDICAL GROUPOFTHECAROLINAS-VASCULARACCESSSERVICES,100 E WOOD ST STE 202 SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1548779457,"MANN, JOHN, NICHOLAS",100 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 39 , 42 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548780653,"FUTTERMAN, ANDREW, MICHAEL",447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 3500 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548780653,"FUTTERMAN, ANDREW, MICHAEL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548780653,"FUTTERMAN, ANDREW, MICHAEL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1386158475,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CLEMMONS,4168 CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548783350,"FARHAN, MOHAMMAD, SHAHID",4168 CLEMMONS RD   CLEMMONS NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1891798054,GREENE COUNTY HEALTH CARE INC,SNOW HILL INTEGRATED CARE SERVICES,1106 KINGOLD BLVD   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548784853,"DEENA, DEBORAH, VIOLA",1106 KINGOLD BLVD   SNOW HILL NC,040,Greene,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548785876,"PAIGE, CRISTEN, ANN",40 DUKE MEDICINE CIR CLINIC 1F DURHAM NC,032,Durham,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548786577,"COATES, MAEGAN, HEWETT",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1548786577,"COATES, MAEGAN, HEWETT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1548786577,"COATES, MAEGAN, HEWETT",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548786577,"COATES, MAEGAN, HEWETT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548786577,"COATES, MAEGAN, HEWETT",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1548786577,"COATES, MAEGAN, HEWETT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1548789266,"RAPER, ALEXANDRA, KORIN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1548789266,"RAPER, ALEXANDRA, KORIN",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 26 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1548790017,"SIGMAN, KIMBERLY, BETTS",401 IRVING PWKY STE 110 HOLLY SPRINGS NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 36 , 78 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548791106,"BALTIC, STEVEN, PAUL",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548791197,"MENDOZA, CAROLINA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548791361,"MCCULLOUGH, MARY, ALYCE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 75 , 95 , 100 ," $12,678.83 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548791379,"PICKERSGILL, ANGELA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548791379,"PICKERSGILL, ANGELA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548791379,"PICKERSGILL, ANGELA, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548791379,"PICKERSGILL, ANGELA, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 20 , 35 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548791981,"MAY, JOSEPH, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548791981,"MAY, JOSEPH, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114373404,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548791981,"MAY, JOSEPH, ANDREW",351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548791981,"MAY, JOSEPH, ANDREW",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 35 , 77 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548792294,"YUAN, SHUAI",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 76 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548793136,"WISE, MEREDITH, KATHERIN",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548793680,"MCSURDY, JESSICA, GRACE",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548793680,"MCSURDY, JESSICA, GRACE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548793680,"MCSURDY, JESSICA, GRACE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548794183,"COHEN, ZACHARY, LEWIS",77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548794183,"COHEN, ZACHARY, LEWIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 16 , 34 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548794290,"HARRIS, SHELBY, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 58 , 57 , 68 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548794290,"HARRIS, SHELBY, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548795354,"STONER, BENJAMIN, JOSEPH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548795354,"STONER, BENJAMIN, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548795354,"STONER, BENJAMIN, JOSEPH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 39 , 70 , 75 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1548796675,"WALKER, COLTON, HARRISON",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1548796675,"WALKER, COLTON, HARRISON",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548796675,"WALKER, COLTON, HARRISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548796675,"WALKER, COLTON, HARRISON",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548796675,"WALKER, COLTON, HARRISON",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548796675,"WALKER, COLTON, HARRISON",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548798127,"CHAUDHARY, SEJUL, ANJALI",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548798127,"CHAUDHARY, SEJUL, ANJALI",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 75 , 93 , 103 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548798127,"CHAUDHARY, SEJUL, ANJALI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396041075,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH CENTRA CARE,436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548798150,"BANUCHI, LIZETH, JOANNA REGO",436 AIRPORT RD STE 20 ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 19 , 39 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548803943,"JONES, CASEY, NICHOLAS",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1487899902,LOVE CHIROPRACTIC CENTER,LOVE CHIROPRACTIC CENTER,215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1548805435,"LOVE, TIMOTHY, PHILLIP",215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1184808586,QUALITY SURGICAL MANAGEMENT PA,~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193400000X,Group,Single Specialty,,1548807399,"KELSEY, KIMBERLY, DENISE",2626 GLENWOOD AVE STE 550 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1548807399,"KELSEY, KIMBERLY, DENISE",2626 GLENWOOD AVE STE 550 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 39 , 55 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548807399,"KELSEY, KIMBERLY, DENISE",2626 GLENWOOD AVE STE 550 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 61 , 84 , 111 ,$#,,
MEDICAID DIRECT,1477785756,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - GRE,802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548814072,"FRIDDLE, ASHLEY, GOODWIN",802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1477785756,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - GRE,802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548814072,"FRIDDLE, ASHLEY, GOODWIN",802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 25 , 47 , 100 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1548814312,"NEWTON, ELIZABETH, WEAVER",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 29 , 33 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548814312,"NEWTON, ELIZABETH, WEAVER",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1548814312,"NEWTON, ELIZABETH, WEAVER",201 E GROVER ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 35 , 38 ,$#,,
MEDICAID DIRECT,1275536427,HOSPICE OF CLEVELAND COUNTY,HOSPICE CLEVELAND COUNTY,951 WENDOVER HEIGHTS DR   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548814312,"NEWTON, ELIZABETH, WEAVER",951 WENDOVER HEIGHT DR   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548817000,"REA, KELSEY, LAURA",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548817000,"REA, KELSEY, LAURA",2601 LAKE DR STE 201 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548819774,"TROMBETTA, NICOLE, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770624637,FOOTHILLS CONSULTING ASSOCIATES PLL,FOOTHILLS CONSULTING ASSOCIATES LLC,1610 E MARION ST STE 250 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548821291,"MORGAN, MORGAN, ELIZABETH",615 S DEKALB ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 152 , 180 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548821903,"SAUND, AMARDEEP",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548824394,"SHARP, MATTHEW, GARY",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 47 , 98 , 195 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548824394,"SHARP, MATTHEW, GARY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 20 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548827736,"MORROW, WILLIAM, PATRICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 167 , 193 , 262 ,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548828106,"MCNEILL, SELENA, HAMMONDS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 27 , 30 ,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548828106,"MCNEILL, SELENA, HAMMONDS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184681496,ROBESON HEALTH CARE CORPORATION,LUMBERTON HEALTH CENTER,1309 E 5TH ST   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548828106,"MCNEILL, SELENA, HAMMONDS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 89 , 248 , 280 ,$#,,
MEDICAID DIRECT,1508522996,ROBESON HEALTH CARE CORPORATION,RHCC MOBILE UNIT,307 E WARDELL DR   PEMBROKE NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548828106,"MCNEILL, SELENA, HAMMONDS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548828106,"MCNEILL, SELENA, HAMMONDS",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548829542,"AMBROSE, MICHAEL, SCOTT",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548830227,"MYERS, AMY, CAROLINE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548830409,"MAIZELS, MATTHEW, GABRIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548830771,"BAEZ MARINEZ, LAZARINA, DIOMARIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 87 , 146 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1548830771,"BAEZ MARINEZ, LAZARINA, DIOMARIS",1301 CENTRAL DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548831761,DIVINE MEASURES HOME HEALTHCARE,,2103 E CONE BLVD STE 119 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1548831761,DIVINE MEASURES HOME HEALTHCARE,2103 E CONE BLVD STE 119 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 276 , 276 ," $14,665.81 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548831985,"GENTLE, ANNE-MARIE, ZAHRA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 20 ,$#,,
MEDICAID DIRECT,1548836406,ONE TOUCH SPOT PLLC,,7 CORPORATE CENTER CT STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548836406,ONE TOUCH SPOT PLLC,7 CORPORATE CENTER CT STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,, 36 , 196 , 196 ," $15,149.74 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1548837636,"COOK, ANNA, MANGUM",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548837636,"COOK, ANNA, MANGUM",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 80 , 131 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548837636,"COOK, ANNA, MANGUM",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1053973354,UNC PHYSICIANS NETWORK GROUP PRACTI,,8305 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548837727,"PIERSON, KYLEIGH, HOLT",8305 FALLS OF NEUSE RD STE 100 RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1053973354,UNC PHYSICIANS NETWORK GROUP PRACTI,,1505 SW CARY PKWY STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548837727,"PIERSON, KYLEIGH, HOLT",1505 SW CARY PKWY STE 200 CARY NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1053973354,UNC PHYSICIANS NETWORK GROUP PRACTI,,501 HEALTH PARK DR STE 180 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1548837727,"PIERSON, KYLEIGH, HOLT",501 HEALTH PARK DR STE 180 GARNER NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 22 , 31 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548837925,"KING, HANNAH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548837925,"KING, HANNAH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548838907,"ROSARIO-SINGER, HANS, BECK",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548838907,"ROSARIO-SINGER, HANS, BECK",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548843477,"SMITH, HANNAH, CHRISTINE",8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 35 , 49 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548843477,"SMITH, HANNAH, CHRISTINE",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548843477,"SMITH, HANNAH, CHRISTINE",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548843840,"BUSIC, JOSEPH, FRANKLIN",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548844558,"NAUSEDA, KRISTA, SUE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1548844558,"NAUSEDA, KRISTA, SUE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1940 WEST BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548848823,"BUTLER, JULIAN, ROBERT",1940 WEST BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 32 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548848914,"BRADER, WILLIAM, TIMOTHY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 93 , 93 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1548849490,"DIETRICH, COLLIN, ANDERS",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 39 , 96 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548851900,"MCGUIRE, MEGAN, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548851900,"MCGUIRE, MEGAN, ELIZABETH",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174879670,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE UNION OBGYN,1550 FAULK ST STE 2100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1548851900,"MCGUIRE, MEGAN, ELIZABETH",1550 FAULK ST STE 2100 MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548851900,"MCGUIRE, MEGAN, ELIZABETH",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548852718,"BEAMAN, RAYMOND, TYLER",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 81 , 136 , 215 ,$#,,
MEDICAID DIRECT,1548853542,ALL LIFE HOME CARE LLC,,5710 SIX FORKS RD STE 201EXT15 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1548853542,ALL LIFE HOME CARE LLC,5710 SIX FORKS RD STE 201EXT15 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 36 , 36 ,$#,,
MEDICAID DIRECT,1205590510,SAL C ZAMMITTI DMD MMSC PLLC AND MA,HUNTERSVILLE SMILES,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548855851,"WELLS, JONATHAN, ALAN",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 311 ," 1,095 "," 1,127 "," $215,200.10 ",,
MEDICAID DIRECT,1205590510,SAL C ZAMMITTI DMD MMSC PLLC AND MA,HUNTERSVILLE SMILES,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548855851,"WELLS, JONATHAN, ALAN",132 WELTON WAY   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1215664339,SAL C ZAMMITTI DMD MMSC AND MATTHEW,ZAMMITTI & GIDALY ORTHODONTICS,132 WELTON WAY   MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1548855851,"WELLS, JONATHAN, ALAN",132 WELTON WAY   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 109 , 360 , 364 ," $76,044.89 ",,
MEDICAID DIRECT,1548855984,SPLENDID CORPORATION,,5501 EXECUTIVE CENTER DR STE 236 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1548855984,SPLENDID CORPORATION,5501 EXECUTIVE CENTER DR STE 236 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 71 ," 15,560 "," 15,576 "," $1,026,937.08 ",,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548858285,"LARTEY, LYDIA",113 GAINSBOROUGH SQ STE 400 CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548859598,"RAY, OLIVIA, ADDIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548863004,"QUAYE, BRIDGET, AKWETEY",444 SW CENTER ST   FAISON NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548863004,"QUAYE, BRIDGET, AKWETEY",104 ADAIR DR # A GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 11 , 11 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548863004,"QUAYE, BRIDGET, AKWETEY",109 S SYCAMORE ST   FREMONT NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1679718316,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FREMONT,109 S SYCAMORE ST   FREMONT NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548863004,"QUAYE, BRIDGET, AKWETEY",109 S SYCAMORE ST   FREMONT NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700396934,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - MOBILE MEDICAL 2,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548863004,"QUAYE, BRIDGET, AKWETEY",109 S SYCAMORE ST   FREMONT NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1548866239,ASHEVILLE GERIATRIC LLC,RICHMOND HILL ASSISTED LIVING 4,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548866239,ASHEVILLE GERIATRIC LLC,95 RICHMOND HILL RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 14 ," 2,277 "," 2,277 "," $147,221.66 ",,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1548866494,"ARDITO, TARA, CORIN",911 E ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1548866494,"ARDITO, TARA, CORIN",600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 34 , 62 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 28 , 28 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",1804 FOREST HILLS RD W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",1987 HILTON RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 74 , 75 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",1306 S KING ST   WINDSOR NC,008,Bertie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",1987 HILTON RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548867526,"SCHOLL, PAMELA, JEAN",1987 HILTON RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 73 , 73 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548870975,"DENNING, ANNE, MARIE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 36 , 72 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548870975,"DENNING, ANNE, MARIE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548870975,"DENNING, ANNE, MARIE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548871445,"JHUREMALANI, DEBORAH, HUGH",706 WILKINS ST STE C SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548871445,"JHUREMALANI, DEBORAH, HUGH",3330 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 31 , 46 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548871445,"JHUREMALANI, DEBORAH, HUGH",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548872633,"ROGGE, CHRISTOPHER, JAMES",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548872633,"ROGGE, CHRISTOPHER, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548872633,"ROGGE, CHRISTOPHER, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548873003,"COLEMAN, JAMES, PRESTON",2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548873003,"COLEMAN, JAMES, PRESTON",2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548873003,"COLEMAN, JAMES, PRESTON",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548873003,"COLEMAN, JAMES, PRESTON",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1548873003,"COLEMAN, JAMES, PRESTON",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548873433,"CLELLAND, OLIVIA, MUSTIN",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 32 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,109 S HOLDEN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548873664,"SOLIS, ROSALYNN, MARIA",109 S HOLDEN RD   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1201 CAROLINA ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1548873664,"SOLIS, ROSALYNN, MARIA",1201 CAROLINA ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1028 BLAIR ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1548873664,"SOLIS, ROSALYNN, MARIA",1028 BLAIR ST   THOMASVILLE NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548873664,"SOLIS, ROSALYNN, MARIA",1900 W 1ST ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1548873664,"SOLIS, ROSALYNN, MARIA",4911 BRIAN CENTER LN   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1548873664,"SOLIS, ROSALYNN, MARIA",543 MAPLE AVE   REIDSVILLE NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548877939,"WINTER, SARAH, KATHERINE",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 67 , 116 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548877939,"WINTER, SARAH, KATHERINE",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1548878390,"SHRESTHA, MOBINA",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 94 , 249 , 252 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1548881493,"AFRIDI, BABAR, KHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548881493,"AFRIDI, BABAR, KHAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 54 , 54 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548881998,"LEE, ELIZABETH, AVERY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548881998,"LEE, ELIZABETH, AVERY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548881998,"LEE, ELIZABETH, AVERY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548881998,"LEE, ELIZABETH, AVERY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548881998,"LEE, ELIZABETH, AVERY",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548881998,"LEE, ELIZABETH, AVERY",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548883424,"VAN BUREN, ELIZABETH, JORDAN",915 TATE BLVD SE STE 170 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548884380,"BAUMAN, MCKENZIE, ANN",9965 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548884380,"BAUMAN, MCKENZIE, ANN",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 25 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1548884687,"HANSON, LAURA, KAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548884687,"HANSON, LAURA, KAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548884984,EYECARECENTER OD PA,EYECARE CENTER,215 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1548884984,EYECARECENTER OD PA,215 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,, 71 , 71 , 142 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548886815,"KHATRI, HASEEB, MOHAMMAD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 36 , 55 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548886815,"KHATRI, HASEEB, MOHAMMAD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548886815,"KHATRI, HASEEB, MOHAMMAD",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548886849,"CHAMBERS, STEPHANIE, DAWN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1003500109,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1548889074,"DESPENZA, RACHEL, ANNE",568 RUIN CREEK RD STE 1 HENDERSON NC,091,Vance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1548889074,"DESPENZA, RACHEL, ANNE",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1821496753,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1548889074,"DESPENZA, RACHEL, ANNE",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1548889074,"DESPENZA, RACHEL, ANNE",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548889991,"HOLT, MORGAN, DAILEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,545 MICHAEL MARTIN RD   MOUNT OLIVE NC,096,Wayne,193200000X,Group,Multi-Specialty,,1548891039,"DUPREE, LESLIE ANN, BYRD",545 MICHAEL MARTIN RD   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2303 EXECUTIVE CIR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1548891039,"DUPREE, LESLIE ANN, BYRD",545 MICHAEL MARTIN RD   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528470325,RENEW COUNSELING CENTER OF NC LLC,~,2212 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548895451,"COX, LAUREN, BRITTANY",2212 HOPE MILLS RD   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1548895469,"PATEL, PAIGE, EMIG",91 ENTERPRISE DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548895469,"PATEL, PAIGE, EMIG",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 15 , 25 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548895956,"WHITEHURST, MICHAEL, JAMES",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 17 , 22 , 22 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548895956,"WHITEHURST, MICHAEL, JAMES",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 29 , 40 , 40 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548897465,"THRASHER, TYLER, WAYNE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 54 , 56 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548897655,"GLEASON, RACHEL, NAOMI",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548897671,"OWENS, COURTNEY, RENEE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 129 , 129 , 190 ," $12,114.08 ",,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1548898117,"KOHLER, SOPHIA, REAGAN",1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 350 , 474 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1548899313,"BROWN, TRAVIS, DILLON",232 BOONE HEIGHTS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 95 , 179 ,$#,,
MEDICAID DIRECT,1225471980,APPALACHIAN REGIONAL MEDICAL ASSOCI,~,232 BOONE HEIGHTS DR STE A BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1548899313,"BROWN, TRAVIS, DILLON",194 DOCTORS DR   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942865316,INTEGRATED WOUND CARE NORTH CAROLIN,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1548901069,"BROWN-PARKER, PATRICE, RENEE",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 145 , 874 ," 1,248 "," $40,511.52 ",,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,530 NEW WAVERLY PL STE 314 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1548906209,"HARTNELL, LAYNE",530 NEW WAVERLY PL STE 314 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 21 , 33 ,$#,,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1548906209,"HARTNELL, LAYNE",530 NEW WAVERLY PL STE 314 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1548875883,MD PSYCHIATRY AND EMOTIONAL HEALTH,,6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1548906209,"HARTNELL, LAYNE",6104 FAYETTEVILLE RD STE 101 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1548909559,"CAMPBELL, JANET, MARIE",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 26 , 32 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1548909559,"CAMPBELL, JANET, MARIE",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1548909559,"CAMPBELL, JANET, MARIE",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 32 , 36 ,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1548909559,"CAMPBELL, JANET, MARIE",105 MCALPINE LN   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1548909559,"CAMPBELL, JANET, MARIE",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1548909559,"CAMPBELL, JANET, MARIE",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 87 , 195 , 224 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1548909559,"CAMPBELL, JANET, MARIE",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1548913213,"THUMMA, KELLY, JANE",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548913965,GOLD STAR HOME CARE,,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1548913965,GOLD STAR HOME CARE,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 2,996 "," 3,012 "," $327,583.76 ",,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548914328,"JOHNSEN, CAROLINE, JAMEY",501 N MAIN ST   SALISBURY NC,080,Rowan,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548915648,"WINSLOW, ANNA, GATES",1700 TARBORO ST W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 30 , 30 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548915648,"WINSLOW, ANNA, GATES",1700 TARBORO ST W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 205 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1548915648,"WINSLOW, ANNA, GATES",1700 TARBORO ST W   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 119 , 203 , 204 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1548921794,"BRYANT, JASON, STUART",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 15 , 16 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1548921794,"BRYANT, JASON, STUART",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 21 , 28 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1548921794,"BRYANT, JASON, STUART",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548922503,"CORRIGAN, PATRICK, RYAN",20 DUKE MEDICINE CIR # 51 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 36 , 68 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548922503,"CORRIGAN, PATRICK, RYAN",20 DUKE MEDICINE CIR # 51 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 25 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548923972,"ADAMS, MAUREEN, GALOS",1559 E BOOKER DAIRY RD STE B SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548923972,"ADAMS, MAUREEN, GALOS",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548923972,"ADAMS, MAUREEN, GALOS",320 GIDEON CREEK WAY   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548923972,"ADAMS, MAUREEN, GALOS",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548923972,"ADAMS, MAUREEN, GALOS",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 27 , 39 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1548923972,"ADAMS, MAUREEN, GALOS",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1043618523,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,730 MALCOLM BLVD STE 150 CONNELLY SPRINGS NC,012,Burke,193400000X,Group,Single Specialty,,1548924160,"HARDING, AMBER, MICHELLE",730 MALCOLM BLVD STE 150 CONNELLY SPG NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 87 , 180 , 246 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548924608,"BOWERS, KELLY, PAIGE",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548924608,"BOWERS, KELLY, PAIGE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1548924608,"BOWERS, KELLY, PAIGE",1833 HENDERSONVILLE RD STE 140 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548925860,"DOLAN, ERIC, ROBERT",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 47 , 104 ,$#,,
MEDICAID DIRECT,1750648077,ROBESON HEALTH CARE CORPORATION,SCOTLAND HEALTH CENTER,507 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548927841,"YORK, BRITTANY, QUAMEL",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 123 , 357 , 455 ," $20,099.59 ",,
MEDICAID DIRECT,1750348538,ROBESON HEALTH CARE CORPORATION,JULIAN T PIERCE HEALTH CENTER,307 E WARDELL DR   PEMBROKE NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548927841,"YORK, BRITTANY, QUAMEL",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548927841,"YORK, BRITTANY, QUAMEL",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548927841,"YORK, BRITTANY, QUAMEL",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457829996,ROBESON HEALTH CARE CORPORATION,DR AJ ROBINSON HEALTH CENTER,800 MARTIN LUTHER KING JR DR   LUMBERTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548927841,"YORK, BRITTANY, QUAMEL",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548927965,"KARCHER, ELISABETH, JOY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548927965,"KARCHER, ELISABETH, JOY",7752 GATEWAY LN NW STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 57 , 149 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1548929912,"KAHLER, AMANDA, KAYLA",4275 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 50 , 77 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548930712,"HARRS, ADRIANNA, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 27 , 27 ,$#,,
MEDICAID DIRECT,1134474059,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE INDIAN TRAIL FAMILY MED,4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1548931538,"RYAN, JOHN, CHRISTOPHER",4503 OLD MONROE RD   INDIAN TRAIL NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 44 , 51 , 77 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548934847,"COATS, STACEY, JEFFERSON",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548934847,"COATS, STACEY, JEFFERSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 74 , 102 , 105 ,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548938954,"MURRAY, AMBER, GRACE",300 N SALISBURY AVE   SPENCER NC,080,Rowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 140 , 147 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1548940588,"SEITER, ANTHONY, WILLIAM",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548940588,"SEITER, ANTHONY, WILLIAM",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1548941594,"HAYNES, ERYN, GREY",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1548941594,"HAYNES, ERYN, GREY",113A HOSPITAL LOOP RD   CHEROKEE NC,087,Swain,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1548941883,S & B HOME SERVICES LLC,,3007 SLATE CT   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1548941883,S & B HOME SERVICES LLC,3007 SLATE CT   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 3,410 "," 3,410 "," $220,334.46 ",,
MEDICAID DIRECT,1710012174,PSYCHIATRIC SERVICES OF CAROLINAS,PSYCHIATRIC SERVICES OF CAROLINAS PC,1530 UNION RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1548942212,"GASTLEY, CARLI, MADISON",1530 UNION RD STE A GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1023013836,HORNSBY REHABILITATION SERVICES INC,~,235 JIM BERRY RD   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1548942683,"WHORTON, NINA, DAVIS",235 JIM BERRY RD   FRANKLIN NC,056,Macon,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 39 ,$#,,
MEDICAID DIRECT,1184302655,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT ST STEPHENS ELEMENTARY,684 30TH ST NE   CONOVER NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548942949,"WALKER, LINA, MELISSA",409 S OAKLAND ST   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548943681,"MARINELLO, ANGELA, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1548945496,"HAMMER, MEREDITH, GRACE",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528404571,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548945496,"HAMMER, MEREDITH, GRACE",100 MEDICAL PARK DR STE 110 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 33 , 33 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548949431,"MCDOWELL, CAMERON, SCHYLER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1396762886,TRINITY WELLNESS CENTER INC,TRINITY WELLNESS CENTER INCORPORATED,200 HORIZON DR STE 115 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548949779,"MARTIN, HALEY, LORENE",200 HORIZON DR STE 115 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 25 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548953441,"CARDEN, GABRIELLE, STEWART",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528304235,CABARRUS ROWAN COMMUNITY HEALTH CEN,CHINA GROVE FAMILY MEDICINE,307 E THOM ST   CHINA GROVE NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548953441,"CARDEN, GABRIELLE, STEWART",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1851177539,CABARRUS ROWAN COMMUNITY HEALTH CEN,SUGAR CREEK HEALTH CENTER,721 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548953441,"CARDEN, GABRIELLE, STEWART",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982371514,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - ALBEMARLE,1000 N 5TH ST   ALBEMARLE NC,084,Stanly,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548953441,"CARDEN, GABRIELLE, STEWART",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548959281,"PICKETT, CHELSEA, ALAINE",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice, 182 , 196 , 692 ," $25,166.09 ",,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548959281,"PICKETT, CHELSEA, ALAINE",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1548959281,"PICKETT, CHELSEA, ALAINE",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 440 , 530 ," 1,922 "," $72,057.36 ",,
MEDICAID DIRECT,1578385191,RAYNALD L DESAMEAU DMD PLLC,RADIANT SMILES FAMILY AND COSMETIC DENTISTRY,10460 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1548959281,"PICKETT, CHELSEA, ALAINE",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 192 , 239 , 833 ," $45,325.30 ",,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548959281,"PICKETT, CHELSEA, ALAINE",582 KANNAPOLIS PKWY   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 122 , 130 , 396 ," $19,610.93 ",,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1548959281,"PICKETT, CHELSEA, ALAINE",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 22 , 42 ,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1548959281,"PICKETT, CHELSEA, ALAINE",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548959281,"PICKETT, CHELSEA, ALAINE",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 15 , 48 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1548959281,"PICKETT, CHELSEA, ALAINE",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1548964844,"RUIZ, BRANDON, JORNEL",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548964844,"RUIZ, BRANDON, JORNEL",8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 67 , 157 ,$#,,
MEDICAID DIRECT,1801640461,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,109 AIRPORT RD STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1548966062,"VIERA, BRITTANY, MICHELLE",109A AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 , 158 , 268 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,109A AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1548966062,"VIERA, BRITTANY, MICHELLE",109A AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548966401,"CAREY, JACOB, LOUIS",3116 N DUKE ST   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1987 HILTON RD   BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1306 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1306 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1306 S KING ST   WINDSOR NC,008,Bertie,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1073380515,WOUNDSWIFT LLC,,5540 CENTERVIEW DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972150084,WOUND MANAGEMENT SPECIALISTS LLC,,6 REGIONAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 349 , 355 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 101 , 101 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",1075 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 76 ," 1,127 "," 1,149 "," $11,305.20 ",,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1548966500,"LANDRETH, ELLEN, DUNN",901 HALSTEAD BLVD   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548968365,HENDERSON SCH OPERATING LLC,SENIOR CITIZENS HOME,2275 RUIN CREEK RD   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1548968365,HENDERSON SCH OPERATING LLC,2275 RUIN CREEK RD   HENDERSON NC,091,Vance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#," $13,755.68 ",,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,1212 CENTRAL DR STE 201 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1548969363,"HINRICHS, PATRICIA, ELLEN",1212 CENTRAL DR STE 201 SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 61 , 75 ,$#,,
MEDICAID DIRECT,1821789322,MCPC-25 LLC,FIRSTHEALTH RADIATION ONCOLOGY,135 PAGE RD N   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1548969363,"HINRICHS, PATRICIA, ELLEN",135 PAGE RD N   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417010422,FIRSTHEALTH OF THE CAROLINAS INC,~,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1548969363,"HINRICHS, PATRICIA, ELLEN",220 PAGE RD   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 26 ,$#,,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,501 DOUGLAS ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548973662,"WILLIAMS, KENDALL, ELIZABETH",501 DOUGLAS ST   DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548974678,"ONUOHA, CHINWENDU, VICTORIA",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548975758,"PANJWANI, SHAMA, DINMOHAMED",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548975758,"PANJWANI, SHAMA, DINMOHAMED",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548975758,"PANJWANI, SHAMA, DINMOHAMED",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548975758,"PANJWANI, SHAMA, DINMOHAMED",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548975758,"PANJWANI, SHAMA, DINMOHAMED",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4300 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1548975758,"PANJWANI, SHAMA, DINMOHAMED",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548975758,"PANJWANI, SHAMA, DINMOHAMED",442 S HIGHWAY 27   STANLEY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1548976004,"VANSANT, KIMBERLY, KAY",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 148 , 167 , 197 ," $11,373.39 ",,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548976962,"RUNYON, CALEB, TYLER",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548976962,"RUNYON, CALEB, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 25 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1548976962,"RUNYON, CALEB, TYLER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1548978737,"TRABOLSKY, ROMI",115 ADAMS ST   PLYMOUTH NC,094,Washington,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801222716,METROPOLITAN COMMUNITY HEALTH SERVI,~,1130 GODWIN DR   WILLIAMSTON NC,058,Martin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548978737,"TRABOLSKY, ROMI",1130 GODWIN DR 1130 GODWIN DR WILLIAMSTON NC,058,Martin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 84 , 151 , 158 ,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1548978810,"DUKE, JOSEPH, RALEIGH",584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1548978810,"DUKE, JOSEPH, RALEIGH",106 W MEDICAL PARK DR STE A LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 96 , 185 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548979057,"PLEVA, ALISON, NICOLE",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 36 , 91 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548979495,"MCMUNN, MORGAN, JANEL",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548979495,"MCMUNN, MORGAN, JANEL",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1548985278,"BROWN, FLAVIA, DESOUSA",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2770 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548985567,"WALL, MICHELLE, DUNCAN",3325 ROBINHOOD RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,605 COLLEGE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548985567,"WALL, MICHELLE, DUNCAN",3325 ROBINHOOD RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1548985732,"SPALDING, CASSANDRA, MARIE",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1548985732,"SPALDING, CASSANDRA, MARIE",3320 WAKE FOREST RD STE 430 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1548991144,"LLOYD, KATHERINE, ISABELLA",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 56 , 56 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 39 , 42 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,2660 TATE BVLD SE STE 202 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1548991565,"HOLMES, KELLY, BRITTAIN",2660 TATE BLVD SE STE 202 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 72 , 115 , 118 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 132 , 141 , 462 ," $15,961.41 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548993298,"SMITH, HANNAH, LEIGH",,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1548993298,"SMITH, HANNAH, LEIGH",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 24 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 137 , 140 , 647 ," $16,569.09 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1548993298,"SMITH, HANNAH, LEIGH",2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1548994593,"MATTFELD, ABBIGAIL, AMANDA",201 E GROVER ST   SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 59 , 59 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548995186,"MAHON, COURTNEY, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 27 , 27 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548995186,"MAHON, COURTNEY, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 91 , 134 , 135 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548995186,"MAHON, COURTNEY, LYNN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1548995186,"MAHON, COURTNEY, LYNN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548995970,"SHARPE, ANNA, MANESS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548995970,"SHARPE, ANNA, MANESS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1548995970,"SHARPE, ANNA, MANESS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1548998065,"JANKOWSKI, VICTORIA, ROSE",2277 NC 24-87   CAMERON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 43 , 97 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1548999246,"ROEMHILDT, LORIN, TYLER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558006130,SOUNDSIDE ORTHOTICS & PROSTHETICS L,EVERGREEN PROSTHETICS & ORTHOTICS,3705 HENDERSON DR   JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558006130,SOUNDSIDE ORTHOTICS & PROSTHETICS L,3705 HENDERSON DR   JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 17 , 21 , 120 ,$#,,
MEDICAID DIRECT,1558007658,SPRING ARBOR WILSON NC TENANT LLC,SPRING ARBOR OF WILSON,2045 WARD BLVD   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558007658,SPRING ARBOR WILSON NC TENANT LLC,2045 WARD BLVD   WILSON NC,098,Wilson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,356 "," 1,356 "," $84,989.60 ",,
MEDICAID DIRECT,1437643988,MOSES CONE AFFILIATED PHYSICIANS IN,COX FAMILY PRACTICE,350 N COX ST STE 28 ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1558013508,"ARYAL, REKHA",350 N COX ST STE 28 ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558014134,OPEN HEART HEALTHCARE LLC,OPEN HEARTS HEALTHCARE LLC,2006 N PINE ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1558014134,OPEN HEART HEALTHCARE LLC,2006 N PINE ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,#," 2,150 "," 2,150 "," $175,023.96 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558014787,"GRANATO, NICHOLAS",420 NORTH CENTER STREET   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558014787,"GRANATO, NICHOLAS",420 NORTH CENTER STREET   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558015859,"VINCENT, ALEXA, MARIE",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558017806,"TURNER, SHELITA, DANIELLE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 25 , 27 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558017806,"TURNER, SHELITA, DANIELLE",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1558022947,"HATCH, JESSICA, YVONNE",100 AIRPORT RD   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 114 , 120 , 157 ,$#,,
MEDICAID DIRECT,1720247570,CAROLINA THERAPEUTIC SERVICES INC,~,1528 UNION RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558026971,"HALEY, MONICA, JEAN",1528 UNION RD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1558027227,ALL IN ONE HOME CARE INC,ALL IN ONE HOME CARE INC,2629 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1558027227,ALL IN ONE HOME CARE INC,2629 SUNSET AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,091 "," 4,091 "," $264,107.00 ",,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1558027425,"WRIGHT, JENNIFER",534 CARATOKE HWY   MOYOCK NC,027,Currituck,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 23 , 41 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558027748,"STUTESMAN, KATHLEEN, BARKLEY",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 36 , 102 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558030619,"SMITH, JOSHUA, CHARLES",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 23 , 30 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558030684,"CHAVIS-WATSON, TAMMY, RENEA",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 104 , 118 , 312 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558030684,"CHAVIS-WATSON, TAMMY, RENEA",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 49 , 55 , 144 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558030684,"CHAVIS-WATSON, TAMMY, RENEA",1212 S WALNUT ST   FAIRMONT NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 22 , 40 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,217 W BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558030684,"CHAVIS-WATSON, TAMMY, RENEA",128 E BROAD ST   SAINT PAULS NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1558034470,BELLS ANGELS HOMECARE SERVICES,,5736 N TRYON ST STE 221C CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558034470,BELLS ANGELS HOMECARE SERVICES,5736 N TRYON ST STE 221C CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 149 , 149 ,$#,,
MEDICAID DIRECT,1558037325,UNION OPCO LLC,WOODRIDGE ASSISTED LIVING FACILITY,2515 FOWLER SECREST RD   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558037325,UNION OPCO LLC,2515 FOWLER SECREST RD   MONROE NC,090,Union,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 53 ," 10,363 "," 10,365 "," $926,987.09 ",,
MEDICAID DIRECT,1558038174,CCJ ADULT CARE IV LLC,WALDEN POND CARE HOME,101 OLDE COACH LN   CHERRYVILLE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558038174,CCJ ADULT CARE IV LLC,101 OLDE COACH LN   CHERRYVILLE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 680 , 688 ," $41,997.31 ",,
MEDICAID DIRECT,1558039966,FIRST WATCH HOMECARE LLC,,3201 YORKTOWN AVE STE E DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1558039966,FIRST WATCH HOMECARE LLC,3201 YORKTOWN AVE STE E DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,279 "," 1,279 "," $132,781.97 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558046565,"GEER, WILLIAM, EDMUNDSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 64 , 78 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558046565,"GEER, WILLIAM, EDMUNDSON",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558047399,"JUDY, REBECCA, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558054668,"BURKE, SUNCERI, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558054668,"BURKE, SUNCERI, MARIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558067504,"TIPTON, HILDA, RICO",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558067504,"TIPTON, HILDA, RICO",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 35 , 35 ," $10,126.71 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558073197,"BUSKIRK, KYLIE",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 32 , 74 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558073841,"PASSMORE, BRANDON, STERLING",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558076695,"LAMB, CRYSTAL, DAWN",109 PENNY RD   HIGH POINT NC,041,Guilford,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558076695,"LAMB, CRYSTAL, DAWN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558076695,"LAMB, CRYSTAL, DAWN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558076695,"LAMB, CRYSTAL, DAWN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1386682367,EAST ASHEVILLE FAMILY HEALTH CARE,~,997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1558078550,"WILBANKS GRISINGER, PAULA, DENISE",997 OLD US HWY 70 W STE A BLACK MOUNTAIN NC,011,Buncombe,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558082859,BUTTERFLIES 4 EVELYN LLC,,502 JORDAN ST SW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1558082859,BUTTERFLIES 4 EVELYN LLC,502 JORDAN ST SW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,#," 1,734 "," 1,734 "," $96,826.16 ",,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558092775,"SUTTON-HANNAH, JENNIFER, RENEE",1207 EAST ST   WAYNESVILLE NC,044,Haywood,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 24 , 129 , 129 ," $31,539.09 ",,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",128 E PLAZA DR UNIT 34 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",128 E PLAZA DR UNIT 34 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",128 E PLAZA DR UNIT 34 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 26 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",128 E PLAZA DR UNIT 34 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",128 E PLAZA DR UNIT 34 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",128 E PLAZA DR UNIT 34 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",128 E PLAZA DR UNIT 34 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",724 S HORNER BLVD   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1800 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1558092791,"MARIA, TRACY",1800 N SANDHILLS BLVD   ABERDEEN NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558093021,"CORLETT, ERIC, JAMES",10905 PROVIDENCE RD W STE 270 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 17 , 24 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558093021,"CORLETT, ERIC, JAMES",12611 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558093021,"CORLETT, ERIC, JAMES",1450 MATTHEWS TOWNSHIP PKWY STE 170 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1558095414,"NORMAN, MATTHEW, PAUL",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 22 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558096560,"GRIFFIN, MELISSA, CHANEL",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558102038,"CAVANAUGH, JENNA, LIANE",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 41 , 66 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558102038,"CAVANAUGH, JENNA, LIANE",15 REGIONAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1558104414,A HEAVENLY HEALING HOME CARE,,213 PALACE GREEN LN   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,1558104414,A HEAVENLY HEALING HOME CARE,213 PALACE GREEN LN   SANFORD NC,053,Lee,253Z00000X,Agencies,In Home Supportive Care,,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558105411,"EAST, KIMBERLY, CORNETTE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 436 , 437 ,$#,,
MEDICAID DIRECT,1487494811,EVENTUS WH SOUTHEAST LLC,,212 S TRYON ST STE 1000 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558105411,"EAST, KIMBERLY, CORNETTE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 80 , 81 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1558109900,"CROSBY, TYESHA, DENEE",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 93 , 114 , 415 ," $17,161.24 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558110361,"KIDD, DOMIZIANA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 30 , 47 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558121384,"LEE, JORDAN, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 339 , 341 , 419 ," $47,845.41 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,3612 HWY 49S   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 56 , 56 , 56 ," $47,799.06 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 11 ,$#,,
MEDICAID DIRECT,1518392125,BURROW WELCHEL CULP AND REIMELS DD,SIGNATURE SMILES ORTHODONTICS,2250 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1558121780,"BURROW, ALBERT, BRANDON",2250 NASH ST N   WILSON NC,098,Wilson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 57 , 57 , 57 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558123323,"ROGERS, SHERRY, LYNN",1000 COLLEGE ST   WILKESBORO NC,097,Wilkes,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558123323,"ROGERS, SHERRY, LYNN",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 94 , 613 , 614 ," $18,954.76 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558123323,"ROGERS, SHERRY, LYNN",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,3030 RANDOLPH RD STE 105   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558124669,"WYATT, THOMAS, FRAZIER",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 31 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1558127340,"RUNYON, ZAKARY, SCOTT",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558127340,"RUNYON, ZAKARY, SCOTT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558127340,"RUNYON, ZAKARY, SCOTT",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1558127340,"RUNYON, ZAKARY, SCOTT",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1558127340,"RUNYON, ZAKARY, SCOTT",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558127340,"RUNYON, ZAKARY, SCOTT",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1558127340,"RUNYON, ZAKARY, SCOTT",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558134593,"SILVA, HERMES, YANUEL",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558138206,"VENZON, JESSICA, LEIGH PENN",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558144865,"DEDIO, JEANAE, ELYSE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558144865,"DEDIO, JEANAE, ELYSE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558172593,"LOWRY, JADA, BROOKE",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1558174243,"CLYMENS, KIMBERLY, DAWN",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1558174441,"AAWAR, WALID",401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice, 517 , 582 ," 2,055 "," $79,841.72 ",,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1558174441,"AAWAR, WALID",401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 19 , 71 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558174441,"AAWAR, WALID",401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,1223G0001X,Dental Providers,Dentist,General Practice, 103 , 137 , 404 ," $21,144.34 ",,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1558178442,"SABATURA, HEIDI, JEANNETTE",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366522369,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558178442,"SABATURA, HEIDI, JEANNETTE",10210 COULOAK DR STE E CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558178442,"SABATURA, HEIDI, JEANNETTE",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003861386,NORTH CAROLINA EMERGENCY PHYSICIANS,NORTH CAROLINA EMERGENCY PHYSICIANS LLC,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1558189720,"SEWELL, WHITNEY, BROOKE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558191254,"FRENCH, YAJUN, LI",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1558300830,"MANSUR, LISA, IRENE",601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 22 , 33 ,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1558300830,"MANSUR, LISA, IRENE",601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 256 , 373 , 576 ," $10,063.92 ",,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1558300830,"MANSUR, LISA, IRENE",601 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558301135,"BARRETT, ANDREW, SCOTT",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558301135,"BARRETT, ANDREW, SCOTT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 35 , 35 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1558302182,"BURNS, ROYCE, ALAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558302182,"BURNS, ROYCE, ALAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 42 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558302182,"BURNS, ROYCE, ALAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 43 , 45 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1558302182,"BURNS, ROYCE, ALAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558302182,"BURNS, ROYCE, ALAN",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558302182,"BURNS, ROYCE, ALAN",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558303453,"WILLIAMS, JUDITH, VIRGINIA",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1558304097,"MCMANUS, MARK, WARREN",~,6336 US HIGHWAY 64   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1558304097,"MCMANUS, MARK, WARREN",6336 US HIGHWAY 64   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558304113,"RIMMER, GREGORY, ALAN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558305276,"ZIEBELL, JOSHUA, THOMAS",Joshua Thomas Ziebell,,,Unknown,152W00000X,Eye and Vision Services Providers,Optometrist,,1558305276,"ZIEBELL, JOSHUA, THOMAS",404 E CENTER AVE   MOORESVILLE NC,049,Iredell,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558305383,"SAMLI, BILLUR",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558305433,"THOMPSON, LINDSAY, ACHESON",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558305433,"THOMPSON, LINDSAY, ACHESON",1200 N MARTIN LUTHER KING JR DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558305433,"THOMPSON, LINDSAY, ACHESON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558305433,"THOMPSON, LINDSAY, ACHESON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558307397,"CHANDLEY, ERIC, ALLAN",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558307397,"CHANDLEY, ERIC, ALLAN",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558307397,"CHANDLEY, ERIC, ALLAN",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 44 , 93 ,$#,,
MEDICAID DIRECT,1518918259,RALEIGH DURHAM MEDICAL GROUP PA,NORTH RALEIGH PEDIATRIC GROUP,7205 STONEHENGE DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558308155,"RUTLEDGE, WILLIAM, JEFFREY",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1558308155,"RUTLEDGE, WILLIAM, JEFFREY",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 20 , 44 ,$#,,
MEDICAID DIRECT,1518918259,RALEIGH DURHAM MEDICAL GROUP PA,NORTH RALEIGH PEDIATRIC GROUP,7205 STONEHENGE DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558308155,"RUTLEDGE, WILLIAM, JEFFREY",7205 STONEHENGE DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 16 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558309955,"BLACK, MARTIN, LARRY",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,430 RANKIN DR   MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1558309955,"BLACK, MARTIN, LARRY",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558309955,"BLACK, MARTIN, LARRY",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659828291,RESERVE HEALTH PC,,135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558310078,"BIONDI, DANIEL, THOMAS",135 W 10TH ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558310276,"WERT, MICHAEL, BRUCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 25 , 42 , 60 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558310276,"WERT, MICHAEL, BRUCE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 177 , 295 , 393 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558310276,"WERT, MICHAEL, BRUCE",3518 DRAWBRIDGE PKWY STE 220 GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558310276,"WERT, MICHAEL, BRUCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1558310276,"WERT, MICHAEL, BRUCE",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1558310789,"NEELY, PHILIP, EARL",340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1558310789,"NEELY, PHILIP, EARL",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760669931,SOUTH GEORGIA RADIOLOGY ASSOCIATES,,340 EISENHOWER DR STE 1305 SAVANNAH GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1558310789,"NEELY, PHILIP, EARL",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558311464,"BURNS, BETH, ANN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558311464,"BURNS, BETH, ANN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558311464,"BURNS, BETH, ANN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558312934,EAST CAROLINA UNIVERSITY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,, 21 , 75 , 84 ,$#,,
MEDICAID DIRECT,1710926662,WILSON EYE ASSOCIATES,~,2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1558313379,"PERRY SR, RALPH, BARNES",2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1558313478,RALEIGH HAND CENTER PA,~,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558313478,RALEIGH HAND CENTER PA,3701 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,, 13 , 18 , 20 ,$#,,
MEDICAID DIRECT,1275271462,SHRINERS HOSPITALS FOR CHILDREN,,950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558313494,"WIENKE, JEFFREY, RYAN",950 W FARIS RD   GREENVILLE SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 17 , 19 ,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,561 YOPP RD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558314120,"LIKENS, ELWOOD, GLENN",2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,250 TURNER ST   ABERDEEN NC,063,Moore,193200000X,Group,Multi-Specialty,,1558314120,"LIKENS, ELWOOD, GLENN",2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,1550 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558314120,"LIKENS, ELWOOD, GLENN",2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1073584157,RISK OPTOMETRIC ASSOCIATES PA,RISK OPTOMETRIC ASSOCIATES PA,2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558314120,"LIKENS, ELWOOD, GLENN",2025 N MARINE BLVD   JACKSONVILLE NC,067,Onslow,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 14 , 25 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558314369,"SKINNER, ELIZABETH, NAISANG",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558314369,"SKINNER, ELIZABETH, NAISANG",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558314369,"SKINNER, ELIZABETH, NAISANG",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558314369,"SKINNER, ELIZABETH, NAISANG",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,207VX0201X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecologic Oncology, 18 , 54 , 75 ,$#,,
MEDICAID DIRECT,1508123571,SESSOMS MEDICAL ASSOCIATES LLC,~,500 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1558314476,"SESSOMS, RODNEY, KEVIN",414 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1508123571,SESSOMS MEDICAL ASSOCIATES LLC,~,500 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1558314476,"SESSOMS, RODNEY, KEVIN",414 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508123571,SESSOMS MEDICAL ASSOCIATES LLC,~,500 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1558314476,"SESSOMS, RODNEY, KEVIN",500 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 137 , 443 , 490 ,$#,,
MEDICAID DIRECT,1508123571,SESSOMS MEDICAL ASSOCIATES LLC,~,500 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1558314476,"SESSOMS, RODNEY, KEVIN",500 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 146 , 381 , 531 ," $18,521.96 ",,
MEDICAID DIRECT,1508123571,SESSOMS MEDICAL ASSOCIATES LLC,~,414 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558314476,"SESSOMS, RODNEY, KEVIN",500 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558314575,"FOLSTAD, STEVEN, GERALD",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558314914,"MCGINLEY, CHRISTINE, MARIE",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558315267,"SHERARD, GORDON, BROWN",853 N CHURCH ST STE 600 SPARTANBURG SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1972024354,RDMG ASSOCIATES PA,,827 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1558315721,"BOUTTAMY, KATAY",827 E KING ST   KINGS MOUNTAIN NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 109 , 183 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558316554,"MYERS, ERIKA, BETH GROMELSKI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 188 , 189 ," $10,132.63 ",,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558317453,"HOSEK, WILLIAM, TREANOR",5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558317453,"HOSEK, WILLIAM, TREANOR",8115 MARKET ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 17 , 19 , 25 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,16455 STATESVILLE RD STE 310 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1585 FORNEY CREEK PKWY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326849456,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PAIN SPECIALIST,720 MALCOLM BLVD STE 400 VALDESE NC,012,Burke,193400000X,Group,Single Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",720 MALCOLM BLVD STE 400 VALDESE NC,012,Burke,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1326849456,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE PAIN SPECIALIST,2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558318535,"EVANS, WILLIAM, MARTIN",2134 14TH AVENUE CIR NW   HICKORY NC,018,Catawba,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1558318683,JOHNSON DRUG COMPANY INC,JOHNSON DRUG COMPANY INC,714 NEW BRIDGE ST   JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558318683,JOHNSON DRUG COMPANY INC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1558318683,JOHNSON DRUG COMPANY INC,JOHNSON DRUG COMPANY INC,714 NEW BRIDGE ST   JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558318683,JOHNSON DRUG COMPANY INC,714 NEW BRIDGE ST   JACKSONVILLE NC,067,Onslow,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 553 ," 2,120 "," 3,902 "," $203,790.29 ",,
MEDICAID DIRECT,1558318683,JOHNSON DRUG COMPANY INC,JOHNSON DRUG COMPANY INC,714 NEW BRIDGE ST   JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1558318683,JOHNSON DRUG COMPANY INC,714 NEW BRIDGE ST   JACKSONVILLE NC,067,Onslow,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 67 , 265 , 265 ," $42,396.93 ",,
MEDICAID DIRECT,1558319251,SELF CARE THERAPY INC,~,6626 GORDON RD STE H WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558319251,SELF CARE THERAPY INC,6626 GORDON RD STE H WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1558320291,"GREENLAW, PAUL, REGINALD",738 NEWMAN RD   NEW BERN NC,025,Craven,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 14 , 25 ,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1558320382,"VERM, ALAN, MURRY",215 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 120 , 180 , 258 ,$#,,
MEDICAID DIRECT,1275592271,LOOKING GLASS EYE CENTER PA,LOOKING GLASS EYE CENTER PA,188 MEDICAL PARK DR STE C BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1558320382,"VERM, ALAN, MURRY",215 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 60 , 88 ,$#,,
MEDICAID DIRECT,1740249465,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558320523,"SMITH, WILLIAM, THOMAS",770 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 36 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558320671,"RAYNOR, EILEEN, MARGOLIES",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 120 , 187 , 205 ," $13,064.85 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558320671,"RAYNOR, EILEEN, MARGOLIES",2351 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558320671,"RAYNOR, EILEEN, MARGOLIES",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558320671,"RAYNOR, EILEEN, MARGOLIES",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 40 , 50 , 55 ,$#,,
MEDICAID DIRECT,1992819056,JAMES J CASEIO MD PA,,547 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558320945,"CASERIO, JAMES, JOSEPH",547 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 86 , 114 ,$#,,
MEDICAID DIRECT,1558322305,HOME MEDICAL SYSTEMS INC,IDEAL HOME MEDICAL,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558322305,HOME MEDICAL SYSTEMS INC,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1558322305,HOME MEDICAL SYSTEMS INC,IDEAL HOME MEDICAL,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1558322305,HOME MEDICAL SYSTEMS INC,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 26 , 27 ,$#,,
MEDICAID DIRECT,1558322305,HOME MEDICAL SYSTEMS INC,IDEAL HOME MEDICAL,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558322305,HOME MEDICAL SYSTEMS INC,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 395 ," 1,611 "," 3,180 "," $49,096.44 ",,
MEDICAID DIRECT,1558322305,HOME MEDICAL SYSTEMS INC,IDEAL HOME MEDICAL,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1558322305,HOME MEDICAL SYSTEMS INC,1147 JEFFREYS RD   ROCKY MOUNT NC,064,Nash,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 352 ," 1,145 "," 2,160 "," $35,693.82 ",,
MEDICAID DIRECT,1376899252,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH OF MCGEES CROSSROADS,70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558322511,"YEARWOOD, BEVERLY, ANN",70 CRAPE MYRTLE DR STE 104 BENSON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1700054574,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL OF FOUR OAKS,725 BOYETTE RD   FOUR OAKS NC,051,Johnston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558322511,"YEARWOOD, BEVERLY, ANN",725 BOYETTE RD   FOUR OAKS NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 25 ,$#,,
MEDICAID DIRECT,1952061517,TRI COUNTY COMMUNITY HEALTH COUNCIL,COMMWELL HEALTH,1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558322511,"YEARWOOD, BEVERLY, ANN",1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 14 , 44 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1558322511,"YEARWOOD, BEVERLY, ANN",1480 MAPLE GROVE CHURCH RD   DUNN NC,082,Sampson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558323113,"BENSON, JILL, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 130 , 147 , 187 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558323113,"BENSON, JILL, LYNN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 14 , 19 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1558323113,"BENSON, JILL, LYNN",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1558323113,"BENSON, JILL, LYNN",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558323113,"BENSON, JILL, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 33 , 39 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1558323113,"BENSON, JILL, LYNN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1558323113,"BENSON, JILL, LYNN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1558324442,"KHOURI, ELIE, JOSEPH",430 RANKIN DR   MARION NC,059,McDowell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1558324442,"KHOURI, ELIE, JOSEPH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558325811,"JACOB JR, GREGORIO, ZERRUNDO",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 510 ," 1,160 "," 1,280 "," $37,157.38 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558326637,"KENNEDY, SCOTT, REED",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 61 , 70 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558326637,"KENNEDY, SCOTT, REED",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 116 , 118 , 154 ,$#,,
MEDICAID DIRECT,1518081363,G & G HEALTHCARE PC,~,326 COLUMBUS CORNERS DR   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1558327031,"GREENE, JOHN, ROBERT",326 COLUMBUS CORNERS DR   WHITEVILLE NC,024,Columbus,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 35 , 190 , 319 ,$#,,
MEDICAID DIRECT,1518081363,G & G HEALTHCARE PC,~,326 COLUMBUS CORNERS DR   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1558327031,"GREENE, JOHN, ROBERT",326 COLUMBUS CORNERS DR   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 95 , 279 , 483 ," $10,096.68 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558327973,"SURYANARAYANAN, SOWMYA, KANAMANGALATH",3724 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 44 , 66 , 99 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558328021,"VARNELL, ROBERT, MARTIN",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558328021,"VARNELL, ROBERT, MARTIN",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558328062,"DIXON, ELIZABETH, ELLEN",98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 19 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1558328062,"DIXON, ELIZABETH, ELLEN",98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 45 , 67 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558328351,"KELLY, JENNIFER, AMY",1120 SE CARY PKWY   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558328393,COASTAL PROSTHETICS ORTHOTICS,,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558328393,COASTAL PROSTHETICS ORTHOTICS,433 NETWORK STA   CHESAPEAKE VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 13 ,$#,,
MEDICAID DIRECT,1558328393,COASTAL PROSTHETICS ORTHOTICS,,6330 N CENTER DR STE 125 NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558328393,COASTAL PROSTHETICS ORTHOTICS,6330 N CENTER DR STE 125 NORFOLK VA,101,Out of State <= 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 39 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558328492,"HARRIS, SEAN, MICHAEL",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558329110,"BLISS, PENELOPE, SUE",101 KELLIE DR   SMITHFIELD NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 34 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1558329110,"BLISS, PENELOPE, SUE",6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 14 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558329110,"BLISS, PENELOPE, SUE",3801 COMPUTER DR STE 200 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558329326,"SIMON, YVONNE, LUYANDO",77 VILCOM CIR STE 200 CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558329326,"SIMON, YVONNE, LUYANDO",100 E DOGWOOD DR   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558329326,"SIMON, YVONNE, LUYANDO",919 S FIFTH ST   MEBANE NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 67 , 88 ,$#,,
MEDICAID DIRECT,1700184470,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,322 MULBERRY ST SW STE C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1558331223,"CLENNEY, TIMOTHY, LEE",322 MULBERRY ST SW STE C LENOIR NC,014,Caldwell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 44 , 74 , 101 ,$#,,
MEDICAID DIRECT,1134727233,TERRA PAIN CONSULTANTS PLLC,,812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1558332551,"PATEL, UTPAL, KANTILAL",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 52 , 134 , 152 ,$#,,
MEDICAID DIRECT,1134727233,TERRA PAIN CONSULTANTS PLLC,,812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1558332551,"PATEL, UTPAL, KANTILAL",812 CANDY PARK RD STE 6103 PEMBROKE NC,078,Robeson,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 101 , 568 , 707 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558332684,"BENOIT-WILSON, MICHELE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558332692,"GROSS, SCOTT, KIM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 136 , 136 ,$#,,
MEDICAID DIRECT,1851362503,PIEDMONT ADULT AND PEDIATRIC MEDICI,PIEDMONT ADULT AND PEDIATRIC MEDICINE PA,640 SUMMIT CROSSING PL STE 204 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1558332833,"OWUSU ADDO, YAW, ADJEI",640 SUMMIT CROSSING PL STE 204 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 129 , 218 ,$#,,
MEDICAID DIRECT,1831687912,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN WOMENS HEALTHCARE AT THE OAKS,,,Unknown,193200000X,Group,Multi-Specialty,,1558334086,"MULROY, CONSTANCE, MARIE",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558334086,"MULROY, CONSTANCE, MARIE",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 38 , 56 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558334086,"MULROY, CONSTANCE, MARIE",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558334086,"MULROY, CONSTANCE, MARIE",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 56 , 65 , 86 ," $10,412.18 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558334086,"MULROY, CONSTANCE, MARIE",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1558334201,"COTTLE, RONALD, WADE",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 229 , 334 , 638 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558334284,"DAVIS JR, WILEY, MASON",11840 SOUTHMORE DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 25 , 57 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558334284,"DAVIS JR, WILEY, MASON",11030 GOLF LINKS DR N STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 41 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1558334730,"FARKAS, LINDA, MARIE",1138 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558337501,"WARD, ROBERT, WILLIAM",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 27 , 88 , 100 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558338020,"GUNTER WOODS, ELIZABETH, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1255307187,REX PATHOLOGY ASSOCIATES PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558338475,"SMITH, VINCENT, CHARLES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 87 , 89 , 149 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1558338657,"MATTHEWS, LAURA, LEIGH",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1376510651,WEST CARY FAMILY PHYSICIANS,WEST CARY FAMILY PHYSICIANS,256 TOWNE VILLAGE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1558338830,"NUNEZ, PEDRO, JUAN",256 TOWNE VILLAGE DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 117 , 259 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 16 , 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 33 , 40 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 24 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 70 , 133 , 153 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",250 18TH ST SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 30 , 36 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558341255,"HUNT, CHRISTOPHER, LOREN",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1558341420,"ALLEN, MARK, EDWARD",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558343624,"PARIS, YVONNE, MARIE",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558343624,"PARIS, YVONNE, MARIE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558343624,"PARIS, YVONNE, MARIE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 34 , 44 , 86 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558343624,"PARIS, YVONNE, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558344259,"BERTONI, ALAIN, GERALD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 53 , 53 ,$#,,
MEDICAID DIRECT,1912300187,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193400000X,Group,Single Specialty,,1558344804,"HOFFMAN, KEITH, RAYMOND",3500 N DUKE ST STE 1 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558345553,"MURILLO, PAMELA, SUE",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1356439566,RAINBOW PEDIATRICS OF FAYETTEVILLE,RAINBOW PEDIATRICS OF FAYETTEVILLE PA,1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558345892,"ESENSOY, TANER",1327 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558345942,"THOMASON, JASON, WILLIAM WHITE",3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 163 , 196 , 393 ," $11,135.23 ",,
MEDICAID DIRECT,1801878632,SPECTRUM MEDICAL GROUP PA,~,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558345942,"THOMASON, JASON, WILLIAM WHITE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 14 , 27 , 30 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558345942,"THOMASON, JASON, WILLIAM WHITE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 19 , 38 , 43 ,$#,,
MEDICAID DIRECT,1558346940,LABORATORY CORPORATION OF AMERICA H,LABORATORY CORPORATION OF AMERICA HOLDIN,1126 N CHURCH ST STE 104 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,,1558346940,LABORATORY CORPORATION OF AMERICA H,1126 N CHURCH ST STE 104 GREENSBORO NC,041,Guilford,291U00000X,Laboratories,Clinical Medical Laboratory,, 20 , 35 , 86 ,$#,,
MEDICAID DIRECT,1649230921,CAROLINA PEDIATRICS PA,CAROLINA PEDIATRICS PA,201 COLONY AVE S   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1558347484,"PIERCE, CHARLES, GRAINGER",201 COLONY AVE S   AHOSKIE NC,046,Hertford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 11 ,$#,,
MEDICAID DIRECT,1649230921,CAROLINA PEDIATRICS PA,CAROLINA PEDIATRICS PA,201 COLONY AVE S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1558347484,"PIERCE, CHARLES, GRAINGER",201 COLONY AVE S   AHOSKIE NC,046,Hertford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 24 , 62 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558348227,"SIMMONS, TONY, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558348227,"SIMMONS, TONY, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 944 ," 1,257 "," 1,279 ",$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558348227,"SIMMONS, TONY, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 55 , 55 , 56 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558348227,"SIMMONS, TONY, WILLIAM",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558348227,"SIMMONS, TONY, WILLIAM",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 271 , 384 , 384 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1558348276,"YAEGER, EDWIN, PAUL",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 45 , 46 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1558348276,"YAEGER, EDWIN, PAUL",1705 TARBORO ST SW   WILSON NC,098,Wilson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 52 , 52 ,$#,,
MEDICAID DIRECT,1164503702,DUPLIN MEDICAL ASSOCIATION INC,ROSE HILL MEDICAL CENTER,600 S SYCAMORE ST   ROSE HILL NC,031,Duplin,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1558348276,"YAEGER, EDWIN, PAUL",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 16 , 21 ,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558348276,"YAEGER, EDWIN, PAUL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1801064886,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558348441,"OBRIEN, FRANCIS, XAVIER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558348441,"OBRIEN, FRANCIS, XAVIER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558349811,"RAGONESI, PETER, BRIAN",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 46 , 89 ,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558350496,"VEASY, GEORGE, DALE",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 40 , 40 , 68 ,$#,,
MEDICAID DIRECT,1932424355,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558350504,"GREENE, CRAIG, ALAN",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013232438,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS CONGENITAL HEART C,1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558350504,"GREENE, CRAIG, ALAN",1781 TATE BLVD SE STE 203 HICKORY NC,018,Catawba,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558350504,"GREENE, CRAIG, ALAN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558350504,"GREENE, CRAIG, ALAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1942440375,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES,3024 NEW BERN AVE FL 2 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558352120,"DOW SMITH, CARRIE, ANN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 31 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558352922,"BUTLER, MICHAEL, CHRISTOPHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 65 , 74 , 112 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558352922,"BUTLER, MICHAEL, CHRISTOPHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 47 , 58 , 73 ,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558353136,"EATON, MATTHEW, JAY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 29 , 29 ,$#,,
MEDICAID DIRECT,1073891719,CAROMONT MEDICAL GROUP INC,CAROMONT PATHOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558353300,"TRACY, STEVEN, LYNN",2525 COURT DR   GASTONIA NC,036,Gaston,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 19 , 20 , 24 ,$#,,
MEDICAID DIRECT,1396918413,LUKE MEDICAL CLINIC,LUKE MEDICAL CLINIC PA,125 W CATAWBA AVE   MOUNT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558353896,"GLASS, GREGORY, LEE",125 W CATAWBA AVE   MOUNT HOLLY NC,036,Gaston,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1396918413,LUKE MEDICAL CLINIC,LUKE MEDICAL CLINIC PA,125 W CATAWBA AVE   MOUNT HOLLY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558353896,"GLASS, GREGORY, LEE",125 W CATAWBA AVE   MOUNT HOLLY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 185 , 197 ,$#,,
MEDICAID DIRECT,1477840791,ALLEGHANY EMERGENCY GROUP LLC,ALLEGHANY EMERGENCY GROUP LLC,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1558353946,"TOMA, SABAH, SALMAN",233 DOCTORS ST   SPARTA NC,003,Alleghany,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558353946,"TOMA, SABAH, SALMAN",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1699760926,WAKE INTERNAL MEDICINE CONSULTANTS,WAKE INTERNAL MEDICINE CONSULTANTS INC,3237 BLUE RIDGE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558356618,"FLESCHER, JONATHAN",3100 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558356865,"AMYOT, ANN, BERRY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558356865,"AMYOT, ANN, BERRY",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558356865,"AMYOT, ANN, BERRY",3866 RURAL RETREAT RD STE 104 BURLINGTON NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558358234,"BRADLEY, CANDACE, ANGELENA",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1558358234,"BRADLEY, CANDACE, ANGELENA",117 E KINGS HWY   EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 30 , 30 ,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1558358333,"HAUSER, RICHARD, JOSEPH",103 PARKWAY OFFICE CT STE 100 CARY NC,092,Wake,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 22 , 60 , 121 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558358770,"STEVENS, LEIGH, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 40 , 45 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1558358770,"STEVENS, LEIGH, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,623 COUNTRY DAY RD   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1558358770,"STEVENS, LEIGH, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558358770,"STEVENS, LEIGH, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 40 , 44 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558358770,"STEVENS, LEIGH, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 112 , 125 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558358770,"STEVENS, LEIGH, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1558358770,"STEVENS, LEIGH, ANN",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 37 , 46 ,$#,,
MEDICAID DIRECT,1164683108,EAST CAROLINA RETINA CONSULTANTS PL,EAST CAROLINA RETINA CONSULTANTS PLLC,2501 STANTONSBURG RD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558359299,"VAN HOUTEN, PETER, ARTHUR",2501 STANTONSBURG RD STE A GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 23 , 35 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558360297,"WALDRON, LAUREN, CHAPMAN",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 66 , 93 ,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1558360412,"WHITTAKER, DAVID, STANTON",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 16 , 31 , 64 ,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1558360412,"WHITTAKER, DAVID, STANTON",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1558360412,"WHITTAKER, DAVID, STANTON",169 DOCTORS DR   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1558360412,"WHITTAKER, DAVID, STANTON",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558361246,"BOERTJE, DOUGLAS, LEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 39 , 40 , 41 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558361246,"BOERTJE, DOUGLAS, LEE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558361626,"GIOFFRE, RONALD, ANTHONY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 43 , 83 , 170 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1558361626,"GIOFFRE, RONALD, ANTHONY",3200 NORTHLINE AVE STE 200 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 17 , 31 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,640 S VAN BUREN RD UNIT B EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1558362889,"KEELING, JOHN, WAYNE",601 S MAIN ST   REIDSVILLE NC,079,Rockingham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,601 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1558362889,"KEELING, JOHN, WAYNE",601 S MAIN ST   REIDSVILLE NC,079,Rockingham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 81 , 273 , 429 ,$#,,
MEDICAID DIRECT,1194823039,ROCKINGHAM ORTHOPAEDIC ASSOCIATES P,Rockingham Orthopaedic Associates PA,,,Unknown,193400000X,Group,Single Specialty,,1558362889,"KEELING, JOHN, WAYNE",601 S MAIN ST UNIT A REIDSVILLE NC,079,Rockingham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1558364729,"BARRIER, CHARLES, HAROLD",197 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1558364729,"BARRIER, CHARLES, HAROLD",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558364729,"BARRIER, CHARLES, HAROLD",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1558364828,"FULP, CAMMIE, JO",1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 28 , 34 ,$#,,
MEDICAID DIRECT,1558364828,"FULP, CAMMIE, JO",~,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1558364828,"FULP, CAMMIE, JO",1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366180374,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE,1001 MONROE ST STE D CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1558365403,"BALLARD, MARCIA, HOLMAN",1001 MONROE ST STE D CARTHAGE NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 109 , 219 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",300 MEDICAL PAVILION DRIVE   RAEFORD NC,047,Hoke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 43 , 57 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",169 RAWLS RD   ANGIER NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 48 , 63 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 27 , 32 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",800 TILGHMAN DR   DUNN NC,043,Harnett,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 41 , 53 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 47 , 46 , 58 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1245474022,MEDICAL IMAGING CENTER LLC,VALLEY REGIONAL IMAGING,3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",3186 VILLAGE DR STE 101 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 71 , 72 , 92 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 285 , 357 , 403 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 40 , 42 ,$#,,
MEDICAID DIRECT,1558537282,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN COUNTY HOSPITAL,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558366138,"ZACCO, TERRI, LYNN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 45 , 54 ,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1558366138,"ZACCO, TERRI, LYNN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1558366138,"ZACCO, TERRI, LYNN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558366187,"O DONNELL, BRIAN, F",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558366278,"LINDEL, WILLIAM, MICHAEL",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558366765,"DURHAM, STEPHEN, BRYAN",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 40 , 46 ,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558366765,"DURHAM, STEPHEN, BRYAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558366765,"DURHAM, STEPHEN, BRYAN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1558366765,"DURHAM, STEPHEN, BRYAN",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 21 , 24 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558367680,"KELLY-JONES, ALYSE, MARGARET",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558368894,"SNYDER, JAMES, GLENN",880 KEMPSVILLE RD STE 1000 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558368936,"BOUTILIER, SUSAN, BLACKWELL",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558368936,"BOUTILIER, SUSAN, BLACKWELL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 91 , 116 , 123 ," $11,050.94 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558368936,"BOUTILIER, SUSAN, BLACKWELL",2280 HEMBY LN   GREENVILLE NC,074,Pitt,2084N0600X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Clinical Neurophysiology,#,#,#,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1558369207,"WIMMER, MARK, THOMAS",825 W HENDERSON ST STE A SALISBURY NC,080,Rowan,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 17 , 24 ,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1558369207,"WIMMER, MARK, THOMAS",631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 67 , 138 , 223 ,$#,,
MEDICAID DIRECT,1811517311,NOVANT HEALTH ROWAN MEDICAL CENTER,NOVANT HEALTH CANCER INSTITUTE,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1558369207,"WIMMER, MARK, THOMAS",631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,,,$#,,
MEDICAID DIRECT,1326384652,WNC LONGTERM HEALTHCARE PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558369462,"FORD, ALBERT, SHEDERICK",86 OLD AIRPORT RD   FLETCHER NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 43 , 87 , 87 ,$#,,
MEDICAID DIRECT,1326384652,WNC LONGTERM HEALTHCARE PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558369462,"FORD, ALBERT, SHEDERICK",200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 86 , 294 , 294 ," $11,532.82 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558369462,"FORD, ALBERT, SHEDERICK",200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558369462,"FORD, ALBERT, SHEDERICK",101 LIONS WAY   BLACK MOUNTAIN NC,011,Buncombe,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1760885321,REX HOSPITAL INC,REX EAR NOSE & THROAT SPECIALISTS AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558370734,"DORFMAN, BRETT, EDWARD",11200 GOVERNOR MANLY WAY STE 301 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 50 , 72 , 90 ,$#,,
MEDICAID DIRECT,1760885321,REX HOSPITAL INC,REX EAR NOSE & THROAT SPECIALISTS AT WAKEFIELD,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558370734,"DORFMAN, BRETT, EDWARD",11200 GOVERNOR MANLY WAY STE 301 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 27 , 35 ,$#,,
MEDICAID DIRECT,1720670862,EDWARDS AND ASSOCIATES PHYSICAL THE,,159 CROSSOVER RD   BEULAVILLE NC,031,Duplin,193400000X,Group,Single Specialty,,1558372227,"KILDOW, KURT, ERIC",159 CROSSOVER RD   BEULAVILLE NC,031,Duplin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 58 , 106 ,$#,,
MEDICAID DIRECT,1558372680,"BHATTI, MUHAMMAD, ASHRAF",~,2807 MCLAMB PL   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1558372680,"BHATTI, MUHAMMAD, ASHRAF",2807 MCLAMB PL   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 157 , 583 , 865 ," $26,001.24 ",,
MEDICAID DIRECT,1689638025,WAYNE FAMILY MEDICAL CENTER INC,~,2807 MCLAMB PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1558372680,"BHATTI, MUHAMMAD, ASHRAF",2807 MCLAMB PL   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 217 , 294 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558374801,"RUSSO, CHERYL, ANNE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558374801,"RUSSO, CHERYL, ANNE",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558374801,"RUSSO, CHERYL, ANNE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 47 , 63 , 102 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558375048,"BYRD, MARSHALL, DEWAYNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558375048,"BYRD, MARSHALL, DEWAYNE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558376657,WALGREEN CO,WALGREENS 05761,4701 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1558376657,WALGREEN CO,4701 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1604 MEDICAL DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 50 , 60 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,9848 N TRYON ST STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,152 E KINDERTON WAY STE 101 BERMUDA RUN NC,030,Davie,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 35 , 45 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1622 HIGHWOODS BLVD UNIT G105 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1730 KERNERSVILLE MEDICAL PKWY STE 204 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 13 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3311 JESSIE VILLAGE DR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,703 COMFORT LN   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 27 , 34 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",280 N POINTE BLVD   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1558378364,"DEIBLER, ANDREW, ROBERT",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770615114,PROMED HEALTHCARE PLLC,~,7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558378786,"MCDOWELL, JULIA, HOLLIDAY",7004 SMITH CORNERS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 25 , 37 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558381103,"MCNEELY, MARY, JENNIFER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 60 , 75 ,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1558381558,"HORSLEY, LAURIE, DUNN",709 N DEKALB ST   SHELBY NC,023,Cleveland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1558381558,"HORSLEY, LAURIE, DUNN",709 N DEKALB ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 73 , 99 , 228 ,$#,,
MEDICAID DIRECT,1558382416,NEWTON CONOVER CITY SCHOOLS,NEWTON CONOVER CITY SCHOOLS,605 N ASHE AVE   NEWTON NC,018,Catawba,251300000X,Agencies,Local Education Agency (LEA),,1558382416,NEWTON CONOVER CITY SCHOOLS,605 N ASHE AVE   NEWTON NC,018,Catawba,251300000X,Agencies,Local Education Agency (LEA),, 174 ," 5,517 "," 5,797 "," $241,478.68 ",,
MEDICAID DIRECT,1558382523,MONTGOMERY COUNTY SCHOOLS,MONTGOMERY COUNTY SCHOOLS,441 PAGE ST   TROY NC,062,Montgomery,251300000X,Agencies,Local Education Agency (LEA),,1558382523,MONTGOMERY COUNTY SCHOOLS,441 PAGE ST   TROY NC,062,Montgomery,251300000X,Agencies,Local Education Agency (LEA),, 136 ," 1,337 "," 1,359 "," $71,937.35 ",,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558385062,"DICKERSON, GINGER, ANN",101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558385062,"DICKERSON, GINGER, ANN",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558385062,"DICKERSON, GINGER, ANN",101 E WT HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558386045,"LEE-VALKOV, PAULA, MARIA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558386045,"LEE-VALKOV, PAULA, MARIA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558386045,"LEE-VALKOV, PAULA, MARIA",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558386458,"YOCKEY, JASON, EUGENE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770182933,WAKE PET SERVICES LLC,,210 ASHVILLE AVE STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 24 , 36 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 99 , 105 , 127 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,601 ATTAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558387365,"ROTH, TODD, JASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558387605,PRONURSE,,1125 E MOREHEAD ST STE 209 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558387605,PRONURSE,1125 E MOREHEAD ST STE 209 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 35 ," 8,443 "," 9,553 "," $1,638,443.02 ",,
MEDICAID DIRECT,1558388702,WAL-MART STORES EAST LP,~,160 LOWES BLVD   LEXINGTON NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1558388702,WAL-MART STORES EAST LP,160 LOWES BLVD   LEXINGTON NC,029,Davidson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1558389353,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1300,3105 MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1558389353,WAL-MART STORES EAST LP,3105 MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558391011,"HAGEN, JEFFREY, AUGUST",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558391011,"HAGEN, JEFFREY, AUGUST",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558391011,"HAGEN, JEFFREY, AUGUST",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558391862,"HAMMOND, NANCY, EMILY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,, 23 , 40 , 45 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 190 , 426 , 553 ," $18,935.55 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558393066,"MUELLER, CAROLYN",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 135 ," 1,277 "," 1,306 "," $25,358.02 ",,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558393066,"MUELLER, CAROLYN",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 577 , 596 ," $13,012.83 ",,
MEDICAID DIRECT,1558393959,MAXIM HEALTHCARE SERVICES,~,216 N BICKETT BLVD STE 2 LOUISBURG NC,035,Franklin,251J00000X,Agencies,Nursing Care,,1558393959,MAXIM HEALTHCARE SERVICES,216 N BICKETT BLVD STE 2 LOUISBURG NC,035,Franklin,251J00000X,Agencies,Nursing Care,,#, 46 , 50 ," $21,710.00 ",,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558394767,"DINOME JR, ANTHONY, JOSEPH",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558394767,"DINOME JR, ANTHONY, JOSEPH",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558394767,"DINOME JR, ANTHONY, JOSEPH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558394767,"DINOME JR, ANTHONY, JOSEPH",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558395780,"DIGIUSEPPE, ROBERT, MICHAEL",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558395780,"DIGIUSEPPE, ROBERT, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558395780,"DIGIUSEPPE, ROBERT, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 19 , 89 , 89 ," $16,183.51 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558396259,"HENIFORD, BRANT, TODD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 18 , 29 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1558397596,"SHORT, JOSHUA, HARRISON",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 82 , 87 , 94 ,$#,,
MEDICAID DIRECT,1750735064,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS HEALTHCARE SYSTEM WOUND CARE PHYSICIANS-,101 E W T HARRIS BLVD STE 5203 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558397778,"LETTMAN CARSWELL, NADINE, AMORETTE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 79 , 100 ,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558398164,"KRAFT, BRIAN, CLIFTON",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558398164,"KRAFT, BRIAN, CLIFTON",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558398164,"KRAFT, BRIAN, CLIFTON",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1962869446,FAYETTEVILLE GASTROENTEROLOGY ENDOS,,2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1558398511,"DANIELS, ANTHONY, MAURICE",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 23 , 32 ,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558398511,"DANIELS, ANTHONY, MAURICE",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 334 , 518 , 576 ," $17,306.71 ",,
MEDICAID DIRECT,1457365751,FAYETTEVILLE GASTROENTEROLOGY ASSOC,FAYETTEVILLE GASTROENTEROLOGY ASSOCIATES PA,,,Unknown,193200000X,Group,Multi-Specialty,,1558398511,"DANIELS, ANTHONY, MAURICE",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1831157866,UNIVERSITY EYE ASSOCIATES OD PA,UNIVERSITY EYE ASSOCIATES OD PA,8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558399055,"HAWKS, TAMMY, HUNT",8316 MEDICAL PLAZA DR STE E CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",3943 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 42 , 42 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",465 STRATFORD DR   ZEBULON NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",465 STRATFORD DR   ZEBULON NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 41 , 41 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558399907,"KOENIG, DANIEL, WILLIAM",670 GRANITE VISTA DR   ROLESVILLE NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1558396622,HOME HEALTH AND HOSPICE CARE INC,HOME HEALTH AND HOSPICE CARE INC,107 HANDLEY PARK CT   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1558400515,"GRAHAM, JAMIE, RAE",2402 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558400820,"GAMBLE, RENEE, OVERMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558400820,"GAMBLE, RENEE, OVERMAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558400945,CAROLINA PERSONAL CARE AGENCY,~,916 SOUTHEAST BLVD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1558400945,CAROLINA PERSONAL CARE AGENCY,916 SOUTHEAST BLVD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,#, 943 , 943 ," $124,492.48 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558401455,"BELFI, MELANIE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558401455,"BELFI, MELANIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558401455,"BELFI, MELANIE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558401455,"BELFI, MELANIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558401455,"BELFI, MELANIE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558401455,"BELFI, MELANIE",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558403956,"FARLAND, SANDRA, BRYANT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 48 , 86 ,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558404954,"RICHTER, BRAD, ARTHUR",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1073914024,LITTLE OAKS PEDIATRICS PLLC,,13200 STRICKLAND RD STE 120 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558405498,"OZTURK, CEYHUN",13200 STRICKLAND RD STE 120 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 37 , 96 ,$#,,
MEDICAID DIRECT,1558409706,PEDIATRIC SPEECH AND LANGUAGE SERVI,PEDIATRIC SPEECH AND LANGUAGE SERVICES LLC,1305 W WENDOVER AVE STE C GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558409706,PEDIATRIC SPEECH AND LANGUAGE SERVI,1305 W WENDOVER AVE STE C GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1558409706,PEDIATRIC SPEECH AND LANGUAGE SERVI,PEDIATRIC SPEECH AND LANGUAGE SERVICES LLC,3201 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558409706,PEDIATRIC SPEECH AND LANGUAGE SERVI,3201 W MARKET ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1558409706,PEDIATRIC SPEECH AND LANGUAGE SERVI,PEDIATRIC SPEECH AND LANGUAGE SERVICES LLC,3201 W MARKET ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1558409706,PEDIATRIC SPEECH AND LANGUAGE SERVI,3201 W MARKET ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,, 387 ," 5,198 "," 5,306 "," $365,690.92 ",,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558411348,"CASERTA, ERIKA, LYNN",11840 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558411348,"CASERTA, ERIKA, LYNN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558411348,"CASERTA, ERIKA, LYNN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558411348,"CASERTA, ERIKA, LYNN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558414607,LOVE WITHIN HOME CARE SERVICES LLC,LOVE WITHIN HOME CARE SERVICES LLC,8401 UNIVERSITY EXEC PARK DR STE 114 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558414607,LOVE WITHIN HOME CARE SERVICES LLC,8401 UNIVERSITY EXEC PARK DR STE 114 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 2,598 "," 2,598 "," $157,427.44 ",,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558415190,"WESSON, LYNN, ELISE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558422600,"CHAMBERLIN, PATRICIA, ANN",~,350 N COX ST STE 12 ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,1558422600,"CHAMBERLIN, PATRICIA, ANN",350 N COX ST STE 12 ASHEBORO NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 53 , 102 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558425520,"SMITH, SCOTT, LEANDER",10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 18 , 26 ,$#,,
MEDICAID DIRECT,1558427443,SOUTHEASTERN BEHAVIORAL HOMECARE SE,Southeastern Behavioral Homecare Services Inc,3573 LACKEY ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1558427443,SOUTHEASTERN BEHAVIORAL HOMECARE SE,3573 LACKEY ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 5,805 "," 6,050 "," $757,480.44 ",,
MEDICAID DIRECT,1558428045,COUNTRY LIVING GUEST HOME INC,COUNTRY LIVING GUEST HOME 2,3052 MARKET STREET EXT   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558428045,COUNTRY LIVING GUEST HOME INC,3052 MARKET STREET EXT   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 909 , 909 ," $65,830.46 ",,
MEDICAID DIRECT,1558428045,COUNTRY LIVING GUEST HOME INC,COUNTRY LIVING GUEST HOME 2,3052 MARKET STREET EXT   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1558428045,COUNTRY LIVING GUEST HOME INC,3052 MARKET STREET EXT   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 984 , 987 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558431387,"LEKAVICH, CAROLYN, LOUISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 39 , 43 ,$#,,
MEDICAID DIRECT,1639242068,EYECARECENTER OD PA,EYECARE CENTER,4811 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1558434977,"WHITE, KATHERINE, SINGLETARY",4811 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558437442,"DAWSON, MELANIE, ERIN",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 42 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558438093,"HOBSON, MICHELE, LEIGH",75A LIVINGSTON ST   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 42 , 95 ,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558441576,"BRENNAN, MICHAEL, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,125Q00000X,Dental Providers,Dentist,Oral Medicine, 67 , 71 , 140 ,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558441576,"BRENNAN, MICHAEL, THOMAS",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,125Q00000X,Dental Providers,Dentist,Oral Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558441576,"BRENNAN, MICHAEL, THOMAS",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558441576,"BRENNAN, MICHAEL, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 50 , 55 , 106 ,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558441576,"BRENNAN, MICHAEL, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1558444216,"SAMPLE, SCOTT, ALLEN",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1558444216,"SAMPLE, SCOTT, ALLEN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 44 , 50 , 81 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1558444216,"SAMPLE, SCOTT, ALLEN",1001 NEWMAN RD   NEW BERN NC,025,Craven,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 27 , 35 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558444794,"BOGGESS, BLAKE, REID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1558444794,"BOGGESS, BLAKE, REID",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 21 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1558444794,"BOGGESS, BLAKE, REID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558444794,"BOGGESS, BLAKE, REID",100 DUKE HEALTH   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445429,"SWAMINATHAN, MADHAV",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445429,"SWAMINATHAN, MADHAV",DUKE HOSP SOUTH TRENT DR DUKE INTERNATIONAL PHYS DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558445429,"SWAMINATHAN, MADHAV",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445460,"MCDONALD, MARIE, THERESA",2100 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445460,"MCDONALD, MARIE, THERESA",2100 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1558445460,"MCDONALD, MARIE, THERESA",2100 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445460,"MCDONALD, MARIE, THERESA",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 31 , 42 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558445601,"HARDMAN, HAROLD, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 57 , 58 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445619,"HEFLIN, MITCHELL, TOD",DUKE MEDICAL CTR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445619,"HEFLIN, MITCHELL, TOD",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558445619,"HEFLIN, MITCHELL, TOD",DUKE MEDICAL CTR DUKE SURGICAL PDC DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1124115886,DILLON INTERNAL MEDICINE,DILLON INTERNAL MEDICINE ASSOCIATES,705 N 8TH AVE STE 1A DILLON SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558447185,"ODIN, ALTO, BERNAT",705 N 8TH AVE STE 1A DILLON SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1720033988,MCLEOD MEDICAL CENTER DILLION,MCLEOD MEDICAL CENTER DILLON,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558447185,"ODIN, ALTO, BERNAT",705 N 8TH AVE STE 1A DILLON SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 47 , 51 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558452037,"MAJI, DEBABRATA",600 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558452037,"MAJI, DEBABRATA",7921 ACC BLVD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558452037,"MAJI, DEBABRATA",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558452037,"MAJI, DEBABRATA",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 19 , 26 ,$#,,
MEDICAID DIRECT,1457519514,ADOLESCENT CHILD AND PSYCHIATRY OF,ADOLESCENT CHILD AND PSYCHIATRY OF RALEIGH PA,4041 ED DR STE 108 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558454322,"MAROOF, SHAHEDA, FATIMA",4041 ED DR STE 108 RALEIGH NC,092,Wake,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558454900,"WISCHMEYER, PAUL, EDMUND",2400 PRATT ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558454900,"WISCHMEYER, PAUL, EDMUND",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558454900,"WISCHMEYER, PAUL, EDMUND",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558458166,"PETERSON WILSON, TWYLA, JOANNE",146 NESBITT RDG   LAKE LURE NC,081,Rutherford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 13 , 75 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558458240,"FITCH, ROBERT, DOUGLAS",3000 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558458240,"FITCH, ROBERT, DOUGLAS",2301 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1558458463,"ROSEN, DAVID, AARON",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1558459719,"BERGDOLT, BARBARA, ANN",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 37 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1558459719,"BERGDOLT, BARBARA, ANN",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558459933,"BENTON, GEORGE, RUFFIN",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558459958,"HICKS, ANNA, MAJZLIK",501 ESSEOLA DR   SALUDA NC,075,Polk,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558459958,"HICKS, ANNA, MAJZLIK",501 ESSEOLA DR   SALUDA NC,075,Polk,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 16 , 27 , 27 ,$#,,
MEDICAID DIRECT,1558459958,"HICKS, ANNA, MAJZLIK",~,501 ESSEOLA DR   SALUDA NC,075,Polk,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,1558459958,"HICKS, ANNA, MAJZLIK",501 ESSEOLA DR   SALUDA NC,075,Polk,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558459958,"HICKS, ANNA, MAJZLIK",~,5593 OLD HAYWOOD RD   MILLS RIVER NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,1558459958,"HICKS, ANNA, MAJZLIK",5593 OLD HAYWOOD RD   MILLS RIVER NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558459958,"HICKS, ANNA, MAJZLIK",~,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,1558459958,"HICKS, ANNA, MAJZLIK",290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558459958,"HICKS, ANNA, MAJZLIK",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,290 CLEAR CREEK RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558459958,"HICKS, ANNA, MAJZLIK",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,501 ESSEOLA DR   SALUDA NC,075,Polk,193400000X,Group,Single Specialty,,1558459958,"HICKS, ANNA, MAJZLIK",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558459958,"HICKS, ANNA, MAJZLIK",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 20 ,$#,,
MEDICAID DIRECT,1558459958,"HICKS, ANNA, MAJZLIK",~,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,1558459958,"HICKS, ANNA, MAJZLIK",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558462937,"WILSON, EWAIN, PETER",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558462937,"WILSON, EWAIN, PETER",1914 W PARK DR WILKES REGIONAL ENT & SLEEP MEDICINE NORTH WILKESBORO NC,097,Wilkes,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1558464230,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07521,773 RUSS AVE   WAYNESVILLE NC,044,Haywood,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1558464230,NORTH CAROLINA CVS PHARMACY LLC,773 RUSS AVE   WAYNESVILLE NC,044,Haywood,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1558464230,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07521,773 RUSS AVE   WAYNESVILLE NC,044,Haywood,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558464230,NORTH CAROLINA CVS PHARMACY LLC,773 RUSS AVE   WAYNESVILLE NC,044,Haywood,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1558465278,"ALMONY, ARGHAVAN",1223 CARTHAGE ST   SANFORD NC,053,Lee,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1558465278,"ALMONY, ARGHAVAN",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1558465278,"ALMONY, ARGHAVAN",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 72 , 229 , 423 ," $71,313.61 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1558465278,"ALMONY, ARGHAVAN",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 79 , 143 ," $27,822.32 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1558465278,"ALMONY, ARGHAVAN",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,256 SHENSTONE LN   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558466102,"WRIGHT, JILL, CATHERINE",256 SHENSTONE LN   GARNER NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 32 , 86 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558467571,"VEERAGANDHAM, AJAY, KUMAR",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558467571,"VEERAGANDHAM, AJAY, KUMAR",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558470310,"BROZYNA, DIANNA, LOREN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558470435,"FLOYD, GEORGE, WESLEY",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 43 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558471680,"WRIGHTSON, WILLIAM, RICHARD",191 DEEP SOUTH FARM RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558472761,"VIDWAN, GURPREET, SINGH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 155 , 155 ," $12,130.73 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558476887,"DODD, BRIAN, STANLEY",232 SHARON AVE NW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 94 , 175 , 269 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1558476887,"DODD, BRIAN, STANLEY",232 SHARON AVE NW   LENOIR NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 43 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558476929,"KANNE, GERALDINE, ELIZABETH",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558479519,"SURPRENANT, ANN, ELIZABETH",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 136 , 136 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558482521,"LOFTON, LATANYA, DENISE",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1558482695,GOLDSBORO EYE CLINIC PLLC,OPHTHALMOLOGY EYE ASSOCIATES OF GOLDSBORO,2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1558482695,GOLDSBORO EYE CLINIC PLLC,2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,, 56 , 59 , 107 ,$#,,
MEDICAID DIRECT,1558482695,GOLDSBORO EYE CLINIC PLLC,OPHTHALMOLOGY EYE ASSOCIATES OF GOLDSBORO,2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1558482695,GOLDSBORO EYE CLINIC PLLC,2709 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,, 228 , 252 , 455 ,$#,,
MEDICAID DIRECT,1659495133,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558484931,"CABEZA, YURI, MILTON",4515 PREMIER DR STE 204 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 178 , 232 ,$#,,
MEDICAID DIRECT,1558485318,"BROOKS, BENCITA, BUGARIN",,6696 OLD 421 S   DEEP GAP NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1558485318,"BROOKS, BENCITA, BUGARIN",6696 OLD 421 S   DEEP GAP NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 13 , 612 , 613 ," $41,266.82 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558486431,"BEAVEN, ANNE, WOOD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 30 , 62 , 70 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558486688,"ROBOTTOM, BRADLEY, JAMES",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 65 , 120 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558486688,"ROBOTTOM, BRADLEY, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558487744,"LOCKLEAR, JUDITH, ANN",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558487744,"LOCKLEAR, JUDITH, ANN",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558487744,"LOCKLEAR, JUDITH, ANN",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558487744,"LOCKLEAR, JUDITH, ANN",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558487744,"LOCKLEAR, JUDITH, ANN",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 55 , 58 , 62 ," $15,890.97 ",,
MEDICAID DIRECT,1558489724,"HALL, TERRY, CORNELIUS",Terry Cornelius Hall,424 MAIN ST W   AHOSKIE NC,046,Hertford,1223G0001X,Dental Providers,Dentist,General Practice,1558489724,"HALL, TERRY, CORNELIUS",424 MAIN ST W   AHOSKIE NC,046,Hertford,1223G0001X,Dental Providers,Dentist,General Practice, 634 ," 1,012 "," 2,780 "," $115,702.65 ",,
MEDICAID DIRECT,1558491159,BEVERLY RUCKER FCH,BEVERLY RUCKERS FAMILY CARE HOME 2,503 NE MARKET ST   REIDSVILLE NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558491159,BEVERLY RUCKER FCH,503 NE MARKET ST   REIDSVILLE NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 338 , 338 ," $22,431.95 ",,
MEDICAID DIRECT,1558491860,COUNTY OF WASHINGTON,WASHINGTON COUNTY DEPARTMENT OF SOCIAL SERVICES,209 E MAIN ST   PLYMOUTH NC,094,Washington,251B00000X,Agencies,Case Management,,1558491860,COUNTY OF WASHINGTON,209 E MAIN ST   PLYMOUTH NC,094,Washington,251B00000X,Agencies,Case Management,, 69 , 660 , 660 ," $248,343.25 ",,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1558496117,"WILSON, HENRY, BENJAMIN",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 11 , 28 , 68 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1558496117,"WILSON, HENRY, BENJAMIN",7476 WATERSIDE LOOP RD STE 600 DENVER NC,055,Lincoln,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558496117,"WILSON, HENRY, BENJAMIN",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1558496117,"WILSON, HENRY, BENJAMIN",13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558499301,"SCHMELZER, THOMAS, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 22 , 31 ,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558499301,"SCHMELZER, THOMAS, MICHAEL",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1174640163,PEDIATRIC SURGICAL ASSOCIATES PA,,1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558499301,"SCHMELZER, THOMAS, MICHAEL",1900 RANDOLPH RD STE 210 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558499301,"SCHMELZER, THOMAS, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 18 , 22 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558499301,"SCHMELZER, THOMAS, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558501296,"PLUMMER, STEPHANIE, JEAN",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 15 , 24 , 34 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558501296,"PLUMMER, STEPHANIE, JEAN",14135 BALLANTYNE CORPORATE PL STE 100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 20 , 29 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558501296,"PLUMMER, STEPHANIE, JEAN",811 COX RD   GASTONIA NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 19 , 25 , 29 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558501296,"PLUMMER, STEPHANIE, JEAN",550 MOUNT HOLLY MEDICAL PKWY   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 14 , 28 , 40 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558501296,"PLUMMER, STEPHANIE, JEAN",550 MOUNT HOLLY PKWY   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 12 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558501296,"PLUMMER, STEPHANIE, JEAN",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558503458,"VEGA, JOSE, LUIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558503458,"VEGA, JOSE, LUIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558504266,"CHAPMAN, TODD, MASTERS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558504266,"CHAPMAN, TODD, MASTERS",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 49 , 68 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558504266,"CHAPMAN, TODD, MASTERS",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558504266,"CHAPMAN, TODD, MASTERS",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558504316,"MARTIN, KEVIN, LEE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558504316,"MARTIN, KEVIN, LEE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 92 , 94 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558504316,"MARTIN, KEVIN, LEE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558504316,"MARTIN, KEVIN, LEE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558511410,"HARRIS, JAMES, ERNEST",1212 SPRUCE ST STE 305A BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 59 , 59 ,$#,,
MEDICAID DIRECT,1710359757,CAROMONT MEDICAL GROUP INC,CAROMONT INTEGRATED PAIN SPECIALISTS BELMONT,640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558511410,"HARRIS, JAMES, ERNEST",640 SUMMIT CROSSING PL STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 42 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1558511824,"BERKLEY, BARBARA, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558511824,"BERKLEY, BARBARA, KATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558513960,"MULHOLLAND, ANDREA, MARIE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5221 PARAMOUNT PKWY STE 220 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1558513960,"MULHOLLAND, ANDREA, MARIE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558513960,"MULHOLLAND, ANDREA, MARIE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 18 , 33 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,194 FINLEY GOLF COURSE RD STE 104 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558513960,"MULHOLLAND, ANDREA, MARIE",919 S FIFTH ST   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1700130754,UNC PHYSICIANS NETWORK LLC,UNC PRIMARY CARE AT MEBANE,919 S FIFTH ST   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558513960,"MULHOLLAND, ANDREA, MARIE",919 S FIFTH ST   MEBANE NC,001,Alamance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 50 , 78 , 158 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 33 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558522672,"BASS, CANDRA, ROWELL",109 CONNER DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558522854,"HOBBS, CAROLINE, BENNETT",4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 16 , 32 , 40 ,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558522854,"HOBBS, CAROLINE, BENNETT",11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1558523779,"GRIFFIN, BESSALIEA, ATHALIA",~,514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1558523779,"GRIFFIN, BESSALIEA, ATHALIA",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 27 , 30 , 55 ,$#,,
MEDICAID DIRECT,1669747135,FOOTPRINT PODIATRY PLLC,,514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1558523779,"GRIFFIN, BESSALIEA, ATHALIA",514 N BRIGHTLEAF BLVD STE 1610 SMITHFIELD NC,051,Johnston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558524074,"JORDAN, MEGAN, ELAINE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 22 , 23 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558524074,"JORDAN, MEGAN, ELAINE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558524074,"JORDAN, MEGAN, ELAINE",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 16 , 50 , 51 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558525469,"JONES, ANDREW, SKILES",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558525469,"JONES, ANDREW, SKILES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558525469,"JONES, ANDREW, SKILES",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 38 , 38 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558525535,"YALOWITZ, JOEL, AARON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 172 , 181 , 209 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558525535,"YALOWITZ, JOEL, AARON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558525535,"YALOWITZ, JOEL, AARON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558525535,"YALOWITZ, JOEL, AARON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558525535,"YALOWITZ, JOEL, AARON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558525535,"YALOWITZ, JOEL, AARON",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558527341,"POTTER, ZACHARY, ERIC",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558527341,"POTTER, ZACHARY, ERIC",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 193 , 380 , 669 ," $11,996.71 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558527341,"POTTER, ZACHARY, ERIC",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 45 , 84 , 138 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558528000,"SABO, RACHEL, PECK",144 FOUNTAIN PLACE   MOORESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558528000,"SABO, RACHEL, PECK",144 FOUNTAIN PLACE   MOORESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 26 , 39 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558528000,"SABO, RACHEL, PECK",646 HARTNESS RD   STATESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 56 , 79 , 107 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558529180,"NICHOLS, SUSAN, ANNE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558529438,"MARTIN, LARRY",2000 WELLNESS BLVD STE 140 MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 44 , 77 ,$#,,
MEDICAID DIRECT,1952821381,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH ORTHOPEDICS & SPORTS MEDICINE,2000 WELLNESS BLVD STE 140 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558529438,"MARTIN, LARRY",2000 WELLNESS BLVD STE 140 MONROE NC,090,Union,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558529438,"MARTIN, LARRY",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558529438,"MARTIN, LARRY",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 69 , 103 , 172 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558529438,"MARTIN, LARRY",19485 OLD JETTON RD STE 210 CORNELIUS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 26 , 57 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558529438,"MARTIN, LARRY",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 17 , 22 ,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1558529768,"HALBEDEL, CHRISTY, CLINE",557 BROOKDALE DIRVE   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558529958,"ROSENBERGER, LAURA, HORST",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558529958,"ROSENBERGER, LAURA, HORST",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558529958,"ROSENBERGER, LAURA, HORST",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558530568,"KENNEY, SHAWN, EDWARD",325 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,110 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",110 PINE STATE ST   LILLINGTON NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 104 , 208 , 339 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 61 , 93 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,500 REDWOOD LN   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 21 , 37 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 60 , 79 , 141 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 188 , 404 , 527 ," $16,093.64 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1480 KELLY RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1558532374,"VAKANI, RAJESH, CHIMANLAL",781 AVENT FERRY RD STE 212 HOLLY SPRINGS NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558534768,"DEESE, GEOVANNA, OTILIA",8210 UNIVERSITY EXEC PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 87 , 87 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558534768,"DEESE, GEOVANNA, OTILIA",8210 UNIVERSITY EXEC PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558534768,"DEESE, GEOVANNA, OTILIA",1085 NE GATEWAY CT NE STE 280 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558534768,"DEESE, GEOVANNA, OTILIA",1085 NE GATEWAY CT NE STE 280 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 90 , 112 , 116 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,100 DODD ST   SPRING HOPE NC,064,Nash,193200000X,Group,Multi-Specialty,,1558537753,"COOK, NATALIE, JEAN",921 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 29 , 42 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558537753,"COOK, NATALIE, JEAN",921 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 43 , 48 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,100 DODD ST   SPRING HOPE NC,064,Nash,193200000X,Group,Multi-Specialty,,1558537753,"COOK, NATALIE, JEAN",100 DODD ST   SPRING HOPE NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 143 , 223 ,$#,,
MEDICAID DIRECT,1578144747,ELEVATION REHAB LLC,~,3420 HOLLOWAY ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1558538405,"EDDY, CARY",3420 WAKE FOREST RD   DURHAM NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 64 ," 1,955 "," 2,906 "," $32,729.60 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558538587,"LAVALLEY, DANIEL, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1558538587,"LAVALLEY, DANIEL, JOSEPH",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558538587,"LAVALLEY, DANIEL, JOSEPH",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 25 , 26 , 31 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558538587,"LAVALLEY, DANIEL, JOSEPH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558538587,"LAVALLEY, DANIEL, JOSEPH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 76 , 75 , 93 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558538587,"LAVALLEY, DANIEL, JOSEPH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558538587,"LAVALLEY, DANIEL, JOSEPH",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558538702,"HOLLAND, THOMAS, LAWRENCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 36 , 37 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558538702,"HOLLAND, THOMAS, LAWRENCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 69 , 69 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558538702,"HOLLAND, THOMAS, LAWRENCE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 28 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558538983,"ALBRIGHT, CAROL, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 179 , 290 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558538983,"ALBRIGHT, CAROL, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1558538983,"ALBRIGHT, CAROL, ANNE",233 DOCTORS ST   SPARTA NC,003,Alleghany,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1972656262,ASHEVILLE ENDOCRINOLOGY CONSULTANTS,ASHEVILLE ENDOCRINOLOGY CONSULTANTS PA,750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558540518,"RIDENHOUR, AMANDA, LEIGH",750 ALLIANCE CT   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 166 , 221 , 996 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558542456,"INMAN, AMY, FULK",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558542456,"INMAN, AMY, FULK",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558542456,"INMAN, AMY, FULK",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558543819,"MURRAY, AMY, ANTCZAK",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558543819,"MURRAY, AMY, ANTCZAK",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558543819,"MURRAY, AMY, ANTCZAK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558544817,TECHNICAL RESOURCE MANAGEMENT LLC,CORDANT HEALTH SOLUTIONS,1760 E ROUTE 66 STE 1 FLAGSTAFF AZ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1558544817,TECHNICAL RESOURCE MANAGEMENT LLC,1760 E ROUTE 66 STE 1 FLAGSTAFF AZ,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1558546184,JACKSONVILLE PHYSICAL THERAPY CENTE,~,2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558546184,JACKSONVILLE PHYSICAL THERAPY CENTE,2453 GUM BRANCH RD STE 600 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,, 34 , 333 , 471 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1558546598,"PETRICEK, TRAVIS, GRAHAM",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558546598,"PETRICEK, TRAVIS, GRAHAM",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1558546598,"PETRICEK, TRAVIS, GRAHAM",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558546598,"PETRICEK, TRAVIS, GRAHAM",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1861451437,NEWTON FAMILY PHYSICIANS,~,767 W 1ST ST   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1558548917,"MOSTELLER HOPSON, CRYSTAL, DAWN",767 W 1ST ST   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 44 , 83 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558549790,"GARRIDO, BEN, JAVIER",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558549790,"GARRIDO, BEN, JAVIER",170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 40 , 70 , 106 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558551663,"CLARK, KATHRYN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558551663,"CLARK, KATHRYN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558553834,"DAUBERT, MELISSA, ANNE",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1558553834,"DAUBERT, MELISSA, ANNE",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558553834,"DAUBERT, MELISSA, ANNE",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 32 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558553834,"DAUBERT, MELISSA, ANNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 34 , 65 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558554733,"SUTTON, JILL, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558554733,"SUTTON, JILL, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558554733,"SUTTON, JILL, MARIE",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 20 , 25 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558554733,"SUTTON, JILL, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 30 , 31 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558554733,"SUTTON, JILL, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558554733,"SUTTON, JILL, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 28 , 34 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1558555847,"MORRISSEY, KAYLYN, WOOD",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1558555847,"MORRISSEY, KAYLYN, WOOD",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558555847,"MORRISSEY, KAYLYN, WOOD",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 70 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558555847,"MORRISSEY, KAYLYN, WOOD",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 38 , 38 ,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1558557512,"HAMM, KIMBERLY, WRIGHT",609 N HIGHLAND ST   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1558557512,"HAMM, KIMBERLY, WRIGHT",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 15 , 46 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558558999,"PRAKASH CHAND, SUNIL, KUMAR",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1558558999,"PRAKASH CHAND, SUNIL, KUMAR",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 219 , 390 , 706 ," $11,453.65 ",,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2615 HOSPITAL RD STE 300 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1558558999,"PRAKASH CHAND, SUNIL, KUMAR",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558558999,"PRAKASH CHAND, SUNIL, KUMAR",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 69 , 131 , 237 ,$#,,
MEDICAID DIRECT,1073772612,GREENSBORO ANESTHESIA SPECIALISTS I,GREENSBORO ANESTHESIA SPECIALISTS INC,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1558560706,"GREGORY, SUZANNE, MARIE",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558560706,"GREGORY, SUZANNE, MARIE",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558560706,"GREGORY, SUZANNE, MARIE",705 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 42 , 42 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558560987,"DEVORE, ADAM, DAVID",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 37 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1558560987,"DEVORE, ADAM, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558560987,"DEVORE, ADAM, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 68 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558560987,"DEVORE, ADAM, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 93 , 197 , 260 ,$#,,
MEDICAID DIRECT,1477519148,PATHOLOGISTS MEDICAL LABORATORY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1558561209,"WOOD, TERESA, TRAM",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 19 , 23 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558561209,"WOOD, TERESA, TRAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558561571,"HAFIZ, RAZIA, SULTANA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1558561571,"HAFIZ, RAZIA, SULTANA",1135 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1558561571,"HAFIZ, RAZIA, SULTANA",1135 CARTHAGE ST   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",1424 FERN CREEK DR STE D STATESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",1424 FERN CREEK DR STE D STATESVILLE NC,049,Iredell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 11 ,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,131 MEDICAL PARK RD STE 303 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 19 , 23 , 35 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 44 , 46 , 67 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#, 16 , 22 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558561670,"NEAL, DONALD, JEFFREY",1771 TATE BLVD SE STE 101 HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 68 , 94 , 151 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558563205,"LAKS, SHACHAR",417 N MAIN ST   KENANSVILLE NC,031,Duplin,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558564005,"RATHNAM, PUNITHA, IDA",~,111 AIRPORT RD   KINSTON NC,054,Lenoir,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,1558564005,"RATHNAM, PUNITHA, IDA",111 AIRPORT RD   KINSTON NC,054,Lenoir,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1245637701,NEW DAWN PSYCHIATRIC SERVICES PLLC,,111 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1558564005,"RATHNAM, PUNITHA, IDA",111 AIRPORT RD   KINSTON NC,054,Lenoir,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 32 , 72 , 72 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558565838,"BEAVER, CLINT, RICHARD",106 CORPORATE PARK DR STE 200&300 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 70 , 120 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558568485,"PRASAD, ASHISH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558568485,"PRASAD, ASHISH",816 INDEPENDENCE BLVD STE 2H VIRGINIA BCH VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558570408,"KIPNES, JOANNA, RUTH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 19 , 62 , 62 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558570408,"KIPNES, JOANNA, RUTH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558570408,"KIPNES, JOANNA, RUTH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,781 AVENT FERRY RD STE 200 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1558575738,"LU, ROMMEL, PERILLO",117 SUNNYBROOK RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558575738,"LU, ROMMEL, PERILLO",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 38 , 38 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558575738,"LU, ROMMEL, PERILLO",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 51 , 94 , 94 ,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558582692,"MALCOLM, JOHN, B",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1932628401,SHAINA HOLMAN DDS PHD PA,HOLMAN FAMILY DENTAL CARE,1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1558584029,"COOK, HEIDI, REBECCA",1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 233 , 345 ," 1,192 "," $53,717.99 ",,
MEDICAID DIRECT,1962881227,"HOLMAN, SHAINA, DEVI",~,1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,1558584029,"COOK, HEIDI, REBECCA",1836 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558584193,"MULLENS, HEATHER, MARIE",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 42 , 73 ,$#,,
MEDICAID DIRECT,1558584813,"WALKER, JAMES, CARNELL",JAMES CARNELL WALKER III DDS PA,629 W 15TH ST   WASHINGTON NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice,1558584813,"WALKER, JAMES, CARNELL",629 W 15TH ST   WASHINGTON NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 77 , 233 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558585422,"CROCKER, WILLIAM, DANIEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558585422,"CROCKER, WILLIAM, DANIEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 39 , 45 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558585422,"CROCKER, WILLIAM, DANIEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 24 , 25 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558585422,"CROCKER, WILLIAM, DANIEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 33 , 41 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558585422,"CROCKER, WILLIAM, DANIEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558585422,"CROCKER, WILLIAM, DANIEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1558586768,"FLAHERTY, JENNIFER, ELIZABETH",220 FOUST ST STE C ASHEBORO NC,076,Randolph,152W00000X,Eye and Vision Services Providers,Optometrist,, 54 , 65 , 75 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1558586768,"FLAHERTY, JENNIFER, ELIZABETH",725 HIGHLAND OAKS DR STE 101 WINSTON SALEM NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,, 34 , 42 , 55 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558588640,"HILLER, CHRISTINE, ELIZABETH",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 28 , 30 ,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1558590042,"BENNETT, JUSTIN, MARSH",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558590042,"BENNETT, JUSTIN, MARSH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 128 , 154 , 168 ," $13,541.97 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558591362,"GRAY, TIFFANY, RADFORD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558591362,"GRAY, TIFFANY, RADFORD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,123 PROFESSIONAL PARK DR STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558592709,"CULP-ROCHE, AMANDA, DORRITT",167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1891349155,ELEANOR HEALTH PROFESSIONAL NC PLLC,ELEANOR HEALTH,2402 S MIAMI BLVD STE 101 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558592709,"CULP-ROCHE, AMANDA, DORRITT",167 LOCUST ST STE 204 SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1558595108,"MIKKILINENI, SRINIVAS, SAI",1041 MORGANTON BLVD SW STE 200 LENOIR NC,014,Caldwell,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 32 , 50 , 89 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558595108,"MIKKILINENI, SRINIVAS, SAI",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 71 , 101 , 157 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558595108,"MIKKILINENI, SRINIVAS, SAI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 47 , 84 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558595108,"MIKKILINENI, SRINIVAS, SAI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 29 , 33 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558595306,"DUNKMAN, WILLIAM, JONATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558595306,"DUNKMAN, WILLIAM, JONATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558595306,"DUNKMAN, WILLIAM, JONATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 24 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558595306,"DUNKMAN, WILLIAM, JONATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 37 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558595306,"DUNKMAN, WILLIAM, JONATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558596403,"LEIMAN, DAVID, ASHER",3116 N DUKE ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558596403,"LEIMAN, DAVID, ASHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558596403,"LEIMAN, DAVID, ASHER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 41 , 56 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 500 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558596403,"LEIMAN, DAVID, ASHER",3116 N DUKE ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558596403,"LEIMAN, DAVID, ASHER",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558596403,"LEIMAN, DAVID, ASHER",10207 CERNY ST   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558596510,"LANDI, DANIEL, BRYCE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology, 13 , 56 , 56 ,$#,,
MEDICAID DIRECT,1063567428,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BIDDLE POINT,1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558597369,"SUTTLES, SHIVONNE, NACOLE",1801 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558597922,"RUNYAN, CHRISTOPHER, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 78 , 92 , 116 ," $19,430.54 ",,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1558598151,"DOAK, HOYT, BUCHANNAN",705 NEWMAN RD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,, 26 , 34 , 51 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1558598151,"DOAK, HOYT, BUCHANNAN",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1558598151,"DOAK, HOYT, BUCHANNAN",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 26 , 43 ,$#,,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,, 37 , 276 , 595 ," $16,018.38 ",,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,981 HIGH HOUSE RD STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,#, 41 , 97 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558598631,"PARDON, AMANDA, RAYA",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 49 , 49 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558598631,"PARDON, AMANDA, RAYA",1515 DOCTORS CIR BLDG A WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558598680,"CHOI, TAEWOONG",2400 PRATT ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558598680,"CHOI, TAEWOONG",2400 PRATT ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 12 , 18 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558598680,"CHOI, TAEWOONG",2400 PRATT ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558598730,"MILLER, RACHEL, SIMPSON",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,1653 CAMPUS PARK DR STE A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558598920,"CHAVEZ MITCHELL, DEBBIE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1699023648,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS REA VILLAGE PEDIATR,11530 PROVIDENCE RD STE 2200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558598920,"CHAVEZ MITCHELL, DEBBIE",11530 PROVIDENCE RD STE 2200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 34 , 59 ,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558598920,"CHAVEZ MITCHELL, DEBBIE",3173 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,825 SPARTANBURG HWY STE 17 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558600148,"MOORE, SAMANTHA",825 SPARTANBURG HWY   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558600148,"MOORE, SAMANTHA",825 SPARTANBURG HWY   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 27 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,11491 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558600148,"MOORE, SAMANTHA",11491 US 70 BUS HWY W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558600148,"MOORE, SAMANTHA",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 42 , 91 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,5245 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558603050,"ROGERS, PAMELA, MICHELE",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 27 ,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,4402 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558603050,"ROGERS, PAMELA, MICHELE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356345920,MEDAC HEALTH SERVICES PA,~,8115 MARKET ST STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558603050,"ROGERS, PAMELA, MICHELE",8108B MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558603605,"WILLIAMS, NOELLE, LOUISA",10650 PARK RD STE 100 CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558603605,"WILLIAMS, NOELLE, LOUISA",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558603605,"WILLIAMS, NOELLE, LOUISA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558603605,"WILLIAMS, NOELLE, LOUISA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558603795,"HOLMES, DIANE, TRUSILAR",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 24 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558603795,"HOLMES, DIANE, TRUSILAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558603795,"HOLMES, DIANE, TRUSILAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558603795,"HOLMES, DIANE, TRUSILAR",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558603910,"ROMERO, RACHEL, DAVID",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 26 , 50 , 97 ," $32,559.50 ",,
MEDICAID DIRECT,1447634522,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH RHEUMATOLOGY,200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558603910,"ROMERO, RACHEL, DAVID",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 35 , 65 , 116 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558603910,"ROMERO, RACHEL, DAVID",200 MEDICAL PARK DR STE 330 CONCORD NC,013,Cabarrus,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#, 24 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558604520,"DESCHNER, BENJAMIN, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558604520,"DESCHNER, BENJAMIN, WILLIAM",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558604520,"DESCHNER, BENJAMIN, WILLIAM",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558604520,"DESCHNER, BENJAMIN, WILLIAM",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558604520,"DESCHNER, BENJAMIN, WILLIAM",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558604520,"DESCHNER, BENJAMIN, WILLIAM",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558605766,"NYANOR, PEARL, OPOKUA",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275128944,DLP FRYE HOSPITALISTS LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558605766,"NYANOR, PEARL, OPOKUA",420 N CENTER ST   HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558606228,"GRIFFIN, KATIE, PRICE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558608877,"QUIGG, MEGAN, ELIZABETH",1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558608877,"QUIGG, MEGAN, ELIZABETH",9965 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780790592,CABARRUS GASTROENTEROLOGY ASSOCIATE,~,1070 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558608877,"QUIGG, MEGAN, ELIZABETH",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558611772,"GONZALEZ, SARAH, ANN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558611772,"GONZALEZ, SARAH, ANN",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 55 , 251 , 253 ,$#,,
MEDICAID DIRECT,1689881831,CALDWELL MEMORIAL HOSPITAL,THE FALLS PEDIATRICS,4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1558612671,"PENNINGTON, LEONA, ELIZABETH",4355 HICKORY BLVD STE 2 GRANITE FALLS NC,014,Caldwell,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1093883852,CAROLINA FAMILY HEALTH CENTERS INC,HARVEST FAMILY HEALTH CENTER,8250 NC 58 S   ELM CITY NC,064,Nash,193400000X,Group,Single Specialty,,1558612671,"PENNINGTON, LEONA, ELIZABETH",8250 NC 58 S   ELM CITY NC,098,Wilson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1275965410,MCPC-14 LLC,FIRSTHEALTH TRANSITION CARE CLINIC,305 PAGE RD N STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1558613331,"MCBRIDE, CHRISTINE, ANNE",305 PAGE RD N STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 49 , 65 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558615997,"MILLER, TONY, LEMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558615997,"MILLER, TONY, LEMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558615997,"MILLER, TONY, LEMAR",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1558615997,"MILLER, TONY, LEMAR",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1558615997,"MILLER, TONY, LEMAR",201 E GROVER ST   SHELBY NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1558615997,"MILLER, TONY, LEMAR",1000 HEALING WAY   MATTHEWS NC,090,Union,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558615997,"MILLER, TONY, LEMAR",600 HOSPITAL DR   MONROE NC,090,Union,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 45 , 126 , 126 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558617134,"HARTMANN, SUZANNE, LINDA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558617134,"HARTMANN, SUZANNE, LINDA",1540 SUNDAY DR   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 55 , 57 , 69 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558617910,"MORES, ASHLEY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558617910,"MORES, ASHLEY, MARIE",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558620153,"GAINES, THOMAS, CHRISTOPHER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 31 , 79 ,$#,,
MEDICAID DIRECT,1255672473,PRIVATE DIAGNOSTIC CLINIC PLLC,KERNODLE CLINIC - WEST,,,Unknown,193200000X,Group,Multi-Specialty,,1558620153,"GAINES, THOMAS, CHRISTOPHER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558620153,"GAINES, THOMAS, CHRISTOPHER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 113 , 222 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558620153,"GAINES, THOMAS, CHRISTOPHER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558620153,"GAINES, THOMAS, CHRISTOPHER",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558620187,"GALBRAITH, BRANDY, LYNN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558620682,"AZIZ, TAREK",280 BROAD ST STE E KERNERSVILLE NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558620682,"AZIZ, TAREK",250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558624247,"MAZOTAS, IOANNA, GEORGOPOULOS",80 PEACHTREE RD STE 210 ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 18 , 19 , 35 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558624247,"MAZOTAS, IOANNA, GEORGOPOULOS",14 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477144004,GENESISCARE USA OF NORTH CAROLINA P,GENESISCARE SURGICAL SPECIALISTS,20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558624247,"MAZOTAS, IOANNA, GEORGOPOULOS",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558624247,"MAZOTAS, IOANNA, GEORGOPOULOS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558624726,"BAILEY, STEPHANIE, NICOLE",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1558624726,"BAILEY, STEPHANIE, NICOLE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558625467,"GRIFFIN, CRYSTAL, CARUTHERS",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 63 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558627018,"KITTNER, SARAH, LEONARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 43 , 45 , 49 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",208 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627422,"CHUNG, ANN, YIH-ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558627794,"LYCAN, THOMAS, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 35 , 66 , 66 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627810,"SULTANA, SANJEDA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 14 , 26 , 30 ,$#,,
MEDICAID DIRECT,1912205410,UNC PHYSICIANS NETWORK LLC,~,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558627810,"SULTANA, SANJEDA",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 40 , 62 , 109 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558628321,"MULLER, KRISTEN, ELAINE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 14 , 15 , 32 ,$#,,
MEDICAID DIRECT,1558630483,ATLANTIC MEDICAL GROUP PC,AMG ENDOSCOPY CENTER,2541 N QUEEN ST   KINSTON NC,054,Lenoir,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1558630483,ATLANTIC MEDICAL GROUP PC,2541 N QUEEN ST   KINSTON NC,054,Lenoir,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 74 , 85 , 121 ," $12,108.45 ",,
MEDICAID DIRECT,1962728394,ATLANTIC MEDICAL GROUP PC,ATLANTIC MEDICAL GROUP PC,2541 N QUEEN ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1558630483,ATLANTIC MEDICAL GROUP PC,2541 N QUEEN ST   KINSTON NC,054,Lenoir,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1144657636,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST CRITICAL CARE ASSOCIATES,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558635730,"ZEBIAN, RAMI",200 MEDICAL PARK DR STE 550B CHARLOTTE NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558637009,"MCGOVERN, KAYSE, SHAY",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558637009,"MCGOVERN, KAYSE, SHAY",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558639575,"GREY, CARL, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 14 , 27 , 28 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558641415,"KELTON, KARA, ALYSSA",1060 FIRST COLONIAL RD   VIRGINIA BCH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558641746,"ABE-LATHAN, MOBOLUWADE, DUDUYEMI",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558641746,"ABE-LATHAN, MOBOLUWADE, DUDUYEMI",20 DUKE MEDICINE CIR DUKE CANCER CENTER 2 FLOOR DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558641746,"ABE-LATHAN, MOBOLUWADE, DUDUYEMI",4220 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 20 , 35 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558641746,"ABE-LATHAN, MOBOLUWADE, DUDUYEMI",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 30 , 37 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558641746,"ABE-LATHAN, MOBOLUWADE, DUDUYEMI",800 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558648626,"TRAVARS, BRITTANY, BASS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 65 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558648626,"TRAVARS, BRITTANY, BASS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558648626,"TRAVARS, BRITTANY, BASS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 71 , 71 ,$#,,
MEDICAID DIRECT,1821623620,LANE AND ASSOCIATES XXXVIII DDS PA,,101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558649947,"CARRILLO-MEDINA, WALLACE",101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 295 , 461 ," 1,243 "," $63,555.25 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558652016,"FORREST, STEPHANIE, GAYLE",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 26 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558652016,"FORREST, STEPHANIE, GAYLE",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 12 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558653691,"OBERLE, AMBER, JANELLE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 16 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558653691,"OBERLE, AMBER, JANELLE",1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 31 , 39 , 63 ,$#,,
MEDICAID DIRECT,1336191972,RALEIGH DURHAM MEDICAL GROUP PA,CORNERSTONE PEDIATRIC AND ADOLESCENT MEDICINE,97 CORNERSTONE DR   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1558654210,"CHANDRASEKARAN, CHITRABHARATHI",97 CORNERSTONE DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 40 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558655936,"PATEL, MANISH, NAVNITLAL",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 19 , 27 , 44 ,$#,,
MEDICAID DIRECT,1437459021,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH UROLOGY LINCOLN,441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1558655936,"PATEL, MANISH, NAVNITLAL",441 MCALISTER RD STE 1200 LINCOLNTON NC,055,Lincoln,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558655936,"PATEL, MANISH, NAVNITLAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558655936,"PATEL, MANISH, NAVNITLAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 25 , 34 , 44 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558655936,"PATEL, MANISH, NAVNITLAL",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 32 , 41 , 53 ,$#,,
MEDICAID DIRECT,1447383773,ASHEVILLE PEDIATRIC ASSOCIATES PA,ASHEVILLE PEDIATRIC ASSOCIATES PA,2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558656835,"LEIMENA, PETER",2 MEDICAL PARK DR STE 1000 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 84 , 116 , 379 ," $14,257.77 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558657502,"ZARGHAM, SHIVA, RAVANBAKHSH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 47 , 49 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558657502,"ZARGHAM, SHIVA, RAVANBAKHSH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558659201,"NIX, AMY, LOHSE",935 STATE FARM RD   BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 55 , 84 ," $11,361.50 ",,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558659201,"NIX, AMY, LOHSE",448 CRANBERRY ST   NEWLAND NC,006,Avery,363LC1500X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Community Health,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558659201,"NIX, AMY, LOHSE",448 CRANBERRY ST   NEWLAND NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1558665836,ABSOLUTE CARE STAFFING HEALTH AGENC,~,2400 BROAD ST STE 3 DURHAM NC,032,Durham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1558665836,ABSOLUTE CARE STAFFING HEALTH AGENC,2400 BROAD ST STE 3 DURHAM NC,032,Durham,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 397 ," 14,649 "," 14,746 "," $930,094.74 ",,
MEDICAID DIRECT,1558665836,ABSOLUTE CARE STAFFING HEALTH AGENC,~,2400 BROAD ST STE 3 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1558665836,ABSOLUTE CARE STAFFING HEALTH AGENC,2400 BROAD ST STE 3 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 291 , 291 ," $18,201.84 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558666594,"ZIELKE, AMY, MICHELE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558667790,CEDAR COVE ASSISTED LIVING LLC,CEDAR COVE ASSISTED LIVING LLC,4200 JASMINE COVE WAY   WILMINGTON NC,065,New Hanover,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558667790,CEDAR COVE ASSISTED LIVING LLC,4200 JASMINE COVE WAY   WILMINGTON NC,065,New Hanover,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 56 ," 3,105 "," 3,106 "," $628,049.87 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558668210,"FORTIN, NICHOLE, SUSANNA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 51 , 54 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1558668210,"FORTIN, NICHOLE, SUSANNA",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1558668210,"FORTIN, NICHOLE, SUSANNA",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558668210,"FORTIN, NICHOLE, SUSANNA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558668301,"HOWE, LINDSAY, DAWN",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558668996,SMALL WORLD THERAPY PA,SMALL WORLD THERAPY PA,2415 SUNNYFIELD CT   HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1558668996,SMALL WORLD THERAPY PA,2415 SUNNYFIELD CT   HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,, 224 ," 4,059 "," 4,072 "," $283,360.21 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558669176,"FAVORITO, MICHAEL",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 70 , 92 , 163 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558669176,"FAVORITO, MICHAEL",8114 MARKET ST   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 19 , 21 , 36 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558669176,"FAVORITO, MICHAEL",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 46 , 74 , 170 ,$#,,
MEDICAID DIRECT,1396935193,COMMUNITY MEDICAL PA,COMMUNITY MEDICAL PA,520 W MAIN ST   MARSHVILLE NC,090,Union,193400000X,Group,Single Specialty,,1558670604,"QUEEN, BRANDI, SELINA",520 W MAIN ST   MARSHVILLE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 220 , 452 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558671511,"AL-ROHIL, RAMI, NAYEF",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558671511,"AL-ROHIL, RAMI, NAYEF",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558671511,"AL-ROHIL, RAMI, NAYEF",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 19 , 19 , 35 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558672212,"SMITH, ZACHARY, MICHAEL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 75 , 195 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558672212,"SMITH, ZACHARY, MICHAEL",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558672279,NATERA INC,~,201 INDUSTRIAL RD STE 410 SAN CARLOS CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1558672279,NATERA INC,201 INDUSTRIAL RD STE 410 SAN CARLOS CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 473 , 467 ," 1,322 "," $429,732.27 ",,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558674648,"YOUNGER, ALICIA, KAY",501 ESSEOLA DR   SALUDA NC,075,Polk,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 148 , 148 ,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558674648,"YOUNGER, ALICIA, KAY",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 96 , 595 , 595 ," $11,627.82 ",,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,501 ESSEOLA DR   SALUDA NC,075,Polk,193400000X,Group,Single Specialty,,1558674648,"YOUNGER, ALICIA, KAY",510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578739876,WNC FAMILY MEDICAL CENTER PLLC,~,510 BALSAM RD   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558674648,"YOUNGER, ALICIA, KAY",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558675033,"IMBODEN, LAUREN, WHISENANT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 22 , 22 ,$#,,
MEDICAID DIRECT,1558675975,SHIPMAN FAMILY HOME CARE INC,~,3302 UNIVERSITY DR STE A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1558675975,SHIPMAN FAMILY HOME CARE INC,3302 UNIVERSITY DR STE A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 157 , 157 ,$#,,
MEDICAID DIRECT,1558676692,"AHMAD, USMAN, FAYYAZ",,8035 PROVIDENCE RD STE 340 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,1558676692,"AHMAD, USMAN, FAYYAZ",8035 PROVIDENCE RD STE 340 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 22 , 176 , 231 ,$#,,
MEDICAID DIRECT,1629422738,ADVANCED SPORTS & SPINE PLLC,,8035 PROVIDENCE RD STE 340 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558676692,"AHMAD, USMAN, FAYYAZ",8035 PROVIDENCE RD STE 340 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 24 , 106 , 195 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558676924,"HART, RYAN, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558676924,"HART, RYAN, DAVID",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 40 , 76 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558676924,"HART, RYAN, DAVID",10030 GILEAD RD STE 140 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558676924,"HART, RYAN, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558679936,JORDAN MANAGEMENT GROUP LLC,~,106 PAILIN CREEK RD   ELIZABETH CITY NC,070,Pasquotank,251B00000X,Agencies,Case Management,,1558679936,JORDAN MANAGEMENT GROUP LLC,106 PAILIN CREEK RD   ELIZABETH CITY NC,070,Pasquotank,251B00000X,Agencies,Case Management,, 159 ," 1,861 "," 1,872 "," $1,009,739.01 ",,
MEDICAID DIRECT,1558679936,JORDAN MANAGEMENT GROUP LLC,~,,,Unknown,251B00000X,Agencies,Case Management,,1558679936,JORDAN MANAGEMENT GROUP LLC,905 HALSTEAD BLVD STE 8 ELIZABETH CITY NC,070,Pasquotank,251B00000X,Agencies,Case Management,,#,,,$#,,
MEDICAID DIRECT,1558680041,AZORA HEALTHCARE SERVICES PLLC,~,2820 THE PLZ   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558680041,AZORA HEALTHCARE SERVICES PLLC,2820 THE PLZ   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 3,648 "," 3,648 "," $218,553.27 ",,
MEDICAID DIRECT,1730574757,ACTIVE FOOT AND ANKLE OF CAROLINA,,1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1558681197,"SALEM, MUNJED, SHUKRI",1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 50 , 71 , 115 ,$#,,
MEDICAID DIRECT,1730574757,ACTIVE FOOT AND ANKLE OF CAROLINA,,1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1558681197,"SALEM, MUNJED, SHUKRI",1076 US HIGHWAY 17 S   ELIZABETH CITY NC,070,Pasquotank,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 58 , 136 , 215 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558681353,"KOTHARI, DARSHAN, JADGISH",120 E CARVER ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558681353,"KOTHARI, DARSHAN, JADGISH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 13 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558681353,"KOTHARI, DARSHAN, JADGISH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1558681353,"KOTHARI, DARSHAN, JADGISH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558682336,"AYALA-PEACOCK, DIANDRA, NORELLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558682336,"AYALA-PEACOCK, DIANDRA, NORELLE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558682336,"AYALA-PEACOCK, DIANDRA, NORELLE",4101 MACON POND RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 36 , 66 ,$#,,
MEDICAID DIRECT,1609851138,MOUNT AIRY EMERGENCY PHYSICIANS,MOUNT AIRY EMERGENCY PHYSICIANS,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558682385,"DAVIS, CASEY, JAE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 90 , 99 , 145 ,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558682765,"GLOVER, ANDREW, FORD",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558683433,"REGE, APARNA, SHARAD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 21 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558683433,"REGE, APARNA, SHARAD",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558683433,"REGE, APARNA, SHARAD",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558683433,"REGE, APARNA, SHARAD",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558684035,"NOEVERE, ERIC",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558684035,"NOEVERE, ERIC",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 26 , 43 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558684613,"HAGGERTY, JESSICA, LYNN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558687129,"ZADEL, ARI, ALEXANDER",161 WALKER ST   COLUMBUS NC,075,Polk,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1326587932,BLUE RIDGE COMMUNITY HEALTH SERVICE,RAINBOW PEDIATRICS,110 CHADWICK SQUARE CT STE A HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558687129,"ZADEL, ARI, ALEXANDER",110 CHADWICK SQUARE CT   HENDERSONVILLE NC,045,Henderson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 25 , 30 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558688697,"OLSSON, ERIK, CHRISTIAN ANDERS",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558693150,SECOND CHANCES HOME CARE,SECOND CHANCES HOME CARE,3005 S MEMORIAL DR STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1558693150,SECOND CHANCES HOME CARE,3005 S MEMORIAL DR STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,602 "," 3,672 "," $283,660.24 ",,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558695213,"WOOD, JESSICA, DANIELS",310 DAVIE AVE   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 33 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558695528,"HANLON, KATHLEEN, ERIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558695643,"HELMS, AMY, COURTNEY",162 LEGACY OAKS DR STE 201 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558695643,"HELMS, AMY, COURTNEY",162 LEGACY OAKS DR STE 201 KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558695775,"STEWART, KIMBERLY, WILLIAMSON",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558696906,"LOWDER, HAL, JUSTIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598863433,CATAWBA VALLEY MEDICAL CENTER,~,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558696906,"LOWDER, HAL, JUSTIN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558699090,"WIEDUWILT, JESSICA, TOMPKINS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558699728,"HESS, KATE, MCGETTRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 91 , 91 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558699728,"HESS, KATE, MCGETTRICK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 95 , 169 , 169 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558700286,"CUTCHINS, CLIFFORD, ARMSTRONG",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558700286,"CUTCHINS, CLIFFORD, ARMSTRONG",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558700286,"CUTCHINS, CLIFFORD, ARMSTRONG",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558700427,"KIM, JESSICA, KIM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 327 , 341 , 437 ," $13,494.09 ",,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1558700427,"KIM, JESSICA, KIM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 325 , 354 , 423 ,$#,,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558700427,"KIM, JESSICA, KIM",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558700633,"JAMISON, LEE, SWAIN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558700633,"JAMISON, LEE, SWAIN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1558702258,PROVIDENCE HOME CARE AGENCY INC,~,3535 S WILMINGTON ST STE 212 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1558702258,PROVIDENCE HOME CARE AGENCY INC,3535 S WILMINGTON ST STE 212 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 1,979 "," 1,979 "," $199,144.33 ",,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558703090,"YACINTHE, MARYNA, RUDENKO",738 BRYANT ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 74 , 139 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,774 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558703090,"YACINTHE, MARYNA, RUDENKO",738 BRYANT ST STE A STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1750696910,LELAND FAMILY DENTISTRY,LELAND FAMILY DENTISTRY,117H VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1558703231,"BOYD, ASIA, ARNIZE",117H VILLAGE RD NE   LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice," 1,417 "," 3,000 "," 13,384 "," $902,784.59 ",,
MEDICAID DIRECT,1750696910,LELAND FAMILY DENTISTRY,LELAND FAMILY DENTISTRY,117H VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1558703231,"BOYD, ASIA, ARNIZE",104 4TH ST   BLADENBORO NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558705582,"QUINN, CORIDON, JOHN",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 14 , 19 , 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558705582,"QUINN, CORIDON, JOHN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 13 ,#, 18 ," $15,879.55 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558706770,"JOHNSON, ANNE, DUNBAR",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 12 , 18 , 22 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558706788,"PATEL, RIDDHI, P",155 MEMORIAL DR   PINEHURST NC,063,Moore,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 100 , 258 , 258 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558708339,"DOUGLAS, HEATHER, ELIZABETH",601 N ELM ST   HIGH POINT NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",555 KITCHINGS DR STE D STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 152 , 225 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 16 , 22 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 53 , 63 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558709931,"WURZER, ANDREA, CLARKE",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 30 , 57 , 250 ,$#,,
MEDICAID DIRECT,1558710921,BETHEL HOMECARE INC,,4801 E INDEPENDENCE BLVD STE 301 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1558710921,BETHEL HOMECARE INC,4801 E INDEPENDENCE BLVD STE 301 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 11 ," 1,565 "," 1,658 "," $998,010.00 ",,
MEDICAID DIRECT,1174002059,ICH ER SERVICES LLC,~,800 N FANT ST   ANDERSON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558711911,"JOHNSON, CODY, TYLER",800 N FANT ST   ANDERSON SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1558712224,"ROBINSON, PEGGY, MICHELE",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1558712224,"ROBINSON, PEGGY, MICHELE",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 126 , 126 ,$#,,
MEDICAID DIRECT,1750342820,ARDMORE FAMILY PRACTICE,ARDMORE FAMILY PRACTICE PA,2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558713370,"TAGUE, EILEEN, MARGARET",2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 73 , 130 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558713420,"SHEPHERD, RENEE, ELIZABETH",14 DOCTORS CIR STE 2 SUPPLY NC,010,Brunswick,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 39 , 54 , 87 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558713560,"COLNA, MATTHEW, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558713560,"COLNA, MATTHEW, ALAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558713560,"COLNA, MATTHEW, ALAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology, 29 , 53 , 72 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4600 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558714311,"ANDREWS, KATHLEEN, JANE",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 24 , 34 , 44 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558714311,"ANDREWS, KATHLEEN, JANE",4600 CAPITAL BLVD   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 27 , 41 ,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 38 , 53 ,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 71 , 71 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 19 , 32 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 33 , 40 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",144 FOREST HILL RD STE 144146 LEXINGTON NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 105 , 192 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",144 FOREST HILL RD STE 144146 LEXINGTON NC,029,Davidson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 30 , 58 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558715912,"YE, FAN",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 34 , 56 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1558717132,"HUNT, MATTHEW, WILLIAM",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558717215,"NORRIS, ANDREW, MICHAEL",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 84 , 126 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558722827,"SALAS, JASMIN",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558723429,"JACOBS, COURTNEY",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558723544,"DEPRIEST, BRITTANY, PAIGE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558723544,"DEPRIEST, BRITTANY, PAIGE",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 34 , 37 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558724161,"PETRAGLIA, FRANK, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 117 , 118 , 133 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558724161,"PETRAGLIA, FRANK, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558724161,"PETRAGLIA, FRANK, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558724161,"PETRAGLIA, FRANK, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558724161,"PETRAGLIA, FRANK, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558724161,"PETRAGLIA, FRANK, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558724161,"PETRAGLIA, FRANK, WILLIAM",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558724641,"MORGAN, ERIC, EVAN-BROWNING",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#, 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558724641,"MORGAN, ERIC, EVAN-BROWNING",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology, 15 , 15 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558724815,"GREENE, ELIZABETH, ANN",3000 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 33 , 43 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558724815,"GREENE, ELIZABETH, ANN",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 23 , 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558724815,"GREENE, ELIZABETH, ANN",3000 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558724815,"GREENE, ELIZABETH, ANN",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 18 , 23 , 25 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1558725374,"MEIER, BRIANNA, FLEMING",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 18 , 26 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558725374,"MEIER, BRIANNA, FLEMING",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558725374,"MEIER, BRIANNA, FLEMING",16747 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558725580,"TILLERY, MICHAEL, ANDREW",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 57 , 91 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558725580,"TILLERY, MICHAEL, ANDREW",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801011242,NC DHHS CHILD AND FAMILY WELL-BEING,SANDHILLS CHILDRENS DEVELOPMENTAL,95 TROTTER HILLS CIR   PINEHURST NC,063,Moore,252Y00000X,Agencies,Early Intervention Provider Agency,,1558726265,"SHAFFRON, AMY, ELISABETH",95 TROTTER HILLS CIR   PINEHURST NC,063,Moore,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 19 , 41 , 68 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558726745,"MCNALLY, KRISTIN, SUZANNE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 15 , 51 , 51 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558726745,"MCNALLY, KRISTIN, SUZANNE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558726745,"MCNALLY, KRISTIN, SUZANNE",102 LEONARD AVE   NEWTON NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 75 , 75 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558726745,"MCNALLY, KRISTIN, SUZANNE",102 LEONARD AVE   NEWTON NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 32 , 127 , 127 ,$#,,
MEDICAID DIRECT,1558727172,FAMILY MEDICAL SUPPLY LLC,,1620 WRIGHT ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558727172,FAMILY MEDICAL SUPPLY LLC,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1558727172,FAMILY MEDICAL SUPPLY LLC,,1620 WRIGHT ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558727172,FAMILY MEDICAL SUPPLY LLC,1620 WRIGHT ST   WILMINGTON NC,065,New Hanover,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 785 ," 3,941 "," 6,671 "," $180,082.18 ",,
MEDICAID DIRECT,1558727172,FAMILY MEDICAL SUPPLY LLC,,1620 WRIGHT ST   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1558727172,FAMILY MEDICAL SUPPLY LLC,1620 WRIGHT ST   WILMINGTON NC,065,New Hanover,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1558727172,FAMILY MEDICAL SUPPLY LLC,,1620 WRIGHT ST   WILMINGTON NC,065,New Hanover,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1558727172,FAMILY MEDICAL SUPPLY LLC,1620 WRIGHT ST   WILMINGTON NC,065,New Hanover,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1558728055,"WOOLSEY, KAREN, REEL",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558730390,"HUSSEY, ASHLEY, JONES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558730390,"HUSSEY, ASHLEY, JONES",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558731174,LIFESAVER RESOURCES INC,,169 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1558731174,LIFESAVER RESOURCES INC,169 S WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,541 "," 2,541 "," $216,100.36 ",,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558731612,"BRITTON, AMANDA, TINDELL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1225071293,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PINEVILLE PRIMARY CARE,10514 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558734137,"CHRISTOPHER-THOMAS, AMANDA, LEIGH",10514 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558734137,"CHRISTOPHER-THOMAS, AMANDA, LEIGH",10514 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 44 , 122 ,$#,,
MEDICAID DIRECT,1275863722,NAYLOR OF LINCOLNTON PPLC,COMFORT AND CARE DENTISTY OF LINCOLNTON,518 N GENERALS BLVD STE F LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1558740217,"NAYLOR, MICAH, DANIEL",518 N GENERALS BLVD STE F LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 206 , 406 ," 1,574 "," $62,374.33 ",,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558740415,"COLEMAN, KARA, LYNN",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 30 , 53 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558740480,"HARRIS, LYNN, TRAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558742080,"TOMASHESKI, RICHARD, JAMES",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558742080,"TOMASHESKI, RICHARD, JAMES",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497530281,MONARCH,,319 CHAPANOKE RD STE 119 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558742148,"BALES, ERICA, BETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1992143242,MONARCH,~,1001 NAVAHO DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558742148,"BALES, ERICA, BETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,,,$#,,
MEDICAID DIRECT,1154018323,MONARCH,,193 LOWES DR STE 101&102 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1558742148,"BALES, ERICA, BETH",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558743468,"ESEET, EMMA, CHRISTINE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780911339,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558743468,"ESEET, EMMA, CHRISTINE",13640 STEELECROFT PKWY STE 210 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 21 , 41 ,$#,,
MEDICAID DIRECT,1194052761,CHARLOTTE PEDIATRIC CLINIC,ATRIUM HEALTH LEVINE CHILDRENS CHARLOTTE PEDIATRIC,4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558743468,"ESEET, EMMA, CHRISTINE",4501 CAMERON VALLEY PKWY STE 100 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1558744359,"COURTER, ELLIOTT, BRADLEY",1220 SPRUCE ST   BELMONT NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 86 , 167 , 240 ,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558744359,"COURTER, ELLIOTT, BRADLEY",1220 SPRUCE ST   BELMONT NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,159 E DALLAS RD   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1558744359,"COURTER, ELLIOTT, BRADLEY",159 E DALLAS RD   STANLEY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1558745687,JFC MERIDIAN OPCO ROCKY MOUNT LLC,SOMERSET COURT OF ROCKY MOUNT,918 WESTWOOD DR   ROCKY MOUNT NC,064,Nash,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1558745687,JFC MERIDIAN OPCO ROCKY MOUNT LLC,918 WESTWOOD DR   ROCKY MOUNT NC,064,Nash,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 44 , 312 , 314 ,$#,,
MEDICAID DIRECT,1558745687,JFC MERIDIAN OPCO ROCKY MOUNT LLC,SOMERSET COURT OF ROCKY MOUNT,918 WESTWOOD DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558745687,JFC MERIDIAN OPCO ROCKY MOUNT LLC,918 WESTWOOD DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 54 ," 13,868 "," 13,868 "," $948,177.60 ",,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 60 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 37 , 42 , 174 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 142 , 142 ," 2,091 "," $229,202.57 ",,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,166 "," 1,610 "," 6,117 "," $245,226.09 ",,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1689788366,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",312 W MCLEAN ST   SAINT PAULS NC,078,Robeson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 30 ,$#,,
MEDICAID DIRECT,1053795336,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE FAMILY DENTAL,109 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1558749457,"MOHAMMADU, SARAT",109 MCALPINE LN   LAURINBURG NC,083,Scotland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558749598,"BROMAN-FULKS, JORDAN, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558749598,"BROMAN-FULKS, JORDAN, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 48 , 81 , 83 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558750950,"JOHNSON, DEBORAH, SMITH",505 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356890776,SOUTHERN MEDICAL ASSOCIATES,,505 W FLEMING DR   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1558750950,"JOHNSON, DEBORAH, SMITH",505 W FLEMING DR   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 62 , 80 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1558751164,"BOYTIM, TATYANA, VICTOROVNA",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1558751164,"BOYTIM, TATYANA, VICTOROVNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558751164,"BOYTIM, TATYANA, VICTOROVNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558752188,"ZEISLER, GAIL, LEE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 80 , 114 , 118 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558752501,"RYABOY, ILYA, VYACHESLAVOVICH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558754283,"BALDWIN, JAKITA, DANIELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 73 , 113 , 113 ,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1558756155,"KOONTZ, RACHEL, COURTNEY",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558756676,"PATEL, HARDIK, JAY",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 97 , 148 ," 1,004 "," $67,504.23 ",,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,970 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1558756676,"PATEL, HARDIK, JAY",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 20 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558756676,"PATEL, HARDIK, JAY",511 PALADIN DR   GREENVILLE NC,074,Pitt,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 253 , 433 ," 1,146 "," $139,364.09 ",,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558757740,"KING, CAITLIN, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558757740,"KING, CAITLIN, ELIZABETH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 31 , 62 , 65 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558757757,"CHEN, MICHAEL, MENG",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1558759555,"LAGOMARCINO, JACOB, THOMAS",104 BASS LAKE RD STE B-2 HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1558759555,"LAGOMARCINO, JACOB, THOMAS",11491 US HIGHWAY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558759555,"LAGOMARCINO, JACOB, THOMAS",11491 US HIGHWAY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558759555,"LAGOMARCINO, JACOB, THOMAS",11491 US HIGHWAY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558759555,"LAGOMARCINO, JACOB, THOMAS",11491 US HIGHWAY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1558759555,"LAGOMARCINO, JACOB, THOMAS",11491 US HIGHWAY 70 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558761213,"SHUMATE, LINDSAY, KRONZER",1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033667761,ID CARE OF NC PA,,1319 AVON ST   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558761213,"SHUMATE, LINDSAY, KRONZER",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 51 , 315 , 366 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558761247,"SPAINHOUR-REESE, SARAH, BETH",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 25 , 31 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558761247,"SPAINHOUR-REESE, SARAH, BETH",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558761247,"SPAINHOUR-REESE, SARAH, BETH",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558761247,"SPAINHOUR-REESE, SARAH, BETH",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558761247,"SPAINHOUR-REESE, SARAH, BETH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558761247,"SPAINHOUR-REESE, SARAH, BETH",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558761247,"SPAINHOUR-REESE, SARAH, BETH",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558762187,"SADRI, HOOMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 37 , 58 , 70 ,$#,,
MEDICAID DIRECT,1558763235,PUBLIX NORTH CAROLINA LP,PUBLIX PHARMACY 1481,9815 ROSE COMMONS DR   HUNTERSVILLE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1558763235,PUBLIX NORTH CAROLINA LP,9815 ROSE COMMONS DR   HUNTERSVILLE NC,060,Mecklenburg,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1659520187,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE OF MORRISVILLE,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1558763615,"FIKE, MELISSA, MARIE",10950 CHAPEL HILL RD URGENT CARE MORRISVILLE NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 45 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1558765131,"PRESTWICH, DAVID, ANDREW",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558765131,"PRESTWICH, DAVID, ANDREW",3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 21 , 35 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1558765131,"PRESTWICH, DAVID, ANDREW",3722 BRIDGES ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 57 , 62 , 124 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1558765362,"GIBBONS, MEGAN, ELIZABETH",801 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1309 BRENTWAY AVE   WILLIAMSTON NC,058,Martin,193200000X,Group,Multi-Specialty,,1558765362,"GIBBONS, MEGAN, ELIZABETH",801 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558767046,"ABBOUD, SADIE, RUTH",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1558768945,"BELBASE, SANTOSH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 56 , 56 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558768945,"BELBASE, SANTOSH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 78 , 253 , 253 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1558768945,"BELBASE, SANTOSH",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558771584,"SHEPARD, STACI",1272 EAST ST   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 102 , 148 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1558771584,"SHEPARD, STACI",1272 EAST ST   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 27 , 31 ,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558771733,"THORNTON, LINDSEY, NICOLE",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558771733,"THORNTON, LINDSEY, NICOLE",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558771733,"THORNTON, LINDSEY, NICOLE",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1285929554,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY MEDICAL CENTER,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1558771733,"THORNTON, LINDSEY, NICOLE",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1104818475,HEALTHWISE PHARMACY OF GREENVILLE I,HEALTHWISE PHARMACY,615B S MEMORIAL DR   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558772434,"BENTLEY, OLIVIA, SANTOSO",9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1235375742,AFYA GROUP LLC,AVANT PHARMACY AND WELLNESS,9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558772434,"BENTLEY, OLIVIA, SANTOSO",9835 MONROE RD   CHARLOTTE NC,060,Mecklenburg,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558773259,"PROPST, BRADLEY, WILLIAM",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558773259,"PROPST, BRADLEY, WILLIAM",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558773259,"PROPST, BRADLEY, WILLIAM",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 83 , 84 ,$#,,
MEDICAID DIRECT,1629018163,CAROLINA REGIONAL ORTHOPEDICS PA,CAROLINA REGIONAL ORTHEOPAEDICS PA,110 PATRICK CT   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558774794,"KEMKER, BERNARD, PERKINS",110 PATRICK CT   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 145 , 297 , 579 ," $10,164.35 ",,
MEDICAID DIRECT,1205189602,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1558775379,"MCGRADY, BRITTANY, LARSON",1565 ORCHARD VILLAS AVE   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558778498,"MANDELIA, YAMINI",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558778498,"MANDELIA, YAMINI",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases, 22 , 65 , 66 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",95 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",486 HOSPITAL DR   CLYDE NC,044,Haywood,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 14 , 33 , 54 ," $10,388.45 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",1898 S MAIN ST   WAYNESVILLE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",486 HOSPITAL DR   CLYDE NC,044,Haywood,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",1196 SKYLAND DR   SYLVA NC,050,Jackson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 58 , 117 , 162 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",1196 SKYLAND DR   SYLVA NC,050,Jackson,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",1196 SKYLAND DR   SYLVA NC,050,Jackson,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 71 , 193 , 318 ," $79,572.95 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",21 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 71 , 170 , 274 ," $31,051.37 ",,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558781856,"KOMANSKI, CHRISTOPHER, BLIGH",21 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 49 , 67 , 102 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1558782698,"KOZUCH, MARY, LOUISE",6602 KNIGHTDALE BLVD STE 204 KNIGHTDALE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 11 , 15 , 35 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558782698,"KOZUCH, MARY, LOUISE",10831 FOREST PINES DR STE 100 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558784116,"PATEL, NIRAV, DILIPBHAI",1000 HEALING WAY   MATTHEWS NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558784116,"PATEL, NIRAV, DILIPBHAI",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1558784116,"PATEL, NIRAV, DILIPBHAI",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558784116,"PATEL, NIRAV, DILIPBHAI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 45 , 161 , 161 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558784116,"PATEL, NIRAV, DILIPBHAI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558785741,"NANCE, TRACY, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 38 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,131 MILLER ST   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558785741,"NANCE, TRACY, MICHELLE",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558786830,UNC PHYSICIANS NETWORK LLC,400 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,, 151 , 167 , 323 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558786830,UNC PHYSICIANS NETWORK LLC,250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,417 VANCE ST STE A CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1558786830,UNC PHYSICIANS NETWORK LLC,417 VANCE ST STE A CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,#,#, 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1558786830,UNC PHYSICIANS NETWORK LLC,2707 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,, 72 , 79 , 156 ,$#,,
MEDICAID DIRECT,1154336642,LANE AND ASSOCIATES I DDS PA,LANE AND ASSOCIATES I DDS PA,1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1558787457,"AMIN, MITUL, ARVIND",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 45 , 66 , 203 ,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1558787457,"AMIN, MITUL, ARVIND",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 721 , 920 ," 3,342 "," $136,183.35 ",,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1558787457,"AMIN, MITUL, ARVIND",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 33 , 33 , 117 ,$#,,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1558787457,"AMIN, MITUL, ARVIND",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 200 , 262 , 855 ," $37,427.64 ",,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558787457,"AMIN, MITUL, ARVIND",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 31 , 35 , 101 ,$#,,
MEDICAID DIRECT,1750965257,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE KILDAIRE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558788034,"LANGE SMITH, LAUREN, THERESE",110 KILDAIRE PARK DR   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558788687,"CUMARAN, SUJATHA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558788687,"CUMARAN, SUJATHA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558789339,"MILLER, ANNA, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558789339,"MILLER, ANNA, MARIE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558789735,"HALL, JENNIFER, OVERBY",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 24 ,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558789735,"HALL, JENNIFER, OVERBY",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 46 , 63 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558791541,"KEEF, SHANNON, MICHELLE",102 LEONARD AVE   NEWTON NC,018,Catawba,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 30 , 103 , 103 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558791541,"KEEF, SHANNON, MICHELLE",102 LEONARD AVE   NEWTON NC,018,Catawba,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 69 , 69 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558791541,"KEEF, SHANNON, MICHELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558791541,"KEEF, SHANNON, MICHELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558791541,"KEEF, SHANNON, MICHELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558791541,"KEEF, SHANNON, MICHELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 28 , 28 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558791541,"KEEF, SHANNON, MICHELLE",10545 BLAIR RD STE 1300 MINT HILL NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1619452612,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1558794230,"CLINE, LAURA, PAINTER",1007 W VERNON AVE   KINSTON NC,054,Lenoir,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1558795393,"LUKASIK, TRAVIS, DALE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558795393,"LUKASIK, TRAVIS, DALE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1558795393,"LUKASIK, TRAVIS, DALE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1558795393,"LUKASIK, TRAVIS, DALE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558795393,"LUKASIK, TRAVIS, DALE",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1558797399,"TOLAN, MOLLIE, ELIZABETH",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 18 , 20 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558799346,"JOYNER, DELISHA, RENEE",2160 HERBERT CT   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558799346,"JOYNER, DELISHA, RENEE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558799346,"JOYNER, DELISHA, RENEE",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 46 , 50 ,$#,,
MEDICAID DIRECT,1376123182,LOCAL START DENTAL INC,,370 JACKSON ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558799916,"SERAG, MAHMOUD, MOHAMED",370 JACKSON ST   DURHAM NC,032,Durham,1223P0700X,Dental Providers,Dentist,Prosthodontics, 236 , 309 ," 1,498 "," $159,820.67 ",,
MEDICAID DIRECT,1376123182,LOCAL START DENTAL INC,,370 JACKSON ST   DURHAM NC,032,Durham,261QH0100X,Ambulatory Health Care Facilities,Clinic/Center,Health Service,1558799916,"SERAG, MAHMOUD, MOHAMED",370 JACKSON ST   DURHAM NC,032,Durham,1223P0700X,Dental Providers,Dentist,Prosthodontics, 276 , 401 ," 1,761 "," $227,034.06 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558800060,"HESTER, KATIE, LEIGH",6905 KNIGHTDALE BLVD   KNIGHTDALE NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558800722,EYECARECENTER OD PA,,212 S MAIN ST   DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1558800722,EYECARECENTER OD PA,212 S MAIN ST   DOBSON NC,086,Surry,193400000X,Group,Single Specialty,, 35 , 35 , 70 ,$#,,
MEDICAID DIRECT,1558805861,A BRIGHTER DAY HOME CARE INC,~,6600 E WT HARRIS BLVD STE J CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558805861,A BRIGHTER DAY HOME CARE INC,6600 E WT HARRIS BLVD STE J CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 5,984 "," 5,984 "," $382,721.40 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558811190,"SCOTT, STEPHEN, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558811190,"SCOTT, STEPHEN, MICHAEL",1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 55 , 64 , 76 ,$#,,
MEDICAID DIRECT,1558816124,"WOODARD, ROBERT, WILLIAM",~,304 S MAIN ST   GRAHAM NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,,1558816124,"WOODARD, ROBERT, WILLIAM",304 S MAIN ST   GRAHAM NC,001,Alamance,152W00000X,Eye and Vision Services Providers,Optometrist,, 27 , 28 , 47 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558817072,"SMITH, KENDALL, SPENCER",400 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558817072,"SMITH, KENDALL, SPENCER",105 LISBON AVE   GARLAND NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558817072,"SMITH, KENDALL, SPENCER",113 S PINE ST   WARSAW NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558820126,"MELESSE, LIDYA, ADMASSU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558820126,"MELESSE, LIDYA, ADMASSU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558820126,"MELESSE, LIDYA, ADMASSU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558820126,"MELESSE, LIDYA, ADMASSU",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356366413,CRYSTAL COAST FAMILY PRACTICE,CRYSTAL COAST FAMILY PRACTICE,505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1558820209,"PHILLIPS, MICHELE, GARLAND",505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 101 , 142 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558820589,"ZOTTER, OLESEA, SANDULESCU",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558820589,"ZOTTER, OLESEA, SANDULESCU",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558820936,"MASTROSANTE, CAROLINE, ELIZABETH WATT",2525 COURT DR   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1679074181,CAROMONT MEDICAL GROUP INC,CAROMONT HEMATOLOGY & ONCOLOGY,2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558820936,"MASTROSANTE, CAROLINE, ELIZABETH WATT",2711 X RAY DR STE 3701 GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1558821793,"HAYDEN, ARIELLE, RENAE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558823278,"VAN HOOK, ANDREW, LANE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558827832,"MUELLER, CATHERINE, NICHOLS",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 41 , 65 , 136 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1558827832,"MUELLER, CATHERINE, NICHOLS",530 W WEBB AVE   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 18 , 45 ,$#,,
MEDICAID DIRECT,1558828889,L A ENTERPRISES,~,4614 WILGROVE MINT HILL RD STE C1 MINT HILL NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558828889,L A ENTERPRISES,4614 WILGROVE MINT HILL RD STE C1 MINT HILL NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 442 , 442 ," $34,651.44 ",,
MEDICAID DIRECT,1497810212,"JONES, SUSAN, KIMBERLY",SUSAN KIMBERLY JONES,1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1558829796,"HARVEY, ALEXANDRA, DAVIS",1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 121 , 142 , 600 ," $31,658.95 ",,
MEDICAID DIRECT,1558829796,"HARVEY, ALEXANDRA, DAVIS",,1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1558829796,"HARVEY, ALEXANDRA, DAVIS",1204 N CENTER ST   HICKORY NC,018,Catawba,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,264 "," 1,543 "," 5,308 "," $185,116.47 ",,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1558834051,"ECHEVERRIA, JONATHAN, MIGUEL",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 43 , 110 ,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558835363,"MONROE, KIMBERLY, SUMMER",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1558835363,"MONROE, KIMBERLY, SUMMER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558840165,"SAWYER, MACKENZIE",~,127 DRIFTWOOD CT   WRIGHTSVILLE BEACH NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1558840165,"SAWYER, MACKENZIE",127 DRIFTWOOD CT   WRIGHTSVILLE BEACH NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 28 , 654 , 654 ," $62,635.31 ",,
MEDICAID DIRECT,1528157211,COUNTY OF JOHNSTON NORTH CAROLINA,JOHNSTON COUNTY PUBLIC HEALTH DEPARTMENT,517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1558842575,"SMITH, ERIN, MARETT",517 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 77 , 99 , 403 ," $15,960.60 ",,
MEDICAID DIRECT,1417303629,WESTWOOD MEDICAL,,1201 W LEBANON ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558844340,"FAISON, ALPHONZA",5201 W MARKET ST STE 108 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1417303629,WESTWOOD MEDICAL,,1201 W LEBANON ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558844340,"FAISON, ALPHONZA",172 W INDEPENDENCE BLVD   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 81 , 127 ,$#,,
MEDICAID DIRECT,1417303629,WESTWOOD MEDICAL,,1201 W LEBANON ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1558844340,"FAISON, ALPHONZA",505 SAMARITANS RIDGE CT STE 100 ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 176 ," 1,119 "," 1,287 "," $29,516.91 ",,
MEDICAID DIRECT,1417303629,WESTWOOD MEDICAL,,525 SAMARITANS RIDGE CT   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1558844340,"FAISON, ALPHONZA",505 SAMARITANS RIDGE CT STE 100 ELKIN NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558844605,"BOGGS, COURTNEY, ELAINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265949325,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT STROKE AND NEUROSCIENCES-C,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558844605,"BOGGS, COURTNEY, ELAINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558844605,"BOGGS, COURTNEY, ELAINE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558844605,"BOGGS, COURTNEY, ELAINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558844605,"BOGGS, COURTNEY, ELAINE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1558844738,"GRIGORYAN, GRIGORIY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558844738,"GRIGORYAN, GRIGORIY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558845966,"BAEK, EMMA, CHRISTINE",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 22 , 45 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558846352,"KISER, LAUREN, BROOKE",1900 RANDOLPH RD STE 1010 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558846352,"KISER, LAUREN, BROOKE",558 KITCHINGS DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558846527,"SOUTHER, KELLIE, DUVAL",1188 YADKINVILLE RD   MOCKSVILLE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 68 , 81 , 203 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558847053,"MCNEILL, ALEXANDRIA, FAYE NICOLE",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558847053,"MCNEILL, ALEXANDRIA, FAYE NICOLE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558847236,"TRESOHLAVY, ELIZABETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558847236,"TRESOHLAVY, ELIZABETH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558848606,"BURTON, LACIE, KATZ",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 46 , 46 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558849554,"MURPHY, EMILY, LOUISE",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558853101,"TAYLOR, ALEXANDRA, MICHELLE",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558853788,"PIERCE, ASHLEY, NICHOLE",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558853788,"PIERCE, ASHLEY, NICHOLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558853788,"PIERCE, ASHLEY, NICHOLE",728 PINEY GROVE RD   KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 58 , 58 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1558853788,"PIERCE, ASHLEY, NICHOLE",728 PINEY GROVE RD   KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558853788,"PIERCE, ASHLEY, NICHOLE",901 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 28 , 28 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1558855296,"KELLY, JACQUELINE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558858175,"PALACIOS, STEPHANIE, MILAGROS",5601 ARRINGDON PARK DR STE 230 MORRISVILLE NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 35 , 61 ,$#,,
MEDICAID DIRECT,1558858829,RDL THERAPEUTIC ADULT DAY CENTER,~,6007 MORGANTON RD   FAYETTEVILLE NC,026,Cumberland,251B00000X,Agencies,Case Management,,1558858829,RDL THERAPEUTIC ADULT DAY CENTER,6007 MORGANTON RD   FAYETTEVILLE NC,026,Cumberland,251B00000X,Agencies,Case Management,,#, 122 , 122 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1558859629,"PACHOLEC, SEAN, LEON",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558859629,"PACHOLEC, SEAN, LEON",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 204 , 204 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558859991,"LERNER, AARON, JOSEPH",705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1558859991,"LERNER, AARON, JOSEPH",186 MEDICAL PARK LOOP STE 503 SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1558859991,"LERNER, AARON, JOSEPH",186 MEDICAL PARK LOOP STE 503 SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558859991,"LERNER, AARON, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,705 6TH AVE W STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558859991,"LERNER, AARON, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558859991,"LERNER, AARON, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1558860171,"AHN, HYEE JIN",2201 OLD NC HIGHWAY 86   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558860171,"AHN, HYEE JIN",410 MARKET ST STE 400A CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558860171,"AHN, HYEE JIN",3921 SUNSET RIDGE RD STE 202 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1558860684,"MILLER, JUSTIN, RYAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1558860684,"MILLER, JUSTIN, RYAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114223575,ESTRAMONTE CHIROPRACTIC & WELLNESS,,5344 CENTRAL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558863985,"CHOI, DAEHO",5344 CENTRAL AVE   CHARLOTTE NC,060,Mecklenburg,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1558865030,"SUDER, LUCAS, VINCENT",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558865949,"KERNIZAN, AMELIA, LUCILLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 167 , 173 , 212 ,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1558865949,"KERNIZAN, AMELIA, LUCILLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558865949,"KERNIZAN, AMELIA, LUCILLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558865949,"KERNIZAN, AMELIA, LUCILLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558865949,"KERNIZAN, AMELIA, LUCILLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558865949,"KERNIZAN, AMELIA, LUCILLE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558866178,"DARIVEMULA, SHILPA, MELANIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 44 , 45 , 53 ," $11,373.73 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558866178,"DARIVEMULA, SHILPA, MELANIE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558866178,"DARIVEMULA, SHILPA, MELANIE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558866178,"DARIVEMULA, SHILPA, MELANIE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558867093,"BENTZ, GREGORY, DEAN",3640 HIGH ST STE 3B PORTSMOUTH VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558867713,"WILLIAMS, HALEY-MARIE, GREENE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558867721,"ASEMOTA, BROOKE, IVIE",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 35 , 72 , 72 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558867721,"ASEMOTA, BROOKE, IVIE",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558868463,"MAHMOOD, RAFAT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 15 , 34 , 34 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558868463,"MAHMOOD, RAFAT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1558870659,"CROSS, NATALIE, NICHOLE",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 38 , 38 ,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,4024 STIRRUP CREEK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558871715,"HARVILLE, JOHN, CHRISTOPHER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558871715,"HARVILLE, JOHN, CHRISTOPHER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558872754,"SHAFER, SHERRY, SOMMER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 16 , 54 , 93 ,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,1141 N ROAD ST STE 1 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1558873653,"SMITH, MANDY, NICOLE",1141 N ROAD ST STE I ELIZABETH CITY NC,070,Pasquotank,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 32 , 38 , 55 ,$#,,
MEDICAID DIRECT,1699365072,MID-ATLANTIC WOMENS CARE PLC,,109 CURRITUCK COMMERICAL DR   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1558873653,"SMITH, MANDY, NICOLE",109 CURRITUCK COMMERICAL DR   MOYOCK NC,027,Currituck,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558876326,"MOSS, JAMES, ANTHONY DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558876326,"MOSS, JAMES, ANTHONY DAVID",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558876326,"MOSS, JAMES, ANTHONY DAVID",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558876326,"MOSS, JAMES, ANTHONY DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1558878439,"WALL, SARA, EMMA",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 20 , 35 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558878470,"LORENZONI, ANDREW, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558879882,PLAY WORKS THERAPY LLC,,34 WHITE OAK TRL   BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1558879882,PLAY WORKS THERAPY LLC,34 WHITE OAK TRL   BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,, 77 , 668 , 678 ," $60,550.88 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558881730,"PINDER, MEGAN, DANIELLE",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558882514,"WEBB, MOLLY, STUTTS",155 MEMORIAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 45 , 45 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558882514,"WEBB, MOLLY, STUTTS",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 59 , 84 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1558882514,"WEBB, MOLLY, STUTTS",15 REGIONAL DR   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346516895,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - PRE,4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558882613,"MARTIN, BRITTANY, ALYSE",4515 PREMIER DR STE 203 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 35 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558882613,"MARTIN, BRITTANY, ALYSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558885061,"CHESNEE, BRITTANY, MICHELLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558885061,"CHESNEE, BRITTANY, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558885061,"CHESNEE, BRITTANY, MICHELLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558887463,"RHODES, PAUL, ALAN",444 SW CENTER ST   FAISON NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1295113371,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER TABOR CITY,270 N US HIGHWAY 701 BYP   TABOR CITY NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558887463,"RHODES, PAUL, ALAN",270 N US 701 HWY BYP   TABOR CITY NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558887463,"RHODES, PAUL, ALAN",270 N US 701 HWY BYP   TABOR CITY NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881946242,CUMBERLAND COUNTY HOSPITAL SYSTEM I,ONCOLOGY SERVICES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558889907,"HOLBROOK, KRISTIN, NORTON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 59 , 68 , 68 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558891523,"LEATH-WARREN, CHRISTIE, JANEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 101 , 111 , 205 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558891523,"LEATH-WARREN, CHRISTIE, JANEL",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 53 , 58 , 99 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558891523,"LEATH-WARREN, CHRISTIE, JANEL",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558891523,"LEATH-WARREN, CHRISTIE, JANEL",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1558891523,"LEATH-WARREN, CHRISTIE, JANEL",226 N OAKLAND AVE   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 48 , 48 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,226 N OAKLAND AVE   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1558891523,"LEATH-WARREN, CHRISTIE, JANEL",226 N OAKLAND AVE   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1558891523,"LEATH-WARREN, CHRISTIE, JANEL",1560 FREEWAY DR STE F REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 40 , 41 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892125,"STROMAN, WARREN, RILEY",10512 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892125,"STROMAN, WARREN, RILEY",10520 PARK RD   CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#, 19 , 30 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892125,"STROMAN, WARREN, RILEY",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 13 , 31 , 95 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892125,"STROMAN, WARREN, RILEY",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 13 , 33 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1558892257,"CHUMLEY, CANDACE, FRANCINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1558892257,"CHUMLEY, CANDACE, FRANCINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558892604,"GARDNER, CHRISTOPHER, ALLEN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 87 , 87 , 113 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558896126,"HOLLAND, SHELBY, ANDERSON",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558896860,"NELSEN, RYAN, CURRY",188 MEDICAL PARK DR STE A BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 33 , 33 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1558896860,"NELSEN, RYAN, CURRY",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 93 , 153 , 155 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558897488,"BENTON, OLIVER",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558897488,"BENTON, OLIVER",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1922720648,NOVANT HEALTH MEDICAL GROUP LLC,NHMG UROLOGY CLINICS,584 HOSPITAL DR NE UNIT D BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1558897488,"BENTON, OLIVER",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558897488,"BENTON, OLIVER",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 98 , 161 , 214 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558897488,"BENTON, OLIVER",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558897488,"BENTON, OLIVER",1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558897876,"LIN, WEN-HSUAN, WENDY",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207ZH0000X,Allopathic & Osteopathic Physicians,Pathology,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558897876,"LIN, WEN-HSUAN, WENDY",40 DUKE MEDICINE CIRCLE   DURHAM NC,032,Durham,207ZH0000X,Allopathic & Osteopathic Physicians,Pathology,Hematology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558899039,"CARLSON, SCOTT, MICHAEL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558899039,"CARLSON, SCOTT, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558899211,"CAMPBELL, BRETT, JAY",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1962456343,CAPE FEAR EYE ASSOCIATES,CAPE FEAR EYE ASSOCIATES PA,1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1558899211,"CAMPBELL, BRETT, JAY",1726 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1558900035,EYECARECENTER OD PA,EYECARE CENTER,200 W ACADEMY ST   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,,1558900035,EYECARECENTER OD PA,200 W ACADEMY ST   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,, 15 , 17 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558900878,"MARAIA, ANNA, CATHERINE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558900878,"MARAIA, ANNA, CATHERINE",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3310 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558903781,"LESTER, REBECCA, SHEILDS",1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6750 W WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1558903781,"LESTER, REBECCA, SHEILDS",1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,14125 STEELE CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558903781,"LESTER, REBECCA, SHEILDS",1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558905364,"HACKLEY, KARI",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 118 , 118 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558907238,"ROBERTS, HANNAH, JO",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558907238,"ROBERTS, HANNAH, JO",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1669107611,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE SPRING FO,815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558911172,"CULLER, CHARLOTTE, ANNE",815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558911172,"CULLER, CHARLOTTE, ANNE",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669107611,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE SPRING FO,815 SPRINGFIELD COMMONS DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558911172,"CULLER, CHARLOTTE, ANNE",300 KEISLER DR STE 204 CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558915389,"O'FLYNN O'BRIEN, KASEY, LEIGH",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 66 , 127 , 129 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558915439,"CHUCHURU, CHRISTINA, RENEE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 32 , 34 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558916114,"LACOMBE, MICHAEL, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 53 , 111 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558916114,"LACOMBE, MICHAEL, JOSEPH",2005 PISGAH CHURCH RD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558917864,AGAPE CARE FAMILY HOME,,1801 BRITTON ST   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558917864,AGAPE CARE FAMILY HOME,1801 BRITTON ST   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 847 , 859 ," $62,502.25 ",,
MEDICAID DIRECT,1710484811,THE MOSES H CONE MEMORIAL HOSPITAL,CHILD ADVOCACY MEDICAL CLINIC,201 S GREENE ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558918615,"WATT, NATALIE, JEAN",201 S GREENE ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 13 , 31 ,$#,,
MEDICAID DIRECT,1558919969,REVOLUTION ACCESS LLC,~,85 SHILOH RD UNIT 50 ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1558919969,REVOLUTION ACCESS LLC,85 SHILOH RD UNIT 50 ASHEVILLE NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 28 , 37 , 42 ," $167,512.74 ",,
MEDICAID DIRECT,1558919969,REVOLUTION ACCESS LLC,~,85 SHILOH RD UNIT 50 ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1558919969,REVOLUTION ACCESS LLC,85 SHILOH RD UNIT 50 ASHEVILLE NC,011,Buncombe,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#, 41 ," $13,416.24 ",,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558921965,"THOMPSON, JESSE, EUGENE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558922641,"AYE, CHO, NWE",1450 MATTHEWS TOWNSHIP PKWY STE 400 MATTHEWS NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558922641,"AYE, CHO, NWE",6324 FAIRVIEW RD STE 310 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 26 , 72 , 155 ,$#,,
MEDICAID DIRECT,1194389643,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PSYCHIATRY HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558924555,"WRIGHT, DANNEN, DALE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1558926501,"WILSON, KATHRYN, DURHAM",KATHRYN WILSON,2412 TWEEDMORE CT   HIGH POINT NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1558926501,"WILSON, KATHRYN, DURHAM",2412 TWEEDMORE CT   HIGH POINT NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 92 , 152 ," $10,241.76 ",,
MEDICAID DIRECT,1558598532,BREAKTHROUGH PHYSICAL THERAPY INC,~,981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558932806,"CORBETT, ALEXANDER, RANDALL",981 HIGH HOUSE RD STE 100 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558933259,"JOHNSON, AMBER, WALLACE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558936377,"HUTZENBUHLER, MEGAN, ELISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 100 , 100 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1558936377,"HUTZENBUHLER, MEGAN, ELISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 65 , 65 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1558936377,"HUTZENBUHLER, MEGAN, ELISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1558936377,"HUTZENBUHLER, MEGAN, ELISE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 55 , 55 ,$#,,
MEDICAID DIRECT,1558937797,EMMANUEL HOME CARE SERVICES LLC,EMMANUEL HOME CARE SERVICES LLC,3623 LATROBE DR STE 110 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558937797,EMMANUEL HOME CARE SERVICES LLC,3623 LATROBE DR STE 110 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 2,104 "," 2,104 "," $175,659.08 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1558938126,"BROWN, JASON, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558938126,"BROWN, JASON, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 49 , 49 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1558940023,"CORRENTE, CONNOR, SAMUEL",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1558940023,"CORRENTE, CONNOR, SAMUEL",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 60 , 88 ,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1558942565,"TANNER, ROBIN, SNOW MURRAY",129 WOODSON ST   SALISBURY NC,080,Rowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 18 , 32 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558946384,"CAFRO, ALISSA, ROCHELLE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 48 , 51 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558947457,"KOERNER, ASHLEY, BECK",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1558947457,"KOERNER, ASHLEY, BECK",10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1558948638,"WILSON, COURTNEY, ELIZABETH",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 76 , 85 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2101 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1558948638,"WILSON, COURTNEY, ELIZABETH",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558948638,"WILSON, COURTNEY, ELIZABETH",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 41 , 47 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558948638,"WILSON, COURTNEY, ELIZABETH",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1558948638,"WILSON, COURTNEY, ELIZABETH",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1558948638,"WILSON, COURTNEY, ELIZABETH",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558948638,"WILSON, COURTNEY, ELIZABETH",2525 COURT DR   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1558948778,"EZEUDEMBA, OBIORA, CHIMAOBI",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 76 , 94 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558949578,"HATAB, MOHAMED",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1558949578,"HATAB, MOHAMED",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 29 , 29 ,$#,,
MEDICAID DIRECT,1558951384,THE BURWELL CORP LLC,~,19905 W CATAWBA AVE STE 201 CORNELIUS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1558951384,THE BURWELL CORP LLC,19905 W CATAWBA AVE STE 201 CORNELIUS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 639 , 639 ," $40,849.84 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1558953422,"METZGER, GRACE, CHRISTINE",2751 BUSINESS 19   ANDREWS NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972123537,MURPHY MEDICAL CENTER INC,,2751 BUSINESS 19   ANDREWS NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1558953422,"METZGER, GRACE, CHRISTINE",145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1558953422,"METZGER, GRACE, CHRISTINE",145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 42 , 42 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558954891,"EVANS, ALEXANDRA, GRACE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 35 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558954891,"EVANS, ALEXANDRA, GRACE",7420 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558954891,"EVANS, ALEXANDRA, GRACE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558954891,"EVANS, ALEXANDRA, GRACE",1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 46 , 61 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558954891,"EVANS, ALEXANDRA, GRACE",510 CAROLINA BAY DR STE 110 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 30 , 35 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558958694,"BRADSHER-JAMES, MEGHAN, SYDNEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558958694,"BRADSHER-JAMES, MEGHAN, SYDNEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558959338,"THOMPSON, JACQUELINE, BROOKE",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 39 , 53 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1558959338,"THOMPSON, JACQUELINE, BROOKE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1558967885,"POOLE, PRISCILLA, HELEN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1558969014,CINNAMON RIDGE FAMILY CARE,,3211 GROOMETOWN RD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1558969014,CINNAMON RIDGE FAMILY CARE,3211 GROOMETOWN RD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 2,179 "," 2,179 "," $137,990.40 ",,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1558970574,"BANKS, JULIA, ANN",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,19485 OLD JETTON RD STE 100   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558970574,"BANKS, JULIA, ANN",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,16525 HOLLY CREST LN STE 150   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558970574,"BANKS, JULIA, ANN",269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1356394308,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH LAKESIDE FAMILY PHYSICIANS,269 GILLMAN RD STE 100 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1558970574,"BANKS, JULIA, ANN",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558970939,"TIDWELL, JENNIFER, BAREFOOT",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 129 , 184 , 268 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,140 CHARLOIS BLVD FL 2 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558970939,"TIDWELL, JENNIFER, BAREFOOT",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558970939,"TIDWELL, JENNIFER, BAREFOOT",140 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558971390,"ASCUE, AURYELLE, NICHOLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558975417,"SWICK, MARGUERITE",3324 SIX FORKS RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1558975417,"SWICK, MARGUERITE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558975417,"SWICK, MARGUERITE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558975417,"SWICK, MARGUERITE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558975417,"SWICK, MARGUERITE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558978247,OMEGA IN-HOME SERVICE,,2606 W ROOSEVELT BLVD UNIT 4 MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1558978247,OMEGA IN-HOME SERVICE,2606 W ROOSEVELT BLVD UNIT 4 MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,, 30 ," 5,691 "," 5,696 "," $484,241.33 ",,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1558978999,"BALLARD, DEBORAH, LOUISE",1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558978999,"BALLARD, DEBORAH, LOUISE",6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 79 , 84 , 90 ,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1558978999,"BALLARD, DEBORAH, LOUISE",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 63 , 63 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558979021,"HANNA, AUSTIN, MICHAEL",101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558979021,"HANNA, AUSTIN, MICHAEL",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 25 , 34 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1558980847,"THOMPSON, LUVENIA",44 BONNIE LN   SYLVA NC,050,Jackson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558983437,"KUDRNA, TYSON, LEE",1901 MOONEY ST   WINSTON SALEM NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1558984203,"CAIN, SHERICA, LYNN WARFIELD",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558985036,"STANFORD, AMANDA, SUE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 95 , 121 , 149 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558985036,"STANFORD, AMANDA, SUE",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558985036,"STANFORD, AMANDA, SUE",313 AIRPORT RD   KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558985176,"CLAUGUS, COURTNEY, LYNNE",13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 14 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558985176,"CLAUGUS, COURTNEY, LYNNE",6324 FAIRVIEW RD STE 201 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235515446,CLEVELAND FAMILY HEALTH CLINIC PLLC,,22 SHIPWASH DR   GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1558986398,"BLEDSOE, JAMIE, HISAE",22 SHIPWASH DR   GARNER NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235515446,CLEVELAND FAMILY HEALTH CLINIC PLLC,,22 SHIPWASH DR   GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1558986398,"BLEDSOE, JAMIE, HISAE",22 SHIPWASH DR   GARNER NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 159 , 253 ,$#,,
MEDICAID DIRECT,1255098216,CONCINNITY HEALTH PLLC,CONCINNITY HEALTH DIRECT PRIMARY CARE,258 SOUTHTOWN CIR   ROLESVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1558987222,"KENION, TONI",258 SOUTHTOWN CIR   ROLESVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 40 , 59 ,$#,,
MEDICAID DIRECT,1558987222,"KENION, TONI",,258 SOUTHTOWN CIR   ROLESVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1558987222,"KENION, TONI",258 SOUTHTOWN CIR   ROLESVILLE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1922353838,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,1423 E FRANKLIN ST STE D MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1558987552,"PATEL, KULIN, MAHENDRABHAI",1423 E FRANKLIN ST STE D MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 97 , 174 , 219 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558987552,"PATEL, KULIN, MAHENDRABHAI",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1558989269,"MENAFRA, CLIFFORD, SCOTT",2400 N MAIN ST   FUQUAY VARINA NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558989269,"MENAFRA, CLIFFORD, SCOTT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 27 , 46 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558989269,"MENAFRA, CLIFFORD, SCOTT",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 60 , 89 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558989269,"MENAFRA, CLIFFORD, SCOTT",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558990408,"EICHELSDORFER, JASMYN, CAO",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1558990408,"EICHELSDORFER, JASMYN, CAO",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 19 , 41 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558990408,"EICHELSDORFER, JASMYN, CAO",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1558990408,"EICHELSDORFER, JASMYN, CAO",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558990408,"EICHELSDORFER, JASMYN, CAO",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558990846,"KOCASARAC, CAN",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558990846,"KOCASARAC, CAN",234 CROOKED CREEK PKWY STE 100 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558990846,"KOCASARAC, CAN",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 16 ,$#,,
MEDICAID DIRECT,1902963937,WHITEVILLE MEDICAL ASSOCIATES PA,WHITEVILLE MEDICAL ASSOCIATES PA,823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1558991919,"MCPHERSON, KIMBERLY, GODWIN",823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 167 , 322 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1558994491,"STALLWORTH, CANDICE, SHERESE",2301 MEDPARK DR   ROCKY MOUNT NC,064,Nash,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558995266,"NISLEY, DANA, KATHRYN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558995266,"NISLEY, DANA, KATHRYN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1558995266,"NISLEY, DANA, KATHRYN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558998617,"INYANG, ALEXANDRA, BRIGGS",250 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1558998617,"INYANG, ALEXANDRA, BRIGGS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1558998617,"INYANG, ALEXANDRA, BRIGGS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 207 , 207 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1558998617,"INYANG, ALEXANDRA, BRIGGS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 166 , 166 ," $10,274.25 ",,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558998674,"GOTTIMUKKALA, RUSHI",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1558998674,"GOTTIMUKKALA, RUSHI",600 GRESHAM DR 600 GRESHAM DR NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558999342,"RIVERA, MEGAN, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558999342,"RIVERA, MEGAN, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 42 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558999342,"RIVERA, MEGAN, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 81 , 83 , 86 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1558999342,"RIVERA, MEGAN, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1558999342,"RIVERA, MEGAN, JEAN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1558999821,"UEBERROTH, JORDAN, ARTHUR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 51 , 89 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568000982,"STEEN, JACQUELYN, MARIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568000982,"STEEN, JACQUELYN, MARIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568002533,"KAWAS, NAJLA, JAMILEH",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 61 , 110 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568002848,"LONDON, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1568002848,"LONDON, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1568002848,"LONDON, JONATHAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689114969,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN ORTHOPAEDICS,314 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1568003929,"PARKER, ALEXANDRA, CHRISTINE",314 S SOUTH ST   MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 137 , 250 ,$#,,
MEDICAID DIRECT,1568006229,UNIVERSAL HOME CARE SERVICES 2 LLC,,3325 WASHBURN AVE STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1568006229,UNIVERSAL HOME CARE SERVICES 2 LLC,3325 WASHBURN AVE STE 202 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 543 , 543 ," $33,966.04 ",,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1568011641,"THOMPSON, SEAN, LEVALLE",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1568011641,"THOMPSON, SEAN, LEVALLE",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1568011641,"THOMPSON, SEAN, LEVALLE",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568011674,AROUND THE CLOCK HOME CARE INC,AROUND THE CLOCK HOME CARE INC,3125 EASTWAY DR SUITE 202   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1568011674,AROUND THE CLOCK HOME CARE INC,3125 EASTWAY DR SUITE 202   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 6,122 "," 6,122 "," $407,091.86 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568018091,"MITCHELL, MEREDITH, THOMPSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 81 , 154 , 194 ,$#,,
MEDICAID DIRECT,1093762577,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK FAMILY PHYSICIANS,550 WHITE OAK ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1568018091,"MITCHELL, MEREDITH, THOMPSON",550 WHITE OAK ST   ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568019602,TRIANGLE HOME CARE AGENCY LLC,,1100 LOGGER CT STE G103 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1568019602,TRIANGLE HOME CARE AGENCY LLC,1100 LOGGER CT STE G103 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 3,381 "," 3,381 "," $220,549.80 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568020113,"BOYDE, BRYTTIN, PAIGE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568020410,"KELLY, ALEXIS, KEITH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,~,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568022275,"HILL, COURTNEY, BEASLEY",1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 25 , 32 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568024826,"PEELER, MELISSA, BROOKE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 21 , 21 ,$#,,
MEDICAID DIRECT,1760077820,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HANOVER GASTROENTEROLOGY,1520 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568024826,"PEELER, MELISSA, BROOKE",1520 PHYSICIANS DR STE B WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 60 , 90 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1568024917,"ROSE, HALEY, ELIZABETH",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568024917,"ROSE, HALEY, ELIZABETH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1568024917,"ROSE, HALEY, ELIZABETH",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568024917,"ROSE, HALEY, ELIZABETH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1568024917,"ROSE, HALEY, ELIZABETH",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568024917,"ROSE, HALEY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568024917,"ROSE, HALEY, ELIZABETH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427000652,FRANKLIN FAMILY PRACTICE,~,36 WESTGATE PLZ   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1568025526,"BLECKLEY, TIMOTHY, ALAN",36 WESTGATE PLZ   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568025682,"VARADARAJAN, ARJUN",506 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1568025799,"GLEED, MITCHELL, LYMAN",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1568025799,"GLEED, MITCHELL, LYMAN",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568026607,"ADAMS, SAMUEL, CARL",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1568027233,"AXTELL, SCOTT, LEROY",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 50 , 51 , 51 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568027233,"AXTELL, SCOTT, LEROY",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568027639,"GHIASSI, ERFAAN",105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 115 , 200 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568027639,"GHIASSI, ERFAAN",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568032555,"PETRELLA, AMBER, JAE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568032555,"PETRELLA, AMBER, JAE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1851805022,STARMED URGENT & FAMILY CARE PA,,4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568033660,"MANCZKO, SARAH, FRANCES",4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568033967,NEW HARMONY HOME CARE LLC,,4556 NC HIGHWAY 72 W STE C LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1568033967,NEW HARMONY HOME CARE LLC,4556 NC HIGHWAY 72 W STE C LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 358 ," 81,140 "," 81,823 "," $8,126,885.18 ",,
MEDICAID DIRECT,1568035855,PREEMINENT HOME HEALTH,,1566 UNION RD STE E GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1568035855,PREEMINENT HOME HEALTH,1566 UNION RD STE E GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#, 923 , 923 ," $57,657.04 ",,
MEDICAID DIRECT,1780629154,CLINTON MEDICAL CLINIC INC,~,403 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1568036069,"WATTENBURGER, JORDAN, REBECCA",403 FAIRVIEW ST   CLINTON NC,082,Sampson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 79 , 173 ,$#,,
MEDICAID DIRECT,1568039170,MEDIQUE HOMECARE STAFFING INC,,3201 YORKTOWN AVE STE 215A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1568039170,MEDIQUE HOMECARE STAFFING INC,3201 YORKTOWN AVE STE 215A DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#," 1,403 "," 1,403 "," $87,713.32 ",,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568039378,"JOHNSON, KELLY, COOKE",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1598869075,"DEDMOND, RONALD, KEITH",~,1435 N ASPEN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1568039899,"TALLENT, JOHN, DOCK",1435 N ASPEN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 30 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 306 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568040178,"TURSKI, CHRISTOPHER, ANDREAS",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1720151525,COUNTY OF CLEVELAND NORTH CAROLINA,CLEVELAND COUNTY HEALTH DEPARTMENT,200 S POST RD   SHELBY NC,023,Cleveland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1568043438,"FRANKLIN, BRITTANI, SHERRILL",200 S POST RD   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 32 ,$#,,
MEDICAID DIRECT,1720151525,COUNTY OF CLEVELAND NORTH CAROLINA,CLEVELAND COUNTY HEALTH DEPARTMENT,200 S POST RD   SHELBY NC,023,Cleveland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1568043438,"FRANKLIN, BRITTANI, SHERRILL",3970 W HIGHWAY 27   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568048916,"HERNANDEZ, KIRSTEN, SUSAN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1568049856,"GAUDLIP, ELLEN, MAE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 50 , 62 , 132 ,$#,,
MEDICAID DIRECT,1427136845,NC ORTHOTICS AND PROSTHETICS,NC ORTHOTICS AND PROSTHETICS,451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568054740,"HODGES, DENNIS, FRANKLIN",451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1427136845,NC ORTHOTICS AND PROSTHETICS,NC ORTHOTICS AND PROSTHETICS,451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568054740,"HODGES, DENNIS, FRANKLIN",451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568055895,"KISER, MAEGAN, PHILLIPS",400 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 90 , 108 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568058170,"NAQUIN, TORI, DUFRENE",139 FIDDLERS RUN BLVD   MORGANTON NC,012,Burke,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 52 , 102 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568059947,"ARMADA, LUIS, MARIO",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568059947,"ARMADA, LUIS, MARIO",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568059947,"ARMADA, LUIS, MARIO",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568059947,"ARMADA, LUIS, MARIO",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568059947,"ARMADA, LUIS, MARIO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568060853,"JACKSON, SHARONDA, LATECHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1568060853,"JACKSON, SHARONDA, LATECHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568060853,"JACKSON, SHARONDA, LATECHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1568060853,"JACKSON, SHARONDA, LATECHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568060853,"JACKSON, SHARONDA, LATECHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1568060853,"JACKSON, SHARONDA, LATECHA",1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568062545,TS HEALING CONCEPTS LLC,,2315 W ARBORS DR STE 200 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1568062545,TS HEALING CONCEPTS LLC,2315 W ARBORS DR STE 200 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 527 , 642 ," $92,137.60 ",,
MEDICAID DIRECT,1568065902,SERENITY HOME HEALTH CARE,~,3622 LYCKAN PKWY STE 4007 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1568065902,SERENITY HOME HEALTH CARE,3622 LYCKAN PKWY STE 4007 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#," 1,166 "," 1,271 "," $106,792.55 ",,
MEDICAID DIRECT,1568065910,CLEARLY STATED SPEECH AND LANGUAGE,,1451 S ELM EUGENE ST STE 3102 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568065910,CLEARLY STATED SPEECH AND LANGUAGE,1451 S ELM EUGENE ST STE 3102 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5900 QUAIL HOLLOW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568067700,"PANARA, ALLISON, MICHELLE",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,400 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568067700,"PANARA, ALLISON, MICHELLE",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568069748,"JAUSSEN, SETH, LIAM",461 WESTERN BLVD STE 122 JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 29 ,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1568070357,"BAUGHAN, THOMAS, GERALD",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1568070357,"BAUGHAN, THOMAS, GERALD",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568070787,"LIGOURI, SAMANTHA",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568070787,"LIGOURI, SAMANTHA",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 26 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568072817,"SMITH, CARISSA, SHANAE",804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 85 , 128 ,$#,,
MEDICAID DIRECT,1972194868,GENERATIONS FAMILY PRACTICE,ROCKY MOUNT FAMILY MEDICAL CENTER,804 ENGLISH RD STE 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568072817,"SMITH, CARISSA, SHANAE",102 S EASTPOINTE AVE   NASHVILLE NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568075794,"DUTY, JOHN, MICHAEL",19 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 63 , 183 ,$#,,
MEDICAID DIRECT,1699791129,SOUTHEASTERN PHYSICAL THERAPY LLC,~,1870 BREVARD RD STE 115 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568075794,"DUTY, JOHN, MICHAEL",1256 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568077873,"CLARKE, ROBERT, MARTIN",303 AIRPORT RD   ARDEN NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568077873,"CLARKE, ROBERT, MARTIN",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 35 , 35 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568080810,"EBY, RONALD, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 20 , 21 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568080810,"EBY, RONALD, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568080810,"EBY, RONALD, LEE",61 WEAVER BLVD STE 105 WEAVERVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437175700,SISTERS OF MERCY URGENT CARE,MERCY URGENT CARE,1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568080810,"EBY, RONALD, LEE",1201 PATTON AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 38 , 75 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568080810,"EBY, RONALD, LEE",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568080810,"EBY, RONALD, LEE",310 LONG SHOALS RD FL 1 ARDEN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568081123,"MCFARLANE, KAITLYN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 44 , 72 ," $12,002.98 ",,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568082642,"PIERSON, AILEEN, PRISCILLA",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568082642,"PIERSON, AILEEN, PRISCILLA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568082873,"BRIMAGE, VONDRA, DEE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 93 , 106 , 193 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568082873,"BRIMAGE, VONDRA, DEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568083418,"SINGH, DHANVEER",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568083418,"SINGH, DHANVEER",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568083418,"SINGH, DHANVEER",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568083418,"SINGH, DHANVEER",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568083418,"SINGH, DHANVEER",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1568083707,MAVILCARE HOME HEALTH AGENCY LLC,MAVILCARE HOME CARE AGENCY,10931 E INDEPENDENCE BLVD STE A-3 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1568083707,MAVILCARE HOME HEALTH AGENCY LLC,10931 E INDEPENDENCE BLVD STE A-3 MATTHEWS NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 4,971 "," 5,532 "," $659,044.36 ",,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 31 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 22 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568084598,"LEOMBRUNO, MIKAYLA, MARIE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568084879,RESOLUTE CARE SERVICES INC,~,11 UNION ST S STE 228A CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1568084879,RESOLUTE CARE SERVICES INC,11 UNION ST S STE 228A CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,, 11 , 620 , 620 ," $37,202.32 ",,
MEDICAID DIRECT,1568084879,RESOLUTE CARE SERVICES INC,~,1121 OLD CONCORD RD STE 16 SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,1568084879,RESOLUTE CARE SERVICES INC,1121 OLD CONCORD RD STE 16 SALISBURY NC,080,Rowan,253Z00000X,Agencies,In Home Supportive Care,,#, 419 , 419 ," $33,560.76 ",,
MEDICAID DIRECT,1740535657,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1568085066,"WISE, KAYLA, DILL",6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 21 , 27 , 42 ,$#,,
MEDICAID DIRECT,1740535657,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DOVE INTERNAL MEDICINE,6030 W HIGHWAY 74 STE D INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1568085066,"WISE, KAYLA, DILL",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#, 12 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568087112,"MERCADO-ORTIZ, JESSICA, QUEENNIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 65 , 76 , 78 ," $16,981.73 ",,
MEDICAID DIRECT,1407471881,OYEGUNWA AND ASSOCIATES,O2 DENTAL GROUP OF SOUTHERN PINES,340 CAPITAL DR   CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1568089597,"MOGHUL, SARA, YOUSUF",340 CAPITAL DR   CARTHAGE NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice, 46 , 63 , 181 ," $11,939.64 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568094910,"LINHART, SARAH, ALLISON",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568094993,AFFINITY HOME CARE LLC,~,8378 SIX FORKS RD STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1568094993,AFFINITY HOME CARE LLC,8378 SIX FORKS RD STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568097269,"LE, LYNNE",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 86 , 228 ,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568097269,"LE, LYNNE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 30 ,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1568097418,"MIDGETTE, TARRA, OLDS",400 S CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 25 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568102143,"ELSHEIKH, EMAN, HOSSAM ABDELRAOUF",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 51 , 51 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568102556,"BAHRANI, BAHAR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568102556,"BAHRANI, BAHAR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568102952,"REESE, MARYETTA, ASHLEY",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568104107,"SLOWINSKI, SAMANTHA, DIANE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568104107,"SLOWINSKI, SAMANTHA, DIANE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568104107,"SLOWINSKI, SAMANTHA, DIANE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568108413,"GARRETT, GRACE, DANIEL",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 46 , 62 , 62 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568114650,"WOLFF, MEGAN, ALEXANDRIA",3205 RANDALL PKWY   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 265 , 269 ,$#,,
MEDICAID DIRECT,1861155624,LONDRY & MODLIN VIII DDS PLLC,FRENCH BROAD FAMILY DENTISTRY,81 N MAIN ST   MARSHALL NC,057,Madison,193400000X,Group,Single Specialty,,1568114775,"VAN ASCH, KEVIN, DAVIS",81 N MAIN ST   MARSHALL NC,057,Madison,1223G0001X,Dental Providers,Dentist,General Practice, 176 , 359 , 942 ," $42,492.91 ",,
MEDICAID DIRECT,1568116655,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1568116655,MYEYEDR OPTOMETRY OF NORTH CAROLINA,615 HENSON ST STE B ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,, 112 ,#, 15 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568116887,"CAMU, DIANE, VIRGINIA LOOS",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 25 , 26 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568116887,"CAMU, DIANE, VIRGINIA LOOS",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568116887,"CAMU, DIANE, VIRGINIA LOOS",4414 LAKE BOONE TRL STE 505 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 68 , 70 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568123313,"BARTAUSKY, MADELINE, CLAIRE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568123313,"BARTAUSKY, MADELINE, CLAIRE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568123313,"BARTAUSKY, MADELINE, CLAIRE",3324 SIX FORKS RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 16 , 26 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568123313,"BARTAUSKY, MADELINE, CLAIRE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568123313,"BARTAUSKY, MADELINE, CLAIRE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568123313,"BARTAUSKY, MADELINE, CLAIRE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568124303,CHESTERFIELD FAMILY CARE HOME LLC,,2630 PAX HILL RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568124303,CHESTERFIELD FAMILY CARE HOME LLC,2630 PAX HILL RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 20 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568124386,"CACERES, JANIECE, ANN",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568128692,"QADIR, AYEMA, BINT",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1568128692,"QADIR, AYEMA, BINT",912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568128742,"ROBERTSON, LOGAN, BROOKE",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 15 , 81 , 81 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568133916,"CHU, RACHEL, ANN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 105 , 339 , 364 ,$#,,
MEDICAID DIRECT,1235825514,RIVER OF HOPE BEHAVIORAL HEALTH AND,,79 WOODFIN PL STE 208 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568133916,"CHU, RACHEL, ANN",79 WOODFIN PL STE 208 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568135697,"WILLIAMS, KASEY, LYNN",851 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,1110 SE CARY PKWY STE 208 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568135697,"WILLIAMS, KASEY, LYNN",1110 SE CARY PKWY STE 103 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1053919183,UNC PHYSICIANS GROUP PRACTICES II L,UNC HEALTH CARY ORTHOPAEDICS AND SPORTS MEDICINE,600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568135697,"WILLIAMS, KASEY, LYNN",600A VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568139905,"HUSSEIN, NADIM",3100 NC 55 HWY STE 101 CARY NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 34 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1568143576,"ANDERSON, KAITLYN, ELIZABETH",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 49 , 203 , 206 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,106 CAMERON ST   LAKE WACCAMAW NC,024,Columbus,193200000X,Group,Multi-Specialty,,1568143576,"ANDERSON, KAITLYN, ELIZABETH",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 14 , 58 , 59 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1568143576,"ANDERSON, KAITLYN, ELIZABETH",214 LANEFIELD RD   WARSAW NC,031,Duplin,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,214 LANEFIELD RD   WARSAW NC,031,Duplin,193200000X,Group,Multi-Specialty,,1568143576,"ANDERSON, KAITLYN, ELIZABETH",214 LANEFIELD RD   WARSAW NC,031,Duplin,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 26 , 108 , 108 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1568143576,"ANDERSON, KAITLYN, ELIZABETH",214 LANEFIELD RD   WARSAW NC,031,Duplin,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 30 , 122 , 123 ,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568146371,"HERNANDEZ, CITLALY",2210 HEMBY LN   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 174 , 244 , 245 ,$#,,
MEDICAID DIRECT,1568156255,KIPP CHARLOTTE,,931 WILANN DR   CHARLOTTE NC,060,Mecklenburg,251300000X,Agencies,Local Education Agency (LEA),,1568156255,KIPP CHARLOTTE,931 WILANN DR   CHARLOTTE NC,060,Mecklenburg,251300000X,Agencies,Local Education Agency (LEA),, 37 ," 1,090 "," 1,111 "," $47,493.35 ",,
MEDICAID DIRECT,1144796301,MH MISSION HOSPITAL MCDOWELL LLLP,,339 NEBO SCHOOL RD   NEBO NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568157493,"HICKS, ANGELA, HARRISON",339 NEBO SCHOOL RD   NEBO NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 60 , 78 ," $13,409.39 ",,
MEDICAID DIRECT,1144796301,MH MISSION HOSPITAL MCDOWELL LLLP,,339 NEBO SCHOOL RD   NEBO NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568157493,"HICKS, ANGELA, HARRISON",1633 SUGAR HILL RD   MARION NC,059,McDowell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568160877,"WITTENBORN, DEBORAH, MARIE",3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568160877,"WITTENBORN, DEBORAH, MARIE",3200 NORTHLINE AVE STE 250 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568160877,"WITTENBORN, DEBORAH, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 63 , 103 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568160877,"WITTENBORN, DEBORAH, MARIE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 25 , 37 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568160877,"WITTENBORN, DEBORAH, MARIE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568169043,"NGUYEN, KRISTY, THI OUYNH",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1801442033,BRADLEY ROBERTS & ASSOCIATES PLLC,~,401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1568169043,"NGUYEN, KRISTY, THI OUYNH",401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice," 3,936 "," 4,801 "," 22,950 "," $635,609.98 ",,
MEDICAID DIRECT,1568172765,1ST CHOICE HOMECARE AND INFUSION SE,~,712 WILKINS ST STE D SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1568172765,1ST CHOICE HOMECARE AND INFUSION SE,712 WILKINS ST STE D SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,, 14 , 881 , 899 ," $97,184.33 ",,
MEDICAID DIRECT,1568172765,1ST CHOICE HOMECARE AND INFUSION SE,~,502 E MARKET ST UNIT A SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1568172765,1ST CHOICE HOMECARE AND INFUSION SE,502 E MARKET ST UNIT A SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,, 12 , 432 , 432 ," $36,205.69 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568176634,"RAMIREZ RAMIREZ, DARWIN, DE JESUS",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 65 , 122 ,$#,,
MEDICAID DIRECT,1568177962,FIVE ANGELS CARE,,10948 N MAIN ST   ARCHDALE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,1568177962,FIVE ANGELS CARE,10948 N MAIN ST   ARCHDALE NC,076,Randolph,253Z00000X,Agencies,In Home Supportive Care,,#, 804 , 913 ," $131,948.44 ",,
MEDICAID DIRECT,1063096345,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE GLENWOOD,6800 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568178952,"STEBBINS, ALAYNA, MARIE",6800 GLENWOOD AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568183200,"MOLINA, JESSIE, CHRISTINE",101 PLAZA RD   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 41 , 60 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568183200,"MOLINA, JESSIE, CHRISTINE",700A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 96 , 116 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568183200,"MOLINA, JESSIE, CHRISTINE",700A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1568186245,"THOMAS, DANIEL, DUBOSKY",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568186245,"THOMAS, DANIEL, DUBOSKY",2031 SMALLWOOD DR   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1134229669,SPORTS & MORE PHYSICAL THERAPY INC,,8300 HEALTH PARK STE 127 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568186245,"THOMAS, DANIEL, DUBOSKY",2031 SMALLWOOD DR   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 42 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568186245,"THOMAS, DANIEL, DUBOSKY",2031 SMALLWOOD DR   RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568187169,"MORTENSEN, BRAYDEN, BRADLEY",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568187169,"MORTENSEN, BRAYDEN, BRADLEY",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 26 , 53 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568187169,"MORTENSEN, BRAYDEN, BRADLEY",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568188084,"EGGLESTON, JERRICA, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1568192318,CHOSEN HOME CARE INC,,30 DRAKES BRANCH DR   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1568192318,CHOSEN HOME CARE INC,30 DRAKES BRANCH DR   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 67 ," 8,926 "," 8,942 "," $903,222.56 ",,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568192656,"WILSON, MEGAN, HAGER",2300 ABERDEEN BLVD   GASTONIA NC,036,Gaston,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 16 , 50 , 50 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568194124,"NAPIER, CHRISTY, LYNN",6324 FAIRVIEW RD STE 460 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568194975,"SCHROEDER, TIMOTHY, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568194975,"SCHROEDER, TIMOTHY, MICHAEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730520396,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GENERAL SURGERY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568194975,"SCHROEDER, TIMOTHY, MICHAEL",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568195030,"LANCASTER, CASSANDRA, SANTA MARIA",1248 FORT BRAGG RD   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568204089,"BOSTON, BRETT, CHRISTOPHER",420 NORTH CENTER STREET   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568204089,"BOSTON, BRETT, CHRISTOPHER",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568204089,"BOSTON, BRETT, CHRISTOPHER",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568204089,"BOSTON, BRETT, CHRISTOPHER",420 NORTH CENTER STREET   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1568204089,"BOSTON, BRETT, CHRISTOPHER",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568207082,"EDWARDS, ISABELLE, HOPE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568215606,LATESHA BURNS,INSTANT LUV HOMECARE,989 DIGGS RD   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,1568215606,LATESHA BURNS,989 DIGGS RD   WADESBORO NC,004,Anson,253Z00000X,Agencies,In Home Supportive Care,,#, 529 , 612 ," $64,797.12 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568217073,"THOMPSON, ANNA, VICTORIA",5917 OLEANDER DR STE 202 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568218626,"MARTIN, GRAHAM, DELANO",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1568220770,"BOYD, CHRISTIAN, HINSON",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1568220770,"BOYD, CHRISTIAN, HINSON",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,6310 BEACH DR SW   OCEAN ISLE BEACH NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1568220770,"BOYD, CHRISTIAN, HINSON",82 WHITES CROSSING PLZ   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1568220770,"BOYD, CHRISTIAN, HINSON",82 WHITES CROSSING PLZ   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 32 , 80 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1568220770,"BOYD, CHRISTIAN, HINSON",82 WHITES CROSSING PLZ   WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 76 , 76 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1568221406,"SULLIVAN, JAMIE",,91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1568221406,"SULLIVAN, JAMIE",91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,70 SWEETEN CREEK RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 141 , 141 ,$#,,
MEDICAID DIRECT,1568221406,"SULLIVAN, JAMIE",,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1568221406,"SULLIVAN, JAMIE",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,1984 US 70 HWY   SWANNANOA NC,011,Buncombe,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",1984 US 70 HWY   SWANNANOA NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",200 HERITAGE CIR   HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 191 , 193 ," $11,854.10 ",,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,91 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",115 N COUNTRY CLUB RD   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 46 , 48 ,$#,,
MEDICAID DIRECT,1780080218,NATIONAL HEALTH REHABILITATION LLC,,188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,193400000X,Group,Single Specialty,,1568221406,"SULLIVAN, JAMIE",188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568224079,"NORRIS, BETHANY, ARIEL",189 HOSPITAL DR.   SPRUCE PINE NC,061,Mitchell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568228914,"HAVILEY, JONATHAN, MICHAEL",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1235957655,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR ORTHOPEDICS & SPORTS MEDICINE OF CFVH,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568232536,"MCCANN, KELSEY",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 62 , 97 ,$#,,
MEDICAID DIRECT,1215366216,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER CAPE FEAR,3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568236313,"PAYA, ISABELLA",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568236313,"PAYA, ISABELLA",3613 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 33 , 33 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568240042,"SARTAIN, ASHLEY, BLAINE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1629376363,MOSES CONE MEDICAL SERVICES INC,~,401 W DECATUR ST   MADISON NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1568240422,"MILIAN, GABRIELLE, CAPPS",401 W DECATUR ST   MADISON NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 80 , 170 , 227 ,$#,,
MEDICAID DIRECT,1275195679,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT HH BEAM ELEMENTARY,200 DAVIS PARK RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568243137,"HOBBS, TALTON, LAVAR",3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1164203758,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT BROOKSIDE ELEMENTARY,1925 AUTEN RD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568243137,"HOBBS, TALTON, LAVAR",3050 RIVERWOOD PKWY   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1568243715,"ANGELO, KATELYN, NICOLE",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 35 ,$#,,
MEDICAID DIRECT,1174208813,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA SANDHILLS FAMILY CARE RHC,1125 CARTHAGE ST   SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568244762,"WARD, TIESHA, RENEE",1125 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 109 , 124 ,$#,,
MEDICAID DIRECT,1568249001,JSPETERSONYOUTHLCC,,2138 BLACKWOLF RUN LN   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1568249001,JSPETERSONYOUTHLCC,2138 BLACKWOLF RUN LN   RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,, 60 , 962 , 962 ," $62,158.60 ",,
MEDICAID DIRECT,1114351095,MCPC-16 LLC,FIRSTHEALTH PRIMARY CARE AND CARDIOLOGY,6322 FAYETTEVILLE RD OFC RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1568267417,"KAVANAUGH, SUSAN, WRIGHT",6322 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1568278133,"ALBA STORIE, CRYSTAL, MICHELLE",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205090784,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE DENVER INTERNAL AND FAM,1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1568278133,"ALBA STORIE, CRYSTAL, MICHELLE",1585 FORNEY CREEK PKWY STE 2100 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568282747,"BOURGEOIS, MADELYN, BURK",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568291052,"NATALE, MAX-ANTHONY",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568291052,"NATALE, MAX-ANTHONY",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1568293033,"LARRIMORE, CALEB, LADSON",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568293033,"LARRIMORE, CALEB, LADSON",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568293033,"LARRIMORE, CALEB, LADSON",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568293769,"YOW, KELLY, MICHELLE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568293769,"YOW, KELLY, MICHELLE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568293769,"YOW, KELLY, MICHELLE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568400729,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH WAXHAW FAMILY & SPORTS MEDICINE,3614 PROVIDENCE RD S STE 100 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1568400729,NOVANT HEALTH MEDICAL GROUP LLC,3614 PROVIDENCE RD S STE 100 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,#,#, 18 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568400893,"RODRIGUEZ, SUZETTE, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568400943,"DUROJAIYE, BABATOLA, ADEAGBO",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568401966,"MOCK, MICHELE, DIANE",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 26 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1568401966,"MOCK, MICHELE, DIANE",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1568402899,"CAUDLE, JEFFREY, NELSON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568402899,"CAUDLE, JEFFREY, NELSON",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 27 , 27 ,$#,,
MEDICAID DIRECT,1821035775,OBAN ANESTHESIA CONSULTANTS PLLC,OBAN ANESTHESIA CONSULTANT,,,Unknown,193400000X,Group,Single Specialty,,1568403541,"WALDO, AIKYA, FISHER",925 S LONG DR   ROCKINGHAM NC,077,Richmond,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568403541,"WALDO, AIKYA, FISHER",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 110 , 124 , 131 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568405041,"GIOMETTI, JON, ALLEN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 56 , 58 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568405041,"GIOMETTI, JON, ALLEN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568405371,"PAVY, MICHAEL, DUPRE",401 E CHEVES ST STE 201 FLORENCE SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568406262,"BASS, SALLIE, WADDILL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 46 , 48 , 50 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568407294,"TAYLOR, KAREN, ELIZABETH",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568407294,"TAYLOR, KAREN, ELIZABETH",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 28 , 28 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1568407583,"FORMANEK, GREGORY, ANDREW",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 263 , 291 , 292 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 119 , 134 , 134 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",2301 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 56 , 66 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568407781,"SCHOCKEN, DOUGLAS, DAVID",2100 ERWIN RD   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568409423,"PARADIS, PAULA, YVETTE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568409423,"PARADIS, PAULA, YVETTE",1821 HILLANDALE RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 15 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1568409423,"PARADIS, PAULA, YVETTE",267 S CHURTON ST   HILLSBOROUGH NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568409423,"PARADIS, PAULA, YVETTE",10211 ALM ST   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1568409829,"HARDY, CONSTANCE, ALEXIS",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1568409829,"HARDY, CONSTANCE, ALEXIS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568409829,"HARDY, CONSTANCE, ALEXIS",100 AIRPORT RD   KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 34 , 34 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568410041,"VERRILLI, JOHN, THOMAS",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 17 , 45 , 45 ,$#,,
MEDICAID DIRECT,1568116655,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1568410504,"THOMPSON, SAMUEL, EUGENE",615 HENSON ST STE B ALBEMARLE NC,084,Stanly,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1598017212,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1100 HEALING WAY STE 21A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1568410827,"KIM, EUGENE, JAEWOOK",1100 HEALING WAY STE 21A MATTHEWS NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 35 , 53 , 63 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1568410827,"KIM, EUGENE, JAEWOOK",1550 FAULK ST STE 3120 MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 58 , 85 , 125 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1568410827,"KIM, EUGENE, JAEWOOK",1428 ELLEN ST STE B MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 23 , 48 , 49 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568410827,"KIM, EUGENE, JAEWOOK",1428 ELLEN ST STE B MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 27 , 55 , 60 ,$#,,
MEDICAID DIRECT,1437586302,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HICKORY,133 1ST AVE SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568411007,"MOFFETT, COLIN, LEE",111 E 3RD AVE   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 14 , 31 , 31 ,$#,,
MEDICAID DIRECT,1548389125,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - 3RD AVE,111 E THIRD AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568411007,"MOFFETT, COLIN, LEE",111 E 3RD AVE   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568411007,"MOFFETT, COLIN, LEE",111 E 3RD AVE   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568411007,"MOFFETT, COLIN, LEE",111 E 3RD AVE   GASTONIA NC,036,Gaston,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 16 , 23 , 23 ,$#,,
MEDICAID DIRECT,1942715099,SPRAGUE PLLC,SCHILSKY CHIROPRACTIC CENTER,312 DOLPHIN DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1568412328,"SPRAGUE, JAMES, NATHANAEL",312 DOLPHIN DR   JACKSONVILLE NC,067,Onslow,111N00000X,Chiropractic Providers,Chiropractor,, 28 , 145 , 150 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568412468,"WHITEHOUSE, JAMES, DUNCAN",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568412468,"WHITEHOUSE, JAMES, DUNCAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 67 , 157 , 175 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568412468,"WHITEHOUSE, JAMES, DUNCAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 61 , 150 , 153 ," $15,157.91 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568412468,"WHITEHOUSE, JAMES, DUNCAN",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568412468,"WHITEHOUSE, JAMES, DUNCAN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568414217,"YU, KATHY, KA KEE",55 VILCOM CENTER DR STE 140 CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568414217,"YU, KATHY, KA KEE",1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 32 , 40 , 61 ,$#,,
MEDICAID DIRECT,1710926662,WILSON EYE ASSOCIATES,~,2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1568414464,"STONE, RUSSELL, BRYANT",2402 MONTGOMERY DR SW   WILSON NC,098,Wilson,152W00000X,Eye and Vision Services Providers,Optometrist,, 73 , 80 , 89 ,$#,,
MEDICAID DIRECT,1043507130,ACME MEDICAL SPECIALTIES PLLC,ACME MEDICAL SPECIALISTS PLLC,4348 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568414720,"AGYEI-GYAMFI, KWADWO",4901 DAWN DR STE 1100 LUMBERTON NC,078,Robeson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1043507130,ACME MEDICAL SPECIALTIES PLLC,ACME MEDICAL SPECIALISTS PLLC,4348 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568414720,"AGYEI-GYAMFI, KWADWO",4348 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 320 , 488 , 531 ," $11,773.60 ",,
MEDICAID DIRECT,1043507130,ACME MEDICAL SPECIALTIES PLLC,ACME MEDICAL SPECIALISTS PLLC,4348 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568414720,"AGYEI-GYAMFI, KWADWO",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 195 , 293 , 422 ," $19,007.96 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568415057,"MAXY, RALPH, JEAN",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568415057,"MAXY, RALPH, JEAN",232 SHARON AVE NW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568415057,"MAXY, RALPH, JEAN",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568415057,"MAXY, RALPH, JEAN",160 RIVER BEND DR STE C GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568415057,"MAXY, RALPH, JEAN",232 SHARON AVE NW   LENOIR NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568415057,"MAXY, RALPH, JEAN",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568415057,"MAXY, RALPH, JEAN",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 24 , 32 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",605 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 38 , 206 , 206 ," $14,071.74 ",,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",605 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",605 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 23 , 23 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 39 , 39 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 45 , 79 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3943 NEW BERN AVE STE 100 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 34 , 34 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1568415073,"SONAWANE, SAMSHER, BABASAHEB",2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568415313,"ROCHE, MICHAEL, JAMES",1511 WESTOVER TER STE 107 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 92 , 537 , 604 ," $10,042.54 ",,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568415313,"ROCHE, MICHAEL, JAMES",2912 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1409 UNIVERSITY DR STE 105 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568416758,"TULLO, TERESA, LOUISE",1409 UNIVERSITY DR STE 105 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568416758,"TULLO, TERESA, LOUISE",1409 UNIVERSITY DR STE 105 BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568416758,"TULLO, TERESA, LOUISE",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 52 , 115 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568417350,"KHAN, JAMIL, HAKIM",2025 GLENN MITCHELL DR   VIRGINIA BEACH VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568417350,"KHAN, JAMIL, HAKIM",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568417350,"KHAN, JAMIL, HAKIM",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568418291,"MASOOD, HABIB, ABUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 66 , 66 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568418291,"MASOOD, HABIB, ABUL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 39 , 39 ,$#,,
MEDICAID DIRECT,1568419273,ALEXANDER COUNTY,Alexander County EMS,2430 NC HIGHWAY 90 E   TAYLORSVILLE NC,002,Alexander,3416L0300X,Transportation Services,Ambulance,Land Transport,1568419273,ALEXANDER COUNTY,2430 NC HIGHWAY 90 E   TAYLORSVILLE NC,002,Alexander,3416L0300X,Transportation Services,Ambulance,Land Transport, 186 , 319 , 580 ," $13,544.70 ",,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568419398,"PRESSON, THOMAS, LEMUEL",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 274 , 295 , 347 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568419398,"PRESSON, THOMAS, LEMUEL",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 26 , 37 ,$#,,
MEDICAID DIRECT,1699733121,PIEDMONT IMAGING INC,,684 N PINE ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568419422,"SHRAMEK, JEFFREY, KEITH",684 N PINE ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 25 , 38 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568420842,"LANDRY, RANDY, JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568421667,"HUNT, CHRISTI, GARRETT",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568421667,"HUNT, CHRISTI, GARRETT",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1932729688,OBRIEN AND WEST DMD IX PLLC,NIGHT AND DAY DENTAL,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 13 , 20 ,$#,,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 96 , 101 , 256 ," $10,140.62 ",,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1932729688,OBRIEN AND WEST DMD IX PLLC,NIGHT AND DAY DENTAL,40 PITTS SCHOOL RD SW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750871562,OBRIEN AND WEST DMD V PLLC,~,452 SHOTWELL RD   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",452 SHOTWELL RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 24 , 27 , 58 ,$#,,
MEDICAID DIRECT,1942975776,OBRIEN AND WEST DMD XI PLLC,NIGHT AND DAY DENTAL,532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 209 , 282 , 686 ," $38,751.23 ",,
MEDICAID DIRECT,1528628526,OBRIEN AND WEST DMD VIII PLLC,NIGHT AND DAY DENTAL,19911 ZION AVE   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",19911 ZION AVE BLDG D CORNELIUS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 41 , 48 , 125 ,$#,,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 152 , 163 , 336 ," $17,878.41 ",,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 188 , 197 , 399 ," $17,142.57 ",,
MEDICAID DIRECT,1528628526,OBRIEN AND WEST DMD VIII PLLC,NIGHT AND DAY DENTAL,19911 ZION AVE   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",1325 BRADFORD VIEW DR STE 102 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 311 , 387 , 831 ," $42,429.37 ",,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568422681,"OBRIEN, PATRICK, SEAN",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 316 , 442 ," 1,241 "," $51,692.04 ",,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568422970,"SHIELDS, TAMARA, SUE",2340 SPRING FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1568423499,"HARUM, KAREN, HORTON",432 EASTWOOD RD STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1841410412,DR KAREN H HARUM,CLINIC FOR SPECIAL CHILDREN INC,432 EASTWOOD RD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568423499,"HARUM, KAREN, HORTON",432 EASTWOOD RD STE 200 WILMINGTON NC,065,New Hanover,2080P0008X,Allopathic & Osteopathic Physicians,Pediatrics,Neurodevelopmental Disabilities, 117 , 221 , 323 ," $32,492.96 ",,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1568423499,"HARUM, KAREN, HORTON",432 EASTWOOD RD STE 200 WILMINGTON NC,065,New Hanover,2080P0008X,Allopathic & Osteopathic Physicians,Pediatrics,Neurodevelopmental Disabilities,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568424612,"GOULD, JOHN, JAY",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 35 , 55 , 93 ,$#,,
MEDICAID DIRECT,1942440300,CAROLINAEAST PHYSICIANS,CAROLINAEAST HEART CENTER,4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568424612,"GOULD, JOHN, JAY",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 64 , 104 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568424612,"GOULD, JOHN, JAY",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568424612,"GOULD, JOHN, JAY",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568424612,"GOULD, JOHN, JAY",4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1942440300,CAROLINAEAST PHYSICIANS,CAROLINAEAST HEART CENTER,4252 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568424612,"GOULD, JOHN, JAY",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568424737,"SCHWARZ, MATTHEW, KNOX",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 34 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568424737,"SCHWARZ, MATTHEW, KNOX",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 13 , 16 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 50 , 71 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 25 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568424745,"BERRY, BRENDAN, CHARLES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568425403,"BROWNLOW, ROBERT, LEE",1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 74 , 183 , 461 ," $37,647.81 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568425403,"BROWNLOW, ROBERT, LEE",10 DOCTORS CIR STE 1 SUPPLY NC,010,Brunswick,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 45 , 101 ," $12,112.94 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568425403,"BROWNLOW, ROBERT, LEE",2183 JAMES B WHITE HWY N   WHITEVILLE NC,024,Columbus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 32 , 79 ," $12,866.33 ",,
MEDICAID DIRECT,1205944477,CAPE FEAR RETINAL ASSOCIATES PC,CAPE FEAR RETINAL ASSOCIATES PC,1104 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568425403,"BROWNLOW, ROBERT, LEE",402 N MAIN ST   KENANSVILLE NC,031,Duplin,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1568428043,"SILE, CYNTHIA, CHAN",5838 HARBOUR VIEW BLVD STE 105 SUFFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,5900 LAKE WRIGHT DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568428043,"SILE, CYNTHIA, CHAN",2790 GODWIN BLVD STE 101 SUFFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1568428043,"SILE, CYNTHIA, CHAN",2790 GODWIN BLVD STE 101 SUFFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1503B N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1568428043,"SILE, CYNTHIA, CHAN",2790 GODWIN BLVD STE 101 SUFFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,1051 LOFTIS BLVD STE 100 NEWPORT NEWS VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568428043,"SILE, CYNTHIA, CHAN",1051 LOFTIS BLVD STE 100 NEWPORT NEWS VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,2790 GODWIN BLVD SUITE 101 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568428043,"SILE, CYNTHIA, CHAN",2790 GODWIN BLVD STE 101 SUFFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 30 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 27 , 31 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1942956123,METROLINA VASCULAR ACCESS CARE LLC,METROLINA SURGERY CENTER OF CHARLOTTE,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1568428159,"LOHAVICHAN, VERACHAI",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568428159,"LOHAVICHAN, VERACHAI",3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 193 , 230 , 407 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",1901 S HAWTHORNE RD STE 308 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",445 PINEVIEW DR STE 200B KERNERSVILLE NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 33 , 36 , 41 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568429405,"MURPHY, DANIEL, WILLIAM",7126 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568429942,"BURKE, EITHNE, TERESA",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1568430031,"JAFFER, SUKAINA, J",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1568430890,"LINDSAY, MARYANNE, WOLF",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568430890,"LINDSAY, MARYANNE, WOLF",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568430890,"LINDSAY, MARYANNE, WOLF",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568430890,"LINDSAY, MARYANNE, WOLF",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568432128,"THOMAS, RENEE, BETHEA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1568432128,"THOMAS, RENEE, BETHEA",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1649201146,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ARDREY KELL FAMILY MEDI,8930 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568432920,"BRANTON, TARA, LORRAINE",1928 HIGHWAY 84   WEDDINGTON NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649201146,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ARDREY KELL FAMILY MEDI,8930 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568432920,"BRANTON, TARA, LORRAINE",8930 BLAKENEY PROFESSIONAL DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1548242365,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,3361 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568433225,"ZIENO, SALVATORE, ANGELO",3361 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568433258,"MCKINSEY, JONATHAN, PHILIP",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1063849420,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,380 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568433258,"MCKINSEY, JONATHAN, PHILIP",380 COPPERFIELD BLVD NE STE A CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 23 , 65 , 65 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568435311,"LINDAUER, PAUL, ANTHONY",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223E0200X,Dental Providers,Dentist,Endodontics, 41 , 48 , 60 ," $10,466.88 ",,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1568437184,"OVERTON, MARK, HOWARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 20 , 52 , 52 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1568437184,"OVERTON, MARK, HOWARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1568438158,"MOORE, VALERIE, SUTTON",400 US 70 HWY E   GARNER NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,2610 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568438430,"DOOREY, ANDREW, JOSEPH",2610 N ELM ST   LUMBERTON NC,078,Robeson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 19 , 23 , 30 ,$#,,
MEDICAID DIRECT,1447355755,SMOKY MOUNTAIN FOOT CLINIC PA,SMOKY MOUNTAIN FOOT CLINIC PA,289 ACCESS RD   WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1568439073,"PRZYNOSCH, ROBERT, MICHAEL",289 ACCESS RD   WAYNESVILLE NC,044,Haywood,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery, 90 , 154 , 229 ,$#,,
MEDICAID DIRECT,1568439453,"SIDDIQUI, MAHMOOD, ABDULQADIR",MAHMOOD ABDULQADIR SIDDIQUI MD PC,144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1568439453,"SIDDIQUI, MAHMOOD, ABDULQADIR",144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1568439453,"SIDDIQUI, MAHMOOD, ABDULQADIR",144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1427070523,MAHMOOD A SIDDIQUI MD PC,MAHMOOD A SIDDIQUI MD PC,144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568439453,"SIDDIQUI, MAHMOOD, ABDULQADIR",144 MEDICAL CENTER DR STE B COPPERHILL TN,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568439909,"MCMOON, MICHELLE, MARCELLA",210 ASHVILLE AVE   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821736075,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PLASTIC & RECONSTRUCTIVE SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568439909,"MCMOON, MICHELLE, MARCELLA",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568441319,"LOVE, JOYCE, RUTHERFORD",2400 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1568442176,HOME MEDICAL SYSTEMS INC,ROTECH,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1568442176,HOME MEDICAL SYSTEMS INC,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 58 , 60 ,$#,,
MEDICAID DIRECT,1568442176,HOME MEDICAL SYSTEMS INC,ROTECH,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1568442176,HOME MEDICAL SYSTEMS INC,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1568442176,HOME MEDICAL SYSTEMS INC,ROTECH,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568442176,HOME MEDICAL SYSTEMS INC,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 557 ," 1,909 "," 3,505 "," $78,426.98 ",,
MEDICAID DIRECT,1568442176,HOME MEDICAL SYSTEMS INC,ROTECH,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1568442176,HOME MEDICAL SYSTEMS INC,1677 WESTCHESTER DR STE 145 HIGH POINT NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 487 ," 1,409 "," 2,529 "," $67,287.10 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568442242,"BACOT, BRUCE, KENNETH",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 29 , 30 , 30 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568442242,"BACOT, BRUCE, KENNETH",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 141 , 200 , 274 ," $26,775.77 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",250 18TH ST SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1031 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",2972 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 44 , 51 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 38 , 89 , 94 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",2972 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",420 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2972 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",2972 N CENTER ST   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,250 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",250 18TH STREET CIR SE   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568442762,"LAFAVORE, PAUL, RICHARD",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1497880033,COUNTY OF NASH,NASH COUNTY HEALTH DEPARTMENT,214 S BARNES ST   NASHVILLE NC,064,Nash,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1568444339,"COLLINS, MATTHEW, TILL",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 193 , 399 ," 1,687 "," $55,552.16 ",,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1568444339,"COLLINS, MATTHEW, TILL",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 86 , 111 , 154 ," $11,559.30 ",,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568446649,"COHEN, GAIL, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 13 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568446649,"COHEN, GAIL, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 36 , 37 ,$#,,
MEDICAID DIRECT,1750925269,GOLDSBORO INTERNAL MEDICINE AND MED,,1600 WAYNE MEMORIAL DR STE C&D GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1568446789,"SETH, RENU, JERATH",1600 WAYNE MEMORIAL DR STE C&D GOLDSBORO NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 272 , 285 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1568446870,"THAKURI, MOHAN, CHAND",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568446870,"THAKURI, MOHAN, CHAND",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 56 , 73 , 206 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568446870,"THAKURI, MOHAN, CHAND",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1568446870,"THAKURI, MOHAN, CHAND",11921 S 226 HWY   SPRUCE PINE NC,061,Mitchell,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,1860 SUGAR HILL RD STE A MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1568446870,"THAKURI, MOHAN, CHAND",1860 SUGAR HILL RD STE A MARION NC,059,McDowell,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 19 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,10 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1568446870,"THAKURI, MOHAN, CHAND",10 ONE CENTER CT   FRANKLIN NC,056,Macon,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 30 , 87 ," $13,122.44 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568447167,"VICK, GRETCHEN, PACOFSKY",313 AIRPORT RD   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 20 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1568447837,"RANA, NITA, WADHWA",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1821496753,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM WOMENS CARE,1209 SE INDUSTRY DR   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1568447837,"RANA, NITA, WADHWA",1209 SE INDUSTRY DR   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1568447837,"RANA, NITA, WADHWA",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568447845,"KUTCHER, MICHAEL, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568447977,"SHAZ, DAVID, JOSEPH YEHUDA",1821 HILLANDALE RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 51 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568447977,"SHAZ, DAVID, JOSEPH YEHUDA",234 CROOKED CREEK PWKY   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568447977,"SHAZ, DAVID, JOSEPH YEHUDA",1821 HILLANDALE RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 28 , 52 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568447977,"SHAZ, DAVID, JOSEPH YEHUDA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 52 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568447977,"SHAZ, DAVID, JOSEPH YEHUDA",1821 HILLANDALE RD   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 19 , 32 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448173,"WEBSTER, SCOTT, BRANDON",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 73 , 112 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448173,"WEBSTER, SCOTT, BRANDON",2826 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 31 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",9735 KINCEY AVE SUITE 201 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 57 , 92 , 152 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 29 , 44 , 77 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 15 , 21 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568448223,"BLACKMAN, CAMERON, TRENT",301 YADKIN ST   ALBEMARLE NC,084,Stanly,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346069085,HATCHER DDS PLLC,,2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568448413,"HATCHER, STEVEN, LEE",2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1962837153,STEVEN L HATCHER DDS PA,~,2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568448413,"HATCHER, STEVEN, LEE",2707 PINEDALE RD STE C GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1568450344,"STEINBACHER, ERIKA, ANU",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 27 , 48 ,$#,,
MEDICAID DIRECT,1295966109,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,8560 COOK ST   MOUNT PLEASANT NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568450344,"STEINBACHER, ERIKA, ANU",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1568450344,"STEINBACHER, ERIKA, ANU",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568450344,"STEINBACHER, ERIKA, ANU",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568453884,"WEILBACH, HEIDI",2001 VAIL AVE STE 320 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 33 , 103 , 112 ,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568453884,"WEILBACH, HEIDI",7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1073599734,SURGICAL SPECIALISTS OF CHARLOTTE P,~,7300 CARMEL EXECUTIVE PARK DR STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568453884,"WEILBACH, HEIDI",1450 MATTHEWS TOWNSHIP PKWY STE 250 MATTHEWS NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568455459,"MACGILVRAY, SCOTT, STEVEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568455459,"MACGILVRAY, SCOTT, STEVEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568455756,"LOVE, BRYNNE, PATRICE",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568455871,"MANCUSI UNGARO, PETER, CURT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1568455871,"MANCUSI UNGARO, PETER, CURT",516 S VAN BUREN RD   EDEN NC,079,Rockingham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 27 , 27 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568455871,"MANCUSI UNGARO, PETER, CURT",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1568455871,"MANCUSI UNGARO, PETER, CURT",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568456341,"ROSENBLUM, SHEPHERD, FORRESTER",11550 COMMON OAKS DR STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568456341,"ROSENBLUM, SHEPHERD, FORRESTER",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568456341,"ROSENBLUM, SHEPHERD, FORRESTER",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 34 , 62 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568456341,"ROSENBLUM, SHEPHERD, FORRESTER",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568456366,"NEKKANTI, RAJASEKHAR",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568456366,"NEKKANTI, RAJASEKHAR",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568456366,"NEKKANTI, RAJASEKHAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 50 , 58 , 76 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568456366,"NEKKANTI, RAJASEKHAR",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 47 , 50 , 50 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568456366,"NEKKANTI, RAJASEKHAR",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 183 , 237 , 295 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1568457992,"REYNOLDS, MARION, ARLEEN",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1568457992,"REYNOLDS, MARION, ARLEEN",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1568457992,"REYNOLDS, MARION, ARLEEN",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568458495,"BEASLEY, DEBRA, BAKER",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 22 , 26 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568458495,"BEASLEY, DEBRA, BAKER",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,295 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568458495,"BEASLEY, DEBRA, BAKER",295 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 46 , 73 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568458495,"BEASLEY, DEBRA, BAKER",4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568459477,"MIGALY, JOHN",20 DUKE MEDICINE CIR # 3 DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568459477,"MIGALY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568459477,"MIGALY, JOHN",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568459477,"MIGALY, JOHN",20 DUKE MEDICINE CIR # 3 DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1336416460,PRIVATE DIAGNOSTIC CLINIC PLLC,Cancer Center,,,Unknown,193200000X,Group,Multi-Specialty,,1568459477,"MIGALY, JOHN",20 DUKE MEDICINE CIR # 3 DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1609915784,CHILDRENS HOSPITAL MEDICAL CENTER,CINCINNATI CHILDRENS HOSPITAL MEDICAL CENTER,3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1568459642,"RICK, JAMES, ROBERT",3333 BURNET AVE   CINCINNATI OH,102,Out of State > 40 miles,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1568459782,"JOYNER, EDWARD, ASHLEY",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1568459782,"JOYNER, EDWARD, ASHLEY",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 134 , 149 , 149 ,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1568459782,"JOYNER, EDWARD, ASHLEY",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568460053,"MERCER, REBECCA, BRIM",201 WILLIAMSBURG PKWY   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568460053,"MERCER, REBECCA, BRIM",738 NEWMAN RD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 31 , 55 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568460921,"RUSS, PETER, CRAIG",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 338 , 380 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568462869,"SCIMECA, HEATHER, PASTOR",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568462869,"SCIMECA, HEATHER, PASTOR",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 23 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568462869,"SCIMECA, HEATHER, PASTOR",5324 MCFARLAND RD STE 210 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568466308,"LYTLE, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 19 , 26 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568466308,"LYTLE, RICHARD",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 12 , 17 , 17 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568466308,"LYTLE, RICHARD",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1568469641,"BROWN, MARTIN, TODD",~,204 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1568469641,"BROWN, MARTIN, TODD",204 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1215984331,MID ATLANTIC EYE PHYSICIANS PA,,204 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1568469641,"BROWN, MARTIN, TODD",204 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 101 , 107 , 163 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568469674,"LEWIS JR, THOMAS, GERALD",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568470367,"YANKU, LISA, GOODMAN",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1598759482,EASTERN DERMATOLOGY PA,Eastern Dermatology PA,420 SPRING FOREST RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568471555,"MIZELLE, CHRISTOPHER, BRENT",3311 TRENT RD   TRENT WOODS NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 36 , 69 , 152 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568472140,"FOWLER, MELISSA, SUE",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013437755,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST COMPLEX CARE - W,1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568472140,"FOWLER, MELISSA, SUE",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 112 , 114 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 17 , 19 , 22 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878890,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,101 E WT HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",101 E W T HARRIS BLVD STE 1213 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 26 , 38 , 38 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 105 , 185 , 200 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 22 , 29 , 29 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 29 , 50 , 64 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",201 E GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1568474351,"HOLSHOUSER, JOHN, WARREN",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1568476398,"BONFIELD, KENNETH, ROBERT",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 47 , 79 , 111 ,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568476398,"BONFIELD, KENNETH, ROBERT",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1568476398,"BONFIELD, KENNETH, ROBERT",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 37 , 56 , 79 ,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1568476398,"BONFIELD, KENNETH, ROBERT",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568476398,"BONFIELD, KENNETH, ROBERT",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 48 , 104 , 181 ,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1568476398,"BONFIELD, KENNETH, ROBERT",40 E MEDICAL CT   MARION NC,059,McDowell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 20 , 25 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568478758,"NELSON, LINDSEY, ALLAN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1568478758,"NELSON, LINDSEY, ALLAN",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568479285,"GALE, LINDA, LEE",472 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568479285,"GALE, LINDA, LEE",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811999055,GRANVILLE HEALTH SYSTEM,GRANVILLE INTERNAL MEDICINE & GERIATRICS,110 PROFESSIONAL PARK   OXFORD NC,039,Granville,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568482255,"EVANS, RICKY, LEE",110 PROFESSIONAL PARK   OXFORD NC,039,Granville,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1154710291,MYEYEDR OPTOMETRY OF NORTH CAROLINA,~,,,Unknown,193400000X,Group,Single Specialty,,1568482271,"YOAKUM, JOHN, SPENCER",1033 RANDOLPH ST STE 4 THOMASVILLE NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1093731671,GUILFORD MEDICAL ASSOCIATION,GUILFORD MEDICAL ASSOCIATES,2703 HENRY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568482651,"SHAW, WILLIAM, DOUGLAS",2703 HENRY ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1568484426,"BLEVINS, RONDA, BENGE",233 DOCTORS ST   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1851355424,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1568484426,"BLEVINS, RONDA, BENGE",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578854147,HOSPICE OF SURRY CO INC,MOUNTAIN VALLEY,105 N CRUTCHFIELD ST UNIT 2 DOBSON NC,086,Surry,193200000X,Group,Multi-Specialty,,1568484426,"BLEVINS, RONDA, BENGE",105 N CRUTCHFIELD ST # 2 DOBSON NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1821255001,FOOT & ANKLE INSTITUTE OF THE CAROL,PURVIS-MOYER FOOT & ANKLE CENTER,3301 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1568484749,"PURVIS, JENNIFER, HELEN",3301 SUNSET AVE   ROCKY MOUNT NC,064,Nash,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 48 , 51 , 75 ,$#,,
MEDICAID DIRECT,1568484749,"PURVIS, JENNIFER, HELEN",~,3301 SUNSET AVE   ROCKY MOUNT NC,064,Nash,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1568484749,"PURVIS, JENNIFER, HELEN",3301 SUNSET AVE   ROCKY MOUNT NC,064,Nash,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 16 , 18 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568486173,"LAUGHON, MATTHEW, MAXWELL",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 27 , 28 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568486397,"LEESER, DAVID, BLACK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 71 , 92 , 96 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1568487452,"ROBLES, GILBERTO",121 RIVERVIEW ST   FRANKLIN NC,056,Macon,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 49 , 108 , 123 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1568487452,"ROBLES, GILBERTO",98 DOCTORS DR STE 320 SYLVA NC,050,Jackson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 25 , 29 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568487965,"HINNANT, CONNIE, DEANN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 32 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,9101 OCEAN HWY E   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1568487965,"HINNANT, CONNIE, DEANN",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568487965,"HINNANT, CONNIE, DEANN",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 30 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,5111 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,150 PARKWAY OFFICE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11640 NORTHPARK DR STE 110 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 CLAYTON BLVD STE 102 CLAYTON NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 12 , 15 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,2021 WENDELL VALLEY BLVD   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,505 OBERLIN RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,120 BANKS DR STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 US 70 BUSINESS HWY W STE 102 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821694381,RALEIGH RADIOLOGY WAKEMED IMAGING,RALEIGH RADIOLOGY WAKEMED IMAGING LLC,11618 CLAYTON BLVD STE 102 CLAYTON NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 374 , 578 , 684 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,1101 GREAT FALLS CT   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 24 , 25 ,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1568488351,"CARTER, STEVEN, RICKER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1568489110,"DRUMHELLER, GEORGIA, ANN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1568489714,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1287,3141 GARDEN RD   BURLINGTON NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1568489714,WAL-MART STORES EAST LP,3141 GARDEN RD   BURLINGTON NC,001,Alamance,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1568489714,WAL-MART STORES EAST LP,WALMART PHARMACY 10-1287,3141 GARDEN RD   BURLINGTON NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1568489714,WAL-MART STORES EAST LP,3141 GARDEN RD   BURLINGTON NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568494359,"FETZKO, KAREN, MICHELLE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568495067,"TIMMONS, OTWELL, DUDLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",2700 ROYAL COMMONS LN   MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",752 E CENTER AVE   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 62 , 120 , 121 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",11900 VANSTORY DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1548398720,HOSPICE AND PALLIATIVE CARE CHARLOT,HOSPICE & PALLIATIVE CARE CHARLOTTE REGION,7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",7845 LITTLE AVE   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,,,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",716 SIPES ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 49 , 49 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568495547,"CHITTENDEN, TAMARA, ELIZABETH",700 HOWIE MINE RD   WAXHAW NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 175 , 175 ,$#,,
MEDICAID DIRECT,1023323128,PERIOPERATIVE SERVICES LLC,PERIOPERATIVE SERVICES LLC,1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568497618,"FIJALKOWSKI, NATASHA, KASSANDRA",1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568498111,"ELSAIDI, GAMAL, AHMED",200 HOSPITAL DR   GALAX VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568499333,"BAINES, ROBIN, SABRINA",3000 COLISEUM DR STE 200 HAMPTON VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124426804,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HARNETT HOSPITALIST GROUP,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1568500379,"FOLARIN, OLALEKAN, TOKUNBO",800 TILGHMAN DR   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568501526,"CASTLE, KATHLEEN, FITZGERALD",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 23 , 24 , 24 ,$#,,
MEDICAID DIRECT,1073891719,CAROMONT MEDICAL GROUP INC,CAROMONT PATHOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1568501575,"BUNNING, JEFFREY, TODD",2525 COURT DR   GASTONIA NC,036,Gaston,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1073891719,CAROMONT MEDICAL GROUP INC,CAROMONT PATHOLOGY,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568501575,"BUNNING, JEFFREY, TODD",2525 COURT DR   GASTONIA NC,036,Gaston,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 108 , 112 , 171 ,$#,,
MEDICAID DIRECT,1316232598,RHA HEALTH SERVICES INC,RHA HEALTH SERVICES INC,2415 MORGANTON BLVD SW STE 100 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1568509131,"LAFEVRE, ELIZABETH",395 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1568510840,"HONRINE, BECKY",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#, 23 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568511087,"DAVIDSON, LINDSAY, SHANNON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 69 , 97 , 127 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 148 , 176 , 237 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 16 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3320 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10950 CHAPEL HILL RD   MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1568512622,"MILLS, JAMES, STEVEN",3480 WAKE FOREST RD STE 410 RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568512630,"SUMMERS, RHONDA, LYNN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568512630,"SUMMERS, RHONDA, LYNN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568514016,"MARTIN, ROBERT, SHAYN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 98 , 130 , 152 ," $28,549.74 ",,
MEDICAID DIRECT,1568514057,PENDER ADULT SERVICES INC,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,251B00000X,Agencies,Case Management,,1568514057,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,251B00000X,Agencies,Case Management,, 112 ," 1,482 "," 1,492 "," $505,652.22 ",,
MEDICAID DIRECT,1568514057,PENDER ADULT SERVICES INC,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,253Z00000X,Agencies,In Home Supportive Care,,1568514057,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,996 "," 2,997 "," $482,807.68 ",,
MEDICAID DIRECT,1568514057,PENDER ADULT SERVICES INC,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1568514057,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 24 , 40 , 56 ," $81,470.06 ",,
MEDICAID DIRECT,1568514057,PENDER ADULT SERVICES INC,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,332U00000X,Suppliers,Home Delivered Meals,,1568514057,PENDER ADULT SERVICES INC,901 S WALKER ST   BURGAW NC,071,Pender,332U00000X,Suppliers,Home Delivered Meals,, 25 ," 4,774 "," 4,774 "," $36,736.70 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568514289,"REDDY, HARI CHARAN, PABBATHI",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 47 , 48 , 62 ,$#,,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1568515476,"HINSON, JENNY, LYNN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 43 , 90 , 91 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568515757,"BOSWELL, TAMMI, MOORE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1467919126,HAMMOCK DMD & LOTAKIS DDS VI PLLC,~,2222 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568517084,"HAUSCHKA, ANDREW, TOOMEY",2222 CONCORD LAKE RD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 43 , 191 ," $16,653.79 ",,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568519411,"MILEHAM, KATHRYN, FINCH",2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#, 11 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1568519411,"MILEHAM, KATHRYN, FINCH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568519411,"MILEHAM, KATHRYN, FINCH",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 51 , 78 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568519429,"CARROLL, NICOLE, SUMMEROUR",1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568519429,"CARROLL, NICOLE, SUMMEROUR",6727 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568519429,"CARROLL, NICOLE, SUMMEROUR",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568519429,"CARROLL, NICOLE, SUMMEROUR",1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1568520435,HOME LIFE CARE INC,~,101 S WEBB ST   SELMA NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1568520435,HOME LIFE CARE INC,101 S WEBB ST   SELMA NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,, 48 ," 6,330 "," 6,330 "," $426,718.12 ",,
MEDICAID DIRECT,1740702497,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE HOLLY SPRINGS,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568521516,"PAYNE, MATTHEW, WILLIAM",2406 BLUE RIDGE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1740702497,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE HOLLY SPRINGS,101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568521516,"PAYNE, MATTHEW, WILLIAM",101 COTTEN LN   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568522399,"WEBER, THOMAS, JOSEPH",8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 23 , 27 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568522399,"WEBER, THOMAS, JOSEPH",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1568522399,"WEBER, THOMAS, JOSEPH",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568522399,"WEBER, THOMAS, JOSEPH",3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568522399,"WEBER, THOMAS, JOSEPH",8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,8300 HEALTH PARK STE 309 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568522399,"WEBER, THOMAS, JOSEPH",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 23 , 34 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568522399,"WEBER, THOMAS, JOSEPH",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568524023,"ASFAW, MELINDA, RUTH",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 35 , 54 ,$#,,
MEDICAID DIRECT,1568527554,SOUTHERN ASSISTED LIVING INC,BROOKDALE LEXINGTON,161 YOUNG DR   LEXINGTON NC,029,Davidson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568527554,SOUTHERN ASSISTED LIVING INC,161 YOUNG DR   LEXINGTON NC,029,Davidson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 316 , 316 ," $19,176.25 ",,
MEDICAID DIRECT,1568528321,"HENDRIX, RALPH, MCCLURE",~,1002A E 4TH AVE   RED SPRINGS NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,,1568528321,"HENDRIX, RALPH, MCCLURE",1002A E 4TH AVE   RED SPRINGS NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,, 87 , 113 , 173 ,$#,,
MEDICAID DIRECT,1568530855,TOTALLY COMMITTED DIABETIC SUPPLY,Totally Committed Diabetic Supply,340 COMMERCE AVE STE 13B SOUTHERN PINES NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568530855,TOTALLY COMMITTED DIABETIC SUPPLY,340 COMMERCE AVE STE 13B SOUTHERN PINES NC,063,Moore,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 448 ," 3,735 "," 7,347 "," $829,811.53 ",,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1568534485,"WEED, BARRY, CHRISTOPHER",289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568534485,"WEED, BARRY, CHRISTOPHER",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568534485,"WEED, BARRY, CHRISTOPHER",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1821421876,EAST CAROLINA UNIVERSITY,ECU TELEPSYCHIATRY CENTER,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568534485,"WEED, BARRY, CHRISTOPHER",68 HOSPITAL RD   SYLVA NC,050,Jackson,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1982642393,CAROLINA BEHAVIORAL CARE,,289 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1568534485,"WEED, BARRY, CHRISTOPHER",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1487709861,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,209 MILLSTONE DR STE A HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1568534485,"WEED, BARRY, CHRISTOPHER",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 22 , 37 , 67 ,$#,,
MEDICAID DIRECT,1568523371,CAROLINA BEHAVIORAL CARE,CAROLINA BEHAVIORAL CARE PA,4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1568534485,"WEED, BARRY, CHRISTOPHER",4102 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1770921405,DR LACY A COLSON MD,~,123 SUNNYBROOK RD STE 120 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568537579,"COLSON, LACY",123 SUNNYBROOK RD STE 120 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 23 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568539658,"MA, ALICE, DE LING",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 33 , 38 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568539666,"MARGOLIS, DAVID, MICHAEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 19 , 62 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568539666,"MARGOLIS, DAVID, MICHAEL",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 19 , 48 ,$#,,
MEDICAID DIRECT,1669509360,"ALL FOOT CARE PA, ROBERT",ALL FOOT CARE PA,1050 S PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568542181,"WINGATE, ROBERT, CHARLES",1050 S PEACE HAVEN RD   WINSTON SALEM NC,034,Forsyth,213ES0131X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot Surgery,#,#,#,$#,,
MEDICAID DIRECT,1568544179,COUNTY OF CHOWAN,CHOWAN COUNTY EMS,208 W HICKS ST   EDENTON NC,021,Chowan,3416L0300X,Transportation Services,Ambulance,Land Transport,1568544179,COUNTY OF CHOWAN,208 W HICKS ST   EDENTON NC,021,Chowan,3416L0300X,Transportation Services,Ambulance,Land Transport, 96 , 380 , 749 ,$#,,
MEDICAID DIRECT,1568545176,"RESTER, BENJAMIN, TALBOT",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,1568545176,"RESTER, BENJAMIN, TALBOT",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568545713,"HEINE, ROBERT, PHILLIPS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 53 , 68 , 70 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568545721,"PERNA, JENNIFER, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568545721,"PERNA, JENNIFER, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689716599,RICHARD M HOLMES DMD PA,INDIAN TRAIL DENTAL ASSOCIATES,4612 W HIGHWAY 74 STE D MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1568545788,"HOLMES, RICHARD, MARK",4612 W HIGHWAY 74 STE D MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1689716599,RICHARD M HOLMES DMD PA,INDIAN TRAIL DENTAL ASSOCIATES,4612 W HIGHWAY 74 STE D MONROE NC,090,Union,193400000X,Group,Single Specialty,,1568545788,"HOLMES, RICHARD, MARK",4612 W HIGHWAY 74 STE D MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 540 ," 1,290 "," 4,013 "," $178,778.23 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568545820,"PUSCAS, LIANA",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568545820,"PUSCAS, LIANA",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568545820,"PUSCAS, LIANA",2301 ERWIN RD   DURHAM NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568546612,"HAGLUND, MICHAEL, MARTIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568546612,"HAGLUND, MICHAEL, MARTIN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568546612,"HAGLUND, MICHAEL, MARTIN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 22 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568548402,"CHAUSSE IV, CORINNE, MUNN",600 HOSPITAL DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 13 , 17 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568548469,"MASSEY, MATTHEW, BRADLEY",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568549137,"SURAKANTI, SUJANI, GANGA",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 20 , 39 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568549137,"SURAKANTI, SUJANI, GANGA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 22 , 25 ,$#,,
MEDICAID DIRECT,1568550440,"BRIDGES, WESLEY, HUDSON",WESLEY H BRIDGES DDS PA,504 MULBERRY ST SW   LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice,1568550440,"BRIDGES, WESLEY, HUDSON",504 MULBERRY ST SW   LENOIR NC,014,Caldwell,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 90 , 255 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568552206,"GOPALAREDDY, VANI, VALLORE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology, 24 , 34 , 66 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568552206,"GOPALAREDDY, VANI, VALLORE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080T0004X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568552297,"CAPPS, STEPHEN, JOSEPH",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 47 , 50 , 71 ,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,192 HOSPITAL DR   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1568552297,"CAPPS, STEPHEN, JOSEPH",1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1710936190,CAROLINA OPHTHALMOLOGY PA,Carolina Ophthalmology PA,1701 OLD VILLAGE RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568552297,"CAPPS, STEPHEN, JOSEPH",192 HOSPITAL DR   COLUMBUS NC,075,Polk,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 17 , 16 , 19 ,$#,,
MEDICAID DIRECT,1811458177,WOLINSKY PRIMARY CARE PA,,1207 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568552891,"WOLINSKY, SIDNEY, PAUL",1315 AVON ST 101 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 256 ," 1,224 "," 2,005 "," $32,910.65 ",,
MEDICAID DIRECT,1063442861,HENDERSONVILLE PAIN MANAGEMENT,~,4005 HENDERSONVILLE RD STE 2 FLETCHER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568555795,"SCOTT, DUNCAN, R CAMPBELL",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1063442861,HENDERSONVILLE PAIN MANAGEMENT,~,4005 HENDERSONVILLE RD STE 2 FLETCHER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568555795,"SCOTT, DUNCAN, R CAMPBELL",4005 HENDERSONVILLE RD STE 2 FLETCHER NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 179 , 291 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568556199,"DENT, GEORGETTE, AMANTHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 28 , 34 , 61 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568556199,"DENT, GEORGETTE, AMANTHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 26 , 25 , 46 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568556199,"DENT, GEORGETTE, AMANTHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#, 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568556199,"DENT, GEORGETTE, AMANTHA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 141 , 164 , 285 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 16 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251341,GRACE CARE LLC,GRACE CARE LLC,2311 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568557122,"HAVILAND, JULIE, CHRISTINE",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 33 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 17 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568557122,"HAVILAND, JULIE, CHRISTINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568558658,"MILLER, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568558658,"MILLER, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 68 , 84 , 102 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568562320,"ZIMMERMANN, DEBORAH, FRIEL",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568562320,"ZIMMERMANN, DEBORAH, FRIEL",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1568562320,"ZIMMERMANN, DEBORAH, FRIEL",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1568562742,"WITHERSPOON, LOUISE-ANN, GOMBAKO",2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1174806608,CYNTHIA L LOPEZ MD PA,EASTERN NEUROLOGY AND NEUROMUSCULAR,845 JOHNS HOPKINS DR STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568562767,"LOPEZ, CYNTHIA, L",845 JOHNS HOPKINS DR STE A GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 166 , 258 , 528 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568564300,"COOPER, BENJAMIN, ZION",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 44 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1568564300,"COOPER, BENJAMIN, ZION",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1871780254,ASHEVILLE MEDICINE AND PEDIATRICS L,ASHEVILLE MEDICINE AND PEDIATRICS LTD,600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1568564482,"MOREHOUSE, WINIFRED, VICTORIA",600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 32 , 53 ,$#,,
MEDICAID DIRECT,1568565240,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07344,103 CATAWBA RD   HAVELOCK NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1568565240,NORTH CAROLINA CVS PHARMACY LLC,103 CATAWBA RD   HAVELOCK NC,025,Craven,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1043264724,EASTERN CAROLINA CARDIOVASCULAR,EASTERN CAROLINA CARDIOVASCULAR PA,1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1568565760,"MANIET, ALAN, RICHARD",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 62 , 72 , 106 ,$#,,
MEDICAID DIRECT,1043264724,EASTERN CAROLINA CARDIOVASCULAR,EASTERN CAROLINA CARDIOVASCULAR PA,1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1568565760,"MANIET, ALAN, RICHARD",1134 N ROAD ST STE 9 ELIZABETH CITY NC,070,Pasquotank,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 233 , 358 , 592 ," $11,009.21 ",,
MEDICAID DIRECT,1023122736,KNOWLES SMITH & ASSOCIATES LLP,,5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568569697,"KNOWLES, MICHAEL, J",5710 ROCKFISH RD   HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568569697,"KNOWLES, MICHAEL, J",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1750495693,KNOWLES SMITH & ASSOCIATES LLP,Village Family Dental,2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568569697,"KNOWLES, MICHAEL, J",2029 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1275647976,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568569697,"KNOWLES, MICHAEL, J",1031 WEISS AVE STE 101 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578071221,KNOWLES SMITH & ASSOCIATES LLP,VILLAGE KIDS,510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568569697,"KNOWLES, MICHAEL, J",510 HICKORY RIDGE DR STE 101 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 69 , 70 , 276 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568571016,"LEWIS, BRIAN, THOMAS",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568571016,"LEWIS, BRIAN, THOMAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1316943145,CENTRAL CAROLINA DERMATOLOGY,CENTRAL CAROLINA DERMATOLOGY CLINICINC,4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568572279,"WARDEN, ELYSHIA, MICHELLE",4010 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 41 , 62 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568576213,"ARCHER JR, NOAH, ROBERT",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 31 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1568576213,"ARCHER JR, NOAH, ROBERT",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 25 , 25 ," $16,127.00 ",,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568576213,"ARCHER JR, NOAH, ROBERT",4320 HENSON DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 62 , 150 ,$#,,
MEDICAID DIRECT,1639365562,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH PLLC,4320 HENSON DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568576213,"ARCHER JR, NOAH, ROBERT",4320 HENSON DR   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568577633,"WILLIAMS, DEREK, ADAM",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568577633,"WILLIAMS, DEREK, ADAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 108 , 128 , 165 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568577633,"WILLIAMS, DEREK, ADAM",1925 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568577922,"CARR, MARIE, ANN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 31 , 41 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568577922,"CARR, MARIE, ANN",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 23 , 25 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568578524,"BROWN, MARIE, LOUISE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 36 , 36 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1568578524,"BROWN, MARIE, LOUISE",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568580892,"PABON-RAMOS, WALESKA, MICHELLE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568580892,"PABON-RAMOS, WALESKA, MICHELLE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 12 , 15 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568580892,"PABON-RAMOS, WALESKA, MICHELLE",2100 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568580892,"PABON-RAMOS, WALESKA, MICHELLE",2301 ERWIN RD FL 1 DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 33 , 34 , 69 ,$#,,
MEDICAID DIRECT,1568582856,INREACH,INREACH,7401 LISA CIR   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568582856,INREACH,7401 LISA CIR   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 354 , 354 ," $19,566.36 ",,
MEDICAID DIRECT,1568583458,BEST BUY HEALTH INC,~,327 HILLSBOROUGH ST   RALEIGH NC,092,Wake,333300000X,Suppliers,Emergency Response System Companies,,1568583458,BEST BUY HEALTH INC,327 HILLSBOROUGH ST   RALEIGH NC,092,Wake,333300000X,Suppliers,Emergency Response System Companies,, 109 , 623 , 623 ," $18,871.44 ",,
MEDICAID DIRECT,1568584050,CYPRESS LANDING FAMILY CARE HOME,~,622 CULLEN RD   HARRELLSVILLE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568584050,CYPRESS LANDING FAMILY CARE HOME,622 CULLEN RD   HARRELLSVILLE NC,046,Hertford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 140 , 140 ," $47,495.52 ",,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568584183,"FISHER, MICHAEL, JOHN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 49 , 49 , 56 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568584183,"FISHER, MICHAEL, JOHN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 112 , 118 , 142 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568584183,"FISHER, MICHAEL, JOHN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 662 , 680 , 833 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568584688,"THEKDI, ASHISH, DINESH",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568584688,"THEKDI, ASHISH, DINESH",15830 JOHN J DELANEY DR STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568584688,"THEKDI, ASHISH, DINESH",15830 JOHN J DELANEY DR STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568584688,"THEKDI, ASHISH, DINESH",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568584688,"THEKDI, ASHISH, DINESH",2015 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568584688,"THEKDI, ASHISH, DINESH",2015 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568584688,"THEKDI, ASHISH, DINESH",15830 JOHN J DELANEY DR STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568584688,"THEKDI, ASHISH, DINESH",15830 JOHN J DELANEY DR STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568587517,"CRABTREE, WILLIAM, DALE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942699095,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1568590214,"BOWLING, JONATHAN, EARL",215 LAUCHWOOD DR STE A LAURINBURG NC,083,Scotland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568591543,"RUSSO RIVERA, KRISTIN, MAHRI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 554 , 577 , 586 ," $176,088.96 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568591543,"RUSSO RIVERA, KRISTIN, MAHRI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568592509,"HOWELL, ROSE, COLE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1568599801,"SAKACH, VALERIE, ADELE",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1568601870,"HARDISON, LEWIS, SMALLWOOD",,5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1568601870,"HARDISON, LEWIS, SMALLWOOD",5 RICHLAND MEDICAL PARK DR   COLUMBIA SC,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568603843,"IRELAND, MICAELA, ANGELA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1568603967,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,1349 S MADISON ST   WHITEVILLE NC,024,Columbus,251J00000X,Agencies,Nursing Care,,1568603967,AVID HEALTH AT HOME NORTH CAROLINA,1349 S MADISON ST   WHITEVILLE NC,024,Columbus,251J00000X,Agencies,Nursing Care,,#, 278 , 278 ," $155,025.00 ",,
MEDICAID DIRECT,1568603967,AVID HEALTH AT HOME NORTH CAROLINA,AVID HEALTH AT HOME NC,1349 S MADISON ST   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1568603967,AVID HEALTH AT HOME NORTH CAROLINA,1349 S MADISON ST   WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,214 "," 1,214 "," $85,073.87 ",,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568605244,"KELLY, DOUGLAS, CRAIG",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568605657,"LILLEY, DEENA, SMITH",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568605657,"LILLEY, DEENA, SMITH",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 14 , 19 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568605707,"BARNES, EDWARD, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 30 , 42 , 49 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568605921,"WEEKS, KENNETH, DURHAM",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 25 , 44 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1568606259,"NAGARAJA, HARSHA, GHATGE",1423 E FRANKLIN ST STE I MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1568606259,"NAGARAJA, HARSHA, GHATGE",1550 FAULK ST   MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 131 , 178 , 266 ," $20,886.71 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1568607422,"PACE, HAGAN, EGGLESTON",117 E KINGS HWY   EDEN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1275010043,UNC ROCKINGHAM HEALTH CARE INC,UNC ROCKINGHAM HOSPITAL BASED PROVIDER SERVICES,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1568607422,"PACE, HAGAN, EGGLESTON",117 E KINGS HWY   EDEN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 66 , 66 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568607422,"PACE, HAGAN, EGGLESTON",6845 NC HIGHWAY 135   MAYODAN NC,079,Rockingham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568613842,"BOYD, ALLISON, LEE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568613842,"BOYD, ALLISON, LEE",1950 GLENN MITCHELL DR STE 200 VIRGINIA BEACH VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1568614691,"SHAFFMAN, TARA, ANNE",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568616084,"INSUASTI BELTRAN, GIOVANNI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 172 , 196 , 312 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568618874,"PATEL, BINDIT, SAVJIBHAI",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568618874,"PATEL, BINDIT, SAVJIBHAI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568618874,"PATEL, BINDIT, SAVJIBHAI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1407152499,CARYMED PRIMARY CARE PA,,401 HIGH HOUSE RD STE 120 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1568618874,"PATEL, BINDIT, SAVJIBHAI",401 HIGH HOUSE RD STE 120 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 113 , 117 ,$#,,
MEDICAID DIRECT,1568618874,"PATEL, BINDIT, SAVJIBHAI",~,401 HIGH HOUSE RD STE 120 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1568618874,"PATEL, BINDIT, SAVJIBHAI",401 HIGH HOUSE RD STE 120 CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568621332,"BELANGER, ADAM, RICHARD",205 PAGE RD   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 79 , 135 , 242 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568621332,"BELANGER, ADAM, RICHARD",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 48 , 56 , 138 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568621332,"BELANGER, ADAM, RICHARD",205 PAGE RD   PINEHURST NC,063,Moore,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 67 , 103 , 244 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841049913,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE BAPTIST IMAGING,3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",3120 NORTHLINE AVE STE 3120-101 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 376 , 429 , 690 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 31 , 34 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568623569,"POWELL, JASON, ALLEN",861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1101 WEAVER DAIRY RD STE 103 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568623684,"PHILLIPS, IRINA, GAULT",100 TIMBERHILL PL   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568623684,"PHILLIPS, IRINA, GAULT",100 TIMBERHILL PL   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 40 , 75 , 103 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568623684,"PHILLIPS, IRINA, GAULT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 19 , 28 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568623684,"PHILLIPS, IRINA, GAULT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 36 , 43 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1568623684,"PHILLIPS, IRINA, GAULT",100 TIMBERHILL PL   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 16 , 29 ,$#,,
MEDICAID DIRECT,1568623759,A PLUS HOME MEDICAL AND RESPIRATORY,~,1548 NC HIGHWAY 211 W   LUMBERTON NC,078,Robeson,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1568623759,A PLUS HOME MEDICAL AND RESPIRATORY,1548 NC HIGHWAY 211 W   LUMBERTON NC,078,Robeson,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 231 ," 1,240 "," 2,818 "," $220,251.01 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568624021,"STAEBLER, ANDREAS, MANFRED",100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568624021,"STAEBLER, ANDREAS, MANFRED",401 IRVING PKWY STE 310 HOLLY SPRINGS NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568624021,"STAEBLER, ANDREAS, MANFRED",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1635 NC HIGHWAY 66 S STE 110 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 28 , 43 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1568624146,"DAVIS, DREW, EDWARD",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 57 , 59 , 59 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",2630 WILLARD DAIRY RD STE A HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013031301,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST WOMENS IMAGING,1814 WESTCHESTER DR STE 200 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1346996485,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF NORTH CAROLINA-CARY,150 WELLESLEY TRADE LN STE 103 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1002 N CHURCH ST STE 401 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",3812 N ELM ST   GREENSBORO NC,041,Guilford,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 49 , 54 ,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 87 , 83 , 83 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",375 SUNSET AVE   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568624146,"DAVIS, DREW, EDWARD",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568625200,"BLANCO, CARLOS, JAVIER",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1801302492,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - MONROE,1550 FAULK ST STE 2100 MONROE NC,090,Union,193400000X,Group,Single Specialty,,1568626182,"CHANDRA, TANU, SHREE",1085 NE GATEWAY CT NE STE 330 CONCORD NC,013,Cabarrus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 23 , 52 , 82 ,$#,,
MEDICAID DIRECT,1801302492,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ENDOCRINOLOGY - MONROE,1550 FAULK ST STE 2100 MONROE NC,090,Union,193400000X,Group,Single Specialty,,1568626182,"CHANDRA, TANU, SHREE",1550 FAULK ST STE 2100 MONROE NC,090,Union,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 78 , 202 , 341 ,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568626653,"ENNIS, KRISTIE, ANDERSON",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 47 , 49 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568626794,"WALKER, ROBERT, NORMAN",118 CRYSTAL SPRINGS RD   ROCKWOOD TN,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1568628006,COUNTY OF CARTERET COURTHOUSE SQUAR,CARTERET COUNTY EMERGENCY MEDICAL SERVICES,3820 BRIDGES ST STE D MOREHEAD CITY NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1568628006,COUNTY OF CARTERET COURTHOUSE SQUAR,3820 BRIDGES ST STE D MOREHEAD CITY NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport, 25 , 38 , 76 ,$#,,
MEDICAID DIRECT,1568628006,COUNTY OF CARTERET COURTHOUSE SQUAR,CARTERET COUNTY EMERGENCY MEDICAL SERVICES,3010 HIGHWAY 24   NEWPORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1568628006,COUNTY OF CARTERET COURTHOUSE SQUAR,3010 HIGHWAY 24   NEWPORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1568628691,"SINGH, RAJDEEP",202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568628691,"SINGH, RAJDEEP",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568628691,"SINGH, RAJDEEP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 61 , 97 , 109 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568628691,"SINGH, RAJDEEP",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568637106,"WACHTER, ADAM, CONNELL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 94 , 94 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568637247,"SCHRADER, LAURA, JEAN",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1568637247,"SCHRADER, LAURA, JEAN",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 31 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568637437,"DOOLEY, JOSHUA, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568637437,"DOOLEY, JOSHUA, RYAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 23 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568637437,"DOOLEY, JOSHUA, RYAN",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 49 , 53 , 78 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568638641,"SHRESTHA, MOHAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 110 , 329 , 329 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568639441,"HANKS, BRENT, ALLEN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568639441,"HANKS, BRENT, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568639961,"SINDRAM, DAVID",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 28 , 28 ,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568639961,"SINDRAM, DAVID",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568640597,"FIGLER, BRADLEY, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 14 , 17 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1568640597,"FIGLER, BRADLEY, DAVID",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568640597,"FIGLER, BRADLEY, DAVID",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 23 , 25 , 56 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568640597,"FIGLER, BRADLEY, DAVID",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 42 , 59 , 66 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568641983,"KANTOR, OKSANA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 47 , 47 , 61 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568647204,"HOWELL, JENNIFER, WOODALL",6301 STADIUM DR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 51 , 71 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568648335,"SHAH, VIPUL, SHARADBHAI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 114 , 116 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568648400,"MARSHALL, JULIE, MILLER",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 46 , 82 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568648400,"MARSHALL, JULIE, MILLER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568650554,"WALD, MARLA, FRANCES",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568650554,"WALD, MARLA, FRANCES",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568651073,"MATHEW, TED",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568651073,"MATHEW, TED",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 58 , 187 , 187 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568652147,"WILSON, MICHAEL, DEAN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1568654754,HOPE MILLS RETIREMENT CENTER,,4217 ELK RD   HOPE MILLS NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568654754,HOPE MILLS RETIREMENT CENTER,4217 ELK RD   HOPE MILLS NC,026,Cumberland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 17 ," 3,395 "," 3,395 "," $276,832.65 ",,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,401 IRVING PKWY STE 210 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568654903,"TEAGUE, MALINDA, SUZANNE",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1063941128,COMPREHENSIVE DENTAL CENTER OF SC,COMPREHENSIVE DENTAL CENTER OF SC,841 ENTERPRISE RD STE A DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568657492,"DEMORAIS, ELYSA, BAILEY",2509 RICHARDSON DR STE B REIDSVILLE NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 30 , 38 , 121 ,$#,,
MEDICAID DIRECT,1881607505,FELICIA SINGLETARY DMD PLLC,COMPREHENSIVE DENTAL CENTER OF NC,1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568657492,"DEMORAIS, ELYSA, BAILEY",1108 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,1223G0001X,Dental Providers,Dentist,General Practice," 1,491 "," 1,976 "," 5,788 "," $368,687.38 ",,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568661254,"BEYUS, CHRISTOPHER, MICHAEL",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 44 , 47 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568661684,"KIMBROUGH, DORLAN, JAMAL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568661684,"KIMBROUGH, DORLAN, JAMAL",2301 ERWIN RD   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 31 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568661684,"KIMBROUGH, DORLAN, JAMAL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 30 , 47 , 77 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568663227,"OAKES, MICHAEL, FITZGERALD",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 28 , 30 , 35 ,$#,,
MEDICAID DIRECT,1164493615,COMMUNITY FAMILY PRACTICE PA,,260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568663722,"LECHNER, SHARON, LYDIA JACOBSON",260 MERRIMON AVE STE 200 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568665610,"KAHN, SCOTT, MICHAEL",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 36 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568666055,"LONG, CHANDLER, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568666055,"LONG, CHANDLER, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 26 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 312 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568666055,"LONG, CHANDLER, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568666055,"LONG, CHANDLER, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568666055,"LONG, CHANDLER, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 14 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568666055,"LONG, CHANDLER, ALEXANDER",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568667004,"TUCKER, JOSEPH, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 25 , 29 ,$#,,
MEDICAID DIRECT,1033116389,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER CLINIC,470 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568667335,"HITE, NOEL, HARRIS",470 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1568668812,"RICE, JOHN, FITZGERALD",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 88 , 143 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1568668812,"RICE, JOHN, FITZGERALD",610 N FAYETTEVILLE ST STE 106 ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 91 , 600 , 633 ," $13,326.76 ",,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1568668812,"RICE, JOHN, FITZGERALD",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 130 , 148 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568669661,"MUDIREDDY, PRASHANT, REDDY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 79 , 92 , 165 ," $11,528.05 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568669661,"MUDIREDDY, PRASHANT, REDDY",521 MOYE BLVD STE C 3RD FLOOR GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568669661,"MUDIREDDY, PRASHANT, REDDY",521C MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568671626,"MOL, ANDRE'",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223X0008X,Dental Providers,Dentist,Oral and Maxillofacial Radiology, 74 , 73 , 77 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568671782,"GOVIL, HARSH",1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568671782,"GOVIL, HARSH",1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 138 , 309 , 510 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568671782,"GOVIL, HARSH",1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568671782,"GOVIL, HARSH",1404 FERN CREEK DR   STATESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568671782,"GOVIL, HARSH",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568679108,"CLEMENT, KATHERINE, CAMPER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568679108,"CLEMENT, KATHERINE, CAMPER",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 21 , 42 , 55 ," $16,836.58 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568680973,"MASLOW, GARY, ROSS",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568680973,"MASLOW, GARY, ROSS",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 33 , 54 , 85 ,$#,,
MEDICAID DIRECT,1447306113,PRIVATE DIAGNOSTIC CLINIC PLLC,PEDIATRIC PRIMARY CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1568680973,"MASLOW, GARY, ROSS",4020 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1127 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568681161,"BYERLY, FAERA, LEDFORD",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,509 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568681161,"BYERLY, FAERA, LEDFORD",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568681161,"BYERLY, FAERA, LEDFORD",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 18 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1002 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568681161,"BYERLY, FAERA, LEDFORD",1002 N CHURCH ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568681161,"BYERLY, FAERA, LEDFORD",1002 N CHURCH ST STE 302 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568686608,"ROSENKRANZ, CHRISTINE, ELISE",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568686608,"ROSENKRANZ, CHRISTINE, ELISE",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 24 , 50 ,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,, 79 , 93 , 123 ," $15,210.62 ",,
MEDICAID DIRECT,1467972703,NORTH CAROLINA SPECIALTY HOSPITALS,,3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1568688000,"PHICHITH, ALOUNTHITH",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568689917,"GOODWIN, MARY, KATHERINE",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568689917,"GOODWIN, MARY, KATHERINE",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1568690212,STAR HEALTHCARE AGENCY INC,Star Healthcare AgencyInc,1921 N POINTE DR STE 205 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1568690212,STAR HEALTHCARE AGENCY INC,1921 N POINTE DR STE 205 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 34 ," 7,322 "," 7,402 "," $622,070.93 ",,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568691152,"GIURAN-BENETATO, IULIAN, CRISTIAN",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568692242,"VAUGHN, ANDREW, JOSEPH",2824 ROGERS RD STE 101 WAKE FOREST NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1124895354,DR CAMERON & ASSOCIATES OF WAKE FOR,TRIANGLE PEDIATRIC DENTISTRY,2824 ROGERS RD STE 201 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1568692242,"VAUGHN, ANDREW, JOSEPH",2824 ROGERS RD STE 101 WAKE FOREST NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,085 "," 1,725 "," 6,944 "," $279,931.39 ",,
MEDICAID DIRECT,1023162716,"EISBERG II, ROBERT, WILLIAM",ROBERT W EISBERG II DDS PA DBA ATLANTIC FAMILY DEN,1001 W WILLIAMS ST STE 101 APEX NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1568692382,"SHERRILL, ANGELLA, MAE",5111 NC HIGHWAY 55 STE 202 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 242 , 329 ," 1,343 "," $62,963.88 ",,
MEDICAID DIRECT,1124460746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PLASTIC & HAND SURGERY,807 SCHENCK ST STE 3 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568692770,"JENKINS, NELSON, LEE",201 E GROVER ST   SHELBY NC,023,Cleveland,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1124460746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PLASTIC & HAND SURGERY,807 SCHENCK ST STE 3 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568692770,"JENKINS, NELSON, LEE",807 SCHENCK ST STE 3 SHELBY NC,023,Cleveland,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 45 , 66 , 68 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568696938,"WILSON, TIMOTHY, SCOTT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 17 , 20 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568696938,"WILSON, TIMOTHY, SCOTT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194744532,MOSES CONE MEDICAL SERVICES INC,LEBAUER ENDOSCOPY CENTER,520 N ELAM AVE   GREENSBORO NC,041,Guilford,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1568698066,"CUNNINGHAM, SCOTT, ELLIS",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 12 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568698066,"CUNNINGHAM, SCOTT, ELLIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568698066,"CUNNINGHAM, SCOTT, ELLIS",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568698066,"CUNNINGHAM, SCOTT, ELLIS",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 37 , 43 , 48 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568698066,"CUNNINGHAM, SCOTT, ELLIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 22 , 50 , 52 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568698066,"CUNNINGHAM, SCOTT, ELLIS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 33 , 34 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568698066,"CUNNINGHAM, SCOTT, ELLIS",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1063505949,ONSLOW AMBULATORY SERVICES INC,ONSLOW INTERNAL MEDICINE & PRIMARY CARE,31 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1568698264,"HOLLAND-ELLIS, SEQUIA, ANNISE",31 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 96 , 105 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568698272,"CROWDER, JANE, CAROLYN",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568699783,"KAPOOR, SORABH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 36 , 42 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568701050,"SMITH, JAMIE, STABILE",10211 ALM ST STE 1200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568701571,"MOORE, CANDACE, MCINNIS",221A PROFESSIONAL CIR   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1659673838,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT SENIOR CARE,1309 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568703684,"EUBANKS, JESSICA, KARAM",1309 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 78 , 91 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568704740,"GILBERT, ELIZABETH, BRONWEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568704740,"GILBERT, ELIZABETH, BRONWEN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568704740,"GILBERT, ELIZABETH, BRONWEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568704740,"GILBERT, ELIZABETH, BRONWEN",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568705044,"GONZALES, HOLLY, MARIE",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568705044,"GONZALES, HOLLY, MARIE",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 22 , 46 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568705044,"GONZALES, HOLLY, MARIE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1568705044,"GONZALES, HOLLY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568705044,"GONZALES, HOLLY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 23 , 26 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568705044,"GONZALES, HOLLY, MARIE",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 18 , 29 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568705044,"GONZALES, HOLLY, MARIE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 21 , 21 , 32 ,$#,,
MEDICAID DIRECT,1568708238,WP-BREVARD HEALTH HOLDINGS I LLC,CEDAR MOUNTAIN HOUSE,11 SHERWOOD RIDGE RD   BREVARD NC,088,Transylvania,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1568708238,WP-BREVARD HEALTH HOLDINGS I LLC,11 SHERWOOD RIDGE RD   BREVARD NC,088,Transylvania,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 14 , 187 , 216 ," $12,388.00 ",,
MEDICAID DIRECT,1568708238,WP-BREVARD HEALTH HOLDINGS I LLC,CEDAR MOUNTAIN HOUSE,11 SHERWOOD RIDGE RD   BREVARD NC,088,Transylvania,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568708238,WP-BREVARD HEALTH HOLDINGS I LLC,11 SHERWOOD RIDGE RD   BREVARD NC,088,Transylvania,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 20 ," 4,610 "," 4,610 "," $337,640.85 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568710994,"SMITH, JANE, SETHMAN",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 17 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568710994,"SMITH, JANE, SETHMAN",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629588496,LIFE NET SERVICES LLC,,1790 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,1568711067,"TERRELL, ALLISON, MARIE",1014 HAY ST   FAYETTEVILLE NC,026,Cumberland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568711166,"WHITE, EMILY, JOY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 46 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568711166,"WHITE, EMILY, JOY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 123 , 125 , 128 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568713279,"BELL, ELIZABETH, LEIGH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568713279,"BELL, ELIZABETH, LEIGH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568713279,"BELL, ELIZABETH, LEIGH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1568716868,LIFE TOUCH THERAPY PLLC,~,2425 SATCHEL LN   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568716868,LIFE TOUCH THERAPY PLLC,2425 SATCHEL LN   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,, 243 ," 3,395 "," 3,451 "," $302,287.78 ",,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1568718674,"TAIT, DONALD",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 150 , 398 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1568718674,"TAIT, DONALD",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1912954090,NEW HANOVER COMMUNITY HEALTH CENTER,MEDNORTH HEALTH CENTER,925 N 4TH ST   WILMINGTON NC,065,New Hanover,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568720258,"NICKLAS, EVIE, SCHULZ",925 N 4TH ST   WILMINGTON NC,065,New Hanover,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 32 , 72 , 74 ," $12,651.63 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568720381,"STRICKLAND, MICHELLE",1101 N MORGAN ST   SHELBY NC,023,Cleveland,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568720381,"STRICKLAND, MICHELLE",7615 DALLAS CHERRYVILLE HWY   CHERRYVILLE NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568724219,"BONNES, JOHN",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568724607,"GENTRY, MATTHEW, NICHOLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568724607,"GENTRY, MATTHEW, NICHOLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568724607,"GENTRY, MATTHEW, NICHOLAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568725042,"DAS, AMITAVA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1568725042,"DAS, AMITAVA",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568726321,"GLASS, CHARITY, CELESTE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 19 , 23 ,$#,,
MEDICAID DIRECT,1083050389,ORANGE COUNTY,~,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1568726610,"GEORGE, STEPHANIE, FIGUEROA",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 604 , 877 ," 3,057 "," $95,290.20 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568727113,"CUMBERWORTH, DANA, DEMPSEY",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 60 , 112 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568727683,"GUNDALA, SRIVATSATEJASWI, VENKATA",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568727683,"GUNDALA, SRIVATSATEJASWI, VENKATA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 116 , 118 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568727683,"GUNDALA, SRIVATSATEJASWI, VENKATA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1629021076,LITTLE RIVER MEDICAL CENTER INC,LITTLE RIVER MEDICAL CENTER INC,4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568728327,"ALKIS, ANDREW, RUTLEDGE",4303 LIVE OAK DR   LITTLE RIVER SC,101,Out of State <= 40 miles,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1568729705,"ESSENBERG, JAMES, MATTHEW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568729705,"ESSENBERG, JAMES, MATTHEW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 126 , 130 , 155 ,$#,,
MEDICAID DIRECT,1992755680,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING INDIAN TRAIL,6030 W HIGHWAY 74 STE C INDIAN TRAIL NC,090,Union,193400000X,Group,Single Specialty,,1568729705,"ESSENBERG, JAMES, MATTHEW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568729705,"ESSENBERG, JAMES, MATTHEW",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 193 , 193 , 238 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568733434,"GARRETT, CHRISTOPHER, LOWE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568733434,"GARRETT, CHRISTOPHER, LOWE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568734770,"BOWMAN, SAMANTHA, MARIA",8064 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 32 , 71 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568734770,"BOWMAN, SAMANTHA, MARIA",8068 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568734770,"BOWMAN, SAMANTHA, MARIA",8114 MARKET ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568734895,"PRANGE, LYNDSEY, NICOLE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 27 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568734895,"PRANGE, LYNDSEY, NICOLE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568734895,"PRANGE, LYNDSEY, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 33 , 39 ,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,100 W FREMONT ST STE B BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1568744357,"GALL, BETH, ANN",3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1730681388,COASTLINE THERAPY GROUP LLC,,3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568744357,"GALL, BETH, ANN",3901 WRIGHTSVILLE AVE STE 120 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1568744498,QUALITY ADULT CARE INC,QUALITY ADULT CARE INC,180 E COURT ST   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568744498,QUALITY ADULT CARE INC,180 E COURT ST   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 474 , 476 ," $69,255.20 ",,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1568746030,"KISVER, TAMARA, NICOLE",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1568747467,OPEN DOOR MINISTRIES INC,~,120 WESTLAKE RD STE 5 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1568747467,OPEN DOOR MINISTRIES INC,120 WESTLAKE RD STE 5 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 24 ," 3,913 "," 4,014 "," $432,499.32 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568751238,"GROVER, NATALIE, SOPHIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 41 , 48 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568753143,"CAMPBELL, CHASE, LEE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 24 , 27 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568753143,"CAMPBELL, CHASE, LEE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568753143,"CAMPBELL, CHASE, LEE",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 34 , 40 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568753143,"CAMPBELL, CHASE, LEE",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568753143,"CAMPBELL, CHASE, LEE",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568753143,"CAMPBELL, CHASE, LEE",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 62 , 81 , 98 ," $11,413.18 ",,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 VETERANS PARKWAY STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568753143,"CAMPBELL, CHASE, LEE",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 15 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",1534 N HOSKINS RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 46 , 46 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",5601 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 24 , 44 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",1534 N HOSKINS RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 16 , 34 , 34 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 25 , 87 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",5601 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 2101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",2544 COURT DR STE F GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",2544 COURT DR STE F GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 51 , 76 , 113 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",1510 LOWER DALLAS HWY   DALLAS NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",1510 LOWER DALLAS HWY   DALLAS NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568753721,"KATSANOS, SUZANNE, LEIGH",2525 COURT DR   GASTONIA NC,036,Gaston,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 14 , 35 , 39 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568754422,"LORE, VICTORIA, ELLIOT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568754422,"LORE, VICTORIA, ELLIOT",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568754422,"LORE, VICTORIA, ELLIOT",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568758001,"SUN, KAI",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568758001,"SUN, KAI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 19 , 24 , 34 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568758027,"NYANDJO, CLEMENCE, TCHOKOTHE",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568758027,"NYANDJO, CLEMENCE, TCHOKOTHE",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568758027,"NYANDJO, CLEMENCE, TCHOKOTHE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568758027,"NYANDJO, CLEMENCE, TCHOKOTHE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568758027,"NYANDJO, CLEMENCE, TCHOKOTHE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1851724645,COLUMBUS REGIONAL HEALTH NETWORK,SOUTHEAST PEDIATRICS,36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1568758316,"WESSNER, ALLISON, GRISWOLD",36 MCNEILL PLZ   WHITEVILLE NC,024,Columbus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568758605,"THOMA, ERIN, SMITH",4275 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 73 , 153 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568759090,"BURNS, JOHN, FRANCIS",100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568759090,"BURNS, JOHN, FRANCIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1538443254,GENESISCARE USA OF NORTH CAROLINA P,ASHEVILLE UROLOGICAL ASSOCIATES,1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568759090,"BURNS, JOHN, FRANCIS",1 DOCTORS PARK   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 22 , 45 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568759090,"BURNS, JOHN, FRANCIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,, 27 , 38 , 63 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568759090,"BURNS, JOHN, FRANCIS",21 HOSPITAL DR FL 2 ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568759090,"BURNS, JOHN, FRANCIS",1 HOSPITAL DR STE 4100 ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,100 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568759090,"BURNS, JOHN, FRANCIS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,16455 STATESVILLE RD STE 110 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568761070,"MAHANTY, SCOTT, RANJIT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,4525 CAMERON VALLEY PKWY STE 1000B CHARLOTTE NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1568761070,"MAHANTY, SCOTT, RANJIT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568761070,"MAHANTY, SCOTT, RANJIT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 151 , 154 , 186 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,3816 LATROBE DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568761070,"MAHANTY, SCOTT, RANJIT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568761070,"MAHANTY, SCOTT, RANJIT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 146 , 153 , 188 ,$#,,
MEDICAID DIRECT,1699104844,UNION MEDICAL SERVICES LLC,ATRIUM HEALTH IMAGING KANNAPOLIS,201 DALE EARNHARDT BLVD STE 100 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1568761070,"MAHANTY, SCOTT, RANJIT",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568762003,"SCHNEIDER, MICHELLE, MARIE",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568762003,"SCHNEIDER, MICHELLE, MARIE",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 22 , 22 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568762003,"SCHNEIDER, MICHELLE, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 16 , 16 , 40 ,$#,,
MEDICAID DIRECT,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,DRS JOHNSON & JOHNSON EYEWORKS,304 E MAIN ST   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1568765840,"NAIG, BRIAN, TORGER",304 E MAIN ST   BENSON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 20 , 31 ,$#,,
MEDICAID DIRECT,1548345689,JOHNSON AND JOHNSON DOCTORS OF OPTO,DRS JOHNSON & JOHNSON EYEWORKS,2800 N ELM ST STE 1 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568765840,"NAIG, BRIAN, TORGER",2800 N ELM ST STE 1 LUMBERTON NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,, 246 , 263 , 501 ," $19,739.68 ",,
MEDICAID DIRECT,1568772069,NEXT STEP DEVELOPMENTAL LEARNING LL,~,576 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1568772069,NEXT STEP DEVELOPMENTAL LEARNING LL,576 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1568772069,NEXT STEP DEVELOPMENTAL LEARNING LL,~,576 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568772069,NEXT STEP DEVELOPMENTAL LEARNING LL,576 N REILLY RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 31 , 531 , 534 ," $37,012.31 ",,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568773505,"DURHAM, ERIN, KIRBY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568773505,"DURHAM, ERIN, KIRBY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568774636,"PARKER, MARY, WARD",655 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST STE 110 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568774636,"PARKER, MARY, WARD",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 18 , 27 ,$#,,
MEDICAID DIRECT,1477516698,MOUNTAIN KIDNEY HYPERTENSION ASSO,,10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1568774636,"PARKER, MARY, WARD",10 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568776540,"KUPPIREDDY, PALLAVI REDDY",830 KEMPSVILLE RD STE 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568776540,"KUPPIREDDY, PALLAVI REDDY",830 KEMPSVILLE RD STE 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568776672,"JAMES, KIASHA, JAMES",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568778603,"YOUNG, LAUREN, ELISE",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 86 , 174 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568778736,"REED, SARAH, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568778736,"REED, SARAH, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568780062,"CHEN, KAI",1806 S HAWTHORNE RD STE 200 WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 49 , 77 , 234 ," $11,699.10 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568780062,"CHEN, KAI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 29 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568780062,"CHEN, KAI",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1851805022,STARMED URGENT & FAMILY CARE PA,,4001 TUCKASEEGEE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568780591,"PIRAMZADIAN, ARIN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568780591,"PIRAMZADIAN, ARIN",16035 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568780591,"PIRAMZADIAN, ARIN",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1568780591,"PIRAMZADIAN, ARIN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568780591,"PIRAMZADIAN, ARIN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568780591,"PIRAMZADIAN, ARIN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1568780591,"PIRAMZADIAN, ARIN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 26 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568780591,"PIRAMZADIAN, ARIN",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 95 , 101 , 139 ,$#,,
MEDICAID DIRECT,1043646961,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH BEHAVIORAL HEALTH PSYCHIATRY & COUNS,5427 NC HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568781391,"FERGUSON, ANGELA, MOOSE",5427 HIGHWAY 49 S STE 105 HARRISBURG NC,013,Cabarrus,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1568781755,"STANTON, JOSHUA, AARON",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568781755,"STANTON, JOSHUA, AARON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568781755,"STANTON, JOSHUA, AARON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568781755,"STANTON, JOSHUA, AARON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1568781771,"MOONA, MONIQUE, MARY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 32 , 42 , 42 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568781771,"MOONA, MONIQUE, MARY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",109 W RIVER ST   COLERAIN NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790851004,ROANOKE CHOWAN COMMUNITY HEALTH CEN,COLERAIN PRIMARY CARE,109 W RIVER ST   COLERAIN NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",109 W RIVER ST   COLERAIN NC,008,Bertie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1568782845,"JONES, GENIENE, NICOLE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1023675113,ROANOKE CHOWAN COMMUNITY HEALTH CEN,WOODLAND PRIMARY CARE,108 W MAIN ST   WOODLAND NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 31 , 37 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 163 , 356 , 384 ," $15,737.03 ",,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619342706,ROANOKE CHOWAN COMMUNITY HEALTH CEN,CRESWELL PRIMARY CARE,9500 NC HIGHWAY 94 N   CRESWELL NC,094,Washington,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568782845,"JONES, GENIENE, NICOLE",9500 NC HIGHWAY 94 N   CRESWELL NC,094,Washington,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568782928,"RITCHIE, MICHAEL, KYLE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 20 , 27 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 30 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 21 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568783371,"PUSHCHAK, EVAN, MICHAEL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508117185,CAMPBELL UNIVERSITY HEALTH CENTER,~,129 T T LANIER ST   BUIES CREEK NC,043,Harnett,193200000X,Group,Multi-Specialty,,1568784486,"LEE, AMANDA, WARREN",129 T T LANIER ST   BUIES CREEK NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1568787141,"BUNN, BRYAN, CARLTON",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 28 , 28 ," $10,786.91 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568787141,"BUNN, BRYAN, CARLTON",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 84 , 151 , 255 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1568787141,"BUNN, BRYAN, CARLTON",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1568787141,"BUNN, BRYAN, CARLTON",105 MARK DRIVE   EDENTON NC,021,Chowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 27 , 27 ," $19,192.10 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568787141,"BUNN, BRYAN, CARLTON",113 VIRGINIA RD   EDENTON NC,021,Chowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1568787141,"BUNN, BRYAN, CARLTON",113 VIRGINIA RD   EDENTON NC,021,Chowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568787638,"DEHART, MEAGHAN, GRAVES",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659307270,LINCOLN INTERNAL MEDICINE PA,LINCOLN INTERNAL MEDICINE PA,607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1568787778,"MEYER, GABRIELA",607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 95 , 107 ,$#,,
MEDICAID DIRECT,1659307270,LINCOLN INTERNAL MEDICINE PA,LINCOLN INTERNAL MEDICINE PA,607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1568787778,"MEYER, GABRIELA",607 S GENERALS BLVD   LINCOLNTON NC,055,Lincoln,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 15 , 26 , 35 ,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1568788131,"BAHADORI, SHAPOUR",844 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801815063,CHESAPEAKE RADIOLOGISTS LTD,CHESAPEAKE RADIOLOGISTS LTD,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1568788131,"BAHADORI, SHAPOUR",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 13 , 18 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568790095,"ROEHM, MICHELLE, LEA",1822 BRUNSWICK AVE   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 31 , 31 , 31 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568790095,"ROEHM, MICHELLE, LEA",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1568793321,"MORWICK, JENNIFER, RUSS",414 E MAIN ST   DURHAM NC,032,Durham,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1568794204,"WILSON, AMANDA, IRONS",400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 30 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568794204,"WILSON, AMANDA, IRONS",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 28 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568794204,"WILSON, AMANDA, IRONS",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 23 , 37 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568794204,"WILSON, AMANDA, IRONS",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568797736,"ARIWODO, UDO, UCHENDU",2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 60 , 102 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568797736,"ARIWODO, UDO, UCHENDU",2850 S MAIN ST STE 104 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780825539,MC FAMILY MEDICAL PLLC,MC FAMILY MEDICAL PLLC,6700 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568798254,"CANO, NORMA, LINDA",6700 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 104 , 217 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568799559,"ROYCIK, AMANDA, CRAIG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1568800357,GREENSBORO AL HOLDINGS LLC,GUILFORD HOUSE,5918 NETFIELD RD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568800357,GREENSBORO AL HOLDINGS LLC,5918 NETFIELD RD   GREENSBORO NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 36 ," 6,838 "," 6,844 "," $689,516.61 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568800381,"VISHNESKI, SUSAN, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 48 , 50 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1568800662,"HEDGES, LINDA, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 71 , 153 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568800662,"HEDGES, LINDA, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568800662,"HEDGES, LINDA, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568800662,"HEDGES, LINDA, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 42 , 55 , 88 ," $12,080.77 ",,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 11 , 14 , 22 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,,,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,101 E W T HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,,,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 22 , 25 , 59 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 17 , 24 , 29 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568800811,"PIERCE-WILLIAMS, REBECCA, ALISON MOKHIBER",1025 MOREHEAD MEDICAL DR STE 500 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 33 , 38 , 93 ,$#,,
MEDICAID DIRECT,1427697978,NOVANT HEALTH CLEMMONS OUTPATIENT S,,7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568800977,"STEWART, MOLLY, DRUM",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568800977,"STEWART, MOLLY, DRUM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568800977,"STEWART, MOLLY, DRUM",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568800977,"STEWART, MOLLY, DRUM",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124582648,TWIN CITY ANESTHESIA PLLC,,402 W KING ST   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1568800977,"STEWART, MOLLY, DRUM",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568803526,"GAMARALLAGE, RUWAN, LALINDA GAMAGE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 159 , 161 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568805265,"MIKELL, FRANKLIN, CORNELIUS",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568805919,"HAWKINS, JOSHUA, BENTON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568805919,"HAWKINS, JOSHUA, BENTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1568805919,"HAWKINS, JOSHUA, BENTON",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1568805919,"HAWKINS, JOSHUA, BENTON",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568807055,"BRADSHAW, JOHN, DAVID",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 64 , 66 , 72 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568807063,"STRICKLAND, ASHLEY, RODNEY",600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 128 , 207 , 299 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568807063,"STRICKLAND, ASHLEY, RODNEY",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 27 , 39 , 59 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,600 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1568807063,"STRICKLAND, ASHLEY, RODNEY",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568807923,"RAPARLA, SANDEEP",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 43 , 153 , 155 ,$#,,
MEDICAID DIRECT,1831414150,ISLAND FAMILY MEDICINE,~,2540 NC HIGHWAY 210 E   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1568808251,"PASSINGHAM, ALEXIS, DAWN MEDLIN",2540 NC HIGHWAY 210 E   HAMPSTEAD NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568808780,"CURRIE, SHANNON, RATCLIFF",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568808780,"CURRIE, SHANNON, RATCLIFF",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568810174,"DETWILER, COURTNEY, ELLEN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568810174,"DETWILER, COURTNEY, ELLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 15 , 20 ,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1568810190,"BARNEY, JACOB, KENT",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568810190,"BARNEY, JACOB, KENT",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 25 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,218 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568810190,"BARNEY, JACOB, KENT",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 47 , 57 ,$#,,
MEDICAID DIRECT,1053690560,LAKE NORMAN EMERGENCY MEDICAL ASSOC,Lake Norman Emergency Medical Associates LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568810190,"BARNEY, JACOB, KENT",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 39 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568810505,"MCVEY, AMBER, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 47 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568810505,"MCVEY, AMBER, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 58 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568810505,"MCVEY, AMBER, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568810505,"MCVEY, AMBER, LYNN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568812485,"VASIM, IZZAH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 50 , 56 , 56 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568812725,"ROCK, KATHRYN, MARLENE",309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,13539 REESE BLVD W   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568812725,"ROCK, KATHRYN, MARLENE",5815 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1568812725,"ROCK, KATHRYN, MARLENE",309 S SHARON AMITY RD STE 200 CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1568812725,"ROCK, KATHRYN, MARLENE",5815 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568812725,"ROCK, KATHRYN, MARLENE",5815 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1831540251,VAN DYKE AND ASSOCIATES DDS PLLC,KINSTON DENTAL CARE,512 PLAZA BLVD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1568813020,"VAN DYKE, JORDAN, ROSS",512 PLAZA BLVD   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice," 1,738 "," 2,964 "," 17,299 "," $810,786.57 ",,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568813327,"HAMIDI, AMID",301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 24 , 26 ,$#,,
MEDICAID DIRECT,1699448266,MEDICAL CENTER ORTHOTICS AND PROSTH,,6060 PIEDMONT ROW DR S STE 320 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568814077,"DELAROCHE, THOMAS, ARTHUR",6060 PIEDMONT ROW DR S STE 320 CHARLOTTE NC,060,Mecklenburg,225000000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotic Fitter,,#,#, 19 ,$#,,
MEDICAID DIRECT,1972543825,AARON A ROSENSTEIN OD PA,~,2901 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568814242,"GRETZ, DANIELLE",2901 N DUKE ST   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568816536,"DOYLE, WARREN, CHASE",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568817328,"ROONEY, ARYN, MICHELLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 33 , 36 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1568819142,"PACKER, JUSTIN, ALAN",3714 GUARDIAN AVE STE E MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1568819142,"PACKER, JUSTIN, ALAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568819142,"PACKER, JUSTIN, ALAN",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 68 , 124 , 199 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1568819142,"PACKER, JUSTIN, ALAN",4370 ARENDELL ST STE A MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568820447,"DEMARCO, KARA, MICHELLE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1568823003,"WORLEY, ASHLEY, SMITH",2402 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 27 , 87 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1568823003,"WORLEY, ASHLEY, SMITH",104 COMMERCIAL DR   PRINCETON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568823383,"CUTHRIELL, JONATHAN, DANIEL",5402 W MARKET ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568823383,"CUTHRIELL, JONATHAN, DANIEL",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568823383,"CUTHRIELL, JONATHAN, DANIEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1568823383,"CUTHRIELL, JONATHAN, DANIEL",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1568464386,GREENE COUNTY HEALTH CARE INC,GREENE DENTAL SERVICES,6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568823698,"MUNDY, GAVIN, LANDRUM",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice, 72 , 78 , 219 ," $10,167.19 ",,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568823698,"MUNDY, GAVIN, LANDRUM",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1568464386,GREENE COUNTY HEALTH CARE INC,GREENE DENTAL SERVICES,6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568823698,"MUNDY, GAVIN, LANDRUM",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568823698,"MUNDY, GAVIN, LANDRUM",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 93 , 109 , 276 ," $18,511.82 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568824175,"PARKER, JOSHUA, DAVID",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568824175,"PARKER, JOSHUA, DAVID",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 52 , 75 , 102 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1568824175,"PARKER, JOSHUA, DAVID",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568824217,"WILCOX VANDEN BERG, RAND, NICHOLAS",2301 ERWIN RD   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568824217,"WILCOX VANDEN BERG, RAND, NICHOLAS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568824399,"MILLER, ZACHARY, DANE",2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1568826030,"BIDIKOV, LUKE",15 BRETTWOOD TRCE   CLYDE NC,044,Haywood,208800000X,Allopathic & Osteopathic Physicians,Urology,, 37 , 76 , 87 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1568826030,"BIDIKOV, LUKE",15 BRETTWOOD TRCE   CLYDE NC,044,Haywood,208800000X,Allopathic & Osteopathic Physicians,Urology,, 79 , 160 , 277 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568826287,"ADAMS, MATTHEW, JOHN HOWARD",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568826287,"ADAMS, MATTHEW, JOHN HOWARD",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568826287,"ADAMS, MATTHEW, JOHN HOWARD",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 31 , 38 , 81 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568826287,"ADAMS, MATTHEW, JOHN HOWARD",2131 S 17TH ST   CAPE FEAR NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568826287,"ADAMS, MATTHEW, JOHN HOWARD",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568826741,"SPYRIS, SARA, VICTORIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568826741,"SPYRIS, SARA, VICTORIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 41 , 56 , 73 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568826741,"SPYRIS, SARA, VICTORIA",329 NC HIGHWAY 801 N   ADVANCE NC,030,Davie,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 35 , 54 , 64 ,$#,,
MEDICAID DIRECT,1689923757,KINSTON PHYSICIANS GROUP PLLC,KINSTON PHYSICIANS GROUP PLLC,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1568827590,"BUTLER, JASMINE, CHEYENNE",100 AIRPORT RD   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568827590,"BUTLER, JASMINE, CHEYENNE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1568827590,"BUTLER, JASMINE, CHEYENNE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568827590,"BUTLER, JASMINE, CHEYENNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568832228,"MCEVOY, MADISON, MARIE",5955 WEDDINGTON RD   MATTHEWS NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 32 , 35 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568832228,"MCEVOY, MADISON, MARIE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568832228,"MCEVOY, MADISON, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568832228,"MCEVOY, MADISON, MARIE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 178 , 359 , 540 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568834539,"COX, ORVETTE, CLYDIA",391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 34 , 78 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1568834539,"COX, ORVETTE, CLYDIA",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568834539,"COX, ORVETTE, CLYDIA",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568840254,"TOCHE, JUNEVE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568840254,"TOCHE, JUNEVE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568840254,"TOCHE, JUNEVE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568840254,"TOCHE, JUNEVE",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568840932,"HOLLINGSWORTH, JESSICA, WARE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 68 , 84 , 103 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568840932,"HOLLINGSWORTH, JESSICA, WARE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568840932,"HOLLINGSWORTH, JESSICA, WARE",601 N ELM ST   HIGH POINT NC,041,Guilford,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 11 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568842326,"GROSS, KATELYN, RENEE",609 ATTAIN ST STE 101 FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568842326,"GROSS, KATELYN, RENEE",4505 FAIR MEADOWS LN STE 102 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 41 , 41 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568843357,"UPRETY, AJAY",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164784948,MCPC-5 LLC,FIRSTHEALTH CARDIOLOGY SERVICES REID HEART CENTER,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1568843357,"UPRETY, AJAY",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 77 , 107 , 137 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568843530,"HERCO, MAJA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568843530,"HERCO, MAJA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 12 , 66 , 66 ," $16,764.57 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",8108 MARKET ST STE B WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",5211 S COLLEGE RD   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568844595,"STOUTE, MARIA, LUISA",2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 77 , 116 , 118 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,4612 MAIN ST   SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",4612 MAIN ST   SHALLOTTE NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 14 , 42 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568844595,"STOUTE, MARIA, LUISA",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568844702,"KESTY, KENDRA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568844702,"KESTY, KENDRA, ELIZABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568844702,"KESTY, KENDRA, ELIZABETH",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 28 , 37 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568844702,"KESTY, KENDRA, ELIZABETH",111 HANESTOWN CT STE 151 WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1568844702,"KESTY, KENDRA, ELIZABETH",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 18 , 24 ,$#,,
MEDICAID DIRECT,1720377625,CAROMONT MEDICAL GROUP INC,CAROLINAS PLASTIC SURGERY CENTER,2391 COURT DR STE 120B GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568847564,"OLIVER, SHANTIAL, LATOYA",2391 COURT DR STE 120B GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1568847564,"OLIVER, SHANTIAL, LATOYA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1568847564,"OLIVER, SHANTIAL, LATOYA",2007 NEUSE BLVD   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568848646,"ASKELAND, MARY, ASHLEY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568848646,"ASKELAND, MARY, ASHLEY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568848646,"ASKELAND, MARY, ASHLEY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,2304 WESVILL CT STE 360 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568848646,"ASKELAND, MARY, ASHLEY",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568851525,"DEVINE, ERIN, PATRICIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568853638,"WAGNER, ASHLEY, MORGAN",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568856458,"COOK, JESSICA, NICOLE",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1154701415,APPALACHIAN MOUNTAIN COMMUNITY HEAL,LEICESTER COMMUNITY HEALTH CENTER,711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568856458,"COOK, JESSICA, NICOLE",711 NEW LEICESTER HWY   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 19 ,$#,,
MEDICAID DIRECT,1336528314,APPALACHIAN MOUNTAIN COMMUNITY HEAL,DALE FELL HEALTH CENTER,77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568856458,"COOK, JESSICA, NICOLE",77 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 105 , 120 ," $11,327.59 ",,
MEDICAID DIRECT,1619356136,APPALACHIAN MOUNTAIN COMMUNITY HEAL,~,225 PATTON AVE STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568856458,"COOK, JESSICA, NICOLE",225 PATTON AVE STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 75 , 82 ," $13,019.88 ",,
MEDICAID DIRECT,1356069819,APPALACHIAN MOUNTAIN COMMUNITY HEAL,,419 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568856458,"COOK, JESSICA, NICOLE",419 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558128256,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES,101 WILLIAM H. JOHNSON STREET SUITE 600 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568856482,"AYKENT, KAZIM",101 WILLIAM H JOHNSON ST STE 600 FLORENCE SC,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568857480,"RANASINGHE, TAMRA, ISHAN JAYENDRA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1881841518,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT SCOTLAND NECK,919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568857621,"FUTRELL, AMANDA, AYDELETTE",114 MARKET ST   ENFIELD NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952665929,RURAL HEALTH GROUP INC,Rural Health Group at Enfield,114 MARKET ST   ENFIELD NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568857621,"FUTRELL, AMANDA, AYDELETTE",114 MARKET ST   ENFIELD NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881841518,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT SCOTLAND NECK,919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568857621,"FUTRELL, AMANDA, AYDELETTE",919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 23 , 25 ,$#,,
MEDICAID DIRECT,1013157171,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT WHITAKERS,105 SE RAILROAD ST   WHITAKERS NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568857621,"FUTRELL, AMANDA, AYDELETTE",105 NW RAILROAD ST   WHITAKERS NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 81 , 162 , 168 ,$#,,
MEDICAID DIRECT,1881841518,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT SCOTLAND NECK,919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568857621,"FUTRELL, AMANDA, AYDELETTE",105 NW RAILROAD ST   WHITAKERS NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 22 , 28 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1568857829,"SEXTON, SCOTT, DUANE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 64 , 115 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1568857829,"SEXTON, SCOTT, DUANE",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1568857829,"SEXTON, SCOTT, DUANE",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568858579,"SARTIN, MARIA, DANIELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568858579,"SARTIN, MARIA, DANIELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568858579,"SARTIN, MARIA, DANIELLE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568858587,"GHODASARA, NEVIL, NEEL",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 327 , 353 , 449 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568858587,"GHODASARA, NEVIL, NEEL",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 34 , 35 , 47 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568858868,"BRACEWELL, STEPHEN, MICHAEL",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568859395,"PARKER, VIRGINIA, STANLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 61 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568859395,"PARKER, VIRGINIA, STANLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 56 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568859395,"PARKER, VIRGINIA, STANLEY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 64 , 119 , 121 ,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568862688,"HARLEY, KRISTI, ANN",817 VOLVO PKWY   CHESAPEAKE VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1568862688,"HARLEY, KRISTI, ANN",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1568869865,MELODY HOME HEALTH CARE SERVICES IN,,211 E SIX FORKS RD STE 108 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1568869865,MELODY HOME HEALTH CARE SERVICES IN,211 E SIX FORKS RD STE 108 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 47 ," 10,636 "," 10,640 "," $651,654.12 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568870277,"BLOCK, NINA, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568870277,"BLOCK, NINA, DANIELLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568870905,"SALTER, MALLORY, GAIL",4252 ARENDELL ST STE E MOREHEAD CITY NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 49 , 62 ,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1568870905,"SALTER, MALLORY, GAIL",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 34 , 50 ,$#,,
MEDICAID DIRECT,1225794217,DR CAMERON & ASSOCIATES OF HILLSBO,ERIC DAVIS LLC,510 HAMPTON PT STE 100 HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1568876266,"NICKELSON, DAVIA, NECHELLE",510 HAMPTON PT STE 100 HILLSBOROUGH NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 103 , 139 , 370 ," $29,895.31 ",,
MEDICAID DIRECT,1134466790,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - STANLY,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1568876845,"OVU, STEVEN, EHIZOGIE",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 153 , 155 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568876845,"OVU, STEVEN, EHIZOGIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568876845,"OVU, STEVEN, EHIZOGIE",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568876845,"OVU, STEVEN, EHIZOGIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1568876845,"OVU, STEVEN, EHIZOGIE",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568876845,"OVU, STEVEN, EHIZOGIE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1568876845,"OVU, STEVEN, EHIZOGIE",2201 S STERLING ST   MORGANTON NC,012,Burke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568877991,"DILLON, ANGELA, MERCEDES",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,2202 CAROLINA PL STE 100 KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568878619,"RAJPUT, PUNAM, VIJAYSINGH",2202 CAROLINA PL STE 100 KINGS MOUNTAIN NC,023,Cleveland,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568878619,"RAJPUT, PUNAM, VIJAYSINGH",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 13 , 23 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568878619,"RAJPUT, PUNAM, VIJAYSINGH",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568879112,"CALVERT, SARAH, FRANCES",3643 N ROXBORO ST DURHAM REGIONAL HOSPITAL DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 67 , 67 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568879187,"GARLAND, BRIAN, JOSEPH",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568879187,"GARLAND, BRIAN, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 25 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568880631,"GURYSH, KEVIN, MCKENZIE",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 94 , 101 , 113 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1568880631,"GURYSH, KEVIN, MCKENZIE",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568880631,"GURYSH, KEVIN, MCKENZIE",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 40 , 47 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1568881142,"GARRO, SARAH, JONAS",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568881142,"GARRO, SARAH, JONAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568881142,"GARRO, SARAH, JONAS",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568881316,"HACKWORTH, JEREMY, MICHAEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 174 , 182 , 214 ,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,1401 MATTHEWS TOWNSHIP PKWY STE 310 MATTHEWS NC,060,Mecklenburg,293D00000X,Laboratories,Physiological Laboratory,,1568881316,"HACKWORTH, JEREMY, MICHAEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093765851,CAROLINAS IMAGING SERVICES LLC,CAROLINAS HEALTHCARE SYSTEM IMAGING,409 OLIN WAY STE 1100 DENVER NC,055,Lincoln,293D00000X,Laboratories,Physiological Laboratory,,1568881316,"HACKWORTH, JEREMY, MICHAEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568881316,"HACKWORTH, JEREMY, MICHAEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 246 , 257 , 303 ,$#,,
MEDICAID DIRECT,1871507699,CUMBERLAND HOSPITAL,,9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1568881324,"WHITEHILL, BENJAMIN, CAMERON",9407 CUMBERLAND RD   NEW KENT VA,102,Out of State > 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 203 , 203 ," $12,137.83 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568881647,"WILLIAMS, JASON, LUCIOUS",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568881647,"WILLIAMS, JASON, LUCIOUS",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#, 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568881647,"WILLIAMS, JASON, LUCIOUS",2608 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568881647,"WILLIAMS, JASON, LUCIOUS",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 42 , 73 , 136 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1568881647,"WILLIAMS, JASON, LUCIOUS",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 13 , 42 ,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1568882389,"CONSTANS, JAMES",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 16 , 17 , 29 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568883320,"MOORE, CHELSEY, MEGAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568883320,"MOORE, CHELSEY, MEGAN",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568883320,"MOORE, CHELSEY, MEGAN",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 16 , 18 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568885424,"MADDEN, KRISTA, NOELLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568885424,"MADDEN, KRISTA, NOELLE",5 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568885424,"MADDEN, KRISTA, NOELLE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1568887818,J ARTHUR DOSHER MEMORIAL HOSPITAL,~,4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568887818,J ARTHUR DOSHER MEMORIAL HOSPITAL,4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,#,#,#,$#,,
MEDICAID DIRECT,1285205708,GENERATIONS FAMILY PRACTICE,TRIAD PRIMARY CARE,1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568890432,"DALTON, CYNTHIA, DENISE",1309 LEES CHAPEL RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 23 , 32 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568891448,"JOSTEN, ERICA, HOPE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568896116,"SMITH, JENNIFER, PIZZICARA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568896116,"SMITH, JENNIFER, PIZZICARA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",1999 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 34 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",7210 VILLAGE MEDICAL CIR STE 235 CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1568896405,"FARNUM, RICHARD, WARREN",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568896421,"JONES, LISA, KATHLEEN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1568896421,"JONES, LISA, KATHLEEN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 13 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568901411,"STUBBS, REBECCA, WITHERSPOON",8700 PINEVILLE MATTHEWS RD STE 540 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568901411,"STUBBS, REBECCA, WITHERSPOON",8814 RACHEL FREEMAN WAY STE 103 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 11 , 119 , 147 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568901411,"STUBBS, REBECCA, WITHERSPOON",3719 UNION RD   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 22 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1568901411,"STUBBS, REBECCA, WITHERSPOON",2675 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 26 , 83 , 146 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568907764,"FLORES, JULIE, BETH",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568909042,"LISOWSKI, JAMES, KAROL",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 54 , 54 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568912384,"LAWAL, OLUWASEYI, AMINAT",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1568912384,"LAWAL, OLUWASEYI, AMINAT",1135 CARTHAGE ST   SANFORD NC,053,Lee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568912384,"LAWAL, OLUWASEYI, AMINAT",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1568915791,"FITZGERALD, AUDREY, LYNN",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568915791,"FITZGERALD, AUDREY, LYNN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1568915791,"FITZGERALD, AUDREY, LYNN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1568918027,"MOZIAK, BRANDI, MARIE",24 FALCON CREST LN   CLYDE NC,044,Haywood,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154042992,RDMG ASSOCIATES PA,,7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568918027,"MOZIAK, BRANDI, MARIE",7 YORKSHIRE ST STE 201 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 39 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568919199,"HOUSE, SCHYLER, NICOLE",1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568919199,"HOUSE, SCHYLER, NICOLE",1838 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568920072,"KERN, BRIAN, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568920072,"KERN, BRIAN, SCOTT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1568924314,"MAREVCI, HEKURAN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 94 , 100 , 101 ," $10,992.35 ",,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1568924314,"MAREVCI, HEKURAN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568924314,"MAREVCI, HEKURAN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1568925592,"PACANA LIM, MARIA, VICTORIA ROSARIO",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1568925592,"PACANA LIM, MARIA, VICTORIA ROSARIO",1774 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568926509,"O'QUINN, ALISON, GRIMME",3100 DURALEIGH RD STE 205 RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,300 ASHVILLE AVE STE 240 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1568926509,"O'QUINN, ALISON, GRIMME",300 ASHVILLE AVE STE 240 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568926509,"O'QUINN, ALISON, GRIMME",300 ASHVILLE AVE STE 240 CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568927085,"WRIGHT, AMANDA, LEIGH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568927101,"MILLER, VIRGINIA, ELLEN",5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457423907,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE INTERNAL MEDICINE TANNENBAUM DBA,301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1568927101,"MILLER, VIRGINIA, ELLEN",301 E WENDOVER AVE STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 45 , 113 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568927978,"ZAROBAN, LINSEY, MAE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568927978,"ZAROBAN, LINSEY, MAE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568927978,"ZAROBAN, LINSEY, MAE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1568927978,"ZAROBAN, LINSEY, MAE",3916 BEN FRANKLIN BLVD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568928992,"WALTON, ERIC, LEO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 20 , 26 ,$#,,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1568930113,"JACOB, BEENA",615 RIDGE RD   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568930113,"JACOB, BEENA",615 RIDGE RD   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912190281,ESSENTIAL GERIATRIC CARE PA,~,216 FARM GATE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1568930113,"JACOB, BEENA",615 RIDGE RD   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 356 , 356 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1568930527,"THOMAS, APRIL, ELIZABETH",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 48 , 71 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568930527,"THOMAS, APRIL, ELIZABETH",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 151 , 208 ,$#,,
MEDICAID DIRECT,1568933091,RESPRACARE INC,,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568933091,RESPRACARE INC,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 347 ," 1,920 "," 3,159 "," $79,557.97 ",,
MEDICAID DIRECT,1568933091,RESPRACARE INC,,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568933091,RESPRACARE INC,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,,,$#,,
MEDICAID DIRECT,1568933091,RESPRACARE INC,,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1568933091,RESPRACARE INC,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1568933091,RESPRACARE INC,,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1568933091,RESPRACARE INC,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 59 , 283 , 506 ,$#,,
MEDICAID DIRECT,1568933091,RESPRACARE INC,,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568933091,RESPRACARE INC,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1568933091,RESPRACARE INC,,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1568933091,RESPRACARE INC,918 HALSTEAD BLVD STE E ELIZABETH CITY NC,070,Pasquotank,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#," $16,692.00 ",,
MEDICAID DIRECT,1114447083,THE MCINNIS CLINIC PLLC,,1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1568935039,"KALOMBO, CESAR, NSUMANGANYI",1123 S MAIN ST STE C REIDSVILLE NC,079,Rockingham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 110 , 430 , 697 ," $14,835.92 ",,
MEDICAID DIRECT,1275596439,CAROLINA SPECIALTY CARE PA,CAROLINA SPECIALTY CARE PA,293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",350 N COX ST STE 6 ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",3512 E WENDOVER AVE STE B GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,3512 E WENDOVER AVE STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",3512 E WENDOVER AVE STE B GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",150 FAIRVIEW RD STE 300 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,150 FAIRVIEW RD STE 300 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",150 FAIRVIEW RD STE 300 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 66 , 309 , 332 ,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,3512 E WENDOVER AVE STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",150 FAIRVIEW RD STE 300 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 132 , 141 ,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,3512 E WENDOVER AVE STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 119 , 124 ,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,1050 REVOLUTION MILL DR STE 7A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,150 FAIRVIEW RD STE 300 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",500 E CORNWALLIS DR STE G GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1619681384,BELLAMY FAMILY HEALTHCARE,BELLAMY PAIN MANAGEMENT,150 FAIRVIEW RD STE 300 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1568938017,"BELLAMY, MELISSA, MARIE",3512 E WENDOVER AVE STE B GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1568940013,MM HOME CARE LLC,MM HOME CARE,2303 W MOREHEAD ST STE 200 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1568940013,MM HOME CARE LLC,2303 W MOREHEAD ST STE 200 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 62 ," 6,367 "," 6,888 "," $929,811.63 ",,
MEDICAID DIRECT,1568940013,MM HOME CARE LLC,MM HOME CARE,3905 OLEANDER DR STE 4 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,,1568940013,MM HOME CARE LLC,3905 OLEANDER DR STE 4 WILMINGTON NC,065,New Hanover,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 3,154 "," 3,331 "," $463,305.19 ",,
MEDICAID DIRECT,1568940013,MM HOME CARE LLC,MM HOME CARE,3816 BLAND RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1568940013,MM HOME CARE LLC,3816 BLAND RD   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 44 ," 5,754 "," 6,394 "," $839,000.09 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568940724,"PELLINGTON, AMBER, LILIA",1237 HARDING PL STE 4400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 75 , 104 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568940724,"PELLINGTON, AMBER, LILIA",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1568940724,"PELLINGTON, AMBER, LILIA",111 W GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568944411,"COBB, WILLIAM, EDWARD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 33 , 33 , 33 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1568944411,"COBB, WILLIAM, EDWARD",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1568944411,"COBB, WILLIAM, EDWARD",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1568947810,"PINERO, ERIC, LUIS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1063527794,JAMES J MAZUR DPM,JAMES J MAZUR DPM PA,322 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1568949915,"MARTINEZ-JONES, NATALIE, PATRICIA",322 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1063527794,JAMES J MAZUR DPM,JAMES J MAZUR DPM PA,322 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1568949915,"MARTINEZ-JONES, NATALIE, PATRICIA",322 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 43 , 73 , 76 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568949915,"MARTINEZ-JONES, NATALIE, PATRICIA",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 16 , 102 , 112 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568950079,"HUTTO, ALISSA, HARRIET MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 21 , 32 , 36 ,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568953149,"RENNINGER, MICHELLE, SUI",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568953149,"RENNINGER, MICHELLE, SUI",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568953149,"RENNINGER, MICHELLE, SUI",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1568953149,"RENNINGER, MICHELLE, SUI",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1952918948,MARY ELIZABETH STARNES HUFFMAN DDS,SOUTHERN FAMILY DENTISTRY,206 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1568954089,"TRAN HO, THU, NINA",206 S STERLING ST   MORGANTON NC,012,Burke,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 828 , 977 ," 3,777 "," $174,080.67 ",,
MEDICAID DIRECT,1669920609,DAVID E THOME DDS PLLC VII,DENVER PEDIATRIC DENTISTRY,275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1568954089,"TRAN HO, THU, NINA",275 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 104 , 107 , 365 ," $13,414.94 ",,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 27 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 23 , 33 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1568954741,"WHITE, MARLENA, CLAIRE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629037270,LAMOND FAMILY MEDICINE,,317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1568955771,"DEWING, MELISSA, PRISCILLA",317 N KING ST STE A HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 94 , 180 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568955912,"TROUT, ELIZABETH, JOYCE",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 36 , 57 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568955912,"TROUT, ELIZABETH, JOYCE",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568955912,"TROUT, ELIZABETH, JOYCE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568956084,"PILON, LAURENT",~,2741 CAMPUS WALK AVE BLDG 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,1568956084,"PILON, LAURENT",2741 CAMPUS WALK AVE BLDG 300 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568958007,"MIRACLE, ABIGAIL, JEAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1568958007,"MIRACLE, ABIGAIL, JEAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 45 , 46 ,$#,,
MEDICAID DIRECT,1265711956,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MCALISTER PEDIATRI,447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1568958122,"GOFORTH, MCCOY, SCOTT",447 MCALISTER RD STE 3300 LINCOLNTON NC,055,Lincoln,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 30 , 54 , 83 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568958122,"GOFORTH, MCCOY, SCOTT",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568958692,"TRIPLETT, HEATHER, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 43 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568966356,"PATE, NATALIE, PAGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568966877,"JOHNSON, NICHOLAS, ROBERT",2001 VAIL AVE STE 200A CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568968451,"EDER, LENA, VAYNBERG",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568968451,"EDER, LENA, VAYNBERG",2301 ERWIN RD   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568968451,"EDER, LENA, VAYNBERG",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 22 , 28 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568968485,"STANLEY, ELIZABETH, GIDDENS",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568968485,"STANLEY, ELIZABETH, GIDDENS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 77 , 84 , 87 ," $19,772.13 ",,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568968881,"KEY, GUNNAR, EASTON",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 67 , 157 , 194 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568968881,"KEY, GUNNAR, EASTON",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568969228,"MANEY, KAYLI, ALEXANDRA",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1568969228,"MANEY, KAYLI, ALEXANDRA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1568969228,"MANEY, KAYLI, ALEXANDRA",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 32 , 35 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1568969228,"MANEY, KAYLI, ALEXANDRA",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568969228,"MANEY, KAYLI, ALEXANDRA",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 25 , 26 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568969228,"MANEY, KAYLI, ALEXANDRA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568969988,"STOLLE, PATRICIA, B",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1568969988,"STOLLE, PATRICIA, B",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568970291,"PATEL, BANSARI, NAGESH",8201 HEALTHCARE LOOP STE 305 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1568970291,"PATEL, BANSARI, NAGESH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568971026,"FORDHAM, BRANDON, JAMES",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 122 , 245 , 295 ," $15,802.82 ",,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,4806 U ST NW   WASHINGTON DC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1568971083,"WILLIAMS-BOOKER, GAIL",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1568971083,"WILLIAMS-BOOKER, GAIL",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770337412,M MEDICAL NC PLLC,,17 CORNELIA ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1568971083,"WILLIAMS-BOOKER, GAIL",1995 E CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1770589368,CENTER FOR ORTHOTIC AND PROSTHETIC,Center for Orthotic and Prosthetic Care,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568971687,"KESSLER, JOSHUA, ROBERT",4702 CREEKSTONE DR   DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,,,$#,,
MEDICAID DIRECT,1144981366,REX HEALTHCARE INC,UNC HEALTH PROSTHETICS AND ORTHOTICS LLC,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1568971687,"KESSLER, JOSHUA, ROBERT",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568971810,"GREENBERG, GONI, KATZ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 36 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568971810,"GREENBERG, GONI, KATZ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 51 , 100 , 119 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568971810,"GREENBERG, GONI, KATZ",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1568972503,"ELLIOTT, RICHARD, RYLAND DOUGLAS",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193400000X,Group,Single Specialty,,1568972503,"ELLIOTT, RICHARD, RYLAND DOUGLAS",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093772410,ROBESON HEALTH CARE CORPORATION,MAXTON MEDICAL CENTER,610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1568972909,"SZIGEDI, AUDREY, DOMINIQUE",60 COMMERCE PLAZA CIR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568972982,"PENAFLOR, EDGAR, JUDE ARROYO",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568972982,"PENAFLOR, EDGAR, JUDE ARROYO",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568975985,FOCUS FAMILY CARE HOME INC,~,1020 E STAGECOACH TRL   LAWNDALE NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1568975985,FOCUS FAMILY CARE HOME INC,1020 E STAGECOACH TRL   LAWNDALE NC,023,Cleveland,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,947 "," 2,038 "," $120,211.53 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568977163,"KEPHART, KELSI, AUTUMN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568977577,"COLEMAN, ZACHARY, THOMAS",5935 CARNEGIE BLVD STE 104 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 24 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1568978526,"OGALE, MORGAN, KRISTEN",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1568978526,"OGALE, MORGAN, KRISTEN",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 24 , 59 ,$#,,
MEDICAID DIRECT,1255520862,LECHRIS HEALTH SYSTEMS OF NEW BERN,,233 MIDDLE ST STE 109 NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1568981538,"LAINO, JARED, MATTHEW",233 MIDDLE ST STE 109 NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 79 , 79 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568981702,"WORLEY, MICHELLE, LYNN",490 PINEVIEW DR STE A KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 69 , 103 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568982155,"MINHAS, AMJAD",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568982155,"MINHAS, AMJAD",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568985265,"MARTIN, ALLISON, CLARE",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1568985265,"MARTIN, ALLISON, CLARE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568985455,"SYKES, JENNA, BAKER",5815 BLAKENEY PARK DR STE 200B CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 26 , 77 ,$#,,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568987022,"GONZALEZ, SAUL",4815 BEREWICK TOWN CENTER DR STE I& CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 233 , 318 ," 1,323 "," $88,752.52 ",,
MEDICAID DIRECT,1942968078,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL CHARLOTTE STEELE CREEK,4815 BEREWICK TOWN CENTER DR STE I&J CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1568987022,"GONZALEZ, SAUL",4815 BEREWICK TOWN CENTER DR STE I& CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1568988939,"USEDOM, KATHRYN, LENHART",472 RANKIN DR   MARION NC,059,McDowell,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1568991222,"MCMICHAEL, BENJAMIN, DAVID",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 167 , 183 , 250 ," $12,315.85 ",,
MEDICAID DIRECT,1447911490,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-CHATHAM,40 RAMSEUR RD STE 102 PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1568991388,"REPINE, CLAIRE, MAIRE",40 RAMSEUR RD STE 102 PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 29 , 49 ,$#,,
MEDICAID DIRECT,1447911490,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-CHATHAM,40 RAMSEUR RD STE 102 PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1568991388,"REPINE, CLAIRE, MAIRE",200 E SALISBURY ST   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 34 ,$#,,
MEDICAID DIRECT,1851342141,CAROLINA WEST RADIOLOGY PA,Carolina West Radiology PA,87 EASTGATE DR STE 2 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1568993848,"VINSON, ANDREW, ROSS SHILLING",68 HOSPITAL RD   SYLVA NC,050,Jackson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 394 , 486 , 652 ," $11,191.88 ",,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1568993848,"VINSON, ANDREW, ROSS SHILLING",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1568197523,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE TEN TEN,7750 TEN TEN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568994093,"COSTELLO, SEAN, RYAN",7750 TEN TEN RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1568994093,"COSTELLO, SEAN, RYAN",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568994499,"SCHWABE, JOHN, ROBERT",2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568994499,"SCHWABE, JOHN, ROBERT",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568994499,"SCHWABE, JOHN, ROBERT",1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568994499,"SCHWABE, JOHN, ROBERT",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568994499,"SCHWABE, JOHN, ROBERT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1568994499,"SCHWABE, JOHN, ROBERT",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,, 79 , 120 , 161 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568994903,"BRADY, TIMOTHY, DONALD",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 13 , 32 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568994903,"BRADY, TIMOTHY, DONALD",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 16 , 32 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1568996130,"SMITH, KAYLA, HAUSS",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568996601,"BROWNLEE, AMY, JANELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568996601,"BROWNLEE, AMY, JANELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568996601,"BROWNLEE, AMY, JANELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568996601,"BROWNLEE, AMY, JANELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 59 , 59 , 101 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1568997492,"COCKERHAM, JODI, KATHERINE",107 MCLEOD HEALTH BLVD   MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1568997492,"COCKERHAM, JODI, KATHERINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 64 , 74 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1568997492,"COCKERHAM, JODI, KATHERINE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1568997740,"KASHYAP, AKANKSHA, SINGH",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 19 , 21 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1568997740,"KASHYAP, AKANKSHA, SINGH",208 COX BLVD STE 102 GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 73 , 174 , 253 ,$#,,
MEDICAID DIRECT,1093284010,MH ANGEL MEDICAL CENTER LLLP,,190 RIVERVIEW ST   FRANKLIN NC,056,Macon,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578000246,"COLBURN, KARLA, ROSS",190 RIVERVIEW ST   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578000774,"HALL, LINDSEY, ROSE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578002309,"POPE, AMY, PITTS",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578002309,"POPE, AMY, PITTS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 43 , 45 ,$#,,
MEDICAID DIRECT,1407036056,CAROMONT MEDICAL GROUP INC,CAROMONT GASTROENTEROLOGY AND HEPATOLOGY,2544 COURT DR STE G GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578005948,"CALDER, JESSICA, BRIDGES",2544 COURT DR STE G GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 74 , 74 ,$#,,
MEDICAID DIRECT,1447792148,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,401 ATTAIN ST STE 121 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1578007589,"THOSAR, KETKI, SATEESH",401 ATTAIN ST   FUQUAY VARINA NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1578009197,"SONNTAG, DANIEL, RAY",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1578009197,"SONNTAG, DANIEL, RAY",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1154475036,LANE & ASSOCIATES X DDS PA,~,407 TIFFANY DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1578012381,"PATEL, VAISHALIBEN, ASHOKKUMAR",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154475036,LANE & ASSOCIATES X DDS PA,~,407 TIFFANY DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1578012381,"PATEL, VAISHALIBEN, ASHOKKUMAR",1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,1223P0300X,Dental Providers,Dentist,Periodontics,#,#,#,$#,,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578015871,"SHAHANI, NUBLA, FATIMAH",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1144336587,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578015871,"SHAHANI, NUBLA, FATIMAH",5727 PROSPERITY CROSSING DR STE 2200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 119 , 204 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1578015871,"SHAHANI, NUBLA, FATIMAH",451 E CHARLOTTE AVE   MT HOLLY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578017307,"MACPHERSON, BRITTLYNN, ROSE",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578017521,"WROBLEWSKI, GENEVIEVE, CATHERINE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 32 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578017521,"WROBLEWSKI, GENEVIEVE, CATHERINE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578017521,"WROBLEWSKI, GENEVIEVE, CATHERINE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578020947,"SCHULZE, MALLORY, SHANNON",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 95 , 95 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578021085,"PARKER, DONNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 77 , 77 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1578021309,"KIM, CATHERINE, HONG",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1578021374,"MOLLENKAMP, SHELBY, TANNER",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1578021374,"MOLLENKAMP, SHELBY, TANNER",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578023115,"THOMPSON, FARRAH, RINK",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1922013457,CALDWELL MEMORIAL HOSPITAL,MULBERRY PEDIATRICS,906 COLLEGE AVE SW STE C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1578024311,"MALLES, AARON, STEVEN",906 COLLEGE AVE SW STE C LENOIR NC,014,Caldwell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 81 , 197 ,$#,,
MEDICAID DIRECT,1912919481,CHILDRENS HOSPITAL OF THE KINGS DAU,CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578025326,"CHRISTIAN, CAROLINE, AIMEE",817 VOLVO PKWY   CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1578025383,A NEW PATHWAY LLC,,1935 J N PEASE PL STE 102 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1578025383,A NEW PATHWAY LLC,1935 J N PEASE PL STE 102 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#," 1,114 "," 1,114 "," $72,998.08 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578027017,"LOCKE, CHARLES, STUART",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1578027017,"LOCKE, CHARLES, STUART",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578029062,"KRINGS, SHANA, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 94 , 95 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578035218,"HILL, ASHLEY, NICOLE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 154 , 154 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578035218,"HILL, ASHLEY, NICOLE",1509 DOCTORS CIRCLE BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578035770,"AUTH, MARISSA, GLORIE",505 OBERLIN RD   RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578035770,"AUTH, MARISSA, GLORIE",110 KILDAIRE PARK DR   CARY NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1578037073,FAMILY FIRST PHYSICAL THERAPY LLC,FAMILY FIRST THERAPY,19114 KANAWHA DR   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578037073,FAMILY FIRST PHYSICAL THERAPY LLC,19114 KANAWHA DR   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 65 ," 1,554 "," 1,563 "," $146,488.54 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578037099,"TINGEN, KATE, LAUKAITIS",6231 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578040143,"MCCALL, MICHAELA, ELDER",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 138 , 177 , 403 ," $11,409.39 ",,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1578040143,"MCCALL, MICHAELA, ELDER",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 36 , 98 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578040325,"MULDER, ERIN, BERK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578040325,"MULDER, ERIN, BERK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578041562,"MAMMEN, SUBY",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578041562,"MAMMEN, SUBY",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578042594,"REED, ASHLEY, WILKINS",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 60 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578044558,"FITZKO, SUE, ADKINS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 20 , 23 , 29 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578046942,"CUDJOE, AKUBA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578047312,"BURNHAM, ROBERT, COLIN",131 E MARKET ST   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578047312,"BURNHAM, ROBERT, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 100 , 199 , 200 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578047312,"BURNHAM, ROBERT, COLIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 122 , 123 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578048666,"SKEHAN, LEIGH, MARY",3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 28 , 36 , 40 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578048666,"SKEHAN, LEIGH, MARY",3480 WAKE FOREST RD STE 204 RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 716 ," 1,051 "," 3,575 "," $145,989.24 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 28 , 89 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 37 , 138 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 342 , 359 ," 1,781 "," $43,863.48 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 29 , 110 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 264 , 313 ," 1,077 "," $39,447.45 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578050001,"NEWMAN, HEATHER, ANN",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578050589,"REID, DAVID, SETTLE",2131 S. 17TH ST   CAPE FEAR NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 44 , 138 , 149 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578051009,"MEIER, JEREMY, ALLEN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 15 , 19 ,$#,,
MEDICAID DIRECT,1164526109,PIEDMONT HEALTH SERVICES INC,CARRBORO COMMUNITY HEALTH CENTER,301 LLOYD ST   CARRBORO NC,068,Orange,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578051454,"SCHETTINI, PRISCILLE",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 70 , 88 ," $15,363.66 ",,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578051454,"SCHETTINI, PRISCILLE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821192865,PIEDMONT HEALTH SERVICES INC,SILER CITY COMMUNITY HEALTH CENTER,224 S 10TH AVE   SILER CITY NC,019,Chatham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578051454,"SCHETTINI, PRISCILLE",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578051454,"SCHETTINI, PRISCILLE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154425890,PIEDMONT HEALTH SERVICES INC,PROSPECT HILL COMMUNITY HEALTH,322 MAIN ST   PROSPECT HILL NC,017,Caswell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578051454,"SCHETTINI, PRISCILLE",301 LLOYD ST   CARRBORO NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578051751,"BURKS, COLLIN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578051751,"BURKS, COLLIN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 20 , 21 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578051751,"BURKS, COLLIN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578051751,"BURKS, COLLIN, ELIZABETH",4220 N ROXBORO ST   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 11 , 17 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3300 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578051751,"BURKS, COLLIN, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578055679,"LEE, PAUL, HYUNGKWON",3600 NW CARY PKWY STE 105 CARY NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 20 ,$#,,
MEDICAID DIRECT,1770637779,K KEVIN NESHAT DDS MD PA,NU-IMAGE SURGICAL CENTER,8305 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578055679,"LEE, PAUL, HYUNGKWON",100 OSTERVILLE RD   HOLLY SPRINGS NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 11 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578057345,"ALLEN, LAUREN, GRANT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 52 , 75 , 75 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578057543,"ZHOU, XIAO, YI",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578057543,"ZHOU, XIAO, YI",2351 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578057543,"ZHOU, XIAO, YI",2301 ERWIN RD   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578057725,"REECE, BRITTANY, KURSTIN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578057725,"REECE, BRITTANY, KURSTIN",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578057725,"REECE, BRITTANY, KURSTIN",621 MICAVILLE LOOP STE 600 BURNSVILLE NC,100,Yancey,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1184705865,JOHNSTON PAIN MANAGEMENT,,250 HUFF DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578057824,"KARLE, SAMANTHA, LYNN",250 HUFF DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 28 , 30 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578057964,"GARCIA, SARA, FRANCES",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578057964,"GARCIA, SARA, FRANCES",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 32 , 55 ,$#,,
MEDICAID DIRECT,1023568995,RED MILL PEDIATRIC DENTISTRY AND BE,,2033 FISHER ARC STE 100 VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578059481,"DIFFEE, HILLARY, ANNE",1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 47 ,$#,,
MEDICAID DIRECT,1346613528,HAMPTON ROADS PEDIATRIC DENTISTRY,HANBURY PEDIATRIC DENTISTRY & BEHL ORTHODONTICS,1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578059481,"DIFFEE, HILLARY, ANNE",1933 EDWIN DR STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 148 , 158 , 675 ," $23,688.96 ",,
MEDICAID DIRECT,1174996359,HAMPTON ROADS PEDIATRIC DENTISTRY,FRIENDLY FACES PEDIATRIC DENTISTRY,446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578059481,"DIFFEE, HILLARY, ANNE",446 EFFINGHAM ST   PORTSMOUTH VA,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 30 , 157 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1578060208,"PARKER, CHARLES",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 35 , 35 , 48 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578060208,"PARKER, CHARLES",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578061065,"CALAMUSA, MEGAN, MARIE",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 116 , 116 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578061065,"CALAMUSA, MEGAN, MARIE",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578061065,"CALAMUSA, MEGAN, MARIE",125 QUEENS RD STE 640 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578061065,"CALAMUSA, MEGAN, MARIE",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578061065,"CALAMUSA, MEGAN, MARIE",14135 BALLANTYNE CORPORATE PL STE 200&160 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396020202,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH HOSPICE AND PALLIATIVE CARE PROFESSION,251 CAMPGROUND RD   WEST END NC,063,Moore,193200000X,Group,Multi-Specialty,,1578066973,"GRAHAM, HANNAH, RACHEL",809 S LONG DR STE H ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578067468,"KASPER, REBECCA, ELISABETH ENGELL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578067468,"KASPER, REBECCA, ELISABETH ENGELL",10030 EDISON SQUARE DR NW STE 100 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 26 , 33 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578068607,"RILEY, WENDY, POWELL",280 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578068607,"RILEY, WENDY, POWELL",9929 REA RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578068789,"MINOTT, KERRIANN, SEDONIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578068789,"MINOTT, KERRIANN, SEDONIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578068789,"MINOTT, KERRIANN, SEDONIE",2610 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 26 , 35 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578068789,"MINOTT, KERRIANN, SEDONIE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578069258,"WHITAKER, JASON, HESTLE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 114 , 350 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578069258,"WHITAKER, JASON, HESTLE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 32 , 57 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578069266,"TOLANI, KARISHMA, VIJAY",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578069266,"TOLANI, KARISHMA, VIJAY",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578069720,"BELLAMY, J, TAYLOR",180 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 35 , 45 , 75 ,$#,,
MEDICAID DIRECT,1578069779,ADVANCED BUSINESS CONCEPTS INC,CATAWBA VALLEY THERAPY SERVICES,409 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1578069779,ADVANCED BUSINESS CONCEPTS INC,409 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,, 26 , 484 , 500 ," $33,638.84 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578069878,"CLARK, MEGHAN, RUTH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 55 , 63 , 138 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578073219,"SHEHANE, ASHLEY, LYNN",742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578073631,IREDELL PHYSICIAN NETWORK,IREDELL AMBULATORY SURGERY CENTER,701 BRYANT ST   STATESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1578073631,IREDELL PHYSICIAN NETWORK,701 BRYANT ST   STATESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#, 11 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1578075206,"UM, MI-YOUNG",150 ROBESON ST   E FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1578075206,"UM, MI-YOUNG",150 ROBESON ST   E FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578075206,"UM, MI-YOUNG",150 ROBESON ST   E FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578075206,"UM, MI-YOUNG",7021 HARPS MILL RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578077780,"HARPOLE, LINDA",3475 ERWIN RD STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578077780,"HARPOLE, LINDA",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 24 , 44 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1578078895,"GREER, ZACHARY, CHAD",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578078895,"GREER, ZACHARY, CHAD",1927 3RD AVENUE LN SE   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 100 , 155 , 193 ,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578079356,"ROSE, BRIAN, PATRICK",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 192 , 313 , 337 ,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578079356,"ROSE, BRIAN, PATRICK",210 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 15 , 15 ,$#,,
MEDICAID DIRECT,1578080040,AGAPE SPEECH AND LANGUAGE SERVICES,AGAPE SPEECH AND LANGUAGE SERVICES PLLC,3405 QUARTERHORSE CT   SUMMERFIELD NC,041,Guilford,193400000X,Group,Single Specialty,,1578080040,AGAPE SPEECH AND LANGUAGE SERVICES,3405 QUARTERHORSE CT   SUMMERFIELD NC,041,Guilford,193400000X,Group,Single Specialty,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1578080578,"SHIVERS, NADINE, STACY",2909 MARKET ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 108 , 273 , 291 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1578080578,"SHIVERS, NADINE, STACY",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 42 , 74 , 92 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1578080578,"SHIVERS, NADINE, STACY",20 MEDICAL CAMPUS DR NW STE 207 SUPPLY NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 111 , 437 , 459 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1578080578,"SHIVERS, NADINE, STACY",2149 VALLEYGATE DR STE 201 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1578080578,"SHIVERS, NADINE, STACY",3145 HENDERSON DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1578080578,"SHIVERS, NADINE, STACY",610 N FAYETTEVILLE ST STE 106 ASHEBORO NC,076,Randolph,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1578080578,"SHIVERS, NADINE, STACY",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 177 , 198 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578081501,"SCHMIDTKE, SAMANTHA, LEANN",2400 PRATT ST STE 110 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578081501,"SCHMIDTKE, SAMANTHA, LEANN",30 DUKE MEDICINE CIR DUKE SOUTH WHITE ZONE ROOM 25153 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578082905,"BOVA, MARGARET, FAYE",4207 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578082905,"BOVA, MARGARET, FAYE",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1578083283,"GUILFORD, PATRICIA, TURNER",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1578083283,"GUILFORD, PATRICIA, TURNER",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1578083283,"GUILFORD, PATRICIA, TURNER",730 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578083358,"D ANNIBALE, MELISSA, JEAN SCINTO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578083697,"SHRESTHA, RHISTI",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578083697,"SHRESTHA, RHISTI",7030 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790283844,NAOMI LANE DDS PA,,2600 OAKCREST AVE STE A GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1578083788,"MACDONALD, JENNIFER, HALLEY",2600 OAKCREST AVE STE A GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,898 "," 2,396 "," 8,950 "," $333,655.55 ",,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578084802,"LOMAS, JESSICA, ANNE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 55 , 55 ,$#,,
MEDICAID DIRECT,1710586581,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 200 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1578084927,"JACKSON, NICOLE, ETTA",1690 US HIGHWAY 1 S STE 200 SOUTHERN PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 80 , 152 , 268 ,$#,,
MEDICAID DIRECT,1710586581,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 200 SOUTHERN PINES NC,063,Moore,193400000X,Group,Single Specialty,,1578084927,"JACKSON, NICOLE, ETTA",3349 US 1 HWY   VASS NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 36 , 67 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578086179,"LIGHT, ALYSSA, BASEN",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578086179,"LIGHT, ALYSSA, BASEN",1350 WHITAKER RIDGE DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 88 , 211 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578087151,"WILSON, CAMERON, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578087151,"WILSON, CAMERON, JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 20 , 22 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578087151,"WILSON, CAMERON, JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1578090858,"SHERROD, KRYSTEN, ELIZABETH",180 PARKWOOD DR   ELKIN NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 81 , 89 , 118 ,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1578094348,"HOOVER, KRISTIN, ELIZABETH",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578095428,"RING, JOSHUA, GARRETT",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 184 , 193 , 213 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578095550,"ZEB, MUHAMMAD, WALEED",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 28 , 95 , 98 ," $10,904.80 ",,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,300 MED TECH PKWY   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578096632,"MATTESON, JESSE, JEFFREY",2030 TEMPLE HILL RD   ERWIN TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932485943,DLP MARIA PARHAM PHYSICIAN PRACTICE,MARIA PARHAM SURGICAL ASSOCIATES,120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1578096681,"MCLEOD, MORGAN, AINSLEY",120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578096681,"MCLEOD, MORGAN, AINSLEY",120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578096681,"MCLEOD, MORGAN, AINSLEY",120 CHARLES ROLLINS RD STE 206 HENDERSON NC,091,Vance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578098091,"LI, MENG",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 21 , 48 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578098091,"LI, MENG",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 46 , 48 ,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578098091,"LI, MENG",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578098232,"MOTTESHEARD, COREY, SCOTT",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578098232,"MOTTESHEARD, COREY, SCOTT",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 30 , 58 ,$#,,
MEDICAID DIRECT,1396845004,PHOENIX COUNSELING CENTER,~,510 S ASPEN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1578098620,"PANEK, LINDSAY, NICOLE",1530 UNION RD STE A GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578103081,RJR KALLI LLC,RJR KALLI HEALTHCARE,206 W ASH ST # A GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1578103081,RJR KALLI LLC,206 W ASH ST # A GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1255507737,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES ELIZABE,300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578110482,"GOODEN, STEPHANIE, HAYS",300A E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 139 , 333 , 336 ," $16,802.20 ",,
MEDICAID DIRECT,1114193695,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN MEDICAL ASSOCIATES DUBLIN,16 3RD ST   DUBLIN NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578110482,"GOODEN, STEPHANIE, HAYS",16 3RD ST   DUBLIN NC,009,Bladen,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578112579,ASCEND REHAB THERAPY PLLC,,45 WATERPINE DR   GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1578112579,ASCEND REHAB THERAPY PLLC,45 WATERPINE DR   GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,#, 143 , 143 ,$#,,
MEDICAID DIRECT,1740904895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE HORNER,3110 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1578112959,"TILLMAN, KELLI, MARIE BAKER",1411 GREENWAY CT   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740904895,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE HORNER,3110 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1578112959,"TILLMAN, KELLI, MARIE BAKER",3110 S HORNER BLVD   SANFORD NC,053,Lee,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 66 , 161 ,$#,,
MEDICAID DIRECT,1942975776,OBRIEN AND WEST DMD XI PLLC,NIGHT AND DAY DENTAL,532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578113965,"VINH, MINH-KHA, BAO",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 499 , 922 ," 2,700 "," $195,274.83 ",,
MEDICAID DIRECT,1942975776,OBRIEN AND WEST DMD XI PLLC,NIGHT AND DAY DENTAL,532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578113965,"VINH, MINH-KHA, BAO",452 SHOTWELL RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750871562,OBRIEN AND WEST DMD V PLLC,~,452 SHOTWELL RD   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578113965,"VINH, MINH-KHA, BAO",452 SHOTWELL RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1942975776,OBRIEN AND WEST DMD XI PLLC,NIGHT AND DAY DENTAL,532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578113965,"VINH, MINH-KHA, BAO",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578113965,"VINH, MINH-KHA, BAO",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 233 , 307 , 929 ," $59,340.54 ",,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1578113965,"VINH, MINH-KHA, BAO",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578114914,GAHC3 MOORESVILLE NC TRS SUB LLC,CADENCE MOORESVILLE,198 E WATERLYNN RD   MOORESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578114914,GAHC3 MOORESVILLE NC TRS SUB LLC,198 E WATERLYNN RD   MOORESVILLE NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 317 , 317 ," $32,355.72 ",,
MEDICAID DIRECT,1285275305,CHEROKEE MEDICAL CENTER,CMC - IMMEDIATE CARE CENTER - GAFFNEY,840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578116943,"REYNOLDS, MARK, W",840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902447022,CHEROKEE MEDICAL CENTER,CMC - IMMEDIATE CARE CENTER - GAFFNEY,840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578116943,"REYNOLDS, MARK, W",840 W FLOYD BAKER BLVD   GAFFNEY SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780900589,DAVID E GALATAS DDS PA,CAMERON FAMILY DENTISTRY,1054 NC 24/87   CAMERON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1578123337,"CONNELL, JEFFREY, DAVID",1054 NC 24-87   CAMERON NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 336 , 520 ," 1,972 "," $113,120.78 ",,
MEDICAID DIRECT,1255054623,ASHE MULTISPECIALTY GROUP LLC,ASHE WOMEN AND CHILDRENS HEALTH,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1578123956,"CARDOZO GALLAGHER, FABIOLA, COROMOTO",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 21 , 35 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578125019,"BERRY, MARY ANNE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 16 , 24 ,$#,,
MEDICAID DIRECT,1326748815,BERRY PERSONALIZED PRIMARY CARE LLC,,704 MAIN ST   GATESVILLE NC,037,Gates,193400000X,Group,Single Specialty,,1578125019,"BERRY, MARY ANNE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1326748815,BERRY PERSONALIZED PRIMARY CARE LLC,,4 GATES BANK RD   GATES NC,037,Gates,193200000X,Group,Multi-Specialty,,1578125019,"BERRY, MARY ANNE",4 GATES BANK RD   GATES NC,037,Gates,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1326748815,BERRY PERSONALIZED PRIMARY CARE LLC,,4 GATES BANK RD   GATES NC,037,Gates,193400000X,Group,Single Specialty,,1578125019,"BERRY, MARY ANNE",4 GATES BANK RD   GATES NC,037,Gates,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1326748815,BERRY PERSONALIZED PRIMARY CARE LLC,,106 PAIGE RIDDICK RD   GATES NC,037,Gates,193400000X,Group,Single Specialty,,1578125019,"BERRY, MARY ANNE",4 GATES BANK RD   GATES NC,037,Gates,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578126892,"BAHRAINI, SARAH, ANN",931 3RD ST   GREENSBORO NC,041,Guilford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578127809,"MARTINEZ, JOSE, CARLOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#, 38 , 50 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578128419,"QUATTLEBAUM, ALEXANDER, MERITT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578128419,"QUATTLEBAUM, ALEXANDER, MERITT",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578128419,"QUATTLEBAUM, ALEXANDER, MERITT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 36 , 38 , 38 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1578129151,"WARD, TAMMY, GRAVES",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1578129151,"WARD, TAMMY, GRAVES",929 N 2ND ST   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578129318,"WILLIS, LEAH, NIXON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 201 , 201 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578132221,"CLARK, CAROLINE, ASHTON",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578132221,"CLARK, CAROLINE, ASHTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578132221,"CLARK, CAROLINE, ASHTON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1659673838,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT SENIOR CARE,1309 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578132908,"FARGO, AMY, ELIZABETH",1309 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 12 , 21 , 27 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578134656,"SRIDHARAN, SAIJANAKAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 130 , 130 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1578134656,"SRIDHARAN, SAIJANAKAN",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 56 , 56 ,$#,,
MEDICAID DIRECT,1861451437,NEWTON FAMILY PHYSICIANS,~,767 W 1ST ST   NEWTON NC,018,Catawba,193400000X,Group,Single Specialty,,1578134854,"BRUMLEY, JESSICA, STORY",767 W 1ST ST   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 37 , 88 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578140166,"BUTLER, KAITLYNN, ELIZABETH",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578140166,"BUTLER, KAITLYNN, ELIZABETH",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962737452,MCPC-2 LLC,FIRSTHEALTH RICHMOND MEDICAL GROUP INTERNAL MEDICI,809 S LONG DR STE H ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1578142543,"BRIGMAN-WALLACE, TAMMY, LYNN",809 S LONG DR STE H ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 106 , 262 , 446 ,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,072 "," 3,253 "," 3,870 "," $575,069.32 ",,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 221 , 288 , 413 ," $77,220.44 ",,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578142584,"STARKS, SHEILLA, MAGALY",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 165 , 218 , 218 ," $22,342.08 ",,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578142857,"LANE, TANNHYA, LYNDSEY",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578142857,"LANE, TANNHYA, LYNDSEY",6371 JESSIE LN   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 16 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578142949,"ZEITANY, ALANA, MARIE",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 54 , 58 ,$#,,
MEDICAID DIRECT,1912324740,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-ARDEN,303 AIRPORT RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578143251,"WEEMS, AMELIE, HARRISON",303 AIRPORT RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578143251,"WEEMS, AMELIE, HARRISON",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 43 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578143962,"AMENDOLA, JULIE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578143962,"AMENDOLA, JULIE, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578144747,ELEVATION REHAB LLC,~,3420 HOLLOWAY ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1578144747,ELEVATION REHAB LLC,3420 HOLLOWAY ST   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1013956150,"KELLY, MICHAEL, WALKER",~,8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1578147922,"KLINGLER, LINUS",11009 INGLESIDE PL STE 104 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1013956150,"KELLY, MICHAEL, WALKER",~,8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,1578147922,"KLINGLER, LINUS",8851 ELLSTREE LN STE 200 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578151031,"COLLMAR, KEVIN, RICHARD",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 93 , 165 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578151031,"COLLMAR, KEVIN, RICHARD",144 FOREST HILL RD STE 144&146 LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 29 , 57 ,$#,,
MEDICAID DIRECT,1578152021,HEALTHY TOUCH HOMECARE LLC,HEALTHY TOUCH HOMECARE LLC,1525 E MARION ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1578152021,HEALTHY TOUCH HOMECARE LLC,1525 E MARION ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 113 ," 18,445 "," 18,491 "," $1,475,158.96 ",,
MEDICAID DIRECT,1578152021,HEALTHY TOUCH HOMECARE LLC,HEALTHY TOUCH HOMECARE LLC,418 S SOUTH ST UNIT 2 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1578152021,HEALTHY TOUCH HOMECARE LLC,418 S SOUTH ST UNIT 2 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 2,409 "," 2,414 "," $197,818.79 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5000 GLENHOPE CT   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578154043,"SNEED, MEGAN, ELIZABETH",5000 GLENHOPE CT   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578154043,"SNEED, MEGAN, ELIZABETH",5000 GLENHOPE CT   CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1487244943,FAMILY RESOURCES OF RUTHERFORD COUN,,331 S BROADWAY ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1578156782,"PENDLETON, DIANNA, MARIE",331 S BROADWAY ST   FOREST CITY NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578157624,PROFESSIONAL TOUCH HOME CARE LLC,PROFESSIONAL TOUCH HOME CARE,1451 S ELM EUGENE ST STE 3105 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1578157624,PROFESSIONAL TOUCH HOME CARE LLC,1451 S ELM EUGENE ST STE 3105 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 159 , 159 ," $13,088.16 ",,
MEDICAID DIRECT,1578157624,PROFESSIONAL TOUCH HOME CARE LLC,PROFESSIONAL TOUCH HOME CARE,1451 S ELM EUGENE ST STE 2309 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1578157624,PROFESSIONAL TOUCH HOME CARE LLC,1451 S ELM EUGENE ST STE 2309 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 626 , 626 ," $49,984.52 ",,
MEDICAID DIRECT,1164657532,KIDZCARE PEDIATRICS PC,~,5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578158895,"CORRALES, CARLOS, MIGUEL",5335 YADKIN RD   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1881877793,ANESTHESIA CONSULTANTS OF AUGUSTA,,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1578159372,"PEEBLES, BRIAN, DORSEY",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578163259,"BELTON, SYDNEY, ANNE",211 S CENTENNIAL ST   HIGH POINT NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578163838,"NARIGON, KARA, JEAN",190 KIMEL PARK DR STE 155 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 23 , 44 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578163838,"NARIGON, KARA, JEAN",865 W LAKE DR STE 200 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 78 , 164 , 321 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578163838,"NARIGON, KARA, JEAN",933 ROCKFORD ST STE 2 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1407937972,ROSEDALE INFECTIOUS DISEASES PLLC,~,103 COMMERCE CENTRE DR STE 103 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578166443,"DAWSON-TRIPODIS, THOMAS, LEYLAND",103 COMMERCE CENTRE DR STE 103 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407937972,ROSEDALE INFECTIOUS DISEASES PLLC,~,103 COMMERCE CENTRE DR STE 103 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578166443,"DAWSON-TRIPODIS, THOMAS, LEYLAND",103 COMMERCE CENTRE DR STE 103 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1578171260,"REYNOLDS, MATHEW, MAZO",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 33 , 80 ,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,105 N CRUTCHFIELD ST   DOBSON NC,086,Surry,193400000X,Group,Single Specialty,,1578171260,"REYNOLDS, MATHEW, MAZO",105 N CRUTCHFIELD ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578172169,"PARKS, AMBER, NICOLE",6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 50 , 54 ,$#,,
MEDICAID DIRECT,1790739571,"WILLIAM D HUNTER MD PA, WILLIAM",~,2555 COURT DR STE 400 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578172748,"SPIKES, TEMESHIA, LASHA",2555 COURT DR STE 400 GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 95 , 177 , 193 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578173902,"GOYAL, PAYAL",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,6620 OLD STATESVILLE RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578173902,"GOYAL, PAYAL",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578173902,"GOYAL, PAYAL",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 36 , 37 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578173902,"GOYAL, PAYAL",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 19 , 21 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578173902,"GOYAL, PAYAL",9800 KINCEY AVE STE 150 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1578174306,"KARRI, MANOZNA",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 44 , 44 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578177903,"PELUSO, MARIA, ROSE",2025 FRONTIS PLAZA BLVD STE 100 WINSTON SALEM NC,034,Forsyth,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1578180006,"MOCK, LOGAN, TRENT",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578180006,"MOCK, LOGAN, TRENT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1851355390,SOUTHEASTERN RADIATION ONCOLOGY,,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1578180006,"MOCK, LOGAN, TRENT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245661701,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV CANCER CENTER AT HPN,6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578180006,"MOCK, LOGAN, TRENT",6387 RAMSEY ST UNIT 140 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 89 , 89 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1578182390,"JONES, TERRELL, JAMAR",601 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 33 , 33 , 34 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578182390,"JONES, TERRELL, JAMAR",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 30 , 37 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578182390,"JONES, TERRELL, JAMAR",601 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 24 , 31 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578182390,"JONES, TERRELL, JAMAR",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417061011,ABC PEDIATRICS OF DUNN PA,~,104 TILGHMAN DR   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1578183679,"DARKOW, KAYLA, RANDALL",104 TILGHMAN DR   DUNN NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 72 , 237 ,$#,,
MEDICAID DIRECT,1598467813,EMILY B WHEELER MALTBA DMD PLLC,,54 BROAD ST   SPRUCE PINE NC,061,Mitchell,193400000X,Group,Single Specialty,,1578184347,"WHEELER MALTBA, EMILY, BROOKE",54 BROAD ST   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 90 , 249 ," $10,680.72 ",,
MEDICAID DIRECT,1689372187,SURRY MEDICAL MINISTRIES FOUNDATION,SURRY MEDICAL MINISTRIES FOUNDATION INC,951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578186110,"KING, JESSICA, RAE",951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1689372187,SURRY MEDICAL MINISTRIES FOUNDATION,SURRY MEDICAL MINISTRIES FOUNDATION INC,951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578186110,"KING, JESSICA, RAE",951 ROCKFORD ST   MOUNT AIRY NC,086,Surry,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578186581,"STOUT, JANICE, MCSHANE",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578190096,"GIBBONS, ERICA, LEANNE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578190096,"GIBBONS, ERICA, LEANNE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578190096,"GIBBONS, ERICA, LEANNE",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578191052,"ENGBERG, ADAM, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 30 , 54 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578196119,"WATKINS, JARED, LYLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578196119,"WATKINS, JARED, LYLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578198115,"EMBORGO, TRISHA, SOFIA GALICIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578199865,"BOSWELL, MADISON, WHITLOCK",2001 TODAYS WOMAN AVE   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 24 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578200630,"CHADA, CHRISTINA, MARIE",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578200630,"CHADA, CHRISTINA, MARIE",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578201794,"RANSOM, RILEY, MANON",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578202990,"PLEMMONS, KARA, MICHELLE",316 NC HIGHWAY 801 S   ADVANCE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 50 , 50 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578202990,"PLEMMONS, KARA, MICHELLE",316 NC HIGHWAY 801 S   ADVANCE NC,030,Davie,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 158 , 161 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578202990,"PLEMMONS, KARA, MICHELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 214 , 216 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578202990,"PLEMMONS, KARA, MICHELLE",4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578202990,"PLEMMONS, KARA, MICHELLE",903 W MAIN ST   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578202990,"PLEMMONS, KARA, MICHELLE",903 W MAIN ST   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 83 , 83 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578208245,"WHITTED, ALEXANDRIA, LAURELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 24 , 24 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578208245,"WHITTED, ALEXANDRIA, LAURELLE",2801 BLUE RIDGE RD   RALEIGH NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#, 16 ,$#,,
MEDICAID DIRECT,1578208955,INNOVATIVE TRANSITIONAL CARE INC,SYNERGY HOMECARE OF GASTONIA,609 S NEW HOPE RD STE 200B GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1578208955,INNOVATIVE TRANSITIONAL CARE INC,609 S NEW HOPE RD STE 200B GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#, 940 , 940 ," $100,521.36 ",,
MEDICAID DIRECT,1225445331,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - THOMASVILLE,611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578209813,"PUGH, CANDICE, NICOLE",2668 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578210498,"WITCHER, FELISHA, SOMERS",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578210498,"WITCHER, FELISHA, SOMERS",3800 INDEPENDENCE BLVD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 54 , 54 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1578210928,"MOSS, CRYSTAL, MARIE",2041 WILLOW RD   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1578210928,"MOSS, CRYSTAL, MARIE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 45 , 469 , 469 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578210928,"MOSS, CRYSTAL, MARIE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 30 , 30 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1578210928,"MOSS, CRYSTAL, MARIE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 95 , 95 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578214045,"KITTLE, KELLY, MADISON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 17 , 44 , 44 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578216222,"NELSON, MKAYLA, BROOKE",621 MICAVILLE LOOP STE 600 BURNSVILLE NC,100,Yancey,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578216222,"NELSON, MKAYLA, BROOKE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 51 , 51 ," $12,808.14 ",,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578216222,"NELSON, MKAYLA, BROOKE",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578226387,"VASQUEZ, NICO, EDWARD",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 38 , 93 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1578227930,"SMITH, FOWLER, RICHARDS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578227930,"SMITH, FOWLER, RICHARDS",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578227930,"SMITH, FOWLER, RICHARDS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 31 , 36 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578231296,"WILLIAMS, CAREY, REBECCA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578231296,"WILLIAMS, CAREY, REBECCA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578233466,"LITTLE, DESIREE', LASHON",1760 E DIXON BLVD   SHELBY NC,023,Cleveland,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578235453,"BROUSSEAU, BREANNA, JORDAN",1124 GALLERY PARK LN STE 103 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578235453,"BROUSSEAU, BREANNA, JORDAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 120 , 217 ,$#,,
MEDICAID DIRECT,1578235693,HARRISONS CARING HANDS 2,,538 WARRINER ST   REIDSVILLE NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578235693,HARRISONS CARING HANDS 2,538 WARRINER ST   REIDSVILLE NC,079,Rockingham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 873 , 917 ," $92,038.08 ",,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1578239042,"BRINGLE, KELLY, WEEKS",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 29 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578240529,"LOONEY, MORGAN, ELIZABETH",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578240529,"LOONEY, MORGAN, ELIZABETH",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 20 , 25 , 36 ,$#,,
MEDICAID DIRECT,1477729952,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN WOMENS HEALTH SPECIALISTS,300F E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1578240644,"GRAHAM JONES, ASHLEY, ANN",300F E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 31 ,$#,,
MEDICAID DIRECT,1477729952,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BLADEN WOMENS HEALTH SPECIALISTS,300F E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1578240644,"GRAHAM JONES, ASHLEY, ANN",300F E MCKAY ST   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 27 , 41 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1578240982,"OWENS, KAITLIN, MARIE",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578240982,"OWENS, KAITLIN, MARIE",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1578240982,"OWENS, KAITLIN, MARIE",212 THOMPSON ST STE A HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,193400000X,Group,Single Specialty,,1578240982,"OWENS, KAITLIN, MARIE",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518971910,HENDERSON COUNTY URGENT CARE CENTER,PARDEE URGENT CARE FOUR SEASONS,45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,193400000X,Group,Single Specialty,,1578240982,"OWENS, KAITLIN, MARIE",45 HENDERSONVILLE HWY STE A PISGAH FOREST NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578827507,BLUE RIDGE COMMUNITY HEALTH SERVICE,BREVARD HEALTH CENTER,29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578240982,"OWENS, KAITLIN, MARIE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 87 , 117 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578240982,"OWENS, KAITLIN, MARIE",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578241048,"STEVENS, TERRY, JAMES",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578241048,"STEVENS, TERRY, JAMES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578241048,"STEVENS, TERRY, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,700 WALTER REED DR   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578241048,"STEVENS, TERRY, JAMES",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578244208,"SHEMWELL, SHALICIA, CAPRICE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578244208,"SHEMWELL, SHALICIA, CAPRICE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578244208,"SHEMWELL, SHALICIA, CAPRICE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578245783,"WATTS, LOREN, SIMONE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578245783,"WATTS, LOREN, SIMONE",4796 OLD TAR RD   WINTERVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699102012,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE NORTHEAST OBGYN,2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578248407,"LITTLE, KATHERINE, BETH",2101 SHILOH CHURCH RD STE 202 DAVIDSON NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578248589,"MAKSIMTSOV, ANDREY, SEGEEVICH",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1578248589,"MAKSIMTSOV, ANDREY, SEGEEVICH",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1578248589,"MAKSIMTSOV, ANDREY, SEGEEVICH",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 27 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1578248589,"MAKSIMTSOV, ANDREY, SEGEEVICH",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1760824700,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1578249769,"RIDGEWAY, LAUREN, RHONEY",1124 N WASHINGTON ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 86 , 139 , 223 ,$#,,
MEDICAID DIRECT,1679915615,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE SHELBY FAMILY MEDICINE,708 MCBRAYER HOMESTEAD RD   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1578249769,"RIDGEWAY, LAUREN, RHONEY",708 MCBRAYER HOMESTEAD RD   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1447829726,DRS REIMELS AND RONCAGLIONE PLLC,,9115 SAMLEN LN APT 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578255956,"TRUONG, ANDY, MINH",9115 SAMLEN LN STE 105 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 1,082 "," 1,836 "," 7,577 "," $429,416.97 ",,
MEDICAID DIRECT,1902963937,WHITEVILLE MEDICAL ASSOCIATES PA,WHITEVILLE MEDICAL ASSOCIATES PA,823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1578256350,"CAISON, KATIE, LYNN",823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 146 , 405 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578266425,"SHIELDS, GREGORY, MCLELLAND",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 22 , 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578266425,"SHIELDS, GREGORY, MCLELLAND",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578266425,"SHIELDS, GREGORY, MCLELLAND",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 58 , 113 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578267571,"WALSH, SARA, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 168 , 168 ,$#,,
MEDICAID DIRECT,1578275939,ANN VIRGINIA HOME CARE AGENCY,ANN VIRGINIA HOME CARE AGENCY,2717 WESTERN BYP STE 120 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1578275939,ANN VIRGINIA HOME CARE AGENCY,2717 WESTERN BYP STE 120 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1710209473,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LINCOLNTON,212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578276077,"MCMILLAN, BRANDY, NICOLE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 25 , 28 , 28 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578276077,"MCMILLAN, BRANDY, NICOLE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1467123091,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA BEHAVIORAL HEALTH - HICKORY,858 2ND ST NE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578276077,"MCMILLAN, BRANDY, NICOLE",212 GAMBLE DR   LINCOLNTON NC,055,Lincoln,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 22 , 30 , 37 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578282844,"VOLLANO, ERICA, LEE",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578282844,"VOLLANO, ERICA, LEE",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578282844,"VOLLANO, ERICA, LEE",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578282844,"VOLLANO, ERICA, LEE",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578282844,"VOLLANO, ERICA, LEE",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 21 , 94 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578282844,"VOLLANO, ERICA, LEE",146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 56 , 103 ,$#,,
MEDICAID DIRECT,1821112665,CAROLINAS REHABILITATION,~,1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578292124,"LINDBERG, KATHARINE, ELIZABETH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 12 ,$#,,
MEDICAID DIRECT,1861147829,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - KINGS MOUNTAIN WEST,812 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578294583,"FREEMAN, ROBERT, KEVIN",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1699471839,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY - DIXON BLVD,1758 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578294583,"FREEMAN, ROBERT, KEVIN",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,, 33 , 258 , 258 ," $11,971.91 ",,
MEDICAID DIRECT,1043963564,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - FALLSTON,5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578294583,"FREEMAN, ROBERT, KEVIN",5009 FALLSTON RD   LAWNDALE NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1710549118,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT TRYON ELEMENTARY,2620 TRYON COURTHOUSE RD   BESSEMER CITY NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578295804,"KEYSER, VIVIANNE, NICOLE",2620 TRYON COURTHOUSE RD   BESSEMER CITY NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 41 , 41 ," $13,133.53 ",,
MEDICAID DIRECT,1639607153,SPINE & PAIN ASSOCIATES PLLC,,1303 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1578311643,"CROW, ANA, N",1303 CARTHAGE ST   SANFORD NC,053,Lee,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 42 , 144 , 261 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578314985,"COLE, MORGAN, EMILY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578317368,PARTNERS IN CARE LLC,,101 FOREST RD STE C PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,,1578317368,PARTNERS IN CARE LLC,101 FOREST RD STE C PLYMOUTH NC,094,Washington,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 1,766 "," 2,083 "," $174,495.44 ",,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1578317442,"SERRANO, RAQUEL",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1578317442,"SERRANO, RAQUEL",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1578317442,"SERRANO, RAQUEL",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 24 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1578317442,"SERRANO, RAQUEL",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780014761,CAROLINA CHILD NEUROLOGY,CAROLINA CHILD NEUROLOGY PLLC1,1540 PURDUE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1578320644,"LAZO, MAEGAN",1540 PURDUE DR STE 101 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,5010 SOUTHPORT CROSSING WAY   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1578329496,"GOODNIGHT, OLIVIA, MARIE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578329496,"GOODNIGHT, OLIVIA, MARIE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1578329496,"GOODNIGHT, OLIVIA, MARIE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 35 ,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1578329496,"GOODNIGHT, OLIVIA, MARIE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1578331799,"MACFIE, AMANDA, EMELYN",1272 EAST ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 26 , 58 , 80 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1578331799,"MACFIE, AMANDA, EMELYN",1272 EAST ST   WAYNESVILLE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 151 , 236 ,$#,,
MEDICAID DIRECT,1578336533,VISION BEYOND HOME CARE SERVICES,,1530 EVANS ST STE 205 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1578336533,VISION BEYOND HOME CARE SERVICES,1530 EVANS ST STE 205 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 822 , 822 ," $48,407.12 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578339834,"OVERTURF, JACKSON, LONNIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578339834,"OVERTURF, JACKSON, LONNIE",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578339834,"OVERTURF, JACKSON, LONNIE",3518 DRAWBRIDGE PKWY STE 240 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578339834,"OVERTURF, JACKSON, LONNIE",3518 DRAWBRIDGE PKWY STE 240 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 59 , 87 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578339834,"OVERTURF, JACKSON, LONNIE",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1578344644,"MOYA, MARTIN, PEDRO",300 W 27TH ST   LUMBERTON NC,078,Robeson,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 57 , 57 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1578349619,"DUNNIGAN, NICOLE, MARIE",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578349619,"DUNNIGAN, NICOLE, MARIE",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1578349619,"DUNNIGAN, NICOLE, MARIE",1630 MILITARY CUTOFF RD STE 108 WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1578349619,"DUNNIGAN, NICOLE, MARIE",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578364915,"BECKHAM, RACHEL, GEORGIA",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578364915,"BECKHAM, RACHEL, GEORGIA",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578373650,"LANE, KATIE, ELIZABETH",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578387437,"JONES-BARNETT, KHADENE, ASHA-MARIE",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578392221,"THAKEL, DAHVINA",911 W HENDERSON ST KISER BLDG STE 410 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578399010,"MCCAIN, STEPHANIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578500617,"SALLAS, RONALD, KIRKLAND",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578500617,"SALLAS, RONALD, KIRKLAND",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578500641,"SASS, LAURA, ANN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0208X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Infectious Diseases,#,#,#,$#,,
MEDICAID DIRECT,1578501490,NEWPORT FIRE DEPARTMENT,NEWPORT FIRE DEPARTMENT,125 HOWARD BLVD   NEWPORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1578501490,NEWPORT FIRE DEPARTMENT,125 HOWARD BLVD   NEWPORT NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport, 99 , 178 , 331 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578501813,"FALK, STEVEN, MURRAY",2719 NEUSE BLVD STE B NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578501813,"FALK, STEVEN, MURRAY",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578501813,"FALK, STEVEN, MURRAY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 35 , 37 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578501813,"FALK, STEVEN, MURRAY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 30 , 33 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578501813,"FALK, STEVEN, MURRAY",100 AIRPORT RD   KINSTON NC,054,Lenoir,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 80 , 90 , 94 ,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578502597,"DARR, THEODORE, LOUIS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578502597,"DARR, THEODORE, LOUIS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578503645,"MATZKO, JOHN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 82 , 84 , 119 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578503645,"MATZKO, JOHN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 197 , 205 , 250 ,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1578503868,"TAYLOR, JENNIFER, HUNNICUTT",1700 ASHEVILLE HWY   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 52 , 74 ,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1578503868,"TAYLOR, JENNIFER, HUNNICUTT",1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 26 , 42 ,$#,,
MEDICAID DIRECT,1396926507,FOREST DERMATOLOGY PA,~,2315 ASHEVILLE HWY STE 30 HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1578503868,"TAYLOR, JENNIFER, HUNNICUTT",1119 HENDERSONVILLE RD STE 200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1578504106,"LIPPE, CRAIG, NATHAN",701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 188 , 396 , 786 ,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1578504106,"LIPPE, CRAIG, NATHAN",612 JEFFERSON ST STE 16 WHITEVILLE NC,024,Columbus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 42 , 80 ,$#,,
MEDICAID DIRECT,1790224962,COLUMBUS REGIONAL HEALTH NETWORK,ADVANCED ORTHOPEDICS,701 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1578504106,"LIPPE, CRAIG, NATHAN",1717 SHIPYARD BLVD STE 350 WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 36 , 45 , 52 ,$#,,
MEDICAID DIRECT,1245204494,CAPE FEAR ORTHOPAEDIC CLINIC PA,CAPE FEAR ORTHOPAEDIC CLINIC PA,4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578505848,"MULLHOLAND, ALICE, JEAN",4140 FERNCREEK DR STE 801 FAYETTEVILLE NC,026,Cumberland,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 17 , 51 , 96 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578506507,"LOWRY, MICHAEL, HUNTER",310 S MCCASKEY RD   WILLIAMSTON NC,058,Martin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 54 , 58 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578506929,"JOHNSON, RICHARD, C.",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578507125,"MCLEAN, HEATHER, SEABURY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 53 , 209 , 212 ," $17,376.25 ",,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578509238,"BLAKE, SHANNON, CRYSTI",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578509238,"BLAKE, SHANNON, CRYSTI",3800 INDEPENDENCE BLVD   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578509238,"BLAKE, SHANNON, CRYSTI",820 WELLINGTON AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578509238,"BLAKE, SHANNON, CRYSTI",121 RACINE DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578509238,"BLAKE, SHANNON, CRYSTI",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 37 , 37 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578509857,"NEY, LISA, LYNN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578509881,"SOLAK, CAROLYN, KAY",110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578509881,"SOLAK, CAROLYN, KAY",5241 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578509881,"SOLAK, CAROLYN, KAY",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 52 , 70 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1578509881,"SOLAK, CAROLYN, KAY",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 62 , 76 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578509881,"SOLAK, CAROLYN, KAY",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 23 , 35 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578510384,"BOLTZ, JEROME, DORIAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1578511044,"WELCH, KENNETH, JAMES",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1386388874,TARHEEL EMERGENCY GROUP PLLC,,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578511044,"WELCH, KENNETH, JAMES",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1477840791,ALLEGHANY EMERGENCY GROUP LLC,ALLEGHANY EMERGENCY GROUP LLC,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1578511812,"MARTINEZ, PAUL, ARMANDO",233 DOCTORS ST   SPARTA NC,003,Alleghany,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 28 , 32 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578511911,"LEE, DAVID, ETHAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 41 , 64 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578511911,"LEE, DAVID, ETHAN",7130 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 76 , 145 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578511911,"LEE, DAVID, ETHAN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1578514261,"SCOGGINS, VINCE, RENE",444 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 62 , 82 ,$#,,
MEDICAID DIRECT,1720849391,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD FAMILY CARE RHC,444 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578514261,"SCOGGINS, VINCE, RENE",444 NC 108 HWY   RUTHERFORDTON NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 60 , 110 , 115 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578514519,"MCALISTER, JENNIFER, MARIE",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 20 , 30 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578514519,"MCALISTER, JENNIFER, MARIE",805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,805 6TH AVE W STE 100 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578514519,"MCALISTER, JENNIFER, MARIE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578514519,"MCALISTER, JENNIFER, MARIE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578515763,"MOLPUS, JOHN, LANE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578515763,"MOLPUS, JOHN, LANE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578515763,"MOLPUS, JOHN, LANE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578515763,"MOLPUS, JOHN, LANE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578515763,"MOLPUS, JOHN, LANE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578518940,"RAJAGOPALAN, SHRINIVAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 24 , 27 , 39 ,$#,,
MEDICAID DIRECT,1477704443,WAKE MEDICAL LABORATORY CONSULTANTS,WAKE MEDICAL LABORATORY CONSULTANTS INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578518940,"RAJAGOPALAN, SHRINIVAS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578519435,"BRECHTELSBAUER, PAUL, BRADLEY",850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578519872,"VANARTHOS, WILLIAM, JAMES",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578519872,"VANARTHOS, WILLIAM, JAMES",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 109 , 112 , 137 ,$#,,
MEDICAID DIRECT,1104804459,CATAWBA PEDIATRIC ASSOCIATES PA,~,240 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1578520177,"LOWRY, JOY, SIGMON",240 18TH STREET CIR SE   HICKORY NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 82 , 122 , 297 ," $12,310.75 ",,
MEDICAID DIRECT,1417914292,WINSTON BONE AND JOINT SURGICAL ASS,WINSTON BONE AND JOINT SURGICAL ASSOCIATES PA,3817 FORRESTGATE DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578520391,"SPANGLER, THOMAS, CLAYTON",3817 FORRESTGATE DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 136 , 277 ,$#,,
MEDICAID DIRECT,1033935853,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE ELITECARE,3622 N MAIN ST   HOPE MILLS NC,026,Cumberland,193400000X,Group,Single Specialty,,1578520417,"ROSS, TRAVIS, SANDERS",3622 N MAIN ST   HOPE MILLS NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1508297003,ELITECARE OF FAYETTEVILLE PLLC,,3622 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578520417,"ROSS, TRAVIS, SANDERS",3622 N MAIN ST   HOPE MILLS NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 157 , 344 , 509 ," $10,024.51 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578520789,"REYNOLDS, SANDRA, MOSTELLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 27 , 28 ,$#,,
MEDICAID DIRECT,1699735951,GROWING UP PEDIATRICS PA,GROWING UP PEDIATRICS,8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578522421,"TALLEY, WENDY, GAYLE",8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 22 , 49 , 73 ,$#,,
MEDICAID DIRECT,1699735951,GROWING UP PEDIATRICS PA,GROWING UP PEDIATRICS,8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578522421,"TALLEY, WENDY, GAYLE",8301 MAGNOLIA ESTATES DR STE 17 CORNELIUS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1093480964,MACON FAMILY MEDICAL CARE PLLC,,36 WESTGATE PLZ   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1578523916,"CREEL, JASON, DOUGLAS",36 WESTGATE PLZ   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 52 , 62 ,$#,,
MEDICAID DIRECT,1740692656,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM BEHAVIORAL HEALTH,690 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1578524070,"LUFFMAN, CRYSTAL, BLEVINS",690 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1578524591,"FOSTER, ORVILLE, RYLAND",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578525630,"CASTRO GONZALEZ, JUAN",109 SCOTTS HILL MEDICAL DR STE 102 WILMINGTON NC,065,New Hanover,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578527354,"VESSEY, JOSHUA, COLIN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 100 , 343 , 343 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578527636,"HILL, VICENTE, JOSE",6 ROBERTS RD STE 103 ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 20 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578527636,"HILL, VICENTE, JOSE",6 ROBERTS RD STE 103 ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1578527636,"HILL, VICENTE, JOSE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578527636,"HILL, VICENTE, JOSE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578527636,"HILL, VICENTE, JOSE",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578529608,"HVOZDOVIC, LORI, PAGE",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578529962,"KIZER, WILLIAM, STEEL",700 TILGHMAN DR STE 702 DUNN NC,043,Harnett,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1578529962,"KIZER, WILLIAM, STEEL",ASSOCIATED UROLOGISTS OF NC PA,700 TILGHMAN DR STE 702 DUNN NC,043,Harnett,208800000X,Allopathic & Osteopathic Physicians,Urology,,1578529962,"KIZER, WILLIAM, STEEL",700 TILGHMAN DR STE 702 DUNN NC,043,Harnett,208800000X,Allopathic & Osteopathic Physicians,Urology,, 14 , 16 , 30 ,$#,,
MEDICAID DIRECT,1578529962,"KIZER, WILLIAM, STEEL",ASSOCIATED UROLOGISTS OF NC PA,3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,1578529962,"KIZER, WILLIAM, STEEL",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 44 , 93 , 139 ,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578529962,"KIZER, WILLIAM, STEEL",3821 ED DR   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578530002,"SNIDER, GINA, MURPH",110 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 67 , 118 ,$#,,
MEDICAID DIRECT,1720457567,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DIGESTIVE HEALTH CENTER SEACOAST,3980 HIGHWAY 9 E STE 320 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578530457,"ELRAIE, KHALED, FOUAD",3980 HIGHWAY 9 E STE 320 LITTLE RIVER SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578532768,"CAMPBELL, JANICE, LYNNE",13 MEDICAL CAMPUS DR NW STE 101 SUPPLY NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1578532768,"CAMPBELL, JANICE, LYNNE",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 20 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578533824,"JUSTIS, DENISE, BILLETT",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578533956,"GOVERNO, SCOTT, WILLIAM",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 101 , 146 , 283 ," $11,475.70 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578535241,"GRAUDONS, DOUGLAS, SCOTT",209 PARK ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 23 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578535241,"GRAUDONS, DOUGLAS, SCOTT",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 126 , 231 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578535621,"SPIES, ROBERT, SCOTT",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578535621,"SPIES, ROBERT, SCOTT",1401 MATTHEWS TOWNSHIP PKWY STE 100 MATTHEWS NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 63 , 85 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578536074,"MAJURE, DAVID, ANDREW",158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 63 , 63 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 85 , 85 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1578536074,"MAJURE, DAVID, ANDREW",179 COMBS ST   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",179 COMBS ST   SPARTA NC,003,Alleghany,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",542 ALLRED MILL RD   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 77 , 77 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578536074,"MAJURE, DAVID, ANDREW",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 126 , 126 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578536074,"MAJURE, DAVID, ANDREW",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",1297 GALAX TRL   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 32 , 32 ,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",340 SNOWHILL DR   MOUNT AIRY NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568093672,PREMIER GERIATRIC SOLUTIONS PLLC,,158 CHESTNUT GROVE CHURCH RD   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1578536074,"MAJURE, DAVID, ANDREW",711 W ATKINS ST   DOBSON NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578536249,"DINGESS, RODNEY, LEE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578536249,"DINGESS, RODNEY, LEE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578538658,"GARLAND, JEFFERY, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578539201,"MAHONEY, PAUL, DENNIS",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 25 , 31 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578539201,"MAHONEY, PAUL, DENNIS",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 32 , 37 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578539201,"MAHONEY, PAUL, DENNIS",115 HEART DR   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578540076,"CANNON, MICHAEL, LOUIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 28 , 56 , 69 ," $13,333.85 ",,
MEDICAID DIRECT,1578540860,"UBA, DANIEL, CHIDI",~,1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1578540860,"UBA, DANIEL, CHIDI",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1508522343,RAPHA URGENT CARE,,1905 SKIBO RD STE 102 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578540860,"UBA, DANIEL, CHIDI",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 95 , 132 , 338 ," $12,062.95 ",,
MEDICAID DIRECT,1275510695,RAPHA PRIMARY CARE,~,1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1578540860,"UBA, DANIEL, CHIDI",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 343 , 706 ," 1,009 "," $21,888.42 ",,
MEDICAID DIRECT,1275510695,RAPHA PRIMARY CARE,~,1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578540860,"UBA, DANIEL, CHIDI",1905 SKIBO RD STE 100 FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 612 ," 2,242 "," 4,620 "," $84,973.01 ",,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578541421,"WILLIAMS, LANDIRS, SHAUN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 77 , 109 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578541421,"WILLIAMS, LANDIRS, SHAUN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 35 , 36 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578541421,"WILLIAMS, LANDIRS, SHAUN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,~,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578542825,"JONES, SHONDELL, LAMONT",1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1881792992,CHAPEL HILL CHILDREN & ADOLESCENTS,CHAPEL HILL CHILDREN & ADOLESCENTS,301 KILDAIRE RD STE 200 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1578543310,"MINOZZI III, MICHAEL, FRANCIS",301 KILDAIRE RD STE 200 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 30 , 77 ,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,10880 DURANT RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578543740,"WILSON, KAREN, LYNN",10880 DURANT RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,10880 DURANT RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578543740,"WILSON, KAREN, LYNN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518521905,WAKEMED SPECIALISTS GROUP LLC,WAKEMED MATERNAL FETAL MEDICINE,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578543740,"WILSON, KAREN, LYNN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578543740,"WILSON, KAREN, LYNN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1578543740,"WILSON, KAREN, LYNN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578543740,"WILSON, KAREN, LYNN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1578544409,"HATCHETT, MARY, MOTLEY",~,10926 DAVID TAYLOR DR STE 120 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,1578544409,"HATCHETT, MARY, MOTLEY",10926 DAVID TAYLOR DR STE 120 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 252 , 844 ," $58,162.62 ",,
MEDICAID DIRECT,1346636768,MY OMNI HOUSECALLS,MY OMNI HOUSECALLS LLC,10926 DAVID TAYLOR DR STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578544409,"HATCHETT, MARY, MOTLEY",10926 DAVID TAYLOR DR STE 120 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 35 , 474 , 744 ," $17,698.04 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578546602,"FERNANDEZ, ANDREA, STEPHANIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1124356423,TOTAL JOINT CARE PA,TOTAL JOINT CARE PA,115 PARKWAY OFFICE CT STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578546644,"STRUBLE, STEPHEN, GRAHAM",115 PARKWAY OFFICE CT STE 101 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578548210,"THOMAS, JOHN, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 50 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578548210,"THOMAS, JOHN, ANDREW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578548210,"THOMAS, JOHN, ANDREW",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578548210,"THOMAS, JOHN, ANDREW",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578548210,"THOMAS, JOHN, ANDREW",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578548368,"DELLAERO, DAVID, THOMAS",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1111 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578548368,"DELLAERO, DAVID, THOMAS",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578548368,"DELLAERO, DAVID, THOMAS",100 PERKINS DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 22 ,$#,,
MEDICAID DIRECT,1568696748,WAKE SPINE AND PAIN SPECIALISTS PC,~,3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578551040,"LOULOUDES, JENNIFER, ELYCE",3801 WAKE FOREST RD STE 210 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 155 , 180 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578551875,"HERODOTOU, DEMETRIOS",512 VILLAGE RD STE 207 SHALLOTTE NC,010,Brunswick,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 58 , 78 , 109 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578551875,"HERODOTOU, DEMETRIOS",512 VILLAGE RD STE 205 SHALLOTTE NC,010,Brunswick,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 16 , 24 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578551875,"HERODOTOU, DEMETRIOS",204 SMITH AVE   SHALLOTTE NC,010,Brunswick,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 20 , 22 , 26 ,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578551875,"HERODOTOU, DEMETRIOS",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1558497297,CHILDRENS MEDICAL CENTER,CHILDRENS MEDICAL CENTER LTD,15 CLEVELAND AVE STE 14 MARTINSVILLE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578552006,"SEAMON, DAVID",15 CLEVELAND AVE STE 14 MARTINSVILLE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578552261,"LEWIS, YVONNE, WILSON",3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1639173222,CUMBERLAND COUNTY HOSPITAL SYSTEM I,SLEEP CENTER OF CFVHS,3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578552261,"LEWIS, YVONNE, WILSON",3308 MELROSE RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 102 , 102 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,5200 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1578552485,"DOOLITTLE, THOMAS, PATRICK",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1578552485,"DOOLITTLE, THOMAS, PATRICK",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 30 , 31 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578552485,"DOOLITTLE, THOMAS, PATRICK",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578552956,"BEECHER, SCOTT, THOMAS",354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1578553541,"PEREZ, RODNEY, ALEXANDER",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1578553541,"PEREZ, RODNEY, ALEXANDER",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 70 , 91 , 125 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578554606,"SUTHERLAND, MARK, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578554606,"SUTHERLAND, MARK, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578554606,"SUTHERLAND, MARK, JOSEPH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1861485146,REGIONAL OBSTETRICAL CONSULTANTS PC,REGIONAL OBSTETRICAL CONSULTANTS PC,902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578556858,"KIPIKASA, JOSEPH, HENRY",902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1861485146,REGIONAL OBSTETRICAL CONSULTANTS PC,REGIONAL OBSTETRICAL CONSULTANTS PC,902 MCCALLIE AVE   CHATTANOOGA TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578556858,"KIPIKASA, JOSEPH, HENRY",136 HOSPITAL DR STE B BLAIRSVILLE GA,101,Out of State <= 40 miles,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1619903481,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578557393,"SLATER, DOUGLAS, KENNETH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578557393,"SLATER, DOUGLAS, KENNETH",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 214 , 471 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578558474,"BLACK, QUINTEN, CURTIS",63 S MEDICAL CT   MARION NC,059,McDowell,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 59 , 107 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578558474,"BLACK, QUINTEN, CURTIS",179 N BUNCOMBE SCHOOL RD   WEAVERVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 70 , 115 ," $29,119.62 ",,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578558474,"BLACK, QUINTEN, CURTIS",20 MEDICAL PARK DR STE A ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 13 , 22 , 47 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1578558474,"BLACK, QUINTEN, CURTIS",20 MEDICAL PARK DR STE A ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,1 HOSPITAL DR STE 102 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578558474,"BLACK, QUINTEN, CURTIS",20 MEDICAL PARK DR STE A ASHEVILLE NC,011,Buncombe,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578558474,"BLACK, QUINTEN, CURTIS",171 DANIEL RD   FOREST CITY NC,081,Rutherford,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 15 , 136 , 242 ," $12,872.67 ",,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578558912,"SCHULS, ERIK, LAWRENCE",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 28 , 57 , 57 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2544 COURT DR STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578559373,"BONAR, ADOLPHUS, SOLOMON",2544 COURT DR STE A GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,,,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2544 COURT DR STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578559373,"BONAR, ADOLPHUS, SOLOMON",2544 COURT DR STE A GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 105 , 153 , 157 ,$#,,
MEDICAID DIRECT,1184805103,CAROMONT MEDICAL GROUP INC,ENDOCRINOLOGY ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578559373,"BONAR, ADOLPHUS, SOLOMON",2525 COURT DR   GASTONIA NC,036,Gaston,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 32 , 52 , 54 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578560041,"EVANS, HA, NGOC",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 19 , 39 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560041,"EVANS, HA, NGOC",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560041,"EVANS, HA, NGOC",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 250 , 243 , 319 ,$#,,
MEDICAID DIRECT,1043677669,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE TRIANGLE,2615 LAKE DR STE 301 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578560363,"AARONS, ALAN, LAWRENCE",2615 LAKE DR STE 301 RALEIGH NC,092,Wake,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 24 , 56 , 60 ,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578560652,"BARRETT, MARY, LYNN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1427342948,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OUTPATIENT BEHAVIORAL HEALTH GROUP,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578560652,"BARRETT, MARY, LYNN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1333 S DICKINSON DR   LELAND NC,010,Brunswick,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1333 S DICKINSON DR   LELAND NC,010,Brunswick,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 63 , 63 , 78 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 334 , 348 , 438 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1960 S 16TH ST SOCIAL SECURITY ADMIN WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 20 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 47 , 55 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1135 MILITARY CUTOFF RD   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 63 , 56 , 84 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",8115 MARKET ST STE 104 WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 36 , 42 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",2800 ASHTON DR STE 102 WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",8115 MARKET ST STE 104 WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 39 , 46 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578560934,"CRAWFORD, STEVEN, TODD",507 E FREMONT ST   BURGAW NC,071,Pender,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 35 , 31 , 39 ,$#,,
MEDICAID DIRECT,1891135067,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,410 S JONES ST   PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1578562849,"SALLOUM, LESLIE, JOHN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 ,#,#,$#,,
MEDICAID DIRECT,1164726105,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1578562849,"SALLOUM, LESLIE, JOHN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 38 , 88 , 91 ,$#,,
MEDICAID DIRECT,1164726105,SCOTLAND REGIONAL HEALTH NETWORK,SCOTLAND SURGICAL AND GI ASSOCIATES,1600 MEDICAL DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1578562849,"SALLOUM, LESLIE, JOHN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 85 , 105 ,$#,,
MEDICAID DIRECT,1598757916,ALBEMARLE MEDICAL ASSOCIATES PLLC,~,1507 N ROAD ST STE 3 ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1578562955,"CHANDI, TEJWANT, SINGH",1507 N ROAD ST STE 3 ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 170 , 875 ," 1,383 "," $20,830.81 ",,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1578563235,"FILLMAN, KIMBERLY, MALLICK",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 104 , 107 , 113 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578564076,"CALHOUN, BENJAMIN, CARLISLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578564076,"CALHOUN, BENJAMIN, CARLISLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578564076,"CALHOUN, BENJAMIN, CARLISLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578564076,"CALHOUN, BENJAMIN, CARLISLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#,#,$#,,
MEDICAID DIRECT,1760633994,TOTS N TEENS PEDIATRICS PLLC,,3434 KILDAIRE FARM RD STE 124 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1578564571,"SADAGOPAN, RADHIKA",3434 KILDAIRE FARM RD STE 124 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 43 , 73 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578564803,"POINDEXTER, JANET, CARMEN",201 WINDSOR CREEK PKWY   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 33 , 37 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578564803,"POINDEXTER, JANET, CARMEN",201 WINDSOR CREEK PKWY   GOLDSBORO NC,096,Wayne,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#, 76 , 79 ,$#,,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578564803,"POINDEXTER, JANET, CARMEN",201 WINDSOR CREEK PKWY   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578564803,"POINDEXTER, JANET, CARMEN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578564803,"POINDEXTER, JANET, CARMEN",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 47 , 304 , 332 ," $10,742.24 ",,
MEDICAID DIRECT,1598533275,LIFESOURCE PRIME INC,,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578564803,"POINDEXTER, JANET, CARMEN",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 33 , 39 ,$#,,
MEDICAID DIRECT,1710021811,ABC PEDIATRICS OF ASHEVILLE PA,ABC PEDIATRICS OF ASHEVILLE PA,64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1578564928,"PASCHALL, JOHN, SPRUILL",64 PEACHTREE RD STE 100 ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 39 , 105 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578565032,"LACOURSE, JEFFREY, HORACE",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 197 , 197 ,$#,,
MEDICAID DIRECT,1932628187,LOCKLEAR FAMILY PRACTICE PLLC,,17 LIVERMORE DR   PEMBROKE NC,078,Robeson,193400000X,Group,Single Specialty,,1578565164,"LOCKLEAR, JODELLA",17 LIVERMORE DR   PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 402 , 613 ,$#,,
MEDICAID DIRECT,1578565305,MAIDEN OPTOMETRIC EYE CARE CENTER P,MAIDEN EYE CLINIC,503 ISLAND FORD RD   MAIDEN NC,018,Catawba,193400000X,Group,Single Specialty,,1578565305,MAIDEN OPTOMETRIC EYE CARE CENTER P,503 ISLAND FORD RD   MAIDEN NC,018,Catawba,193400000X,Group,Single Specialty,, 14 , 14 , 28 ,$#,,
MEDICAID DIRECT,1578565305,MAIDEN OPTOMETRIC EYE CARE CENTER P,MAIDEN EYE CLINIC,503 ISLAND FORD RD   MAIDEN NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578565305,MAIDEN OPTOMETRIC EYE CARE CENTER P,503 ISLAND FORD RD   MAIDEN NC,018,Catawba,193200000X,Group,Multi-Specialty,, 358 , 358 , 716 ,$#,,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1578565776,"DANIEL, TERRY, GLENN",723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 204 , 553 , 975 ," $29,967.86 ",,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1578565776,"DANIEL, TERRY, GLENN",723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235131426,DAY SPRING FAMILY MEDICINE,DAY SPRING FAMILY MEDICINE,723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1578565776,"DANIEL, TERRY, GLENN",723 S VAN BUREN RD STE B EDEN NC,079,Rockingham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578567012,"GRAHAM, AUTUMN, COLLEEN",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578568457,"HAHN, CHARLES, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 17 , 20 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578568457,"HAHN, CHARLES, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1578568457,"HAHN, CHARLES, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1578568457,"HAHN, CHARLES, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578568457,"HAHN, CHARLES, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578568457,"HAHN, CHARLES, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1578568457,"HAHN, CHARLES, MICHAEL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578568580,"CLEMENTE, JONATHAN, DANIEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578568580,"CLEMENTE, JONATHAN, DANIEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 184 , 195 , 208 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578568580,"CLEMENTE, JONATHAN, DANIEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 154 , 163 , 195 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578568580,"CLEMENTE, JONATHAN, DANIEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 173 , 176 , 210 ,$#,,
MEDICAID DIRECT,1205113248,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS PRIMARY CARE,3109 CASEY ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578571592,"BARRETT, GARY, JOSEPH",3109 CASEY ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578574042,"TUOHY, CHRISTOPHER, JOHN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 27 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578574042,"TUOHY, CHRISTOPHER, JOHN",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 32 , 42 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578574638,"GULATI, SANJEEV, KUMAR",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578574638,"GULATI, SANJEEV, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578574638,"GULATI, SANJEEV, KUMAR",1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578574638,"GULATI, SANJEEV, KUMAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578576674,"BLACKLEY, SHEM, KEARNEY",1001 N WASHINGTON ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 26 , 34 , 98 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578576674,"BLACKLEY, SHEM, KEARNEY",1001 N WASHINGTON ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 89 , 128 , 279 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578576674,"BLACKLEY, SHEM, KEARNEY",201 E GROVER ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578576674,"BLACKLEY, SHEM, KEARNEY",1001 N WASHINGTON ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,, 127 , 202 , 460 ," $13,736.68 ",,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578576674,"BLACKLEY, SHEM, KEARNEY",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578576674,"BLACKLEY, SHEM, KEARNEY",201 E GROVER ST   SHELBY NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578576674,"BLACKLEY, SHEM, KEARNEY",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1578578423,INGLES MARKETS INC,INGLES PHARMACY 179,3643 HOWARD GAP RD   HENDERSONVILLE NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1578578423,INGLES MARKETS INC,3643 HOWARD GAP RD   HENDERSONVILLE NC,045,Henderson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 25 , 35 ,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578580031,"FERKOL, THOMAS, WILLIAM",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578580031,"FERKOL, THOMAS, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology, 44 , 133 , 145 ," $13,261.63 ",,
MEDICAID DIRECT,1578580726,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1217,273 COMMONS DR   FRANKLIN NC,056,Macon,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1578580726,WAL-MART STORES EAST LP,273 COMMONS DR   FRANKLIN NC,056,Macon,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1578580726,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-1217,273 COMMONS DR   FRANKLIN NC,056,Macon,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1578580726,WAL-MART STORES EAST LP,273 COMMONS DR   FRANKLIN NC,056,Macon,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1578580734,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-2496,200 WATAUGA VILLAGE DR   BOONE NC,095,Watauga,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1578580734,WAL-MART STORES EAST LP,200 WATAUGA VILLAGE DR   BOONE NC,095,Watauga,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578581328,"TRANTHAM, ERIN, JUNE",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578581328,"TRANTHAM, ERIN, JUNE",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1578581328,"TRANTHAM, ERIN, JUNE",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578581989,"CONSTANTINE, JEFFREY, CHARLES",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578581989,"CONSTANTINE, JEFFREY, CHARLES",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578582342,"MERRILL, STEVEN, CARLSON",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578582342,"MERRILL, STEVEN, CARLSON",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1578582342,"MERRILL, STEVEN, CARLSON",393 3RD AVE SW   TAYLORSVILLE NC,002,Alexander,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1184165607,EYECARECENTER OD PA,EYECARE CENTER,5121 REIDSVILLE RD   WALKERTOWN NC,034,Forsyth,193400000X,Group,Single Specialty,,1578582383,"FREEMAN, DAVID",5121 REIDSVILLE RD   WALKERTOWN NC,034,Forsyth,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578582797,"ADEOLA, TOLULOLA, OMOLULU",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356366413,CRYSTAL COAST FAMILY PRACTICE,CRYSTAL COAST FAMILY PRACTICE,505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1578582912,"HENDERSON, DAVID, FRANCIS",505 N 35TH ST   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 96 , 151 ,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578583738,"HAIMES, DAVID, MICHAEL",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578583779,"BLAZER, DAN, GERMAN",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578583779,"BLAZER, DAN, GERMAN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578583779,"BLAZER, DAN, GERMAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053597856,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM HEALTH-UROLOGY,200 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1578583829,"RACKLEY, JUDSON, DANIELL",200 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,208800000X,Allopathic & Osteopathic Physicians,Urology,, 88 , 214 , 416 ,$#,,
MEDICAID DIRECT,1770561193,CAROLINA PSYCHOLOGICAL HEALTH SERVI,CAROLINA PSYCHOLOGICAL HEALTH SERVICES,1703 COUNTRY CLUB RD STE 204 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578584215,"COX, RUTH, PINNIX",1703 COUNTRY CLUB RD STE 204 JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1578584439,CHAPEL HILL CARRBORO CITY SCHOOL,CHAPEL HILL CARRBORO CITY SCHOOL,750 S MERRITT MILL RD   CHAPEL HILL NC,068,Orange,251300000X,Agencies,Local Education Agency (LEA),,1578584439,CHAPEL HILL CARRBORO CITY SCHOOL,750 S MERRITT MILL RD   CHAPEL HILL NC,068,Orange,251300000X,Agencies,Local Education Agency (LEA),, 256 ," 6,551 "," 6,884 "," $324,511.90 ",,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1578586053,"RHEINBOLT, RICHARD, MERWIN",233 DOCTORS ST   SPARTA NC,003,Alleghany,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1578586053,"RHEINBOLT, RICHARD, MERWIN",233 DOCTORS ST   SPARTA NC,003,Alleghany,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 33 , 48 ,$#,,
MEDICAID DIRECT,1770782450,UNIFOUR PEDIATRICS,~,3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,193400000X,Group,Single Specialty,,1578586053,"RHEINBOLT, RICHARD, MERWIN",3411 GRAYSTONE PL SE   CONOVER NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578586541,"WISE, BARBARA, VIRGINIA",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1578588638,"NEIDENTHAL, BRENT, RANDALL",SUNSET RIDGE FAMILY DENTISTRY,1100 HOLLY SPRINGS RD STE 115 HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1578588638,"NEIDENTHAL, BRENT, RANDALL",1100 HOLLY SPRINGS RD STE 115 HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#, 19 , 62 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 21 , 28 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",800 MEDICAL CAMPUS DR   BURNSVILLE NC,100,Yancey,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",206 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",7 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 20 , 30 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 21 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 13 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 428 , 590 , 774 ," $10,150.76 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 53 , 56 , 64 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 61 , 68 , 88 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 44 , 48 , 65 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578591962,"HODGES, DAVID, STEWART",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1578591988,"POWELL, JOHN, DAVID",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 163 , 220 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578592622,"THOMAS, FREDA, CLARICE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578594065,"MERCADO, AXEL, LUIS",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1578594065,"MERCADO, AXEL, LUIS",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1386605608,HOOPER AND BURNETTE INTERNAL MEDICI,~,2130 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1578594065,"MERCADO, AXEL, LUIS",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 34 ,$#,,
MEDICAID DIRECT,1952306599,PREMIER GASTROENTEROLOGY PA,~,1880 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1578596896,"POULOS, JOHN, EMANUEL",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 229 , 408 , 440 ," $14,344.21 ",,
MEDICAID DIRECT,1962869446,FAYETTEVILLE GASTROENTEROLOGY ENDOS,,2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1578596896,"POULOS, JOHN, EMANUEL",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 18 , 21 ,$#,,
MEDICAID DIRECT,1457365751,FAYETTEVILLE GASTROENTEROLOGY ASSOC,FAYETTEVILLE GASTROENTEROLOGY ASSOCIATES PA,,,Unknown,193200000X,Group,Multi-Specialty,,1578596896,"POULOS, JOHN, EMANUEL",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,,,$#,,
MEDICAID DIRECT,1578597670,"ALBERT, SUSAN, LAYNE",~,206 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1578597670,"ALBERT, SUSAN, LAYNE",206 OLD BRICKYARD RD   NORTH WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 220 , 220 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578599668,"MCLAUGHLIN, MIRIAM, KLEM",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578599668,"MCLAUGHLIN, MIRIAM, KLEM",908 S WILLIAMSON AVE   ELON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578599668,"MCLAUGHLIN, MIRIAM, KLEM",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 75 , 243 ,$#,,
MEDICAID DIRECT,1578600680,DURHAM RIDGE ASSISTED LIVING,DURHAM RIDGE ASSISTED LIVING,3420 WAKE FOREST RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578600680,DURHAM RIDGE ASSISTED LIVING,3420 WAKE FOREST RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 109 ," 24,325 "," 24,336 "," $2,601,218.04 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578600854,"MATLOCK, KEVIN, ALLEN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578600854,"MATLOCK, KEVIN, ALLEN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1578604245,"DOTY, SHAWN, ALLEN",13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1578604245,"DOTY, SHAWN, ALLEN",13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1578604245,"DOTY, SHAWN, ALLEN",Shawn Allen Doty,13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,,1578604245,"DOTY, SHAWN, ALLEN",13820 HWY 55 E   ALLIANCE NC,069,Pamlico,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1578604245,"DOTY, SHAWN, ALLEN",2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164563938,C & S OPTOMETRIC SERVICES PLLC,PAMLICO FAMILY CARE,13820 HWY 55 E PAMLICO FAMILY EYE CARE ALLIANCE NC,069,Pamlico,193200000X,Group,Multi-Specialty,,1578604245,"DOTY, SHAWN, ALLEN",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1336280544,C & S OPTOMETRIC SERVICES PLLC,NEW BERN FAMILY EYE CARE,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,193200000X,Group,Multi-Specialty,,1578604245,"DOTY, SHAWN, ALLEN",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,, 16 , 19 , 23 ,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1578604245,"DOTY, SHAWN, ALLEN",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1578604245,"DOTY, SHAWN, ALLEN",Shawn Allen Doty,2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,1578604245,"DOTY, SHAWN, ALLEN",2805 VILLAGE WAY   TRENT WOODS NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1366407124,ATLANTIC BRAIN AND SPINE PA,ATLANTIC NEUROSURGICAL AND SPINE SPECIALIST PA,2208 S 17TH ST STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578607867,"STEYSKAL, CHRISTOPHER, JOSEPH",2800 ASHTON DR STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 51 , 52 ,$#,,
MEDICAID DIRECT,1578609228,WAKE ASSISTED LIVING,WAKE ASSISTED LIVING,2800 KIDD RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578609228,WAKE ASSISTED LIVING,2800 KIDD RD   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 40 ," 11,269 "," 11,271 "," $1,176,975.18 ",,
MEDICAID DIRECT,1578610960,"BOOKER, LATONYA, RHODES",LATONYA BOOKER DBA ARTICULATORS SPEECH SERVICES,10215 PINESHADOW DR APT T102 CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1578610960,"BOOKER, LATONYA, RHODES",10215 PINESHADOW DR APT T102 CHARLOTTE NC,060,Mecklenburg,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 24 , 249 , 249 ," $16,655.61 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578612594,"MUNCY, MEREDITH, LEE",2100 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1578612594,"MUNCY, MEREDITH, LEE",5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1578612701,"SHINAMAN, BRADFORD, CHARLES",BRADFORD C SHINAMAN DDS PA,406 8TH ST   N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,1578612701,"SHINAMAN, BRADFORD, CHARLES",406 8TH ST   N WILKESBORO NC,097,Wilkes,1223G0001X,Dental Providers,Dentist,General Practice,#, 14 , 44 ,$#,,
MEDICAID DIRECT,1578612818,INTERIM HEALTHCARE OF THE EASTERN C,INTERIM HEALTHCARE,1424 S JK POWELL BLVD STE G WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,,1578612818,INTERIM HEALTHCARE OF THE EASTERN C,1424 S JK POWELL BLVD STE G WHITEVILLE NC,024,Columbus,253Z00000X,Agencies,In Home Supportive Care,, 46 ," 8,667 "," 8,673 "," $1,289,418.56 ",,
MEDICAID DIRECT,1578613097,IDEAL HOME HEALTH SERVICES INC,IDEAL HOME HEALTH SERVICES INC,1420 E CLUB BLVD   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1578613097,IDEAL HOME HEALTH SERVICES INC,1420 E CLUB BLVD   DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 1,779 "," 1,779 "," $144,119.56 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578617833,"PARDEN, JEREMY, DOUGLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578618526,"KOSCAL, TAMMY, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578618526,"KOSCAL, TAMMY, MICHELLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578618641,"TILLEY, MARILEE, MARSHALL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578618641,"TILLEY, MARILEE, MARSHALL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1578620175,"LANCASTER JR, COLEMAN, HARRISON",~,129 S BICKETT BLVD   LOUISBURG NC,035,Franklin,152W00000X,Eye and Vision Services Providers,Optometrist,,1578620175,"LANCASTER JR, COLEMAN, HARRISON",129 S BICKETT BLVD   LOUISBURG NC,035,Franklin,152W00000X,Eye and Vision Services Providers,Optometrist,, 67 , 90 , 127 ,$#,,
MEDICAID DIRECT,1578621264,VICTORIOUS HEALTH SERVICES,A VICTORIOUS HOME CARE,2332 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1578621264,VICTORIOUS HEALTH SERVICES,2332 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 6,170 "," 6,340 "," $688,322.66 ",,
MEDICAID DIRECT,1578621264,VICTORIOUS HEALTH SERVICES,A VICTORIOUS HOME CARE,2332 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1578621264,VICTORIOUS HEALTH SERVICES,2332 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,#," 1,324 "," 1,325 "," $957,918.75 ",,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,742 MIDDLE CREEK RD   SEVIERVILLE TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578626073,"HULL, ELIZABETH, JANE",742 MIDDLE CREEK ROAD   SEVIERVILLE TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578627345,"IRIZARRY, RICARDO, RUBEN",210 ASHVILLE AVE   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,5241 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578627345,"IRIZARRY, RICARDO, RUBEN",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578627345,"IRIZARRY, RICARDO, RUBEN",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1578627345,"IRIZARRY, RICARDO, RUBEN",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578627345,"IRIZARRY, RICARDO, RUBEN",11221 GALLERIA AVE STE 105 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1578628780,MASON & MINCEY OD PA,~,2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578628780,MASON & MINCEY OD PA,2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,, 53 , 53 , 102 ,$#,,
MEDICAID DIRECT,1578628780,MASON & MINCEY OD PA,~,2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578628780,MASON & MINCEY OD PA,2396 E FRANKLIN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,, 122 , 122 , 243 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578631644,"DEES, ELIZABETH, CLAIRE",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578631644,"DEES, ELIZABETH, CLAIRE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 19 , 24 , 38 ,$#,,
MEDICAID DIRECT,1619371903,MYEYEDR OPTOMETRY OF NORTH CAROLINA,EYE CARE ASSOCIATES,,,Unknown,193400000X,Group,Single Specialty,,1578631677,"REESE, BRUCE, LAURENCE",110 CAPCOM AVE STE 100 WAKE FOREST NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578638276,"JONAS, BETH, LAURIE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 23 , 26 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578638276,"JONAS, BETH, LAURIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578638276,"JONAS, BETH, LAURIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 15 , 20 , 29 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578638276,"JONAS, BETH, LAURIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1578639779,"BENJAMIN, JOSEPH, SCOTT",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1578639779,"BENJAMIN, JOSEPH, SCOTT",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1578639779,"BENJAMIN, JOSEPH, SCOTT",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 29 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1578639779,"BENJAMIN, JOSEPH, SCOTT",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578639779,"BENJAMIN, JOSEPH, SCOTT",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578639779,"BENJAMIN, JOSEPH, SCOTT",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578639779,"BENJAMIN, JOSEPH, SCOTT",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 244 , 289 , 669 ," $12,003.63 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578640603,"BOUCHER, RICHARD, CHARLES",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1730728270,NOVANT HEALTH KERNERSVILLE OUTPATIE,,1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578642310,"ADAMS, AMY, ANDRAZA",1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578642310,"ADAMS, AMY, ANDRAZA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578644654,"LOVE, PAMELA, DENISE",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578644969,"LAUER, CYNTHIA, WEBER",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578644969,"LAUER, CYNTHIA, WEBER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD STE 5500A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578644969,"LAUER, CYNTHIA, WEBER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578644969,"LAUER, CYNTHIA, WEBER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 47 , 50 ,$#,,
MEDICAID DIRECT,1225649718,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ACUTE CARE SURGERY UNIVERSITY,101 E WT HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578644969,"LAUER, CYNTHIA, WEBER",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1073148581,AMPUTATION PREVENTION CENTER OF NC,VASCULAR SOLUTIONS OF NORTH CAROLINA,1000 CRESCENT GRN STE 102 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1578644977,"RAO, SIDDHARTHA, ANNAMRAJU",1000 CRESCENT GRN STE 102 CARY NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 173 , 394 , 794 ," $154,887.12 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578646410,"SIMONS, JOHN, PATRICK",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578646410,"SIMONS, JOHN, PATRICK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1760924641,RICKERT WATSON & ASSOCIATES DDS PLL,HEALTHY SMILES,9424 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578646675,"RICKERT, SHELLY, LYNNE",9424 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,187 "," 2,298 "," 9,390 "," $269,946.71 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578646717,"ARCHAMBAULT, BRIDGET, LANE",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1578646865,CHARLOTTE SPEECH AND HEARING CENTER,~,817 E MOREHEAD ST STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578646865,CHARLOTTE SPEECH AND HEARING CENTER,817 E MOREHEAD ST STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,, 82 , 837 , 841 ," $54,312.91 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578647467,"MYERS, SARAH, ANN CARPENTER",DUKE MEDICAL CIR DUKE SURGICAL PDC DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578647467,"MYERS, SARAH, ANN CARPENTER",DUKE MEDICAL CIR DUKE SURGICAL PDC DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578649471,"CUMMINS, MARK, OWEN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 65 , 79 , 207 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578649471,"CUMMINS, MARK, OWEN",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 278 , 342 , 820 ," $46,652.63 ",,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578649471,"CUMMINS, MARK, OWEN",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 15 , 33 ,$#,,
MEDICAID DIRECT,1093879363,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC DENTAL HEALTH CENTER,130 FOREST GLEN RD   COLUMBUS NC,075,Polk,193200000X,Group,Multi-Specialty,,1578649471,"CUMMINS, MARK, OWEN",130 FOREST GLEN RD   COLUMBUS NC,075,Polk,1223G0001X,Dental Providers,Dentist,General Practice, 113 , 151 , 349 ," $16,429.31 ",,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1578652236,"EVANS, DARRELL, BRIAN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 96 , 104 , 104 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578652830,"DAWKINS, KARON",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578653044,"GENDZEL, LEONARDO",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 63 , 68 ,$#,,
MEDICAID DIRECT,1548525470,BAILLIARD HENRY PEDIATRIC CARDIOLOG,~,4301 LAKE BOONE TRL STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578653200,"HENRY, GEORGE, WILLIAM",4301 LAKE BOONE TRL STE 300 RALEIGH NC,092,Wake,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 19 , 20 , 66 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578655643,"SMITH, KAREN, MARIE",311 E PRESNELL ST   ASHEBORO NC,076,Randolph,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578655643,"SMITH, KAREN, MARIE",601 N ELM ST   HIGH POINT NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 15 , 27 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578655643,"SMITH, KAREN, MARIE",601 N ELM ST   HIGH POINT NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578655643,"SMITH, KAREN, MARIE",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 35 , 47 , 57 ,$#,,
MEDICAID DIRECT,1578658837,QUALITY MOBILE X RAY INC,~,3330 HEALY DR STE 100 WINSTON SALEM NC,034,Forsyth,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,,1578658837,QUALITY MOBILE X RAY INC,3330 HEALY DR STE 100 WINSTON SALEM NC,034,Forsyth,335V00000X,Suppliers,Portable X-ray and/or Other Portable Diagnostic Imaging Supplier,," 2,766 "," 5,372 "," 11,233 "," $123,783.13 ",,
MEDICAID DIRECT,1861244477,EASTER SEALS UCP NORTH CAROLINA & V,EASTERSEALS PORT HEALTH,203 GOVERNMENT CIR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578659694,"PUGH, CAROLYN, KNOWLTON",2602 COURTIER DR   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1356368708,CAMPUS HEALTH PHARMACY,CAMPUS HEALTH SERVICES,320 EMERGENCY ROOM DR JAMES A TAYLOR BLDG CB 7470 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578662441,"CIOCCA, MARIO, FRANK",320 EMERGENCY ROOM DR TAYLOR STUDENT HEALTH SERVICES CHAPEL HILL NC,068,Orange,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine,#,#,#,$#,,
MEDICAID DIRECT,1437552015,UNC PHYSICIANS NETWORK LLC,,400 N ENGLEWOOD DR   KENLY NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578665444,"CAPPS, DONNA, MICHELLE",400 N ENGLEWOOD DR   KENLY NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 61 , 106 , 199 ,$#,,
MEDICAID DIRECT,1578666251,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07335,1601 FOREST HILLS RD W   WILSON NC,098,Wilson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1578666251,NORTH CAROLINA CVS PHARMACY LLC,1601 FOREST HILLS RD W   WILSON NC,098,Wilson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1578666251,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07335,1601 FOREST HILLS RD W   WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1578666251,NORTH CAROLINA CVS PHARMACY LLC,1601 FOREST HILLS RD W   WILSON NC,098,Wilson,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1578666251,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07335,1601 FOREST HILLS RD W   WILSON NC,098,Wilson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1578666251,NORTH CAROLINA CVS PHARMACY LLC,1601 FOREST HILLS RD W   WILSON NC,098,Wilson,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1578666913,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07587,3116 E 10TH ST   GREENVILLE NC,074,Pitt,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1578666913,NORTH CAROLINA CVS PHARMACY LLC,3116 E 10TH ST   GREENVILLE NC,074,Pitt,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1578666913,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07587,3116 E 10TH ST   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1578666913,NORTH CAROLINA CVS PHARMACY LLC,3116 E 10TH ST   GREENVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1578667242,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07163,3966 S MAIN ST   HOPE MILLS NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1578667242,NORTH CAROLINA CVS PHARMACY LLC,3966 S MAIN ST   HOPE MILLS NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1578667242,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07163,3966 S MAIN ST   HOPE MILLS NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1578667242,NORTH CAROLINA CVS PHARMACY LLC,3966 S MAIN ST   HOPE MILLS NC,026,Cumberland,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1578668711,"BUJOLD, EDWARD, JAMES",~,4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1578668711,"BUJOLD, EDWARD, JAMES",4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 42 , 48 ,$#,,
MEDICAID DIRECT,1861685364,EDWARD J BUJOLD MD,GRANITE FALLS FAMILY MEDICAL CENTER,4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1578668711,"BUJOLD, EDWARD, JAMES",4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 46 , 54 ,$#,,
MEDICAID DIRECT,1679387427,BLUE RIDGE HEALTHCARE MEDICAL GROUP,GRANITE FALLS FAMILY MEDICAL CENTER,4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1578668711,"BUJOLD, EDWARD, JAMES",4132 HICKORY BLVD   GRANITE FALLS NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 31 , 55 ,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578668810,"COREY, JOHN, DANIEL",75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 91 , 155 ,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578668810,"COREY, JOHN, DANIEL",72 CHATHAM BUSINESS DR   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 21 , 21 ,$#,,
MEDICAID DIRECT,1124281084,GRANT AND JOYNER DDS PA,HORIZON FAMILY DENTISTRY,6250 ROGERS RD   ROLESVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1578671103,"GRANT-HYMAN, KENISHA, LASHAE",6250 ROGERS RD   ROLESVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 381 , 689 ," 2,476 "," $119,924.31 ",,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578671103,"GRANT-HYMAN, KENISHA, LASHAE",6250 ROGERS RD   ROLESVILLE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 459 , 479 ," 1,879 "," $82,038.87 ",,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578672499,"TORSONE, JULIE, MCCLELLAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1982269346,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CHILDRENS PEDIATRIC SURGERY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578672499,"TORSONE, JULIE, MCCLELLAN",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 21 , 35 , 42 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578674248,"MAZALEWSKI, JAMES, GEORGE",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578674248,"MAZALEWSKI, JAMES, GEORGE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578674248,"MAZALEWSKI, JAMES, GEORGE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578675674,"STOCKTON, LEON, EUGENE",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1578675674,"STOCKTON, LEON, EUGENE",2811 MCLAMB PL   GOLDSBORO NC,096,Wayne,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 42 , 55 ,$#,,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1578675955,"AINSWORTH, DEBORAH, LOWRY",1206 BROWN ST   WASHINGTON NC,007,Beaufort,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 114 , 171 , 406 ," $16,559.61 ",,
MEDICAID DIRECT,1679576763,COUNTY OF BEAUFORT,BEAUFORT COUNTY HEALTH DEPT,1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1578675955,"AINSWORTH, DEBORAH, LOWRY",1436 HIGHLAND DR   WASHINGTON NC,007,Beaufort,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 17 , 50 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578676979,"LITTLE, CHARLES, ANDREW",10305 HAMPTONS PARK DR STE 101 HUNTERSVILLE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 27 , 62 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578678066,"DESAIX, ANNA, CHRISTINE",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 14 , 14 , 21 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578678066,"DESAIX, ANNA, CHRISTINE",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578678066,"DESAIX, ANNA, CHRISTINE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 18 , 22 , 31 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578678066,"DESAIX, ANNA, CHRISTINE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 34 , 40 , 54 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 PERKINS DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578678066,"DESAIX, ANNA, CHRISTINE",100 PERKINS DR   CHAPEL HILL NC,068,Orange,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578678595,"IKONOMIDIS, JOHN, SOTIRIOS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 35 , 52 ," $33,502.76 ",,
MEDICAID DIRECT,1578680930,INREACH,InReach,6637 PLAZA RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578680930,INREACH,6637 PLAZA RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 120 , 120 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578683397,"FISHER, JULIE, GOTTLIEB",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 32 , 63 , 63 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1578683397,"FISHER, JULIE, GOTTLIEB",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578683397,"FISHER, JULIE, GOTTLIEB",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1578683397,"FISHER, JULIE, GOTTLIEB",411 BILLINGSLEY RD STE 103 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578683397,"FISHER, JULIE, GOTTLIEB",2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1578683611,"PATEL, SHETUL, ISHVERBHAI",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 68 , 107 , 236 ,$#,,
MEDICAID DIRECT,1578687232,WILKINSON CARE CENTER INC,ELDERBERRY HEALTH CARE,415 ELDERBERRY LN   MARSHALL NC,057,Madison,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578687232,WILKINSON CARE CENTER INC,415 ELDERBERRY LN   MARSHALL NC,057,Madison,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 13 ," 2,872 "," 2,895 "," $260,179.72 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578689907,"BUNN, BARRY, DUKE",310 S MCCASKEY RD   WILLIAMSTON NC,058,Martin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 23 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578689907,"BUNN, BARRY, DUKE",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578690210,"METHENY, VIKKI, GRIFFIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 42 , 70 , 71 ,$#,,
MEDICAID DIRECT,1578695441,SHIPMAN FAMILY HOME CARE INC,~,1614 E MARKET ST   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1578695441,SHIPMAN FAMILY HOME CARE INC,1614 E MARKET ST   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 25 ," 3,224 "," 3,225 "," $233,316.12 ",,
MEDICAID DIRECT,1053534446,HAMLET PODIATRY PC,~,16 WILLIAMS ST   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1578695573,"CRAWFORD, REMBERT, ALPHONSO",16 WILLIAMS ST   HAMLET NC,077,Richmond,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 44 , 149 , 483 ,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578695862,"CHONG, GABRIEL, TSING-TZONG",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 43 , 84 , 137 ,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578695862,"CHONG, GABRIEL, TSING-TZONG",10880 DURANT RD STE 112&124 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1578696233,PREMIER HOMECARE LLC,~,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,251J00000X,Agencies,Nursing Care,,1578696233,PREMIER HOMECARE LLC,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1578696233,PREMIER HOMECARE LLC,~,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,,1578696233,PREMIER HOMECARE LLC,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 8,007 "," 8,742 "," $1,305,785.57 ",,
MEDICAID DIRECT,1578696233,PREMIER HOMECARE LLC,~,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,251J00000X,Agencies,Nursing Care,,1578696233,PREMIER HOMECARE LLC,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,251J00000X,Agencies,Nursing Care,, 11 , 488 , 488 ," $199,715.52 ",,
MEDICAID DIRECT,1578696233,PREMIER HOMECARE LLC,~,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,385H00000X,Respite Care Facility,Respite Care,,1578696233,PREMIER HOMECARE LLC,91 N MAIN ST   GRANITE FALLS NC,014,Caldwell,385H00000X,Respite Care Facility,Respite Care,,#,#,#,$#,,
MEDICAID DIRECT,1114143542,NC DHHS CHILD AND FAMILY WELL-BEING,MORGANTON HICKORY CDSA,145 W PARKER RD STE A MORGANTON NC,012,Burke,252Y00000X,Agencies,Early Intervention Provider Agency,,1578697645,"JOHNSON, LISA, DOBSON",145 W PARKER RD STE A MORGANTON NC,012,Burke,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 179 , 199 , 233 ," $28,903.62 ",,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578700118,"VERKA, LISENA, GABRIELA",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 34 , 58 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578704474,"YANCEY, KATHERINE, HABENICHT",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578704474,"YANCEY, KATHERINE, HABENICHT",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 23 , 30 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578704474,"YANCEY, KATHERINE, HABENICHT",204 AIRPORT RD   KINSTON NC,054,Lenoir,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578705745,"FOX, DANIEL, LESTER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578705745,"FOX, DANIEL, LESTER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578705745,"FOX, DANIEL, LESTER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578705745,"FOX, DANIEL, LESTER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578705745,"FOX, DANIEL, LESTER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 69 , 109 , 119 ," $14,445.62 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1578706495,"DEVANI, VRINDA, DHRUVE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 26 , 30 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578706495,"DEVANI, VRINDA, DHRUVE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 80 , 89 , 107 ," $28,860.06 ",,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1083251300,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH WOMENS HEART & VASCULAR CENTER,,,Unknown,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",1718 E 4TH ST STE 501 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1083251300,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH WOMENS HEART & VASCULAR CENTER,,,Unknown,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 28 , 37 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",8110 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578706685,"CHARLES, SANDY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,1100 HEALING WAY STE 21C MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1578706859,"SOOD, POONAM",1100 HEALING WAY STE 21C MATTHEWS NC,090,Union,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 63 , 91 , 124 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,1100 HEALING WAY STE 21C MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1578706859,"SOOD, POONAM",1100 HEALING WAY STE 21C MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1578706917,"BULLERDICK, KERRY, CAMDEN",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 83 , 122 , 157 ," $15,279.71 ",,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578706925,"KUMAR, BALJINDER",1210 NEW GARDEN RD   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1659339596,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH URGENT CARE & OCCUPATIONAL MEDICINE,,,Unknown,193400000X,Group,Single Specialty,,1578706925,"KUMAR, BALJINDER",7811 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578706925,"KUMAR, BALJINDER",7811 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 71 , 109 ,$#,,
MEDICAID DIRECT,1093779951,EYE SURGERY AND LASER CLINIC INC,EYE SURGERY AND LASER CLINIC INC,500 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1578707261,"ROBINSON, SHAUN, BRADLEY",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578707261,"ROBINSON, SHAUN, BRADLEY",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 45 , 81 , 111 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578707923,"RIBOH, JONATHAN, CHARLES",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 33 , 46 ,$#,,
MEDICAID DIRECT,1578708368,APP-ECP LLC,EASTERN CAROLINA PATHOLOGY,2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,291U00000X,Laboratories,Clinical Medical Laboratory,,1578708368,APP-ECP LLC,2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,291U00000X,Laboratories,Clinical Medical Laboratory,, 57 , 62 , 104 ,$#,,
MEDICAID DIRECT,1578710521,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04988,101 W WASHINGTON ST   NASHVILLE NC,064,Nash,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1578710521,NORTH CAROLINA CVS PHARMACY LLC,101 W WASHINGTON ST   NASHVILLE NC,064,Nash,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1578710521,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 04988,101 W WASHINGTON ST   NASHVILLE NC,064,Nash,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1578710521,NORTH CAROLINA CVS PHARMACY LLC,101 W WASHINGTON ST   NASHVILLE NC,064,Nash,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578711024,"CHALLA, SURESH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 64 , 260 , 260 ," $10,380.91 ",,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578711024,"CHALLA, SURESH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578711024,"CHALLA, SURESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578711024,"CHALLA, SURESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1578712113,"PARSONS, BOBBI, JEAN",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578712113,"PARSONS, BOBBI, JEAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578712113,"PARSONS, BOBBI, JEAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578712113,"PARSONS, BOBBI, JEAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548909146,REX HOSPITAL INC,NORTH CAROLINA NEUROLOGY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578714143,"WABULYA, ANGELA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578714143,"WABULYA, ANGELA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578714143,"WABULYA, ANGELA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 71 , 110 , 130 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578714580,"STEPANEK, KELLY, DIANE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 77 , 77 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578716429,"FRECHMAN, ERICA, LYNN",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851931257,LANE AND ASSOCIATES XXXV DDS PA,,11180 E FINCH AVE   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1578719548,"BYRNE, JESSICA, MARIA",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578719548,"BYRNE, JESSICA, MARIA",6480 TRYON RD   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 53 , 72 , 205 ," $16,897.14 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578721395,"LAM, JACK, WEI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,110 CAPCOM AVE STE 200 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1578721395,"LAM, JACK, WEI",3050 DURALEIGH RD STE 201 RALEIGH NC,092,Wake,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,11200 GOVERNOR MANLY WAY STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578721395,"LAM, JACK, WEI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1578721395,"LAM, JACK, WEI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578721395,"LAM, JACK, WEI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578721395,"LAM, JACK, WEI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578722294,"DAW, MEGAN, ANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,2100 RIDGEFIELD BLVD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578722294,"DAW, MEGAN, ANNE",2100 RIDGEFIELD BLVD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578723102,"PISCOYA, JOSE, LUIS",1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 22 , 37 , 41 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578723102,"PISCOYA, JOSE, LUIS",3940 ARROWHEAD BLVD STE 230 MEBANE NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 33 , 42 ,$#,,
MEDICAID DIRECT,1164980546,MOSES CONE PHYSICIAN SERVICES INC,ALAMANCE SURGICAL ASSOCIATES,1041 KIRKPATRICK RD STE 150 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578723102,"PISCOYA, JOSE, LUIS",3940 ARROWHEAD BLVD STE 230 MEBANE NC,001,Alamance,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 22 , 23 ,$#,,
MEDICAID DIRECT,1538108535,EMERGENCY MEDICINE PHYSICIANS OF CA,,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578723144,"YOUNG, BRONWYN, LOUIS",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1154453496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT MINERAL SPRINGS,4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578723656,"SNOW, MERYL, JONES",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578723656,"SNOW, MERYL, JONES",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 37 , 95 , 99 ,$#,,
MEDICAID DIRECT,1881978690,DAVIS ORTHODONTICS PA,,111 POWELL MILL RD STE B SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578726360,"DAVIS, GLEN, STEWART",111 POWELL MILL RD STE B SPARTANBURG SC,101,Out of State <= 40 miles,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1578726378,"DIERKS, KRISTIN, PATRICIA",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,270 HORIZON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578726378,"DIERKS, KRISTIN, PATRICIA",270 HORIZON DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 26 , 65 ,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578726592,"SHAH, BINIT, PRABHULAL",9735 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 98 , 222 , 295 ,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1578726592,"SHAH, BINIT, PRABHULAL",9735 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578726592,"SHAH, BINIT, PRABHULAL",9735 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 187 , 426 , 608 ,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1578726592,"SHAH, BINIT, PRABHULAL",9735 KINCEY AVE STE 100 HUNTERSVILLE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 39 , 43 ,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1578726592,"SHAH, BINIT, PRABHULAL",269 GILLMAN RD STE 200 DENVER NC,055,Lincoln,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1912292335,CAROLINAS PAIN CENTER PLLC,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578726592,"SHAH, BINIT, PRABHULAL",269 GILLMAN RD STE 200 DENVER NC,055,Lincoln,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1487969507,FOREFRONT DERMATOLOGY SC,,801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1578726717,"HUTCHENS, KELLI, ANN",801 YORK ST   MANITOWOC WI,102,Out of State > 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 32 , 37 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 117 , 119 , 143 ,$#,,
MEDICAID DIRECT,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",,120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 83 , 86 , 95 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578729141,"JAKUBOWICZ, ANDREW, MICHAEL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1578730115,"RHODES, BRIAN, BERTRAND",18 13TH AVE NE   HICKORY NC,018,Catawba,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578730867,"JERE, CHARLES, SHINGIRAI",111 HOSPITAL DR   TARBORO NC,033,Edgecombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 68 , 68 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578730867,"JERE, CHARLES, SHINGIRAI",230 S FAIRVIEW RD   ROCKY MOUNT NC,033,Edgecombe,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 78 , 474 , 474 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578730867,"JERE, CHARLES, SHINGIRAI",901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 84 , 173 , 259 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578730867,"JERE, CHARLES, SHINGIRAI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 78 , 241 , 241 ,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1578730867,"JERE, CHARLES, SHINGIRAI",1676 S WESLEYAN BLVD   ROCKY MOUNT NC,098,Wilson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 24 , 47 , 47 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578734208,"SCHULZ, DAVID, IAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 118 , 119 , 169 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578734208,"SCHULZ, DAVID, IAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 225 , 233 , 292 ,$#,,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578735478,"HIREMATH, ADARSH, MALLINATH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 26 , 73 , 183 ," $14,078.58 ",,
MEDICAID DIRECT,1053805127,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578735478,"HIREMATH, ADARSH, MALLINATH",2610 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 64 , 163 , 374 ," $25,212.08 ",,
MEDICAID DIRECT,1558812594,ST LUKES HOSPITAL INC,FOOTHILLS MEDICAL ASSOCIATES,130 FOREST GLEN RD STE B COLUMBUS NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578735502,"HOWELL, JANET, DODGE",130 FOREST GLEN RD STE B COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 28 , 32 ,$#,,
MEDICAID DIRECT,1396573804,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH MULTISPECIALTY CLINIC FOOTHILLS,130 FOREST GLEN RD STE B COLUMBUS NC,075,Polk,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578735502,"HOWELL, JANET, DODGE",801 W MILLS ST STE C COLUMBUS NC,075,Polk,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922335462,CHRISTINA L POWERS DDS PLLC,CHRISTINA L POWERS DDS PLLC,110 FOX HOLLOW CT   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1578737698,"POWERS, CHRISTINA, LOUISE",10564 S US HIGHWAY 15 501 STE E SOUTHERN PINES NC,063,Moore,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1922335462,CHRISTINA L POWERS DDS PLLC,CHRISTINA L POWERS DDS PLLC,110 FOX HOLLOW CT   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1578737698,"POWERS, CHRISTINA, LOUISE",10564 S US HIGHWAY 15 501 STE E SOUTHERN PINES NC,063,Moore,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,603 "," 2,693 "," 9,642 "," $390,121.06 ",,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578738241,"BAKER, ERIN, HANNA",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578738241,"BAKER, ERIN, HANNA",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 34 , 44 , 44 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578738241,"BAKER, ERIN, HANNA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 44 , 61 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578738241,"BAKER, ERIN, HANNA",15830 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578739413,"MING, DAVID, YUNG",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578739413,"MING, DAVID, YUNG",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 73 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578739413,"MING, DAVID, YUNG",3643 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578739413,"MING, DAVID, YUNG",3643 N ROXBORO ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578740312,"HALSTEAD, LISA, SHERRILL",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 24 , 24 ,$#,,
MEDICAID DIRECT,1578742037,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-3864,561 YOPP RD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1578742037,WAL-MART STORES EAST LP,561 YOPP RD   JACKSONVILLE NC,067,Onslow,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578743076,"NEFF, LUCAS, PAUL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 62 , 120 , 131 ," $13,424.95 ",,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578743159,"POWELL II, GLEN, ELLIS",2525 COURT DR   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1811761349,CAROMONT MEDICAL GROUP INC,CAROMONT HEALTH MATERNITY CLINIC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578743159,"POWELL II, GLEN, ELLIS",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 136 , 191 , 240 ," $20,447.74 ",,
MEDICAID DIRECT,1578746848,DEVELOPMENTAL PLAY,~,1080 TAYLOR ESTATE RD   WILLIAMSTON NC,058,Martin,251S00000X,Agencies,Community/Behavioral Health,,1578746848,DEVELOPMENTAL PLAY,1080 TAYLOR ESTATE RD   WILLIAMSTON NC,058,Martin,251S00000X,Agencies,Community/Behavioral Health,, 16 , 293 , 293 ," $16,677.00 ",,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578747952,"SHARP, LINDSEY, SEAN",4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 47 , 79 , 81 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4207 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578747952,"SHARP, LINDSEY, SEAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578747952,"SHARP, LINDSEY, SEAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 17 , 19 ,$#,,
MEDICAID DIRECT,1578749594,SHI-ORANGE LLC,THE STRATFORD,405 SMITH LEVEL ROAD   CHAPEL HILL NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578749594,SHI-ORANGE LLC,405 SMITH LEVEL ROAD   CHAPEL HILL NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 49 ," 11,990 "," 11,993 "," $1,073,920.32 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1578749990,"LYNN, MATTHEW, ADAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578749990,"LYNN, MATTHEW, ADAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 190 , 211 , 263 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1578751319,"ZICKERMAN, ERIC, SCOTT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 102 , 113 , 122 ,$#,,
MEDICAID DIRECT,1538214713,CHILDRENS MEDICAL GROUP INC,TIDEWATER CHILDRENS ASSOCIATES,171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578752283,"MCCUE, ELLEN, WILLIAMS",171 KEMPSVILLE RD BLDG B NORFOLK VA,101,Out of State <= 40 miles,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,4009 BARRETT DR STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578755922,"HARRISON, DIONNE, DILLON",4009 BARRETT DR   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1912959834,CARTER CLINIC PA,CARTER CLINIC PA,19 NOBLE ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578755922,"HARRISON, DIONNE, DILLON",4009 BARRETT DR   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578757167,"KRISHNAN, SUNDAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578757167,"KRISHNAN, SUNDAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 15 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578757167,"KRISHNAN, SUNDAR",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578760286,"MODY, GITA, NATWAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 46 , 109 , 129 ," $12,215.42 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578760351,"DIPERT, KARLA, BROOKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 38 , 38 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1578760351,"DIPERT, KARLA, BROOKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1578760351,"DIPERT, KARLA, BROOKE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1578761102,"BEDELEY, EMMANUEL, NARH",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578761102,"BEDELEY, EMMANUEL, NARH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578761102,"BEDELEY, EMMANUEL, NARH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578761102,"BEDELEY, EMMANUEL, NARH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 44 , 126 , 126 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578761268,"SAINI, NATINDER, KAUR",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578762076,"GORDON-WILLIS, PATRICIA, LYNN",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1801442033,BRADLEY ROBERTS & ASSOCIATES PLLC,~,401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578762076,"GORDON-WILLIS, PATRICIA, LYNN",401 RANDOLPH ST   THOMASVILLE NC,029,Davidson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 63 , 63 ," 1,176 "," $98,548.88 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578762076,"GORDON-WILLIS, PATRICIA, LYNN",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 835 , 863 ," 5,793 "," $260,097.42 ",,
MEDICAID DIRECT,1902452139,BRADLEY ROBERTS & ASSOCIATES PLLC,,1135 N CHURCH ST   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1578762076,"GORDON-WILLIS, PATRICIA, LYNN",1135 N CHURCH ST   BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 66 , 64 ," 1,144 "," $93,895.57 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1578762076,"GORDON-WILLIS, PATRICIA, LYNN",510 NICHOLAS RD STE F GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 474 , 479 ," 3,875 "," $217,956.29 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1578762076,"GORDON-WILLIS, PATRICIA, LYNN",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 475 , 491 ," 3,414 "," $177,302.72 ",,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1578763140,"SUMMEY, BRETT, TAYLOR",169 DOCTORS DR   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1578763140,"SUMMEY, BRETT, TAYLOR",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 56 , 67 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578764213,"GOTTFRIED, OREN, NATHAN",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578764213,"GOTTFRIED, OREN, NATHAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578764213,"GOTTFRIED, OREN, NATHAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578764213,"GOTTFRIED, OREN, NATHAN",2100 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 14 , 22 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578764213,"GOTTFRIED, OREN, NATHAN",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578764213,"GOTTFRIED, OREN, NATHAN",2100 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 16 , 25 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578764213,"GOTTFRIED, OREN, NATHAN",3643 N ROXBORO ST   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1609912096,COUNTY OF JACKSON,JACKSON COUNTY HEALTH DEPARTMENT,538 SCOTTS CREEK RD   SYLVA NC,050,Jackson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1578764684,"PRENGER, CASEY, LEE",68 HOSPITAL RD   SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 123 , 438 ," $18,250.04 ",,
MEDICAID DIRECT,1386186120,JACKSON HM SERVICES PC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1578764684,"PRENGER, CASEY, LEE",68 HOSPITAL RD   SYLVA NC,050,Jackson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 59 , 215 , 219 ," $16,246.05 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578764866,"PALUMBO RASCH, APRIL, KRISTEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578764866,"PALUMBO RASCH, APRIL, KRISTEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 25 , 33 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578764866,"PALUMBO RASCH, APRIL, KRISTEN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 19 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578764866,"PALUMBO RASCH, APRIL, KRISTEN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 24 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578764866,"PALUMBO RASCH, APRIL, KRISTEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578764866,"PALUMBO RASCH, APRIL, KRISTEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578764866,"PALUMBO RASCH, APRIL, KRISTEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578766192,"GRAVES, DONNA, CHANDLER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 18 , 25 , 25 ,$#,,
MEDICAID DIRECT,1578766481,DAVIS FAMILY CARE HOME,DAVIS FAMILY CARE HOME,408 MIMOSA ST   OXFORD NC,039,Granville,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578766481,DAVIS FAMILY CARE HOME,408 MIMOSA ST   OXFORD NC,039,Granville,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,103 "," 1,103 "," $69,257.64 ",,
MEDICAID DIRECT,1790491751,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE PHYSICAL THERAPY,5921 W FRIENDLY AVE STE A1 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1578767125,"WAY, MICHAEL, COLE",5921 W FRIENDLY AVE STE A1 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1760420186,PRIDE IN NORTH CAROLINA LLC,~,5710 OLEANDER DR STE 112 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578768578,"MILLER, JENNIFER, MAE",5710 OLEANDER DR STE 112 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 47 , 47 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578768941,"HABERMAN, CARA, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 37 , 109 , 110 ," $10,739.60 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578769022,"DICKENS, JONATHAN, FREDERICK",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578769022,"DICKENS, JONATHAN, FREDERICK",3475 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578770095,"POTU, SANGEETHA",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578770095,"POTU, SANGEETHA",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 136 , 137 ,$#,,
MEDICAID DIRECT,1972079127,MH TRANSYLVANIA REGIONAL HOSPITAL L,,360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578772919,"PLOTT, EVA, JANICE",360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578772919,"PLOTT, EVA, JANICE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1578773842,"NARZYNSKI, MARGARETE",1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 134 , 134 , 136 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578776068,"HARING, JAMIE, FUTO",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578776068,"HARING, JAMIE, FUTO",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578776472,"JOHNSTON, MICHAEL, STUART",JOHNSTON ORTHODONTICS,3115 BRUSHY CREEK RD BLDG E GREER SC,101,Out of State <= 40 miles,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1578776472,"JOHNSTON, MICHAEL, STUART",3115 BRUSHY CREEK RD BLDG E GREER SC,101,Out of State <= 40 miles,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 41 , 196 , 222 ," $38,942.59 ",,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578777017,"HIGGINS, KRISTEN, BALKCUM",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 16 , 28 , 63 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578777017,"HIGGINS, KRISTEN, BALKCUM",937 COX RD   GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 13 , 25 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578777017,"HIGGINS, KRISTEN, BALKCUM",959 COX RD STE 1 GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 22 , 44 ,$#,,
MEDICAID DIRECT,1598584781,AMAN MASOOMI DDS PLLC,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1578778577,"JACOBS, DIANE, MILDRED",3823 GUESS RD STE P DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 73 , 74 , 296 ," $11,308.13 ",,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578778577,"JACOBS, DIANE, MILDRED",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 48 , 48 , 196 ,$#,,
MEDICAID DIRECT,1598584781,AMAN MASOOMI DDS PLLC,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1578778577,"JACOBS, DIANE, MILDRED",49 QUAIL PLACE TRL   CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578778577,"JACOBS, DIANE, MILDRED",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578778577,"JACOBS, DIANE, MILDRED",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 147 , 224 , 507 ," $26,406.79 ",,
MEDICAID DIRECT,1023177151,ACCESS DENTAL CARE,ACCESS DENTAL CARE,513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1578778577,"JACOBS, DIANE, MILDRED",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1598584781,AMAN MASOOMI DDS PLLC,WILLOWDAILE FAMILY DENTISTRY,3823 GUESS RD STE P DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1578778577,"JACOBS, DIANE, MILDRED",513 WHITE OAK ST STE D ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1083779797,COUNTY OF BLADEN OFFICE OF AUDITOR,BLADEN CO HEALTH DEPT,300 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1578779880,"CLARKE, CAROL, ANN",300 MERCER MILL ROAD   ELIZABETHTOWN NC,009,Bladen,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 20 , 56 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578780177,"BOTSE BAIDOO, EDWARD, KWAMENA BOSOMTWI",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 33 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578780201,"TIPTON, JOHN, SISON",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 108 , 169 , 323 ," $14,411.70 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578781415,"FELDMAN, ZACHARY, WILLIAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578782330,"HAYES, CAROL, LYNN",700A PROGRESS PL   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 73 , 96 , 122 ,$#,,
MEDICAID DIRECT,1124552310,SCOTLAND MEMORIAL HOSPITAL INC,WOLONICK FAMILY PRACTICE CENTER,106 MCALPINE LN   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578782330,"HAYES, CAROL, LYNN",106 MCALPINE LN   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 47 , 57 ,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,101 PLAZA RD   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1578782330,"HAYES, CAROL, LYNN",106 MCALPINE LN   LAURINBURG NC,083,Scotland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 40 , 53 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578782819,"BUCK, ROSILAND, DIXON",275 BETHESDA DR   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578782819,"BUCK, ROSILAND, DIXON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 58 , 90 , 113 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578784005,"MOSHER, KELLI, ANN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 66 , 67 ,$#,,
MEDICAID DIRECT,1730583600,THE BONE AND JOINT SURGERY CLINIC,,3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578784591,"IDLER, CARY, SCOTT",3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 34 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578785002,"MERRITT, BRADLEY, GENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 31 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578785002,"MERRITT, BRADLEY, GENE",410 MARKET ST STE 400B CHAPEL HILL NC,068,Orange,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 19 , 25 , 59 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578785390,"BELL, MARGARET, DAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 48 , 49 , 52 ,$#,,
MEDICAID DIRECT,1134172604,WESTERN PIEDMONT ANESTHESIA,WESTERN PIEDMONT ANESTHESIA,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1578785390,"BELL, MARGARET, DAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 50 , 51 , 58 ,$#,,
MEDICAID DIRECT,1144259961,ALLCARE CLINICAL ASSOCIATES PA,~,,,Unknown,193400000X,Group,Single Specialty,,1578785390,"BELL, MARGARET, DAY",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1578785556,"CUMMINGS, MARK, WILLIAMS",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1578785556,"CUMMINGS, MARK, WILLIAMS",2754 NC HIGHWAY 68 S STE 111 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 54 , 100 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1578785655,"BOULKINA, LIOUBOV",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578785655,"BOULKINA, LIOUBOV",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578785655,"BOULKINA, LIOUBOV",3434 EDWARDS MILL RD STE 112-398 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578785655,"BOULKINA, LIOUBOV",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1578786919,"VAIKUNTH, APARNA, BHASKAR",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 91 , 155 , 399 ," $23,680.65 ",,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1578786919,"VAIKUNTH, APARNA, BHASKAR",130 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578788162,"HAAG, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578788162,"HAAG, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 263 , 409 , 575 ," $16,611.09 ",,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578788162,"HAAG, JASON",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578788162,"HAAG, JASON",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578788162,"HAAG, JASON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 16 , 17 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578788162,"HAAG, JASON",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578788162,"HAAG, JASON",166 SPRINGBROOK AVE   CLAYTON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578790549,"PALADUGU, JYOTHI",1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 97 , 163 , 380 ,$#,,
MEDICAID DIRECT,1760918684,OBRIEN AND WEST DMD IV PLLC,NIGHT AND DAY DENTAL,6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",6316 E INDEPENDENCE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 62 , 144 ,$#,,
MEDICAID DIRECT,1528628526,OBRIEN AND WEST DMD VIII PLLC,NIGHT AND DAY DENTAL,19911 ZION AVE   CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",19911 ZION AVE BLDG D CORNELIUS NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 13 , 12 , 28 ,$#,,
MEDICAID DIRECT,1942975776,OBRIEN AND WEST DMD XI PLLC,NIGHT AND DAY DENTAL,532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 163 , 224 , 494 ," $32,214.72 ",,
MEDICAID DIRECT,1750871562,OBRIEN AND WEST DMD V PLLC,~,452 SHOTWELL RD   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",452 SHOTWELL RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 21 ,$#,,
MEDICAID DIRECT,1265829030,OBRIEN AND WEST DMD II PLLC,NIGHT AND DAY DENTAL,3500 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",3500 N DUKE ST   DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 53 ,$#,,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",1325 BRADFORD VIEW DR STE 102 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 36 , 36 , 95 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1124659602,OBRIEN AND WEST DMD VII PLLC,NIGHT AND DAY DENTAL,420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",420 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 40 , 105 ,$#,,
MEDICAID DIRECT,1942975776,OBRIEN AND WEST DMD XI PLLC,NIGHT AND DAY DENTAL,532 N ELAM AVE STE B GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578790762,"WEST, CHAUNCEY, WALKER",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1871327080,RALEIGH DURHAM MEDICAL GROUP PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578791422,"SANGINENI, SHIREESHA",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 48 , 85 , 188 ,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,413 OWEN DR STE 202 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578791422,"SANGINENI, SHIREESHA",413 OWEN DR STE 202 FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447739149,RDMG ASSOCIATES PA,,405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578791422,"SANGINENI, SHIREESHA",405 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 59 , 112 , 203 ,$#,,
MEDICAID DIRECT,1811313356,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY HEALTHCARE,327 1ST AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578791513,"TEDROW, UMPAI, POOPAT",327 1ST AVE NW   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 139 , 301 , 643 ," $14,643.82 ",,
MEDICAID DIRECT,1962478362,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE,327 1ST AVE NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578791513,"TEDROW, UMPAI, POOPAT",327 1ST AVE NW   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578792453,"BREWTON, CARY, LLOYD",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235682022,PLEASURE ISLAND HEALTH PLLC,,1328 LAKE PARK BLVD N STE 102 CAROLINA BEACH NC,065,New Hanover,193400000X,Group,Single Specialty,,1578793725,"FARMER, KENNETH, CHRISTOPHER",1328 LAKE PARK BLVD N STE 102 CAROLINA BEACH NC,065,New Hanover,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 66 , 306 , 587 ," $10,518.83 ",,
MEDICAID DIRECT,1578793766,MED-TRANS CORPORATION,~,251 DRY VALLEY RD NE   CLEVELAND TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1578793766,MED-TRANS CORPORATION,251 DRY VALLEY RD NE   CLEVELAND TN,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578794780,"SUDINI, SRIKAR, REDDY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578794780,"SUDINI, SRIKAR, REDDY",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578795290,"GRINSTEAD, RICHARD, DAVID",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578795290,"GRINSTEAD, RICHARD, DAVID",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578797395,"FELDER, JERROD, JOSEPH",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578797395,"FELDER, JERROD, JOSEPH",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578797395,"FELDER, JERROD, JOSEPH",601 N ELM ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 16 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578797395,"FELDER, JERROD, JOSEPH",611 N LINDSAY ST STE 200 HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 101 , 165 , 369 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578797395,"FELDER, JERROD, JOSEPH",600 N LINDSAY ST   HIGH POINT NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1316455223,MOSES CONE PHYSICIAN SERVICES INC,~,1248 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578798591,"VANGA, ROHINI, REDDY",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1316455223,MOSES CONE PHYSICIAN SERVICES INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578798591,"VANGA, ROHINI, REDDY",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316455223,MOSES CONE PHYSICIAN SERVICES INC,~,1248 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578798591,"VANGA, ROHINI, REDDY",1248 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 59 , 89 , 101 ,$#,,
MEDICAID DIRECT,1174624498,EAST TENNESSEE ORAL MAXILLOFACIAL,EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY PC,1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578798666,"MAY, WILLIAM, RUSSELL",307 MAPLE ST   ATHENS TN,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 90 , 108 , 605 ," $66,649.31 ",,
MEDICAID DIRECT,1174624498,EAST TENNESSEE ORAL MAXILLOFACIAL,EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY PC,1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578798666,"MAY, WILLIAM, RUSSELL",1505 E LAMAR ALEXANDER PKWY   MARYVILLE TN,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 19 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1578802427,"COUNTOURIOTIS, MICHELLE",2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1538171897,SALEM PROFESSIONAL ANESTHESIA SERVI,SALEM PROFESSIONAL ANESTHESIA SERVICES,128 PEACHTREE LN STE B ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1578802427,"COUNTOURIOTIS, MICHELLE",2041 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",1605 MEDICAL PARK DR W   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",2833 WOOTEN BLVD SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",2833 WOOTEN BLVD SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 57 , 147 , 245 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3604 BUSH ST FL 2 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 24 , 36 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",2503 WOOTEN BLVD SW   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1578803219,"COLLIER, LORIE, TYSON",1605 MEDICAL PARK DR W   WILSON NC,098,Wilson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1578804258,"KELLEY, KIMBERLY, BETH",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 36 , 68 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578806725,"ANTAAL MANN, GUNJAN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 122 , 124 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578815619,"KO, ALLISON, MOORE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,100 KELLIE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578816401,"HOLMES, MICHAEL, RAY",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 25 , 54 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578816401,"HOLMES, MICHAEL, RAY",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578816401,"HOLMES, MICHAEL, RAY",100 KELLIE DR   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578816401,"HOLMES, MICHAEL, RAY",2196 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1316375140,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-MEDICALINTENSIVISTS,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578818258,"SIDDIQUI, FARHAJ",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1578818423,AVERY COUNTY SCHOOLS,~,775 CRANBERRY ST   NEWLAND NC,006,Avery,251300000X,Agencies,Local Education Agency (LEA),,1578818423,AVERY COUNTY SCHOOLS,775 CRANBERRY ST   NEWLAND NC,006,Avery,251300000X,Agencies,Local Education Agency (LEA),, 79 ," 1,565 "," 1,610 "," $57,874.48 ",,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1578820171,"SCHMIDT, SCOTT, GARY",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578820171,"SCHMIDT, SCOTT, GARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 34 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578820171,"SCHMIDT, SCOTT, GARY",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578820171,"SCHMIDT, SCOTT, GARY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578820171,"SCHMIDT, SCOTT, GARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578820171,"SCHMIDT, SCOTT, GARY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 53 , 69 , 77 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578820171,"SCHMIDT, SCOTT, GARY",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578820452,"JADAPALLE, SREE LATHA KRISHNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578822052,"MURPH, DANIEL, CHRISTIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 52 , 59 , 91 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578822052,"MURPH, DANIEL, CHRISTIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578822052,"MURPH, DANIEL, CHRISTIAN",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 ,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578822128,"LAU, WINNIE, KAY",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 44 , 93 , 103 ," $12,868.71 ",,
MEDICAID DIRECT,1790446672,LANE & ASSOCIATES XLIV DDS PA,~,7430 RICHLANDS HWY   RICHLANDS NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 63 , 76 , 221 ,$#,,
MEDICAID DIRECT,1033794300,LANE AND ASSOCIATES XLI DDS PA,,571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1851746853,LANE AND ASSOCIATES XXIX DDS PA,~,6480 TRYON RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 17 , 47 ,$#,,
MEDICAID DIRECT,1952940926,LANE AND ASSOCIATES XXXVI DDS PA,,900 S GARNETT ST   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1902950769,LANE & ASSOCIATES XV DDS PA,LANE & ASSOCIATES XV DDS PA,2617 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1508917592,LANE AND ASSOCIATES III DDS PA,Lane and Associates III DDS PA,15 RAWLS RD STE 200 ANGIER NC,043,Harnett,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 16 , 62 ,$#,,
MEDICAID DIRECT,1538776455,LANE AND ASSOCIATES XXXIX,,161 KODIAK LN   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1497465207,LANE AND ASSOCIATES XLV DDS PA,,1310 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245992999,LANE AND ASSOCIATES XLII DDS PA,,2401 CAPITAL BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 40 , 139 ,$#,,
MEDICAID DIRECT,1154954550,LANE AND ASSOCIATES XXXVII DDS PA,,473 WOOD ST   TROY NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 23 ,$#,,
MEDICAID DIRECT,1821623620,LANE AND ASSOCIATES XXXVIII DDS PA,,101 NORTHPOINT AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 31 ,$#,,
MEDICAID DIRECT,1083144992,LANE AND ASSOCIATES XXXII DDS PA,,411 FAIRVIEW ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 12 , 12 , 32 ,$#,,
MEDICAID DIRECT,1417008442,LANE AND ASSOCIATES II DDS PA,~,100 N 10TH ST   ERWIN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice," 1,120 "," 1,869 "," 6,413 "," $281,345.16 ",,
MEDICAID DIRECT,1841694254,LANE AND ASSOCIATES XXVIII DDS PA,,920 W HAMLET AVE   HAMLET NC,077,Richmond,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 126 , 146 , 465 ," $20,970.68 ",,
MEDICAID DIRECT,1720131972,LANE ASSOCIATES DDS XVII PA,LANE & ASSOCIATES XVII DDS PA,12450 CLEVELAND RD STE 100 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972654655,LANE AND ASSOCIATES VII DDS PA,LANE AND ASSOCIATES VII DDS PA,102 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 36 ,$#,,
MEDICAID DIRECT,1588717912,LANE AND ASSOCIATES VIII DDS PA,LANE AND ASSOCIATES VIII DDS PA,912 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 41 ,$#,,
MEDICAID DIRECT,1154336642,LANE AND ASSOCIATES I DDS PA,LANE AND ASSOCIATES I DDS PA,1213 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 42 ,$#,,
MEDICAID DIRECT,1689458168,LANE AND ASSOCIATES LI DDS PA,,311 S BICKETT BLVD   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1881940906,LANE AND ASSOCIATES XXVI DDS PA,LANE AND ASSOCIATES XXVI DDS PA,401 E DR MARTIN L KING JR BLVD   ROSEBORO NC,082,Sampson,193200000X,Group,Multi-Specialty,,1578822599,"PIERMONT, HUNTER, HENDRY",100 N 10TH ST   ERWIN NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 44 , 172 ,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578822615,"ZARICK, AMANDA, SAYED",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 ,#, 25 ,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1578824686,"DEMARIANO, MEGAN, ANN",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3416 POOLE RD STE 120 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578824686,"DEMARIANO, MEGAN, ANN",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 31 , 59 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578824686,"DEMARIANO, MEGAN, ANN",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1578824785,"STEIGERWALD, MICHAEL, LEE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578824785,"STEIGERWALD, MICHAEL, LEE",1705 TARBORO ST SW   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114430451,AMANDA LEE DDS PA,HILLSBOROUGH PEDIATRIC DENTISTRY,310 MILLSTONE DR   HILLSBOROUGH NC,068,Orange,193400000X,Group,Single Specialty,,1578825170,"WOODY, SHAUNA, REQUEL",310 MILLSTONE DR   HILLSBOROUGH NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 36 ,$#,,
MEDICAID DIRECT,1124235205,MICHAEL A IGNELSI JR DDS PHD PA,LAKE JEANETTE ORTHO PED DENT,3901 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1578825170,"WOODY, SHAUNA, REQUEL",306 ALAMANCE RD STE C BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 21 , 23 , 84 ,$#,,
MEDICAID DIRECT,1689852477,M TODD GROOMS DDS PA,ALAMANCE PEDIATRIC DENTISTRY,306 ALAMANCE RD STE C BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578825170,"WOODY, SHAUNA, REQUEL",306 ALAMANCE RD STE C BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 660 , 870 ," 3,163 "," $89,909.80 ",,
MEDICAID DIRECT,1669573010,"GROOMS, MICHAEL, TODD",,306 ALAMANCE RD STE C BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1578825170,"WOODY, SHAUNA, REQUEL",306 ALAMANCE RD STE C BURLINGTON NC,001,Alamance,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 15 ,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1578827010,"BAILEY, JODI, LYNN",2076 VETERANS PKWY STE 110 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1578827010,"BAILEY, JODI, LYNN",2076 NC HIGHWAY 42 W STE 110 CLAYTON NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 17 , 29 ,$#,,
MEDICAID DIRECT,1457398380,TRIANGLE PREMIER WOMENS HEALTH PA,~,520 NORTH ST   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1578827010,"BAILEY, JODI, LYNN",520 NORTH ST   SMITHFIELD NC,051,Johnston,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 31 , 37 ," $15,816.23 ",,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1578828661,"BROWN, ANGELA, BENNETT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578828661,"BROWN, ANGELA, BENNETT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578829073,"BRIDGFORTH, ANDREW, BAGLEY",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 141 , 292 , 599 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578829313,"PATEL, BHAVINKUMAR, VIJAYBHAI",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578829313,"PATEL, BHAVINKUMAR, VIJAYBHAI",5151 SARDIS RD   CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578829313,"PATEL, BHAVINKUMAR, VIJAYBHAI",101 E WT HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 26 , 61 , 61 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578829313,"PATEL, BHAVINKUMAR, VIJAYBHAI",600 FULLWOOD RD   MATTHEWS NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 23 , 95 , 98 ,$#,,
MEDICAID DIRECT,1417267428,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SENIOR CARE,101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578829313,"PATEL, BHAVINKUMAR, VIJAYBHAI",101 E WT HARRIS BLVD STE 1110 CHARLOTTE NC,060,Mecklenburg,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 28 , 68 , 69 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 226 , 227 ," $12,623.73 ",,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1578832663,"SHERI, VENKATA, NARSIMHA REDDY",1000 HEALING WAY   MATTHEWS NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578836995,"BROOKSHIRE, ELIZABETH, ANN ESSICK",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1578836995,"BROOKSHIRE, ELIZABETH, ANN ESSICK",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1578836995,"BROOKSHIRE, ELIZABETH, ANN ESSICK",117 E KINGS HWY   EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1578836995,"BROOKSHIRE, ELIZABETH, ANN ESSICK",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578836995,"BROOKSHIRE, ELIZABETH, ANN ESSICK",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578836995,"BROOKSHIRE, ELIZABETH, ANN ESSICK",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578839395,"SOOD, CHANCHALDEEP, KAUR",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 17 , 28 , 36 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578839395,"SOOD, CHANCHALDEEP, KAUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578839395,"SOOD, CHANCHALDEEP, KAUR",101 MANNING DR   CHAPEL HILL NC,068,Orange,207KA0200X,Allopathic & Osteopathic Physicians,Allergy & Immunology,Allergy, 12 , 47 , 56 ,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578839908,"SIMPSON, MATTHEW, JAMES",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578839908,"SIMPSON, MATTHEW, JAMES",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578839908,"SIMPSON, MATTHEW, JAMES",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1578841334,"WESTER, MEGAN, JANE",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 38 , 64 ,$#,,
MEDICAID DIRECT,1679976864,LOCKHART & LOCKHART PLLC,DUAL IMAGE ORTHODONTICS,2620 W ARROWOOD RD STE 102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578842001,"LOCKHART, LAUREN, RENNICK",2620 W ARROWOOD RD STE 102 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 826 ," 3,082 "," 4,253 "," $717,828.09 ",,
MEDICAID DIRECT,1104819754,SHELBY MEDICAL ASSOCIATES PA,~,711 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1578842332,"FOX, COLLETTE, ROBERTS",711 N DEKALB ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 38 , 127 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578842894,"COURTEMANCHE, RACHEL, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578842894,"COURTEMANCHE, RACHEL, MARIE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578843447,"GOFF, DAVID, CHRISTOPHER",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578843447,"GOFF, DAVID, CHRISTOPHER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578843447,"GOFF, DAVID, CHRISTOPHER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912008459,"WARREN ULANCH, JULIA, GLADYS",CREEDMOOR CENTRE ENDOCRINOLOGY,8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",1578844775,"POLANCO CASTILLO, GEORGINA, GLORIVEL",8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 11 , 15 ,$#,,
MEDICAID DIRECT,1841627692,CREEDMOOR CENTRE ENDOCRINOLOGY,~,8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578844775,"POLANCO CASTILLO, GEORGINA, GLORIVEL",8340 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578848735,"IVEY, LAURA, ANN",2208 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639123979,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY HOSPITALIST,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578850475,"CLARK, TYLER, ALLEN",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 140 , 140 ,$#,,
MEDICAID DIRECT,1710991153,TIDEWATER EMERGENCY MEDICAL CARE LT,CHESAPEAKE EMERGENCY PHYSICIANS,736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578850889,"SHARKEY, CRAIG, MUN CONG",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578854261,"HABIBI, SUSAN, ENAYAT POUR",100 SENTARA CIR RM 2C WILLIAMSBURG VA,102,Out of State > 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578854956,"BHAT, SUNEEL, BHASKAR",1080 FIRST COLONIAL RD STE 305 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578854956,"BHAT, SUNEEL, BHASKAR",850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578856159,"DIAZ, JONATHAN, RAY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578856159,"DIAZ, JONATHAN, RAY",155 MEMORIAL DR   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1578856266,CPS HOME CARE INC,~,1700 E ASH ST STE 301 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1578856266,CPS HOME CARE INC,1700 E ASH ST STE 301 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 2,631 "," 2,631 "," $264,635.92 ",,
MEDICAID DIRECT,1730583600,THE BONE AND JOINT SURGERY CLINIC,,3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578857652,"NELSON, JOHN, THOMAS",3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 33 , 77 ,$#,,
MEDICAID DIRECT,1972874907,CAPITAL CITY SURGERY CENTER LLC,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1578857652,"NELSON, JOHN, THOMAS",3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578857652,"NELSON, JOHN, THOMAS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,1423 E FRANKLIN ST STE I MONROE NC,090,Union,193400000X,Group,Single Specialty,,1578857975,"GLEASON, RYAN, MICHAEL",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578857975,"GLEASON, RYAN, MICHAEL",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578857975,"GLEASON, RYAN, MICHAEL",600 HOSPITAL DR STE A MONROE NC,090,Union,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578857975,"GLEASON, RYAN, MICHAEL",10660 PARK RD STE 4500 CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 40 , 57 , 84 ,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578857975,"GLEASON, RYAN, MICHAEL",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,1460 KELLY RD   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1578858015,"SHAW, NATHANAEL, STEPHEN",2350 BENTRIDGE LN   FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 25 ,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,1625 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1578858015,"SHAW, NATHANAEL, STEPHEN",2350 BENTRIDGE LN   FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 31 ,$#,,
MEDICAID DIRECT,1710692918,DRS ABDELBAKY BOES CAMERON & ASS,CAROLINA ORTHODONTICS & CHILDRENS DENTISTRY,2350 BENTRIDGE LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578858015,"SHAW, NATHANAEL, STEPHEN",2350 BENTRIDGE LN   FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 53 , 83 , 520 ," $22,606.70 ",,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,7535 CARPENTER FIRE STATION RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578858015,"SHAW, NATHANAEL, STEPHEN",2350 BENTRIDGE LN   FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1063868438,JESSE D ARBON DDS MS PA,CAROLINA ORTHODONTICS AND CHILDRENS DENTISTRY,101 REDFORD PLACE DR STE 100   ROLESVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1578858015,"SHAW, NATHANAEL, STEPHEN",2350 BENTRIDGE LN   FAYETTEVILLE NC,026,Cumberland,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 25 , 27 , 77 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578859039,"VICE, TAYLOR, FREDERICK RANDALL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578859278,"DAY, LAUREN, LOVEJOY",10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578859278,"DAY, LAUREN, LOVEJOY",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 40 , 52 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10405 CENTRUM PKWY   PINEVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578859278,"DAY, LAUREN, LOVEJOY",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1578859716,"PATEL, RAJ, VINOD",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1578859716,"PATEL, RAJ, VINOD",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578859716,"PATEL, RAJ, VINOD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578859716,"PATEL, RAJ, VINOD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 49 , 56 , 59 ,$#,,
MEDICAID DIRECT,1497792469,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PSYCHIATRIC SERVICES,1120 FAIRGROVE CHURCH RD STE 12 HICKORY NC,018,Catawba,273R00000X,Hospital Units,Psychiatric Unit,,1578860110,"BLUE, INDIA, MOONDANCER",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1497792469,CATAWBA VALLEY MEDICAL CENTER,CATAWBA VALLEY PSYCHIATRIC SERVICES,1120 FAIRGROVE CHURCH RD STE 12 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578860110,"BLUE, INDIA, MOONDANCER",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578863742,"MILLS, TAMI, JEAN",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578863742,"MILLS, TAMI, JEAN",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578863742,"MILLS, TAMI, JEAN",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 66 , 80 , 113 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578863742,"MILLS, TAMI, JEAN",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578863742,"MILLS, TAMI, JEAN",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578863742,"MILLS, TAMI, JEAN",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578863742,"MILLS, TAMI, JEAN",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578866075,"BULLARD, CHRISTINA, MARIE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578866075,"BULLARD, CHRISTINA, MARIE",15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578866075,"BULLARD, CHRISTINA, MARIE",15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578866075,"BULLARD, CHRISTINA, MARIE",15825 JOHN J DELANEY DR STE 220 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558686188,MECKLENBURG MEDICAL GROUP,ATRIUM HEALTH PRIMARY CARE MECKLENBURG MEDICAL GRO,15110 JOHN J DELANEY DR STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578866075,"BULLARD, CHRISTINA, MARIE",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578866471,"SELF, REBECCA, MCCLUNG",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 41 , 67 ,$#,,
MEDICAID DIRECT,1578867057,JACKSONVILLE VISION CENTER OD PLLC,JACKSONVILLE VISION CENTER OD PLLC,409 WESTERN BLVD STE 700 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1578867057,JACKSONVILLE VISION CENTER OD PLLC,409 WESTERN BLVD STE 700 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,, 49 , 49 , 97 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578867313,"LISENBY, LORIE, ANN",301 YADKIN ST   ALBEMARLE NC,084,Stanly,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1578869624,"LOMASNEY, EVELYN, MCMATH",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 38 , 44 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578869624,"LOMASNEY, EVELYN, MCMATH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 81 , 198 , 269 ,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578872248,"KING, KELLY, HOLT",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609833474,ANESTHESIA CARE SERVICES,~,2730 GEORGIA RD   FRANKLIN NC,056,Macon,193400000X,Group,Single Specialty,,1578872248,"KING, KELLY, HOLT",875 BETHESDA RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578872248,"KING, KELLY, HOLT",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1578872495,"MCGROARTY, ELIZABETH, ANN",205 PAGE RD   PINEHURST NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 68 , 126 , 131 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578876363,"BURIEV, ULUGBEK, NARBEKOVICH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578876363,"BURIEV, ULUGBEK, NARBEKOVICH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578876363,"BURIEV, ULUGBEK, NARBEKOVICH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578876363,"BURIEV, ULUGBEK, NARBEKOVICH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 85 , 158 , 158 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578876363,"BURIEV, ULUGBEK, NARBEKOVICH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578880142,"OVIEDO, SERGIO, PINA",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 16 , 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578880142,"OVIEDO, SERGIO, PINA",30 DUKE MED CIR RM 05150 MORRIS BUILDING WHITE ZONE DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578880142,"OVIEDO, SERGIO, PINA",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 13 , 13 , 41 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578881991,"MACATANGAY GERONILLA, CONSTANCIA, FATIMA",612 KINGSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578882593,"KALP, MATTHEW, DOUGLAS",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578882593,"KALP, MATTHEW, DOUGLAS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 102 , 179 , 179 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578884557,"CLARK, WENDY, AUCLAIR",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578884557,"CLARK, WENDY, AUCLAIR",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 25 , 36 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578884623,"PATWARDHAN, MANISH, JAYANT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578884623,"PATWARDHAN, MANISH, JAYANT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578884623,"PATWARDHAN, MANISH, JAYANT",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1982998159,PIEDMONT CARDIOVASCULAR PA,~,1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578884623,"PATWARDHAN, MANISH, JAYANT",1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 38 , 61 , 85 ,$#,,
MEDICAID DIRECT,1982998159,PIEDMONT CARDIOVASCULAR PA,~,1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578884623,"PATWARDHAN, MANISH, JAYANT",1910 N CHURCH ST STE A GREENSBORO NC,041,Guilford,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578884623,"PATWARDHAN, MANISH, JAYANT",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 57 , 66 , 103 ,$#,,
MEDICAID DIRECT,1689072688,BHG XXXVII LLC,BHG CLYDE TREATMENT CENTTER,414 HOSPITAL DR   CLYDE NC,044,Haywood,251S00000X,Agencies,Community/Behavioral Health,,1578895447,"MULLINS, NATHAN, HERMAN",414 HOSPITAL DR   CLYDE NC,044,Haywood,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1629476627,BHG XXXVI LLC,BHG ASHEVILLE TREATMENT CENTER,18 WEDGEFIELD DR   ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1578895447,"MULLINS, NATHAN, HERMAN",18 WEDGEFIELD DR   ASHEVILLE NC,011,Buncombe,2084A0401X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Addiction Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578895447,"MULLINS, NATHAN, HERMAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578895447,"MULLINS, NATHAN, HERMAN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578895520,"FIORE, AMELIA, TAYLOR",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124057484,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,101 PROFESSIONAL PARK STE A OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1578898540,"CAGE, DANA, DENEEN",1490 WILLIAMSBORO ST   OXFORD NC,039,Granville,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1578899241,"JONES, HOLLIS, LEE",~,3860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1578899241,"JONES, HOLLIS, LEE",3860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1013635176,HOLLIS LEE JONES DDS PA,AFFORDABLE DENTURES & IMPLANTS - GASTONIA,3860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578899241,"JONES, HOLLIS, LEE",3860 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 199 , 271 ," 1,396 "," $213,747.09 ",,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1578900106,"PRICE, SAMANTHA, JANE",206 JOE KNOX AVE STE D MOORESVILLE NC,049,Iredell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,,,$#,,
MEDICAID DIRECT,1073804712,FOOT AND ANKLE SPECIALISTS OF THE M,FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC,1600 E GUDE DR STE 200 ROCKVILLE MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1578900106,"PRICE, SAMANTHA, JANE",16419 NORTHCROSS DR STE A HUNTERSVILLE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,193400000X,Group,Single Specialty,,1578900106,"PRICE, SAMANTHA, JANE",440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 15 , 19 , 24 ,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,193400000X,Group,Single Specialty,,1578900106,"PRICE, SAMANTHA, JANE",440 ALTAPASS HWY   SPRUCE PINE NC,061,Mitchell,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,2211 HIGHWAY 105   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1578900106,"PRICE, SAMANTHA, JANE",2211 HIGHWAY 105   BOONE NC,095,Watauga,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1891935821,ALTA RIDGE FOOT SPECIALISTS PLLC,~,2211 HIGHWAY 105   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1578900106,"PRICE, SAMANTHA, JANE",2211 HIGHWAY 105   BOONE NC,095,Watauga,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 18 , 27 , 28 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578901666,"CARTWRIGHT, KAYCIE, LEA",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578901666,"CARTWRIGHT, KAYCIE, LEA",3920 BRIDGE RD   SUFFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578901963,"PEARSON, RON, HUNTER",1924 ALCOA HWY   KNOXVILLE TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1578901963,"PEARSON, RON, HUNTER",1924 ALCOA HWY   KNOXVILLE TN,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578901963,"PEARSON, RON, HUNTER",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 23 , 29 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1578901963,"PEARSON, RON, HUNTER",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 83 , 97 , 130 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 21 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD STE 300 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 117 , 125 , 184 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 19 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578902706,"PURAKAL, ALIXANDRA, SCHEUFLER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1013351824,S ROSS PENLAND DMD PA,~,110 N CENTER ST STE 200 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1578903407,"BYRD, JILLIAN",206 S STERLING ST   MORGANTON NC,012,Burke,1223G0001X,Dental Providers,Dentist,General Practice," 1,513 "," 1,861 "," 5,902 "," $198,382.65 ",,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578905154,"BALMURI, USHA",12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 22 , 26 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1578906616,"BAZAROV, ANTON, SERGEEVICH",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 20 , 34 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",21 THOMPSON RD STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",21 THOMPSON RD STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 27 , 36 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578907176,"BEALS, COREY, TAPSCOTT",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578909396,"ALLEN, MELISSA, MUNDY",3000 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 42 , 53 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578909396,"ALLEN, MELISSA, MUNDY",3000 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578909396,"ALLEN, MELISSA, MUNDY",3000 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1578909396,"ALLEN, MELISSA, MUNDY",3000 ERWIN RD   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578910006,"CRIMMINS, JENNIFER, MICHELLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578910006,"CRIMMINS, JENNIFER, MICHELLE",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 23 , 23 , 47 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578910311,"SHAH, MALAV, BHARATKUMAR",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 239 , 284 , 487 ," $23,663.31 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578910311,"SHAH, MALAV, BHARATKUMAR",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1578912879,FIRST TRANSPORTATION OF SALISBURY,~,909 S MAIN ST STE 204 SALISBURY NC,080,Rowan,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1578912879,FIRST TRANSPORTATION OF SALISBURY,909 S MAIN ST STE 204 SALISBURY NC,080,Rowan,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 165 ," 2,847 "," 2,930 "," $411,533.50 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578914974,"BARSAM, ALEXANDER, STEVEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578914974,"BARSAM, ALEXANDER, STEVEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 44 , 66 , 89 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578914974,"BARSAM, ALEXANDER, STEVEN",5726 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578914974,"BARSAM, ALEXANDER, STEVEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578914974,"BARSAM, ALEXANDER, STEVEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 28 , 50 , 69 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578914974,"BARSAM, ALEXANDER, STEVEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1194858498,CASWELL COUNTY HEALTH DEPARTMENT,COUNTY OF CASWELL,189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1578914982,"JOELIN, VINEETHA, EBI",189 COUNTY PARK RD   YANCEYVILLE NC,017,Caswell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 38 , 68 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578915468,"BOLTON, ALISHA, KING",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 158 , 159 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578916342,"GARCEAU, AUSTIN, TIMOTHY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578916714,"NICHOLLS, CHRISTOPHER, LEWIS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578917332,"MCCLURG, ASHA, BELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1578917332,"MCCLURG, ASHA, BELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#, 14 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578917613,"ST. JULES, RICCI",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578917613,"ST. JULES, RICCI",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1689018756,BLADEN HEALTHCARE LLC,BLADEN HOSPITALISTS,501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1578917613,"ST. JULES, RICCI",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578917613,"ST. JULES, RICCI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1578917613,"ST. JULES, RICCI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1578917613,"ST. JULES, RICCI",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497026058,CHRISTI M DAVIS DDS PA III,CHRISTI M DAVIS DDS PA III,2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578918595,"MOORE, LOVE",2401 WOOTEN BLVD SW   WILSON NC,098,Wilson,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 35 ,$#,,
MEDICAID DIRECT,1174575799,"DAVIS, CHRISTI, MICHELLE",~,2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1578918595,"MOORE, LOVE",2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1497026058,CHRISTI M DAVIS DDS PA III,CHRISTI M DAVIS DDS PA III,2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578918595,"MOORE, LOVE",2406 BLUE RIDGE RD STE 210 RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 2,011 "," 4,188 "," 17,320 "," $746,769.66 ",,
MEDICAID DIRECT,1346816667,COVENANT PRIMARY & BEHAVIORAL CARE,,812 CANDY PARK RD STE 6101-A PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1578924130,"JOHNSON, WILLIAM, JOSHUA",812 CANDY PARK RD STE 6101A PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 52 , 131 , 159 ,$#,,
MEDICAID DIRECT,1861660540,APOGEE MEDICAL GROUP VIRGINIA PC,APOGEE MEDICAL GROUP VIRGINIA PC,320 HOSPITAL DR   MARTINSVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578926721,"OWOYEMI, OLUWAKEMI, OLUWASOLA",142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578931507,"NOLAN, REBECCA, ELISE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 28 , 31 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1578933826,"SELF, EMILY, MIKAYLA",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 17 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1131 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578934170,"FOUST-BROWN, VASHONDA, ANN",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 99 , 102 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1578934170,"FOUST-BROWN, VASHONDA, ANN",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 166 , 171 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,1131 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578934170,"FOUST-BROWN, VASHONDA, ANN",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1578934170,"FOUST-BROWN, VASHONDA, ANN",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 209 , 210 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1578934170,"FOUST-BROWN, VASHONDA, ANN",1131 N CHURCH ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 139 , 139 ,$#,,
MEDICAID DIRECT,1437725041,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-HIGHLANDS CASHIERS,209 HOSPITAL DR   HIGHLANDS NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578938759,"HOLMES, REBECCA, ANN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578938759,"HOLMES, REBECCA, ANN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437725041,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-HIGHLANDS CASHIERS,209 HOSPITAL DR   HIGHLANDS NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578938759,"HOLMES, REBECCA, ANN",209 HOSPITAL DR   HIGHLANDS NC,056,Macon,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407200264,BLUE RIDGE COMMUNITY HEALTH SERVICE,HAYWOOD HEALTH CENTER,490 HOSPITAL DR   CLYDE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578938759,"HOLMES, REBECCA, ANN",490 HOSPITAL DR   CLYDE NC,044,Haywood,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578938759,"HOLMES, REBECCA, ANN",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881130540,BLUE RIDGE COMMUNITY HEALTH SERVICE,SYLVA HEALTH CENTER,293 HOSPITAL RD   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1578938759,"HOLMES, REBECCA, ANN",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1578940037,"ASHER, MCKENZIE, WREN",1 HOSPITAL RD CALLER BOX C-268 CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 48 , 48 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 19 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 32 , 34 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578941142,"VAN NIMWEGEN, LENA, LOUISA",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578941167,"ANTONY, MARTINA, JOLANE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1578941167,"ANTONY, MARTINA, JOLANE",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 31 , 32 , 33 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1578941423,"KIRBY, KRISTIN, ANN",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578941423,"KIRBY, KRISTIN, ANN",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 96 , 155 , 207 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578941423,"KIRBY, KRISTIN, ANN",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578942405,"BULLON, KARLA, STEPHANIE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 255 , 255 ,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1578942561,"GILLESPIE, JENNIE, MICHELINA",200 STONEBRIDGE SQ   HAVELOCK NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1962458265,EASTERN CAROLINA WOMENS CENTER,EASTERN CAROLINA WOMENS CENTER,801 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1578942561,"GILLESPIE, JENNIE, MICHELINA",801 MCCARTHY BLVD   NEW BERN NC,025,Craven,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 33 , 47 , 65 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578942736,"BISTA, RABIN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1578942736,"BISTA, RABIN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 71 , 173 , 175 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578942793,"JENSEN, CLAIRE, ELISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578942793,"JENSEN, CLAIRE, ELISE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 39 , 44 , 48 ," $15,052.58 ",,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578942843,"SANTIVASI, WIL, LEONARD",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578942843,"SANTIVASI, WIL, LEONARD",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578942843,"SANTIVASI, WIL, LEONARD",2301 ERWIN RD   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 18 , 47 , 50 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578942843,"SANTIVASI, WIL, LEONARD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578943833,"CARTER, DAVID, LITTLE",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 12 , 13 ,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578943833,"CARTER, DAVID, LITTLE",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578943833,"CARTER, DAVID, LITTLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 37 , 37 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1578943833,"CARTER, DAVID, LITTLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 66 , 107 , 128 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578943866,"STILLWAGON, MATTHEW, RYAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 16 , 28 ," $10,820.51 ",,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578943866,"STILLWAGON, MATTHEW, RYAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 36 , 54 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578943866,"STILLWAGON, MATTHEW, RYAN",1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 26 , 87 , 90 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 25 , 25 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",655 COTTON ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",500 W HANES MILL RD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",120 MILLER ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",500 W HANES MILL RD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",3333 BROOKVIEW HILLS BLVD STE 105 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 24 , 44 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",2705 BOULDER PARK CT   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",120 MILLER ST   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 47 , 63 , 93 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 26 , 42 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",10 LAURA LN   THOMASVILLE NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",233 ANNA LEWIS DR   LEXINGTON NC,029,Davidson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",190 INTERSTATE DR   MOCKSVILLE NC,030,Davie,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",190 INTERSTATE DR   MOCKSVILLE NC,030,Davie,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",225 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",225 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,730 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",1280 NEWSOME ST   MOUNT AIRY NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1275580854,W SCOTT MOORE ET AL PTR,NEPHROLOGY ASSOCIATES P L L C,10 LAURA LN   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1578944013,"SPANGLER, ANDREW, HENICAN",941 JOHNSON RIDGE RD   ELKIN NC,086,Surry,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1609827393,BILTMORE MEDICAL ASSOCIATES,BILTMORE MEDICAL ASSOCIATES,147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1578945010,"BAILES, CHRISTOPHER, STEVEN",147 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 31 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578946067,"JONES, ANGELA, DENISE",700 ACADEMY ST S   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578946067,"JONES, ANGELA, DENISE",1006 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 176 , 199 , 199 ,$#,,
MEDICAID DIRECT,1104959055,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OPHTHALMOLOGY -,1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578946315,"TSAMIS, KATHERINE, AGATHA",1565 N UNIVERSITY PKWY   HIGH POINT NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 93 , 153 , 226 ," $11,671.24 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE A KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578946729,"WADE, KIMBERLY, CARRUTH",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD STE A2 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578946729,"WADE, KIMBERLY, CARRUTH",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,204 AIRPORT RD   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1578946729,"WADE, KIMBERLY, CARRUTH",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578946729,"WADE, KIMBERLY, CARRUTH",204 AIRPORT RD   KINSTON NC,054,Lenoir,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 36 , 36 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578946950,"HUNTER, TAWANA, MONET",101 CABARRUS AVE E   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 50 , 73 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1578947735,"FERGUSON, MICHELLE, MARIE",100 S BOYLAN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578947735,"FERGUSON, MICHELLE, MARIE",1765 DOBBINS DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578948550,"DONOGHUE, AUBRY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1578950572,"LINDSEY, ZACHARY, ALLEN",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1578950572,"LINDSEY, ZACHARY, ALLEN",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1730212739,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1578950572,"LINDSEY, ZACHARY, ALLEN",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 42 , 73 , 101 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1578950572,"LINDSEY, ZACHARY, ALLEN",1622 E MARION ST   SHELBY NC,023,Cleveland,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1588678817,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1578950572,"LINDSEY, ZACHARY, ALLEN",335 E PARKER RD   MORGANTON NC,012,Burke,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 45 , 67 , 84 ,$#,,
MEDICAID DIRECT,1831222637,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,40 E MEDICAL CT   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1578950572,"LINDSEY, ZACHARY, ALLEN",40 E MEDICAL CT   MARION NC,059,McDowell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 27 , 35 , 43 ,$#,,
MEDICAID DIRECT,1255464244,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,640 OAK ST   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1578950572,"LINDSEY, ZACHARY, ALLEN",640 OAK ST   FOREST CITY NC,081,Rutherford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 35 , 57 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578950770,"FRAZER, LAUREN, CAROLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 13 , 45 , 45 ,$#,,
MEDICAID DIRECT,1508305293,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA CARDIOLOGY,709 WICKER ST STE A SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1578951935,"DOLGOVSKIJ, ANASTASIA",11491 US HIGHWAY 70 W   CLAYTON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508305293,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA CARDIOLOGY,709 WICKER ST STE A SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1578951935,"DOLGOVSKIJ, ANASTASIA",709 WICKER ST STE A SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 22 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578952818,"PHILLIPS, BONNIE, DARLENE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1578952818,"PHILLIPS, BONNIE, DARLENE",1212 SPRUCE STREET   BELMONT NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1578952818,"PHILLIPS, BONNIE, DARLENE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811710999,ROBERT T CHRISTENSEN DDS MS PA,DURHAM PEDIATRIC DENTISTRY AND ORTHODONTICS,121 W WOODCROFT PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578953295,"CHRISTENSEN, ROBERT, THOMAS",121 W WOODCROFT PKWY   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 76 , 91 , 303 ,$#,,
MEDICAID DIRECT,1255546420,JOHN R CHRISTENSEN DDS MS MS PA,DURHAM PEDIATRIC DENTISTRY,121 W WOODCROFT PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578953295,"CHRISTENSEN, ROBERT, THOMAS",121 W WOODCROFT PKWY   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 71 , 98 , 341 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",520 TIMBER DR E STE 105 GARNER NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",520 TIMBER DR E STE 105 GARNER NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",520 TIMBER DR E STE 105 GARNER NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",3604 BUSH ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 17 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578956058,"HULL, CAROLYN, MULLER",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 30 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578956157,"NASH, CHRISTOPHER, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 99 , 106 , 117 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1578956157,"NASH, CHRISTOPHER, JAMES",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 44 , 51 ,$#,,
MEDICAID DIRECT,1326346602,MOSES CONE AFFILIATED PHYSICIANS IN,PIEDMONT PEDIATRICS,719 GREEN VALLEY RD STE 209 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578956546,"KLETT, LYNN, MICHELLE",719 GREEN VALLEY RD STE 209 GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 26 , 47 , 97 ,$#,,
MEDICAID DIRECT,1003638719,RAYNALD L DESAMEAU DMD P LLC IV,GALAXY ORTHODONTICS,10460 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",1589 SKEET CLUB RD STE 150 HIGH POINT NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,400 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",4901 N TRYON ST STE A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 13 ,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1528754546,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,4901 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1033566039,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1275229296,RIVERA & ASSOCIATES PA,WIRY SMILES,1819 BRENNER AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1578956991,"QUARTERMAN, CHRISTINA, GRACE",1819 BRENNER AVE   SALISBURY NC,080,Rowan,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578958153,"SKARET, REBECCA, LAUREN",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578958526,"BLACKARD, KAITLIN, RHIANNON",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,401 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578958526,"BLACKARD, KAITLIN, RHIANNON",401 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578959219,"BRANTHAM, JULIA, KAYCE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1578959490,"TAYNE, SAMANTHA",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578959490,"TAYNE, SAMANTHA",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1578959490,"TAYNE, SAMANTHA",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578959490,"TAYNE, SAMANTHA",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578959490,"TAYNE, SAMANTHA",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1578959490,"TAYNE, SAMANTHA",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578959490,"TAYNE, SAMANTHA",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578959755,"DOTHARD, EMILY, HIX",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 55 , 88 , 135 ,$#,,
MEDICAID DIRECT,1437775749,M AVEY AND ASSOCIATES NC PC IV,GOKIDS PEDIATRIC DENTISTRY,17214 LANCASTER HWY STE 301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1578962254,"PATEL, SONAM, SHAH",17214 LANCASTER HWY STE 301 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 235 , 472 ," 2,192 "," $89,412.74 ",,
MEDICAID DIRECT,1952965345,ALIGN AMERICA SC LLC,,130 BEN CASEY DR   FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1578962254,"PATEL, SONAM, SHAH",130 BEN CASEY DR STE 105 FORT MILL SC,101,Out of State <= 40 miles,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 90 , 141 , 577 ," $21,160.79 ",,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1578963021,"KIM, GRACE, SOON",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1578963765,"MCDANIEL, LUCY, HALL",101 E W T HARRIS BLVD STE 5202 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619319621,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH NEUROLOGY CLEVELAND,202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1578963765,"MCDANIEL, LUCY, HALL",202 E GROVER ST STE 1 SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 108 , 157 , 195 ," $15,103.02 ",,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578963823,"FRYAR, MEGAN, MICHELE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578963823,"FRYAR, MEGAN, MICHELE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1578963823,"FRYAR, MEGAN, MICHELE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578963823,"FRYAR, MEGAN, MICHELE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1578963823,"FRYAR, MEGAN, MICHELE",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1578968574,"MAVREDES, KATHRYN, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578970406,"MATSON, MELISSA, ANTHONY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1578971214,ACUMEN OF NORTH CAROLINA LLC,~,8408 SIX FORKS RD STE 204 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1578971214,ACUMEN OF NORTH CAROLINA LLC,8408 SIX FORKS RD STE 204 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 858 ," 180,752 "," 195,546 "," $32,725,158.83 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1578974309,"BURKE, GARY, FRANCIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578974309,"BURKE, GARY, FRANCIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 68 , 74 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 54 , 54 , 136 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 23 , 25 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578974382,"PARIKH, AMAR, PRADIP",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 17 , 27 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1578976684,"BONNECAZE, ALEX, KYLE",200 PAVILION WAY   SOUTHERN PINES NC,063,Moore,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1578976684,"BONNECAZE, ALEX, KYLE",205 PAGE RD   PINEHURST NC,063,Moore,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 61 , 137 , 276 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578976775,"SYLVESTER, JILLIAN, ELIZABETH",75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578976775,"SYLVESTER, JILLIAN, ELIZABETH",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 22 , 51 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578976775,"SYLVESTER, JILLIAN, ELIZABETH",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 11 , 23 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,75 FREEDOM PKWY   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578976775,"SYLVESTER, JILLIAN, ELIZABETH",75 FREEDOM PKWY STE D PITTSBORO NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 37 , 56 , 90 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1578976775,"SYLVESTER, JILLIAN, ELIZABETH",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 16 , 29 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1578976775,"SYLVESTER, JILLIAN, ELIZABETH",163 MEDICAL PARK DR STE 110 SILER CITY NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 25 ,$#,,
MEDICAID DIRECT,1578977179,ENDEAVORS PEDIATRIC THERAPY,~,541 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1578977179,ENDEAVORS PEDIATRIC THERAPY,541 GAITHER RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,, 127 ," 1,262 "," 1,851 "," $122,181.55 ",,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1578977906,"SREENATH, SUDHEER, BELUR",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 183 , 183 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578979803,"KHANAL, RUPESH",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 28 , 71 , 71 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1578979936,"BUSH, KRISTEN, ELIZABETH",2615 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578981114,"ABDOU, YARA, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 22 , 57 , 60 ,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1578981676,"MORGAN, TIFFANY, MARIE",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 14 , 66 , 93 ,$#,,
MEDICAID DIRECT,1164448130,NEW HANOVER RADIATION ONCOLOGY,COASTAL CAROLINA RADIATION ONCOLOGY PA,1988 S 16TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1578981676,"MORGAN, TIFFANY, MARIE",1988 S 16TH ST   WILMINGTON NC,065,New Hanover,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 31 , 130 , 179 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1578983078,"POLITO, KARLA, MARIE",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578983789,"MIMS, EMILY, LAMBERT",10208 CERNY ST STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1437187010,RALEIGH CHILDREN AND ADOLESCENTS ME,RALEIGH CHILDREN AND ADOLESCENTS MEDICINE PC,3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1578983789,"MIMS, EMILY, LAMBERT",3100 DURALEIGH RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609851138,MOUNT AIRY EMERGENCY PHYSICIANS,MOUNT AIRY EMERGENCY PHYSICIANS,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1578983995,"MILLS, BRANDON, KEITH",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 92 , 100 , 140 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1578988309,"HARTZELL, JENNIFER, WIENER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1578988309,"HARTZELL, JENNIFER, WIENER",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1184915639,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MOUNTAIN VALLEY ACADEMIC HEALTH CENTER,117 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1578989653,"BURNETTE, KYLE, DAVID",117 FOOTHILLS DR   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 135 , 237 , 421 ,$#,,
MEDICAID DIRECT,1922601764,WARE FAMILY MEDICINE PLLC,OLD FORT FAMILY MEDICINE,32 E MAIN ST   OLD FORT NC,059,McDowell,193200000X,Group,Multi-Specialty,,1578990875,"WARE, BRIAN, MICHAEL",32 E MAIN ST   OLD FORT NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 125 , 177 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1578991576,"HURDLE DARR, CAITLIN, ELIZABETH",305 E LEE AVE   YADKINVILLE NC,099,Yadkin,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 64 , 81 , 109 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1578992582,"REY, RAQUEL, MERCEDES",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 106 , 107 , 107 ,$#,,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,204 CIRCLE DR   GIBSONVILLE NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,204 CIRCLE DR   GIBSONVILLE NC,041,Guilford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,206 FRIENDLY RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,206 FRIENDLY RD   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,316 DENNY CIR   GRAHAM NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,316 DENNY CIR   GRAHAM NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#," $10,012.80 ",,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,209 E 6TH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,209 E 6TH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 30 , 30 ," $29,561.60 ",,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,711 ASKEW ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,711 ASKEW ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,205B E 6TH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,205B E 6TH ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#," $10,012.80 ",,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,724 ASKEW ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,724 ASKEW ST   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 32 ," 6,752 "," 6,785 "," $473,159.99 ",,
MEDICAID DIRECT,1578992962,CLEGAIL PROFESSIONAL SERVICES,~,2655 WHITE OAK DR   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1578992962,CLEGAIL PROFESSIONAL SERVICES,2655 WHITE OAK DR   BURLINGTON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1740312552,CALDWELL MEMORIAL HOSPITAL,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1578993853,"CLIFFORD, ANDREA, CONTESSA",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1578993853,"CLIFFORD, ANDREA, CONTESSA",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1578993853,"CLIFFORD, ANDREA, CONTESSA",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1578998852,"SHAMBLIN, BRADLEY, DAVIS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 13 , 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1578998852,"SHAMBLIN, BRADLEY, DAVIS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1578998852,"SHAMBLIN, BRADLEY, DAVIS",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 21 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588002893,"ALLURI, KRISHNA, CHAITANYA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588002893,"ALLURI, KRISHNA, CHAITANYA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588002893,"ALLURI, KRISHNA, CHAITANYA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 48 , 67 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588002893,"ALLURI, KRISHNA, CHAITANYA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1588004410,MEDSCAN LABORATORY INC,~,1502 13TH AVE W   WILLISTON ND,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1588004410,MEDSCAN LABORATORY INC,1502 13TH AVE W   WILLISTON ND,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1891058699,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588004600,"SHAH, RONAK, JASWANT",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 76 , 83 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588008387,"SMITH, KELLY, LACY",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 19 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588008387,"SMITH, KELLY, LACY",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 57 , 100 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588009310,"MILES, MATTHEW, JOHN",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 15 , 25 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588009310,"MILES, MATTHEW, JOHN",10030 GILEAD RD STE 300 HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 46 , 76 , 126 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588009310,"MILES, MATTHEW, JOHN",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 18 , 18 , 22 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588009310,"MILES, MATTHEW, JOHN",125 QUEENS RD STE 640 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588010268,"RUSHING, MATTHEW, AARON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 125 , 141 , 211 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588010268,"RUSHING, MATTHEW, AARON",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588010268,"RUSHING, MATTHEW, AARON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 47 , 47 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588010268,"RUSHING, MATTHEW, AARON",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588012132,"GRAHAM, SARAH, BRADFORD",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588012132,"GRAHAM, SARAH, BRADFORD",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588012132,"GRAHAM, SARAH, BRADFORD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 52 , 52 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588013411,"NASHAD, HILANA, H. MUSBAH",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588014237,"NEVE, MORGAN, KARMEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588014666,"LAWSON, KIERSTEN, ELIZABETH",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1861671471,CAROMONT MEDICAL GROUP INC,CAROMONT INTERNAL MEDICINE,660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588014708,"PATEL, SHRADDHA, RAJESHKUMAR",660 SUMMIT CROSSING PL STE 301 GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588014948,"BROWN, TAYLA, RENE",1010 BETHESDA CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588016620,"HALLER, NICHOLAS, FREDERICK",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 89 , 89 ,$#,,
MEDICAID DIRECT,1871521807,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUAP BUTNER CREEDMOOR FAMILY,2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,193200000X,Group,Multi-Specialty,,1588018550,"MIKELL, ASIYAH, ZAHRA",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 38 , 77 , 186 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588018782,"BAKER, JOSEPH, ROBERT",313 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 67 , 85 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,193200000X,Group,Multi-Specialty,,1588018782,"BAKER, JOSEPH, ROBERT",404 WESTWOOD AVE STE 303 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588018782,"BAKER, JOSEPH, ROBERT",404 WESTWOOD AVE STE 303 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164949814,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH PEDIATRIC SPECIALISTS,301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588019673,"MILLS, CAMILLA, LAMAUDE",301 E WENDOVER AVE STE 311 GREENSBORO NC,041,Guilford,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 20 , 38 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588019673,"MILLS, CAMILLA, LAMAUDE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1649331638,PUBLIC HEALTH AUTHORITY OF CABARRUS,CABARRUS HEALTH ALLIANCE,300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588019798,"EASTERDAY, MEGAN, CAMPBELL",300 MOORESVILLE RD   KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 95 , 153 ," $12,391.21 ",,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1588020770,MURPHY MEDICAL CENTER INC,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1588020911,"BURGESS, ADAM, OLIVA",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477173292,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588021125,"SHELDON, JENNIFER, SHIELDS",12311 COPPER WAY STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 15 , 18 ,$#,,
MEDICAID DIRECT,1588021422,DIVINE HEALTH ACADEMY,~,501 S DEKALB ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1588021422,DIVINE HEALTH ACADEMY,501 S DEKALB ST   SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 19 ," 4,322 "," 4,322 "," $299,551.04 ",,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588027254,"HOLDER, TARA, AYANNA FARHA",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588027320,"ECKELBARGER, DAVID, LAWRENCE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588027320,"ECKELBARGER, DAVID, LAWRENCE",6251 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588027783,"DYAL, JAMESON, ANDREW",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 29 , 40 , 45 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588027783,"DYAL, JAMESON, ANDREW",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 45 , 61 , 151 ," $15,495.27 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588027783,"DYAL, JAMESON, ANDREW",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588027783,"DYAL, JAMESON, ANDREW",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588028880,"REIGHARD, SHANE, GREGORY",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 11 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,811 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",811 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 32 , 47 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,220 US 70 HWY W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",220 US 70 HWY W   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",1418 N MAIN ST   FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",2908 N HERRITAGE ST   KINSTON NC,054,Lenoir,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,212 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588029052,"GILMORE, KAYLEIGH, ANN",550 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700918125,RHA HEALTH SERVICES INC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1588030142,"DUNN, ELAINE, ANITA",356 BILTMORE AVE STE 200 ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588031108,"STAAB, NICHOLE, CROWELL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1588032288,"COX, LINDSAY, KELBY",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588032288,"COX, LINDSAY, KELBY",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588032288,"COX, LINDSAY, KELBY",2201 S STERLING ST   MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1588032288,"COX, LINDSAY, KELBY",720 MALCOLM BLVD   VALDESE NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1285952671,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1588032288,"COX, LINDSAY, KELBY",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316264195,CAROLINAS EMERGENCY PHYSICIANS PA,Shelby Emergency Associates PA,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1588032288,"COX, LINDSAY, KELBY",201 E GROVER ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 20 , 22 ,$#,,
MEDICAID DIRECT,1154453496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT MINERAL SPRINGS,4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588033260,"GARWOOD, LAUREN, KEITY",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1972283166,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT MOORE ELEMENTARY,451 KNOLLWOOD ST   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588033260,"GARWOOD, LAUREN, KEITY",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1588033450,"FORMYDUVAL, AMY, LANDIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1588033450,"FORMYDUVAL, AMY, LANDIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588034961,"NOCHAJSKI, PETER, ROSS",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588035273,"MIDTHUN, MICHELLE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588035273,"MIDTHUN, MICHELLE, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1487936514,GATEWAY COMMUNITY HEALTH CENTERS IN,~,201 E EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588039036,"SMITH, SHELLEY, ANN",1134 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 60 , 154 , 259 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1588040844,"ZHANG, YANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 18 , 21 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",101 MANNING DR   CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 13 , 30 , 58 ,$#,,
MEDICAID DIRECT,1184641524,ALAMANCE EYE CARE PA,~,1016 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588040844,"ZHANG, YANG",2226 NELSON HWY STE 200 CHAPEL HILL NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 12 , 20 , 46 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 12 , 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588041149,"BRAMALL, ALEXA, NATALIE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 11 , 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588043905,"BEATTY, JENNIFER, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588043905,"BEATTY, JENNIFER, ANN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588043905,"BEATTY, JENNIFER, ANN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588043905,"BEATTY, JENNIFER, ANN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588043905,"BEATTY, JENNIFER, ANN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588043905,"BEATTY, JENNIFER, ANN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 27 , 44 ,$#,,
MEDICAID DIRECT,1073541124,UNIVERSITY PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS UNIVERSITY PEDIATRI,101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588044002,"IRBY, LOVERICA, FIDELIA",101 E W T HARRIS BLVD STE 1121 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588044911,"BROSE, CHRISTINA, MARIE",7752 GATEWAY LN NW STE 100 CONCORD NC,013,Cabarrus,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588045108,"ZHANG, RICHARD, LIQI",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588045108,"ZHANG, RICHARD, LIQI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1588045108,"ZHANG, RICHARD, LIQI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 32 , 37 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1588045108,"ZHANG, RICHARD, LIQI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588045108,"ZHANG, RICHARD, LIQI",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 63 , 65 , 72 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588045108,"ZHANG, RICHARD, LIQI",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 44 , 51 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588045108,"ZHANG, RICHARD, LIQI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588045108,"ZHANG, RICHARD, LIQI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 48 , 58 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588045108,"ZHANG, RICHARD, LIQI",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588045793,"WAGNER, ANALIESE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 30 , 33 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588045793,"WAGNER, ANALIESE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1588045793,"WAGNER, ANALIESE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1588045793,"WAGNER, ANALIESE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 30 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588045793,"WAGNER, ANALIESE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 29 , 35 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588045819,"PANUGANTI, SRAVAN",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 104 , 141 , 265 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588045819,"PANUGANTI, SRAVAN",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 20 , 30 , 63 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588045819,"PANUGANTI, SRAVAN",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,, 62 , 83 , 147 ,$#,,
MEDICAID DIRECT,1457377954,STONE INSTITUTE OF THE CAROLINAS LL,~,215 SOUTH MAIN STREET SU 201 DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588045819,"PANUGANTI, SRAVAN",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588047609,"MOORE, NATALIE, ERDMAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 23 ,$#,,
MEDICAID DIRECT,1952690109,NMG SOUTHPARK SERVICES LLC,NMG SOUTHPARK SERVICES LLC,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588047609,"MOORE, NATALIE, ERDMAN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588048714,TRUECARERX LLC,TRUECARE PHARMACY,760 CABARRUS AVE W   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1588048714,TRUECARERX LLC,760 CABARRUS AVE W   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 57 , 400 , 462 ," $52,218.43 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588049639,"MASSEY, NICOLE, MARIE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568043537,ANIMO SANO PSYCHIATRY PLLC,ANIMO SANO PSYCHIATRY PLLC,5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588051023,"ANDREW, WHITNEY, CLAIRE",5501 FORTUNES RIDGE DR STE P DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588051288,"TANGO, JENNIFER, MICHELLE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588051288,"TANGO, JENNIFER, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588051288,"TANGO, JENNIFER, MICHELLE",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588051288,"TANGO, JENNIFER, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588051288,"TANGO, JENNIFER, MICHELLE",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588051288,"TANGO, JENNIFER, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588051288,"TANGO, JENNIFER, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 21 , 26 ,$#,,
MEDICAID DIRECT,1164453726,CARMEL FAMILY PHYSICIANS,ATRIUM HEALTH PRIMARY CARE CARMEL FAMILY MEDICINE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588051585,"PAYNE, KERI, LYNN",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 51 , 80 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588051585,"PAYNE, KERI, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 22 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588051585,"PAYNE, KERI, LYNN",10000 PARK CEDAR DR   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 18 , 33 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588051759,"WOO, JEFFREY, JE CHUEN",2075 GLENN MITCHELL DR STE 500 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588051759,"WOO, JEFFREY, JE CHUEN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,5249 EMMETT I DAVIS JR AVE   NORTH CHARLESTON SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1588054092,"STARODUB, ASHLEY, NICOLE",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1588055586,"LOZADA, TABITHA, TAYLOR",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588056113,"KELLER, ERIC, JAMES",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 27 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1588056113,"KELLER, ERIC, JAMES",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 31 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588056113,"KELLER, ERIC, JAMES",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 228 , 247 , 334 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,10226 COULOAK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588056303,"LISBOA, COURTNEY, ALICE",10226 COULOAK DR STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 58 , 79 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588056303,"LISBOA, COURTNEY, ALICE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588057137,"JOHNSON, ERNESTINE",107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 PINE RUN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1588057137,"JOHNSON, ERNESTINE",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 21 , 21 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588059554,"LAUTENBACHER, JENNA, RAYE",825 FAIRFAX AVE STE 310 NORFOLK VA,101,Out of State <= 40 miles,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588059836,"BARRORD, JOHN, VINCENT",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588059836,"BARRORD, JOHN, VINCENT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 33 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1588059836,"BARRORD, JOHN, VINCENT",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 41 , 53 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588059836,"BARRORD, JOHN, VINCENT",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588059836,"BARRORD, JOHN, VINCENT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1588059836,"BARRORD, JOHN, VINCENT",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588059836,"BARRORD, JOHN, VINCENT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1588059836,"BARRORD, JOHN, VINCENT",1010 COLLEGE ST   OXFORD NC,039,Granville,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588060412,"MICHALAK, JESSICA, FOWLER",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588060412,"MICHALAK, JESSICA, FOWLER",125 QUEENS RD STE 520 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588060412,"MICHALAK, JESSICA, FOWLER",125 QUEENS RD STE 540 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 18 , 29 ,$#,,
MEDICAID DIRECT,1588060735,MACON HEALTH HOLDINGS LLC,FRANKLIN HOUSE,186 ONE CENTER CT   FRANKLIN NC,056,Macon,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588060735,MACON HEALTH HOLDINGS LLC,186 ONE CENTER CT   FRANKLIN NC,056,Macon,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 27 ," 6,109 "," 6,110 "," $585,655.37 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588063754,"KOVALICK, LEONARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588064836,"LAMBERT, MARY, KELLAR",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588064836,"LAMBERT, MARY, KELLAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588064836,"LAMBERT, MARY, KELLAR",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1588064836,"LAMBERT, MARY, KELLAR",145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588067367,MONARCH,,319 CHAPANOKE RD STE 101 RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1588067367,MONARCH,319 CHAPANOKE RD STE 101 RALEIGH NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588068597,"CHILKULWAR, ABHISHEK, REDDY",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588068597,"CHILKULWAR, ABHISHEK, REDDY",125 QUEENS RD STE 610 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 18 , 40 , 40 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588068597,"CHILKULWAR, ABHISHEK, REDDY",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 19 , 57 , 57 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588068597,"CHILKULWAR, ABHISHEK, REDDY",10030 GILEAD RD STE 350 HUNTERSVILLE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588068597,"CHILKULWAR, ABHISHEK, REDDY",125 QUEENS RD STE 600 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588068597,"CHILKULWAR, ABHISHEK, REDDY",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588069066,"GREEN, MATTHEW, STEVEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 62 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588071484,"PETERS, ELDON, CAMERON",1514 GLENWOOD AVE   RALEIGH NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 15 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588071484,"PETERS, ELDON, CAMERON",7560 CARPENTER FIRE STATION RD STE 303A CARY NC,092,Wake,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 47 , 47 , 54 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 38 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,305 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1225 LEWISVILLE CLEMMONS RD   LEWISVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 27 , 31 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3001 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,50 MILLER ST STE G WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 27 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,485 VALLEY RD   MOCKSVILLE NC,030,Davie,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588074348,"CHETI, DEV, RAO",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588076616,"MOORE, WILLIAM, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588076616,"MOORE, WILLIAM, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 45 , 46 , 46 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588077408,"SAKHOVSKAYA, NATALIA, VLADIMIROVNA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 91 , 207 , 234 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 87 , 93 , 119 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",3000 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 45 , 56 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 13 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 60 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 22 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",3116 N DUKE ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588077440,"COLGLAZIER, ROY, JOHN",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077499,"FRESCO, AMBER, INGRAM",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 42 , 49 , 73 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077499,"FRESCO, AMBER, INGRAM",200 TRENT DR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588077499,"FRESCO, AMBER, INGRAM",200 TRENT DR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 14 , 23 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588077747,"AHN, CHRISTINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 85 , 116 , 178 ,$#,,
MEDICAID DIRECT,1518247576,GATEWAY COMMUNITY HEALTH CENTERS IN,GATEWAY COMMUNITY HEALTH CENTERS INC,501 MAIN ST   GATESVILLE NC,037,Gates,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588078000,"AL-JARBOUA, LA TASHA, ANNETTE",1530 UNION RD   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588080436,WAKE FAMILY EYE CARE OD PA,WAKE FAMILY EYE CARE,100 PARKWAY OFFICE CT STE 112 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588080436,WAKE FAMILY EYE CARE OD PA,100 PARKWAY OFFICE CT STE 112 CARY NC,092,Wake,193400000X,Group,Single Specialty,,#,#, 14 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588082036,"FALTAOUS, MARK, ADEL",4460 MALIBU PT APT 204 COLORADO SPRINGS CO,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 50 , 55 , 72 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1588082036,"FALTAOUS, MARK, ADEL",4460 MALIBU PT APT 204 COLORADO SPRINGS CO,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588083067,"GRASSO, IAN, ANTHONY",600 GRESHAM DR STE 8630B NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588083448,"ZENDEL, JORDAN, RICHARDSON",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 24 , 61 ,$#,,
MEDICAID DIRECT,1720433634,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH RURAL HALL FAMILY MEDICINE,290 W WALL ST   RURAL HALL NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588083448,"ZENDEL, JORDAN, RICHARDSON",290 W WALL ST   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588083448,"ZENDEL, JORDAN, RICHARDSON",290 W WALL ST   RURAL HALL NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 156 , 395 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588083448,"ZENDEL, JORDAN, RICHARDSON",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588083828,"MILLER, MATTHEW, QUINN",2226 NELSON HWY STE 101 CHAPEL HILL NC,032,Durham,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588083828,"MILLER, MATTHEW, QUINN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588083828,"MILLER, MATTHEW, QUINN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1588084982,"WEBSTER, YTHAN, WYE",800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1588084982,"WEBSTER, YTHAN, WYE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 23 , 24 , 39 ,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1588084982,"WEBSTER, YTHAN, WYE",1421 S GLENBURNIE RD STE D NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1184278335,COASTAL CAROLINA HEALTH CARE PA,CCHC PODIATRY,800 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1588084982,"WEBSTER, YTHAN, WYE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 77 , 97 , 174 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588086185,"ADAMS, ALLISON, TIFFANY",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 55 , 57 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588088595,"BRIDGES, MELISSA, RICKER",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588088595,"BRIDGES, MELISSA, RICKER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588088595,"BRIDGES, MELISSA, RICKER",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 92 , 91 , 108 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 51 , 52 , 56 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588088744,"HOGER, MICHAEL, KELLY",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588089783,"EICHORN, JONATHAN, CONRAD",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1255039897,MAYRX PLLC,,302 STONE RIDGE BLVD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588089882,"EIFLER, ALICIA, HILL",1 RESORT DR   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578996252,CUMBERLAND COUNTY HOSPITAL SYSTEM I,COMMUNITY MENTAL HEALTH CENTER AT CAPE FEAR VALLEY,711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588092506,"LAMIA, MALLORIE, RAE",711 EXECUTIVE PL FL 4 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588093728,"CASTILLO SCHILDER, ROSA MARIA",6011 FARRINGTON RD STE 201 CHAPEL HILL NC,019,Chatham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588093728,"CASTILLO SCHILDER, ROSA MARIA",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588093728,"CASTILLO SCHILDER, ROSA MARIA",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588093728,"CASTILLO SCHILDER, ROSA MARIA",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588093728,"CASTILLO SCHILDER, ROSA MARIA",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588093728,"CASTILLO SCHILDER, ROSA MARIA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588093728,"CASTILLO SCHILDER, ROSA MARIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 29 , 30 , 32 ,$#,,
MEDICAID DIRECT,1558671529,LEONARD D SALTZMAN MD PA,LEONARD D SALTZMAN MD PA,1420 US 52 N   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1588094726,"HATLEY, HOLLY, SMITH",1420 US 52 N STE G ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 86 , 682 , 720 ," $18,122.00 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588095137,"HACKMANN LEIB, ROBIN, ASHLEY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 16 , 28 , 28 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588095137,"HACKMANN LEIB, ROBIN, ASHLEY",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 23 , 40 , 40 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588095913,"CARRICO, BRYAN, ALOYSIUS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588095913,"CARRICO, BRYAN, ALOYSIUS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588095913,"CARRICO, BRYAN, ALOYSIUS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588095913,"CARRICO, BRYAN, ALOYSIUS",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588097406,"CARTER, JENNIFER, STRONG",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588097406,"CARTER, JENNIFER, STRONG",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588097406,"CARTER, JENNIFER, STRONG",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588102982,"HEDGES, EMILY, KAY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588102982,"HEDGES, EMILY, KAY",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1063733442,KINETIC PHYSICAL THERAPY AND WELLNE,~,1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588103428,"MYERS, BENJAMIN, CLAY",1540 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 51 , 67 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588105761,"RAWLS, WILLIAM, FOSTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 44 , 60 , 89 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588105761,"RAWLS, WILLIAM, FOSTER",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588105761,"RAWLS, WILLIAM, FOSTER",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,275 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588105761,"RAWLS, WILLIAM, FOSTER",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1568767002,ASSOCIATED UROLOGISTS OF NC PA,,3821 ED DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588105761,"RAWLS, WILLIAM, FOSTER",3821 ED DRVIE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588113641,"GARCIA, OLIVIA, MICHELLE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588113641,"GARCIA, OLIVIA, MICHELLE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588113641,"GARCIA, OLIVIA, MICHELLE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588113641,"GARCIA, OLIVIA, MICHELLE",201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588116008,"PUGMIRE, REBECCA, S",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588116008,"PUGMIRE, REBECCA, S",600 GRESHAM DR STE 8620 NORFOLK VA,101,Out of State <= 40 miles,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588118111,"MOSS, NATHAN, ALAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1588120315,"WOODARD, CHARLES, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1093793473,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1588120315,"WOODARD, CHARLES, PATRICK",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1922630912,MEDASIC,MEDASIC,1630 CAMPUS PARK DRIAVE   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588122501,"MOORE, BRANDI, SHAYE",106 PARRIS BRIDGE RD STE A BOILING SPRINGS SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922630912,MEDASIC,MEDASIC,1630 CAMPUS PARK DRIAVE   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588122501,"MOORE, BRANDI, SHAYE",300 JOHN ST STE 4B GREER SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588123699,"CHEN, JANE, JINYAN",802 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,802 GREEN VALLEY RD STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588123699,"CHEN, JANE, JINYAN",802 GREEN VALLEY RD   GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588127328,"EDWARDS, JOSEPH, TIMOTHY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588127328,"EDWARDS, JOSEPH, TIMOTHY",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 19 , 31 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588127328,"EDWARDS, JOSEPH, TIMOTHY",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588127328,"EDWARDS, JOSEPH, TIMOTHY",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 28 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588127534,"LAWSING, JAMES, FULLER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588127658,"MOURO, STEVEN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588127658,"MOURO, STEVEN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 38 , 41 , 46 ," $14,983.66 ",,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588127658,"MOURO, STEVEN, MICHAEL",2160 HERBERT CT   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 39 , 54 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588127658,"MOURO, STEVEN, MICHAEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 57 , 67 , 87 ," $10,499.86 ",,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588127658,"MOURO, STEVEN, MICHAEL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 18 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588127658,"MOURO, STEVEN, MICHAEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 17 , 25 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588128102,"CORVAIA, MAGGIE, HIELD",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588132070,"MITCHELL, MELISSA, DRAUGHN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 123 , 152 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588132070,"MITCHELL, MELISSA, DRAUGHN",2511 OLD CORNWALLIS RD STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 247 , 265 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588134027,"CONLEY, BENJAMIN, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588136212,"COLANTUONO, SHANNON, MICHELLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 37 , 37 ,$#,,
MEDICAID DIRECT,1144726928,EVANS PHYSICAL THERAPY & SPORT PERF,,2585 W ROOSEVELT BLVD   MONROE NC,090,Union,193400000X,Group,Single Specialty,,1588143077,"EVANS, ANTHONY, JAMES",2585 W ROOSEVELT BLVD   MONROE NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 29 , 109 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1588146633,"CHEEKS, NANCY, LYNAE",163 HWY 64 W WESTGATE PLAZA SUITE 4 HAYESVILLE NC,022,Clay,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1275280513,HOMETOWN HEALTHCARE,,163 HWY 64 W WESTGATE PLAZA SUITE 4 HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,,1588146633,"CHEEKS, NANCY, LYNAE",163 HWY 64 W WESTGATE PLAZA SUITE 4 HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 25 , 36 ,$#,,
MEDICAID DIRECT,1275280513,HOMETOWN HEALTHCARE,,1662 HWY 64 W   HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,,1588146633,"CHEEKS, NANCY, LYNAE",1662 HWY 64 W   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932745197,UNIVERSITY OF NORTH CAROLINA HOSPIT,UNC TRANSPLANT SERVICES,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588147847,"SCHOOLER, MATTHEW, EDWARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588148761,"MCCORMICK, SARAH, PILLING",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588148761,"MCCORMICK, SARAH, PILLING",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 21 , 31 ,$#,,
MEDICAID DIRECT,1730146267,NASH OB GYN ASSOCIATES PA,NASH OBGYN ASSOCIATES PA,200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1588149652,"MCDANIEL, REBECCA, DANIELS",200 NASH MEDICAL ARTS MALL   ROCKY MOUNT NC,064,Nash,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 30 , 44 , 71 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588150338,"SYLVESTER, KATHRYN, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 76 , 76 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588156848,"FORD, KELSEY, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588156848,"FORD, KELSEY, NICOLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588158646,"BASHIRI, RAFIULLAH",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics, 38 , 40 , 71 ," $14,399.80 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588158646,"BASHIRI, RAFIULLAH",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0700X,Dental Providers,Dentist,Prosthodontics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588161616,"SCHWARTZ, ALEXANDRIA, CREMEANS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 17 , 114 , 114 ," $21,578.81 ",,
MEDICAID DIRECT,1255380143,CAROLINA ORTHOPAEDIC AND SPORTS MED,CAROLINA ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA,2345 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588161640,"MOGK, LAUREN, MALIA",2345 COURT DR   GASTONIA NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 53 , 99 , 160 ,$#,,
MEDICAID DIRECT,1063896132,KIDZCARE PEDIATRICS PC,,20 SOUTHEND CT   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1588161731,"PARISH, MONIREH",120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1760865760,KIDZCARE PEDIATRICS PC,,1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588161731,"PARISH, MONIREH",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 97 , 173 , 472 ," $21,216.09 ",,
MEDICAID DIRECT,1699483586,EYECARE SPECIALTIES OF NORTH CAROLI,,504 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1588163000,"RANASINGHE, RUVINA, DILINI",504 VILLAGE WALK DR   HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 14 , 26 ,$#,,
MEDICAID DIRECT,1174813224,CAROMONT MEDICAL GROUP INC,CAROMONT HEART AND VASCULAR,2555 COURT DR STE 200 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588164370,"POOLE, BILLY, LEE",2555 COURT DR STE 200 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 83 , 83 ,$#,,
MEDICAID DIRECT,1851766885,LAKE NORMAN INPATIENT SPECIALISTS,,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588168538,"BOSS, MATTHEW, JOSEPH",171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 120 , 120 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588169171,"SHOGBESAN, GBENGA, ADEYEMI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1588169171,"SHOGBESAN, GBENGA, ADEYEMI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588169171,"SHOGBESAN, GBENGA, ADEYEMI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1588169171,"SHOGBESAN, GBENGA, ADEYEMI",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1497100721,GREENSBORO RHEUMATOLOGY PA,,2835 HORSE PEN CREEK RD STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588169460,"STRAZANAC, ALYSSA, ROSS",2835 HORSE PEN CREEK RD STE 101 GREENSBORO NC,041,Guilford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 27 , 66 , 105 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588172381,"PIETROCOLA, MICHELLE, MARIE",40 DUKE MEDICINE CIR CLINIC 1G DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588172381,"PIETROCOLA, MICHELLE, MARIE",40 DUKE MEDICINE CIR CLINIC 1G DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 22 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588172381,"PIETROCOLA, MICHELLE, MARIE",40 DUKE MEDICINE CIR CLINIC 1G DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 27 , 33 , 40 ,$#,,
MEDICAID DIRECT,1033877592,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DILLON FAMILY MEDICINE,603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588173579,"ROWELL, HOLLY, HUNT",603 N 6TH AVE   DILLON SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 23 , 77 ,$#,,
MEDICAID DIRECT,1952665929,RURAL HEALTH GROUP INC,Rural Health Group at Enfield,114 MARKET ST   ENFIELD NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588174700,"DOWNEY, MARY, LAMONICA",114 MARKET ST   ENFIELD NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 52 , 60 ,$#,,
MEDICAID DIRECT,1871081000,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT DRUGCO EXPRESS,1096 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588174700,"DOWNEY, MARY, LAMONICA",1096 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588174700,"DOWNEY, MARY, LAMONICA",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 22 , 27 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588175483,"FARRELL, SARAH, NOELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 35 , 42 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588175483,"FARRELL, SARAH, NOELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1588180806,"LUM, TINA, LASHAE",1771 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740870468,EYE SOLUTIONS OPTOMETRY PA,,7758 MCCRIMMON PKWY   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588181507,"ALSAIDI, HAKKAM, ALI ALI",1550 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1740870468,EYE SOLUTIONS OPTOMETRY PA,,4431 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588181507,"ALSAIDI, HAKKAM, ALI ALI",1550 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 16 , 21 ,$#,,
MEDICAID DIRECT,1740870468,EYE SOLUTIONS OPTOMETRY PA,,4431 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588181507,"ALSAIDI, HAKKAM, ALI ALI",701 TILGHMAN DR   DUNN NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1740870468,EYE SOLUTIONS OPTOMETRY PA,,7758 MCCRIMMON PKWY   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588181507,"ALSAIDI, HAKKAM, ALI ALI",701 TILGHMAN DR   DUNN NC,043,Harnett,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588184287,"SHULTZ, JOANNA, BARAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1588184287,"SHULTZ, JOANNA, BARAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588184287,"SHULTZ, JOANNA, BARAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1588184287,"SHULTZ, JOANNA, BARAN",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922555689,DAVID E THOME DDS PLLC V,CABARRUS PEDIATRIC DENTISTRY,2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588184451,"TURNER, ERIN, RODGERS",2301 S CANNON BLVD   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1104469808,DAVID E THOME DDS PLLC IX,AFTON PEDIATRIC DENTISTRY,5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588184451,"TURNER, ERIN, RODGERS",5641 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 136 , 138 , 520 ," $18,886.10 ",,
MEDICAID DIRECT,1174166359,THOME & ZIMMER DDS PLLC I,SHELBY PEDIATRIC DENTISTRY,221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1588184451,"TURNER, ERIN, RODGERS",221 SIMPSON PARK RD   SHELBY NC,023,Cleveland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1942820105,DAVID E THOME DDS PLLC X,SHERRILLS FORD PEDIATRIC DENTISTRY,7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,193200000X,Group,Multi-Specialty,,1588184451,"TURNER, ERIN, RODGERS",7856 VILLAGE CTR N   SHERRILLS FORD NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 18 , 18 , 82 ,$#,,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588184451,"TURNER, ERIN, RODGERS",202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1588184451,"TURNER, ERIN, RODGERS",202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice," 1,086 "," 1,377 "," 5,946 "," $208,486.18 ",,
MEDICAID DIRECT,1538935432,THOME & KENDRICK DDS PLLC,,9625 NORTHCROSS CENTER CT STE 101 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588184451,"TURNER, ERIN, RODGERS",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 302 , 338 ," 1,396 "," $45,412.16 ",,
MEDICAID DIRECT,1124457817,DAVID E THOME DDS PLLC II,MOORESVILLE PEDIATRIC DENTISTRY,202 WILLIAMSON RD STE 200 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1588184451,"TURNER, ERIN, RODGERS",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 685 , 787 ," 3,365 "," $112,879.84 ",,
MEDICAID DIRECT,1437597853,DAVID E THOME DDS PLLC III,SALISBURY PEDIATRIC DENTISTRY,140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1588184451,"TURNER, ERIN, RODGERS",140 MAHALEY AVE STE B SALISBURY NC,080,Rowan,1223G0001X,Dental Providers,Dentist,General Practice, 78 , 78 , 338 ," $12,205.31 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588184725,"HENSON, JACQUELINE, BOYKIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588184725,"HENSON, JACQUELINE, BOYKIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588185367,"HEGDE, SHARANA",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588185367,"HEGDE, SHARANA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 17 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588185367,"HEGDE, SHARANA",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 23 , 40 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588185367,"HEGDE, SHARANA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588185367,"HEGDE, SHARANA",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588185367,"HEGDE, SHARANA",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 19 , 32 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588185367,"HEGDE, SHARANA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588186969,"WILSON, BRANDY, LEA",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588187553,"HAYES, ASHLEIGH, RAE THOROGOOD",171 KEMPSVILLE RD BLDG A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952830432,FHPG LLC,FIRSTHEALTH TROY CARE CLINIC,522 ALLEN ST STE 203 TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1588188155,"RICHARDS, MARGARET, HEFFERNAN",7810 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1952830432,FHPG LLC,FIRSTHEALTH TROY CARE CLINIC,522 ALLEN ST STE 203 TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1588188155,"RICHARDS, MARGARET, HEFFERNAN",522 ALLEN ST STE 203 TROY NC,062,Montgomery,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1588188890,"PALMER, BROOKE, JONES",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 49 , 54 , 137 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1588188890,"PALMER, BROOKE, JONES",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1588188890,"PALMER, BROOKE, JONES",210 SCHOOL RD   TRINITY NC,076,Randolph,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 25 , 28 , 62 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588193239,"TU, CHING, TING",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588193239,"TU, CHING, TING",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588193239,"TU, CHING, TING",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588193239,"TU, CHING, TING",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588193239,"TU, CHING, TING",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588195150,"DENNIS, ERIN, NICOLE",104 E NORTHWOOD ST   GREENSBORO NC,041,Guilford,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588195150,"DENNIS, ERIN, NICOLE",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 81 , 181 , 238 ,$#,,
MEDICAID DIRECT,1861792004,MOSES CONE AFFILIATED PHYSICIANS IN,ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA,120 DAVIS ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1588195150,"DENNIS, ERIN, NICOLE",120 DAVIS ST   ASHEBORO NC,076,Randolph,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1811350887,PIEDMONT HEALTHCARE PA,,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588195440,"GLENER, JULIE, ELLEN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 61 , 98 , 190 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588195440,"GLENER, JULIE, ELLEN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588195440,"GLENER, JULIE, ELLEN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588195440,"GLENER, JULIE, ELLEN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 14 , 23 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588195440,"GLENER, JULIE, ELLEN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588195440,"GLENER, JULIE, ELLEN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588195440,"GLENER, JULIE, ELLEN",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 31 , 61 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 28 , 41 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 36 , 45 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588196265,"HO, SUSANA, J",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588196968,"COREY, KRISTEN, BLAKE",11530 PROVIDENCE RD STE 1400 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 12 , 27 , 30 ,$#,,
MEDICAID DIRECT,1215573423,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ALLERGY ASTHMA & IMMUNOLOGY,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588196968,"COREY, KRISTEN, BLAKE",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588197057,"FERGUSON, VIRGINIA, MARY",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588197560,"NGUYEN, DEREK, LE",40 DUKE MEDICINE CIR # 1B1C DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 140 , 168 , 223 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588197560,"NGUYEN, DEREK, LE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 65 , 88 , 104 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588197560,"NGUYEN, DEREK, LE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 32 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588197560,"NGUYEN, DEREK, LE",5324 MCFARLAND RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588197560,"NGUYEN, DEREK, LE",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 247 , 268 , 369 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588197586,"HICKEY, ANDREW, JAY",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588197586,"HICKEY, ANDREW, JAY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 18 , 20 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588197586,"HICKEY, ANDREW, JAY",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 24 , 77 , 82 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588197586,"HICKEY, ANDREW, JAY",10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588197586,"HICKEY, ANDREW, JAY",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1588198394,"WAGNER, HEATHER, DAWN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 36 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588198394,"WAGNER, HEATHER, DAWN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588198477,"PATEL, AKASH, NITIN",4590 PREMIER DR   HIGH POINT NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 11 , 17 , 28 ,$#,,
MEDICAID DIRECT,1255466355,GREENSBORO SPINE AND SCOLIOSIS CENT,SPINE AND SCOLIOSIS SPECIALISTS,2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588198477,"PATEL, AKASH, NITIN",2105 BRAXTON LN STE 101 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 43 , 111 , 241 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588199459,"TODD, SARAH, HALE",118 KNOX WAY   CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 30 , 65 ,$#,,
MEDICAID DIRECT,1306260674,UNC PHYSICIANS NETWORK LLC,~,118 KNOX WAY   CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588199459,"TODD, SARAH, HALE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1588204846,AMERITA SOUTH ATLANTIC LLC,ADVANCED HOME INFUSION,9741 SOUTHERN PINE BLVD STE H CHARLOTTE NC,060,Mecklenburg,251F00000X,Agencies,Home Infusion,,1588204846,AMERITA SOUTH ATLANTIC LLC,9741 SOUTHERN PINE BLVD STE H CHARLOTTE NC,060,Mecklenburg,251F00000X,Agencies,Home Infusion,, 34 , 402 , 726 ," $23,621.26 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588204994,"WARREN, STEVEN, HODNETT",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588209258,"MARTIN, ADRIAN, THERON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588209258,"MARTIN, ADRIAN, THERON",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588209498,"PATEL, SHIVANI, AMUL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588210215,"GOUJON, SARAH, ROTELLA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1588212997,"PORCHERON, MICHAEL, ROBERT",114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 34 , 57 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1588212997,"PORCHERON, MICHAEL, ROBERT",114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588217459,"TITCHER, LAUREN, KAYLEIGH",870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1588218002,AMBUCARE MEDICAL TRANSPORT INC,,7187 COUNTY HOME RD   AYDEN NC,074,Pitt,3416L0300X,Transportation Services,Ambulance,Land Transport,1588218002,AMBUCARE MEDICAL TRANSPORT INC,7187 COUNTY HOME RD   AYDEN NC,074,Pitt,3416L0300X,Transportation Services,Ambulance,Land Transport, 83 , 249 , 350 ," $54,944.42 ",,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1588219125,"RIORDEN, KYNDAL, ANNETTE ROUSE",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1588219125,"RIORDEN, KYNDAL, ANNETTE ROUSE",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1588219125,"RIORDEN, KYNDAL, ANNETTE ROUSE",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1588219125,"RIORDEN, KYNDAL, ANNETTE ROUSE",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588219125,"RIORDEN, KYNDAL, ANNETTE ROUSE",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588219125,"RIORDEN, KYNDAL, ANNETTE ROUSE",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1588219125,"RIORDEN, KYNDAL, ANNETTE ROUSE",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588219307,"VAZQUEZ, YERILIS, ORTIZ",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",400 US 70 HWY E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 16 , 19 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 50 , 58 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588220545,"DEERY, CHRISTOPHER, BRIAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588220586,"MPOFU, FIKILE, SITHEMBISO",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588220586,"MPOFU, FIKILE, SITHEMBISO",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1588221394,"OBERACKER, LINDSEY, CATHERINE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 37 , 45 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1588221394,"OBERACKER, LINDSEY, CATHERINE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588221857,"DORRELL, DEBORAH, NEGUS",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588221857,"DORRELL, DEBORAH, NEGUS",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 79 , 111 , 171 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588221857,"DORRELL, DEBORAH, NEGUS",3333 BROOKVIEW HILLS BLVD STE 204 WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1437146800,COASTAL INTERNAL MEDICINE PA,~,2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1588223754,"LAZARO, AUTUMN, RAE",2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 58 , 73 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588223754,"LAZARO, AUTUMN, RAE",2032 S 17TH ST STE 101 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 35 , 83 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588224299,"OGUNBEKUN, EBONI, DANIELLE PULLEN",3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588224299,"OGUNBEKUN, EBONI, DANIELLE PULLEN",3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588224299,"OGUNBEKUN, EBONI, DANIELLE PULLEN",3200 NORTHLINE AVE STE 130 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 17 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588224299,"OGUNBEKUN, EBONI, DANIELLE PULLEN",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 11 , 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588224497,"STONE, AUTUMN, HART",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588224497,"STONE, AUTUMN, HART",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760559926,EAST CAROLINA UNIVERSITY,~,1000 E 5TH ST STUDENT HEALTH MAIL STOP 408 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588225387,"GALLOWAY, BRANDY, JONES",1000 E 5TH ST   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588228274,"WINSOR, KRISTEN, NICOLE",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588228274,"WINSOR, KRISTEN, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2340 SPRING FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588228571,"RYBALOV, DANIEL",2340 SPRING FOREST RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588229595,"BELL, BENJAMIN, STEVEN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881127942,SOUTHLAND CHATUGE EMERGENCY MEDICAL,,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588229595,"BELL, BENJAMIN, STEVEN",110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588230007,"WHITAKER, SHAKETA, DION",101 HEART DR   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588230007,"WHITAKER, SHAKETA, DION",101 CLINIC DR   TARBORO NC,033,Edgecombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 55 , 62 , 77 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588234645,"IGLINSKI, CLAYTON, DANIEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 28 , 28 , 30 ,$#,,
MEDICAID DIRECT,1588235238,UNION HOME CARE INC,,1434 S CHURCH ST   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,,1588235238,UNION HOME CARE INC,1434 S CHURCH ST   ROCKY MOUNT NC,064,Nash,253Z00000X,Agencies,In Home Supportive Care,, 70 ," 13,610 "," 13,612 "," $2,349,558.00 ",,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1588238406,"JIANG, DESAI, VICTOR",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588238406,"JIANG, DESAI, VICTOR",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588245971,"FURSTENBERG, YARA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588246144,"TRAMBERT KYLSTRA, EMILY, LAUREN",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588246300,"RAJAMREDDY, SARPITHA",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588246300,"RAJAMREDDY, SARPITHA",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588246300,"RAJAMREDDY, SARPITHA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588246300,"RAJAMREDDY, SARPITHA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 64 , 71 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1588252100,"BRYANT, MISTY, MAE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 25 ,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1588252100,"BRYANT, MISTY, MAE",703 LEONARD AVE   ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 71 , 77 , 137 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588252290,"SMALLWOOD, BEVERLY, SMITH",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 69 , 69 ,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588252290,"SMALLWOOD, BEVERLY, SMITH",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 119 , 332 , 348 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1588252290,"SMALLWOOD, BEVERLY, SMITH",2080 W ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588252290,"SMALLWOOD, BEVERLY, SMITH",517 B HWY 210 N   SPRING LAKE NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588252290,"SMALLWOOD, BEVERLY, SMITH",2153 VALLEYGATE DR STE 102 FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 16 , 31 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1588252837,"BURR, CHRISTOPHER, COLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588252837,"BURR, CHRISTOPHER, COLE",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 50 , 51 , 51 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1588252837,"BURR, CHRISTOPHER, COLE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588252837,"BURR, CHRISTOPHER, COLE",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1705 TARBORO ST SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1588253124,"BARBER, TIFFANY, JOY",1705 TARBORO ST SW   WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1588253462,"CASEY, GARRETT, STEPHEN",401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 21 , 21 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588253462,"CASEY, GARRETT, STEPHEN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588253462,"CASEY, GARRETT, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588253520,CHANCEY HOME CARE INC,,421 FAYETTEVILLE ST STE 1100 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1588253520,CHANCEY HOME CARE INC,421 FAYETTEVILLE ST STE 1100 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 609 , 616 ," $49,122.32 ",,
MEDICAID DIRECT,1588253983,LIFES ANGEL GROUP HOME,LIFES ANGEL HOME CARE,2530 MERIDIAN PKWY STE 3066 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,,1588253983,LIFES ANGEL GROUP HOME,2530 MERIDIAN PKWY STE 3066 DURHAM NC,032,Durham,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,711 "," 1,725 "," $287,534.20 ",,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588255871,"HARRIS, DAVID, CHRISTOPHER",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 51 , 95 ,$#,,
MEDICAID DIRECT,1578176723,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,134 PROFESSIONAL PARK DR   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588255871,"HARRIS, DAVID, CHRISTOPHER",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588255871,"HARRIS, DAVID, CHRISTOPHER",11530 PROVIDENCE RD STE 1300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588255889,"DONAHUE, ALEXANDRA, BEERY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588255889,"DONAHUE, ALEXANDRA, BEERY",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588255889,"DONAHUE, ALEXANDRA, BEERY",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588255889,"DONAHUE, ALEXANDRA, BEERY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",100 DURHAM   STOVALL NC,039,Granville,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902995145,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT TWIN COUNTY,204 EVANS RD   HOLLISTER NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",204 EVANS RD   HOLLISTER NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881841518,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT SCOTLAND NECK,919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",919 JR HIGH SCHOOL RD   SCOTLAND NECK NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 22 , 27 ,$#,,
MEDICAID DIRECT,1932696267,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX COMMUNITY COLLEGE,100 COLLEGE DR BLDG 700 WELDON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",100 COLLEGE DR BLDG 700 WELDON NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871081000,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT DRUGCO EXPRESS,1096 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",1096 E 10TH ST   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1720030232,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS,2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 53 , 55 ,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1932696267,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX COMMUNITY COLLEGE,100 COLLEGE DR BLDG 700 WELDON NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",2066 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1528489895,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HALIFAX REGIONAL MEDICAL CTR,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1902995145,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT TWIN COUNTY,204 EVANS RD   HOLLISTER NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588257935,"PERNESKY, JENNIFER, ANN",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588258446,"GONZALEZ, SONJA, JOHANNA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1588261549,ALLIANCE GROUP I HOME CARE LLC,ALLIANCE GROUP I HOME CARE LLC,244 AUDUBON DR   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,1588261549,ALLIANCE GROUP I HOME CARE LLC,244 AUDUBON DR   RAEFORD NC,047,Hoke,253Z00000X,Agencies,In Home Supportive Care,,#, 85 , 85 ,$#,,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588262653,"SPENCE, JEANNE, MARIE",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1669500997,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT ROANOKE RAPIDS DENTAL,2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588262653,"SPENCE, JEANNE, MARIE",2064 NC HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 22 ,$#,,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588262653,"SPENCE, JEANNE, MARIE",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice, 691 , 835 ," 2,886 "," $115,834.89 ",,
MEDICAID DIRECT,1124269022,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT HENDERSON,100 W PARKVIEW DR   HENDERSON NC,091,Vance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588262653,"SPENCE, JEANNE, MARIE",9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1558308080,THE C W WILLIAMS COMMUNITY HEALTH C,~,5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588264527,"LOPEZ, ELIZABETH",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 24 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1814 WESTCHESTER DR STE 103 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588264584,"SMITH, KELSEY, KILLEEN",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588264584,"SMITH, KELSEY, KILLEEN",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588264584,"SMITH, KELSEY, KILLEEN",1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 49 , 101 ,$#,,
MEDICAID DIRECT,1437860889,PINNACLE URGENT CARE PLLC,,1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1588264584,"SMITH, KELSEY, KILLEEN",1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1588264584,"SMITH, KELSEY, KILLEEN",10102 S MAIN ST STE U ARCHDALE NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588269799,"HUTCHINSON, JOSHUA, JAMES",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 84 , 89 ,$#,,
MEDICAID DIRECT,1124786256,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL HOPE MILLS,3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",3020 N MAIN ST STE 270 HOPE MILLS NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 19 ,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 434 , 589 ," 2,302 "," $133,325.66 ",,
MEDICAID DIRECT,1205595998,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WILSON,3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",3401 RALEIGH ROAD PKWY W STE 10C WILSON NC,098,Wilson,1223G0001X,Dental Providers,Dentist,General Practice, 347 , 508 ," 2,063 "," $110,813.82 ",,
MEDICAID DIRECT,1184325102,ALLES DDS WAKE FOREST PLLC,IDEAL DENTAL WAKE FOREST,515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",515 DR CALVIN JONES HWY STE 120 WAKE FOREST NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 29 , 96 ,$#,,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 143 , 173 , 459 ," $29,504.17 ",,
MEDICAID DIRECT,1497166912,OBRIEN AND WEST DMD PLLC,NIGHT AND DAY DENTAL,2945 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 127 , 184 , 602 ," $46,746.03 ",,
MEDICAID DIRECT,1487188967,OBRIEN AND WEST DMD III PLLC,NIGHT AND DAY DENTAL,1325 BRADFORD VIEW DR STE 120 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1982362018,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF FAYETTEVILLE,4251 RAMSEY ST STE 8&9 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588271316,"LIMERICK, THEODORE, JOSEPH",2945 NEW BERN AVE   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588272462,"SIMMS, SHANEEKQUA, GERRAAY",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1972645422,MECKLENBURG COUNTY,~,249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588272462,"SIMMS, SHANEEKQUA, GERRAAY",249 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588272785,"BARNES, KATHRYN, ANN",1225 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588272785,"BARNES, KATHRYN, ANN",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588274062,"HAMILTON, HUNTER, MEREDITH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588274062,"HAMILTON, HUNTER, MEREDITH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588274062,"HAMILTON, HUNTER, MEREDITH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588274963,WILMINGTON EYE SURGERY CENTER LLC,,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1588274963,WILMINGTON EYE SURGERY CENTER LLC,1919 S 16TH ST   WILMINGTON NC,065,New Hanover,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 78 , 106 , 106 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1588277735,"MASSENGILL, MARY ELIZABETH, RAYNOR",113 W MAIN ST   BENSON NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,124 E MAIN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1588277735,"MASSENGILL, MARY ELIZABETH, RAYNOR",124 E MAIN ST   CLINTON NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 28 , 38 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1588277735,"MASSENGILL, MARY ELIZABETH, RAYNOR",124 E MAIN ST   CLINTON NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,, 21 , 25 , 31 ,$#,,
MEDICAID DIRECT,1356529960,PEC OPTOMETRY GROUP PA,,113 W MAIN ST   BENSON NC,051,Johnston,193400000X,Group,Single Specialty,,1588277735,"MASSENGILL, MARY ELIZABETH, RAYNOR",305 W ROSEBORO ST   ROSEBORO NC,082,Sampson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1225085707,BURKE PRIMARY CARE PLLC,BURKE PRIMARY CARE PLLC,103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1588280077,"SMITH, STEPHEN, BROOKS",103 MEDICAL HEIGHTS DR   MORGANTON NC,012,Burke,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 53 , 160 , 473 ,$#,,
MEDICAID DIRECT,1588282438,TRANQUILITY HOME CARE SERVICES LLC,,202 CARWEN CT   KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1588282438,TRANQUILITY HOME CARE SERVICES LLC,202 CARWEN CT   KANNAPOLIS NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,230 "," 1,230 "," $73,313.96 ",,
MEDICAID DIRECT,1851567663,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM INPATIENT MEDICINE SPECIALISTS,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1588284434,"TOBIN, STEPHEN, PAUL",180 PARKWOOD DR   ELKIN NC,086,Surry,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 23 , 25 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588285290,"MITCHELL, REBECCA, WEST",404 WESTWOOD AVE STE 303 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 26 , 26 ,$#,,
MEDICAID DIRECT,1174767073,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HIGHLAND,609 N HIGHLAND ST   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588285480,"THOMAS, KENYA, EVETTE",111 E 3RD AVE   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548389125,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - 3RD AVE,111 E THIRD AVE   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588285480,"THOMAS, KENYA, EVETTE",111 E 3RD AVE   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 92 , 127 , 142 ," $13,682.46 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588287015,"KABRICH, WILLIAM, PRESTON",5010 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 48 , 117 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588289581,"SANDEFER, KATIE, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588289581,"SANDEFER, KATIE, ELIZABETH",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588289995,"PELLERIN, ASHLEY, BELLE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588289995,"PELLERIN, ASHLEY, BELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 51 , 55 ,$#,,
MEDICAID DIRECT,1588290506,TRINITY ADULT AND SENIOR SERVICES,,13818 NC HIGHWAY 55   BAYBORO NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,,1588290506,TRINITY ADULT AND SENIOR SERVICES,13818 NC HIGHWAY 55   BAYBORO NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,056 "," 4,351 "," $534,857.28 ",,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1588291041,"KURTOM, MUHANNAD, HELMY",2201 S STERLING ST   MORGANTON NC,012,Burke,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588291066,"MACKAY, ALYSSA, FINNEGAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588291066,"MACKAY, ALYSSA, FINNEGAN",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588291876,"TRUONG, STEPHANIE, CHLOE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 70 , 70 ,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588292015,"PATEL, NIYANTA, HIMANSHU",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 36 , 36 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588292171,"BOLDOSSER, CHRISTINA, DAWN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 40 , 58 , 58 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1588292171,"BOLDOSSER, CHRISTINA, DAWN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 55 , 81 , 81 ,$#,,
MEDICAID DIRECT,1588296362,PALMETTO OXYGEN LLC,,1767 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1588296362,PALMETTO OXYGEN LLC,1767 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1588296362,PALMETTO OXYGEN LLC,,1767 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1588296362,PALMETTO OXYGEN LLC,1767 OLD EARNHARDT RD   KANNAPOLIS NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 524 ," 2,592 "," 4,171 "," $70,071.19 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588296826,"WILLIAMS, LAUREN, ALEXA",35 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 119 , 313 , 333 ,$#,,
MEDICAID DIRECT,1053074369,MCPC 22 LLC,FIRSTHEALTH-SANDHILLS NEUROLOGISTS,295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588296826,"WILLIAMS, LAUREN, ALEXA",4565 FAYETTEVILLE RD STE B RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1689849200,NORTH CAROLINA BAPTIST HOSPITAL,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,237700000X,"Speech, Language and Hearing Service Providers",Hearing Instrument Specialist,,1588298665,"BENEDICT, LEAH, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1588298863,JAYCEES HOME CARE LLC,,308 W MILLBROOK RD STE A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1588298863,JAYCEES HOME CARE LLC,308 W MILLBROOK RD STE A RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#," 2,122 "," 2,137 "," $181,550.42 ",,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588298988,"KAZEMI, KAREN, AZAR",1730 KERNERSVILLE MEDICAL PKWY STE 101 KERNERSVILLE NC,034,Forsyth,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1588311328,"COWART, ELIZABETH, MOORE",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 28 , 117 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588311328,"COWART, ELIZABETH, MOORE",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2001 SUNSET AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588311328,"COWART, ELIZABETH, MOORE",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 29 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2503 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1588311328,"COWART, ELIZABETH, MOORE",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588311328,"COWART, ELIZABETH, MOORE",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 17 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1261 JULIAN ALLSBRK HWY   ROANOKE RAPIDS NC,042,Halifax,193200000X,Group,Multi-Specialty,,1588311328,"COWART, ELIZABETH, MOORE",402 SW GREENVILLE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1588317648,"HARDEN, JOSHUA, BECK",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1588317648,"HARDEN, JOSHUA, BECK",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1588317648,"HARDEN, JOSHUA, BECK",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588317648,"HARDEN, JOSHUA, BECK",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1588317648,"HARDEN, JOSHUA, BECK",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588317648,"HARDEN, JOSHUA, BECK",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588317648,"HARDEN, JOSHUA, BECK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588317648,"HARDEN, JOSHUA, BECK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588317648,"HARDEN, JOSHUA, BECK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588317648,"HARDEN, JOSHUA, BECK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588317648,"HARDEN, JOSHUA, BECK",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588317648,"HARDEN, JOSHUA, BECK",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588318182,"GOETHEL, EMMA, ANN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1588324636,"WOOLDRIK, ASHLEY, ANN",1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588324636,"WOOLDRIK, ASHLEY, ANN",1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 ,#, 28 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588324636,"WOOLDRIK, ASHLEY, ANN",1385 COBB CORNERS DR   ROCKY MOUNT NC,064,Nash,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588327506,"MUSA, IDIL",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588327829,"PURVIS, JILLIAN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588327829,"PURVIS, JILLIAN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 51 , 78 ,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588330005,"HOOTS, KAILEY, SUMMER",4048 E U S HIGHWAY 64 ALTERNATE STE 1 MURPHY NC,020,Cherokee,1835P0018X,Pharmacy Service Providers,Pharmacist,Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588330070,"HUTCHENS, EVELYN, ELIZABETH",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 21 , 55 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588330070,"HUTCHENS, EVELYN, ELIZABETH",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588331615,"ROBINSON, KASEY, COOKE",3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 33 , 63 ,$#,,
MEDICAID DIRECT,1982710562,STEWART PHYSICAL THERAPY CLINICS,STEWART PHYSICAL THERAPY CLINIC INC,3948 FOREST OAKS LN BLDG E   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588331615,"ROBINSON, KASEY, COOKE",3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588333116,"THOMPSON, MADDISON, DOUGLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588333116,"THOMPSON, MADDISON, DOUGLAS",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588333447,"MILLESON, COURTNEY, KEITH",137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 105 , 126 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588333447,"MILLESON, COURTNEY, KEITH",2025 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 19 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588334775,"LANGER, MARLEE, MATLOCK",160 RIVER BEND DR STE C GRANITE FALLS NC,014,Caldwell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588334775,"LANGER, MARLEE, MATLOCK",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 94 , 122 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588334775,"LANGER, MARLEE, MATLOCK",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588339709,"JOINES, BROOKE, KILLIAN",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 33 , 34 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588347579,"REYNOLDS, MARY, KATHERINE",1 HOSPITAL DR STE 5200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588349112,"HAJEK, MATTHEW, DAVID",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588349112,"HAJEK, MATTHEW, DAVID",10628 PARK ROAD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588349112,"HAJEK, MATTHEW, DAVID",10628 PARK ROAD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588349534,"HARBESON, CATHERINE, STILLE",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 20 , 28 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588351449,"BOWMAN, BRIAN, WAYNE",9101 PINEVILLE MATTHEWS RD STE D PINEVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 61 , 101 ,$#,,
MEDICAID DIRECT,1588352447,ASA BEHAVIORAL HEALTHCARE,ASA BEHAVIORAL HEALTHCARE AND RESEARCH INSTITUTE,5508 FAITH DR APT 202 FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,1588352447,ASA BEHAVIORAL HEALTHCARE,5508 FAITH DR APT 202 FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,#, 23 , 26 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588353262,"TEMPLETON, JAMES, HUNTER",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588353262,"TEMPLETON, JAMES, HUNTER",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588353262,"TEMPLETON, JAMES, HUNTER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588353262,"TEMPLETON, JAMES, HUNTER",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588353262,"TEMPLETON, JAMES, HUNTER",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588353262,"TEMPLETON, JAMES, HUNTER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588353262,"TEMPLETON, JAMES, HUNTER",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588357644,BW DALEA ENTERPRISES LLC,WILHAM RIDGE ALF,30 DALEA DR   ASHEVILLE NC,011,Buncombe,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1588357644,BW DALEA ENTERPRISES LLC,30 DALEA DR   ASHEVILLE NC,011,Buncombe,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 13 , 71 , 75 ,$#,,
MEDICAID DIRECT,1588357644,BW DALEA ENTERPRISES LLC,WILHAM RIDGE ALF,30 DALEA DR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588357644,BW DALEA ENTERPRISES LLC,30 DALEA DR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 18 , 120 , 120 ," $217,945.28 ",,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1588358246,"CHASE, TREVOR, JAMES",1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 22 , 22 , 66 ,$#,,
MEDICAID DIRECT,1801232244,MILLER AND ASSOCIATES FOUR PLLC,MILLER AND ASSOCIATES,1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1588358246,"CHASE, TREVOR, JAMES",1107 NEW POINTE BLVD STE 13 LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 52 , 165 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588362925,"BRACKEN, ALISHA, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588362925,"BRACKEN, ALISHA, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588366355,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,108 DOCTORS DR   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588366355,HIGH COUNTRY COMMUNITY HEALTH,108 DOCTORS DR   BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1588366900,ANGELS OF MERCY HOME CARE LLC,,564 CANDY PARK RD STE 102 PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1588366900,ANGELS OF MERCY HOME CARE LLC,564 CANDY PARK RD STE 102 PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 45 ," 6,998 "," 7,090 "," $1,013,704.92 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588372841,"DOUGLAS, HOLLY, NICOLE",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 31 , 50 , 75 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588372841,"DOUGLAS, HOLLY, NICOLE",2029 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1245486067,BLUE RIDGE HEALTHCARE MEDICAL GROUP,WOMENS HEALTH GROUP,2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1588374144,"LYLE, KIMBERLY, WRIGHT",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 13 , 16 , 26 ,$#,,
MEDICAID DIRECT,1457356651,COUNTY OF BURKE,BURKE COUNTY HEALTH DEPARTMENT,700 E PARKER RD UNIT A MORGANTON NC,012,Burke,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588374144,"LYLE, KIMBERLY, WRIGHT",2209 S STERLING ST STE 400 MORGANTON NC,012,Burke,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1588374581,COUNTRY LIVING GUEST HOME,COUNTRY LIVING WILLOW HOUSE,3644 CHERRY RD   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588374581,COUNTRY LIVING GUEST HOME,3644 CHERRY RD   WASHINGTON NC,007,Beaufort,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,096 "," 1,096 "," $81,723.13 ",,
MEDICAID DIRECT,1588374581,COUNTRY LIVING GUEST HOME,COUNTRY LIVING WILLOW HOUSE,3644 CHERRY RD   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1588374581,COUNTRY LIVING GUEST HOME,3644 CHERRY RD   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 113 , 114 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,295 MIDLAND PKWY   SUMMERVILLE SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1588376339,"GERBER, JOSHUA, ERNST",1626 N MAIN ST   SUMMERVILLE SC,102,Out of State > 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1588377378,"GEISS, ALAINA, DOROTHY",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588377378,"GEISS, ALAINA, DOROTHY",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588377378,"GEISS, ALAINA, DOROTHY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588377378,"GEISS, ALAINA, DOROTHY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588378269,"PARKER, KARA, PERRY",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 25 , 28 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1588378269,"PARKER, KARA, PERRY",250 NASH MEDICAL ARTS MALL STE D ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 109 , 141 , 191 ,$#,,
MEDICAID DIRECT,1336188184,MIDCAROLINA PEDIATRICS,MIDCAROLINA PEDIATRICS,2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588382279,"ALVARADO, BRIANNA, NICOLE",2607 W ARROWOOD RD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 12 , 12 , 34 ,$#,,
MEDICAID DIRECT,1487845020,AVANCE CARE PA,,1821 MARTIN LUTHER KING PKWY   DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1588382279,"ALVARADO, BRIANNA, NICOLE",9805 SANDY ROCK PL STE E CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1588382766,SMALL TALK SOLUTIONS LLC,,6708 VAUGHN RD   FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,,1588382766,SMALL TALK SOLUTIONS LLC,6708 VAUGHN RD   FAYETTEVILLE NC,026,Cumberland,251S00000X,Agencies,Community/Behavioral Health,, 31 , 495 , 495 ," $31,867.52 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588389480,"CHAVIS, JACKIE, LOCKLEAR",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 96 ," 1,117 "," 1,177 "," $30,516.02 ",,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588389480,"CHAVIS, JACKIE, LOCKLEAR",101 CABARRUS AVE E STE 100 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1588389480,"CHAVIS, JACKIE, LOCKLEAR",620 JOHNS RD   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588391080,"WOOLARD, MIRANDA, DANIELS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588391080,"WOOLARD, MIRANDA, DANIELS",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588391080,"WOOLARD, MIRANDA, DANIELS",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1588391593,YOUR CHOICE HOME CARE LLC,,2459 WILKINSON BLVD STE 326 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1588391593,YOUR CHOICE HOME CARE LLC,2459 WILKINSON BLVD STE 326 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 6,356 "," 6,356 "," $388,961.52 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588397152,"JACKSON, KERRA, JONES",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588397152,"JACKSON, KERRA, JONES",3515 W MARKET ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 43 , 65 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588397152,"JACKSON, KERRA, JONES",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588397418,TANDEM COMMUNICATION PLLC,,1293 HENDERSONVILLE RD STE 14 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588397418,TANDEM COMMUNICATION PLLC,1293 HENDERSONVILLE RD STE 14 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,, 13 , 141 , 151 ," $10,746.92 ",,
MEDICAID DIRECT,1477834992,DEST REIMELS DDS PLLC,BELVEDERE DENTISTRY,2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588398317,"SODERFELT, ALEXANDER, MIKAEL",2734 ROZZELLES FERRY RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 28 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588400154,"KOSTILNIK, JULIE, MARIE",830 KEMPSVILLE RD RM 2B223 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588404990,"HICKS, LAUREN, NICOLE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588410872,RSS DURHAM OPERATIONS LLC,CAROLINA RESERVE OF DURHAM,4523 HOPE VALLEY RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588410872,RSS DURHAM OPERATIONS LLC,4523 HOPE VALLEY RD   DURHAM NC,032,Durham,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 43 , 49 ," $31,260.20 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588411128,"ALMOND, EMILY, CLAIRE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588411128,"ALMOND, EMILY, CLAIRE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588412258,"SHAW, NYKICHIA, SHAMON",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 22 , 23 , 92 ,$#,,
MEDICAID DIRECT,1588420863,CARE ADVANTAGE HOME CARE,,3808 E VANCROFT CIR UNIT M4 WINTERVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1588420863,CARE ADVANTAGE HOME CARE,3808 E VANCROFT CIR UNIT M4 WINTERVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,#, 61 , 61 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1588423610,"MICHELS, JONATHAN, SCOTT",125 MEDICAL PARK LN STE H MURPHY NC,020,Cherokee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 26 , 26 ," $10,296.00 ",,
MEDICAID DIRECT,1639352032,NORTH WHITEVILLE URGENT CARE,NORTH WHITEVILLE URGENT CARE,614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1588426498,"SMITH, SHEEKETA, BELLAMY",614 N JK POWELL BLVD   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 296 , 546 ," 1,210 "," $22,855.93 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1588426498,"SMITH, SHEEKETA, BELLAMY",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1588426498,"SMITH, SHEEKETA, BELLAMY",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588426860,"COBDEN, JAY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1093772410,ROBESON HEALTH CARE CORPORATION,MAXTON MEDICAL CENTER,610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588427066,"OXENDINE, LEYIA, BULLARD",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 123 , 246 , 319 ," $12,662.54 ",,
MEDICAID DIRECT,1518525526,ROBESON HEALTH CARE CORPORATION,ST PAULS HEALTH CENTER,128 E BROAD ST   SAINT PAULS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588427066,"OXENDINE, LEYIA, BULLARD",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407461106,ROBESON HEALTH CARE CORPORATION,RED SPRINGS HEALTH CENTER,302 MOUNT TABOR RD   RED SPRINGS NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588427066,"OXENDINE, LEYIA, BULLARD",610 E DR MARTIN LUTHER KING JR DR   MAXTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750348538,ROBESON HEALTH CARE CORPORATION,JULIAN T PIERCE HEALTH CENTER,307 E WARDELL DR   PEMBROKE NC,078,Robeson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588427066,"OXENDINE, LEYIA, BULLARD",307 E WARDELL DR   PEMBROKE NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588433718,"BEDARD, DOROTHY, MICHELLE",136 CREEKVIEW CT   MARION NC,059,McDowell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588433718,"BEDARD, DOROTHY, MICHELLE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588433718,"BEDARD, DOROTHY, MICHELLE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588435283,"JOHNSON, JESSICA, STEPHENSON",127 E MARKET ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 24 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,127 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588435283,"JOHNSON, JESSICA, STEPHENSON",127 E MARKET ST   SMITHFIELD NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 82 , 126 ,$#,,
MEDICAID DIRECT,1588436331,PRECISE LOVING HANDS HOME CARE,,503 S QUEEN ST   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,1588436331,PRECISE LOVING HANDS HOME CARE,503 S QUEEN ST   WINDSOR NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 50 ," 8,868 "," 9,096 "," $722,522.39 ",,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1588437065,"BALOYO, JOEMEL JAY, MEDIAVILLA",1200 FAIRMONT CT   FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1629843933,OPTUM BEHAVIORAL CARE OF NORTH CARO,CAROLINA BEHAVIORAL CARE CENTERS,1101 MARCO DR STE 200 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1588437065,"BALOYO, JOEMEL JAY, MEDIAVILLA",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588448401,"BLACKLEY, ANNA, CHRISTINE",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588449888,"MOORE, PARKER, DAVIS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588449888,"MOORE, PARKER, DAVIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588449888,"MOORE, PARKER, DAVIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588449888,"MOORE, PARKER, DAVIS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588449888,"MOORE, PARKER, DAVIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588449888,"MOORE, PARKER, DAVIS",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588449888,"MOORE, PARKER, DAVIS",3009 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588472039,"MONTERO, ADRIENNE, CAROLINE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588484414,POLITE TOUCH HOME CARE,,5736 N TRYON ST STE 219A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1588484414,POLITE TOUCH HOME CARE,5736 N TRYON ST STE 219A CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 258 , 258 ," $17,182.68 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588485395,"MINOR, MASON, MCCLELLAND",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588485395,"MINOR, MASON, MCCLELLAND",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588487789,DIVINE HOME CARE AGENCY LLC,DIVINE HOME CARE AGENCY & SERVICES,4244 CUMBERLAND ROAD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1588487789,DIVINE HOME CARE AGENCY LLC,4244 CUMBERLAND ROAD   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 105 , 105 ,$#,,
MEDICAID DIRECT,1588492854,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH POLK CAP SERVICES,46 HOSPITAL DR STE 1B COLUMBUS NC,075,Polk,251B00000X,Agencies,Case Management,,1588492854,FLETCHER HOSPITAL INCORPORATED,46 HOSPITAL DR STE 1B COLUMBUS NC,075,Polk,251B00000X,Agencies,Case Management,, 52 , 378 , 378 ," $142,317.50 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588600381,"PARTIN, TRACY, LOWRY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 26 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588600381,"PARTIN, TRACY, LOWRY",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,,,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588603005,"BRIGGS, DANIEL, ROSS",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 34 , 35 , 43 ,$#,,
MEDICAID DIRECT,1740626605,CAROLINA BREAST IMAGING SPECIALISTS,~,990 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588603393,"HASS, MARK, JOSEPH",990 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 135 , 143 , 285 ," $10,145.85 ",,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588603658,"FINK, CHRISTOPHER, DANIEL",3004 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 48 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588603930,"TURRENTINE, ENNIS, EMELINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588604201,"VEDDER, CHARLES, TODD",7800 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588604201,"VEDDER, CHARLES, TODD",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1740225929,DUKE UNIVERSITY AFFILIATED PHYSICIA,,2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588605075,"BURK, CAROL, DANKO",2609 N DUKE ST STE 1000 DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 23 , 56 ,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588606537,"HUTCHINS, CYNTHIA, MARIE",2000 BROOKSIDE DR   KINGSPORT TN,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588606552,"DIAL, DEKARLOS, MEGAIL",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 191 , 305 , 431 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588606552,"DIAL, DEKARLOS, MEGAIL",601 N ELM ST   HIGH POINT NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1588606826,"SZTYBER, GERARD",68 HOSPITAL RD   SYLVA NC,050,Jackson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1588606826,"SZTYBER, GERARD",68 HOSPITAL RD   SYLVA NC,050,Jackson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669808143,SYLVA EMERGENCY GROUP LLC,,68 HOSPITAL RD   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1588606826,"SZTYBER, GERARD",68 HOSPITAL RD   SYLVA NC,050,Jackson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 136 , 145 , 160 ," $11,671.91 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588606982,"BOZOKI, ANDREA, CATHRYN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 19 , 26 , 49 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588607634,"LANGSTON, TIFFANY, BUCK",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588607634,"LANGSTON, TIFFANY, BUCK",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 61 , 97 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1588610083,"HAAS, STEPHAN, O",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 19 ,$#,,
MEDICAID DIRECT,1144080227,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-DIAGNOSTIC RADIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588610083,"HAAS, STEPHAN, O",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 18 , 21 , 32 ,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588610323,"DAVIS, TIMOTHY, BILLOCK",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 19 ,$#,,
MEDICAID DIRECT,1518493022,PRESBYTERIAN SAMEDAY SURGERY CENTER,NOVANT HEALTH HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588610323,"DAVIS, TIMOTHY, BILLOCK",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1588610711,"WALTERS, THEINKIM, NGUYEN",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 182 , 219 ,$#,,
MEDICAID DIRECT,1366588212,PRIVATE DIAGNOSTIC CLINIC PLLC,GENERAL INTERNAL MEDICINE,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588611123,"BOWLBY, LYNN, ANNE",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588611818,"DOYLE, CHARLENE, ANASTACIA",1501 W ELK AVE   ELIZABETHTON TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588612006,"BOBB, MICHAEL, DEAN",1010 COLLEGE ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588612691,"OWENS, CLAIRE, RENEE",2402 CAMDEN ST SW STE 300 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 79 , 79 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588612691,"OWENS, CLAIRE, RENEE",2402 CAMDEN ST SW STE 300 WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 87 , 122 , 122 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588612766,"WILMOTH, JENNIFER, ELAINE",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 34 , 40 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588612766,"WILMOTH, JENNIFER, ELAINE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588612766,"WILMOTH, JENNIFER, ELAINE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1588613285,"PEGHER, MATTHEW, DAVID",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588613285,"PEGHER, MATTHEW, DAVID",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1588613285,"PEGHER, MATTHEW, DAVID",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 41 , 42 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,3680 ROBINWOOD RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588615124,"ODELL, KEVIN, BRUCE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 25 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588615124,"ODELL, KEVIN, BRUCE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 25 , 52 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588615124,"ODELL, KEVIN, BRUCE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 51 , 89 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,419 EARL RD   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1588615124,"ODELL, KEVIN, BRUCE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588615124,"ODELL, KEVIN, BRUCE",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 51 , 53 , 74 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,3680 ROBINWOOD RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588615124,"ODELL, KEVIN, BRUCE",1805 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588615538,"DURBIN, MICHAEL, BRIAN",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588615538,"DURBIN, MICHAEL, BRIAN",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588615538,"DURBIN, MICHAEL, BRIAN",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588615538,"DURBIN, MICHAEL, BRIAN",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588615538,"DURBIN, MICHAEL, BRIAN",17078 NAT BYNUM LN UNIT 3 CORNELIUS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 26 , 36 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588616338,"MINER, BRENDAN",18 13TH AVE NE   HICKORY NC,018,Catawba,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1588618029,"MICHAU, KENNETH, JOE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588618029,"MICHAU, KENNETH, JOE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 58 , 64 , 95 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588618029,"MICHAU, KENNETH, JOE",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1790736973,RALEIGH EMERGENCY MEDICINE ASSOCIAT,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1588618029,"MICHAU, KENNETH, JOE",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588618300,"WILE, GEOFFREY",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588618300,"WILE, GEOFFREY",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588618300,"WILE, GEOFFREY",301 E WENDOVER AVE STE 100 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588618300,"WILE, GEOFFREY",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588618300,"WILE, GEOFFREY",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3700 NW CARY PKWY STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588618573,"BLOOM, O JOSH",3700 NW CARY PKWY STE 110 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,,,Unknown,193200000X,Group,Multi-Specialty,,1588618656,"LAMIELLE, CINDY, OLDSON",313 MAIN ST   BAYBORO NC,069,Pamlico,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,306 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1588618656,"LAMIELLE, CINDY, OLDSON",313 MAIN ST   BAYBORO NC,069,Pamlico,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 30 , 58 ,$#,,
MEDICAID DIRECT,1942242599,CARTERET SURGICAL ASSOCIATES PA,CAROLINAS CENTER FOR SURGERY,4370 ARENDELL ST STE A MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1588618656,"LAMIELLE, CINDY, OLDSON",313 MAIN ST   BAYBORO NC,069,Pamlico,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1588618656,"LAMIELLE, CINDY, OLDSON",313 MAIN ST   BAYBORO NC,069,Pamlico,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588620066,"DOHMEIER, CARMEN",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 51 , 76 , 85 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588620132,"POFF, PATRICIA, PERDUE",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588620504,"PAZ, JOSE, ERNESTO",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 38 , 109 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588620504,"PAZ, JOSE, ERNESTO",2630 WILLARD DAIRY RD STE 200 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1275788416,GROVE PARK PEDIATRICS,,113 TRAIL ONE   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1588621544,"GOLDAR, MARGARITA, MARIA",113 TRAIL ONE   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 65 , 118 , 244 ," $11,006.29 ",,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588623367,"MOORE, JENNIFER, MARIE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588623367,"MOORE, JENNIFER, MARIE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588623920,"COURT, CHARLES, JOSEPH",1135 CARTHAGE ST   SANFORD NC,053,Lee,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1841015245,RADIOLOGY ASSOCIATES OF NORTH CAROL,,364 WHITE OAK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1588624993,"RAO, PATRICK, MICHAEL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1588626519,COUNTY OF HARNETT,~,1005 EDWARDS BROTHERS DR   LILLINGTON NC,043,Harnett,3416L0300X,Transportation Services,Ambulance,Land Transport,1588626519,COUNTY OF HARNETT,1005 EDWARDS BROTHERS DR   LILLINGTON NC,043,Harnett,3416L0300X,Transportation Services,Ambulance,Land Transport," 1,141 "," 2,428 "," 4,451 "," $103,643.06 ",,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588626741,"MYLES, HERBERT, LOUIS",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588626741,"MYLES, HERBERT, LOUIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 52 , 53 , 73 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588626741,"MYLES, HERBERT, LOUIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1588626741,"MYLES, HERBERT, LOUIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1588626741,"MYLES, HERBERT, LOUIS",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588626741,"MYLES, HERBERT, LOUIS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 28 , 35 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1588626741,"MYLES, HERBERT, LOUIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588626741,"MYLES, HERBERT, LOUIS",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588626741,"MYLES, HERBERT, LOUIS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588626915,"HARRELSON, AMY, ELIZABETH",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 24 ,$#,,
MEDICAID DIRECT,1588627053,"SESSIONS, WILLIE, JAMES",WILLIE JAMES SESSIONS MD,568 RUIN CREEK RD STE 122 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1588627053,"SESSIONS, WILLIE, JAMES",568 RUIN CREEK RD STE 122 HENDERSON NC,091,Vance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 87 , 187 , 298 ,$#,,
MEDICAID DIRECT,1730583600,THE BONE AND JOINT SURGERY CLINIC,,3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588627582,"BURROUGHS, PAUL, LEACH",3801 WAKE FOREST RD STE 220 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 16 ,$#,,
MEDICAID DIRECT,1538147087,CHAPEL HILL OPHTHALMOLOGY CLINIC PA,CHAPEL HILL OPHTHALMOLOGY CLINIC PA,110 CONNER DR STE 2 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1588627996,"HAAS, DAVID, ROBERT",110 CONNER DR STE 2 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1538147087,CHAPEL HILL OPHTHALMOLOGY CLINIC PA,CHAPEL HILL OPHTHALMOLOGY CLINIC PA,110 CONNER DR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588627996,"HAAS, DAVID, ROBERT",110 CONNER DR STE 2 CHAPEL HILL NC,068,Orange,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588628549,"JOHN, JAMES, WILLIAM",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 129 , 414 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588628549,"JOHN, JAMES, WILLIAM",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1730343922,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST OBSTETRICS AND G,136 S PARK ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1588631881,"RICHARDSON, CRIS, RAY",136 S PARK ST   ASHEBORO NC,076,Randolph,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 25 , 32 , 41 ,$#,,
MEDICAID DIRECT,1144624446,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1588632418,"COFFEY, RANDOLPH, ALAN",179 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,1223G0001X,Dental Providers,Dentist,General Practice, 184 , 316 , 784 ," $42,926.21 ",,
MEDICAID DIRECT,1417180209,DR LAURIE ARCOLANO OD AND DR WILLIA,VILLAGE EYE CARE,3526 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588634109,"VAUGHAN JR, WILLIAM, HENDRIX",3526 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1588636195,"MANNAVA, VENKATA, SIVA NAGA PRASAD",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 122 , 122 ,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1588636195,"MANNAVA, VENKATA, SIVA NAGA PRASAD",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 37 , 37 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1588636195,"MANNAVA, VENKATA, SIVA NAGA PRASAD",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 87 , 87 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588636195,"MANNAVA, VENKATA, SIVA NAGA PRASAD",106 JEFFERSON ST   HAMLET NC,077,Richmond,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1588636294,"SCHWARTZ, GARRY, HOWARD",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588636294,"SCHWARTZ, GARRY, HOWARD",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1588636294,"SCHWARTZ, GARRY, HOWARD",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1679542971,GREENVILLE PEDIATRIC SERVICES,GREENVILLE PEDIATRIC SERVICES,300 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588636518,"COKER, REBECCA, SUE",300 BETHESDA DR   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588638621,"KAZMI, NARJIS, SEYYED",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 92 , 225 , 227 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588638621,"KAZMI, NARJIS, SEYYED",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1588638621,"KAZMI, NARJIS, SEYYED",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518532126,MOUNTCASTLE MEDICAL & MED SPA PLLC,,701 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588638951,"TEMBLADOR, RICHARD, WILLIAM",701 S MAIN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 337 , 525 ,$#,,
MEDICAID DIRECT,1659362911,CLAY COMPREHENSIVE HEALTH SERVICES,CHATUGE FAMILY PRACTICE,241 CHURCH ST   HAYESVILLE NC,022,Clay,193400000X,Group,Single Specialty,,1588639496,"ROBY, JUSTIN, DAVID",241 CHURCH ST   HAYESVILLE NC,022,Clay,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 34 , 43 ,$#,,
MEDICAID DIRECT,1659362911,CLAY COMPREHENSIVE HEALTH SERVICES,CHATUGE FAMILY PRACTICE,241 CHURCH ST   HAYESVILLE NC,022,Clay,193200000X,Group,Multi-Specialty,,1588639496,"ROBY, JUSTIN, DAVID",241 CHURCH ST   HAYESVILLE NC,022,Clay,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 29 , 42 ,$#,,
MEDICAID DIRECT,1588020770,MURPHY MEDICAL CENTER INC,ERLANGER WESTERN CAROLINA HOSPITAL,3990 E US 64 ALT   MURPHY NC,020,Cherokee,251B00000X,Agencies,Case Management,,1588639496,"ROBY, JUSTIN, DAVID",241 CHURCH ST   HAYESVILLE NC,022,Clay,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588639801,"RENIVA, FAUSTINO, ANDRADA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588640643,"CHANDLER, ARCHIE, HORTENSE",Archie Hortense Chandler III,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1588640643,"CHANDLER, ARCHIE, HORTENSE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588640643,"CHANDLER, ARCHIE, HORTENSE",Archie Hortense Chandler III,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1588640643,"CHANDLER, ARCHIE, HORTENSE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588644157,"ALLIGOOD, GILBERT, RAY",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 25 , 30 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY STE B MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1588644157,"ALLIGOOD, GILBERT, RAY",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 117 , 164 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,193200000X,Group,Multi-Specialty,,1588644157,"ALLIGOOD, GILBERT, RAY",7540 MIDDLESEX CORPORATE PKWY   MIDDLESEX NC,064,Nash,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588644587,"BAUER, GREGORY, SCOTT",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 40 , 72 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588644587,"BAUER, GREGORY, SCOTT",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 74 , 147 , 288 ,$#,,
MEDICAID DIRECT,1992989669,KAREN J ARMSTRONG DMD & BETHANY K T,KAREN J ARMSTRONG DMD & BETHANY K TANT DDS PLLC,3160 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1588644611,"TANT, BETHANY, KRAMLICH",3160 HENDERSON DR   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 142 , 203 , 774 ," $22,647.18 ",,
MEDICAID DIRECT,1649406760,CLETUS HELMS SIMPSON DDS PA,BUNN FAMILY DENTISTRY,565 MAIN ST   BUNN NC,035,Franklin,193400000X,Group,Single Specialty,,1588645006,"SIMPSON, CLETUS, HELMS",565 MAIN ST   BUNN NC,035,Franklin,1223G0001X,Dental Providers,Dentist,General Practice," 1,138 "," 2,603 "," 11,718 "," $605,775.72 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588645675,"LAFAVE, MARK, STEVEN",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,, 34 , 51 , 91 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2607 MEDICAL OFFICE PL STE A GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588645675,"LAFAVE, MARK, STEVEN",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1112 GRACIE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588645675,"LAFAVE, MARK, STEVEN",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,, 114 , 183 , 361 ,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588645758,"BACCHI-SMITH, DONNA, RAE",25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 61 , 64 , 123 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588647028,"MESSIER, MATTHEW, ROLAND",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588647028,"MESSIER, MATTHEW, ROLAND",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 33 , 75 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588647051,"BARR, ROBERT, MARLOWE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588647051,"BARR, ROBERT, MARLOWE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 356 , 371 , 453 ,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588647051,"BARR, ROBERT, MARLOWE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 18 ,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588647051,"BARR, ROBERT, MARLOWE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1588647051,"BARR, ROBERT, MARLOWE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588647051,"BARR, ROBERT, MARLOWE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588647051,"BARR, ROBERT, MARLOWE",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780651695,HOT SPRINGS HEALTH PROGRAM,MARS HILL MEDICAL CENTER,119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588647390,"PENCE, BILLY, JACK",119 MOUNTAIN VIEW RD   MARS HILL NC,057,Madison,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 136 , 223 , 253 ," $11,066.53 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588649610,"RIRIE, DOUGLAS, GORDON",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 61 , 62 , 63 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 486 , 722 ," 1,674 "," $83,323.69 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice, 109 , 158 , 352 ," $23,028.99 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245441864,"BARNARD, JULIA, ANNE",,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,1588650097,"DE JESUS BENITEZ, JOSE, RAMON",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 42 , 44 , 104 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588650097,"DE JESUS BENITEZ, JOSE, RAMON",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice, 229 , 359 , 839 ," $36,150.14 ",,
MEDICAID DIRECT,1548221856,CHAPEL HILL PEDIATRICS,CHAPEL HILL PEDIATRICS,205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588650378,"MERRITT, KATHY, ANN",205 SAGE RD STE 100 CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 39 , 74 ,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,159 E DALLAS RD   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1588650394,"BRADSHAW, JOHN, MARTIN",159 E DALLAS RD   STANLEY NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 40 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588651293,"HAWKINS, CLAUDE, ANTHONY",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 34 , 68 , 113 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 69 , 144 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 15 , 17 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 28 , 92 , 176 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588652267,"DESAI, SUNIL, JAYANT",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,145 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 18 , 28 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588652267,"DESAI, SUNIL, JAYANT",145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,145 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,1 MEDICAL DR   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",1 MEDICAL DR   BENSON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 29 , 60 , 103 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 90 , 137 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 33 , 52 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588652283,"DESAI, PRATIK, VIPIN",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 19 , 21 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1588652283,"DESAI, PRATIK, VIPIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 25 , 33 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588652283,"DESAI, PRATIK, VIPIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1588652366,"SPENCER, HONNIE, PATRICIA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588653521,"BAYARD, MAX, MCMURRAY",~,917 W WALNUT ST   JOHNSON CITY TN,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1588653521,"BAYARD, MAX, MCMURRAY",917 W WALNUT ST   JOHNSON CITY TN,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366984403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-JOHN SMITH,2356 JOHN SMITH RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588654529,"HEINE, JAMES, WALTER",2356 JOHN SMITH RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548704042,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588654529,"HEINE, JAMES, WALTER",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1629886189,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CFV PRIMARY CARE-FAYETTEVILLE FAMILY,1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588654529,"HEINE, JAMES, WALTER",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1366984403,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PRIMARY CARE-JOHN SMITH,2356 JOHN SMITH RD STE 101 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588654529,"HEINE, JAMES, WALTER",1307 AVON ST   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558351726,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF THE PIEDMONT,1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588654750,"NASTASI, KENT, JOSEPH",1372 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 97 , 306 , 405 ," $11,361.82 ",,
MEDICAID DIRECT,1215022926,B & D INTEGRATED HEALTH SERVICES,~,249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588655666,"SMITH, PAMELA",300 ASHVILLE AVE STE 200 CARY NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295196780,LLD LABORATORIES LLC,,249 E NC HIGHWAY 54 STE 310 DURHAM NC,032,Durham,291U00000X,Laboratories,Clinical Medical Laboratory,,1588655666,"SMITH, PAMELA",300 ASHVILLE AVE STE 200 CARY NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1215022926,B & D INTEGRATED HEALTH SERVICES,~,249 E NC HIGHWAY 54 STE 320 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588655666,"SMITH, PAMELA",350 E HOLDING AVE   WAKE FOREST NC,092,Wake,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588656342,"HERRING, BROCKFORD, DAMON",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588656342,"HERRING, BROCKFORD, DAMON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629439963,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS-POPLAR TENT,5651 POPLAR TENT RD STE 200 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588656342,"HERRING, BROCKFORD, DAMON",5651 POPLAR TENT RD   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 18 , 38 ,$#,,
MEDICAID DIRECT,1629432281,THE CHARLOTTE-MECKLENBURG HOSPITAL,PIEDMONT ORTHOPEDIC SPECIALISTS,1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588656342,"HERRING, BROCKFORD, DAMON",1090 NE GATEWAY CT NE STE 204 CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 81 , 121 , 246 ,$#,,
MEDICAID DIRECT,1053406298,GASTROENTEROLOGY EAST PA,GASTROENTEROLOGY EAST PA,2210 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588656821,"KRAGEL, PETER, JUDE",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 14 , 15 , 17 ,$#,,
MEDICAID DIRECT,1679535496,ONSLOW MEMORIAL HOSPITAL,~,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1588656821,"KRAGEL, PETER, JUDE",2693 FOREST HILLS RD SW STE B WILSON NC,098,Wilson,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588657258,"ELLERTSON, DAVID, GARTH",2525 COURT DR   GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1588657258,"ELLERTSON, DAVID, GARTH",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 44 , 58 , 69 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588658025,"WIEGMAN, PETER, JOSEPH",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 25 , 64 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588658025,"WIEGMAN, PETER, JOSEPH",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588658025,"WIEGMAN, PETER, JOSEPH",1515 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 48 , 56 , 99 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588658025,"WIEGMAN, PETER, JOSEPH",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 28 , 33 , 77 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1588658025,"WIEGMAN, PETER, JOSEPH",1515 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588658025,"WIEGMAN, PETER, JOSEPH",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588659601,"FRAITES, TEGRAN, OSAFU",3053B FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588659601,"FRAITES, TEGRAN, OSAFU",12 N BROAD ST E   ANGIER NC,043,Harnett,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1285803197,RAFAEL RIVERA JR DDS PLLC,SMILE STARTERS,1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588659601,"FRAITES, TEGRAN, OSAFU",1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 66 , 40 , 183 ,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588659601,"FRAITES, TEGRAN, OSAFU",1400 WALTER REED RD STE 200 FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1700055613,RAFAEL RIVERA JR DDS PLLC,,3212 S WILMINGTON ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588659601,"FRAITES, TEGRAN, OSAFU",3212 S WILMINGTON ST   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 6,133 "," 8,433 "," 35,421 "," $1,059,685.17 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588660625,"DANNER, CHRISTOPHER, JOHN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588660625,"DANNER, CHRISTOPHER, JOHN",1918 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 33 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588660625,"DANNER, CHRISTOPHER, JOHN",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588660625,"DANNER, CHRISTOPHER, JOHN",10905 PROVIDENCE RD W STE 260 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 29 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588660625,"DANNER, CHRISTOPHER, JOHN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588660989,"GUICE, STEPHEN, LEE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 107 , 171 , 293 ,$#,,
MEDICAID DIRECT,1639244478,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BRHC RADIOLOGY PRACTICE,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1588661763,"CHARRON, AMY, RUBEIS",2201 S STERLING ST   MORGANTON NC,012,Burke,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588662498,"MACDONALD, ANN",300 W 27TH ST   LUMBERTON NC,078,Robeson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154370104,SOUTHERN SURGICAL ASSOCIATES PA,~,2455 EMERALD PL   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588662514,"CHAPMAN, WILLIAM, H. HARRISON",2455 EMERALD PL   GREENVILLE NC,074,Pitt,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 85 , 191 , 200 ,$#,,
MEDICAID DIRECT,1003863580,ASSOCIATED PATHOLOGISTS LLC,PATHGROUP,5301 VIRGINIA WAY   BRENTWOOD TN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1588663447,"PULKINGHAM, NATHAN, CARR",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1750682431,QUEEN CITY GASTROENTEROLOGY HEPAT,~,320 LILLINGTON AVE STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588663447,"PULKINGHAM, NATHAN, CARR",320 LILLINGTON AVE STE 101 CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,300 MEDICAL PKWY STE 212   CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588663751,"SNIDER, GILBERT, MARTIN",300 MEDICAL PKWY STE 212 CHESAPEAKE VA,101,Out of State <= 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,930 3RD ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588665525,"SHANKAR, RAVI",930 3RD ST STE 200 GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 47 , 63 , 98 ,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1588665525,"SHANKAR, RAVI",930 3RD ST STE 200 GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,930 3RD ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588665525,"SHANKAR, RAVI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 16 , 16 , 18 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588665756,"PATEL, ANILKUMAR, R",612 KINGSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588665756,"PATEL, ANILKUMAR, R",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588665863,"ADAMS, WENJING, HUANG",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588665863,"ADAMS, WENJING, HUANG",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588665863,"ADAMS, WENJING, HUANG",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588665863,"ADAMS, WENJING, HUANG",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588665863,"ADAMS, WENJING, HUANG",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588666705,"HOWARD, KEVIN, PRICE",371 NC HIGHWAY 65   WENTWORTH NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 19 , 45 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588666705,"HOWARD, KEVIN, PRICE",371 NC HIGHWAY 65   WENTWORTH NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 14 , 25 ,$#,,
MEDICAID DIRECT,1306947445,ROCKINGHAM COUNTY FINANCE OFFICE,ROCKINGHAM COUNTY PUBLIC HEALTH,371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588666705,"HOWARD, KEVIN, PRICE",371 NC HIGHWAY 65 STE 204 REIDSVILLE NC,079,Rockingham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 16 , 35 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588666929,"JOLLY, RAYMOND, JOSEPH",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 77 , 151 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588666929,"JOLLY, RAYMOND, JOSEPH",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 20 , 38 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588666929,"JOLLY, RAYMOND, JOSEPH",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588671440,"BOWER JR, JAMES, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588671440,"BOWER JR, JAMES, CHARLES",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588671440,"BOWER JR, JAMES, CHARLES",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588672315,"PATTON, LAUREN, LESLIE",101 MANNING DR 101 MANNING DRIVE CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 35 , 35 , 311 ," $19,076.19 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588672315,"PATTON, LAUREN, LESLIE",101 MANNING DR 101 MANNING DRIVE CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588672315,"PATTON, LAUREN, LESLIE",DENTAL FACULTY PRACTICE 143 BRAUER HALL CB 7450 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 65 , 65 ," 1,043 "," $75,992.31 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588672315,"PATTON, LAUREN, LESLIE",101 MANNING DR 101 MANNING DRIVE CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588672315,"PATTON, LAUREN, LESLIE",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 225 , 241 , 392 ," $16,807.20 ",,
MEDICAID DIRECT,1427138676,UNIVERSITY OF NORTH CAROLINA AT CHA,CRANIOFACIAL CENTER,140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588672315,"PATTON, LAUREN, LESLIE",140 DENTAL CIR STE 2 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1588673396,K AND K HOME HEALTH CARE,K and K Home Health Care,,,Unknown,253Z00000X,Agencies,In Home Supportive Care,,1588673396,K AND K HOME HEALTH CARE,505 OLD HWY RD   GARYSBURG NC,066,Northampton,253Z00000X,Agencies,In Home Supportive Care,,#,,,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588675409,"LIPINSKI, THEODORE",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1902963937,WHITEVILLE MEDICAL ASSOCIATES PA,WHITEVILLE MEDICAL ASSOCIATES PA,823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1588677736,"TRAYLOR, HENRY, WILLIAM",823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 93 , 204 , 825 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1588677736,"TRAYLOR, HENRY, WILLIAM",823 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588677975,"STOWE, ROBERT",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 752 ," 1,612 "," 4,318 "," $242,554.73 ",,
MEDICAID DIRECT,1407969264,STOWE STEINBICKER TAYLOR & ALBERTSO,~,1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588677975,"STOWE, ROBERT",1410 PLAZA WEST RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 82 , 113 , 239 ," $26,378.60 ",,
MEDICAID DIRECT,1982700258,NEPHROLOGY AND HYPERTENSION,NEPHROLOGY AND HYPERTENSION CONSULTANTS PA,8401 UNIVERSITY EXEC PARK DR STE 123 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588679211,"MUNDRA, SHALINI",8401 UNIVERSITY EXEC PARK DR STE 123 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 140 , 785 , 844 ," $24,173.84 ",,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1588682355,"POWELL, MARCY, STEPHENS",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588682611,"BUCHANAN, APRIL, ODOM",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588683825,"GORMAN, GREGORY, HARRON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 25 , 27 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",201 E GROVER ST   SHELBY NC,023,Cleveland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",1237 HARDING PL STE 1300 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1558702191,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH SLEEP MEDICINE,1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",1601 ABBEY PL STE 200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1237 HARDING PL # 3200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",1237 HARDING PL STE 3200 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 24 , 24 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588684690,"REIF, MICHAEL, STEVEN",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 23 , 26 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588684856,"MARTIN, TAMI, SHELL",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588684856,"MARTIN, TAMI, SHELL",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 45 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588684856,"MARTIN, TAMI, SHELL",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 77 , 120 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588684856,"MARTIN, TAMI, SHELL",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 38 , 61 ,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588685937,"WILKINSON, JOSEPH, MICHAEL",110 BARCELONA DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1235886870,ABOVE AND BEYOND WELLNESS MEDSPA,,505 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1588685937,"WILKINSON, JOSEPH, MICHAEL",505 W BROAD ST ELIZABETHTOWN NC 28337 ELIZABETHTOWN NC,009,Bladen,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588685937,"WILKINSON, JOSEPH, MICHAEL",131 FOY DR   ROCKY MOUNT NC,064,Nash,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588685937,"WILKINSON, JOSEPH, MICHAEL",110 LONG CIR   ROANOKE RAPIDS NC,042,Halifax,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588685937,"WILKINSON, JOSEPH, MICHAEL",3516 US HIGHWAY 301 S   SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588685937,"WILKINSON, JOSEPH, MICHAEL",1806 GLENDALE DR SW   WILSON NC,098,Wilson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 50 , 57 , 76 ,$#,,
MEDICAID DIRECT,1104847714,POLLEY CLINIC OF DERMATOLOGY AND DE,POLLEY CLINIC OF DERMATOLOGY AND DERMATOLOGIC SURG,1806 GLENDALE DR SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1588685937,"WILKINSON, JOSEPH, MICHAEL",1100 E ASH ST   GOLDSBORO NC,096,Wayne,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 23 , 27 ,$#,,
MEDICAID DIRECT,1588686646,STOKES COUNTY SCHOOLS,Stokes County Schools,100 COURTHOUSE CIR   DANBURY NC,085,Stokes,251300000X,Agencies,Local Education Agency (LEA),,1588686646,STOKES COUNTY SCHOOLS,100 COURTHOUSE CIR   DANBURY NC,085,Stokes,251300000X,Agencies,Local Education Agency (LEA),, 386 ," 11,151 "," 11,637 "," $408,694.50 ",,
MEDICAID DIRECT,1245419845,CAROMONT MEDICAL GROUP INC,~,700 N MAIN ST   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1588687982,"RODGERS-MORALES, PATRICE, DALE",700 N MAIN ST   STANLEY NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 77 , 260 , 428 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588688642,"BECKER, ANN, YOUNG",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588688642,"BECKER, ANN, YOUNG",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588688642,"BECKER, ANN, YOUNG",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 19 , 26 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588688642,"BECKER, ANN, YOUNG",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 16 , 20 , 39 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588688642,"BECKER, ANN, YOUNG",6905 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,, 12 , 15 , 19 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588688642,"BECKER, ANN, YOUNG",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1588688782,"SHAH, SHREE, JAYENDRA",2231 ORIOLE DR   SARASOTA FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588688782,"SHAH, SHREE, JAYENDRA",2231 ORIOLE DR   SARASOTA FL,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588690499,"FORTUNER, WILLIAM",1816 FRONT ST STE 320 DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 70 , 77 , 82 ,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588690655,"TRAIL, MELANIE, GAYE",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 16 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588692255,"NIELSEN, PATRICIA, DE YOUNG",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588692255,"NIELSEN, PATRICIA, DE YOUNG",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 17 , 25 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588693857,"ADIMOOLAM, VIJAY, VENKATA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588694608,"PARIYADATH, MANOJ",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 38 , 39 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1588695381,"HUNTER, PAULA, DIANE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 28 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1588695381,"HUNTER, PAULA, DIANE",15 SKYLAND INN DR   ARDEN NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 30 ,$#,,
MEDICAID DIRECT,1588696322,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,1105 E DIXON BLVD STE 3 SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,,1588696322,BAYADA HOME HEALTH CARE INC,1105 E DIXON BLVD STE 3 SHELBY NC,023,Cleveland,253Z00000X,Agencies,In Home Supportive Care,, 59 ," 10,767 "," 10,932 "," $1,262,202.82 ",,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588697007,"PLEASANT, MICHELLE",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 79 , 80 , 82 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588697304,"FLEMING, STEPHEN, GODWIN",1917 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 99 , 168 , 241 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1588698567,"ROBINSON, WANDA, SPOLNICKI",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588698724,"MATKINS, JERRY, FRANKLIN",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 30 , 40 , 56 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588698724,"MATKINS, JERRY, FRANKLIN",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588698724,"MATKINS, JERRY, FRANKLIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588699573,"BRITT, JAMES, WOODROW",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 54 , 116 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588700165,"KOVACH, JAMES, ALBERT",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 63 , 132 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,1803 FOREST HILLS RD W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1588700165,"KOVACH, JAMES, ALBERT",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 137 , 239 , 529 ,$#,,
MEDICAID DIRECT,1821112665,CAROLINAS REHABILITATION,~,1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588705248,"MATUSEWICZ, MARLENA, NICOLE",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1588705305,SURE CARE HEALTH SERVICES INC,~,3804 GOVERNORS RD   KELFORD NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,,1588705305,SURE CARE HEALTH SERVICES INC,3804 GOVERNORS RD   KELFORD NC,008,Bertie,253Z00000X,Agencies,In Home Supportive Care,, 14 ," 2,371 "," 2,371 "," $144,335.20 ",,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588705909,"CAIN, KYRON, LAFAYETTE",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,3600 MINNESOTA DR STE 800 EDINA MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1588710487,"RECKSON, MARK, WESLEY",585 KANEAPU PL   KAILUA HI,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1588710487,"RECKSON, MARK, WESLEY",585 KANEAPU PL   KAILUA HI,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 13 , 19 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588710669,"HINCHMAN, BRIAN, KEITH",2400 PRATT ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588711303,"LAMBETH, JOHN, PHILLIP",500 PINEVIEW DR STE 101 KERNERSVILLE NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 71 , 133 , 234 ,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588711303,"LAMBETH, JOHN, PHILLIP",755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588711386,"ADLER, DAVID, HENRY",1101 FIRST COLONIAL RD STE 300 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588711386,"ADLER, DAVID, HENRY",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588711386,"ADLER, DAVID, HENRY",612 KINGSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588711501,"MARACIC, LINDY, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588711717,"FAIRCLOTH, RON, CHRISTOPHER",1991 FORDHAM DR   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 101 , 114 , 177 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588711717,"FAIRCLOTH, RON, CHRISTOPHER",404 S MAIN ST   RAEFORD NC,047,Hoke,152W00000X,Eye and Vision Services Providers,Optometrist,, 157 , 183 , 247 ," $10,632.68 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588711717,"FAIRCLOTH, RON, CHRISTOPHER",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 67 , 83 , 160 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588711717,"FAIRCLOTH, RON, CHRISTOPHER",2905 N ELM ST   LUMBERTON NC,078,Robeson,152W00000X,Eye and Vision Services Providers,Optometrist,, 85 , 102 , 170 ,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588713507,"MEREDITH, MICHAEL, WILLIAM",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 58 , 85 ,$#,,
MEDICAID DIRECT,1588714232,CAROLINA PERSONAL CARE AGENCY,~,916 SOUTHEAST BLVD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,,1588714232,CAROLINA PERSONAL CARE AGENCY,916 SOUTHEAST BLVD   CLINTON NC,082,Sampson,253Z00000X,Agencies,In Home Supportive Care,, 11 ," 2,878 "," 2,878 "," $190,118.04 ",,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1588714786,"PLAYER, KIRSTEN, SCHUPPENHAUER",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 25 , 26 , 26 ,$#,,
MEDICAID DIRECT,1346302783,CHARLES A CANNON JR MEMORIAL HOSPIT,~,434 HOSPITAL DR   LINVILLE NC,006,Avery,193400000X,Group,Single Specialty,,1588714786,"PLAYER, KIRSTEN, SCHUPPENHAUER",434 HOSPITAL DRIVE   LINVILLE NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1588716914,"GREENFIELD, DWYNN, NOEL",233 DOCTORS ST   SPARTA NC,003,Alleghany,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 63 , 182 , 203 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588717227,"THIRUNAVUKARASU, PRAGATHEESHWAR",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 56 , 110 , 132 ,$#,,
MEDICAID DIRECT,1366957615,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV GENERAL SURGERY-VILLAGE SURGICAL,1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588717227,"THIRUNAVUKARASU, PRAGATHEESHWAR",1841 QUIET CV   FAYETTEVILLE NC,026,Cumberland,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1588720072,SOUTHEASTERN GASTROENTEROLOGY ENDOS,SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER PA,101 W 27TH ST   LUMBERTON NC,078,Robeson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1588720072,SOUTHEASTERN GASTROENTEROLOGY ENDOS,101 W 27TH ST   LUMBERTON NC,078,Robeson,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 22 , 24 , 27 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588721484,"BAILEY, VALERIE, SHARPE",327 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 ,#,#,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588721484,"BAILEY, VALERIE, SHARPE",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 170 , 243 , 640 ," $26,503.78 ",,
MEDICAID DIRECT,1588722458,HOME LIFE CARE INC,~,514 E BOULEVARD   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,,1588722458,HOME LIFE CARE INC,514 E BOULEVARD   WILLIAMSTON NC,058,Martin,253Z00000X,Agencies,In Home Supportive Care,, 108 ," 26,218 "," 26,485 "," $2,576,811.96 ",,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588722730,"GARDNER, WILLIAM, GRANT",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 134 , 164 , 313 ,$#,,
MEDICAID DIRECT,1588723514,VITAL HOMECARE OF NORTH CAROLINA IN,VITAL HOMECARE F-K-A HOME CAREFREE,900 HENDERSONVILLE RD STE 204A ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,,1588723514,VITAL HOMECARE OF NORTH CAROLINA IN,900 HENDERSONVILLE RD STE 204A ASHEVILLE NC,011,Buncombe,253Z00000X,Agencies,In Home Supportive Care,, 61 ," 4,860 "," 4,860 "," $639,472.24 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588724769,"SPAID, KELLY, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588724769,"SPAID, KELLY, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588727358,"COTTEN, CHARLES, MICHAEL",3643 N ROXBORO ST   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588727358,"COTTEN, CHARLES, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 15 , 65 , 66 ," $13,429.84 ",,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588728380,"WHITE, JENNIFER, WILSON",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588728380,"WHITE, JENNIFER, WILSON",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1588731335,"GRIFFIN, CHRISTOPHER, PARKS",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588731335,"GRIFFIN, CHRISTOPHER, PARKS",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 162 , 200 , 458 ," $21,639.95 ",,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588731335,"GRIFFIN, CHRISTOPHER, PARKS",104 COMMERCIAL DR   PRINCETON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 ,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1588731574,"ENGLE, CHRISTY, SEAY",6048 W HIGHWAY 74   INDIAN TRAIL NC,090,Union,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1669443487,CLECO PRIMARY CARE NETWORK,CLECO MEDICAL CENTER OF SHELBY,,,Unknown,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1588732275,"BROCK, ANNE, LUCY",808 SCHENCK ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588735880,"ENGLAND, EGAN, WILLIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1972650059,HARDISON & BURGETTE PA,~,121 DUPLIN PROFESSIONAL CT   WARSAW NC,031,Duplin,193200000X,Group,Multi-Specialty,,1588736458,"STOPPELBEIN, WILLIAM",121 DUPLIN PROFESSIONAL CT   WARSAW NC,031,Duplin,1223G0001X,Dental Providers,Dentist,General Practice, 68 , 91 , 234 ," $11,731.21 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588742100,"EDWARDS, DONNA, HELEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588744858,"BRIGHT, CEDRIC, MARC",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 124 , 141 , 162 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588745392,"RUSSO, MARK, WILLIAM",2630 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology, 26 , 32 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588745392,"RUSSO, MARK, WILLIAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588745392,"RUSSO, MARK, WILLIAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588745814,"GUY, LISA, RENEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1316023443,HIGGINS MANI & WATSON IV DDS PA,THE DENTAL CARE CENTER,545 VENTURE DR   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588745822,"WATSON, MICHAEL, STEVEN",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 48 , 158 ,$#,,
MEDICAID DIRECT,1609952738,HIGGINS MANI & WATSON II DDS PA,THE DENTAL CARE CENTER,3001 RALEIGH ROAD PKWY W   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1588745822,"WATSON, MICHAEL, STEVEN",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 51 , 51 , 180 ,$#,,
MEDICAID DIRECT,1609389113,HIGGINS MANI WATSON VII DDS PA,THE DENTAL CARE CENTER,2470 EMERALD PL STE A GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588745822,"WATSON, MICHAEL, STEVEN",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 18 , 50 ,$#,,
MEDICAID DIRECT,1730263211,HIGGINS MANI & WATSON III DDS PA,THE DENTAL CARE CENTER,3621 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588745822,"WATSON, MICHAEL, STEVEN",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice," 1,825 "," 2,827 "," 10,149 "," $512,772.97 ",,
MEDICAID DIRECT,1306491444,HIGGINS MANI AND WATSON VIII DDS PA,THE DENTAL CARE CENTER,877 E GANNON AVE STE 401 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588745822,"WATSON, MICHAEL, STEVEN",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1932283421,HIGGINS MANI & WATSON I DDS PA,THE DENTAL CARE CENTER,2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588745822,"WATSON, MICHAEL, STEVEN",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 227 , 250 , 931 ," $38,193.89 ",,
MEDICAID DIRECT,1942509534,HIGGINS MANI & WATSON VI DDS PA,THE DENTAL CARE CENTER,1900 S MAIN ST STE 206 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1588745822,"WATSON, MICHAEL, STEVEN",2140 W ARLINGTON BLVD STE E GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 235 , 275 ," 1,044 "," $49,199.77 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588747539,"ESKRIDGE, MATTHEW, RAMSEY",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588747539,"ESKRIDGE, MATTHEW, RAMSEY",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 78 , 123 , 240 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588747539,"ESKRIDGE, MATTHEW, RAMSEY",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 23 , 39 , 56 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588747539,"ESKRIDGE, MATTHEW, RAMSEY",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588747539,"ESKRIDGE, MATTHEW, RAMSEY",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748446,"SOBOLEWSKI, CRAIG, JOSEPH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748446,"SOBOLEWSKI, CRAIG, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748446,"SOBOLEWSKI, CRAIG, JOSEPH",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1200 NAVAHO DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588748446,"SOBOLEWSKI, CRAIG, JOSEPH",1200 NAVAHO DR   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588748446,"SOBOLEWSKI, CRAIG, JOSEPH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748479,"MORSE, MICHAEL, AARON",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 22 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748479,"MORSE, MICHAEL, AARON",DUKE MEDICAL CTR PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 24 , 36 , 52 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748495,"KAZAN, RANIA, YOUSSEF",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 108 , 110 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748495,"KAZAN, RANIA, YOUSSEF",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 24 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748495,"KAZAN, RANIA, YOUSSEF",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 32 , 123 , 123 ,$#,,
MEDICAID DIRECT,1205159316,PRIVATE DIAGNOSTIC CLINIC PLLC,DUKE PERINATAL CONSULTANTS DURHAM,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748636,"LIVINGSTON, ELIZABETH, GRESHAM",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748636,"LIVINGSTON, ELIZABETH, GRESHAM",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 130 , 141 , 173 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748636,"LIVINGSTON, ELIZABETH, GRESHAM",2100 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588748636,"LIVINGSTON, ELIZABETH, GRESHAM",2100 ERWIN RD   DURHAM NC,032,Durham,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,600 NEW WAVERLY PL STE 305 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588748636,"LIVINGSTON, ELIZABETH, GRESHAM",600 NEW WAVERLY PL   CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11001 DURANT RD STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588748636,"LIVINGSTON, ELIZABETH, GRESHAM",11001 DURANT RD   RALEIGH NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588749303,"WORTH, ROBERT, HARRY",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 115 , 115 , 127 ," $17,766.77 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588749634,"WALBY, LAURA",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 21 , 33 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588749873,"MCKEEL, BRADFORD, LAMB",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588754774,"MORGAN, JACKSON, PAUL",1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 106 , 118 , 175 ," $13,858.39 ",,
MEDICAID DIRECT,1104289685,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ORAL MEDICINE & MAXILLOFACIAL SURGER,1601 ABBEY PL STE 220 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588754774,"MORGAN, JACKSON, PAUL",1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1588755219,"JENISON WILLIAMS, TAMARA, L",,12201 N NC HIGHWAY 150 STE 23 WINSTON SALEM NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,,1588755219,"JENISON WILLIAMS, TAMARA, L",12201 N NC HIGHWAY 150 STE 23 WINSTON SALEM NC,029,Davidson,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#, 17 ,$#,,
MEDICAID DIRECT,1588756803,"PACKMAN, JON, CHARLES",~,1316 DAVIE AVE STE A STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,1588756803,"PACKMAN, JON, CHARLES",1316 DAVIE AVE STE A STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice, 16 , 35 , 89 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1588758601,"WARD, THOMAS, SANDERS ROBERT",1272 EAST ST   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 22 , 29 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1588758601,"WARD, THOMAS, SANDERS ROBERT",1272 EAST ST   WAYNESVILLE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588759989,"TANGREDI, CHRISTINE, MARIE",510 CAROLINA BAY DR STE 200 WILMINGTON NC,065,New Hanover,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 68 , 108 , 151 ," $31,355.88 ",,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588759989,"TANGREDI, CHRISTINE, MARIE",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 12 , 17 , 18 ,$#,,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588759989,"TANGREDI, CHRISTINE, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 49 , 59 , 66 ," $14,176.34 ",,
MEDICAID DIRECT,1811576515,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR UNC CHILDREN,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588759989,"TANGREDI, CHRISTINE, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1588762033,"SPENCER, VARNAR, DALISE",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 39 , 42 , 42 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588762074,"LAND, STEPHANIE, GRETCHEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1588762298,"GREENE, CHRISTINE, DEMETRA",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588762298,"GREENE, CHRISTINE, DEMETRA",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588762686,"ETIENNE, STEFANIE, LINETTE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588762686,"ETIENNE, STEFANIE, LINETTE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1588762686,"ETIENNE, STEFANIE, LINETTE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619058955,FRANKLIN COUNTY HEALTH DEPT,FRANKLIN CO HEALTH DEPT,107 INDUSTRIAL DR   LOUISBURG NC,035,Franklin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588762686,"ETIENNE, STEFANIE, LINETTE",6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992754311,MEADOWS LUTCACAGE SMITH VINTON FIDL,Meadows Schaberg Lutcacage DBA Drs Lutcavage & Fi,2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1588762892,"JOHNSON, MARK, WINTON",2400 WAYNE MEMORIAL DR STE K GOLDSBORO NC,096,Wayne,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 47 ,$#,,
MEDICAID DIRECT,1588763254,OLIN VILLAGE LLC,OLIN VILLAGE LLC,999 TABOR RD   OLIN NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588763254,OLIN VILLAGE LLC,999 TABOR RD   OLIN NC,049,Iredell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 24 ," 5,502 "," 5,504 "," $345,438.03 ",,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588764161,"DAVIS, DEVON, LYNN",51 MOSAIC BLVD STE 100 PITTSBORO NC,019,Chatham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588764161,"DAVIS, DEVON, LYNN",6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1588764161,"DAVIS, DEVON, LYNN",2800 OLD NC 86 STE 100 HILLSBOROUGH NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 35 ,$#,,
MEDICAID DIRECT,1720386220,UNC PHYSICIANS NETWORK LLC,UNC URGENT CARE AT CAROLINA POINTE II,6013 FARRINGTON RD STE 101 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588764161,"DAVIS, DEVON, LYNN",197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720080070,CAPE FEAR NEUROSURGERY,CAPE FEAR NEUROSURGERY,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588764385,"CARSON, LARRY, VAN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588766547,"MELVIN, AL, LEODUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588766547,"MELVIN, AL, LEODUS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 62 , 66 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588766547,"MELVIN, AL, LEODUS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 105 , 108 , 116 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588768055,"BECKER-DREPS, SYLVIA, IRENE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588768055,"BECKER-DREPS, SYLVIA, IRENE",2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588768162,"COULSON, CAROL, CATHERINE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 28 , 30 , 30 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 31 , 32 , 45 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 24 , 30 , 46 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",25 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",360 HOSPITAL DR   CLYDE NC,044,Haywood,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",430 RANKIN DR   MARION NC,059,McDowell,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",190 RIVERVIEW ST STE 2 FRANKLIN NC,056,Macon,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588768162,"COULSON, CAROL, CATHERINE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 13 , 15 , 19 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588768188,"IMSEIS, HYTHAM, MANUEL",1450 MATTHEWS TOWNSHIP PKWY STE 410 MATTHEWS NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588768188,"IMSEIS, HYTHAM, MANUEL",1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 16 , 16 , 42 ,$#,,
MEDICAID DIRECT,1699464750,NMG HEALTH SERVICES LLC,NHMG MATERNAL FETAL MEDICINE CLINICS,1718 E 4TH ST STE 404 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588768188,"IMSEIS, HYTHAM, MANUEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1437338050,CAROMONT MEDICAL GROUP INC,CAROMONT WOMENS HEALTH,620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1588768188,"IMSEIS, HYTHAM, MANUEL",620 SUMMIT CROSSING PL STE 108C GASTONIA NC,036,Gaston,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 11 , 11 , 32 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588769103,"TISCHER, JASON, THOMAS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114368560,JOSEPH GUARINO MD MPH,PIEDMONT OCCUPATIONAL & URGENT CARE,217 TURNER DR STE A REIDSVILLE NC,079,Rockingham,193400000X,Group,Single Specialty,,1588779102,"GUARINO, JOSEPH, ANTHONY",217 TURNER DR STE A REIDSVILLE NC,079,Rockingham,208D00000X,Allopathic & Osteopathic Physicians,General Practice,, 20 , 25 , 60 ,$#,,
MEDICAID DIRECT,1780809111,NC DHHS CHILD AND FAMILY WELL-BEING,~,1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,252Y00000X,Agencies,Early Intervention Provider Agency,,1588781694,"FILIPPINI, MARGOT, HEITLER",1100 NAVAHO DR STE 100 RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003827155,HARNETT COUNSELING SERVICES PC,~,1186 N MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588782072,"BROWN, AMY, WHITLEY",5841 US 421 S   LILLINGTON NC,043,Harnett,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588787147,"LIN, JINGMEI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 117 , 118 , 168 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588790646,"BUTLER, ERIK, SMITH",75 OLD GRAHAM RD   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,893 EAST ST   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588790646,"BUTLER, ERIK, SMITH",893 EAST ST   PITTSBORO NC,019,Chatham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 39 , 95 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588790646,"BUTLER, ERIK, SMITH",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",5420 BARBER MILL RD   CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",67 JR RD STE 1200 SELMA NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",86 HEALTHPARK WAY   CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",86 HEALTHPARK WAY   CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",86 HEALTHPARK WAY   CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 20 , 20 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",67 JR RD STE 1200 SELMA NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",545 E MARKET ST   SMITHFIELD NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1588790877,"MERRITT JAMES, PHYLLIS, ALETA",5420 BARBER MILL RD   CLAYTON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588795025,"SCANNELL, BRIAN, PATRICK",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 95 , 150 , 277 ," $23,984.87 ",,
MEDICAID DIRECT,1144652330,UNIVERSITY SURGERY CENTER LLC,MALLARD CREEK SURGERY CENTER,9848 N TRYON ST STE 200 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1588795025,"SCANNELL, BRIAN, PATRICK",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588795215,"ELLINGTON, JOHN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588795215,"ELLINGTON, JOHN",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588795215,"ELLINGTON, JOHN",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 21 , 32 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,2001 VAIL AVE STE 200B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588795215,"ELLINGTON, JOHN",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588795215,"ELLINGTON, JOHN",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588795215,"ELLINGTON, JOHN",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 20 , 28 ,$#,,
MEDICAID DIRECT,1437181914,AULANDER MEDICAL PRACTICE PA,~,114 HOLLOWELL RD   AULANDER NC,008,Bertie,193400000X,Group,Single Specialty,,1588796742,"FIELDS, BOBBY",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 64 , 85 , 167 ,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588796742,"FIELDS, BOBBY",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 31 , 34 ,$#,,
MEDICAID DIRECT,1588796791,VANDERBILL CHERRY JR,PATHWAYS,812 CHARLES TAYLOR RD   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588796791,VANDERBILL CHERRY JR,410 S COMMERCE ST   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,,,$#,,
MEDICAID DIRECT,1588796791,VANDERBILL CHERRY JR,PATHWAYS,812 CHARLES TAYLOR RD   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588796791,VANDERBILL CHERRY JR,812 CHARLES TAYLOR RD   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 256 , 256 ," $19,811.04 ",,
MEDICAID DIRECT,1588796791,VANDERBILL CHERRY JR,PATHWAYS,410 S COMMERCE ST   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588796791,VANDERBILL CHERRY JR,410 S COMMERCE ST   AULANDER NC,008,Bertie,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 713 , 713 ," $44,985.90 ",,
MEDICAID DIRECT,1588799597,HOLLY SPRINGS SENIOR CITIZENS HOME,~,1881 BIG ISLAND RD   RUTHERFORDTON NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588799597,HOLLY SPRINGS SENIOR CITIZENS HOME,1881 BIG ISLAND RD   RUTHERFORDTON NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 770 , 770 ," $50,871.77 ",,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1588800809,"KILLIAN, FRANK, ANDREAS",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 20 , 24 , 26 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588800809,"KILLIAN, FRANK, ANDREAS",144 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 47 , 55 , 72 ,$#,,
MEDICAID DIRECT,1295799823,ASHEVILLE EYE ASSOCIATES PLLC,ASHEVILLE EYE ASSOCIATES PLLC,8 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588800809,"KILLIAN, FRANK, ANDREAS",95 HOLLY SPRINGS PARK DR   FRANKLIN NC,056,Macon,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588806772,"JONES, DIANNA, L.",1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#, 11 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588807127,"AGBATA, TOCHUKWU, NWAMAKA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 84 , 84 ,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588807127,"AGBATA, TOCHUKWU, NWAMAKA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588807127,"AGBATA, TOCHUKWU, NWAMAKA",250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 65 , 65 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1588807127,"AGBATA, TOCHUKWU, NWAMAKA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1588807127,"AGBATA, TOCHUKWU, NWAMAKA",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588809982,"DEMBOWSKI, SARAH, PAKRON",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1588809982,"DEMBOWSKI, SARAH, PAKRON",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588809982,"DEMBOWSKI, SARAH, PAKRON",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 48 , 49 , 49 ,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1588810519,"WILD, CHRISTY, BOONE",400 S CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 29 , 70 ,$#,,
MEDICAID DIRECT,1295193340,ASHE FINANCIAL SERVICES LLC,ASHE FINANCIAL SERVICES LLC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1588814131,"BURGHER, TARA, BLALOCK",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588814131,"BURGHER, TARA, BLALOCK",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1588814131,"BURGHER, TARA, BLALOCK",105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1588814131,"BURGHER, TARA, BLALOCK",301 YADKIN ST   ALBEMARLE NC,084,Stanly,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346534419,ALLMED CLINIC PA,~,3708 FORESTVIEW RD STE 207 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588814628,"KARIM, ZAKIYA",3708 FORESTVIEW RD STE 207 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 126 , 474 , 683 ," $18,386.86 ",,
MEDICAID DIRECT,1588815476,"GILCHRIST, KEVIN, WESLEY",DRS KINDRACHUK AND GILCHRIST,7800 SIX FORKS RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1588815476,"GILCHRIST, KEVIN, WESLEY",7800 SIX FORKS RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 39 , 70 , 195 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588816706,"CUTSHAW, HOUSTON, GREGORY",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 50 , 101 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588816706,"CUTSHAW, HOUSTON, GREGORY",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588818298,"GUPTA, MADHUR",395 W 27TH ST   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588818298,"GUPTA, MADHUR",601 E SIX FORKS RD STE 102 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588818298,"GUPTA, MADHUR",4020 WAKE FOREST RD STE 201 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1588822118,"DIEFENDORF, LAURA, PATRICIA",480 RUIN CREEK RD   HENDERSON NC,091,Vance,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 207 , 430 ," 1,100 "," $13,787.15 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588823629,"OSHUNKENTAN, KIKELOMO, ADEDAYO",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588824031,"MEHTA, DIPALI, SANDIP",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588824114,"MCGINIGLE, KATHARINE, LILLIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 48 , 68 , 91 ,$#,,
MEDICAID DIRECT,1215617709,SOUTHERN MENTALITY PLLC,,1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588824478,"THOMPSON, NICOLE, JANE",1914 J N PEASE PL   CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588824593,"ALKER, ALISA, PATRICIA",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588824593,"ALKER, ALISA, PATRICIA",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588824593,"ALKER, ALISA, PATRICIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 35 , 82 , 83 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588824593,"ALKER, ALISA, PATRICIA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 38 , 65 , 65 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588824593,"ALKER, ALISA, PATRICIA",900 HENDERSONVILLE RD STE 205 ASHEVILLE NC,011,Buncombe,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588825020,"ANDERSON-DILLON, ALISHA, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588826358,"LEWIS, MARGARET, RUFFIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 38 , 48 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588829386,"BLACK, AMY, JACQUELINE",1450 MATTHEWS TOWNSHIP PKWY STE 110 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588829386,"BLACK, AMY, JACQUELINE",325 HAWTHORNE LN STE 100 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588829386,"BLACK, AMY, JACQUELINE",16525 HOLLY CREST LN STE 210 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588829386,"BLACK, AMY, JACQUELINE",200 MEDICAL PARK DR   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588830053,"MANESS, PATRICIA, NEAL",1002 DOGWOOD DR   ZEBULON NC,051,Johnston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 24 , 74 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588830053,"MANESS, PATRICIA, NEAL",350 E HOLDING AVE   WAKE FOREST NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 44 , 71 , 244 ," $10,548.80 ",,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1588830053,"MANESS, PATRICIA, NEAL",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 18 , 25 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588832042,"MCDOWELL, KAREN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588832042,"MCDOWELL, KAREN",2525 COURT DR   GASTONIA NC,036,Gaston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1588832042,"MCDOWELL, KAREN",2525 COURT DR   GASTONIA NC,036,Gaston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588832042,"MCDOWELL, KAREN",2525 COURT DR   GASTONIA NC,036,Gaston,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1588832166,WASHINGTON COUNTY SCHOOLS,WASHINGTON COUNTY SCHOOLS,802 WASHINGTON ST   PLYMOUTH NC,094,Washington,251300000X,Agencies,Local Education Agency (LEA),,1588832166,WASHINGTON COUNTY SCHOOLS,802 WASHINGTON ST   PLYMOUTH NC,094,Washington,251300000X,Agencies,Local Education Agency (LEA),, 39 , 710 , 710 ," $35,850.85 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588832695,"KAMATH, GANESH, VASANT",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588832695,"KAMATH, GANESH, VASANT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 29 , 30 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588832695,"KAMATH, GANESH, VASANT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588832695,"KAMATH, GANESH, VASANT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 28 , 33 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1588832695,"KAMATH, GANESH, VASANT",6118 FARRINGTON RD STE A CHAPEL HILL NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 23 , 28 ,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588834030,"ROGERS, LATASHA, REGENIA",501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,1816 LYNDHURST AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588834030,"ROGERS, LATASHA, REGENIA",10400 MALLARD CREEK RD STE 210 CHARLOTTE NC,060,Mecklenburg,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588835839,"OJO, OLUKAYODE, OLUDAPO",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588837173,"GREYARD, JAMES, WILLIAM",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588838965,"HERRICK, BENJAMIN, WRIGHT",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588838965,"HERRICK, BENJAMIN, WRIGHT",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 88 , 144 , 300 ,$#,,
MEDICAID DIRECT,1700827409,PIEDMONT STONE CENTER PLLC,~,1907 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588838965,"HERRICK, BENJAMIN, WRIGHT",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588838965,"HERRICK, BENJAMIN, WRIGHT",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588838965,"HERRICK, BENJAMIN, WRIGHT",1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588839690,"PATEL, JANISH, JAY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 104 , 109 , 118 ," $10,180.05 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588840862,"MOHEET, ASMA, MAHAVASH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1588841183,ANGEL HOUSE FCH LLC,ANGEL HOUSE FAMILY CARE HOMES,60 HORNOT CIR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1588841183,ANGEL HOUSE FCH LLC,60 HORNOT CIR   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 633 , 633 ," $40,422.62 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588844187,"ZAMUDIO II, DANIEL",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1689628729,NURSE ANESTHESIA OF NC PLLC,~,180 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1588844187,"ZAMUDIO II, DANIEL",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588844187,"ZAMUDIO II, DANIEL",180 PARKWOOD DR   ELKIN NC,086,Surry,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1588848006,"BRENNEMAN, TERRY, RICHARD",8841 SIX FORKS RD   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1588848758,"BAGNULO, ELSA, MAE Q",1030 SIENA DR   WAKE FOREST NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1588848758,"BAGNULO, ELSA, MAE Q",11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1225684004,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE WAKE FOREST,11640 NORTHPARK DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1588848758,"BAGNULO, ELSA, MAE Q",176 S BECKFORD DR   HENDERSON NC,091,Vance,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1588849319,"NEKL, CASEY, GUY",1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588849319,"NEKL, CASEY, GUY",1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 92 , 124 , 181 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1588849319,"NEKL, CASEY, GUY",1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 36 , 52 , 83 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD # 140 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1588849319,"NEKL, CASEY, GUY",1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1811204431,ALBEMARLE PHYSICIAN SERVICES,~,1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1588849319,"NEKL, CASEY, GUY",1134 N ROAD ST STE 2 ELIZABETH CITY NC,070,Pasquotank,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,,,$#,,
MEDICAID DIRECT,1750342820,ARDMORE FAMILY PRACTICE,ARDMORE FAMILY PRACTICE PA,2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588849350,"SMITH, JENNIFER, MICHELLE",2805 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 40 , 77 , 141 ,$#,,
MEDICAID DIRECT,1588852487,HANDS ON PHYSICAL THERAPY,HANDS ON PHYSICAL THERAPY,1439 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1588852487,HANDS ON PHYSICAL THERAPY,1439 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588854525,"MCCALL, CHRISTY, RENE",3164 US HIGHWAY 70   BLACK MOUNTAIN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 23 , 29 ,$#,,
MEDICAID DIRECT,1215488481,RDMG ASSOCIATES PA,,3164 US HIGHWAY 70   BLACK MOUNTAIN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588854525,"MCCALL, CHRISTY, RENE",3164 US HIGHWAY 70   BLACK MOUNTAIN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588854616,"O'CONNOR, STACY, DOROTHY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1588854616,"O'CONNOR, STACY, DOROTHY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588854616,"O'CONNOR, STACY, DOROTHY",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 183 , 197 , 231 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588854673,"AHEARN, CARLA, JONES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LN0005X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Neonatal, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1588855944,"CORDIAL, LORI, OAKLEY",WELLNESS FOR LIFE PLLC,648 ALMONDRIDGE DR   RURAL HALL NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1588855944,"CORDIAL, LORI, OAKLEY",648 ALMONDRIDGE DR   RURAL HALL NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1588856611,"MCCRAW, CHARLENE, PADGETT SHEARON",111 W GROVER ST   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588861843,"BOWEN, MEREDITH, DAVIS",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912262593,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,2090 S US 29 HWY   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1588861843,"BOWEN, MEREDITH, DAVIS",12925 HIGHWAY 601 STE 300 MIDLAND NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 33 ,$#,,
MEDICAID DIRECT,1912262593,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,2090 S US 29 HWY   CHINA GROVE NC,080,Rowan,193200000X,Group,Multi-Specialty,,1588861843,"BOWEN, MEREDITH, DAVIS",2090 S US 29 HWY   CHINA GROVE NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 75 , 146 , 238 ,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1588863187,"ANDREWS, NEAL, DAVID",1000 HEALING WAY   MATTHEWS NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588863187,"ANDREWS, NEAL, DAVID",600 HOSPITAL DR   MONROE NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588863187,"ANDREWS, NEAL, DAVID",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2700 PROVIDENCE RD S   WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1588863187,"ANDREWS, NEAL, DAVID",2700 PROVIDENCE RD S   WAXHAW NC,090,Union,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1407929094,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5701 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588864730,"GAY, APRIL, LAVELLE",5500 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1013086321,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5500 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588864730,"GAY, APRIL, LAVELLE",5500 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 22 , 47 ,$#,,
MEDICAID DIRECT,1033463500,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1588865737,"BECK, CHRISTINA, OWEN",540 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 71 , 170 ,$#,,
MEDICAID DIRECT,1922040419,WILMINGTON GASTROENTEROLOGY ASSOCIA,WILMINGTON GASTROENTEROLOGY ASSOCIATES PA,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1588866362,"CARNEY, DAVID, SPENCER",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 87 , 125 , 180 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588866636,"NARLA, SUNIL, KUMAR",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588866636,"NARLA, SUNIL, KUMAR",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 40 , 125 , 125 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1588866636,"NARLA, SUNIL, KUMAR",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588866636,"NARLA, SUNIL, KUMAR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588866636,"NARLA, SUNIL, KUMAR",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588868400,NORTHAMPTON COUNTY,NORTHAMPTON COUNTY AMBULANCE SERVICE,132 LANDFILL RD   JACKSON NC,066,Northampton,3416L0300X,Transportation Services,Ambulance,Land Transport,1588868400,NORTHAMPTON COUNTY,132 LANDFILL RD   JACKSON NC,066,Northampton,3416L0300X,Transportation Services,Ambulance,Land Transport, 275 , 521 ," 1,021 ",$#,,
MEDICAID DIRECT,1194899542,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588868467,"HOUSTON, MARY BENNETT",702 N MAIN ST   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice, 145 , 163 , 312 ," $19,191.77 ",,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588868467,"HOUSTON, MARY BENNETT",702 N MAIN ST   ROXBORO NC,073,Person,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588872642,"CLAYTOR, TEDRA, MICHELLE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 39 , 107 , 107 ,$#,,
MEDICAID DIRECT,1477980050,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH INFECTIOUS DISEASE CABARRUS,200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588872642,"CLAYTOR, TEDRA, MICHELLE",200 MEDICAL PARK DR STE 280 CONCORD NC,013,Cabarrus,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 61 , 90 , 92 ,$#,,
MEDICAID DIRECT,1124460514,VAN L ADAMS MD PLLC,CAROLINA INTERNAL MEDICINE AND PEDIATRICS,202 MALLOY ST SUITE B GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1588872964,"ADAMS, VAN, LEE",202 MALLOY ST STE B GOLDSBORO NC,096,Wayne,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 90 , 312 , 444 ," $10,240.16 ",,
MEDICAID DIRECT,1073897310,GAYLIA C SMITH DDS PA,GIBSONVILLE FAMILY DENTISTRY,408 BURLINGTON AVE   GIBSONVILLE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588875736,"SMITH, GAYLIA, CHAVIS",408 BURLINGTON AVE   GIBSONVILLE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 202 , 489 ," 1,539 "," $85,531.35 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588877187,"GALL, SARAH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588877187,"GALL, SARAH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588877187,"GALL, SARAH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 16 , 48 , 55 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588877187,"GALL, SARAH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1588890297,WALGREEN CO,WALGREENS 12780,3062 HICKORY BLVD   HUDSON NC,014,Caldwell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1588890297,WALGREEN CO,3062 HICKORY BLVD   HUDSON NC,014,Caldwell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588892012,"DOLAN-SOTO, DIANE, ROSE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588892111,"PATHAK, SACHIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 280 , 280 ," $13,199.21 ",,
MEDICAID DIRECT,1245734995,CALDWELL MEMORIAL HOSPITAL,CALDWELL ONCOLOGY ASSOCIATES,212 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1588893218,"JOLLY, TREVOR, AUGUSTUS",212 MULBERRY ST SW   LENOIR NC,014,Caldwell,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 19 , 43 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588893218,"JOLLY, TREVOR, AUGUSTUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588897029,"WOLFE, STACEY, QUINTERO",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 71 , 133 , 203 ," $27,811.07 ",,
MEDICAID DIRECT,1780011825,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PEDIATRIC NEUROLOGY CARE - EASTOVER,,,Unknown,193400000X,Group,Single Specialty,,1588897664,"STEWART, ALEJANDRA, MARIA",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,,,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588897664,"STEWART, ALEJANDRA, MARIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588897664,"STEWART, ALEJANDRA, MARIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1588898571,"KING, WHITNEY, NUGENT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 68 , 72 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588898639,"SUN, DANYU",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1194090613,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588898639,"SUN, DANYU",10660 PARK RD STE 2100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1588898639,"SUN, DANYU",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588898639,"SUN, DANYU",1100 S TRYON ST STE 400 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1588898639,"SUN, DANYU",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1588898639,"SUN, DANYU",1100 HEALING WAY STE 31 MATTHEWS NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1588899306,"WRUBLE, RACHAEL, ANNE",~,6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,1588899306,"WRUBLE, RACHAEL, ANNE",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,3 S TUNNEL RD # 187 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588899306,"WRUBLE, RACHAEL, ANNE",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588899306,"WRUBLE, RACHAEL, ANNE",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588899306,"WRUBLE, RACHAEL, ANNE",6801 NORTHLAKE MALL DR STE 253 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1588902282,"AMAKA, DOROTHY, ADANMA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 29 , 29 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1588903470,"OCHS, RYAN, THOMAS",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1588903470,"OCHS, RYAN, THOMAS",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1144748948,APPALACHIAN REGIONAL MEDICAL ASSOCI,WATAUGA SURGICAL GROUP,965 STATE FARM RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1588904650,"CAMPBELL, DERECK, GAVIN",965 STATE FARM RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588905012,"HOLBROOK, JAIME, ANNE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588905566,"PINEDA MALDONADO, ANDRES, MAURICIO",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1588905566,"PINEDA MALDONADO, ANDRES, MAURICIO",5601 ARRINGDON PARK DR STE 410 MORRISVILLE NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588905566,"PINEDA MALDONADO, ANDRES, MAURICIO",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 13 , 19 , 29 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588908149,"SOBEL, SUSAN, OLIVER",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 24 , 38 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588908149,"SOBEL, SUSAN, OLIVER",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 81 , 128 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588910574,"JOSEPH, ARUN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 57 , 189 , 190 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588910574,"JOSEPH, ARUN",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588910574,"JOSEPH, ARUN",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1881316586,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH ENDOCRINOLOGY CLINICS,755 HIGHLAND OAKS DR STE 201 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588914337,"SPASSOVA, ROUMYANA, IVANOVA",903 RANDOLPH ST   THOMASVILLE NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1881278299,ARCHWELL HEALTH PROFESSIONAL SERVIC,,3022 EASTWAY DR STE 1-3 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588918395,"VAIDADI, RAJA KUMARI",3022 EASTWAY DR STE 1-3 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 20 , 23 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588920052,"ARAUZ, ALAN, XAVIER",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588920052,"ARAUZ, ALAN, XAVIER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",1633 SUGAR HILL RD   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 26 , 26 , 30 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",490 HOSPITAL DR   CLYDE NC,044,Haywood,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 24 , 36 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",534 BILTMORE AVE STE 102 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 34 , 38 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",7 VANDERBILT PARK DR FL 1 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",100 RIDGEFIELD CT   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",2695 HENDERSONVILLE RD STE 150 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,1 HOSPITAL DR STE 4200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588921019,"DONG, HUAN",534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",21 HOSPITAL DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",428 BILTMORE AVE FL 4 ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",310 LONG SHOALS RD STE 110 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",20 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 172 , 204 , 245 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588921019,"DONG, HUAN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1295967586,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",5651 POPLAR TENT RD STE 102 CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 16 , 27 , 38 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",275 BEATTY DR   BELMONT NC,036,Gaston,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1639425796,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",3030 RANDOLPH RD STE 105 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1790024974,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 21 , 39 , 61 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1790024974,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,9726 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1053668012,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921365,"THAKUR, SIDDARTH",5735 PROSPERITY CROSSING DR STE 2100 CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 13 , 18 , 38 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588921530,"BROGAN, JOSEPH, DONALD",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 56 , 150 , 150 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588921530,"BROGAN, JOSEPH, DONALD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588921530,"BROGAN, JOSEPH, DONALD",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 24 , 24 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588921969,"OSTERGARD, THOMAS, ALEXANDER",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 25 , 34 , 41 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1588922041,"LI, NA",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588922041,"LI, NA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1053748426,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS ROCKY RIVER PEDIAT,5427 NC HIGHWAY 49 S STE 103 HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588922421,"GAGINA, MARIANNA",5427 HWY 49 S STE 103 HARRISBURG NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 36 , 87 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588923593,"LECOMPTE, MICHAEL, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588923593,"LECOMPTE, MICHAEL, THOMAS",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588923593,"LECOMPTE, MICHAEL, THOMAS",2901 BLUE RIDGE RD STE 201 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 25 , 25 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588923593,"LECOMPTE, MICHAEL, THOMAS",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700350287,SOUTHERN PAIN & SPINE SPECIALISTS P,,3081 SENNA DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588923817,"ALAMARIE, AMMAR, AHMED",105 WAXHAW PROFESSIONAL PARK DR STE D WAXHAW NC,090,Union,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#, 21 , 59 ,$#,,
MEDICAID DIRECT,1700350287,SOUTHERN PAIN & SPINE SPECIALISTS P,,3081 SENNA DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588923817,"ALAMARIE, AMMAR, AHMED",3081 SENNA DR   MATTHEWS NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 32 , 144 , 335 ,$#,,
MEDICAID DIRECT,1700350287,SOUTHERN PAIN & SPINE SPECIALISTS P,,3081 SENNA DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588923817,"ALAMARIE, AMMAR, AHMED",101 E MATTHEWS ST STE 200 MATTHEWS NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588924856,"VANDEGRIFT, ANGELA, MARI",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588924856,"VANDEGRIFT, ANGELA, MARI",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1588924856,"VANDEGRIFT, ANGELA, MARI",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588927826,"PATEL, AMI, YOGESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 17 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588927826,"PATEL, AMI, YOGESH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588927826,"PATEL, AMI, YOGESH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588927826,"PATEL, AMI, YOGESH",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588927826,"PATEL, AMI, YOGESH",10207 CERNY ST   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 21 , 34 ,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1588927891,"ABRAHAM, MATTHEW, PAUL",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588927891,"ABRAHAM, MATTHEW, PAUL",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588927891,"ABRAHAM, MATTHEW, PAUL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588927891,"ABRAHAM, MATTHEW, PAUL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588927891,"ABRAHAM, MATTHEW, PAUL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588927891,"ABRAHAM, MATTHEW, PAUL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588927917,"KNOWLTON, SASHA, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 80 , 127 , 141 ,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1588928824,"KAMMARI, CHETAN, BRAHMA",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1588928824,"KAMMARI, CHETAN, BRAHMA",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 172 , 173 ,$#,,
MEDICAID DIRECT,1811145014,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS GASTONIA CHILDRENS,2544 COURT DR STE C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1588930937,"GNANASEKARAN, KAVITHASHREE",2544 COURT DR   GASTONIA NC,036,Gaston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 75 , 116 , 293 ," $12,048.95 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588935829,"SLUSSER, HEATHER, STERLING",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588936413,"HOPKINS, EMRA, MCALEXANDER",600 HOSPITAL DR   MONROE NC,090,Union,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588942049,"DHEER, ANJU",1501 N BICKETT BLVD STE F LOUISBURG NC,035,Franklin,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1588942601,"CORRAO, MARIA, KATHLEEN",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 16 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588942676,"ARDALAN, KAVEH",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588942676,"ARDALAN, KAVEH",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588942676,"ARDALAN, KAVEH",3000 ERWIN RD   DURHAM NC,032,Durham,2080P0216X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1588945109,INOMANCY INC,INOMANCY MEDICAL SUPPLY,4111 NEW BERN AVE STE 121 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1588945109,INOMANCY INC,4111 NEW BERN AVE STE 121 RALEIGH NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 355 ," 3,636 "," 6,331 "," $528,284.24 ",,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1588947394,"PARDEE, KATIE, ELIZABETH",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1740870484,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - GENERAL SURGERY,821 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1588947394,"PARDEE, KATIE, ELIZABETH",821 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1740870484,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL - GENERAL SURGERY,821 N ATLANTIC AVE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1588947394,"PARDEE, KATIE, ELIZABETH",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588947501,"CREECH, JESSE, BROOKE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588950729,"PARSON, EBONY, NICOLE MADDOX",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588950729,"PARSON, EBONY, NICOLE MADDOX",1450 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 13 , 17 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588950729,"PARSON, EBONY, NICOLE MADDOX",12611 N COMMUNITY HOUSE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588951156,"DILORENZO, DAMON, JAMES",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588951644,"CHANDLER, PAMELA, ARRINGTON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 27 , 35 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,30 CHOCTAW ST STE A ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588951644,"CHANDLER, PAMELA, ARRINGTON",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1588953343,"PETERS, LUKE, ALLEN",233 DOCTORS ST   SPARTA NC,003,Alleghany,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 28 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1588953343,"PETERS, LUKE, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1588953343,"PETERS, LUKE, ALLEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 162 , 199 , 221 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588954457,"SHAH, NEIL, DEVANDRA",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,521 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588954457,"SHAH, NEIL, DEVANDRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1588954457,"SHAH, NEIL, DEVANDRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 69 , 112 , 153 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588954788,"WINNINGHAM, MELANIE, JEAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588954788,"WINNINGHAM, MELANIE, JEAN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588954788,"WINNINGHAM, MELANIE, JEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588954788,"WINNINGHAM, MELANIE, JEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084V0102X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Vascular Neurology,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588955231,"HAGAN, TYLER, KENNETH",612 MCCARTHY BLVD   NEW BERN NC,025,Craven,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#, 15 ,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1588955231,"HAGAN, TYLER, KENNETH",612 MCCARTHY BLVD   NEW BERN NC,025,Craven,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 103 , 198 , 330 ,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588955439,"FETTER, MAYA, DAGHER",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588955439,"FETTER, MAYA, DAGHER",16817 MARVIN RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588955520,"AHO, NICOLE, FRANCES",330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588955520,"AHO, NICOLE, FRANCES",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588955520,"AHO, NICOLE, FRANCES",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1922563923,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH ADDICTION SERVICES CHARLOTTE,330 BILLINGSLEY RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588955520,"AHO, NICOLE, FRANCES",380 COPPERFIELD BLVD NE STE A CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3158 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 38 , 65 , 164 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 2101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",910 PARK CENTER DR   MATTHEWS NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",910 PARK CENTER DR   MATTHEWS NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 23 , 70 , 73 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 88 , 183 , 300 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588957666,"SANGHANI, VIVEK, RAMESH",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1588958003,"SEAY, REBECCA, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588958003,"SEAY, REBECCA, LYNN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588959183,"MCKENZIE, ALEXANDRA, SAMANTHA",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 26 ,$#,,
MEDICAID DIRECT,1649201542,REX HOSPITAL INC,UNC URGENT CARE AT WAKEFIELD,11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1790244192,REX HOSPITAL INC,UNC URGENT CARE AT BEAVER CREEK COMMONS,1059 BEAVER CREEK COMMONS DR UNIT 230 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1588959407,"WILLIAMS, MARY, KATHERINE",11200 GOVERNOR MANLY WAY STE 114 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588959811,"CHAMBERS, STEPHANIE, STEWART",50 BOWMAN DR   WAYNESVILLE NC,044,Haywood,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 17 , 18 , 87 ,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588959811,"CHAMBERS, STEPHANIE, STEWART",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588959811,"CHAMBERS, STEPHANIE, STEWART",10 YORKSHIRE ST # B ASHEVILLE NC,011,Buncombe,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1225129067,DOCTORS CHAMBERS HALDERMAN AND PRAT,GREAT BEGINNINGS AND GREAT SMILES,10 YORKSHIRE ST B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1588959811,"CHAMBERS, STEPHANIE, STEWART",10 YORKSHIRE ST # B ASHEVILLE NC,011,Buncombe,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 159 , 190 ," 1,003 "," $78,988.42 ",,
MEDICAID DIRECT,1649221342,RALEIGH DURHAM MEDICAL GROUP PA,~,4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588960579,"HEMMINGS, JASMINE, PAULINE",4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 23 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588964233,"KALINOWSKI, KATHERINE, HANSEN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588964233,"KALINOWSKI, KATHERINE, HANSEN",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1588964233,"KALINOWSKI, KATHERINE, HANSEN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588966220,"DILORENZO, DANIELLE, CHRISTINE",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 37 , 44 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588966220,"DILORENZO, DANIELLE, CHRISTINE",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 14 , 16 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588966220,"DILORENZO, DANIELLE, CHRISTINE",4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,2101 OAKHEART RD   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1588967533,"SUMMERFIELD, GARY, ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1588967533,"SUMMERFIELD, GARY, ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,301 E JACKSON ST   DILLON SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1588967533,"SUMMERFIELD, GARY, ALLEN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1588967533,"SUMMERFIELD, GARY, ALLEN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1588967533,"SUMMERFIELD, GARY, ALLEN",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,360 PLAIN VIEW HWY   DUNN NC,082,Sampson,193200000X,Group,Multi-Specialty,,1588968812,"HERRINGTON, AMANDA, DARDEN",301 MAIN ST   NEWTON GROVE NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,516 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1588968812,"HERRINGTON, AMANDA, DARDEN",301 MAIN ST   NEWTON GROVE NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 99 , 129 ,$#,,
MEDICAID DIRECT,1730311648,SAMPSON REGIONAL PROFESSIONAL SERVI,~,301 MAIN ST   NEWTON GROVE NC,082,Sampson,193200000X,Group,Multi-Specialty,,1588968812,"HERRINGTON, AMANDA, DARDEN",301 MAIN ST   NEWTON GROVE NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1588971790,"SICELOFF, DANIEL, SIMEON",DANIEL SIMEON SICELOFF,6595 OLD US HIGHWAY 52   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,1588971790,"SICELOFF, DANIEL, SIMEON",6595 OLD US HIGHWAY 52   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice, 536 ," 1,113 "," 2,610 "," $116,283.53 ",,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1588972178,"TANOU, LEAH, MIRAGLIA",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 24 ,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1588972178,"TANOU, LEAH, MIRAGLIA",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 54 , 60 , 70 ,$#,,
MEDICAID DIRECT,1942569330,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588972764,"COVINGTON, TOSHA, YVETTE",10320 FELD FARM LN   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871854752,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588972764,"COVINGTON, TOSHA, YVETTE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 49 , 53 ,$#,,
MEDICAID DIRECT,1215348156,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES PRIMARY CARE APEX,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1588973341,"PETROVIC, MILAN",250 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215348156,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PHYSICIAN PRACTICES PRIMARY CARE APEX,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1588973341,"PETROVIC, MILAN",120 HEALTHPLEX WAY   APEX NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1003011446,BAXTER J SMITH JR OD PA,HEALTHDRIVE EYE CARE GROUP,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588974224,"GORDON, NICOLE, MARIE",4325 GLENWOOD AVE STE 4001 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 360 , 393 , 486 ," $16,367.92 ",,
MEDICAID DIRECT,1003011446,BAXTER J SMITH JR OD PA,HEALTHDRIVE EYE CARE GROUP,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1588974224,"GORDON, NICOLE, MARIE",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 73 , 75 , 100 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588979868,"HAYES, ARCHIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588979868,"HAYES, ARCHIE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588981161,"BADDORF, SARAH, WILLIAMSON",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1588981161,"BADDORF, SARAH, WILLIAMSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1588981161,"BADDORF, SARAH, WILLIAMSON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE D KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1588982417,"DOCTOR, NEHA, NINAD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE B KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1588982417,"DOCTOR, NEHA, NINAD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588982417,"DOCTOR, NEHA, NINAD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,701 DOCTORS DR STE H KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1588982417,"DOCTOR, NEHA, NINAD",701 DOCTORS DR STE N KINSTON NC,054,Lenoir,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1588982417,"DOCTOR, NEHA, NINAD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 61 , 151 , 289 ,$#,,
MEDICAID DIRECT,1902991698,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1588982466,"RANDALL, JACQUETTA, TAISHA",451 RUIN CREEK RD STE 101 HENDERSON NC,091,Vance,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1003902313,CORNELIUS F CATHCART PEDIATRICS PA,NC PEDIATRIC ASSOCIATES,1417 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1588982466,"RANDALL, JACQUETTA, TAISHA",1417 COLLEGE ST   OXFORD NC,039,Granville,2080A0000X,Allopathic & Osteopathic Physicians,Pediatrics,Adolescent Medicine, 36 , 63 , 108 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1588982755,"SANTOS-CUBINA, JAVIER",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 39 , 39 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1588986335,"VICKERY, BRIAN, SCOTT",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 39 , 40 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1588986335,"VICKERY, BRIAN, SCOTT",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1588989040,"NEVITT, MICHAEL, JOHN",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,193400000X,Group,Single Specialty,,1588989040,"NEVITT, MICHAEL, JOHN",180 RIVER BEND DR   GRANITE FALLS NC,014,Caldwell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1548335581,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1588989040,"NEVITT, MICHAEL, JOHN",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1588989040,"NEVITT, MICHAEL, JOHN",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1588989040,"NEVITT, MICHAEL, JOHN",336 DEERFIELD RD   BOONE NC,095,Watauga,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588991913,"KITCHENS, CATHERINE, HEATHER",1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 77 , 120 ,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,5 REGIONAL CIR STE BANDC PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1588991913,"KITCHENS, CATHERINE, HEATHER",5 REGIONAL CIR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649237082,SKIN SURGERY CENTER PA,~,1450 PROFESSIONAL PARK DR STE 150 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1588991913,"KITCHENS, CATHERINE, HEATHER",120 BRAEMAR CT   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1346204088,ALLIANCE UROLOGY SPECIALISTS,~,509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1588992168,"BELL, EUGENE, DEMARQUE",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,, 120 , 210 , 455 ,$#,,
MEDICAID DIRECT,1346501798,ARMC PHYSICIANS CARE INC,BURLINGTON UROLOGICAL ASSOCIATES,1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1588992168,"BELL, EUGENE, DEMARQUE",509 N ELAM AVE FL 2 GREENSBORO NC,041,Guilford,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1588992267,APRIL SEIBLES,JATZ HOME CARE SERVICES,125 OLD WAREHOUSE SQ   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,,1588992267,APRIL SEIBLES,125 OLD WAREHOUSE SQ   OXFORD NC,039,Granville,253Z00000X,Agencies,In Home Supportive Care,, 18 ," 4,700 "," 4,809 "," $480,423.68 ",,
MEDICAID DIRECT,1609907138,NEUROLOGY AND PAIN MANAGEMENT CENTE,NEUROLOGY AND PAIN MANAGEMENT CENTER PLLC,350 PINE STATE ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1588995591,"GOO, BIANCA, LEONA",350 PINE STATE ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 207 ," 1,259 "," 2,527 "," $31,177.99 ",,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588998371,"ANDERSON, CORY, DALE",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588998371,"ANDERSON, CORY, DALE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1588998371,"ANDERSON, CORY, DALE",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 114 , 138 , 226 ,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1588998371,"ANDERSON, CORY, DALE",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1588998371,"ANDERSON, CORY, DALE",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588998850,"AFTHINOS, JOHN",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 17 , 25 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 VETERANS PARKWAY STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588998850,"AFTHINOS, JOHN",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588998850,"AFTHINOS, JOHN",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588998850,"AFTHINOS, JOHN",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1588998850,"AFTHINOS, JOHN",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 50 , 65 , 79 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1588998850,"AFTHINOS, JOHN",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 45 , 50 ,$#,,
MEDICAID DIRECT,1730346974,BATISH FAMILY MEDICINE,BATISH FAMILY MEDICINE,51 LEE DR   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1598000382,"HINDT, ALLISON, SANDRA",51 LEE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 145 , 309 ,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1598001158,"CASAREZ, SARA, ROCHELLE",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 77 , 118 , 185 ," $26,699.18 ",,
MEDICAID DIRECT,1598001638,AAA HOMECARE LLC,~,401 N WALNUT ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1598001638,AAA HOMECARE LLC,401 N WALNUT ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 87 ," 2,779 "," 2,851 "," $304,225.54 ",,
MEDICAID DIRECT,1598001638,AAA HOMECARE LLC,~,2006 1/2 N CEDAR ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1598001638,AAA HOMECARE LLC,2006 1/2 N CEDAR ST   LUMBERTON NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 104 ," 18,444 "," 19,644 "," $2,088,296.19 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598001927,"STOHL, AMBER, DAWN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1598001927,"STOHL, AMBER, DAWN",5601 ARRINGDON PARK DR STE 240 MORRISVILLE NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 22 , 50 ,$#,,
MEDICAID DIRECT,1598004749,BROOKSTONE HAVEN OF RANDLEMAN LLC,~,501 POINTE SOUTH DR   RANDLEMAN NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598004749,BROOKSTONE HAVEN OF RANDLEMAN LLC,501 POINTE SOUTH DR   RANDLEMAN NC,076,Randolph,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 50 ," 14,724 "," 14,724 "," $997,595.09 ",,
MEDICAID DIRECT,1952665929,RURAL HEALTH GROUP INC,Rural Health Group at Enfield,114 MARKET ST   ENFIELD NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598005597,"RAMEY, REBECCA, STONE",105 NW RAILROAD ST   WHITAKERS NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1013157171,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT WHITAKERS,105 SE RAILROAD ST   WHITAKERS NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598005597,"RAMEY, REBECCA, STONE",105 NW RAILROAD ST   WHITAKERS NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 97 , 211 , 222 ,$#,,
MEDICAID DIRECT,1952665929,RURAL HEALTH GROUP INC,Rural Health Group at Enfield,114 MARKET ST   ENFIELD NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598005597,"RAMEY, REBECCA, STONE",114 MARKET ST   ENFIELD NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699722389,BOICE WILLIS CLINIC PA,BOICE WILLIS CLINIC,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1598006975,"WELBORN, CHRISTY, WILLIAMS",921 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 24 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598007023,"CROSS, MELISSA, DEAL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1386184661,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN OBSTETRICS & GYNECOLOGY,510 S SOUTH ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1598007411,"GENTRY, MICHAEL, JAMES",510 S SOUTH ST   MOUNT AIRY NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 63 , 80 , 94 ," $25,212.00 ",,
MEDICAID DIRECT,1043061559,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN OBSTETRICS AND GYNECOLOGY,510 S SOUTH ST   MOUNT AIRY NC,086,Surry,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1598007411,"GENTRY, MICHAEL, JAMES",510 S SOUTH ST   MOUNT AIRY NC,086,Surry,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598007866,"SHAIKH, SOPHIE, KAY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 24 , 34 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598007866,"SHAIKH, SOPHIE, KAY",3116 N DUKE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 32 ,$#,,
MEDICAID DIRECT,1043283591,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD OB GYN ASSOCIATES,101 WILLIAM H JOHNSON ST STE 500 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598007908,"COUGHLIN, ERIC, CLAYTON",144 N RAVENEL ST   FLORENCE SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598007940,"MOON, ANDREW, MARTIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 57 , 92 , 119 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598010803,"GRIMES, LINDA, SIMPSON",1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1790258234,LOWER CAPE FEAR HOSPICE INCORPORATE,LOWER CAPE FEAR LIFECARE,1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598015083,"BALL, CASEY, ELLEN",1414 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 17 ,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598016073,"KIRKPATRICK, SHELBY, MAE",2305 N MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 73 , 142 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598017154,"MCVEY, REBECCA, ANNE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598017154,"MCVEY, REBECCA, ANNE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598017154,"MCVEY, REBECCA, ANNE",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1598017733,STEPPING STONE OF NORTH CAROLINA,~,643 GREENWAY RD STE L BOONE NC,095,Watauga,251S00000X,Agencies,Community/Behavioral Health,,1598017733,STEPPING STONE OF NORTH CAROLINA,643 GREENWAY RD STE L BOONE NC,095,Watauga,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598017758,"MANSFIELD, REBECCA, COX",5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 55 , 55 ," $10,811.13 ",,
MEDICAID DIRECT,1538407036,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WHITEVILLE,5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598017758,"MANSFIELD, REBECCA, COX",5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 21 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598017758,"MANSFIELD, REBECCA, COX",800 JEFFERSON ST STE 116 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 40 , 40 ,$#,,
MEDICAID DIRECT,1538407036,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER WHITEVILLE,5 WHITEVILLE TOWN CTR   WHITEVILLE NC,024,Columbus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598017758,"MANSFIELD, REBECCA, COX",800 JEFFERSON ST STE 116 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 24 , 24 ,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598018723,"COX, ALEXANDRA, CASAT",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598018723,"COX, ALEXANDRA, CASAT",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598018723,"COX, ALEXANDRA, CASAT",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346338159,CAROLINA FAMILY AND URGENT CARE CEN,~,,,Unknown,193400000X,Group,Single Specialty,,1598020430,"NGO MAYEBA, NGONDA'YEBENIT, NZELLE",329 SANFORD DR STE B MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1194393769,FAITH PRIMARY CARE PLUS PLLC,,329 SANFORD DR STE B MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1598020430,"NGO MAYEBA, NGONDA'YEBENIT, NZELLE",329 SANFORD DR STE B MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 123 , 136 ,$#,,
MEDICAID DIRECT,1194393769,FAITH PRIMARY CARE PLUS PLLC,,329 SANFORD DR STE B MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1598020430,"NGO MAYEBA, NGONDA'YEBENIT, NZELLE",329 SANFORD DR STE B MORGANTON NC,012,Burke,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 42 , 57 ,$#,,
MEDICAID DIRECT,1477510659,LINCOLN PEDIATRICS CLINIC PA,LINCOLN PEDIATRICS CLINIC PA,113 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1598021149,"JANARDHANAM, NIRMALA",113 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 78 , 110 , 229 ," $12,058.56 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598021560,"BYRUM, GRAHAM, VANCE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 101 , 129 , 166 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598021560,"BYRUM, GRAHAM, VANCE",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598022089,"MCKIBBEN, MAXIM, JAMES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 21 , 28 , 38 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598022089,"MCKIBBEN, MAXIM, JAMES",1021 MOREHEAD MEDICAL DR STE 6100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 32 , 43 , 73 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598022089,"MCKIBBEN, MAXIM, JAMES",1023 EDGEHILL RD S   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598022394,"FRANKLIN, GARETT, RANDALL",530 NEW WAVERLY PL STE 200 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598022394,"FRANKLIN, GARETT, RANDALL",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598022394,"FRANKLIN, GARETT, RANDALL",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1306321252,DLP MARIA PARHAM PHYSICIAN PRACTICE,,120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1598022733,"TAHILIANI, VARNITA",120 CHARLES ROLLINS RD STE 201 HENDERSON NC,091,Vance,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 112 , 231 , 275 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598022782,"KENNEDY, RHIANNON, MELISSA",2700 S PROVIDENCE RD   WAXHAW NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1598022782,"KENNEDY, RHIANNON, MELISSA",1000 HEALING WAY   MATTHEWS NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598024101,"MANNING, JOHN, DOUGLAS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 74 , 74 , 86 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3315 SPRINGBANK LN STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598025983,"MANVAR, ANKUR, MANSUKHLAL",3315 SPRINGBANK LN STE 202 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3315 SPRINGBANK LN STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598025983,"MANVAR, ANKUR, MANSUKHLAL",3315 SPRINGBANK LN STE 202 CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 56 , 119 , 149 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598025983,"MANVAR, ANKUR, MANSUKHLAL",2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598025983,"MANVAR, ANKUR, MANSUKHLAL",2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 17 , 34 , 58 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3315 SPRINGBANK LN STE 202 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598025983,"MANVAR, ANKUR, MANSUKHLAL",2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598026254,"CALDERON, MELINA, REE",2754 NC HIGHWAY 68 S STE 111 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 25 , 50 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598026254,"CALDERON, MELINA, REE",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 45 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598026551,"DRENNEN, MICHAEL, ELLSWORTH",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598026551,"DRENNEN, MICHAEL, ELLSWORTH",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 18 , 28 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,9735 KINCEY AVE STE 300 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598027252,"LEAS, DANIEL, PAUL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,9735 KINCEY AVE STE 300 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598027252,"LEAS, DANIEL, PAUL",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 30 , 48 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598027252,"LEAS, DANIEL, PAUL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598027252,"LEAS, DANIEL, PAUL",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598027252,"LEAS, DANIEL, PAUL",110 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 64 , 95 , 149 ,$#,,
MEDICAID DIRECT,1922601764,WARE FAMILY MEDICINE PLLC,OLD FORT FAMILY MEDICINE,32 E MAIN ST   OLD FORT NC,059,McDowell,193200000X,Group,Multi-Specialty,,1598027765,"PACE, JESSE, WILLIAM",32 E MAIN ST   OLD FORT NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 70 , 250 , 554 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598029704,"VELASCO, JOHN, PAUL APUN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598029704,"VELASCO, JOHN, PAUL APUN",1534 W D ST   N WILKESBORO NC,097,Wilkes,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1891409322,CENTERWELL SENIORPRIMARYCARENC JVPC,,3901 CAPITAL BLVD STE 113 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598031122,"FULTON, LATOYA, DENISE",2806 W SUGAR CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447964754,DR LAREE JOHNSON PLLC,~,2620 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598032831,"JOY, MELISSA, MAY",5904 SIX FORKS RD STE 101 RALEIGH NC,092,Wake,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 222 , 234 ," 1,118 "," $146,307.28 ",,
MEDICAID DIRECT,1518620665,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH PRIMEDICAL,240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598035263,"PRESSLY, KATI, HAMM",240 HIGHWAY 105 EXT STE 100 BOONE NC,095,Watauga,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1083979082,HIGH COUNTRY COMMUNITY HEALTH,HIGH COUNTRY COMMUNITY HEALTH,448 CRANBERRY ST   NEWLAND NC,006,Avery,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598035263,"PRESSLY, KATI, HAMM",448 CRANBERRY ST   NEWLAND NC,006,Avery,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1598037681,"HUNEYCUTT, ANNA, PEPPER",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164052726,BALLANTYNE EMERGENCY PHYSICIANS PL,,11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598037681,"HUNEYCUTT, ANNA, PEPPER",11516 PROVIDENCE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235728031,STALLINGS EMERGENCY PHYSICIANS PLL,,1000 HEALING WAY   MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1598037681,"HUNEYCUTT, ANNA, PEPPER",1000 HEALING WAY   MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598037681,"HUNEYCUTT, ANNA, PEPPER",600 HOSPITAL DR   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 33 ,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1598037681,"HUNEYCUTT, ANNA, PEPPER",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598043077,JOINT TECHNOLOGY INC,JOINT TECHNOLOGY INC,10440 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598043077,JOINT TECHNOLOGY INC,10440 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 86 , 171 , 272 ," $44,639.44 ",,
MEDICAID DIRECT,1598043077,JOINT TECHNOLOGY INC,JOINT TECHNOLOGY INC,111 E CHARLOTTE AVE   MT HOLLY NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598043077,JOINT TECHNOLOGY INC,111 E CHARLOTTE AVE   MT HOLLY NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1598046609,BARNARDSVILLE VOLUNTEER FIRE DEPART,BARNARDSVILLE VOLUNTEER FIRE DEPARTMENT,100 DILLINGHAM RD   BARNARDSVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport,1598046609,BARNARDSVILLE VOLUNTEER FIRE DEPART,100 DILLINGHAM RD   BARNARDSVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport, 24 , 34 , 58 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598049843,"NATIVIDAD, LANE, KIERSTON",114 E RAILROAD ST   LA GRANGE NC,054,Lenoir,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598049843,"NATIVIDAD, LANE, KIERSTON",327 NC HIGHWAY 55 W   MT OLIVE NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,,,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598049843,"NATIVIDAD, LANE, KIERSTON",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 46 , 44 , 109 ,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598052318,"GUPTA, AJAY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 127 , 370 , 372 ," $21,249.75 ",,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598052318,"GUPTA, AJAY",1000 BLYTHE BLVD CMC ANNEX 1ST FLOOR CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598052318,"GUPTA, AJAY",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598055998,"NEWELL, ASHLEY, CANA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 27 , 112 , 119 ," $21,052.29 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598057317,"WHITACRE, MEREDITH, LAINE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598057317,"WHITACRE, MEREDITH, LAINE",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598057317,"WHITACRE, MEREDITH, LAINE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 23 , 34 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598057986,"RAGON, BRITTANY, KNICK",1100 S TRYON ST STE 1100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1598057986,"RAGON, BRITTANY, KNICK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598057986,"RAGON, BRITTANY, KNICK",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1598058158,"LOFTIS, SERAPH, GRACE KLINE",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1598058158,"LOFTIS, SERAPH, GRACE KLINE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598058497,"KIOK, RICHARD, TE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 50 , 51 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598058497,"KIOK, RICHARD, TE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598059065,"MANSELL, MARSHA NOR, PASCUAL",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1598060105,"HEFFNER, GRACE, MATHIS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 84 , 146 ,$#,,
MEDICAID DIRECT,1598060147,A PRIMARY CHOICE INC,~,2950 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,,1598060147,A PRIMARY CHOICE INC,2950 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 4,055 "," 4,055 "," $263,014.80 ",,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598062879,"BLANKENSHIP, CHAD, ELVIS",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 32 , 103 , 103 ,$#,,
MEDICAID DIRECT,1598067449,AUTISM THERAPEUTIC SERVICES LLC,HEALTHPRO PEDIATRICS LLC - HEALTHPRO HERITAGE,3020 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1598067449,AUTISM THERAPEUTIC SERVICES LLC,3020 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598069734,"HANOPOLE, JENNIFER, PITTS",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 37 , 39 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 27 , 27 , 30 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 74 , 74 , 87 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598069858,"NARRON, JOHN, ARTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598071797,"TURNER, MIRANDA, JOCELYN",147 PEACHTREE LN   ADVANCE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 35 , 53 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598078586,"BRAGANZA, MELANIE, LAURA",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 117 , 119 ,$#,,
MEDICAID DIRECT,1336543495,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,105 YADKIN ST STE 101 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1598079527,"MANGUM, BRIANNA, ONEIL",105 YADKIN ST STE 101 ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 120 , 222 ,$#,,
MEDICAID DIRECT,1336543495,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,193200000X,Group,Multi-Specialty,,1598079527,"MANGUM, BRIANNA, ONEIL",123 PROFESSIONAL PARK DR   LOCUST NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 25 , 42 ,$#,,
MEDICAID DIRECT,1336543495,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,105 YADKIN ST STE 101 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1598079527,"MANGUM, BRIANNA, ONEIL",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598081986,"GIOVACCHINI, CORAL, XANTIA",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598081986,"GIOVACCHINI, CORAL, XANTIA",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598081986,"GIOVACCHINI, CORAL, XANTIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598081986,"GIOVACCHINI, CORAL, XANTIA",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598081986,"GIOVACCHINI, CORAL, XANTIA",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598081986,"GIOVACCHINI, CORAL, XANTIA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 17 , 22 , 54 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1350 RALEIGH RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598082414,"MAUCK, MATTHEW, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 16 , 30 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598082414,"MAUCK, MATTHEW, CHRISTOPHER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598083560,"MCMICKENS, COURTNEY",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598083560,"MCMICKENS, COURTNEY",140 KIMEL PARK DR STE 101 WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1528704418,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CENTER FOR COMMUNITY HEALTH,2600 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598085128,"SHIRLEY, SHELBY, MITCHELL",2600 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 29 , 36 , 39 ,$#,,
MEDICAID DIRECT,1528704418,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CENTER FOR COMMUNITY HEALTH,2600 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598085128,"SHIRLEY, SHELBY, MITCHELL",8311 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1528704418,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CENTER FOR COMMUNITY HEALTH,2600 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598085128,"SHIRLEY, SHELBY, MITCHELL",8311 BANDFORD WAY STE 1 RALEIGH NC,092,Wake,363LC1500X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Community Health,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598085755,"BOIES, BRIAN, TAYLOR",1131 N CHURCH ST STE C GREENSBORO NC,041,Guilford,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598088635,"KELLERMEYER, ANGELA, MARIE",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 299 , 312 ,$#,,
MEDICAID DIRECT,1003956079,BOWEN PRIMARY AND URGENT CARE,BOWEN PRIMARY AND URGENT CARE,116 3RD ST NW STE 102 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598088635,"KELLERMEYER, ANGELA, MARIE",116 3RD ST NW STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 548 , 556 ," $13,927.55 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598089377,"COBB, BENJAMIN, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 73 , 73 , 77 ," $11,203.55 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1598089377,"COBB, BENJAMIN, GEORGE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598089567,"WHITE, MICHELLE, JOETTE",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 30 , 31 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598089997,"GONZALES, NICOLE, ALICIA",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 14 , 20 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598089997,"GONZALES, NICOLE, ALICIA",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 77 , 136 , 186 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598089997,"GONZALES, NICOLE, ALICIA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598089997,"GONZALES, NICOLE, ALICIA",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598089997,"GONZALES, NICOLE, ALICIA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1598093007,TARBORO ENDOSCOPY CENTER LLC,TARBORO ENDOSCOPY CENTER LLC,201 CLINIC DR   TARBORO NC,033,Edgecombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1598093007,TARBORO ENDOSCOPY CENTER LLC,201 CLINIC DR   TARBORO NC,033,Edgecombe,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,#,#,$#,,
MEDICAID DIRECT,1548401789,GATEWAY ANESTHESIA,GATEWAY ANESTHESIA LLC,1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598096711,"SHERRIN, SHERRIE, LYNN",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1598097685,"KELLER, MICHAEL, TYRRELL",546 WINSTON RD   JONESVILLE NC,099,Yadkin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 29 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1598097685,"KELLER, MICHAEL, TYRRELL",1908 CAUDLE DR STE 103 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 25 ,$#,,
MEDICAID DIRECT,1275812273,HUGH CHATHAM MEMORIAL HOSPITAL,~,400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1598097685,"KELLER, MICHAEL, TYRRELL",400 JOHNSON RIDGE MEDICAL PARK   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 72 , 140 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598098329,"COOPER, JESSICA, KATE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 82 , 104 , 116 ,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1598099376,"SRINIVASAN, JANARDHAN",336 DEERFIELD RD   BOONE NC,095,Watauga,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 20 , 26 , 39 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598099483,"BLANTON, SHANNON, MICHEAL",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598100729,"ALSTATT, KELLEN, DEAN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1598100729,"ALSTATT, KELLEN, DEAN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1598100729,"ALSTATT, KELLEN, DEAN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 25 , 28 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598100729,"ALSTATT, KELLEN, DEAN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 56 , 66 ,$#,,
MEDICAID DIRECT,1972274447,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH TWIN CITY PEDIATRICS,2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598101727,"SMITH, EMILY, LEROY",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598101727,"SMITH, EMILY, LEROY",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 37 , 96 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598101743,"GYURJYAN, HARUTYUN, VARDAN",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1598101750,"ABAROA-SALVATIERRA, ANA, ROSAURA",137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 113 , 266 ,$#,,
MEDICAID DIRECT,1225524598,GEM CAPITAL PHYSICIANS PLLC,,100 HOSPITAL DR   LOUISBURG NC,035,Franklin,193200000X,Group,Multi-Specialty,,1598103350,"BENSON, RICHARD, THOMAS",100 FAIRVIEW RD   LOUISBURG NC,035,Franklin,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1598103350,"BENSON, RICHARD, THOMAS",566 RUIN CREEK RD   HENDERSON NC,091,Vance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 67 , 107 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598103368,"HORTON, MEGAN, LEANN",7130 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 55 , 92 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598103368,"HORTON, MEGAN, LEANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598103368,"HORTON, MEGAN, LEANN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598103368,"HORTON, MEGAN, LEANN",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598103673,"YOUNIS, MOOTAZ, SUBHI SAID",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 VETERANS PKWY   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598103673,"YOUNIS, MOOTAZ, SUBHI SAID",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598103673,"YOUNIS, MOOTAZ, SUBHI SAID",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 35 , 62 , 66 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598103673,"YOUNIS, MOOTAZ, SUBHI SAID",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 41 , 48 , 51 ,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1598103673,"YOUNIS, MOOTAZ, SUBHI SAID",336 DEERFIELD RD   BOONE NC,095,Watauga,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1598106668,"GREEN, THOMAS, MEARES",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 94 , 240 , 441 ," $10,874.96 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598106668,"GREEN, THOMAS, MEARES",2808 MCLAMB PL   GOLDSBORO NC,096,Wayne,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 21 , 29 ,$#,,
MEDICAID DIRECT,1598106759,BLUE RIDGE HOME CARE,,222 THOMPSON ST STE 10 HENDERSONVILLE NC,045,Henderson,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598106759,BLUE RIDGE HOME CARE,222 THOMPSON ST STE 10 HENDERSONVILLE NC,045,Henderson,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 44 , 211 , 449 ,$#,,
MEDICAID DIRECT,1366499733,PATHOLOGY SCIENCES MEDICAL GROUP PC,PATHOLOGY SCIENCES MEDICAL GROUP PC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598108235,"LI, LI",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598108623,"POPLIN, WHITNEY, LYLES",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598108623,"POPLIN, WHITNEY, LYLES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1750718128,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC HOSPITALISTS,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598108623,"POPLIN, WHITNEY, LYLES",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care", 15 , 37 , 37 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598108672,"TROTTMAN, PAUL, ALAN",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598108672,"TROTTMAN, PAUL, ALAN",2076 NC HIGHWAY 42 W STE 210 CLAYTON NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,131 E MARKET ST   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598108672,"TROTTMAN, PAUL, ALAN",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 28 , 37 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598108672,"TROTTMAN, PAUL, ALAN",131 E MARKET ST   SMITHFIELD NC,051,Johnston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598109381,"GARBEE, COURTNEY, FLEMING",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598109381,"GARBEE, COURTNEY, FLEMING",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 19 , 22 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1598109381,"GARBEE, COURTNEY, FLEMING",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598109381,"GARBEE, COURTNEY, FLEMING",2305 CANTERWOOD DR   WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 69 , 69 , 73 ,$#,,
MEDICAID DIRECT,1073003752,GOODEN MOBILE POD NC PLLC,,311 MCFADYEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598109902,"NEALAND, LANA",23 ALPINE WAY   SWANNANOA NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598110298,"MULLIKIN, TREY, CARLTON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 25 , 81 , 123 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598110298,"MULLIKIN, TREY, CARLTON",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 46 , 77 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598110298,"MULLIKIN, TREY, CARLTON",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598110298,"MULLIKIN, TREY, CARLTON",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1972266237,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - SHALLOTTE,301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1598110546,"ROGERS, CLAYTON, LEA",301 S WILLIS DR STE 100 SHALLOTTE NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 60 , 102 , 284 ," $13,326.79 ",,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598111270,"RICHBOURG, WILLIAM, JAMES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 150 , 150 ,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598111270,"RICHBOURG, WILLIAM, JAMES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,101 HEART DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598111270,"RICHBOURG, WILLIAM, JAMES",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598111270,"RICHBOURG, WILLIAM, JAMES",101 HEART DR   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598111270,"RICHBOURG, WILLIAM, JAMES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 79 , 89 , 153 ,$#,,
MEDICAID DIRECT,1801237466,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ENDOCRINOLOGY,4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598113565,"STEINMAN, JEREMY, ROSS",4525 CAMERON VALLEY PKWY STE 4100 CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 100 , 161 , 311 ," $10,363.34 ",,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598116469,"GRAVELY, TREVOR, STEVEN",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598117327,"HILL, VINCENT, JODELL",611 N LINDSAY ST STE 100&102 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598117327,"HILL, VINCENT, JODELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 79 , 119 , 287 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598118408,"MUNOZ GONZALEZ, EZEQUIEL, DAVID",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598118499,"LAWRENCE, ERIN, BRAY",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598118499,"LAWRENCE, ERIN, BRAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 115 , 138 , 152 ,$#,,
MEDICAID DIRECT,1497986509,DUPLIN GENERAL HOSPITAL INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193400000X,Group,Single Specialty,,1598119133,"ODELL, KATHERINE, LILLEY",401 N MAIN ST   KENANSVILLE NC,031,Duplin,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1194703884,EAST CAROLINA HEALTH HERITAGE INC,~,111 HOSPITAL DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1598119133,"ODELL, KATHERINE, LILLEY",111 HOSPITAL DRIVE   TARBORO NC,033,Edgecombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1700864980,EAST CAROLINA HEALTH CHOWAN INC,CHOWAN HOSPITAL,211 VIRGINIA RD   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1598119133,"ODELL, KATHERINE, LILLEY",211 VIRGINIA RD   EDENTON NC,021,Chowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598119133,"ODELL, KATHERINE, LILLEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598119133,"ODELL, KATHERINE, LILLEY",2080 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598119133,"ODELL, KATHERINE, LILLEY",2080 W ARLINGTON BLVD STE B GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598119851,"FOXWORTH, LISA, GOODING",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598119851,"FOXWORTH, LISA, GOODING",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598119851,"FOXWORTH, LISA, GOODING",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780974253,SUPPORT INCORPORATED,SUPPORT INCORPORATED,708 S CHESTNUT ST   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598120438,"MATTFELD, PETER, CHRISTIAN",708 S CHESTNUT ST   GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598120941,"SMITH, WHITNEY, HARRISON",400 ATHLETIC CLUB BLVD UNIT 101 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 24 , 61 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",179 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",3836 CORNING PL   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",9121 SAM FURR RD STE 108 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",13129 S TRYON ST STE 120 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",9600 E INDEPENDENCE BLVD STE B MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 23 , 32 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",2452 FAIRLAWN CT   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,910 E INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1598121311,"BRIGGS, ZACKRY, SCOTT",910 E INNES ST   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598121493,"GUIDRY, XENEQUIA, MONIQUE",420 N CENTER ST   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598121493,"GUIDRY, XENEQUIA, MONIQUE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598123457,"HEDGES, JEFFREY, TODD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598128050,"PALMER, REBECCA, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 54 , 54 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1598128597,"DANG, BIM, THUY DUNG NGOC",433 MCALISTER RD LINCOLN LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598128597,"DANG, BIM, THUY DUNG NGOC",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 74 , 72 , 72 ,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598128597,"DANG, BIM, THUY DUNG NGOC",600 HOSPITAL DR   MONROE NC,090,Union,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598129108,"TESTA, REBEKAH, LEIGH",4000 COLISEUM DR STE 445 HAMPTON VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598129835,"CHEN, MELISSA, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 26 , 60 , 63 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1598130346,"HAMLIN, BRITTANY, LEE",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 90 , 91 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,345 MANOR RD   MARS HILL NC,057,Madison,193200000X,Group,Multi-Specialty,,1598130346,"HAMLIN, BRITTANY, LEE",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598130346,"HAMLIN, BRITTANY, LEE",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 38 , 155 , 158 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,345 MANOR RD   MARS HILL NC,057,Madison,193200000X,Group,Multi-Specialty,,1598130346,"HAMLIN, BRITTANY, LEE",345 MANOR RD   MARS HILL NC,057,Madison,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 52 , 53 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598133365,"LINDLEY, KRYSTA, MARIE",2608 ERWIN RD STE 200 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 59 , 80 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598136905,"HAHNE, KATHERINE, NADINE",1333 S DICKINSON DR UNIT 200 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598136905,"HAHNE, KATHERINE, NADINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 67 , 68 ,$#,,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,8509 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,251S00000X,Agencies,Community/Behavioral Health,,1598138778,"FROHRIEP, EMILY, ROSE",8509 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 15 , 18 ,$#,,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1598138778,"FROHRIEP, EMILY, ROSE",8509 CROWN CRESCENT CT   CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#,,,$#,,
MEDICAID DIRECT,1790331841,ABLE KIDS SERVICES LLC,,215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,251S00000X,Agencies,Community/Behavioral Health,,1598138778,"FROHRIEP, EMILY, ROSE",215 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#, 50 , 58 ," $49,745.22 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598141921,"BERSCH, KEITH, THOMAS",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598141921,"BERSCH, KEITH, THOMAS",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598141921,"BERSCH, KEITH, THOMAS",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598141921,"BERSCH, KEITH, THOMAS",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1982364469,CHMA OF NC LLC,,6047 TYVOLA GLEN CIR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598142648,"TABRON, LAVONDA, MARIE",6047 TYVOLA GLEN CIR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 63 , 177 , 235 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,3610 MATTHEWS MINT HILL RD   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598142648,"TABRON, LAVONDA, MARIE",6047 TYVOLA GLEN CIR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669701306,DRX HIGH POINT PLLC,DOCTORS EXPRESS,2305 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598144248,"HAHNE, MITCHELL, ALAN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 13 ,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598146177,"JOHNSON, TIY, CHEREIGNA",40 AUTUMN FERN TRL   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548495914,KIDZCARE PEDIATRICS PC,~,3115 BORDEAUX PARK DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598146177,"JOHNSON, TIY, CHEREIGNA",3115 BORDEAUX PARK DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 32 , 70 ,$#,,
MEDICAID DIRECT,1548495914,KIDZCARE PEDIATRICS PC,~,3115 BORDEAUX PARK DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598146177,"JOHNSON, TIY, CHEREIGNA",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679529051,KIDZCARE PEDIATRICS PC,~,3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598146177,"JOHNSON, TIY, CHEREIGNA",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 24 , 72 ,$#,,
MEDICAID DIRECT,1861627226,KIDZCARE PEDIATRICS PC,~,5617 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598146177,"JOHNSON, TIY, CHEREIGNA",3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699311563,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DERMATOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598146870,"DUNN, SARAH, NICHOLS",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 15 , 19 , 28 ,$#,,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598146870,"DUNN, SARAH, NICHOLS",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1689750663,ADVANTAGE BEHAVIORAL HEALTHCARE INC,~,732 DAVIS AVE   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1598147142,"EASON, ELIZABETH, ASHLEY",732 DAVIS AVE   WHITEVILLE NC,024,Columbus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1598147217,"DOWNES, NICKI, RENEE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558776997,ONSLOW AMBULATORY SERVICES INC,ONSLOW SURGICAL CLINIC,255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1598147217,"DOWNES, NICKI, RENEE",255 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 27 , 31 ,$#,,
MEDICAID DIRECT,1598149635,INGLES MARKETS INC,INGLES PHARMACY 134,1572 SAND HILL RD   CANDLER NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1598149635,INGLES MARKETS INC,1572 SAND HILL RD   CANDLER NC,011,Buncombe,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1831789817,NBK ENTERPRISES LLC,MARION MEDICAL CLINIC,"6 E. MEDICAL CT, STE 1   MARION NC",059,McDowell,193400000X,Group,Single Specialty,,1598149775,"BANNER, KELLI, HALL",61 LOGAN ST   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831789817,NBK ENTERPRISES LLC,MARION MEDICAL CLINIC,61 LOGAN ST   MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1598149775,"BANNER, KELLI, HALL",61 LOGAN ST   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 17 , 42 ,$#,,
MEDICAID DIRECT,1114034121,HOSPICE OF WAKE COUNTY INC,TRANSITIONS PALLIATIVECARE,250 HOSPICE CIR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598150054,"KETNER, ADAM, ROSS",250 HOSPICE CIR   RALEIGH NC,092,Wake,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 15 , 73 , 76 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598151177,"KELLY, ALLIE",2001 VAIL AVE STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 36 , 70 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598151458,"BELL, ALLISON, NICOLE MANKUS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1659695781,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598151458,"BELL, ALLISON, NICOLE MANKUS",16455 STATESVILLE RD STE 480 HUNTERSVILLE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598151458,"BELL, ALLISON, NICOLE MANKUS",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598151458,"BELL, ALLISON, NICOLE MANKUS",1901 SOUTH BLVD   CHARLOTTE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598151458,"BELL, ALLISON, NICOLE MANKUS",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598151581,"PATEL, NIKESH, ANILKUMAR",4525 CAMERON VALLEY PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1699311563,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DERMATOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598151581,"PATEL, NIKESH, ANILKUMAR",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 59 , 64 , 73 ,$#,,
MEDICAID DIRECT,1538975636,ATRIUM HEALTH SPECIALTY NETWORK INC,ATRIUM HEALTH DERMATOLOGY,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598151581,"PATEL, NIKESH, ANILKUMAR",10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1699311563,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DERMATOLOGY,10650 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598151581,"PATEL, NIKESH, ANILKUMAR",10650 PARK RD STE 3000 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1699311563,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DERMATOLOGY,10650 PARK RD STE 330 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598151581,"PATEL, NIKESH, ANILKUMAR",10650 PARK RD STE 3000 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598151763,"GIGLIOTTI, ADAM, RICHARD",6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 42 , 47 , 63 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,400 E BROOKLYN VILLAGE AVE STE A1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598151763,"GIGLIOTTI, ADAM, RICHARD",400 E BROOKLYN VILLAGE AVE STE A1 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598151763,"GIGLIOTTI, ADAM, RICHARD",400 E BROOKLYN VILLAGE AVE STE A1 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 53 , 81 , 117 ,$#,,
MEDICAID DIRECT,1053175299,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH LEVINE CHILDRENS PEDIATRICS NORTHWE,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598151862,"DEWEESE, DAVID, MATTHEW",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1336296698,NORTHWEST PEDIATRICS INC,~,4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598151862,"DEWEESE, DAVID, MATTHEW",4529 JESSUP GROVE RD   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922013457,CALDWELL MEMORIAL HOSPITAL,MULBERRY PEDIATRICS,906 COLLEGE AVE SW STE C LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1598152175,"DARNELL, ELIZABETH, PAIGE",906 COLLEGE AVE SW STE C LENOIR NC,014,Caldwell,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 59 , 116 , 294 ," $10,467.82 ",,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598152886,"PIANTADOSI, YVETTE, JOSEPHINE",217 GLENSFORD DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144279670,MATRIX OCCUPATIONAL HEALTH INC,NEXTCARE URGENT CARE,1110 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598152886,"PIANTADOSI, YVETTE, JOSEPHINE",1110 KILDAIRE FARM RD   CARY NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598153488,"GRAHAM, MEGHAN, REBEKAH",621 MICAVILLE LOOP STE 600 BURNSVILLE NC,100,Yancey,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1831799667,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BURNSVILLE HEALTH CENTER,71 BLUE RIDGE LN   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598153488,"GRAHAM, MEGHAN, REBEKAH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598153488,"GRAHAM, MEGHAN, REBEKAH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598153488,"GRAHAM, MEGHAN, REBEKAH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598153488,"GRAHAM, MEGHAN, REBEKAH",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1598154098,THERAPY SMARTS INC,,1920 E NC HIGHWAY 54 STE 240 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598154098,THERAPY SMARTS INC,1920 E NC HIGHWAY 54 STE 240 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,, 113 ," 1,044 "," 1,317 "," $108,565.14 ",,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,930 3RD ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598154387,"SCHAIBLE, BURK, NASH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1598154387,"SCHAIBLE, BURK, NASH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,930 3RD ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598154387,"SCHAIBLE, BURK, NASH",930 3RD ST STE 200 GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 42 , 53 , 84 ,$#,,
MEDICAID DIRECT,1891351847,THE MOSES H CONE MEMORIAL HOSPITAL,CENTER FOR MATERNAL FETAL MEDICINE,618 S MAIN ST   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1598154387,"SCHAIBLE, BURK, NASH",930 3RD ST STE 200 GREENSBORO NC,041,Guilford,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 12 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1598154627,"BEAM, SARA, HARMON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598155350,"SEYMOUR, RYAN, MATTHEW",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598155350,"SEYMOUR, RYAN, MATTHEW",300 W 27TH ST   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 17 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 18 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",6715 MCCRIMMON PKWY STE 205A CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073009825,MCPC 8 LLC,~,2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",2919 BEECHTREE DR STE 1100 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1598155673,"SANDERSON, KATELYN, HOUMARD",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598158974,"JOSEY, LADONNA, MONIQUE",601 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 95 , 95 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598165938,"MURRILL WILLIAMS, SAMANTHA, ANN",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 24 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598165938,"MURRILL WILLIAMS, SAMANTHA, ANN",1123 N CHURCH ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,3711 ELMSLEY ST STE 102 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598165938,"MURRILL WILLIAMS, SAMANTHA, ANN",3711 ELMSLEY ST STE 102 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1922193622,WHITE OAK FAMILY PHYSICIANS PA,WHITE OAK URGENT CARE,197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1598165938,"MURRILL WILLIAMS, SAMANTHA, ANN",197 NC HIGHWAY 42 N STE B ASHEBORO NC,076,Randolph,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 29 , 58 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598167256,"LEAKE, JENNIFER, LOUISE",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1598167256,"LEAKE, JENNIFER, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598167256,"LEAKE, JENNIFER, LOUISE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 38 , 38 ,$#,,
MEDICAID DIRECT,1598168346,EXPRESS COMMUNICATION THERAPY PLLC,EXPRESS COMMUNICATION THERAPY,836 W LEXINGTON AVE   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598168346,EXPRESS COMMUNICATION THERAPY PLLC,836 W LEXINGTON AVE   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,, 42 , 154 , 155 ," $10,814.15 ",,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 NC HIGHWAY 42 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1598168445,"BLACK, CAMERON, CONRAD",5638 NC HIGHWAY 42 W STE 207 GARNER NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 NC HIGHWAY 42 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1598168445,"BLACK, CAMERON, CONRAD",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1720169220,DR ALAN L BYRD ASSOCIATES OF ANGIER,DR ALAN L BYRD & ASSOCIATES OF ANGIER,8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,193200000X,Group,Multi-Specialty,,1598168445,"BLACK, CAMERON, CONRAD",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 13 ,$#,,
MEDICAID DIRECT,1952354458,EYECARECENTER OD PA,EYECARE CENTER,4170 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598168445,"BLACK, CAMERON, CONRAD",8313 S NC 55 HWY   WILLOW SPRING NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1912995630,THE PURCELL CLINIC PA,THE PURCELL CLINIC PA,125 BILTMORE DR STE 2 ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1598170706,"JIMENEZ, ELAINE, GONZALEZ",125 BILTMORE DR STE 2 ROCKINGHAM NC,077,Richmond,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1912995630,THE PURCELL CLINIC PA,THE PURCELL CLINIC PA,418 S KING ST   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1598170706,"JIMENEZ, ELAINE, GONZALEZ",418 S KING ST   LAURINBURG NC,083,Scotland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 112 , 162 , 399 ," $21,744.67 ",,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1598170797,"SEAGROVE-GUFFEY, MAIGHAN, ANNE",617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1598170797,"SEAGROVE-GUFFEY, MAIGHAN, ANNE",617 6TH AVE W   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598175382,"GEORGE, DAVID, MCNEASE",1918 RANDOLPH RD STE 670 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 15 , 24 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598175382,"GEORGE, DAVID, MCNEASE",14215 BALLANTYNE CORPORATE PL STE 110 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598177446,"JONES, KARRA, ANNE",2351 ERWIN RD   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598177446,"JONES, KARRA, ANNE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598177818,"BOURKE, PATRICK, JOSEPH",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598178030,"GILLONE, ALEX",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0300X,Dental Providers,Dentist,Periodontics,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1871738195,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598178071,"CALHOUN, VIRGINIA, GRAE",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598178303,"WILLIAMS, JEFFREY, LEE",2909 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 21 , 31 , 44 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598178303,"WILLIAMS, JEFFREY, LEE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598180440,"DIAZ PEREZ, JUANA",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 75 , 95 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1598180440,"DIAZ PEREZ, JUANA",29 W FRENCH BROAD ST   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598183279,"PALMA, ATILIO, EDGARDO",1814 WESTCHESTER DR STE 401 HIGH POINT NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598184509,"WEAVER, ANNE, COPELAND",30 DUKE MEDICINE CLINIC 1A   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598184509,"WEAVER, ANNE, COPELAND",30 DUKE MEDICINE CLINIC 1A   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598184509,"WEAVER, ANNE, COPELAND",30 DUKE MEDICINE CLINIC 1A   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598184509,"WEAVER, ANNE, COPELAND",30 DUKE MEDICINE CLINIC 1A   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598185787,"CROWDER, VIRGINIA, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 25 , 26 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598187684,"SHEA, JILL, MARIE",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 22 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1598187684,"SHEA, JILL, MARIE",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598190324,"SCHERY, ALEXANDRA",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 37 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598190894,"CALKIN, VALERIE, ANN",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598190894,"CALKIN, VALERIE, ANN",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598190894,"CALKIN, VALERIE, ANN",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598191819,"FLANNERY, ALISHA, ANN",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598191819,"FLANNERY, ALISHA, ANN",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598191819,"FLANNERY, ALISHA, ANN",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598191819,"FLANNERY, ALISHA, ANN",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598193583,"OMMUNDSEN, MICHAEL, STANLEY",3708 FORESTVIEW RD STE 101 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 26 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 41 , 40 , 46 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598194847,"SANGHANI, RAVI, RAMNIK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 17 , 17 , 20 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1598195182,"FROST, NICOLE, LYNETTE",3610 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598195232,"ROMINIECKI, HELEN, RAMSEY",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598195232,"ROMINIECKI, HELEN, RAMSEY",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1598197683,"ELLSTROM, ALISSA, KATHLEEN",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 143 , 212 , 363 ," $52,739.43 ",,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598197832,"MEHTA, DHWANI, SATISH",335 PENNY LN   CONCORD NC,013,Cabarrus,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 20 , 27 , 49 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,7780 BRIER CREEK PKWY STE 330 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598200230,"SCHMITTEL, LYDIA, ANN",120 CONNER DR STE 101 CHAPEL HILL NC,068,Orange,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598200321,"OCONNOR, BRENDAN, ANDREW",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598200321,"OCONNOR, BRENDAN, ANDREW",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1598203424,"IVANOFF, ERIN, KRISTINA",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 11 , 67 , 69 ,$#,,
MEDICAID DIRECT,1598205353,GUARDIAN HOME HEALTHCARE,~,8408 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1598205353,GUARDIAN HOME HEALTHCARE,8408 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 3,093 "," 3,148 "," $475,839.96 ",,
MEDICAID DIRECT,1598205353,GUARDIAN HOME HEALTHCARE,~,8408 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1598205353,GUARDIAN HOME HEALTHCARE,8408 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#, 808 , 820 ," $485,326.92 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598206914,"CHENG, KEVIN, LEO",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598206914,"CHENG, KEVIN, LEO",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 13 , 35 , 40 ,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598207730,"DESAI, ANKITA, YOGESH",101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 41 , 71 ,$#,,
MEDICAID DIRECT,1588847420,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE NORTH CHARLOTTE INTERNA,101 E WT HARRIS BLVD STE 5401 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598207730,"DESAI, ANKITA, YOGESH",101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598208050,"THOMPSON, LANE, PURSER",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 83 , 89 ,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598208282,"IROHA, GRETCHEN, SITCHON",2503 E LYON STATION RD   CREEDMOOR NC,039,Granville,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598208282,"IROHA, GRETCHEN, SITCHON",7021 HARPS MILL RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 36 ,$#,,
MEDICAID DIRECT,1215596135,PAIN MANAGEMENT PLUS PLLC,,249 OAK ST   FOREST CITY NC,081,Rutherford,193400000X,Group,Single Specialty,,1598209553,"COUCH, SHERI, HYDER",249 OAK ST   FOREST CITY NC,081,Rutherford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 202 ," 1,506 "," 2,223 "," $42,004.86 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598210064,"MOHAMMAD, BUDOUR, NASRI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598210064,"MOHAMMAD, BUDOUR, NASRI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598211542,"NICKEL, CHRISTINA, ROSE",3643 N ROXBORO ST   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1053351593,EMERGENCY COVERAGE SERVICES PC,EMERGENCY COVERAGE SERVICES PC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598212482,"DUBOCQ BERNSTEIN, ANDREA, MOORE",615 RIDGE RD   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598212482,"DUBOCQ BERNSTEIN, ANDREA, MOORE",1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598212847,"ACHEAMPONG, AFUA, BOATEMAA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 14 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598212847,"ACHEAMPONG, AFUA, BOATEMAA",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598212847,"ACHEAMPONG, AFUA, BOATEMAA",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 47 , 63 ,$#,,
MEDICAID DIRECT,1346264835,NOVANT HEALTH MEDICAL GROUP LLC,~,6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598212847,"ACHEAMPONG, AFUA, BOATEMAA",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598213548,"LINEBERRY, SHERI, DEDEEN",606 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 31 , 35 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700079225,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",332 N TRADE ST STE 1100 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",7810 PROVIDENCE RD STE 102 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023397874,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,420 PARK ST   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",420 PARK ST   BELMONT NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043819535,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",9623 REDSTONE DR STE 300 INDIAN LAND SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598214660,"BEAUDELAIRE, SARAH, ANNE",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285350439,ERIC WEED DDS PLLC,STANLEY SMILES,510 S HIGHWAY 27   STANLEY NC,036,Gaston,193400000X,Group,Single Specialty,,1598219792,"WEED, ERIC, CRANDALL",510 S HIGHWAY 27   STANLEY NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 229 , 402 ," 1,595 "," $63,779.34 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598220907,"CRICHTON, MARY, RUDD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598220907,"CRICHTON, MARY, RUDD",257 HOSPITAL DR NE STE 101 BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598220907,"CRICHTON, MARY, RUDD",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598223281,UWHARRIE GREEN SCHOOL INC,UWHARRIE CHARTER ACADEMY,5154 US HIGHWAY 220 BUS S   ASHEBORO NC,076,Randolph,251300000X,Agencies,Local Education Agency (LEA),,1598223281,UWHARRIE GREEN SCHOOL INC,5154 US HIGHWAY 220 BUS S   ASHEBORO NC,076,Randolph,251300000X,Agencies,Local Education Agency (LEA),, 17 , 150 , 150 ,$#,,
MEDICAID DIRECT,1780244376,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA AT JENKINS ELEMENTARY,3750 N CENTER ST   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598225930,"WALLACE, LISA, BUCKNER",366 4TH ST NW   HICKORY NC,018,Catawba,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 37 , 37 ," $11,852.21 ",,
MEDICAID DIRECT,1700446663,GASTON FAMILY HEALTH SERVICES INC,~,366 4TH ST NW   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598225930,"WALLACE, LISA, BUCKNER",366 4TH ST NW   HICKORY NC,018,Catawba,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598226029,"GRAY, ALICIA, PAULETTE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598226458,"MOSELEY, CONNOR, ANDERS",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 16 , 34 , 34 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598226458,"MOSELEY, CONNOR, ANDERS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 11 , 33 , 33 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598226458,"MOSELEY, CONNOR, ANDERS",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1538784509,REX HOSPITAL INC,UNC URGENT CARE AT MIDTOWN RALEIGH,601 E SIX FORKS RD STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598228488,"DEMEULENAERE, KATHERINE, ROSA",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316562374,REX HOSPITAL INC,UNC URGENT CARE AT FUQUAY VARINA,1617 N MAIN ST STE 101 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1598228488,"DEMEULENAERE, KATHERINE, ROSA",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 17 , 30 ,$#,,
MEDICAID DIRECT,1821551920,REX HOSPITAL INC,UNC URGENT CARE AT GARNER,1165 US HWY 70 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1598228488,"DEMEULENAERE, KATHERINE, ROSA",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1245799782,REX HOSPITAL INC,UNC URGENT CARE AT PARK WEST VILLAGE,1104 MARKET CENTER DR # 130 MORRISVILLE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598228488,"DEMEULENAERE, KATHERINE, ROSA",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134404437,REX HOSPITAL INC,UNC URGENT CARE AT HOLLY SPRINGS,781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1598228488,"DEMEULENAERE, KATHERINE, ROSA",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1649412867,REX HOSPITAL INC,UNC URGENT CARE AT KNIGHTDALE,6602 KNIGHTDALE BLVD STE 102 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598228488,"DEMEULENAERE, KATHERINE, ROSA",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023477866,REX HOSPITAL INC,UNC URGENT CARE AT RALEIGH,3050 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598228488,"DEMEULENAERE, KATHERINE, ROSA",781 AVENT FERRY RD STE 102 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235680463,RDMG ASSOCIATES PA,,1 SAINT DUNSTANS RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598229676,"DAVIS, WILLIAM, HAYDEN",1 SAINT DUNSTANS RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 72 , 120 ,$#,,
MEDICAID DIRECT,1598232563,NASH OPCO LLC,THE LANDINGS OF ROCKY MOUNT MILLS,1365 RIVER DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598232563,NASH OPCO LLC,1365 RIVER DR   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 21 ," 3,259 "," 3,260 "," $300,848.34 ",,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598238644,"OXENDINE, COURTNEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 23 ,$#,,
MEDICAID DIRECT,1316486640,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PALLIATIVE CARE,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598238644,"OXENDINE, COURTNEY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 57 , 141 , 161 ,$#,,
MEDICAID DIRECT,1689445520,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY LEGACY PEDIATRICS,556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598239436,"PARKER, CHEYANNE, TRINITY",556 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 30 , 64 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598245771,"LUSK, MORGAN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1598245771,"LUSK, MORGAN, TYLER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598245771,"LUSK, MORGAN, TYLER",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1598245771,"LUSK, MORGAN, TYLER",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598245771,"LUSK, MORGAN, TYLER",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1598245771,"LUSK, MORGAN, TYLER",120 HEALTHPLEX WAY   APEX NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1598245771,"LUSK, MORGAN, TYLER",400 US 70 HWY E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598245771,"LUSK, MORGAN, TYLER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598245771,"LUSK, MORGAN, TYLER",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1285945600,REX HOSPITAL INC,REX CANCER SPECIALTY CENTER,2901 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598249583,"LEWIS, THOMAS, VERNON",2901 BLUE RIDGE RD STE 102 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1598250938,"TAJEDDINI, KARL, ASHKAN",,530 NEW WAVERLY PL STE 302 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1598250938,"TAJEDDINI, KARL, ASHKAN",530 NEW WAVERLY PL STE 302 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 345 , 571 ," 1,665 "," $80,439.64 ",,
MEDICAID DIRECT,1255165205,SAL C ZAMMITTI DMD MMSC PLLC AND MA,NC TOOTH DOCS- HARRISBURG KIDS DENTISTRY,4079 HARRIS SQUARE DR   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598252447,"SETTLE, AMANDA, MELISSA",4079 HARRIS SQUARE DR   HARRISBURG NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 249 , 283 ," 1,110 "," $36,104.00 ",,
MEDICAID DIRECT,1740904341,SAL C ZAMMITTI DMD MMSC PLLC AND MA,NC TOOTH DOCS HARRISBURG KIDS DENTISTRY,4079 HARRIS SQUARE DR   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598252447,"SETTLE, AMANDA, MELISSA",4079 HARRIS SQUARE DR   HARRISBURG NC,013,Cabarrus,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 513 , 703 ," 3,089 "," $98,725.05 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598252447,"SETTLE, AMANDA, MELISSA",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 61 , 75 , 155 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598252447,"SETTLE, AMANDA, MELISSA",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,,,$#,,
MEDICAID DIRECT,1255165205,SAL C ZAMMITTI DMD MMSC PLLC AND MA,NC TOOTH DOCS- HARRISBURG KIDS DENTISTRY,4079 HARRIS SQUARE DR   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598252447,"SETTLE, AMANDA, MELISSA",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1740904341,SAL C ZAMMITTI DMD MMSC PLLC AND MA,NC TOOTH DOCS HARRISBURG KIDS DENTISTRY,4079 HARRIS SQUARE DR   HARRISBURG NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598252447,"SETTLE, AMANDA, MELISSA",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1205590510,SAL C ZAMMITTI DMD MMSC PLLC AND MA,HUNTERSVILLE SMILES,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598252447,"SETTLE, AMANDA, MELISSA",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 1,458 "," 2,153 "," 9,362 "," $347,757.38 ",,
MEDICAID DIRECT,1538803267,SAL C ZAMMITTI DMD MMSC PLLC AND MA,NC TOOTH DOCS- HUNTERSVILLE KIDS DENTISTRY,4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598252447,"SETTLE, AMANDA, MELISSA",4605 HYLAS LN STE B HUNTERSVILLE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 852 , 979 ," 4,213 "," $144,218.70 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598253221,"WILLIAMS, DE-VAUGHN, AMONTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 68 , 80 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598253221,"WILLIAMS, DE-VAUGHN, AMONTE",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 64 , 124 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598253221,"WILLIAMS, DE-VAUGHN, AMONTE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 23 , 46 ,$#,,
MEDICAID DIRECT,1922422294,UNC PHYSICIANS NETWORK LLC,~,2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1598253254,"IGLESIA, DELFIN, ABANO",2800 OLD NC 86 STE 105 HILLSBOROUGH NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598253528,"NEITZKE, DANIEL, JOSEPH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598253528,"NEITZKE, DANIEL, JOSEPH",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 19 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598253528,"NEITZKE, DANIEL, JOSEPH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598253734,RURAL HEALTH GROUP INC,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 128 , 206 , 206 ," $17,034.74 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598253783,"SIMEON-THOMPSON, LAIKA, ROSE",791 JONESTOWN RD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598253783,"SIMEON-THOMPSON, LAIKA, ROSE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 14 , 19 , 19 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1598256174,"JAMISON, AARON, MICHAEL",10 MEDICINE CIRCLE   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881033009,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINA REHAB NORTH,487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",201 E GROVER ST   SHELBY NC,023,Cleveland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 82 , 82 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1114348802,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - KINGS MOUNTAIN,706 W KING ST   KINGS MOUNTAIN NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598260408,"PATEL, NEELAM, AMBALAL",600 HOSPITAL DR   MONROE NC,090,Union,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1598261224,APOLLO MEDFLIGHT LLC,,304 WRIGHT BROTHERS WAY   RICHLANDS NC,067,Onslow,3416A0800X,Transportation Services,Ambulance,Air Transport,1598261224,APOLLO MEDFLIGHT LLC,304 WRIGHT BROTHERS WAY   RICHLANDS NC,067,Onslow,3416A0800X,Transportation Services,Ambulance,Air Transport, 39 , 26 , 51 ," $20,827.13 ",,
MEDICAID DIRECT,1598261224,APOLLO MEDFLIGHT LLC,,5305 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,3416A0800X,Transportation Services,Ambulance,Air Transport,1598261224,APOLLO MEDFLIGHT LLC,5305 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,3416A0800X,Transportation Services,Ambulance,Air Transport, 46 , 41 , 82 ," $54,997.16 ",,
MEDICAID DIRECT,1598261224,APOLLO MEDFLIGHT LLC,,410 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,3416A0800X,Transportation Services,Ambulance,Air Transport,1598261224,APOLLO MEDFLIGHT LLC,410 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#, 14 ,$#,,
MEDICAID DIRECT,1598261224,APOLLO MEDFLIGHT LLC,,330 JEFFERSON ST   WHITEVILLE NC,024,Columbus,3416A0800X,Transportation Services,Ambulance,Air Transport,1598261224,APOLLO MEDFLIGHT LLC,330 JEFFERSON ST   WHITEVILLE NC,024,Columbus,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598261398,"UDANI, KUNJAN, DANISH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942539010,CAROLINAS MEDICAL CENTER,TEEN HEALTH CONNECTION,3541 RANDOLPH RD STE 206 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598261703,"DEHOFF, CHRISTIE, BRYAN",3541 RANDOLPH RD STE 206 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 87 , 132 , 146 ,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598261703,"DEHOFF, CHRISTIE, BRYAN",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598261703,"DEHOFF, CHRISTIE, BRYAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 51 , 55 , 252 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1598262099,"MEYERS, MATTHEW, HAMILTON",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1598262099,"MEYERS, MATTHEW, HAMILTON",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 29 , 37 , 48 ,$#,,
MEDICAID DIRECT,1811710999,ROBERT T CHRISTENSEN DDS MS PA,DURHAM PEDIATRIC DENTISTRY AND ORTHODONTICS,121 W WOODCROFT PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598264285,"MOLINA, JAMIE, LEE",121 W WOODCROFT PKWY   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 31 , 37 , 115 ,$#,,
MEDICAID DIRECT,1255546420,JOHN R CHRISTENSEN DDS MS MS PA,DURHAM PEDIATRIC DENTISTRY,121 W WOODCROFT PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598264285,"MOLINA, JAMIE, LEE",121 W WOODCROFT PKWY   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 31 , 35 , 109 ,$#,,
MEDICAID DIRECT,1124235205,MICHAEL A IGNELSI JR DDS PHD PA,LAKE JEANETTE ORTHO PED DENT,3901 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598264285,"MOLINA, JAMIE, LEE",3901 N ELM ST   GREENSBORO NC,041,Guilford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 109 , 115 , 403 ," $12,181.27 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598264301,"HENDERSON, LORALYE, INGRID",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 76 , 88 , 105 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598264301,"HENDERSON, LORALYE, INGRID",2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598266025,KARONS FAMILY CARE HOME LLC,KARONS FAMILY CARE HOME,570 OAK TREE RD   WILLARD NC,071,Pender,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598266025,KARONS FAMILY CARE HOME LLC,570 OAK TREE RD   WILLARD NC,071,Pender,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 701 , 726 ," $45,140.71 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598266694,"NAPIER, TAMARA, LEIGH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598267080,"ANTONELLI, CHRISTOPHER, MARK",3475 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1922004852,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCS INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598269680,"WILCOCK, JONATHAN, NEPHI",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 70 , 85 , 161 ,$#,,
MEDICAID DIRECT,1194998781,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCIATES INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598269680,"WILCOCK, JONATHAN, NEPHI",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598269748,"BULLARD, CAROL, ANN",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598269748,"BULLARD, CAROL, ANN",1589 SKEET CLUB RD STE 155 HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 22 , 47 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2101 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598269748,"BULLARD, CAROL, ANN",2101 N MAIN ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2728 W MALLARD CREEK CHURCH RD STE 30 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598269748,"BULLARD, CAROL, ANN",2021 CREEKSIDE LANDING DR   APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1598269771,"CRIHFIELD, LORI, KATHLEEN",117 E KINGS HWY   EDEN NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 32 , 49 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598269771,"CRIHFIELD, LORI, KATHLEEN",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 29 , 35 ,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1598269771,"CRIHFIELD, LORI, KATHLEEN",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 30 , 31 , 43 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598269771,"CRIHFIELD, LORI, KATHLEEN",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598271140,"ROBERTS, JACQUELYN, HENSLEY",1450 MATTHEWS TOWNSHIP PKWY STE 280 MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104145390,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH WOUND CARE AND HYPERBARIC MEDICINE,300 BILLINGSLEY RD STE 105 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598271140,"ROBERTS, JACQUELYN, HENSLEY",300 BILLINGSLEY RD STE 105 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 54 , 104 , 106 ,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598271843,"DEHLIN, ANDREW, PAUL",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 38 , 67 , 106 ,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598271843,"DEHLIN, ANDREW, PAUL",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 30 ,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598273286,"KIRK, KIMBERLY, LYNN",2216 E NC HIGHWAY 54   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1932714284,DISPATCHHEALTH PC,DISPATCHHEALTH,1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598273286,"KIRK, KIMBERLY, LYNN",1616 E MILLBROOK RD STE 140 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598273286,"KIRK, KIMBERLY, LYNN",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578724183,MOORE MEDICAL GROUP INC,,2050 MERCANTILE DR   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1598273484,"MOJAZZA, SARAH, RENEE",2050 MERCANTILE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 194 ," 1,023 "," 1,025 "," $62,276.11 ",,
MEDICAID DIRECT,1790752715,"WRIGHT, CHRISTOPHER, HAROLD",,2050 MERCANTILE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,1598273484,"MOJAZZA, SARAH, RENEE",2050 MERCANTILE DR   LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598277402,PATTY VISION CENTER OD PA,MEBANE VISION CENTER,1107 S FIFTH ST STE 300 MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,1598277402,PATTY VISION CENTER OD PA,1107 S FIFTH ST STE 300 MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,, 742 , 781 ," 1,499 "," $20,199.46 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598277592,"AREHEART, LAURA, ASHLEY",2400 SOUTH BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 37 , 79 ,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1598277691,"HOUSTON, FRANK, MATT MURPHEY",1650 LIBERTY DR STE 100 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 85 , 125 , 185 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1598277691,"HOUSTON, FRANK, MATT MURPHEY",1650 LIBERTY DR STE 100 THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 39 , 46 , 63 ,$#,,
MEDICAID DIRECT,1700843323,JAMES TODD WILLIAMS MD,ASHEBORO DERMATOLOGY AND SKIN SURGERY CENTER,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1598277691,"HOUSTON, FRANK, MATT MURPHEY",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780453464,TLK DERMATOLOGY PLLC,,360 SUNSET AVE   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1598277691,"HOUSTON, FRANK, MATT MURPHEY",360 SUNSET AVE   ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 17 , 23 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598278798,"TSIOPANAS, CARMEN, LYNDA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1144406539,PHYSICAL THERAPY FOR WOMEN,~,1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598281198,"REED, BRITTANY, ANN",1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598283293,"LEONARD, SHANE, CHRISTOPHER",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598283293,"LEONARD, SHANE, CHRISTOPHER",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598283293,"LEONARD, SHANE, CHRISTOPHER",10 MEDICINE   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598284580,"WILLIAMS, KIENA, APRIL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 43 , 43 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598288631,"BINGHAM, CLAIRE, ELIZABETH",214 18TH ST SE   HICKORY NC,018,Catawba,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598288813,"MORI, JONALEEN, ORDANES",310 COMMERCE DR   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 52 , 56 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598288813,"MORI, JONALEEN, ORDANES",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 94 , 124 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598290173,"BARRETT, CAROLINE, MOFFETT",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598290173,"BARRETT, CAROLINE, MOFFETT",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598290173,"BARRETT, CAROLINE, MOFFETT",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598290173,"BARRETT, CAROLINE, MOFFETT",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598290561,"GRAVITZ, ZOE, ROSE NAUMBURG",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 57 , 88 , 177 ,$#,,
MEDICAID DIRECT,1629469895,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN FAMILY MEDICINE CLINIC AT THE OAKS,730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1598290561,"GRAVITZ, ZOE, ROSE NAUMBURG",730 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 44 , 66 ,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598291163,"ILLSLEY, JOHN, DAVID",702 N MAIN ST   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 23 , 23 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598292674,"GONZALES, MIA, DAVIELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598292674,"GONZALES, MIA, DAVIELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 16 , 17 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598292674,"GONZALES, MIA, DAVIELLE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598293029,"PUNJALA-PATEL, ADVAITA",10660 PARK RD STE 4300 CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598293029,"PUNJALA-PATEL, ADVAITA",905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 24 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598293029,"PUNJALA-PATEL, ADVAITA",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#, 13 ,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598293029,"PUNJALA-PATEL, ADVAITA",251 EASTWAY DR   CHARLOTTE NC,060,Mecklenburg,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790123081,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE MATERNAL FETAL MEDICINE,200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598293029,"PUNJALA-PATEL, ADVAITA",200 MEDICAL PARK DR STE 250 CONCORD NC,013,Cabarrus,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,905 KENILWORTH AVE STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598293029,"PUNJALA-PATEL, ADVAITA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 11 , 16 , 21 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598293029,"PUNJALA-PATEL, ADVAITA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598294365,"CORN, WILBURN, GREGORY",161 WALKER ST   COLUMBUS NC,075,Polk,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 21 , 64 , 64 ,$#,,
MEDICAID DIRECT,1023376829,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MULTISPECIALTY CLINIC - LENOIR,1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1598296220,"CANNON, JAYME, MCKENZIE",1208 HICKORY BLVD SW STE 102 LENOIR NC,014,Caldwell,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1407203052,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE GERIATRICS,2209 S STERLING ST STE 330 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1598296220,"CANNON, JAYME, MCKENZIE",2209 S STERLING ST STE 330 MORGANTON NC,012,Burke,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 51 , 78 , 79 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598297764,"MILNER, JOSEPH, DAVIS",10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 16 , 21 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,1106 REYNOLDS ST STE 100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598297764,"MILNER, JOSEPH, DAVIS",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 148 , 271 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598297764,"MILNER, JOSEPH, DAVIS",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 14 , 23 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,10545 BLAIR RD   MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598297764,"MILNER, JOSEPH, DAVIS",1106 REYNOLDS ST STE 100 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598298960,"KILLEBREW, SEQUOYA, RENEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598299893,"HUDSON, JOSHUA, LOCKHART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598299893,"HUDSON, JOSHUA, LOCKHART",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 59 , 82 , 92 ,$#,,
MEDICAID DIRECT,1598299927,"PLANKENHORN, DAVID, ANDREW",,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,1598299927,"PLANKENHORN, DAVID, ANDREW",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598300717,"PEARSON, TIFFANY, RENAE",310 E WARDELL DR   PEMBROKE NC,078,Robeson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598300717,"PEARSON, TIFFANY, RENAE",11 UNION ST S   CONCORD NC,013,Cabarrus,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598300717,"PEARSON, TIFFANY, RENAE",3532 DUNN RD   EASTOVER NC,026,Cumberland,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598300717,"PEARSON, TIFFANY, RENAE",90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1396103305,OPPORTUNITIES INDUSTRIALIZATION CEN,~,90 GUARDIAN CT   ROCKY MOUNT NC,064,Nash,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598300717,"PEARSON, TIFFANY, RENAE",1206 FULTON ST   RAEFORD NC,047,Hoke,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1598301194,"GREEN, KATHERINE, SMITH",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1598301780,PLAY TO GROW OT,PLAY TO GROW OT LLC,214 PRINCE ST   CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,,1598301780,PLAY TO GROW OT,214 PRINCE ST   CARRBORO NC,068,Orange,193400000X,Group,Single Specialty,, 63 , 998 ," 1,001 "," $93,084.47 ",,
MEDICAID DIRECT,1598302960,GA HC REIT II LINCOLNTON ALF TRS SU,TERRABELLA LINCOLNTON,440 SALEM CHURCH RD   LINCOLNTON NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598302960,GA HC REIT II LINCOLNTON ALF TRS SU,440 SALEM CHURCH RD   LINCOLNTON NC,055,Lincoln,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,645 "," 1,645 "," $160,331.94 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598303356,"ABLES, HENNA, SHAH",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598303356,"ABLES, HENNA, SHAH",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#, 18 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1598305252,"JOHNSON, WESLEY, RAY JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1598305252,"JOHNSON, WESLEY, RAY JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1598305252,"JOHNSON, WESLEY, RAY JOSEPH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 26 , 29 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598305252,"JOHNSON, WESLEY, RAY JOSEPH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598311896,"OBENG-ADUASARE, AKOSUA, NEFERTETI",915 PEE DEE RD   ABERDEEN NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 42 , 42 ,$#,,
MEDICAID DIRECT,1598312118,THE PRESBYTERIAN HOSPITAL,NOVANT HEALTH PHARMACY,8401 UNIVERSITY EXEC PARK DR STE 127 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1598312118,THE PRESBYTERIAN HOSPITAL,8401 UNIVERSITY EXEC PARK DR STE 127 CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598312530,"ELLER, CORTNEY, JULIAN",1910 JAKE ALEXANDER BLVD W STE 201 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 40 , 110 , 116 ,$#,,
MEDICAID DIRECT,1598314437,BILLIONTOONE INC,BILLIONTOONE LABORATORY,3200 WHIPPLE RD   UNION CITY CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1598314437,BILLIONTOONE INC,3200 WHIPPLE RD   UNION CITY CA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 116 , 116 , 453 ," $162,363.47 ",,
MEDICAID DIRECT,1598315814,KARDI BILINGUAL THERAPY,KARDI BILINGUAL CONSULTING PLLC,9820 NORTHCROSS CENTER CT STE 119 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598315814,KARDI BILINGUAL THERAPY,9820 NORTHCROSS CENTER CT STE 119 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1053531889,"FISCHER, AMY JO",AMY JOFISCHER DDS PA,406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1598319576,"WARD, MEREDITH, AMY",406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1841350824,AMY-JO FISCHER DDS PA,SMILES BY DESIGN,406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1598319576,"WARD, MEREDITH, AMY",406 W MOUNTAIN ST   KERNERSVILLE NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598320673,"MANGROLA, KARNA, RAJU",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598320673,"MANGROLA, KARNA, RAJU",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598320673,"MANGROLA, KARNA, RAJU",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 24 , 24 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598320699,"TSEVAT, DANIELLE, GOULD",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598320699,"TSEVAT, DANIELLE, GOULD",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598320699,"TSEVAT, DANIELLE, GOULD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598320699,"TSEVAT, DANIELLE, GOULD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 35 , 38 , 41 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598320699,"TSEVAT, DANIELLE, GOULD",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6011 FARRINGTON RD STE 201 CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1598320699,"TSEVAT, DANIELLE, GOULD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1598320699,"TSEVAT, DANIELLE, GOULD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598320897,"GINZBURG, YANA, ILINICHNA",3475 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1821529249,RACHAEL A WRUBLE OD PLLC,~,8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598322299,"SZULBORSKI, KASIA, ROSE",8111 CONCORD MILLS BLVD STE 359 CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598322539,"PATEL, KUNAL",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 358 , 358 ," 3,029 "," $209,147.32 ",,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598322539,"PATEL, KUNAL",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 308 , 309 ," 2,616 "," $180,824.98 ",,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598323081,"CIRAULA, STEPHANIE, MARIE",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 74 , 77 , 77 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598324329,"DHUNGANA, SANTOSH, KUMAR",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 52 , 123 , 123 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1598324329,"DHUNGANA, SANTOSH, KUMAR",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 27 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 26 , 27 , 38 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598327546,"KNELLER, VICTORIA, KIRSTEN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1598328031,"COOK, ARIANNA, ROSE FELICI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598328031,"COOK, ARIANNA, ROSE FELICI",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 53 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598328270,"PREZIOSI, NICHOLAS, ALLAN",2927 LYNDHURST AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 27 , 51 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598328916,"REINES, KATY, LAUREN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598328916,"REINES, KATY, LAUREN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,1030 SIENA DR   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1598328916,"REINES, KATY, LAUREN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598328916,"REINES, KATY, LAUREN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205491487,WAKEMED SPECIALISTS GROUP LLC,WAKEMED UROLOGY,23 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598328916,"REINES, KATY, LAUREN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598329153,"LAMB, SARAH, MARGARET",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 80 , 83 , 113 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598329153,"LAMB, SARAH, MARGARET",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 76 , 81 , 120 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598329872,"OKUNADE, ADENIYI, SAMUEL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598335440,"DINH, THU, LINH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598335440,"DINH, THU, LINH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598335440,"DINH, THU, LINH",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033726567,CAROLINA PHYSICAL THERAPY ASSOCIATE,CAROLINA PHYSICAL THERAPY ASSOCIATES-CONCORD,236 LE PHILLIP CT NE STE A CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598339376,"POTTS, TAYLOR, FAULKENBURY",236 LE PHILLIP CT NE STE A CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1548544802,DLP PERSON PHYSICIAN PRACTICES LLC,DLP PERSON PHYSICIAN PRACTICES LLC,3762 DURHAM RD STE B ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598339699,"BOWLIN, ELIZABETH, YANCEY",3762 DURHAM RD STE B ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 46 , 82 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598341349,"PHAM, NGUYEN",155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 35 , 84 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1598341349,"PHAM, NGUYEN",155 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 81 , 200 ,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,214 E ELM ST   GRAHAM NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598343139,"SANTOS, MARIA",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 35 , 61 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598343139,"SANTOS, MARIA",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 24 , 41 ,$#,,
MEDICAID DIRECT,1568745149,ARMC PHYSICIANS CARE INC,CRISSMAN FAMILY PRACTICE,1041 KIRKPATRICK RD STE 250 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598343139,"SANTOS, MARIA",214 E ELM ST   GRAHAM NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598344301,"LAI, MICHAEL, JAN WING",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598344301,"LAI, MICHAEL, JAN WING",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598344301,"LAI, MICHAEL, JAN WING",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598344301,"LAI, MICHAEL, JAN WING",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598344301,"LAI, MICHAEL, JAN WING",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 23 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598344301,"LAI, MICHAEL, JAN WING",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 37 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1598347130,"JASWANEY, ROHIT, VIKRAM",6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 14 , 37 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598347130,"JASWANEY, ROHIT, VIKRAM",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 28 , 28 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1598348120,"DURHAM, JAMES, STANTON",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 56 , 56 ,$#,,
MEDICAID DIRECT,1750041497,BLOOMING MEDICAL GROUP PLLC,,964 HIGH HOUSE RD PMB 4037 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1598353427,"BARNES, GRETCHEN, DANIELLE",964 HIGH HOUSE RD PMB 4037 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598357808,"MCCONNELL, WILLIAM, CHRISTOPHER",400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1649427089,TINA S MERHOFF DDS PA,,185 KIMEL PARK DR STE 202 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598357907,"O'NEAL, VICTORIA, GRACE PHIPPS",185 KIMEL PARK DR STE 202 WINSTON SALEM NC,034,Forsyth,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598361065,"BARWICK, ERICA, PROFFITT",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 21 , 22 ,$#,,
MEDICAID DIRECT,1972593382,ALLERGY PARTNERS PLLC,ALLERGY PARTNERS OF EASTERN CAROLINA,1150 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598363681,"KENNEDY, KRYSTAL, GLADSON",1150 E ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 48 , 86 , 141 ,$#,,
MEDICAID DIRECT,1598366114,SISTERS IN SPEECH PC,,367 DELLWOOD RD STE E2 WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,1598366114,SISTERS IN SPEECH PC,367 DELLWOOD RD STE E2 WAYNESVILLE NC,044,Haywood,193400000X,Group,Single Specialty,,#, 65 , 65 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598367658,"GILMORE, LUKAS, ALAN",2675 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598370041,"MALLETTE, IESHA, LINNETTE",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 12 , 26 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2411 LANDMARK DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598370041,"MALLETTE, IESHA, LINNETTE",13304 LEESVILLE CHURCH RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598370934,AFFINITY CARE PARTNERS,,5511 MONROE RD 206 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1598370934,AFFINITY CARE PARTNERS,5511 MONROE RD 206 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598371320,"LIVELY, JONATHAN, BYRON",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 63 , 121 ,$#,,
MEDICAID DIRECT,1427561638,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598371320,"LIVELY, JONATHAN, BYRON",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 29 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598374951,"YOUNG, MADELEINE, MONET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598374951,"YOUNG, MADELEINE, MONET",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598374951,"YOUNG, MADELEINE, MONET",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598374951,"YOUNG, MADELEINE, MONET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598374951,"YOUNG, MADELEINE, MONET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598374951,"YOUNG, MADELEINE, MONET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598374951,"YOUNG, MADELEINE, MONET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598374951,"YOUNG, MADELEINE, MONET",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598375032,"GENTILE, ANTHONY, MICHAEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 45 , 48 ,$#,,
MEDICAID DIRECT,1376132571,FULLER & ASSOCIATES VII PLLC,CLINTON FAMILY & COSMETIC DENTISTRY,320 NORTHEAST BLVD   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1598375099,"TRAN, AUVI, TU",320 NORTHEAST BLVD   CLINTON NC,082,Sampson,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 156 , 195 , 216 ," $22,541.85 ",,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598376600,"BROOKS, BRIANNA, MARIE",2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1750965257,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED CHILDRENS PEDIATRIC PRIMARY CARE KILDAIRE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598378937,"DOWELL, SAMANTHA, LYNNE",110 KILDAIRE PARK DR   CARY NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 17 ,$#,,
MEDICAID DIRECT,1598381378,TYJEAN MOORE LLC,EMBRACING THERAPEUTIC CARE,250 TIMBERVIEW DR   LEXINGTON NC,029,Davidson,251S00000X,Agencies,Community/Behavioral Health,,1598381378,TYJEAN MOORE LLC,250 TIMBERVIEW DR   LEXINGTON NC,029,Davidson,251S00000X,Agencies,Community/Behavioral Health,, 43 , 571 , 571 ," $37,904.60 ",,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598381527,"ISSA, RONNIE, HATEM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598381527,"ISSA, RONNIE, HATEM",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598381527,"ISSA, RONNIE, HATEM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1598382046,"SAMMY, NYRON, MCKENZIE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 33 , 34 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598382046,"SAMMY, NYRON, MCKENZIE",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 15 , 15 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598382459,"RAMOS, LORENA, OTILA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598382459,"RAMOS, LORENA, OTILA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144884636,WAKEMED SPECIALISTS GROUP LLC,WAKEMED H & V CARDIOVASCULAR & THORACIC SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598382459,"RAMOS, LORENA, OTILA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598382459,"RAMOS, LORENA, OTILA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598383077,"RICE, AUTUMN, JOY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1235198177,COUNTY OF DUPLIN,DUPLIN COUNTY HEALTH DEPARTMENT,340 SEMINARY ST   KENANSVILLE NC,031,Duplin,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1598384257,"POLK, JESSICA, LYNN",340 SEMINARY ST   KENANSVILLE NC,031,Duplin,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 28 , 34 , 73 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598384646,"WILSON, IVY, LILLIAN",601 CHILDREN'S LN   NORFOLK VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598387755,"MORRISON, CONSTANCE, REBECCA CHAMBERLIN",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 31 , 37 , 70 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598387755,"MORRISON, CONSTANCE, REBECCA CHAMBERLIN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 45 , 53 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598389462,"ROBINSON, CLARA, WORTHAM",9101 OCEAN HWY E   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598389462,"ROBINSON, CLARA, WORTHAM",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 17 , 33 , 38 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598389462,"ROBINSON, CLARA, WORTHAM",8064 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598389462,"ROBINSON, CLARA, WORTHAM",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 23 , 35 ,$#,,
MEDICAID DIRECT,1144406539,PHYSICAL THERAPY FOR WOMEN,~,1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598390809,"MOORMAN, BRIANA, JO",1630 MILITARY CUTOFF RD STE 110 WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598391443,"JEAN-LOUIS, RICHARD, P",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598391443,"JEAN-LOUIS, RICHARD, P",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 126 , 135 , 156 ," $12,831.12 ",,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598392375,"BOOMER, TESHEIKA, NAVOY",3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598392375,"BOOMER, TESHEIKA, NAVOY",1704 E ARLINGTON BLVD STE A GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 55 , 55 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598392375,"BOOMER, TESHEIKA, NAVOY",215B MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194811026,GREENE COUNTY HEALTH CARE INC,JAMES D BERNSTEIN COMMUNITY HEALTH CENTER,261 BELVOIR HWY   GREENVILLE NC,074,Pitt,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598392730,"CHENG, KERRY, ZHU",261 BELVOIR HWY   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1093706111,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - SOUTHEAST RALEIGH DENTA,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598392730,"CHENG, KERRY, ZHU",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 255 , 268 , 899 ," $33,091.25 ",,
MEDICAID DIRECT,1093706111,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH - SOUTHEAST RALEIGH DENTA,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598392730,"CHENG, KERRY, ZHU",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice, 772 ," 1,195 "," 3,813 "," $142,444.71 ",,
MEDICAID DIRECT,1568464386,GREENE COUNTY HEALTH CARE INC,GREENE DENTAL SERVICES,6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598392730,"CHENG, KERRY, ZHU",6 PROFESSIONAL DR   SNOW HILL NC,040,Greene,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598393811,"LOUGEE, LAUREN, NEWTON",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 39 , 65 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598393811,"LOUGEE, LAUREN, NEWTON",56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598393811,"LOUGEE, LAUREN, NEWTON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598393811,"LOUGEE, LAUREN, NEWTON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669890562,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER AT ENKACANDLER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598393811,"LOUGEE, LAUREN, NEWTON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598393811,"LOUGEE, LAUREN, NEWTON",25 WESTRIDGE MARKET PL   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972100683,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS AT FRANKLIN,56 MEDICAL PARK DR   FRANKLIN NC,056,Macon,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598393811,"LOUGEE, LAUREN, NEWTON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 26 , 26 ,$#,,
MEDICAID DIRECT,1952356388,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC FAMILY HEALTH CENTER,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598393811,"LOUGEE, LAUREN, NEWTON",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 16 , 16 ,$#,,
MEDICAID DIRECT,1265549919,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC OBGYN SPECIALISTS,119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598393811,"LOUGEE, LAUREN, NEWTON",123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1407483175,INFINITE MEDICAL PC,,310 PENSACOLA RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1598394900,"YOUNG, MARLENE BEVERLY",310 PENSACOLA RD   BURNSVILLE NC,100,Yancey,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 96 , 113 , 134 ,$#,,
MEDICAID DIRECT,1992459515,MONTERA HEALTH TEXAS LLC,,3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598397598,"TRAMMEL, SAMANTHA, IMARA",3626 LATROBE DR STE 300 PMB 1101 CHARLOTTE NC,060,Mecklenburg,103K00000X,Behavioral Health & Social Service Providers,Behavior Analyst,,#,#,#,$#,,
MEDICAID DIRECT,1992084198,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH WOMENS CARE UROGYNECOLOGY AND PELVIC,2001 VAIL AVE STE 360 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598399529,"FIOLA, JORDAN, MICHELE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598399743,"VAILLANCOURT, SAMANTHA, PANDICK",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 47 , 65 ,$#,,
MEDICAID DIRECT,1346501798,ARMC PHYSICIANS CARE INC,BURLINGTON UROLOGICAL ASSOCIATES,1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598399743,"VAILLANCOURT, SAMANTHA, PANDICK",1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 175 , 244 ,$#,,
MEDICAID DIRECT,1811286156,LIFESOURCE OF NORTH CAROLINA,~,3205 RANDALL PKWY STE 105 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598400350,"PAINTER, JOHN, KEVIN",3205 RANDALL PKWY STE 5 WILMINGTON NC,065,New Hanover,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 16 , 41 , 41 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598400889,"TAYLOR, RENAE, OWENS",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 32 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE B PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598400889,"TAYLOR, RENAE, OWENS",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE C PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598400889,"TAYLOR, RENAE, OWENS",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598400889,"TAYLOR, RENAE, OWENS",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598400889,"TAYLOR, RENAE, OWENS",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1598401929,A CARING HAND INC,,783 MAIN ST SUITE 102 ALLIANCE NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,,1598401929,A CARING HAND INC,783 MAIN ST SUITE 102 ALLIANCE NC,069,Pamlico,253Z00000X,Agencies,In Home Supportive Care,,#, 213 , 213 ," $15,561.56 ",,
MEDICAID DIRECT,1598401929,A CARING HAND INC,,8378 SIX FORKS RD STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1598401929,A CARING HAND INC,8378 SIX FORKS RD STE 202 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 1,506 "," 1,506 "," $97,010.28 ",,
MEDICAID DIRECT,1598401929,A CARING HAND INC,,616 ATLANTIC AVE   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598401929,A CARING HAND INC,616 ATLANTIC AVE   ROCKY MOUNT NC,033,Edgecombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 244 , 249 ," $48,821.62 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,621 S MAIN ST STE 205 REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1598402752,"ZARWOLO, GLORIA, KOU",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598402752,"ZARWOLO, GLORIA, KOU",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 43 , 56 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598402752,"ZARWOLO, GLORIA, KOU",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 78 , 156 , 192 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,621 S MAIN ST STE 201 REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1598402752,"ZARWOLO, GLORIA, KOU",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598404055,"MANTOOTH, MACY, ALEXANDRA",10479 N NC HIGHWAY 109 STE 107A WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 15 , 25 ,$#,,
MEDICAID DIRECT,1598409088,OPTIMAL LIVING HOME CARE SERVICES,OPTIMAL LIVING HOME CARE SERVICES,8025 N POINT BLVD STE 268 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1598409088,OPTIMAL LIVING HOME CARE SERVICES,8025 N POINT BLVD STE 268 WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 447 , 447 ," $39,917.50 ",,
MEDICAID DIRECT,1598411159,WECARE HOME CARE,~,1025 HOMELAND AVE STE 3 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1598411159,WECARE HOME CARE,1025 HOMELAND AVE STE 3 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 354 , 354 ," $27,928.56 ",,
MEDICAID DIRECT,1205237245,SENIOR HEALTH AND EDUCATION PARTNER,,5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598412926,"BROWN, RENARTA, PATRICE",5306 NC HIGHWAY 55 STE 105 DURHAM NC,032,Durham,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598415283,"ALDRIDGE, RACHEL, ALLISON",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598415283,"ALDRIDGE, RACHEL, ALLISON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598415283,"ALDRIDGE, RACHEL, ALLISON",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598415283,"ALDRIDGE, RACHEL, ALLISON",9592 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598415283,"ALDRIDGE, RACHEL, ALLISON",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598415283,"ALDRIDGE, RACHEL, ALLISON",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 32 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598417008,"JOHNSON, STUART, CRAIG",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598419848,"KOJIMA, JACKSON, KISUKE",4515 PREMIER DR STE 307 HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1598421869,"EBERHART, AMBER, HOPE",600 S CHURCH ST   HERTFORD NC,072,Perquimans,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1598421869,"EBERHART, AMBER, HOPE",480 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 64 , 127 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1598421877,"BRENISH, SUZANNE, LISA",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598427643,"MCCLEARY, KELLY, LEE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1598428062,"BOYER, JULIA",1 TOWN SQUARE BLVD STE 220 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1598428062,"BOYER, JULIA",1 TOWN SQUARE BLVD STE 220 ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1962941773,DLP FRYE MEDICAL GROUP,FRYECARE URGENT CARE,1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598429078,"SLAGER, NICHOLAS, JAY",1105 FAIRGROVE CHURCH RD SE   CONOVER NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598429078,"SLAGER, NICHOLAS, JAY",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 32 , 61 ,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,60 2ND AVE SW   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1598429078,"SLAGER, NICHOLAS, JAY",2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598429375,"THURMOND, BRITTANY, ANN",500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598429375,"THURMOND, BRITTANY, ANN",9930 KINCEY AVE STE 130 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1598430100,CARING HEARTS OF GRACE HOMECARE AGE,,363 CHURCH ST N STE 260C CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,1598430100,CARING HEARTS OF GRACE HOMECARE AGE,363 CHURCH ST N STE 260C CONCORD NC,013,Cabarrus,253Z00000X,Agencies,In Home Supportive Care,,#," 1,086 "," 1,086 "," $76,198.56 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598432304,"MULHOLLAN, MEGAN, BRIANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1598432304,"MULHOLLAN, MEGAN, BRIANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598437121,"HINDES, COURTNEY, ANN",4705 S HIGHWAY 150 STE B&C LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598437121,"HINDES, COURTNEY, ANN",110 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 103 , 195 , 373 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598437121,"HINDES, COURTNEY, ANN",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,114C MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1598439002,"TUPES, DANIELLE, NICOLE",25 OFFICE PARK DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1164519070,JACKSONVILLE CHILDRENS AND MULTISPE,JACKSONVILLE CHILDRENS AND MULTISPECIALTY CLINIC,120 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1598439002,"TUPES, DANIELLE, NICOLE",338 HOWARD BLVD   NEWPORT NC,016,Carteret,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 15 , 28 ,$#,,
MEDICAID DIRECT,1043568090,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD CARDIOLOGY ASSOCIATES,3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598451536,"MARTIN, LORA, LEIGH",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366209918,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD CARDIOLOGY ASSOCIATES SEACOAST,3793 MCDOWELL LANE SUITE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598451536,"MARTIN, LORA, LEIGH",3793 MCDOWELL LN STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598451742,"ADAMS, CHRISTINE, NOEL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598451742,"ADAMS, CHRISTINE, NOEL",1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598452427,"OWENS, AMBER, RENEE",522 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 29 , 48 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598452427,"OWENS, AMBER, RENEE",5070 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 22 , 55 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2934 N ELM ST STE B LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598452427,"OWENS, AMBER, RENEE",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 131 , 153 , 353 ,$#,,
MEDICAID DIRECT,1104597350,BURROW WELCHEL CULP MOORE PLLC KANN,~,3612 HWY 49S   HARRISBURG NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",3612 HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 251 , 270 ," 1,038 "," $32,201.91 ",,
MEDICAID DIRECT,1104597350,BURROW WELCHEL CULP MOORE PLLC KANN,~,1843 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",1843 S RIDGE AVE   KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice," 1,405 "," 1,961 "," 7,328 "," $272,794.31 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,130 HARBOUR PLACE DR STE 180   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",130 HARBOUR PLACE DR STE 180 DAVIDSON NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 128 , 138 , 566 ," $22,468.28 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 62 , 62 , 235 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",10818 MALLARD CREEK RD STE 102 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 40 , 40 , 134 ,$#,,
MEDICAID DIRECT,1104597350,BURROW WELCHEL CULP MOORE PLLC KANN,~,14746 LANCASTER HWY STE B PINEVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",14746 LANCASTER HWY STE B PINEVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 30 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",130 HARBOUR PLACE DR STE 180 DAVIDSON NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",11835 SOUTHMORE DR STE 201 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 162 , 166 , 617 ," $20,646.66 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",10818 MALLARD CREEK RD STE 102 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 29 , 95 ,$#,,
MEDICAID DIRECT,1780386680,BURROW WELCHEL CULP MOORE PLLC - 5,WHITE & JOHNSON PEDIATRIC DENTISTRY,109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",109 MENDENHALL DR STE A WILMINGTON NC,065,New Hanover,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 25 , 25 , 72 ,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice," 2,027 "," 2,375 "," 9,123 "," $322,628.47 ",,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1417977950,DAVID H MOORE DDS MS PA,CHARLOTTE PEDIATRIC DENTISTRY,10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598454944,"DARJI, BHARGAV, JAYENDRA",10818 MALLARD CREEK RD STE 101 CHARLOTTE NC,060,Mecklenburg,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 147 , 148 , 576 ," $19,444.20 ",,
MEDICAID DIRECT,1437653359,SANDHILLS BEHAVIORAL CARE PLLC,SANDHILLS BEST CARE,523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1598457996,"JOSEPH, ROSETTE",523 ROCKINGHAM RD   ROCKINGHAM NC,077,Richmond,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 20 , 31 , 34 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598459075,"LONDON, MEGAN, ASHLEY",1803 FOREST HILLS RD W   WILSON NC,098,Wilson,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#, 19 ,$#,,
MEDICAID DIRECT,1598460909,TLC HOME HEALTHCARE LLC,,9625 DAVID TAYLOR DR STE 101 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1598460909,TLC HOME HEALTHCARE LLC,9625 DAVID TAYLOR DR STE 101 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 12 , 777 , 777 ," $48,908.38 ",,
MEDICAID DIRECT,1598460909,TLC HOME HEALTHCARE LLC,,1101 TYVOLA RD STE 215   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1598460909,TLC HOME HEALTHCARE LLC,1101 TYVOLA RD STE 215   CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 3,153 "," 3,153 "," $197,384.70 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598462012,"WOODY, JENNIFER, CHRISTINE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 94 , 132 , 180 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598462012,"WOODY, JENNIFER, CHRISTINE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598462012,"WOODY, JENNIFER, CHRISTINE",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1598469512,COBBS ENTERPRISE HOME CARE LLC,,1341 NEW HILL RD   HOLLY SPRINGS NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1598469512,COBBS ENTERPRISE HOME CARE LLC,1341 NEW HILL RD   HOLLY SPRINGS NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,749 "," 2,749 "," $203,080.44 ",,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1598469702,"HOUSTON, DREAMA, SARVER",221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 21 , 21 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,3031 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598469702,"HOUSTON, DREAMA, SARVER",3031 TATE BLVD SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1598469702,"HOUSTON, DREAMA, SARVER",221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033170113,HART FAMILY PRACTICE,HART FAMILY PRACTICE,221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598469702,"HOUSTON, DREAMA, SARVER",221 13TH AVENUE PL NW STE 101 HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1598469702,"HOUSTON, DREAMA, SARVER",3031 TATE BLVD SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 330 , 334 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1598469702,"HOUSTON, DREAMA, SARVER",3031 TATE BLVD SE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 82 ," 1,156 "," 1,179 ",$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598470353,"LAWLER, THOMAS, WILLIAM",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 18 ,$#,,
MEDICAID DIRECT,1396782710,CABARRUS ROWAN COMMUNITY HEALTH CEN,~,202D MCGILL AVE NW   CONCORD NC,013,Cabarrus,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598471492,"KUBUANU, GLORIA, BENEDICTE",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 28 , 29 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598471492,"KUBUANU, GLORIA, BENEDICTE",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1982371514,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER - ALBEMARLE,1000 N 5TH ST   ALBEMARLE NC,084,Stanly,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598471492,"KUBUANU, GLORIA, BENEDICTE",1000 N 5TH ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1194196550,MURPHY MEDICAL CENTER INC,MURPHY GROUP PRACTICE HAYESVILLE,146 HWY 64 E   HAYESVILLE NC,022,Clay,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1598471765,"PALMER, DANIELLE",146 HWY 64 E   HAYESVILLE NC,022,Clay,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 84 , 86 ," $14,772.59 ",,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598481152,"EVERDING, GRANT, JOHN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598481152,"EVERDING, GRANT, JOHN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598487779,"MORRISON, JEFFREY, KENDRICK",5959 TRIANGLE TOWN BLVD STE 2001 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174564900,EYE CENTER DOCTORS OF OPTOMETRY,~,302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598487779,"MORRISON, JEFFREY, KENDRICK",302 CROSS CREEK MALL   FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 19 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598492092,"WADDLE, SARAH, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 49 , 56 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598497158,"PALAZZI, SAMANTHA, SAXE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 19 , 31 , 34 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598498305,"CLAYTON, DAVID, GRANT",1919 W PARK DR   N WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 72 , 149 , 306 ,$#,,
MEDICAID DIRECT,1598499311,UNITED HOME HEALTH SOLUTIONS LLC,,8025 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1598499311,UNITED HOME HEALTH SOLUTIONS LLC,8025 N POINT BLVD   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,#, 327 , 327 ," $16,376.98 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598499485,"STAHL, MORGAN, BOYD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 11 , 14 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598499956,"SKILLMAN, BRITTANY, ALEXANDRA",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 20 , 40 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598499956,"SKILLMAN, BRITTANY, ALEXANDRA",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 26 , 55 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1598499956,"SKILLMAN, BRITTANY, ALEXANDRA",107 E MCCLANAHAN ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 33 , 73 ,$#,,
MEDICAID DIRECT,1386991297,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598503385,"MCNAMEE, BRENNA, ERIN",14214 BALLANTYNE LAKE RD STE 150 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598503542,"ALRED, KAILEE, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 40 , 41 ,$#,,
MEDICAID DIRECT,1710012174,PSYCHIATRIC SERVICES OF CAROLINAS,PSYCHIATRIC SERVICES OF CAROLINAS PC,1530 UNION RD STE A GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598509150,"PIERRE, LUTZ, SUE-ELLEN",1530 UNION RD STE A GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 93 , 96 ,$#,,
MEDICAID DIRECT,1801450283,WAKEMED SPECIALISTS GROUP LLC,WAKEMED VASCULAR SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598518060,"MITCHELL, KRISTEN, ANN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598526444,"PUTNAM, SAMANTHA, DANIELLE",850 SOUTHAMPTON AVE   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,923 W 3RD ST STE C PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598527558,"CHAVIS, KEVIN, LEE",923 W 3RD ST STE C PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1598527558,"CHAVIS, KEVIN, LEE",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598527558,"CHAVIS, KEVIN, LEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 69 , 211 , 211 ,$#,,
MEDICAID DIRECT,1023406261,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITALIST GROUP,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1598527558,"CHAVIS, KEVIN, LEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1396842514,CFV EXPRESS CARE BILLING SERVICES L,HIGHSMITH RAINEY EXPRESS CARE,150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598527558,"CHAVIS, KEVIN, LEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 25 , 25 , 25 ,$#,,
MEDICAID DIRECT,1134162597,CUMBERLAND COUNTY HOSPITAL SYSTEM I,EXPRESS CARE OF HEALTH PAVILION NORTH,6387 RAMSEY ST UNIT 100 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598527558,"CHAVIS, KEVIN, LEE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649327750,ORTHOPAEDIC SPECIALISTS OF NC PA,~,11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598529539,"KOENIG, CHRISTINE, NORA",11221 GALLERIA AVE STE 101 RALEIGH NC,092,Wake,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 27 , 34 , 45 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598531022,"HAUCK, CORINNE, NATICA LELIA",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1598532442,"ANDERSON, CYNDI, JENAY",2277 NC 24-87   CAMERON NC,043,Harnett,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598532657,"BLACK, KYLEE, MARIE",3719 UNION RD   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 13 , 86 , 121 ,$#,,
MEDICAID DIRECT,1407932775,COMPREHAB INC,~,2675 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598532657,"BLACK, KYLEE, MARIE",2675 COURT DR   GASTONIA NC,036,Gaston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598535148,"BOWES, SARAH, ELIZABETH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 59 , 64 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598542870,"NWANGUMA, TIA, SHANNEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 115 , 115 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1000 TANDAL PL   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598542870,"NWANGUMA, TIA, SHANNEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598542870,"NWANGUMA, TIA, SHANNEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598542870,"NWANGUMA, TIA, SHANNEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 197 , 197 ,$#,,
MEDICAID DIRECT,1518913656,CAROLINA REHABILITATION AND SURGICA,~,3809 COMPUTER DR STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598542870,"NWANGUMA, TIA, SHANNEL",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1598542946,"GODINE, SOPHIA, MARIE",101 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 70 , 111 , 215 ," $10,183.58 ",,
MEDICAID DIRECT,1356339154,BLACK RIVER HEALTH SERVICES INC,BLACK RIVER HEALTH SERVICES INC,4811 NC HWY 50   MAPLE HILL NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598544074,"STEWART, JOHN, GREGORY",4811 NC HWY 50   MAPLE HILL NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1174511976,BLACK RIVER HEALTH SERVICES INC,Black River Health Services,109 W CHURCH ST   ATKINSON NC,071,Pender,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598544074,"STEWART, JOHN, GREGORY",109 W CHURCH ST   ATKINSON NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1508275553,KIDZCARE PEDIATRICS PC,,216 E BROAD ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598545816,"HUEY, KATHERINE, CLAIRE",216 E BROAD ST   SAINT PAULS NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 19 , 31 , 65 ,$#,,
MEDICAID DIRECT,1346624590,KIDZCARE PEDIATRICS PC,,1035 GRANDIFLORA DR STE 102 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1598545816,"HUEY, KATHERINE, CLAIRE",1035 GRANDIFLORA DR   LELAND NC,010,Brunswick,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1972015097,KIDZCARE PEDIATRICS PC,,112 MEDICAL VILLAGE DR STE D WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1598545816,"HUEY, KATHERINE, CLAIRE",112 MEDICAL VILLAGE DR STE D WALLACE NC,031,Duplin,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1861947905,KIDZCARE PEDIATRICS PC,,1001 W CUMBERLAND ST   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1598545816,"HUEY, KATHERINE, CLAIRE",1001 W CUMBERLAND ST   DUNN NC,043,Harnett,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1972015097,KIDZCARE PEDIATRICS PC,,112 MEDICAL VILLAGE DR STE D WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1598545816,"HUEY, KATHERINE, CLAIRE",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1679529051,KIDZCARE PEDIATRICS PC,~,3436 N MAIN ST   HOPE MILLS NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598545816,"HUEY, KATHERINE, CLAIRE",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 15 ,$#,,
MEDICAID DIRECT,1760865760,KIDZCARE PEDIATRICS PC,,1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598545816,"HUEY, KATHERINE, CLAIRE",1606 WELLINGTON AVE STE F WILMINGTON NC,065,New Hanover,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 78 , 99 , 254 ," $10,429.59 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598546442,"VALLEJO, CYNTHIA, AILEEN SOLIS",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 28 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598546442,"VALLEJO, CYNTHIA, AILEEN SOLIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 28 , 49 ,$#,,
MEDICAID DIRECT,1972040848,PHYCINITY PLLC,~,2277 NC 24-87   CAMERON NC,043,Harnett,193400000X,Group,Single Specialty,,1598561045,"CUTBIRTH, CASSANDRA, NOEL",2277 NC 24-87   CAMERON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598587693,"WAVERKA, MADISON, LOUISE",3940 ARROWHEAD BLVD STE 270 MEBANE NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598587693,"WAVERKA, MADISON, LOUISE",530 W WEBB AVE   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 17 ,$#,,
MEDICAID DIRECT,1841378296,BURLINGTON PEDIATRICS PA,BURLINGTON PEDIATRICS PA,530 W WEBB AVE   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598587693,"WAVERKA, MADISON, LOUISE",3804 S CHURCH ST   BURLINGTON NC,001,Alamance,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1598253734,RURAL HEALTH GROUP INC,~,270 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598588170,"NIVER, VIRGINIA, LELLE",270 SMITH CHURCH RD   ROANOKE RAPID NC,042,Halifax,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1598593725,COMMUNITY EMBRACE HOMECARE,COMMUNITY EMBRACE HOMECARE,310 MORRIS BBQ RD   HOOKERTON NC,040,Greene,253Z00000X,Agencies,In Home Supportive Care,,1598593725,COMMUNITY EMBRACE HOMECARE,310 MORRIS BBQ RD   HOOKERTON NC,040,Greene,253Z00000X,Agencies,In Home Supportive Care,,#, 685 , 685 ," $50,787.00 ",,
MEDICAID DIRECT,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,GRAYSTONE EYE,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598700114,GRAYSTONE OPHTHALMOLOGY ASSOCIATES,2424 CENTURY PL SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,, 434 , 439 , 872 ," $11,703.77 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,500 GATEWAY DR   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598700692,"CONWAY, ADA, MARIE",500 GATEWAY DR   CLAYTON NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,116 E HORTON ST   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1598700692,"CONWAY, ADA, MARIE",116 E HORTON ST   ZEBULON NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 46 , 75 , 206 ," $10,344.35 ",,
MEDICAID DIRECT,1598700718,NORTHWESTERN DRUG CO INC,NORTHWESTERN DRUG COMPANY INC,53 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598700718,NORTHWESTERN DRUG CO INC,53 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 18 , 28 , 30 ,$#,,
MEDICAID DIRECT,1598700718,NORTHWESTERN DRUG CO INC,NORTHWESTERN DRUG COMPANY INC,53 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1598700718,NORTHWESTERN DRUG CO INC,53 E MAIN AVE   TAYLORSVILLE NC,002,Alexander,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 57 , 386 , 720 ," $60,610.98 ",,
MEDICAID DIRECT,1740323682,NAVEED K AZIZ MD PA,NAVEED K AZIZ MD PA,224 N MAIN ST   SPRING LAKE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598700726,"AZIZ, NAVEED, KHALID",224 N MAIN ST   SPRING LAKE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 195 , 356 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1598700767,"WILLIAMS, DIANE, METZLER",205 PAGE RD   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 62 , 73 , 85 ,$#,,
MEDICAID DIRECT,1356421853,PINEHURST MEDICAL CLINIC INC,,15 REGIONAL DR   PINEHURST NC,063,Moore,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1598700767,"WILLIAMS, DIANE, METZLER",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1598700767,"WILLIAMS, DIANE, METZLER",155 MEMORIAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1598700767,"WILLIAMS, DIANE, METZLER",15 REGIONAL DR   PINEHURST NC,063,Moore,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 25 , 25 , 33 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,,,Unknown,193200000X,Group,Multi-Specialty,,1598702359,"YATES, MARK, CHARLES",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,640 S VAN BUREN RD UNIT B EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1598702359,"YATES, MARK, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 47 , 84 , 137 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598702359,"YATES, MARK, CHARLES",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 43 , 82 , 132 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598702359,"YATES, MARK, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598703274,"KELEKAR, ANITA, HIREN",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598703274,"KELEKAR, ANITA, HIREN",148 BURNETTS WAY   SUFFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1598703290,TOWN OF MOREHEAD CITY FIRE AND EMS,TOWN OF MOREHEAD CITY FIRE AND EMS,4034 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport,1598703290,TOWN OF MOREHEAD CITY FIRE AND EMS,4034 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,3416L0300X,Transportation Services,Ambulance,Land Transport, 140 , 218 , 397 ,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1598703910,"LIPPMAN, CALEB, ROSS",10 AVIEMORE DRIVE   PINEHURST NC,063,Moore,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,781 AVENT FERRY RD STE 106 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1598706533,"GRAHAM, ERNESTO, J F",1521 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598706533,"GRAHAM, ERNESTO, J F",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598707978,"BABB, JEFFREY, DEAN",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598707978,"BABB, JEFFREY, DEAN",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 13 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598707978,"BABB, JEFFREY, DEAN",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598708042,"OLSEN, ELISE, ARLINE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 25 , 29 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598709008,"MALKIN, MORTON, DAVID",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1598709008,"MALKIN, MORTON, DAVID",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598709008,"MALKIN, MORTON, DAVID",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598709230,"DAVIA, NICOLE, MARIE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 124 , 124 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1598710907,"KOZEL, WILLIAM, LEE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 596 , 797 ," 1,092 ",$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598710907,"KOZEL, WILLIAM, LEE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 307 , 354 , 459 ," $10,910.79 ",,
MEDICAID DIRECT,1225281876,PIEDMONT EYE SURGICAL AND LASER,~,1002 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598710923,"BEVIS, TIMOTHY, RANDOLPH",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1225281876,PIEDMONT EYE SURGICAL AND LASER,~,1002 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598710923,"BEVIS, TIMOTHY, RANDOLPH",1002 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 59 , 108 , 145 ," $10,740.85 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598712572,"CLEMENT, RYAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 85 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598712572,"CLEMENT, RYAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598715526,"ORTIZ, RACHEL, SCHAEFER",1025 NE GATEWAY CT NE   CONCORD NC,013,Cabarrus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 42 , 42 ,$#,,
MEDICAID DIRECT,1124393657,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598717829,"BUTLER, RONALD, DEAN",1550 FAULK ST STE 1500 MONROE NC,090,Union,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1639575400,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - ASHEBO,223 W WARD ST STE B ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 11 , 11 , 15 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",3812 N ELM ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 15 , 17 , 17 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 22 , 22 , 27 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 25 , 24 , 43 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 12 , 13 , 21 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 13 , 15 ,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598718066,"YAMAGATA, GLENN, TAKESHI",315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1417443771,YADKIN EMERGENCY PHYSICIANS PLLC,,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1598720385,"ARLEDGE, ROBERT, EDWOOD",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 101 , 105 , 123 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598720526,"LEWIS, STEVEN, JOHN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598722548,"DILLENDER, SUSANNAH, PLAYFORD",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598722548,"DILLENDER, SUSANNAH, PLAYFORD",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598722548,"DILLENDER, SUSANNAH, PLAYFORD",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598722803,"DHILLON, KIRANJIT, KAUR",500 W 21ST ST STE 102 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598722803,"DHILLON, KIRANJIT, KAUR",301 RIVERVIEW AVE STE 512 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1992846570,HALIFAX REGIONAL MEDICAL CENTER INC,HALIFAX REGIONAL MEDICAL CENTER INC,250 SMITH CHURCH RD   ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1598722829,"HUTCHINSON, DAVID, KNOX",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598722829,"HUTCHINSON, DAVID, KNOX",211 VIRGINIA RD   EDENTON NC,021,Chowan,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 46 , 46 ,$#,,
MEDICAID DIRECT,1205119914,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH WINSTON SALEM CARDIOLOGY,1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598723660,"MCCABE, JOHN, MICHAEL",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598723660,"MCCABE, JOHN, MICHAEL",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598723660,"MCCABE, JOHN, MICHAEL",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207UN0901X,Allopathic & Osteopathic Physicians,Nuclear Medicine,Nuclear Cardiology, 57 , 84 , 116 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598723660,"MCCABE, JOHN, MICHAEL",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598723934,"GORDON, SCOTT, DAVID",~,225 E LEE AVE   YADKINVILLE NC,099,Yadkin,152W00000X,Eye and Vision Services Providers,Optometrist,,1598723934,"GORDON, SCOTT, DAVID",225 E LEE AVE   YADKINVILLE NC,099,Yadkin,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1487807616,YADKIN VISION CENTER OD PLLC,~,225 E LEE AVE   YADKINVILLE NC,099,Yadkin,193200000X,Group,Multi-Specialty,,1598723934,"GORDON, SCOTT, DAVID",225 E LEE AVE   YADKINVILLE NC,099,Yadkin,152W00000X,Eye and Vision Services Providers,Optometrist,, 25 , 28 , 44 ,$#,,
MEDICAID DIRECT,1487807616,YADKIN VISION CENTER OD PLLC,~,225 E LEE AVE   YADKINVILLE NC,099,Yadkin,193400000X,Group,Single Specialty,,1598723934,"GORDON, SCOTT, DAVID",225 E LEE AVE   YADKINVILLE NC,099,Yadkin,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598724148,"CLEVELAND, MARYJO, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,310 LONG SHOALS RD STE 202 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598724692,"SIMMONS, MICHELLE, AILEEN",310 LONG SHOALS RD STE 202 ARDEN NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598724692,"SIMMONS, MICHELLE, AILEEN",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598724692,"SIMMONS, MICHELLE, AILEEN",143 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598726119,"HARRIGAN, MARIBETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 30 , 30 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598727281,"JONES, JENNIFER, MARGARET",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 44 , 55 , 55 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,14135 BALLANTYNE CORPORATE PL STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598729063,"PARK, RICHARD, IN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 12 , 18 , 23 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3030 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598729063,"PARK, RICHARD, IN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,355 VENUS ST A MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598729063,"PARK, RICHARD, IN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 14 , 17 , 26 ,$#,,
MEDICAID DIRECT,1174817993,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,275 BEATTY DR   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598729063,"PARK, RICHARD, IN",927 EAST BLVD   CHARLOTTE NC,060,Mecklenburg,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598729345,"PIAZZA, MICHAEL, JOHN",620 TOM HUNTER RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 100 , 104 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598729345,"PIAZZA, MICHAEL, JOHN",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598729345,"PIAZZA, MICHAEL, JOHN",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 106 , 198 , 198 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598729345,"PIAZZA, MICHAEL, JOHN",1315 GREENSBORO RD   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598729345,"PIAZZA, MICHAEL, JOHN",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 41 , 41 ,$#,,
MEDICAID DIRECT,1699940270,CHESAPEAKE REGIONAL MEDICAL GROUP,~,667 KINGSBOROUGH SQ STE 101 CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598730632,"WEISS, MARYLOU, M",736 BATTLEFIELD BLVD N   CHESAPEAKE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619452612,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1598731341,"WALSH, EILEEN, MARIE",1007 W VERNON AVE   KINSTON NC,054,Lenoir,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598731945,"WASKO, MARY CHESTER, MORGAN",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 14 , 21 , 21 ,$#,,
MEDICAID DIRECT,1942478383,DUPLIN GENERAL HOSPITAL INC,DUPLIN GENERAL HOSPITAL INC,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1598733412,"RICE, TAMARA, DEE",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1801989504,AMSOL PHYSICIANS OF ELKIN NC PLLC,AMSOL PHYSICIANS OF ELKIN NC PLLC,180 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1598733412,"RICE, TAMARA, DEE",180 PARKWOOD DR   ELKIN NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598733560,"ZAPPA, MICHAEL, JOSEPH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 40 , 53 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598734196,"WAGNER, PETER, BRIAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 92 , 104 , 122 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598734196,"WAGNER, PETER, BRIAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 33 , 33 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,115 HEART DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598734196,"WAGNER, PETER, BRIAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598734196,"WAGNER, PETER, BRIAN",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 211 , 287 , 360 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598735714,"ESTOK JR, MARTIN, BEHUL",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 46 , 47 ,$#,,
MEDICAID DIRECT,1598735938,HOME MEDICAL SYSTEMS INC,ROTECH,301 10TH ST NW STE D103 CONOVER NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598735938,HOME MEDICAL SYSTEMS INC,301 10TH ST NW STE D103 CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1598735938,HOME MEDICAL SYSTEMS INC,ROTECH,301 10TH ST NW STE D103 CONOVER NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598735938,HOME MEDICAL SYSTEMS INC,301 10TH ST NW STE D103 CONOVER NC,018,Catawba,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 314 ," 1,131 "," 1,853 "," $33,049.00 ",,
MEDICAID DIRECT,1598735938,HOME MEDICAL SYSTEMS INC,ROTECH,301 10TH ST NW STE D103 CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598735938,HOME MEDICAL SYSTEMS INC,301 10TH ST NW STE D103 CONOVER NC,018,Catawba,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 303 ," 1,141 "," 1,772 "," $30,192.76 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598736134,"BARUCH, AMY, ROSEANNE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1871640458,HOSPICE OF THE PIEDMONT INC,HOSPICE OF THE PIEDMONT INC,1801 WESTCHESTER DR   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598736134,"BARUCH, AMY, ROSEANNE",1803 WESTCHESTER DR   HIGH POINT NC,041,Guilford,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine,#,#,#,$#,,
MEDICAID DIRECT,1841248077,MYEYEDR OPTOMETRY OF NORTH CAROLINA,MYEYEDR,,,Unknown,193400000X,Group,Single Specialty,,1598736258,"PRESSON, JOSEPH, VANN",3001 MARTIN LUTHER KING JR BLVD   NEW BERN NC,025,Craven,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1164724100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE MINT HILL COMMONS FAMIL,11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598738213,"HEITBRINK, MARK, JOHN",11304 HAWTHORNE DR STE 100 MINT HILL NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 106 , 154 ,$#,,
MEDICAID DIRECT,1598738403,AMERICAN HOMEPATIENT OF SANDFORD,AMERICAN HOMEPATIENT,2912 S HORNER BLVD UNIT 80 SANFORD NC,053,Lee,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598738403,AMERICAN HOMEPATIENT OF SANDFORD,2912 S HORNER BLVD UNIT 80 SANFORD NC,053,Lee,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#, 15 ,$#,,
MEDICAID DIRECT,1598738403,AMERICAN HOMEPATIENT OF SANDFORD,AMERICAN HOMEPATIENT,2912 S HORNER BLVD UNIT 80 SANFORD NC,053,Lee,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1598738403,AMERICAN HOMEPATIENT OF SANDFORD,2912 S HORNER BLVD UNIT 80 SANFORD NC,053,Lee,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#,#,#,$#,,
MEDICAID DIRECT,1598738403,AMERICAN HOMEPATIENT OF SANDFORD,AMERICAN HOMEPATIENT,2912 S HORNER BLVD UNIT 80 SANFORD NC,053,Lee,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598738403,AMERICAN HOMEPATIENT OF SANDFORD,2912 S HORNER BLVD UNIT 80 SANFORD NC,053,Lee,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 162 ," 1,153 "," 2,231 "," $45,416.80 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598738866,"HOH, JENA, ENGEL",3213 ROGERS RD   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 45 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598739823,"BRAVO, JULIO, RAFAEL",1995 BETHABARA RD   WINSTON SALEM NC,034,Forsyth,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 30 , 67 , 121 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598740243,"MUSANTE, DAVID, BENJAMIN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 28 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1598740243,"MUSANTE, DAVID, BENJAMIN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598740243,"MUSANTE, DAVID, BENJAMIN",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 25 , 36 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,193200000X,Group,Multi-Specialty,,1598740243,"MUSANTE, DAVID, BENJAMIN",7810 NC HIGHWAY 751   DURHAM NC,019,Chatham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598740243,"MUSANTE, DAVID, BENJAMIN",3100 DURALEIGH RD STE 100 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598740631,"KOZLOWSKI, JEFFERY, DAVID",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 43 , 42 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1598740631,"KOZLOWSKI, JEFFERY, DAVID",401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 20 , 21 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598740631,"KOZLOWSKI, JEFFERY, DAVID",3480 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598740631,"KOZLOWSKI, JEFFERY, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 71 , 71 , 76 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1598740631,"KOZLOWSKI, JEFFERY, DAVID",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 48 , 48 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1598740631,"KOZLOWSKI, JEFFERY, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,,,$#,,
MEDICAID DIRECT,1598741134,"ARTHUR, WILLIAM, TODD",~,551 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice,1598741134,"ARTHUR, WILLIAM, TODD",551 BECKER DR   ROANOKE RAPIDS NC,042,Halifax,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 31 , 69 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1598741290,"HANSON, ARTHUR, HENNING",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 33 , 48 , 79 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598741290,"HANSON, ARTHUR, HENNING",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1255390225,WILSON OB GYN,WILSON OB GYN,2500 HORTON BLVD SW   WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1598741290,"HANSON, ARTHUR, HENNING",2500 HORTON BLVD SW   WILSON NC,098,Wilson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 47 , 62 , 83 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598741563,"PENA, JOSE, RAUL",9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 26 , 36 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598741670,"SAM, MARIA, CARIDAD",624 QUAKER LN STE 201 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598741670,"SAM, MARIA, CARIDAD",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 63 , 83 , 94 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598741688,"KUMAR, SANDHYA, RANI",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 38 , 44 , 44 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598741993,"PIRTTIMA, STEVEN, TODD",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598741993,"PIRTTIMA, STEVEN, TODD",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 26 , 39 ,$#,,
MEDICAID DIRECT,1598350647,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH FAMILY PRACTICE - LIBERTY,525 W SWANNANOA AVE   LIBERTY NC,076,Randolph,193200000X,Group,Multi-Specialty,,1598742066,"CONROY, NATHAN, WALES",525 W SWANNANOA AVE   LIBERTY NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 25 , 42 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598742603,"MCLEOD, TONYA, SHONELLE",5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598742603,"MCLEOD, TONYA, SHONELLE",5815 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1598744823,"NAVARRO, FELIPE",447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 24 , 32 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1598744823,"NAVARRO, FELIPE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598744823,"NAVARRO, FELIPE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 63 , 75 , 152 ,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598744823,"NAVARRO, FELIPE",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 16 , 17 , 27 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1598744823,"NAVARRO, FELIPE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598744823,"NAVARRO, FELIPE",200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598744823,"NAVARRO, FELIPE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598744823,"NAVARRO, FELIPE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 114 , 138 , 199 ,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1598744823,"NAVARRO, FELIPE",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 14 ,$#,,
MEDICAID DIRECT,1053624247,CAROLINAS PHYSICIANS NETWORK INC,The Sanger Clinic,307 YADKIN ST   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1598744823,"NAVARRO, FELIPE",307 YADKIN ST   ALBEMARLE NC,084,Stanly,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 30 , 37 , 52 ,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598745663,"MCHUGH, REBECCA, ELIZABETH",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 38 , 69 , 171 ,$#,,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598746547,"LEWIS, KRISTINE, RENEE",600 S SYCAMORE ST   ROSE HILL NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1598746547,"LEWIS, KRISTINE, RENEE",600 S SYCAMORE ST   ROSE HILL NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 93 , 93 ," $35,329.60 ",,
MEDICAID DIRECT,1538143375,MED EMPORIUM LLC,,1300 CROSS BEAM DR   CHARLOTTE NC,060,Mecklenburg,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598746547,"LEWIS, KRISTINE, RENEE",600 S SYCAMORE ST   ROSE HILL NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598747149,"TERMIN, CHARLES, SCOTT",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 19 , 26 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598747149,"TERMIN, CHARLES, SCOTT",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY STE 2500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598747149,"TERMIN, CHARLES, SCOTT",4525 CAMERON VALLEY PKWY STE 2500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 16 , 20 ,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598747149,"TERMIN, CHARLES, SCOTT",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598747149,"TERMIN, CHARLES, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598747149,"TERMIN, CHARLES, SCOTT",15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598747313,"BROWN, LAURA, DEVEREUX",1505 SW CARY PKWY STE 301 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598747313,"BROWN, LAURA, DEVEREUX",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 15 , 17 , 31 ,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598747313,"BROWN, LAURA, DEVEREUX",2308 WESVILL CT   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598747313,"BROWN, LAURA, DEVEREUX",10208 CERNY ST STE 300 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598747388,"BEVERLY RUDISEL, NETTIE, YVETTE",1401 MATTHEWS TOWNSHIP PKWY STE 200 MATTHEWS NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598747388,"BEVERLY RUDISEL, NETTIE, YVETTE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1598747446,"CHIANG, KARL, SY CHERNG",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 204 , 228 , 311 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598747446,"CHIANG, KARL, SY CHERNG",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 153 , 165 , 238 ,$#,,
MEDICAID DIRECT,1215048459,COUNTY OF HARNETT,HARNETT COUNTY HEALTH DEPT,307 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1598748220,"BRIGGS, JOHN, LESLIE",307 W CORNELIUS HARNETT BLVD   LILLINGTON NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 41 , 89 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598748634,"COLLIER, ANNAMARIE",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598749392,"DONOVAN, SHERRY, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598749392,"DONOVAN, SHERRY, LEE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154456143,JEFFREY L TAYLOR OD AND LYNN C TAYL,PEACHTREE FAMILY EYE CARE MURPHY,4295 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1598750069,"TAYLOR, LYNN, CARRINGER",4295 E US 64 ALT   MURPHY NC,020,Cherokee,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 27 , 38 ,$#,,
MEDICAID DIRECT,1275668170,JEFFREY L TAYLOR OD AND LYNN C TAYL,ANDREWS FAMILY EYE CARE,29 CHESTNUT ST   ANDREWS NC,020,Cherokee,193400000X,Group,Single Specialty,,1598750069,"TAYLOR, LYNN, CARRINGER",29 CHESTNUT ST   ANDREWS NC,020,Cherokee,152W00000X,Eye and Vision Services Providers,Optometrist,, 34 , 42 , 56 ,$#,,
MEDICAID DIRECT,1407369440,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRICS SYMPHONY PARK,6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598751513,"PRIDEMORE, LAURA, TAYLOR",6010 CARNEGIE BLVD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598751513,"PRIDEMORE, LAURA, TAYLOR",1994 WELLNESS BLVD STE 110 MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 24 , 55 ,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598752198,"ONIME, GODFREY, DELE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 112 , 339 , 341 ," $11,181.97 ",,
MEDICAID DIRECT,1386753457,LAKE NORMAN ANESTHESIA,LAKE NORMAN ANESTHESIA ASSOCIATES,146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1598753089,"BURKE, TIMOTHY, ALAN",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 30 , 30 , 31 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598753089,"BURKE, TIMOTHY, ALAN",146 MEDICAL PARK RD STE 108 MOORESVILLE NC,049,Iredell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598753303,"HA, ANUPAMA, SINGH",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 22 , 43 ,$#,,
MEDICAID DIRECT,1518197458,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598753303,"HA, ANUPAMA, SINGH",4949 PROFESSIONAL PARK DR STE 101 KANNAPOLIS NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 121 , 196 ,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598753303,"HA, ANUPAMA, SINGH",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023006707,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598753303,"HA, ANUPAMA, SINGH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598753360,"POLLACK, RONALD, ANTHONY",270 COPPERFIELD BLVD NE STE 102 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 25 , 35 ,$#,,
MEDICAID DIRECT,1336370295,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE CABARRUS FAMILY MEDICIN,5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1598753360,"POLLACK, RONALD, ANTHONY",5641 POPLAR TENT RD STE 101 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 68 , 157 , 223 ," $11,923.10 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598754772,"WHELAN, JAMES, WILLIAM",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598755845,"DARAB, DAVID, JOHN",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598755845,"DARAB, DAVID, JOHN",5509 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598755845,"DARAB, DAVID, JOHN",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1598755845,"DARAB, DAVID, JOHN",~,601 N ELM ST   HIGH POINT NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1598755845,"DARAB, DAVID, JOHN",601 N ELM ST   HIGH POINT NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,5509B W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598755845,"DARAB, DAVID, JOHN",231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598756934,"CABBELL, KYLE, LAWRENCE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 80 , 156 , 200 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598757288,"HILLENBRAND, KARIN, MARIE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 60 , 293 , 342 ," $18,450.20 ",,
MEDICAID DIRECT,1932353208,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAYETTEVILLE,1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598757999,"SY, ANGELITO, CABACAB",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 14 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598757999,"SY, ANGELITO, CABACAB",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 15 , 34 ,$#,,
MEDICAID DIRECT,1932353208,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAYETTEVILLE,1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598757999,"SY, ANGELITO, CABACAB",1738 OWEN DR STE 107 FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 90 , 129 , 367 ," $19,028.03 ",,
MEDICAID DIRECT,1093779951,EYE SURGERY AND LASER CLINIC INC,EYE SURGERY AND LASER CLINIC INC,500 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1598758492,"RAFLO, GARY, TODD",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1922063304,CABARRUS EYE CENTER PA,Cabarrus Eye Center PA,201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598758492,"RAFLO, GARY, TODD",201 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 24 , 27 ,$#,,
MEDICAID DIRECT,1376983171,CALDWELL MEMORIAL HOSPITAL,UNC SURGICAL SPECIALISTS,401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1598759995,"PALMER, MEADE, TODD",401 MULBERRY ST SW STE 202 LENOIR NC,014,Caldwell,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598759995,"PALMER, MEADE, TODD",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598759995,"PALMER, MEADE, TODD",300 GATEWOOD AVE   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1598760274,"KESSLER, JOHN, FRANKLIN",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 17 , 21 , 48 ,$#,,
MEDICAID DIRECT,1598760274,"KESSLER, JOHN, FRANKLIN",~,905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,1598760274,"KESSLER, JOHN, FRANKLIN",905 THUNDER RD STE 250 ELIZABETH CITY NC,070,Pasquotank,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598760332,"MCLAREN, MATTHEW, DOUGLAS",5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 13 , 12 , 16 ,$#,,
MEDICAID DIRECT,1780352252,J ARTHUR DOSHER MEMORIAL HOSPITAL,,4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1598760332,"MCLAREN, MATTHEW, DOUGLAS",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1710336243,PREMIER PAIN SOLUTIONS PLLC,,5710 OLEANDER DR STE 201 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598760332,"MCLAREN, MATTHEW, DOUGLAS",9 WALDEN RIDGE DR STE 10 ASHEVILLE NC,011,Buncombe,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1275596439,CAROLINA SPECIALTY CARE PA,CAROLINA SPECIALTY CARE PA,293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598760407,"SZOSTAK WODECKI, DEBRA, ANNE",293 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,207RG0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Geriatric Medicine, 73 , 163 , 241 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598760993,"TERZIAN, ANDREW, MIRKIL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598760993,"TERZIAN, ANDREW, MIRKIL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598760993,"TERZIAN, ANDREW, MIRKIL",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 39 , 58 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598760993,"TERZIAN, ANDREW, MIRKIL",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1598760993,"TERZIAN, ANDREW, MIRKIL",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1598761603,"JENKINS, OSCAR, RAY",472 RANKIN DR   MARION NC,059,McDowell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",430 RANKIN DR   MARION NC,059,McDowell,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",55 MEDICAL PARK DR STE 114 FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 123 , 144 , 165 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 32 , 35 , 37 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598761603,"JENKINS, OSCAR, RAY",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 41 , 42 , 46 ,$#,,
MEDICAID DIRECT,1952397028,IMMEDIATE CARE OF GOLDSBORO PLLC,IMMEDIATE CARE OF GOLDSBORO PLLC,2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1598761892,"GRANT, TERRY, ALAN",2604 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 45 ,$#,,
MEDICAID DIRECT,1164418232,GOLDSBORO EMERGENCY MEDICAL SPECIAL,GOLDSBORO EMERGENCY MEDICAL SPECIALISTS,2700 WAYNE MEMORIAL DR EMERGENCY DEPT GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1598761892,"GRANT, TERRY, ALAN",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558551671,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS BRUNSWICK,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1598762114,"RESCHLY, KEITH, CHRISTIAN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1598762114,"RESCHLY, KEITH, CHRISTIAN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,,,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1598762114,"RESCHLY, KEITH, CHRISTIAN",924 N HOWE ST   SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,1915 RANDOLPH RD FL 1 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598763054,"FARRES, JENNIFER, ANN",2001 RANDOLPH RODAD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598763054,"FARRES, JENNIFER, ANN",2001 RANDOLPH RODAD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 56 , 67 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,937 RIVERWALK PKWY STE 101 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598764250,"TUCKER, EMILY, CATHERINE HOPE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598764417,"COCKMAN, PATTY, KISER",130 LONGVIEW DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598764417,"COCKMAN, PATTY, KISER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 20 , 26 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598764417,"COCKMAN, PATTY, KISER",130 LONGVIEW DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 80 , 80 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598764417,"COCKMAN, PATTY, KISER",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 33 , 102 , 102 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598764417,"COCKMAN, PATTY, KISER",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 100 , 100 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598764417,"COCKMAN, PATTY, KISER",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598764417,"COCKMAN, PATTY, KISER",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598765562,"WILSON, DENNIS, NORMAN FARMER",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 28 , 39 , 67 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598765562,"WILSON, DENNIS, NORMAN FARMER",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 193 , 308 , 504 ," $11,003.06 ",,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1598765562,"WILSON, DENNIS, NORMAN FARMER",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 47 , 47 ,$#,,
MEDICAID DIRECT,1639179393,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1598765562,"WILSON, DENNIS, NORMAN FARMER",401 MOCKSVILLE AVE FL 2 SALISBURY NC,080,Rowan,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598765810,"JONES, MICHAEL, ALLEN",225 W WARD ST   ASHEBORO NC,076,Randolph,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 119 , 165 , 216 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598765810,"JONES, MICHAEL, ALLEN",601 N ELM ST   HIGH POINT NC,041,Guilford,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598766610,"PHYTHYON, EVE, KAREN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1598766610,"PHYTHYON, EVE, KAREN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477828788,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,2359 SPRINGS RD NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598767006,"FALTERMAYER JR, WILLIAM, COOK",2359 SPRINGS RD NE   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 99 , 127 ,$#,,
MEDICAID DIRECT,1326313735,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,305 1ST ST E   CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598767006,"FALTERMAYER JR, WILLIAM, COOK",305 1ST ST E   CONOVER NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1578613717,GEORGE ALBERT HOWARD III MD,ONSLOW RADIOLOGY CENTER,299 DOCTORS DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1598767071,"HOWARD, GEORGE, ALBERT",299 DOCTORS DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 52 , 60 ,$#,,
MEDICAID DIRECT,1598767071,"HOWARD, GEORGE, ALBERT",~,299 DOCTORS DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,1598767071,"HOWARD, GEORGE, ALBERT",299 DOCTORS DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 22 , 26 , 27 ,$#,,
MEDICAID DIRECT,1356906705,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GASTROENTEROLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598767402,"MERCURE, KEVIN, BRADLEY",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598767774,"BEASLEY, HARLEY, SCOTT",2101 W ARLINGTON BLVD STE 210 GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 193 , 201 , 240 ,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,1431 FERN CREEK DRIVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1598769010,"BROWN, CHRISTOPHER, HEATH",1431 FERN CREEK DRIVE   STATESVILLE NC,049,Iredell,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 36 , 41 , 102 ,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,261 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598769010,"BROWN, CHRISTOPHER, HEATH",110 JUNIPER ST STE 400 MORGANTON NC,012,Burke,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 12 , 11 , 51 ,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,110 JUNIPER ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1598769010,"BROWN, CHRISTOPHER, HEATH",110 JUNIPER ST STE 400 MORGANTON NC,012,Burke,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery," 1,875 "," 3,479 "," 15,356 "," $1,750,402.69 ",,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,110 JUNIPER ST STE 400 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1598769010,"BROWN, CHRISTOPHER, HEATH",261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1598769010,"BROWN, CHRISTOPHER, HEATH",~,261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,1598769010,"BROWN, CHRISTOPHER, HEATH",261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,1431 FERN CREEK DRIVE   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1598769010,"BROWN, CHRISTOPHER, HEATH",261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,261 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598769010,"BROWN, CHRISTOPHER, HEATH",261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery," 1,749 "," 3,223 "," 15,135 "," $1,673,306.29 ",,
MEDICAID DIRECT,1295752194,CHRISTOPHER H BROWN BS DENT DDS PA,CHRISTOPHER H BROWN BS DENT DDS PA,2 MEDICAL PARK DR STE 201 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1598769010,"BROWN, CHRISTOPHER, HEATH",261 18TH STREET CIR SE   HICKORY NC,018,Catawba,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1801853270,GREENMAN EYE ASSOCIATES PLLC,GREENMAN EYE ASSOCIATES PLLC,2801 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598769028,"GREENMAN, HERBERT, EMANUEL",2801 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 86 , 116 , 191 ,$#,,
MEDICAID DIRECT,1801853270,GREENMAN EYE ASSOCIATES PLLC,GREENMAN EYE ASSOCIATES PLLC,2801 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598769028,"GREENMAN, HERBERT, EMANUEL",2801 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 69 , 107 , 132 ,$#,,
MEDICAID DIRECT,1457696361,BLACK MOUNTAIN PHYSICAL THERAPY LLC,PHOENIX REHABILITATION AND HEALTH SERVICES INC,10610 METROMONT PKWY STE 108 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598769085,"OSTRANDER, DENNIS, CHRISTOPHER",10616 METROMONT PKWY STE 108 CHARLOTTE NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1457696361,BLACK MOUNTAIN PHYSICAL THERAPY LLC,PHOENIX REHABILITATION AND HEALTH SERVICES INC,997 OLD HIGHWAY 70 W STE D BLACK MOUNTAIN NC,011,Buncombe,193400000X,Group,Single Specialty,,1598769085,"OSTRANDER, DENNIS, CHRISTOPHER",997 OLD HIGHWAY 70 W STE D BLACK MOUNTAIN NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598770372,"ST REMY, CARL, RAPHAEL",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 16 , 19 , 31 ,$#,,
MEDICAID DIRECT,1245248947,CHILDRENS SURGICAL SPECIALTY GROUP,CHILDRENS SURGICAL SPECIALTY GROUP,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598770372,"ST REMY, CARL, RAPHAEL",500 DISCOVERY DRIVE   CHESAPEAKE VA,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235670175,ARTHRITIS AND REHAB MEDICINE PLLC,,320 SALTER PATH RD   ATLANTIC BEACH NC,016,Carteret,193200000X,Group,Multi-Specialty,,1598773343,"MCKNIGHT, KEVIN, MICHAEL",320 SALTER PATH RD   ATLANTIC BEACH NC,016,Carteret,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 32 , 50 ,$#,,
MEDICAID DIRECT,1598774002,HARRIS TEETER LLC,HARRIS TEETER PHARMACY 0341,265 EASTCHESTER DR   HIGH POINT NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1598774002,HARRIS TEETER LLC,265 EASTCHESTER DR   HIGH POINT NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598774606,"DIOHEP, DEANNA, THERESA",3787 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1831130798,BENSON AREA MEDICAL CENTER INC,BENSON HEALTH,3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1598774697,"MACKINNON, CHRISTOPHER, JOHN",804 S MARKET ST   BENSON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 34 , 48 ,$#,,
MEDICAID DIRECT,1598774697,"MACKINNON, CHRISTOPHER, JOHN",MACKINNON MEDICAL CENTER PLLC,804 S MARKET ST   BENSON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1598774697,"MACKINNON, CHRISTOPHER, JOHN",804 S MARKET ST   BENSON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1831130798,BENSON AREA MEDICAL CENTER INC,BENSON HEALTH,3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1598774697,"MACKINNON, CHRISTOPHER, JOHN",3333 NC HIGHWAY 242 N   BENSON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 70 , 111 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598774770,"DELAIRE-HENRY, CHRISTY, LOUISE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598774770,"DELAIRE-HENRY, CHRISTY, LOUISE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598774770,"DELAIRE-HENRY, CHRISTY, LOUISE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598775751,PIEDMONT TRIAD AMB AND RESCUE INC,PIEDMONT TRIAD AMB AND RESCUE INC,1422 S MAIN ST   HIGH POINT NC,041,Guilford,3416L0300X,Transportation Services,Ambulance,Land Transport,1598775751,PIEDMONT TRIAD AMB AND RESCUE INC,1422 S MAIN ST   HIGH POINT NC,041,Guilford,3416L0300X,Transportation Services,Ambulance,Land Transport," 1,955 "," 3,436 "," 6,455 "," $151,053.55 ",,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598776106,"SCHANO, ANDREW, ARTHUR",5603 DURALEIGH RD STE 111 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1275660342,J ARTHUR DOSHER MEMORIAL HOSPITAL,J ARTHUR DOSHER MEMORIAL HOSPITAL,924 N HOWE ST   SOUTHPORT NC,010,Brunswick,193400000X,Group,Single Specialty,,1598779191,"REAL, JENNIFER, SWISHER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1598779399,"KELLER, ROBERT, MICHAEL",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 108 , 232 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598779795,"JAMES, MICHAEL, LUCAS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598779795,"JAMES, MICHAEL, LUCAS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598779795,"JAMES, MICHAEL, LUCAS",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598780884,"MARX, WILLIAM, FOSTER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 184 , 207 , 253 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598780884,"MARX, WILLIAM, FOSTER",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 87 ,#,#,$#,,
MEDICAID DIRECT,1376537555,COLUMBUS REGIONAL HEALTHCARE SYSTEM,~,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193400000X,Group,Single Specialty,,1598781072,"MILLER, GLORIA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1528461670,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - SOUTH HICKORY,1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598782922,"SYKES, PAUL, WILSON",1985 STARTOWN RD   HICKORY NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 76 , 317 , 786 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598783102,"COOK, BRIAN, CHRISTOPHER",2802 MCLAMB PL   GOLDSBORO NC,096,Wayne,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,215 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1598783102,"COOK, BRIAN, CHRISTOPHER",215 BEAMAN ST   CLINTON NC,082,Sampson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598783102,"COOK, BRIAN, CHRISTOPHER",215 BEAMAN ST   CLINTON NC,082,Sampson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 30 , 228 , 485 ," $19,650.73 ",,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1598783102,"COOK, BRIAN, CHRISTOPHER",215 BEAMAN ST   CLINTON NC,082,Sampson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598783961,"DEAL, STEPHEN, EDGAR",1450 MATTHEWS TOWNSHIP PKWY STE 460 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598783961,"DEAL, STEPHEN, EDGAR",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598783961,"DEAL, STEPHEN, EDGAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598783961,"DEAL, STEPHEN, EDGAR",300 BILLINGSLEY RD STE 200B CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598783961,"DEAL, STEPHEN, EDGAR",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#, 25 , 45 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598783961,"DEAL, STEPHEN, EDGAR",300 BILLINGSLEY RD STE 200B CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 14 ,$#,,
MEDICAID DIRECT,1124052444,CAROLINA DIGESTIVE HEALTH ASSOCIATE,CAROLINA DIGESTIVE HEALTH,300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598783961,"DEAL, STEPHEN, EDGAR",300 BILLINGSLEY RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598785297,"HEDRICK, JAMES, FLETCHER",908 S WILLIAMSON AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 73 , 249 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598785297,"HEDRICK, JAMES, FLETCHER",908 S WILLIAMSON AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598785297,"HEDRICK, JAMES, FLETCHER",908 S WILLIAMSON AVE   ELON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598785438,"SEAMAN, BARBARA, ALINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598785438,"SEAMAN, BARBARA, ALINE",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598785594,"HAKE, STEVEN, EDWARD",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 45 , 46 , 56 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598785594,"HAKE, STEVEN, EDWARD",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598785594,"HAKE, STEVEN, EDWARD",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 40 , 42 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598785834,"BLASENAK, JASON, HOWARD",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770597486,HOWDY AND JONES DDS,~,1103 BROWN ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1598786527,"HOWDY, DAVID, ALLAN",1103 BROWN ST   WASHINGTON NC,007,Beaufort,1223G0001X,Dental Providers,Dentist,General Practice, 17 , 23 , 62 ,$#,,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598787806,"SCHATTSCHNEIDER, GARY",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 218 , 304 , 335 ,$#,,
MEDICAID DIRECT,1306894597,MACON COLLIE PRETZER KORNSTEIN AND,WAKE ORTHODONTICS AND PEDIATRIC DENTISTRY,100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1598788820,"PRETZER, STEPHEN, CHARLES",100 HEALTH PARK DR STE 100 GARNER NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 450 , 571 ," 1,995 "," $73,781.60 ",,
MEDICAID DIRECT,1598788820,"PRETZER, STEPHEN, CHARLES",,7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,1598788820,"PRETZER, STEPHEN, CHARLES",7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1306894597,MACON COLLIE PRETZER KORNSTEIN AND,WAKE ORTHODONTICS AND PEDIATRIC DENTISTRY,7401 CREEDMOOR RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598788820,"PRETZER, STEPHEN, CHARLES",7401 CREEDMOOR RD   RALEIGH NC,092,Wake,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 354 , 449 ," 1,539 "," $55,772.00 ",,
MEDICAID DIRECT,1598791246,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,636 HIGHWAY 24 27 BYP E STE 8&9 ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,,1598791246,BAYADA HOME HEALTH CARE INC,636 HIGHWAY 24 27 BYP E STE 8&9 ALBEMARLE NC,084,Stanly,253Z00000X,Agencies,In Home Supportive Care,, 59 ," 12,370 "," 13,224 "," $1,862,440.40 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598792277,"REARDON, WHITMAN, LILLEY",940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598793036,"ZIMMERMAN, DANIEL, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518393560,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1598793424,"HERSHNER, GREGORY, SCOTT",151 MEDICAL PARK DR   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 16 , 25 ,$#,,
MEDICAID DIRECT,1013437755,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST COMPLEX CARE - W,1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598795478,"TERRELL, GRACE, EMERSON",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730472671,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE MEDICAL GROUP NEUROLOGY,2209 S STERLING ST STE 330 MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1598795635,"ALLABOUN, KADRY, RAJI",2209 S STERLING ST STE 330 MORGANTON NC,012,Burke,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 446 , 725 , 754 ," $30,795.85 ",,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598797748,"MICHAEL, JOEL, CRAIG",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598797748,"MICHAEL, JOEL, CRAIG",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1598798100,"GIFFORD, MARK, WILLIAM",~,3419 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,1598798100,"GIFFORD, MARK, WILLIAM",3419 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 40 , 41 , 65 ,$#,,
MEDICAID DIRECT,1548409576,VISION CARE ASSOCIATES OD PA,VISION CARE ASSOCIATES OD PA,3419 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598798100,"GIFFORD, MARK, WILLIAM",3419 PINEVILLE MATTHEWS RD   CHARLOTTE NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 28 , 28 , 30 ,$#,,
MEDICAID DIRECT,1760190607,NOVANT HEALTH BALLANTYNE MEDICAL CE,NOVANT HEALTH BALLANTYNE MEDICAL CENTER,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598799470,"TURNER, LATRICE, ANNETTE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598799470,"TURNER, LATRICE, ANNETTE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598799470,"TURNER, LATRICE, ANNETTE",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598799470,"TURNER, LATRICE, ANNETTE",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598799470,"TURNER, LATRICE, ANNETTE",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1578152773,FULLER & ASSOCIATES VI PLLC,BLADENBORO FAMILY DENTISTRY,104 4TH ST   BLADENBORO NC,009,Bladen,193200000X,Group,Multi-Specialty,,1598799603,"FRENCH, SHANNON, IRENE",104 4TH ST   BLADENBORO NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice," 1,313 "," 2,471 "," 8,319 "," $534,167.77 ",,
MEDICAID DIRECT,1255506861,CHRISTOPHER CLARK DDS PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1598799603,"FRENCH, SHANNON, IRENE",104 4TH ST   BLADENBORO NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1598799751,TALK TO ME TECHNOLOGIES LLC,,1100 TECHNOLOGY PKWY   CEDAR FALLS IA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598799751,TALK TO ME TECHNOLOGIES LLC,1100 TECHNOLOGY PKWY   CEDAR FALLS IA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 56 , 59 , 102 ," $415,518.82 ",,
MEDICAID DIRECT,1598799751,TALK TO ME TECHNOLOGIES LLC,,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598799751,TALK TO ME TECHNOLOGIES LLC,3508 TERRACE DR   CEDAR FALLS IA,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,,,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598799900,"REUTER, ROBERT",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 455 , 718 , 914 ," $10,860.13 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598801193,"HURLEY, ROBERT, WILLSON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598803108,"SUAREZ-SANCHEZ, OSCAR, RAUL",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223P0700X,Dental Providers,Dentist,Prosthodontics, 40 , 44 , 86 ,$#,,
MEDICAID DIRECT,1538776455,LANE AND ASSOCIATES XXXIX,,161 KODIAK LN   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1598803108,"SUAREZ-SANCHEZ, OSCAR, RAUL",161 KODIAK LN   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 22 , 24 , 55 ,$#,,
MEDICAID DIRECT,1538776455,LANE AND ASSOCIATES XXXIX,,161 KODIAK LN   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1598803108,"SUAREZ-SANCHEZ, OSCAR, RAUL",161 KODIAK LN   MOUNT AIRY NC,086,Surry,1223P0700X,Dental Providers,Dentist,Prosthodontics, 43 , 45 , 128 ," $13,347.48 ",,
MEDICAID DIRECT,1437110905,CAPE FEAR ORTHOTICS AND PROSTHETICS,Cape Fear Orthotics and Prosthetics,435 W RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598803785,"SPEELMAN, ELMER, JAMES",435 W RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,, 117 , 126 , 378 ," $13,481.00 ",,
MEDICAID DIRECT,1437110905,CAPE FEAR ORTHOTICS AND PROSTHETICS,Cape Fear Orthotics and Prosthetics,435 W RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598803785,"SPEELMAN, ELMER, JAMES",435 W RUSSELL ST   FAYETTEVILLE NC,026,Cumberland,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 66 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598805483,"WU, JACK, CHIA WUN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 16 , 25 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598805483,"WU, JACK, CHIA WUN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1598805483,"WU, JACK, CHIA WUN",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598805483,"WU, JACK, CHIA WUN",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1598805483,"WU, JACK, CHIA WUN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1598805483,"WU, JACK, CHIA WUN",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598807265,"CABARRUS, BRIAN, RAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 17 , 18 , 19 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598807265,"CABARRUS, BRIAN, RAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598807265,"CABARRUS, BRIAN, RAY",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 30 , 34 , 52 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598807265,"CABARRUS, BRIAN, RAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 26 , 29 , 33 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598809089,"NARAIN, PRISCILLA, ANNE",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598809089,"NARAIN, PRISCILLA, ANNE",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 17 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598809089,"NARAIN, PRISCILLA, ANNE",1717 SHIPYARD BLVD STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598809089,"NARAIN, PRISCILLA, ANNE",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598810897,"JONES, CLIFFORD, BELL",CLIFFORD BELL JONES III,407 S ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice,1598810897,"JONES, CLIFFORD, BELL",407 S ROAD ST   ELIZABETH CITY NC,070,Pasquotank,1223G0001X,Dental Providers,Dentist,General Practice," 1,025 "," 1,669 "," 6,383 "," $265,309.48 ",,
MEDICAID DIRECT,1912338328,ONSITE CARE PLLC,,10130 PERIMETER PKWY STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598811127,"RUCCI, JENNIFER, MARIE",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598811663,"BLACKWELL, ANNIE, DELORES",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598813982,"SCHUSTER, JEANNETTE, JONES",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 29 , 31 , 31 ,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598813982,"SCHUSTER, JEANNETTE, JONES",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1598815045,HEAVENLY TOUCH LLC,HEAVENLY TOUCH LLC,636 PROSPECT RD   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,,1598815045,HEAVENLY TOUCH LLC,636 PROSPECT RD   PEMBROKE NC,078,Robeson,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 4,485 "," 4,485 "," $315,088.68 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598815532,"MODI, ANKITA",8169 ARDREY KELL RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1598816381,SOUTHEASTERN WAKE ADULT DAY CENTER,SOUTHEASTERN ADULT DAY CENTER,328 DOGWOOD ST   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1598816381,SOUTHEASTERN WAKE ADULT DAY CENTER,328 DOGWOOD ST   SMITHFIELD NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,#, 181 , 181 ," $12,951.08 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598819104,"CRICHTON, HEATHER, BAKER",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3001 EDWARDS MILL RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598819153,"SHAFER, SUSAN, ANN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598819542,"POPE, KAREN, LYNN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1598819542,"POPE, KAREN, LYNN",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1457667800,ROWAN PSYCHIATRIC AND MEDICAL SERVI,~,310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1598821191,"MARTIN, MARY, ANN",310 STATESVILLE BLVD STE 1 SALISBURY NC,080,Rowan,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1053444901,PENDER MEMORIAL HOSPITAL INC,NOVANT HEALTH PENDER MEDICAL CENTER,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1598822827,"TURNER, DONALD, WAYNE",507 E FREMONT ST   BURGAW NC,071,Pender,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598822827,"TURNER, DONALD, WAYNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598822827,"TURNER, DONALD, WAYNE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 19 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598824237,"PILLAY, MIDESHA",3800 INDEPENDENCE BLVD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 381 , 384 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1598824237,"PILLAY, MIDESHA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598824237,"PILLAY, MIDESHA",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 39 , 39 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598824237,"PILLAY, MIDESHA",1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 71 , 93 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598824237,"PILLAY, MIDESHA",83 CAVALIER DR STE 200 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598824237,"PILLAY, MIDESHA",5725 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598824237,"PILLAY, MIDESHA",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396893640,SENIOR HEALTH ASSOCIATES PA,~,1709 S 16TH ST STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598824237,"PILLAY, MIDESHA",647 S EAST RAILROAD ST   WALLACE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 194 , 194 ,$#,,
MEDICAID DIRECT,1700228418,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SHELBY CHILDRENS C,709 N DEKALB ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598825853,"CALABRO, MICHELLE, MCCLAIN",709 N DEKALB ST   SHELBY NC,023,Cleveland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 77 , 120 , 278 ," $12,350.83 ",,
MEDICAID DIRECT,1427106079,COASTAL FAMILY PRACTICE AND INTERNA,~,2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598827180,"BIBB, PHILIP, WAYNE",2744 S 17TH ST   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 122 , 123 ,$#,,
MEDICAID DIRECT,1427106079,COASTAL FAMILY PRACTICE AND INTERNA,~,2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598827180,"BIBB, PHILIP, WAYNE",2207 DELANEY AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 65 , 441 , 447 ," $10,504.08 ",,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 VETERANS PKWY STE 207 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,5638 VETERANS PKWY STE 207 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,, 163 , 163 , 326 ,$#,,
MEDICAID DIRECT,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,DR ALAN L BYRD AND ASSOCIATES AT LANDMARK OD PA,5638 NC HIGHWAY 42 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1598829418,DR ALAN L BYRD AND ASSOCIATES AT LA,5638 NC HIGHWAY 42 W   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,, 440 , 443 , 879 ," $11,463.52 ",,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,600 GRESHAM DR STE 700 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598830903,"GRANATA, LAUREN, ROSE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598830903,"GRANATA, LAUREN, ROSE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598830903,"GRANATA, LAUREN, ROSE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598830945,"RAMAN, LAKSHMI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598830945,"RAMAN, LAKSHMI",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 93 , 93 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598832354,"TAYLOE, DAVID",327 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598832354,"TAYLOE, DAVID",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 132 , 108 , 248 ," $13,849.21 ",,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1598832354,"TAYLOE, DAVID",2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 19 , 19 ," $21,087.37 ",,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598832354,"TAYLOE, DAVID",114 E RAILROAD ST   LA GRANGE NC,054,Lenoir,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1114195617,WAYNE MEMORIAL HOSPITAL INC,WAYNE MEMORIAL HOSPITAL INC,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1598832461,"COKER, CHRISTIE, MARIE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 20 , 20 ,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598833188,"SADR, HOOMAN",500 W 21ST ST STE 102 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780624627,TIDEWATER KIDNEY SPECIALISTS INC,TIDEWATER KIDNEY SPECIALISTS INC,300 MEDICAL PKWY STE 110 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1598833188,"SADR, HOOMAN",301 RIVERVIEW AVE STE 512 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598833261,"CAUSEY, MICHELLE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,23 SUNNYBROOK RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598833261,"CAUSEY, MICHELLE, LYNN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760870323,AZALEA COAST PODIATRY AND FOOT SPA,,1604 PHYSICIANS DR STE 105 WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598834350,"SMITH, KERRY, ALLYSON",1604 PHYSICIANS DR STE 105 WILMINGTON NC,065,New Hanover,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 55 , 149 , 213 ,$#,,
MEDICAID DIRECT,1699863068,CAROLINA EYE CARE OF LINCOLN COUNTY,CAROLINA EYE CARE OF LINCOLN COUNTY,623 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1598835662,"MOTTELER, MATTHEW, BYNUM",623 N NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 29 , 52 ,$#,,
MEDICAID DIRECT,1063953602,RDMG ASSOCIATES PA,,6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598836462,"ILLOBRE, ANDREW, NICHOLAS",6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598838336,"ERON JR, JOSEPH, JOHN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 28 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598838336,"ERON JR, JOSEPH, JOHN",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598838518,"BONHAM, STEPHANIE, LYNN",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598838518,"BONHAM, STEPHANIE, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ROGERS RD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1598838518,"BONHAM, STEPHANIE, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 33 , 38 ,$#,,
MEDICAID DIRECT,1598839474,HANGER PROSTHETICS & ORTHOTICS EAST,HANGER PROSTHETICS AND ORTHOTICS,146 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598839474,HANGER PROSTHETICS & ORTHOTICS EAST,146 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 17 , 18 , 89 ," $12,545.34 ",,
MEDICAID DIRECT,1942424387,NC DHHS CHILD AND FAMILY WELL-BEING,ASHEVILLE CDSA,2500 HEART DR STE 100 ASHEVILLE NC,011,Buncombe,252Y00000X,Agencies,Early Intervention Provider Agency,,1598842049,"GERRETY, KRISTIN, SIEGFRIED",852 MERRIMON AVE   ASHEVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 40 , 310 , 310 ," $24,680.38 ",,
MEDICAID DIRECT,1821043274,RALEIGH PATHOLOGY LABORATORY ASSOCI,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598842239,"RITTERSHAUS, AHREN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 71 , 72 , 114 ,$#,,
MEDICAID DIRECT,1477704443,WAKE MEDICAL LABORATORY CONSULTANTS,WAKE MEDICAL LABORATORY CONSULTANTS INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598842239,"RITTERSHAUS, AHREN, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1417907940,LPCH MEDICAL GROUP DIV OF LUCILE,,725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1598842593,"SHIN, ANDREW, YOUNG",725 WELCH RD   PALO ALTO CA,102,Out of State > 40 miles,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1598844052,"LITTLE, CARL, PHILEMON",~,628 WASHINGTON ST   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1598844052,"LITTLE, CARL, PHILEMON",628 WASHINGTON ST   HIGH POINT NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 471 ," 1,007 "," 1,439 "," $104,222.09 ",,
MEDICAID DIRECT,1679517296,LENOIR MEMORIAL HOSPITAL INC,UNC HEALTH LENOIR,100 AIRPORT RD   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1598845687,"HENNING, MARK, EDWARD",100 AIRPORT RD   KINSTON NC,054,Lenoir,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 27 , 29 , 29 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1598846701,"KAUFMAN, JILL, RAE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598846701,"KAUFMAN, JILL, RAE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598846701,"KAUFMAN, JILL, RAE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1598846701,"KAUFMAN, JILL, RAE",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1598846701,"KAUFMAN, JILL, RAE",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1407875610,UROLOGY ASSOCIATES OF SOUTHEASTERN,UROLOGY ASSOCIATES OF SOUTHEASTERN NC PA,1905 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598847188,"DIXON, ROBERT, GEORGE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1518951144,SCOTLAND MEMORIAL HOSPITAL INC,SCOTLAND PROFESSIONAL GROUP,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1598847188,"DIXON, ROBERT, GEORGE",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598848046,"MARCH, MICHAEL, ROSS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 34 , 36 , 43 ,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598848046,"MARCH, MICHAEL, ROSS",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598849457,"SETJI, NOPPON, POOH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598849457,"SETJI, NOPPON, POOH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 32 , 32 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598849457,"SETJI, NOPPON, POOH",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 19 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598849465,"WESTMAN, ERIC, CHARLES",4220 N ROXBORO ST PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598849465,"WESTMAN, ERIC, CHARLES",4220 N ROXBORO ST PRIVATE DIAGNOSTIC CLINIC DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 58 , 58 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598850075,"THORNE, LEIGH, BOYETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 24 , 26 , 26 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598850075,"THORNE, LEIGH, BOYETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598850075,"THORNE, LEIGH, BOYETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598850075,"THORNE, LEIGH, BOYETTE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598850729,"MILLER, THERESA, KIERNAM",8115 MARKET ST STE 108 WILMINGTON NC,065,New Hanover,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 11 , 22 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1598851677,"MOLNAR, MARCIA, ANN",338 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1598851677,"MOLNAR, MARCIA, ANN",338 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 33 , 33 ,$#,,
MEDICAID DIRECT,1861567893,WATAUGA MEDICAL CENTER INC,SEBY B JONES REGIONAL CANCER CENTER,338 DEERFIELD RD   BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1598851677,"MOLNAR, MARCIA, ANN",338 DEERFIELD RD   BOONE NC,095,Watauga,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598851974,"YANCY, WILLIAM, SAMUEL",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598851974,"YANCY, WILLIAM, SAMUEL",2100 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336448810,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE DIET AND FITNESS CENTER,501 DOUGLAS ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598851974,"YANCY, WILLIAM, SAMUEL",501 DOUGLAS ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 35 , 50 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598852238,"SCHWARTZ, JEANNE, EYMAN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588818512,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE RUTHERFORD INTERNAL MED,181 DANIEL RD   FOREST CITY NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1598852444,"DAIGLE, SEEMA, NASREEN",181 DANIEL RD   FOREST CITY NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 90 , 285 , 417 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1598854077,"PELHAM, CATHY, CHARESE",1705 TARBORO ST SW   WILSON NC,098,Wilson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598854077,"PELHAM, CATHY, CHARESE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 54 , 65 , 66 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1598854077,"PELHAM, CATHY, CHARESE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598854325,"OXENDINE, MONICA, LOCKLEAR",4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598854325,"OXENDINE, MONICA, LOCKLEAR",800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 11 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598854325,"OXENDINE, MONICA, LOCKLEAR",2934 N ELM ST STE B LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598854325,"OXENDINE, MONICA, LOCKLEAR",4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 47 , 52 , 54 ," $19,709.68 ",,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1598854325,"OXENDINE, MONICA, LOCKLEAR",4300 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598855447,"LOWRY, BRIAN, PATRICK",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 56 , 63 , 64 ,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598855447,"LOWRY, BRIAN, PATRICK",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,,,Unknown,193400000X,Group,Single Specialty,,1598855447,"LOWRY, BRIAN, PATRICK",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598856098,"LEWIS, EUGENE, ALEXANDER",4709 CREEKSTONE DR   DURHAM NC,032,Durham,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1598856098,"LEWIS, EUGENE, ALEXANDER",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1545 ORCHARD VILLAS AVE STE 100 APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1598856098,"LEWIS, EUGENE, ALEXANDER",1545 ORCHARD VILLAS AVE   APEX NC,092,Wake,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1598856593,"TOWNS, ERRON, JOSEPH",129 WOODSON ST   SALISBURY NC,080,Rowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 79 , 108 , 217 ," $10,011.75 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1916 W PARK DR   NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1598857039,"REDMAN, MICHELLE, LISA",1404 WILLOW LN STE A NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598857039,"REDMAN, MICHELLE, LISA",1404 WILLOW LN STE A NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 38 , 58 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,1915 W PARK DR STE 101 NORTH WILKESBORO NC,097,Wilkes,193200000X,Group,Multi-Specialty,,1598857039,"REDMAN, MICHELLE, LISA",1404 WILLOW LN STE A NORTH WILKESBORO NC,097,Wilkes,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598857187,"HIGDON, MARK, LOWELL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598857187,"HIGDON, MARK, LOWELL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598857187,"HIGDON, MARK, LOWELL",19485 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 37 , 58 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,3800 S OCEAN DR STE 209 HOLLYWOOD FL,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1598857310,"MORRIS, CRYSTAL, GOLLIDAY",230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 12 ,$#,,
MEDICAID DIRECT,1881136893,QSM-NC PA,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1598857310,"MORRIS, CRYSTAL, GOLLIDAY",230 NC HIGHWAY 141   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 66 , 75 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,146 MEDICAL PARK RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598857401,"MASTOR, JASON, ELIA",206 JOE KNOX AVE STE F MOORESVILLE NC,049,Iredell,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598857609,"LEBLANC, MONIQUE, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 13 , 13 , 13 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598857609,"LEBLANC, MONIQUE, MICHELLE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1598857609,"LEBLANC, MONIQUE, MICHELLE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598857625,"WASHBURN, ERIN, LEE",1994 WELLNESS BLVD STE 110 MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 30 , 53 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598862690,"JACKSON-EVANS, CATHERINE, SHEILA",1091 KIRKPATRICK RD   BURLINGTON NC,001,Alamance,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598865180,"CASH, CLARK",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 849 ," 1,895 "," 2,461 "," $318,231.93 ",,
MEDICAID DIRECT,1366560443,LARRY J MORAY DDS MS PA,MYORTHODONTIST,2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598865180,"CASH, CLARK",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1598865180,"CASH, CLARK",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 11 ,$#,,
MEDICAID DIRECT,1306384474,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598865180,"CASH, CLARK",1002 N CHURCH ST STE 400 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#, 17 ,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598865180,"CASH, CLARK",501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 910 ," 1,885 "," 2,543 "," $320,354.01 ",,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1598865180,"CASH, CLARK",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 14 , 15 , 44 ,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598865180,"CASH, CLARK",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 268 , 321 , 409 ," $160,759.00 ",,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598865180,"CASH, CLARK",2501 ATRIUM DR STE 301 RALEIGH NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,,,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1598865180,"CASH, CLARK",616 DR CALVIN JONES HWY   WAKE FOREST NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598865438,"ELLISON, MATTHEW, DAVID",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598865438,"ELLISON, MATTHEW, DAVID",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598865438,"ELLISON, MATTHEW, DAVID",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598865438,"ELLISON, MATTHEW, DAVID",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598865438,"ELLISON, MATTHEW, DAVID",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 39 , 43 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598865438,"ELLISON, MATTHEW, DAVID",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598865768,"ELLIS, ALLISON, INGOLD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1720381395,THERAPEUTIC SPECIALTIES OF NORTH CA,THERAPEUTIC SPECIALTIES OF NC,104 MARKET ST   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1598865883,"JUNTUNEN, TAMMY, SATTERWHITE",104 MARKET ST   HENDERSON NC,091,Vance,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598866865,"RAGSDALE, LUNA, CHEN",2301 ERWIN RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 24 , 25 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598866865,"RAGSDALE, LUNA, CHEN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 21 ,$#,,
MEDICAID DIRECT,1316002629,ALAMANCE COUNTY GOVT,ALAMANCE COUNTY HEALTH DEPT,1914 MCKINNEY ST   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598867368,"ACKALL, IBRAHEEM, GEORGE",1914 MCKINNEY ST   BURLINGTON NC,001,Alamance,1223D0001X,Dental Providers,Dentist,Dental Public Health," 1,809 "," 2,557 "," 8,283 "," $310,258.27 ",,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598867475,"WILLIAMS, CHARLES, EDWARDS",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 82 , 155 ,$#,,
MEDICAID DIRECT,1003881822,NASH HOSPITALS INC,NASH HOSPITALS INC,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1598867483,"HILL, BRANDYCE, FAULKNER",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598867483,"HILL, BRANDYCE, FAULKNER",521C MOYE BLVD   GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1598868358,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03823,1850 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598868358,NORTH CAROLINA CVS PHARMACY LLC,1850 W FRANKLIN BLVD   GASTONIA NC,036,Gaston,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1598868937,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07523,1040 ALAMANCE CHURCH RD   GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1598868937,NORTH CAROLINA CVS PHARMACY LLC,1040 ALAMANCE CHURCH RD   GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1598868937,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07523,1040 ALAMANCE CHURCH RD   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598868937,NORTH CAROLINA CVS PHARMACY LLC,1040 ALAMANCE CHURCH RD   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1598868937,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 07523,1040 ALAMANCE CHURCH RD   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1598868937,NORTH CAROLINA CVS PHARMACY LLC,1040 ALAMANCE CHURCH RD   GREENSBORO NC,041,Guilford,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1598869075,"DEDMOND, RONALD, KEITH",~,1435 N ASPEN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1598869075,"DEDMOND, RONALD, KEITH",1435 N ASPEN ST   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 12 ,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1598871147,"PARNELL, PAULA, BRANTON",5540 CENTERVIEW DR STE 204 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1811756182,NCMWC INC,,5540 CENTERVIEW DR STE 204 # 789702 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598871147,"PARNELL, PAULA, BRANTON",5540 CENTERVIEW DR STE 204 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1588813786,COLUMBUS EMERGENCY GROUP LLC,,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1598871147,"PARNELL, PAULA, BRANTON",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1093793473,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193400000X,Group,Single Specialty,,1598871840,"SCHLIFSTEIN, BRETT, HOWARD",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 32 , 36 , 37 ,$#,,
MEDICAID DIRECT,1689967457,CHATHAM HOSPITAL INC,CHATHAM PROFESSIONAL GROUP,475 PROGRESS BLVD   SILER CITY NC,019,Chatham,193200000X,Group,Multi-Specialty,,1598871840,"SCHLIFSTEIN, BRETT, HOWARD",475 PROGRESS BLVD   SILER CITY NC,019,Chatham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598876229,"JONES, WILLIAM, TAYLOR HILL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1013371061,RALEIGH DURHAM MEDICAL GROUP PA,HORIZON FAMILY MEDICINE,236 BUTTERNUT LN   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598877359,"HARRIS, BRIAN, KEITH",236 BUTTERNUT LN   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 97 , 179 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598877623,"LEE, BRYAN, COLE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1144332404,WASHINGTON PEDIATRICS PA,,1206 BROWN ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1598877995,"CLANCY, DEBRA, STEIN",1206 BROWN ST   WASHINGTON NC,007,Beaufort,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 20 , 89 ,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598879801,"JANDZINSKI, DANA, IWALANI",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1598879868,APRIA HEALTHCARE LLC,,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1598879868,APRIA HEALTHCARE LLC,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1598879868,APRIA HEALTHCARE LLC,,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598879868,APRIA HEALTHCARE LLC,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1598879868,APRIA HEALTHCARE LLC,,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1598879868,APRIA HEALTHCARE LLC,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,#, 20 , 30 ,$#,,
MEDICAID DIRECT,1598879868,APRIA HEALTHCARE LLC,,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598879868,APRIA HEALTHCARE LLC,1824 PROGRESS RD   GREENVILLE NC,074,Pitt,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 764 ," 3,985 "," 7,975 "," $111,081.01 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598879991,"MENZ, MICHAEL, JOSEPH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 108 , 134 , 283 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598879991,"MENZ, MICHAEL, JOSEPH",3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598879991,"MENZ, MICHAEL, JOSEPH",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 13 , 15 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,101 MEDICAL PARK DR   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598879991,"MENZ, MICHAEL, JOSEPH",3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 20 ,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598880791,"WOOD-CUMMINGS, TERRI, ANGIE",495 ARBOR HILL RD STE R KERNERSVILLE NC,034,Forsyth,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1710453550,BETHANY MEDICAL CENTER,,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598880791,"WOOD-CUMMINGS, TERRI, ANGIE",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1598881245,"HARTIGAN, JACQUELINE, ANN",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598881245,"HARTIGAN, JACQUELINE, ANN",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598881245,"HARTIGAN, JACQUELINE, ANN",100 DUKE HEALTH CARY PL STE 230 CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1295729747,THE CHILD HEALTH CENTER,THE CHILD HEALTH CENTER,1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598881443,"MANUS, TONYA, PENLAND",1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 22 , 30 , 109 ,$#,,
MEDICAID DIRECT,1598883811,LOVING TOUCH ADULT DAY HEALTH CENTE,~,1302 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,1598883811,LOVING TOUCH ADULT DAY HEALTH CENTE,1302 BEATTIES FORD RD   CHARLOTTE NC,060,Mecklenburg,251B00000X,Agencies,Case Management,,#, 401 , 401 ," $17,173.74 ",,
MEDICAID DIRECT,1598885899,INTERVENTION FOR YOUNG CHILDREN,INTERVENTION FOR YOUNG CHILDREN,1077 HILLCREST DR   WILLIAMSTON NC,058,Martin,251S00000X,Agencies,Community/Behavioral Health,,1598885899,INTERVENTION FOR YOUNG CHILDREN,1077 HILLCREST DR   WILLIAMSTON NC,058,Martin,251S00000X,Agencies,Community/Behavioral Health,, 43 , 174 , 174 ,$#,,
MEDICAID DIRECT,1457077737,JULIO LAMBOY-RUIZ DDS PA,,2563 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1598886863,"CAMACHO, LUIS, DANIEL",2563 PETERS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 282 , 282 ," 1,008 "," $26,647.67 ",,
MEDICAID DIRECT,1598891566,P LAMB INC,~,600 MT MORIAH CHURCH RD   LUMBERTON NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598891566,P LAMB INC,600 MT MORIAH CHURCH RD   LUMBERTON NC,078,Robeson,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 12 ," 2,188 "," 2,188 "," $157,332.43 ",,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1598892309,"ANTHONY, ROBERT, RAY",112 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1598893265,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,233 GREEN ST   WILLIAMSTON NC,058,Martin,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition,1598893265,LINCARE INC,233 GREEN ST   WILLIAMSTON NC,058,Martin,332BP3500X,Suppliers,Durable Medical Equipment & Medical Supplies,Parenteral & Enteral Nutrition, 26 , 146 , 306 ," $111,760.69 ",,
MEDICAID DIRECT,1598893265,LINCARE INC,ADULT & PEDIATRIC SPECIALISTS,233 GREEN ST   WILLIAMSTON NC,058,Martin,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1598893265,LINCARE INC,233 GREEN ST   WILLIAMSTON NC,058,Martin,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 278 ," 2,089 "," 3,963 "," $121,298.16 ",,
MEDICAID DIRECT,1598893547,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON DENTAL,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598893547,RURAL HEALTH GROUP INC,9409 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),#,#,#,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598893711,"LANDAU, JOSHUA, P",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 98 , 224 , 526 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1598897860,"BAREFOOT JR, ROBERT, ALLEN",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1477840791,ALLEGHANY EMERGENCY GROUP LLC,ALLEGHANY EMERGENCY GROUP LLC,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1598897860,"BAREFOOT JR, ROBERT, ALLEN",233 DOCTORS ST   SPARTA NC,003,Alleghany,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 54 , 70 , 77 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598897951,"HARVEY, STEPHEN, ANDREW",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598897951,"HARVEY, STEPHEN, ANDREW",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598897951,"HARVEY, STEPHEN, ANDREW",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1598898751,"DIDIER, AARON, JUEL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1598898991,HORIZON MARKETING & RESEARCH INC,NEB DOCTORS OF NC,301 N MAIN ST STE 2308 WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598898991,HORIZON MARKETING & RESEARCH INC,301 N MAIN ST STE 2308 WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 411 ," 1,031 "," 1,433 "," $28,356.80 ",,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598901712,"GONZALEZ, LEANNE, DENISE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598903056,"MADERA MANZUETA, CARLOS, EMILIO",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 57 , 124 , 124 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598903056,"MADERA MANZUETA, CARLOS, EMILIO",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598903056,"MADERA MANZUETA, CARLOS, EMILIO",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265908479,MH MISSION HOSPITAL MCDOWELL LLLP,,1633 SUGAR HILL RD   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1598904807,"RASMUSSEN, MARK",1633 SUGAR HILL RD   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 34 , 35 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598904807,"RASMUSSEN, MARK",111 VICTORIA RD   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598904807,"RASMUSSEN, MARK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1598911703,"KLEIBER, MEREDITH, ROSS",6845 KNIGHTDALE BLVD STE 100 KNIGHTDALE NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 39 , 77 , 181 ,$#,,
MEDICAID DIRECT,1790782126,WAKE FOREST PEDIATRIC ASSOCIATES PL,WAKE FOREST PEDIATRIC ASSOC PLLC,1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1598911703,"KLEIBER, MEREDITH, ROSS",1655 WAKE DR UNIT 101 WAKE FOREST NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1598911885,BOICE WILLIS CLINIC PA,,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,291U00000X,Laboratories,Clinical Medical Laboratory,,1598911885,BOICE WILLIS CLINIC PA,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,291U00000X,Laboratories,Clinical Medical Laboratory,," 1,060 "," 1,551 "," 4,145 "," $32,475.44 ",,
MEDICAID DIRECT,1598911885,BOICE WILLIS CLINIC PA,,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1598911885,BOICE WILLIS CLINIC PA,901 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598915381,"JAHANSHAHI, FEEROZEH, DAWN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 36 , 89 , 89 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598915381,"JAHANSHAHI, FEEROZEH, DAWN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598915381,"JAHANSHAHI, FEEROZEH, DAWN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 51 , 154 , 154 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598915381,"JAHANSHAHI, FEEROZEH, DAWN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598919276,"OSTROVSKY, ANN",9 MEDICAL DR   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598919276,"OSTROVSKY, ANN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 60 , 99 , 167 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598920225,"VARMA, SIDDHARTHA",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 23 , 33 , 50 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598920225,"VARMA, SIDDHARTHA",3330 SISKEY PKWY   MATTHEWS NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 52 , 77 , 135 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598920225,"VARMA, SIDDHARTHA",1401 MATTHEWS TOWNSHIP PKWY STE 312 MATTHEWS NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 13 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1598921884,"CHOATE, MARGARET, SARLES",313 MAIN ST   BAYBORO NC,069,Pamlico,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619244084,GREENE COUNTY HEALTH CARE INC,PAMLICO COMMUNITY HEALTH CENTER,313 MAIN ST   BAYBORO NC,069,Pamlico,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598921884,"CHOATE, MARGARET, SARLES",313 MAIN ST   BAYBORO NC,069,Pamlico,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598923583,"OLUSESI, OLUSEGUN, OLALEKAN",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 22 , 38 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598923583,"OLUSESI, OLUSEGUN, OLALEKAN",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598923583,"OLUSESI, OLUSEGUN, OLALEKAN",2790 GODWIN BLVD STE 100 SUFFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598923583,"OLUSESI, OLUSEGUN, OLALEKAN",301 RIVERVIEW AVE STE 700 NORFOLK VA,101,Out of State <= 40 miles,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598923856,"THENGANATT, MARY ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 26 , 34 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598924995,"WILDER, JULIUS, MIDDLETON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598924995,"WILDER, JULIUS, MIDDLETON",2301 ERWIN RD   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598924995,"WILDER, JULIUS, MIDDLETON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598924995,"WILDER, JULIUS, MIDDLETON",3643 N ROXBORO ST   DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 21 , 30 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598924995,"WILDER, JULIUS, MIDDLETON",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,3831 BOYLSTON HWY   MILLS RIVER NC,045,Henderson,193200000X,Group,Multi-Specialty,,1598925125,"BRADFORD, WILLIAM, TATE",1135 CARTHAGE ST   SANFORD NC,053,Lee,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598925125,"BRADFORD, WILLIAM, TATE",1135 CARTHAGE ST   SANFORD NC,053,Lee,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1598925125,"BRADFORD, WILLIAM, TATE",1135 CARTHAGE ST   SANFORD NC,053,Lee,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1598925125,"BRADFORD, WILLIAM, TATE",1135 CARTHAGE ST   SANFORD NC,053,Lee,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598925166,"LINKOUS, MICHELLE, CHIDESTER",517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598925166,"LINKOUS, MICHELLE, CHIDESTER",167 MOORE RD STE 201 KING NC,085,Stokes,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 69 , 192 , 429 ," $21,677.09 ",,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598925745,"DUMLAO, ALDO, CUARESMA",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 48 , 53 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1598925745,"DUMLAO, ALDO, CUARESMA",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1598925745,"DUMLAO, ALDO, CUARESMA",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,933 ROCKFORD ST STE 7 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST STE 1 MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 28 , 111 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,511 GREENSBORO ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST STE 1 MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,231 PLAZA LN STE 101 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,4606 OLD BATTLEGROUND RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST STE 1 MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,933 ROCKFORD ST STE 7 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST STE 7 MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 93 , 138 , 544 ," $58,192.99 ",,
MEDICAID DIRECT,1548907942,HPU HEALTH LLC,,933 ROCKFORD ST STE 7 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598926305,"HAIRSTON, MELANIE, MICHELLE",933 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 128 , 210 , 761 ," $63,238.85 ",,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598927030,"CARMODY, JAMES, BRYAN",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1598929747,"NGALE, YVONNE, WELEDJI NGWE",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1316346976,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ENT,1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598931370,"WILSON, ELLEN, ROSSER",1565 PURDUE DR STE 301 FAYETTEVILLE NC,026,Cumberland,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 21 ,$#,,
MEDICAID DIRECT,1598934374,"NEAL, JOHN, WILLIAM",~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1598934374,"NEAL, JOHN, WILLIAM",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 38 , 74 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598936130,"BROWN, ROBERTA, LEDBETTER",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1598937591,SENIOR VENTURES & MANAGEMENT INC,~,1285 W A ST   KANNAPOLIS NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598937591,SENIOR VENTURES & MANAGEMENT INC,1285 W A ST   KANNAPOLIS NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 36 ," 2,734 "," 2,763 "," $581,708.09 ",,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598939217,"KLINE, LAURA, MCCASKILL",959 COX RD STE 1 GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598939217,"KLINE, LAURA, MCCASKILL",959 COX RD STE 1 GASTONIA NC,036,Gaston,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 12 , 12 , 25 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,959 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598939217,"KLINE, LAURA, MCCASKILL",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 46 , 61 , 105 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,105 DELTA PARK DR   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1598939217,"KLINE, LAURA, MCCASKILL",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 21 , 26 , 37 ,$#,,
MEDICAID DIRECT,1801832837,PIEDMONT PLASTIC SURGERY CENTER,~,937 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598939217,"KLINE, LAURA, MCCASKILL",105 DELTA PARK DR   SHELBY NC,023,Cleveland,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598939688,"GUINN, NICOLE, RENEE",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598939688,"GUINN, NICOLE, RENEE",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598939688,"GUINN, NICOLE, RENEE",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 13 , 19 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598939688,"GUINN, NICOLE, RENEE",2100 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1598940686,"WALKER, JAMES, BENNING",10 AVIEMORE DR   PINEHURST NC,063,Moore,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 118 , 154 , 185 ,$#,,
MEDICAID DIRECT,1255591566,FIRSTHEALTH OF THE CAROLINAS INC,FIRSTHEALTH NEUROSURGERY,10 AVIEMORE DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1598940686,"WALKER, JAMES, BENNING",155 MEMORIAL DR   PINEHURST NC,063,Moore,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 38 , 58 , 76 ,$#,,
MEDICAID DIRECT,1598942435,"BEVERLY, PATRICIA, ARNOLD",BEVERLY SPEECH SERVICES,202 E MORGAN ST-B   WADESBORO NC,004,Anson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1598942435,"BEVERLY, PATRICIA, ARNOLD",202 E MORGAN ST-B   WADESBORO NC,004,Anson,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598944522,"BENJAMIN BRYANT, SOLANGE, N M",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598944522,"BENJAMIN BRYANT, SOLANGE, N M",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 13 , 29 , 31 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598945636,"WINTER, STEPHEN, BRADLEY",170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 35 , 50 , 77 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598945636,"WINTER, STEPHEN, BRADLEY",3311 JESSIE VILLAGE DR   CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 47 , 80 ,$#,,
MEDICAID DIRECT,1750346748,GASTROENTEROLOGY ASSOCIATES PA,GASTROENTEROLOGY ASSOCIATES PA,415 N CENTER ST STE 300 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1598945834,"SCAIFE, DIANE, THERESA",415 N CENTER ST STE 300 HICKORY NC,018,Catawba,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 41 , 50 , 50 ,$#,,
MEDICAID DIRECT,1598948770,LUTHERAN HOME-HICKORY INC,LUTHERAN NSG HOME INC HICKORY,1265 21ST ST NE   HICKORY NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598948770,LUTHERAN HOME-HICKORY INC,1265 21ST ST NE   HICKORY NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 19 ," 4,053 "," 4,053 "," $286,752.18 ",,
MEDICAID DIRECT,1861446346,COASTAL CAROLINA HEALTH CARE PA,CCHC ATLANTIC PRIMARY CARE,730 NEWMAN RD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1598949935,"HEALY, ANNE, VERONICA",730 NEWMAN RD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1598949935,"HEALY, ANNE, VERONICA",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598953408,PEARLS FAMILY CARE HOMES LLC,PEARLS FAMILY CARE HOMES LLC,107 ASH CT   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598953408,PEARLS FAMILY CARE HOMES LLC,107 ASH CT   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 328 , 328 ," $21,825.25 ",,
MEDICAID DIRECT,1598955569,"BOEHME, JASON",~,,,Unknown,111N00000X,Chiropractic Providers,Chiropractor,,1598955569,"BOEHME, JASON",408 2ND AVE NE   HICKORY NC,018,Catawba,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598955742,"NEHUS, NATHAN, ROBERT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 91 , 99 , 107 ,$#,,
MEDICAID DIRECT,1598960890,DUPLIN SAMPSON GROUP HOMES INC,DUPLIN SAMPSON GROUP HOMES INC,716 CURTIS RD   WARSAW NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1598960890,DUPLIN SAMPSON GROUP HOMES INC,716 CURTIS RD   WARSAW NC,031,Duplin,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1598961187,"PATEL, SHIV, SHASHIKANT",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598961187,"PATEL, SHIV, SHASHIKANT",730 HARTNESS RD   STATESVILLE NC,049,Iredell,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598961187,"PATEL, SHIV, SHASHIKANT",730 HARTNESS RD   STATESVILLE NC,049,Iredell,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 11 , 19 , 20 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,730 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598961187,"PATEL, SHIV, SHASHIKANT",730 HARTNESS RD   STATESVILLE NC,049,Iredell,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 33 , 125 , 137 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598961187,"PATEL, SHIV, SHASHIKANT",730 HARTNESS RD   STATESVILLE NC,049,Iredell,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598961187,"PATEL, SHIV, SHASHIKANT",730 HARTNESS RD   STATESVILLE NC,049,Iredell,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1505 SW CARY PKWY STE 100 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1598961260,"SCHWINDT, KALI, ANN",1505 SW CARY PKWY STE 100 CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1598961690,"TOMASHESKI, JOHN, CLIFFORD",1000 CRESCENT GRN STE 202   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598961690,"TOMASHESKI, JOHN, CLIFFORD",1000 CRESCENT GRN STE 202   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 43 ,$#,,
MEDICAID DIRECT,1538589577,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY APEX,966 US 64 HWY W   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1598961690,"TOMASHESKI, JOHN, CLIFFORD",1000 CRESCENT GRN STE 202   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1598961690,"TOMASHESKI, JOHN, CLIFFORD",1000 CRESCENT GRN STE 202   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1598962011,"ABELL, BECKY, ANNE",3651 WHEELER RD   AUGUSTA GA,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1598962367,"LISTER, STEVEN, PAUL",1000 BLYTHE BLVD FL 4 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598962367,"LISTER, STEVEN, PAUL",1000 BLYTHE BLVD FL 4 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 45 , 59 , 71 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598962367,"LISTER, STEVEN, PAUL",10650 PARK RD STE 220 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598963472,"BAUTE, VANESSA",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 29 , 47 , 51 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598964629,"DE GRAVELLE, OLIVER, LOUIS",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598964629,"DE GRAVELLE, OLIVER, LOUIS",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,~,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598964942,"ROURA II, NELSON, CHRISTIANO",2800 SAINT LEO ST   GREENSBORO NC,041,Guilford,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#, 11 ,$#,,
MEDICAID DIRECT,1043384928,HANGER PROSTHETICS & ORTHOTICS EAST,~,2716 HENRY ST   GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598964942,"ROURA II, NELSON, CHRISTIANO",2800 SAINT LEO ST   GREENSBORO NC,041,Guilford,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1598966111,"SEIGEL, JONATHAN, KEVIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598966111,"SEIGEL, JONATHAN, KEVIN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598966111,"SEIGEL, JONATHAN, KEVIN",3024 NEW BERN AVE   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1598966111,"SEIGEL, JONATHAN, KEVIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 58 , 58 ," $13,220.48 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598967010,"MOCK, JASON, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598967010,"MOCK, JASON, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 53 , 63 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598967010,"MOCK, JASON, ROBERT",100 EASTOWNE DR FL 104 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598967010,"MOCK, JASON, ROBERT",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 44 , 59 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598967200,"CHUDGAR, SAUMIL, MAHENDRA",2100 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1598967200,"CHUDGAR, SAUMIL, MAHENDRA",2301 ERWIN RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 63 , 63 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1598969313,"EHRMANN, DAVID, CHARLES",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1598969313,"EHRMANN, DAVID, CHARLES",1200 N ELM ST   GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1386991297,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE SPORTS MED,14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598970840,"RAINBOW, CATHERINE, ROGERS",14214 BALLANTYNE LAKE RD STE 150B CHARLOTTE NC,060,Mecklenburg,207RS0010X,Allopathic & Osteopathic Physicians,Internal Medicine,Sports Medicine, 14 , 35 , 42 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,2901 WESLEY CHAPEL STOUTS RD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598971921,"NEWELL, MARYANN, ZEIDLER",2901 WESLEY CHAPEL STOUTS RD   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598978009,"SCOTT, AARON, TITUS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598978009,"SCOTT, AARON, TITUS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 71 , 87 , 104 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598978009,"SCOTT, AARON, TITUS",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1598978470,"PATEL, SHIPRA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1255070868,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2695 HENDERSONVILLE ROAD SUITE 200,2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598979312,"JABLECKI, NATHANIEL, THOMAS",2695 HENDERSONVILLE RD STE 200 ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 114 , 131 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1598979312,"JABLECKI, NATHANIEL, THOMAS",21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598981474,"ZAIDMAN, JEFFREY, SCOTT",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598981474,"ZAIDMAN, JEFFREY, SCOTT",15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598981474,"ZAIDMAN, JEFFREY, SCOTT",2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598981474,"ZAIDMAN, JEFFREY, SCOTT",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 23 , 27 , 30 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598981474,"ZAIDMAN, JEFFREY, SCOTT",1340 MATTHEWS TOWNSHIP PKWY STE 301 MATTHEWS NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1598983678,"THOMPSON, STEPHEN, BRIAN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 63 , 71 , 72 ,$#,,
MEDICAID DIRECT,1780647578,ASHEVILLE ARTHRITIS AND OSTEOPOROSI,ASHEVILLE ARTHRITIS AND OSTEOPOROSIS CENTER PA,4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1598984155,"MEYER, CHRISTOPHER, GEORGE",4 VANDERBILT PARK DR STE 200 ASHEVILLE NC,011,Buncombe,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 37 , 55 , 148 ,$#,,
MEDICAID DIRECT,1104144914,FERNCREEK CARDIOLOGY PA,FERNCREEK CARDIOLOGY PA,3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598985715,"DAKA, MATTHEW, AMIEBI",3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 357 ," 1,146 "," 2,049 "," $44,292.60 ",,
MEDICAID DIRECT,1104144914,FERNCREEK CARDIOLOGY PA,FERNCREEK CARDIOLOGY PA,3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1598985715,"DAKA, MATTHEW, AMIEBI",3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 22 , 36 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 17 , 20 , 20 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1598989196,"MEHTA, ROHIT",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080012,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,447 MCALISTER RD STE 3200 LINCOLNTON NC,055,Lincoln,193400000X,Group,Single Specialty,,1598989196,"MEHTA, ROHIT",447 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 24 , 33 , 35 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 13 , 16 , 22 ,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 26 , 51 , 54 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 41 , 61 , 66 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1598989196,"MEHTA, ROHIT",1100 HEALING WAY STE 13 MATTHEWS NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1558312934,EAST CAROLINA UNIVERSITY,ECU SPEECH LANGUAGE AND HEARING CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598990079,"EBLIN, WILLIAM, JAMES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1598990079,"EBLIN, WILLIAM, JAMES",600 MOYE BLVD   GREENVILLE NC,074,Pitt,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1427669613,LUZ E ESTRADA DDS PLLC III,MT AIRY DENTAL STUDIO,933 ROCKFORD ST STE 1 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598990129,"ESTRADA, LUZ, ELIYER",933 ROCKFORD ST   MOUNT AIRY NC,086,Surry,1223G0001X,Dental Providers,Dentist,General Practice, 38 , 45 , 199 ," $15,905.33 ",,
MEDICAID DIRECT,1386115293,LUZ E ESTRADA DDS PLLC II,CARY DENTAL STUDIO,300 ASHVILLE AVE STE 270 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1598990129,"ESTRADA, LUZ, ELIYER",300 ASHVILLE AVE   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 333 , 397 ," 1,613 "," $60,961.28 ",,
MEDICAID DIRECT,1598990129,"ESTRADA, LUZ, ELIYER",~,300 ASHVILLE AVE   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1598990129,"ESTRADA, LUZ, ELIYER",300 ASHVILLE AVE   CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1366268542,LUIS GAMBOA DMD PC,,3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598990129,"ESTRADA, LUZ, ELIYER",3110 NEW BERN AVE STE 102 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 37 , 37 , 200 ," $17,011.82 ",,
MEDICAID DIRECT,1427669613,LUZ E ESTRADA DDS PLLC III,MT AIRY DENTAL STUDIO,933 ROCKFORD ST STE 1 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1598990129,"ESTRADA, LUZ, ELIYER",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 39 , 46 , 186 ," $11,442.56 ",,
MEDICAID DIRECT,1134536188,LUZ E ESTRADA DDS PLLC,DURHAM DENTAL STUDIO,6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1598990129,"ESTRADA, LUZ, ELIYER",6104 FAYETTEVILLE RD STE 104 DURHAM NC,032,Durham,1223G0001X,Dental Providers,Dentist,General Practice, 291 , 401 ," 1,648 "," $78,092.52 ",,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598990277,"MCNABB, DAVID, CLINTON",3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 33 , 61 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598990277,"MCNABB, DAVID, CLINTON",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 21 , 22 , 57 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1598990277,"MCNABB, DAVID, CLINTON",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1598990277,"MCNABB, DAVID, CLINTON",1325 TIMBER DR E   GARNER NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598990285,"WATKINS, CHRISTOPHER, BRADLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 45 , 46 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1598990301,"NUNN, ANDREW, MITCHELL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 106 , 142 , 167 ," $22,890.42 ",,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598991127,"PATTERSON RAVINDRAN, ANN, MARIE",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598991408,"DAVIS, DAYTON, SCOTT",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health, 11 , 132 , 132 ," $33,447.48 ",,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598991408,"DAVIS, DAYTON, SCOTT",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598991994,"WALKER, RENEE, SCOTT",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1598991994,"WALKER, RENEE, SCOTT",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598992620,"FLOWERS, LAURA, ASHLEY",~,507 N MAIN ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice,1598992620,"FLOWERS, LAURA, ASHLEY",507 N MAIN ST   SPARTA NC,003,Alleghany,1223G0001X,Dental Providers,Dentist,General Practice, 547 ," 1,189 "," 3,595 "," $167,112.40 ",,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598993107,"DAWSON, DANIEL, PAUL",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 44 , 135 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1598993107,"DAWSON, DANIEL, PAUL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598993107,"DAWSON, DANIEL, PAUL",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598993677,"CHALK, KRISTEN, BROOKE MERRITT",2221 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 22 , 28 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598993677,"CHALK, KRISTEN, BROOKE MERRITT",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 11 , 13 , 17 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598993677,"CHALK, KRISTEN, BROOKE MERRITT",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 78 , 81 , 104 ," $39,531.18 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1598993677,"CHALK, KRISTEN, BROOKE MERRITT",1809 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598994956,"WILLETT, DWIGHT, JAMES",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598994956,"WILLETT, DWIGHT, JAMES",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 56 , 102 , 105 ," $10,277.41 ",,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1598994956,"WILLETT, DWIGHT, JAMES",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1770821589,MOUNTAIN COMMUNITY HEALTH PARTNERSH,SPRUCE PINE HEALTH CENTER,11728 S 226 HWY   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1598994956,"WILLETT, DWIGHT, JAMES",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 16 , 16 ,$#,,
MEDICAID DIRECT,1619606316,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-2775 HENDERSONVILLE ROAD,2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1598995409,"BARREROARROYO, ANA, SUSANA",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 85 , 127 ,$#,,
MEDICAID DIRECT,1255805065,CAREPARTNERS HHA LLLP,CAREPARTNERS PRIVATE DUTY SERVICES,8 ROTARY DR   ASHEVILLE NC,011,Buncombe,251B00000X,Agencies,Case Management,,1598995409,"BARREROARROYO, ANA, SUSANA",2775 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598995987,MEDISOLUTIONS INC,~,1146 N CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1598995987,MEDISOLUTIONS INC,1146 N CHURCH ST   BURLINGTON NC,001,Alamance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#, 34 , 65 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1598996944,"BALASINGHAM, SHIVASHANKER",2201 S STERLING ST   MORGANTON NC,012,Burke,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 62 , 179 , 182 ,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1598997314,"KAMP, AARON, ROSS",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 11 ,$#,,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1598997314,"KAMP, AARON, ROSS",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223G0001X,Dental Providers,Dentist,General Practice, 66 , 67 , 457 ," $26,381.19 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609000744,"KEY, KRISTOPHER, LOGAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609000744,"KEY, KRISTOPHER, LOGAN",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609000744,"KEY, KRISTOPHER, LOGAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609002179,"HUMPHREY, ALYSSA, NICOLE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609002385,"DAMM, PAUL, EDWARD",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609002385,"DAMM, PAUL, EDWARD",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609002385,"DAMM, PAUL, EDWARD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 14 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609002385,"DAMM, PAUL, EDWARD",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265708119,MCLEOD LORIS SEACOAST HOSPITAL,MCLEOD LORIS SEACOAST PHYSICIANS,3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609002682,"LIANG, GRACE",3655 MITCHELL ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609004852,"TITO, KANDIE",~,4014 OLEANDER DR STE 203 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1609004852,"TITO, KANDIE",4014 OLEANDER DR STE 203 WILMINGTON NC,065,New Hanover,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 48 ," 2,506 "," 2,508 "," $178,022.56 ",,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,1032 COLLEGE ST   OXFORD NC,039,Granville,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1609004936,"GUTHRIE, SHAUNA, LEIGH",1032 COLLEGE ST   OXFORD NC,039,Granville,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 26 , 51 ,$#,,
MEDICAID DIRECT,1609004936,"GUTHRIE, SHAUNA, LEIGH",~,123 HORNER ST   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1609004936,"GUTHRIE, SHAUNA, LEIGH",123 HORNER ST   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184783409,GRANVILLE-VANCE DISTRICT HEALTH DEP,~,115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1609004936,"GUTHRIE, SHAUNA, LEIGH",115 CHARLES ROLLINS RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 23 , 27 , 79 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609005396,"BOHRT TERCEROS, VALERIA",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609005396,"BOHRT TERCEROS, VALERIA",1925 GLENN MITCHELL DR STE 202 VIRGINIA BEACH VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609005461,"VIN-PARIKH, ANITA, PRAKASH",3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist, 50 , 80 , 119 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609005461,"VIN-PARIKH, ANITA, PRAKASH",3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 30 , 57 , 96 ,$#,,
MEDICAID DIRECT,1902857675,THE RALEIGH EYE CENTER PA,RALEIGH EYE CENTER PA,3320 EXECUTIVE DR STE 111 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609005461,"VIN-PARIKH, ANITA, PRAKASH",2406 BLUE RIDGE RD STE 280 RALEIGH NC,092,Wake,207WX0009X,Allopathic & Osteopathic Physicians,Ophthalmology,Glaucoma Specialist, 29 , 38 , 61 ,$#,,
MEDICAID DIRECT,1609005859,"MAIN, KRISTIN, LEIGH",,110 VILLAGE RD NE UNIT A LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,1609005859,"MAIN, KRISTIN, LEIGH",110 VILLAGE RD NE UNIT A LELAND NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 28 , 72 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609007301,"PARKAR, IRFAN, UMER",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 155 , 155 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1609007301,"PARKAR, IRFAN, UMER",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1487276499,NH - CL CLINICS LLC,CORELIFE NOVANT HEALTH,500 PINEVIEW DR STE 205 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609008366,"ALLEN, CASSANDRA, JEAN",6329 UNITY ST STE A THOMASVILLE NC,076,Randolph,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609008655,"LAIRD, KAREN, MARIE",20 MEDICAL CAMPUS DR NW STE 205 SUPPLY NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 37 , 85 , 176 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609014133,"IGBOKWE, ONYINYE",1480 WESLEY CHAPEL RD   INDIAN TRAIL NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 54 , 111 ,$#,,
MEDICAID DIRECT,1295763217,PRISMA HEALTH UNIVERSITY MEDICAL GR,UNIVERSITY MEDICAL GROUP,300 E MCBEE AVE STE 302 GREENVILLE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609018001,"HARTKE, AMANDA, GALLOWAY",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609018019,NOVA EYECARE,NOVA EYE CARE,328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1609018019,NOVA EYECARE,328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1609018019,NOVA EYECARE,NOVA EYE CARE,328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1609018019,NOVA EYECARE,328 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,, 666 , 667 ," 1,330 "," $18,068.12 ",,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609018407,"GINGRAS, JEAN-MARTIN",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 18 , 22 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609019090,"GRATIAN, LAUREN, FRITZ",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 28 , 40 , 72 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609019090,"GRATIAN, LAUREN, FRITZ",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 15 , 17 , 27 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609019090,"GRATIAN, LAUREN, FRITZ",8114 MARKET ST   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609019090,"GRATIAN, LAUREN, FRITZ",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 66 , 113 , 179 ,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609019314,"BURGESS, JESSICA, ROBIN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609019314,"BURGESS, JESSICA, ROBIN",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609019322,"CHRISTO, MICHAEL, MATTHEW",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 19 , 20 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609019322,"CHRISTO, MICHAEL, MATTHEW",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609019322,"CHRISTO, MICHAEL, MATTHEW",1900 RANDOLPH RD STE 800 CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609024710,"RUIZ-BONILLA, JOSE, ALBERTO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750976809,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR CANCER SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609024710,"RUIZ-BONILLA, JOSE, ALBERTO",1333 S DICKINSON DR UNIT 200 LELAND NC,010,Brunswick,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1982656252,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL CRNA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609025410,"STARKEY, LAUREN, VENABLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1003867516,MEDICAL PARK HOSPITAL LLC,MEDICAL PARK HOSPITAL PROFESSIONAL STAFF,1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609025410,"STARKEY, LAUREN, VENABLE",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609026046,"NAGARAJ, RAGHAVA",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609026046,"NAGARAJ, RAGHAVA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 24 , 32 , 32 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609026046,"NAGARAJ, RAGHAVA",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1609030063,"RUDD, JOSHUA, DAVID",262 LEROY GEORGE DR FL 2 CLYDE NC,044,Haywood,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 46 , 70 , 75 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1609030063,"RUDD, JOSHUA, DAVID",40 BRETTWOOD TRCE   CLYDE NC,044,Haywood,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 31 , 34 ,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609035351,"EMMONS, SHAWN, PATRICK",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 191 , 197 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 80 , 96 , 132 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 39 , 43 , 57 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 28 , 38 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 87 , 131 , 176 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609035757,"BRANCH, JONATHAN, FRANKLIN",110 S PARK TER STE A EDEN NC,079,Rockingham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609038843,"DAVIDSON, JOHNATHAN, BOYCE",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609038843,"DAVIDSON, JOHNATHAN, BOYCE",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609038843,"DAVIDSON, JOHNATHAN, BOYCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 25 , 38 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609038843,"DAVIDSON, JOHNATHAN, BOYCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 81 , 89 , 110 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609038843,"DAVIDSON, JOHNATHAN, BOYCE",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609039353,"ANCHETA THORP, WARREN, MANUEL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 27 , 27 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1609039353,"ANCHETA THORP, WARREN, MANUEL",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1639607153,SPINE & PAIN ASSOCIATES PLLC,,1303 CARTHAGE ST   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1609039692,"DHALIWAL, JASBIR, SINGH",1303 CARTHAGE ST   SANFORD NC,053,Lee,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 147 , 545 ," 1,088 "," $13,233.04 ",,
MEDICAID DIRECT,1619271004,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD PULMONARY AND CRITICAL CARE ASSOCIATES,101 S RAVENEL ST STE 230 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609039734,"TAYPE ROBERTS, CARMEN, AMELIA",401 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609042126,"ARRINGTON, DAVID, DARRELL",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609049212,"SHAW, RYAN, C",844 KEMPSVILLE RD STE 212 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760744361,SAMPSON REGIONAL PROFESSIONAL SERVI,SAMPSON SURGICAL SERVICES,607 BEAMAN ST   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1609049709,"MENDIBLE, MARIANA",607 BEAMAN ST   CLINTON NC,082,Sampson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 25 , 28 ,$#,,
MEDICAID DIRECT,1760744361,SAMPSON REGIONAL PROFESSIONAL SERVI,SAMPSON SURGICAL SERVICES,603 BEAMAN ST STE 300 CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1609049709,"MENDIBLE, MARIANA",603 BEAMAN ST STE 300 CLINTON NC,082,Sampson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 24 , 28 ,$#,,
MEDICAID DIRECT,1760744361,SAMPSON REGIONAL PROFESSIONAL SERVI,SAMPSON SURGICAL SERVICES,603 BEAMAN ST STE 300 CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1609049709,"MENDIBLE, MARIANA",603 BEAMAN ST STE 300 CLINTON NC,082,Sampson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 41 , 64 , 68 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609051929,"OSALVO, NICOMEDES, GARCIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609051929,"OSALVO, NICOMEDES, GARCIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609051929,"OSALVO, NICOMEDES, GARCIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609052398,"COOK, LYDIA, CAUTHREN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 66 , 68 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609056506,"SAMAROPOULOS, XANTHIA",3434 EDWARDS MILL RD STE 112-398 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609056506,"SAMAROPOULOS, XANTHIA",3434 EDWARDS MILL RD STE 112-398 RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609056506,"SAMAROPOULOS, XANTHIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609056506,"SAMAROPOULOS, XANTHIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#, 11 , 11 ,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1609056506,"SAMAROPOULOS, XANTHIA",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1346456209,CAPITAL ENDOCRINE CONSULTANTS PA,~,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1609056506,"SAMAROPOULOS, XANTHIA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1609057462,CHUNNS COVE OF ASHEVILLE,,67 MOUNTAINBROOK RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609057462,CHUNNS COVE OF ASHEVILLE,67 MOUNTAINBROOK RD   ASHEVILLE NC,011,Buncombe,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 32 ," 6,641 "," 6,648 "," $459,435.75 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609057611,"CAMPOS, KEVIN, MICHAEL",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,250 HOSPITAL DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1609057611,"CAMPOS, KEVIN, MICHAEL",250 HOSPITAL DR   LEXINGTON NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609057611,"CAMPOS, KEVIN, MICHAEL",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 114 , 119 , 134 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609057652,"DAVIS, JUSTIN, BRIAN",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609058338,"HANES, HOLLY, CRAIN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0214X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Pulmonology,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609059567,"RUBIN, MICHAEL, JONAH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609059567,"RUBIN, MICHAEL, JONAH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609059567,"RUBIN, MICHAEL, JONAH",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1361 KLUMAC RD   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1609061449,"STEPHENS, SARAH, KERLEY",1361 KLUMAC RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609061449,"STEPHENS, SARAH, KERLEY",310 S STRATFORD RD STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609061449,"STEPHENS, SARAH, KERLEY",4415 SCHOOL HOUSE CMNS   HARRISBURG NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 28 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4415 SCHOOL HOUSE CMNS   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609061449,"STEPHENS, SARAH, KERLEY",4415 SCHOOL HOUSE CMNS   HARRISBURG NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 37 , 82 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2101 N MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609061449,"STEPHENS, SARAH, KERLEY",2101 N MAIN ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609061449,"STEPHENS, SARAH, KERLEY",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,2728 W MALLARD CREEK CHURCH RD STE 30 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609061449,"STEPHENS, SARAH, KERLEY",2728 W MALLARD CREEK CHURCH RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1417929639,VIRGINIA ONCOLOGY ASSOCIATES PC,VIRGINIA ONCOLOGY ASSOCIATES PC,2790 GODWIN BLVD SUITE 101 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609066216,"PATEL, KEVIN, KUMAR",2790 GODWIN BLVD STE 101 SUFFOLK VA,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609066349,"RUFFIN, DAVID, MONROE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1568686988,NC DHHS CHILD AND FAMILY WELL-BEING,GREENSBORO CHILDRENS DEVELOPMENT SELF HELP CNTR,122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,252Y00000X,Agencies,Early Intervention Provider Agency,,1609066638,"WEBER, LISA, HENNES",122 N ELM ST STE 400 GREENSBORO NC,041,Guilford,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,, 92 , 92 , 161 ," $21,408.02 ",,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609068394,"DUNCAN, LORI, VAUGHT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609068394,"DUNCAN, LORI, VAUGHT",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1912977802,MEADOWS LUTCACAGE SMITH VINTON FIDL,MEADOWS LUTCAVAGE SMITH VINTON FIDLER AND LONG PA,501 PENNY LN   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1609070002,"ARMSTRONG JR, ROBERT, THOMAS",501 PENNY LN   MOREHEAD CITY NC,016,Carteret,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 123 , 186 , 887 ," $90,972.66 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609070093,"LEAKE, KRISTINA, ANN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609070093,"LEAKE, KRISTINA, ANN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609070192,"BARRIER, CHARLES, HAROLD",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1073754131,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609070192,"BARRIER, CHARLES, HAROLD",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 42 , 173 , 173 ," $11,575.16 ",,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609071661,"MASOOD, FARAZ",323 BALDWIN RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609071661,"MASOOD, FARAZ",509 W GANNON AVE   ZEBULON NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548207483,COGENT HEALTHCARE OF NORTH CAROLINA,COGENT HEALTHCARE OF NORTH CAROLINA PC,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609071661,"MASOOD, FARAZ",1212 E SUNSET DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609072495,"END, CHRISTOPHER, ALEXANDER",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609072495,"END, CHRISTOPHER, ALEXANDER",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 92 , 130 , 206 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609072495,"END, CHRISTOPHER, ALEXANDER",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 30 , 37 ,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609072495,"END, CHRISTOPHER, ALEXANDER",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1033523709,MOSES CONE AFFILIATED PHYSICIANS IN,CHMG CARDIOVASCULAR DIVISION,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609072495,"END, CHRISTOPHER, ALEXANDER",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1164438578,THE MOSES H CONE MEMORIAL HOSPITAL,MOSES CONE URGENT CARE CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609072495,"END, CHRISTOPHER, ALEXANDER",1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1932372521,KERNERSVILLE CHIROPRACTIC CENTER,KERNERSVILLE CHIROPRACTIC CENTER,127 N MAIN ST   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1609072859,"SMITH, DARIAN, JUSTIN",127 N MAIN ST   KERNERSVILLE NC,034,Forsyth,111N00000X,Chiropractic Providers,Chiropractor,, 12 , 98 , 98 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609073220,"KANAAN, HILAL, AZZAM",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 72 , 99 , 121 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609073220,"KANAAN, HILAL, AZZAM",2325 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1220 SPRUCE ST STE B BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609074111,"BENSON, MELISSA, KELLY",1220 SPRUCE ST   BELMONT NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609074111,"BENSON, MELISSA, KELLY",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609075357,"BENNETT, JENNIFER, MILLICENT",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 62 , 65 , 67 ,$#,,
MEDICAID DIRECT,1013971308,WOMENS WELLNESS CENTER PA,Womens Wellness Center PA,2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609075381,"COLE, ELIZABETH",2950 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 31 , 48 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609076140,"KORNEGAY, CHRISTOPHER, CHAD",401A N MAIN ST   KENANSVILLE NC,031,Duplin,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 60 , 114 , 117 ,$#,,
MEDICAID DIRECT,1609076942,D-POM LLC,,2109 SAINT ANDREW ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,1609076942,D-POM LLC,2109 SAINT ANDREW ST   TARBORO NC,033,Edgecombe,253Z00000X,Agencies,In Home Supportive Care,,#," 1,945 "," 1,945 "," $115,946.25 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077023,"BREWER LITTLEJOHN, ROBYN, BETRICE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077023,"BREWER LITTLEJOHN, ROBYN, BETRICE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 98 , 144 ,$#,,
MEDICAID DIRECT,1285959767,CHARLOTTE MEDICAL CLINIC,ATRIUM HEALTH PRIMARY CARE CHARLOTTE MEDICAL CLINI,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077023,"BREWER LITTLEJOHN, ROBYN, BETRICE",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 20 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077023,"BREWER LITTLEJOHN, ROBYN, BETRICE",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 57 , 82 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077841,"REDDY, USHA, PALLE",144 FOUNTAIN PL   MOORESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,646 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609077841,"REDDY, USHA, PALLE",646 HARTNESS RD   STATESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077841,"REDDY, USHA, PALLE",646 HARTNESS RD   STATESVILLE NC,049,Iredell,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 15 , 16 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077841,"REDDY, USHA, PALLE",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 32 , 47 , 68 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609077841,"REDDY, USHA, PALLE",10305 HAMPTONS PARK DR STE 201 HUNTERSVILLE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609079441,"BHAN, RENUKA, MATTOO",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 78 , 103 ,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609079441,"BHAN, RENUKA, MATTOO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 179 , 179 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609080746,"GREEN, MIYVETTESHAUNE, MARQUISETTE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609080746,"GREEN, MIYVETTESHAUNE, MARQUISETTE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 19 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609080746,"GREEN, MIYVETTESHAUNE, MARQUISETTE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609083187,"PAMPERIN, JOHN, WILLIAM",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609083849,"HULL, KATHRYN, JESSICA",13557 STEELECROFT PKWY STE 2100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609083849,"HULL, KATHRYN, JESSICA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609084045,"ATKINS, SARAH, ELIZABETH",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 24 , 51 ,$#,,
MEDICAID DIRECT,1609087345,SPECIAL KARE FOR SPECIAL KIDS LLC,SPECIAL KARE FOR SPECIAL KIDS LLC,199 LAKE RD   STANLEY NC,036,Gaston,251S00000X,Agencies,Community/Behavioral Health,,1609087345,SPECIAL KARE FOR SPECIAL KIDS LLC,199 LAKE RD   STANLEY NC,036,Gaston,251S00000X,Agencies,Community/Behavioral Health,, 21 , 584 , 585 ," $35,067.48 ",,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609087881,"PIBOOLNURAK, PANIDA",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,,,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609088970,"HURSEY, DARRIN, ROBERT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205491495,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609088970,"HURSEY, DARRIN, ROBERT",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609088970,"HURSEY, DARRIN, ROBERT",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 30 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609092154,"LEE, GRACE, MING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609092154,"LEE, GRACE, MING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609092154,"LEE, GRACE, MING",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 29 , 46 , 47 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609092329,"PRIMIS, SYDNEY, PARTIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 16 , 38 , 55 ,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609095173,"KOMJATHY, STEVEN, FERENC",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 111 , 209 ,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609095173,"KOMJATHY, STEVEN, FERENC",3604 PETERS CT   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609095173,"KOMJATHY, STEVEN, FERENC",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609095926,"HOSMER, KATHLEEN, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 105 , 115 , 123 ," $10,488.75 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609095926,"HOSMER, KATHLEEN, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1901 S HAWTHORNE RD STE 310 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609097666,"GREGORY, PAUL, MELVIN",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 41 , 41 ,$#,,
MEDICAID DIRECT,1336585561,GASTROENTEROLOGY ASSOCIATES OF THE,~,1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609097666,"GREGORY, PAUL, MELVIN",1830 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 21 , 21 ,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609097708,"BUSCHER, APRIL, LAVERNE",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 108 , 191 , 630 ," $13,592.22 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609097708,"BUSCHER, APRIL, LAVERNE",414 E MAIN ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609098235,"SHARMA, DEEPTI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 37 , 37 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609098235,"SHARMA, DEEPTI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 32 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609098623,"DELLON, EVAN, SAMUEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1417909409,ALAMANCE EAR NOSE AND THROAT LLP,~,4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1609099209,"VAUGHT, CREIGHTON, CHARLES",4030 OAKS PROFESSIONAL PKWY STE 201 BURLINGTON NC,001,Alamance,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 34 , 50 , 92 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 14 , 18 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 24 , 35 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 14 , 16 , 18 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609100247,"JOHNSON, DAVID, ALBERT",501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 20 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",2138 HIGHWAY 42 W   CLAYTON NC,051,Johnston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 23 , 30 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 16 , 25 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 21 , 29 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 24 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609101021,"PETERSON, DREW, CAMPBELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609103738,"ELLENDER, JOSEPH, WILLIAM",6019 OLEANDER DR STE 200 WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609103738,"ELLENDER, JOSEPH, WILLIAM",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 17 , 32 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609103738,"ELLENDER, JOSEPH, WILLIAM",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 43 , 86 , 140 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609103738,"ELLENDER, JOSEPH, WILLIAM",1168 E CUTLAR XING STE 2011 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609103738,"ELLENDER, JOSEPH, WILLIAM",1168 E CUTLAR XING STE 2011 LELAND NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1609107390,"GARNER, HOLLY",2711 RANDOLPH RD STE 400 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1033160205,NOVANT HEALTH THOMASVILLE MEDICAL C,PROFESSIONAL STAFF,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1609109230,"CASEY, SANDY, STEWART",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 21 , 24 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9805 ROCKY RIVER RD   CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609112721,"BELK, CATHERINE, MARIE",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609112721,"BELK, CATHERINE, MARIE",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1609112721,"BELK, CATHERINE, MARIE",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609112721,"BELK, CATHERINE, MARIE",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 22 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609112721,"BELK, CATHERINE, MARIE",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,442 S HIGHWAY 27   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609112721,"BELK, CATHERINE, MARIE",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609114073,"PEARSON, MARK, RAY",10 MEDICAL PARK DR LOWR LEVEL LEXINGTON NC,029,Davidson,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1609114073,"PEARSON, MARK, RAY",10 MEDICAL PARK DR LOWR LEVEL LEXINGTON NC,029,Davidson,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 63 , 326 , 364 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609114073,"PEARSON, MARK, RAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 13 , 29 , 31 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609114073,"PEARSON, MARK, RAY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1609115062,KID STRIDES THERAPY LLC,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,251S00000X,Agencies,Community/Behavioral Health,,1609115062,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,251S00000X,Agencies,Community/Behavioral Health,, 33 , 425 , 429 ," $26,976.80 ",,
MEDICAID DIRECT,1609115062,KID STRIDES THERAPY LLC,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,,1609115062,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,251S00000X,Agencies,Community/Behavioral Health,,#,,,$#,,
MEDICAID DIRECT,1609115062,KID STRIDES THERAPY LLC,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1609115062,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,, 68 , 872 , 945 ," $85,864.25 ",,
MEDICAID DIRECT,1609115062,KID STRIDES THERAPY LLC,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,,1609115062,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,193400000X,Group,Single Specialty,, 114 ," 1,946 "," 2,006 "," $181,051.82 ",,
MEDICAID DIRECT,1609115062,KID STRIDES THERAPY LLC,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,193200000X,Group,Multi-Specialty,,1609115062,KID STRIDES THERAPY LLC,5746 ROLLING MEADOWS RD   RANDLEMAN NC,076,Randolph,251S00000X,Agencies,Community/Behavioral Health,,#,,,$#,,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1609116086,"FLOWERS, KIMBERLEY, WEAVER",2359 HIGHWAY 105   BOONE NC,095,Watauga,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 76 , 86 , 89 ,$#,,
MEDICAID DIRECT,1629032347,CAROLINA ANESTHESIOLOGY PA,CAROLINA ANESTHESIOLOGY PA,401 FERNDALE BLVD   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1609116854,"COSGROVE, ALI, BOYCE",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609116854,"COSGROVE, ALI, BOYCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609116854,"COSGROVE, ALI, BOYCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",606 N ELM ST   HIGH POINT NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881059723,TRIAD ADULT AND PEDIATRIC MEDICINE,,1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",1205 ARLINGTON ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447980883,TRIAD ADULT AND PEDIATRIC MEDICINE,,300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",300 W NORTHWOOD ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1063712727,TRIAD ADULT AND PEDIATRIC MEDICINE,~,1002 S EUGENE ST   GREENSBORO NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",1002 S EUGENE ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",136 CREEKVIEW CT   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700548377,WESTERN NC COMMUNITY HEALTH SVCS,,1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 127 , 127 ," $42,027.72 ",,
MEDICAID DIRECT,1790402345,WESTERN NC COMMUNITY HEALTH SVCS,,136 CREEKVIEW CT   MARION NC,059,McDowell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700548377,WESTERN NC COMMUNITY HEALTH SVCS,,1914 SMOKY PARK HWY   CANDLER NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609118462,"ROBINSON, CARMEN, TABRIELLE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 73 , 165 , 169 ," $32,071.58 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5832 FAYETTEVILLE RD STE 113 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609118793,"SCHWARTZ, JESSICA, CATHERINE",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609118793,"SCHWARTZ, JESSICA, CATHERINE",4022 FREEDOM LAKE DR   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609118876,"XIAO, JIPING",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609118876,"XIAO, JIPING",2525 COURT DR   GASTONIA NC,036,Gaston,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609122910,"BAUGHMAN, SAMUEL, DEAN",1726 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609122910,"BAUGHMAN, SAMUEL, DEAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 78 , 148 , 164 ," $19,853.51 ",,
MEDICAID DIRECT,1841877263,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PHYSICIAN SPECIALISTS,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609122910,"BAUGHMAN, SAMUEL, DEAN",1725 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 41 , 41 ,$#,,
MEDICAID DIRECT,1629022868,DANVILLE PHYSICIAN PRACTICES LLC,~,142 S MAIN ST   DANVILLE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609127059,"EVANS, MICHEL, ANTHONY",159 EXECUTIVE DR STE C DANVILLE VA,101,Out of State <= 40 miles,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609129667,"STOIA, KELLY, BYRNE",1800 N SANDHILLS BLVD STE B ABERDEEN NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609129667,"STOIA, KELLY, BYRNE",160 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1609130327,"SUTTON, ERNEST, HENRY",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1609130327,"SUTTON, ERNEST, HENRY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609130327,"SUTTON, ERNEST, HENRY",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609130327,"SUTTON, ERNEST, HENRY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609130889,"JOHNSTON, DARA, MCLEAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609130889,"JOHNSTON, DARA, MCLEAN",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609130889,"JOHNSTON, DARA, MCLEAN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609130889,"JOHNSTON, DARA, MCLEAN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1212 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1609130889,"JOHNSTON, DARA, MCLEAN",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114544996,COASTAL CAROLINA SEDATION ASSOCIATE,,5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609131671,"BRATON, SARAH, RIEMAN",5115 OLEANDER DR   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609131671,"BRATON, SARAH, RIEMAN",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1609131671,"BRATON, SARAH, RIEMAN",1305 GLEN MEADE RD   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609132059,"ROBLES, ANGELICA, VICTORIA",CORALIS HEALTH PLLC,501 S SHARON AMITY RD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,1609132059,"ROBLES, ANGELICA, VICTORIA",501 S SHARON AMITY RD STE 500 CHARLOTTE NC,060,Mecklenburg,2080P0006X,Allopathic & Osteopathic Physicians,Pediatrics,Developmental - Behavioral Pediatrics,#, 13 , 28 ,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609133180,"HESTER, KRISTINA, NICHOLE",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609133180,"HESTER, KRISTINA, NICHOLE",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 11 , 11 , 18 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609133313,"MIKHAILOV, ALEXEI, VLADIMIROVITCH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology, 37 , 43 , 161 ,$#,,
MEDICAID DIRECT,1194925206,PACIFIC NEUROMONITORING ASSOCIATES,,10275 LITTLE PATUXENT PKWY STE 300 COLUMBIA MD,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1609134352,"KANANI, REZA",23822 BITTERN LN   LAGUNA NIGUEL CA,102,Out of State > 40 miles,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609134386,"LICHTMAN, EBEN, ISAAC",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 26 , 47 , 72 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609134386,"LICHTMAN, EBEN, ISAAC",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 15 , 65 , 65 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609135490,"IPATII, CRISTINA",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 122 , 179 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,893 EAST ST   PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1609136530,"WILLIAMS, HEATHER, WRIGHT",893 EAST ST   PITTSBORO NC,019,Chatham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 44 ,$#,,
MEDICAID DIRECT,1477240711,RDMG ASSOCIATES PA,RDMG BEHAVIORAL HEALTH,7205 STONEHENGE DR STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609142702,"SIMONSON, MARY, MARSHALL",7205 STONEHENGE DR STE 200 RALEIGH NC,092,Wake,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1063556983,NORTH CAROLINA ORTHOTICS AND PROSTH,NORTH CAROLINA ORTHOTICS AND PROSTHETICS OF RALEIG,,,Unknown,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609142777,"WALKER, BENGT, ALAN",2717 LEIGHTON RIDGE DRIVE SUITE 100 WAKE FOREST NC,068,Orange,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1427136845,NC ORTHOTICS AND PROSTHETICS,NC ORTHOTICS AND PROSTHETICS,451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609142777,"WALKER, BENGT, ALAN",451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1427136845,NC ORTHOTICS AND PROSTHETICS,NC ORTHOTICS AND PROSTHETICS,451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609142777,"WALKER, BENGT, ALAN",451 RUIN CREEK RD STE 102 HENDERSON NC,091,Vance,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 20 ,$#,,
MEDICAID DIRECT,1114002847,NC ORTHOTIC AND PROSTHETICS OF RR,NC ORTHOTIC AND PROSTHETICS OF RR,725 HAMILTON ST STE D ROANOKE RAPIDS NC,042,Halifax,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609142777,"WALKER, BENGT, ALAN",725 HAMILTON ST STE D ROANOKE RAPIDS NC,042,Halifax,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1376830273,NORTH CAROLINA ORTHOTICS AND PROSTH,NORTH CAROLINA ORTHOTICS AND PROSTHETICS OF ROCKY,3721 SUNSET AVE   ROCKY MOUNT NC,064,Nash,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609142777,"WALKER, BENGT, ALAN",3721 SUNSET AVE   ROCKY MOUNT NC,064,Nash,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609142819,"SMITH, DANIEL, CLARENCE",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 46 , 95 , 102 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609142819,"SMITH, DANIEL, CLARENCE",3511 W MARKET ST STE 100 GREENSBORO NC,041,Guilford,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 38 , 81 , 88 ," $13,849.06 ",,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609142819,"SMITH, DANIEL, CLARENCE",621 S MAIN ST STE 100 REIDSVILLE NC,079,Rockingham,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609143494,"MAHALA, LORI, DAWN",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609147255,"MARTIN, SARAH, YTTRI",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 38 , 63 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 506 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609147255,"MARTIN, SARAH, YTTRI",3480 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1609148022,"HARTMAN, NICHOLAS, MERLE",720 MALCOLM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1609148022,"HARTMAN, NICHOLAS, MERLE",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 17 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609150879,"SAGER, MEGAN, BRISSIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 26 , 26 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609150879,"SAGER, MEGAN, BRISSIE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609150879,"SAGER, MEGAN, BRISSIE",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609154327,"FLEET, BRYAN, STERLING",222 HERLONG AVE S   ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609155043,"BROWER, BLAINE, YORK",101 MANNING DR   CHAPEL HILL NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 40 , 65 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5080 KAHN DR   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609155829,"LANCER, BRIAN, ALAN",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5214 MARKET ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609155829,"LANCER, BRIAN, ALAN",1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 35 , 78 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,202 VILLAGE RD NE   LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1609155829,"LANCER, BRIAN, ALAN",202 VILLAGE RD NE   LELAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1659656916,CENTER FOR ORTHOTIC AND PROSTHETIC,HANGER CLINIC,4702 CREEKSTONE DR   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609156264,"MEADOWS, ELIZABETH, ASHLEY HEARD",4702 CREEKSTONE DR   DURHAM NC,032,Durham,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#,#,$#,,
MEDICAID DIRECT,1659656916,CENTER FOR ORTHOTIC AND PROSTHETIC,HANGER CLINIC,4601 CREEKSTONE DR STE 112 DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609156264,"MEADOWS, ELIZABETH, ASHLEY HEARD",4702 CREEKSTONE DR   DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1659656916,CENTER FOR ORTHOTIC AND PROSTHETIC,HANGER CLINIC,4702 CREEKSTONE DR   DURHAM NC,032,Durham,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609156264,"MEADOWS, ELIZABETH, ASHLEY HEARD",4702 CREEKSTONE DR   DURHAM NC,032,Durham,222Z00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Orthotist,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609160241,"NOMIDES, JENNIFER, MARIE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 20 , 59 , 59 ,$#,,
MEDICAID DIRECT,1881651347,GOLDSBORO COUNSELING CENTER PA,Goldsboro Counseling Center PA,208 MALLOY ST STE E GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609160522,"COX, JENNIFER, LONG",208 MALLOY ST STE E GOLDSBORO NC,096,Wayne,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609160936,"WOODFIN, AMY, ALEXANDER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 20 , 32 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609160936,"WOODFIN, AMY, ALEXANDER",208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 29 , 86 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,193200000X,Group,Multi-Specialty,,1609160936,"WOODFIN, AMY, ALEXANDER",375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 95 , 196 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609160936,"WOODFIN, AMY, ALEXANDER",375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609160936,"WOODFIN, AMY, ALEXANDER",375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609160936,"WOODFIN, AMY, ALEXANDER",375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609160936,"WOODFIN, AMY, ALEXANDER",375 HOSPITAL ST   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609163039,"GUPTA, NEHA",830 KEMPSVILLE RD FL 1 NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609165455,"WOODARD, GENEVIEVE, ANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 55 , 61 , 136 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,3811 MERTON DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609165455,"WOODARD, GENEVIEVE, ANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609165455,"WOODARD, GENEVIEVE, ANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1609166321,"DORSEY, KIMBERLY, FLETCHER",615 RIDGE RD   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609166321,"DORSEY, KIMBERLY, FLETCHER",615 RIDGE RD   ROXBORO NC,073,Person,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 12 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609166321,"DORSEY, KIMBERLY, FLETCHER",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1609166321,"DORSEY, KIMBERLY, FLETCHER",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609166321,"DORSEY, KIMBERLY, FLETCHER",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 15 , 43 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609168855,"BRACKMAN, MARRI, KAJFEZ",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609169044,"MCCULLOUGH, SARAH, BOUNDS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609169044,"MCCULLOUGH, SARAH, BOUNDS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 40 , 92 , 92 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1609180306,"UDDIN, QAZI, FARHAN",1407 BALDERSTON CT NE   LEESBURG VA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1609180306,"UDDIN, QAZI, FARHAN",1407 BALDERSTON CT NE   LEESBURG VA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 75 , 84 , 112 ,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1609180306,"UDDIN, QAZI, FARHAN",1407 BALDERSTON CT NE   LEESBURG VA,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 56 , 61 , 76 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609181130,"MONCION, RENE, JULIO",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1609181130,"MONCION, RENE, JULIO",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609181130,"MONCION, RENE, JULIO",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1609181130,"MONCION, RENE, JULIO",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609181130,"MONCION, RENE, JULIO",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609181254,"KELLY, MARYELLEN, SUSANNA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 15 , 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609181254,"KELLY, MARYELLEN, SUSANNA",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609182294,CLAYTON HEALTH HOLDINGS LLC,CLAYTON HOUSE,145 DAIRY RD   CLAYTON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609182294,CLAYTON HEALTH HOLDINGS LLC,145 DAIRY RD   CLAYTON NC,051,Johnston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 32 ," 7,938 "," 7,940 "," $799,302.65 ",,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1609185222,"MURPHY, JOANNE, CAROLINE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1609185222,"MURPHY, JOANNE, CAROLINE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609187178,CAROLINA THERAPY CONNECTION,~,1925A TURNBURY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609187178,CAROLINA THERAPY CONNECTION,1925A TURNBURY DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,, 343 ," 3,200 "," 4,124 "," $290,474.21 ",,
MEDICAID DIRECT,1326122805,ALBEMARLE REGIONAL HEALTH SERVICES,ELIZABETH CITY CDSA,1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,252Y00000X,Agencies,Early Intervention Provider Agency,,1609187327,"KRAMER, JENNIFER, ASHLEY",1417 PARKVIEW DR   ELIZABETH CITY NC,070,Pasquotank,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 57 , 79 , 79 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609189372,"SETZER, TIMOTHY, DAVID",600 HOSPITAL DR   MONROE NC,090,Union,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1972829562,SCOTLAND REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - SCOTLAND,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1609189372,"SETZER, TIMOTHY, DAVID",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609189372,"SETZER, TIMOTHY, DAVID",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609189372,"SETZER, TIMOTHY, DAVID",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 37 , 74 , 84 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609189372,"SETZER, TIMOTHY, DAVID",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609189372,"SETZER, TIMOTHY, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609189372,"SETZER, TIMOTHY, DAVID",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609193523,"VANN, LISA, MARIE",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 30 , 62 , 62 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609193523,"VANN, LISA, MARIE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609193523,"VANN, LISA, MARIE",3643 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609194307,"BARRETT, DEBORAH, ANNE",101 MANNING DR   CHAPEL HILL NC,068,Orange,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609194372,"RICHARDSON, KARL, MATTHEW",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 151 , 186 , 221 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609194802,"GINN, STUART, DAVID",505 OBERLIN RD   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609194802,"GINN, STUART, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 12 , 14 , 20 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609194802,"GINN, STUART, DAVID",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 25 , 26 , 39 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,400 US HIGHWAY 70 E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1609194802,"GINN, STUART, DAVID",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 24 , 39 , 52 ,$#,,
MEDICAID DIRECT,1053976415,WAKEMED SPECIALISTS GROUP LLC,WAKEMED ENT-HEAD & NECK SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609194802,"GINN, STUART, DAVID",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609195080,"STEELE, HANNAH, BOSDELL",1511 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609195080,"STEELE, HANNAH, BOSDELL",13640 STEELECROFT PKWY STE 240 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 16 , 21 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609195080,"STEELE, HANNAH, BOSDELL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609195205,"SKLEROV, MIRIAM, MALKAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609195205,"SKLEROV, MIRIAM, MALKAH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 20 , 31 , 39 ,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609195650,"NOTLEY, MARK, WILFRED",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,3000 COLISEUM DR   HAMPTON VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609195650,"NOTLEY, MARK, WILFRED",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609196203,"JOHNSON, LEONARD",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 121 , 121 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609196583,"TURNEY, ELIZABETH, CAROLINE",1200 N ELM ST ENTRANCE C GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 34 , 35 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609196583,"TURNEY, ELIZABETH, CAROLINE",1200 N ELM ST ENTRANCE C GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609196583,"TURNEY, ELIZABETH, CAROLINE",1200 N ELM ST ENTRANCE C GREENSBORO NC,041,Guilford,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609197425,"MARTIN, JONATHAN, GILBERT",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 12 , 12 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609197425,"MARTIN, JONATHAN, GILBERT",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 25 , 25 , 56 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609197425,"MARTIN, JONATHAN, GILBERT",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609197425,"MARTIN, JONATHAN, GILBERT",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215314778,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM WOMENS CENTER,150 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1609198209,"THARPE, TERESA, SUDDRETH",150 PARKWOOD DR   ELKIN NC,086,Surry,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 21 , 42 , 50 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609198761,"WOODARD, CHARLSIE, COBB",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 33 , 33 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609201748,"HULEN, MEGAN, PEABODY",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609201748,"HULEN, MEGAN, PEABODY",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 34 , 46 , 58 ,$#,,
MEDICAID DIRECT,1891050357,OUTER BANKS PROFESSIONAL SERVICES,OUTER BANKS HEALTH MEDICAL GROUP,4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1609204585,"TYRE, CHARLEY, COWAN",4800 S CROATAN HWY   NAGS HEAD NC,028,Dare,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1881021475,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,2550 COURT DR STE 203 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609204890,"SAWYER, RACHEL, SHARLENE",2550 COURT DR STE 203 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 24 , 24 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609204890,"SAWYER, RACHEL, SHARLENE",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 17 , 18 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609204890,"SAWYER, RACHEL, SHARLENE",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609204890,"SAWYER, RACHEL, SHARLENE",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,310 DAVIE AVE   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609205103,"ROBERTSON, RACHEL",774 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609205103,"ROBERTSON, RACHEL",774 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 43 , 66 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1609205442,"WHALEY, MARLENE, BLIZZARD",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1639294309,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER BEULAVILLE,119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609205442,"WHALEY, MARLENE, BLIZZARD",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609205442,"WHALEY, MARLENE, BLIZZARD",119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 46 , 48 ,$#,,
MEDICAID DIRECT,1639294309,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER BEULAVILLE,119 CROSSOVER RD   BEULAVILLE NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609205442,"WHALEY, MARLENE, BLIZZARD",130 N CENTER ST   MOUNT OLIVE NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609213701,"HULKOWER, BENJAMIN, MARK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 41 , 121 , 121 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1609213701,"HULKOWER, BENJAMIN, MARK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 68 , 183 , 183 ,$#,,
MEDICAID DIRECT,1760155808,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - ANESTHESIOLOGY,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609214899,"SEARLES, ROBERT, JAMES",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1447845599,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR HOSPITALIST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609215136,"BEAM, WILLIAM, MOORE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 68 , 216 , 217 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609215334,"KLINGER, SARAH, ALLISON",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 77 , 121 , 127 ," $11,704.21 ",,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609215334,"KLINGER, SARAH, ALLISON",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 35 , 38 , 40 ,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609215334,"KLINGER, SARAH, ALLISON",2608 E 7TH ST   CHARLOTTE NC,060,Mecklenburg,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1396172516,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609215334,"KLINGER, SARAH, ALLISON",100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 26 , 41 , 48 ,$#,,
MEDICAID DIRECT,1902233505,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH LEVINE CHILDRENS NEUROLOGY,6600 W WILKINSON BLVD   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1609215334,"KLINGER, SARAH, ALLISON",6600 W WILKINSON BLVD   BELMONT NC,036,Gaston,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1740047455,MCLEOD REGIONAL MEDICAL CENTER OF T,MCLEOD DIGESTIVE HEALTH CENTER,401 EAST CHEVES STREET SUITE 301 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609215599,"DHALIWAL, AMANINDER JEET, SINGH",401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1255731204,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD DIGESTIVE HEALTH CENTER,401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609215599,"DHALIWAL, AMANINDER JEET, SINGH",401 E CHEVES ST STE 301 FLORENCE SC,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,193200000X,Group,Multi-Specialty,,1609216803,"THEBERGE, DANIELLE, FECK",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609216803,"THEBERGE, DANIELLE, FECK",40 RAVENSWOOD RD   HAMPSTEAD NC,071,Pender,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 21 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609216803,"THEBERGE, DANIELLE, FECK",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 21 ,$#,,
MEDICAID DIRECT,1265277172,ELITE COMPREHENSIVE CARE,ELITE COMPREHENSIVE CARE,13094 NC HWY   SURF CITY NC,071,Pender,193200000X,Group,Multi-Specialty,,1609216803,"THEBERGE, DANIELLE, FECK",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609217603,"MUZZY, JENNIFER, ANN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 31 , 84 , 87 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609217793,"SANDAHL, INGRID",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 74 , 79 , 91 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609219856,"SNYDER, NICCOLE, MARIE",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235148529,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS ROCK HILL PEDIATRIC,1935 HOLBROOK RD STE 2200 FORT MILL SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609220045,"CHAKRA, RANYA, PATRICIA",1935 HOLBROOK RD STE 2200 FORT MILL SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1396414488,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN 69 NORTH BROAD,69 N BROAD ST   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609221084,"REDMOND, MICHAEL, LEE",69 N BROAD ST   BREVARD NC,088,Transylvania,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 22 , 74 , 75 ,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609221084,"REDMOND, MICHAEL, LEE",1207 EAST ST   WAYNESVILLE NC,044,Haywood,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 46 , 101 , 104 ,$#,,
MEDICAID DIRECT,1861592271,ASHE MEMORIAL HOSPITAL INC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1609221407,"DOWNING, CAITLIN, MARIE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720495336,JEFFERSON EMERGENCY SERVICES PLLC,,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1609221407,"DOWNING, CAITLIN, MARIE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 27 , 26 , 31 ,$#,,
MEDICAID DIRECT,1427121144,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,413 MCCONNELL ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1609221407,"DOWNING, CAITLIN, MARIE",413 MCCONNELL ST   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609223908,"GOODMAN, MARK, BRANDON",101 MANNING DR W1017 CB 7600 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 17 , 24 , 24 ,$#,,
MEDICAID DIRECT,1609226844,LITTLE BEAN SPEECH PLLC,,5221 SUNSET WALK LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1609226844,LITTLE BEAN SPEECH PLLC,5221 SUNSET WALK LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,, 20 , 618 , 696 ," $39,261.06 ",,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609226901,"WATSON, JAMES, RICHARDS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609226901,"WATSON, JAMES, RICHARDS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 52 , 52 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609226901,"WATSON, JAMES, RICHARDS",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 118 , 119 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609229681,"ALEY, MICHAEL, RYAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 35 , 56 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609229681,"ALEY, MICHAEL, RYAN",2695 HENDERSONVILLE RD STE 204 ARDEN NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 24 , 43 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609230341,"JASPER TROTTER, ALANA, DAIVA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609230481,"LEWIS, KIMBERLY, DENISE",3173 W HIGHWAY 74   MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609230481,"LEWIS, KIMBERLY, DENISE",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609230481,"LEWIS, KIMBERLY, DENISE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1609230689,"LOONEY, AUSTIN, MACFARLAND",1915 LENDEW ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1609232172,"WEAVER, SAMANTHA, GWEN",50 13TH AVE NE STE 1 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609232172,"WEAVER, SAMANTHA, GWEN",201 E GROVER ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1588386296,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ENDOCRINOLOGY CLINICS,1918 RANDOLPH RD STE 220 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609232867,"OGUNSOLA, ABIADE",1718 E 4TH ST STE 207 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609233295,MODERATE LIVING FOR THE AGING INC,,110 ROOSEVELT ST   MOUNT GILEAD NC,077,Richmond,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1609233295,MODERATE LIVING FOR THE AGING INC,110 ROOSEVELT ST   MOUNT GILEAD NC,077,Richmond,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 53 , 898 , 924 ," $120,530.16 ",,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609233857,"BECK, RILEY, LEIGH",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,, 12 , 66 , 106 ,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,1704 W INNES ST   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1609233857,"BECK, RILEY, LEIGH",1704 W INNES ST   SALISBURY NC,080,Rowan,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1336254622,STEWART PHYSICAL THERAPY OF ROWAN C,STEWART PHYSICAL THERAPY OF ROWAN COUNTY INC,3948 FOREST OAKS LN STE E MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609233857,"BECK, RILEY, LEIGH",2766 NC HIGHWAY 68 S STE 105 HIGH POINT NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 41 , 103 ,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1609234566,"BARDASH, BRYAN, GREGORY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1326706763,INNOVATIVE ANESTHESIA SOLUTIONS LLC,,144 MEADOW CIR   BLAIRSVILLE GA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609234566,"BARDASH, BRYAN, GREGORY",3990 E US 64 ALT   MURPHY NC,020,Cherokee,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1609236371,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT STOVALL,100 DURHAM   STOVALL NC,039,Granville,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609236371,RURAL HEALTH GROUP INC,100 DURHAM   STOVALL NC,039,Granville,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 37 , 95 , 95 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",1605 S MAIN ST   LILLINGTON NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",1605 S MAIN ST   LILLINGTON NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 87 , 87 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",290 H M CAGLE DR   CAMERON NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",290 H M CAGLE DR   CAMERON NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",1605 S MAIN ST   LILLINGTON NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",800 TILGHMAN DR   DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",290 H M CAGLE DR   CAMERON NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 12 , 15 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 27 , 39 , 73 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 20 , 60 , 60 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 306 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 17 , 55 , 56 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609238526,"GEHERTY, RAYMOND, ALLEN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1801428487,PRIMARY MEDICAL CARE AT THE CROSSRO,,58 OLD ROBERTS RD   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1609239672,"LANIER, LAURA, ELIZABETH MCCOY",58 OLD ROBERTS RD   BENSON NC,051,Johnston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 25 , 51 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609241736,"CONSTANT, JULIA, POWER",4220 N ROXBORO ST FL 1 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609241736,"CONSTANT, JULIA, POWER",3643 N ROXBORO ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 31 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609241736,"CONSTANT, JULIA, POWER",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609241736,"CONSTANT, JULIA, POWER",10207 CERNY ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609241843,"JOYNER, HEATHER, LILES",10030 GREEN LEVEL CHURCH RD STE 808 CARY NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609245224,"HANFORD, RACHEL, DRYE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609245224,"HANFORD, RACHEL, DRYE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,2160 HERBERT CT   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609245224,"HANFORD, RACHEL, DRYE",2160 HERBERT CT   GREENVILLE NC,074,Pitt,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 19 , 21 , 37 ,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609245224,"HANFORD, RACHEL, DRYE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 13 , 14 , 27 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609245224,"HANFORD, RACHEL, DRYE",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609248566,"BROWN, KAITLIN, ADAIRE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609248566,"BROWN, KAITLIN, ADAIRE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609248566,"BROWN, KAITLIN, ADAIRE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609253053,"TAKALO, ELISA, LUND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609253053,"TAKALO, ELISA, LUND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609253053,"TAKALO, ELISA, LUND",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609256056,"MILANO, JOSEPH, MICHAEL",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518570761,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609259050,"WEISS, KEVIN, SCOTT",1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609259050,"WEISS, KEVIN, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1518570761,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCULOSKELETAL INSTITUTE ORTHOPEDIC,1690 HIGHWAY 160 W   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609259050,"WEISS, KEVIN, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1568075422,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH MUSCOLOSKLETAL INSTITUTE ORTHOPEDICS,10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609259050,"WEISS, KEVIN, SCOTT",10660 PARK RD STE 3100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 44 , 67 , 114 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609259175,"ROSE, RYANN, MCGOUGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 41 , 44 , 45 ,$#,,
MEDICAID DIRECT,1477942613,OPTIMED HOSPITALISTS PLLC,OPTIMED SPECIALTY SERVICES,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609259183,"CAMPBELL, NUNTA, JITOUN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609259183,"CAMPBELL, NUNTA, JITOUN",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609260249,"WILLIAMS, CHARLES, JERRY",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609260520,"WEISS, AUSTIN, HENRY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine, 35 , 60 , 63 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609260520,"WEISS, AUSTIN, HENRY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609261916,"MARTINEZ, MAXIMILIAN, STEPHEN JOSEPH",810 MITCHELL AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 46 , 56 , 113 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,104 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609262146,"PASSMORE, TEWANA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609262146,"PASSMORE, TEWANA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,5402 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609262146,"PASSMORE, TEWANA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 15 , 31 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1407 E FRANKLIN ST   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609262146,"PASSMORE, TEWANA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,3215 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609262146,"PASSMORE, TEWANA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609262146,"PASSMORE, TEWANA",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1437860889,PINNACLE URGENT CARE PLLC,,1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193400000X,Group,Single Specialty,,1609262146,"PASSMORE, TEWANA",1201 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263375,"NAGARAJA, TARA, GHATGE",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,409 OLIN WAY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1609263375,"NAGARAJA, TARA, GHATGE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1518405257,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH DIABETES & NUTRITION CARE,409 OLIN WAY   DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1609263375,"NAGARAJA, TARA, GHATGE",409 OLIN WAY   DENVER NC,055,Lincoln,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263375,"NAGARAJA, TARA, GHATGE",810 MITCHELL AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 65 , 115 , 206 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263375,"NAGARAJA, TARA, GHATGE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1952493587,PERSON FAMILY MEDICAL CENTER,PERSON FAMILY MEDICAL CENTER INC,702 N MAIN ST   ROXBORO NC,073,Person,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609263599,"PALIY, ALISA",702 N MAIN ST   ROXBORO NC,073,Person,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 26 , 37 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609263599,"PALIY, ALISA",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609263599,"PALIY, ALISA",3643 N ROXBORO ST   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609263805,"NAFISSI, NAVID, AZAR",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1023440898,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,111 W GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",111 W GROVER ST   SHELBY NC,023,Cleveland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 32 , 38 , 64 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 12 , 18 , 19 ,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609263805,"NAFISSI, NAVID, AZAR",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 61 , 63 , 95 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609263995,"WINGO, LAUREN, BECK",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 41 , 41 , 55 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609268143,"BREWER, GRACE, YOUNGOK CHO",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609268143,"BREWER, GRACE, YOUNGOK CHO",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609268143,"BREWER, GRACE, YOUNGOK CHO",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609268143,"BREWER, GRACE, YOUNGOK CHO",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 13 ,$#,,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609269596,"DIXON, RASHAUN, MILESE",550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326010273,ALAMANCE REGIONAL MEDICAL CENTER,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609269596,"DIXON, RASHAUN, MILESE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609272087,"WILTSIE, JUSTINE, MARIE",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609273085,"SHIM, AHMED, ADNAN",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 90 , 114 , 121 ,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609274687,"FARMER, TIFFANY, LEANNE",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1245637701,NEW DAWN PSYCHIATRIC SERVICES PLLC,,201 N SPENCE AVE   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609274687,"FARMER, TIFFANY, LEANNE",2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609280734,"MCNEILL, JENNA, NICOLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 40 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1821 HILLANDALE RD STE 25A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609280734,"MCNEILL, JENNA, NICOLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 15 , 21 , 34 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609280734,"MCNEILL, JENNA, NICOLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609280734,"MCNEILL, JENNA, NICOLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 19 , 42 , 47 ,$#,,
MEDICAID DIRECT,1548348824,Riccobene & Associates I DDS PA,~,12330 NC HIGHWAY 210 STE 115 BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 47 , 214 ,$#,,
MEDICAID DIRECT,1174067813,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - MEBANE,1931 S NC HIGHWAY 119   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 27 , 28 , 84 ,$#,,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 27 ,$#,,
MEDICAID DIRECT,1093064958,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - RALEIGH FA,4400 FALLS OF NEUSE RD STE 202 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 71 , 72 , 390 ," $10,281.79 ",,
MEDICAID DIRECT,1265778963,Riccobene & Associates XIII DDS PA,RICCOBENE DENTISTRY FOR KIDS CARY,1000 CRESCENT GRN STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 11 , 11 , 34 ,$#,,
MEDICAID DIRECT,1982076071,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CARY WEST,1203 NW MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1588207435,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY- OAKWOOD,105 WAYFARER CT   ROCKY MOUNT NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice, 15 , 15 , 66 ,$#,,
MEDICAID DIRECT,1538589577,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY APEX,966 US 64 HWY W   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1245536218,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - WAKEFIELD,13251 FALLS OF NEUSE RD STE 141 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609280817,"BANGALORE, SHEELA, SATISH",9096 CLEVELAND RD   CLAYTON NC,051,Johnston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1912188939,CAROMONT MEDICAL GROUP INC,CAROMONT INPATIENT PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609281187,"JACOB, RAHUL",2525 COURT DR   GASTONIA NC,036,Gaston,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 64 , 186 , 186 ,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609281435,"KHANDELWAL, ARPIT",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1609285030,IN TERRIS HANDS LLC,IN TERRIS HANDS LLC,318 CLOISTER CT   CHAPEL HILL NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,1609285030,IN TERRIS HANDS LLC,318 CLOISTER CT   CHAPEL HILL NC,068,Orange,253Z00000X,Agencies,In Home Supportive Care,,#, 88 , 88 ," $16,055.76 ",,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",201 E GROVER ST   SHELBY NC,023,Cleveland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1003104183,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",2400 SOUTH BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609288505,"BROWN, JONISHA, RAESHELLA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609289461,"GELMAN, ERIC, DARRIN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3621 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609289461,"GELMAN, ERIC, DARRIN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609289461,"GELMAN, ERIC, DARRIN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 39 , 40 , 41 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609289461,"GELMAN, ERIC, DARRIN",2825 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1609289495,"CAPARASO, ANNA, ATKINSON",ANNA A CAPARASO DDS PLLC,1433 N MAIN ST   MARION NC,059,McDowell,1223G0001X,Dental Providers,Dentist,General Practice,1609289495,"CAPARASO, ANNA, ATKINSON",1433 N MAIN ST   MARION NC,059,McDowell,1223G0001X,Dental Providers,Dentist,General Practice, 112 , 147 , 392 ," $17,400.89 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609289529,"SMITH, KERI, LYNN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 36 , 49 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609289529,"SMITH, KERI, LYNN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 34 , 38 , 49 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609290956,"PANDEY, SHANTA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 25 , 69 , 69 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609290956,"PANDEY, SHANTA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 137 , 152 , 221 ,$#,,
MEDICAID DIRECT,1922633742,HOSPICE OF ROCKINGHAM COUNTY,,2150 NC HIGHWAY 65   REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1609292127,"LUCAS, RHONDA, WELLS",2150 NC HIGHWAY 65   REIDSVILLE NC,079,Rockingham,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 14 , 34 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609294743,"ROBLES, JOANNA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 21 , 22 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609294743,"ROBLES, JOANNA, MARIA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609295591,"AN, SI, SANDY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609295591,"AN, SI, SANDY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 18 , 45 , 49 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609295591,"AN, SI, SANDY",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609296185,"BHAGWANDASS, NITHIN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 21 , 24 , 24 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1609296185,"BHAGWANDASS, NITHIN",850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 31 , 32 , 32 ,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1609298009,"NAYMICK, STEPHEN, ANDREW",702 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609298009,"NAYMICK, STEPHEN, ANDREW",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 21 , 56 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609298009,"NAYMICK, STEPHEN, ANDREW",702 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 55 , 119 , 239 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,941 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609298009,"NAYMICK, STEPHEN, ANDREW",702 NEWMAN RD   NEW BERN NC,025,Craven,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609298264,HAVEN HOME CARE INC,,206 6TH ST UNIT B NORTH WILKESBORO NC,097,Wilkes,253Z00000X,Agencies,In Home Supportive Care,,1609298264,HAVEN HOME CARE INC,206 6TH ST UNIT B NORTH WILKESBORO NC,097,Wilkes,253Z00000X,Agencies,In Home Supportive Care,, 16 ," 2,766 "," 2,794 "," $330,127.12 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609300581,"KEENE, STACI, ARLENE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZH0000X,Allopathic & Osteopathic Physicians,Pathology,Hematology, 62 , 65 , 173 ,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1609300920,"STEVENS, PATRICK, LEE",112 N SWAIM ST   JONESVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 34 , 59 , 110 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609301035,"SIMS, LAURA, ELIZABETH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 38 , 77 , 87 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609301035,"SIMS, LAURA, ELIZABETH",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609301035,"SIMS, LAURA, ELIZABETH",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609301035,"SIMS, LAURA, ELIZABETH",3031 NEW BERN AVE STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609301035,"SIMS, LAURA, ELIZABETH",3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 28 , 76 , 83 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,3700 BARRETT DR STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609301035,"SIMS, LAURA, ELIZABETH",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1750835336,NORTH CAROLINA NEPHROLOGY PA,,2824 ROGERS RD STE 104 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609301035,"SIMS, LAURA, ELIZABETH",700 TILGHMAN DR STE 722 DUNN NC,043,Harnett,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1306283080,MCPC-12 LLC,FIRSTHEALTH SOUTHERN PINES WOMENS HEALTH CENTER,145 APPLECROSS RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609301415,"PEARCE, CALEB, DALE",145 APPLECROSS RD   PINEHURST NC,063,Moore,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 26 , 41 , 61 ,$#,,
MEDICAID DIRECT,1699171868,PREMIER FOOT AND ANKLE PLLC,,821 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1609302850,"PATEL, MANSI",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 12 , 12 , 19 ,$#,,
MEDICAID DIRECT,1629662598,HEALTHDRIVE PODIATRY GROUP NC PC,,5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609302850,"PATEL, MANSI",5960 FAIRVIEW RD STE 300 CHARLOTTE NC,060,Mecklenburg,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 58 , 69 , 79 ,$#,,
MEDICAID DIRECT,1215463450,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PULMONARY MEDICINE,1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609302868,"GRAHAM, ROSE, MARY",1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 173 , 247 , 247 ,$#,,
MEDICAID DIRECT,1750197042,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY PULMONARY MEDICINE,1537 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609302868,"GRAHAM, ROSE, MARY",1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 105 , 111 , 111 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609303429,"PATE, LAUREL, HAD-LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609303429,"PATE, LAUREL, HAD-LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609304203,"EDMONDS, SARAH, SHELTON",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 40 , 40 ,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609304203,"EDMONDS, SARAH, SHELTON",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1124775655,DAYENA LEE DDS AND KANDICE LEE DDS,MEBANE OAKS FAMILY DENTISTRY,975 CAMERON LN   MEBANE NC,001,Alamance,193400000X,Group,Single Specialty,,1609305994,"LEE, KANDICE, SEUL",975 CAMERON LN   MEBANE NC,001,Alamance,1223G0001X,Dental Providers,Dentist,General Practice, 96 , 119 , 435 ," $15,087.01 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609306505,"CREGAR, WILLIAM, MASON",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,,,$#,,
MEDICAID DIRECT,1124757836,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-3334 BOYLSTON HIGHWAY SUITE 20,3334 BOYLSTON HWY STE 20 MILLS RIVER NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609306778,"PRECHT, MACKENZIE, CASHMAN",3334 BOYLSTON HWY STE 10 MILLS RIVER NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1528707130,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1824 PISGAH DRIVE,1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609306778,"PRECHT, MACKENZIE, CASHMAN",1824 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 36 , 50 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609306778,"PRECHT, MACKENZIE, CASHMAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,600 GRESHAM DR STE 700 NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609307107,"HIRA, JASPREET, KAUR",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609307107,"HIRA, JASPREET, KAUR",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609308022,"ZHOU, SHAN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 37 , 37 , 40 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1609308451,"CREED, ERIC, BRANDON",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 18 , 23 , 28 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609308451,"CREED, ERIC, BRANDON",300 MEADOWMONT VILLAGE CIR STE 202 CHAPEL HILL NC,032,Durham,2084N0008X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neuromuscular Medicine, 65 , 95 , 96 ,$#,,
MEDICAID DIRECT,1609308790,GALA IN-HOME CARE SERVICES LLC,,5549 GRACE CHAPEL RD   HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,1609308790,GALA IN-HOME CARE SERVICES LLC,5549 GRACE CHAPEL RD   HICKORY NC,018,Catawba,253Z00000X,Agencies,In Home Supportive Care,,#, 178 , 178 ," $11,127.32 ",,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609309590,"HANEFELD-FOX, LILIANNA",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1609310275,"WEATHERS, ANDREA, CAMPBELL",2007 WALNUT ST   CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1932679446,WAKEMED CHILDRENS PM PEDIATRICS URG,~,1125 HATCHES POND LN STE 101 MORRISVILLE NC,092,Wake,193400000X,Group,Single Specialty,,1609310275,"WEATHERS, ANDREA, CAMPBELL",8841 SIX FORKS RD STE 102 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609311174,"HEATLEY, KATHY, WORTHY",2701 STATESVILLE AVE   CHARLOTTE NC,060,Mecklenburg,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,193400000X,Group,Single Specialty,,1609311471,"HAHN, TYLER, GREGORY",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609311471,"HAHN, TYLER, GREGORY",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 55 , 103 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609311471,"HAHN, TYLER, GREGORY",1100 HEALING WAY STE 12 MATTHEWS NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 30 , 55 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609315670,"GRUE, TINA, ANN",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609315670,"GRUE, TINA, ANN",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609315670,"GRUE, TINA, ANN",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 21 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609315670,"GRUE, TINA, ANN",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609315670,"GRUE, TINA, ANN",7903 PROVIDENCE RD STE 110 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,LIFEBRITE FAMILY MEDICAL OF DANBURY,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609319490,LIFEBRITE HOSPITAL GROUP OF STOKES,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,#,#,#,$#,,
MEDICAID DIRECT,1609321124,"HAMRICK, CAMERON, STREET",,422 W WARREN ST   SHELBY NC,023,Cleveland,152W00000X,Eye and Vision Services Providers,Optometrist,,1609321124,"HAMRICK, CAMERON, STREET",422 W WARREN ST   SHELBY NC,023,Cleveland,152W00000X,Eye and Vision Services Providers,Optometrist,," 1,990 "," 2,040 "," 3,872 "," $64,479.15 ",,
MEDICAID DIRECT,1891192019,CLEVELAND EYECARE OD PA,~,422 W WARREN ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1609321124,"HAMRICK, CAMERON, STREET",422 W WARREN ST   SHELBY NC,023,Cleveland,152W00000X,Eye and Vision Services Providers,Optometrist,, 67 , 67 , 118 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609322676,"WALLIN, MARGOT, CHANTELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 36 , 36 , 36 ,$#,,
MEDICAID DIRECT,1609323203,HARRIS TEETER LLC,HARRIS TEETER PHARMACY 344,6024 FALLS OF THE NEUSE RD   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1609323203,HARRIS TEETER LLC,6024 FALLS OF THE NEUSE RD   RALEIGH NC,092,Wake,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609334119,"HADDOCK, JOHN, HAMILTON",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1609334119,"HADDOCK, JOHN, HAMILTON",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,341 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609334341,"STEPHENS, LORA, MICHELLE",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 86 , 142 , 143 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609334341,"STEPHENS, LORA, MICHELLE",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609334341,"STEPHENS, LORA, MICHELLE",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609334341,"STEPHENS, LORA, MICHELLE",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609334341,"STEPHENS, LORA, MICHELLE",341 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 30 , 57 , 57 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609336965,"ORTIZ GOMEZ, CAMILA",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1609336965,"ORTIZ GOMEZ, CAMILA",1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609336965,"ORTIZ GOMEZ, CAMILA",1550 FAULK ST   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679977730,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1609336965,"ORTIZ GOMEZ, CAMILA",105 YADKIN ST STE 203 ALBEMARLE NC,084,Stanly,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1112 GRACIE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,701 DOCTORS DR STE L KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",701 DOCTORS DR STE L KINSTON NC,054,Lenoir,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",701 DOCTORS DR STE L KINSTON NC,054,Lenoir,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",7210 VILLAGE MEDICAL CIR STE 225 CLEMMONS NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205558913,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH UROLOGY CLINICS,2010 BALDWIN LN   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609337153,"CARPINITO, GIANPAOLO",140 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609337690,"CATANESE, BENJAMIN, PETER",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609337690,"CATANESE, BENJAMIN, PETER",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609337765,"ANASTASIO, MARY, KATHERINE",2301 ERWIN RD   DURHAM NC,032,Durham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1457435349,COUNTY OF DURHAM FINANCE DEPT,~,414 E MAIN ST   DURHAM NC,032,Durham,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1609337930,"KONTOS GINNIS, JEAN",414 E MAIN ST   DURHAM NC,032,Durham,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 15 , 15 , 35 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,CB #7450 UNC SCHOOL OF DENTISTRY CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1609337930,"KONTOS GINNIS, JEAN",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609337930,"KONTOS GINNIS, JEAN",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609337930,"KONTOS GINNIS, JEAN",101 MANNING DR UNC HOSPITALS CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 41 , 41 , 403 ," $30,906.00 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609337930,"KONTOS GINNIS, JEAN",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 61 , 62 , 766 ," $67,696.50 ",,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609337930,"KONTOS GINNIS, JEAN",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 533 , 652 ," 1,794 "," $57,900.09 ",,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1609338110,"SCHENK, MALLORY, GAYLE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1609338110,"SCHENK, MALLORY, GAYLE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609338110,"SCHENK, MALLORY, GAYLE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609338441,"BJERKEN, ELEANOR, ELISE","3617 CASEY STREET, STE D   LORIS SC",101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1154609196,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD LORIS SEACOAST SURGERY,3617 CASEY ST STE D   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609338441,"BJERKEN, ELEANOR, ELISE",3980 HIGHWAY 9 E STE 220 LITTLE RIVER SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1801957295,RALEIGH OPHTHALMOLOGY PC,,2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609339019,"HOFFMAN, BRENT, BLACKWELL",2709 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 13 , 15 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609339357,"TOLLEY, CHRISTOPHER, WILLIAM",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609339357,"TOLLEY, CHRISTOPHER, WILLIAM",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 23 , 23 , 29 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609339357,"TOLLEY, CHRISTOPHER, WILLIAM",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 116 , 123 , 168 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609339357,"TOLLEY, CHRISTOPHER, WILLIAM",501 S POPLAR ST   ELIZABETHTOWN NC,009,Bladen,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609340843,"NZENWA, RUTH, CHINASARA",606 N ELM ST   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1528720653,TRIAD ADULT AND PEDIATRIC MEDICINE,,606 N ELM ST   HIGH POINT NC,041,Guilford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609340843,"NZENWA, RUTH, CHINASARA",606 N ELM ST   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 60 , 113 , 137 ," $10,228.97 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609342013,"GORDON, SARAH, BRITTANY",1941 NEW GARDEN RD STE 216 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 102 , 251 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609342013,"GORDON, SARAH, BRITTANY",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609342054,"BEZDZIECKI, JESSICA, LEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609342054,"BEZDZIECKI, JESSICA, LEE",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1265673651,UNITED QUEST CARE SERVICES LLC,~,2627 GRIMSLEY ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609344977,"SAJOUS, FARAH",2627 GRIMSLEY ST   GREENSBORO NC,041,Guilford,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 24 , 111 , 112 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609345263,"KHOURY, STEPHANIE, BROOKE",5241 SIX FORKS RD STE 200 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609346147,"BOSTWICK, VANESSA, ELISABETH",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609346147,"BOSTWICK, VANESSA, ELISABETH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609346238,"RAQUET, KRISTA, DANIELLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609346238,"RAQUET, KRISTA, DANIELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 43 , 43 , 48 ,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609346709,"LACHOWITZ, ALLISON, MICHELE",2711 RANDOLPH RD STE 301 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 24 , 31 , 31 ,$#,,
MEDICAID DIRECT,1447877931,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH PEDIATRIC ALLERGY & IMMUNOLOGY - CAR,6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609346709,"LACHOWITZ, ALLISON, MICHELE",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,,,$#,,
MEDICAID DIRECT,1679295307,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPECIALTY CLINICS,9604 HOLLY POINT DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609346709,"LACHOWITZ, ALLISON, MICHELE",6331 CARMEL RD STE 102 CHARLOTTE NC,060,Mecklenburg,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",, 22 , 51 , 51 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609348473,"JOYCE, BRITNEY, FARRINGTON",515 THOMPSON ST STE D EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 13 , 22 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609348473,"JOYCE, BRITNEY, FARRINGTON",515 THOMPSON ST STE D EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801838677,MANN EAR NOSE THROAT CLINIC PA,Mann Ear Nose & Throat Clinic PA,601 KEISLER DR STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609351055,"DEMATTA, MEGHAN, FRANCESCA",601 KEISLER DR STE 200 CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 22 , 36 ,$#,,
MEDICAID DIRECT,1801838677,MANN EAR NOSE THROAT CLINIC PA,Mann Ear Nose & Throat Clinic PA,601 KEISLER DR STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609351055,"DEMATTA, MEGHAN, FRANCESCA",11618 US HWY 70 W STE 206 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1164850525,MONARCH,~,2505 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609351501,"HUDSON, TIMOTHY, BEAUFORD",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1609351501,"HUDSON, TIMOTHY, BEAUFORD",820 GRIMES BLVD   LEXINGTON NC,029,Davidson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1326475302,MONARCH,~,201 W MARION ST STE 100 SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1609351501,"HUDSON, TIMOTHY, BEAUFORD",201 W MARION ST   SHELBY NC,023,Cleveland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1295738920,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY PEDIATRIC CARE,1262 OLIVER ST STE B FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609353648,"GROESSER, ALLISON, KATHLEEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 14 , 28 , 28 ,$#,,
MEDICAID DIRECT,1932849858,NEIGHBOR HEALTH CENTER INC,,2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609353648,"GROESSER, ALLISON, KATHLEEN",2605 BLUE RIDGE RD STE 225 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#, 13 ,$#,,
MEDICAID DIRECT,1609353903,CHANGING LIVES HOME CARE,,5412 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1609353903,CHANGING LIVES HOME CARE,5412 RAEFORD RD STE B FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 4,563 "," 4,563 "," $345,054.20 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609354000,"BISSEY, JENNIFER, MARGARET",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609354000,"BISSEY, JENNIFER, MARGARET",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609354000,"BISSEY, JENNIFER, MARGARET",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609356815,"SERRANO-ORTIZ, LAURA, MARIA",487 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609356815,"SERRANO-ORTIZ, LAURA, MARIA",1100 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 20 , 45 , 46 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609356815,"SERRANO-ORTIZ, LAURA, MARIA",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609360239,"NEAL, TYESHA, HARVEY",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609360239,"NEAL, TYESHA, HARVEY",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609360239,"NEAL, TYESHA, HARVEY",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609360239,"NEAL, TYESHA, HARVEY",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609360239,"NEAL, TYESHA, HARVEY",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609360379,"SANDERS, WILLIAM, JOSEPH",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1609361377,"ASHISH, KUMAR",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 148 , 148 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609361377,"ASHISH, KUMAR",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609361583,"SHEFFERLY, ALEXANDRA, CELLA",725 HIGHLAND OAKS DR STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609361583,"SHEFFERLY, ALEXANDRA, CELLA",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609361583,"SHEFFERLY, ALEXANDRA, CELLA",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609361583,"SHEFFERLY, ALEXANDRA, CELLA",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 57 , 94 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609362235,"SAINDON, CHRISTOPHER, LEE",4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 26 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609362235,"SAINDON, CHRISTOPHER, LEE",449 N WENDOVER RD STE A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,193200000X,Group,Multi-Specialty,,1609364025,"POLLARD, KATHARINE, MARY LUDOVICI",200 N GREENSBORO ST STE C6 CARRBORO NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609364025,"POLLARD, KATHARINE, MARY LUDOVICI",77 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#, 19 , 20 ,$#,,
MEDICAID DIRECT,1073861266,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,2700 PROVIDENCE RD S STE 180 WAXHAW NC,090,Union,193200000X,Group,Multi-Specialty,,1609364215,"RATAKONDA, BHARGAVI",2700 S PROVIDENCE RD STE 180 WAXHAW NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609364215,"RATAKONDA, BHARGAVI",1550 FAULK ST STE 3120 MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 48 , 67 , 103 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609364215,"RATAKONDA, BHARGAVI",1550 FAULK ST STE 3120 MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 13 , 23 , 32 ,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,1550 FAULK ST STE 3120 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609364215,"RATAKONDA, BHARGAVI",600 HOSPITAL DR   MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1821345919,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PULMONOLOGY & SLEEP MEDICINE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609364215,"RATAKONDA, BHARGAVI",600 HOSPITAL DR   MONROE NC,090,Union,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,401 IRVING PKWY STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1609367226,"O'NEILL, NIKKI, SOOD",100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609367226,"O'NEILL, NIKKI, SOOD",100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609367226,"O'NEILL, NIKKI, SOOD",100 DUKE HEALTH CARY PL STE 310 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1902596448,PREMIER FOOT & ANKLE SPECIALISTS,,119 E UNION ST   MARSHVILLE NC,090,Union,193400000X,Group,Single Specialty,,1609368117,"HALL, SHALANDA, LATRICE",119 E UNION ST   MARSHVILLE NC,090,Union,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 29 , 50 , 51 ,$#,,
MEDICAID DIRECT,1902596448,PREMIER FOOT & ANKLE SPECIALISTS,,119 E UNION ST   MARSHVILLE NC,090,Union,193400000X,Group,Single Specialty,,1609368117,"HALL, SHALANDA, LATRICE",907 FITZGERALD ST   MONROE NC,090,Union,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609369099,"ROWNER, ISAAC, RICHARD",1995 WELLNESS BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609369099,"ROWNER, ISAAC, RICHARD",6324 FAIRVIEW RD STE 310 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 17 , 21 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609369099,"ROWNER, ISAAC, RICHARD",6324 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 23 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609369099,"ROWNER, ISAAC, RICHARD",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609369099,"ROWNER, ISAAC, RICHARD",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1609370709,"ROSE, LEAH, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1609370709,"ROSE, LEAH, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 37 , 41 , 47 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609370709,"ROSE, LEAH, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 88 , 97 , 115 ,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1609370709,"ROSE, LEAH, MICHELLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609371921,FOOD LION LLC,FOOD LION PHARMACY,683 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1609371921,FOOD LION LLC,683 S HUGHES BLVD   ELIZABETH CITY NC,070,Pasquotank,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609372283,"MEHURON, THOMAS, ALLEN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 195 , 206 , 283 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609372283,"MEHURON, THOMAS, ALLEN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609372283,"MEHURON, THOMAS, ALLEN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609372283,"MEHURON, THOMAS, ALLEN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609372424,"SULLIVAN, LONNIE, THOMAS",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609372481,"MOON, AMY, KAY",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 34 , 83 ,$#,,
MEDICAID DIRECT,1497058804,PIEDMONT HEALTH SERVICES INC,BURLINGTON COMMUNITY HEALTH CENTER,1214 VAUGHN RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609372481,"MOON, AMY, KAY",1214 VAUGHN RD   BURLINGTON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 43 , 69 ," $12,322.68 ",,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1609372952,"BOHM, CARL, PHILIP",3990 E US 64 ALT   MURPHY NC,020,Cherokee,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1598729014,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH LUMBERTON,400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609375393,"HUNT, CRYSTAL, DEE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 56 , 61 , 141 ,$#,,
MEDICAID DIRECT,1679324412,CHILDRENS HEALTH OF CAROLINA PA,CHILDRENS HEALTH FAIRMONT,202 LEESVILLE ST   FAIRMONT NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609375393,"HUNT, CRYSTAL, DEE",400 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 80 , 148 , 426 ," $17,643.62 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609390392,"MOORE, CHRISTOPHER, RYAN",710 PARK CENTER DR STE 200 MATTHEWS NC,060,Mecklenburg,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1700053865,MURPHY MEDICAL CENTER INC,ERLANGER MURPHY GROUP PRACTICE,145 MEDICAL PARK LN STE I MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1609390814,"CORSO, WENDY, YVONNE",183 LEDFORD ST STE A MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1770792137,MURPHY MEDICAL CENTER INC,~,183 LEDFORD ST   MURPHY NC,020,Cherokee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609390814,"CORSO, WENDY, YVONNE",183 LEDFORD ST STE A MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 144 , 131 , 138 ," $25,910.34 ",,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609392745,"ANNA, CATHERINE, MICHELLE",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609392745,"ANNA, CATHERINE, MICHELLE",2901 BLUE RIDGE RD STE 203 RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1356101711,DENTIST IN CONCORD LLC,,2460 WONDER DR STE C KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609394576,"SHAH, MANSI, NAYANKUMAR",2460 WONDER DR STE C KANNAPOLIS NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 631 ," 1,343 "," 3,954 "," $256,354.43 ",,
MEDICAID DIRECT,1578021952,RAGHAV SUNDARESH DDS PLLC,FOURTH WARD DENTISTRY,230 E WT HARRIS BLVD STE A3 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609394576,"SHAH, MANSI, NAYANKUMAR",230 E WT HARRIS BLVD STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 131 , 196 , 636 ," $30,547.93 ",,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,4111 MONARCH WAY STE 500 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609396068,"OSMAN, RADWA, MOHY SAYED ALI",855 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609396068,"OSMAN, RADWA, MOHY SAYED ALI",855 W BRAMBLETON AVE   NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1073143343,EASTERN THERAPY SOLUTIONS PLLC,,9020 SENCA DR STE 220 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609397702,"BAILEY, KAITLIN, ELISABETH",9020 SENCA DR   WILMINGTON NC,065,New Hanover,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 16 , 23 ,$#,,
MEDICAID DIRECT,1609400365,MERRILL GARDENS LLC,TRUEWOOD BY MERRILL NEW BERN,2701 AMHURST BLVD   NEW BERN NC,025,Craven,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609400365,MERRILL GARDENS LLC,2701 AMHURST BLVD   NEW BERN NC,025,Craven,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 129 , 129 ," $11,562.40 ",,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609401363,"JONES, BRITTANY, SOUTHARD",3545 WHITEHALL PARK DR STE 300 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 27 , 46 ,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609401363,"JONES, BRITTANY, SOUTHARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1013265909,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH SICKLE CELL CENTER,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609402866,"PORTER, SUSAN, KAY",509 N ELAM AVE STE 3E GREENSBORO NC,041,Guilford,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609405687,"GARCES, NATALIE, SHARON",125 QUEENS RD STE 560 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609408004,"GROTH, CHERYL, KRISTINE",412 S JONES ST   PEMBROKE NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,,,$#,,
MEDICAID DIRECT,1417498403,SCOTLAND MEMORIAL HOSPITAL INC,LAURINBURG FAMILY PRACTICE AND URGENT CARE,700A PROGRESS PL   LAURINBURG NC,083,Scotland,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609408004,"GROTH, CHERYL, KRISTINE",700A PROGRESS PL   LAURINBURG NC,083,Scotland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609412998,"CARTER, JESSICA, LYNN",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 13 , 27 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609412998,"CARTER, JESSICA, LYNN",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609412998,"CARTER, JESSICA, LYNN",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609412998,"CARTER, JESSICA, LYNN",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1609412998,"CARTER, JESSICA, LYNN",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609413566,"MEYNARDIE, CORINNE, PRICE",9101 PINEVILLE MATTHEWS RD STE C4 PINEVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 31 , 58 , 58 ,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609413566,"MEYNARDIE, CORINNE, PRICE",15015 LANCASTER HWY STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609413566,"MEYNARDIE, CORINNE, PRICE",9101 PINEVILLE MATTHEWS RD STE C4 PINEVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 89 , 461 , 463 ," $11,741.81 ",,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609413566,"MEYNARDIE, CORINNE, PRICE",9930 KINCEY AVE STE 130 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609413566,"MEYNARDIE, CORINNE, PRICE",9101 PINEVILLE MATTHEWS RD STE C4 PINEVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 54 , 54 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609416932,"STEFANO, EMILY, CLAIRE",4614 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1609418789,HEALING HEARTS HOME CARE,HEALING HEARTS HOME CARE,3740 EVANS ST STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1609418789,HEALING HEARTS HOME CARE,3740 EVANS ST STE C GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 59 ," 9,476 "," 9,627 "," $871,966.84 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609419126,"HAFFEMAN, CARLY, ANN",16455 STATESVILLE RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609419126,"HAFFEMAN, CARLY, ANN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 48 , 48 , 50 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609419126,"HAFFEMAN, CARLY, ANN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609419126,"HAFFEMAN, CARLY, ANN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 26 ,$#,,
MEDICAID DIRECT,1063151678,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-1409 ASHEVILLE HIGHWAY,1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609421411,"SALGADO DOS SANTOS, DANIELA, OLIVIA",1409 ASHEVILLE HWY   BREVARD NC,088,Transylvania,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609424431,"WEBB, KIERSTIN, NICOLE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871209866,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - SHELBY MARKETPLACE,1760 E DIXON BLVD   SHELBY NC,023,Cleveland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609424431,"WEBB, KIERSTIN, NICOLE",305 W COLLEGE AVE   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 137 , 233 , 260 ," $14,076.40 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609428887,"SHORE, ERICA, MATHIS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609428887,"SHORE, ERICA, MATHIS",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 39 , 182 , 185 ,$#,,
MEDICAID DIRECT,1205997053,DRS KRISHINGNER ROOT & ASSOCIATE PL,~,344 GALLIMORE RD   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1609434984,"NICOPOULOS, ALEXANDER, JOHN",344 GALLIMORE RD   BREVARD NC,088,Transylvania,1223G0001X,Dental Providers,Dentist,General Practice, 124 , 281 , 708 ," $29,230.10 ",,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1609435213,"GUGLANI, SARITA",929 N 2ND ST STE 201 ALBEMARLE NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 43 , 93 , 229 ,$#,,
MEDICAID DIRECT,1821681271,SANDY SHORES MEDICAL CENTER AND URG,,13741 NC HIGHWAY 50 STE A HOLLY RIDGE NC,071,Pender,193200000X,Group,Multi-Specialty,,1609435684,"HILL, KATIE, LYNN",118 MEMORIAL DR   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1609439520,"PATEL, AXITA, CHETAN",105 MCALPINE LN   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 67 , 123 , 142 ,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,105 MCALPINE LN   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1609439520,"PATEL, AXITA, CHETAN",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1609439520,"PATEL, AXITA, CHETAN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609439520,"PATEL, AXITA, CHETAN",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609439686,"SINHA, ALOK, KUMAR",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 25 , 25 , 33 ,$#,,
MEDICAID DIRECT,1124768544,MURPHY HOSPITALIST GROUP PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193400000X,Group,Single Specialty,,1609441609,"BERGERON, SHAMIR, MYION DOMINIKUE",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1336782507,ROBESON HOSPITALIST GROUP PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609441609,"BERGERON, SHAMIR, MYION DOMINIKUE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609442797,CARING HANDS HOME CARE LLC,COMPASSIONATE HANDS HOME CARE,3409 W WENDOVER AVE STE F GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1609442797,CARING HANDS HOME CARE LLC,3409 W WENDOVER AVE STE F GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 17 , 997 ," 1,009 "," $108,459.14 ",,
MEDICAID DIRECT,1609442797,CARING HANDS HOME CARE LLC,COMPASSIONATE HANDS HOME CARE,204 MUIRS CHAPEL RD STE 324 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1609442797,CARING HANDS HOME CARE LLC,204 MUIRS CHAPEL RD STE 324 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 21 ," 1,256 "," 1,288 "," $151,878.49 ",,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609444058,"COLEMAN, BIANCA, CRISTINE",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609444058,"COLEMAN, BIANCA, CRISTINE",7420 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609444058,"COLEMAN, BIANCA, CRISTINE",109 SCOTTS HILL MEDICAL DR STE 204 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 30 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1609444058,"COLEMAN, BIANCA, CRISTINE",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 40 , 118 ,$#,,
MEDICAID DIRECT,1770244212,ERIN RAKE DDS PC,ARIA DENTAL CARE,160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609445741,"PATTESON, JOSEPH, RILEY",201 MCCULLOUGH DR STE 180 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 89 , 118 , 268 ," $13,705.63 ",,
MEDICAID DIRECT,1396814331,MECKLENBURG COUNTY,~,3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,252Y00000X,Agencies,Early Intervention Provider Agency,,1609447952,"KENDRICKS, HIWET",3205 FREEDOM DR STE 7500 CHARLOTTE NC,060,Mecklenburg,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 74 , 155 , 223 ," $32,667.55 ",,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609448182,"CASCIELLO, BRITNEY, CAITLIN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1609448182,"CASCIELLO, BRITNEY, CAITLIN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 58 , 71 , 138 ,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,,,Unknown,193400000X,Group,Single Specialty,,1609448182,"CASCIELLO, BRITNEY, CAITLIN",941 NEWMAN RD   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609448182,"CASCIELLO, BRITNEY, CAITLIN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 25 , 21 , 46 ,$#,,
MEDICAID DIRECT,1477992501,COASTAL CAROLINA HEALTH CARE PA,CCHC HEART AND VASCULAR SPECIALISTS,1000 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1609448182,"CASCIELLO, BRITNEY, CAITLIN",108 MARKET ST   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609448687,"SIMPSON, DANIELLE, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609448687,"SIMPSON, DANIELLE, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609448687,"SIMPSON, DANIELLE, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1043761513,APPALACHIAN DISTRICT HEALTH DEPT,APPHEALTHCARE,225 COURT ST   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1609449644,"WUERFEL, ANNIKA, JANE",225 COURT ST   JEFFERSON NC,005,Ashe,1223D0001X,Dental Providers,Dentist,Dental Public Health, 609 , 790 ," 2,685 "," $108,008.91 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609454420,"MASLOWSKI, DOUGLAS, JOSEPH",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609454420,"MASLOWSKI, DOUGLAS, JOSEPH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609454420,"MASLOWSKI, DOUGLAS, JOSEPH",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609454420,"MASLOWSKI, DOUGLAS, JOSEPH",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609455989,"DAVIS, LOPEZ, DUANE",13460 PLAZA ROAD EXT STE 100 CHARLOTTE NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609456771,"TREACY, STEPHEN, THOMAS",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 66 , 76 , 106 ," $15,957.75 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609456771,"TREACY, STEPHEN, THOMAS",860 SUMMIT CROSSING PL STE 130 GASTONIA NC,036,Gaston,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 12 , 13 , 16 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609456771,"TREACY, STEPHEN, THOMAS",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,517 "," 2,140 "," 2,331 "," $296,013.14 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609456771,"TREACY, STEPHEN, THOMAS",1515 S MINT ST STA A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609456771,"TREACY, STEPHEN, THOMAS",411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 57 , 57 , 57 ,$#,,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,1515 S MINT ST STE A CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609456771,"TREACY, STEPHEN, THOMAS",1515 S MINT ST STA A CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 35 , 35 , 35 ," $30,882.88 ",,
MEDICAID DIRECT,1578785994,DRS BURROWS AND WELCHEL PA,BURROW WELCHEL CULP ORTHODONTICS,411 BILLINGSLEY RD STE 106 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609456771,"TREACY, STEPHEN, THOMAS",2711 RANDOLPH RD STE 600 CHARLOTTE NC,060,Mecklenburg,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 67 , 67 , 67 ," $25,590.69 ",,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609459205,"BINGHAM, KYLE, SAMUEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 44 , 103 , 103 ,$#,,
MEDICAID DIRECT,1891489118,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED INTERNAL MEDICINE RALEIGH,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609459205,"BINGHAM, KYLE, SAMUEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,111 SUNNYBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609459205,"BINGHAM, KYLE, SAMUEL",111 SUNNYBROOK RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1609459429,"MAHAT, SANJAY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 45 , 45 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609459429,"MAHAT, SANJAY",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 121 , 121 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609461656,"OXENDINE, LISA, MAE",285 OLMSTED BLVD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 102 , 593 , 706 ," $21,374.49 ",,
MEDICAID DIRECT,1104193432,MOSES CONE PHYSICIAN SERVICES INC,Cone Health Palliative Care,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609461995,"SMITH, AMBER, MARIE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 63 , 65 ,$#,,
MEDICAID DIRECT,1558308080,THE C W WILLIAMS COMMUNITY HEALTH C,~,3333 WILKINSON BLVD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609464122,"OLLISON, GABRIEL, LAMONT",10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558308080,THE C W WILLIAMS COMMUNITY HEALTH C,~,5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 59 , 67 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 42 , 45 , 104 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609464122,"OLLISON, GABRIEL, LAMONT",5800 OLD PINEVILLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 20 , 32 ,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609467638,"CARSON-JOHNSON, TRACEY",381 RUIN CREEK RD   HENDERSON NC,091,Vance,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1609468255,TRU COMPASSION HOME HEALTH CARE,,2300 W MEADOWVIEW RD STE 115 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1609468255,TRU COMPASSION HOME HEALTH CARE,2300 W MEADOWVIEW RD STE 115 GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 12 ," 2,563 "," 2,586 "," $194,796.58 ",,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",430 RANKIN DR   MARION NC,059,McDowell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 21 , 21 , 25 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 28 , 28 , 35 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1609473172,"AULDREDGE, AMY, MARIE",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1609474303,"LARA, MELISSA, FELLMETH",817 E GANNON AVE STE 104 ZEBULON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609475821,"NORMAN, DAVINA",188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 275 , 280 ,$#,,
MEDICAID DIRECT,1023083268,PHYSICIANS ELDERCARE PA,~,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609475821,"NORMAN, DAVINA",188 OSCAR JUSTICE RD   RUTHERFORDTON NC,081,Rutherford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 33 , 33 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609477322,"ZARCO, ASHLEY, NICOLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609478098,"MCCUTCHEN, KELLIE",3793 MCDOWELL LN STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609478601,SERENITY SMILES HOME CARE LLC,SERENITY SMILES HOME CARE LLC,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1609478601,SERENITY SMILES HOME CARE LLC,5960 FAIRVIEW RD STE 400 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 389 , 389 ," $38,796.32 ",,
MEDICAID DIRECT,1891429593,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE HOPE VALL,7021 NC HIGHWAY 751   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609478882,"PRICE, ELIZABETH, MARIE",7021 NC HIGHWAY 751   DURHAM NC,032,Durham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1982288262,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE FAYETTE,4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609478882,"PRICE, ELIZABETH, MARIE",4530 FAYETTEVILLE RD   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1386605608,HOOPER AND BURNETTE INTERNAL MEDICI,~,2130 FOREST HILLS RD W STE B WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1609482280,"MCLAMB, DEANNA, LEIGH",315 GREENVILLE BLVD SE STE 110 GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770135808,AMERICAN FAMILY CARE FUQUAY PLLC,~,1298 N MAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1609482280,"MCLAMB, DEANNA, LEIGH",2200 TREELIGHT WAY   WENDELL NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,1987 HILTON RD   BURLINGTON NC,001,Alamance,193400000X,Group,Single Specialty,,1609483106,"MITCHELL, MELADIE, SHARIE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 44 , 44 ,$#,,
MEDICAID DIRECT,1407117625,UNIVERSAL HEALTH CORPORATION,,574 FRONTIER WAY   FINCASTLE VA,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1609483106,"MITCHELL, MELADIE, SHARIE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1245813757,PAI PARTICIPANT 29 PC,,1287 NEWSOME ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1609483106,"MITCHELL, MELADIE, SHARIE",17 CORNELIA ST   LEXINGTON NC,029,Davidson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 50 , 50 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,210 TURNERSBURG HWY STE C STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14221 BOREN ST   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",129 SHERLOCK DR   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",702 HARTNESS RD   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1609486083,"OLSZEWSKI, GERGANA, NIKOLOVA",409 OLIN WAY STE 1200 DENVER NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1609487453,KEY LOVE HOME CARE LLC,KEY LOVE HOME CARE LLC,221 ORANGE ST   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,,1609487453,KEY LOVE HOME CARE LLC,221 ORANGE ST   HENDERSON NC,091,Vance,253Z00000X,Agencies,In Home Supportive Care,, 97 ," 23,595 "," 24,090 "," $1,553,477.35 ",,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609488428,"BRANTON, SAMANTHA, KUHLMAN",1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 20 , 27 ,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609488428,"BRANTON, SAMANTHA, KUHLMAN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1730154857,PEDIATRIC PARTNERS PA,~,5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609488535,"NORTON, ALEXIS, FERNANDEZ",5904 SIX FORKS RD STE 111 RALEIGH NC,092,Wake,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1407893944,CAROLINAS REHABILITATION,CHARLOTTE INST OF REHABILITATION,5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609489830,"PEARSON, MICHELE, LEE",5651 POPLAR TENT RD STE 201 CONCORD NC,013,Cabarrus,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1609492586,MAJESTIC SUPPORT SERVICES LLC,,610 LYNNDALE CT STE E GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1609492586,MAJESTIC SUPPORT SERVICES LLC,610 LYNNDALE CT STE E GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 21 , 261 , 261 ," $25,175.04 ",,
MEDICAID DIRECT,1609492586,MAJESTIC SUPPORT SERVICES LLC,,3106 S MEMORIAL DR STE D-1 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1609492586,MAJESTIC SUPPORT SERVICES LLC,3106 S MEMORIAL DR STE D-1 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 32 ," 6,812 "," 6,812 "," $489,929.73 ",,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609494004,"PATEL, HIRAL, PRAMODBHAI",6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1174850168,ACCUVISION EYE CARE,ACCUVISION EYE CARE,8455 PIT STOP CT NW STE 125 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609494004,"PATEL, HIRAL, PRAMODBHAI",1480 CONCORD PKWY N   CONCORD NC,013,Cabarrus,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1609494780,"MILLER, JACQUELYN, RENEE",1501 TATE BLVD SE   HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1609494897,P&C ADULT CARE LLC,PIEDMONT VILLAGE AT NEWTON,1345 CHAPMAN LN   NEWTON NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609494897,P&C ADULT CARE LLC,1345 CHAPMAN LN   NEWTON NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 34 ," 8,979 "," 9,130 "," $708,824.15 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1609495407,"HEYES-DARWIN, ALEXANDRA, RIDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1609495407,"HEYES-DARWIN, ALEXANDRA, RIDER",HOUPT BUILDING 170 MANNING DRIVE-CB# 7594 CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609495407,"HEYES-DARWIN, ALEXANDRA, RIDER",101 MANNING DR   CHAPEL HILL NC,068,Orange,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 18 , 19 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1609497817,"MULCAHY, RAYMOND, ANDREW",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 41 , 61 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609497890,"SABATINI REGUEIRA, ERIC",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609497890,"SABATINI REGUEIRA, ERIC",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609497890,"SABATINI REGUEIRA, ERIC",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609497890,"SABATINI REGUEIRA, ERIC",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609497890,"SABATINI REGUEIRA, ERIC",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609497890,"SABATINI REGUEIRA, ERIC",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 39 , 41 , 51 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609497890,"SABATINI REGUEIRA, ERIC",8201 HEALTHCARE LOOP   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 19 , 31 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609499177,"HARDY, ELIZA, CLAIRE",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 12 , 12 , 21 ,$#,,
MEDICAID DIRECT,1376564625,WILSON MEDICAL GROUP PLLC,WILSON MEDICAL GROUP,3302 NASH ST N   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1609499698,"RAZZAQ, SUMAYYAH",3302 NASH ST N   WILSON NC,098,Wilson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 80 , 156 , 278 ,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609499748,"STOCKE, KRISTA, MARIE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609499748,"STOCKE, KRISTA, MARIE",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1609499748,"STOCKE, KRISTA, MARIE",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609499748,"STOCKE, KRISTA, MARIE",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 56 , 82 , 93 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609499771,"BASTIEN, KARLEY, ELIZABETH",444 SW CENTER ST   FAISON NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083216618,REX HOSPITAL INC,NORTH CAROLINA OBGYN AND MIDWIFERY,4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609499771,"BASTIEN, KARLEY, ELIZABETH",4414 LAKE BOONE TRL STE 402 RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1100 HOLLY SPRINGS RD STE 212 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1609499771,"BASTIEN, KARLEY, ELIZABETH",1100 HOLLY SPRINGS RD STE 212 HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 14 ,$#,,
MEDICAID DIRECT,1487899902,LOVE CHIROPRACTIC CENTER,LOVE CHIROPRACTIC CENTER,215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609502665,"XIONG, POLOYEN",215 BRANCHVIEW DR NE   CONCORD NC,013,Cabarrus,111N00000X,Chiropractic Providers,Chiropractor,,#,#,#,$#,,
MEDICAID DIRECT,1568197523,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE TEN TEN,7750 TEN TEN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609503960,"KANIARU, ELIZABETH, WAMBUI",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1609503960,"KANIARU, ELIZABETH, WAMBUI",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 13 , 16 ,$#,,
MEDICAID DIRECT,1609505551,API METROLINA CARE SERVICES INC,COMFORCARE HOME CARE - SURBURBAN METROLINA,3302 W HIGHWAY 74   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,1609505551,API METROLINA CARE SERVICES INC,3302 W HIGHWAY 74   MONROE NC,090,Union,253Z00000X,Agencies,In Home Supportive Care,,#, 110 , 110 ," $15,645.00 ",,
MEDICAID DIRECT,1609506526,YOUR CHOICE HOME HEALTH LLC,,5 CENTERVIEW DR   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1609506526,YOUR CHOICE HOME HEALTH LLC,5 CENTERVIEW DR   GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,, 15 ," 2,493 "," 2,504 "," $299,283.44 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609506948,"DOLS, DAYNA, ELIZABETH",1168 E CUTLAR XING   LELAND NC,010,Brunswick,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1609512284,"STEBBINS, TIFFANY, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609512284,"STEBBINS, TIFFANY, MARIE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1609516236,"PAIGE, AMANDA, MARIE",1328 W BROAD ST   ELIZABETHTOWN NC,009,Bladen,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1609516236,"PAIGE, AMANDA, MARIE",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609516236,"PAIGE, AMANDA, MARIE",555 CARTHAGE ST   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609516236,"PAIGE, AMANDA, MARIE",205 PAGE RD   PINEHURST NC,063,Moore,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 14 , 40 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1609516236,"PAIGE, AMANDA, MARIE",2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 23 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 20 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",13640 STEELECROFT PKWY   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609525575,"KEBLES, CARALINE, PIERCE",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1609527746,"MESSURA, CARINA, ANA MARIE",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 47 , 48 ,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1609527746,"MESSURA, CARINA, ANA MARIE",302 PENNY LN   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,380 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609528009,"ROARK, MICHELLE, MARIE",380 BREVARD RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,100 SILVER BLUFF DR   CANTON NC,044,Haywood,193200000X,Group,Multi-Specialty,,1609528009,"ROARK, MICHELLE, MARIE",380 BREVARD RD   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,104 COLLEGE DR   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609528009,"ROARK, MICHELLE, MARIE",104 COLLEGE DR   FLAT ROCK NC,045,Henderson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 195 , 195 ,$#,,
MEDICAID DIRECT,1609531508,CARLISLE AT CARRBORO,,624 JONES FERRY RD   CARRBORO NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609531508,CARLISLE AT CARRBORO,624 JONES FERRY RD   CARRBORO NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,075 "," 1,123 "," $34,757.00 ",,
MEDICAID DIRECT,1609535327,BAYADA HOME HEALTH CARE INC,,1609 W ARLINGTON BLVD STE 100 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,,1609535327,BAYADA HOME HEALTH CARE INC,1609 W ARLINGTON BLVD STE 100 GREENVILLE NC,074,Pitt,253Z00000X,Agencies,In Home Supportive Care,, 81 ," 13,727 "," 14,128 "," $1,412,615.36 ",,
MEDICAID DIRECT,1518642255,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA WOMENS HEALTH CENTER RHC,1140 CARTHAGE ST STE A SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609538180,"MURPHY SPENCER, LAKEESHA, MARIA CHRISTINE",1140 CARTHAGE ST STE A SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1518642255,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA WOMENS HEALTH CENTER RHC,1140 CARTHAGE ST STE A SANFORD NC,053,Lee,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609538180,"MURPHY SPENCER, LAKEESHA, MARIA CHRISTINE",1140 CARTHAGE ST   SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1659810455,DLP CENTRAL CAROLINA MEDICAL GROUP,CENTRAL CAROLINA INTERNAL MEDICINE ASSOCIATES,1140 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1609538180,"MURPHY SPENCER, LAKEESHA, MARIA CHRISTINE",1140 CARTHAGE ST   SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1609543917,EARTHLY ANGELS HOME CARE LLC,,625 E 2ND AVE STE 1 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1609543917,EARTHLY ANGELS HOME CARE LLC,625 E 2ND AVE STE 1 GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 27 ," 4,467 "," 4,588 "," $354,034.08 ",,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609544576,"FRANCE, HELENE, LATISHA",125 QUEENS RD STE 510 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 29 , 64 , 64 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609544576,"FRANCE, HELENE, LATISHA",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609547652,"DECKER, NIKKI, ELYSSE",10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609547652,"DECKER, NIKKI, ELYSSE",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609549179,"LAROE, SARAH, KATHRYN",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 56 , 83 , 150 ,$#,,
MEDICAID DIRECT,1134391758,WESTERN CAROLINA EMERGENCY PHYSICIA,WESTERN CAROLINA EMERGENCY PHYSICIANS LLC,301 YADKIN ST   ALBEMARLE NC,084,Stanly,193400000X,Group,Single Specialty,,1609551878,"HATLEY, TAYLOR, ELI",301 YADKIN ST   ALBEMARLE NC,084,Stanly,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 83 , 94 , 119 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1609555754,"HICKS, CODY, STEVEN",101 MEDICAL CIR   ROCKINGHAM NC,077,Richmond,152W00000X,Eye and Vision Services Providers,Optometrist,, 37 , 44 , 54 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1609555754,"HICKS, CODY, STEVEN",310 N GREEN ST   WADESBORO NC,004,Anson,152W00000X,Eye and Vision Services Providers,Optometrist,, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1609555754,"HICKS, CODY, STEVEN",1991 FORDHAM DR STE 301 FAYETTEVILLE NC,026,Cumberland,152W00000X,Eye and Vision Services Providers,Optometrist,, 22 , 25 , 33 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1609555754,"HICKS, CODY, STEVEN",2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,152W00000X,Eye and Vision Services Providers,Optometrist,, 38 , 44 , 57 ,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609556034,"TURNAU, MADELINE, JENKS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1275968620,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CAROLINAS REHAB PINE,10648 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609556034,"TURNAU, MADELINE, JENKS",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609556554,"BURCHETTE, RACHAEL, JOHNSON",509 BILTMORE AVENUE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2214 NELSON HWY   CHAPEL HILL NC,032,Durham,193200000X,Group,Multi-Specialty,,1609557743,"DERYCKE, SARAH, MARRONE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609557743,"DERYCKE, SARAH, MARRONE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 90 , 99 , 131 ,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609562685,"ANGELL, MADISON",630 COMFORT LN STE E MONROE NC,090,Union,152W00000X,Eye and Vision Services Providers,Optometrist,, 23 , 25 , 35 ,$#,,
MEDICAID DIRECT,1700839305,METROLINA EYE ASSOCIATES PLLC,~,630 COMFORT LN STE E MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609562685,"ANGELL, MADISON",4101 CAMPUS RIDGE RD STE 200 MATTHEWS NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1609565027,FOUNDATIONS DIAGNOSTIC LABORATORY L,,1139 N CHARLOTTE AVE STE C MONROE NC,090,Union,291U00000X,Laboratories,Clinical Medical Laboratory,,1609565027,FOUNDATIONS DIAGNOSTIC LABORATORY L,1139 N CHARLOTTE AVE STE C MONROE NC,090,Union,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609569888,"JIMENEZ, ANDREW, DAVID",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609569888,"JIMENEZ, ANDREW, DAVID",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609573120,"MOORE, AUSTIN, TAYLOR",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1609575661,MED-TRANS CORPORATION,,501 S POPLAR ST STE 211 ELIZABETHTOWN NC,009,Bladen,3416A0800X,Transportation Services,Ambulance,Air Transport,1609575661,MED-TRANS CORPORATION,501 S POPLAR ST STE 211 ELIZABETHTOWN NC,009,Bladen,3416A0800X,Transportation Services,Ambulance,Air Transport, 22 , 22 , 44 ," $15,806.34 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1609579960,"HORNE, BRITTANY, FAYE",1501 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609579960,"HORNE, BRITTANY, FAYE",106 LANGTREE VILLAGE DR STE 200 MOORESVILLE NC,049,Iredell,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609579960,"HORNE, BRITTANY, FAYE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1609581404,CONNECT SPEECH AND LANGUAGE PLLC,,20 BARNARD AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1609581404,CONNECT SPEECH AND LANGUAGE PLLC,20 BARNARD AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1609581404,CONNECT SPEECH AND LANGUAGE PLLC,,4 ELLENWOOD DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1609581404,CONNECT SPEECH AND LANGUAGE PLLC,4 ELLENWOOD DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,#, 42 , 54 ,$#,,
MEDICAID DIRECT,1750757803,BLUE RIDGE COMMUNITY HEALTH SERVICE,POLK HEALTH CENTER,161 WALKER ST   COLUMBUS NC,075,Polk,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609583582,"BLIZARD, BETHANY, DAVIS",161 WALKER ST   COLUMBUS NC,075,Polk,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1609583657,FULLEST EXPRESSIONS SPEECH THERAPY,,10650 SAPPHIRE TRL   DAVIDSON NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609583657,FULLEST EXPRESSIONS SPEECH THERAPY,10650 SAPPHIRE TRL   DAVIDSON NC,013,Cabarrus,193400000X,Group,Single Specialty,,#, 25 , 25 ,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609583764,"MITCHELL, CANDACE, GAIL",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 124 , 201 , 225 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609584143,"GERALD, SUZANNE, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 41 , 46 , 48 ,$#,,
MEDICAID DIRECT,1609586452,BIONIC PROSTHETICS AND ORTHOTICS GR,,470 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1609586452,BIONIC PROSTHETICS AND ORTHOTICS GR,470 LAKE CONCORD RD NE   CONCORD NC,013,Cabarrus,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 28 , 35 , 203 ," $37,803.54 ",,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609589019,"MOOSMANN, VICTORIA, RAFFALDT",200 MEDICAL PARK DR STE 300 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 36 , 68 , 78 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,6150 BAYFIELD PKWY   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609589019,"MOOSMANN, VICTORIA, RAFFALDT",5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,9841 NORTHLAKE CENTRE PKWY   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609589019,"MOOSMANN, VICTORIA, RAFFALDT",5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609589019,"MOOSMANN, VICTORIA, RAFFALDT",5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609589019,"MOOSMANN, VICTORIA, RAFFALDT",5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1538412739,WEST CALDWELL HEALTH COUNCIL INC,WEST CALDWELL MOBILE HEALTH,4330 COLLETTSVILLE RD BASE OF OPERATIONS COLLETTSVILLE NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609592385,"TRANSOU, MEREDITH, PAIGE",4330 COLLETTSVILLE RD   COLLETTSVILLE NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1467513143,WEST CALDWELL HEALTH COUNCIL INC,HAPPY VALLEY MEDICAL CENTER,1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609592385,"TRANSOU, MEREDITH, PAIGE",1345 NC HIGHWAY 268   LENOIR NC,014,Caldwell,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609592427,"PRICE, CARLA, ELIZABETH",2300 OAK RIDGE RD   OAK RIDGE NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 74 , 93 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10100 S MAIN ST   ARCHDALE NC,076,Randolph,193200000X,Group,Multi-Specialty,,1609592427,"PRICE, CARLA, ELIZABETH",2300 OAK RIDGE RD   OAK RIDGE NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1710001292,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST INTERNAL MEDICIN,1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609592427,"PRICE, CARLA, ELIZABETH",1814 WESTCHESTER DR STE 301 HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609594365,"DILLARD, ALISON, CLAIRE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 27 , 37 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609597483,"SANTOS, BERTHA, LAURA",300 W 27TH ST   LUMBERTON NC,078,Robeson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 33 , 33 , 41 ,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1609603786,"MARTINEZ UTRERA, YESSUNI, DEL ROCIO",100 SOUTH 10TH ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 78 , 140 , 348 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1609625821,"MCTAGGART, KRISTEN, MARIE",2201 S STERLING ST   MORGANTON NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 25 , 28 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1609625821,"MCTAGGART, KRISTEN, MARIE",720 MALCOLM BLVD   VALDESE NC,012,Burke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609631829,"DAVIS, NATHAN, GRAHAM",7118 MAIN ST   WADE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 61 , 125 , 152 ,$#,,
MEDICAID DIRECT,1609638956,BEYOND ELITE HOME CARE CORP,,128 E GARRISON BLVD STE A GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1609638956,BEYOND ELITE HOME CARE CORP,128 E GARRISON BLVD STE A GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,#, 788 , 834 ," $64,320.20 ",,
MEDICAID DIRECT,1609638956,BEYOND ELITE HOME CARE CORP,,1006 UNION RD STE B GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,,1609638956,BEYOND ELITE HOME CARE CORP,1006 UNION RD STE B GASTONIA NC,036,Gaston,253Z00000X,Agencies,In Home Supportive Care,, 11 , 665 , 701 ," $64,093.84 ",,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609643196,"HALEY, SARAH, HALEY LOUISE",2901 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609643196,"HALEY, SARAH, HALEY LOUISE",2901 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609643196,"HALEY, SARAH, HALEY LOUISE",2901 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265716922,HOPSCOTCH PRIMARY CARE PLLC,HOPSCOTCH PRIMARY CARE,6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609643279,"SHEPHERD, AMY, MARIE",6 BROOKLET ST   ASHEVILLE NC,011,Buncombe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 77 , 134 , 286 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609648997,"TOE, EM",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609648997,"TOE, EM",11635 NORTHPARK DR STE 250 WAKE FOREST NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 108 , 527 , 536 ," $16,223.73 ",,
MEDICAID DIRECT,1609649680,ZARA HOMECARE SERVICES LLC,,5300 ATLANTIC AVE STE 106N RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1609649680,ZARA HOMECARE SERVICES LLC,5300 ATLANTIC AVE STE 106N RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 307 , 307 ," $19,077.28 ",,
MEDICAID DIRECT,1609649680,ZARA HOMECARE SERVICES LLC,,6208 OAK PASSAGE DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1609649680,ZARA HOMECARE SERVICES LLC,6208 OAK PASSAGE DR   RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 71 , 71 ,$#,,
MEDICAID DIRECT,1720839228,NORTHERN HOSPITAL DISTRICT OF SURRY,,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609652494,"WEASE, OLIVIA, RAE",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215477591,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN FAMILY MEDICINE,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609652494,"WEASE, OLIVIA, RAE",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 19 , 44 ,$#,,
MEDICAID DIRECT,1255950325,NORTHERN HOSPITAL DISTRICT OF SURRY,NORTHERN URGENT CARE,119 WELCH RD STE A MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609652494,"WEASE, OLIVIA, RAE",119 WELCH RD STE A MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 40 , 40 , 102 ,$#,,
MEDICAID DIRECT,1700901287,GOSHEN MEDICAL CENTER INCORPORATED,COMMUNITY HEALTH SERVICES,325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609657188,"LINDAUER, JESSICA, RACHEL",325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609657188,"LINDAUER, JESSICA, RACHEL",325 NC HIGHWAY 55 W   MOUNT OLIVE NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 15 , 15 ,$#,,
MEDICAID DIRECT,1649838590,BOULDER CARE PROVIDER GROUP PA,,106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1609657394,"MORALES, JAMES, CHARLES",106 LANGTREE VILLAGE DR STE 301 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1689626178,RURAL HEALTH GROUP INC,RURAL HEALTH GROUP AT JACKSON,9425 NC HIGHWAY 305   JACKSON NC,066,Northampton,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609658665,"BALMER, LAQUITA, EDWARDS",9425 NC HIGHWAY 305   JACKSON NC,066,Northampton,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 104 , 212 , 226 ,$#,,
MEDICAID DIRECT,1144803040,MAINSTREET AND KIDSSTREET OF NORTH,MAINSTREET FAMILY CARE,130 JAMES AVE   LOCUST NC,084,Stanly,193400000X,Group,Single Specialty,,1609698703,"CASO, JENNA, MARIE",130 JAMES AVE   LOCUST NC,084,Stanly,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 47 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1609800739,"GAMA, OMA",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1609802248,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,2014 LITHO PL STE 100 FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,,1609802248,BAYADA HOME HEALTH CARE INC,2014 LITHO PL STE 100 FAYETTEVILLE NC,026,Cumberland,251J00000X,Agencies,Nursing Care,, 36 ," 4,291 "," 4,961 "," $2,415,252.29 ",,
MEDICAID DIRECT,1609802248,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,2014 LITHO PL STE 100 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1609802248,BAYADA HOME HEALTH CARE INC,2014 LITHO PL STE 100 FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,, 15 , 645 , 652 ," $260,395.12 ",,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609803790,"BARNES, DANIEL, GILCHRIST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 66 , 66 , 86 ,$#,,
MEDICAID DIRECT,1649256983,FORSYTH EMERGENCY SERVICES PA,FORSYTH EMERGENCY SERVICES PA,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609803790,"BARNES, DANIEL, GILCHRIST",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 95 , 101 , 138 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609803949,"GABR, RHONDA, WINSTEAD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609803949,"GABR, RHONDA, WINSTEAD",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 31 , 51 , 115 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,,,Unknown,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 16 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 19 , 21 , 29 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 59 , 78 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",1381 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 45 , 66 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 34 , 36 , 51 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 27 , 36 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1609806009,"PATTON, WILLIAM, RUDD",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1922734375,MCPC-24 LLC,FIRSTHEALTH TELEMEDICINE,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609806801,"PEDACCHIO, MISTY, HOCHREIN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609806801,"PEDACCHIO, MISTY, HOCHREIN",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609807007,"LEBOSQUET, THOMAS, PAYNE",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 83 , 88 , 122 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609807007,"LEBOSQUET, THOMAS, PAYNE",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,124 ONE CENTER CT   FRANKLIN NC,056,Macon,193200000X,Group,Multi-Specialty,,1609807007,"LEBOSQUET, THOMAS, PAYNE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609807007,"LEBOSQUET, THOMAS, PAYNE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609807007,"LEBOSQUET, THOMAS, PAYNE",190 HOSPITAL DR   HIGHLANDS NC,056,Macon,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609807007,"LEBOSQUET, THOMAS, PAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609807007,"LEBOSQUET, THOMAS, PAYNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1609808054,"BUIST, NIGEL, ANDERSON",522 S VAN BUREN RD   EDEN NC,079,Rockingham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609808054,"BUIST, NIGEL, ANDERSON",522 S VAN BUREN RD   EDEN NC,079,Rockingham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,522 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1609808054,"BUIST, NIGEL, ANDERSON",522 S VAN BUREN RD   EDEN NC,079,Rockingham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 20 , 22 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1609808054,"BUIST, NIGEL, ANDERSON",117 E KINGS HWY   EDEN NC,079,Rockingham,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1112 GRACIE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609808401,"HAWKINS JR, SHERMAN, MELVIN",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,, 83 , 162 , 437 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609808401,"HAWKINS JR, SHERMAN, MELVIN",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,, 30 , 65 , 141 ,$#,,
MEDICAID DIRECT,1821419508,KIDZCARE PEDIATRICS PC,~,5244B N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609808567,"ENGEL, JENNIFER, DUCK",5244B N SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 42 , 53 , 142 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609809920,"KODALI, VALLISITARAM, PRASAD",2041 VALLEYGATE DR   FAYETTEVILLE NC,026,Cumberland,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609809920,"KODALI, VALLISITARAM, PRASAD",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1871854828,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609811264,"SNYDER, RACHEL, DIANNE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1871854752,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609811264,"SNYDER, RACHEL, DIANNE",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,,,$#,,
MEDICAID DIRECT,1861753741,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS PALLIATIVE CARE AND HOSPICE GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609811264,"SNYDER, RACHEL, DIANNE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 47 , 91 , 91 ,$#,,
MEDICAID DIRECT,1235449125,OPTIMED HOSPITALISTS PLLC,OPTIMED HOSPITALISTS PLLC,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609812338,"SIDDIQUI, ADEEL, MOHAMMAD",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629252986,GRANVILLE HEALTH SYSTEM,GRANVILLE HOSPITALIST SPEC GROUP,1010 COLLEGE ST   OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1609812338,"SIDDIQUI, ADEEL, MOHAMMAD",1010 COLLEGE ST   OXFORD NC,039,Granville,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 26 , 26 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3521 HAWORTH DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609812338,"SIDDIQUI, ADEEL, MOHAMMAD",3521 HAWORTH DR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609812338,"SIDDIQUI, ADEEL, MOHAMMAD",3521 HAWORTH DR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1104962315,RALEIGH MEDICAL GROUP PA,RALEIGH MEDICAL GROUP PA,3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609812338,"SIDDIQUI, ADEEL, MOHAMMAD",3700 BARRETT DR STE 300 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1831386531,INSIGHT OPTOMETRIC SERVICES PA,Insight Optometric Services PA,300 CAMPEN RD STE A BEAUFORT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1609813666,"GRAY, ANGELA, BOYETTE",4252 ARENDELL ST STE G MOREHEAD CITY NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 14 , 17 ,$#,,
MEDICAID DIRECT,1831386531,INSIGHT OPTOMETRIC SERVICES PA,Insight Optometric Services PA,300 CAMPEN RD STE A BEAUFORT NC,016,Carteret,193200000X,Group,Multi-Specialty,,1609813666,"GRAY, ANGELA, BOYETTE",300 CAMPEN RD STE A BEAUFORT NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,, 45 , 53 , 68 ,$#,,
MEDICAID DIRECT,1831386531,INSIGHT OPTOMETRIC SERVICES PA,Insight Optometric Services PA,4252 ARENDELL ST STE G MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1609813666,"GRAY, ANGELA, BOYETTE",4252 ARENDELL ST STE G MOREHEAD CITY NC,016,Carteret,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,409 OLIN WAY STE 2300 DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1609814011,"BUSHEY COLYER, JENNIFER, LOUISE",409 OLIN WAY STE 2300 DENVER NC,055,Lincoln,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 32 , 68 ,$#,,
MEDICAID DIRECT,1063647394,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - FOR,2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609814144,"ARMENTROUT, MARY, ELIZABETH",2933 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 18 , 39 , 102 ,$#,,
MEDICAID DIRECT,1457600504,MCPC-10 LLC,FIRSTHEALTH CARDIOVASCULAR AND THORACIC SERVICES,135 PAGE RD N   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1609815729,"KITCHENS, WILLIAM, CLIFFORD",135 PAGE RD N   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1457600504,MCPC-10 LLC,FIRSTHEALTH CARDIOVASCULAR AND THORACIC SERVICES,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1609815729,"KITCHENS, WILLIAM, CLIFFORD",155 MEMORIAL DR   PINEHURST NC,063,Moore,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 46 , 56 , 65 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609817865,"BOWERS, MARGARET, THERESE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 25 , 25 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1609817865,"BOWERS, MARGARET, THERESE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,,,$#,,
MEDICAID DIRECT,1467481762,MT OLIVE FAMILY MEDICAL CENTER,MT OLIVE FAMILY MEDICINE CENTER,201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,193400000X,Group,Single Specialty,,1609820463,"WILSON, VINCENT, PAUL",201 N BREAZEALE AVE   MOUNT OLIVE NC,096,Wayne,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 94 , 194 , 308 ,$#,,
MEDICAID DIRECT,1538415906,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS UNION PEDIATRICS,3173 W HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609820927,"MCCASKILL, QUIMBY, EDWARD",704 GOLD HILL RD STE 207 FORT MILL SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1447373063,HUGH CHATHAM MEMORIAL HOSPITAL,CLINGMAN MEDICAL CENTER,3369 CLINGMAN RD   RONDA NC,097,Wilkes,193400000X,Group,Single Specialty,,1609821289,"MARION, WADE, ASHLEY",3369 CLINGMAN RD   RONDA NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134372477,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE,600 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1609821289,"MARION, WADE, ASHLEY",911 E ATKINS ST   DOBSON NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 47 , 53 , 59 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609824622,"DAY, LUANNE, JORDAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1184782419,NOVANT HEALTH MATTHEWS MEDICAL CENT,PROFESSIONAL SERVICES OF PRESBYTERIAN MATTHEWS,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609824622,"DAY, LUANNE, JORDAN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1609827112,"WILSON, JAMES",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609827112,"WILSON, JAMES",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 29 , 32 , 34 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609827112,"WILSON, JAMES",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609828805,"WASHINGTON, CAROLE",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609828805,"WASHINGTON, CAROLE",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609828805,"WASHINGTON, CAROLE",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609828805,"WASHINGTON, CAROLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609828987,"ALLEN, ANTHONY, TERRANCE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609828987,"ALLEN, ANTHONY, TERRANCE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 32 , 35 , 46 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609828987,"ALLEN, ANTHONY, TERRANCE",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 31 , 36 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609828987,"ALLEN, ANTHONY, TERRANCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 13 , 22 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609828987,"ALLEN, ANTHONY, TERRANCE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1427156447,ROXBORO MEDICAL ASSOCIATES PA,ROXBORO MEDICAL ASSOCIATES,783 DOCTORS CT   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1609830389,"KAFER, JEFFREY, CHARLES",783 DOCTORS CT   ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 71 , 167 ,$#,,
MEDICAID DIRECT,1427156447,ROXBORO MEDICAL ASSOCIATES PA,ROXBORO MEDICAL ASSOCIATES,783 DOCTORS CT   ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1609830389,"KAFER, JEFFREY, CHARLES",783 DOCTORS CT STE B ROXBORO NC,073,Person,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609833011,"COATES, GEORGE, GLENN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 64 , 64 , 82 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609833011,"COATES, GEORGE, GLENN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085B0100X,Allopathic & Osteopathic Physicians,Radiology,Body Imaging, 15 , 15 , 23 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609834613,"GAAL JR, IMRE",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 192 , 197 , 254 ," $10,782.73 ",,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609834613,"GAAL JR, IMRE",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 257 , 294 , 337 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609836253,"PANNER, ERIC, JOHN",4315 PHYSICIANS BLVD   HARRISBURG NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1023291960,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE COPPERFIELD OBGYN,349 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609836253,"PANNER, ERIC, JOHN",349 PENNY LN   CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 32 , 37 , 49 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609836279,"WEAVER, DAVID, ELLIS",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 44 , 44 , 104 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609836279,"WEAVER, DAVID, ELLIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 34 , 33 , 74 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1609836279,"WEAVER, DAVID, ELLIS",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1609836279,"WEAVER, DAVID, ELLIS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609836279,"WEAVER, DAVID, ELLIS",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 35 , 38 , 95 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609836279,"WEAVER, DAVID, ELLIS",1960 S 16TH STREET   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609836279,"WEAVER, DAVID, ELLIS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1518696236,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-712 FLEMING STREET,712 FLEMING ST   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609837053,"WALKER, PAUL, CREASY",712 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 42 , 47 ,$#,,
MEDICAID DIRECT,1518696236,HENDERSON COUNTY HOSPITAL CORPORATI,PARDEE BLUEMD-712 FLEMING STREET,712 FLEMING ST   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609837053,"WALKER, PAUL, CREASY",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1609837079,"BAILEY, ROBERT, WOODWARD",1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 46 , 56 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609837079,"BAILEY, ROBERT, WOODWARD",1881 PISGAH DR BLDG A HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 23 , 23 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1609837129,"LIM, ROGER",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 73 , 94 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609838010,"KERZNER, MICHAEL, STEVEN",3643 N ROXBORO ST   DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 17 , 35 , 47 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609838010,"KERZNER, MICHAEL, STEVEN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 36 , 49 , 53 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609838010,"KERZNER, MICHAEL, STEVEN",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609838010,"KERZNER, MICHAEL, STEVEN",2301 ERWIN RD   DURHAM NC,032,Durham,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine, 15 , 20 , 23 ,$#,,
MEDICAID DIRECT,1215080536,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING MOORESVILLE,118 GATEWAY BLVD STE E MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609838028,"ZBAN, THOMAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609838028,"ZBAN, THOMAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1609838028,"ZBAN, THOMAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609838028,"ZBAN, THOMAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 342 , 363 , 419 ,$#,,
MEDICAID DIRECT,1770636268,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING GASTONIA,920 COX RD STE 101 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609838028,"ZBAN, THOMAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093773384,MECKLENBURG DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING SOUTHPARK,6324 FAIRVIEW RD STE 120A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609838028,"ZBAN, THOMAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 16 , 16 ,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609838028,"ZBAN, THOMAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1609838283,"WIATER, JOSEPH, GERARD",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1609838283,"WIATER, JOSEPH, GERARD",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 ,#, 13 ,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609838283,"WIATER, JOSEPH, GERARD",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 20 , 23 ,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193400000X,Group,Single Specialty,,1609838283,"WIATER, JOSEPH, GERARD",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609838283,"WIATER, JOSEPH, GERARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609838283,"WIATER, JOSEPH, GERARD",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1609838283,"WIATER, JOSEPH, GERARD",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043492853,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,120 HEALTHPLEX WAY   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1609838283,"WIATER, JOSEPH, GERARD",120 HEALTHPLEX WAY   APEX NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1609838283,"WIATER, JOSEPH, GERARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609838283,"WIATER, JOSEPH, GERARD",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 25 , 27 , 39 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609838283,"WIATER, JOSEPH, GERARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 38 , 58 ,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1609838283,"WIATER, JOSEPH, GERARD",2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609838283,"WIATER, JOSEPH, GERARD",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1487694352,CALDWELL MEMORIAL HOSPITAL,CALDWELL ACUTE CARE SPECIALISTS,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1609838580,"AWNY, LAILA, AHMED",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609839836,"KING, JOHN, RAYMOND",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609839836,"KING, JOHN, RAYMOND",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1609839836,"KING, JOHN, RAYMOND",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609839836,"KING, JOHN, RAYMOND",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609839836,"KING, JOHN, RAYMOND",16455 STATESVILLE RD STE 114 HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1609839901,"MCDONALD, RALPH, NORMAN",1771 TATE BLVD SE STE 201 HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 19 , 19 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1609839901,"MCDONALD, RALPH, NORMAN",2660 TATE BLVD SE   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 45 , 48 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609839984,"BURNWORTH, CRAIG, MARSHALL",129 MCDOWELL ST   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 62 , 72 , 164 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609841394,"HERRE, JOHN, MILTON",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609841394,"HERRE, JOHN, MILTON",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RA0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Advanced Heart Failure and Transplant Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1457436917,FAMILY MEDICINE AND REHABILITATION,~,2902 CENTRAL HEIGHTS RD STE A-C GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609841444,"GRIMM, PAUL, JEFFREY",502 MCKNIGHT DR STE 100B KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2265 NC HIGHWAY 24 27 E   BISCOE NC,062,Montgomery,193200000X,Group,Multi-Specialty,,1609841444,"GRIMM, PAUL, JEFFREY",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#,#,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,2807 RAEFORD RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609841444,"GRIMM, PAUL, JEFFREY",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,208D00000X,Allopathic & Osteopathic Physicians,General Practice,,#,#, 13 ,$#,,
MEDICAID DIRECT,1457957938,HARNETT HEALTH SYSTEM INC,CAPE FEAR VALLEY PRIMARY CARE-BUFFALO LAKES,1619 BUFFALO LAKE RD   SANFORD NC,043,Harnett,193200000X,Group,Multi-Specialty,,1609841444,"GRIMM, PAUL, JEFFREY",1249 CHICKEN FOOT RD   HOPE MILLS NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 33 , 41 ,$#,,
MEDICAID DIRECT,1770897142,LILLINGTON MEDICAL SERVICES LLC,CAPE FEAR VALLEY PRIMARY CARE-LILLINGTON,7 E DUNCAN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1609841444,"GRIMM, PAUL, JEFFREY",7 E DUNCAN ST   LILLINGTON NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1457957938,HARNETT HEALTH SYSTEM INC,CAPE FEAR VALLEY PRIMARY CARE-BUFFALO LAKES,1619 BUFFALO LAKE RD   SANFORD NC,043,Harnett,193200000X,Group,Multi-Specialty,,1609841444,"GRIMM, PAUL, JEFFREY",1619 BUFFALO LAKE RD   SANFORD NC,043,Harnett,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 94 , 115 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609841584,"HEIFERT, THERESA, ANN",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1609841584,"HEIFERT, THERESA, ANN",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 27 , 41 , 55 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1609841584,"HEIFERT, THERESA, ANN",1301 CENTRAL DR   SANFORD NC,053,Lee,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609841584,"HEIFERT, THERESA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 17 , 41 , 43 ,$#,,
MEDICAID DIRECT,1477977742,UNC PHYSICIANS NETWORK LLC,UNC SPECIALTY CARE AT SANFORD,1301 CENTRAL DR   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1609841584,"HEIFERT, THERESA, ANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1376510875,HOT SPRINGS HEALTH PROGRAM,HOT SPRINGS MEDICAL AND DENTAL CENTER,66 NW US 25 70 HIGH   HOT SPRINGS NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609842772,"LEAKE, RUTH, LORETTA",66 NW US 25 70 HWY   HOT SPRINGS NC,057,Madison,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942277454,HOT SPRINGS HEALTH PROGRAM,MASHBURN MEDICAL CENTER,590 MEDICAL PARK DR   MARSHALL NC,057,Madison,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609842772,"LEAKE, RUTH, LORETTA",590 MEDICAL PARK DR   MARSHALL NC,057,Madison,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609843804,"RAINES-HART, CYNTHIA, LEE",,11631 ASHEVILLE HWY STE A INMAN SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice,1609843804,"RAINES-HART, CYNTHIA, LEE",11631 ASHEVILLE HWY STE A INMAN SC,101,Out of State <= 40 miles,1223G0001X,Dental Providers,Dentist,General Practice, 132 , 210 , 576 ," $30,809.56 ",,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609845478,"NEIL, GRANADA, STEPHENS",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609845478,"NEIL, GRANADA, STEPHENS",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 23 , 23 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609847664,"BAHRANI, OTAROD",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609849694,"RABASSA, JILL, LYNN",1918 RANDOLPH RD STE 275 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 33 , 69 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609850114,"NEAL, SARA, LYNN",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609850114,"NEAL, SARA, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 129 , 206 , 305 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609850114,"NEAL, SARA, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1125 N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609850114,"NEAL, SARA, LYNN",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609850882,"RUSH, JENNIFER, LEE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,600 GRESHAM DR STE 700 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609850882,"RUSH, JENNIFER, LEE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609850882,"RUSH, JENNIFER, LEE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1720079254,MEDICAL CENTER RADIOLOGISTS INC,MEDICAL CENTER RADIOLOGISTS INC,6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609850882,"RUSH, JENNIFER, LEE",6275 E VIRGINIA BEACH BLVD STE 300 NORFOLK VA,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609851732,"LOESER, RICHARD, FRANK",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609851732,"LOESER, RICHARD, FRANK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609851732,"LOESER, RICHARD, FRANK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609851732,"LOESER, RICHARD, FRANK",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1477791507,SCOTLAND MEMORIAL HOSPITAL INC,SURGICAL ASSOCIATES OF SCOTLAND,521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1609852987,"REGAN, JAMES, BARRY",521 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1841248358,EAST CAROLINA UNIVERSITY,FIRETOWER MEDICAL OFFICE,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609853373,"HARRELL, MARK, ANDREW",1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1033677240,GASTON FAMILY HEALTH SERVICES INC,CATAWBA VALLEY FAMILY MEDICINE - MAIDEN,137 ISLAND FORD RD   MAIDEN NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609854587,"STUMP, TERESA",137 ISLAND FORD RD   MAIDEN NC,018,Catawba,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 24 , 44 ,$#,,
MEDICAID DIRECT,1881712842,NORTH CAROLINA STATE UNIVERSITY,,2815 CATES AVE   RALEIGH NC,092,Wake,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1609854728,"VINZANI, CATHERINE, OFALLON",2815 CATES AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609855543,COUNTY OF CABARRUS OFFICE OF TREASU,CABARRUS COUNTY EMS,793 CABARRUS AVE W   CONCORD NC,013,Cabarrus,341600000X,Transportation Services,Ambulance,,1609855543,COUNTY OF CABARRUS OFFICE OF TREASU,793 CABARRUS AVE W   CONCORD NC,013,Cabarrus,341600000X,Transportation Services,Ambulance,,#,,,$#,,
MEDICAID DIRECT,1609855543,COUNTY OF CABARRUS OFFICE OF TREASU,CABARRUS COUNTY EMS,793 CABARRUS AVE W   CONCORD NC,013,Cabarrus,3416L0300X,Transportation Services,Ambulance,Land Transport,1609855543,COUNTY OF CABARRUS OFFICE OF TREASU,793 CABARRUS AVE W   CONCORD NC,013,Cabarrus,3416L0300X,Transportation Services,Ambulance,Land Transport, 917 ," 1,429 "," 2,175 "," $79,476.08 ",,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1609856905,"YENNI, LAWRENCE, JON",1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 101 , 231 , 415 ,$#,,
MEDICAID DIRECT,1932521010,DLP WILSON PHYSICIAN PRACTICES LLC,,2605 FOREST HILLS RD SW STE A WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1609856905,"YENNI, LAWRENCE, JON",1700 TARBORO ST W STE 103 WILSON NC,098,Wilson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 23 , 41 , 82 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609858661,"STIEBER, VOLKER, WILHELM",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1609858661,"STIEBER, VOLKER, WILHELM",1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 13 , 73 , 104 ,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1609858661,"STIEBER, VOLKER, WILHELM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1134219108,PIEDMONT RADIATION ONCOLOGY PA,~,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609858661,"STIEBER, VOLKER, WILHELM",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 32 , 113 , 151 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609859578,"PATEL, NISHA, NARENDRA",472 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609859578,"PATEL, NISHA, NARENDRA",430 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1720556269,MH BLUE RIDGE MEDICAL CENTER LLLP,,189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1609859578,"PATEL, NISHA, NARENDRA",189 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",75 CAVALIER DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1011 PORTERS NECK RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1011 PORTERS NECK RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",75 CAVALIER DR   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1011 PORTERS NECK RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1011 PORTERS NECK RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 32 , 32 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,214 LANEFIELD RD   WARSAW NC,031,Duplin,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",214 LANEFIELD RD   WARSAW NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 19 , 20 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 41 , 103 , 103 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",630 N FODALE AVE   SOUTHPORT NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1070 OLD OCEAN HWY   BOLIVIA NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 40 , 40 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",90 SOUTHSIDE AVE STE 350 ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 26 , 60 , 60 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 21 , 21 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",208 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 49 , 49 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,1555 WILLIS AVE   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 30 , 30 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 71 , 273 , 273 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,1555 WILLIS AVE   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609862010,"CAQUIAS GONZALEZ, EILEEN, MARIE",1555 WILLIS AVE   LUMBERTON NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609862283,"JUNG, KI, SOO",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 13 , 17 , 19 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,9735 KINCEY AVE STE 300 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609862283,"JUNG, KI, SOO",10314 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 41 , 62 , 70 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609862473,"LAVIGNE, GREGORY, SCOTT",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 15 , 20 , 20 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1609862473,"LAVIGNE, GREGORY, SCOTT",2315 ASHEVILLE HWY STE 20 HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 14 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1609862473,"LAVIGNE, GREGORY, SCOTT",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 11 , 16 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609862473,"LAVIGNE, GREGORY, SCOTT",1 HEALTH PARK DR   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 12 , 20 ,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,35 VALLEY VIEW TER   WAYNESVILLE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1609862473,"LAVIGNE, GREGORY, SCOTT",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,21 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609862473,"LAVIGNE, GREGORY, SCOTT",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1053782318,HENDERSON COUNTY HOSPITAL CORPORATI,~,212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609862473,"LAVIGNE, GREGORY, SCOTT",212 THOMPSON ST STE C HENDERSONVILLE NC,045,Henderson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609863810,"RIBAKOVE, EVERETT, CRAIG",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 31 , 73 , 78 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,707 BRYANT ST   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609868132,"LANDAU, STEVEN, JAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 135 , 192 , 287 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609868132,"LANDAU, STEVEN, JAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1578073631,IREDELL PHYSICIAN NETWORK,IREDELL AMBULATORY SURGERY CENTER,701 BRYANT ST   STATESVILLE NC,049,Iredell,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1609868132,"LANDAU, STEVEN, JAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609868132,"LANDAU, STEVEN, JAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609868132,"LANDAU, STEVEN, JAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 23 , 27 , 31 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609868132,"LANDAU, STEVEN, JAY",707 BRYANT ST   STATESVILLE NC,049,Iredell,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 14 , 19 , 28 ,$#,,
MEDICAID DIRECT,1417112756,KIDZ PEDIATRICS,KIDZ PEDIATRICS PA,285 W DORA ST   ANGIER NC,043,Harnett,193400000X,Group,Single Specialty,,1609869437,"PEREDA, LOURDES, AMPARO",285 W DORA ST   ANGIER NC,043,Harnett,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 21 , 32 , 72 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609869676,"MCDONALD, JAMES, PATRICK",124 WELTON WAY   MOORESVILLE NC,049,Iredell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 29 , 55 , 96 ,$#,,
MEDICAID DIRECT,1295194751,SMITHFIELD FAMILY EYE CARE OD PA,~,1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1609871854,"WHITACRE, STEPHANIE, TOMKINS",1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,152W00000X,Eye and Vision Services Providers,Optometrist,, 98 , 130 , 231 ,$#,,
MEDICAID DIRECT,1295194751,SMITHFIELD FAMILY EYE CARE OD PA,~,1680 E BOOKER DAIRY RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1609871854,"WHITACRE, STEPHANIE, TOMKINS",5225 SUNSET LAKE RD   HOLLY SPRINGS NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609872282,"BLACK, JOHN, ALEXANDER",1025 MEDICAL CENTER DR STE 201 WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1194707901,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609872498,"EAGERTON, DONALD, CHARLES",945 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1508853698,STRAND PHYSICIAN SPECIALISTS PA,CAROLINA HEALTH SPECIALISTS,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609872498,"EAGERTON, DONALD, CHARLES",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1659427474,VALERIE HOLMES WADDELL DDS PA,VALERIE HOLMES WADDELL DDS PA,1601 E GARRISON BLVD STE C GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609872514,"WADDELL, VALERIE, HOLMES",1601 E GARRISON BLVD STE C GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 202 , 430 ," 1,684 "," $93,652.61 ",,
MEDICAID DIRECT,1760890495,COOKE AND MVULA PLLC,BELMONT PEDIATRIC DENTISTRY,3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609872514,"WADDELL, VALERIE, HOLMES",3340 ROBINWOOD RD STE 140 GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 29 , 29 , 120 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609872647,"CRITIKOS II, JOHN, PETER",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609872647,"CRITIKOS II, JOHN, PETER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 22 , 40 , 55 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609872647,"CRITIKOS II, JOHN, PETER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609872647,"CRITIKOS II, JOHN, PETER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609872647,"CRITIKOS II, JOHN, PETER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 17 , 23 , 29 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609872647,"CRITIKOS II, JOHN, PETER",691 BLYTHE STREET CT   HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1881614170,ASSOCIATED MEDICAL SPECIALISTS PA,COASTAL CANCER CENTER,8121 ROURK ST   MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609873785,"FRANCKE, PATRICK, MICHAEL",4708 OLEANDER DR   MYRTLE BEACH SC,101,Out of State <= 40 miles,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,850 S MAIN ST   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6602 KNIGHTDALE BLVD STE 205 KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1505 SW CARY PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",1505 SW CARY PKWY STE 300 CARY NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 27 , 31 , 43 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 53 , 133 , 239 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4201 LAKE BOONE TRL STE 104 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 143 , 301 , 406 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,400 HEALTH PARK DR STE 120 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609874130,"MOBAREK, SAMEH, KHAMIS",11200 GOVERNOR MANLY WAY STE 303A RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1043307887,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - CARDIOTHORACIC &,225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609876374,"CALTON, WILLIAM, CUYLER",225 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1215652425,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - ASHEBORO,1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609876606,"ANDERSON, DERRICK, EUGENE",1831 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 45 , 69 , 74 ,$#,,
MEDICAID DIRECT,1538637137,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINAS PRIMARY CARE,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1609876606,"ANDERSON, DERRICK, EUGENE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1205204476,CABARRUS ROWAN COMMUNITY HEALTH CEN,NORTHERN ROWAN FAMILY MEDICINE,300 N SALISBURY AVE   SPENCER NC,080,Rowan,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609876606,"ANDERSON, DERRICK, EUGENE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 18 , 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609876788,"FOSTER, MARK, DUPREE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 18 , 29 , 51 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609876788,"FOSTER, MARK, DUPREE",2716 ASHTON DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 52 , 77 , 120 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609877091,"BARNES, SHARROL, ELIZABETH",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609877091,"BARNES, SHARROL, ELIZABETH",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609877620,"CONNELLY, JASON, ROBERT",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609877620,"CONNELLY, JASON, ROBERT",650 JULIAN RD   SALISBURY NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609877620,"CONNELLY, JASON, ROBERT",335 SCHOOL ST   CLEVELAND NC,080,Rowan,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 44 , 100 ,$#,,
MEDICAID DIRECT,1932287182,COUNTY OF ROBESON OFFICE OF TREASUR,ROBESON COUNTY HEALTH DEPARTMENT,460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1609878800,"CLARK, VICKI, EDWARDS",460 COUNTRY CLUB RD   LUMBERTON NC,078,Robeson,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 32 , 48 , 187 ,$#,,
MEDICAID DIRECT,1831249986,CUMBERLAND COUNTY HEALTH DEPT,COUNTY OF CUMBERLAND,1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1609878800,"CLARK, VICKI, EDWARDS",1235 RAMSEY ST   FAYETTEVILLE NC,026,Cumberland,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1609879444,"BILLUE, ANGELA, RENEE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,,,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609879444,"BILLUE, ANGELA, RENEE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811637366,360 ANESTHESIA PLLC,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1609879444,"BILLUE, ANGELA, RENEE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,551 KENT ST   ANDREWS NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1609882026,"REYNOLDS, DEBORAH, ANN",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 58 , 58 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,551 KENT ST   ANDREWS NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1609882026,"REYNOLDS, DEBORAH, ANN",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 38 , 38 ,$#,,
MEDICAID DIRECT,1053808378,MURPHY EMERGENCY PHYSICIANS PLLC,,3990 E US 64 ALT   MURPHY NC,020,Cherokee,193200000X,Group,Multi-Specialty,,1609882026,"REYNOLDS, DEBORAH, ANN",3990 E US 64 ALT   MURPHY NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1609882026,"REYNOLDS, DEBORAH, ANN",551 KENT ST   ANDREWS NC,020,Cherokee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1609882026,"REYNOLDS, DEBORAH, ANN",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,193 ASHEVILLE HWY   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1609882026,"REYNOLDS, DEBORAH, ANN",193 ASHEVILLE HWY   SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1871780254,ASHEVILLE MEDICINE AND PEDIATRICS L,ASHEVILLE MEDICINE AND PEDIATRICS LTD,600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,193400000X,Group,Single Specialty,,1609882059,"BERNSTEIN, JOSHUA, EMIL",600 JULIAN LN STE 630 ARDEN NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 14 , 24 ,$#,,
MEDICAID DIRECT,1336131010,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOPE MILLS FAMILY CARE,5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1609882117,"MOULTRIE, JOHNNIE, LEWIS",5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1336131010,CUMBERLAND COUNTY HOSPITAL SYSTEM I,HOPE MILLS FAMILY CARE,5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609882117,"MOULTRIE, JOHNNIE, LEWIS",5523 WALDOS BEACH RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 115 , 304 , 341 ,$#,,
MEDICAID DIRECT,1750616108,CAPE FEAR VALLEY HEALTH SYSTEM SPEC,THREE RIVERS MEDICAL CENTER,580 W MCLEAN ST   SAINT PAULS NC,078,Robeson,193200000X,Group,Multi-Specialty,,1609882117,"MOULTRIE, JOHNNIE, LEWIS",580 W MCLEAN ST   SAINT PAULS NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",303 S MCNEIL ST   BURGAW NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 94 , 97 , 172 ," $24,900.23 ",,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 116 , 129 , 296 ," $31,183.19 ",,
MEDICAID DIRECT,1235340803,LARRY J MORAY DDS MS PA,MYORTHODONTIST,120 CLINTON CT   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 16 , 16 , 26 ,$#,,
MEDICAID DIRECT,1184928574,LARRY J MORAY DDS MS PA,MYORTHODONTIST,303 S MCNEIL ST   BURGAW NC,071,Pender,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 137 , 150 , 189 ," $31,996.67 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 23 , 23 , 23 ,$#,,
MEDICAID DIRECT,1699893792,LARRY J MORAY DDS MS PA,MYORTHODONTIST,616 DR CALVIN JONES HWY STE 200 WAKE FOREST NC,092,Wake,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 35 , 35 , 47 ,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 354 , 401 , 516 ," $73,754.65 ",,
MEDICAID DIRECT,1992975593,LARRY J MORAY DDS MS PA,MYORTHODONTIST,7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 53 , 53 , 69 ," $18,100.83 ",,
MEDICAID DIRECT,1568681658,LARRY J MORAY DDS MS PA,MYORTHODONTIST,933 ROCKFORD ST STE 4 MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 126 , 129 , 144 ," $22,609.55 ",,
MEDICAID DIRECT,1306056049,LARRY J MORAY DDS MS PA,MYORTHODONTIST,501 EASTOWNE DR STE 230 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 43 , 44 , 48 ,$#,,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 71 , 72 , 83 ," $14,248.89 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",3475 ERWIN RD   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 95 , 227 , 260 ," $70,424.06 ",,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",2301 ERWIN RD   DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1356468938,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1919 BRAGG ST STE 7 SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",1919 BRAGG ST STE 7 SANFORD NC,053,Lee,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1336495027,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1401 N BRIDGE ST   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1083732531,LARRY J MORAY DDS MS PA,MYORTHODONTIST,1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,193400000X,Group,Single Specialty,,1609882802,"LEVY-BERCOWSKI, DANIEL",1165 GREGORY DR STE A ROANOKE RAPIDS NC,042,Halifax,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 24 , 25 , 29 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1609882844,"POTTS, CARL, RICHARD",615 RIDGE RD   ROXBORO NC,073,Person,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1972150084,WOUND MANAGEMENT SPECIALISTS LLC,,6 REGIONAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609883511,"STROM, DAVID, EDWARD",6 REGIONAL DR STE D PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609883511,"STROM, DAVID, EDWARD",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609884378,"OGARA, TADHG, JAMES",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 30 , 38 , 47 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1609885557,"MARTIN, PHILIP, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609885557,"MARTIN, PHILIP, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609885557,"MARTIN, PHILIP, JOSEPH",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609886167,"KERLIN, KEVIN, JAMES",215 BEAMAN ST   CLINTON NC,082,Sampson,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,,,Unknown,193200000X,Group,Multi-Specialty,,1609886167,"KERLIN, KEVIN, JAMES",2802 MCLAMB PL   GOLDSBORO NC,096,Wayne,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#, 14 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,2802 MCLAMB PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609886167,"KERLIN, KEVIN, JAMES",2802 MCLAMB PL   GOLDSBORO NC,096,Wayne,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#, 17 , 36 ,$#,,
MEDICAID DIRECT,1306826961,GENESISCARE USA OF NORTH CAROLINA P,~,801 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609886167,"KERLIN, KEVIN, JAMES",2802 MCLAMB PL   GOLDSBORO NC,096,Wayne,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology, 34 , 366 , 748 ," $25,572.53 ",,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,107 W HARGETT ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609888478,"IBACH, AMY",107 W HARGETT ST STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1311 E MILLBROOK RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609888478,"IBACH, AMY",1311 E MILLBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6010 GLENWOOD AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609888478,"IBACH, AMY",6010 GLENWOOD AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 16 , 24 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609888478,"IBACH, AMY",6500 CREEDMOOR RD STE 110 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609888478,"IBACH, AMY",7010 NC HIGHWAY 751   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1336215821,WATAUGA MEDICAL CENTER INC,~,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1609888569,"HELAK, JOSEPH, WALTER",336 DEERFIELD RD   BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1609888999,PLAY AGAIN THERAPY INC,PLAY AGAIN TERAPY INC,205 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1609888999,PLAY AGAIN THERAPY INC,205 S STERLING ST   MORGANTON NC,012,Burke,251S00000X,Agencies,Community/Behavioral Health,,#,,,$#,,
MEDICAID DIRECT,1609888999,PLAY AGAIN THERAPY INC,PLAY AGAIN TERAPY INC,205 S STERLING ST   MORGANTON NC,012,Burke,251S00000X,Agencies,Community/Behavioral Health,,1609888999,PLAY AGAIN THERAPY INC,205 S STERLING ST   MORGANTON NC,012,Burke,251S00000X,Agencies,Community/Behavioral Health,, 44 , 778 , 778 ," $55,903.15 ",,
MEDICAID DIRECT,1609888999,PLAY AGAIN THERAPY INC,PLAY AGAIN TERAPY INC,205 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1609888999,PLAY AGAIN THERAPY INC,205 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,, 33 , 333 , 339 ," $25,670.71 ",,
MEDICAID DIRECT,1609888999,PLAY AGAIN THERAPY INC,PLAY AGAIN TERAPY INC,551 BURMA RD W STE 1 MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1609888999,PLAY AGAIN THERAPY INC,551 BURMA RD W STE 1 MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,, 40 , 357 , 400 ," $34,981.91 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609890656,"WHITE, RICHARD, LAVERNE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609890656,"WHITE, RICHARD, LAVERNE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1710165501,PREFERRED PAIN MANAGEMENT PA,PREFERRED PAIN MANAGEMENT PA,,,Unknown,193200000X,Group,Multi-Specialty,,1609890664,"CAMPBELL, PAMELA, DIANN",1511 WESTOVER TER STE 107 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1710165501,PREFERRED PAIN MANAGEMENT PA,PREFERRED PAIN MANAGEMENT PA,,,Unknown,193200000X,Group,Multi-Specialty,,1609890664,"CAMPBELL, PAMELA, DIANN",1638 MEMORIAL DR   BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1548230204,IREDELL MEMORIAL HOSPITAL INCORPORA,IMH PROFESSIONAL CRNA,557 BROOKDALE DR   STATESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1609890888,"HOTTLE, KIMBERLEY, WISECUP",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 54 , 55 , 55 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1609891415,"KHETERPAL, NEIL, M",6905 KNIGHTDALE BLVD STE 106 KNIGHTDALE NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609891415,"KHETERPAL, NEIL, M",11200 GOVERNOR MANLY WAY STE 200 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609891415,"KHETERPAL, NEIL, M",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609891415,"KHETERPAL, NEIL, M",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609891415,"KHETERPAL, NEIL, M",8300 HEALTH PARK STE 327 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609891415,"KHETERPAL, NEIL, M",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 12 , 15 , 18 ,$#,,
MEDICAID DIRECT,1386195444,REX HOSPITAL INC,REX DIGESTIVE HEALTHCARE,2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609891415,"KHETERPAL, NEIL, M",2417 ATRIUM DR STE 150 RALEIGH NC,092,Wake,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 14 , 20 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609891860,"KEEN, SUSAN, KELLY",3681 N MAIN ST   FARMVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 179 , 352 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609891969,"CHELMINSKI, PAUL, ROMAN",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 65 , 92 , 179 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609891969,"CHELMINSKI, PAUL, ROMAN",102 MASON FARM RD   CHAPEL HILL NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 23 , 48 ,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609891969,"CHELMINSKI, PAUL, ROMAN",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609893874,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-2749,2514 HALLTOWN RD   SPRUCE PINE NC,061,Mitchell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1609893874,WAL-MART STORES EAST LP,2514 HALLTOWN RD   SPRUCE PINE NC,061,Mitchell,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609894229,"HERSEY, ADRIENNE, ASH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 30 , 42 , 42 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609894229,"HERSEY, ADRIENNE, ASH",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609894328,"MATTHEWS, BRENT, DUANE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609894328,"MATTHEWS, BRENT, DUANE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 32 , 69 , 73 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609894799,"DUNN, KELLI, COOP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 39 , 172 , 172 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609894831,"GOODING, JULIE, REGAL",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609894831,"GOODING, JULIE, REGAL",1000 BLYTHE BLVD MEDICAL CENTER PLAZA CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 15 , 80 , 80 ," $11,813.11 ",,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609895580,"GRIFFITHS, CHRISTINA, GARDNER",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 108 , 278 , 319 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1609895580,"GRIFFITHS, CHRISTINA, GARDNER",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 53 , 53 ," $40,668.35 ",,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1609895580,"GRIFFITHS, CHRISTINA, GARDNER",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609896026,"DEVITO, THOMAS, JOSEPH",505 OBERLIN RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609896026,"DEVITO, THOMAS, JOSEPH",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972914992,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE BRIER CREEK,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609897156,"MESSER, ROSA, YUEH",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255851424,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE FORESTVILLE CROSSING,2930 FORESTVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609897156,"MESSER, ROSA, YUEH",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1609898634,"MCTEER, MARCUS, STEPHEN",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 57 , 58 , 71 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609899285,"DOWNING, WILMA, THEODORA",9224 ARDREY KELL RD STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1609899657,"MASTERS, TASSIE, MILIC",~,290 QUEST RDG   SYLVA NC,050,Jackson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1609899657,"MASTERS, TASSIE, MILIC",290 QUEST RDG   SYLVA NC,050,Jackson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1609899657,"MASTERS, TASSIE, MILIC",~,3195 OLD MURPHY RD   FRANKLIN NC,056,Macon,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,1609899657,"MASTERS, TASSIE, MILIC",3195 OLD MURPHY RD   FRANKLIN NC,056,Macon,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1871996058,MYEYEDR OPTOMETRY OF NORTH CAROLINA,~,505 RETAIL WAY STE 118 LOUISBURG NC,035,Franklin,193400000X,Group,Single Specialty,,1609899947,"FULLER, LISA, JOY",505 RETAIL WAY STE 118 LOUISBURG NC,035,Franklin,152W00000X,Eye and Vision Services Providers,Optometrist,, 42 , 42 , 44 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609902360,"CARTER III, RALPH, EDWARD",410D S JONES ST   PEMBROKE NC,078,Robeson,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#, 13 , 30 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609902360,"CARTER III, RALPH, EDWARD",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609902360,"CARTER III, RALPH, EDWARD",1604 MEDICAL DR   LAURINBURG NC,083,Scotland,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 64 , 116 , 220 ,$#,,
MEDICAID DIRECT,1780064832,APPALACHIAN MOUNTAIN COMMUNITY HEAL,TALLULAH COMMUNITY HEALTH CENTER,409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609904317,"PUDIL, JULIE, ANN",409 TALLULAH RD   ROBBINSVILLE NC,038,Graham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 75 , 148 , 190 ," $16,776.33 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609905876,"MULLINS-FRASHIER, ERIN, MARIE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609905876,"MULLINS-FRASHIER, ERIN, MARIE",1995 WELLNESS BLVD STE 110&210 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 105 , 196 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609905876,"MULLINS-FRASHIER, ERIN, MARIE",1995 WELLNESS BLVD STE 110 MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 26 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609906239,"GAMBRELL, PAUL, GREGG",201 E GROVER ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 108 , 110 , 110 ,$#,,
MEDICAID DIRECT,1386787422,COUNTY OF UNION,UNION COUNTY HEALTH DEPARTMENT,2330 CONCORD AVE   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609910629,"CROWE, CANDACE, CASEY",2330 CONCORD AVE   MONROE NC,090,Union,1223D0001X,Dental Providers,Dentist,Dental Public Health, 329 , 836 ," 2,323 "," $103,249.04 ",,
MEDICAID DIRECT,1366491185,EAST CAROLINA UNIVERSITY,ECU PRIMARY MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609911270,"HOBGOOD, LACY, CHADWICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609911270,"HOBGOOD, LACY, CHADWICK",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609911270,"HOBGOOD, LACY, CHADWICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 25 , 25 ,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609911270,"HOBGOOD, LACY, CHADWICK",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 20 , 13 , 19 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609911270,"HOBGOOD, LACY, CHADWICK",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 64 , 85 , 158 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609911270,"HOBGOOD, LACY, CHADWICK",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 23 , 35 , 70 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1609911270,"HOBGOOD, LACY, CHADWICK",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1992396048,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ANESTHESIA,506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609911791,"CAIAFA, GUY, JOSEPH",506 E CHEVES ST STE 202 FLORENCE SC,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1609914100,CARLYLE DUKES HAYWOOD JR,,211 W BROAD AVE   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,1609914100,CARLYLE DUKES HAYWOOD JR,211 W BROAD AVE   ROCKINGHAM NC,077,Richmond,193400000X,Group,Single Specialty,,#,#, 12 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609915461,"WRENN, LAURA, LUQUIRE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609915461,"WRENN, LAURA, LUQUIRE",40 DUKE MEDICINE CIR # 2H DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 21 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609915461,"WRENN, LAURA, LUQUIRE",40 DUKE MEDICINE CIR # 2H DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 103 , 104 , 145 ,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 36 , 55 ,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",400 US HIGHWAY 70 E   GARNER NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193400000X,Group,Single Specialty,,1609918093,"HUGHES, STEPHANIE, ANNE",2138 HIGHWAY 42 W   CLAYTON NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235562067,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,400 US 70 HWY E   GARNER NC,092,Wake,193400000X,Group,Single Specialty,,1609919331,"BRIGHTON, ARTHUR, JAMES",400 US HIGHWAY 70 E   GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609919331,"BRIGHTON, ARTHUR, JAMES",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609919331,"BRIGHTON, ARTHUR, JAMES",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1043251960,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGECY PHYSICIANS PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609919331,"BRIGHTON, ARTHUR, JAMES",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609919331,"BRIGHTON, ARTHUR, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609919331,"BRIGHTON, ARTHUR, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669253274,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2021 WENDELL VALLEY PKWY   WENDELL NC,092,Wake,193400000X,Group,Single Specialty,,1609919331,"BRIGHTON, ARTHUR, JAMES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609921212,"ADEKANMBI, ADEBOLA, KOLAWOLE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1609921212,"ADEKANMBI, ADEBOLA, KOLAWOLE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 18 , 23 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1609921212,"ADEKANMBI, ADEBOLA, KOLAWOLE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 45 , 51 , 59 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1609921212,"ADEKANMBI, ADEBOLA, KOLAWOLE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 23 , 27 , 31 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609922343,"YU, BENNETT, WINSTON",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1457411381,HIGH POINT REGIONAL HEALTH,ATRIUM HEALTH HIGH POINT MEDICAL CENTER,601 N ELM ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609923705,"JONES, DAVID, SHELDON",601 N ELM ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811524754,BRIGHTSIDE MEDICAL OF NEW JERSEY PC,,3064 WAKE FOREST RD # 1271 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609924729,"KIRBY, DONOVAN, RICHARD",3064 WAKE FOREST RD # 1271 RALEIGH NC,092,Wake,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609925841,"PATEL, ANITA, SHASHIKANT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 47 , 47 , 77 ,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609925841,"PATEL, ANITA, SHASHIKANT",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1609931617,"FIROZVI, ASRA, SHABANA",1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609931617,"FIROZVI, ASRA, SHABANA",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609931617,"FIROZVI, ASRA, SHABANA",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 48 , 74 , 118 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609931617,"FIROZVI, ASRA, SHABANA",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 21 , 47 , 64 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1609931617,"FIROZVI, ASRA, SHABANA",1010 TRYON VILLAGE DR   CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1609932318,"VILLAFLOR ZITOUNI, ANTONNETTE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609939487,"LINARDIC, CORINNE, MARY",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#, 31 , 31 ,$#,,
MEDICAID DIRECT,1972747053,CAROMONT MEDICAL GROUP INC,CAROMONT SURGICAL ASSOCIATES,2555 COURT DR STE 450 GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1609940287,"OCONNOR, LINH, NGUYEN",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 36 , 38 ,$#,,
MEDICAID DIRECT,1093063398,CAROMONT MEDICAL GROUP INC,CAROMONT BREAST SURGICAL SPECIALISTS,2000 CAROMONT PKWY STE 202 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609940287,"OCONNOR, LINH, NGUYEN",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093063398,CAROMONT MEDICAL GROUP INC,CAROMONT BREAST SURGICAL SPECIALISTS,2391 COURT DR STE 105 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609940287,"OCONNOR, LINH, NGUYEN",2555 COURT DR STE 450 GASTONIA NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1093063398,CAROMONT MEDICAL GROUP INC,CAROMONT BREAST SURGICAL SPECIALISTS,2000 CAROMONT PKWY STE 202 BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1609940287,"OCONNOR, LINH, NGUYEN",2000 CAROMONT PKWY   BELMONT NC,036,Gaston,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609941343,"WROTH, THOMAS, HUNTINGTON",221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 42 , 42 ,$#,,
MEDICAID DIRECT,1609943497,PERSONAL TOUCH CARE TEAM INC,,137 JENNINGS RD STE B STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1609943497,PERSONAL TOUCH CARE TEAM INC,137 JENNINGS RD STE B STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,761 "," 1,761 "," $113,418.80 ",,
MEDICAID DIRECT,1225195746,MOORE FOOT AND ANKLE SPECIALISTS PA,~,136 MIMOSA DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1609943703,"MOORE, LILY, LEE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 73 , 198 , 217 ,$#,,
MEDICAID DIRECT,1225195746,MOORE FOOT AND ANKLE SPECIALISTS PA,~,136 MIMOSA DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1609943703,"MOORE, LILY, LEE",136 MIMOSA DR   ASHEVILLE NC,011,Buncombe,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 173 , 411 , 723 ,$#,,
MEDICAID DIRECT,1396886842,BERTIE COUNTY RURAL HEALTH ASSOCIAT,BERTIE COUNTY RURAL HEALTH ASSOCIATION,104 RHODES AVE   WINDSOR NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609944727,"BROOKS, RICKY, LORENZO",104 RHODES AVE   WINDSOR NC,008,Bertie,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1609945997,"BUENASEDA, LEAMOR, DE LEON",6415 BROOKSTONE LN STE 101 FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 51 , 132 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1609945997,"BUENASEDA, LEAMOR, DE LEON",2035 VALLEYGATE DR STE 101 FAYETTEVILLE NC,026,Cumberland,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 43 , 122 ,$#,,
MEDICAID DIRECT,1235439613,KIDS FIRST PEDIATRICS OF RAEFORD PC,~,4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1609945997,"BUENASEDA, LEAMOR, DE LEON",4005 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 104 , 189 , 524 ," $23,903.34 ",,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609946607,"LOCKLEAR, IRLENE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 31 , 108 , 120 ,$#,,
MEDICAID DIRECT,1750197042,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY PULMONARY MEDICINE,1537 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609946607,"LOCKLEAR, IRLENE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 64 , 148 , 165 ," $13,206.53 ",,
MEDICAID DIRECT,1750197042,CAPE FEAR VALLEY HEALTH MEDICAL GRO,CAPE FEAR VALLEY PULMONARY MEDICINE,1537 OWEN PARK LN   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609946607,"LOCKLEAR, IRLENE",1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#, 18 ,$#,,
MEDICAID DIRECT,1215463450,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PULMONARY MEDICINE,1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609946607,"LOCKLEAR, IRLENE",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 115 , 182 , 219 ,$#,,
MEDICAID DIRECT,1215463450,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV PULMONARY MEDICINE,1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609946607,"LOCKLEAR, IRLENE",1201 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 12 , 25 ,$#,,
MEDICAID DIRECT,1609947548,"FREEDLAND, ROBERT, DAVID",ROBERT D FREEDLAND DDS PA,212 MEDICAL CENTER DR   RIEGELWOOD NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice,1609947548,"FREEDLAND, ROBERT, DAVID",212 MEDICAL CENTER DR   RIEGELWOOD NC,009,Bladen,1223G0001X,Dental Providers,Dentist,General Practice, 423 , 900 ," 3,444 "," $207,254.28 ",,
MEDICAID DIRECT,1760924641,RICKERT WATSON & ASSOCIATES DDS PLL,HEALTHY SMILES,9424 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1609948439,"WATSON, CRYSTAL, GRACE",9424 FALLS OF NEUSE RD STE 105 RALEIGH NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice," 1,304 "," 2,258 "," 9,095 "," $254,614.99 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609949858,"NOONAN, JAIME, BRIAN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 32 , 37 , 39 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609949858,"NOONAN, JAIME, BRIAN",11 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609949858,"NOONAN, JAIME, BRIAN",430 RANKIN DR   MARION NC,059,McDowell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609949858,"NOONAN, JAIME, BRIAN",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1609949858,"NOONAN, JAIME, BRIAN",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 306 , 352 , 452 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609949858,"NOONAN, JAIME, BRIAN",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609950344,"ELLINGTON, KENNETH, SCOTT",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609950344,"ELLINGTON, KENNETH, SCOTT",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 24 , 24 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609950344,"ELLINGTON, KENNETH, SCOTT",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 126 , 127 , 157 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609950344,"ELLINGTON, KENNETH, SCOTT",3643 N ROXBORO ST   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 59 , 62 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609950591,"PROIA, ALAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609950591,"PROIA, ALAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609950591,"PROIA, ALAN, DAVID",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1609952241,"OWENS, JACK, DARREN",325 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609956192,"THOMAS, DAVID, BRIAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207ZP0101X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology,#,#, 17 ,$#,,
MEDICAID DIRECT,1144657677,ROBERT C PENNEBAKER PLLC,CUMBERLAND BEHAVIORAL CARE,2931 BREEZEWOOD AVE STE 104 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609957505,"PENNEBAKER, ROBERT, CHRISTOPHER",2931 BREEZEWOOD AVE STE 104 FAYETTEVILLE NC,026,Cumberland,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609960715,"EWEND, MATTHEW, GLAIZE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 2 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609960715,"EWEND, MATTHEW, GLAIZE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1609960715,"EWEND, MATTHEW, GLAIZE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609961465,"COX, SUSAN, KILE",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1609961465,"COX, SUSAN, KILE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1609961853,"MCCLELLAN, SCOTT, DAVID",3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1609961853,"MCCLELLAN, SCOTT, DAVID",3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 33 , 47 , 77 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1609961853,"MCCLELLAN, SCOTT, DAVID",3332 BRIDGES ST STE 3B MOREHEAD CITY NC,016,Carteret,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 21 , 34 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1609961853,"MCCLELLAN, SCOTT, DAVID",2115 NEUSE BLVD   NEW BERN NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1609961853,"MCCLELLAN, SCOTT, DAVID",2115 NEUSE BLVD   NEW BERN NC,025,Craven,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 72 , 52 , 73 ,$#,,
MEDICAID DIRECT,1619903176,DERMATOLOGY ASSOCIATES OF COASTAL C,~,2115 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1609961853,"MCCLELLAN, SCOTT, DAVID",2115 NEUSE BLVD   NEW BERN NC,025,Craven,207ZD0900X,Allopathic & Osteopathic Physicians,Pathology,Dermatopathology,#,#,#,$#,,
MEDICAID DIRECT,1942478383,DUPLIN GENERAL HOSPITAL INC,DUPLIN GENERAL HOSPITAL INC,401 N MAIN ST   KENANSVILLE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1609961986,"ROOS, TAMMI, CESARINA",401 N MAIN ST   KENANSVILLE NC,031,Duplin,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609961986,"ROOS, TAMMI, CESARINA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609962919,"PAULSON, ERIK, KARL",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609962919,"PAULSON, ERIK, KARL",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609962919,"PAULSON, ERIK, KARL",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609962919,"PAULSON, ERIK, KARL",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 40 , 59 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609962919,"PAULSON, ERIK, KARL",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1609962919,"PAULSON, ERIK, KARL",718 RUTHERFORD ST   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 48 , 48 , 61 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609964097,"MARKS, JENNIFER, AYOUB",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,82 PATTON AVE STE 510 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1609964097,"MARKS, JENNIFER, AYOUB",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1124285515,SURGICENTER OF EASTERN CAROLINA,ECU HEALTH SURGICENTER,102 BETHESDA DR   GREENVILLE NC,074,Pitt,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1609965508,"HAMILTON, JONATHAN, NATHANIEL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1639153448,EASTERN UROLOGICAL ASSOCIATES PA,EASTERN UROLOGICAL ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1609965508,"HAMILTON, JONATHAN, NATHANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,,,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609965508,"HAMILTON, JONATHAN, NATHANIEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,, 59 , 95 , 144 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609965508,"HAMILTON, JONATHAN, NATHANIEL",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1609965508,"HAMILTON, JONATHAN, NATHANIEL",JONATHAN N HAMILTON,275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,1609965508,"HAMILTON, JONATHAN, NATHANIEL",275 BETHESDA DR   GREENVILLE NC,074,Pitt,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1609968528,"BONNEY, STEPHEN, RONALD",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 19 , 22 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609968528,"BONNEY, STEPHEN, RONALD",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 14 , 16 ,$#,,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609969716,"DONIGAN, WILLIAM, THOMAS",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 997 ," 1,240 "," 4,036 "," $185,362.01 ",,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609969716,"DONIGAN, WILLIAM, THOMAS",871 HUFFMAN ST   GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",518 BROOKDALE DR   STATESVILLE NC,049,Iredell,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 26 , 73 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 16 ,$#,,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609969716,"DONIGAN, WILLIAM, THOMAS",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 15 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,518 BROOKDALE DR   STATESVILLE NC,049,Iredell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",32 KIRKWOOD AVE   LEXINGTON NC,029,Davidson,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1588833131,PERRY L JEFFRIES DDS PA,JEFFRIES L PERRY,871 HUFFMAN ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609969716,"DONIGAN, WILLIAM, THOMAS",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205076668,PERRY L JEFFRIES DDS PA,JEFFRIES PERRY L,1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609969716,"DONIGAN, WILLIAM, THOMAS",1500 MOUNT ZION PL STE B WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 496 , 587 ," 1,805 "," $87,603.08 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,2222 S FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609969716,"DONIGAN, WILLIAM, THOMAS",308 BREWER ST   ASHEBORO NC,076,Randolph,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1972962363,CAROLINA PRIORITY CARE PLLC,CAROLINA PRIORITY CARE,8001 MARKETPLACE DR STE A OAK RIDGE NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609970045,"LARGEN, KEVIN, NEAL",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 50 , 68 , 140 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609970045,"LARGEN, KEVIN, NEAL",601 N ELM ST   HIGH POINT NC,041,Guilford,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 60 , 60 , 62 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",1818 DOCTORS DR   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",1135 CARTHAGE ST   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",110 FIELDS DR STE A SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",1135 CARTHAGE ST   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",1135 CARTHAGE ST   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 46 , 57 ,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",1818 DOCTORS DR   SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",110 FIELDS DR STE A SANFORD NC,053,Lee,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1295262103,MCPC-18,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 112 , 269 , 576 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1609971068,"GILLESPIE, MICHAEL, JOSEPH",205 PAGE RD   PINEHURST NC,063,Moore,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 74 , 131 , 220 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1609971605,"MADDOX, PATRICK, TATE",80 DOCTORS DR STE 2 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 17 , 21 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1609971605,"MADDOX, PATRICK, TATE",80 DOCTORS DR STE 2 HENDERSONVILLE NC,045,Henderson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 39 , 63 , 75 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609974237,"HOWARD MCNATT, MARISSA, MICHELLE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 43 , 57 , 62 ,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609974468,"PAPARAZO, SUSAN, FREELAND",444 SW CENTER ST   FAISON NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1255456794,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER GOLDSBORO,2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609974468,"PAPARAZO, SUSAN, FREELAND",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1154378933,GOSHEN MEDICAL CENTER INCORPORATED,GOSHEN MEDICAL CENTER FAISON,444 SW CENTER ST   FAISON NC,031,Duplin,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609974468,"PAPARAZO, SUSAN, FREELAND",2701 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 137 , 137 ,$#,,
MEDICAID DIRECT,1609976901,CENTURY CARE OF CHERRYVILLE INC,PEAK RESOURCES - CHERRYVILLE,7615 DALLAS CHERRYVILLE HWY   CHERRYVILLE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609976901,CENTURY CARE OF CHERRYVILLE INC,7615 DALLAS CHERRYVILLE HWY   CHERRYVILLE NC,036,Gaston,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 36 ," 3,688 "," 3,688 "," $532,352.22 ",,
MEDICAID DIRECT,1396282463,TENNESSEE RIVER PHYSICIANS PLLC,,71 WHEELERTOWN AVE   PIKEVILLE TN,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1609976927,"BOWERS, TAMARA, MCVAY",71 WHEELERTOWN AVE   PIKEVILLE TN,102,Out of State > 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1609977099,"STEIN, JEANNETTE, FISCHER",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1609977388,"MEISINGER, TODD, DOUGLAS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1609977388,"MEISINGER, TODD, DOUGLAS",510 N ELAM AVE STE 101 GREENSBORO NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#, 22 ,$#,,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1609978550,"HARRISON, BENJAMIN, GEOFFREY",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 19 , 19 , 70 ,$#,,
MEDICAID DIRECT,1609979475,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03898,1718 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1609979475,NORTH CAROLINA CVS PHARMACY LLC,1718 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609979715,"MOSHIREE, BAHARAK",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609979715,"MOSHIREE, BAHARAK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 18 , 20 , 27 ,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609979715,"MOSHIREE, BAHARAK",1025 MOREHEAD MEDICAL DR FL 3 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 15 , 16 , 23 ,$#,,
MEDICAID DIRECT,1679944706,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY,1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609979715,"MOSHIREE, BAHARAK",1225 HARDING PL STE 5100 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609979715,"MOSHIREE, BAHARAK",1225 HARDING PL STE 5200 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1992173165,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GASTROENTEROLOGY & HEPATOLOGY MOREHE,1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1609979715,"MOSHIREE, BAHARAK",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1881712842,NORTH CAROLINA STATE UNIVERSITY,,2815 CATES AVE   RALEIGH NC,092,Wake,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1609979897,"HESSION, HELEN, MAUREEN",2815 CATES AVE   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1609980077,"GRAGG, KIMBERLY, LUTZ",~,509 HARPER AVE SW   LENOIR NC,014,Caldwell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1609980077,"GRAGG, KIMBERLY, LUTZ",509 HARPER AVE SW   LENOIR NC,014,Caldwell,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1609980077,"GRAGG, KIMBERLY, LUTZ",~,303 S GREEN ST STE 201 MORGANTON NC,012,Burke,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1609980077,"GRAGG, KIMBERLY, LUTZ",303 S GREEN ST STE 201 MORGANTON NC,012,Burke,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 225 , 931 ," 1,269 "," $214,265.71 ",,
MEDICAID DIRECT,1003385790,KIMBERLY L GRAGG DDS MS PLLC,GRAGG ORTHODONTICS,303 S GREEN ST STE 201 MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1609980077,"GRAGG, KIMBERLY, LUTZ",303 S GREEN ST STE 201 MORGANTON NC,012,Burke,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,#,#,#,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1609980564,"SPENCER, DORAINE, GRIESER",631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 20 , 21 ,$#,,
MEDICAID DIRECT,1427770130,NOVANT HEALTH ROWAN MEDICAL CENTER,NH ROWAN CANCER CLINICS,631 MOCKSVILLE AVE STE 1020 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1609980564,"SPENCER, DORAINE, GRIESER",825 W HENDERSON ST STE A SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,435 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",435 E STATESVILLE AVE   MOORESVILLE NC,049,Iredell,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 128 , 350 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 71 , 285 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1609981026,"FOX, JESSICA, LYN",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 30 , 69 ,$#,,
MEDICAID DIRECT,1821168055,SENIOR CARE SYSTEMS PA,SENIOR CARE SYSTEMS PA,1013 PORTERS NECK RD STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1609987197,"MCPHERSON, BELINDA, JACOBS",1013 PORTERS NECK RD STE 100 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 72 , 86 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1609987197,"MCPHERSON, BELINDA, JACOBS",1013 PORTERS NECK RD STE 100 WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609988393,"CALLAHAN, JOHN, CONWAY",151 3RD ST   AURORA NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 80 , 164 , 261 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,193200000X,Group,Multi-Specialty,,1609988393,"CALLAHAN, JOHN, CONWAY",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1609988393,"CALLAHAN, JOHN, CONWAY",740 BRAGAW LN   CHOCOWINITY NC,007,Beaufort,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 19 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,20 MEDICAL PARK DR STE 2 MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1609988997,"LANE, RONALD, WILLIAM",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 19 , 27 , 34 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1609988997,"LANE, RONALD, WILLIAM",1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 60 , 80 , 116 ,$#,,
MEDICAID DIRECT,1356303507,ASHEVILLE HEAD NECK AND EAR SURGEON,ASHEVILLE HEAD NECK AND EAR SURGEONS PA,1065 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1609988997,"LANE, RONALD, WILLIAM",2315 ASHEVILLE HWY STE 30 HENDERSONVILLE NC,045,Henderson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1013332642,UMA PAIN & SPINE CLINIC PLLC,,230 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1609989870,"PATEL, DIVYA, JATINKUMAR",230 N WINSTEAD AVE   ROCKY MOUNT NC,064,Nash,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 209 ," 2,027 "," 3,802 "," $44,168.10 ",,
MEDICAID DIRECT,1609991611,THE MENTAL HEALTH FUND INC,CATAWBA VALLEY BEHAVIORAL HEALTHCARE GROUP HOME 3,1516 STEEPLE ST NE   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609991611,THE MENTAL HEALTH FUND INC,1516 STEEPLE ST NE   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 430 , 430 ," $14,231.52 ",,
MEDICAID DIRECT,1609994821,BURKEMONT MOUNTAIN MEN GROUP HOME,BMMGH-OPGH INC,166 VFW RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609994821,BURKEMONT MOUNTAIN MEN GROUP HOME,166 VFW RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,868 "," 1,892 "," $80,995.30 ",,
MEDICAID DIRECT,1609994821,BURKEMONT MOUNTAIN MEN GROUP HOME,BMMGH-OPGH INC,401 DREXEL RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609994821,BURKEMONT MOUNTAIN MEN GROUP HOME,401 DREXEL RD   MORGANTON NC,012,Burke,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 738 , 738 ," $31,209.08 ",,
MEDICAID DIRECT,1609995588,INREACH,INREACH,8223 LARKHAVEN RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1609995588,INREACH,8223 LARKHAVEN RD   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 636 , 636 ," $34,369.28 ",,
MEDICAID DIRECT,1609995786,"GREENE, STACEY, ANDREW",STACEY ANDREW GREENE,709 E MARKET ST STE 204 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1609995786,"GREENE, STACEY, ANDREW",709 E MARKET ST STE 204 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 466 , 847 ," 1,953 "," $135,947.63 ",,
MEDICAID DIRECT,1962435529,VIEWMONT UROLOGY CLINIC,VIEWMONT UROLOGY CLINIC,1202 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1609996537,"CREIGHTON, MATTHEW, AARON",1202 N CENTER ST   HICKORY NC,018,Catawba,208800000X,Allopathic & Osteopathic Physicians,Urology,, 161 , 305 , 571 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609998541,"HOIMES, MATTHEW, LUKAS",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 176 , 189 , 229 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1609998541,"HOIMES, MATTHEW, LUKAS",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 64 , 68 , 101 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619001989,"HARRIS, ERIN, FIELDS",5370 RIDGE RD   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 19 , 52 ,$#,,
MEDICAID DIRECT,1619004314,SUNNYSIDE RETIREMENT HOME,SUNNYSIDE RETIREMENT HOME,1600 US HIGHWAY 221 S   FOREST CITY NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619004314,SUNNYSIDE RETIREMENT HOME,1600 US HIGHWAY 221 S   FOREST CITY NC,081,Rutherford,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 36 ," 9,693 "," 10,062 "," $729,878.75 ",,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,110 KILDAIRE PARK DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619005204,"SPROUL, MATTHEW, THOMAS",110 KILDAIRE PARK DR   CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1386209633,WAKEMED SPECIALISTS GROUP LLC,WAKEMED URGENT CARE,231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1619005204,"SPROUL, MATTHEW, THOMAS",231 N JUDD PKWY NE   FUQUAY VARINA NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1760804181,GERRI MORRISON,UPPER ROOM FAMILY CARE,,,Unknown,261QP2300X,Ambulatory Health Care Facilities,Clinic/Center,Primary Care,1619005360,"MORRISON, GERRI, FISHER",105B N MAIN AVE   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1619005360,"MORRISON, GERRI, FISHER",UPPER ROOM FAMILY CARE,,,Unknown,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,1619005360,"MORRISON, GERRI, FISHER",105B N MAIN AVE   NEWTON NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1134714298,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PEDS SURGERY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619005469,"WALTERS, KENNETH, CHRISTIAN",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,301 E WENDOVER AVE STE 111   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619006137,"VU, TRUNG, THANH",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619006137,"VU, TRUNG, THANH",301 E WENDOVER AVE STE 111 GREENSBORO NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 83 , 167 , 206 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619006152,"BILSKA, MAGDALENA, ALICJA",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 33 , 63 , 117 ,$#,,
MEDICAID DIRECT,1467094607,REX HOSPITAL INC,UNC REX RADIATION ONCOLOGY,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619006681,"KOONTZ, BRIDGET, FEY",524 MOYE BLVD   GREENVILLE NC,074,Pitt,2085R0001X,Allopathic & Osteopathic Physicians,Radiology,Radiation Oncology,#,#,#,$#,,
MEDICAID DIRECT,1619012812,CEDARBROOK RESIDENTIAL CENTER,CEDARBROOK RESIDENTIAL CENTER INC,1267 PINNACLE CHURCH RD   NEBO NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619012812,CEDARBROOK RESIDENTIAL CENTER,1267 PINNACLE CHURCH RD   NEBO NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 57 ," 12,205 "," 12,205 "," $782,072.26 ",,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619016557,"VASQUEZ, AMY, LYNN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619017472,"PULLIAS, MICHAEL, ANDRE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619017472,"PULLIAS, MICHAEL, ANDRE",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619017472,"PULLIAS, MICHAEL, ANDRE",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1437713914,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR ADVANCED HEART FAILURE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619017811,"FOSTER, TANAYA, PATEL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 70 , 101 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619020179,"GOODMAN, MICHAEL, MOSES",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 18 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619020179,"GOODMAN, MICHAEL, MOSES",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 25 , 60 , 71 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1619022001,"LARSON, KELLY, MICHELLE",55 BUCKEYE COVE RD   CANTON NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 52 , 130 , 180 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1619022001,"LARSON, KELLY, MICHELLE",176 WALMART PLZ   SYLVA NC,050,Jackson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 25 , 32 ,$#,,
MEDICAID DIRECT,1619022779,RANDOLPH SPECIALTY GROUP PRACTICE,RANDOLPH HEALTH ENDOSCOPY CENTER,,,Unknown,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1619022779,RANDOLPH SPECIALTY GROUP PRACTICE,700 SUNSET AVE   ASHEBORO NC,076,Randolph,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,#,,,$#,,
MEDICAID DIRECT,1619022985,PROSPEROUS HOME CARE SERVICES,~,8501 TOWER POINT DR STE B-20 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1619022985,PROSPEROUS HOME CARE SERVICES,8501 TOWER POINT DR STE B-20 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,, 28 ," 8,152 "," 8,982 "," $692,235.77 ",,
MEDICAID DIRECT,1942251251,WESTERN WAKE PEDIATRICS PA,WESTERN WAKE PEDIATRICS PA,940 SE CARY PKWY STE 200 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1619024254,"HANNON, EMILY, AIKENHEAD",940 SE CARY PKWY STE 200 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 29 , 45 , 91 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619026259,"CAMERON, STEPHEN, MARCO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619026259,"CAMERON, STEPHEN, MARCO",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 21 , 21 , 27 ,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619028248,"HADLEY, MARY, MOREHEAD",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 16 , 19 , 43 ,$#,,
MEDICAID DIRECT,1164954715,SOUTHLAND UNION EMERGENCY MEDICAL S,,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619028255,"LEE, MARK, ALLEN",35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619028289,QUALITY LIFE HOME CARE INC,~,148 EAST ST STE 201 PITTSBORO NC,019,Chatham,253Z00000X,Agencies,In Home Supportive Care,,1619028289,QUALITY LIFE HOME CARE INC,148 EAST ST STE 201 PITTSBORO NC,019,Chatham,253Z00000X,Agencies,In Home Supportive Care,, 17 ," 2,848 "," 2,848 "," $435,848.84 ",,
MEDICAID DIRECT,1619029584,ROWAN SALISBURY SCHOOLS,~,500 N MAIN ST   SALISBURY NC,080,Rowan,251300000X,Agencies,Local Education Agency (LEA),,1619029584,ROWAN SALISBURY SCHOOLS,500 N MAIN ST   SALISBURY NC,080,Rowan,251300000X,Agencies,Local Education Agency (LEA),, 738 ," 10,260 "," 10,696 "," $479,091.19 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619030491,"ZAAS, AIMEE, KIRSCH",DUKE HOSP SOUTH TRENT DR   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619030491,"ZAAS, AIMEE, KIRSCH",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 16 , 32 , 32 ,$#,,
MEDICAID DIRECT,1700579489,MANENTE NC PC,MCMILLIAN ORTHODONTICS,1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619031440,"MCMILLIAN, ALISON, JEANETTE",1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics," 1,742 "," 4,603 "," 5,864 "," $1,002,122.70 ",,
MEDICAID DIRECT,1255022869,MANENTE NC PC,CLEAR SMILE DESIGN,2301 BATTLEGROUND AVE STE 101 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619031440,"MCMILLIAN, ALISON, JEANETTE",1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 33 , 54 , 93 ," $10,226.56 ",,
MEDICAID DIRECT,1952606436,ALISON J MCMILLIAN DDS MS PA,ALISON J MCMILLIAN DDS MS PA,1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619031440,"MCMILLIAN, ALISON, JEANETTE",1126 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 37 , 66 , 67 ," $10,160.64 ",,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619033164,"TEOH, SU, WOOI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 57 , 73 , 114 ,$#,,
MEDICAID DIRECT,1164668505,SU WOOI TEOH MD PA,SU WOOI TEOH MD PA,3824 N ELM ST STE 201 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619033164,"TEOH, SU, WOOI",3824 N ELM ST STE 201 GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 31 , 33 , 62 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619033164,"TEOH, SU, WOOI",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619033164,"TEOH, SU, WOOI",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1619034097,"MOIR, RONALD, JEFFREY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 104 , 112 , 133 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619034097,"MOIR, RONALD, JEFFREY",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 33 , 35 ,$#,,
MEDICAID DIRECT,1427125269,GOLDSBORO PEDIATRICS PA,GOLDSBORO PEDIATRICS PA,2706 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1619040532,"NICKENS, LARRY, COBB",327 HWY 55 W   MT OLIVE NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1992192694,UNC PHYSICIANS NETWORK GROUP PRACTI,GARNER FAMILY PRACTICE,801 POOLE DR   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1619041233,"FERENCE VALENTA, MARY, JEAN",801 POOLE DR   GARNER NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 30 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619042892,"DIGIOVANNI, RUTH, NORMAN",2301 ERWIN RD   DURHAM NC,032,Durham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1619045275,ROCKINGHAM COUNTY CONSOLIDATED SCHO,ROCKINGHAM COUNTY SCHOOLS,511 HARRINGTON HWY   EDEN NC,079,Rockingham,251300000X,Agencies,Local Education Agency (LEA),,1619045275,ROCKINGHAM COUNTY CONSOLIDATED SCHO,511 HARRINGTON HWY   EDEN NC,079,Rockingham,251300000X,Agencies,Local Education Agency (LEA),, 446 ," 7,310 "," 7,454 "," $313,233.33 ",,
MEDICAID DIRECT,1619047123,MCDOWELL ASSISTED LIVING LLC,MCDOWELL ASSISTED LIVING LLC,5235 NC 226 S   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619047123,MCDOWELL ASSISTED LIVING LLC,5235 NC 226 S   MARION NC,059,McDowell,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 45 ," 5,428 "," 5,428 "," $411,794.28 ",,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619048782,"MCDONELL, ANNE, ASHLEY",3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1619049939,CAROLINA ENDOSCOPY CENTER MONROE,CAROLINA ENDOSCOPY CENTER MONROE,1663 CAMPUS PARK DR STE A MONROE NC,090,Union,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1619049939,CAROLINA ENDOSCOPY CENTER MONROE,1663 CAMPUS PARK DR STE A MONROE NC,090,Union,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 30 , 33 , 43 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3480 WAKE FOREST RD STE 502 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619051505,"PORTENIER, DANA, DALE",3480 WAKE FOREST RD STE 520 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619051505,"PORTENIER, DANA, DALE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,407 CRUTCHFIELD ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619051505,"PORTENIER, DANA, DALE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 20 , 27 , 27 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619051505,"PORTENIER, DANA, DALE",TRENT DR DUKE HOSPITAL SOUTH DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619051505,"PORTENIER, DANA, DALE",3643 N ROXBORO ST   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 16 , 19 , 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619052693,"GWERTZMAN, ALAN, RANDALL",433 MCALISTER RD   LINCOLNTON NC,055,Lincoln,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 22 , 25 ,$#,,
MEDICAID DIRECT,1013086321,EAGLE PHYSICIANS AND ASSOCIATES PA,~,5500 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619055548,"QUINLAN, AVELINE, FAYANNE",5500 W FRIENDLY AVE STE 200 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 16 , 37 ,$#,,
MEDICAID DIRECT,1013781400,SPARTANBURG MEDICAL CENTER,MEDICALGRPOFTHECAROLINAS-CARDIOLOGY-SPARTANBURG,1083 BOILING SPRINGS RD   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619060357,"CAMPBELL, LESLIE, ANNE",709 N JUSTICE ST STE A HENDERSONVILLE NC,045,Henderson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1619060845,FUTRELL PHARMACY SERVICE INC,FUTRELL PHARMACY SERVICES,124 N MAIN ST 124 S MAIN ST RICH SQUARE NC,066,Northampton,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1619060845,FUTRELL PHARMACY SERVICE INC,124 N MAIN ST 124 S MAIN ST RICH SQUARE NC,066,Northampton,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619063450,"DUKOWICZ, ANDREW, CHRISTOPHER",1032 FLEMING ST   HENDERSONVILLE NC,045,Henderson,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619063450,"DUKOWICZ, ANDREW, CHRISTOPHER",15 TURTLE CREEK DR   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 31 , 34 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619063450,"DUKOWICZ, ANDREW, CHRISTOPHER",191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 55 , 76 , 98 ,$#,,
MEDICAID DIRECT,1326037680,DIGESTIVE HEALTH PARTNERS PA,DIGESTIVE HEALTH PARTNERS PA,191 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619063450,"DUKOWICZ, ANDREW, CHRISTOPHER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619063690,"EISENBERG, NELL, BARBARA",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619063690,"EISENBERG, NELL, BARBARA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 25 , 77 , 90 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619063690,"EISENBERG, NELL, BARBARA",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619063724,"WHEELER, NAMRATA, PAI",1900 SCOTT AVE STE 200 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619063773,"JONES, SUSANNE, NEWMAN",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,4300 NC HIGHWAY 49 S   HARRISBURG NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619063773,"JONES, SUSANNE, NEWMAN",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1403 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619063773,"JONES, SUSANNE, NEWMAN",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,1075 E HUDSON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619063773,"JONES, SUSANNE, NEWMAN",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,5225 POPLAR TENT RD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619063773,"JONES, SUSANNE, NEWMAN",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,10515 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619063773,"JONES, SUSANNE, NEWMAN",7920 SAM FURR RD   HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1548409626,ACTIVCARE PHYSICAL THERAPY LLC,PIVOT PHYSICAL THERAPY OF CAROLINA,4109 WAKE FOREST RD STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619065596,"PORATH, RACHELLE, KELLY",166 SPRINGBROOK AVE STE 201 CLAYTON NC,051,Johnston,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 39 , 131 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1619066040,"HINES, JONATHAN, STEELE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1124 GALLERY PARK BLVD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619066040,"HINES, JONATHAN, STEELE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619066040,"HINES, JONATHAN, STEELE",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 55 , 86 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619066040,"HINES, JONATHAN, STEELE",1124 GALLERY PARK LN   WILMINGTON NC,065,New Hanover,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 37 , 87 , 133 ,$#,,
MEDICAID DIRECT,1619070380,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05545,1115 US HIGHWAY 64   MANTEO NC,028,Dare,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1619070380,NORTH CAROLINA CVS PHARMACY LLC,1115 US HIGHWAY 64   MANTEO NC,028,Dare,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1619070380,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05545,1115 US HIGHWAY 64   MANTEO NC,028,Dare,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1619070380,NORTH CAROLINA CVS PHARMACY LLC,1115 US HIGHWAY 64   MANTEO NC,028,Dare,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1619070380,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05545,1115 US HIGHWAY 64   MANTEO NC,028,Dare,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1619070380,NORTH CAROLINA CVS PHARMACY LLC,1115 US HIGHWAY 64   MANTEO NC,028,Dare,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1619070489,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03895,4240 S MAIN ST   FARMVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1619070489,NORTH CAROLINA CVS PHARMACY LLC,4240 S MAIN ST   FARMVILLE NC,074,Pitt,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1619070489,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 03895,4240 S MAIN ST   FARMVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1619070489,NORTH CAROLINA CVS PHARMACY LLC,4240 S MAIN ST   FARMVILLE NC,074,Pitt,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1396907903,THE PEDIATRIC PRACTICE,CAPE FEAR VALEY PEDIATRIC ENDOCRINOLOGY,101 ROBESON ST STE 410 FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619074408,"CORDERO, BRUNILDA",101 ROBESON ST STE 410 FAYETTEVILLE NC,026,Cumberland,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 46 , 70 , 84 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619074531,"BLANCO, OMAR, ANORICO",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine,#,#,#,$#,,
MEDICAID DIRECT,1821396326,UNC PHYSICIANS NETWORK LLC,REX PRIMARY CARE OF HOLLY SPRINGS,781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1619074804,"BYRD, CHRISTOPHER, SOTHORON",781 AVENT FERRY RD STE 310 HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 47 , 80 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1619075280,"PRICE, PHILIP, ADAMS",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619075280,"PRICE, PHILIP, ADAMS",210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598862732,SALISBURY PEDIATRIC ASSOCIATES PA,SALISBURY PEDIATRIC ASSOCIATES PA,129 WOODSON ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1619075470,"CRAIGHEAD, BENJAMIN, HERRON",129 WOODSON ST   SALISBURY NC,080,Rowan,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619079571,"LEE, KENNETH, STUART",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 19 , 25 , 41 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619080868,"GRAHAM, LINDA, VUNCANNON",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619080868,"GRAHAM, LINDA, VUNCANNON",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619080934,"PESCARO, DENISE",150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 20 , 35 , 35 ,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619080934,"PESCARO, DENISE",150 PARKWAY OFFICE CT STE 200 CARY NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1619081569,"BARLOW, TIMOTHY, SCOTT",~,515 KEISLER DR STE 204 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,1619081569,"BARLOW, TIMOTHY, SCOTT",515 KEISLER DR STE 204 CARY NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619082484,"HOWARD, JAMES, FRANCIS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619082575,"BARBOUR, JILL, CAUSBY",216 ASHVILLE AVE   CARY NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4101 MACON POND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619082575,"BARBOUR, JILL, CAUSBY",4101 MACON POND RD   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health,#,#,#,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1619083797,"WILLARD, BRANDI, HARTMAN",275 NC 24& 50 HWY   KENANSVILLE NC,031,Duplin,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 62 , 135 , 311 ,$#,,
MEDICAID DIRECT,1144621822,BLUE RIDGE HEALTHCARE MEDICAL GROUP,BLUE RIDGE HOSPITALISTS,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1619084407,"DREWNO, MICHAEL, GERARD",2201 S STERLING ST   MORGANTON NC,012,Burke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 21 , 57 , 57 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619084449,"ROBINETT, STEPHANIE, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619084449,"ROBINETT, STEPHANIE, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology, 45 , 102 , 103 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1619084639,"MISENAR, GARIK, TRAVERSE",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 262 , 297 , 403 ," $17,297.00 ",,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619084647,"CONDER, BEVERLY, MCCORKLE",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 50 , 50 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1619087640,"ELEY HARDY, KATINA, MARQUINETTE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619087640,"ELEY HARDY, KATINA, MARQUINETTE",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619087640,"ELEY HARDY, KATINA, MARQUINETTE",109 W RIVER ST   COLERAIN NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1619087640,"ELEY HARDY, KATINA, MARQUINETTE",109 W RIVER ST   COLERAIN NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790851004,ROANOKE CHOWAN COMMUNITY HEALTH CEN,COLERAIN PRIMARY CARE,109 W RIVER ST   COLERAIN NC,008,Bertie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619087640,"ELEY HARDY, KATINA, MARQUINETTE",109 W RIVER ST   COLERAIN NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 75 , 229 , 253 ,$#,,
MEDICAID DIRECT,1205993136,HEALTHACCESS INC,VIDANT HOME HEALTH AND HOSPICE,304 W GRANVILLE ST   WINDSOR NC,008,Bertie,251B00000X,Agencies,Case Management,,1619087640,"ELEY HARDY, KATINA, MARQUINETTE",109 W RIVER ST   COLERAIN NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497776470,ROANOKE CHOWAN COMMUNITY HEALTH CEN,MURFREESBORO PRIMARY CARE,305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619087640,"ELEY HARDY, KATINA, MARQUINETTE",109 W RIVER ST   COLERAIN NC,008,Bertie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619094547,"WALSH III, MICHAEL, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 81 , 101 , 152 ,$#,,
MEDICAID DIRECT,1619096559,INREACH,InReach,232 STILWELL OAKS CIR   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619096559,INREACH,232 STILWELL OAKS CIR   CHARLOTTE NC,060,Mecklenburg,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 651 , 651 ," $35,031.64 ",,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619098183,"DELEMOS, ANDREW, SCOTT",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619098183,"DELEMOS, ANDREW, SCOTT",1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619098183,"DELEMOS, ANDREW, SCOTT",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619098183,"DELEMOS, ANDREW, SCOTT",1025 MOREHEAD MEDICAL DR STE 300D CHARLOTTE NC,060,Mecklenburg,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology, 32 , 44 , 45 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619098183,"DELEMOS, ANDREW, SCOTT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RT0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Transplant Hepatology,#,#,#,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619100856,"DEGON, MICHAEL, STEPHEN",1333 S DICKINSON DR UNIT 230 LELAND NC,010,Brunswick,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 18 , 31 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619100856,"DEGON, MICHAEL, STEPHEN",1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 33 , 66 , 111 ,$#,,
MEDICAID DIRECT,1578158622,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR ATLANTIC UROLOGY,1814 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619100856,"DEGON, MICHAEL, STEPHEN",1099 MEDICAL CENTER DR STE 101 WILMINGTON NC,065,New Hanover,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 14 , 20 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619101367,"MILLER, KATE, KLATT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619101367,"MILLER, KATE, KLATT",131 PROVIDENCE RD STE 200 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 17 , 18 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619101367,"MILLER, KATE, KLATT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 13 , 13 , 15 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619103462,"MCELHINNEY, BRIAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1000 BRABHAM LN   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1619105517,"LEE, TIDA, KUMBALASIRI",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619105517,"LEE, TIDA, KUMBALASIRI",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 35 , 98 , 155 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619106036,"SUAREZ, ARTURO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 22 , 24 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619106036,"SUAREZ, ARTURO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 29 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619106036,"SUAREZ, ARTURO",2301 ERWIN RD   DURHAM NC,032,Durham,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619106036,"SUAREZ, ARTURO",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 14 , 29 , 43 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619107356,"GAUTAM, BIKKI",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619107356,"GAUTAM, BIKKI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 21 , 45 , 45 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619107901,"BURDEN, JULIA, GUSEV",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619109865,"MILLER, JUSTIN, PHILIP",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619109865,"MILLER, JUSTIN, PHILIP",102 BETHESDA DR   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619109865,"MILLER, JUSTIN, PHILIP",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619109865,"MILLER, JUSTIN, PHILIP",2485 HEMBY LN STE A GREENVILLE NC,074,Pitt,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619110418,"LONG, LYSA, ANN",6488 WEDDINGTON MONROE RD   WESLEY CHAPEL NC,090,Union,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619110418,"LONG, LYSA, ANN",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619110418,"LONG, LYSA, ANN",5933 BLAKENEY PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619110624,"GRIMM, LARS, JOHANNES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619110624,"GRIMM, LARS, JOHANNES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619110624,"GRIMM, LARS, JOHANNES",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619110624,"GRIMM, LARS, JOHANNES",20 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 13 , 22 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619110624,"GRIMM, LARS, JOHANNES",20 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 38 ,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619116605,"MODI, MONICA, NITIN",11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619116605,"MODI, MONICA, NITIN",4525 CAMERON VALLEY PKWY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1134443260,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,4525 CAMERON VALLEY PKWY STE 2500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619116605,"MODI, MONICA, NITIN",4525 CAMERON VALLEY PKWY STE 2500 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619116605,"MODI, MONICA, NITIN",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619116605,"MODI, MONICA, NITIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1053635185,CHARLOTTE OBSTETRIC AND GYNECOLOGIC,ATRIUM HEALTH WOMENS CARE CHARLOTTE OBGYN,1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619116605,"MODI, MONICA, NITIN",1025 MOREHEAD MEDICAL DR STE 400 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 22 , 29 , 42 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1619116605,"MODI, MONICA, NITIN",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,11530 PROVIDENCE RD STE 1500 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619116605,"MODI, MONICA, NITIN",1100 HEALING WAY STE 23 MATTHEWS NC,090,Union,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1619116639,"STAMATAROS, GEORGE",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 31 , 37 , 49 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619116639,"STAMATAROS, GEORGE",141 ROSEWOOD CENTRE DR STE 125 HOLLY SPRINGS NC,092,Wake,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 18 , 21 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619118650,"MOULDER, JANELLE, KATIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619119252,"FORTUN, CHAD, MICHAEL",9101 OCEAN HWY E   LELAND NC,010,Brunswick,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619119252,"FORTUN, CHAD, MICHAEL",1000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619119252,"FORTUN, CHAD, MICHAEL",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 35 , 54 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619119252,"FORTUN, CHAD, MICHAEL",1717 SHIPYARD BLVD STE 350 WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619119252,"FORTUN, CHAD, MICHAEL",8114 MARKET ST   WILMINGTON NC,065,New Hanover,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 20 , 21 ,$#,,
MEDICAID DIRECT,1619124401,CHARLOTTE GASTROENTEROLOGY AND HEPA,~,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1619124401,CHARLOTTE GASTROENTEROLOGY AND HEPA,15830 BALLANTYNE MEDICAL PL STE 175 CHARLOTTE NC,060,Mecklenburg,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical, 24 , 25 , 35 ,$#,,
MEDICAID DIRECT,1679905350,ABRAMS BARROWS COHEN & ASSOCIATES I,~,3326 SISKEY PKWY STE 310 MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619125184,"SANDHU, SUKHJINDER, KAUR",5700 UNIVERSITY POINTE BLVD STE 103 CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice, 201 , 275 , 980 ," $53,419.96 ",,
MEDICAID DIRECT,1407188071,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - LEXINGTON,420 N SALISBURY ST   LEXINGTON NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619125861,"BEASLEY, AMANDA, DILLON",420 N SALISBURY ST   LEXINGTON NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 77 , 233 , 245 ,$#,,
MEDICAID DIRECT,1225445331,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - THOMASVILLE,611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619125861,"BEASLEY, AMANDA, DILLON",611 RANDOLPH ST   THOMASVILLE NC,029,Davidson,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619125861,"BEASLEY, AMANDA, DILLON",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619128147,"ROSENSTEIN, DONALD, LEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 13 , 19 , 21 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619129046,"MANNS, STEPHENIE, TAKAHASHI",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619129046,"MANNS, STEPHENIE, TAKAHASHI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619129046,"MANNS, STEPHENIE, TAKAHASHI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 41 , 75 , 77 ,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619129046,"MANNS, STEPHENIE, TAKAHASHI",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619129046,"MANNS, STEPHENIE, TAKAHASHI",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619130176,"MUNGER-CLARY, HEIDI, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 37 , 53 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619131372,"DEW, RACHEL, ELIZABETH",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619131372,"DEW, RACHEL, ELIZABETH",2100 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619131372,"DEW, RACHEL, ELIZABETH",2100 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619131372,"DEW, RACHEL, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619132628,"LITTLETON, AMANDA, KENNEDY",2821 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619132628,"LITTLETON, AMANDA, KENNEDY",5175 OLD CLEMMONS SCHOOL RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 13 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619135092,"NEELAKANTA, ANUPAMA",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 22 , 22 ,$#,,
MEDICAID DIRECT,1003242876,CAROLINAS PHYSICIANS NETWORK INC,ID CONSULTANTS & INFUSION CARE SPECIALISTS,1225 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619135092,"NEELAKANTA, ANUPAMA",4539 HEDGEMORE DR STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1619135415,"MAPLES, CHRISTOPHER, JOHN",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619136942,"NEVREKAR, DIPTI, VENKATESH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 38 , 39 , 43 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1619136942,"NEVREKAR, DIPTI, VENKATESH",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619137270,"BLACKWOOD, ROBERT, TALMADGE",910 BERKSHIRE RD   SMITHFIELD NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,1425 PROMISE BEACON CIR STE 110 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619137270,"BLACKWOOD, ROBERT, TALMADGE",2076 NC HIGHWAY 42 W STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619137270,"BLACKWOOD, ROBERT, TALMADGE",2800 BLUE RIDGE RD STE 204 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 19 , 38 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1619137270,"BLACKWOOD, ROBERT, TALMADGE",603 BEAMAN ST STE 501 CLINTON NC,082,Sampson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 51 , 95 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619137312,"LIGHTFOOT, HARRELL, OBA",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619137312,"LIGHTFOOT, HARRELL, OBA",301 E WENDOVER AVE STE 411 GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 24 , 26 ,$#,,
MEDICAID DIRECT,1508850447,SCOTLAND MEMORIAL HOSPITAL INC,~,412 S JONES ST   PEMBROKE NC,078,Robeson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619139029,"BROOKS-LOCKLEAR, CHAMAINE, RENEE",412 S JONES ST   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 106 , 313 , 622 ," $15,256.02 ",,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619139052,"MARADIA, KULDEEP, KANTILAL",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619139052,"MARADIA, KULDEEP, KANTILAL",1237 HARDING PL STE 2400 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 79 , 81 , 113 ,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619139052,"MARADIA, KULDEEP, KANTILAL",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1619139052,"MARADIA, KULDEEP, KANTILAL",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619139136,"FILE, WILSON, MCCALL",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0207X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Hematology-Oncology,#,#,#,$#,,
MEDICAID DIRECT,1811920101,RALEIGH RADIOLOGY ASSOCIATES INC,RALEIGH RADIOLOGY ASSOCIATES INC,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619139649,"LLANOS, ROBERT, CARLOS",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1952527343,RALEIGH RADIOLOGY LLC,RALEIGH RADIOLOGY LLC,3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619139649,"LLANOS, ROBERT, CARLOS",3200 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619140449,"HOLDER, DAVID, MICHAEL",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619140449,"HOLDER, DAVID, MICHAEL",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619140449,"HOLDER, DAVID, MICHAEL",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 42 , 43 , 52 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619141603,"DENNEY, JEFFREY, MORGAN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619141603,"DENNEY, JEFFREY, MORGAN",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,034,Forsyth,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 151 , 183 , 244 ," $21,052.85 ",,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619142320,"COATES, PENNI, RENE",10905 PROVIDENCE RD W   CHARLOTTE NC,060,Mecklenburg,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619143245,"LESSNE, MARK, LEWIS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 90 , 103 , 156 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619143245,"LESSNE, MARK, LEWIS",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 152 , 173 , 223 ,$#,,
MEDICAID DIRECT,1619146727,FAITH ASSISTED LIVING FACILITY LLC,,3032 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619146727,FAITH ASSISTED LIVING FACILITY LLC,3032 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 162 , 162 ," $50,345.50 ",,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619149473,"MIDGETT, JOHN, DAMERON",1300 BRIDGE BARRIER RD STE 2 CAROLINA BEACH NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 39 ,$#,,
MEDICAID DIRECT,1063953602,RDMG ASSOCIATES PA,,6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619149473,"MIDGETT, JOHN, DAMERON",6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619149473,"MIDGETT, JOHN, DAMERON",6419 CAROLINA BEACH RD STE A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619150554,"JANIK, MATTHEW, JAMES",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 110 , 151 , 250 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619150950,"COHEN, SAMUEL, DAVID",1705 TARBORO ST SW   WILSON NC,098,Wilson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 13 , 14 , 14 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619150950,"COHEN, SAMUEL, DAVID",2801 WOOTEN BLVD SW STE A WILSON NC,098,Wilson,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 108 , 182 , 249 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619152923,"HAAS, SUSAN, ABIGAIL",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 28 , 52 , 105 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619152923,"HAAS, SUSAN, ABIGAIL",2311 LEWISVILLE CLEMMONS RD   CLEMMONS NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619154218,"MOUZON, JON, AUGUST",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 18 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619154218,"MOUZON, JON, AUGUST",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619157310,"MALLAVARAPU, RAVI, KIRAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619157310,"MALLAVARAPU, RAVI, KIRAN",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619157310,"MALLAVARAPU, RAVI, KIRAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1700446770,WEAVERVILLE PHYSICAL THERAPY AND WE,BIG IVY PHYSICAL THERAPY AND WELLNESS,3 GARRISON RD STE 101 WEAVERVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619165933,"TRAIL, ANGEL, ELIZABETH",3 GARRISON RD ST 101 WEAVERVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1700446770,WEAVERVILLE PHYSICAL THERAPY AND WE,BIG IVY PHYSICAL THERAPY AND WELLNESS,3 GARRISON RD STE 101 WEAVERVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619165933,"TRAIL, ANGEL, ELIZABETH",3 GARRISON RD ST 101 WEAVERVILLE NC,011,Buncombe,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619166253,"LOGAN, BRENT, JUSTIN",1814 WESTCHESTER DR STE 203 HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 23 , 48 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619167228,"BELCHER, BARRY, JUSTIN",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1962466631,JEFFERS MANN ARTMAN PEDIATRIC,~,2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619170396,"GARRISH, HAZEL, GRAY",2406 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 21 , 60 ,$#,,
MEDICAID DIRECT,1538189279,FAYETTEVILLE OTOLARYNGOLOGY,FAYETTEVILLE OTOLARYNGOLOGY HEAD AND NECK SURGERY,1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619170529,"BLANKS, DEIDRA, ARELENE",1839 QUIET CV   FAYETTEVILLE NC,026,Cumberland,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 92 , 210 , 309 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619175684,"KANG, MYUNGSA, ONE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 72 , 72 , 80 ,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1619175791,"BUSTOS, JESSICA",8001 CREEDMOOR RD STE 107 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205032984,"KIM, SEUNG, WON",~,8001 CREEDMOOR RD STE 107 RALEIGH NC,092,Wake,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,1619175791,"BUSTOS, JESSICA",8001 CREEDMOOR RD STE 107 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1710046925,SOLAS HEALTH PLLC,SOLAS HEALTH PLLC,285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1619175791,"BUSTOS, JESSICA",285 OLMSTED BLVD STE 1 PINEHURST NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 100 , 689 , 942 ," $19,356.24 ",,
MEDICAID DIRECT,1619175924,"MURRAY, RHUNELLE, CAMILLE",LIFEWORKS NEURODIAGNOSTIC CENTER PLLC,2919 BREEZEWOOD AVE STE 201 FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,1619175924,"MURRAY, RHUNELLE, CAMILLE",2919 BREEZEWOOD AVE STE 201 FAYETTEVILLE NC,026,Cumberland,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 34 , 35 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619177102,"HERRING, RICHARD, CHARLES",900 BRANCHVIEW DR NE STE 100 CONCORD NC,013,Cabarrus,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 25 , 57 , 83 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619177102,"HERRING, RICHARD, CHARLES",2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 18 , 116 , 124 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619177102,"HERRING, RICHARD, CHARLES",8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 116 , 124 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619177102,"HERRING, RICHARD, CHARLES",5970 FAIRVIEW RD STE 500 CHARLOTTE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619177102,"HERRING, RICHARD, CHARLES",15940 NORTHCROSS DR STE C HUNTERSVILLE NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#, 51 , 62 ,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619177102,"HERRING, RICHARD, CHARLES",19475 OLD JETTON RD STE 100 CORNELIUS NC,060,Mecklenburg,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619179132,"WALLACE, CONNIE, SUE",650 JULIAN RD   SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619179587,"FANDEL, SARI, NICOLE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine, 41 , 49 , 57 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619179843,"LENFESTEY, ROBERT, WILLIAM",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 11 , 44 , 44 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619179843,"LENFESTEY, ROBERT, WILLIAM",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1619180445,"SMITH, INSOOK, BAIK",INSOOK SMITH DDS PA,120B W ARBOR LN   EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice,1619180445,"SMITH, INSOOK, BAIK",120B W ARBOR LN   EDEN NC,079,Rockingham,1223G0001X,Dental Providers,Dentist,General Practice, 294 , 828 ," 3,254 "," $162,012.02 ",,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619181898,"KIEHNA, ERIN, NICOLE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 16 , 21 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619181898,"KIEHNA, ERIN, NICOLE",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 14 , 17 , 18 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619181898,"KIEHNA, ERIN, NICOLE",2711 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619181898,"KIEHNA, ERIN, NICOLE",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619184710,"REIFSCHNEIDER, KENT, LEE",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,,,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619184983,"MEEKINS, PAULINE, ELISE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619184983,"MEEKINS, PAULINE, ELISE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619184983,"MEEKINS, PAULINE, ELISE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 117 , 133 , 303 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1619184983,"MEEKINS, PAULINE, ELISE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1619184983,"MEEKINS, PAULINE, ELISE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619184983,"MEEKINS, PAULINE, ELISE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619184983,"MEEKINS, PAULINE, ELISE",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619185014,"CONNOR, KAREN, SMITH",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619185014,"CONNOR, KAREN, SMITH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,,,Unknown,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619185014,"CONNOR, KAREN, SMITH",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619187317,"PATEL, AASHISH, RAMAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1801107735,GRANVILLE HEALTH INC,Granville Heart & Vascular,103 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,193400000X,Group,Single Specialty,,1619189057,"PACCA, RICHARD, JOSEPH",102 PROFESSIONAL PARK STE C OXFORD NC,039,Granville,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 288 , 719 , 970 ," $14,066.19 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619189529,"SUMRALL, ASHLEY, LOVE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 12 , 20 , 25 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619189529,"SUMRALL, ASHLEY, LOVE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 31 , 55 , 67 ,$#,,
MEDICAID DIRECT,1023084340,GREENSBORO PATHOLOGY LLC,GREENSBORO PATHOLOGY LLC,706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619194560,"LEGOLVAN, MARK, PAUL",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZH0000X,Allopathic & Osteopathic Physicians,Pathology,Hematology, 13 , 12 , 13 ,$#,,
MEDICAID DIRECT,1265929723,AMERICAN ONCOLOGY PARTNERS PA,,551 BREVARD RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619195294,"RAAB, RACHEL, ELIZABETH",551 BREVARD RD   ASHEVILLE NC,011,Buncombe,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 58 , 89 , 245 ," $15,673.22 ",,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1619195302,"WALL, MICHELLE, DEANNA",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 22 , 30 , 54 ,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,1806 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619195302,"WALL, MICHELLE, DEANNA",1908 CAUDLE DR STE 101 MOUNT AIRY NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619208345,CENTRAL CAROLINA SKIN DERMATOLOGY,CENTRAL CAROLINA SKIN & DERMATOLOGY CENTER PA,202 FIELDALE RD   MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619197845,"BENITEZ-GRAHAM, ANA, MARIA",202 FIELDALE RD   MEBANE NC,001,Alamance,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 22 , 29 , 39 ,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,906 BINGHAM DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619199056,"MILLER, DILLON, DERRICK",906 BINGHAM DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619199056,"MILLER, DILLON, DERRICK",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,4113 CAPITOL ST STE A DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619199056,"MILLER, DILLON, DERRICK",3416 POOLE RD STE 120 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619199700,"VESS, GINA, RENEE",3480 WAKE FOREST RD STE 404 RALEIGH NC,092,Wake,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619200375,"ESTHER, THOMAS, ANTHONY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 35 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619200375,"ESTHER, THOMAS, ANTHONY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619200375,"ESTHER, THOMAS, ANTHONY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 13 , 13 ,$#,,
MEDICAID DIRECT,1336416460,PRIVATE DIAGNOSTIC CLINIC PLLC,Cancer Center,,,Unknown,193200000X,Group,Multi-Specialty,,1619200375,"ESTHER, THOMAS, ANTHONY",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619200557,"JORAN, ELIZABETH, HILL",234 CROOKED CREEK PWKY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 30 , 117 ," $11,652.93 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY STE 110 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619200557,"JORAN, ELIZABETH, HILL",234 CROOKED CREEK PWKY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619200557,"JORAN, ELIZABETH, HILL",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 61 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10207 CERNY ST STE 200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619200557,"JORAN, ELIZABETH, HILL",10207 CERNY ST   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 32 ,$#,,
MEDICAID DIRECT,1619202702,PIEDMONT MEDICAL SOLUTIONS INC,PIEDMONT MEDICAL SOLUTIONS INC,2255 LEWISVILLE CLEMMONS RD STE F CLEMMONS NC,034,Forsyth,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1619202702,PIEDMONT MEDICAL SOLUTIONS INC,2255 LEWISVILLE CLEMMONS RD STE F CLEMMONS NC,034,Forsyth,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,,,$#,,
MEDICAID DIRECT,1619202702,PIEDMONT MEDICAL SOLUTIONS INC,PIEDMONT MEDICAL SOLUTIONS INC,2255 LEWISVILLE CLEMMONS RD STE F CLEMMONS NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1619202702,PIEDMONT MEDICAL SOLUTIONS INC,2255 LEWISVILLE CLEMMONS RD STE F CLEMMONS NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 186 , 580 , 954 ," $67,343.76 ",,
MEDICAID DIRECT,1205597721,LUMBERTON CARE CLINIC PLLC,,4307 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1619202884,"CAMPBELL, TERRI, LISA DAVIS",4307 FAYETTEVILLE RD   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 84 , 141 , 335 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619204245,"CURRY, JOY, ELLIOTT",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 18 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619204245,"CURRY, JOY, ELLIOTT",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619204245,"CURRY, JOY, ELLIOTT",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619204245,"CURRY, JOY, ELLIOTT",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 53 , 122 , 158 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619204245,"CURRY, JOY, ELLIOTT",1991 FORDHAM DR STE 200 FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619207701,"THOMAS, JONATHAN, GEORGE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 70 , 110 , 146 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619209459,"SULLIVAN, MARGARET, HANCOCK",430 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619209459,"SULLIVAN, MARGARET, HANCOCK",472 RANKIN DR   MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 16 , 20 , 23 ,$#,,
MEDICAID DIRECT,1285791087,FOOTHILLS HEALTH DISTRICT,RUTHERFORD COUNTY HEALTH DEPT,221 CALLAHAN KOON RD   SPINDALE NC,081,Rutherford,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619209459,"SULLIVAN, MARGARET, HANCOCK",1633 SUGAR HILL RD STE 1 MARION NC,059,McDowell,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 18 , 26 , 64 ,$#,,
MEDICAID DIRECT,1609342815,MH MISSION HOSPITAL MCDOWELL LLLP,,472 RANKIN DR   MARION NC,059,McDowell,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619209459,"SULLIVAN, MARGARET, HANCOCK",184 ALLENDALE DR   FOREST CITY NC,081,Rutherford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619210184,"MUTHERSBAUGH, HANNAH, COX",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 50 , 50 , 58 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619210770,"KOMISAROW, JORDAN, MICHAEL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619210770,"KOMISAROW, JORDAN, MICHAEL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619210770,"KOMISAROW, JORDAN, MICHAEL",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#, 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619210770,"KOMISAROW, JORDAN, MICHAEL",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 18 , 56 , 65 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619214756,"ZUFALL, ERIC, JON",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 23 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619214756,"ZUFALL, ERIC, JON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619214756,"ZUFALL, ERIC, JON",6909 PROSPERITY CHURCH RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 28 , 56 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619218427,"CHANG, DANIEL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 11 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619219169,"WEINSTEIN, NONNA, KOZLENKO",707 MEMORIAL BLVD   CONCORD NC,013,Cabarrus,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619219573,"NIKITINA, YANA, ANATOLYEVNA",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 80 , 287 , 287 ," $15,854.98 ",,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619219573,"NIKITINA, YANA, ANATOLYEVNA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619219573,"NIKITINA, YANA, ANATOLYEVNA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619219763,"KIPER, CARMEN, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619219763,"KIPER, CARMEN, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619219763,"KIPER, CARMEN, ELIZABETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology, 65 , 83 , 113 ,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1619219862,"PEARSON, COURTNEY, SCHNELL",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740889864,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE SOUTHERN PINES,1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1619219862,"PEARSON, COURTNEY, SCHNELL",1690 US HIGHWAY 1 S STE 100 SOUTHERN PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1619219862,"PEARSON, COURTNEY, SCHNELL",7473-C HWY 22   WHISPERING PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902323561,FHPG LLC,FIRSTHEALTH FAMILY MEDICINE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1619219862,"PEARSON, COURTNEY, SCHNELL",7473-C HWY 22   WHISPERING PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 19 ,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1619219862,"PEARSON, COURTNEY, SCHNELL",1602 WESTOVER DR   SANFORD NC,053,Lee,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619220944,"MYINT, MYO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619226073,"BACON, MADERICA",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619228137,"COMBS, JENNIFER, EILEEN",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619228137,"COMBS, JENNIFER, EILEEN",125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619228632,"GARCIA-GRIDER, ANGELA, MARIE",6431 OLD PLANK RD   HIGH POINT NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 131 , 247 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619228632,"GARCIA-GRIDER, ANGELA, MARIE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306273768,THE CHARLOTTE-MECKLENBURG HOSPITAL,NORTHEAST PEDIATRIC PULMONOLOGY,100 MEDICAL PARK DR STE 310 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1619229879,"MENDOZA, MICHELLE, MARIE",100 MEDICAL PARK DR STE 310D CONCORD NC,013,Cabarrus,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 42 , 68 , 85 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619231321,"TOWNSEND, WILLIAM, BLAIR",125 QUEENS RD STE 420 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1085 NE GATEWAY CT NE STE 180   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1619231321,"TOWNSEND, WILLIAM, BLAIR",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 17 , 33 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619231321,"TOWNSEND, WILLIAM, BLAIR",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 11 , 16 , 28 ,$#,,
MEDICAID DIRECT,1669404208,UROLOGY SPECIALISTS OF THE CAROLINA,~,1518 E 3RD ST STE 250 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619231321,"TOWNSEND, WILLIAM, BLAIR",325 HAWTHORNE LN STE 300 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 32 , 64 , 116 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619231594,"IMBARRATO, GREGORY, JAMES",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 43 , 66 , 107 ," $11,657.44 ",,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619231594,"IMBARRATO, GREGORY, JAMES",2801 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1760105407,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SPINE CLINICS,190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619231594,"IMBARRATO, GREGORY, JAMES",330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619231594,"IMBARRATO, GREGORY, JAMES",190 KIMEL PARK DR STE 140 WINSTON SALEM NC,034,Forsyth,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619234812,"TREXLER, STEPHANIE, THERESE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 17 , 19 , 19 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619234812,"TREXLER, STEPHANIE, THERESE",1730 KERNERSVILLE MEDICAL PKWY STE 104 KERNERSVILLE NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1124300876,OBHG NORTH CAROLINA PC,,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619234812,"TREXLER, STEPHANIE, THERESE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619235017,"SWAMY, RAKSHA",201 E GROVER ST   SHELBY NC,023,Cleveland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 53 , 144 , 146 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619235132,"PETTIGREW, ERICA, MARIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 17 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,590 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619235132,"PETTIGREW, ERICA, MARIE",590 MANNING DR   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 28 , 45 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619235132,"PETTIGREW, ERICA, MARIE",2501 HOMESTEAD RD   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 24 , 32 , 74 ,$#,,
MEDICAID DIRECT,1760576722,ORANGE COUNTY,ORANGE COUNTY HEATLH DEPT,300 W TRYON ST   HILLSBOROUGH NC,068,Orange,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619235132,"PETTIGREW, ERICA, MARIE",300 W TRYON ST   HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 42 , 66 , 146 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619235280,"PUSATERI, CHAD, RICHARD",2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619235280,"PUSATERI, CHAD, RICHARD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,2301 ROBESON ST STE 203 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619235280,"PUSATERI, CHAD, RICHARD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619237690,"HOAG, BRYAN, MICHAEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 317 , 365 , 447 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619237690,"HOAG, BRYAN, MICHAEL",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 379 , 435 , 566 ," $10,795.45 ",,
MEDICAID DIRECT,1508001009,COLUMBUS REGIONAL HEALTH NETWORK,CAROLINAS HOSPITALIST GROUP - COLUMBUS,500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1619237971,"SRIDHARAN, PRASANNA",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255632006,CAROLINAEAST PHYSICIANS,CAROLINAEAST INTERNAL MEDICINE,137 MEDICAL LN   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1619238169,"CHECK, NICOLE, RENAE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1972079127,MH TRANSYLVANIA REGIONAL HOSPITAL L,,360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619239365,"NGUYEN, HOA-DUNG, THI",360 HOSPITAL DR STE 102 CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1619239670,"ATTREYA, AKASH, KANWAL",430 RANKIN DR   MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1619239670,"ATTREYA, AKASH, KANWAL",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1619239670,"ATTREYA, AKASH, KANWAL",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1619242377,"MARANO, CYNTHIA, LOUISE",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699723791,CAROLINA ANESTHESIA ASSOC PA,CAROLINA ANESTHESIA ASSOCIATES PA,3313 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619242377,"MARANO, CYNTHIA, LOUISE",242A 9TH AVENUE DR NE   HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619243037,"TURNER, NICHOLAS, ANDREW",1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619243037,"TURNER, NICHOLAS, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 11 , 17 , 18 ,$#,,
MEDICAID DIRECT,1811072812,FAYETTEVILLE AREA HEALTH EDUCATION,SOUTHERN REGIONAL AHEC,1601 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619243037,"TURNER, NICHOLAS, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619243037,"TURNER, NICHOLAS, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619243037,"TURNER, NICHOLAS, ANDREW",2301 ERWIN RD   DURHAM NC,032,Durham,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 18 , 40 , 48 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619243037,"TURNER, NICHOLAS, ANDREW",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1619244084,GREENE COUNTY HEALTH CARE INC,PAMLICO COMMUNITY HEALTH CENTER,313 MAIN ST   BAYBORO NC,069,Pamlico,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619244084,GREENE COUNTY HEALTH CARE INC,313 MAIN ST   BAYBORO NC,069,Pamlico,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 26 , 36 , 37 ,$#,,
MEDICAID DIRECT,1245429794,RICHARD A DOUGHERTY MD PA,~,10450 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619244241,"MOHSENI, RAHELE",10450 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 76 , 228 ,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619246394,"HALL, KRISTEN, NICOLE",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1649834102,WAKEMED SPECIALISTS GROUP LLC,WAKEMED NEONATOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619246394,"HALL, KRISTEN, NICOLE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1619253747,ESTHER WAMUYU MURIUKI,WAMUS FAMILY CARE HOME,1251 SHELTER CV   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619253747,ESTHER WAMUYU MURIUKI,1251 SHELTER CV   WINSTON SALEM NC,034,Forsyth,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 259 , 259 ," $22,764.64 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619254901,"SHEETS, JOSHUA, ASHTON",621 S MAIN ST STE 200 REIDSVILLE NC,079,Rockingham,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619258530,"ALTUN, ERSAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619258530,"ALTUN, ERSAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619258530,"ALTUN, ERSAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 375 , 435 , 503 ," $10,299.61 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,210 S CAMERON ST   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1619258530,"ALTUN, ERSAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619263621,"BAHEN, HOLLIE, LE'ANN",6011 FAYETTEVILLE RD STE 102 DURHAM NC,032,Durham,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619263753,"GRUBEY, JAMIE, SEGEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619263753,"GRUBEY, JAMIE, SEGEL",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619263753,"GRUBEY, JAMIE, SEGEL",102 BETHESDA DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 11 , 12 , 18 ,$#,,
MEDICAID DIRECT,1912957606,EASTERN CAROLINA ENT HEAD NECK SU,,850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619263753,"GRUBEY, JAMIE, SEGEL",850 JOHNS HOPKINS DR   GREENVILLE NC,074,Pitt,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 71 , 127 , 252 ,$#,,
MEDICAID DIRECT,1619265915,REEMS CREEK VALLEY FIRE DEPARTMENT,REEMS CREEK VALLEY FIRE DEPARTMENT INC,730 REEMS CREEK RD   WEAVERVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport,1619265915,REEMS CREEK VALLEY FIRE DEPARTMENT,730 REEMS CREEK RD   WEAVERVILLE NC,011,Buncombe,3416L0300X,Transportation Services,Ambulance,Land Transport, 48 , 54 , 97 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619266566,"ZIMMERMAN, PAUL, ERIC",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0002X,Allopathic & Osteopathic Physicians,Internal Medicine,Hospice and Palliative Medicine, 15 , 29 , 34 ,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619266913,"CANHAM, COLIN, DOUGLAS",3793 MCDOWELL LN STE 100 LITTLE RIVER SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619266913,"CANHAM, COLIN, DOUGLAS",115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 14 , 23 , 38 ,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619266913,"CANHAM, COLIN, DOUGLAS",3980 HIGHWAY 9 E STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619267267,"BLUMER, ADAM, RIVERS",115 POWELL MILL RD   SPARTANBURG SC,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 31 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,160 TURNBERRY WAY   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1619267267,"BLUMER, ADAM, RIVERS",115 POWELL MILL RD   SPARTANBURG SC,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,7482 WATERSIDE CROSSING BLVD STE 101 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619267267,"BLUMER, ADAM, RIVERS",1325 DRAYTON RD   SPARTANBURG SC,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#, 24 ,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,4 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619267267,"BLUMER, ADAM, RIVERS",115 POWELL MILL RD   SPARTANBURG SC,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1972554186,DRS FARRELL FARRELL NALE COOK KAPIT,CAROLINAS CENTER FOR ORAL & FACIAL SURGERY,5550 77 CENTER DR STE 320 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619267267,"BLUMER, ADAM, RIVERS",115 POWELL MILL RD   SPARTANBURG SC,101,Out of State <= 40 miles,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",167 MOORE RD   KING NC,085,Stokes,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 17 , 21 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 45 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3015 MAPLEWOOD AVE STE 200 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,121 MEDICAL DR   ADVANCE NC,030,Davie,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619267523,"HEMP, JEANETTE, HANKINS",2705 HENRY ST   GREENSBORO NC,041,Guilford,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",134 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 15 , 20 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",15830 BALLANTYNE MEDICAL PL STE 275 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 29 , 58 ,$#,,
MEDICAID DIRECT,1891764320,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH HEART AND VASCULAR INSTITUTE,301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",301 HAWTHORNE LN STE 200 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 24 , 30 , 39 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619268430,"JAIN, ASHISH, KUMAR",125 QUEENS RD STE 250 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 113 , 152 , 243 ,$#,,
MEDICAID DIRECT,1881305605,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE AND OBSTETRICS,680 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1619268471,"LAMPHIER, JONA, MARIE",680 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881305605,HUGH CHATHAM MEMORIAL HOSPITAL,HUGH CHATHAM FAMILY MEDICINE AND OBSTETRICS,680 PARKWOOD MEDICAL PARK   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1619268471,"LAMPHIER, JONA, MARIE",546 WINSTON RD   JONESVILLE NC,099,Yadkin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619268893,"HAMSHER, CARLYLE, PETERS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine,#,#, 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619268893,"HAMSHER, CARLYLE, PETERS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207LP2900X,Allopathic & Osteopathic Physicians,Anesthesiology,Pain Medicine, 57 , 108 , 155 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619268893,"HAMSHER, CARLYLE, PETERS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619268893,"HAMSHER, CARLYLE, PETERS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 20 , 24 , 36 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619269347,"NEAL, HALEY, AMANDA",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 33 , 44 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619269537,"BALIKCIOGLU, PINAR, GUMUS",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619269537,"BALIKCIOGLU, PINAR, GUMUS",2301 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 36 , 51 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619269537,"BALIKCIOGLU, PINAR, GUMUS",2100 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#, 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619269537,"BALIKCIOGLU, PINAR, GUMUS",3000 ERWIN RD   DURHAM NC,032,Durham,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619271681,"WINFREE, MICHAEL, RAY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 21 , 25 , 53 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619271681,"WINFREE, MICHAEL, RAY",5145 SELLERS RD   SHALLOTTE NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 95 , 112 , 233 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619271681,"WINFREE, MICHAEL, RAY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619272143,"WALKER, CASEY, BRYANT",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1619272143,"WALKER, CASEY, BRYANT",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1619272143,"WALKER, CASEY, BRYANT",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1316232598,RHA HEALTH SERVICES INC,RHA HEALTH SERVICES INC,2415 MORGANTON BLVD SW STE 100 LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1619275260,"POWELL, PAUL, MARTIN",2415 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619276888,"MERVAK, BENJAMIN, MARCUS",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1619276920,"MOON, JIHUN",JIHUN MOON DDS PLLC,255 N 2ND ST   ALBEMARLE NC,084,Stanly,1223G0001X,Dental Providers,Dentist,General Practice,1619276920,"MOON, JIHUN",255 N 2ND ST   ALBEMARLE NC,084,Stanly,1223G0001X,Dental Providers,Dentist,General Practice, 49 , 110 , 280 ," $14,919.53 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619277357,"LAYDEN, SANDRA, JORDAN",314 W QUEEN ST   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 27 , 28 , 31 ,$#,,
MEDICAID DIRECT,1902412729,CENTENNIAL HOUSING & COMMUNITY SERV,WASHINGTON REGIONAL MEDICAL CENTER,958 US HIGHWAY 64 E   PLYMOUTH NC,094,Washington,193200000X,Group,Multi-Specialty,,1619277357,"LAYDEN, SANDRA, JORDAN",314 W QUEEN ST   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619280179,"MAGAR, JAMES, EMMETT",~,110 W KING ST STE 2 KINGS MOUNTAIN NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,1619280179,"MAGAR, JAMES, EMMETT",110 W KING ST STE 2 KINGS MOUNTAIN NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,#, 37 , 38 ,$#,,
MEDICAID DIRECT,1629468616,CHIROPRACTIC PHYSICIANS OF THE CARO,CHIROPRACTIC PHYSICIANS OF THE CAROLINAS - KINGS M,110 W KING ST STE 2 KINGS MOUNTAIN NC,023,Cleveland,193400000X,Group,Single Specialty,,1619280179,"MAGAR, JAMES, EMMETT",110 W KING ST STE 2 KINGS MOUNTAIN NC,023,Cleveland,111N00000X,Chiropractic Providers,Chiropractor,,#, 103 , 105 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619282282,"YANGUAS, ROBIN, RENEE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1043518228,APOGEE MEDICAL GROUP NORTH CAROLINA,APOGEE MEDICAL GROUP NORTH CAROLINA,317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1619282282,"YANGUAS, ROBIN, RENEE",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3650 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619282365,"JYOTHIDASAN, AMUDHAN",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 13 ,$#,,
MEDICAID DIRECT,1831165802,CAPE FEAR CARDIOLOGY ASSOCIATES,CAPE FEAR CARDIOLOGY ASSOCIATES,3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619282365,"JYOTHIDASAN, AMUDHAN",3634 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 261 , 662 ," 1,064 "," $34,504.44 ",,
MEDICAID DIRECT,1619282910,ATLANTIC HEALTH GROUP INC,ATLANTIC HOME STAFFING,141 TECHNOLOGY DR STE C GARNER NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,,1619282910,ATLANTIC HEALTH GROUP INC,141 TECHNOLOGY DR STE C GARNER NC,051,Johnston,253Z00000X,Agencies,In Home Supportive Care,, 77 ," 5,914 "," 5,914 "," $511,111.11 ",,
MEDICAID DIRECT,1619283249,PROVIDENCE HEALTH CARE STAFFING AND,PROVIDENCE HEALTH CARE STAFFING AND SENIOR CARE,1040 RANDOLPH ST STE 42 THOMASVILLE NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,,1619283249,PROVIDENCE HEALTH CARE STAFFING AND,1040 RANDOLPH ST STE 42 THOMASVILLE NC,029,Davidson,253Z00000X,Agencies,In Home Supportive Care,, 26 ," 4,149 "," 4,188 "," $560,806.20 ",,
MEDICAID DIRECT,1619284031,"TANNER, ELIZABETH, LEIGH",~,408 DEPOT ST STE 120 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice,1619284031,"TANNER, ELIZABETH, LEIGH",408 DEPOT ST STE 120 ASHEVILLE NC,011,Buncombe,1223G0001X,Dental Providers,Dentist,General Practice, 25 , 46 , 124 ,$#,,
MEDICAID DIRECT,1558371286,CAROLINA KIDS PEDIATRIC,CAROLINA KIDS PEDIATRIC ASSOCIATES PLLC,2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619286291,"EMMET, MARJA-LEENA",2605 BLUE RIDGE RD STE 100 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 11 , 18 , 28 ,$#,,
MEDICAID DIRECT,1396481495,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN BONNIE LANE,44 BONNIE LN   SYLVA NC,050,Jackson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619287265,"TURNER, CECIL, ALEXANDER",293 HOSPITAL RD STE B SYLVA NC,050,Jackson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1437593787,BLUE RIDGE COMMUNITY HEALTH SERVICE,HENDERSONVILLE FAMILY HEALTH CENTER,709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619287265,"TURNER, CECIL, ALEXANDER",709 N JUSTICE ST STE B HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 15 , 30 , 30 ,$#,,
MEDICAID DIRECT,1225029051,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE COMMUNITY HEALTH SERVICES INC,2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619287265,"TURNER, CECIL, ALEXANDER",2579 CHIMNEY ROCK RD   HENDERSONVILLE NC,045,Henderson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 34 , 68 , 68 ,$#,,
MEDICAID DIRECT,1619288008,CHAMPION FAMILY HEALTHCARE SERVICES,CHAMPION HOME CARE AGENCY,1410 MILLGATE DR STE A   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1619288008,CHAMPION FAMILY HEALTHCARE SERVICES,1410 MILLGATE DR STE A   WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 13 ," 1,808 "," 1,809 "," $222,933.80 ",,
MEDICAID DIRECT,1619288008,CHAMPION FAMILY HEALTHCARE SERVICES,CHAMPION HOME CARE AGENCY,1410 MILLGATE DR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1619288008,CHAMPION FAMILY HEALTHCARE SERVICES,1410 MILLGATE DR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 11 , 512 , 512 ," $72,819.28 ",,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 HEALING WAY   MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1619288354,"MOGILI, KALYAN KUMAR REDDY",1000 HEALING WAY   MATTHEWS NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366799249,CAROLINAS PHYSICIANS NETWORK INC,Carolinas Hospitalist Group Union,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1619288354,"MOGILI, KALYAN KUMAR REDDY",600 HOSPITAL DR   MONROE NC,090,Union,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 160 , 160 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619289428,"VESTAL, MATTHEW, LEPORE",3000 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619289428,"VESTAL, MATTHEW, LEPORE",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619289428,"VESTAL, MATTHEW, LEPORE",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,, 38 , 46 , 54 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619289428,"VESTAL, MATTHEW, LEPORE",2301 ERWIN RD   DURHAM NC,032,Durham,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1619290731,"ROCA, WENDY, GLADYS",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1619291903,PHILLIPS HOME HEALTH CARE,Phillips Home Health Care,3621 AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1619291903,PHILLIPS HOME HEALTH CARE,3621 AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 59 ," 14,570 "," 16,363 "," $2,208,265.89 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619292109,"HILL, NATHAN, CARY",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 24 , 39 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619292109,"HILL, NATHAN, CARY",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 88 , 136 , 240 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619293701,"WYNNE, JOHN, PATRICK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 81 , 187 , 227 ," $20,077.44 ",,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619293701,"WYNNE, JOHN, PATRICK",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619294097,"CHIEMPRABHA, ARLENE, ROSE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 27 , 88 , 88 ,$#,,
MEDICAID DIRECT,1669725198,BRUNSWICK COMMUNITY HOSPITAL LLC,~,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1619297371,"CHAMBERS, APRIL, DYAN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619297579,"COHEN, CERRONE, AKIL",2100 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 31 , 37 , 43 ,$#,,
MEDICAID DIRECT,1740869395,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE SPECIALTY CARE,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619297579,"COHEN, CERRONE, AKIL",2100 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619297579,"COHEN, CERRONE, AKIL",2100 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619297595,"MEHTA, HARDIK, JASWANTLAL",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619297595,"MEHTA, HARDIK, JASWANTLAL",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 25 , 31 , 31 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619297595,"MEHTA, HARDIK, JASWANTLAL",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 58 , 77 , 97 ,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619297595,"MEHTA, HARDIK, JASWANTLAL",125 QUEENS RD STE 200 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1811610058,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619297595,"MEHTA, HARDIK, JASWANTLAL",10030 GILEAD RD STE 201 HUNTERSVILLE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619297876,"SARKAR, JOY",125 QUEENS RD STE 430 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 30 , 30 ,$#,,
MEDICAID DIRECT,1922198977,HIGH POINT PEDIATRICS,~,404 WESTWOOD AVE STE 103 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1619298551,"MILLS, RACHEL, JUSTUS",404 WESTWOOD AVE STE 103 HIGH POINT NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 23 , 34 , 110 ,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1750317921,STEELE CREEK URGENT CARE,ATRIUM HEALTH URGENT CARE STEELE CREEK,9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",9332 S TRYON ST   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477100683,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",9325 JW CLAY BLVD STE 221 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1932722980,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",2041 SOUTH BLVD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1497762686,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",5727 PROSPERITY CROSSING DR STE 1100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1508892746,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",12905 ROSEDALE HILL AVE   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871965038,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1802 E MAIN ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1437168937,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1467481127,EASTLAND URGENT CARE,ATRIUM HEALTH URGENT CARE EASTLAND,5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",5717 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942679329,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,703 LEONARD AVE   ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1497256143,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",3320 ROBINWOOD RD STE 100 GASTONIA NC,036,Gaston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1821613480,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",8815 CHRISTENBURY PKWY STE 30 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1902049190,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",1090 NE GATEWAY CT NE STE 202 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1770925703,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",1010 E DIXON BLVD STE B SHELBY NC,023,Cleveland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477814622,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",340 JAKE ALEXANDER BLVD W STE 105 SALISBURY NC,080,Rowan,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 31 ,$#,,
MEDICAID DIRECT,1851649180,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",6030 W HIGHWAY 74 STE A INDIAN TRAIL NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912255241,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,613 E ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1619301231,"DROSINIS, DONNA, JEAN",613 E ROOSEVELT BLVD   MONROE NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL OAK ISLAND,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619301926,"COBB, DEBORAH, ELIZABETH",4222 LONG BEACH RD SE   SOUTHPORT NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL OAK ISLAND,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619301926,"COBB, DEBORAH, ELIZABETH",4700 E OAK ISLAND DR   OAK ISLAND NC,010,Brunswick,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1235405358,J ARTHUR DOSHER MEMORIAL HOSPITAL,DOSHER MEDICAL OAK ISLAND,4700 E OAK ISLAND DR STE F OAK ISLAND NC,010,Brunswick,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619301926,"COBB, DEBORAH, ELIZABETH",1007 NC HIGHWAY 150 W STE G SUMMERFIELD NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619309135,"HATALA, LARISSA, MARIA",1710 KERNERSVILLE MEDICAL PKWY STE 220 KERNERSVILLE NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619309135,"HATALA, LARISSA, MARIA",3641 WESTGATE CENTER CIR STE A WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 36 , 65 , 82 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619309135,"HATALA, LARISSA, MARIA",3641 WESTGATE CENTER CIR STE A WINSTON SALEM NC,034,Forsyth,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 14 , 38 , 45 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619309135,"HATALA, LARISSA, MARIA",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 33 , 54 , 66 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619309564,"GUSTAFSON, CAMELYN, TIMBERLAKE",1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619311305,"LEVERENZ, DAVID, LYNN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619311305,"LEVERENZ, DAVID, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619311305,"LEVERENZ, DAVID, LYNN",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 14 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619311305,"LEVERENZ, DAVID, LYNN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 26 , 37 , 54 ,$#,,
MEDICAID DIRECT,1255054623,ASHE MULTISPECIALTY GROUP LLC,ASHE WOMEN AND CHILDRENS HEALTH,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193200000X,Group,Multi-Specialty,,1619311461,"CRANE, ALICIA, MARIE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 35 , 70 , 95 ,$#,,
MEDICAID DIRECT,1427048172,ASHE MEMORIAL HOSPITAL INC,AMH MOUNTAIN FAMILY CARE CENTER,310 HOSPITAL AVENUE   JEFFERSON NC,005,Ashe,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619311461,"CRANE, ALICIA, MARIE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1619313202,"JACOBS, NICOLE",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,2084P0804X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Child & Adolescent Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1619313277,123 GO KIDZ,123 GO KIDZ,2339 SHORE DR   MOREHEAD CITY NC,016,Carteret,251S00000X,Agencies,Community/Behavioral Health,,1619313277,123 GO KIDZ,2339 SHORE DR   MOREHEAD CITY NC,016,Carteret,251S00000X,Agencies,Community/Behavioral Health,,#, 310 , 310 ," $23,376.60 ",,
MEDICAID DIRECT,1154196020,FD BILLING LLC,WAVERLY ORAL SURGERY,11840 SOUTHMORE DR STE 150 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619314556,"SOUNG, GEORGE, YI-JAAN",6 N POINTE CT STE 101 GREENSBORO NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 244 , 343 ," 1,615 "," $210,103.13 ",,
MEDICAID DIRECT,1700236023,G ABRAMS & R COHEN XV PC,,11840 SOUTHMORE DR STE 150 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619314556,"SOUNG, GEORGE, YI-JAAN",6 N POINTE CT STE 101 GREENSBORO NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery,#,,,$#,,
MEDICAID DIRECT,1255171104,ROUPAS SULLIVAN TREMONT PLLC-2,WEST BALLANTYNE DENTISTRY,14746 LANCASTER HWY # B PINEVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619314556,"SOUNG, GEORGE, YI-JAAN",6 N POINTE CT STE 101 GREENSBORO NC,041,Guilford,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 83 , 148 , 582 ," $74,261.88 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619316429,"VOLERTAS, SOFIJA, DALIA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619316429,"VOLERTAS, SOFIJA, DALIA",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,, 15 , 21 , 38 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619316650,"DANESHMAND, ALI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619316650,"DANESHMAND, ALI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619316726,"SONNENBERG, ERIC, GRAHAM",1409 UNIVERSITY DR STE 105 BURLINGTON NC,001,Alamance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619316726,"SONNENBERG, ERIC, GRAHAM",520 N ELAM AVE   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 20 , 37 , 87 ,$#,,
MEDICAID DIRECT,1114373404,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619316726,"SONNENBERG, ERIC, GRAHAM",351 WELLESLEY TRADE LN STE 100 CARY NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255859211,MILLER AND ASSOCIATES THREE PLLC,,104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1619319134,"ERIKSSON, KURT, ALLAN",104 COLLEGE PLZ   JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 20 , 20 , 70 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619319829,"YANG, YIRAN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619319829,"YANG, YIRAN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 140 , 142 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619319829,"YANG, YIRAN",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 80 , 83 ,$#,,
MEDICAID DIRECT,1457550451,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC CHILDRENS PRIMARY AND SPECIALTY CARE AT CAROLI,6013 FARRINGTON RD STE 301 CHAPEL HILL NC,019,Chatham,193200000X,Group,Multi-Specialty,,1619321189,"ALLISON, BIANCA, ANSU",6330 QUADRANGLE DR STE 175 CHAPEL HILL NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 12 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619321189,"ALLISON, BIANCA, ANSU",101 MANNING DR   CHAPEL HILL NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619321478,"METCALF, CHRISTOPHER, JEROME",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619323474,"CLIFTON, MARGARET, RUTH",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619324035,"SELFRIDGE, JULIA, MARIE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 28 , 32 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619325503,"ANAND, RAVI",2301 ERWIN RD   DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry, 13 , 25 , 25 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619325610,"RIESTER, ALEXA, SUZANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 36 , 36 , 46 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619325610,"RIESTER, ALEXA, SUZANNE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 38 , 39 , 48 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619325610,"RIESTER, ALEXA, SUZANNE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 17 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1619325610,"RIESTER, ALEXA, SUZANNE",260 HOSPITAL DR   BREVARD NC,088,Transylvania,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619326212,"GRIMES, SARAH, BUNDRICK",624 QUAKER LN STE 100E HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 23 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619326212,"GRIMES, SARAH, BUNDRICK",624 QUAKER LN STE 100E HIGH POINT NC,041,Guilford,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619326436,"WILBURN, ANGELA, DENISE",500 ARCHDALE DR   CHARLOTTE NC,060,Mecklenburg,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1548724669,BRENTON BUNDRICK DDS PLLC,~,7204 E MARSHVILLE BLVD   MARSHVILLE NC,090,Union,193200000X,Group,Multi-Specialty,,1619327020,"BUNDRICK, BRENTON, MATTHEW",7204 E MARSHVILLE BLVD   MARSHVILLE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice, 174 , 269 , 832 ," $74,681.40 ",,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1619327434,"LEONARD, ANTHONY, PRESLEY",3312 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 25 , 35 , 52 ,$#,,
MEDICAID DIRECT,1245211333,CAROLINA EYE ASSOCIATES INC,CAROLINA EYE ASSOCIATES PA,2170 MIDLAND RD   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1619327434,"LEONARD, ANTHONY, PRESLEY",725 HIGHLAND OAKS DR STE 101 WINSTON SALEM NC,034,Forsyth,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1558817932,COMPREHENSIVE PAIN CONSULTANTS OF,,310 OVERLOOK RD SUITE B ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619327954,"MYCHAK, COLIN, WALKER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1447444559,HENDERSON COUNTY HOSPITAL CORPORATI,Pardee Medical Associates,800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1619327954,"MYCHAK, COLIN, WALKER",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 60 , 74 ,$#,,
MEDICAID DIRECT,1497944912,ST LUKES HOSPITAL INC,St Lukes Hospital Inc,101 HOSPITAL DR   COLUMBUS NC,075,Polk,193400000X,Group,Single Specialty,,1619327954,"MYCHAK, COLIN, WALKER",101 HOSPITAL DR   COLUMBUS NC,075,Polk,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619328200,"SUBEDI, CHHITIZ",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 115 , 116 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,2613 HOSPITAL RD   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1619329000,"MCNEIL, PATRICK, CHARLES",5589 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 33 , 72 ,$#,,
MEDICAID DIRECT,1326532169,FOREFRONT DERMATOLOGY SC,,5589 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1619329000,"MCNEIL, PATRICK, CHARLES",5589 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 39 , 53 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331725,"SABINO, GABRIELLE, LEE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 14 , 20 , 31 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331725,"SABINO, GABRIELLE, LEE",201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 22 , 54 , 64 ,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331725,"SABINO, GABRIELLE, LEE",10030 GILEAD RD STE 300 HUNTERSVILLE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1073235230,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PULMONOLOGY CLINICS,201 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331725,"SABINO, GABRIELLE, LEE",1918 RANDOLPH RD STE 580 CHARLOTTE NC,060,Mecklenburg,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 55 , 89 , 146 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331873,"SPIVEY, MATTHEW, GRAY",7210 VILLAGE MEDICAL CIR STE 110 CLEMMONS NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 22 , 29 , 62 ,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331873,"SPIVEY, MATTHEW, GRAY",200 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331873,"SPIVEY, MATTHEW, GRAY",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1558084772,NOVANT HEALTH MEDICAL GROUP LLC,NHMG ORTHOPEDIC CLINICS,4741 RANDOLPH RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619331873,"SPIVEY, MATTHEW, GRAY",167 MOORE RD STE 202 KING NC,085,Stokes,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 20 , 28 , 62 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619332152,"MOODY, CANDACE, JACKSON",3001 EDWARDS MILL RD SECOND FLOOR WEST RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 14 , 21 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619332152,"MOODY, CANDACE, JACKSON",932 MORREENE RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 37 , 56 , 82 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619333812,"VICK, JUDITH, BINA",3643 N ROXBORO ST   DURHAM NC,032,Durham,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 14 , 16 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1619335411,"ATKINSON, LAUREN, FAYE",4012 MENDENHALL OAKS PKWY   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 27 , 40 ,$#,,
MEDICAID DIRECT,1407355704,TRIAD PEDIATRICS PC,,2754 HWY 68 STE 111 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1619335411,"ATKINSON, LAUREN, FAYE",2754 HWY 68 STE 111 HIGH POINT NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 20 , 22 , 37 ,$#,,
MEDICAID DIRECT,1083684898,ELKIN PEDIATRIC AND ADULT MEDICINE,ELKIN PEDIATRIC AND ADULT MEDICINE PA,124 SAMARITANS RIDGE RD   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1619335411,"ATKINSON, LAUREN, FAYE",2754 HWY 68 STE 111 HIGH POINT NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619336211,"GRAVES, APRIL, LYNN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 27 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1619336211,"GRAVES, APRIL, LYNN",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 21 , 48 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619336211,"GRAVES, APRIL, LYNN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619336211,"GRAVES, APRIL, LYNN",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 ,#, 12 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619340106,"BOWERS, KIMBERLY, AUTUMN",1104A S MAIN ST   LEXINGTON NC,029,Davidson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 11 , 89 , 89 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619343639,"SMITH, ADAM, CLARK",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1619343639,"SMITH, ADAM, CLARK",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 15 , 15 , 15 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1619343639,"SMITH, ADAM, CLARK",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619343639,"SMITH, ADAM, CLARK",8300 HEALTH PARK STE 210 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1619353612,"ANDERSON, DONNA, NICOLE",~,5720 CREEDMOOR RD STE 100 RALEIGH NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,1619353612,"ANDERSON, DONNA, NICOLE",5720 CREEDMOOR RD STE 100 RALEIGH NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care,#,#,#,$#,,
MEDICAID DIRECT,1821538877,INNERLOGIC LLC,,5720 CREEDMOOR RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619353612,"ANDERSON, DONNA, NICOLE",5720 CREEDMOOR RD STE 100 RALEIGH NC,092,Wake,363LP2300X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Primary Care, 62 , 147 , 201 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619354586,"CARTER, MELISSA, NICOLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619354586,"CARTER, MELISSA, NICOLE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619354586,"CARTER, MELISSA, NICOLE",4709 CREEKSTONE DR STE 150 DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619356128,"QUICKSELL, NINA, GONCAROVS",12701 US 70W BUSINESS   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841881919,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE CLAYTON,12701 US 70 BUSINESS HWY W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619356128,"QUICKSELL, NINA, GONCAROVS",12701 CLAYTON BLVD   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1881439479,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE MARKET,126 PRITCHARD RD   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619356128,"QUICKSELL, NINA, GONCAROVS",126 PRITCHARD RD   CLAYTON NC,051,Johnston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619356136,APPALACHIAN MOUNTAIN COMMUNITY HEAL,~,225 PATTON AVE STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619356136,APPALACHIAN MOUNTAIN COMMUNITY HEAL,225 PATTON AVE STE 200 ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC), 20 , 30 , 30 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619358405,"COBB, KATHRYN, SCHUYLER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 59 , 63 , 85 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619358405,"COBB, KATHRYN, SCHUYLER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 33 , 35 , 54 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1619358405,"COBB, KATHRYN, SCHUYLER",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 16 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619358405,"COBB, KATHRYN, SCHUYLER",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1619358405,"COBB, KATHRYN, SCHUYLER",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619358405,"COBB, KATHRYN, SCHUYLER",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,260 HOSPITAL DR   BREVARD NC,088,Transylvania,193200000X,Group,Multi-Specialty,,1619358405,"COBB, KATHRYN, SCHUYLER",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1083779797,COUNTY OF BLADEN OFFICE OF AUDITOR,BLADEN CO HEALTH DEPT,300 MERCER MILL RD   ELIZABETHTOWN NC,009,Bladen,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619358710,"HINES, SHAUN, CAPRI",107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 21 , 48 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1619358710,"HINES, SHAUN, CAPRI",1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417123993,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BMA BLADENBORO,1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619358710,"HINES, SHAUN, CAPRI",1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 127 , 359 , 377 ," $16,849.27 ",,
MEDICAID DIRECT,1689103582,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTERNAL MEDICINE CONTINUITY CLINIC,1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619358710,"HINES, SHAUN, CAPRI",1218 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 36 , 38 , 43 ,$#,,
MEDICAID DIRECT,1417123993,BLADEN HEALTHCARE LLC,CAPE FEAR VALLEY BMA BLADENBORO,1106 W SEABOARD ST   BLADENBORO NC,009,Bladen,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619358710,"HINES, SHAUN, CAPRI",107 E DUNHAM ST   ELIZABETHTOWN NC,009,Bladen,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194776765,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING BALLANTYNE,14215 BALLANTYNE CORPORATE PL STE 140 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619358884,"SAMSON, CHELSEA, REED",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1376591545,CABARRUS DIAGNOSTIC IMAGING LLC,NOVANT HEALTH IMAGING CABARRUS,13460 PLAZA ROAD EXT STE 150 CHARLOTTE NC,013,Cabarrus,193400000X,Group,Single Specialty,,1619358884,"SAMSON, CHELSEA, REED",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619358884,"SAMSON, CHELSEA, REED",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1144477258,PRESBYTERIAN IMAGING CENTERS LLC,NOVANT HEALTH IMAGING STEELE CREEK,13557 STEELECROFT PKWY STE 1100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619358884,"SAMSON, CHELSEA, REED",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1619358926,"WATTS, AMANDA, KORZEP",155 MEMORIAL DR   PINEHURST NC,063,Moore,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 44 , 44 , 55 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1619358926,"WATTS, AMANDA, KORZEP",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 31 , 39 ,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1619358926,"WATTS, AMANDA, KORZEP",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 19 , 26 ,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619358926,"WATTS, AMANDA, KORZEP",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831928803,AVERY WELLNESS PLLC,,137 NOTALEE ST   NEWLAND NC,006,Avery,193400000X,Group,Single Specialty,,1619359338,"STORER, JESSICA, LINIECE",436 HOSPITAL DR STE 230 NEWLAND NC,006,Avery,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1215977194,CALDWELL MEMORIAL HOSPITAL,WESTPOINTE MEDICAL PRACTICE,2651 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1619360906,"LORENZO, RICHARD, SCOTT",2651 MORGANTON BLVD SW   LENOIR NC,014,Caldwell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 74 , 181 , 216 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619361102,"MALLOY, KIMBERLY, MICHELLE",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619361102,"MALLOY, KIMBERLY, MICHELLE",6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 110 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619361102,"MALLOY, KIMBERLY, MICHELLE",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619361102,"MALLOY, KIMBERLY, MICHELLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 24 , 26 , 31 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619361664,"ROBINSON, CHARLES, ANDREW",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 360 , 414 , 536 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619361664,"ROBINSON, CHARLES, ANDREW",3949 BROWNING PL   RALEIGH NC,092,Wake,2085R0204X,Allopathic & Osteopathic Physicians,Radiology,Vascular & Interventional Radiology, 51 , 51 , 82 ,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 18 , 23 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 13 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 31 , 59 , 63 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619363538,"SHERRILL, WILLIAM, CHARLES",1025 MOREHEAD MEDICAL DR STE 300 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619363967,"MATRACHISIA, JOSHUA, KEVIN",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 21 , 26 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619363967,"MATRACHISIA, JOSHUA, KEVIN",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 17 , 23 , 29 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1619364023,"REDDY, PRANEETH, T S",430 RANKIN DR   MARION NC,059,McDowell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619364023,"REDDY, PRANEETH, T S",2512 HENDERSONVILLE RD   ARDEN NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619364023,"REDDY, PRANEETH, T S",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619364023,"REDDY, PRANEETH, T S",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619364411,"BALLARD, DEBORAH, BROWN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 24 , 46 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619364411,"BALLARD, DEBORAH, BROWN",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1326373697,SPARTANBURG MEDICAL CENTER,SPARTANBURG MEDICAL CENTER,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619364668,"ALWINE, ISAAC, EDWARD",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1619365103,"GLOVER, KELLIE, PEARSON",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 32 , 42 , 42 ,$#,,
MEDICAID DIRECT,1801252275,NHCS PHYSICIANS INC,~,2460 CURTIS ELLIS DR BLDG 100 ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1619365103,"GLOVER, KELLIE, PEARSON",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 35 , 37 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1619365327,"VALDEZ, GABRIEL",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1619365327,"VALDEZ, GABRIEL",300 WEST 27TH STREET   LUMBERTON NC,078,Robeson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619464559,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619366929,"MCCOY, JAMIE, ELIZABETH",146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619366929,"MCCOY, JAMIE, ELIZABETH",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619464559,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,146 MEDICAL PARK RD STE 206 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619366929,"MCCOY, JAMIE, ELIZABETH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619366929,"MCCOY, JAMIE, ELIZABETH",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619374824,"MCCALMON, CAROLINA, MARTA",1515 DOCTORS CIR BLDG A WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316523822,NOVANT HEALTH MEDICAL GROUP COASTAL,NHRMC PG NEUROLOGY,1509 DOCTORS CIR BLDG C WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619374824,"MCCALMON, CAROLINA, MARTA",1509 DOCTORS CIR BLDG C CAPE FEAR NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 21 , 31 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619378387,"SUBEDI, ASHISH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 112 , 266 , 267 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619381753,"GREENWOOD, ELIZABETH, LEIGH",137 MOUNT CALVARY RD STE A THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619381753,"GREENWOOD, ELIZABETH, LEIGH",112 KINDERTON BLVD STE 100 ADVANCE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 12 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619381753,"GREENWOOD, ELIZABETH, LEIGH",2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 49 , 68 , 90 ,$#,,
MEDICAID DIRECT,1801837745,DIGESTIVE HEALTH SPECIALISTS PA,DIGESTIVE HEALTH SPECIALISTS PA,2025 FRONTIS PLAZA BLVD STE 200 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619381753,"GREENWOOD, ELIZABETH, LEIGH",280 BROAD ST STE F KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801481965,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR WRIGHTSVILLE BEACH FAMILY MEDICINE,1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619382868,"MACKOVJAK, EMILY, ELAINE",1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 15 ,$#,,
MEDICAID DIRECT,1801481965,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR WRIGHTSVILLE BEACH FAMILY MEDICINE,1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619382868,"MACKOVJAK, EMILY, ELAINE",1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 17 , 37 ,$#,,
MEDICAID DIRECT,1730776295,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,251B00000X,Agencies,Case Management,,1619382868,"MACKOVJAK, EMILY, ELAINE",1721 ALLENS LN STE 100 WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619386497,"CHANDRA, BELINDA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619386497,"CHANDRA, BELINDA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 36 , 72 , 83 ," $10,954.68 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619387511,"FORD-PIERCE, SHAUNTA, WYNETT",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619387511,"FORD-PIERCE, SHAUNTA, WYNETT",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 26 , 31 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619387560,"BATCHELOR, ELIZABETH, KATHERINE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619387560,"BATCHELOR, ELIZABETH, KATHERINE",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RC0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1619387719,"HOLLIDAY, REX, MONROE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1619387719,"HOLLIDAY, REX, MONROE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 30 , 32 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619387719,"HOLLIDAY, REX, MONROE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 15 , 15 , 17 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1619387719,"HOLLIDAY, REX, MONROE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 37 ,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619387719,"HOLLIDAY, REX, MONROE",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619387784,"NEAL, LEIGH-ANN, HILL",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#, 13 , 13 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619387784,"NEAL, LEIGH-ANN, HILL",2301 ERWIN RD   DURHAM NC,032,Durham,363LP0222X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,"Pediatrics, Critical Care",#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619387859,"ATWOOD, ERIN, SLATTER",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology, 28 , 35 , 48 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,2150 HERBERT CT   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619387859,"ATWOOD, ERIN, SLATTER",2150 HERBERT CT   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619387859,"ATWOOD, ERIN, SLATTER",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619388188,"PUCIATY, ANDREW, JOSEPH",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619388352,"SCHOENECK, JACOB, HENRY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 72 , 76 , 92 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3940 ARROWHEAD BLVD STE 130 MEBANE NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619388790,"BACHICH, JENNIFER, MARIE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619388790,"BACHICH, JENNIFER, MARIE",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1619389947,"KATTA, GAURAV, REDDY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619391109,"ROSE, LE'STARR, MONIQUE",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1275658692,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST HIGH POINT FAMIL,905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619391109,"ROSE, LE'STARR, MONIQUE",905 PHILLIPS AVE   HIGH POINT NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 33 , 41 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619395084,"HILLS, BYRON, BRYCE",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619395084,"HILLS, BYRON, BRYCE",301 RIVERVIEW AVE STE 202A NORFOLK VA,101,Out of State <= 40 miles,207T00000X,Allopathic & Osteopathic Physicians,Neurological Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619395092,"JEFFREYS, CASEY, FARIN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619395092,"JEFFREYS, CASEY, FARIN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619395092,"JEFFREYS, CASEY, FARIN",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 68 , 110 , 189 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619395241,"TULP, ADAM, MCQUILLAN",2301 ERWIN RD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922112044,PHOENIX CHILDRENS HOSPITAL,PHOENIX CHILDRENS MEDICAL GROUP,1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1619395357,"GONSALVES, ROBERT, FRANCIS",1919 E THOMAS RD   PHOENIX AZ,102,Out of State > 40 miles,2080P0205X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1700326089,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN GENERAL SURGERY,,,Unknown,193400000X,Group,Single Specialty,,1619396082,"BOND, ELIZABETH, GRACE",708 S SOUTH ST STE 100 MOUNT AIRY NC,086,Surry,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700326089,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN GENERAL SURGERY,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619396082,"BOND, ELIZABETH, GRACE",708 S SOUTH ST STE 100 MOUNT AIRY NC,086,Surry,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 58 , 108 , 127 ," $10,238.50 ",,
MEDICAID DIRECT,1700326089,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN GENERAL SURGERY,,,Unknown,193400000X,Group,Single Specialty,,1619396082,"BOND, ELIZABETH, GRACE",97 HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700326089,NORTHERN HOSPITAL OF SURRY COUNTY,NORTHERN GENERAL SURGERY,1016 S SOUTH ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619396082,"BOND, ELIZABETH, GRACE",97 HIGHWAY 125   ROANOKE RAPIDS NC,042,Halifax,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#, 14 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 29 , 73 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 20 , 31 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 11 , 22 , 22 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",2349 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",2349 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",433 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",1338 E SUNSET DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",600 HOSPITAL DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",1640 CAMPUS PARK DR STE C MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 45 , 92 , 104 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",1338 E SUNSET DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 23 , 29 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",1338 E SUNSET DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",600 HOSPITAL DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619396108,"SHAH, ROOPA",331 NORTH BLVD STE 40 CLINTON NC,082,Sampson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 13 , 21 ,$#,,
MEDICAID DIRECT,1831331503,CHESAPEAKE REGIONAL MEDICAL GROUP,~,534 CARATOKE HWY   MOYOCK NC,027,Currituck,193200000X,Group,Multi-Specialty,,1619396470,"MANNING, NITISH, JASMINE",534 CARATOKE HWY   MOYOCK NC,027,Currituck,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 31 , 83 , 144 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1619396579,"STREICH-TILLES, TARA, ARIEL",5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 22 , 24 , 35 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619396579,"STREICH-TILLES, TARA, ARIEL",4709 CREEKSTONE DR STE 300 DURHAM NC,032,Durham,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology, 21 , 28 , 36 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619396579,"STREICH-TILLES, TARA, ARIEL",2301 ERWIN RD   DURHAM NC,032,Durham,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619396579,"STREICH-TILLES, TARA, ARIEL",2400 PRATT ST   DURHAM NC,032,Durham,207VG0400X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Gynecology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619397718,"TAYLOR, KATHERINE, DOWDY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619397718,"TAYLOR, KATHERINE, DOWDY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619399300,"RUSSELL, SEAN, CHRISTOPHER",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1598702490,RALEIGH NEUROSURGICAL CLINIC,RALEIGH NEUROSURGICAL CLINIC,5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619399300,"RUSSELL, SEAN, CHRISTOPHER",5838 SIX FORKS RD STE 100 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 36 , 41 , 54 ,$#,,
MEDICAID DIRECT,1932137676,DUKE UNIVERSITY AFFILIATED PHYSICIA,HENDERSON FAMILY MEDICINE CLINIC,480 RUIN CREEK RD   HENDERSON NC,091,Vance,193200000X,Group,Multi-Specialty,,1619400744,"BITENCOURT, JESSICA, COLLEEN GARCIA",480 RUIN CREEK RD   HENDERSON NC,091,Vance,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 123 , 245 , 576 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",117 E KINGS HWY   EDEN NC,079,Rockingham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",615 RIDGE RD   ROXBORO NC,073,Person,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",223 W WARD ST STE B ASHEBORO NC,076,Randolph,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",839 DURHAM RD # A WAKE FOREST NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1212 CEDARHURST DR   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1760610836,BRIER CREEK IMAGING LLC,CARDINAL POINTS IMAGING OF THE CAROLINAS,8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",8851 ELLSTREE LN STE 100 RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 20 , 20 , 21 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",601 N ELM ST   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",4515 PREMIER DR   HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1619400819,"XU, LIMIN",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,315 W WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1457300089,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS MIDTOWN,1212 CEDARHURST DR STE 101 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265679179,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - WESTCH,1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1619400819,"XU, LIMIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1548454127,PINNACLE HEALTH SERVICES OF NORTH C,CARDINAL POINTS IMAGING OF THE CAROLINAS CLAYTON,166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 274 , 285 , 323 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",166 SPRINGBROOK AVE STE 103 CLAYTON NC,051,Johnston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1265469795,DIAGNOSTIC RADIOLOGY & IMAGING LLC,,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 37 , 31 , 34 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619400819,"XU, LIMIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 34 , 41 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619401940,"STRATTON, KARA MIA, VILLANUEVA",8201 HEALTHCARE LOOP STE 302 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 26 , 45 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619402229,"CARR, CARA, ELIZABETH",101 MANNING DR   CHAPEL HILL NC,068,Orange,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 19 , 76 , 80 ," $17,675.16 ",,
MEDICAID DIRECT,1073822029,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619405859,"MCCULLOUGH, SARAH, CLAIRE",711 NATIONAL HWY STE 500 THOMASVILLE NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 32 , 48 , 54 ,$#,,
MEDICAID DIRECT,1295990406,LANE AND ASSOCIATES VI DDS PA,Lane and Associates VI DDS PA,3020 S MIAMI BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619406451,"GEORGIEV, PETAR, VALERIEV",3020 S MIAMI BLVD   DURHAM NC,032,Durham,1223E0200X,Dental Providers,Dentist,Endodontics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619408937,"CONNER, JEFFREY, RYAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 39 , 42 , 51 ," $10,098.30 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619408937,"CONNER, JEFFREY, RYAN",601 N ELM ST   HIGH POINT NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619409562,"O'CONNOR, CASEY, MICHAEL",710 PARK CENTER DR STE 300 MATTHEWS NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 25 , 48 , 81 ,$#,,
MEDICAID DIRECT,1619409778,GOLDEN YEARS OUTREACH SERVICES LLC,,7366 RYAN ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,1619409778,GOLDEN YEARS OUTREACH SERVICES LLC,7366 RYAN ST   FAYETTEVILLE NC,026,Cumberland,253Z00000X,Agencies,In Home Supportive Care,,#, 596 , 596 ," $42,712.08 ",,
MEDICAID DIRECT,1619411592,INFINIUM HEALTH SERVICES LLC,INFINIUM HEALTH SERVICES,10130 MALLARD CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,,1619411592,INFINIUM HEALTH SERVICES LLC,10130 MALLARD CREEK RD STE 200 CHARLOTTE NC,060,Mecklenburg,251J00000X,Agencies,Nursing Care,, 30 ," 4,893 "," 5,038 "," $3,387,106.04 ",,
MEDICAID DIRECT,1356318968,ALLEGHANY COUNTY MEMORIAL HOSPITAL,ALLEGHANY HEALTH,233 DOCTORS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1619411881,"ROMANOV, KEITH, EDWARD",233 DOCTORS ST   SPARTA NC,003,Alleghany,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 46 , 66 , 106 ,$#,,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619413200,"TITHERINGTON, AMANDA, TUCKER",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#, 12 ,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1619413226,"KING, TINA, YVONNE",701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 28 , 31 , 44 ,$#,,
MEDICAID DIRECT,1114771771,UNIVERSITY OF NC HOSPITALS AT CHAPE,UNC HEALTH COMPLETE CARE,701 DOCTORS DR STE E1 KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1619413226,"KING, TINA, YVONNE",1140 CARTHAGE ST   SANFORD NC,053,Lee,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1255354130,CHILDRENS SPECIALTY GROUP PLLC,CHILDRENS SPECIALTY GROUP PLLC,601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619415866,"NIX, ILANA, ALLISON",601 CHILDRENS LN   NORFOLK VA,101,Out of State <= 40 miles,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1407902059,GENERATIONS FAMILY PRACTICE,~,1021 DARRINGTON DR STE 101 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619416351,"GRAY, SARAH, SPITZFADEN",1021 DARRINGTON DR   CARY NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619417789,"HAMMOCK, SHERI, RENEE",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619417789,"HAMMOCK, SHERI, RENEE",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619417789,"HAMMOCK, SHERI, RENEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 44 , 75 , 118 ,$#,,
MEDICAID DIRECT,1033523709,MOSES CONE AFFILIATED PHYSICIANS IN,CHMG CARDIOVASCULAR DIVISION,1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619417789,"HAMMOCK, SHERI, RENEE",1236 HUFFMAN MILL RD STE 130 BURLINGTON NC,001,Alamance,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1619421088,"ROBERTSON-TURNER, ANGELA, KAY",420 N CENTER ST   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 17 , 17 , 18 ,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1619421088,"ROBERTSON-TURNER, ANGELA, KAY",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1619421088,"ROBERTSON-TURNER, ANGELA, KAY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 34 , 36 , 46 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619421088,"ROBERTSON-TURNER, ANGELA, KAY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 14 , 17 , 37 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619421088,"ROBERTSON-TURNER, ANGELA, KAY",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,774 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619421088,"ROBERTSON-TURNER, ANGELA, KAY",653 BLUEFIELD RD STE A MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619421088,"ROBERTSON-TURNER, ANGELA, KAY",557 BROOKDALE DR   STATESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1487907531,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,200 MEDICAL PARK DR STE 230 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619423712,"YORKE, BRIAN, PHILIP",920 CHURCH ST N   CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 18 , 22 ,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1619425840,"MOORE, CHRISTOPHER, ALLEN",311 HILL ST   MURPHY NC,020,Cherokee,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1962163782,BRIGHTVIEW LLC,,341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1619425840,"MOORE, CHRISTOPHER, ALLEN",341 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,101YA0400X,Behavioral Health & Social Service Providers,Counselor,Addiction (Substance Use Disorder),#,#,#,$#,,
MEDICAID DIRECT,1962752881,HOKE HEALTHCARE LLC,HOKE PRIMARY CARE CLINIC,300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1619426624,"HAMAL, DIKSHYA",300 MEDICAL PAVILION DR STE 150 RAEFORD NC,047,Hoke,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 67 , 193 , 275 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619431475,"TIMSINA, MUNA, KUMARI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 65 , 75 , 94 ,$#,,
MEDICAID DIRECT,1619431822,DEDOVE HOMES INC,DEDOVE HOMES INC,1616 RIVERKNOLL DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619431822,DEDOVE HOMES INC,1616 RIVERKNOLL DR   RALEIGH NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home, 19 ," 1,614 "," 1,614 "," $240,694.44 ",,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619435724,"SZYMAREK, JAMIE, LYNN",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 15 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619435724,"SZYMAREK, JAMIE, LYNN",1730 KERNERSVILLE MEDICAL PKWY STE 101 KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 47 , 79 ,$#,,
MEDICAID DIRECT,1962124115,NOVANT HEALTH MEDICAL GROUP LLC,NHMG BARIATRIC CLINICS,16525 HOLLY CREST LN STE 210&120 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619435724,"SZYMAREK, JAMIE, LYNN",3515 W MARKET ST STE 310 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1619436763,"KEOWN, LAURA, FLINCHUM",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 19 , 19 , 19 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619437779,"BOURNE, MATTHEW, DULLES",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619438413,"WILLIAMS, AUTUMN, DAWN",1700 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1275256422,THE PRESBYTERIAN HOSPITAL,NH PRESBYTERIAN CANCER CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619438413,"WILLIAMS, AUTUMN, DAWN",10905 PROVIDENCE RD W STE 150 CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1720793094,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY ORTHOPEDICS AND SPORTS MEDICINE,1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619438819,"GENDRON, AMBER, JUNE",413 OWEN DR STE 201 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720793094,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY ORTHOPEDICS AND SPORTS MEDICINE,1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619438819,"GENDRON, AMBER, JUNE",1219 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 13 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1619439965,"RIVERA, MATTHEW",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1619440559,"MILLS, STACY, ALICE",5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 15 , 31 ,$#,,
MEDICAID DIRECT,1609058056,SURF PEDIATRICS AND MEDICINE PC,~,5107 N CROATAN HWY   KITTY HAWK NC,028,Dare,193200000X,Group,Multi-Specialty,,1619440559,"MILLS, STACY, ALICE",400 S CROATAN HWY   KILL DEVIL HILLS NC,028,Dare,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1619441284,"ALLEN, JUDY, PORTER",401 N MORGAN ST   SHELBY NC,023,Cleveland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 98 , 104 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1619441284,"ALLEN, JUDY, PORTER",401 N MORGAN ST   SHELBY NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1619441284,"ALLEN, JUDY, PORTER",111 HARRELSON RD   CHERRYVILLE NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,581 NC HIGHWAY 16 S   TAYLORSVILLE NC,002,Alexander,193200000X,Group,Multi-Specialty,,1619441284,"ALLEN, JUDY, PORTER",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 74 ," 1,144 "," 1,171 "," $16,582.12 ",,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619441284,"ALLEN, JUDY, PORTER",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1619441284,"ALLEN, JUDY, PORTER",1410 E GASTON ST   LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 49 , 163 , 168 ,$#,,
MEDICAID DIRECT,1801478086,GERIATRIC CONSULTANTS PLLC,,220 13TH AVENUE PL NW   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1619441284,"ALLEN, JUDY, PORTER",300 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619448560,"COLLINS, JARED, LLOYD",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1619448560,"COLLINS, JARED, LLOYD",2545 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1619448560,"COLLINS, JARED, LLOYD",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1619448560,"COLLINS, JARED, LLOYD",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2511 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1619448560,"COLLINS, JARED, LLOYD",2511 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1619452612,MYEYEDR OPTOMETRY OF NORTH CAROLINA,,,,Unknown,193400000X,Group,Single Specialty,,1619452612,MYEYEDR OPTOMETRY OF NORTH CAROLINA,1007 W VERNON AVE   KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,, 496 , 102 , 203 ,$#,,
MEDICAID DIRECT,1730626359,MOSES CONE PHYSICIAN SERVICES INC,~,300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1972842839,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,1010 COLLEGE ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",1010 COLLEGE ST   OXFORD NC,039,Granville,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1225268238,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",2138 NC HIGHWAY 42 W   CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033770292,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIAN PA,2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",2460 CURTIS ELLIS DR   ROCKY MOUNT NC,064,Nash,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619452711,"COUTURE, CORTNI, SUE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619758018,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1619452711,"COUTURE, CORTNI, SUE",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699044669,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912071903,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,10000 FALLS OF NEUSE RD STE 204 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922063387,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174086441,WAKE EMERGENCY PHYSICIANS PA,WAKE EMERGENCY PHYSICIANS PA,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619452711,"COUTURE, CORTNI, SUE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1770217176,CURANA HEALTH OF NORTH CAROLINA,,4692 BROWNSBORO RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619453289,"WEILAND, JESSICA, LYNN",716 SIPES ST   KINGS MOUNTAIN NC,023,Cleveland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1235718248,OAK CITY VISION CENTER OD PLLC,,8821 SIX FORKS RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619455268,"AUGUSTINO, BIANCA, GABRIELLE",8821 SIX FORKS RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1235718248,OAK CITY VISION CENTER OD PLLC,,8821 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619455268,"AUGUSTINO, BIANCA, GABRIELLE",8821 SIX FORKS RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,16740 DAVIDSON CONCORD RD   DAVIDSON NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619458502,"COLNER, MATTHEW, GREGORY",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255775029,CAROLINAS MEDICAL CENTER,ATRIUM HEALTH BEHAVIORAL HEALTH PRIMARY CARE,501 BILLINGSLEY RD COTTAGE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619458502,"COLNER, MATTHEW, GREGORY",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619458502,"COLNER, MATTHEW, GREGORY",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093038887,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619458502,"COLNER, MATTHEW, GREGORY",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619458502,"COLNER, MATTHEW, GREGORY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 186 , 186 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619460334,"DISARNO, ALEXA, KAY",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 113 , 178 , 286 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1619461175,"WILLIAMSON, JESSICA, RENAE",191 P AND J RD   ROBBINSVILLE NC,038,Graham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 18 , 20 , 25 ,$#,,
MEDICAID DIRECT,1003687187,DLP WESTERN CAROLINA PHYSICIAN PRAC,HARRIS WOMENS CARE,70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619461175,"WILLIAMSON, JESSICA, RENAE",191 P AND J RD   ROBBINSVILLE NC,038,Graham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 13 , 13 , 18 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1619461175,"WILLIAMSON, JESSICA, RENAE",390 S FRENCH BROAD AVE   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 29 , 28 , 33 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619461811,"SKOW, ALEXANDRIA, NICOLE",15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 27 , 51 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619462488,"SALVATO, LEAH, DANIEL",5815 BLAKENEY PARK DR STE 200B CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 34 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619462876,"ELZANATY, AHMED, MOHAMED SAAD",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 56 , 57 , 73 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619462876,"ELZANATY, AHMED, MOHAMED SAAD",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 88 , 109 , 114 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619465119,"NI, SAMANTHA, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619465119,"NI, SAMANTHA, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619465689,ABACOA MEDICAL SUPPLIES INC,,3100 NW BOCA RATON BLVD STE 213 BOCA RATON FL,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1619465689,ABACOA MEDICAL SUPPLIES INC,3100 NW BOCA RATON BLVD STE 213 BOCA RATON FL,102,Out of State > 40 miles,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619467529,"DE AZEVEDO FILHO, CLERIO, FRANCISCO",234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1619468352,KATHY L MANNING MS CCC-SLP PL,,3764 LOBLOLLY DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1619468352,KATHY L MANNING MS CCC-SLP PL,3764 LOBLOLLY DR   ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,#,#,#,$#,,
MEDICAID DIRECT,1619468352,KATHY L MANNING MS CCC-SLP PL,,237 S WINSTEAD AVE APT Q3 ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,1619468352,KATHY L MANNING MS CCC-SLP PL,237 S WINSTEAD AVE APT Q3 ROCKY MOUNT NC,064,Nash,193400000X,Group,Single Specialty,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619469103,"COOK, JULIA, CHRISTINE",404 WESTWOOD AVE STE 207 HIGH POINT NC,041,Guilford,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619469103,"COOK, JULIA, CHRISTINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 101 , 149 , 168 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619469103,"COOK, JULIA, CHRISTINE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619469442,"AKERS, PAIGE, MARIE",100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477878981,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619469442,"AKERS, PAIGE, MARIE",134 MEDICAL PARK RD STE 111 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 23 , 28 , 45 ,$#,,
MEDICAID DIRECT,1962727388,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619469442,"AKERS, PAIGE, MARIE",16455 STATESVILLE RD STE 490 HUNTERSVILLE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 15 , 24 ,$#,,
MEDICAID DIRECT,1750042958,TIMOTHY TURBETT MD PC,,211 MILTON BROWN HEIRS RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1619470325,"PORTARO, HEATHER, ELIZABETH",12208 N NC HIGHWAY 150   WINSTON SALEM NC,029,Davidson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 67 , 324 , 324 ,$#,,
MEDICAID DIRECT,1285846493,BLUE RIDGE EAR NOSE AND THROAT,~,870 STATE FARM RD STE 101 BOONE NC,095,Watauga,193400000X,Group,Single Specialty,,1619470325,"PORTARO, HEATHER, ELIZABETH",870 STATE FARM RD STE 102 BOONE NC,095,Watauga,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 24 , 33 , 64 ,$#,,
MEDICAID DIRECT,1821469735,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619471729,"WELLS, ALEXANDRA, BROOKE",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619471729,"WELLS, ALEXANDRA, BROOKE",1025 MOREHEAD MEDICAL DR STE 600 CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619471729,"WELLS, ALEXANDRA, BROOKE",10650 PARK RD STE 480A CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619472131,"FARAH, FILSAN, ABDULLAHI",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1154371433,MCLEOD REGIONAL MEDICAL CENTER OF T,,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619472321,"ABBASI, KENAN, ARSHAD",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619472354,"WISE, CLARK, PATRICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 24 , 25 , 33 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619472354,"WISE, CLARK, PATRICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 215 , 247 , 317 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619472354,"WISE, CLARK, PATRICK",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619472511,"VIOLE, NICHOLAS, STEVEN",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 35 , 37 , 49 ,$#,,
MEDICAID DIRECT,1023142122,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619472511,"VIOLE, NICHOLAS, STEVEN",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1023142122,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619472511,"VIOLE, NICHOLAS, STEVEN",1665 WESTBROOK PLAZA DR   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 51 , 123 , 205 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619474962,"FEUER, ZACHARY, SCOTT",701 DOCTORS DR STE L KINSTON NC,054,Lenoir,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1112 GRACIE PL   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1619474962,"FEUER, ZACHARY, SCOTT",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619474962,"FEUER, ZACHARY, SCOTT",1112 GRACIE PL   GOLDSBORO NC,096,Wayne,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619474962,"FEUER, ZACHARY, SCOTT",101 MANNING DR   CHAPEL HILL NC,068,Orange,208800000X,Allopathic & Osteopathic Physicians,Urology,, 13 , 28 , 32 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619480738,"WYATT, HANNAH, ELIZABETH",106 CORPORATE PARK DR STE 200&300 MOORESVILLE NC,049,Iredell,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619480738,"WYATT, HANNAH, ELIZABETH",120 RIVERVIEW ST   FRANKLIN NC,056,Macon,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 18 , 35 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619481314,"HANSEN, SETH, CHRISTIANSEN",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619488228,"MEADOWS, JONATHAN, WARREN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619488228,"MEADOWS, JONATHAN, WARREN",4000 HIGHWAY 9 E   LITTLE RIVER SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619490372,"MYERS, AMANDA, DRAKE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619490372,"MYERS, AMANDA, DRAKE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619490372,"MYERS, AMANDA, DRAKE",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619490372,"MYERS, AMANDA, DRAKE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 14 , 24 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619490372,"MYERS, AMANDA, DRAKE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1326110909,CAROLINAS MEDICAL CENTER,CAROLINAS MEDICAL CENTER,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619492386,"TURNER, RENICE, MICHELLE",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 50 , 52 , 132 ,$#,,
MEDICAID DIRECT,1528209681,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619492386,"TURNER, RENICE, MICHELLE",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 11 , 12 , 12 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,1126 N CHURCH ST STE 300 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619493319,"WORLEY, SAMANTHA, JEAN",300 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 20 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619493319,"WORLEY, SAMANTHA, JEAN",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 48 , 97 ,$#,,
MEDICAID DIRECT,1194714063,PEAK PERFORMANCE SPORTS AND PHYSICA,ALLIED REHAB,900 S FRANKLIN ST STE 201 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1619493475,"QUAGLIA, TAYLOR, MAIN",900 S FRANKLIN ST STE 201 WAKE FOREST NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 15 , 36 ,$#,,
MEDICAID DIRECT,1619498441,INFINITY CARE LLC,,3640 WESTGATE CENTER CIR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,,1619498441,INFINITY CARE LLC,3640 WESTGATE CENTER CIR STE A WINSTON SALEM NC,034,Forsyth,253Z00000X,Agencies,In Home Supportive Care,, 29 ," 6,390 "," 6,656 "," $481,907.72 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619498987,"ENRICH, YOLANDA",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619498987,"ENRICH, YOLANDA",652 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 32 , 46 , 86 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619498987,"ENRICH, YOLANDA",648 E MONMOUTH ST   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619498987,"ENRICH, YOLANDA",335 N CASWELL RD   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1619503158,BARCARE HEALTH HOMECARE SERVICES,BARCARE HEALTH HOMECARE SERVICES,148 VANDIVER DR   LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,1619503158,BARCARE HEALTH HOMECARE SERVICES,148 VANDIVER DR   LINCOLNTON NC,055,Lincoln,253Z00000X,Agencies,In Home Supportive Care,,#," 1,261 "," 1,500 "," $150,466.16 ",,
MEDICAID DIRECT,1881289932,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR DIVISION OF PSYCHIATRY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619503695,"THORNTON, MIRIAM, PALEY",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619504958,"ELLIS, MATTHEW, NIGEL HUGH",601 N ELM ST   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619504958,"ELLIS, MATTHEW, NIGEL HUGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 34 , 34 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619507027,"LIPSCOMB, KYLE, THOMAS",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 18 , 29 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619507027,"LIPSCOMB, KYLE, THOMAS",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619507027,"LIPSCOMB, KYLE, THOMAS",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 13 , 13 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,357 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619507027,"LIPSCOMB, KYLE, THOMAS",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619507027,"LIPSCOMB, KYLE, THOMAS",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,359 WILLIAMSON RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619507027,"LIPSCOMB, KYLE, THOMAS",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 14 , 22 ,$#,,
MEDICAID DIRECT,1811350887,PIEDMONT HEALTHCARE PA,,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619507027,"LIPSCOMB, KYLE, THOMAS",633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 46 , 69 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619508629,"COUSEN, YOLANDA, SHAUNTAI",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619511771,LHCG L LLC,ACCESS COMMUNITY-BASED SERVICES,13 HAYWOOD OFFICE PARK STE 106A WAYNESVILLE NC,044,Haywood,253Z00000X,Agencies,In Home Supportive Care,,1619511771,LHCG L LLC,13 HAYWOOD OFFICE PARK STE 106A WAYNESVILLE NC,044,Haywood,253Z00000X,Agencies,In Home Supportive Care,, 31 ," 4,371 "," 4,371 "," $805,470.16 ",,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619518545,"FLEMING, OLIVIA, DESENA",3000 ERWIN RD   DURHAM NC,032,Durham,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619519428,"DECRISCIO, BRANDI, MELISSA",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619519428,"DECRISCIO, BRANDI, MELISSA",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 36 , 47 , 47 ,$#,,
MEDICAID DIRECT,1972015097,KIDZCARE PEDIATRICS PC,,112 MEDICAL VILLAGE DR STE D WALLACE NC,031,Duplin,193200000X,Group,Multi-Specialty,,1619520962,"DICKSON, NANCY, STEWART MCLENDON",112 MEDICAL VILLAGE DR STE D WALLACE NC,031,Duplin,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 45 , 73 ,$#,,
MEDICAID DIRECT,1346201340,CAROLINA PEDIATRICS OF WILMINGTON,~,715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619520962,"DICKSON, NANCY, STEWART MCLENDON",715 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1730288895,EDEN INTERNAL MEDICINE ASSOCIATES,EDEN INTERNAL MEDICINE PLLC,405 THOMPSON ST   EDEN NC,079,Rockingham,193400000X,Group,Single Specialty,,1619522414,"WOODSON, TAYLOR, BETH",405 THOMPSON ST   EDEN NC,079,Rockingham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1083209381,DAYMARK RECOVERY SERVICES INC,,523 N US HIGHWAY 1 STE C ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1619523628,"MILLIGAN, STEVEN, KYLE",523 N US HIGHWAY 1 STE C ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619523628,"MILLIGAN, STEVEN, KYLE",1104A S MAIN ST   LEXINGTON NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3808 W GATE CITY BLVD # A1 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619524527,"SMITH, FRED, ALLEN",3808 W GATE CITY BLVD # A1 GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619524527,"SMITH, FRED, ALLEN",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1033766092,OSH - MI PHYSICIANS GROUP PC,,3250 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619524527,"SMITH, FRED, ALLEN",1007 SUMMIT AVE   GREENSBORO NC,041,Guilford,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1619524675,"OUELLETTE, MELISSA, ANN",6408 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1619524675,"OUELLETTE, MELISSA, ANN",520 ALLEN ST   TROY NC,062,Montgomery,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 38 , 39 , 39 ,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1619524675,"OUELLETTE, MELISSA, ANN",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619525102,"WILLIAMS, WHITNEY, ANN",799 DOCTORS CT   ROXBORO NC,073,Person,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 43 , 104 ,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,442 S HIGHWAY 27   STANLEY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619527835,"TURK, ERIN, CHRISTINE",1504 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,105 E COLLEGE AVE   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1619527835,"TURK, ERIN, CHRISTINE",1504 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1699748608,MINUTE CLINIC DIAGNOSTIC OF NORTH C,MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC,178 TURNERSBURG HWY   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619527835,"TURK, ERIN, CHRISTINE",1504 2ND ST NE   HICKORY NC,018,Catawba,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619529351,"WATSON, MATTHEW, TYLER",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 24 , 24 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619532355,"SAMSON, EMILY, MAE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 13 , 26 , 26 ,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,193200000X,Group,Multi-Specialty,,1619532355,"SAMSON, EMILY, MAE",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619532868,"WALKER, BREANNA, BLAKLEY",485 VALLEY RD   MOCKSVILLE NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 98 , 159 ,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,1000 CAROMONT PKWY   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1619533643,"VARGAS, BRANDON, RAFAEL",1000 CAROMONT PKWY   BELMONT NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,193400000X,Group,Single Specialty,,1619533643,"VARGAS, BRANDON, RAFAEL",451 E CHARLOTTE AVE   MOUNT HOLLY NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1316367691,GASTONIA PHYSICIAN SERVICES LLC,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1619533643,"VARGAS, BRANDON, RAFAEL",2525 COURT DR   GASTONIA NC,036,Gaston,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 33 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1619533643,"VARGAS, BRANDON, RAFAEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 22 , 28 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,1000 WELLNESS WAY   FORT MILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619533643,"VARGAS, BRANDON, RAFAEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,222 S HERLONG AVE   ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619533643,"VARGAS, BRANDON, RAFAEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992184543,SCOTLAND MEMORIAL HOSPITAL INC,WOMENS HEALTH CENTER OF THE CAROLINAS,17 LIVERMORE DR   PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1619535069,"SMITH, KELSEY, KURTZ",410 S JONES ST   PEMBROKE NC,078,Robeson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1497757785,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY OB GYN,1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619535069,"SMITH, KELSEY, KURTZ",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1619535069,"SMITH, KELSEY, KURTZ",1341 WALTER REED RD   FAYETTEVILLE NC,026,Cumberland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1114277035,HOKE HEALTHCARE LLC,HOKE OBGYN CLINIC,300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1619535069,"SMITH, KELSEY, KURTZ",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1134286321,COUNTY OF HOKE,HOKE COUNTY HEALTH DEPARTMENT,683 E PALMER ST   RAEFORD NC,047,Hoke,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619535069,"SMITH, KELSEY, KURTZ",300 MEDICAL PAVILION DR STE 250 RAEFORD NC,047,Hoke,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 73 , 161 , 486 ," $17,739.28 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619535689,"FAUCHEUX, ANDREW, THOMAS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619538568,"KLEEAN, JENNIFER, CRYSTAL",1351 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 48 , 129 ,$#,,
MEDICAID DIRECT,1619540903,LABORATORY CORPORATION OF AMERICA H,,1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,291U00000X,Laboratories,Clinical Medical Laboratory,,1619540903,LABORATORY CORPORATION OF AMERICA H,1818 RICHARDSON DR STE F REIDSVILLE NC,079,Rockingham,291U00000X,Laboratories,Clinical Medical Laboratory,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619544772,"CHAPMAN, MEREDITH, LINDLEY",6161 LAKE BRANDT RD UNIT B GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 25 , 55 , 98 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619544772,"CHAPMAN, MEREDITH, LINDLEY",4901 AUBURN RD   SUMMERFIELD NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619544772,"CHAPMAN, MEREDITH, LINDLEY",1135 CARTHAGE ST   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 22 , 43 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619544772,"CHAPMAN, MEREDITH, LINDLEY",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669801155,REX HOSPITAL INC,REX EAR NOSE AND THROAT SPECIALISTS,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619546835,"ABHILASH, SONITHA",11200 GOVERNOR MANLY WAY STE 301 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#, 13 ,$#,,
MEDICAID DIRECT,1760885321,REX HOSPITAL INC,REX EAR NOSE & THROAT SPECIALISTS AT WAKEFIELD,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619546835,"ABHILASH, SONITHA",11200 GOVERNOR MANLY WAY STE 301 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1952580557,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,4235 S NEW HOPE RD STE A GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619553237,"SIMPSON, ALGIMANTAS",4235 S NEW HOPE RD   GASTONIA NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 18 , 29 ,$#,,
MEDICAID DIRECT,1215646500,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY UNIVERSITY,8320 UNIVERSITY EXEC PARK DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619555406,"CHAVEZ, KEVIN, ANTHONY",8320 UNIVERSITY EXEC PARK DR STE A CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619558780,"AMPONSAH, PROSPER, MENSAH",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1326363383,MOSES CONE PHYSICIAN SERVICES INC,Triad Hospitalists,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619558780,"AMPONSAH, PROSPER, MENSAH",1200 N ELM ST   GREENSBORO NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 15 , 15 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619560786,"OWENS, DAVID",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 64 , 86 , 177 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619560786,"OWENS, DAVID",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,4128 MONROE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619560786,"OWENS, DAVID",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 31 , 57 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619560786,"OWENS, DAVID",16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 11 , 11 , 20 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619567062,"MILLS, BRADFORD, THOMAS",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 49 , 62 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619567062,"MILLS, BRADFORD, THOMAS",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619567062,"MILLS, BRADFORD, THOMAS",1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619567062,"MILLS, BRADFORD, THOMAS",1 HOSPITAL DR STE 3200 ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 165 , 181 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619567062,"MILLS, BRADFORD, THOMAS",260 HOSPITAL DR   BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 55 , 57 ,$#,,
MEDICAID DIRECT,1619567815,KOODY HEALTHCARE SERVICES,,1805 E MULBERRY ST   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619567815,KOODY HEALTHCARE SERVICES,1805 E MULBERRY ST   GOLDSBORO NC,096,Wayne,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 570 , 570 ," $36,093.76 ",,
MEDICAID DIRECT,1619567815,KOODY HEALTHCARE SERVICES,,2709 GARY RD   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619567815,KOODY HEALTHCARE SERVICES,2709 GARY RD   ROCKY MOUNT NC,064,Nash,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 297 , 297 ," $18,404.32 ",,
MEDICAID DIRECT,1619576311,FREEDOM NOW HOME CARE - NC LLC,,9635 SOUTHERN PINE BLVD STE 126 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1619576311,FREEDOM NOW HOME CARE - NC LLC,9635 SOUTHERN PINE BLVD STE 126 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 51 , 51 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619576360,"PARSONS, ELIZABETH",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 46 , 68 , 68 ,$#,,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619587615,"RAO, JIA",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice," 1,056 "," 2,057 "," 6,025 "," $317,234.94 ",,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619587615,"RAO, JIA",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 20 ,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1619590130,"GRIFFIN, GREGORY, NATHANIEL",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619593738,"BAGGETT, BRADLEY, NATHANIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619593738,"BAGGETT, BRADLEY, NATHANIEL",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 19 , 21 , 32 ,$#,,
MEDICAID DIRECT,1386158616,CAROLINA ELITE WOMENS CARE,,901 US 70 HWY W STE 100 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1619593795,"MUDD WRIGHT, KATOYA, YVETTE",901 US HWY 70 W STE 100 GARNER NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 ,#,#,$#,,
MEDICAID DIRECT,1619594678,WOOD SLP SERVICES INC,,811 W WARREN ST   SHELBY NC,023,Cleveland,251S00000X,Agencies,Community/Behavioral Health,,1619594678,WOOD SLP SERVICES INC,811 W WARREN ST   SHELBY NC,023,Cleveland,251S00000X,Agencies,Community/Behavioral Health,,#, 56 , 56 ,$#,,
MEDICAID DIRECT,1770795817,LARRY J MORAY DDS MS PA,MYORTHODONTIST,845 CHURCH ST N STE 301 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1619594967,"OTTEY, ELIZABETH, MARIE ALSTON",845 CHURCH ST N STE 301 CONCORD NC,013,Cabarrus,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 961 ," 2,443 "," 2,994 "," $436,085.30 ",,
MEDICAID DIRECT,1770795817,LARRY J MORAY DDS MS PA,MYORTHODONTIST,845 CHURCH ST N STE 301 CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1619594967,"OTTEY, ELIZABETH, MARIE ALSTON",7011 FAYETTEVILLE RD STE 201 DURHAM NC,032,Durham,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 961 ," 2,758 "," 3,394 "," $491,520.10 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619596681,"BRILEY, MEAGAN, ELIZABETH",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 18 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619597630,"REINECKE, MEAGAN, MARIE",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 49 , 86 , 163 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619597630,"REINECKE, MEAGAN, MARIE",7903 PROVIDENCE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 14 , 29 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619597630,"REINECKE, MEAGAN, MARIE",10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902170442,RALEIGH CAPITOL EAR NOSE AND THROAT,RALEIGH CAPITOL EAR NOSE THROAT AND ALLERGY,4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619599099,"CYPHERT, KAYLA",4600 LAKE BOONE TRL STE 100 RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619601010,"GARDINER, JODI-ANN, ARETHA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619601010,"GARDINER, JODI-ANN, ARETHA",1200 N ELM ST   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619602810,"VAN BELOIS, ALINE, LIMA",3404 WAKE FOREST RD STE 303 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619602810,"VAN BELOIS, ALINE, LIMA",3404 WAKE FOREST RD STE 303 RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 25 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619604576,"CRONIN, REGAN, CHRISTINE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619604576,"CRONIN, REGAN, CHRISTINE",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1477506343,BEST DAY PSYCHIATRY AND COUNSELING,~,2587 RAVENHILL DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619605250,"WIRTH, ANDREW, VINCENT",2309 W CONE BLVD STE 110 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619605847,"TILLEY, DEVIN, KATHLEEN",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1811517170,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619605847,"TILLEY, DEVIN, KATHLEEN",447 MCALISTER RD STE 2400 LINCOLNTON NC,055,Lincoln,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 93 , 159 , 224 ,$#,,
MEDICAID DIRECT,1619606332,KT SPEECH THERAPY PLLC,,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619606332,KT SPEECH THERAPY PLLC,10130 MALLARD CREEK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,#, 29 , 29 ,$#,,
MEDICAID DIRECT,1801957576,COUNTY OF WAKE,WAKE COUNTY HEALTH DEPT,10 SUNNYBROOK RD   RALEIGH NC,092,Wake,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619606977,"MCCLURKIN, BARALYN, QASHONDA",10 SUNNYBROOK RD   RALEIGH NC,092,Wake,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 13 , 13 , 48 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619607710,"TAYLOR, SAVANNAH, RAE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619607710,"TAYLOR, SAVANNAH, RAE",136 E 36TH ST STE 200 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 24 , 48 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619608635,"WULFORST, JULIANA, RAE",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 16 , 19 ,$#,,
MEDICAID DIRECT,1699171868,PREMIER FOOT AND ANKLE PLLC,,821 S HORNER BLVD   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1619609021,"THOMAS, JEREMIAH",821 S HORNER BLVD   SANFORD NC,053,Lee,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 70 , 137 , 182 ,$#,,
MEDICAID DIRECT,1699171868,PREMIER FOOT AND ANKLE PLLC,,35 TROTTER HILLS CIR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1619609021,"THOMAS, JEREMIAH",821 S HORNER BLVD   SANFORD NC,053,Lee,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 11 , 35 , 42 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3116 N DUKE ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619618790,"LEWTER, CATHERINE, MARIE",3116 N DUKE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 19 , 19 , 24 ," $10,300.08 ",,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619623873,"PEREZ, PHILLIP, ANTHONY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407906084,"JACKSON, JONATHAN, FLOYD",~,5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1619626330,"VAN, CUC, THI",5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,1112 NEW POINTE BLVD   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1619626330,"VAN, CUC, THI",5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619626330,"VAN, CUC, THI",5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1619626330,"VAN, CUC, THI",5135 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1619180387,JACKSON EYE ASSOCIATES OD PA,JACKSON EYE ASSOCIATES OD PA,1112 NEW POINTE BLVD   LELAND NC,010,Brunswick,193400000X,Group,Single Specialty,,1619626330,"VAN, CUC, THI",1112 NEW POINTE BLVD   LELAND NC,010,Brunswick,152W00000X,Eye and Vision Services Providers,Optometrist,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619629813,"HALL, CANDACE, PHILLIPS",7118 MAIN ST   WADE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609186790,THE STEDMAN WADE HEALTH SERVICES IN,~,2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619629813,"HALL, CANDACE, PHILLIPS",2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1609186790,THE STEDMAN WADE HEALTH SERVICES IN,~,2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619629813,"HALL, CANDACE, PHILLIPS",2313 MURCHISON RD   FAYETTEVILLE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 111 , 331 , 374 ," $11,094.46 ",,
MEDICAID DIRECT,1558428789,INTERVENTIONAL PAIN CENTER PLLC,FAYETTEVILLE PAIN CENTER PLLC,517 B HWY 210 N   SPRING LAKE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619629813,"HALL, CANDACE, PHILLIPS",517 B HWY 210 N   SPRING LAKE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1578534871,THE STEDMAN WADE HEALTH SERVICES IN,STEDMAN WADE HEALTH SERVICES INC,7118 MAIN ST   WADE NC,026,Cumberland,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619629813,"HALL, CANDACE, PHILLIPS",7118 MAIN ST   WADE NC,026,Cumberland,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 19 ,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619632098,"MCFATE, VANESSA, FULTON",2000 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1780949032,DHP OF NORTH CAROLINA PC,DHP OF NORTH CAROLINA PC,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619632098,"MCFATE, VANESSA, FULTON",2007 NEUSE BLVD   NEW BERN NC,025,Craven,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,,,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619643012,"LYLES, SARAH, KATHLEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,300 HEALTH PARK DR STE 220 GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1619643012,"LYLES, SARAH, KATHLEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942239538,REX HOSPITAL INC,REX HEMATOLOGY ONCOLOGY ASSOCIATES,11200 GOVERNOR MANLY WAY STE 102 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619643012,"LYLES, SARAH, KATHLEEN",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619644168,"BROWN, SARAH, NICOLE",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619647021,"HIGDON, HUNTER, LEE",794 S MAIN ST STE B KERNERSVILLE NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619647021,"HIGDON, HUNTER, LEE",105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619647021,"HIGDON, HUNTER, LEE",50 MILLER ST STE C WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619647021,"HIGDON, HUNTER, LEE",1977 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 18 , 19 , 40 ,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619647021,"HIGDON, HUNTER, LEE",9550 ROCKY RIVER RD STE 150 CHARLOTTE NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 16 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619647021,"HIGDON, HUNTER, LEE",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619647021,"HIGDON, HUNTER, LEE",650 JULIAN RD   SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 11 , 12 , 19 ,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619647971,"GIESE, LAUREN, WALLRICHS",3004 TOWER BLVD   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 24 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1619648318,"TURNER, JENNIFER, MCLEOD",801 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1356896187,APPALACHIAN MOUNTAIN COMMUNITY HEAL,PEACHTREE COMMUNITY HEALTH CENTER,4226 E US 64 ALT   MURPHY NC,020,Cherokee,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619652021,"THIGPEN, DEBRA, WYNN",4048 E U S HIGHWAY 64 ALTERNATE SUITE   MURPHY NC,011,Buncombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619653680,"BARNES, HANNAH, LOUISE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619653680,"BARNES, HANNAH, LOUISE",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619654241,"HEINTZELMAN, MARY, CAITLIN SAMUELS",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 108 , 108 ,$#,,
MEDICAID DIRECT,1619655131,MEDLINK HOMECARE LLC,,2307 W CONE BLVD STE 110A GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,1619655131,MEDLINK HOMECARE LLC,2307 W CONE BLVD STE 110A GREENSBORO NC,041,Guilford,253Z00000X,Agencies,In Home Supportive Care,,#, 181 , 193 ," $28,238.48 ",,
MEDICAID DIRECT,1619656444,MG DEVELOPMENTAL SUPPORT SERVICES,MG DEVELOPMENTAL SUPPORT SERVICES,107 PARK JAMES WAY   CARY NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,,1619656444,MG DEVELOPMENTAL SUPPORT SERVICES,107 PARK JAMES WAY   CARY NC,092,Wake,251S00000X,Agencies,Community/Behavioral Health,, 29 , 594 , 594 ," $38,086.20 ",,
MEDICAID DIRECT,1619658341,LIBBY J BLACKWELL,LIBBY FAMILY CARE HOME,4035 WOODLEAF BARBER RD   CLEVELAND NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619658341,LIBBY J BLACKWELL,4035 WOODLEAF BARBER RD   CLEVELAND NC,080,Rowan,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 365 , 365 ," $35,094.75 ",,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619658549,"WESLEY, BRIANNA, CHRISTINE",507 E FREMONT ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1619658549,"WESLEY, BRIANNA, CHRISTINE",507 E FREMONT ST   BURGAW NC,071,Pender,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 19 , 25 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619658549,"WESLEY, BRIANNA, CHRISTINE",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619658549,"WESLEY, BRIANNA, CHRISTINE",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1619658549,"WESLEY, BRIANNA, CHRISTINE",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 22 , 23 , 25 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1619658549,"WESLEY, BRIANNA, CHRISTINE",348 S COLLEGE RD STE A WILMINGTON NC,065,New Hanover,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 44 , 127 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,193200000X,Group,Multi-Specialty,,1619658549,"WESLEY, BRIANNA, CHRISTINE",82 WHITES CROSSING LN   WHITEVILLE NC,024,Columbus,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 26 , 26 , 81 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619661089,"LAWSON, ALEXANDRA, LEIGH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 62 , 64 , 86 ,$#,,
MEDICAID DIRECT,1619661600,C & S OPTOMETRIC SERVICES PLLC,CREEKSIDE FAMILY EYE CARE,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619661600,C & S OPTOMETRIC SERVICES PLLC,2038 WATERSCAPE WAY   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,, 18 , 19 , 36 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619661725,"RATHBUN, KAYLEIGH, ELIZABETH",10211 ALM ST STE 212 RALEIGH NC,092,Wake,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619665825,"LOVETTE, DANIEL, ROSS",146 NESBITT RDG   LAKE LURE NC,081,Rutherford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 44 , 136 , 179 ," $12,399.62 ",,
MEDICAID DIRECT,1003384140,BLUE RIDGE COMMUNITY HEALTH SERVICE,LAKE LURE HEALTH CENTER,146 NESBITT RDG   LAKE LURE NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1619665825,"LOVETTE, DANIEL, ROSS",29 W FRENCH BROAD ST STE 202 BREVARD NC,088,Transylvania,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619665924,BEAZI HOMECARE SERVICES,BEAZI HOMECARE SERVICES,9723 NORTHCROSS CENTER CT STE K HUNTERSVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1619665924,BEAZI HOMECARE SERVICES,9723 NORTHCROSS CENTER CT STE K HUNTERSVILLE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 61 , 61 ,$#,,
MEDICAID DIRECT,1437834058,DLP WILSON PHYSICIAN PRACTICES LLC,WILSON FAMILY CARE,1700 TARBORO ST W STE 100 WILSON NC,098,Wilson,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619673019,"MENDOZA, PATRICIA, MARIA",1700 TARBORO ST W STE 100 WILSON NC,098,Wilson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 69 , 131 , 258 ," $14,513.39 ",,
MEDICAID DIRECT,1619673258,THRIVE SAMPSON LLC,THRIVE SAMPSON PHYSICAL THERAPY & WELLNESS,1302 SUNSET AVE   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,1619673258,THRIVE SAMPSON LLC,1302 SUNSET AVE   CLINTON NC,082,Sampson,193400000X,Group,Single Specialty,,#, 15 , 34 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619674116,"LANIER, OLIVIA, MARGARET",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619674116,"LANIER, OLIVIA, MARGARET",3000 NEW BERN AVENUE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619677754,"GERST, JENETTE, G",2525 COURT DR   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",12201 N NC HIGHWAY 150 STE 11 WINSTON SALEM NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",2630 WILLARD DAIRY RD   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912381203,MEDIQ URGENT CARE PC,MEDIQ URGENT CARE,5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",5718 W GATE CITY BLVD   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",3518 DRAWBRIDGE PKWY   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619678281,"ROBBINS, COOPER, ALAN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1619682358,RENA HOME CARE LLC,,7208 BRICE KNOLL LN APT 401 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,1619682358,RENA HOME CARE LLC,7208 BRICE KNOLL LN APT 401 CHARLOTTE NC,060,Mecklenburg,253Z00000X,Agencies,In Home Supportive Care,,#, 724 , 724 ," $44,881.54 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619687449,"SPURLING, REBECCA, LYNN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619687449,"SPURLING, REBECCA, LYNN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 22 , 23 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619688975,"SYKES, SHAMIR, MCCALL",2301 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619688975,"SYKES, SHAMIR, MCCALL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619688975,"SYKES, SHAMIR, MCCALL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1306597695,ALLES & ASSOCIATES NORTH CAROLINA,IDEAL DENTAL OF WINSTON-SALEM,336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619689536,"SALEM, ESRAA, FATHY",336 E HANES MILL RD   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 142 , 249 , 849 ," $74,448.18 ",,
MEDICAID DIRECT,1093497521,ALLES DDS HUNTERSVILLE PLLC,IDEAL DENTAL HUNTERSVILLE,14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619689536,"SALEM, ESRAA, FATHY",14227 BOREN ST STE 102 HUNTERSVILLE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 74 ,$#,,
MEDICAID DIRECT,1619691185,SPRINGVIEW SENIOR LIVING INC,SPRINGVIEW-COOK BUILDING,715 E HAGGARD AVE   ELON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619691185,SPRINGVIEW SENIOR LIVING INC,715 E HAGGARD AVE   ELON NC,001,Alamance,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,836 "," 1,836 "," $128,594.35 ",,
MEDICAID DIRECT,1265064414,VITAE HEALTH MEDICAL NORTH CAROLINA,,550 GLENWOOD DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619692605,"MONCREIFT, ANTHONY, CURTIS",136 FAIRVIEW RD STE 125 MOORESVILLE NC,049,Iredell,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 65 , 116 , 116 ,$#,,
MEDICAID DIRECT,1316160641,MOUNT ZION MEDICAL AND NURSING SERV,THE MOUNT ZION MEDICAL CLINICS PA,6608 E WT HARRIS BLVD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619714466,"JOHNSON, KOLU, LEELEE",6608 E W T HARRIS BLVD STE A CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 130 , 415 , 421 ," $13,738.48 ",,
MEDICAID DIRECT,1295390409,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC CENTER FOR PSYCHIATRY,125 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619719523,"SANDS, NICHOLAS, ROBERT",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,101YM0800X,Behavioral Health & Social Service Providers,Counselor,Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619732849,"STALFORD, ELIZABETH, ASHLEIGH",3000 NEW BERN AVE   RALEIGH NC,092,Wake,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619735396,"CULPEPPER, GRACE, KELLI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1053618801,B G HARRISON DDS AND ASSOCIATES PA,DAY AND NIGHT FAMILY DENTAL,1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619743382,"WHITEKO, STEPHEN, VICTOR",1408 SKIBO RD   FAYETTEVILLE NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 202 , 217 , 690 ," $41,953.24 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619744208,"VANCE, SAMANTHA, MARIE",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 27 , 65 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619744208,"VANCE, SAMANTHA, MARIE",2165 MEDICAL PARK DR   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 76 , 153 ,$#,,
MEDICAID DIRECT,1619746781,C GROUP HOME CARE AGENCY LLC,,701 S GEORGE ST STE 12 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,1619746781,C GROUP HOME CARE AGENCY LLC,701 S GEORGE ST STE 12 GOLDSBORO NC,096,Wayne,253Z00000X,Agencies,In Home Supportive Care,,#, 706 , 706 ," $46,946.92 ",,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,2600 E 7TH ST UNIT A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619751773,"KURIAKOSE, ANGELA",2600 E 7TH STREET UNIT A   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215995444,CAROLINA ASTHMA AND ALLERGY CENTER,CAROLINA ASTHMA & ALLERGY CENTER PA,8401 UNIVERSITY EXEC PARK DR STE 128 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619751773,"KURIAKOSE, ANGELA",2600 E 7TH STREET UNIT A   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215932215,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA FAMILY MEDICINE - HUDSON,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619752300,"HIXSON, CHRISTINA, CAMPBELL",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 36 , 48 , 106 ,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619752821,"YARBOROUGH, ELIZABETH, HILL",2525 COURT DR   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1629197744,CAROMONT MEDICAL GROUP INC,CAROMONT PSYCHIATRIC ASSOCIATES,1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619752821,"YARBOROUGH, ELIZABETH, HILL",1337 E GARRISON BLVD   GASTONIA NC,036,Gaston,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619753605,"VOLOS, HEIDI",3500 N DUKE ST STE 1 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619753605,"VOLOS, HEIDI",3500 N DUKE ST STE 1 DURHAM NC,032,Durham,152W00000X,Eye and Vision Services Providers,Optometrist,, 14 , 14 , 22 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619756210,"BROWN, EMYLEE, MORGAN",170 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 17 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619756210,"BROWN, EMYLEE, MORGAN",170 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619756210,"BROWN, EMYLEE, MORGAN",170 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 28 , 43 , 93 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619756210,"BROWN, EMYLEE, MORGAN",170 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 14 , 18 , 42 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619756210,"BROWN, EMYLEE, MORGAN",170 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 42 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619756210,"BROWN, EMYLEE, MORGAN",170 MEDICAL PARK RD STE 301 MOORESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 30 , 77 , 174 ,$#,,
MEDICAID DIRECT,1093029563,ONSLOW COUNTY PARTNERSHIP FOR CHIL,ONE PLACE,900 DENNIS RD   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1619757523,"MALU, CHRISTINA, YVONNE",900 DENNIS RD   JACKSONVILLE NC,067,Onslow,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,150 FAIRVIEW RD STE 210 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619758182,"CLAY BARTOSZ, ALYSSA, DANIELLE",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619758182,"CLAY BARTOSZ, ALYSSA, DANIELLE",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 36 , 71 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619758182,"CLAY BARTOSZ, ALYSSA, DANIELLE",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 23 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619758182,"CLAY BARTOSZ, ALYSSA, DANIELLE",131 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1619762481,COMFORT COVE BUSINESS LLC,,807 4TH ST SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1619762481,COMFORT COVE BUSINESS LLC,807 4TH ST SW   CONOVER NC,018,Catawba,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 323 , 323 ," $20,017.31 ",,
MEDICAID DIRECT,1295740934,CALDWELL MEMORIAL HOSPITAL,ANDERSON MEDICAL PARK,270 PINE MOUNTAIN RD STE 2 HUDSON NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1619783651,"FARRELL, MICHAELA, ELIZABETH",270 PINE MOUNTAIN RD STE 4 HUDSON NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1114935673,CALDWELL MEMORIAL HOSPITAL,ROBBINS MEDICAL PARK,322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1619783651,"FARRELL, MICHAELA, ELIZABETH",322 MULBERRY ST SW STE A LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1417962150,CALDWELL MEMORIAL HOSPITAL,SOUTHFORK MEDICAL PARK,1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1619783651,"FARRELL, MICHAELA, ELIZABETH",1731 CONNELLY SPRINGS RD   LENOIR NC,014,Caldwell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 21 , 21 ,$#,,
MEDICAID DIRECT,1477089613,UNC PHYSICIANS NETWORK LLC,~,2400 WAYNE MEMORIAL DR STE I GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1619791969,"AGARDI, MEGAN, MARY FRANCES",2400 WAYNE MEMORIAL DR STE 1 GOLDSBORO NC,096,Wayne,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1245223783,ADVANCE COMMUNITY HEALTH INC,ADVANCE COMMUNITY HEALTH,1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619798147,"MINELLA, SHORUS, MANNING",1011 ROCK QUARRY RD   RALEIGH NC,092,Wake,133V00000X,Dietary & Nutritional Service Providers,"Dietitian, Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619900206,"LESSARIS, KAREN, JOYCE",352 2ND ST NW STE 205 HICKORY NC,018,Catawba,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,,,$#,,
MEDICAID DIRECT,1831137330,NEONATOLOGY & PEDIATRIC ACUTE CARE,~,352 2ND ST NW STE 205 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1619900206,"LESSARIS, KAREN, JOYCE",352 2ND ST NW STE 205 HICKORY NC,018,Catawba,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#, 127 , 128 ," $27,014.86 ",,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619901030,"ALLEN, JOANNE, BELL",1721 ALLENS LN STE 101 WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 37 , 46 , 146 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619901030,"ALLEN, JOANNE, BELL",1721 ALLENS LN STE 101 WILMINGTON NC,065,New Hanover,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#, 35 ,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619901360,"JOHNSON, NICOLE, BELSLEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1265493233,PRESBYTERIAN PATHOLOGY GROUP PLLC,PRESBYTERIAN PATHOLOGY GROUP PLLC,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619901360,"JOHNSON, NICOLE, BELSLEY",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 18 , 18 , 33 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2545 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1619902673,"COTTER, DANIEL, TIMOTHY",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1316455223,MOSES CONE PHYSICIAN SERVICES INC,~,1248 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619902749,"GARRETT, TINA, SMITH",1248 HUFFMAN MILL RD STE 201 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 100 , 101 ,$#,,
MEDICAID DIRECT,1427095249,MOSES CONE MEDICAL SERVICES INC,~,520 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619902749,"GARRETT, TINA, SMITH",520 N ELAM AVE   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619902749,"GARRETT, TINA, SMITH",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1073698502,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE GASTROENTEROLOGY,1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619902749,"GARRETT, TINA, SMITH",1002 N CHURCH ST STE 201 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1720115512,THE NEIL GROUP INC,~,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619902871,"NEIL II, RANSFORD, AUTHURBURY",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619906443,"SAWHNEY, ANITA",140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 21 , 23 , 36 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619906872,"KUNDARIA, BHANJI, DHARAMSHI",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619906872,"KUNDARIA, BHANJI, DHARAMSHI",16455 STATESVILLE RD STE 280 HUNTERSVILLE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1619907334,"WONSICK, MELINDA, DONELLE",~,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,1619907334,"WONSICK, MELINDA, DONELLE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1619907334,"WONSICK, MELINDA, DONELLE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 43 , 43 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1619907334,"WONSICK, MELINDA, DONELLE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1295193340,ASHE FINANCIAL SERVICES LLC,ASHE FINANCIAL SERVICES LLC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1619907334,"WONSICK, MELINDA, DONELLE",200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 69 , 210 , 295 ,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619907599,"KALICH, JENNIFER, ANN",1025 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619907599,"KALICH, JENNIFER, ANN",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 13 , 15 , 23 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619907987,"NICOLOTTI, LINDA, MARIE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,500 ACADEMY ST S   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",500 ACADEMY ST S   AHOSKIE NC,046,Hertford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 146 ," $12,805.87 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,4384 NC HIGHWAY 41 W   TRENTON NC,052,Jones,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",4384 NC HIGHWAY 41 W   TRENTON NC,052,Jones,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 29 , 34 , 185 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1378 NC HIGHWAY 58 S   TRENTON NC,052,Jones,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",1378 NC HIGHWAY 58 S   TRENTON NC,052,Jones,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 88 , 172 , 608 ," $14,512.76 ",,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,300 TRENT ST   POLLOCKSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",300 TRENT ST   POLLOCKSVILLE NC,052,Jones,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 21 , 34 , 149 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,814 SIXTH ST   MAYSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",814 SIXTH ST   MAYSVILLE NC,052,Jones,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 24 , 38 , 157 ,$#,,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",100 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 82 , 104 , 263 ," $15,595.19 ",,
MEDICAID DIRECT,1689815284,EAST CAROLINA UNIVERSITY,~,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#, 18 ,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,102 BETHESDA DR   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",102 BETHESDA DR   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 18 , 18 , 310 ," $24,618.01 ",,
MEDICAID DIRECT,1275806762,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,716 US HIGHWAY 13 N   WINDSOR NC,008,Bertie,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#,#,#,$#,,
MEDICAID DIRECT,1669750014,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF DENTAL MEDICINE,1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619908399,"WEBB, MICHAEL, DEAN",1851 MACGREGOR DOWNS RD   GREENVILLE NC,074,Pitt,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry, 441 , 496 ," 1,612 "," $59,696.11 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619908811,"BERGE, CHRISTOPHER, RONALD",501 N ELAM AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619908811,"BERGE, CHRISTOPHER, RONALD",1200 N ELM ST   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 45 , 77 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619908951,"SMITH, CANDACE, THIELE",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 21 , 35 , 113 ,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619908951,"SMITH, CANDACE, THIELE",3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902512957,EAGLE PHYSICIANS AND ASSOCIATES PA,EAGLE AT WEST FRIENDLY,5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619908951,"SMITH, CANDACE, THIELE",5921 W FRIENDLY AVE STE D GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1619908951,"SMITH, CANDACE, THIELE",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619908951,"SMITH, CANDACE, THIELE",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 21 ,$#,,
MEDICAID DIRECT,1184665499,EAGLE PHYSICIANS AND ASSOCIATES PA,~,3511 W MARKET ST STE 250 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619908951,"SMITH, CANDACE, THIELE",3511 W MARKET ST STE A GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 12 , 43 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619909058,"LESLIE, LAWRENCE, F",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1619909058,"LESLIE, LAWRENCE, F",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619909389,"REDD, TANYA, DONIELLE",TANYA DONIELLE REDD DBA REDD FAMILY DENTISTRY,2006 NEW GARDEN RD STE 101 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice,1619909389,"REDD, TANYA, DONIELLE",2006 NEW GARDEN RD STE 101 GREENSBORO NC,041,Guilford,1223G0001X,Dental Providers,Dentist,General Practice, 43 , 73 , 235 ," $10,948.57 ",,
MEDICAID DIRECT,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,PROMPTCARE HOMETOWN RESPIRATORY,2205 MERCANTILE DR # 2 LELAND NC,010,Brunswick,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,2205 MERCANTILE DR # 2 LELAND NC,010,Brunswick,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 18 , 18 ," $12,717.87 ",,
MEDICAID DIRECT,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,PROMPTCARE HOMETOWN RESPIRATORY,2205 MERCANTILE DR # 2 LELAND NC,010,Brunswick,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,2205 MERCANTILE DR # 2 LELAND NC,010,Brunswick,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 129 ," 1,508 "," 2,716 "," $470,771.75 ",,
MEDICAID DIRECT,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,PROMPTCARE HOMETOWN RESPIRATORY,,,Unknown,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,369 CONCORD PKWY N   CONCORD NC,013,Cabarrus,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,PROMPTCARE HOMETOWN RESPIRATORY,2205 MERCANTILE DR # 2 LELAND NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1619909496,HOMETOWN OXYGEN CHARLOTTE LLC,2205 MERCANTILE DR # 2 LELAND NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619913068,"COPELAND, GARY, BRENT",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 11 , 18 , 19 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619913274,"REESE, JOHN, LESLIE",415 N CENTER ST STE 201 HICKORY NC,018,Catawba,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1285767129,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,1622 E MARION ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1619913274,"REESE, JOHN, LESLIE",1622 E MARION ST   SHELBY NC,023,Cleveland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 68 , 82 , 82 ,$#,,
MEDICAID DIRECT,1407960354,MORGANTON EYE PHYSICIANS PA,Morganton Eye Physicians PA,335 E PARKER RD   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1619913274,"REESE, JOHN, LESLIE",335 E PARKER RD   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 22 , 22 , 22 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619914850,"MACMILLAN JR, DOUGLAS, PIERCE",222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 23 , 28 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619914850,"MACMILLAN JR, DOUGLAS, PIERCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 76 , 100 , 140 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,222 ASHELAND AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619914850,"MACMILLAN JR, DOUGLAS, PIERCE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 25 , 26 , 39 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619915600,"MASTEN, BETTY, MCDONALD",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619915600,"MASTEN, BETTY, MCDONALD",1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 26 , 26 , 54 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1619915600,"MASTEN, BETTY, MCDONALD",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619916038,"SAXONHOUSE, MATTHEW, ADAM",101 E W T HARRIS BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619916038,"SAXONHOUSE, MATTHEW, ADAM",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 24 , 120 , 120 ," $25,893.60 ",,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619916640,"ELLIOTT, MICHAEL, DAVID",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 27 , 28 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619916640,"ELLIOTT, MICHAEL, DAVID",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 15 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619916640,"ELLIOTT, MICHAEL, DAVID",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 78 , 78 , 219 ,$#,,
MEDICAID DIRECT,1710290564,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,100 MEDICAL PARK DR STE 210 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619916640,"ELLIOTT, MICHAEL, DAVID",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,,,Unknown,193200000X,Group,Multi-Specialty,,1619916640,"ELLIOTT, MICHAEL, DAVID",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619916640,"ELLIOTT, MICHAEL, DAVID",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,,,$#,,
MEDICAID DIRECT,1417272907,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,10650 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619916640,"ELLIOTT, MICHAEL, DAVID",1001 BLYTHE BLVD STE 300 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,430 RANKIN DR   MARION NC,059,McDowell,193200000X,Group,Multi-Specialty,,1619916947,"MARTIN, DEVIN, REECE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619916947,"MARTIN, DEVIN, REECE",430 RANKIN DR   MARION NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619916947,"MARTIN, DEVIN, REECE",124 ONE CENTER CT   FRANKLIN NC,056,Macon,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619916947,"MARTIN, DEVIN, REECE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 18 , 20 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,615 RIDGE RD   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619916947,"MARTIN, DEVIN, REECE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1407881691,ROANOKE CHOWAN COMMUNITY HEALTH CEN,AHOSKIE COMPREHENSIVE CARE,120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1619919230,"DHOOPATI, VIJAY, RAMARAJU",120 HEALTH CENTER DR   AHOSKIE NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619920378,"HARRIS, TIMOTHY, EDWARD",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 19 , 24 , 41 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619920378,"HARRIS, TIMOTHY, EDWARD",505 OBERLIN RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 17 , 28 , 46 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619920378,"HARRIS, TIMOTHY, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 26 , 41 , 74 ,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619920378,"HARRIS, TIMOTHY, EDWARD",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 31 , 36 , 61 ," $19,970.09 ",,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619920378,"HARRIS, TIMOTHY, EDWARD",23 SUNNYBROOK RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1417512690,WAKEMED SPECIALISTS GROUP LLC,WAKEMED WAKE ORTHOPAEDICS,3009 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619920378,"HARRIS, TIMOTHY, EDWARD",3009 NEW BERN AVE   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 33 , 45 , 81 ,$#,,
MEDICAID DIRECT,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,MOUNTAIN EAR NOSE AND THROAT ASSOCIATES PA,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1619920550,MOUNTAIN EAR NOSE AND THROAT ASSOCI,38 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,, 172 , 196 , 399 ,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619921269,"PAL, SUBODH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619921269,"PAL, SUBODH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902126444,SAMPSON REGIONAL HOSPITALISTS LLC,SAMPSON REGIONAL HOSPITALISTS LLC,607 BEAMAN ST   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1619921269,"PAL, SUBODH",607 BEAMAN ST   CLINTON NC,082,Sampson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 172 , 854 , 866 ," $26,422.70 ",,
MEDICAID DIRECT,1063950046,TRI-CITIES REGIONAL EMERGENCY PHYSI,,400 N STATE OF FRANKLIN RD   JOHNSON CITY TN,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619923729,"KEHLER, GEORGE, BELA",1420 TUSCULUM BLVD   GREENEVILLE TN,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,941 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619923836,"LUCAS, KENT, VINCENT",702 NEWMAN RD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538114244,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,1300 HELEN AVE   NEW BERN NC,025,Craven,251B00000X,Agencies,Case Management,,1619923836,"LUCAS, KENT, VINCENT",702 NEWMAN RD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 34 , 34 ," $12,630.00 ",,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619923836,"LUCAS, KENT, VINCENT",702 NEWMAN RD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 118 , 275 , 470 ,$#,,
MEDICAID DIRECT,1750567970,COASTAL CAROLINA HEALTH CARE PA,CCHC CENTRAL LAB,1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619923836,"LUCAS, KENT, VINCENT",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 42 , 129 ,$#,,
MEDICAID DIRECT,1780623207,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN INTERNAL MEDICINE SPECIALISTS,702 NEWMAN RD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619923836,"LUCAS, KENT, VINCENT",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 34 , 38 , 38 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619925419,"RODDEY, JOHN, GARDINER RICHARDS",2015 RANDOLPH RD STE AND101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619925419,"RODDEY, JOHN, GARDINER RICHARDS",2015 RANDOLPH RD STE AND101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 14 , 20 , 33 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619925419,"RODDEY, JOHN, GARDINER RICHARDS",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619925419,"RODDEY, JOHN, GARDINER RICHARDS",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619925419,"RODDEY, JOHN, GARDINER RICHARDS",2015 RANDOLPH RD STE AND101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 27 , 33 , 39 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 101 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619925419,"RODDEY, JOHN, GARDINER RICHARDS",2015 RANDOLPH RD STE AND101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#, 13 ,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,2015 RANDOLPH RD STE 208 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619925419,"RODDEY, JOHN, GARDINER RICHARDS",2015 RANDOLPH RD STE AND101 CHARLOTTE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619925567,"JOSEPHSON, STEVEN, ARTHUR",115 COMMERCE POINTE BLVD   MOORESVILLE NC,049,Iredell,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619925567,"JOSEPHSON, STEVEN, ARTHUR",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology,#,#,#,$#,,
MEDICAID DIRECT,1730100801,CHARLOTTE GASTROENTEROLOGY AND HEPA,CHARLOTTE GASTROENTEROLOGY AND HEPATOLOGY PLLC,13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619925567,"JOSEPHSON, STEVEN, ARTHUR",13808 PROFESSIONAL CENTER DR   HUNTERSVILLE NC,060,Mecklenburg,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 16 , 24 , 27 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619925575,"MCGREGOR, JON, BRANT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 21 , 26 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,428 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619925575,"MCGREGOR, JON, BRANT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 13 , 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619925575,"MCGREGOR, JON, BRANT",5 VANDERBILT PARK DR   ASHEVILLE NC,011,Buncombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194031211,PETER K DUNN OD PA,PETER K DUNN OD PA,306 MUIRS CHAPEL RD STE B GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619925799,"DUNN, PETER",306 MUIRS CHAPEL RD STE B GREENSBORO NC,041,Guilford,152W00000X,Eye and Vision Services Providers,Optometrist,, 67 , 77 , 124 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,720 MALCOLM BLVD   VALDESE NC,012,Burke,193200000X,Group,Multi-Specialty,,1619925815,"TAYLOR, JERRY, JUERGEN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 22 , 23 , 24 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1619925815,"TAYLOR, JERRY, JUERGEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 40 , 41 , 44 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2201 S STERLING ST   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1619925815,"TAYLOR, JERRY, JUERGEN",2201 S STERLING ST   MORGANTON NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 29 , 32 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1619925815,"TAYLOR, JERRY, JUERGEN",720 MALCOLM BLVD   VALDESE NC,012,Burke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619927043,COUNTY OF EDGECOMBE OFFICE OF AUDI,COUNTY OF EDGECOMBE,122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,251B00000X,Agencies,Case Management,,1619927043,COUNTY OF EDGECOMBE OFFICE OF AUDI,122 E SAINT JAMES ST   TARBORO NC,033,Edgecombe,251B00000X,Agencies,Case Management,, 159 ," 1,593 "," 1,593 "," $600,278.25 ",,
MEDICAID DIRECT,1427212562,EAST CAROLINA CENTER FOR SIGHT PA,EAST CAROLINA CENTER FOR SIGHT PA,1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619930120,"TITONE, CHARLES, WILLIAM",1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 15 , 21 , 31 ,$#,,
MEDICAID DIRECT,1427212562,EAST CAROLINA CENTER FOR SIGHT PA,EAST CAROLINA CENTER FOR SIGHT PA,1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619930120,"TITONE, CHARLES, WILLIAM",1011 WH SMITH BLVD STE 108 GREENVILLE NC,074,Pitt,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 11 , 15 , 18 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619930740,"EBERT, ANGELA, FANELLA",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 16 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,501 S SHARON AMITY RD STE 300 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619932746,"YORK, JOANNA, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 12 , 13 , 14 ,$#,,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619932746,"YORK, JOANNA, ELIZABETH",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2080P0204X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Emergency Medicine, 39 , 39 , 41 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1619933322,"TAUSCH, GILBERT, STEPHEN",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 37 , 39 , 39 ,$#,,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1619933322,"TAUSCH, GILBERT, STEPHEN",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619934817,"HSI, ERIC",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207ZP0105X,Allopathic & Osteopathic Physicians,Pathology,Clinical Pathology/Laboratory Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,300 ASHVILLE AVE STE 307 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619935152,"FINAZZO, JOSEPHINE, JOANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619935152,"FINAZZO, JOSEPHINE, JOANN",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,110 S ESTES DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619935152,"FINAZZO, JOSEPHINE, JOANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,4301 LAKE BOONE TRL STE 103 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619935152,"FINAZZO, JOSEPHINE, JOANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,7636 PURFOY RD STE 200 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1619935152,"FINAZZO, JOSEPHINE, JOANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619935152,"FINAZZO, JOSEPHINE, JOANN",101 MANNING DR   CHAPEL HILL NC,068,Orange,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 334 , 400 , 448 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619937760,"VERDINO, NINA, JAIME",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2080P0203X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Critical Care Medicine,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1619937760,"VERDINO, NINA, JAIME",11130 CAPITAL BLVD   WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 43 , 57 , 107 ,$#,,
MEDICAID DIRECT,1619938479,VANCE FAMILY MEDICINE PA,Vance Family Medicine PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1619938479,VANCE FAMILY MEDICINE PA,381 RUIN CREEK RD   HENDERSON NC,091,Vance,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,#,#,#,$#,,
MEDICAID DIRECT,1295790657,MECKLENBURG RADIOLOGY ASSOCIATES,Mecklenburg Radiology Associates,3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619939667,"ORAVETZ, NICHOLAS, ANDREW",3623 LATROBE DR STE 216 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 35 , 38 , 48 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619940228,"HAILE, DEREJE, ZEWDE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619940228,"HAILE, DEREJE, ZEWDE",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1881667251,OBERLIN ROAD PEDIATRICS PA,OBERLIN ROAD PEDIATRICS PA,1321 OBERLIN RD STE A RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1619940434,"WASSERMAN, BRADLEY, JARED",1321 OBERLIN RD STE A RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 16 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,2100 RIDGEFIELD BLVD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619941135,"LEBLANC, MICHELLE, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1619941135,"LEBLANC, MICHELLE, ANN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",150 ROBESON ST   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",2560 LEGION RD   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 19 , 54 , 54 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 135 , 177 , 242 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 51 , 169 , 169 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",300 W 27TH ST   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 47 , 47 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",810 WESLEY PINES RD   LUMBERTON NC,078,Robeson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",1740 SOUTHEAST BLVD   CLINTON NC,082,Sampson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 18 , 105 , 105 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",100 E PLEASANT ST   ROSEBORO NC,082,Sampson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 43 , 43 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619941150,"SUN, EMILY, XIAOMEI",100 E PLEASANT ST DIALYSIS CLINIC ROSEBORO NC,082,Sampson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619941150,"SUN, EMILY, XIAOMEI",1740 SOUTHEAST BLVD   CLINTON NC,082,Sampson,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1316013733,WATAUGA MEDICAL CENTER INC,WATAUGA MEDICAL CENTER,336 DEERFIELD RD   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1619942158,"PLYLER, WILLIAM, LANSON",336 DEERFIELD RD   BOONE NC,095,Watauga,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114467404,NORTHERN HOSPITAL OF SURRY COUNTY,HOSPITALISTS OF MT AIRY,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1619943982,"MELVIN, ERIC, JOE",830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 52 , 162 , 162 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1619945029,"WILLIAMS, DAVID, ROBERT",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 19 , 72 ,$#,,
MEDICAID DIRECT,1922004852,PIEDMONT PATHOLOGY ASSOCIATES,PIEDMONT PATHOLOGY ASSOCS INC,1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1619945649,"OLYMPIO, GEORGIA, KANTRALES",1899 TATE BLVD SE STE 1105 HICKORY NC,018,Catawba,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 22 , 25 , 42 ,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619945698,"HAWKINSON, MURRAY, GREY",1104A S MAIN ST   LEXINGTON NC,029,Davidson,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1013246727,DIGESTIVE DISEASE CENTER PA,~,2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1619945953,"MOTAPARTHY, VENKATASOMAIAH, CHOUDARY",2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 169 , 289 , 307 ," $10,147.96 ",,
MEDICAID DIRECT,1205804697,GOLDSBORO ENDOSCOPY CENTER INC,GOLDSBORO ENDOSCOPY CENTER INC,2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,261QA1903X,Ambulatory Health Care Facilities,Clinic/Center,Ambulatory Surgical,1619945953,"MOTAPARTHY, VENKATASOMAIAH, CHOUDARY",2705 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 56 , 62 , 76 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619946472,"METCALF, MICHAEL, RICHARD",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 42 , 144 , 144 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,195 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1619946738,"SANDERS, JASON, BROWNING",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#,#,#,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619946738,"SANDERS, JASON, BROWNING",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist, 42 , 83 , 130 ," $28,236.72 ",,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619946738,"SANDERS, JASON, BROWNING",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1477788297,PIEDMONT RETINA SPECIALISTS PA,PIEDMONT RETINA SPECIALISTS,1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619946738,"SANDERS, JASON, BROWNING",1132 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,207WX0107X,Allopathic & Osteopathic Physicians,Ophthalmology,Retina Specialist,#, 13 , 28 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619947215,"HINES, SUSAN, JEAN",175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology,#,#,#,$#,,
MEDICAID DIRECT,1083338677,NOVANT HEALTH THOMASVILLE MEDICAL C,NH THOMASVILLE CANCER CLINICS,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619947215,"HINES, SUSAN, JEAN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1952610073,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CANCER INSTITUTE,,,Unknown,193200000X,Group,Multi-Specialty,,1619947215,"HINES, SUSAN, JEAN",865 WESTLAKE DR   MOUNT AIRY NC,086,Surry,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1952610073,FORSYTH MEMORIAL HOSPITAL INC,NOVANT HEALTH CANCER INSTITUTE,1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1619947215,"HINES, SUSAN, JEAN",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619947215,"HINES, SUSAN, JEAN",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 33 , 59 , 59 ,$#,,
MEDICAID DIRECT,1114649894,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH SPECIALTY CLINICS,175 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619947215,"HINES, SUSAN, JEAN",1908 CAUDLE DR STE 200 MOUNT AIRY NC,086,Surry,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 27 , 46 , 46 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619948072,"DEMASI, RICHARD, JAMES",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619948072,"DEMASI, RICHARD, JAMES",850 KEMPSVILLE RD STE 100 NORFOLK VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1427096528,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS FAMILY MEDICINE,133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1619948379,"WALTER, CORNELIUS, TODD",133 N HOWARD AVE   LANDRUM SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 32 , 55 ,$#,,
MEDICAID DIRECT,1588654610,PROSCAN RADIOLOGY LLC,,5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1619948387,"COHEN, BRADLEY, MILES",5400 KENNEDY AVE   CINCINNATI OH,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396906780,ROBERT B HARRISON DMD MSD PLLC,COASTAL PEDIATRIC DENTISTRY,700 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1619948841,"HARRISON, ROBERT, BRYAN",700 MCCARTHY BLVD   NEW BERN NC,025,Craven,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry,#, 12 , 53 ,$#,,
MEDICAID DIRECT,1396906780,ROBERT B HARRISON DMD MSD PLLC,COASTAL PEDIATRIC DENTISTRY,700 MCCARTHY BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1619948841,"HARRISON, ROBERT, BRYAN",700 MCCARTHY BLVD   NEW BERN NC,025,Craven,1223P0221X,Dental Providers,Dentist,Pediatric Dentistry," 3,567 "," 7,301 "," 26,849 "," $1,199,255.14 ",,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",10211 ALM ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 14 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 51 , 114 ,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619949617,"WALKER, BRIAN, ANTHONY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 19 , 20 , 39 ,$#,,
MEDICAID DIRECT,1770976789,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV-HOKE HOSPITAL ANESTHESIA,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1619949922,"MASON, KATHERINE, WRIGHT",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619949922,"MASON, KATHERINE, WRIGHT",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 14 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",400 THOMPSON ST   HENDERSONVILLE NC,045,Henderson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 23 , 23 ,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 29 , 108 , 108 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 76 , 487 , 487 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 43 , 77 , 77 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",237 TRYON RD   RUTHERFORDTON NC,081,Rutherford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 17 , 17 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,430 W HEALTH CENTER DR   NAGS HEAD NC,028,Dare,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 23 , 23 ,$#,,
MEDICAID DIRECT,1609362375,THEORIA MEDICAL,,41800 W 11 MILE RD STE 109 NOVI MI,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 16 , 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1619950557,"MAKER, CHARLES, G",160 MINE LAKE CT STE 200 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1619950771,"DAILY, JEFFREY, MORRIS",2293 SUGAR HILL RD STE B MARION NC,059,McDowell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619950771,"DAILY, JEFFREY, MORRIS",2293 SUGAR HILL RD STE B MARION NC,059,McDowell,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,799 DOCTORS CT   ROXBORO NC,073,Person,193200000X,Group,Multi-Specialty,,1619950771,"DAILY, JEFFREY, MORRIS",503 E PARKER RD   MORGANTON NC,012,Burke,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619951688,"KNORR, ERIC, JOHN",200 PROVIDENCE RD STE 101 CHARLOTTE NC,060,Mecklenburg,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 104 , 105 , 114 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619952058,"CRISP, PENELOPE, ANN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 43 , 44 , 44 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619952991,"OHL, CHRISTOPHER, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619952991,"OHL, CHRISTOPHER, ALAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 54 , 98 , 103 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,107 E MCCLANAHAN ST   OXFORD NC,039,Granville,193200000X,Group,Multi-Specialty,,1619953353,"SILVER, WILLIAM, PAIGE",120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,,1619953965,MARLBORO CHESTERFIELD PATHOLOGY PC,30 PAGE ST   PINEHURST NC,063,Moore,291U00000X,Laboratories,Clinical Medical Laboratory,, 55 , 54 , 122 ,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1619954500,"DAVIS, THOMAS, ROWLAND",201 E GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1619954500,"DAVIS, THOMAS, ROWLAND",110 W GROVER ST   SHELBY NC,023,Cleveland,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 36 , 44 , 62 ,$#,,
MEDICAID DIRECT,1699006858,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH GENERAL SURGERY LINCOLN,441 MCALISTER RD STE 2100 LINCOLNTON NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1619954948,"ELLIS, MADGE, ELAINE",441 MCALISTER RD STE 2100 LINCOLNTON NC,055,Lincoln,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1134361272,DUKE UNIVERSITY AFFILIATED PHYSICIA,NORTH HILLS INTERNAL MEDICINE,3320 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619955846,"DAWKINS JR, ROBERT, GENE",3320 WAKE FOREST RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 50 , 96 , 208 ,$#,,
MEDICAID DIRECT,1104804459,CATAWBA PEDIATRIC ASSOCIATES PA,~,240 18TH STREET CIR SE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1619955952,"BRIDGEMAN, KELLY, BISCEGLIA",240 18TH STREET CIR SE   HICKORY NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 111 , 150 , 404 ," $17,997.73 ",,
MEDICAID DIRECT,1073562757,MID ATLANTIC EMERGENCY MEDICAL ASSO,~,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619956109,"DIORIO, CHRISTOPHER, ALLEN",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1982994117,UROLOGY OF VIRGINIA PLLC,,225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1619956661,"YOUNG, JAMES, D",225 CLEARFIELD AVE   VIRGINIA BEACH VA,101,Out of State <= 40 miles,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 12 , 21 ,$#,,
MEDICAID DIRECT,1619956901,CAROLINA DIABETIC SUPPLY GROUP INC,CDSG MEDICAL AND WELLNESS,301 N GLENBURNIE RD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1619956901,CAROLINA DIABETIC SUPPLY GROUP INC,301 N GLENBURNIE RD   NEW BERN NC,025,Craven,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 255 , 954 ," 2,198 "," $132,178.73 ",,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1619957305,"CAIN, FELICIA, KAY",720 MALCOLM BLVD   VALDESE NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 21 , 22 , 25 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1619957305,"CAIN, FELICIA, KAY",2201 S STERLING ST   MORGANTON NC,012,Burke,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1912987090,CAROLINA PEDIATRICS OF THE TRIAD,,2707 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1619957644,"NEWELL, MELISSA, VAUGHN",2707 HENRY ST   GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 61 , 145 ,$#,,
MEDICAID DIRECT,1295729747,THE CHILD HEALTH CENTER,THE CHILD HEALTH CENTER,1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1619961166,"FRIERSON, ANGELA, MARIE",1455 25TH AVENUE DR NE   HICKORY NC,018,Catawba,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 57 , 85 , 260 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619962784,"HESTER, MILTON, MARK",9101 MONROE RD STE 155 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 57 , 151 ,$#,,
MEDICAID DIRECT,1619963048,"HALE, LLOYD, SCOTT",~,80 BRYSON WALK   BRYSON CITY NC,087,Swain,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine,1619963048,"HALE, LLOYD, SCOTT",80 BRYSON WALK   BRYSON CITY NC,087,Swain,213EP1101X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Primary Podiatric Medicine," 1,148 "," 2,889 "," 3,426 "," $15,792.95 ",,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1619963121,"CRAWFORD, GARY, STEPHEN",125 RIVER VINE PKWY   WALLACE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 22 , 47 , 78 ,$#,,
MEDICAID DIRECT,1679943674,HEALTHACCESS INC,~,401 N MAIN ST   KENANSVILLE NC,031,Duplin,251B00000X,Agencies,Case Management,,1619963121,"CRAWFORD, GARY, STEPHEN",748 KENANSVILLE BYP   KENANSVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1770699514,GASTON COUNTY,GASTON COUNTY,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1619964046,"SMITH, RAMADA, SHERICE",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1619965274,COUNTY OF RANDOLPH,Randolph County EMS,152 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,3416L0300X,Transportation Services,Ambulance,Land Transport,1619965274,COUNTY OF RANDOLPH,152 N FAYETTEVILLE ST   ASHEBORO NC,076,Randolph,3416L0300X,Transportation Services,Ambulance,Land Transport, 883 ," 1,575 "," 2,988 "," $31,021.95 ",,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619966132,"FERRIS, EDITH",1520 SUNDAY DR   RALEIGH NC,092,Wake,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619966249,"PARACHA, MUHAMMAD, AKRAM",210 LIBERTY HILL RD   LUMBERTON NC,078,Robeson,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 23 , 22 , 22 ,$#,,
MEDICAID DIRECT,1174965826,VALLEY CARDIOLOGY PA,~,3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619966249,"PARACHA, MUHAMMAD, AKRAM",3656 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 192 , 365 , 455 ," $66,810.84 ",,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619966298,"THEVAOS, GEORGE, PHILIP",1994 WELLNESS BLVD STE 110 MONROE NC,090,Union,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 19 , 38 , 89 ,$#,,
MEDICAID DIRECT,1518990423,NEPHROLOGY ASSOCIATES OF TIDEWATER,NEPHROLOGY ASSOCIATES OF TIDEWATER LTD,6160 KEMPSVILLE CIR STE 302A NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1619966512,"RIJHWANI, SURESH, KUMAR",301 RIVERVIEW AVE STE 600 NORFOLK VA,101,Out of State <= 40 miles,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619968864,"CROTTE, FERNANDO",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 14 , 27 , 27 ,$#,,
MEDICAID DIRECT,1508237967,FHPG LLC,~,300 S MIDDLETON ST   ROBBINS NC,063,Moore,193200000X,Group,Multi-Specialty,,1619971694,"BELL, WILLIAM, LEE",7473-B HIGHWAY 22   WHISPERING PINES NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 18 , 32 , 68 ,$#,,
MEDICAID DIRECT,1508237967,FHPG LLC,~,300 S MIDDLETON ST   ROBBINS NC,063,Moore,193200000X,Group,Multi-Specialty,,1619971694,"BELL, WILLIAM, LEE",300 S MIDDLETON ST   ROBBINS NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 60 , 159 , 331 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619972684,"EARLY, TODD, FRANKLIN",1200 N ELM ST   GREENSBORO NC,041,Guilford,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619972684,"EARLY, TODD, FRANKLIN",618 S MAIN ST   REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619973633,"BLAKEY III, GEORGE, HENRY",150 DENTAL CIR 115 BRAUER HALL CB 7450 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 50 , 56 , 265 ," $40,887.88 ",,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619973633,"BLAKEY III, GEORGE, HENRY",150 DENTAL CIR 115 BRAUER HALL CB 7450 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 29 , 29 , 33 ,$#,,
MEDICAID DIRECT,1922176791,SCHOOL OF DENTISTRY UNIVERSITY OF,STUDENT CLINIC,140 DENTAL CIR STE 106 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619973633,"BLAKEY III, GEORGE, HENRY",150 DENTAL CIR 115 BRAUER HALL CB 7450 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 38 , 38 , 83 ,$#,,
MEDICAID DIRECT,1790866564,UNIVERSITY OF NORTH CAROLINA AT CHA,ORAL MAXILLOFACIAL SURGERY,140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1619973633,"BLAKEY III, GEORGE, HENRY",140 DENTAL CIR STE 115 CHAPEL HILL NC,068,Orange,1223S0112X,Dental Providers,Dentist,Oral and Maxillofacial Surgery, 201 , 226 , 485 ," $43,681.88 ",,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619973732,"ROGERS, LOUISE, CREE",8820 RACHEL FREEMAN WAY   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619973732,"ROGERS, LOUISE, CREE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619973732,"ROGERS, LOUISE, CREE",1918 RANDOLPH RD STE 300 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619975752,"CUTRONE, MARTIN, BERNARD",1450 MATTHEWS TOWNSHIP PKWY STE 380 MATTHEWS NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619975752,"CUTRONE, MARTIN, BERNARD",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619975752,"CUTRONE, MARTIN, BERNARD",14035 GRANDIFLORA DR   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1942269451,TRIANGLE COMMUNITY PHYSICIANS PA,Triangle Community Physicians PA,4309 MEDICAL PARK DR STE 200 DURHAM NC,032,Durham,193400000X,Group,Single Specialty,,1619976297,"KLEIN, KOMBIZ, PATRICK",4309 MEDICAL PARK DR STE 200-A DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1619976297,"KLEIN, KOMBIZ, PATRICK",Kombiz Patrick Klein,4309 MEDICAL PARK DR STE 200-A DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,1619976297,"KLEIN, KOMBIZ, PATRICK",4309 MEDICAL PARK DR STE 200-A DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 200 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 36 , 69 , 156 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,124 PROFESSIONAL PARK DR STE A MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 300 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology, 21 , 29 , 113 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1619976479,"FAHEY, SEAN, MICHAEL",128 MEDICAL PARK RD STE 101 MOORESVILLE NC,049,Iredell,207RR0500X,Allopathic & Osteopathic Physicians,Internal Medicine,Rheumatology,#, 23 , 39 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619976537,"WILLIAMS, DELORES, RAYNOR",6959 NEXUS CT   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619976537,"WILLIAMS, DELORES, RAYNOR",557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 26 , 41 ,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619976537,"WILLIAMS, DELORES, RAYNOR",219 MARTIN LUTHER KING JR DR   BLADENBORO NC,009,Bladen,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619976537,"WILLIAMS, DELORES, RAYNOR",101 DIALYSIS DR   ELIZABETHTOWN NC,009,Bladen,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619976537,"WILLIAMS, DELORES, RAYNOR",100 E PLEASANT ST   ROSEBORO NC,082,Sampson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1831198761,CAROLINA KIDNEY CARE PA,~,557 SANDHURST DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1619976537,"WILLIAMS, DELORES, RAYNOR",1740 SOUTHEAST BLVD   CLINTON NC,082,Sampson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1053679944,PERSONALIZED HEMATOLOGY ONCOLOGY OF,~,11635 NORTHPARK DR STE 250 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1619978285,"CASTILLOS, FRANCISCO, ANTONIO",11635 NORTHPARK DR STE 250 WAKE FOREST NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 66 , 390 , 708 ," $14,195.01 ",,
MEDICAID DIRECT,1972551919,EAST CAROLINA UNIVERSITY,FAMILY MEDICINE CTR,1204 E FIRE TOWER RD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619978616,"DAUGHERTY, JANICE, ELAINE",100 HICKORY ST   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1619978939,"MANGUM, JOHN, ROWLAND",205 PAGE RD   PINEHURST NC,063,Moore,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1619979226,PHYSICIANS TOTAL REHAB OF FAYETTEVI,~,2930 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1619979226,PHYSICIANS TOTAL REHAB OF FAYETTEVI,2930 VILLAGE DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 32 , 69 , 109 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619979846,"JOHN, REKHA, ELIZABETH",100 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 30 , 79 , 79 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619979846,"JOHN, REKHA, ELIZABETH",3101 W NEW BERN RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 38 , 247 , 247 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1619979846,"JOHN, REKHA, ELIZABETH",608 AIRPORT RD   KINSTON NC,054,Lenoir,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 133 , 266 , 520 ," $16,830.79 ",,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619982295,"CABAN, AMI, MARIE",9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619982295,"CABAN, AMI, MARIE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619982295,"CABAN, AMI, MARIE",10320 MALLARD CREEK RD STE 260A CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,13620 REESE BLVD E STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619982295,"CABAN, AMI, MARIE",13620 REESE BLVD E STE 110 HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1619985439,"OCONNELL, SUSAN, ROBERTS",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1619986775,SHM LLC,SWAN VIEW MEDICAL SUPPLY,675 W CORBETT AVE STE 1 SWANSBORO NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1619986775,SHM LLC,675 W CORBETT AVE STE 1 SWANSBORO NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies, 37 , 203 , 281 ,$#,,
MEDICAID DIRECT,1619986775,SHM LLC,SWAN VIEW MEDICAL SUPPLY,,,Unknown,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1619986775,SHM LLC,654 W CORBETT AVE   SWANSBORO NC,067,Onslow,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,#, 11 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619989332,"MEYER, JOHN, ANDREW",76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 36 , 43 , 43 ,$#,,
MEDICAID DIRECT,1558468256,PEDIATRIX MEDICAL GROUP OF NORTH CA,CAROLINA NEONATOLOGY ASSOCIATES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619991007,"PAYNE, THOMAS, ARTHUR",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 34 , 156 , 165 ," $22,329.06 ",,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619991353,"CHANG, ALBERT, SHOU YEN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 52 , 55 ,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1619991353,"CHANG, ALBERT, SHOU YEN",2800 BLUE RIDGE RD STE 300 RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 19 , 32 , 37 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1619991528,"ANAND, SANJAY, KUMAR",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 53 , 56 , 61 ,$#,,
MEDICAID DIRECT,1538596747,THE CHARLOTTE-MECKLENBURG HOSPITAL,CAROLINA PEDIATRIC GASTROENTEROLOGY,100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1619992344,"SUMMERS, LISA, ANN",100 MEDICAL PARK DR STE 310E CONCORD NC,013,Cabarrus,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 49 , 71 , 72 ,$#,,
MEDICAID DIRECT,1033637178,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS SUBURBAN PEDIATRICS,201 DALE EARNHARDT BLVD STE 201 KANNAPOLIS NC,013,Cabarrus,193400000X,Group,Single Specialty,,1619992344,"SUMMERS, LISA, ANN",201 DALE EARNHARDT BLVD STE 201 KANNAPOLIS NC,013,Cabarrus,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 20 , 29 , 31 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619992740,"MATTHEWS, MICHELLE, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VE0102X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Reproductive Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1619992740,"MATTHEWS, MICHELLE, LYNN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207VE0102X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Reproductive Endocrinology,#,#,#,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619993946,"RADIONTCHENKO, ALEXEI",291 BROAD ST   KERNERSVILLE NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 44 , 75 , 114 ,$#,,
MEDICAID DIRECT,1023074580,CALDWELL EMERGENCY MEDICAL ASSOC,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1619993979,"RASHID, DANIEL, JEFFREY",321 MULBERRY ST SW   LENOIR NC,014,Caldwell,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1619993979,"RASHID, DANIEL, JEFFREY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619993979,"RASHID, DANIEL, JEFFREY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 21 , 22 , 27 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619993979,"RASHID, DANIEL, JEFFREY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 28 , 30 , 44 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1619993979,"RASHID, DANIEL, JEFFREY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 27 , 29 , 32 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1619993979,"RASHID, DANIEL, JEFFREY",2711 LANE ST   KANNAPOLIS NC,013,Cabarrus,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1194781369,FRYE EMERGENCY MEDICAL ASSOC LLC,,420 N CENTER ST   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1619993979,"RASHID, DANIEL, JEFFREY",420 N CENTER ST   HICKORY NC,018,Catawba,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1619994852,WAL-MART STORES EAST LP,WAL-MART PHARMACY 10-5346,1318 MEBANE OAKS RD   MEBANE NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1619994852,WAL-MART STORES EAST LP,1318 MEBANE OAKS RD   MEBANE NC,001,Alamance,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619995628,"HENRY, ROBERT, PAUL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619995628,"HENRY, ROBERT, PAUL",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1619995628,"HENRY, ROBERT, PAUL",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#, 12 ,$#,,
MEDICAID DIRECT,1619995974,"MOLES, HARVEY",HARVEY MOLES DBA KING CHIROPRACTIC,617 E KING ST   KING NC,085,Stokes,111N00000X,Chiropractic Providers,Chiropractor,,1619995974,"MOLES, HARVEY",617 E KING ST   KING NC,085,Stokes,111N00000X,Chiropractic Providers,Chiropractor,,#, 88 , 88 ,$#,,
MEDICAID DIRECT,1275965410,MCPC-14 LLC,FIRSTHEALTH TRANSITION CARE CLINIC,305 PAGE RD N STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1619996121,"WILSON, SUZANNE, LEE",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619998598,ALAMANCE BURLINGTON SCHOOLS,TURNING POINT DAY TREATMENT PROGRAM,1712 VAUGHN RD   BURLINGTON NC,001,Alamance,251300000X,Agencies,Local Education Agency (LEA),,1619998598,ALAMANCE BURLINGTON SCHOOLS,1712 VAUGHN RD   BURLINGTON NC,001,Alamance,251300000X,Agencies,Local Education Agency (LEA),, 407 ," 3,186 "," 3,238 "," $136,199.25 ",,
MEDICAID DIRECT,1619998671,YADKIN COUNTY SCHOOLS,YADKIN COUNTY SCHOOLS,121 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,251300000X,Agencies,Local Education Agency (LEA),,1619998671,YADKIN COUNTY SCHOOLS,121 WASHINGTON ST   YADKINVILLE NC,099,Yadkin,251300000X,Agencies,Local Education Agency (LEA),, 299 ," 7,458 "," 7,565 "," $241,469.09 ",,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629002910,"AJIZIAN, VANESSA, KRISTEN",3431 WALKERTOWN COMMONS DR   WALKERTOWN NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 34 , 77 , 153 ,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629003314,"NEWMAN, DAVID, EARL",10030 EDISON SQUARE DRIVE SUITE 100A CONCORD NC,013,Cabarrus,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 19 , 28 , 37 ,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629003314,"NEWMAN, DAVID, EARL",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1588091177,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH WOMENS CARE GYN OF THE CAROLINAS,10030 EDISON SQUARE DR NW STE 100A CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629003314,"NEWMAN, DAVID, EARL",101 E WT HARRIS BLVD STE 2320 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1508941535,RALEIGH PEDIATRIC ASSOCIATES PA,RALEIGH PEDIATRIC ASSOCIATES PA,1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629003603,"HEWETT II, FREDERICK, ALLEN",1921 FALLS VALLEY DR   RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 14 , 26 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,193200000X,Group,Multi-Specialty,,1629004346,"JOHNSON, MELANIE, LINDA",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629004346,"JOHNSON, MELANIE, LINDA",125 HOSPITAL DR   SPRUCE PINE NC,061,Mitchell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 35 , 35 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629008149,"BROWN, SARA, JOHNSON",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629008149,"BROWN, SARA, JOHNSON",509 OLDE WATERFORD WAY STE 200 LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,630 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1629009261,"JORDAN, LAURIE, O DANIEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1629009261,"JORDAN, LAURIE, O DANIEL",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 46 , 55 ,$#,,
MEDICAID DIRECT,1538124201,SOUTHEAST ANESTHESIOLOGY CONSULTANT,~,630 MCCARTHY BLVD   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1629009261,"JORDAN, LAURIE, O DANIEL",509 N BRIGHTLEAF BLVD   SMITHFIELD NC,051,Johnston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629011481,"SMALLS STOKES, SHEILA, MARIE",190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 38 , 51 , 66 ,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629011481,"SMALLS STOKES, SHEILA, MARIE",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 174 , 212 , 246 ,$#,,
MEDICAID DIRECT,1447496120,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH NEUROLOGY AND SLEEP,1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1629011481,"SMALLS STOKES, SHEILA, MARIE",1910 JAKE ALEXANDER BLVD W STE 102 SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629011481,"SMALLS STOKES, SHEILA, MARIE",911 W HENDERSON ST STE 120 SALISBURY NC,080,Rowan,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 21 , 21 , 25 ,$#,,
MEDICAID DIRECT,1629012018,"CALHOUN, MICHAEL, DAVID",ISLAND HAND AND UPPER BODY REHAB,3210 N CROATAN HWY STE 3 KILL DEVIL HILLS NC,028,Dare,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,1629012018,"CALHOUN, MICHAEL, DAVID",3210 N CROATAN HWY STE 3 KILL DEVIL HILLS NC,028,Dare,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1376585836,PERSON SURGICAL ASSOCIATES,PERSON SURGICAL ASSOCIATES,783 DOCTORS CT STE B ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1629012653,"GEORGE, MATHEW",615 RIDGE RD   ROXBORO NC,073,Person,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1376585836,PERSON SURGICAL ASSOCIATES,PERSON SURGICAL ASSOCIATES,783 DOCTORS CT STE B ROXBORO NC,073,Person,193400000X,Group,Single Specialty,,1629012653,"GEORGE, MATHEW",783 DOCTORS CT STE B ROXBORO NC,073,Person,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 38 , 41 ,$#,,
MEDICAID DIRECT,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,~,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629012935,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,1130 N CHURCH ST STE 100 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,, 59 , 313 , 762 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629014600,"JUDSON, MELISSA, ERIN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 12 , 15 , 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629014600,"JUDSON, MELISSA, ERIN",30 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1649221342,RALEIGH DURHAM MEDICAL GROUP PA,~,4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629015227,"PARTRIDGE, JAMES, ARTHUR",4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 15 , 18 , 42 ,$#,,
MEDICAID DIRECT,1629015516,CRAVEN COUNTY,Craven County EMS,406 CRAVEN ST   NEW BERN NC,025,Craven,3416L0300X,Transportation Services,Ambulance,Land Transport,1629015516,CRAVEN COUNTY,406 CRAVEN ST   NEW BERN NC,025,Craven,3416L0300X,Transportation Services,Ambulance,Land Transport, 207 , 280 , 510 ,$#,,
MEDICAID DIRECT,1275943698,DLP RUTHERFORD PHYSICIAN PRACTICES,RUTHERFORD ORTHOPAEDICS,139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629015813,"GLOVER, JASON, PHILLIP",139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 139 , 280 , 461 ,$#,,
MEDICAID DIRECT,1962821322,DLP RUTHERFORD PHYSICIAN PRACTICES,,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629015813,"GLOVER, JASON, PHILLIP",139 DOCTOR HENRY NORRIS DR   RUTHERFORDTON NC,081,Rutherford,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery, 27 , 43 , 70 ,$#,,
MEDICAID DIRECT,1629017223,"CHERUBINI, MICHAEL, LOUIS",~,17550 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics,1629017223,"CHERUBINI, MICHAEL, LOUIS",17550 US HIGHWAY 17   HAMPSTEAD NC,071,Pender,1223X0400X,Dental Providers,Dentist,Orthodontics and Dentofacial Orthopedics, 41 , 85 , 96 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1629018049,"STINSON, JEREMY, RICHARD",1325 TIMBER DR E 1325 TIMBER DR EAST GARNER NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629018049,"STINSON, JEREMY, RICHARD",3001 EDWARDS MILL RD # 200 RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 13 , 26 ,$#,,
MEDICAID DIRECT,1396739884,PROVIDENCE ANESTHESIOLOGY ASSOCIATE,~,3735 GLENLAKE DR STE 250 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629018338,"RICHMAN, ELIZABETH, STAUFFER",10 FIRST VILLAGE DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629019971,"GREENBLATT, LAWRENCE, HOWARD",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629019971,"GREENBLATT, LAWRENCE, HOWARD",4220 N ROXBORO ST   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 78 , 120 , 201 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629019971,"GREENBLATT, LAWRENCE, HOWARD",3024 PICKETT RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 29 , 51 ,$#,,
MEDICAID DIRECT,1265589097,THE MOSES H CONE MEMORIAL HOSPITAL,CONE HEALTH CANCER CENTER,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629020565,"MAGRINAT, GUSTAV, CHARLES",501 N ELAM AVE   GREENSBORO NC,041,Guilford,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,,,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629020599,"GUPTA, VINENDRA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629020599,"GUPTA, VINENDRA",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629022199,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,,,Unknown,193200000X,Group,Multi-Specialty,,1629022199,CAROLINA PHYSICAL THERAPY ASSOCIATE,1201 CAROLINA AVE   WASHINGTON NC,007,Beaufort,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1629022199,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,,,Unknown,193200000X,Group,Multi-Specialty,,1629022199,CAROLINA PHYSICAL THERAPY ASSOCIATE,143 NASHVILLE COMMONS DR   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,#,,,$#,,
MEDICAID DIRECT,1629022199,CAROLINA PHYSICAL THERAPY ASSOCIATE,CORA PHYSICAL THERAPY,627 E WASHINGTON ST   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,,1629022199,CAROLINA PHYSICAL THERAPY ASSOCIATE,627 E WASHINGTON ST   NASHVILLE NC,064,Nash,193200000X,Group,Multi-Specialty,, 133 ," 2,116 "," 2,779 "," $175,240.26 ",,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1629022280,"KODZAI, WILLIAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629022280,"KODZAI, WILLIAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 248 , 318 , 382 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629022280,"KODZAI, WILLIAM",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 286 , 320 , 398 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629023338,"CLARK, GILBERT, WILSON",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 58 , 88 , 185 ,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629023338,"CLARK, GILBERT, WILSON",1211 VIRGINIA ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427680768,MOSES CONE PHYSICIAN SERVICES INC,CONE HEALTH ORTHOCARE,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629023338,"CLARK, GILBERT, WILSON",640 S VAN BUREN RD UNIT B EDEN NC,079,Rockingham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629023635,"OLEA, OLIVER, MODEQUILLO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194150110,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CFV INTENSIVISITS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629023635,"OLEA, OLIVER, MODEQUILLO",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 62 , 66 , 78 ,$#,,
MEDICAID DIRECT,1417083783,EASTERN NEPHROLOGY ASSOCIATES PLLC,EASTERN NEPHROLOGY ASSOCIATES PLLC,511 PALADIN DR   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629024898,"HERION, JOHN, MURDOCH",1302 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 120 , 501 , 536 ," $33,662.76 ",,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629024948,"OLYAI, ARTHUR, AMIN",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 19 , 20 , 25 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629024948,"OLYAI, ARTHUR, AMIN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 18 , 17 , 23 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629024948,"OLYAI, ARTHUR, AMIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629024948,"OLYAI, ARTHUR, AMIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629024948,"OLYAI, ARTHUR, AMIN",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 15 ,$#,,
MEDICAID DIRECT,1962966556,ROBERTS & ASSOCIATES PLLC,WILMINGTON KIDS DENTIST,5023 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629025259,"STOKER, CHAD, MICHAEL",5023 MARKET ST   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 43 ,$#,,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629025259,"STOKER, CHAD, MICHAEL",2643 RANDLEMAN RD   GREENSBORO NC,041,Guilford,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 637 , 642 ," 4,832 "," $331,635.63 ",,
MEDICAID DIRECT,1578054557,KOELLING JOHNSTUN & ASSOCIATES PLLC,TRIAD KIDS DENTAL,5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629025259,"STOKER, CHAD, MICHAEL",5069 UNIVERSITY PKWY STE 11 WINSTON SALEM NC,034,Forsyth,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 347 , 349 ," 2,704 "," $185,513.91 ",,
MEDICAID DIRECT,1235800897,ROBERTS KAMP & ASSOCIATES PLLC,GREENVILLE KIDS DENTAL,1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629025259,"STOKER, CHAD, MICHAEL",1701 SE GREENVILLE BLVD   GREENVILLE NC,074,Pitt,1223D0004X,Dental Providers,Dentist,Dental Anesthesiology, 51 , 51 , 397 ," $27,244.59 ",,
MEDICAID DIRECT,1629025283,CAROLINA HEALTHCARE PRODUCTS,Carolina Healthcare Products Inc,1635 N HOWE ST STE H SOUTHPORT NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1629025283,CAROLINA HEALTHCARE PRODUCTS,1635 N HOWE ST STE H SOUTHPORT NC,010,Brunswick,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 148 , 153 , 166 ," $19,442.68 ",,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629026471,"CHAMBLISS, MARSHALL, LEE",1125 N CHURCH ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 12 , 14 , 14 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1131C N CHURCH ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629026471,"CHAMBLISS, MARSHALL, LEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629026471,"CHAMBLISS, MARSHALL, LEE",1200 N ELM ST   GREENSBORO NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 156 , 208 , 311 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629026547,"MILTICH, ANN, HAMPTON",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 37 , 41 , 55 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629027891,"RIESER, GEOFFREY, DAVIS",3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629027891,"RIESER, GEOFFREY, DAVIS",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629027891,"RIESER, GEOFFREY, DAVIS",2025 FRONTIS PLAZA BLVD STE 300 WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629027891,"RIESER, GEOFFREY, DAVIS",185 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1609299064,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN SURGICAL CENTER-2,,,Unknown,193200000X,Group,Multi-Specialty,,1629028576,"BRITT II, SAMUEL, EMERSON",2934 N ELM ST STE E LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629029665,"ROSE, GEORGE, STEVENSON",2400 W FRIENDLY AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 30 , 34 ,$#,,
MEDICAID DIRECT,1295194397,SARMC ANESTHESIA SPECIALIST LLC,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629029665,"ROSE, GEORGE, STEVENSON",600 GREEN VALLEY RD STE 304 GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629029665,"ROSE, GEORGE, STEVENSON",1127 N CHURCH ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 13 ,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629029665,"ROSE, GEORGE, STEVENSON",509 N ELAM AVE   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1811409568,ANESTHESIOLOGY CONSULTANTS OF NORTH,,1200 N ELM ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629029665,"ROSE, GEORGE, STEVENSON",1200 N ELM ST   GREENSBORO NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 60 , 60 , 75 ,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1629030598,"SPRAGUE, AMY, MCELROY",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 27 , 27 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629030598,"SPRAGUE, AMY, MCELROY",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1548234651,ROBERT L HAY PA,HAY CLINIC OF CHIROPRACTIC,927 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629030663,"TRAVIS, CHRISTOPHER, ROBERT",927 COX RD   GASTONIA NC,036,Gaston,111N00000X,Chiropractic Providers,Chiropractor,, 14 , 83 , 90 ,$#,,
MEDICAID DIRECT,1679684948,CATAWBA RADIOLOGICAL ASSOCS,CATAWBA RADIOLOGICAL ASSOCIATES INC,18 13TH AVE NE   HICKORY NC,018,Catawba,193400000X,Group,Single Specialty,,1629031299,"BELLE, TROY, ALLYN",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1093779621,WAYNE RADIOLOGISTS PA,WAYNE RADIOLOGISTS PA,2700 MEDICAL OFFICE PL   GOLDSBORO NC,096,Wayne,193400000X,Group,Single Specialty,,1629031299,"BELLE, TROY, ALLYN",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1386426864,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH IMAGING CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1629031299,"BELLE, TROY, ALLYN",222 N LAFAYETTE ST STE 1 SHELBY NC,023,Cleveland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 33 , 35 , 47 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,915 TATE BLVD SE STE 186 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629031323,"MENARD, DALE, ANTHONY",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 103 , 142 , 157 ,$#,,
MEDICAID DIRECT,1821537697,DLP FRYE MEDICAL GROUP,FRYECARE FAMILY PHYSICIANS,1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629031323,"MENARD, DALE, ANTHONY",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 129 , 165 , 223 ,$#,,
MEDICAID DIRECT,1083722482,NEUROLOGY ASSOCIATES PA,NEUROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1629031323,"MENARD, DALE, ANTHONY",1985 TATE BLVD SE STE 600 HICKORY NC,018,Catawba,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629031844,"BACHMANN, ELKE",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1629031844,"BACHMANN, ELKE",7 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 11 , 14 , 14 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629031844,"BACHMANN, ELKE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 30 , 32 , 34 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629031869,"SALINAS, JEANNETTE, INGRID",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 18 , 18 , 18 ,$#,,
MEDICAID DIRECT,1053677195,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629031869,"SALINAS, JEANNETTE, INGRID",101 MANNING DR   CHAPEL HILL NC,068,Orange,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1053074369,MCPC 22 LLC,FIRSTHEALTH-SANDHILLS NEUROLOGISTS,295 OLMSTED BLVD STE 12 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1629033428,"MANDELBAUM, MARK, ALON",295 OLMSTED BLVD   PINEHURST NC,063,Moore,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 78 , 110 , 138 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629034020,"MESSINA, JOSEPH, FRANK",2000 NEUSE BLVD   NEW BERN NC,025,Craven,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 17 , 17 ,$#,,
MEDICAID DIRECT,1437869302,USACS INTEGRATED ACUTE CARE SERVICE,,1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629034020,"MESSINA, JOSEPH, FRANK",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1619099256,FAMILY MEDICAL ASSOCS OF RALEIGH,,3500 BUSH ST   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629035027,"SUEHS, AUDREY, LYNNE",3500 BUSH ST   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1487612628,KIDS CARE PEDIATRICS PA,KIDS CARE PEDIATRICS PA,101 KELLIE DR   SMITHFIELD NC,051,Johnston,193400000X,Group,Single Specialty,,1629036256,"TETREAULT, DEBRA, JEANETTE",101 KELLIE DR   SMITHFIELD NC,051,Johnston,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 23 , 56 ,$#,,
MEDICAID DIRECT,1285698126,WAKE RADIOLOGY CONSULTANTS PA,~,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629036439,"CORNETT, JOSEPH, BURAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 228 , 242 , 303 ,$#,,
MEDICAID DIRECT,1538123450,WAKE RADIOLOGY DIAGNOSTIC IMAGING I,WAKE RADIOLOGY DIAGNOSTIC IMAGING INC,3949 BROWNING PL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629036439,"CORNETT, JOSEPH, BURAN",3949 BROWNING PL   RALEIGH NC,092,Wake,2085N0700X,Allopathic & Osteopathic Physicians,Radiology,Neuroradiology, 41 , 41 , 65 ,$#,,
MEDICAID DIRECT,1093253205,DLP FRYE MEDICAL GROUP,FRYECARE CARDIOLOGY ASSOCIATES,2660 TATE BLVD SE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629036488,"FOX JR, LEVERNE, SMITH",178 HIGHWAY 105 EXT STE 202 BOONE NC,095,Watauga,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 85 , 126 , 214 ,$#,,
MEDICAID DIRECT,1366689291,CHRISTINE E LEMLEY OD PLLC,CHRISTINE E LEMLEY OD PLLC,18736 DEMBRIDGE DR   DAVIDSON NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629036660,"LEMLEY, CHRISTINE, EILEEN",18736 DEMBRIDGE DR   DAVIDSON NC,060,Mecklenburg,152W00000X,Eye and Vision Services Providers,Optometrist,, 60 , 52 , 55 ,$#,,
MEDICAID DIRECT,1407529696,WILCOX OPTOMETRY PLLC,,1070 TUNNEL RD BLDG 1 SUITE 10 BOX 354 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1629036660,"LEMLEY, CHRISTINE, EILEEN",1070 TUNNEL RD BLDG 1 STE 10 BOX 354 ASHEVILLE NC,011,Buncombe,152W00000X,Eye and Vision Services Providers,Optometrist,, 66 , 66 , 80 ,$#,,
MEDICAID DIRECT,1629036991,"WINESETT, MARVIN, ALAN",~,3398 HICKORY BLVD   HUDSON NC,014,Caldwell,152W00000X,Eye and Vision Services Providers,Optometrist,,1629036991,"WINESETT, MARVIN, ALAN",3398 HICKORY BLVD   HUDSON NC,014,Caldwell,152W00000X,Eye and Vision Services Providers,Optometrist,, 402 , 419 , 474 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1144 N ROAD ST STE 200 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629037445,"PHARR, TARKTEN, ALEXANDER",1144 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629037445,"PHARR, TARKTEN, ALEXANDER",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 123 , 183 , 315 ," $11,784.01 ",,
MEDICAID DIRECT,1962719609,ALBEMARLE PHYSICIAN SERVICES,~,1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629037445,"PHARR, TARKTEN, ALEXANDER",1177 N ROAD ST   ELIZABETH CITY NC,070,Pasquotank,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1053503763,MED FIRST IMMEDIATE CARE AND FAMILY,~,609 RICHLANDS HWY STE 6 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1629037858,"WICHMAN, NOAH, JESSE",107 WEEKS DR   ROXBORO NC,073,Person,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 92 , 170 , 300 ,$#,,
MEDICAID DIRECT,1649221342,RALEIGH DURHAM MEDICAL GROUP PA,~,4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629037858,"WICHMAN, NOAH, JESSE",4020 N ROXBORO ST STE 100 DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 12 , 28 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629038906,"AGARWAL, SURESH, KUMAR",40 DUKE MEDICINE CIR STE 2B2C DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629038906,"AGARWAL, SURESH, KUMAR",40 DUKE MEDICINE CIR STE 2B2C DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 28 , 46 , 48 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629038906,"AGARWAL, SURESH, KUMAR",40 DUKE MEDICINE CIR STE 2B2C DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629038906,"AGARWAL, SURESH, KUMAR",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 62 , 87 , 89 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629038906,"AGARWAL, SURESH, KUMAR",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 20 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629038906,"AGARWAL, SURESH, KUMAR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629038906,"AGARWAL, SURESH, KUMAR",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629039243,"BOWMAN, MARY, CATHERINE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 37 , 44 , 66 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629039243,"BOWMAN, MARY, CATHERINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 34 , 71 , 78 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629039862,"TYSON JR, ARCHIE, ALEXANDER",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629039862,"TYSON JR, ARCHIE, ALEXANDER",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 19 , 26 , 41 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629039862,"TYSON JR, ARCHIE, ALEXANDER",211 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629039862,"TYSON JR, ARCHIE, ALEXANDER",125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629039862,"TYSON JR, ARCHIE, ALEXANDER",4515 PREMIER DR STE 300 HIGH POINT NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 11 , 22 , 39 ,$#,,
MEDICAID DIRECT,1679295398,NOVANT HEALTH MEDICAL GROUP LLC,NHMG CARDIOLOGY CLINICS,125 QUEENS RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629039862,"TYSON JR, ARCHIE, ALEXANDER",1226 EASTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 51 , 98 , 140 ,$#,,
MEDICAID DIRECT,1619994233,MCLEOD PHYSICIAN ASSOCIATES II,PEE DEE SURGICAL GROUP,800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629040845,"MASHAS, WAYNE, EDWARD",800 E CHEVES ST STE 260 FLORENCE SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1831158245,DURHAM EMERGENCY PHYSICIANS PA,~,,,Unknown,193400000X,Group,Single Specialty,,1629043328,"WIEGAND, PAUL",3643 N ROXBORO ST   DURHAM NC,032,Durham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629043724,"LEDDY, MARGARET, GORMAN",200 TRENT DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629043724,"LEDDY, MARGARET, GORMAN",200 TRENT DR   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1790784999,CUMBERLAND COUNTY HOSPITAL SYSTEM I,CAPE FEAR VALLEY ANESTHESIA,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1629043914,"BANKS, KRISTIE, LAKETA",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 24 , 24 , 24 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629043914,"BANKS, KRISTIE, LAKETA",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629043914,"BANKS, KRISTIE, LAKETA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629043914,"BANKS, KRISTIE, LAKETA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629043914,"BANKS, KRISTIE, LAKETA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629045380,"HINSON, JONATHAN, CORDELL",110 W MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 40 , 84 , 142 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629045380,"HINSON, JONATHAN, CORDELL",4705 S HIGHWAY 150 STE B&C LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629045380,"HINSON, JONATHAN, CORDELL",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629047089,"DVERGSTEN, SUZANNE, ELIZABETH",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,908 S WILLIAMSON AVE   ELON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629047089,"DVERGSTEN, SUZANNE, ELIZABETH",908 S WILLIAMSON AVE   ELON NC,001,Alamance,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 50 , 116 ,$#,,
MEDICAID DIRECT,1801838677,MANN EAR NOSE THROAT CLINIC PA,Mann Ear Nose & Throat Clinic PA,601 KEISLER DR STE 200 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629048004,"SPECTOR, JARED, ELI",601 KEISLER DR STE 200 CARY NC,092,Wake,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 54 , 110 , 201 ,$#,,
MEDICAID DIRECT,1083345664,LANE AND ASSOCIATES XLVII DDS PA,,515 S CASWELL ST   LA GRANGE NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1629049986,"BEUTEL, WILLIAM, CLAUDE",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193200000X,Group,Multi-Specialty,,1629049986,"BEUTEL, WILLIAM, CLAUDE",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 253 , 299 ," 1,643 "," $170,149.07 ",,
MEDICAID DIRECT,1033794300,LANE AND ASSOCIATES XLI DDS PA,,571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1629049986,"BEUTEL, WILLIAM, CLAUDE",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 14 , 134 ," $12,041.30 ",,
MEDICAID DIRECT,1205426756,LANE AND ASSOCIATES XL DDS PA,,1002 JENKINS AVE   MAYSVILLE NC,052,Jones,193400000X,Group,Single Specialty,,1629049986,"BEUTEL, WILLIAM, CLAUDE",571 YOPP RD STE 308 JACKSONVILLE NC,067,Onslow,1223G0001X,Dental Providers,Dentist,General Practice, 36 , 40 , 190 ," $19,676.12 ",,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629050034,"ALEXANDER, JAMES, ROBERT",2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629050034,"ALEXANDER, JAMES, ROBERT",9848 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1740480722,KNOWLES SMITH & ASSOCIATES LLP,,3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629051057,"WALTERS, TERESE, MARIE",3551 DUNN RD STE 102 EASTOVER NC,026,Cumberland,1223G0001X,Dental Providers,Dentist,General Practice, 14 , 16 , 59 ,$#,,
MEDICAID DIRECT,1780645812,SISTASIS FAMILY PRACTICE INC,SISTASIS FAMILY PRACTICE INC,147 E ACADEMY ST   ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1629051115,"SISTASIS, JIM",147 E ACADEMY ST   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 111 , 172 ,$#,,
MEDICAID DIRECT,1710923875,CAROLINA EAST MEDICAL CENTER,CAROLINAEAST MEDICAL CENTER,2000 NEUSE BLVD   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1629052113,"VANZURA, TRACY, HEMBREE",2000 NEUSE BLVD   NEW BERN NC,025,Craven,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629052493,"ROUSE, CRYSTAL, COLEMAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 37 , 37 ,$#,,
MEDICAID DIRECT,1497704217,ORTHOCAROLINA,ORTHOCAROLINA,4601 PARK RD STE 300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629052949,"LISY, REBECCA, REEP",1915 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629053780,"ZELMAN, STACIE, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 46 , 49 , 54 ,$#,,
MEDICAID DIRECT,1679586309,CLIMAX FAMILY PRACTICE PA,~,,,Unknown,193200000X,Group,Multi-Specialty,,1629054275,"LITTLE JR PA, JAMES",1008 NC HIGHWAY 62 E   CLIMAX NC,041,Guilford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629055033,"SOPALA, JERZY, ANTONI",2108 SAN FERNANDO DR   HIGH POINT NC,041,Guilford,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 18 , 32 , 32 ,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629055033,"SOPALA, JERZY, ANTONI",155 MEMORIAL DR   PINEHURST NC,063,Moore,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 79 , 186 , 186 ,$#,,
MEDICAID DIRECT,1932789641,AMERICAN HEALTHCARE SYSTEMS LLC,RANDOLPH HEALTH HOSPITALIST GROUP,237 N FAYETTEVILLE ST STE A ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1629055033,"SOPALA, JERZY, ANTONI",364 WHITE OAK ST   ASHEBORO NC,076,Randolph,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629055041,"BURNS, CYNTHIA, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 51 , 55 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629056643,"WOLFF, CHRISTIAN, GEORGE",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 23 , 34 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629056643,"WOLFF, CHRISTIAN, GEORGE",20036 ZION AVE STE 100 CORNELIUS NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 24 , 35 ,$#,,
MEDICAID DIRECT,1629058235,"STYERS, EDWIN, LYNN",~,10160 BEACH DR SW   CALABASH NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice,1629058235,"STYERS, EDWIN, LYNN",10160 BEACH DR SW   CALABASH NC,010,Brunswick,1223G0001X,Dental Providers,Dentist,General Practice, 56 , 137 , 350 ," $18,619.55 ",,
MEDICAID DIRECT,1114978582,LINCOLN COMMUNITY HEALTH CENTER INC,LINCOLN COMMUNITY HEALTH CENTER INC,1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629058433,"KEELING, MARION",1301 FAYETTEVILLE ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 13 ,$#,,
MEDICAID DIRECT,1003337528,HOKE EMERGENCY GROUP PC,,210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,193200000X,Group,Multi-Specialty,,1629058821,"DORSCH, JOHN, ROBERT",210 MEDICAL PAVILION DR   RAEFORD NC,047,Hoke,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801375373,ROBESON EMERGENCY PHYSICIANS PLLC,,300 W 27TH ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1629058821,"DORSCH, JOHN, ROBERT",300 W 27TH ST   LUMBERTON NC,078,Robeson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 203 , 223 , 337 ," $15,518.90 ",,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629060520,"MEYER, BARBARA, ELLEN",101 E WT HARRIS BLVD STE 5002 CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629060520,"MEYER, BARBARA, ELLEN",16645 BIRKDALE COMMONS PKWY STE 100 HUNTERSVILLE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 17 , 26 , 29 ,$#,,
MEDICAID DIRECT,1871112920,ATRIUM HEALTH NORTH MARKET NETWORK,ATRIUM HEALTH PRIMARY CARE ONE HEALTH FAMILY MEDIC,4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629060520,"MEYER, BARBARA, ELLEN",4525 CAMERON VALLEY PKWY STE 4100D CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 18 ,$#,,
MEDICAID DIRECT,1831151539,CAROLINA EAR NOSE & THROAT SINUS AN,~,304 10TH AVE NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629062641,"DE NEEF, DAWN, ELISSA",304 10TH AVE NE   HICKORY NC,018,Catawba,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 44 , 53 , 67 ,$#,,
MEDICAID DIRECT,1285713859,CHEROKEE INDIAN HOSPITAL AUTHORITY,~,1 HOSPITAL RD CALLER BOX C268 CHEROKEE NC,087,Swain,193200000X,Group,Multi-Specialty,,1629063003,"BEEBE, CHRISTIAN, ANDREW",1 HOSPITAL RD   CHEROKEE NC,087,Swain,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1134714298,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR PEDS SURGERY,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629063722,"PENCE, JEFFERY, CARL",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629065602,"MOMENI, ARASH, KESHMIRI",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 25 , 25 , 40 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629065644,"NORTEY, CYNTHIA, KORLEI",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629065644,"NORTEY, CYNTHIA, KORLEI",1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1679296305,NOVANT HEALTH MEDICAL GROUP LLC,NHMG INFECTIOUS DISEASE CLINICS,1900 RANDOLPH RD STE 216 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629065644,"NORTEY, CYNTHIA, KORLEI",1340 MATTHEWS TOWNSHIP PKWY STE 102 MATTHEWS NC,060,Mecklenburg,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 45 , 132 , 150 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629066931,"ROBEY III, WALTER, CHARLES",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740688191,SPARTANBURG MEDICAL CENTER,MGC MEDICAL AFFILIATE- NORTH GROVE,1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629068036,"GO, ROBIN, ONG",1330 BOILING SPRINGS RD STE 2500 SPARTANBURG SC,101,Out of State <= 40 miles,207K00000X,Allopathic & Osteopathic Physicians,Allergy & Immunology,,#,#,#,$#,,
MEDICAID DIRECT,1710211560,BLUE RIDGE HEALTHCARE MEDICAL GROUP,~,5920 US HIGHWAY 70 E   NEBO NC,059,McDowell,193200000X,Group,Multi-Specialty,,1629068069,"ORANGE, MELANIE, MARKHAM",5920 US HIGHWAY 70 E   NEBO NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 47 , 131 , 241 ,$#,,
MEDICAID DIRECT,1801120654,BLUE RIDGE HEALTHCARE MEDICAL GROUP,MCDOWELL MEDICAL ASSOCIATES PA,2293 SUGAR HILL RD STE D MARION NC,059,McDowell,193400000X,Group,Single Specialty,,1629068069,"ORANGE, MELANIE, MARKHAM",2293 SUGAR HILL RD STE D MARION NC,059,McDowell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629068283,"MALTON, MARK, LELAND",1800 E 4TH ST   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629068283,"MALTON, MARK, LELAND",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 19 , 21 , 32 ,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629068283,"MALTON, MARK, LELAND",15419 HODGES CIR   HUNTERSVILLE NC,060,Mecklenburg,207WX0109X,Allopathic & Osteopathic Physicians,Ophthalmology,Neuro-ophthalmology,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629068283,"MALTON, MARK, LELAND",135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207WX0200X,Allopathic & Osteopathic Physicians,Ophthalmology,Ophthalmic Plastic and Reconstructive Surgery,#,#,#,$#,,
MEDICAID DIRECT,1235192113,HORIZON EYE CARE PA,HORIZON EYE CARE PA,135 S SHARON AMITY RD STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629068283,"MALTON, MARK, LELAND",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1245429794,RICHARD A DOUGHERTY MD PA,~,10450 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629068515,"DOUGHERTY, RICHARD, ALLEN",10450 PARK RD STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 39 , 152 , 419 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,35 HOSPITAL RD   BLAIRSVILLE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629069141,"DAVIS, KEVIN, SCOTT",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 23 , 43 , 55 ,$#,,
MEDICAID DIRECT,1902305063,UNION GENERAL AFFILIATED SERVICES,~,110 S MAIN ST   HIAWASSEE GA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629069141,"DAVIS, KEVIN, SCOTT",19 DOCTORS WAY   BLAIRSVILLE GA,101,Out of State <= 40 miles,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1093119513,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE STANLY OBGYN,105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,193200000X,Group,Multi-Specialty,,1629071642,"JONES, PHILIP, BRENT",105 YADKIN ST STE 102 ALBEMARLE NC,084,Stanly,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,,,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1629072582,"DAINTY, THOMAS, STANLEY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629073010,"WARREN, MARK, LOWE",1006 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 44 , 101 , 144 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629073010,"WARREN, MARK, LOWE",1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism", 34 , 81 , 180 ,$#,,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629074323,"LERIS, DENNIS, GEORGE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 20 , 23 ,$#,,
MEDICAID DIRECT,1265150494,COVENANT SPINE AND NEUROLOGY PLLC,~,280 BROAD ST STE A KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629074323,"LERIS, DENNIS, GEORGE",1130 N CHURCH ST STE 200 GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 123 , 160 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629075189,"REMINGTON, JOHN, LAUREN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 14 , 14 , 20 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629075189,"REMINGTON, JOHN, LAUREN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 40 , 41 , 52 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629075189,"REMINGTON, JOHN, LAUREN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 276 , 263 , 347 ,$#,,
MEDICAID DIRECT,1679025522,DIAGNOSTIC IMAGING PARTNERS LLC,,2000 BRABHAM AVE STE 110 JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1629075189,"REMINGTON, JOHN, LAUREN",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1629075973,HANGER PROSTHETICS & ORTHOTICS EAST,~,744 HARTNESS RD   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1629075973,HANGER PROSTHETICS & ORTHOTICS EAST,744 HARTNESS RD   STATESVILLE NC,049,Iredell,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 24 , 22 , 73 ,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,920 S LOMBARD ST STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629076161,"SACHAR, RAVISH",920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 21 , 23 , 64 ," $32,057.44 ",,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,320 VETERANS PKWY STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629076161,"SACHAR, RAVISH",320 VETERANS PKWY STE 100 CLAYTON NC,051,Johnston,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629076161,"SACHAR, RAVISH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 27 , 27 , 37 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,193200000X,Group,Multi-Specialty,,1629076161,"SACHAR, RAVISH",2605 FOREST HILLS RD SW STE D WILSON NC,098,Wilson,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 19 , 21 , 31 ,$#,,
MEDICAID DIRECT,1336443712,REX HOSPITAL INC,REX VASCULAR SPECIALISTS,920 S LOMBARD ST STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629076161,"SACHAR, RAVISH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1043947104,NORTH CAROLINA VASCULAR CENTER PLLC,,920 S LOMBARD ST STE 200 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629076161,"SACHAR, RAVISH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629076161,"SACHAR, RAVISH",2800 BLUE RIDGE RD STE 400 RALEIGH NC,092,Wake,207RI0011X,Allopathic & Osteopathic Physicians,Internal Medicine,Interventional Cardiology, 24 , 33 , 73 ,$#,,
MEDICAID DIRECT,1891982526,MARIA MEDICAL CENTER,MARIA MEDICAL CENTER LLC,13840 NC HIGHWAY 210 S SPRING LAKE NC,043,Harnett,193400000X,Group,Single Specialty,,1629076690,"MARIA, JOSETTE",800 SUSAN TART RD   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1891982526,MARIA MEDICAL CENTER,MARIA MEDICAL CENTER LLC,800 SUSAN TART RD   DUNN NC,043,Harnett,193400000X,Group,Single Specialty,,1629076690,"MARIA, JOSETTE",800 SUSAN TART RD   DUNN NC,043,Harnett,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 108 , 663 ," 1,497 "," $20,499.32 ",,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629077615,"PLAYER, JOHN, GREGORY",5145 S COLLEGE RD   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 32 ,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629077615,"PLAYER, JOHN, GREGORY",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1740875806,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR NEW HANOVER MEDICAL GROUP,1960 S 16TH ST   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629077615,"PLAYER, JOHN, GREGORY",1333 S DICKINSON DR UNIT 140 LELAND NC,010,Brunswick,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 29 , 84 ,$#,,
MEDICAID DIRECT,1225153984,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,138 DUBLIN SQUARE RD STE C ASHEBORO NC,076,Randolph,193200000X,Group,Multi-Specialty,,1629077862,"WHYTE, THOMAS, MURPHY",138 DUBLIN SQUARE RD STE C ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1225153984,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,138 DUBLIN SQUARE RD STE C ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1629077862,"WHYTE, THOMAS, MURPHY",138 DUBLIN SQUARE RD STE C ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 59 , 80 ,$#,,
MEDICAID DIRECT,1225153984,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,138 DUBLIN SQUARE RD STE C ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1629077862,"WHYTE, THOMAS, MURPHY",375 SUNSET AVE   ASHEBORO NC,076,Randolph,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 32 , 51 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1629079066,"HILLENBRAND, JUDITH, LYNN",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 11 ,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1629079066,"HILLENBRAND, JUDITH, LYNN",720 MALCOM BLVD   VALDESE NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629079140,"BLOCK, JARED, GAVIN",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 12 , 12 , 43 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629079140,"BLOCK, JARED, GAVIN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 29 , 31 , 89 ,$#,,
MEDICAID DIRECT,1689628158,CAROLINAS PATHOLOGY GROUP PA,~,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629079140,"BLOCK, JARED, GAVIN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629079926,"QUINONES, DEOGRACIA",815 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 18 , 23 , 46 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,815 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1629079926,"QUINONES, DEOGRACIA",815 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,208800000X,Allopathic & Osteopathic Physicians,Urology,, 66 , 130 , 254 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629082623,"STOJADINOVIC, BONNIE, JEAN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 28 , 107 , 109 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629088612,"MOHS, GREGORY, JOHN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629088612,"MOHS, GREGORY, JOHN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629088653,"BRODY, SETH, CHARLES",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 20 , 20 , 20 ,$#,,
MEDICAID DIRECT,1518374800,NC EMERGENCY PHYSICIAN SERVICES,,117 E KINGS HWY   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1629089545,"HENDRIX, RONNIE, EUGENE",117 E KINGS HWY   EDEN NC,079,Rockingham,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 17 , 21 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1629089545,"HENDRIX, RONNIE, EUGENE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 12 , 12 , 14 ,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629089545,"HENDRIX, RONNIE, EUGENE",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1629090998,"DOUGLAS, JANICE, MARIE",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629090998,"DOUGLAS, JANICE, MARIE",3714 GUARDIAN AVE STE W MOREHEAD CITY NC,016,Carteret,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1700317096,MOSES CONE PHYSICIAN SERVICES INC,ROCKINGHAM SURGICAL ASSOCIATES,1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1629092184,"JENKINS, MARK, ALAN",1818 RICHARDSON DR STE E REIDSVILLE NC,079,Rockingham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 35 , 63 , 67 ,$#,,
MEDICAID DIRECT,1003288093,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1656 RIVERCHASE BLVD STE 1800 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629092861,"BOLTON, TANNIS, JEANETTE",1656 RIVERCHASE BLVD STE 1800 ROCK HILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003288093,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH URGENT CARE,1656 RIVERCHASE BLVD STE 1800 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629092861,"BOLTON, TANNIS, JEANETTE",704 GOLD HILL RD STE 1200 FORT MILL SC,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629092895,"MCKAY, CHARLES, PHILIP",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 49 , 61 , 61 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629092895,"MCKAY, CHARLES, PHILIP",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629092895,"MCKAY, CHARLES, PHILIP",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,2080P0210X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Nephrology, 13 , 32 , 32 ,$#,,
MEDICAID DIRECT,1629093026,WILSONS HOME CARE AGENCY INC,~,7914 MAIN ST   VANCEBORO NC,025,Craven,253Z00000X,Agencies,In Home Supportive Care,,1629093026,WILSONS HOME CARE AGENCY INC,7914 MAIN ST   VANCEBORO NC,025,Craven,253Z00000X,Agencies,In Home Supportive Care,, 52 ," 9,351 "," 9,758 "," $1,116,255.13 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",2301 ERWIN RD   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 13 , 14 , 21 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",3609 SW DURHAM DR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,,,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR STE 500 MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#, 15 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3609 SOUTHWEST DURHAM DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",3609 SW DURHAM DR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,, 29 , 43 , 66 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629093109,"MITHANI, SUHAIL, KAMRUDIN",10 DUKE MEDICINE CIRCLE CLINIC   DURHAM NC,032,Durham,208200000X,Allopathic & Osteopathic Physicians,Plastic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629094610,"WARREN, BRIAN, BUTLER",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629094610,"WARREN, BRIAN, BUTLER",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1356689996,CAROLINAS MEDICAL CENTER,CMC PSYCHIATRY AND BEHAVIORAL HEALTH,501 BILLINGSLEY RD STE B CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629096094,"MUNDLE, LINDA, BICK",501 BILLINGSLEY RD   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 18 , 41 , 41 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 92 , 95 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 16 , 17 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",502 MCKNIGHT DR STE 100B KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 101 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",502 MCKNIGHT DR STE 100B KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",502 MCKNIGHT DR STE 100B KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",502 MCKNIGHT DR STE 100B KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",1001 W WILLIAMS ST STE 103 APEX NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,321 MULBERRY ST SW   LENOIR NC,014,Caldwell,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",333 EARNIE LN   HOLLY SPRINGS NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,193400000X,Group,Single Specialty,,1629096615,"HOLT, DAVIS, WILLIAM TROY",6905 KNIGHTDALE BLVD STE 105 KNIGHTDALE NC,092,Wake,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 44 , 46 ,$#,,
MEDICAID DIRECT,1023044526,UNC SCHOOL OF DENTISTRY,DENTAL FACULTY PRACTICE,140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629099171,"HOLLOWELL, ROBERT, PERRY",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice, 381 , 468 , 934 ," $31,803.87 ",,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629099171,"HOLLOWELL, ROBERT, PERRY",140 DENTAL CIR STE 143 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629099171,"HOLLOWELL, ROBERT, PERRY",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 31 ,$#,,
MEDICAID DIRECT,1114380698,THE CHARLOTTE-MECKLENBURG HOSPITAL,ATRIUM HEALTH DENTAL CLINIC,1000 BLYTHE BLVD ANNEX BLDG 2ND FLOOR CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629099171,"HOLLOWELL, ROBERT, PERRY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 26 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629099833,"LILLEY, LORI, BROWN",210 ASHVILLE AVE   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629099833,"LILLEY, LORI, BROWN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 15 , 16 ,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629099833,"LILLEY, LORI, BROWN",10000 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629099833,"LILLEY, LORI, BROWN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629099833,"LILLEY, LORI, BROWN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629099833,"LILLEY, LORI, BROWN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629101720,"WAUGH, MICHAEL, STUART",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 115 , 116 , 159 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629101720,"WAUGH, MICHAEL, STUART",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2351 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629101720,"WAUGH, MICHAEL, STUART",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 56 , 59 , 90 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629101720,"WAUGH, MICHAEL, STUART",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 38 , 40 , 64 ,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629102868,"THARPE, MELISSA, YORK",4130 CLEMMONS RD   CLEMMONS NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629102868,"THARPE, MELISSA, YORK",114 CHARLOIS BLVD   WINSTON SALEM NC,034,Forsyth,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 30 , 37 , 63 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629104443,"LEE, DAMIAN, ORLANDO",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 18 , 19 , 24 ,$#,,
MEDICAID DIRECT,1629106273,HEAVENS TOUCH HOME CARE SERVICES,HEAVENS TOUCH HOME CARE SERVICES LLC,215 N QUEEN ST   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,1629106273,HEAVENS TOUCH HOME CARE SERVICES,215 N QUEEN ST   KINSTON NC,054,Lenoir,253Z00000X,Agencies,In Home Supportive Care,,#," 3,066 "," 3,240 "," $529,998.96 ",,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629106687,"BURKETT, MELISSA, MERRILL",2100 ERWIN RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 14 , 24 ,$#,,
MEDICAID DIRECT,1629107982,"POOLE, FELICIA, NICOLE",EXCEL AND ACHIEVE SPEECH THERAPY SERVICES PLLC,5401 HIGHSTREAM CT   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,1629107982,"POOLE, FELICIA, NICOLE",5401 HIGHSTREAM CT   GREENSBORO NC,041,Guilford,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1548759392,EVENTUS WHOLEHEALTH PLLC,~,101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629109152,"CONNER, COLLEEN, CAROL",101 CABARRUS AVE E STE 200 CONCORD NC,013,Cabarrus,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629109285,"DESAI, PAYAL, CHANDARANA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology, 28 , 70 , 70 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1629109285,"DESAI, PAYAL, CHANDARANA",1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,275 N NC 16 BUSINESS HWY SUITE 202 DENVER NC,055,Lincoln,193200000X,Group,Multi-Specialty,,1629109285,"DESAI, PAYAL, CHANDARANA",101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1508135799,THE CHARLOTTE-MECKLENBURG HOSPITAL,LEVINE CANCER INSTITUTE,1021 MOREHEAD MEDICAL DR STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629109285,"DESAI, PAYAL, CHANDARANA",101 E W T HARRIS BLVD STE 5500 CHARLOTTE NC,060,Mecklenburg,207RH0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629110036,"HIRATA, TAKASHI",121 MEDICAL DR   ADVANCE NC,030,Davie,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 29 , 48 , 143 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629110036,"HIRATA, TAKASHI",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 12 , 34 ,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629112990,"BAILIFF, LEAH, DAWN",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363LN0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Neonatal,#,#,#,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629116488,"CABRAL, GONZALO",303 GREEN ST E   WILSON NC,098,Wilson,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 94 , 327 , 334 ,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629116488,"CABRAL, GONZALO",303 GREEN ST E   WILSON NC,098,Wilson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1144248683,REX HOSPITAL INC,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629116801,"VAISHNAVI, SANDEEP",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629118203,"BOYD, THOMAS, MADISON",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629122213,CAROLINA MEDICAL HEALTH SUPPLY,CAROLINA MEDICAL HEALTH SUPPLY,1203 FAIRVIEW ST   GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1629122213,CAROLINA MEDICAL HEALTH SUPPLY,1203 FAIRVIEW ST   GREENSBORO NC,041,Guilford,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1629122213,CAROLINA MEDICAL HEALTH SUPPLY,CAROLINA MEDICAL HEALTH SUPPLY,1203 FAIRVIEW ST   GREENSBORO NC,041,Guilford,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies,1629122213,CAROLINA MEDICAL HEALTH SUPPLY,1203 FAIRVIEW ST   GREENSBORO NC,041,Guilford,332BD1200X,Suppliers,Durable Medical Equipment & Medical Supplies,Dialysis Equipment & Supplies, 15 , 41 , 67 ," $10,495.85 ",,
MEDICAID DIRECT,1629125109,ST MARKS MANOR,ST MARKS MANOR,3735 HERITAGE MEADOW LN   HOLLY SPRINGS NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1629125109,ST MARKS MANOR,3735 HERITAGE MEADOW LN   HOLLY SPRINGS NC,092,Wake,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 787 , 787 ," $49,151.00 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629125380,"RA, JIN, HEE",101 MANNING DR   CHAPEL HILL NC,068,Orange,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 74 , 173 , 206 ," $20,254.62 ",,
MEDICAID DIRECT,1457719130,MISSION HEALTH COMMUNITY MULTISPECI,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629126727,"MUELLER, JOSEPH, JAMES",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629127915,"PETERSON, STEPHEN, PAUL",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629127915,"PETERSON, STEPHEN, PAUL",8300 HEALTH PARK STE 107 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992491666,GODEL & ASSOCIATES III PLLC,CHAPEL HILL FAMILY DENTAL CARE,121 S ESTES DR STE 206 CHAPEL HILL NC,068,Orange,193400000X,Group,Single Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",121 S ESTES DR STE 206 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 17 ,$#,,
MEDICAID DIRECT,1962861278,ALAN A GODEL & JUSTIN P HANNON,~,1228 W ROOSEVELT BLVD   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",1228 W ROOSEVELT BLVD   MONROE NC,090,Union,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 42 ,$#,,
MEDICAID DIRECT,1992491666,GODEL & ASSOCIATES III PLLC,CHAPEL HILL FAMILY DENTAL CARE,121 S ESTES DR STE 206 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",121 S ESTES DR STE 206 CHAPEL HILL NC,068,Orange,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1033989637,GODEL AND ASSOCIATES II PLLC,KANNAPOLIS FAMILY DENTAL CARE,2320 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",2320 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice, 103 , 222 , 509 ," $36,206.26 ",,
MEDICAID DIRECT,1629130091,"GODEL, ALAN, ABRAHAM",~,2320 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,1629130091,"GODEL, ALAN, ABRAHAM",2320 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 14 ,$#,,
MEDICAID DIRECT,1033989637,GODEL AND ASSOCIATES II PLLC,KANNAPOLIS FAMILY DENTAL CARE,2320 CONCORD LAKE RD   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629130091,"GODEL, ALAN, ABRAHAM",~,6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,1629130091,"GODEL, ALAN, ABRAHAM",6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750585154,ALAN A GODEL DDS PA,BELMONT FAMILY DENTAL CARE,6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",6655 E WILKINSON BLVD   BELMONT NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 80 , 95 , 216 ," $19,532.04 ",,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1750826319,GODEL & ASSOCIATES PLLC,WINSTON SALEM FAMILY DENTAL CARE,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice, 78 , 90 , 324 ," $18,098.37 ",,
MEDICAID DIRECT,1629130091,"GODEL, ALAN, ABRAHAM",~,145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,1629130091,"GODEL, ALAN, ABRAHAM",145 COLUMBINE DR   WINSTON SALEM NC,034,Forsyth,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1821596115,GODEL AND ASSOCIATES II PLLC,CHARLOTTE FAMILY DENTAL CARE,5232 ALBEMARLE RD STE A CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629130091,"GODEL, ALAN, ABRAHAM",5232 ALBEMARLE RD   CHARLOTTE NC,060,Mecklenburg,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629130950,"PHELPS, JOHN, YANCEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1528016938,EAST CAROLINA UNIVERSITY,ECU PRIMARY OB GYN CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629130950,"PHELPS, JOHN, YANCEY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1629132576,"JEDLICA, MICHELE, THERESA",6329 UNITY ST STE I THOMASVILLE NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1629132576,"JEDLICA, MICHELE, THERESA",210 SCHOOL RD   TRINITY NC,076,Randolph,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 12 , 37 ,$#,,
MEDICAID DIRECT,1427018894,THOMASVILLE-ARCHDALE PEDIATRICS PL,THOMASVILLE-ARCHDALE PEDIATRICS PLLC,200 ARTHUR DR   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1629132576,"JEDLICA, MICHELE, THERESA",200 ARTHUR DR   THOMASVILLE NC,029,Davidson,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 25 , 27 , 67 ,$#,,
MEDICAID DIRECT,1225228463,EAST CAROLINA HEALTH,VIDANT ROANOKE-CHOWAN HOSPITAL,113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,333300000X,Suppliers,Emergency Response System Companies,,1629134127,"PICKETT, JOHN, ROBERT",305 BEECHWOOD BLVD   MURFREESBORO NC,046,Hertford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629135116,COUNTRY LIVING GUEST HOME INC,~,424 WHARTON STATION RD   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1629135116,COUNTRY LIVING GUEST HOME INC,424 WHARTON STATION RD   WASHINGTON NC,007,Beaufort,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,#, 487 , 487 ,$#,,
MEDICAID DIRECT,1033136841,EMERGENCY PHYSICIANS OF TIDEWATER P,EMERGENCY PHYSICIANS OF TIDEWATER PLC,2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629135439,"KLINKHAMMER, MARTIN, DAVID",2800 GODWIN BLVD   SUFFOLK VA,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629136205,"MEHRA, SANJAY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 277 , 422 , 451 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,101 CLINIC DR   TARBORO NC,033,Edgecombe,193200000X,Group,Multi-Specialty,,1629136205,"MEHRA, SANJAY",107 WEST ST   TARBORO NC,033,Edgecombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629136205,"MEHRA, SANJAY",107 WEST ST   TARBORO NC,033,Edgecombe,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1629137484,SAVANNAH FAMILY CARE,Savannah Family Care,128 N CARLISLE ST   SOUTHERN PINES NC,063,Moore,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1629137484,SAVANNAH FAMILY CARE,128 N CARLISLE ST   SOUTHERN PINES NC,063,Moore,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 265 , 265 ," $32,984.08 ",,
MEDICAID DIRECT,1629137773,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05558,325 PINEOLA ST   NEWLAND NC,006,Avery,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1629137773,NORTH CAROLINA CVS PHARMACY LLC,325 PINEOLA ST   NEWLAND NC,006,Avery,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1629137773,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05558,325 PINEOLA ST   NEWLAND NC,006,Avery,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1629137773,NORTH CAROLINA CVS PHARMACY LLC,325 PINEOLA ST   NEWLAND NC,006,Avery,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1629137773,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05558,325 PINEOLA ST   NEWLAND NC,006,Avery,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1629137773,NORTH CAROLINA CVS PHARMACY LLC,325 PINEOLA ST   NEWLAND NC,006,Avery,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1114143542,NC DHHS CHILD AND FAMILY WELL-BEING,MORGANTON HICKORY CDSA,145 W PARKER RD STE A MORGANTON NC,012,Burke,252Y00000X,Agencies,Early Intervention Provider Agency,,1629138193,"BYRD, DEBRA, WULFHORST",145 W PARKER RD STE A MORGANTON NC,012,Burke,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 978 ," 6,061 "," 6,462 "," $441,564.11 ",,
MEDICAID DIRECT,1891919254,NC DHHS CHILD AND FAMILY WELL-BEING,~,2359 HIGHWAY 105   BOONE NC,095,Watauga,252Y00000X,Agencies,Early Intervention Provider Agency,,1629138193,"BYRD, DEBRA, WULFHORST",2359 HIGHWAY 105   BOONE NC,095,Watauga,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 348 ," 3,498 "," 3,751 "," $239,247.43 ",,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1629140645,"TANG, JENNIFER, HUI-YU",460 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629144894,"SPOSATO, JOSEPH, J",612 KINGSBOROUGH SQ STE 100 CHESAPEAKE VA,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1001 BLYTHE BLVD STE 500 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629146477,"ALLSHOUSE, KRISTA, JEAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629147459,"REID, PAUL, ROBERT",775 W CORBETT AVE STE 2 SWANSBORO NC,067,Onslow,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 30 , 73 ,$#,,
MEDICAID DIRECT,1093953127,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629147665,"MCGOWAN, SHANNON, ANN",1200 N ELM ST   GREENSBORO NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 31 , 44 , 59 ,$#,,
MEDICAID DIRECT,1346501798,ARMC PHYSICIANS CARE INC,BURLINGTON UROLOGICAL ASSOCIATES,1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629147665,"MCGOWAN, SHANNON, ANN",1236 HUFFMAN MILL RD STE 1300 BURLINGTON NC,001,Alamance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 90 , 152 , 220 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629148416,"CHILDS, DAVID, DIXON",MEDICAL CENTER BLVD BOWMAN GRAY SCHOOL OF MED WINSTON SALEM NC,029,Davidson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 206 , 215 , 276 ,$#,,
MEDICAID DIRECT,1972763357,WAKE FOREST BAPTIST IMAGING LLC,ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING,265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629148416,"CHILDS, DAVID, DIXON",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 36 , 36 , 43 ,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629148416,"CHILDS, DAVID, DIXON",265 EXECUTIVE PARK BLVD   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1700490232,WAKE FOREST BAPTIST IMAGING LLC,WAKE FOREST BAPTIST IMAGING KERNERSVILLE,861 OLD WINSTON RD STE 105 KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629148416,"CHILDS, DAVID, DIXON",861 OLD WINSTON RD   KERNERSVILLE NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629150065,"GIORDANO, JOSEPH, ANGELO",1500 MATTHEWS TOWNSHIP PKWY   MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629151097,PARKERS FAMILY CARE HOME,PIEDMONT AREA TRANSPORTATION SRV,10123 WADES DEAD END RD   CEDAR GROVE NC,068,Orange,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),,1629151097,PARKERS FAMILY CARE HOME,10123 WADES DEAD END RD   CEDAR GROVE NC,068,Orange,343900000X,Transportation Services,Non-emergency Medical Transport (VAN),, 89 ," 1,076 "," 1,132 "," $131,999.50 ",,
MEDICAID DIRECT,1629151097,PARKERS FAMILY CARE HOME,PIEDMONT AREA TRANSPORTATION SRV,10123 WADES DEAD END RD   CEDAR GROVE NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1629151097,PARKERS FAMILY CARE HOME,10123 WADES DEAD END RD   CEDAR GROVE NC,068,Orange,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,622 "," 1,622 "," $105,525.69 ",,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629151261,"FISHER, THOMAS, DAVID",300 W 27TH ST   LUMBERTON NC,078,Robeson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 , 11 , 16 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629151261,"FISHER, THOMAS, DAVID",317 WESTERN BLVD   JACKSONVILLE NC,067,Onslow,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1447290010,COASTAL CAROLINA HEALTH CARE PA,CCHC IMAGING CENTER,1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1629151261,"FISHER, THOMAS, DAVID",1030 MEDICAL PARK AVE   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 41 , 35 , 53 ,$#,,
MEDICAID DIRECT,1821035999,GREENSBORO RADIOLOGY PA,GREENSBORO RADIOLOGY PA,1331 N ELM ST STE 200 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629151261,"FISHER, THOMAS, DAVID",640 MCCARTHY BLVD   NEW BERN NC,025,Craven,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629151550,"SPEIGHT, OTIS, DONNELL",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 20 , 22 , 25 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629151550,"SPEIGHT, OTIS, DONNELL",3536 MT HOLLY HUNTERSVILLE RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629151832,PROFESSIONAL EARLY INTERVENTION,~,1708A OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629151832,PROFESSIONAL EARLY INTERVENTION,1708A OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,, 46 , 352 , 403 ," $28,303.91 ",,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,600 HOSPITAL DR   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629154554,"USADI, MOSHE, MARK E",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477508836,THE CAROLINAS EMERGENCY GROUP LLC,~,2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,193200000X,Group,Multi-Specialty,,1629154554,"USADI, MOSHE, MARK E",2301 US HIGHWAY 74 W   WADESBORO NC,004,Anson,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629157060,"LEMAUVIEL, LAURIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699392498,MOUNTAIN AREA HEALTH EDUCATION CENT,MAHEC INTERNAL MEDICINE,123 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629157060,"LEMAUVIEL, LAURIE",119 HENDERSONVILLE RD   ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710058086,CAROLINA INTERNAL MEDICINE ASSOCIAT,CAROLINA INTERNAL MEDICINE ASSOCIATES PA,4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1629157060,"LEMAUVIEL, LAURIE",4 VANDERBILT PARK DR STE 100 ASHEVILLE NC,011,Buncombe,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629163209,"MARTIN, WILLIAM, JOSEPH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 11 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629163209,"MARTIN, WILLIAM, JOSEPH",180 PARKWOOD DR   ELKIN NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1801989504,AMSOL PHYSICIANS OF ELKIN NC PLLC,AMSOL PHYSICIANS OF ELKIN NC PLLC,180 PARKWOOD DR   ELKIN NC,086,Surry,193400000X,Group,Single Specialty,,1629163209,"MARTIN, WILLIAM, JOSEPH",180 PARKWOOD DR   ELKIN NC,086,Surry,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 12 , 12 , 12 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,959 EAST ST STE B PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1629164850,"KLEINMAN, DAWN, ELIZABETH",959 EAST ST STE B PITTSBORO NC,019,Chatham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1629164850,"KLEINMAN, DAWN, ELIZABETH",100 S 10TH ST   LILLINGTON NC,043,Harnett,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,959 EAST ST STE B PITTSBORO NC,019,Chatham,193400000X,Group,Single Specialty,,1629164850,"KLEINMAN, DAWN, ELIZABETH",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1629164850,"KLEINMAN, DAWN, ELIZABETH",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 21 , 25 ,$#,,
MEDICAID DIRECT,1205240868,SANFORD DERMATOLOGY PLLC,~,100 S 10TH ST   LILLINGTON NC,043,Harnett,193400000X,Group,Single Specialty,,1629164850,"KLEINMAN, DAWN, ELIZABETH",1911 K M WICKER MEMORIAL DR   SANFORD NC,053,Lee,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1629165022,WATAUGA OPPORTUNITIES INC,~,364 KELLWOOD DR   BOONE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1629165022,WATAUGA OPPORTUNITIES INC,364 KELLWOOD DR   BOONE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 676 , 676 ," $38,978.40 ",,
MEDICAID DIRECT,1629165022,WATAUGA OPPORTUNITIES INC,~,1099 WINKLERS CREEK RD   BOONE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1629165022,WATAUGA OPPORTUNITIES INC,1099 WINKLERS CREEK RD   BOONE NC,095,Watauga,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#," 1,094 "," 1,094 "," $74,500.00 ",,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1629165030,"STIEHL, BARBARA, JILL",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 22 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629165030,"STIEHL, BARBARA, JILL",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629166103,"SHAH, RITESH, RAJNIKANT",Ritesh R Shah,830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1629166103,"SHAH, RITESH, RAJNIKANT",830 S BUNCOMBE RD   GREER SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1629166103,"SHAH, RITESH, RAJNIKANT",Ritesh R Shah,905 VERDAE BLVD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1629166103,"SHAH, RITESH, RAJNIKANT",905 VERDAE BLVD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1629166103,"SHAH, RITESH, RAJNIKANT",Ritesh R Shah,701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,1629166103,"SHAH, RITESH, RAJNIKANT",701 GROVE RD   GREENVILLE SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629167788,"RIOS MERCADO, FRANCISCO, JAVIER",324 N QUEEN ST   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1487799730,KINSTON COMMUNITY HEALTH CENTER,~,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629167788,"RIOS MERCADO, FRANCISCO, JAVIER",324 N QUEEN ST   KINSTON NC,054,Lenoir,1223G0001X,Dental Providers,Dentist,General Practice, 690 ," 1,102 "," 3,425 "," $122,630.28 ",,
MEDICAID DIRECT,1023420973,KIDZCARE PEDIATRICS PC,,1406 S MAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1629168331,"GOLDBACH, ROBERT, HERMAN",1406 S MAIN ST   LILLINGTON NC,043,Harnett,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",1821 HILLANDALE RD STE 24A DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 16 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,13300 STRICKLAND RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",2406 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",10211 ALM ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 43 , 46 , 103 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,7021 HARPS MILL RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",7021 HARPS MILL RD   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,401 IRVING PKWY STE 110 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",401 IRVING PKWY   HOLLY SPRINGS NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,65 TW ALEXANDER DR UNIT 110566 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",2406 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,10211 ALM ST STE 1200 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",10211 ALM ST   RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1801338272,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUC HILLSBOROUGH,267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",267 S CHURTON ST STE 200 HILLSBOROUGH NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,3000 ROGERS RD STE 100 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",3000 ROGERS RD   WAKE FOREST NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 18 ,$#,,
MEDICAID DIRECT,1710120795,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE URGENT CARE BRIER CREEK,100 DUKE HEALTH CARY PL STE 110 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629170873,"HARDIN-LEE, LAURA, KAY",2406 BLUE RIDGE RD STE 190 RALEIGH NC,092,Wake,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 17 ,$#,,
MEDICAID DIRECT,1629171392,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05588,6050 S NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1629171392,NORTH CAROLINA CVS PHARMACY LLC,6050 S NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,#,#,#,$#,,
MEDICAID DIRECT,1629171392,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 05588,6050 S NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1629171392,NORTH CAROLINA CVS PHARMACY LLC,6050 S NC 16 BUSINESS HWY   DENVER NC,055,Lincoln,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1225693419,WAKEMED SPECIALISTS GROUP LLC,WAKEMED GENERAL SURGERY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629171855,"RIPPEL, JANET, LETICIA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1629172390,NORTH CAROLINA CVS PHARMACY LLC,CVS PHARMACY 02771,11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1629172390,NORTH CAROLINA CVS PHARMACY LLC,11911 US 70 BUS HWY W   CLAYTON NC,051,Johnston,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#,#,#,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629174974,"RIZZA, DIANA, RITA",3200 NORTHLINE AVE STE 160 GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",3145 HENDERSON DR   JACKSONVILLE NC,067,Onslow,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 119 , 594 , 655 ," $17,606.00 ",,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",2909 MARKET ST   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 47 , 67 , 112 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",20 MEDICAL CAMPUS DR NW STE 207 SUPPLY NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",1113 LENNOXVILLE RD   BEAUFORT NC,016,Carteret,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 66 , 277 , 295 ,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",800 JEFFERSON ST STE 102 WHITEVILLE NC,024,Columbus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,695 S BENNETT ST   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",515 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1790728921,INTEGRATED PAIN SOLUTIONS PLLC,INTEGRATED PAIN SOLUTIONS PLLC,704A PROGRESS PL   LAURINBURG NC,083,Scotland,193200000X,Group,Multi-Specialty,,1629175609,"GRANT, PATRICIA, ANN",704A PROGRESS PL   LAURINBURG NC,083,Scotland,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 38 , 218 , 237 ,$#,,
MEDICAID DIRECT,1629178629,ORANGE COUNTY,ORANGE COUNTY EMS,510 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,3416L0300X,Transportation Services,Ambulance,Land Transport,1629178629,ORANGE COUNTY,510 MEADOWLANDS DR   HILLSBOROUGH NC,068,Orange,3416L0300X,Transportation Services,Ambulance,Land Transport, 434 , 806 ," 1,417 "," $26,690.44 ",,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1629179858,"ROBERTS, OWEN, WILLIAM",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1467497081,PIEDMONT TRIAD ANESTHESIA PA,PIEDMONT TRIAD ANESTHESIA,145 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629180781,"GOOD, MELANIE, BERTHEL",1950 S HAWTHORNE RD   WINSTON SALEM NC,034,Forsyth,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,,,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,501 N ELAM AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629180781,"GOOD, MELANIE, BERTHEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629180781,"GOOD, MELANIE, BERTHEL",501 N ELAM AVE   GREENSBORO NC,041,Guilford,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629180849,"KELLY, MELISSA, DAWN",802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,363LP0200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Pediatrics, 15 , 15 , 27 ,$#,,
MEDICAID DIRECT,1184762049,WALTER J WULF DDS PA,AFFORDABLE DENTURES & IMPLANTS - WILMINGTON,2253 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629181235,"MCGEE, MARK, EDWARD",2253 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice, 385 , 414 , 776 ," $52,155.53 ",,
MEDICAID DIRECT,1184762049,WALTER J WULF DDS PA,AFFORDABLE DENTURES & IMPLANTS - WILMINGTON,2253 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629181235,"MCGEE, MARK, EDWARD",2253 CAROLINA BEACH RD   WILMINGTON NC,065,New Hanover,1223G0001X,Dental Providers,Dentist,General Practice,#,,,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 275 , 360 ," 2,424 "," $193,453.96 ",,
MEDICAID DIRECT,1245441864,"BARNARD, JULIA, ANNE",,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice, 28 , 30 , 129 ," $10,523.31 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,100 RIDGEVIEW DR   MOCKSVILLE NC,030,Davie,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 13 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,308 BREWER ST   ASHEBORO NC,076,Randolph,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629181482,"SCOTT, CORDELL",111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 25 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice, 32 , 34 , 509 ," $44,385.54 ",,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,991 W HUDSON BLVD   GASTONIA NC,036,Gaston,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",991 W HUDSON BLVD   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#, 18 ,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,111 DOCTORS PARK   LINCOLNTON NC,055,Lincoln,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",890 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1629181482,"SCOTT, CORDELL",~,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,1629181482,"SCOTT, CORDELL",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154662369,GASTON FAMILY HEALTH SERVICES INC,GASTON FAMILY HEALTH SERVICES INC,3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629181482,"SCOTT, CORDELL",3070 11TH AVENUE DR SE   HICKORY NC,018,Catawba,1223G0001X,Dental Providers,Dentist,General Practice, 22 , 22 , 319 ," $28,960.44 ",,
MEDICAID DIRECT,1205061256,HUGH CHATHAM MEMORIAL HOSPITAL,~,180 PARKWOOD DR   ELKIN NC,086,Surry,193200000X,Group,Multi-Specialty,,1629181706,"JOHNSON, JERAY, JAMES",520 CHATHAM MEDICAL PARK   ELKIN NC,086,Surry,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 105 , 208 , 321 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",3009 MEDICAL PLAZA LN   SOUTHPORT NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",584 HOSPITAL DR NE UNIT E BOLIVIA NC,010,Brunswick,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",800 JEFFERSON ST STE 112 WHITEVILLE NC,024,Columbus,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 65 , 74 , 147 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",2000 BRABHAM AVE   JACKSONVILLE NC,067,Onslow,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 16 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629186622,"HOBART, FRANK, ADAMS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 24 , 25 , 25 ,$#,,
MEDICAID DIRECT,1750978839,NOVANT HEALTH NEW HANOVER REGIONAL,,9104 MARKET ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629186622,"HOBART, FRANK, ADAMS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 18 , 19 , 19 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",1500 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",7420 MARKET ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",2150 SHIPYARD BLVD   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 60 , 73 , 88 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 53 , 56 , 82 ,$#,,
MEDICAID DIRECT,1649865791,NOVANT HEALTH MEDICAL GROUP COASTAL,NHMGCR CAPE FEAR HEART,1415 PHYSICIANS DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629186622,"HOBART, FRANK, ADAMS",1960 S 16TH ST   WILMINGTON NC,065,New Hanover,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",3610 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1174722391,BETHANY MEDICAL CENTER,,3610 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 224 , 582 ," 1,717 "," $13,967.42 ",,
MEDICAID DIRECT,1740381581,BETHANY MEDICAL CENTER,BETHANY MEDICAL CENTER,3604 PETERS CT   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",3604 PETERS CT   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1427641224,BETHANY MEDICAL CENTER,,2805 S MAIN ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1316303076,BETHANY MEDICAL CENTER,,3402 BATTLEGROUND AVE   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1255880571,BETHANY MEDICAL CENTER,,1580 SKEET CLUB RD   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",507 N LINDSAY ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952404188,BETHANY MEDICAL CENTER,~,507 N LINDSAY ST   HIGH POINT NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629187281,"WATTERSON, PATRICK, JAMES",5093 UNIVERSITY PKWY   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,180 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1629189279,"WILSON, ROBERT, ALLEN",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 16 , 16 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629189279,"WILSON, ROBERT, ALLEN",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1629189279,"WILSON, ROBERT, ALLEN",180 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1366928749,NM PACS 2 LLC,,179 COMBS ST   SPARTA NC,003,Alleghany,193200000X,Group,Multi-Specialty,,1629189279,"WILSON, ROBERT, ALLEN",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,204 E OLD HIGHWAY 74   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629189279,"WILSON, ROBERT, ALLEN",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1669422846,INPATIENT CONSULTANTS OF NC PC,INPATIENT CONSULTANTS OF NC PC,120 SOUTHWOOD DR   CLINTON NC,082,Sampson,193200000X,Group,Multi-Specialty,,1629189279,"WILSON, ROBERT, ALLEN",120 SOUTHWOOD DR   CLINTON NC,082,Sampson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 20 , 20 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,193200000X,Group,Multi-Specialty,,1629190806,"DOSSETT, DONNA, SUE",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 14 , 15 , 18 ,$#,,
MEDICAID DIRECT,1104859313,KINSTON COMMUNITY HEALTH CENTER,KINSTON COMMUNITY HEALTH CENTER INC,324 N QUEEN ST   KINSTON NC,054,Lenoir,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629190806,"DOSSETT, DONNA, SUE",324 N QUEEN ST   KINSTON NC,054,Lenoir,363LW0102X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Women's Health, 60 , 102 , 120 ," $28,388.85 ",,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1629193594,"TAYLOR, RYAN, WILKES",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 14 , 43 , 43 ,$#,,
MEDICAID DIRECT,1629195953,ADMINISTRATIVE CARE SERVICES OF MAD,HOT SPRINGS FAMILY CARE HOME 2,311 N SERPENTINE AVE # 2 HOT SPRINGS NC,057,Madison,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1629195953,ADMINISTRATIVE CARE SERVICES OF MAD,311 N SERPENTINE AVE # 2 HOT SPRINGS NC,057,Madison,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 301 , 301 ," $21,265.28 ",,
MEDICAID DIRECT,1205024007,CENTRAL CAROLINA ORTHOPAEDIC ASSOCI,~,1139 CARTHAGE ST STE 101 SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1629197207,"PILECKI, KEVIN",1139 CARTHAGE ST STE 101 SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 26 , 60 , 95 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629200498,"KARVELAS, KRISTOPHER, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 17 , 35 , 50 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1807 FORDHAM BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629200498,"KARVELAS, KRISTOPHER, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,029,Davidson,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 89 , 143 , 213 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629201280,"BALSLY, JOSH, A",204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 49 , 64 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629201280,"BALSLY, JOSH, A",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,3645 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1629201280,"BALSLY, JOSH, A",1 MEDICAL DR   BENSON NC,051,Johnston,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 22 , 24 ,$#,,
MEDICAID DIRECT,1639317332,ADVANCED SPINE PAIN CENTER PA,ADVANCED SPINE & PAIN CENTER PA,204 MEDSPRING DR STE 100 CLAYTON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629201280,"BALSLY, JOSH, A",3024 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629202866,"HARTMAN, HEIDI, JON",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 133 , 154 , 195 ,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629202866,"HARTMAN, HEIDI, JON",620 SUMMIT CROSSING PL STE 106 GASTONIA NC,036,Gaston,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 167 , 181 , 256 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,4901 DAWN DR STE 3200 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",105 NEWSOM ST STE 101 DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 12 , 14 , 15 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,800 OAKRIDGE BLVD   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",105 NEWSOM ST STE 101 DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",105 NEWSOM ST STE 101 DURHAM NC,032,Durham,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841248622,COUNTY OF BRUNSWICK,~,25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,261QP0905X,Ambulatory Health Care Facilities,Clinic/Center,"Public Health, State or Local",1629204870,"DAVIES, DENISE, ANNA-MARIE",25 COURTHOUSE DR   BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",584 HOSPITAL DR NE UNIT B BOLIVIA NC,010,Brunswick,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1841632882,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE SHELBY OBGYN,110 W GROVER ST   SHELBY NC,023,Cleveland,193400000X,Group,Single Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",110 W GROVER ST   SHELBY NC,023,Cleveland,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1649282930,EASTOVER UNIVERSITY OB AND GYN ASSO,ATRIUM HEALTH WOMENS CARE EASTOVER UNIVERSITY OBGY,101 E W T HARRIS BLVD STE 5301 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1730709429,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE ONE HEALTH OBGYN,15110 JOHN J DELANEY DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1477276699,NOVANT HEALTH MEDICAL GROUP LLC,NHMG OBGYN CLINICS,14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",14330 OAKHILL PARK LN STE 200 HUNTERSVILLE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1740848100,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH OB GYN HOSPITALIST,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1144239625,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH WOMENS CARE NORTH CHARLOTTE OBGYN,16455 STATESVILLE RD STE 400 HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629204870,"DAVIES, DENISE, ANNA-MARIE",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1366912586,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629205935,"EVERSON, PETER, DALE",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1740989516,ONSITE NEONATAL NC PC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1629205935,"EVERSON, PETER, DALE",2201 S STERLING ST   MORGANTON NC,012,Burke,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine, 16 , 60 , 62 ," $10,903.73 ",,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629206784,"POPLAWSKI, SARAH, BETH",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629206784,"POPLAWSKI, SARAH, BETH",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 26 , 26 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629206784,"POPLAWSKI, SARAH, BETH",601 N ELM ST   HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629206784,"POPLAWSKI, SARAH, BETH",1370 W D ST   NORTH WILKESBORO NC,097,Wilkes,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629206784,"POPLAWSKI, SARAH, BETH",180 PARKWOOD DR   ELKIN NC,086,Surry,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629206826,"RICE, DAVID, JAMAAR",600 HOSPITAL DR   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,193200000X,Group,Multi-Specialty,,1629206826,"RICE, DAVID, JAMAAR",1100 HEALING WAY STE 11A MATTHEWS NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629206826,"RICE, DAVID, JAMAAR",1550 FAULK ST STE 1100 MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 14 , 21 , 22 ,$#,,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629206826,"RICE, DAVID, JAMAAR",1550 FAULK ST STE 1100 MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 38 , 54 , 62 ," $10,212.30 ",,
MEDICAID DIRECT,1245587856,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH GENERAL SURGERY,1550 FAULK ST   MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629206826,"RICE, DAVID, JAMAAR",600 HOSPITAL DR   MONROE NC,090,Union,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629207139,"MARCHIGIANI, RAFFAELE, JAMES",3000 COLISEUM DR STE 200 HAMPTON VA,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1477785756,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST PEDIATRICS - GRE,802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629207337,"DU, NGOC, MY",802 GREEN VALLEY RD STE 210 GREENSBORO NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 13 , 15 , 38 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629207337,"DU, NGOC, MY",601 N ELM ST   HIGH POINT NC,041,Guilford,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629207337,"DU, NGOC, MY",920 CHURCH ST N STE 255-D CONCORD NC,013,Cabarrus,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629207576,"CARTER, NATHAN, MARCELLOUS",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1629207832,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,5505 CREEDMOOR RD STE 220-B RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,1629207832,BAYADA HOME HEALTH CARE INC,5505 CREEDMOOR RD STE 220-B RALEIGH NC,092,Wake,251J00000X,Agencies,Nursing Care,,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1629207832,BAYADA HOME HEALTH CARE INC,BAYADA HOME HEALTH CARE INC,5505 CREEDMOOR RD STE 220-B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1629207832,BAYADA HOME HEALTH CARE INC,5505 CREEDMOOR RD STE 220-B RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1629211198,"JONES, HEATH, MICHAEL",706 GREEN VALLEY RD STE 104 GREENSBORO NC,041,Guilford,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 37 , 42 , 61 ,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1629211198,"JONES, HEATH, MICHAEL",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1477519148,PATHOLOGISTS MEDICAL LABORATORY PA,~,10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,291U00000X,Laboratories,Clinical Medical Laboratory,,1629211198,"JONES, HEATH, MICHAEL",10 MEDICAL PARK DR   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology,#,#,#,$#,,
MEDICAID DIRECT,1386600054,MOUNTAIN AREA PATHOLOGY PA,~,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1629211198,"JONES, HEATH, MICHAEL",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207ZP0102X,Allopathic & Osteopathic Physicians,Pathology,Anatomic Pathology & Clinical Pathology, 16 , 12 , 19 ,$#,,
MEDICAID DIRECT,1083449680,CAROLINA CARING SERIOUS ILLNESS LLC,CAROLINA CARING,3975 ROBINSON RD   NEWTON NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629211727,"SHIRES, MARGARET, BRALLEY",3975 ROBINSON RD   NEWTON NC,018,Catawba,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629211727,"SHIRES, MARGARET, BRALLEY",258 E GARRISON BLVD   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 11 ,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629211727,"SHIRES, MARGARET, BRALLEY",2525 COURT DR   GASTONIA NC,036,Gaston,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 23 , 24 , 26 ,$#,,
MEDICAID DIRECT,1215398789,CAROMONT MEDICAL GROUP INC,CAROMONT PALLIATIVE CARE PHYSICIANS,2525 COURT DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629211727,"SHIRES, MARGARET, BRALLEY",2525 COURT DR   GASTONIA NC,036,Gaston,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629213566,"JONNALAGADDA, KRISHNAMURTHY, VENKATA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629213566,"JONNALAGADDA, KRISHNAMURTHY, VENKATA",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 25 , 44 , 44 ,$#,,
MEDICAID DIRECT,1144362864,FAYETTEVILLE ANESTHESIA PA,FAYETTEVILLE ANESTHESIA PA,1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1629220017,"JACKSON, HEATHER, MARIE",1781 METROMEDICAL DR   FAYETTEVILLE NC,026,Cumberland,367H00000X,Physician Assistants & Advanced Practice Nursing Providers,Anesthesiologist Assistant,, 36 , 37 , 37 ,$#,,
MEDICAID DIRECT,1881360899,CAROLINA QUICKCARE FAMILY PRACTICE,CAROLINA QUICKCARE FAMILY PRACTICE,41 BAIN ST   LILLINGTON NC,043,Harnett,193200000X,Group,Multi-Specialty,,1629221379,"SPRIGGS, TIA, LYN",41 BAIN ST   LILLINGTON NC,043,Harnett,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1184737462,COASTAL CAROLINA NEUROPSYCHIATRIC C,COASTAL CAROLINA NEUROPSYCHIATRIC CENTER PA,200 TARPON TRL   JACKSONVILLE NC,067,Onslow,193200000X,Group,Multi-Specialty,,1629223342,"HOBBY STRICKLAND, KRISTINA, ALLEN",200 TARPON TRL   JACKSONVILLE NC,067,Onslow,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#, 40 , 40 ,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629224688,"DUMONSKI, MARK, LEONARD",1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 44 , 86 , 122 ,$#,,
MEDICAID DIRECT,1790724706,SOUTHEASTERN ORTHOPAEDIC SPECIALIST,GUILFORD ORTHOPAEDIC AND SPORTS MEDICINE CENTER,1915 LENDEW ST STE 100 GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629224688,"DUMONSKI, MARK, LEONARD",1200 N ELM ST   GREENSBORO NC,041,Guilford,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629225701,"LEO, TROY",1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 15 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629225701,"LEO, TROY",1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 27 , 27 , 45 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 2100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629225701,"LEO, TROY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 20 , 20 , 27 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629225701,"LEO, TROY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 19 , 35 , 36 ,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 3100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629225701,"LEO, TROY",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447545777,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629225701,"LEO, TROY",2680 ABERDEEN BLVD   GASTONIA NC,036,Gaston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1609191121,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1656 RIVERCHASE BLVD STE 2500 ROCK HILL SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629225701,"LEO, TROY",1656 RIVERCHASE BLVD STE 2500 ROCK HILL SC,101,Out of State <= 40 miles,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1598080087,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1550 FAULK ST STE 3100 MONROE NC,090,Union,193200000X,Group,Multi-Specialty,,1629225701,"LEO, TROY",1550 FAULK ST STE 3100 MONROE NC,090,Union,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1982076071,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - CARY WEST,1203 NW MAYNARD RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629226576,"TAWFIK, HAYSAM, GALAL",1001 WIDEWATERS PKWY STE B KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1154523769,Riccobene & Associates I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - KNIGHTDALE,1001 WIDEWATERS PKWY   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1629226576,"TAWFIK, HAYSAM, GALAL",1001 WIDEWATERS PKWY STE B KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice,#,#,#,$#,,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 VETERANS PKWY STE 214 GARNER NC,051,Johnston,193400000X,Group,Single Specialty,,1629226576,"TAWFIK, HAYSAM, GALAL",1001 WIDEWATERS PKWY STE B KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 132 , 179 , 691 ," $67,610.57 ",,
MEDICAID DIRECT,1902980493,RICCOBENE & ASSOCIATES I DDS PA,RICCOBENE ASSOCIATES FAMILY DENTISTRY - GARNER,5638 NC HIGHWAY 42 W STE 214 GARNER NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629226576,"TAWFIK, HAYSAM, GALAL",1001 WIDEWATERS PKWY STE B KNIGHTDALE NC,092,Wake,1223G0001X,Dental Providers,Dentist,General Practice, 204 , 304 ," 1,164 "," $108,827.91 ",,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629227889,"ZAMANIFEKRI, BEHROUZ",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 274 , 437 , 549 ," $11,527.43 ",,
MEDICAID DIRECT,1730354978,CAROMONT MEDICAL GROUP INC,CAROMONT NEUROLOGY,815 COX RD   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629227889,"ZAMANIFEKRI, BEHROUZ",815 COX RD   GASTONIA NC,036,Gaston,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#, 11 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 11 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",2001 VAIL AVENUE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",2001 VAIL AVENUE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",2001 VAIL AVENUE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",6965 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 15 , 15 , 24 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629231212,"GERHART, CALEB, CHRISTOPHER",2001 VAIL AVENUE   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629231451,"EL-GHARBAWY, AREEG, HASSAN",3000 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629231451,"EL-GHARBAWY, AREEG, HASSAN",2301 ERWIN RD   DURHAM NC,032,Durham,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD STE 310 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629234547,"MONTGOMERY, SEAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629234547,"MONTGOMERY, SEAN, PAUL",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 27 , 43 , 47 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629234547,"MONTGOMERY, SEAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 28 , 31 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629234547,"MONTGOMERY, SEAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 17 , 20 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629234547,"MONTGOMERY, SEAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 13 , 33 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 EXECUTIVE DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629234547,"MONTGOMERY, SEAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3320 EXECUTIVE DR STE 218 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629234547,"MONTGOMERY, SEAN, PAUL",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1700888542,GREENE COUNTY HEALTH CARE INC,KATE B REYNOLDS MEDICAL CENTER,205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629236013,"WARREN, HOLLY, ALISHA CARRAWAY",205 MARTIN L KING JR PKWY   SNOW HILL NC,040,Greene,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629236021,"MABRY, FREDERICK, HARRISON",105 PAVILION WAY   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 51 , 82 , 195 ,$#,,
MEDICAID DIRECT,1114998150,SANDHILLS PEDIATRICS INC,,195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,193200000X,Group,Multi-Specialty,,1629236021,"MABRY, FREDERICK, HARRISON",195 W ILLINOIS AVE   SOUTHERN PINES NC,063,Moore,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1083927438,THE PRESBYTERIAN HOSPITAL,PROFESSIONAL SERVICES OF PRESBYTERIAN HUNTERSVILLE,10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629237532,"ZIEGLER, KIRSTEN, FRIDLUND",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 302 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",9735 KINCEY AVE STE 200 HUNTERSVILLE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#, 12 , 33 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 22 , 43 , 92 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,1084 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,, 15 , 22 , 42 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",12610 N COMMUNITY HOUSE RD STE 100 CHARLOTTE NC,060,Mecklenburg,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",924 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1013210004,CAROLINA UROLOGY PARTNERS PLLC,~,9735 KINCEY AVE STE 201 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629239256,"MCKIM, STEPHEN, ERNEST",631 COX RD   GASTONIA NC,036,Gaston,208800000X,Allopathic & Osteopathic Physicians,Urology,,#,#,#,$#,,
MEDICAID DIRECT,1538214309,CHILDRENS MEDICAL GROUP INC,CHESAPEAKE PEDIATRICS,500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629239587,"WHITESIDE, PAUL, F.",500 DISCOVERY DR STE 302 CHESAPEAKE VA,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1356379382,SOUTHEASTERN EMERGENCY PHYSICIAN,S E EMERGENCY PHYSICIANS INC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193400000X,Group,Single Specialty,,1629240189,"BARNETT, TEODOR, VITENBERG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 76 , 80 , 85 ,$#,,
MEDICAID DIRECT,1609308113,RANGE URGENT CARE PLLC,,,,Unknown,193200000X,Group,Multi-Specialty,,1629240189,"BARNETT, TEODOR, VITENBERG",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",145 TILGHMAN DR   DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,145 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",145 TILGHMAN DR   DUNN NC,043,Harnett,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 17 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,145 TILGHMAN DR STE 100 DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",145 TILGHMAN DR   DUNN NC,043,Harnett,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,1 MEDICAL DR   BENSON NC,051,Johnston,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",1 MEDICAL DR   BENSON NC,051,Johnston,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#, 17 , 21 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 40 , 72 , 139 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 36 , 130 , 266 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",400 ATTAIN ST   FUQUAY VARINA NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#, 12 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193400000X,Group,Single Specialty,,1629240395,"NETREBKO, PAVLO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 25 ,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",1900 KILDAIRE FARM RD   CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 15 , 20 , 31 ,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#, 12 , 12 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629240395,"NETREBKO, PAVLO",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 102 , 190 ,$#,,
MEDICAID DIRECT,1568443224,CARY CARDIOLOGY PA,CARY CARDIOLOGY PA,300 KEISLER DR STE 204 CARY NC,092,Wake,193400000X,Group,Single Specialty,,1629240395,"NETREBKO, PAVLO",300 KEISLER DR STE 204 CARY NC,092,Wake,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 14 , 18 ,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629242029,"GARLAND, MARY, RUTH",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629242300,"KIRKPATRICK, MCNEILL, PALMER",501 N ELAM AVE   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1255609038,MOSES CONE PHYSICIAN SERVICES INC,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629242300,"KIRKPATRICK, MCNEILL, PALMER",1200 N ELM ST   GREENSBORO NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 55 , 70 , 71 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,,,Unknown,193200000X,Group,Multi-Specialty,,1629242490,"INKUMSAH, SAMUEL, EKRO",1418 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,,,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,171 FAIRVIEW RD   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629242490,"INKUMSAH, SAMUEL, EKRO",1418 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 11 , 12 ,$#,,
MEDICAID DIRECT,1811381593,IREDELL PHYSICIAN NETWORK,,766 HARTNESS RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629242490,"INKUMSAH, SAMUEL, EKRO",555 KITCHINGS DR STE D STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,170 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629242490,"INKUMSAH, SAMUEL, EKRO",1418 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 18 , 23 ,$#,,
MEDICAID DIRECT,1700028982,MOORESVILLE PPM LLC,Mooresville PPM LLC,1410 FERN CREEK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629242490,"INKUMSAH, SAMUEL, EKRO",1410 FERN CREEK DR   STATESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 28 , 38 , 52 ,$#,,
MEDICAID DIRECT,1275528176,HOSPICE OF HENDERSON COUNTY INC,FOUR SEASONS THE CARE YOU TRUST,571 S ALLEN RD   FLAT ROCK NC,045,Henderson,193200000X,Group,Multi-Specialty,,1629243092,"ENGLISH, CARA, LYNN",571 S ALLEN RD   FLAT ROCK NC,045,Henderson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 67 , 224 , 247 ,$#,,
MEDICAID DIRECT,1902881147,DELANEY RADIOLOGISTS PA,Delaney Radiologists PA,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629245113,"PROSCIA, NICOLE",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 26 , 46 ,$#,,
MEDICAID DIRECT,1912982166,DELANEY RADIOLOGISTS GROUP PLLC,Delaney Radiologists Group PLLC,1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629245113,"PROSCIA, NICOLE",1025 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 30 , 30 , 69 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629253489,"TURCOTTE, RIZALYN, LORENA",1901 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629253489,"TURCOTTE, RIZALYN, LORENA",2525 COURT DR   GASTONIA NC,036,Gaston,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1932375102,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE PICKETT ROAD,3004 TOWER BLVD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629254685,"SUSON, SHARON, MATARLO",3044 TOWER BLVD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 22 , 34 , 81 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629259254,"MODELL PARRISH, KENDRA, JOY",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 12 , 16 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629259254,"MODELL PARRISH, KENDRA, JOY",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2400 PRATT ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629259254,"MODELL PARRISH, KENDRA, JOY",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629259254,"MODELL PARRISH, KENDRA, JOY",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629259254,"MODELL PARRISH, KENDRA, JOY",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629259254,"MODELL PARRISH, KENDRA, JOY",1200 PINE RUN DR   LUMBERTON NC,078,Robeson,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629268149,"LOVORN, MEGAN, BETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629268149,"LOVORN, MEGAN, BETH",1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,,#,#,#,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,1200 N ELM ST   GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629268149,"LOVORN, MEGAN, BETH",1200 N ELM ST   GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 59 , 162 , 188 ,$#,,
MEDICAID DIRECT,1356372064,THE MOSES H CONE MEMORIAL HOSPITAL,~,510 N ELAM AVE STE 301 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629268149,"LOVORN, MEGAN, BETH",1126 N CHURCH ST STE 103 GREENSBORO NC,041,Guilford,208100000X,Allopathic & Osteopathic Physicians,Physical Medicine & Rehabilitation,, 21 , 106 , 112 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629268537,"KOWALSKI, ADAM, EDGAR",700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 99 , 101 , 116 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629270632,"POST, DEAN, ALLEN",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629271267,"COOK, ERIN, FOSTER",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1548876923,CAROLINAS PHYSICIANS NETWORK INC,~,1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629271267,"COOK, ERIN, FOSTER",1001 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 42 , 49 , 57 ,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629271267,"COOK, ERIN, FOSTER",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1275774333,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629271267,"COOK, ERIN, FOSTER",1350 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1518982768,EASTOVER OBSTETRICS AND GYNECOLOGY,ATRIUM HEALTH WOMENS CARE EASTOVER OBGYN,1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629271267,"COOK, ERIN, FOSTER",1025 MOREHEAD MEDICAL DR STE 450 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1942539010,CAROLINAS MEDICAL CENTER,TEEN HEALTH CONNECTION,3541 RANDOLPH RD STE 206 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629271267,"COOK, ERIN, FOSTER",3541 RANDOLPH RD STE 206 CHARLOTTE NC,060,Mecklenburg,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1629272117,"KORZYNIOWSKI, ANDREW, DONOVAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 31 , 31 , 33 ,$#,,
MEDICAID DIRECT,1477995124,FLETCHER HOSPITAL INCORPORATED,ADVENTHEALTH HENDERSONVILLE,80 DOCTORS DR STE 1 HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1629272117,"KORZYNIOWSKI, ANDREW, DONOVAN",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 14 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,193200000X,Group,Multi-Specialty,,1629272182,"CLARK, BADIE, TRAVIS",2700 WAYNE MEMORIAL DR   GOLDSBORO NC,096,Wayne,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#, 11 , 13 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,335 PENNY LN   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629272455,"HUANG, WILLIAM, WEI-TING",525 CORPORATE CIR   SALISBURY NC,080,Rowan,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 97 , 122 , 161 ,$#,,
MEDICAID DIRECT,1437110772,DERMATOLOGY GROUP OF THE CAROLINAS,~,525 CORPORATE CIR   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1629272455,"HUANG, WILLIAM, WEI-TING",525 CORPORATE CIR   SALISBURY NC,080,Rowan,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629272455,"HUANG, WILLIAM, WEI-TING",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1841516960,PREMIER IMAGING LLC,~,4515 PREMIER DR STE 101 HIGH POINT NC,041,Guilford,293D00000X,Laboratories,Physiological Laboratory,,1629272943,"KEELER, NANCY, ELIZABETH",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1700901436,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST FAMILY MEDICINE,4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,193400000X,Group,Single Specialty,,1629272943,"KEELER, NANCY, ELIZABETH",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 51 , 56 , 85 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629272943,"KEELER, NANCY, ELIZABETH",4515 PREMIER DR STE 201 HIGH POINT NC,041,Guilford,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1992802607,PEDIATRIX MEDICAL GROUP OF SOUTH CA,~,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629273131,"HAMILTON, EMILY, LAUREN",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,2080N0001X,Allopathic & Osteopathic Physicians,Pediatrics,Neonatal-Perinatal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1629273735,"JACKSON, JONATHAN, WESLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1407840374,SCOTLAND MEMORIAL HOSPITAL INC,~,500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1629273735,"JACKSON, JONATHAN, WESLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 35 , 41 , 41 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,1705 TARBORO ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1629273735,"JACKSON, JONATHAN, WESLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1669231452,PROLIFIC ANESTHESIA SERVICE PLLC,,1705 TARBORA ST SW   WILSON NC,098,Wilson,193400000X,Group,Single Specialty,,1629273735,"JACKSON, JONATHAN, WESLEY",500 LAUCHWOOD DR   LAURINBURG NC,083,Scotland,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1699729939,SPARTANBURG MEDICAL CENTER,MEDICALGROUPOFTHECAROLINAS-EMERGENCYMEDICINE,101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629274964,"JUAN, EMERSON, ALFONSO",101 E WOOD ST   SPARTANBURG SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629275805,"VIKRAMAN-SUSHAM, DEEPAK",2301 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629275805,"VIKRAMAN-SUSHAM, DEEPAK",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629275805,"VIKRAMAN-SUSHAM, DEEPAK",2100 ERWIN RD   DURHAM NC,032,Durham,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 21 , 25 , 29 ,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629278122,"HUDSON, DAVID, WESLEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 29 , 29 , 30 ,$#,,
MEDICAID DIRECT,1386622231,NORTHEAST ANESTHESIA AND PAIN SPECI,NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA,920 CHURCH ST N   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629278122,"HUDSON, DAVID, WESLEY",920 CHURCH ST N   CONCORD NC,013,Cabarrus,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 24 ,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,517 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629278981,"MATHAI, ANGIE, ELIZABETH",517 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1023423274,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS MEDPEDS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629278981,"MATHAI, ANGIE, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 ,#, 14 ,$#,,
MEDICAID DIRECT,1730139171,EAST CAROLINA UNIVERSITY,ECU PRIMARY PEDIATRICS CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629278981,"MATHAI, ANGIE, ELIZABETH",600 MOYE BLVD   GREENVILLE NC,074,Pitt,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 53 , 86 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,216 MOORE RD   KING NC,085,Stokes,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,2001 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 HOSPITAL AVE   JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1073571352,PIEDMONT IMAGING LLC,NOVANT HEALTH IMAGING PIEDMONT,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 46 , 47 , 54 ,$#,,
MEDICAID DIRECT,1104874387,JACKSONVILLE DIAGNOSTIC IMAGING LLC,COASTAL DIAGNOSTIC IMAGING,3606 HENDERSON DR   JACKSONVILLE NC,067,Onslow,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 16 , 15 , 16 ,$#,,
MEDICAID DIRECT,1790743078,TRIAD IMAGING LLC,NOVANT HEALTH IMAGING TRIAD,2705 HENRY ST   GREENSBORO NC,041,Guilford,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,354 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,9848 N TRYON ST STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 201 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1570 NC 8 AND 89 HWY N   DANBURY NC,085,Stokes,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,865 W LAKE DR   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3155 MAPLEWOOD AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,445 PINEVIEW DR STE 100 KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,870 SUMMIT CROSSING PL   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,185 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1669430971,CAROLINA IMAGING LLC OF FAYETTEVILL,CAROLINA IMAGING LLC OF FAYETTEVILLE,3628 CAPE CENTER DR   FAYETTEVILLE NC,026,Cumberland,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,10315 HAMPTONS PARK DR   HUNTERSVILLE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,390 W SALEM AVE   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,,,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,200 ROBINHOOD MEDICAL PLZ BLDG 2 WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,1604 MEDICAL DR   LAURINBURG NC,083,Scotland,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,170 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 45 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,167 MOORE RD STE 202 KING NC,085,Stokes,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,15825 BALLANTYNE MEDICAL PL STE 100 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 23 , 31 ,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,105 VEST MILL CIR   WINSTON SALEM NC,034,Forsyth,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1659485001,TRIAD INTERVENTIONAL RADIOLOGY CLIN,TRIAD INTERVENTIONAL RADIOLOGY CLINIC,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 66 , 68 , 86 ,$#,,
MEDICAID DIRECT,1750349015,ASHEVILLE OPEN MRI LLC,OPEN MRI OF ASHEVILLE,675 BILTMORE AVE STE A ASHEVILLE NC,011,Buncombe,193400000X,Group,Single Specialty,,1629282306,"CUDA, JEREMY, FRANCIS",3010 TRENWEST DR   WINSTON SALEM NC,034,Forsyth,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 29 , 29 , 36 ,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629282371,"FALCONE, MICHAEL, THOMAS",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,,#,#,#,$#,,
MEDICAID DIRECT,1043287469,CHARLOTTE EYE EAR NOSE AND THROAT A,~,6035 FAIRVIEW RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629282371,"FALCONE, MICHAEL, THOMAS",2325 W ARBORS DR STE 201 CHARLOTTE NC,060,Mecklenburg,207Y00000X,Allopathic & Osteopathic Physicians,Otolaryngology,, 85 , 121 , 160 ,$#,,
MEDICAID DIRECT,1700918877,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - TRIA,145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629283908,"ISAAC, MITCHELL, GARETH",1814 WESTCHESTER DR STE 100 HIGH POINT NC,041,Guilford,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#, 18 , 32 ,$#,,
MEDICAID DIRECT,1700918877,WAKE FOREST HEALTH NETWORK LLC,ATRIUM HEALTH WAKE FOREST BAPTIST NEUROLOGY - TRIA,145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629283908,"ISAAC, MITCHELL, GARETH",145 KIMEL PARK DR STE 100 WINSTON SALEM NC,034,Forsyth,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 74 , 112 , 159 ,$#,,
MEDICAID DIRECT,1912232182,EMERGENCY MEDICINE PHYSICIANS OF ME,~,10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629284559,"WELSH, IAN, ROBERT",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003887118,EVMS ACADEMIC PHYSICIANS AND SURGEO,EVMS MEDICAL GROUP,3920A BRIDGE RD STE 305 SUFFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629286059,"LIEB, DAVID, CHARLES",600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,207RE0101X,Allopathic & Osteopathic Physicians,Internal Medicine,"Endocrinology, Diabetes & Metabolism",#,#,#,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193400000X,Group,Single Specialty,,1629287438,"BROWN, RICHARD, WAYNE",1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 18 ,$#,,
MEDICAID DIRECT,1366498297,COASTAL CAROLINA HEALTH CARE PA,CCHC NEW BERN FAMILY PRACTICE,1040 MEDICAL PARK AVE   NEW BERN NC,025,Craven,193200000X,Group,Multi-Specialty,,1629287438,"BROWN, RICHARD, WAYNE",1020 MEDICAL PARK AVE   NEW BERN NC,025,Craven,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629287610,"GROSS, TERESA, MCDONALD",608 AIRPORT RD   KINSTON NC,054,Lenoir,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629287610,"GROSS, TERESA, MCDONALD",2355 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629287610,"GROSS, TERESA, MCDONALD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 12 , 16 ,$#,,
MEDICAID DIRECT,1023068392,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS NEPHROLOGY,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629287610,"GROSS, TERESA, MCDONALD",600 MOYE BLVD   GREENVILLE NC,074,Pitt,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 24 , 58 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629289814,"SADIQ, TERESA, ELAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629289814,"SADIQ, TERESA, ELAINE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology, 31 , 49 , 54 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,2316A S MAIN ST   LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1629290523,"VLAD, LUCIAN, GABRIEL",10 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 14 , 15 ,$#,,
MEDICAID DIRECT,1639454499,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,10 MEDICAL PARK DR STE 1 LEXINGTON NC,029,Davidson,193200000X,Group,Multi-Specialty,,1629290523,"VLAD, LUCIAN, GABRIEL",10 MEDICAL PARK DR   LEXINGTON NC,029,Davidson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629290523,"VLAD, LUCIAN, GABRIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 154 , 450 , 548 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629290523,"VLAD, LUCIAN, GABRIEL",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629292685,"PHELPS, JANEY, ROXANNA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 46 , 47 , 56 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629292776,"ISENBERG, AMY, VIRGINIA",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 26 , 26 , 26 ,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629292776,"ISENBERG, AMY, VIRGINIA",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 15 , 15 , 18 ,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,1168 E CUTLAR XING STE 101 LELAND NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1629292776,"ISENBERG, AMY, VIRGINIA",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629292776,"ISENBERG, AMY, VIRGINIA",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1932402195,SOUTHEAST ANESTHESIOLOGY CONSULTANT,AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629292776,"ISENBERG, AMY, VIRGINIA",2520 INDEPENDENCE BLVD STE 200 WILMINGTON NC,065,New Hanover,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629295597,"STEINBAKER, CHRISTOPHER, RYAN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 459 , 494 , 611 ," $16,862.32 ",,
MEDICAID DIRECT,1619312238,EAST CAROLINA UNIVERSITY,~,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629295597,"STEINBAKER, CHRISTOPHER, RYAN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1215990171,EASTERN RADIOLOGIST INC,~,630 E 11TH ST   WASHINGTON NC,007,Beaufort,193400000X,Group,Single Specialty,,1629295597,"STEINBAKER, CHRISTOPHER, RYAN",2101 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 543 , 640 , 777 ,$#,,
MEDICAID DIRECT,1720557002,KIDS RULE PEDIATRICS PA,,3604 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,193400000X,Group,Single Specialty,,1629296355,"HOLLAND, NANCY, WHITFORD",3604 MEDICAL PARK CT   MOREHEAD CITY NC,016,Carteret,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 53 , 75 , 196 ,$#,,
MEDICAID DIRECT,1629297494,STALLS MEDICAL INC,,7980 CHAPEL HILL RD STE 101 CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1629297494,STALLS MEDICAL INC,7980 CHAPEL HILL RD STE 101 CARY NC,092,Wake,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 164 , 348 ," 1,274 "," $415,080.27 ",,
MEDICAID DIRECT,1629297494,STALLS MEDICAL INC,,7980 CHAPEL HILL RD STE 101 CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1629297494,STALLS MEDICAL INC,7980 CHAPEL HILL RD STE 101 CARY NC,092,Wake,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,, 11 , 11 , 11 ," $48,438.10 ",,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",101 HOSPITAL DR   COLUMBUS NC,075,Polk,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",15 SKYLAND INN DR FL 1 ARDEN NC,011,Buncombe,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 59 , 59 , 87 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",21 S MAIN ST   ROBBINSVILLE NC,038,Graham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,207U00000X,Allopathic & Osteopathic Physicians,Nuclear Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 27 , 33 , 40 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",100 HOSPITAL DR   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 23 , 25 , 35 ,$#,,
MEDICAID DIRECT,1538106810,HENDERSONVILLE RADIOLOGICAL CONSULT,~,807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,193400000X,Group,Single Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 39 , 53 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",800 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 31 , 32 , 40 ,$#,,
MEDICAID DIRECT,1164474094,ARA HEALTH SPECIALISTS PA,ASHEVILLE RADIOLOGY ASSOCIATES PA,534 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629299979,"SOMMERVILLE, LEWIS, CASS",807 N JUSTICE ST   HENDERSONVILLE NC,045,Henderson,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1629303003,PHILLIPS HOME HEALTH CARE,PHILLIPS HOME HEALTH CARE,3621 AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,,1629303003,PHILLIPS HOME HEALTH CARE,3621 AIRPORT BLVD NW   WILSON NC,098,Wilson,253Z00000X,Agencies,In Home Supportive Care,, 94 ," 19,158 "," 19,158 "," $1,156,978.82 ",,
MEDICAID DIRECT,1902859952,EYECARECENTER OD PA,Eyecare Center OD PA,1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,193400000X,Group,Single Specialty,,1629304191,"ALDRICH, MARISSA, ANNE",1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1902859952,EYECARECENTER OD PA,Eyecare Center OD PA,1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629304191,"ALDRICH, MARISSA, ANNE",1813 W EHRINGHAUS ST   ELIZABETH CITY NC,070,Pasquotank,152W00000X,Eye and Vision Services Providers,Optometrist,, 19 , 19 , 21 ,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629307772,"STRATTON, ELIZABETH, ANNE",1021 MOREHEAD MEDICAL DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1568400109,SOUTHEAST RADIATION ONCOLOGY,,200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629307772,"STRATTON, ELIZABETH, ANNE",200 QUEENS RD STE 400 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1912620030,NOVANT HEALTH MEDICAL GROUP LLC,NHMG NEUROLOGY & SLEEP CLINICS,190 KIMEL PARK DR STE 120 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629314836,"DAHLBERG, KATHERINE, WILLETT",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629317045,"CALHOUN, AMANDA, LEWIS",115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 13 ,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629317045,"CALHOUN, AMANDA, LEWIS",107 MCLEOD HEALTH BLVD STE 101 MYRTLE BEACH SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1194090720,MCLEOD PHYSICIAN ASSOCIATES II,MCLEOD ORTHOPEDICS-SEACOAST,115 MCLEOD HEALTH BLVD STE 301 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629317045,"CALHOUN, AMANDA, LEWIS",3980 HIGHWAY 9 E STE 200 LITTLE RIVER SC,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1245399542,THE PRESBYTERIAN HOSPITAL,THE PRESBYTERIAN HOSPITAL,200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629318449,"RUSS, ROSALIND, LASEAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629318449,"RUSS, ROSALIND, LASEAN",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1629318704,HOME CARE HELPERS LLC,HOME CARE HELPERS LLC,211 S CENTER ST STE 212 STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,,1629318704,HOME CARE HELPERS LLC,211 S CENTER ST STE 212 STATESVILLE NC,049,Iredell,253Z00000X,Agencies,In Home Supportive Care,, 22 ," 4,292 "," 4,305 "," $624,894.08 ",,
MEDICAID DIRECT,1629319900,THE SPRUILL STUDIO FOR SPEECH AND V,SPRUILLS SPEECH AND LANGUAGE SERVICES,1228 BRIDGEFORD DR NW   HUNTERSVILLE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629319900,THE SPRUILL STUDIO FOR SPEECH AND V,1228 BRIDGEFORD DR NW   HUNTERSVILLE NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,#, 29 , 38 ,$#,,
MEDICAID DIRECT,1841977568,DANVILLE PHYSICIAN PRACTICES LLC,SOVAH INTERNAL MEDICINE DANVILLE,125 EXECUTIVE DR STE H DANVILLE VA,101,Out of State <= 40 miles,261QR1300X,Ambulatory Health Care Facilities,Clinic/Center,Rural Health,1629321146,"CRUMPTON, STEPHANIE, PRUETT",125 EXECUTIVE DR STE H DANVILLE VA,101,Out of State <= 40 miles,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1629322524,"CHEVALIER, CASEY, JO",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629322987,"JAVED, BUSHRA",1540 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology, 55 , 84 , 141 ,$#,,
MEDICAID DIRECT,1215954003,RALEIGH NEUROLOGY ASSOCIATES PA,RALEIGH NEUROLOGY ASSOCIATES PA,1540 SUNDAY DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629322987,"JAVED, BUSHRA",1520 SUNDAY DR   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1457601601,INSTRIDE FOOT AND ANKLE SPECIALISTS,~,1022 LEE ANN DR NE   CONCORD NC,013,Cabarrus,193400000X,Group,Single Specialty,,1629323175,"PATEL, KINJAL, MAHESH",13521 STEELECROFT PKWY STE B CHARLOTTE NC,060,Mecklenburg,213ES0103X,Podiatric Medicine & Surgery Service Providers,Podiatrist,Foot & Ankle Surgery,#,#, 13 ,$#,,
MEDICAID DIRECT,1770651655,CAROLINA FAMILY HEALTH CENTERS INC,FREEDOM HILL COMMUNITY HEALTH CENTER,162 NC 33 E   TARBORO NC,033,Edgecombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629324512,"DAVIS, CHRISTIE, LOIS",162 NC HIGHWAY 33 E   TARBORO NC,033,Edgecombe,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical, 14 , 46 , 47 ,$#,,
MEDICAID DIRECT,1184792103,CAROLINA FAMILY HEALTH CENTERS INC,WILSON COMMUNITY HEALTH CENTER,303 GREEN ST E   WILSON NC,098,Wilson,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629324512,"DAVIS, CHRISTIE, LOIS",303 GREEN ST E   WILSON NC,098,Wilson,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1558329243,DAYMARK RECOVERY SERVICES INC,~,284 EXECUTIVE PARK DR STE 100 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629325048,"LITTLE, CYNTHIA, WALL",1104A S MAIN ST   LEXINGTON NC,029,Davidson,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1154453496,GASTON FAMILY HEALTH SERVICES INC,KINTEGRA SHA AT MINERAL SPRINGS,4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629327341,"KILLION, AMANDA, BETHCOX",4555 OGBURN AVE   WINSTON SALEM NC,034,Forsyth,1041C0700X,Behavioral Health & Social Service Providers,Social Worker,Clinical,#,#,#,$#,,
MEDICAID DIRECT,1275291361,LIVING THE BREAMEDICAL SALISBURY PL,BREAM MEDICAL SALISBURY,721 GROVE ST   SALISBURY NC,080,Rowan,193400000X,Group,Single Specialty,,1629328190,"UPTON, JULANE, CHAPPELL",309 N BROAD ST   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 15 , 21 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,203A EARNHART DR   EDENTON NC,021,Chowan,193200000X,Group,Multi-Specialty,,1629328190,"UPTON, JULANE, CHAPPELL",203A EARNHART DR   EDENTON NC,021,Chowan,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629328190,"UPTON, JULANE, CHAPPELL",309 N BROAD ST   EDENTON NC,021,Chowan,363LX0001X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Obstetrics & Gynecology,#,,,$#,,
MEDICAID DIRECT,1629328828,"COX, HILARY, BETH",WILMINGTON EYE PA,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,1629328828,"COX, HILARY, BETH",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 33 , 33 , 66 ,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629328828,"COX, HILARY, BETH",9020 SENCA DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1831280205,WILMINGTON EYE PA,~,1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629328828,"COX, HILARY, BETH",1729 NEW HANOVER MEDICAL PARK DR   WILMINGTON NC,065,New Hanover,152W00000X,Eye and Vision Services Providers,Optometrist,, 118 , 150 , 192 ,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1629329149,"MESSINA, ASHLEY, GRAY",1260 N ARENDELL AVE   ZEBULON NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1699361618,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY & URGENT CARE ZEBULON,1260 N ARENDELL AVE   ZEBULON NC,092,Wake,193200000X,Group,Multi-Specialty,,1629329149,"MESSINA, ASHLEY, GRAY",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346852407,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED MYCARE 365 PRIMARY URGENT CARE WAKE FOREST,2001 S MAIN ST   WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1629329149,"MESSINA, ASHLEY, GRAY",2001 S MAIN ST   WAKE FOREST NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,193200000X,Group,Multi-Specialty,,1629329727,"GRUBER, LEAH, MARIE",1617 N MAIN ST STE 100 FUQUAY VARINA NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 21 , 45 , 89 ,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,940 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629329727,"GRUBER, LEAH, MARIE",2412 WILKINS DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 18 , 30 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629330006,"WLODARSKI, MICHAEL, STEPHEN",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 16 , 20 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629330006,"WLODARSKI, MICHAEL, STEPHEN",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 17 , 34 , 39 ,$#,,
MEDICAID DIRECT,1134530074,WAKE SPECIALTY PHYSICIANS LLC,WAKEMED PRIMARY CARE NORTH RALEIGH,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629331673,"AHMAD, SUKAINA",10010 FALLS OF NEUSE RD STE 103 RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1629332325,MED-TRANS CORPORATION,~,212 AIRPORT CT   MULLINS SC,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,1629332325,MED-TRANS CORPORATION,212 AIRPORT CT   MULLINS SC,101,Out of State <= 40 miles,3416A0800X,Transportation Services,Ambulance,Air Transport,#,#,#,$#,,
MEDICAID DIRECT,1922721141,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PEDIATRIC CLINICS,517 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629334818,"JANOVSKI, ALEXANDER, JOHN",14215 BALLANTYNE CORPORATE PL STE 130 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629335153,"BUTLER, KATHERINE, ANNE",131 MILLER ST   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629335153,"BUTLER, KATHERINE, ANNE",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 60 , 88 , 116 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629335153,"BUTLER, KATHERINE, ANNE",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,1821 HILLANDALE RD STE 25B DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629335799,"LEVICK, TYLER, GRAY",1821 HILLANDALE RD STE 25 B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 54 , 57 , 165 ,$#,,
MEDICAID DIRECT,1780612713,DUKE UNIVERSITY AFFILIATED PHYSICIA,~,5716 FAYETTEVILLE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629335799,"LEVICK, TYLER, GRAY",1821 HILLANDALE RD STE 25 B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1619113909,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE UNIVERSITY AFFILIATED PHYSICIANS,162 LEGACY OAKS DR   KNIGHTDALE NC,092,Wake,193200000X,Group,Multi-Specialty,,1629335799,"LEVICK, TYLER, GRAY",1821 HILLANDALE RD STE 25 B DURHAM NC,032,Durham,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1477584894,DUKE UNIVERSITY HEALTH SYSTEM INC,Duke University Health System DBA,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629335799,"LEVICK, TYLER, GRAY",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 67 , 70 , 71 ,$#,,
MEDICAID DIRECT,1093723538,VALLEY RADIOLOGY PA,~,3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629336573,"BARKER, CHAD, HERMAN",3186 VILLAGE DR STE 201 FAYETTEVILLE NC,026,Cumberland,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 17 , 18 , 24 ,$#,,
MEDICAID DIRECT,1508813387,BAYVIEW PHYSICIAN SERVICES PC,~,3241 WESTERN BRANCH BLVD STE A CHESAPEAKE VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629336995,"ARUSI, ELI",1060 FIRST COLONIAL RD   VIRGINIA BEACH VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629338884,"BRANCATO, ALISON, JEAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,1900 KILDAIRE FARM RD   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629338884,"BRANCATO, ALISON, JEAN",1900 KILDAIRE FARM RD   CARY NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1538723184,WAKEMED SPECIALISTS GROUP LLC,WAKEMED CRITICAL CARE MEDICINE,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629338884,"BRANCATO, ALISON, JEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 13 , 14 ,$#,,
MEDICAID DIRECT,1245894898,WAKEMED SPECIALISTS GROUP LLC,WAKEMED PULMONOLOGY- HOSPITAL BASED,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629338884,"BRANCATO, ALISON, JEAN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629339007,"ROYSTER, JENNIFER, SUSAN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629339007,"ROYSTER, JENNIFER, SUSAN",3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629339098,"ESKILDSEN, JENNY, FELDMAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,, 23 , 23 , 25 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,102 MASON FARM RD FL 3 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629339098,"ESKILDSEN, JENNY, FELDMAN",101 MANNING DR   CHAPEL HILL NC,068,Orange,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,201 S COLLEGE ST FL 12 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629339783,"KIRKLAND, ELIZABETH, BARNHART",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1992204549,TRYON MEDICAL PARTNERS PLLC,,10635 PARK RD STE I CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629339783,"KIRKLAND, ELIZABETH, BARNHART",6060 PIEDMONT ROW DR S FL 8 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 13 , 20 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629343835,"JAMISON, LATONYA, YVETTE",5920 SANDY FORKS RD STE 200 RALEIGH NC,092,Wake,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#, 16 , 29 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629347901,"LOTHARAKPHONG, VIRACH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 11 , 11 , 12 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629347901,"LOTHARAKPHONG, VIRACH",1900 KILDAIRE FARM RD   CARY NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629348214,"WILSON, AUBREY, LENORE",100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 55 , 74 , 130 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629348214,"WILSON, AUBREY, LENORE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 17 ,$#,,
MEDICAID DIRECT,1770004285,BULL CITY PHYSICIANS PLLC,,566 RUIN CREEK RD   HENDERSON NC,091,Vance,193400000X,Group,Single Specialty,,1629349477,"LEE, YOUNG, AH",566 RUIN CREEK RD   HENDERSON NC,091,Vance,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 66 , 69 , 75 ,$#,,
MEDICAID DIRECT,1629415914,NORTH CAROLINA GROUP SERVICES PLLC,~,1135 CARTHAGE ST   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1629349477,"LEE, YOUNG, AH",1503 E BROAD ST   STATESVILLE NC,049,Iredell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629349717,"FRANCIS, JENNIFER, LYNN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629349717,"FRANCIS, JENNIFER, LYNN",8001 T W ALEXANDER DR   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629349717,"FRANCIS, JENNIFER, LYNN",10010 FALLS OF NEUSE RD   RALEIGH NC,092,Wake,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 15 ,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629358742,"BISTA, SUKIRTI",2295 E 14TH ST   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1235978834,NORTH CAROLINA BAPTIST HOSPITAL,ATRIUM HEALTH WAKE FOREST BAPTIST MEDICAL CENTER,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629358742,"BISTA, SUKIRTI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 12 , 13 , 49 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629358742,"BISTA, SUKIRTI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 24 , 24 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BOULEVARD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629358742,"BISTA, SUKIRTI",2295 E 14TH ST   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,,,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629358742,"BISTA, SUKIRTI",2295 E 14TH ST   WINSTON SALEM NC,034,Forsyth,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1952354458,EYECARECENTER OD PA,EYECARE CENTER,4170 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629359666,"AUNE, CAROL, ANN",4170 FAYETTEVILLE RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,,#,#,#,$#,,
MEDICAID DIRECT,1952354458,EYECARECENTER OD PA,EYECARE CENTER,4170 FAYETTEVILLE RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629359666,"AUNE, CAROL, ANN",4170 FAYETTEVILLE RD   RALEIGH NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629360144,"BROWN, CHRISTOPHER, PATRICK",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,2084N0402X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology with Special Qualifications in Child Neurology,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629360250,"SIGMON, ERIC, RUSSELL",600 MOYE BLVD   GREENVILLE NC,074,Pitt,2080P0202X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Cardiology,#,#,#,$#,,
MEDICAID DIRECT,1073863221,NOVANT HEALTH MEDICAL GROUP LLC,NOVANT HEALTH INPATIENT CARE SPECIALISTS FORSYTH,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629362629,"CISER, KATHRYN, GLENN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,,,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629362629,"CISER, KATHRYN, GLENN",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 32 , 139 , 139 ,$#,,
MEDICAID DIRECT,1881730315,MURDOCH DEVELOPMENTAL CENTER,DENTAL DIVISION MURDOCH CENTER,1600 E C ST   BUTNER NC,039,Granville,193400000X,Group,Single Specialty,,1629362744,"BORKAN-SEVIM, UMIT",1600 E C ST   BUTNER NC,039,Granville,1223G0001X,Dental Providers,Dentist,General Practice,#, 11 , 23 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 5-6 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629362843,"PATEL, KUNAL, PARIMAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629362843,"PATEL, KUNAL, PARIMAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 300 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629362843,"PATEL, KUNAL, PARIMAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629362843,"PATEL, KUNAL, PARIMAL",100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 17 , 21 , 32 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629362843,"PATEL, KUNAL, PARIMAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease, 11 , 31 , 44 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,100 EASTOWNE DR FL 1-4 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629362843,"PATEL, KUNAL, PARIMAL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RP1001X,Allopathic & Osteopathic Physicians,Internal Medicine,Pulmonary Disease,#, 25 , 29 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629362884,"COPELAND, JOHN, NATHAN",100 W H ST   BUTNER NC,039,Granville,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2608 ERWIN RD STE 300 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629362884,"COPELAND, JOHN, NATHAN",2608 ERWIN RD STE 300 DURHAM NC,032,Durham,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1326036138,SOUTHEASTERN INTEGRATED CARE,~,3005 N ELM ST   LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1629363122,"SCOTT, ALLISON, LYNNE",3005 N ELM ST   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 20 , 37 , 80 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,812 CANDY PARK RD STE 5103 PEMBROKE NC,078,Robeson,193200000X,Group,Multi-Specialty,,1629363122,"SCOTT, ALLISON, LYNNE",812 CANDY PARK RD STE 5103 PEMBROKE NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 105 , 155 , 155 ,$#,,
MEDICAID DIRECT,1376065854,SOUTHEASTERN REGIONAL PHYSICIAN SER,SOUTHEASTERN CARDIOLOGY AND CARDIOVASCULAR CLINIC,2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,193200000X,Group,Multi-Specialty,,1629363122,"SCOTT, ALLISON, LYNNE",2936 N ELM ST STE 102 LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 56 , 61 , 64 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,2390 HEMBY LN   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629363361,"GHIMIRE, RABINDRA",2390 HEMBY LN   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#,#,#,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629363361,"GHIMIRE, RABINDRA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease,#, 12 , 26 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629363361,"GHIMIRE, RABINDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 12 , 19 , 19 ,$#,,
MEDICAID DIRECT,1043260474,EAST CAROLINA UNIVERSITY,ECU SCHOOL OF MEDICINE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629363361,"GHIMIRE, RABINDRA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 22 , 36 , 39 ,$#,,
MEDICAID DIRECT,1285683060,EAST CAROLINA UNIVERSITY,ECU PHYSICIANS INFECTIOUS DISEASE CLINIC,600 MOYE BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629363361,"GHIMIRE, RABINDRA",600 MOYE BLVD   GREENVILLE NC,074,Pitt,207RI0200X,Allopathic & Osteopathic Physicians,Internal Medicine,Infectious Disease, 25 , 33 , 46 ,$#,,
MEDICAID DIRECT,1780655803,ORTHOPAEDICS EAST & SPORTS MEDICINE,ORTHOPAEDICS EAST INC,810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629363551,"MCGRAW, MICHAEL, HOWARD",810 WH SMITH BLVD   GREENVILLE NC,074,Pitt,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 167 , 408 , 798 ," $13,461.12 ",,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629363619,"HURST, ADRIAN, HILARY DAVID",3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 24 , 36 , 57 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629363619,"HURST, ADRIAN, HILARY DAVID",3030 RANDOLPH RD   CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 13 , 18 , 33 ,$#,,
MEDICAID DIRECT,1689604340,RANDOLPH INTERNAL MEDICINE,ATRIUM HEALTH PRIMARY CARE RANDOLPH INTERNAL MEDIC,3030 RANDOLPH RD STE 200 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629363619,"HURST, ADRIAN, HILARY DAVID",330 BILLINGSLEY RD STE 100 CHARLOTTE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1376898148,CAROLINAS PHYSICIANS NETWORK INC,UNION FAMILY PRACTICE,15110 JOHN J DELANEY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629363619,"HURST, ADRIAN, HILARY DAVID",16455 STATESVILLE RD STE 360 HUNTERSVILLE NC,060,Mecklenburg,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#, 13 ,$#,,
MEDICAID DIRECT,1568424299,CENTRAL DERMATOLOGY CENTER PA,~,2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,193400000X,Group,Single Specialty,,1629364112,"BEASLEY, KNOX, JOSEPH",2238 NELSON HWY STE 100 CHAPEL HILL NC,032,Durham,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 17 , 25 , 34 ,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629364385,"JORDAN, MARY MARGARET, HOLLOMAN",200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629364385,"JORDAN, MARY MARGARET, HOLLOMAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,14214 BALLANTYNE LAKE RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629364385,"JORDAN, MARY MARGARET, HOLLOMAN",431 COPPERFIELD BLVD NE   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629364385,"JORDAN, MARY MARGARET, HOLLOMAN",201 E GROVER ST   SHELBY NC,023,Cleveland,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1356700132,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH ACUTE CARE SURGERY,200 MEDICAL PARK DR STE 430 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629364385,"JORDAN, MARY MARGARET, HOLLOMAN",920 CHURCH ST N   CONCORD NC,013,Cabarrus,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 17 , 17 , 22 ,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629364385,"JORDAN, MARY MARGARET, HOLLOMAN",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629366562,"JOSEPH, LEAH",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629367289,"CORBETT, JAMIE, ELIZABETH",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 17 , 17 ,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629367289,"CORBETT, JAMIE, ELIZABETH",2301 ERWIN RD   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629367289,"CORBETT, JAMIE, ELIZABETH",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629367289,"CORBETT, JAMIE, ELIZABETH",615 RIDGE RD   ROXBORO NC,073,Person,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1922601764,WARE FAMILY MEDICINE PLLC,OLD FORT FAMILY MEDICINE,32 E MAIN ST   OLD FORT NC,059,McDowell,193200000X,Group,Multi-Specialty,,1629367727,"SHTYMAK, ANNA, NIKOLAYEVNA",32 E MAIN ST   OLD FORT NC,059,McDowell,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 34 , 75 , 122 ,$#,,
MEDICAID DIRECT,1104548874,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH PRIMARY CARE CLINICS,100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629367933,"YARBROUGH, CRAIG, MICHAEL",100 ROBINHOOD MEDICAL PLZ   WINSTON SALEM NC,034,Forsyth,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 81 , 102 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629368469,"DUDE, ANN, MELISSA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 31 , 38 , 49 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629368469,"DUDE, ANN, MELISSA",1181 WEAVER DAIRY RD STE 150 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629368469,"DUDE, ANN, MELISSA",55 VILCOM CENTER DR STE 300 CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine, 58 , 65 , 110 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,516 S VAN BUREN RD   EDEN NC,079,Rockingham,193200000X,Group,Multi-Specialty,,1629368469,"DUDE, ANN, MELISSA",101 MANNING DR   CHAPEL HILL NC,068,Orange,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629368469,"DUDE, ANN, MELISSA",6715 MCCRIMMON PKWY STE 204 CARY NC,092,Wake,207VM0101X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,Maternal & Fetal Medicine,#,#,#,$#,,
MEDICAID DIRECT,1356324487,GASTON RADIOLOGY PA,GASTON RADIOLOGY PA,336 BURTONWOOD DR   GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629368519,"ROZELL, JOSEPH, MICHAEL",255 PATROON CREEK BLVD APT 3439 ALBANY NY,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,3600 MINNESOTA DR STE 800 EDINA MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1629368519,"ROZELL, JOSEPH, MICHAEL",2 SPRING HILL WAY   AVERILL PARK NY,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1932342029,VIRTUAL RADIOLOGIC PROF LLC,,11995 SINGLETREE LN STE 500 EDEN PRAIRIE MN,102,Out of State > 40 miles,193400000X,Group,Single Specialty,,1629368519,"ROZELL, JOSEPH, MICHAEL",2 SPRING HILL WAY   AVERILL PARK NY,102,Out of State > 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",694 RIVERSIDE DR   MOUNT AIRY NC,086,Surry,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 16 , 29 ,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 44 , 50 , 50 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 13 , 16 , 24 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 14 , 17 , 27 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1154371052,FORSYTH MEMORIAL HOSPITAL INC,FORSYTH MEMORIAL HOSPITAL PROFESSIONAL SERVICES,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology, 14 , 18 , 25 ,$#,,
MEDICAID DIRECT,1538881248,FORSYTH MEMORIAL HOSPITAL INC,NH FORSYTH CARDIOLOGY CLINICS,186 KIMEL PARK DR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629368931,"COSTA, NICHOLAS, JOSEPH",7114 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,207RC0001X,Allopathic & Osteopathic Physicians,Internal Medicine,Clinical Cardiac Electrophysiology,#,#,#,$#,,
MEDICAID DIRECT,1225073554,DUKE UNIVERSITY AFFILIATED PHYSICIA,DUKE PRIMARY CARE CROASDAILE,3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,193200000X,Group,Multi-Specialty,,1629369079,"CRAVANAS, ERIKA, COLLINS",3000 ROGERS RD STE 210 WAKE FOREST NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 17 , 28 , 57 ,$#,,
MEDICAID DIRECT,1457389033,PRIVATE DIAGNOSTIC CLINIC PLLC,PRIVATE DIAGNOSTIC CLINIC PLLC,,,Unknown,193200000X,Group,Multi-Specialty,,1629369350,"GRACE, SARA, FRANSEN",1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,,,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629369350,"GRACE, SARA, FRANSEN",1010 TRYON VILLAGE DR STE 701 CARY NC,092,Wake,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 46 , 58 , 85 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629369350,"GRACE, SARA, FRANSEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4102 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629369350,"GRACE, SARA, FRANSEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,, 26 , 28 , 37 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,1234 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629369350,"GRACE, SARA, FRANSEN",4102 N ROXBORO ST   DURHAM NC,032,Durham,207W00000X,Allopathic & Osteopathic Physicians,Ophthalmology,,#,#,#,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,600 GRESHAM DR   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629370028,"PFEIFFER, REBECCA, BROWN",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629370697,"HOWARD, ELLEN, MARIE",257 BILTMORE AVE STE 200 ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,,#,#,#,$#,,
MEDICAID DIRECT,1780801050,WESTERN NC COMMUNITY HEALTH SVCS,~,257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629370697,"HOWARD, ELLEN, MARIE",257 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,367A00000X,Physician Assistants & Advanced Practice Nursing Providers,Advanced Practice Midwife,, 128 , 320 , 420 ," $101,441.19 ",,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629373261,"AUSTIN, LEIGH TAYLOR",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 16 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629373261,"AUSTIN, LEIGH TAYLOR",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629373261,"AUSTIN, LEIGH TAYLOR",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629373261,"AUSTIN, LEIGH TAYLOR",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 73 , 88 , 183 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629373261,"AUSTIN, LEIGH TAYLOR",700 SULLIVAN RD   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629373527,BEACON RESPIRATORY SERVICES OF GEOR,AEROCARE,7204 W FRIENDLY AVE STE E GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1629373527,BEACON RESPIRATORY SERVICES OF GEOR,7204 W FRIENDLY AVE STE E GREENSBORO NC,041,Guilford,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment, 561 ," 2,640 "," 5,105 "," $80,661.86 ",,
MEDICAID DIRECT,1629373527,BEACON RESPIRATORY SERVICES OF GEOR,AEROCARE,7204 W FRIENDLY AVE STE E GREENSBORO NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,1629373527,BEACON RESPIRATORY SERVICES OF GEOR,7204 W FRIENDLY AVE STE E GREENSBORO NC,041,Guilford,332BX2000X,Suppliers,Durable Medical Equipment & Medical Supplies,Oxygen Equipment & Supplies,#,,,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,193200000X,Group,Multi-Specialty,,1629375092,"PITTS, STEPHANIE, HODGSON",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 33 , 141 , 141 ,$#,,
MEDICAID DIRECT,1437736881,PHYSIATRY CONSULTANTS OF NC PLLC,,109 FOOTHILLS DR   MORGANTON NC,012,Burke,193200000X,Group,Multi-Specialty,,1629375092,"PITTS, STEPHANIE, HODGSON",1870 PISGAH DR   HENDERSONVILLE NC,045,Henderson,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 13 , 13 ,$#,,
MEDICAID DIRECT,1376592964,EMERGEORTHO PA,~,120 WILLIAM PENN PLZ   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629375399,"SWANSON, AARON, LOUIS",800 FLEMING ST   HENDERSONVILLE NC,045,Henderson,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#,#, 15 ,$#,,
MEDICAID DIRECT,1114441565,POST ACUTE SPECIALISTS LLC,,500 BEAVERDAM RD   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629383153,"DHAMIJA, SULAKSHNA",310 E WARDELL DR   PEMBROKE NC,078,Robeson,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 2101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",600 HOSPITAL DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,,,Unknown,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 44 , 44 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",615 COMFORT LN   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 37 , 37 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",600 HOSPITAL DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",1640 CAMPUS PARK DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 80 , 179 , 211 ," $13,425.49 ",,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3057 FREEDOM DR   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",1640 CAMPUS PARK DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",1640 CAMPUS PARK DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",1640 CAMPUS PARK DR   MONROE NC,090,Union,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 12 , 15 , 31 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology, 22 , 25 , 67 ,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 3102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",3158 FREEDOM DR STE 3101 CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1083664189,METROLINA NEPHROLOGY ASSOCIATES,METROLINA NEPHROLOGY ASSOCIATES PA,3158 FREEDOM DR STE 1102 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629385117,"ACHARYA, PRANAB, SHARMA",10628 PARK RD   CHARLOTTE NC,060,Mecklenburg,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629388145,"LINDSEY, BENJAMIN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1942248547,AMERICAN ANESTHESIOLOGY OF NORTH CA,~,3100 SPRING FOREST RD STE 130 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629388145,"LINDSEY, BENJAMIN",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1265420335,HANGER PROSTHETICS & ORTHOTICS EAST,~,1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,332BC3200X,Suppliers,Durable Medical Equipment & Medical Supplies,Customized Equipment,1629392931,"MORTON, WILLIAM, PAUL",1399 WESTGATE CENTER DR   WINSTON SALEM NC,034,Forsyth,224P00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Prosthetist,,#,#, 35 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629393574,"MCGRATH, BRIAN, JAMES",5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629393574,"MCGRATH, BRIAN, JAMES",2131 S 17TH ST   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 66 , 73 , 97 ,$#,,
MEDICAID DIRECT,1558755165,ECEP II PA,,151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629393574,"MCGRATH, BRIAN, JAMES",151 SCOTTS HILL MEDICAL DR   WILMINGTON NC,065,New Hanover,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1831265263,ECEP II PA,ECEP II PA,2131 S 17TH ST   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629393574,"MCGRATH, BRIAN, JAMES",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#, 11 , 14 ,$#,,
MEDICAID DIRECT,1992871917,ECEP II PA,ECEP II PA,5301 WRIGHTSVILLE AVE   WILMINGTON NC,065,New Hanover,193400000X,Group,Single Specialty,,1629393574,"MCGRATH, BRIAN, JAMES",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1255407680,ECEP II PA,ECEP II PA,507 E FREMONT ST   BURGAW NC,071,Pender,193400000X,Group,Single Specialty,,1629393574,"MCGRATH, BRIAN, JAMES",507 E FREMONT ST   BURGAW NC,071,Pender,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629394390,"SAHA, SAM, KUMAR",1900 KILDAIRE FARM RD   CARY NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1194907717,WAKEMED,WAKEMED PROFESSIONAL STAFF,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629394390,"SAHA, SAM, KUMAR",3000 NEW BERN AVE   RALEIGH NC,092,Wake,2084N0400X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Neurology,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,16704 HAWFIELD WAY DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",1366 NC HIGHWAY 16 S   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1908 E FRANKLIN BLVD STE 100 GASTONIA NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",1366 NC HIGHWAY 16 S   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 11 , 20 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,1 BRIAN BLVD STE C ARDEN NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",1366 NC HIGHWAY 16 S   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 41 , 46 , 79 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,10102 JOHNSTON RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",1366 NC HIGHWAY 16 S   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 52 , 56 , 112 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,314 BLOWING ROCK BLVD STE A LENOIR NC,014,Caldwell,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",1366 NC HIGHWAY 16 S   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760767446,URGENT CARE OF MOUNTAIN VIEW PLLC,~,2330 BROOKFORD BLVD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",2872 S NC 127 HWY   HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,14001 E INDEPENDENCE BLVD STE C INDIAN TRAIL NC,090,Union,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",1366 NC HIGHWAY 16 S   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 11 ,$#,,
MEDICAID DIRECT,1679066658,AFC URGENT CARE AND FAMILY CARE OF,,955 2ND ST NE   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629394762,"PYLE, ANDREW, CLAYTON",1366 NC HIGHWAY 16 S   NEWTON NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 29 , 31 , 87 ,$#,,
MEDICAID DIRECT,1720181514,ATLANTIC ANESTHESIA INC,ATLANTIC ANESTHESIA INC,830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629396254,"OLES, STEVEN, WILLIAM",830 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1639506470,UWH OF THE CAROLINAS PLLC,~,4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629398185,"MATTHEWS, KIRK, JOSEPH",4414 LAKE BOONE TRL STE 210 RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1629401203,WP-JACKSONVILLE HEALTH HOLDINGS LLC,ONSLOW HOUSE,34 MCDANIEL DR   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,1629401203,WP-JACKSONVILLE HEALTH HOLDINGS LLC,34 MCDANIEL DR   JACKSONVILLE NC,067,Onslow,311ZA0620X,Nursing & Custodial Care Facilities,Custodial Care Facility,Adult Care Home,#, 583 , 583 ," $40,066.36 ",,
MEDICAID DIRECT,1154384568,CAROLINA NEUROSURGERY & SPINE ASSOC,CAROLINA NEUROSURGERY & SPINE ASSOCIATES PA,225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629401849,"HOWARD, LINDSEY, ANNE",225 BALDWIN AVE   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 12 , 14 ,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,,,Unknown,193200000X,Group,Multi-Specialty,,1629404769,"DODSON, HANNAH, JANE",855 EAST ST   PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,,,$#,,
MEDICAID DIRECT,1750704367,UNC PHYSICIANS NETWORK LLC,~,75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,193200000X,Group,Multi-Specialty,,1629404769,"DODSON, HANNAH, JANE",75 FREEDOM PKWY STE C PITTSBORO NC,019,Chatham,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1629405592,HARRIS TEETER LLC,HARRIS TEETER PHARMACY 0204,8538 PARK RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,1629405592,HARRIS TEETER LLC,8538 PARK RD   CHARLOTTE NC,060,Mecklenburg,3336C0003X,Suppliers,Pharmacy,Community/Retail Pharmacy,#,#,#,$#,,
MEDICAID DIRECT,1629405873,A PLUS HOME CARE AGENCY LLC,~,3948 BROWNING PL STE 101 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,,1629405873,A PLUS HOME CARE AGENCY LLC,3948 BROWNING PL STE 101 RALEIGH NC,092,Wake,253Z00000X,Agencies,In Home Supportive Care,, 39 ," 7,477 "," 7,964 "," $627,707.20 ",,
MEDICAID DIRECT,1629407069,EXACT SCIENCES LABORATORIES LLC,,145 E BADGER RD STE 100 FITCHBURG WI,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1629407069,EXACT SCIENCES LABORATORIES LLC,145 E BADGER RD STE 100 FITCHBURG WI,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 279 , 276 , 276 ," $125,606.90 ",,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1629409305,"BRYSON, DANIEL",925 S LONG DR   ROCKINGHAM NC,077,Richmond,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1851477970,FIRSTHEALTH OF THE CAROLINAS INC,MOORE REGIONAL HOSPITAL,155 MEMORIAL DR   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1629409305,"BRYSON, DANIEL",155 MEMORIAL DR   PINEHURST NC,063,Moore,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1992369540,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HOSPITALIST,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629410386,"GHIMIRE, MANISHA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1902200991,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS STANLY PEDIATRICS,6235 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629410683,"MCCORD, JACLYN, LEIGH",6235 BLAKENEY PARK DR   CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1477582385,ARBORETUM PEDIATRICS,ATRIUM HEALTH LEVINE CHILDRENS ARBORETUM PEDIATRI,7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629410683,"MCCORD, JACLYN, LEIGH",7800 PROVIDENCE RD STE 203 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1760479331,CARTERET GENERAL HOSPITAL PROFESSIO,CARTERET GENERAL HOSPITAL,3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1629410774,"MUNSHI, FARHAN, ANWAR",3500 ARENDELL ST   MOREHEAD CITY NC,016,Carteret,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629411855,"COSTA, PETER, ANTHONY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,2080P0206X,Allopathic & Osteopathic Physicians,Pediatrics,Pediatric Gastroenterology, 33 , 42 , 43 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629412010,"WOODCOCK, MARK, GRISWOLD",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 18 , 32 , 33 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629412747,"NYSTROM, SARAH, ELISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629412747,"NYSTROM, SARAH, ELISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 14 , 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629412747,"NYSTROM, SARAH, ELISE",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,207RN0300X,Allopathic & Osteopathic Physicians,Internal Medicine,Nephrology,#, 24 , 24 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,9120 WILLOW RIDGE RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629413935,"DUNCAN-MCKOY, TRICIA, EVERLISE",5125 MICHAUX RD   GREENSBORO NC,041,Guilford,225100000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Physical Therapist,,#, 35 , 41 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,633 BROOKDALE DR STE 100 STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 205 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#, 22 , 33 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,128 MEDICAL PARK RD STE 102 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 302 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 24 , 33 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 11 , 28 , 114 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 13 , 38 , 66 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,125 DAYS INN DR   MOORESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629414107,"SCHARBIUS, JENNIFER, MILLER",170 MEDICAL PARK RD STE 201 MOORESVILLE NC,049,Iredell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629414164,"BECKHAM, AILEEN, JENNA",505 OBERLIN RD   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629414164,"BECKHAM, AILEEN, JENNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3024 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629414164,"BECKHAM, AILEEN, JENNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,, 174 , 183 , 201 ," $92,668.75 ",,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,505 OBERLIN RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629414164,"BECKHAM, AILEEN, JENNA",3000 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1811033210,PLANNED PARENTHOOD SOUTH ATLANTIC,PLANNED PARENTHOOD HEALTH SYSTEMS INC,100 S BOYLAN AVE   RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629414164,"BECKHAM, AILEEN, JENNA",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1063076453,WAKEMED SPECIALISTS GROUP LLC,WAKEMED OBSTETRICS & GYNECOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629414164,"BECKHAM, AILEEN, JENNA",3024 NEW BERN AVE   RALEIGH NC,092,Wake,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629414727,"MAPLE, INGRID, KATARINA",10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629414727,"MAPLE, INGRID, KATARINA",1816 FRONT ST STE 320 DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1558392977,DUKE UNIVERSITY HEALTH SYSTEM INC,DUKE UNIVERSITY HEALTH SYSTEM,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629414727,"MAPLE, INGRID, KATARINA",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1003280108,SOUTHEASTERN HOSPITALIST SERVICES P,,9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,193200000X,Group,Multi-Specialty,,1629416219,"REPPERT, PATRICK, RAY",9330 MEDICAL PLAZA DR   CHARLESTON SC,102,Out of State > 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629419494,"OPNEJA, AMAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629419494,"OPNEJA, AMAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1841222395,DUKE UNIVERSITY,DUKE UNIVERSITY,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629419494,"OPNEJA, AMAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,216 ASHVILLE AVE STE 20 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629419494,"OPNEJA, AMAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3404 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629419494,"OPNEJA, AMAN",3404 WAKE FOREST RD   RALEIGH NC,092,Wake,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 26 , 26 ,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629420955,"LOMAX, AMY, LYNN",1926 COTTON GROVE RD   LEXINGTON NC,029,Davidson,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1770821233,MOSES CONE AFFILIATED PHYSICIANS IN,GUILFORD NEUROLOGIC ASSOCIATES,912 3RD ST STE 101 GREENSBORO NC,041,Guilford,193200000X,Group,Multi-Specialty,,1629420955,"LOMAX, AMY, LYNN",912 3RD ST STE 101 GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 96 , 116 , 134 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629421276,"STANCIL, TAMMY, CASTLEBURY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 17 , 82 , 82 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,911 S HUGHES ST   APEX NC,092,Wake,193200000X,Group,Multi-Specialty,,1629421276,"STANCIL, TAMMY, CASTLEBURY",101 MANNING DR   CHAPEL HILL NC,068,Orange,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#, 15 , 16 ,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629422423,"PACHECO, PARIS, ETHAN",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629422423,"PACHECO, PARIS, ETHAN",600 GRESHAM DR FL 5 NORFOLK VA,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 11 , 11 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629424742,"BLEVINS, JENNIFER, SUZANNE",1904 JAKE ALEXANDER BLVD W STE 303 SALISBURY NC,080,Rowan,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#, 19 , 40 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629424742,"BLEVINS, JENNIFER, SUZANNE",1426 E MOREHEAD ST   CHARLOTTE NC,060,Mecklenburg,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629424742,"BLEVINS, JENNIFER, SUZANNE",501 OLDE WATERFORD WAY   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 22 , 63 , 164 ,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629424742,"BLEVINS, JENNIFER, SUZANNE",319 VILLAGE RD NE   LELAND NC,010,Brunswick,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5324 MCFARLAND RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629424858,"MONTOYA, MARGARETA, ANN",5324 MCFARLAND RD   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#, 14 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4116 CAPITOL ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629424858,"MONTOYA, MARGARETA, ANN",4116 CAPITOL ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 17 , 25 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629424858,"MONTOYA, MARGARETA, ANN",4116 CAPITOL ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629424858,"MONTOYA, MARGARETA, ANN",1100 E WENDOVER AVE   GREENSBORO NC,041,Guilford,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1699979732,CAROLINAS MEDICAL CENTER,CMC FACULTY PHYSICIANS,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629425608,"ALLRED, LEIGH, ROBISON",1001 BLYTHE BLVD STE 200 CHARLOTTE NC,060,Mecklenburg,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,850 KEMPSVILLE RD   NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629427588,"WINTERS, MARY, KATHRYN",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629427588,"WINTERS, MARY, KATHRYN",713 VOLVO PKWY STE 200 CHESAPEAKE VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1265485270,SENTARA MEDICAL GROUP,~,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629427588,"WINTERS, MARY, KATHRYN",844 KEMPSVILLE RD STE 204 NORFOLK VA,101,Out of State <= 40 miles,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1528461670,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY FAMILY MEDICINE - SOUTH HICKORY,1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629428149,"BENFIELD, ADAM, TYLER",1985 STARTOWN RD STE 102 HICKORY NC,018,Catawba,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 27 , 76 , 193 ,$#,,
MEDICAID DIRECT,1619582343,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH LEVINE CHILDRENS MOUNTAIN ISLAND P,9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629428560,"GARCIA, DANIEL",9908 COULOAK DR STE 103 CHARLOTTE NC,060,Mecklenburg,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 39 , 51 , 124 ,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629429469,"AJUONUMA, FELIX, OKECHUKWU",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 49 , 112 , 112 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,724 AUBREY BELL DR   MATTHEWS NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629431846,"NORBY, RAY, GUSTAF",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 136 , 159 , 221 ,$#,,
MEDICAID DIRECT,1649220443,CHARLOTTE RADIOLOGY PA,~,700 E MOREHEAD ST STE 400 CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629431846,"NORBY, RAY, GUSTAF",700 E MOREHEAD ST STE 300 CHARLOTTE NC,060,Mecklenburg,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 204 , 231 , 286 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,193200000X,Group,Multi-Specialty,,1629432059,"TAN, TING XU",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 17 , 22 , 36 ,$#,,
MEDICAID DIRECT,1396216735,WAKE FOREST EMERGENCY PROVIDERS,,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629432059,"TAN, TING XU",1240 HUFFMAN MILL RD   BURLINGTON NC,001,Alamance,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 16 , 22 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629432927,"ALDRICH, JEFFREY, DANIEL",430 WATERSTONE DR   HILLSBOROUGH NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 12 , 37 , 65 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629432927,"ALDRICH, JEFFREY, DANIEL",101 MANNING DR   CHAPEL HILL NC,068,Orange,207RX0202X,Allopathic & Osteopathic Physicians,Internal Medicine,Medical Oncology, 30 , 89 , 108 ,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#, 13 ,$#,,
MEDICAID DIRECT,1629498878,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1021 W HAMLET AVE   HAMLET NC,077,Richmond,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235793381,MCPC 8 LLC,~,208 W SALISBURY ST STE A ASHEBORO NC,076,Randolph,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",1021 W HAMLET AVE   HAMLET NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1033885249,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",3716 MORGANTON RD STE 2 FAYETTEVILLE NC,026,Cumberland,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1023535648,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE-PINEHURST,150 IVEY LN   PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",150 IVEY LN STE A PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1275965410,MCPC-14 LLC,FIRSTHEALTH TRANSITION CARE CLINIC,305 PAGE RD N STE 1 PINEHURST NC,063,Moore,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",305 PAGE RD N STE 1 PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,7473 C HWY 22   WHISPERING PINES NC,063,Moore,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",7473-C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 ,#, 24 ,$#,,
MEDICAID DIRECT,1922734375,MCPC-24 LLC,FIRSTHEALTH TELEMEDICINE,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",155 MEMORIAL DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1801215330,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",225 CAPITAL DR STE 101 CARTHAGE NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 12 , 12 , 17 ,$#,,
MEDICAID DIRECT,1437418142,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",4565 FAYETTEVILLE RD   RAEFORD NC,047,Hoke,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1922552322,MCPC 8 LLC,FIRSTHEALTH CONVENIENT CARE,1602 WESTOVER DR   SANFORD NC,053,Lee,193400000X,Group,Single Specialty,,1629433230,"MORGAN, ERIN, ELIZABETH",1602 WESTOVER DR   SANFORD NC,053,Lee,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1447852579,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR CARY CARDIOLOGY,300 KEISLER DR   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629433644,"ANSTOETTER, JESSICA, LYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,210 ASHVILLE AVE   CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629433644,"ANSTOETTER, JESSICA, LYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3324 SIX FORKS RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629433644,"ANSTOETTER, JESSICA, LYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1104480532,WAKEMED SPECIALISTS GROUP LLC,WAKEMED HEART & VASCULAR-CARDIOLOGY,3000 NEW BERN AVE   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629433644,"ANSTOETTER, JESSICA, LYN",3000 NEW BERN AVE   RALEIGH NC,092,Wake,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629434691,"ZICCARELLI, IVY, LANE",9929 REA RD STE 201 WAXHAW NC,090,Union,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1588387211,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PSYCHIATRIC CLINICS,13815 PROFESSIONAL CENTER DR STE 100 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629434691,"ZICCARELLI, IVY, LANE",1401 MATTHEWS TOWNSHIP PKWY STE 320 MATTHEWS NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952830432,FHPG LLC,FIRSTHEALTH TROY CARE CLINIC,522 ALLEN ST STE 203 TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1629434980,"MIEDEMA, ANGELA, RACHELLE",7473C HWY 22   WHISPERING PINES NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1952830432,FHPG LLC,FIRSTHEALTH TROY CARE CLINIC,522 ALLEN ST STE 203 TROY NC,062,Montgomery,193400000X,Group,Single Specialty,,1629434980,"MIEDEMA, ANGELA, RACHELLE",522 ALLEN ST STE 203 TROY NC,062,Montgomery,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 15 , 16 , 25 ,$#,,
MEDICAID DIRECT,1962434324,PINEHURST SURGICAL CLINIC,PINEHURST SURGICAL CLINIC,5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629435714,"GAGNIER, JOHN, FRANCIS",5 FIRST VILLAGE DR   PINEHURST NC,063,Moore,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 132 , 139 , 326 ,$#,,
MEDICAID DIRECT,1801966395,KINSTON HEAD AND NECK PHYSICIANS AN,KINSTON HEAD & NECK PHYSICIANS AND SURGEONS PA,701 DOCTORS DR STE K KINSTON NC,054,Lenoir,193400000X,Group,Single Specialty,,1629437470,"JONES, ANDREA",701 DOCTORS DR STE K KINSTON NC,054,Lenoir,231H00000X,"Speech, Language and Hearing Service Providers",Audiologist,,#,#,#,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1629438486,"KNOP, TRACI, NICHELLE",197 RIVERVIEW ST   FRANKLIN NC,056,Macon,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 39 , 51 , 51 ,$#,,
MEDICAID DIRECT,1790870830,WESTERN CAROLINA DIGESTIVE,WESTERN CAROLINA DIGESTIVE,26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,193400000X,Group,Single Specialty,,1629438486,"KNOP, TRACI, NICHELLE",26 WESTCARE DR STE 302 SYLVA NC,050,Jackson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 19 , 24 , 24 ,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,76 PEACHTREE RD STE 300 ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629439104,"GEROLIMATOS, MELISSA, SUE",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1649616160,MEDSTREAM ANESTHESIA PLLC,,830 ROCKFORD ST   MOUNT AIRY NC,086,Surry,193200000X,Group,Multi-Specialty,,1629439104,"GEROLIMATOS, MELISSA, SUE",68 HOSPITAL RD   SYLVA NC,050,Jackson,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1346828878,MORGANTON ANESTHESIA PARTNERS PLLC,,2201 S STERLING ST   MORGANTON NC,012,Burke,193400000X,Group,Single Specialty,,1629439104,"GEROLIMATOS, MELISSA, SUE",2201 S STERLING ST   MORGANTON NC,012,Burke,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1508931544,NOVANT HEALTH ROWAN MEDICAL CENTER,ROWAN REGIONAL MEDICAL CENTER,612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,193200000X,Group,Multi-Specialty,,1629439104,"GEROLIMATOS, MELISSA, SUE",612 MOCKSVILLE AVE   SALISBURY NC,080,Rowan,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,105 HANES SQUARE CIR   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629439401,"SIEGEL, KATHLEEN, KELLER",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629439401,"SIEGEL, KATHLEEN, KELLER",2085 FRONTIS PLAZA BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1578939914,CAROLINAS PHYSICIANS NETWORK INC,ATRIUM HEALTH VIRTUAL CARE,10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629439401,"SIEGEL, KATHLEEN, KELLER",10620 PARK RD STE 202 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,114 S SHARON AMITY RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629439401,"SIEGEL, KATHLEEN, KELLER",116 S SHARON AMITY RD STE 114 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629439401,"SIEGEL, KATHLEEN, KELLER",11300 CRESTHILL DR STE 120 MINT HILL NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1760950646,CAROLINA MEDICORP ENTERPRISES INC,NOVANT HEALTH GOHEALTH URGENT CARE,445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629439401,"SIEGEL, KATHLEEN, KELLER",445 S KINGS DR   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,1325 TIMBER DR E   GARNER NC,092,Wake,193200000X,Group,Multi-Specialty,,1629439559,"JAMES, EVAN, WILLIAM",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629439559,"JAMES, EVAN, WILLIAM",781 AVENT FERRY RD STE 110 HOLLY SPRINGS NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 12 , 18 , 38 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629439559,"JAMES, EVAN, WILLIAM",3001 EDWARDS MILL RD   RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 12 ,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629439559,"JAMES, EVAN, WILLIAM",11200 GOVERNOR MANLY WAY STE 309 RALEIGH NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1235137563,RALEIGH ORTHOPAEDIC CLINIC PA,RALEIGH ORTHOPAEDIC CLINIC PA,3001 EDWARDS MILL RD STE 200 RALEIGH NC,092,Wake,193400000X,Group,Single Specialty,,1629439559,"JAMES, EVAN, WILLIAM",6715 MCCRIMMON PKWY STE 205 CARY NC,092,Wake,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,,#,#, 17 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1629440599,"WIMBISH, PATRICK",1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 59 , 65 , 145 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,4613 UNIVERSITY DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629440599,"WIMBISH, PATRICK",1262 E BROAD AVE   ROCKINGHAM NC,077,Richmond,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 13 , 26 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,724 S HORNER BLVD   SANFORD NC,053,Lee,193200000X,Group,Multi-Specialty,,1629440599,"WIMBISH, PATRICK",724 S HORNER BLVD   SANFORD NC,053,Lee,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1134841802,NOVANT HEALTH MEDICAL GROUP LLC,NHMG PRIMARY CARE CLINICS,10810 MALLARD CREEK RD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629447875,"UPCHURCH, AMANDA, FURR",1035 DALE EARNHARDT BLVD   KANNAPOLIS NC,013,Cabarrus,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 57 , 134 , 261 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629450515,"BAROT, HARSH, VINUBHAI",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629450515,"BAROT, HARSH, VINUBHAI",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,, 53 , 125 , 125 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629450515,"BAROT, HARSH, VINUBHAI",601 N ELM ST   HIGH POINT NC,041,Guilford,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1629451141,"GARNER, MICHAEL, LEONARD",169 DOCTORS DR   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#, 15 ,$#,,
MEDICAID DIRECT,1629451141,"GARNER, MICHAEL, LEONARD",,169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,1629451141,"GARNER, MICHAEL, LEONARD",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#, 11 , 26 ,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 DOCTORS DR   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1629451141,"GARNER, MICHAEL, LEONARD",169 DOCTORS DR   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,,#,#,#,$#,,
MEDICAID DIRECT,1417913260,BOONE DERMATOLOGY CLINIC PA,~,169 BIRCH ST   BOONE NC,095,Watauga,193200000X,Group,Multi-Specialty,,1629451141,"GARNER, MICHAEL, LEONARD",169 BIRCH ST   BOONE NC,095,Watauga,207N00000X,Allopathic & Osteopathic Physicians,Dermatology,, 13 , 19 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629452990,"SIMERS, LESLI, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 28 , 35 , 84 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,932 MORREENE RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629452990,"SIMERS, LESLI, ANN",40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 20 , 30 , 70 ,$#,,
MEDICAID DIRECT,1225014657,CAROLINA RADIOLOGY ASSOCIATES LLC,CAROLINA RADIOLOGY ASSOCIATES LLC,1303 AZALEA CT STE C MYRTLE BEACH SC,101,Out of State <= 40 miles,193400000X,Group,Single Specialty,,1629455134,"CUNNINGHAM, AUSTIN, THOMAS",300 SINGLETON RIDGE RD   CONWAY SC,101,Out of State <= 40 miles,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 21 , 22 , 28 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629455258,"SHEW, WILLARD, JEFFREY",1370 W D ST   N WILKESBORO NC,097,Wilkes,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 52 , 52 , 52 ,$#,,
MEDICAID DIRECT,1588768527,PIEDMONT HEALTH SERVICES INC,CHARLES DREW COMMUNITY HEALTH CTR,221 N GRAHAM HOPEDALE RD   BURLINGTON NC,001,Alamance,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629455316,"STONEKING, SARAH, KATHERINE",301 LLOYD ST   CARRBORO NC,068,Orange,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1962097626,BREECHES BUOY ADDICTION MEDICINE,~,300 W 27TH ST   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1629456330,"SMITH, HEIDI, MICHELLE",300 W 27TH ST   LUMBERTON NC,078,Robeson,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health,#, 22 , 22 ,$#,,
MEDICAID DIRECT,1912938432,SPARTANBURG MEDICAL CENTER,MEDICAL GROUP OF THE CAROLINAS - INPATIENT MEDICIN,101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629456892,"MOTIWALA, TAHIRALI, HATIM",101 E WOOD ST STE 401 SPARTANBURG SC,101,Out of State <= 40 miles,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629458658,"HICKS, JUSTIN, PAUL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 140 , 163 , 244 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629458658,"HICKS, JUSTIN, PAUL",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 140 , 242 , 432 ,$#,,
MEDICAID DIRECT,1790194322,CATAWBA VALLEY MEDICAL CENTER,,810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629458658,"HICKS, JUSTIN, PAUL",810 FAIRGROVE CHURCH RD   HICKORY NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 185 , 235 , 236 ,$#,,
MEDICAID DIRECT,1750659488,CATAWBA VALLEY MEDICAL GROUP INC,CATAWBA VALLEY CARDIOLOGY,3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,193200000X,Group,Multi-Specialty,,1629458658,"HICKS, JUSTIN, PAUL",3521 GRAYSTONE PL SE STE 202 CONOVER NC,018,Catawba,207RC0000X,Allopathic & Osteopathic Physicians,Internal Medicine,Cardiovascular Disease, 31 , 35 , 59 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629462700,"SHIANI, ASHOK, VALJI",2421 SILVER STREAM LN   WILMINGTON NC,065,New Hanover,207RG0100X,Allopathic & Osteopathic Physicians,Internal Medicine,Gastroenterology, 28 , 36 , 38 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1629463070,"SILVERBERG, ARNOLD, JUSTIN",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 84 , 138 , 237 ,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,98 DOCTORS DR STE 200 SYLVA NC,050,Jackson,193200000X,Group,Multi-Specialty,,1629463070,"SILVERBERG, ARNOLD, JUSTIN",581 LEROY GEORGE DR STE 300 CLYDE NC,044,Haywood,207X00000X,Allopathic & Osteopathic Physicians,Orthopaedic Surgery,, 24 , 51 , 90 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2100 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,5601 ARRINGDON PARK DR   MORRISVILLE NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 39 , 40 , 52 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,6301 HERNDON RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,4220 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3475 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 83 , 85 , 122 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,234 CROOKED CREEK PKWY   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 74 , 78 , 108 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3000 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",2301 ERWIN RD   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",20 DUKE MEDICINE CIR   DURHAM NC,032,Durham,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology, 11 ,#, 12 ,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 EXECUTIVE DR STE 107 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3400 WAKE FOREST RD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629464458,"WALDMAN, LEAH, ESTHER",3400 WAKE FOREST RD   RALEIGH NC,092,Wake,2085R0202X,Allopathic & Osteopathic Physicians,Radiology,Diagnostic Radiology,#,#,#,$#,,
MEDICAID DIRECT,1609281641,DLP WESTERN CAROLINA PHYSICIAN PRAC,,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1629466453,"STRASBURGER III, ALVIN",70 THE VILLAGE OVERLOOK   SYLVA NC,050,Jackson,207V00000X,Allopathic & Osteopathic Physicians,Obstetrics & Gynecology,,#,#,#,$#,,
MEDICAID DIRECT,1881624807,CAROLINAS PHYSICIANS NETWORK INC,THE SANGER CLINIC,1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629473855,"WELLS, LAURYN, CHILDRESS",1237 HARDING PL STE 4300 CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1730548413,RHA BEHAVIORAL HEALTH NC LLC,,219 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629475009,"BRUNSON, CHRISTI, SAMANTHA",219 LE PHILLIP CT NE   CONCORD NC,013,Cabarrus,101YP2500X,Behavioral Health & Social Service Providers,Counselor,Professional,#,#,#,$#,,
MEDICAID DIRECT,1033412267,AMERICAN ANESTHESIOLOGY OF NORTH CA,CAROLINA PAIN AND SPINE,800 TILGHMAN DR   DUNN NC,043,Harnett,193200000X,Group,Multi-Specialty,,1629476031,"GREY, SHEREEN, ODELL",3000 NEW BERN AVE   RALEIGH NC,092,Wake,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 32 , 32 , 32 ,$#,,
MEDICAID DIRECT,1629476627,BHG XXXVI LLC,BHG ASHEVILLE TREATMENT CENTER,18 WEDGEFIELD DR   ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,1629476627,BHG XXXVI LLC,18 WEDGEFIELD DR   ASHEVILLE NC,011,Buncombe,251S00000X,Agencies,Community/Behavioral Health,,#,#,#,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629477088,"SIMMS, KIMBERLY, WALTERS",1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 14 , 22 , 69 ,$#,,
MEDICAID DIRECT,1881632339,WILMINGTON HEALTH PLLC,WILMINGTON HEALTH ASSOCIATES,1202 MEDICAL CENTER DR   WILMINGTON NC,065,New Hanover,193200000X,Group,Multi-Specialty,,1629477088,"SIMMS, KIMBERLY, WALTERS",6781 PARKER FARM DR   WILMINGTON NC,065,New Hanover,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,, 20 , 34 , 46 ,$#,,
MEDICAID DIRECT,1629477377,EICCUA LLC,WILSONVALUE DRUG STORE,404 NASH ST NE   WILSON NC,098,Wilson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,1629477377,EICCUA LLC,404 NASH ST NE   WILSON NC,098,Wilson,332B00000X,Suppliers,Durable Medical Equipment & Medical Supplies,,#, 11 , 25 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629480132,"GUKASOV, SERGEY, BORISOVICH",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#, 12 ,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2525 COURT DR   GASTONIA NC,036,Gaston,193400000X,Group,Single Specialty,,1629480132,"GUKASOV, SERGEY, BORISOVICH",2545 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1205996519,EAST CAROLINA ANESTHESIA ASSOCIATES,,2430 EMERALD PL STE 103 GREENVILLE NC,074,Pitt,193400000X,Group,Single Specialty,,1629480132,"GUKASOV, SERGEY, BORISOVICH",2525 COURT DR   GASTONIA NC,036,Gaston,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003183120,MCLEOD PHYSICIAN ASSOCIATES II,SOUTHERN MEDICAL ASSOCIATES,3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629480751,"CRESS, LYNDSI, RENEE",3418 CASEY ST   LORIS SC,101,Out of State <= 40 miles,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#, 12 ,$#,,
MEDICAID DIRECT,1972939643,REX HOSPITAL INC,NORTH CAROLINA HEART AND VASCULAR,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629480975,"GUTIERREZ, RACHEL, DICKASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,4024 STIRRUP CREEK DR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629480975,"GUTIERREZ, RACHEL, DICKASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1174017511,MED-X CONSULTING PC,,10901 WORLD TRADE BLVD   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629480975,"GUTIERREZ, RACHEL, DICKASON",4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,363LA2200X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Adult Health,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,193200000X,Group,Multi-Specialty,,1629482047,"HALL, PATRICIA, LYNN FEENEY",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1043315054,MOUNTAIN COMMUNITY HEALTH PARTNERSH,BAKERSVILLE MEDICAL CLINIC,86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629482047,"HALL, PATRICIA, LYNN FEENEY",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1568914521,MOUNTAIN COMMUNITY HEALTH PARTNERSH,CELO HEALTH CENTER,116 SEVEN MILE RIDGE RD   BURNSVILLE NC,100,Yancey,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629482047,"HALL, PATRICIA, LYNN FEENEY",86 N MITCHELL AVE   BAKERSVILLE NC,061,Mitchell,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 14 , 18 , 18 ,$#,,
MEDICAID DIRECT,1437396454,WENDELL EYE CARE OPTOMETRIC PA,WENDELL EYE CARE OPTOMETRIC PA,18 S MAIN ST   WENDELL NC,092,Wake,193200000X,Group,Multi-Specialty,,1629482617,"VICK, RACHEL, MILLER",18 S MAIN ST   WENDELL NC,092,Wake,152W00000X,Eye and Vision Services Providers,Optometrist,, 26 , 33 , 41 ,$#,,
MEDICAID DIRECT,1003484734,DOCTORS URGENT CARE PLLC,CAROLINA URGENT CARE,1840 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629484373,"PATEL, RUCHA, KHARWA",1840 MARTIN LUTHER KING JR BLVD   CHAPEL HILL NC,068,Orange,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 46 , 73 , 135 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,650 SIGNAL HILL DRIVE EXT   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629487186,"WILLIAMS, THERESA, MILLER",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#, 11 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,129 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629487186,"WILLIAMS, THERESA, MILLER",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 29 , 48 , 230 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,700 SULLIVAN RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629487186,"WILLIAMS, THERESA, MILLER",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,142 SHERLOCK DR   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629487186,"WILLIAMS, THERESA, MILLER",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 48 , 125 , 352 ,$#,,
MEDICAID DIRECT,1912999897,PIEDMONT HEALTHCARE PA,~,208 OLD MOCKSVILLE RD   STATESVILLE NC,049,Iredell,193200000X,Group,Multi-Specialty,,1629487186,"WILLIAMS, THERESA, MILLER",142 SHERLOCK DR   STATESVILLE NC,049,Iredell,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 12 , 21 , 66 ,$#,,
MEDICAID DIRECT,1629487236,MONARCH,~,4140 CHERRY ST   WINSTON SALEM NC,034,Forsyth,251S00000X,Agencies,Community/Behavioral Health,,1629487236,MONARCH,4140 CHERRY ST   WINSTON SALEM NC,034,Forsyth,251S00000X,Agencies,Community/Behavioral Health,,#,,,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629488606,"MCELFRESH, MEGAN, ROYALL",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 20 , 30 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629488879,"CHACKO, PRAVIN, PHILIP",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 35 , 120 , 120 ,$#,,
MEDICAID DIRECT,1629492327,MICHAEL VOLLMER OD PLLC,MICHAEL VOLLMER OD PLLC,1500 MEADOWVIEW DR   WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,,1629492327,MICHAEL VOLLMER OD PLLC,1500 MEADOWVIEW DR   WILKESBORO NC,097,Wilkes,193400000X,Group,Single Specialty,, 58 , 58 , 116 ,$#,,
MEDICAID DIRECT,1629492327,MICHAEL VOLLMER OD PLLC,MICHAEL VOLLMER OD PLLC,900 US HIGHWAY 221 BUS   WEST JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,,1629492327,MICHAEL VOLLMER OD PLLC,900 US HIGHWAY 221 BUS   WEST JEFFERSON NC,005,Ashe,193400000X,Group,Single Specialty,, 51 , 51 , 99 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,101 MANNING DR   CHAPEL HILL NC,068,Orange,193200000X,Group,Multi-Specialty,,1629494364,"RAUSCH, KELLY, LUCILLE",101 MANNING DR   CHAPEL HILL NC,068,Orange,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 16 , 17 , 18 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629495189,"KIM, EDWARD",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 83 , 85 , 129 ,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629495189,"KIM, EDWARD",800 TILGHMAN DR   DUNN NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1215931589,CFVHS ED PHYSICIANS,CFVHS ED PHYSICIANS,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629495189,"KIM, EDWARD",215 BRIGHTWATER DR   LILLINGTON NC,043,Harnett,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,4420 LAKE BOONE TRL   RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629496054,"GORDON, ANDREW, JAMES",781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1912338054,REX HOSPITAL INC,NORTH CAROLINA SURGERY,781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,193200000X,Group,Multi-Specialty,,1629496054,"GORDON, ANDREW, JAMES",781 AVENT FERRY RD STE 214 HOLLY SPRINGS NC,092,Wake,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629496625,"STETTLER, GREGORY, RAY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,208600000X,Allopathic & Osteopathic Physicians,Surgery,, 99 , 162 , 172 ," $19,968.28 ",,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629497334,"MCGARY, REBECCA, DEZOUCHE",200 HAWTHORNE LN   CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 18 , 18 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629497334,"MCGARY, REBECCA, DEZOUCHE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629497334,"MCGARY, REBECCA, DEZOUCHE",10030 GILEAD RD   HUNTERSVILLE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 23 , 43 , 43 ,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629497334,"MCGARY, REBECCA, DEZOUCHE",1901 RANDOLPH RD CHARLOTTE CHARLOTTE NC,060,Mecklenburg,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629498712,"BRIDGE, WILLIAM, WESLEY",113B HERTFORD COUNTY HIGH RD   AHOSKIE NC,046,Hertford,2084P0800X,Allopathic & Osteopathic Physicians,Psychiatry & Neurology,Psychiatry,#,#,#,$#,,
MEDICAID DIRECT,1740903566,NOVANT HEALTH MEDICAL GROUP LLC,NHMG HOSPITAL BASED MEDICINE,3333 SILAS CREEK PKWY   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629499439,"DELABASTIDE, SARAH, HAYDEN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 24 , 35 , 35 ,$#,,
MEDICAID DIRECT,1063134344,NOVANT HEALTH MEDICAL GROUP LLC,NHMG SURGERY CLINICS,330 BILLINGSLEY RD STE 202 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629499439,"DELABASTIDE, SARAH, HAYDEN",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629500145,"DRESSER, HELEN, BROOKS YEARLEY",329 NC HIGHWAY 801 N   BERMUDA RUN NC,030,Davie,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629500145,"DRESSER, HELEN, BROOKS YEARLEY",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 72 , 73 , 87 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 430 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629500426,"CARGE, MICHAEL, JAMES",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#,#, 11 ,$#,,
MEDICAID DIRECT,1841465804,GRAND STRAND SURGICAL SPECIALISTS T,GRAND STRAND SURGICAL SPECIALISTS TRAUMA AND GENER,920 DOUG WHITE DR STE 210 MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629500426,"CARGE, MICHAEL, JAMES",809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,208600000X,Allopathic & Osteopathic Physicians,Surgery,,#, 11 , 15 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,193200000X,Group,Multi-Specialty,,1629501317,"LEWIS, CORI, MARIE",4109 WAKE FOREST RD STE 300 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 32 , 59 , 155 ,$#,,
MEDICAID DIRECT,1700057486,KIDS FIRST PEDIATRICS OF RALEIGH PL,~,,,Unknown,193200000X,Group,Multi-Specialty,,1629501317,"LEWIS, CORI, MARIE",23 SUNNYBROOK RD STE 116 RALEIGH NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1770512865,FHPG LLC,FIRSTHEALTH OF THE CAROLINAS INC,155 MEMORIAL DR   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629501325,"CARBONE, THOMAS, VINCENT",155 MEMORIAL DR   PINEHURST NC,063,Moore,208M00000X,Allopathic & Osteopathic Physicians,Hospitalist,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629502935,"FERNANDEZ, RICHARD, ANTHONY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,262 LEROY GEORGE DR   CLYDE NC,044,Haywood,193200000X,Group,Multi-Specialty,,1629502935,"FERNANDEZ, RICHARD, ANTHONY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629502935,"FERNANDEZ, RICHARD, ANTHONY",262 LEROY GEORGE DR   CLYDE NC,044,Haywood,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629502935,"FERNANDEZ, RICHARD, ANTHONY",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1588668396,CUMBERLAND COUNTY HOSPITAL SYSTEM I,VALLEY MEDICAL ASSOCIATES,1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,193200000X,Group,Multi-Specialty,,1629502935,"FERNANDEZ, RICHARD, ANTHONY",1638 OWEN DR   FAYETTEVILLE NC,026,Cumberland,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 16 , 16 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629502935,"FERNANDEZ, RICHARD, ANTHONY",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 16 , 36 , 36 ,$#,,
MEDICAID DIRECT,1760410385,HOSPITAL PHYSICIAN SERVICES- SOUTHE,HOSPITAL PHYSICIAN SERVICES- SOUTHEAST PC,288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,193200000X,Group,Multi-Specialty,,1629502935,"FERNANDEZ, RICHARD, ANTHONY",288 S RIDGECREST AVE   RUTHERFORDTON NC,081,Rutherford,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,146 MEDICAL PARK RD STE 212 MOORESVILLE NC,049,Iredell,193400000X,Group,Single Specialty,,1629503222,"LIANG, JIA, HAO",146 MEDICAL PARK RD STE 212 MOORESVILLE NC,049,Iredell,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#,#,#,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,268 GILLMAN RD STE A DENVER NC,055,Lincoln,193400000X,Group,Single Specialty,,1629503222,"LIANG, JIA, HAO",268 GILLMAN RD STE A DENVER NC,055,Lincoln,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 24 , 79 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629503222,"LIANG, JIA, HAO",10320 MALLARD CREEK RD STE 100 CHARLOTTE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology, 14 , 46 , 126 ,$#,,
MEDICAID DIRECT,1336455674,SOUTHERN ONCOLOGY SPECIALISTS PLLC,SOUTHERN ONCOLOGY SPECIALISTS PLLC,9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629503222,"LIANG, JIA, HAO",9930 KINCEY AVE STE 165 HUNTERSVILLE NC,060,Mecklenburg,207RH0003X,Allopathic & Osteopathic Physicians,Internal Medicine,Hematology & Oncology,#, 22 , 129 ,$#,,
MEDICAID DIRECT,1902317589,BROAD RIVER REHABILITATION,,,,Unknown,193200000X,Group,Multi-Specialty,,1629506431,"WOODING, LISA, GRAVES",1404 S SALISBURY AVE   SPENCER NC,080,Rowan,225X00000X,"Respiratory, Developmental, Rehabilitative and Restorative Service Providers",Occupational Therapist,,#,,,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,2301 ERWIN RD   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629509195,"KACHORIA, JAY, SUBHASH",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 46 , 133 , 133 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629509195,"KACHORIA, JAY, SUBHASH",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 16 , 26 , 26 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,10 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629509195,"KACHORIA, JAY, SUBHASH",2301 ERWIN RD   DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,,#, 15 , 15 ,$#,,
MEDICAID DIRECT,1992802607,PEDIATRIX MEDICAL GROUP OF SOUTH CA,~,555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629509286,"TOWNSEND, TABITHA, LEE",555 E CHEVES ST   FLORENCE SC,101,Out of State <= 40 miles,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,,#,#,#,$#,,
MEDICAID DIRECT,1629512140,VARIANTYX INC,VARIANTYX INC,1671 WORCESTER RD STE 300 FRAMINGHAM MA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,,1629512140,VARIANTYX INC,1671 WORCESTER RD STE 300 FRAMINGHAM MA,102,Out of State > 40 miles,291U00000X,Laboratories,Clinical Medical Laboratory,, 34 , 48 , 75 ," $249,349.26 ",,
MEDICAID DIRECT,1629514112,CARTERET VISION CENTER OD PA,,5053 EXECUTIVE DR STE A MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,,1629514112,CARTERET VISION CENTER OD PA,5053 EXECUTIVE DR STE A MOREHEAD CITY NC,016,Carteret,193200000X,Group,Multi-Specialty,, 108 , 108 , 213 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629522339,"WARDEN, JENNA, LYNN",920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 61 , 85 , 85 ,$#,,
MEDICAID DIRECT,1902249097,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP-NORTHEAST,920 CHURCH ST N STE 255 CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629522339,"WARDEN, JENNA, LYNN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1306855846,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629522339,"WARDEN, JENNA, LYNN",500 JEFFERSON ST   WHITEVILLE NC,024,Columbus,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care, 17 , 16 , 16 ,$#,,
MEDICAID DIRECT,1326480310,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP - CLEVELAND,201 E GROVER ST   SHELBY NC,023,Cleveland,193200000X,Group,Multi-Specialty,,1629522339,"WARDEN, JENNA, LYNN",201 E GROVER ST   SHELBY NC,023,Cleveland,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1447573829,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629522339,"WARDEN, JENNA, LYNN",8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1538482914,CAROLINAS PHYSICIANS NETWORK INC,CAROLINAS HOSPITALIST GROUP,2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629522339,"WARDEN, JENNA, LYNN",2001 VAIL AVE   CHARLOTTE NC,060,Mecklenburg,363LA2100X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Acute Care,#,#,#,$#,,
MEDICAID DIRECT,1346464716,NC DHHS CHILD AND FAMILY WELL-BEING,CONCORD CDSA,1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,252Y00000X,Agencies,Early Intervention Provider Agency,,1629526140,"FRANK, VALERIE, CHRISTINE",1065 VINEHAVEN DR NE   CONCORD NC,013,Cabarrus,235Z00000X,"Speech, Language and Hearing Service Providers",Speech-Language Pathologist,, 80 , 104 , 123 ," $15,476.74 ",,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629526231,"BRIGHT, CHRISTINE, WEAVER",3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#, 11 , 21 ,$#,,
MEDICAID DIRECT,1124682927,CAROMONT MEDICAL GROUP INC,CAROMONT FAMILY MEDICINE,3326 BESSEMER CITY RD   BESSEMER CITY NC,036,Gaston,193200000X,Group,Multi-Specialty,,1629526231,"BRIGHT, CHRISTINE, WEAVER",600 W TRADE ST STE B DALLAS NC,036,Gaston,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 13 , 28 , 38 ,$#,,
MEDICAID DIRECT,1629528104,OLIVER OPTOMETRIC EYE CARE,~,18 GRAYSON ST   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,,1629528104,OLIVER OPTOMETRIC EYE CARE,18 GRAYSON ST   SPARTA NC,003,Alleghany,193400000X,Group,Single Specialty,, 307 , 309 , 616 ,$#,,
MEDICAID DIRECT,1780669200,UNIVERSITY OF NORTH CAROLINA AT CHA,UNC FACULTY PHYSICIANS,8401 UNIVERSITY EXEC PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,193200000X,Group,Multi-Specialty,,1629529425,"RHAMES, ALEXIS, SHANNON",8401 UNIVERSITY EXEC PARK DR STE 100 CHARLOTTE NC,060,Mecklenburg,103T00000X,Behavioral Health & Social Service Providers,Psychologist,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629531918,"PETRILLI, ANDREW, ROBERT",601 N ELM ST   HIGH POINT NC,041,Guilford,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#,#,#,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629531918,"PETRILLI, ANDREW, ROBERT",MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,207L00000X,Allopathic & Osteopathic Physicians,Anesthesiology,,#, 19 , 19 ,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629533146,"FARLEY, KATHY, PARKER",1991 FORDHAM DR STE 302 FAYETTEVILLE NC,026,Cumberland,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629533146,"FARLEY, KATHY, PARKER",1413 GREENWAY CT   SANFORD NC,053,Lee,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology,#,#,#,$#,,
MEDICAID DIRECT,1255388369,PINEHURST MEDICAL CLINIC INC,~,205 PAGE RD   PINEHURST NC,063,Moore,193200000X,Group,Multi-Specialty,,1629533146,"FARLEY, KATHY, PARKER",205 PAGE RD   PINEHURST NC,063,Moore,363LG0600X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Gerontology, 106 , 176 , 188 ,$#,,
MEDICAID DIRECT,1376574798,DUKE UNIVERSITY HEALTH SYSTEM INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629533872,"BLODGETT, THOMAS, JAMES",3643 N ROXBORO ST   DURHAM NC,032,Durham,363L00000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,40 DUKE MEDICINE CIR   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629535331,"DANIEL, ANNA",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,3643 N ROXBORO ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629535331,"DANIEL, ANNA",3643 N ROXBORO ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",,#,#,#,$#,,
MEDICAID DIRECT,1205553369,DUKE HEALTH INTEGRATED PRACTICE INC,~,120 E CARVER ST   DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629535331,"DANIEL, ANNA",120 E CARVER ST   DURHAM NC,032,Durham,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 17 , 18 , 18 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629535521,"THEODORE, JASON",309 CRUTCHFIELD ST   DURHAM NC,032,Durham,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1518142280,THE NEIL GROUP INC,,1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629535521,"THEODORE, JASON",1399 ASHLEYBROOK LN STE 100 WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629535521,"THEODORE, JASON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629535521,"THEODORE, JASON",32 APEX CIR   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#, 28 , 28 ,$#,,
MEDICAID DIRECT,1003386228,MISSION HEALTH COMMUNITY MULTISPECI,,32 APEX CIR   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629535521,"THEODORE, JASON",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 11 , 25 , 25 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,905 THUNDER RD STE 210 ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629537386,"NEEDHAM, KRYSTAL, LEE",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629537386,"NEEDHAM, KRYSTAL, LEE",1141 N ROAD ST STE G ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 15 , 25 , 50 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,824 N MILITARY HWY STE 100 NORFOLK VA,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629537386,"NEEDHAM, KRYSTAL, LEE",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 30 , 59 , 103 ,$#,,
MEDICAID DIRECT,1942443130,ALBEMARLE PHYSICIAN SERVICES,SENTARA ALBEMARLE PHYSICIAN SERVICES,1141 N ROAD ST STE M ELIZABETH CITY NC,070,Pasquotank,193200000X,Group,Multi-Specialty,,1629537386,"NEEDHAM, KRYSTAL, LEE",100 MEDICAL DR   ELIZABETH CITY NC,070,Pasquotank,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family,#,#,#,$#,,
MEDICAID DIRECT,1316975972,DUKE UNIVERSITY AFFILIATED PHYSICIA,,234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,193200000X,Group,Multi-Specialty,,1629537402,"HOFFMAN, DANIEL, DOUGLAS",234 CROOKED CREEK PKWY STE 200 DURHAM NC,032,Durham,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 20 , 44 , 99 ,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629538434,"HEIFETZ, ROBERT, ADAM",152 CROSSOVER RD   BEULAVILLE NC,031,Duplin,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1598761967,PHYSICIANS EAST PA,PHYSICIANS EAST PA,1850 W ARLINGTON BLVD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629538434,"HEIFETZ, ROBERT, ADAM",744 AIRPORT RD   KINSTON NC,054,Lenoir,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 39 , 95 , 159 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,809 82ND PKWY   MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629538467,"LINDSTROM, DALLIN, LANE",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,, 13 , 13 , 14 ,$#,,
MEDICAID DIRECT,1861430555,ACS PRIMARY CARE PHYSICIANS SOUTHEA,ACS PRIMARY CARE PHYSICIANS-SOUTHEAST PC,806 HIGHWAY 17 S   NORTH MYRTLE BEACH SC,101,Out of State <= 40 miles,193200000X,Group,Multi-Specialty,,1629538467,"LINDSTROM, DALLIN, LANE",711 CHESTERFIELD HWY   CHERAW SC,101,Out of State <= 40 miles,207P00000X,Allopathic & Osteopathic Physicians,Emergency Medicine,,#,#,#,$#,,
MEDICAID DIRECT,1558786830,UNC PHYSICIANS NETWORK LLC,,1515 SW CARY PKWY STE 220 CARY NC,092,Wake,193200000X,Group,Multi-Specialty,,1629538764,"RABINOVICH, HANNAH, MCGAREY",1515 SW CARY PKWY STE 220 CARY NC,092,Wake,208000000X,Allopathic & Osteopathic Physicians,Pediatrics,, 15 , 33 , 63 ,$#,,
MEDICAID DIRECT,1093315574,HEALING HANDS FAMILY PRACTICE PLLC,,1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,193400000X,Group,Single Specialty,,1629539473,"LOCKLEAR, LARISSA",1003 WOODRIDGE DR   LUMBERTON NC,078,Robeson,363LF0000X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Family, 41 , 147 , 294 ,$#,,
MEDICAID DIRECT,1265722318,CAROMONT MEDICAL GROUP INC,SOUTH POINT FAMILY PRACTICE,1220 SPRUCE ST   BELMONT NC,036,Gaston,193400000X,Group,Single Specialty,,1629539671,"ROPER, PHILLIP, JERVEY",1220 SPRUCE ST   BELMONT NC,036,Gaston,207Q00000X,Allopathic & Osteopathic Physicians,Family Medicine,, 25 , 55 , 80 ,$#,,
MEDICAID DIRECT,1003803032,WAKE FOREST UNIVERSITY HEALTH SCIEN,~,MEDICAL CENTER BLVD   WINSTON SALEM NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629544689,"MCPEEKS, KIMBERLY, KINCAID",4618 COUNTRY CLUB RD   WINSTON SALEM NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,, 71 , 89 , 126 ,$#,,
MEDICAID DIRECT,1750852034,KERNERSVILLE EMERGENCY GROUP PLLC,,1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629546239,"OMEARA, AARON, EDWARD",1750 KERNERSVILLE MEDICAL PKWY   KERNERSVILLE NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1093286379,TANGLEWOOD PARK PHYSICIANS PLLC,,6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,193200000X,Group,Multi-Specialty,,1629546239,"OMEARA, AARON, EDWARD",6915 VILLAGE MEDICAL CIR   CLEMMONS NC,034,Forsyth,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1457822264,BRUNSWICK PHYSICIAN PARTNERS PLLC,,240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,193200000X,Group,Multi-Specialty,,1629546239,"OMEARA, AARON, EDWARD",240 HOSPITAL DR NE   BOLIVIA NC,010,Brunswick,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1295206464,PIEDMONT TRIAD PHYSICIANS PLLC,,207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,193200000X,Group,Multi-Specialty,,1629546239,"OMEARA, AARON, EDWARD",207 OLD LEXINGTON RD   THOMASVILLE NC,029,Davidson,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1003853409,SANDHILLS EMERGENCY PHYSICIANS PA,SANDHILLS EMERGENCY PHYSICIANS,925 S LONG DR   ROCKINGHAM NC,077,Richmond,193200000X,Group,Multi-Specialty,,1629546239,"OMEARA, AARON, EDWARD",925 S LONG DR   ROCKINGHAM NC,077,Richmond,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,#,#,$#,,
MEDICAID DIRECT,1346649415,CHS ANESTHESIA SERVICES GROUP INC,,8800 N TRYON ST   CHARLOTTE NC,060,Mecklenburg,193400000X,Group,Single Specialty,,1629547328,"POWELL, JOSEPH, FINLEY",1000 BLYTHE BLVD   CHARLOTTE NC,060,Mecklenburg,367500000X,Physician Assistants & Advanced Practice Nursing Providers,"Nurse Anesthetist, Certified Registered",, 14 , 14 , 15 ,$#,,
MEDICAID DIRECT,1477648731,VIDANT MEDICAL GROUP LLC,VIDANT MEDICAL GROUP,2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,193200000X,Group,Multi-Specialty,,1629548672,"SRIRAMULU, LAKSHMI, DURGA",2100 STANTONSBURG RD   GREENVILLE NC,074,Pitt,207R00000X,Allopathic & Osteopathic Physicians,Internal Medicine,, 50 , 107 , 109 ,$#,,
MEDICAID DIRECT,1427005008,EMERGENCY COVERAGE LLC,EMERGENCY COVERAGE LLC,509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,193200000X,Group,Multi-Specialty,,1629549852,"GUSTAFSON, JESSE, ROBERT",509 BILTMORE AVE   ASHEVILLE NC,011,Buncombe,363A00000X,Physician Assistants & Advanced Practice Nursing Providers,Physician Assistant,,#,,,$#,,
MEDICAID DIRECT,1740959741,BLUE RIDGE COMMUNITY HEALTH SERVICE,BLUE RIDGE HEALTH-MERIDIAN EAST,1207 EAST ST   WAYNESVILLE NC,044,Haywood,261QF0400X,Ambulatory Health Care Facilities,Clinic/Center,Federally Qualified Health Center (FQHC),1629551866,"BARBEE, ERIN, NICOLE",1207 EAST ST   WAYNESVILLE NC,044,Haywood,363LP0808X,Physician Assistants & Advanced Practice Nursing Providers,Nurse Practitioner,Psychiatric/Mental Health, 49 , 74 , 74 ,$#,,
MEDICAID DIRECT,1629841788,FASTMED PC,FASTMED URGENT CARE,391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,193200000X,Group,Multi-Specialty,,1629552435,"KOSHY, LEENA, CHACKO",391 GEORGE W LILES PKWY NW   CONCORD NC,013,Cabarrus,363A00000X,Physician Assista